The Eclectic Materia 
Medica, Pharmacology 
and Therapeutics 
By 
HARVEY WICKES FELTER, M. D. 
Professor of Materia Medica and Therapeutics, and of the History of Medicine 
in the Eclectic Medical College of Cincinnati, Ohio; Ex-President and 
Member of the National Eclectic Medical Association; Ex- 
President and Member of the Ohio State Eclectic 
Medical Association, Etc. 
ILLUSTRATED 
cinCTWAtt; ohio 
JOHN K. SCUDDER 
1922 COPYRIGHT, 1922 
JOHN K. SCUDDER 
"The use in this volume of certain portions of the text of the United States Pharma- 
copoeia is by virtue of permission received from the Board of Trustees of the United States 
Pharmacopceial Convention. The said Board of Trustees is not responsible for any in- 
accuracy of quotation nor for any errors in the statement of quantities or percentage 
strengths." Preface. 
This text-book upon drugs and their uses is the response to the repeated 
requests of students and graduates of the Eclectic Medical College of Cin- 
cinnati, who for some years have attended the author's lectures upon 
materia medica and therapeutics. These requests he has accepted as the 
expression of an evident need of such a book. 
In acceding to this demand it has been the purpose of the author 
to present the accepted facts of Eclectic therapeutics in as condensed a form 
as possible without the sacrifice of clarity, and in as plain and every-day 
language as might be consistent with the purpose. Notwithstanding this, 
it has been necessary, at the risk of appearing pedantic, to use a large 
preponderance of scientific terminology. Our only excuse for this is that 
the student at least once during his study of the subject should familiar- 
ize himself with the technical language of the science. 
Many apochryphal statements, it seems to the author, have in the last 
few years crept into the literature of our therapeutics. By close pruning, 
he has endeavored in this work to eliminate some of these, realizing, how- 
ever, that he has succeeded but partially. Over-praise of drugs, like 
adulation of individuals, is often equivalent to their damnation. He 
has, therefore, not hesitated to criticize boldly statements of writers where 
he has believed them to be at variance with the accepted truths of common 
experience, or with his own conception of them. This he has done in no 
unfriendly spirit of antagonism, but rather in the charitable belief that un- 
restrained enthusiasm rather than sound therapeutic judgment is responsible 
for many misstatements and exaggerations concerning the virtues of drugs, 
and that such a course of deletion is essential if our drug literature is 
to be purged of exaggerated and unsustained statements. 
Lest he himself be unwary the author has endeavored to avoid the too 
common pitfail of over-enthusiastic claims concerning the virtues of drugs 
and therapeutic measures. He has, moreover, set up his own judgment in 
the selection and collating of facts which seem to him well authenticated 
and best substantiated, as well as in recording that which is of personal 
knowledge to him and which his professional experience supports. He does 
not expect every one to agree with him and he welcomes constructive 
criticism. If, in the consideration of a drug, he has not done full justice to 
it, as others see it, it is because he believes that drug to have been overesti- 
mated, and consequently overlauded, and that a conservative estimate must 
alone be recorded. If a drug apparently of slight value to others seems to 
3 PREFACE. 
have received fulsome praise, it is because the personal experience of the au- 
thor with that drug justifies such consideration. The latter is notably true of 
some of the minor drugs (e. g., matricaria) from which non-shocking effects 
alone are obtained, and which from their seeming unimportance have not 
been used much by many physicians. Again, many drugs not frequently 
employed have been given space because they sometimes serve purposes 
which no other drugs can fulfill. Conservatism and fidelity to the experi- 
ences of the many, rather than a record of the merely new, novel, or bizarre, 
and generalizations rather than the single experiences in drug therapy 
have been kept uppermost in the plan of the book; and wherever possible 
the specific use of specific means, according to established specific indica- 
tions, has been given preference to other forms of medication. 
Throughout this work the author has attempted that which he believes 
to be largely an innovation in Eclectic therapy-the consideration of the 
relative value of drug uses by contrast, noting the failures of medicines 
as well as their successes. This he believes to be the most meritorious of 
his efforts, and of the greatest value to the student who may use this book 
as a therapeutic guide. 
Though the pharmacological or so-called physiological action of drugs 
is neither followed nor relied upon in Eclectic therapy for the purpose of 
prescribing drugs (except in a few instances noted in the text), a condensed 
statement of the pharmacology of each drug, with few exceptions, has been 
included. This we believe to be of importance in order that the student 
may have access to a summary of the accepted views of pharmacologists, 
and that he may know the tissues acted upon and the kind and extent of 
action when a drug is administered in certain or in varying amounts. As 
such pharmacological studies are not the results of experimental or other 
studies by Eclectic physicians, the author has drawn freely, for this part of 
the book, upon the excellent treatises of such old-school authors as Cushny, 
Hare, Wilcox, Butler, Bastedo, Stevens, Sollmann, Potter, and others. To 
these authors credit is herein cheerfully extended for such material as has 
been abstracted or subjected to digest. Besides these sources, a large part 
of the pharmacology has been derived from the author's previous work-the 
revised American Dispensatory. From the latter, as well as from Taylor's 
Medical Jurisprudence, and from special contributions by the author to 
Journals, have been derived most of the facts of Toxicology. These two 
phases-the latter quite fully-have been stressed because no other Eclectic 
materia medica has given them space and because both students and prac- 
titioners alike need and demand such information. 
It is a matter of regret that in some otherwise excellent works on 
Eclectic therapeutics there appears an almost hopeless and well-nigh 
inextricable entanglement of the subjects of pharmacologic and toxicologic 
4 PREFACE. 
action with those of symptomatology and therapeutic action. This confusion 
the author has attempted to rectify by keeping distinctly separate the sub- 
divisions of action (pharmacologic and near-toxic), toxicology, and thear- 
peutic action. Under therapy he has also made two divisions of uses- 
External and Internal-thus facilitating quick access or reference to means 
of treatment. 
Every page of this work reflects Specific Medication as far as the 
limits of the latter will permit, the specific uses of drugs according to es- 
tablished indications having been accorded the greatest prominence. Other 
approved therapy has been fully included, many of the sound and older 
remnants of a past practice of therapeutics not having as yet been replaced 
by specific medication methods. To satisfy the demands of those who de- 
sire to study and prescribe according to therapeutic classes of drugs (as 
cathartics, diuretics, etc.), a Classification of Drugs has been devised which 
comprises physiologic, pharmacologic, biologic, and therapeutic features. 
A careful study of this, we believe, will be a valuable aid to the student, and 
will in no way interfere with the study of the specific medication method 
of applying drugs. As yet no satisfactory or complete classification of specific 
medication has been made, but an outline of a method toward such a classi- 
fication follows the preceding. 
Under each drug the Specific Medicines have been made the prepara- 
tions of preference, whenever such representatives are available. The sole 
reasons for this preference, aside from their preeminent excellence, are the 
facts that the practice of Modern Eclecticism is chiefly that of Specific 
Medication and that the latter has been built up upon specific indications 
established through the use of the Eclectic Specific Medicines. Where it is 
desired to use other preparations a list of other classes of medicines has been 
included-a list embracing the tincture and fluid extracts, etc., with doses 
of the chief drugs not otherwise mentioned in the text. 
The few illustrations that have been introduced do not in all instances 
represent the leading Eclectic medicines, but rather those of plant drugs 
that are typical of certain features, historic or medicinal, and most of which, 
in one way or another, have in some measure contributed from the earliest 
days of American aboriginal, domestic, and botanic medicine to the evolution 
and progress and final development of Eclectic therapeutics. Some merely 
represent drug landmarks that have been passed by in the therapeutic march 
to the present. The author regrets that lack of space precludes the inclusion 
in this work of historic notes-a purpose originally intended. 
Finally, the author hereby extends his grateful thanks to all not 
otherwise mentioned, for borrowed material, or who in any way have con- 
tributed toward the production of the book. For the use of illustrations 
and tables credit has been acknowledged at their place of insertion. To men- 
5 PREFACE. 
tion the Eclectic sources of data would be to quote the whole range of Eclec- 
tic literature. Usually, however, where an important quotation has been 
used or material facts recorded from the works of Eclectic authors credit 
has been given in the article. The author has drawn largely upon his own 
contributions to The Eclectic Medical Journal, to The Eclectic Medical 
Gleaner, to Locke's Syllabus of Eclectic Materia Medica, and to his revision 
of King's American Dispensatory. In some instances considerable material 
has been taken verbatim et literatim from the latter work. For all these 
sources we extend our thanks to the publishers. 
Harvey Wickes Felter. 
1728 Chase Ave., Cincinnati, Ohio, June 10, 1922. 
Note.-Since this work has been "set up" in type, an article by J. F. Rock, Agricultural 
Explorer for the United States Bureau of Plant Industry, establishes the source of true 
Chaulmoogra Oil as the fruit of the Kalaw Tree-the Taraktogenos Kurzii, King, found in 
northern Burma and in Assam. For more than a century the source has been credited 
to a tree of the same family-the Gynocardia odorata. (See page 400.) Closely similar 
trees-the Hydnocarpus anthelmintica (of Siam) and Hydnocarpus castanea (of Burma)- 
yield an oil very similar to that of Chaulmoogra. True chaulmoogra oil and its acid 
constituents-chaulmoogric and hydnocarpic acids, and especially their esters (isolated 
some years ago by Dr. Frederick B. Power and assistants) have recently been used intra- 
muscularly with reputed remarkably curative effects in leprosy. Chaulmoogra seeds have 
been planted in this country to furnish a future source of the oil. See interesting illustrated 
article by Rock in The National Geographic Magazine, Vol. XLI, No. 3, March, 1922, 
detailing the journey and quest of the explorer for the true chaulmoogra tree.-(H. W. F.) 
6 Contents. 
PART I 
INTRODUCTION. 
Chapter Page 
I. Definitions and General Considerations 11 
A Medicine 11 
A Drug 11 
Materia Medica 11 
Pharmacodynamics 11 
Toxicology 11 
Pharmacology 11 
Physiological Action 11 
Therapeutics 12 
Empirical Therapeutics 12 
Rational Therapeutics 12 
Specific Medication (Specific Therapy) 12 
Other Forms of Therapy 12 
Pharmacognosy 13 
Pharmacy 13 
Posology 13 
II. The Parts, Constituents, and Derivatives of Plant 
Drugs 13 
Parts of Plants Employed as Medicines, or in Their 
Preparation 13 
Derivatives of Plant Drugs 18 
Proximate and Other Principles of Plant Drugs ... 22 
III. Pharmaceutical Forms and Classes of Medicines . . 26 
IV. Action and Effects of Medicines 32 
General Nature of Drug Action . 32 
Effects of Drug Action 33 
Selective Drug Affinity 34 
Absorbability of Medicines 35 
Administration and Rate of Absorption and Elimination. 36 
Circumstances Modifying Drug Effects 37 
Cumulative Action 37 
Drug Tolerance 37 
Idiosyncrasy 38 
Synergists and Antagonists 38 
Dosage 38 
7 Chapter Page 
Dosage of Specific Medicines 39 
Salt Action 40 
V. Application and Administration of Medicines ... 40 
VI. Incompatibility 42 
VIL Management of Acute Poisoning 45 
VIII. Dispensing of Medicines 50 
IX. Specific Medication 54 
X. Classification of Specific Medication 55 
XI. Prescription Writing 60 
The Prescription 60 
Medical Latin 61 
Rules and Groups of Terminations 62 
Construction of the Prescription 64 
Illustrative Prescriptions 65 
XII. Weights and Measures 66 
XIII. Percentage Solutions and Dispensing Tables ... 69 
XIV. Definitions of Therapeutic Terms 70 
XV. Abbreviations, Words, and Phrases 74 
XVI. Pharmaceutical Preparations with Doses (Other Than 
Specific Medicines) 76 
XVII. Therapeutic Classification of Drugs 78 
XVIII. Sources of Drug Knowledge 109 
CONTENTS. 
PART II 
Individual Drugs 112 
8 Illustrations. 
Opposite Page 
Yarrow {Achillea Millefolium) 117 
Wild Ginger {Asarum canadense) 221 
Catnip {Nepeta Cataria) 281 
Blue Cohosh {Caulophyllum thalictroides) 282 
Stone Root {Collinsonia canadensis) 315 
Smaller Yellow Lady's Slipper {Cypripedium parviflorum) . . . 330 
Wild Yam {Dioscorea villosa) 344 
Skunk Cabbage {Symplocarpus foetidus) 345 
Purple Cone Flower {Brauneria [Echinacea] angustifolia) .... 347 
Boneset {Eupatorium perfoliatum) 364 
Golden Seal {Hydrastis canadensis) 417 
Elecampane {Inula Helenium) 426 
Culver's Physic {Veronica [Leptandra] virginica) 443 
Black Cohosh {Cimicifuga racemosa) 466 
Spearmint {Mentha spicata [M. viridis]) 479 
Horse Mint {Monarda punctata) 481 
Poke {Phytolacca decandra) 535 
May Apple {Podophyllum peltatum) 555 
Poison Ivy {Rhus Toxicodendron) 602 
Yellow Dock {Rumex crispus) 610 
Bloodroot {Sanguinaria canadensis) 615 
Virginia Snakeroot {Aristolochia Serpentaria) 629 
Jimson Weed {Datura Stramonium) 657 
Mullein {Verbascum Thapsus) 693 
9 PART I. 
Introduction. 
I. DEFINITIONS AND GENERAL 
CONSIDERATIONS. 
A Medicine is a drug or remedial substance given or applied in the 
treatment of, or for the prevention of disease. 
A Drug, strictly speaking, is a dried medicinal plant, or any crude 
medicinal substance. The term is now used interchangeably with that 
of A Medicine. 
Materia Medica (materials of medicine) are the medicinal substances 
used in the treatment of disease. The term Materia Medica is usually 
applied to a treatise on the materials used as medicines-comprising 
their history, source, physical characters, constituents, chemical proper- 
ties, preparations, doses, and administration. Generally such a work 
also includes more or less of Pharmacodynamics, or the consideration of drug 
power, and of Toxicology, or the consideration of poisons. 
Pharmacodynamics is a study of the power of drugs upon the normal 
living organism, and the term is the equivalent of that of the "Physio- 
logical Action of Drugs". 
Toxicology is a study of poisons and the poisonous effects of drugs. 
It includes their description, detection, symptoms, antidotes, antagonists, 
and treatment. 
Pharmacology, strictly, is a discussion of the changes produced by 
unorganized substances in minute attenuation, aside from foods, in living 
organized tissues. It is practically identical with physiological action, 
but of greater scope, and with pharmacodynamics. Some, chiefly in the 
past, use the term more broadly to cover those branches of medical science 
included in Materia Medica and Therapeutics; i. e., a consideration of 
drugs and medicines in all their relations. 
Physiological Action is chiefly the action of drugs upon healthy animals, 
and has been studied to a lesser extent upon man. Pharmacological 
Action is determined upon both healthy and diseased tissues in animals 
and man. Drugs sometimes fail to make any impression in health but 
act readily in disease. Effects upon the higher types of organisms usually 
coincide in the same types, but conditions, food, and chemical forces tend 
to cause variations and modifications, so that experimental conclusions and 
deductions are not always absolutely dependable. Again there is great 
variance in the action of drugs upon animals and upon man, and that 
in some animals is widely divergent from that upon other mammals. 
In the main, however, there is quite general agreement. The chief value 
of animal experimentation is to point out the direction and extent of 
11 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
activity which a drug has upon certain types of tissue. The ultimate 
object, however, is to find a sufficient and sound reason for its application 
in the administration of medicines for the relief or cure of disease. This 
has been but partially attained, and a vast field awaits the future explorer. 
The fullness of realization, perhaps, will not come until the effects of drugs 
upon man, and not so much those upon animals, will have become more 
accurately determined by the use of drugs of standard quality, given in 
varied doses, both in a state of health and in that of disease. Much of 
the physiological action of drugs upon man has been acquired from over- 
dosing and cases of poisoning, and to lesser extent from drug-proving. 
Therapeutics is the art of applying drugs and other agents and meas- 
ures for the alleviation or for the cure of disease. Therapeutics is (1) 
Empirical, (2) Rational, and (3) Specific. 
Empirical Therapeutics is that for which no other reason can be 
given than that it has been hitherto repeatedly used with success. When 
a medicine or measure is employed to accomplish that which it has been 
known to do in previous like conditions, in like doses, and under like 
circumstances, it is said to be an Empiric Remedy. Empirical Therapeutics 
has been aptly named the "Therapeutics of Experience". It does not take 
into consideration physiologic or pathologic reasons, but is based solely 
upon observations in past experiences of the effects of drugs and of other 
remedial measures. It is a valuable form of therapeutics, but should con- 
stitute only a part of its practice; and will gradually be supplanted by the 
rational form as fast as scientific knowledge attains that stage which reveals 
exactly how a medicine acts in disease. 
Rational Therapeutics is that in which the method of action of a 
remedy can be accounted for. It is based upon the use of medicines ac- 
cording to their known physiologic, chemical or biologic action upon 
definitely known pathological conditions or perverted functions. While 
Empirical and Rational Therapeutics are diametrically opposite, both are, 
in the present state of our knowledge, necessary in the treatment of the 
sick until a more perfect knowledge of the action of medicines upon the 
body, in both health and disease, shall have been established. Many of 
our best drugs are employed empirically, no other guide than the record 
of experience of repeated successes being available. On the other hand, 
the use of drugs through Rational Therapeutics will prevail as instruments 
of precision when a scientifically known and predetermined positive effect 
can be verified by actual clinical application. 
Specific Medication (Specific Therapy) is that in which known specific 
remedies, repeatedly proved to be such, are employed to correct condi- 
tions evidenced by known specific indications for such remedies. Though 
the result of a process of gradual evolution in early Eclectic medicine, the 
theory was formulated, established, and put into practice in 1869 by Dr. 
John Milton Scudder of Cincinnati, Ohio. It is based upon the theory 
that there is a fixed relationship between drug-force and disease-expression. 
(For further consideration, see article on Specific Medication, p. 54.) 
Other Forms of Therapeutics.-Therapeutics is also spoken of as 
Natural Therapeutics, the operation of Nature's healing power; and 
12 INTRODUCTION. 
Applied Therapeutics, the practical and customary application of known 
means and drugs in the treatment of disease. The following specialized 
terms are also recognized: 
Drug Therapy is the application of drugs or medicines in the 
treatment of disease. 
Electrotherapy is the application of electricity in the treatment 
of disease. 
Hydrotherapy is the application of water in the treatment of 
disease. 
Psychotherapy (Mental Therapeutics or Mind Cure) is the use 
of the power of the mind over that of the sick individual. 
Radiotherapy is the application of the various light-rays in the 
treatment of the sick. More recently it has been largely restricted 
to the use of Radium in disease. 
Sero-Therapy (Serum-Therapy) and Vaccino-Therapy (Vaccine- 
Therapy) refer to the use of serums and bacterial vaccines in the 
prevention and treatment of disease. 
Organotherapy (Cellular Therapy) is the use of animal organs 
or their extracts in the treatment of disease. 
Dynamic Therapeutics is "treatment based on the careful selection 
of each separate drug for distributive purpose'' (Dorland). 
Mediate Therapeutics. The administration of a medicine to a 
nursing mother in order to affect the child. 
Suggestive Therapeutics. The use of hypnotic suggestion in the 
treatment of disease. 
Pharmacognosy treats of the identification and chemical composition 
of crude drugs. It takes the place of much that once constituted pure 
materia medica, but includes not only macroscopic but microscopic identi- 
fication. 
Pharmacy is the art of preparing, compounding, and dispensing 
drugs and medicines for therapeutic uses. 
Posology is the study of dosage and its relation to different ages, 
sizes, weights, sex, idiosyncrasy, tolerance, time of administration, and 
conditions of disease in individuals. 
II. THE PARTS, CONSTITUENTS AND DERIVATIVES 
OF PLANT DRUGS. 
[This section is arranged so that it may serve as a Brief Laboratory Manual of Organic Materia Medica.] 
(a) PARTS OF PLANTS EMPLOYED AS MEDICINES OR 
IN THEIR PREPARATION. 
The parts of plants (plant organs and accessory parts or derivatives) 
used in medicine are: Roots, rhizomes, tubers, bulbs, and corms; woods 
and twigs and barks; herbs, leaves, whole flowers, styles and stigmas; 
fruits and seeds; hairs, pith, spores, glands, excrescences, exudates, in- 
spissated juices, and fecula. 
13 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ROOTS (Radices}. 
The Root (radix) is the descending or underground (usually) portion 
of the plant axis or stem, and has neither leaves nor modifications of leaves. 
It varies in size, shape and color in different plants, and is usually irregularly 
divided or branched. The function of the root is to hold the plant in a 
fixed position and to absorb plant food (moisture and salts) for elaboration 
in the leaf. So-called tuberous roots (see Tubers and to some extent 
some other roots) also serve as storehouses of reserve food material (starch, 
etc.). Roots are destitute of, or nearly free from chlorophyll. 
Macroscopic Examination.- 
Note: (1) size and shape; 
(2) color, both external and internal; 
(3) nature of fracture (abrupt or brittle, fibrous or elastic, etc.); 
(4) odor; 
(5) taste (insipid, sweet, bitter, acrid, etc.). 
Examples for Study. Apocynum, belladonna, ipecac, echinacea, phytolacca, gelsemium, 
asclepias, bryonia, althaea, lappa, baptisia. 
The student should make a detailed examination of the root or roots assigned him 
and record his findings upon a blank provided for the purpose. A drawing of the drug 
should also be made by the student. 
RHIZOMES (Rhizomata). 
The Rhizome (rhizoma), or rootstock, is a modified stem creeping partly 
or wholly underground, commonly thickened by containing reserve food 
material, and has rootlets or radicles attached chiefly on the under side. 
Rhizomes are marked by well-defined cup-shaped scars indicating the 
site of the stem of the previous year's growth, and by sheathing leaf- 
bases. The older extremity of the rhizome is frequently decayed. Rhizomes 
grow mostly in a horizontal or oblique position; sometimes perpendicular, 
in which case they may be wholly surrounded by rootlets. 
Macroscopic Examination. 
Note; (1) size and shape; 
(2) color, within and without; 
(3) nature of fracture (short or fibrous, etc.); 
(4) position and character of stem-scars; 
(5) whether rootlets are large or small, sparse or abundant, wiry or brittle; 
and whether they are grouped near nodes or more widely distributed; 
(6) odor; 
(7) taste. 
Examples for Study.-Podophyllum, sanguinaria, geranium, hydrastis, valerian, 
cimicifuga, cypripedium, convallaria, collinsonia, iris, serpentaria, triticum. 
TUBERS (Tubera). 
The Tuber (tuber) is a subterranean stem or thickened portion of a 
rootstock, marked with buds or eyes. (There are all gradations between 
a tuber and a rootstock.) It has no leaves nor scales. Sometimes the 
term tuberous root is used for tuber and is so accepted in pharmacognosy. 
The tuber is a storehouse of plant food, many being particularly rich in starch. 
Macroscopic Examination.- 
Note: (1) size, shape (napiform, conical, pyriform, globular) and surface; 
(2) color, within and without; 
(3) appearance upon fracture; 
(4) odor; 
(5) taste. 
Make a cross section. 
Examples for Study.-Aconite (do not taste aconite), jalap, corydalis. 
14 INTRODUCTION. 
BULBS {Bulbi). 
The Bulb consists of a short stem embraced by fleshy scales, which are 
modified leaves, or leaf-bases. Bulbs are called scaly, when the scales are 
thick but comparatively narrow (e. g., the lily), or tunicated or coated when 
the scales envelop one another, forming crescentic layers (e. g., the onion). 
The thick scales are food storehouses. (Compare Corm.) 
Macroscopic Examination.- 
Note: (1) size, shape and surface; 
(2) odor; 
(3) taste. 
Study a cross section. 
Examples for Study.-Scilla, Allium Cepa. 
CORMS (Cormi). 
The Corm, or solid bulb, is a thickened underground stem often broader 
than high, and partakes of the character of both bulb and tuber. The 
reserve food material is contained in this modified stem. (Compare Bulb 
and Tuber). Rootlets are attached to the corm. 
Macroscopic Examination.-Same as for Tuber, which see. 
Examples for Study.-Arisaema, cyclamen, colchicum, trillium. 
WOODS AND TWIGS (Ligno, et Stipites). 
The Woods in medicine occur chiefly as chips, billets, fragments, or in 
coarse powder. 
Twigs are overground stems and branches of herbaceous perennials, or 
suffruticose plants deprived of leaves, flowers, or fruits. They are com- 
posed of a column of woody substance surrounding a pith, and have a green 
or greenish bark-e. g., Bittersweet. 
Macroscopic Examination.- 
Note: (1) size and shape (flat, curved, quilled, etc.); 
(2) consistence (dense, woody, pithy); 
(3) color; 
(4) odor; 
(5) taste (bitter, sweet, acrid, etc.); 
(6) does it yield color or stain the saliva? 
Examples for Study.-Wood-Quassia, guaiac, hematoxylon, red saunders. Twigs- 
Dulcamara. 
BARKS (Cortices) 
The term Bark is applied to that portion of the stem or root external 
to the cambium layer, which separates it from the wood of the plant. 
Barks consist of an inner or white layer or fibrous bark called liber and 
composed of bast cells; the middle or green bark, which is a cellular layer, 
containing the sap and chlorophyll (green coloring matter); and the 
outer bark or cortical layer (cortex), often called the brown bark, though it 
may present all shades from white to almost black and is modified (suber- 
ized) so as to prevent maceration of the bark by water. When very thick 
the outer layer constitutes cork (as in the cork oak). The official barks 
15 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
may differ from these distinctions in consisting of one or more of the botan- 
ical layers. 
Macroscopic Examination.- 
Note: (1) whether whole bark or only a layer or two; 
(2) size and shape (thick, thin, flat, quilled, etc.); 
(3) surface, external and internal (rough, smooth, striated, etc.); 
(4) fracture (appearance and color of fractured surface); 
(5) color; 
(6) odor; 
(7) taste. 
If in powder, note the characteristics. 
Examples for Study.-Cascara sagrada, cinchona, cornus, myrica, granatum, ulmus, 
sassafras, cinnamon (varieties), black haw, wild cherry, white oak, rubus, cotton-root 
bark. 
HERBS (Herba). 
Herbs, in materia medica, consist chiefly of the smaller stems with 
their leaves, flowers, and fruits. Some algae, such as Irish moss, and some 
lichens, such as Iceland moss and lungwort (Sticta pulmonaria), are in- 
cluded among the herbs. 
Macroscopic Examination.- 
Note: (1) general appearance; 
(2) shape of stems and manner of division; 
(3) kind of leaves (see leaves); 
(4) form of flower or fruit (see Flowers and Fruits); 
(5) color; 
(6) odor; 
(7) taste. 
Examples for Study.-Peppermint, spearmint, lobelia, pulsatilla, chelidonium, eu- 
patorium, absinthium, drosera, e.uphrasia, St. John's wort, marrubium, hedeoma, Scutel- 
laria, tansy, cannabis, scoparius, maidenhair, thuja, gold-thread, epilobium, yarrow, 
bladder-wrack, Iceland moss, Irish moss, sticta. 
LEAVES AND LEAFLETS (Folia et Foliola). 
The Leaf is the expanded stem appendage whose office is to nourish 
the plant by absorption of gases and solar energy to be used in the growth 
and motion of the plant. Leaves are simple and compound. They are 
either net-veined (reticulated) or parallel veined. They are petiolate 
when narrowly prolonged at their point of attachment, or sessile when 
devoid of such prolongation. Leaves are also entire, or notched, lobed, 
or divided, etc. 
Macroscopic Examination.- 
Note: (1) whether simple or compound; 
(2) petiolate or sessile; 
(3) size; 
(4) shape (linear, lanceolate, oblong, oval, ovate (egg-shaped), orbicular 
(round or nearly so), oblanceolate, spatulate, obovate (reversed egg- 
shape), cuneate (wedge-shaped). 
(5) margin entire, notched, toothed, lobed (divided less than half-way be- 
tween margin and center of blade), cleft (when half-way or more), parted 
(when still deeper), or divided (when division reaches to the midrib), 
serrate (saw-toothed), dentate (toothed), crenate (scalloped), repand 
(wavy), sinuate (sinuous), incised (cut or jagged). 
Shape at base: cordate (heart-shaped), reniform (kidney-shape), 
sagittate (arrow-shape), hastate (halberd-shape), or peltate (shield- 
shape). 
Shape at apex: acuminate (pointed), acute, obtuse, truncate (cut off 
squarely), retuse (slightly notched), obcordate (reversed heart-shaped). 
16 INTRODUCTION. 
cuspidate (tipped with a sharp rigid point), mucronate (tipped with a 
short small point), aristate (long bristle form or extended mucronate). 
(6) surface (smooth, rough, hairy, etc.). 
(7) texture (thin, fragile, thick, leathery (coriaceous); 
(8) color (both surfaces; translucent dots when held up to light-oil glands); 
(9) odor; 
(10)taste; 
(11) venation. 
Owing to the fact that compound leaves become disjointed in handling, the individual 
leaflets may be studied as simple leaves. 
Examples for Study.-Digitalis, pilocarpus, eucalyptus, sage, coca, senna, hamamelis, 
buchu. 
FLOWERS (Flores) 
The Flower, often the most conspicuously showy part of a plant, con- 
sists of four parts: the calyx (or cup), composed of sepals and usually of a 
green color and surrounding the corolla, composed of the petals; within 
the corolla are the stamens or male organs of reproduction, and the pistils 
or female organs. The corolla is usually white or colored, rarely green. 
The terminal appendages of the stamens are called anthers; those of the 
pistil the stigma. The shaft of the pistil is known as the style. At the base 
of the pistil is the ovary, containing the ovule or ovtdes. The seed is the 
ripened ovule. 
Dried flowers are usually broken and show only parts of the whole. 
They may be studied best by means of soaking them in water, and using 
a magnifying glass. 
Macroscopic Examination.- 
Note: (1) parts present; 
(2) color; 
(3) odor; 
(4) taste; 
(5) whether in bud, or partly or fully opened. 
Examples for Study.-Arnica, saffron (stigma only), cloves (unexpanded flower buds), 
calendula, matricaria. 
The Fruit (Fructus) is the matured ovary of a flower; sometimes 
with floral fragments which persist and take part in its development. 
The purpose of the fruit is embodied in the seed and "that portion external 
to the seed is important in the life-history of the plant only as it ministers 
to the maturing, transporting, or planting of the germ." Some fruits 
consist of a soft fleshy part, while a great number constitute the dry fruits, 
bearing a great variety of names, and having no soft or fleshy parts. Most 
of the medicinal fruits are of the dry varieties. 
Macroscopic Examination.- 
Note: (1) kind of fruit (soft or dry), berry, drupe (stone-fruit), achene (small, 
dry, one-seeded), grain, nut, follicle, capsule, legume (like peas), sy- 
conium (fig-like). 
(2) shape; 
(3) ripe or unripe; 
(4) texture (outer and inner parts); 
(5) color; 
(6)taste; 
(7)seed. 
Examples for Study.-Cubeb, hops, phytolacca berries, prune, capsicum, colocynth, 
illicium, cardamom, coriander, fennel, fig, orange (peel). 
FRUITS (Fructi). 
17 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
SEEDS (Semina). 
The Seed (Semen) is the final product of the flower-the result of fertil- 
ization and development of the ovule. Like the latter, from which it origi- 
nates, it is invested by two (usually) coats or integuments-the outer, often 
hard and crustaceous and then called the testa or shell, and the inner, usually 
thin and delicate, the tegmen. The internal portion of the seed is the 
kernel. Seeds are variously marked and often fitted with outgrowths for 
easy dispersion by winds, water, and other agencies. 
An arillus, aril or arilode, is a loose transparent bag enclosing some 
seeds, such as those of the water-lily. The arilode of the nutmeg con- 
stitutes the mace of commerce. 
Macroscopic Examination.- 
Note: (1) shape and size; 
(2) color; 
(3) taste; 
(4) character and markings of the integuments (smooth, hairy, tufted, 
awned, grooved, raphe (ridge), hilum (stalk-scar). 
Examples for Study.-Strophanthus, physostigma, staphisagria, linseed, colchicum, 
cacao, nux vomica, ricinus. 
Cellular Drugs. (Hairs, Pith, Spores, Glands, and Excrescences). 
The parts comprised under this heading form a small part of plant medi- 
cines. They need be but mentioned here, with examples of each. They 
are derived from plant sources but are not properly plant organs. 
Macroscopic Examination. Examples for Study.- Hairs: Mucuna (cowage), cotton; 
Pith: Sassafras Pith; Spores: Lycopodium; Glands: Lupulin (from the strobiles of the 
Hop); Excrescences: Nutgall (the chief source of tannic acid). 
CELLULAR DRUGS. 
(b) DERIVATIVES OF PLANT DRUGS. 
INSPISSATED JUICES AND EXTRACTS (Sued Inspissati 
et Extracta). 
Inspissated Juices and Extracts are indefinite exudates, usually of a 
black or brown color, yielding solutions of a brownish hue, and are wholly 
or partly soluble in water or alcohol. They often contain fragments of 
plant tissue. Two of them are insoluble in alcohol and water. These are 
Gutta-percha, which becomes plastic in hot water, and Caoutchouc or 
India rubber. 
Macroscopic Examination.- 
Note: (1) color; 
(2) consistence; 
(3) odor; 
(4) taste; 
(5) solubility. 
Examples for Study.-Opium, aloes, extract of glycyrrhiza, guarana. 
RESINS (Resina). 
Resins (Resinse) are non-volatile excretions or secretions of very 
indefinite composition, being chiefly oxidation products of essential oils 
of plant drugs. Loosely speaking they may be regarded as the alcohol- 
soluble constituent or constituents of vegetable drugs. Resins are fusible 
and combustible, yielding a sooty flame; are insoluble in water but dis- 
solve in one or more of the following menstrua: alcohol, chloroform, ether, 
18 INTRODUCTION. 
fixed oils, essential oils, and some alkalies. When exuding from living plants 
they are usually in solution in essential oils. Resins are frequently mix- 
tures of various resins and all are free from nitrogenous compounds. The 
precipitate falling upon adding alcoholic tinctures to water is usually 
resinous. Some resins contain benzoic and cinnamic acids. The latter 
are often referred to as solid balsams. 
Macroscopic Examination.- 
Note: (1) appearance; 
(2) consistence; 
(3) odor; 
(4) color; 
(5)taste; 
(6) behavior with solvents. 
Examples for Study.-Elaterium, guaiac, benzoin, resin (colophony). 
GUMS {Gummatdj. 
Gums are exudates having an insipid taste, insoluble in alcohol and 
ether. When treated with water they either dissolve to form a mucilage- 
like liquid, or soften to form a jelly-like adhesive mass or paste. 
Macroscopic Examination.- 
Note: (1) appearance; 
(2) consistence; 
(3) behavior with water. 
Examples for Study.-Acacia, tragacanth. 
GUM-RESINS (Gummi-Resin ce) 
Gum-resins are milky exudates from plants and are composed of 
a gum or gums partly or wholly soluble in water, and a resin or resins 
soluble in alcohol. Gum-resins, when triturated with water, yield emul- 
sions, the gum constituent dissolving more or less while the resin is mechan- 
ically suspended in the solution. 
Macroscopic Examination.- 
Note: (1) appearance; 
(2) consistence; 
(3) odor; 
(4) color; 
(5) taste; 
(6) comparative solubility in alcohol and water; 
(7) emulsify a portion. 
Examples for Study.-Asafetida, myrrh, scammony. 
OILS AND FATS. 
Oils (Olea) are fluid substances, and Fats solid or semisolid bodies, 
having a more or less greasy or unctuous feel. The oils are (1) Fixed or Non- 
Volatile Oils (Olea Pinguia); (2) Volatile or Essential Oils (Olea Volatilia}. 
Fats and Fixed Oils are organic substances of a semisolid or solid 
consistence, greasy to the touch, and soluble readily in chloroform, ether, 
and volatile oils, or other fats. They are insoluble in water or glycerin. 
They are composed chiefly of the radical glyceryl (Cs H5) in chemical 
union with fatty acids (stearin, palmitin, and olein). Heated in the 
presence of alkalies they form soaps, and one of the by-products is glycerin 
19 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
(C, H5 (O H)j), a triatomic alcohol. Fats and fixed oils are obtained 
chiefly by the process of expression. They leave a greasy stain upon paper. 
Macroscopic Examination.-As for Inspissated Juices, which see. 
Examples for Study.-Oils.-Castor oil, cottonseed oil, cod-liver oil, croton oil (do 
not taste or touch), lard oil, olive oil, expressed almond oil; cocoa butter. 
Fats.-Lard, suet, wool-fat, spermaceti. 
Volatile or Essential Oils.-These are aromatic inflammable liquids, 
resembling the fixed oils only in solubility. Some are fragrant, others dis- 
agreeably odorous. They dissolve in alcohol and ether in varying propor- 
tions, very slightly in water, are usually colorless or yellowish, and resinify, 
by oxidation, upon exposure to the air. They are separable usually into 
a crystallizable portion, or stearopten (also called camphors-see Camphors), 
and a fluid portion, or elaopten. Though nearly all are compound organic 
bodies, one-oil of birch-is nearly pure methyl salicylate, and oil of 
wintergreen is very similar. They do not leave a greasy stain upon paper. 
With but one or two exceptions, they are obtained by distillation. 
Macroscopic Examination.-As for Inspissated Juices, which see. 
Examples for Study.- Volatile Oils.-Oils of orange, anise, cade, cajuput, caraway, 
clove, worm-seed, coriander, cubeb, eucalyptus, fennel, juniper, lavender, lemon, pepper- 
mint, spearmint, nutmeg, tar, pine-needles, allspice, rosemary, santal, sassafras, thyme, 
mustard (do not taste, and smell very cautiously), and turpentine. 
Stearoptens (secondary alcohols).-Menthol, eucalyptol, camphor. 
Camphors(Stearoptenes or Stearoptens), both physically and chemically, 
are closely allied to the Volatile Oils, which see. They constitute one of the 
elements of many of these oils, and may be separated from them by subjecting 
the oils to a cooling process (e. g., Menthol from peppermint oil). Camphors, 
at ordinary temperatures, are (mostly) solid bodies, but may be easily 
melted or sublimed. They dissolve in alcohol and are insoluble in water. 
Many of them possess the characteristic of liquefying when triturated 
with molecular parts of hydrated chloral. 
Macroscopic Examination.- 
Note: (1) appearance; 
(2) smell; 
(3) taste; 
(4) solubility; 
(5) behavior when triturated with chlorate hydrate. A similar behavior takes 
place when about equal parts of camphor, menthol, and thymol (a phenol), 
all of which are solids, are triturated together. 
Examples for Study.-Camphor, menthol. 
CAMPHORS (Camphor a). 
OLEORESINS (Oleoresina) 
Oleoresins are the natural solutions of resins in essentials oils, and 
the latter are capable of separation by distillation. 
Macroscopic Examination.-As for Inspissated Juices, which see. 
Examples for Study.-Oleoresins of capsicum, ginger, cubeb, black pepper (be careful 
not to taste all the preceding without dilution), and male-fern. 
BALSAMS (Balsama). 
Balsams are resins or oleoresins containing cinnamic or benzoic acids, 
or both. They may be liquid or solid. 
Macroscopic Examination.-As for Inspissated Juices, which see. 
Examples for Study.-Balsam of Peru, balsam of tolu, storax. 
20 INTRODUCTION. 
WAXES (Cera). 
Waxes are compounds of fatty acids with certain alcohols and differ 
from fats chiefly in containing no glyceryl. They are of varying degrees 
of solidity, melt when heated, and at a low temperature are brittle. The 
most familiar example is beeswax. 
Macroscopic Examination.-As for Inspissated Juices, which see. 
Examples for Study.-Yellow wax, white wax. 
SUGARS (Sacchara). 
Sugars have a sweet taste, are soluble in water and in diluted alcohol, 
but insoluble in eth'er. Sugars are solid and liquid. The following, modified 
from Maisch, is a convenient classification: 
I. Solid Sugars: 
Crystalline; non-fermentable; does not reduce cupric oxide. 
-Saccharum (cane sugar). 
Fermentable; reduces cupric oxide to cuprous oxide.-Saccharum 
uveum (grape sugar). 
Fermentable; contains mucilage and mannit.-Manna. 
Gritty; white; not forming syrup.-Saccharum lactis (sugar 
of milk). 
II. Liquid Sugars: 
Brown; somewhat empyreumatic.-Syrupus fuscus (molasses). 
Brown; aromatic; gradually becomes granular.-Mel (honey). 
Macroscopic Examination.- 
Note: (1) solid or liquid; 
(2)taste; 
(3) odor; 
(4) solubility; 
(5) behavior with Fehling's solution of copper and soda. 
Examples for Study.-Sugar, sugar of milk, glucose, manna, honey, molasses. 
FECULA. 
Fecula (diminutive of fax, sediment) has reference to the starchy part 
of a seed or other part of a plant. More loosely it is applied to a sediment 
subsiding from an infusion or mixture. 
1. Starch is one of the most important derivatives of plant cells, 
and is prepared from "amylaceous seeds, tubers, rhizomes, and palm- 
stems" (Maisch). It occurs as granules usually having a laminated ar- 
rangement around a center (hilum or nucleus). The character of the 
lamination and the average size and shape of the granule are important 
aids in the differentiation and identification of plant-drugs and the de- 
tection of adulterations. Starch is insoluble in ordinary solvents, but 
swells (finally dissolves-according to Hatcher and Soliman) in boiling 
water to form a peculiar jelly-like or mucilaginous paste (starch paste), 
which acquires a deep blue color when treated with iodine. 
2. A mixture of substances deposited from plant juices by sedi- 
mentation. 
21 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Macroscopic Examination.- 
(1) appearance; 
(2) taste; 
(3) behavior with cold and boiling water; 
(4) behavior of starch paste with tincture of iodine. 
Examples for Study.-1. Corn starch (official), potato starch, wheat starch, rice 
starch, barley starch, sago, tapioca, oatmeal. Most of these, except the first two, are 
largely admixtures with gluten and other substances. A miscroscopic examination would 
be interesting and more productive than a macroscopic study of them. 
2. Elaterium (properly a resin, see Resins, but deposited in the fecula of the juice of the 
squirting cucumber). 
COLORING MATTER. 
Coloring Matter.-Plant drugs, and some of insect origin (cochineal) 
possess coloring properties due to pigments contained in them, the nature 
of which is as yet undetermined. 
Macroscopic Examination.-As for Inspissated Juices, which see. 
Examples for Study.-Chlorophyll (green) in all green plant drugs; carminic acid 
(brilliant red) in cochineal; curcumin (yellow) in turmeric; haematoxylin (deep red) in 
logwood; carthamin (orange red) in saffron. 
TANNINS 
Tannins are amorphous, non-nitrogenous bodies, having an astringent 
taste, and striking a blue-black or green-black color with ferric salts. 
Tannins are widely distributed, especially in barks and leaves. Most of 
them form precipitates with albumen, alkaloids and many metallic salts, 
particularly with iron salts. For this reason they are of especial interest to 
prescribers who would avoid the preparation of unsightly mixtures, or of 
dangerous precipitates. Powerful alkaloids, thus precipitated, would be 
apt to be taken in the last doses of a bottle of medicine in which there had 
been a failure "to shake the bottle". Tannins are soluble in water, glycerin, 
and alcohol; sparingly in ether. Tannins have been divided by some into 
(1) "physiologic tannins" because they are produced in normal tissues; 
these stain greenish-black with ferric salts; and (2) into "pathologic 
tannins" produced by disease processes and usually precipitated bluish- 
black with iron salts. An example of the latter is the official tannic acid, 
often known merely as tannin and derived from nutgall. There are many 
peculiar tannins differing slightly, such as occur in cinchona, granatum, 
hamamelis, uva ursi, and other plant-drugs. 
Macroscopic Examination.-Preparations of drugs above mentioned containing 
peculiar tannins may be examined by testing with iron-salts and observing the precipitate. 
Examples for Study.-Tannic acid, preparations of cinchona, uva ursi, krameria, 
hamamelis, chestnut, pomegranate. 
(c) PROXIMATE AND OTHER PRINCIPLES OF PLANT 
DRUGS. 
ALKALOIDS. 
Alkaloids are organic bodies derived chiefly from plants in which they 
are believed to exist in combination with organic acids. They are basic 
substances, containing carbon, hydrogen, and nitrogen (hence called nitro- 
genous principles); a few liquid alkaloids also contain oxygen. Alkaloids 
unite with acids to form salts, after the manner of ammonia. These salts 
22 INTRODUCTION. 
are usually well-defined and colorless (berberine is yellow), odorless, crystal- 
line, and soluble. If the salts be formed with the halogen acids, the prefix 
hydro is generally used in naming them. Most alkaloids are bitter, slightly 
alkaline, soluble in ether and chloroform, often less readily in alcohol; 
in water they are comparatively insoluble. On the contrary, the solubility 
of their salts is usually the reverse-water freely dissolving them, while they 
are practically insoluble in ether and chloroform. Of the alkaloidal salts the 
chlorides are generally the most easily soluble; and the ready solubility 
of the salts of alkaloids have caused them to be preferred to the alkaloids 
themselves for therapeutic uses. All the important alkaloids produce 
profound physiologic and pharmacologic effects; many of them are the 
most poisonous of known substances; the latter are functional or physi- 
ologic poisons and leave (usually) no post mortem physical lesions. As 
a rule, alkaloids are the purest bodies derived from plant structures without 
disintegration (proximate principles). Their chemical composition is not 
fully understood. While alkaloids and their salts have distinctive ther- 
apeutic properties of their own, they do not fully nor exactly represent the 
action of the whole drugs from which they are derived. 
The names of alkaloids should end in ine (English), or inum (Latin). 
Historic Note.-The first vegetable alkaloid (morphine) was discovered by Sertiirner, a Hanoverian 
chemist and apothecary, between 1805 and 1816, and announced in the latter year, though Derosne and Seguin, 
two French chemists, had separated it, as well as narcotine, as early as 1803 and 1805, without recognizing 
their difference, or establishing their alkaloidal nature. 
As a matter of historic interest we have compiled the following table, which includes the most important 
alkaloids, and their discoverers, date of discovery, and doses. The maximum doses of the potent alkaloids 
named should not be exceeded, nor seldom should even the full amount be used, especially as an initial dose. 
ALKALOID 
DISCOVERED BY 
DOSE 
Morphine 
Narcotine 
Emetine 
Veratrine 
Strychnine 
Hyoscyamine 
. .Sertiirner, 1805-1816 
. .Derosne, 1803 (see above); Robiquet, 1817 
. .Pelletier and Magendie (impure), 1817 
. .Meissner, 1818 
. .Pelletier and Caventou, 1818 
. . Runge (as Koromeygn), 1819; Peschi^r, 1821 
■ 'A to Xgr. (salts). 
. 1 to 3 gr. 
. 1-100 to 1-60 gr. 
(emetic 1-6 gr.) 
. 1-100 to 1-60 gr. 
. 1-80 to 1-25 gr. (salts). 
. 1-200 to 1-100 gr. (salts). 
Piperine 
Delphinine 
Brucine 
Quinine 
Cinchonine 
. .Oersted, 1819 
. .Brandes, Lassaigne and Fenuelle, 1819 
. . Pelletier and Caventou, 1819 
. . Pelletier and Caventou, 1820 
. .Gomez (named), 1812; established by Pelletier and 
. 1 to 10 gr. 
. M to % gr. 
. 1-60 to 1-6 gr. 
. 1 to 20 gr. (salts). 
Solanine , 
Caffeine 
Colchicine 
Caventou, 1820 
.. Desforses, 1820 
.. Runge, 1820 
. .Pelletier and Caventou, 1820; later established by 
. 1 to 20 gr. (salts) 
% to 3 gr. (salts), 1 to 5 gr. 
Chelidonine 
Geiger and Hesse 
. .Godefroy, 1825; Dana (Sanguinarine), 1829; pure by 
1-150 to 1-50 gr. (salts). 
Corydaline 
Berberine 
Curarine 
Nicotine 
Atropine 
Coniine 
Probst, 1838 
. .Wachenroder, 1826 
. . Hiittenschmid(?), 1824; Pelletier and Caventou, 1826. 5 to 10 gr. (salts). 
. . Roulin and Boussingault, 1828 1-400 to 1-100 gr. 
. . Posselt and Riemann, 1829 1 -6 to 1 gr. 
. .Mein, 1830 1-200 to 1-100 gr. (salts). 
Giesecke, 1827; pure and established by Geiger, 1831.1-60 to 1-30 gr. 
Codeine Robiquet, 1832 
Aconitine Geiger and Hesse, 1833 
Lobeline William Proctor, Jr., 1838 
Cinchonidine F. L. Winkler, 1847 ' 
Hydrastine Alfred B. Durand, 1850 
Trimethylamine (both of ani- 
mal and vegetable origin). .Wertheim, 1830 
% to 2 gr. (salts). 
1-600 to 1-300. 
% to 1 gr. (salts). 
1 to 20 gr. (salts). 
% to % gr. (salts). 
X to 3 gr. 
Sparteine 
Gelsemine 
Cocaine 
. .Stenhouse, 1851 
. .Henry Kollock, 1855 
. Gaedecke (as erythroxyline), 1855; named Cocaine 
X to X gr. 
1-150 to 1-50 gr. 
Physostigmine 
Pilocarpine 
Calabarine. 
Pelletierine (a mixture 
by Niemann, 1860 
. .Jobst and Hesse, 1864 
. . E. Hardy (France) and A. W. Gerrard (England) 
almost simultaneously, 1875 
. .Harnack and Urtkowski, 1876 
of 
X to 1 gr. (salts). 
1-150 to 1-50 gr. (salts). 
X to X gr. (salts). 
1-100 to 1-20 gr. 
several alkaloids) 
Gelseminine 
. .Tanret, 1878, 1880 
.. F. A. Thompson, 1887 
3 to 6 gr. (salts 4 to 8 gr). 
1-150 to 1-50 gr. (salts). 
23 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Poisoning by Alkaloids.-As many of the alkaloids are extremely poison- 
ous, it is well to remember that the initial treatment consists in chemical 
destruction or occlusion of the alkaloid; and subsequent evacuation of it. 
While each alkaloid, when taken by mouth, will require its own special 
chemical antidote, if any be known, and if by mouth or hypodermic, its 
own physiological antagonist, the following general methods and drugs 
may be used: 
Tannin (tannic acid or common store tea may be used) precipi- 
tates most alkaloids. As the precipitate redissolves in the acid gastric 
juice it should be given with alkaline substances, as sodium carbonate 
or bicarbonate: and then removed by emesis or by means of the 
stomach pump. 
Iodine in the form of Tincture of Iodine diluted, or Lugol's 
Solution (Iodine with Potassium Iodide) may be given as a general 
antidote, but as the precipitate redissolves in the alkaline juices of the 
intestines it should be hurried through the bowels by means of a 
purgative, if too late to remove it by emesis or the stomach pump. 
Diluted alkalies may be used to precipitate alkaloids. 
Animal charcoal occludes alkaloids, as does Hydrated Silicate of 
Aluminum (Lloyd's Reagent). These may be used if quickly re- 
moved from the stomach before re-solution takes place. 
Potassium Permanganate (15 to 50 grains in a pint of water) 
has been advised. It forms a precipitate with alkaloids, but can only 
do so when its own integrity is secured. As it is at once destroyed 
by organic matter, it can only be of service when the stomach is com- 
paratively empty. Its precipitate is not redissolved in the intestinal 
canal. (See also Acute Poisoning, Antidotes and Treatment.') 
GLUCOSIDES. 
Glucosides are organic plant principles, usually of a neutral char- 
acter. Their distinguishing property is that of splitting into glucoses, 
or into glucose-yielding sugars and some other bodies, when heated in 
the presence of acids or alkalies, or when in contact with some unorgan- 
ized ferments. Always one product of such disintegration is some form 
of glucose. They all contain carbon, hydrogen, and oxygen. Some of 
them, like ergotinic acid (a glucoside with sapotoxic action) contain ni- 
trogen, very rarely sulphur. They vary greatly in solubility, but nearly 
all are soluble in alcohol and a very few are dissolved by ether. In plants 
glucosides are frequently associated with alkaloids, and in many instances 
they constitute the active ingredient of a drug. 
The names of glucosides end in in (English) and inum (Latin). The 
following are among those of interest in therapeutics: Salicin (in Salix 
and Populus species); arbutin (in uva ursi); cathartin [cathartic acid] 
(in senna); digitalin, digitoxin, digitalein, and digitonin (in digitalis); 
strophanthin (in strophanthus); convolvulin (in jalap); glycyrrhizin (in 
liquorice-root); colocynthin (in colocynth); jalapin (in scammony); amyg- 
dalin (in bitter almond); convallamarin (in lily of the valley); adonidin 
(in adonis), etc. 
24 INTRODUCTION. 
SAPONINS. 
Saponins are plant constituents belonging to the glucosidal group 
(breaking up in the presence of acids or ferments into glucose [grape sugar], 
and inactive and unknown bodies). They possess the characteristic 
quality of foaming when shaken with water. Many of them are innocuous; 
others extremely poisonous. To the latter are given the name Sapotoxins; 
while the term Saponin is reserved for the inactive and less active of these 
bodies. The chief saponins and sapotoxins are saponin and saporubrin 
[methyl-sapotoxin] (in soapwort or Saponaria officinalis); senegin (in senega 
or Poly gala Senega); quillaja-sapotoxin (in soap bark, Quillaja Saponaria); 
cyclamin (in sowbread, Cyclamen Europeum); chamcelirium-sapotoxin (in 
blazing star, Chamcelirium luteum); and parillin, sarsa-sapotoxin and 
sarsaparill-saponin [smilacin], (in sarsaparilla, Smilax officinalis). 
AMAROIDS. 
Amaroids, Bitter or Neutral Principles, are neutral or but feebly acid 
bodies devoid of basic qualities. Many of them are bitter. They vary 
greatly in composition and properties, and lack characters which would 
place them in the classes with alkaloids, glucosides or other plant con- 
stituents. Unlike glucosides they are not split into glucoses, and unlike 
alkaloids are not percipitated by Millon's Test Reagent nor by Tannic acid. 
Like the glucosides the names of these preparations end in in (English), 
and inum (Latin). The most notable examples are aloin, elaterin, santonin, 
cantharidin, quassin, picrotoxin, chrysarobin, etc. 
FERMENTS. 
Ferments are peculiar bodies existing in or formed in the chemic manip- 
ulations of both plants and animals, and known chiefly by the changes 
they produce in other bodies. They have not been isolated as pure prin- 
ciples, but some of the bodies containing them are in common use: 
(1) Of animal origin: pepsin (in gastric juice); pancreatin (in pan- 
creatic juice); ptyalin (in saliva) 
(2) In plant substances: emulsin (in almond and peach, cherry, etc.); 
diastase (in cereals); myrosin (in mustard-seed); papain [papayotin] 
(in West Indian papaw juice); bromelin (in pineapple juice), etc. 
ORGANIC ACIDS. 
Organic Acids are devoid of N. but contain carboxyl (CO,H) joined 
with a hydrocarbon residue. They form salts with bases, and have the 
general properties of acids. As types may be named: acetic, salicylic, 
tannic, citric, malic, oxalic, oleic, benzoic, and a number of similar acids. 
25 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
III. PHARMACEUTICAL FORMS OR CLASSES 
OF MEDICINES. 
Medicines are divided into three classes, viz.: Solids, Liquids, and 
Gases or Vapors. 
The chief solid (some semisolid) forms are the powder, trituration, 
tablet, poison tablet, pill, granule, mass, effervescent salts, extract, resin, 
oleoresin, confection, wafer, capsule, and lozenge. For external use are the 
poultice, ointment, cerate, plaster, paper, and suppository. 
The principal liquids are the aromatic or medicated water, infusion, 
decoction, vinegar, mixture, elixir, glycerite, mucilage, emulsion, collodion, 
solution, juices, oils, magma, spirit, fluidextract, specific medicine, col- 
loidums, tincture, syrup, honey, enema, eye-wash, and wine. For external 
use, the liniment, lotion, oleate, and bath. Serums and vaccines are special 
biologic products usually of liquid or semi-liquid form, and intended for 
subcutaneous or intramuscular injection or intracutaneous application. 
Gaseous medicines are usually employed as inhalations, or as vapors, 
produced by means of atomization, with a spray-apparatus, nebulizer, 
or other means. 
While the foregoing are in groups, the following are arranged in al- 
phabetic order in order to facilitate consultation: 
Waters.-(/!§««) Medicated Waters (Aqua Medicata) are solutions of volatile sub- 
stances, usually of oils or camphors, in water. Aromatic Waters (A qua A romatica) are solu- 
tions prepared by several methods, as by direct solution in hot or cold water, or by filtering 
water through some inert powder or cotton impregnated with the volatile body. Unless 
otherwise directed they are to be prepared by triturating two parts of the volatile ingredient 
with 15 of talc and abstracting by filtration with 1,000 parts of boiled distilled water. 
They are employed chiefly as vehicles. Example: Aqua Menthae Piperitae. 
Baths (Balnea) are general washes designed to be applied to the whole surface of the 
body. They may be simple or medicated. 
Cachets or Wafers (Cachet®) are molded forms of flour or starch and water for the 
administration of dry powdered drugs. They hold more, and more readily dissolve than 
the capsule and are easily swallowed if previously dipped in, or floated into the mouth, 
on water. 
Capsules (Capsula).-Telescoping gelatin containers for the administration of 
medicines. They dissolve readily in the stomach, thus liberating the medicament. They 
are often to be preferred to pills. Soft capsules are sometimes used for administering 
balsamic and oily fluids. 
Cerates (Cerata) are unctuous bodies intermediate in consistence between the oint- 
ment and plaster. They are sufficiently soft to be easily spread upon muslin with a spatula, 
and when applied to the skin adhere, but do not become soft enough to liquefy at the 
body temperature. The most abundant constituent is wax, hence their name. They are 
(1) simple and (2) medicated. Examples: (1) Ceratum, (2) Ceratum Cantharidis. 
Collodions (Collodia) are fluid solutions of gun-cotton (pyroxylin), in a mixture of 
alcohol and ether, or of acetone. They may be (1) simple or (2) medicated. Collodia are used 
externally. Examples: (1) Collodium; (2) Collodium Cantharidatum. 
Colloidums. See under Specific Medicines. 
Confections (Confectiones), which also include electuaries and conserves, are soft 
pasty solids, composed of vegetable bodies or active drugs, preserved by means of sugar 
or honey, or both. Example: Confectio Rosae. 
Decoctions (Decocta) are freshly prepared aqueous solutions of the soluble princi- 
ples of vegetable drugs, but, unlike infusions, are prepared by boiling the drug in water. 
The same remarks regarding the strength of infusions apply to decoctions; one part of 
drug to twenty parts of water, unless otherwise specified. Decoctions are usually boiled 
for fifteen minutes and then allowed to cool. After cooling and straining, the preparation 
26 INTRODUCTION. 
should be made to measure up to the original quantity of menstruum by the addition of 
cold water passed through the mass in the strainer. Remember that the process is the 
opposite to that for preparing infusions. In the latter, hot or cold water is employed, and 
if hot, the product is allowed to cool; in the decoction, cold or warm water is employed and 
the preparation is boiled. Example: Decoctum Granati Radicis. 
Effervescent Salts {Sales Efervescentes).-Mixtures in the form of a fine or a gran- 
ulated powder of soluble chemical compounds with citric or tartaric acid, or both, and 
sodium bicarbonate. When added to water they form an effervescent draught which 
should be swallowed while it is foaming. Example: Sodii Phosphas Effervescens. 
Elixirs {Elixiria) are sweetened, aromatic and spirituous solutions, designed as 
vehicles for small amounts of active medicines. As a class they are very unsatisfactory, 
though pleasant, preparations. Example: Elixir Glycyrrhizae. 
Emulsions {Emulsa or Emulsiones).-Aqueous fluid preparations holding in sus- 
pension oils or resinous substances by means of mucilaginous or viscid media. As the 
latter, acacia or tragacanth is often employed. Examples: Emulsum Olei Morrhuse, Emul- 
sum Asafcetidse (milk of asafetida). 
Enemas {Enemata) or Clysters {Clysteria) are fluids designed for injection into the 
rectum. They may be (1) simple, or (2) medicated, or (3) saponated. Examples: (1) water, 
(2) Enemata Terebinthin ae, (3) soap suds. 
Extracts {Extrada) are prepared by evaporating the solutions, alcoholic or other- 
wise, of vegetable medicines at a low heat. They are either solid or semisolid in consist- 
ence. They may be (1) simple or (2) compound. Powdered extracts are fine dry powders. 
Examples: (1) Extractum Aconiti, (2) Extractum Colocynthidis Compositum, (3)Powdered 
Extract of Cascara Sagrada. 
Eye Washes {Collyria).-Fluids designed to cleanse or locally medicate the eye. 
Example: Collyrium Acidi Borici. 
Fluidextracts {Fluidextrada or Extracta fluida) are fluid alcoholic preparations of 
vegetable drugs, prepared by percolation, and subsequent concentration of a portion of 
the percolate by evaporation. Alcohol constitutes the bulk of the menstruum, though 
water and glycerin and sometimes acids, in varying proportions, are often used with it. 
