PRACTICAL Materia Medica AND PRESCRIPTION WRITING WITH ILLUSTRATIONS BY OSCAR W. BETHEA, M.D., Ph.G.,F.C.S. Professor of Materia Medica and Clinical Therapeutics, Tulane University of Louisiana. Formerly Professor of Chemistry and Professor of Pharmacology, Mississippi Medical College, etc. THIRD REVISED EDITION PHILADELPHIA F. A. DAVIS COMPANY, Publishers English Depot Stanley Phillips, London 1920 Copyright, 1915 Copyright, 1917 Copyright, 1919 BY F. A. DAVIS COMPANY Copyright, Great Britain. All Rights Reserved. The use in this volume of certain portions of the text of the United States Pharmacopoeia is by virtue of permission received from the Board of Trustees of the United States Pharmacopoeial Convention. The said Board of Trustees is not responsible for any inaccuracy of quotation, nor for any errors in the statement of quantities or percentage strengths. PRESS OF F. A. DAVIS COMPANY PHILADELPHIA. U.S.A. TO HIS FATHER AND MOTHER A KNOWLEDGE OF WHOSE HIGH IDEALS, UNSELFISH AMBITIONS, AND UNSWERVING DEVOTION TO DUTY HAVE PROVEN A NEVER- FAILING SOURCE OF INSPIRATION THIS VOLUME IS AFFECTIONATELY DEDICATED BY THE AUTHOR PREFACE TO THIRD EDITION. It has seemed advisable in issuing a revised edition at this time, not to make any radical changes but to improve some details of the previous text and to meet the demands incident to later information in the sub- jects covered. Acknowledgments are made for many favorable suggestions from various sources. O. W. B. V PREFACE TO FIRST EDITION. In the treatment of disease a physician is usually confronted with the following problems which must be considered in the order given:- What is the true condition of the patient? What changes should be produced in that condition? What agents will best effect those changes? In what form and by what methods should those agents be employed to obtain the best possible results ? How should his orders for those agents be written so as to serve the best interests of the patient and of his associates? The first three of these propositions are exhaustively treated in many excellent volumes and are ably taught in the medical schools, but the last two are often neglected. For example-the student is taught how to diagnose certain blood conditions, the changes that should be effected, and that Iron is the drug to bring about these desired results. It is often neglected to impress upon the student what preparations of iron will best meet the demands of particular conditions, the precautions to be observed in employing them and how to correctly prescribe them, alone or in combination, and, if in combination, with what forms or preparations of the other agents; how to order for the safest, most convenient and agreeable administration; how to use the correct names and conveniently estimate the proper quantities and the best hours for administration; and many other matters, an ignorance of which may render the physician unable to put to practical use his knowledge of the other departments of medical science. Such in- struction is the particular object of this book. The purpose of the author has been to handle the subject-mat- ter in such a practical way as to render this work a dependable one for every-day service. VII VIII PREFACE. The author wishes to express his indebtedness to other writers from whose works he has, in some instances, had to draw. The volumes of particular assistance in compiling this work were: The U. S. Pharmacopoeia, Remington's Pharmacy, Useful Remedies (A. M. A.), Wilcox's Materia Medica and Pharmacy, the U. S. Dispensatory, The National Formulary, Merck's Index, Shoe- maker's Materia Medica and Sollmann's Pharmacology. The writer is also much indebted to the publishers and authors who kindly allowed the use of the prescriptions from their works; in each case acknowledgment is made in footnotes. O. W. B. CONTENTS. PAGE Definitions 1 Introduction to Part I 11 PART I.-Materia Medica. Official and Unofficial Drugs, Their Therapeutic Action and Uses, Ar- ranged Alphabetically 13-326-333 Introduction to Part II 327 PART II.-Prescription Writing. Metrology 329 Metric System 332 Medical Latin 337 Rules, Groups, and Exceptions 339 Construction of Official Names 343 Abbreviations ._. 344 Definition 347 History 348 Parts of a Prescription , 348 Calculating Amounts • 363 Choice of Vehicle 365 Quantity of a Prescription 368 Proportioning Dosage 369 Written Instructions ; 371 Concentrated Mixtures 373 Saturated Solutions 373 Percentage Solutions 374 Forms of Administration 375 Comparative Dosage of Preparations 378 The Pharmacopoeia 379 The National Formulary 379 Dispensatory 379 Official Drugs and N. F. Preparations 380 Proprietary and Patent Medicines 380 Specifying Manufacturers 381 Write Prescriptions 382 Prescription Blanks 383 IX X CONTENTS. PAGE Carbon Copies 385 Care of Copies and Other Uses for them 386 Copies to a Successor 386 Care as to Writing 386 Rereading 388 Telephoning Prescriptions 388 Recommending Credit 389 Naming a Price 389 Charity 390 Local Peculiarities 390 Refilling and Giving Copies 391 Errors 392 Domestic Measures 393 Examining the Medicine 394 Ownership of a Prescription 395 Stock Prescriptions 395 State and Federal Laws 396 Incompatibility in Liquids; in Solids; Formation of a Precipitate; Evolu- tion of a Gas; Separation of aji Immiscible Liquid; Formation of a Gelatinous Mass; Incomplete Solutions; Immiscibility; Therapeutic Incompatibility 397 Table of Relative Value of Weights and Measures 406 Table of Abbreviations, Words, and Phrases 407 Table of Drops and Weight in a Fluidrachm 411 Table of the Solubility of Official Substances in Water and in Alcohol .. 412 Introduction to Part III 417 PART III. Illustrations showing Incorrect and Correct Forms in Prescription Writ- ing (actual examples) 418 APPENDIX. Problems and Blackboard Exercises 499 Clinical Index 519 General Index ' 535 DEFINITIONS. Familiarity with the following definitions is essential to a correct understanding of a treatise on Materia Medica. Acid.-A compound composed of hydrogen with an electronegative element or group of elements and possessing the following properties: It contains hydrogen that can be replaced by a metal or base to form a salt; it changes the color of litmus from blue to red; it has (when soluble in water) an acid or sour taste. Examples: Sulphuric acid, hy- drochloric acid, citric acid. Acetum (Acet.)-Vinegar.-The vinegars are solutions of medicinal substances in diluted acetic acid. There is one official vinegar. They are seldom prescribed. Alcohol.-As a class name it means a hydrocarbon radical in com- bination with the radical OH. As a name for a definite substance it means ethyl alcohol. Aldehyde.-A compound intermediate between an alcohol and acid. A hydrocarbon radical in combination with the radical COH. Example: Acetic aldehyde. Alkali.-A metallic oxide (except ammonia) that has the property of combining with an acid to form a salt, or with an oil to form soap. Examples: Caustic soda, caustic potash. Alkaloid.-A basic substance, usually the active principle of a plant, and composed of carbon, hydrogen, nitrogen, and, usually, oxygen. Examples: Quinine, morphine, strychnine. Alterative.-An agent that will restore deranged nutritive processes. Examples: Corrosive mercuric chloride, calomel, arsenic trioxide, and potas- sium iodide are usually placed in this class. Anaphrodisiac.-An agent that will depress the sexual function. Examples: Bromides, opium, monobromated camphor. Anesthetic.-An agent that will produce insensibility to pain or touch. According to action, they are subdivided as general and local. Examples: General-ether, chloroform, ethyl chloride. Local-cocaine, novocaine, phenol. Anodyne or Analgesic.-An agent that will relieve pain. Examples: Morphine, codeine, acetylsalicylic acid. Antacid.-An agent that will neutralize acidity. Examples: Mag- nesium oxide, sodium bicarbonate. Anthelmintic.-An agent used in the treatment for intestinal worms. Examples:* Santonin, phenyl salicylate, thymol. Antiemetic.-An agent that will prevent or arrest vomiting. Ex- amples: Cocaine, peppermint, bismuth subnitrate, cerium oxalate. Antigalactagogue.-An agent that lessens the secretion of milk. Ex- amples: Belladonna, probably all hydragogue purgatives. 1 2 DEFINITIONS. Antilithic.-An agent that prevents the formation or favors the re- moval of stones or calculi in the urinary or biliary tracts. Examples: Lithium citrate, hexamethylenamine, alkaline waters, and glycerin are usually placed in this class. Antimalarial.-An agent that will prevent or relieve malaria. Examples: Quinine, arsenic. Antiphlogistic.-An agent that tends to relieve inflammation. Ex- amples: Cataplasma of kaolin, ichthyol. Antipyretic or Febrifuge.-An agent that will reduce febrile tempera- tures. Examples: Quinine, antipyrine, acetylsalicylic acid. Antirheumatic.-An agent that will prevent or relieve rheumatism. Examples: Sodium salicylate, acetylsalicylic acid, colchicum. Antiscorbutic.-An agent that will prevent or relieve scurvy. Ex- amples: Citric acid, orange-juice. Antiseptic.-An agent that will prevent the growth or arrest the development of micro-organisms. Examples: Sodium benzoate, boric acid, or almost any germicide in diluted form. Antisialagogue or Antisialic.-An agent that lessens the flow of saliva. Examples: Belladonna, sodium bicarbonate. Antispasmodic.-An agent that will relieve muscular spasm. Ex- amples: Morphine, atropine, asafetida, bromides. Anti syphilitic.-An agent that will prevent or relieve syphilis. Ex- amples: Mercury, arsenic, iodides. Antizymotic.-An agent that will prevent or arrest fermentation. Examples: Salicylic acid, alcohol. Aperient.-A very mild purgative. Examples: Honey, potassium bitartrate, magnesium oxide. The term seems to be particularly applied to mild purgative waters. Aphrodisiac.-An agent that will increase sexual desire or power. Examples: Nux vomica, phosphorus, alcohol, and cantharides are usually placed in this class. Aqua-Water; Medicated Water.-Used in this sense a water is an aqueous solution of a volatile substance. They usually contain only a comparatively small percentage of the active drug. Many of them are merely water saturated with a volatile oil. They are used more as vehicles and to give odor and taste to solutions. There are nineteen official waters. Astringent.-An agent that will produce contraction or condensation of tissue: Examples: Alum, tannic acid, ferrous sulphate. Balsams.-Natural resinous substances derived from plants, and containing benzoic, cinnamic or analogous acids. Examples: Balsam of Peru, Balsam of Tolu. Bark.-The outer cover of the woody parts of a plant. Examples: Cinchona, wild cherry, cascara sagrada. Base or Basic Substance.-A compound usually composed of a metal with oxygen, or oxygen and hydrogen, and possessing the following proper- ties: With an acid it forms a salt; it has (when soluble in water) an alkaline taste and reaction. DEFINITIONS. 3 Bulb.-A short, thick, underground stem, composed of layers. Ex- ample: Squill. Carminative.-An agent that will remove gases from the gastro- intestinal tract. Examples : Asafetida, peppermint, cardamom. Cathartic.-An active purgative, usually producing several evacuations, which may or may not be accompanied by pain or tenesmus. Examples: Castor oil, calomel, cascara sagrada. Caustic.-An agent that will destroy living tissue. Examples: Silver nitrate, potassium hydroxide, nitric acid. Ceratum-Cerate.-Cerates are unctuous substances of such consist- ency that they may be easily spread, at ordinary temperature, upon mus- lin, or similar material, with a spatula, and yet not so soft as to liquefy and run when applied to the skin. They are not often prescribed. Three cerates are official. Charta Paper.-Papers are preparations intended principally for ex- ternal application, made either by saturating paper with medicinal sub- stances or by applying the latter to the surface of the paper by the addi- tion of some adhesive liquid. These should not be confounded with chartula, meaning "a little paper," folded so as to form a receptacle con- taining a dose of a medicinal substance. There is no official paper. Cholagogue.-A purgative that stimulates the flow of bile. Examples: Calomel, inspissated oxgall, sodium glycocholate, and sodium tauro- cholate are usually placed in this class. Coilodium-Collodion.-These are preparations intended for external use, having for their base a solution of pyroxylin or gun-cotton, in a mixture of ether and alcohol. Three are official. Confectio-Confection.-Confections are saccharine soft solids in which one or more medicinal substances are incorporated with the object of affording an agreeable form for their administration and a convenient method for their preservation. They are not often prescribed, and are not official. Corm.-A short, solid, underground stem. Example: Colchicum. Counterirritant.-An agent that is applied locally to produce in- flammatory reaction, with the object of affecting some other part usually adjacent to or underlying the surface irritated. Examples: Mustard, chloroform, cantharides. Decoctum-Decoction.-Decoctions are liquid preparations made by boiling vegetable substances with water. When the strength and method of preparation are not otherwise specified, they are made by boiling 5 parts of the coarsely comminuted drug for fifteen minutes with enough water to make 100 parts. There are no official decoctions. Deliriant or Delirifacient.-An agent that will produce delirium. Ex- amples : Hyoscine, atropine. Demulcent.-An agent that will soothe the part to which applied. The term is usually restricted to agents acting on mucous membrane. Examples: Mucilage of acacia, mucilage of tragacanth, milk. Deodorant.-An agent that removes odor. Examples: Potassium per- manganate, chlorine, hydrogen peroxide. DEFINITIONS. 4 Depressant.-An agent that will depress a body function. Accord- ing to action they are subdivided as motor, cerebral, etc. Examples: Bromides, aconite, hydrated chloral. Diaphoretic or Sudorific.-An agent that will increase perspira- tion. The term sudorific is usually confined to those active agents that cause drops of perspiration to collect on the skin. Examples: Pilocarpine, opium, camphor. Digestant.-An agent that will digest food or aid in digestion. Ex- amples: Pepsin, pancreatin. Disinfectant.-An agent that destroys the organisms capable of pro- ducing disease. Examples: Formaldehyde, sulphur dioxide, phenol, iodine. Diuretic.-An agent that increases the flow of urine. Examples: Hexamethylenamine, theobromine sodiosalicylate, potassium acetate. Drastic.-A very active purgative, usually producing many .evacu- ations, and accompanied by pain and tenesmus. Examples: Croton oil, elaterin. Ecbolic or Abortifacient.-An agent that will cause the pregnant uterus to expel its contents. Examples: Ergot, cotton-root bark, tansy. Elixir (Elix.)-Elixir.-Elixirs are aromatic, sweetened, spirituous solutions containing small amounts of medicinal substances. They con- stitute one of the most commonly used classes of preparations, and con- tribute largely toward the possibility of pleasant medication. The National Formulary contains many of the more popular formulae, but only two elixirs are official. Emetic.-An agent that will cause vomiting. Examples: Apomor- phine hydrochloride, ipecac, sodium chloride, mustard. Emmenagogue.-An agent that stimulates the menstrual function. Examples: Viburnum, preparations of iron, manganese dioxide, ergot. Emollient.-An agent that will soften and soothe the part when ap- plied locally. The term is usually confined to agents affecting the surface of the body. Examples: Ointment of rose-water, petrolatum, olive oil. Emplastrum (Emplast.)-Plaster.-Plasters are preparations for exter- nal application, and of such consistency that they require heat in spread- ing them, and adhere to the skin when applied. They are not often pre- scribed. Seven plasters are official. Emulsum (Emul.)-Emulsion.-Emulsions are aqueous liquids in which immiscible substances are held in suspension by the use of some viscid agent. The immiscible substance is usually an oil and the viscid agent is usually a gum. There are four official emulsions. Epispastic.-An agent that, applied locally, will produce a serous or puriform discharge by exciting inflammation. Examples: Red mercuric iodide, iodine. Errhine.-An agent that will increase the secretion of the mucous membrane lining the nose. The term is usually employed as synonymous with sternutatory. Examples: Quillaja, salicylic acid. Escharotic.-An agent that will destroy tissue with the production of a slough. The term is often used synonymously with caustic, but DEFINITIONS. 5 usually indicates a more extensive action. Examples: Arsenic trioxide, zinc chloride. Ester or Compound Ether.-A substance composed of an alcohol and acid radical in combination with O. Examples: Acetic ether, amyl ether. Ether.-As a class name it means a substance composed of two alcohol radicals in combination with O. As the name of a definite substance it means ethyl ether. Excitant.-An agent that will excite a special function of the body. They are subdivided according to action as motor, cerebral, etc. Ex- amples: Alcohol, strychnine, cocaine. Expectorant.-An agent that facilitates the removal of the secretions of the bronchopulmonary mucous membrane. Examples: Ammonium chloride, ammonium carbonate, ipecac. Expectorants are sometimes classed as sedative expectorants and stimulating expectorants. Extractum (Ext.)-Extract.-Extracts are solid or semi-solid prepara- tions produced by evaporating solutions of vegetable principles. The official extracts are either powders or soft solids. The majority of them can be obtained in powdered form and many prescribers prefer them that way. Extracts are usually about five times the strength of the crude drug. Twenty-five are official. Flower.-That part of a plant which comprises the organs of repro- duction. Examples: Arnica, anthemis, matricaria. Fluidextractum (Flext.)-Fluidextract.-These are solutions of the soluble constituents of organic drugs of such strength that each mil repre- sents 1 gramme of the drug. The majority of the fluidextracts contain a comparatively large percentage of alcohol and many of these give pre- cipitates with water. Most of them contain tannic acid; so, should not be used with agents incompatible with that drug. Forty-nine fluidextracts are official. Fruit-The product of a plant for propagation of its kind. It is the seed usually with the part containing it. Examples: Colocynth, vanilla, capsicum. Galactagogue.-An agent that stimulates the secretion of milk. Examples: Mild malt drinks. Germicide.-An agent that will kill germs. Examples: Phenol, cor- rosive mercuric chloride, potassium permanganate, iodine. Glucoside.-A substance (usually of vegetable origin) that is capable of being split up into two or more simpler bodies, one of which is glucose. Examples: Santonin, salicin, digitalin. Glyceritum (Glyc.)-Glycerite.-Glycerites are solutions of medicinal substances in glycerin. They are not often prescribed. Five glycerites are official. Gum.-An amorphous, non-volatile solid or soft-solid substance obtained as a natural exudate from a plant, and possessing the properties of being more or less soluble in water, insoluble in alcohol and, when moist, having adhesive qualities. Examples: Acacia, tragacanth. Gum-resin.-A natural mixture of gum and resin. Examples: Asafetida, myrrh. 6 DEFINITIONS. Haematinic.-An agent that will increase the hematin in the blood. Example: Iron. Haemostatic.-An agent that will arrest bleeding without being di- rectly applied to the bleeding area. Examples: Calcium lactate, horse- serum, ergot. Herb.-A plant of tender, juicy nature, only living one season. Ex- amples: Peppermint, lobelia, pennyroyal. Hydragogue.-An agent that produces watery evacuations of the intestinal contents. Examples: Magnesium sulphate, solution of magnesium citrate, sodium phosphate. Hypnotic.-An agent that will produce sleep. Examples: Sulphon- ethylmethanum, morphine, hydrated chloral. Infusum (Inf.)-Infusion.-Infusions are liquid preparations made by treating vegetable substances with either hot or cold water. The drug is not subjected to boiling, as in making decoctions. When the strength and method of preparations is not otherwise specified, they are made by treating 5 parts of the coarsely comminuted drug with boiling water to make 100 parts. Two are official. Irritant.-An agent which, when used locally, produces more or less local inflammatory reaction. Examples: Iodine, chloroform, mustard. Laxative.-A mild purgative, usually producing one or two evacu- ations without pain or tenesmus. Examples: Olive oil, liquid petrolatum, and small doses of many of the more active purgatives. Leaf.-A plant organ usually shooting out from the side of a stem or branch. Usually somewhat flattened and oval in shape and green in color. Examples: Belladonna, hyoscyamus, digitalis. Leaflet.-One of the subdivisions of a compound leaf. Examples: Senna, pilocarpus. Linimentum (Lin.)-Liniment.-Liniments are liquid preparations for external use and usually applied with rubbing. Eight are official. Liquor (Liq.)-Solution.-This class consists of aqueous solutions of non-volatile subtances. They present the greatest variety in strength, character, and method of preparation. They are usually very active medicinal preparations. There are twenty-five official solutions. Lithontriptic.-An agent that tends to dissolve calculi in the urinary or bile tracts. Examples: Lithium citrate, potassium citrate, and ammonium benzoate are usually placed in this class. Massa (Mas.)-Mass.-Masses are soft-solid preparations for internal use, and of such consistency that they may be molded into pills. They are frequently prescribed alone or with other agents, and may be given in pill form or put into capsules. Two masses are official. Mistura (Mist.)-Mixture.-This class includes the aqueous liquid preparations intended for internal use, and containing suspended in- soluble substances. They should always be shaken before using. There are two official mixtures. Mucilago (Mucil.)-Mucilage.-These are thick, viscid, adhesive liquids, containing gum or mucilaginous principles dissolved in water. They are usually employed to hold insoluble substances in suspension in aqueous liquids. There are two official mucilages. DEFINITIONS. 7 Mydriatic.-An agent that will dilate the pupil of the eye. Examples: Atropine, homatropine hydrobromide. Myotic.-An agent that will contract the pupil of the eye. Examples: Physostigmine, pilocarpine. Narcotic.-An agent that will cause stupor. Examples: Morphine, hydrated chloral. Neutral Principle.-A proximate principle of neutral reaction, not otherwise classified. Examples: Aloin, elaterin. Nutrient.-An agent that supplies to the body material for building tissue. Examples: Codliver oil, olive oil, gelatin, milk. Oil.-A greasy liquid not miscible with water, usually obtained from a vegetable or animal source. According to character, they are sub- divided principally as fixed and volatile (or essential). Examples: Fixed-castor oil, olive oil, codliver oil. Volatile-oils of mustard, pep- permint, rose. Oleatum-Oleate.-Oleates are preparations made by dissolving metallic salts or alkaloids in oleic acid. One is official. Oleoresin.-A natural mixture of oil and resin. Examples: Oleo- resins of aspidium, turpentine, ginger. Oxytocic.-An agent that hastens the process of labor. Examples: Pituitrin, quinine. Parasiticide.-An agent that will kill parasites. Examples: Sulphur, iodine, mercurial ointment. Pilulae (Pil.)-Pills.-Pills are small, solid bodies of a globular, ovoid or lenticular shape, which are intended to be swallowed and thereby pro- duce medicinal action. They may be ordered to be made extemporane- ously by the druggist, or the ready-prepared pills may be used. The latter usually are coated with sugar, gelatin, chocolate, etc. The gelatin- coated pills are the most desirable, as a rule, for many reasons. Pills are not. prescribed as often as formerly. Administration of drugs in capsules possesses all of the advantages and few of the disadvantages of the older method. There are, of course, some exceptions to this rule, as will be noted elsewhere. Seven pills are official. Protective.-An agent that will mechanically protect the part to which applied. Examples: Collodion, plasters. Pulvis (Pulv.)-Powder.-The official powders are mixtures of pow- dered medicinal substances. Seven are official. Purgative.-An agent that will cause an evacuation of the intestinal contents. Examples: Calomel, castor oil, magnesium sulphate. Pustulant.-An agent that will produce pustules. Examples: Croton oil, antimony and potassium tartrate. Reconstituent Tonic.-An agent that improves or strengthens one or more parts or functions of the body by replacing lost material. Ex- amples : Iron, phosphorus, calcium. Refrigerant.-An agent which, when taken by mouth, produces a sensation of coolness. Examples: Peppermint, spearmint, fruit juices. Refrigerants usually tend to allay thirst. Resin.-An amorphous, non-volatile solid or soft-solid substance, obtained as a natural exudation from or by treatment of plants. It is prac- 8 DEFINITIONS. tically insoluble in water, but soluble in alcohol. Examples: Guaiac, rosin. As a class name, with the exception of the official "Rosin," a resin is a powder consisting principally of the resinous principles of a vegetable drug. They are prepared by adding water to the alcoholic preparation of a drug and collecting, drying, and powdering the precipitate; so they con- sist of those principles which are soluble in alcohol and insoluble in water. Four are official. Resorbent.-An agent that tends to promote the absorption of ab- normal matter, as exudates or blood-clots. Examples: Potassium iodide, ammonium chloride. Restorative.-An agent that restores lost tone or function. Examples: Preparations of iron, arsenic, mercury, etc. Rhizome.-A more or less underground and horizontal root-stem of a plant. Examples: Hydrastis, valerian, ginger. Root.-The underground part of a plant. Usually applied to the principal underground plant axis. Examples: Stillingia, glycyrrhiza, belladonna. Rubefacient.-An agent that, when applied to the skin, produces red- ness. Examples: Chloroform, mustard, menthol. Saline.-A mineral salt that will produce an evacuation of the intes- tinal contents. Examples: Magnesium sulphate, sodium sulphate, potas- sium and sodium tartrate. Sedative.-An agent that will allay irritability or excitement. Ac- cording to action, they are subdivided as general, local, nervous, vascu- lar, etc. Examples: Bromides, morphine, codeine, hydrated chloral. Seed.-The part of the fruit containing the germ. Examples: Nux vomica, mustard, colchicum seed. Sialagogue.-An agent that increases the flow of saliva. Examples: Pilocarpine, potassium iodide, citric acid. Spiritus (Spir.)-Spirit.-Spirits are alcoholic solutions of volatile sub- stances. Most of them contain matter insoluble in water. While there is no uniform strength for spirits, they are usually about 5 to 10 per cent. Fifteen are official. Stearopten.-A concrete or solid substance obtained from a volatile oil. Examples: Menthol, thymol. Sternutatory.-An agent that will cause sneezing. Examples: Quil- laja, salicylic acid. Stimulant.-An agent that will excite one or more portions of the body. The agents are usually subdivided according to special action: cerebral stimulants, cardiac stimulants, etc. Examples: Atropine, strych- nine, caffeine. Styptic.-An agent that will arrest bleeding when applied locally. Examples: Ferrous sulphate, alum, tannic acid, iodine. Suppositoria (Suppos.)-Suppositories.-Suppositories are solid bodies intended to be introduced into the rectum, vagina, or urethra to produce medicinal action. This is often a very convenient and efficient form for administering remedies and, with the exception of the official glycerin DEFINITIONS. 9 suppository, they are usually better prepared extemporaneously by the pharmacist. Oil of theobroma is the vehicle usually employed with the medicinal substances, and the amount of this should be left to the dis- cretion of the compounder. One is official. Syrupus (Syr.)-Syrup.-Syrups are concentrated solutions of sugar in water or aqueous liquids. They usually do not represent a very high percentage of the active drug. Some are used merely to give a pleasant odor and taste to solutions. There are twenty-two official syrups. Tabellae (Tab.)-Tablets.-Tablets are small, disk-like masses of medicinal powders. Tablet Triturates (T. T.) are made by moistening the powder with a volatile liquid, as alcohol, and then molding into shape and allowing the liquid to evaporate. They are seldom made to contain more than 1 grain of the active agent. They will usually disintegrate readily and are a very desirable form for administering certain drugs. Coated Tablets are usually made by coating compressed tablets with sugar, chocolate, etc. (S. C. T.; C. C. T.; G. C. T.). Compressed Tablets (C. T.) are made by forcibly compressing the powdered substances into the desired shape. They are usually made to contain from 1 to 10 grains of the active drug. They are frequently very hard and sometimes not readily soluble. Dispensing Tablets (D. T.) are those that contain a comparatively large amount of the active drug, as 1 grain of strychnine sulphate. They are used by pharmacists and dispensing physicians to avoid the necessity of weighing small amounts of a potent drug in filling prescriptions. There is one official tablet. Hypodermic Tablets (H. T.) are usually made as are tablet triturates. They frequently contain, in addition, some agents that produce chemical action when water is added and cause a rapid disintegration of the mass. Taenifuge or Taeniafuge.-An agent that will effect the removal of tape-> worms. Examples: Pelletierine tannate, oleoresin of male fern. Tinctura (Tinct.)-Tincture.-Tinctures are alcoholic solutions of non- volatile substances (tincture of iodine is an exception). They are the most commonly used class of preparations. They usually contain tannic acid; so, in most instances, cannot be employed with agents that are incompatible with that drug. Those tinctures that contain much resinous matter or oils will precipitate with water. Some examples are tinctures of ginger, benzoin, guaiac, etc. Tinctures of the most potent drugs usu- ally represent 10 per cent, of the crude drug; as tinctures of opium, digi- talis, aconite, etc. Where more than a fluidrachm of a 10 per cent, tincture would have to be taken to get a dose of the drug, the tincture is usually made to represent 20 per cent., or more, of the agent. As to the dosage, the majority of tinctures can be put roughly into two groups: those the dose of which is about 10 minims and those of fluidrachm doses. Fifty-four tinctures are official. Tonic.-An agent that improves or strengthens one or more parts or functions of the body. According to action these are subdivided as general, cardiac, etc. Examples: Preparations of iron, arsenic, digitalis. 10 DEFINITIONS. Trituratio (Trit.)-Trituration.-Triturations are powdered prepara- tions containing 10 per cent, of the active drug and 90 per cent, of sugar of milk. One is official. Trochisci (Troch.)-Troches.-Troches, or lozenges, are solid, discoid, or cylindrical masses consisting chiefly of medicinal powders, sugars, and mucilage. They are intended to be used by placing them in the mouth and allowing them to remain until, through slow solution or disintegra- tion, their purpose of mild medication is effected. They are not often prescribed. Five troches are official. Tuberous Root.-A thickened primary root. Examples: Aconite, jalap. Unguentum (Ung.)-Ointment.-Ointments are fatty, soft-solid prep- arations intended to be applied to the skin by inunction. Twenty oint- ments are official. Vermicide.-An agent that will kill intestinal worms. Examples: Santonin, thymol. There can be no sharp distinction between the last two terms, and they are used as practically synonymous. Vermifuge.-An agent that will effect the removal of intestinal worms. Examples: Castor oil, calomel, jalap. Vesicant.-An agent that will produce blisters. Examples: Mustard, cantharides. Vinum-Wine.-The medicated wines are solutions of medicinal sub- stances in wine. They are not often prescribed. None are official. INTRODUCTION TO PART I. In the following pages are included all official drugs, also some few others that are frequently employed by prescribers. In the case of the frequently used agents the effort has been made to give complete information as to how to employ them to meet the conditions for which they are commonly used. No effort has been made to show the use in each disease, but only to give the practical information and illustrations that will enable the busy practitioner to apply theory, and, sitting at the bedside, write pre- scriptions for the well-known medicinal agents in a way that will reflect credit on himself and serve the best interests of the patient. Drugs that are seldom prescribed are not discussed in detail. While this is not intended as a work on therapeutics, the pre- scriptions given are selected from many thousands and are, with few exceptions, formulae that are of tried therapeutic merit. The thera- peutic indications in the index are arranged to convert this part of the work into a formulary of considerable scope. Effort has been made to have each prescription correct from every standpoint, and so given that it can be copied on a pre- scription blank, letter for letter, and sent to the drug-store-a docu- ment above criticism. 11 PART I. Materia Medica. ACACIA. Latin, Acacia (Gen., Acaciae; Abbrev., Acac.). Eng., Acacia. Synonym, Gum Arabic. A dried, gummy exudation of Acacia Senegal, and of other African species of Acacia. These are trees growing in Africa. Form.-A gummy solid substance that is marketed in the form of translucent masses (tears), granular powder or fine, white powder. The granular form is the most convenient for general use. Odor and Taste.-Almost odorless and tasteless. Solubility.-Soluble in water; insoluble in alcohol. Incompatibles.-Should not be prescribed with strongly alco- holic liquids, ammonia, lead subacetate, solutions of ferric salts, or sodium borate. Dose.-Ad libitum. Official Preparations. Mucilago Acaciae (Gen., Mucilaginis Acaciae; Abbrev., Mucil. Acac.). Eng., Mucilage of Acacia. Acacia, 350 Gm.; Distilled Water, to make 1000 Gm. Syrupus Acaciae (Gen., Syrupi Acaciae; Abbrev., Syr. Acac). Eng., Syrup of Acacia. Acacia, 100 Gm.; Sugar, 800 Gm.; Distilled Water, to make 1000 mils. Also used in several other official preparations. Average Dose.-4 fluidrachms (15 mils). Therapeutic Action.-Demulcent. Uses.-Chiefly used to give viscosity or body to liquids, so that after shaking the bottle insoluble matter will remain sus- pended long enough for a dose to be poured out before it settles. It is also a favorite emulsifying agent and is sometimes used for its demulcent properties. Mucilage of acacia does not keep well, particularly in warm weather, and preparations containing it often spoil in a few days. 13 14 ACETANILIDUM. Administration.-The following will illustrate some common modes of prescribing: In the treatment of stomatitis (child 3 years old): IP or Potas. Chloratis 1 50 Tinct. Myrrhae TRX 65 Syr. Acaciae fSj 30 00 Aquae q. s. fSiij 90 00 M. Sig.-Teaspoonful every three hours. In the treatment of the diarrhea of typhoid fever: $2 or Bismuthi Subnit 10 0 Phenolis Liq ntviij 5 Tinct. Opii Deod f3j 4 0 Mucil. Acaciae 30 0 Aquae q. s. f5iv 120 0 M. Sig.-Teaspoonful every three hours. (Shake-label.) In the treatment of acute bronchitis: $3 Terebeni f5ij or 8 Creosoti f3ss 2 Acaciae Aquae Chloroformi q- s. q. s. f5iij 90 M. ft. emul. Sig.-Teaspoonful with water every four hours. ACETANILIDUM. Latin, Acetanilidum (Gen., Acetanilidi; Abbrev., Acetanil.). Eng., Acetanilid. Synonym, Antifebrin. Formula, CgHgON. A derivative of aniline. Form.-Shining, crystalline laminae or crystalline powder. Odor and Taste.-Odorless and almost tasteless. Solubility.-In 190 parts of water or in 3.4 parts of alcohol. Incompatibles.-Alkaline bromides and iodides in aqueous solu- tions, chloroform, hydrated chloral, phenol, resorcin, thymol, spirit of nitrous ether. 1 Anders: Practice of Medicine. 2 Hughes: Practice of Medicine, s Ibid. ACETANILIDUM. 15 Average Dose.-3 grains (0.2 Gm.). Therapeutic Action.-Analgesic, antipyretic, antiseptic. Uses.-At one time acetanilid was the principal constituent of most proprietary headache remedies. The present require- ments of the federal and state drug laws and the press campaign against it have now largely restricted its employment in pro- prietaries. Its chief use by the profession is in the treatment of certain forms of headache. Sometimes used to reduce fever and in antiseptic dusting powders and ointments. Toxicology.-Poisoning by the coal-tar antipyretics is usually diagnosed by the history of an excessive amount of headache medicine having been taken. Some of the symptoms are: cya- nosis; cold, moist skin; weak pulse; general depression. There may be a skin eruption. Treatment consists in emptying the stomach and stimulating, usually by ammonia, caffeine, strych- nine, etc. The patient should be kept warm. Administration.-Acetanilid is usually prescribed in capsules or powders. The following illustrate some of the best combinations for administering the drug: The following has been recommended for headache: Ri or Acetanilidi gr. xxxvj 2 25 Caffeinae Citratae, Camphorae Monobromatae aa. gr. vj 40 Sodii Bicarbonatis gr. xxiv 1 50 M. ft. cap. no. xij. Sig.-One every hour until three (3) are taken. The remaining capsules may be ordered to be taken every few hours as indicated. In the treatment of postanesthetic vomiting: $2 or Cocainae Hydrochlor gr. j 065 Acetanilidi gr. x 650 Cerii Oxalatis gr. xx 1 300 M. ft. cht. no. iv. Sig.-One every two hours when indicated. i Musser and Kelly: Practical Treatment. 2 Ashton: Practice of Gynecology. 16 ACETANILIDUM. Acetanilid is sometimes ordered in aromatic spirit of am- monia, as in the following, which has been extensively used for headache, nervousness, hiccough, etc., particularly when fol- lowing alcoholism: or Acetanilidi 5ss . 2 Spir. Ammon. Arom f5iv 15 Caffeinae Citratae gr. xvj 1 Sodii Bromidi gr. Ixxx 5 Elix. Aromatici q. s. f3ij 60 M. Sig.-Two (2) teaspoonfuls in water every two hours until relieved. This is written in the order in which it should be prepared by the compounder. Acetanilid is sometimes prescribed in suspension, as in the fol- lowing, which has been employed in the beginning of colds: B ' or Pulv. Acetan. Co gr. xxx 2 0 Ammonii Carb gr. xxiv 1 5 Tinct. Hyoscyami f5j 4 0 Spir. Vini Gallici ...' fXij 60 0 Syr. Tolutani q. s. fSiij 90 0 M. Sig.-Tablespoonful in water every three hours until relieved. (Shake- label.) The preparation does not present a very elegant appearance, but seems clinically of value. Compressed tablets are kept by pharmacists, containing from 2 to 5 grains of the drug, either alone or with agents, as citrated caffeine, etc. They are often very hard and undesirable. Acetanilid is sometimes used with other agents in dusting powders, as: 3 or Acetanilidi Pulv 3j 4 Acidi Borici 3ij 8 Amyli q. s. 3j 30 M. tere bene. Sig.-Apply as directed. Some ointments are shown in the following: ACETONUM. ACETPHENETIDINUM. 17 In the treatment of erythema: RI or Acetanilidi, gr. xxx 2 0 Acidi Borici gr. xx 1 3 Adipis Lanae Hyd • 5ss 15 0 Ung. Aquae Rosae • q. s. 5j 30 0 M. Sig.-Apply thin several times daily. As a bland ointment in the treatment of comedo: B2 or Acetanilidi gr. xx 1 3 Bismuthi Subnit 5j 4 0 Ung. Aquae Rosae .... q. s. 5j 30 0 M. Sig.-Apply as directed. In the treatment of erythema scarlatiniforme: $3 or Cocainae Hydrochlor gr. iv 2 6 Acetanilidi gr. xx 1 3 Zinci Oxidi 3iss 6 0 Ung. Zinci Oxidi q. s. 5ij 60 0 M. Sig.-Apply thin on a cloth. ACETONUM. Latin, Acetonum (Gen., Acetoni; Abbrev., Aceton.). Eng., Acetone. A colorless liquid containing not less than 99 per cent, by weight of absolute Acetone. Therapeutic Action.-Said to be anesthetic and hypnotic. Uses.-Acetone is extensively used in pharmaceutical manu- facturing, but is not often a prescription ingredient. ACETPHENETIDINUM. Latin, Acetphenetidinum (Gen., Acetphenetidini; Abbrev., Acet- phen.). Eng., Acetphenetidin. Synonym, Phenacetin. Formula, CioHi302N. 1 A coal-tar derivative. Form.-White scales or white crystalline powder. Odor and Taste.-Almost odorless and tasteless. 1 Ohmann-Dumesnil: Diseases of the Skin. 2 Ohmann-Dumesnil: Diseases of the Skin. 3 Ibid. 18 ACETPHENETIDINUM. Solubility.-In 1310 parts of water or 15 parts of alcohol. Incompatibles.-Hydrated chloral, iodine, phenol, salicylic acid, and oxidizing agents. Average Dose.-5 grains (0.3 Gm.). Therapeutic Action.-Analgesic, antipyretic, sedative. Uses.-Extensively employed for the relief of headache. Used in the treatment of colds, "grip," tonsillitis, bronchitis, etc., either to relieve pain or reduce temperature or both. Sometimes used for nervousness. It is considered safer than acetanilid. Administration.-Owing to the lack of odor and taste and its limited solubility it is prescribed almost exclusively in capsules or powders. Acetphenetidin when used alone may be ordered as: or Acetphenetidini 2I Ft. cht. no. vj. Sig.-One every three hours until relieved. In the treatment of coryza: Bi or Acetphenetidini 215 Phenylis Salicyl 5j 4|0 M. ft. cht. no. xij. Sig.-One every two hours. In the treatment of influenza: $2 or Caffeinae Citratae . gr. x 65 Camphorae gr. x 65 Acetphenetidini gr. xxx ? 00 M. ft. cap. no. x. Sig.-One every two hours. Used in the treatment of influenza: IP or Pulv. Ipecac, et Opii gr. viij 5 Acetphenetidini, Phenylis Salicyl ... .aa. gr. xlv 3 0 M. ft. cap. no. xv. Sig.-One every three hours. 1 Musser and Kelly: Practical Treatment. 2 Hughes: Practice o£ Medicine. 3 Ibid. ACIDUM ACETICUM. ACIDUM BORICUM. 19 In the treatment of migraine: or Barbital gr. xx 1 30 Acetphenetidini gr. xx 1 30 Acidi Acetylsalicylici gr. xx 1 30 M. ft. cap. no. x. Sig.-One every two hours until relieved. ACIDUM ACETICUM. Latin, Acidum Aceticum (Gen., Acidi Acetici; Abbrev., Acid. Acet.). Eng., Acetic Acid. Formula, HC2H3O2. An aqueous solution containing not less than 36 per cent, by weight of absolute Acetic Acid. Acidum Aceticum Dilutum.-(Gen., Acidi Acetici Diluti). Eng., Diluted Acetic Acid. An aqueous solution containing about 6 per cent, of absolute Acetic Acid. Average Dose.-30 minims (2 mils). Acidum Aceticum G.laciale.-Eng., Glacial Acetic Acid. A liquid containing not less than 99 per cent, of absolute Acetic Acid. Therapeutic Action.-Antiseptic, astringent, refrigerant, irri- tant, caustic. Uses.-The acetic acids are not often prescribed as such. They are used in pharmaceutical manufacturing, as reagents, and sometimes in the treatment of local conditions, as ulcers, new growths, etc. Seldom prescribed. ACIDUM BENZOICUM. See Benzoinum, p. 90. ACIDUM BORICUM. Latin, Acidum Boricum (Gen., Acidi Borici). Eng., Boric Acid. Synonym, Boracic Acid. Formula, H3BO3. Form.-May be in scales or crystals, but usually a light, white, very fine light, white powder. Odor and Taste.-Odorless and almost tasteless. Solubility.-In 18 parts of water, 18 parts of alcohol, and 4 parts of glycerin. 20 ACIDUM BORICUM. Incompatibles.-Alkali hydroxides and carbonates. Average Dose.-8 grains (0.5 Gm.). Official Preparations. Glyceritum Boroglycerini (Gen., Glyceriti Boroglycerini). Eng., Glycer- ite of Boroglycerin. Synonym, Solution of Boroglyceride. Boric .Acid, 310 Gm.; Glycerin, to make 1000 Gm. Unguentum Acidi Borici (Gen., Unguenti Acidi Borici). Eng., Oint- ment of Boric Acid. Boric Acid, 100 Gm.; Paraffin, 50 Gm.; White Petrolatum, 850 Gm. Therapeutic Action.-Antiseptic, mild germicide, and recom- mended as a urinary antiseptic. Uses.-Boric acid, by mouth or irrigation, is used in the treat- ment of gonorrhea, cystitis, and some other conditions of the urinary tract, particularly when it is desired to increase the acidity of the urine. It is used as a wash for eye troubles, sores, etc. In the form of the boroglyceride tampons it is employed in vaginitis, metritis, etc. In ointments or dusting powders it is used for sores, dermatitis, prickly heat, and many other super- ficial conditions. It enters into many mouth-washes, nasal sprays, antiseptic solutions, etc., that are employed in the treat- ment of nasal catarrh, rhinitis, stomatitis, pyorrhea, etc. Administration.-Boric acid is frequently prescribed in solu- tion. The following will illustrate: The so-called "saturated solution" is probably best ordered as: $ Acidi Borici 3iss or 6! Aquae Dest q. s. f3iv 120| M. ft. sol. Sig.-Apply as directed. In rendering the urine more acid: Bi Acidi Benzoici 5ij or 8 Acidi Borici 5iij 12 Aquae Cinnamomi fSxij 360 M. Sig.-Tablespoonful in water four times daily. i Ashton: Practice of Gynecology. ACIDUM BORICUM. 21 In the treatment of gonorrhea: Hi or Acidi Borici, Sodii Bromidi aa. gr. clx 10 Tinct. Belladon. Fol f5j 4 Liq. Potas. Citratis q. s. fjviij 240 M. Sig.-Tablespoonful in water four times daily. As a mouth-wash in pyorrhoea alveolaris: $2 or Acidi Borici 5j 4 00 Phenolis Liq nixij 75 Glycerini f3j 4 00 Aquas Menthae Pip 180 00 M. Sig.-Use as a mouth-wash. In the treatment of miliaria: R3 or Phenolis, gr. xv 1 Acidi Borici 3ij 8 Glycerini f3ss 2 Alcoholis fSj 30 Aquae q. s. fSviij 240. M. Sig.-Apply locally. The following illustrate its use in dusting powders: As dusting powder in the treatment of "prickly heat": B or Acidi Salicylici gr. xv 1 Acidi Borici 3ij 8 Zinci Oxidi 5iv IS Amyli Sij 60 M. tere bene simul. Sig.-Apply as directed. This is best applied by putting the powder in a cloth bag and patting the affected parts with it several times a day, particularly after each bath. 1 White and Martin: Genito-urinary and Venereal Diseases. 2 Musser and Kelly: Practical Treatment. 3 Stelwagon: Diseases of the Skin. 22 ACIDUM CITRICUM. As a dusting powder in the treatment of hyperidrosis: Ri or Acidi Salicyl. Pulv gr. xx 1 3 Acidi Borici Pulv 3v 19 0 Zinci Oxidi 3iij 12 0 M. Sig.-Apply as directed. It is often used in ointments. Some combinations are shown in the following: In the treatment of ecthyma: R2 Acidi Borici or gr. x 65 Bismuthi Subnit 3j 4 00 Picis Liquids gr. xx 1 30 Ung. Aqus Ross q- s. 5j 30 00 M. Sig.-Apply on a cloth twice a day. In the treatment of erythema: R3 or Acetanilidi gr. xxx 2 0 Acidi Borici gr. xx 1 3 Adipis Lanae Hyd 5ss 15 0 Ung. Aquae Rosae q. s. Sj 30 0 M. Sig.-Apply thin several times daily. The following is frequently employed on vaginal tampons: or Ichthyolis fSij 81 Glyc. Boroglycerini q. s. f5iv 120 M. Sig.-For office use. ACIDUM CITRICUM. Latin, Acidum Citricum (Gen., Acidi Citrici). Eng., Citric Acid. Formula, H3C6H5O7 4- H2O. An organic acid usually prepared from the juice of limes or lemons. Form.-Colorless crystals. Odor and Taste.-Odorless and having an agreeable acid taste. Solubility.-In 0.5 part of water and in 1.8 parts of alcohol. 1 Stelwagon: Diseases of the Skin. 2 Ohmann-Dumesnil: Diseases of the Skin. «Ibid. ACIDUM CITRICUM. 23 Incompatibles.-Should not be prescribed in dry form or with alkaline acetates, carbonates, sulphides, tartrates, or mineral acids. Average Dose.-8 grains (0.5 Gm.). Syrupus Acidi Citrici (Gen., Syrupi Acidi Citrici). Eng., Syrup of Citric Acid. Synonym, Syrup of Lemon. Contains 1 per cent, each of Citric Acid and Tincture of Lemon-peel. This was introduced to replace the old syrup of lemon. A pleasant flavor and vehicle that may be given in doses as wanted. Citric acid is used in the preparation of many effervescing preparations, solutions, syrups, etc. The effect is usually sought by prescribing the citrates. Therapeutic Action.-Refrigerant, antiscorbutic, mild laxative, and the citrates are systemic alkalinizers. Uses.-Citric acid is seldom employed as such by the physician. Its uses are more fully discussed under Citrates and Limonis Succus. Official Preparations. Official Citrates. LITHII CITRAS (Gen., Lithii Citratis). Eng., Lithium Citrate. Formula, LisCeHsOj + 4H2O. Form.-A white powder. Odor and Taste.-Odorless and having a cooling, alkaline taste. Solubility.-In about 1.4 parts of water; very slightly soluble in alcohol. Incompatibles.-Alcohol, carbonates, lead acetate, silver nitrate. Average Dose.-8 grains (0.5 Gm.). POTASSII CITRAS (Gen., Potassii Citratis). Eng., Potassium Citrate. Formula, K3C6H5O7.+ H2O. Form.-Transparent crystals or white powder. Odor and Taste.-Odorless and having a cooling, saline taste. Solubility.-In about 0.6 part of water; sparingly soluble in alcohol. Incompatibles.-Alcohol, lead acetate, potassium permanganate in acid solution, silver nitrate. Average Dose.-15 grains (1 Gm.). Preparations. Potassii Citras Effervescens. Eng., Effervescent Potassium Citrate. A fine white, odorless, soluble powder, containing 20 per cent, of the salt with sodium bicarbonate and citric and tartaric acids. Average Dose.-60 grains (4 Gm.). Liquor Potassii Citratis. Eng., Solution of Potassium Citrate,. A colorless, odorless liquid containing about 8 per cent, of potassium citrate with small amounts of citric and carbonic acids. Average Dose.-4 fluidrachms (15 mils). SODII CITRAS (Gen., Sodii Citratis). Eng., Sodium Citrate. For- mula, NasCeHsOj + 2H2O. 24 ACIDUM CITRICUM. Form.-A white, granular powder. Odor and Taste.-Odorless and having a cooling, saline taste. Solubility.-In 1.3 parts of water, slightly soluble in alcohol. Incompatibles.-Alcohol, lead acetate, silver nitrate. Average Dose.-15 grains (1 Gm.). BISMUTHI ET AMMONII CITRAS.-See Bismuth, p. 95. FERRI ET AMMONII CITRAS.-See Ferrum, p. 159. FERRI ET QUININE CITRAS.-See Ferrum, p. 159. FERRI ET QUININ2E CITRAS SOLUBILIS.-See Ferrum, p. 159. FERRI ET STRYCHNINES CITRAS.-See Ferrum, p. 159. Therapeutic Action.-Said to be mildly diuretic, diaphoretic, expectorant, refrigerant, alkalinizer. Uses.-The real value of the citrates in medicine seems to be very poorly established, some using them extensively and claiming much, and others placing no reliance upon them at all. They are prescribed as such or as the "solution of potassium citrate" in the treatment of gonorrhea, cystitis, etc., particularly when it is desired to render the urine less acid. They are also still used in the treatment of renal or cystic calculi, gout, and rheumatism. They are largely used in cough and fever mixtures, particularly for colds, influenza, bronchitis, and pneumonia. They have been recom- mended to lessen coagulability in the early stages of pneumonia, and late in typhoid fever. Recommended for pellagra. Sodium citrate is quite extensively employed in infant feeding to prevent the formation of hard curds of milk. Administration.-The citrates of sodium, potassium and lithium are the salts used for the citric acid radical. They are somewhat deliquescent, so are not prescribed in powders. The doses are rather large for capsules. Their solubility and freedom from odor or unpleasant taste render them well suited to administration in aqueous solution, which is the usual method of employment. The lithium citrate is on the market in 3- and 5- grain tablets, put up 40 to the bottle. They are frequently prescribed and should always be ordered in this number, so that the original bottle may be dispensed. Sodium citrate should be the salt of choice as it pos- sesses many advantages. Some prescriptions showing the usual employment of citrates are shown in the following: R Tab. Lithii Cit. (gr. v) .... no. xl. Sig.-One in a glass of water every four hours. ACIDUM CITRICUM. 25 For cough, bronchitis, etc. (child 4 years old) : 3 or Sodii Citratis gr. Ixxx 5 Spir. .Etheris Nit f5ij 8 Syr. Ipecacuanhas f5ss 2 Syr. Acidi Citrici f3iv 15 Aquae q. s. fSij 60 M. Sig.-Teaspoonful every two hours. In the treatment of cough: RI or Codeinae Sulphatis 1 Sodii Citratis Bij 8 0 Syr. Tolutani fSj 30 0 Aquae 90 0 M. Sig.-Teaspoonful every two hours. In the treatment of the cough of measles: R2 Sodii Citratis 5ss or 15 Limonis Succi fSj 30 Tinct. Opii Camph f5ij 8 Syr. Ipecacuanhae f5ij 8 Syr. Tolutani q. s. f5ij 60 M. Sig.-Teaspoonful in water every two hours. Something like the following has been suggested in the effort to abort pneumonia: R Sodii Citratis Si or 301 Aquae Menth. Pip q. s. f3iij 90 M. Sig.-Teaspoonful in water every two hours. In the treatment of gonorrhea: $3 or Acidi Borici, Sodii Bromidi aa. 5iij 12 Tinct. Belladon. Fol fSj 4 Liq. Potas. Citratis q. s. fSviij 240 M. Sig.-Tablespoonful in water four times daily. 1 Musser and Kelly: Practical Treatment. 2 Anders: Practice of Medicine. 8 White and Martin: Genito-urinary and Venereal Diseases. 26 ACIDUM GALLICUM. ACIDUM HYDROCHLORICUM. Used as an antipyretic in the acute diseases of childhood, as measles, scarlatina, bronchitis, etc.: Bi or Tinct. Aconiti TH,Xvj 1 Spir. Athens Nit f3iij 12 Liq. Potassii Cit f5ij 60 M. Sig.-Teaspoonful in water every two hours. ACIDUM GALLICUM. Latin, Acidum Gallicum (Gen., Acidi Gallici). Eng., Gallic Acid. An organic acid usually prepared from tannic acid. Form.-White or pale fawn-colored needles or prisms. Odor and Taste.-Odorless; an astringent and slightly acidulous taste. Solubility.-In about 87 parts of water or 4.6 parts of alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Astringent, styptic; also classed as a hemostatic. Uses.-Gallic acid is now seldom employed in treatment. Bismuth subgallate is discussed elsewhere. ACIDUM HYDRIODICUM DILUTUM. See lodum, p. 199. ACIDUM HYDROBROMICUM DILUTUM. See Bromum, p. 100. ACIDUM HYDROCHLORICUM. Latin, Acidtim Hydrochloricum (Gen., Acidi Hydrochloric!). Eng., Hydrochloric Acid. Synonym, Muriatic Acid. - Form.-An aqueous solution, containing not less than 31 per cent, nor more than 33 per cent, of HC1. Odor and Taste.-Pungent odor which disappears on diluting. Intensely acid taste. Solubility.-Miscible in all proportions with water or alcohol. Incompatibles.-Alkaline carbonates, chlorates, permanganates, 1 Hughes: Practice of Medicine. ACIDUM HYDROCHLORICUM. 27 silver salts, lead salts, tartar emetic, alcohol, ether, carbohydrates, sulphur, etc. Acidum Hydrochloricum Dilutum (Gen., Acidi Hydrochloric! Diluti). Eng., Diluted Hydrochloric Acid. Synonym, Diluted Muriatic Acid. An aqueous solution containing not less than 9.5 per cent, nor more than 10.5 per cent, of HC1. Average Dose.-15 minims (1 mil). Hydrochloric Acid is also contained in some other preparations, as Liquor Acidi Arsenosi and Tinctura Ferri Chloridi. Therapeutic Action.-Aids digestion. Uses.-The diluted acid is extensively used, either alone or in combination, in the treatment of indigestion, where there is a defi- ciency of normal gastric secretion. Sometimes used in tonic and stomachic preparations. Administration.-The Diluted Hydrochloric Acid is the prep- aration usually employed. It should be ordered to be taken well diluted and through a tube. The official dose is very often exceeded. When it is desired to give hydrochloric acid alone, it may be ordered as: Official Preparation. or Acidi Hydrochlor. Dil fSij 60| Sig.-Fifteen (15) drops in water after meals. Or: or Acidi Hydrochlor. Dil fSj 301 Aquae 120 M. Sig.-Teaspoonful in water after meals. In combination with other digestive agents it may be ordered as: B or Acidi Hydrochlor. Dil fSj 30| Liq. Pepsini Arom. (N. F.) q. s. fSviij 2401 M. Sig.-Two (2) teaspoonfuls in water after meals. Other pepsin preparations may be used instead of the Liq. Pep- sini Arom. in the above. 28 ACIDUM HYDROCYANICUM DILUTUM. In combination as a digestant: or Pepsini 3ij 8 Acidi Hydrochlor. Dil., Tinct. Nucis Vomicae, Glycerini aa. f3j 30 Aquae q. s. f5vj 180 M. Sig.-Teaspoonful in water after meals. Or: Bi or Strychninae Sulph gr. ss |03 Pepsini Sj 4|00 Acidi Hydrochlor. Dil f5ss . 15|00 Glycerini f3ss 15|00 Aquae Chloroformi q. s. fBiij 90]00 M. Sig.-Teaspoonful in water after meals. In a tonic formula: or Hydrarg. Chlor. Corros gr. j 065 Liq. Acidi Arsenosi f3j 4 000 Tinct. Ferri Chlor., Acidi Hydrochlor. Dil., Syrupi aa. f3iv 8 000 Aquae q. s. f5vj 180 000 M. Sig.-Two (2) teaspoonfuls in water after meals. This constitutes the well-known "Elixir Four Chlorides." ACIDUM HYDROCYANICUM DILUTUM. Latin, Acidum Hydrocyanicum Dilutum (Gen., Acidi Hydro- cyanici Diluti). Eng., Diluted Hydrocyanic Acid. Synonym, Di- luted Prussic Acid. A colorless liquid composed of about 2 per cent, of absolute Hydrocyanic Acid and about 98 per cent, of water. Average Dose.-iy2 minims (0.1 mil). Therapeutic Action.-Sedative and local anesthetic. Uses.-Hydrocyanic acid as such is seldom used in medicine. Internally it is sometimes used to allay cough or nausea. Externally it is used to allay itching. Seldom prescribed as such, except by dermatologists. 1 Hughes: Practice of Medicine. ACIDUM HYPOPHOSPHOROSUM. 29 ACIDUM HYPOPHOSPHOROSUM. Latin, Acidum Hypophosphorosum (Gen., Acidi Hypophos- phorosi). Eng., Hypophosphorous Acid. Formula, HPH2O2- A colorless liquid composed of about 30 per cent, by weight of absolute Hypophosphorous Acid and 70 per cent, of water. Official Preparation. Acidum Hypophosphorosum Dilutum (Gen., Acidi Hypophosphorosi Diluti). Eng., Diluted Hypophosphorous Acid. An aqueous solution containing about 10 per cent, of absolute Hypophosphorous Acid. Average Dose.-8 minims (0.5 mil). Diluted Hypophosphorous Acid is used in the syrup of ferrous iodide. Official Hypophosphites and Preparations. Incompatibles.-Arsenic salts, bromine, bromates, chlorine and chlorates, chromates, copper salts, ferric salts, iodine and iodates, nitric acid, perman- ganates, sulphuric and sulphurous acids. CALCII HYPOPHOSPHIS (Gen., Calcii Hypophosphitis). Eng., Calcium Hypophosphite. Formula, Ca(PH2O2)2- Form.-Colorless prisms, scales or white crystalline powder. Odor and Taste.-Odorless; having a nauseous, bitter taste. Solubility.-In 6.5 parts of water; insoluble in alcohol. Average Dose.-8 grains (0.5 Gm.). POTASSII HYPOPHOSPHIS (Gen., Potassii Hypophosphitis). Eng., Potassium Hypophosphite. Formula, KPH2O2. Form.-White plates, masses or granular powder. Odor and Taste.-Odorless; having a pungent saline taste. Solubility.-In 0.6 part of water or 9 parts of alcohol; deliquescent. Average Dose.-8 grains (0.5 Gm.). SODII HYPOPHOSPHIS (Gen., Sodii Hypophosphitis). Eng., Sodium Hypophosphite. Formula, NaPH2O2. Form.-Colorless plates or white granular powder. Odor and Taste.-Odorless; having a bitterish-sweet, saline taste. Solubility.-In about 1 part of water; soluble in alcohol; deliquescent. Average Dose.-15 grains (1 Gm.). Official Preparations. Syrupus Hypophosphitum. Eng., Syrup of Hypophosphites. Calcium Hypophosphite, 45 Gm.; Potassium Hypophosphite, 15 Gm.; Sodium Hypophosphite, 15 Gm.; Diluted Hypophosphorous Acid, 2 mils; Glycerin, 50 mils; Sugar, 600 Gm.; Water, to make 1000 mils. Average Dose.-fluidrachms (10 mils). 30 ACIDUM HYPOPHOSPHOROSUM. Syrupus Hypophosphitum Compositus. Eng., Compound Syrup of Hypophosphites. Calcium Hypophosphite, 35 Gm.; Potassium Hypo- phosphite, 17.50 Gm.; Sodium Hypophosphite, 17.50 Gm.; Ferric Hypo- phosphite, 2.25 Gm.; Manganese Hypophosphite, 2.25 Gm.; Quinine, 1.10 Gm.; Strychnine, 0.115 Gm.; Sodium Citrate, 3.75 Gm.; Diluted Hypophos- phorous Acid, 15 mils; Sugar, 775 Gm.; Water, to make 1000 mils. Average Dose.-2 fluidrachms (8 mils). Official Glycerophosphates and Preparation. Calcii Glycerophosphas (Gen., Calcii Glycerophosphatis). Eng., Cal- cium Glycerophosphate. Form.-A white powder. Odor and Taste.-Odorless and almost tasteless. Solubility.-Soluble in 50 parts of water; somewhat hygroscopic. Insoluble in alcohol. Average Dose.-4 grains (0.25 Gm.). Sodii Glycerophosphas (Gen., Sodii Glycerophosphatis). Eng., Sodium Glycerophosphate. Form.-A white powder, plates or scales. Odor and Taste.-Odorless and having a saline taste. Solubility.-Very soluble in water; nearly insoluble in alcohol. Average Dose.-4 grains (0.25 Gm.). Liquor Sodii Glycerophosphatis. Eng., Solution of Sodium Glycero- phosphate. An aqueous solution containing about 50 per cent, of the salt. Average Dose.-6 minims (0.35 mil). Therapeutic Action.-Tonic. Uses.-The value of these preparations is seriously ques- tioned, but they have been, and still are, extensively used for general debility, neurasthenia, hysteria, phthisis, convalescence from ex- hausting fevers, etc. It is possible that the good results claimed are due to the fact that the compound syrup or solution is usually employed and these contain iron, strychnine and quinine in addition to the metallic hypophosphites or glycerophosphates. Administration.-The Hypophosphites are most frequently prescribed in the form of the Compound Syrup of Hypophosphites, which is either ordered alone or with other agents as additional Strychnine or the Tincture of Nux Vomica. The Emulsion of Cod- liver Oil with Hypophosphites is also a favorite form for adminis- tration. Many claim that there is no advantage from a combination as found in the syrups, and prefer to prescribe one or two alone. Calcium Hypophosphite seems to be the salt of choice under these circumstances. ACIDUM LACTICUM. ACIDUM NITRICUM. 31 These glycerophosphates are prescribed alone or combined with other agents. By far the most common use is as the unofficial compound solution or compound syrup. These contain the glycero- phosphates of calcium, sodium, potassium, iron, manganese, quinine, and strychnine. The hypophosphites may be ordered as: or Syr. Hypophos 2401 Sig.-Two (2) teaspoonfuls in water after meals. Or: or Syr. Hypophos. Co 240| Sig.-Teaspoonful in water after meals. Or: Tinct. Nucis Vomicae or fSj 301 Syr. Hypophos. Co 240 M. Sig.-Teaspoonful in water before meals. The following unofficial preparation is often used, particularly in phthisis, chronic bronchitis, etc.: or Emul. 01. Morrh. cum Hypophos Oj Sig.-Tablespoonful after meals. (Shake-label.) ACIDUM LACTICUM. Latin, Acidum Lacticum (Gen., Acidi Lactici). Eng., Lactic Acid. Formula, HC3H5O3. A colorless liquid containing about 85 per cent, of absolute Lactic Acid. Average Dose.-30 minims (2 mils). Therapeutic Action.-Astringent, irritant, caustic, antiseptic. Uses.-Sometimes used for the local lesions of diphtheria, scarlatina, tubercular laryngitis, etc. Seldom prescribed. Latin, Acidum Nitricum (Gen., Acidi Nitrici). Eng., Nitric Acid. Synonym, Aqua Fortis. Formula, HNO3. An aqueous solution containing about 68 per cent, of absolute Nitric Acid. ACIDUM NITRICUM. 32 ACIDUM NITROHYDROCHLORICUM. Therapeutic Action.-Caustic. Uses.-Nitric acid is used as a caustic to remove warts and other small growths, and to cauterize ulcers, particularly chancre and chancroid. ACIDUM NITROHYDROCHLORICUM. Latin, Acidum Nitrohydrochloricum (Gen., Acidi Nitrohydro- chlorici). Eng., Nitfohydrochloric Acid. Synonyms, Nitromuriatic Acid, Aqua Regia. Nitric acid, 18 mils; hydrochloric acid, 82 mils. Average Dose.-3 minims (0.2 mil). Official Preparation. Acidum Nitrohydrochloricum Dilutum . (Gen., Acidi Nitrohydro- chlorici Diluti). Eng., Diluted Nitrohydrochloric Acid. Nitric Acid, 10 mils; Hydrochloric Acid, 45.5 mils; Distilled Water, 194.5 mils. Average Dose.-15 minims (1 mil). Therapeutic Action.-Astringent, caustic, cholagogue. Uses.-Employed in gastric and intestinal indigestion, chronic diarrhea, hepatitis, hepatic cirrhosis, furunculosis, etc. Administration.-These, if prescribed, are usually ordered alone. They should be well diluted when taken. Used for furunculosis: or Acidi Nitrohydroch. Dil 90| Sig.-Fifteen (15) drops in water after meals. Care should be exercised to protect the teeth. ACIDUM OLEICUM. Latin, Acidum Oleicum (Gen., Acidi Oleici). Eng., Oleic Acid. Formula, HCi8H33O2. A yellowish or brownish-yellow oily liquid. ACIDUM PHENYLCINCHONINICUM. Latin, Acidum Phenylcinchoninicum (Gen., Acidi Phenylcin- choninici). Eng., Phenylcinchonic Acid. An organic acid. Average Dose.-8 grains (0.5 Gm.). ACIDUM PHOSPHORICUM. ACIDUM SALICYLICUM. 33 ACIDUM PHOSPHORICUM. Latin, Acidum Phosphoricum (Gen., Acidi Phosphorici). Eng., Phosphoric Acid. Synonyms, Syrupy Phosphoric Acid; Orthophos- phoric Acid. Formula, H3PO4. Form.-A liquid containing about 85 per cent, of absolute Or- thophosphoric Acid. Odor and Taste.-Odorless and strongly acid taste. Solubility.-Miscible with water or alcohol in all proportions. Incompatibles.-Practically all metallic salts except those of the alkali metals. Official Preparation. Acidum Phosphoricum Dilutum (Gen., Acidi Phosphorici Diluti). Eng., Diluted Phosphoric Acid. An aqueous liquid containing about 10 per cent, of absolute Orthophosphoric Acid. Average Dose.-30 minims (2 mils). i Therapeutic Action.-Has been classed as a tonic and altera- tive. Uses.-Sometimes employed in tonic preparations, particu- larly for conditions characterized by loss of appetite, indigestion, etc. Administration.-The following will serve to illustrate the way to prescribe the drug: R or Acidi Phosph. Dil., Tinct. Ferri Chlor., Tinct. Nucis Vom aa. f5j 30 Syr. Pruni Virg q. s. fSvj 180 M. Sig.-Teaspoonful in water after meals. ACIDUM SALICYLICUM. Latin, Acidum Salicylicum (Gen., Acidi Salicylici). Eng., Sali- cylic Acid. Formula, HC7H5O3. Form.-Fine, white needles or crystalline powder. Odor and Taste.-Almost odorless and having a sweetish, after- ward acrid taste. Incompatibles.-Spirit of nitrous ether, lead and iron salts, iodides, etc. Average Dose.-12 grains (0.75 Gm.). ACIDUM SALICYLICUM. 34 Therapeutic Action.-Antiseptic, germicide, antirheumatic, antipyretic. Uses.-Sometimes employed internally in the treatment of rheumatism. Locally-used for the removal of corns, etc.; also to remove the superficial layers of the skin and in the treatment of various skin diseases, as eczema, dermatitis, pruritus, and prickly heat. It is a common constituent of powders for dressing the cord stump of the newborn. Administration.-Internally.-Salicylic Acid is now not often prescribed in this way, but the effect is obtained by use of salicylates. When the acid is given as such it is usually ordered in capsules of 5 grains each. It is often prescribed with sodium bicarbonate to make fresh sodium salicylate. (See p. 37.) Externally.-Salicylic Acid is used in solution, powder and ointment: In the treatment of corns: R or Acidi Salicylici gr. xx 1 3 Ext. Cannabis gr. xx 1 3 Olei Ricini f3ss 2 0 Collodii Flex q. s. f5iv 15 0 M. Sig.-Apply as directed. In the treatment of diabetic vulvitis: Bi or Acidi Salicylici gr. x 165 Petrolati q. S. 5j 30 00 M. tere bene. Sig.-Use locally. As a dressing for the stump of the cord in obstetrical work: B or Acidi Salicylici gr. xv 11 Amyli q. s. 3iv 15| M. et tere bene. Sig.-For dressing umbilicus. This is usually applied freely on cotton when cord is first dressed and is not removed until the stump of the cord separates. 1 Ashton: Practice of Gynecology. ACIDUM SALICYLICUM. 35 In the treatment of psoriasis: Bi or Chrysarobini 3ss 2 0 Acidi Salicylici gr. xx 1 3 Athens f5j 4 0 Olei Ricini TH.X 6 Collodii q- s. ffj 30 0 M. Sig.-Paint on affected parts. As a dusting powder, as in the treatment of prickly heat: 3 Acidi Salicylici gr. xv Acidi Borici 3j Zinci Oxidi 5ij Amyli q. s. 5ij M. Sig.-Apply as directed. This is best applied by putting in a cloth bag and patting the affected parts with it, particularly after bathing. As a dusting powder in the treatment of hyperidrosis: B2 or Acidi Salicyl. Pulv gr. xx 1 3 Acidi Borici Pulv 3v 19 0 Zinci Oxidi 3iij 12 0 M. Sig.-Apply as directed. In an ointment, as in the treatment of dermatitis from drugs, poison ivy, etc.: or Acidi Salicylici gr. x 6 Amyli 3j 4 0 Ung. Zinci Oxidi ... 3ij 8 0 Adipis Lanae.Hyd. . 3ij 8 0 Petrolati q- S. 5j 30 0 M. Sig.-Apply freely as directed. 1 Stelwagon: Diseases of the Skin. 2 Ibid. 36 ACIDUM SALICYLICUM. Official Salicylates. Incompatibles of Salicylates.-Hydrobromic acid, mineral acids, ferric salts, lead acetate, lime-water, quinine salts (in solution), spirit of nitrous ether, silver nitrate (in solution), sodium phosphate (in powder). AMMONII SALICYLAS (Gen., Ammonii Salicylatis). Eng., Am- monium Salicylate. Formula, NH4C7H5O3. Form-Colorless prisms; plates or powder. Odor and Taste.-Odorless and having a slight saline, bitter taste, with a sweetish after-taste. Solubility.-In 1 part of water or 3 parts of alcohol. Average Dose.-8 grains (0.5 Gm.). SODII SALICYLAS (Gen., Sodii Salicylatis). Eng., Sodium Salicy- late. Formula, NaCyHsOs. Form.-A white powder or having not more than a faint pink tinge. Odor and Taste.-Odorless and having a sweetish saline taste. Solubility.-In 0.9 part of water or 9.2 parts of alcohol. Average Dose.-15 grains (1 Gm.). STRONTII SALICYLAS (Gen., Strontii Salicylatis). Eng., Stron- tium Salicylate. Formula, Sr(C7HsO3)2 + 2 H2O. Form.-A white powder. Odor and Taste.-Odorless and having a sweetish saline taste. Solubility.-In 19 parts of water or 61 parts of alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antipyretic, antirheumatic and anti- septic. Uses.-Extensively used in the treatment of rheumatism, gout, tonsillitis, and kindred conditions, as endocarditis and chorea, and for neuralgia. Recommended for iritis and various other eye conditions. Sometimes used for goiter. Administration.-It will be noted that these salts are prac- tically white, odorless powders with a sweetish taste and, with the exception of Strontium, they are freely soluble in water. They are usually prescribed in solution, but sometimes in capsules, either alone or with other agents. The sweetish taste is rather nauseating to some patients. Not more than 5 or 6 grains of a salicylate can be ordered to a capsule, which practically eliminates this form of administration. Sodium Salicylate is by far the most commonly used of these salts. When an alkaline salicylate is introduced into the stomach con- taining free hydrochloric acid, salicylic acid is precipitated; so it cer- tainly seems desirable to prevent this by the use of such agents as sodium bicarbonate or magnesia magma (milk of magnesia). The ACIDUM SALICYLICUM. 37 latter is particularly useful where intestinal elimination is desir- able. The sodium bicarbonate is recommended in dose about twice the weight of the salicylate. The Milk of Magnesia of course is a mild antacid. In some conditions the best results seem to be obtained by using large doses, as 100 grains per day, and concentrating this into a short period, much as quinine is used in malaria. Such dosage may cause discomfort if given in the early part of the day, and may incapacitate a patient who might otherwise continue active. Prob- ably the best plan is to give, say, 20 grains at 2, 4, 6 and 8 p.m. and at 10 p.m., if too much dizziness, nausea, etc., has not been induced; the patient then can sleep through what might be the uncomfortable period. When a salicylate is ordered, the salt made with the synthetic salicylic acid is supplied, unless definitely specified to the contrary. The salt made from the "true" acid is many times as expensive, and, it is claimed, on good authority, that the action in every particular is the same as the synthetic product. Many experienced clinicians still claim that the "true" salt is better tolerated, and con- tinue to employ it. For administering the drug alone the following method is a desirable one: R or Sodii Salicylatis 3y 201 Aquae Menthae Pip q. s. f5ij 60| M. Sig.-Teaspoonful in water at 2, 4, 6, 8, and 10 p.m. Patient may be given 40 gram powders of Sodium Bicarbonate to take one with each dose. Used in the treatment of rheumatism: Ri or Sodii Salicylatis Sss 15 Sodii Bicarbonatis 3ij 8 Aquae Menthae Pip q. s. f3iv 120 M. Sig.-Two (2) teaspoonfuls well diluted as directed. 5 or Acidi Salicylici gr. clx 10 Sodii Bicarbonatis gr. cxx 8 Aquae Menthae Pip q. s. f^iv 120 M. Sig.-Tablespoonful in water as directed. 1 Musser and Kelly: Practical Treatment. 38 ACIDUM SALICYLICUM. This gives a slightly alkaline solution containing about 20 grains of sodium salicylate to the tablespoonful. It should not be dis- pensed till after standing about one hour. More'sodium bicarbonate can be used if desired. The "natural" or "true" salt from the oil of wintergreen may be prescribed as follows: or Sodii Salicylatis (O.W.) 3v 201 Aquae Menthae Pip q. s. f3ij 601 M. Sig.-Teaspoonful in water as directed. Sodium bicarbonate or milk of magnesia may be ordered added to each dose. Or: R or Acidi Salicylic! (O.W.) gr. clx 10| Sodii Bicarbonatis gr. cxx 8I Tinct. Colchici Sem f3ij 8I Aquae Menthae Pip q. s. f5iv 1201 M. Sig.-Tablespoonful in water at 2, 4, 6, 8, and 10 p.m. In the treatment of rheumatism, tonsillitis, endocarditis, etc.: or Sodii Salicylatis, Sodii Bicarbonatis aa. gr. clx 10 Spir. Chloroformi f3ij 8 Aquae Menth. Pip q. s. f?iv 120 M. Sig.-Tablespoonful in water every three hours until effect. The patient is instructed to discontinue for that day when ring- ing in the ears, dizziness, etc., develop. In the treatment of rheumatism, gout, etc.: or Sodii Salicylatis 3iv 15 Sodii Bicarbonatis .... 3ij 8 Vin. Colchici Sem f3iv 15 Aquas Chloroformi q. s. f3ij 60 M. Sig.-Teaspoonful in water as directed. ACIDUM SALICYLICUM. 39 BISMUTHI SUBSALICYLAS.-See Bismuth, p. 95. HYDRARGYRI SALICYLAS.-See Hydrargyrum, p. 181. PHYSOSTIGMINE SALICYLAS.-See Physostigma, p. 261. QUININE SALICYLAS.-See Cinchona, p. 130. PHENYLIS SALICYLAS (Gen., Phenylis Salicylatis). Eng., Phenyl Salicylate. Synonym, Salol. Formula, C13H10O3. Form.-A white crystalline powder. Odor and Taste.-A faint aromatic odor and a slight but characteristic taste. Solubility.-In 6670 parts of water or 6 parts of alcohol. Very soluble in ether, chloroform or oils. Incompatibles.-Liquefies when triturated with camphor, phenol, hydrated chloral, thymol. Also general incompatibles of other salicylates. Average Dose.-5 grains (0.3 Gm.). Therapeutic Action.-Antirheumatic, intestinal antiseptic, anthelmintic, analgesic, antipyretic. Uses.-Extensively employed as an intestinal antiseptic in the treatment of diarrhea, dysentery, typhoid fever, intestinal parasites, etc. Recommended in the treatment of gonorrhea, cys- titis, and other genito-urinary conditions. Sometimes employed where salicylates are indicated, as for rheumatism, tonsillitis, etc. Administration.-Phenyl Salicylate is often prescribed alone in capsules; but this is rather undesirable, as it is so nearly insoluble that concretions of the drug might result after the gelatin of the capsule has been dissolved. A thoroughly agreeable way of adminis- tering is in powders, as the drug is so nearly odorless and tasteless. As it is readily soluble in oils it may be dissolved in olive oil and taken that way or the oil made into an emulsion. The drug must be given with some caution on account of the Phenol content. When given alone Phenyl Salicylate is best given in powders, as: B or Phenylis Salicylatis 5j Ft. cht. no. xij. Sig.-One every four hours. Or it may be ordered in suspension, as: or Phenyl. Salicyl 5ij 8 Muc. Acaciae f3iv 15 Syr. Tolutani q. s. f3ij 60 M. Sig.-Teaspoonful every four hours. (Shake-label.) 40 ACIDUM SALICYLICUM. Used in the treatment of influenza: Bi or Phenylis Salicylatis, Acetphenetidini aa. gr. xlv 3 0 Pulv. Ipecac, et Opii gr. viij 5 M. ft. cap. no. xv. Sig.-One every three hours. In the treatment of the diarrhea of typhoid fever: R2 or Phenylis Salicyl 21 Bismuthi Subsalicyl 3j 4| M. ft. cht. no. x. Sig.-One after each stool. Used for the relief of abdominal tympany: R3 or Phenylis Salicyl gr. xx 1|3 Bismuthi Subnit gr. L- 3|0 M. ft. cap. no. x. Sig.-One two hours after each meal. In the treatment of coryza: B4 or Phenylis Salicylatis 3j <1 Acetphenetidini 2I M. ft. cht. no. xij. Sig.-One every two hours till relieved. Phenyl Salicylate is frequently ordered as the coating for enteric pills, as in the treatment of amebic dysentery. Both the ipecac and the salt are probably desirable. R or Ipecacuanha Pulv gr. ccl 16| Phenylis Salicylatis q. s. Ft. pil, ent. no. L. Sig.-Take as directed. Detailed written instructions should be left with the patient. About 3 to 4 grains of the salt is usually employed for each pill. 1 Musser and Kelly: Practical Treatment. 2 Hughes: Practice of Medicine. 3 Ashton: Practice of Gynecology. 4 Musser and Kelly: Practical Treatment. ACIDUM SALICYLICUM. 41 When 10 or more pills are given at one time it necessitates a fairly large dose of the drug, but no ill effects seem to have been noted. METHYLIS SALICYLAS (Gen., Methylis Salicylatis). Eng.; Methyl Salicylate. Synonyms, Oleum Gaultheriae, Oil of Gaultheria, Oil of Wintergreen, Oleum Betulae, Oil of Sweet Birch, Oil of Teaberry. It is produced synthetically or is obtained by distillation from Gaultheria procumbens or from Betula lenta. The label must indicate whether the methyl salicylate has been made synthetically or distilled from either of the above-mentiond plants. Form.-A colorless, yellowish or reddish liquid. Odor and Taste.-The characteristic odor and taste of Gaultheria. Solubility.-Sparingly soluble in water, freely miscible with alcohol. Average Dose.-12 minims (0.75 mil). 1 Therapeutic Action.-Antipyretic, antirheumatic, antiseptic. Uses.-Sometimes used internally in place of salicylic acid or the mineral salts, but has many disadvantages, as taste, odor, liquid form, etc., and possesses no marked advantages. Externally.-Sometimes used in local applications in conjunc- tion with the internal administration of other salicylates. ACIDUM ACETYLSALICYLICUM (Gen., Acidi Acetylsalicylici). Eng., Acetylsalicylic Acid. Aspirin (not official). Form.-A white crystalline powder. Odor and Taste.-Odorless and having a faintly acid taste. Solubility.-Slightly soluble in water, soluble in alcohol. Average Dose.-7% grains (0.500 Gm.). Therapeutic Action.-Anodyne, hypnotic, antipyretic, diapho- retic, antirheumatic. Uses.-Extensively used for the relief of headaches and some other classes of pain; also for rheumatism, gout, tonsillitis, colds, in- fluenza, etc. Recommended for exophthalmic goiter. Probably disturbs the digestive apparatus less than the other salicylates, but depresses more. Administration.-Its comparative insolubility and its freedom from unpleasant odor or taste render its administration more con- venient in powders or capsules. The capsules are usually preferred. Prescribed alone for headache: or Acidi Acetylsalicyl 2I Ft. cap. no. vj. Sig.-One (1) every three hours till relieved. 42 ACIDUM STEARICUM. For influenza, colds, etc.: R or Camphorae Monobrom., Quininae Hydrobrom aa gr. xv 1 [0 Acidi Acetylsalicyl gr. xl 2|5 M. ft. cap. no. xij. Sig.-Four (4) tonight, then one every four hours. The first night a capsule may be ordered every hour till four are taken. For rheumatic pain: B or Acidi Acetylsalicyl gr- l 31 Phenylis Salicylatis gr. Ixxv 5| M. ft. cht. no. x. Sig.-One (1) every four hours. Latin, Acidum Stearicum (Gen., Acidi Stearici). Eng., Stearic Acid. A hard, white, somewhat glossy solid. ACIDUM STEARICUM. Latin, Acidum Sulphuricum (Gen., Acidi Sulphurici). Eng., Sulphuric Acid. Synonym, Oil of Vitriol. Formula, H2SO4. Form.-A heavy, colorless liquid containing not less than 93 nor more than 95 per cent, of absolute Sulphuric Acid. Odor and Taste.-Odorless; strongly acid taste. Solubility.-Miscible in all proportions with water or alcohol- with evolution of much heat. Incompatibles.-Alkaline carbonates and hydroxides; salts of barium, calcium, lead and silver; vegetable astringents, etc. ACIDUM SULPHURICUM. Official Preparations. Acidum Sulphuricum Aromaticum (Gen., Acidi Sulphurici Aromatici). Eng., Aromatic Sulphuric Acid. Synonym, Elixir of Vitriol. Sulphuric Acid, 109 mils; Tincture of Ginger, 50 mils; Oil of Cinnamon, 1 mil; Alcohol, to 1000 mils. Contains about 20 per cent, by weight of absolute sulphuric acid. Average Dose.-15 minims (1 mil). Acidum Sulphuricum Dilutum (Gen., Acidi Sulphurici Diluti). Eng., Diluted Sulphuric Acid. Contains about 10 per cent, of absolute sulphuric acid and 90 per cent, of water. Average Dose.-30 minims (2 mils). ACIDUM SULPHUROSUM. 43 Therapeutic Action.-Escharotic, astringent. Uses.-The principal employment is in diarrhea preparations, and in quinine solutions for the treatment of malaria or for general tonic purposes. Administration.-Sulphuric Acid is usually employed in the form of the diluted or the aromatic acid. They should always be well diluted when taken. Some methods of prescribing are shown in the following: As a part of the treatment of comedo: R or Magnesii Sulphatis 3iss 45 Ferri Sulphatis gr. xvj 1 Acidi Sulph. Dil f5ij 8 Aquae q. s. fSviij 240 M. Sig.-Tablespoonful in water before breakfast. In the treatment of diarrhea: or Magnesii Sulphatis 3iv 15 0 Tinct. Opii Deod ntxl 2 5 Acidi Sulph. Arom f3iss 6 0 Aquae Menthae Pip q. s. fSiv 120 0 M. Sig.-Tablespoonful every four hours till relieved. To effect the solution of quinine, as in a preparation for malaria: or Quininae Sulph 5iss 6 Acidi Sulph. Aroin f3ij 8 Liq. Acidi Arsenosi f5ij 8 Aquae q. s. f3iv 120 M. Sig.-Teaspoonful in water after meals. ACIDUM SULPHUROSUM. (U. S. P., viii-Not Official.) Latin, Acidum Sulphurosum (Gen., Acidi Sulphurosi). Eng., Sulphurous Acid. Formula, H2SO3. Form.-A colorless liquid containing not less than 6 per cent, by weight of Sulphur Dioxide and about 94 per cent, of water. Odor and Taste.-A pungent, disagreeable odor and acid taste. 44 ACIDUM TANNICUM. Solubility.-Miscible in all proportions with water or alcohol. Incompatibles.-Those of sulphuric acid may apply. Average Dose.-30 minims (2 mils). Therapeutic Action.-Antiseptic, germicide, disinfectant. Uses.-Principally used in the treatment of such conditions as tonsillitis, pharyngitis, diphtheria, stomatitis, etc. Has been recommended for flatulence, vomiting, etc. Administration.-It should be well diluted when taken. Prob- ably the most frequent employment is shown in the treatment of throat diseases. The following illustrates: Potassii Chloratis 5j or 4 Tinct. Ferri Chloridi f3ij 8 Acidi Sulphurosi f3iij 12 Glycerini f3iv 1S| Aquae q. s. f3iv 1201 M. Sig.-Tablespoonful in water every two hours. ACIDUM TANNICUM. Latin, Acidum Tannicum (Gen., Acidi Tannici). Eng., Tannic Acid. Synonyms, Tannin, Gallotannic Acid. Formula, HC14H9Og. A tannin usually obtained from nutgalls. Form.-A yellowish-white to light-brown powder. Odor and Taste.-Almost odorless and having a strong astring- ent taste. Solubility.-Very soluble in water, alcohol or glycerin. Incompatibles.-Salts of antimony, copper, iron, lead, mercury and silver; chlorates, permanganates and other oxidizers; alkaloids, spirit of nitrous ether, lime-water, albumin, etc. Average Dose.-8 grains (0.5 Gm.). Glyceritum Acidi Tannici (Gen., Glyceriti Acidi Tannici). Eng., Glycerite of Tannic Acid. A thick, heavy liquid containing 20 per cent, of Tannic Acid dissolved in Glycerin. Average Dose.-30 minims (2 mils). Trochisci Acidi Tannici-(Gen., Trochiscorum Acidi Tannici). Eng., Troches of Tannic Acid. Each troche contains about 1 grain of Tan- nic Acid. Unguentum Acidi Tannici (Gen., Unguenti Acidi Tannici). Eng., Ointment of Tannic Acid. An ointment containing 20 per cent, of Tan- nic Acid. Official Preparations. ACIDUM TANNICUM. 45 Therapeutic Action.-Astringent and styptic. Uses.-Used as a local application in tonsillitis, pharyngitis, etc.; also to arrest bleeding from nasal, gastric or other mucous membrane. Frequently employed as such or more commonly as a tannate in the treatment of diarrhea or dysentery. Used as such or in the form of catechu, tea, etc., as an antidote for poisoning with alkaloids, tartar emetic, etc. Administration.-Internally. Tannic Acid is seldom pre- scribed as such, but agents containing it are employed, as tincture of kino, tincture of catechu, etc. Locally it is used in dusting powders, ointments, solutions and suppositories. Some formulae are illustrated in the following: In the treatment of salivation: Ri or Acidi Borici, Acidi Tannici aa. gr. xl 2 5 Meilis Rosae f3ij 8 0 Aquae q. s. f3vj 180 0 M. Sig.-Use as a mouth-wash every two hours. As an application in the treatment of tonsillitis, pharyngitis, etc.: or Tinct. lodi f3ij 81 Glyc. Acidi Tannici q. s. f5j 30 M. Sig.-Apply twice daily. It is sometimes prescribed in suppositories, as in the following for hemorrhoids: R or Ext. Stramonii gr. iij 20 Acidi Tannici gr. xij 75 Plumbi Acetatis gr. iij 20 01. Theobromatis q- s. M. ft. suppos. no. vj. Sig.-Use one night and morning. In enemas it is sometimes employed, as in the following for dysentery: n or Acidi Tannici gr. xl 2150 Acidi Borici 5iv 1500 M. Sig.-Use a heaping teaspoonful in quart of hot water as enema. 1 White and Martin: Genito-urinary and Venereal Diseases. 46 ACIDUM TARTARICUM. ACONITUM. As an antidote in alkaloidal or tartar-emetic poisoning, where tannic acid as such cannot be obtained, strong tea, tincture of catechu, tincture of kino, etc., may be used. ACIDUM TARTARICUM. Latin, Acidum Tartaricum (Gen., Acidi Tartarici). Eng., Tar- taric Acid. Formula, H2C4H4O6. An organic acid usually pre- pared from Argol-the sediment in wine casks. Form.-Usually a white powder. Odor and Taste.-Odorless and with an acid taste. Solubility.-In 0.75 part of water and 3.3 parts of alcohol. Incompatibles.-Salts of calcium, mercury, lead, etc. Average Dose.-8 grains (0.5 Gm.). Tartaric Acid enters into a large percentage of the effervescing prepara- tions. Therapeutic Action.-Refrigerant, astringent, antiseptic. Uses.-Used in pharmaceutical manufacturing, but not often a prescription ingredient. Administration.-For effect potassium bitartrate or potassium and sodium tartrate are used. Official Preparations. ACIDUM TRICHLORACETICUM. Latin, Acidum Trichloraceticum (Gen., Acidi Trichloracetici). Eng., Trichloracetic Acid. Form.-White, soluble, deliquescent crystals. Therapeutic Action.-Caustic, germicide. Uses.-It is used as a caustic in the treatment of ulcers, new growths, etc. Seldom prescribed. ACONITINA. See Aconitum. ACONITUM. Latin, Aconitum (Gen., Aconiti). Eng., Aconite. Synonyms, Monkshood, Wolf bane, Aconite Root. The dried tuberous root of Aconitum napcllus. Principal Constituents.-Aconitine, about 0.5 per cent. Average Dose.-% grain (0.03 Gm.). ACONITUM. 47 Official Preparations. Extractum Aconiti (Gen., Extracti Aconiti). Eng., Extract of Aconite. A powder about four times the strength of the powdered root. Average Dose.-% grain (0.01 Gm.). Fluidextractum Aconiti (Gen., Fluidextracti Aconiti). Eng., Fluidex- tract of Aconite. Average Dose.-% minim (0.03 mil). Tinctura Aconiti (Gen., Tincturae Aconiti). Eng., Tincture of Aconite. Represents 10 per cent, of Aconite, in alcohol 70 per cent, and water 30 per cent. Average Dose.-5 minims (0.3 mil). Before the eighth revision of the Pharmacopoeia this preparation was 35 per cent., so allowance must be made for dosage given in old books. Aconitina (Gen., Aconitine). Eng., Aconitine. Average Dose.-}4oo grain (0.00015 Gm.). Therapeutic Action.-Depressant, antipyretic (?), diaphoretic, antiseptic, local anodyne. Uses.-This drug is not used as much as formerly. It is sometimes given in the early stages of fevers of the sthenic type, as pneumonia, bronchitis, tonsillitis, etc. Recommended in combina- tion with other agents for the reduction of high blood-pressure. Locally the tincture is extensively used in combination with tincture of iodine as an application in the treatment of tonsillitis, diphtheria, scarlatina, toothache, swollen glands, furuncles, infections, etc. Administration.-Aconite is usually employed in the form of the tincture either alone or with other agents. It is miscible with water or alcohol in any proportions. Aconitine is seldom prescribed or used. It is sometimes administered hypodermically by the physician. The manner of prescribing is shown in the following: In the treatment of the primary stages of conditions character- ized by high temperature, tension, etc.: or Sodii Citratis 3iv 15 Tinct. Aconiti f5iss 6 Spir. JEtheris Nit f5iv 15 Aquae Menth. Pip fSij 60 M. Sig.-Teaspoonful in water every three hours until relieved. 48 ACONITUM. Or: Ri or Tinct. Aconiti tn, xx 1 3 Liq. Ammonii Acet fSij 60 0 Liq. Potassii Cit q. s. f5iv 120 0 M. Sig.-Tablespoonful in water every two hours. In the interval treatment of spasmodic laryngitis: R2 or Tinct. Aconiti ntviij 5 Syr. Ipecacuanhas f3iss 6 0 Tinct. Opii Camph f3iij 12 0 Liq. Potassii Cit q. s. f5iij 90 0 M. Sig.-Teaspoonful in water every two hours. (Shake-label.) As a local application for toothache, inflamed glands, furuncle, etc.: n or Tincturae lodi, Tincturae Aconiti aa. f$ss 151 M. Sig.-Apply as directed. (Poison-label.) In the treatment of neuralgia (to be applied with friction along the course of the affected nerve) : $3 Tinct. Aconiti, or Chloroformi aa. f3iv 15 Lin. Saponis q. s. f5iv 120 M. Sig.-Apply as directed. (Poison-label.) In the treatment of epididymitis: H4 or Tincturae Aconiti, Tincturae Opii aa. f^j 30 Liq. Plumbi Subacet f5ij 60 Aquae q. s. f5vj 180 M. Sig.-Saturate cotton and keep applied. i Hughes: Practice of Medicine. 2 Ibid. 3 Shoemaker: Materia Medica and Therapeutics. 4 White and Martin: Genito-urinary and Venereal Diseases. ADEPS. 49 ADEPS. Latin, Adeps (Gen., Adipis). Eng., Lard. The purified inter- nal fat'of the abdomen of the hog. Official Preparation. Adeps Benzoinatus (Gen., Adipis Benzoinati). Eng., Benzoinated Lard. A soft, white solid containing the soluble constituents of 1 per cent, of Benzoin. Odor and Taste.-Pleasant odor, bland taste. Incompatibles.-Aqueous and alcoholic liquids. Therapeutic Action.-Emollient. Uses.-It is used as a vehicle for ointments. It is not as fre- quently employed as petrolatum or ointment of rose-water. It is more apt to become rancid on the druggist's shelves, or if kept for an extended time by the patient. In some localities it is so seldom employed that it is difficult to obtain a usable article. Administration.-The following illustrate the employment of lard in prescribing: In the treatment of scabies: or Sulphuris Loti, Olei Cadini, Cretae Praep aa. 5ij 8 Saponis Mollis 5v 19 Adipis q. s. 3ij 60 M. Sig.-Rub in thoroughly. Used in the treatment of grain-itch: Ri or Betanaphtholis gr. xxx 2 0 Sulphuris Praecip gr. xl 2 5 Adipis Benzoinati q. s. 5j 30 0 M. Sig.-Apply as directed. 1 Musser and Kelly: Practical Treatment. 50 ADEPS LAN^. ADEPS LANJE. Latin, Adeps Lanae (Gen., Adipis Lanae). Eng., Wool-fat. The purified fat of the wool of sheep, freed from water. Used almost exclusively in the form of the Official Preparation. Adeps Lanae Hydrosus (Gen., Adipis Lanae Hydrosi). Eng., Hydrous Wool-fat. Synonym, Lanolin. The purified fat of the wool of the sheep combined with not less than 25 nor more than 30 per cent, of water. Form.-A nearly white, ointment-like mass. Odor and Taste.-Very slight odor or taste. Solubility.-Insoluble in water or alcohol. Therapeutic Action.-Emollient. Uses.-This is an excellent vehicle for ointments where ab- sorption is desirable. It is used as a vehicle itself, but more fre- quently combined with other agents. Administration.-The hydrous preparation is used almost ex- clusively. It is particularly employed as an ointment base where absorption of the active constituents through the skin is desired. Owing to its rather sticky character it is seldom employed alone. The following illustrate its use: In the treatment of tinea barbae: or Chrysarobini 3ss 2 Adipis Lanae Hyd 5ss 15 Ung. Aquae Rosae * q. s. 3j 30 M. Sig.-Apply thoroughly once a day. In the treatment of eczema of the scrotum: or Camphorae, Chlorali Hydrati aa. gr. xx 1 3 Adipis Lanae Hyd 5ss 15 0 Ung. Aquae Rosae q- s. 5j 30 0 M. Sig.-Apply liberally several times daily. AETHER. 51 In the treatment of acute bronchitis: Bi Guaiacolis or 2 Methylis Salicyl ; f5j 4 Adipis Lanae Hyd q- s. Sj 30 M. Sig.-Apply to chest as directed. In the treatment of dermatitis: R2 or Phenolis gr. xij 8 Bismuthi Subnit 3iss 6 0 Adipis Lanae Hyd 3ij 8 0 Ung. Zinci Oxidi q- s. 3j 30 0 M. Sig.-Apply locally. ^THER. Latin, AZther (Gen., Athens). Eng., Ether. Synonyms, Sul- phuric Ether; Ethyl Ether. Formula (C2H5)2O. Form.-A colorless liquid. Odor and Taste.-Characteristic odor and a burning and sweet- ish taste. Solubility.-In about 12 volumes of water. Miscible in all pro- portions with alcohol. Average Dose.-15 minims (1 mil). Official Preparation. Spiritus Athens (Gen., Spiritus ALtheris). Eng., Spirit of Ether. Synonyms, Hoffmann's Anodyne, Hoffmann's Drop. Ether, 325 mils; Alcohol, to 1000 mils. Average Dose.-1 fluidrachm (4 mils). Formerly there were two spirits of ether, the above and another known as the Compound Spirit of Ether, which contained, in addition to 32.5 per cent, of Ether, 2.5 per cent, of Ethereal Oil. It was this latter preparation which was known as Hoffmann's Anodyne. Therapeutic Action.-Anesthetic; also variously classed as a stimulant, sedative, anodyne, antispasmodic, carminative, dia- phoretic, anthelmintic. It should be remembered that the Spirit of Ether is a habit-forming drug. 1 Musser and Kelly: Practical Treatment. 2 Ashton: Practice of Gynecology. 52 EITHER. Uses.-Extensively employed by inhalation for general anaes- thesia. By needle it is recommended in shock, poisoning by certain narcotics, etc. By mouth the spirit is used in the treatment of acute indigestion, flatulence, hysteria and abdominal cramps of in- testinal origin. Locally it is used for cleaning the skin and some- times as a spray for local anesthesia. Administration.-Ether is seldom prescribed as such. The Spirit of Ether is the preparation of common choice, and is either prescribed alone or with other agents. In the treatment of acute indigestion, particularly in hysterical patients: or Spir. JEtheris, Tinct. Valerianae Am aa. fXss 151 M. Sig.-Teaspoonful in water every two hours if necessary. Used in the treatment of acute indigestion: Ri or Tinct. Opii Camph fSiij 12 Spir. Ammoniae Arom., Spir. Athens aa f3ss 15 Tinct. Lavandulae Comp q. s. fjij 60 M. Sig.-Teaspoonful well diluted every fifteen minutes until relieved. In the treatment of flatulence, hysteria, etc.: R2 or Sodii Bicarbonatis gr. xl 3 Spir. Ammonise Arom., Tinct. Zingiberis aa. f3ss 15 Spir. Athens q. S. f5ij 60 M. Sig.-Two (2) teaspoonfuls in water. Repeat when necessary. (Shake- label.) In the treatment of psoriasis: R3 or Chrysarobini 3j 4 0 Acidi Salicylici 1 3 Athens f5j 4 0 Olei Ricini TT[X 6 Collodii q. s. f5j 30 0 M. Sig.-Paint on affected parts. 1 Musser and Kelly: Practical Treatment. 2 Shoemaker: Materia Medica and Therapeutics. 3 Stelwagon: Diseases of the Skin. SPIRITUS 2ETHERIS NITROSI. 53 SPIRITUS AETHERIS NITROSI. Latin, Spiritus 2Etheris Nitrosi (Gen., Spiritus .Etheris Nitrosi). Eng., Spirit of Nitrous Ether. Synonym, Sweet Spirit of Nitre. Contains about 4 per cent, of Ethyl Nitrite. Form.-A clear, yellowish liquid. Odor and Taste.-Fragrant ethereal odor and burning taste. Solubility.-Miscible in all proportions with water or alcohol. Incompatibles.-Acacia, acetanilide, acetphenetidin, antipyrine, carbonates, iodides, tannic acid, ferrous sulphate, fluidextract of buchu, tincture of guaiac, etc. Average Dose.-30 minims (2 mils). Official Preparation. Spirit of Nitrous Ether is contained in Mistura Glycyrrhizae Composita. Therapeutic Action.-Recommended as a diuretic, diaphoretic, antipyretic. Uses.-Used in the treatment of retention of urine, renal colic, gonorrhea, etc.; also in the early stages of bronchitis, colds, etc., particularly in children. Administration.-Spirit of Nitrous Ether is prescribed alone or with other agents. Prescribed alone, as in acute retention of urine, renal colic, etc.: or Spir. TEtheris Nit fSj 30| Sig.-Teaspoonful in hot lemonade every two hours until relieved. In a diuretic combination, as in the treatment of renal colic, cys- titis, gonorrhea, retention of urine, etc.: Sodii Citratis 3vj or 23 Tinct. Belladon. Fol f5ij 8 Spir. TEtheris Nit f5iss 45 Aquae q. s. fBiij 90 M. Sig.-Teaspoonful in glass of water every four hours. Used as an antipyretic in the acute diseases of childhood: Ri or Tinct. Aconiti nxvj 1 Spin 2Etheris Nit f3iij 12 Liq. Potassii Cit q. s. fXij 60 M. Sig.-Teaspoonful every two hours. 1 Hughes: Practice of Medicine. 54 A£THYL1S CARBAMAS. ASTHYL1S CHLORIDUM. In the treatment of ascites: Bi or Potassii Acetatis 5j 30 Spir. JEtheris Nit 15 Inf. Digitalis q. S. f3iv 120 M. Sig.-Two (2) teaspoonfuls every six hours. In the treatment of bronchitis, cough, etc. (for child 4 years old): R Sodii Citratis or gr. Ixxx 5 Spir. Athens Nit f3ij 8 Syr. Ipecacuanhas f3ss 2 Syr. Limonis f3iv 15 Aquae q. s. f5ij 60 M. Sig.-Teaspoonful in water every two hours. This quantity of ipecac may produce nausea in some patients. jETHYLIS carbamas. Latin, /Ethylis Carbamas (Gen., /Ethylis Carbamatis). Eng., Ethyl Carbamate. Form.-Colorless crystals or scales. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Hypnotic. Uses.-It is used to induce sleep when the insomnia is not the result of pain or discomfort. Seldom prescribed. ^THYLIS CHLORIDUM. Latin, 2Ethylis Chloridum (Gen., ^Ethylis Chloridi). Eng., Ethyl Chloride. A colorless liquid. Therapeutic Action.-Anesthetic. Uses.-Employed to produce local and general anesthesia. It is used as a general anesthetic when only a brief period of uncon- sciousness is desired, or when rapid effect is wished. It is often used at the beginning of anesthesia, and then followed by ether. As a local anesthetic it acts by rapid evaporation from the sur- face on which it is sprayed; heat is removed and the part may be rapidly frozen. Ethyl Chloride is on the market in bottles, but the most con- 1 Hughes: Practice of Medicine. JETHYLMORPHINAL HYDROCHLORIDUM. ALCOHOL. 55 venient package for general use is that equipped with a device that permits a part to be used as a spray and the balance retained. ^THYLMORPHINyE HYDROCHLORIDUM. See Opium, p. 239. Latin, Agar. Eng., Agar. Synonym, Agar-agar. A dried, mucilaginous substance abstracted from certain marine Algae grow- ing along the coast of Asia. Odor and Taste.-Almost odorless and tasteless. Average Dose.-2% drachms (10 Gm.). Uses.-Employed in the treatment of constipation. Administration.-It is usually ordered to be taken with some cereal at mealtime. AGAR. ALCOHOL. Latin, Alcohol (Gen., Alcoholis). Eng., Alcohol. Synonyms, Spiritus Rectificatus, Spiritus Vini Rectificatus, Rectified Spirit, etc. Formula, C2H5OH. Form.-A colorless liquid containing not less than 94.9 per cent, by volume of absolute Ethyl Alcohol. Odor and Taste.-Slight odor and burning taste. Solubility.-Miscible in all proportions with water, chloroform, ether, glycerin and most oils. Incompatibles.-Acacia, albumin, bromine, chlorine, chromium trioxide, permanganates. Alcohol is a constituent of the majority of official liquids, as fluidextiacts, spirits, tinctures, wines, etc. Alcohol Dehydratum (Gen., Alcoholis Dehydrati). Eng., Dehydrated Alcohol. Synonym, Absolute Alcohol. A liquid containing not less than 99 per cent, of C2H5OH. Alcohol Dilutum (Gen., Alcoholis Diluti). Eng., Diluted Alcohol. Synonym, Proof Spirit. Alcohol, 500 mils; water, 500 mils. Official Preparations. Spiritus Vini Gallici (Gen., Spiritus Vini Gallici). Eng., Brandy. Con- tains from 44 to 55 per cent, by volume of absolute alcohol. Spiritus Frumenti (Gen., Spiritus Frumenti). Eng., Whiskey. Con- tains from 44 to 55 per cent, by volume of absolute alcohol. Vinum Album (Gen., Vini Albi). Eng., White Wine. Contains from 8.5 to 15 per cent, by volume of absolute alcohol. Vinum Rubrum (Gen., Vini Rubri). Eng., Red Wine. Contains 8.5 to 15 per cent, by volume of absolute alcohol. Unofficial Preparations. 56 ALCOHOL. Vinum Xericum (Gen., Vini Xerici). Eng., Sherry Wine. Usually contains about 15 per cent, of alcohol. Therapeutic Action.-Antiseptic, germicide, diaphoretic, pos- sibly stimulant, hypnotic and nutrient. Uses.-Used in medicine as a preservative and solvent. Ex- tensively employed for cleaning the skin for operations and for cleansing instruments. Used in antiseptic solutions for dress- ing wounds, infections, etc., and for suppurative conditions, as otitis media. Recommended as a dressing to abort furuncles, felons, etc. Alcohol as such, or various dilutions, are used for giving sponge baths to reduce temperature in febrile conditions and to prevent bedsores in protracted illness. It is sometimes used in concen- tration to harden the skin, so as to prevent chafing from trusses or other mechanical devices, and to relieve local areas of excessive perspiration. Internally alcoholic liquids are frequently em- ployed for pneumonia, bronchitis, etc., and brandy, particularly, is quite frequently used in the treatment of dysentery, diarrhea, typhoid fever, and other related troubles. Administration.-Alcohol as a solvent is not often prescribed as such by the physician, but alcoholic tinctures, spirits, etc., are employed. For its effect, alcohol is often a factor in selecting a vehicle. Some prescriptions illustrating the uses of alcohol follow: To abort furuncle: or Hydrarg. Chlor. Corros gr. j |06 Alcoholis q. s. f5j 30|00 M. Sig.-Saturate pad and keep applied to boil. (Poison-label.) In the treatment of alopecia: Bi or Resorcinolis gr. Ixxx 5 0 Quininae gr. xv 1 0 Olei Ricini nixx 1 3 Alcoholis q. s. f5iv 120 0 M. Sig.-Apply as directed. i Stelwagon: Diseases of the Skin. ALOE. 57 For "liver spots," freckles, etc.: or Acidi Salicylici gr. xx i|3 Alcoholis q. s. fSj 30|0 M. Sig.-Apply to spots three times a day. When used only as a stimulant, brandy or whisky is usually employed. For example: For the exhaustion attendant upon intestinal trouble, etc. (for a child 2 years old) : or Spin Vini Gallici Opt f3vj 231 Aquae q. s. fjiij 90| M. Sig.-Teaspoonful in water every four hours. In the treatment of bronchitis: Ri or Tinct. Opii Camph., Spir. Vini Gallici, Glycerini 30 M. Sig.-Teaspoonful every three hours. For coughs, bronchitis, colds, etc.: •R Sodii Citratis 5j or 30 Limonis Succi, Spir. Vini Gallici aa f5j 30 Tinct. Opii Camph f3ss 15 Syr. Acidi Citrici q. s. f5iv 120 Sig.-Teaspoonful in water every two hours. ALOE. Latin, Aloe (Gen., Aloes). Eng., Aloes. Synonym, Gum Aloes. The inspissated juice of the leaves of Aloe Perryi Baker, yielding Socatrine Aloes; or Aloe vera Linne, yielding Curasao Aloes; or Aloe ferox Miller, yielding Cape Aloes. Form.-Brownish masses. Odor and Taste.-Disagreeable odor and bitter, nauseous taste. i Musser and Kelly: Practical Treatment. 58 ALOE. Active Constituents.-Aloin (5 to 30 per cent.), etc. Average Dose.-4 grains (0.25 Gm.). Official Preparations. Tincturae Aloes.-Tincture of Aloes. Average Dose.-30 minims (2 mils). Aloes is contained in the Compound Extract of Colocynth and the Compound Tincture of Benzoin. Aloinum (Gen., Aloini). Eng., Aloin. An active principle obtained from Aloes. Form.-A yellowish powder. Odor and Taste.-Disagreeable odor and intensely bitter taste. Solubility.-In 65 parts of water and 10.75 parts of alcohol. Average Dose.-% grain (0.015 Gm.). Pilulae Laxativae Compositae. Eng., Compound Laxative Pills. Syn- onyms; Pills Aloin, Strychnine, Belladonna and Ipecac; Pills A., S., B. and I. Each pill contains about: Aloin, 0.0130 (gr. %); Strychnine, 0.0005 (gr. ^35); Ex. Belladon. Leaves, 0.0080 (gr. J^); Ipecac, 0.0040 (gr. ^e). Average Dose.-2 pills. Therapeutic Action.-Purgative, emmenagogue, abortifacient. Uses.-For constipation, particularly of the chronic type, and for amenorrhea. Administration.-Of the preparations of and from Aloes, Aloin is the one most often used. It is usually prescribed as the Compound Laxative Pills or in some other combination of pur- gatives. Its employment is based to some extent on the belief that Aloes acts particularly on the lower part of the intestinal tract. Unofficial Preparation of Aloin. As a laxative in tuberculosis: Bi or Mas. Hydrargyri, Aloes Pulv., Ipecacuanhae Pulv., Capsici Pulv aa.gr. xij 8 M. ft. cap. no. xxiv. Sig.-One at night. 1 Musser and Kelly: Practical Treatment. ALTHJEA. ALUMEN. 59 In the treatment of chlorosis associated with constipation: Ri or • Aloes Pulv gr. xl 3 Mas. Ferri Carb 5ij 8 Pulv. Aromatici q. s. M. ft. cap. no. xl. Sig.-Two (2) at bedtime. In the treatment of amenorrhea (to be used six days before expected period) : $2 or Aloini gr. ij 13 Mas. Ferri Carb 2 00 Oleores. Petroselini • f3j 4 00 M. ft. cap. no. xij. Sig.-One morning and evening. ALTHEA. Latin, Althaea. Eng., Althaea. The dried root of Althaa officinalis, deprived of the brown, corky layer and small roots and carefully dried. Therapeutic Action.-Emollient, demulcent. Uses.-It is used in the manufacture of some pharmaceutical preparations, etc., but is seldom prescribed. ALUMEN. Latin, Alumen (Gen., Alumenis). Eng., Alum. Synonym, Potassium Alum. It contains not less than 99.5 per cent, of A1NH4(SO4)2 + 12H2O or A1K(SO4)2 + 12H2O. The label of the container must indicate whether the salt is Ammonium or Potassium Alum. The Potassium Alum has been the official alum till the present U. S. P. (IX). Form.-Large colorless crystals or crystalline fragments. Odor and Taste.-Odorless, and having a sweetish and strongly astringent taste. Solubility.-Potassium Alum is soluble in 7.2 parts of water, and insoluble in alcohol. Ammonium Alum is somewhat less soluble in water. 1 Shoemaker: Materia Medica and Therapeutics. 2 Ibid. 60 ALUMEN. Incompatibles.-Alkalies; salts of lead, mercury, and iron; bo- rates, carbonates, phosphates, tartrates, tannic acid, etc. Average Dose.-8 grains (0.5 Gm,). Official Preparation. Alumen Exsiccatum (Gen., Alumenis Exsiccati). Eng., Exsiccated Alum. Synonyms, Dried Alum, Burnt Alum. One hundred parts of Alum are deprived of water of crystallization by heat till reduced to 55 parts by weight. Form.-A white granular powder. Odor and Taste.-See Alum. Solubility.-Slowly and usually incompletely soluble in 20 parts of water. Insoluble in alcohol. Incompatibles.-See Alum. Therapeutic Action.-Astringent, styptic, emetic. Uses.-There are three forms of alum on the market: Lump alum, powdered alum, and the exsiccated alum. "Powdered alum" is not the dried product, but is the weaker product obtained by powdering the lumps without exsiccating. Alum or exsiccated alum is used locally to arrest bleeding. In solution it is employed locally in the treatment of hyperidrosis, to harden the skin, as in tender feet, and as a vaginal douche in vaginitis, cystocele, etc. It is still sometimes employed as an emetic, but more desirable agents are usually available. Recommended in the treatment of lead colic. By enema, it is employed for energetic action, particularly to promote the removal of intestinal gas and intestinal parasites. Administration.-Seldom prescribed for internal use. For External Use.-Powdered Alum and the Exsiccated Alum are sometimes prescribed, either alone or with other agents, as astringent powders, lotions, douches, etc. As an enema or vaginal douche: or Alumenis Pulv Sij 60| Sig.-Use heaping teaspoonful to half-gallon hot water as directed. This would call for the powder made by pulverizing the lumps and not for the exsiccated product. ALUMINI HYDROXIDUM. AMMONIUM. 61 In the treatment of herpes, bromidrosis, etc.: IP Alumenis Exsic 3ss or 2 Phenylis Salicyl 3ss 2 Bismuthi Subnit 3j 4 Ung. Zinci Oxidi q. s. 3j 30 M. Sig.-Apply. ALUMINI HYDROXIDUM. Latin, Alumini Hydroxidum. Eng., Aluminum Hydroxide. A white powder. AMMONIUM. Official Salts and Preparations. AQUA AMMONIA (Gen., Aquae Ammoniae). Eng., Ammonia Water. Synonym, Hartshorn. An aqueous solution containing about 10 per cent, by weight of gaseous ammonia. Average Dose.-15 minims (1 mil). AQUA AMMONIA FORTIOR. Eng., Stronger Ammonia Water. An aqueous solution containing about 28 per cent, by weight of gaseous ammonia. SPIRITUS AMMONIA AROMATICUS (Gen., Spiritus Ammoniae Aromatici). Eng., Aromatic Spirit of Ammonia. An almost colorless aromatic liquid becoming slightly darker on standing. Ammonuim Carbonate, 34 Gm.; Ammonia Water, 90 mils; Oil of Lemon, 10 mils; Oil of Lavender, 1 mil; Oil of Nutmeg, 1 mil; Alcohol, 700 mils; Water, to make 1000 mils. Average Dose.-30 minims (2 mils). Aromatic Spirit of Ammonia is used in making Tinctura Guaiaci Am- moniata and Tinctura Valerianae Ammoniata. Therapeutic Action.-Stimulant, carminative, irritant. Uses.-As a stimulant in syncope, asphyxia, collapse and poisoning from narcotic or depressant agents. Frequently em- ployed for acute indigestion, hysteria, etc. Administration.-When used alone it may be prescribed as: or Spin Ammon. Arom fSj 30| Sig.-Half (J4) teaspoonful in water every hour when necessary. 1 Shoemaker: Materia Medica and Therapeutics. 62 AMMONIUM. Or: or Spir. Ammon. Arom., Tinct. Aurant. Dulc 1 M. Sig.-Teaspoonful in water every hour when necessary. In the treatment of headache following a debauch: Ri Ammonii Bromidi 3iij or 12 Spir. Ammoniae Arom f5iv 15 Elix. Aromatici q. s. fSiij 90 M. Sig.-Two (2) teaspoonfuls in water every two hours till relieved. In the treatment of acute indigestion: B Sodii Bicarbonatis 5j or 4 Spir. Ammon. Arom f5ss 15 Spir. Athens q. s. f5j 30 M. Sig.-"Shake." Teaspoonful in water every two hours till relieved. In the treatment of acute indigestion: $2 or Tinct. Opii Camp f 3ii j * 12 Spir. Ammoniae Arom., Spir. ^Etheris aa fSss 15 Tinct. Lavandulae Comp q. s. fSij 60 M. Sig.-Teaspoonful well diluted every fifteen minutes until relieved. LINIMENTUM AMMONIA. Eng., Ammonia Liniment. LIQUOR AMMONII ACETATIS. Eng., Solution of Ammonium Acetate. Synonym, Spirit of Mindererus. A colorless aqueous solution containing about 7 per cent, of Ammonium Acetate. Average Dose.-4 fluidrachms (15 mils). Therapeutic Action.-Diuretic, diaphoretic, refrigerant. Uses.-Sometimes used in fevers, nephritis, etc. Administration.-Its employment is illustrated in the following: 1 Musser and Kelly: Practical Treatment. 2 Ibid. AMMONIUM. 63 For acute febrile conditions: Hi or Tinct. Aconiti irxx 1 3 Liq. Ammonii Acet f&j 60 0 Liq. Potassii Cit q. s. f5iv 120 0 M. Sig.-Tablespoonful every two hours. AMMONII BENZOAS.-See Benzoates, p. 92. AMMONII BROMIDUM.-See Bromides, p. 100. AMMONII CARBONAS (Gen., Ammonii Carbonatis). Eng., Am- monium Carbonate. A mixture of Acid Ammonium Carbonate and Am- monium Carbamate. Form.-White, translucent masses or cubes. Odor and Taste.-Strong odor of ammonia; sharp saline taste. Solubility.-Slowly soluble in 4 parts of water; partly soluble in alcohol. Incompatibles.-Acids, acid salts, etc. Average Dose.-5 grains (0.3 Gm.). Therapeutic Action.-Stimulant, expectorant. Uses.-Principally employed in the treatment of coughs, colds, bronchitis, etc.; has been used extensively in treating pneu- monia. Ammonium carbonate should be kept in a well-stoppered bottle, and even then there is a tendency to deterioration, as evidenced by the formation of a powder on the surface of the hard, translucent lumps. This powder should be discarded. Administration.-It is almost always given in solution, usually in some flavored syrup. Its employment is illustrated in the following: As an expectorant: or Ammonii Carb ... 3iss 6 00 Tinct. Hyoscyami f3iv 15 00 Syr. Pruni Virg q. s. fSiv 120 00 M. Sig.-Teaspoonful every two hours till relieved. In the treatment of capillary bronchitis of infants: $2 or Ammonii Carb gr. xx ' 1l3 Syr. Tolutani f5ss 150 Liq. Ammonii Acet q. s. fSiij 900 M. Sig.-Teaspoonful in water every two hours. 1 Hughes: Practice of Medicine. 2 Shoemaker: Materia Medica and Therapeutics. 64 AMMONIUM. AMMONII CHLORIDUM (Gen., Ammonii Chloridi). Eng., Am- monium Chloride. Synonyms, Ammonium Muriate, Sal Ammoniac. Form.-A white, crystalline powder. Odor and Taste.-Odorless and having a disagreeable saline taste. Solubility.-In 2.6 parts of water, 100 parts alcohol, or 8 parts glycerin. Average Dose.-5 grains (0.3 Gm.). Official Preparation. Trochisci Ammonii Chloridi. Eng., Troches of Ammonium Chloride. Each troche contains about 1^2 grains of the salt. Therapeutic Action.-Expectorant, diuretic, diaphoretic, stimulant. . Uses.-Principally employed in the treatment of coughs, colds, bronchitis, pneumonia, etc. It is used to promote the absorption of ecchymoses, also to increase the solubility of cor- rosive mercuric chloride. Administration.-Ammonium Chloride seems to be the salt of choice as an expectorant. Its ready solubility and comparative freedom from incompatibility facilitate its use in any reasonable combination. The common cough syrups, as "Syr. Pine Co.," "Honey and Tar," etc., etc., usually contain about 8 grains to the fluidounce. Some expectorant combinations are shown in the following: As an expectorant: or Apomorphinge Hydrochlor gr. ss 03 Ammonii Chloridi 3j 4 00 Limonis Succi f3j 30 00 Syr. Acidi Citrici 90 00 M. Sig.-Teaspoonful in water every two hours till relieved. Or: or Diacetylmorph. Hydrochlor gr. ij 13 Ammonii Chloridi 5ij 8 00 Syr. Ipecacuanhae f3ij 8 00 Syr. Pruni Virg q. s. f5iv 120 00 M. Sig.-Teaspoonful every two hours till relieved. AMYGDALA AMARA. 65 In the treatment of the laryngo-bronchial irritation of influenza: RI or Codeinae Sulph gr. iv 26 Ammonii Chlor 3ij 8 00 Syr. Pruni Virg f5ij 60 00 Spir. Juniperis Comp q. s. f$iv 120 00 M. Sig.-Teaspoonful in water every three hours. In the treatment of an acute exacerbation of dry chronic bron- chitis : B2 or Ammonii Chloridi 5ij 8 Tinct. Hyoscyami, Syr. Scillae Comp aa f3iv 15 Aquae Chloroformi q. s. f&ij 90 M. Sig.-Teaspoonful in water every three hours. Recommended to promote the absorption of ecchymosis: B Ammonii Chloridi «j or 301 Aquae 120| M. Sig.-Wet pad of gauze and keep applied. AMMONII IODIDUM.-See lodum, p. 202. AMMONII SALICYLAS.-See Acidum Salicylicum, p. 33. AMMONII VALERAS.-See Valeriana, p. 317. AMYGDALA AMARA. Latin, Amygdala Amara (Gen., Amygdalae Amarae). Eng., Bit- ter Almond. The ripe seed of Prunus amygdalus; var., amara. Bitter Almond is not official, but there are the following: Oleum Amygdalae Amarae. Eng., Oil of Bitter Almond. Average Dose.-% minim (0.03 mil). Aqua Amygdalae Amarae. Eng., Bitter Almond-water. Contains 0.1 per cent, of the Oil of Bitter Almond. Average Dose.-1 fluidrachm (4 mils). Spiritus Amygdalae Amarae. Eng., Spirit of Bitter Almond. Contains 1 per cent, of the Oil of Bitter Almond. Average Dose.-8 minims (0.5 mil). Official Constituent and Preparations. 1 Anders: Practice of Medicine. 2 Hughes: Practice of Medicine. 66 AMYGDALA DULCIS. AMYLIS NITRIS. Therapeutic Action.-Classed as a sedative, depressant, anti- spasmodic, and flavor. Uses.-Recommended for cough and some other conditions. Administration.-Seldom prescribed. AMYGDALA DULCIS. Latin, Amygdala Dulcis. Eng., Sweet Almond. The ripe seeds of Prunus Amygdalus dulcis. Official Preparation and Constituent. Emulsum Amygdalae. Eng., Emulsion of Almond. Represents about 6 per cent, of the sweet almond. Average Dose.-4 fluidounces (120 mils). Oleum Amygdalae Expressum. Eng., Expressed Oil of Almond. Average Dose.-1 fluidounce (30 mils). The Expressed Oil of Almond is contained in several official preparations. Therapeutic Action.-Demulcent and nutrient. Uses.-Principally employed in the preparation of ointments, emulsions, etc. Administration.-Seldom prescribed as such. Latin, Amylis Nitris (Gen., Amylis Nitritis). Eng., Amyl Nitrite. Formula, C5HHNO2. A liquid containing about 80 per cent, of absolute amyl nitrite. Average Dose.-By inhalation, 3 minims (0.2 mil). Therapeutic Action.-Vasodilator and antispasmodic. Uses.-Conditions characterized by high blood-pressure, and requiring prompt remedial action, as angina pectoris. Recom- mended for epilepsy, convulsions, seasickness, vomiting of preg- nancy, etc. Administration.-The three drugs, Amyl Nitrite, Nitro- glycerin and Sodium Nitrite are employed for the same effect. Amyl Nitrite being the most rapid and transient, Nitroglycerin next, and Sodium Nitrite the slowest and most lasting. Amyl Nitrite is usually administered by inhalation. The most convenient form is the "pearls," which are little glass bulbs each containing a few minims. These can be crushed in the handker- chief and inhaled when needed. It should be remembered that the drug is very volatile and inflammable. AMYLIS NITRIS. AMYLUM. 67 AMYLUM. Latin, Amylum (Gen., Amyli). Eng., Starch. Synonym, Corn Starch. Form.-A white powder or white masses. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water or alcohol. Forms a whitish, gelatinous paste when boiled with water. Official Preparations. Glyceritum Amyli. Eng., Glycerite of Starch. Starch, 10 Gm.; Water, 10 mils; Glycerin, 80 Gm. Therapeutic Action.-Protective and diluent. Uses.-Employed with other agents in the treatment of prickly heat, chafing, dermatitis, etc. Prepared by boiling with water it is used in baths for the relief of skin diseases character- ized by itching, as pruritus, eczema, etc. It is an antidote for iodine poisoning. Administration.-The only common employment of starch in prescription writing is in various powders and ointments. In the treatment of prickly heat: or Acidi Salicylici 6 Acidi Borici 3j 4 0 Zinci Oxidi 5iv 15 0 Amyli 5j 30 0 M. Sig.-Apply as directed. Or: Hi Acidi Borici, Talci Pur., Zinci Oxidi, Amyli or 8 M. Sig.-Apply freely. i Stelwagon: Diseases of the Skin. 68 ANISUM. In the treatment of the lesions of smallpox: Ri or Hydrarg. Ammon gr. x 65 Amyli, Zinci Oxidi aa. 5ij 8 00 Petrolati q. s. 5j 30 00 M. Sig.-Apply as directed. ANISUM. Latin, Anisum (Gen., Anisi). Eng., Anise. Synonym, Aniseed. The ripe fruit of Pimpinella anisum. Average Dose.-8 grains (0.5 Gm.). Official Preparations and Constituent. Oleum Anisi. Eng., Oil of Anise, Oil of Star Anise. Average Dose.-3 minims (0.2 mil). Aqua Anisi. Eng., Anise Water. Average Dose.-4 fluidrachms (15 mils). Spiritus Anisi. Eng., Spirit of Anise. Contains 10 per cent, of the oil. Average Dose.-30 minims (2 mils). Oil of Anise is contained in several other official preparations. Therapeutic Action.-Stimulant, stomachic, expectorant and flavor. Uses.-Employed almost exclusively as a flavoring agent. Administration.-Seldom prescribed. ANTIMONII et POTASSII TARTRAS. Latin, Antimonii et Potassii Tartras (Gen., Antimonii et Potassii Tartratis). Eng., Antimony and Potassium Tartrate. Synonym, Tartar Emetic. Form.-Colorless crystals or white powder. Odor and Taste.-Odorless and having a sweet, afterward dis- agreeable, metallic taste. Solubility.-In 12 parts water. Insoluble in alcohol. Incompatibles.-Alkalies, lead salts, gallic and tannic acids, etc. Average Dose.-Expectorant, %2 grain (0.005 Gm.). Official Preparations. Antimony and Potassium Tartrate is contained in Compound Syrup of Squill (0.2 per cent.) and in small amount in Compound Mixture of Glycyrrhiza. 1 Musser and Kelly: Practical Treatment. ANTIPYRINA. 69 Therapeutic Action.-Expectorant, emetic, pustulant. Uses.-Sometimes used in the treatment of coughs, colds, bronchitis, etc. Toxicology.-Poisoning with tartar emetic is rather frequent, particularly among children, as it is a constituent of many ant- poisons. The symptoms are: vomiting, purging, rice-water and bloody stools, abdominal and epigastric pain, muscular cramps, prostration. Treatment.-The stomach should be washed out with a solution of tannic acid and enough of the antidote left in the stomach to act on any remaining poison. An infusion of green tea is frequently employed, as the caffeine content is also desirable. Demulcents, as milk or olive oil, should be given freely. The patient should be kept warm and stimulants used as indicated. Administration.-Antimony and Potassium Tartrate as such is not a popular prescription ingredient. As an emetic it has fallen into disuse with the profession almost altogether. As an expectorant the Compound Syrup of Squill is sometimes used. ANTIPYRINA. Latin, Antipyrina (Gen., Antipyrinae). Eng., Antipyrine. Syno- nym, Phenazone. Form.-Usually a colorless crystalline powder. Odor and Taste.-Almost odorless and tasteless. Solubility.-In less than 1 part of water. In 1.3 parts of alcohol. Incompatibles.-Acids and drugs containing tannic acid in ap- preciable amounts; alkalies, salts of iron, mercury, lead and arsenic; iodine and iodides; sodium bicarbonate and salicylate; alum, ben- zoates, phenol, cinchona alkaloids, resorcin, spirit of nitrous ether, thymol, etc. Average Dose.-5 grains (0.3 Gm.). Therapeutic Action.-Antipyretic, sedative, analgesic. Uses.-Employed in the treatment of fevers, headache, neu- ralgia, whooping-cough, etc. Administration.-Antipyrine is so generally incompatible with other drugs that it is better to remember the few desirable agents with which it can be prescribed to advantage. This would include few others than caffeine, sodium bromide and flavored syrups. It is the most soluble of the common coal-tar anti- pyretics. It is prescribed alone in powders, capsules or in solution. 70 APOMORPHIN2E HYDROCHLORIDUM. AQUA. Antipyrine may be prescribed as: R or Antipyrinae gr. xl 215 Elix. Aromatici q. s. fSj 300 M. Sig.-Teaspoon ful in water every two hours when necessary. A frequent combination of antipyrine is shown in the following prescription for the paroxysmal stage of whooping-cough: For a child 4 years old: or Antipyrinae 3ss 2 Sodii Bromidi 3j 4 Syr. Tolutani q. s. f5ij 60 M. Sig.-Teaspoonful in water every two hours until relieved. Tinctura Belladonnae Foliorum is sometimes added. As a hypnotic, analgesic, cough sedative and antispasmodic: Bi or Codeinae Sulphatis gr. ss 03 Antipyrinae gr. xvj 1 00 Syrupi Aurantii q. s. fjij 60 00 M. Sig.-Teaspoonful every two hours when needed. (Child 2 years old). It is sometimes used by the physician as a local application, as in the following formula used by the rhinologist on cotton applica- tors to relieve congestion of the nasal mucosa: B or Cocainae Hydrochlor gr. v 3 Antipyrinae gr. xv 1 0 Aquae Dest q. s. f3j 30 0 M. Sig.-Formula. See Opium, p. 242. APOMORPHIN^ HYDROCHLORIDUM. AQUA. Latin, Aqua (Gen., Aquae). Eng., Water. Formula, H2O. Potable water in its purest obtainable state. This is the great ve- hicle of medicine. The old custom still adhered to by some physi- 1 Ruhrah: Diseases of Children. AQUaE AROMATICaE. AQUA DESTILLATA. 71 cians of prescribing rain-water, river-water, etc., is not recom- mended, as the one prescribed may not be obtainable by the par- ticular pharmacist handling the order, and if the word water is employed the purest potable water will be used. Distilled water should only be specified when its use is particularly indicated. Aqua Ammoniae.-See Ammonium. Aqua Ammoniae Fortior.-See Ammonium. Aqua Amygdalae Amarae.-See Amygdala Amara. Aqua Anisi.-See Anisum. Aqua Aurantii Florum.-See Aurantium. Aqua Aurantii Florum Fortior.-See Aurantium. Aqua Camphorae.-See Camphora. Aqua Chloroformi.-See Chloroformum. Aqua Cinnamomi.-See Cinnamomum. Aqua Creosoti.-See Creosotum. Aqua Destillata.-See Aqua Destillata. Aqua Destillata Sterilizata.-See Aqua Destillata. Aqua Fceniculi.-See Foeniculum. Aqua Hamamelidis.-See Hamamelis. Aqua Menthae Piperitae.-See Mentha Piperita. Aqua Menthae Viridis.-See Mentha Viridis. Aqua Rosae.-See Rosa Gallica. Aqua Rosae Fortior.-See Rosa Gallica. AQU^E AROMATICS. Latin, Aquae Aromaticae. Eng., Aromatic Waters. Aromatic waters, when prepared from volatile oils, are intended to be, as nearly as practicable, saturated solutions which must be clear and free from solid impurities, and, unless otherwise specified, should be prepared by using 0.2 per cent, of the volatile oil in distilled water. AQUA DESTILLATA. Latin, Aqua Destillata (Gen., Aquae Destillatae). Eng., Distilled Water. 1000 volumes of water are distilled. The first 100 volumes, which contain the volatile impurities, are rejected. The next 750 volumes constitutes Distilled Water (U. S. P.). The remaining water contains the non-volatile impurities and is rejected. This should be the vehicle used in prescribing solutions of silver nitrate, potassium permanganate, corrosive mercuric chloride, boric acid, calcium chloride, lead acetate and subacetate, iron sulphate, zinc sulphate, tartar emetic, and it is usually desirable for simple solu- tions of alkaloidal salts. It is entirely unnecessary to make common 72 AQUA DESTILLATA STERILIZATA. use of distilled water. Such employment may be well attributed by the pharmacist to the ignorance of the prescriber. AQUA DESTILLATA STERILIZATA. Latin, Aqua Destillata Sterilizata (Gen., Aquae Destillatae Steri- lizatae). Eng., Sterilized Distilled Water. This should be the vehicle used for making solutions for hypo- dermic or intravenous use, and for eye-washes, etc. ARGENTUM-Silver. Official Salts and Preparations. (Not Official.) ARGENTI NITRAS (Gen., Argenti Nitratis). Eng., Silver Nitrate. Formula, AgNOs. Form.-Colorless crystals becoming dark on exposure to light in the pres- ence of organic matter. Odor and Taste.-Odorless; having bitter, caustic, metallic taste. Solubility.-In 0.4 part water and in 30 parts alcohol (incompatible). Incompatibles.-Acetates, arsenites, bromides, carbonates, chlorides, chro- mates, cyanides, hypophosphites, iodides, phosphates, sulphides, sulphates, tartrates, acids (except nitric), alkalies, alkaloids, alcohol, creosote, and organic matter generally. Average Dose.-% grain (0.01 Gm.). Official Preparation. Argenti Nitras Fusus. Eng., Moulded Silver Nitrate. Synonyms, Caustic, Lunar Caustic. Hard white pencils or cones made by treat- ing 100 Gm. of Silver Nitrate with 4 Gm. of Hydrochloric Acid and melt- ing and moulding the product. ARGENTI OXIDUM. Eng., Silver Oxide. Average Dose.-1 grain (0.06 Gm.). Therapeutic Action.-Silver Nitrate and Caustic are antisep- tic, germicide, astringent and caustic. Uses.-Silver Nitrate is sometimes used by mouth in such conditions as gastric catarrh, gastric ulcer, etc. By rectum for ulceration, fissure, amoebic dysentery, etc. It is used as an ap- plication for tonsillitis, diphtheria, scarlatina, ulcers, chancroids, and kindred conditions. It is used in eye diseases, particularly for the prevention and cure of gonorrheal ophthalmia. Frequently used for vaginitis, endometritis, etc. Toxicology.-Acute poisoning by silver nitrate is rare. It would probably be recognized, if seen early, by the whitish appearance of ARGENTUM. 73 the mouth and throat; if seen later, by the characteristic dark color of the skin around the mouth. The antidote is sodium chloride. Argyria is the condition resulting from the continued use of a silver salt. In the superficial circulation of the exposed parts of the body it is acted upon by the light and deposited in the skin, giving a bluish tint to the complexion. The condition has been considered beyond relief. Hexamethylenamine has recently been recommended. Administration.-Practically the only preparations of silver employed by the physician are the Nitrate and the Fused Nitrate. The latter is frequently used by the physician, but seldom prescribed. Silver Nitrate is practically always prescribed alone. Silver Nitrate, or Lunar Caustic, should not be prescribed for the patient's use. When used as a caustic, the well-known dis- coloration is slow in developing, and much damage is often done. The areas affected seem rather prone to inflammatory changes^ The discoloration may sometimes be removed by the careful use (by the physician) of a 1 per cent, aqueous solution of potassium cyanide. Internally.-The drug if prescribed is probably best administered in the form of the pills prepared by the pharmaceutical manufac- turing houses. They may be ordered as: Pil. Argenti Nitratis (gr. %) no. xx. Sig.-One three times a day. Locally.-Silver Nitrate is not often prescribed to be used by the patient, but is frequently employed by the physician in the form of aqueous solution. The strength of the solution varies from 1: 5 to 1: 1000. For the eyes of the newborn a 1 per cent, solution is usually employed. As an application for tonsillitis, etc., the 5, 10, or 20 per cent, solutions are used. Overaction may be prevented by neutralizing with normal salt solution. Solutions for the prescriber's use may be ordered as: R or Argenti Nitratis gr. xiv 3| Aquae Destillatae q. s. fSj 30| M. Sig.-Ten per cent, solution of silver nitrate. (Poison-label.) 74 ARNICA. ARGYROL.-A proteid salt of silver (silver vitellin) in the form of black hygroscopic scales representing about 30 per cent, of metallic silver. It is freely soluble in water, forming a dark-colored solution that stains material brown to black. Therapeutic Action.-Said to be an antiseptic, germicide, anti- pruritic, etc. Uses.-Extensively employed in solution as a non-irritating application in the treatment of pharyngitis, tonsillitis, rhinitis, conjunctivitis, etc. Used as an injection for gonorrhea and cystitis; also as an application for vaginitis, vulvitis, pruritus vulvae and kindred conditions. Administration.-Usually employed in solution in distilled water in from 5 per cent, to 25 per cent, strength. In the treatment of gonorrhea: Unofficial Salts of Silver. or Argyrol 3iij 121 Aquae Dest q. s. f5vj 180| M. Sig.-Inject after urination. A 20 per cent, solution of argyrol as is us"ed in tonsillitis, vaginitis, etc., may be ordered as: R or Argyrol • •• gr. xc 61 Aquae Dest q. s. fSj 301 M. Sig.-Apply as directed. PROTARGOL.-A proteid compound of silver representing about 8 per cent, of the metal. A yellow powder, slowly but freely soluble in water. Therapeutic Action.-Said to be an antiseptic and germicide. Uses.-Employed in the treatment of gonorrhea, cystitis, tonsillitis, ulcers, etc. Administration.-Usually employed in aqueous solution. ARNICA. Latin, Arnica (Gen., Arnicse). Eng., Arnica. Synonyms, Arnica Flowers, Leopard's bane. The dried flower-heads of Arnica montana. ARSENUM. 75 Tinctura Arnicae (Gen., Tinctura Arnicae). Eng., Tincture of Arnica. Represents 20 per cent, of the drug. Average Dose.-15 minims (1 mil). Therapeutic Action.-Arnica has been variously classed as an irritant, carminative, tonic, etc. Uses.-The use of arnica is largely confined to the application of the tincture alone, or with other agents, for bruises, sprains, rheumatism, etc. Administration.-Seldom prescribed internally. The tincture is sometimes employed externally with other agents in the form of a liniment. Official Preparation. ARSENUM-Arsenic. {Not Official.) ARSENI IODIDUM. Eng., Arsenous Iodide. Synonym, Arsenic Iodide. Average Dose.-^2 grain (0.005 Gm.). Liquor Arseni et Hydrargyri lodidi. Eng., Solution of Arsenous and Mercuric Iodides. Synonym, Donovan's Solution. A clear or slightly yellowish aqueous liquid containing about 1 per cent, of Arsenous Iodide and 1 per cent, of Red Mercuric Iodide. Incompatibles.-See Arseni Trioxidum and Hydrargyrum. Average Dose.-1^4 minims (0.1 mil.). ARSENI TRIOXIDUM (Gen., Arseni Trioxidi). Eng., Arsenic Tri- oxide. Synonyms, Arsenous Acid, White Arsenic (the latter term is usually applied to the impure commercial article). Form.-Heavy white powder or irregular masses. Odor and Taste.-Odorless and practically tasteless. Solubility.-Slowly soluble in from 30 to 100 parts of water. Sparingly soluble in alcohol. Incompatibles.-Tannic acid; salts of iron, copper, and magnesium; lime water, iodides, etc. In the very dilute solutions in which arsenic is used, incompatibility is seldom a factor. Average Dose.-^0 grain (0.002 Gm.). Liquor Acidi Arsenosi (Gen., Liquoris Acidi Arsenosi). Eng., Solu- tion of Arsenous Acid. Synonym, Solution of Arsenic Chloride. A colorless aqueous solution containing 1 per cent, of Arsenic Trioxide. Incompatibles.-See Arseni Trioxidum. Average Dose.-3 minims (0.2 mil). Liquor Potassii Arsenitis (Gen., Liquoris Potassii Arsenitis). Eng., Solution of Potassium Arsenite. Synonym, Fowler's Solution. A slightly colored aqueous solution in the preparation of which 1 per-cent. Arsenic Trioxide is used. Official Salts and Preparations. 76 ARSENUM. Incompatibles.-See Arseni Trioxidum. Average Dose.-3 minims (0.2 mil). SODII ARSENAS. Eng., Sodium Arsenate. Average Dose.-H2 grain (0.005 Gm.). Sodii Arsenas Exsiccatus. Eng., Exsiccated Sodium Arsenate. Average Dose.-%o grain (0.003 Gm.). Liquor Sodii Arsenatis. Eng., Solution of Sodium Arsenate. Contains 1 per cent, of Exsiccated Sodium Arsenate. Average Dose.-3 minims (0.2 mil). Therapeutic Action.-Alterative, tonic, escharotic. Uses.-Employed in the treatment of malaria, anemia, syphilis pellagra, goiter, neurasthenia, hysteria, chorea, and various skin diseases, as eczema, herpes, etc. Locally it is used in dentistry and in the treatment of cancer. Toxicology.-Among the symptoms of acute arsenic poison- ing are epigastric and abdominal pain, nausea, vomiting, rice- water and bloody stools, purging, tenesmus, dryness of throat, thirst, frequent micturition, albuminuria, depression, skin lesions and edema. The treatment consists principally in washing out the stomach with a suspension of freshly precipitated ferric hydroxide with magnesium oxide and leaving in the stomach enough of the antidote to act upon any remaining arsenic. If this official antidote is not available or the ingredients for mak- ing it, the tincture of ferric chloride with magnesium oxide or "Milk of Magnesia" may be used. Morphine may be cautiously used for the intestinal condition and demulcents freely given. The patient should be kept warm and stimulants used as indi- cated. The patient should be kept under observation several days, as symptoms may recur. Chronic arsenic poisoning is usually first manifested by edema, particularly under the eyes. Administration.-The taste and odor of Fowler Solution is disagreeable to some patients, and the solution of arsenous acid should not be overlooked. Some useful prescriptions illustrating the employment of Arsenic are shown in the following: The prescription for the rather extensively used Asiatic Pill (best given in capsule) is as follows: B or Arseni Trioxidi gr. ij 13 Piperis Pulv 3ij 8 00 Ext. Gentianae 3ij 8 00 M. ft. cap. no. lx. Sig.-One after each meal. ARSENUM. 77 As a tonic in malaria, etc.: or Arseni Trioxidi gr. ij 130 Strychninae Sulph gr. j 065 Quininae Sulph gr. cl 10 000 Massae Ferri Carb gr. cl 10 000 M. ft. cap. no. L. Sig.-One after each meal. As a general tonic for debility, anemia, etc., the quinine sulphate is reduced to about 50 grains. Ferrum Reductum (about 100 grains) may be substituted for the Massa Ferri Carbonatis, particularly when there is constipation. In the treatment of neurasthenia, hysteria, etc.: Ri Arseni Trioxidi or gr. ss 03 Asafcetidae Pulv gr. x 65 Ext. Sumbul, Ferri Sulph. Exsic aa. gr. xx 1 30 M. ft. cap. no. xx. Sig.-One after each meal. As a postoperative tonic: B2 or Hydrarg. Chlor. Corros., Arseni Trioxidi aa.gr. j 065 Ext. Nucis Vomicae gr. xxv 1 600 Ferri et Quin. Cit gr. cc 13 000 M. ft. cap. no. c. Sig.-One after each meal. The extensively used combination of "Four Chlorides" is shown in the following: or Hydrarg. Chlor. Corros gr. ij 13 Liq. Acidi Arsenosi f3ij 8 00 Tinct. Ferri Chloridi, Acidi Hydrochi. Dil., Glycerini aa. 30 00 Aquae q. s. f3vj 180 00 M. Sig.-Teaspoonful in water after meals. 1 Shoemaker: Materia Medica and Therapeutics. 2 Ashton: Practice of Gynecology. 78 ASAFCETIDA. In combination as a tonic, particularly in the treatment of malaria: B or Quininae Sulph 3iij 12 Liq. Acidi Arsenosi f3ij 8 Tinct. Ferri Chloridi f3vj 23 Glycerini fSj 30 Aquae q. s. f^vj 180 M. Sig.-Teaspoonful in water after meals. In the treatment of the chronic vomiting of childhood: Bi or Liq. Potas. Arsenitis IRxij 75 Sodii Bicarbonatis gr. xxiv 1 50 Aquae Menth. Pip q. s. fSiij 90 00 M. Sig.-Teaspoonful three times a day. When it is desired to give arsenic alone or to give for some par- ticular effect it may be ordered as follows: or Liq. Acidi Arsenosi fSj 30| Sig.-Begin with three (3) drops as directed. Or: n or Liq. Potas. Arsenitis fSiss 61 Elix. Aromatici q. s. f5iv 120 [ M. Sig.-Teaspoonful with water after meals. ASAFOETIDA. Asafcetida (Gen., Asafcetidae). Eng., Asafetida. Synonym, Gum Asafetida. A gum-resin obtained by incising the rhizomes and roots of Ferula asafoetida and Ferula foetida, and of some other species of Ferula indigenous to Persia and adjacent countries, yield- ing not less than 60 per cent, (or, if powdered, 50 per cent.) of alcohol-soluble constituents. Form.-a soft solid usually appearing in the form of brownish, irregular masses. Odor and Taste.-Disagreeable odor and taste. 1 Ruhrah: Diseases of Children. ASAFCETIDA. 79 Solubility.-Active constituents insoluble in water. Soluble in alcohol. Average Dose.-4 grains (0.25 Gm.). Official Preparations. Emulsum Asafoetidae. Eng., Emulsion of Asafetida. Contains 4 per cent, of Asafetida. Average Dose.-4 fluidrachms (15 mils). Pilulae Asafoetidae. Eng., Pills of Asafetida. Each pill contains about 3 grains of Asafetida. Average Dose.-2 pills. Tinctura Asafoetidae. Eng., Tincture of Asafetida. Represents 20 per cent, of Asafetida in alcohol. Average Dose.-15 minims (1 mil.). Therapeutic Action.-Carminative, sedative, antispasmodic. Uses.-By mouth it is sometimes given for nervousness, hys- teria, flatulence, whooping-cough and kindred conditions. By enema it is extensively used to relieve the tympanites of typhoid, pelvic inflammation, peritonitis, etc. Administration.-Owing to the extremely disagreeable odor and taste, asafetida is not often prescribed for administration by mouth. The following prescriptions illustrate its employment: 3 Pil. Asafoetidae no. x Sig.-One after each meal. Or: or Asafoetidae Pulv., Sodii Bicarbonatis aa. 5ss 2 M. ft. cap. no. x. Sig.-One after each meal. In the treatment of neurasthenia, hysteria, etc.: Ri Arseni Trioxidi Asafoetidae Pulv or gr. ss gr. x 03 65 Ext. Sumbul, Ferri Sulph. Exsic aa.gr. XX 1 30 M. ft. cap. no. xx. Sig.-One after each meal. 1 Shoemaker: Materia Medica and Therapeutics. 80 ASPIDIUM. As an enema to remove intestinal gas: R or Tinct. Asafcetidae f3ij 60| Sig.-Use tablespoonful to gallon warm water as directed. ASPIDIUM. Latin, Aspidium (Gen., Aspidii). Eng., Aspidium. Synonym, Male Fern. The rhizome and stipes of Dryopterus felix-mas or of Dryopterus marginalis. Average Dose.-60 Grains (4 Gm.). Official Preparation. Oleoresina Aspidii. Eng., Oleoresin of Aspidium. Average Dose.-30 grains (2 Gm.). Therapeutic Action.-Taeniafuge and anthelmintic. Uses.-It is used almost exclusively for the removal of tape- worms. Administration.-It should be employed with extreme caution, and castor oil or other fixed oils or fats avoided. In the treatment for tapeworm: R or Oleoresinae Aspidii f5j 4 0 Chloroformi IRX 6 Glycerini 15 0 M. Sig.-No. 1. For doctor's use. B or Oleoresinae Aspidii fSj 4 00 Olei Tiglii gtt. ij 13 Chloroformi 1RX 65 Glycerini 15 00 M. Sig.-No. 2. Take an hour after No. 1. No. 1 is administered on an empty stomach. No. 2 is given an hour later, and is followed in an hour by a purgative if necessary. Patient should be under a physician's observation during the treat- ment and, preferably, in a hospital. The same care as to diet should be exercised as in using Thymol for hookworm. ASPIDOSPERMA. AURANTII DULCIS CORTEX. 81 ASPIDOSPERMA. Latin, Aspidosperma. Synonym, Quebracho. The dried bark of Aspidosperma quebracho bianco. Average Dose.-60 grains (4 Gm.). Official Preparation. Fluidextractum Aspidospermatis. Eng., Fluidextract of Aspidosperma. Average Dose.-1 fluidrachm (4 mils). Uses.-Has been used in the treatment of asthma, emphysema, bronchitis, etc. Administration.-Seldom prescribed. ATROPINA. See Belladonna, p. 86. ATROPINA SULPHAS. See Belladonna, p. 86. AURANTII AMARI CORTEX. Latin, Aurantii Amari Cortex (Gen., Aurantii Amari Corticis). Eng., Bitter Orange Peel. The dried rind of the fruit of Citrus Aurantium amara. Average Dose.-15 grains (1 Gm.). Official Preparations. Fluidextractum Aurantii Amari. Eng., Fluidextract of Bitter Orange Peel. Average Dose.-15 minims (1 mil). Tinctura Aurantii Amari. Eng., Tincture of Bitter Orange Peel. Represents 20 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Bitter Orange Peel is used in preparing Compound Tincture of Cin- chona and Compound Tincture of Gentian. AURANTII DULCIS CORTEX. Latin, Aurantii Dulcis Cortex (Gen., Aurantii Dulcis Corticis). Eng., Sweet Orange Peel. The fresh outer rind of the ripe fruit of Citrus Aurantium sinensis. 82 AURANTII DULCIS CORTEX. Syrupus Aurantii. Eng., Syrup of Orange. Represents 2.5 per cent, of the drug. Tinctura Aurantii Dulcis. Eng., Tincture of Sweet Orange Peel. Represents 50 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Oleum Aurantii. Eng., Oil of Orange. Synonym, Oil of Sweet Orange. A volatile oil obtained by expression from the fresh peel of the sweet orange. Average Dose.-3 minims (0.2 mil). Official Preparations and Constituent. Official Preparations of the Oil. Elixir Aromaticum. Eng., Aromatic Elixir. Synonyms, Elixir of Orange, Elixir Simplex, Simple Elixir. Contains about 1.2 per cent, of Compound Spirit of Orange and 25 per cent, alcohol, with sugar and water. Spiritus Aurantii Compositus. Eng., Compound Spirit of Orange. Oil of Orange, 200 mils; Oil of Lemon, 50 mils; Oil of Coriander, 20 mils; Oil of Anise, 5 mils; Alcohol, to make 1000 mils. Official Preparations of the Volatile Oil of Fresh Orange Flowers. Aqua Aurantii Florum. Eng., Orange Flower Water. Equal parts of Stronger Orange Flower Water and Distilled Water. Orange Flower Water is contained in several official preparations. Aqua Aurantii Florum Fortior. Eng., Stronger Orange Flower Water. Water saturated by distillation with the Volatile Oil of fresh Orange Flowers. This preparation is used in making troches of Tannic Acid. Syrupus Aurantii Florum. Eng., Syrup of Orange Flowers. Sugar 850 Gm., Orange Flower Water, to make 1000 mils. Therapeutic Action.-Stomachic, tonic. Uses.-These preparations of orange are used for flavoring purposes and as vehicles. The preparations of Bitter Orange Peel are also employed as bitter tonics. Aromatic Elixir is one of the most useful vehicles in the Pharmacopoeia. The smaller drug-stores often will be unable to supply good fresh preparations of Syrup of Orange or Syrup of Orange Flow- ers, and the Tincture of Sweet Orange Peel and the Compound Spirit of Orange are so seldom used in some sections that they are not carried in stock. Administration.-Some common methods of prescribing are shown in the following formulae: 83 AURANTII DULCIS CORTEX. In the treatment of headache following a debauch: Bi or Ammonii Bromidi 3iij 12 Spir. Ammoniae Arom f3iv 15 Elix. Aromatici q. s. fSiij 90 M. Sig.-Two (2) teaspoonfuls in water every two hours till relieved. As a hypnotic, analgesic, cough sedative and antispasmodic in childhood: R2 or Codeinae Sulphatis gr. ss 03 Antipyrinae gr. xvj 1 00 Syrupi Aurantii q. s. f5ij 60 00 M. Sig.-Teaspoonful every two hours when needed. In the treatment of convulsions of infancy: $3 or Chlorali Hydrati gr. viij 5 Sodii Bromidi gr. xvj 1 0 Syrupi Aurantii q. s. f3ij 60 0 M. Sig.-Teaspoonful. Repeat in one hour if necessary. In the treatment of tuberculosis: R4 or Creosoti ntxxiv 1 5 Glycerini f3ij 60 0 Tinct. Aurantii Dulc q. s. fXiij 90 0 M. Sig.-Teaspoonful with water or milk after meals. In the treatment of stomatitis in children: R5 or Potassii Chloratis gr. xxiv 1 5 Syrupi Aurantii f5j 30 0 Aquae q. s. f3iij 90 0 M. Sig.-Teaspoonful every two hours. 1 Musser and Kelly: Practical Treatment. 2Ruhrah: Diseases of Children. s Ibid. 4 Musser and Kelly: Practical Treatment. 5 Ruhrah: Diseases of Children. 84 AURI ET SODII CHLORIDUM. AURI et SODII CHLORIDUM. Latin, Auri et Sodii Chloridum. Eng., Gold and Sodium Chloride. A mixture of equal parts by weight of the anhydrous chlorides of gold and sodium. An orange-yellow powder, odorless, having a saline and metallic taste and deliquescent when exposed to damp air. Freely soluble in water. Average Dose.-%2 grain (0.005 Gm.). Therapeutic Action.-Said to be alterative, tonic, nerve seda- tive, aphrodisiac. Use.-Sometimes used in the treatment of chronic nephritis, cirrhosis of the liver, chronic gastritis, impotence, etc. Seldom prescribed. BALSAMUM PERUVIANUM. Latin, Balsamum Peruvianum (Gen., Balsami Peruviani). Eng., Balsam of Peru. A balsam obtained from Toluifera Pereira. Form.-A thick, dark-brown liquid. Odor and Taste.-An agreeable vanilla-like odor and disagree- able bitter taste. Solubility.-Insoluble in water. Soluble in alcohol. Therapeutic Action.- Internally, said to be expectorant, stim- ulant, etc. Externally, antiseptic and stimulant to granulating areas. Uses.-Extensively employed in the treatment of burns, ab- scesses, indolent ulcers and kindred conditions. Administration.-Balsam of Peru is extensively used as a local application, being prescribed either alone (as for indolent ulcers) or in combinations. Used alone in the treatment of indolent ulcers: or Bal. Peruvian! fSj 30| Sig.-Apply twice daily. In the treatment of superficial burns: R Bal. Peruvian! f5iv or 151 Olei Ricini q. s. f5iv 120] M. Sig.-Apply freely twice a day. BALSAMUM TOLUTANUM. 85 BALSAMUM TOLUTANUM. Latin, Balsamum Tolutanum (Gen., Balsami Tolutani). Eng., Balsam of Tolu. A balsam obtained from Toluifera Balsamum. Form.-A yellowish-brown plastic solid becoming brittle when old or dried or exposed to cold. Official Preparations. Syrupus Tolutanus. Eng., Syrup of Tolu. Represents about 1 per cent, of the drug. Average Dose.-4 fluidrachms (15 mils). Tinctura Tolutana. Eng., Tincture of Tolu. Represents about 20 per cent, of the drug. Average Dose.-30 minims (2 mils). Tolu is employed in several other official preparations. Therapeutic Action.-Expectorant, stomachic. Uses.-Practically confined to the employment of its prepara- tions as flavors and vehicles, particularly in cough preparations. Administration.-The Syrup is the only form in which the drug is often prescribed. In the treatment of the cough of measles: RI Sodii Citratis or 15 Limonis Succi f3j 30 Tinct. Opii Camph 8 Syr. Ipecacuanha f5j 4 Syr. Tolutani q. s. f3ij 60 M. Sig.-Teaspoonful in water every two hours. In the treatment of spasmodic croup (child 2 years old) : B2 or Ammonii Bromidi '3ss 2 Tinct. Opii Camph f5ss 2 Tinct. Belladon. Fol H.xv 1 Syr. Tolutani f3j 30 Aquae q. s. fSij 60 M. Sig.-Teaspoonful in water every hour till relieved. 1 Anders: Practice of Medicine. 2 Musser and Kelly: Practical Treatment. 86 BELLADONNA. In the treatment of capillary bronchitis of infants: Ri or Ammonii Carb., gr. xx 1 3 Syr. Tolutani fXss 15 0 Liq. Ammonii Acet q. s. fSiij 90 0 M. Sig.-Teaspoonful in water every two hours. In the treatment of a cough: R2 or Codeinae Sulphatis gr. iiss 16 Sodii Citratis 5ij 8 00 Syr. Tolutani f3j 30 00 Aquae 90 00 M. Sig.-Teaspoonful every two hours. BELLADONNA. Latin, Belladonna (Gen., Belladonnae). Eng., Belladonna. Synonym, Deadly Night-shade. The following parts are official: Belladonnae Folia. Eng., Belladonna Leaves. The dried leaves of Atropa Belladonna yielding not less than 0.3 per cent, of alkaloids (prin- cipally atropine). Average Dose.-1 grain (0.06 Gm.). Belladonna Radix. Eng., Belladonna Root. The dried root of Atropa Belladonna yielding not less than 0.45 per cent, of alkaloids (principally atropine). Average Dose.-Y grain (0.045 Gm.). Official Preparations of the Leaves. Emplastrum Belladonnae. Eng., Belladonna Plaster. Contains 30 per cent, of the Extract of Belladonna Leaves. Extractum Belladonnae Foliorum. Eng., Extract of Belladonna Leaves. Contains about 1.25 per cent, of the alkaloids of Belladonna Leaves. Average Dose.-% grain (0.015 Gm.). Tinctura Belladonnae Foliorum. Eng., Tincture of Belladonna Leaves. Represents 10 per cent, of the drug in diluted alcohol. Average Dose.-12 minims (0.75 mil). 1 Shoemaker: Materia Medica and Therapeutics. 2 Musser and Kelly: Practical Treatment. BELLADONNA. 87 Unguentum Belladonnae. Eng., Belladonna Ointment. Contains 10 per cent, of the Extract of Belladonna Leaves. Official Preparations of the Root. Fluidextractum Belladonnae Radicis. Eng., Fluidextract of Bella- donna Root. Average Dose.-1 minim (0.05 mil). Linimentum Belladonnae. Eng., Belladonna Liniment. Contains 5 per cent, of Camphor in Fluidextract of Belladonna Root. Official Alkaloid and Salt. Atropina. Eng., Atropine. Average Dose.-H20 grain (0.0005 Gm.). Atropinae Sulphas. Eng., Sulphate of Atropine. Average Dose.-H20 grain (0.0005 Gm.). Therapeutic Action.-Stimulant, narcotic, anodyne, anti- spasmodic, mydriatic, rubefacient, anhydrotic, antisialic, antiga- lactagogue. Uses.-Used as an antispasmodic and anodyne in connection with other agents, as morphine or bromides, in the treatment of renal colic, gall-stone colic, cramp colic, dysmenorrhea, etc. Employed with other agents for cystitis, constipation, neuralgia, asthma, whooping-cough, incontinence of urine, etc. Useful for pulmonary edema, night-sweats, salivation, hay fever, and to arrest the secretion of milk. Used externally in ointments for glandular swellings, infections, etc. Atropine or homatropine are employed to dilate the pupil. Toxicology.-Belladonna poisoning is usually manifested by dilated pupils, dry mouth, dry and flushed skin, excitement, delirium, elevated blood-pressure and rapid pulse. Later there may follow collapse and coma. There may be a skin eruption which is usually scarlatiniform in appearance. Treatment.-In the early stages the stomach should be washed out, preferably with a solution of potassium permanganate (about 1:3000), and sedatives and ice-cap used as indicated. Morphine, with proper care, is serviceable. During the stage of coma, stimulants, as caffeine, camphor, etc., are indicated. Administration.-Internal.-The tincture and extract and atro- pine sulphate are the preparations most commonly used, the tinc- ture being used for solutions and the extract or atropine sulphate when it is desired to give in pills, capsules, etc. 88 BELLADONNA. Hypodermic.-Atropine Sulphate is the form employed, either alone or more commonly with morphine. It is used by the physician but not prescribed to be used by the patient. Locally.-The extract itself or the ointment made from the ex- tract are the preparations most commonly used. The following prescriptions illustrate the use of the drug: In the treatment of cystitis: B Sodii Citratis 3vj or 23 Sodii Bromidi 5iv 15 Tinct. Belladon. Fol f5ij 8 Aquae Menth. Pip q. s. fSiij 90 M. Sig.-Teaspoonful in water every four hours. In the treatment of whooping-cough; also spasmodic croup: R or Antipyrinae gr. l 3 Sodii Bromidi 5ij 8 Tinct. Belladon. Fol f5ss 2 Syr. Aurantii q. s. f3iij 90 M. Sig.-Teaspoonful in water every two to four hours. (For child 5 years old). This is not used for an extended period. In whooping-cough it is employed to control the stage of most violent paroxysms. In croup a dose is usually given in the morning, and two or three doses in the after- noon and evening, for three days. In the treatment of gonorrhea: Bi or Acidi Borici, Sodii Bromidi aa. gr. clx 10 Tinct. Belladon. Fol f3j 4 Liq. Potas. Citratis q. s. fSviij 240 M. Sig.-Tablespoonful in water four times daily. In the treatment of spasmodic croup: H2 or Sodii Bromidi 3ss 2 Tinct. Opii Camph f3ss 2 Tinct. Belladon. Fol TTLXV 1 Syr. Tolutani fSj 30 Aquae M. q. s. f5ij 60 Sig.-Teaspoonful every hour till relieved. (For child 2 years old). 1 White and Martin: Genito-urinary and Venereal Diseases. 2 Musser and Kelly: Practical Treatment. BELLADONNA. 89 As a postoperative laxative: Ri Ext. Belladon. Fol or gr. j 065 Ext. Cascarae Sag. ... gr. xx 1 300 Ext. Colocynth. Comp gr. xxv 1 600 M. ft. cap. no. x. Sig.-One at bedtime. In the treatment of constipation: R2 or Ext Cascarae Sag gr. xi 2 50 Ext. Nucis Vomicae gr. v 32 Ext. Belladon. Fol gr. ij 13 Resinae Podophylli gr. ij 13 M. ft. cap. no. xx. Sig.-One at bedtime. In the treatment of coryza: $3 Ext. Belladon. Fol or gr. ss 03 Campho rae gr- vj 40 Quininae Sulph., Pulv. Ipecac, et Opii aa.gr. xij 80 M. ft. cap. no. xij. Sig.-One every half-hour for four hours, then one every three hours. In the treatment of inflammations, as mastitis, furuncle, inflam- matory rheumatism, orchitis, etc.: or Camphorse Ung. Belladon., 5ss 2 Ichthyolis aa. 3ij 8 Petrolati q. s. 5j 30 M. Sig.-Apply twice daily. To relieve pain, particularly in such conditions as cystitis, oophoritis, appendicitis, etc.: or Ext. Belladon. Fol gr. j 065 Ext. Opii gr- "j 200 Olei Theobromatis q. s. M. ft. suppos. no. iv. Sig.-One twice daily. 1 Ashton: Practice of Gynecology. 2 Ibid. 3 Musser and Kelly: Practical Treatment. 90 BENZALDEHYDUM. BENZOINUM. In the treatment of salivation: Ri or Atropinse Sulphatis gr. %2 002 Sacchari Lactis 5ss 2 000 M. ft. cht. no. x. Sig.-One every three hours until pupils dilate. As a purgative prescription, particularly for such conditions as colds, grip, acute alcoholism, etc.: B or Atropinae Sulph gr. Moo 0006 Strychninae Sulph gr. M2 0020 Hydrarg. Chlor. Mitis gr. v 3200 Ext. Cascarae Sag gr. vj 4000 M. ft. cap. no. ij. Sig.-Take one hour apart. BENZALDEHYDUM. Latin, Benzaldehydum. Eng., Benzaldehyde. A colorless liquid. Average Dose.-% minim (0.03 mil). Used commercially as a flavoring agent. BENZINUM PURIFICATUM. Latin, Benzinum Purificatum. Eng., Purified Petroleum Benzin. Synonym, Purified Benzin. A colorless liquid. BENZOINUM. Latin, Benzoinum (Gen., Benzoini). Eng., Benzoin. Synonyms, Gum Benzoin, Gum Benjamin. A balsamic resin obtained from Styrax Benzoin and other species of Styrax. Active ingredients, Benzoic Acid, Volatile Oil, etc. Form.-Usually appearing as brownish tears or fragments Odor and Taste.-Pleasant odor and slightly acid taste. Solubility.-Active constituents soluble in alcohol. Insoluble in water. Average Dose.-15 grains (1 Gm.). Adeps Benzoinatus.-See Adeps, p. 49. Tinctura Benzoini. Eng., Tincture of Benzoin. Benzoin, 200 Gm.; Alcohol, to make 1000 mils. Official Preparations. 1 White and Martin: Genito-urinary and Venereal Diseases. BENZOINUM. 91 Average Dose.-15 minims (1 mil). Tinctura Benzoini Composita. Eng., Compound Tincture of Benzoin. Synonym, Friar's Balsam. Benzoin, 100 Gm.; Storax, 80 Gm.; Balsam of Tolu, 40 Gm.; Purified Aloes, 20 Gm.; Alcohol, to make 1000 mils. Average Dose.-30 minims (2 mils). The tincture and the compound tincture are frequently employed. Therapeutic Action.-Expectorant. Uses.-The tinctures of benzoin are sometimes used by mouth as expectorants for cough, bronchitis, etc. By inhalation the com- pound tincture is frequently used for cough, bronchitis, pneumonia, croup, etc. Externally the tinctures are employed in cosmetics to add sticking qualities and as protectives. The use of Benzoin by inhalation in bronchitis, whooping-cough, etc., is shown in the following: or Tinct. Benzoini Co 60| Sig.-Use teaspoonful to pitcher of hot water as directed. R or Creosoti f5ij 8| Tinct. Benzonini Co q. s. fSij 601 M. Sig.-Use teaspoonful to pitcher of hot water as directed. Written instructions should be given in detail as to the method of employment. Usually for about fifteen minutes every three hours. The Compound Tincture of Benzoin lends itself well to the local applicaction of remedies, as in the following for ringworm, etc.: or Hydrarg. Chlor. Corros gr. ss 103 Tinct. Benzoini Co. q. s. fSj 30 00 M. Sig.-Paint the part twice daily. n or Acidi Salicylici gr. x I6 Tinct. Benzoini Co q. s. f5j 30 0 M. Sig.-Paint the part twice daily. ACIDUM BENZOICUM (Gen., Acidi Benzoici). Eng., Benzoic Acid. Formula, HC7H5O2. An organic acid obtained from benzoin or pre- pared synthetically. 92 BENZOINUM. Form.-Whitish scales or needles. Odor and Taste.-Almost odorless and somewhat pungent taste. Solubility.-In 275 parts of water or 2.3 parts of alcohol. Average Dose.-8 grains (0.5 Gm.). Benzoic Acid is contained in Liquor Antisepticus and Tinctura Opii Camphorata. Incompatibles.-Acids, ferric salts, alkali hydroxides, lead acetate, cor- rosive mercuric chloride. AMMONII BENZOAS (Gen., Ammonii Benzoatis). Eng., Am- monium Benzoate. Formula, NH4C7H5O2. Form.-White crystals or crystalline powder. Odor and Taste.-Slight odor; saline, bitter, afterward slightly acid taste. Solubility.-In about 10 parts of water or 35.5 parts of alcohol. Average Dose.-15 grains (1 Gm.). SODII BENZOAS (Gen., Sodii Benzoatis). Eng., Sodium Benzoate. Formula, NaC7Hr,O2. Form.-A white powder. Odor and Taste.-Odorless; having a sweetish, astringent taste. Solubility.-In 1.8 parts of water or 61 parts of alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antiseptic, stimulant, expectorant, diu- retic, antipyretic. Uses.-Principally used in the treatment of genito-urinary dis- eases, as gonorrhea, cystitis, etc., particularly when it is desirable to increase the acidity of the urine. Administration.-Sodium Benzoate is the preparation most frequently used. The Benzoates may be administered in capsules or in solution in a vehicle, as water, peppermint water, or aromatic elixir. Official Benzoates. In cystitis, gonorrhea, etc., with alkaline urine: Sodii Benzoatis 3iv or 15 Sodii Bromidi 3iij 12 Inf. Buchu q. s. f5ij 60 M. Sig.-Two (2) teaspoonfuls in water every four hours. For rendering the urine more acid: RI or Acidi Benzoici 3ij 8 Acidi Borici 3iij 12 Aquse Cinnamomi fSxij 360 M. Sig.-Tablespoonful in water four times daily. 1 Ashton: Practice of Gynecology. BENZOSULPHINIDUM. 93 In the treatment of acne: RI or Sodii Benzoatis 5ij 8 Tinct. Nucis Vomicae f3ij 8 Flext. Cascarae Sag f5ss 15 Tinct. Cardamomi Comp q. s. fSiij 90 M. Sig.-Teaspoonful in water after meals. BENZOSULPHINIDUM. Latin, Benzosulphinidum (Gen., Benzosulphinidi). Eng., Ben- zosulphinide, Saccharin. Form.-A white, crystalline powder. Odor and Taste.-Nearly odorless, and having an intensely sweet taste. Solubility.-Ip 290 parts of water or 31 parts of alcohol. Average Dose.-3 grains (0.2 Gm.). The product is about 500 times as sweet as sugar. Uses.-Employed as a substitute for sugar. Administration.-It is sometimes prescribed in formulae, as for the "tasteless" Castor Oil (see p. 236) or to be used by diabetics in place of sugar. BETAEUCAIN^ HYDROCHLORIDUM. Latin, Betaeucainae Hydrochloridum (Gen., Betaeucainae Hydro- chloridi). Synonyms, Eucaine, Eucaine Chloride. A synthetic derivative of piperidine. Form.-A white powder. Odor and Taste.-Odorless; local anesthetic to sense of taste. Solubility.-Soluble in 30 parts of water and in 35 parts of alcohol. Incompatibles.-Prescribed alone in sterile distilled water, or with the addition of solution of adrenalin chloride. Toxicity.-Slightly less than cocaine. Uses.-A local anesthetic. Administration.-Not prescribed to be used by patients. It is extensively employed by the profession in aqueous solution as a local anesthetic. 1 Hughes: Practice of Medicine. BETANAPHTHOL. 94 The Braun solution may be ordered as R or Betaeucainae Hydroch gr. iiiss 24 Sodii Chloridi gr. xv 96 Aquae Dest. Ster q. s. f5iv 120 00 M. Sig.-Formula. Solution of Adrenalin Chloride may be added just before using. Latin, Betanaphthol (Gen., Betanaphtholis). Eng., Betanaph- thol. Synonym, Naphthol. A Phenol occurring in coal-tar, but usually prepared from naphthalene. Form.-Colorless or pale buff-colored crystals or powder. Odor and Taste.-Faint, phenol-like odor and slight pungent taste. Solubility.-In 1000 parts of water and 0.8 part alcohol. Incompatibles.-Antipyrine, camphor, exalgine, ferric chloride, menthol, phenol, potassium permanganate, urethane. Average Dose.-4 grains (0.25 Gm.). Therapeutic Action.-Antiseptic, irritant. Uses.-Sometimes used internally for diarrhea, intestinal in- digestion, flatulent dyspepsia, typhoid fever, etc. Externally, it is used for various skin diseases, as scabies, ringworms, sebor- rhea and kindred disorders. Administration.-Internally.-It is sometimes used as a salt, particularly Bismuth Betanaphthol. In the treatment of diarrhea of typhoid fever: BETANAPHTHOL. Ri or Betanaphtholis 3j 4I Bismuthi Subgal 5ij 8I M. ft. cap. no. xxiv. Sig.-One every three hours. Externally it is extensively used by the dermatologist. The following will illustrate some combinations: In the treatment of seborrhea: R2 or Resorcinolis 3j 4 0 Betanaphtholis gr. xx 1 3 Tinct. Cinchonae Comp 12 0 Spiritus Myrciae q. s. f3vj 180 0 M. Sig.-Apply twice daily. 1 Anders: Practice of Medicine. 2 Ohmann-Dumesnil: Diseases of the Skin. 95 BISMUTHUM. In the treatment of seborrhea: Ri or Betanaphtholis f3ij 8 Alcoholis fSiij 90 Spir. Myrciae q. s. f3vj 180 M. Sig.-Apply twice daily. In the treatment of scabies: B2 or Betanaphtholis, Sulphuris Praecip aa. 3ss 2 Petrolati q. s. 30 M. Sig.-Apply as directed. Used in the treatment of grain-itch: B3 or Betanaphtholis gr. xxx 2 0 Sulphuris Praecip gr. xl 2 5 Adipis Benzoinati q. s. 5j 30 0 M. Sig.-Apply as directed. In the treatment of ringworm of the scalp: R4 or Betanaphtholis 2 Olei Cadini 3j 4 Ung. Sulphuris q- s. ij 30 M. Sig.-Apply as directed. BISMUTHUM-Bismuth. Official Salts. {Not Official.) General Character of Bismuth Salts. Form.-All white, or nearly white, powders except the subgallate, which is yellow, and Bismuth Betanaphthol, which is brownish. Odor and Taste.-All practically odorless and tasteless except Bismuth and Ammonium Citrate, which has a metallic taste. 1 Ohmann-Dumesnil: Diseases of the Skin. 2 Hughes: Practice of Medicine. 3 Musser and Kelly: Practical Treatment. 4 Stelwagon: Diseases of the Skin. 96 BISMUTHUM. Solubility.-All practically insoluble except the Bismuth and Ammonium Citrate, which is soluble in water. Incompatibles.-As they are insoluble and usually given in dry form, incompatibility is seldom a factor. They are best not prescribed with other acids or with iodine, iodides, etc. BISMUTHI ET AMMONII CITRAS (Gen., Bismuthi et Ammonii Citratis). Eng., Bismuth and Ammonium Citrate. Average Dose.-2 grains (0.125 Gm.). BISMUTHI SUBCARBONAS (Gen. Bismuthi Subcarbonatis). Eng., Bismuth Subcarbonate. Average Dose.-8 grains (0.5 Gm.). BISMUTHI SUBGALLAS (Gen. Bismuthi Subgallatis). Eng., Bis- muth Subgallate. Average Dose.-8 grains (0.5 Gm.). BISMUTHI SUBNITRAS (Gen., Bismuthi Subnitratis). Eng., Bis- muth Subnitrate. Average Dose.-8 grains (0.5 Gm.). BISMUTHI SUBSALICYLAS (Gen., Bismuthi Subsalicylatis). Eng., Bismuth Subsalicylate. Average Dose.-8 grains (0.5 Gm.). Therapeutic Action.-Antiseptic, astringent, protective. Uses.-Internally used in the treatment of gastritis, hyper- chlorhydria, gastric ulcer, diarrhea, dysentery, etc. Externally, in powders or ointments in the treatment of ulcers, burns, miliaria, eczema and many other skin conditions. The subnitrate (33 per cent.) with petrolatum (Beck's Paste) is used for chronic suppurat- ing sinuses, cavities, etc., particularly of tuberculous origin. Administration.-Internally.-The subnitrate is the salt of common choice, though the subgallate is considered more astringent, and the subcarbonate better for some forms of gas- tric disturbances. The tendency is to give large doses. These salts may be given dry or in mixtures, but when in the latter form, as the powders are heavy, care should be exercised that the liquid be sufficiently thick to hold the powder suspended while a dose is being poured. The following examples show some usual combinations: When it is desired to administer a bismuth salt alone it may be ordered as follows: or Bismuthi Subnit 3ij Ft. cht. no. xij. Sig.-One every four hours. BISMUTHUM 97 Or: R or Bismuthi Subnit gr. clx 10 Muc. Acaciae 5ss 15 Syr. Aurantii q. s. f5ij 60 M. Sig.-Teaspoonful every four hours. (Shake-label.) In the treatment of the intestinal disturbances of childhood when the bismuth salt does not change the character of the stool it is often combined with sulphur at the time of administration. In addition to one of the prescriptions just given, another is written as follows: B or Sulphuris Praecip gr. xxx 2| M. ft. cht. no. xv. Sig.-One with each dose of the other medicine. In the treatment of diarrhea of typhoid fever: IP or Betanaphtholis - . . 5j 41 Bismuthi Subgal • 3ij 8 M. ft. cap. n-e. xxiv. Sig.-One every three hours. This could also be ordered in suspension in mucilage of acacia, syrup, etc. Used for the relief of abdominal tympany: R2 or Phenylis Salicyl gr. xx 1|3 Bismuthi Subnit gr- 1 3|0 M. ft. cap. no. x. Sig.-One two hours after each meal. This may be ordered in powders. In the treatment of dysentery: R3 or Phenylis Salicyl., Bismuthi Subnit., Cretas Praep aa. 5j 4 M. ft. cht no. xij. Sig.-One every two hours. 1 Anders: Practice of Medicine. 2 Ashton: Practice of Gynecology. 8 Shoemaker: Materia Medica and Therapeutics. 98 BISMUTHUM. In the treatment of gastric ulcer, etc.: or Atropinae Sulph gr. Ks 004 Bismuthi Subnitratis 5iv 15 000 Magnesii Oxidi 3iv 15 000 Sodii Bicarbonatis 3ij 8 Calcii Carb. Praecip 3j 4 000 M. ft. cht. no. xv. Sig.-One in a glass of milk three times a day. In the treatment of diarrhea, dysentery, nausea, etc.: or Bismuthi Subnit 3iij 12 Spir. Chloroformi fSiss 6 Tinct. Opii Camph Siij 12 Spir. Vini Gallici f5vj 23 Mist. Cretae q. s. fjiij 90 Sig.-Tablespoonful every three hours until relieved. (Shake-label.) In the treatment of diarrhea of typhoid fever: Bi or Bismuthi Subnitratis 10 0 Phenolis Liq Tqxxx 2 0 Tinct. Opii Deod f3j 4 0 Mucil. Acaciae f3j 30 0 Aquae q. s. f3iv 120 0 M. Sig.-Teaspoonful every three hours. (Shake-label.) In the treatment of acute intestinal indigestion: B2 or Phenolis gr. iv 32 Naphthaleni gr. xxx 2 00 Bismuthi Subsalicyl gr. Ixxx 5 00 Glycerini fSj 30 00 Aquae Chloroformi q. s. fSiij 90 00 M. Sig.-Two (2) teaspoonfuls in water every two hours. (Shake-label.) In the treatment of enterocolitis: $3 Bismuthi Subnitratis 5iij or 12 Tinct. Kino, Tinct. Opii Camph aa. fjiss 45 Mist. Cretae q. s. f5vj 180 M. Sig.-Tablespoonful every three hours. (Shake-label.) i Hughes: Practice of Medicine. 2 Ibid. »Ibid. BISMUTHUM. 99 Externally.-Bismuth Subnitrate is extensively used as a local application. It is prescribed either alone or with other agents. The following will illustrate: As a local application in the treatment of impetigo, fever blis- ters, etc.: ♦ or Hydrarg. Chlor. Mitis gr. xv 11 Bismuthi Subnitratis q. s. 3iv 15 M. Sig.-Apply twice daily. In the treatment of herpes, bromidrosis, etc.: Qi or Alumenis Pulv 3j 4 Phenylis Salicyl 2 Bismuthi Subnit 3j 4 Ung. Zinci Oxidi q. s. 3j 30 M. Sig-Apply. In the treatment of erythema venenatum: B or Morphinae Sulph gr. v 32 Bismuthi Subnit 3j 4 00 Ung. Aquae Rosae q. s. 3j 30 00 M. Sig.-Apply in a thin layer. In the treatment of ecthyma: R Acidi Borici or 65 Bismuthi Subnit 5j 4 00 Picis Liquidae gr. xx 1 30 Ung. Aquae Rosae q. S. 3j 30 00 M. Sig.-Apply on a cloth twice daily. In the treatment of dermatitis: R2 or Phenolis gr. xij 8 Bismuthi Subnit 3iss 6 0 Adipis Lanae Hyd Sij 8 0 Ung. Zinci Oxidi q. s. 5j 30 0 M. Sig.- Apply locally. 1 Shoemaker: Materia Medica and Therapeutics. 2 Ashton: Practice of Gynecology. 100 BROMOFORMUM. BROMUM. BROMOFORMUM. Latin, Bromoformum. Eng., Bromoform. A colorless liquid. Average Dose.-3 minims (0.2 mil). Therapeutic Action.-Antispasmodic, anesthetic. Uses.-Has been recommended principally for the treatment of whooping-cough. Not often prescribed. BROMUM. (Not Official.) Latin, Bromum. Eng., Bromine. A heavy, dark, brownish-red liquid. Official Bromides. General Characteristics. Form.-Colorless crystals or white granular or crystalline powders. Odor and Taste.-Odorless and having a sharp, saline, rather disagree- able taste. Solubility.-Soluble in less than 2 parts of water and usually deliques- cent. Soluble in alcohol. Incompatibles.-Acids, acid salts, many metallic salts, alkaloids, chlorine water, salts of mercury, spirit of nitrous ether. AMMONII BROMIDUM (Gen., Ammonii Bromidi). Eng., Am- monium Bromide. Formula, NFUBr. Average Dose.-15 grains (1 Gm.). CALCII BROMIDUM (Gen., Calcii Bromidi). Eng., Calcium Bro- mide. Formula, CaBr2. Average Dose.-15 grains (1 Gm.). LITHII BROMIDUM (Gen., Lithii Bromidi). Eng., Lithium Bro- mide. Formula, LiBr. Average Dose.-15 grains (1 Gm.). POTASSII BROMIDUM (Gen., Potassii Bromidi). Eng., Potassium Bromide. Formula, KBr. SODII BROMIDUM (Gen., Sodii Bromidi). Eng., Sodium Bromide. Formula, NaBr. Average Dose.-15 grains (1 Gm.). STRONTII BROMIDUM (Gen., Strontii Bromidi). Eng., Strontium Bromide. Formula, SrBr2. Average Dose.-15 grains (1 Gm.). ACIDUM HYDROBROMICUM DILUTUM. (Gen. Acidi Hydro- bromici Diluti). Eng., Diluted Hydrobromic Acid. An aqueous solution containing about 10 per cent, of HBr. Average Dose.-15 minims (1 mil). Therapeutic Action.-Sedative, hypnotic, anodyne, antispas- modic. BROMUM. 101 Uses.-To relieve pain or produce quiet or sleep in headache, nervousness, hysteria, epilepsy, alcoholism, tetanus, rabies, strychnine poisoning, eclampsia and kindred conditions. Administration.-It will be noted that the bromides are all white or nearly white salts freely 'soluble in water, forming clear, colorless solutions. Most of them will become moist on exposure to air, so should not be dispensed in powder. The taste of the salts is usually sharp, so they should be well diluted. When diluted the taste is not very disagreeable. They are best prescribed in solution in such vehicles as water, peppermint water, aromatic elixir, etc. Potassium Bromide is the most largely used, but is not necessarily the most desirable. The bromides may be administered by mouth or rectum. A bromide may be ordered alone, as: or Sodii Bromidi t 8I Elix. Aromatici q- s. f5j U 301 M. Sig.-Teaspoonful in water every three hours when needed. As a hypnotic, sedative, etc., they are often combined with other agents, as: B or Chlorali Hydrati 5j 4 Sodii Bromidi 3ij 8 Tinct. Hyoscyami f3ss 2 Aquse Menth. Pip q. s. f5j 30 M. Sig.-Teaspoonful in water every four hours when necessary. Or: B or Codeinae Phos gr. iv 26 Chlorali Hydrati 5j 4 00 Sodii Bromidi 8 00 Aquae Chloroformi q. s. f5j 30 00 M.. Sig.-Teaspoonful in water every four hours until relieved. Bromides are often prescribed as: or Ammon. Bromidi gr. xx 1 3 Sodii Bromidi gr. xxx 2 0 Strontii Bromidi gr. xxx 2 0 Potassii Bromidi gr. xl 2 5 Syr. Aurantii q. s. f3j 30 0 M. Sig.-Teaspoonful in water every three hours when necessary. 102 BROMUM. In the treatment of convulsions: Bi or Chlorali Hydrati • •••' gr. viij 5 Sodii Bromidi gr. xvj 1 0 Syrupi Aurantii q. s. fjij 60 0 M. Sig.-Teaspoonful. Repeat in one hour if necessary. (For child 2 years old.) In the treatment of acute laryngitis: R2 or Chlorali Hydrati gr. Ixxv 5 Ammonii Bromidi gr. xxx 2 Sodii Bromidi gr. xlv 3 Aquae Cinnamomi q. s. fSij 60 M. Sig.-Teaspoonful in water every twenty minutes till improvement takes place. In the treatment of headache following a debauch: $3 Ammonii Bromidi 5iij or 12 Spir. Ammoniae Arom f3iv 15 Elix. Aromatici q. s. f5iij 90 M. Sig.-Two (2) teaspoonfuls in water every two hours till relieved. In the treatment of gonorrhea: R4 or Acidi Borici, Sodii Bromidi aa. gr. clx 10 Tinct. Belladon. Fol f3j 4 Liq. Potas. Citratis q. s. fSviij 240 M. Sig.-Tablespoonful in water four times daily. Or: $5 or Tinct. Veratri n.v"j 5 Sodii Bromidi, Sodii Bicarb aa. gr. clx 10 0 Liq. Potas. Citratis q. s. f jviij 240 0 M. Sig.-Tablespoonful in water every two hours. 1 Ruhrah: Diseases of Children. 2 Musser and Kelly: Practical Treatment. 3 Ibid. ♦ White and Martin: Genito-urinary and Venereal Diseases. 6 Ibid. BUCHU. CAFFEINA. 103 In the treatment of spasmodic croup: Hi or Ammonii Bromidi 5ss 2 Tinct. Opii Camph f3ss 2 Tinct. Belladon. Fol Tqxv 1 Syr. Tolutani fSj 30 Aquae q. s. fSij 60 M. Sig.-Teaspoonful every hour till relieved. (For child 2 years old.) Bromides are frequently used by enema, as in strychnine poison- ing, convulsions, etc.: or Chlorali Hydrati 5j 4 Sodii Bromidi 5ij 8 Aquae q. s. f5ij 60 M. Sig.-Use tablespoonful to cup of warm water as enema. BUCHU. Latin, Buchu (Gen., Buchu). Eng., Buchu. The dried leaves of Barosma betulina or of Barosma serratifolia. Average Dose.-30 grains (2 Gm.). Fluidextractum Buchu. Eng., Fluidextract of Buchu. Average Dose.-30 minims (2 mils). Therapeutic Action.-Diuretic, urinary disinfectant, diapho- retic. Uses.-Principally employed in the treatment of diseases of the genito-urinary tract. Administration.-Usually prescribed in combination with other agents, the most popular preparation being the Elixir of Buchu, Juniper and Potassium Acetate. Official Preparation, CAFFEINA. Latin, Caffeina (Gen., Caffeinae). Eng., Caffeine. A feebly basic alkaloid obtained from tea {Thea sinensis') or coffee (Coffea arabica). Also occurring in other plants or prepared synthetically. Coffee contains about 0.67 to 2.25 per cent., and tea about 3.2 per cent. Average Dose.-2^ grains (0.15 Gm.). i Musser and Kelly: Practical Treatment. 104 CAFFEINA. Caffeina Citrata (Gen., Caffeinae Citratae). Eng., Citrated Caffeine. Composed of equal parts of Caffeine and Citric Acid. Form.-A white powder. Odor and Taste.-Odorless and having a slightly bitter taste. Solubility.-Soluble in water or alcohol. Average Dose.-5 grains (0.3 Gm.). Caffeina Citrata Effervescens. Eng., Effervescent Citrated Caffeine. Contains 4 per cent. Caffeine. Average Dose.-60 grains (4 Gm.). Caffeinae Sodiobenzoas (Gen., Caffeinae Sodiobenzoatis). Eng., Caf- feine Sodiobenzoate. A mixture of caffeine and sodium benzoate in equal parts. Form.-A white powder. Odor and Taste.-Odorless and having a slightly bitter taste. Solubility.-Soluble in 1.1 parts of water; some caffeine separates on standing. Soluble in 30 parts of Alcohol. Average Dose.-By mouth 5 grains (0.3 Gm.). Hypodermic, 3 grains (0.2 Gm.). Therapeutic Action.-Stimulant, diuretic. Uses.-To counteract the depressing effects of analgesics and antipyretics in thq treatment of headache, neuralgia, colds, grip, etc. In the treatment of dropsy and cardiac weakness. An effi- cient antidote for poisoning by opium, alcohol and some other narcotics. Administration.-Caffeine is usually prescribed in the form of citrated caffeine either in solution or dry. The Citric Acid is used to render the alkaloid more soluble. It is not a salt, but a mix- ture. Caffeine is also rendered more soluble by the addition of such drugs as antipyrine, potassium bromide and sodium benzoate and salicylate, etc. The following prescriptions show some frequently used combina- tions : Official Preparations. In the treatment of colds, etc.: R Caffeinae Citratae or gr. x 6 Acidi Acetylsalicylici gr. xl 2 5 Quininae Hydrobrom M. ft. cap. no. xv. gr. xx 1 3 Sig.-Take 6 today and 4 tomorrow. Instructions can be given patient as to time of taking, etc., as, 1 in the morning, 2 at noon, and 3 at night. CALAMINA PR2EPARATA. 105 The following has been recommended for headache: Ri or Acetanilidi gr. Ixxij 4 50 Caffeinae Citratae, Camphorae Monobromatae aa. gr. xij 75 Sodii Bicarbonatis gr. xlviij 3 00 M. ft. cap. no. xxiv. Sig.-One every half-hour until four (4) are taken. In the treatment of chronic valvular disease: I}2 or Strychninae Sulph gr. % 02 Sparteinae Sulph gr. iij 20 Caffeinae Citratae 5ss 2 00 M. ft. cap. no. xij. Sig.-One every four hours. In the treatment of migraine: R3 Caffeinae Citratae or gr. v 32 Camphorae Monobromatas gr. xx 1 30 Acetphenetidini gr. xx 1 30 M. ft. cap. no. x. Sig.-One every two hours until relieved. CALAMINA PRJEPARATA. Latin, Calamina Praeparata. Eng., Prepared Calamine. Not official. A mixture of the native carbonate and silicate of zinc. A pinkish or flesh-colored powder of earthy appearance, prac- tically odorless and insoluble in water. It was official in the U. S. Pharmacopoeia of 1850. Therapeutic Action.-Astringent, desiccant. Uses.-In the treatment of herpes, some forms of eczema, ulcerations, etc. Administration.- It is used rather frequently by the der- matologist in external applications. 1 Musser and Kelly: Practical Treatment. 2 Anders: Practice of Medicine. ® Hughes: Practice of Medicine. 106 CALCIUM. In the treatment of herpes progenitalis: Ri or Zinci Oxidi, Calaminae Praep aa. gr. x 65 Glycerini, Alcoholis aa. n^xij 75 Aquae q. s. f jij 60 00 M. Sig.-Apply freely. (Shake-label.) (Not Official.) CALCIUM. Official Salts and Preparations of Calcium. CALCII BROMIDUM.-See Bromum, p. 100. CALCII CARBONAS PR^CIPITATUS. Eng., Precipitated Cal- cium Carbonate. Synonym, Precipitated Chalk. Formula, CaCOs. Form.-White powder. Odor and Taste.-Odorless and tasteless. Solubility.-Practically insoluble in water or alcohol. This salt is used in making some other preparations of minor importance. Average Dose.-15 grains (1 Gm.). CALCII CHLORIDUM (Gen., Calcii Chloridi). Eng., Calcium Chlo- ride. Formula, CaCh. Form.-White powder. Odor and Taste.-Odorless; having sharp, saline taste. Solubility.-In 0.62 part of water or 10 parts of alcohol. Incompatibles.-Acids, carbonates, sulphates, etc. Average Dose.-8 grains (0.5 Gm.). CALCII GLYCEROPHOSPHAS.-See Glycerophosphates, p. 30. CALCII HYPOPHOSPHIS.-See Acidum Hypophosphorosum, p. 29. CALCII LACTAS (Gen., Calcii Lactatis). Eng., Calcium Lactate (Formula, CatCsHgOs^ + 5H2O). Form.-White powder or granular masses. Odor and Taste.-Odorless and nearly tasteless. Solubility.-Soluble in 20 parts of water. Almost insoluble in alcohol. Average Dose.-8 grains (0.5 Gm.). CALCII SULPHIDUM CRUDUM. Eng., Crude Calcium Sulphide. Synonyms, Calx Sulphurata; Sulphurated Lime (U. S. P., viii). It con- tains not less than 55 per cent, of CaS. Average Dose.-1 grain (0.06 Gm.). CALX. Eng., Calcium Oxide, Lime. Synonym, Quick Lime. CALX CHLORINATA. Eng., Chlorinated Lime. Synonym, Chlo- ride of Lime. A product resulting from the action of chlorine upon 1 Stelwagon: Diseases of the Skin. CALCIUM. 107 calcium hydroxide and containing not less than 30 per cent, of available chlorine. Care should be exercised to avoid confusing this with calcium chlo- ride. Chlorinated Lime is not used internally, but is a disinfectant em- ployed for the chlorine content. Calcium chloride is used internally and for the calcium content. CRETA PR7EPARATA (Gen., Cretae Praeparatae). Eng., Prepared Chalk. Synonym, Drop Chalk. A native form of Calcium Carbonate freed from most of its impurities by elutriation and containing, when dried to a constant weight, not less than 97 per cent, of CaCO3. Form.-Whitish powder often moulded into cones. Odor and Taste.-Odorless and tasteless. Solubility.-Practically insoluble in water or alcohol. Incompatibles.-Acids, salicylates, alum, etc. Average Dose.-15 grains (1 Gm.). Mistura Cretae. Eng., Chalk Mixture. Compound Chalk Powder, 20 Gm.; Cinnamon Water, 40 mils; Water, to make 100 mils. Average Dose.-4 fluidrachms (15 mils). Pulveris Cretae Compositus. Eng., Compound Chalk Powder. Pre- pared Chalk, 30 Gm.; Acacia, 20 Gm.; Powdered Sugar, 50 Gm. Average Dose.-30 grains (2 Gm.). Prepared chalk is contained in Hydrargyrum Cum Creta. Linimentum Calcis. Eng., Lime Liniment. Synonym, Carron Oil. Equal parts of Linseed Oil and Lime Water. LIQUOR CALCIS. Eng., Lime Water. A saturated aqueous solu- tion which should contain not less than 0.14 per cent, of pure Calcium Hydroxide. Average Dose.-4 fluidrachms (15 mils). This solution should be clear when dispensed, as unfortunate results have occurred from patients using a preparation containing an excess of the calcium salt and ignorantly shaking the preparation before using. SYRUPUS CALCII LACTOPHOSPHATIS. Eng., Syrup of Cal- cium Lactophosphate. Average Dose.-2)4 fluidrachmsi (10 mils). Therapeutic Action.-Prepared Chalk, Precipitated Calcium Carbonate and Lime Water are antacid and mildly astringent. Chlo- rinated Lime is antiseptic and disinfectant. Calcium Chloride and Lactate are classed as resolvents and hemostatics. Uses.-The precipitated carbonate is used for hyperchlor- hydria, gastric ulcer, etc. Prepared chalk is used in combination with other agents in dusting powders or ointments in the treat- ment of eczema, dermatitis, ulcers, etc. Its preparations are used for diarrhea, dysentery and other gastro-intestinal conditions. Lime Water is extensively employed in the artificial feeding of infants and the milk diet of adults; also as a spray for diphtheria, 108 CALCIUM. etc. Lime Liniment is employed for burns. Calcium chloride and lactate are used for hemorrhages, particularly purpura haemor- rhagica, scurvy, etc. Recommended for chronic bronchitis and asthma. Administration.-Internally.-In solution, Calcium Chloride or Lactate, or Calcium Hydroxide in the form of Lime Water, are the preparations ordinarily prescribed. They are usually pre- scribed alone. To increase the coagulability of the blood, as in the treatment of purpura: B Calcii Chloridi 3j or 41 Aquas Dest q. s. f5ij 60 M. Sig.-Tablespoonful in water every two hours if necessary. Lime Water is largely used in the artificial feeding of infants. Patients should be cautioned that a clear solution is necessary and that they should not shake the bottle before using, as it might dis- turb a sediment. It may be ordered as: or Liquoris Calcis Oj 480| Sig.-Lime water. Prepared Chalk in powders or suspension is largely used, par- ticularly in intestinal disturbances. It is prescribed either alone or with other agents. The following will illustrate: In the treatment of dysentery: Ri or Phenylis Salicyl., Bismuthi Subnit., Cretae Praep 4 M. ft. cht. no. xij. Sig.-One every two hours. In the treatment of catarrhal enteritis of childhood: R2 or Tinct. Opii Deodorati nixvj 1 Bismuthi Subnitratis gr. Ixxx 5 Misturae Cretae q. s. f$ij 60 M. Sig.-Teaspoonful every two hours. (Shake-label.) 1 Shoemaker: Materia Medica and Therapeutics. 2 Hughes: Practice of Medicine. CALCIUM. 109 In the treatment of enteric troubles of childhood: R Bismuthi Subnit 5ij or 81 Misturae Cretae q. S. f3ij 60 M. Sig.-Teaspoonful every three hours until relieved. (Shake-label.) In the treatment of enterocolitis: Ri Bismuthi Subnit 3iij or 12 Tinct. Kino, Tinct. Opii Camph aa. f5iss 45 Misturae Cretae q. s. fSvj 180 M. Sig.-Tablespoonful every three hours. (Shake-label.) Calcium Carbonate and Phosphate are frequently employed in- ternally in dry form. In the treatment of hyperacidity: B or Magnesii Oxidi 3iv 15|0 Calcii Carb. Praec., 3iij 1210 Bismuthi Subnit aa. 3iij 120 01. Menth. Pip TT1V |3 M. Sig.-Level teaspoonful in glass of milk two hours after meals. This may be ordered in twenty powders and the directions made to read ''One in glass of milk two hours after meals." Externally.-Lime Liniment is an old-time remedy tor burns. It is usually prescribed alone or with a small amount of Phenol. n or Phenolis Liquefacti Tlxv 1| Linimenti Calcis q. s. fSvj 1801 M. Sig.-Apply to burn as directed. (Shake-label.) Some prescribers prefer to order lime water and olive oil in equal parts, and for some reasons it would seem more desirable. Calcium Carbonate and Phosphate and Prepared Chalk are some- times used externally. 1 Hughes: Practice of Medicine. 110 CALUMBA. CAMBOGIA. In the treatment of erythema venenatum: Bi or Acidi Borici gr. xv • 1 0 Talci Purificati gr. xx 1 3 Crete Praep 5iv 15 0 Magnesii Carbonatis 5iij 12 0 M. Sig.-Use as a dusting powder. In the treatment of scabies: B2 or Sulphuris Loti, Olei Cadini, Cretae Praep aa. 3ij 8 Saponis Mollis 3v 19 Adipis q. s. Sij 60 M. Sig.-Rub in thoroughly. CALUMBA. Latin, Calumba (Gen., Calumbae). Eng., Calumba. Synonyms, Calumbo, Columbo, Colombo. The dried root of Jateorhiza pal- mata. Average Dose.-30 grains (2 Gm.). Tinctura Calumbae. Eng., Tincture of Calumba. Represents 20 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Therapeutic Action.-Bitter tonic. Uses.-Principally used as a vehicle for tonic preparations. Administration.-The tincture is used almost exclusively and is usually prescribed with such agents as nux vomica. Official Preparation. CAMBOGIA. Latin, Cambogia (Gen., Cambogiae). Eng., Gamboge. A gum- resin obtained from Garcinia Hanburii. Average Dose.-2 grains (0.125 Gm.). Gamboge is contained in Compound Cathartic Pills. Therapeutic Action.-Cathartic. 1 Ohmann-Dumesnil: Diseases of the Skin. 2 Ibid. CAMPHORA. 111 Uses.-Employed in combination when an active purgative of the drastic and hydragogue type is indicated. Administration.-It is seldom used except in the compound cathartic pill. CAMPHORA. Latin, Camphora (Gen., Camphorae). Eng., Camphor. Syno- nym, Gum, Camphor. Formula, CioHjgO. A ketone obtained from Cinnamomum Camphora. Form.-White, translucent masses. Odor and Taste.-Characteristic pleasant odor, and a pungent, aromatic taste. Solubility.-Sparingly soluble in water. Readily soluble in alcohol. Incompatibles.-Will liquefy when rubbed with hydrated chloral, menthol, phenol, thymol, etc. Camphor Water is incompatible with strong solutions of salts. Average Dose.-By mouth, 3 grains (0.2 Gm.) ; hypodermic, 1% grains (0.1 Gm.). Official Preparations. Aqua Camphorae. Eng., Camphor Water. A saturated aqueous solu- tion of Camphor. Average Dose.-2% fluidrachms (10 mils). Linimentum Camphorae. Eng., Camphor Liniment. Synonym, Cam- phorated Oil. Camphor, 200 Gm.; Cotton Seed Oil, 800 Gm. Spiritus Camphorae. Eng., Spirit of Camphor. Synonym, Tincture of Camphor. Camphor, 100 Gm.; Alcohol, to make 1000 mils. Average Dose.-15 minims (1 mil). Camphor is contained in some other preparations, as Linimentum Saponis, Tinctura Opii Camphorata, etc. CAMPHORA MONOBROMATA (Gen., Camphorae Monobromatae). Eng., Monobromated Camphor. Form.-Colorless needles, scales, or powder. Odor and Taste.-A mild but characteristic camphoraceous odor and taste. Solubility.-Almost insoluble in water. Soluble in 6.5 parts of alcohol. Average Dose.-2 grains (0.125 Gm.). Therapeutic Action.-Carminative, stimulant, diaphoretic, anti- septic. Monobromated camphor is also esteemed as a nerve sedative and anaphrodisiac. Uses.-Camphor is used as a stimulant in collapse, narcotic poisoning, etc. Camphor and monobromated camphor are em- 112 CAMPHORA. ployed in the treatment of colds, bronchitis, pneumonia, head- ache, diarrhea, hysteria, and kindred conditions. Externally cam- phor is used for dermatitis, pruritus, neuralgia, etc. Administration.-Camphor is sometimes used hypodermatic- ally, and the form of choice is camphor dissolved in sterile oil. The aseptic packages put out by the pharmaceutical manufacturers are the most desirable. Camphor is frequently prescribed in dry form in capsules with other agents. In the treatment of coryza: Bi or Ext. Belladon. Fol gr. ss 03 Camphorae gr. vj 40 Quininae Sulph., Pulv. Ipecac, et Opii aa. gr. xij 80 M. ft. cap. no. xij. Sig.-One every half-hour for four hours, then one every three hours. In the treatment of influenza: $2 or Caffeinae Citratae gr. x 65 Camphorae gr. x 65 Acetphenetidini gr. xxx 2 00 M. ft. cap. no. x. Sig.-One every two hours. Camphor Water is a frequently employed vehicle. Camphor is frequently used locally in solution or liquefied. As an inhalation in coryza: or Camphorse, Mentholis aa. 3ss 2 Tinct. Benzoini Co q. s. fSj 30 M. Sig.-Use teaspoonful to pitcher of hot water every four hours. As a spray in coryza, laryngitis, etc.: H or Camphorae gr. vj 4 Eucalyptolis, 01. Menth. Pip., Olei Pini Syl aa. nxvJ* 4 Petrolati Liq q. s. f5vj 180 0 M. Sig.-Use as a spray every four hours. i Musser and Kelly: Practical Treatment. 2 Hughes: Practice of Medicine. CAMPHORA. 113 Patients should be instructed to inhale while using spray. The following liquefies when triturated: In the treatment of neuralgia: Ri or Chlorali Hydrati, Camphorae, Mentholis aa. 3j 4 M. et tere bene. Sig.-Paint over parts as directed. Some combinations in ointments are as follows: In the treatment of pruritus: R2 or Mentholis, Camphorae, Chlorali Hydrati Petrolati aa. gr. v 32 q. s. Sss 15 00 M. Sig.-Apply locally. As an application in pruritic diseases of the skin: B3 Phenolis or 32 Camphorae gr. x 65 Sulphuris Subl gr. xxx 2 00 Ung. Zinci Oxidi q. s. 3j 30 00 M. Sig.-Apply, frequently to irritated surface. In the treatment of dermatitis calorica: B4 or Phenolis, Camphorae aa. 5ss 2 Adipis Lanae Hyd 5j 30 Ung. Aquae Rosae q. s. 3ij 60 M. • Sig.-Apply on cloth every four hours. In the treatment of eczema of the scrotum: $5 or Camphorae, Chlorali Hydrati aa. gr. xx 1 3 Adipis Lanae Hyd 5ss 15 0 Ung. Aquae Rosae q. S. 5j 30 0 M. Sig.-Apply liberally several times daily. 1 Hughes: Practice of Medicine. 2 Ibid. 3 Shoemaker: Materia Medica and Therapeutics 4 Ohmann-Dumesnil: Diseases of the Skin. 3 Ibid. 114 CANNABIS. Camphor Liniment may be ordered as in the following for bronchitis in children: or Linimenti Camphorse 60| Sig.-Warm and apply to chest as directed. Monobromated Camphor is usually prescribed in capsules with other agents. In the treatment of cold, influenza, etc.: $ or Camphorae Monobrom., Quininae Hydrobrom aa gr. xv 11 Acidi Acetylsalicyl gr. xxx 2 M. ft. cap. no. xij. Sig.-One every hour till four (4) are taken. The others may be ordered to be taken as one every four hours. This is particularly used in connection with hot drinks, foot- baths, etc, to abort a "cold." The following has been recommended for headache: Hi or Acetanilidi gr. Ixxij 4 50 Caffeinae Citratae, Camphorae Monobromatae aa. gr. xij 75 Sodii Bicarbonatis gr. xlviij 3 00 M. ft. cap. no. xxiv. Sig.-One every half-hour until four (4) are taken. In the treatment of migraine: $2 or Caffeinae Citratae gr. v 32 Camphorae Monobromatae gr. xx 1 30 Acetphenetidini gr. xx 1 30 M. ft. cap. no. x. Sig.-One every two hours until relieved. CANNABIS. Latin, Cannabis (Gen., Cannabis). Eng., Cannabis. Synonyms, Cannabis Indica (U. S. P., viii), Indian Cannabis, Indian Hemp. Dried flowering tops of the pistillate plant of Cannabis sativa or of the variety indica. Average Dose.-1 grain (0.065 Gm.). 1 Musser and Kelly: Practical Treatment. 2 Hughes: Practice of Medicine. CANNABIS. 115 Official Preparations. Extractum Cannabis. Eng., Extract of Cannabis. A soft solid about five times the strength of the crude drug. Average Dose.-% grain (0.01 Gm.). Fluidextractum Cannabis. Eng., Fluidextract of Cannabis. Average Dose.-minims (0.1 mil). Tinctura Cannabis. Eng., Tincture of Cannabis, Represents 10 per cent, of the drug in alcohol. Average Dose.-12 minims (0.75 mil). • Cannabis is considered by some as very uncertain in its action and many prescribers will not employ it. Therapeutic Action.-Sedative, anodyne, narcotic. Uses.-For headache, neuralgia and kindred conditions. It is an ingredient in many of the corn remedies. Administration.-Internally.-The tincture is the preparation usually employed. It may be prescribed alone, as: Tinct. Cannabis f 3j or 41 Tinct. Aurantii Dulc q. s. f3j 30 M. Sig.-Teaspoonful in water every four hours. Some prescribe the tincture alone by drops and increase to effect. About two drops must be allowed for. each minim. or Tincturae Cannabis fli 30| Sig.-Begin with 10 drops three times a day. It is sometimes used with other agents. The following will illustrate: In a hypnotic preparation: or Chlorali Hydrati 5j 4 Sodii Bromidi 3ij 8 Tinct. Cannabis fSj 4 Syr. Tolutani 30 M. Sig.-Teaspoonful in water every four hours when necessary. Externally.-The extract is sometimes used in combination with other agents. The following illustrates: 116 CANTHARIS. CAPSICUM. In the treatment of clavus: Ri or Acidi Salicylici gr. xxx 2 0 Ext. Cannabis gr. x 6 Collodii Flex q. s. f3ss 15 0 M. Sig.-Apply to lesions twice daily. In employing the above many add Ol. Ricini, f3j. CANTHARIS Latin, Cantharis (Gen., Cantharidis). Eng., Cantharides. Synonym, Spanish Flies. The dried beetles Cantharis vesicatoria. Ceratum Cantharidis. Eng., Cantharides Cerate. Contains 35 per cent, of the drug. Coilodium Cantharidatum. Eng., Cantharidal Collodion. Represents 60 per cent, of the drug. Emplastrum Cantharidis. Eng., Cantharides Plaster. Cantharides Cerate and Resin Plaster spread on fabric. Each square centimeter of spread plaster contains 0.1 Gm. of Cantharides Cerate. Tinctura Cantharidis. Eng., Tincture of Cantharides. Represents 10 per cent, of the drug. Average Dose.-1J4 minims (0.1 mil). Therapeutic Action.-Rubefacient, vesicant, and also classed as a diuretic and aphrodisiac, though not used as such. Uses.-Sometimes used as a counter-irritant as in the treat- ment of neuralgia, sciatica, or related conditions. Used in hair preparations to stop loss of hair. Administration.-Cantharides is seldom prescribed. The Cerate or Collodion is sometimes ordered for external use to produce counter-irritation. The tincture is employed with other agents in applications to the scalp. Internally it is almost never employed. Official Preparations. CAPSICUM. Latin, Capsicum (Gen., Capsici). Eng., Capsicum. Synonyms, Cayenne Pepper, African Pepper, Red Pepper. The dried ripe fruit of Capsicum frutescent. Average Dose.-1 grain (0.06 Gm.). 1 Stelwagon: Diseases of the Skin. CARBO LIGNI. CARDAMOMI SEMEN. 117 Official Preparations. Emplastrum Capsici. Eng., Capsicum Plaster. Oleoresin of Capsi- cum spread in a thin coating over adhesive plaster. Oleoresina Capsici. Eng., Oleoresin of Capsicum. Average Dose.-% grain (0.03 Gm.). Tinctura Capsici. Eng., Tincture of Capsicum. Represents 10 per cent, of the drug. Average Dose.-8 minims (0.5 mil). Therapeutic Action.-Rubefacient, vesicant, stimulant, stom- achic. Uses.-Alcoholism, indigestion, certain forms of nephritis, etc. Administration.-Capsicum is not often prescribed. The most frequent employment is that of the powdered drug or the tincture with other agents: In a laxative preparation for tuberculosis: Bi or Mas. Hydrargyri, Aloes Pulv., Ipecacuanhas Pulv., Capsici Pulv 8 M. ft. cap. no. xxiv. Sig.-One at night. CARBO LIGNI. Latin, Carbo Ligni. Eng., Wood Charcoal. Synonym, Charcoal. Charcoal prepared from soft wood and finely powdered. A black, odorless, tasteless and insoluble powder. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Absorbent. Uses.-Employed in testing intestinal activity and sometimes prescribed for certain forms of dyspepsia. Its medicinal value is questionable. Administration.-Charcoal is sometimes employed internally alone or with other agents. It is usually administered in cap- sules. Not over 5 grains should be ordered to each capsule. CARDAMOMI SEMEN. Latin, Cardamomi Semen. Eng., Cardamom Seed (Cardamo- mum, U. S. P., viii). The dried seeds of Elettaria Cardamomum. Average Dose.-15 grains (1 Gm.). 1 Musser and Kelly: Practical Treatment. 118 CARDAMOMI SEMEN. Official Preparations. Tinctura Cardamomi. Eng., Tincture of Cardamom. Represents 15 per cent, of the drug. Average Dose.-30 minims (2 mils). Tinctura Cardamomi Composita. Eng., Compound Tincture of Car- damom. Cardamom seed, 20 Gm.; Saigon Cinnamon, 25 Gm.; Caraway, 12 Gm.; Cochineal, 5 Gm.; Glycerin, 50 mils ; Diluted Alcohol, to make 1000 mils. .Average Dose.-1 fluidrachm (4 mils). Therapeutic Action.-Stomachic, carminative. Uses.-In flatulent colic, loss of appetite, etc. A vehicle and flavoring agent. Administration.-Usually prescribed as a vehicle and adju- vant for more active agents. The compound tincture is the preparation of choice. In the treatment of constipation: Rl or Flext. Cascarae Sag f5j 30 Tinct. Cardamomi Comp f$ss 15 Glycerini f3j 30 Aquae Menth. Pip q. s. f&ij 90 M. Sig.-Teaspoonful in water after meals. In the treatment of acne: B2 Sodii Benzoatis 3ij or 8 Tinct. Nucis Vomicae f5ij 8 Flext. Cascarae Sag f3ss 15 Tinct. Cardamomi Comp q. s. fSiij 90 M. Sig.-Teaspoonful in water after meals. As a laxative in the treatment of acne: $3 or Flext. Cascarae Sag., Tinct. Nucis Vomicae aa. f5iij 12 Tinct. Cardamomi Comp q. s. fSiij 90 M. Sig.-Teaspoonful in water before meals. 1 Hughes: Practice of Medicine. 2 Ibid. 8 Stelwagon: Diseases of the Skin. CARUM. CASCARA SAGRADA. 119 CARUM. Latin, Carum. Eng., Caraway. Synonym, Caraway Seed. The dried fruit of Carum Carvi. Average Dose.-15 grains (1 Gm.). Official Constituent. Oleum Cari. Eng., Oil of Caraway. Average Dose.-3 minims (0.2 mil). Oil of Caraway is contained in the Compound Spirit of Juniper. Therapeutic Action.-Stomachic, carminative. Uses.-A domestic remedy for flatulent colic, particularly of infants. Seldom prescribed. CARYOPHYLLUS. Latin, Caryophyllus. Eng., Clove. The dried flower-buds of Eugenia aromatica or Jambosa caryophyllus. Average Dose.-4 grains (0.25 Gm.). Official Constituents. Oleum Caryophylli. Eng., Oil of Clove. Average Dose.-3 minims (0.2 mil). Eugenol. Eng., Eugenol. An unsaturated aromatic phenol obtained from Oil of Cloves and other sources. Average Dose.-3 minims (0.2 mil). Cloves are contained in some other official preparations. Therapeutic Action.-Stomachic, carminative, antiseptic, irritant, local analgesic. Uses.-Employed as a flavoring agent and as an adjuvant to stomachic preparations. The oil is used locally for toothache. Administration.-Seldom used in medicine, except the oil, which is extensively employed by dentists. CASCARA SAGRADA. Latin, Cascara Sagrada. Eng., Cascara Sagrada. Synonyms, Cascara, Rhamnus Purshiana (U. S. P., viii). The dried bark of Rhamnus Purshiana. Average Dose.-15 grains (1 Gm.). Official Preparations. Extractum Cascarae Sagradae. Eng., Extract of Cascara Sagrada. Form.-A dark-colored powder. Average Dose.-4 grains (0.25 Gm.). 120 CASCARA SAGRADA. Fluidextractum Cascarae Sagradae. Eng., Fluidextract of Cascara Sagrada. Average Dose.-15 minims (1 mil). Fluidextractum Cascarae Sagradae Aromaticum. Eng., Aromatic Fluidextract of Cascara Sagrada. Average Dose.-30 minims (2 mils). Therapeutic Action.-Purgative, stomachic, tonic. Uses.-Extensively used alone or in combination with other agents to produce purgation. Particularly serviceable in the treat- ment of chronic constipation. Administration.-All three of these preparations are exten- sively used. The fluidextract and the aromatic fluidextract are more commonly employed alone and administered three times a day, particularly when the object is to correct a chronic con- stipation. The dose may often be gradually decreased until the drug is entirely discontinued, while the improved physical con- dition continues. The simple fluidextract is very bitter, so given three times a day it exercises a tonic effect aside from its laxative action. The aromatic fluidextract is supposed to represent the same strength of the drug, but many prescribers claim that its purgative action is decidedly less than that of the other preparation. The aromatic fluidextract is miscible with water, the plain fluidextract is not. The U. S. P. average dose is frequently exceeded, particularly when the fluidextracts are ordered alone. The extract is seldom ordered alone, but is frequently used with other agents. It is preferably administered in capsules. The crude drug is seldom if ever prescribed. As a tonic and laxative: R or Flext. Cascarae Sagr f5j 30 Glycerini, Elix. Aromatici 15 M. Sig.-Teaspoonful after meals. Or: R or Flext. Cascarae Sagr. Atom., Glycerini aa. fjss 15 Ext. Malti q. s. fSij 60 M. Sig.-Teaspoonful after meals. CATECHU. 121 Or: R or Flext. Cascarae Sagr. Arom fSj 30| Sig.-Teaspoonful at bedtime. As a laxative in the treatment of acne: Bi or Flext. Cascarae Sagr., Tinct. Nucis Vomicae aa f3iij 12 Tinct. Cardamomi Comp .. .q. s. f3iij 90 M. Sig.-Teaspoonful in water before meals. In capsules in combination with other purgatives: or Atropinae Sulph gr. Moo 0006 Strychninae Sulph gr. Mo 0002 Hydrarg. Chlor. Mitis gr. v 3200 Ext. Cascarae Sagr gr. vj 4000 M. ft. cap. no. ij. Sig.-Take an hour apart. In the treatment of constipation: $2 Ext. Belladon. Fol or gr. ij 13 Resinae Podophylli gr. ij 13 Ext. Nucis Vomicae gr. v 32 Ext. Cascarae Sagr gr. xl 2 50 M. ft. cap. no. xx. Sig.-One at bedtime. CATECHU. (Not Official.) Latin, Catechu (Gen., Catechu). Eng., Catechu. An extract prepared from the wood of Acacia catechu. The U. S. P. of 1900 dropped Catechu and adopted Gambir in its place, owing to the greater uniformity of the latter. Therapeutic Action.-Astringent. Uses.-Principally in the treatment of diarrhea. Administration.-Catechu in the form of the tincture is still prescribed by the profession. 1 Stelwagon: Diseases of the Skin. 2 Ashton: Practice of Gynecology. 122 CERATA-CERATES. CERII OXALAS. In the treatment of gonorrhea: Hi or Zinci Sulphatis gr. xv 1 0 Plumbi Acetatis gr. xx 1 3 Tincturae Opii, Tincturae Catechu aa. f3ij 2 0 Aquae q. s. fjvj 180 0 M. Sig.-Inject after urination. (Shake-label.) CERATA-Cerates. Cerates are unctuous substances of such consistency that they may be easily spread, at ordinary temperature, upon muslin, or similar material, with a spatula, and yet not so soft as to liquefy and run when applied to the skin. They are not often prescribed. The following three cerates are official:- Ceratum.-See Cera Flava. Ceratum Cantharidis.-See Cantharis. Ceratum Resinae.-See Terebinthina. CERA FLAVA. Latin, Cera Flava. Eng., Yellow Wax. A solid substance pre- pared from the honeycomb of the bee, Apis mellifera. Official Preparations. Cera Alba. Eng., White Wax. Yellow wax bleached. Ceratum. Eng., Cerate. White Wax, 300 Gm.; Benzoinated Lard, 700 Gm. Wax is a constituent of all the official cerates except one. CERII OXALAS. Latin, Cerii Oxalas (Gen., Cerii Oxalatis). Eng., Cerium Oxalate. A mixture of the oxalates of cerium and other associated elements. Form.-A white or nearly white powder. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water or alcohol. Average Dose.-3 grains (0.2 Gm.). Therapeutic Action.-Antiemetic. 1 White and Martin: Genito-urinary and Venereal Diseases. CETACEUM. CHLORALUM HYDRATUM. 123 Uses.-Principally used in the treatment of nausea and vomit- ing, particularly that of pregnancy. Recommended for certain forms of diarrhea. Administration.-This is used in dry form or suspended in a liquid, either alone or, more frequently, with other agents. The above dose of the U. S. P. is often exceeded. Some combinations are illustrated in the following: In the treatment of postanesthetic vomiting: TP or Cocainae Hydrochlor - . •. • gr. j 065 Acetanilidi .... gr. x 650 Cerii Oxalatis .... gr. xx 1 300 M. ft. cht. no. iv. Sig.-One every two hours when indicated. In suspension in' the treatment of nausea: B or Cocainae Hydrochlor gr- j 065 Cerii Oxalatis 3ss 2 000 Bismuthi Subnit 3j 4 000 Syr. Acaciae fSj 30 000 Aquae q. s. f jiij 90 000 M. Sig.-Tablespoonful every hour till relieved. (Shake-label.) CETACEUM. Latin, Cetaceum. Eng., Spermaceti. A concrete, fatty sub- stance, obtained from the head of sperm whale, Physeter macro- cephalus. CHLORALUM HYDRATUM. Latin, Chloralum Hydratum (Gen., Chlorali Hydrati). Eng., Hydrated Chloral. Synonyms, Chloral, Chloral Hydrate. Formula, C2HC13O + H2O. Form.-Colorless crystals. Odor and Taste.-An aromatic, penetrating odor and somewhat bitter taste. Solubility.-Freely soluble in water. Soluble in alcohol, but decomposed by strong alcoholic solutions. 1 Ashton: Practice of Gynecology. 124 CHLORALUM HYDRATUM. Incompatibles.-Alcohol, alkalies, borates, potassium iodide and permanganate, etc. It liquefies when rubbed with camphor, phenol, menthol, thymol, etc. Average Dose.-8 grains (0.5 Gm.). Therapeutic Action.-Hypnotic, analgesic, antispasmodic, antiseptic. Uses.-Used for insomnia, particularly when the result of nervous excitement. Employed in the treatment of convulsions, as those of strychnine poisoning, tetanus, etc., and for the con- vulsions of childhood. Frequently used in the management of labor. Toxicology.-Acute poisoning with hydrated chloral is usually characterized by coma, lowered blood-pressure, impaired respira- tion, lowered temperature, dilated pupils and abolished reflexes. Treatment.-The stomach should be washed out, the patient kept warm, and stimulants, as caffeine, strychnine, atropine and camphor, used. Artificial respiration, if necessary. Administration.-Hydrated Chloral cannot be prescribed in dry form, but is used in solution or ointment. AUmza/Zy.-^-Used in aqueous solution either alone or with other agents, as the bromides. It is administered either by mouth or by rectum. Some combinations are shown by the following: In the treatment of convulsions of childhood: Hi or Chlorali Hydrati gr. viij 5 Sodii Bromidi gr. xvj 1 0 Syrupi Aurantii q. s. f3ij 60 0 M. Sig.-Teaspoonful. Repeat in one hour if necessary. In the treatment of acute laryngitis: R2 or Chlorali Hydrati gr. Ixxv 5 Ammonii Bromidi gr. xxx 2 Potassii Bromidi gr. xlv 3 Aquae Cinnamomi q. s. f5ij 60 M. Sig.-Teaspoonful in water every twenty minutes until improvement takes place. 1 Ruhrah: Diseases of Children. 2 Musser and Kelly: Practical Treatment. CHLOROFORMUM. 125 Externally.-Some combinations are shown by the following: In the treatment of eczema of the scrotum: R or Camphorae, Chlorali Hydrati aa gr. xx 1 3 Adipis Lanae Hyd r. . . 5ss IS 0 Ung. Aquae Rosae * . ...q. s. 3j 30 0 M. Sig.-Apply liberally several times daily. In the treatment of pruritus: RI or Mentholis, Camphorae, Chlorali Hydrati aa. gr. v 32 M. et adde Petrolati q. s. 5ss 15|00 Sig.-Apply locally. In the treatment of pruritus: R2 or Chlorali Hydrati 3j 41 Petrolati q. s. 3j 30 M. Sig.-Apply locally. The following liquefies when triturated: In the treatment of neuralgia: B3 or Chlorali Hydrati, Camphorae, Mentholis aa. 3j 4 M. et tere bene. Sig.-Paint over parts as directed. Latin, Chloroformum (Gen., Chloroformi). Eng., Chloroform. Formula, CHCI3. Form.-A heavy, colorless liquid. Odor and Taste.-Characteristic odor and burning, sweetish taste. Solubility.-In about 210 volumes of water and in all proportions in alcohol. Average Dose.-5 minims (0.3 mil). CHLOROFORMUM. 1 Hughes: Practice of Medicine. 2 Ashton: Practice of Gynecology. 3 Hughes: Practice of Medicine. 126 CHLOROFORMUM. Aqua Chloroformi. Eng., Chloroform Water. A saturated, aqueous solution containing about 0.5 per cent, of Chloroform. Average Dose.-4 fluidrachms (15 mils). Linimentum Chloroformi. Eng., Chloroform Liniment. Chloroform, 300 mils; Soap Liniment, 700 mils. Spiritus Chloroformi. Eng., Spirit of Chloroform. Chloroform, 60 mils; Alcohol, 940 mils. Average Dose.-30 minims (2 mils). Therapeutic Action.-General anesthetic, sedative, antispas- modic^ anodyne, carminative, rubefacient. Uses.-By inhalation, extensively used as a general anes- thetic, though not considered as safe as ether. By mouth, it is used in the treatment of acute indigestion, dysentery, diarrhea, and various abdominal pains; also for the cough of bronchitis and kindred conditions. Externally it is an ingredient of lini- ments for sprains, rheumatism, etc. Administration.-Internally.-Chloroform Water is sometimes used as a vehicle in the administration of sedatives, carmina- tives, etc. Spirit of Chloroform is used alone or with other agents. Some combinations for internal use are shown in the following: In the treatment of acute bronchitis: Official Preparations. Bi Terebeni f5ij or 8 Creosoti Acaciae f5ss q- s. 2 Aquae Chloroformi q. s. fXiij 90 M. ft. emulsion. Sig.-Teaspoonful with water every four hours. In the treatment of an acute exacerbation of a dry chronic bronchitis: $2 Ammonii Chloridi 3ij or 8 Tinct. Hyoscyami, Syr. Scillae Comp aa. f3iv 15 Aquae Chloroformi q. s. fjiij 90 M. Sig.-Teaspoonful in water every three hours. 1 Hughes: Practice of Medicine. 2 Ibid. CHLOROFORMUM. 127 In the treatment of acute intestinal indigestion: $1 or Naphthaleni gr. xxx 2 00 Bismuthi Subsalicyl gr. Ixxx 5 00 Phenolis gr. iv 32 Glycerini fSj 30 00 Aquae Chloroformi q. s. fSiij 90 00 M. Sig.-Two (2) teaspoonfuls in water every two hours. (Shake-label.) In a preparation for indigestion: B2 or Pepsini 5j 4 00 Acidi Hydrochlor. Dil f3iv 15 00 Strychninae Sulph gr. ss 03 Glycerini f&s 15 00 Aquae Chloroformi q. s. f5iij 90 00 M. Sig.-Teaspoonful in water after meals. In the treatment of cough: or Spin Chloroformi, Tinct. Opii Camph aa. f5ij 8 Elix. Aromatici q. s. f5ij 60 M. Sig.-Teaspoonful in water every two hours. (Shake-label.) In the treatment of "cramp colic," acute indigestion, etc. or Spir. Chloroformi, Spir. Menth. Pip aa. f3ss 15 M. Sig.-Teaspoonful in water every two hours till relieved. In the treatment of tapeworm: or Oleoresinae Aspidii f5j 4 Chloroformi n^xv 1 00 Olei Tiglii no 13 Glycerini q. s. f5j 30 a) M. Sig.-Take half at 8 a.m., the rest in an hour if needed. (Shake- label.) 1 Hughes: Practice of Medicine. 2 Ibid. CHROMII TRIOXIDUM. 128 CHONDRUS. Externally.-The official Chloroform Liniment is used alone or with other agents, or chloroform is prescribed with Soap Lini- ment in other proportions. Decided rubefacient action is effected by covering after applying. Some illustrations are shown in the following: Externally, Chloroform may be ordered as: or Lin. Chloroformi 180| Sig.-Apply with massage as directed. Or: R Mentholis 3j or 4 Chloroformi f5j 30 Lin. Saponis 180 M. Sig.-Apply with massage as directed. In the treatment of neuralgia (to be applied with friction along the course of the affected nerve) : Bi or Tinct. Aconiti, Chloroformi aa. fXj 30 Lin. Saponis q. s. f3vj 120 M. Sig.-Apply as directed. (Poison-label.) CHONDRUS. Latin, Chondrus. Eng., Chondrus. Synonyms, Irish Moss, Carrageen. The dried plant of Chondrus crispus or of Gigartina mamillosa. Average dose.-In decoction, 4 drachms (15 Gm.). Therapeutic Action.-Demulcent, nutrient. Uses.-Seldom employed. Recommended for diarrhea, dysentery, inflammations of the genito-urinary tract and some skin diseases. Administration.-May be employed in the form of a mucilage. CHROMII TRIOXIDUM. Latin, Chromii Trioxidum (Gen., Chromii Trioxidi). Eng., Chromium Trioxide. Synonym, Chromic Acid. Small crystals or prisms of a dark purplish-red color. Very soluble in water. 1 Shoemaker: Materia Medica and Therapeutics. CHRYSAROBINUM. 129 Therapeutic Action.-Caustic. Uses.-Sometimes used in the treatment of warts, etc. Administration.-it is used either in the pure state or in aqueous solution. CHRYSAROBINUM. Latin, Chrysarobinum (Gen., Chrysarobini). Eng., Chrysarobin. A neutral principle extracted from Goa powder. Form.-A pale orange-yellow powder. Odor and Taste.-Odorless and tasteless. Solubility.-Very slightly soluble in water. Soluble in 85 parts of alcohol. Average Dose.-y2 grain (0.03 Gm.). O fficial Preparations. Unguentum Chrysarobini. Eng., Chrysarobin Ointment. Chrysa- robin, 6 Gm.; Benzoinated Lard, 94 Gm. Therapeutic Action.-Antiparasitic. Uses.-Principally in the treatment of skin diseases, as ring- worm, psoriasis, etc. Administration.-Internally.-Seldom used. Externally.-It should be used with caution as it is a powerful irritant and is liable to cause dermatitis, and on the face, edema, also. It stains the skin a yellowish-brown. Some combinations are shown in the following: In the treatment of tinea barbae: Ri or Chrysarobini 5ss 2 Adipis Lanae Hyd 5ss 15 Ung. Aquae Rosae q- s. 3j 30 M. Sig.-Apply thoroughly to scalp once daily. In the treatment of psoriasis: R2 or Chrysarobini 3j 4 0 Acidi Salicylici .... gr. xx 1 3 Athens f3j 4 0 Olei Ricini n^x 6 Collodii q. s. fSj 30 M. Sig.-Paint on affected parts. 1 Ohmann-Dumesnil: Diseases of the Skin. 2 Stelwagon: Diseases of the Skin. 130 CIMICIFUGA. CINCHONA RUBRA. CIMICIFUGA. Latin, Cimicifuga. Eng., Cimicifuga. Synonyms, Black Snake- root, Black Cohosh. The dried rhizome and roots of Cimicifuga racemosa. Average Dose.