Ether is also employed, as in Fluidextract of Lactucarium. Fluidextracts of Triticum 
and Castanea are prepared most largely with boiling water. 
Fluidextracts are so constructed as to represent one grain of the crude drug in each 
minim of fluidextract. As a part of this one grain is made up of the extracted inert mat- 
ter-plant dirt-the preparation can not be said to represent the active constituents of 
the drug, grain for minim. Though designed to be uniform unless they are standardized 
they may vary in actual medicinal strength. Many fluidextracts throw down a precipi- 
tate when mixed with water. They are, as a rule, concentrated tinctures. They may be 
(1) simple or (2) compound. Examples: (1) Fluidextractum Lobeliae; (2) Fluidextractum 
Sarsaparillae Compositum. 
Glycerites {Glycerita or Glycerines or Glyceroles) are mixtures or solutions of medicines 
in glycerin. They are intended for both external (chiefly) and internal exhibition. 
Example: Glyceritum Hydrastis. 
Granules {Granula).-Very small pills. 
Honeys {Mellila') are preparations related to the syrups, but differing in the sub- 
stitution of clarified honey for syrup. Example: Mel Rosse. 
Infusions {Infusa) are solutions of the soluble constituents of vegetable drugs pre- 
pared usually by pouring upon the drug hot water and allowing the product to macerate 
and cool. If the properties of the drug are impaired by hot water, cold water is employed. 
They are often prepared of the strength of one part of the material to sixteen of water; 
unless otherwise specified they should be prepared of one part of drug to twenty of waiter 
for ordinary infusions. The finished product should be made to measure up to the original 
quantity of menstruum, by passing, if necessary, the required amount of cold water through 
the mass in the strainer. The strength of infusions of powerful drugs, like digitalis, should 
always be indicated in the physician's prescription. In the absence of this the official 
infusion should be dispensed. Infusions differ from decoctions in not being prepared by 
boiling. Example: Infusum Digitalis. 
Juices {Sued).-Fresh juices of vegetable drugs preserved by a small amount of 
alcohol. Example: Succus Solani. 
Liniments {Linimenta) are fluid, or semifluid preparations, usually oleaginous, 
though alcohol or even water may be employed as the base, intended for external use, 
and to be applied with friction. Cotton seed oil or olive oil is usually preferred as a base. 
Some liniments are perfect solutions, while others are mere mixtures; certain soft solids, 
27 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
which will liquefy at the temperature of the body, are also denominated liniments. Most 
liniments, except Linimentum Calcis, are designed to be rubbed into the skin. Example: 
Linimentum Chloroformi. 
Lotions {Lotiones or Washes) are solutions of medicinal bodies in water or other 
menstrua, designed chiefly to be applied to localized regions for their topical influence. 
They are (1) simple or (2) compound. Examples: (1) Lotio Alkalini; (2) Lotio Myrrhse 
Composita. 
Lozenges {Troches or Trochisci) are solid, candy-like masses, usually flattened and 
discoid or round or cylindrical in shape, composed of powdered drugs combined with 
sugar and mucilage, and sometimes flavored. They are designed to influence the mouth 
or throat. Example: Trochisci Acidi Tannici. 
Masses {Masses).-Soft solid substances that may be preserved in bulk and usually 
intended for the formation of pills. Often called pill-masses. Example: Massa Hydrargyri _ 
Milk {Magma) an aqueous suspension of very finely divided particles of insoluble 
chemicals produced at the time of preparation. Example: Magma Magnesiae (Milk of 
Magnesia). 
Mixtures {Misturoe) are aqueous fluid preparations, holding in suspension insol- 
uble or partially soluble powders, or other substances. Mixtures are intended for in- 
ternal use. Example: Mistura Cretae. 
Mucilages {Mucilagines) are more or less viscid, thick, and adhesive fluids, pre- 
pared by extracting the mucilaginous constituents of plants with water, or aqueous solu- 
tions of gums, or of starch, as these bodies swell with water. Some are prepared with 
heat, while others are not. Mucilage of slippery elm, and some others, are best prepared 
with ice-cold water. Example: Mucilago Amyli. 
Oils {Olea).-Solids, semisolids, and fluid, greasy, and water insoluble preparations 
obtained by expression or by maceration and distillation: I. Olea Pinguia (Fixed Oils 
and Fats). Non-volatile neutral esters of animal or vegetable origin, and chiefly glycerol 
compounds of oleic, palmitic and stearic acids. Example: Oleum Lini (liquid) and Oleum 
Theobromatis (solid). II. Olea Volatilia (Volatile or Essential Oils): Odorous volatile 
liquids derived from aromatic plants and containing or consisting of neutral principles, 
esters, phenols, aldehydes, ketones, etc. Example: Oleum Menthse Piperitae. 
Oleates {Oleata): Solutions of alkaloids or of other solids in oleic acid, intended for 
external application. Example: Oleatum Hydrargyri. 
Ointments ( Unguenta) are fatty preparations of about the consistence of cold lard, 
which substance benzoinated (or petrolatum) usually constitutes their bulk. Some con- 
tain either one or more of the following: hydrous wool fat, or glycerin, wax, paraffin, 
spermaceti, expressed oil of almond, or prepared suet, according to the use to be made 
of them. When applied to the skin they are softened and rendered fluid by the heat of 
the body. They may be medicated or unmedicated, and are applied generally by inunction, 
hence their name. Example: Unguentum Belladonnae. 
Oleoresins {Oleoresinoe) consist generally of oils (fixed and essential) associated 
with resins, and extracted from the crude drug by means of ether, acetone, or alcohol, 
the solvents being subsequently evaporated. Example: Oleoresina Capsici. 
Papers {Charite).-Paper impregnated with or coated with medicinal substances, 
and designed for external application. Example: Charta Sinapis. 
Pills {Pilulce) are small, ovoid, spherical, or lenticular bodies, composed of a med- 
icine, or medicines, combined with substances termed excipients, such as soap, mucilages, 
confection of rose, etc., which cause them to retain their shape and firmness. Pills are 
usually composed of active substances; are generally sugar or gelatin coated, sometimes 
gilded or silvered, and are intended to be swallowed whole. Those intended for solution 
in the intestines only are coated with keratin. A very large pill is denominated a bolus. Pills 
are (1) simple and (2) compound. Examples: (1) Pilulae Aloes; (2) Pilulae Aloes et Myrrhae. 
Plasters {Emplastra) are tenacious substances usually spread upon some kind of 
pliable skin or fabric, and intended to be applied to the exterior of the body either for 
purposes of counter irritation or as simple adhesives. They require heat to spread them. 
When applied to the body they adhere but do not become soft. They are composed chiefly 
of lead plaster (oleate of lead) or some resinous body, and may be simple or medicated. 
Commercial plasters have largely supplanted those prepared by the ordinary pharmacist. 
Example: Emplastrum Capsici. 
Poison Tablets {Toxitabella). Blue Angular tablets stamped with skull and cross- 
bones and the word "Poison". They are designed to prevent mistakes and lessen the 
liability to poisoning from mercuric chloride. Example: Toxitabellae Hydrargyri Chloridi 
Corrosivi. 
28 INTRODUCTION. 
Poultices (Cataplasmata) are formed of such substances as, when wet, will be more 
or less tenacious, and will accommodate themselves to parts to which they are applied. 
They are employed to soften and relax the tissues, and at the same time exclude the air, 
to stimulate, induce hyperemia, or to apply counterirritants. A poultice should be pre- 
pared from flax seed, elm, bread, bran or meal, as desired, by gradually adding them to hot 
water in a hot vessel, and spreading them in convenient thickness upon a hot fabric with a 
hot knife or spatula. Kaolin poultices-like plasmas-under various trade names, as 
Antiphlogistine, etc., are common and convenient applications. Libradol is a ready-pre- 
pared, magma-like plasma used as a medicated poultice. This and many of the kaolin 
preparations, owing to the glycerin present, act also as topical dehydrating agents. They 
may or may not be medicated. Examples: (1) Calaplasma Lini (Linseed or Flaxseed 
Poultice); (2) Libradol and Antiphlogistine (ready-prepared, magma-like plasmas used 
like poultices). 
Powders (Pulveres) are solid medicines reduced to uncompacted particles of various 
degrees of fineness, by means of mechanical force, or by such means of precipitation as 
elutriation and levigation. The degrees of fineness in powders (in pharmaceutical manipu- 
lations) are officially designated by numbers, representing the greatest diameter of the 
powdered particle as measured by the full lumen of the mesh in the sieve through which 
the powder is passed. Medicinal powders (not those designed for pharmaceutical manipu- 
lations and numbered) are usually dispensed in papers (chartulse), capsules, or cachets. 
Loosely the term "powders" is applied to single doses of a dry powdered drug dispensed 
in "powder papers" (chartulse). 
Powders are (1) simple and (2) compound. Examples: (1) Pulvis Rhei; (2) Pulvis 
Ipecacuanhae et Opii (Dover's Powder). 
Resins (Resina) are the solid, non-volatile or soft-solid resinous constituents of 
vegetable substances, usually prepared by precipitation of an alcoholic solution of the 
drug in simple or acidulated water, or by distilling the oil from oleo-resins. Resins are 
soluble in alcohol but not in water. Example: Resina Podophylli (podophyllin). 
Serums and Vaccines (Sera et Vaccina). Biologic products known as serums, vac- 
cines and viruses, designed chiefly for subcutaneous administration. They must conform 
to standards established by the United States Public Health Service, which has super- 
vision and licensure over the firms preparing them. Examples: (1) Serum Antidiph- 
thericum; (2) Bacterial Vaccines; (3) Virus Vaccinum. 
Solutions (Solutio), or Liquors (Liquores) are such aqueous (mostly) solutions of 
non-volatile materials, as are not included in decoctions, infusions, syrups, and mucilages. 
Liquor Gutta-perchae, or solution of Gutta-percha, is, however, an exception; this solu- 
tion being effected by means of chloroform instead of water. Example: Liquor Potassii 
Arsenitis (Fowler's Solution). 
Specific Medicines.-Specific Medicines are standardized prepara- 
tions, usually liquids, more or less alcoholic, and generally of vegetable 
origin. They are derived from materials specially selected to produce the 
desirable therapeutic qualities, according to Specific Medication (which 
see). Consequently, some of the Specific Medicines derived from energetic 
drugs hold a different balance of toxic alkaloids or other constituents 
than that of the official fluidextracts and tinctures. They are designed 
for kindly therapeutic effect rather than for intense physiological activity. 
Therefore they are not as a class standardized for high proportions of 
toxic material, be it alkaloidal or otherwise, to the unbalance of the less 
pronounced drug constituents in the finished preparation. 
They are prepared upon the premise that: Every drug contains 
closely related, inter-structural constituents; that every part of a plant 
is an inter-cellular complexity; and that no one constituent, whether 
educt or product, represents the drug as a whole. "In many cases a dom- 
inating substance becomes thus less valuable than its less vicious com- 
panions". The conspicuous alkaloid or resin of a drug may on these 
grounds be an enemy to its finer qualities. 
In the vegetable Specific Medicines, the desirable structures of the 
drug are selected, and the undesirable excluded, as a rule, by the 
29 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
discriminating actions of neutral solvents. The study of each drug and 
each part of a drug has been made with a view to balancing such inter- 
structural complexities, a process usually ignored in pharmacy in the 
desire to give a preponderance of proportion of toxic constituents to a 
final product. 
Specific Medicines have been developed under the auspices of Eclectic 
authorities, and are employed in Eclectic therapy because they are re- 
garded as the logical as well as the best representatives of drugs, in balanced 
qualities, for specific purposes. 
The primary exhausting solvent, when possible, is pure alcohol (never 
denatured or poisoned for commercial purposes), either strong, or ap- 
propriately diluted. The finished product is usually more or less alcoholic, 
that liquid being the best known preservative of some of the very delicate 
proximate principles of plant drugs. 
Drugs possess individual qualities, hence the menstrua vary, both 
as to manipulation and final result, a specially-proportioned menstruum 
being generally required for each drug, in accordance with its particular 
condition. Hence, Specific Medicines are not the result of group proc- 
esses, such as are applied to classes known as fluidextracts and tinctures. 
It must be recognized that Specific Medicines are not tinctures and are 
not fluidextracts, for they do not conform either to the authoritative 
definition or to the process required for producing these, or non-official 
preparations. They could not be properly classed as tinctures, on account 
of color, for some of them are colorless, a few are definite chemicals, some 
are acids, and others dry drug products. To the class the term Specific 
Medicines, originally applied, is both fair and comprehensive. 
The drug strength of Specific Medicines, on an average, is about 
eight times that of the old-time commercial tinctures, although, as already 
stated, by reason of their origins and manipulative processes, comparisons 
are impossible. 
The best vehicle for the administration of Specific Medicines is water. 
Some of them, when dropped into water, throw down resinous or oleaginous 
precipitates. These precipitates may carry therapeutic constituents, and 
should not be removed. Only after being stirred to uniform suspension 
should such mixtures be administered to the patient. Recent developments 
in plant pharmacy have given remarkable insight to plant structures, 
resulting in Colloidal Specific Medicines that now mix clear with water. 
Historic Note.-Specific Medicines were devised, and given that name, in 1869, by Dr. John Milton 
Scudder. They were the outgrowth of a necessary movement for better as well as more representative med- 
icines, necessitated by bad commercial conditions both previous to and at the time of their introduction. At 
first Scudder advised office pharmacy, and under the then-existing necessity, placed a series of copyrighted 
labels for the more important remedies in the hands of competent manufacturing pharmacists. These were 
offered free, and absolutely without fee or price, to legitimate pharmacists who would contract to procure the 
desired crude drugs and prepare them as directed. The name "Specific Medicines" was thus established, and 
the labels employed to protect physicians using these remedies, by insuring their integrity, proper preparation 
and quality. Firm after firm refused them, not caring to meet the exactions imposed, as well as hesitating to 
appear to be affiliated with the then often despised group of American physicians known as Eclectic. Two 
drug houses finally undertook their preparation, but only one made a serious effort to meet Dr. Scudder's 
requirements. Many improvements in process of manufacture and quality of product, as well as the addition 
of many drugs to the list originally selected by Scudder, resulted. As the preparations upon which the Eclectic 
specific indications have been founded, they are universally employed by specific medicationists as well as 
progressive members of all schools of practice. 
As Eclectics have been co-laborers in their evolution, and mostly employ these medicines in their practice 
they are given the preference throughout this work. Each Specific Medicine representative of the individual 
drugs considered, the dosage, and, in potent preparations, the usual manner of administration, is thus made a 
necessary feature in our pages. (See also Colloidums.) 
30 INTRODUCTION. 
Colloidums or Colloidal Specific Medicines are a recently perfected form of fluid 
preparations, carrying either in extremely minute dispersion or complete solution the 
desired medicinal non-crystalline or colloidal substances of plant drugs, the solutions as 
such being more readily absorbable than other forms of medicines. They have a varied 
menstruum according to the drug employed and usually contain less alcohol than the Specific 
Medicines. They represent the full medicinal values, minim for grain, of the drug employed 
according to the studies of the manufacturers. The flavor and color are natural, pure 
grain alcohol is used, and most of them mix without precipitation with water, alcohol, or 
glycerin. Colloidums are prepared by means of a special apparatus called a colloider. 
{Colloid-The term Colloid originated with Thomas Graham (1805-1869), a Scotch 
scientist, who discovered the now well-known process of dialysis or the separation of 
crystalline (crystalloids) and non-crystalline (colloids) substances in solution by means of 
an animal diaphragm, usually of bladder or parchment. The term which thus referred to 
structureless substances, the best example of which is glue (colla, hence the name colloid- 
having the appearance of glue), outside of dialysis, played but little part in general chem- 
istry, until revived in the last few years in the most important phase of Colloidal Chemistry, 
or the chemistry of formless (colloidal) life structures. It is now assumed that life de- 
pends upon water-dominated and disseminated colloidal or formless vitalized substances. 
"It seems," says Lloyd (Ellingwood's New American Materia Medica, Therapeutics and 
Pharmacognosy, 11th edition), "as though all that nourishes life structure as foods, as well 
as normal life structures thus served, are colloidal in their nature. Cast-off excretions 
(such as perspiration) carry crystalline salts, while urine is a prolific field of crystalline 
research (possibly salt and sugar may be cited as "crystalline" forms of food; possibly, 
too, both become colloidal before assimilation). But the stepping onward of normal bi- 
ological processes, the transferring of vitality from colloidal cell to colloidal cell, or from 
colloidal created organisms to organisms concerned in the support of life, seems ever to 
lean upon the movements and actions of colloidal bodies, which in their formation, and 
transformation, produce derivatives- that, if normal, are colloidal." Crystalline sub- 
stances are found in the secretions and under certain diseased conditions, hence 
the dictum of Lloyd that "Life structures detest a crystal". The same author 
summarizes briefly as follows: "In their relationship to life, as this writer now views 
the problem, colloids may be classed as formless, vitalized structures (cellular, 
emulsion or serum), capable of creating, nourishing and even of destroying the very life 
of their host." "Colloids that take our care as pharmacists maybe in liquid form, as serums, 
clear as water; an emulsion like milk or egg yolk, glutinous as egg albumen, or plastic as 
the jelly fish; or they may be, on the contrary, tough, dry, and hard, as horn" (ibid). 
Colloids, according to Graham, are substances without definite structure which may 
be liquid, gelatinous or solid, colored or colorless, refuse to dialyze, or dialyze very slowly, 
and are at least, under ordinary conditions, without crystalline structure. Colloids may be 
either organic or inorganic, using those convenient but not strictly true older terms of 
chemistry. Colloidal dispersions represent particles infinitely smaller than the finest of 
powder particles produced by attrition, and as such remain in suspension when under 
like conditions the latter would precipitate. True colloidal solution results when these 
colloidal dispersions dissolve and the milkiness of suspension disappears. It is logical, 
therefore, that medicinal preparations in colloidal solution should be most active and 
assimilable according to nature's own plan.] 
Spirits (Spiritus) are solutions of essential oils and other volatile substances in al- 
cohol. They are practically the same as essences, but the latter are usually stronger, 
though prepared in the same manner. They are (1) simple; (2) compound. Example: 
Spiritus Camphorse; (2) Spiritus Lavandulae Compositus. 
Suppositories (Suppositoria) are rolled, molded, or pressed solid bodies, usually 
prepared from cacao butter, glycerinated gelatin, or sodium stearate, and with or without 
some medicinal agent, and intended for introduction into the pelvic and other orifices. 
Sometimes wax or spermaceti is added to prevent them from melting during hot weather. 
Ten per cent Japan wax is to be preferred for this purpose. Example: Suppositoria Glycerini. 
Syrups (Syrupi) are concentrated aqueous solutions of sugar or thick solutions 
of sugar in aqueous medicated or flavoring solutions. They are (1) simple, (2) medicated, or 
(3) flavored. Examples: (1) Syrupus; (2) Syrupus Pruni Virginianae; (3) Syrupus Aurantii. 
Tablets (Tabellce). Small disk-like bodies prepared by molding or compression. 
Often they are but medicated candies, and when hard and old often fail to disintegrate in 
the gastro-intestinal canal and may pass unbroken in the feces. When made from per- 
manent and readily soluble chemicals they form convenient medicines; but when pre- 
pared from delicate and volatile plant constituents, little dependence can be placed upon 
them. (1) Tablet Triturates are disks prepared from milk sugar triturations of drugs, 
with the addition of some excipient, or merely moistened with alcohol, to cause the in- 
gredients to adhere together. (2) Compressed Tablets are composed of compressed powdered 
31 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
drugs often in considerable doses. They are the most unreliable and often fail to dissolve. 
(3) Coated Tablets are compressed tablets coated with chocolate, sugar, gelatin, keratin, 
etc. (4) Hypodermic Tablets-These are readily and completely soluble tablets usually 
of triturates of powerful substances, designed for subcutaneous injection. Except the last 
named, tablets have never been popular with Eclectic physicians. 
Tinctures {Tinctura) are alcoholic solutions of non-volatile vegetable (and some- 
times mineral) substances. They are prepared by maceration or percolation, generally 
the latter. Tincture of iodine and tincture of ferric chloride are alcoholic solutions of 
chemicals. Tinctures are practically identical in nature with fluidextracts, though their 
degree of strength is much lower than that of the latter. Tinctures of potent drugs are of 
10 per cent strength. Others usually of 20 per cent or more. Tinctures are extensively 
used. Like fluidextracts they contain their relative proportion of plant-dirt and other 
colored impurities. Tinctures made from fresh bruised or crushed herbs, by maceration, 
are known as Tinctura Herbarum Recentium or Tinctures of Fresh Herbs. Tinctures are 
also (1) simple, and (2) compound. Examples: (1) Tinctura Digitalis; (2) Tinctura 
Gentianse Composita. 
Tincturae Homcepathicae {Homoeopathic Mother Tinctures') are prepared in four classes: 
(1) by expressing the juice from freshly-gathered plants or parts thereof, chopped and 
pounded to a pulp, and enclosed in new linen and expressed, and mixing the juice so obtained 
and briskly agitating with an equal bulk of alcohol, allowing it to stand eight days in a 
dark, cool place, and finally filtering the product. The amount of drug power is one-half. 
(2) by mixing two parts of alcohol with three parts of the comminuted plant, straining 
the liquid through new muslin, and proceeding further as above directed. The amount of 
drug power is one-half: 
(3) by taking two parts of alcohol to one part of the comminuted plant and macerating 
them together for eight days in a well-filled bottle, and lastly, decanting, straining, and 
filtering. The amount of drug power is one-sixth. 
(4) by taking alcohol, five parts, to the comminuted drug (vegetable or animal), 
one part, macerating eight days, shaking twice daily, and lastly, decanting, straining, and 
filtering the product. The amount of drug power is one-tenth. 
Triturations {Triturationes or Triturates) are made by triturating (rubbing) a me- 
dicinal substance with sugar of milk, the latter being employed simply as a diluent. Trit- 
urations containing one part in ten are denominated fir st decimal triturations (lx); one part 
of the foregoing with nine parts of milk sugar, second decimal (2x), and so on. Examples: 
(1) Trituratio Podophylli; (2) Trituratio Santonini 2x. 
Vinegars {Aceta) are filtered solutions of the active constituents of drugs in diluted 
acetic acid. As many alkaloidal principles are best dissolved in this menstruum, these 
preparations (of certain drugs, as lobelia, sanguinaria, etc.) are very excellent medicines. 
Vinegar was formerly, and to some extent is still, used in many excellent Eclectic aceta. 
Examples: Acetum Scillae; Acetum Lobelise, 
Wines ( Vina) or Medicated Wines (Vina medicata) are fluid preparations, in which the 
soluble medicinal principles are dissolved in or extracted with wine. They are in reality 
weak vinous tinctures, and are fast being discarded. Example: Vinum Colchici Seminis. 
IV. ACTION AND EFFECTS OF MEDICINES. 
THE GENERAL NATURE OF DRUG ACTION. 
The student and the doctor are eternally seeking the "reason why". 
How do medicines act? they ask; what is the nature of pharmacological 
action? This can only be answered at the present time by saying that we 
do not know definitely; that while many theories have been advanced, 
they have been found wholly or in part untenable, no definite conclusion 
as to how drugs act having as yet been satisfactorily reached. Theories 
have included chiefly the Physical, including protective and salt action; 
and Chemical, comprising also "electrolytic dissociation", and others. 
The chemic theory has been that most largely accepted, but within a few 
years the physical has gained much ground. While most of the theories 
propounded have not been satisfactorily proved, neither have they been 
conclusively disproved. The probabilities are that drugs act both physically 
and chemicallv. 
32 INTRODUCTION. 
Sollmann (Text-Book of Pharmacology) flatly declares that "phar- 
macologic action must be conceived as purely ch<mic" and that sub- 
stances often produce the same changes in living as in dead protoplasm 
("H2 SO4 and other caustics"); while others change mainly or solely the 
living molecule ("extremely active muscle and nerve poisons, as most 
alkaloids and glucosids"). 
Butler (A Textbook of Materia Medica, Therapeutics and Pharmacology) 
says: "The action of drugs is fundamentally a question of protoplasmic 
chemistry, but the investigations of the biologists have not yet reduced 
the interpretations of nature to a question of molecular physics." 
Among some of the theories of general drug action may be men- 
tioned the following: (1) Mutual rearrangements of molecules of the drug 
and those of protoplasm; (2) Some drugs act upon tissues, probably alter- 
ing their chemical characters, yet are themselves unchanged; (3) "electro- 
lytic dissociation," an electro-chemic reaction in which not the molecules 
but the ions of the salt and those of the protoplasm exchange places; 
(4) salt action, a physical osmotic process in which a changed relation of 
fluid to cells takes place, etc. While none of these theories fully explain 
the nature of the action of drugs, except in limited or special fields, it is 
probably true that each plays some part in the sum total of activities in 
this as yet unexplained question of the action of drugs upon living organic 
tissue. 
Without question the protoplasmic cell is the part of the body primarily 
acted upon. In very recent years there has been a strong leaning toward 
the physical theory of the action of drugs, especially in accounting for 
changes shown as the result of penetration or non-penetration of the cell 
walls, leading to alterations or rearrangements of the contents of the cell, 
or to the change of surface tension altering the relationship of the cell 
membrane to its enveloping fluids. On the other hand some maintain 
the chief action takes place in the intra-cellular membranes-and several 
other theories have reference to electrical conductivity and other altera- 
tions in the cells and their contents. 
While much has thus been written to prove certain physical and 
chemical changes occurring through the exhibition of drugs, none of them 
explains the whole process of pharmacologic action. Cushny (Pharma- 
cology and Therapeutics) wisely concludes: "From the present confusion 
the only legitimate conclusion seems to be that the activity of drugs de- 
pends on a large variety of factors and that pharmacological action cannot 
be brought under any one law, either chemical or physical." 
EFFECTS OF DRUG ACTION. 
While the manner of action of drugs has not been settled, the assump- 
tions and results as stated by pharmacologists are as follows: In the present 
state of knowledge drugs are believed to act upon the cells of living matter 
in some way, whether chemic, physical, or otherwise, altering their activity. 
The effects of such action are stimulation, depression, irritation, paralysis, 
and death. When a drug increases the functional activity of a part it is 
assumed that it does so by stimulating it. Reversely when it decreases 
functional activity it does so by depressing it. When an alteration in the cell 
33 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
is produced, irritating, inflaming, or altering its growth or nutrition, it is 
brought about by irritation. Stimulation carried to excess, either as to force 
or time, results in over-stimulation, which then lapses into depression and 
finally paralysis. Paralysis is impairment and sometimes death of function, 
and may even end in death of the vital organs. Continued irritation leads 
to death of structure. 
Drugs, then, excite, depress, irritate, paralyze, and kill. The effects 
of their action are upon function or structure, or both. No new function 
is ever created by a drug. According to Cushny, stimulation is said to 
take place chiefly in, or at least is most observable in, the higher function- 
ating or more specialized cells of the nervous system, the heart, and the 
glands of secretion; irritation, while it may be met in all living tissues, is 
best noted in the action of drugs upon the cell-contents of the connective 
and epithelial tissues. 
SELECTIVE DRUG AFFINITY. 
There is no medicine known to act upon all the tissues of the body, 
but when one acts detrimentally to a wide area of cells it is called a proto- 
plasmic poison. There are a number of such agents, of which quinine and 
mercury may be mentioned. Some few are said to have a specific or highly 
selective action, as when they attack parasites infesting the blood cells 
and destroy them and accomplish this destruction in doses which do not 
harm the host. These drugs, however, carried to excess become poisons 
to the host. Quinine again may be cited, as it destroys the plasmodium of 
malaria in the blood. Probably arsenic and mercury have a similar action 
upon the treponema of syphilis and other spirillae, and possibly the salicy- 
lates directly attack and cripple or destroy the micro-organism of acute 
rheumatism. The latter, however, in the very large doses often admin- 
istered, are very apt to injure the host and do so unless used in a very 
circumspect manner. These are among the so-called specifics for diseases 
now admitted in regular medicine and, while they are in a sense specific 
medication, they are not to be confused with Eclectic Specific Medication 
(which see). 
Medicines are said to have a direct action when their effects come 
through contact with the tissues; indirect when a secondary result is the 
reflection of a direct or primary action. Medicines act locally when the 
effect takes place at the point of contact; they are called systemic or general 
remedies when they are absorbed into the blood and carried by that current 
to their selected field of action. 
Medicines have a selective affinity for the cells of certain tissues or 
parts of the body. They may act upon one or more organs, or merely 
upon a specialized part of them. One remedy may select the heart (digi- 
talis); another the blood vessels (nitrites), some act upon the medullary 
centers (belladonna), others on the peripheral nerves (aconite). Some 
select and control the secretory glands, increasing their function (pilo- 
carpine)-while still others act oppositely upon the same structures, de- 
pressing activity (atropine). The renal cells are directly acted upon by 
some drugs (theobromine); a few attack the hepatic cells (podophyllin); 
others the unstriped muscular fibres (ergot), and still others the cells of 
34 INTRODUCTION. 
the cerebral cortex (bromides), and the higher cerebral tissues (cannabis). 
This selective affinity of drugs is one of their most characteristic qualities, 
and it must be remembered that to this phenomenon alone must we look 
to do good instead of harm with medicines. The action of the great ma- 
jority of medicines, however, as before stated, is unknown, though the 
structure or function feeling its effects may be determined. Until the 
action of drugs is better understood physicians will treat patients em- 
pirically and symptomatically, and Eclectics especially by the present 
method of specific medication-all using the least amount of a drug that 
will produce beneficial results without harmful collateral or after-effects. 
ABSORBABILITY OF MEDICINES. 
Medicines, to be systemically effective, must be soluble in some ab- 
sorbable menstruum, or be capable of solution in some of the fluids of 
the body. Invariably drugs are most readily absorbed when in solution. 
Alcoholic solutions are more easily taken up than aqueous solutions, and 
for this reason would be preferable to the latter were it not for the two- 
fold reason that they may have an undesired effect of alcohol itself and that 
they tend to initiate a pernicious habit. Elixirs, though pleasant and 
preservative as vehicles, are open to the same objections, especially when 
administered to children and youth. Water, being innocuous and ab- 
sorbable, is almost always employed as the vehicle for the administration 
of the specific medicines. Water-borne medicines are readily absorbed, 
and, with rare exceptions, no change is induced in the medicines so ad- 
ministered. No habit is created; none fostered. 
Insoluble medicines, except for local effect and as protectives, are not 
desirable forms of administration unless they can be dissolved by the 
gastric or intestinal juices. Sometimes it is intended that a medicine shall 
not act until it reaches the intestinal canal; then one insoluble in the 
stomach may be given. If it is a medicine likely to be changed or de- 
stroyed by the gastric contents, or if it is intended to be protected from the 
salivary and gastric secretions, and made to dissolve in or be dissociated by 
the alkaline juices of the intestines, it may be encased in some such sub- 
stance as keratin, which is not dissolved in the stomach, but disintegrates 
at once when in contact with the alkaline media of the intestinal and 
associate secretions. The administration of hard and difficultly soluble 
medicines is to be avoided because of their slow and uncertain rate of 
disintegration and absorption, and their consequent unreliability. Old 
and hardened pills, with a practically insoluble coating due to ageing, 
and notably certain compressed tablets, may pass completely through the 
intestinal tract without solution or effect. Syrups and mucilages are 
useful where a prolonged contact with the tissues is intended, provided they 
do not lessen the efficiency of the medicinal ingredients. The syrups are 
valued chiefly for their agreeable taste. The sick individual, however, 
generally has little appetite for things enjoyed in health, and the stomach 
often rebels against sweetened and aromatized medicines. Especially 
is this true in acute illness. Neither should sugar be administered to those 
suffering from sugar intolerance, glycosuria, or diabetes mellitus. It 
follows then that, all things considered, the Eclectic physician, in using the 
35 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
majority of medicines prescribed by specific medication methods, has come 
to regard water as the most useful, pleasant, and efficient vehicle for the 
administration of medicines, as well as the most readily absorbable, with- 
out interference with the action desired, or the integrity of the medicinal 
ingredients (see also The Dispensing of Medicines). 
Bearing in mind that systemic medicines can act only when absorbed 
by the blood or lymphatics, it follows that, to obtain the promptest results, 
conditions must be right for their absorption. Drugs, when administered 
by mouth, act most readily when the stomach is empty; and tardily, 
sometimes not at all, when diluted by the contents of the stomach. A 
full stomach may absolutely prevent absorption, or the medicine may be 
destroyed by the material present. Nevertheless most medicines, while 
undoubtedly some of them and their effects are lost, are necessarily given 
at short intervals, and in spite of stomachic conditions the general con- 
sensus of opinion is in favor, as has long been advocated in Eclectic therapy, 
of administering medicines in small and oft-repeated doses. 
Medicines probably act best when the circulation is active and slowest 
when depressed; they also act quicker when the stomach is irritated, and 
in atonic conditions of both the gastric and intestinal tracts when local 
stimulants, such as capsicum, are given with them. When diarrhoea is 
present or vomiting occurs while medicines are being administered, naturally 
less absorption is taking place and a portion of them is being lost through 
hasty elimination. Local medicines (with a few exceptions) are not absorbed 
but act solely by contact with the tissues or their secretions or excretions. 
ADMINISTRATION AND RATE OF ABSORPTION AND 
ELIMINATION. 
Drugs which act promptly and are generally quickly absorbed and 
rapidly eliminated are given at short intervals. Thus fractional doses of 
aconite, belladonna, gelsemium, or rhus may be repeated every half hour, 
hour, or two hours. Full amounts of these drugs are completely eliminated 
in a few hours, hence fractional doses at short intervals are not cumu- 
lative. If aconite, in poisonous doses, does not kill in three hours, the patient 
is likely to recover, so rapid is its elimination. By repeating the small 
doses of actively absorbed and readily eliminated drugs a continuous and 
kindly therapeutic action is maintained, and no over-activity or cumulation 
occurs. Such a drug as digitalis, however, which is slowly absorbed and 
more slowly excreted, should be administered at long intervals lest over- 
lapping of doses and alarming cumulative effects be produced. It is 
quite the custom when giving foxglove for long periods to stop its 
administration for one or two days out of a week, and for the rest of 
the period administering but one full dose a day. A single dose produces 
its effects for many hours. It is evident, therefore, that no absolute rule 
of dosage can be given for medicines, and that a study of each individual 
drug, noting its rate of absorption and excretion, should be made by the 
student in considering all active and powerful drugs. This will guide as 
nearly as possible to the frequency with which a drug should be admin- 
istered. It must be noted also that the duration of the action of drugs, 
while depending most largely upon their rapidity of absorption and their 
36 INTRODUCTION. 
rate of destruction within the body tissues or their complete or partial 
elimination, may depend to some extent upon the integrity of the anatomic 
structures and their capability of physiologic functioning. In some in- 
stances drugs cannot be eliminated because the organs of excretion are 
crippled, or actually destroyed, or functional powers so impaired that 
excretion either is effected very slowly and imperfectly or cannot take 
place at all. When pathological conditions of such a character are known 
one must be exceedingly cautious in the exhibition of powerful medicines. 
CIRCUMSTANCES MODIFYING DRUG EFFECTS. 
While in the main the effects of drugs generally are much the same 
on most individuals, there are conditions or circumstances which tend to 
modify their action. Among these are usually noted the (1) age, (2) sex, 
(3) race, (4) weight, and (5) temperament; and the presence of (6) varia- 
tions of temperature, (7) diseased tissues, (8) drug habit, (9) pregnancy 
(and sometimes menstruation), and (10) idiosyncrasy. The preparations 
of medicines employed and their doses, and time and manner of adminis- 
tration also figure largely in the results obtainable from medicines. During 
pregnancy harsh cathartics should be avoided lest through increasing 
pelvic congestion they may favor abortion. 
(a) Cumulative Action.-When a drug has been administered for a 
considerable time with but ordinary results and then suddenly produces 
a violent, unexpected, or alarming effect, it is said to have cumulated; and 
the action is termed cumulative. This phenomenon may be caused by slow 
or irregular absorption after accumulation of a considerable amount of the 
drug in the intestinal canal; to greatly overlapping doses; to absorption 
taking place faster than the drug is excreted; or, as some have suggested, 
to a process induced by which excretion of the drug is prevented by its own 
action upon the eliminating organ, as of the kidney. A notable cumulative 
drug is digitalis; arsenic and mercury are others, the so-called chronic 
poisoning by metallic medicines being due to cumulation in the tissues. 
Apocynum may be given with no other effect than to strengthen the 
heart's action and reduce dropsical effusion, when, after several weeks' use, 
it will suddenly induce a prostrating diarrhoea. 
(&) Drug Tolerance.-Certain medicines, which at first produce only 
intended and expected effects and can be used up to certain limits with 
safety, subsequently may be given in increasingly larger amounts, usually 
without danger to life, but not without undesirable results. A drug habit 
or state of acquired tolerance is thus established, examples of which 
are the tobacco, opium, arsenic and cocaine habits, and to a lesser extent, 
alcoholic addiction. Just how this takes place is not well understood. 
While, in a measure, it may be due to diminished or irregular absorption 
with increased elimination by the bowels, or to destruction of a greater 
amount of the drug or its more rapid excretion by the tissues preventing 
concentration, it is thought to be largely due to some change in the body 
tissues making them more resistant to the action of the drug. Sometimes 
this action appears to be limited to certain parts of the body, which at first 
responding normally to the drug, finally become tolerant of its presence, 
37 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
as is seen in acquired tolerance of some vital organ, as the brain or heart, 
or as takes place in some of the organs of special sense, and in all of which 
permanent damage results. 
(c) Idiosyncrasy is the peculiar susceptibility (sometimes insuscepti- 
bility) of the tissues of certain persons to the influence of certain drugs. 
Some individuals cannot take quinine without experiencing a severe attack 
of urticaria, and ipecac will excite in others a violent asthmatic seizure. 
Probably a failure to prescribe according to specific indications, with 
a resultant untoward effect, is often mistakenly attributed to idiosyncrasy 
and undoubtedly some cases of so-called idiosyncrasy to protein substances 
are probably examples of anaphylaxis. In the present state of scientific 
knowledge no real cause for idiosyncrasy has been satisfactorily determined. 
(d) Synergists and Antagonists.-When a drug by its very presence 
increases the efficiency of another, both as to rendering the latter safer 
and in assisting a lesser quantity of either to produce desired effects, it is 
said to act as a synergist. There are many such drugs, and most of them 
have been used as adjuvants in combinations designed to act upon the 
intestinal tract; some on the nervous system. A combination of cathartics 
is often used because it acts more thoroughly than a single agent. A 
commonly cited association is that of chloral and morphine, which, when 
combined, requires a lesser amount than of either when given alone, and 
acts with equal efficiency. Other agents act synergistically by correcting 
obstructive conditions, as when the nitrites relax vascular tension so that 
digitalis may act more safely and effectively. 
When medicines prevent or lessen the effects of another they are 
said to be antagonists, and such an instance is often cited in the failure 
of strychnine to act when the body is fully under the anaesthetic influence 
of chloroform. 
DOSAGE. 
Exactitude in dosage, were this accurately determined for various 
conditions, would unquestionably greatly aid in medication. As a rule, 
doses usually administered are far in excess of necessity, and it is better to 
err on the side of insufficient dosage and trust to nature, than to overdose 
to the present or future harm or danger of the patient. With potent drugs 
especially should the greatest care be had to give the smallest possible 
quantities that will achieve results, and never to give them without a well- 
defined indication. With non-potent drugs the danger of damage is dimin- 
ished, and even those should be used only when indicated. No medication 
is better than aimless medication. These have been fixed rules in the 
practice of specific medication. It must not be understood that by non- 
potent medicines is meant that such drugs have no therapeutic power or 
value. It remains a clinical fact that many drugs of supposedly non- 
potent character, when given in minute doses, best influence conditions of 
disease, even though no explanation of the action can be given. The 
fractional dose of matricaria or of pulsatilla effects a positive control over 
nervous phenomena that cannot be duplicated by the more powerful 
agents or doses. 
Unless otherwise stated, the doses of preparations named in this work 
are those for adults. The age limit governs, in some degree, the quantity 
38 INTRODUCTION. 
of a drug to be given at a single dose and the daily amount. The very 
young obviously should not be plied with vicious doses of potent drugs, and 
in those past three-score the body conditions are relatively like those of 
infancy and childhood; hence care should be exercised lest they be over- 
drugged. In the aged, perhaps, the most usual exception will be in the use 
of cathartics, and sometimes of diuretics. As a rule, large and robust 
persons require fuller doses than small and frail individuals; women less 
than men; and children much less than adults, and in amounts graduated 
according to age and weight. These strictures apply to drugs given for the 
gross effects, and less to those administered in small doses according to the 
practice of specific medication (see Dosage of Specific Medication). Even 
in the latter, only the smaller and graduated doses should be administered 
to children and infants. 
In the medication of children certain rules of dosage have been fol- 
lowed by some prescribers. These rules apply only to gross doses, and not 
to the fractional doses of specific medication methods. While no absolute 
law can be laid down in administering medicines to children, one or the 
other of the following rules is that most favored: 
1. Young's Rule: In which the dose is computed by dividing the 
child's age by 12 plus the age. Thus, for a child of 4 years = ; 
therefore, the dose should be one-fourth that which would be given to an adult. 
2. Cowling's Rule: In which the year number of the next birthday is 
divided by 24. Thus, for a child coming 3 years of age: 3/24 = 1/8; hence 
the dose should be one-eighth that of the dose for an adult. 
Obviously no exact rule can be established, and these doses should be 
curtailed in some instances, notably in the administration of narcotics and 
intensely poisonous drugs, while in the use of cathartics the doses may have 
to be increased. Beginning at 60 years of age, dosage by systemic remedies 
should run a gradually descending scale, while it may be necessary to greatly 
increase that of eliminants, as cathartics and diuretics. It must be re- 
membered that opium and its derivatives are especially dangerous to 
children and tend to invite pulmonary oedema in the aged. 
For rectal administration, larger doses are required than by mouth; 
usually from one-fourth to one-half larger. 
For hypodermatic use the dose is usually from one-third to one-half 
less than by mouth. As most drugs so administered are very powerful, the 
initial dose should be as small as possible unless the patient's susceptibility 
or tolerance be known; and even then only much smaller doses of powerful 
poisons or narcotics should be permitted. Very innocent vegetable drugs 
taken by mouth may become harmful when hypodermatically used. 
DOSAGE OF SPECIFIC MEDICINES. 
The doses given under each individual drug are those found to be 
within the range of the maximum and minimum amounts for most adults. 
The determination of dosage for gross effects is, to a large degree, a personal 
matter with the prescriber and depends very largely upon his individual 
experience and his skill in determining the needs of the patient. In specific 
medication the relationship between medicine and dosage is based usually 
upon the smallest quantity of drug which will meet a specific indication, 
39 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
learned through experience in a large number of similar conditions, and 
which will act kindly and produce the desired effect without shock or dam- 
age to function or structure. For most of the medicines it has not been 
thought that dosage amounted to so much as selection for the specific 
adaptability of the drug to the disease-condition. It has been determined 
that very small doses are effective when directly indicated, and this ac- 
counts for the apparent smallness of the dose usually administered specifi- 
cally as compared with the range of dosage indicated as possible under the 
drug considered. For most of the very active drugs, as aconite, the dose is 
the small fraction of a drop, from 1 to 5 drops (rarely 10) of the specific 
medicine being added to 4 fluid ounces of water, and of the mixture so pre- 
pared a teaspoonful being administered frequently. Of less powerful agents, 
as gelsemium, the larger proportion of 5 to 30 (sometimes 60) drops may 
be added to the menstruum; while belladonna and others of the more 
powerful of the Solanacese give a decidedly wide range of effects from 
different sized doses, ranging from the smaller fractions to the full accredited 
dose of the drugs. 
SALT ACTION. 
An important action of drugs is that known as salt action, in which 
salts (also acids, alkalies, sugars, and some other substances) act upon the 
principle of osmosis-that when two solutions of different density separated 
by a membrane through penetration of that membrane come into con- 
tact with each other, they tend to equalize in concentration. In the living 
tissues this takes place with the cells acting as the dialyzer and is more 
varied in its reaction to different substances than the action through a 
dead membrane. Most cells are permeable in differing degrees by water and 
certain salts; some substances do not penetrate or the cells are not pene- 
trable at least to any great degree. The chief object attained by salt 
action is the change of watery contents that takes place within the cell, 
and in this way a therapeutic effect is obtained. Some instances of in- 
creased diuresis are thought to take place in this manner, and the well- 
known effects of salts (saline laxatives) in inducing watery catharsis is 
explained upon the theory of "salt action". 
V. APPLICATION AND ADMINISTRATION 
OF MEDICINES. 
Medicines are applied or administered chiefly to the skin and to and 
by way of the mucous surfaces; by way of the subcutaneous areolar tissues; 
by intracutaneous injection; by intramuscular injection; by intravenous 
injection; by intraspinal puncture; by intraperitoneal injection; and 
occasionally to serous tissues, wounds, ulcers, etc. 
There are three general (and one special-Schleich's) methods of applying remedies to 
the skin: (1) a, enepidermatic; b, epidermatic; and c, endermatic; (2) intracutaneous. 
(a) By the enepidermatic method the medicine is applied to the skin without friction. 
Examples: Baths, fomentations, sinapisms, poultices, blisters, etc. 
(b) By the epidermatic method the medicine is applied to the skin with friction. Ex- 
amples: Ointments, liniments, etc. 
L To the Skin, or External Integument 
40 INTRODUCTION. 
When used by inunction, a site for easy absorption by reason of thinness of skin and 
abundant lymphatic circulation should be selected; usually the axillae, groin, and inner 
aspect of the thigh. This is a favorite method in Eclectic practice of administering quinine 
to children, or when the stomach will not tolerate it, and by those of other schools for the 
use of mercury in syphilis. 
(c) By the endermatic method the medicine is brought in direct contact with the 
denuded derma, the epidermis having been first removed by means of a blister, cantharides 
or ammonia generally being employed. The medicine subsequently sprinkled upon the 
raw surface is quickly absorbed. This method is a relic of therapeutic barbarism, and has 
been practically abandoned. Examples: Morphine, quinine, etc. 
(2) By the Intracutaneous method a drug-laden solution is injected directly into and be- 
tween the layers, but not through the skin, as when cocaine is used as a local anaesthetic 
to prepare the part for incision. 
II. To or By Way of the Mucous Surfaces or Internal Integument. 
(a) To the Nasal or Pituitary Membranes, by means of insufflations, douches, and 
atomization. 
(b) To the Conjunctives, chiefly by insufflation or instillation for purposes of (a) con- 
trolling local and deeper ocular inflammation; (b) for protection; (c) to relieve pain; and 
(d) for mydriatic, myotic, and cycloplegic effects. 
(c) To the Naso-tracheo-bronchial Membranes, by insufflation, inhalation, and atomiza- 
tion. It is a question whether by ordinary atomization medicines reach the alveoli of the 
lungs, but by means of nebulizing outfits even the uttermost part of the breathing organs 
may be treated. 
(d) To the Gastro-intestinal Membranes, by ingestion. Examples: Powders, pills, 
tablets, triturations, mixtures, extracts (solid and fluid), infusions, decoctions, vinegars, 
wines, specific medicines, tinctures, solutions, lozenges, etc. 
Medicines are administered by mouth for (a) local effect upon the tissues over which 
and to which they pass; and (b) for absorption by the lymphatics and blood for distribu- 
tion to the parts intended. When a local effect upon the mucosa of the stomach is desired 
they should be given before meals; when upon the intestines from two to four hours after 
partaking of food, especially if ulcer is present. When an irritant effect is to be avoided 
or when slow absorption is intended they should be administered immediately after a meal. 
Iodides are far less apt to produce "iodide punishment" if given in this manner. Unless 
an irritant action is wanted, or very rapid absorption, medicines are generally given after 
partaking of food. Eclectic Specific Medicines for specific medication purposes are usually 
administered in small doses frequently repeated for continuous effect. 
(e) To the Recto-colic Membranes. Medicines are applied to these parts both in solid 
and liquid form: (1) solid, suppositories and ointments. Suppositories are employed (a) 
for slow absorption of medicines; (6) to provoke fecal expulsion; ointments (a) for slow 
absorption; (b) for protection. (2) fluid, enemas, lavements or clysters, and by entero- 
clysis. 
Enemas are employed to remove fecal accumulations and flatus. Enteroclysis-a slowly 
injected enema, usually of normal salt solution-is resorted to (a) to wash out the bowel; 
(6) to dilute poisonous material; (c) to inhibit bacterial infection; (d) to keep up body heat; 
(e) to prevent anuria; (/) to remove impacted feces; and (g) to reinforce body fluid after 
exhaustive waste. It is often used after operations to overcome tendency to or revive from 
shock, and supply fluid, and to prevent failure of the renal function. It should be used, 
preferably, by means of a fountain syringe, placed at desired height, and without force, the 
fluid being allowed to merely trickle into the bowel. A large quantity should be employed, 
the proper temperature being from 101° to 103° F, lest chilling and possibly death result 
from a lower degree, or heat-stroke follow a higher degree of heat. 
(J) To the Urino-genital Membranes, by means of bougies, medicated ointments, and 
injections. 
(g) To the Utero-vaginal Membranes, by means of ointments, suppositories, tampons, 
and injections (douches). 
III. By Way of the Subcutaneous Areolar Tissues. 
Medicines to take effect quickly are applied to these parts hypodermatically, i. e., 
by the injection of small quantities of solutions by means of the hypodermatic syringe, 
and in larger amounts by employing a fountain syringe with larger canula by the process 
of hypodermoclysis. 
The advantages of hypodermatic medication are (a) rapid absorption; and (6) no 
loss of medicinal dose provided the drug be completely dissolved. The disadvantages are 
(a) pain; (b) danger of entering a vein and producing a too rapid effect; (c) abscess, if 
41 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
carelessly performed; and (d) rarely, air embolism. The latter may be avoided by expelling 
the air from the barrel of the syringe, which may be known by the drops of fluid emerging 
from the point of the needle. 
Absolute cleanliness both as to instrument and site, both being sterilized, must be 
observed in hypodermatic medication. The best sites for ready entrance and absorbability 
are the arm, the forearm, buttock, belly wall, and calf of leg; sometimes the back of the 
body. A spot as free from veins as possible should be selected, pinching the skin to a fold 
to prevent pain and provide easy penetration, and the injection made between the fingers 
and the surface. The needle should enter the areolar tissue and not between the layers of 
the skin. 
Hypodermoclysis is resorted to when we wish (a) to replace lost fluid, as in hemorrhage, 
cholera, etc.; (J) to increase elimination of impurities by way of the blood and lymph 
channels; (c) to flush out the kidneys; (d) to increase diuresis in some cases of uraemia; 
and (e) to supply fluids to the body when vomiting is persistent. Sterile normal salt 
solution is employed by means of a sterile apparatus, with hose and canula, the latter being 
plunged into the subcutaneous areolar tissue, preferably of the chest or abdomen, and the 
injection allowed to proceed slowly. Absorption takes place rapidly. The rule (Hare) is 
not to exceed one drachm of fluid to each pound of body-weight in fifteen minutes. 
IV. By Intravenous Injection. 
By means of transfusion and by the injection of medicinal substances directly into the 
veins. Ordinarily this is too dangerous a method except for those thoroughly equipped 
and trained for this purpose. The average practitioner, unless so prepared, should not 
attempt it. It has rapidly come into renewed use since the introduction of medicines for the 
treatment of syphilis and similar constitutional diseases. 
V. To the Muscular Tissues. 
By intramuscular injection deeply into the belly of the muscle. Absorption takes 
place rapidly. Painful indurations are common and abscesses may result from this method 
of employing medicines. Examples: Mercury; Arsphenamine. 
VI. By Intraspinal Puncture. 
By the intraspinal method, as when stovaine, or solution of magnesium sulphate, or 
certain serums, are introduced into the spinal canal by means of lumbar puncture. 
VII. By Intraperitoneal Injection. 
By the intraperitoneal method, as when solutions of glucose or of salt are introduced 
through the belly-wall into the peritoneal cavity. 
VI. INCOMPATIBILITY. 
Incompatibility is a subject of wide and almost endless consideration. 
[For general purposes, however, a few only of the incompatibles need be 
r considered. Incompatibility is a state in which, two or more substances 
being brought together in a preparation, undesired changes are effected, 
viz.: (1) Chemical, by decomposition, precipitation, or by the formation 
of new, or poisonous, or dangerously explosive compounds; (2) Phar- 
maceutical, by the formation of imperfect or unsightly preparations (which, 
however, are not necessarily altered in activity), through immiscibility, 
incomplete solution, or gelatinous or other turbidity; (3) Therapeutic, 
by mixing drugs having an antagonistic action within the body. 
Incompatibility in preparations may be avoided best by simplicity in 
prescribing, using but one medicament to the proper solvent. The doctor 
should have some general knowledge of chemistry, particularly of the 
solubility, insolubility, and reactions of chemicals. In this way he may cut 
to the minimum the instances of chemical incompatibility. The responsi- 
bility for pharmaceutical incompatibility, except where the physician 
dispenses, rests with the pharmacist. Physicians as a rule are not expected 
42 INTRODUCTION. 
to possess a wide knowledge of pharmacy and pharmaceutical manipula- 
tion. Therapeutic incompatibility rests entirely upon the physician, for if 
he prescribes antagonistic agents in a single preparation he, and not the 
pharmacist, makes the error. The pharmacist, however, may check him 
up and inform him, to his benefit, of his mistake. 
The Eclectic physician who follows specific medication is less likely 
to have incompatibles to contend with, as the amounts of alcoholic or 
resinous or other precipitable material added to water, the usual men- 
struum, is negligible and easily kept in suspension. Only when he departs 
from the rule of single medicines may he occasionally have to contend with 
therapeutic incompatibility, as when he mixes aconite and digitalis in the 
same mixture. As the physician occasionally has need of other than specific 
medication we have listed below some of the commonest and more im- 
portant of incompatibles. 
Substances. 
Incompatibles. 
Acacia (Gum Arabic). 
Stronger alcoholic solutions; sodium biborate (borax); 
iron salts; mineral acids; lead water. 
Acid Salts (Vegetable). 
Are changed by mineral acids; decomposed by alkalies. 
Acid, Salicylic. 
Alkalies; alkaloids; iron salts (turn purple); carbolic 
acid (purple). 
Acid, Tannic. 
All alkaloids; iron salts (form inks); gelatin; chlorates 
and other oxidizers (explode). 
Acids, Mineral. 
Alkalies; carbonates; bicarbonates; hydrates; oxides; 
halogen salts (bromides, chlorides, and iodides). Strong 
acids decompose acid salts. Strong acids set free 
relatively weaker acids (usually organic). Strong 
acids form ethers with alcohol or alcoholic solutions; 
fluidextract of licorice (precipitates glycyrrhizin); 
mucilages. 
Acids, Organic. 
Decomposed by strong mineral acids. 
Alkalies (including alkaline 
All acids (mineral or organic-neutralize); or relatively 
carbonates, acid carbon- 
weak salts; all alkaloids precipitate but sometimes re- 
ates, hydrates, lime water 
dissolve in excess of precipitant, or if sufficient alcohol 
and ammonia water). 
be present; some glucosides (decompose); and fixed 
oils and fats (saponify). 
Alkaloids. 
All alkalies; tannin or tannin-bearing solutions; iodine and 
iodides; salicylates; mercuric chloride or corrosive subli- 
mate; chlorinouspreparations. Alkaloidsalsoprecipitate 
each other. Alkaline salts, e. g. Na H CO3 are precipitants. 
Antipyrine. 
Spirit of nitrous ether (sweet spirit of nitre) (forms 
poisonous compound); free iodine; calomel; prepara- 
tions of cinchona; metallic salts. 
Arsenic Compounds (Fowler's 
Tannin; iron salts, especially the freshly precipitated 
solution; Scheele's green; 
hydroxide; magnesia; lime. 
Paris green; Arsenous acid). 
Bismuth. 
Mercurous chloride (calomel); tannin; sulphur. 
Bitter Infusions (except of 
calumba, gentian and quas- 
sia, which do not contain 
tannin). 
Salts of iron and of lead. 
Bromides. 
Acids; alkalies; acid salts; alkaloids; especially morphine. 
Chloral, Hydrated. 
Alkalies; camphor or menthol (cause liquefaction); 
potassium bromide; acid salts; cyanide of potassium 
(sets free prussic [hydrocyanic] acid). 
Chlorides. 
Silver and lead salts; alkalies; hydrogen peroxide. 
Chlorates. 
Explode when triturated with any substances that will 
burn (sugars, tannin, sulphur, powdered vegetable drugs); 
changes mercurous to mercuric salts. 
43 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Substances. 
Incompatibles. 
Chloroform (except in minute 
With water. 
quantity). 
Cocaine. 
Borax (but not boric acid) with which it forms an insoluble 
borate. 
Corrosive Sublimate 
Almost universally incompatible, especially with alkaloids 
(Mercuric chloride). 
and vegetable astringents; (exception: alkaline chlo- 
rides and some chlorides of the metals); iodide of po- 
tassium, unless solution of double salt is desired. 
Calomel. 
Alkalies; iodides; antipyrine; chlorates and chlorides; 
(Mercurotts chloride). 
salts of iron or of lead. 
Camphor (Spirit of). 
With water (precipitates). 
Carbonates and Bicarbonates. 
With acids and acid salts. 
Digitalis. 
Iron salts; tannin-bearing preparations. 
Emulsions. 
With alcoholic solutions (precipitate). 
Fluidextracts. 
Most of them precipitate with water. 
Glucosides. 
Tannin; strong acids (decompose); some alkalies 
(decompose). 
Hydrogen Dioxide. 
Decomposes readily in solution; loses value with alkalies. 
Iodine and Iodides. 
All alkaloids; starch; salts of the metals; strong acids; 
spirit of nitrous ether; turpentine; iodine mixed with 
ammonia water explodes upon evaporating. 
Iron Salts. 
Tannin (forms inks); alkalies; mucilages; arsenious acid 
(Ferric and Ferrous; Tinc- 
(arsenic trioxide) and its salts; all vegetable drug 
ture of Iron Chloride). 
solutions or preparations, excepting calumba, gentian, 
and quassia, which contain no tannin. 
Lead Salts. 
All alkalies (precipitate); all acid radicals except of 
acetate or nitrate, the only two soluble lead salts. 
Magnesia. 
Acid radicals (precipitate) with soluble compounds of 
magnesium, except citrate and sulphate; arsenic prepa- 
rations. 
Mercuric Salts. 
All alkaloids and alkalies; albumens or preparations con- 
taining albuminous material. 
Mucilages. 
Acids; iron salts; alcohol. 
Pancreatin. 
Acids. 
Pepsin. 
Alcohol; alkalies; tannin. 
Potassium Chlorate. 
Explosive [see page 45]: with organic or oxidizable sub- 
stances; decomposes iodides and calomel. 
Potassium Iodide. 
All strong acids and acid salts (see Corrosive Sublimate). 
Potassium Permanganate. 
See page 45: Explosive with deoxidizers; alkaloids. 
Resin-bearing Solutions. 
Water (precipitate). 
Silver Nitrate. 
All substances except nitrates and nitric acid. 
Spirit of Nitrous Ether. 
Antipyrine (forms poisonous compound); strong acids; 
(Sweet Spirit of Nitre). 
iodides of alkalies; mucilage of acacia, unless largely 
diluted; iron sulphate; tincture of guaiac; most 
carbonates. 
Tinctures (1) and all strong 
(1) Acacia; aqueous solutions. 
alcoholic menstrua; (2) If 
(2) Tannin; iodine and iodides; alkalies. 
containing alcohol. (3) If 
(3) Iron salts. 
containing oils (fixed) and 
Alkalies (form soaps). 
fats. 
Oils, Essential. 
Water (precipitates) unless not more than one minim of 
oil to one ounce of water. 
Vegetable Tannin-holding 
Salts of iron or of lead. 
preparations. 
Morphine. 
Bromides (precipitates on standing). 
Strychnine. 
Bromides (precipitates on standing). 
44 INTRODUCTION. 
Dangerous Explosive Mixtures. 
Oxidizers and Deoxidizers when triturated together. 
Do not mix any of the following together with trituration, as a dangerous explosion 
may result: 
Permanganate of Potassium 
Chlorate of Potassium 
Chromic Acid (Chromium trioxide) 
Picric Acid 
Bromates 
Iodates 
Concentrated Nitric Acid 
Nitrates 
Strong Hydrochloric Acid 
Nitro-Hydrochloric Acid 
Easily oxidizable material (anything 
that will burn), such as all Organic 
substances: Sugar, Powdered Drugs, 
Starch, Glycerin; Alcohols; Ethers; 
Tannin. Iodine and Iodides; Re- 
duced Iron; Phosphorus, Phosphites, 
and Hypophosphites; Sulphur, Sul- 
phides, Sulphites, and Hyposul- 
phites. 
with 
Do not mix Iodine with Ammonia (explosive upon evaporation) or with Turpentine 
(inflammable). 
Keep Phosphorus under water lest it become spontaneously inflammable. 
The Following Agents should be given without admixture with other 
drugs: Antipyrine, in capsule or powder, or with water or alcohol. 
Acetanilid, in capsule or powder, or with water or alcohol. 