-15 grains (1 Gm.). Official Preparations. Extractum Cimicifugae. Eng., Extract of Cimicifuga. Average Dose.-4 grains (0.25 Gm.). Fluidextractum Cimicifugae. Eng., Fluidextract of Cimicifuga. Average Dose.-15 minims (1 mil). Therapeutic Action.-Has been classed as a simple bitter, mild cardiac stimulant, alterative and emmenagogue. Uses.-Has been used for chorea, amenorrhea, dysmenor- rhea, and some other conditions. Administration.-Cimicifuga or its preparations are seldom prescribed as such. The drug is used in some unofficial prepara- tions that are sometimes employed. CINCHONA. Latin, Cinchona (Gen., Cinchonae). Eng., Cinchona. Synonyms, Yellow Cinchona, Peruvian Bark, Jesuits' Bark, etc. The dried bark of Cinchona Ledgeriana, Cinchona Calisaya, and of hybrids of these with other species of Cinchona. Latin, Cinchona Rubra. Eng., Red Cinchona. Synonyms, Peru- vian Bark, Jesuits' Bark, etc. The dried bark of Cinchona succirubra or of its hybrids. CINCHONA RUBRA. Constituents of Cinchona and Red Cinchona. Not less than 5 per cent, of alkaloids, the most important of which is the official Quinine. The cinchonas contain tannic acid. Average Dose.-15 grains (1 Gm.). Official Preparations of Cinchona. Fluidextractum Cinchonas. Eng., Fluidextract of Cinchona. Average Dose.-15 minims (1 mil). Tinctura Cinchonas. Eng., Tincture of Cinchona. Represents 20 per cent, of Cinchona in glycerin, alcohol and water. Average Dose.-1 fluidrachm (4 mils). CINCHONA RUBRA. 131 Tinctura Cinchonae Composita. Eng., Compound Tincture of Cin- chona. Represents Red Cinchona, 100 Gm.; Bitter Orange Peel, 80 Gm.; Serpentaria, 20 Gm. in glycerin, alcohol and water, to make 1000 mils. Average Dose.-1 fluidrachm (4 mils). Official Preparation of Red Cinchona. Official Alkaloids and Salts. (Obtained from both.) Quinina. Eng., Quinine. Average Dose.-Tonic 1J4 grains (0.1 Gm.) ; antimalarial, at least 15 grains (1 Gm.) daily. Used in many official preparations. Quininae Sulphas (Gen., Quininae Sulphatis). Eng., Quinine Sulphate. Synonym, Quinine. Odor and Taste.-Odorless and having a bitter taste. Solubility.-In 725 parts of water or 107 parts of alcohol. Incompatibles.-Ammonia, alkalies, lime-water, tannic acid, Donovan's solution, iodine, iodides, bromides, etc. Average Dose.-Tonic 1^4 grains (0.1 Gm.) ; antimalarial, at least 15 grains (1 Gm.) daily. Quininae Bisulphas (Gen., Quininae Bisulphatis). Eng., Quinine Bi- sulphate. Form, Odor, Taste, Incompatibility and Dose.-Same as Quininae Sulphas. Solubility.-In 9 parts of water or 23 parts of alcohol. Quininae Dihydrochloridum (Gen., Quininae Dihydrochloridi). Eng., Quinine Dihydrochloride. Form, Odor, Taste, Dose.-Same as Quininae Sulphas. Solubility.-In 0.6 part of water, or 12 parts of alcohol. Quininae et Ureae Hydrochloridum (Gen., Quininae et Ureae Hydro- chloridi). Eng., Quinine and Urea Hydrochloride. Synonyms, Quinine and Urea Chloride, Quinine Carbamate. Form, Odor, Taste.-Same as Quininae Sulphas. Solubility.-In 0.9 part of water, or 2.4 parts of alcohol. Average Dose.-Hypodermic (one dose daily), 15 grains (1 Gm.). Quininae Hydrobromidum (Gen. Quininae Hydrobromidi). Eng., Quinine Hydrobromide. (Synonym, Quinine Hydrobromate.) Form, Odor, Taste, Incompatibility and Dose.-Same as Quininae Sulphas. Solubility.-In 40 parts of water or 0.9 part of alcohol. Quininae Hydrochloridum (Gen., Quininae Hydrochloridi). Eng., Quinine Hydrochloride. Synonyms, Quinine Muriate, Quinine Hydro- chlorate. Form, Odor, Taste, Incompatibility and Dose.-Same as Quininae Sulphas. Solubility.-In 18 parts of water or 0.8 part of alcohol. Quininae Salicylas (Gen., Quininae Salicylatis). Eng., Quinine Salicylate. Form, Odor, Taste, Incompatibility and Dose.-Same as Quininae Sulphas. Solubility.-In about 77 parts of water or 14 parts of alcohol. 132 CINCHONA RUBRA. Quininae Tannas (Gen., Quininae Tannatis). Eng., Quinine Tannate. Form.-A pale-yellow or yellowish-white powder. Odor and Taste.-Odorless and tasteless or not having more than a slightly bitter or astringent taste. Solubility.-Only slightly soluble in water; somewhat more soluble in alcohol. Average Dose.-3 grains (0.2 Gm.). Cinchoninae Sulphas. Eng., Cinchonine Sulphate. Form, Odor, Taste, Incompatibility.-Same as Quininae Sulphas. Solubility.-In 60 parts of water or 12^ parts of alcohol. Average Dose.-2% grains (0.15 Gm.). Cinchonidinae Sulphas. Eng., Cinchonidine Sulphate. Form, Odor, Taste, Incompatibility.-Same as Quininae Sulphas. Solubility.-In 65 parts of water or 90 parts of alcohol. Average Dose.-2% grains (0.15 Gm.). Therapeutic Action.-Cinchona and its preparations and official alkaloids are antimalarial, antipyretic, tonic, antiseptic. Uses.-The preparations of cinchona are used as bitter tonics. The alkaloids other than quinine are seldom employed by the profession. Quinine-by the mouth-is used for malaria, coryza, influenza, bronchitis, pertussis, erysipelas, septicemia, etc. By Enema.-Injections or irrigations are used for amebic dysen- tery, pinworms, ulcerated colon, gonorrhea, cystitis, abscesses, etc. Externally.-For sores, ulcers, scalp diseases. By Needle.-For malaria and as a local anesthetic. Cinchonism.-Severe results from taking quinine are very rare, but considerable discomfort is quite common. Many people have such an idiosyncrasy for the drug that even a few grains will occasion alarming symptoms. The usual toxic symptoms are a sense of fullness in the head, dizziness, ringing in the ears, nausea, partial or even total deafness. There may be itching of the skin with or without eruption. The skin may show lesions any- where from a mild erythema to purpura hemorrhagica. These symptoms may be accompanied with an elevation of temperature. Quinine given during pregnancy may produce an abortion. Treatment.-The unpleasant symptoms of cinchonism may be in part prevented by associating the bromides with the drug. If very disagreeable symptoms develop, the drug should be discontinued unless there is more demand for its continuance. Sodium or potassium bromide in rather large doses may be given and elim- ination favored. The cutaneous symptoms may be treated by CINCHONA RUBRA. 133 starch or bran baths and antipruritic inunctions or applications, if necessary. Hypodermic injections of adrenalin may be of value. Administration.-By Mouth.-The Bark, Fluidextract and Tincture are seldom used. The Compound Tincture is fre- quently employed, but as it contains only about 0.3 grain total alkaloids to the teaspoonful it has little effect except that due to its bitter taste. It should be remembered that the tinctures and fluidextract of cinchona contain tannic acid. The use of the Compound Tincture is illustrated in the following prescription, in which case it is said to prevent the unpleasant gastric disturbances that might result from the use of the other agents. The cinchona alka- loids are not precipitated for reasons elsewhere explained. 3 or Hydrarg. Chlor. Corros gr. j 065 Potassii lodidi 15 000 Tinct. Cinchonse Comp fSij 60 000 Aquae q. s. fBiv 120 000 M. Sig.-Teaspoonful in water an hour before meals. Tasteless Administration by Month.-The quinine salts in cap- sules are by far the most desirable form for administration in the vast majority of cases, where the patient is old enough to swallow a capsule. Pills and tablets possess no advantages over capsules and are particularly subject to the disadvantages mentioned under Pills, p. 377, and Tablets, p. 377. The prescriber should see that the pharmacist dispenses the cap- sules free from adhering particles. The salts of choice seem to be Quinine Sulphate, Hydrobromide, and Hydrochloride for general use as an antiperiodic and tonic, and Quinine Hydrobromide and Salicylate for colds, influenza, ton- sillitis, etc. Not more than 5 grains should usually be ordered to the capsule. Some frequently used prescriptions are as follows: In the treatment of malaria: or Quininae Hydrobromidi 6I Ft. cap. no. xviij. Sig.-Take six (6) each day as directed. Written instructions should be given, based on the time of the expected chill, so that the greatest possible concentration of the 134 CINCHONA RUBRA. drug may be present in the blood at the time of liberation of the malaria organisms. With this in view, it is certainly necessary to base the size of the dose on the probable amount of blood in the particular patient (size of patient). The prescription direction may read as Sig.-One each morning at 6, 7, 8, 9, 10, 11. For children, see below, and p. 135. In the treatment of malaria following the first three days of quinine in large doses: B or Arseni Trioxidi gr. ij 130 Strychninae Sulph gr. j 065 Quininae Sulph., Ferri Reducti aa gr. cl 10 000 M. ft. cap. no. L. Sig.-One after each meal. While it is customary to continue the treatment longer than six- teen clays, it is usually desirable to order in the above amount, so that the other ingredients may be changed or discontinued, as con- ditions may indicate. This may be prescribed for children in the proper doses, put into powders, and directions given that they may be administered in syrup of chocolate. For adults the Massa Ferri Carbonatis is frequently used instead of the Ferrum Reductum. In the treatment of subinvolution of the uterus: Hi or Strychninae Sulph gr. j 065 Ext. Ergotae, Quininae Sulph aa. gr. xxx 2 000 M. ft. cap. no. xxx. Sig.-One before each meal. In the treatment of coryza: B2 or Ext. Belladon. Fol gr. ss 03 Camphorae gr. vj 40 Quininae Sulph., Pulv. Ipecac, et Opii .... aa. gr. xij 80 M. ft. cap. no. xij. Sig.-One every half-hour for four hours, then one every three hours. 1 Shoemaker: Materia Medica and Therapeutics. 2 Musser and Kelly: Practical Treatment. CINCHONA RUBRA. 135 In the treatment of grip, cold, etc.: or Caffeinae Citratae gr. x 65 Quininae Hydrobrom gr. xx 1 30 Acidi Acetylsalicyl gr. l 3 00 M. ft. cap. no. xvj. Sig.-One every two hours till eight (8) are taken each day. In the treatment of chronic heart disease: Ri or Digitalis Pulv, Quininae Hydrochlor 1 0 Ext. Valerianae 5j 4 0 M. ft. cap. no. xxx. Sig.-One three times a day. The principle in preparing a so-called "tasteless" quinine is to use a salt that will dissolve only to the smallest possible extent, so it will not come into contact with the special nerve-endings in such form as to be appreciated. The sulphate is probably the best salt for this purpose. The tannate is less bitter but has to be given in large amounts and at least is slower and more uncertain in action. It is usually possible to ascertain the preference of the child as to flavor. Glycyrrhiza may be distinctly disagreeable to some, while syrup of chocolate would be very acceptable. Some adults and practically all small children are unable to swallow capsules. The prescriber should always ascertain as to this matter before writing his prescription. If patient is a child 8 to 10 years of age, but has never been tried on capsules, the prescription may be written for that form and the nurse instructed to empty them and administer in syrup of chocolate if the capsules cannot be swallowed. This method is sometimes desirable, anyway, as, for example, when other agents are ordered with the quinine salt that cannot well be put in solution. To illustrate: The following has been used for a child 6 years old, to follow the customary three days' intensive quinine treatment for malaria: B or Arseni Trioxidi, Strychninae Sulph aa. gr. % 002 Quininae Sulph., Ferri Reducti aa. gr. l 3 000 M. ft. cap. no. l. Sig.-One after meals as directed. i Musser and Kelly: Practical Treatment. 136 CINCHONA RUBRA. A "tasteless" syrup for administration to a child: or Quininse Sulphatis gr. xvj 11 Syr. Eriodictyi Arom q. s. f$ij 60 M. Sig.-Five (5) teaspoonfuls each day as directed. (Shake-label.) Syrup of glycyrrhiza or syrup of chocolate may be ordered as the vehicle in the above. In the treatment of malaria (child 6 years old) : or Quininas Sulphatis Ft. cht. no. xviij. gr. xxx 2 Sig.-Six (6) powders in chocolate syrup each day as directed. Bitter Solutions.-These are frequently desirable for adults and sometimes for children. Some combinations are shown in the fol- lowing : As a bitter tonic to follow the intensive treatment of malaria: B or Quininae Sulphatis 3iiss 10 Tinct. Ferri Chlor f3vj 23 Liq. Acidi Arsenosi f3ij 8 Aquae q. s. f3vj 180 M. Sig.-Teaspoonful in water after meals. B or Quininae Sulphatis 3iiss 10 Acidi Sulph. Arom f3ij 8 Elix. Aromatici q. s. f3vj 180 M. Sig.-Teaspoonful in water before meals. Hypodermic Use.-This method is sometimes employed, particu- larly when it is desirable to get the patient rapidly under the in- fluence of the drug. Quinine Hydrochloride is sometimes used but Quinine Dihydrochloride is even more desirable for this purpose. It is soluble in less than its own weight of water. Quinine and Urea Hydrochloride is soluble in its own weight of water, so is a valuable form for hypodermic use. Hypodermic employment is, of course, confined to the physician himself. He may use the tablets and prepare the solutions extemporaneously or order them as follows: CINCHONA RUBRA. 137 R or Quininae Dihydrochlor 3j 410 Aquae Destillatae 150 M. Sig.-Formula. Or: R or Quin, et Ureae Hydrochlor gr. xxx 2100 Aquae Dest q. s. fSj 400 M. Sig.-Formula. These solutions should be given largely diluted and even then there is frequently slow absorption, local irritation, and, it is claimed, sometimes even tetanus. Intravenously.-Considered by many as preferable to the hypo- dermic method. The solutions, as just stated for hypodermic use, may be employed only largely diluted with normal saline. By Rectum.-The administration of quinine in the Murphy drip for constitutional effect is probably practical and worthy of more thorough investigation. Other Uses.-The salts of quinine are sometimes used in enemas, as the following for amebic dysentery: or Quininae Sulphatis 3j 30| Ft. cht. no. x. Sig.-Use one to % gallon of warm water as directed. Or the following for pinworms in a child: or Quininse Bisulphatis 21 Quassiae Sj 30 Sig.-Make a tea with gallon of hot water and use as enema. Quinine and its salts are sometimes used in hair tonics, oint- ments, etc. In the treatment of alopecia: Hi or Resorcinolis gr. Ixxx 5 0 Quininae gr. xv 1 0 Olei Ricini IRxx 1 3 Alcoholis q. s. f5iv 120 0 M. Sig.-Apply as directed. 1 Stelwagon: Diseases of the Skin. 138 CINNAMOMUM. CINNAMOMUM. Latin, Cinnamomum. Eng., Cinnamon. The following are official: CINNAMOMUM SAIGONICUM. Eng., Saigon Cinnamon. The dried bark of an undetermined species of Cinnamomum. Average Dose.-4 grains (0.25 Gm.). Pulvis Aromaticus. Eng., Aromatic Powder. A finely powdered mix- ture of Saigon Cinnamon, Ginger, Cardamom and Nutmeg. Average Dose.-15 grains (1 Gm.). Fluidextractum Aromaticum. Eng., Aromatic Fluidextract. Repre- sents 100 per cent, of Aromatic Powder in alcohol. Average Dose.-15 minims (1 mil). Tinctura Cinnamomi. Eng., Tincture of Cinnamon. Represents 20 per cent, of the drug. Average Dose.-30 minims (2 mils). Saigon Cinnamon also enters into several other preparations. CINNAMOMUM ZEYLANICUM. Eng., Ceylon Cinnamon. The dried inner bark of the cultivated trees of Cinnamomum zeylanicum. Average Dose.-4 grains (0.25 Gm.). OLEUM CASSI2E. Eng., Oil of Cinnamon. Synonym, Oil of Cassia. A volatile oil distilled from Cassia cinnamon. Average Dose.-3 minims (0.2 mil). Official Preparations. Official Preparations of the Oil. Aqua Cinnamomi. Eng., Cinnamon Water. Distilled water saturated with Oil of Cinnamon. Average Dose.-4 fluidrachms (15 mils). Spiritus Cinnamomi. Eng., Spirit of Cinnamon. Contains 10 per cent, of the oil in alcohol. Average Dose.-30 minims (2 mils). The oil, water and spirit are used in making other official preparations. Therapeutic Action.-Stomachic and carminative. Uses.-The preparations of cinnamon are used as vehicles or flavors. Administration.-With the exception of the water, which is much employed as a pleasant vehicle, the preparations of cin- namon are not often prescribed. COCAINA. 139 As a vehicle in a prescription for rendering the urine more acid: Bi or Acidi Benzoici $ij 8 Acidi Borici 3iij 12 Aquae Cinnamomi fSxij 360 M. Sig.-Tablespoonful in water four times daily. As a vehicle in a prescription for the treatment of chlorosis as- sociated with constipation: R2 or Aloes Purificati gr. xl 3 Mas. Ferri Carb &j 8 Pulv. Aromatici q- s. M. ft. cap. no. xx. Sig.-One at bedtime. COCAINA. Latin, Cocaina. Eng., Cocaine. An alkaloid obtained from Ery- throxylon Coca. Average Dose.-% grain (0.015 Gm.). Cocainae Hydrochloridum (Gen., Cocainae Hydrochloridi). Eng., Cocaine Hydrochloride. Form.-Colorless prisms, flaky leaflets or white powder. Odor and Taste.-Odorless and having a bitter taste. Solubility.-In 0.4 part of water and 3.2 parts of alcohol. Incompatibles.-Alkalies, bromides, iodides, mercury salts, chloroform, etc. Average Dose.-% grain (0.015 Gm.). Cocaine Hydrochloride is used almost to the exclusion of all other preparations from coca. Therapeutic Action.-Local anesthetic, antiemetic, stimulant. Uses.-Chiefly employed to produce local anesthesia for sur- gical work; also used for pruritus, eczema, hemorrhoids, anal fis- sure, etc. Used to counteract unpleasant effects of other agents in the treatment of eye diseases, rhinitis, etc. Administration.-By Motith.-It is not often prescribed in this way except to allay gastric irritability. The following will illustrate: 1 Ashton: Practice of Gynecology. 2 Shoemaker: Materia Medica and Therapeutics. 140 COCAINA. Ri or Cocainae Hydrochlor gr. J 065 Acetanilidi gr. x 650 Cerii Oxalatis gr. xx 1 300 M. ft. cht. no. iv. Sig.-One every two hours when indicated. For Hypodermic Use.-It is used either alone or with such agents as Sodium Chloride or Adrenalin Chloride. Hypodermic solutions are not ordered for the patient's use, and the physician frequently employs tablets to make the solution extemporaneously. They may be ordered as follows: As a local anesthetic: B2 or Cocainae Hydrochlor gr. j 065 Sodii Chloridi gr- iij 200 Adrenalin Chlor. (Sol. 1:1000) .... iRv 300 Aquae Destil. Ster q. s. f5j 30 000 M. Sig.-Formula. Unless the solution is for immediate use, the adrenalin should be omitted from the prescription, and added just before the prep- aration is employed. To prescribe percentage solutions of cocaine: or Cocainae Hydrochlor gr. xviij i|2 Aquae Destil. Ster q. s. f5j 3010 M. Sig.-Four per cent, solution cocaine hydrochloride. Locally.-Cocaine is frequently a constituent of local applica- tions. In the treatment of erythema venenatum: or Cocainae Hydrochlor gr. x 65 Adrenalin Chloridi (1:1000) f5ss 15 00 Aquae Rosae q. s. fSvj 180 00 M. Sig.-Apply every two hours. 1 Ashton: Practice of Gynecology. 2 White and Martin: Genito-urinary and Venereal Diseases. COCAINA. 141 In the treatment of conjunctival inflammation as caused by foreign particles, etc.: or Cocainae Hydrochlor gr. ij 13 Adrenalin Chlor. (1:1000) m,v 30 Acidi Borici gr. x 60 Aquae Destil. Ster . .q. s. f5j 30 00 M. Sig.-Drop in eye every three hours till relieved. In the treatment of turgescent rhinitis: 3 or Cocainae Hydrochlor gr. v 3 Antipyrinae gr. xv 1 0 Aquae Dest q. S. fSj 30 0 M. Sig.-For physician's use. This is usually applied on long, slender rolls of absorbent cotton made by rolling cotton around a probe or applicator and then slipping it off. They are dipped into the solution and inserted in the nose and allowed to remain a few minutes. In the treatment of erythema scarlatiniforme: B or Cocainae Hydrochlor gr. iv 26 Acetanilidi gr. xx 1 30 Zinci Oxidi 5iss 6 00 Ung. Zinci Oxidi q. s. Sij 60 00 M. Sig.-Apply thin on a cloth. In the treatment of herpes progenitalis: Bi or Cocainae Hydrochlor gr. j 065 Mentholis gr. xij 800 Adipis Lanae Hyd q. s. 5ss 15 000 M. Sig.-Apply locally. i White and Martin: Genito-urinary and Venereal Diseases. COCCUS. COLCHICUM. 142 In the treatment of pruritus ani: R1 or Cocainae Hydrochlor gr. x 65 Phenolis gr. xx 1 30 Petrolati q. s. 3j 30 00 M. Sig.-Apply locally. COCCUS. Latin, Coccus. Eng., Cochineal. The dried female of the insect Coccus cacti. Used in manufacturing as a coloring agent, but not often pre- scribed. CODEINA. See Opium, p. 239. CODEINA PHOSPHAS. See Opium, p. 239. CODEINA SULPHAS. See Opium, p. 239. COLCHICUM. The corm and the seed are official. Principal Constituent.-Colchicine. COLCHICI CORMUS. Eng., Colchicum Corm. The dried corm of Colchicum autumnale. Official Preparation. Extractum Colchici Cormi. Eng., Extract of Colchicum Corm. Average Dose.-1 grain (0.06 Gm.). COLCHICI SEMEN. Eng., Colchicum Seed. The dried seeds of Colchicum autumnale. Average Dose.-3 grains (0.2 Gm.). Official Preparations. Fluidextractum Colchici Seminis. Eng., Fluidextract of Colchicum Seed. Average Dose.-3 minims (0.2 mil). i Hughes: Practice of Medicine. COLLODIUM. 143 Tinctura Colchici Seminis. Eng., Tincture of Colchicum Seed. Rep- resents 10 per cent, of the drug. Average Dose.-30 minims (2 mils). Official Alkaloid from Colchicum. Colchicina. Eng., Colchicine. Form.-Pale-yellow scales or powder. Solubility.-In 22 parts of water. Very soluble in alcohol. Average Dose.-4120 grain (0.0005 Gm.). Therapeutic Action.-Antirheumatic, analgesic. Uses.-Employed in the treatment of rheumatism, gout and neuralgia. Administration.-The Tincture and the unofficial Wine (10 per cent.) are the preparations most employed. They are usually pre- scribed with other agents, as the salicylates, etc. In rheumatism, gout, etc.: R or Sodii Salicylatis gr. clx 10 Sodii Bicarbonatis 3ij 8 Tinct. Col chici Sem f3iv 15 Aquae Menth. Pip q. s. f§iv 120 M. Sig.-Tablespoonful every four hours. COLLODIUM-Collodion. Latin, Coilodium (Gen., Collodii). Eng., Collodion. Pyroxylin, 40 Gm.; Ether, 750 mils; Alcohol, 250 mils. This is a liquid preparation, intended for external use, having for its base a solution of pyroxylin or gun-cotton, in a mixture of ether and alcohol. Official Preparations. Coilodium Cantharidatum. See Cantharis. Coilodium Flexile. Eng., Flexible Collodion. Collodion, 950 Gm.; Camphor, 20 Gm.; Castor Oil, 30 Gm. Therapeutic Action.-Protective. Uses.-As a protective dressing for wounds and as a vehicle for the administration of active agents, as in the treatment of clavus and various skin diseases. Administration.-They are used locally either alone or with other agents. 144 COLOCYNTHIS. In the treatment of clavus: Ri or Acidi Salicylici gr. xxx 2 0 Ext. Cannabis gr. x 6 Collodii Flex q. s. f3ss 15 0 M. Sig.-Apply twice daily. Many prescribers add about 25 per cent, of Oleum Ricini to collodion to render it more flexible and to prevent too rapid evapo- ration. In the treatment of psoriasis: R2 or Chrysarobini 3j 4|0 Acidi Saticylici gr. xx 1|3 2Etheris f3j 4|0 Olei Ricini ni,x I6 Collodii q. s. fSj 30|0 M. Sig.-Paint on affected parts. COLOCYNTHIS. Latin, Colocynthis (Gen., Colocynthidis). Eng., Colocynth. Synonym, Bitter Apple. The peeled dried fruit of Citrullus Colo- cynthis. Average Dose.-1 grain (0.06 Gm.). 0 fficial Preparations. Extractum Colocynthidis. Eng., Extract of Colocynth. Average Dose.-% grain (0.03 Gm.). Extractum Colocynthidis Compositum. Eng., Compound Extract of Colocynth. Extract of Colocynth, 160 Gm.; Aloes, 500 Gm.; Resin of Scammony, 140 Gm.; Cardamom Seed, 50 Gm.; Powdered Soap, 150 Gm. A bitter, brownish powder. Average Dose.-4 grains (0.25 Gm.). Compound Extract of Colocynth is a constituent in the official Pilulae Catharticae Compositae. Therapeutic Action.-Purgative of the hydragogue, drastic, and possibly cholagogue type. 1 Stelwagon: Diseases of the Skin. 2 Ibid. COPAIBA. 145 Uses.-Employed almost exclusively in combination with other agents to produce purgation. Administration,-Compound Extract of Colocynth is seldom prescribed alone, but it is sometimes used with other purgative agents. The full U. S. P. dose is not often employed. It is very apt to produce griping. Combinations like the following are used: As a postoperative laxative: Bi Ext. Belladon. Fol or gr. j 065 Ext. Cascarae Sag gr. xx 1 300 Ext. Colocynth. Comp gr. xxv 1 600 M. ft. cap. no. x. Sig.-One at bedtime. As a purgative: or Hydrarg. Chlor. Mitis gr. iij 200 Ext. Colocynth. Comp gr. vj 400 Ext. Hyoscyami gr. j 065 M. ft. cap. no. iij. Sig.-One every hour. COPAIBA. Latin, Copaiba (Gen., Copaibas). Eng., Copaiba. Synonym, Balsam of Copaiba. An oleoresin derived from South American species of Copaiba. Form.-A pale-yellow or brownish-yellow, more or less trans- parent and viscid liquid. Odor and Taste.-Very disagreeable. • Average Dose.-15 minims (1 mil). Therapeutic Action.-Diuretic, antiseptic. Uses.-Its disagreeable taste and odor and disturbance of digestive function have caused this drug to be almost dropped by the profession. It has been recommended for gonorrhea, cystitis and kindred conditions. Administration.-Seldom prescribed. It is best administered in the ready-prepared, soft, elastic capsules. It can be obtained in this form either alone or with other agents, as Salol, Oil of Santal, etc. 1 Ashton: Practice of Gynecology. 146 CORIANDRUM. CREOSOTUM. CORIANDRUM. Latin, Coriandrum. Eng., Coriander. Synonym, Coriander Seed. The dried ripe fruit of Coriandrum sativum. Average Dose.-8 grains (0.5 Gm.). Official Constituent. Oleum Coriandri. Eng., Oil of Coriander. Average Dose.-3 minims (0.2 mil). Solubility.-Insoluble in water, soluble in alcohol. Therapeutic Action.-Stomachic and carminative. Uses.-As a flavoring agent and recommended to prevent griping of purgatives. Administration.-Oil of Coriander is contained in several of- ficial preparations. Coriander or the Oil are seldom prescribed as such. COTARNINAE HYDROCHLORIDUM. Latin, Cotarninae Hydrochloridum (Gen., Cotarninae Hydro- chloridi). Eng., Cotarnine Hydrochloride. Synonym, Stypticin. The hydrochloride of a synthetic alkaloid obtained from narcotine. Form.-Yellow powder. Odor and Taste.-Practically odorless and tasteless. Solubility.-Very soluble in water or alcohol; deliquescent. Average Dose.-1 grain (0.06 Gm.). Therapeutic Action.-Hemostatic. Uses.-Used to aid in arresting hemorrhage, as pulmonary, uterine, etc.; also in the treatment of purpura hemorrhagica. Administration.-Usually prescribed alone in capsules. CREOSOTUM. Latin, Creosotum (Gen., Creosoti). Eng., Creosote. Synonym, Beechwood Creosote. A mixture of phenols and phenol deriva- tives, chiefly guaiacol and creosol, obtained during the distillation of wood-tar. Form.-An almost colorless liquid. Odor and Taste.-Penetrating odor and burning taste. Solubility.-In about 140 parts of water, but without forming a clear solution. Freely soluble in alcohol. Incompatibles - Cupric, ferric and silver salts, acacia, albumin, and oxidizing agents. Average Dose.-4 minims (0.25 mil). CREOSOTUM. 147 Official Preparations and Salt. Aqua Creosoti. Eng., Creosote Water. Creosote, 10 mils; Distilled Water, 990 mils. Average Dose.-2j4 fluidrachms (10 mils). Creosoti Carbonas (Gen., Creosoti Carbonatis). Eng., Creosote Car- bonate. Synonym, Creosotal. A mixture of the carbonates of various constituents of creosote, chiefly guaiacol and creosol. Form.-A thick, oily liquid. Odor and Taste.-Almost odorless and tasteless. Solubility.-Insoluble in water; soluble in alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antiseptic, germicide, expectorant, irritant. Uses.-Creosote is employed by mouth or inhalation in the treatment of coughs, bronchitis, pneumonia, tuberculosis, croup, etc. Locally it is used1 for toothache and for various skin diseases. The carbonate is used by mouth in the treatment of bronchitis, pneumonia, tuberculosis, etc. Administration.-By Mouth.-Creosote is too powerful an irritant to be prescribed pure, but is frequently used in bland liquids, as emulsions, particularly the Emulsion of Codliver Oil and the Emulsion of Oil of Turpentine. Prescribed alone, as in the treatment of tuberculosis: or Creosoti f3ij Sig.-Begin with four (4) drops as directed. In the treatment of tuberculosis, bronchitis, etc.: Creosoti f3j or 41 Emul. 01. Morrh. cum Hypoph q. s. oj 480 M. tere bene. Sig.-Tablespoonful after meals and at bedtime. (Shake-label.) Or: R Creosoti Carbonatis f5v or 19) Emul. 01. Morrh. cum Hypoph q. s. Oj 480 M. tere bene. Sig.-Tablespoonful after meals and at bedtime. (Shake-label.) Creosoti or f3ss 21 Emul. Petrolei fSviij 240 M. tere bene. Sig.-Tablespoonful after meals and at bedtime. (Shake-label.) 148 creosotum: In the treatment of bronchitis: Rl Terebeni f3ij or 8 Creosoti f3ss 2 Acaciae q- s. Aquae Chloroformi q. s. fSiij 90 M. ft. emul. Sig.-Teaspoonful with water every four hours. Tn the treatment of tuberculosis: $2 or Creosoti f5j 4 Tinct. Gentianae Comp f5j 30 Alcoholis 240 M. Sig.-Teaspoonful in water after meals. In the treatment of tuberculosis: R3 or Creosoti nixxiv 1 5 Glycerini fSij 60 0 Tinct. Aurantii Dulc q. s. fjiij 90 o M. Sig.-Teaspoonful in water or milk after meals. Creosote Carbonate, being less irritating, may be administered alone in capsules. Creosote is frequently employed as an inhalation, alone or with other agents. A common method is to arrange for a supply of aqueous vapor, as in the following: As an inhalation in bronchitis, laryngitis, etc. Creosoti f5ij or 81 Tinct. Benzoini Co q. s. fSij 60 M. Sig.-Use teaspoonful to pitcher of hot water as directed. Patient may be given instructions, as to use for fifteen minutes every three hours. Children are sometimes best treated during sleep by making a tent out of a newspaper. Locally.-Creosote is a constituent of many of the toothache remedies, or is used alone for that purpose. 1 Hughes: Practice of Medicine. 2 Musser and Kelly: Practical Treatment. 3 Fbid. CRESOL. CUBEBA. 149 CRESOL. Latin, Cresol (Gen., Cresolis). Eng., Cresol. A mixture of isomeric cresols obtained from coal-tar. A colorless or straw-colored liquid turning yellowish brown on prolonged exposure to light. Soluble in 50 parts of water, usually forming a cloudy solution. Average Dose.-1 minim (0.05 mil). Liquor Cresolis Compositus. Eng., Compound Solution of Cresol. Alcohol, 30 mils; Cresol, 500 Gm.; Linseed Oil, 300 Gm.; Potassium Hy- droxide, 80 Gm.; Water, to make 1000 Gm. Miscible with water in all proportions. This was introduced into the U. S. P. to furnish a uniform and reliable preparation to replace the numer- ous more or less uncertain proprietaries. Therapeutic Action.-Disinfectant, germicide. Uses.-Employed as a cleansing solution and dressing after labor and for infected wounds, periostitis and other infective and suppurative conditions. Administration.-The compound solution or some of the sim- ilar proprietary products are employed. They are prescribed alone and used properly diluted with water (1: 20 to 1: 1000). Official Preparation. For local use after labor: or Liq. Cresolis Co 120| Sig.-Use teaspoonful to quart of warm water as directed. (Poison- label.) Nurse is instructed to pour over the vulva after urination, etc. This prescription, with the exception that the water is used hot, is used for soaking the parts in some suppurating conditions, as of the feet in osteoperiostitis, etc. See Calcium, p. 106. CRETA PR^PARATA. CUBEBA. Latin, Cubeba. Eng., Cubeb. The dried, unripe but fully grown fruit of Piper Cubeba. Average Dose.-15 grains (1 Gm.). 150 CUPRI SULPHAS. DIACETYLMORPH1N2E. Official Preparations and Constituents. Oleoresina Cubebae. Eng., Oleoresin of Cubeb. Average Dose.-8 grains (0.5 Gm.). Trochisci Cubebae. Eng., Troches of Cubeb. Each troche contains about 0.02 mil (14 minim) of Oleoresin of Cubeb. Oleum Cubebae. Eng., Oil of Cubeb. Average Dose.-8 minims (0.5 mil). Therapeutic Action.-Diuretic, urinary antiseptic, irritant. Uses.-By mouth for gonorrhea, cystitis, etc. By mouth or inhalation for bronchitis, asthma, hay fever, nasal catarrh, etc. Administration.-By mouth it is usually prescribed in the form of the ready-prepared capsules, either alone or more fre- quently with other agents, as copaiba, salol or santal oil. It is used for inhalation in the form of cigarettes or of powders to be smoked in a pipe. CUPRI SULPHAS. Latin, Cupri Sulphas. Eng., Copper Sulphate. Synonyms, Blue Vitriol, Blue Stone. Large, deep-blue crystals. Average Dose.-Emetic, 4 grains (0.25 Gm.). Therapeutic Action.-Astringent, styptic, caustic, antiseptic, emetic. Uses.-Still frequently employed as a domestic remedy, but almost unused by the profession. DEC OCTUM-Decoction. Decoctions are liquid preparations made by boiling vegetable substances with water. When the strength and method of prepara- tion are not otherwise specified, they are made by boiling 5 parts of the coarsely comminuted drug for fifteen minutes with enough water to make 100 parts. There are no official decoctions. DIACETYLMORPHIN^E. See Opium, p. 239. DIACETYLMORPHIN.® HYDROCHLORIDUM. See Opium, p. 239. DIASTASUM. DIGITALIS. 151 DIASTASUM. Latin, Diastasum (Gen., Diastasi). Eng., Diastase. A mixture containing amylolytic enzymes obtained from an infusion of malt. It converts not less than fifty times its weight of potato starch into sugars. Form.-A yellowish-white powder, or translucent scales. Odor and Taste.-Odorless and tasteless. Solubility.-Soluble in water; almost insoluble in alcohol. Average Dose.-8 grains (0.5 Gm.). Therapeutic Action.-Digestant. Uses.-For the digestion of starchy food. It is seldom prescribed as such, but preparations containing it are sometimes employed. DIGITALIS. Latin, Digitalis (Gen., Digitalis). Eng., Digitalis. Synonym, Foxglove. The dried leaves of Digitalis purpurea. Principal Constituents.-The glucosides, digitoxin, digitalin, digi- talein, digitonin, digitin; tannic acid, etc. Average Dose.-1 grain (0.06 Gm.). Official Preparations. Fluidextractum Digitalis. Eng., Fluidextract of Digitalis. Average Dose.-1 minim (0.05 mil). Infusum Digitalis. Eng., Infusion of Digitalis. Represents 1.5 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Tinctura Digitalis. Eng., Tincture of Digitalis. Represents 10 per cent, of the drug. Average Dose.-8 minims (0.5 mil). Unofficial Preparation. Digitalinum. Eng., Digitalin. A glucoside obtained from Digitalis. Average Dose.-^oo grain (0.0006 Gm.). This is not to be confused with Digitalinum Germanicum. It seems to have been established that these preparations are uncertain, and that the dosage as usually given is not based on the modern intelligent employ- •ment of digitalis. Many standardized proprietary preparations of digitalis are available. 152 DIGITALIS. Therapeutic Action.-Cardiac tonic and stimulant, diuretic. Uses.-Employed for various cardiac and renal diseases and conditions. Administration.-The physiologically tested, fat-freq tincture put out by the larger pharmaceutical houses is now extensively employed, and is probably the preparation of choice with discrim- inating prescribers. All preparations may produce gastric disturbances. For rapid effect it is customary to use some specially prepared preparation hypodermically. Digitalis or its preparations are usually administered only two or three times a day, as the effect is slow in developing, but lasting. The tendency among those best able to intelligently use Digitalis is to give rather large doses till effect (or its continuance is contra- indicated), and then maintain the effect with smaller doses. As the effect of the drug is slow in developing, but lasting, it is better to calculate dosage on a twenty-four-hour basis than by the amount of each single administration. In beginning the use of the drug in a given case, particularly if it is to be used by needle, it is, necessary to take into consideration the amount of the drug, if any, that has been recently administered. The powdered Leaves, Fluidextract, Tincture, and Infusion are administered by mouth. Digitalin is sometimes given by mouth or needle. Many of our best therapists prescribe the Tincture alone, to be administered by drops, well diluted with water, as: 3 or Tincturae Digitalis f5j 30| Sig.-Begin with fifty (50) drops as directed. Fifty drops would average a little more than twenty minims. The advantage is that the dose can be readily increased or dimin- ished. It must be remembered, however, that tinctures average about 120 drops to every 60 minims, and that this may vary greatly, owing to shape of dropper, temperature, etc. As a diuretic, the infusion is the preparation of frequent choice, as it has been claimed that water does not dissolve digitoxin to an appreciable extent, but does dissolve the other active constituents. Present information tends to establish this as an error. It is used alone or with other agents, as Spirit of Nitrous Ether, Potassium Citrate, etc. The infusion should be freshly prepared. DIGITALIS. 153 Some common methods of prescribing digitalis are as follows: In the treatment of heart disease, etc.: R or Tinct. Digitalis, Tinct. Nucis Vom aa. fSss 15 Sig.-Twenty (20) drops in water three times a day. Or: B or Tinct. Digitalis. Flext. Cascarae Sag. Ar aa f3vj 22 5 Tinct. Cardam. Co q. s. f3iv 120 0 Sig.-Teaspoonful in water three times a day. In the treatment of chronic heart disease: Ri Digitalis Pulv., Quininae Hydrochlor 1 Ext. Valerianae 5j 4 M. ft. cap. no. xxx. Sig.-One three times a day. In the treatment of chronic nephritis with anasarca: R or Digitalis Pulv., Scillae Pulv., Hydrarg. Chlor. Mitis aa. gr. xx 1 3 Ext. Hyoscyami gr. x 6 M. ft. cap. no. xx. Sig.-One after each meal. This is a much ordered formula, but the calomel is in such dosage that it often will not be tolerated. In the treatment of goiter: B2 or Strychninae Sulph gr. ss 03 Ferri Arsenatis gr. ij 13 Extracti Digitalis gr- iv 26 Extracti Ergotae gr. XXX 2 00 M. ft. cap. no. xxiv. Sig.-One after each meal. 1 Musser and Kelly: Practical Treatment. 2 Anders: Practice of Medicine. 154 ELATERINUM. In the treatment of ascites: Ri or Potassii Acetatis 5j 30 Spir. /Etheris Nit 15 Inf. Digitalis q. s. f^iv 120 M. Sig.-Two (2) teaspoonfuls every six hours. In the treatment of chronic valvular disease: R2 Potassii Acetatis 3j or 41 Infusi Digitalis q. s. fBij 60 M. Sig.-Tablespoonful every three hours. ELATERINUM. Latin, Elaterinum (Gen., Elaterini). Eng., Elaterin. A prin- ciple obtained from Elaterium, a substance deposited by the juice of Ecballium Elaterium. Form.-Minute white scales or crystals. Odor and Taste.-Odorless; having a slightly acrid, bitter taste. Solubility.-Insoluble in water; soluble in 325 parts of alcohol. Average Dose.-%0 grain (0.003 Gm.). Official Preparation. Trituratio Elaterini. Eng., Trituration of Elaterin. Contains 10 per cent, of the drug. Average Dose.-y2 grain (0.03 Gm.). Therapeutic Action.-Drastic purgative. Uses.-Employed principally in those urgent cases when immediate and active purgation is desired, or when the patient is unable to swallow the dose of other purgatives, as in apoplexy, uremia and eclampsia. Administration.-The drug is suspended in a small amount of water or olive oil, and if patient is unconscious it is allowed to pass back to the pharynx a few drops at a time. Elixir Aromaticum.-See Aurantium. Elixir Glycyrrhizae.-See Glycyrrhiza. Emetinae Hydrochloridum.-See Ipecacuanha. 1 Hughes: Practice of Medicine. 2 Anders: Practice of Medicine. ERGOTA. 155 Emplastrum Belladonnas.-See Belladonna. Emplastrum Cantharidis.-See Cantharis. Emplastrum Capsici.-See Capsicum. Emplastrum Elasticum. Eng., Rubber Plaster. Synonyms, Rubber Adhesive Plaster; Adhesive Plaster. Emplastrum Plumbi.-See Plumbum. Emplastrum Resinae.-See Terebinthina. Emplastrum Sinapis.-See Sinapis. Emulsum Amygdalae.-See Amygdala. Emulsum Asafcetidae.-See Asafoetida. Emulsum Olei Morrhuae.-See Oleum Morrhuae. Emulsum Olei Terebinthinae.-See Terebinthina. ERGOTA. Latin, Ergota (Gen., Ergotae). Eng., Ergot. Synonym, Ergot of Rye, Rye Smut. The carefully dried sclerotium of Claviceps purpurea, a fungous growth replacing the grain of rye, Secale cereale. Principal Constituents.-Ergotine, Tannic Acid, etc. Average Dose.-30 grains (2 Gm.). Official Preparations. Extractum Ergotae. Eng., Extract of Ergot. Synonym, Ergotin. A soft solid about eight times the strength of the drug. Average Dose.-4 grains (0.25 Gm.). Fluidextractum Ergotae. Eng., Fluidextract of Ergot. Average Dose.-30 minims (2 mils). Therapeutic Action.-Oxytocic, emmenagogue, and hemostatic (for uterine hemorrhage). Uses.-Employed after the third stage of labor to promote contraction of the uterus; also for menorrhagia, metrorrhagia, purpura haemorrhagica, etc. It should be remembered that Ergot is a hemostatic for uterine hemorrhage, and its indiscriminate use, particularly in cerebral hemorrhage, is to be condemned. Administration.-For temporary use, as during labor, the Fluidextract is the preparation usually employed. When the use of Ergot is to be continued for some time, it is frequently advisable to administer the Extract in capsules on account of the disagreeable taste of the drug. 156 ERGOTA. The preparation "Ergotin" should not be confused with Ergotine the alkaloid. When a solid preparation is desired it is better to order the official extract. Most of the larger pharmaceutical manufacturing houses now physiologically test all the ergot they put on the market. Its hypo- dermic use has sometimes been followed by such unpleasant results that it should be used in this way only in cases of extreme emergency, and then the special aseptic hypodermic preparations should be employed. Some common methods of prescribing ergot are as follows: In the treatment of goiter: Bi or Strychninae Sulph gr. ss 03 Ferri Arsenitis gr. ij 13 Extracti Digitalis gr. iv 26 Extracti Ergotae '3ss 2 00 M. ft. cap. no. xxiv. Sig.-One after each meal. In the treatment of menorrhagia and metrorrhagia: $2 or Strychninae Sulph gr. ss 03 Hydrastininae Hydrochi gr. x 65 Extracti Ergotae gr. xl 2 50 M. ft. cap. no. xx. Sig.-One two hours after meals. In the treatment of subinvolution of the uterus: R3 or Strychninae Sulph gr. j 065 Ext. Ergotae, Quininae Sulph aa. gr. xxx 2 000 M. ft. cap. no. xxx. Sig.-One before each meal. In the treatment of menorrhagia, metrorrhagia, etc.: or Flext. Ergotae fSj 30 Flext. Hydrastis, Tinct. Nucis Vomicae aa. f$ss 15 Tinct. Aurant. Dulc q. s. f5iv 120 M. Sig.-Teaspoonful in water after meals. 1 Anders: Practice of Medicine. 2 Ashton: Practice of Gynecology. 3 Shoemaker: Materia Medica and Therapeutics. ERIODICTYON. EUCALYPTUS. 157 ERIODICTYON. Latin, Eriodictyon (Gen., Eriodictyi). Eng., Eriodictyon. Synonym, Yerba Santa. The dried leaves of Eriodictyon cali- fornicum. Average Dose.-15 grains (1 Gm.). Official Preparation. Fluidextractum Eriodictyi. Eng., Fluidextract of Eriodictyon. Average Dose.-15 minims (1 mil). National Formulary Preparations. Elixir Eriodictyi Aromaticum. Eng., Aromatic Elixir of Eriodictyon. Represents 6.25 per cent, of the drug with aromatics. Average Dose.-2 fluidrachms (8 mils). Syrupus Eriodictyi Aromaticus. Eng., Aromatic Syrup of Eriodictyon. Represents 3.2 per cent, of the drug with aromatics. Average Dose.-2 fluidrachms (8 mils). Therapeutic Action.-Classed as an expectorant and tonic. Uses.-Employed almost exclusively to disguise the taste of quinine. Administration.-For disguising the taste of quinine, the Aromatic Syrup is preferable. The Aromatic Elixir is also some- times used. The taste of Eriodictyon itself is very objectionable to some patients. or Quininae Sulphatis gr. xxx 2] Syr. Eriodictyi Arom q. s. f&j 60 M. Sig.-Teaspoonful as directed. (Shake-label.) EUCALYPTUS. Latin, Eucalyptus. Eng., Eucalyptus. Synonym, Blue Gum Leaves. The dried leaves of Eucalyptus Globulus, collected from the older parts of the tree. Average Dose.-30 grains (2 Gm.). Official Preparation and Constituents. Fluidextractum Eucalypti. Eng., Fluidextract of Eucalyptus. Average Dose.-30 minims (2 mils). Oleum Eucalypti. Eng., Oil of Eucalyptus. Average Dose.-8 minims (0.5 mil). 158 EUGENOL. Eucalyptol. Eng., Eucalyptol. An organic compound obtained from the volatile oil of Eucalyptus and other sources. A colorless liquid, very slightly soluble in water; soluble in alcohol. Average Dose.-5 minims (0.3 mil). Therapeutic Action.-Antiseptic, rubefacient, expectorant, antispasmodic. Uses.-Principally employed as Eucalyptol in sprays or inhala- tions for nasal catarrh, acute rhinitis, hay fever, asthma, bronchitis, etc. Sometimes used externally in the treatment of ulcers and vari- ous skin diseases. Administration.-Eucalyptol and the Oil of Eucalyptus are frequently employed in oily sprays. Liquid petrolatum is an ex- cellent vehicle. If used in aqueous solutions the quantity must be comparatively small. For external use they may be pre- scribed in bland oils, or such ointment vehicles as Petrolatum. B or Camphorae gr. iv 26 Eucalyptolis, 01. Pini Pum., 01. Menth. Pip aa. gtt. iv 26 Petrolati Liq q. s. f$iv 120 00 M. Sig.-Spray nose and throat every three hours. EUGENOL. See Caryophyllus, p. 119. Extractum Aconiti.- See Aconitum. Extractum Belladonnae Foliorum.-See Belladonna. Extractum Cannabis.-See Cannabis. Extractum Cascarae Sagradae.-See Cascara Sagrada. Extractum Cimicifugae.-See Cimicifuga. Extractum Colchici Cormi.-See Colchicum. Extractum Colocynthidis.-See Colocynthis. Extractum Colocynthidis Compositum.-See Colocynthis. Extractum Ergotae.-See Ergota. Extractum Fellis Bovis.-See Fei Bovis. Extractum Gelsemii.-See Gelsemium. Extractum Gentianae.-See Gentiana. Extractum Glycyrrhizae.-See Glycyrrhiza. Extractum Glycyrrhizae Purum.-See Glycyrrhiza. Extractum Hydrastis.-See Hydrastis. Extractum Hyoscyami.-See Hyoscyamus. Extractum Malti.-See Maltum. Extractum Nucis Vomicae.-See Nux Vomica. FEL BOVIS. FERRUM. 159 Extractum Opii.-See Opium. Extractum Physostigmatis.-See Physostigma. Extractum Rhei.-See Rheum. Extractum Stramonii.-See Stramonium. Extractum Sumbul.-See Sumbul. Extractum Taraxaci.-See Taraxacum. Extractum Viburni Prunifolii.-See Viburnum Prunifolium. FEL BOVIS. Latin, Fei Bovis (Gen., Fellis Bovis). Eng., Oxgall. The fresh bile of the ox, Bos taunts. A brownish-green or dark-green liquid. Official Preparation. Extractum Fellis Bovis. Eng., Extract of Oxgall. Synonym, Pow- dered Extract of Oxgall. A powder representing eight times the strength of oxgall. Average Dose.-1J4 grains (0.1 Gm.). Therapeutic Action.-Cholagogue, purgative and intestinal antiseptic. Uses.-It is generally prescribed with other purgative agents, particularly for intestinal indigestion, tympanites, etc. The previous Pharmacopeia did not contain a usable (dried) preparation, so the unofficial Inspissated Oxgall (Fei Bovis Inspis- satus) was the preparation most frequently employed. This should now be replaced by the official powdered extract, which answers every requirement. R Hydrarg. Chlor. Mitis . gr. v 30 Ext. Fei. Bovis gr. ij 12 Pulv. Rhei gr. v 30 Ext. Hyoscyami M. ft. cap. no. iij. gr. j 06 Sig.-One every two hours. FERRUM. Latin, Ferrum (Gen., Ferri). Eng., Iron. Metallic iron in the form of fine bright wire. Official Preparations and Salts. FERRUM REDUCTUM. Eng., Reduced Iron. Synonyms, Iron by Hydrogen, Black Iron, Quevennes' Iron. Contains not less than 90 per cent, of metallic Iron. 160 FERRUM. Form.-A grayish-black, granular powder. Odor and Taste.-Odorless and tasteless. Solubility,-Insoluble in water or alcohol. Incompatibles.-Oxidizing agents, salts of antimony, bismuth, copper, lead, mercury and silver. Average Dose.-1 grain (0.06 Gm.). FERRI CARBONAS SACCHARATUS. Eng., Saccharated Ferrous Carbonate. A brownish powder containing about 15 per cent, of Ferrous Carbonate. Average Dose.-4 grains (0.25 Gm.). MASSA FERRI CARBONATIS. Eng., Mass of Ferrous Carbonate. Synonym, Vallet's Mass. A soft, dark-colored mass containing about 35 per cent, of Ferrous Carbonate. Average Dose.-4 grains (0.25 Gm.). PILULE FERRI CARBONATIS. Eng., Pills of Ferrous Carbonate. Synonyms, Blaud's Pills, Ferruginous Pills, Chalybeate Pills. Each pill contains about 1 grain of Ferrous Carbonate. Average Dose.-2 pills. FERRI CHLORIDUM. Eng., Ferric Chloride. Synonym, Iron Per- chloride. Average Dose.-1 grain (0.06 Gm.). Liquor Ferri Chloridi. Eng., Solution of Ferric Chloride. Average Dose.-1% minims (0.1 mil.). Tinctura Ferri Chloridi. Eng., Tincture of Ferric Chloride. Synonym, Tincture of Iron. A hydroalcoholic liquid containing some free acid and about 13 per cent, of Ferric Chloride. Average Dose.-8 minims (0.5 mil). FERRI ET AMMONII CITRAS. Eng., Iron and Ammonium Citrate. Average Dose.-4 grains (0.25 Gm.). FERRI ET QUININ2E CITRAS. Eng., Iron and Quinine Citrate. Synonyms, Ferri et Quininse Citras Solubilis (U. S. P., viii). Average Dose.-4 grains (0.25 Gm.). FERRI PHOSPHAS. Eng., Ferric Phosphate. Synonym, Ferri Phosphas Solubilis (U. S. P., viii). Average Dose.-4 grains (0.25 Gm.). FERRI HYDROXIDUM CUM MAGNESII OXIDO. Eng., Ferric Hydroxide with Magnesium Oxide. Average Dose.-Arsenical antidote-4 fluidounces (120 mils). SYRUPUS FERRI IODIDI. Eng., Syrup of Ferrous Iodide. Con- tains about 5 per cent, by weight of Ferrous Iodide. Average Dose.-15 minims (1 mil). PILULE FERRI IODIDI. Eng., Pills of Ferrous Iodide. Each pill contains about 1 grain of Ferrous Iodide. Average Dose.-2 pills. FERRUM. 161 FERRI SULPHAS. Eng., Ferrous Sulphate. Synonyms, Green Vit- riol; if impure, Copperas. Average Dose.-1)4 grains (0.1 Gm.). Ferri Sulphas Exsiccatus. Eng., Exsiccated Ferrous Sulphate. Synonyms, Dried Ferrous Sulphate. 100 parts of Ferrous Sulphate are deprived of water of crystallization till the weight is reduced to about 65 parts. A grayish-white powder. Average Dose.-1 grain (0.06 Gm.). Ferri Sulphas Granulatus. Eng., Granulated Ferrous Sulphate. A greenish, granular powder. Average Dose.-1)4 grains (0.1 Gm.). Liquor Ferri Subsulphatis. Eng., Solution of Ferric Subsulphate. Synonym, Monsel's Solution. Average Dose.-3 minims (0.2 mil). Liquor Ferri Tersulphatis. Eng., Solution of Ferric Sulphate. LIQUOR FERRI ET AMMONII ACETATIS. Eng., Solution of Iron and Ammonium Acetate. Synonym, Basham's Mixture. Average Dose.-4 fluidrachms (15 mils). Unofficial Preparations. Compound Glycerophosphates in the form of the syrup, elixir or solution (without sugar) have about the same formula as the Compound Syrup of Hypophosphites (see p. 30) except that the glycerophosphates instead of the hypophosphites are used. They seem to be excellent pharmaceutical products. The preparation without sugar is particularly popular. Average Dose.-1 fluidrachm (4 mils). Elixir Ferri, Quininae et Strychninae Phosphatum. Eng., Elixir of the Phosphates of Iron, Quinine, and Strychnine. Synonym, Elixir of I. Q. and S. Each fluidounce represents, about, Iron Phosphate 8 grains, Quinine 4 grains, Strychnine % grain. Average Dose.-1 fluidrachm (4 mils). This was official in the previous Pharmacopeia and is one of the most extensively used preparations in medicine. Liquor Ferri Peptonati Cum Mangano. Eng., Solution of Peptone of Iron with Manganese. A National Formulary preparation frequently prescribed. Average Dose.-2 fluidrachms (8 mils). Therapeutic Action.-Tonic, hematinic. The iodide is also alterative and the chloride, sulphate and some others are astringent and styptic. Most of the solutions of iron are anti- septic or disinfectant. Uses.-Internally the preparations of iron are employed in the treatment of anemia, chlorosis, malaria, amenorrhea, ery- sipelas and many other conditions. Locally, they are used for tonsillitis, pharyngitis, diphtheria, epistaxis, gastric ulcer, etc. 162 FERRUM. Administration.-The medicinal use of the preparations of Iron are confined almost altogether to administration by mouth. They are usually either given alone or associated only with the salts of metals or alkaloids. Administration may be either in solid form or in solution. The greatest care should be used to protect the patient's teeth, particularly in administering the syrup of the iodide or the tincture of the chloride. These should not be given for an extended period of time. Probably the safest way to protect the teeth is to have the patient take the medicine, well diluted with water, through a glass tube extending well back into the mouth, and then clean the mouth and teeth with a solution of sodium bicarbonate. Solid Form.-Where comparatively large amounts of iron are to be given, or the use continued for an extended time, this is usually the most desirable form on account of the action of iron on the teeth and the unpleasant taste of most of the liquid preparations. Re- duced Iron, the Exsiccated Ferrous Sulphate, the Mass of Ferrous Carbonate, Pills of Ferrous Carbonate and the Pills of Ferrous Iodide are employed, but the latter are particularly apt to deteriorate with age, and they are so infrequently used that it is usually hard to find a fresh stock on the shelves of the average pharmacy. It should be remembered that the Mass of Ferrous Carbonate is a soft solid; so, while it can be dispensed in capsules alone or with other agents, it will first have to be made into pill form. The Pills of Ferrous Carbonate are on the market in all sizes, from about 2 to 5 grains. The "5-grain" pill, which contains about 1 grain of the Ferrous Carbonate, is the official pill and is the one dispensed unless some other size is specified. It has been claimed that these pills soon become insoluble if kept, but this does not seem to be the case if they are well made. In the treatment of chlorosis: Pil. Ferri Carbonatis no. c Sig.-Two after each meal. This is the most economical way of administering Ferrous Carbonate. In the treatment of chlorosis, etc.: R or Ferri Sulphatis Gran gr. cc 121 Potassn Carbonatis gr. c 6 M. ft. cap. no. l. Sig.-One after each meal. FERRUM. 163 Strychnine, arsenic, etc., may also be ordered in this. This forms the fresh carbonate and liberates water of crystallization, producing a moist mixture, which has to be made into a mass before putting into capsules. In the treatment of anemia: Bi or Ferri Sulph. Exsic., Potassii Bicarb aa. 3j 4 M. ft. cap. no. xxiv. Sig.-One after each meal. The idea here is to have the fresh Ferrous Carbonate formed in the stomach. In the treatment of amenorrhea (to be used 6 days preceding expected period) : R2 or Aloini gr- ij 13 Mas. Ferri Carb 2 00 Oleores. Petroselini f5j 4 00 M. ft. cap. no. xij. Sig.-One morning and evening. In the treatment of chlorosis associated with constipation: R3 or Aloes gr. xl 3 Mas. Ferri Carb 5ij 8 Pulv. Aromatici q- s. M. ft. cap. no. xx. Sig.-One at bedtime. As a tonic, particularly in the treatment of malaria: R Strychninae Sulphatis or gr. j 065 Arseni Trioxidi gr. ij 130 Quininae Sulphatis gr. cl 10 000 Ferri Reducti gr. c 6 000 M. ft. cap. no. L. Sig.-One after each meal. Massa Ferri Carbonatis in four-grain doses may be used instead of the Ferrum Reductum. i Musser and Kelly: Practical Treatment. 2 Shoemaker: Materia Medica and Therapeutics. •Ibid. 164 FERRUM. In the treatment of neurasthenia, hysteria, etc.: Ri or Arseni Trioxidi gr. ss 03 Asafoetida Pulv gr. x 65 Ext. Sumbul, Ferri Sulph. Exsic aa. gr. xx 1 30 M. ft. cap. no. xx. Sig.-One after each meal. In the treatment of goiter: $2 or Strychnine Sulph gr. ss 03 Ferri Arsenatis gr- ij 13 Extracti Digitalis gr. iv 26 Ext. Ergote 3ss 2 00 M. ft. cap. no. xxiv. Sig.-One after each meal. As a postoperative tonic: B3 Hydrarg. Chlor. Corros., Arseni Trioxidi or 065 Ext. Nucis Vomicae gr. xxv 1 600 Ferri et Quin. Cit gr. cc 13 000 M. ft. cap. no. c. Sig.-One after each meal. In Solution.-Care should be used to protect the teeth, as pre- viously outlined. The Tincture of Ferric Chloride, the Syrup of Ferrous Iodide, the Elixir of Iron, Quinine and Strychnine and the Compound Syrup of Hypophosphites are the preparations most frequently employed. The Syrup of Ferrous Iodide is usually prescribed alone. It is the most alterative preparation of iron. It is damaging to the teeth, is apt to produce iodism, and altogether is so undesirable that it seems that its use should be discouraged. Probably the safest way to administer the drug is to order the patient to put the desired number of drops in a capsule just before taking. 1 Shoemaker: Materia Medica and Therapeutics. 2 Anders: Practice of Medicine. 8 Ashton: Practice of Gynecology. FERRUM. 165 For a child 8 years old: R or Syr. Ferri lodidi fSj 30| Sig.-Take five (5) drops in capsule after meals. The Tincture of Ferric Chloride is used alone or with other agents. The U. S. P. average dose is frequently exceeded. For example, the following is sometimes used empirically in erysipelas: or Tinct. Ferri Chlor., Elixir Aromatici aa. f5j 3o| M. Sig.-Teaspoonful in water through a tube every four hours. Some combinations art as follows: As a tonic in the treatment of anemia, etc.: R or Hydrarg. Chlor. Corros gr. ij 13 Liq. Acidi Arsenosi f5ij 8 00 Tinct. Ferri Chlor f3iv 15 00 Acidi Hydrochi. Dil f3iv 15 00 Glycerini f5j 30 00 Aquae Dest q. s. f.5vj 180 00 M. Sig.-Teaspoonful in water after meals. As a tonic, particularly in malaria: or Quininae Sulphatis gr. cl 10 Liq. Acidi Arsenosi 5ij 8 Tinct. Ferri Chlor f5vj 23 Glycerini fSj 30 Aquae q. s. f3vj 180 M. Sig.-Teaspoonful in water after meals. In an aperient preparation for the treatment of comedo: Qi or Magnesii Sulphatis 5iss 45 Ferri Sulphatis gr. xvj 1 Acidi Sulph. Dil 3ij 8 Aquae q. s. f^viij 240 M. Sig.-Tablespoonful in water before breakfast. 1 Ohmann-Dumesnil: Diseases ot the Skin. 166 FERRUM. In the treatment of stomatitis of childhood: Hi or Potassii Chloratis gr. xxiv 1 5 Tinct. Ferri Chlor. nixxxvj 2 5 Syr. Zingiberis £5ss 15 0 Aquae q. s. f3iij 90 0 M. Sig.-Teaspoonful in water every two hours. In the treatment of tonsillitis, pharyngitis, etc.: or Potassii Chloratis 5ij 8 Tinct. Ferri Chlor f3iij 12 0 Acidi Sulphurosi f5iv IS 0 Glycerini f5vj 22 0 Aquae fq. s. f3vj 180 0 M. Sig.,•Tablespoonful in water every four hours. The Elixir of Iron, Quinine and Strychnine Phosphate, the Com- pound Syrup of Hypophosphites, the Compound Glycerophosphates and the Solution of the Peptonate of Iron with Manganese are used where a more pleasant preparation is desired and the action of the other agents included is also indicated. They are usually prescribed alone. As a tonic, etc.: or Elix. Ferri, Quin, et Strych. Phos. .. fSviij 240| Sig.-Teaspoonful in water after meals. As a tonic, etc.: 3 or Liq. Ferri Pep. cum Mang 240| Sig.-Two (2) teaspoonfuls in water after meals. In smaller doses this is frequently administered to children. Solution of Arsenous Acid, etc., may be added as indicated. Fluidextractum Aconiti.-See Aconitum. Fluidextractum Aromaticum.-See Cinnamomum. Fluidextractum Aspidospermatis.-See Aspidosperma. Fluidextractum Aurantii Amari.-See Aurantium. Fliudextractum Belladonnae Radicis.-See Belladonna. Fluidextractum Buchu.-See Buchu. 1 Ruhrah: Diseases of Children. FCENICULUM. 167 Fluidextractum Cannabis.-See Cannabis. Fluidextractum Cascarae Sagradae.-See Cascara Sagrada. Fluidextractum Cascarae Sagradae Aromaticum.-See Cascara Sagrada. Fluidextractum Cimicifugae.-See Cimicifuga. Fluidextractum Cinchonae.-See Cinchona. Fluidextractum Colchici Seminis.-See Colchicum. Fluidextractum Digitalis.-See Digitalis. Fluidextractum Ergotae.-See Ergota. Fluidextractum Eriodictyi.-See Eriodictyon. Fluidextractum Eucalypti.-See Eucalyptus. Fluidextractum Frangulae.-See Frangula. Fluidextractum Gelsemii.-See Gelsemium. Fluidextractum Gentianae.-See Gentiana. Fluidextractum Glycyrrhizae.-See Glycyrrhiza. Fluidextractum Granati.-See Granatum. Fluidextractum Grindeliae.-See Grindelia. Fluidextractum Guaranae.-See Guarana. Fluidextractum Hydrastis.-See Hydrastis. Fluidextractum Hyoscyami.-See Hyoscyamus. Fluidextractum Ipecacuanhae.-See Ipecacuanha. Fluidextractum Lobeliae.-See Lobelia. Fluidextractum Nucis Vomicae.-See Nux Vomica. Fluidextractum Pilocarpi.-See Pilocarpus. Fluidextractum Podophylli.-See Podophyllum. Fluidextractum Rhei.-See Rheum. Fluidextractum Rosae.-See Rosa. Fluidextractum Sabal.-See Sabal. Fluidextractum Sarsaparillae.-See Sarsaparilla. Fluidextractum Sarsaparillae Compositum.-See Sarsaparilla. Fluidextractum Scillae.-See Scilla. Fluidextractum Senegae.-See Senega. Fluidextractum Sennae.-See Senna. Fluidextractum Spigeliae.-See Spigelia. Fluidextractum Staphisagriae.-See Staphisagria. Fluidextractum Stillingiae.-See Stillingia. Fluidextractum Sumbul.-See Sumbul. Fluidextractum Taraxaci.-See Taraxacum. Fluidextractum Tritici.-See Triticum. Fluidextractum Uvae Ursi.-See Uva Ursi. Fluidextractum Veratri Viridi.-See Veratrum Viride. Fluidextractum Viburni Prunifolii.-See Viburnum Prunifolium. Fluidextractum Xanthoxyli.-See Xanthoxylum. Fluidextractum Zingiberis.-See Zingiber. FCENICULUM. Latin, Foeniculum. Eng., Fennel. Synonym, Fennel Seed. The dried, ripe fruit of cultivated varieties of Foeniculum vulgare. Average Dose.-15 grains (1 Gm.). 168 FORMALDEHYDUM. FRANGULA. Official Constituent and Preparations. Oleum Foeniculi. Eng., Oil of Fennel. Average Dose.-3 minims (0.2 mil). Aqua Foeniculi. Eng., Fennel Water. Average Dose.-4 fluidrachms (15 mils). Fennel and the Oil of Fennel are contained in several official preparations. Therapeutic Action.-Classed as a stomachic, carminative, galactagogue, diuretic, etc. Uses.-Principally used in combination with other agents as a flavor and possibly to prevent the griping of purgatives. Sel- dom prescribed as such. FORMALDEHYDUM. Official in the form of the solution given below. Liquor Formaldehydi. Eng., Solution of Formaldehyde. Synonym, Formalin. A colorless, aqueous solution containing not less than 37 per cent, by weight of absolute Formaldehyde (HCOH). It is miscible with water or alcohol. Therapeutic Action.-Antiseptic, disinfectant. This preparation is, of course, extensively used by the profession, but is seldom prescribed. It is the most desirable agent for disin- fecting rooms, clothing, etc., as it does not damage or decolorize material. Special "generators" are usually employed for liberating the gas from solution. For rooms about 1 pint is used for each 1000 cubic feet of space. Formaldehyde Torches are a convenient form for use. They contain paraformaldehyde, a solid condensation product of formaldehyde, and the gas is liberated by heat. See Paraformaldehydum. FRANGULA. Latin, Frangula. Eng., Frangula. Synonym, Buckthorn. The dried bark of Rhamnus Frangula. Average Dose.-15 grains (1 Gm.). Official Preparation. Fluidextractum Frangulae. Eng., Fluidextract of Frangula. Average Dose.-15 minims (1 mil). Therapeutic Action.-Laxative. Uses.-Chronic constipation. Seldom prescribed. GALLA. GAMBIR. GELATINUM. 169 GALLA. Latin, Galla. Eng., Nutgall. An excrescence on Quercus infec- toria and other allied species of Quercus, caused by the punctures and deposited ova of Cynips tinctoria. Principal Constituents. Tannic Acid, Gallic Acid, etc. Official Preparation. Unguentum Gallae. Eng., Nutgall Ointment. Contains 20 per cent, of the drug. Therapeutic Action.-Astringent, styptic. Uses.-Almost unused as such. See Tannic and Gallic Acids. GAMBIR. Latin, Gambir. Eng., Gambir. Synonym, Pale Catechu. An extract prepared from the leaves and twigs of Ourouparia Gambir. Average Dose.-15 grains (1 Gm.). Official Preparation. Tinctura Gambir Composita. Eng., Compound Tincture of Gambir. Represents Gambir, 5 per cent.; Cinnamon, 2.5 per cent. Average Dose.-1 fluidrachm (4 mils). Therapeutic Action.-Astringent. Uses.-Used in the treatment of diarrhea, hemorrhoids, epistaxis, etc. This was introduced into the Pharmacopeia (viii) to replace Catechu. Administration.-The Compound Tincture is the preparation of choice. Its most common use is as an intestinal astringent, in which case it is usually prescribed with other agents, as bis- muth subnitrate, chalk mixture, etc. GELATINUM. Latin, Gelatinum. Eng., Gelatin. The purified product obtained from certain animal tissues, as skin, ligaments, and bones, by treat- ment with boiling water. An amorphous, more or less transparent solid. 170 GELSEMIUM. GENTIANA. Official Preparation. Gelatinum Glycerinatum. Eng., Glycerinated Gelatin. Contains 50 per cent, of gelatin. GELSEMIUM. Latin, Gelsemium. Eng., Gelsemium. Synonyms, Yellow Jasmine (or Jassamine), Carolina Jasmine. The dried rhizome and roots of Gelsemium sempervirens. Average Dose.-y2 grain (0.03 Gmi). Official Preparations. Extractum Gelsemii. Eng., Extract of Gelsemium. A powder rep- resenting about 4 times the strength of the drug. Average Dose.-% grain (0.01 Gm.). Fluidextractum Gelsemii. Eng., Fluidextract of Gelsemium. Average Dose.-% minim; (0.3 mil). Tinctura Gelsemii. Eng., Tincture of Gelsemium. Represents 10 per cent, of the drug. Average Dose.-4 minims (0.25 mil). Therapeutic Action.-Classed as a nervine, sedative, antispas- modic, antiperiodic. Uses.-Recommended for headache, migraine, neuralgia, dys- menorrhea, asthma, whooping-cough, chorea, laryngismus stridulus, etc. Administration.-It is usually recommended in the form of the tincture to be prescribed alone. Not often employed. GENTIANA. Latin, Gentiana (Gen., Gentianae). Eng., Gentian. The dried rhizome and roots of Gentiana lutea. Average dose.-15 grains (1 Gm.). Official Preparations. Extractum Gentianae. Eng., Extract of Gentian. Average Dose.-4 grains (0.25 Gm.). Fluidextractum Gentianae. Eng., Fluidextract of Gentian. Average Dose.-15 minims (1 mil). Tinctura Gentianae Composita. Eng., Compound Tincture of Gentian. Gentian, 100 Gm.; Bitter Orange Peel, 40 Gm.; Cardamom Seed, 10 Gm.; Alcohol, 500 mils; Water and Glycerin, to make 1000 mils. Average Dose.-1 fluidrachm (4 mils). GENTIANA. 171 Therapeutic Action.-Bitter tonic, stomachic. Uses.-Employed as a simple bitter, usually in combination with more active agents. Administration.-The use of Gentian is practically confined to the employment of the Extract in pill masses, and the Com- pound Tincture as a vehicle. Some combinations are as follows: In tonic pills or capsules: R or Strychninae Sulph gr. ss 030 Arseni Trioxidi : gr. j 065 Ferri Reducti gr. xxx 2 000 Ext. Gentianae q. s. M. ft. pil. no. xxx. Sig.-One after each meal. Note that in using the extract as an excipient the amount is left to the discretion of the druggist. Or: R Strychnin® Sulph or 03 Arseni Trioxidi gr- j 06 Ferri Reducti gr. xxx 2 00 Ext. Gentian® 5ij 8 00 M. ft. cap. no. xxx. Sig.-One after each meal. As a bitter tonic: Tinct. Nucis Vomicae f5iv or 151 Tinct. Gentianae Co q. s. f3iv 120 M. Sig.-Teaspoonful in water before meals. Ri or Arseni Trioxidi gr. ij 13 Piperis Pulv 5ij 8 00 Ext. Gentianae 3ij 8 00 M. ft. cap. no. lx. Sig.-One after each meal. In the treatment of tuberculosis: $2 or Creosoti f3j 4 Tinct. Gentianae Comp fSj 30 Alcoholis 240 M. Sig.-Teaspoonful in water or milk after meals. 1 Ohmann-Dumesnil: Diseases of the Skin. 2 Musser and Kelly f Practical Treatment. 172 GLUCOSUM. GLYCERINUM. GLUCOSUM. Latin, Glucosum (Gen., Glucosi). Eng., Glucose. A syrupy product obtained by the incomplete hydrolysis of starch, consisting chiefly of dextrose and dextrins. Form.-A colorless or slightly colored, thick, syrupy liquid. Odor and Taste.-Odorless or nearly so, and has a sweet taste. Solubility.-Very soluble in water, sparingly soluble in alcohol. Uses.-Chiefly used as a nutrient, and in the treatment of eclampsia, uremia, and kindred conditions. Administration.-Chiefly by Murphy Drip, usually in about 6 per cent, solutions, and by intravenous infusion in solutions of 30 per cent, or less. GLYCERINUM. Latin, Glycerinum (Gen., Glycerini). Eng., Glycerin. Syno- nym, Glycerol. A liquid obtained by the hydrolysis of vegetable or animal fats or fixed oils. Form.-A clear, colorless liquid of a syrupy consistence. Odor and Taste.-Odorless. Sweet taste and producing a sense of warmth upon the mouth and lips. Solubility.-Miscible with water and alcohol in all proportions. Incompatibles.-Oxidizing agents such as nitric acid, potassium permanganate, etc. Average Dose.-1 fluidrachm (4 mils). Official Preparations. Suppositoria Glycerini. Eng., Suppositories of Glycerin. Each sup- pository contains about 3 Gm. (45 grains) of Glycerin. Glycerin is a constituent of all the glycerites and of many other official preparations. Therapeutic Action.-Laxative, dehydrating agent, antiseptic, emollient. Uses.-Largely used as a vehicle, solvent and sweetening agent. Used by rectum as a laxative. By vaginal tampons it is used for subinvolution, pelvic congestion, etc. Recommended for renal calculi, chronic constipation and many other conditions. Externally it is used in many lotions and ointments for skin diseases. Administration.-Glycerin is not often prescribed alone, but is a constituent of many preparations for internal or local use. The following will illustrate: GLYCERINUM. 173 In the treatment of bronchitis: Ri or Tinct. Opii Camph., Spir. Vini Gallici, Glycerini aa. fXj 30 M. Sig.-Teaspoonful in water every three hours. In the treatment of tuberculosis: R2 or Creosoti ntxxiv 1 5 Glycerini f5ij 8 0 Tinct. Aurantii Dulc q. s. f5iij 90 0 M. Sig.-Teaspoonful in water or milk after meals. In a purgative preparation: R3 Tinct. Nucis Vomicae fjss or 15 Flext. Cascarae Sagr f5j 30 Glycerini f^ss 15 Aquae Chloroformi q. s. fjiij 90 M. Sig.-Teaspoonful in water after meals. Locally.-The strong affinity of Glycerin for water makes it a valuable agent in preparations for use as tampons, suppositories, etc. It is a much-used emollient, and is a constituent of many face lotions, etc. Some combinations of glycerin for local use are shown in the following: As a local application for chapped hands, etc.: R or Phenolis Liq Glycerini, nvj 4 Alcoholis aa. fSj 30 0 Aquae Rosae q. s. f&ij 90 0 M. Sig.-Apply after bathing. 1 Musser and Kelly: Practical Treatment. 2 Ibid. 3 Hughes: Practice of Medicine. 174 GLYCERITUM. GLYCERYLIS NITRAS. Used for cleansing the nose in infectious diseases: Bi or Phenolis Liq -nivj 4 Sodii Bicarb gr. xxx 2 0 Sodii Boratis gr. xl 2 5 Glycerini f3ij 8 0 Aquae Dest q. s. fSvj 180 0 M. Sig.-Spray as directed. GLYCERITUM-Glycerite. Glycerites are solutions of medicinal substances in glycerin. They are not often prescribed. The following five glycerites are official: Glyceritum Acidi Tannici.-See Acidum Tannicum. Glyceritum Amyli.-See Amylum. Glyceritum Boroglycerini.-See Acidum Boricum. Glyceritum Hydrastis.-See Hydrastis. Glyceritum Phenolis.-See Phenol. GLYCERYLIS NITRAS. Latin, Glycerylis Nitras. Eng., Glyceryl Trinitrate-Nitro- glycerin. Average Dose.-%00 grain (0.0006 Gm.). The drug as such is not official, but the U. S. P. contains the following: Spiritus Glycerylis Nitratis. Eng., Spirit of Glyceryl Trinitrate. Synonyms, Spirit of Nitroglycerin, Spirit of Glonoin. A colorless alco- holic solution containing 1 per cent, of Glyceryl Trinitrate. Average Dose.-1 minim (0.0S mil). Therapeutic Action.-Vasodilator, circulatory depressant. Uses.-Employed in the treatment of angina pectoris, asthma, etc. Administration.-Nitroglycerin is frequently used, but not often prescribed by physicians. Hypodermic tablets containing from %0 to %oo grain can be obtained for use. In rapidity of action and duration of effect Nitroglycerin stands between Amyl Nitrite and Sodium Nitrite. 1 Musser and Kelly: Practical Treatment. GLYCYRRHIZA. GOSSYPIUM PURIFICATUM. 175 GLYCYRRHIZA. Latin, Glycyrrhiza (Gen., Glycyrrhizae). Eng., Glycyrrhiza. Synonym, Liquorice. The dried rhizome and roots of Glycyrrhiza glabra typica or Glycyrrhiza glabra glandulifera. Average Dose.-30 grains (2 Gm.). Official Preparations. Elixir Glycyrrhizae. Eng., Elixir of Glycyrrhiza (Elixir Adjuvans, U. S. P., VIII). Fluidextract of Glycyrrhiza, 125 mils; Aromatic Elixir, 875 mils. Extractum Glycyrrhizae Purum. Eng., Pure Extract of Glycyrrhiza. Fluidextractum Glycyrrhizae. Eng., Fluidextract of Glycyrrhiza. Average Dose.-30 minims (2 mils). Glycyrrhizinum Ammoniatum. Eng., Ammoniated Glycyrrhizin. Average Dose.-4 grains (0.25 Gm.). Mistura Glycyrrhizae Composita. Eng., Compound Mixture of Glycyr- rhiza. Synonym, Brown Mixture. Pure Extract of Glycyrrhiza, 30 Gm.; Syrup, 50 mils; Acacia, 30 Gm.; Camphorated Tincture of Opium, 120 mils; Antimony and Potassium Tartrate, 0.24 Gm.; Spirit of Nitrous Ether, 30 mils; Water, to make 1000 mils. Average Dose.-2% fiuidrachms (10 mils). Pulvis Glycyrrhizae Composita. Eng., Compound Powder of Glycyrrhiza. Senna, 180 Gm.; Glycyrrhiza, 236 Gm.; Washed Sulphur, 80 Gm.; Oil of Fennel, 4 Gm.; Powdered Sugar, 500 Gm. Average Dose.-1 drachm (4 Gm.). Glycyrrhiza is a constituent in many other official and N. F. preparations. Therapeutic Action.-Expectorant, laxative. Uses.-Sometimes employed in the treatment of cough, bron- chitis, etc., and in laxative preparations. It is used to disguise the taste of quinine. Administration.-To disguise the taste of quinine the Fluid- extract and the unofficial Syrup are employed. The Compound Mixture and the Compound Powder are usually prescribed alone. GOSSYPIUM PURIFICATUM. Latin, Gossypium Purificatum. Eng., Purified Cotton. Synonym, Absorbent Cotton. The hairs of the seed of Gossypium herbaceum or other cultivated species of Gossypium, freed from adhering im purities and deprived of fatty matter. 176 GRANATUM. GRINDELIA. GUAIACOL. GRANATUM. Latin, Granatum. Eng., Pomegranate. The bark of the stem and root of Punica Granatum. Average Dose.-30 grains (2 Gm.). Fluidextractum Granati. Eng., Fluidextract of Pomegranate. Average Dose.-30 minims (2 mils). Pelletierinae Tannas. Eng., Pelletierine Tannate. A mixture of the tannates of four alkaloids obtained from Pomegranate. A light-yellow, odorless powder having an astringent taste. Soluble in 240 parts of water or 16 parts of alcohol. Average Dose.-4 grains (0.25 Gm.). Therapeutic Action.-Teniafuge and anthelmintic. Uses.-To remove tapeworms. Administration.-Usually given in the form of Pelletierine Tannate, which is preferably given in capsules. The success of the treatment seems to largely depend on having the intestinal tract fairly empty before administering the drug, and on follow- ing it in from one to two hours with a sufficiently active saline purgative. The treatment is apt to produce temporary dizziness and nausea. Official Preparation and Constituent. GRINDELIA. Latin, Grindelia. Eng., Grindelia. The dried leaves and flower- ing tops of Grindelia camporum or Grindelia cu/neifolia, or of Grin- delia squarrosa. Average Dose.-30 grains (2 Gm.). Fluidextractum Grindeliae. Eng., Fluidextract of Grindelia. Average Dose.-30 minims (2 mils). Therapeutic Action.-Expectorant, diuretic, antispasmodic. Uses.-Recommended for bronchitis, asthma, cystitis, and as a local application for poisoning by ivy. Seldom prescribed. Official Preparation. GUAIACOL. Latin, Guaiacol (Gen., Guaiacolis). Eng., Guaiacol. One of the chief constituents of Creosote. GUAIACOL. 177 Form.-As usually seen, a colorless liquid. Solubility.-In 53 parts of water. Readily soluble in alcohol, glycerin and oils. Average Dose.-8 minims (0.5 mil). Guaiacolis Carbonas (Gen., Guaiacolis Carbonatis). Eng., Guaiacol Carbonate. Synonym, Duotal. Form.-A white powder. Odor and Taste.-Almost odorless and tasteless. Solubility.-Insoluble in water, soluble in 60 parts of alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antiseptic, germicide, expectorant, antipyretic. Uses.-Employed in the treatment of phthisis, bronchitis, etc. Locally for tonsillitis, orchitis and adenitis. The carbonate is extensively used as an antirheumatic, particularly in certain forms of arthritis. Administration.-Guaiacol may be administered by mouth by incorporating with some bland agent, as emulsion of codliver oil or emulsion of petroleum, but for internal administration the carbonate is used almost exclusively. Its comparative freedom from odor and taste renders it easy to take in powders, which is the preferable form for large doses. Small doses are often given in capsules. The local application of guaiacol and the administration of the carbonate are shown in the following prescriptions: In a local application, as in the treatment of orchitis, lymphangitis, arthritis, etc.: Official Preparation. B or Guaiacolis nixl 2I5 Olei Olivae _ . ..q. s. fSj 30|0 M. Sig.-Apply a teaspoonful once daily. In the treatment of acute bronchitis: Ri Guaiacolis or 2 Olei Gaultheriae 4 Adipis Lange Hydr q- s. Sj 30 M. Sig.-Apply to chest as directed. 1 Musser and Kelly: Practical Treatment. 178 GUAIACUM. Guaiacol Carbonate may be administered in powders or capsules. While in this way it may be mixed with other agents, it is the custom to order it alone. In the treatment of "rheumatism": or Guaiacolis Carb gr. cc 13] Ft. cht. no. xx. Sig.-One every four hours. Or: or Guaiacolis Carb gr. clx 101 Syr. Tolutani q. s. f5ij 60 M. Sig.-Teaspoonful every three hours. (Shake-label.) Or:. R or Guaiacolis Carb gr. cc 13 Ft. cap. no. xl. Sig.-Two (2) every four hours. GUAIACUM. Latin, Guaiacum (Gen., Guaiaci). Eng., Guaiac. The resin of the wood of Guaiacum officinale or of Guaiacum sanctum. Average Dose.-15 grains (1 Gm.). Official Preparations. Tinctura Guaiaci. Eng., Tincture of Guaiac. Represents 20 per cent, of the drug in alcohol. Average Dose.-1 fluidrachm (4 mils). Tinctura Guaiaci Ammoniata. Eng., Ammoniated Tincture of Guaiac. Represents 20 per cent, of the drug in Aromatic Spirit of Ammonia. Average Dose.-30 minims (2 mils). Therapeutic Action.-Classed as an alterative, diaphoretic, laxative, etc. Uses.-Recommended for tonsillitis, rheumatism and related conditions. A valuable reagent in testing for blood. Administration.-Seldom prescribed. The taste is usually considered very disagreeable. GUARANA. HEXAMETHYLENAMINA. 179 GUARANA. Latin, Guarana. Eng., Guarana. A dried paste consisting chiefly of the crushed seeds of Paullinia Cupana. Average Dose.-30 grains (2 Gm.). Official Preparation. Fluidextractum Guaranae. Eng., Fluidextract of Guarana. Average Dose.-30 minims (2 mils). Therapeutic Action.-Stimulant, diuretic, astringent. Uses.-Recommended for headache, diarrhea, etc. Seldom used. HAMAMELIS Latin, Hamamelis. Eng., Hamamelis. Synonym, Witchhazel. Not official, but the U. S. P., ix, contains the following: Official Preparation. Aqua Hamamelidis. Eng., Hamamelis Water. Synonyms, Extract of Witchhazel, Distilled Extract of Witchhazel. A saturated aqueous solution obtained by distilling with steam or water the bark, twigs, smaller stems or the entire shrub of Hamamelis Virginiana: 15 per cent, of alcohol is added to the distillate. Therapeutic Action.-Antiseptic and astringent. It is probable that what therapeutic virtue the preparation possesses depends on the alcohol and the tannic acid it contains. Uses.-A popular household remedy for wounds, infections, insect-bites, etc. Seldom prescribed. HEXAMETHYLENAMINA. Latin, Hexamethylenamina (Gen., Hexamethylenaminae). Eng., Hexamethylenamine. Synonym, Hexamethylene-tetramine, Urotro- pin. A condensation product of Ammonia and Formaldehyde. Form.-Small, colorless crystals or white powder. Odor and Taste.-Odorless, almost tasteless. Solubility.-In 1.5 parts of water and in 12.5 parts of alcohol. Incompatibles.-All acids. Average Dose.-4 grains (0.25 Gm.). Therapeutic Action.-Diuretic, urinary antiseptic. Uses.-Employed in the treatment of gonorrhea, cystitis, pyelitis, renal calculi, phosphaturia, typhoid fever, etc. Recom- 180 HUMULUS. mended for argyria, biliary calculi, arthritis, gout, bronchitis, etc. Administration.-Usually prescribed alone, either in aqueous solution or in the form of tablets to be dissolved in water. While other sizes of tablets may be obtained the 7%-grain are the most popular. It is best to have each dose administered in a glass of water. The tendency is to administer large doses, and some of our best therapists give as much as 15 grains every three hours. Some patients cannot tolerate the drug, and even small doses may cause painful micturition or even hematuria. In giving the drug, it is always desirable to have the patient or nurse instructed as to untoward symptoms and discontinue its use upon their appear- ance. The simultaneous use! of alkalies interferes with the decomposi- tion therefore with the action of the drug. In solution: or Hexamethylenaminae 3iv 151 Aquae q. s. f$iv 120 M. Sig.-Teaspoonful in glass of water every four hours. In tablets: Tab. Hexamethylenaminae (7j4 gr.) Sig.-One in water every 4 hours. Patient should be told to break up the tablet, else its solution is sometimes very slow. HOMATROPINE HYDROBROMIDUM. See Belladonna, p. 87. HUMULUS. Latin, Humulus. Eng., Hops. The dried strobiles of Humulus Lupulus. Average Dose.-30 grains (2 Gm.). Therapeutic Action.-Stomachic, carminative, sedative, anti- spasmodic. HYDRARGYRUM. 181 Uses.-Recommended in the treatment of hysteria, flatulent colic, atonic dyspepsia, alcoholic psychosis, etc. In the form of malt beverages, used to promote appetite and digestion and as a galactagogue for nursing mothers, etc. HYDRARGYRUM. Latin, Hydrargyrum. Eng., Mercury. Synonym, Quicksilver. Incompatibles of Mercurial Salts and Preparations. The incompatibles of mercurials are so general and the indica- tions for combinations so limited that it is usually better to learn what may than what may not be used with them. Most of the desirable combinations are indicated in the following pages. Preparations of Metallic Mercury. HYDRARGYRUM CUM CRETA (Gen., Hydrargyri Cum Creta). Eng., Mercury with Chalk. Synonym, Gray Powder. Contains 38 per cent, of Mercury. Form.-A gray powder. Odor and Taste.-Odorless; having slightly sweetish taste. Average Dose.-4 grains (0.25 Gm.). MASSA HYDRARGYRI (Gen., Massae Hydrargyri). Eng., Mass of Mercury. Synonyms, Blue Mass, Blue Pill. Contains 33 per cent, of Mercury. Average Dose.-4 grains (0.25 Gm.). UNGUENTUM HYDRARGYRI (Gen., Unguenti Hydrargyri). Eng., Mercurial Ointment. Contains 50 per cent, of mercury. Unguentum Hydrargyri Dilutum. Eng., Blue Ointment. Contains about 30 per cent, of Mercury. Salts of Mercury and their Preparations. • HYDRARGYRUM AMMONIATUM (Gen., Hydrargyri Ammoniati). Eng., Ammoniated Mercury. Synonym, White Precipitate. Contains about 80 per cent, of Mercury. Form.-White pieces or powder. Odor and Taste.-Odorless and having a metallic taste. Solubility.-Insoluble in water or alcohol. Unguentum Hydrargyri Ammoniati. Eng., Ointment of Ammoniated Mercury. Contains 10 per cent, of Ammoniated Mercury. HYDRARGYRI CHLORIDUM CORROSIVUM (Gen., Hydrargyri Chloridi Corrosivi). Eng., Corrosive Mercuric Chloride. Synonyms, Corrosive Sublimate, Bichloride of Mercury, etc. 182 HYDRARGYRUM. Form.-Heavy, colorless crystals or crystalline masses. Odor and Taste.-Odorless and having an acrid, metallic taste. Solubility.-In 13.5 parts of water or 3.8 parts of alcohol. More readily soluble in the presence of ammonium chloride. Average Dose.-grain (0.003 Gm.). HYDRARGYRI CHLORIDUM MITE (Gen., Hydrargyri Chloridi Mitis). Eng., Mild Mercurous Chloride. Synonyms, Calomel, Mercurous Chloride, Subchloride of Mercury. Form.-White or yellowish-white powder. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water or alcohol. Average Dose.-Laxative-2% grains (0.15 Gm.). Alterative-% grain (0.015 Gm.). HYDRARGYRI IODIDUM FLAVUM (Gen., Hydrargyri lodidi Flavi). Eng., Yellow Mercurous Iodide. Synonyms, Protiodide of Mer- cury, Green Iodide of Mercury, Mercurous Iodide. Form.-A yellow powder. Odor and Taste.-Odorless and tasteless. Solubility.-Almost insoluble in water. Insoluble in alcohol. Average Dose.-% grain (0.01 Gm.). HYDRARGYRI IODIDUM RUBRUM (Gen., Hydrargyri lodidi Rubri). Eng., Red Mercuric Iodide. Synonym, Biniodide of Mercury, Mercuric Iodide. Form.-Red powder. Odor and Taste.-Odorless and tasteless. Solubility.-Almost insoluble in water. Soluble in 115 parts of alcohol. Average Dose.-fa grain (0.003 Gm.). Liquor Arseni et Hydrargyri lodidi.-See Arsenum, p. 75. HYDRARGYRI OXIDUM FLAVUM (Gen., Hydrargyri Oxidi Flavi). Eng., Yellow Mercuric Oxide. Form.-A yellowish powder. Odor and Taste.-Odorless, with metallic taste. Solubility.-Almost insoluble in water. Insoluble in alcohol. Unguentum Hydrargyri Oxidi Flavi. Eng., Ointment of Yellow Mer- curic Oxide. Contains 10 per cent, of Yellow Mercuric Oxide. Oleatum Hydrargyri. Eng., Oleate of Mercury. Represents 25 per cent, of Yellow Mercuric Oxide. HYDRARGYRI OXIDUM RUBRUM (Gen., Hydrargyri Oxidi Rubri). Eng., Red Mercuric Oxide. Synonym, Red Precipitate. Form.-Heavy, red crystalline powder. Odor and Taste.-Odorless; having metallic taste. Solubility.-Almost insoluble in water. Insoluble in alcohol. HYDRARGYRI SALICYLAS (Gen., Hydrargyri Salicylatis). Eng., Mercuric Salicylate. Form.-A white or nearly white powder. Odor and Taste.-Odorless and tasteless. Solubility.-Nearly insoluble. Average Dose.-fa grain (0.004 Gm.). HYDRARGYRUM. 183 UNGUENTUM HYDRARGYRI NITRATIS. Eng., Ointment of Mercuric Nitrate. Synonym, Citrine Ointment. The official Tablets of Corrosive Mercuric Chloride, commonly called Bichloride Tablets or Antiseptic Tablets, are extensively used. They contain about 7.3 grains of the mercuric salt with some agent or agents to facilitate solubility. They may be white or con- tain coloring matter. It is desirable to use those of odd shape and color, and in a distinctive style of package, so as to avoid error. They should not be prescribed for patients' use, except in original packages (if at all). These should not be confused with the "Alka- line Antiseptic Tablets," used in making mild sprays and gargles. Therapeutic Action.-The salts and preparations of mercury are generally ^Iterative, antisyphilitic and germicide. Mass of Mercury, Mercury with Chalk, and the Mild Chloride are par- ticularly purgative. The Ointment of the Nitrate, the Red Iodide and some others are active irritants. Uses.-The employment of the salts and preparations of mer- cury covers almost the entire realm of medicinal treatment. They are particularly used for syphilis in all of its forms and stages; as purgatives in the early stages of acute diseases, such as intestinal indigestion, typhoid fever, pneumonia, etc.; for para- sitic diseases, ulcers, impetigo, etc. Extensively employed as wet or dry antiseptic dressings, etc. Toxicology (Mercurialism-Hydrargyrism).-Mercury poison- ing may be acute, subacute, or chronic. A common form of acute poisoning is that occasioned by taking an excess of some poisonous mercuric salt, usually the corrosive mercuric chloride tablets. This is frequently done with suicidal intent or by error, as mistaking them for headache tablets. The patient may have intense pain, par- ticularly in the epigastric region, and usually purging, tenesmus and bloody stools. Nausea and vomiting may or may not occur. The treatment is to wash out the stomach, preferably with water con- taining milk or the,white of eggs, and, when this has been done, to leave a large excess of the albuminous matter in the stomach. Mor- phine may be used for the abdominal symptoms, and the patient otherwise treated symptomatically. A subacute mercurialism may develop from one or a few doses of a mercurial given as a purgative or in an effort to rapidly produce results, as in the treatment of syphilis. It should be 184 HYDRARGYRUM. emphasized that "salivation" from a simple calomel purge is now extremely rare. Like human hydrophobia, it is often heard of, but seldom observed. Its rarity may, in part, be due to the quality of the drug as now marketed. The usual toxic symptoms are fetid breath, disagreeable taste, swollen gums and a profuse flow of saliva. There may be lesions on the gums or elsewhere and the teeth become loose or even fall out. There may be abdominal pain, purging and bloody stools. The treatment is to discontinue the mercury, give opiates and demulcents if necessary for the intestinal symptoms, and use mouth-washes for the local lesions. Probably the best mouth- wash is one containing potassium chlorate, tincture of myrrh and tincture of belladonna leaves. Belladonna internally is fre- quently used to advantage. Potassium iodide used with proper care has been recommended. A purely chronic mercurialism may develop from the con- tinued use of the drug or in those whose work exposes them to it. The symptoms resemble those just described, but it is more apt to be characterized by necrosis of bone and cachexia. Administration.-Care should be exercised that irritating or poisonous compounds are not formed. Particular consideration should be given when the patient is taking iodides, and in making local applications of mercuric salts they should not come in contact with iodine. Some of the common uses and methods of employ- ment are indicated in the following: By Mouth.-As a purgative the Mild Mercurous Chloride, Mer- cury with Chalk and sometimes Mass of Mercury are the prepara- tions used. For children, the first two are employed, usually com- bined with sugar of milk and administered in powders. For adults, the Mild Mercurous Chloride is the preparation of choice, though the others are used. It may be administered with sugar or sugar of milk, in powder or capsules. A more common method is a combina-* tion with some other purgatives put into capsules. Among the other agents used are such as Phenolphthalein, Podophyllin, Compound Extract of Colocynth, Rhubarb, Inspissated Oxgall, etc. Strychnine and sometimes Atropine are also used. Extract of Hyoscyamus and Powder of Ipecac and Opium are very often associated in these mixtures to prevent griping. Some combinations are shown in the following: HYDRARGYRUM. 185 As an initial purge in the treatment of grip, etc.; also in alco- holism : R or Atropinae Sulph gr. ^ioo 0006 Strychninae Sulph gr. %o 0030 Hydrarg. Chlor. Mitis gr. v 3200 Ext. Cascarae Sag gr. vj 4000 M. ft. cap. no. ij. Sig.-One every hour. As a purgative: or Hydrarg. Chlor. Mitis, Ext. Fei. Bovis, Rhei Pulv aa. gr. v 320 Ext. Hyoscyami gr. j 065 M. ft. cap. no. iij. Sig.-One every hour. Or: 3 Hydrarg. Chlor. Mitis, or Phenolphthalein!, Rhei Pulv aa. gr. v 3 M. ft. cap. no iij. Sig.-Take an hour apart. As a laxative in tuberculosis: Ri or Mas. Hydrargyri, Aloes Pulv., Ipecacuanhae Pulv., Capsici Pulv 8 M. ft. cap. no. xxiv. Sig.-One at night. As a purgative (for child 2 years old) : B or Hydrarg. Chlor. Mitis gr- j 1065 Sacchari Lactis gr. xxx 2 000 M. ft. cht. no. v. Sig.-One every half-hour. When nausea and vomiting are factors this is often put into ten powders and one given every fifteen minutes. i Musser and Kelly: Practical Treatment. 186 HYDRARGYRUM. In the treatment of acid intoxication of infancy: R or Hydrarg. Chlor. Mitis gr. ij I15 Sodii Bicarbonatis gr. cc 13 00 M. ft. cht. no. xx. Sig.-One every three hours till relieved. As an alterative, antisyphilitic, etc., the preparations most com- monly used are the Yellow Mercuric Iodide, the Red Mercuric Iodide, the Corrosive Mercuric Chloride, and the Mild Mercurous Chloride. The Red Mercuric Iodide and the Corrosive Mercuric Chloride are more frequently prescribed in solution with potassium iodide when the soluble Potassio-mercuric Iodide is formed. The Yellow Mercurous Iodide is usually prescribed in the ready prepared gelatin-coated pills, which may be obtained in almost any size. The %, %, and % grain are the most popular. An advantage is the facility for increasing or decreasing the dose. In the treatment of syphilis: B Pil. Hydrarg. lod. Flav. (% gr.) Sig.-One before each meal. In the treatment of congenital syphilis: R or Hydrarg. cum Creta gr. iij I2 Sacchari Lactis 3j 410 M. ft. cht. no. xxx. Sig.-One three times a day. The mild mercurous chloride is often prescribed in the same dose. In the treatment of syphilis: or Hydrarg. Chlor. Corros gr. ij 13 Potassii lodidi Sj 30 00 Aquae Dest q. s. f5j 30 00 M. ft. sol. Sig.-Begin with five (5) drops as directed. The patient is usually instructed to take this one hour before or two hours after meals. It is best given in a small amount of water, and a glass of milk taken after. The drops are increased to desired dosage. HYDRARGYRUM. 187 In the treatment of syphilis in the tertiary stage: Ri or Hydrarg. lod. Rub gr. iv 26 Potassii lodidi 5j 30 00 Aquae Dest q. s. f3vj 180 00 M. Sig.-Teaspoonful in water after meals. In the treatment of syphilis in infants: B2 or Hydrarg. Chlor. Corros gr. j 065 Potassii lodidi 5ij 8 000 Syr. Zingiberis fSj 30 000 Aquae 60 000 M. Sig.-Five (5) drops in milk three times a day. In the treatment of anemia: or Hydrarg. Chlor. Corros gr. ij 13 Liq. Acidi Arsenosi f3ij 800 Tinct. Ferri Chlor., Acidi Hydrochlor. Dil., Glycerini aa. f5j 30 00 Aquae Dest q. s. fjvj 180 00 M. Sig.-Teaspoonful in water after meals. This is known under the popular name of Elixir Four Chlorides. As a postoperative tonic: R3 Hydrarg. Chlor. Corros., Arseni Trioxidi or 065 Ext. Nucis Vomicae gr. XXV 1 600 Ferri et Quin. Cit • • . gr. cc 13 000 M. ft. cap. no. c. Sig.-One after each meal. Intravenously and Hypodermatically.-The corrosive mercuric chloride or the red mercuric iodide are used in solution or salts as the mild chloride or the salicylate are used in suspension. The aseptic ampoules are probably the most desirable form, but the following illustrate some prescriptions used: 1 Musser and Kelly: Practical Treatment. 2 Ibid. 3 Ashton: Practice of Gynecology. 188 HYDRARGYRUM. For intravenous use in the treatment of syphilis: Ri or Hydrarg. Chlor. Corros gr- j 065 Sodii Chloridi gr- iij 200 Aquse Destillatae q. s. fSij 60 000 M. Sig.-Formula. (Poison-label.) (From 20 to 60 minims well diluted are given daily.) For hypodermic use in the treatment of syphilis: R2 or Hydrarg. Chlor. Corros gr. ivss 30 Sodii Chloridi gr. iiiss 23 Aquae Destillatae q. s. f3j 30 00 M. Sig.-One per cent, solution corrosive mercuric chloride. (10 to 30 minims are used at each injection.) By Inunction.-Mercurial Ointment is the preparation of choice. It is usually considered too strong to be used undiluted, but the of- ficial diluted ointment being made with Petrolatum is not as desir- able as the stronger preparation diluted with some agent, as Hydrous Wool Fat. The ointment may be ordered in bulk or put into papers. Paraffine paper is used. Written instructions should be given the patient as to method of use. The most common is to instruct patients to take a hot bath each night, then apply the given amount of the ointment and massage until absorption is effected. The right axillary region (below the hair) may be used one night, the next night the left, then the inner side of the right thigh, then the left, then the axillary region, etc., in the same order. This will rarely cause local symptoms of an un- pleasant character. Some desirable methods of prescribing are shown in the follow- ing: R or Ung. Hydrargyri, Adipis Lanae Hyd 3o| M. ft. cht. cer. no. xvj. Sig.-Use one each night as directed. 1 White and Martin: Genito-urinary and Venereal Diseases. 2 Z&id. HYDRARGYRUM. 189 When economy is a factor this may be ordered, as: or Ung. Hydrargyri, Adipis Lanae Hyd aa. f5j 30 M. Sig.-Use level teaspoonful each night. Inhalation and Fumigation.-In general practice mercury is sel- dom prescribed in this way. The Mild Mercurous Chloride is the salt usually employed. Separate instructions are given the patient as to bath, use of cabinet or blanket, supply of aqueous vapor, etc. Locally, in Solutions.-The Corrosive Mercuric Chloride is most commonly used. As an antiseptic or germicide it is considered by some as very desirable to prescribe it in acid solution to retard the formation of the insoluble albuminate. Tartaric Acid is most fre- quently employed. Tablets are on the market containing enough of the Corrosive Chloride (about 7.3 grains) to make a 1: 1000 solu- tion when 1 tablet is added to a pint of water. They also contain Ammonium Chloride or Tartaric Acid, etc. They are convenient for the practitioner, but they are rather dangerous to be prescribed under ordinary circumstances. Some desirable formulae are shown in the following: As a wet dressing: or Hydrarg. Chlor. Corros gr. iv 26 Acidi Tartarici gr. xx 1 30 Aquae Destillatae q. s. f5iv 120 00 M. Sig.-Use 1 part to 10 parts of water to wet dressing. (Poison-label.) In the treatment of tinea versicolor: Ri or Hydrarg. Chlor. Corros gr, iv 26 Ammonii Chloridi '3ss 2 00 Alcoholis f3vj 22 00 Aquae Rosae . q. s. f5vj 180 00 M. Sig.-Apply frequently. (Poison-label.) i Hughes: Practice of Medicine. HYDRARGYRUM. 190 As a mouth-wash in the treatment of the mucous patches of syphilis: Hi or Hydrarg. Chlor. Corros gr. j 065 Meilis Rosae Uij 60 000 Aquae Destillatae q. S. f5vj 180 000 M. Sig.-Use as a mouth-wash. In the treatment of gonorrhea: R2 or Hydrarg. Chlor. Corros gr. ss 03 Phenolis gr. xij 80 Zinci Phenolsulph 2 00 Glyc. Boroglycerini fSj 30 00 Aquae Destillatae q. s. f5vj 180 00 M. Sig.-Use as directed. (Not to be taken.) Patient should be instructed to inject after urination. In the treatment of the local lesions of diphtheria: $3 or Hydrarg. Chlor. Corros gr. ss 03 Tinct. Ferri Chlor f3ij 8 00 Glycerini f5ss 15 00 Aquae Dest q. s. fSiij 90 00 M. Sig.-Teaspoonful in water every two hours. In Dusting Powders.-The Mild Mercurous Chloride is the salt most commonly used. It is prescribed alone or with other agents. The following will illustrate: In the treatment of impetigo, "fever blisters," etc.: B or Hydrarg. Chlor. Mitis 5j 41 Bismuthi Subnitratis 26| M. Sig.-Apply three times a day. In Ointments.-The Mild Chloride, Yellow Oxide and Am- moniated Mercury are more frequently employed. When some ir- ritant or decidedly stimulating action is desired (as in the indolent 1 White and Martin: Genito-urinary and Venereal Diseases. 2 Ibid. 3 Hughes: Practice of Medicine. HYDRARGYRUM. 191 syphilitic lesions) the Ointment of Mercuric Nitrate, properly diluted, is used. In ordering the Yellow Oxide in ointments it is particularly de- sirable to see that the salt is in a state of minute subdivision and thoroughly incorporated with the vehicle, else an irritant effect may be produced. Some strengths and combinations are shown in the following: In the treatment of eczema of the scalp of infancy: n or Hydrarg. Chlor. Mitis 3ss 21 Petrolati q. s. f3j 30 M. Sig.-Apply twice daily. In the treatment of the skin lesions of smallpox: IP Phenolis or 65 Hydrarg. Chlor. Mitis .. . . . - gr. xv 1 00 Amyli, Zinci Oxidi aa. 3ij 8 00 Petrolati q. s. 3j 30 00 M. Sig.-Apply as directed. Or: $2 or Hydrarg. Ammoniati gr. x 65 Amyli, Zinci Oxidi aa. 3ij 8 00 Petrolati q. s. 5j 30 00 M. Sig.-Apply as directed. In the treatment of the skin lesions of syphilis: R3 or Hydrarg. Ammoniati ... . . . - gr. xx i|3 Ung. Aquae Rosae q- s. Sj 30|0 M. Sig.-Apply as directed. i Musser and Kelly: Practical Treatment. 2 Ibid. 8 White and Martin: Genito-urinary and Venereal Diseases. 192 HYDRASTIS. Used in the treatment of the cutaneous lesions of hereditary syphilis: Hi or Hydrarg. Ammoniati gr. xv 11 Ung. Zinci Oxidi Sj 30| M. Sig.-Apply as directed. In the treatment of indolent ulcers: B or Ung. Hydrarg. Nitr 5ij 81 Petrolati 3vj 22| M. Sig.-Apply as directed. In the treatment of inflamed lids, etc.: or Hydrarg. Oxidi Flavi gr- j 1065 Petrolati q. S. 3j 4 000 M. tere bene. Sig.-Apply twice daily. HYDRASTIS. Latin, Hydrastis (Gen., Hydrastis). Eng., Hydrastis. Syno- nyms, Golden Seal, Yellow Root. The rhizome and roots of Hydrastis canadensis. Principal Constituents.-Hydrastine (about 2.5 per cent.), Ber- berine, etc. Average Dose.-30 grains (2 Gm.). Official Preparations, Alkaloids and Salt. Extractum Hydrastis. Eng., Extract of Hydrastis. A powdered ex- tract about four times the strength of the drug. Average Dose.-8 grains (0.5 Gm.). Fluidextractum Hydrastis. Eng., Fluidextract of Hydrastis. Average Dose.-30 minims (2 mils). Glyceritum Hydrastis. Eng., Glycerite of Hydrastis. Average Dose.-30 minims (2 mils). Tinctura Hydrastis. Eng., Tincture of Hydrastis. Average Dose.-1 fluidrachm (4 mils). Hydrastina. Eng., Hydrastine. An alkaloid obtained from Hydrastis or prepared synthetically. Average Dose.-% grain (0.01 Gm.). 1 Musser and Kelly: Practical Treatment. HYDRASTIS. 193 Hydrastinae Hydrochloridum. Eng., Hydrastine Hydrochloride. Average Dose.-% grain (0.01 Gm.). Hydrastininae Hydrochloridum. Eng., Hydrastinine Hydrochloride. The hydrochloride of an artificial alkaloid derived from Hydrastine. Form.-Yellowish needles or powder. Odor and Taste.-Odorless; bitter taste. Solubility.-Soluble in water or alcohol. Average Dose.-% grain (0.03 Gm.). Unofficial Preparation. Hydrastinum. Eng., Hydrastin. An impure mixture of alkaloids, resin, etc. Average Dose.-5 grains (0.3 Gm.). This should now be replaced by the Extract of Hydrastis. The unofficial Aqueous Fluidextract of Hydrastis is extensively used. It is miscible with water. Therapeutic Action.-Astringent, antiseptic, bitter tonic. Said to be hemostatic in uterine hemorrhage. Uses.-Principally employed in genito-urinary conditions, as gonorrhea, menorrhagia and metrorrhagia; also for chronic gas- tritis, intestinal indigestion, diarrhea, etc. Administration.-Care should be exercised to distinguish be- tween the impure Hydrastin and the alkaloid Hydrastine or Hydras- tinine Hydrochloride. Mistakes have occurred both on the part of the prescriber and the compounder. The Fluidextract, Hydrastinine Hydrochloride and Hydrastin are the preparations most fre- quently employed. The alkaloids are not usually recommended for gastric disturbances or in local applications. All of these preparations will stain the skin or clothing. Some combinations are as follows: In the treatment of menorrhagia, metrorrhagia, etc.: Hi or Strychninae Sulph gr. ss 03 Hydrastininae Hydrochi gr. x 65 Extract! Ergotae gr. xl 2 50 M. ft. cap. no. xx. Sig.-One two hours after meals. 1 Ashton: Practice of Gynecology. 194 HYOSCYAMUS. Or: R Flext. Hydrastis, Flext. Ergotae Tinct. Nucis Vomicae aa. f5j f3iv or 30 15 Tinct. Aurantii Dulc q. s. f&v 120 M. Sig.-Teaspoonful in water after meals. Note that the fluidextract is dispensed in an. alcoholic vehicle to prevent precipitation. This preparation is of distinctly disagreeable taste, and capsules are usually considered preferable. As an injection in the treatment of gonorrhea: B or Hydrastinae Sulph., Morphinae Sulph., Quininae Bisulph Muc. Acaciae aa. gr. viij 5 q. s. fSviij 240 0 M. Sig.-Use as directed. (Not to be taken.) This constitutes the "Hot Springs Remedy" extensively used in some localities. HYOSCYAMUS. Latin, Hyoscyamus (Gen., Hyoscyami). Eng., Hyoscyamus. Synonym, Henbane. The dried leaves and flowering or fruiting tops of Hyoscyamus niger. Principal Constituents.-Hyoscine, Hyoscyamine, etc. Contains not less than 0.065 per cent, of the Alkaloids of Hyoscyamus. Average Dose.-4 grains (0.25 Gm.). Official Preparations and Alkaloidal Salts. Extractum Hyoscyami. Eng., Extract of Hyoscyamus. A soft solid about four times the strength of the drug. Average Dose.-1 grain (0.06 Gm.). Fluidextractum Hyoscyami. Eng., Fluidextract of Hyoscyamus. Average Dose.-3 minims (0.2 mil). Tinctura Hyoscyami. Eng., Tincture of Hyoscyamus. Represents 10 per cent, of the drug in diluted alcohol. Average Dose.-30 minims (2 mils). HYOSCYAMUS. 195 HYOSCYAMINE HYDROBROMIDUM. Eng., Hyoscyamine Hydro- bromide. The hydrobromide of an alkaloid obtained from Hyoscyamus and other related plants. Solubility.-Soluble in water or alcohol. Average Dose.-%oo grain (0.0003 Gm.). Therapeutic Action.-Sedative, antispasmodic, anodyne, de- liriant and mydriatic. Uses.-Principally employed as antispasmodic for whooping- cough, asthma, croup, etc. Used in combination with other agents for hysteria, alcoholic psychosis and related conditions. A common constituent in purgative preparations to prevent grip- ing. Hyoscine is employed in the treatment of alcoholism. Administration.-Extract of Hyoscyamus is more frequently used in the form of the unofficial powdered extract. The tincture is the preparation used in fluid combinations. The alkaloidal salt is sometimes used by physicians, but sel- dom prescribed, and frequently disappointing. In the treatment of palpitation in hysterical subjects: UI or Strychninae Sulph gr. % 02 Zinci Valeratis gr. X 65 Ext. Sumbul gr. X 65 Ext. Hyoscyami gr. V 32 M. ft. cap. no. x. Sig.-One after each meal. In a purgative mixture, to prevent griping: H or Hydrarg. Chlor. Mitis, Rhei Pulv., Ext. Fei. Bovis aa. gr. v 320 Ext. Hyoscyami Pulv gr. j 065 M. ft. cap. no. iij. Sig.-One every hour. In the treatment of colds, etc.: or Acetphenetidini gr. xxx 2 0 Ammonii Carb gr. xx 1 3 Tinct. Hyoscyami f3j 4 0 Meilis Depur f5iss 45 0 Spir. Vini Gallici q. s. fSiij 90 0 M. Sig.-(Shake-label). Tablespoonful in water every four hours. i Anders: Practice of Medicine. 196 HYPOPHYSIS SICCA. This does not make an elegant-looking mixture, but seems to be clinically of value. As a sedative in the treatment of violent cough: B or Heroinae Hydrochlor gr. j 065 Ammonii Chlor 5j 4 000 Tinct. Hyoscyami 12 000 Syr. Pruni Virg q. s. f5ij 60 000 M. Sig.-Teaspoonful every two hours till relieved. In the treatment of cough: Bi or Codeinae Sulph gr. iij 2 Tinct. Hyoscyami f3iij 12 0 Syr. Tolutani f3ss 15 0 Aquae q. s. fliij 90 0 M. Sig.-Teaspoonful every three hours. In the treatment of cystitis, whooping-cough, etc.: $2 or Tinct. Hyoscyami 2 Potassii Citratis 3j 4 Aquae q. s. f&v 120 M. Sig.-Teaspoonful in water every three hours. In a sedative mixture: B or Chlorali Hydrati 3j 4 Sodii Bromidi 3ij 8 Tinct. Hyoscyami 8 Aquae Chloroformi q. s. fSj 30 M. Sig.-Teaspoonful every four hours till relieved. HYPOPHYSIS SICCA. , Latin, Hypophysis Sicca. Eng., Desiccated Hypophysis. Syn- onym, Desiccated Pituitary Body. The posterior lobe obtained from the pituitary body of cattle, cleaned, dried and powdered. A yellowish or grayish amorphous powder having a characteristic odor. It is only partially soluble in water. 1 Musser and Kelly: Practical Treatment. 2Ruhrah: Diseases of Children. ICHTHYOL. 197 Average Dose.-% grain (0.03 Gm.). Official Preparation. Liquor Hypophysis. Eng., Solution of Hypophysis. Average Dose.-15 minims (1 mil). Uses.-Used to promote uterine pains in labor and to contract the uterus after delivery; also for tympanites, and many other con- ditions. Administration-Principally used by needle. The aseptic ampoules of the solution are employed almost exclusively. It is extensively used under the proprietary name of Pituitrin. ICHTHYOL. (Not Official.') Latin, Ichthyol (Gen., Ichthyolis). Eng., Ichthyol (Ammonium Ichthyosulphonate). Form.-A thick, brown liquid. Odor.-Bituminous, disagreeable. Solubility.-Readily soluble in water or glycerin. Incompatibles.-Acids, alkali hydroxides or carbonates, alkaloids, potassium iodide, mercury bichloride, resorcin. Therapeutic Action.-Said to be antiphlogistic, anodyne, al- terative, antigonorrheal, antiseptic. Uses.-Recommended for phthisis, rheumatism, scrofula, ne- phritis, gonorrhea, inflammations and various skin diseases. Administration.-While ichthyol is recommended for internal administration, by far the most common employment is local. It is used in ointments or in solution in water or glycerin. It mixes readily with the usual ointment bases. To disguise the odor in ointments, use 1 drop each of the Oil of Bergamot and Oil of Eucalyptus to each drachm of Ichthyol. One drop of Oil of Citronella to the drachm of Ichthyol is frequently employed. Some also add 1 drop of Oil of Rose in addition to the Oil of Citronella. In prescribing less than two fluidrachms of Ichthyol, it is advis- able to prescribe by weight, as small quantities are not conveniently measured. 198 IODOFORMUM. Some combinations are shown in the following: As an application on vaginal tampons: or Ichthyolis f3ij 81 Glyc. Boroglycerini q. s. f3iv 120 M. Sig.-For office use. In the treatment of furuncle: Ri or Ichthyolis 3j 4 Empl. Plumbi 3ij 8 Empl. Resinae 3j 4 M. Sig.-Apply as directed. In the treatment of mastitis, orchitis, lymphadenitis, etc.: B or Camphorae 3ss 2 Ichthyolis, Ung. Belladon aa. 3ij 8 Petrolati q. s. 3j 30 M. Sig.-Apply twice a day. IODOFORMUM. Latin, lodoformum. Eng., Iodoform. Formula, CHI3. Form.-A lemon-yellow powder or crystals. Odor and Taste.-A peculiar, very penetrating and persistent odor, and an unpleasant, slightly sweetish and iodine-like taste. Solubility.-Almost insoluble in water. Soluble in 60 parts of alcohol. Average Dose.-4 grains (0.25 Gm.). Official Preparation. Unguentum lodoformi. Eng., Iodoform Ointment. Contains 10 per cent.-of the drug. Therapeutic Action.-Probably a mild antiseptic and local analgesic. Uses.-Principally as a dressing for wounds and various local lesions, particularly if of a syphilitic or tuberculous character. 1 Stelwagon: Diseases of the Skin. IODUM. 199 Administration-The odor renders the drug particularly ob- jectionable. As a dressing it is usually applied dry or by means of the five or ten per cent, iodoform gauze. Sometimes used in the form of ointments, or suspensions. I0DUM. Latin, lodum (Gen., lodi). Eng., Iodine. Synonym, Resub- limed Iodine. A solid element, at one time largely obtained from the ashes of seaweed, known as Kelp, now chiefly from the niter beds of South America. Form.-Heavy, bluish-black plates of a metallic luster. Odor and Taste.-A distinctive, penetrating odor; a sharp, acrid taste. Solubility.-In about 2950 parts of water; in 12.5 parts of alcohol. More soluble in the presence of Potassium Iodide. Incompatibles.-Alkaloids, ammonia, mineral acids, tannic acid, oil of turpentine, starch, vegetable colors, etc. Average Dose.-%2 grain (0.005 Gm.). Official Preparations. Liquor lodi Compositus. Eng., Compound Solution of Iodine. Synonym, Lugol's Solution. Iodine, 5 Gm.; Potassium Iodide, 10 Gm.; Water, to make 100 mils. Average Dose.-3 minims (0.2 mil). Tinctura lodi. Eng., Tincture of Iodine. Synonym, Compound Tinc- ture of Iodine. Iodine, 70 Gm.; Potassium Iodide, 50 Gm.; Water, 50 mils; Alcohol, to make 1000 mils. Average Dose.-1^2 minims (0.1 mil). Unguentum lodi. Eng., Iodine Ointment. Iodine, 4 Gm.; Potassium Iodide, 4 Gm.; Glycerin, 12 Gm.; Benzoinated Lard, 80 Gm. Therapeutic Action.-Germicide, irritant, alterative, resolvent. Uses.-Sometimes used in the treatment of goiter, typhoid fever, diarrhea, vomiting, etc. Locally, it is used for disinfect- ing the skin for surgical work and for disinfecting fresh wounds, abscesses, etc.; also used as an application for toothache, ton- sillitis, ulcers, adenitis, erysipelas, and superficial infections gen- erally. Used as a counterirritant in pleurisy and many other conditions. Sometimes used by inhalation for bronchitis, etc. Toxicology.-Chronic iodine poisoning is discussed under "Iodides." Acute iodine poisoning is usually evidenced by the characteristic discoloration of the mucous membrane of the 200 IODUM. mouth and throat. The treatment consists in administering starch or, if that is inaccessible, a dilute solution of ammonia. Demulcent drinks should be given freely. If the quantity of the drug taken is large, emesis should be induced. Administration.-The Tincture is the preparation most com- monly used. It is usually prescribed alone. The present offi- cial tincture, which contains Potassium Iodide, is freely miscible with either water or alcohol. Before the U. S. P., viii, the tincture of iodine did not contain potassium iodide; so it was insoluble in water to any appreciable extent. This caused many to order a tinc- ture containing the iodide which was unofficial; it is the same as the present tincture of iodine, but was then called the compound tincture. It will be seen, therefore, that there is now no "compound tincture," known as such. Somewhat similar misunderstanding sometimes occurs relative to the old "resublimed iodine." All "iodine" is now resublimed. Therefore to prescribe the "compound" tincture of iodine or "resublimed" iodine is unnecessary, and shows a lack of knowledge of present conditions. The pure tincture of iodine is rather strong for common use, and many institutions dilute it one-half as a routine measure. If the undiluted tincture is applied to the skin several days in succes- sion it will often irritate, or even blister. Much of the blistering resulting from the local application of iodine is due to the presence of some dressing or application con- taining a mercuric salt, the red mercuric iodide (a powerful irritant) being formed. When a bottle containing the tincture of iodine is left open the alcohol evaporates more rapidly than the iodine; so there is a con- centration of the solution, and this may take place to where one application will blister. When the tincture is carried for some time in a cork-stoppered bottle, sufficient of the cork may be acted upon and dissolved to interfere with obtaining a clear solution when the preparation is added to water. Some frequently used prescriptions are shown in the following: As a local application in the treatment of tonsillitis, inflamed glands, abscess, furuncle, insect-bite, inflamed joints, etc.: B or Tincturse lodi 30| Sig.-Apply once daily as directed. (Poison-label.) IODUM. 201 Or, better still is the following, known by the dentists as "Iodine and aconite": or Tincturae lodi, Tincturae Aconiti aa f5ss is| Sig.-Apply twice a day as directed. (Poison-label.) It may usually be applied to the skin several days before too much local irritation develops. This is also extensively used in the treatment of toothache. As a local application for tonsillitis, etc.; also for clavus: II or Phenolis Liq th, xxv 1 5 Tinct. lodi f3iv 15 0 Glycerini q. s. f5j 30 0 M. Sig.-Apply as directed. As an application to mucous membrane: Rl or lodi gr- j 065 Potassii lodidi gr. xx 1 300 Glycerini q. s. fSj 30 000 M. Sig.-Apply as directed. Iodine is sometimes used internally in the treatment of goiter: or lodi gr. ij 13 Potas. lodidi gr. viij 50 Alcoholis f3j 4 00 Glycerini 15 00 Aquae q. s. f5ij 60 00 M. Sig.-Teaspoonful in water after meals. As a vaginal douche in vaginitis, endometritis, ovaritis, salpin- gitis, etc.: R or Tinct. lodi fjij 60| Sig.-Use teaspoonful to gallon of hot water every second night. 1 Ruhrah: Diseases of Children. 202 IODUM. This makes about as strong a solution as can well be tolerated by the patient and often proves too strong. If used oftener than once a day it will frequently cause too much irritation. It is usually employed in connection with the daily or twice daily douches of hot saline. Official Iodides. Incompatibles.-Mineral acids and salts, alkaloids, bismuth subnitrate, soluble lead salts, mercurous salts, glycyrrhiza, potassium chlorate, spirit of nitrous ether, silver nitrate, starch. AMMONII IODIDUM. Eng., Ammonium Iodide. Formula, NH4I. Form.-Small colorless crystals or granular powder. Odor and Taste.-Odorless; a sharp, saline taste. Solubility.-In 0.6 part of water or 3.7 parts of alcohol. Average Dose.-5 grains (0.3 Gm.). POTASSII IODIDUM. Eng., Potassium Iodide. Formula, KI. Form.-Colorless crystals or white granular powder. Odor and Taste.-A faint, iodine-like odor; a pungent, saline, afterward bitter taste, with a disagreeable, brassy after-taste. Solubility.-In 0.7 part of water or about 22 parts of alcohol. Average Dose.-5 grains (0.3 Gm.). SODII IODIDUM. Eng., Sodium Iodide. Formula, Nai. Form.-Colorless crystals or white crystalline powder. Odor and Taste.-Odorless; a saline and slightly bitter taste. Solubility.-In about 0.55 part of water or 2 parts of alcohol. Average Dose.-5 grains (0.3 Gm.). ARSENI IODIDUM.-See Arsenum, p. 75. FERRI IODIDUM (Syrup and Pills).-See Ferrum, p. 159. HYDRARGYRI IODIDUM FLAVUM.-See Hydrargyrum, p. 181. HYDRARGYRI IODIDUM RUBRUM.-See Hydrargyrum, p. 181. STRONTII IODIDUM. Eng., Strontium Iodide. Formula, Srl2. Form.-Usually a white powder. Odor and Taste.-Odorless; a bitter, saline taste. Solubility.-In 0.2 part of water. Soluble in alcohol. Average Dose.-5 grains (0.3 Gm.). THYMOLIS IODIDUM.-See Thymol, p. 311. ACIDUM HYDRIODICUM DILUTUM. Eng., Diluted Hydriodic Acid. A colorless liquid containing about 10 per cent, of the absolute acid (HI) and about 90 per cent, of water. Average Dose.-8 minims (0.5 mil). Syrupus Acidi Hydriodici. Eng., Syrup of Hydriodic Acid. Contains about 1.4 per cent, by weight of the absolute acid (HI). Average Dose.-1 fluidrachm (4 mils'*. IODUM. 203 Therapeutic Action.-Alterative, resolvent. Uses.-Extensively employed in the treatment of syphilis, rheumatism, arteriosclerosis, angina pectoris, interstitial nephritis, chronic bronchitis, asthma, goiter, lead- and mercury- poisoning, hepatic cirrhosis, and after the acute stage in apoplexy, menin- gitis, etc. lodism.-The iodides may sometimes produce unpleasant results even when taken in comparatively small amounts. The usual symptoms are: pain in the articulation of the inferior maxilla, coryza, excessive flow of saliva and skin lesions which may assume any one of a variety of forms. A condition charac- terized by a bullous eruption may occur, though it is, fortunately, rather rare. It is said to usually develop in cardiorenal cases. It is generally fatal and no rational line of treatment seems to have even been suggested. The treatment of iodism consists in dis- continuing the drug and favoring elimination. Large doses of sodium bicarbonate have been recommended. Administration.-Potassium Iodide is by far the most largely used; Sodium Iodide would come next. It will be noted that the iodides are colorless crystalline salts, freely soluble in water, and forming clear, colorless solutions. They have a disagreeable taste and a tendency to absorb moisture from the air, so should not be dispensed in powders. They should not be given in capsules, as the action on the gastric mucosa would be undesirable. They should always be prescribed in solution, if for internal use, and adminis- tered well diluted. Many prefer that the patient use milk as the diluent, as it seems to reduce to a minimum the disagreeable gastric effects and tends to better disguise the taste. Probably a better plan is to give the dose in water and follow with a glass of milk. The favorite time for administration is two hours after meals, and there seems to be less interference with the gastric function by giving at that time. An iodide is usually prescribed in solution alone or with iodine or other iodides; an exception to this is the so-called "Mixed Treat- ment," when an iodide is prescribed with a mercuric salt, and some- times with such agents as the Compound Tincture of Cinchona or Aromatic Fluidextract of Cascara. When the dose of the iodide is to be changed or the drug long continued, the most convenient and economical method is to pre- scribe it alone in an aqueous solution, a minim of which will repre- sent about a grain of the drug. Too large an amount should not be 204 IODUM. ordered at any time, as the solution is apt to undergo decomposition and free iodine be liberated. It should be remembered that the iodides precipitate most alkaloids. Probably the most common and convenient method of administer- ing an iodide is in the following so-called "saturated solution": B Potassii lodidi Sj or 301 Aquae Dest 30| M. ft. sol. Sig.-Begin with five (5) drops as directed. Among the advantages of this prescription are economy and convenience in changing dose. Several iodides are sometimes combined, as: $ or Potassii lodidi, Sodii lodidi aa. 3ij 8 Strontii lodidi 3j 4 Aquse q. s. f5iv 120 M. Sig.-Teaspoonful as directed two hours after meals. Ammonium Iodide is sometimes used alone or in combination for pulmonary trouble, as in the following for asthma: R or Ammonii lodidi 3J 4 Potassii lodidi 3iv 15 Ammonii Bromidi 5ij 8 Elix. Aromatici q. s. f3iv 120 M. Sig.-Teaspoonful with water three times a day. Mixed treatment may be prescribed, as: or Hydrarg. Chlor. Corros gr. ij 13 Potassii lodidi 5j 30 00 Aquae Dest q. s. f5j 30 00 M. ft. sol. Sig.-Begin with five (5) drops as directed. Mixed treatment with a bitter tonic is often considered desirable: or Hydrarg. Chlor. Corros gr. iss 1 Potassii lodidi 3v 20 0 Aquae • f3j 30 0 Tinct. Cinchon. Co q. s. f5iv 120 0 M. Sig.-Teaspoonful with water before meals. IODUM. 205 Or mixed treatment with a laxative: B or Hydrarg. Chlor. Corros gr. ij 13 Potassii lodidi Sj 30 00 Flext. Cascarae Sag. Arom fSj 30 00 Vini Xerici 180 00 M. Sig.-Teaspoonful in water two hours after meals. In the treatment of syphilis in infants: Ri or Hydrarg. Chlor. Corros gr. j 065 Potassii lodidi 8 000 Syr. Zingiberis fSj 30 000 Aquae q. s. fXij 60 000 M. Sig.-Five (5) drops in milk three times a day. In the treatment of syphilis in the tertiary stage: R2 or Hydrarg. lod. Rub gr. iv 26 Potassii lodidi Sj 30 00 Aquae Destill q. S. f3vj 180 00 M. Sig.-Teaspoonful in water after meals. In the treatment of syphilis: $3 or Potassii lodidi, Sodii lodidi, Ammonii lodidi aa. gr. xcvj 6 Syrupi Aurantii fSj 30 Aquae q. s. f5vj 180 M. Sig.-Teaspoonful well diluted four times daily. In the treatment of conditions attended with high blood-pressure, as arteriosclerosis: or Sodii Nitritis gr. xv 1 Potassii lodidi gr. clx 10 Aquae q. s. f5iv 120 M. Sig.-Teaspoonful with milk two hours after meals. 1 Musser and Kelly: Practical Treatment. 2 Ibid. 3 White and Martin: Genito-urinary and Venereal Diseases. 206 IPECACUANHA. As an application to the mucous membranes: Bi or lodi gr. J 065 Potassii lodidi gr. xx 1 300 Glycerini q. s. f5j 30 000 M. Sig.-Apply as directed. IPECACUANHA. Latin, Ipecacuanha (Gen., Ipecacuanhae). Eng., Ipecac. The dried root to which may be attached a portion of the stem of Cepha- elis ipecacuanha, or Cephaelis acuminata. Principal Constituents.-Emetine (1 to 2 per cent.), Tannic Acid, etc. Average Dose.-Expectorant, 1 grain (0.06 Gm.). Emetic, 15 grains (1 Gm.). Official Preparations and Alkaloid. Fluidextractum Ipecacuanhae. Eng., Fluidextract of Ipecac. Average Dose.-Expectorant, 1 minim (0.05 mil). Emetic, 15 minims (1 mil). Pulvis Ipecacuanhae et Opii.-See Opium, p. 239. Syrupus Ipecacuanhae. Eng., Syrup of Ipecac. Represents 7 per cent, of Ipecac. Contains some free Acetic Acid. Average Dose.-Expectorant, 15 minims (1 mil). Emetic, 4 fluidrachms (15 mils). Emetinae Hydrochloridum (Gen., Emetinae Hydrochloridi). Eng., Emetine Hydrochloride. The hydrochloride of an alkaloid obtained from ipecac. Form.-A white or very slightly yellowish crystalline powder. Odor and Taste.-Odorless. Not given by mouth. Solubility.-Freely soluble. Average Dose.-Hypodermic, % grain (0.2 Gm.). Therapeutic Action.-Emetic, expectorant, diaphoretic. Uses.-Coughs, bronchitis, pneumonia, amebic dysentery and liver abscesses, etc. A valuable emetic for acute indigestion, croup, poisoning, etc. A constituent of many purgative formulae. Administration.-Emetine Hydrochloride, the Syrup of Ipecac, and the Powder of Ipecac and Opium are the forms most commonly used. The expectorant dose as here given will often prove too large. A safe rule would probably be to make 5 minims of the syrup the maximum expectorant dose till the tolerance of the patient is known. 1 Ruhrah: Diseases of Children. IPECACUANHA. 207 Emetine Hydrochloride is administered by needle, usually in- jected deep into the deltoid muscle, where it seems much less apt to cause local trouble than if put under the skin. The aseptic ampoules are the form of choice. They are supplied to contain the various doses in common usie. The following prescriptions illustrate some methods of pre- scribing : As an emetic: 3 or Syr. Ipecacuanhas fSij 60| Sig.-Tablespoonful every fifteen minutes till effect. For children, as in the treatment of spasmodic croup, a teaspoonful would be given. In expectorant preparations (for child 4 years old) : R or Sodii Citratis gr. Ixxx 5 Syr. Ipecacuanhae f3ss 2 Spin Aitheris Nit f5ij 8 Syr. Limonis f5iv 15 Aquae q. s. f5ij 60 M. Sig.-Teaspoonful in water every two hours. Or: 3 or Syr. Ipecacuanhae f3ss 2 Limonis Succi f3iv 15 Liq. Potas. Citratis q. s. fSij 60 M. Sig.-Teaspoonful in water every two hours. In the treatment of the cough of measles: Ri Sodii Citratis 5ss or 15 Limonis Succi fSj 30 Tinct. Opii Camph f5ij 8 Syr. Ipecacuanha f3ij 8 Syr. Tolutani q. s. fjij 60 M. Sig.-Teaspoonful in water every two hours. i Anders: Practice of Medicine. 208 IPECACUANHA. In a laxative preparation for tuberculosis: Bi or Mas. Hydrargyri, Aloes Pulv., Ipecacuanhae Pulv., Capsici Pulv aa. gr. xij 8 M. ft. cap. no. xxiv. Sig.-One at night. In the interval treatment of spasmodic laryngitis of childhood: $2 or Tinct. Aconiti iRviij 5 Syr. Ipecacuanhas f5iss 6 0 Tinct. Opii Camph fSiij 12 0 Liq. Potassii Cit q. s. f5iij 90 0 M. Sig.-Teaspoonful in water every two hours. (Shake-label.) In the treatment of amebic dysentery, while Emetine Hydro- chloride is employed by needle, it is often considered desirable to give ipecac by mouth. The freshly prepared, salol-coated pills, are usually considered more desirable, and may be ordered as follows: or Ipecacuanhas Pulv gr. ccl 161 Phenylis Salicylatis q. s. Ft. pil. enter, no. L. Sig.-Ten (10) at night as directed. Written instructions should be left with patient, giving detailed information. Some prefer to give full doses each time the pills are adminis- tered, some to begin with a large dose and gradually decrease. Particular care should be exercised that the pills are properly coated. If the coating is too thick they may pass through the intes- tinal tract without change; if too thin or incomplete, some of the ipecac may be liberated in the stomach and violent emesis occur. The diarrhea often charged to ipecac in this treatment is probably often due to hard fragments of the shells of the salol coating acting as an irritating foreign body, and the patient sometimes passes those pieces having the appearance of the shells of bird-eggs. In some cases of dysentery the peristalsis is so active that, even when properly coated, the pills are passed before the salol is dis- solved. In such cases opium is indicated, and may be administered as paregoric or the tincture an hour or two before the pills are taken. i Musser and Kelly: Practical Treatment. 2 Hughes: Practice of Medicine. JALAPA. KAOLINUM. 209 JALAPA. Latin, Jalapa (Gen., Jalapae). Eng., Jalap. The dried tuberous root of Exogonium Purga. Average Dose.-15 grains (1 Gm.). 0fficial Preparations. Pulvis Jalapae Compositus. Eng., Compound Powder of Jalap. Jalap, 35 Gm.; Potassium Bitartrate, 65 Gm. Average Dose.-30 grains (2 Gm.). Resina Jalapae. Eng., Resin of Jalap. Average Dose.-2 grains (0.125 Gm.). Resin of Jalap is contained in the Compound Cathartic Pills. Therapeutic Action.-Purgative (hydragogue), diuretic. Uses.-Employed as a purgative, particularly in such condi- tions as nephritis, dropsy, apoplexy and uremia. Administration.-It is usually given in the form of the Com- pound Powder. The U. S. P. dose is often greatly exceeded. The following illustrates a method of prescribing: As a hydragogue cathartic: or Pulv. Jalapae Co 15| Ft. cht. no. vj. Sig.-One every two hours till effect. In the treatment of ascites: Ri or Pulv. Jalapae Comp 5j 30| Ft. cht. no. viij. Sig.-One in water an hour before breakfast. KAOLINUM. {Not Official.) Latin, Kaolinum. Eng., Kaolin. A native Aluminum Silicate. A soft, white or yellowish-white powder, or in lumps. Preparation (U. S. P., viii). Cataplasma Kaolini. Eng., Cataplasm of Kaolin. Kaolin, 577 Gm.; Boric Acid, 45 Gm.; Thymol, 0.5 Gm.; Methyl Salicylate, 2 Gm.; Oil of Peppermint, 0.5 Gm.; Glycerin, 375 Gm. Therapeutic Action.-Cataplasm of Kaolin is said to be emol- lient, local sedative, exosmotic, antiphlogistic. i Hughes: Practice of Medicine. KINO. 210 LACTUCARIUM. Uses.-The Cataplasm is employed in the treatment of pleurisy, pneumonia, mastitis, sprains and deep-seated pain generally. Administration.-The official Cataplasm of Kaolin is still not stocked by many druggists or often prescribed, as the proprietary preparations have a rather strong hold on the profession. It should be applied direct to the skin over the part affected. It is used as hot as patient can tolerate, and is used in a layer from one-eighth to one-quarter inch in thickness. This is covered with a heavy layer of absorbent cotten. The application is usually changed every six to twelve hours. KINO. Latin, Kino (Gen., Kino). Eng., Kino. The spontaneously dried juice of Pterocarpus Marsupium. Principal Constituent.-Kinotannic Acid (about 75 per cent.). Average Dose.-8 grains (0.5 Gm.). Official Preparation. Tinctura Kino. Eng., Tincture of Kino. Represents 10 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Therapeutic Action.-Astringent. Uses.-Principally used in the treatment of diarrhea and dysentery. Administration.-The tincture is the preparation employed. It is usually given with other agents, as' in the following illustration: In the treatment of enterocolitis: Bi Bismuthi Subnit 3iij or 12 Tinct. Kino, Tinct. Opii Camph aa f3iss 45 Misturae Cretae q. s. £5vj 180 M. Sig.-Tablespoonful every three hours till effect. (Shake-label.) LACTUCARIUM. Latin, Lactucarium. Eng., Lactucarium. Synonym, Lettuce. The dried milk-juice of Lactuca virosa. Average Dose.-15 grains (1 Gm.). 1 Hughes: Practice of Medicine. LEPTANDRA. LIMON. 211 Syrupus Lactucarii. Eng., Syrup of Lactucarium. Represents 5 per cent, of the drug. Average Dose.-2% fluidrachms (10 mils). Tinctura Lactucarii. Eng., Tincture of Lactucarium. Represents 50 per cent, of the drug. Average Dose.-30 minims (2 mils). Therapeutic Action.-Sedative, hypnotic. Uses.-Has been recommended for whooping-cough, hysteria, neurasthenia, etc. Seldom prescribed. Official Preparations. LEPTANDRA Latin, Leptandra. Eng., Leptandra. Synonym, Culver's Root. The dried rhizome and roots of Veronica virginica. Principal Constituent.-Leptandrin. Average Dose.-15 grains (1 Gm.). (U. S. P., viii). Preparations. Extractum Leptandrae. Eng., Extract of Leptandra. Average Dose.-4 grains (0.250 Gm.). Fluidextractum Leptandrae. Eng., Fluidextract of Leptandra. Average Dose.-15 minims (1 mil). Therapeutic Action.-Said to be a cholagogue purgative. Uses.-Has been recommended for chronic constipation and as an adjuvant for other purgative agents. Seldom prescribed. The following are official: LIMONIS CORTEX. Eng., Lemon Peel. The outer rind of the fresh ripe fruit of Citrus medica limonum. LIMON-Lemon. Tinctura Limonis Corticis. Eng., Tincture of Lemon Peel. Repre- sents 50 per cent, of the drug. Syrupus Acidi Citrici. Eng., Syrup of Citric Acid. Synonym, Syrup of Lemon. Contains 1 per cent, each of Citric Acid and the Tincture of Lemon Peel. Oleum Limonis. Eng., Oil of Lemon. Average Dose.-3 minims (0.2 mil). Official Preparations and Constituent of Lemon Peel. LIMONIS SUCCUS.. Eng., Lemon Juice (U. S. P., viii). The freshly expressed juice of the ripe fruit of Citrus limonum. Unofficial. LIMON. 212 Average Dose.-1 fluidounce (30 Cc.). Lemon and Oil of Lemon are contained in several official preparations. Therapeutic Action.-The Oil of Lemon and the preparation of the peel are stomachic and flavoring agents. Lemon Juice is refrigerant and antiscorbutic. Uses.-These preparations are used as flavoring agents. Lemon juice in the form of lemonade is frequently employed in fevers as a refrigerant drink and as a means of inducing the patient to take large quantities of water. See Citric Acid and Citrates. For cough, bronchitis, etc.: R Sodii Citratis 5j or 30 Limonis Succi fSj 30 Tinct. Opii Camph 15 Spir. Vini Gallici f^j 30 Syr. Acidi Citrici 120 M. Sig.-Teaspoonful in water every two hours. In the treatment of the cough of measles: Bi Sodii Citratis Sss or 15 Limonis Succi fSj 30 Tinct. Opii Camph f3ij 8 Syr. Ipecacuanhas f3ij 8 Syr. Tolutani q. s. fSij 60 M. Sig.-Teaspoonful in water every two hours. In the treatment of cough (for child 4 years old) : Sodii Citratis 3ij or 8 Spir. JEtheris Nit fSiij 12 Syr. Ipecacuanha f5ss 2 Syr. Acidi Citrici f3iv 15 Aquae q. s. fSiij 90 M. Sig.-Teaspoonful every two hours when awake. Linimentum Ammoniae.-See Ammonia. Linimentum Belladonnae.-See Belladonna. Linimentum Calcis.-See Calcium. Linimentum Camphorae.-See Camphora. 1 Anders: Practice of Medicine. LINUM. 213 Linimentum Chloroformi.-See Chloroformum. Linimentum Saponis.-See Sapo. Linimentum Saponis Mollis.-See Sapo. Linimentum Terebinthinae.-See Terebinthina. LINUM. Latin, Linum. Eng., Linseed, Flaxseed. The ripe seeds of Linum usitatissimum. Official Constituent. Oleum Lini. Eng., Linseed Oil. Average Dose.-1 fluidounce (30 mils). Linseed Oil is contained in several official preparations. Two Linseed Oils are on the market, known as the "raw" and the "boiled." The former is the one used in medicine. Therapeutic Action.-Demulcent, emollient, laxative, diuretic. Uses.-Flaxseed in the form of meal is extensively used by the public as poultices for boils, sprains, etc. The oil is used in veterinary practice for colic. It is seldom prescribed for internal use in man, but is a constituent in making Lime Liniment, which is much used for minor bums. Liquor Acidi Arsenosi.-See Arsenum. Liquor Ammonii Acetatis.-See Ammonium. Liquor Arseni et Hydrargyri lodidi.-See Arsenum. Liquor Calcis.-See Calcium. Liquor Cresolis Compositus.-See Cresol. Liquor Ferri Chloridi.-See Ferrum. Liquor Ferri et Ammonii Acetatis.-See Ferrum. Liquor Ferri Subsulphatis.-See Ferrum. Liquor Ferri Tersulphatis.-See Ferrum. Liquor Formaldehydi.-See Formaldehydum. Liquor Hydrogenii Dioxidi.-See next page. Liquor Hypophysis.-See Hypophysis Sicca. Liquor lodi Compositus.-See lodum. Liquor Magnesii Citratis.-See Magnesium. Liquor Plumbi Subacetatis.-See Plumbum. Liquor Plumbi Subacetatis Dilutus.-See Plumbum. Liquor Potassii Arsenitis.-See Arsenum. Liquor Potassii Citratis.-See Potassium. Liquor Potassii Hydroxidi.-See Potassium. Liquor Sodae Chlorinatae.-See Sodium. Liquor Sodii Arsenatis.-See Arsenum. Liquor Sodii Glycerophosphatis.-See Acidum Hypophosphorosutn. Liquor Sodii Hydroxidi.-See Sodium. Liquor Zinci Chloridi.-See Zincum. 214 LIQUOR HYDROGENII DIOXIDI. LITHIUM. LIQUOR HYDROGENII DIOXIDI. Latin, Liquor Hydrogenii Dioxidi (Gen., Liquoris Hydrogenii Dioxidi). Eng., Solution of Hydrogen Dioxide. Synonyms, Per- oxide of Hydrogen, Aqua Hydrogenii Dioxidi. The ninth revision of the Pharmacopeia changed the name of this preparation from an "aqua" to "liquor." An aqueous solution containing not less than 3 per cent, by weight of absolute Hydrogen Dioxide (H2O2) corresponding to 10 volumes of available oxygen. Form.-A colorless liquid. Odor and Taste.-Practically odorless. A slightly acidulous taste and producing a peculiar sensation and soapy froth in the mouth. Average Dose.-1 fluidrachm (4 mils). Therapeutic Action.-Antiseptic and deodorant. Uses.-It is seldom used internally. Locally, it is extensively employed in the treatment of sores, ulcers, abscesses, tonsillitis, diphtheria, scarlatina, stomatitis, etc. Administration.-This preparation is prescribed either alone or diluted with one or more volumes of distilled water. It is seldom prescribed with other medicinal agents. The manner of prescribing is shown in the following: R Liq. Hydrogenii Diox f5ij M. Sig.-Use 1 part to 3 parts of water as a spray. or 60| Or: R or Liq. Hydrogenii Diox fSj 301 Aquae Destillatae 120| M. Sig.-Use as a spray every four hours. Official Salts and Preparations. LITHIUM. LITHII BROMIDUM.-See Bromides, p. 100. LITHII CARBONAS. Eng., Lithium Carbonate. Average Dose.-8 grains (0.5 Gm.). LITHII CITRAS.-See Citrate, p. 23. LOBELIA. MAGNESIUM. 215 LOBELIA. Latin, Lobelia. Eng., Lobelia. The dried leaves and flowering tops of Lobelia inflata. Average Dose.-2)4 grains (0.15 Gm.). Official Preparations. Fluidextractum Lobeliae. Eng., Fluidextract of Lobelia. Average Dose.-2% minims (0.15 mil). Tinctura Lobeliae. Eng., Tincture of Lobelia. Represents 10 per cent, of the drug. Average Dose.-15 minims (1 mil). Therapeutic Action.-Antispasmodic, depressant, emetic, expectorant. Uses.-Principally used for asthma, bronchitis, and kindred conditions. Seldom prescribed. LYCOPODIUM. Latin, Lycopodium. Eng., Lycopodium. The spore of Lycopo- dium clavatum. A fine yellowish powder, almost odorless and tasteless. Magma Magnesiae.-See Magnesium. MAGNESIUM. Official Salts and Preparations. MAGNESII CARBONAS. Eng., Magnesium Carbonate. Synonym, Block Magnesia. Form.-White powder or mass. Usually pressed into blocks. Odor and Taste.-Odorless; almost tasteless. Solubility.-Insoluble in water or alcohol. Average Dose.-45 grains (3 Gm.). Magnesium Carbonate is used in preparing many official preparations. LIQUOR MAGNESII CITRATIS. Eng., Solution of Magnesium Citrate. An aqueous solution of freshly prepared Magnesium Citrate con- taining an excess of citric acid, impregnated with carbon dioxide, flavored with Lemon, and sweetened with syrup. Average Dose.-12 fluidounces (350 mils). Magma Magnesiae. Eng., Magnesia Magma. Synonym, Milk of Magnesia. An aqueous liquid containing in suspension about 7 per cent, of Magnesium Hydroxide. Average Dose.-2% fluidrachms (10 mils). MAGNESII OXIDUM. Eng., Magnesium Oxide. Synonyms, Mag- nesia, Calcined Magnesia, Light Magnesia. 216 MAGNESIUM. Form.-White, bulky powder. Odor and Taste.-Odorless and almost tasteless. Solubility.-Practically insoluble in water or alcohol. Incompatibles.-Acids, copaiba, salts of iron; water, etc. Average Dose.-30 grains (2 Gm.). Magnesium Oxide is used in several official preparations. MAGNESII OXIDUM PONDEROSUM. Eng., Heavy Magnesium Oxide, Heavy Magnesia. A white powder differing from the foregoing in not being so bulky nor so readily uniting with water. Average Dose.-30 grains (2 Gm.). MAGNESII SULPHAS. Eng., Magnesium Sulphate. Synonyms, Epsom Salt, Salts. Form.-Small, colorless prisms or needles. Odor and Taste.-Odorless; with a saline and bitter taste. Solubility.-In 1 part of water. Insoluble in alcohol. Incompatibles.-Alkaloids, arsenates, carbonates, phosphates, tartrates, phosphoric acid, lime water, lead acetate, silver nitrate, etc. Average Dose.-4 drachms (15 Gm.). Magnesium Sulphate is contained in the Compound Infusion of Senna. Therapeutic Action.-The oxides, the carbonate, and the magma are antacid and laxative. The sulphate is a hydragogue purgative. Uses.-The oxides and the carbonates are principally used in hyperchlorhydria, gastric ulcer, etc. The sulphate is one of the most extensively used purgatives. Administration.-Magnesium Sulphate, Magnesium Oxide, and the solution of Magnesium Citrate are the preparations most frequently prescribed. The latter preparation is dispensed in bottles of 12 fluidounces, and should always be prescribed in that quantity. After it has been opened and the excess of carbon dioxide escaped, it acquires a flat taste; so should always be ordered fresh. Magnesium Sulphate is the cheapest and probably the most largely used purgative. It is usually kept by the laity, and it is often advisable, particularly with the poorer class of patients, to merely include in the written instructions for patient, an order that a cer- tain amount of Epsom Salts be taken. This preparation is com- monly called "Salts," and when the word is written without the final "s" being legible, or the word "Epsom" being employed, it has been mistaken for "Salt," and Sodium Chloride used. A desirable method of administering it is in a glass of lemonade. MAGNESIUM. 217 As a purgative: or Magnesii Sulph 5j 30 Syrupi f3ss 15 Limonis Succi q. s. f$ij 60 M. Sig.-Tablespoonful in glass of water every four hours until effect. In the treatment of diarrhea: 3 or Magnesii Sulphatis 5iv 15 0 Tinct. Opii Deod Wlxl 2 5 Acidi Sulph. Arom f3iss 6 0 Aquae Menth. Pip q. s. f3iv 120 0 M. Sig.-Tablespoonful every four hours until relieved. As an aperient in the treatment of comedo: or Magnesii Sulphatis 3iss 45 Ferri Sulphatis gr. xvj 1 Acidi Sulph. Dil 5ij 8 Aquae q. s. fSviij 240 Sig.-Tablespoonful in water before breakfast. As a purgative: B or Liq. Magnesii Citratis 3601 Sig.-Take before breakfast. As an antacid, as in the treatment of hyperacidity, gastric ulcer, etc.: B or Atropinae Sulphatis gr. #0 006 Bismuthi Subnit., Magnesii Oxidi aa. 3iv 15 000 Sodii Bicarb 5ij 8 000 M. ft. cht. no. xv. Sig.-One in milk two hours after meals. In the treatment of erythema venenatum: or Acidi Borici gr. xv 1 0 Talci Purificati gr. xx 1 3 Cretae Praeparatae 3ij 8 0 Magnesii Carbonatis 3iij 12 0 M. Sig.-Use as a dusting powder. 218 MALTUM. MANNA. MALTUM. Latin, Maltum. Eng., Malt. The grain of barley, Hordeum sativum, partially germinated artificially and then dried. Extractum Malti. Eng., Extract of Malt. A sweet, thick, brownish liquid. Average Dose.-4 fluidrachms (15 mils). Therapeutic Action.-Nutrient and tonic. Uses.-Malt food and beverages are frequently recommended to improve digestion, increase weight, stimulate the secretion of milk and relieve constipation. Administration.-Seldom used except in the form of the various proprietary beverages, foods, etc. Official Preparation. MANGANUM. Official Salts. MANGANI DIOXIDUM PR^ECIPITATUM. Eng., Precipitated Manganese Dioxide. Form.-A black powder. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water and alcohol. Incompatibles.-Alkalies, carbonates, phosphates, etc. Average Dose.-4 grains (0.25 Gm.). POTASSII PERMANGANAS.-See Potassium, p. 267. Therapeutic Action.-Manganese dioxide is classed as a tonic, alterative and emmenagogue. Uses.-Principally used for functional amenorrhea and anemia. Administration.-Precipitated manganese dioxide is usually employed in the form of the ready-prepared pills or in capsules, either alone or with Ferrous Carbonate, Arsenic Trioxide, etc. Latin, Manna. Eng., Manna. The dried saccharine exudation of Fraxinus Ornus. Average Dose.-4 drachms (15 Gm.). Therapeutic Action.-Classed as a laxative, demulcent and nutrient. Uses.-It is employed as a household remedy, usually in com- bination with Senna, as a purgative. Manna is considered par- ticularly desirable on account of its pleasant taste. Seldom prescribed. MANNA. MATRICARIA. MENTHA PIPERITA. 219 MATRICARIA. Latin, Matricaria. Eng., Matricaria. Synonym, German Chamomile. The dried flower-heads of Matricaria Chamomilla. Average Dose.-4 drachms (15 Gm.). Therapeutic Action.-Stomachic, carminative, antispasmodic. Uses.-Seldom prescribed. MEL-Honey. Latin, Mel (Gen., Meilis). Eng., Honey. A saccharine secretion deposited in the honey-comb by the bee, Apis mellifera. Official Preparations. Mel Depuratum. Eng., Clarified Honey. Mel Rosae.-See Rosa Gallica. Honey is contained in some other official preparations. Therapeutic Action.-Nutrient, mild laxative. Uses.-A pleasant flavor and sweetening agent. A constitu- ent of many cough and laxative preparations, gargles, etc. Administration.-Clarified Honey is usually prescribed with other agents in quantities only sufficient to give a pleasant taste. MENTHA PIPERITA. Latin, Mentha Piperita (Gen., Menthae Piperitae). Eng., Pep- permint. The dried leaves and flowering tops of Mentha piperita. Average Dose.-60 grains (4 Gm.). Oleum Menthae Piperitae. Eng., Oil of Peppermint. A volatile oil. Average Dose.-3 minims (0.2 mil). Menthol.-See Menthol, p. 221 Aqua Menthae Piperitae. Eng., Peppermint Water. A saturated, aqueous solution of Oil of Peppermint. Average Dose.-4 fluidrachms (15 mils). Spiritus Menthae Piperitae. Eng., Spirit of Peppermint. Synonym, Essence of Peppermint. Represents 10 per cent, of Oil of Peppermint and 1 per cent, of the crude drug. Average Dose.-30 minims (2 mils). Therapeutic Action.-Oil of Peppermint is refrigerant, car- minative, stomachic, antiseptic. Uses.-Frequently used as a flavoring agent; also in the treatment of acute indigestion, flatulence, hysteria, etc. Exter- nally it is sometimes employed for neuralgia, rheumatism, etc. Official Constituents and Preparations. 220 MENTHA PIPERITA. Administration.-The following prescriptions illustrate the employment of the preparations of peppermint both as active agents and as vehicles: R - or Camphorse gr. iv 26 01. Menth. Pip., 01. Pini Pum., Eucalyptolis aa. i^iv 26 Petrolati Liq ;. .q. s. f5iv 120 00 M. Sig.-Use as a spray every four hours. The internal use of peppermint is shown in the following for acute indigestion: R or Spir. Menth. Pip., Spin ^Etheris Co 1 15| M. Sig.-Teaspoonful in water every hour till relieved. In the treatment of acute indigestion, etc.: B or Spin Chloroformi, Spin Menth. Pip is| M. Sig.-Teaspoonful in water every two hours till relieved. These are usually employed in a glass of hot water, after having emptied the stomach by the use of warm saline solution. Sodium Bicarbonate is often added at the time of administration. Used as a vehicle in the treatment of rheumatism: Til or Sodii Salicylatis Sss 151 Aquae Menthae Pip q. s. fjiv 120| M. Sig.-Two (2) teaspoonfuls well diluted every two hours. In the treatment of chronic vomiting of childhood: B2 or Liq. Potas. Arsenitis BLxij 75 Sodii Bicarbonatis gr. xxiv 1 50 Aquae Menthae Pip q. s. fSiij 90 00 M. Sig.-Teaspoonful three times a day. 1 Musser and Kelly: Practical Treatment. 2Ruhrah: Diseases of Children. MENTHA VIRIDIS. MENTHOL. 221 As a vehicle in a preparation for the treatment of constipation: Hi or Flext. Cascarae Sagr fSj 30 Tinct. Cardamomi Comp 15 Glycerini fSj 30 Aquae Menthae Pip 90 M. Sig.-Teaspoonful in water after meals. MENTHA VIRIDIS. Latin, Mentha Viridis. Eng., Spearmint. The dried leaves and flowering tops of Mentha spicata. Average Dose.-60 grains (4 Gm.). Official Constituent and Preparation. Oleum Menthae Viridis. Eng., Oil of Spearmint. A volatile oil. Average Dose.-3 minims (0.2 mil). Aqua Menthae Viridis. Eng., Spearmint Water. An aqueous, satu- rated solution of Oil of Spearmint. Average Dose.-4 fluidrachms (15 mils). Spiritus Menthae Viridis. Eng., Spirit of Spearmint. Represents 10 per cent, of the oil and 1 per cent, of the crude drug. Average Dose.-30 minims (2 mils). Therapeutic Action.-Carminative, refrigerant, etc. Less active than peppermint. Uses.-Seldom prescribed. MENTHOL. Latin, Menthol (Gen., Mentholis). Eng., Menthol. A second- ary alcohol obtained from Oil of Peppermint or other mint oils. Form.-Colorless Crystals. Odor and Taste.-Odor of Peppermint. A warm, aromatic taste, followed by a sensation of cold when air is drawn into the mouth. Solubility.-Only slightly soluble in water. Freely soluble in alcohol and chloroform. Incompatibles.-Liquefies when triturated with camphor, hy- drated chloral, thymol, etc. Average Dose.-1 grain (0.06 Gm.). Therapeutic Action.-Antiseptic, stimulant, carminative, local sedative. 1 Hughes: Practice of Medicine. 222 MENTHOL. Uses.-In various ways it is employed in the treatment of bronchitis, coryza, neuralgia, pruritus, diarrhea, typhoid fever, etc. Administration.-Menthol is seldom prescribed as such for internal use. It is a constituent of many of the so-called "anti- septics." It is frequently used in ointments, liniments, inhala- tions, etc. Some combinations are shown in the following: As an inhalation in rhinitis, sinus involvement, laryngitis, bron- chitis, etc.: ' ft or Mentholis, Camphorae 8I M. tere bene. Sig. Inhale frequently. Or: $ or Mentholis, Camphorae .... aa. '3j 4 Tinct. Benzoini Co q. s. f&j 60 M. Sig.-Use teaspoonful to pitcher of hot water. Written instructions should be left with patient as to frequency and dura- tion of the inhalations. Usually they are employed for about ten minutes every three hours. With children they are sometimes best employed during sleep by making a tent out of a newspaper, as the drug would affect the eyes if they were open. Adults should be instructed to keep the eyes closed. In the treatment of neuralgia: RI or Chlorali Hydrati, Camphorse, Mentholis aa. 5j 4 M. et tere bene. Sig.-Paint over parts as directed. In the treatment of pruritus: B2 or Phenolis, Mentholis aa. gr. xx 13 Petrolati q. s. 5j 30 0 M. tere bene. Sig.-Apply locally. 1 Hughes: Practice of Medicine. 2 Ashton: Practice of Gynecology. METHYLTHIONINE CHLORIDUM. 223 In the treatment of pruritus: Bi or Mentholis, Camphorae, Chlorali Hydrati Petrolati aa. gr. v. 32 q. s. 5ss 15 00 M. Sig.-Apply locally. In the treatment of herpes progenitalis: B2 or Cocainae Hydrochlor gr. j 065 Mentholis gr. xij 800 Adipis Lanae Hyd q. s. 5ss 15 000 M. Sig.-Apply locally. In a liniment, as for myalgia, lumbago, strains, etc.: $ - or Mentholis 5j - 4 Chloroformi f3j 30 Lin. Saponis 180 M. Sig.-Apply with massage twice daily. METHYLIS SALICYLAS. See Acidum, Salicylicum, p. 41. METHYLTHI0NIN2E CHLORIDUM. Latin, Methylthioninse Chloridum. Eng., Methylthionine Chlo- ride. Synonym, Methylene Blue, Methylthioninae Hydrochloridum (U. S. P., viii). Form.-A dark-green, crystalline powder or crystals having a bronze-like luster. Solubility.-Readily soluble in water and somewhat less readily in alcohol, the solution having a deep-blue color. Average Dose.-2*4 grains (0.15 Gm.). Therapeutic Action.-Classed as a diuretic, urinary antiseptic, etc. Uses.-Sometimes employed in the treatment of gonorrhea, cystitis, pyelitis, and other conditions. 1 Hughes: Practice of Medicine. 2 White and Martin: Genito-urinary and Venereal Diseases. 224 MEZEREUM. MOSCHUS. Administration.-Usually prescribed in capsules, either alone or with other agents. A convenient form is the ready-filled cap- sule, either hard or soft, put out by the pharmaceutical manu- facturing houses. They may be obtained containing the drug alone or in various combinations. MEZEREUM. Latin, Mezereum. Eng., Mezereum. Synonym, Mezereon. The dried bark of Daphne Mezereum, Daphne Gnidium or Daphne Laureola. Mezereum is contained in the Compound Fluidextract of Sarsaparilla. Therapeutic Action.-Rubefacient, vesicant, etc. Uses.-Has been recommended for such conditions as rheu- matism, indolent ulcers, and scrofula. Seldom prescribed. Mistura Cretae.-See Calcium. Mistura Glycyrrhizae Composita.-See Glycyrrhiza. MORPHINA. See, Opium, p. 239. MORPHINE HYDROCHLORIDUM. See Opium, p. 239. MORPHINE SULPHAS. See Opium, p. 239. MOSCHUS. Latin, Moschus. Eng., Musk. The dried secretion from the preputial follicles of Moschus moschiferus. Average Dose.-4 grains (0.25 Gm.). Official Preparation. Tinctura Moschi. Eng., Tincture of Musk. Represents 5 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Therapeutic Action.-Said to be stimulant and antispasmodic. Uses.-Has been recommended in the treatment of hysteria, neurasthenia, hiccough, and certain debilitated conditions. Seldom prescribed. MYRISTICA. MYRRHA. 225 Mucilago Acaciae.-See Acacia. Mucilago Tragacanthae.-See Tragacantha. MYRISTICA. Latin, Myristica. Eng., Myristica. Synonym, Nutmeg. The ripe seed of Myristica fragrans. Average Dose.-8 grains (0.5 Gm.). Official Constituent. Oleum Myristicae. Eng., Oil of Myristica. A volatile oil. Average Dose.-3 minims (0.2 mil). Myristica or the Oil of Myristica is contained in several official prepara- tions. Therapeutic Action.-Carminative, sedative. Uses.-Sometimes used in the treatment of nausea, flatulence, diarrhea, neuralgia, rheumatism, etc. Seldom prescribed. MYRRHA. Latin, Myrrha. Eng., Myrrh. A gum-resin obtained from one or more species of Commiphora. Average Dose.-8 grains (0.5 Gm.). Official Preparations. Tinctura Myrrhae. Eng., Tincture of Myrrh. Represents 20 per cent, of the drug in alcohol. Average Dose.-15 minims (1 mil). Myrrh is contained in the Compound Pills of Rhubarb. Therapeutic Action.-Antiseptic, astringent, carminative. Uses.-Employed principally in mouth-washes and gargles for salivation, stomatitis, tonsillitis, etc. Administration.-Not often prescribed. The following illus- trates the use of the drug: In the treatment of stomatitis (child 3 years old) : Hi or Potas. Chloratis gr. xxiv l|50 Tinct. Myrrhae TT[X |65 Syr. Acaciae 30|00 Aquae q. s. fSiij 90|00 M. Sig.-Teaspoonful every three hours. 1 Anders: Practice of Medicine. 226 NITROGENII MONOXIDUM. NUX VOMICA. NITROGENII MONOXIDUM. Latin, Nitrogenii Monoxidum. Eng., Nitrogen Monoxide. Synonym, Nitrous Oxide. A colorless gas. Used extensively as a general anesthetic. NUX VOMICA. Latin, Nux Vomica (Gen., Nucis Vomicae). Eng., Nux Vomica. Synonyms, Poison Nut, Dog Button, Quaker Button. The dried ripe seeds of Strychnos nux vomica, yielding not less than 2% per cent, of Alkaloids. Principal Constituents.-Strychnine (about 1.25 per cent.), bru- cine, tannic acid, etc. Average Dose.-1 grain (0.06 Gm.). Official Alkaloid, Salts and Preparations. Extractum Nucis Vomicae. Eng., Extract of Nux Vomica. A light- colored powder. Average Dose.-% grain (0.015 Gm.). Fluidextractum Nucis Vomicae. Eng., Fluidextract of Nux Vomica. Average Dose.-1 minim (0.05 mil). Tinctura Nucis Vomicae. Eng., Tincture of Nux Vomica. Represents about 10 per cent, of the drug. Average Dose.-8 minims (0.5 mil). Strychnina. Eng., Strychnine. An alkaloid obtained from Nux Vomica. Form.-Colorless crystals or white powder. Odor and Taste.-Odorless. Intensely bitter taste. Solubility.-In 6420 parts of water or 136 of alcohol. Incompatibles.-For Strychnine and its Salts: Alkalies, alkali carbonates and bicarbonates, ammonium chloride, benzoates, dichromates, bromides, borates, cyanides, iodides, salicylates, gold chloride, ichthyol, mercuric chloride, potassio-mercuric iodide, oxalic acid, picric acid, piperazin, oxidizers, tannic acid. Average Dose.-}4o grain (0.0015 Gm.). Strychnine is contained in many official preparations. Strychninae Nitras. Eng., Strychnine Nitrate. Form.-Colorless needles. Odor and Taste.-Odorless. Intensely bitter taste. Solubility.-In 42 parts of water or 150 parts of alcohol. Incompatibles.-See Strychnina. Average Dose.-Pio grain (0.0015 Gm.). Strychninae Sulphas. Eng., Strychnine Sulphate. Form.-Colorless or white crystals. NUX VOMICA. 227 Odor and Taste.-Odorless. Intensely bitter taste. Solubility.-In 32 parts of water or 81 parts of alcohol. Incompatibles.-See Strychnina. Average Dose.-grain (0.0015 Gm.). Therapeutic Action.-Stimulant, tonic, stomachic. Uses.-The preparations of Nux Vomica or the Strychnine salts have been used in the treatment of almost all diseases either during the progress of the maladies or to aid in the proc- esses of repair. Particularly employed in conditions characterized by loss of appetite, weakness, indigestion, constipation or other evidences of lowered vitality. Toxicology.-The usual symptoms of strychnine poisoning are nervous twitchings, hyperesthesia, convulsions. Some dif- ferential features of the convulsions are the relaxation between the attacks, the exaggerated reflexes and the lateness of the in- volvement of the muscles of neck and face. In children a com- paratively small dose of strychnine may produce toxic symptoms. Treatment consists largely in keeping the patient free from dis- turbing surroundings, chloroform by inhalation during the convul- sions, and hydrated chloral and bromides by mouth or rectum. The stomach should be washed out, if possible, with a solution of potassium permanganate (1:3000). Elimination should be favored particularly by diuretics. Administration.-The preparations most frequently used are the Tincture of Nux Vomica and Strychnine Sulphate. Extract of Nux Vomica and Strychnine Nitrate are also extensively used by some practitioners. A common error seems to be that of giving the tincture in such small dosage as to be almost without effect; particularly is this the case when ordered to be taken by drops, as it averages about 140 drops to 60 minims. The strychnine content is only about 0.1 per cent.; so 5 drops would only represent about %00 grain of strych- nine, while about %0 grain is the average dose when using the alkaloidal salt. In prescribing strychnine in solution it is particularly inadvisable to employ it with the bromides or iodides, as the precipitate forms slowly, and being comparatively small in amount may be overlooked by both dispenser and patient and a poisonous amount taken at the final dose. 228 NUX VOMICA. As a tonic, stimulant, stomachic, appetizer, etc.: or Tinct. Nucis Vomicae 60| Sig.-Twenty (20) drops in water before meals. Or: 3 Tinct. Nucis Vomicae f3j or 301 Tinct. Cardam. Co 180| M. Sig.-Teaspoonful in water before meals. Used to stimulate appetite: Hi Tinct. Nucis Vomicae f5j or 4 Tinct. Gentianae Comp fSij 60 Aquae 120 M. Sig.-Two (2) teaspoonfuls in water half-hour before meals. As a tonic, etc.: R Tinct. Nucis Vomicae, Acidi Phos. Dil., Tinct. Ferri Chlor., Syr. Pruni Virg or 30 M. Sig.-Teaspoonful in water after meals. As a laxative, etc., in the treatment of atony: $2 Tinct. Nucis Vomicae aa. f3iij or 12 Flext. Cascarae Sag., Tinct. Cardamomi Comp q. s. fSiij 90 M. Sig.-Teaspoonful in water before meals. In the treatment of indigestion: H or Pepsini Acidi Hydrochlor. Dil., 3ij 8 Tinct. Nucis Vomicae, Glycerini aa. f3j 30 Aquae q. s. f3vj 180 M. Sig.-Teaspoonful in water after meals. 1 Musser and Kelly: Practical Treatment. ^Stelwagon: Diseases of the Skin. NUX VOMICA. 229 In the treatment of heart and kidney disease: R Tinct. Nucis Vomicae f3iv or 15| Inf. Digitalis q. s. f5vj 180| M. Sig.-Two (2) teaspoonfuls in water after meals. Or: or Tinct. Nucis Vomicae, Tinct. Digitalis aa. f5j 30 Tinct. Cardam. Co q. s. f3iv 120 M. Sig.-Teaspoonful in water after meals. As a stimulant: Tab. Strych. Sulph. (^o gr.) Sig.-One every six hours. As a tonic, in the treatment for malaria: R or Strychninae Sulph., Arseni Trioxidi aa. gr. j 065 Quininae Sulph gr. cxx 8 00 Ferri Reducti gr. lx 4 00 M. ft. cap. no. xxx. Sig.-One after each meal. In the treatment of chronic valvular disease: Bi or Strychninae Sulph gr. % 02 Sparteinae Sulph gr. iij 20 Caffeinae Citratae 3ss 2 00 M. ft. cap. no. xij. Sig.-One every four hours. In the treatment of menorrhagia and metrorrhagia: H2 or Strychninae Sulph gr. ss 03 Hydrastininae Hydrochi gr. x 65 Extract! Ergotae gr. xl 2 50 M. ft. cap. no. xx. Sig.-One two hours after meals. 1 Anders: Practice of Medicine. 2 Ashton: Practice of Gynecology. 230 NUX VOMICA. In the treatment of subinvolution of the uterus: Ri or Strychninae Sulph gr. j 065 Ext. Ergotae, Quininae Sulph aa. gr. xxx 2 000 M. ft. cap. no. xxx. Sig.-One before each meal. In the treatment of indigestion: R or Strychninae Sulph gr. ss 103 Elix. Pepsini Arom q. s. fSvj 180 00 M. Sig.-Two (2) teaspoonfuls in water after meals. In the treatment of palpitation, etc., in hysteric subjects: B2 or Strychninae Sulph gr. % 02 Zinci Valeratis gr- X 65 Ext. Sumbul gr- X 65 Ext. Hyoscyami gr. V 32 M. ft. cap. no. x. Sig.-One after each meal. In the treatment of herpes zoster: R3 or Zinci Phosphidi, Ext. Nucis Vomicae aa. gr. x [65 M. ft. cap. no. xxx. Sig.-One every three hours. As a postoperative tonic: R4 or Hydrarg. Chlor. Corros., Arseni Trioxidi .* aa. gr. j 065 Ext. Nucis Vomicae gr. xxv 1 600 Ferri et Quin. Cit gr. cc 13 000 M. ft. cap. no. c. Sig.-One after each meal. 1 Shoemaker: Materia Medica and Therapeutics. 2 Anders: Practice of Medicine. 3 Hughes: Practice of Medicine. 4 Ashton: Practice of Gynecology. NUX VOMICA. 231 In the treatment of constipation: Ri or Ext. Cascarae Sag gr. xl 2 50 Ext. Nucis Vomicae gr. v 32 Ext. Belladon. Fol gr. ij 13 Resinae Podophylli gr. ij 13 M. ft. cap. no. xx. Sig.-One at bedtime. In a laxative preparation: R2 Tinct. Nucis Vomicae fSss or 15 Flext. Cascarae Sag fSj 30 Glycerini f5ss 15 Aquae Chloroformi q. s. f&ij 90 M. Sig.-Teaspoonful in water after meals. Oleatum Hydrargyri.-See Hydrargyrum. Oleoresina Aspidii.-See Aspidium. Oleoresina Capsici.-See Capsicum. Oleoresina Cubebae.-See Cubeba. Oleoresina Petroselini.-See Petroselinum. Oleoresina Piperis.-See Piper. Oleoresina Zingiberis.-See Zingiber. Oleum Amygdalae Amarae.-See Amygdala Amara. Oleum Amygdalae Expressum.-See Amygdala. Oleum Anisi.-See Anisum. Oleum Aurantii.-See Aurantium. Oleum Cadinum.-See next page. Oleum Cajuput. Eng., Oil of Cajuput. Average Dose.-8 minims (0.5 mil). Oleum Cari.-See Carum. Oleum Caryophylli.-See Caryophyllus. Oleum Cassiae.-See Cinnamomum. Oleum Chenopodii. Oil of Chenopodium. Synonym, Oil of American Wormseed. Average Dose.-3 minims (0.2 mil). Oleum Coriandri.-See Coriandrum. Oleum Cubebae.-See Cubeba. Oleum Eucalypti.-See Eucalyptus. Oleum Foeniculi.-See Fceniculum. Oleum Gossypii Seminis. Eng., Cotton-seed Oil. Average Dose.-4 fluidrachms (15 mils). Oleum Juniperi.-See p. 233. 1 Ashton: Practice of Gynecology. 2 Hughes: Practice of Medicine. 232 OLEUM CADINUM. Oleum Lavandulae.-See p. 234. Oleum Limonis.-See Limon. Oleum Lini.-See Linum. Oleum Menthae Piperitae.-See Mentha Piperita. Oleum Menthae Viridis.-See Mentha Viridis. Oleum Morrhuae.-See p. 235. Oleum Myristicae.-See Myristica. Oleum Olivae.-See p. 235. Oleum Picis Liquidae Rectificatum.-See Pix Liquida. Oleum Pimentae. Eng., Oil of Pimenta. Synonym, Oil of Allspice. Average Dose.-3 minims (0.2 mil). Oleum Pini Pumilionis. Eng., Oil of Dwarf Pine Needles. Oleum Ricini.-See p. 236. Oleum Rosmarini. Eng., Oil of Rosemary. Average Dose.-3 minims (0.2 mil). Oleum Santali. Eng., Oil of Santal. Average Dose.-8 minims (0.5 mil). Oleum Sassafras.-See Sassafras. Oleum Sesami. Eng., Sesame Oil. Synonym, Benne Oil. Oleum Sinapis Volatile.-See Sinapis Nigra. Oleum Terebinthinae.-See Terebinthina. Oleum Terebinthinae Rectificatum.-See Terebinthina. Oleum Theobromatis.-See p. 238. Oleum Thymi. Eng., Oil of Thyme. Average Dose.-3 minims (0.2 mil). Oleum Tiglii.-See p. 238. OLEUM CADINUM. Latin, Oleum Cadinum (Gen., Olei Cadini). Eng., Oil of Cade. Synonym, Oil of Juniper Tar. A product of the dry distillation of the wood of Juniperus Oxycedrus. A brownish or dark-brown, thick liquid. Therapeutic Action.-Antiseptic, irritant, expectorant. Uses.-Employed externally in the treatment of chronic skin diseases, as eczema, etc., and for parasitic diseases, as tinea and scabies. Administration.-It is usually prescribed with other agents, and well diluted with a bland ointment base. The following illustrate: OLEUM JUNIPERI. 233 Used in the treatment of ringworm of the scalp: Hi or Betanaphtholis 2 Olei Cadini 5j 4 Ung. Sulphuris q- s. 5j 30 M. Sig.-Apply as directed. Used as an antiparasitic: B2 or Sulphuris Praecip 3ij 8 Saponis Mollis, Olei Cadini aa. 3j 4 Adipis Benzoinati q. s. Sj 30 M. Sig.-Apply as directed. In the treatment of eczema of the feet and legs: 5 or Phenolis gr. x 65 Olei Cadini -nix 65 Picis Liquidae gr. xx 1 30 Ung. Aquae Rosae q. s. 5j 30 00 M. Sig.-Apply thoroughly twice a day. OLEUM JUNIPERI. Latin, Oleum Juniperi. Eng., Oil of Juniper. A volatile oil dis- tilled from the ripe fruit of Juniperus communis. Average Dose.-3 minims (0.2 mil). Official Preparations. Spiritus Juniperi. Eng., Spirit of Juniper. Contains 5 per cent, of the Oil. Average Dose.-30 minims (2 mils). Spiritus Juniperi Compositus. Eng., Compound Spirit of Juniper. Average Dose.-2% fluidrachms (10 mils). Therapeutic Action.-Classed as a diuretic, diaphoretic, stomachic, antiseptic, etc. Uses.-Has been used in the treatment of chronic nephritis, particularly when evidenced by dropsy; also for bronchitis, asthma, etc. 1 Stelwagon: Diseases of the Skin. 2 Ibid. 234 OLEUM LAVANDULAE FLORUM. Administration.-Not often prescribed. The following illus- trates a way of ordering: In the treatment of the laryngo-bronchial irritation of influenza: Ri or Codeinae Sulph gr. iv 26 Ammonii Chlor 5v 19 00 Syr. Pruni Virg f5ij 60 00 Spir. Juniperi Comp q. s. f$iv 120 00 M. Sig.-Teaspoonful in water every three hours. OLEUM LAVANDULAE FLORUM. Latin, Oleum Lavandulae. Eng., Oil of Lavender. A volatile oil distilled from the fresh flowering tops of Lavandula vera or Lavandula spica. Average Dose.-3 minims (0.2 mil). Official Preparations. Spiritus Lavandulae. Eng., Spirit of Lavander. Contains 5 per cent, of the Oil. Average Dose.-30 minims (2 mils). Tinctura Lavandulae Composita. Eng., Compound Tincture of Laven- der. Oil of Lavender, 8 mils; Oil of Rosemary, 2 mils; Saigon Cinnamon, 20 Gm.; Clove, 5 Gm.; Nutmeg, 10 Gm.; Red Sanders, 10 Gm.; Alcohol and water, to make 1000 mils. Average Dose.-30 minims (2 mils). Oil of Lavender is contained in several other official preparations. Therapeutic Action.-Stomachic, carminative. Uses.-Principally employed as an adjuvant and flavoring agent, particularly in preparations for the relief of neurasthenia, hysteria, flatulence, etc. Administration.-Not often used. The following will illus- trate how it may be prescribed. In the treatment of acute indigestion: H2 or Tinct. Opii Camph Spir. Ammoniae Arom., f5iij 12 Spir. Athens aa. fSss 15 Tinct. Lavandulae Comp q. s. fjij 60 M. Sig.-Teaspoonful well diluted every fifteen minutes until relieved. i Anders: Practice of Medicine. 2 Musser and Kelly: Practical Treatment. OLEUM MORRHU2E. OLEUM OLIV^E. 235 OLEUM MORRHUJE. Latin, Oleum Morrhuae (Gen., Olei Morrhuae). Eng., Codliver Oil. Synonym, Oleum Jecoris Aselli. A fixed oil obtained from the fresh livers of Gadus morrhua and other species of Gadus. Average Dose.-2% fluidrachms (10 mils). Official Preparation. Emulsum Olei Morrhuae. Eng., Emulsion of Codliver Oil. Contains 50 per cent, of the Oil. Average Dose.-4 fluidrachms (15 mils). Unofficial Preparation. Emulsum Olei Morrhuae cum Hypophosphitibus. Eng., Emulsion of Codliver Oil with Hypophosphites. Codliver Oil, 500 mils; Acacia, 125 Gm.; Calcium Hypophosphite, 10 Gm.; Potassium Hypophosphite, 5 Gm.; Sodium Hypophosphite, 5 Gm.; Oil of Gaultheria, 4 mils; Water, to make 1000 mils. Average Dose.-4 fluidrachms (15 mils). Therapeutic Action.-Emollient, nutrient, tonic, alterative. Uses.-Extensively employed in the treatment of tubercu- losis, chronic bronchitis, rachitis, etc. Sometimes used externally for chronic skin diseases, as eczema. Administration.-A satisfactory way for the patient to take the emulsion is by first pouring into a graduated glass a table- spoonful of "Beef, Iron and Wine," and then pouring in the oil preparation. The wine envelops the thick emulsion so that it can be taken at one swallow, almost without taste. The wine preparation is, of course, of therapeutic advantage. Attention is directed to the so-called Wines of Codliver Oil and Tasteless Preparations that really contain none of the oil at all. The Emulsions of Codliver Oil, particularly the one with hypo- phosphites, are seldom prepared extemporaneously. They are thick and hard to pour from a small-mouth bottle; so it is usually best to prescribe a pint, the druggist then giving an original package and merely putting on a new label. OLEUM OLIVJE. Latin, Oleum Olivae (Gen., Olei Olivae). Eng., Olive Oil. Synonym, Impure or imitation Olive Oil is frequently called Sweet Oil or Malaga Oil. A fixed oil expressed from the ripe fruit of Olea Europoea. 236 OLEUM RICINI. Average Dose.-1 fluidounce (30 mils). Olive Oil is employed in many official preparations. Therapeutic Action.-Laxative, nutrient, emollient, lubricant. Uses.-Employed in the treatment of tuberculosis, chronic constipation, obstructive jaundice, hyperchlorhydria, etc. Ex- ternally for indurative skin diseases, exanthematous eruptions, etc. It is a desirable vehicle for the solution or dilution of more active agents. Administration.-Olive Oil is often recommended by the pro- fession, but is seldom a prescription ingredient except as a sol- vent or diluent, as for croton oil, salol, etc. The following illustrates: In the treatment of orchitis complicating mumps: n or Guaiacolis iRxl 2|5 Olei Olivae q. s. fSj 30|0 M. Sig.-Apply a teaspoonful as directed. OLEUM RICINI. Latin, Oleum Ricini. Eng., Castor Oil. A fixed oil expressed from the seed of Ricinus communis. Average Dose.-4 fluidrachms (15 mils). Castor Oil is contained in Flexible Collodion. Therapeutic Action.-Purgative, emollient, lubricant. Uses.-Probably the most valuable and extensively used pur- gative in medicine. Particularly indicated after parturition and operations, and for acute digestive disturbances. Externally used in the treatment of burns, ulcers, chronic indurative skin diseases, conjunctivitis, and many other conditions. Administration.-Among the various ways for the patient to take castor oil, probably the most satisfactory is to incorporate it with an ounce or two of the fresh or bottled pineapple-juice. It is also frequently taken in soda pop, orange-juice, etc. The claim is often made that a small dose occasions more abdominal inconvenience than a large one; so many practitioners never give less than a tablespoonful to an average child over one year old. In administering the oil to children, the first dose will frequently be vomited. If it is repeated promptly it will almost always be retained. It is a valuable agent to check persistent vomiting resulting from OLEUM RICINI. 237 gastric irritation. The first one or two doses may be vomited and then a dose retained with a subsidence of the nausea. Many so-called tasteless preparations are on the market. Some of them are more disagreeable than the pure oil. Castor Oil often exhibits a constipating effect after the purgative action; so that it is sometimes advisable to give with it some cascara sagrada or other purgative. It is frequently recommended by the physician as a purgative, but it is so well known and generally kept by the laity that it is not often a part of a regular prescription. It is sometimes employed locally either alone or with other agents. The so-called "tasteless" Castor Oil may be ordered as follows: or Olei Menth. Pip TRviij 50 Benzosulphinidi gr. iv 26 Olei Ricini q. s. fjiv 120 00 M. Sig.-Tablespoonful as directed. An Emulsion of Castor Oil is said to be ( ?) less unpleasant to take, and more active than the amount of oil it represents. r or Olei Ricini f5iv 120 Olei Gaultheriae 1H.XV 1 Acaciae q- s. Syrupi f3vj 24 Aquae q. s. fSviij 240 M. ft. emul. Sig.-Tablespoonful as directed. (Shake-label.) Oleum Menthae Piperitae, Oleum Aurantii Corticis, Oleum Limonis or other flavors may be substituted for the Oleum Gaultheriae. In burns, diphtheria, etc., of the conjunctiva: R or Olei Ricini «j 30| Sig.-Drop in eyes every two hours. In a surgical dressing for burns, ulcers, etc.: R Bal. Peruviani f3iv or 15| Olei Ricini q. s. f5iv 120| M. Sig.-Apply freely as directed. 238 OLEUM THEOBROMATIS. OLEUM TIGLII. In the treatment of seborrhoea capitis: RI Resorcinolis 3j or 4 Olei Ricini f5j 4 Alcoholis 120 M. Sig.-Apply as directed. OLEUM THEOBROMATIS. Latin, Oleum Theobromatis (Gen., Olei Theobromatis). Eng., Oil of Theobroma. Synonym, Cacao Butter. A fixed oil obtained from the roasted seeds of Theobroma Cacao. Form.-A yellowish-white solid. Odor and Taste.-A faint, agreeable odor, and a bland, chocolate- like taste. Solubility.-Insoluble in water or alcohol. Therapeutic Action.-Emollient, lubricant. Uses.-Principally employed as a vehicle in the manufacture of suppositories. It is particularly adapted to this purpose, as it is a rather firm solid at ordinary temperatures, but readily melts at the temperature of the body. Administration.-Suppositories with a base of Cacao Butter should be kept in a cool place, and before inserting they may be dipped in olive oil. If they are held long in the fingers they become too soft to insert. The following prescription illustrates the use of the drug: B. or Ext. Opii gr. ij 130 Ext. Belladon. Fol gr. j 065 Olei Theobromatis q. s. M. ft. suppos. no. iv. Sig.-Use one twice daily. Note that the amount of the oil is left to the discretion of the druggist. OLEUM TIGLII. Latin, Oleum Tiglii (Gen., Olei Tiglii). Eng., Croton Oil. A fixed oil expressed from thd seed of Croton Tiglium. Average Dose.-1 minim (0.05 mil). 1 Stelwagon: Diseases of the Skin. OPIUM. 239 Therapeutic Action.-Drastic purgative, irritant, pustulant. Uses.-Sometimes used to produce very active purgation, as in the treatment of uremia, apoplexy, taenia, etc. Administration.-This is seldom prescribed except in cases of emergency, as where prompt catharsis is needed and the patient is unable to swallow the ordinary purgatives. It is usually di- luted with about 30 to 60 times its volume of olive oil, or incorporated with glycerin. As an active purgative, useful when the patient is unable to swallow ordinary remedies: R or Olei Tiglii niviij |5 Olei Olivse q. s. fSj 30|0 M. Sig.-Teaspoonful every hour till effect. This can be administered under almost any circumstances by allowing a few drops at a time to trickle down the base of the tongue. As a purgative: Bi or Olei Tiglii mi |06 Glycerini q. s. f5j 30]00 M. Sig.-Two (2) teaspoonfuls every hour till bowels act. OPIUM. Latin, Opium (Gen., Opii). Eng., Opium. The air-dried, milky exudation obtained by incising the unripe capsules of Papaver somniferum and its variety album, and yielding in its normal, moist condition, not less than 9.5 per cent, of anhydrous morphine. Principal Constituents.-Morphine, Codeine, etc. Incompatibles.-Alkalies, alkaline carbonates, salts of arsenic, copper, iron, lead, silver and zinc; mercuric chloride, tannic acid, potassium permanganate, lime-water, etc. Average Dose.-1 grain (0.06 Gm.). It will be noted that Powdered Opium and Granulated Opium contain about 10 per cent, of morphine, and that the Powder of Ipecac and Opium, the Tincture of Opium and the Tincture of Deodorized Opium represent 10 per cent, of these; so, contain about 1 per cent, of morphine. 1 Ashton: Practice of Gynecology. 240 OPIUM. The extract contains about 20 per cent, of morphine, differing from other extracts, which are usually about five times the strength of the drug. Opium differs from most other important vegetable drugs in having no fluidextract. Official Preparations. Opii Pulvis. Eng., Powdered Opium. A dark-colored powder con- taining from 10 to 10.5 per cent, of morphine. Average Dose.-1 grain (0.06 Gm.). Opium Deodoratum. Eng., Deodorized Opium. Synonym, Denar- cotized Opium. Contains from 10 to 10.5 per cent, of morphine. Average Dose.-1 grain (0.06 Gm.). Opium Granulatum. Eng., Granulated Opium. Contains 10 to 10.5 per cent, of morphine. Average Dose.-1 grain (0.06 Gm.). Extractum Opii. Eng., Extract of Opium. A dark-colored powder containing about 20 per cent, of morphine. Average Dose.-% grain (0.03 Gm.). Pulvis Ipecacuanhae et Opii. Eng., Powder of Ipecac and Opium. Synonym, Dover's Powder. Powdered Opium, 10 Gm.; Ipecac, 10 Gm.; Sugar of Milk, 80 Gm. (Morphine about 1 per cent.) Average Dose.-ft grains (0.5 Gm.). Tinctura Opii. Eng., Tincture of Opium, Laudanum. Represents 10 per cent, of Granulated Opium (about 1 per cent, of morphine). Average Dose.-8 minims (0.5 mil). Tinctura Opii Camphorata. Eng., Camphorated Tincture of Opium, Paregoric. Powdered Opium, 4 Gm.; Benzoic Acid, 4 Gm.; Camphor, 4 Gm.; Oil of Anise, 4 mils; Glycerin, 40 mils; Diluted Alcohol, to make 1000 mils (about 0.04 per cent, of morphine). Average Dose.-1 fluidrachm (4 mils). Tinctura Opii Deodorati. Eng., Tincture of Deodorized Opium. Represents 10 per cent, of Deodorized Opium (about 1 per cent, of morphine). Average Dose.-8 minims (0.5 mil). Official Alkaloids and their Salts. Morphina. Eng., Morphine. An alkaloid obtained from Opium. (Opium contains not less than 9.5 per cent, of Morphine.) Form.-White prisms, needles or crystalline powder. Odor and Taste.-Odorless. Bitter taste. Solubility.-In 3340 parts of water or 210 parts of alcohol. Incompatibles (also of the Salts of Morphine).-Alkalies, borates, chlo- rates, iodides, tannic acid, potassium permanganate, ferric chloride, gold and OPIUM. 241 sodium chloride, lead acetate, lead subacetate, magnesia, mercuric chloride, spirit of nitrous ether, silver nitrate. Average Dose.-% grain (0.008 Gm.). Morphinae Hydrochloridum (Gen., Morphinae Hydrochloridi). Eng., Morphine Hydrochloride. Form.-White needles or powder. Odor and Taste.-Odorless and having a bitter taste. Solubility.-In 17.5 parts of water or 52 parts of alcohol. Incompatibles.-See Morphina. Average Dose.-% grain (0.008 Gm.). Morphinae Sulphas (Gen., Morphinae Sulphatis). Eng., Morphine Sulphate. Form.-White, feathery acicular crystals or cubical masses. Odor and Taste.-Odorless and with a bitter taste. Solubility.-In 15.5 parts of water or 565 of alcohol. Incompatibles.-See Morphina. Average Dose.-% grain (0.008 Gm.). Codeina. Eng., Codeine. An alkaloid obtained from opium. Form.-White or nearly white crystals, prisms or powder. Odor and Taste.-Odorless and having faintly bitter taste. Solubility.-In 120 parts of water or 2 of alcohol. Incompatibles (also Salts of Codeine).-Alkalies, ammonium bromide or valerate, tannic acid, mercuric chloride; salts of copper, iron or lead; potas- sium permanganate, etc. Average Dose.-% grain (0.03 Gm.). , Codeinae Phosphas (Gen., Codeinae Phosphatis). Eng., Codeine Phosphate. Form.-Needle-shaped crystals or powder. Odor and Taste.-Odorless. A bitter taste. Solubility.-In 2.3 parts of water or 325 of alcohol. Incompatibles.-See Codeina. Average Dose.-y2 grain (0.03 Gm.). Codeinae Sulphas (Gen., Codeinae Sulphatis). Eng., Codeine Sulphate. Form.-Needle-shaped crystals, prisms or powder. Odor and Taste.-Odorless. A bitter taste. Solubility.-In 30 parts of water or 1280 of alcohol. Incompatibles.-See Codeina. Average Dose.-y2 grain (0.03 Gm.). Official Derivative Alkaloids, Prepared from Morphine, and Their Salts. TEthylmorphinae Hydrochloridum (Gen., ^Ethylmorphinae Hydro- chloridi). Eng., Ethylmorphine Hydrochloride. Synonyms, Ethylmor- phine chloride, Dionin. The hydrochloride of an alkaloid prepared from morphine. Form.-A white or yellowish powder. Odor and Taste.-Odorless and with bitter taste. Solubility.-In 8 parts of water or 22 parts of alcohol. Average Dose.-% grain (0.015 Gm.). 242 OPIUM. Apomorphinae Hydrochloridum (Gen., Apomorphinae Hydrochlofidi). Eng., Apomorphine Hydrochloride. The hydrochloride of an alkaloid prepared from Morphine. Form.-Grayish-white powder, acquiring a greenish tint on exposure to the light and air. Odor and Taste.-Odorless and having a faintly bitter taste. Solubility.-Soluble in 50 parts of water or alcohol; more soluble in hot water. Incompatibles.-See Morphina. Average Dose.-Expectorant, grain (0.003 Gm.). Emetic, by mouth, % grain (0.01 Gm.). Emetic, by hypodermic, %2 grain (0.005 Gm.). Diacetylmorphinae. Eng., Diacetylmorphine. Synonym, Heroine. An alkaloid prepared from morphine. Form.-A white crystalline powder. Odor and Taste.-Odorless and having slight taste. Solubility.-In 1700 parts of water or 31 parts of alcohol. Average Dose.-grain (0.003 Gm.). Diacetylmorphinae Hydrochloridum (Gen., Diacetylmorphinae Hydro- chloridi). Eng., Diacetylmorphine Hydrochloride. Synonym, Heroine Hydrochloride. The Hydrochloride of an alkaloid prepared from morphine. Form.-A white crystalline powder. Odor and Taste.-Odorless and with a bitter taste. Solubility.-Very soluble in water or alcohol. Average Dose.-%o grain (0.003 Gm.). Therapeutic Action.-Sedative, antispasmodic, anodyne, hypnotic, narcotic, diaphoretic. Use.-The employment of opium and its preparations and alkaloids covers almost the entire field of medicine. Some of the conditions in which they are particularly employed are renal and intestinal colic, abdominal inflammation, convulsions, diar- rhea, dysentery, cough, etc. Toxicology.-The usual symptoms of acute opium poisoning are drowsiness, deepening into coma; slow pulse, contracted pupils, moist skin. During the stage of coma there is slow, ster- torous breathing. There may be vomiting. Treatment: The unabsorbed drug should be removed, preferably by washing out the stomach with a solution of potassium permanganate (1:3000). A pint of this should be left in the stomach. Caffeine is probably the best physiological antidote, and may be given in the form of coffee by mouth or rectum. Other measures are the use of ammonia by mouth and inhalation, atropine, strychnine OPIUM. 243 or camphor by needle. Cold water to head and face, exercise, artificial respiration, etc. Apomorphine hydrochloride being a powerful hypnotic, should not be used as the emetic for opium poisoning except in cases of extreme urgency that are seen early. Administration.-Internally in solution. The preparations most frequently used are the Tincture, the Camphorated Tinc- ture and the Tincture of Deodorized Opium, Morphine Sulphate, Codeine Phosphate, Apomorphine Hydrochloride and Diacetylmor- phine Hydrochloride. For action upon the central nervous system the preparations usually employed are Morphine Sulphate, Codeine Phosphate, Tincture of Opium and Tincture of Deodorized Opium. Some methods of prescribing are shown in the following: As a sedative, hypnotic, etc.: R or Codeinae Phosphatis gr. iv |26 Elixiris Aromatici q. s. fSj 30|00 M. Sig.-Teaspoonful every four hours when necessary. As a sedative, hypnotic, etc.: n or Codeinae Phosph gr. ij 13 Chlorali Hydrati gr. xl 2 50 Sodii Bromidi gr. Ixxx 5 00 Aquae q. s. f^j 30 00 M. Sig.-Teaspoonful every four hours when necessary. As a sedative in threatened abortion: 3 or Chlorali Hydrati gr. xl 2 5 Sodii Bromidi gr. ixxx 5 0 Tinct. Opii Deod iRxl 2 5 Aquae Chloroformi q. s. f3j 30 0 M. Sig.-Teaspoonful night and morning when necessary. As a hypnotic, analgesic, cough sedative and antispasmodic: Bi or Codeinae Sulph gr. ss 03 Antipyrinae gr. xvj 1 00 Syr. Aurantii q. s. f5ij 60 00 M. Sig.-Teaspoonful every two hours when needed. (For child 2 years old.) 1 Ruhrah: Diseases of Children. 244 OPIUM. For action upon the respiratory system Apomorphine Hydro- chloride is employed as a secretory stimulant. Diacetylmorphine Hydrochloride, Codeine Phosphate and Camphorated Tincture of Opium are employed as sedatives. Diacetylmorphine has the advan- tage of being less depressing, generally not affecting the intestinal functions, etc. Some uses are shown in the following: For cough, bronchitis, etc.: Sodii Citratis 5j or 30 Limonis Succi f'Sj 30 Tinct. Opii Camph fSss 15 Spir. Vini Gallici f5j 30 Syr. Acidi Citrici 120 M. Sig.-Teaspoonful in water every two hours. For an "irritative" cough: R or Diacetylmorph. Hydrochlor gr. ij 13 Ammonii Chloridi 3iss 6 00 Syr. Ipecacuanhae f3ij 8 00 Syr. Pruni Virg q. s. fjiv 120 00 M. Sig.-Teaspoonful every two hours till relieved. For a "dry" cough: R or Apomorphinae Hydrochlor gr. ss 03 Sodii Citratis 3iv 15 00 Limonis Succi f3iv 15 00 Syr. Acidi Citrici q. s. fSiij 90 00 M. Sig.-Teaspoonful in water every two hours. For an acute cough: Ri or Codeinae Sulph gr. iij 2 Tinct. Hyoscyami f3iij 12 0 Syr. Tolutani f5ss 15 0 Aquae q. s. f3iij 90 0 M. Sig.-Teaspoonful every three hours. 1 Musser and Kelly: Practical Treatment. OPIUM. 245 In the treatment of the laryngo-bronchial irritation of influenza: Ri or Codeinae Sulph gr. iv 26 Ammonii Chlor 3ij 8 00 Syr. Pruni Virg fSij 60 00 Spir. Juniperis Comp q. s. f3iv 120 00 M. Sig.-Teaspoonful in water every three hours. In the treatment of bronchitis: R2 or Tinct. Opii Camph., Spir. Vini Gallici, Glycerini 30 M. Sig.-Teaspoonful in water every three hours. In the treatment of cough: or Tinct. Opii Camph f5iij 12 Spir. Chloroformi f3iss 6 Syrupi Tolutani fSj 30 Aquae q. s. fSiij 90 M. Sig.-Teaspoonful every two hours till relieved. (Shake-label.) (For a child 5 years old.) In the treatment of spasmodic croup: (For child 2 years old.) R3 or Ammonii Bromidi 5ss 2 Tinct. Opii Camph f5ss 2 Tinct. Belladon. Fol nixv 1 Syr. Tolutani fSj 30 Aquae q. s. fSij 60 M. Sig.-Teaspoonful in water every hour till relieved. In the treatment of the cough of measles: R4 Sodii Citratis 5ss or "15 Limonis Succi fSj 30 Tinct. Opii Camph., Syr. Ipecacuanhas aa. f3ij 8 Syr. Tohitani q. s. fSij 60 M. Sig.-Teaspoonful in water every two hours. 1 Anders: Practice of Medicine. 2 Musser and Kelly: Practical Treatment. 3 Ibid. < Anders: Practice of Medicine. 246 OPIUM. For action upon the intestinal tract the Tincture of Opium, Tincture of Deodorized Opium, Camphorated Tincture of Opium and Morphine Sulphate are commonly used. Some preparations are shown in the following: In the treatment of diarrhea: or Magnesii Sulph 5vj 12 Tinct. Opii Deod f5j 4 Acidi Sulph. Arom f3iij 12 Aquae Menth. Pip q. s. fSvj 180 M. Sig.-Tablespoonful in water every four hours till relieved. In the treatment of diarrhea, dysentery, nausea, etc.: B Bismuthi Subnit 3iij or 12 Tinct. Opii Camph f3iij 12 Spir. Chloroformi f3ij 8 Spir. Vini Gallici f3vj 23 Mist. Cretae q. s. fSiij 90 M. Sig.-Tablespoonful every three hours until relieved. (Shake-label.) Used in the treatment of acute indigestion: Hi or Tinct. Opii Camph Spir. Ammoniae Arom., fSiij 12 Spir. /^Etheris aa. fXss 15 Tinct. Lavandulae Comp q. s. fjij 60 M. Sig.-Teaspoonful well diluted every fifteen minutes until relieved. In the treatment of catarrhal enteritis of childhood: R2 or Bismuthi Subnit gr. Ixxx 5 Tinct. Opii Deod IRXvj 1 Misturae Cretae q. s. fjij 60 M. Sig.-Teaspoonful every two hours. (Shake-label.) 1 Musser and Kelly: Practical Treatment. 2 Hughes: Practice of Medicine. OPIUM. 247 In the treatment of the diarrhea of typhoid fever: Hi or Bismuthi Subnit 10 0 Phenolis Liq iRviij 5 Tinct. Opii Deod f5j 4 0 Mucil. Acaciae f$j 30 0 Aquae q. s. f5iv 120 0 M. Sig.-Teaspoonful every three hours. (Shake-label.) In the treatment of enterocolitis: $2 Bismuthi Subnit 5iij or 12 Tinct. Kino, Tinct. Opii Camph aa. f3iss 45 Misturae Cretae q. s. fSvj 180 M. Sig.-Tablespoonful every three hours. (Shake-label.) Internally-Dry Form.-Powdered Opium and Powder of Ipecac and Opium, Morphine Sulphate and Codeine Phosphate and Sulphate are employed. For action upon the nervous system, the Morphine or Codeine Salts or Powdered Opium are used. For action upon the respiratory system, the Codeine Salts, Diacetylmorphine Hydrochloride and Powder of Ipecac and Opium are more commonly employed. Some frequently used formulae are shown in the following: In the treatment of coryza: $3 or Ext. Belladon. Fol gr. ss 03 Camphorse gr. vj 40 Quininae Sulph., Pulv. Ipecac, et Opii aa. gr. xij 80 M. ft. cap. no. xij. Sig.-One every half-hour for four hours, then one every three hours. Used as a diaphoretic in the treatment of colds and kindred conditions: or Camphorae gr. v 32 Pulv. Ipecac, et Opii gr. x 65 Quininae Hydrobrom gr. x 65 M. ft. cap. no. v. Sig.-Take at bedtime. 1 Hughes: Practice of Medicine. 2 Ibid. 3 Musser and Kelly: Practical Treatment. 248 OPIUM. Used in the treatment of influenza: Hi or Phenylis Salicyl., Acetphenetidinae aa. gr. xlv 3^0 Pulv. Ipecac, et Opii gr. viij |5 M. ft. cap. no. xv. Sig.-One every three hours. With purgative to prevent griping: or Hydrarg. Chlor. Mitis gr. v 32 Ext. Colocynth. Comp gr. v 32 Pulv. Ipecac, et Opii gr. x 65 M. ft. cap no. iv. Sig.-One every hour tonight. By Rectum.-The Extract of Opium is used in suppositories or the Tincture of Opium is administered in enemas. In the treatment of threatened abortion: or Extracti Opii gr. ij Olei Theobromatis q- s. [13 M. ft. suppos. no. iv. Sig.-One night and morning. In the treatment of acute cystitis, pelvic peritonitis, etc.: or Ext. Belladon. Fol gr- j 065 Ext. Opii gr. ij 130 Olei Theobromatis q. s. M. ft. suppos. no. iv. Sig.-One night and morning when necessary. The Tincture of Opium and Morphine are frequently used in preparations for local application. The following are given to illus- trate some common usage: In the treatment of epididymitis: $2 or Tincturae Aconiti, Tincturae Opii aa. f5j 30 Liq. Plumbi Subacet f3ij 8 Aquae Dest q. s. fSvj 180 M. Sig.-Keep applied on cotton. 1 Musser and Kelly: Practical Treatment. 2 White and Martin: Genito-urinary and Venereal Diseases. OXYGENIUM. PANCREATINUM. PARAFFINUM. 249 In the treatment of erythema venenatum: B or Morphinae Sulph gr. v 32 Bismuthi Subnit 3j 4 00 Ung. Aquae Rosae q. s. 30 00 M. Sig.-Apply in a thin layer. In the treatment of gonorrhea: Bi or Zinci Sulphatis . gr. xv 1 0 Plumbi Acetatis Tincturae Opii, gr. xx 1 3 Tincturae Catechu ... aa. fSi j 8 0 Aquae . .q. s. f3vj 180 0 M. Sig.- (Shake-label). Inject after urination. OXYGENIUM. Latin, Oxygenium. Eng., Oxygen. A colorless, odorless, and tasteless gaseous element. PANCREATINUM. Latin, Pancreatinum. Eng., Pancreatin. A mixture of enzymes naturally existing in the pancreas of warm-blooded animals, usually obtained from the fresh pancreas of the hog (Sus scrofa) or the ox (Bos taurus). It converts not less than 25 times its own weight of starch into soluble carbohydrates. A cream-colored powder having a faint, peculiar, not unpleasant odor and a somewhat meat-like taste. Average Dose.-8 grains (0.5 Gm.). Therapeutic Action.-Digestant. Uses.-To aid digestion and to predigest food. Not often prescribed as such, but is employed in the form of the various ready-prepared or proprietary preparations. PARAFFINUM. Latin, Paraffinum. Eng., Paraffin. A colorless, tasteless mass usually obtained from petroleum. 1 White and Martin: Genito-urinary and Venereal Diseases. 250 PARAFORMALDEHYDUM. PEPO. PARAFORMALDEHYDUM. Latin, Paraformaldehydum. Eng., Paraformaldehyde. A polymeric form of formaldehyde. White friable masses, or a powder, having a faint odor of formaldehyde. On heating it is partly converted into formaldehyde and partly sublimed unchanged. Used principally as the prepared "Formaldehyde Troches." See Formaldehyde. , PARALDEHYDUM. Latin, Paraldehydum. Eng., Paraldehyde. A colorless liquid having a strong characteristic odor and a burn- ing then cooling taste. Average Dose.-30 minims (2 mils). Paraldehyde is usually prescribed in the form of the National Formulary Preparation- Elixir Paraldehydi {N. F.). Eng., Elixir of Paraldehyde. Contains 25 per cent, of the drug. Average Dose.-2 fluidrachms (8 mils). Therapeutic Action.-Hypnotic, sedative, antiseptic. Uses.-Employed in the treatment of alcoholic psychoses, dementia, hysteria, etc. Administration.-The odor and taste of paraldehyde are often considered decidedly objectionable both by patient and attendants. Usually ordered as the Elixir alone, as in the following for the treatment of alcoholic psychosis, hysteria, etc.: B or Elixir Paraldehydi (N. F.) f5ij 60| Sig.-Two (2) teaspoonfuls in water every three hours till effect. See Granatum, p. 176. PELLETIERINJE TANNAS. PEPO. Latin, Pepo. Eng., Pepo. Synonym, Pumpkin Seed. The ripe seed of Cucurbita Pepo. Average Dose.-1 ounce (30 Gm.). PEPSINUM. 251 Therapeutic Action.-Taenifuge. Uses.-Sometimes used to remove tape-worms. Seldom pre- scribed, as more reliable agents are usually available. PEPSINUM. Latin, Pepsinum (Gen., Pepsini). Eng., Pepsin. A mixture containing a proteolytic ferment or enzyme obtained from the glandular layer of the fresh stomach of the hog {Sus scrofa). It digests not less than 3000 times its own weight of freshly coagulated and disintegrated egg-albumin. Form.-White or yellowish scales, grains or powder. Odor and Taste.-Slight odor and taste. Solubility.-Soluble or almost entirely soluble in about 50 parts of water. More soluble in water acidulated with Hydrochloric Acid. Insoluble in alcohol. Incompatibles.-Alcohol, tannic acid, alkalies or alkaline carbo- nates, etc. Average Dose.-8 grains (0.5 Gm.). Some Unofficial Preparations. Elixir Digestivum Compositum (N. F.). Eng., Compound Digestive Elixir. Synonym, Elixir of Lactated Pepsin. A pleasantly flavored, red- colored elixir containing Pepsin, Pancreatin, Diastase, etc. Average Dose.-2 fluidrachms (8 mils). Liquor Pepsini (N. F.). Eng., Solution of Pepsin. Contains Pepsin, Diluted Hydrochloric Acid, Glycerin and Water. Average Dose.-2 fluidrachms (8 mils). Liquor Pepsini Aromaticus (N. F.). Eng., Aromatic Solution of Pepsin. Contains about the same as Solution of Pepsin with the addi- tion of cloves, cinnamon, etc. Average Dose.-2 fluidrachms (8 mils). Pepsinum Saccharatum (N. F.). Eng., Saccharated Pepsin. Pepsin, 10 Gm.; Sugar of Milk, 90 Gm. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Digestant. Uses.-As an aid to gastric digestion and for the predigestion of foods. The value of many long-used Pepsin preparations and the necessity for often using it at all have been seriously ques- tioned by good authority. The Compound Digestive Elixir seems to be an incompatible mixture, yet it is possibly the most largely used pharmaceutical preparation in the country. 252 PEPSINUM. Administration.-The following are given more to illustrate the present employment of pepsin and its preparations than to offer the formulae for indiscriminate use: 3 or Liq. Pepsini Arom 180] Sig.-Two (2) teaspoonfuls in water after meals. Or: n or Acidi Hydrochlor. Dil f3vj 231 Liq. Pepsini Arom q. s. f5vj 180| M. Sig.-Two (2) teaspoonfuls in water after meals. Or: $ or Tinct. Nucis Vom., Acidi Hydrochlor. Dil aa. f5iv 15 Liq. Pepsini Arom q. s. f3vj 180 M. Sig.-Two (2) teaspoonfuls in water after meals. In digestive disturbances: Hi or Pepsini 3ij 8 Acidi Hydrochlor. Dil f5iiss 9 Tinct. Nucis Vomicae, Glycerini aa. f3iss 6 Aquae q. s. f3ij 60 M. Sig.-Teaspoonful in water after meals. As a digestant: R2 or Pepsini 5iv 15 Acidi Hydrochlor. Dil f5iv 15 Glycerini q. s. f5iv 120 M. Sig.-Teaspoonful in water after meals. 1 Anders: Practice of Medicine. 2 Shoemaker: Materia Medica and Therapeutics. PETROLATUM. 253 To aid digestion: Bi or Pepsini 3j 4 00 Acidi Hydrochlor. Dil. ... f3iv 15 00 Strychninae Sulph gr. ss 03 Glycerini f3ss 15 00 Aquae Chloroformi q. s. fSiij 90 00 M. Sig.-Teaspoonful in water after meals. Or: B or Pepsini Acidi Hydrochlor. Dil., 5ij 8 Tinct. Nucis Vom., Glycerini aa. f3j 30 Aquae q. s. f3vj 180 M. Sig.-Teaspoonful in water after meals. PETROLATUM. Latin, Petrolatum (Gen., Petrolati). Eng., Petrolatum. Syno- nym, Petroleum Jelly, Vaselin, Cosmoline, etc. A purified mixture of semisolid hydrocarbons obtained from petroleum. Form.-An unctuous mass, varying in color from yellowish to light amber. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water or alcohol. Petrolatum Album. Eng., White Petrolatum. A white, unctuous mass. Odor and-Taste and Solubility.-Same as Petrolatum. Petrolatum Liquidum. Eng., Liquid Petrolatum. Synonym, Hydro- carbon Oil, Liquid Paraffin, American Oil, Russian Oil, etc. Form.-A colorless, oily liquid. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water or alcohol. Average Dose.-4 fluidrachms (15 mils). The Heavy and Light Liquid Petrolatum are recognized. Therapeutic Action.-Emollient, lubricant, laxative. Uses.-Petrolatum is principally used as a vehicle and lubricant, though its emollient action is a factor in its selection. The Liquid Petrolatum is now extensively employed in the treatment of chronic constipation. 1 Hughes: Practice of Medicine. 254 PETROSELINUM. Administration.-The following illustrate the employment of these agents: In the treatment of pruritus: Ri or Phenolis, Mentholis aa. gr. xx 13 Petrolati q. s. 3j 30 00 M. tere bene. Sig.-Apply locally. In the treatment of scabies: R2 or Sulphuris Praecip., Betanaphtholis aa. 3ss 2 Petrolati q- s. 5j 30 00 M. Sig.-Apply as directed. As a vehicle for a nasal spray: B or Camphorae gr. iv 13 Eucalyptolis, 01. Pini Pum., 01. Menth. Pip aa. gtt. iv 13 Petrolati Liq t. .q. s. f3iv 120 00 M. Sig.-Spray nose every four hours. As a laxative: or Petrolati Liq. Opt fSviij Sig.-Tablespoonful night and morning. PETROSELINUM. Latin, Petroselinum. Eng., Parsley Fruit. Synonym, Parsley Seed. The dried ripe fruit of Petroselinum sativum. Official Preparation. Oleoresinae Petroselini. Eng., Oleoresin of Parsley Fruit. Synonym, Liquid Apiol. Average Dose.-8 minims (0.5 mil). 1 Ashton: Practice of Gynecology. 2 Hughes: Practice of Medicine. PHENOL. 255 Therapeutic Action.-Emmenagogue. Uses.-In the treatment of amenorrhea. Administration.-The oleoresin under the name of apiol has long been in use. It is usually administered in capsules in com- bination with other agents. PHENOL. Latin, Phenol (Gen., Phenolis). Eng., Phenol. Synonym, Car- bolic acid. Formula, C6H5OH. Obtained from coal-tar by fractional distillation and subsequent purification, or made synthetically. Form.-Colorless, needle-shaped crystals or crystalline mass, sometimes acquiring a reddish tint. This does not seem to impair its efficiency. It melts when heated, but recrystallizes at about 100° F. Odor and Taste.-A characteristic, somewhat aromatic odor. When well diluted with water, a sweetish taste with a slightly burn- ing after-taste. Solubility.-In 15 parts of water. Freely soluble in alcohol, glycerin, oils, etc. Incompatibles.-Albumin, collodion, iron salts; when triturated with the following it yields a liquid or soft mass: acetanilide, acet- phenetidin, antipyrine, camphor, hydrated chloral, lead acetate, men- thol, phenyl salicylate, resorcinol, sodium phosphate, thymol, terpin hydrate, and urethane. Average Dose.-1 grain (0.06 Gm.). Official Preparations. Phenol Liquefactum (Gen., Phenolis Liquefacti). Eng., Liquefied Phenol. A liquid obtained by melting phenol and adding 10 per cent, of water. It contains not less than 87 per cent, of CeHgOH. Form.-A colorless liquid which may develop a slight reddish tint. Odor and Taste.-See Phenol. Solubility.-In 12 parts of water, miscible in all proportions with alcohol or glycerin. When diluted with an equal volume of glycerin it is miscible with water. Incompatibles.-See Phenol. Average Dose.-1 minim (0.05 mil). Glyceritum Phenolis. Eng., Glycerite of Phenol. Liquefied Phenol, 20 mils ; Glycerin, 80 mils. Average Dose.-5 minims (0.3 mil). Unguentum Phenolis. Eng., Ointment of Phenol. Contains about 2 per cent, of Phenol. 256 PHENOL. Therapeutic Action.-Antiseptic, germicide, local anesthetic, caustic, antiemetic. Uses.-Internally.-For nausea, diarrhea, dysentery, typhoid fever, etc. Locally.-For otitis media, ulcers, pruritus, endome- tritis, and various skin diseases. It is used for sterilizing instru- ments, excretions, etc. Toxicology.-Toxic amounts of liquefied phenol are fre- quently taken either through error or with suicidal intent. Among the symptoms are: Odor of the drug, the white areas around the mouth or on the mucous membrane of the mouth and throat, if patient is seen early. There may also be depres- sion, collapse, weak pulse, lowered temperature, and smoky- colored urine. Vomiting may occur. Large amounts may cause prompt collapse and death. Treatment: The stomach should be washed out with about a 20 per cent, solution of alcohol, then demulcents given and the patient stimulated with ammonia, strychnine, atropine, etc., as indicated. The body should be kept warm. It should be remembered that alcohol is an antidote to the local action of the drug, but does not prevent the absorption and systemic effects; so alcohol should not merely be administered, but removed (with the phenol) from the stomach. Poisoning has occurred from absorption from wet dressings containing Phenol. Administration.-In prescribing it is desirable for the sake of correctness to remember that Phenol is a solid, so should be prescribed in grains, and that when it is desired to prescribe by minims, Liquefied Phenol must be specified. The former is the preparation that should generally be used in ointments, oily liquids, etc., while the latter is often the more con- venient preparation for other solutions. Unfortunate results have sometimes followed the prescribing of an excess of Phenol in an aqueous liquid. Not more than 5 per cent, should be ordered in water unless glycerin is used to facilitate solu- tion. It has been claimed on good authority that it requires several hours for complete solution of Phenol in water to take place; so, if possible, it should be allowed to stand some time after mixing, before it is used. Ointments should always be made by melting both the Phenol crystals and the vehicle, and effecting the solution while in this state. Unpleasant results have frequently followed the use of an ointment made by the cold incorporation of the Liquefied Phenol with Petrolatum or other fatty vehicles. Solution may not be ef- PHENOL. 257 fected, but small drops of the liquid distributed through the ve- hicle. Solution of the drug was at one time extensively used as a wet dressing and many cases of poisoning occurred, both local (as gangrene) and systemic, from absorption. When the solution is sufficiently strong to coagulate the proteids of the surface, absorp- tion is retarded, but weak solution may admit of sufficient absorption to cause toxic symptoms. Some methods of using Phenol are shown in the following: Solutions in water up to 5 per cent, may be ordered as: or Phenolis Liq f3iss 61 Aquae Dest q. s. fSiv 120] M. Sig.-Apply as directed. Solutions in water stronger than 5 per cent, may be ordered as: or Phenolis Liq f3iij 12 Glycerini f3iij 12 Aquae Dest q. s. f5iv 120 M. Sig.-Apply as directed. (Shake-label.) As a local application in otitis: or Phenolis Liq "ixi] I75 Glycerini q. s. f5ss 15]00 M. Sig.-Two (2) drops in ear twice daily if necessary. As a local application, as for tonsillitis, etc. or Phenolis Liq nt xxv 1 5 Tinct. lodi f3iv 15 0 Glycerini * q. s. f5j 30 0 M. Sig.-Apply as directed. Used to allay itching in the treatment of smallpox: Ri or Phenolis Liq f3j 4 Glycerini f3j 4 Alcoholis fSj 30 Aquae 180 M. Sig.-Use locally. i Musser and Kelly: Practical Treatment. 258 PHENOL. In the treatment of gonorrhea: Bi or Hydrarg. Chlor. Corros gr. ss 03 Phenolis gr. xij 80 Zinci Phenolsulph gr. xxx 2 00 Aquae Dest q. s. f5vj 180 00 M. Sig.-Use as directed. (Not to be taken.) Patient should be instructed to inject after urination. In the treatment of alopecia: $2 or Resorcinolis gr. Ixxx S 0 Phenolis gr. xx 1 3 Spir. Myrciae q. s. £3iv 120 0 M. Sig.-Apply as directed. In the treatment of diarrhea of typhoid fever: B3 or Bismuthi Subnit 10 0 Phenolis Liq TTLviij 5 Tinct. Opii Deed f5j 4 0 Mucil. Acacias fSj 30 0 Aquae 120 0 M. Sig.-Teaspoonful every three hours. (Shake-label.) In the treatment of skin lesions of syphilis: R4 or Hydrarg. Chlor. Mitis 5j 4 Ung. Zinci Oxidi 15 Ung. Phenolis q- s. Sj 30 M. Sig.-Apply locally. In the treatment of eczema of the feet and legs: R or Phenolis gr. x 65 Olei Cadini mx 65 Picis Liquids gr. xx 1 30 Ung. Aqus Ross q. s. 5j 30 00 M. Sig.-Apply thoroughly twice a day. 1 White and Martin: Genl to-urinary and Venereal Diseases. 2 Stelwagon: Diseases of the Skin. 8 Hughes: Practice of Medicine. * White and Martin: Genitourinary and Venereal Diseases. PHENOLSULPHONATES. PHENOLPHTHALEINUM 259 In the treatment of pruritus: Hi Phenolis, or Mentholis aa. gr. xx 1 3 Petrolati ..q. s. 5j 30 0 M. tere bene. Sig.-Apply locally. PHENOLSULPHONATES, OFFICIAL. SODII PHENOLSULPHONAS (Gen., Sodii Phenolsulphonatis). Eng., Sodium Phenolsulphonate. Synonym, Sodium Sulphocarbolate. Form.-Colorless prisms. Odor and Taste.-Odorless. A cooling, saline, slightly bitter taste. Solubility.-In 4.2 parts of water or about 140 of alcohol. Average Dose.-4 grains (0.25 Gm.). ZINCI PHENOLSULPHONAS (Gen. Zinci Phenolsulphonatis). Eng., Zinc Phenolsulphonate. Synonym, Zinc Sulphocarbolate. Form.-Colorless prisms or crystals. Odor and Taste.-Odorless. An astringent, metallic taste. Solubility.-In 1.6 parts of water or 1.8 of alcohol. Average Dose.-2 grains (0.125 Gm.). % Therapeutic Action.-Classed as intestinal antiseptic and astringent. Uses.-Sometimes used in the treatment of diarrhea, dysen- tery, typhoid fever, etc. Administration.-These are usually prescribed in capsules, sometimes in solution. Tablets of various sizes are on the market. Latin, Phenolphthaleinum (Gen., Phenolphthaleini). Eng., Phe- nolphthalein. A phenol derivative. Form.-A white or faintly yellowish-white, crystalline powder. Odor and Taste.-Odorless and tasteless. Solubility.-Almost insoluble in water. Soluble in 13 parts of alcohol. Average Dose.-2% grains (0.15 Gm.). Therapeutic Action.-Purgative. Uses.-Promotes the emptying of the intestinal tract, partic- ularly in chronic constipation. Administration.-Tablets from one to five grains are on the market, and are a convenient form of using the drug. It is fre- PHENOLPHTHALEINUM. i Ashton: Practice of Gynecology. 260 PHENYLIS SALICYLAS. PHOSPHORUS. quently prescribed in powder or capsules, alone, or with other agents. The following will illustrate. For chronic constipation: Tab. Phenolphthaleini (3 gr.) Sig.-One every night when necessary. As a purgative: 3 Hydrarg. Chlor. Mitis, or Phenolphthalein!, Rhei Pulv aa. gr. v 3 M. ft. cap. no. iij. Sig.-Take an hour apart. PHENYLIS SALICYLAS See Acidum Salicylicum. PHOSPHORUS. Latin, Phosphorus. Eng., Phosphorus. Average Dose.-%20 grain (0.0005 Gm.). Official Preparation. Pilulae Phosphori. Eng., Pills of Phosphorus. Each pill contains Hoo grain (0.0006 Gm.) of the drug. Average Dose.-1 pill. Therapeutic Action.-Classed as a nerve stimulant and re- constituent. Uses.-Has been recommended for the treatment of rachitis, osteomalacia, neurasthenia, impotence, etc. Administration.-It is seldom if ever that Phosphorus should be prescribed as such by the physician, as few druggists are equipped to handle it. The official pills and many unofficial prepara- tions containing it can be obtained. Phosphorus is probably best ordered as: B Pil. Phosphori Sig.-One after each meal. PHYSOSTIGMA. PILOCARPUS. 261 PHYSOSTIGMA. Latin, Physostigma. Eng., Physostigma. Synonyms, Calabar Bean, Ordeal Bean. The ripe dried seeds of Physostigma vene- nosum. Average Dose.-1% grains (0.1 Gm.). Official Preparations and Constituent. Extractum Physostigmatis. Eng., Extract of Physostigmia. A powder. Average Dose.-% grain (0.008 Gm.). Tinctura Physostigmatis. Eng., Tincture of Physostigma. Repre- sents 10 per cent, of the drug. Average Dose.-15 minims (1 mil). Physostigminae Salicylas. Eng., Physostigmine Salicylate. Synonym, Eserine Salicylate. The Salicylate of an alkaloid obtained from Physostigma. Average Dose.-%o grain (0.001 Gm.). Therapeutic Action.-Myotic and peristaltic. Uses.-The salt of Physostigmine is used to contract the pupils in the treatment of various eye conditions, and to produce purgation and combat intestinal distention, particularly after abdominal opera- tions and in peritonitis, eclampsia, etc. Administration.-The Salicylate of Physostigmine is frequently employed by the physician hypodermically or otherwise, but is not often prescribed. । Latin, Pilocarpus. Eng., Pilocarpus. Synonym, Jaborandi. The dried leaflets of Pilocarpus jaborandi or of Pilocarpus microphyllus. Principal Constituents.-1Contains not less than 0.6 per cent, of alkaloids, the most important of which is Pilocarpine. Average Dose.-30 grains (2 Gm.). PILOCARPUS. Fluidextractum Pilocarpi. Eng., Fluidextract of Pilocarpus. Average Dose.-30 minims (2 mils). Pilocarpinae Hydrochloridum. Eng., Pilocarpine Hydrochloride. The hydrochloride of an alkaloid obtained from Pilocarpus. Form.-Colorless crystals. Odor and Taste.-Odorless. A faintly bitter taste. Solubility.-In 0.3 part of water or 3 parts of alcohol. Incompatibles.-Alkalies, iodides, gold salts, mercuric and mercurous chloride, potassium permanganate, silver nitrate, tannic acid. Official Preparation and Alkaloidal Salts. 262 PIPER. Average Dose.-By mouth, % grain (0.01 Gm.) ; hypodermic, ^2 grain (0.005 Gm.). Pilocarpinae Nitras. Eng., Pilocarpine Nitrate. Form, Odor, Taste, Incompatibility and Dose.-See Pilocarpinae Hydro- chloridum. Solubility.-In 4 parts of water or 75 parts of alcohol. Therapeutic Action. - Diaphoretic, diuretic, sialagogue, myotic. Uses.-Its employment is largely confined to cases when prompt diaphoresis is urgently indicated, as in uremia, con- vulsions, etc. Administration.-Seldom prescribed. Its use is largely con- fined to hypodermic tablets of Pilocarpine salts administered by the physician himself. It should be remembered that it is a very dangerous drug. Pilulae Asafoetidae.-See Asafcetida. Pilulae Catharticae Compositae.-See Colocynthis. Pilulae Ferri Carbonatis.-See Ferrum. Pilulae Ferri lodidi.-See Ferrum. Pilulae Phosphori.-See Phosphorus. Pilulae Rhei Compositae.-See Rheum. PIPER. Latin, Piper. Eng., Pepper. Synonym, Black Pepper. The dried, unripe fruit of Piper nigrum. Average Dose.-8 grains (0.5 Gm.). Official Constituent. Oleoresina Piperis. Eng., Oleoresin of Pepper. Average Dose.-% grain (0.03 Gm.). Therapeutic Action.-Carminative, stomachic, irritant. Uses.-Sometimes employed with other agents for its stomachic effect. Administration.-The following will illustrate the use of the drug. or Arseni Trioxidi gr. ij 13 Piperis Pulv., Ext. Gentianae aa. 5ij 800 M. ft. cap. no. lx. Sig.-One after each meal. PIX LIQUIDA. 263 PIX LIQUIDA. Latin, Fix Liquida (Gen., Picis Liquidae). Eng., Tar. A prod- uct obtained by the destructive distillation of the wood of Pinus palustris and other species of Pinus. Form.-A blackish-brown semi-liquid. Odor and Taste.-Empyreumatic, terebinthinate odor; sharp, empyreumatic taste. Solubility.-Only slightly soluble in water. Almost entirely sol- uble in alcohol. Average Dose.-8 grains (0.5 Gm.). Official Preparations. Syrupus Picis Liquidae. Eng., Syrup of Tar. Represents about 0.5 per cent, of tar. Average Dose.-1 fluidrachm (4 mils). Unguentum Picis Liquidae. Eng., Tar Ointment. Contains 50 per cent, of tar. Oleum Picis Liquidae Rectificatum. Eng., Rectified Oil of Tar. A volatile oil distilled from tar. Average Dose.-3 minims (0.2 mil). Therapeutic Action.-Antiseptic, irritant, expectorant, di- uretic. Uses.-Tar or its preparations are used in the treatment of many skin diseases, particularly of the chronic type; also for coughs, bronchitis and kindred conditions. Administration.-The following will illustrate the manner of prescribing: In the treatment of eczema of the feet and legs: Phenolis or 65 Olei Cadini nix 65 Picis Liquidae gr. xx 1 30 Ung. Aquae Rosae Sj 30 00 M. Sig.-Apply thoroughly twice a day. 264 PLUMBUM. In the treatment of ecthyma: Acidi Borici or 65 Bismuthi Subnit. ... 3j 4 00 Picis Liquidae gr. xx 1 30 Ung. Aquae Rosae .. q. s. 5j 30 00 M. Sig.-Apply on a cloth twice a day. PLUMBUM. The metal is not official, but the Pharmacopoeia contains the fol- lowing: PLUMBI ACETAS. Eng., Lead Acetate. Synonym, Sugar of Lead. Form.-Colorless prisms, plates or powder. Odor and Taste.-A faintly acetous odor and a sweetish, astringent, after- ward metallic taste. Solubility.-In 1.4 parts of water or 38 parts of alcohol. Incompatibles.-Acids, alkalies, carbonates, chlorides, citrates, iodides, phosphates, sulphates, sulphites, tartrates, hydrated chloral, resorcinol, phenol, etc. Average Dose.-1 grain (0.06 Gm.). LIQUOR PLUMBI SUBACETATIS. Eng., Solution of Lead Sub- acetate. Synonym, Goulard's Extract. An aqueous liquid containing about 25 per cent, of Lead Subacetate. Incompatibles.-See Plumbi Acetas. LIQUOR PLUMBI SUBACETATIS DILUTUS. Eng., Dilute Solution of Lead Subacetate. Synonym, Lead-water. An aqueous solu- tion containing about 1 per cent, of Lead Subacetate. PLUMBI OXIDUM. Eng., Lead Oxide. Synonym, Litharge. Form.-A yellowish powder. Odor and Taste.-Odorless and tasteless. Solubility.-Almost insoluble in water or alcohol. EMPLASTRUM PLUMBI. Eng., Lead Plaster. Synonym, Diachy- lon Plaster. Lead Acetate, 60 Gm.; Soap, 100 Gm.; Water, sufficient quantity. UNGUENTUM DIACHYLON. Eng., Diachylon Ointment. Lead Plaster, 50 Gm.; Oil of Lavender Flowers, 1 Gm.; White Petrolatum, 49 Gm. Lead Plaster is also contained in some other preparations. Therapeutic Action.-Astringent and local sedative. Uses.-Employed in the treatment of diarrhea, dysentery, gonorrhea, vaginitis, various skin diseases, bruises, sprains, erysipelas, local infections, etc. Official Salts and Preparations. PODOPHYLLUM. 265 Administration.-Lead Acetate, Lead Plaster and the solutions of the Subacetate are the preparations most frequently used. In the treatment of furuncle: Hi or Ichthyolis 5j 4 Empl. Plumbi ... 