Silver Nitrate in pill made with clay, talc, vaseline or cacao-butter, 
and enclosed in capsule. For external use dispense in aqueous solution in 
bottle of blue or brown glass to exclude actinic rays. Solutions of organic 
silver salts-Argyrol, Protargol, Silvol-should be similarly dispensed. 
Corrosive Sublimate should be given alone, as it is changed by or 
changes most other salts. 
Acids (unless greatly diluted), alkalies, alkaloidal salts, Antimony and 
Potassium Tartrate and Calomel should be given alone. Sometimes Bi- 
carbonate of Soda is given in tablet or powder with the latter. 
Spirits and strong alcoholic solutions should be diluted only at time 
of administration. 
Strophanthus decomposes gradually in water with the formation of a 
more poisonous substance: hence it should be dropped into water at time of 
administration. 
VII. THE MANAGEMENT OF ACUTE POISONING. 
Without going into detail in the matter of the definition and classifica- 
tion of poisons, nor to any extent into the symptoms produced by them, 
nor into toxicological analysis, we purpose to offer a few practical notes 
concerning the antidoting and treatment of acute poisoning by the energetic 
drugs most largely employed by Eclectic practitioners of medicine or en- 
countered by them as used by others. It is not easy, nor is it practicable, 
for the physician to hold in his memory the antidotes and necessary pro- 
cedures for all the poisons one may meet nowadays. While he can and 
should carry in his pocket a brief memorandum, most of such aids known to 
the writer are antiquated and of little practical value. The doctor would 
do better to compile his own list from authentic sources. 
For this article we have purposely selected a few of the agents most 
commonly employed by or encountered by Eclectic physicians, for we are 
most frequently asked for information concerning these drugs. Some 
45 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
others not so commonly employed by them are also included. It not in- 
frequently happens that an overdose of medicine is unintentionally ad- 
ministered, or that through some circumstance-idiosyncrasy, perhaps- 
toxic effects result from ordinary or even small doses of energetic medicines. 
Several times we have known small doses of aconite, belladonna, opium, 
lobelia, and ipecac to produce symptoms that might be regarded as mildly 
toxic. It is presupposed, in the matters treated of in this connection, that 
the drug taken and the amount are known. Therefore no space will be 
taken up in the consideration of discovering the unknown drug. 
General Considerations.-The first consideration in a case of acute poisoning is to get 
the poison out of the stomach as quickly as possible. At the same time there may be given 
such agents as are known to combine with or convert the poison into a harmless or, at least, 
less soluble condition or salt, or to physiologically antagonize its effects. Only substances 
that will dissolve in the fluids used or in the juices of the stomach will act as poisons. 
Hence, to render them less soluble or to throw them out of solution is a step always to be 
taken advantage of. Empty the stomach by the quickest known method. 
Means.-Emetics head the list of necessities. The quick-acting or irritant emetics 
are to be selected, except where the gastric membranes are so obtunded as to fail to respond 
to the emeto-stimulus, or when narcosis is profound. In such cases Apomorphine hydro- 
chloride (1-8 to 1-10 grain) hypodermatically is the most reliable aid. The list of good 
emetics include: 
Zinc sulphate, the best emetic for internal use; grains 20 to 30 in 2 ounces of water. 
Children, smaller doses (5 grains); repeat every 10 to 15 minutes until free emesis occurs. 
Copper sulphate, grains 10 in 2 ounces of water. 
Mustard, one-half to one tablespoonful in a half pint of lukewarm water; follow with 
plenty of tepid water. A teaspoonful of salt may be added if desired. 
Melted fats and bland oils are often protective, envelop and retard the action of the 
poison, and often produce emesis. They have little antidoting power (except in alkali 
poisoning) and should not be used in cases of poisoning by phosphorus, thymol, cantharides, 
or carbolic acid (phenol). 
With all emetics the patient should be made to drink from a pint to a quart of tepid 
water, and be encouraged to tickle the soft palate or to press down the base of the tongue 
with the finger. These are great aids to vomiting and alone may be sufficient to thoroughly 
empty the stomach. 
Other Emetics.-If the above-named emetics are not at hand, use- 
Ipecac, powdered, 30 to 40 grains in lukewarm water. 
Specific Medicine Lobelia, one-half to one teaspoonful in warm water. 
Compound emetic powder, one to three teaspoonfuls in plenty of warm water. Especially 
valuable where a stimulating effect is desired. 
Acetous emetic tincture, one to three teaspoonfuls in plenty of warm water. 
Stimulants.-These are often required in depressive poisoning. The best agents are: 
Brandy or whisky, two teaspoonfuls every 10 or 15 minutes, or 30 drops hypodermat- 
ically, using care not to produce alcoholic poisoning. 
Aromatic spirit of ammonia, one teaspoonful every 10 or 15 minutes, or 30 drops 
hypodermatically. 
Ether (sulphuric), 15-drop doses hypodermatically repeated as often as necessary to 
keep up the circulation. 
Coffee. Freshly prepared, strong black coffee freely administered. 
Atropine sulphate, 1-100 grain hypodermatically often has a sustaining stimulant 
action upon the breathing and the heart. 
Strychnine sulphate 1-20 to 1-30 grain hypodermatically, will help sustain the heart- 
action. 
Antidotes are of two kinds, chemical and physiological. 
Chemical antidotes combine with the poison to form new and harmless or less harmful 
compounds, or render it insoluble or less soluble. Examples: Egg-whites (albumen) for 
corrosive sublimate; common salt for silver nitrate poisoning. 
Physiological antidotes are those which counteract the effect of the poison which has 
been absorbed. Examples: Belladonna for opium poisoning; stimulants in nerve-de- 
pressing poisons; coffee in opium narcosis. 
Sometimes both chemical and physiological actions are exerted by the same antidote. 
The Stomach Pump.-This should be used where emesis is not easily accomplished. 
It should not, except rarely, be used where the membranes are destructively corroded or 
softened by the poison. 
46 INTRODUCTION. 
Lenitives and After-treatment.-Among the best lenitives for after-treatment are 
mucilages of starch, slippery elm, or acacia, albumen, milk, flaxseed tea, flour and water, 
oatmeal gruel, etc., and liquor bismuth and bismuth subnitrate. If these do not relieve 
irritation or pain, opiates, or hyoscyamus or similar agents, may be cautiously employed. 
Poisons. Acetanilid (and other coal-tar antipyretics).-Recumbent posture; stomach 
pump or emetic of mustard or zinc sulphate. Stimulate with aromatic spirit of ammonia, 
ether, brandy, or whisky. Give strychnine, 1-30 grain, to effect, and atropine sulphate 
to sustain arterial pressure and breathing. Artificial heat and forced respiration. 
Acid, Carbolic (Phenol).-Give freely of whisky, or dilute alcohol (cupful of alcohol 
and water, equal parts) and sulphate of magnesium (Epsom salt), or sulphate of sodium 
(Glauber's salt). Administer also diluted vinegar. Soapsuds, albumen, and mucilages 
retard the action of carbolic acid. Employ stomach pump at once, and repeatedly wash 
out the stomach. If pump is not at hand, give hypodermatic of apomorphine hydrochloride, 
1-10 grain. If no other means of emesis is at hand, use mustard. 
Acids, Corrosive (Nitric, Hydrochloric, and Sulphuric).-Neutralize with alkaline sub- 
stances, as lime water, soda solution, soapsuds, plaster from wall, oxide of magnesia. 
Use plenty of water and employ stomach tube. Avoid the use of the emetic if possible, for, 
if stomach is much corroded, the action is liable to rupture it; hence the preference for the 
stomach pump, or trusting to the results of chemical neutralization. 
Aconite.-Insist on recumbent posture, with head lower than the feet. Use stomach 
pump if possible. Emetics act poorly; if used, select mustard in plenty of warm water. 
Give strong tea and coffee. Use artificial respiration if breathing flags. Use stimulants, 
ether, brandy, aromatic spirit of ammonia, atropine sulphate. Maintain quiet as much 
as possible. 
AEsculus.-Use emetic of mustard or zinc sulphate or stomach pump. Stimulate freely. 
Alcohol.-Siphon out stomach, or give an emetic of mustard or zinc sulphate. Provide 
plenty of fresh air, and give ammonium chloride, 30 grains in half pint of warm water. 
Apply heat to body, and support the heart with strychnine nitrate, 1-30 grain, hypodermat- 
ically. Inhalations of aqua ammoniae cautiously administered may be of service. If 
asphyxiated, the electric current may revive. Draw the urine. 
Alkalies.-Neutralize with diluted vinegar, lemon or orange juice, or citric or tartaric 
acid, well diluted. Or convert into soaps by the use of bland oils or fats-melted lard, 
cottonseed or olive or sweet oil. Avoid emetics if stomach pump can be used, lest the 
softened stomach membranes become ruptured by the act of emesis. 
Alkaloids (and their Salts).-For this class of salts the following have been repeatedly 
recommended as valuable antagonists: Tannin, by reason of forming insoluble tannates 
with alkaloids; permanganate of potassium for morphine and strychnine; and animal 
charcoal, iodine, and albumen. Emetics are usually needed, and cathartics in some cases. 
Antimony (Tartar Emetic and other Salts).-Give freely of solutions of tannic acid, 
or preparations containing tannin (table tea, infusions of vegetable astringents); opium 
to check evacuations; and use the usual means to combat inflammation. Alcohol and 
digitalis may be required to support the circulation. 
Arsenic.-(See Fowler's Solution.) 
Atropine.-(See Belladonna; also Alkaloids and their Salts.) 
Belladonna.-Stomach pump or emetic of mustard, zinc sulphate, or ipecac, or apo- 
morphine hypodermatically. Keep patient in motion. Small doses of opium, morphine, 
or muscarine are physiologically antagonistic. Be governed by action of pupils in anti- 
doting with opium preparations. Pilocarpine nitrate said to be best physiological antago- 
nist. Employ heat to body, stimulate with brandy or ammonia, use artificial respiration, and 
catheterize to prevent reabsorption of poison from the urine. 
Bryonia.-Empty the stomach by siphon or emetic, using water copiously. If bowels 
have not freely moved, purge with Epsom salt or castor oil or demulcent enemata. Give 
freely of demulcents, stimulate with brandy or whisky, maintain body heat by external 
warmth, and administer morphine or other opiates to control pain and allay nervous 
irritability. Hot fomentations to the abdomen. 
Cannabis.-Stomach pump or emetic of mustard, zinc sulphate, or apomorphine. 
Give strong tea and coffee. Keep patient in motion and awake. Liberal doses of sweet 
spirit of nitre to encourage renal action. Catheterize, and give stimulants, particularly 
small doses of specific medicine belladonna or atropine sulphate. 
Cannabis Saliva (American Hemp).-Treat same as for Cannabis. 
Cantharis.-No chemical antidote. Use stomach pump preferably, or emetic of zinc 
sulphate, or mustard, or ipecac, or apomorphine hypodermatically. Give opium to relieve 
pain, stimulate with brandy. Use artificial heat and demulcent drinks. Do not use oils. 
Chloral.-Recumbent posture, with head lower than feet. Empty stomach with tube. 
Emetics are debilitating. Give liquor potassae (2 drachms in half pint of warm water) 
every hour. Give plenty of strong coffee or tea, and siphon out; or administer them per 
rectum. Strychnine sulphate 1-30 grain, or picrotoxin 1-60 grain, or amyl nitrite (3 to 5 
47 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
minim pearl crushed and inhaled), or brandy or whisky. Oxygen by inhalation; also 
ammonia. Apply cold to head, artificial heat to body, keep patient awake by shaking, 
flagellation, shouts, or by electricity. Artificial respiration, if breathing is labored. 
Chloroform.-Press jaw forward, and draw out tongue; use artificial respiration, 
slap the chest vigorously, forcibly and quickly dilate the rectum. Inject atropine sulphate 
and strychnine, or nitro-glycerin; employ external heat, and avoid alcohol or ether. 
Cocaine.-If used hypodermatically: Recumbent position, fresh air, artificial respira- 
tion, stimulants, and electricity. Brandy, ether, strychnine, atropine, belladonna, nitro- 
glycerin, or strong coffee may be used as stimulants. 
If swallowed: Precede treatment with use of stomach pump or emetic of zinc sulphate, 
mustard, or ipecac. Give tannic acid or strong tea freely and repeatedly while washing 
out the stomach. Control convulsive attacks with chloroform or ether. 
Colchicum.-Empty the stomach with tube or emetic. Give freely of tannic acid or 
strong tea. Use demulcents, as milk, eggs, mucilages, etc. ; employ artificial heat, relieve 
pain with opiates, and stimulate freely. Hot fomentations to the abdomen are grateful, 
and the bowels should be evacuated with castor oil. 
Colocynth.-Treat same as for Bryonia, which see. 
Conium.-Evacuate stomach by stomach pump or emetic of mustard. Give tannic 
acid or strong tea freely. Give demulcents. Keep head low; use stimulants as indicated, 
artificial heat, and artificial respiration. 
Digitalis.-Recumbent position. Stomach pump or emetic (zinc sulphate, mustard, 
ipecac, or apomorphine). Give tannic acid (30 grains) or strong tea freely while emesis is 
going on. Purge with Epsom salt or Rochelle salt. Fluidextract of soap bark or fluid- 
extract of senega are physiologically antagonistic. Give in 10-drop doses in tablespoonful 
of water. Aconite and tincture of opium may also be used. Stimulate with brandy or 
ammonia, and employ artificial respiration. 
Elaterium.-Treat same as for Bryonia, which see. 
Fowler's Solution of Arsenic.-Give freely of freshly prepared hydrated sesquioxide 
of iron, or use the official antidote (ferri hydroxidum cum magnesii oxidum), both in table- 
spoonful doses every few minutes. Use stomach pump or emetics repeatedly. Follow 
with opiates to relieve pain, and use stimulants to sustain circulation and respiration. 
Ergot.-Recumbent position; stomach pump or emetic. Plenty of strong tea or coffee, 
or solution of tannic or gallic acid. Purge with castor oil, Epsom salt, or 1 drop of croton 
oil; stimulate with nitro-glycerin, brandy, whisky, strychnine, or atropine. Employ 
friction and artificial heat. 
Gelsemium.-Siphon out the stomach, preferably, or give emetic of zinc sulphate, or 
mustard, or ipecac, or apomorphine. Give repeatedly liberal quantities of strong tea or 
tannic acid (30 grains) in plenty of water. Purge with castor oil. Stimulate with bella- 
donna or atropine, or whisky, strong coffee, aromatic spirit of ammonia, strychnine sul- 
phate (1-60 to 1-20 grain every 2 hours), or digitalis. Morphine (1-4 grain every 2 hours, 
or as required) is considered the most perfect antagonist. It should be used with care. 
Resort to artificial heat and forced respiration if needed. 
Helleborus Niger.-Same as for Veratrum, which see. 
Horse Chestnut.-Same as for AEsculus, which see. 
Hyoscyamus.-Same as for Belladonna, which see. 
Ignatia.-Same as for Strychnine, which see. 
Ipecac.-Wash out the stomach freely, give vegetable acids, as vinegar, lemon or 
orange juice, citric acid or tartaric acid, juice of currants, in plenty of water. Stimulate 
heart, if necessary, with brandy, atropine, ammonia, or digitalis. 
Lead and its Salts.-For acute lead poisoning use a solution of the soluble sulphates 
(magnesium or sodium sulphates, or "sulphuric acid lemonade"); opiates for pain. 
For chronic lead poisoning iodide of potassium (eliminant), opiates to relieve cramps 
and pain, castor oil or croton oil for intense constipation; electricity or strychnine to over- 
come paralysis. 
Lobelia.-Keep patient in recumbent position, and for some time after acute symp- 
toms subside. If stomach is not well emptied, use stomach tube or emetic, preferably 
zinc sulphate or mustard. Give freely of tannic or gallic acid, or strong tea and coffee. 
Purge with castor oil, and stimulate freely with whisky, ammonia, and heart stimulants, 
as strychnine, atropine, or digitalis. Use artificial heat, and morphine or opium may be 
required to relieve nervousness and pain. 
Jaborandi (Pilocarpus and Pilocarpine).-Evacuate stomach by siphon or emetic. 
Give strong tea or tannic acid freely. Atropine sulphate is antagonistic, or belladonna 
may be used. Stimulate freely, give strong coffee; and morphine may be required to check 
nausea and vomiting. 
Mercury Compounds.-Plenty of egg albumen whipped up in water. Evacuate the 
stomach rapidly by emesis or stomach tube. Employ stimulants and artificial heat to 
maintain circulation, and opiates for pain. (See also article on Mercuric Chloride.) 
Morphine.-Same as for Opium, which see. 
48 INTRODUCTION. 
Nitro-glycerin.-Apply ice, or cloths wrung out of ice water, to head. Relieve head- 
ache with belladonna or ergot. Stimulate with whisky or strychnine, if heart flags. 
Nux Vomica.-Same as for Strychnine, which see. 
CEnanthe.-Same as for Belladonna, which see. 
Opium (laudanum, paregoric, morphine, heroin, codeine, syrup of poppy, soothing 
syrups, black drop, Godfrey's cordial, Jackson's cough syrup, etc.). Keep patient moving 
by means of flagellation, shouting, slapping with wet towel, alternate dashing of cold and 
hot water, pinching, spinal cold.douche, etc., but take care not to exhaust the patient; 
resort to artificial respiration, and stimulate as quickly as possible. Evacuate stomach by 
means of tube or emetic, apomorphine being especially valuable. Give early 10 grains of 
potassium permanganate in pint of water. Remove this solution as quickly as possible, 
and repeat if necessary. If latter is not at hand, use tannic acid, strong tea, or animal 
charcoal freely. Cautiously administer small doses of atropine or belladonna, and copious 
quantities of hot, strong coffee. Give sweet spirit of nitre to keep up elimination, and 
catheterize. Diffusible and heart stimulants should be given, and rectal injections of 
tincture of capsicum may quickly arouse from stupor. Apply artificial heat, and resort to 
forced respiration. Do not walk the victim to exhaustion. 
Phenol.-(See Acid, Carbolic.) 
Phosphorus.-Do not give oils or fats, except old, thick (oxidized) oil of turpentine- 
Use stomach pump or emetic of sulphate of copper or mustard. Give freely of Epsom salt 
in solution. Opiates to relieve pain. 
Physostigma.-Empty stomach with tube or emetic. Give strong tea or tannic acid, 
or potassium permanganate (10 grains in 1 pint of warm water). Atropine (1-120 to 1-60 
grain) is best physiologic antagonist; chloral (10 grains every 1-2 to 1 hour) next. Stim- 
ulate and support heart with strychnine or nux vomica. Resort to artificial respiration. 
Phytolacca.-Siphon or emetic, with large quantities of water. Stimulate with brandy, 
ammonia, and relieve irritation and pain with bismuth and opiates. 
Rhus.-(Internally.) Treat as for Sanguinaria, which see. Purge with magnesium 
sulphate. 
Sanguinaria.-Wash out the stomach, or use emetic of zinc sulphate; give strong tea 
or tannic acid, stimulate freely, and administer opiates, bismuth, or demulcents to allay 
gastro-intestinal irritation and pain. 
Santonin.-Siphon out stomach or use emetics. Stimulate the heart with aromatic 
spirit of ammonia and strychnine, and give freely of strong coffee. Control convulsions 
with ether or chloroform. 
Scopolamine.-(Treat as for Belladonna, which see.) 
Silver Salts.-Give freely of solution of common salt. Administer albumen or milk as 
demulcents, evacuate the stomach, stimulate if necessary, and relieve pain with opiates. 
Staphisagria.-Same as for Bryonia, which see. 
Stramonium.-Same as for Belladonna, which see. 
Strophanthus.-Treat practically the same as for Strychnine, which see. Give also 
purge of Epsom salt, and employ artificial respiration. Emetics to be used are zinc sul- 
phate or mustard. 
Strychnine.-Empty stomach quickly by means of stomach pump or emetic; next to 
useless after tetanic symptoms have set in. Keep patient absolutely quiet, in recumbent 
position, in dark room. Allow no draughts of air to blow upon patient. Give freely of 
animal charcoal or tannic acid in water. Control spasms by inhalations of chloroform or 
chloral hydrate (by mouth, 30 grains; or by rectum, 60 grains). Potassium permanganate 
and iodine are said to be chemical antidotes. They must be given well diluted, and promptly 
removed from the stomach. 
Sulphonal.-If in the stomach but a short time, siphon or give an emetic (zinc sulphate 
or mustard, or apomorphine, with plenty of water). Administer Epsom salt (1-2 ounce) 
and sodium bicarbonate (1 drachm) in plenty of water. Give 2 teaspoonfuls of sweet 
spirit of nitre every 1 or 2 hours. Support the heart and lungs with diffusible stimulants 
and strychnine hypodermatically. 
Trional.-Same as for Sulphonal, which see. 
Veratrum.-Recumbent position, with plenty of fresh air. If free vomiting has not 
already occurred, evacuate the stomach with the stomach tube; or, if not at hand, use emetic 
of zinc sulphate or mustard. Give freely of tannic acid in solution, or of strong tea or coffee. 
Stimulate freely, employ artificial heat and forced respiration. Give opium or morphine 
to quiet pain and restrain action of the bowels. Hot tea assists in rapidly eliminating the 
poison by way of the kidneys. Catheterize. 
Veronal (Barbital).-Same as for Sulphonal, which see. 
Zinc Salts.-Tannic acid and albumen freely. Evacuate the stomach. Give lime 
water, soap suds, mucilages, and milk. Apply heat to abdomen and give opiates to relieve 
pain. 
49 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
VIII. THE DISPENSING OF MEDICINES. 
The necessities of the early Eclectics made them office pharmacists, 
and as such they prepared and dispensed their own medicines. Most of 
the remedies then in use among them and many of those just being intro- 
duced were not to be found in apothecaries' shops; besides, being counted 
irregular, there was not that harmony conducive to a good drug service 
between the doctor and the druggist. Moreover, the history of Eclectic 
progress shows that much of the vegetable remedies in use at the time the 
Eclectics came into the field were next to worthless, having been pre- 
pared from old or indifferent material. The Eclectic, crude though his 
methods may have been, and however inelegant his products, produced 
powerful medicines. This may be attributed to his study of plants and 
plant conditions, and to his partiality to fresh or to carefully preserved crude 
materials. Office pharmacy became popular among our physicians, and it 
was taught in our colleges. Gradually the making of medicines became 
largely a thing of the past, as Eclectic pharmacy per se supplied the neces- 
sary and reliable products desired-products of full strength, greatest 
power in smallest compass, and unsurpassed in elegance and convenience. 
But while the preparation of stock medicine was largely discarded, the 
custom of dispensing medicines from the office and during visits to the sick 
remained in vogue and has continued to this day and with ever-increasing 
popularity. The advantages of this custom are best known to those who 
follow it, and space will not be taken up in enumerating them. That they 
outnumber and outweigh the objections offered to the practice is evident 
from the tenacity with which our physicians cling to it and by the eagerness 
of manufacturers to place tablets and other forms of dry medicines in small 
compass directly into the hands of the physician. These forms, however, 
have never yet supplanted reliable liquid medicines. We would say some- 
thing, however, concerning the methods of dispensing. In the earlier days 
the conveniences for dispensing were not what they are now. The pre- 
scriber then had to dispense his own medicines. In this he followed his own 
fancy, and the ways of men left to themselves differ greatly. The paramount 
thought of all was the quality and power of the medicine and what it could 
accomplish therapeutically. Esthetics did not always enter into the dis- 
pensing of such medicines. The customary doses of nauseous medicines swal- 
lowed by people led them to expect nothing pleasant in the giving and the 
taking of medicines. Little uniformity or elegance then accompanied 
office dispensing, and we are sorry to note that antiquated and even slovenly 
methods still prevail among many, who may be good therapeutists. That the 
physician so dispensing harms not only his own practice but that of all 
followers of his school, for most Eclectics dispense, probably does not enter 
his mind. To such we would plead for a more elegant and up-to-date 
method for the good of the physician, the patient and the school at large. 
Were a druggist of to-day to dispense medicines as we have many times 
seen them dispensed from the doctor's office, he would soon have to part 
with his store and fixtures. An attractive store and elegant service draws 
trade. We have seen doctors use all sorts of bottles, some even using 
flavoring extract vials, and old corks, in dealing out their medicines. A 
label to match, with the directions scrawled upon it with a pencil, and a 
50 INTRODUCTION. 
piece of newspaper or a page torn from an almanac, or a journal, if per- 
chance a sample copy has strayed their way, complete the package. Some- 
times the label is pasted on, or perchance a string or rubber band holds it in 
place. Paper of any sort and size is used to envelop powders. These days 
will not long permit the continuance in practice of those who are thus 
careless and slovenly in the dispensing of medicines. Bottles must be of 
good quality and should have good new corks. The label should be neatly 
printed or engraved and should convey the necessary directions. The 
doctor's address should be on the label, the office hours particularly ap- 
pearing, and it should display no flaunting advertising matter. Suitable 
wrapping paper may now be had in tints and texture to suit the most 
fastidious, cut to size desired or rolled upon standards, furnished with a 
cutting blade. Powder papers of proper size, uniformity, and flexibility 
may now be had, and capsules, if not contraindicated, may be made to 
carry objectionable-tasting powders. All these cost but a trifle in the dis- 
pensing of a day and yield the dispenser untold profit. Medicines should 
not be compounded in the office in the presence of the patient, but all 
medicines should be out of sight in a laboratory or airy and well-lighted 
room devised for the purpose. Pills and tablets may be dispensed in small 
boxes or envelopes, and the homoeopathic vials come into frequent service 
for pills, powders, or tablets, as well as for liquid medicines to be admin- 
istered by drops. We knew a physician in Cincinnati, originally a homoeo- 
path, but with a strong leaning toward Eclecticism, who acquired an 
aristocratic patronage and amassed wealth largely through his punctilious- 
ness in dispensing. He employed a chemist to compound his medicines, 
invariably dispensed them in homoeopathic vials with velvet corks, the 
vials being placed in a handsome paper box and imbedded in jeweler's 
cotton. This, you will argue, was going to extremes. Perhaps it was, but 
it pleased his clientele and brought him a good round fee for his wisdom 
in so doing. That such a procedure would not suit all classes we freely 
admit, but we are safe in predicting that no patient will object to neatness 
and elegance in the dispensing of medicines; and that few there be who 
do not rebel, mentally at least, when slovenly served. 
Vehicles, Flavors and Corrigents.-What shall I use for a vehicle for 
my medicines? is a question the doctor frequently asks. Wherever it is 
practical we have no hesitancy in saying that water is the best and most 
uniform solvent and carrier for most medicines. Eclectics especially are 
wedded to water as a vehicle. If a medicine is disagreeable water seldom 
makes it more so, but, on the contrary, dilutes it so as to lessen its objection- 
able taste. The more a medicine is fortified with alcohol or other preserving 
or flavoring material, the sooner, as a rule, will the patient tire of taking the 
medicine. There are, of course, well-known exceptions to this. For in- 
stance, water increases the objectionable qualities of the valerianates, and 
by some patients sodium salicylate can not long be taken in water alone. 
Fluidextract of licorice with essence of wintergreen is the best combination 
we have found to render the salicylate pleasant and endurable. 
Unfortunately medicines put up in water alone do not keep well- 
Something must be added to counteract change. If the medicine is one 
that can be given in an acid medium and an acid is required by the patient, 
51 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
nothing serves better than hydrochloric or phosphoric acid. Glycerin is a 
favorite with many, for as a rule whatever can be dispensed in water can 
be dispensed in glycerin and water in variable proportions. This imparts 
slight sweetness to the medicines, tends to act as an antiseptic, and is 
particularly grateful to the stomach. We are aware that some object to 
its use, claiming that it tends to irritate the throat by causing abstraction of 
water therefrom. This we have not encountered when plenty of water is 
admixed with the glycerin. Such medicines as specific medicine iris, 
specific medicine cannabis, and specific medicine chimaphila, are best 
dispensed in glycerin with directions to add a certain quantity to water 
when the dose is to be administered. The aromatic, or medicated, waters 
find some advocates, but their use is limited as compared with former years. 
The best agent we have used in dispensing at the bedside, and particularly 
for children, is a few drops of specific medicine cinnamon. It gives a pleasant 
taste, mixes fairly well, sweetens and tends to preserve the mixture, and is 
decidedly antiseptic. It is seldom contraindicated, and if too much has 
been used it can be readily removed by dipping into the solution a piece of 
bibulous paper. Essence of cloves is also a good flavoring preservative, 
but lacks sweetness. 
An elegant preparation used by many is the simple elixir. This is, of 
course, quite strongly alcoholic, and already the alarmists are justly calling 
attention to the danger of fostering a taste for alcohol by its long continued 
use. Chloroform is one of the best flavoring, sweetening, and preserving 
agents, and is especially useful in summer. It may be used as chloroform 
water, readily prepared by shaking a drachm of chloroform in a quart of 
pure water, leaving always an excess of chloroform in the bottom of the 
container. This has the advantage also of being a pain reliever of especial 
value in gastro-intestinal disorders, flatulence, and as an ingredient of 
cough medicines. Another method is to mix equal parts of chloroform and 
alcohol (making practically chloric ether) and adding a few drops to the 
mixture to be dispensed. The chloroform water is to be preferred to this, 
as the chloroform frequently separates from alcohol on the addition of 
water. For medicines that permit of an alkaline medium, asepsin is a 
useful flavoring, sweetening, and preserving agent and is also carminative. 
Either asepsin or essence of wintergreen may be added to specific medicine 
macrotys when used as an antimyalgic and antirheumatic. When not 
contraindicated and a flavor is desired for the dispensing of medicines, the 
following agents not named above may be used: Specific medicines anise, 
caraway, cardamom, coriander, glycyrrhiza, nutmeg, orange-peel (bitter), 
pennyroyal, peppermint, pimenta, sarsaparilla, sassafras, and spearmint. 
Compound tincture of lavender is useful in preparations for infants, and 
camphor-water as a vehicle for gastric and bronchial sedatives. 
Often it is desired to overcome odor or bitterness. For the former the 
neutralizing cordial or glyconda, or syrup of sarsaparilla compound, are 
useful, if not otherwise objectionable. To overcome bitterness, syrups of 
licorice, coffee, chocolate, and eriodictyon compound are more or less 
effective, especially with quinine salts. Finally, simple syrup, plain or 
flavored, may be used as a vehicle for many medicines, but the disposition 
nowadays is to reject sugars on account of their tendency to induce 
52 INTRODUCTION. 
fermentative conditions in the gastro-intestinal tract. Should a syrup be 
desired, however, a choice may be had of the following: syrup of orange 
flowers or orange-peel, wild cherry, tolu, citric acid, ginger, vanilla, winter- 
green, or red raspberry. After all, water is the best medium for the ad- 
ministration of most fluid medicines, and as such has long been used by 
modern Eclectics who see little reason to depart from the practice. 
Coloring Agents.-It is sometimes desirable, for one reason or another, 
to color medicines that are colorless or nearly so when put up in water. 
We do not favor this, though many do, and undoubtedly is has its effect 
upon the patient-being one of those acts of so-called "harmless deception." 
For this purpose agents must be employed which impart color and practi- 
cally no taste. One of the least objectionable of these is caramel (a heavy 
semi-liquid burnt sugar). A very little of this will impart a beautiful 
transparent yellowish-brown to deepest brown tint, according to quantity 
used. We are not aware that it counteracts any of the commoner medicines 
in use. Owing to the irritating fumes given off in preparing caramel it is 
better to purchase it than to attempt to prepare it. It is cheap and a little 
of it goes a long way. For a yellow color, tincture of turmeric (curcuma) 
may be employed. A beautiful red is imparted by solution of carmine, and 
this is to be preferred over tincture of cochineal, once largely used, but 
which spoils readily owing to the fatty bodies present. As solution of 
carmine is alkaline through the small quantity of ammonia water em- 
ployed in producing a clear color, it can only be used to color neutral or 
alkaline mixtures. As a rule alkaline substances should not be used where 
there are present powerful alkaloids. For coloring acid mixtures, tincture 
of cudbear will give a beautiful bright red tint. If these agents are not 
desired for coloring, dealers in essential oils carry various colors freed 
from all harmful ingredients, which can be purchased at reasonable 
prices. 
The following Specific Medicines have been prepared to meet the needs 
of Eclectic physicians for either bedside or office dispensing: Specific med- 
icines caramel compound (brown), cochineal (red), cudbear (purple-red), 
curcuma (yellow), logwood (red), Poa pratensis, or blue grass (green). 
Syrup of red raspberry (Syrupus Rubi Idaei), when miscible and a syrup is 
not objectionable, is a favorite with many. It imparts a beautiful red 
color. 
This demand for colored medicines is occasioned by those patients 
who feel that they are getting better medicines when the latter appear 
more like those issued from the pharmacies. Personally, we shall welcome 
the day when all medicines are colorless, or as nearly so as it is possible to 
make them, for the natural color in most of them is only plant or other 
forms of dirt. 
Ointments may be colored pink with liquor of cochineal, from pink to 
red with powdered cochineal, yellow with curcuma, or green with 
chlorophyll. There is no good reason, however, for adding colors to oint- 
ments, and certainly none for any that may stain the tissues or garments. 
Practically all ointments have more or less color of their own due to the 
necessary ingredients they contain. 
53 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
IX. SPECIFIC MEDICATION. 
The theory of Eclectic specific medication is essentially as follows: 
Disease is a wrong or impairment of life. It may be due to forces, living or 
dead, within or without the body. Clinically it is manifest through well- 
defined symptoms or disease-expressions. The totality of symptoms ex- 
press a complex or state to which, in common nosology, a special name is 
given: that is, it is called a disease, as pneumonia, rheumatism, dysentery, 
etc. This disease-name is of value in the study of the natural history of 
disease for statistical data, for the purpose of recognizing contagion and 
infections, and for establishing a prognosis. The specific medicationist 
recognizes the necessity for such a nosological diagnosis for the purposes 
named, as do others of associated schools of medical practice. Unlike the 
latter, however, the Eclectic specific medicationist does not use such a 
diagnosis as a guide to aid him in drug selection. For therapeutic purposes 
he resorts to analysis of these group-symptoms or symptom-complexes 
(diseases) and attempts, so far as drug application is concerned, to discover 
the varying conditions of the patient regardless of the named disease, as 
evidenced by certain well-defined and specific symptoms revealing disease- 
expressions. 
Specific medication takes into account the facts that medicines have a 
certain force and are definite in action. Like effects flow from like causes. 
Hence, having found, by repeated experimentation, the opposing action of 
a drug in a condition of disease as expressed by definite symptoms, be- 
longing to it and to it only-whether objective or subjective-the same 
remedy will relieve or cure like abnormal conditions no matter what the 
name of the disease may be. Specific medication holds that there is a 
fixed relationship between drug-force and disease-expression. 
Specific medication does not admit of specifics for diseases as such, but 
specific remedies for specific conditions (phases of disease) of such diseases. 
Specific Diagnosis implies diagnosis to discover the condition curable or 
remediable by a certain remedy, the latter having been established as such 
by previous experimentation or experience; and Specific Medication means 
the application of the known remedy for the phase or condition of dis- 
ease so found. Specific diagnosis is, therefore, therapeutic diagnosis; 
not nosological diagnosis. Specific diagnosis is not for the purpose of 
finding out what the disease may be called, but what the specific condition 
and its remedy is. In practice the Specific medicationist is guided by the 
Specific Indication-a term used to express the fact that a specific con- 
dition existing as a part of a disease, and shown by symptomatic expression, 
indicates the employment of the remedy which has been repeatedly found 
to correct that abnormal phase or wrong of life. 
The Eclectic recognizes no law of cure. In this he differs from the 
Homoeopath. While he also prescribes symptomatically (with some ex- 
ceptions) in this resembling the latter, he does not prejudge the effect of 
his medicines because it has produced a certain action in health (drug 
proving). His prescribing is based upon past experience with a drug used 
successfully in disease-conditions. Empiricism enters largely into his 
practice, but rationalism or experimentation is not ignored. Both ex- 
perience and to a lesser degree the results of pharmacological investigations 
54 INTRODUCTION. 
furnish the basis of his medication, but he is guided in the administration 
of drugs by symptoms expressing conditions known to be specifically met 
by a drug and that drug only. 
Specific medication has a curative or palliative effect (according to the 
curability or non-curability of the disease-condition existing) when the 
known specific drug is specifically administered-a single medicine being 
effective in the same abnormal condition occurring in diseases even though 
the latter appear widely different from each other, if the name of the 
disease alone be considered. 
As examples of specific indications the following may be noted: the 
strong, large and full bounding pulse, indicates veratrum; the small frequent 
pulse in acute illness not depending upon sepsis, indicates aconite; the 
sharp, cutting or lancinating pain in serous tissues, bryonia; full, oppressed 
breathing, with sense of praecordial oppression and dyspnoea, not due to a 
diseased heart, lobelia; the moist tongue, soft, moist skin, open pulse and 
marked periodicity, but with freedom from nervous excitement, quinine; 
cadaverous odor of the secretions, potassium chlorate. Thus veratrum, or 
aconite, or bryonia, may equally be indicated in pneumonia, in pleurisy, 
or in acute rheumatism accordingly as the specific conditions are in evidence 
through specific indications. 
Classification of Specific Diagnosis and Specific Medication.-It is 
not possible, at present, to make a classification of Specific Medication 
that will perfectly represent it. The following scheme, however, will aid 
the student to an understanding of its more important features: 
I. Preventive Medicine. 
(a) General hygiene. 
(b) Mental or psychic influence. 
(c) Ablutions. 
(d) Massage. 
(e) Electricity. 
(J) Dietetics. 
II. Pathologic Diagnosis and Medication. 
(a) A knowledge of wrong in structure or function. 
(b) A knowledge of drugs which influence wrongs of structure or function. 
III. Symptomatic Specific Diagnosis and Medication. 
{a) Symptoms as expressions of pathologic processes. 
(b) Symptoms as related to palliative remedies. 
(c) Symptoms as related to curative drugs. 
(d) Epidemics and the relation of drugs thereto. 
(e) Endemic remedies. 
(/) Basic conditions and the basic remedy. 
IV. Chemical and Physical Specific Medication. 
(a) Catalytic action of drugs. 
(b) Antidotes and Antagonists. 
(c) Antiseptic or antiputrefactive action of drugs. 
(d) Antiparasitic action of drugs. 
(e) Antitoxic action upon toxines. 
(/) The supply of deficient chemical constituents to the body. 
(g) The chemical and physical destruction of formations and concretions upon 
or within the body. 
(A) The relation of drugs to metabolic processes. 
V. Surgery. 
(a) Palliative. 
(b) Curative. 
55 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
I. Preventive Medicine.-Preventive medicine is always specific. 
Within its province comes: 
(a) The study of dirt (to use a homely expression), whether it be 
dirty surroundings giving rise to disease through infection or contagion, 
or whether it be dirt generated within the body, as ptomaines, bacteria, 
and their toxins, or what not. The prophylactic use of diphtheria and 
tetanus antitoxins and the antityphoid and antivariola vaccines come 
within the legitimate scope of preventive specific medication. Other 
forms of preventive biologic medicine have not, as yet, been sufficiently 
proven as to become accepted as a part of specific medication. 
That "cleanliness is next to Godliness" is an old, but true, dictum. 
It applies especially in medicine. Our first duty toward the sick is to make 
his surroundings pleasant and cleanly. Not alone must the environment 
be clean, the food and drink clean, but the patient must be made as clean as 
possible, inside and out. This was a strong contention with the formulator 
of specific medication; and has been rigidly insisted upon by those whom 
he taught. Hygienic conditions must be safeguarded. Sunlight, whole- 
some air, and protection, as far as possible, from contamination through 
irritant and noxious gases, and the foul effluvia of privy vaults and sewers, 
are inalienable rights of the sick individual. 
(b) The patient's psychic or mental condition should have its quota of 
attention. Pleasant companions, cheerful surroundings, and wholesome 
literature and entertainment are more essential to some mind-sick mortals 
than any form of medicine ever could be. 
(c) The patient should be properly bathed, in one form or another, 
as indicated. Unless contraindicated, water should be given freely; and 
sometimes lavage and enemas are essentially specific measures for the 
relief of disease. As water is the universal purifier, so also is it the most 
generally useful solvent for impurities within or without the body. Being 
always abundant and accessible it should be used more freely than it is by 
the majority of patients. There is no reason why physicians should over- 
look ablutions, inside and out, when considering specific means to fight 
disease. 
(d) When able to take it a patient should be given plenty of properly- 
directed exercise. In the absence of exercise, manual manipulations may be 
substituted. Massage should be invoked for the benefit of those whose 
muscular tissues are lax, and nervous debility so great that either or both 
give rise to diseased states, or aggravate existing disorders. 
(e) Electricity is a factor that should enter into specific therapeutics 
with a view to its special adaptability to disease-conditions, and as to its 
effects in producing disease. The excess of electrical force manifest in 
some persons whose work confines them to shops and offices where electric 
power and lights are used, is sometimes productive of functional disorders. 
Thus electricity as a remedy and electricity as a disturber of function may 
equally well be taken into consideration. 
(f) The study of diet is a most important part of preventive, as well as 
of palliative and curative medicine. Its judicious application may pre- 
vent dyspeptic, intestinal, nervous, and nutritional wrongs-especially 
56 INTRODUCTION. 
diabetes, nephritis, arteriosclerosis, and other disorders now believed by 
many physicians to be chiefly due to errors of diet. 
The importance of the foregoing will not be ignored by the careful 
physician; and it should all be included in the study of specific diagnosis 
and medication, and given equal consideration with drug medication. 
Sections II, III, and IV deal with the outlines for the study of the 
specific application of drugs. These cover the subject of Specific Medica- 
tion proper and include those features which have been most fully developed. 
By some they alone are held to constitute the only part of medicine that 
is to be considered as Specific Diagnosis and Specific Medication. 
II. Pathologic Diagnosis and Medication.-In Section II we take 
into account the following: (a) the anatomic structure and physiologic 
functions of the normal body and the relation thereto of pathologic changes. 
To know a wrong of structure we must know the healthy body: to know 
a wrong of function we must know the normal function. ' Knowing the 
healthy part or function enables us to recognize the degree and kind of 
departure in pathologic states. Little would be gained, however, were 
we to rest here, where we have gone only so far as to find the wrong of 
life. We want to know what will change the morbid state to one of health, 
and this is the province of Specific Diagnosis and Specific Medication. 
We proceed as in subsection 
(b) To study remedies as related to diseased or disordered structure or 
function. 
III. Symptomatic Specific Diagnosis and Medication.-In Section III 
we have before us: (a) the study of drugs repeatedly known to have cor- 
rected abnormal conditions as evidenced by symptoms-symptomological 
selection. Here we must carefully note what pathological states have 
been repeatedly marked by the same symptoms, and, having recognized 
these conditions by the symptoms, apply the remedy which experience 
has proved best adapted to correct such wrongs. 
(b and c) Some pathologic states are incurable; others, being curable, 
yield most readily when the known specific drug is applied. In other words, 
the relationship between a pathologic condition and the action of a certain 
drug or drugs is so unvarying that, if no mistake has been made in the 
specific diagnosis, palliation or a cure results. 
(d) Epidemics seem to bear a peculiar relation to some remedies. 
It has been observed during years when epidemics were prevalent that there 
were among diseases occurring during or after the epidemic peculiar symp- 
toms or disease-expressions indicating certain established remedies. Thus 
in one year the well-known indication for Baptisia was present; another 
season, the symptoms called for Rhus; while still another, Tincture of Iron 
Chloride was the most needed medicine. Further than this, it has been 
noted that a disease condition depending upon or having its origin in 
a former attack of illness occurring during an epidemic, even when coming 
on, or recurring several months or years after the original attack, is curable 
or relievable by the remedy whose indication was most prominent during 
the original epidemic. Such drugs have been denominated Epidemic 
Remedies. 
57 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
(e) That which applies to the Epidemic Remedy is true also of En- 
demics and the Endemic Remedy. 
(f) The relationship between basic conditions and causes of disease 
and the known remedy therefor has assumed wider significance and 
greater proportion in recent years, since scientific investigations have re- 
vealed the definite causative factors in a few diseases. Long ago the 
specific medicationist used sodium sulphite for the condition as expressed 
by symptoms denoting a zymotic causation of certain disorders. Long ago 
he recognized the importance of periodicity as an indication for quinine. 
As the periodicity, in malarial fevers at least, takes place while the path- 
ogenic protozoa are going through a certain phase of their life-cycle (sporu- 
lation), he was right in applying his Specific Medicine for the condition as 
shown by the basic indication of periodicity, though he did not then know 
the exact cause of the condition. Thus it frequently happens that a 
whole train of morbid processes, call it disease if you will, depends upon a 
single primary or basic cause, giving rise to basic symptoms, and a remedy 
which will correct that basic wrong, will rectify the whole process of illness. 
This is the nearest the Eclectic specific medicationist has come to having 
"specifics for diseases." Even here he does not recognize malaria, but a 
phase of that disease recognizable by specific symptoms, as the basis for his 
prescribing. He even goes farther than noting mere periodicity, one of the 
main links in his chain of specific indications, but adds, "when the nervous 
system is not excited, the tongue is moist and cleaning, the skin moist, and 
temperature not elevated." In this one may readily detect the period of 
quiescence in intermittents, before the recurring chill and subsequent 
febrile exacerbation-the time recognized by most clinicians as the moment 
to administer the antiperiodic drug-a clinical condition and a therapeutic 
propriety, the philosophy of which is now well explained by our under- 
standing of the presporulation period, or new invasion of the infecting 
protozoa. Here he does not treat the disease malaria, but the disease con- 
dition as expressed by specific symptoms. If it be contended that this 
amounts to "treating the disease," in this and a few similar instances, he 
has not viewed it as such, for he bases his procedure, as in medicating other 
conditions, upon the specific indications present. 
There has always been a misconception as to the meaning of the term 
Specific as used in Eclectic medicine. The regular school long maintained 
the attitude that there were no specifics for diseases, but erroneously at- 
tributed such a claim to Eclectics, misconstruing this interpretation of 
Specifics for disease-conditions to mean "specifics for diseases." 
Now the old school has its "specifics for diseases," as mercury and arsenic 
for syphilis and other spirillar diseases; thymol and oil of chenopodium, 
for hookworm disease, quinine for malaria, sulphur for the itch, salicylates 
for rheumatism, and numerous serums and vaccines for diseases due to 
infections. 
Another example of the use of the Specific Medicine for a basic wrong 
is well-illustrated in certain gastro-intestinal disorders, several apparently 
separate conditions depending upon one prominent wrong, which, when 
corrected, is followed by relief from the other symptoms. Thus, when 
58 INTRODUCTION. 
seemingly uncontrollable vomiting is dependent, not primarily upon a dis- 
order of the stomach, but is due to an irritation of the brain through 
determination of blood to that organ, as revealed by the symptomatic 
expressions-bright eyes, contracted pupils, and intense nervous agitation, 
-the remedy which will relieve is gelsemium. The surety with which that 
drug has repeatedly checked vomiting under these conditions entitles it 
to be called here the Basic Remedy. 
IV. Chemical and Physical Specific Medication.-(a) Certain drugs 
are generally believed to induce or facilitate the breaking-down of tis- 
sues or the elimination of deleterious products of the body; or, if they 
are not directly the cause of such phenomena, or "retrograde metamor- 
phosis" as it was once called, act as catalytics-drugs which by their 
very presence favor the elimination of waste material. The iodides are 
familiar examples of this class, and acetate of potassium is especially active 
as an eliminant. The larger number of alteratives, specific or other- 
wise, probably act in some manner so as to favor these processes. 
(b) The chemical antidotes to poisons, as well as those which physically, 
or in some unexplained manner, antagonize the effects of poisons, belong 
within the domain of specific medication. The acids are specifically antago- 
nistic to the action of alkaline substances, and the latter are used to antidote 
the acids by neutralization. Some chemical compounds act as specific 
antidotes by combining with the soluble poison to form insoluble salts, 
which by reason of their insolubility cannot enter the circulation and 
thereby exert their toxic effects. Such is the case when calcium carbonate 
(chalk) is administered to antidote oxalic acid. Other antidotes produce 
comparatively non-toxic products when combined with the poisons, as 
when albumen is used to antidote mercuric chloride poisoning, or when 
hydroxide of iron is employed to hinder the action of arsenic. In such 
cases, however, these apparently non-poisonous products must be gotten 
out of the stomach, for they are still poisons, though of lesser virulence 
than the original substance. Common salt prevents the toxic action of silver 
nitrate by forming the less poisonous silver chloride, thus giving more time 
to evacuate the stomach when a poisonous dose of the former has been 
swallowed. 
(c) Some drugs destroy the lower forms of organic life. These are the 
antiseptics, and antiferments, and antiputrefactives. Notable in this class 
are phenol, mercuric chloride, salicylic acid, potassium permanganate, and 
asepsin. Salicylic and sulphurous acids and the salicylates and sulphites 
are active antiferments, and baptisia and quinine antiputrefactives. These 
drugs are indicated in disorders having putrefaction or fermentation as 
prominent factors. Hydrogen dioxide will destroy pus, and is also to a 
degree antiseptic. This is a very important and useful class of drugs, 
and for many of them specific indications have been established. 
(d) Certain drugs specifically attack and overpower or kill parasites. 
Sulphur destroys the itch-insect and the harvest mite; corrosive sublimate, 
staphisagria, or cocculus, pediculi; santonin assists in the removal of the 
round-worm; quassia the seat-worm; granatum and male-fern the tape- 
worm, and thymol and oil of chenopodium the hookworm. Quinine and 
arsenic destroy certain protozoal parasites within the blood. 
59 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS, 
(e) Antitoxins antagonize the effects of bacterial toxines within the 
body, and some of them probably destroy bacteria or limit their activity. 
Most likely the specific action of mercury and of arsphenamine is due to a 
somewhat similar action, though purely bio-chemical, to that of the bio- 
logical antitoxins. The established antitoxins are the antidiphtheric, 
the antitetanic, and possibly the Pasteur products for the treatment and 
prevention of rabies; and of the vaccines, the anti variolic and antityphoidaL 
Other serums and vaccines are as yet in the experimental class. 
(f) Some drugs supply deficiencies in the constituents of the blood 
or other fluids, or correct abnormal conditions of those fluids. Acids are 
indicated when the blood is excessively alkaline (as shown by the deep 
redness of tissue); alkalies when lessened alkalinity (not acidity) predomi- 
nates. (This is recognized by pallor of the tissues). Potassium chlorate is 
administered in pyaemia and septicaemia, and certain forms of septic ab- 
sorption, for its chemical action upon the fluids of the body (cadaverous 
odor of secretions and excretions). Iron, phosphorus and sodium and 
potassium salts are given to supply deficiencies of such compounds in the 
tissues of the body. 
(g) Another type of chemical and physical specifics includes those which 
act upon the solid substances and formations found upon or within the 
body. It is necessary to bring these agents into direct contact with the 
offending substance, as false formations or concretions within the tubal 
structures of the body. Thus hydrochloric acid will destroy bony ex- 
crescences, chloroform biliary calculi, could it be made to reach them, and 
such is the effect of pepsin and trypsin and other tissue digestants upon 
diphtheritic and other deposits, and the action of lithium and other alkaline 
compounds in dissolving the cementing substances and thus dissociating 
the particles of calculous concretions. 
V. Surgery.-Surgery is always specific. It, like medicine, has its 
specific indications. There is a definite wrong depicted, a definite object 
sought, and a definite way of obtaining results. Surgical measures may be 
merely 
(a) Palliative, as in paracentesis abdominis for ascites, due to malig- 
nancy, or for the removal of recurrent carcinomata. Or it may be 
(b) Curative, as in the removal of the uterine appendages for ovarian 
disease, in appendectomy for appendicitis, or in cutting away a portion of 
the veins for the cure of varicocele. 
XI. PRESCRIPTION WRITING 
Definition.-Prescription (Latin, prascriptio) is a term derived 
from two Latin words pra and scribo, meaning "written before." In the 
most restricted sense, a prescription is an order from the physician to the 
druggist for the preparation of a medicine, with instructions for its ad- 
ministration. 
The Prescription Blank.-A Prescription Blank should be either 
plain, or may bear across the top the physician's name, address, including 
city or town, and, if desired, his office hours and telephone number. As a 
convenience for Federal compliance it mav also contain his Federal registry 
60 INTRODUCTION. 
number. It is not considered good taste or highly ethical to use blanks 
furnished by druggists, bearing their name and place of business, or any 
advertising matter. 
Date of Prescription.-Always date the prescription. The date 
is required on prescriptions coming under the Federal Narcotic Law and 
that pertaining to alcohol. Besides if a fac-simile or carbon copy of the 
prescription be preserved by the physician the date may serve as valuable 
data for record, or for use in case of litigation. 
The date, preferably, should be written in full. To use only the 
calendar number for the month might cause confusion between the month 
and the day of the month. Thus 4. 9. '12 may be interpreted as April 9th, 
1912, or may be read 4th day of September, 1912. Some avoid this chance 
of error by using Roman numerals for the month, thus IV. 9. '12. As the 
prescriber dates the prescription for record and reference for himself or to 
meet legal contingencies, it is the better part of wisdom to write the date 
in full. 
Name and Address of Patient.-The name and address of the pa- 
tient should appear somewhere on the prescription, perferably in the upper 
left-hand corner. It insures the package being properly marked for the 
person intended, and when carbon copies are kept enables the prescriber to 
keep his records. 
Prescriptions for Narcotics or Alcohol.-If the prescription is for 
or contains a narcotic coming under the ban of the Federal Narcotic Act, 
the patient's name and address, the date of the prescription, and the name, 
address, and registry number of the physician must appear on the order. 
If a quantity is to be given, or the prescription repeated, a valid reason 
must be shown thereon why it should so be acquired and administered, as 
when a patient is suffering from an incurable disease, or that it is necessary 
to sustain life. As the regulations of the Government change from time to 
time, the doctor must keep informed of such changes and prescribe ac- 
cordingly. 
In the case of alcohol only a certain amount may be allowed by the 
Government to be prescribed for a given time, and all of the items named 
above must appear upon the prescription. Not alone must the street 
address be given, but if the patient lives in an apartment its number must 
also be included. 
Medical Latin.-Prescriptions are usually written in Latin, but few 
are correctly composed. For the latter reason it is better to write the order 
in English than to present it in bad Latin. As the chief purpose of the 
prescriber is to express himself so that his desires as to the preparation he 
orders cannot be misinterpreted, it matters little whether the pre- 
scription be in Latin or English. As a matter of fact in so-called Latin 
prescriptions, the order is written partly in Latin and partly in English. 
Even among those who write prescriptions there are many in high 
standing who advocate the discarding of Latin entirely in prescription- 
writing. However, the greater percentage of prescriptions are written in 
Latin, more or less perfectly. The chief consideration urged against the 
61 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Latin prescription is the generally imperfect form in which it is written. 
The considerations for it are: It is a dead language, not subject to change, 
and is more definite and concise; it is the language of science; there are 
often several English names for the same substance and again the same Eng- 
lish word is sometimes used for many substances. A very important reason is 
that, if constructed in Latin, the patient is ignorant of the drugs ordered, 
and therefore cannot set up his own prejudices and fears, and exercise his 
own self-supposed better judgment against that of the prescriber, as to the 
action and dosage of the medicine ordered. Moreover, it avoids the estab- 
lishment of self-medication on the part of the patient. Latin prescriptions, 
being in an unchangeable language, are readily understood and easily 
translatable in any part of the civilized world. 
The names of drugs, in official guides and materia medicas, are usually 
given in Latin and in the nominative case. These are followed by English 
synonyms. For the purpose of writing prescriptions, changes in the termi- 
nation of these names are important and necessary to be learned by the 
prescriber. To write a prescription in Latin then: 
1. The first requisite is to know the Latin name or title of the drug, 
which is always in the nominative case. Examples: Morphina, Quinina, 
Cinchona, etc. 
2. In the list of ingredients in the prescription the Latin nominative 
is changed to the genitive, it being an order to the pharmacist. Thus, 
Quinina sulphas is changed Quinines Sulphate's, Morphina Hydrochloridam 
to Morphines Hydrochloride, Cinchona to Cinchones, etc. 
3. The directions to the druggists as to method of compounding is 
usually abbreviated Latin, therefore the word terminations are not required 
to be learned by the prescriber. 
RULES AND GROUPS OF TERMINATIONS. 
Remembering, then, that the Latin official name of a drug is in the 
nominative, and that the names of the drugs in a prescription are written in 
the genitive (the prescription being an order to the druggist), it is necessary 
to know the Latin official drug name and the change of termination into 
the genitive. The following rules, groups, examples, and exceptions will 
help the prescriber to formulate any prescription. 
a-Nouns ending in the Latin nominative in a change, in the genitive, to ce. 
Example: Morphina (nom.), Morphinae (gen.). 
[Exceptions: Aspidosperma, Cataplasma, Enema, Gargarisma, Physostigma, and 
Theobroma. It will be observed that each of these names end in a preceded by w; 
these take the genitive atis. Folia is plural; foliorum is the genitive; Coca is usually 
unchanged though some write it Cocse.] 
It will help if the student will remember that (1) all names of alkaloids end in the 
nominative a and change in the genitive to ce; (2) that the terminology of classes of 
preparations whose names end in a also take the genitive ce, as Aqua (ae); Tinctura 
(ae); etc. 
ma-Nouns ending in the Latin nominative in ma change, in the genitive, 
to atis (see Exceptions above). Example: Aspidosperma (nom.), As- 
pidospermatis (gen.). 
62 INTRODUCTION. 
as-Nouns ending in the Latin nominative in as change, in the genitive, to 
atis. Example: Sodii Bicarbonas (nom.), Sodii Bicarbonatis (gen.). 
[Exceptions: Asclepias (nom.), Asclepiadis (gen.); Mas (nom,), Maris (gen,); 
Rhoeas (nom.), Rhoeados (gen.). 
The following remains unchanged: Sassafras.] 
1-Nouns ending in the Latin nominative in I change, in the genitive, to is. 
Example: Phenol (nom.), Phenolis (gen.). 
[Exceptions: Fei (nom.), Fellis (gen.); Mel (nom.), Meilis (gen.); Sumbul (nom.), 
Sumbuli (gen.). Some do not change the last-named. DeLorme makes this ending w]' 
o-Nouns ending in the Latin nominative in o (without a preceding g) 
change, in the genitive, to onis. Example: Sapo (nom.), Saponis (gen.). 
[Exceptions: Mucilago (nom.), Mucilaginis (gen.); Ustilago (nom.), Ustilaginis 
(gen.). It will be observed that each of the foregoing ends in go; these take the 
genitive inis. 
The following remain unchanged: Condurango, Kino, and Matico.] 
us, um, os, on-Nouns ending in the Latin nominative in us, um, os, or on, 
change, in the genitive, to i. Examples: Hyoscyamus (nom.), Hy- 
oscyami (gen.); Maltum (nom.), Malti (gen.); Pothos (nom.), Pothi, 
(gen.); Haematoxylon (nom.), Haematoxyli (gen.). 
[Exceptions: Bos (nom.), Bovis (gen.); Erigeron (nom.), Erigerontis (gen.); Flos 
(nom.), Floris (gen.); Limon (nom.), Limonis (gen.); Rhus (nom.), Rhois (gen.). 
The following remain unchanged: Cornus, Fructus, Haustus, Quercus, Spiritus, 
and Potus]. 
It will facilitate prescribing if it be remembered that (1) all metals, (2) all gluco- 
sides, (3) neutral principles, (4) all parts of the names of acids (which always, with the 
exception of glaciale, end in um), and all (5) names of classes of preparations, which 
end in um end in the genitive i. In the forming of the nominative um in glucosides and 
neutral principles, the latter is added to the English name of the preparation; thus 
Strophanthin, Strophanthinwm.] 
is-Nouns ending in the Latin nominative in is change, in the genitive, to 
idis. Example: Cantharis (nom.), Cantharidis (gen.). 
[Exceptions: Arsenis (nom.), Arsenitis (gen.); Pulveris (nom.), Pulveritis (gen.); 
Phosphis, Sulphis, and other names of salts ending in is take the genitive itis-, e. g., 
Sulphis (nom.), Sulphitis (gen.).] 
x-Nouns ending in the Latin nominative in x change, in the genitive, to cis. 
Example: Nux Vomica (nom.), Nucis Vomicae (gen.). 
e, en, ps, r-Nouns ending in the Latin nominative in e, en, ps, or r, take 
respectively, in the genitive, es, inis, ipis, or ris. Examples: Aloe 
(nom.), Aloes (gen.); Alumen (nom.), Aluminis (gen.); Adeps (nom.), 
Adipis (gen.); Liquor (nom.), Liquoris (gen.). 
UNCHANGED.-Nouns in which no change is made-the nominative 
and genitive being the same, are: yEthyl* (Ethyl), Amyl*, Azederach, 
Berberis*, Buchu, Cannabis, Caoutchouc, Condurango, Cornus, Curare, 
Cusso, Digitalis, Fructus, Gambir, Haustus, Hydrastis, Jaborandi, Kino, 
Matico, Menthol*, Potus, Quercus, Sabal, Sago, Sassafras, Sinapis, Spiritus, 
Sumbul*, and Thymol*. 