8 Empl. Resinae 3j 4 M. Sig.-Apply as directed. In the treatment of epididymitis: R2 Tincturae Aconiti, Tincturae Opii, Liq. Plumbi Subacet aa. f3ij or 8 Aquae Dest q. s. fSvj 180 M. Sig.-Keep applied on cotton. In the treatment of gonorrhea: R3 or Zinci Sulphatis gr. xv 1 0 Plumbi Acetatis gr. xx 1 3 Tincturae Opii, Tincturae Catechu aa. f3ij 8 0 Aquae q. s. f5vj 180 0 M. Sig.-Inject after urination. (Shake-label.) PODOPHYLLUM. Latin, Podophyllum. Eng., Podophyllum. Synonyms, May Apple, Mandrake. The dried rhizome and roots of Podophyllum peltatum. Official Preparations. Fluidextractum Podophylli. Eng., Fluidextract of Podophyllum. Average Dose.-8 minims (0.5 mil). Resina Podophylli. Eng., Resin of Podophyllum. Synonym, Podo- phyllin. Form.-A yellowish powder. Odor and Taste.-Slight odor and bitter taste. Solubility.-Insoluble in water. Soluble in alcohol. 1 Stelwagon: Diseases of the Skin. 2 White and Martin: Genito-urlnary and Venereal Diseases, a Ibid. 266 PODOPHYLLUM. Average Dose.-% grain (0.01 Gm.). The words Podophyllin and Podophyllum should not be con- fused, as one is many times stronger than the other. The synonym is unfortunate. Podophyllum is sometimes known as Mandrake, but is not the Mandrake (Mandragora) of medical history. Therapeutic Action.-Drastic purgative, said to be chola- gogue. Uses.-Podophyllum, or more commonly the resin, is used to produce purgation, particularly when there are evidences of deficient bile. As its taste, odor and action are rather unpleasant, its usefulness is questionable. Administration.-The Resin of Podophyllum is the prepa- ration most frequently used. It is seldom employed alone, as when given in sufficient doses it is apt to produce nausea and griping. It is often ordered in small doses with' other agents to increase their purgative action. In a purgative combination: r or Hydrarg. Chlor. Mitis gr. ij 13 Res. Podophylli gr. ss 03 Sodii Bicarb gr. x 65 M. ft. cap. no. iv. Sig.-One every hour. In the treatment of constipation: Ri or Ext. Nucis Vomicae gr. v 32 Ext. Belladon. Fol gr. ij 13 Resinae Podophylli gr. ij 13 Ext. Cascarae Sagr gr. xl 2 50 M. ft. cap. no. xx. Sig.-One at bedtime. As a laxative: R2 or Ext. Belladon. Fol gr. j 065 Res. Podophylli gr. j 065 Ext. Cascarse Sagr gr. xx 1 300 M. ft. cap. no. x. Sig.-One at bedtime. 1 Ashton: Practice of Gynecology. 2 Ibid. POTASSIUM. 267 POTASSIUM. The metal is not official, but the Pharmacopoeia contains the fol- lowing official salts and preparations: POTASSA SULPHURATA. Eng., Sulphurated Potassa. Synonym, Liver of Sulphur. A mixture composed chiefly of potassium polysulphide and potassium thiosulphate, and containing an amount of sulphides corresponding to not less than 12.8 per cent, of Sulphur. POTASSII ACETAS (Gen., Potassii Acetatis). Eng., Potassium Acetate. Form.-A white powder or crystalline masses. Odor and Taste.-Odorless. A warming, saline taste. Solubility.-In 0.5 part of water or 2.9 parts of alcohol. Incompatibles.-Mineral acids. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Diuretic, refrigerant. Uses.-It is used in the treatment of chronic nephritis, dropsy, etc. Administration.-This salt should always be prescribed in solution. In the treatment of chronic valvular disease: Ri or Potassii Acetatis $ 41 Infusi Digitalis 601 M. Sig.-Tablespoonful every three hours. In the treatment of ascites: R2 or 30 15 Potassii Acetatis Spir. ^theris Nit Sj f5ss Inf. Digitalis q. s. fSiv 120 M. Sig.-Two (2) teaspoonfuls every six hours. A frequently used combination is the pharmaceutical prepara- tion ordered as: 3 or Elix. Buchu, Junip. et Pot. Acet 120| Sig.-Teaspoonful in water every four hours. 1 Anders: Practice of Medicine. 2 Hughes: Practice of Medicine. 268 POTASSIUM. POTASSII BICARBONAS (Gen., Potassii Bicarbonatis). Eng., Potassium Bicarbonate. Form.-Colorless prisms or powder. Odor and Taste.-Odorless and a saline taste. Solubility.-In 2.8 parts of water. Almost insoluble in alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antacid, diuretic. Uses.-Sometimes used in the treatment of rheumatism, gout, nephritis, etc. Administration.-The following is a method of giving dry agents to form' fresh ferrous carbonate in the stomach. Bi or Ferri Sulph. Exsic., Potassii Bicarb aa. 3j 4 M. ft. cap. no. xxiv. Sig.-One after each meal. POTASSII BITARTRAS (Gen., Potassii Bitartratis). Eng., Potas- sium Bitartrate. Synonym, Cream of Tartar. Form.-A white powder. Odor and Taste.-Odorless. Pleasant, acidulous taste. Solubility.-In about 155 parts of water. Sparingly soluble in alcohol. Average Dose.-30 grains (2 Gm.). Potassium Bitartrate is contained in Compound Powder of Jalap. Therapeutic Action.-Aperient, diuretic. Uses.-It is a pleasant agent to produce elimination, as in hypertension, nephritis, dropsy; etc.; also is extensively employed as a mild laxative in chronic constipation. Administration.-A pleasant method of administering is the following, for chronic constipation: or Potassii Bitartratis 5ij 60| Sig.-Teaspoonful in glass of lemonade on arising. Or it is frequently ordered: Potassii Bitartratis Sj or 301 Sodii Sulphatis Sij 60 M. Sig.-Teaspoonful in glass of lemonade on arising. This is best taken hot. Hot water is often used instead of the lemonade. i Musser and Kelly: Practical Treatment. POTASSIUM. 269 POTASSII BROMIDUM.-See Bromides, p. 100. POTASSII CARBONAS. Eng., Potassium Carbonate. Synonyms, Salt of Tartar, Sal Tartar. Form.-A white powder. Odor and Taste.-Odorless. A strong, alkaline taste. Solubility.-In 0.9 part of water. Insoluble in alcohol. Incompatibles.-Acids and most salts. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antacid, irritant. Uses.-Sometimes used in the treatment of alopecia, ichthy- osis, etc. Seldom prescribed. POTASSII CHLORAS (Gen., Potassii Chloratis). Eng., Potassium Chlorate. Form.-Colorless prisms, plates or a granular powder. Solubility.-In 11.5 parts of water. Insoluble in alcohol. Incompatibles.-Iron iodide, sulphuric acid, tartaric acid, etc. Should not be triturated with easily oxidizable substances, as sulphur, tannic acid, etc. Average Dose.-4 grains (0.25 Gm.). Trochisci Potassii Chloratis. Eng., Troches of Potassium Chlorate. Each troche contains about 2)4 grains (0.15 Gm.) of the drug. Therapeutic Action.-Classed as an astringent and as a dis- infectant and stimulant to mucous membrane. Uses.-Its employment is almost confined to the treatment of diseases of the throat and mouth, as tonsillitis, laryngitis, diphtheria, stomatitis, etc. Administration.-The above dose is very often exceeded. Some clinicians prescribe the drug well diluted with water and with the addition of hydrochloric acid. When the local action on the mucous membrane of the mouth and throat is particularly desired, potassium chlorate may be ordered, as: R Troch. Potas. Chloratis no. xx Sig.-Use one every three hours as directed. Or: n Tab. Potas. Chloratis (5 gr.) no. xx Sig.-Use one every three hours as directed. These are allowed to dissolve in the mouth and the saliva swallowed. 270 POTASSIUM. The official troches are not always stocked by the smaller drug- stores. In the treatment of tonsillitis, pharyngitis, etc.: 5 or Potassii Chloratis 3j 4 Tinct. Ferri Chlor f5iij 12 Acidi Sulphurosi, Glycerini aa. f3iv 15 Aquae q. s. f5iij 90 M. Sig.-Two (2) teaspoonfuls in water every four hours. In the treatment of stomatitis: Hi or Potassii Chloratis gr. xxiv 1 5 Syrupi Aurantii fSj 30 0 Aquae q. s. fjiij 90 0 M. Sig.-Teaspoonful in water every two hours. (For child 4 years old.) In the treatment of stomatitis (child 3 years old): $2 or Potas. Chloratis gr. xxiv 1 50 Tinct. Myrrhae H.x 65 Syr. Acaciae fSij 60 00 Aquae q. s. f3iij 90 00 M. Sig.-Teaspoonful in water every three hours. POTASSII CITRAS.-See Citrates, p. 23. Potassii Citras Effervescens.-See Citrates, p. 23. Liquor Potassii Citratis.-See Citrates, p. 23. POTASSII HYDROXIDUM. Eng., Potassium Hydroxide. Syno- nym, Caustic Potash. Form.-White, or, nearly white flakes, fused masses or pencils. Odor and Taste.-Almost odorless. A very acrid and caustic taste. Solubility.-In 0.9 part of water or 3 parts of alcohol. Liquor Potassii Hydroxidi. Eng., Solution of Potassium Hydroxide. An aqueous solution containing about 5 per cent, of Potassium Hy- droxide. Average Dose.-15 minims (1 mil). Therapeutic Action.-Caustic, antacid. Uses.-Sometimes used for its caustic effect in the treatment of warts, callosities, ulcers, cancers, etc. Seldom prescribed. 1 Ruhrah: Diseases of Children. 2 Anders: Practice of Medicine. POTASSIUM. 271 POTASSII HYPOPHOSPHIS.-See Hypophosphites, p. 29. POTASSII IODIDUM.-See Iodides, p. 202. POTASSII NITRAS. Eng., Potassium Nitrate. Synonym, Saltpetre. Average Dose.-8 grains (0.5 Gm.). Therapeutic Action.-Diuretic, diaphoretic. Uses.-Seldom prescribed. POTASSII PERMANGANAS (Gen., Potassii Permanganatis). Eng., Potassium Permanganate. Form.-Purple-colored prisms. Odor and Taste.-Odorless. Taste at first sweet, but afterwards dis- agreeable and astringent. Solubility.-In 13.5 parts of water. Decomposed by alcohol. Incompatibles.-Organic matter, mineral acids, ammonia, arsenites, bro- mides, chlorides, hypophosphites, hyposulphites, sulphites, ferrous salts, hydro- gen dioxide, mercurous salts, etc. Average Dose.-1 grain (0.06 Gm.). Therapeutic Action.-Germicide, disinfectant, deodorant. Uses.-Sometimes used for disinfecting the hands for opera- tions. Extensively employed as a wet dressing for infected wounds, erysipelas, etc. Used by irrigation for gonorrhea, cystitis, vaginitis, pelvic congestios, etc. A remedy for snake-bite. Used as a deodorant for cast-off dressings, sinks, etc. Administration.-The action of this drug depends on its split- ting up in the presence of organic matter with the liberation of oxygen, which oxidizes the organic material. It is therefore a true chemical antidote for alkaloidal poisoning. It should be prescribed in distilled water, as the small amount of organic matter in ordinary water will decompose the drug to that extent. When triturated with glycerin or other easily oxidized matter, a dangerous explosion may occur. As an irrigation for gonorrhea, cystitis, etc., it is usually employed in aqueous solution about 1: 20,000 to 1:3000 strength. As a vaginal douche or wet dressing the strength is commonly about 1: 5000. It should be remembered that it will stain clothing or the skin. The stains may be removed by solution of oxalic acid. The following illustrates the method of prescribing: Asa vaginal douche: or Potas. Permanganatis gr. cl 1010 Aquae Destillatae q. s. fSvj 1800 M. Sig.-Use tabkspoonful to gallon of hot water as directed. This makes a solution of about 1:5000. 272 PRUNUS VIRGINIANA. As a wet dressing for carbuncles, etc.: or Potassii Permangan gr. l 31 Aquae Dest q. s. f5ij 601 M. Sig.-Use a teaspoonful to a quart of hot water as directed. This makes a solution of about 1 to 5000. POTASSII ET SODII TARTRAS (Gen., Potassii et Sodii Tartratis). Eng., Potassium and Sodium Tartrate. Synonym, Rochelle Salt. Form.-White powder. Odor and Taste.-Odorless. A cooling saline taste. Solubility.-In 0.9 part of water. Insoluble in alcohol. Average Dose.-2% drachms (10 Gm.). Pulvis Effervescens Compositus. Eng., Compound Effervescing Powder, Seidlitz Powder. These are prepared in sets of one blue and one white paper. Each blue paper contains Potassium and Sodium Tartrate, 7.5 Gm. (120 grains); Sodium Bicarbonate, 2.5 Gm. (40 grains). Each white paper contains Tartaric Acid, 2.15 Gm. (35 grains). Average Dose.-1 set of two powders. Therapeutic Action.-Purgative (saline and hydragogue). Uses.-Potassium and sodium tartrate, usually in the form of Seidlitz powder, is a popular and pleasant purgative. Administration.-Care should be exercised in ordering (partic- ularly by phone) potassium and sodium tartrate, to prevent con- fusion with antimony and potassium tartrate (tartar emetic). Rochelle Salt is most frequently employed in the form of Seidlitz powders, which constitute one of the most agreeable saline purga- tives. The two powders of a Seidlitz powder are dissolved in sep- arate glasses about a fourth full of water; then the contents of the glassed are mixed and swallowed while still effervescing. It is best taken before breakfast. LIQUOR POTASSII ARSENITIS.-See Arsenum, p. 75. PRUNUS VIRGINIANA. Latin, Prunus Virginiana. Eng., Wild Cherry. The bark of Prunus serotina. Principal Constituents.-Amygdalin (which yields with water, hydrocyanic acid, etc.), tannic acid. Average Dose.-30 grains (2 Gm.). Official Preparation. Syrupus Pruni Virginianae. Eng., Syrup of Wild Cherry. Represents 15 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). PYRETHRUM. PYROGALLOL. 273 Therapeutic Action.-Bitter tonic and sedative. Uses.-Frequently used in cough preparations and in tonics. Administration.-The syrup is the preparation most fre- quently used. It is seldom prescribed alone, but is used as a vehicle, particularly for tonic and expectorant preparations. or Diacetylmorph. Hydrochlor gr. J 065 Ammonii Chlor 3ij 8 000 Syr. Ipecacuanhae f3j 4 000 Syr. Pruni Virg 90 000 M. Sig.-Teaspoonful every two hours. Pulvis Aromaticus.-See Cinnamomum. Pulvis Cretae Compositus.-See Calcium. Pulvis Effervescens Compositus.-See Potassii et Sodii Tartras. Pulvis Glycyrrhizae Compositus.-See Glycyrrhiza. Pulvis Ipecacuanhae et Opii.-See Opium. Pulvis Jalapae Compositus.-See Jalapa. Pulvis Rhei Compositus.-See Rheum. PYRETHRUM. Latin, Pyrethrum. Eng., Pyrethrum. Synonym, Pellitory. The dried root of Anacyclus Pyrethrum. Average Dose.-30 grains (2 Gm.). Official Preparation. Tinctura Pyrethri. Eng., Tincture of Pyrethrum. Represents 20 per cent, of the drug. Therapeutic Action.-Rubefacient, sternutatory, sialagogue. Uses.-Recommended principally for scurvy, and for relaxed and other conditions of the mouth and throat. Seldom prescribed. PYROGALLOL. Latin, Pyrogallol. Eng., Pyrogallol. Synonyms, Pyrogallic Acid, Pyro. White or nearly white laminae, or fine needles; odor- less, bitter taste, freely soluble. Not often prescribed, but under the name of "Pyro" is exten- sively used in photography. 274 PYROXYLINUM. QUASSIA. QUININE BISULPHAS. PYROXYLINUM. Latin, Pyroxylinum. Eng., Pyroxylin. Synonym, Soluble Gun Cotton. QUASSIA. Latin, Quassia. Eng., Quassia. The wood of Picrasma excelsa, or of Picrasma amara. Average Dose.-8 grains (0.5 Gm.). Official Preparation. Tinctura Quassiae. Eng., Tincture of Quassia. Represents 20 per cent, of the drug. Average Dose.-30 minims (2 mils). Therapeutic Action.-Stomachic, bitter tonic. Uses.-Sometimes used for loss of appetite, dyspepsia, etc. By enema it is used for pinworms. It is a vegetable bitter that can be prescribed with iron. The solution turns dark, but does not give a precipitate. Administration.-The following illustrates one of the most frequent uses of the drug. As an enema in the treatment of pinworms: ft or Quininae Bisulph 5j 41 Tinct. Quassiae 60 M. Sig.-Use two (2) tablespoonfuls to quart of warm water as directed Or: or Quininae Bisulph 2] Quassiae Sj 30| M. Sig.-Make a tea and use as directed. Patient is instructed to add one or two quarts of boiling water and let stand until cool enough to use, then strain. These enemas are usually preceded by an active purgative and repeated in a few days. QUININA. See Cinchona, p. 130. QUININE BISULPHAS. See Cinchona, p. 130. QUININE DIHYDROCHLORIDUM. RESORCINOL. 275 QUININE DIHYDROCHLORIDUM. See Cinchona, p. 130. QUININ® ET URE.® HYDROCHLORIDUM. See Cinchona, p. 130. QUININE HYDROBROMIDUM. See Cinchona, p. 130. QUININE HYDROCHLORIDUM. See Cinchona, p. 130. QUININE SALICYLAS. See Cinchona, p. 130. QUININ® SULPHAS. See Cinchona, p. 130. See Cinchona, p. 130. Resina.-See Terebinthina. Resina Jalapae.-See Jalapa. Resina Podophylli.-See Podophyllum. Resina Scammoniae.-See Scammoniae Radix. QUININE TANNAS. RESORCINOL. Latin, Resorcinol (Gen., Resorcinolis). Eng., Resorcinol. Synonym, Resorcin. A diatomic phenol. Form.-Colorless, needle-shaped crystals or a powder acquiring a pinkish tint on exposure to air and light. Odor and Taste.-A peculiar odor and a sweetish and afterward bitter taste. Solubility.-In 0.9 part of water or alcohol. Incompatibles.-Acetanilide, alkalies, antipyrine, camphor, ferric chloride, menthol, spirit of nitrous ether, urethane, etc. Average Dose.-2 grains (0.125 Gm.). Therapeutic Action.-Germicide. 276 RESORCINOL. Uses.-Sometimes given internally, as for intestinal fermen- tation, gastritis, etc.; but its use is principally confined to the treatment of skin diseases, as alopecia, tinea, scabies, etc. Administration.-Internally.-Resorcin, if administered by mouth, is best given in solution well diluted. Externally.-It is used both in solution and in ointments. It is most commonly combined with other agents. In the treatment of alopecia: Ri or Resorcinolis gr. Ixxx 5 0 Quininae gr. xv 1 0 Olei Ricini 1RXX 1 3 Alcoholis q. s. f&iv 120 0 M. Sig.-Apply as directed. In the treatment of alopecia: B2 or Resorcinolis gr. Ixxx 5 0 Phenolis gr. xx 1 3 Spir. Myrcise q. s. f$iv 120 0 M. Sig.-Apply as directed. In the treatment of seborrhoea capitis: $3 Resorcinolis 3j or 4 Olei Ricini f5j 4 Alcoholis 120 0 M. Sig.-Apply as directed. In the treatment of ecthyma: R4 or Resorcinolis 3j 4 Acidi Borici 3ij 8 Glycerini f3j 4 Alcoholis 15 Aquae .. q. s. fSviij 240 M. Sig.-Apply freely. 1 Stelwagon: Diseases of the Skin. 2 Ibid. s Ibid. < Ibid. RHEUM. 277 In the treatment of scabies: R or Resorcinolis gr. xxx 2 Ung. Sulphuris oj 30 Petrolati q. s. f^ij 60 M. Sig.-Apply as directed. RHEUM. Latin, Rheum (Gen., Rhei). Eng., Rhubarb. The rhizome and roots of Rheum officinale, R. palmatum, etc. Principal Constituents.-Chrysophan, rheotannic acid, etc. Average Dose.-15 grains (1 Gm.). Official Preparations. Extractum Rhei. Eng., Extract of Rhubarb. A powder. Average Dose.-4 grains (0.25 Gm.). Fluidextractum Rhei. Eng., Fluidextract of Rhubarb. Average Dose.-15 minims (1 mil). Pilulae Rhei Compositae. Eng., Compound Pills of Rhubarb. Each Pill contains 0.13 Gm. (2 grains) of Rhubarb with Aloes, Myrrh and Peppermint. Average Dose.-2 pills. Pulvis Rhei Compositus. Eng., Compound Powder of Rhubarb. Rhubarb, 25 Gm.; Magnesium Oxide, 65 Gm.; Ginger, 10 Gm. Average Dose.-30 grains (2 Gm.). Syrupus Rhei. Eng., Syrup of Rhubarb. Represents 10 per cent, of the drug with Potassium Carbonate and Cinnamon. Average Dose.-2% fluidrachms (10 mils). Syrupus Rhei Aromaticus. Eng., Aromatic Syrup of Rhubarb. Rep- resents 3 per cent, of the drug with aromatics. Average Dose.-2j4 fluidrachms (10 mils). Tinctura Rhei. Eng., Tincture of Rhubarb. Represents 20 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Tinctura Rhei Aromatica. Eng., Aromatic Tincture of Rhubarb. Represents 20 per cent, of the drug with aromatics. Average Dose.-30 minims (2 mils). Therapeutic Action.-Purgative, stomachic, also astringent. Uses.-Rhubarb is still a popular purgative with the laity. It is sometimes prescribed by the profession, but usually as an adjuvant for other agents. Its secondary effect is astringent. 278 ROSA GALLICA. Administration.-Powdered Rhubarb is sometimes used with other purgative agents, and the other preparations are occasionally employed. The taste is disagreeable. In combination with other purgatives: B or Hydrarg. Chlor. Mitis., Rhei Pulv., Ext. Fei. Bovis aa. gr. v 320 Ext. Hyoscyami gr. j 065 M. ft. cap. no. iij. Sig.-One every hour. ROSA GALLICA. Latin, Rosa Gallica. Eng., Red Rose. The dried petals of Rosa gallica. Principal Constituents.-Volatile oil, etc. Official Preparations. Fluidextractum Rosae. Eng., Fluidextract of Rose. Average Dose.-30 minims (2 mils). Mel Rosae. Eng., Honey of Rose. Fluidextract of Rose, 120 mils; Clarified Honey, to make 1000 Gm. Average Dose.-^\ fluidrachm (4 mils). Aqua Rosae. Eng., Rose Water. Stronger Rose Water and Distilled Water equal parts. Aqua Rosae Fortior. Eng., Stronger Rose Water. Water saturated with the volatile Oil of Rose petals by distillation. Unguentum Aquae Rosae. Eng., Ointment of Rose Water. Synonym, Cold Cream. Spermaceti, 125 Gm.; White Wax, 120 Gm.; Expressed Oil of Almond, 560 Gm.; Stronger Rose Water, 190 mils; Sodium Borate, 5 Gm. Unofficial Constituent. Oleum Rosae. Eng., Oil of Rose. Synonym, Attar of Rose. A volatile oil. Therapeutic Action.-Rose is a mild astringent and stomachic. Uses.-The preparations are extensively employed as vehicles and flavors. Administration.-These preparations are used almost exclu- sively as vehicles, and to disguise unpleasant tastes and odors. The Honey and Syrup are not used in some neighborhoods with enough frequency to enable the smaller; drug-stores to keep a fresh supply on hand. Rose Water and the Ointment of Rose Water are ROSA GALLICA. 279 very desirable vehicles, and can usually be supplied in good condi- tion by any pharmacy. As a vehicle in a prescription for the treatment of chapped face and hands: R or Phenolis Liq nix 65 Glycerini 30 00 Alcoholis 30 00 Aquae Rosae 120 00 M. Sig.-Apply after bathing. As a flavor in a prescription for the treatment of salivation: Bi or Acidi Borici, Acidi Tannici aa. gr. xl 2 5 Meilis Rosae f3ij 60 0 Aquae q. s. f3vj 180 0 M. Sig.-Use as a mouth-wash every two hours. As a vehicle in a prescription for the treatment of eczema of the scrotum: or Camphorae, Chlorali Hydrati aa gr. xx 1 3 Adipis Lanae Hyd 5s s 15 0 Ung. Aquae Rosae q. s. 5j 30 0 M. Sig.-Apply liberally several times a day. As a vehicle in a prescription for the treatment of eczema of the feet and legs: or Phenolis gr. x 65 Olei Cadini nix 65 Picis Liquidae gr. xx 1 30 Ung. Aquae Rosae q. s. 5j 30 00 M. Sig.-Apply thoroughly twice a day. 1 White and Martin: Genito-urinary and Venereal Diseases. 280 SABAL. SACCHARUM LACTIS. SABAL. Latin, Sabal. Eng., Sabal. Synonym, Saw Palmetto. The par- tially dried ripe fruit of Serenoa serrulata. Average Dose.-15 grains (1 Gm.). Official Preparation. Fluidextractum Sabal. Eng., Fluidextract of Sabal. Average Dose.-15 minims (1 mil). Therapeutic Action.-Diuretic, expectorant. Uses.-Sabal is a constituent of some of the popular pharma- ceutical preparations for genito-urinary diseases, as cystitis, urethritis, etc. It is also recommended for chronic bronchitis, asthma, etc. Administration.-The most frequently used preparation is the Elixir of Saw Palmetto and Santal Co., which is prescribed alone. SACCHARUM. Latin, Saccharum (Gen., Sacchari). Eng., Sugar. Synonyms, Cane Sugar, Granulated Sugar, Sucrose. Form.-White, dry, hard, distinctly crystalline granules or crys- talline powder. Odor and Taste.-Odorless. A purely sweet taste. Solubility.-In 0.5 part of water or 170 parts of alcohol. Syrupus. Eng., Syrup. Synonym, Simple Syrup. Sugar, 850 Gm.; Distilled Water, to make 1000 mils. Sugar is a constituent of all syrups and many other officinal prep- arations. Sugar as such is often prescribed to give bulk and sweet taste to powders and in solution to disguise unpleasant tastes and also to render liquids thicker so that soluble matter will remain longer in suspension when the mixture is agitated. The flavored syrups, as Syrup of Orange, etc., are more frequently employed. Official Preparations. SACCHARUM LACTIS. Latin, Saccharum Lactis (Gen., Sacchari Lactis). Eng., Sugar of Milk. Synonym, Lactose. Obtained from the whey of cow's milk. SALICINUM. SANGUINARIA. 281 Form.-Usually a white powder. Odor and Taste.-Odorless. A faintly sweet taste. Solubility.-In 4.9 parts of water. Insoluble in alcohol. Sugar of milk is used in Powder of Ipecac and Opium and Tritu- ration of Elaterin. It is therapeutically inactive, only faintly sweet as compared with cane sugar, and being a clean white powder it makes a very desirable vehicle in administering powders. It is a valuable constituent in the modified milk formulae. The following will show how it is ordered in prescribing: Asa vehicle: R or Hydrarg. Chlor. Mitis gr. j 1065 Sacchari Lactis gr. xxx 2|000 M. ft. cht. no. v. Sig.-One every half-hour. SALICINUM. Latin, Salicinum. Eng., Salicin. A glucoside obtained from several species of Salix and Populus and appearing in the form of crystals, needles, prisms, or powder; odorless, and having a very bitter taste. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antipyretic, antirheumatic, antiseptic. Uses.-Sometimes employed in the treatment of rheumatism, tonsillitis and kindred conditions. Not often prescribed. SANGUINARIA. Latin, Sanguinaria. Eng., Sanguinaria. Synonym, Bloodroot. The dried rhizome and roots of Sanguinaria canadensis. Average Dose.-2 grains (0.125 Gm.). Official Preparation. Tinctura Sanguinariae. Eng., Tincture of Sanguinaria. Represents 10 per cent, of the drug. Average Dose.-15 minims (1 mil). Therapeutic Action.-Expectorant, emetic, etc. Uses.-Sanguinaria is a constituent of some pharmaceutical preparations for cough, etc. It has been recommended for other conditions. It is seldom a prescription ingredient. 282 SANTALUM RUBRUM. SANTONINUM. SANTALUM RUBRUM. Latin, Santalum Rubrum. Eng., Red Saunders. The heart-wood of Pterocarpus santalinus. Therapeutic Action.-Probably none. Uses.-As a coloring agent for pharmaceutical preparations. SANTONINUM. Latin, Santoninum (Gen., Santonini). Eng., Santonin. The inner anhydride or lactone of Santonic Acid obtained from San- tonica (Artemisia pauciflora). Form.-Colorless prisms, turning yellow on exposure to light. Odor and Taste.-Odorless and nearly tasteless when first put in the mouth, but afterward developing a bitter taste. Solubility.-In about 5300 parts of water or 43 parts of alcohol. Average Dose.-1 grain (0.06 Gm.). Therapeutic Action.-Vermifuge. Uses.-Santonin is used for the removal of roundworms and sometimes, in connection with other measures, for the removal of pinworms. Administration.-It should be remembered that Santonin is a dangerous remedy, sometimes, even in the usual medicinal doses, causing toxic symptoms. Another matter of importance is to advise the family of patient as to the possibility of its caus- ing a yellow- or red- colored urine. Santonin is prescribed either with some inert substance, as sugar, or with a purgative, particularly the mild mercurous chloride. Its virtue depends largely on its comparative insolubility, which en- ables it to reach the lower part of the intestinal tract. It is con- sidered desirable, therefore, by many, to administer crystals in preference to powder. In the case of adults this is readily accom- plished by prescribing the crystals, with other agents, in capsules. For children, small crystals may be used with granulated sugar or sugar of milk. The crystals may also be incorporated with con- fection of rose, or made into lozenges with sugar and tragacanth. In the treatment of roundworms (for child 4 years old) : or Santonini (cryst.) gr. j 06 Hydrarg. Chlor. Mitis gr. ij 13 Sacchari Lactis gr. xxx 2 00 M. (non trit.) ft. cht. no. iv. Sig.-One every hour. SAPO. SAPO MOLLIS. 283 This is probably best given in the early morning and followed in a few hours by an active purgative. The advantage is an empty stomach and upper intestine, and the patient being under better observation (for toxic symptoms). The common practice of people purchasing and administering the ready-prepared worm candy and syrupsi should be unqualifiedly discouraged. SAPO. Latin, Sapo. Eng., Soap. Synonym, White Castile Soap, Hard Soap. Soap prepared from olive oil and sodium hydroxide. Preparations. Linimentum Saponis. Eng., Soap Liniment. Synonym, Liquid Opo- deldoc. Soap, 60 Gm.; Camphor, 45 Gm.; Oil of Rosemary, 10 Gm.; Alcohol, 700 mils; Water, to 1000 mils. Soap Liniment is contained in Chloroform Liniment. Therapeutic Action.-Detergent, and the liniment is a rube- facient and cutaneous stimulant. Uses.-Soap is used externally as a cleansing agent, and by suppository or enema to empty the bowels. Soap liniment is used as a mild rubefacient and lubricant for massage, and as a vehicle for more active agents. Administration.-Soap Liniment is rather extensively used externally either alone or with other agents, as chloroform or menthol and chloroform in various proportions. See Chloroformum. In the treatment of neuralgia (to be applied with friction along the course of the affected nerve) : Ri or Tinct. Aconiti, Chloroform! aa. f3iv 15 Lin. Saponis ;... q. s. fjiv 120 M. Sig.-Apply as directed. (Poison-label.) SAPO MOLLIS. Latin, Sapo Mollis. Eng., Soft Soap. Synonym, Green Soap. Soap prepared from potassium hydroxide and cottonseed oil. Form.-A soft, unctuous, yellowish-brown mass. 1 Shoemaker: Materia Medica and Therapeutics. 284 SARSAPARILLA. Odor and Taste.-Characteristic odor and alkaline taste. Solubility.-In hot water to nearly a clear liquid. Official Preparations. Linimentum Saponis Mollis. Eng., Liniment of Soft Soap. Synonym, Tincture of Green Soap. Soft Soap, 650 Gm.; Oil of Lavender Flowers, 20 mils; Alcohol, to 1000 mils. Therapeutic Action.-Detergent. Stimulant to the skin. Uses.-The liniment of soft soap is used alone or with other agents as a shampoo in the treatment of diseases of the scalp, and various other skin affections. It is extensively used in place of hard soap for cleansing the skin for surgical procedures. Administration.-Liniment of Soft Soap is extensively used and recommended by the profession, but does not often consti- tute part of a prescription except in dermatological work. Soft Soap is often used in ointments with other agents. Used in an antiparasitic ointment': Bi or • Sulphuris Praecip 3ij 8 Saponis Mollis, Olei Cadini aa. 3j • 4 Adipis Benzoinati q. s. 30 M. Sig.-Apply as directed. SARSAPARILLA. Latin, Sarsaparilla. Eng., Sarsaparilla. The dried root of sev- eral species of S mil ax. Average Dose.-30 grains (2 Gm.). Official Preparations. Fluidextractum Sarsaparillae. Eng., Fluidextract of Sarsaparilla. Average Dose.-30 minims (2 mils). Fluidextractum Sarsaparillae Compositum. Eng., Compound Fluid- extract of Sarsaparilla. Sarsaparilla, 750 Gm.; Glycyrrhiza, 120 Gm.; Sassafras, 100 Gm.; Mezereum, 30 Gm.; Glycerin, Alcohol'and Water, to 1000 mils. Average Dose.-30 minims (2 mils). Syrupus Sarsaparillae Compositum. Eng., Compound Syrup of Sar- saparilla. Fluidextract of Sarsaparilla, 200 mils; Fluidextract of Glycyr- i Stelwagon: Diseases ot the SKin. SASSAFRAS. SCAMMONIA RADIX. 285 rhiza, 15 mils; Fluidextract of Senna, 15 mils; with Oils of Sassafras, Anise and Gaultheria; Sugar and Water. Average Dose.-4 fluidrachms (15 mils). Therapeutic Action.-Has been classed as an alterative, but any virtue is questionable. Uses.-The preparations of sarsaparilla are used as vehicles, particularly for alterative agents. It is a constituent of many pharmaceutical and proprietary remedies. Administration.-Sarsaparilla and its preparations are not now very extensively prescribed. The Compound Syrup is some- times used as a vehicle in the administration of "Mixed Treat- ment." The taste of Sarsaparilla is regarded as very pleasant by some and decidedly disagreeable by others. It is an ingredient in the unofficial Compound Elixir of Salicylic Acid, a rather popular remedy for rheumatism. In the treatment of syphilis: IP or Hydrarg. lodidi Rub gr. iv 26 Potassii lodidi 5iv 4 00 Syr. Sarsaparil. Co q. s. f3vj 180 00 M. Sig.-Teaspoonful in water four times daily. SASSAFRAS. Latin, Sassafras. Eng., Sassafras. The dried bark of the root of Sassafras varifolium. Average Dose.-2% drachms (10 Gm.). Official Constituents. Oleum Sassafras. Eng., Oil of Sassafras. A volatile oil. Average Dose.-3 minims (0.2 mil). Sassafras and the oil are contained in some other official preparations. Therapeutic Action.-Stomachic. The oil is also an irritant. Uses.-The oil is a favorite constituent of household lini- ments, and sassafras is used in the preparation of some pharma- ceutical and proprietary remedies. Seldom prescribed. SC AMMO NITE RADIX. Latin, Scammoniae Radix. Eng., Scammony Root. The dried root of Convolvulus Scammonia. Average Dose.-4 grains (0.250 Gm.). 1 White and Martin: Genito-urinary and Venereal Diseases. 286 SCILLA. SCOPOLAMINE HYDROBROMIDUM. Official Preparation. Resina Scammoniae. Eng., Resin of Scammony. Average Dose.-3 grains (0.25 Gm.). Resin of Scammony is contained in Compound Extract of Colocynth. Therapeutic Action.-Hydragogue purgative. Uses.-Seldom prescribed. SCILLA. Latin, Scilla. Eng., Squill. The bulb of Urginea maritima. Average Dose.-1% grains (0.1 Gm.). Official Preparations. Acetum Scillae. Eng., Vinegar of Squill. Represents 10 per cent, of the drug. Average Dose.-15 minims (1 mil). Fluidextractum Scillae. Eng., Fluidextract of Squill. Average Dose.-D/2 minims (0.1 mil). Syrupus Scillae. Eng., Syrup of Squill. Represents 4.5 per cent, of the drug. Contains some Acetic Acid. Average Dose.-30 minims (2 mils). Syrupus Scillae Compositus. Eng., Compound Syrup of Squill. Synonym, Hive Syrup. Represents Squill 8 per cent., Senega 8 per cent., Antimony and Potassium Tartrate 0.2 per cent. Average Dose.-30 minims (2 mils). Tinctura Scillae. Eng., Tincture of Squill. Represents 10 per cent, of the drug. Average Dose.-15 minims (1 mil). Therapeutic Action.-Expectorant, diuretic, emetic. Uses.-Employed in the treatment of bronchitis, pneumonia, asthma, cardiac diseases, dropsy, etc. Not often prescribed. Administration.-When employed as a diuretic, Powdered Squill is the form of common choice. (See Digitalis.) It is usually combined with other agents and administered in pills or capsules. As an expectorant the syrup is sometimes prescribed. It is usually associated with other agents. Squill and its preparation are not often used by the profession. SCOPOLAMINE HYDROBROMIDUM. Latin, Scopolaminae Hydrobromidum (Gen., Scopolaminae Hy- drobromidi). Eng., Scopolamine Hydrobromide. Synonym, Hyos- cine Hydrobromide. , SENEGA. SENNA. 287 Form.-Colorless crystals. Odor.-Odorless. Solubility.-In 1.5 parts of water or 20 parts of alcohol. Average Dose.-%Oo grain (0.0003 Gm.). Therapeutic Action.-Mydriatic, anodyne, hypnotic, anti- spasmodic, delirifacient. Uses.-Sometimes used for dilating the pupil; also for such conditions as alcoholic psychosis, dementia, etc. Administration.-Used by the physician, but is not often a pre- scription ingredient. It is a dangerous drug even when used with every caution. SENEGA. Latin, Senega. Eng., Senega. Synonym, Senega Snakeroot. The dried roots of Polygala Senega. Average Dose.-15 grains (1 Gm.). Official Preparations. Fluidextractum Senegae. Eng., Fluidextract of Senega. Average Dose.-15 minims (1 mil). Syrupus Senegae. Eng., Syrup of Senega. Represents 20 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Senega is contained in the Compound Syrup of Squill. Therapeutic Action.-Expectorant, diuretic. Uses.-Sometimes used in the treatment of bronchitis. Sel- dom prescribed. SENNA. Latin, Senna. Eng., Senna. The dried leaflets of Cassia acuti- folia or of C. angustifolia. Average Dose.-1 drachm (4 Gm.). Official Preparations. Fluidextractum Sennae. Eng., Fluidextract of Senna. Average Dose.-30 minims (2 mils). Infusum Sennae Compositum. Eng., Compound Infusion of Senna. Synonym, Black Draught. Represents 6 per cent, of Senna with Manna, Fennel and Magnesium Sulphate. Average Dose.-4 fluidounces (120 mils). Syrupus Sennae. Eng., Syrup of Senrfa. Represents 25 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). 288 SERPENTARIA. SERUM ANTIDIPHTHERICUM. Senna is also contained in Compound Syrup of Sarsaparilla and Compound Powder of Glycyrrhiza. Therapeutic Action.-Purgative. Uses.-Senna is a popular remedy of the laity and is a con- stituent of many of the proprietary laxatives and "Liver Medi- cines." Not often prescribed. SERPENTARIA. Latin, Serpentaria. Eng., Serpentaria. Synonyms, Virginia Snakeroot, Texas Snakeroot. The dried rhizome and roots of Aristolochia serpentaria or of A. reticulata. Average Dose.-15 grains (1 Gm.). Serpentaria is also contained in the Compound Tincture of Cinchona. Therapeutic Action.-Classed as a bitter tonic, expectorant, diuretic. Uses.-It is sometimes used as an adjuvant and corrective for other agents in the treatment of anorexia, indigestion, etc., and in the treatment of bronchitis and related conditions. Seldom prescribed. SERUM ANTIDIPHTHERICUM. Latin, Serum Antidiphthericum. Eng., Antidiphtheric Serum, Diphtheria Antitoxin. A fluid having a potency of not less than 250 antitoxic units per mil, separated from the coagulated blood of the horse, Equus Caballus, or other large domestic animal, which has been properly immunized against diphtheria toxin. Average Dose.-Hypodermic, 10,000 units; protective, 1000 units. SERUM ANTIDIPHTHERICUM PURIFICATUM. Latin, Serum Antidiphthericum Purificatum. Eng., Purified Antidiphtheric Serum. Synonyms, Antidiphtheric Globulins, Con- centrated Diphtheria Antitoxin, etc. A solution in physiological solution of sodium chloride of certain antitoxic substances obtained from the blood-serum or plasma of the horse, Equus Caballus, or other large domestic animal, which has been properly immunized against diphtheria toxin. Average Dose.-Hypodermic, 10,000 units; protective, 1000 units. SERUM ANTITETANICUM. 289 Very large doses are sometimes given, particularly in laryngeal infection. The dose should be based on the probable amount of blood in the patient (size of patient). The serum is best injected into the loose connective tissue under the skin, care being taken not to inject into the skin. Probably the most desirable site is over the lower ribs in about the anterior axillary line, or a little to the front of this. The patient is then able to lie on the back or either side. The area should be cleaned, the site of injection touched with tincture of iodine, the skin lifted with the thumb and index finger of the operator's left hand, and the needle inserted with a firm, rapid motion. The pain is less if the liquid is injected slowly. The puncture may be covered with a strip of sterile adhesive plaster for a few hours. Serum Sickness.-Considerable pain at the site of injection is often experienced for a few hours. Sometimes, particularly when the patient has recently been given a serum, toxic symptoms may develop. Acute anaphylaxis is rare, but an elevation of temperature and general discomfort occur often. The most common manifesta- tion is edema and urticaria, developing between the fifth and eighth days after the injection. Sodium bicarbonate, internally and exter- nally, has been extensively used. A hypodermic of 10 to 15 minims (for an adult) of Solution of Adrenalin Chloride (1 to 1000) seems to give excellent results. SERUM ANTITETANICUM. Latin, Serum Antitetanicum. Eng., Antitetanic Serum. Syno- nyms, Tetanus Antitoxin, Lockjaw Antitoxin. A fluid having a potency of not less than 100 units per mil, separated from the coagulated blood of the horse, Equus Caballus, or other large do- mestic animal which has been properly immunized against tetanus toxin. Average Dose.-Hypodermic, 10,000 units; protective, 1500 units. SERUM ANTITETANICUM PURIFICATUM. Eng., Purified Antitetanic Serum. Synonyms, Antitetanic Glob- ulins, Concentrated Tetanus Antitoxin, etc. A solution in physio- logical solution of sodium chloride, of certain antitoxic substances obtained from the blood-serum or plasma of the horse, Equus 290 SERUM ANTITETANICUM SICCUM. Caballus, or other large domestic animal which has been properly immunized against tetanus toxin. Average Dose.-Hypodermic, 10,000 units; protective, 1500 units. SERUM ANTITETANICUM SICCUM. Eng., Dried Antitetanic Serum. Synonyms, Dried Tetanus Anti- toxin, etc. Obtained by the evaporation of either of the two other antitetanic serums. Average Dose.-Hypodermic, 10,000 units; protective, 1500 units. The curative value of Antitetanic Serum is seriously questioned, but its protective value; is beyond dispute. It is the custom to give 1500 units as the protective dose for patients of almost any size or age. The sooner the injection is made after injury the better the pro- tection seems to be. For site of injection, serum sickness and its treatment, see Serum Antidiphthericum. SEVUM PR^PARATUM. Latin, Sevum Praeparatum. Eng., Prepared Suet. Synonym, Mutton Suet. The purified internal fat of the abdomen of the sheep, Ovis aries. Therapeutic Action.-Emollient. Uses.-Employed in pharmaceutical manufacturing, but sel- dom prescribed. SINAPIS ALBA. Latin, Sinapis Alba. Eng., White Mustard. Synonym, Yellow Mustard. The seed of Sinapis alba. Average Dose.-Emetic, 2J4 drachms (10 Gm.). Therapeutic Action.-Emetic, rubefacient, vesicant. Uses.-Extensively used in the form of poultices, plasters, etc., in the treatment of pleurisy, bronchitis, pneumonia, and as a counterirritant for deep-seated pain generally. In the pow- dered form it is a prompt and safe emetic. Administration.-As an emetic a tablespoonful of powdered mustard is given in a glass of warm water. As a counterirritant, a satisfactory formula is one heaping tablespoonful of powdered mustard to eight of flour and the white of one egg and hot water. SINAPIS NIGRA. SODIUM. 291 It is applied hot and allowed to remain until the desired redness has been induced. SINAPIS NIGRA. Latin, Sinapis Nigra. Eng., Black Mustard. Synonym, Brown Mustard. The seed of Brassica nigra. Average Dose.-Emetic, 2% drachms (10 Gm.). Official Preparations and Constituents. Emplastrum Sinapis. Eng., Mustard Plaster. Synonyms, Charta Sinapis, Mustard Paper (U. S. P., viii). A uniform mixture of powdered black mustard (deprived of its fixed oil) and a solution of rubber, spread on paper, cotton cloth, or other fabric. Oleum Sinapis Volatile. Eng., Volatile Oil of Mustard. Synonym, Essential Oil of Mustard. Average Dose.-% minim (0.008 mil). Therapeutic Action.-Emetic, rubefacient, vesicant. Uses.-See Sinapis Alba. The oil is a constituent of many proprietary liniments. It is a powerful irritant. SODIUM. The metal is not official, but the Pharmacopoeia contains the fol- lowing salts and preparations: SODII ACETAS. Eng., Sodium Acetate. Formula, NaC2NaO2- + 3H2O. Form.-Colorless prisms or powder. Odor and Taste.-Odorless. A cooling saline taste. Solubility.-In about 0.8 part of water or 19 parts of alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Diuretic, diaphoretic. Uses.-Seldom prescribed. SODII ARSENAS.-See Arsenum, p. 75. Sodii Arsenas Exsiccatus.-See Arsenum, p. 75. Liquor Sodii Arsenatis.-See Arsenum, p. 75. SODII BENZOAS.-See Benzoates, p. 92. SODII BENZOSULPHINIDUM. Eng., Sodium Benzosulphinide. Synonyms, Sodium-Saccharin, Soluble Saccharin. Average Dose.-3 grains (0.2 Gm.). SODII BICARBONAS (Gen., Sodii Bicarbonatis). Eng., Sodium Bicarbonate. Synonyms, Soda, Cooking Soda. Formula NaHCOs. Form.-A white powder. Odor and Taste.-Odorless. A cooling saline taste. 292 SODIUM. Solubility.-In 10 parts of water. Insoluble in alcohol. Incompatibles.-It is decomposed by acids and acid salts. Average Dose.-15 grains (1 Gm.). Trochisci Sodii Bicarbonatis. Eng., Troches of Sodium Bicarbonate. Each troche contains about 3 grains of Sodium Bicarbonate. Therapeutic Action.-Antacid. Uses.-Extensively used in the treatment of hyperchlorhy- dria, gastric ulcers, "acidosis," etc. Administration.-The following will illustrate some common uses of the drug: Given alone, as in "acid intoxication," it may be ordered as follows (for child 4 years old): B or Sodii Bicarbonatis gr. c Ft. cht. no. x. Sig.-One in water every three hours till relieved. Or: or Hydrarg. Chlor. Mitis gr j 1065 Sodii Bicarbonatis gr. c 6 000 M. ft. cht. no. x. Sig.-One in water every three hours till relieved. The following has been recommended for headache: IP or Acetanilidi Caffeinae Citratae, gr. Ixxij 4 50 Camphorae Monobrom aa. gr. xij 75 gr. xlviij 3|00 Sodii Bicarbonatis M. ft. cap. no. xxiv. Sig.-One every half-hour until six (6) are taken. It may also be ordered for enema: b or Sodii Bicarbonatis . 3j 30| Sig.-Use tablespoonful to half-gallon warm water. 1 Musser and Kelly: Practical Treatment. SODIUM. 293 Used in a preparation for cleansing the nose in infectious diseases: RI or Phenolis Liq Rvj 4 Sodii Bicarb gr. xxx 2 0 Sodii Boratis gr. xl 2 5 Glycerini • f3ij 8 0 Aquse Dest q. s. f5vj 180 0 M. Sig.-Spray as directed. In the treatment of flatulence, hysteria, etc.: $2 or Sodii Bicarbonatis gr. xl 3 Spir. Ammoniae Arom., Tinct. Zingiberis aa. f5ss 15 Spir. Athens q. s. f5ij 60 M. Sig.-Two (2) teaspoonfuls in water. Repeat when necessary. (Shake- label.) SODII BORAS (Gen. Sodii Boratis). Eng., Sodium Borate. Syn- onyms, Borax, Sodium Tetraborate. Formula Na2B40j + I0H2O. Form.-Colorless prisms or white powder. Odor and Taste.-Odorless. A sweetish, alkaline taste. Solubility.-In 15 parts of water. Insoluble in alcohol. Incompatibles.-Mineral acids, most metallic and alkaloidal salts. Average Dose.-12 grains (0.75 Gm.). Sodium Borate is contained in the Ointment of Rose Water. Therapeutic Action.-Antiseptic. Uses.-Sometimes employed with other agents in the treat- ment of nasal catarrh, stomatitis, etc. Administration.-Not often prescribed. The following will illustrate how it may be ordered: In the treatment of chronic nasal catarrh: B3 or Phenolis gr. iv 26 Sodii Bicarb., Sodii Boratis aa. gr. xx 1 30 Glycerini f5iv 15 00 Aquae q. s. f$iv 120 00 M. Sig.-Spray as directed. i Musser and Kelly: Practical Treatment. 2 Shoemaker: Materia Medica and Therapeutics. 3 Hughes: Practice of Medicine. 294 SODIUM. SODII BROMIDUM.-See Bromides, p. 100. SODII CARBONAS MONOHYDRATUS. Eng., Monohydrated Sodium Carbonate. Formula, Na2COs + H2O. Form.-A white powder. Odor and Taste.-Odorless. A strongly alkaline taste. Solubility.-In 3 parts of water. Insoluble in alcohol. Average Dose.-4 grains (0.25 Gm.). Therapeutic Action.-Antacid. Uses.-Seldom used for effect. It is sometimes prescribed in capsules with exsiccated ferrous sulphate so as to form fresh fer- rous carbonate in the stomach. SODII CHLORIDUM. Eng., Sodium Chloride. Synonyms, Salt, Common Salt. Formula, NaCl. Form.-Colorless crystals or white crystalline powder. Odor and Taste.-Odorless. Saline taste. Solubility.-In 2.8 parts of water. Almost insoluble in alcohol. Average Dose.-Emetic, 4 drachms (15 Gm.). Therapeutic Action.-Emetic. An essential agent in metab- olism. Uses.-A valuable emetic, etc., but seldom a prescription in- gredient. Administration.-A teaspoonful of table salt is used to each glass of lukewarm water, and the patient required to take one glass after another until emesis is induced. SODII CITRAS.-See Citrates, p. 23. LIQUOR SOD2E CHLORINATE. Eng., Solution of Chlorinated Soda. Synonym, Labarraque's Solution. An aqueous solution of chlo- rine compounds of sodium, containing not less than 2.5 per cent, of available chlorine. Therapeutic Action.-Antiseptic, disinfectant. SODII CYANIDUM. Eng., Sodium Cyanide. Sodium cyanide replaces potassium cyanide of the U. S. P., viii. Uses.-This drug is seldom a prescription ingredient. It is sometimes used by the profession in solutions of about 1 per cent., to remove the stains of silver nitrate. SODII GLYCEROPHOSPHAS.-See Glycerophosphates, p. 30. SODII HYDROXIDUM. Eng., Sodium Hydroxide. Synonym, Caustic Soda. Form.-Dry, white or nearly white flakes, fused masses or pencils. Odor and Taste.-Odorless. A caustic taste. Solubility.-In about 0.9 part of water. Very soluble in alcohol. SODIUM. 295 Liquor Sodii Hydroxidi. Eng., Solution of Sodium Hydroxide. A colorless aqueous solution containing about 5 per cent, of the drug. Average Dose.-15 minims (1 mil). Therapeutic Action.-Antacid, caustic. Uses.-Seldom prescribed. SODII HYPOPHOSPHIS.-See Hypophosphites, p. 29. SODII INDIGOTINDISULPHONAS. Eng., Sodium Indigotindi- sulphonate. Synonym, Indigo Carmine. SODII IODIDUM.-See Iodides, p. 202. SODII NITRIS (Gen., Sodii Nitritis). Eng., Sodium Nitrite. For- mula NaNO2. Form.-White or nearly white masses, pencils or colorless crystals. Odor and Taste.-Odorless and having a mild saline taste. Solubility.-In about 1.5 parts of water, slightly soluble in alcohol. Incompatibles.-Acetanilide, antipyrine, chlorates, chromates, gold chloride, hypophosphites, iodides, mercury salts, permanganates, sulphites, tannic acid. Average Dose.-1 grain (0.06 Gm.). Therapeutic Action.-Circulatory depressant. Uses.-Used to lower blood-pressure in the treatment of an- gina pectoris, chronic nephritis, etc. Administration.-The dosage as recommended in many works on practice is probably much too high for the average case. It is better to begin with a small dose and gradually increase as the tolerance of the patient is ascertained. Sodium Nitrite is prescribed in solution and should be well di- luted before being administered. It is frequently associated with Sodium Iodide. In the treatment of hypertension: or Sodii Nitritis gr. xvj 1 Sodii lodidi gr. clx 10 Aquae q. s. f&v 120 M. Sig.-Teaspoonful with water or milk two hours after meals. Or: B Sodii Nitritis or gr- l 3 Sodii lodidi . Sj 30 Aquae 60 M. Sig.-Begin with ten (10) drops as directed. 296 SODIUM. SODII PERBORAS. Eng., Sodium Perborate. It contains not less than 9 per cent, of available oxygen. . Average Dose.-1 grain (0.06 Gm.). SODII PHENOLSULPHONAS.-See Phenol, p. 259. SODII PHOSPHAS (Gen., Sodii Phosphatis). Eng., Sodium Phos- phate. Synonym, Sodium Orthophosphate. Formula, Na2HPO4 + I2H2O. Form.-Large colorless prisms of granular salt. Odor and Taste.-Odorless. A cooling, saline but disagreeable taste. Solubility.-In about 2.7 parts of water. Insoluble in alcohol. Average Dose.-1 drachm (4 Gm.). Official Preparation. Sodii Phosphas Effervescens. Eng., Effervescent Sodium Phosphate. A granular powder containing 20 per cent, of Exsiccated Sodium Phos- phate with Citric and Tartaric Acids and Sodium Bicarbonate. Average Dose.-120 grains (8 Gm.). Sodii Phosphas Exsiccatus. Eng., Exsiccated Sodium Phosphate. Sodium Phosphate deprived of its water of crystallization. _ Average Dose.-30 grains (1 Gm.). Unofficial Preparation (U. S. P., viii). Liquor Sodii Phosphatis Compositus. Eng., Compound Solution of Sodium Phosphate. Sodium Phosphate, 1000 Gm.; Sodium Nitrate, Cit- ric Acid, and Distilled Water, to make 1000 mils. Average Dose.-2 fluidrachms (8 mils). Therapeutic Action.-Hydragogue purgative. Uses.-The effervescing salt, particularly, is a popular morn- ing laxative. It is also used in conditions characterized by jaundice. Administration.-Effervescing Sodium Phosphate, if dispensed in boxes, rapidly deteriorates and loses its effervescing quality. As it is a granular salt, it could not readily be emptied from a regular small-mouth prescription bottle. It is put on the market in 2-, 4-, and 16- ounce, large-mouth, colored bottles with special waxed corks and caps. It should be prescribed in these sizes only, so that the original bottle may be dispensed by merely removing the trade label and putting on the one desired. or Sodii Phos. Efferves 120| Sig.-Heaping teaspoonful, in glass of water, on arising. The solution may be ordered as: R or Liq. Sodii Phos. Co 120| Sig.-Two (2) teaspoonfuls, with glass of water, on arising. SODIUM. 297 Sodium Phosphate is often prescribed in bulk to be taken in water. SODII SALICYLAS.-See Salicylates, p. 36. SODII SULPHAS (Gen, Sodii Sulphatis). Eng, Sodium Sulphate. Synonyms, Glauber's Salt, Horse Salts. Form.-Large, colorless prisms. Odor and Taste.-Odorless. A bitter saline taste. Solubility.-In about 1 part of water. Insoluble in alcohol. Average Dose.-4 drachms (15 Gm.). Therapeutic Action.-Hydragogue purgative. Uses.-Sometimes used to produce purgation, particularly when it is desired to deplete the body liquid. Administration.-It is not often prescribed. The following will illustrate its use: As a laxative: R or Sodii Sulphatis Sj 301 Potassii Bitartratis 3ij 601 M. Sig.-Teaspoonful in glass of hot water before breakfast. SODII SULPHIS EXSICCATUS. Eng, Exsiccated Sodium Sul- phite. Form.-White powder. Odor and Taste.-Odorless. A cooling, saline, sulphurous taste. Solubility.-In 2.3 parts of water; sparingly soluble in alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antiseptic. Uses.-Seldom prescribed. SODII THIOSULPHAS. Eng, Sodium Thiosulphate. Synonyms, Sodium Hyposulphite, Hypo. Form.-Colorless prisms. Odor and Taste.-Odorless. A cooling, afterward bitter taste. Solubility.-In about 0.5 part of water. Insoluble in alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antiseptic. Uses.-Used externally for eczema, scabies, tinea, and various other skin diseases. Seldom given internally. Extensively used in photography. Administration.-The following shows how it may be pre- scribed. 298 SPARTEINAE SULPHAS. SPIGELIA. In the treatment of tinea versicolor: B1 or Sodii Thiosulphatis 5iij 12 Glycerini f3ij 8 Aquae q. s. i$iv 120 M. Sig.-Apply frequently. POTASSII ET SODII TARTRAS.-See Potassium, p. 272. SPARTEINE SULPHAS. Latin, Sparteinae Sulphas (Gen., Sparteinse Sulphatis). Eng., Sparteine Sulphate. The sulphate of an alkaloid obtained from Scoparius (Cytisus Scoparius). Form.-Colorless crystals or powder. Odor and Taste.-Odorless. A slightly saline and somewhat bitter taste. Solubility.-In 1.1 parts of water, or 3 parts of alcohol. Average Dose.-% grain (0.01 Gm.). Therapeutic Action.-Diuretic, circulatory stimulant. Uses.-Sparteine sulphate is used in the treatment of heart and kidney conditions. Administration.-The following will illustrate the manner of prescribing: In the treatment of chronic valvular disease: B2 or Strychninae Sulph gr. % 02 Sparteinae Sulph gr. iij 20 Caffeinae Citratae 5ss 2 00 M. ft. cap. no. xij. Sig.-One every four hours. SPIGELIA. Latin, Spigelia. Eng., Spigelia. Synonym, Pinkroot. The dried rhizome and roots of Spigelia marilandica. Average Dose.-60 grains (4 Gm.). Fluidextractum Spigeliae. Eng., Fluidextract of Spigelia. Average Dose.-1 fluidrachm (4 mils). Official Preparation. 1 Hughes: Practice of Medicine. 2 Anders: Practice of Medicine. SPIRITUS MYRCI/E. 299 Therapeutic Action.-Vermifuge. Uses.-Has been used for the removal of roundworms, and in connection with other measures for pinworms. "Pinkroot and Senna" was once a popular remedy for this purpose. Seldom prescribed. Spiritus ^theris.-See /Ether. Spiritus TEtheris Nitrosi.-See /Ether. Spiritus Ammoniae Aromaticus.-See Ammonium. Spiritus Amygdalae Amarae.-See Amygdala. Spiritus Anisi.-See Anisum. Spiritus Aurantii Compositus.-See Aurantium. Spiritus Camphorae.-See Camphora. Spiritus Chloroformi.-See Chloroformum. Spiritus Cinnamomi.-See Cinnamomum. Spiritus Glycerylis Nitratis.-See Glycerylis Nitras. Spiritus Juniperi.-See Oleum Juniperi. Spiritus Juniperi Compositus.-See Oleum Juniperi. Spiritus Lavandulae.-See Oleum Lavandulae Florum. Spiritus Menthae Piperitae.-See Mentha Piperita. Spiritus Menthae Viridis.-See Mentha Viridis. SPIRITUS MYRCI2E. (Not Official.) Latin, Spiritus Myrciae. Eng., Spirit of Myrcia. Synonym, Bay Rum. A liquid containing the Oils of Myrcia, Orange-peel, and Pimenta, in about 65 per cent, alcohol. Bay Rum is a pleasant vehicle for external applications and represents enough aromatic oils and alcohol to have some thera- peutic value. The following will illustrate its use : In the treatment of seborrhea: Bi or Betanaphtholis 5ij 8 Alcoholis fSiij 90 Spir. Myrciac q. s. f3vj 180 M. Sig.-Apply twice daily. In the treatment of alopecia: B2 or Resorcinolis gr. Ixxx 5 0 Phenolis gr. xx 1 3 Spiritus Myrciae q. s. f$iv 120 0 M. Sig.-Apply as directed. 1 Ohmann-Dumcsnil: Diseases of the Skin. 2Stelwagon: Diseases of the Skin. 300 STAPHISAGRIA. STILLINGIA. STRAMONIUM. STAPHISAGRIA. Latin, Staphisagria. Eng., Staphisagria. Synonym, Stavesacre. The ripe seeds of Delphinium staphisagria. Average Dose.-1 grain (0.06 Gm.). Fluidextractum Staphisagriae. Eng., Fluidextract of Staphisagria. Average Dose.-1 minim (0.05 mil). Therapeutic Action.-Irritant, antiparasitic, depressant. Uses.-Has been used in the treatment of scabies, pediculosis, etc. Seldom prescribed. Official Preparation. Latin, Stillingia. Eng., Stillingia. Synonym, Queen's Root. The dried root of Stillingia sylvatica. Average Dose.- 30 grains (2 Gm.). STILLINGIA. Official Preparation. Fluidextractum Stillingiae. Eng., Fluidextract of Stillingia. Average Dose.-30 minims (2 mils). Therapeutic Action.-Has been classed as an alterative. Uses.-It is a constituent of many pharmaceutical and pro- prietary remedies for syphilis, rheumatism, etc. Seldom pre- scribed. STRAMONIUM. Latin, Stramonium. Eng., Stramonium. Synonym, Jamestown (Jimson) Weed. The dried leaves of Datura Stramonium or of Datura Tatula. Average Dose.-1 grain (0.06 Gm.). Extractum Stramonii. Eng., Extract of Stramonium. A soft solid about five times the strength of the crude drug. Average Dose.-Yq grain (0.01 Gm.). The pilular and the powdered extract are both official. Tinctura Stramonii. Eng., Tincture of Stramonium. Represents 10 per cent, of the drug. Average Dose.-8 minims (0.5 mil). Unguentum Stramonii. Eng., Stramonium Ointment. Contains 10 per cent, of the extract (pilular). Official Preparations. STRONTIUM. STROPHANTHUS. 301 Therapeutic Action.-Antispasmodic, anodyne, mydriatic. Uses.-Stramonium is used principally in the treatment of asthmatic attacks. Administration.-The leaves are generally smoked, alone or with other agents. The tincture is sometimes given by mouth, but altogether they are not often prescribed. The following will illustrate a way of ordering the drug. In the form of a cigarette in the treatment of asthma: or Stramonii 5j Sig.-Use as a cigarette when necessary. STRONTIUM. The metal is not official, but the U. S. P. contains the following salts: STRONTII BROMIDUM.-See Bromides, p. 100. STRONTII IODIDUM.-See Iodides, p. 202. STRONTII SALICYLAS.-See Salicylates, p. 36. STROPHANTHUS. Latin, Strophanthus. Eng., Strophanthus. The ripe seed of Strophanthus Kombe or of Strophanthus hispidus. Average Dose.-1 grain (0.06 Gm.). Official Preparation and Constituent. Tinctura Strophanthi. Eng., Tincture of Strophanthus. Represents 10 per cent, of the drug. Average Dose.-8 minims (0.5 mil). Strophanthinum. Eng., Strophanthin. A glucoside or mixture of glucosides obtained from Strophanthus (0.45 to 1 per cent.). Form.-A white or faintly yellowish powder. Odor and Taste.-Odorless. Intensely bitter taste. Solubility.-Very soluble in water; less soluble in alcohol. Average Dose.-Mouth, %o grain (0.001 Gm.) ; intravenous, grain (O.OOO75 Gm.). Therapeutic Action.-Heart tonic and stimulant, vasoconstrictor. Uses.-Tincture of Strophanthus and Strophanthin are used almost exclusively for heart weakness and irregularity. Administration.-The tincture is given by mouth. It is usually prescribed alone. Strophanthin is sometimes employed hypodermically by the physician, but is seldom a prescription SULPHONETHYLMETHANUM. 302 STYRAX. ingredient. Owing to the high toxicity of these agents, the pa- tient should be under the frequent observation of the physician during their use. See Nux Vomica, p. 226. STRYCHNINA. STRYCHNINE NITRAS. See Nux Vomica, p. 226. STRYCHNINE SULPHAS. See Nux Vomica, p. 226. STYRAX. Latin, Styrax. Eng., Storax. Synonym, Liquid Storax. A balsam obtained from the wood and inner bark of Liquidambar orientalis. A semiliquid, grayish, sticky, opaque mass; it deposits, on stand- ing, a dark-brown stratum, and has an agreeable odor and balsamic taste. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Antiseptic, expectorant, carminative. Uses.-It is a constituent of some preparations for bronchitis, etc., but is seldom a prescription ingredient. SULPHONETHYLMETHANUM. Latin, Sulphonethylmethanum (Gen., Sulphonethylmethani). Eng., Sulphonethylmethane. Synonym, Trional. Form.-A colorless crystalline powder. Odor and Taste.-Odorless and almost tasteless. Solubility.-In 200 parts of water; readily soluble in alcohol. Average Dose.-12 grains (0.75 Gm.). Therapeutic Action.-Hypnotic. Uses.-Extensively used to induce sleep when the insomnia is not the result of pain or discomfort. Administration.-This is prescribed alone and usually in powder. To produce sleep: R or Sulphonethylmethani 3j 4| Ft. cht. no. v. Sig.-One at 8 p.m.; repeat at 10 if necessary. If 10 p.m. is the usual time for sleep, one is given two hours before, and is repeated soon after 10 if sleepiness has not been induced. SULPHONMETHANUM. SULPHUR. 303 SULPHONMETHANUM. Latin, Sulphonmethanum (Gen., Sulphonmethani). Eng., Sul- phonmethane. Synonym, Sulphonal. Form.-A colorless crystalline powder. Odor and Taste.-Odorless and nearly tasteless. Solubility.-In 365 parts of water or 60 parts of alcohol. Average Dose.-12 grains (0.75 Gm.). Therapeutic Action.-Hypnotic. Uses.-Sulphonal is used to induce sleep when the insomnia is not the result of pain or discomfort. Administration.-This is prescribed alone and usually in powder. For the relief of insomnia: 3 or Sulphonmethani 3j 4I Ft. cht. no. v. Sig.-One at night if necessary. This is usually given about two hours before the time that it is desired for the patient to sleep, and may be repeated once, if necessary. SULPHUR. Sulphur is official in three forms. SULPHUR SUBLIMATUM. Eng., Sublimed Sulphur. Synonyms, Sulphur, Flowers of Sulphur. Form.-A fine yellow powder. Odor and Taste.-A slight characteristic odor and faintly acid taste. Solubility.-Insoluble in water or alcohol. Average Dose.-1 drachm (4 Gm.). SULPHUR LOTUM. Eng., Washed Sulphur. Prepared by washing Sublimed Sulphur with ammonia water and water. Form.-A fine yellow powder. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water or alcohol. Average Dose.-1 drachm (4 Gm.). Washed Sulphur is contained in Compound Powder of Glycyrrhiza. SULPHUR PR^CIPITATUM. Eng., Precipitated Sulphur. Made by acting upon Sublimed Sulphur with calcium hydroxide, precipitating the solution with hydrochloric acid and washing the precipitate. Official Preparations. 304 SULPHUR. Form.-A fine amorphous powder of a pale lemon-yellow color. Odor and Taste.-Odorless and tasteless. - Solubility.-Insoluble in water or alcohol. Average Dose.-1 drachm (4 Gm.). Unguentum Sulphuris. Eng., Sulphur Ointment. Contains 15 per cent, of Sublimed Sulphur in Benzoinated Lard. Therapeutic Action.-Antiseptic, antiparasitic, laxative, dia- phoretic. Uses.-Internally it is sometimes used as a laxative and as an adjuvant to the bismuth treatment of diarrhea and dysentery. Externally it is extensively employed in the treatment of para- sitic skin diseases, as scabies, tinea, etc. Administration.-Owing to its fine state of subdivision, its purity and freedom from odor and taste, the Precipitated Sul- phur would seem to be the preferable form for medicinal use. Internally Sulphur is not often employed by the profession, though it is sometimes prescribed either alone or with some other agents, as Potassium Bitartrate. Externally it is frequently employed in ointments. In the treatment of grain-itch: Bi or Betanaphtholis gr. xxx 2 0 Sulphuris Praecip gr. xl 2 5 Adipis Benzoinati q. s. 5j 30 0 M. Sig.-Apply as directed. Used as an antiparasitic: B2 or Sulphuris Praecip 3ij 8 Saponis Mollis Olei Cadini aa. 3j 4 Adipis Benzoinati .... q. s. 5j 30 M. Sig.-Apply as directed. Used in the treatment of ringworm of the scalp: $3 or Betanaphtholis 2 Olei Cadini 3j 4 Ung. Sulphuris q- s. 5j 30 M. Sig.-Apply as directed. i Musser and Kelly: Practical Treatment. 2 Stelwagon: Diseases of the Skin. a Ibid. SUMBUL. 305 In the treatment of scabies: H or Sulphuris Loti, Olei Cadini, Cretae Praep aa. 3ij 8 Saponis Mollis 3v 19 Adipis q. s. 3ij 60 M. Sig.-Rub in thoroughly. As an application in pruritic diseases of the skin: Ri Phenolis or 32 Camphorae gr. x 65 Sulphuris Praecip gr. xxx 2 00 Ung. Zinci Oxidi q. s. Sj 30 00 M. Sig.-Apply frequently to irritable surface. Latin, Sumbul. Eng., Sumbul. Synonym, Muskroot. The rhizome and roots of, Ferula Sumbul. Average Dose.-30 grains (2 Gm.). SUMBUL. Extractum Sumbul. Eng., Extract of Sumbul. Average Dose.-4 grains (0.25 Gm.). Fluidextractum Sumbul. Eng., Fluidextract of Sumbul. Average Dose.-30 minims (2 mils). Therapeutic Action.-Classed as a stomachic, carminative, antispasmodic and nervine. Uses.-Employed in the treatment of nervousness, neuras- thenia, hysteria, flatulence, etc. Administration.-The extract is the preparation usually em- ployed. It is given in capsules and generally with other agents. In the treatment of palpitation of hysterical subjects: Official Preparations. $2 or Strychninse Sulph gr. % 02 Zinci Valeratis gr. x 65 Ext. Sumbul gr. x 65 Ext. Hyoscyami gr. v 32 M. ft. cap. no. x. Sig.-One after each meal. 1 Shoemaker: Materia Medica and Therapeutics. 2 Anders: Practice of Medicine. 306 SUPRARENALUM SICCUM. In the treatment of neurasthenia, hysteria, etc.: Ri or Arseni Trioxidi gr. ss 03 Asafoetidse Pulv gr. x 65 Ext. Sumbul, Ferri Sulph. Exsic .aa. gr. xx 1 30 M. ft. cap. no. xx. Sig.-One after each meal. SUPRARENALUM SICCUM. Latin, Suprarenalum Siccum. (Gen., Suprarenali Sicci). Eng., Dried Suprarenals (Glandulae Suprarenales Siccae, U. S. P., viii- Desiccated Suprarenal Glands). The suprarenal glands of animals, which are used for food by man, cleaned, dried, freed from fat, and powdered and containing not less than 0.4 per cent, nor more than 0.6 per cent, of epinephrin, the active principle of the suprarenal gland. One part of Dried Suprarenal represents approximately 6 parts of fresh glands, free from fat. A light, yellowish-brown powder. Average Dose.-4 grains (0.25 Gm.). Epinephrina. Eng., Epinephrine. The blood-pressure-raising prin- ciple of the suprarenal gland. Average Dose.-D/i minims (0.5 mil) of a 1: 1000 solution. Therapeutic Action.-Cardiac stimulant and vasoconstrictor. Uses.-Employed in solutions for local anesthesia. Exten- sively used for asthma, turgescent rhinitis, sinusitis, otitis media, nasal or gastric hemorrhage, nausea, pulmonary edema, hemor- rhoids, etc. Administration.-It should be particularly remembered that these preparations are incompatible with alkalies. The preparation under the trade name Adrenalin is extensively used in the form of the Solution of Adrenalin Chloride 1: 1000, Adrenalin Ointment, Suppositories, Inhalant, etc. For systemic effect the drug is administered by needle. The solution does not keep well, and for hypodermic purposes the aseptic ampoules are desirable. Unofficial Preparation. 1 Shoemaker: Materia Medica and Therapeutics. SUPRARENALUM SICCUM. 307 For preparing small amounts of solutions for local anesthesia, tablets can be obtained (as of novocaine) containing the proper proportion of adrenalin. The dried product, when employed, is usually administered in capsules. As a nasal spray: or Adrenalin Chlor. (Sol. 1:1000) fSiss 6 Liq. Antiseptici fSiij 12 Aquae q. s. fSiij 90 M. Sig.-Use to spray nose every three hours. This is much to be preferred to the common formula calling for the alkaline solution, which rapidly decomposes the adrenalin. In a local anesthetic solution: Bi or Cocainae Hydrochlor gr- j 065 Sodii Chloridi gr. iij 200 Adrenalin Chloridi (Sol. 1:1000) ... IRV 300 Aquae Destillatae .... q. s. fjj 30 000 M. Sig.-Formula. Unless to be used at once, it is better to omit the adrenalin from the prescription, and add it immediately before using. In the treatment of erythema venenatum: B or Cocainae Hydrochlor gr. x 65 Adrenalin Chloridi (Sol. 1:1000) ... Sss 15 00 Aquae Rosae * q. s. 180 00 M. Sig.-Apply every two hours. Syrupus.-See Saccharum. Syrupus Acaciae.-See Acacia. Syrupus Acidi Citrici.-See Acidum Citricum. Syrupus Acidi Hydriodici.-see, lodum. Syrupus Aurantii.-See Aurantium. Syrupus Aurantii Florum.-See Aurantium. Syrupus Calcii Lactophosphatis.-See Calcium. Syrupus Ferri lodidi.-See Ferrum. Syrupus Hypophosphitum.-See Acidum Hypophosphorosum. Syrupus Ipecacuanhae.-See Ipecacuanha. 1 White and Martin: Genito-urinary and Venereal Diseases. 308 TALCUM PURIFICATUM. TEREBINTHINA. Syrupus Lactucarii.-See Lactucarium. Syrupus Picis Liquidae.-See Pix Liquida. Syrupus Pruni Virginianae.-See Prunus Virginiana. Syrupus Rhei.-See Rheum. Syrupus Rhei Aromaticus.-See Rheum. Syrupus Sarsaparillae Compositus.-See Sarsaparilla. Syrupus Scillae.-See Scilla. Syrupus Scillae Compositus.-See Scilla. Syrupus Senegae.-See Senega. Syrupus Sennae.-See Senna. Syrupus Tolutanus.-See Balsamum Tolutanum. Syrupus Zingiberis.-See Zingiber. TALCUM PURIFICATUM. Latin, Talcum Purificatum (Gen., Talci Purificati). Eng., Puri- fied Talc. A purified, native, hydrous magnesium silicate sometimes containing a small amount of aluminum silicate. Form.-A white powder. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water and alcohol. It is used as an absorbent and protective and as a diluent for more active agents in the treatment of many moist skin affections, and for cosmetic purposes. TARAXACUM. Latin, Taraxacum. Eng., Taraxacum. Synonym, Dandelion. The dried rhizome and roots of Taraxacum officinale. Official Preparations. Extractum Taraxaci. Eng., Extract of Taraxacum. Average Dose.-15 grains (1 Gm.). Fluidextractum Taraxaci. Eng., Fluidextract of Taraxacum. Average Dose.-2% fluidrachms (10 mils). Therapeutic Action.-Bitter tonic, laxative. Uses.-Sometimes used as adjuvant to other tonics or purga- tives. Seldom prescribed. TEREBINTHINA. Latin, Terebinthina. Eng., Turpentine. A concrete oleoresin obtained from various species of Pinus. TEREBINTHINA. 309 Turpentine is not now official, but the Pharmacopoeia contains the following: OLEUM TEREBINTHINAE. Eng., Oil of Turpentine. Synonyms, Spirit of Turpentine, Turpentine. A volatile oil distilled from Turpentine. Form.-A thin, colorless liquid. Odor and Taste.-A characteristic odor and taste. Solubility.-Almost insoluble in water. Soluble in 5 parts of alcohol. Oleum Terebinthinae Rectificatum. Eng., Rectified Oil of Turpentine. Form, Odor, Taste, Solubility.-See Oleum Terebinthinae. Average Dose.-5 minims (0.3 mil). Ceratum Resinae. Eng., Rosin Cerate. Synonym, Basilicon Ointment. Rosin, 350 Gm.; Yellow Wax, 150 Gm.; Lard, 500 Gm. Emulsum Olei Terebinthinae. Eng., Emulsion of Oil of Turpentine. Rectified Oil of Turpentine, 15 mils; Expressed Oil of Almond, 5 mils; Syrup, 25 mils; Acacia, 15 Gm.; Water, to 100 mils. Average Dose.-% fluidrachm (2 mils). Linimentum Terebinthinae. Eng., Turpentine Liniment. Rosin Cerate, 650 Gm.; Oil of Turpentine, 350 Gm. TEREBENUM. Eng., Terebene. Obtained by the action of concen- trated sulphuric acid on Oil of Turpentine. Form.-A colorless liquid. Odor and Taste.-An agreeable, thyme-like odor, and an aromatic, some- what terebinthinate taste. Solubility.-Only slightly in water. Soluble in 3 parts alcohol. Average Dose.-4 minims (0.25 mil). Therapeutic Action.-Antiseptic, diuretic, carminative, an- thelmintic, rubefacient, counterirritant. Uses.-Quite extensively employed by mouth, rectum, or as an application for wounds, sprains, rheumatism, intestinal worms, tympanites, typhoid fever, chronic nephritis, bronchitis, etc. Administration.-Bromine, chlorine and iodine are incompat- ible with Oil of Turpentine in concentration, but iodine is some- times prescribed with it when the agents are in very dilute form. Oil of Turpentine is very irritating to mucous membrane; so should always be administered in an emulsion or with some bland oil. The Oil is frequently used in "turpentine stupes" for renal colic, gall-stone colic, intestinal distention, dysentery, etc. They are or- dered prepared by instructing that a tablespoonful of the oil of tur- pentine be used to each bowl of hot water and large folded bath towels or pieces of flannel be wrung out of this and applied as hot Official Constituents and Preparations. 310 TERPINI HYDRAS. as the patient can tolerate. Fresh application is made about every three minutes. In typhoid fever, etc.: or Emul. 01. Terebinth 120| Sig.-Half (%) teaspoonful every four hours. In the treatment of acute bronchitis: Ri Terebeni f3ij or 8 Creosoti f3ss 2 Acaciae Aquae Chloroformi q- s. q. s. f5iij 90 M. ft. emul. Sig.-Teaspoonful with water every four hours. TERPINI HYDRAS. Latin, Terpini Hydras (Gen., Terpini Hydratis). Eng., Terpin Hydrate. Form.-Colorless prisms. Odor and Taste.-Nearly odorless and having a slightly aromatic and somewhat bitter taste. Solubility.-In 200 parts of water or in 13 parts of alcohol. Average Dose.-4 grains (0.25 Gm'.). Therapeutic Action.-Diuretic, antiseptic, lessens bronchial secretion. Uses.-Employed in the treatment of bronchitis, phthisis, whooping-cough, etc.; also for gonorrhea, cystitis, and kindred conditions. Administration.-Usually prescribed in capsules or in hydro- alcoholic solutions such as Aromatic Elixir. TERRA SILICA PURIFICATA. Latin, Terra Salicae Purificata. Eng., Purified Siliceous Earth. Synonyms, Purified Kieselguhr, Purified Infusorial Earth. THEOBROMINE SODIO-SALICYLAS. Latin, Theobrominae Sodio-Salicylas (Gen., Theobrominae Sodio- Salicylatis). Eng., Theobromine Sodio-Salicylate. Synonym, Diu- retin. 1 Hughes: Practice of Medicine. THEOPHYLLINA. THYMOL. 311 Form.-A white powder. Odor and Taste.-Odorless; nearly tasteless. Solubility.-In 1 part of water, slightly soluble in alcohol. Average Dose.-15 grains (1 Gm.). Therapeutic Action.-Diuretic. Uses.-Used in the treatment of those conditions where in- creased diuresis is indicated, as nephritis, dropsy, high blood-pres- sure, etc. Administration.-If the drug has been long exposed to air, it becomes partly insoluble in water, and makes a milky mixture. The fresh powder makes a colorless solution. It is practically always prescribed alone in aqueous solution, as: B Theobrom. Sodio-Salicyl 5iv or 151 Aquae Dest q. s. fSij 601 M. Sig.-Teaspoonful in water every four hours. THEOPHYLLINA. Latin, Theophyllina. Eng., Theophylline. Synonym, Dimeth- ylxanthine. An organic base isomeric with theobromine. It is found in small amounts in tea-leaves (Thea Sinesis) and is also prepared synthetically. A white, odorless, bitter, sparingly soluble powder. Average Dose.-4 grains (0.25 Gm.). THYMOL. Latin, Thymol (Gen., Thymolis). Eng., Thymol. A phenol oc- curring in the volatile oil of thyme and in some other volatile oils. Form.-Large, colorless prisms. Odor and Taste.-An aromatic, thyme-like odor and a pungent, aromatic taste, with a very slight caustic effect upon the lips. Solubility.-In about 1010 parts of water. Soluble in alcohol, oils, etc. Incompatibles.-Should not be triturated with acetanilid, anti- pyrine, camphor, monobromated camphor, hydrated chloral, menthol, phenol, phenyl salicylate, quinine sulphate or prescribed with spirit of nitrous ether or gold salts. Average Dose.-Antiseptic, 2 grains (0.125 Gm.) ; anthelmintic, 15 grains (1 Gm.) per day. 312 THYMOL. Thymolis lodidum. Eng., Thymol Iodide. Synonyms, Thymol Di- iodide, Aristol. A brown or yellowish powder, almost odorless and insoluble in water. Sometimes used as a dusting powder for cutaneous lesions. Seldom employed. Therapeutic Action.-Antiseptic, anthelmintic. Uses.-Principally employed for hookworms; also used in so- lution with other agents as a mouth-wash, nasal spray, gargle, etc., in the treatment of such conditions as nasal catarrh, stoma- titis, pharyngitis and pyorrhoea alveolaris. Administration.-While Thymol is a constituent of some oint- ments, antiseptic solutions, etc., its more common employment is for intestinal parasites, particularly hookworm. For this pur- pose it is usually administered in doses of from 30 to 80 grains. It may be prescribed in a powdered state suspended in water by means of Acacia, but is more commonly administered in capsules, either alone or with sugar of milk. When well triturated with an inert powder, as sugar of milk, it is supposed to be less irri- tating to the gastric mucosa, and less apt to form concretions when the gelatin of the capsule is dissolved. Not more than 5 to 7 grains of the powder should be prescribed to the capsule. As the safety of large doses depends on the com- parative insolubility of the drug in the normal intestinal juices, care should be exercised that the patient has and keeps the intestinal tract free from alcoholics, oils and fats. The drug should be eliminated promptly, as it is slightly soluble even in water. A common method of employment is as follows: Official Salt. or Thymolis gr. L 310 Sacchari Lactis gr. x 6 M. ft. cap. no. xij. Sig.-Take four (4) at 8, 9, and 10 a.m. Written instructions as to diet, purgative, etc., should be given the patient. The following illustrates:- Saturday.-Eat or drink only skimmed milk, buttermilk, rice broth, gelatin, toast, jelly, baked apples, sherbet, tea, coffee, lemorb- ade, water. Nothing but water after 6 p.m. No alcoholics, oil or grease during the day. Sunday.-Take a tablespoonful of Epsom Salt in a glass of hot lemonade at 6 a.m. Take four (4) capsules every hour beginning at 8 a.m. Repeat the salts and lemonade at 11 a.m. THYROIDEUM SICCUM. 313 Take nothing in the way of food or drink but water till 1 p.m. ; can then have dry toast, jelly, gelatin, baked apples, sherbet, tea, coffee, lemonade, grape-juice, oranges. No alcoholics, oils or grease during the day. Monday.-Same diet, etc., as Saturday. When capsules are inadvisable the following may be used in the same way as the prescription just given: or Thymolis gr. l 31 Syrupi Acaciae q. s. f3ij 60 M. Sig.-"Shake." Tablespoonful at 8, 9, 10, and 11 a.m. The following illustrates a somewhat common employment of the drug: In the treatment of dermatitis: Ri or Phenolis Liq f5ss 2 0 Thymolis gr. viij 5 Glycerini f5ss 15 0 Alcoholis 30 0 Aquae q. s. £3viij 240 0 M. Sig.-Apply freely. THYROIDEUM SICCUM. Latin, Thyroideum Siccum (Gen., Thyroidei Sicci). Eng., Dried Thyroids. (Glandulae Thyroideae Siccae-Desiccated Thyroid Glands, U. S. R, viii.) The thyroid glands of animals, which are used for food by man, freed from connective tissue and fat, dried and powdered and con- taining not less than 0.17 nor more than 0.23 per cent, of iodine in thyroid combination. One part of Dried Thyroid corresponds to approximately 5 parts of the fresh glands. A yellowish powder. Average Dose.-1% grains (0.1 Gm.). Therapeutic Action.-Vasodilator; affects metabolism. Uses.-In the treatment of myxedema, cretinism and goiter. Administration.-Probably best given in capsules, also used in tablets. Tinctura Aconiti.-See Aconitum. Tinctura Aloes.-See Aloe. 1 Stelwagon: Diseases of the Skin. 314 TINCTURA. Tinctura Arnicae.-See Arnica. Tinctura Asafoetidae.-See Asafoetida. Tinctura Aurantii Amari.-See Aurantium. Tinctura Aurantii Dulcis.-See Aurantium. Tinctura Belladonnas Foliorum.-See Belladonna. Tinctura Benzoini.-See Benzoinum. Tinctura Benzoini Composita.-See Benzoinum. Tinctura Calumbae.-See Calumba. Tinctura Cannabis.-See Cannabis. Tinctura Cantharidis.-See Cantharis. Tinctura Capsici.-See Capsicum. Tinctura Cardamomi.-See Cardamomum. Tinctura Cardomomi Composita.-See Cardamomum. Tinctura Cinchonas.-See Cinchona. Tinctura Cinchonae Composita.-See Cinchona. Tinctura Cinnamomi.-See Cinnamomum. Tinctura Colchici Seminis.-See Colchicum. Tinctura Digitalis.-See Digitalis. Tinctura Ferri Chloridi.-See Ferrum. Tinctura Gambir Composita.-See Gambir. Tinctura Gelsemii.-See Gelsemium. Tinctura Gentianas Composita.-See Gentiana. Tinctura Guaiaci.-See Guaiacum. Tinctura Guaiaci Ammoniata.-See Guaiacum. Tinctura Hydrastis.-See Hydrastis. Tinctura Hyoscyami.-See Hyoscyamus. Tinctura lodi.-See lodum. Tinctura Kino.-See Kino. Tinctura Lactucarii.-See Lactucarium. Tinctura Lavandulae Composita.-See Oleum Lavandulae Florum. Tinctura Limonis Corticis.-See Limon. Tinctura Lobeliae.-See Lobelia. Tinctura Moschi.-See Moschus. Tinctura Myrrhae.-See Myrrha. Tinctura Nucis Vomicae.-See Nux Vomica. Tinctura Opii.-See Opium. Tinctura Opii Camphorata.-See Opium. Tinctura Opii Deodorati.-See Opium. Tinctura Physostigmatis.-See Physostigma. Tinctura Pyrethri.-See Pyrethrum. Tinctura Quassiae.-See Quassia. Tinctura Rhei.-See Rheum. Tinctura Rhei Aromatica.-See Rheum. Tinctura Sanguinariae.-See Sanguinaria. Tinctura Scillae.-See Scilla. Tinctura Stramonii.-See Stramonium. Tinctura Strophanthi.-See Strophanthus. Tinctura Tolutana.-See Balsamum Tolutanum. Tinctura Valerianae.-See Valeriana. TRAGACANTHA. TRINITROPHENOL. 315 Tinctura Valerianae Ammoniata.-See Valeriana. Tinctura Veratri Viridis.-See Veratrum Viride. Tinctura Zingiberis.-See Zingiber. T0XITABELL2E HYDRARGYRI CHLORIDI CORROSIVE See Hydrargyrum, p. 181. TRAGACANTHA. Latin, Tragacantha. Eng., Tragacanth. Synonym, Gum Traga- canth. The spontaneously dried, gummy exudation from the stems of Astragalus gummifer or from other Asiatic species of Astragalus. Official Preparation. Mucilago Tragacanthae. Eng., Mucilage of Tragacanth. Contains 6 per cent, of the drug. Dose.-Ad lib. Therapeutic Action.-Demulcent. Uses and Administration.-Principally used to render aqueous solutions of insoluble drugs sufficiently thick so that when the bot- tle is shaken the insoluble matter will remain suspended long enough to admit of a dose being poured. TRINITROPHENOL. Latin, Trinitrophenol (Gen., Trinitrophenolis). Eng., Trinitro- phenol. Synonym, Picric Acid. Form.-Pale-yellow prisms or scales. Odor and Taste.-Odorless. An intensely bitter taste. Solubility.-In 78 parts of water or 12 of alcohol. Incompatibles.-Most substances easily oxidized. Is always pre- scribed alone, in solution. Average Dose.-y2 grain (0.03 Gm.). Therapeutic Action.-Antiseptic, germicide, local anesthetic. Uses.-The use of this drug is now almost exclusively confined to the wet dressing of burns. Administration.-Usually prescribed alone in solution. As a dressing, particularly for burns, it may be ordered as follows: or Trinitrophenolis . .. gr. xl 2 5 Alcoholis .. f3iv 15 0 Aquae Dest s. fjviij 240 0 M. Sig.-Use to wet dressing as directed. 316 TRITICUM. ULMUS. It stains tissues a deep yellow, which gradually wears off in a few days. Toxic symptoms may develop from using too strong a solution or applying a weak solution to too large an area. Latin, Triticum. Eng., Triticum. Synonym, Couch-grass. The dried rhizome and roots of Agrophyron repens, gathered in the spring. Average Dose.-2 drachms (8 Gm.). TRITICUM. Fluidextractum Tritici. Eng., Fluidextract of Triticum. Average Dose.-2 fluidrachms (8 mils). Therapeutic Action.-Emollient and demulcent. Uses.-Has been recommended in the treatment of chronic cystitis, prostatitis, urethritis, etc. Seldom prescribed. Trochisci Acidi Tannici.-See Acidum Tannicum. Trochisci Ammonii Chloridi.-See Ammonium. Trochisci Cubebae.-See Cubeba. Trochisci Potassii Chloratis.-See Potassium. Trochisci Sodii Bicarbonatis.-See Sodium. Official Preparation. ULMUS. Latin, Ulmus. Eng., Elm. Synonym, Slippery Elm Bark. The dried bark of Ulmus fulva. Therapeutic Action.-Demulcent, astringent. Uses.-Is sometimes used internally for gastritis, dysentery, cystitis, etc., and externally it is a popular household remedy in the form of poultices, for deep-seated pain. Seldom prescribed. Unguentum.-See Adeps. Unguentum Acidi Borici.-See Acidum Boricum. Unguentum Acidi Tannici.-See Acidum Tannicum. Unguentum Aquae Rosae.-See Rosa. Unguentum Belladonnae.-See Belladonna. Unguentum Chrysarobini.-See Chrysarobinum. Unguentum Diachylon.-See Plumbum. Unguentum Gallae.-See Galla. Unguentum Hydrargyri.-See Hydrargyrum. Unguentum Hydrargyri Ammoniati.-See Hydrargyrum. Unguentum Hydrargyri Dilutum.-See Hydrargyrum. Unguentum Hydrargyri Nitratis.-See Hydrargyrum. Unguentum Hydrargyri Oxidi Flavi.-See Hydrargyrum. URANII NITRAS. UVA URSI. VALERIANA. 317 Unguentum lodi.-See lodum. Unguentum lodoformi.-See lodoformum. Unguentum Phenolis.-See Phenol. Unguentum Picis Liquidae.-See Pix Liquida. Unguentum Stramonii.-See Stramonium. Unguentum Sulphuris.-See Sulphur. Unguentum Zinci Oxidi.-See Zincum. URANII NITRAS. Latin, Uranii Nitras. Eng., Uranium Nitrate. Light-yellow prism, odorless and having a bitter, astringent taste. Freely soluble in water or alcohol. Average Dose.-% grain (0.01 Gm.). Seldom prescribed. UVA URSI. Latin, Uva Ursi. Eng., Uva Ursi. Synonym, Bearberry. The dried leaves of Arctostaphylos Uva-ursi. Average Dose.-30 grains (2 Gm.). Official Preparation. Fluidextractum Uvae Ursi. Eng., Fluidextract of Uva Ursi. Average Dose.-30 minims (2 mils). Therapeutic Action.-Astringent, diuretic. Uses.-Uva Ursi is sometimes used in the treatment of gon- orrhea, cystitis, pyelitis, dropsy, etc. Not often prescribed. VALERIANA. Latin, Valeriana. Eng., Valerian. The dried rhizome and roots of Valeriana officinalis. Principal Constituents.-Valeric Acid, Tannic Acid, etc. Average Dose.-30 grains (2 Gm.). Tinctura Valerianae. Eng., Tincture of Valerian. Represents 20 per cent, of the drug. Average Dose.-1 fluidrachm (4 mils). Tinctura Valerianae Ammoniata. Eng., Ammoniated Tincture of Valerian. Represents 20 per cent, of the drug in Aromatic Spirit of Ammonia. Average Dose.-30 minims (2 mils). Official Preparations. 318 VALERATES, OFFICIAL. Therapeutic Action.-Nerve sedative, antispasmodic. Uses.-The preparations of Valerian are used in the treat- ment of neurasthenia, hysteria, flatulence, incontinence of urine, etc. Administration.-The odor and taste of the preparation is con- sidered very disagreeable by many. The Ammoniated Tincture is the preparation most frequently employed. It is prescribed alone or with other agents. The unofficial Extract is sometimes used. In nervous conditions, as enuresis, etc.: 5 or Tinct. Valerianae 120| Sig.-Teaspoonful in water after meals. In acute indigestion, hysteria, etc.: or Tinct. Valerianae Ammon., Spir. JEtheris aa. f5ss is| M. Sig.-Teaspoonful in water every two hours until relieved. In the treatment of chronic heart disease: Bi or Digitalis Pulv., Quininae Hydrochlor Ext. Valerianae 5j 4 M. ft. cap. no. xxx. Sig.-One three times a day. VALERATES, OFFICIAL. Incompatibles.-Acids, carbonates, most metallic salts. AMMONII VALERAS. Eng., Ammonium Valerate. Form.-Colorless or white plates. Odor and Taste.-Characteristic odor and sharp, sweetish taste. Solubility.-Very soluble in water or alcohol. Average Dose.-8 grains (0.5 Gm.). ZINCI VALERAS. Eng., Zinc Valerate. Form.-White scales or powder. Odor and Taste.-Characteristic odor, and a sweetish, astringent and metallic taste. Solubility.-In about 70 parts of water or 22 parts of alcohol. Average Dose.-2 grains (0.125 Gm.). 1 Musser and Kelly: Practical Treatment. VANILLINUM. VERATRUM VIRIDE. 319 Therapeutic Action.-Nerve sedative, antispasmodic. Uses.-Employed in the treatment of neurasthenia, hysteria, etc. Administration.-The official Valerates are not extensively used. They are best administered in capsules and are most often prescribed with other agents. The unofficial Iron Valerate is sometimes employed. The odor and taste are considered very objectionable by some and are frequently complained of even when the drugs are administered in capsules. In the treatment of palpitation of hysterical subjects: Bi or Strychninae Sulph gr. % 02 Ext. Hyoscyami . • • gr. v 32 Zinci Valeratis gr. x 65 Ext. Sumbul gr. x 65 M. ft. cap. no. x. Sig.-One after each meal. VANILLINUM. Latin, Vanillinum. Eng., Vanillin. White or nearly white crys- talline needles-occurs naturally in vanilla or made synthetically. Average Dose.-% grain (0.03 Gm.). Vanillin is extensively used as a flavoring agent, but is not often a prescription ingredient. VERATRUM VIRIDE. Latin, Veratrum Viride. Eng., Veratrum Viride. Synonyms, Veratrum (U. S. P., viii), American Hellebore, Green Hellebore. The dried rhizome and roots of Veratrum viride. Average Dose.-1 grain (0.06 Gm.). Official Preparations and Constituent. Fluidextractum Veratri Viridis. Eng., Fluidextract of Veratrum Average Dose.-minims (0.1 mil). Tinctura Veratri Viridis. Eng., Tincture of Veratrum Viride. Rep- resents 10 per cent, of the drug. Average Dose.-8 minims (0.5 mil.). Veratrina. Eng., Veratrine. A mixture of alkaloids obtained from the seed of Asagrcea officinalis. 1 Anders: Practice of Medicine. 320 VIBURNUM OPULUS. Form.-A white or grayish-white powder. Odor and Taste.-Odorless, but causing intense irritation and sneezing when even a minute quantity reaches the nasal mucous membrane. An acrid taste, leaving a sensation of tingling and numbness on the tongue. Solubility.-In 1760 parts of water or 2.8 parts of alcohol. Average Dose.-%o grain (0.002 Gm.). Therapeutic Action.-Circulatory depressant, antipyretic, antispasmodic. Uses.-Employed in the treatment of eclampsia, and other conditions characterized by high blood-pressure. Sometimes used in the early stages of acute febrile conditions. Administration.-The tincture of veratrum viride is sometimes given by mouth. It is usually prescribed alone. For eclampsia, the drug is used by hypodermic injection, either the fluidextract, tinc- ture, or veratrine being employed. VIBURNUM OPULUS. (Not Official.') Latin, Viburnum Opulus. Eng., Viburnum Opulus. Synonym, Cramp Bark. The dried bark of Viburnum opulus. Average Dose.-30 grains (2 Gm.). Preparation. Fluidextractum Viburni Opuli. Eng., Fluidextract of Viburnum Opulus. Average Dose.-30 minims (2 Cc.). Therapeutic Action.-Nerve sedative, antispasmodic, diuretic. Uses.-Employed in the treatment of dysmenorrhea, amenor- rhea, threatened abortion, etc. Administration.-Probably the most common employment is in the form of the Elixir, as in the following for dysmenorrhea: or Elix. Viburni Opuli fSj Sig.-Teaspoonful every hour until relieved. VIBURNUM PRUNIFOLIUM. Latin, Viburnum Prunifolium. Eng., Viburnum Prunifolium. Synonym, Black Haw. The dried bark of Viburnum prunifolium or of V. Lentago. Average Dose.-30 grains (2 Gm.). VIRUS VACCINICUM. XANTHOXYLUM. 321 Official Preparations. Extractum Viburni Prunifolii. Eng., Extract of Viburnum Pruni- folium. A powder. Average Dose.-8 grains (0.5 Gm.). Fluidextractum Viburni Prunifolii. Eng., Fluidextract of Viburnum Prunifolium. Average Dose.-30 minims (2 mils). Therapeutic Action.-Nerve sedative, antispasmodic, diuretic. Uses.-Frequently used in the treatment of dysmenorrhea, amenorrhea, threatened abortion, etc. Administration.-The fluidextract is frequently employed and usually alone, as in the following for threatened abortion: or Flext. Viburni Prun Hij 60] Sig.-Teaspoonful three times a day. With many patients the fluidextract produces nausea or even vomiting, so the Elixir (containing 12.5 per cent.) is often the prep- aration of choice or necessity. The following illustrates its use in dysmenorrhea: Sodii Bromidi 3ij or 81 Elix. Viburni Prvn q. s. f5j 30 M. Sig.-Teaspoonful in water every two hours till relieved. VIRUS VACCINICUM. Latin, Virus Vaccinicum. Eng., Vaccine Virus. Synonyms, Smallpox Vaccine, Glycerinated Vaccine Virus, etc. The pustules of vaccinia or cowpox from healthy, vaccinated animals of the bovine species, removed and prepared under aseptic conditions, and made into a smooth emulsion with a glycerin solution. XANTHOXYLUM. Latin, Xanthoxylum. Eng., Xanthoxylum. Synonym, Prickly Ash Bark. The dried bark of Xanthoxylum americanum or of Xanthoxylum Clava-Herculis. Average Dose.-30 grains (2 Gm.). Official Preparation. Fluidextractum Xanthoxyli. Eng., Fluidextract of Xanthoxylum. Average Dose.-30 minims (2 mils). 322 ZINCUM. Therapeutic Action.-Laxative, diuretic, expectorant. Uses.-It is a constituent of many pharmaceutical and pro- prietary preparations that are recommended for syphilis, rheu- matism, scrofula, etc. Seldom prescribed. ZINCUM-Zinc. Official Salts and Preparations. General Incompatibles of Zinc Salts.-Acacia, alkalies, arsenates, carbo- nates, cyanides, phosphates, sulphates, sulphides, lead acetate, lime-water, silver nitrate, tannic acid, milk. ZINCI ACETAS. Eng., Zinc Acetate. Form.-White plates. Odor and Taste.-A faintly acetous odor, and in dilute solutions an astrin- gent, metallic taste. Solubility.-Jn 2.3 parts of water or 30 parts of alcohol. Incompatibles.-See Zincum. Average Dose.-2 grains (0.125 Gm.). Therapeutic Action.-Astringent, antiseptic. Uses.-Its only common use is in the treatment of gonorrhea, when it is prepared by prescribing together zinc sulphate and lead acetate. ZINCI CARBONAS PR^CIPITATUS. Eng., Precipitated Zinc Carbonate. Form.-A white powder. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water or alcohdl. Therapeutic Action.-Astringent, absorbent, protective. Uses.-Sometimes used in the treatment of skin diseases. Not often prescribed. ZINCI CHLORIDUM. Eng., Zinc Chloride. Formula ZnC12. Form.-White or nearly white powder, mass or pencils. Odor and Taste.-Odorless. The dilute solution has an astringent, metallic taste. Tasting is dangerous except when in very dilute solution. ' Solubility.-In 0.25 part of water. Very soluble in alcohol. Incompatibles.-See Zincum. Liquor Zinci Chloridi. Eng., Solution of Zinc Chloride. A colorless liquid containing about 50 per cent, by weight of the salt. Therapeutic Action.-Antiseptic, astringent, escharotic. Uses.-Sometimes used in the treatment of cancer, indolent ulcers, etc. Not often prescribed. ZINCUM. 323 ZINCI OXIDUM. Eng., Zinc Oxide. Form.-A white or yellowish-white powder. Odor and Taste.-Odorless and tasteless. Solubility.-Insoluble in water or alcohol. Unguentum Zinci Oxidi. Eng., Ointment of Zinc Oxide. Contains 20 per cent, of the Zinc Oxide in Benzoinated Lard. Therapeutic Action.-Antiseptic, astringent. Uses.-Extensively used in dusting powders or ointments in the treatment of various skin lesions, as ulcers, eczema, prickly heat, herpes, etc. Administration.-A point of value in using Zinc Oxide is its sticking quality when applied to the surface. The following will illustrate the use of the drug: As a dusting powder in the treatment of hyperidrosis: Hi or Acidi Salicyl. Pulv ; gr. xx 1 3 Acidi Borici Pulv 3j 4 0 Zinci Oxidi Pulv 12 0 M. Sig.-Apply as directed. For prickly heat: R or Acidi Salicylici gr. x 6 Acidi Borici 3j 4 0 Zinci Oxidi 12 0 Amyli 5j 30 0 M. Sig.-Apply as directed. In the treatment of prickly heat: R2 or Acidi Borici, Talci Pur., Zinci Oxidi, Amyli 8 M. Sig.-Apply freely. 1 Stelwagon: Diseases of the Skin. 2 Ibid. 324 ZINCUM. In the treatment of herpes progenitalis: Bi or Zinci Oxidi, Calaminae Praep aa. gr. x 65 Glycerini, Alcoholis aa. nxxij 75 Aquae q. s. fjij 60 00 M. Sig.-Apply freely. (Shake-label.) Used in the treatment of the cutaneous lesions of hereditary syphilis: B2 or Hydrargyri Ammoniati 11 Ung. Zinci Oxidi Sj 30| M. Sig.-Apply as directed. In the treatment of dermatitis: $3 or Phenolis gr. xij 8 Bismuthi Subnit 5iss 6 0 Adipis Lanae Hyd 3ij 8 0 Ung. Zinci Oxidi q. s. 8j 30 0 M. Sig.-Apply locally. ZINCI PHENOLSULPHONAS.-See Phenol, p. 259. ZINCI STEARAS. Eng., Zinc Stearate. Form.-A white powder. Odor and Taste.-A faint odor resembling that of fat. Tasteless. Solubility.-Insoluble in water or alcohol. Therapeutic Action.-Astringent, absorbent. Uses.-Sometimes used in the treatment of various skin lesions. It is employed in dusting powders, ointments, and dry- ing lotions. ZINCI SULPHAS. Eng., Zinc Sulphate. Synonym, White Pre- cipitate. Formula, ZnSO4. Form.-Colorless crystals or granular powder. Odor and Taste.-Odorless and having an astringent, metallic taste. Solubility.-In 0.6 part of water. Insoluble in alcohol. 1 Stelwagon: Diseases of the Skin. 2 Musser and Kelly: Practical Treatment. 8 Ashton: Practice of Gynecology. ZINGIBER. 325 Incompatibles.-See Zincum. Average Dose.-Emetic, 15 grains (1 Gm.). Therapeutic Action.-Astringent, styptic, antiseptic, emetic. Uses.-Sometimes used in the treatment of conjunctivitis, gonorrhea, vaginitis, etc. Not used as an emetic, as more practical agents are usually available. Administration.-The following will show how the drug may be prescribed: In the treatment of gonorrhea: Bi or Zinci Sulphatis gr. xv 1 0 Plumbi Acetatis gr. xx 1 3 Tincturse Opii, Tincturse Catechu aa. f3ij 8 0 Aquae q. s. f3vj 180 0 M. Sig.-Inject after urination. (Shake-label.) ZINCI VALERAS.-See Valerates, p. 318. The unofficial Phosphide is sometimes employed. It is always given in capsules. In the treatment of herpes zoster: $2 or Zinci Phosphidi, Ext. Nucis Vomicae aa. gr. x 65 M. ft. cap. no. xxx. Sig.-One every three hours. ZINGIBER. Latin, Zingiber. Eng., Ginger. Synonyms, Jamaica Ginger, Ginger Root, etc. The dried rhizomes of Zingiber officinalis. Principal Constituents.-Volatile Oil to 2 per cent.), resin, gingerol. Average Dose.-15 grains (1 Gm.). Official Preparations. Fluidextractum Zingiberis. Eng., Fluidextract of Ginger. Average Dose.-15 minims (1 mil). 1 White and Martin: Genito-urinary and Venereal Diseases. 2 Hughes: Practice of Medicine. 326 ZINGIBER. Oleoresina Zingiberis. Eng., Oleoresin of Ginger. Average Dose.-/2 grain (0.03 Gm.). Syrupus Zingiberis. Eng., Syrup of Ginger. Represents 3 per cent, of the drug. Average Dose.-4 fluidrachms (15 mils). Tinctura Zingiberis. Eng., Tincture of Ginger. Synonyms, Essence of Ginger, Extract of Ginger, Jamaica Ginger, etc. Average Dose.-30 minims (2 mils). Tincture of Ginger is contained in Aromatic Sulphuric Acid. Therapeutic Action.-Stomachic, carminative, anodyne. Uses.-The preparations of ginger are used in the treatment of acute indigestion, flatulence, intestinal cramps, dysmenorrhea, etc. The tincture is extensively employed as an intoxicant in pro- hibition districts. Administration.-The following will illustrate the use of the drug: In the treatment of stomatitis: Bi or Potassii Chloratis gr. xxiv 1 5 Tinct. Ferri Chlor iTLxxxvj 2 5 Syr. Zingiberis f3ss 15 0 Aquae . r q. s. fjiij 90 0 - M. Sig.-Teaspoonful in water every two hours. In the treatment of flatulence, hysteria, etc.: $2 or Sodii Bicarbonatis gr. xl 3 Spir. Ammoniae Arom., Tinct. Zingiberis aa. f3ss 15 Spir. ^theris q. s. fSij 60 M. Sig.-Two (2) teaspoonfuls in water. Repeat when necessary. As a flavor, etc., in a prescription for mixed treatment for infantile syphilis: $3 or Hydrarg. Chlor. Corros gr. j 065 Sodii lodidi 3ij 8 000 Syr. Zingiberis 30 000 Aquae q. s. fSij 60 000 M. Sig.-Five (5) drops in milk three times a day. 1 Ruhrah: Diseases of Children. 2 Shoemaker: Materia Medica and Therapeutics. 3 Musser and Kelly: Practical Treatment. INTRODUCTION TO PART II. Prescribing is the final expression of a physician's effort in the treatment of disease. Without the ability to prescribe intelligently, pathology, diagnosis, therapeutics, and all else in practice is almost useless. Imagine a capitalist with a fortune in the bank, but unable to write a check; a singer with an exhaustless knowledge of music, but who cannot control the vocal cords, or a sharpshooter who cannot pull the trigger of his rifle, and a picture is obtained of the practi- tioner who cannot prescribe. Suppose an expert accountant locates in a city and sends this note to Mr. Smith: John Smit, Crescent City, Pelican State, dear Sir: Give this slave 5 slugs. J. W. Would not the recipient reason that courtesy demanded for him the title of Mr., that the writer should go to the trouble to spell his name correctly, that Crescent City and Pelican State are not the proper names for his town and State, that capitals should be properly used, that the writer should know that slaves are things of the past, that slugs is not the proper name for dollars, and that an order should be better signed? Mr. Smith would hardly employ that accountant should he later need the services of one. Yet prescriptions, open to all these and many more criticisms, are daily sent to our drug-stores and sent by our otherwise able physicians. The prescription is often the only written evidence of the physi- cian's ability. It should not only be excellent, but it should represent the acme of perfection. Many of the ideas expressed here are at variance with those of other writers. The only apology offered is the author's conception of the demands of present conditions, based on many years of prac- tical experience behind the prescription case and in the laboratory. 327 PART IL Prescription Writing. METROLOGY. Metrology is the science of measure. The term was originally used to express the measure of distance, but now is understood to include measures of quantity also. Weight is the sum of the attraction of gravity existing between the earth and a body on its surface. The origin of standards for weights and measures is an interest- ing study. Josephus states that Cain after leaving the neighborhood of Eden introduced among his new neighbors means for weighing and measuring. It might be believed that these were also the first crooked weights and measures. The origin of some of the familiar units seems decidedly crude. The grain from a grain of wheat; the foot from the length of the pedal extremity; the cubit, the distance from the elbow to the tip of the fingers; the hand, the distance from the tip of the abducted thumb to the edge of the ulna side of the hand; the span, the distance be- tween the tips of the little finger and the thumb when separated as widely as possible. There are now in use in the United States several standards with which the physician and pharmacist must be familiar. It should be one of the duties of every member of both professions to lend his influence toward the much desired end, that the metric system alone be used by the entire world. Table of Avoirdupois Weights. 437.5 grains (gr.) = 1 ounce (oz.) 16 oz. = 1 pound (lb) 100 lbs. = 1 hundredweight (cwt.) 20 cwt = 1 ton This table is never used in prescribing. These are the weights that are used almost exclusively in buying and selling all solid and many liquid drugs. A physician who orders a "pound" gets an Avoirdupois pound, or 7000 grains. 329 330 PRESCRIPTION WRITING. If he orders an "oz." he receives an Avoirdupois ounce of 437.5 grains, as "oz." stands for the Avoirdupois ounce only. Potent drugs, as strychnine, morphine, etc., are usually handled in %-oz. bottles. It should be remembered that these do not contain % of an Apothecaries' ounce, or 60 grains, but % of an Avoirdupois ounce, or about 54.7 grains. Table of Apothecaries' (or Troy) Weights. 20 grains (gr.) = 1 scruple (9) 3 scruples = 1 drachm (3) 8 drachms = 1 ounce (5) 12 ounces = 1 pound (lb) It should be remembered that the grain here is the same as the Avoirdupois grain. The ounce contains 480 grains as against 437.5 of the Avoirdupois. The pound contains 12 ounces of 480 grains, or 5760 grains in- stead of the Avoirdupois pound of 16 oz. of 437.5 grains each, or 7000 grains. Of this table only the grains, drachms, and ounces should be used in prescription writing. The scruple is still sometimes employed, but its use should be discouraged, as it is altogether unnecessary, and the character when carelessly made or blurred is too easily mistaken for the character for the drachm. Table of Apothecaries' (or Wine) Measure. 60 minims ( tq. ) =1 fluidrachm (f3) 8 fluidrachms = 1 fluidounce (fj) 16 fluidounces = 1 pint (O) 8 pints . = 1 gallon (Cong.) Some points to remember are: The character 5 represents 60 grains, while f3 represents 60 minims. 5 represents 480 grains only, while f§ is necessary to ex- press 480 minims. A minim is not the equivalent of a grain. 480 minims (1 f§) of water weighed at the standard temperature weighs 456.37 grains. This should be remembered for percentage solutions. Specific gravities of liquids vary; a pint of a liquid is not neces- sarily a pound. METROLOGY. 331 Two pints make 1 quart and 4 quarts make 1 gallon, but the em- ployment of the quart is hardly considered good form in medicine and pharmacy. In prescriptions where Apothecaries' weights and measures are employed, quantities are expressed in Roman numerals. In printed matter the small letters are used, while in writing it is necessary to sacrifice grammatical exactness on the altar of caution to the extent of using a capital L as the small letter might be too easily mistaken for an i. It is customary to make the letters harmonize in size, as: It is also customary to draw a line over the letter or group of letters expressing the quantity, and the greatest care should be used in printing them. The numerals i and j should be dotted, but under no circumstances should the others be dotted, as in a hastily written or blurred prescription the pharmacist often depends on the dots to differentiate an indistinct i from an Z or a comma or period, or a j from an imperfectly formed v, as in the following: They should also not be written together as: Final i is made / as an additional safeguard (see above). When poorly written or when an imperfect effort is made to follow the numerals with a comma or period, there is more danger of confus- ing an i than a j with a punctuation mark. The / means the last numeral in that quantity, and any mark following it is understood to be an accident, artefact or punctuation. Table of Approximate Measures. 1 teaspoonful = 1 f3 1 dessertspoonful = 2 f5 1 tablespoonful = 4 f5 1 wineglassful = 2 fS 1 cupful = 4 fS 1 glassful = 8 fS 332 PRESCRIPTION WRITING. It should be remembered that these equivalents are far from cor- rect. It is not unusual to see teaspoonfuls measured that really amount to anywhere from 30 to 120 minims. It is always the better policy to have a family use a graduated glass, which will either be supplied free by the pharmacist as an advertisement or can be pur- chased at a nominal price. When regular spoons, glasses, etc., are used, the physician on his first visit should select the ones that are best suited and have them set aside for the particular use. The so-called "glassful" varies from 6 to 14 ounces. There may be much difference between a tablespoonful of brandy and one of codliver oil, or a glassful of purgative water and one of beer. With the expenditure of a small amount of effort any prescriber can so familiarize himself with spoons and glasses as to readily estimate their capacity. METRIC SYSTEM. The Metric system of weights and measures is a decimal system and possesses as many or more advantages over the common stand- ards as does our money system over that of Great Britain. A great advance will have been made when it is established as the only system for this country as it now is for many others. The idea of the Metric system seems to have originated with the statesman Talleyrand of France, about the year 1790. A committee of scientists appointed to select a definite unit decided upon %ooooooo of the earth's circumference around the poles or, as it is often re- ferred to, /looooooo of a quadrant of the earth's meridian, which is the distance from the equator to the pole. This unit was called a Meter and measures about 39.37 inches. Bars of metal measuring a Meter so constructed as to be the least affected by temperature were made and sent to other civilized nations. It is now claimed that the scientists in calculating this distance made a slight error, but their standard has remained unchanged. Metric weights and measures were made legal in France in 1801 and were made compulsory in 1840. They were made legal, but not compulsory, in England in 1864, and in the United States in 1866. In the present state of things it is not recommended that any but the exceptional use be made of the Metric quantities in writing pre- scriptions. All drug-stores are equipped with Apothecaries' weights and measures, while many do not have the Metric; and where the pharmacist has to transpose the quantities and fill the Metric pre- METRIC SYSTEM. 333 scription by the Apothecaries' table, there is too great a possibility of error. The druggist with few exceptions has learned dosage in the old quantities and is more apt to let an error slip through in checking up a Metric prescription. The compounder may from a lack of familiarity be more apt to make an error in selecting a weight. If he should through error select a drachm instead of a scruple weight for-say calomel-having the . scruple weight and the cor- responding quantity of calomel in mind, instinct would tell him the quantity weighed was too much. This would only obtain in the use of standards with which he was intensely familiar. Some of these reasons may seem far-fetched, but almost any pharmacist of general experience will be reminded of many incidents in his past. The Metric system should be made compulsory by the federal govern- ment, but until that time, and paving the way for that event, it should be thoroughly taught in not only the professional but all schools. It might be practicable for the medical and pharmaceutical societies to arrange for the exclusive adoption (after a reasonable interval) of the system by both professions. The unit of the Metric system is the Meter-39.37 inches, or about three feet three inches and three-eighths of an inch. The unit of the measure of bulk is the Liter. A vessel that is one-tenth of a Meter (a decimeter) in each of its dimensions will hold a Liter. The unit of weight is the Gramme, which is the weight of one cubic centimeter (the cube of one-hundredth of a Meter) of water at 4° Centigrade (39.2° F.). Greater or less quantities are designated by adding prefixes to the particular unit. These prefixes are either Latin or Greek words for 10, 100, 1000, and 10,000. The Latin prefixes are: deci (ten), centi (hundred), and milli (thousand). The Greek prefixes are: Deka (ten), Hecto (hundred), Kilo (thousand), and Myria (ten thousand). The Latin prefix to a unit means that the unit is divided by that amount, as decimeter means %0 of a Meter, centigramme means %oo a Gramme. The Greek prefix to a unit means that the unit is multiplied by that amount, as Dekameter for ten Meters or a Hectogramme for a hundred Grammes. To aid the student in remembering which prefix increases and which decreases, the word "gild" has been suggested as follows: G Greek I increases L Latin D decreases. 334 PRESCRIPTION WRITING. As a precaution against mistakes the Latin prefixes are written with a small letter and the Greek with a capital, as deci and Deka. Changes in the spelling of the original languages have been made where it was thought advisable, as changing the original Greek Deca to Deka to prevent its being mistaken for the Latin deci. The correct pronunciation of these words should be remembered. Meter is pronounced Me-ter, the me having the same sound as the personal pronoun me. Liter is pronounced Le-ter, the le having the same accent as the me in meter. Gramme is pronounced Gram, having the same accent as dram, sham, etc. Centi is pronounced Sen-ti. In this country the simplest English pronunciation is employed. The most frequent errors are made in using the words Me'ter, Liter, Gramme, and Centi. Only a few of the many Metric terms are commonly used. In measures of distance the Kilometer (about % of a mile), the Meter (a little more than a yard), the centimeter (about % of an inch) and the millimeter (about V25 inch). In weights the Kilogramme is used in commerce and is usually simply referred to as a Kilo. The Gramme and fractions of a Gramme and the milligramme are employed. In measures of quantity the Liter and the milliliter and the fractions of them are used. Previous to the ninth revision of the U. S. P., the cubic centi- meter was used instead of the present mil (milliliter). This change was made on account of greater accuracy and convenience, and to secure uniformity between the two pharmacopoeias in the English language. In reading in our money system an item like $25.75 we would not say two eagles, five dollars, seven dimes and five cents, but twenty- five and three-fourths dollars or twenty-five dollars and seventy-five cents. So in the Metric system in reading-say, 25.75 Grammes- we would say twenty-five and three-fourths Grammes, or twenty-five and seventy-five hundredths Grammes, or twenty-five Grammes and seventy-five centigrammes. In prescription writing we use only two units-Grammes and milliliters, abbreviated Gm. and mil. If the quantity is in mils, it is read as mils and fractions of a mil. If a part of a Gramme is not read as a fraction it is read in round numbers of the largest denomination that applies,-as 0.375 METRIC SYSTEM. 335 Gramme may be read as three hundred and seventy-five milli- grammes. A bookkeeper in entering a charge does not use the dollar mark or write the word dollar or cents, but all on the left-hand side of a certain line or decimal point is understood to be dollars and all on the right-hand side to be fractions of a dollar. In writing a prescription it is not customary to write the words Gramme or milliliter or their abbreviations, but as these are the only units used, if the drug is a solid the figures are understood to be for Grammes and fractions of a Gramme, unless specified to the contrary, and if the drug is liquid the figures stand for mils and fractions of a mil, unless otherwise specified. Arabic numerals are used. It is certainly desirable that all prescription blanks for Metric prescriptions have a line near the right-hand margin for use instead of the prescriber having to employ decimal points which are so fre- quently not in line, vertically, and if imperfectly made may be mis- taken or may be obliterated by the wear and tear of being carried in the pocket or being handled on the files of the druggist. It is acknowledged that this is not the general custom in those countries where the system is exclusively used, but it seems desirable and is also rather the custom here. The following illustrates the Metric inscription: Sodii Bromidi 51 Elix. Aromatici q. s. 30 This would represent 5 grammes of sodium bromide and 30 mils of aromatic elixir. It is not written Sodii Bromidi Gm. 51 Elix. Aromatici mil. 30| Or: Gm. or mil. Sodii Bromidi 51 Elix. Aromatici 30| Or: Sodii Bromidi Elix. Aromatici Or: Sodii Bromidi 5. Elix. Aromatici 30. If for any reason it is desired to have the liquid by weight or the solid by measure, then specify, as 336 PRESCRIPTION WRITING. Acidi Hydrochlorici Gm. 10100 Aquae Gm. 21 19 The prescriber can almost without exception follow the regular custom by taking into consideration the specific gravity and pre- scribing more or less bulk should he think a definite weight of a liquid necessary. For example: should he wish about 30 Gm. of glycerin he can prescribe 24 mils, which, instead of Glycerini Gm. 30| would be written Glycerini 24| There seems to be no fixed rule as to the use of ciphers on the right of the decimal line. The custom of bookkeepers in making out statements, etc., is a good one for the sake of appearance. Where fractions occur in one or more items the ciphers are used for the others, as Hydrarg. Chlor. Mitis 125 Sacchari Lactis 1 00 Or: Strychninae Sulph 065 Arseni Trioxidi 065 Ferri Reducti 4 000 Quininae Sulph 4 000 It should be particularly noted that Arabic numerals are used. The Roman numerals are never employed in a Metric inscription. Prescriptions may be readily transposed from one system to the other by remembering only two essential equivalents. 1 Gm. = 15.432 grains 1 mil = 16.23 minims. For average work these may be used approximately as 1 Gm. = 15.5 grains 1 mil = 16 minims. Rules.-To transpose Metric weights to Apothecaries' weights multiply the number of Grammes by 15.432 (or 15.5) to find the number of grains. To transpose Apothecaries' weights to Metric weights, divide the number of grains by 15.432 (or 15.5) to find the number of Grammes. -To transpose Metric measures to Apothe- caries' measures, multiply the number of mils by 16.23 (or 16) to find the number of minims. To transpose Apothecaries' measures to MEDICAL LATIN. 337 Metric measures, divide the number of minims by 16.23 (or 16) to find the number of mils. It is convenient to also remember the following two approximate equivalents. 1 fluidounce = 30 mils. 1 grain = 0.065 Gm. (65 milligrammes). MEDICAL LATIN. The use of the Latin names of drugs in prescription writing seems to be still far from universal adoption. Some teachers, even in the larger medical colleges, openly advise against it. Some of the older practitioners claim that they have not time to learn it, but the general trend is certainly toward its general employment, at least by the bet- ter element of the profession. If Latin could be discarded by all physicians, dentists, and phar- macists it would be in order to discuss the advantage and disad- vantages of its use, but such concert of action is hardly to be hoped for at this time. The Metric system has been adopted in this coun- try for fifty years. Its advantages are unquestioned, yet how far it is from universal employment. The individual is not so much concerned with the question of the general use of Medical Latin as with the proposition-Must he learn it ? The particular school must face the proposition only-Must they teach it? The following facts should be considered: Nearly all medical books having the drugs arranged alphabetic- ally, have them arranged according to their Latin names. For example, the U. S. Pharmacopoeia, U. S. Dispensatory, National Dispensatory, National Formulary, Useful Remedies (A. M. A.) and practically all Materia Medicas. Not knowing the Latin name it would be rather difficult to even locate a drug. Over 90 per cent, of the prescriptions in medical books are in Latin. For example, Anders, Ashton, Musser and Kelley, Keen, Gilliam, Stelwagon, Ruhrah, and most others. Without a knowledge of Medical Latin much of this would be valueless to the reader. The vast majority of prescriptions in current medical literature are in Latin; even those in the Department of Therapeutics of the Journal of the A. M. A. Excluding those calling for proprietary medicines, between 80 and 90 per cent, of prescriptions sent to drug-stores today are in 338 PRESCRIPTION WRITING. Latin. It might, at least, be rather embarrassing to meet other medical men in consultation. As long as some use it, all must be familiar with it. The pharmacist is taught Medical Latin. He regards it as the language of prescribing, and he certainly is favorably impressed by its proper use, and impressing the pharmacist is not to be over; looked. The laity know that it is the usual language for prescribing, and far from resenting its use (as often claimed), they regard it as rather a hallmark of excellence. Nearly all students (about 99 per cent.), on entering a medical college, have studied Latin. The matter to be learned has been greatly magnified, as an hour's study is all that is necessary to master 95 per cent, of the subject and enable a student totally ignorant of the language to correctly give the Latin names of 95 per cent, of all drugs. Most Latin names of drugs are Latinized English; therefore either the whole name or the root is the same. The English name of the drug has been made the Latin name, unless there is some reason to the contrary. When the words are the same except the terminations (as in alkaloids) definite rules apply, and a few simple rulesl cover the entire field. The language of a modern prescription (in this country) is as follows: Printed heading, date, name of patient, etc.-English. Names of Drugs.-Latin. Directions to Druggist.-Latin abbreviations. Directions for1 Patient.-English. The Latin for the directions to the druggist consists of a few abbreviations that are as well known as Mr., Dr., N. Y., La., etc., are to a postmaster. Terminations are never used. Therefore all the Latin necessary is the names of the drugs and the way they should appear on a prescription (Genitive case). This is enormously reduced by the use of abbreviations; for example, the class names as tincture, spirit, etc., and adjectives as compound, exsiccated, etc., are almost always abbreviated (Tinct. Gentianae Co.). An analysis of English prescriptions shows almost as much poor construction as the Latin ones, and the student can probably learn to write one correctly as easily as the other. For example, we MEDICAL LATIN. 339 usually see Tinct. Gentian Co., when in English the adjective should be placed first. The employment of meaningless or undesirable synonyms is also only too common. While a thorough knowledge of Latin is certainly desirable, it is not essential to correct prescription writing. The average Latin scholar, in taking up the study of this subject, has almost as much to learn as the one less fortunate. He should grasp it, however, with greater facility. Leaving out the matter of declension and all else not absolutely necessary, the effort is made to give the reader all the essentials in a few paragraphs arranged on the supposition that he has no knowl- edge whatever of Latin. An official Latin name is in the nominative case. The names of the drugs in a prescription are in the genitive case, as the pre- scription really is an order to the druggist; therefore, the following, R Quininae Sulphatis 3j Ft. cap. xij. would read: "Take thou Of the Sulphate of Quinine, one drachm. Make twelve capsules." In Latin the word of is not written, but the termination of the word to which it belongs is arranged to express it, as Quinina means quinine while quinince means of quinine. The whole matter then resolves itself into knowing the Latin official names of drugs and knowing the change of termination that is necessary when ordering in a prescription. Rules, Groups, and Exceptions. Nouns that in the nominative end in a will in the genitive usually end in ce, as Quinina (nom.), Quininae (gen.). Nouns with the nominative ending ma in the genitive add tis, as Physostigma (nom.), Physostigmatis (gen.). Nouns that in the nominative end in us, um, or on, will in the genitive usually end in i, as Syrupus (nom.), Syrupi (gen.) ; Aconi- tum (nom.), Aconiti (gen.) ; Erythroxylon (nom.), Erythroxyli (gen.). Nouns that in the nominative end in I in the genitive usually add 340 PRESCRIPTION WRITING. is, as Menthol (nom.), Mentholis (gen.). In the case of these nouns the Latin and English name is usually the same, as Alcohol, Thymol, Menthol, etc. Some add Us, as Mel (nom.), Meilis (gen.). Nouns that in the nominative end in x in the genitive end in cis, as Nux (nom.), Nucis (gen.). Nouns that in the nominative end in go in the genitive usually change the o to inis, as Mucilago (nom.), Mucilaginis (gen.). Other nouns with a nominative ending in o in the genitive add nis, as Carbo (nom.), Carbonis (gen.); Sapo (nom.), Saponis (gen.) ; Decoctio (nom.), Decoctionis (gen.). Some nouns with the nominative ending is in the genitive change the is to itis, as Phosphis (nom.), Phosphitis (gen.). Others change the is to idis, as Cantharis (nom.), Cantharidis (gen.). Others do not change in the genitive, as Digitalis (nom.), Digi- talis (gen.). Some nouns are indeclinable, as Buchu (nom.), Buchu (gen.). The following group represents the vast majority of the needs of the prescriber: All metals have the nominative ending um and the genitive i, as Sodium (nom.), Sodii (gen.). The Latin and English names of metals is usually the same, as Potassium, Sodium, Calcium, Lithium, etc. All alkaloids have the nominative ending a and the genitive ce, as Morphina (nom.), Morphinae (gen.). The Latin and English names are the same except the terminations. The English name ends in ine. The Latin name is formed by changing the final e to a. The genitive (prescription) is formed by changing the final a to ce. Mor- phine, Morphina, Morphinae. All glucosides and neutral principles have the nominative ending um and the genitive i, as Strophanthinum (nom.), Strophanthini (gen.). The Latin and English names are the same except the terminations. The English name ends in in. The Latin is formed by adding um. The genitive (prescription) is formed by changing the um to i. Strophanthin, Strophanthinum, Strophanthini. All parts of all names of acids have the nominative ending um and the genitive i, as Acidum Hydrochloricum Dilutum (nom.), Acidi Hydrochlorici Diluti (gen.). The exception is the word Glaciate in Acidum Aceticum Glaciale. The Latin and English names are the same except the terminations. MEDICAL LATIN. 341 In forming the Latin names of the acid radicals in salts the root is always the same. If the English ends in ate (Sulphate) the Latin nominative ends in as (Sulphas), and the genitive (prescription) ends in at is (Sul- phatis). If the English ends in ite (Sulphite) the Latin nominative ends in is (Sulphis), and the genitive (prescription) ends in itis (Sul- phitis). If the English ends in ide (Bromide) the Latin nominative is formed by changing the final e to um (Bromidum), and the genitive (prescription) by changing the um to i (Bromidi). Some exceptions to the rules given for forming the genitive, that are of interest to the prescriber, are: Nom. Aloe Catechu Folia Fructus Indigo Kino Rhus Sassafras Sumbul Gen. Aloes Catechu Foliorum Fructus Indigo Kino Rhois Sassafras Sumbul It will be remembered that the class name of a preparation is usually abbreviated; so the following are not to be memorized, but are given as a matter of interest. It will be noted that the word root is usually the same in Latin and English, so it is usually only necessary to abbreviate the English names to have correct Latin. The following classes of preparations have the nominative a and the genitive ce: Norn. Aqua Massa Mistura Oleoresina Resina Suppositoria Tinctura Eng. (water) (mass) (mixture) (oleoresin) (resin) (suppository) (tincture) Gen. Aquae Massae Misturae Oleoresinae Resinae Suppositoriae Tincturae Abbrev. Mas. Mist. Oleores. Res. Suppos. Tinct. 342 PRESCRIPTION WRITING. The following have the nominative ending um and the genitive i: Nom. Acetum Balsamum Ceratum Coilodium Emplastrum Emulsum Extractum Fluidextractum Glyceritum Infusum Linimentum Oleatum Oleum Unguentum Vinum Eng. (vinegar) (balsam) (cerate) (collodion) (plaster) (emulsion) (extract) (fluidextract) (glycerite) (infusion) (liniment) (oleate) (oil) (ointment) (wine) Gen. Aceti Balsami Cerati Collodii Emplastri Emulsi Extract! Fluidextracti Glyceriti Infusi Linimenti Oleati Olei Unguenti Vini Abbrev. Acet. Bals. Cer. Collod. Emp. Emul. Ext. Flext. Glyc. Inf. Lin. Ung. The following have the nominative and genitive as indicated: Nom. Confectio Mucilago Elixir Liquor Mel Pilulae Pulver Spiritus Syrupus Trochisci Eng. (confection) (mucilage) (elixir) (solution) (honey) (pills) (powder) (spirit) (syrup) (troches) Gen. Confectionis Mucilaginis Elixiris Liquoris Meilis Pilularum Pulveris Spiritus Syrupi Trochiscorum Abb rev. Confec. Mucil. Elix. Liq. Mel. Pil. Pulv. Spir. Syr. Troch. The adjective agrees with the noun it modifies in number, gender, and case, as Compound Tincture of Cinchona-Tinctura Cinchonae Composita. Compound Syrup of Squills-Syrupus Scillae Com- positus. Tincture of Deodorized Opium-Tinctura Opii Deodorati. The following is a list of some of the common adjectives. They are always abbreviated, so it is suggested that a study of terminations is not necessary. It will be noted that usually the abbreviation of the English is also correct Latin. They are given as they appear in the names of official drugs: CONSTRUCTION OF OFFICIAL NAMES. 343 Latin Amara Composita-us Deodoratum Dilutum Dulcis Exsiccatus Flavum Liquefactum Purificatum Rubrum Eng. Bitter Compound Deodorized Dilute Sweet Exsiccated (dried) Yellow Liquefied Purified Red Abb rev. Amar. Comp. (Co.) Deod. Dil. Dulc. Exsic. Flav. Liq. Purif. Rub. Construction of Official Names. In the names of salts the first word is the name of the base, next the acid radical, next the qualifying adjective if there is one, as: Ferri (base) Sulphas (acid radical) Exsiccatus (adjective) This would read: (The) exsiccated sulphate of iron; so ex- siccated and sulphate are in the nominative, while of iron is expressed by using the genitive ending. Therefore: The official name of a salt has first the name of the base, which is in the genitive; next the acid radical in the nominative; next the qualifying adjective, if there is one, in the nominative. In the names of preparations of drugs the class to which it belongs comes first, as tinctura, syrupus, etc. The name of the par- ticular ingredient comes next, as Squill in Syrupus Scillae. The qualifying adjective, if there is one, comes last, as compound in the Compound Syrup of Squills, Syrupus Scillae Compositus. The above would read: (the) compound syrup of squills; so com- pound and syrup are in the, nominative case, while of squills is ex- pressed by the genitive, Scillae. Therefore: In the official names of preparations the name of the class is first and in the nominative case; next is the name of the particular drug and it is in the genitive; next is the qualifying adjective, if there is one, in the nominative. The names of some drugs contain more than one word, when, of course, both words are in the genitive, as Tinctura Belladonna Foliorum, Liquor Potassii Arsenitis, etc. In prescriptions all parts of names are in the genitive. 344 PRESCRIPTION WRITING. In the prescription B Tincturae Opii the druggist is told to Take thou of (the) Tincture of Opium one fluidounce. So that the words Tinctura and Opium must both be put in the Latin genitive case to express the proper meaning. The prescriber should remember the suggestion that a good abbreviation is better than a bad termination; so, when in doubt, abbreviate. Spir. is better than Spirits. ABBREVIATIONS. While the pharmacist must be familiar with all abbreviations that may be used in prescription writing, it is only necessary in a work of this character to call attention to those that it may be to a pre- scriber's advantage to use. 1$, as will be explained, means Take thou or Take thou of. The symbol is also frequently used to represent prescription. For instance, it is customary to order Refill 47,283. Some druggists use, in charging and billing, the symbol Rf. for prescription refilled, as Rf. 47,283 would mean that particular prescription refilled. aa. means of each, and when placed after an item in the inscrip- tion means that the amount following is to be taken of that and each of the ingredients above since a quantity was stated. It should be placed immediately after and on a line with the last item it is to include, as Codeinae Phosphatis gr. iv Potassii Citratis, Sodii Bromidi aa gr. clx q. s. means a sufficient quantity. It is usually understood to mean a sufficient quantity to make up to. ad, meaning to or up to, is gen- erally considered unnecessary when placed after q. s., as q. s. ad. q. s. is placed after the vehicle or excipient, which are ordinarily the last items in the inscription: Sodii Bromidi 5ij Elix. Aromatici q. s. f5j The abbreviation q. s. is also used where the quantity is left to the discretion of the compounder, as in ordering suppositories the prescriber may write: ABBREVIATIONS. 345 Extract! Opii gr. ij Olei Theobromatis q. s. Ft. suppos. no. iv. Or, in abating the unpleasant odor of ichthyol: Ichthyolis 3ij 01. Citronellae q. s. Petrolati 3vj ad means to or up to, and is used after the name of the vehicle. It orders that the agent preceding it should be used in such amount as is necessary to make up to the quantity following, as R Potassii lodidi 5j Aquae ad f When literally translated into English, q. s. ad or even ad may be as good or better than q. s. The principal objection to ad is that it may be mistaken by some for add, and in the prescription just given a fluidounce be used instead of about half of that quantity. ad may also be written so as to read da, while q. s. cannot be mis- taken for anything else. It is understood by all druggists, it is easily written, and it is the abbreviation used for that particular purpose in such a vast majority of instances that its exclusive use would seem desirable. Opt.-optimus-best is used when an excellent quality is desired, and the particular brand is left to the discretion of the pharmacist, as in ordering olive oil or brandy. It is manifestly unreasonable to ex- pect the dispenser to carry all the first-class makes or to expect all to agree as to which is the best, and in such instances to specify a special make may cause delay or other undesirable results : Spir. Vini Gallici, Opt fSvj. Q. R.-quantitum rectum-the quantity is correct. This may be used where the quantity of a medicine is unusual and it is desirable to call the attention of the dispenser to the fact that the prescriber is aware of the condition, but that particular circumstances justify the dose. The abbreviation is placed just after the item to which it calls attention, as Morphinae Sulphatis gr. iv Q. R. If the entire prescription is unusual in dosage the Q. R. may be placed in the lower left-hand corner of the sheet, in which case it should be written in bold letters so as not to escape attention. 346 PRESCRIPTION WRITING. The druggist is required to observe the dosage in a prescription and not fill any that appears excessive unless he is assured of its correctness. He stands between the prescriber and the patient as a safeguard against toxic quantities, and the prescriber's special as- surance is often necessary to prevent delay in delivering. There is danger of arousing the suspicions of the patient or en- tailing inconvenience while the prescriber is being sought to change what is really a correct quantity. As an example of this might be mentioned the use of morphine where the patient has acquired toler- ance, or in the new application of remedies as thymol in uncinariasis, where the former dose was two grains, but as much as fifty to one hundred grains are now prescribed. Much inconvenience was occasioned when the profession first resorted to this application of this drug. Underscoring.-A heavy line under a quantity has the same meaning as Q. R. and is usually more desirable. It is used as Morphinae Sulphatis gr. iv The same method is also used to call attention to a particular word or part of a word, as Acidi Sulphurosi, where it is thought the sulphuric acid might be used. M.-misce-mix or mix thou-is usually written It instructs the compounder to mix the items enumerated above, and is understood to mean that it be done in an intelligent manner. In the majority of instances it is all the compounding instructions necessary. The subject is more fully discussed elsewhere. Ft.-fiat-(plural fiant)-make-means that the drug or drugs of the inscription are to be made into the form specified. The same abbreviation is used to express the singular or plural. Fac.-Make-is not often employed. Chart, (or cht.)-chartula-a small paper. It is used to mean a dose of medicine wrapped up in a small paper. The same abbrevia- tion is used to express any number or case of the word. Chts. should never be used. Chart, cerat.-Chartula cerata-a small waxed paper. Used to mean a dose of medicine wrapped in a small waxed paper. The same abbreviation is used for any number or case. DEFINITION. 347 Cap.-Capsula-a capsule. It is used to mean a dose of medicine put into a capsule. The same abbreviation is used to express any number or case of the word. Caps, should never be used. Pil.-pilula-a pill. The same abbreviation is used to express any number or case. Pill and pils are not correct abbreviations. Suppos.-suppositoria-a suppository. The same abbreviation is used to express any number or case of the word. Non. rep.-non repetatur-not to be repeated (or refilled). This is usually placed in the lower left-hand corner of a prescription that the prescriber does not wish the compounder to refill. Pp.-Pauperismus-a pauper. Used in the lower left-hand cor- ner of a prescription, and is understood to mean that the patient is an object of charity, that the prescriber is rendering his services without charge, and that leniency is asked at the hands of the compounder. The following are frequently employed and hardly need dis- cussions : Sol.-Solutio-a solution. Emul.-Emulsio-an emulsion. No.-numerus-number. Tere bene-rub well. Sig.-signa-write (or write thou). A table of abbreviations will be found elsewhere. DEFINITION. The word prescription comes from the Latin pre and scribo, and means literally written before or that which is written before the ap- plication of the treatment. In its broadest sense it includes any in- structions for the benefit of the patient. It is customary to speak of prescribing forced diet for one patient, of prescribing exercise foi another, or the seashore or the mountains. In its restricted meaning, as it will be employed in this work, a prescription is a written order from a doctor to a druggist for medi- cine for a patient. A layman may send a druggist a written order for a bottle of Compound Syrup of Pine; that would not be con- sidered a prescription. A physician may send a nurse a written order to give the patient a dose of salts; that would not be a prescription. A physician may send a written order to a druggist to pay a patient a dollar on his account; not a prescription. A physician may send a druggist a written order for a pound of chloroform for his obstetrical case; not a prescription, as it is generally understood. 348 PRESCRIPTION WRITING. HISTORY. The history of prescription writing is almost as old as the history of man. Among the most ancient inscriptions now being deciphered are found formulae for preparing medicines. Some of these show that even at the remotest times there was some knowledge of Materia Medica, that this knowledge was employed by some (physicians) in writing instructions (prescriptions) for the preparation of remedies, and there is a reason to suppose that these instructions were ex- ecuted by others (pharmacists). The old Greek legend of 2Esculapius, the God of the Healing Art, associates with him the beautiful Hygeia, who seems to have played the part of druggist. It is known that the priests attached to the temples of these Gods were of two classes, one that visited the sick and the other who remained in the temple and prepared the remedies. The relative duties of the physicians and apothecaries have varied throughout the different periods of the world's history, but there seems to have been at all times a class who, among other duties, wrote prescriptions, and a class at least a part of whose duty was to fill them. The prescription and the treatment of disease have, in the progress of time,,gone through many evolutions. Treatment begin- ning among our Aryan ancestors as songs, dances, and various in- cantations, it was early learned that certain agents, if associated with the other efforts to drive out evil spirits, tended to produce the desired effect, and medicine soon became a partner to religious effort. At some times prescriptions largely took the form of love philters, conjure potions, and like expressions of superstition; but among the fanciful and oft revolting list of ingredients there usually appeared some articles of therapeutic merit. If the statements may be accepted that modern Chinese prescrip- tions are true children of those of our ancestors thousands of years ago, the truth is shown that the intervening centuries have merely devolved and improved what was already an art when the human race first began to write history. PARTS OF A PRESCRIPTION. A prescription should consist of the following seven parts: Date. Name of the patient and information as to age. Superscription, or heading. DATE. NAME OF PATIENT. 349 Inscription, or main body of the prescription. Subscription, or directions to the compounder. Signatura, or directions for the patient. Prescriber's name. A prescription is frequently divided into the superscription, in- cluding all above the list of ingredients; the inscription, including the ingredients and their amounts; the subscription, including all below this, as directions to compounder, directions for patient, and pre- scriber's name. A desirable but not essential part of a prescription is a printed heading, giving the prescriber's name, address, registry number, and other data of interest to the patient and pharmacist. DATE. There is some difference of opinion as to whether or not the pre- scription should be dated by the prescriber, as the compounder must always enter, along with the number and price charged, the date on which the prescription was filled. The present Federal Narcotic Law requires the date on prescrip- tions effected, and the habit of dating all prescriptions is certainly desirable. If a physician retains a carbon copy the date is valuable datum, and( it might be of some advantage on the original in case of legal complications. A good argument for the custom is that the prescrip- tion is a regular order and all orders should bear a date. If the date is placed where it will not interfere with the space required by the compounder, there can be no argument against it. The pharmacist generally uses the lower left-hand corner for entering the number, date, etc.; so the physician should place his date at the upper part of the sheet to avoid any possible confusion. The best place is imme- diately after the name of the city, which should always be at the top of the blank with the physician's name, office address, etc. (See page 384.) NAME OF PATIENT. Information as to the name and age of the patient should appear on every prescription. The best place for this is at the upper part of the sheet, just under the physician's card and the date (see page 384). Among the reasons for giving the name and age of the patient are the following: The pharmacist stands as a safeguard between physician and patient to prevent error in dosage. He is often helpless unless he 350 PRESCRIPTION WRITING. has some idea as to whether the patient is an adult or child and, if a child, how old. If an overdose is prescribed and is dispensed by the compounder, he comes in for a share of the public condemnation, no matter what the circumstances; so, bare justice to the pharmacist demands that he have all necessary information not only for the pa- tient's protection, but for his own. Few drug-stores use the check system, and if they do a customer's check is often lost; so medicines are usually delivered without protection against confusion unless the name of the patient is given. The author, when a pharmacist, had this lesson impressed upon him by the following incident: Two parties left prescriptions, one for a poison to be used as an insecti- cide, the other for a tonic for a tuberculous patient. Both prescrip- tions were to be used "as directed." No name was on either and the insecticide was delivered to the patient for whom the tonic was in- tended, and the error was not discovered until the package was well on its way to a country home many miles from town. Fortunately, a wild ride on a fast horse prevented possible trouble and a lesson for future use was forcibly impressed. The name of the patient is necessary on the prescription so that the compounder may put it on the label of the package for identifica- tion in the home. Mrs. X and her infant daughter may both be under treatment. They may both be taking 2-ounce mixtures of similar appearance. A dose of the child's medicine may not injure the mother, but a dose of hers might prove fatal to the child. The prescriber should see that the patient's name is always en- tered on the label. A physician was recently treating six cases of sickness at one time in the same family. The ages of the patients ranged from one to forty years. It was necessary to give several prescriptions, and on investigation he found the nurse in confusion, as the names of the patients were not on any of the packages. The whole had to be discarded and new medicine ordered. The convenience of the pharmacist must be considered, and the patient's name on each prescription is a great aid to him in charging his work, identifying the prescription for refilling, and in many other ways. The name of the patient on the carbon copy retained by the pre- scriber is of convenience to him in charging his day's work, and is indispensable in filing and keeping his case records. The present Federal Narcotic Law requires the name of the patient on all prescriptions affected. It also requires the patient's address, and the address should be given on all prescriptions, unless NAME OF PATIENT. 351 the prescriber knows the patient to be well known to the pharmacist or the prescription is to be delivered and the medicine received by the patient or someone acting for him. The name of the patient should be the most carefully written part of the whole prescription. If the prescription is left with the patient or. family, they usually try to read it and often the patient's name is the only part intelligible to them. If there is an error in the only part that they can read they have some ground for supposing that there may be errors elsewhere; or, if that part is clumsily writ- ten, they cannot be expected to have too much respect for the rest. The patient may well reason: "If I cannot read my own name, how can the druggist read the rest?" The experienced druggist can usu- ally decipher the names of the drugs, the amounts, and the directions from his knowledge of medical usages, but unless a patient's name is a common one or familiar to him, there is no scheme for deciphering it unless each letter is plainly formed. A label carrying a patient's name improperly transcribed is well calculated to dissipate confidence in the contents of the package. If the patient is a male adult the name should be written, as: or John Blank (adult) ; or, a specific title may be given; for example, If the patient is a female adult the name should be written, as: or Mary Blank (adult). 352 PRESCRIPTION WRITING. It is unnecessary to write Mr. John Blank (adult) or Mrs. John Blank (adult). The humbler the patient, the more he appreciates a title. The physician may know the patient as John, but in this democratic country he may prefer the druggist to know him as Mr. Blank. Young girls and young men are sometimes particularly jeal- ous of titles, and there is no objection to prescribing for the young militia officer as Captain Blank or the country justice as Judge Blank. Other departments of human activity should not be allowed to main- tain a corner on courtesy or policy. If the patient is a child the name should be followed by informa- tion as to age, as: The name should never be followed by a figure only, as Mary Blank (3) ; that might mean either years or months. Mrs. Blank's baby or Baby Blank should never be written, as Mrs. Blank's baby may be one year old today and the dose arranged accordingly, and next year Mrs. Blank may have another baby one month old and get hold of the medicine for the former patient, with unfortunate results. Also the word baby gives only limited information to the pharmacist, as a child often bears the title from the first hour up to five or more years of age. When the prescription is written for more than one patient, the prescriber may so specify, as: The prescription may be written for one patient and written in- structions left as to the use for the others, as Give John a teaspoon- ful of James's medicine every three hours. It sometimes happens, as in prescribing for venereal diseases, that it is inadvisable to give much information as to the identity of the patient. In such cases it is still necessary for the druggist to have some aid in rechecking dosage, identifying the prescription, etc., and THE SUPERSCRIPTION. THE INSCRIPTION. 353 for the doctor in handling his copies. Probably the best method is to merely use initials and give the age data, as: This matter has been treated at some length, as it is a detail sadly neglected by the profession; and when it is so easy to do a thing right, there is little excuse for failure. THE SUPERSCRIPTION. The superscription consists of the sign 1$, which consists of the letter R with an oblique dash across the final stroke. The letter R is an abbreviation for the Latin word Recipe, meaning take or take thou; so it instructs the pharmacist to take of the ingredients men- tioned below the amounts specified. The oblique dash across the final stroke of the R probably is derived from the old symbol n which represented a prayer to Jupiter. It was the custom of the old Roman physicians to begin a prescription with this invocation to their God of Gods to bless the remedies. The theory as to the origin is strengthened by the fact that the early Christian physicians used, instead of it, the cross. The letter R and the symbol are very well represented by our present sign IJ. Another theory is based on the claim that the oblique line was used by the Romans much as we use the period, and that in this instance it has no other meaning. THE INSCRIPTION. The inscription is that part which contains the name of the drug or drugs ordered and the amount desired. It is usually best written in Latin. Some inscriptions may be divided into the following parts: Basis, or principal ingredient. Adjuvant-that which aids the action of the principal ingredient. Corrective-that which modifies some undesirable action of the other ingredients. Vehicle-that which facilitates the dispensing or administration of the other ingredients. 354 PRESCRIPTION WRITING. This is sometimes called the diluent or solvent and in the case of ointments is often called the base. For example: B Chlorali Hydrati 5iss Potassii Bromidi 3iss Syr. Aurantii f5ij Aquae q. s. f3j M. Here the hydrated chloral is the most active agent. The bromide aids the action of the basis. The syrup of orange modifies the un- pleasant taste and tendency to nausea of the other agents. The water dissolves and dilutes. It is often impossible to definitely classify the parts of an in- scription. There may be more than one drug belonging to a class, as sodium bromide and potassium bromide may be ordered in equal amounts in the same prescription. The same agent may act as a member of two or more classes, as in the following, where chloroform-water may be regarded as adjuvant, corrective, and vehicle at the same time: Sodii Bromidi 3ij Aquae Chloroformi q. s. f5j Of course, a large percentage of the prescriptions written only- call for one or two items. Each item and the character expressing its amount should be on one line except under circumstances as mentioned later. In using unruled blanks, care should be exercised that the char- acters designating the quantity of an ingredient should be on a line with the name of the drug. The total amounts of the ingredient should be specified in the inscription. Sometimes a prescriber will specify the amount of each dose, and then order so many of such doses to be made. This practice is to be unqualifiedly condemned. It requires as much writing as the common method. It is so unusual that it may be overlooked or misunderstood by the pharmacist, and an educated physician should not throw the burden of making calculations on a drug clerk of unknown ability. ARRANGEMENT OF INSCRIPTION. 355 The following will illustrate: Hydrarg. Chlor. Mitis gr. j Sacchari Lactis gr. x M. ft. cht. mitte talis no. iij. This was submitted to twenty registered pharmacists in one of our large cities, and five out of the twenty understood that the quantities as given were to be divided into three doses containing % of a grain of calomel to each dose. It is better, for the sake of appearance and conformity to custom, to begin each word, forming a part of the name of an ingredient, with a capital letter, as: Tinct. Opii Camph. Sodii Bromidi. ARRANGEMENT OF INSCRIPTION. Several general methods of arrangements might be suggested, but no one fixed rule will apply to all cases. The items may be arranged in the order of their importance, somewhat as basis, adjuvant, corrective, vehicle; but in many in- stances the basis may consist of more than one drug of practically equal importance, or it is sometimes impossible to definitely fix the items under these heads, as they may merge into each other or one agent may equally belong to more than one class. The items may be arranged with the solids first and the liquids last, these respectively arranged as far as possible in the order of their importance. Where a prescriber is competent to do so, it is often better to list the ingredients in the order in which they should be handled. For example: H Tinct. Ferri Chloridi, Acidi Phosph. Dil., Tinct. Nucis Vomicae aa f3j Syr. Pruni Virg q. s. fivj M. In this instance the Diluted Phosphoric Acid should be added to the Tincture of Ferric Chloride before the next item, which con- tains tannic acid, is added, else iron tannate will be formed and an unsightly mixture result. 356 PRESCRIPTION WRITING. Another example would be: Acetanilidi gr. Ixxx Spir. Ammon. Arom f3j Caffeinae Citratae gr. xxx Sodii Bromidi 7. gr. clx Elix. Aromatici q. s. f$ij M. Here the Acetanilid should be dissolved in the Aromatic Spirit of Ammonia and the Citrated Caffeine and Sodium Bromide should be dissolved in the Aromatic Elixir, and the two solutions then care- fully mixed. Sometimes special instructions may be given as in the following: Phenolis gr. v Camphorae, Chlorali Hydrati aa. gr. xx M. et adde Ung. Aq. Rosae q. s. 5j Here it is desirable to mix the first ingredients which liquefy and then incorporate them with the vehicle. Good judgment should always govern the arrangement in the entire matter of prescription writing, but the prescriber can usually profit by bearing in mind the following suggestions: It is usually best to have the most important ingredients first. It is usually best to have the solids first. If for any reason a special order of mixing is desired, it may often be indicated by arrangement. The vehicle or diluent should always be last and practically always q. s. to make up to the total amount desired. THE SUBSCRIPTION.' The subscription as here considered consists of the prescriber's directions to the compounder. It is usually written in Latin and almost always abbreviated; so the terminations are of no practical importance. The primary consideration, here as elsewhere, is for the pre- scriber to so express his wishes that therfe is no possibility for any 357 THE SUBSCRIPTION. misinterpretation, and if this cannot be done in Latin, it is certainly better to use good English. Many of the abbreviations employed are so commonly used that there is no possibility of any misunderstanding as to what is in- tended, but many of those found in some textbooks and occasionally used are little known and unsafe. Brevity is always a consideration, but should not be used at a sacrifice of completeness. The prescriber should say all that is necessary and then stop. In a large percentage of prescriptions the single abbreviation M. (misce-mix) is all that is required. It is always wise to avoid tell- ing the pharmacist to do something that is obviously necessary, as M. et ft. sol., when the ingredients are such that they could not be mixed without making a solution, or M. et ft. ung. when an ointment is the only possible result of following the directions, M. M. S. A. (mix according to art) is always unnecessary, as the compounder is naturally going to employ the art of compounding to the best of his ability and understanding. When the medicine is to be put into doses it is necessary to indi- cate the form of administration. The directions to the compounder may then be written, as M. ft. cap. no. x, or M. ft. pil. no. x, or M. ft. cht. no. x, etc. • When a special form of preparation is desired and it would be possible to make some other, it is best to specify, as M. ft. emul. When it is desired to emphasize any particular point in com- pounding it may be specified, as when a solution is wished and it will take some effort to get one or more of the ingredients to dissolve. A druggist might not be familiar with the solubilities and merely mix the ingredients without triturating, depending on solution being effected before the preparation reaches the patient. Under such cir- cumstances it is best to specify solution and, if the solid will not then dissolve entirely, the preparation cannot be dispensed without the prescriber's further instruction. An example would be: Acidi Borici gr. Ixxx Aquae Destillatae f^iv M. ft. sol. When it is particularly desired that the ingredients in a powder or ointment should be wpll incorporated, it should be specified. An example would be in the following prescription for the eye: 358 PRESCRIPTION WRITING. Hydrargyri Oxidi Flavi gr. j Petrolati q. s. 3j M. et tere bene. When it is desired to explain at length some particular matter as to the compounding, it is often better to mark in the lower left-hand corner (over), and on the back of the paper explain fully in plain English what is wished. SIGNATURA. The signatura consists of the directions that are to be copied on the label by the compounder for the instruction of the patient or nurse. They should, therefore, always be written so that when copied verbatim et literatim they will constitute the desired label. The prescriber substantially tells the compounder to "write on the label the following," and while the druggist usually is competent and willing to take upon himself the responsibility of writing what he understands the doctor wishes, it still does not make the position of the careless prescriber correct. The point is well illustrated by an incident occurring in a Southern city, where the railway warehouse keeper was in the habit of directing a porter: "Go tell Mr. Blank that if he does not take out his freight I will come up and beat the face off him." The porter would modestly say to Mr. Blank: "The boss say wont you please git out your freight." A new porter finally terminated the custom by delivering the message literally, with dis- astrous results. This understanding of the instruction to the dis- penser bars all Latin abbreviations and, in fact, all but complete plain, every-day English. Dismissing as even not meriting discussion such as Tcaspoonful t. i. d. or q. 3 v. 4 h., we will take up the simple English directions. The directions As directed are justifiable only under rare condi- tions, if ever, and then only when the remedy would hardly admit of injurious use; for example, in the use of mercurial ointment by in- unction ; and then it would be better to indicate something more, as Apply as directed or Apply with massage as directed. In the case of a remedy as a concentrated solution of potassium permanganate to be used in making a vaginal douche, in composing the label the patient's feelings must be considered. Many merely order As di- rected. There are few objections to and many reasons for a label as Use tablespoonfid to gallon of hot water, or Dilute with hot water and use as directed. SIGNATURA. 359 In directing the use of urethral injections it is permissible to put Use as directed; this contraindicates Take as directed, as would also be the case in the douche just mentioned. In fact, where a liquid is not to be administered by mouth, it is wise always to so indicate on the label. Some use instructions as Not to be taken, and, in case of a poison, Poison-not to be taken. Separate labels bearing these and other legends are frequently employed, but it is much more desirable to have pharmacists use a prescription label carrying the printing desired on its face, as a separate label might become detached. It is understood in many places that the part of the signa that the pre- scriber puts in quotation marks may be supplied by dispenser with printed label. For example: Sig.-"Poison." Use to moisten dressing. Sig.-"Not to be taken." Apply to back with massage. Sig.-"For external use." Apply to swelling twice daily. Or, if there is any doubt about the particular druggist under- standing: Sig.- (Poison-label.) Use to moisten dressing. In this connection attention should be called to the many objec- tions to the unfortunate practice of using certain classes of special labels or label information, as "For Cough" or "Teaspoonful every 2 hours for Cough;" "For Fever" or Teaspoonful every 2 hours for fever. For example: In a certain city one "For Diarrhea" pre- scription was used hundreds of times and for scores of patients suf- fering with almost every variety of intestinal disturbance. For the original patient and condition it probably was excellent, from all reports; but when used without the necessary intelligent discrimina- tion, it becomes an injustice not only to the patient but to the original prescriber, who is to some extent held responsible for his remedies, even under these conditions, and he and his confreres sustain a loss of legitimate practice represented by the cases that are cured. This example is merely an illustration of a state of affairs that in some communities, particularly, is unfortunately only too prevalent. The prescriber should always remember that in the greater part of the country the custom of the dispensers giving copies of prescriptions 360 PRESCRIPTION WRITING. on request of patient is so well established that "business judgment" prevents a refusal to conformity. Unnecessary words should be avoided, especially in the case of prescribing pills, capsules, tablets, etc., as these are dispensed in con- tainers that have very limited label space. To illustrate: The label One pill three times a day before meals could be written One before meals or One before each meal, for the reason that where one is to be taken, and there is nothing but pills in the container, the patient hardly needs specific instructions to take a pill. The three times a day may under most circumstances be omitted, as the patient is prob- ably definitely understood to be taking three meals a day. Only in the case of infants or special feeding, where more than three regular meals are being taken, would a question be raised. Directions are frequently put up to a dispenser to be put on a label an inch in diameter, such as Take the capsules an hour apart and three hours after last capsule take a bottle of Citrate of Mag- nesia. Better would be a label Take an hou^ apart and the instruc- tions as to the saline given to the patient on a special sheet of in- structions, as will be discussed later. Care should be used in the arrangement of words. One before each meal in zvater would be better One in zvater before each meal. Or, for example, Teaspoonful on retiring in zvater might appear better as Teaspoonful in zvater before retiring. Where the common quantities as teaspoonful, tablespoonful, and drops are used and the remedy is not for internal use, the first word of the label should so indicate, as Apply teaspoonful to szvelling, Pour tablespoonful on bandage, Put one drop in eyes three times daily. In prescribing powders more label room is available, as they are usually dispensed in envelopes or comparatively large boxes. In the case of liquids the label space available will depend to some extent on the size of the bottle ordered. The label that will fit a half-ounce bottle is so small that only a very few words can be written on it, while a comparatively large label may be used on bottles holding twelve or sixteen ounces, or even on those holding four ounces. It must be remembered that, whatever else may or may not be written on the label, the druggist must have his business card and also put the number and date of the prescription and the name of the doctor and patient, and many also put the name of the clerk compounding the formula. SIGNATURA. 361 The following represent labels that may be used on the various- size containers, and show the other information that must be written in addition to the prescriber's instructions. Of course, these are only rough averages, as there is no uniform- ity in these matters: MAIN STREET PHARMACY Cor. Main and Broad Sts. BLANKVILLE No Dr..................... For Date For 1, and 2 fluidounce bottles. MAIN STREET PHARMACY Cor. Main and Broad Sts. BLANKVILLE No Dr . For Date For 2, 3, and 4 fluidounce bottles. MAIN STREET PHARMACY Cor. Main and Broad Sts. BLANKVILLE No.....................Dr.. For Date For 4, 6, and 8 fluidounce bottles. 362 PRESCRIPTION WRITING. MAIN STREET PHARMACY Cor. Main and Broad Sts. BLANKVILLE No Dr For Date For 6 or more fluidounce bottles. For boxes holding from 1 to 4 capsules or j4-ounce ointment jars. For boxes holding from 4 to 12 capsules or for 1-ounce ointment jars. For boxes holding from 12 to 24 capsules or for larger ointment jars. PRESCRIBER'S NAME. CALCULATING AMOUNTS. 363 Suppository boxes have very little label space. Larger quantities of capsules are put into square boxes, which give more label space. If a "shake" label or other special label is used, less space will be available, as a smaller label will have to be employed. PRESCRIBER'S NAME. The prescriber's name should always be so written as to leave no possible doubt as to identity at any time. When the prescriber uses his own private blanks carrying his name and address, he can naturally take more liberties than when such is not the case. Where the private printed blanks are used it is the custom to merely sign the surname or even that monstrosity of penmanship, the fancy signature, may be permitted. Among the reasons for the foregoing might be mentioned that in the case of those agents which can be dispensed only on physicians' prescriptions it is necessary to have the full signature of the physi- cian. This is now required by the Federal Narcotic Law on all prescriptions affected. If the blank does not carry his name and title his signature should always include his medical degree if the drug is one the sale of which is restricted by law. In cases of unusual or uncertain doses it is only justice to the compounder that the prescription be properly signed to constitute an order in the full legal sense. It is not advisable to force the pharmacist to ask the patient who wrote the prescription. The physician may flatter him- self that every one knows who B or J is, but the compliment may not be fully merited. The patient may leave the prescription to be called for later or to be sent to his address, and after his departure it may develop that it is necessary to communicate with the pre- scriber, and the questions who? when? where? are not answered by the paper in hand. In writing the inscription a matter of some embarrassment to the beginner is calculating the total amount to order of each ingredient. The usual method is to write first the name of each drug, then decide on the number of doses in the prescription, and by making the vehicle q. s. to the desired bulk, or ordering the desired number of capsules, etc., and writing the directions, get the number of doses CALCULATING AMOUNTS. 364 PRESCRIPTION WRITING. fixed before the writer; then beginning with the first drug multiply the amount desired for each dose by the total number of doses of the finished product. For example: B Sodii Bromidi, Elix. Aromatici q. s. fSij Sig.-Teaspoonful in water every three hours. Two fluidounces being the total quantity and a teaspoonful the dose, the number of doses would be sixteen. If ten grains of Sodium Bromide are desired at each dose, the amount would be 16 times 10, or 160 grains. Or: B Quininae Sulphatis Ferri Reducti M. ft. cap. no. xx. Sig.-One after each meal. If it is desired to give two grains of the quinine salt at a dose and there are twenty doses, the amount of the salt would be 20 times 2 grains, or 40 grains. In ointments, etc., the amounts are usually based on per cent.; Phenolis, Petrolati q. s. M. Sig.-Apply twice daily. If it is desired to use about 1 per cent, of Phenol the calculation is 1 per cent, of 480 grains, or 4.8 gr. (or about 5 grains) total quan- tity of phenol. A method sometimes used for calculating approximate amounts is as follows: Base the calculations on an 8-fluidounce prescription with tea- spoonful doses. This would give about 60 doses to the entire quan- tity. For each ingredient write for as many drachms or fluidrachms as it is desired to give grains or minims at a dose. For example: B Sodii lodidi, Elix. Aromatici q. s. fSviij M. Sig.-Tcaspoonful in water three times a day. CHOICE OF VEHICLE. 365 This would give about 60 doses, and as a drachm is 60 grains, each dose will contain about as many grains as there are drachms in the total quantity of the salt. If it is desired to give 5 grains at a dose write for 5 drachms of the salt. A 4-fluidounce prescription would naturally require one-half the number of drachms or fluidrachms as grains or minims were desired at a dose. Fluid prescriptions of any size may be adjusted on this basis. The same rule would apply in writing for 60 pills or cap- sules or greater or less amounts adjusted as in the case of fluids. In metric prescriptions the following excellent scheme has been suggested: A gramme or a mil contains about 15 or 16 grains or minims respectively. The slight difference is immaterial. In ordering fluid preparations base the calculations on a 60 mil quantity (about 2 fluid- ounces) with teaspoonful doses; this will give about 16 doses. For each item (except, of course, the vehicle) write for as many grammes or mils as it is desired to give grains or minims at a dose. For example: B Sodii Bromidi, Elix. Aromatici q. s. 60| M. Sig.-Teaspoonful in water every three hours. As this would contain about 16 doses and a gramme is about 16 grains, for each gramme of the salt ordered the patient would get a grain at a dose. So if it is desired to give ten grains of the salt at a dose, write for ten grammes in the inscription. Larger or smaller prescriptions can be arranged on the same basis. In ordering capsules, pills, etc., if the prescription calls for 15 or 16 the patient will get as many grains in each dose as there are grammes in the total quantity. Prescriptions for greater or less num- ber can, of course, be calculated on the same basis. The scheme is too simple and its advantages too obvious to require discussion. It is a safe plan to calculate the amounts by one of the methods mentioned and, in recheeking, to use another, as this reduces the chance for error to a minimum. In selecting a vehicle for a liquid prescription the prescriber must consider its solvent action, compatibility, taste, odor, color, and cost. CHOICE OF VEHICLE. 366 PRESCRIPTION WRITING. Solvent Action.-If it is desired to administer a drug in solution the vehicle must naturally be one that will dissolve that particular substance. This matter is discussed at some length elsewhere, but the following general rules will bear repetition: Salts (metallic or alkaloidal) and gums are usually more soluble in aqueous liquids. Alkaloids, oils, resins, oleoresins, and some coal- tar products are more soluble in alcoholic liquids. If it is desired to administer a drug in suspension the vehicle must naturally be one that will not dissolve that particular drug. Compatibility.-This is taken up in detail on page 397. Taste.-The matter of taste is one that cannot be overlooked. Unpleasant developments, as nausea and vomiting, may result from a disagreeable preparation. The patient may, if an adult, refuse to take the medicine, and, if a child, the struggle to administer the dose may often more than counterbalance the good effect of the remedy. To a certain extent the people demand to be cured not only quickly but pleasantly, and if one physician can not or will not do it another will. Odor.-Disagreeable odors are usually unnecessary and possess all the bad features mentioned in regard to taste. Color.-Under this head might be included the matter of general appearance. When it is possible to do so without a sacrifice of qual- ity, it is certainly better to order a preparation that will be elegant in appearance. Color often has some psychic effect. It is very common to hear a patient rail against the doctor who "did not give me any- thing but water." Cost.-This is often a factor. Unless there is a definite reason for so doing, an expensive vehicle should not be employed. The remark is common when a doctor writes for an expensive proprietary q. s.: "I do not think that it is much good, but it makes a good vehicle." The patient has to pay for that good vehicle. The following very imperfect list of vehicles are among those worthy of special mention: Water should be considered as the one great vehicle, and em- ployed unless there is some reason against its use. Make it the agent of first thought in prescribing solutions, and elaborate from it. Distilled Water is valuable when it is desired to use a vehicle free from matter that might result in chemical action, as in pre- scribing silver nitrate, etc. CHOICE OF VEHICLE. 367 Peppermint-water, Cinnamon-water, and Chloroform-water are valuable where there is nausea and for disguising the taste of many salts. Aromatic Elixir, which contains about 25 per cent. Alcohol, is a very valuable vehicle. It is a good solvent, has a pleasant taste and odor, and the alcoholic content makes it a good preservative. It is particularly desirable in prescribing such salts as the bromides, alkaloidal salts, etc. Syrup of Tolu, Syrup of Lemon, Syrup of Wild Cherry, and Syrup of Squills are used particularly in prescribing cough mixtures. They are used as the vehicle alone or with water. Mucilage of Acacia, Syrup of Acacia, and Syrup are frequently employed when insoluble agents are to be suspended in a liquid. Compound Tincture of Gentian and Compound Ticture of Cin- chona are used as vehicles in prescribing bitter tonics. They, of course, are not compatible with ferric salts. They contain about 50 per cent, alcohol, which must be taken into consideration. Tincture of Sweet Orange and Compound Spirit of Orange are good alcoholic vehicles, particularly for such drugs as creosote, guaiacol, etc. Alcohol is an indispensable part of many other vehicles and is frequently used alone, as when prescribing agents requiring its sol- vent effect or preservative action. Glycerin is frequently employed alone or in connection with other vehicles, particularly for such agents as phenol, iodine, tannic acid, etc. Soap Liniment is a useful vehicle in prescribing liniments. To it can be added such agents as chloroform, menthol, etc. Liquid Petrolatum is the vehicle of common choice for prescrib- ing oil-soluble drugs as sprays, particularly such agents as camphor, menthol, and the volatile oils. Sugar of Milk is the most commonly used vehicle in prescribing powders. It is an inert, white powder, without odor and of a mildly sweet taste. Aromatic Powder is a finely powdered mixture of spices, and is often useful in disguising taste and odor and in giving bulk and color to powders. Petrolatum for ointments occupies the place that water does for solutions. It should be the vehicle used unless there is some reason to the contrary. It is inert, odorless, clean, and permanent. Ointment of Rose-water is an excellent ointment base. 368 PRESCRIPTION WRITING. Hydrous Wool-fat is used as a vehicle in ointments when absorp- tion of the active agent is desired. QUANTITY OF A PRESCRIPTION. Only a comparatively small percentage of the medicine manufac- tured is actually taken by patients. Much is lost from one cause and another while still in the hands of the manufacturer. The ware- houses of the wholesale druggists are fairly packed with medicine that has spoiled, is out of date, unpopular, etc. A good part of the retailers' gross profits are represented by similar articles, and last, but not least, almost every family has a medicine chest which, in spite of frequent "cleaning ups," contains the remains of many prescriptions usually representing the poor judgment of the prescriber. The cus- tom of prescribing in quantities too large has many objections. The patient is put to unnecessary expense; the unused portion remains as a monument to the doctor's error, for it is usually an error to pre- scribe more than a patient needs.. The patient feels that if the physi- cian had understood the case he would not have prescribed two or three times more than was necessary. It may be used in subse- quent sickness with unfortunate results, in that or some other family, or either by its aid or in spite of it the future patients recover without a consultation and the doctor is deprived of a legitimate fee. In many instances even where a considerable quantity of the agent will be used it may be advisable to prescribe comparatively small amounts on account of possible deterioration, as in the case of cer- tain syrups in warm weather. The quantity should usually be such as the prescriber feels reasonably sure the patient will require before deterioration occurs or a change is necessary or a cure is effected. As examples: In prescribing an ointment of yellow mercuric oxide for the eye- lids, 1 drachm is usually all that is necessary. In any event it is enough to order, as the possibility of dust from the atmosphere, dirt from fingers, etc., makes it desirable not to use the same package too long. For a case of scarlatina where it is desired to prescribe a cold- cream application for the skin during desquamation, a half-pound or pound may be ordered at one time to advantage. To break up a cold one dozen capsules may be more than enough, while in prescribing ferrous carbonate for chlorosis a prescription for less than 100 doses will probably be putting the patient to unnecessary trouble and expense. PROPORTIONING DOSAGE. 369 As a rule in conditions of more or less chronic character, where the patient is under observation and the necessity for change pos- sible, from seven to ten days' treatment is a convenient amount. If a liquid is being administered in teaspoonful doses three times a day, three or four fluidounces would be the amount indicated. Sometimes, as in prescribing tonics, it is advisable to order enough to have some effect, particularly if the patient may not be under regular observation. A twenty- or thirty- day treatment may be justified. A study of almost any prescription file shows a distressing num- ber of 16-dose tonics and 64-dose headache mixtures. The prescriber should always remember that too great a dis- crepancy either way between the needs of the patient and the amount of his order shows a lack of grasp of the situation and may well shake the confidence of the patient. With regard to having the pa- tient frequently refill small prescriptions the prescriber should re- member that the druggist justly makes a charge for his time, and usually four two-ounce prescriptions will cost the patients two or three times as much as one eight-ounce prescription calling for the same ingredients. PROPORTIONING DOSAGE. By the dose of a drug is meant the average dose for the average adult under average conditions. Variations from the usual require special consideration. The prescriber must consider the age, size, sex, temperament, habits, and condition of the patient, and the action of the drug employed. Age.-Young's rule is the one most commonly used for propor- tioning the dose for a child. It is: Divide the age of the child in years by the age plus tzuelve to obtain the fraction of the adult dose. For example: If the adult dose of a medicine is 20 grains, to find the dose for a child four years old, divide the age (4) by the age (4) plus 12 to obtain the fraction of 20 grains desired: 4 4 1 1 . ™ e 4 + 12 16 4 * 4 of 20 - S- Five grains would, therefore, be the dose for a child four years old. Another rule is: Make 20 the denominator of a fraction the numerator of which is the age of the child expressed in years. The result is the fraction of the adult dose. By this method if the dose 370 PRESCRIPTION WRITING. for an adult is 20 grains, to find the dose for a child four years old the following would be the calculation: = T 5 01 20 =4' Four grains would, therefore, be the dose required. It will be observed that these rules only apply to those children whose ages are expressed in years. In the case of infants each is a problem unto itself. Size.-The size of a patient is naturally an important factor. It would be manifestly unwise to expect a child four years old and weighing only 20 pounds to tolerate what would be a normal dose for another child of the same age and weighing 40 pounds. A man six feet high and weighing two hundred pounds may require different dosage from one five feet high and weighing one hundred pounds. Sex.-Women are, on the average, smaller than men; their organs are smaller; they have less blood; they are weaker and per- form less work. These facts should receive due consideration in prescribing, and the average dose is usually smaller than for men. There are some exceptions; for example, purgatives, which are gen- erally required in larger doses and stimulants in comparatively smaller doses for women than for men. Temperament.-This in some instances is an important factor. For example: A patient of a highly nervous type can tolerate less strychnine than can one of a phlegmatic temperament. Habit.-This must often be considered. One addicted to opium, alcohol, coffee, etc., will require larger doses of these drugs to pro- duce a desired effect than will one who has not previously used them. A patient who has been taking potassium iodide can frequently be given comparatively large doses without unpleasant effect. Condition.-The condition of the patient is almost always an im- portant consideration. The weak, anemic patient may not be able to tolerate the same dose of a purgative that would be a benefit to one who was of the robust, full-blooded type. A child in the paroxysmal stage of whooping-cough may be given antipyrine to advantage in doses several times the usual proportion. The Drug.-Some drugs are exceptions to the foregoing rules. For example: The same dose of castor oil is usually given to a child over two or three years old as to an adult. Calomel is ordinarily given in comparatively large doses to children, while opium is usu- ally best administered in comparatively small amounts to children. WRITTEN INSTRUCTIONS. 371 WRITTEN INSTRUCTIONS. In connection with the writing of prescriptions, particularly with the matter of the signature, or instructions for label, it is important to consider the means of giving more complete directions to patient or nurse, as it must be remembered that the label space is limited and yet that instructions should be complete. As elsewhere sug- gested, it is best to leave with each case special instructions which may be conveniently written on the regular prescription blanks, and a carbon copy retained by the prescriber and filed with the copies of prescriptions and other data relating to that case. Where a trained nurse is in charge the matter may often be simple, but where, as is usually the case, an anxious and excited mother or wife is the one to look to, the instructions can hardly be too explicit. Where sev- eral medicines are to be given, a time chart is almost indispensable if correctness is to be expected. This, with the other instructions, may be arranged something like the following, which is taken from the instructions left for a case of tonsillitis: 372 PRESCRIPTION WRITING. In arranging the chart after treatment is under way, it is best to list the prescriptions by number. In the written instructions it is particularly desirable to include such items as: Give a tablespoonful of castor oil two hours after last powder; or, If bowels have not acted by noon give enema of half- gallon of warm water with one tablespoonful of table salt; or, If not asleep by eleven o'clock give another powder, but not again during the night. A diet list should always be written and a copy retained by the prescriber. Instructions for modified milk, etc., should always be written and a copy retained. Formulae for home preparation should always be written, as: Dissolve one teaspoonful of Boric Acid in a glass of warm water and bathe the part every three hours. Receipts for special articles of diet should usually be written, as the following for a milk-shake: CONCENTRATED MIXTURES. 373 1 fresh egg; 1 tablespoonful malted milk; Cracked ice; Flavor, as sherry, chocolate, or grated nutmeg; Milk to fill shaker; Shake in milk-shaker and take two hours after each meal. CONCENTRATED MIXTURES. Whether the practice is just or not, the fact remains that the druggist bases his charges, to a considerable extent, on the size of the preparation dispensed. The best interests of the patient should be the paramount consideration in the prescriber's mind; he can, therefore, frequently concentrate the preparations and allow the pa- tient to add the water,-often known in the drug-store as ''profit." As an example: A physician wishing to have a poor patient use a wet bichloride dressing and, as is usually the case, not thinking it advisable to prescribe tablets, ordered a pint of a 1: 5000 solution. He found that the druggist charged $1.50. The next order was for a two-ounce solution 1: 500, with directions to use one teaspoonful to nine teaspoonfuls of water; the price charged was 25 cents. The same conditions obtain in such cases as in prescribing potas- sium iodide in syphilis, or in ordering solutions of potassium per- manganate for douches, irrigations, etc. To illustrate another point: A concentrated solution of corrosive mercuric chloride was ordered with directions "Use one teaspoonful to two tablespoonfuls of water to wet bandage." A dermatitis was produced, as a large teaspoon and a small tablespoon were used and a dilution of little more than 1: 2000 resulted; so it should be remem- bered that, when possible, the patient should be instructed to use the same measure for the drug and the diluent. SATURATED SOLUTIONS. A saturated solution is often ordered. The custom is subject to criticism. Many employ the term in prescribing potassium iodide, sodium phosphate, etc., when they want a solution representing a grain to the minim. The druggist usually understands what is de- sired and fills the prescription accordingly, but the order is open to criticism. A saturated solution is one that contains all of the solid that will dissolve in the given solvent. Water is usually understood to be 374 PRESCRIPTION WRITING. the solvent unless otherwise specified. The amount of a salt that will be dissolved depends to some extent on the temperature and other conditions. In no instance is the finished product just one grain to the minim. When such concentration is desired the inscrip- tion may be written as: Potassii lodidi Aquae q. s. f5j In the case of agents, as boric acid, where a concentration of a grain to the minim is not obtainable or desired, it is even more neces- sary to prescribe a definite amount of the salt. The druggist usually handles orders for saturated solutions of this class by adding the salt in slight excess of the solvent, triturat- ing and filtering. The amount of the drug that dissolves will de- pend very much on the patience and energy of the compounder. The prescriber should know the solubility and arrange the prescription accordingly. For example: Boric acid is soluble in 18 parts of water. The full amount that is possible to get into solution should not be employed, as the state- ment "soluble in 18 parts of water" means that 1 part is the maximum amount that may be dissolved in 18 parts of water even under the most favorable conditions and by the expenditure of unlimited time and effort. These factors cannot be expected in the filling of pre- scriptions ; so it is always better to order an amount slightly less than the quantity indicated by the given solubility. The inscription may be arranged as follows: Acidi Borici gr. xx Aquae Dest q. s. f3j The prescriber then knows what his patient will receive. PERCENTAGE PRESCRIPTIONS. This is found to be one of the hardest problems in prescription writing, to impress upon the student. Some grasp it with such facility and it seems so simple withal that an apology would seem necessary for laying any stress upon it; but in almost any senior medical examination, where every student thinks the matter either mastered or too simple to be worthy of study, less than half of the exercises will be found correctly written. Some methods of cal- culation might be illustrated, as follows: The quantities for a four-fluidounce prescription for a 5 per cent, solution of liquefied phenol in glycerin. FORMS OF ADMINISTRATION. 375 If the complete prescription contains 4 fluidounces or 32 fluidrachms, 1 per cent, would be %Oo of that amount and found by pointing off two decimal places (0.32 drachm) 5 per cent, would be five times as much, or 0.32 X 5= 1.60 fluidrachms, or 96 minims. Or, 5 per cent, is equal to one-twentieth; therefore, %0 of the total bulk of the prescription must be liquefied phenol, the prescrip- tion containing 4 fluidounces. of 4 fluidounces equals 4 -F- 20 - %o - % of a fluidounce. One fluidounce being 480 minims, % would be 480 -4-5 - 96 minims. Or, the prescriber soon remembers that 4.8 minims are 1 per cent, of a fluidounce; therefore, 5 per cent, of a fluidounce is 4.8 X 5 = 24 minims; then 5 per cent, of 4 fluidounces would be 24 X 4 = 96 minims. In making a correct percentage solution all items must either be weighed or measured. It is not correct to weigh the shot and measure the feathers. Water at standard temperature, etc., weighs 456.37 grains to the fluidounce of 480 minims; therefore, 4.8 grains of cocaine hydro- chloride with water to make a fluidounce is not strictly speaking a 1 per cent, solution by either weight or measure. There should be 4.56 grains of the cocaine salt. The prescriber seldom finds such exactness necessary, but may well carry in mind 4.5 grains of the solid as the 1 per cent, quantity of a 1 fluidounce aqueous solution of solids. The metric system being a decimal one, the matter of percentage solutions is simplicity itself: Phenolis Liq., Glycerini q. s. 120] 120 being the total quantity, 1 per cent, is found by dividing by 100, that is, pointing off two decimal places - 1.20; 5 per cent, by multiplying 1.20 by 5 = 6.00: Phenolis Liq 61 Glycerini 120| In, say, a 25 per cent, solution, 25 per cent, is one-fourth of the total; therefore, % of the total quantity (120) is 30, which would be the quantity of the liquefied phenol for a 25 per cent, solution. Before writing his prescription the physician must first decide, from the condition of the patient, as to the effect to be produced, FORMS OF ADMINISTRATION. 376 PRESCRIPTION WRITING. then the agent that will best produce the desired effect, then the most desirable route under the circumstances to get the remedy into action, and then the most desirable form in which to administer it. To produce a systemic effect, drugs may be given by mouth, rectum, skin, hypodermically, intravenously, or by inhalation. The mouth is the natural channel for the intake for all matter except oxygen. Doses, not otherwise specified, are understood to be by this route. Medicines for general effect are supposed to be ad- ministered by mouth unless there is some reason to the contrary. It should be remembered that in some conditions, as when much undigested food is present, or when the patient is in great pain, absorption from the stomach may be delayed. The intravenous method gives the quickest results and the dose is smallest. Hypodermic administration is next in point of prompt action and smallness of dose. The dose is usually one-half to two-thirds of that by mouth. Rectal administration gives slower results than by mouth, and the dose is usually 50 to 100 per cent, larger. The local effect may be produced by any method that brings the agent into contact with the part to be affected. Mouth for Systemic Effect. Solutions.-It is a safe rule to make this the form of first choice and use, unless there are reasons to the contrary, as odor, taste, insolubility, etc. Liquids not Solutions.-This includes mixtures, emulsions, etc. They are employed when an agent is administered by mouth that is insoluble in the desired vehicle and there are reasons against giving in capsules, powders, etc.; also when the taste would be objection- able if in solution. Examples are bismuth salts suspended in thick liquids, oil of turpentine in emulsion, quinine salts suspended in* chocolate syrup, etc. Capsules.-This is one of the most convenient and agreeable forms for administering medicine. They are particularly useful for drugs of unpleasant taste or odor, as quinine salts, thymol, etc. The effect is not produced as quickly as when the drug is in solution, and they should not contain agents in such form as will cause irritation of the alimentary mucosa. It should be remembered that small chil- dren and many adults are unable to swallow capsules or are nauseated BY RECTUM FOR SYSTEMIC EFFECT. 377 by them. Before prescribing capsules it is always best to ascertain if the patient can take them. Papers.-By papers is here meant doses of medicine wrapped up in papers (cht.) instead of put into capsules or other container. The form answers well for those powders that are not disagreeable in taste or odor, as calomel with milk sugar, sulphonmethane, etc. Pills.-This is a convenient form for the administration of some drugs, as silver nitrate, phosphorus, etc., and is sometimes an economic method where the drug is to be continued for a consider- able time, as in giving yellow mercurous iodide for syphilis or fer- rous carbonate for chlorosis. It is not often that a prescriber should order pills to be prepared extemporaneously. Pills of silver nitrate or phosphorus cannot usually be made to advantage by the local drug- gist, and if it is desired to have freshly prepared doses of such agents as ferrous carbonate or yellow mercurous iodide it will be better for many reasons to order capsules. Pills are subject to many disadvantages, such as hardening and becoming insoluble, crumbling, tasting if not coated, sticking together if coated, etc. Tablets.-Hypodermic tablets and tablet triturates usually dis- integrate readily when taken into the stomach, and are sometimes a convenient form for administering medicines of small dosage. If the medicine is disagreeable, as strychnine, the patient does get the benefit of it to some extent, particularly if hypodermic tablets are used. Compressed tablets are usually hard and very apt to disinte- grate slowly, if at all, in the alimentary tract. Their usefulness is very limited to the prescriber, though they are sometimes a great convenience to the dispensing physician. Cachets.-This is not usually considered a practical method of administration, in this country. By Rectum for Systemic Effect. Liquids.-For the best results the agent should be in solution and so diluted as to be non-irritating. When possible, the rectum should be first cleansed by irrigation and the bulk of the dose should not exceed about six fluidounces for an adult. Medicines are sometimes administered to advantage by the Murphy drip. Suppositories.-These are usually made with a vehicle of cocoa butter. They should be non-irritating and the active agents should be readily soluble. 378 PRESCRIPTION WRITING. Rectal administration is often useful, particularly when the upper alimentary tract is intolerant, as in gastric irritation or when there is much nausea, or when it is undesirable for any other reason to give a remedy by mouth, as in appendicitis, etc. Hypodermic and Intravenous Administration. These methods are resorted to when quick results are demanded or when there are reasons against the use of other routes. The agents should usually be in solution and non-irritating. The opera- tion should, of course, be aseptic. By Absorption from the Skin. This is not often a practical route for producing the systemic effect of a drug. The principal exception is inunction of mercury for syphilis. By Inhalation. To produce a systemic effect by absorption from the mucous membrane of the respiratory tract a drug must be in the form of a vapor. The most common example of this form of administration is the use of chloroform, ether, amyl nitrite, etc. Local Effect. This may be produced by any method that brings the agent into contact with the part to be affected. Solutions, mixtures, ointments, powders, and practically all forms of medication are employed. Ex- amples are: liniments, ointments, dusting powders, eye-washes, nasal sprays, gargles, mouth-washes, enema, injections, caustics, etc. COMPARATIVE DOSAGE OF PREPARATIONS. In remembering dosage it is often advisable for the prescriber not to try to remember the dose of each preparation of a drug, but to remember the dose of the drug itself; then the dose of the prepara- tions can be called to mind by the following rules: The dose of the fluidextract is the same in minims as the dose of the drug in grains. The dose in minims of the tincture is usually ten times the dose in grains of the drug. The dose of the extract is usually one-fifth the dose of the drug. For example: THE PHARMACOPCEIA. 379 Nux Vomica-dose, 1 grain. Fluidextract of Nux Vomica-dose, 1 minim. Tincture of Nux Vomica-dose, 10 minims. Extract of Nux Vomica-dose, % grain. This, of course, is approximate only, but in the largest percentage of cases it answers all requirements and is often a valuable aid to memory. Where the dose of the drug is large, as 30 to 60 grains, the rule as to the tincture will not often apply. A rule can hardly be given for preparations as infusions, elixirs, etc., but the fluidextract, tincture, and extract are the preparations of common use. THE PHARMACOPCEIA. A Pharmacopoeia is a book compiled by a recognized authority and containing a list of drugs with information concerning them. The United States Pharmacopoeia is not published by the govern- ment, as is the case in some countries, but it is accepted by the government as standard in as far as it goes, and this gives it all necessary prestige. For example, the Pharmacopoeia fixes the strength of tincture of opium at 10 per cent., and the government requires that for government use, interstate commerce, etc., a prep- aration to be called tincture of opium must have 10 per cent, strength. State drug laws also recognize the Pharmacopoeia as does the federal government. The United States Pharmacopoeia was first published in 1820, and each ten years it is revised by a committee selected by the Pharmacopceial Convention, which is composed of representatives from incorporated medical and pharmaceutical colleges and associa- tions and the Army, Navy and Public Health Service. THE NATIONAL FORMULARY. The National Formulary is a book containing formulae of prep- arations not included in the Pharmacopoeia, but that are still con- sidered of sufficient importance to render standardization advisable. It is published by the American Pharmaceutical Association. DISPENSATORY. A Dispensatory is a commentary on the Pharmacopoeia. They contain all that the Pharmacopoeia states regarding official drugs and 380 PRESCRIPTION WRITING. much additional information. They also treat of other drugs not included in the Pharmacopoeia. They are compiled and published as private enterprises and contain a vast amount of information that is invaluable to the student of Materia Medica. The American Medical Association is maintaining a department for the investigation of unofficial preparations offered the medical profession. The effort is made to eliminate fraud and encourage merit. The remedies included in these volumes are those found to meet certain requirements. It is one of the greatest advances ever made in Materia Medica. An official drug is one that is contained in the Pharmacopoeia. In prescribing an official drug it is not necessary to write U. S. P., as that is understood. In prescribing a preparation of the National Formulary, if it is particularly desirable to get the N. F. product, it is usually best to specify N. F., as pharmacists are not always very familiar with the formulae of this valuable guide. While it is inadvisable for a prescriber to even try to confine him- self to the Pharmacopoeia and National Formulary, they certainly contain the vast majority of drugs that should be used. These books should be in the library of every physician, and he should so famil- iarize himself with their contents as to know what agents he can get so well standardized and give them the preference. OFFICIAL DRUGS AND N. F. PREPARATIONS. PROPRIETARY AND PATENT MEDICINES. The use of these preparations by the medical profession is cer- tainly carried to excess. The distressing neglect of Materia Medica by the majority of our medical colleges is probably the chief cause of the fault. Students are given a limited knowledge of a few drugs. They are not sufficiently grounded in a knowledge of medicines as to enable them to meet the demands of practice or to intelligently discriminate between the good and the bad of what is afterward offered them. They soon realize the inadequacy of their armamen- tarium and seize upon any suggested additions. This means, of course, that they fall an easy prey to the detail man, the circular, or the well-filled advertisement page. Many of the patent or proprietary medicines are excellent prep- arations. Our Pharmacopoeia and National Formulary are stocked SPECIFYING MANUFACTURERS. 381 with remedies originally introduced to the profession in this way; so, if for no other reason, it would ill become the physician to indis- criminately rail against them. To impress the lesson it is only necessary to mention Acetphenetidin, Sulphonmethane, Phenol Sali- cylate, and a host of others might be cited. This is not to be construed as advocating proprietary medicines, and before adding any such remedy to his armamentarium the pre- scriber should know its value. Almost unlimited help can be derived from "New and Non-official Remedies" and "The Propaganda for Reform" of the Journal of the A. M. A. The fact remains, however, that the more a physician knows of Materia Medica and the more he studies the Pharmacopoeia and the National Formulary, the less frequently does he have to go outside of them for his prescription material. The detail man, to the student of Materia Medica, is often a source of valuable information. They frequently present new* products of decided merit. The plea is not to avoid them, but to intelligently weigh their statements. The prescriber should not be urged to confine himself to the standards, but to have intelligent reasons when he goes to other sources. SPECIFYING MANUFACTURERS. There is a tendency on the part of members of the medical pro- fession to specify on prescriptions the preparation of some particular manufacturer. When there is any reasonable cause of advantage to the patient, there should be no hesitation in so doing, but the more familiar one becomes with medicines the more one becomes convinced that there is seldom a necessity for this practice. There was a time when it was frequently advisable, but the present State and National drug laws and the present status of pharmaceutical education have practically forced a uniformly high standard in manufacturing. Pro- miscuous specifying of special makes is usually a sign of ignorance or gullibility rather than of superior information. Another fact is that if a certain manufacturer puts out one preparation superior to that of competitors it is no indication that the other preparations of that make are above the average. As a general rule it may be stated that in prescribing the agents included in the Pharmacopoeia and National Formulary, it is best no4 to specify a particular make. 382 PRESCRIPTION WRITING. WRITE PRESCRIPTIONS. A prescriber should avoid the habit of telling the patient what to get. The oldest friendship may not stand the strain. Even a physician often does not like to prescribe for himself, and when he consults a confrere prefers that he write a prescription. A patient seldom consults a physician unless he, at least, imagines himself sick, and however slight his ailments he wants to be shown full consideration. If he is given medicine at all he appreciates his ailment being accorded the dignity of having a prescription written for it. Also nothing so encourages self-medication as telling the patient what to get, nothing is so apt to result in mistakes, and nothing so disgusts the doctor's friend and should-be supporter-the druggist. An example will illustrate: A family sent for a physician to treat a child with earache. The physician, after a careful examination, told them to get an ounce of glycerin, put twenty drops of carbolic acid in it, shake it up and put two or three drops in the ear affected. It seemed to be the straw that broke the camel's back, for the family, who had employed him for years, sent for another physician who gave them the following prescription and retained the practice: For Mary Jones (5 years). R Phenolis Liq n]_xx Glycerini q. s. f5j M. Sig.-Use two (2) drops in ear as directed. One doctor had lost a family's practice and another gained one, not through the latter's superior medical ability, but through his knowledge of human nature and the demands of his position. The principle is not to be carried to extremes. For example: in prescribing a calomel purge to be followed next day by a saline, the prescriber can well write his prescription for the calomel, etc., and in his written instructions left with the patient instruct as to a dose of Epsom salt being taken the following morning. It should always be remembered that it is hard to overestimate the psychic factor in the treatment of disease, and that while the pre- scription is a very commonplace scrap of paper to the prescriber, it is, to the patient, the ultimate expression of an oracle and is that which he feels is to stand between him and dread disease or even the Grim Reaper. PRESCRIPTION BLANKS. 383 PRESCRIPTION BLANKS. Prescriptions are written on everything from paper bags and scraps of wrapping paper on down-and up. Mohammed showed somewhat of the medical spirit in writing the Koran on pieces of bone and other waste material picked up in his wanderings. A prescription is the most important product of a dignified pro- fession, and there is every reason why it should represent the acme of neatness. A physician should use his own private prescription blanks, ordered and paid for by himself. The sheets should be of standard size (about 3% x 5% inches), so that they will snugly fit in the regu- lar box files so commonly used by pharmacists. If they are too small they do not present a neat appearance and are rather hard for the druggist to locate if it is necessary to refer to them again. If a blank is too large it may have to be folded to fit a box file, or if a druggist uses the wire files the sheets project beyond the edges of the others and are apt to get torn or become unreadable through hand- ling and the usual accumulation of dust. The blank should be of good white paper, which is neater and more dignified, and shows the writing better than does a colored paper. At the top of the blank should be, in modest type and black ink, the doctor's name and some information concerning him. It is not considered good taste to use the degrees, but the abbreviation Dr followed by the name as the doctor uses it-that is, the full Christian name or part or only initials and surname. The home and office address, office hours, and home and office phone numbers should also be given, and the U. S. registry number, and usually nothing more. A blank arranged in this way enables the druggist to translate the prescriber's signature, to readily reach him should it be necessary, and serves the purpose to some extent of a business card. When instructions for the patient are left on these blanks, they constitute a modest, ethical advertisement, the purpose that is served by the blotter or calendar of the merchant. Something like the blank on the next page is recommended. Now, the nice blanks so generously furnished by the friendly ( ?) druggist. If they did not bear the druggist's advertisement they would entail an obligation that should be avoided for many reasons; but free blanks usually bear some legend, as "Take this to the Avenue Pharmacy." The doctor in signing the blank makes printed instruc- tions also a part of his order, and tells the patient to take the pre- 384 PRESCRIPTION WRITING. scription to that store, to the exclusion of all others. This is not only a gratuitous insult to the other druggists, but to the patient, as the choice of a druggist is a matter without the province of the physi- cian, and he should not specify unless there are particular reasons, Dr. J. C. BLANK RESIDENCE: 1776 FIRST AVENUE PHONE 2893 Office: 736 Central Bank Building Hours: 2 to 4 P. M. Phone 1345 «o. 1736 BLANKVILLE For of interest to the patient, for his doing so, and then the patient has the right to know those reasons. The standpoint of the other druggists and a frequent result are well shown in the following incident: A young physician located in a suburban neighborhood with CARBON COPIES. 385 five drug-stores. The active physicians doing practice in that sec- tion were using the blanks liberally supplied by two of those stores. If druggist A referred a patient to one of the old physicians, he either never heard of the case again or the patient returned with a prescription which carried instructions, "Take this to B's drug- store." The new man used his own blanks with the result that in a few months three 'druggists were referring all unattached patients to him and the other two stores were just about as friendly as if he had been using their blanks. CARBON COPIES. Prescription blanks should be securely bound in small books of about 50 sheets. It is better to have these wired at the top and per- forated so that the sheets can be easily torn out. The books need not have covers, but should have a V back that will enable them to fit into a regular leather case. Every other sheet should be plain, colored paper for making a carbon copy. This will give twenty-five originals to each book. In lots of eighty books (2000 prescription blanks) they should not cost over about eight cents each. There can be no reason against keeping carbon copies, and there are certainly many advantages. Twenty-five cents' worth of carbon paper will last almost any physician a year. A sheet is cut the size of the prescription blank and is merely transferred after each writing. One carbon sheet answers well for several books. It is impossible for any physician to remember all that he pre- scribes, and a copy of all the prescriptions for a case filed with the other data is an invaluable record. Again, everyone makes mistakes, and the habit of rereading the copies after leaving each case, or at least at night, is a practice that cannot be too highly recommended. What physician has not spent many anxious moments, after leaving a case, wondering if he did not write Corrosivi instead of Mitis or some similar possibility? How easy it is to get peace of mind by referring to a carbon copy! Referring to the copies of the day's prescriptions is also a valu- able check on the day's work, and will frequently remind one of a consultation that might otherwise have gone uncharged. In case of error on the part of the druggist the doctor has indis- putable evidence as to what he wrote, no matter how the original may have been altered. 