[Exceptions: * Amyl is sometimes rendered Amylis; Berberis, Berberidis; and Sumbul, 
Sumbuli or Sumbulis. While no change is made in the genitive in the British names, Chloral, 
Ethyl, Menthol, and Thymol, in the United States these are written as follows: Chloralum 
(nom.), Chlorali (gen.); ALthyl (nom.), ALthylis (gen.); Menthol (nom.), Mentholis (gen.); 
and Thymol (nom.), Thymolis (gen.).] 
The following names of classes of preparations (see above for those 
ending in a and um), have the nominative and genitive as follows: Con- 
fectio (nom.), Confectionis (gen.); Mucilago (nom.), Mucilaginis (gen.); 
Elixir (nom.), Elixiris (gen.); Liquor (nom.), Liquoris (gen.); Mel (nom.), 
Meilis (gen.); Pilulae (nom.), Pilularum (gen.); Pulver (nom.), Pulveris 
63 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
(gen.); Spiritus (nom.), Spiritus (gen. [no change]); Syrupus (nom.), Syrupi 
(gen.); Trochisci (nom.), Trochiscorum (gen.). 
All adjectives agree with their nouns in number, gender, and case. 
As they are usually abbreviated in writing prescriptions, it is not necessary 
that their terminations be learned. Moreover, they usually correspond 
in both English and Latin. 
CONSTRUCTION OF THE PRESCRIPTION 
A Prescription should contain at least five parts, viz: (1) Super- 
scription; (2) inscription; (3) subscription; (4) signature; and (5) the 
prescriber's name. 
Some add to the foregoing: (1) date; (2) name and age (if desired) of 
patient. 
The Superscription, or Heading, consists of the symbol 1$, meaning Recipe or "take 
thou." (Some authors include in the Superscription all above the Inscription or list of 
ingredients. This then would include the date and patient's name, address, and age.) 
The Inscription contains the names of the ingredients and the quantities to be used. 
This is usually in Latin. 
The Inscription is divided into 
Basis.-The principal medicinal ingredient; 
Adjuvant.-That which aids the action of the basis; 
Corrigent or Corrective.-That which modifies the action of the other ingredients. 
Vehicle.-The indifferent substance or carrier, with which the other ingredients 
are incorporated to facilitate dispensing and administering. 
The Subscription consists of directions to the druggist as to the kind of preparation 
desired and how it shall be labeled. These instructions are usually in Latin abbreviations. 
The Signature, introduced by the sign 5. or Sig. (srgna=mark), comprises the in- 
structions to the patient or nurse, directing how and when the medicine is to be taken. 
This is always in English. 
Lastly should follow the prescriber's name in full. 
Arrangement of Items in the Inscription.-The ingredients are 
usually arranged in the order of their importance-the chief component, 
then the adjuvant, corrective, and vehicle or excipient, if any. If the order 
of compounding is understood by the physician he may place the items in 
proper sequence for preparation. This, however, is the business of the 
pharmacist and it is not to be expected of the prescriber that he be ac- 
quainted with the details of the pharmaceutical manipulation. 
Each word of the name of an ingredient should begin with a capital 
letter, as Tinct. Aconiti; Syr. Pruni Virg. Custom, however, varies in this 
respect. 
Known and unmistakable and official abbreviations may be used 
instead of full names of drugs, but great care must be taken to have them 
exact and not ambiguous. Thus, these and some other abbreviations are 
dangerous: Aconit. may mean Aconite or Aconitine; Acid Hydroc. either 
Hydrochloric Acid or Hydrocyanic Acid; Hyd. Chlor, may call for Chloral 
Hydrate, Calomel, or Corrosive Sublimate. 
Specific Directions.-In the prescription the directions to the druggist 
may be, and usually are, abbreviated, and in a Latin prescription are 
written in Latin. 
The directions to the patient should always be carefully and plainly 
written out in full and always in English; and the compounder must 
duplicate exactly these directions upon the label placed upon the finished 
package. Indefinite directions should be avoided in the prescription, such as 
64 INTRODUCTION. 
"Use as directed" supported only by verbal directions to the patient, who 
at time of hearing them may have his mind perturbed by pain, or excitement, 
or may be afflicted with a fickle memory. Neither should the time be loosely 
expressed, as "Take One Teaspoonful every two or three hours," without 
included written reasons for the one period or other of administration. 
Common Abbreviations in Prescriptions: 
IJ = Take, or Take thou. 
gr. =grain or grains. 
Gm. = Gram or Grams (Capitalize the G to prevent confusion with gr. for grain). 
3 = drachm or dram. 
5 = ou nee. 
fl3 (or f 3) = fluid drachm. 
fl5 (or f§) = fluid ounce. 
c. c. = cubic centimeter (mil). 
mil = milliliter (c. c.) 
mg. = milligram. 
O = pint. _ 
a a (ana)or aa = of each. 
ss (semis) = a half. 
q. s. =a sufficient quantity. 
ad =to or up to (not needed after q. s.). 
Sig. = Write, or mark the directions to nurse or patient. 
No. = number (as number of powders required to be made). 
Ft. = make. Fiat (plural, Fiant; abbreviated, ft.) is also used, meaning let it.(or them) 
be made. 
Cap. (not caps.) = capsule or capsules. 
Pil (not pils). =pill or pills. 
gtt. (not gtts.) =drop or drops. 
M (or min) or ii]j = minim or minims (an accurately measured drop). 
M. (or Misce). = Mix. 
Non rep (or Ne rep). = Not to be repeated or refilled. 
Q. R. (quantitum rectum). = the quantity is correct (to be used where doubt might 
arise as to the physician's intention). Underscoring the quantity or the whole or part of 
the name of an ingredient has the same significance. 
Pp. (Pauperissimus) = pauper. A request to the compounder not to charge for service 
as the prescriber has also given his service free. 
(For other abbreviations see List of Abbreviations.) 
Illustrative Prescriptions: 
1. For a Cough Syrup: 
For Thomas Jones (age 60), 
510 Broadway, Denver, Col. 
Sunerscriot'^"-"R 
Fluidextractum Lobeliae fl5ij 
Ammonii Chloridi gr. xxx 
Tinct. Opii Camphorat ae flgss. 
Syr. Pruni Virg. q. s. flgiv. 
Basis. 
Adjuvant. 
Corrective. 
Vehicle. 
Inscription 
Subscription-M (or misce). 
Signature-Sig. One teaspoonful every three (3) hours. 
Jan. 10, 1902. John Rush, M.D. 
2. For Dermatitis: 
For John Alden, age 10, 
Mt. Holly, Mich. 
3 
Acidi Borici 5} 
Magnesii Carbonatis 3 iii 
Talci Purificata 3v. 
M. 
Sig. Dust upon the parts as needed. 
Feb. 2. 1887. John Rush. M.D. 
65 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
3. For Scabies: 
For Peter Parley (30), 
Westwood, Ohio. 
I|. Sulphuris Sublim. 3j. 
Betanaphtholis gr. xxx 
Liq. Potass. Hydrox. gtt. xv 
Adipis Benzoinati q. s. 5 ij- 
Misce. 
Sig. Apply to skin after a hot bath and friction. 
Mar. 10, 1901. Benjamin Weston, M.D. 
4. For Dysentery: 
For John Doe (age 20), 
730 Baltimore Ave., 
Cincinnati, Ohio. 
H. Nov. 1, 1912. 
Magnesium sulphate 3i 
Specific Medicine Ipecac gtt. xv 
Specific Medicine Aconite gtt. x. 
Water ad fl5iv. 
Mix. 
Sig. One teaspoonful every (1) hour. Peter Mars, M.D. 
In using Specific Medicines the drop is used, based on custom of bedside 
prescribing, rather than the minim. 
5. For Full Bounding Pulse: 
For Martin Luther (age 60), 
Mt. Washington, N. H. 
June 30, 1908. 
T$. Specific Medicine Veratrum gtt. xxx. 
Water q. s. fl 5iv. 
Mix. 
Sig. One teaspoonful every half (X) hour. 
Henry Henderson, M.D. 
XII. WEIGHTS AND MEASURES. 
Troy or Apothecaries' Weight. 
20 grains (gr.) = 1 scruple (3) = 20 grains. 
3 scruples (9) = 1 drachm (3) = 60 grains. 
8 drachms (3) = 1 ounce (3) = 480 grains. 
12 ounces (3) = 1 pound (lb) = 5760 grains. 
Wine or Apothecaries' Measure. 
60 minims (m) = 1 fluid drachm (fl3 or f 3) = 60 minims. 
8 fluid drachms (fl3) = 1 fluid ounce (fl3 or f3) = 480 minims. 
16 fluid ounces (fl 3) = 1 pint (O) = 7680 minims. 
2 pints (O) = 1 quart (qt.). 
4 quarts (qts.) = 1 gallon (Cong.). 
Metric Weight. 
(Approximate Equivalents). 
1 Milligramme (mg. or mgm. = 0.001) = grain (gr.) 1/64 
1 Centigramme (eg. or cgm. = 0.01 ) = grain (gr.) 1/6 
1 Decigramme (dg. or dgm. = 0.1 ) = grain (gr.) 1 1/2 
1 Gramme (Gm. = 1. ) = grain (gr.) 15 1/2 (or 
more accurately gr. 15.432) 
1 Kilogramme (Kg. or "Kilo") = 1000. = ft>2.7 (Apoth); lb 2.2 (Avoir) 
Apothecaries' Equivalents 
(Approximate) 
gr. j. (grain,) or mj (min. j. = minim) = .06 Gramme (Gm.). 
3j (drachm) or fl3j (fluid drachm) = 4. Grammes (Gm.). 
3 j (ounce) = 31. Grammes (Gm.). 
fl5j (fluid ounce) = 30. Grammes (Gm.). 
66 INTRODUCTION. 
Factors in Converting from One Scale to the Other. 
To convert Grammes (Gm.) into grains (gr.) multiply by 15.432, or divide by 0.065. 
To convert grains (gr.) into Grammes (Gm.) multiply by 0.065 (exact 0.0648). 
To convert Troy ounces (3) into Grammes (Gm.) multiply by 31.104. 
To convert mils (mil or c. c.) into fluid ounces (fl 3) multiply by 0.0338. 
To convert fluid ounces (fl 3) into mils (mil or c. c.) multiply by 29.57. 
Equivalents. 
1 grain (gr.) is equivalent to 0.0648 Gramme (Gm.), or 64.8 milligrams (Mgm.), or ap- 
proximately 65 milligrams. 
1 mil ( = cubic centimeter = c. c.) is equivalent to 16.23 minims. 
1 milligram (Mgm.) is equivalent to 0.01543 grains (gr.) or approximately 1/64 grain. 
1 Gramme (Gm.) is equivalent to 15.4323 grains (gr.), or approximately 15 1/2 grains. 
Practically the Apothecaries' ounce (3) is equal to 30 Grammes (Gm.), (accurately, 31.104). 
Practically the Apothecaries' fluid ounce (fl 3) is equal to 30 mils (mil) or cubic centimeters 
(c. c.); (accurately, 29.57). 
1 pint (U. S. A.) is equivalent to 473.179 mils (= c. c.). 
1 Litre (L.) is equivalent to 33 fluid ounces and 391 minims. 
Apothecaries' Weight and Metric Equivalents. 
Fractions of a grain. 
From 1/1000 of a grain to 1 grain. 
1/1000 gr. = 0.00006 Gm. 1/40 gr. = 0.0016 Gm. 
1/750 gr. = 0.00008 Gm. 1/32 gr. = 0.002 Gm. 
1/500 gr. = 0.00013 Gm. 1/30 gr. = 0.0022 Gm. 
1/400 gr. = 0.00016 Gm. 1/25 gr. = 0.0026 Gm. 
1/300 gr. = 0.00022 Gm. 1/24 gr. = 0.0027 Gm. 
1/250 gr. = 0.00026 Gm. 1/20 gr. = 0.0032 Gm. 
1/240 gr. = O.OOO27 Gm. 1/16 gr. = 0.004 Gm. 
1/200 gr. = 0.00032 Gm. 1/15 gr. = 0.0043 Gm. 
1/180 gr. = 0.00036 Gm. 1/12 gr. = 0.0054 Gm. 
1/150 gr. = 0.00043 Gm. 1/10 gr. = 0.0065 Gm. 
1/130 gr. = 0.0005 Gm. 1/8 gr. = 0.008 Gm. 
1/120 gr. = 0.00054 Gm. 1/7 gr. = 0.009 Gm. 
1/128 gr. = 0.0005 Gm. 1/6 gr. = 0.011 Gm. 
1/100 gr. = 0.00065 Gm. 1/5 gr. = 0.013 Gm. 
1/90 gr. = 0.00072 Gm. 1/4 gr. = 0.016 Gm. 
1/96 gr. = 0.0007 Gm. 1/3 gr. = 0.022 Gm. 
1/80 gr. = 0.00081 Gm. 1/2 gr. = 0.032 Gm. 
1/75 gr. = 0.0009 Gm. 2/3 gr. = 0.043 Gm. 
1/64 gr. = 0.001 Gm. 3/4 gr. = 0.049 Gm. 
1/60 gr. = 0.00108 Gm. 1 gr. = 0.065 Gm. 
1/50 gr. = 0.0013 Gm. 
Multiples of a grain. 
From 1 grain to 1 ounce (Apoth.) 
gr. 1 = 0.065 Gm. gr. 20 =1.3 Gm. 
gr. 1 1/3 = 0.086 Gm. gr. 24 = 1.55 Gm. 
gr. 11/2 = 0.1 Gm. gr. 25 = 1.620 Gm. 
gr. 13/4 = 0.113 Gm. gr. 30 = 1.944 Gm. 
gr. 2 =0.13 Gm. gr. 35 = 2.27 Gm. 
gr. 2 1/2 = 0.162 Gm. gr. 40 = 2.6 Gm. 
gr. 3 = 0.194 Gm. gr. 45 = 2.92 Gm. 
gr. 3 1/2 = 0.227 Gm. gr. 50 = 3.24 Gm. 
gr. 4 = 0.26 Gm. gr. 60(3j) = 3.89 Gm. 
gr. 5 = 0.324 Gm. gr. 120(3 ij) = 7.78 Gm. 
gr. 6 = 0.39 Gm. gr. 180(3 iij)= 11.65 Gm. 
gr. 7 = 0.454 Gm. gr. 240(3 ss) = 15.55 Gm. 
gr. 8 = 0.52 Gm. gr. 300 = 19.43 Gm. 
gr. 8 3/4 = 0.57 Gm. gr. 360 = 23.3 Gm. 
gr. 9 = 0.583 Gm. gr. 480(3j) = 31.1 Gm. 
gr. 10 = 0.65 Gm. 
gr. 12 = 0.78 Gm. oz. 1/8 (avoir) = 3.54 Gm. 
gr. 15 = 0.972 Gm. oz. 1/4 (avoir) = 7.08 Gm. 
gr. 15.4 = 1. Gm. oz. 1/2 (avoir) = 14.17 Gm. 
gr. 18 = 1.166 Gm. oz. 1 (avoir) = 28.35 Gm. 
67 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Apothecaries' Measure and Metric Equivalents. 
From 1/2 minim to 4 Fluid ounces. 
Min. 1/2 = 0.03 mil (c. c.) Min. 40 = 2.464 mil (c. c.) 
Min. 1 = 0.06 mil (c. c.) Min. 45 = 2.80 mil (c. c.) 
Min. 2 - 0.12 mil (c. c.) Min. 50 = 3.08 mil (c. c.) 
Min. 3 = 0.185 mil (c. c.) Min. 60 (A3) = 3.70 mil (c. c.) 
Min. 4 = 0.246 mil (c. c.) Min. 75 = 4.65 mil (c. c.) 
Min. 5 = 0.308 mil (c. c.) Min. 90 = 5.54 mil (c. c.) 
Min. 6 = 0.370 mil (c. c.) Min. 120 = 7.39 mil (c. c.) 
Min. 7 = 0.431 mil (c. c.) Min. 180 = 11.09 mil (c. c.) 
Min. 8 = 0.492 mil (c. c.) Min. 240 = 14.80 mil (c. c.) 
Min. 9 = 0.554 mil (c. c.) Min. 300 = 18.48 mil (c. c.) 
Min. 10 = 0.616 mil (c. c.) Min. 360 = 22.18 mil (c. c.) 
Min. 12 = 0.74 mil (c. c.) Min. 480 (If3 approx. = 30 Gm. or mil) 
Min. 15 = 0.924 mil (c. c.) exact = 29.57 mil (c. c.) 
Min. 20 = 1.232 mil (c. c.) A3ij = 59.15 mil (c. c.) 
Min. 25 = 1.54 mil (c. c.) A5iij = 88.72 mil (c. c.) 
Min. 30 = 1.85 mil (c. c.) A5iv = 118.29 mil (c. c.) 
Min. 35 = 2.156 mil (c. c.) 
Approximate Equivalents of Metric Measures of Mass. * 
(The unit of Mass in the Metric System is the Gramme.) 
1 mgm. (miligram)= 1/64 gr. (grain). 75 cgm. = 11 1/2 gr. 
2 mgm. = 1/33 gr. 1 Gm. (Gramme) = 15 1/2 (15.432) gr. 
3 mgm. = 1/21 gr. 2 Gm. = 30 7/8 gr. 
4 mgm. = 1/16 gr. 3 Gm. = 46 1/4gr. 
5 mgm. = 1/13 gr. 4 Gm. = 61 3/4 gr. 
6.5mgm. = l/10gr. 5 Gm. = 77 1/6gr. 
8/mgm.. = 1/8 gr. 7.5 Gm. = 115 3/4 gr. 
1 cgm.(centigram) = 1/6 gr. 10 Gm. = 154 1/3 gr. 
2 cgm. = 1/3 gr. 15 Gm. = 231 1/2 gr. 
3 cgm. = 1/2 gr. 20 Gm. = 308 3/5 gr. 
5 cgm. = 3/4 gr. 30 Gm. = 1 3, 25 1/2 gr. 
6.5 cgm. = 1 gr. 40 Gm. = 1 5, 179 4/5 gr. 
10 cgm. = 1 1/2 gr. 75 Gm. = 2 3, 282 1/2 gr. 
15 cgm. = 2 1/4 gr. 100 Gm. = 33, 230 3/4 gr. 
20 cgm. = 3 gr. 150 Gm. = 5 5, 127 1/2 gr. 
26 cgm. = 4 gr. 250 Gm. = 8 3,358 gr. 
30 cgm. = 4 1/2 gr. 500 Gm. = 1 lb., 1 3, 278 gr. 
40 cgm. = 6 1/4 gr. 750 Gm. = 1 lb., 10 3, 200 gr. 
50 cgm. = 7 3/4 gr. 1 Kgm. (kilogram) = 2 lbs., 3 3, 120 gr. 
♦From Excerpta Therapeutica (By permission of Burroughs, Wellcome & Co.) 
Approximate Equivalents of Metric Measures of Capacity.* 
(The unit, of measure of capacity in the Metric System is the Litre). 
1 mil. = (c. c.) = 16(16.23)minims(min.) 20 mil. = (c. c.) = 5 fl3, 25 min. 
2 mil. = (c. c.) - 32 1/2 min. 25 mil. = (c. c.) = 6 fl3, 46 min. 
3 mil. = (c. c.) = 48 3/4 min. 30 mil. = (c. c.) = 1 A3, 7 min. 
4 mil. = (c. c.) = 1 fl3, 5 min. 40 mil. = (c. c.) = 1 A3, 2 A3, 49 min. 
5 mil. = (c. c.) = 1 A3, 21 min. 50 mil. = (c. c.) = 1 A3, 5 A3, 32 min. 
6 mil. = (c. c.) = 1 fl3, 37 min. 75 mil. = (c. c.) = 2 fl3, 4 fl3, 17 min. 
7 mil. = (c. c.) = 1 A3, 54 min. 100 mil. = (c. c.) = 3 A3, 3 A3, 3 min. 
8 mil. = (c. c.) = 2 A3, 10 min. 125 mil. = (c. c.) = 4 A3, 1 A3, 49 min. 
9 mil. = (c. c.) = 2 A 3, 26 min. 150 mil. = (c. c.) = 5 A 3, 0 A 3, 35 min. 
10 mil. = (c. c.) = 2 A 3, 42 min. 200 mil. = (c. c.) = 6A3,6A3,6 min. 
12.5 mil. = (c. c.) = 3 A 3, 23 min. 300 mil. = (c. c.) = 10 A 5, 1 A 3, 9 min. 
15 mil. = (c. c.) = 4 A3, 4 min. 500 mil. = (c. c.) =16 A3, 7 A3, 15 min. 
1 litre =33 fl3,6 fl3» 31 min. 
♦Adapted from Excerpta Therapeutica (By permission of Burroughs, Wellcome & Co.) 
Domestic or Popular Measures. 
(Approximate) 
A teaspoonful is approximately 1 fluid drachm (fl 3 j). 
A desertspoonful is approximately 2 fluidrachms (fl3ij). 
A tablespoonful is approximately 3 1/2 fluidrachms(fl3iijss) to 1/2 fluidounce (fl^ss). 
A wineglass is approximately 2 fluidounces (fl 5ij). 
A teacupful is approximately 3 1/2 to 5 fluidounces (fl 3 iijss to A5v). 
The average cup holds about 4 fluidounces (flgiv). 
68 INTRODUCTION. 
A breakfast cupful is approximately 8 fluidounces (flgviij). 
A tumblerful is approximately 8 fluidounces (flgviij). 
A half-glassful is approximately 4 fluidounces (Agiv). 
(The latter is usually employed in the bedside administration of Eclectic medicines.) 
Drop.-A drop is irregular in size depending upon the size or form of the edge of the 
container, and being of greater size if of thick material dropped from a wide-mouthed bottle, 
and, reversely, smaller when thin and dropped from a thin-lipped bottle. 
The abbreviation for both drop and drops is gtt. (not gtts.). 
Minim.-The Minim is a true drop accurately measured in a minim graduate. The 
abbreviation for both minim and minims is M, m, or min. 
XIII. PERCENTAGE SOLUTIONS AND 
DISPENSING TABLES. 
"The following table gives the amounts of material to be used with 
one fluidounce and one pint of distilled water, respectively. If a smaller 
or larger quantity of solution is desired, increase or decrease the amount of 
material given in the table accordingly. Many tables of this kind attempt 
to state the weight of material required to make a definite volume of 
solution but, inasmuch as the amount so required varies with the density 
of the material to be dissolved, such a table obviously is incorrect, except 
for material of the particular density on which it is based. 
"The amount of substance required for a definite volume of a par- 
ticular solvent, to make a certain strength of solution, is the same for any 
material and, therefore, no correction for density is necessary for the 
figures given in this table. The material dissolved will add approximately 
one minim of volume for every two grains of substance. 
"The quantities given below are based on the weight of distilled water 
at 25°C" (77°F.)." 
TABLE FOR MAKING SOLUTIONS* 
Strength 
of 
Solution 
Amount to be dissolved in: 
1 Fl. Ounce of 
Distilled Water 
1 Pint of 
Distilled Water 
1:5000 
1:2000 
1:1000 
1:500 
1:200 
1 per cent 
2 " " 
3 " " 
4 « « 
5 " " 
6 " " 
.091 grs. 
.227 " 
.455 " 
.911 " 
2.28 
4.59 
9.28 
14.06 
18.94 
23.9 
29. 
1.45 grs. 
3.64 " 
7.28 " 
14.57 " 
36.5 " 
73.5 " 
148.5 " 
225. 
303. 
383. 
1 av. oz. 27. " 
8 " " 
39.5 
1 " " 195. " 
10 " " 
50.5 
1 " " 371. 
12 1/2 " " 
64.9 
2 " ozs. 164. " 
15 " " 
80.2 
2 " " 408. 
16 2/3 " " 
90.9 
3 " " 142. 
20 " " 
113.6 
4 " " 68. 
25 " " 
151.5 
5 " " 237. 
30 " " 
194.8 
7 " " 55. 
33 1/3 " " 
227.3 
8 " " 137. 
35 " " 
245. 
8 " " 416. 
40 " " 
303. 
11 " " 36. 
45 " " 
372. 
13 " " 263. 
50 " " 
1 av. oz. 17. 
16 " " 273. 
*(From "Handbook of Pharmacy and Therapeutics, Lilly," by permission of Eli Lilly & Co.) 
69 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Percentage Table for Ointments. 
(In round numbers.) 
5 grains to 1 ounce of base = 1%. 
10 " " " " " " = 2%. 
15 = 3%. 
20 " " " " " " = 4%. 
25 = 5%. 
30 " " " " " " = 6%. 
40 " " " " " " = 8%. 
50 " " " " " " = 10%. 
DRUG CONTENT IN MINIMS OF EACH FLUID DRACHM 
DOSE OF MEDICINE. 
Fluidounces of Vehicle 
1 Minim 
of Medicine 
5 Minims 
10 Minims 
15 Minims 
20 Minims 
30 Minims 
60 Minims 
1(= 8 fluid drachms) 
X Minim 
X Minim 
IX Minim 
1% Minim 
2X Minim 
3X Minim 
7X Minim 
2(=16 " " ) 
1/16 " 
5/16 " 
X " 
15/16 " 
IX " 
IX " 
3X " 
3(=24 " " ) 
1/24 " 
5/24 " 
5/12 " 
SA " 
5/6 " 
1X " 
4f-32 " " ) 
1 /32 " 
5/32 " 
5/16 " 
15/32 " 
X " 
15/16 " 
IX " 
6^=48 " " ) 
1/48 " 
5 /48 " 
5/24 " 
5/16 " 
5/12 " 
X " 
IX " 
8 (=64 " " ) 
1/64 " 
5/64 " 
5/32 " 
15/64 " 
5/16 " 
15/32 " 
15/16 " 
LENGTH OF TIME A QUANTITY OF MEDICINE WILL LAST IF 
ADMINISTERED IN TEASPOONFUL (DRACHM) DOSES, 
AT INTERVALS STATED, DURING 24 HOURS.* 
Fluid- 
ounces 
Every 
1 hour 
Every 
2 hours 
Every 
3 hours 
Every 
4 hours 
Every 
6 hours 
Every 
8 hours 
Remarks 
1 
2 
3 
4 
6 
8 
8 hours 
(K day) 
16 hours 
(K day) 
24 hours 
(1 day) 
32 hours 
(IK days) 
48 hours 
(2 days) 
64 hours 
(2K days) 
16 hours 
(K day) 
32 hours 
(IK days) 
48 hours 
(2 days) 
64 hours 
(2K days) 
96 hours 
(4 days) 
128 hours 
(5K days) 
24 hours 
(1 day) 
48 hours 
(2 days) 
72 hours 
(3 days) 
96 hours 
(4 days) 
144 hours 
(6 days) 
192 hours 
(8 days) 
32 hours 
(IK days) 
64 hours 
(2K days) 
96 hours 
(4 days) 
128 hours 
(5K days) 
192 hours 
(8 days) 
256 hours 
(10K days) 
48 hours 
(2 days) 
96 hours 
(4 days) 
144 hours 
(6 days) 
192 hours 
(8 days) 
288 hours 
(12 days) 
384 hours 
(16 days) 
64 hours 
(2K days) 
128 hours 
(5K days) 
192 hours 
(8 days) 
256 hours 
(10K days) 
384 hours 
(16 days) 
512 hours 
(2IK days) 
♦If administered during 
16 hours of the day, omit- 
ting 8 of the night hours, 
the quantities of medicines 
will last one third longer. 
If administered for but 
12 hours out of the twenty- 
four, the medicine will last 
twice as long. 
XIV. DEFINITIONS OF THERAPEUTIC TERMS. 
Abortient. Same as Abortifacient, which see. 
Abortifacient. A drug which causes expulsion of the fetus (abortion). 
Abortive. Same as Abortifacient, which see. 
Absorbent. A drug that promotes absorption. 
Absorbifacient. Same as Absorbent, which see. 
Abstergent. A cleansing or purifying medicine. 
Acidifier. A drug which imparts acidity to the fluids, especially to the blood (more cor- 
rectly lessens alkalinity here), and to the urine. 
Alkalinizer. A drug which increases alkalinity of the body fluids, especially the blood, 
or the urine. 
Alterative. A drug which causes a favorable change or alteration in the processes of nutri- 
tion and repair, probably through some unknown way improving metabolism. 
Analgesic. Same as Anodyne. An agent that relieves pain. 
Anaphrodisiac. A drug that lessens sexual desire or depresses sexual power. 
Anesthetic (anaesthetic). An agent which temporarily abolishes sensation, producing in- 
sensibility to contact and pain. There are local and general anesthetics, the latter 
being administered by inhalation. 
Anhydrotic. An agent which prevents or checks excessive sweating (same as Antihydrotic). 
Anodyne. An agent that relieves pain, but does not necessarily produce unconsciousness. 
Antacid. An agent that will correct acidity by neutralization, chiefly acidity of the stomach. 
70 INTRODUCTION. 
Antagonist. An agent which opposes the action of some other medicine, and especially 
the toxic effects of alkaloidal poisons. 
Anthelmintic. A remedy against intestinal worms. 
Antiarthritic. A remedy employed to subdue inflammation of the joints. 
Antidote. A remedy to counteract poisons. It is (a) chemical, destroying the poison; 
(6) mechanical, preventing absorption; (c) physiologic, opposing the effect upon the 
system after absorption of the poison. 
Antiemetic. A remedy that prevents or stops vomiting (emesis). 
Antigalactagogue. An agent that diminishes the secretion of milk. 
Antihemorrhagic. A remedy which arrests or controls bleeding (hemorrhage). 
Antihydrotic. A remedy to prevent or control excessive sweating (same as Anhydrotic). 
Antilithic. An agent which is believed to prevent the formation of stone, or calculi. 
Antimalarial. A remedy against, or relieving in, malarial infection. 
Antimiasmatic. A remedy against miasmatic disorders (miasm-noxious exhalation or 
effluvium); an unsatisfactory term. 
Antimicrobic. A drug checking the development or growth of microbes. 
Antiperiodic. An agent that diminishes or arrests the periodicity of malarial attacks; 
in general, an antimalarial, which see. 
Antiphagocytic. Opposing or counteracting the action of phagocytes (phagocytosis). 
Antiphlogistic. An agent which counteracts inflammation, with fever. 
Antipyretic. An agent which reduces the temperature of fevers. 
Antirheumatic. An agent employed to prevent or to relieve in rheumatic infection (rheu- 
matism). 
Antiscorbutic. A remedy that prevents or corrects scurvy. 
Antiseptic. An agent which prevents the growth of microbes and cripples their activity 
while in contact with them. An agent that opposes or prevents sepsis. 
Antisialagogue. An agent that prevents or diminishes the flow of saliva. 
Antisialic. An agent that prevents or diminishes the flow of saliva (same as Antisialagogue, 
which see). 
Antispasmodic. An agent that will prevent and relieve spasm of the voluntary or in- 
voluntary muscles. 
Antisudorific. An agent to prevent or relieve excessive sweating. 
Antisyphilitic. A remedy to prevent or to relieve in syphilitic infection (syphilis). 
Antitetanic. An agent to prevent or relieve tetanus. 
Antithermic. An agent to reduce body temperature. 
Antitoxin- Any defensive protein acting as a neutralizer of poison. Most therapeutic 
antitoxins are derived from the blood-serum of animals in which a specific disease has 
been purposely developed. Examples-. Antidiphtheric and Antitetanic Serums. 
Antitussive. A remedy to relieve or prevent cough. 
Antizymotic. An agent which prevents or arrests the process of fermentation. 
Aperient. A gentle and nonirritating purgative causing but little increase of peristalsis 
and producing soft feces. 
Aphrodisiac. An agent which increases sexual desire, or increases sexual power. 
Astringent. An agent which, by acting upon the albumen of tissues, causes condensation 
and contraction, and restrains discharges. 
Bitter. An agent which increases the tone and activity of the gastric mucosa, thereby 
improving the appetite. 
Cardiac. An agent which stimulates and tones the heart; also a cordial or restorative. 
Cardiant. An agent which acts upon the heart, either stimulating or depressing its action. 
Carminative- An agent that prevents or relieves flatulence and thereby allays pain. 
Cathartic. An agent that hastens and increases evacuation of the bowels. Same as Pur- 
gative, which see. 
Caustic. An agent having an escharotic or corrosive action on living tissue. (Used inter- 
changeably with Cauterant.) 
Cauterant. An agent which has a corrosive destructive action upon living tissue. 
Cholagogue. A medicine which stimulates and increases the flow of bile. 
Corrigent. An agent which favorably modifies the action of powerful or harsh drugs; 
a correctant or corrective. 
71 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Corrosive. An agent destructive to tissue. 
Counterirritant. An agent which, by inducing local irritation or hyperaemia, acts as a 
derivative to relieve irritation, inflammation or pain in some part remote from that 
to which it is applied. 
Cycloplegic. An agent which paralyzes the ciliary muscle, resulting in relaxation of accom- 
modation (cycloplegia). 
Dacryagogue. An agent which causes a flow of tears. 
Deliriant. A drug which may produce delirium. (Same as Delirifacient, which see.) 
Delirifacient. A drug which may cause delirium. (Same as Deliriant, which see.) 
Demulcent A bland and soothing oily or mucilaginous application or medicine to relieve 
irritation of inflamed or abraded surfaces, usually intended for use upon the mucosa. 
(See also Emollient.) 
Deobstruent. A medicine that removes obstructions. 
Deodorant. A substance that masks, removes, or destroys odor. 
Depilatory. A substance that removes or destroys hair. 
Depressant. An agent that will depress function and vital energies by causing relaxation 
of muscular tissues and sweating; a medicine that depresses any function. 
Depresso-motor. An agent which depresses or diminishes motor activity. 
Depurant. A purifying medicine; e. g., a renal depurant. 
Detergent. A cleansing or purifying medicine. 
Diaphoretic. An agent that will stimulate and cause increased perspiration: a sedative 
diaphoretic is one that acts by dilation of the vessels of the skin, as when induced by 
heart sedatives or emetics. 
Digestant. An agent, which digests, or assists the digestion of food. 
Diluent. An agent that dilutes the fluids of the body and renders the excretions less 
irritant. 
Discutient. A medicine which causes a disappearance or scattering of a local tumefaction 
or inflammation. 
Disinfectant. An agent that prevents, or frees from infection, acting chiefly by destroying 
pathogenic germs or rendering organic ferments inactive. 
Diuretic. A drug which causes and increases secretion and flow of urine. 
Drastic. A harsh purgative usually causing pain, tormina or tenesmus, and causing re- 
peated evacuations. 
Ecbolic. An agent which excites and accelerates parturition. 
Eliminant. A drug which causes evacuations; also one by which soluble compounds are 
formed of insoluble substances in the body, thus facilitating their removal by the 
excretory organs. 
Eliminator. Same as Eliminant, which see. 
Emmenagogue. An agent that stimulates menstruation. 
Emetic. An agent that causes vomiting (emesis). 
Emollient. A medicine or agent which softens or soothes the skin, or soothes the mucosa, 
when irritated. (Compare Demulcent.) 
Epispastic. An agent which causes blistering (vesication). 
Errhine. An agent which excites nasal secretion and sneezing. 
Escharotic. A caustic or corrosive agent capable of producing an eschar or slough. 
Excitant. A medicine which causes excitation of the vital functions, as of the nervous 
(nervous excitant), muscular (motor excitant), circulatory (vaso-motor and cardiac 
excitants) systems. 
Excito-motor. An agent which excites to increased muscular activity. 
Exhilarant. An agent which excites or elevates the psychic function. 
Expectorant. An agent which promotes expectoration; i. e., the ejection, by spitting, of 
fluids secreted by the broncho-pulmonic mucosa. Stimulant expectorants excite in 
atony while sedative expectorants allay irritation, both facilitating the expulsion of 
sputum. 
Febrifuge. An agent that will reduce temperature in fevers. 
Galactagogue. An agent that stimulates the secretion or promotes the flow of milk. 
Galactophyge. An agent that diminishes or arrests the flow of milk. 
Germicide. An agent destructive to germs or micro-organisms. 
72 INTRODUCTION. 
Hematic (haematic). An agent which improves the quality of the blood. 
Hematinic (haematinic). An agent which improves the quality of the blood. 
Hepatic. A drug that stimulates the function of the liver. 
Hydragogue. An agent that causes watery discharge; especially a purge which produces 
watery catharsis. 
Hypnotic. A medicine which induces sleep simulating that of normal slumber. Some pain 
relievers are also hypnotic, but true hypnotics only cause sleep. 
Irritant. An agent which, when applied locally, excites hyperaemia or inflammation. 
Laxative. A medicine causing a mild and painless evacuation of the bowels. 
Lenitive. A medicine which has the soothing action of a demulcent on the internal mem- 
branes. 
Lithontriptic. A medicine supposed to be capable of dissolving calculi within the body. 
Miotic (myotic). A medicine which causes the pupil to contract (miosis). 
Motor depressant. A drug which depresses or restrains motor or muscular activity. 
Motor-excitant. A drug which excites to increased motor or muscular activity. 
Mydriatic. An agent which dilates the pupil (mydriasis). 
Myotic (miotic). An agent which causes contraction of the pupil (myosis). 
Narco-hypnotic. An agent that not only causes sleep, but if given in larger doses induces 
narcosis. (See Narcotic.) 
Narcotic. A drug that will induce stuporous sleep, at the same time relieving pain and 
abolishing consciousness. 
Nutriant (nutrient). A medicine which affects the nutritive process, or metabolic changes 
in the body; one that supplies material for tissue building. 
Oxytocic. A drug which accelerates or hastens the process of delivery in childbirth. 
Paralyzant. A drug that causes temporary functional paralysis of some part of the body. 
Parasiticide. An agent which destroys parasites. 
Parturifacient. A medicine that induces or facilitates childbirth. 
Partus praeparator. An agent that strengthens preparatory to labor. 
Protective. An agent that protects mechanically by covering or coating the skin or a lesion 
of the surface. 
Purgative. A cathartic; an agent that will cause evacuation of the contents of the bowels. 
Purge. A purgative medicine, or a dose of the same; to purge. 
Pustulant. An agent that attacks isolated areas of the skin, as the sudoriferous glands, 
causing pustules (pustulation). 
Reconstructive. An agent that, through furnishing needed medicinal substances, restores 
strength and integrity to the body. 
Refrigerant. An agent which imparts a cooling sensation to the mucosa and allays thirst; 
externally it cools by evaporation. 
Resinoids. A class of preparations resembling somewhat the resins, and being a mixture 
of resins with other substances. A name especially applied to a group of substances 
obtained by precipitating alcoholic preparations containing resins, with water. The 
so-called Eclectic resinoids were of this class, all of them, with the exception of podo- 
phyllin, iridin, and macrotyn, being of little value. 
Resolvent. An agent that is supposed to promote resolution, or dissipation of pathologic 
growths. 
Resorbent. An agent that promotes the removal of excreted material, as exudates, etc. 
Restorative. An agent that restores to consciousness, or one that aids in restoring tone, 
function, vigor, or health. 
Revulsive. An agent which, by producing a localized determination of blood, reduces 
other blood engorged areas. 
Roborant. An agent that by supplying needed material or food to the tissues, imparts in- 
creased strength. 
Rubefacient. An agent which, when locally applied, reddens the skin. 
Salivant. Same as Salivator, which see. 
Salivator. An agent which salivates or causes an excessive flow of saliva. 
Sedative. A drug that allays or calms excitement. 
Sedative, Arterial or Special. An Eclectic term for Aconite, Veratrum, and Gelsemium, 
when given in small doses. (See Aconitum or Gelsemium.) 
73 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Sialagogue. An agent that promotes an increased flow of saliva. 
Somnifacient. An agent which induces sleep; a hypnotic. 
Specific. An agent supposed to have a selective curative action in a special disease, or 
in some phases of disease. 
Sternutatory. An agent that excites sneezing. 
Stimulant. An agent that excites functional activity. A term often loosely applied. Stim- 
ulants are diffusible when they excite the circulation and general functions of the body; 
nervous, when they act chiefly upon the nerve centers; hepatic, when they arouse the 
functions of the liver; cardiac, when they increase the heart's action; gastric, when they 
quicken digestion; respiratory, when they increase respiratory movements; etc. 
Also applied to medicines in which the action of the contained ethyl alcohol is desired. 
Styptic. A local agent that, through a strongly astringent action, will arrest bleeding. 
Subculoyds. Non-irritating sterile preparations of plant drugs intended for hypodermatic 
medication. (See Subculoyd Lobelia.) 
Sudorific. An agent that will cause active or droplet perspiration, a more intense action 
than that of the ordinary diaphoretic. 
Synergist. A drug which has a similar effect upon tissue or function to that of some other 
drug. Synergists usually act harmoniously with such other drugs. 
Teeniacide (taenicide). An agent that will kill and expel the tapeworm. 
Taenifuge (Taeniafuge). An agent that will expel the tapeworm. 
Tonic. An agent which tends to produce or restore normal tone to the functions and tissues 
of the body. 
Vaso-constrictor. A drug which causes constriction of blood vessels. 
Vaso-depressant. An agent that, by acting on the vaso-motor or nervous system, will de- 
crease arterial pressure and relax the blood vessels. 
Vaso-dilator. A drug which causes dilation of blood vessels. 
Vaso-stimulant. An agent which, by acting upon the vasomotor nervous system, will in- 
crease arterial tension and thereby constrict the blood vessels. 
Vermicide. A medicine that will kill intestinal worms. 
Vermifuge. A medicine that will cause the expulsion of intestinal worms. 
Vesicant. A drug which causes blistering (vesication). 
XV. ABBREVIATIONS, WORDS, AND PHRASES. 
Used in Prescriptions, Pharmacy, and Medicine. 
A.-Ana, of each. 
aa.-ana, of each. 
Abs. febr.-Absente febre, while 
the fever is off. 
A. C.-Ante cibum, before meals. 
Ad.-To, up to. 
Adde.-Add. 
Adst. feb.-Adstante febre, while 
the fever is on. 
Agit.-Agita, shake. 
Alb.-Albus, white. 
Alt.-Alter, the other. 
Alt. noct.-Alternis noctibus. Every 
other night. 
Alternis horis.-Every other or 
second hour. 
a. m.-Ante meridiem, before noon. 
Am. or Amer. Disp.-American 
Dispensatory. 
Amplus-Large 
Ana.-Of each. 
Ante.-Before 
Aq. dest.-Aqua destillata, distilled 
water. 
Aq. bull.-Aqua bulliens, boiling 
water. 
Aq. comm.-Aqua communis, com- 
mon water or tap water. 
Aq.-Aqua, water. 
Aq. ferv.-Aqua fervens, hot water. 
Aq. fluv.-Aqua fluviatilis, river or 
flowing water. 
Aq. font.-Aqua fontalis, spring- 
water. 
Aq. mar.-Aqua marina, sea or 
salt water. 
Aq. niv.-Aqua nivalis, snow water. 
Aq. pluv.-Aqua pluviatilis, rain 
water. 
Aq. pur.-Aqua pura, pure water, 
b. i. d.-bis in die, twice a day. 
Ben-Bene, well. 
Bib.-Bibat, let him drink. 
Bis-Twice. 
Bis in d.-Bis in die, twice a day. 
Bol.-Bolus, a large pill. 
Bonus-Good. 
Bulliat, bulliant-Let it or them 
boil. 
Bulliens-Boiling. 
Bullio-To boil. 
C.-cum, with. 
c.c.-Cubic Centimeter. 
Caut.-Caute, cautiously. 
Cap.-Capsula, capsule. 
Cap. or Capt.--Capiat, let (patient) 
take. 
Cat.-Cataplasma, a poultice. 
Chart.-Chartula, paper. 
Chart.-Chartula, a small paper. 
Cib.-cibus, food. 
Coch. amp.--Cochleare amplum, 
a tablespoonful. 
Coch. med.-Cochleare medium, a 
dessertspoonful. 
Coch. par.-Cochleare parvum, a 
teaspoonful. 
Cochl. j.-Cochlear or cochleare, a 
spoonful. 
Coct.-Coctio, boiling. 
Col.-Cola, strain. 
Colent.-Colentur, let them be 
strained. 
Colet.-Coletur, let it be strained. 
74 INTRODUCTION. 
Coll.--Collyrium, an eye wash. 
Collator.-Collutorium, a mouth 
wash. 
Collyr.-Collyrium, an eye-water. 
Comp.-C ompositus, co m - 
pounded. 
Conf.-Confectio, a confection. 
Cong.-Congius, a gallon. 
Coq.-Coque, boil. 
Cort.-Cortex, the bark. 
Cyath. j.-A glassful. 
Cyath. vinar.-Cyathus vinarius, 
a wineglassful. 
D. in p. aeq.-Dividatur in partes 
equales. Let it be divided into 
equal parts. 
D. or Dos.-Dosis, a dose. 
Da-Give. 
Dec.-Decanta, pour off. 
Decem.-Ten. 
Decoct.-Decoctio, Decoctum, a 
decoction. 
Decub.-Decubitus, lying down. 
Die-In a day. 
Dieb. alt.-Diebus alternis, every 
other or second day. 
Dieb. tert.-Diebus tertius. Every 
third day. 
Dies-A day. 
Dil.-Dilutum, diluted. 
Dil.-Dilue. Dilute (thou) or 
• dilutus, diluted. 
Div.-Divide, divide. 
Dividendus.-To be divided. 
Dolor, Dolores.-Pain, pains. 
Dr. or Drm.-Drachma, a drachm. 
Effund.-Effunde, pour out. 
Elect.-An electuary. 
Emp.-Emplastrum, a plaster. 
Enema. Enemata.-Enema, or 
enemas (clysters). 
et-And. 
Ex. or Ext.-Extractum, an extract. 
Exhib.-Exhibo, give. 
Ext.-Extractum, an extract. 
Exten.-Extensus, spread. 
f3. or fl 3.-Fluid drachma, a fluid 
drachm. 
f? or fl?.-Fluid uncia, a fluid 
ounce. 
F. S. A.-Fiat secundum artem; 
let it be prepared according to the 
rules of the art. 
F. s. a. r.-Fiat secundum artis 
regulus. Let it be made ac- 
cording to the rules of art. 
F. ft.-Fac, fiat, fiant, make or let 
there be made. 
Farina.-Flour or meal. 
Febris-Fever. 
Filt.-Filtra, filter. 
Flav.-Flavus, flavor. 
Flo. or Flos.-Flores, flowers. 
Fol.-Folins, a leaf. 
Fotus-A fomentation. 
Fruct.-Fructus, a fruit. 
Ft.-Fiat, make. 
Ft. cat.-Fiat cataplasma, make a 
poultice or cataplasm. 
Ft. emuls.-Fiat emulsio, make an 
emulsion. 
Ft. Garg.-Fiat Gargarisma, make 
a gargle. 
Ft. Mass.-Fiat Massa, make a 
mass. 
Ft. mist.-Fiat mistura, make a 
mixture. 
Ft. Pulv.-Fiat pulvis or pulveres, 
make a powder or powders. 
Ft. Solut.-Fiat solutio, make a 
solution. 
Ft. Suppos.-Fiat suppositorium, 
make a suppository or supposi- 
tories. 
Ft. ung.-Fiat unguentum, make an 
ointment. 
Garg.-Gargarisma, a gargle. 
Gm.-A gram. 
gr.-Granum, a grain. 
Gtt.-Gutta, guttae, drop or drops. 
Gutt.-Gutta, a drop or drops. 
H.-Hora, an hour. 
H. decub. or H. d.-Hora decubitus, 
at the hour of going to bed; at 
bed time. 
H. s. or Hor. som.-Hora somnis, 
at the hour of rest; just before 
time of sleep. 
Haust.-Haustus, a draught. 
Herb.-Herba, an herb. 
Idem-The same. 
Infus.-Infusio, infusum, infuse; 
an infusion. 
In-In. 
Ind. or In dies.-Indies, every day, 
daily, from day to day. 
Infunde-Infuse. 
Inject-Injectio, an injection. 
Jus.-Jusculum, a broth; 
J us. ovillum, mutton broth; 
Jus. bovinum, beef broth. 
Lac.-Milk. 
lb-Libra, a pound. 
Liq.-Liquor, liquor. 
Lot.-Lotio, a lotion. 
M.-Minimum, a minim, or accu- 
rately measured drop. 
M. F. Mist.-Misce fiat mistura, 
mix to form a liquid mixture. 
M. F. P.-Misce fiat pulvis, mix to 
form a powder. 
M. F. Pil.-Misce fiant pilulae, mix 
to form pills. 
M. S. D.-Misce, signa, da, mix the 
medicine, and deliver it, with the 
requisite instruction, in writing, 
to the patient (or nurse). 
Mac.-Macera, macerate. 
Mane.-In the morning. 
Mass.-Massa, a mass. 
Mil.-Milliliter or cubic centimeter. 
(A new word, not an abbrevia- 
tion, derived from first syllable of 
milliliter, and designed to displace 
the term cubic centimeter.) 
Min.-Minimum, a minim, or ac- 
curately measured drop. 
Mic. pan.-Mica panis, crumb of 
bread. 
Mist.-Mistura, a mixture. 
Mitte.-Send. 
Mucil.-Mucilago, mucilage. 
N.-Nocte, at night. 
N. F. or Nat. Form.-National 
Formulary. 
Ne rep.-Ne repetatur, not to be 
refilled. 
No.-Numerus, number. 
No. 1, 2, 3, etc.-Number of pieces 
or parts, etc. (also written j, ij, 
iij, iv, v). 
Noman.-Nocte maneque, night 
and morning. 
Non-Not. 
Non rep.-Non repetatur, do not 
repeat. 
O. or Oct.-Octarius, a pint. 
o. d.-omni die, daily. 
Omn. hor.-Omni hora, every hour. 
Omn. man.-Omni mane, every 
morning. 
Omn. n.-Omni nocte, every night. 
Omnis-All. 
Ovum-An egg. 
P. AL-Partes equates, equal parts, 
p. c.-post cibum, after meals. 
P. P.-Poor patient (a request to 
the druggist to make lowest price 
possible; the doctor should do 
likewise), to be placed at top or 
bottom of prescription. 
p. r. n.-pro re nata, when required; 
occasionally, or as the symptoms 
may require. 
Pars, partis-A part. 
Parvus--A little. 
Ph.-Pharmacopoeia, a pharma- 
copoeia. 
Pil.-Pilula, a pill. 
Pone-Behind. 
Pone aurum.-Behind the ear. 
Pot.-Potus, drink. 
Pot.-Poteo, a potion. 
Pulv.-Pulvis, a powder; also 
pulvis factis, powdered. 
q. h.-quaque hora, every hour. 
q. 2 h.-every 2 hours. 
q. 3 h.-every 3 hours. 
q. 4 h.-every 4 hours. 
Q. 1.-Quantum libet, as much as 
you like. 
Q. q. or quaq.-Quaque, each or 
every one. 
Q. s.-Quantum sufficiat, sufficient. 
q. s.-quantam sufficiat, as much 
as may be required. 
Q. v.-Quantum volueris, as much 
as you like. 
Quater-Four times. 
Quartus-Fourth. 
Quinque-Five. 
Quintus-Fifth. 
ft.-Recipe, take or take thou. 
Rad.-Radix, the root. 
Rept. or repet.-Repetatur (repe- 
tantur), let it (or them) be re- 
peated; and repetendus, to be 
repeated. 
S.-Signa, write thou (directions 
to patient or nurse). 
s.-sine, without. 
S. a.-Secundum artem. According 
to art; that is, to use your own 
ingenuity to do it in the most 
proper and scientific way. 
S. o. s.-Si opus sit, when required. 
Sig.-Signa (or signetur), Write 
thou (directions to patient or 
nurse) or let it be marked, di- 
rected or written upon. 
Siccus-Dry or dried, 
Sex-Six. 
Sextus-Sixth. 
Sesq.-Sesqui, one and a half. 
Septem-Seven. 
Septimus-Seventh. 
Soi-Solve, dissolve. 
Spissus-Thick. 
Spt.-Spiritus, spirit. 
Ss.-Semis, a half. 
Stat.-Statim, at once. 
Subtep.-Subtepidus, a little warm; 
lukewarm. 
Succus-Juice or sap. 
Syr.-Syrupus, syrup. 
T. d.-Ter die, three times a day. 
t. i. d.-ter in die, three times a day. 
Tabei.-Tabelte, tabulae, lozenges. 
Ter.-Tere, terendus, rub; to be 
rubbed. 
Ter-Three times. 
Tertius-Third. 
Tinct.-Tinctura, a tincture. 
Tres-Three. 
Trit.-Tritura, Triturate. 
T ritus-Ground. 
U. S. P.-United States Pharma- 
copoeia. 
V. or Vel-Vel, or. 
V. o. s.-Vitello ovi solutum, dis- 
solved in the yolk of an egg. 
Vertus-true, real, genuine. 
Vesp.-Vespere, in the evening. 
Vigesimus-The twentieth. 
Viginti-Twenty. 
Vitell. ovi-The yolk of an egg. 
Vitellus.-The yolk of the egg. 
Vitrum.-A glass. 
Vehiculum.-A vehicle. 
Ubi-Where, whenever. 
Una-Together. 
Unguilla-An ointment box. 
Ut-As, that, so that; in the same 
manner as. 
Ut diet.-Ut dictum. As directed. 
3.-Drachma, a drachm or dram. 
5.-Uncia, an ounce. 
9.-Scrupulus, a scruple (or 20 
grains). 
4 i. d.-Four times a day. 
75 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
XVI. PHARMACEUTICAL PREPARATIONS, 
WITH DOSES. 
(List of Fluidextracts, Tinctures, Syrups, Elixirs, Wines, and Powders, not systemat- 
ically mentioned in the articles on individual drugs. The extremely energetic are in heavy- 
face type; those of slightly lesser strength in italics; the balance in ordinary type.) 
FLUIDEXTRACTS. 
Aconite 1/2 to 2 minims. 
Adonis 1 to 5 " 
Aletris 5 to 60 " 
Alstonia constricta 5 to 40 " 
Alstonia scholaris 5 to 60 " 
Angelica 5 to 60 " 
Apocynum 1 to 20 " 
Aralia 5 to 60 " 
Aromatic 1 to 20 " 
Aspidosperma 
(Quebracho) 5 to 60 " 
Belladonna Leaves.... 1/5 to 2 " 
Belladonna Root 1/5 to 2 " 
Berberisaquifolium... . 5 to 40 " 
Bitter Orange Peel 5 to 30 " 
Black Cohosh 1 to 30 " 
Black Haw 5 to 60 " 
Bloodroot 1 to 5 " 
Blue Flag 1 to 15 " 
Buchu 5 to 60 " 
Calamus 5 to 40 " 
Calendula 5 to 60 " 
Calumba 5 to 30 " 
Canada Snake Root... 5 to 60 " 
Capsicum 1/2 to 2 " 
Cascara Sagrada 20 to 60 " 
Celery Seed 20 to 60 " 
Chestnut Leaves 60 to 120 " 
Chionanthus 5 to 60 " 
Cinchona 5 to 60 " 
Cinchona (Red) 5 to 60 " 
Colchicum Root 1 to 8 " 
Colchicum Seed 1 to 8 " 
Colocynth 1 to 4 " 
Condurango 5 to 60 " 
Conium Fruit 1 to 5 " 
Corn Silk 30 to 120 " 
Cornus 5 to 60 " 
Corydalis 10 to 60 " 
Cotton Root 20 to 60 " 
Cubeb 5 to 40 " 
Digitalis 1 to 2 " 
Dioscorea 5 to 60 " 
Echinacea 5 to 30 " 
Elecampane 10 to 60 " 
Ergot 15 to 120 " 
Eriodictyon 5 to 60 " 
Eucalyptus 5 to 60 " 
Euonymus 5 to 30 " 
Eupatorium 5 to 60 " 
Euphorbia pilulifera... 10 to 60 " 
Frangula 5 to 60 " 
Fucus 10 to 60 " 
Gelsemium 1 to 5 " 
Gentian Compound 
(Eclectic) 30 to 60 " 
Geranium 5 to 120 " 
Glycyrrhiza 10 to 120 " 
Grindelia 5 to 60 minims. 
Guarana 15 to 60 " 
Hamamelis Leaves 30 to 60 " 
Hawthorn Berries 5 to 15 " 
Helonias 5 to 60 " 
Hemlock Bark 10 to 60 " 
Hops 15 to 60 " 
Hydrangea 20 to 120 " 
Hydrastis 5 to 60 " 
Hyoscyamus 1 to 10 " 
Indian Cannabis 1 to 10 " 
Ipecac 5 to 30 " 
Jalap. 5 to 30 " 
Jamaica Dogwood 5 to 40 " 
Juglans 5 to 60 " 
Kamala 60 to 180 " 
Krameria 10 to 30 " 
Lactucarium 10 to 30 " 
Lappa 15 to 60 " 
Larkspur 1/2 to 5 " 
Leptandra 5 to 60 " 
Lobelia 1 to S " 
Logwood 30 to 60 " 
Lupulin 5 to 15 " 
Male Fern 1 to 4fl$. 
Matico 30 to 120 minims. 
Nux Vomica 1 to 4 " 
Pareira 10 to 60 " 
Physostigma 1 to 3 " 
Phytolacca 1 to 10 " 
Pichi 10 to 40 " 
Pilocarpus 5 to 40 " 
Podophyllum 1 to 20 " 
Pomegranate 30 to 60 " 
Prickly Ash Berries... 5 to 30 " 
Quassia 5 to 10 " 
Quercus 10 to 60 " 
Rhubarb 5 to 30 " 
Rubus 10 to 60 " 
Rumex 10 to 60 " 
Sabah... 15 to 60 
Sarsaparilla 30 to 60 " 
Sarsaparilla Compound (used in making 
Compound Syrup of Sarsaparilla) 
Senega 1 to 30 minims. 
Senna 30 to 120 " 
Senna, Compound 20 to 60 " 
Spigelia 30 to 120 " 
Squill 1 to 5 " 
Squill, Compound 2 to 3 " 
Stillingia 10 to 60 " 
Stillingia, Compound.. 10 to 60 " 
Sumbul 5 to 60 " 
Taraxacum 60 to 180 " 
Trifolium, Compound. 30 to 60 " 
Triticum 1 to 4fl5 
Viburnum Opulus 20 to 60 minims. 
Wafer Ash 10 to 30 " 
Wild Cherry 30 to 60 " 
76 INTRODUCTION. 
TINCTURES. 
Acetous Emetic 
(Comp. Tr. Lobelia). 1/4 to 1A3. 
Aconite 1 to 10 minims. 
Aloes 2 to 4 A3- 
Aloes and Myrrh 30 to 60 minims. 
Antispasmodic (Comp. Tr. Lobelia 
and Capsicum) .... 30 to 60 " 
Arnica 5 to 30 " 
Asafetida 5 to 60 " 
Avena 2 to 4 A5._ 
Belladonna Leaves.... 1 to 20 minims. 
Belladonna Root 1 to 15 " 
Benzoin 10 to 60 " 
Benzoin, Compound.. 10 to 60 " 
Buchu 1 to 2 A3. 
Calumba 1 to 2 A5. 
Cannabis i to 30 minims. 
Cantharides 1 to 5 " 
Capsicum 1 to 15 " 
Capsicum and Myrrh.. 10 to 60 " 
Cardamom 10 to 60 " 
Cardamom, Compound 10 to 120 " 
Catechu 1 to 3 A3. 
Catechu, Compound.. 1 to 3 A 3 • 
Cimicifuga 1 to 2 A3- 
Cinchona 1 to 2 A 3 • 
Cinchona, Compound. 1 to 2 A3- 
Cinnamon 20 to 60 minims. 
Colchicum Corm 5 to 60 " 
Colchicum Seed 5 to 60 " 
Cubeb 5 to 120 
Digitalis 1 to 20 " 
Gambir, Compound.... 30 to 120 " 
Gelsemium 1 to 15 " 
Gentian 10 to 120 " 
Gentian, Compound.. . 10 to 120 " 
Ginger 5 to 60 " 
Golden Seal 30 to 60 " 
Guaiac 30 to 120 " 
Guaiac, Ammoniated.. 5 to 120 " 
Hyoscyamus 5 to 60 " 
Iodine Externally. 
Iron Chloride 1 to 30 " 
Kino 10 to 120 
Krameria 20 to 120 " 
Lactucarium 10 to 60 " 
Larkspur Externally only. 
Lavender, Compound.. 15 to 60 minims. 
Lemon Peel (for flavoring). 
Lobelia 5 to 30 minims. 
Myrrh 10 to 60 " 
Nux Vomica 5 to 30 " 
Opium, (Laudanum).... 1 to 15 " 
Opium, Camphorated (Paregoric) 
(infants 5 to 10 minims) 1 to 4 fl 3- 
Opium, Deodorized .... 1 to 15 minims. 
Orange Peel, Sweet (for flavoring). 
Physostigma 1 to 30 
Quassia 10 to 60 " 
Rhubarb 15 to 120 
Rhubarb, Aromatic... 15 to 120 " 
Sanguinaria 5 to 30 
Squill 5 to 30 " 
Stramonium 5 to 20 " 
Strophanthus 5 to 15 " 
Valerian 5 to 120 " 
Valerian, Ammoniated 5 to 120 minims. 
Vanilla (for flavoring). 
Veratrum Viride 5 to 20 " 
Viburnum Opulus .... 20 to 120 " 
Warburg's 1 to 4 fl3. 
SYRUPS. 