386 PRESCRIPTION WRITING. CARE OF COPIES AND OTHER USES FOR THEM. If a physician uses a filing system (and all should) the copies of the prescriptions should be kept with the case history and other data. The most desirable filing system for this purpose is that which uses folders. A separate folder for each patient enables the physician to carry all matter regarding each case in the most convenient pos- sible way. This data is probably best kept in the office. The folder should be made for the history, etc., but if the physi- cian contents himself, as many do, with a comparatively brief his- tory, the prescription blank answers well by using one or more sheets. It is advisable to make a carbon duplicate of this also, and keep one in the office, and one can be kept in the study at home for reference, as in reading up on the case. The blanks and copies answer well for keeping a record of mat- ters of interest concerning the case, as pulse, temperature, etc., at each visit; alsq for blood-counts, urinalysis, etc., unless special forms are used. These should be filed as suggested for other data. Some use the blanks for giving receipts for payments received during the day, and the carbon copy left in the book constitutes all the necessary data for making the proper credits when posting the day's work. Except in hospital work, written instructions for pa- tient or nurse are best made on the regular blanks and copies filed with the other data. COPIES TO A SUCCESSOR. It frequently happens that a physician is called in a case of emergency to see the patient of another physician. He should always leave a copy of any prescription he may write and a memorandum of his findings, and instruct that they be given to the other physician when he next calls. This is not only a courtesy due to the other attendant, but justice to the patient, and of advantage to himself. The regular attendant coming in cannot well continue the use of a remedy without knowing what it is, and for him to abruptly discon- tinue the first physician's treatment subjects the patient to additional expense and may cause an unpleasant impression in the mind of the patient with regard to the treatment started by the first attendant. CARE AS TO WRITING. Few physicians are so fortunate as to be expert penmen, yet any- one can write neatly and plainly if he will devote the proper care ARRANGEMENT ON SHEET. 387 and time to the effort. It does not require a master of the art of penmanship to dot an i and cross a t and to make an o so that it can be distinguished from an a and a u from an n or m. A physician may have to hurry in giving a hypodermic or in applying forceps to an after-coming head, but it is seldom that he cannot take a reason- able time to write his prescriptions. Aside from other considerations, neatness in this will have a better moral effect upon both patient and pharmacist than will neatness in dress, which all regard as a matter of importance. Not only should the writing be plain and neat, but the sheet should be spotless. A soiled blank should be dis- carded and if one is damaged in writing or in removing from the book, it should be destroyed and the work done over. This also applies to errors in writing. A word should not be scratched or overwritten, but a new prescription be made. ARRANGEMENT ON SHEET. A prescriber can get a good idea of the effect of arrangement by studying the letters sent out by some of the up-to-date business houses. It will be noted that when the amount of reading matter is small it is placed about the middle of the sheet with equal mar- gins above and below, instead of having the reading matter at the top of the sheet and the total margin below. It will also be noted that the margin on the left of the sheet is strictly observed and on the right as far as possible. The application of these rules to pre- scription writing is illustrated in Part III. The lines should run straight across the page and the name of the drug and the amount should be on one line except under unusual circumstances, as when the name of the manufacturer is specified in parentheses, or some other descriptive information is given. The amounts of the different ingredients ordered should be placed under each other and each on a line with the name of the drug to which it belongs. PEN AND PENCIL. Since a good fountain pen can be purchased at a nominal price, there is every reason why all prescriptions should be written in ink. It is much neater, more dignified, and the general appearance of the finished product is much better. Carbon copies can be made as well as with a pencil. The writing is more durable and it is not so apt to become illegible through the prescription being carried in the pocket, getting wet, or being sub- 388 PRESCRIPTION WRITING. jected to the usual wear and tear of the frequent handling of the druggist's files. There is not the chance of an item being changed to cover an error of a prescription clerk. If ink is not used a good indelible pencil should be employed.' ORDER OF WRITING. The date is first written, then the name of the patient and age. The superscription or heading (3) should be printed on the blank. The names of the ingredients should then be written without amounts, except the vehicle, which is followed by the total amount of the prescription; then the directions to the compounder, then the directions to the patient, then the prescriber's signature. When this is complete the prescriber has before him the total amount of the preparation, the amount of each dose, and the number of doses; so he can better calculate the amounts of the active ingredients. These are filled in, beginning with the first and taking them in the order in which they are written. REREADING. After a prescription has been written it should be carefully re- read, the amounts recalculated, and every part carefully reconsidered. It is best to allow some time to elapse between the writing and the rechecking. The best custom is to let all the matter remain in the book when first written and then, if with the patient, give attention to some other matters that will always require attention, then re- read carefully each prescription or sheet of instructions as it is torn from the book. This custom possesses the additional advantage that if an error has been made the sheet can be quietly allowed to remain in the book, and a new one written without subjecting the prescriber to the possible embarrassment of acknowledging an error by destroy- ing a prescription in the presence of the patient. TELEPHONING PRESCRIPTIONS. A fruitful source of unpleasant circumstances is the questionable custom of telephoning prescriptions. It is sometimes unavoidable, but should be done only when absolutely necessary. In case of error from any cause the burden of proof is on the prescriber to estab- lish the fact that he really dictated what he claims. When it is posi- tively necessary to telephone a prescription it should be first written just as if to be delivered in person; then with this before him the RECOMMENDING CREDIT. 389 prescriber should, after ascertaining that he is speaking to a pre- scription clerk, read it off carefully and slowly enough to admit of it being taken down in full; then the clerk should be asked to read what he has written, which the prescriber should recheck from the original. He should then either send by hand or mail, at once, the written prescription marked original of prescription phoned. The druggist should use this to replace the copy which he had filled and filed. The doctor as usual retains his carbon copy. RECOMMENDING CREDIT. The matter of financial arrangements between patient and drug- gists are best left to the parties most concerned. It is an unfortunate practice for the prescriber to take to the drug-store the prescriptions for parties unknown to the pharmacist and recommend that they be filled and charged. A like practice is to mark the prescription, when not taken in person, 0. K. or a/c 0. K. There are sometimes ex- ceptional circumstances that would justify such action, but such is rarely the case. A refusal to recognize such recommendation is fre- quently embarrassing to the druggist, physician, and patient, and the prescriber should only make such suggestion when he intends to pay the account if the patient should not do so. The fact that the patient lives in a nice home and pays the bills of the physician, whom he likes and needs, is not always a certain indication that he will pay the pharmacist, whom he does not know or care about. The prescriber may feel that in recommending that the pharmacist extend credit for one little prescription the matter is small anyway, but the end result may be the opening up of an extensive account and consider- able loss to the druggist. It is certain that this class of interference is usually unnecessary, undesired, and unappreciated. NAMING A PRICE. A prescriber will often be asked as to the probable price of the prescription. He should never be led into hazarding a guess. The knowledge that the same prescription cost a previous patient a cer- tain amount is no ground for an answer. Each pharmacy is, to a large extent, a law unto itself as to price, and the same applies to even the different clerks in the same establishment. There neces- sarily can be no fixed price for prescriptions, as the variety of com- binations runs into countless thousands. Each charge is an estimate and the same man may charge 35 cents for a mixture today and 40 cents tomorrow. The fluctuations of the market, the condition of 390 PRESCRIPTION WRITING. the customer, the character of the account, and many other factors enter into the fixing of the price. The druggist always marks the price charged on each prescription, so that if refilled a discrepancy will not occur. Where this practice is neglected the result is often unfortunate. If for particular reasons the prescriber should find it necessary to name a price to the patient, the amount should be plainly entered on the prescription and he should remember that he owes the pharmacist an explanation, as the doctor has no more right to dictate the price of filling than the druggist the price of pre- scribing. How oft, oh how oft, has every druggist asked a customer a dollar for a prescription, only to have him or her say, "Why, Doc- tor Blank said that only would cost me fifty cents!" The only recourse is to acknowledge himself a thief or discredit Dr. Blank's fund of information. CHARITY. It sometimes happens that prescriptions are written for parties not able to pay anything, or frequently the patient is deserving of some concession on the part of both doctor and druggist. • If the physician is rendering his services gratuitously and the condition of the patient justifies it, he may write, in the lower right- hand corner of the prescription, Pp. (meaning pauperismus-see page 347), which indicates to the druggist that the patient is in very reduced circumstances and that only a nominal charge, if any, should be made for the medicine. It should be remembered that this always carries the understanding that the medical attendant is receiving no remuneration whatever. It sometimes happens that a family in modest circumstances may require considerable medical attention and medicine, that they are able and willing to pay something, but are deserving of leniency at the hands of all parties concerned. It is better under such circum- stances for the physician to communicate with the pharmacist direct and discuss the circumstances in detail. LOCAL PECULIARITIES. In deciding what drugs to order for a patient it is frequently necessary to take into consideration what the local druggist can supply. This applies particularly to small towns and suburban neighborhoods. What may be a common remedy in one section of the country may be almost unused and not carried in stock in another. For example, the average village pharmacy might not be able to sup- REFILLING AND GIVING COPIES. 391 ply good fresh preparations of benzoinated lard, confection of rose, syrup of orange, etc., as these are seldom used in some sections, and do not keep very well. In New Orleans many preparations that are in common use on account of the large French element might not be obtainable in other cities of a different character of population. The point'to be impressed is that a physician prescribing drugs that are not in common use should be reasonably sure that the drug- gist can supply them. If there is a doubt it is better for the pre- scriber to inform himself in the matter, as he may be able to save himself, the pharmacist, and the patient inconvenience or em- barrassment. REFILLING AND GIVING COPIES. The custom among druggists is to refill, when requested, any pre- scription that does not specify to the contrary or to give a copy to be filled elsewhere. So general is this custom that it is demanded by the patient as a matter of right. An exception to the rule, of course, is in the case of those prescriptions that call for drugs that the laws of the Federal Government or of the particular State allow to be dispensed only once on a prescription, unless a written order to refill is given by the prescriber. Even when the law does not cover the point some few pharmacists will not refill a prescription calling for a habit-forming drug. Some prescribers write on prescriptions that they do not particularly want refilled, Not to be refilled or Non. rep. (see page 347). Others have this printed on all their blanks and only erase it when they think it will be necessary to have that par- ticular prescription refilled. This latter custom is not recommended for reasons later explained. Aside from other considerations the custom of refilling and giving copies is manifestly unjust to the physician, as he does not usually sell the patient a formula for present and future use for himself and friends. He is paid for his effort to correct a particular condition then existing, and his prescription is an order to the druggist to de- liver a drug or drugs in a certain amount for that object. To refer to a previous illustration, the druggist has no more right to execute that order again than would the merchant to deliver a second pair of shoes on the order for one. The custom is frequently even more unjust to the patient, as what would cure at one time might really do damage to the same patient or another at some other time, though the condition might seem to 392 PRESCRIPTION WRITING. be the same. An active purge for an abdominal pain due to consti- pation may give relief, but if taken when the pain is due to appen- dicitis it might produce unfortunate results. The illustration is used by another author of a lady who suffered from headache due to syphilis. Without being informed of the condition she was relieved by pills of yellow mercurous iodide. She later told her physician that she was so much pleased with the remedy that she had given copies of the prescription to all of her friends who suffered with headache. It sometimes happens that for sentimental or other reasons a pa- tient will wish to retain a particular prescription, as when consulting some eminent physician. The custom is for the patient to so state when giving the prescription to the druggist, who then fills the original and puts his name and his particular number and date on it, and sometimes the price charged in plain figures, or in a cipher code understood by most druggists. He makes a copy for himself, which he numbers, dates, and files as he would an original. The custom of refilling and giving copies is too well established for the pharmacist to fail to comply with it, and the only remedy is for the prescriber to specify against it and try to educate the public to the many disadvantages. It is a matter, however, that requires concerted action, and for one doctor, particularly if he is not well established, to try to stem the tide of custom and popular demand might prove decidedly unfortunate. ERRORS. The prescriber who claims to never have made an error is one who disregards truth, has a poor memory, or has done very little practice indeed. The most earnest co-operation should exist between compounder and prescriber, and in case of a mistake by either the other should render all reasonable assistance. If a physician dis- covers that a prescription has not been properly compounded, he can always find a pretext for taking it back to the pharmacist without arousing the suspicions of the patient. When the prescriber makes a mistake it is the duty of the compounder to discover it and to pro- tect against any injury to the reputation of the physician. If the physician can be reached, the prescription should be taken to him by the pharmacist or he may be telephoned. The prescription should never be returned to the patient or the patient be allowed to sus- pect that there is any trouble. If the physician is not accessible and his intention is obvious, the druggist may make the necessary cor- DOMESTIC MEASURES. 393 rection and advise the physician at the earliest possible opportunity. For example: B Hydrarg. Chlor. Corros gr. iv Sacchari Lactis gr. xx M. ft. cht. no. iv. Sig.-One every hour. Any pharmacist should know that the mild mercurous chloride was intended, and should change the prescription if the physician cannot be reached. The pharmacist is more apt to discharge his full duties in these matters than is the physician, and the point to be impressed is that the prescriber must remember that the compounder is his co-worker and entitled to every consideration at his hands, and that sooner or later that co-worker is apt to have an opportunity to repay any such debt with interest. DOMESTIC MEASURES. Liquid medicines are usually ordered to be administered in quan- tities familiar to the laity, as teaspoonful, tablespoonful, wineglassful, teacupful, glassful, etc. The prescriber bases his calculations on such equivalents as a teaspoonful being one fluidrachm, a tablespoon- ful being four fluidrachms, etc., as shown on page 331. As a matter of fact, there is a great variation in the size of these measures. The teaspoonful is probably the most uniform of any, yet they vary through a range of over a hundred per cent, and the shape is such that even this variation is increased in use. A spoon filled nearly to the top may not contain more than half the amount that could be measured into it. Dessertspoons vary in size to such an extent as to render their use inadvisable; the same applies to the wineglass. It is interesting to note the difference in a wineglassful of castor oil and a wineglassful of old port or Spanish sherry. The cup used by the coffee taker confined to one cup a day and the one used for measuring a disagreeable purgative water are very different vessels. The medical attendant must either accustom himself to recognize spoons, glasses, etc., of the proper size and have them set aside for use in measuring medicines, or he must insist on graduated medicine glasses. Graduated medicine glasses, if of the proper size and make, possess many advantages. They are not acted upon by the medicinal agent; they are easily cleaned; they are marked to hold correct 394 PRESCRIPTION WRITING. amounts; there is less discrepancy in filling a glass to a mark than in filling a spoon to the top; there is less chance for waste in adminis- tering from a partly filled glass than from a full spoon. The lesson in domestic measures was very forcibly impressed upon the author in ordering a concentrated antiseptic solution with directions to use one teaspoonful of the medicine to two tablespoon- fuls of water. The result was very distressing and it was found that the patient used a teaspoon holding about 90 minims for the medicine and a tablespoon holding about 120 minims for the water. EXAMINING THE MEDICINE. It is an excellent practice to examine the medicine the patient is taking on each visit after prescribing. This is particularly de- sirable on the first visit after starting treatment. The first object is to see that the medicine has been properly prepared. Even a physi- cian without pharmaceutical experience can soon learn what should be the appearance of the remedy ordered. Unfortunately, it is a fact that the careful observer will frequently find cause to justify this practice. Gross errors and evident substitutions are not com- mon, but frequently a powder has not been properly dissolved, an emulsion has been imperfectly made, a dusting powder is gritty, an ointment shows lack of proper incorporation, or a preparation has not been mixed in the order to obtain the best results. A prescriber by seeing the finished product can best learn his own errors in combination and improve upon his work in that particular field. He sees that he is ordering quantities too large for capsules, that agents he thought would go well together are hopelessly incom- patible, and he gets a better idea as to odor, taste, and general ap- pearance of the remedies he is imposing upon a trusting public. Another important object is to see that the patient is getting the proper amount of the remedy. If four fluidounces of a preparation is ordered and a teaspoonful is to be taken three times a day, and it is found that after five days only about a fourth of the preparation has been taken, something is wrong. Either the spoon is too small, is not being properly filled, or the regular number of doses is not being taken. If twelve capsules are ordered, and six are to be taken the first day, the next morning's visit should find only six remaining. It will be found that, among poorer patients particularly, the second visit will frequently find the prescription still unfilled, or, if the medicine is promptly obtained, that constant effort is sometimes necessary to secure for the patient the proper care as to the adminis- OWNERSHIP OF A PRESCRIPTION. 395 tration of the remedies. Mothers are apt to humor children who object to unpleasant remedies. Men who are not sick enough to re- quire a nurse are very apt to take a remedy only when there is press- ing demand for it. And yet the neighbors, the family, and even the patient hold the physician responsible for the progress of the case, irrespective of all conditions. OWNERSHIP OF A PRESCRIPTION. When a prescription is written it is the property of the pre- scriber until he delivers it to the patient, or to the druggist for the patient; it then ceases to be his and he has no legal right to recall it. If the patient has the prescription it is his to do with as he chooses, and when it is delivered to the druggist to be filled it becomes and remains the property of the druggist. The patient cannot demand its return nor can the physician, and should a prescriber for any reason wish to regain possession of one of his prescriptions that has been filled, he should remember that he is to ask the druggist for the favor of its return and not demand it. It is the same proposition as if the doctor sent an order to a merchant to deliver to his servant a pair of shoes. The merchant should retain the order as his evidence of the transaction. Of course, the major object in the pharmacist retaining prescriptions is really that he may have them in case it is necessary to have them refilled. STOCK PRESCRIPTIONS. Most physicians have certain formulae that they are in the habit of frequently employing. These are known as stock prescriptions. The practice is often carried to excess, but there can be no doubt that well-selected stock prescriptions are better than none at all. It is usually necessary for the medical attendant to write his prescrip- tions in the presence of the patient or family. The vast majority of cases will represent only a limited number of conditions, as tonsillitis, colds, intestinal intoxication, etc. There can be no objecton to the prescriber drilling himself in correctly writing one or more formulae for each common demand. The matter of compatibility, taste, odor, appearance, etc., can be carefully worked out, and the dosage later adjusted to meet the demands of each particular case. The pre- scriber can often use these stock formulae as a starting point and build his Materia Medica to them to better advantage than if he works at random. For example: 396 PRESCRIPTION WRITING. Quinine is the remedy for malaria. Let the physician work out a prescription, correct from every standpoint, for adminstering the drug in tasteless form to an adult that cannot take capsules; in a tasteless form to a child that cannot take capsules; in bitter solution, in capsules, and quinine tonics to meet the requirements of these patients after the first few days of intensive treatment. Many teachers insist on learning "to use a drug"-certainly-but the prescriber should always stock his memory with facts as to how to order it for definite conditions, how to combine it, disguise its taste and odor if necessary, how and when to order it in liquid or solid form, and how to write the other details of the order. STATE AND FEDERAL LAWS. Every prescriber should familiarize himself with the laws of his State that particularly affect his profession. This applies especially to those restricting the sale or prescribing of alcoholics, poisons, narcotics, ergot, etc. The Federal (Harrison) Narcotic Law is, in its effect, probably the greatest law ever enacted in the history of the world. None but those in a position to know can estimate the extent to which narcotics were used, the rapid progress of the scourge, and the utter ineffectiveness of State legislation. The essentials of this law that are of particular interest to the prescriber are: A physician must register with the Department of Internal Rev- enue and be assigned a number. This number must appear on his orders for drugs affected, and on his prescriptions calling for these drugs. The drugs specified are Opium or Coca Leaves, or any prepara- tion of them or derivative from them, or substitute, as Eucaine, Novacaine, etc. It exempts those prepared remedies containing not over 2 grains of opium or 1 grain of codeine, or % grain of morphine, or % grain heroine to the fluidounce if liquid, or avoirdupois ounce if solid. Certain external preparations are also exempted. Paregoric is the only U. S. P. preparation exempted. The prescription for drugs included in the law must not only have the physician's registry number, but must show the name and address of the patient, and have the physician's signature. When the amount of the drug is unusual, as in treating an addict INCOMPATIBILITY. 397 or a patient with an incurable disease, the prescription should carry a statement to that effect. A physician is not allowed to prescribe these drugs to supply an addict, but only to treat disease. A physician can administer these drugs to a patient he is attend- ing (out of his office) without keeping a record, but if he leaves any of them to be administered in his absence he must keep a record of the amount of the drug, name and address of patient and date. In office work where the physician is using very small amounts, he is permitted to merely keep a record of the date of purchase and date of exhaustion of his stock solutions. This is not intended to serve as a working interpretation of the Harrison Narcotic Law, and is only the writer's personal under- standing of those essentials now in force most affecting the prescrib- ing of drugs. Every prescriber should secure a copy of the law from the Treasury Department and familiarize himself with its entire text. It is certainly desirable to have the registry number printed on all prescription blanks. INCOMPATIBILITY. Incompatibility is a term used to express the condition where two or more agents when brought into contact result in a chemical de- composition, physical disassociation, or therapeutic opposition. The various classes of incompatibility are grouped under three heads: chemical, physical (or pharmaceutical), and therapeutical (or physiological). Excellent treatises on this important subject can be obtained. Some of them can hardly be improved upon for completeness, but the average student is apt to find difficulty in gleaning the actual necessities and becomes bewildered by the very completeness that to some is desirable. As many of the phases of incompatibility are of minor interest to the prescriber, it will here be treated only under the following heads: In Liquids. I. Formation of a precipitate: (a) The separation of a metal or insoluble metallic salt by chemical action. (&) The separation of an alkaloid or insoluble alkaloidal salt by chemical action. 398 PRESCRIPTION WRITING. (c) Precipitation due to other causes. II. The evolution of a gas. III. Separation of an immiscible liquid. IV. Formation of a gelatinous mass. V. Incomplete solutions. VI. Immiscibility. In Solids. I. Chemical changes. II. Undesirable pharmaceutical mixtures. I. Formation of a Precipitate. (a) The Separation of a Metal or Insoluble Metallic Salt by Chemical Action.-It may be broadly stated that when two or more substances in solution are brought together, if by an ex- change of radicals an insoluble substance can be formed or a gas evolved-that exchange will take place. The matter resolves itself, therefore, largely into a study of solubilities. In ordering two or more solids in solution the prescriber must reason, "Are all soluble in the vehicle ? Can an insoluble substance be formed from the bases and radicals used?" For example: Zinci Sulphatis gr. x Plumbi Acetatis gr. x Aquae q. s. f3iv Is zinc sulphate soluble in water? Yes. Is lead acetate soluble in water? Yes. Can an insoluble substance be formed by an exchange of radi- cals? Yes; lead sulphate, which is insoluble, can be formed. Will the exchange take place? Certainly. Potassii lodidi 5iv Sodii Bromidi 5iv Aquas q. s. f$iv Is potassium iodide soluble in water? Yes. Is sodium bromide soluble in water? Yes. Can an insoluble substance be formed (or gas evolved) by an exchange of radicals? No. If potassium bromide and sodium iodide were formed they would still be soluble in water. Will an exchange take place? No. INCOMPATIBILITY. 399 A precipitate is not always undesirable, so this must be taken into consideration by the prescriber. The precipitate resulting in the following mixture does not spoil the value of the remedy: Plumbi Acetatis, Tincture Opii, Aque q. s. The following would be undesirable: Strychnine Sulphatis gr. j Potassii lodidi 3iv Aque q. s. f3iv The matter of precipitation resulting from chemical action is often made to appear complicated by giving a large amount of in- formation as to the solubilities of chemicals without sufficiently em- phasizing the small part that is of practical importance. Ammonium, Potassium, and Sodium.-The salts of these are soluble, so need cause no fear that they will be precipitated. Lithium.-Soluble except the oxide and carbonate, which are sparingly soluble, and the phosphate, which is insoluble. Magnesium.-Seldom prescribed in solution except the citrate and sulphate, which are freely soluble and usually not ordered with other chemicals. The insoluble oxide is often ordered in suspension. The acetate, chloride, citrate, iodide, nitrate, sulphate and sulphide are soluble; so care need be used only when prescribing with acids or salts that will form other combinations. Calcium, Barium, Strontium.-Not often used in solution ex- cept the soluble calcium chloride, this being unassociated with other chemicals, and strontium bromide and iodide, which are soluble and are usually prescribed alone or with other bromides or iodides. The important soluble salts are the acetates, bromides, chlorides, citrates, iodides, nitrates, and sulphides; so care should be used as to other com- binations. Zinc, Manganese, and Copper.-Seldom prescribed in solution except as follows: Zinc as the soluble acetate, chloride, or sulphate, which are used alone or with other acetates, chlorides, or sulphates. Manganese as potassium permanganate, which is soluble and not often used with other chemicals. 400 PRESCRIPTION WRITING. Copper as copper sulphate, which is soluble and used alone or with other sulphates. The soluble salts of interest are the acetates, bromides, chlorides, citrates, iodides, nitrates, and sulphates; so care should be used where other com- binations might be formed. Mercury.-Seldom prescribed in solution except the soluble corrosive chloride or the red mercuric iodide, which are often ordered with potassium iodide in excess, forming the soluble potas- siomercuric iodide. The corrosive chloride is also prescribed in solution with ammonium chloride or tartaric acid. Mercury is sometimes ordered in an insoluble form in water by prescribing the mild chloride or the corrosive chloride with lime-water. Insoluble salts, as the salicylate, are sometimes used suspended in oil for hypodermic medication. Mercuric acetate, bromide, chloride, citrate, nitrate, and sulphate are soluble. Mercurous salts are insoluble. Iron.-With a few exceptions, iron salts are not often ordered in solution with active chemicals. The principal source of trouble is prescribing ferric salts with vegetable drugs containing tannic acid, when a dark-colored precipitate is formed. Salicy- lates also give a strong color reaction. The tincture of ferric chloride is frequently prescribed with potas- sium chlorate with an excess of water and with the solution of potassium arsenite. The tendency is and should be to prescribe iron in dry form or, when given in solution, to use it alone. Exceptions to this are the iron hypophosphite and glycerophosphate in the com- pound preparations, and the scale salts as in the elixir of iron, quinine and strychnine, wine of iron, etc. The insoluble reduced iron is sometimes ordered with alkaloidal quinine suspended in a heavy syrup. The more important soluble salts are the acetate, bromide, chloride, iodide, nitrate, sulphate; the scale salts-the citrate, soluble phosphate, pyrophos- phate, iron and ammonium citrate, iron and ammonium tartrate, iron and potassium tartrate, iron and quinine citrate, soluble iron and quinine citrate, iron and strychnine citrate, and the double crystalline salt iron and ammonium sulphate. Particular care should be exercised against the formation of the insoluble hydroxide or carbonate. Silver.-The nitrate is the only inorganic salt often used in solution, and should be employed alone or with nitric acid or some other nitrate. Organic combinations, as argyrol, protargol, etc., are frequently used in solution, but are prescribed alone. INCOMPATIBILITY. 401 The nitrate and sulphate are soluble. Lead.-Seldom prescribed in solution except as the acetate, which is not usually associated with other agents except the tinc- ture of opium or zinc sulphate, the resulting precipitate to be sus- pended by shaking before using. The acetate and nitrate are soluble. Bismuth.-With the exception of the double salt, bismuth and ammonium citrate, none of the common salts of bismuth are soluble. They are frequently prescribed in liquids to be sus- pended by shaking when used. Antimony.-The only salt of much interest to the prescriber for use in solution is the soluble double salt antimony and potas- sium tartrate. The quantity used is comparatively so small that it is not often a source of trouble from a chemical standpoint. The simple salts of antimony may be regarded as generally insoluble. Arranged by Acids. Acetates and Nitrates.-Generally soluble except bismuth sub- nitrate ; so the prescriber need not worry about an acetate or nitrate being precipitated. Bromides, Chlorides, and Iodides.-Generally soluble except silver, mercurous, lead, and bismuth; with these exceptions the prescriber need not expect a precipitate from the metallic agents in common use. It should be remembered that iodides and bro- mides precipitate alkaloidal salts. Sulphates.-Generally soluble except barium, calcium, lead, and strontium. Tartrates and Citrates.-Mostly soluble. Lactates, Hypophosphites, and Nitrites.-Soluble or slightly soluble. Arsenates. Arsenites. Borates. Carbonates. Hydrates. Oxides. Oxalates. Phosphates. These are mostly insoluble, or sparingly so, except those of am- monium, potassium, and sodium. Those of lithium are soluble or slightly soluble. Salicylates. Sulphates. Valerates. These salts that are in more common use are soluble, but they are seldom prescribed in solution with other chemicals. Mercury salicy- late is insoluble and is often prescribed in suspension. 402 PRESCRIPTION WRITING. Tannates may be considered as generally insoluble, though the tannic acid in vegetable drugs is not a common source of trouble except with ferric and some alkaloidal salts. (&) Precipitation of Alkaloids and Alkaloidal Salts by Chemical Action.-As a general rule alkaloids should not be pre- scribed with hydroxides, carbonates, iodine, iodides, bromides, borates, or tannic acid. The presence of glycerin or alcohol in sufficient percentage (10 to 50) will prevent precipitation in the majority of instances. With a few exceptions it is not often that a prescriber will want to combine an alkaloid with these chemicals. The alkaloids in the various tinctures need seldom be considered as possible factors in precipitation. Morphine or codeine may sometimes be desirable with the bro- mides. The hydrobromides of these are soluble; so these mixtures seldom precipitate. Cocaine is sometimes ordered with boric acid or borates. The presence of glycerin will prevent precipitation. Compound tincture of cinchona is prescribed with potassiomer- curic iodide. The alcohol present prevents the precipitation of the small amount of quinine. (c) Precipitation Due to Other Causes.-There are some in- stances of the precipitation of other than metallic and alkaloidal substances by chemical action, but they are seldom encountered in the regular course of prescription writing. Gelatinous precipi- tates will be treated elsewhere. The majority of the trouble coming in this division of the sub- ject results from adding to a solid in solution a liquid in which the solid is insoluble. Gums.-These are soluble in water, but insoluble in alcohol. A most common instance is adding an alcoholic liquid to acacia in aqueous solution. Resins.-These are soluble in alcohol, but insoluble in water. Common examples are adding aqueous liquids to tincture of asafetida, tincture of guaiac, tincture of myrrh, etc. A large percentage of fluidextracts will precipitate either gums or resins when treated with a liquid of materially different alcoholic strength. Among the drugs soluble in alcohol and insoluble or sparingly soluble in water are: acetanilide, acetphenetidin, benzoic acid, betanaphthol, camphor, monobromated camphor, iodine, menthol, methyl salicylate, phenyl salicylate, terpin hydrate, thymol, alkaloids. INCOMPATIBILITY. 403 Care should, therefore, be used in prescribing alcoholic solutions of these substances with aqueous liquids. Salts, both of metals and alkaloids, are usually much more solu- ble in water than in alcohol. Among those soluble in water and almost entirely insoluble in alcohol are: alum, tartar emetic, arsenic trioxide, double salts of iron, iron phosphate, iron sulphate, lithium citrate, magnesium sulphate, potassium bicarbonate, potassium carbonate, potassium chlorate, potassium citrate, potassium and sodium tartrate, sugar, milk sugar, sodium borate, sodium carbonate, sodium chloride, sodium citrate, sodium nitrite, sodium phosphate, sodium sulphate, zinc sulphate. It should be remembered that considerable water can usually be added to an alcoholic solution or alcohol to an aqueous solution with- out precipitation. II. Evolution of a Gas. The most common instances are the evolution of carbon dioxide when a carbonate or bicarbonate and an acid or acid salt are brought together in solution. This action is often desirable either to give the patient a freshly formed salt or to have the agents dispensed in a liquid charged with carbonic acid. Examples of intentional mixtures of this class are prescriptions for salicylic acid and sodium bicarbonate or the formulse for the preparation of the solution of potassium citrate, solution of am- monium acetate, solution of magnesium citrate, seidlitz powders, etc. A common example of the unintentional prescription of this class is ordering ammonium carbonate and syrup of squills. Gas may be liberated with explosive violence when strong oxidiz- ing and easily oxidizable substances are brought together. Potassium chlorate should not be prescribed with easily oxidizable substances if trituration is necessary. It should not be prescribed with sulphuric acid or with hydro- chloric acid or glycerin except in the presence of considerable water. Spirit of nitrous ether should not be prescribed with substances containing tannic acid, as undesirable nitric oxide gas is evolved. Nitric acid should not be prescribed with glycerin or other easily oxidizable substances. Sulphuric acid should not be prescribed with chlorates. Glycerin should not be rubbed with dry oxidizing agents, as potassium chlorate, potassium permanganate, etc. Iodine should not be prescribed with oil of turpentine in concen- tration. It should not be ordered with ammonia water (to make the 404 PRESCRIPTION WRITING. so-called colorless tincture of iodine), as explosions may occur after evaporation of the liquid. Chromium trioxide is a strong, oxidizing agent. It is seldom used by the general practitioner. It should be used alone. III. Separation of an Immiscible Liquid. (a) The Result of Chemical Action.-The only common ex- ample of this is the separation of the oily chloral alcoholate when hydrated chloral is dissolved in a strongly alcoholic liquid. (&) Due to Physical Incompatibility.-Most oils are readily soluble in or miscible with alcohol, and only sparingly so with water. When, therefore, an alcoholic solution of an oil has water added to it in sufficient quantity, more or less of the oil separates, producing, first, a cloudy or milky appearance, then collecting as a separate strata. Alcoholic solutions that are particularly liable to this action are aromatic spirit of ammonia, spirit of orange, spirit of lemon, spirit of peppermint, spirit of camphor, camphorated tincture of opium, etc. IV. Formation of a Gelatinous Mass. The most common examples are: ordering phenol with collodion or albumin, or an aqueous solution of acacia with alcohol, ferric salts, or strong solutions of borates or lead subacetate. V. Incomplete Solutions. This constitutes one of the most common sources of trouble with which the pharmacist has to contend. A physician may prescribe insoluble or sparingly soluble sub- stances to be dissolved in liquid, as bismuth subnitrate in water. Sometimes a moderately soluble substance is prescribed in excess, as in ordering for a 2-f§ aqueous solution 1 3 of boric acid. Sometimes too small an amount of the solvent is used, as wishing to give 2 grains of quinine hydrobromide in solution at a dose, to prescribe it 2 grains to the teaspoonful. The solvent should be in- creased so as to represent the two grains to two teaspoonfuls. Often the wrong solvent is ordered, as prescribing alkaloidal or metallic salts in alcohol instead of aqueous liquids in which they are more soluble. VI. Immiscibility. The most common examples are prescribing oils with aqueous liquids. INCOMPATIBILITY. 405 Incompatibility in Solids. I. Chemical Changes.-Dry medicinal agents are not so apt to undergo chemical changes and the possibility of such occurring need not often be a cause of apprehension. The following, how- ever, may well be remembered: Chemical changes may take place after the agents have been dis- solved in the fluids of the intestinal tract; so drugs that in solution would form poisonous or inert compounds should not be prescribed together even in dry form. Examples are calomel and potassium bromide or silver nitrate and sodium chloride. Agents apt to explode when rubbed together should not be pre- scribed, as potassium chlorate and tannic acid. Certain salts when mixed with certain other agents liberate water of crystallization. The most common example is iron sulphate with alkaline carbonates. II. Undesirable Pharmaceutical Mixtures.-Some drugs when mixed develop excessive moisture. The following should usually not be prescribed together in dry form: Camphor, menthol, thymol, hydrated chloral, citric acid, sodium phosphate. ' The above should not usually be prescribed in dry form with acetanilide, antipyrine, acetphenetidin, sodium salicylate, phenyl- salicylate, resorcin, betanaphthol, diuretin, sulphonal, trional. There are, of course, some minor exceptions in the foregoing. In ointments, aqueous liquids should not be ordered with oily or fatty bases, as tincture of opium or solution of lead subacetate with petrolatum. Therapeutic Incompatibility. This is the condition resulting where agents are prescribed to- gether that have an antagonistic therapeutic effect. The considera- tion of this belongs to the realm of therapeutics. Therapeutic in- compatibility is not always undesirable. Where an agent affects several organs, another agent may be employed with it that modifies or counteracts its effect upon one or more of these parts and leaves its action on the others more or less uninfluenced. When an agent has two or more different actions, another agent may be employed with it that will modify or counteract one or more of these effects without materially interfering with its other action. Atropine is often ordered with morphine or opium with calomel. As general examples of therapeutic incompatibility might be men- tioned prescribing stimulants with depressants, purgatives with astringents, etc. 406 PRESCRIPTION WRITING. Table of Relative Value of Weights and Measures.1 Weights, Old Form. Metric Weight and Measure. Measures, Old Form. Weights, Old Form. Metric Weight and Measure. Measures, Old Form. Fluidounces Fluidounces Grains. Gm. or Mils. and Grains. Gm. or Mils. and fractions. fractions. 15432.4 1000 33.814 6845.9 443.606 15 14660.7 950 32.123 6389.5 414.032 14 14604.5 946.358 32 6172.9 400 13.526 14148.2 916.875 31 5933.1 384.458 13 13889.1 900 30.432 5476.7 354.884 12 13691.8 887.211 30 5401.3 350 11.835 13235.0 857.637 29 5020.3 325.311 11 13117.5 850 28.742 4629.7 300 10.144 12779.0 828.064 28 4563.9 295.737 10 12345.0 800 27.051 4107.5 266.163 9 12322.6 798.490 27 3858.1 250 8.453 11866.2 768.916 26 3651.1 236.590 8 11574.3 750 25.360 3194.7 207.016 7 11409.8 739.343 25 3086.5 200 6.763 10953.4 709.769 24 2738.4 177.442 6 10802.6 700 23.670 2314.9 150 5.072 10497.0 680.195 23 2282.0 147.869 5 10040.6 650.621 22 1929.0 125 4.227 9584.2 621.048 21 1825.5 118.285 4 9259.4 600 20.288 1543.2 100 3.381 9127.8 591.474 20 1388.9 90 3.043 8671.4 561.900 19 1369.2 88.721 3 8487.8 550 18.598 1234.6 80 2.705 8215.1 532.327 18 1157.4 75 2.536 7758.7 502.753 17 1080.3 70 2.367 7716.2 500 16.907 925.9 60 2.029 7302.3 473.179 16 912.8 59.147 2 7000.0 453.592 15.338 771.6 50 1.691 6944.6 450 15.216 617.3 40 1.353 Minims. Minims. 480 31.103 504.8 47.5 3.081 50 463 30 486.9 46.3 3 48.7 456.392 29.573 480 45 2.916 47.3 447.5 29 470.7 42.8 2.773 45 432.1 28 454.5 40 2.592 42.1 420 27.216 441.7 38.03 2.464 40 416.7 27 438.2 35 2.268 36.8 401.2 26 422 33.3 2.156 35 400 25.920 420.7 30.9 2 32.5 399.3 25.877 420 30 1.944 31.6 385.8 25 405.8 28.5 1.848 30 370.4 24 389.5 25 1.620 26.3 360 23.328 378.6 23.8 1.540 25 354.9 23 373.3 20 1.296 21.03 342.3 22.180 360 19.02 1.232 20 339.5 22 357.1 15.432 1 16.2 324.1 21 340.8 15.2 0.986 16 1 Condensed from Remington's "Practice of Pharmacy." WEIGHTS AND MEASURES. 407 Table of Relative Value of Weights and Measures. Weights, Old Form. Metric Weight and Measure. Measures, Old Form. Weights, Old Form. Metric Weight and Measure. Measures, Old Form. Grains. Gm. or Mils. Minims. Grains. Gm. or Mils. Minims. V 308.6 20 324.6 15 0.972 15.8 300 19.440 315.5 14.3 0.924 15 293.2 19 308.4 14 0.907 14.7 285.2 18.483 300 13.3 0.863 14 277.8 18 292.2 13 0.842 13.7 262.4 17 275.9 12.4 0.801 13 246.9 16 259.7 12 0.778 12.6 240 15.552 252.4 11.6 0.75 12.2 231.5 15 243.4 11.4 0.739 12 228.2 14.787 240 11 0.713 11.6 216.1 14 227.2 10.5 0.678 11 200.6 13 211 10 0.648 10.5 185.2 12 194.8 9.5 0.616 10 180 11.664 189.3 9 0.583 9.5 171.1 11.090 180 8.6 0.555 9 169.8 11 178.5 8 0.518 8.4 154.3 10 162.3 7.7 0.5 8.1 138.9 9 146.1 7.6 0.493 8 123.5 8 129.8 7 0.454 7.4 120 7.776 126.2 6.7 0.431 7 114.1 7.393 120 6 0.389 6.3 108 7 113.6 5.7 0.370 6 100 6.480 105.2 5 0.324 5.3 92.6 6 97.4 4.8 0.308 5 90 5.832 94.7 4 0.259 4.2 80 5.184 84.1 3.8 0.246 4 77.2 5 81.2 3 0.194 3.2 70 4.536 73.6 2.9 0.185 3 61.7 4 64.9 2 0.130 2.1 60 3.888 63.1 1.9 0.123 2 57 3.697 60 1 0.065 1.0517 50 3.240 52.6 0.9508 0.06161 1 Table of Abbreviations, Words, and Phrases.1 Word or Phrase. Abbreviation. Meaning. Acerbus Sour Ad Ad To, up to Adde Add Ad libitum Ad lib. At pleasure Admove Admov. Apply Agita A git. Shake Albus Alb. White Alter The other Alternis horis Every other hour 1 Condensed from'Remington's "Practice of Pharmacy." 408 PRESCRIPTION WRITING. Table of Abbreviations, Words, and Phrases. Word or Phrase. Abbreviation. Meaning. Amplus Large Ana A., aa. Of each Ante Before Aqua bulliens Aq. bull. Boiling water Aqua communis Aq. comm. Common water Aqua fervens Aq. ferv. Hot water Aqua fluviatilis Aq. fluv. River-water Aqua fontalis Aq. font. Spring-water Aqua marina Aq. mar. Sea-water Aqua pluviatilis Aq. pluv. Rain-water Bene Well Bibe Bib. Drink Bis Twice Bis in die Bis in d. Twice a day Bolus Bol. A large pill Bonus Good Brevis Short Bulliat, bulliant Bull. Let boil Capiat Cap. Let him (or her) take Caute Cautiously Charta Chart. Paper Charta cerata Chart, cerat. Waxed paper Chartula C. Small paper Cibus Food Cochlear or cochleare Coch. A spoonful Cochleare amplum Coch. amp. A tablespoonful Cochleare medium Coch. med. A dessertspoonful (about 2 fluidrachms) Cochleare parvum Coch. parv. A teaspoonful (about 1 flui- drachm) Coctio Coet. Boiling Cola Col. Strain Colentur Colent. Let them be strained Coletur Colet. Let it be strained Collutorium Collut. A mouth-wash Collyrium Collyr., Coll. An eye-wash Confectio Conf. Confection Congius Cong. A gallon Contere Rub together Contra Against Coque Coq. Boil Cortex Cort. The bark Cras, Crastinus Crast. Tomorrow Cum C. With Decanta Dec. Pour off Decern Ten Decubitus Decub. Lying down Diebus alternis Dieb. alt. Every other day Diebus tertiis Dieb. tert. Every third day Dilue, Dilutus Dil. Dilute (thou), diluted Dividatur in partes aequales D. in p. aeq. Let it be divided into equal parts Dividendus To be divided Dolor Pain Donee Until ABBREVIATIONS, ETC. 409 Table of Abbreviations, Words, and Phrases. Word or Phrase. Abbreviation. Meaning. Electuarium Elect. An electuary Enema An enema, a clyster Et And Extend Spread Fac, fiat, fiant F., ft. Make Febris Fever Fiat cataplasma Ft. cataplasm. Make a poultice Fiat emulsio Ft. emuls. Make an emulsion Fiat gargarisma Ft. garg. Make a gargle Fiat massa Ft. massa Make a mass Fiat mistura Ft. mist. Make a mixture Fiat pulvis Ft. pulv. Make a powder Fiat secundum artis regulas F. s. a. r. Let it be made according to the rules of art. Fiat solutio Ft. solut. Make a solution Fiat suppositorium Ft. suppos. Make a suppository Fiat unguentum Ft. ung. Make an ointment Filtra Filter Flavus Flav. Yellow Folius Fol. A leaf Gargarisma Garg. A gargle Gratus Pleasant Gutta Gtt. A drop Haustus Haust. A draught Herba An herb Hora H. An hour Hora decubitus H. d. At the hour of going to bed Hora somni H. s. or Hor. som. Just before going to sleep Idem The same In dies In d.; i. d. From day to day. Daily Injectio An injection Inter Between Involve gelatina Coat with gelatin Lac Milk Magnus Mag. Large Mane In the morning Massa A mass Minimum M. or Min. A minim Misce M. Mix Ne tradas sine nummo Ne tr. s. num. Do not deliver unless paid Non Not Non repetatur Non. rep. Do not repeat Numerus No. Number Octarius O. A pint Omni hora Omn. fiora Every hour Omni mane Every morning Omni nocte Every night Ovum An egg Pabulum Food. Nourishment Panis Bread Pars, partis A part Partes aequales P. X. Equal parts Parvus Little Pectus The breast Pes The foot 410 PRESCRIPTION WRITING. Table of Abbreviations, Words, and Phrases. Word or Phrase. Abbreviation. Meaning. Placebo P. To please, satisfy Pondere By weight Pone aurem Behind the ear Post cibo P. C. After eating Potus Drink Primus The first Pro re nata P. r. n. Occasionally Pulvis, Pulverizatus Pulv. A powder, powdered Quantum sufficiat Q. s. As much as is sufficient Quaque Q-, q. Each or every Quaque hora Q. h. Each hour Quartus Fourth Quater Four times Quinque Five Quintus The fifth Recipe R Take Repetatur Rept. Let it be repeated. Repetantur Rept. Let them be repeated. Secundum artem S. a. According to art Secundus Second Semis Ss. A half Septem Seven Sex Six Sextus Sixth Siccus Dry. Dried Signa Sig. Mark thou Simul Together Sine Without Sit Let it be Solve Dissolve Somnus Sleep Spissus Dense, hard Subinde When the boiling is nearly finished. Succus Juice, sap Supra Above Tabs Such, like this Ter Three times Tere Ter. Rub Ter in die, or Ter die T. i. d., or T. d. Three times a day Tertius Third Tres Three Tritura Trit. Triturate Ubi Where, whenever Una Together Uncia An ounce Unguilla Ut diet. An ointment box Ut dictum As directed Veniculum A vehicle Vel V. Or Verus True, genuine Vitellus Yolk DROPS AND WEIGHT OF FLUIDRACHM. 411 Table Exhibiting the Number of Drops in a Fluidrachm of Different Liquids, with the Weight in Grains and Grammes.1 Name Drops In f5j (60 m.) Weight of f5j Name Drops in f5j (60 m.) Weight of f3j in gr. in Gm. in gr. in Gm. Acetum Opii 90 61 3.95 Liquor Hydrarg. Nit.. 131 123 7.97 Sanguinariae 78 55% 3.59 lodi Compositus .... 63 59 3.82 Scillae 68 57 3.69 Plumbi Subacetatis.. 74 70 4.53 Acidum Aceticum .... 108 58 3.75 Potass. Hydroxidi .. 62 58 3.75 Aceticum Dilutum . 68 55 3.56 Potassii Arsenitis ... 57 55 3.56 Carbolicum 111 59 3.82 Sodae Chlorinatae .. 63 62 4.01 Hydrochloricum .... 70 65 4.21 Zinci Chloridi 89 88 5.70 Hydrochlor. Dilutum 60 56 3.62 Oleoresina Aspidii ... 130 52 3.36 Hydrocyanicum Dil. 60 54 3.49 Capsici 120 51 3.30 Lacticum 111 66 4.27 Cubebae 123 52 3.36 Nitricum 102 77 4.98 Oleum .-Ethereum .... 125 50 3.24 Nitricum Dilutum .. 60 58 3.62 Amygdalae Amarae .. 115 55 3.56 Nitrohydrochloricum. 76 66 4.27 Amygdalae Expres. . 108 48% 3.14 Phosphoricum Dil... 59 57 3.69 Anisi 119 54 3.49 Sulphuricum 128 101 6.54 Bergamottae 130 46 2.98 Sulphuricum Aromat. 146 53 3.43 Cari 132 50 3.24 Sulphuricum Dilutum 60 58% 3.79 Caryophylli 130 57 3.69 Sulphurosum 59 55 3.56 Cinnamomi 126 53% 49% 3.46 JEther 176 39 2.52 Copaibae 123 3.20 Alcohol 146 44 2.85 Cubebae 125 51 3.30 Dilutum 137 49 3.17 Foeniculi 125 53 3.43 Aqua 60 55 3.56 Gaultherias 125 62 4.01 Ammoniae Fortior .. 66 50 3.24 Juniperi 148 49 3.17 Destillata 60 53% 3.46 Lavandulas 138 52 3.36 Balsamum Peruvlanum 101 60 3.88 Limonis 129 47 3.04 Bromum 250 165 10.69 Menthae Piperitae ... 129 50 3.24 Chloroformum 250 80 5.18 Ricini 77 51% 3.33 Copaiba 110 51 3.30 Rosas 132 47 3.04 Creosotum 122 56% 3.66 Rosmarini 143 50 3.24 Fluidextract. Belladon. 156 57 3.69 Sassafras 133 58 3.75 Buchu 150 47% 3.07 Terebinthinae 136 45% 2.94 Cimicifugae 147 48 3.11 Tiglii 104 50 3.24 Cinchonas 138 58 3.75 Spiritus Either. Comp. 148 45 2.91 Colchici Radicis .... 160 57 3.69 yEtheris Nitrosi .... 146 47 3.04 Colchici Seminis .... 158 55 3.56 Ammonias Aromat. . 142 48 3.11 Conii 137 61 3.95 Camphoras 143 47 3.04 Digitalis 134 62 4.01 Chloroformi 150 48 3.11 Ergotas 133 60 3.88 Menthae Piperitae ... 142 47 3.04 Gelsemil 149 49 3.14 Syrupus 65 72 4.66 Glycyrrhizae 133 61 3.95 Acaciae 44 73 4.73 Hyoscyami 160 59 3.82 Ferri lodidi 65 77 4.98 Ipecacuanhae 120 60 3.88 Scillae 75 74 4.79 Pareiras 140 57 3.72 Sclllae Compositus .. 102 70 4.53 Rhei 158 61 3.95 Senegas 106 70 4.53 Sarsaparillae Comp... 134 60 3.88 Tinctura Aconiti 146 46 2.98 Senegas 137 62 4.01 Belladonnas Fol 137 53 3.43 Serpentariae 148 47 3.07 Benzoini Composita. 148 48 3.11 Uvae Ursi 137 60 3.88 Cantharidis 131 51 3.33 Valerianae 150 49 3.17 Cinchonas Comp. ... 140 49 3.17 Veratri Viridis 150 50 3.24 Digitalis 128 53 3.43 Zingiberis 142 48 3.11 Ferri Chloridi 150 53 3.43 Glycerinum 67 68 4.40 lodi 148 47 3.04 Hydrargyrum 150 760 49.24 Nucis Vomicae,. 140 44 2.85 Liquor Acidi Arsenosi. 75 56 3.62 Opii 130 53 3.43 Ammonii Acetatis .. 57 55 3.56 Opii Camphorata ... 130 52 3.36 Arseni et Hydrargyri Opii Deodorati 110 54 3.49 lodidi 58 55 3.56 Valerianae 130 52 3.36 Ferri Chloridi 71 72 4.66 Veratri 145 46 2.98 Ferri Citratis 71 72 4.66 Zingiberis 144 46 2.98 Ferri Nitratis 59 59 3.82 Vin. Colchici Radicis.. 107 55 3.56 Ferri Subsulphatis . 73 83 5.37 Colchici Seminis .... 111 54 3.49 Ferri Tersulphatis . 83 72 4.66 Opii 100 55 3.56 1 Remington's "Practice of Pharmacy." 412 PRESCRIPTION WRITING. Table of the Solubility of Official Substances in Water and in Alcohol.: Abbreviations: s. = soluble; ins. = insoluble; sp. = sparingly; v. s. = very soluble; alm. = almost; dec. = decomposed; r s. = readily soluble; p. s. = partially soluble. One Part is Soluble In Water In Alcohol At 25° C. At 25° C. (77° F.) (77° F.) Parts Parts Acetanilidum 190 3.4 Acetphenetidinum 1310 15 Acidum Benzoicum 275 2.3 Boricum 18 18 Citricum 0.5 1.8 Gallicum 87 4.6 Phenylcinchoninicum .... ins. sp. Salicylicum 460 2.7 Stearicum .... ins. 21 Tannicum .... v. s. v. s. Tartaricum 0.75 3.3 Trichloraceticum .... v. s. v. s. Aconitina 3200 28 Adeps .... ins. v. sp. yEthylis Carbamas .... v. s. 0.8 jEthylmorphinae Hydrochloridum 8 22 Agar ins. Aloinum 65 10.75 Alumen 7.2 ins. Exsiccatum 20 ins. Alumini Hydroxidum .... ins. ins. Ammonii Benzoas 10 35.5 Bromidum 1.3 12 Carbonas 4 dec. Chloridum 2.6 100 lodidum 0.6 3.7 Salicylas 1 3 Valeras .... v. s. v. s. Antimonii et Potassii Tartras 12 ins. Antipyrina .... V. s. 1.3 Apomorphinae Hydrochloridum 50 50 Argenti Nitras 0.4 30 Nitras Fusus 0.4 30 Oxidum .... v. sp. ins. Arseni lodidum 12 5 Trioxidum 30-100 sp. Atropina 455 2 Atropinae Sulphas 0.4 5 Auri et Sodii Chloridum .... v. s. v. s. Benzinum Purificatum V. s. Benzosulphinidum 290 31 Betaeucainae Hydrochloridum 30 35 Betanaphthol 1000 0.8 Bismuthi Betanaphtholas .... alm. ins. alm. ins. et Ammonii Citras .... v. s. sp. Subcarbonas .... ins. ins. Subgallas ins. Subnitras .... alm. ins. alm. ins. Subsalicylas - Bromoformum .... v. sp. V. s. SOLUBILITY OF OFFICIAL SUBSTANCES. 413 Solubility of Official Substances in Water and in Alcohol-Continued. One Part is Soluble In Water In Alcohol At 25° C. At 25° C. (77° F.) (77° F.) Parts Parts Caffeina 46 66 Citrata .... v. s. - Caffeinae Sodio-benzoas 1.1 30 Calcii Bromidum 0.7 1.3 Carbonas Praecipitatus .... alm. ins. ins. Chloridum 0.62 10 Glycerophosphas 50 ins. Hypophosphis 6.5 ins. Lactas 20 alm. ins. Sulphidum Crudum .... v. sp. ins. Calx 840 ins. Chlorinata p. s. p. s. Camphora . . . . V. sp. r. s. Monobromata .... alm. ins. 6.5 Cerii Oxalas .... ins. ins. Cetaceum .... ins. alm. ins. Chloralum Hydratum .... v. s. v. s. Chromii Trioxidum . . . . V. s. dec. Chrysarobinum . . . . V. sp. 385 Cinchonidinae Sulphas 65 90 Cinchonae Sulphas 60 12.5 Cocaina 600 6.5 Cocainae Hydrochloridum 0.4 3.2 Codeina 120 2 Codeinae Phosphas 2.3 325 Sulphas 30 1280 Colchicina 22 v. s. Cotarninae Hydrochloridum .... v. s. V. s. Creosoti Carbonas .... ins. V. s. Creta Praeparata .... alm. ins. ins. Cupri Sulphas 2.5 500 Diacetylmorphina 1700 31 Diacetyhnorphinae Hydrochloridum 2 5 Elaterium .... ins. 325 Emetinae Hydrochloridum .... v. s. v. s. Ferri Chloridum . . . . V. s. V. s. et Ammonii Citras .... r. s. ins. et Quininae Citras .... r. s. p. s. Phosphas .... v. s. ins. Sulphas 1.4 ins. Exsiccatus 1.4 ins. Granulatus 1.4 ins. Ferrum Reductum .... ins. ins. Gelatinum .... ins. ins. Glycyrrhizinum Ammoniatum .... r. s. r. s. Guaiacol 53 v. s. Guaiacolis Carbonas .... ins. 60 Hexamethylenamina 1.5 12.5 Homatropinas Hydrobromidum 6 40 Hydrargyri Chloridum Corrosivum 13.5 3.8 Chloridum Mite .... ins. ins. lodidum Flavum .... alm. ins. ins. Rubrum .... alm. ins. 115 Oxidum Flavum .... alm. ins. ins. Rubrum .... alm. ins. ins. Salicylas .... alm. ins. alm. ins. 414 PRESCRIPTION WRITING. Solubility of Official Substances in Water and in Alcohol-Continued. One Part Is Soluble In Water In Alcohol At 25° C. At 25° C. (77° F.) (77° F.) Parts Parts Hydrargyrum Ammoniatum ins. Hydrastina 170 Hydrastinae Hydrochloridum V. S. V. s. Hydrastininae Hydrochloridum V. s. V. s. Hyoscyaminae Hydrobromidum v. s. 2.5 lodoformum 60 lodum 2950 12.5 Lithii Bromidum 0.6 V. s. Carbonas 78 alm. ins. Citras 1.4 alm. ins. Magnesii Carbonas ins. ins. Oxidum ins. Ponderosum ins. Sulphas 1 alm. ins. Mangani Dioxidum Praecipitatum ins. Menthol v. s. Methylis Salicylas V. s. Methylthioninae Hydrochloridum r. s. Morphina 3340 210 Morphinae Hydrochloridum 17.5 52 Sulphas 15.5 565 Paraffinum ins. Paraldehydum 8 v. s. Pelletierinae Tannas 240 16 Pepsinum 50 alm. ins. Phenol 15 v. s. Liquefactum 12 - Phenolphthaleinum 13 alm. ins. Phenylis Salicylas 6670 6 Phosphorus - Physostigminae Salicylas 75 16 Pilocarpinae Hydrochloridum 0.3 3 Nitras 4 75 Plumbi Acetas 1.4 38 Oxidum ins. Potassii Acetas „ 0.5 2.9 Bicarbonas 2.8 alm. ins. Bitartras 155 v. sp. Bromidum 1.5 250 Carbonas 0.9 ins. Chloras 11.5 alm. ins. Citras 0.6 alm. ins. et Sodii Tartras 0.9 alm. ins. Hydroxidum 0.9 3 Hypophosphis 0.6 9 lodidum 0.7 22 Nitras 2.8 620 Permanganas 13.5 dec. Pyrogallol 1.7 1.3 Quinina 1560 0.8 Quininae Bisulphas 9 23 Dihydrochloridum 0.6 12 et Ureae Hydrochloridum 0,9 2.4 Hydrobromidum 40 0.9 Hydrochloridum 18 0.8 SOLUBILITY OF OFFICIAL SUBSTANCES. 415 Solubility of Official Substances in Water and in Alcohol-Continued. One Part Is Soluble In Water In Alcohol At 25° C. At 25° C. (77° F.) (77° F.) Parts Parts Quininae Salicylas 77 14 Sulphas 725 . 107 Tannas sp. Sp. Resorcinol 0.9 0.9 Saccharum 0.5 170 Lactis 4.9 alm. ins. Salicinum 23.5 88.5 Santoninum 5300 43 Scopolaminae Hydrobromidum 1.5 20 Sevum Praeparatum ins. Sodii Acetas 0.8 19 Arsenas 1.5 v. sp. Exsiccatus 3.1 V. sp. Benzoas 1.8 61 Benzosulphinidum 1.2 50 Bicarbonas 10 ins. Boras 15 ins. Bromidum 1.1 16 Cacodylas 0.5 2.5 Carbonas Monohydratus 3 ins. Chloridum 2.8 alm. ins. Citras 1.3 ins. Cyanidum v. s. - Glycerophosphas alm. ins. Hydroxidum 0.9 v. s. Hypophosphis 1 s. Indigotindisulphonas alm. ins. lodidum 0.55 2 Nitris 1.5 sp. Perboras s. Phenolsulphonas 4.2 140 Phosphas 2.7 ins. Exsiccatus 8.1 ins. Salicylas 0.9 9.2 Sulphas 1 + ins. Sulphis Exsiccatus 3.2 sp. Thiosulphas 0.5 ins. Sparteinae Sulphas 1.1 3 Strontii Bromidum 0.35 r. s. lodidum 0.2 s. Salicylas 19 61 Strophanthinum s. Strychnina 6420 136 Strychninae Nitras 42 150 Sulphas 32 81 Sulphonethylmethanum 200 r. s. Sulphonmethanum 365 60 Sulphur Lotum alm. ins. Praecipitatum alm. ins. Sublimatum alm. ins. Terebenum sp. 3 Terpini Hydras 200 13 Theobrominae Sodio-salicylas 1 sp. Theophyllina 100 80 Thymol 1010 1 416 PRESCRIPTION WRITING. Solubility of Official Substances in Water and in Alcohol-Concluded. One Part is Soluble In Water At 25° C. (77° F.) Parts In Alcohol At 25° C. (77° F.) Parts Thymolis lodidum ins. sp. Trinitrophenol 78 12 Uranii Nitras 1.2 V. s. Vanillinum 100 r. s. Veratrina 1760 2.8 Zinci Acetas 2.3 30 Carbonas Praecipitatus ins. ins. Chloridum 0.25 1.3 Oxidum ins. Phenolsulphonas 1.6 1.8 Stearas . ins. ins. Sulphas 0.6 ins. Valeras 70 22 INTRODUCTION TO PART III. In the following pages, fifty prescriptions are given so ar- ranged as to illustrate the common errors of prescription writing. In each instance, also, the same prescription is shown, written just as it should be for delivery to the pharmacist. These pre- scriptions are selected from many thousands, and the intention is not only to point out pitfalls to the prescriber, but to give formulae of therapeutic merit; to offer (with due apologies) a substantial formulary of stock prescriptions with the hope that the students in this important field may daily build to this modest foundation, carefully working out every detail of each addition, until they are able to meet any emergency with all credit. It is earnestly urged that the student read each incorrect prescrip- tion with the criticisms and then try to write it correctly, afterward comparing his finished product with the correct copy given. 417 418 PRESCRIPTION WRITING. Prescribed for a persistent cough with slight or no evident lesions. General arrangement is imperfect. Tincture of opium compound is not the proper name for the remedy wanted. Spts. is not considered a good abbreviation for Spiritus. The camphor and oil of anise in the paregoric, and the chloroform in the spirit of chloroform, would be thrown out of solution. Final i is best made j in numerals. PRESCRIPTION WRITING. 419 Note the expression "when awake." Directions are usually understood to either mean during the day or during the entire twenty-four hours, regard- less. Many do not approve of waking patients for medicine except under pressing circumstances, but these directions instruct a dose to be given when the little patient is awakened by a paroxysm of coughing. Sodium bromide is often a good addition to this preparation. 420 PRESCRIPTION WRITING. For a "dry" cough with some bronchial involvement and fever. Compare the appearance of the short abbreviations with more complete writing. Ether is not the correct writing of the official word. It is unnecessary to instruct the druggist to make a solution; he could not make anything else by mixing these ingredients. What would the patient think if the druggist carried out his orders and wrote the above directions on the label? 421 PRESCRIPTION WRITING. As this is an expectorant mixture it is not often indicated unless the child is old enough to expectorate. The spirit of nitrous ether is often omitted if there is no fever. Even a small dose of ipecac will frequently cause nausea; so the pre- scriber should be on his guard. 422 PRESCRIPTION WRITING. Frequently used during the paroxysmal stage of whooping-cough. Margins should be observed. Antipyrine does not have the genitive ending i. It only comes in crystal- line form. The aromatic elixir would appear better written more completely, as the name above it is long. The character 3 calls for weight and not volume. The total quantity is too much for this class of remedy. PRESCRIPTION WRITING. 423 As this is only to be used to control the paroxysms, a small amount should be ordered. Instructions are given that the prescription is not to be refilled, else the family may use it too long or in subsequent cases of cough when it would be inadvisable. Tincture of belladonna leaves is frequently added to the above. This should be given in water. 424 PRESCRIPTION WRITING. Prescribed for cough. Heroine is very sparingly soluble and not often stocked. The salt should be used, and under the proper name. A carbonate is incompatible with the free acetic acid in syrup of ipecac. The abbreviation Ipecac, is too well understood by the laity, and nausea often occurs from the psychic effect of even a small dose. Periods should follow abbreviations. PRESCRIPTION WRITING. 425 Syrup of ipecac, contains free acetic acid; but in this instance the amount is small as compared with the carbonate. The carbonate can be used in this combination with the diacetylmorphine and wild cherry alone, or apomorphine hydrochloride in about %o-grain doses. The full expectorant dose of the syrup of ipecac. (15 minims) is often not well tolerated. 426 PRESCRIPTION WRITING. Used in treating a "dry cough." Unusual proper names should be plainly written. The salt of apomorphine should be used, and the above dose will fre- quently produce nausea. The proper name for lemon juice is not used. If an error is made or a word erased for any reason, a new prescription should be written. A cough medicine is usually better administered at frequent intervals. Syrup of Lemon has been replaced by the Syrup of Citric Acid. PRESCRIPTION WRITING. 427 When ordering expectorants, as apomorphine hydrochloride, ipecac., etc., even in small doses, it is well to advise the nurse as to the possibility of nau- sea, and to reduce the dose if necessary, otherwise they may not only pro- duce an undesired result, but it leads to a doubt as to the knowledge and judgment of the physician. 428 PRESCRIPTION WRITING. Prescribed for the headache, hiccough, etc., following acute alcoholism. The quantity is too large for an acute condition, as headache. Acetanilid does not take the ending a. Citrated caffeine is not a salt. As a remedy of this type is only given until symptoms are relieved, it should be so specified. This should be taken in water. PRESCRIPTION WRITING. 429 Attention is called to the rather unusual arrangement of the items in the inscription. To get a good solution the druggist must dissolve the acetanilid in the aromatic spirit of ammonia, and the other solids in the elixir and then mix the two solutions. The arrangement is to indicate that order. Patient should be told to take this diluted with water. 430 PRESCRIPTION WRITING. Used as a sedative in hysteria, convulsions, threatened abortion, etc. The first item ordered is chloralum hydratum, the last word being an adjective and agreeing with the noun in case, etc. Hydrated chloral is incompatible with a strongly alcoholic solvent, as chloral alcoholate is formed. The directions are too long for the size label available. The punctuation is imperfect. PRESCRIPTION WRITING. 431 Longer instructions than this for a 1-ounce bottle should be written on a separate sheet and left with patient or nurse. Aqua menthae piperitae or syrupus aurantii are pleasant vehicles for salts as the above. If it is undesirable to order as many as eight doses the quantity of the salts can be reduced by one-half, and two teaspoonfuls given at a dose. 432 PRESCRIPTION WRITING. Prescribed for the "mucous diarrhea" of childhood. Information as to age is incomplete. The sign " should never be used in prescription writing. A very short word is usually best not abbreviated. The subscription is misplaced. The arrangement of the directions could be improved. Margins are not properly observed. PRESCRIPTION WRITING. 433 This is frequently ordered to be taken after every action or every second action. Instructions should always be left as to just how much water must be used in diluting the dose. In the "acid intoxication" this is sometimes used with an increase in the amount of sodium bicarbonate, in which case more of the vehicle must be used or the vehicle made thicker and a shake label employed. 434 PRESCRIPTION WRITING. In a case of diarrhea, after the intestinal tract had been cleansed by a purgative, the following was ordered: "Mrs. Bill" may not be considered respectful. The arrangement of the drugs is not good. Acidi is better not abbreviated. Magnesium ends in ii in the genitive. Peppermint is not the official name of the drug wanted. An i should be dotted and a t crossed. PRESCRIPTION WRITING. 435 The tincture of opium is the most potent ingredient and may be listed first. The above is the order in which the drugs would be handled by the compounder. This formula is particularly useful where there is intestinal pain and tenderness. 436 PRESCRIPTION WRITING. Prescribed for ileocolitis. It is usually best not to employ a nickname, particularly when it refers to a characteristic that may be shared by a parent. The vehicle in this mixture would be so thin that the powder would not remain suspended long enough to admit of a dose being poured out before it settled. A shake-label should be ordered. Sufficient information as to prescriber is not given. PRESCRIPTION WRITING. 437 This seems to be one of the most satisfactory ways of administering bismuth subnitrate. A vehicle frequently employed is chalk mixture (Mistura Creta), which contains sufficient acacia and sugar for effecting a suspension. Astringent tinctures, as tincture of catechu, or gambir, or kino, are some- times used in the above. 438 PRESCRIPTION WRITING. For acute pharyngitis. The alkali metals, as well as calcium, strontium, magnesium, etc., have the genitive ending ii. The acid radicals in the salts of all the acids except the hydri acids and the lower oxy acids have the genitive atis, as sulphatis for sulphate. The word acid appears better when written with proper termination. The genitive of all acids ends in i. PRESCRIPTION WRITING. 439 Note the ending of sulphurous acid is underscored. It is not very fre- quently used, and might be misread as sulphuric acid. Patient may be instructed to take the dose with one or two tablespoonfuls of water, and to clean the teeth afterward, but not to remove the remedy from the throat, as by eating or drinking soon after a dose has been taken. 440 PRESCRIPTION WRITING. Prescribed for a case of acute "rheumatism." The arrangement on the sheet is open to criticism. In an acute condition, particularly if painful, energetic treatment is usually indicated. The wine has been discontinued to a great extent in favor of the tincture. The disease should never be specified on the label. PRESCRfPTION WRITING. 441 Chloroform water only contains about one minim to the tablespoonful; so can well be given in above dose. Instructions should be left as to reducing dosage upon relief of pain or development of unpleasant effects, as ringing in ears, etc. Some patients seem to tolerate the salicylates better if they are administered in cold milk. As an adjunct to this treatment many employ massage with a liniment containing oil of wintergreen or methyl salicylate. 442 PRESCRIPTION WRITING. Prescribed for the high fever incident to the early stages of certain acute diseases. Spir. Nitris Dulcis is not the name of the agent wanted. Solution is not the official Latin term for the class of preparation wanted. The directions to druggist and patient are best treated as separate paragraphs. The quantity is too large and the dosage not sufficiently intense for an acute condition. PRESCRIPTION WRITING. 443 Lemonade is often a desirable diluent for a remedy of this type. In using a combination of this character the prescriber should have patient sufficiently under observation to enable him to discontinue the medi- cine at the proper time. The trend of the profession is toward the employment of water as the one great antipyretic. 444 PRESCRIPTION WRITING. First prescription for a patient with high blood-pressure, and urine with low specific gravity. The nitrate is not the salt desired. Large doses of sodium nitrite should never be used until the effect of smaller doses has been noted. A small bottle containing a smaller dose would be indicated to begin the treatment. lodi is the genitive for iodine, but not for iodide. PRESCRIPTION WRITING. 445 Note that the attention of the compounder is called to the word nitritis, which closely resembles nitratis. The direction "in a glass" is changed to "with a glass" The patient often can better take a dose with a small amount of the diluent ordered and use the rest to remove the taste from the mouth, in preference to drinking a whole glass of a disagreeable mixture. The dilution in the stomach is the same, of course. It is often more desirable to give a preparation of this type with water. 446 PRESCRIPTION WRITING. Prescribed for a patient suffering from anemia, loss of appetite, general weakness, etc. In a prescription of this type it is better to list the ingredients in the order in which they should be mixed. Nux vomica added to tincture of ferric chloride would cause a precipitate of iron tannate. If the phosphoric acid is added to the iron first the reaction does not take place. Nux in the genitive changes to nucis. The directions would be better if transposed. PRESCRIPTION WRITING. 447 Attention is called to the instructions that the preparation be taken in water. Dilution lessens the action on the teeth, renders the taste less dis- agreeable, and aids the action as a bitter tonic. In ordering an iron solution the physician should always instruct that the preparation be taken through a tube and the teeth cleansed after each dose. 448 PRESCRIPTION WRITING. The following "Four Chlorides" tonic is often prescribed. "Mrs. Sam" may be objectionable. The mercuric salt being a solid, a potent drug and one of the principal ingredients, should be written first. The arsenic solution, as the most potent and probably important of the liquids, should be written before the others. There is no reason why this should not be concentrated to a 6-ounce solution with teaspoonful dose. PRESCRIPTION WRITING. 449 It is particularly desirable in prescribing preparations as the above to give the patient written instructions as to the amount of water to use, the time of taking, the use of a glass tube, and the cleaning of the teeth after each dose. 450 PRESCRIPTION WRITING. Prescribed as an agreeable quinine prepa- ration for a child. The principle in pre- paring so-called "taste- less" quinine is to use a salt that will dissolve only to the smallest pos- sible extent so that it will not come into con- tact with the special nerve elements in such form as to be appre- ciated. The age of the pa- tient should be given. Liquorici is not the proper name of the drug wanted. The vehicle should be used in sufficient quan-' tity to make up to 2 fluidounces. The sulphate is prob- ably the best salt for "tasteless" quinine mix- tures. The tannate is the least bitter of the quinine salts, but has to be given in larger amounts and at least is slower and more uncer- tain in action. It is usually possible to ascertain the prefer- ence of the child as to flavor. Glycyrrhiza may be distinctly disagree- able to some, while syrup of chocolate would be very agreeable. Written instructions may be given as to shaking the mixture. PRESCRIPTION WRITING. 451 Used as a tonic par- ticularly in chronic ma- laria. Liquor Arseni Chlor- idi and Tinctura Ferri are not the proper names for the prepara- tions wanted. It is unnecessary to use distilled water in a preparation of this char- acter. ad may well be omit- ted. The directions are subject to improvement. Physician's name should be more care- fully written. Where the condition was not malarial the amount of quinine sul- phate would probably be reduced. Written instructions should be given patient as to amount of water, use of glass tube, clean- ing teeth, etc. It should be remem- bered that a quinine so- lution is always in- tensely bitter and that patients are apt to dis- continue the remedy. 452 PRESCRIPTION WRITING. Prescribed for indi- gestion. Pepsini here calls for the U. S. P. product, which is standardized at 1 to 3000; so further specification is unneces- sary. Acidi Hyd. Dil. might mean the diluted hydro- chloric, hydrobromic, hy- drocyanic or others. The label should in- dicate that the prepara- tion is to be diluted for administration. It should be remem- bered that a preparation of this character without instructions as to diet, manner of eating, etc., is practically useless. It is probably best to discontinue the use of the pepsin preparation gradually. It may be first omitted after the lightest meal of the day, then used only after the principal meal, etc. PRESCRIPTION WRITING. 453 Has been prescribed for syphilis. The name of the pa- tient is usually best omit- ted in venereal diseases. The proper name is not used for the mer- curial salt. The content of a "sat- urated solution" often depends on the amount of effort put forth by the particular compounder. The quantity is rather large for the dose, as de- composition may occur to some extent before the amount would be used. While convenience or economy may dictate this style of prescription, the physician should avail himself of an early op- portunity to test the dropper the patient is using or note the rapid- ity with which the liquid is disappearing. Written instructions should be given as to time of taking, diluting, etc. It is probably best to administer one hour be- fore or two hours after meals and to have the patient take the medicine diluted with one-fourth glass of water and fol- low with a glass of milk. 454 PRESCRIPTION WRITING. Prescribed as a pur- gative for a child 2 years old suffering from intestinal indigestion. The name and age of the patient should be given. Mite is not in the genitive case. A child cannot usu- ally take capsules till 8 or 10 years of age. The subscription is a Latin sentence; so Roman numerals should be used. Attention is called to the advantage of using sugar of milk in admin- istering calomel to chil- dren. It has an agree- able taste and, of course, is therapeutically inert. In this quantity sufficient bulk is given to the pow- der to facilitate handling. In administering calomel to a child it is usually considered best to give in the early part of the day and follow in two or three hours by castor oil. The active purging is over before bedtime or may be checked by a warm colon irrigation. PRESCRIPTION WRITING. 455 Ordered for a child 5 years old when a diag- nosis of roundworms had been made. All glucosides, neu- tral principles, etc., have the genitive ending i. Santonin, although sometimes prescribed recklessly, is rather a potent drug, and this dose is too large. This should be pre- scribed with something to dilute and render more palatable. It is probably wise to instruct that the above is not to be triturated, as the crystals of santonin are more apt to reach the lower intestinal tract than the powdered drug. This should be fol- lowed by an active pur- gative, as a tablespoon- ful of castor oil. Many prefer to give the san- tonin and sugar of milk without the calomel and follow with a purgative later. Written instructions should be left with the family as to diet, etc. The best time for admin- istering the above is probably in the morning, so that it can be prop- erly followed by the castor oil and then by the colon irrigation. 456 PRESCRIPTION WRITING. For typhoid fever, etc. Salol is neither the official Latin nor the proper English name of the drug wanted. It is usually best to express a quantity by its largest denomination. It is probably inad- visable to prescribe salol alone in capsules. It is not often ad- visable to order more than 5 grains of a sub- stance to each capsule. As the drug is almost odorless and tasteless, there is no objection to giving in powders. The size of the dose and the tendency to form con- cretions would militate against the use of cap- sules. If it is ordered in capsules it should be mixed with a small amount of some soluble powder, as milk sugar, to cause the disintegration of the lump resulting from packing in the cap- sules. PRESCRIPTION WRITING. 457 Prescribed for Mr. Smith, who complained that he was "bilious." It should be specified that John Smith is an adult. Hyoscyamus is not in the genitive case. This preparation would have a very dis- agreeable taste and would be best administered in capsules. If patient could not take capsules, other agents should be selected. Adjectives should fol- low nouns. These capsules are best given so that the last will be at bedtime and a saline adminis- tered early the following morning. It is claimed that the purgation from the above is accompanied by a minimum of discomfort. As a rule it is par- ticularly undesirable to give a mercurial purge in broken doses at long in- tervals during the day, as the patient may be un- necessarily given a day of considerable discom- fort. Note the use of the new official extract of oxgall. 458 PRESCRIPTION WRITING. Prescribed in the treatment of dropsy. Squill is not the Latin name of the drug wanted. Pulv. is here the abbreviation of the Latin for the adjective, powdered; so it should follow the noun. The words pill and every in the directions are obviously unnecessary. PRESCRIPTION WRITING. 459 This is given here more to illustrate the old formula than to recommend it. This is certainly more desirable in capsules. Hyoscyamus is frequently omitted from this combination, but its use to limit intestinal discomfort, etc., seems to be well founded. Even if it is desired to continue this treatment for some time, the first prescription should be for a small amount, as it is frequently not well tolerated. 460 PRESCRIPTION WRITING. Prescribed for a case of menorrhagia. The abbreviation gr. stands for both the singular and the plural. In cases where there are two substances with the names so nearly alike, as Hydrastina and Hydrastinina, an abbreviation that might represent either is obviously incorrect. The| indefinite ergotin is better replaced by the U. S. P. product. Preparations of this character are better prescribed in capsules. PRESCRIPTION WRITING. 461 An important point here is the use of the concentrated products in cap- sules to replace the old custom of using the fluidextracts, which constituted such a disagreeable mixture, and frequently led to gastric disturbances. The same idea will often apply in prescribing. It is usually best in prescribing potent drugs to write out the names as completely as possible. 462 PRESCRIPTION WRITING. Prescribed for a patient recovering from malaria. He was slightly anemic, had no appetite, was weak and generally "run down." Adult is unnecessary, as Mr. conveys that information. The abbreviation for of each is not properly made. It is usually best to list the most potent drugs first. The druggist selects them first for several good reasons. The Quinine is not sufficient for malarial treatment. The prescriber would not wish t. i. d. on the label, so should not instruct the druggist to put it there. PRESCRIPTION WRITING. 463 The mass of ferrous carbonate is often used instead of the reduced iron. When a drug is given three times a day it is usually best to know whether it should be given before or after meals, and so specify. The pa- tient cannot be too forcibly impressed with the fact that the physician knows just what he wants. 464 PRESCRIPTION WRITING. Ordered for a case of hookworm. Drugs the nominative of which end in I usually have the genitive ending is. It is usually consid- ered best to dilute this agent. Thymol is best ad- ministered in capsules. Part of this label is unnecessary, as specific written instructions as to dose, etc., should be left with the patient. It is not often advis- able to tell a patient to "take a saline." Definite directions should be given as to what to take and how much. Note the number of capsules. It is not often that more than 5 or 6 grains should be ordered to the capsule. Detailed instructions should be left with the patient as to the taking of the capsules, the diet, etc. Thymol may often be given to advantage, pow- dered and suspended in a thick liquid. PRESCRIPTION WRITING. 465 Prescribed for amebic dysentery. The inscription can be better written. It is impossible to put sufficient directions on the available label space; so it is best to make out a special sheet of in- structions to be left with the patient. These writ- ten instructions should of course include diet, etc. These are best taken at bedtime. Patient or family should be warned as to the possibility of nausea and vomiting, and in- structed as to the use of the cold cloth to throat, etc. If the pills are too heavily coated they may pass through entire; so patient should be in- structed to watch for them. 466 PRESCRIPTION WRITING. This was for a young lady suffering from chlorosis. It would be better to indicate the age of the patient in a different way. Blauds Pills is not the official name. It is unnecessary to specify the size, as there is only one official. The condition for which the iron carbonate is used generally re- quires extended treat- ment and in that case it is cheaper for the pa- tient to purchase more at a time. The directions could be better expressed. This is the so-called 5-grain Blaud's Pill. It contains about S grains of the total mass or about 1 grain of ferrous carbonate. Unofficial pills may be ordered prepared of any size. The ready- prepared pills are on the market containing 2, 3, and 4 as well as 5 grains of the mass. If other than the official pill is wanted the size should be specified. It should be remem- bered that on the above prescription the phar- macist would dispense the ready-prepared pills, probably gelatin coated. PRESCRIPTION WRITING. 467 Prescribed for a case of acute cystitis. A pet name should seldom be employed, a nickname never, partic- ularly if of a racial character. Extr actum Bella- donna is not the full name of the drug wanted. Cocoa Butter is not the official name of that drug and the quantity is best left to the discre- tion of the pharmacist. The directions are subject to improvement. In warm weather these should be kept in a cool place. The first can be quickly hardened by put- ting it in a spoon resting on cracked ice and salt. They may be dipped in cool olive oil to facili- tate introduction. In prescribing rectal suppositories for women the physician should make it definitely under- stood that they are not for vaginal use. 468 PRESCRIPTION WRITING. Ordered as a morn- ing laxative. There is a general disregard of margins and arrangement. Mrs. "Bill" might ap- preciate a more dignified title. The word teaspoonful is understood to mean 1 teaspoonful. The degrees do not look modest. If the preparation is taken in hot water the effect is usually more pronounced. Hot lemonade is often the more desirable sol- vent. When the taste of the sodium sulphate is found too objectionable it may be omitted and the potas- sium bitartrate alone be administered in a glass of hot lemonade. PRESCRIPTION WRITING. 469 Ordered in the treat- ment of syphilis. The continued appli- cation of the above will frequently produce irri- tation. More than eight ap- plications in succession are usually indicated, so may well be ordered at once for several reasons. There is nothing to mix. It is better to specify waxed or oiled paper. Complete written in- structions should, of course, be left with pa- tient as to baths, site of applications, etc. The pharmacist will charge for putting this into doses; so when econ- omy is a factor the ointment may be ordered in bulk and the direc- tions made to read: Apply a teaspoonful every night. 470 PRESCRIPTION WRITING. Prescribed for a case of scabies. Sulphur, unless otherwise specified, means the sublimed or common, which is not the best to use here. Peru is not the full word wanted; so should either be carried out or a period used. The quantity here would be too much for a l-ounce jar and too little to look well in a 2-ounce jar. PRESCRIPTION WRITING. 471 Written instructions should be left as to duration of treatment, bathing, change of clothes, etc. Note the fluid, balsam of Peru, is prescribed by weight. It adheres to the vessel to such an extent that in this quantity it is more conveniently weighed than measured. 472 PRESCRIPTION WRITING. This ointment was ordered for Mrs. Coleman to relieve an erythema resulting from the continued use of wet bichloride vulva pads. The name of the patient is misspelled. The correctness of patient's name is important. The name of the acid is misspelled. Each word in each name in the inscription should begin with a capital letter. It is hard to well incorporate zinc oxide in an extemporaneous ointment. It is better to order the ointment of zinc oxide. PRESCRIPTION WRITING. 473 Phenol may be added to this if marked itching is a factor. Boric Acid is often used in the above formula. After the ointment has been thoroughly applied the area may be dusted with bismuth subnitrate for comfort and protection to clothing. 474 PRESCRIPTION WRITING. Prescribed for ec- zema, particularly of the scrotum. Camphor is not a gum. Petroleum Jelly is not the proper name of the agent wanted. It is unnecessary to instruct that an ointment be made, as nothing else could result from mixing the above ingredients. The ointment boxes used by the majority of druggists admit of only limited label space. Camphor and hy- drated chloral will liquefy when triturated together, and with the petrolatum should form a smooth ointment. Written instructions should be left as to man- ner and frequency of ap- plication, use of water, oil, etc. From 1 to 5 grains of cocaine hydrochloride are sometimes added, but is usually unnecessary. If it produces discom- fort, instruct that it be diluted with vaseline. PRESCRIPTION WRITING. 475 This ointment is fre- quently ordered for sore eyelids. There is no advan- tage in specifying the color of the patient, but age should be indicated. Petroleum Jelly is not the official name of the agent wanted. The quantity of the ointment is too large for the purpose intended, as it might become contam- inated, and only a small amount is usually re- quired. An abbreviation should be followed by a period. The prescription should be signed. Experience has taught that it requires a consid- erable effort to get the salt distributed through the vehicle in a sufficient degree of fineness. Par- ticles of any appreciable size are apt to be dis- tinctly irritating. It is well, therefore, to in- struct that the druggist "rub well." 476 PRESCRIPTION WRITING. Prescribed for acute mastitis. When a small quantity of an oil is wanted for flavoring it is better to prescribe drops, as 5 minims are not easily measured. Cold Cream is not the official name of the preparation wanted. The quantity of the ointment is entirely too small for the purpose intended. The abbreviation a.a. is both improperly made and placed. PRESCRIPTION WRITING. 477 This formula is frequently employed for such conditions as'orchitis, infected hands and feet, etc. Ammoniated mercury is frequently added when an active antiseptic is desired. The area is often painted with tincture of iodine before applying oint- ment. If iodine is used mercury must be omitted. Camphor and phenol are frequently employed additions to the above. 478 PRESCRIPTION WRITING. This has been used for prickly heat. The manner of giving the name of patient might be improved upon. Boracic Acid is not the name of the drug wanted. It would be well to emphasize the fact that the ingredients should be rubbed well. If the directions for applying are too long to put on a label it would be well to remind patient that there is a special method of employment. PRESCRIPTION WRITING. 479 If there are too many children to specify, it would be better to write as Mr. Jones's Children. The ages are unimportant here, but it is a good habit to always specify, if possible. Written instructions may be given the nurse, aS "Put the powder in a cloth bag and apply three times daily by gently patting the affected parts after bathing." Frequency of bath would depend on the weather, condition of patient, etc. 480 PRESCRIPTION WRITING. The following has been ordered as a spray in the treatment of rhinitis, nasal catarrh, etc.: As 2 minims cannot well be measured in the average pharmacy, it would probably be well to prescribe drops. Atomizers are usually so constructed that a larger amount of the liquid would be necessary for the best results if the treatment was many times repeated. It would be well to indicate in the directions the use of the preparation. PRESCRIPTION WRITING. 481 This character of remedy is usually employed to follow an aqueous cleansing spray. The tendency of the profession seems to be to make their oil solutions rather irritating by ordering too much of the volatile oils. Particular attention is called to the use of the official liquid petrolatum as a vehicle to replace less ethical products. 482 PRESCRIPTION WRITING. Ordered for the use of the physician as a local application in the treat- ment of follicular tonsillitis. It is preferable for many reasons for the prescriber to specify the actual amount of each ingredient. This, of course, would be too dangerous a preparation for the layman to use, and when having the patient purchase for the physician's use it is better to so specify. It would be well to order the bottle labeled "Poison" or "Not to be taken" PRESCRIPTION WRITING. 483 This method of writing for a percentage solution prevents the possibility of trouble through mathematical error on the part of some incompetent clerk. It enables the prescriber to specify distilled water. A Poison or Not to be taken label is certainly desirable. In some instances the physician, in having the patient get medicine for his own use, can to advantage order the formula for a label, as: Sig.- Formula. 484 PRESCRIPTION WRITING. For a case of acute bronchitis. Creosotum does not have the genitive ending ce. B. W., standing for beechwood, is now useless and unnecessary. It is unnecessary to specify that solution be made. The directions are too long. PRESCRIPTION WRITING. 485 Written instructions as to the use of this should be left with the family. It is usually employed by the patient holding the head over pitcher or by making a tent to cover both. An open newspaper answers very well. It must be prepared fresh for each inhalation. It may be administered to small children during sleep. 486 PRESCRIPTION WRITING. Prescribed as an inhalation in rhinitis with involvement of the accessory sinuses. The name of the patient should be given. The proper termination is not used for the genitive of menthol. Spiritus Rectificatus is not the proper name of the drug desired. When a liquid is not to be taken internally the first word of the direc- tions should so indicate. The directions are too long for the size of the label available. PRESCRIPTION WRITING. 487 This should not be used for a young child on account of the effect of menthol on the eyes. Patients should be instructed to keep the eyes tightly closed while using. Written instructions should be left with patient as to frequency and duration of inhalation. Usually for about five minutes two to four times a day. This is frequently employed in certain forms of asthma. The Compound Tincture of Benzoin is frequently used instead of the Alcohol. 488 PRESCRIPTION WRITING. Prescribed as a wet dressing for an infected hand. Information as to the age of the patient should be given. The quantity of the salt can be better expressed. A soluble salt of mercury should never be ordered in ordinary water. A solution of this character should usually be prescribed in a more economical form. A poison label should be ordered. PRESCRIPTION WRITING. 489 As did the other prescription, this gives a solution of about 1 to 5000. The economy of the above is self-evident, as the druggist usually con- siders bulk an important factor in determining price. The value of the addition of tartaric acid hardly needs discussion. Written instructions should be given the family as to changing the dress- ing to prevent too great concentration by evaporation, also as to frequency of use, etc. 490 PRESCRIPTION WRITING. The full name of the patient may well be omitted. The salt is only partially soluble in the amount of vehicle ordered. Distilled water should be used. The word douche may be omitted as the "gallon of hot water" would prevent other use of the remedy, and more complete instructions should be left with the patient, anyway. PRESCRIPTION WRITING. 491 More complete written instructions should, of course, be left with patient. These may include the position of patient, elevation of reservoir, temperature of the water, etc. It will be noted that the above gives a solution of about 1 to 5000. It is a convenient method of prescribing the drug. 492 PRESCRIPTION WRITING. Prescribed for ear- ache in a child 5 years old. The prescription should be better placed on the sheet. Carbolic Acid is not the official name of the drug wanted. Carbolic Acid is a solid; so should not be prescribed by minims. Glycerin is the Eng- lish name of the drug. If 1 fluidounce of the mixture is wanted the glycerin should be q. s. More definite direc- tions should be used, particularly as this is a poison for local use. Phenol is a crystalline solid; so should be pre- scribed in grains. Liquefied phenol is a liquid obtained by melt- ing phenol and adding 10 per cent, of water so that it will not recrystallize. While 1 ounce is far in excess of the needs of the patient it is not usu- ally advisable to order less of a fluid, as there is no saving in price, and the ounce bottle is more convenient for label, handling, etc. PRESCRIPTION WRITING. 493 Ordered as a local application for tonsillitis, enlarged cervical glands, etc. Even in the case of children it is best to em- ploy the correct name. The surname should also be given. The quantity is too large for the purpose desired. Tr. is not the best ab- breviation for tincture. lodidi is not the geni- tive for the Latin name of Iodine. Margins should be better observed. "Paint the neck" was probably not sufficiently definite, as only a com- paratively small part is usually to be covered. It is best, when possible, for the physician to make the first applica- tion to show family the method of applying and the area to be covered. An application will sometimes be kept up in- definitely unless instruc- tions are given as to when to discontinue. This constitutes the well-known "Iodine and Aconite" of the dentist. It is used by them for toothache, etc. 494 PRESCRIPTION WRITING. Used with massage on a patient suffering from soreness following violent exercise. Chloroform does not have the genitive ending is. A prescriber should have some definite term for each purpose, and q. s. seems more desir- able than ad, though the latter is entirely correct. The quantity is too small for the purpose in- tended. The directions may be improved upon. This is probably best used following a hot bath. It may be made to act as a better rubefa- cient by covering for a short time with the hands or a woollen cloth. Camphor is some- times added to the above. The use of a liniment of this type is frequently preceded by the applica- tions of hot turpentine steeps. PRESCRIPTION WRITING. 495 Prescribed as a local application in orchitis complicating mumps. The arrangement on the sheet is not good. Guaiacol is usually a liquid; so it is unneces- sary to specify. The majority of liquid prescriptions are for internal use. Such is understood where specifications are not to the contrary. If a preparation is not to be administered by mouth the directions should, with rare excep- tions, indicate the fact. This is frequently used during the febrile stage. As this usually lasts only about four days or less, a fluidounce is all that is necessary. In prescriptions for local use it is better to have the first word of the directions call atten- tion to the fact that it is not to be taken. 496 PRESCRIPTION WRITING. Prescribed for a small superficial burn. It would be better to order the ingredients by their official titles. Such a small quantity as a fluidrachm of a thick, tenacious liquid is best ordered by weight. A shake-label should be used. The total quantity should be made to suit containers in common use. PRESCRIPTION WRITING. 497 This does not make a clear solution, so should be shaken before used. A larger percentage of the balsam is frequently employed, but may irritate if long applied. Two fluidounces of a preparation of this character will usually be dis- pensed at the same price as the above. APPENDIX. Problems and Blackboard Exercises. In the following pages are given some problems and exer- cises such as are met every day in the practice of medicine. No attempt is made to cover the entire field, but it is hoped that enough and sufficient variety is given to be of advantage in the study of materia medica and prescription writing. They are also so arranged as to amount to a quiz on many important points in posology, toxicology, metrology and other phases of the sub- jects. The author begs to acknowledge his rather remote acquaintance with arithmetic, and the discussions, from this standpoint, may seem rather crude and void of system to better scholars, but the effort was made to illustrate different methods of reasoning out the desired results, and the reader can make his choice or be led to improve on any of the lines suggested. In teaching medical students, the urgent need of exercises of this character has been thoroughly demonstrated. The common preparations of opium,-tincture of opium, tincture of deodorized opium, camphorated tincture of opium and powder of ipecac and opium,-are made from the powdered or granulated opium, which now contains about 10 per cent, of morphine. In giving opium, or its preparations, a smaller dose is employed than the morphine content would indicate, for it must be remembered that there are other active ingredients, particularly codeine. (1) How much opium; how much morphine, in: (a) 5 drops of laudanum? (&) 10 drops of paregoric? (c) 5 grains Dover's powder? 499 500 APPENDIX. (a) Laudanum, as most other tinctures, gives about 2 drops to the minim-usually a little more than 2 drops. One minim of laudanum represents about 0.1 (Ho) grain of opium, or 0.01 (Hoo) grain of mor- phine. Five drops, which would be a little more than 2 minims, would represent a little more than % grain of opium and Ho grain of morphine. (6) Paregoric represents 0.4 per cent, of opium, or about 0.04 per cent, of morphine. One minim would, therefore, represent about 0.004 grain opium, or 0.0004 grain morphine. Ten drops would be about 4 minims, and would represent about 0.016 (Ho) grain opium, or 0.0016 (Hoo) grain morphine, or Paregoric represents 4 parts of opium to 1000, or 1 to 2S0; 1 minim would, therefore, represent Hso of a grain, and 4 minims would represent Hso (Ho) of a grain; Ho of this (Hoo) would be morphine. (c) Dover's powders contain 10 per cent, of opium, so 10 grains would contain 1 grain of opium, or 5 grains would contain H grain of opium; Ho of this would be morphine-Ho of H is Ho (grain of morphine). Discussion. (2) How much morphine in: (a) 2 grains powdered opium? (&) % grain extract of opium? Discussion. (a) Powdered opium contains about 10 per cent, of morphine, so Ho of it is morphine. If 1 grain of opium contains Ho grain of morphine, 2 grains contain %o (H) grain morphine. (b) Extract of opium contains about 20 per cent, of morphine-20 per cent, of 1 grain would be % grain; 20 per cent, of grain would be Ho grain; or-20 per cent, is 20 to the 100-100 grains of the extract contain 20 grains of morphine, so 1 grain of the extract contains H grain of morphine and y2 grain of the extract contains y2 that much, or Ho grain. (3) A man phones that his wife has swallowed a tablespoonful of laudanum. (a) How much opium did the patient get? (b) How much morphine? (c) Relation of amount to average dose? Discussion. (a) A tablespoonful is about 4 fluidrachms or 240 minims. If lauda- num represents 10 per cent, of opium, 240 minims of the tincture would represent 24 grains of the drug. APPENDIX. 