Asarum Compound... .1/2 to 1 fl5. 
Calcium Lacto- 
phosphate 1/2 to 4 fl 3. 
Ginger 1/2 to 4 fl3. 
Hydriodic Acid 1/2 to 1 fl 3 • 
Hypophosphites (calcium, sodium, 
and potassium) 1 to 2 fl 3. 
Ipecac 2 to 60 minims. 
Iodide of Iron 15 to 30 " 
Lactucarium 1/2 to 2 fl3- 
Partridgeberry, Compound 
(Mother's Cordial)... 2 to 4fl3. 
Phosphates, Compound (Chemical Food- 
calcium, iron, sodium and potassium) 
1/2 to 1 A3- 
Raspberry Vehicle. 
Rhubarb ..... 1 to 4 A3- 
Rhubarb, Aromatic... 1 to 4 fl3- 
Rhubarb and Potassa, Compound (Neutral- 
izing Cordial) 1/4 to 2 A3- 
Sarsaparilla, Compound. Vehicle. 
Senega 1 to 2 A3. 
Squill... 1/2 to 1 A3. 
Stillingia, Compound.. 1/2 to 1 A3. 
Tar 1 to 4 A3. 
Tolu... Ito 4 A3. 
Trifolium Compound.. 2 to 4 A3. 
Wild Cherry 1 to 2 A 3. 
Wormseed,Compound 1/2 to 1 A3. 
Yerba Santa,Aromatic. 2 to 4 A3. 
WINES, MEDICATED. 
Colchicum Corm 1 to 15 minims. 
Colchicum Seed 1 to 20 " 
Ipecac 5 to 60 " 
Tar 30 to 60 " 
ELIXIRS. 
Adjuvant ' 
Glycyrrhiza 
Aromatic (simple) 
Aromatic (red) 
All as Vehicles. 
OLEORESINS. 
Aspidium 15 to 60 minims. 
Capsicum 1/10 to 1 minim 
Cubeb 5 to 20 minims. 
Ginger 5 to 20 " 
POWDERS. 
Compound Licorice Powder..30 to 60 grains 
Dover's Powder (Ipecac 10% 
and Opium 10%) 5 to 15 " 
Compound Emetic Powder. .60 to 120 " 
Diaphoretic Powder 5 to 15 " 
Jalap, Compound (Anti- 
bilious Physic) 15 to 60 " 
Tully Powder (Compound 
Morphine Powder) 5 to 10 " 
= (1/12 to 1/6 gr. morphine.) 
77 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
XVII. THERAPEUTIC CLASSIFICATION OF DRUGS. 
CLASSIFICATION OF DRUGS 
Owing to the limitations of exact knowledge concerning the action and 
effects of drugs, and their application in more than one way, it is obvious 
that it is impossible to arrange a strict classification of drugs. In the 
following pages the attempt has been made to satisfy those who demand 
some sort of classification. This is arrived at from several angles, but 
chiefly from (1) known therapeutic effects, and secondly (2), from pharma- 
cological action, based upon effect upon tissue and function. While some 
drugs properly come under more than one head (e. g.; ipecac, large doses, 
emetic; small doses, antiemetic), the individual drugs have been placed 
chiefly under that therapeutic head in which their most prominent action 
and effects are known, and only in a few instances repeated where a lesser 
action is credited to them. 
This classification is necessary for those whose methods extend beyond 
those of Specific Medication, the latter not being largely considered in this 
connection. 
Group I-Drugs used for their Local Effects upon the Skin and adjacent 
Mucous Membranes (Topical Medicines) 
1. Irritants: 
(a) Rubefacients. 
(b) Vesicants. 
(c) Suppurants (Pustulants). 
(d) Escharotics (Caustics and 
Corrosives). 
2. Astringents. 
3. Styptics. 
4. Emollients (and Demulcents). 
5. Protectives. 
6. Absorbents. 
Topical medicines are those which are applied to the skin and such 
portions of the mucosa as are naturally exposed to view. Some of them 
dilate the peripheral vessels of the skin, exciting redness (Rubifacients) and 
their prolonged action may cause subsequent desquamation. Those which 
inflame the skin and cause an exudation of serum between its true structure 
and the epiderm, are the blistering agents (Vesicants or Epispastics). 
Agents which inflame small points which finally end in pustulation are 
called Pustulants (or Suppurants'):, while to those which destroy the life 
of the tissues, causing a slough or eschar, with a dilatation of the surround- 
ing bloodvessels, the terms Caustics, Cauterants, or Escharotics are applied. 
Some drugs cause a constriction of bloodvessels, decrease exudation, 
contract the muscular fibres when in direct contact (wounds), and pre- 
cipitate albumen or gelatin, thus causing condensation of tissue. These 
are called Astringents. When the latter control bleeding by acting upon 
the surrounding tissues and the oozing of blood, and also form clots, they are 
Styptics. 
Many agents are employed to alleviate pain by protecting the parts 
from the air and contact with irritating material, by reducing tension and 
tumefaction, and relaxing and softening the surface. These are the Emol- 
lients, and most of them are oily in character. Occasionally colloidal 
substances are used and called Demulcents. The latter agents and the term 
are more commonly employed in connection with disorders of the mucous 
surfaces (see also Demulcents under Group IV, I, 7). Other agents are 
78 INTRODUCTION. 
used solely to protect from outside encroachment {Protectives), while still 
others have the added property of absorbing excessive secretion {Absorb- 
ents) . 
The uses of the preceding are obvious, all being now in common use 
except the vesicants and pustulants, which very largely have been dis- 
carded. 
1. IRRITANTS. 
Rubefacients. 
Mustard. 
Oil of mustard. 
Capsicum. 
Turpentine. 
Vesicants. 
Ammonia water. 
Cantharidal collodion. 
Suppurants (Pustulants). 
Croton oil. 
Chrysarobin. 
Escharotics. 
Zinc chloride. 
Silver nitrate. 
Phenol. 
Chromic acid. 
Sulphuric acid. 
Nitric acid. 
Arsenic trioxide. 
2. ASTRINGENTS. 
Zinc carbonate. 
Zinc oxide. 
Rose water. 
Tannic acid. 
Zinc sulphate. 
3. STYPTICS. 
Turpentine. 
Iron chloride. 
Iron persulphate. 
4. EMOLLIENTS. 
Adeps. 
Wool-fat (Lanolin). 
Yeast. 
Ulmus. 
Glycerin. 
Fig- 
Linseed oil. 
Cacao-butter. 
Petroleum. 
Petrolatum. 
Soap (detergent). 
Libradol. 
Poultices. 
Impatiens. 
Plantago. 
5. PROTECTIVES. 
Collodion. 
Petrolatum. 
Spermaceti. 
White wax. 
Yellow wax. 
Bismuth. 
Starch. 
Talc. 
Gelatin. 
Wheat flour. 
Carron oil (burns). 
Paraffin. 
Resina. 
Plaster of Paris. 
The fatty emollients above. 
6. ABSORBENTS. 
Zinc oxide. 
Calcium carbonate. 
Starch. 
Wheat flour. 
Group II.-Drugs used for their Effects upon Pathogenic or other Micro- 
Organisms and Parasites. 
1 and 2 Antiseptics and Disinfectants. 
3 Anthelmintics. 
4 Parasitics. 
Disinfectants {Germicides) are agents which kill or destroy micro- 
organisms or germs and their spores, both pathogenic and non-pathogenic. 
Antiseptics are agents which prevent or retard the growth, or arrest 
the development of organisms, or which render toxins less harmful, or even 
harmless; or interfere with their absorption, or possibly so strengthen the 
tissues that they are enabled to resist the toxic influence. Unlike dis- 
infectants they usually do not kill germ-life. A few agents ordinarily used 
79 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
as antiseptics, if sufficiently concentrated, may prove germicidal. On the 
other hand disinfectants kill when used of sufficient strength, but when 
diluted some of them may prove merely antiseptic. Disinfectants may be 
used locally, where there is no danger of destroying the parts, but are 
employed chiefly to destroy septic material or germs in the air, or upon 
clothing, in habitations, in drains and other places harboring infectious 
and zymotic material. Obviously, disinfectants are not used as such 
internally, for they would be destructive to the host as well as to the organ- 
isms. Some, however, attenuated by dilution, or vaporized with diluting 
fluids, and the antiseptics proper, are employed for respiratory, intestinal, 
and urinary antisepsis. Internal antiseptics may inhibit but seldom 
destroy the organisms. The terms antiseptic and antizymotic frequently are 
used interchangeably, but the latter belongs more properly to agents 
counteracting the putrefactive process known as zymosis. The germs of 
some diseases are called zymes and the diseases zymotic, though these terms 
are used less frequently than formerly. 
The action of both disinfectants and antiseptics is not well understood, 
but it is believed to be chiefly chemical, by which they cause coagulation of 
the albuminous constituents of the micro-organism, or enter into a union with 
the microprotein. The effects of these bodies vary greatly according to the 
circumstances and conditions under which they are used. The best dis- 
infectant, where it can be used, is fire; the next, moist heat. Boiling infected 
material for ten to fifteen minutes is sufficient to kill all known forms of 
germ-life. 
Some agents, while neither disinfectants nor antiseptics, rob offensive 
material of its odor. These are the Deodorants. They act (1) by oxidation; 
(2) by dehydration. They need possess neither disinfectant nor antiseptic 
properties. 
Agents which cause the death or facilitate expulsion of worms from the 
intestinal canal are called Anthelmintics. Some drugs (1) kill the parasites 
(Vermicides'); (2) others weaken their vitality or possibly paralyze them so 
that they can no longer retain their station in the intestines, and are then 
readily removed by catharsis (Vermifuges'). Worms are the more readily 
removed when deprived of the sustenance of proteins, and in the presence 
of irritating foods. As children are those most subject to intestinal worms, 
it should be remembered that most anthelmintics are poisonous, and if 
carelessly or wrongly used are capable of doing much harm. Hence they 
should never be employed without positive evidence of the presence of 
worms. This is best attested by ocular evidence of the fact that the patient 
has recently voided some of the parasites; or, if the tapeworm, sections of it. 
Parasitics (Parasiticides or Antiparasitics') destroy both animal or 
vegetable parasites, whether upon the skin or located in the tubes or 
tissues of the body. Antimalarials (often called Antiperiodics') destroy the 
specific parasite of malaria within the blood. The synonymous term is also 
used to denote drugs to be used in diseases showing periodicity, in which 
they tend to mitigate the paroxysms, or to prevent their recurrence. 
While some are known to be toxic to certain specific germs, not all of them 
have been so proved; but the probabilities are that they are all destructive 
in some way to micro-organisms of some types. 
80 INTRODUCTION. 
1 and 2. ANTISEPTICS AND DISIN- 
FECTANTS. 
Asepsin. 
Iodine. 
Iodol. 
Iodoform. 
Thymol. 
Thymol iodide. 
Mercuric chloride (corrosive sublimate). 
Yellow oxide of mercury. 
Salicylic acid. 
Bromine. 
Lime. 
Chlorinated lime. 
Labarraque's Solution of chlorinated lime. 
Phenol. 
Salol. 
Creosote. 
Lysol. 
Cresol (Comp. Sol.). 
Creolin. 
Trikresol. 
Oxalic acid. 
Picric acid. 
Boric acid. 
Sodium biborate. 
Sodium sulphite. 
Sodium thiosulphate. 
Benzoic acid. 
Hydrogen dioxide. 
Formaldehyde. 
Potassium permanganate. 
Potassium chlorate. 
Resorcin. 
Quinine. 
Turpentine. 
Ichthyol. 
Baptisia. 
Antiseptic oils. 
3. ANTHELMINTICS. 
Taenicides: 
Granatum. 
Pelletierine tannate. 
Aspidium. 
Pepo. 
Kousso. 
Kamala. 
Round Worms: 
Santonin. 
Spigelia. 
Chenopodium. 
Turpentine. 
Hook-worms: 
Thymol. 
Oil of chenopodium. 
Monarda. 
Ascarides: 
Quassia. 
Vinegar. 
Acetic acid. 
4. PARASITICS. 
Sulphur. 
Resorcin. 
Oil of cade. 
Copper subacetate. 
Betanaphthol. 
Quinine. 
Potassa sulphurata. 
Sulphurous acid. 
Balsam of Peru. 
Quinine. 
Cocculus. 
Ammonia water. 
Ammoniated mercury. 
Chrysarobin. 
Staphisagria. 
Group III-Drugs used for their Effects upon Nutrition, Metabolism, 
and Heat-Control. 
1. Digestants. 
2. Tonics. 
3. Reconstructives (Restoratives). 
4. Alteratives. 
5. Antipyretics. 
6. Antiperiodics (see Parasiticides, under 
Group II.) 
Agents which favor or assist digestion are important for the upbuilding 
or nutrition of the body. They-the Digestants-include those drugs 
and products which are the animal and vegetable counterparts of, or the 
natural peptics and digestive acids, ferments, and enzymes. Thus hydro- 
chloric acid, which is a normal constituent of gastric juice, is not only a 
direct digestant, but indirectly it prevents fermentative changes in the 
gastric contents, chemically affects certain ferments, and stimulates 
peristaltic movements. 
These drugs are especially useful in aiding digestion: hydrochloric acid 
in hypoacidity or achlorhydria; pepsin to digest albumens; pancreatic 
ferments to convert starches into sugars, proteids into peptones, emulsify 
fats, etc. 
81 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Drugs and other agents and agencies which permanently exalt the 
energies of the body at large, without vitally affecting any one organ in 
particular, are known as Tonics. While, as a rule, they do not increase the 
rapidity of the circulation, nor heighten temperature, nor produce marked 
excitement like stimulants, they do, however, increase muscular tone, 
sharpen the appetite, improve the processes of digestion and assimilation, 
strengthen the vascular system, and improve the quality of the blood and 
the nutrition of the nervous apparatus. Their effect is that of slowly and 
permanently exalting organic action. While the heart may contract more 
firmly under their use, its action may not be increased in rapidity though 
it may gain in power. Tonics change the character of the pulse from 
flaccidity to firmness and fullness. In short, tonics tone the whole system. 
Without doubt most tonics act primarily upon the nervous system, and 
while some are of mineral origin the greater number of them is derived from 
the vegetable kingdom, and most of them are bitter. Formerly there were 
included among the tonics agents known as antiperiodics. While the 
result of their use is ultimately tonic they now properly belong with the 
antiparasitics, as they act upon the protozoa which cause malarial cycles. 
Tonics are useful in debilitated conditions of the organs of digestion, 
and in depressed states of the nervous system. They are especially valuable 
in convalescence from acute diseases and have long held an enviable reputa- 
tion in the after-treatment of periodical disorders. When long and ex- 
cessively employed, tonics may induce febrile reaction and other abnormal 
effects. They are contraindicated, as a rule, during active fevers and in- 
flammations. 
When drugs, such as iron and the mineral acids, act by supplying 
deficiency in the fluids of the body, or alter their chemical character, they 
are classed as Restoratives or Reconstructives. In this group properly belong 
Hematinics, which increase the supply of haemoglobin in the red discs as 
well as having a tendency to increase the number of red corpuscles. Plasma- 
altering drugs (Alkalivers) also belong in this group. There are also agents 
(gelatins and the calcium salts) which favor coagulability of the blood. 
On the other hand, a few are said to diminish coagulability (certain acids 
and salts derived from them). Some drugs arrest the migration of white 
blood corpuscles (quinine and allied alkaloids), and there are those which 
alter the composition of the haemoglobin and prevent its union with oxygen 
(coal-tar group). 
The term Alterative is an elastic one, used largely as a matter of con- 
venience in considering a group of drugs, the mode of action of which is 
largely unknown. This much is accepted, however, that all medicines act 
in such a manner as to alter some function or condition. More strictly, the 
term alterative is applied to drugs, which by their effects are believed to 
act in a quiet and unexplainable manner, so as to modify disordered proc- 
esses of nutrition. Most of them are eliminants of morbific material. 
How alteratives act is not always known, but their effects are apparent. 
Administered in small and continuous doses, alteratives improve the 
quality of the blood, increase the appetite, promote digestion, and ac- 
celerate the processes of elimination. They also improve the condition of 
the nerve centers, and give an impetus to greater and healthier activity of 
82 INTRODUCTION. 
the circulatory and breathing organs. The results are those desired in the 
correction of faulty metabolism, as far as the latter is understood. As 
normal metabolic processes are still matters of future determination, the 
effects of alteratives under deviations of metabolic operation cannot now 
be definitely explained. Almost all of our knowledge concerning alteratives 
is wholly empiric. 
A special action of alteratives is believed to be the breaking down and 
removal of certain noxious substances in the system; in other words, 
they have long been thought to act favorably in such constitutional dis- 
orders as were formerly included in the misnomer "bad blood," or at present 
as toxaemia. That they do improve such conditions is evident from their 
effects in syphilis, scrofula (tuberculosis of the glands), and in tubercular, 
carcinomatous and malarial manifestations. Though their action cannot 
be explained, they still constitute a very valuable group of drugs, hetero- 
geneous though they be. The so-called alteratives have been among the 
most useful of medicines in Eclectic therapy. 
Some drugs cause a lowering, some a rise of heat of the body. In health 
heat is derived from the mechanical movements of the muscles and other 
parts of the body, and from the oxidation of foods. The temperature in 
health is maintained in nicely adjusted balance by a heat-regulating function 
(thermotaxis) believed to reside in a heat-regulating center, or mechanism, 
presumably located in the basal ganglia of the brain. Such a coordinating 
center, however, has never been located or proved in any other way; it is 
merely assumed that it exists. Through this assumption it is conceived 
that heat-production (thermogenesis) and heat-dissipation (thermolysis) 
are so nicely adjusted in health that a mean normal temperature of 98.6°F. 
is maintained regardless of the surrounding variations of heat. Now, 
when this proportioned balance is disturbed, fever occurs on the one hand, 
or a subnormal temperature on the other. Whether through the control of 
the center referred to or not, the body, while gaining heat through muscular 
movements and food oxidation, also loses heat by radiation and evaporation 
through the dilatation of the cutaneous capillaries, by the action of external 
cold (usually compensated for by increased heat-production), by denuda- 
tion of the epiderm (as in burns), and normally by the output of watery 
vapor by the lungs and the skin. 
Drugs that reduce temperature in fevers are called Antipyretics or 
Febrifuges. As a rule they do not affect the temperature in health. Some 
drugs temporarily depress the heat-center, lowering the increased tempera- 
ture (coal-tar series); some increase heat-dissipation through the circulation 
(alcohol, and probably aconite); some lower heat by inducing sweating 
(diaphoretics); some retard metabolism or lessen oxidation, causing a 
diminished production of heat (quinine); a few agents cause a great loss of 
watery vapor by way of the lungs and skin (ether); others produce increased 
conduction and abstraction of heat (long continued cold bath, ice), and 
spraying with volatile liquids (ethyl chloride, ether) reduces local tempera- 
ture by abstracting heat. Refrigerant purgatives (by watery abstraction) 
and other purgatives, by removing offending or irritating material, cause a 
subsidence of temperature, when above normal. 
83 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
The use of antipyretics solely for the forcible depression or reduction of 
heat is bad medication. The simple means and drugs which approach more 
nearly the normal bodily functions are always to be selected. All the medical 
world has come to see the folly of the methods used so freely a few years 
ago, of depressing temperature by excessive doses of antipyretic drugs, 
especially those of the coal-tar group. 
(A few drugs are known to raise temperature probably by acting upon 
the heat centers. Among these are belladonna, cocaine, coffee and caffeine, 
nux vomica and strychnine, and certain of the biologic products.) 
1. DIGESTANTS. 
Pepsin. 
Papain. 
Ox-gall. 
Diastase. 
Hydrochloric acid. 
Caroid. 
2. TONICS. 
Bitter Tonics: 
Hydrastis. 
Gentian. 
Frasera. 
Fraxinus. 
Cornus. 
Coptis. 
Nux Vomica. 
Colombo. 
Chelone. 
Berberis. 
Berberis aquif. 
Aletris. 
Quassia. 
Ligustrum. 
General Tonics: 
Nux Vomica. 
Berberis. 
Fraxinus. 
Hydrastis. 
Cornus. 
Absinthium. 
Salicin. 
Populus. 
Ceanothus. 
Prinos. 
Euonymus. 
Salvia. 
Ptelia. 
Agrimony. 
Aletris. 
Cinchona. 
Quinine salts. 
Coca. 
Piper Methysticum. 
Myrica. 
Iron and strychnine citrate. 
Asclepias cornuti. 
Ligustrum. 
3. RECONSTRUCTIVES {Restoratives). 
Cod-liver oil. 
Phosphorus. 
Hydrochloric acid. 
Nitro-hydrochloric acid. 
Sulphuric acid. 
Phosphoric acid. 
Nitric acid. 
Lactic acid. 
Manganese sulphate. 
Fowler's solution of arsenic. 
Calcium phosphate. 
Calcium hypophosphite. 
Potassium hypophosphite. 
Sodium chloride. 
Sodium hypophosphite. 
Copper acetate (Tinct.). 
Hematinics: 
Iron,reduced. 
Iron, acid solution. 
Iron carbonate. 
Iron chloride. 
Iron chloride (Tinct.). 
Iron acetate (Tinct.). 
Iron ferrocyanide. 
Iron lactate. 
Iron phosphate. 
Iron subcarbonate. 
Iron sulphate. 
Iron hypophosphite. 
Iron pyrophosphate. 
Iron valerianate. 
Iron and ammonium citrate. 
Iron and ammonium tartrate. 
Iron and quinine citrate. 
Iron and potassium tartrate. 
Iron and strychnine citrate. 
4. ALTERATIVES. 
Echinacea. 
Phytolacca. 
Iris. 
Baptisia. 
Podophyllum. 
Podophyllin. 
Stillingia. 
Rumex. 
Corydalis. 
Lappa. 
Jeffersonia. 
Chionanthus. 
Collinsonia 
Kalmia. 
Condurango. 
Colchicum. 
Alnus. 
Guaiac. 
84 INTRODUCTION. 
Chaulmoogra. 
Trifolium. 
Gaultheria. 
Sassafras. 
Calendula. 
Rhamnus californica. 
Xanthoxylum. 
Sarsaparilla. 
Fucus. 
Iodine. 
Potassium iodide. 
Sodium iodide. 
Calcium iodide. 
Potassium acetate. 
Hydriodic acid. 
Ammonium iodide. 
Sulphur. 
Calcium sulphide (crude). 
Sodium salicylate. 
Mercury. 
Mercuric chloride. 
Mercuric iodide (red iodide). 
Mercurous iodide (yellow iodide). 
Arsenic. 
Arsphenamine (Salvarsan). 
At oxy 1. 
Iron arsenate. 
Tartaric acid. 
Sodium cacodylate. 
Chromium sulphate. 
Gold and Sodium chloride. 
Dulcamara. 
Myrica. 
Plantago. 
Ceanothus. 
Lemon juice. 
Citric acid. 
Chimaphila. 
Salicin. 
Menispermum. 
Manaca. 
Liatris. 
Polymnia. 
Acetic acid. 
5. ANTIPYRETICS. 
Antipyrine. 
Acetanilide. 
Phenacetine. 
Aconite. 
Veratrum. 
Gelsemium. 
Quinine Salts. 
Cinchona and its Alkaloids. 
Salicin. 
6. ANTIPERIODICS. 
Cinchona. 
Quinine salts. 
Arsenic. 
Boletus. 
Tela araneae. 
Eupatorium perf. 
Agaricus. 
Group IV-Drugs used for their Effects upon Secretion and Excretion. 
I. On Mucous Membranes and their 
Glandular Appendages. 
A. Alimentary canal: 
1. Sialagogues. 
2. Stomachics (Peptics). 
3. Gastric Sedatives. 
4. Carminatives. 
5. Emetics. 
6. Antiemetics. 
7. Demulcents. 
8. Absorbents (see also Group I, 6). 
9. Antacids. 
10. Cathartics: 
(a) Laxatives. 
(b) Simple Purgatives. 
(c) Drastics. 
(d) Hydragogue Cathartics. 
(e) Saline Cathartics. 
11. Cholagogues. 
12. Astringents: 
(a) Organic (tannin bearing). 
(b) Inorganic (mineral). 
13. Pancreatic Stimulants. 
14. Gastro-Intestinal Antiseptics. 
(a) Antifermentatives. 
(b) Antiputrefactives. 
B. Respiratory Tract: 
1. Irritants. 
2. Stimulating Expectorants. 
3. Sedative Expectorants. 
C. Genite-Urinary Tract: 
1. Diuretics: 
(a) Hydragogue. 
(b) Renal Depurants. 
(c) Antiseptics. 
(d) Antilithics. 
(e) Lithontriptics. 
(f) Astringentsand Repressants 
(g) Genito-Urinary Stimulants. 
(h) Genito-Urinary Sedatives. 
II. On Reproductive Organs: 
1. Emmenagogues and Uterine Tonics. 
2. Galactagogues. 
3. Antigalactagogues. 
HI. On Skin and Appendages: 
1. Diaphoretics. 
(a) Sudorifics. 
2. Anhydrotics. 
85 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
A very large number of medicines have an exciting or modifying 
action upon secretion and excretion, and the parts concerned in these 
functions. 
On the alimentary canal may be noted those which excite the flow of 
saliva (Sialagogues), and those which restrain it (Antisialagogues or Anti- 
sialicsfi These effects are produced chiefly by the action of drugs upon 
(1) the nerves entering the salivary glands, notably branches of the chorda 
tympani and cervical sympathetic trunks; (2) by direct impression of the 
glandular cells; or (3) reflexly, by stimulation of the terminals of neighbor- 
ing nerves, as the gustatory and glossopharyngeal. Mental impressions 
and peptic bitters also reflexly excite the flow of saliva. 
Stomachics or Peptics sharpen the appetite and increase gastric func- 
tional activity. Nearly all of them contain a bitter principle, though 
alcohol and some of the volatile oils and pungent principles act as gastric 
excitants. Their action is not well understood, but it is generally con- 
ceded that they (1) increase the muscular movements of the stomach, and 
(2) probably increase secretion by impressing the terminals of the vagi, 
resulting reflexly in a stimulation of the secretory cells of the glands of the 
stomach. 
Stomachics are used chiefly in atony of the stomach with failing 
appetite, and in chronic gastric catarrh; and are usually contraindicated 
when there is marked irritability, inflammation, or hypersecretion (some 
are valuable in the latter), gastric sedatives being preferred here. 
Gastric Sedatives are agents which by their effects upon the peripheral 
nerves of the stomach, and possibly by inhibition of excessive movements 
of the organ, produce sedation. The general nervous sedatives used for 
other purposes often fulfill this office. In Eclectic practice minute doses of 
gastric excitants (capsicum, ipecac, nux vomica, lobelia) and of the special 
arterial sedatives (aconite) are often our most effectual gastric sedatives. 
Agents which are known to cause or facilitate the expulsion of gas from 
the stomach and intestines are denominated Carminatives. Usually they 
are aromatic, more or less antiseptic, and by relief of tension physical re- 
lievers of pain. They are believed to act by increasing the local circulation 
of the parts involved, and by provoking increased peristalsis, and relaxation 
of the gastric orifices. 
Vomiting is a reflex act and is produced by many causes, all of which 
really operate in one way or another upon the vomiting center, a point in 
close relationship to the respiratory center. Probably this explains why 
emetics are usually also expectorants. It is the general consensus of opinion 
that impulses originating in any part of the body may be conveyed to the 
vomiting center and thus produce emesis. Drugs taken into the stomach, 
or injected, or absorbed from denuded surfaces, are carried by the blood 
current, and affect the medullary center. They are then called the direct, 
specific, general or centric Emetics. When by irritation of the nerve-endings 
of the gastric surfaces they reflexly induce vomiting they are denominated 
irritant, gastric, local, mechanical, or indirect Emetics. Some drugs act 
solely as centric emetics; others as gastric emetics. Some act in both ways. 
Confusion has arisen from the fact that the terms direct and indirect have 
been reversed from the positions here given. Unquestionably the best 
86 INTRODUCTION. 
terms are centric and gastric. The gastric emetics are less apt to impress 
the whole system than are the centrics, whose influence often extends to 
the muscular, nervous, and vascular systems and produces general re- 
laxation, and sometimes sweating. 
Emetics are used chiefly (1) to rid the stomach of undigestible or 
offending material; (2) to evacuate poisons; (3) to dislodge foreign bodies 
from the stomach or esophagus or adjacent larynx; (4) to aid in the ex- 
pulsion of false membranes and mucus from the respiratory tract; (5) to 
compress the abdominal organs and thus aid in expelling mucus, bile, and 
sometimes concretions from the gall-duct; (6) occasionally to avert spasm 
by producing relaxation; (7) and rarely for general systemic effect. 
Specific Indications for Emetics.-"Emetics are specifically indicated 
when the tongue is broad, full, dirty, and especially coated at its 
base. There is sometimes nausea, disgust for food and drink, and every- 
thing taken seems to stop at the stomach. The patient complains of 
sensations of weight and oppression at the epigastrium" (Scudder's Materia 
Medica, p. 112). 
Contraindications.-Emetics are contraindicated, as a rule, where 
there is a marked determination of blood to the brain, as in cerebral con- 
gestion, apoplexy, and phrenitis; atheroma, arterio-sclerosis, aneurysmal, 
and other organic degenerations of the circulatory organs; in pregnancy and 
herniae; in marked gastro-intestinal irritation or inflammations; in advanced 
inflammations and fevers; and in cases of great debility. As a rule, they are 
not to be used in corrosive poisoning by the tissue-destroying acids or alkalies. 
As emesis depends upon a variety of causes, only certain types of 
vomiting are relieved by the Antiemetics proper, agents which probably act 
(1) directly upon the vomiting center, depressing it, or (2) indirectly upon 
the gastric sensory nerve terminals. When vomiting is due to kidney 
disease, to pregnancy, reflexly from pain, or purely nervous or hysterical, 
it must be specially rectified and cannot, as a rule, be controlled by so- 
called antiemetics. When due to irritation of the vomiting center or to 
gastric irritability, cancer or gastric ulcer, the antiemetics may relieve. 
Agents which are antiemetics are also generally among those named in the 
group of gastric sedatives. 
Agents of a colloidal type designed to soften, relax, relieve tension, 
diminish pressure, and protect from inflammation and friction are grouped 
under the name Demulcents. They are usually of a mucilaginous or syrupy 
nature and are used chiefly upon mucous membranes. Rarely, they are 
applied to the skin. Somewhat similar in action, and nearly always applied 
to the skin and exposed mucosa, are the emollients, preparations chiefly 
of an oleaginous character. 
A bsorbents are physical agents which take up by absorption the 
excessive fluids or gases in the gastro-intestinal tube. 
Antacids act chemically, overcoming excessive acidity. They also 
serve in many instances as antiseptics, checking or retarding fermentation 
and putrefaction. 
Acids are sometimes required to furnish a deficiency of such agents, 
and for their general effect upon secretions not only of the intestinal tube 
but upon the renal and vesical contents. 
87 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Gastric Antacids are especially valuable to prevent lactic, butyric 
and acetic fermentation, and prevent or relieve pyrosis and sour eructations. 
They often promptly relieve gastralgia due to excessive acidity, and are 
useful to lessen hyperacidity in hyperchlorhydria. They are required in 
alkali poisoning; and their influence is sometimes needed in parts remote 
from the stomach, as in extreme acid conditions of the urine. 
Cathartics are agents which cause evacuation of the bowels. They are 
divided into classes according to their intensity of action and the char- 
acter of the stools produced. Cathartics are often spoken of in general as 
purgatives, and purgatives as cathartics. They act (1) by increasing 
peristalsis, and also (2) it is generally believed, but still a matter of dispute, 
by exciting an increase of the natural secretion of the glands of the in- 
testinal tract. A few are thought to act by salt action (Salines'). 
Cathartics are divided into Laxatives or Aperients when mild in action 
and causing but little evacuation beyond that of normal and with but 
little or no increase of secretions. A similar action increased in severity 
and with semiliquid stools is produced by the Purgatives. Necessarily a 
laxative may be a purgative or a purgative a laxative according to dose and 
conditions under which it is administered. Agents which act harshly 
or violently, and may, in overdoses, cause enteritis, and often emeto- 
catharsis, are called Drastics. When a brisk action, with full evacuations 
and an augmentation of the intestinal and accessory glandular juices, but 
not in sufficient force to create enteric inflammation, are caused by drugs, 
some physicians reserve for such the general name Cathartics. Agents 
which cause copious watery stools are denominated Hydragogues, a class 
which may include the Vegetable Hydragogues and the Saline Purgatives. The 
latter, being cooling and capable of reducing the body-heat, are sometimes 
referred to as the Refrigerant Cathartics. A few drugs are believed to stimulate 
the bile-secreting apparatus to a greater output of bile, and at the same 
time produce purgation. These are called Cholagogues. Small doses of 
cholagogues may act silently upon the liver and not produce catharsis. 
These are often more effectual as medicines than doses which also purge. 
Emmenagogue Cathartics, like hellebore and aloes, by acting directly upon 
the pelvic viscera, assist in the establishment of menstruation. 
Laxatives or purgatives are in common use (1) to cleanse the gastro- 
intestinal tube; (2) to promote hepatic activity; (3) to overcome acute 
and chronic constipation (the latter seldom achieved when cathartic doses 
are used); (4) to act as derivatives in certain brain disorders; (5) to assist 
in the removal of dropsical fluid; (6) to rid the body of toxic material giving 
rise to autointoxication; and (7) to promote a general sense of well-being. 
If used with judgment, cathartics are valuable medicines; as usually 
abused they are capable of more harm than good. 
Agents, which when brought into contact with the tissues in any 
part of the body cause a constriction or condensation of the same, are 
denominated Astringents. Their action is undoubtedly chiefly chemical, 
acting by precipitating albumen, and to some extent by shrinking proto- 
plasm, constricting secreting-cells, or local blood-vessels. The effects are 
best observed upon the mucosa. Tannin is the astringing principle of the 
vegetable astringents, while the mineral astringents comorise the metallic 
88 INTRODUCTION. 
salts. They are used chiefly as protectives, to restrain secretion and to 
check hemorrhages (styptics). Besides these, they are believed by many to 
have a remote but undefined action upon the body at large, conserving 
tone and strength. This old view is shared by only a few at the present 
day; but is probably not wholly groundless. 
Pancreatic Stimulants are agents which increase pancreatic secretion. 
Gastro-intestinal Antiseptics are agents which prevent, retard, or over- 
come gastric fermentation or putrefaction. 
The Respiratory Irritants are agents which excite local action, such 
as the Sternutatories, which increase nasal secretion and provoke sneezing; 
and the Errhines which properly excite secretion only. Both act upon the 
vaso-motor control, causing some increase in arterial tension, while the 
former excites the respiratory center through conduction of the irritating 
impulse by the nasal branch of the fifth cranial nerve, and sneezing results. 
Powdered drugs are usually employed, though some pungent gases may 
have a similar effect. 
Agents which modify the quality and quantity of the secretions of the 
respiratory mucous membrane and facilitate its expulsion are called 
Expectorants. Some drugs impress the respiratory tract by acting directly 
upon the glands of the mucosa, some act through centric influence, others 
by local irritant properties (especially vapors), and some by antibacterial and 
antiseptic powers. Also drugs and measures which modify the action of the 
circulatory and other organs have an indirect effect upon secretion and 
excretion of bronchial mucus. 
When drugs promote or excite secretion and render the sputum less 
viscid they are termed Sedative Expectorants. The smaller doses of drugs 
which in full amounts cause emesis usually act in this manner. This class 
of expectorants often causes increased liquefaction of the secretions, depletes 
congested surfaces, renders offending material less irritating by attenuation, 
and occasionally acts through an antibacterial influence. They are indicated 
by the dry, hard cough, with under-secretion and little or no expectoration. 
Drugs which lessen the quantity of secretion, probably by allaying 
irritation and raising the tone of the mucous membrane and sometimes 
through antisepsis, are called Stimulating Expectorants. These are indicated 
by over-secretion, loud mucous rales, loose cough, and abundant expectora- 
tion. (For action of drugs upon respiration, see also Group V, C.) 
Diuretics act upon the kidneys, increasing the secretion of urine. 
Some agents act directly upon the secreting cells; others through in- 
creased blood-pressure and blood supply. Their efficiency depends largely 
upon the integrity of the renal organs, congestion preventing adequate 
secretion, and destroyed cells contributing to anuria. Agents which in- 
crease the power of the heart and give better tone to the blood vessels, 
usually, if the kidneys be intact, act as efficient diuretics in disease. Cold, 
checking the cutaneous function, and the imbibition of water generally 
increase diuresis, and these are invoked to rid the system of already broken- 
down material of the body. When drugs do this they are called Renal 
Depurants; agents which increase the fluid output only, Hydragogue Diuretics. 
Diuretics are useful and indicated to maintain renal activity in de- 
ficient urination, particularly in febrile states, when only the non-stimulating 
89 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
and refrigerant types should be used. The alkaline salts are used in acid 
conditions, and together with plenty of water when uric acid is abundant. 
Both water and the latter are especially valuable to soothe and lessen 
irritation, and to prevent the formation of calculi. Many substances are 
given to render the urine as antiseptic as possible ( Urinary Antiseptics), 
and some drugs diuretic in themselves carry antiseptic principles. Other 
agents are given to repress the secretion of urine (Astringents or Repress ants), 
as in polyuria. 
There are some drugs which, while increasing the urinary output, 
have a direct stimulating effect upon the mucous passages as well. These 
may be called Genito - Urinary Stimulants. Many of them owe their virtues 
not alone to their stimulating qualities, but to antiseptic principles they 
contain. For this reason they inhibit or retard bacterial growth and 
subsequent urinal decomposition. In excessive amounts they may cause 
inflammation of the whole urinary tract, and when the latter is active from 
other causes they are contraindicated. They are, however, often useful 
in so-called subacute, acute, and chronic types of cystitis, urethritis, and 
even when pus is present, as in the same grades of pyelitis. On the other 
hand there are drugs which, in addition to alkalinizing or acidifying qualities, 
or to demulcent or antiseptic effect, have a general sedative action upon the 
genito-urinary mucosa. These are the Genito-Urinary Sedatives. 
It has also been commonly supposed that certain agents have the 
power to dissolve concretions. This is doubtful, though some drugs appear 
to have a disintegrating effect by dissolving the cementing substance binding 
together particles of gravel. Hence the term Antilithics, and Lithontriptics, 
though not strictly apt, are still retained in therapeutic classifications. 
A few medicines are believed to act directly upon the uterine mucous 
membranes, producing or increasing the menstrual flow. These are the 
direct Emmenagogues. As the need for emmenagogues usually depends 
upon anemia, debility, some constitutional disorder, or a pelvic malady, 
the correction of these, when practicable, usually is followed by a restora- 
tion of the menstrual function. General and uterine tonics and blood 
restoratives generally act indirectly as emmenagogues. 
The secretion of milk is probably a purely local or independent function 
of glandular action, and its perfection depends largely upon the general 
state of health. However, some drugs are believed to impress the gland 
tissues themselves, or to stimulate some nervous mechanism connected 
therewith, causing an increased production of milk. These are the Gal- 
actagogues. Agents and conditions acting inversely prove Antigalactagogue. 
Both cold and warm water, the body being kept warmly covered, 
and certain drugs increase perspiration. Drugs used for this purpose are 
Diaphoretics. In many instances sweating occurs indirectly through in- 
fluences producing a sudden dilatation of the peripheral blood vessels, as 
respiratory depression with dyspnoea, strong emotions, as joy or fright, and 
nausea. Drugs which increase sweating are those which (1) stimulate the 
special nerve terminals in the sweat glands, or (2) indirectly the cells of the 
sweat centers (central nervous system), or (3) reflexly irritate the periph- 
eral sensory terminals, or (4) drugs which increase the peripheral blood 
supply. When drugs cause profuse sweating they are Sudorifics. 
90 INTRODUCTION. 
Conversely agents that (1) lessen irritability of the sweat centers, or 
(2) depress the secretory cells of the sudoriferous glands, or (3) their terminal 
nerves, check excessive sweating, are called Antihydrotics or Anhydrotics. 
Diaphoretics are valuable to prevent or arrest local congestion or 
inflammation when caused by sudden checking of perspiration by cold 
or other agencies; to rid the body of poisonous detritus, especially in 
uraemia; and to promote the elimination of dropsical effusions. 
Antihydrotics are useful in colliquative sweating and in local hyper- 
hydrosis and bromidrosis. 
A. ALIMENTARY TRACT. 
1. Sialagogues. 
Pilocarpus. 
Sanguinaria. 
Piper. 
Capsicum. 
Cubeba. 
Ginger. 
Mustard. 
Ether. 
Chloroform. 
Physostigma. 
Ipecac. 
2. Stomachics {Peptics). 
Nux vomica (small doses). 
Hydrastis. 
Hydrochloric acid. 
Capsicum. 
Gentian. 
Piper Methysticum. 
Calumba. 
Frasera. 
Alcohol. 
Volatile oils. 
3. Gastric Sedatives. 
Amygdalus. 
Bismuth. 
Charcoal. 
Morphine (minute doses). 
Nux vomica (minute doses). 
Aconite (minute doses). 
Ipecac (minute doses). 
Lobelia (minute doses). 
4. Carminatives. 
Cinnamon. 
Cloves. 
Peppermint. 
Spearmint. 
Coriander. 
Calamus. 
Piper. 
Wintergreen oil. 
Anise. 
Fennel. 
Asepsin. 
Nutmeg. 
Oil of cajuput. 
5. Emetics. 
Lobelia. 
Ipecac. 
Squill. 
Zinc sulphate. 
Copper sulphate. 
Apo morphine hydrochloride. 
Mustard. 
Sodium chloride. 
Sodium bicarbonate (in acid stomach). 
6. Antiemetics. 
Ipecac (minute dose). 
Cocaine. 
Aconite. 
Nux Vomica. 
Cerium oxalate. 
7. Demulcents. 
Flaxseed. 
Egg-albumen. 
Ulmus. 
Honey. 
Barley. 
Starch. 
Acacia. 
Marshmallow. 
Sugar. 
Glycyrrhiza. 
8. Absorbents. 
Agar. 
Charcoal. 
Chalk. 
Bismuth. 
9. Antacids. 
Chalk. 
Sodium bicarbonate. 
Potassium bicarbonate. 
Potassium hydroxide. 
Sodium hydroxide. 
Potassium carbonate. 
Calcium hydroxide. 
Sodium carbonate. 
Asepsin. 
Ammonia. 
91 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS 
10. Cathartics. 
Laxatives: 
Rhubarb. 
Cascara sagrada. 
Phenolphthalein. 
Liquid petrolatum. 
Juglans. 
Taraxacum. 
Manna. 
Olive oil. 
Magnesium oxide. 
Magnesium carbonate. 
Aloes. 
Sodium phosphate. 
Frangula. 
Rhamnus californica. 
Calomel. 
Agar-agar. 
Salines: 
Magnesium sulphate. 
Solution of magnesium citrate. 
Sodium sulphate. 
Sodium phosphate. 
Rochelle salt. 
Simple Purgatives or Cathartics: 
Castor oil. 
Jalap. 
Senna. 
Podophyllum. 
Podophyllin. 
Leptandra. 
Cassia marilandica. 
Drastics: 
Croton oil. 
Colocynth. 
Hydragogue Cathartics: 
Elaterium. 
Hellebore. 
Gamboge. 
Colocynth. 
Veratrum album. 
11. Cholagogues. 
Sodium salicylate. 
Podophyllum. 
Podophyllin. 
Chionanthus. 
Chelidonium. 
Ox-gall. 
Sodium phosphate. 
Sanguinaria. 
Iris. 
Grindelia. 
12. Astringents. 
(«) Organic: 
Tannic acid. 
Gallic acid. 
Geranium. 
Rhubarb (secondary). 
Mangifera. 
Cinnamon. 
Hemlock. 
Epilobium. 
Erigeron. 
Nutgall. 
Gambir. 
Haematoxylon. 
Hamamelis. 
Kino. 
Rhatany. 
Quercus. 
Rubus. 
Rhus glabra. 
Urtica. 
(b) Inorganic: 
Alum. 
Iron and ammonium sulphate. 
Solution of ferric chloride. 
Monsel's solution. 
Zinc sulphate. 
Lead acetate. 
Copper sulphate. 
Chalk. 
Bismuth subnitrate. 
13. Pancreatic Stimulants. 
Ether. 
14. Gastro-Intestinal Antiseptics. 
Salol. 
Phenol. 
Potassium chlorate. 
Sodium sulphocarbolate. 
Zinc sulphocarbolate. 
Sodium sulphite. 
Echinacea. 
Charcoal. 
Salicylic acid. 
Salicylate of sodium. 
Asepsin. 
B. RESPIRATORY TRACT. 
1. Irritants. 
Sanguinaria. 
Ammonia. 
Ipecac. 
Veratrum. 
Veratrum album. 
Ginger. 
Tobacco (snuff). 
Capsicum. 
Cubeba. 
2. Stimulating Expectorants. 
Asarum. 
Serpentaria. 
Balsam of Tolu. 
Balsam of Peru. 
Tar. 
Inula. 
Guaiacol. 
Pichi. 
Yerba reuma. 
Eucalyptol. 
Eucalyptus. 
Yerba santa. 
Dracontium. 
Spikenard. 
Ammonium chloride. 
Potassium iodide. 
Onion. 
Garlic. 
Potassium bichromate. 
92 INTRODUCTION. 
Terpin hydrate. 
Terebene. 
Stillingia liniment (full dose). 
Senega. 
Sanguinaria. 
Copaiba. 
Cubeba. 
Squill. 
Liquidambar. 
Myrrh. 
Grindelia. 
Aris ze ma. 
3. Sedative Expectorants. 
Ipecac. 
Lobelia. 
Citrate of potassium. 
Citrate of sodium. 
Acetate of potassium. 
Solution of ammonium acetate. 
Euphrasia. 
Stramonium. 
Euphorbia Ipecacuanhae. 
Euphorbia pilulifera. 
Euphorbia corollata. 
Euphorbia hypericifolia. 
Eupatorium perfoliatum. 
Drosera. 
Quebracho. 
Apomorphine. 
Anemopsis. 
Hydrocyanic acid. 
Symphytum. 
Stillingia liniment (small dose). 
Spongia 
Prunus virginiana. 
Catalpa. 
Hepatica. 
Impatiens. 
C. GENITO-URINARY TRACT. 
1. Diuretics. 
(a) Hydragogues: 
Diuretin (Theobromine sodium salicy- 
late). 
Mentha viridis. 
Petroselinum. 
Oxydendron. 
CEnothera. 
Galium. 
Apis. 
Eryngium. 
Equisetum. 
Verbascum. 
Capsella. 
Triticum. 
Spirit of nitrous ether. 
Aralia hispida. 
Cantharides. 
Sparteine sulphate. 
Scoparius. 
Squill. 
Sambucus. 
Sugar of milk. 
Potassium nitrate. 
Digitalis. 
Caffeine. 
Convallaria. 
Cucurbita. 
Pepo. 
Asclepias incarnata. 
(&) Renal Depurants: 
Potassium acetate. 
Potassium citrate. 
Potassium nitrate. 
Potassium bitartrate. 
Sodium acetate. 
Sodium nitrate. 
Basham's mixture. 
Eupatorium purpureum. 
(c) Antiseptics: 
Diuretin. 
Uva ursi. 
Hexamethylenamine (Urotropin). 
Buchu. 
Chimaphila. 
Epigeze. 
Copaiba. 
Cubeba. 
Thuja. 
Turpentine. 
Pyrola. 
Methylene blue. 
Sodium benzoate. 
Oil of sandal wood. 
Juniper. 
Matico. 
Eryngium. 
Eupatorium purpureum. 
Lithium benzoate. 
Lithium salicylate. 
Pichi. 
Piper Methysticum. 
Ammonium benzoate. 
(d and e) Antilithics and Lithontriptics. 
Lithium carbonate. 
Lithium citrate. 
Lithium benzoate. 
Lithium salicylate. 
Hydrangea. 
Piperazine. 
Lycopodium. 
Sodium acid phosphate. 
Diuretin. 
Potassium acetate. 
Potassium citrate. 
Sodium benzoate. 
Dilute nitric acid. 
Dilute nitro-hydrochloric acid. 
Ammonium benzoate. 
(f) Astringents and Repressants: 
Rhus aromatica. 
Belladonna. 
Uva ursi. 
Chimaphila. 
Eupatorium purpureum. 
Pareira. 
Agrimony. 
(g) Genito-Urinary Stimulants: 
Apis. 
Spirit of nitrous ether. 
Cantharides. 
Diuretin. 
93 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS 
(A) Genito-Urinary Sedatives: 
Staphisagria. 
Rhus aromatica. 
Sambucus. 
Althaea. 
Hypericum. 
Verbascum. 
Zea. 
Triticum. 
Equisetum. 
Eryngium. 
Xanthium spinosum. 
Xanthium Strumarium. 
Serenoa. 
Lycopodium. 
II. REPRODUCTIVE ORGANS. 
1. Emmenagogues and Uterine Tonics. 
Macrotys. 
Senecio. 
Gossypium. 
Manganese dioxide. 
Potassium permanganate. 
Tansy. 
Actaea. 
Caulophyllum. 
Leontin. 
Ruta. 
Hedeoma. 
Apiol. 
Mitchella. 
Pulsatilla. 
Helonias. 
Liatris. 
Viburnum prunifolium. 
Viburnum Opulus. 
Salix nigra. 
Ustilago. 
Ergot. 
Viscum. 
Leonurus. 
Lilium tigrinum. 
Iron salts. 
Myrrh. 
Borax. 
Alcohol. 
Fraxinus. 
2. Galactagogues. 
Pilocarpus. 
Castor oil leaves (locally). 
Anise. 
Vanilla. 
Physostigma. 
Potassium chlorate. 
Alcohol. 
3. Antigalactagogues. 
Belladonna. 
Camphor. 
Antipyrine. 
Sage. 
III. SKIN AND APPENDAGES. 
1. Diaphoretics. 
Asclepias. 
Corallorhiza. 
Jaborandi (Pilocarpus). 
Pilocarpine. 
Anthemis. 
Serpentaria. 
Crocus. 
Carthamus. 
Matricaria. 
Opium. 
Dover Powder. 
Diaphoretic Powder. 
Monarda. 
2. Anhydrotics. 
Agaricus. 
Agaricine. 
Salvia. 
Aromatic sulphuric acid. 
Leucanthemum. 
Camphoric acid. 
Group V. Drugs used for their Effects upon the Circulation and Respiration. 
A. Cardiants: 
1. Heart Stimulants. 
2. Heart Sedatives. 
3. Heart Tonics. 
4. Special Sedatives. 
B. Vaso-Cardiants: 
1. Vasomotor Stimulants. 
2. Vasomotor Sedatives. 
C. Respirants: 
1. Respiratory Stimulants. 
2. Respiratory Depressants (Sedatives). 
3. Antispasmodics (see also Grou p VI,3). 
The parts and functions of the various parts of the circulatory, and 
to some extent those of the respiratory, systems are so interwoven and 
inter-related that the effects of drugs impressing one part or function are 
apt to be reflected in the others. The control over the circulation by 
drugs is by (1) direct action upon the heart-muscle, (2) by direct im- 
pression upon the cardiac centers and ganglia, (3) by those regulating the 
tonus and lumen of the blood vessels, and (4) by agents which produce 
changes in the composition of the blood. 
Heart Stimulants increase the rate of the heart-beat but do not neces- 
sarily augment its power or force. They are used chiefly in shock, syncope, 
94 INTRODUCTION. 
and in circulatory depression in emergencies and in acute inflammatory 
or febrile diseases. 
Heart Sedatives (Heart-Depressants') decrease both the rate and the 
force of the heart-beat. They are used in nervous over-action of the heart 
associated with general nervous irritability of a sthenic character, and to 
lower blood pressure in aneurysmal and arterio-sclerotic conditions and in 
hypertrophy of the heart. Their need is generally shown by an overly 
vigorous circulation, with full, straining pulse. 
Heart Tonics slow the heart, increase its tone, and improve its nutri- 
tion. They are of value in faulty nutrition and debilitated states of the heart 
due to anatomic or constitutional causes; or to mechanical non-adaptability 
of the heart to the work imposed upon it, or to over-strain of that organ 
from any cause, even when the result of functional autotoxaemias is due to 
the toxins of general infectious diseases. 
The term Special Sedatives (Arterial Sedatives) has been applied in 
Eclectic therapy to small doses of agents which in large doses are strongly 
depressant upon the circulation. These are used in minute doses (usually), 
which then really act as stimulants, for their effect in reducing rapid 
action of the heart and gradual lowering of temperature. When so employed 
they are never depressing, and have been among the most valued of thera- 
peutic means used by the specific medicationist. The chief of these drugs 
are Aconite, Veratrum, and Gelsemium. 
Vaso-Stimulants (Vaso- Constrictors) constrict the blood vessels, lessen- 
ing their calibre. They are governed chiefly from the vaso-motor center 
in the medulla. Their important offices are to assist in raising blood pres- 
sure in states of collapse, or of shock, and indirectly to increase cardiac 
force. Locally they act as hemostatics. 
Vaso-Sedatives (Vaso-Dilators) relax arterial walls, and like the con- 
strictors are governed by the centric center. By lowering blood pressure they 
are of special service in arteriosclerosis, angina pectoris, eclampsias, chronic 
nephritis, convulsions (with high blood pressure), and indirectly to decrease 
force and increase the rate of heart action, relieving the organ from overwork. 
The respiratory tract is acted upon by drugs which directly stimulate 
the respiratory center in the medulla-True Respiratory Stimulants; 
or indirectly by stimulation produced reflexly by artificial methods of 
inducing respiration (Sylvester's method, Laborde's rhythmic traction on 
the tongue), by the sudden application of cold, electricity, or by irritating 
the nasal branches of the fifth cranial nerves by means of pungent gases. 
These are called Respiratory Stimulants. 
Conversely depression of the respiration may be caused by drugs which 
directly depress the medullary center (True Respiratory Depressants), by 
excessive doses of those which depress the spinal cord (spinal cord de- 
pressants), and by drugs which cause poisoning by asphyxiation (the latter 
being caused in several ways). To all these where respiration is depressed 
is applied the term Respiratory Depressants. (See also Group IV, B-3, 
for Sedative Expectorants.) 
Respiratory Stimulants are employed in dyspnoea, in certain stages of 
inflammation of the lungs, emphysema, and threatened asphyxiation, 
especially from poisons. 
95 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Respiratory Depressants (Sedatives) are used to relieve respiratory 
pain and cough, often being unwisely pushed to the detriment of the 
patient. 
Drugs which relieve asthmatic breathing have been called Respiratory 
Antispasmodics or Antiasthmatics. Evidently they act by relaxing local 
muscular spasms, the assumed action which takes place during an asthmatic 
seizure. Probably they exert their effects through motor and nerve de- 
pression. (See also Group VI, 3 and 6.) 
A. CARDIANTS. 
1. Heart Stimulants. 
Digitalis. 
Strophanthus. 
Ammonia (inhalation). 
Ether. 
Ammonium carbonate. 
Adonis. 
Crataegus. 
Alcohol. 
Convallaria. 
Cactus. 
Apocynum. 
Epinephrine (Adrenalin). 
Amyl nitrite (brief). 
Sodium nitrite. 
Opium. 
Morphine. 
Sparteine sulphate. 
Coffee. 
Caffeine. 
Nux vomica. 
Strychnine. 
Atropine. 
2. Heart Sedatives. 
Aconite. 
Veratrum. 
Gelsemium. 
(In minute doses these are heart 
stimulants.) 
3. Heart Tonics. 
Digitalis. 
Cactus. 
Crataegus. 
Adonis. 
Convallaria. 
Apocynum. 
4. Special Sedatives. 
(A rlerial-Sedatives). 
Aconite. 
Veratrum. 
Gelsemium. 
Rhus. 
Bryonia. 
Lycopus. 
B. VASO-CARDIANTS. 
1. Vasomotor Stimulants. 
(Vaso-Contractors). 
Adrenalin (Epinephrine.) 
Digitalis. 
Caffeine. 
Coffee. 
Ergot. 
Pituitrin. 
Hydrastinine. 
Hamamelis. 
Camphor. 
Strychnine. 
Opium (small dose). 
Atropine (small dose). 
2. Vasomotor Sedatives. 
( Vaso-Dilators). 
Nitrite of sodium. 
Potassium nitrite. 
Amyl nitrite. 
Nitroglycerin. 
Cathartics. 
Alcohol. 
Ether. 
Chloroform. 
Ipecac (full doses). 
Opium (full doses). 
C. RESPIRANTS. 
1. Respiratory Stimulants. 
Strychnine. 
Nux vomica. 
Atropine. 
Belladonna. 
Ammonia (inhalation). 
Ammonium chloride. 
Camphor. 
Eucalyptus. 
Lobelia (small dose). 
Grindelia. 
Spirit of Mindererus. 
Aromatic spirit of ammonia. 
Alcohol (transient). 
Ether (transient). 
Opium (minute dose). 
Caffeine. 
Ipecac (minute dose). 
Monarda. 
Myrrh. 
96 INTRODUCTION. 
2. Respiratory Sedatives. 
Lobelia. 
Ipecac. 
Potassium citrate. 
Potassium acetate. 
Sodium bromide. 
Potassium bromide. 
Amyl nitrite. 
Hydrocyanic acid. 
Amygdalus Persica. 
Prunus virginiana. 
Alcohol. 
Ether. 
Chloroform. 
Chloral. 
Gelsemium. 
Aconite. 
Bromoform. 
Quebracho. 
Squill. 
Yerba santa. 
Tolu. 
Penthorum. 
3. Respiratory Antispasmodics (Anti- 
asthmatics). 
Stramonium. 
Lobelia. 
Potassium nitrate. 
Potassium iodide. 
Morphine. 
Castanea. 
Group VI. Drugs used for their Effects upon the Nervous and Muscular 
Systems. 
NERVINES. 
1. Nerve Stimulants (Cerebral Stimulants). 
2. Nerve Sedatives (Cerebral Sedatives). 
(a) Somnifacients (Hypnotics). 
(b) Anodynes (Analgesics). 
(c) Anaesthetics: 
x General. 
y Local. 
z Antipruritic. 
3. Antispasmodics. 
4. Anticonvulsants. 
5. Motor Excitants. 
6. Motor Depressants. 
7. Mydriatics. 
8. Myotics. 
9. Antihemorrhagics. 
Owing to selective affinity certain drugs expend their whole force 
upon the nervous system, not all parts of which, however, are acted upon 
alike. Some impress that portion of the central nervous system involved 
in the so-called higher development; some the spinal portion. Some act 
upon the brain cells at the origin of the nerves; some upon the peripheral 
nerve endings, while still others impress both. Located in different areas 
of the central nervous system are collections or limited aggregations of 
specialized areas composed of peculiar nerve cells whose office is the con- 
trol over particular functions. These are known as "nerve centers''. 
Thus, in the cerebrum are the so-called higher centers, whose positions are 
not all so definitely known as some others-governing the emotional, psychic, 
and intellectual acts-perception, the will, thought, consciousness, and 
indirectly the whole living body. In the cortex are the more definitely 
defined centers of speech, of the muscular movements, and of sight. It is 
in the medulla, however, that the so-called vital centers are found-those 
governing the very control of life and whose integrity should be especially 
regarded in the administration of drugs. There is a respiratory center 
controlling the function of breathing, an accelerator center for the quicken- 
ing of the heart's action, a vagus or inhibiting center for slowing the heart- 
beat, a vaso-motor center which causes the arteries to contract or to dilate 
accordingly as they are stimulated or depressed, and a vomiting center 
which controls the act of emesis. Besides these there is believed to be a 
thermic center, whose business is the regulation of the heat-balance of the 
body. These centers are closely aggregated and in close proximity to each 
other. A knowledge of them and of the effects of drugs thereon is of the 
greatest importance, and no large survey of drug action can be compre- 
hended without taking them into consideration. 
97 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Further down the nervous tract, in the cord, are the reflex centers- 
those which have control over reflex activity, and the motor centers having 
the regulating power over muscular movements. Some of the nerve trunks 
are connected directly with the sympathetic nervous system by the nervi 
communicantes, or communicating branches; others are independent of 
such a union. 
The effect of drugs, by selective action, whether it be upon the nerve 
cells, the centers, or the terminals, is either to stimulate or to depress them. 
Stimulation usually increases functional power, as when the vagus is 
stimulated, though it may inhibit rapidity of action; depression lowers 
function. Overstimulation may precipitate convulsions. Overdepression 
means progressively paralysis, stupor, coma, or death, all being brought 
about by the depression of the vital centers in the medulla-a series of 
phenomena best exhibited in the action of so-called physiologic poisons. 
Only the specialized types of muscles and of the involuntary type (non- 
striated) seem to be directly acted upon by drugs. The voluntary (striated) 
muscular movements are governed by the effects of drugs upon the nerves 
supplied to them. Indirectly the latter are impressed by drugs and measures 
affecting the general system, as tonics, exercise, massage, electricity, etc. 
The involuntary types of musculature, however, are directly governed by 
a few drugs, such as those which act upon the heart muscle itself, the 
intestines, and the uterus. Furthermore, this variety of muscle is in- 
directly affected by drugs which alter the general state of the system 
through circulatory control. 
Drugs which temporarily increase the functions of one or several 
organs are denominated Stimulants. While, with a few supposed exceptions, 
nearly all medicines first stimulate, all do not come under the head of 
stimulants. The latter may equally well be called Excitants. Stimulants 
are, primarily, neurotic agents, for they first impress the nervous system. 
Some, through nervous influence, govern the circulation and breathing 
power, temporarily increasing respiratory and arterial activity. The 
secretions at large are not sensibly augmented, nor are the excretions 
greatly increased. When, however, drugs act topically, as upon the mucosa 
of the stomach {Stomachics or Gastric Stimulants'), by their excitant action 
they increase locally the circulation, the secretions, and the muscular 
movements. Digestion is quickened by some of them, and the processes 
of chymification and chylification are facilitated. The whole system 
consequently partakes, by sympathy, of this local effect. 
Of the manner in which stimulants act upon the nervous system (Nerve 
Stimulants') our knowledge is very imperfect. Their effects are better 
known. Many impress the motor centers of both the brain and the cord. 
Some are believed to stimulate the brain-cells concerned in psychic processes; 
some presumably increase reasoning power (coffee and caffeine); some 
the imagination (opium, alcohol, cannabis, etc.); some produce mental 
confusion and act as delirifacients (belladonna group, alcohol, etc.); 
and many of them, which in small doses merely stimulate, in large doses 
cause convulsions (strychnine). The size of the dose often determines the 
action, placing the same drug in one or another category. Most stimulants 
increase the activity of the mental function, even producing a degree of 
98 INTRODUCTION. 
exhilaration; their overaction, as when taken in too large doses or for a 
continued length of time, tend to impair the mentality, prostration resulting. 
Stimulants are often named from the parts or functions which they ul- 
timately affect, as the skin (ammonium carbonate), the mucous surfaces 
(turpentine), the muscular system (nux vomica), which, of course, primarily 
stimulates the spinal centers. We also have Respiratory Stimiclants, 
Circulatory Stimulants, and Nervous Stimulants, etc. Primarily they 
are almost all stimulants of nerve tissue. Some Cerebral Excitants, given 
in excessive dose, induce epileptiform convulsions. The use of cerebral 
excitants may be sufficiently inferred from the preceding considerations. 
Some of them also are valuable in states of profound depression, such as 
occur in narcotic poisoning. Thus coffee and caffeine, or belladonna and 
atropine, may be useful in opium poisoning. 
Depressants are agents which act oppositely in most respects to stimu- 
lants. The primary action of depressants is probably upon the same 
anatomic structures and physiologic functions as those for stimulation. 
Thus we have Circulatory Depressants, Respiratory Depressants, Nervous 
Depressants, etc. Primarily the depressant action is upon the nervous 
system. The excessive use of stimulants may result in depression. 
Agents which lessen functional activity of the spinal cord are called 
Spinal Cord Depressants or Motor Depressants (Depresso-Motors). They 
act by depressing (1) the cells of the lower motor or sensory neurons of the 
cord; or (2) indirectly by stimulating the inhibitory centers of Setschenow 
in the medulla oblongata. In very large doses they may also cause a 
more or less abolishment of power. Some drugs in physiologic doses prove 
motor depressant (bromides, gelsemium, potash salts, anaesthetics); others so 
only when given in poisonous doses (quinine, macrotys, opium, cocaine, etc.). 
A few act more strongly on the sensory than the motor neurons (ether, 
bromides, chloroform, cocaine); others with a selective force upon the latter 
(gelsemium, veratrum, chloral, etc.). 
These drugs are of value in reducing excessive action or pain from 
irritation or hyperexcitability; muscular overaction in laryngismus strid- 
ulus, tetany, and paralysis agitans; tetanus and tetanic convulsions from 
poisons; or even in cerebral convulsions by preventing the transmission of 
nervous explosions from the brain to the muscles, or conduction of ex- 
ternal irritation to the brain by way of the spinal pathways. 
Some drugs act upon the periphery of the motor nerve. These are the 
Motor Nerve Depressants, notable among which are conium, belladonna, 
and lobelia. The bromides do the same to a lesser degree, but are active 
chiefly through cerebral, spinal, and sensory nerve impressions. 
Motor nerve depressants are of service in such local disorders of an 
incoordinate type, as spasmodic asthma, chorea (sometimes), spasmodic 
torticollis, whooping cough, etc. 
The Sensory Nerve Depressants {Nerve Sedatives) are those which, 
when given internally, diminish sensibility to pain or discomfort by directly 
depressing the sensory nerves or their terminals, and more readily in lesser 
amounts when applied locally. They act both directly and indirectly to 
relieve pain and itching. Many of them are local anaesthetics and local 
anodynes. 
99 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Drugs which increase the functional activity of the spinal cord are 
termed Spinal Cord Excitants or Motor Excitants (Excito-Motors'). Their 
effect is the exaggeration of normal reflex action by stimulation of the 
cells of certain of the lower motor-neurons of the cord. If administered 
in poisonous doses they cause tetanic convulsions. Even less than 
poisonous doses of the nux vomica alkaloids sensibly heighten the spinal 
reflexes; and in toxic doses they are among the most violent of tetanizers. 
The motor excitants are used when depression but not destruction of 
the motor cells of the cord gives rise to loss of power. Under no circum- 
stances should any appreciable amounts of them be given when active 
inflammation is present, nor should they be given in inflammation of the 
nervous tract, or for some weeks after the subsidence of the latter (as in 
the loss of nervous and muscular power after poliomyelitis). 
Hypnotics or Somnifacients induce sleep. When mild in action they 
are often called Soporifics. Pure hypnotics directly depress the brain 
cells, inhibiting their functional activity. This inhibitory action is not so 
complete, however, as to interfere with the recuperative power of the cells, 
and thus the object of normal sleep is partially obtained at least. Neither 
is the depression so great as to prevent the recognition of outside stimuli, 
for one may easily be aroused from the slumber induced. The action of 
other hypnotics has been explained as due to the withdrawal of, or inter- 
ference with, afferent stimuli, to the lessening of the blood supply to the 
brain (temporary anemia), to brain-cell fatigue decreasing their responsive- 
ness to ordinary stimuli, and to nerve-cell waste circulating in the blood 
current. Wilcox assumes "that it is probable that the anemia is the result 
of depression of the neurone from retraction of the terminal filaments 
of the dendrons." When given in ordinary amounts hypnotics merely 
induce sleep, but when administered in overdoses they produce narcosis- 
a state in which stupor replaces sleep, the cells are depressed until their 
recuperative (rest) powers are more or less completely suspended and, as 
has been well expressed, the individual's relationship with external nature 
has been cut off. Most hypnotics may, therefore, be Narcotics. They are 
also depressants of respiration and the circulation. Some of the narcotics 
are general anaesthetics also (see page 101). 
Hypnotics may be very beneficent agents if properly employed, but 
medical history bears no greater stain than the record of wrecked lives 
from their abuse. To scores they have proved a blessing. To thousands 
they have proved a curse. None of the hypnotics are free from danger; 
none from the possibility of inducing drug addiction. No hypnotic should 
ever be used until other means to produce sleep have been exhausted, and 
the fullest consideration and best judgment of the prescriber invoked. 
Not only have certain of the narcotics played havoc with the individual, 
but their reckless and unwise use by the physician has militated to curtail 
his liberty in the use of medicines and necessitated drastic control on part 
of the Federal Government. This has added clerical burdens to the pre- 
scriber and resulted in a limitation of his once-enjoyed prerogatives in 
the legitimate use of not only the narcotics, but other powerful agents, 
such as the alcoholics. 
100 INTRODUCTION. 
Anodynes relieve pain. They are general when given internally; local 
when applied topically. General Anodynes are more generally called 
Analgesics. They act (1) by depressing the pain-receptive centers of the 
brain or by lessening the excitability of the centers; (2) by lowering the 
excitability of the nerves; or (3) by preventing conduction of painful im- 
pressions going to the brain by way of the sensory nerves and spinal cord 
pathways. They do not necessarily abolish consciousness nor induce 
general insensibility. As general anodynes act systemically, so Local 
Anodynes act locally. They depress or paralyze the sensory nerve terminal 
at the surface of application. Counterirritants sometimes relieve local pain. 
General Anesthetics are agents which produce total loss of conscious- 
ness with abolishment of sensibility to pain and of the reflexes. Their 
depressing action upon the brain cells is more profound than that of other 
drugs and the response to external stimuli completely abolished. 
Local Anesthetics produce insensibility at and around the point of 
application. They do not suspend consciousness. They abolish not only 
sensibility to pain but in many instances to contact. (Compare Anodynes.) 
Agents which act upon the terminals of the sensory nerves, or in any 
other manner, and thereby relieve itching, are called Antipruritics. 
Antispasmodics are drugs which lessen nervous irritability and the 
lesser grades of motor excitation (compare Anticonvulsants). They 
probably produce sedation through stimulation (not by depression) of 
the higher brain centers, thus inhibiting inordinate movements by more 
completely controlling excessive action in the lower motor centers in the 
cord. Some of them in excessive doses cause depression. They are some- 
times called Antihysterics. 
Antispasmodics are especially valuable in hysteria in its varying forms, 
to avert local spasmodic action, and to control general nervous excitability. 
Anticonvulsives are drugs which depress the motor cells of the cerebral 
cortex, lessening motor excitability. Some, more than others, in addition 
to this depression, interrupt or diminish conduction of impulses to and 
from the brain by way of the spinal pathways-i. e., external stimuli com- 
ing to the cerebrum through the sensory tract of the cord, or the trans- 
mission of excessive motor discharges from the cortex to the muscles. 
They thus prevent or control convulsions (compare Antispasmodics). 
Among the most powerful of the anticonvulsives are the general anaesthetics, 
which, when inhaled, depress the cerebral motor centers, and less power- 
fully those of the cord. 
The iris has two sets of muscular fibres, both of unstriated variety- 
the circular and the radiating (presumptive). The former, a constrictor, 
is governed by the third or motor oculi nerve; the second (if it exists) is 
probably a dilator, and is under the control of the sympathetic. Depending 
upon conditions, and to a considerable extent upon the concurrent use of 
antagonistic drugs, dilatation or constriction of the iris can be made to take 
place by means of certain drugs (1) applied locally or (2) less rapidly when 
administered internally. When the motor oculi is stimulated, contraction 
of the pupil is observed; when the sympathetic is stimulated, dilatation 
takes place nrobablv through the action of the dilator muscle (if present). 
101 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Drugs which cause a dilatation of the pupils are Mydriatics. They 
act (1) by centrally paralyzing the motor oculi center (said to be located in 
the corpora quadrigemina), or (2) by paralyzing the motor oculi peripheral 
endings in the iris; or (3) by paralyzing the constrictor muscle itself. 
Or (1) by stimulating the centric or medullary center of the sympathetic; 
or (2) by stimulating the peripheral terminals of the latter; or (3) pre- 
sumably by stimulation of the musculature of the dilator radiating muscles. 
As the actual presence or status of the last named and their control is 
problematical, the action of drugs in reference to them is not well established. 
Drugs act selectively and in differing degrees of power upon one or more of 
the mechanisms named. 
Mydriatics are employed to facilitate the examination of the fundus 
of the eye by means of the opththalmoscope; to paralyze accommodation in 
refractive work; in iritis to prevent or break up adhesions and to give the 
iris rest; to allay irritation of the inflamed cornea; and, alternately with 
miotics, in ulcers of the margin of the cornea. Occasionally, when the 
marginal area of the lens is clear, they may be employed to widen the 
field of vision in nuclear cataracts. 
All mydriatics are Cycloplegics, paralyzing the accommodating or ad- 
justing power of the eye to see objects at near or greater distances. This 
effect is produced by the drug paralyzing the ciliary muscle. 
Miotics (Myotics) contract the pupil of the eye, acting exactly in reverse 
order to the mydriatics. They also lessen the tension of the eye ball and 
thereby facilitate the escape of the ocular humor. 
Miotics are used to counteract mydriasis; to reduce intraocular 
tension (as in incipient glaucoma; staphyloma); and (alternately with 
mydriatics) in such disorders as sclero-corneal or marginal ulcers. 
Hemostatics are drugs which, when given internally, arrest hemor- 
rhage. They are thought to act in one or more of the following ways: (1) 
by vaso-constriction through the vaso-motor nerves; or (2) by direct 
effect upon the musculature of the blood vessels; or (3) probably by in- 
creasing the coagulability of the blood. Those which check bleeding when 
locally applied are called Styptics (sometimes Local Hemostatics). The 
modus operandi of haemostatics is still a question of dispute, many contend- 
ing that astringents, such as tannin and certain mineral agents, are absorbed 
in a changed condition, or in inadequate amount to check hemorrhage, 
and that they only act when given by mouth upon hemorrhages into the 
gastro-intestinal canal; that ergot, so much relied upon in the past, can 
only act where non-striated muscle is maintained to the ends or periphery 
of the vessels, or where it is present in the tissues in which the latter termi- 
nate, hence its value in uterine hemorrhage, and its probable worthlessness in 
hemoptysis and renal hemorrhage. It is also assumed that if vaso-constric- 
tion is sought for as the cause of arrest of bleeding, such a view is contra- 
dictory, for in all probability the bleeding vessel alone is not constricted, but 
the whole system of vessels, through vaso-motor control. This would raise 
tension in the vessels and thus increase the probability of hemorrhage and 
the preventing of clotting. When bleeding vessels can be reached surgically, 
ligation is the surest and safest procedure. Shock by means of cold, sud- 
denly applied, and rest favor the arrest of bleeding. 
102 INTRODUCTION. 
NERVINES. 
1. Nerve Stimulants. 
Cerebral Stimulants: 
Strychnine. 
Nux vomica. 
Ignatia. 
Arnica. 
Rhus. 
Sumbul. 
Avena. 
Coffee. 
Caffeine. 
Kola. 
Panax. 
2. Nerve Sedatives. 
Cerebral Sedatives: 
Gelsemium. 
Belladonna. 
Stramonium. 
Pulsatilla. 
Valerian. 
Macrotys. 
Matricaria. 
Cypripedium. 
Scutellaria. 
Solanum. 
Tobacco. 
Bryonia. 
Nepeta. 
Guarana. 
Melilotus. 
Sticta. 
^Esculus glabra. 
Hippocastanum. 
Humulus. 
Lupulin. 
Lactucarium. 
Black haw. 
Viburnum Opulus. 
Dulcamara. 
Aspirin. 
Dioscorea. 
Duboisine. 
Conium. 
Cannabis. 
Physostigma. 
Asafoetida. 
Camphor, monobromated. 
Acetanilid. 
Sodium bromide. 
Potassium bromide. 
Ammonium bromide. 
Strontium bromide. 
Lithium bromide. 
Iron bromide. 
Calcium bromide. 
Zinc phosphide. 
Zinc valerate. 
Chloral. 
(a) Somnifacients or Hypnotics: 
Opium. 
Morphine. 
Hyoscyamus. 
Hyoscine (Scopolamine). 
Scopolamine hydrobromide. 
Paraldehyde. 
Barbital (Veronal). 
Trional. 
Sulphonal. 
Passiflora. 
(b) Anodynes: 
Opium. 
Morphine. 
Codeine. 
Aspirin. 
Acetanilid. 
Phenacetine. 
Antipyrine. 
Piscidia. 
Dioscorea. 
(c) Anaesthetics. 
(x) General Anaesthetics: 
Chloroform. 
Ether. 
Nitrous oxide. 
Ethyl bromide. 
Ethyl chloride. 
Butyl-chloral. 
(y) Local Anaesthetics: 
Cocaine. 
Procaine (Novocaine). 
Ethyl chloride. 
Eucaine. 
Stovaine. 
Holocaine. 
Alypin. 
Tropacocaine. 
Apothesine. 
Urea and quinine hydrochloride, 
Veratrine. 
(z) Antipruritics: 
Menthol. 
Phenol. 
Camphor. 
Chloral. 
Aconite. 
Antipyrine. 
Veratrine. 
3. Antispasmodics. 
Asafoetida. 
Lobelia. 
(Enanthe. 
Lavandula. 
Camphor. 
Stramonium. 
Solan um. 
Belladonna. 
Hyoscyamus. 
Lupulin. 
Hops. 
Amyl nitrite. 
Opium. 
Valerian. 
Monobromated camphor. 
Macrotys. 
Black haw. 
Cannabis. 
Scutellaria. 
103 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS 
4. Anticonvulsants. 
Chloroform. 
Ether. 
Gelsemium. 
Lobelia. 
Chloral hydrate. 
Morphine. 
Jacaranda. 
5. Motor Excitants. 
Strychnine. 
Nux vomica. 
Ignatia. 
Cocaine. 
Ergot. 
Ustilago. 
Gossypium. 
Picrotoxin. 
Camphor. 
Cimicifuga (Macrotys). 
Rhus Toxicodendron. 
Pilocarpus. 
Digitalis. 
Convallaria. 
Small doses of alcohol, ether, or chloro- 
form. Large doses of morphine or 
atropine. 
6. Motor Depressants. 
Gelsemium. 
Lobelia. 
Bromide of sodium. 
Bromide of potassium. 
Bromide of lithium. 
Bromide of calcium. 
Opium. 
Morphine. 
Belladonna. 
Atropine. 
Stramonium. 
Hyoscyamus. 
Digitalis. 
Pilocarpus (Jaborandi). 
Pilocarpine. 
Chloral. 
Aconite. 
Veratrum. 
Arnica. 
Camphor. 
Pulsatilla. 
Black haw. 
Piscidia. 
jEsculus. 
Physostigma. 
Physostigmine. 
Large doses of alcohol, ether, chloro- 
form, or quinine. 
7. Mydriatics. 
Atropine. 
Homatropine hydrochloride. 
Cocaine. 
Gelseminine. 
8. Myotics. 
Eserine (Physostigmine). 
Pilocarpine. 
9. Antihemorrhagics. 
Ergot. 
Calcium. 
Cinnamon. 
Adrenalin. 
Pituitrin. 
Calcium chloride. 
Oil of erigeron. 
Oil of erechtites. 
Mangifera. 
Yarrow. 
Group VII. Drugs used for their Effects upon the Reproductive Organs. 
1. Emmenagogues (see Group IV. Repro- 
ductive Tract, 1). 
2. Aphrodisiacs. 
3. Anaphrodisiacs. 
4. Oxytocics (Ecbolics). 
5. Galactagogues and 
6. Antigalactagogues (see Group IV. Re- 
productive Tract, 1 and 2). 
Certain agents, by improving the general health, act upon the sexual 
organs, increasing or exciting their venereal propensities when weakened 
or lost. So far as drugs are concerned they are supposed to stimulate, 
either directly or by reflex action, a lumbar spinal-genital center, or one 
located in the cerebrum, or both. Such drugs are called Aphrodisiacs. 
Probably they regulate nerve control and the blood supply to the genital 
organs. 
Conversely, agents may be employed to diminish local circulation or to 
depress the genital centers and nerves (Anaphrodisiacs). The action of 
both classes is but imperfectly understood. Cold affusions often have a 
temporary anaphrodisiac effect, but the heightened tone gradually induced 
finally tends to increase sexual power. 
104 INTRODUCTION. 
Drugs that increase the expulsive power of the uterus, thus accelerating 
or facilitating parturition, probably do so (1) by direct stimulation of the 
specialized unstriped musculature of the womb, exciting contraction, or 
by (2) indirect stimulation of a special center believed to have its seat in 
the spinal cord. These drugs are known as Oxytocics or Ecbolics. 
Oxytocics are employed to hasten the uterine action in labor, to 
prevent or check post-partum hemorrhage, and after parturition, to re- 
duce subinvolution of the uterus. 
2. Aphrodisiacs. 
Cantharis. 
Camphor. 
Ginseng. 
Volatile oils. 
Garlic. 
Strychnine (indirect). 
Arsenic (indirect). 
Phosphorus (indirect). 
Alcohol (mental). 
Cannabis (mental). 
Morphine (small doses) (mental). 
3. Anaphrodisiacs. 
Bromides. 
Iodides. 
Salix nigra. 
Pulsatilla. 
Staphisagria. 
Belladonna. 
Hyoscyamus. 
Ergot. 
Stramonium. 
Digitalis. 
Opium (large doses) 
Purgatives. 
4. Oxytocics. 
Ergot. 
Gossypium. 
Ustilago. 
Viscum. 
Pituitrin. 
Quinine. 
Group VIII. Agents having an Action upon Toxins or Bacteria. 
1. Serums (Serum Therapy). 
2. Vaccines or Bacterins (Vaccine Therapy). 
Serum Therapy is the therapeutic use of the serum of animals im- 
munized against bacterial products or toxins. Toxins are poisons of un- 
determined character, produced by pathogenic organisms, and are intensely 
virulent. By the repeated injections into the blood of small but repeatedly 
increasing amounts of toxins an animal acquires an immunity against them, so 
that comparatively large doses may be given that animal without detect- 
able harm-amounts which would quickly kill a similar animal not so 
immunized. Active immunity, therefore, is acquired by the repeated ad- 
ministration of the toxin. At the same time that this toxin is being gradu- 
ally injected the body of the animal is forming "resisting bodies" con- 
stituting an Antitoxin, a material inoccuous in itself, but which, it is sup- 
posed, forms a loose attachment with the toxin, thus rendering it in- 
capable of poisonous effects. From the serum of an animal so treated 
can be obtained a certain amount of excess antitoxin, of which usually 
more has been formed than is necessary to control the toxin. This when 
tested by experimentation upon animals, usually guinea-pigs, and attenuated 
to a definite standard, is used to control infections produced by the toxin 
of the identical kind of bacteria which was used in producing the anti- 
toxin. This antitoxin then, used early, is effective in combating the toxin 
(not the bacteria producing it) causing the disease to be treated. It must 
be remembered that each antitoxin (with but few exceptions) is effective 
only as against the toxin used in its production; i. e., diphtheria antitoxin 
acts only upon diphtheria toxin, tetanus antitoxin against tetanus toxin. 
105 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Moreover, it should be fresh and it acts with greatest efficiency when 
given early during the course of the infection while the toxins are afloat in 
the blood serum and before they combine with the solid tissues. This is 
especially true of the tetanus antitoxin, which is probably of little or no 
value after the toxin has combined with the nerve tissues. The established 
antitoxins of worth are the Antidiphtheric Serum or Diphtheria Antitoxin, 
and probably the Antitetanic Serum, if used early. 
It will be observed that in the use of antitoxins upon a human being 
the body of the latter does not have to furnish the immunizing substance, 
but that antitoxin of the animal immunized against bacterial toxins ready 
to furnish the immunity required is injected. Space forbids an extensive 
discussion of Serum Therapy and the reader is referred to special treatises 
for a consideration of the philosophy of Immunity. 
Occasionally sera act deleteriously producing so-called Serum Disease 
and Anaphylaxis. A few sera are said to act upon certain bacteria as 
well as their toxins. 
Serum Disease (Serum Sickness) exhibits skin rashes, most generally 
of an urticarial type, pruritus, pains in the joints, malaise, febrile and other 
unpleasant disturbances. These, however, are transitory. These effects 
are probably not due to the bactericidal or antitoxic elements, but to the 
serum, as these phenomena frequently follow the use of normal horse 
serum. It is well, however, to be cautious in administering sera to those 
inclined to asthmatic seizures, for such frequently have been found to be 
especially susceptible to serum sickness. 
Anaphylaxis is an acquired exaggerated sensitiveness to subsequent 
injections of a foreign protein substance into the body, which sometimes 
follows a primary injection of such a substance. It usually does not occur 
until after ten days to two weeks, and during that period injections may be 
given without harm. Even minute amounts of a second injection of the 
same protein after the ten-day period may prove fatal, and in man this 
anaphylactic state may persist for years, so that a fatal or dangerous result 
may follow an injection of the same protein substance many years after 
the primary injection. Anaphylaxis is also called hyper susceptibility, 
protein sensitization, and Theobald Smith phenomenon. 
Bacterial Vaccines (Bacterins) are suspensions or sterilized emulsions 
of killed pathogenic bacteria, in physiologic salt solution, standardized so 
as to contain a definite number of micro-organisms to the cubic centimeter. 
They are preserved by 0.3 per cent of trikresol. The bacteria are so modified 
as not to produce the corresponding disease, yet are so little changed in 
their protein nature that they stimulate the body cells to the production 
of antibodies, that will destroy invading living organisms, or in infections 
already established will invite recovery or establish active immunity. 
When prepared afresh from the infected individuals they are called autog- 
enous vaccines; when not so prepared, ''stock vaccines"; when several 
strains of the same bacteria are used they are called "polyvalent" or multi- 
valent vaccines. When mixed infection is present several strains of the 
various species of bacteria corresponding to the bacterial infection are 
employed (polyvalent mixed or combined vaccines'). 
106 INTRODUCTION. 
Serums and Vaccines are chiefly used subcutaneously, by ordinary 
and specialized means of hypodermatic administration, or intramuscularly. 
Good judgment and careful diagnosis should accompany these forms of 
medication, for they are by no means free from danger to the patient. 
It will be observed that there is a marked difference between serum 
therapy (antitoxins) and vaccine therapy (bacterins) in that the human 
subject, in case of the former, does not have to furnish its own defensive 
material, for that is supplied in the immunizing antitoxin injected. With 
the vaccines, on the contrary, the body is stimulated to furnish its own 
antibodies. In case of a failure to do so it is questionable whether or not 
harm may come from the vaccine injected. Moreover, it takes careful 
diagnosis to determine the type of vaccine to be used, and thus doubtful 
therapy attends the procedure. Where the organism producing the in- 
fection is definitely known, the practice has more to commend it. Thus 
it is believed that typhoid fever is prevented temporarily at least by the 
use of the antityphoid prophylactic vaccine. When the disease is estab- 
lished, however, its course does not seem to be shortened or rendered any 
milder by its administration. Modern Vaccine Therapy should not be 
confounded with vaccination against small-pox as dead material is used in 
the former, whereas living virus is employed in the latter. Vaccines have 
not as yet become popular in Eclectic therapy; diphtheria antitoxin and 
antitetanic serum alone have gained advocates in our school, the first 
especially gaining in favor on account of its undoubted value. 
Serums: 
Diphtheria Antitoxin; 
Tetanus Antitoxin. 
Vaccines: 
Antityphoid Vaccine. 
Group IX. Agents which Supply, Provoke a Needed Glandular Secre- 
tion, or Modify Function or Nutrition. 
1. Animal Organs. 
2. Animal Extracts. 
The treatment of disease by the administration of animal organs or their 
extracts is termed Or gano -Therapy. While giving promise of therapeutic 
worth but few of these products have justified the claims made for them- 
that of supplying deficient secretions, or of provoking the formation of 
secretions in organs deficient in such secretions. Other properties than those 
originally suspected have developed from the clinical use of some of them, 
however, and their employment, with three exceptions, may be said to be 
in the experimental stage. These exceptions are adrenalin, thyroid extract, 
and pituitrin (which see). 
1 and 2. Animal Organs and Extracts: 
Dried Thyroids (and Thyroid Extract). 
Adrenalin (Epinephrine). 
Pituitrin. 
Animal therapy is of very ancient origin, a history of which would be 
profitable reading. Brought into more recent notice about seventy years 
ago by Berthold, and later by Claude Bernard, the ductless and other 
glands have assumed importance in therapy, even to being a rich field for 
the exploitation of biologic quackery. The historic use of testicular juice 
upon himself by Brown-Sequard is the beginning of modern animal therapy. 
Now the science of endocrinology or the therapy of the action of gland sub- 
107 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
stances has taken on a new aspect, the soundness of which remains to be 
established. It is maintained that the "endocrinous system" (internal 
secretory system) exerts a powerful stimulating and modifying action 
"upon anomalies of growth," metabolism, nutrition and excitability of the 
nervous system, morphogenesia, the causation of dyscrasias, and resistance 
to intoxications and infections, etc. Preparations representing the internal 
secretions are employed to arouse or excite or to inhibit certain wayward 
or inactive functions. To these substances the term Hormones has been 
applied. Hormones are defined as the active principles of the internal 
secretory glands serving as "chemical messengers to correlate the activities 
of the body"-positive excitants (stimulators) or negative exci tors (in- 
hibitors). Starling defines the hormone "as any substance normally pro- 
duced in the cells of some parts of the body and carried by the blood 
stream to distant parts, which it affects for the good of the organism as a 
whole. The hormones are thus chemical means of correlation of the ac- 
tivities of different parts of the body. Their action may be either the 
increase or diminution of function, or the alteration of nutrition or rate 
of growth" (Hormones, page 9, by Harrower). The endeavor in the use of 
hormones is to establish a so-called hormone balance. For a further study of 
Endocrinology the reader is referred to special treatises on animal therapy. 
Group X. Agents having an Antidotal Power over Ingested Poisons. 
Chemical Antidotes, etc. 
This group includes agents which act chemically or physiologically 
(antagonistic) upon poisonous substances ingested. 
Chemical Antidotes. 
(a) For Arsenic: 
Iron hydroxide. 
Iron hydroxide with magnesia. 
Iron dialysed. 
For other Antidotes to Poisons, see "The Management of Acute 
Poisoning," page 45. 
Group XI. Agents having no Pronounced Therapeutic Properties. 
1. Coloring substances. (See page 53). 
2. Sweetening and Flavoring agents. (See 
page 51). 
3. Vehicles. (See page 51). 
1. Coloring Substances. 
See also page 53. 
Cardamom. 
Catnip. 
Cinnamon. 
Coriander. 
Calamus. 
Peppermint. 
Spearmint. 
Fennel. 
Pennyroyal. 
Eucalyptus. 
Pimenta. 
Clove. 
Pepper. 
Ginger. 
Vanilla. 
Anise. 
Orange peel. 
Lemon peel. 
Lemon juice. 
Curcuma. 
Carmine. 
Caramel. 
Chlorophyll. 
Cudbear. 
Cochineal. 
Saffron. 
Rubus Ideae (syrup) 
2. Sweetening and Flavoring Agents. 
(See also page 51). 
Sugar. 
Honey. 
Glycerin. 
Sugar of milk. 
Saccharin. 
Syr. Rubus Ideae. 
Aromatic oils. 
Capsicum. 
3. Vehicles. 
(See page 51). 
108 INTRODUCTION. 
XVIII. SOURCES OF DRUG KNOWLEDGE. 
Considering the therapeutic side of medicine we are led to assert 
that perhaps fewer books on materia medica are purchased by fewer 
physicians of all schools than works bearing upon the other branches of 
medicine. It is not uncommon for doctors to frequently renew their pur- 
chases of books on obstetrics and surgery, and less frequently those on 
practice. Many monographs are bought, and not uncommonly a system 
of medicine is purchased at great expense, only to become obsolete matter 
in a few years and an object of regret to the purchaser. But on the most 
important topic-the subject of drugs and their uses-too frequently 
only the text-book used while in college is made to do duty through long 
years in the practice of his art. Were we to select a working library for a 
young practitioner, or an old one for that matter, first among the books 
chosen would be, not one book but several on the practice of medicine and 
materia medica and therapeutics. Many practitioners begin and end with 
one book, in which the reader hopes to find included all that has been 
written concerning medicines and their uses. He fails to recognize that 
while there are many works touching these topics in a general way, no 
one as fully presents them as a collection of books, each devoted to some 
particular phase of the subject. He who purchases only a pure materia 
medica, searches in vain for some fact concerning a medicine, and is dis- 
appointed that the writer has failed to include that fact-perhaps thera- 
peutic-or some other he is seeking. He is the doctor who so frequently 
asks, "What is the best work on medicines?" not realizing that what he 
desires must be looked for in one or the other of five classes of books. 
It is just this type of practitioner who finally comes to a realization that there 
is a difference between materia medicas, pharmacopoeias, dispensatories, 
formularies, and works upon therapeutics alone. Let us briefly differentiate: 
A Materia Medica is a work describing the characteristics of vegetable, 
chemical, and animal drugs, giving names and synonyms, chemical formulae 
and equations, describing the crude drug and noting the microscopic 
appearance, giving tests to identify sophistications and adulterations, etc. 
Preparations and doses are mentioned, and brief therapeutic and toxicologic 
notes are usually given. 
More generally works on materia medica are combined with thera- 
peutics, and these are called works on "Materia Medica and Therapeutics." 
This is the usual type of book purchased by the doctor. It may embrace 
all that a specific materia medica includes (some lean most strongly to 
therapeutics), and also extensively cover the so-called physiologic, chemical, 
and toxicologic action, as well as the therapy of the drugs considered. 
Such works are usually selective and do not cover all the drugs in use, 
thus differing from a dispensatory. A materia medica of this sort in the 
regular school most frequently considers chiefly the official drugs, though 
some have overstepped these bounds and include such agents as appeal to 
the author. A materia medica should show strongly the individuality of 
its author, and what he includes in it is usually such matter as he has 
personal knowledge of or which meets his approval. Here it differs from 
a dispensatory, which is designed to give a compilation that makes it a 
book of reference. 
109 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
A Formulary is a collection of working formulae for the preparation 
of medicines and may or may not give the therapeutic properties of such 
compounds. If the latter are given, they are very briefly noted and usually 
in condensed general therapeutic terms, as cathartic, etc. Some books of 
formulae are little more than a collection of prescriptions, though they 
generally differ in directions concerning the preparations of common stock 
medicines rather than prescriptions for specific uses. A popular work of this 
kind that served its purpose for many years was "Griffith's Formulary." 
The National Formulary of to-day is a semi-official work which in- 
cludes standard formulae and directions for the making of preparations used 
largely over the country, or in some restricted localities of our Union, but 
which are not included in the United States Pharmacopoeia. The National 
Formulary is prepared by a committee of the American Pharmaceutical 
Association, and is therefore a semi-official work, it being a legal standard 
under the National Pure Food Law. Like other formularies, it is of 
more use to druggists than to doctors, though the latter need it to familiarize 
themselves with the names and contents of its preparations, should they 
desire to dispense or prescribe them. The National Formulary includes 
several Eclectic preparations, but unfortunately has seemingly been 
careful not to list them under the commonly employed Eclectic names, 
thus withholding credit where credit is due. National Formulary prepara- 
tions are designated by the abbreviation N. F. 
The United States Pharmacopoeia is the official manual of standards for 
the identification of drugs known as official in this country and is re- 
vised every ten years by a committee of delegates from the American 
Pharmaceutical Association, medical and pharmaceutical colleges, and 
medical and other pharmaceutical associations, and the Army, Navy, and 
Marine Hospital services sitting in decennial convention. It is accepted as 
the standard concerning the quality, uniformity, purity, and integrity of the 
drugs and chemicals embraced. It describes them, gives tests, notes the usual 
adulterants and sophisticants, prescribes the limitation of impurities, and 
directs means of preservation of drugs. It does not give therapy in any 
form except as may be inferred from the titles of some of its preparations. 
It is the standard guide to the making of such preparations as are official, 
and is indispensable to the manufacturing pharmacist and the dispensing 
druggist. Up to the eighth edition doses were not given, but since then 
each issue includes the average dose of a drug, chemical, or preparation, 
expressed in both metric and common weights and measures. 
In the absence of statutory provision regulating the quality and 
character of a medicine, the dictum of the United States Pharmacopoeia 
is usually accepted in the courts of law. The National Food and Drugs 
Act (1906) makes the United States Pharmacopoeia and National Form- 
ulary standards for drugs. Though the Pharmacopoeia and the National 
Formulary are recognized by the Federal Government as authoritative, the 
government has no control over their formulation or publication. 
Drugs and preparations bearing the official title must conform in all 
respects to the provisions of the Pharmacopoeia. The abbreviation U. S. P. 
stamps such a drug or preparation as official. 
110 INTRODUCTION. 
A Dispensatory is, primarily, a commentary upon pharmacopoeias 
(United States as well as some foreign), but is broad enough in scope to 
include also every known medicinal or pharmaceutical article and its 
most important preparations. It is the most comprehensive of single 
works upon medicines and their uses. In it the doctor may find the official 
and non-official and common names and synonyms of drugs and chemicals; 
the chemical formula, if a chemical; the botanical origin, if a vegetable or 
vegetable product or educt. If a vegetable substance is under consideration, 
the botanical source, a botanical description of the plant yielding the drug, 
a description of the parts used, marks of identity, and a discussion of 
sophisticants and adulterants are presented. If a chemical is the subject 
of comment, the various processes of production are noted and criticized 
or commended. Preparations are listed and formulae given for compounding 
them. Related plants, products, and educts and preparations are included, 
and doses-maximum and minimum-are given in both the metric and 
common weights and measures. Tests of identity and, in some instances, 
of strength and of microscopic appearances are fully but concisely stated. 
The action of medicines-physiologic, toxic, and' medicinal- is fully 
but briefly given, and in the Eclectic work, The American Dispensatory, 
the specific indications for medicines are fully presented. 
It will readily be seen that a dispensatory is in reality an encyclopedia 
of drugs and their uses. While no words are wasted and loose construction 
scarcely permitted on account of the vastness of material which must be in- 
cluded in as brief a compass as possible, it still remains for the doctor the 
most useful and comprehensive of books on the general study of drugs and 
therapy. 
A dispensatory is not necessarily official, nor is it necessarily, in this 
country, the legal criterion. In the case of the Eclectic work, however, 
it has the official endorsement of the National Eclectic Medical Association. 
It is always a private work, owned and controlled either by its authors or 
publisher or other interested party. 
While a dispensatory includes all sides of the study of medicines and 
their uses, it must be borne distinctly in mind that, so far as the prepara- 
tions included and the uses are concerned, the work is necessarily a compila- 
tion, and while the author or authors are supposed to exercise great care 
and judgment concerning the matter included, such matter may not 
necessarily have their endorsement or full approval. Being encyclopaedic 
in character, it must necessarily include largely the views of others than 
the authors on debatable questions and recommendations. Where selection 
is possible, the authors present the views and opinions of investigators and 
practitioners upon whose judgment they can rely. Dispensatories are in- 
dispensable to both druggists and physicians. 
This, then, is the group of books that the doctor must go to for his 
knowledge of medicines. The Pharmacopaeia, the Formularies, and the 
National Formulary are relatively of little value to him. But every practi- 
tioner of medicine should have two or three good works on materia medica 
and therapeutics, and renew them frequently, thus getting the advantage 
of the viewpoints of the several authors. For general encyclopaedic matter, 
he cannot justly deprive himself of the advantages of a dispensatory. 
111 PART II. 
Individual Drugs. 
ABIES. 
The bark and prepared resinous exudate of Tsuga canadensis, Carriere (Abies cana- 
densis, Michaux; Pinus canadensis, Linne). (Nat. Ord. Coniferse.) A well known and 
handsome evergreen tree of the forests of Northern United States and Canada. 
Common Names: Hemlock, Hemlock Spruce. 
Principal Constituents.-The oleoresin Canada pitch, and a volatile oil known as 
Oil of Hemlock or Oil of Spruce; that from the leaves is known as Pine-needle Oil, and 
contains pinene, bornyl acetate, and cadinene; the bark contains a large amount of tannic acid. 
Preparations.-1. Specific Medicine Pinus. Dose, 5 to 60 drops. 
2. Oil of Hemlock. Dose, 1 to 5 drops. 
Specific Indications.-General asthenia, with feeble digestion, vas- 
cular weakness, and pale and relaxed mucosa; broncho-pulmonic irritation, 
with profuse secretions; coughs and colds; pyrosis with gastric irritation, 
vomiting, and diarrhoea. Contraindicated in inflammations. 
Therapy.-External. A strong decoction of the bark is a satisfac- 
tory astringent for the checking of leucorrhoea and a good local applica- 
tion of this type for aphthous and other oral ulcerations, gangrenous 
ulcers, prolapsus ani and prolapsus uteri. The specific medicine on cotton 
may be applied to the cervix uteri to heal abrasions and control discharge. 
The oil may be used as an embrocation for painful and swollen parts, 
and by spray in nose and throat disorders attended by mild catarrhal 
symptoms. It enters into many proprietary and semi-proprietary prepara- 
tions for the treatment of coryza, congested turbinates, and ulcerations of 
the nasal fossae and throat. The oil dropped upon boiling water is a time- 
honored inhalation for croup. It has also been used to advantage in some 
forms of eczema, particularly the weeping type. 
Internal. Pinus Canadensis, the name under which most of the 
alcoholic preparations pass, is mildly stimulant, antiseptic, and useful 
where an astringent remedy is desired in conditions of relaxation, with 
pallid mucosa. In small doses, the specific medicine may be employed 
in gastric irritation and in that of the urinary organs, in both of which 
there is an excess of mucous secretion. As a remedy for passive hemorrhages 
it has little to commend it, though it is not wholly without effect, acting 
much like but with less power than the oil of erigeron and similar prepara- 
tions. Both the specific medicine and the oil may be incorporated into 
cough medicines, to be used where there is excessive secretion of mucus 
and the cough is largely precipitated by a feeble and relaxed state of the 
uvula and fauces. 
ABSINTHIUM. 
The flowering tops and leaves of Artemisia Absinthium, Linne (Nat. Ord. Composite); 
Europe, Siberia, Barbary, Newfoundland, and the United States; naturalized in New Eng- 
land; cultivated. Dose, 10 to 20 grains. 
Common Name: Wormwood. 
Principal Constituents.-A volatile v oil (Oleum Absinthii), containing principally 
absinthol (C10 H16 O) and a crystalline bitter absinthin (Ci5 H20 Ot). 
Preparations.-1. Infusum Absinthii, Infusion of Absinthium (5j to Oj). Dose, 
1 to 2 fluidrachms. 
2. Oleum Absinthii, Oil of Wormwood. Dose, 1 to 5 drops. 
112 INDIVIDUAL DRUGS. 
Action.-Both oil of wormwood and extract of absinth act as nerve 
depressants upon man. Small doses at first stimulate, larger ones produce 
headache, and still larger doses induce cerebral disturbances and clonic 
hysteroidal convulsions. Victims of absinthism, a vicious form of drunken- 
ness, are subject to disturbed rest, with disagreeable dreams, and morning 
sickness and vomiting. A chronic intoxication ensues that is more fearful 
in its effects than that resulting from the abuse of alcoholics. Epileptoid 
attacks are common, physical and mental force is seriously impaired, and 
virile power is lost in the male, while a premature menopause is a common 
result in the female. It is also said to produce a peculiar hyperesthesia, 
most marked in the integument of the hypogastrium. The French liquer 
Absinthe, which is a viscous alcoholic cordial, and Wermuth, a German beer, 
both depend upon wormwood for their activity. 
Therapy.-External. Absinthium, steeped in vinegar and water, 
makes an admirable hot fomentation for sprains, bruises and local in- 
flammations. It should not be applied to abraded surfaces. 
Internal. Small doses of absinthium stimulate the appetite and 
give tone to the gastric membranes, thus favoring digestion. For this 
purpose it is sometimes useful in atonic dyspepsia; especially in that form 
due to alcoholic excesses. Large doses irritate the stomach and give rise 
to increased action of the heart. Though less agreeable than santonin, 
it may also be used for the expulsion of the intestinal parasites-Ascaris 
vermicularis and Ascaris lumbricoides. The oil may be given in doses of 
1 to 5 drops. 
ACACIA. 
The dried gummy exudate of Acacia Senegal, Willdenow; and of some other African 
species of Acacia. (Nat. Ord. Leguminosse.) Eastern Africa (Kordofan, chiefly), and 
Western Africa north of river Senegal. 
Common Names: Acacia; Gum Arabic. 
Principal Constituents.-Arabin (C12 HM Ou-Arabic acid) in combination with salts 
of calcium, magnesium, and potassium. 
Description.-Tears or fragments of a nearly odorless, translucent white, yellow- 
white, to pale amber-colored exudate, having a rather insipid and mucilaginous taste; 
soluble in water, but insoluble in alcohol. 
Preparations.-l. MucilagoAcacia, Mucilage of Acacia. Dose, 1 to4 fluidrachms or more. 
2. Syrupus Acacia, Syrup of Acacia. Dose, 1 to 4 fluidrachms or more. 
Action and Therapy.-Acacia is largely employed in the preparation 
of pills and in the emulsification of oils and resins. It is demulcent and 
probably slightly nutritive. In the form of a solution or mucilage it is an 
agreeable lenitive for irritated and inflamed membranes, and for this 
purpose is frequently used in medicinal preparations for coughs, colds, 
hoarseness, pharyngitis, gastric irritation and inflammation, diarrhoea, 
dysentery, ardor urinae, etc. It also forms a good mucilage in which to 
suspend heavy and insoluble powders. When the stomach is irritable in 
low fevers and in pulmonary tuberculosis, a half ounce of acacia may be 
dissolved in 5 fluidounces of water, sweetened with sugar, and given in table- 
spoonful doses occasionally to relieve the sense of hunger when but little 
food can be taken. Mucilage of acacia is soothing to burns and scalds of the 
mouth and alimentary canal, and may be used as a demulcent after poison- 
ing by irritant and corrosive poisons. Acacia may be given freely and at 
pleasure, in the form of powder, troches, mucilage, or syrup, as desired. 
113 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ACETANILIDUM. 
Acetanilid, Acetanilide, Antifebrin. 
The monoacetyl derivative of aniline (Formula: C8 H9 ON). 
Description.-Shining mica-like, colorless, crystalline scales, or a white crystalline 
powder; permanent, odorless, and having a slight burning and subsequently benumbing 
taste. Readily soluble in alcohol, chloroform, and ether, and in boiling water; less soluble 
in cold water. Dose, 2 to 8 grains; usual dose, 3 to 5 grains. 
Specific Indications.-Severe frontal and neuralgic headaches; diffused 
headache of nervous origin; congestive and reflex headaches when not due 
to gastric disorders or faulty digestion; sick headache; acute pain, with 
high temperature, provided the heart and kidneys are in good condition. 
The small dose preferred. 
Caution.-Acetanilid should be avoided in all cases of fatty degenera- 
tion, particularly of the heart, kidneys, and liver, and in renal irritation 
and congestion. 
Action.-In health the effects of acetanilid are less pronounced than 
in disease, especially fevers. Small doses produce a quieting effect, sensory 
sedation, and the secretions of the skin and kidneys are increased. Blood 
pressure is first elevated, then depressed; and cardiac action is decreased 
in frequency. In all doses the tendency is toward depression rather than 
stimulation of the circulation. 
It is claimed by some that the reduction of temperature when fever 
is present is due to the reduction of haemoglobin into methaemoglobin and 
its consequent interference with oxidation causes the cyanosis. Hare, 
however, attributes it to a decrease of heat-production mostly and to an 
increase of heat-dissipation, the exact cause of both not being known. 
Very large doses increase the urea and uric acid in the urine, destroy the 
red corpuscles, decrease the alkalinity of the blood, liberate haemoglobin, 
and impart to the urine a deep-brown or chocolate color, the latter being 
due to the methaemoglobin formed. Acetanilid is quickly absorbed and 
quickly eliminated, being observed in the urine in two hours and passing 
completely from the body by the renal route in the form of para-amido- 
phenol sulphate. Before death complete motor and sensory paralysis 
occurs; and though the heart is arrested in diastole, death is attributed to 
centric respiratory paralysis. 
Toxicology.-Large doses produce serious symptoms, depressing 
powerfully the nervous and circulatory systems. Weakness, slight head- 
ache, sounds in the ears (tinnitus aurium) and general malaise are ex- 
perienced together with a sense of coldness. A characteristic livid cyanosis 
of face and body occurs, differing somewhat from ordinary cyanosis, and 
the deepened color is probably intensified by the methaemoglobin pro- 
duced in the blood. First the head and then the body is profusely bathed 
in sweat, respiration becomes slow and shallow, the pulse soft, slow, and 
finally very weak, and collapse and death take place. Even five grains have 
been said to have caused collapse in one case and death in another. Other 
symptoms which have occurred from varying doses of the drug are a 
peculiar measles-like eruption, anaesthesia, coma, and loss of reflexes; 
nausea, vomiting, and diarrhea is claimed by some, denied by others. 
114 INDIVIDUAL DRUGS. 
In case of collapse or poisoning, external heat, friction, and artificial 
respiration should be used, and hypodermatic stimulation by means of 
ether, alcohol, atropine, and strychnine; oxygen should be given by in- 
halation to combat cyanosis and sustain respiration. 
Therapy.-External. Acetanilid is a local hemostatic and as such 
may be used in epistaxis and capillary oozing after operations and injuries; 
as it is also antiseptic it may be applied to wounds, and it makes a fairly 
good topical dressing for chancre and chancroid. Applied to the gum it 
relieves toothache where there is no cavity. For all local uses it should 
be employed upon small areas only and in quantities within the ordinary 
internal dosage, for poisoning is very likely to occur from absorption. 
Internal. Acetanilid was originally introduced as a remedy for pyrexia, 
and indeed by many its chief action is asserted to be antipyretic. It has, 
however, fallen into almost complete discredit on account of the dangerous 
collapse and cyanotic condition which it often produces. It should have 
no place in fevers of a low or typhoid type, and we are admonished that 
while excellent results have been obtained in scarlatina, it should be care- 
fully watched on account of the numerous instances of drug-intoxica- 
tion observed from its use in children. Practically no use is made of the 
drug in febrile states by Eclectic practitioners, the exceptions, perhaps, 
being in puerperal fever, rheumatic fever, uncomplicated with cardiac 
disorders, and in erysipelas, in all cases to be used only when the tem- 
perature is excessively high. Even in these tepid sponging or the special 
sedatives are to be preferred. While capable of subduing many of the un- 
pleasant features of la grippe, it has frequently proved detrimental, and 
had better be dispensed with in favor of macrotys, gelsemium, bryonia, or 
aconite or veratrum when these are indicated. It may be used cautiously 
to control the hectic fever of phthisis. If excessive sweating is produced it 
should be discontinued. Acetanilid is of considerable value in acute in- 
flammatory rheumatism, especially in cases in which the salicylates are 
said to be admissible, but fail to do any good. It reduces the swelling and 
alleviates the pain. It should not, however, be used for any length of 
time, nor in large doses. It is particularly useful when the rheumatic 
affection is ushered in with sharp and severe pain, in which case it should 
be preferred to opiates. Intense pain from muscular spasm is quickly 
relieved by it. 
Acetanilid is used in Eclectic practice mostly in nervous disorders 
characterized by spasm and pain, for it is decidedly antispasmodic and 
analgesic. Very small doses restrain whooping-cough, but its action should 
be closely guarded lest symptoms of collapse arise, and the drug cyanosis 
should be carefully differentiated from the cyanotic seizures naturally 
occurring during attacks of cough. It should be employed only when 
other agents fail and in robust children. The pain and spasms of gastralgia 
and gall-stone colic are often mitigated by it, but it is less effectual than 
morphine. By some it is valued in spasmodic asthma, chorea, and especially 
in epilepsy, though Eclectic therapy offers safer remedies. It is of the 
most value in headaches of nervous origin. In migraine, neuralgic and 
rheumatic headaches, sick headache, reflex headache from uterine dis- 
orders, menstrual headache, and facial and sciatic neuralgia its effects are 
115 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
most gratifying. In all these cases the condition of the circulation and 
kidneys should be ascertained previously, for it is dangerous and should 
never be used where there is cardiac embarrassment, fatty degeneration 
or ventricular dilatation, or renal irritation or congestion. For those neu- 
ralgias arising from changes in the spinal cord; in the pains of tabes dorsalis 
and locomotor ataxia acetanilid acts surprisingly well and has largely 
supplanted morphine and its congeners as a pain reliever. Indirectly, 
by relieving acute and subacute pain, it plays the part of a hypnotic, or 
rather prepares the way for a refreshing sleep. Acetanilid is best adminis- 
tered in powder, capsule, or cachet; owing to slow solubility-or sudden 
late disintegration-it should not be given in the form of compressed tablets. 
It should not be given with caffeine, which seems to increase its toxic 
power. 
ACETPHENETIDINUM. 
Phenacetin, Acetphenetidin. 
A para-amidophenetol acetyl derivative. (Formula: C10 H1S O2 N.) 
Description.-Glistening white scales or a fine crystalline powder without odor, and 
having a feebly bitter and slightly benumbing taste. Permanent in the air; soluble in al- 
cohol, and less so in boiling water, and almost insoluble in cold water (about 1300 parts). 
Dose, 2 to 8 grains; usual dose, 5 grains. 
Specific Indications.-In sthenic conditions only: Severe muscular 
pain; pain from congestion; neuralgic pain; nervo-congestive or catarrhal 
headache; high temperature; preparator for quinine administration. 
Action and Toxicology.-Phenacetin is the best and least toxic of the 
coal-tar antipyretics. Ordinarily safe in proper doses, in large amounts, 
and sometimes even with the regulation doses, it is capable of producing 
great depression and dangerous collapse. Toxic symptoms are violent 
vomiting, chills, deep cyanosis, profuse sweating, marked reduction of the 
temperature, quickened respiration, sleepiness, and almost complete stop- 
page of the heart's action. No cases of death in man have been directly 
traceable to phenacetin. 
Phenacetin acts as a nerve sedative, especially upon the sensory 
tracts of the spinal cord. Only overdoses appreciably affect the circulation. 
The urine becomes dark yellow or chocolate colored, the blood blackish 
from the formation of methaemoglobin, and bodily heat is lowered by de- 
creasing heat-production and increasing heat-dissipation. The urine reacts 
to Fehling's solution, and the drug probably is converted in the body into 
para-amidophenol sulphate. Any depression from its use should be promptly 
met by heat and cardiac and respiratory stimulants. 
Therapy.-Phenacetin is analgesic, antipyretic, diaphoretic, and a 
nerve sedative. In small doses it may be used in fevers when the temper- 
ature is very high, and it gives comfort in typhoid fever, but does not in 
the least shorten the course of the disease. In a disease so prone to dis- 
organization of the blood and marked nervous and circulatory depression 
the use of any of the coal-tar antipyretics is unwise, save only in an oc- 
casional case when at the onset very great heat and unrest are experienced; 
then a single dose or two may be given. The sweating produced by this drug 
is not as profuse as with antipyrine, nor is it so apt to produce the cutaneous 
eruptions and aural symptoms so common to the allied antipyretics. In 
116 YARROW 
(Achillea Millefolium) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Yarrow is a type of a once popular class of drugs valued in early Eclectic medicine as remedies 
for the restraint of excessive secretions and passive hemorrhages. INDIVIDUAL DRUGS. 
two-grain doses it controls the high temperature in phthisis pulmonalis, 
without producing excessive diaphoresis. In local congestions and in- 
flammations it reduces swelling in proportion as it controls the pain. An 
important use for phenacetin is to render the skin and tongue moist and 
the nervous system calm preparatory to the use of quinine. In this way 
only does it benefit in malarial fevers. As a general antipyretic its use is 
not favored by Eclectic physicians, who prefer, where antipyresis is at all 
permissible, to employ the small doses of the special arterial sedatives, and 
sponging with tepid water. 
Phenacetin promptly controls pain. It acts best when pain is in- 
dependent of structural change, and may be used in both acute and chronic 
conditions. If small doses do not relieve, larger ones are also apt to fail. 
It is especially valuable in nervo-congestive and catarrhal headaches, and 
for headache from eyestrain and frontal sinusitis, though it is less effective 
in the latter than codeine. For the relief of muscular pain in la grippe it is 
prompt, but has been recklessly used. It is useful to control pain in ton- 
sillitis, gastralgia, and that of febrile and inflammatory diseases. Acute 
rheumatism is made more endurable by it, though it possesses no inherent 
antirheumatic power, nor should it be given when there is great debility 
or any circulatory embarrassment. Its analgesic properties are taken 
advantage of in dysmenorrhea, in various types of neuralgia-especially 
facial, sciatic, and intercostal, and it softens the distressing pains of pleurisy. 
Phenacetin relaxes muscular spasm; lessens the irritability of the 
congested larynx in whooping-cough and stridulous laryngitis and spas- 
modic asthma; and it has benefited some cases of hysteria and epilepsy. 
Owing to its sparing solubility phenacetin is best given floated upon 
water, or in capsule; never in tablets which are difficultly disintegrated. 
In all instances it is contraindicated by debility. 
ACHILLEA. 
The whole plant Achillea Millefolium, Linne (Nat. Ord. Composita); a common 
wayside and field herb in North America and Europe. 
Common Names: Yarrow, Milfoil, Thousand Leaf. 
Principal Constituents.-The bitter alkaloid achilleine (C20 HM N2 O15), achilleic acid 
(aconitic acid); a volatile oil, tannin, and potassium and calcium salts. 
Preparation.-Specific Medicine Achillea. Dose, 5 to 30 drops. 
Specific Indications.-Atony and relaxation of tissue, with free dis- 
charges; passive hemorrhage. 
Action and Therapy.-Achillea is astringent and tonic. Its chief 
virtues are shown in its occasional control of passive menorrhagia due 
wholly to atony, and not to the presence of tissue change or destruction. 
It sometimes relieves hematuria, and is soothing to the urinary tract. 
ACIDUM ACETICUM. 
Acetic Acid 
An aqueous solution of not more than 37 nor less than 36 per cent of Acetic Acid 
(QH^O,). 
Description.-A sharply sour, clear and colorless liquid, having a vinegar-like odor. 
It acts strongly on litmus, turning it red. It mixes with water or alcohol in all proportions. 
Preparation.-Acidum Aceticum Dilutum, Diluted Acetic Acid. An aqueous dilution 
containing about 6 per cent of acetic acid. Dose, 10 to 60 minims well diluted. 
Related Acids.-1. Acidum Aceticum Glaciate, Glacial Acetic Acid (nearly pure, or 
99 per cent acetic acid, C2 O2). For local use only. 
2. Acidum Trichloraceticum, Trichloracetic Acid (99 per cent pure). For 
external use only. 
117 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Deep redness of tongue and mucosa. Antidote 
to poisoning by alkalies. 
Action.-Acetic Acid is a mild irritant to the skin unless contact be 
prolonged, then it blisters and finally destroys the epiderm. Mucous mem- 
branes are first whitened by it, and then become brown. If a large dose be 
swallowed there will follow violent burning in the stomach, with vomiting 
and diarrhoea Fatal perforation has occurred from it. When diluted it 
reduces temperature and slows the pulse. Used continuously, changes 
occur affecting the alkalinity of the blood and crippling the corpuscles. 
When acetic acid kills, it is by paralysis of the heart. 
Glacial Acetic Acid may produce convulsions and coma, followed by 
death; when not fatal, gastro-enteritis results. 
In poisoning by any form of acetic acid, weak alkaline solutions, lime 
water, or soapsuds, or milk should be administered immediately, and the 
stomach pump or emetic be used. The after treatment should be lenitive- 
the free use of milk and mucilaginous drinks, and opiates to relieve pain. 
Therapy.-I. Glacial Acetic Acid. External. Glacial Acetic Acid 
may be used as an escharotic where limited action is desired, as upon corns, 
warts, venereal condylomata, papillomata, lupus, and nasal polypi, and 
hypertrophies. Small epitheliomata have been removed by it, but with no 
assurance against a recurrence. Some value it when lightly applied to 
chancre and syphilitic ulcers. It is of especial worth for the local treatment 
of ringworm and other forms of tinea and scald-head. Sluggish and fetid 
ulcers may be stimulated by it, and a mixture of equal parts of the acid and 
chloroform has been advised to limit the extension, and to promote the 
growth of hair, in alopecia circumscripta. The spots should be lightly 
touched daily. In the use of this acid, if much pain is caused, it may be 
diluted to the point of toleration. In all conditions, however, it must be 
very carefully applied by touching the parts with a pencil dipped in the 
acid, and with the remembrance that it attacks flesh powerfully and may 
produce a painful sore. 
II. Acetic Acid. External. Antiseptic, refrigerant, astringent, and 
deodorant. This acid, in small amounts, may be added to vessels holding 
typhoid and tubercular discharges to destroy their offensive odor. In- 
jected into small nasal polypi it causes them to shrivel and drop away. 
Should they suppurate, borax or asepsin solutions may be used to cleanse 
and deodorize the nasal surfaces. It has been used upon epithelioma upon 
the theory that it is "the only agent that will liquefy and disorganize 
cancer cells"-an extravagant claim-; it should only be attempted upon 
those who refuse to be operated upon, and then with no assurance of perma- 
nent relief. Inhaled it sometimes relieves fainting, headache, and hoarse- 
ness. 
III. Diluted Acetic Acid (or its equivalent, Vinegar). External. 
Either diluted acetic acid or vinegar may be used to check moderate hem- 
orrhages, as epistaxis, bleeding from superficial wounds, or from hemorrhoids 
and in postpartum hemorrhages. A vinegar bath is refreshing, cooling, 
and stimulant, as well as constricting to the skin, and is often agreeable in 
fevers, inflammations, contusions, dermatitis, and sunburn, and may 
118 INDIVIDUAL DRUGS. 
prevent the occurrence of bed sores. Used in this manner it contracts the 
local blood vessels, and it sometimes relieves colliquative sweating. Ap- 
plied full strength it often relieves the itching of urticaria, and when not 
desirable to use glacial acetic acid, may be applied to ringworm. Both 
the diluted acid and vinegar may be used in local poisoning by the caustic 
alkalies; and inhaled, it alleviates the nausea and vomiting following 
the use of chloroform as an anaesthetic. Vinegar, diluted, relieves to 
some degree the distress of the mouth and throat occasioned by the 
administration of aconite; and it is also said to antagonize the local effects 
of carbolic acid. Hot diluted vinegar and salt and red pepper is an effectual 
though severe domestic remedy for sluggish and congested sore throat. 