501 (&) If opium contains 10 per cent, of morphine, 24 grains of opium contains Ho as much, or 2.4 (2Ho) grains of the alkaloid. (c) As the dose of opium is 1 grain and morphine % grain, this patient received over twenty times the average dose. (4) A lady phoned that a child 2 years old had been given a tea- spoonful of paregoric by mistake, and what should she do till medical attention arrived? (a) How much opium had the child received? (&) How much morphine? (c) Relation of morphine received to an average dose for a child that age? Discussion. (a) Paregoric contains 4 parts of opium to the 1000; therefore, 1 minim contains Hso grain of opium; 60 minims (1 teaspoonful) contains sixty times as much, or 6%so, or about % grain opium. (b) As opium contains about 10 per cent, of morphine, 1 grain opium contains Ho grain morphine, and % grain opium contains Ho grain of the alkaloid. (c) A child 2 years old would usually receive H of the adult dose (Young's rule). If the dose of morphine is % grain, this child would take H as much, or H of % = Ho- So the morphine received is to the average dose as Ho is to He, or about H more than the average. It should be remembered that opium contains other active agents, so the child received equal to about twice an average dose of morphine, but hardly a toxic quantity. (5) Through error the tincture of deodorized opium was ordered in place of paregoric in what was intended to be this prescrip- tion : (Adult) Date, n Bismuthi Subnit 3iij Tinct. Opii Camph fSiij Mist. Cretae q. s. fSiij M. Sig.-Tablespoonful every four hours. (Shake-label.) How much opium per dose did patient get? How much morphine? Relation to average dose? 502 APPENDIX. As the tincture of deodorized opium represents 10 per cent, of the drug, 3 fluidrachms (180 minims) would represent about 18 grains of opium, or about 1.8 grains morphine. Three fluidounces contain 6 tablespoonfuls, so the patient would receive in each dose about 3 grains opium or about 0.3 (14) grain mor- phine. This would be about three times the average dose, but hardly a toxic quantity under ordinary circumstances, unless repeated. Discussion. (6) Write a prescription for suppositories that will contain a sufficient amount of some preparation of opium to give about 15 mg. of morphine to each suppository. Discussion. If 1 grain is about 65 milligrammes, 15 mg. is about % grain. The extract of opium contains practically no refuse matter and is the prepara- tion usually employed for suppositories. It contains 20 per cent. (%) of morphine, so to get 1 part of the alkaloid 5 parts of the extract must be employed. Five times % grain is %, or 1% grains, and this much of the extract must be in each dose. If 4 doses are desired, it would be 4 times 1% grains, or 5 grains. Heading showing doctor's name, address, registry number, etc. Name and address of patient. Ext. Opii gr. v Ol. Theobromatis q. s. M. ft. suppos. no. iv. Sig.-Use one twice daily. Date, Signature. It should be remembered that extract of opium contains other active ingredients than morphine. While Nux Vomica and its preparations are now standard- ized on their total alkaloidal content, they probably contain about the percentage of strychnine as required in the U. S. P. viii, that is, Nux vomica about 1.25 per cent. Flext. of nux vomica about 1 per cent. Extract of nux vomica about 5 per cent. Tincture of nux vomica about 0.1 per cent. APPENDIX. 503 (7) A physician stated that his favorite tonic was tincture of nux vomica in 5-drop doses. How much strychnine did his patients receive? Discussion. Five drops of tincture of nux vomica averages a little more than 2 minims. One minim contains about Mooo of a grain of strychnine, and 2 minims about Hoo (or %oo) of a grain of strychnine. (8) A physician was surprised that he was able to gradually increase the dosage of tincture of nux vomica till the patient was taking 50 drops. How much strychnine was the patient receiving? Discussion. Fifty drops would average between 20 and 25 minims, probably about 20. One minim contains about %ooo of a grain of strychnine; 20 minims contain about 2%ooo, or %o of a grain of strychnine. (9) Write a prescription for tincture of nux vomica, alone, and instruct the patient to begin with enough drops to represent about %oo grain of strychnine and increase to about %o grain. If tincture of nux vomica contains about 0.1 per cent, of strychnine, 1000 minims would contain about 1 grain, 1 minim about %ooo of a grain, or 10 minims about Moo of a grain, and 25 minims about Mo grain (1000 divided by 40 = loo%o - 25). Allowing 2 drops to each minim, the pre- scription would be as follows: Discussion. Name, etc. R Tinct. Nucis Vomicae f5ij Sig.-Twenty (20) to fifty (50) drops in water as directed. Date, Signature. (10) Write a prescription for a tonic, in thirty capsules, contain- ing enough extract of nux vomica to represent an average dose of strychnine. Extract of nux vomica contains about 5 per cent, of strychnine, so 100 grains of the extract contains about 5 grains of the alkaloid, or 20 grains Discussion. 504 APPENDIX. of the extract contains 1 grain of the alkaloid. The dose of strychnine is Mo grain, so the amount of the extract to contain this much is found by taking Mo of the amount that contains 1 grain (Mo of 20 = 2%o = /4). If % grain of the extract is to be given at each dose and there are 30 doses, the total is thirty times % grain or 15 grains. Name, etc. R Arseni Trioxidi gr. j Ext. Nucis Vomicae gr. xv Mas. Ferri Carb gr. cl M. ft. cap. no. xxx. Sig.-One after each meal. Date, It should be remembered that nux vomica contains other active ingredients than strychnine, so about 10 grains would probably be nearer the amount wanted in the prescription. (11) Write a prescription for, an adult for a 4-fluidounce tonic containing enough tincture of nux vomica to give an average dose of strychnine. The average dose of strychnine is %o grain. Tincture of nux vomica contains about 0.1 per cent, of strychnine, or 1000 minims contain about 1 grain, so the number of minims for Mo of a grain is of 1000 (tooo/4O = 25). Four fluidounces, teaspoonful dose, gives about 32 doses, so the total amount of the tincture is twenty-five times 32 or 800 minims, or about 13 fluidrachms or about 1J4 fluidounces. The prescription might be written as follows: Discussion. Name, etc. Date, Tinct. Nuc. Vomicae fXiss Tinct. Cardam. Co q. s. f5iv M. Sig.-Teaspoonful in water before meals. It should be remembered that nux vomica contains other active con- stituents besides strychnine, so the dose is not altogether as would be indicated by the strychnine content. In this prescription 1 fluidounce of the tincture would probably be nearer the correct amount. (12) Complete the following so that the patient will get an aver- age dose of strychnine for a child her age: APPENDIX. 505 For Mary Jones (4 years). R Tinct. Nux Vomicae, Liq. Ferri Pep. cum Mang f5vj M. Sig.-Teaspoonful in water after meals. Date, Discussion. The tincture of nux vomica contains about 0.1 per cent, of strychnine, therefore 1000 minims contain about 1 grain. The average dose of strychnine for an adult is 14o grain. A child 4 years old would usually receive % of the adult dose (Young's rule), or |4go grain strychnine. If 1000 minims of the tincture contains about 1 grain of the alkaloid, the number of minims for %60 of a grain would be found by taking 14.60 of 1000 (1000 divided by 160 = loo%co = about 6 minims). The prescription contains 48 doses (teaspoonfuls), so 48 times 6 is the total amount of minims required (48 x 6 = 288 or about 4% or 5 fluidrachms). It should be remembered that nux vomica is not given altogether in the dose as indicated by the strychnine content as it contains some other active ingredients. Also some claim that strychnine in full proportional doses is not well tolerated by some children. (13) A child 2 years old received 1 drop of tincture of bella- donna leaves. What is the relation to average adult dose? Discussion. The average dose of tincture of belladonna leaves is 12 minims. A child 2 years old usually takes of an adult dose (Young's rule); Vz of 12 minims equals or about 1% minims. One drop is about ^2 minim, so the child receives about % of the average dose. It should be remem- bered that size, sex, etc., should also be considered. (14) What is the approximate percentage of alkaloid in the fol- lowing prescription: B Ung. Belladon., Ung. Zinci Ox aa 3ij Petrolati q. s. 5j M. Discussion. This prescription contains 25 per cent, of belladonna ointment. Bella- donna ointment contains 10 per cent, of the extract (as other vegetable 506 APPENDIX. ointments). The extract is about five times as strong as the drug (as most other extracts). The leaves contain 0.3 per cent, of alkaloids, prin- cipally atropine. If the ointment of belladonna represents 10 per cent, of the extract, which is five times as strong as the drug, it represents 50 per cent, of the drug, and a preparation containing 25 per cent, of this would represent 12.5 per cent, of the drug (0.50 x 0.25 equals 0.125). The drug containing about 0.3 per cent, of alkaloids, the preparation would contain 0.3 per cent of 12.5 per cent. (0.003 x 0.125 = 0.000375) or 0.0375 per cent, of alkaloids. This, of course, could be calculated directly from the alkaloidal content of the extract, but the student does well to remember the content of the drug, and, for approximate work, the foregoing answers well. (15) Write a prescription for Fowler's solution, alone, to be taken by drops, so that the patient will get the equivalent of %5 grain of arsenic trioxide to each dose. Discussion. Fowler's solution (as most other solutions) averages about a drop to the minim. It represents 1 per cent, of arsenic trioxide, therefore 100 drops would represent about 1 grain of the salt, 1 drop about Koo of a grain, 4 drops about Koo or Ks of a grain. Jt should be remembered that drops vary in size owing to style of dropper, rapidity of dropping and many other conditions. (16) A patient taking Fowler's solution after meals, gradually- increased to 9 drops per dose before showing toxic symptoms. How much, and of what salt, was he getting per day? Discussion. In making Fowler's solution 1 per cent, of arsenic trioxide is used. This is acted upon by potassium bicarbonate to form potassium arsenite, which is the form in which arsenic is present in the solution. If the solution represents 1 per cent, of arsenic trioxide, 1 minim would repre- sent Koo of a grain, 9 minims would represent %oo of a grain or about Ko grain as a dose. Three doses a day would give a total of nearly K of a grain. (17) Write a tonic prescription (for an adult) containing solu- tion of arsenous acid in such amount that there will be an average dose of arsenic trioxide to each teaspoonful of the preparation. APPENDIX. 507 Discussion. Solution of arsenous acid contains 1 per cent, of arsenic trioxide, or about 1 grain to each 100 minims or Hoo of a grain to each minim. The dose of arsenic trioxide is Ho grain, so it would take about 3H minims of the solution to give an average dose of the salt, and each teaspoonful of the prescription must contain that much. A prescription for 4 fluid- ounces would contain about 32 doses, so multiply this (32) by the 3H minims (for each dose) and the total amount is obtained-3H x 32 = 107. In practice we would use 1)4 or 2 fluidrachms. Name, etc. Date, 3 Liq. Acidi Arsenosi f3ij Elix. Ferri, Quin, et Strych. Phos fSiv M. Sig.-Teaspoonful in water after meals. (18) The Pharmacopoeia gives 1J4 minims as the average dose of Donovan's solution. (a) How much, and of what, does this dose contain? (&) How do these amounts compare with the average doses of these salts? (c) Based on the average doses of its contents, what would be a safe dose of the solution? Discussion. (a) Donovan's solution contains 1 per cent, each of arsenous iodide and red mercuric iodide, therefore 100 minims contain about 1 grain each of the salts, 1 minim contains Hoo of a grain each, 1% minims contains about of a grain of each. (b) The average dose of arsenous iodide is Ho grain, of red mercuric iodide Ho grain, so the dose of the solution as stated would be about %o of the average dose of the arsenic salt and %o of the dose of the mercuric salt. (c) Five minims would contain the average dose of the mercuric salt and Y the average dose of the arsenous salt. (19) A physician wished to prescribe the tincture of digitalis in drops so that the dose could be easily changed as conditions might require. Write the prescription so that the patient will begin with about 20 minims at a dose. 508 APPENDIX. The tincture of digitalis, as most other tinctures, averages a little more than 2 drops to 1 minim. Discussion. Patient's name, etc. Tinct. Digitalis fjij Sig.-Begin with forty (40) drops in water as directed. Date, (Over) Signature. On the back of the prescription it is well to specify "Dispense a physiologically standardized, fat-free tincture of digitalis." (20) Write a prescription for tincture of digitalis so that the patient will get 15 minims in each teaspoonful. Discussion. If the prescription is to contain 15 minims to each fluidrachm (tea- spoonful), it would have to contain eight times as much to each ounce- 8 x 15 = 120 minims = 2 fluidrachms. Or, as 15 minims is of a tea- spoonful, % of the prescription must be for tincture of digitalis. Name of patient, etc. Tinct. Digitalis f3iv Tinct. Cardam. Co q. s. f3ij M. Sig.-Teaspoonful in water 3 times a day. Date, (Over) Signature. It is well to write on the back of the prescription blank, "Use a physiologically standardized, fat-free tincture of digitalis." (21) Write a prescription in the metric system calling for 60 capsules, each containing an average dose of a strychnine salt, an arsenic salt and about 2 grains of actual FeCOs. Discussion. Ferrous carbonate is on the market only in the form of its prepara- tions. The mass is used for capsules, and contains about 35 per cent, of the salt, so 6 grains would be required for each capsule. The average dose of strychnine sulphate is grain, of arsenic trioxide is grain; 60 doses would require sixty times these amounts, or 60x^40 or 6%o equals 1J4 grains strych. sulphate. 6Ox^o or 6%0 equals 2 grains arsenic trioxide. 60 x 6 or 360 grains mass of ferrous carbonate. APPENDIX. 509 Using the rule for transposing (see p. 336) we would have about as follows: Name of patient, etc. Date, Strychnine Sulph Arseni Trioxidi ~ Mas. Ferri Carb 24 M. ft. cap. no. lx. Sig.-One after each meal. 100 130 000 Signature. (22) How much actual ferrous iodide in the U. S. P. average dose of the syrup ? Discussion. As the syrup contains 5 per cent, of the salt, 1 minim contains about of a grain; 15 minims (the average dose) contains or grain. (23) A common vehicle is chloroform water in tablespoonful doses. How much chloroform to each dose? As chloroform is soluble in about 200 parts of water and the official chloroform water is a saturated solution, 200 minims of the water would contain 1 minim of chloroform, 240 minims (1 tablespoonful) would con- tain 24%oo or 1% minims of chloroform. Discussion. (24) In treating certain gastro-intestinal pains, the spirit of chloroform is recommended in % teaspoonful doses. How much chloroform to each dose? Discussion. As the spirit of chloroform is a 6 per cent, solution, and a half tea- spoonful is 30 minims, the answer is obtained by finding 6 per cent, of 30. 30 x 0.06= 1.80 (minims of chloroform). (25) A doctor orders a spray of 2 fluidrachms of the solution of hydrogen dioxide to each 6 fluidrachms of water (each fluid- ounce of the finished prescription). What percentage of H2O2 in the preparation, and how many volumes of available oxygen? 510 APPENDIX. Two fluidrachms to the fluidounce gives a 25 per cent, solution. The official preparations contain 3 per cent, of H2O2, so the prescription would contain 25 per cent, of 3 per cent., or 0.25 x 0.03 equals 0.0075 or 0.75 per cent. The official preparation contains 10 volumes of available oxy- gen. If the prescription contains 25 per cent, of the solution, it would contain 25 per cent, of as many volumes of oxygen-25 per cent, of 10 = 0.25 x 10 = 2.50 (2^ volumes of available oxygen). Discussion. (26) How much ether in a teaspoonful of Hoffmann's anodyne? Discussion. As the preparation contains 32.5 per cent, of ether, 60 minims (1 teaspoonful) would contain 32.5 per cent., of 60 minims of ether-0.325 x 60 = 19.500 (minims of ether). The approximate amount may be found as follows: As the spirit is about % ether and a teaspoonful is about 60 minims, % of 60 is 20 (minims of ether). (27) How much tartar emetic in 2 teaspoonfuls of the compound syrup of squills? Discussion. As the preparation contains 0.2 per cent, of the salt, and 2 teaspoonfuls is 120 minims it would contain 0.2 per cent, of 120, or 120 x 0.002 = 0.240 (or about % grain). (28) Through error a patient swallowed a teaspoonful of a mix- ture of equal parts of tinctures of iodine and aconite. How much actual iodine did the patient get? Discussion. As the tincture of iodine is a 7 per cent, solution, and a teaspoonful (60 minims) of the preparation was taken, and it was half tincture of iodine, the patient received 30 minims of tincture of iodine containing about 7 grains to each 100 minims-7 per cent, of 30 = 30 x 0.07 = 2.10 (grains of iodine). (29) Write a prescription calling for 2 ounces of an ointment containing 1 per cent, phenol and 5 per cent, zinc oxide-use the ointment of zinc oxide instead of the salt. APPENDIX. 511 An ounce by weight is 480 grains (apothecaries), so the amount of phenol to make 1 per cent, in 1 ounce is 1 per cent, of 480 or 4.8 grains. Five per cent, would be five times that much, or 5x4.8 or 24 grains. For a 2 ounce ointment, twice as much would be required, or 9.6 grains phenol and 48 grains zinc oxide. Zinc oxide is hard to properly incor- porate, so the U. S. P. 20 per cent, ointment should be employed. If the ointment contains 20 per cent, of the salt, each 5 parts of the ointment contains 1 part of the salt. If 48 grains of the salt is required, five times that much of the prepared ointment would be necessary-48x5 or 240 grains, or 4 drachms. Discussion. Name, etc. Date, Phenolis gr. x Ung. Zinci Ox 3iv Petrolati q. s. 5ij M. Sig.-Apply as directed. (Over) Signature. Directions may be given on back of prescription to melt the phenol and petrolatum and incorporate while hot, or the necessary amount of the U. S. P. phenol ointment may be ordered. (30) Write a prescription for an office solution containing about 1 per cent, cocaine and 3 per cent, of antipyrine. Discussion. A fluidounce of water weighs about 450 grains, so the amount of a salt required to make a 1 per cent, solution in 1 fluidounce is 1 per cent, of 450 or 4.5 grains. Three per cent, would require three times 4.5 or 13.5 grains. Approximate quantities are usually employed. As the solu- tion does not keep well, a small quantity is usually ordered. Heading showing address, registry number, etc. Name, etc. Date, Cocainae Hydrochi gr. v Antipyrinae gr. xv Aquae Dest q. s. fSj M. Sig.-Formula. Signature. (31) A physician wished a patient to use a 1 to 500 quinine solu- tion to irrigate the colon in the treatment for pinworms. Write the prescription necessary. 512 APPENDIX. Discussion. Quinine alkaloid, sulphate or tannate would not dissolve in this strength. The hydrochloride would answer well. One grain to the fluidounce makes a little more than a 1 to 500 solution, so about 15 grains to the pint, or 60 grains to the half gallon, would be required. Name, etc. Date, B Quininae Hydrochlor 3j Sig.-Use to half gallon of warm water as directed. Signature. (32) Write a prescription for a solution of potassium perman- ganate so that when a teaspoonful is added to a quart of water it will make a solution of about 1 to 5000. Discussion. A quart of water weighs nearly 15,000 grains, so 3 grains of the salt would be the amount necessary in each teaspoonful.* Name, etc. B Potassii Permangan gr. L Aquae Dest q. s. fjij M. Sig.-Use teaspoonful to quart of water as directed. Date, Signature. (33) You wish to have a patient use douches of a gallon of 1 to 5000 potassium permanganate solution. Write the necessary prescription. Discussion. A pint of water weighs about 7500 grains, so 1% grains of the salt would be required for 1 pint. A gallon contains 8 pints, so would require about 12 grains. Tablets are inconvenient for patient's use and a solu- tion should be ordered. It should be so concentrated that the smallest possible domestic measureful can be added to a gallon of water to give the required strength. Twelve grains will just comfortably dissolve in % fluidounce (1 tablespoonful) of water. If about a dozen douches are indicated the prescription should be for 6 fluidounces as follows: Name, etc. Potassii Permangan 3iiss Aquae Dest q. s. f5vj M. Sig.-Use tablespoonful to gallon of hot water as directed. Date, Signature. APPENDIX. 513 (34) If you wish to prescribe a solution for a wet bichloride dressing for a poor patient, how will you write the prescription so that the patient can use 1 part to 10 parts of water and get a solution of about 1 to 5000? An ounce of water weighs about 450 grains, so 1 grain of the salt would give a solution (by weight) of about 1 to 450. If 10 more ounces of water (about 4500 grains) are added to this, it gives a solution of about 1 to 5000. Discussion. Name, etc. Date, B Hydrarg. Chlor. Corros gr. iv Acidi Tartarici gr. xx Aquae Dest q. s. f5iv M. Sig.-Use 1 part to 10 parts of water to wet dressing. Signature. (35) Write a prescription for mercurial inunctions so that each dose will contain about 15 grains of metallic mercury. Discussion. The official ointment is too strong for continued use and the diluted is undesirable for systemic effect on account of the petrolatum content. The ointment contains 50 per cent, of metallic mercury, and if diluted half it will contain 25 per cent. If it is arranged to use 1 drachm of this ointment to each inunction it gives 15 grains of mercury. Initials of patient. Date, 3 Ung. Hydrargyri, Adipis Lanae Hyd aa. M. ft. cht. cer. no. xvj. Sig.-Apply one each night as directed. Signature. (36) Write a prescription for chloroform liniment and soap lini- ment to make 6 fluidounces, so that the finished product will contain about 10 per cent, of chloroform. Discussion. Chloroform liniment contains 30 per cent, of chloroform and the solu- tion wanted is one-third as strong (10 per cent.), so if one-third of the prescription is chloroform liniment, it will give the necessary reduction. 514 APPENDIX. The percentage strength of the preparation (30) is to the percentage strength desired (10), as the number of ounces of prescription (6) is to the number of ounces of the preparation required (X). 30 :10 ::6 : X =2. Name of patient, etc. Date, Lin. Chloroformi f5ij Lin. Saponis q. s. f5vj M. Sig.-Apply as directed. Signature. (37) A mother gave her baby five feedings of 6 fluidounces each. Her formula calls for 6 per cent, of lime water. How much calcium hydroxide does the child receive daily? Discussion. Five feedings of 6 fluidounces each totals 30 fluidounces; 6 per cent, of this is 1.8 fluidounces (limewater). Lime-water contains about 0.14 per cent, of calcium hydroxide-0.14 per cent, of 1.8 fluidounces (864 minims) = 0.0014 x 864 = 1.2 (grains calcium hydroxide). (38) Write a prescription for a 4-fluidounce saturated solution of boric acid. Discussion. It is not practical to get a solution as concentrated as would be indi- cated by the stated solubility of the drug, as that only indicates the total amount soluble under the most favorable conditions and by the expendi- ture of unlimited time. If a prescriber merely orders a "Saturated Solu- tion," the druggist usually triturates an excess of the drug with water for a few moments and filters. It is better to prescribe a definite amount and know what the patient is receiving. Boric acid is stated to be soluble in 18 parts water. That is 1 grain to dissolve in about 18 minims of water, but practically it is best not to order over 1 grain to 20 minims of water, or 24 grains to the fluidounce (480 minims). Name of patient, etc. Date, 3 Acidi Borici 3iss Aquae Dest q. s. fSiv M. ft. sol. Sig.-Apply locally as directed. Signature. APPENDIX. 515 (39) Write a metric prescription calling for 3 fluidounces of a saturated solution of potassium chlorate. Discussion. Potassium chlorate is said to be soluble in 11.5 parts of water or 1 grain in about 11.5 minims of water, but, making the usual allowance, as suggested in discussing the previous problem, it is better not to use more than 1 grain to 15 minims, or 32 grains to the fluidounce (480 minims), or 90 grains to the 3 fluidounces. Using the rule for transposing to metric equivalents (p. 336), the prescription would be as follows: Name of patient, etc. Date, R Potassii Chloratis 61 Aquae q. s. 90] M. ft. sol. Sig.-Use for throat as directed. (40) What may occur when a wet bichloride dressing is applied to a surface previously painted with tincture of iodine? Discussion. The following reaction may result : HgCh plus 2 1 = Hgla plus 2 Cl. Red mercuric iodide is a powerful irritant, and may cause extensive vesication, etc. (41) In the following prescription what mercurial salt does the patient get, and how much at a dose? R Hydrarg. Chlor. Corros gr. ij Potassii lodidi 3vj Aquae Dest q. s. f3vj M. Sig.-Teaspoonful in water after meals. Discussion. Mercuric chloride with potassium iodide forms the red mercuric iodide, which, in the presence of an excess of the potassium iodide, forms the potassio-mercuric iodide. The molecule of mercuric chloride is HgCh with a molecular weight of about 270. The molecule of red mercuric iodide is Hgl2 with a molecular weight of about 450, so for each 270 parts of the chloride used 450 parts of the iodide are formed. If 3^4 of a grain of the chloride is ordered for each dose (2 grains in 48 doses), the resulting iodide of each dose is found by the following: %4 : x :: 270 : 450 = about 144 grain at each dose of red mercuric iodide in the form of potassio-mercuric iodide. 516 APPENDIX. (42) What does the patient get in the following prescription, and how much sodium bicarbonate is required to neutralize the acid? 3 Acidi Salicylici 3iv Sodii Bicarbonatis, Aquae q. s. f5vj M. Sig.-Tablespoonful in water each evening at 4, 6, 8 and 10. Discussion. Sodium salicylate and carbon dioxide are formed so the patient gets a freshly formed sodium salicylate in water charged with carbon dioxide. Salicylic acid had the chemical formula HC7H5O3 which has the molec- ular weight of about 138. Sodium bicarbonate has a formula NaHCOs, which has a molecular weight of about 84. So for each 138 grains of the acid 84 grains of the sodium salt will be required. The prescription calls for 240 grains of the acid, so the amount of bicarbonate is found as follows: 240 : x :: 138 : 84 or 146 grains of the sodium bicarbonate. It is usually considered better for therapeutic reasons to prescribe an excess of the bicarbonate, say 4 drachms for this prescription. (43) Demonstrate why the compound tincture of cinchona can- not be used in the treatment of malaria. Discussion. This preparation represents 10 per cent, of cinchona, and cinchona contains about 5 per cent, of alkaloids (about 4 per cent, of quinine), so a teaspoonful (60 minims) of the tincture represents 6 grains of cin- chona, about of which is active (^o of 6 is %o, or about % grain). If it contains about % grain of alkaloid to 1 fluidrachm, it would require 3 fluidrachms to yield 1 grain, or 90 fluidrachms (nearly a pint), to give a day's treatment. The alcohol, tannic acid, bad taste, etc., would be intolerable. (44) Write a prescription for quinine for malaria in a child 6 years old, based on 30 grains per day for an adult. Discussion. A child 6 years old should receive one-third the adult dose (Young's rule) ; this would be 10 grains per day. Following the custom of divid- ing into about five daily doses, it would give 2 grains per dose. A child this age can seldom swallow a capsule and would not take a bitter solu- tion. In making a tasteless mixture a nearly insoluble salt should be used. The sulphate is the most desirable common salt. Two grains of APPENDIX. 517 this can be conveniently disguised in a teaspoonful of syrup. The usual three (or more) days intensive treatment should be ordered. Name and age of patient. Date, ft Quininae Sulph 3ss Syr. Chocolatae q. s. fjij M. Sig.-Teaspoonful each morning at 7, 8, 9, 10 and 11. (Shake- label.) Signature. (45) What would be the daily amount of quinine for the first few days of the treatment of malaria in an adult weighing 75 pounds if the average adult dose was 30 grains? Discussion. An "average dose" means the dose for an average man. In using drugs for systemic effect by absorption into the blood, it is usually intended to secure a certain percentage concentration-so much of the drug to so much blood. The probable amount of blood is based largely on the size of patient, so a patient about half the average size would usually receive half the average dose, which would give about 15 grains of quinine for this patient. (46) One doctor gives 30 grains quinine sulphate, another gives 30 grains quinine hydrobromide. Demonstrate which gives the most of the alkaloid. Discussion. Quinine sulphate has the formula (C2oH2402N2)2H2S04 + 7H2O, which has the molecular weight 872, the quinine 2(C2oH2402N2) being 648 and the sulphate radical and water (H2SO4 + 7H2O) being 224. Quinine hydrobromide has the formula C2oH2402N2HBr + H2O, which has the molecular weight 423, the quinine being 324 and the hydrobromide radical and water (HBr + H2O) being 99. So quinine sulphate is 74 per cent, quinine (64%72), while quinine hydrobromide is 76 per cent, quinine (^2%23), 74 per cent, of 30 is 22.2 (grains of quinine in 30 grains of quinine sulphate), 76 per cent, of 30 is 22.8 (grains of quinine in 30 grains of quinine hydrobromide). (47) Demonstrate which official quinine salt contains the larger percentage of quinine. i 518 APPENDIX. Discussion. The official salts, with the formulae and molecular weights of their acid radicals and water of crystallization, are as follows: Bisulphate (H2SO4+■ (7H2O) = 224), dihydrochloride (2HC1 = 72), hydrobromide (HBr + H2O = 98), hydrochloride (HC1 + 2H2O = 72), sulphate (H2SO4- 1+7H2O = 224), salicylate (HC7H5O3 + H2O = 156), the radical in quinine and urea hydrochloride (HC1CO(NH2)2HC1 + (5H2O)H2O = 222). Quinine sulphate contains 2 quinine radicals to each acid radical, so the 224 should be divided by 2. Quinine tannate is not constant in composi- tion, but as it only contains from 30 to 35 per cent, of quinine, it is out of consideration. As the quinine radical (C2oH2402N2) is constant in all, the salt having the lightest radical naturally has the largest percentage of quinine alkaloid. This shows the hydrochloride and the dihydrochloride to contain the largest percentage of the alkaloid. CLINICAL INDEX. Abscess. page Balsam of Peru 84 Hydrogen Peroxide 214 Iodine (B) 200 Ipecac 206 Quinine 132 Abortion, Threatened. Facsimile Prescription 431 Bromides (B) 101 Opium (B) 243, 248 Viburnum Opulus (B) 320 Viburnum Prunifolium (B).. 321 Acidosis. Calomel (B) 186 Sodium Bicarbonate ( B ) .... 292 Acne. Cascara Sagrada (B) 121 Sodium Benzoate (B) 93 Adenitis. Facsimile Prescriptions, 482, 493, 495 Aconite (B) 48 Belladonna (B) 89 Cataplasm of Kaolin 210 Guaiacol 177 Ichthyol (B) 198 Iodine (B) 200 Alcoholism. Facsimile Prescription 428 Acetanilide 16 Ammonia (B) 62 Belladonna (B) 90 Bromides (B) 102 Calomel 185 Capsicum 117 Hops 181 Hyoscine 195 Hyoscyamus 195 Paraldehyde (B) 250 Scopolamine Hydrobromide... 287 Trional 302 Alkalinuria. page Acid, Boric 20 Sodium Benzoate (B) 92 Alopecia. Alcohol (B) 56 Bay Rum (B) 299 Cantharides 116 Potassium Carbonate 269 Quinine (B) 137 Resorcinol (B) 276 Amebic Dysentery. See Dysen- tery. Amenorrhea. Aloes (B) 59 Cimicifuga 130 Iron (B) 163 Manganese 218 Petroselinum 255 Viburnum Opulus (B) 320 Viburnum Prunifolium (B).. 321 Anasarca. See Dropsy. Anemia. Facsimile Prescriptions, 447, 449, 463, 467 Acid, Hydrochloric (B) 28 Arsenic (B) 76, 77 Ferric Chloride (B) 165 Ferrous Sulphate (B) 163 Ferrous Carbonate (B) 162 Ferrum Reductum (B) 163 Manganese 218 Angina Pectoris. Amyl Nitrite 66 Iodides 203 Nitroglycerin 174 Sodium Nitrite (B) 295 Anorexia. Facsimile Prescriptions, 447, 452, 454, 462 Acid, Phosphoric 33 Cardamom 118 Malt 218 519 CLINICAL INDEX. 520 Anorexia (continued). page Nux Vomica (R) 228 Quassia 274 Serpentaria 288 Appendicitis. Belladonna (R) 89 Opium (R) 248 Apoplexy. Croton Oil (R) 239 Elaterin 154 Iodides 203 Jalap (R) ....'. 209 Argyria. Hexamethylenamine 180 Arteriosclerosis. Iodides (R) 205 Arthritis. Facsimile Prescriptions 441 Guaiacol (R) 177 Guaiacol Carbonate (R) .... 178 Hexamethylenamine (R) .... 180 Iodine (R) 201 Salicylates (R) 37, 38 Ascites. See Dropsy. Asphyxia. Ammonia 61 Asthma. Aspidosperma 81 Belladonna 87 Calcium 108 Cubeb 150 Eucalyptol 158 Gelsemium 170 Grindelia 176 Iodides (R) 204 Lobelia 215 Nitroglycerin 174 Oil of Juniper 233 Sabal 280 Squill 286 Stramonium (R) 301 Bedsores. Alcohol 56 (See also Ulcers.) Blepharitis. Facsimile Prescription 475 Mercury, Yellow Oxide (R). 192 Bromidrosis. Alum (R) 61 Bromidrosis (continued). page Bismuth Subnitrate (R) .... 99 Bronchitis. Facsimile Prescriptions, 419, 421, 485 Acacia (R) 10 Acetphenetidin 18 Aconite 47 Alcohol 56, 57 Ammonium Salts ( R) ... 63, 65 Benzoates 92 Benzoin (R) 91 Brandy (R) 57 Camphor (R) 112, 114 Chloroform (R) 126 Citrates (R) 25, 26 Codliver Oil 235 Codeine (R) 244 Creosote (R) 147, 148 Cubeb 150 Eucalyptol 158 Glycyrrhiza 175 Grindelia 176 Guaiacol 177 Heroine (R) 244 .Hexamethylenamine (R) .... 180 Hypophosphites (R) 31 Iodides 203 Iodine 199 Ipecac (R) 207 Lobelia 215 Menthol (R) 222 Mustard 290 Opium 244 Quinine 132 Saw Palmetto 280 Serpentaria 288 Senega 287 Spirit of Nitrous Ether 53 Squill 286 Styrax 302 Tar 263 Tartar Emetic 69 Terebene (R) 310 Terpin Hydrate 310 Tolu 86 Burns. Facsimile Prescription 497 Balsam of Peru (R) 84 CLINICAL INDEX. 521 Burns (continued). page Bismuth 96 Camphor (B) 113 Castor Oil (B) 237 Lime Liniment (B) 109 Linseed Oil 213 Picric Acid (B) 315 Calculi. Belladonna 87 Citrates 24 Glycerin 172 Hexamethylenamine (B) .... 180 Spirit of Nitrous Ether (B). 53 Cancer. Arsenic 76 Potassium Hydroxide 270 Zinc Chloride 322 Catarrh, Nasal. See Nasal Ca- tarrh. Chancroids. Acid, Nitric 32 Silver Nitrate 72 Chapped Skin. Glycerin (B) 173 Petrolatum 253 Rose Water (B) 279 Chlorosis. Facsimile Prescription 466 Aloes (B) 59 Arensic 77 Ferrous Carbonate, Mass (B) 163 Ferrous Carbonate, Pills (B) 162 Ferrous Sulphate (B) 162 Chorea. Arsenic 76 Cimicifuga 130 Gelsemium 170 Salicylates 36 Cirrhosis, Hepatic. Acid, Nitrohydrochloric 32 Gold and, Sodium Chloride ... 84 Iodides 203 Clavus. Acid, Salicylic (B) 30 Collodion (B) 143 Indian Cannabis (B) 116 Iodine (B) 201 Colic. See Indigestion. Cold. See Coryza. Comedo. page Acetanilide (B) 17 Acid, Sulphuric (B) 43 Magnesium Sulphate (B) ... 217 Conjunctivitis. Facsimile Prescription 475 Acid, Boric 20 Argyrol (B) 74 Castor Oil (B) .* 237 Cocaine (B) 141 Yellow Mercuric Oxide (B). 192 Constipation. Facsimile Prescription 468 Agar 55 Aloes (B) 58, 59 Belladonna (B) 89 Cascara Sagrada (B^ ... 120, 121 Castor Oil (B) 237 Colocynth (B) 145 Frangula 168 Glycerin 172 Glycyrrhiza 175 Honey '. 219 Leptandra 211 Liquid Petrolatum (B) 254 Malt 218 Mercury Salts and Prepara- tions (B) 185-188 Nux Vomica) (B) 228-230 Olive Oil 236 Phenolphthalein 259, 260 Potassium Bitartrate 268 Podophyllum (B) 266 Rhubarb 278 Senna 288 Soap 283 Sodium Phosphate (B) .... 296 Sodium Sulphate (B) 297 Sulphur 304 Taraxacum 308 Convulsions. Facsimile Prescription 430 Amyl Nitrite 66 Bromides (B) 102 Hydrated Chloral (B) 124 Opium 242 Pilocarpine 262 Coryza. Acetphenetidin (B) 18 522 CLINICAL INDEX. Croup (continued') page Hydrated Chloral (B) 124 Ipecac (B) 207, 208 Paregoric (B) 245 Potassium Bromide (B) .... 102 Tolu 85 Cystitis. Facsimile Prescription 467 Acid, Boric 20 Argyrol 74 Belladonna (B) 88 Benzoates (B) 92 Citrates 24 Copaiba 145 Cubeb 150 Elm 316 Grindelia 176 Hexamethylenamine (B) .... 180 Hyoscyamus (B) 196 Methylene Blue 223 Opium (B) 248 Phenyl Salicylate 39 Potassium Permanganate .... 271 Protargol 74 Quinine 132 Saw Palmetto 280 Spirit of Nitrous Ether (B). 53 Triticum 316 Uva Ursi 317 Cystocele. Alum 60 Dandruff. See Alopecia. Dermatitis (Drug, Poison Ivy, etc.). Facsimile Prescription 474 Acid, Boric 20 Salicylic (B) 35 Bismuth (B) 99 Camphor (B) 113 Hydrous Wool-fat (B) 50 Prepared Chalk 107 Starch 67 Thymol (B) 313 Diabetes. Codeine 243 Saccharin 93 Diarrhea. Facsimile Prescriptions, 433, 435, 437 Coryza (continued). page Acetanilide (B) 16 Acid, Acetylsalicylic (B) .... 42 Ammonium Carbonate (B)... 63 Belladonna (B) 89 Caffeine (B) 104 Camphor (B) 112 Citrates 24 Cocaine (B) 141 Hyoscyamus 195 Menthol 222 Phenyl Salicylate (B) 40 Powder of Ipecac and Opium (B) ' 247 Quinine (B) 134, 135 Cough. Facsimile Prescriptions, 419, 421, 423, 425, 427, 485 Acid, Hydrocyanic 28 Ammonium (B) 63-65 Antipyrine (B) 70 Apomorphine (B) 244 Benzoates 92 Benzoin (B) 91 Bitter Almond 66 Brandy 57 Chloroform (B) 127 Citrates (B) ., 25 Codeine (B) 243 Creosote (B) 147, 148 Glycyrrhiza 175 Heroine (B) 244 Honey 219 Hyoscyamus (B) 196 Ipecac (B) 207 Lemon (B) 212 Sanguinaria 281 Spirit of Nitrous Ether (B). 54 Tar 263 Tartar Emetic 69 Tolu (B) 85, 86 Wild Cherry (B) 273 Croup. Aconite (B) 48 Ammonium Bromide (B).1O2, 103 Belladonna (B) 88 Benzoin 91 Bromides (B) 103 Creosote 147 CLINICAL INDEX. 523 Diarrhea (continued). page Acacia (B) 14 Acid, Nitrohydrochloric 32 Sulphuric (B) 43 Tannic 45 Betanaphthol (B) 94 Bismuth Salts (B) 97, 98 Brandy 56 Calcium 107 Camphor 112 Catechu 121 Cerium 123 Chloroform 126 Chondrus 128 Gambir 169 Guarana 179 Hydrastis 193 Iodine 199 Kino (B) 210 Lead Acetate 264 Magnesium Sulphate (B) ... 217 Menthol 222 Nutmeg 225 Opium (B) 246-248 Phenol (B) 258 Phenolsulphonates 259 Phenyl Salicylate (B) 40 Sulphur (B) 97 Sulphur 304 Diphtheria.. Acid, Lactic 31 Sulphurous (B) 44 Aconite (B) 43 Castor Oil 237 Chloroform 126 Corrosive Mercuric Chloride (B) 190 Hydrogen Peroxide 214 Iron 161 Lime Water 107 Potassium Chlorate 269 Serum Antidiphtheriticum ... 288 Silver Nitrate 72 Dropsy. Facsimile Prescription 459 Caffeine 104 Digitalis (B) 153 Jalap (B) 209 Juniper 233 Dropsy (continued). page Potassium Acetate (B) 267 Potassium Bitartrate (B).... 268 Spirit of Nitrous Ether (B).. 54 Squill 286 Uva Ursi 317 Dysentery. Facsimile Prescriptions, 433, 435, 437 Acid, Tannic (B) 45 Bismuth Subnitrate (B) .... 97 Brandy 56 Chalk, Prepared (B) 108 Chalk Mixture (B) .... 108, 109 Chloroform 126 Chondrus 128 Elm 316 Ipecac (B) 208 Kino (B) 210 Lead 264 Opium (B) 246-248 Phenolsulphonates 259 Phenyl Salicylate (B) 40 Quinine 132 Silver Nitrate 72 Sulphur (B) 97 Sulphur 304 Dysmenorrhea. Belladonna 87 Bromides (B) 101, 102 Cimicifuga 130 Gelsemium 170 Ginger 326 Viburnum Opulus (B) 320 Viburnum Prunifolium (B).. 321 Dysentery, Amebic. Facsimile Prescription 465 Ipecac (B) 40 Phenyl Salicylate (B) 40 Quinine (B) 137 Dyspepsia. See Indigestion. Ecchymoses. Ammonium Chloride 65 Eclampsia. Bromides 101 Elaterin 154 Glucose 172 Physostigmine 261 Veratrum 320 CLINICAL INDEX. 524 Ecthyma. page Acid, Boric (B) 22 Bismuth (B) 99 Resorcinol (B) 276 Tar (B) 264 Eczema. Facsimile Prescription 474 Acid, Salicylic 34 Arsenic 76 Bismuth 96 Calamine 105 Calomel (B) 191 Camphor (B) 113 Codliver Oil 235 Hydrated Chloral (B) 125 Hydrous Wool-fat (B) 50 Oil of Cade (B) 233 Phenol (B) 258 Prepared Chalk 107 Sodium Thiosulphate 297 Starch 67 Talcum 308 Tar (B) 263 Zinc Oxide 323 Edema. See Dropsy. Endocarditis. Salicylates (B) 38 Endometritis. Iodine (B) 201 Phenol 256 Silver Nitrate 72 Enterocolitis. Facsimile Prescriptions . 433, 437 Acid, Sulphuric 43 Bismuth Subnitrate (B) 98 Chalk Mixture (B) .... 108, 109 Kino (B) 210 Paregoric (B) 247 Phenol 258 Phenyl Salicylate 40 Tincture of Deodorized Opium (B) 246 Sulphur (B) 97 Enuresis. Belladonna 87 Bromides 101 Valerian (B) 318 Epididymitis. Aconite (B) 48 Epididymitis (continued). page Guaiacol (B) 177 Lead Subacetate (B) 265 Opium (B) 248 Epilepsy. Amyl Nitrite 66 Arsenic 77 Bromides (B) 101 Epistaxis. Gambir 169 Iron 161 Erysipelas. Iodine 199 Iron (B) 165 Lead Acetate 264 Potassium Permanganate .... 271 Quinine 132 Erythema (Venenatum, Scarla- tiniforme, etc.) Facsimile Prescription 473 Acetanilide (B) 17 Acid, Boric (B) 22 Bismuth (B) 99 Chalk (B) 110 Cocaine (B) 140 Magnesium (B) 217 Morphine (B) 249 Felons. Alcohol 56 Fever Blisters. Bismuth (B) 99 Calomel (B) 190 Fissure. Cocaine 139 Silver Nitrate 72 Flatulence. Acid, Sulphurous 44 Asafetida (B) 79 Caraway 119 Cardamom 118 Eserine 261 Fei Bovis 159 Ginger (B) 326 Hops 181 Lavender, Compound Tincture (B) 234 Nutmeg 225 Peppermint (B) 220 Physostigma 261 CLINICAL INDEX. 525 Flatulence (continued). page Sodium Bicarbonate (B) .... 293 Spirit of Ether (B) 52 Sumbul 305 Freckles. Acid, Salicylic 34 Alcohol (B) 57 Furunculosis. Facsimile Prescription 477 Acid, Nitrohydrochloric (B).. 32 Aconite (B) 48 Alcohol (B) 56 Belladonna (B) 89 Ichthyol (B) 198 Iodine (B) 200 Linseed 213 Lead Plaster (B) 265 Gall-stones. Belladonna 87 Olive Oil 236 Opium 242 Gastric Ulcer. Bismuth Subnitrate 98 Calcium Carbonate 107 Iron 161 Magnesium Oxide (B) 217 Silver Nitrate 72 Sodium Bicarbonate 292 Goiter. Acid, Acetylsalicylic 41 Arsenic 76 Digitalis (B) 153 Ergot (B) 156 Iodides 203 Iodine (B) 201 Iron (B) 164 Iron Arsenite (B) 164 Salicylates 36 Gonorrhea. Facsimile Prescription 491 Acid, Boric (B) 21 Argyrol (B) 74 Belladonna (B) 88 Benzoates 92 Bromides (B) 102 Catechu (B) 122 Citrates 24 Copaiba 145 Cubeb 150 Gonorrhea (continued). page Hexamtheylenamine (B) ... 180 Hydrastine (B) 194 Ichthyol 197 Lead Acetate (B) 265 Mercury, Corrosive Chloride (B) 190 Methylene Blue 223 Opium (B) 249 Phenol (B) 258 Phenyl Salicylate ....« 39 Potassium Bromide (B) .... 102 Potassium Citrate (B) 24 Potassium Permanganate (B) 271 Protargol 74 Quinine 132 Saw Palmetto 280 Silver Nitrate 72 Sodium Bromide (B) 102 Spirit of Nitrous Ether 53 Terpin Hydrate 310 Uva Ursi 317 Gout. Acid, Acetylsalicylic 41 Citrates 24 Colchicum (B) 143 Hexamethylenamine (B) ... 180 Potassium Bicarbonate 268 Salicylates (B) 38 Grip. See Influenza. Hay Fever. Belladonna 87 Cubeb 150 Eucalyptol (B) 158 Headache. Facsimile Prescription 429 Acetanilide (B) 15, 16 Acetphenetidin 18, 19 Acid, Acetylsalicylic 41 Ammonia, Aromatic Spirit (B) 62 Ammonium Bromide (B) ... 83 Antipyrine 69 Bromides 101 Caffeine (B) 105 Camphor, Monobromated (B) 114 Canabis Indica 115 Gelsemium 170 Guarana 179 526 CLINICAL INDEX. Heart Disease. page Caffeine (B) 105 Digitalis (B) 152-154 Potassium Acetate (B) 267 Sparteine (B) 298 Squill 286 Strophanthus 301 Strychnine (B) 229 Valerian (B) 318 Hemorrhage. Acid, Tannic 45 Alum 60 Calcium Lactate 108 Calcium Chloride (B) 108 Cotarnine hydrochloride 146 Ergot (B) 156 Hemorrhoids. Acid, Tannic (B) 45 Cocaine 139 Gambir 169 Herpes. Alum (B) 61 Arsenic 76 Bismuth (B) 99 Calamine (B) 106 Cocaine (B) 141 Menthol (B) 223 Nux Vomica (B) 230 Hiccough. Facsimile Prescription 429 Acetanilide 16 Bromides (B) 102 Musk 224 Hookworm. Facsimile Prescription 464 Thymol 312 Hyperchlorhydria. Bismuth Subnitrate 96 Calcium Carbonate (B) .... 109 Magnesium Oxide (B) 217 Olive Oil 236 Sodium Bicarbonate 292 (See also Gastric Ulcer.) Hyperidrosis. Acid, Boric (B) 22 Acid, Salicylic (B) 35 Alcohol 56 Alum 60 Belladonna 87 Hypertension. page Facsimile Prescription 445 Aconite ( B ) 47 Amyl Nitrite 66 Potassium Bitartrate (B) ... 268 Sodium Nitrite (B) 295 Veratrum 320 (See also Apoplexy, Nephritis, Uremia, etc.) Hysteria. Facsimile Prescription 431 Ammonia (B) 61 Arsenic (B) ■ 77 Asafetida (B) 79 Bromides 101 Camphor 112 Ether, Spirit (B) 52 Ginger (B) 326 Glycerophosphates 30 Hops 181 Hyoscyamus 195 Hypophosphites 30 Iron (B) ,..164 Lactucarium 211 Musk , 224 Paraldehyde (B) 250 Peppermint 219 Sumbul (B) 305, 306 Valerates (B) 319 Valerian (B) 318 Ileocolitis. See Enterocolitis. Impetigo. Bismuth (B) 99 Mercury (B) 190 Sulphur 304 Indigestion. Facsimile Prescription 452 Acid, Hydrochloric 27, 28 Acid, Nitrohydrochloric 32 Acid, Phosphoric 33 Ammonium (B) 62 Betanaphthol 94 Bismuth (B) 98 Capsicum 117 Charcoal 117 Chloroform (B) 127 Hops 181 Hydrastis 193 Ipecac 206 CLINICAL INDEX. 527 Insomnia (continued'). page Paraldehyde (B) 250 Sulphonethylmethane ( B ) ... 302 Sulphonmethane (B) 303 Intestinal Parasites. See Hook- worm, Pinworm, Roundworm, Dysentery, etc. Itch. See Scabies. Jaundice. Acid, Nitrohydrochloric 32 Hexamethylenamine 180 Mercury 184 Olive Oil 236 Sodium Phosphate (B) 296 (See also Calculi, Malaria, etc.) La Grippe. See Influenza. Laryngitis. Acid, Lactic 31 Aconite 48 Benzoin (B) 91 Bromide (B) 102 Camphor (B) 112 Creosote (B) 148 Ipecac (B) 208 Menthol (B) 222 Potassium Chlorates 269 (See also Bronchitis, Cough, Influenza, etc.) Leucorrhea. Facsimile Prescription 491 Boroglyceride (B) 22 Ichthyol (B) 198 Iodine (B) 201 Potassium Permanganate (B). 271 (See also Endometritis, Gonor- rhea, etc.) Lymphadenitis. Facsimile Prescriptions, 475, 477, 493, 495 Belladonna (B) 89 Ichthyol (B) 198 Iodine (B) 200 Guaiacol (B) 177 Lymphangitis. See Lymphadenitis. Malaria. Facsimile Prescriptions, 450, 451, 463 Acid, Sulphuric 43 Arsenic (B) 77 Indigestion (continued). page Malt 218 Nux Vomica (B) 228-230 Oxgall 159 Pepsin (B) 252, 253 Quassia 274 Serpentaria 288 Strychnine (B) 230 Indigestion, Acute. Ammonia (B) 62 Chloroform (B) 127 Ether (B) 52 Opium (B) 246 Peppermint (B) 220 Valerian (B) 318 Indolent Ulcers. See Ulcers. Infections, Local. Facsimile Prescription 489 Aconite 47 Alcohol 56 Belladonna (B) 89 Cresol 149 Hamamelis '. 179 Ichthyol (B) 198 Iodine 199 Lead 264 Mercury (B) 189 Potassium Permanganate .... 271 Inflammation. See Infections, Local. Influenza. Acetphenetidin (B) 18 Acid, Acetylsalicylic (B) ... 42 Ammonium (B) 65 Belladonna (B) 90 Caffeine (B) 104 Calomel (B) 185 Camphor (B) 112, 114 Citrates 24 Codeine (B) 245 Opium (B) 248 Phenyl Salicylate (B) 40 Quinine (B) 135 Insect Bites. Hamamelis 179 Iodine (B) 201 Witchhazel 179 Insomnia. Hydrated Chloral 124 477, 493, 495 451, 463 528 CLINICAL INDEX. Malaria {continued}. page Iron (B) 163, 165 Quinine (B) 133-136 Mastitis. Facsimile Prescription 477 Aconite (B) 48 Belladonna (B) 89 Cataplasm of Kaolin 210 Ichthyol (B) 198 Iodine (B) 200 Menorrhagia. Facsimile Prescription 461 Ergot (B) 156 Hydrastis (B) 193 Strychnine (B) 229 (See also Endometritis, Subin- volution, etc.) Metrorrhagia. See Menorrhagia. Measles. See Bronchitis, Coryza, Cough, etc. Migraine. See Headache. Miliaria. See Prickly Heat. Myalgia. Facsimile Prescription 494 Chloroform (B) 128 Menthol (B) 223 (See also Rheumatism.) Nasal Catarrh. Facsimile Prescription 481 Acid, Boric 20 Cubeb 150 Eucalyptol (B) 158 Petrolatum, Liquid (B) 254 Sodium Bicarbonate (B) ... 293 Thymol 312 Nausea. Acid, Hydrocyanic 28 Bismuth (B) 98 Cerium Oxalate (B) 123 Cocaine (B) 139 Nutmeg 225 Phenol 256 Nephritis Facsimile Prescription 459 Ammonium Acetate 62 Digitalis (B) .' 153 Gold and Sodium Chloride .. 84 Ichthyol 197 Iodides 203 Nephritis (continued). page Jalap (B) 209 Oil of Juniper 233 Oil of Turpentine 309 Potassium Acetate (B) 267 Potassium Bicarbonate 268 Potassium Bitartrate (B) ... 268 Sodium Nitrite 295 Squill 286 (See also Dropsy, Uremia, etc.) Nervousness. See Hysteria, Neu- rasthenia, etc. Neuralgia. Aconite (B) 48 Antipyrine 69 Belladonna 87 Caffeine (B) 105 Canabis Indica 115 Cantharides 116 Camphor (B) 113 Chloroform (B) 128 Colchicum 143 Gelsemium 170 Hydrated Chloral 125 Menthol 222 Nutmeg 225 Salicylates 36 (See also Headache and Rheu- matism.) Neurasthenia. Acetic Acid 19 Arsenic (B) 76 Asafetida (B) 79 Glycerophosphates 30 Gold and Sodium Chloride .. 84 Hypophosphites 30 Iron (B) 164 Lactucarium 211 Musk 224 Phosphorus (B) 260 Sumbul (B) 305, 306 Valerates (B) 319 Valerian (B) 318 New Growths. Acid, Glacial Acetic 19 Acid, Nitric 32 Acid, Trichloracetic 46 Arsenic 76 Chromium Trioxide 129 CLINICAL INDEX. 529 New Growths {continued). page Potassium Hydroxide 270 Orchitis. Facsimile Prescriptions . .477, 495 Belladonna (B) 89 Guaiacol (B) 177 Ichthyol (B) 198 Lead 265 Opium (B) 248 Otitis Media. Facsimile Prescription 492 Alcohol 56 Phenol (B) 257 Palpitation. Bromides (B) 101 Hyoscyamus (B) 195 Strychnine (B) 230 Sumbul (B) 305 Valerates (B) 319 (See also Hysteria and Neu- rasthenia.) Pharyngitis. Facsimile Prescription 439 Acid, Sulphurous (B) 44 Acid, Tannic (B) 45 Argyrol 74 Ferric Chloride, Tintcure (B). 166 Potassium Chlorate (B) .... 270 Thymol 312 Phthisis. See Tuberculosis. Pinworms. Castor Oil 237 Quassia (B) 274 Quinine (B) 137 Santonin (B) 282 Pleurisy. Cataplasm of Kaolin 210 Iodine 199 Mustard 290 (See also Bronchitis, Cough, and Influenza.) Pneumonia. Aconite 47 Alcohol 56 Ammonium 63 Benzoin 91 Camphor 112 Cataplasm of Kaolin 210 Citrates (B) 25 Pneumonia {continued). page Codeine 244 Creosote (B) 147, 148 Ipecac (B) 207 Mustard 290 Squill 286 Strychnine 227 (See also Bronchitis, Cough, and Influenza.) Prickly Heat. Facsimile Prescription 479 Acid, Boric (B) 21 Salicylic (B) 35 Bismuth 96 Starch (B) 67 Zinc Oxide (B) 323 Pruritus. Facsimile Prescription 474 Acid, Hydrocyanic 28 Acid, Salicylic 34 Argyrol 74 Camphor (B) 113 Cocaine (B) 142 Hydrated Chloral (B) 125 Menthol (B) 222, 223 Phenol (B) 257, 259 Starch 67 Sulphuric (B) 304 Psoriasis. Acid, Salicylic (B) 35 Chrysarobin (B) 129 Colodion (B) 144 Ether (B) 52 Purpura. Calcium Chloride (B) 108 Calcium Lactate 107 Cotarnine Hydrochloride .... 146 Ergot 155 Pyelitis. Hexamethylenamine (B) .... 180 Methylene Blue 223 Uva Ursi 317 Pyorrhcea Alveolaris. Acid, Boric (B) 21 Renal Colic. See Calculi. Retention of Urine. See Cal- culi and Nephritis. Rheumatism. Facsimile Prescriptions ...441,494 530 CLINICAL INDEX. Rheumatism (continued). page Acid, Acetylsalicylic 41 Acid, Salicylic 34 Arnica 75 Belladonna (B) 89 Chloroform (B) 128 Citrates 24 Colchicum (B) 143 Guaiac 178 Guaiacol Carbonate (B) .... 178 Ichthyol 197 Iodides 203 Lithium (B) 24 Mezereum 224 Nutmeg 225 Oil of Turpentine 309 Phenyl Salicylate 39 Potassium Bicarbonate 268 Salicin 281 Salicylates 36 Stillingia 300 Xanthoxylon 322 (See also Arthritis.) Rhinitis. Facsimile Prescriptions ...481-487 Acid, Boric 20 Antipyrine (B) 70 Argyrol 74 Eucalyptol (B) 158 (See also Coryza and Influ- enza.) Ringworm. See Tinea. Roundworms. Calomel 185 Oil of Turpentine 309 Phenyl Salicylate (B) 39 Santonin (B) 282 Spigelia 299 Thymol 312 Salivation. Acid, Tannic (B) 45 Belladonna (B) 90 Honey of Rose (B) 279 Myrrh 225 Scabies. Facsimile Prescription 471 Betanaphthol (B) 95 Chalk (B) 110 Scabies (continued'). page Lard (B) 49 Oil of Cade (B) 232 Resorcinol (B) 277 Sodium Thiosulphate 297 Soft Soap (B) 284 Staphisagria 300 Sulphur (B) * . 305 Seborrhea. Betanaphthol (B) 94, 95 Castor Oil (B) 238 Resorcinol (B) 276 Spirit of Myrcia (B) 299 Sinusitis. Facsimile Prescription 487 Antipynhe 70 Benzoin (B) 91 Bismuth 96 Menthol (B) 222 (See also Coryza, Influenza, Headache, etc.) Spasmodic Laryngitis. See Croup. Sprain. Arnica 75 Cataplasm of Kaolin 210 Chloroform (B) 128 Lead Acetate 264 Menthol (B) 223 Oil of Turpentine 309 Stomatitis. Facsimile Prescription 439 Acacia (B) 14 Acid, Boric 20 Sulphurous (B) 44 Borax 293 Ferric Chloride, Tincture ( B ). 166 Hydrogen Peroxide 214 Myrrh (B) 225 Potassium Chlorate (B) .... 270 Subinvolution. Boroglyceride (B) 22 Ergot (B) 156 Glycerin 172 Iodine (B) 201 Quinine (B) 134 Strychnine (B) 230 Syphilis Facsimile! Prescriptions .. .453, 469 Acid, Nitric 32 CLINICAL INDEX. 531 Syphilis (continued). page Arsenic 76 Iodides (B) 204, 205 Iodoform 198 Mercury, Ammoniated ( B ) .191, 192 Mercury, Corrosive Chloride (B) 187, 188, 190 Mercury, Mass (B) 188, 189 Mercury, Ointment (B) .188, 189 Mercury,Mild Chloride ( B) .186, 189 Mercury, Red Iodide (B) ... 187 Mercury, Yellow Iodide (B). 186 Mercury with Chalk (B).... 186 Sarsaparilla (B) 285 Stillingia 300 Xanthoxylon T*. 322 Tapeworm. Aspidium (B) 80 Chloroform (B) 127 Croton Oil 239 Granatum 176 Pelletierine 176 Pumpkin Seed 251 Resorcinol 276 Threatened Abortion. See Abor- tion, Threatened. Tinea. Facsimile Prescription 471 Acid, Salicylic 91 Betanaphthol (B) 95 Chrysarobin (B) 129 Corrosive Mercuric Chlo- ride 91, 189 Hydrous Wool-fat (B) 50 Oil of Cade (B) 233 Resorcinol 276 Sodium Thiosulphate (B) .. 298 Sulphur (B) 304 Tinea Versicolor. Corrosive Mercuric Chloride (B) 189 Sodium! Thiosulphate (B) ... 298 (See also Tinea.) Tonsillitis. Facsimile Prescriptions ..483, 493 Acetphenetidin 18 Acid, Acetylsalicylic 41 Acid, Sulphurous (B) 44 Acid, Tannic (B) 45 Tonsillitis (continued'). page Aconite (B) 47 Argyrol (B) 74 Ferric Chloride, Tincture (B). 166 Guaiac 178 Guaiacol 177 Hydrogen Peroxide 214 Iodine (B) 201 Myrrh 225 Phenyl Salicylate 39 Phenol (B) 257 Potassium Chlorate (B) .... 270 Protargol 74 Salicin 281 Salicylates (B) 38 Silver Nitrate 72 Toothache. Facsimile Prescription 493 Aconite (B) 48 Creosote 147 Iodine (B) 201 Oil of Cloves 119 Tuberculosis. Acid, Lactic 31 Bismuth Paste 96 Calomel (B) 185 Codliver Oil 235 Codliver Oil (B) 31 Creosote (B) 147, 148 Creosote Carbonate (B) 147 Glycerophosphates 30 Guaiacol 177 Hypophosphites (B) 31 Ichthyol 197 Iodoform 198 Olive Oil 236 Terpin Hydrate 310 (See also Anorexia, Cough etc.) Turgescent Rhinitis. See Rhi- nitis, Turgescent. Tympanites. Asafetida (B) 80 Bismuth (B) 97 Eserine 261 Hypophysis 197 Oil of Turpentine (B) 310 Oxgall 159 Phenyl Salicylate (B) 40 532 CLINICAL INDEX. Typhoid Fever. page Facsimile Prescription 456 Asafetida (B) 79 Betanaphthol (B) 94 Bismuth (B) 97, 98 Brandy 56 Citrates 24 Hexamethylenamine (B) .... 180 Iodine 199 Menthol 222 Phenyl Salicylate (B) 39 Phenolsulphonates 259 Oil of Turpentine 310 (See also Diarrhea, Tympani- tes, etc.) Ulcers. Acid, Glacial Acetic 19 Acid, Nitric 32 Acid, Trichloracetic 46 Balsam of Peru (B) 84 Bismuth 96 Calamine 105 Eucalyptol 158 Hydrogen Peroxide 214 Iodine 199 Mercury (B) 192 Mezereum 224 Phenol 256 Potassium Hydroxide 270 Prepared Chalk 107 Protargol 74 Quinine 132 Silver Nitrate 72 Zinc Chloride 322 (See also Syphilis, etc.) Uremia. Croton Oil (B) 239 Digitalis (B) 154 Elaterin 154 Glucose 172 Jalap (B) 209 Pilocarpine 262 Veratrum 320 (See also Hypertension, Ne- phritis, etc.) Urethritis. See Cystitis and Gonorrhea. Vaginitis. page Facsimile Prescription 491 Acid, Boric 20 Alum 60 Argyrol (B) 74 Boroglyceride (B) 22 Iodine (B) 201 Lead Acetate 264 Potassium Permanganate (B) 271 Silver Nitrate 72 Zinc Sulphate 325 (See also Gonorrhea, Pruritus, etc.) Vomiting. Acetanilide (B) 15 Acid, Sulphurous 44 Amyl Nitrite 66 Arsenic (B) 78 Bismuth 96 Cerium Oxalate (B) 123 Cocaine (B) 139 Iodine 199 Peppermint (B) 220 Phenol 256 (See also Nausea.) Vulvitis. Argyrol (B) 74 Acid, Salicylic (B) 34 Cocaine (B) 139 (See also Leucorrhea, Pruritus, Vaginitis, etc.) Whooping-cough. Facsimile Prescription 423 Antipyrine (B) 70 Asafetida 79 Belladonna (B) 88 Benzoin (B) 91 Bromoform 100 Gelsemium 170 Hyoscyamus (B) 196 Lactucarium 211 Quinine 132 Terpin Hydrate 310 (See also Bronchitis, Cough, Laryngitis, etc.) Worms. See Hookworms, Pin- worms, Roundworms, Tape- worms, etc. CLINICAL INDEX. 533 Wounds. page Alcohol 56 Cresol 149 Hamamelis 179 Iodine 199 Iodoform 198 Wounds (continued'). page Mercury (H) 189 Potassium Permanganate .... 271 Oil of Turpentine 309 Witchhazel 179 (See also Infections, Local.) GENERAL INDEX. page Abbreviations 344 Abortifacient 4 Absolute Alcohol 55 Absorbent Cotton 175 Acacia .... 13 Acetanilid 14 Acetanilidum 14 Acetic Acid 19 Acetone 17 Acetonum 17 Acetphenetidin 17 Acetphenetidinum 17 Acetum 1 Scillae 286 Acetylsalicylic Acid 41 Acid, Acetic 19 Acetic, Diluted 19 Acetic, Glacial 19 Acetylsalicylic 41 Arsenous 75 Benzoic 91 Boracic ; 19 Boric 19 Carbolic 255 Citric 22 Chromic 128 Gallic 26 Hydriodic, Diluted 202 Hydrobromic, Diluted 100 Hydrochloric 26 Hydrochloric, Diluted 27 Hydrocyanic, Diluted 28 Hypophosphorous 29 Hypophosphorous, Diluted ... 29 Lactic 31 Muriatic 26 Nitric 31 Nitrohydrochloric 32 Nitrohydrochloric, Diluted ... 32 Nitromuriatic 32 Oleic 32 PAGE Acid, Phosphoric 33 Phosphoric, Diluted 33 Prussic, Diluted 28 Salicylic 33 Stearic 42 Sulphuric 42 Sulphuric, Aromatic 42 Sulphuric, Diluted 42 Sulphurous 43 Tannic 44 Tartaric 46 Trichloracetic 46 Acidum Aceticum .... 19 Aceticum Dilutum 19 Aceticum Glaciale 19 Acetylsalicylicum 41 Benzoicum 91 Boricum 19 Citricum 22 Gallicum 26 Hydriodicum Dilutum 202 Hydrobromicum Dilutum .... 100 Hydrochloricum 26 Hydrochloricum Dilutum .... 27 Hydrocyanicum Dilutum .... 28 Hypophosphorosum 29 Hypophosphorosum Dilutum.. 29 Lacticum 31 Nitricum 31 Nitrohydrochloricum 32 Nitrohydrochloricum Dilutum. 32 Oleicum 32 Phenylcinchoninicum 32 Phosphoricum 33 Phosphoricum Dilutum 33 Picricum 315 Pyrogallic 273 Salicylicum 33 Stearicum 42 Sulphuricum 42 Sulphuricum Aromaticum .... 42 535 536 GENERAL INDEX. page Acidum, Sulphuricum Dilutum . 42 Sulphurosum 43 Tannicum 44 Tartaricum 46 Trichloraceticum 46 Aconite 46 Extract 47 Fluidextract 47 Root 46 Tincture 47 Aconitina 47 Aconitine 47 Aconitum 46 Adeps 49 Benzoinatus 49 Lanae 50 Lanae Hydrosus 50 Adhesive Plaster 155 Adjuvant 353 Elixir 175 ^Ether 51 .Ethylis Carbamas 54 Chloridum 54 .Ethylmorphinae Hydrochloridum 241 Agar 55 Alcohol 1, 55 Absolute 55 Absolutum 55 Dehydratum 55 Diluted 55 Dilutum 55 Ethyl 50 Aldehyde 1 Alkali 1 Alkaloid 1 Almond, Bitter 65 Sweet 66 Aloe 57 Aloes , 57 Tincture of 58 Aloin 58 Aloinum 58 Alterative 1 Althaea 59 Alum 59 Burnt 60 Dried 60 Exsiccated 60 PAGE Alumen 59 Exsiccatum 60 Alumini Hydroxidum 61 Aluminum Hydroxide 61 American Hellebore 319 Oil 253 Ammonia Liniment 62 z Water 61 Water, Stronger 61 Ammoniated Glycyrrhizin 175 Mercury 181 Mercury, Ointment of 181 Tincture of Guaiac 178 Tincture of Valerian 317 Ammonii Benzoas 92 Bromidum 100 Carbonas 63 Chloridum 64 lodidum ..> 202 Salicylas 36 Ammonium 61 Alum 59 Benzoate 92 Bromide 100 Carbonate 63 Chloride 64 Ichthyosulphonate 197 Iodide 202 Muriate 64 Salicylate 36 Amygdala Amara 65 Dulcis 66 Amyl Nitrite 66 Amylis Nitris 66 Amylum 67 Analgesic 1 Anaphrodisiac 1 Anesthetic 1 Anise 68 Oil 68 Spirit 68 Water 68 Aniseed 68 Anisum 68 Anodyne 1 Antacid 1 Anthelmintic 1 Antidiphtheric Serum 288 GENERAL INDEX. 537 page Antiemetic 1 Antifebrin 14 Antigalactagogue 1 Antilithic 2 Antimalarial 2 Antimonii et Potassii Tartras... 68 Antimony and Potassium Tar- trate 68 Antiphlogistic 2 Antipyretic 2 Antipyrina 69 Antipyrine 69 Antirheumatic 2 Antiscorbutic 2 Antiseptic 2 Antisialagogue 2 Antisialic 2 Antispasmodic 2 Antisyphilitic 2 Antitoxin, Diphtheria 288 Purified 288 Antitetanic Serum 289 Purified 289 Antizymotic 2 Aperient 2 Aphrodisiac 2 Apomorphinae Hydrochloridum.. 242 Apomorphine Hydrochloride ... 242 Apothecaries' Measures 330 Weights 330 Approximate Measures 331 Aqua ~ 2, 70 Ammoniae 61 Ammoniae Fortior 61 Amygdalae Amarae 65 Anisi 68 Aurantii Florum 82 Aurantii Florum Fortior 82 Camphorae Ill Chloroformi 126 Cinnamomi 138 Creosoti 147 Destillata 71 Destillata Sterilizata 72 Foeniculi 168 Fortis 31 Hamamelidis 179 Hydrogenii Dioxidi 214 PAGE Aqua Menthae Piperitae 219 Menthae Viridis 221 Regia 32 Rosa 278 Rosa Fortior 278 Aqua Aromatica 71 Argentum 72 Argenti Nitras 72 Nitras Fusus 72 Qxidum 72 Argyrol 74 Arnica 74 Flowers 74 Tincture 75 Aromatic Elixir 82 Elixir of Eriodictyon 157 Fluidextract 138 Fluidextract of Cascara Sa- grada 120 Powder 138 Solution of Pepsin 51 Spirit of Ammonia 61 Syrup of Eriodictyon 157 Sulphuric Acid 42 Syrup of Rhubarb 277 Tincture of Rhubarb 277 Waters < 71 Arrangement of Prescriptions .. 387 Arseni lodidum 75 Trioxidum 75 Arsenic 75 Antidote 160 Iodide 75 Trioxide 75 White 75 Arsenous Acid 75 Iodide 75 Arsenum 75 Asafetida 78 Emulsion 79 Pills 79 Tincture 79 Asafcetida 78 Astringent 2 Aspidium 80 Oleoresin 80 Aspidosperma 81 Aspirin 41 538 GENERAL INDEX. PAGE Atropina 87 Atropinae Sulphas 87 Atropine 87 Sulphate 87 Attar of Rose 278 Aurantii Amari Cortex 81 Dulcis Cortex 81 Auri et Sodii Chloridum 84 Avoirdupois Weights 329 Balsam of Copaiba 145 of Peru 84 of Tolu 85 Balsams 2 Balsamum Peruvianum 84 Tolutanum 85 Bark 2 Base 2 Basham's Mixture 161 Basic Substance 2 Basis 353 Bay Rum 299 Bearberry 317 Belladonna 86 Leaves 86 Leaves, Extract of 86 Leaves, Tincture of 86 Liniment 87 Ointment 87 Plaster 86 Root 86 Root, Fluidextract of 86 Belladonnae Folia 86 Radix 86 Benzaldehyde 90 Benzaldehydum 90 Benzin 90 Purified 90 Benzinum : 90 Purificatum 90 Benzoates 92 Benzoic Acid 91 Benzoin 90 Tincture 90 Tincture, Compound 91 Benzoinated Lard 49 Benzoinum 90 Benzosulphinide 93 PAGE Benzosulphinidum 93 Betaeucainae Hydrochloridum... 93 Betanaphthol 94 Bichloride of Mercury 181 Biniodide of Mercury 182 Bismuth 95 and Ammonium Citrate 96 Subcarbonate 96 Subgallate 96 Subnitrate 96 Subsalicylate 96 Bismuthi et Ammonii Citras ... 96 Subcarbonas 96 Subgallas 96 Subnitras 96 Subsalicylas 96 Bi smuthum 95 Bitter Almond 65 Almond-Water 65 Apple 144 Orange Peel 81 Orange Peel, Fluidextract ... 81 Orange Peel, Tincture 81 Black Cohosh 130 Draught 287 Haw 320 Iron 159 Mustard 291 Pepper 262 Snake-root 130 Blaud's Pills 160 Bloodroot 281 Blue Gum Leaves 157 Blue Mass 181 Ointment 181 Pill 181 Stone 150 Vitriol 150 Boracic Acid 19 Borax 293 Boric Acid 19 Boroglyceride, Solution 20 Brandy 55 Bromides 100 Bromine 100 Bromoform 100 Bromoformum 100 Bromum 100 GENERAL INDEX. 539 PAGE Brown Mixture 175 Mustard 291 Buchu 103 Fluidextract 103 Buckthorn 168 Bulb 3 Burnt Alum 60 Cacao Butter 238 Caffeina 103 Citrata 104 Citrata Effervescens 104 Caffeinae Sodiobenzoas 104 Caffeine 103 Citrated 104 Citrated, Effervescent 104 Sodiobenzoate 104 Calabar Bean 261 Calamina Praeparata 105 Calamine, Prepared 105 Calcii Bromidum 100 Carbonas Prsecipitatus 106 Chloridum 106 Glycerophosphas 30 Hypophosphis 29 Lactas 106 Sulphidum Crudum 106 Calcined Magnesia 215 Calcium 106 Bromide 100 Carbonate Precipitated 106 Chloride 106 Glycerophosphate 30 Hypophosphite *.... 29 Lactate 106 Oxide 106 Sulphide, Crude 106 Calculating Amounts on Pre- scriptions 363 Calomel 182 Calumba 110 Tincture 110 Calx 106 Chlorinata 106 Sulphurata 106 Cambogia 110 Camphor Ill Liniment Ill PAGE Camphor, Monobromated Ill Spirit Ill Water Ill Camphor a Ill Monobromata Ill Camphorated Oil Ill Tincture of Opium 240 Cane Sugar 280 Cannabis 114 Indica 114 Cantharidal Collodion 116 Cantharides 116 Cerate 116 Collodion 116 Plaster 116 Tincture 116 Cantharis 116 Capsicum 116 Oleoresin 117 Plaster 117 Tincture 117 Caraway 119 Oil 119 Carbo Ligni 117 Carbolic Acid 255 Carbon Copies of Prescriptions. 385 Cardamom Seed 117 Tincture 118 Tincture, Compound 118 Cardamomum 117 Care as to Writing Prescriptions 386 of Carbon Copies of Prescrip- tions 385 Carminative 3 Carolina Jasmine 170 Carron Oil 107 Carum 119 Caryophyllus 119 Cascara Sagrada 119 Extract . 119 Fluidextract 120 Fluidextract, Aromatic 120 Castile Soap 283 Castor Oil 236 Cataplasma Kaolini 209 Cataplasm of Kaolin 209 Catechu 121 Pale 169 540 GENERAL INDEX. PAGE Cathartic 3 Caustic 3, 72 Potash 270 Soda 294 Caustics 3 Cayenne Pepper 116 Cera Alba 122 Flava v 122 Cerata 122 Cerate 3, 122 Cantharides . 116 Cerates 122 Ceratum 3, 122 Cantharidis 116 Cerii Oxalas 122 Cerium Oxalate 122 Cetaceum 123 Ceylon Cinnamon 138 Chalk Mixture 107 Chalybeate Pills 160 Chamomile, German 219 Charcoal, Wood 117 Charta 3 Sinapis 291 Chloral 123 Chloralum Hydratum 123 Chlorinated Lime 106 Chloroform 125 Liniment 126 Spirit 126 Water 126 Chloroformum 125 Choice of Vehicles for Prescrip- tions 365 Cholagogue 3 Chondrus 128 Chromii Trioxidum 128 Chromium Trioxide 128 Chrysarobin 129 Ointment 129 Chrysarobinum 129 Cimicifuga 130 Extract 130 Fluidextract 130 Cinchona 130 Fluidextract 130 Rubra 130 Tincture 130 PAGE Cinchona, Tincture, Compound . 131 Cinchonidinae Sulphas 132 Cinchonidine Sulphate 132 Cinchoninae Sulphas 132 Cinchonine Sulhpate 132 Cinchonism 132 Treatment 132 Cinnamomum 138 Saigonicum 138 Zeylanicum 138 Cinnamon 138 Ceylon 138 Saigon 138 Spirit 138 Tincture 138 Water 138 Citrate, Lithium 23 Potassium 23 Sodium 23 Citrated Caffeine 104 Citrates 23 Citric Acid 22 Citrine Ointment 183 Clarified Honey 219 Clove 119 Oil 119 Cocaina 139 Cocainae Hydrochloridum 139 Cocaine 139 Hydrochloride 139 Coccus 142 Cochineal 142 Cocoa Butter 238 Codeina 241 Codeinae Phosphas 241 Sulphas 241 Codeine 241 Phosphate 241 Sulphate 241 Codliver Oil 235 Emulsion 235 Emulsion with Hypophosphites 235 Colchici Cormus 142 Semen 142 Colchicina 142, 143 Colchicine 142, 143 Colchicum 142 Corm 142 GENERAL INDEX. 541 PAGE Colchicum, Extract 142 Fluidextract 142 Seed 142 Tincture 143 Cold Cream 278 Collodion 3, 143 Cantharidal ...' 116 Flexible 143 Coilodium 3, 143 Cantharidatum 116 Flexile 143 Colocynth 144 Extract 144 Extract, Compound 144 Colocynthis 144 Columbo 110 Comparative Dosage of Prepa- rations 378 Compound Chalk Powder 107 Digestive Elixir 251 Effervescing Powder 272 Ether 5 Extract of Colocynth 144 Fliudextract of Sarsaparilla... 284 Infusion of Senna 286 Laxative Pills ~... 58 Mixture of Glycyrrhiza 175 Pills of Rhubarb 277 Powder of Glycyrrhiza 175 Powder of Jalap 209 Powder of Rhubarb 277 Solution of Cresol 149 Solution of Iodine 199 Solution of Sodium Phosphate 296 Spirit of Juniper 233 Spirit of Orange 82 Syrup of Glycerophosphates.. 161 Syrup of Hypophosphites .... 30 Syrup of Sarsaparilla 284 Syrup of Squill 286 Tincture of Benzoin 91 Tincture of Cardamom 118 Tincture of Cinchona 131 Tincture of Gambir 169 Tincture of Gentian 170 Tincture of Iodine 199 Tincture of Lavender 234 PAGE Concentrated Diphtheria Anti- toxin 288 Concentrated Mixtures 373 Tetanus Antitoxin 289 Confectio 3 Confection 3 Cooking Soda 291 Copaiba 145 Copies of Prescriptions to Suc- cessor 386 Copper Sulphate 150 Copperas 161 Coriander 146 Oil 146 Seed 146 Coriandrum 146 Corm 3 Corrective 353 Corrosive Mercuric Chloride.... 181 Sublimate 181 Cosmoline 253 Cotarninae Hydrchloridum 146 Cotarnine Hydrochloride 146 Cotton, Absorbent 175 -root Bark 175 Couch-grass 316 Counterirritant 3 Cramp-bark 320 Cream of Tartar 268 Creosotal 147 Creosote 146 Carbonate .... 147 Water 147 Creosotum 146 Cresol : 149 Compound Solution 149 Creta Praeparata 107 Croton Oil 238 Cubeb 149 Oil 150 Oleoresin 150 Troches 150 Cubeba 149 Cubic Centimeter 334 Culver's Root 211 Cupri Sulphas 150 Dandelion 308 Deadly Night-shade 86 542 GENERAL INDEX. PAGE Decoction 3, 150 Decoctum 3, 150 Definitions 1 Dehydrated Alcohol 55 Deliriant 3 Delirifacient 3 Demulcent 3 Deodorant 3 Deodorized Opium 240 Depressant 4 Desiccated Hypophysis 196 Pituitary Body 196 Diacetylmorphine 242 Hydrochloride 242 Diacetylmorphinae 242 Hydrochloridum 242 Diachylon Ointment 264 Plaster 264 Diaphoretic 4 Diastase 151 Diastasum 151 Digestant 4 Digitalin 151 Digitalinum 151 Digitalis 151 Fluidextract 151 Infusion 151 Tincture 151 Diluted Acetic Acid 19 Alcohol 55 Hydriodic Acid 202 Hydrobromic Acid 100 Hydrochloric Acid 27 Hydrocyanic Acid 28 Hypophosphorous Acid 29 Lunar Caustic 72 Muriatic Acid 27 Nitrohydrochloric Acid 32 Nitromuriatic Acid 32 Phosphoric Acid 33 Prussic Acid 28 Solution of Lead Subacetate.. 264 Sulphuric Acid 42 Dionin 241 Diphtheria Antitoxin 288 Disinfectant 4 Dispensatory 379 Distilled Water 71 PAGE Diuretic 4 Dog Button 226 Domestic Measures 393 Donovan's Solution 75 Dover's Powder 240 Drastic 4 Dried Alum 60 Ferrous Sulphate 161 Dried Antitetanic Serum 290 Drop Chalk 107 Duotal 177 Ecbolic 4 Effervescent Citrated Caffeine .. 104 Potassium Citrate 23 Sodium Phosphate 296 Elaterin 154 Trituration 154 Elaterinum 154 Elixir 4 Adjuvant 175 Aromatic 82 Aromaticum 82 Digestive Compound 251 Digestivum Compositum 251 Eriodictyi Aromaticum 157 Ferri, Quininae et Strychnine Phosphatum 161 of Glycyrrhiza 175 of Iron, Quinine and Strych- nine Phosphates 161 of Lactated Pepsin 251 of Orange 82 of Paraldehyde 250 of Vitriol 42 Simplex -82 Elixirs 154 Elm 316 Emetic 4 Emetinae Hydrochloridum 206 Emetine Hydrochloride 206 Emmenagogue 4 Emollient 4 Emplastrum 4, 155 Belladonnas 86 Cantharidstum 116 Capsici 117 Elasticum 155 GENERAL INDEX. 543 PAGE Emplastrum, Plumbi 264 Sinajus 291 Emulsion 4 of Almond 66 of Asafetida 79 of Codliver Oil 235 of Codliver Oil with Hypo- phosphite 235 of Oil of Turpentine 309 Emulsions 155 Emulsum 4 Amygdalae 66 Asafcetidae 79 Olei Morrhuae 235 Olei Morrhuae cum Hypophos- phitibus 235 Emulsion Olei Terebinthinae ... 309 Epispastic 4 Epsom Salt 216 Ergot 155 Extract 155 Fluidextract 155 Ergota 155 Eriodictyon 157 Elixir, Aromatic 157 Fluidextract t. 157 Syrup, Aromatic 157 Errhine 4 Errors in Prescribing 392 Escharotic 4 Eserine Salicylate 261 Sulphate 261 Essence of Peppermint 219 Ester 5 Ether 5, 51 Compound 5 Nitrous, Spirit of 53 Ethyl Alcohol 55 Carbamate 54 Chloride 54 Ether 51 Eucaine 93 Chloride 93 Ethylmorphine Hydrochloride .. 241 Chloride 241 Eucalyptol 158 Eucalyptus 157 Fluidextract 157 PAGE Eucalyptus Oil 157 Eugenol 119 Examining the Medicine after Prescribing 394 Excitant 5 Expectorant 5 Expressed Oil of Almond 66 Exsiccated Alum 60 Ferrous Sulphate 161 Sodium Arsenate 76 Sodium Phosphate 296 Extract 5 of Aconite 47 of Belladonna Leaves 86 of Cannabis 115 of Cascara Sagrada 119 of Cimicifuga 130 of Colchicum Corm 142 of Colocynth 144 of Colocynth, Compound 144 of Ergot 155 of Gelsemium 170 of Gentian 170 of Glycyrrhiza, Pure 175 of Hydrastis 192 of Hyoscyamus 194 of Indian Cannabis 115 of Leptandra 211 of Malt 218 of Nux Vomica 226 of Opium 240 of Oxgall 159 of Physostigma 261 of Rhubarb 277 of Stramonium 300 of Sumbul 305 of Taraxacum 308 of Witchhazel 179 Extracts 158 Extractum 5, 158 Aconite 47 Belladonnae Foliorum 86 Cannabis 115 Cascarae Sagradae 119 Cimicifugae 130 Colchici Cormi 142 Colocynthidis 144 Colocynthidis Compositum ... 144 544 GENERAL INDEX. page Extractum Ergotae 155 Gelsemii 170 Gentianae 170 Glycyrrhizae Purum 175 Hydrastis 192 Hyoscyami 194 'Leptandrae 211 Malti 218 Nucis Vomicae 228 Opii 240 Rhei 277 Physostigmatis 261 Stramonii 300 Sumbul 305 Taraxaci 308 Febrifuge 2 Fei Bovis 159 Extractum 159 Inspissatus 159 Fennel 167 Oil 168 Water 168 Ferri Carbonas Saccharatus .... 160 Chloridum 160 et Ammonii Citras 160 et Quininae Citras 160 et Quininae Citras Solubilis .. 160 Hydroxidum cum Magnesii Oxido 160 Phosphas 160 Phosphas Solubilis 160 Sulphas 161 Sulphas Exsiccatus 161 Sulphas Granulatus 161 Ferric Chloride 160 Hydroxide with Magnesium Oxide 160 Phosphate 160 Ferrous Carbonate, Saccharated. 160 Sulphate 161 Sulphate, Exsiccated 161 Sulphate, Granulated 161 Ferruginous Pills 160 Ferrum 159 Reductum 159 Flaxseed 213 Flexible Collodion 143 PAGE Flower 5 Flowers of Sulphur 303 Fluidextract 5 Aromatic 138 of Aconite 47 of Belladonna Root 87 of Bitter Orange Peel 81 of Buchu 103 of Cannabis 115 of Cascara Sagrada 120 of Cascara Sagrada, Aromatic 120 of Cimicifuga 130 of Cinchona 130 of Colchicum Seed 142 of Digitalis 151 of Ergot 155 of Eriodictyon 157 of Eucalyptus 157 of Frangula 168 of Gelsemium 170 of Gentian 170 of Ginger 325 of Glycyrrhiza 175 of Grindelia '.... 176 of Guarana 179 of Hydrastis 193 of Hyoscyamus 194 of Indian Cannabis 115 of Ipecac 206 of Leptandra 211 of Lobelia 215 of Nux Vomica 226 of Pilocarpus 261 of Podophyllum 265 of Pomegranate 176 of Rhubarb 277 of Rose 278 of Sabal 280 of Sarsaparilla 284 of Sarsaparilla, Compound ... 284 of Senega 287 of Senna 287 of Serpentaria 297 of Spigelia 298 of Squill 286 of Staphisagria 300 of Stillingia 300 of Sumbul 305 GENERAL INDEX. 545 page Fluidextract of Taraxacum .... 308 of Triticum 316 of Uva Ursi 317 of Veratrum 319 of Viburnum Opulus 320 of Viburnum Prunifolium ... 321 of Xanthoxylum 321 Fluidextracts 166 Fluidextractum 5, 166 Aconiti 47 Aspidospermatis 81 Aromaticum 138 Aurantii Amari 81 Belladonnas Radicis 87 Buchu 103 Cannabis 115 Cascarae Sagradae 120 Cascarae Sagradae Aromaticum. 120 Cimicifugae 130 Cinchonae 130 Colchici Seminis 142 Digitalis 151 Ergotae 155 Eriodictyi 157 Eucalypti 157 Frangulae 168 Gelsemii 170 Gentianae 170 Glycyrrhizae 175 Granati 176 Grindeliae 176 Guaranae 179 Hydrastis 192 Hyoscyami 194 Ipecacuanhae 206 Leptandrae 211 Lobeliae 215 Nucis Vomicae 226 Pilocarpi 261 Podophylli 265 Rhei 272 Rosae 278 Sabal 280 Sarsaparillae 284 Sarsaparillae Compositum .... 284 Scillae 286 Senegae 287 Sennae 287 PAGE Fluidextractum Spigeliae 298 Staphisagriae 300 Stillingiae 300 Sumbul 305 Taraxaci 308 Tritici 316 Uvae Ursi 317 Veratri 319 Viburni Opuli 320 Viburni Prunifolii 321 Xanthoxyli 321 Zingiberis 325 Foeniculum .... 167 Formaldehyde 168 Solution 168 Troches 168 Formaldehydum 168 Formalin 168 Forms of Administration 380 Fowler's Solution 75 Foxglove 151 Frangula 168 Fluidextract 168 Friar's Balsam 91 Fruit 5 Galactagogue 5 Galla 169 Gallic Acid 26 Gallotannic Acid 44 Gambir 169 Tincture, Compound 169 Gamboge 110 Gelatin 169 Glycerinated 170 Gelatinum 169 Glycerinatum 170 Gelsemium 170 Fluidextract 170 Tincture 170 Gentian 170 Extract 170 Fluidextract 170 Tincture, Compound 170 Gentiana 170 German Chamomile 219 Germicide 5 Ginger 325 546 GENERAL INDEX. page Ginger, Fluidextract 325 Oleoresin 326 Syrup 326 Tincture 326 Glacial Acetic Acid 19 Glauber's Salt 297 Glucose 172 Glucoside 5 Glucosum 172 Glycerin 172 Suppositories 172 Glycerinated Gelatin 170 Glycerinum 172 Glycerite 5 Glycerite of Boroglycerin 20 of Hydrastis 192 of Phenol 255 of Starch 67 of Tannic Acid 44 Glycerites 174 Glyceritum 5, 174 Acidi Tannici 44 Amyli 67 Boroglycerini 20 Hydrastis 192 Phenolis 255 Glycerophosphates 161 Glyceryl Trinitrate 174 Glycerylis Nitras 174 Glycyrrhiza 175 Extract, Pure 175 Fluidextract 175 Mixture, Compound 175 Powder, Compound 175 Glycyrrhizinum Ammoniatum .. 175 Gold and Sodium Chloride .... 84 Golden Seal 192 Gossypium Purificatum 175 Goulard's Extract 264 Gramme 333 Granatum 176 Granulated Ferrous Sulphate ... 161 Opium 240 Sugar 280 Gray Powder 181 Green Iodide of Mercury 182 Soap 283 Soap, Tincture 284 PAGE Green Vitriol 161 Grindelia 176 Fluidextract 176 Guaiac 178 Tincture 178 Tincture, Ammoniated 178 Guaiacol 176 Carbonate 177 Guaiacolic Carbonas 177 Guaiacum 178 Guarana 179 Fluidextract 179 Gum 5 Asafetida 78 Aloes 57 Arabic 13 Benjamin 90 Benzoin 90 Camphor Ill -resin 5 Gun Cotton 274 Haematinic 6 Haemostatic 6 Hamamelis 179 Water 179 Hard Soap 283 Hartshorn 61 Heavy Magnesium Oxide 216 Hellebore 319 Henbane 194 Herb 6 Heroinae Hydrochloridum 242 Heroine Hydrochloride 242 Hexamethylenamina 179 Hexamethylenamine 179 Hive Syrup 286 Hoffman's Anodyne 51 Drop 51 Honey 219 Clarified 219 of Rose 278 Hops 180 Horse Salts 297 Humulus 180 Hydragogue 6 Hydrargyri Chloridum Corrosi- vum 181 GENERAL INDEX. 547 PAGE Hydrargyri Chloridum Mite ... 182 lodidum Flavum 182 lodidum Rubrum 182 Oxidum Flavum 182 Oxidum Rubrum 182 Salicylas 182 Hydrargyrum 181 Ammoniatum 181 cum Creta 181 Hydrargyrism 183 Hydrastin 192 Hydrastina 192 Hydrastinae Hydrochloridum ... 193 Hydrastine 192 Hydrochloride 193 Hydrastine Hydrochloride 193 Hydrastinum 193 Hydrastis 192 Extract 192 Fluidextract 192 Glycerite 192 Tincture 192 Hydrated Chloral 123 Hydrochloric Acid 26 Diluted 27 Hydrocarbon Oil 253 Hydrocyanic Acid, Diluted 28 Hydrogen Dioxide 214 Hydrous Wool-fat 50 Hyoscyaminae Hydrobromium .. 195 Hyoscyamine Hydrobromide ... 195 Hyoscyamus 194 Extract 194 Fluidextract 194 Tincture 194 Hypnotic 6 Hypo 297 Hypodermic Administration ... 378 Hypophosphites 29 Hypophosphorous Acid 29 Hypophysis sicca 196 Liquor 197 Ichthyol 197 Incompatibility 397 Indian Cannabis 114 Extract 115 Fluidextract 115 PAGE Indian Hemp 114 Tincture 115 Indigo Carmine 295 Infusion 6 of Digitalis 151 of Senna, Compound 287 Infusum 6 Digitalis 151 Sennae Compositum 287 Inhalations 378 Inscription 353 Iodides 202 Iodine 199 Ointment 199 Solution, Compound 199 Tincture 199 lodism 203 Iodoform 198 Ointment 198 lodoformum 198 lodum 199 Ipecac 206 Fluidextract 206 Powder, with Opium 240 Syrup 206 Wine 206 Ipecacuanha 206 Irish Moss 128 Iron 159 and Ammonium Citrate 160 and Quinine Citrate 160 and Quinine Citrate, Soluble . 160 by Hydrogen 159 Perchloride 160 Irritant 6 Jaborandi 261 Jalap 209 Powder, Compound 209 Resin 209 Jalapa 209 Jamestown Weed 300 Jesuits' Bark 130 Kaolin 209 Cataplasm 209 Kaolinum 209 Kilo 333 548 GENERAL INDEX. PAGE Kino 210 Tincture 210 Labarraque's Solution 294 Lactic Acid 31 Lactose 280 Lactucarium 210 Syrup 211 Tincture 211 Lard 49 Benzoinated 49 Laudanum 240 Laxative 6 Lead 264 Acetate 264 Ointment 264 Oxide 264 Plaster 264 Subacetate Solution 264 Subacetate Solution, Diluted . 264 Water 264 Leaf 6 Leaflets 6 Leaves 6 Lemon 211 Juice 211 Oil 211 Peel 211 Syrup 211 Tincture 211 Leopard's Bane 74 Leptandra 211 Extract 211 Fluidextract 211 Lettuce 210 Licorice 175 Lime 106 Chlorinated 106 Liniment 107 Sulphurated 106 Syrup of Lactophosphate .... 107 Water 107 Limon 211 Limonis Cortex 211 Succus 211 Liniment 6 Ammonia 62 Belladonna 87 PAGE Liniment, Camphor Ill Chloroform 126 Lime 107 Soap 283 Soft-soap 283 Turpentine 309 Liniments 212 Linimentum 6 Ammoniae 62 Belladonnae 87 Calcis 107 Camphorse Ill Chloroformi 126 Saponis 283 Saponis Mollis 284 Terebinthinae 309 Linseed 213 Oil 213 Linum 213 Liquefied Phenol 255 Liquid Paraffin 253 Petrolatum 253 Liquor 6, 213 Acidi Arsenosi 75 Ammonii Acetatis 62 Arseni et Hydrargyri lodidi .. 75 Calcis 107 Creosolis Compositus 149 Ferri Chloridi 160 Ferri et Ammonii Acetatis ... 161 Ferri Peptonati cum Mangano. 161 Ferri Subsulphatis 161 Ferri Tersulphatis 161 Formaldehydi 168 Hydrargyri Nitratis 183 Hydrogenii Dioxidi 214 Hypophysis 197 lodi Compositus 199 Magnesii Citratis 215 Pepsini 251 Pepsini Aromaticus 251 Plumbi Subacetatis 264 Plumbi Subacetatis Dilutus ... 264 Potassii Arsenatis 75 Potassii Citratis 23 Potassii Hydroxidi 270 Sodae Chlorinatae 294 Sodii Arsenatis 76 GENERAL INDEX. 549 PAGE Liquor Sodii Glycerophosphatis.. 30 Sodii Hydroxidi 295 Sodii Indigoindisulphonas ... 295 Sodii Phosphatis Compositus . 296 Zinci Chloridi 322 Liter 333 Litharge 264 Lithii Bromidum 100 Carbonas 214 Citras 23 Lithium 214 Bromide 100 Carbonate 214 Citrate 23 Lithontriptic 6 Liver of Sulphur 267 Lobelia 215 Fluidextract 215 Tincture 215 Local Peculiarities in Prescribing. 390 Lockjaw Antitoxin 289 Lugol's Solution 199 Lunar Caustic 72 Lycopodium 215 Magma Magnesiae 215 Magnesia 215 Magnesii Carbonas 215 Citratis, Liquor 215 Oxidum 215 Oxidum Ponderosum 216 Sulphas 216 Magnesium 215 Calcined 215 Carbonate 215 Citrate, Solution of 215 Heavy 216 Light 215 Milk 215 Oxide 215 Oxide, Heavy 216 Sulphate 216 Male Fern 80 Malt 218 Extract 218 Maltum 218 Mandrake 265 Manganese 218 PAGE Manganese Dioxide, Precipitated. 218 Mangani Dioxidum Praecipita- tum 218 Manganum 218 Manna 218 Mass 6 Blue 181 of Ferrous Carbonate 160 of Mercury 181 Vallet's 160 Massa 6 Ferri Carbonatis 160 Hydrargyri 181 Matricaria 219 May Apple 265 Medical Latin 337 Mel 219 Depuratum 219 Rosae 278 Mentha Piperita 219 Viridis 221 Menthol 221 Mercurial Ointment 181 Ointment, Diluted 181 Mercurialism 183 Mercuric Iodide 182 Salicylate 182 Mercurous Chloride 182 Iodide 182 Mercury 181 Mass 181 Ointment 181 with Chalk 181 Methyl Salicylate 41 Mthylene Blue 223 Methylis Salicylas 41 Methylthioninae Chloriduin 223 Hydrochloridum 223 Methylthionine Chloride 223 Hydrochloride 223 Meter 332 Metric System 332 Metrology 329 Mezereon 224 Mezereum 224 Mild Mercurous Chloride 182 Milk of Magnesia 215 Milk Sugar 280 550 GENERAL INDEX. PAGE Mistura 6 Cretae 107 Glycyrrhizae Composita 1^5 Mixture 6 Basham's 161 of Glycyrrhiza, Compound .. 175 Monkshood . 46 Monobromated Camphor Ill Monohydrated Sodium Carbo- nate 294 Monsel's Solution 161 Morphina 240 Morphinae Hydrochloridum .... 241 Sulphus 241 Morphine 240 Hydrochloride 241 Sulphate 241 Moschus 224 Mouth Administration 376 Mucilage 6 of Acacia 13 Mucilago 6 Acaciae 13 Muriatic Acid 26 Musk 224 Root 305 Tincture 224 Mustard, Black 291 Oil, Volatile 291 Paper 291 White 290 Mutton Suet 290 Mydriatic 7 Myotic 7 Myristica 225 Oil 225 Myrrh 225 Tincture 225 Myrrha 225 Name of Patient on Prescrip- tions 349 Naming a Price of Prescrip- tions 389 Naphthol 94 Narcotic 7 National Formulary 379 Neutral Principle 7 PAGE Nitric Acid 31 Nitrogen Monoxide 226 Nitrogenii Monoxidum 226 Nitroglycerin 174 Spirit 174 Nitrohydrochloric Acid 32 Diluted 32 Nitromuriatic Acid 32 Diluted 32 Nutgall 169 Ointment •• 169 Nutmeg 225 Oil 225 Nutrient 7 Nux Vomica 226 Extract 226 Fluidextract 226 Tincture 226 Official Drugs 380 Names 343 Oil 7 of Allspice 232 of Almond, Expressed 66 American 253 of Anise 68 Benne 232 of Betula 41 of Bitter Almond 65 of Cade 232 of Cajuput 231 of Orange Peel 82 of Cassia 138 Castor 236 of Chenopodium 231 of Cinnamon 138 of Clove 119 Codliver 235 of Coriander 146 Cotton-seed 231 Croton 238 of Cubeb 150 of Dwarf Pine Needles 232 of Eucalyptus 157 of Fennel 168 of Gaultheria 41 of Hydrocarbon 253 of Juniper 233 GENERAL INDEX. 551 PAGE Oil of Juniper Tar 232 of Lavender Flowers 234 of Lemon 211 Linseed 213 of Mustard, Volatile 291 of Myristica 225 of Nutmeg 225 Olive 235 of Orange Peel 82 of Peppermint 219 of Pimenta 232 of Rose 278 of Rosemary 232 Russian 253 of Santal 232 of Sassafras 285 Sesame 232 of Spearmint 221 of Star Anise 68 Sweet 235 of Sweet Birch 41 of Sweet Orange 82 of Tar, Rectified 263 of Teaberry 41 of Theobroma 238 of Thyme 232 of Turpentine 309 of Turpentine, Rectified 309 of Vitriol 42 of Wintergreen 41 of Wintergreen, Synthetic ... 41 Ointment 10 Ammoniated Mercury 181 Belladonna 87 Blue 181 of Boric Acid 20 Chrysarobin 129 Citrine 183 Diachylon 264 Iodine 199 Iodoform 198 Mercurial 181 of Mercuric Nitrate 183 of Mercury 181 of Mercury, Diluted 181 Nutgall 169 of Phenol 255 of Rose Water 278 PAGE Ointment, Stramonium 300 Sulphur 304 of Tannic Acid 44 Tar 263 of Yellow Mercuric Oxide ... 182 of Zinc Oxide 323 Oleate 7 of Mercury 182 Oleatum 7, 231 Hydrargyri 182 Oleic Acid 32 Oleoresin 7 of Aspidium 80 of Capsicum 117 of Cubeb 150 of Ginger 326 of Parsley Fruit 254 of Pepper 262 Oleoresina Aspidii 80 Capsici 117 Cubebae 150 Petroselini 254 Piperis 262 Zingiberis 326 Oleum Amygdalae Amarae 65 Amygdalae Expressum 66 Anisi -. 68 Aurantii Corticis 82 Betulae 41 Cadinum 232 Cajuput 231 Cari 119 Carophylli 119 Cassiae 138 Chenopodii 231 Coriandri 146 Cubebae 150 Eucalypti 157 Fceniculi 168 Gaultheriae 41 Gossypii Seminis 231 Jecoris Aselli 235 Juniperi 233 Lavandulae Florum 234 Limonis 211 Lini 213 Menthae Piperitae 219 Menthae Viridis 221 552 GENERAL INDEX. PAGE Oleum Morrhuae 235 Myristicae 225 Olivae 235 Picis Liquidae 263 Pimentae 232 Pini Pumilionis 232 Ricini 236 Rosae 278 Rosmarmi 232 Santali 232 Sassafras 285 Sesami 232 Sinapis Volatile 291 Terebinthinae 309 Terebinthinae Rectificatum ... 309 Theobromatis 238 Thymi 232 Tiglii 238 Opii Pulvis 240 Opium 239 Camphorated Tincture of .... 240 Denarcotized 240 Deodoratum 240 Deodorized 240 Extract 240 Granulated 240 Granulatum 240 Powdered 240 Powder, with Ipecac 240 Tincture 240 Tincture, Camphorated 240 Tincture of, Deodorized 240 Opodeldoc 283 Orange Flower Water 82 Flower Water, Stronger 82 Peel, Bitter 81 Peel, Sweet 81 Order of Writing Prescriptions. 388 Orthophosphoric Acid 33 Ownership of a Prescription ... 395 Oxgall 159 Oxygen 249 Oxygenium ; 249 Oxytocic 7 Pancreatin 249 Pancreatinum 249 Papers 3 PAGE Paraffin 249 Paraffinum 249 Paraformaldehyde 250 Paraformaldehydum 250 Paraldehyde 250 Elixir 250 Paraldehydum 250 Parasiticide 7 Paregoric 240 Parsley Fruit 254 Oleoresin 254 Seed 254 Patent Medicines 380 Pelletierinae Tanas 176 Pelletierine Tanate 176 Pellitory 273 Pen vs. Pencil in Prescription Writing 387 Pepo 250 Pepper 262 Black 262 Cayenne 116 Oleoresin 262 Red 116 Peppermint 219 Oil 219 Spirit 219 Water 219 Pepsin 251 Saccharated 251 Solution 251 Solution, Aromatic 251 Pepsinum 251 Saccharatum 251 Percentage Solutions 374 Peroxide of Hydrogen 214 Peruvian Bark 130 Petrolatum 253 Album 253 Liquidum 253 Petroleum Benzin 90 Benzin, Purified 90 Jelly 253 Petroselinum 254 Pharmacopoeia .*.. 379 Phenacetin 17 Phenol 255 Glyccrite 255 GENERAL INDEX. 553 PAGE Phenol Liquefactum 255 Ointment 255 Phenolphthalein 259 Phenolphthaleinum 259 .Phenolsulphonates 259 Phenyl Salicylate 39 Phenylis Salicylis 39 Phosphoric Acid 33 Phosphorus 260 Pills 260 Physostigma 261 Extract 261 Tincture 261 Physostigminae Salicylas 261 Physostigmine Salicylate 261 Picric Acid 315 Pills 7 of Aloin, Strychnine, Bella- donna and Ipecac 58 of Asafetida 79 of Ferrous Carbonate 160 of Ferrous Iodide 160 of Phosphorus 260 Pilocarpinae Hydrochloridum ... 261 Nitras 262 Pilocarpine Hydrochloride 261 Nitrate 262 Pilocarpus 261 Fluidextract 261 Pilulae 7 Asafoetidae 79 Ferri Carbonatis 160 Ferri lodidi 160 Laxativae Compositae 58 Phosphori 260 Rhei Compositae 277 Pinkroot 298 Piper 262 Pix Liquida 263 Plaster 4 Belladonna 86 Capsicum 117 Diachylon 264 Lead 264 Plasters 155 Plumbi Acetas 264 Oxidum 264 Plumbum 264 PAGE Podophyl 1 in 265 Podophyllum 265 Fluidextract 265 Resin 265 Poison Nut 226 Pomegranate 176 Fluidextract 176 Potassa Sulphurata 267 Potassii Acetas 267 Bicarbonas 268 Bitartras 268 Bromidum 100 Carbonas 269 Chloras 269 Citras 23 Citras Effervescens 23 et Sodii Tartras 272 Hydroxidum 270 Hypophosphis 29 lodidum 202 Nitras 271 Permanganas 271 Suphurata 267 Potassium 267 Acetate 267 Alum 59 and Sodium Tartrate 272 Bicarbonate 268 Bitartrate 268 Bromide 100 Carbonate 269 Chlorate 269 Citrate 23 Hydroxide 270 Hypophosphite 29 Iodide 202 Nitrate 271 Permanganate 271 Powder 7 Aromatic 138 Compound Chalk 107 Dover's 240 Effervescing, Compound 272 of Glycyrrhiza, Compound ... 175 of Ipecac and Opium 240 of Jalap, Compound 209 of Opium 240 of Rhubarb, Compound 277 554 GENERAL INDEX. PAGE Precipitated Calcium Carbonate. 106 Manganese Dioxide 218 Sulphur 303 Zinc Carbonate 322 Prepared Calamine 105 Chalk 107 Suet 290 Prescriber's Name on Prescrip- tion 363 Prescription, Adjuvant 353 Arrangement of 355 Basis of 353 Banks 383 Corrective of 353 Date on 349 Definition of 347 History of 348 Inscription of 353 Parts of 348 Name of Patient on 349 Prescriber's Name on 363 Signatura of 358 Subscription of 356 Superscription of 353 Vehicle of 353 Prickly Ash Bark 321 Proof Spirit 55 Proportioning Dosage 369 Proprietary Medicines 386 Protargol 74 Protective 7 Protiodide of Mercury 182 Prunus Virginiana 272 Prussic Acid, Diluted 28 Pulvis 7 Aromaticus 138 Cretae Compositus 107 Effervescens Compositus 272 Glycyrrhizae Compositus 175 Ipecacuanhas et Opii 240 Jalapae Compositus 209 Opii 240 Rhei Compositus 277 Pumpkin Seed 250 Pure Extract of Glycyrrhiza ... 175 Purgative 7 Purified Cotton 175 Petroleum Benzin 90 PAGE Purified Talc 308 Pustulant 7 Pyrethrum 273 Tincture 273 Pyrogallol 273 Pyroxylin . 274 Pyroxylinum 274 Quaker Button 226 Quantity of a Prescription 368 Quassia ■ 274 Tincture 274 Queen's Root 300 Quebracho 81 Quevenne's Iron 159 Quicksilver 181 Quinina 131 Quininae Bisulphas 131 Dihydrochloricum 131 et Ureae Hydrochloridum .... 131 Hydrobromidum 131 Hydrochloridum 131 Salicylas 131 Sulphas 131 Tannas 132 Quinine 131 and Urea Hydrochloride 131 Bisulphate 131 Carbamate 131 Dihydrochloride 131 Hydrobromide 131 Hydrochloride 131 Muriate 131 Salicylate 131 Sulphate 131 Tannate 132 Recommending Credit 389 Reconstituent Tonic 7 Rectal Administration 377 Rectified Oil of Tar 263 Oil of Turpentine 309 Spirit 55 Red Cinchona 130 Mercuric Iodide 182 Mercuric Oxide 182 Pepper 116 Precipitate 182 ( GENERAL INDEX. 555 page Red Rose 278 Saunders 282 Wine 55 Reduced Iron 159 Refilling and Giving Copies of Prescriptions 391 Refrigerant 7 Rereading Prescriptions 388 Resin 7 of Jalap 209 of Podophyllum 265 of Scammony 286 Resina Jalapae 209 Podophylli 265 Scammonii 286 Resorbent 8 Resorcin 275 Resorcinol 275 Restorative 8 Rhamnus Purshiana 119 Rheum 277 Rhizome 8 Rhubarb 277 Extract 277 Fluidextract 277 Pills, Compound 277 Powder, Compound 277 Syrup 277 Syrup, Aromatic 277 Tincture 277 Tincture, Aromatic 277 Rochelle Salt 272 Root 8 Rosa Gallica 278 Rose, Red 278 Fluidextract 278 Honey 278 Oil 278 Ointment, of Water 278 Water 278 Water, Stronger 278 Rosin 309 Rubber Plaster 155 Rubefacient 8 Russian Oil 253 Sabal 280 Fluidextract 280 PAGE Saccharated Ferrous Carbonate. 160 Pepsin 251 Saccharin 93 Saccharum 280 Lactis 280 Saigon Cinnamon 138 Sal Rochelle 272 Tartar 269. Salicin 281 Salicinum 281 Salicylates 36 Salicylic Acid 33 Saline 8 Salol 39 Salt 294 of Tartar 271 Saltpetre 271 Salts 216 Sanguinaria 281 Tincture 281 Santalum Rubrum 282 Santonica 282 Santonin 282 Santoninum 282 Sapo 283 Mollis 283 Sarsaparilla 284 'Fluidextract 284 Fluidextract, Compound 284 Syrup, Compound 284 Sassafras 285 Oil 285 Saturated Solutions 373 Saw Palmetto 280 Scammoniae Radix 285 Scammony Root 285 Resin 286 Scilla 286 Scopolaminae Hydrobromidum . 286 Scopolamine Hydrobromide .... 286 Sedative 8 Seed 8 Seidlitz Powder 272 Senega 287 Fluidextract 287 Snakeroot 287 Syrup 287 Senna 287 556 GENERAL INDEX. PAGE Senna, Fluidextract 287 Infusion, Compound 287 Syrup 287 Serpentaria 288 Serum Antidiphthericum 288 Antidiphthericum Purificatum. 288 Antitetanicum 289 Antitetanicum Purificatum ... 289 Antitetanicum Siccum 290 Sevum Praeparatum 290 Sherry Wine 56 Sialagogue ; 8 Signatura 358 Silver 72 Nitrate 72 Nitrate, Moulded 72 Oxide 72 Proteid 74 Vitellin 74 Simple Elixir 82 Simple Syrup 280 Sinapis Alba 290 Nigra 291 Slippery Elm Bark 316 Soap 283 Castile 283 Green 283 Hard 283 Liniment .' 283 Soft 283 Soft, Liniment 284 Tincture 284 Soda 291 Sodii Acetas 291 Arsenas 76 Arsenas Exsiccatus 76 Benzoas 92 Benzosulphinidum 291 Bicarbonas 291 Boras 293 Bromidum 100 Carbonas Monohydratus 294 Chloridum * 294 Citras 23 Cyanidum 294 Glycerophosphas 30 Hydroxidum 294 Hypophosphis 29 PAGE Sodii lodidum 202 Nitris 295 Perboras 296 Phenolsulphonas 259 Phosphas 296 Phosphas Effervescens ; 296 Phosphas Exsiccatus 296 Salicylas 36 Sulphas 297 Sulphis Exsiccatus 297 Thiosulphas 297 Sodium 291 Acetate 291 Arsenate 76 Arsenate, Exsiccated 76 Benzoate 92 Benzosulphinide 291 Bicarbonate 291 Bicarbonate, Troches 292 Borate 293 Bromide 100 Carbonate, Monohydrated ... 294 Chloride 294 Citrate 23 Cyanide . 294 Hydroxide 294 Hypophosphite 29 Hyposulphite 297 Indigotindisulphonate 295 Iodide 202 Nitrate 295 Perborate 296 Phenolsulphonate 259 Phosphate 296 Effervescent 296 Exsiccated 296 Saccharin 291 Salicylate 36 Sulphate 297 Sulphite, Exsiccated 297 Sulphocarbolate 259 Tetraborate 293 Thiosulphate 297 Soft Soap 283 Soluble Ferric Phosphate 160 Gun Cotton 274 Iron and Quinine Citrate .... 160 Saccharin 291 GENERAL INDEX. 557 PAGE Solution 6 of Ammonium Acetate 62 of Arsenic Chloride 75 of Arsenous Acid 75 of Arsenous and Mercuric Iodides 75 of Boroglyceride 20 of Chlorinated Soda 294 of Cresol, Compound 149 Donovan's 75 of Ferric Chloride 160 of Ferric Subsulphate 161 of Ferric Sulphate 161 of Formaldehyde 168 Fowler's 75 of Hydrogen Dioxide 214 of Hypophysis 197 of Iodine, Compound 199 of Iron and Ammonium Ace- tate 161 of Lead Subacetate 264 of Lead Subacetate, Diluted . 264 of Lime 107 Lugol's 200 of Magnesium Citrate 215 of Pepsin 251 of Pepsin, Aromatic 251 of Peptonate of Iron with Manganese 161 of Potassium Arsenite ...... 75 of Potassium Citrate 23 of Potassium Hydroxide 270 of Sodium Arsenate 76 of Sodium Hydroxide 295 of Sodium Phosphate, Com- pound 296 of Zinc Chloride 322 Spanish flies 116 Sparteinae Sulphas 298 Sparteine Sulphate 298 Spearmint 221 Oil 221 Spirit 221 Water 221 Specifying Manufacturers in Pre- scribing 381 Spigelia 298 Fluidextract 298 PAGE Spirit 8 of Ammonia, Aromatic 61 of Anise 68 of Bitter Almond 65 of Camphor Ill of Chloroform 126 of Cinnamon 138 of Ether 51 of Ether, Compound 51 of Glonoin 174 of Glyceryl Trinitrate 174 of Juniper 233 of Juniper, Compound 233 of Lavender 234 of Mindererus 62 of Myrcia 299 of Nitroglycerin 174 of Nitrous Ether 53 of Orange, Compound 82 of Peppermint 219 of Spearmint 221 Spiritus 8, 299 .Etheris 51 .Etheris Compositus 51 .Etheris Nitrosi 53 Ammoniae Aromaticus 61 Amygdalae Amarae 65 Anisi 68 Aurantii Compositus 82 Camphorae Ill Chloroformi 126 Cinnamomi 138 Frumenti 55 Glycerylis Nitratis 174 Juniperi 233 Juniperi Compositus 233 Lavandulae 234 Menthae Piperitae 219 Menthae Viridis 221 Myrcia 299 Rectificatus 55 Vini Gallici 55 Vini Rectificatus 55 Squill 286 Fluidextract 286 Syrup 286 Syrup Compound 286 Tincture 286 GENERAL INDEX. 558 PAGE Squill Vinegar 286 Staphisagria 300 Fluidextract 300 Starch 67 Stavesacre 300 Stearic Acid 42 Stearopten 8 Sterilized, Distilled, Water 72 Sternutatory 8 Stillingia 300 Fluidextract 300 Stimulant 8 Stock Prescriptions 395 Storax 302 Stramonium 300 Extract 300 Ointment 300 Tincture 300 Stronger Ammonia Water 61 Orange Flower Water 82 Rose Water 278 Strontii Bromidum 100 lodidum 202 Salicylas 36 Strontium 301 Bromide 100 Iodide 202 Salicylate 36 Strophanthin 301 Strophanthinum 301 Strophanthus 301 Tincture / 301 Strychninae 226 Nitras 226 Sulphas 226 Styrchnine 226 Nitrate 226 Sulphate 226 Styptic 8 Stypticin ? 146 Styrax 302 Subchloride of Mercury 182 Sublimed Sulphur 303 Subscription 356 Sucrose 280 Suet, Prepared 290 Sugar 280 of Lead 264 PAGE Sugar of Milk 280 Sulphonal 303 Sulphonethylmethane 302 Sulphonethylmethanum 302 Sulphonmethane 303 Sulphonmethanum 303 Sulphur 303 Lotum 303 Ointment 304 Praecipitatum 303 Precipitated 303 Sublimed 303 Washed 303 Sulphurated Lime 106 Potassa 267 Sulphuric Acid 42 Ether 51 Sulphurous Acid 43 Sumbul 305 Extract 305 Fluidextract 305 Superscription 353 Suppositoria 8 Glycerini 172 Suppositories 8 of Glycerin 172 Sweet Almond 66 Oil 235 Orange Peel 81 Orange Peel, Syrup 82 Orange Peel, Tincture 82 Spirit of Nitre 53 Syrup .,.9, 280 of Acacia 13 of Calcium Lactophosphate .. 107 of Citric Acid 23, 211 of Eryodicity, Aromatic 157 of Ferrous Iodide 160 of Ginger 326 of Glycerophosphates 161 of Hydriodic Acid 202 of Hypophosphites 29 of Hypophosphites, Compound. 30 of Ipecac 206 of Lactucarium 211 of Lemon 23, 211 of Orange 82 of Orange Flowers 82 GENERAL INDEX. 559 PAGE Syrup of Rhubarb 277 of Rhubarb, Aromatic 277 of Sarsaparilla, Compound ... 284 of Senega 287 of Senna 287 of Squill 286 of Squill, Compound 286 of Tar 263 of Tolu 85 of Wild Cherry 272 Simple 280 Syrupus 9, 280 Acaciae 13 Acidi Citrici 23, 211 Acidi Hydriodici 202 Aurantii 82 Aurantii Florum 82 Calcii Lactophosphas 107 Eriodictyi Aromaticus 167 Ferri lodidi 160 Glycerophosphatis Compositus. 161 Hypophosphitum 29 Hypophosphitum Compositus.. 30 Ipecacuanhae 206 Lactucarii 211 Picis Liquidae 263 Pruni Virginianae 272 Rhei 277 Rhei Aromaticus 277 Sarsaparillae Compositum .... 284 Scillae 286 Scillae Compositus 286 Senegae 287 Sennae 287 Tolutanus 85 Zingiberis 326 Tabellae 9 Table of Abbreviations, Words and Phrases 407 of Apothecaries' Measures ... 330 of Apothecaries' Weights .... 330 of Approximate Measures ... 331 of Avoirdupois Weight 329 of Drops to Fuidrachm 411 of Relative Values of Weights and Measures 406 of Solubilities 412 PAGE Table Salt 294 Tablet T/iturates 9 Tablets 9 Coated 9 Compressed 9 Dispensing 9 Hypodermic 9 Taenifuge 9 Taeniafuge 9 Talc, Purified 308 Talcum Purificatum 308 Tannic Acid 44 Tannin 44 Tar 263 Oil, Rectified 263 Ointment 263 Syrup 263 Taraxacum 308 Extract 308 Fuidextract 308 Tartar Emetic 68 Tartaric Acid 46 Telephoning Prescriptions 388 Terebene 309 Terebenum 309 Terebinthina 308 Terpin Hydrate 310 Terpini Hydras 310 Tetanus Antitoxin 289 Thymol 311 Iodide 312 Tinctura 9 Aconiti 47 Aloes 58 Arnicae 75 Asafoetidae 79 Aurantii Amari 81 Auranti Dulcis 82 Belladonnae Foliorum 86 Benzoini 90 Benzoini Composita 91 Calumbae 110 Cannabis 115 Cantharidis 116 Capsici 117 Cardamomi 118 Cardamomi Composita 118 Cinch onae 130 560 GENERAL INDEX. PAGE Tinctura Cinchonae Composita .. 131 Cinnamomi 138 Colchici Seminis 143 Digitalis 151 Ferri Chloridi 160 Gallae 169 Gambir Composita 169 Gelsemii 170 Gentianae Composita 170 Guaiaci 178 Guaiaci Ammoniata 178 Hydrastis 192 Hyoscyami 194 lodi 199 Kino 210 Lactucarii 211 Lavandulae Composita 234 Limonis Corticis 211 Lobeliae 215 Moschi 224 Myrrhae 225 Nucis Vomicae 226 Opii 240 Opii Camphorata 240 Opii Deodorati 240 Physostigmatis 261 Pyrethri 273 Quassiae 274 Rhei 277 Rhei Aromatica 277 Sanguinariae 281 Scillae 286 Stramonii 300 Strophanthi 301 Tolutana 85 Valerianae t.... 317 Valerianae Ammoniata 317 Veratri 319 Zingiberis 326 Tincture 9 of Aconite 47 of Aloes 58 of Arnica 75 of Asafetida 79 of Belladonna Leaves 86 of Benzoin 90 of Benzoin, Compound 91 of Bitter Orange Peel 81 PAGE Tincture of Calumba 110 of Camphora Ill of Cannabis 115 of Cantharides 116 of Capsicum 117 of Cardamom 118 of Cardamom, Compound .... 118 of Cinchona 130 of Cinchona, Compound 131 of Cinnamon 138 of Colchicum Seed 143 of Deodorized Opium 240 of Digitalis 151 of Ferric Chloride 160 of Gambir, Compound 169 of Gelsemium 170 of Gentian, Compound 170 of Ginger ...326 of Green Soap 284 of Guaiac 178 of Guaiac, Ammoniated 178 of Hydrastis 192 of Hyoscyamus 194 of Indian Cannabis 114 of Iodine 199 of Kino 210 of Lactucarium 211 of Lavender, Compound 234 of Lemon Peel 211 of Lobelia 215 of Musk 224 of Myrrh 225 of Nutgall 169 of Nux Vomica 226 of Opium 240 of Opium, Camphorated 240 of Opium, Deodorized 240 of Physostigma 261 of Pyrethrum 273 of Quassia 274 of Rhubarb 277 of Rhubarb, Aromatic 277 of Sanguinaria 281 of Squill 286 of Stramonium 300 of Strophanthus 301 of Sweet Orange Peel 82 of Tolu 85 GENERAL INDEX. 561 PAGE Tincture of Valerian 317 of Valerian, Ammoniated .... 317 of Veratrum 319 Tolu, Balsam 85 Syrup ' 85 Tincture 85 Tonic 9 Reconstituent 7 Trichloracetic Acid 46 Trinitrophenol 315 Trional 302 Triticum 316 Fluidextract 316 Trituratio ,.... 9 Elaterini 154 Trituration 9 of Elaterin 154 Troches 10 of Ammonium Chloride 64 of Cubeb 150 of Potassium Chlorate 269 of Sodium Bicarbonate 292 of Tannic Acid 44 Trochisci 10 Acidi Tannici 44 Ammonii Chloridi 64 Cubebae 150 Potassii Chloratis 269 Sodii Bicarbonatis . v 292 Troy Weights 330 Tuberous Root 10 Turpentine 308 Emulsion 309 Liniment 309 Oil 309 Oil, Rectified 309 Ulmus 316 Unguentum 10 Acidi Borici 20 Acidi Tannici 44 Aquae Rosae 278 Belladonnae 87 Chrysarobini 129 Diachylon 264 Gallae 169 Hydrargyri 181 Hydrargyri Ammoniati 181 PAGE Unguentum Hydrargyri Dilutum. 181 Hydrargyri Nitratis 183 Hydrargyri Oxidi Flavi 182 lodi 199 lodoformi 198 Phenolis 255 Picis Liquidae 263 Stramonii 300 Sulphuris 304 Zinci Oxidi 323 Urotropin 179 Uva Ursi 317 Fluidextract 317 Vehicle 353 Vehicles 365 Valerates 318 Valerian 317 Tincture 317 Tincture, Ammoniated 317 Valeriana 317 Vallet's Mass 160 Vanillin 319 Vanillinum 319 Vaselin 253 Veratrina 319 Veratrine 319 Veratrum 319 Fluidextract 319 Tincture 319 Viride 319 Vermicide 10 Vermifuge 10 Vesicant 10 Viburnum Opulus 320 Fluidextract 320 Prunifolium 320 Extract ' 321 Fluidextract 321 Vinegar of Squill 286 Vinegars 1 Vinum 10 Album 55 Rubrum 55 Xericum 56 Virginia Snakeroot 288 Volatile Oil of Mustard 291 562 GENERAL INDEX. PAGE Washed Sulphur 303 Water 2, 70 Ammonia 61 Ammonia, Stronger 61 Anise 68 Aromatic 71 Bitter Almond 65 Camphor Ill Chloroform 126 Cinnamon 138 Creosote 147 Distilled 71 Distilled Sterilized 72 Fennel 168 Hamamelis 179 Lime 107 Medicated 2 Orange Flower 82 Orange Flower, Stronger .... 82 Peppermint 219 Rose 278 Rose, Stronger 278 Spearmint 221 Waters, Medicated 2, 71 Wax, White 122 Yellow 122 Weight 329 Whisky 55 White Arsenic 75 Mustard 290 Petrolatum 253 Precipitate 181 Wax 122 Wine 55 Wild Cherry 272 Syrup 272 Wine 10 Measure 330 Red 55 Sherry . ...c 56 PAGE Wine, White 55 Witchhazel 179 Wolfbane 46 Wood Charcoal 117 Wool-fat 50 Write Prescriptions 382 Written Instructions to Patients. 371 Xanthoxylum 321 Fluidextract 321 Yellow Cinchona ;.... 130 Jasmine 170 Mercuric Oxide 182 Mercuric Oxide, Ointment ... 182 Mercurous Iodide 182 Mustard 290 Root 192 Wax 122 Yerba Santa 157 Zinc 322 Acetate 322 Carbonate, Precipitated 322 Chloride 322 Oxide 323 Phenolsulphonate 259 Stearate 324 Sulphate 324 Valerate 325 Zinci Acetas 322 Carbonas Praecipitatus 322 Chloridum 322 Oxidum 323 Phenolsulphonas 259 Stearas 324 Sulphas 324 Valeras 325 Zincum 322 Zingiber 325 Other Publications of F. A. Davis Company, Philadelphia Old Age Deferred THE CAUSES OF OLD AGE AND ITS POSTPONEMENT BY HYGIENIC AND THERAPEUTIC MEASURES. BY ARNOLD LORAND, M.D. Physician to the Baths, Carlsbad, Austria, etc., etc. Royal Octavo. 4S0 Pages. Attractively Bound in Extra Cloth, Burnished Top. Price, $3.00, net. NEW EDITION With the Addition of an Important New Chapter on Premature Old Looks : Their Prevention and Treatment. DR. LORAND has taken into consideration not the faddists, but the great physiologists and clinicians whose writings are based upon sound premises, extensive research, and vast experience. The author discusses the agencies which govern the nutri- tion of our bodies. Those which govern the condition of the nervous system and mentality. The influence of the various glands upon vitality and long life. The causation and rational prevention of premature old age, and the treatment of old age. The proper hygienic measures to be followed for thei improve- ment of the functions of the body. Personal hygiene in all its phases from infancy on through youth, middle life and maturity. Some of the topics discussed are:- "It is quite within the bounds of possibility, as we shall en- deavor to demonstrate herein, to prolong our term of youthful- ness by ten or twenty years. In other words we need no longer grow old at forty or fifty; we may live to the age of ninety or one hundred years, instead of dying at sixty or seventy. All this can be brought about by the observance of certain hygienic measures, and by improving the functions of a certain few of the glandular structures in our body." (From the author's preface.} This work has now been published in nine languages, large editions being necessary to supply the demand in each language. British Medical Journal (London. England). In his book on "OLD AGE DEFERRED." Dr. Lorand has put together a large amount of learning and has dealt with an immense number of subiects. Other Publications of F. A. Davis Company, Philadelphia Health and Longevity Through Rational Diet PRACTICAL HINTS IN REGARD TO FOOD AND THE USEFULNESS OR THE HARMFUL EFFECTS OF THE VARIOUS ARTICLES OF DIET. BY DR. ARNOLD LORAND Physician to the Baths, Carlsbad, Austria, etc., etc. Translated from the Original German Edition, with an Introduction by Victor C. Vaughan, M.D., Ann Arbor, Mich. Being a complete code of instructions as to the different foods and how they can be best employed. Royal Octavo. 425 pages. Handsomely Bound in Cloth (uniform with "Old Age Deferred"). $3.00, net. SYNOPSIS OF CONTENTS: Introduction, with remarks upon the importance of the Appetite and the Object of the Processes of Nourishment. I. The Influence of Food Upon Man. II. The Fundamental Law's of Rational Feeding. HI. The Injurious Modes of Feeding. IV. The Good and Evil Effects of Various Food Substances. Meat Diet. Fish Diet. Milk Diet. Cereals. Green Vege- tables. Fruit Diet. Beverages. V. Vegetarianism and its Advantages and Disadvantages. Hints for the Prevention of the Latter. VI. The Practical Advantages of Rational Feeding. Useful Hints. VIL Hints for Those Obliged to Take their Meals in Restaurants. The Injurious Effects of the "Table d'Hote" Diet. VIII. The Increased Activity of Certain Functions Brought About by Food. IX. The Increased Muscular Power Resulting from a Suitable Diet. X. Conclusion. The Relationship of Food to Old Age and Lon- gevity. Glossary. List of Diseases. Index. MANY PEOPLE naturally sidestep books on diet because they expect to be warned against their pet dietary follies. This is not the Lorand way. In a most entertaining manner Dr. Lorand explains to the reader the advantages, disadvantages and nutritive values of different foods so clearly that a person of ordinary intelligence cam exercise good judgment. Obviously, no person of reasonable common sense deliberately follows the path of error in diet; if he has the facts he can go ahead and choose for himself; Dr. Lorand's book provides the facts. Journal of the American Medical Association (Chicago, Ill.). Methods of cooking are described and interesting remarks are made as to the size and distribution of the ill effects arising from various special and one-sided diets. It is full of valuable hints from which all can profit. It may be recommended to the layman as well >.s to the practitioner.