Very weak solutions of vinegar are among the most effectual means of dis- 
lodging seat-worms (Ascaris vermicularis). Vinegar stupes make a com- 
forting application to bruises and sprains. 
Inhaled by volatilization from boiling water the vapor of vinegar 
gives relief in quinsy, acute laryngitis, and in spasmodic croup. It aids also 
in membranous croup, which is practically laryngeal diphtheria, by loosen- 
ing the membranes and favoring freer breathing. It must not, however, be 
pushed to the extent of exhausting the already debilitated patient by the 
overheating induced. Sometimes this use of it is excellent to control the 
dry cough of bronchitis and of measles. 
Internal. The internal use of vinegar to reduce obesity is to be con- 
demned on the ground that it does so at the expense of disordering digestion 
and nutrition. It is sometimes agreeable in fevers when an acid is indicated, 
and in small quantities may be added to meat broths, or given simply 
diluted with water. It is among the best antidotes to poisoning by the caustic 
alkalies and has the advantage of being at once obtainable in every house- 
hold. Ellingwood asserts that it is an antidote to carbolic acid. Suitably 
diluted, it may be freely administered in hematemesis. Well diluted, it 
may be used sometimes to allay the thirst and colliquative sweating of 
phthisis. We recall the gratefulness of a vinegar beverage for field workers 
in hot weather, composed of vinegar, water, and ginger, slightly sweetened 
with molasses. This is more refreshing and apparently safer as a harvest 
drink than large draughts of water, and certainly to be preferred to the 
baneful effects of hard cider. 
RELATED ACID. 
Trichloracetic Acid (Acidum Trichloracelicum').-When chlorine acts upon acetic 
acid three modifications of chloracetic acid are produced, accordingly as the hydrogen 
atoms are replaced by one, two, or three atoms of chlorine-viz., mono-, di-, and tri- 
chloracetic acids. The latter forms colorless deliquescent soluble crystals having a faintly 
pungent odor. In full strength to 50 per cent dilutions trichloracetic acid is used as a rapid 
cauterant. It is said to be less painful than most escharotics, and such pain as might be 
caused upon mucous tissues may be forestalled by first applying cocaine or its congeners. 
It closely resembles nitric acid in action, penetrating deeply without very much inflaming 
the surrounding tissues, and forms a small, dry, and smooth whitish eschar which soon falls, 
leaving a granulating and rapidly healing surface. Very little contraction takes place, and 
the scar is inconsiderable. Trichloracetic acid may be used upon papillomata, warts, venereal 
condylomata, lupus, vascular naevi, and various neoplasms; and under proper conditions 
to destroy the remaining bases after removal of exuberant growths in the middle ear. 
The neighboring tissues, when possible, should be protected by collodion, and the acid 
applied directly in crystal, or if liquefied, by means of a glass rod. 
119 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ACIDUM ACETYLSALICYLICUM. 
Aspirin; Acetyl-salicylic Acid. 
Description.-White crystalline needles having a disagreeable, sourish taste, soluble 
in 300 parts of water and in alkaline solutions. Dose, 5 to 15 grains; usual dose, 5 grains. 
Specific Indications.-Rheumatic and neuralgic pain. 
Action.-This agent is used in place of the salicylates, and is said to 
have no irritant effect upon the stomach and to be less apt to provoke tin- 
nitus aurium. In some persons, however, it has caused profuse sweating, 
urticarial eruptions (including a dangerous swelling of the glottis), and col- 
lapse. During the great influenza epidemic (1918-19), many serious results 
and even deaths were afterward believed to have been due to excessive 
dosage of aspirin and other synthetics. Like salol, this drug does not dissolve 
in the stomach, but disintegration takes place in the intestinal canal. Many 
cases of "aspirin habit" have been reported. 
Therapy.-Aspirin is used as an intestinal antiseptic, and instead of the 
salicylates in gouty and lithaemic conditions. Its chief use, however, is 
to relieve pain in neuralgias and acute rheumatism, and particularly in 
headaches of the neuralgic or nervous type. Unfortunately it is one of the 
drugs which has been taken up and used recklessly by the laity for almost 
any painful condition and often with disastrous effects. The blame can 
be laid at the doors of the physicians and druggists who have thoughtlessly, 
or with commercial hopes, placed an unguarded and limited knowledge 
of the drug before the people. If symptoms of salicylism (ringing in the 
ears, or profuse sweating, or urticaria) occur, its use should be discontinued. 
Aspirin should not be dispensed with quinine or its salts, lest a poison- 
ous compound-quinotoxin-be formed. Recently this has been denied. 
SUBSTITUTE FOR ASPIRIN. 
Novaspirin (Methylene-citryl-salicylic acid) contains about 62 per cent of salicylic acid. 
It has been introduced for use in place of aspirin because it is less irritant than that body. 
It is a white powder, readily soluble in alcohol, but almost insoluble in water; it has no 
odor, but a feebly acidulous taste. In the alkaline media of the intestines it becomes dis- 
sociated into salicylic acid and methylene citric acid. As it passes through the stomach 
unchanged it is used interchangeably with aspirin or salol where ordinary salicylates 
cannot be employed on account of the gastric irritation produced. Novaspirin has been 
recommended in neuralgias, neuralgic headache, tonsillitis, intestinal fermentative disorders, 
and in muscular and articular rheumatism. The free use of large doses of both apsirin and 
novaspirin are accused of doing great damage in the epidemic of septic influenza of 1918-19. 
Milder drugs seem preferable in la grippe and epidemic influenza than these too frequently 
employed synthetics. The dose is from 5 to 15 grains; not more than 60 grains a day should 
be given, even in acute rheumatism. Its use should be discontinued if ringing in the 
ears (symptoms of salicylism) occurs. 
ACIDUM BENZOICUM. 
Benzoic Acid. 
An acid obtained by sublimation from benzoin, or synthetically manufactured. 
(Formula: CjHjO,). 
Description.-Lustrous scales or friable needle crystals, white and odorless (synthetic 
acid) or white or yellowish with faint odor of benzoin (natural acid). The latter becomes 
darker in color when exposed to light. Both have a pungent taste. It dissolves easily in 
alcohol, ether, chloroform, and in fixed and volatile oils; and less readily in turpentine; 
more sparingly in water. Dose, 1 to 30 grains; the smaller doses are usually preferred. 
Specific Indications.-Excessively alkaline urine; phosphaturia; vesical 
irritabilitv, with alkaline urine; fermentative urine; brain-fag, with phos- 
120 INDIVIDUAL DRUGS. 
phaturia; "irritation of the sympathetic and spinal system of nerves with 
uric acid deposits" (Scudder). 
Action.-Benzoin and benzoic acid and its salts act quite similarly. 
According to concentration all are irritant to the mucosa, the vapor par- 
ticularly exciting a flow of bronchial mucus. In many respects the acid 
resembles salicylic acid both in its local and internal effects. Its anti- 
bacterial power is about equivalent to that of the latter. Large doses 
cause nausea and vomiting, the pulse is somewhat accelerated, and the 
secretions of the mucous membranes by which it is excreted are rendered 
more or less antiseptic and antiputrefactive. A large part of it is eliminated 
by the urine as hippuric acid, though some unchanged benzoic acid is 
also voided. The effect is to both disinfect and acidify the urine, the 
secretion of which is also augmented, probably through a stimulating action 
upon the cells of the kidneys. 
Therapy.-External. As a constituent of benzoinated lard, or of the 
compound tincture, benzoin is frequently used in local disorders. Equal 
parts of the compound tincture and glycerin (or similar preparations of 
various strengths) is a valuable lotion for chapped hands and lips, chilblains, 
cracked nipples, fissure of the anus, etc., and as an antipruritic and healing 
application in urticaria and eczema. In the light of present views of anti- 
sepsis, the discarded use of the compound tincture as a surgical dressing 
has been justifiedly revived. By inhalation, the compound tincture is 
valuable in acute laryngitis, pharyngitis, bronchial catarrh, and to relieve 
the hoarseness due to irritation of the vocal cords of singers and speakers. 
When this method is employed the tincture (2 or 3 drachms) should be 
added to hot water (1 pint) in a vessel with a large opening and inhaled by 
shrouding the head over the rising vapor. Atomizers cannot be used, as the 
gum easily obstructs the tubes. Benzoinated lard, owing to its non-rancid 
and antiseptic qualities, forms the unctuous base of many ointments for 
local use in various skin diseases. 
Internal. Benzoic acid and the benzoates (sodium and ammonium) 
are used chiefly in urinary disorders with alkaline urine. By checking 
fermentation and rendering the ammoniacal urine acid, it quiets irritation, 
pain, and chronic inflammation, and promotes a better and freer flow of 
urine, and overcomes enuresis, dribbling, and urgent insistence to urinate 
when but small quantities are to be voided. It also dissolves phosphates 
and dissociates the particles of cystic calculi, being especially useful in 
uric acid gravel when the urine is strongly alkaline and fermentative, 
whether a suppurative state be present or not. By its antiseptic action it 
is of marked value in pyelitis. When gonorrhoea is aggravated or pro- 
longed by putrefactive urine it aids by its corrective power. It also prob- 
ably prevents the formation of calculi by rendering the urine acid and by 
converting at least a part of the alkaline material into ammonium hip- 
purate. It is useful in the dribbling of urine in old men, when due to 
excessive alkalinity, and sometimes relieves the urinal incontinence of 
children, especially if due to gravel. It is the remedy for chylous urine, 
and reduces or wholly abolishes the albumen in cyclic albuminuria, but has 
little or no effect upon that due to chronic renal inflammation. 
121 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Scudder suggested benzoic acid as a specific in "irritation of the 
sympathetic and spinal nervous systems, with uric acid deposits," and 
in brain exhaustion in mentally over-worked individuals, with phosphaturia. 
By its undoubted power over intestinal bacteria, and the reduction of the 
amount of indican in the urine, benzoic acid and its salts are useful in 
intestinal putrefaction and intestinal catarrh of children and in jaundice. 
The benzoates should not be used in health, as in the preserving of foods, 
on account of their retarding effects upon the activity of the digestive 
enzymes. 
Benzoic acid is a constituent of Camphorated Tincture of Opium, 
well known as Paregoric. It has also been largely used in chronic respira- 
tory catarrhs. Its use in diphtheria, erysipelas, and allied infectious dis- 
eases, for its antizymotic effect, as employed by German physicians, is 
logical, but has found few followers in this country. 
Boric Acid, Boracic Acid. (Formula: Ha BO3). 
An acid derived from deposits in Tuscany and the Lipari Island, and from the borax 
deposits of California; also prepared chemically from borax. 
Description.-A permanent, odorless and faintly bitterish acid occurring in three forms: 
in transparent, pearly, lustrous, colorless scales; in six-sided crystals; or as a bulky white 
powder, having a slightly grease-like feel. It dissolves easily in glycerin, hot or cold water, 
and hot or cold alcohol. Dose, 1 to 15 grains. 
Preparations.-1. Glyceritum Boroglyceri, Glycerite of Boroglycerin. (Solution of 
Boroglyceride, Glycerite of Glyceryl Borate). Contains about 30 per cent of boric acid in 
solution in glycerin. 
2. Unguentum Acidi Borici, Ointment of Boric Acid. Contains 10 per cent of 
Boric Acid. 
Action.-Though used for the destruction of roaches and other in- 
sects, boric acid, even in considerable quantities, has but little effect upon 
the higher animals. When absorbed from local applications, or injected 
into the pleural cavity of man (5 per cent solution) death has resulted, 
preceded by vomiting, hiccough, mental depression, and collapse. Some 
cases exhibit a general cutaneous erythema and diarrhoea, followed by 
bloody vomitus and increased action of the kidneys. The overactivity of 
the latter finally results in complete anuria and death. (For further effects 
of the acid, which are similar to those of its sodium salt, see Sodii Boras.) 
The use of boric acid as a food preservative, now forbidden by Federal 
act, was not without occasional deleterious action, where foods preserved 
by it, such as milk, were continuously used. 
Therapy.-External. Boric acid in concentrated form is decidedly 
irritant; but in dilute solution it proves wholly non-irritating, and even 
sedative. It is feebly antiseptic, therefore it should not be depended upon 
in serious local infections. To some extent it is antipyic. Applied by 
means of saturated compresses it is a useful dressing for non-septic wounds 
and where such a protective is needed following gynecological and other 
operations. A saturated solution may in this manner be applied to dog- 
bites, and in lesser strength to simple lacerations, and it forms one of the 
best of applications for cellulitis, particularly that occurring in the leg and 
ankles. Boric acid solution is a favorite cleansing wash for the mouth of 
ACIDUM BORICUM. 
122 INDIVIDUAL DRUGS. 
suckling babies and to cleanse the mother's breasts after nursing. Sunburn 
and other cutaneous inflammations are gratefully treated with boric acid 
lotions, and it sometimes bleaches freckles. 
For fetid perspiration the solution is one of the best known agentsand 
compares well with salicylic acid and potassium permanganate for bromid- 
rosis of the feet and axillae. A glycerole (boric acid 1., glycerin, 30) is 
valuable in aphthous ulceration, oezena, nasal catarrh, and pharyngitis. 
This glycerole, or the boroglyceride, may be diluted to a suitable degree 
and employed as a cleansing wash in diphtheria and other forms of sore 
throat, vaginitis, urethritis, and in irritative ophthalmias. The solution 
may be used to wash away mucoid and fetid secretions from cavities, and 
as a douche for leucorrhcea and colic irrigation. Great care must be used, 
however, in flushing the bowels and bladder with it lest poisoning result, 
and only the very weak solutions should be so employed and quickly 
removed, for the acid is rapidly absorbed. 
A 5 to 10 per cent ointment forms a splendid dressing for burns and 
scalds, acting as an antiseptic protective and promoting healing with but 
little or no scarring provided it be kept constantly applied. Applied to 
ulcers and old sores it protects against infection. Ointment of boric acid 
is valuable in many skin affections, notably trichophytosis genito-cruralis, 
and to allay itching, as in urticaria. 
Boric acid, in various preparations, is largely used in ophthalmic and 
aural practice. The solution gives relief to irritable eyes with itching 
and redness, and in the various forms of conjunctivitis with much secretion. 
Where the conjunctival surfaces are thickened and velvety and the se- 
cretions abundant and watery, the acid in impalpable powder may be 
dusted upon the parts, though the practice should not be long continued 
lest unpleasant dryness of the membrane result (Foltz). Corneal ulcer 
and phlyctenular conjunctivitis may be treated in the same manner. 
For ciliary blepharitis an ointment (5 to 10 grains to 2 drachms of petro- 
latum) is useful though less effective than yellow oxide of mercury. In 
ophthalmias a few drops of Lloyd's ergot or colorless hydrastis add greatly 
to the efficiency of the solutions of the acid. In purulent otorrhea a solu- 
tion of 10 to 20 grains in an ounce of absolute alcohol makes an excellent 
cleansing application. Under no circumstances should the powdered acid 
be packed into the canal, as was formerly practiced, on account of damming 
in the secretions and thus forcing infection into the attic and mastoid cells. 
Internal. Boric acid is used but little internally. Owing to its power 
to correct fetor, and its slight astringency, it may be given to modify fetid 
eructations arising from fermentative dyspepsia. By its chemical action 
it may be given to correct excessive alkalinity of the renal secretion re- 
sulting in ammoniacal urine and its consequent cystic irritation and in- 
flammation. It probably renders the urine acid through its power over 
fermentation. 
Citric Acid. 
An organic acid usually obtained from lime-juice or from lemon juice. (Formula: 
C. H8 O7. H2 O). 
Description.-Translucent, colorless, prismatic crystals, or a white odorless powder, 
with sharp, but pleasantly sour taste. It effloresces in a warm atmosphere. It dissolves 
freely in hot and cold water, and less readily in ether. Dose, 1 to 15 grains. 
ACIDUM CITRICUM. 
123 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Elongated, reddened tongue, with prominent 
papillae; scorbutus; fevers with red, long tongue; excessively red in- 
flamed surfaces in inflammatory rheumatism, with acid urine and long, 
red tongue thinly coated white. 
Action.-In large doses in man citric acid acts as a gastro-intestinal 
irritant, though no cases of death from it have been recorded. In small 
animals it has caused heart failure, tetanic convulsions, and death. Used 
moderately it retards the coagulability of the blood, but too continuously 
employed it may have the opposite effect. Its continued use disturbs the 
gastric function and may induce an acid condition of the stomach. Citric acid 
is most largely eliminated by the kidneys, rendering the urine acid if a large 
amount has been taken. Small quantities, through conversion into alka- 
line carbonates, render the urine less acid, and sometimes alkaline. It is 
an active antiseptic. 
Therapy.-External. Solutions of citric acid have been used suc- 
cessfully to reduce enlarged tonsils, retract elongated uvula, and to give 
relief in scrotal and general pruritus. Lemon juice is a popular lotion for 
"tan and freckles". 
Internal. Citric acid is decidedly antiscorbutic and may be used to 
prevent and to cure scurvy or scorbutus. For this purpose it is most 
generally used in the form of lemon juice, which contains it. (See Limon). 
Citric acid and lemon juice are absolute specifics for scurvy, being equaled 
only by fresh vegetables of the cruciform family and by orange-juice. The 
actions of lemon juice and citric acid are not, however, exactly identical, 
though as a rule where citric acid is needed lemon juice may be prescribed 
therefor. When lemons cannot be procured a powder of citric acid (1 part), 
sugar (10 parts), and oil of lemon (1/5 part) may be used. By adding a half 
drachm to a glass of water a factitious lemonade may be prepared for use in 
scurvy, acute rheumatism, with red tongue and acid urine, and as a re- 
freshing, refrigerant drink for acute fevers and inflammations where acids 
are indicated and permissible. Under like conditions it is sometimes useful 
in hepatic torpor and jaundice. 
ACIDUM GALLICUM. 
Gallic Acid. 
An organic acid usually prepared by acting upon tannic acid with sulphuric acid. 
(Formula: CyH#O5+H2O). 
Description.-Permanent white or fawn-colored silky and interlaced needle crystals, 
or three-sided crystals; of feebly acidulous and astringent taste, and without odor. Very 
soluble in boiling water, alcohol, or glycerin; less soluble in cold water, or ether; chloro- 
form scarcely dissolves it. Dose, 3 to 20 grains. 
Specific Indications.-Passive hemorrhage, with feeble pulse and 
cold extremities, inelastic skin and relaxed capillaries; hematuria, with 
nausea, dizziness, headache, and dull aching in the region of the kidneys; 
soft, pasty, granular conjunctivitis. 
Action.-Gallic acid does not precipitate albumin nor gelatin. There- 
fore it is not a good styptic. When ingested it is quickly absorbed. Much 
of it is probably oxidized in the body, and the balance excreted unchanged 
by the kidneys, over the secretions of which and of the skin it has a marked 
control. As a topical astringent it is much inferior to tannic acid, but as a 
remote astringent it is much more powerful than the latter. Upon being 
124 INDIVIDUAL DRUGS. 
absorbed it acts upon the blood vessels by contracting them and thus 
controls the bleeding. Tannic acid, in its passage through the system, is 
converted, partially at least, into gallic acid, and ultimately into sodium 
gallate. Therefore time is saved and more direct action obtained by 
primarily administering the gallic acid. Gallic acid is less valuable to 
control hemorrhage from the gastro-intestinal tract, and diarrhoeal dis- 
charges, than tannic acid, for here the intended action is that of a local 
styptic and astringent. But when it is desired to control bleeding in parts 
that can be reached only through the blood current, gallic acid is to be 
preferred. Gallic acid does not constipate. 
Therapy.-External. Trachoma, with soft, pasty granulations has been 
successfully treated by the insufflation of gallic acid, and the same method 
is sometimes used in old cases of purulent conjunctivitis. Use 1 part of 
gallic acid to 2 of tannic acid twice a day (Foltz). An application of gallic 
acid and stramonium ointment gives relief to irritable and painful hemor- 
rhoids. 
Internal. Gallic acid is probably the most certain astringent for 
hematuria, while for hemoptysis of passive character it is a standard remedy. 
It is also useful in passive uterine hemorrhages, as in the menorrhagia of 
chronic debility. In the latter 5 grains should be given 3 or 4 times a day 
during the flow, as well as during the intermenstrual period. In hemoptysis 
it is best exhibited with Dover's powder, 3 grains of each every hour, while 
at the same time ergot is given by mouth or hypodermatically (Locke). 
Nose-bleed may be controlled by it in doses of 2 to 5 grains every 3 hours, 
and the same doses have been advised in hemorrhage from the bowels in 
typhoid fever. It has long been used for the control of night sweats, and 
for chronic mucous discharges from the bladder. Some have asserted it of 
great value to restrain the excretion of albumen in both acute and chronic 
nephritis; while in polyuria (diabetes insipidus) it sometimes arrests the 
excessive secretion of urine by constringing the renal capillaries. Gallic 
acid is said to have some value in purpura, and to alleviate the distress of 
pyrosis. Often opium is combined with it in the latter affection. The 
glycerole may be given in doses of 10 to 30 minims four times a day (Web- 
ster). 
Diluted Hydrobromic Acid. 
An aqueous solution varying not more than one-half per cent above or below a 10 per 
cent hydrobromic acid (H Br.) content. 
Description.-A strongly acid colorless liquid, having no odor and a sharply acid taste. 
It should be kept away from light, in glass-stoppered containers. Dose, 5 to 60 minims, 
preferably in sweetened water. 
Specific Indications.-Dry, red tongue, headache from cerebral 
hyperaemia, delirium, fever, tinnitus aurium, especially from cinchonism; 
dull pain in the abdomen, with fretfulness and peevishness. 
Action and Therapy.-Hydrobromic acid combines the action of the 
bromides and an acid. As it is powerfully irritant and corrosive it must 
be administered largely diluted. It is less apt to cause acneiform eruptions 
and other symptoms of bromism, but is regarded as less efficient for most 
purposes than the other bromides. It has not completely fulfilled the hopes 
of those who believed it might supplant the latter. The taste is, of course, 
ACIDUM HYDROBROMICUM DILUTUM. 
125 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
more agreeable than that of bromide salts. Its most valuable use is in 
tinnitus aurium of a pulsating and knocking character from the use of 
quinine and the salicylates, and the headache and fullness that frequently 
follow the employment of those preparations and of the salts of iron. It 
may be used also for nervous excitability, nervous exhaustion from too free 
indulgence in tea and alcoholics, in hysteria of ovarian origin, nympho- 
mania, sleeplessness from sexual erethism, and sometimes, though rarely, 
to allay gastric irritability and arrest the vomiting of pregnancy in highly 
excitable women. It is especially serviceable in nervous headache in pleth- 
oric women with full and excited circulation and in similar conditions when 
arising from eye-strain (De Schweinitz). Hale recommended it in fevers 
with marked irritability and restlessness, the tongue being red and dry. 
It is also of value in cerebral excitement during fevers, and when due to 
physical and mental overwork. Epilepsy appears to be aggravated by it. 
A syrup of hydrobromic acid (Gardner's) is a pleasant form of administra- 
tion, the dose being from 1/2 to 4 fluidrachms. 
ACIDUM HYDROCHLORICUM. 
Hydrochloric Acid; Muriatic Acid. 
An aqueous fluid containing about 32 per cent of absolute hydrochloric acid (HC1). 
It must be preserved preferably in dark-colored, glass-stoppered bottles. 
Description.-A strongly acid, colorless fuming fluid, of a pungent odor and intensely 
sour taste. It mixes in all proportions with water or alcohol. Both the odor and fumes 
disappear when hydrochloric acid is diluted with two measures of water. 
Preparations.-1. Acidum Hydrochloricum Dilutum, Diluted Hydrochloric Acid 
(Diluted Muriatic Acid). Contains about 10 per cent of Hydrochloric Acid. Dose, 1 to 30 
minims, largely diluted with water and taken through a glass tube. 
2. Specific Medicine Hydrochloric Acid Dilute. Dose, 1 to 40 drops well diluted 
with water. 
Specific Indications.-Deep-red, dry and contracted tongue, with a 
brownish coating; membranes dark-red when not due to deficient de- 
carbonization of the blood or to cardiac embarrassment; sordes; tongue 
contracted, fissured and brown, or with central brownish stripe; or tongue 
dark or dusky-red, moderately full and slick, having the appearance of spoiled 
beef; pungent heat of skin, slow digestion and nervous prostration; pyrosis. 
Action.-Small doses of hydrochloric acid cause gastric warmth and 
quicken the circulation. It tends to increase the normal secretions, allay 
thirst, and stimulate the digestive processes. Decided intoxicating effects 
may be induced by it, while its long-continued use may result in salivation. 
It precipitates albumens. The concentrated acid is violently irritant and 
corrosive, though it does not attack flesh as energetically as sulphuric acid. 
It is more likely to penetrate the epiderm and vesicate than to com- 
pletely destroy the skin. Poisonous doses corrode the stomach, and 
whether fatal or not result in a violent gastro-enteritis. 
A poisonous dose causes intense burning pain and discoloration of the 
throat, esophagus and stomach. The tongue is swollen and intensely red, 
with occasional whitish patches. Great restlessness, dry feverish skin, 
dilated pupils, sunken features, and a small wiry and irregular pulse, precede 
collapse and death. Vomiting of bloody matter may occur, but more 
frequently only retching, and whitish fumes may be evolved from the 
mouth iust after the acid is swallowed. 
126 INDIVIDUAL DRUGS. 
The treatment should consist in the free use of diluted alkalies, oxide 
of magnesia, or soapsuds. If possible, alkaline carbonates and emetics 
should be avoided, on account of their liability to rupture the already 
softened stomach by the effort of emesis, and the overdistention occasioned 
by the copious liberation of carbon dioxide. Demulcents should be freely 
given-mucilages, milk and eggs, and oils. Morphine should be given 
hypodermatically to allay pain. Recovery has taken place after large quan- 
tities of the acid have been swallowed. 
Therapy.-External. Undiluted hydrochloric acid may be used to 
cauterize cancrum oris and small poisoned wounds. Diluted more or less it 
is a grateful application for the relief of frost-bites and chilblains. The full 
strength acid is useful to decalcify carious ossicles of the ear as well as the 
walls of the tympanum and external auditory canal, to render their re- 
moval by operation less difficult. Foltz suggested a broomstraw as an ap- 
plicator. In very dilute solution it is useful as a wash for aphthae, the 
deep, red, sore throat of scarlatina, and to retract a relaxed uvula. 
Internal. This is a very important medicine when given according 
to its specific indications. There is always the deep-red mucosa, with the 
tendency to decay, and a marked depravation of the fluids of the body, 
as shown by the raw, slick, beef-like tongue, or the dark-red or dusky, dry- 
fissured tongue. There are also such deposits as sordes upon the lips, teeth, 
and tongue. All the exudates are of a dark color. Temperature may be 
high, yet sedatives fail to act. In all such conditions hydrochloric acid 
prepares the system for the kindly action of other indicated medicines. 
Such conditions frequently prevail in fevers from the simplest types to that 
of typhoid. The acid is most often indicated in acute disorders, and acts 
as a powerful azymotic. 
Hydrochloric acid is a most important drug in certain digestive dis- 
orders-chiefly those in which the normal hydrochloric acid of the gastric 
juice is deficient and those in which fermentative changes play an im- 
portant rdle. Laboratory studies now confirm the clinical uses instituted 
many years ago, when, though suspected, it was not proved that achlor- 
hydria or hypoacidity were the causes of many digestive disturbances. 
These cases of deficient normal acid may exhibit nausea, vomiting, pyrosis, 
and stomatitis; there may be greasy-yellow or brown eructations, with an 
exceedingly unpleasant and bitter taste, and the breath is hot and pungent. 
The red and dry or slick tongue and membranes are characteristic. It may 
be simple indigestion or advanced dyspepsia; at all events hydrochloric acid 
is deficient. In typhoid fever it is useful to supply this lack and to in- 
crease the secretion of mucus and to prevent decomposition and disintegra- 
tion of the blood. It aids what little digestion is possible in such depraved 
conditions. The softening and cleaning of the tongue under its use is 
proof of the good it is doing for the patient. It should be given, as a rule, 
with food or just afterwards; a favorite method of Scudder being to add it to 
beef tea. Given before meals it will sometimes check hyperacidity. It is 
also useful in intestinal indigestion with fermentative diarrhoea, and in 
severe dysentery and catarrhal diarrhoea of children, when the indications 
for acids are present. While it may be indicated in many diseases and 
conditions, it is most often needed in diphtheria, pneumonia, rheumatism. 
127 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
torpor of the liver, erysipelas, purpura hemorrhagica, and in the nausea 
following an alcoholic debauch. We have observed grateful effects from 
its use in phthisis, in which it allays thirst and restlessness, and seems to 
stimulate digestion and assimilation and to retard septic changes. In the 
earlier stages of pulmonic tuberculosis it is especially valuable, often 
proving tonic on account of the gastric stimulation excited by it. As 
in cancer of the stomach the natural acid of the gastric juice is abnormally 
deficient, substitution of this chemical form is certainly rational. As a 
gastric stimulant, tonic, and digestant, hydrochloric acid is frequently com- 
bined or associated with nux vomica, hydrastis, and other essential tonics. 
Added to solutions of quinine it prevents many of the unpleasant effects 
attributed to cinchonism. The acid should be given in small doses largely 
diluted to obtain its best effects. 
ACIDUM HYDROCYANICUM DILUTUM. 
Diluted Hydrocyanic Acid; Diluted Prussic Acid. 
An aqueous solution designed to contain 2 per cent of Hydrocyanic Acid (HCN). 
It should not vary more than one-tenth per cent above or below the 2 per cent standard. 
Description.-A colorless, thin liquid, having a characteristic bitter-almond or peach- 
pit odor. 
It should be tasted or smelled only with the greatest caution, as it is one of the 
deadliest poisons. It is also very unstable, and old preparations may be wholly inert. 
It is not to be confused with Scheele's Prussic Acid, which is double or more the strength 
of this acid. Dose, 1 to 3 minims diluted with water, syrup, or mucilage. The smaller 
amounts should always be given as initial doses. It is an extremely uncertain and unsatis- 
factory preparation. 
Action and Toxicology.-Hydrocyanic acid is one of the deadliest, 
if not the most rapid of all poisons. If a sufficient amount has been taken 
it poisons every part of the system-brain, nervous system, heart, and 
lungs and every organ concerned in maintaining the forces of life. Small 
doses produce in man salivation, a hot, bitter taste, irritation of the fauces, 
epigastric warmth, dizziness, swimming, tinnitus and pain in the head, 
numbness, dusky countenance, drowsiness, staggering gait, precordial con- 
striction, and increased or decreased heart-action, with palpitation. Ulcer- 
ation of the mouth, with profuse ptyalism, has followed the use of such 
doses. 
When a lethal dose has been swallowed its action is extremely rapid. 
The victim may gasp and drop dead at once. In any case the symptoms 
are rarely delayed more than one or two minutes (Taylor). Large lethal 
doses commonly cause unconsciousness immediately. The eyes are fixed 
and glistening, and the pupils dilated and unaffected by light, the face 
cyanosed, there is a brief convulsion, then collapse, and death. If a lesser, 
but still lethal, dose is taken, there is difficult breathing, slowing of the 
heart, and mental depression; then follow dilated and irresponsive pupils, 
convulsions, rarely wild cries, flaccid limbs, cold sweating, duskiness and 
turgidity of the face, breathing at long intervals (appearing dead between 
intervals), imperceptible pulse, and involuntary ejaculation of semen and 
discharges of urine and feces. Lastly the stage of collapse and asphyxia 
comes on and death quickly takes place. Usually, in fatal cases, relaxation 
rather than convulsions is the rule. Occasionally rigidity with set jaws and 
oozing of bloody froth are observed. The eyes retain their peculiar luster 
128 INDIVIDUAL DRUGS. 
after death, and the turgescence of the gastric mucosa, as well as the en- 
gorgement of blood in the deeper veins, with empty arteries, and the purplish 
discoloration of the skin, are among the post-mortem appearances. The 
odor of the acid, if present, the deep cyanosis and the rigidity of the jaws 
justify a diagnosis of prussic acid poisoning. As the acid is very unstable 
and its odor easily dissipated, no trace of the latter can be detected unless the 
body be opened. The only substance resembling it is oil of mirbane. The 
odor of the latter persists for hours after autopsy; whereas the excessive 
volatility of the former causes its complete dissipation within a very short 
space of time. Death may result from either respiratory or cardiac paralysis. 
Taylor compares the death to that from lightning; the patient either dies 
quickly or recovers altogether. If death does not take place in one hour, the 
patient will probably recover. 
If a very large dose has been taken, treatment is of little avail. There 
is seldom time to administer antidotes; and so rapid is the action of the 
poison that the patient is either dead or convalescent by the time a physician 
reaches him. But if the patient is still alive every effort should be made 
to keep life in the body. The theoretical antidotes are sulphate of iron 
(ferrous sulphate) and hydrogen dioxide, but as the poison is so rapidly 
absorbed little hope can be entertained from their possible chemical action. 
Cardiac and respiratory stimulants, strychnine and atropine should be 
given subcutaneously, and ammonia by mouth, by inhalation, and even 
intravenously. Alternate hot and cold affusions, dashing the water or 
pouring it from a height, on the head and spinal column, artificial respira- 
tion, and electricity are all rational procedures and should fearlessly be 
employed. 
The symptoms, treatment, and prognosis of poisoning by Potassium 
Cyanide are identical with those for Hydrocyanic Acid. The poisoning, 
however, does not take place quite so rapidly, thus insuring a better op- 
portunity of resuscitating and saving the patient. 
Therapy.-Neither hydrocyanic acid nor potassium cyanide should 
be used where other agents will suffice; nor should they ever be employed 
except in the minutest doses. It must be remembered also that the former 
is prone to decomposition and is often of variable strength on account of its 
great volatility; in such cases it may prove to be inert, leading the phy- 
sician to try larger doses, which in case of good preparations may induce 
collapse or death. 
As a sedative it is sometimes used to allay nervous irritability, vomiting 
from irritation of the stomach, spasmodic cough, dyspepsia with morbid 
sensitiveness of the stomach, and congestive headache. It is most service- 
able in spasmodic coughs and in the irritable cough of phthisis. For the 
latter it is usually prescribed with syrup of wild cherry. It is also recom- 
mended for cough dependent upon irritability of the stomach. So fugacious 
is its action, however, that it had best be dispensed with altogether. Its 
action in angina pectoris and cardiac palpitation is less certain and satis- 
factory than that of amyl nitrite or nitroglycerin; and its employment in 
gastralgia is scarcely justified in view of the fact that there are many safer 
and more certain agents for that purpose. Scudder advised a prescription 
of 5 minims of the 2 per cent acid in 4 fluidounces of water, the dose of 
129 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
which is a teaspoonful every 2 or 4 hours, where there is an "elongated and 
pointed tongue with reddened tip and edges; and uneasy sensations in the 
stomach." 
ACIDUM HYDRIODICUM DILUTUM. 
Diluted Hydriodic Acid. 
An aqueous solution containing 10 per cent of Hydriodic Acid (HI). 
Description.-A strongly acid liquid, colorless, or not more than pale yellow. It has 
a sharp sour taste. It mixes in all proportions with alcohol or water. Owing to liberation 
of free iodine it should be kept from light and air, in a dark-colored and well-stoppered 
bottle. If it is dark in color it contains free iodine and should not be used. Dose, 1 to 15 
minims. 
Preparation.-Syrupus Acidi Hydriodici, Syrup of Hydriodic Acid. Dose, 5 to 60 
minims. 
Action and Therapy.-Syrup of hydriodic acid has practically the same 
action as iodine and the iodides, but is less apt to produce their distressing 
coryza and iodism. It has been especially recommended for the treatment 
of periodic hyperaesthetic rhinitis or hay fever, and as a preferred form of 
the iodides for the relief of gonorrheal arthritis. Foltz advised it in phlycten- 
ula, iritis, interstitial keratitis, and purulent otitis media, all of syphilitic 
origin. On account of its more agreeable taste and milder action many 
prefer it in the various manifestations of tertiary syphilis, when the stomach 
will not tolerate the other iodides. It is a useful absorbent for the offending 
products producing pulmonary indurations following pneumonia and to 
remove pleuritic effusion and deposits. 
Lactic Acid. 
A liquid obtained chiefly by lactic fermentation of milk sugar or grape sugar, and 
composed of lactic acid and lactic anhydrides. 
Description.-A colorless, or nearly colorless, deliquescent, syrup-like liquid, almost 
devoid of odor, and having a not unpleasantly sour taste. It mixes with water, or alcohol, 
or ether, but not with chloroform. Dose, 1 to 60 minims, well diluted. 
Specific Indications.-Gastric irritation with thirst, deep-red tongue, 
and diarrhoea with green stools; itching of the skin, and cutaneous eruptions 
arising from gastro-intestinal disturbances; putrescency in the intestinal 
canal caused by decomposition of proteids. 
Action.-Lactic acid is a normal constituent of the gastric juice, and 
to its excess in the system has been attributed one of the causes of the 
various undefined conditions classed as rheumatism. In the light of present 
pathology it certainly is not the cause of the acute articular variety, now 
definitely known to be an infectious disease. Very large doses are said to 
be hypnotic (Mendel), but as such it is feeble and uncertain and has had no 
practical application. Lactic acid softens hardened epithelium and dis- 
solves false membranes. The lactic acid bacillus prevents proteid fermen- 
tation in the intestinal canal. 
Therapy.-External. Lactic acid continuously applied attacks and 
removes epithelial excrescences, such as warts, horny growths, and tylosis 
of the palms and soles. It should be applied with a hair pencil. "Liver 
spots" (chloasma) and freckles (ephilides) are gradually bleached by a lotion 
of 1 part of the acid to 5 to 20 of water; or more rapidly, though certainly 
less desirably, made to disappear by the application of the concentrated 
ACIDUM LACTICUM. 
130 INDIVIDUAL DRUGS. 
acid repeated until the epiderm and underlying pigment are removed in such 
a manner as to prevent cicatrization. The lesions are dressed with a mild 
zinc or similar ointment. Webster declares it second only to acetic acid in 
obstinate tinea versicolor. It has been applied to ulcers of the nasal fossae 
and in suppurative otitis media. In the latter its good effects are not 
commensurate with the irritation of the auditory canal produced, and the 
same objection holds good as to its use in caries of the bony structures of the 
ear. It fails to destroy granulations of the tympanum. It has rendered aid 
in diphtheria and follicular tonsillitis by dissolving the membranous 
exudate in the one and the cheesy deposits in the other. It has no curative 
properties, however, in either disease. The solution (from 5 to 8 per cent) 
may be used as a spray or gargle, or may be painted directly upon the parts. 
Internal. Lactic acid is a valuable aid to digestion, and proves useful 
in gastro-intestinal disorders with feeble digestive power when the indica- 
tions for acids are present. In fact it acts better in some conditions than 
hydrochloric and other commonly used digestive acids. Within very 
recent years the lactic acid bacillus, in the form of tablets, or milk prepara- 
tions fermented by it, has been largely used to prevent and to correct im- 
perfect intestinal digestion due to putrefaction produced by the decomposi- 
tion of proteids. It is of no value, but rather aggravates that form of in- 
testinal perversion occasioned by the decomposition of carbohydrates. 
This usage has been acquired from the time-immemorial custom of the 
Bulgar peasants of using sour milk and that fermented in goat skins as a 
chief article of diet, with the reputed result of prolonging the years of life. 
Metchnikoff's "old age" theory was based upon the life-prolonging powers 
of the lactic bacillary power of such foods as soured milk. He himself, 
however, barely survived the allotted span of three score years and ten. 
It has been a well-known fact in this country, particularly in the Eastern 
States, that delicate stomachs that can scarcely retain any other food, 
kindly receive buttermilk and coagulated or "clabbered milk," and to a less 
degree freshly prepared "cottage cheese." There is extreme sensitiveness 
to ordinary foods and an evident hypoacidity of the stomach requiring this 
class of acid proteids. An important use for lactic acid is in infantile diar- 
rhea attended with pain and irritation, and the frequent passage of green 
stools. In this condition it is a most positive help, and should be given in 
boiled water, and sweetened if desired, so that the little patient receives 
from 1/2 to 1 drop at a dose. For adults the daily range of dosage should 
be from 1 drop to 3 or 4 drachms, well diluted, but the best specific results 
come from the small doses of from 1/2 to 5 drops, well diluted and, if desired, 
sweetened by the addition of sugar. 
At one time lactic acid was largely used in phosphaturia and oxaluria, 
on account of the facility with which it dissolves phosphate and oxalate 
of calcium, especially those forms which are natural constituents of the 
bones. 
Lactic Acid Bacillus has been advised in rheumatoid arthritis. With- 
out doubt its good results come from the improvement of the condition of 
the digestive tube, for that disorder unquestionably depends largely upon 
intestinal putrefaction and retained products of imperfect metabolism. 
131 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ACID UM NITRICUM. 
Nitric Acid. 
An aqueous solution containing about 68 per cent of HNOS. 
Description.-A fuming caustic and corrosive acid liquid having a peculiar irrespirable 
odor. It should be kept in dark-amber, glass-stoppered bottles. Dose, 1 to 20 drops, largely 
diluted with water or syrup. {The usual method of prescribing it is: 3 Nitric Acid, gtt. 
xxx. Simple Syrup ^iv. Mix. Sig. One teaspoonful every 3 hours. It should be taken 
preferably through a glass tube and the mouth afterward rinsed with an alkaline fluid.) 
Specific Indications.-Pale rose-red, or deep red tongue, with a violet 
haze, seemingly like a transparent color over red, usually with moderately 
red membranes (Scudder); harsh, explosive cough; imperfect waste, with 
foregoing indications. 
Action and Toxicology.-Nitric acid fumes inhaled kill by producing 
congestion, hemorrhage, and oedema of the respiratory tract, with dyspnoea 
as the chief symptom. If death does not occur very shortly traumatic 
or aspiration pneumonia may supervene, with or without recovery. The 
fumes from batteries charged with it may act deleteriously in poorly 
ventilated rooms. 
Like the other strong mineral acids, nitric acid precipitates albumen 
and is a poison to protoplasm. It is powerfully escharotic, the parts 
affected being stained a deep yellow. Fatal doses are immediately followed 
by intense, burning pain in throat and oesophagus, reaching to the stomach; 
gaseous eructations, abdominal swelling; violent emesis of fluids and solids, 
mixed with strongly acid, yellowish shreds of mucus, and dark-brown, 
altered blood. Great tenderness of the abdomen is felt. The oral mem- 
branes are soft and white, turning to yellow or brown. The teeth are also 
white or yellowish, and the dental enamel corroded. Viscid mucus fills 
the mouth, and swallowing or speaking is extremely difficult. The tongue is 
swollen and yellow, and the tonsils enlarged. Obstinate constipation 
ensues, and liquids increase the pain and vomiting. The pulse becomes 
quick, small, and irregular, the surface cold, and shivering takes place. 
A light stupor, from which the sufferer may easily be aroused, supervenes, 
and as a rule the intellect is unimpaired to the last. Should the fumes have 
been inhaled also, pneumonia complicates the case. 
Death usually takes place in from 1 3/4 to 24 hours. The smallest 
quantity that has proved lethal is 2 drachms. If death does not occur the 
prognosis for future health must be guarded, for as with all the corrosive 
poisons there may result destruction of the gastric glands or gradually in- 
creasing oesophageal stricture, terminating in death from starvation many 
months after the ingestion of the poison. 
After death the parts with which the acid came in contact exhibit 
shades varying from white to yellow and brown. The throat and trachea 
and lungs are congested and inflamed. The oesophageal membrane is yellow 
or brown, soft, and readily detachable in long shreds. The stomach shows 
the greatest damage, and though so soft as to break down under the faintest 
pressure, singularly no cases of perforation have yet been observed. The 
gastric membrane is partially inflamed, and exhibits patches of a yellow, 
brown, green, or black color. Such changes may be observed also in the 
duodenum, though only redness may be apparent. 
The treatment of poisoning by nitric acid is identical to that for 
Sulphuric and Hydrochloric Acids (which see). 
132 INDIVIDUAL DRUGS. 
Therapy.-External. Concentrated nitric acid is the best and most 
manageable escharotic for the removal of warts and venereal vegetations; 
and may be used when a cauterant is thought advisable in the treatment of 
chancre and chancroids. It may also prove useful to cauterize poisoned 
wounds, bites, and stings, and to destroy unhealthy flesh in phagedenic 
ulcers, cancrum oris, and rarely to dissipate small hemorrhoids. The latter 
usage is a relic of barbarous medication, though effective; scarcely any pain 
is caused at first, but considerable suffering follows. It may be resorted to 
only in those who refuse operative relief. Nitric acid is similarly used in 
fistula in ano, ulceration of the os uteri, and in syphilitic ulcers of the throat 
and other parts. A solution of 10 to 20 drops of the acid in 1 pint of water 
makes a good stimulating wash for sloughing and ill-conditioned ulcers 
and for certain chronic skin eruptions, as porrigo and acne, and in the 
more acute impetigo and erythema nodosum. In treating these skin 
lesions it is frequently also given internally. Some have used it successfully 
for the removal of pterygium, a method that may well be discarded. When 
applying nitric acid externally a strong solution of soap or of a simple 
alkali or alkaline carbonate should be at hand to limit its action when- 
ever desired. 
Internal. Writing of nitric acid, Scudder {Specific Medication,p. 189) 
pointed out the specific conditions as follows: If the tongue, whether pale, 
rose-red, or deep-red, presents a violet haze, we have an indication for 
nitric acid. We will notice the same violet haze wherever the blood comes 
to the surface in the capillary circulation. I think we get the most decided 
results when the mucous membranes are moderately red. Do not mistake 
the deep, solid purple of the mucous membranes we see sometimes for this 
violet haze, for here the irritable stomach very frequently presents the red 
tip and edges of tongue, and sometimes elongated papillae." 
With the indications clearly in evidence a dilute sweetened solution of 
nitric acid makes a very agreeable cooling drink for use in fevers, particularly 
when there is a disposition to putrescency, or marked prostration. Oc- 
casionally this acidulous draught is useful in serous diarrhoea and dysenteric 
diarrhoea, especially when the hepatic function is imperfect. Though less 
often serviceable than hydrochloric acid, it is, when sharply indicated, useful 
in enfeebled and irritative gastric disorders, more particularly when de- 
pendent upon or associated with torpor of the liver or subacute hepatitis. 
Many have regarded it of especial value when hepatic and gastric de- 
rangements occur in syphilized constitutions. It assists greatly in the 
elimination of uric acid, and though less effectual than nitrohydrochloric 
acid, is effectual in oxaluria. Nitric acid is sometimes indicated in con- 
tinued fevers, typhoid fever, typhoid dysentery, and in pneumonia with 
typhoid symptoms. With quinine, which it easily dissolves, it is of con- 
siderable service in chronic agues and in malarial headache. It lessens the 
probability of cinchonism. 
Nitric acid is one of the most direct and specific of medicines in whoop- 
ing cough. An agreeable form of administration is in syrup, syrup of 
tolu, or syrup of orange, or some such preparation as the following: 1$ 
Nitric Acid, gtt. x; Compound Tincture of Cardamom, 3ij; water, 3j. 
Simple Syrup, q. s. §iv. Mix. Sig. One teaspoonful everv 2 to 4 hours. 
133 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Wash the mouth well, after administering, with a dilute alkaline solution. 
To be effective in pertussis, nitric acid must be given according to the specific 
indications noted above. We have had excellent results in explosive cough, 
evidently due to medullary irritation, from I) Nitric Acid, gtt. x; Sangui- 
narine Nitrate, gr. j; Specific Medicine Drosera, gtt. xxx; Water q. s. giv. 
Mix. Sig. One teaspoonful every 2 or 3 hours. Nitric acid should always 
be administered well diluted. 
Nitrohydrochloric Acid; Nitromuriatic Acid; Aqua Regia (Royal Water). 
A mixture of 18 parts of Nitric Acid and 82 parts of Hydrochloric Acid. To be kept in 
not more than half-filled, dark-amber-colored, glass-stoppered bottles, in a cool place. 
Description.-A fuming, pure yellow, very corrosive acid liquid, emitting a strong 
odor of chlorine. Goldleaf is easily dissolved by it (hence its name Aqua Regia, on account 
of its superior dissolving power). Dose, 1 to 5 minims, largely diluted. 
Preparation.-Acidum Nitrohydrochloricum Dilutum, Diluted Nitrohydrochloric 
Acid (Diluted Nitromuriatic Acid). Dose, 5 to 30 minims, well diluted. 
Action and Therapy.-Large quantities of this acid act as a corrosive 
poison like its constituents, and in poisoning by it like treatment should be 
instituted. Even small doses attack the dental enamel and gold fillings and 
produce gastric derangements. When used diluted as a bath, it is absorbed, 
increasing the hepatic and renal secretions, and producing a sense of 
burning in the mouth and fauces, and induces profuse ptyalism, redness and 
tumefaction of the gums, and ulcers of the cheeks. Diarrhoea is occasioned 
by it also. 
For some unexplained reason nitrohydrochloric acid acts upon the liver 
with greater force than other acids, and proves useful in conditions in which 
even its components are of little or no value. It was introduced as a 
remedy for hepatic affections, especially the chronic hepatitis of tropical 
climes, the bath being formerly preferred. Small doses of this or the diluted 
acid are sometimes employed in hepatic fullness and tenderness, and in 
dyspepsia with constipation or slight jaundice. The type of jaundice 
benefited by it is that occasioned by duodenal catarrh, or by torpor of the 
liver, it being of no practical value in that occasioned by gall-stones or other 
obstruction of the gall-duct. In the conditions that come within the 
compass of the elastic term biliousness this double acid has had a large 
employment; and it has been thought to be effectual in chronic con- 
gestion of the liver with a tendency toward induration or enlargement of 
that viscus. It is one of the agents prescribed by some for cirrhosis of the 
liver in its early stage, but has little to recommend it further than its salutary 
effect upon the gastro-hepatic function in digestion as far as the condition 
of the liver will allow it to participate. A fomentation (1 to 3 drachms to a 
pint of water) has been advised as very efficient in liver troubles, applying 
it to the hypochondrium. When intestinal indigestion results in chronic 
diarrhoea the latter is often checked by nitrohydrochloric acid. It is more 
likely to disorder the stomach and bowels than either of its component acids. 
H. C. Wood is authority for the statement that surprising results come 
from use of nitrohydrochloric acid in oxaluria: "A condition probably 
dependent upon defective primary assimilation, in which the chief symp- 
ACIDUM NITROHYDROCHLORICUM. 
134 INDIVIDUAL DRUGS. 
toms are general malaise, a feeling of weakness, a lack of elasticity, and 
a very great depression of spirits, with the crystals of calcium oxalate 
generally present in the urine." 
What little success attends its use in chronic syphilis and sluggish 
cutaneous ulcers is probably due to its generally beneficial effects upon 
gastro-hepatic metabolism. 
White Liquid Physic.-"The White Liquid Physic as given by Dr. 
Scudder (Mat. Med., p. 185), is made as follows: 1$ Sulphate of sodium 
lb. ss; water Ojss; dissolve the sulphate of sodium in the water, and add 
nitric acid 5j; hydrochloric acid §j. This differs from the original White 
Liquid or Dow's Physic in the omission of alum. This he regarded as one 
of the most efficient remedies in dysentery, used to produce at least one 
bilious evacuation, and afterwards continued in smaller doses. 'It acts 
directly upon the liver, removes the constipated state of the upper part of 
intestinal canal, lessens the tormina and tenesmus, and speedily checks the 
dysenteric discharge' (Scudder). Dose, a tablespoonful every hour in 
sweetened water until catharsis ensues. In order to protect the teeth from 
the action of the acid in this preparation, each dose should be sucked 
through a straw or glass tube; and, immediately after the dose has been 
swallowed, the mouth should be rinsed once or twice with an alkaline 
solution." (American Dispensatory.} 
ACIDUM OXALICUM. 
Oxalic Acid.-(Formula: H2C2O4. 2H2O). 
An organic acid existing naturally in some plants, but prepared chiefly by acting upon 
sugar or starch, or other organic substances, with nitric acid; or by fusing a mixture of 
caustic potash, caustic soda, and saw-dust, and subsequently purifying it. 
Description.-Transparent, colorless and odorless, prismatic crystals of a faintly 
acid taste, and slightly efflorescing in dry air. Readily soluble in alcohol and water. 
Action and Toxicology.-Oxalic acid is a local irritant and escharotic. 
Internally its irritant effects are less pronounced according to dilution, 
but the absorbtive effect is much increased. It poisons the blood and the 
nervous system. The symptoms vary greatly, more so than that of most 
irritant poisons. Death may occur in less than five minutes or be delayed for 
nearly a month. If the dose be large it kills quickly, usually within an hour; 
and one drachm has proved fatal. The soluble oxalates (potassium and 
ammonium) are equally, but less rapidly, poisonous. 
Lethal doses produce the following symptoms: Intensely pure acid 
taste, burning of the parts touched by the acid, intense pain, vomiting of 
bloody material, extremely feeble pulse, inability to sit or stand, mental 
dullness, collapse, and death. The blood becomes excessively red and the 
gastro-intestinal mucosa is bleached, softened, and loosened. When 
death is long delayed the kidneys show deposits of crystals of calcium 
oxalate. 
In poisoning by oxalic acid (or its soluble oxalates) the antidote is 
chalk. If this is not at hand, magnesia should be given. Both form in- 
soluble oxalates. An emetic or the stomach pump should be used immedi- 
ately, and demulcent drinks freely administered. Cardiac and respiratory 
stimulants should be injected subcutaneously. Alkalies should not be given, 
as they form with the acid equally poisonous soluble oxalates. 
135 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Therapy.-External. King advised oxalic acid in saturated solution 
as a cure for acne and scald head. Great care must be exercised lest it 
poison by absorption. It is in use among many surgeons for disinfecting 
the hands preparatory to operating. Kelly declares it and permanganate 
of potassium to be the only practical means of perfect surgical hand prep- 
aration. Oxalic acid and the soluble oxalates remove iron stains from 
garments. For this reason the solutions of the acid or of binoxalate of 
potassium, popularly known as "salts of sorrel", or "salts of lemon", are 
kept on hand in households. The chief reason for including this acid in this 
work is the liability to poisoning by it from the preceding solutions, or when 
children eat too freely of sorrel (Rumex Acetosella and allied species), and 
sumach bobs (the fruit of Rhus glabra and Rhus typhina). A recent case 
of death of a clergyman has been reported from eating stewed rhubarb leaves, 
which at certain periods of growth contain an excess of potassium bin- 
oxalate. 
Oxalic acid has attained no significant position as an internal medicine. 
ACIDUM PHOSPHO RICUM. 
Phosphoric Acid. 
An aqueous solution of between 85 and 88 per cent of Phosphoric Acid (HSPO4). 
Description.-A colorless and odorless syrupy liquid, having a strongly sour taste. 
It mixes in all proportions with water or alcohol. It should be kept in glass-stoppered 
bottles. 
Preparation.-Acidum Phosphoricum Dilutum, Diluted Phosphoric Acid. Contains 
about 10 per cent of Phosphoric Acid. Dose, 5 to 30 minims, largely diluted with water. 
Specific Indications.-Thirst; nervous and mental derangements; 
atonic nervous and functional deafness with debility. 
Action.-Locally concentrated phosphoric acid is an irritant and may 
produce redness and blistering. Internally its effects are those usual to the 
dilute mineral acids, but it is milder and more assimilable. In addition 
a mild intoxication somewhat resembling that from alcohol may be pro- 
duced by half drachm to three drachm doses. Larger doses bring on a 
more or less persistent feeling of inertia and drowsiness. 
Therapy.-Diluted Phosphoric Acid is useful to allay thirst in diabetes, 
and is sometimes used for the same purpose and as a refrigerant drink in 
fevers. In digestive weakness with eructations of sour and bitter material 
and pyrosis it checks fermentation and acts as a mild digestive stimulant. 
By some it is thought most serviceable in so-called nervous dyspepsia and 
in that occasioned by the debility of old age. It has been variously suggested 
for osteomalacia, atonic deep-seated eye disorders, tobacco and alcoholic 
amblyopia (with nux vomica), and keratitis in feeble individuals. Foltz 
is authority for the statement that it has cured disseminated choroiditis. 
Functional nervous deafness is reputed to have been improved by it. It 
has little value as a medicine, however, except as a feeble digestive stimulant 
and in refrigerant and thirst-allaying drinks. Its value as a nerve-tonic is 
much overrated and it is utterly useless for direct aid in sexual debility, 
a state in which it has been proclaimed a medicine of great power. 
136 INDIVIDUAL DRUGS. 
ACIDUM SALICYLICUM. 
Salicylic Acid; Orthohydroxybenzoic Acid.-(Formula: C7H6OS). 
An organic acid, existing naturally in a variety of plants, but most generally prepared 
synthetically from phenol salts. Those varieties prepared from Oil of Wintergreen and 
Oil of Birch are preferred in Eclectic practice. 
Description.-Occurs as fine needle crystals or a crystalline powder, having no odor 
but a sweetish alkaline, subsequently acrid taste. Exposure to air does not change it. 
Very soluble in alcohol and ether; less so in boiling water, and sparingly in cold water. 
Dose, 1 to 15 grains; the smaller doses are to be preferred. 
Specific Indications.-Acute infections caused by the micro-organism 
of rheumatism; acute articular rheumatism; "rheumatic pain with little 
fever; tongue broad, full, purplish or leaden colored, showing spots where 
the fur is detached" (Scudder). Chronic catarrh, with fetor. 
Action and Toxicology.-Salicylic Acid is decidedly antiseptic. When 
inhaled it provokes sneezing and coughing. Applied to the skin it attacks 
the epithelium, and if its action be prolonged it softens the horny layer of 
the epiderm and allows it to separate from the corium. This is accomplished, 
as a rule, without provoking inflammation. Upon abraded surfaces and 
the mucosa it is a decided irritant, and when swallowed in concentrated 
form may be destructive to the esophageal and gastric surfaces; diluted, 
both the acid and its salts disorder digestion, probably by interfering with 
the functions of the digestive enzymes. The acid is readily absorbed, and 
circulates in the blood-current as salicylates of the alkalies. It slightly 
increases the urine, in which it may be detected as early as five minutes 
after ingestion, and is chiefly eliminated in that excretion, though it is also 
found in all the secretions of the body. To the urine, in which some of it is 
eliminated unchanged, or as salicylates, but almost wholly as salicyluric 
acid, it imparts an olive-green color, due to the presence of indican or 
pyrocatechin, or both. The urine, even when strongly alkaline, is rendered 
acid by its presence, and so great is its antiputrefactive power that the 
fluid will remain undecomposed for several days after being voided. 
Salicylic acid and its salts act upon the motor centers, the cerebral cortex, 
and some of the nerves of special sense, as the auditory nerve. In general, 
however, unless the dose be toxic the effect upon the nervous system is not 
noteworthy, nor well understood. Respiration is but little affected, except 
by large doses, when it is increased. In toxic quantities it may be labored, 
quick and deep, and when death occurs from it it is due to centric respira- 
tory paralysis. Its action upon respiration is both centrally and periph- 
erally exerted. The heart and circulation are, if anything, slightly de- 
pressed by even moderate doses, while large amounts are actively depressant, 
especially if the acid be contaminated with creosotinic acid. Salicylic 
acid, and notably its sodium salt, increases the secretion of bile. Temper- 
ature is unaffected in health by small doses, and slightly depressed by large 
amounts. In febrile states, however, a very decided reduction in tempera- 
ture takes place. The elimination of urea and uric acid is greatly in- 
creased by it, as is that of the sulphur compounds. Whether the large 
quantity of urea and uric acid voided are those naturally formed under 
ordinary conditions, or whether of increased formation due to metabolic 
activities induced by the drug, is still a matter undetermined. The pre- 
ponderance of opinion leans toward the latter theory. 
137 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Doses of salicylic acid sufficient to be objectively observed produce 
symptoms analagous to those of quinine-fullness and noises in the head, 
with buzzing and roaring in the ears (tinnitus auriuni). Larger doses in- 
crease the head symptoms and may cause severe headache, defective sight 
and hearing, and profuse sweating. These phenomena are all intensified 
by toxic amounts, when ptosis, dilated pupils, squint, deafness, slow and 
labored pulse, characteristic deep and quickened breathing, and restlessness 
deepening into dilirium may occur, followed by collapse. Blindness and 
hemorrhage into the retina and uterine hemorrhage and abortion have 
been caused by salicylic acid. Extreme irritation of the kidneys, with 
congestion and albuminuria, have also been produced by it, and in some 
instances acetonuria has resulted. Death, though rarely, has resulted from 
salicylic acid. 
Occasionally urticaria has been caused by salicylic acid; more rarely 
exanthematous, bullous, purpuric or gangrenous skin eruptions. Mental 
disturbances are common, and dangerously violent delirium may come on 
in drunkards. In others active dreams and visions, and talking in sleep 
have been noted. In still others delirium-variously cheerful, melan- 
cholic, or furiously maniacal, may ensue. Illusions and hallucinations are 
not uncommon, and a state simulating delirium tremens, but devoid of 
terror, has been observed in some instances of poisoning by this acid and 
its salts. To the syndrome caused by salicylic acid, which is analagous to 
the cinchonism produced by quinine, the term salicylism has been given. 
Therapy.-External. Salicylic acid admixed with talcum powder or 
chalk may be used as a dusting powder to restrain excessive sweating, and 
in bromidrosis of the arm-pits and feet. The acid may also be applied 
full strength to gangrenous and cancerous ulcers to destroy fetor and 
restrain the formation of pus. A spray of it, in solution, is sometimes useful 
for its deodorizing quality inoezena, fetid bronchitis, chronic pharyngitis and 
pulmonary gangrene. At one time it was valued as a local wet dressing to 
wounds, to prevent pus formation, and to ulcerating wounds to restrain 
suppuration and correct offensive odors. It is now seldom used for these 
purposes, though it is very effectual for the last named office. Thiersch's 
solution (salicylic acid 1 part, boric acid 6 parts, water 500 parts) is a useful 
antiseptic solution for diphtheritic throats and other purposes. 
Dissolved in collodion (about 1 to 8 or 10), it is a certain agent for 
many skin diseases showing hardened tissues. A preparation of well- 
deserved approbation, composed of salicylic acid 10 parts, extract of can- 
nabis 4 parts, and flexible collodion 86 parts, is exceedingly effective for the 
removal of corns and warts. Another good form is salicylic acid 10 parts, 
extract of cannabis 3 parts, extract of thuja 10 parts, flexible collodion T1 
parts. Mundy states that a saturated solution of the acid in collodion will 
promptly cure ringworm, and that a solution of it is an excellent applica- 
tion for rhus poisoning. A wash of salicylic acid in water makes an effectual 
douche for offensive leucorrhoea and a cleansing agent in fetid gonorrhoea, 
both in the male and the female. 
The ointment (about 1 to 10) is useful in the various types of tinea, 
especially tinea circinata, in chronic weeping eczema, scaly and exudative 
palpebral eczema (gr. v to petrolatum 3 j), to remove freckles, and in lupus 
138 INDIVIDUAL DRUGS. 
erythematosus and lupus vulgaris. An ointment of salicylic acid gr. x, 
specific medicine veratrum 5j, petrolatum 5 j, is an excellent stimulant and 
deodorant for fetid nasal catarrh and ozaena. Howe valued it in ointment 
to relieve pruritus and soften the hardened edges of rectal fissures. In 
alcoholic solution it is the best agent we have found for sweating of the 
feet with stench and exfoliation of whitish patches of the skin, evidently of 
fungous origin. The shoes should be washed with the same solution, or 
dusted with a salicylated powder of fuller's earth or talc, and a pair of clean 
stockings put on every morning after treating the feet the previous night. 
Salicylic acid is an excellent deodorant for excretions, but is too expensive 
for general purposes. Foltz used a 4 per cent glycerin solution to destroy 
the false membrane in diphtheritic conjunctivitis. 
Internal. (Compare also Sodii Salicylas.) Salicylic acid and its 
alkaline salts, particularly sodium salicylate, are the most direct and certain 
antirheumatics known to medicine. They are believed to act directly upon 
the micro-organism of rheumatism-the diplococcus rheumaticus-destroy- 
ing it or inhibiting its power, or upon its toxines. However they act, they 
are incontestably of the greatest service in acute articular rheumatism or 
rheumatic fever, bringing the active symptoms quickly under control and 
shortening the duration of the disease. If their administration be begun 
early, in considerable doses, they mitigate the severity of the pain, reduce 
the swelling of the joints, lessen the fever, and favor a restoration of the 
suppressed secretions of the skin and kidneys. An important result of their 
early use is the protection they give to the heart valves and the endo- 
cardium from the rheumatic invasion, and the subsequent train of evils 
that follow heart complications ordinarily following long-drawn-out cases 
of acute rheumatic fever. As the heart-lesions usually occur as the disease 
advances, the salicylates prevent their occurrence chiefly by shortening the 
course of the attacks, and destroying the micro-organisms, or inhibiting 
their activity before they migrate to that organ. It has been said that 
relapses are more frequent after salicylates than after any other form of 
treatment. In our opinion this is due to incomplete medication, many 
physicians beginning the treatment with fairly large doses and discon- 
tinuing them upon the abatement of the more distressing symptoms. 
When the drugs have been continued in regularly-given small doses after 
the first use of the larger amounts, and even after the pain and fever have 
subsided, we have observed no greater tendency to relapses or to recurrences 
than is ordinarily encountered in the history of this disease. The salicylates 
are useful in all forms of true acute rheumatism, but are far less effectual, 
though not without value, in subacute or muscular rheumatism, rheumatic 
neuritis, and in the so-called chronic rheumatism-an elastic name covering 
a multitude of ill-defined and misunderstood painful conditions. 
Scudder, writing in the pioneer days of the salicylates, believed salicylic 
acid to be indicated in acute and subacute rheumatism with but little 
febrile reaction, the tongue being full, moist, purplish or leaden-colored, and, 
where the rheumatic area exhibits local redness, with slight purplish dis- 
coloration, especially when pressed upon. He preferred two grain doses of the 
acid every two hours. Locke believed the acid contraindicated by the pointed 
red tongue-an evidence, of course, of gastric and other irritability. In 
139 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
view of the fact of its great general utility in acute rheumatism, however, 
the wisdom of limiting its use strictly to these indications may be questioned. 
A wide use of the sodium salt convinces us that the best indication is the 
genuine uncomplicated rheumatic invasion, provided the heart and kidneys 
are unimpaired. 
In so-called rheumatoid arthritis, or rheumatic gout, the salicylates 
are only relatively useful. As there is here no true rheumatic invasion, but 
more than likely disturbing causes resulting from imperfect metabolism, 
little aid should be hoped for by their administration. In gouty conditions 
associated with or following true rheumatism, more certain results are ob- 
tained. They are best aided by the concurrent use of the acid, or its com- 
pounds, and specific medicine colchicum. Some prefer salicylate of colchicine, 
but in our opinion the latter is less manageable and less effective. Practi- 
cally no results are obtained from the salicylates in gonorrhoeal arthritis, 
misnamed "gonorrhoeal rheumatism", which is due to the ravages of the 
gonococcus. When sciatica and lumbago occur in one of a rheumatic 
diathesis, or closely following an acute rheumatism, the salicylates are 
helpful They are of value also in rheumatic angina. 
The salicylates are of distinct value in various infections of the tonsil 
resulting in acute tonsillitis. When of the quinsy type, they often do good 
by preventing the formation of pus, provided they are used very early. 
After pus begins to form, they do not retard it. But as many such in- 
vasions are known to be closely followed by a rheumatic seizure, their use 
is justifiable, even after suppuration and during convalescence, for un- 
doubtedly they tend to prevent a rheumatic storm, when the damaged 
tonsil acts as a port of entry for the micro-organism. 
Salicylic acid is of value in dyspepsia with yeasty fermentation and 
eructations of gas, and in gastric catarrh, with dilatation of the stomach 
and vomiting of material containing sarcinee. The latter are destroyed by 
its antiseptic action. Given internally in small doses, it is said to cause the 
expulsion of lumbricoids. 
For all of the rheumatic disorders, either the acid or the sodium 
compound may be used, although the acid is converted into salicylates in 
the body. We prefer the latter. 
The internal use of salicylic acid in surgical fever, diphtheria and similar 
states is now practically abandoned. It is certainly not a desirable remedy 
in typhoid fevers or allied adynamic conditions. Sometimes it relieves 
neuralgias, particularly migraine when associated with a rheumatic diathesis; 
and some contend that when chorea is associated with rheumatism or occurs 
in a patient subject to rheumatism it is to be preferred to arsenic. While 
larger doses of salicylic acid (10 to 30 grains) have been advised, the better 
method of administration is to give from 2 to 5 grains in capsule every 
3 hours until 20 grains have been taken. If no untoward effects are pro- 
duced, this may be repeated each day until the desired results are obtained. 
Owing to their undoubted effects as intestinal antiseptics both sali- 
cylic acid and its salts may render service in states leading to intestinal 
inflammation, particularly first attacks of acute catarrhal appendicitis. If 
they do not act quickly, and pain, rectus-rigidity and rising temperature 
persist or increase, they should not further be relied upon. 
140 INDIVIDUAL DRUGS. 
ACIDUM SULPHURICUM. 
Sulphuric Acid; Oil of Vitriol. 
A liquid containing about 94 per cent of H2 SO4. It should be kept in glass-stoppered 
bottles. 
Description.-A colorless and odorless, heavy, oil-like liquid, very corrosive and 
caustic. It strongly reddens litmus and chars organic matter. It mixes, with generation 
of heat, in all proportions with water or alcohol. The acid must always be very 
cautiously added to the diluting medium. 
Preparations.-1. Acidum Sulphuricum Dilutum, Diluted Sulphuric Acid. (Strength, 
about 10 per cent.) Dose, 1 to 2 minims, largely diluted. 
2. Acidum Sulphuricum Aromaticum, Aromatic Sulphuric Acid (Elixir of Vitriol) 
(Sulphuric Acid [about 20 per cent], tincture of ginger, oil of cinnamon, and alcohol). Dose, 5 
to 30 minims, well diluted. 
Specific Indications.-The deep-red tongue; diarrhoea, with deep-red 
tongue and gastric debility; colliquative sweating, with great debility; 
acute lead poisoning. 
Action and Toxicology.-The protracted use of diluted sulphuric acid 
is exceedingly deleterious in its effects on digestion, and may give rise to 
diarrhoea, with consequent weakness and loss of flesh. It is at all times and 
in all conditions destructive to the teeth. It slows the pulse, increases the 
appetite, allays thirst, and checks excessive cutaneous excretion. Injected 
into the venous circulation, the strong acid coagulates and chars the blood. 
The pure acid destroys flesh, redissolves coagula, and penetrates deeply, 
carbonizing the tissues wherever it touches. 
If swallowed in any amount, death is almost sure to follow, as the 
tissues over which it passes are utterly destroyed. The symptoms are 
intense burning pain, escape of gaseous or frothy material, retching and 
vomiting of shreds of tissue and dark, coffee-ground and bloody fluid, and 
excoriation of the parts over which the acid passes, giving them a whitish 
appearance, as of parchment that has been soaked. This whitish hue 
subsequently changes to gray or brownish, and the mouth is filled with a 
thick, sticky mixture of mucus, saliva, and corroded tissue. Breathing, 
speaking and swallowing are very difficult, and the face assumes a livid or 
bluish appearance. If breathing be not obstructed, from injury to the 
larynx, the face is pale and the expression extremely anxious and indicative 
of intense suffering. Pain is increased upon the ingestion of fluids, and upon 
movement of the abdominal muscles. Exhaustion, great weakness, small, 
feeble, quick pulse, cold, mottled skin, bathed in clammy sweat, great 
thirst, obstinate constipation and convulsive movements, are also symp- 
tomatic. The intellect remains unimpaired until death. 
If death is not immediately produced, it may subsequently result from 
oesophageal stricture, or gastric inflammation and ulceration; in either case 
causing death by starvation. After death, the parts are found corroded, 
and colored whitish, gray or brown-black, with ecchymoses. The stomach 
may be perforated, but if not, it is collapsed and its tissues contracted, 
the stain being black or brown over the entire surface, or merely in black 
streaks, according to the amount of food in the organ. The contents are of 
the same hue, and tarry in consistence. If perforation occurs, other neigh- 
boring organs may be attacked. Death from poisoning by this acid 
usually occurs in from 18 to 24 hours. The smallest dose which has killed is 
1/2 drachm. Again, death may result months or years afterward from the 
141 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
effects of the poison. Sulphuric acid should be antidoted with calcined 
magnesia, if at hand; if not, other alkaline solutions may be given. Emetics 
and alkaline carbonates should, if possible, be avoided, and the stomach- 
pump should not be used on account of the friability of the corroded tissues. 
Mucilaginous drinks, milk, oils, albumen and soaps may be given after the 
antidotes if the acid swallowed be small in amount, or in a diluted form. 
Chalk, lime water, white-wash or plaster from the walls may be used if 
nothing else can be obtained. Morphine may be given to quiet pain, and heat 
should be applied to the body. 
Therapy.-External. Sulphuric acid is used, though rarely, as a cauter- 
ant for warts, chancre, syphilitic and slow healing ulcers; sometimes by 
applying it as a paste combined with charcoal, or zinc sulphate. On account 
of its affinity for the water of the tissues it is less manageable, and not so 
desirable as nitric acid for this purpose. When so used the surrounding 
tissues should be protected by oil or petrolatum. It has been employed to 
destroy small malignant growths and to touch poisoned wounds and the 
bites of animals; and in extropion and ectropion to cicatrize the palpebral 
tissue in such a manner as to reverse the direction of growth. A dilution 
may be employed to stimulate healing in indolent, venereal and phagedenic 
ulcers; and very much diluted it makes an agreeable astringent wash for 
ulceration of the mouth and throat, relaxed uvula, profuse salivation, 
certain sluggish and weeping skin diseases, and small hemorrhagic surfaces. 
All of these uses, which are often effective, are more or less archaic. 
Internal. Dilute sulphuric acid is a good tonic. It sharpens the 
appetite, promotes digestion, quenches thirst, and inhibits fermentation of 
the contents of the stomach. Therefore it is useful in hyperacidity, with 
pyrosis, digestive debility and gastric fermentation and relaxation. As a 
refrigerant and antiseptic it may be used in continued fevers as a pleasant 
drink, and as a tonic during convalescence from exhausting diseases. It is 
grateful in erysipelas, in the hectic fevers of suppuration and phthisis, 
and assists in controlling colliquative sweating, the aromatic sulphuric acid 
being one of the best agents for this purpose. As an antiseptic it frequently 
does good service in fevers arising from putrefaction of food or the body 
tissues. In the form of sulphuric acid lemonade (containing about 5 to 10 
drops of the aromatic acid to four ounces of water), it is valuable to prevent 
and to treat acute lead poisoning. An insoluble lead sulphate is formed 
which is less easily absorbed than lead. Workmen employed in the making 
of white lead and paints, and type setters often take this preparation as a 
prophylactic. For acute lead colic and lead constipation a solution of 
magnesium sulphate or sodium sulphate in very dilute sulphuric acid is the 
most effective remedy; for chronic lead poisoning and its results, as wrist 
drop and lead neuritis, iodide of potassium is the remedy best known. 
Asiatic cholera appears to have been as well controlled by sulphuric 
acid as by any other form of treatment; besides it would seem possibly to be 
prophylactic. Serous diarrhoea, or painless colliquative diarrhoea, with 
light colored, watery and alkaline stools is promptly restrained by the 
aromatic acid. Neither should it be overlooked in small passive hemorrhages 
from the stomach and bowels. 
142 INDIVIDUAL DRUGS. 
Aside from its purely astringent action when so desired, the acid should 
be given preferably when acids are specifically indicated-by the deep 
redness of tongue and mucous membranes. Both dilute sulphuric acid and 
the aromatic preparation should be taken through a glass tube in order 
to protect the teeth, employing thereafter an alkaline wash. 
Sulphurous Acid. 
A liquid composed of not less than 6.4 per cent of sulphurous acid gas (SO2). 
Description.-A colorless liquid, having the characteristic odor of burning sulphur, 
and a very sour sulphurous taste. Dose, 5 to 60 minims, well diluted. 
Preparation.-Specific Medicine Acid Sulphurous. Dose, 5 to 60 drops, well diluted. 
Specific Indications.-Full relaxed, dirty-looking tissues, with deep 
redness and sticky, unhealthy discharges; sweetish, mawkish odor of breath 
and excretions; increased and viscid saliva; full, broad, atonic tongue, 
normally red, with a glutinous coat, either transparent or dirty-brownish, 
with effaced papillae; gastric derangements with yeasty fermentation. 
All the conditions are those of sepsis and debility. Locally: parasitic skin 
diseases. 
Action.-Sulphur dioxide or sulphurous acid gas has long been a 
popular disinfectant. Where plenty of moisture is present it is effective, but 
as ordinarily passed off as a dry gas it is of questionable efficiency. Used 
properly it would decolorize and otherwise damage household articles; 
but in empty rooms which have been occupied by the sick and which are to 
be repapered or painted it may be used with an abundance of steam being 
generated in the room, to accomplish satisfactory disinfection. 
Pronounced irritation of the glottis is caused by inhaling sulphur 
dioxide, and the sensation of suffocation is intense. Large amounts violently 
inflame the air passages. Fatal cases from the burning of coal giving off a 
large quantity of this gas show a cold surface, livid countenance, purple 
lips, hands and nails; short, quick breathing; small, feeble and quiet pulse; 
fixed pupils and complete insensibility-in short all the symptoms of 
asphyxia. Congestion of the brain, heart, and lungs is, as a rule, the chief 
post-mortem feature, like that in one who has been hanged (Taylor). 
Sulphurous acid (and its salts) attacks organic matter energetically, 
having a selective affinity for oxygen. Fungi, bacteria, and other low 
forms of life are destroyed by it. It has especial value in its power to 
destroy the low organisms of putrefaction and fermentation. 
Therapy.-External.-Sulphurous acid is an active parasiticide. 
After scabs have been removed and the parts thoroughly cleansed it may 
be applied full strength, or diluted with glycerin or water or both, to the 
desired strength. It is better to combine some water, or rose water, with the 
glycerin, as the latter in full strength irritates the skin and does injury 
by its avidity for the moisture of the tissues, leaving them hard, dry and 
liable to crack. Tinea tonsurans, tinea favosa, and tinea versicolor, and 
other forms of trichophytoses, as ringworm, are diseases in which it is active 
and efficient. It destroys lice and the itch insect, and is effectual in the 
mange of animals. It is a good application for chilblains, chapped hands, 
urticaria, erysipelas (with glycerin), and purpura. Sloughing wounds and 
ACIDUM SULPHUROSUM. 
143 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ulcers, with sticky, glutinous secretion, and mucous patches and mercurial 
stomatitis have been successfully treated by it. It is especially prompt in 
removing pathologic exudates from the throat, tonsils, and fauces. In the 
form of a wash or spray it has been employed with asserted success in 
thrush, diphtheria (with dusky color of membranes), follicular pharyn- 
gitis and tonsillitis, chronic laryngeal irritation, with consequent weakness 
of voice or complete aphonia, and in chronic bronchitis, with abundant 
expectoration. As a decalcifying agent for the removal of fragments of 
carious bone from the aural canal and tympanum it is less efficient than 
hydrochloric acid. In all but the local and parasitic skin diseases it should 
be given internally conjointly with its external application. 
Internal. Sulphurous acid is strongly azymotic and as such was 
introduced into medicine for its influence upon bacterial life. The 
sulphites of sodium or magnesium produce similar results, as they become 
decomposed when in the stomach, and give out sulphurous acid. It has 
little effect upon spores. When specifically employed it is one of the most 
satisfactory of medicines, but the preparation must always be fresh and 
should not be left long in contact with water. Therefore, the fresh acid 
should be dispensed in bulk, with directions for its dilution. When the acid 
is old or has been kept badly corked it changes to sulphuric acid, on ac- 
count of its avidity for oxygen. 
Sulphurous acid cases call for acid medication; though it is not used as an 
acid, for its acid properties are feeble. Still the general state of the system 
tends toward excessive alkalinity (redness), while, on the contrary, the alkaline 
sulphites are indicated in excessive acidity (pallid tongue and membranes). 
The characteristic condition for sulphurous acid is one of a low state, with 
normal or increased redness of the tongue and membranes. The tissues 
are enfeebled, full and relaxed, and appear to have lost vitality; the pulse 
large and empty, the sensation under the finger being that of a large- 
calibered vessel, with a small stream of blood. The secretions are nasty, 
dirty, and exhale, as well as the breath, a peculiar, sweetish, mawkish odor. 
The membranes are reddened and dirty, or muddy in color. The tongue is 
characteristic, being coated, over red, with a glutinous, nasty, yellowish- 
brown, or the coating may be transparent; and, again, it may appear as if 
fecal matter had been rubbed upon it. In later stages a moist, glutinous, 
brownish fur may line the center of the organ. Occasionally the tongue is 
slick and shining, like a piece of raw beef. Dirty-looking sordes soil the 
teeth and lips; and the saliva is increased in quantity, viscid, and mawkish. 
When indicated by external appearances, as in erysipelas and like con- 
ditions, the tissues are deep-red, and appear to have lost vitality. The 
erysipelatous redness blanches more or less as the disease progresses, 
"sometimes in the center, sometimes at the border, sometimes in the deep 
structures, you seem to be looking through the superficial redness" (Scud- 
der, Specific Diagnosis, 90). Wounds and abrasions seem to show a 
tendency to slough, and are bathed in dirty, sticky, unhealthy secretions. 
Add to these a depraved state with yeasty vomiting, and you have the 
specific uses for one of our most important antiseptics. 
Used in the conditions named, it will be found a most useful agent in 
scarlet fever, enteric and remittent fevers, in surgical and puerperal fevers, 
144 INDIVIDUAL DRUGS. 
measles and small-pox, often striking at the basic causes and always of 
assistance to other indicated remedies. In bronchitis and pneumonia it 
may be given freely when the expectoration is fetid and mucopurulent, 
the cases inactive, and the type of fever not high but prostrating. It has no 
effect in tuberculosis other than to modify the odor and quantity of viscid 
and fetid expectoration. In that form of tonsillitis, with stinking, cheesy 
plugs, or a more diffuse and offensive membranous deposit, it should be used 
both locally and internally. For diphtheria it is one of the most certain agents 
to hasten dissolution of the exudate, and should be freely used locally as a 
wash or painted upon the membrane; at the same time it should be given 
internally. An aromatized syrup or glycerin may be used as a vehicle. Eiling- 
wood advises a good form of administration prepared as follows: 1$ Dilute 
sulphurous acid 5iij, Sulphur 3j, Syrup of Tolu (or Mucilage of Acacia) 
5 ij. Mix. Sig. One half to one teaspoonful every half hour, without taking 
water afterward. In this way both its local and internal influence is 
obtained. While it is a valuable medicine in diphtheria, it must not be 
depended upon alone to cure the disease, though it may check the progress 
of mild types. Still every case of diphtheria should be presumed to be 
malignant and treated accordingly. 
Yeasty fermentation is checked by sulphurous acid. Therefore it 
frequently renders good service in fermentative dyspepsia, in sarcinae 
ventriculi, and in indigestion with pyrosis and acid eructations. It is thus 
prompt in checking the excessive secretion, stopping vomiting, and al- 
leviating gastrodynia. When intestinal indigestion appears to depend upon 
yeasty fermentation and is accompanied by sour, frothy and fetid diarrhoea 
with flatulence, this agent is useful to destroy the disturbing intestinal 
flora and restore normal functional activity. 
ACIDUM TANNICUM. 
Tannic Acid; Tannin; Gallotannic Acid; Digallic Acid. 
An organic acid most generally obtained from nutgalls. 
Description.-Cohering glistening scales or spongy masses of a non-crystalline, yellowish- 
white or pale brown powder, becoming gradually darker upon exposure to light and air. 
It has a strongly astringent taste and a distinctive but faint odor. Very soluble in water 
and alcohol; freely in diluted alcohol; sparingly in dehydrated alcohol, and scarcely at 
all in chloroform or ether. Readily soluble when heated in an equal part of glycerin. 
Dose, 1 to 15 grains. 
Preparations.-1. Glyceritum Acidi Tannici, Glycerite of Tannic Acid (Glycerite 
of Tannin). Contains 20 per cent tannic acid. Dose, 5 to 60 drops. 
2. Unguentum Acidi Tannici, Ointment of Tannic Acid. (Contains 20 per cent of 
tannic acid.) 
Action.-Vegetable astringents depend upon tannins for their chief 
quality. The tannins, in the various types of tannic acid, differing chem- 
ically and somewhat physically, all possess the power of precipitating 
albumen and gelatin. Upon fresh blood they act as coagulants. Their 
varying intensity of action, when in their natural colloidal state, depends 
upon their facility and promptness in precipitating the proteids, other 
constituents in their natural drug combinations affecting their relative 
solubility. Tannic acid (gallo-tannic acid) is known to be changed in the 
stomach, and if its effects as a drug are to be sought in the gastro-intestinal 
tract, the slowly tannin-yielding astringents are to be preferred to the acid 
145 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
itself. The slower disintegration of the natural chemical union allows the 
tannin in such forms to reach the intestines without all being transformed 
into gallates in the stomach. In such cases geranium, kino, rhatany, and 
other common astringents are to be preferred to free tannic acid. 
Tannic acid is powerfully astringent and hemostatic. It precipitates 
albumen and coagulates fresh blood, and in this way exerts its styptic effects. 
To the taste it is bitter and harsh, giving a constringing sense of roughness 
to the mucosa of the mouth and fauces. It shrinks the tissues by acting 
upon the epithelial cells and glandular structures, thus restraining their 
secretions. It also precipitates the proteids of the latter, depositing a 
slimy protective layer of albumen tannate. The blood clots formed by it 
are hard and difficult of removal, not only appearing at the point of oozing 
but forming plugs extending into the lumen of the severed blood vessels. 
Moreover, it probably acts also upon the vascular coats. As a rule tannic 
acid does not derange the stomach. It does, however, temporarily inter- 
fere with digestion by uniting with and precipitating the proteids present. 
These, however, are redissolved as the digestive process proceeds, and the 
resulting peptones then refuse to unite with the tannin in the presence of the 
gastric acid. It has generally been held that tannic acid is converted into 
and enters the blood as gallic acid. The probability is that most of it 
undergoes oxidation in the tissues, while the balance is converted into 
sodium gallate. A small proportion of the unchanged acid appears to 
pass out by way of the bowels, but the major portion seems to be converted 
into sodium gallate, and as such a small quantity is eliminated in the urine 
and the feces. 
Tannic acid sometimes, and especially when long given, occasions 
gastric and intestinal pain, febrile phenomena, with thirst and eructations 
of gas, while the tongue is coated, and defecation is tenesmic; or there may 
be general gastro-i»testinal irritation and diarrhoea if a large dose has been 
taken. Rarely erythema, dyspnoea and a cyanotic condition have been 
produced by it. 
Therapy.-External. Tannic acid is a sure and prompt styptic for 
bleeding from small incised or lacerated wounds, or abrasions. It forms a 
firm and antiseptic clot, effectually excluding the air. On account of the 
difficulty of its removal it should not be used, when it can be avoided, in 
small cavities. Moreover, it can only be relied upon when the bleeding is 
small in amount. The powder, the glycerole or the styptic collodion may 
be employed as best suits the purpose. The powder, the glycerole and 
the solution, and in some instances the collodion, may be applied in ex- 
coriations, burns, aphthous and other ulcers of the mouth, severe saliva- 
tion, spongy or bleeding gums, phagedenic and other ulcers, relaxed uvula, 
prolapsus ani, piles, anal fissures, rectal ulcers, chilblains, and frost-bites, 
fungous granulations of ingrown nails, and small nasal polypi. It is of little 
value to destroy aural polypi, and when used in suppurative otitis media, 
as is sometimes advised, it is objectionable on account of the difficultly 
removable hardened mass that it forms. 
The solution of tannic acid is valuable to restrain mucous discharges and 
to overcome irritation and congestion. For this purpose it may be used in 
varying strengths (1 to 60) for relaxed sore throats, sluggish pharyngitis, 
146 INDIVIDUAL DRUGS. 
subacute nasal catarrh, and as a constringing injection, after the previous 
use of plain or borax water, in vaginal leucorrhoea, cystitis, subacute 
gonorrhoea, and gleet. 
The glycerole (or an ointment) applied on tampons and left in situ for 
several hours is extremely effective in erosions and ulcerations of the cervix 
and abrasions of the vaginal canal, and in diminishing the consequent 
leucorrheal discharge. It is sometimes used in pencil to be inserted into 
the cervical canal. The glycerole is one of the best agents to prevent and to 
cure cracked or sore nipples, and is a most grateful application to sores on 
the gums from pressure or erosion by false teeth. 
Ointments of tannic acid alone, or of stramonium and tannic acid, 
or of nutgalls (1) and opium (15), are favorite and ofttimes effective applica- 
tions to relieve and cure painful hemorrhoids. 
In various forms tannic acid, the wash or ointment being preferred, 
is used upon moist skin eruptions to alleviate irritation and itching and to 
restrain the secretions. In this manner it is especially serviceable in moist 
herpes, intertrigo, weeping eczema, and dermatitis venenata. 
Tannic acid is used somewhat in ophthalmology to repress granulation 
and restrain discharges. Among the conditions in which it has been ad- 
vised are the following: Ophthalmia neonatorum when not healing readily 
and a granular condition prevails, after the preliminary treatment with 
a mild silver salt. The latter should be thoroughly washed from the 
eye before the tannic solution (1 to 20) is applied. In the early stage of 
trachoma with beginning granulation and injected and cloudy upper part 
of the cornea, the glycerole (grs. v. to 5 j) in 2-drop doses will allay the gritty 
sensation. In advanced trachoma, with soft, pasty granulations, it may be 
used in connection with gallic or boric acids: (1) Boric acid 5iij, Tannic 
acid 3 j; or (2) Gallic acid 3 j. Tannic acid 3 iij- A solution (2 to 10 grains 
to 1 ounce of distilled water) may be employed in purulent conjunctivitis, 
with but little swelling, small secretion, and tendency to soft granulations. 
Internal. Tannic acid was formerly in great favor with Eclectic 
practitioners in gastro-intestinal disorders, with unduly acid, watery or 
mucoid secretions, accompanied with flatulence. It was also popular in 
non-irritative, non-inflammatory, and non-febrile diarrhoea. It is useful 
to control both the diarrhoea and excessive sweating of phthisis when fever 
is practically absent. During the stage of collapse in Asiatic cholera, tannic 
acid may be given freely and frequently in full doses to control the diarrhoea. 
By means of a spray it is valued by some in bronchial catarrh and 
chronic laryngitis. In the same manner it was and is still employed to 
check passive hemorrhage from the lungs-when the quantity of blood 
passed is small. It is also effective in hematemesis, acting by direct contact 
of the acid with the stomach walls. It is not, however, adapted to active 
nor copious hemorrhages. Notwithstanding the changes it undergoes in 
the system, it is still believed to be useful in passive uterine hemorrhages, 
such as menorrhagia, with pain and nervousness. Locke advised from 3 to 
5 grains each of tannic acid and Dover's powder, every hour or two, until 
bleeding ceased, and stated that it would check the flow provided no 
organic lesion were present. 
147 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Tannic acid is an imperfect chemical antidote in poisoning by alkaloids, 
some metallic salts, and that of poisonous fungi. The acid merely retards 
the absorption by a fugacious chemical union with the poison. As the 
tannate so formed is quickly redissolved, it must be immediately got out 
of the stomach. 
ACIDUM TARTARICUM. 
Tartaric Acid. 
An organic acid usually derived from the lees of wine-making, or Argol. 
Description.-Translucent, colorless crystals, or a fine or a white granular powder, 
without odor and having a pleasantly acid taste. Very soluble in water or alcohol. Chloro- 
form scarcely dissolves it, and ether but slightly. Dose, 5 to 30 grains in water or syrup. 
Action and Toxicology.-In large doses tartaric acid is a gastro- 
intestinal irritant and corrosive poison, producing violent burning, vomit- 
ing and inflammation of the stomach and bowels, and causing death. 
Three drachms, half ounce and ounce respectively, have caused death, 
the fatal effect usually occurring several days after taking the acid. Poison- 
ing by it is to be treated with alkalies-magnesia, sodium bicarbonate, 
soap, etc., and the after symptoms, as acute gastro-enteritis. 
Therapy.-Tartaric acid is a constituent of Seidlitz powders. It is 
antiseptic, refrigerant and antiscorbutic. Of use chiefly in scurvy, and in 
an artificial lemonade in fevers and inflammations admitting of the use of an 
acid. When desiring an effervescent drink, bicarbonate of sodium may be 
added to the sweetened diluted acid, made aromatic with essence of lemon 
or orange. 
ACONITUM. 
The dried tuberous root of Aconitum Napellus, Linne (Nat. Ord. Ranunculacese). 
Mountains of Europe and Asia, and northwestern North America. Dose (maximum), 1 gr. 
Common Names: Aconite, Monkshood, Wolfsbane. 
Principal Constituents.-Aconitine (Cg^H^OnN) one of the most poisonous of known 
alkaloids, occurring as permanent colorless or white crystals, without odor. A drop of 
solution of one part of aconitine in 100,000 of water will produce the characteristic tingling 
and benumbing sensation of aconite. The alkaloid itself must never be tasted, and the 
solution only when extremely diluted, and then with the greatest of caution. Aconitine is 
soluble in alcohol, ether, and benzene; very slightly in water. Other constituents of Aconite 
are aconine and benzaconine, both alkaloids; the former of little activity; the latter a 
strong heart depressant. 
Commercial Aconitine is a more or less impure mixture of aconite alkaloids. 
Preparations.-1. Specific Medicine Aconite. An exceedingly poisonous and repre- 
sentative preparation. Dose, 1/30 to 1/2 drop. ( Usual form of administration: 3 Specific 
Medicine Aconite gtt. j to x: Water fl §iv. Mix. Sig. One teaspoonful every one-half 
(1/2) to two (2) hours.) 
2. Tinctura Aconiti, Tincture of Aconite (10 per cent aconite). Dose, 1 to 8 minims. 
Fleming's Tincture of Aconite is many times stronger than the preceding, with 
which it should not be confounded. It should have no place in modern therapeutics. 
Specific Indications.-The small and frequent pulse, whether corded or 
compressible, with either elevated or depressed temperature and not due 
to sepsis, is the most direct indication. Irritation of mucous membranes 
with vascular excitation and determination of blood; hypersemia; chilly 
sensations; skin hot and dry, with small, frequent pulse. Early stage of 
fevers with or without restlessness. When septic processes prevail it is 
only relatively indicated. 
Action.-The effects of aconite, considered from the so-called physi- 
ological action, are expressed in local and general irritation followed by ting- 
ling, numbness, and peripheral sensory paralysis, primarily reduced force 
148 INDIVIDUAL DRUGS. 
and frequency of the heart action, due to vagal stimulation, and subsequent 
rapid pulse, due to vagal depression. The heart muscle is also thought to be 
paralyzed by it. The action upon the vaso-motor system is not well 
understood, though the lowered arterial pressure is explained by some as 
due to depression of the vaso-motor center. In small doses aconite quiets 
hurried breathing, but large doses may cause death through respiratory 
paralysis. Temperature is lowered by aconite, probably by increase of 
heat-dissipation and possibly through the action of the thermo-genetic 
system. This action is most pronounced during fevers. Except of the 
skin and kidneys, the glands of the body seem to be but little, if at all, 
affected by aconite. The kidney function is slightly increased, while that 
of the skin is markedly influenced according to the quantity administered. 
The motor nervous system is not noticeably affected except when poison- 
ous doses are given, but the sensory nerves, especially at the periphery, are 
notably impressed by even so-called therapeutic doses. It is quite clear 
that aconite does not act strongly upon the cerebrum, except that poisonous 
doses somewhat depress the perceptive faculty. Upon the skin and mucous 
surfaces it acts first as an irritant, then as an anaesthetic. The mode of 
elimination of aconite is not yet well determined, but it is thought that it is 
largely oxidized, thus accounting for the short duration of its action. 
Indeed, the systemic effects of aconite seldom last over three hours, though 
the therapeutic result may be permanent. When aconite kills it does so 
usually by paralyzing the heart, arresting that organ in diastole. 
Locally, aconite and its alkaloid, aconitine, act as irritants, producing 
a tingling, pricking sensation and numbness, followed by peripheral sensory 
impairment, resulting in anaesthesia of the part. The latter is due to 
paralysis of the sensory nerve terminals. Usually no redness nor in- 
flammation follows, but in rarely susceptible cases vesicular or pustular 
eruptions take place, or intense cutaneous itching. Both are extremely 
irritating to the nasal and ocular membranes, and when inhaled may give 
rise to a peculiar local sense of icy-coldness. 
Administered internally in small doses aconite occasions a tingling or 
prickling sensation, felt first in the mouth, tongue, and fauces, and quickly 
extending to the stomach. This is rapidly followed by more or less numb- 
ness. Gastric warmth and a general glow of the surface follow non-lethal 
doses. Slight perspiration may be induced, but sweating to any great degree 
does not take place except from large doses. Then it is an almost constant 
symptom. Temperature is reduced, but the more readily during pyrexia, 
when the pulse is frequent and small, if the dose administered be fractional. 
In maximum doses (by some called full therapeutic doses) aconite 
causes gastric heat. A sense of warmth throughout the system follows, and 
occasionally the thrilling or tingling sensation will be more generally ex- 
perienced, with perhaps some numbness. There may be dizziness most 
marked upon assuming the upright posture, pain in the head, acute body 
pain, excessive depression, with feeble circulation and diminished respira- 
tion. The pulse may fall to 30 or 40 beats per minute and muscular weak- 
ness become extreme. Eclectic teaching has long protested against giving 
aconite in doses sufficient to produce these effects, which some, with 
extreme boldness, declare to be therapeutic results. 
149 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Toxicology.-In poisonous amounts the symptoms given are exag- 
gerated and the effects extremely rapid. Tingling and numbness increase 
and are felt all over the body, the thrilling and creeping coldness approach- 
ing from the extremities to the body. Excessive sweating comes on, rapidly 
lowering the body temperature, dimness of vision, loss of hearing and 
touch, and general peripheral paralysis extending from the extremities 
to the trunk. The victim is conscious of danger, feels cold and is extremely 
anxious and prostrated. Muscular weakness is pronounced, tremors occur, 
and rarely convulsions. The power of standing is lost early. The face is 
extremely pale, the sclerotics pearly, eyes sunken, the countenance one of 
extreme anxiety, and there is a tendency to fainting. There may be gastric 
pain and vomiting. If the recumbent position is not maintained, or 
even if slight exertion be attempted, sudden death may occur from syncope. 
Unless consciousness be lost through syncope, the intellect remains unim- 
paired until just before death, showing that aconite probably does not 
greatly impress the cerebrum. 
The one diagnostic symptom of aconite poisoning is the characteristic 
aconite tingling. If confession (in case of attempted suicide) is not forth- 
coming or the patient is unable to reveal the fact that poison has been 
taken, this of course cannot be known. In the absence of this knowledge, 
and when absolute muscular and other prostration, fainting and other 
forms of collapse, shallow dyspnoeic breathing, merely trickling or barely 
perceptible pulse, with no vomiting, no purging, or no alteration of pupils, 
nor characteristic symptoms of other poisons, poisoning by aconite should 
be suspected. The action of a lethal dose of aconite is rapid, symptoms 
coming on within a few minutes. Death may occur in from one half hour to 
six hours, the average time being a little over three hours. 
The treatment of poisoning by aconite should be prompt and quietly 
administered. The victim must at all hazards be kept in the recumbent 
position, with the feet slightly elevated. If seen early, tannic acid or strong 
infusion of common store tea (to occlude the poison) should be administered. 
External heat should be applied and artificial respiration resorted to as soon 
as respiratory embarrassment takes place. In the earlier stage emetics may 
be tried, but will probably fail to act if the stomach has been anaesthetized 
by the poison. The stomach-pump, or siphon, is to be preferred. Besides, 
emetics may be inadvisable for fear of the muscular contraction producing 
heart-failure. Whatever method be followed the stomach contents should 
be received upon a towel, the patient under no circumstances to be raised 
from the prostrate position. The chief hope lies in stimulation. Am- 
monia or alcohol, or Hoffman's anodyne, may be given by mouth, and 
ether, alcohol, and digitalis hypodermatically. Digitalis is the nearest to a 
physiological antidote to aconite, but acts very slowly, whereas the action 
of aconite is rapid. The more diffusible stimulants, therefore, are to be 
given first, and closely followed by the digitalis. Atropine may stimulate 
respiration, and caffeine (or hot coffee) sustain the heart. Nitrite of amyl 
may be used cautiously, allowing but a whiff or two, lest the stimulant 
action be passed and dangerous depression induced. A full dose of strych- 
nine sulphate or nitrate (1/20 to 1/10 grain) should be given subcutaneously 
to sustain the heart-action. Of the newer biologic products, possibly 
150 INDIVIDUAL DRUGS. 
adrenalin chloride (1 to 1000) or pituitrin, hypodermatically administered! 
might aid in preventing circulatory collapse. 
Therapy.-External.-As a topical agent, aconite, in tincture or as an 
ingredient of anodyne liniments, may be applied to relieve pain, allay 
itching and reduce inflammation. Its use, however, must be guarded as it 
is readily absorbed. A well-diluted spray gives relief in the early stage of 
tonsillitis and when quinsy occurs, and it relieves the distress and shortens 
the duration of faucitis, pharyngitis, and some cases of laryngitis. If used 
in local inflammations it should be in the earlier stages. Locally applied 
above the orbits it may give relief in sinusitis; used over the mastoid bone 
it mitigates the pain of otitis media and modifies external inflammation of 
the ear. Its obtunding power gives temporary relief in facial and other 
forms of neuralgia (when hyperaemia is present), the neuralgia preceding zos- 
ter, pleurodynia, myalgia, rheumatic gout (rheumatoid arthritis), peridental 
inflammation, and so-called chronic rheumatism. It also allays the pain 
and itching of chilblains, and the discomfort of papular eczema, pruritus ani, 
and other forms of pruritus. 
Internal.-Aconite is a most useful internal medicine. The weight of 
evidence from those who use aconite most frequently shows that it is a safe 
agent when used in the minute dose and according to specific indications, 
and is proportionately dangerous as the dose approaches that which pro- 
duces its physiological action. It is capable of great good in the hands of 
the cautious and careful therapeutist, and is capable of great harm if 
carelessly or thoughtlessly employed. 
Aconite is the remedy where there is a dilatation from want of tone in 
the capillary vessels. It moderates the force and frequency of the heart's 
action, increasing its power, and is, therefore, useful in functional asthenia; 
it also lessens pain and nervous irritation. Aconite cases are those showing 
a frequent but free circulation; where there is super-active capillary move- 
ment; and in enfeeblement of the circulation, functional in character and 
not due to structural degeneration or sepsis, and manifested by a frequent 
small pulse, a hard and wiry pulse, a frequent, open and easily compressed 
pulse, a rebounding pulse, or an irregular pulse. It lessens determination of 
blood (hyperaemia), quiets irritation, checks the rapid circulation in the 
capillaries when it is too active, and increases the circulation when it is 
sluggish. We account for this by believing that it gives the right innervation 
to the vascular system. Scudder (Diseases of Children, 42) says of it: 
"I have been in the habit of saying that aconite is a stimulant co the heart, 
arteries, and capillaries, because whilst it lessens the frequency, it increases 
the power of the apparatus engaged in the circulation." It should be 
stated that our term sedative differs in fact from that accepted by other 
schools. An agent such as aconite, which in full doses would depress but 
in minute doses will stimulate the vascular system to normal activity and 
thereby reduce febrile states by correcting or regulating innervation, is 
classed in Eclectic therapy as a "special," vascular," or "arterial sedative." 
Aconite is a remedy for irritation of the mucous membranes. It 
matters little whether it be of the nares preceding an attack of coryza, of 
the larynx, of the bronchi, or of the gastro-intestinal tube, liable to lead 
to inflammation of those tracts, aconite may be used to control the morbid 
151 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
process. In simple gastric irritation with or without vomiting, in the ir- 
ritative forms of diarrhoea-whether simple or of the more complicated 
forms of enteric inflammation, of cholera infantum, or of dysentery-it is 
equally important and usually specifically indicated. In the diarrhoea of 
dentition it often controls the nervous symptoms and the discharges. 
Of course one must take into consideration the r61e played by food toxaemia. 
In such cases modification or complete change of food must be resorted to, 
and frequently a simple purge given to cleanse the gastro-intestinal tract. 
Then if irritation persists, or there is fever, aconite usually acts promptly. 
The form of cholera infantum best treated by it is that showing increased 
bodily heat. If dentition is accompanied by irritation and fever, it may be 
given alone or with matricaria. In many of the stomach and bowel dis- 
orders, particularly gastric irritation with diarrhoea, and gastro-enteritis, 
it acts well with ipecac, or rhus. For aphthous ulcerations with fever, 
aconite and phytolacca internally with infusion of coptis locally have not 
been excelled. In simple dysentery, aconite, ipecac and magnesium sul- 
phate is a most effective combination, seldom failing to control the disease 
in a few hours. 
Aconite allays fever and inflammation, and is the most commonly used 
agent for such conditions. When specifically selected it proves useful in 
glandular fever (with phytolacca) and in acute gastritis and gastric fever, with 
yellow-coated tongue and diarrhoea. In simple febricula it is diagnostic. 
If, as Locke has well stated, the patient is not well or markedly improved 
in twelve hours, he has more than a case of simple fever. In intermittent 
or malarial fevers it prepares the way for the successful exhibition of 
antiperiodics. As quinine, the best antagonist of the malarial parasite, 
acts most kindly when the skin is moist, the tongue soft and clean, and 
nervous system calm, aconite is signally useful as it establishes those very 
conditions. In septic fevers, or those depending upon sepsis, the presence 
of pus, etc., its value is limited, though it may assist other measures. 
It is especially of value in the fevers of irritation of childhood-such as arise 
from overloading the stomach, from colds, and from dentition. Most 
febricula subside quickly, but they do so more quickly and kindly when 
assisted by the small dose of aconite. So valuable has aconite become in 
fevers, that by some writers it has been christened the "vegetable lancet;" 
by Webster, the "pulsatilla of the febrile state;" and by Scudder, the 
"child's sedative." 
In all febrile states in which aconite is indicated there is sudden onset 
and rapid evolution; moreover, the remedy is seldom needed, nor indeed 
is it admissible except in the first few days of the invasion. Very rarely is it 
to be used in the protracted fevers, except at the very outset, and then it 
must be strongly indicated. It is much better to omit it than to advise its 
employment in continued fevers of an adynamic type, lest some carelessly 
or perhaps boldly push it in too large doses or for too long a period to the 
detriment of the patient. In typhoid or enteric fever there are usually 
conditions to face which make aconite an ill-advised medicine, except in 
rare instances in which distinct indications for it may be present. These 
are so rare, however, as to be pronounced exceptions. The blood dis- 
integration, the toxic impression of the secretions and the nervous system, 
152 INDIVIDUAL DRUGS. 
the defective excretion and the progressive weakening of the heart and 
circulation, make aconite all but contraindicated in this devitalizing dis- 
ease. If used at all we question the expediency of employing aconite or any 
other febrifuge for a prolonged period in typhoid or other adynamic fevers. 
In urethral fever, due to catheterization, and in the febrile stage of 
acute gonorrhoeal urethritis, its action is prompt and effective. It may be 
used as an auxiliary agent in visceral inflammations of the abdominal and 
pelvic cavities, when simple in character. In such grave disorders as 
puerperal fever, because of its highly septic character, it is of questionable 
utility. The same is true of peritonitis of septic origin. 
In the acute infectious diseases (including the infectious fevers already 
mentioned, but respecting the limitations in typhoid states) aconite is of 
very great value when used at the onset of the invasion. It is among the 
best agents in acute tonsillitis and quinsy before pus forms, in the initial 
stage of la grippe, in acute colds, acute coryza, lobar, and broncho-pneu- 
monia, pleurisy, and allied infections. Here it controls temperature, re- 
tards hypersemia, establishes secretion, prevents effusion when threatened, 
and gives the nervous system rest. When it alleviates pain it does so chiefly 
by allaying inflammation. In pleurisy, aconite associated with bryonia is an 
admirable remedy until effusion takes place, then it no longer is serviceable. 
To reduce high temperature it is temporarily useful in phthisis when in- 
vasion of new portions of the lungs takes place. Aconite may be used in 
cerebro-spinal meningitis until effusion takes place; after which it should 
be discarded. 
Other disorders of the respiratory tract are benefited by its action as 
far as irritation, hyperaemia, and inflammation prevail-acute nasal and 
faucial catarrh, acute pharyngitis, acute bronchitis, acute laryngitis and 
acute tracheitis. For spasmodic and mucous croup it is the best single 
remedy, often checking the disease in an hour's time. Aconite was at one 
time freely used in diphtheria, and is still valued by some, but its use 
should be carefully guarded for the same reasons stated under typhoid 
fever. The most it can do is to aid in controlling temperature; and if 
carelessly employed it may invite paralysis of the heart in a disease itself 
prone to paralysis through its own toxicity. Aconite should not be omitted in 
the treatment of erysipelas with high temperature. 
Aconite and belladonna are indispensable in the exanthemata, and are 
the drugs most often indicated. It is to be used when the skin is hot, dry, 
and burning and the temperature high. By its timely use the eruption is 
facilitated, the temperature lowered, the secretory organs protected, spasms 
averted, and damage to the kidneys and the over-wrought nervous system 
forestalled. It is, therefore, indicated in the initial stages of varicella, 
measles, scarlatina, and sometimes in variola. 
While by no means an antirheumatic, aconite is of marked benefit in 
acute inflammatory rheumatism, when high fever and great restlessness 
prevail. Besides it protects the heart by lessening the probability of 
endocarditis and possible heart failure. The dose, however, must be small 
lest we induce the very calamity we aim to avoid. Locke regarded it almost 
a specific in uncomplicated rheumatism; but while it greatly aids in re- 
ducing fever, inflammation and pain, it needs the assistance of the more 
153 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
direct antirheumatics and their allies, as sodium salicylate, bryonia and 
macrotys. More slowly, but less certainly, it sometimes alleviates simple 
acute neuritis. 
Mumps is well treated by aconite, asclepias and phytolacca, while for 
mastitis aconite, bryonia, and phytolacca are our most effective agents. 
With careful nursing, emptying of the breasts, and sometimes judicious 
strapping and supporting of the glands the formation of pus may be averted. 
Should it form, the bistoury is the only rational medium of relief. 
As a remedy for the disorders of the female reproductive organs, 
aconite is very valuable. It is particularly valuable in recent amenorrhea, 
due to cold, if the circulation and temperature are increased; and in 
menorrhagia, with excited circulation and hot, dry skin. Dover's powder 
or the diaphoretic powder adds to its efficiency. Some rely on it to relieve 
the nausea and vomiting of pregnancy. 
Neuralgic pain is somewhat relieved by aconite, used both locally 
and internally. The varieties best treated are facial, dental, visceral, and 
rectal neuralgia, and that preceding herpes zoster. Though most efficient 
when fever accompanies, it is held to be useful also when the temperature 
is not exalted. King found aconite a remedy of marked worth in that 
anomalous condition best described as non-febrile spinal irritation. 
Purely functional palpitation of the heart, due to indigestion, has been 
relieved by small doses of aconite. One of the instances in which large or 
physiological doses of aconite are permissible is in simple cardiac hyper- 
trophy, but even then veratrum is to be preferred. In very minute doses 
aconite has been advised by Scudder in the algid stage of Asiatic cholera, 
and in the cold stage of fevers. 
The rhizome and rootlets of Actaa alba, Bigelow (Nat. Ord. Ranunculaceae). A 
perennial of the United States east of the Mississippi, abounding in the rich mold of rocky 
forests and hillsides. Dose, 1 to 20 grains. 
Common Names: White Cohosh, White Baneberry, White Beads. 
Principal Constituents.-A non-acrid and non-bitter resin similar to that obtained 
from black cohosh (cimicifuga). Albumen, starch, sugar, and gum are present, but neither 
tannic nor gallic acids. 
Preparation.-Specific Medicine Actaa. Dose, 1 to 20 drops. {Usual form of ad- 
ministration: 1$. Specific Medicine Actsea, gtt. xx. Water, 3iv. Mix. Sig. One tea- 
spoonful every 1 to 3 hours.) 
Specific Indications.-Atony dependent upon nervous derangements 
from reproductive disturbances, with headache, insomnia, melancholia, 
and convulsive tendencies; extreme sensitiveness of the ovarian region; 
"pinkish hue of parts freely supplied by blood" (Scudder). 
Action and Therapy.-Actsea is an active drug, acting in general some- 
what like cimicifuga. In large doses it is emeto-cathartic, and serious gastro- 
intestinal irritation and inflammation have resulted from overdoses of it. 
It deserves a more extended study than has yet been given it. Actaea acts 
specifically in disorders of the female reproductive organs, with atony and 
nervous impairment-such as the debility conducing to amenorrhoea, 
dysmenorrhoea and menorrhagia, and the irritability of weakness of the 
sexual system provoking choreic, hvsteric, and hystero-epileptic attacks. 
ACTiEA. 
154 INDIVIDUAL DRUGS. 
It is only of value to correct the nervous impairment and sexual disturb- 
ances when they are underlying causes of these spasmodic disorders, and 
has little or no value in controlling the attacks. It has a well-sustained 
reputation as a remedy for after-pains; and may be used in ovarian dis- 
orders when there is pain or uneasy sensations in or around the ovaries, 
with extreme sensitiveness to touch or pressure. It also relieves mental 
aberrations arising from derangement of the reproductive organs. Like 
cimicifuga it is useful in atonic indigestion of the nervous dyspepsia type. 
ADEPS. 
The prepared internal fat of the abdomen of Sus scrofa var. domesticus, Gray (the com- 
mon Hog-Fam. Suidse), purified by washing, melting, and straining. Lard should be 
kept in a cool place, in well closed vessels. 
Common Names: Lard, Prepared Lard, Hog's Lard. 
Description: A greasy, soft, white solid, having scarcely any odor, and a bland, fatty 
taste; soluble in ether or chloroform, sparingly in alcohol, and not dissolved by water. 
It should, not be rancid. 
Principal Constituents.-Lard is composed of the glycerides of oleic acid (olein), 
stearic acid (stearin) and palmitic acid (palmitin). 
Preparations.-1. Adeps Benzoinatus. Benzoinated Lard. Lard preserved by heating 
it with benzoin to prevent rancidity. For use in warm weather 5 per cent of the lard, or 
more, may be replaced with white wax. A largely used ointment base. 
2. Ceratum, Cerate, Simple Cerate. (Composed of White Wax and Benzoinated Lard.) 
Action and Therapy.-External. Lard is emollient and is used as a 
medium for massage of the skin when the sebaceous secretions are im- 
paired. It is sometimes applied to excoriations, but causes considerable pain; 
it is better to apply to parts to cause them to shed excretions and thus 
prevent intertrigo, though it is rapidly absorbed and the surface soon 
becomes dry. Unless pure it may cause unpleasant sores. Lard allays 
itching and may be used to relieve burning and soften the scales and 
prevent their distribution in scarlatina and other eruptive diseases. It 
softens crusts of skin diseases of the scalp and facilitates their removal by 
washing. As a lubricant for manual examinations and obstetric operations 
it is preferable to petrolatum, as it does not so readily mix with the secretions. 
Its chief use is as a base for ointments and to prevent poultices from drying 
and adhering to the skin. 
Internal. Melted lard is sometimes used in suffocative croup, and 
being difficult of digestion is somewhat laxative. It may form a part of 
stomachic medication in poisoning, to retard the absorption of the poison 
(except those poisons soluble in fats), to form soaps with the caustic al- 
kalies, and to act as a demulcent to the resultant inflammation of the 
mucosa. 
ADEPS LANAs. 
Wool-Fat; Anhydrous Lanolin. 
The purified and water-freed fat of the wool of the domestic sheep, Ovis aries, 
Linne-(Fam. Bovidae). 
Description.-A tenacious, pale-yellow, ointment-like mass, almost odorless, and 
freely dissolved by ether or chloroform; very little soluble in hot or cold alcohol, and not 
soluble in, but capable of being mixed into a homogeneous mass with two parts of water. 
Preparation.-Adeps Lance Hydrosus, Hydrous Wool Fat (Lanolin), Purified Wool Fat, 
containing between 25 and 30 per cent of water. 
Action and Therapy.-External. Hydrous wool fat (or lanolin) is 
emollient and soothing, though it does not leave the skin as soft as some other 
155 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
lubricants. It is very readily absorbed, and being miscible freely with 
water and glycerin it is preferred as an ointment base where such liquids 
or their solutions are desired to be used in such a form. Its penetrability 
makes it valuable for the incorporation of drugs for inunctions, massage, 
or to relieve local pain, as in neuralgia. It may be used to allay the pruritus 
of the exanthemata, to protect and soften chapped hands and lips, to 
soothe acute eczema, erythema, frost-bites, dermatitis, impetigo contagiosa, 
and to soften the skin in scleroderma and ichthyosis, to remove dry 
dandruff, and in old age when the skin becomes atrophied and dry. It is 
largely employed as a medium for the application of medicaments in scaly and 
infiltrated conditions in chronic diseases of the skin. 
ADONIS. 
The whole plant of Adonis vernalis, Linne. (Nat. Ord. Ranunculaceae). Southern 
Europe, Siberia, and Labrador. Dose, 1 /2 to 3 grains. 
Common Name: Pheasant's Eye. 
Principal Constituent.-Adonidin, probably a mixture of acids and glucosides. 
Preparation.-Specific Medicine Adonis. Dose, 1/2 to 3 drops. 
Specific Indications.-Weak cardiac action, with low blood pressure, 
and shortened diastole, with consequent venous stasis, with increased 
back-pressure, and feeble intermittent or irregular pulse; cardiac dropsy, 
with weak heart. 
Action.-Fresh adonis is irritant and vesicant. Upon the circulation 
it acts much like digitalis, but is prompter in action and not cumulative. 
It is an energetic agent and capable of poisoning. Adonis slows, regulates, 
and strengthens the heart's contractions, raises blood pressure, and thereby 
acts as a diuretic. It also causes deeper and slower breathing, and in proper 
cases overcomes dyspnoea. Large doses paralyze the heart and blood vessels. 
Therapy.-On account of its quicker action Adonis has been preferred 
by some to digitalis and strophanthus in the same class of heart affections 
to which these are applicable, or in which for some reason it is undesirable 
to employ them. It is especially commended where arryrthmia with feeble 
cardiac force and dyspnoea and dropsy are present. It has long been a 
popular remedy in Russia for dropsies of both heart and kidney origin. 
It is probably less valuable than digitalis where the cardiac valves are greatly 
affected. Scudder valued adonis in heart-strain from overexertion; Hale 
recommended it in endocarditis and in weak and irregular heart action 
resulting from chronic nephritis. Wilcox used it in chronic albuminuria, 
with pale urine and delirium with good results and in uremic convulsions, 
which had been frequent, without a return of the eclampsia for two years, 
when the patient died. It is undoubtedly emmenagogue and has been 
advised in epilepsy, administering it with bromide of potassium. It should 
not be given when there is gastro-intestinal irritation or inflammation. 
^SCULUS. 
The bark and fruit of ^sculus glabra, Willdenow (Nat. Ord. Sapindaceae). A small 
fetid tree common to the central portion of the United States. 
Common Names: Ohio Buckeye, Smooth Buckeye, Fetid Buckeye. 
Principal Constituents.-The glucoside cesculin(CuHl6O9) (displays a blue fluorescence 
in water and more strongly in the presence of alkalies); aesculetin (CjHgOg); a peculiar 
tannin and saponin. Starch is abundant and a rich yellow oil is present. 
Preparation.-Specific Medicine &sculus. (Made from the ripe fruit.) Dose, 1 to 15 
minims. The smaller doses are to be oreferred. 
156 INDIVIDUAL DRUGS. 
Specific Indications.-Sense of constriction, tightness, or uneasiness 
in the rectum, with or without hemorrhoids; intestinal irritation with 
constriction and colicky pain near the umbilicus; dyspnoea and constric- 
tion of the respiratory tract with spasmodic cough. 
Action.-The dried, powdered fruit of the buckeye causes violent 
sneezing. Buckeye acts powerfully upon the nervous and circulatory 
systems. Its action is probably strongest on the spinal nerves, and in some 
respects resembles that of strychnine. The cerebrum is also impressed 
by it. Toxic symptoms include dizziness, fixation of the eye, impaired 
vision, vomiting, wry-neck, opisthotonos, stupor, and tympanites. In 
lethal doses these symptoms are increased, coma comes on, and the victim 
dies. Cattle are often killed by eating buckeyes; if not fatal, a condition 
known as "blind staggers" is produced. 
Therapy.-^Esculus is sedative, somewhat narcotic, and has a special 
control over the portal circulation, relieving venous congestion. When 
the circulation is rapid and the constrictive sensation prominent and 
dyspnoea prolonged, it relieves such conditions as continuous asthmatic 
breathing. There is a sense of constriction back of the upper portion of the 
sternum, with or without irritative cough, that is relieved by it. It is useful 
in intestinal irritability with the contractive colic-like pain centering in 
the umbilical region, probably dependent most largely upon hepatic or portal 
congestion and associated with chronic constipation. Its chief value, 
however, lies in its power to relieve hemorrhoids due to faulty hemorrhoidal 
circulation. The sense of fullness and tightness rather than marked pain 
is the indication for it. It often succeeds admirably, and as often com- 
pletely fails to relieve. Its action upon visceral disorders is practically 
the same as that mentioned under Hippocastanum (which see). 
2Esculus sometimes relieves uterine congestion with full tumid and 
enlarged cervix and too frequent and profuse menstruation. This would 
suggest its possible value in uterine subinvolution. It has a domestic 
reputation for the cure of rheumatism, but this has not been verified to 
any great degree in professional practice. It has been suggested as a 
spinal stimulant in paralysis. If so used it should be used like strychnine 
after active symptoms have ceased, and to stimulate the unimpaired 
nervous tissue. ^Esculus deserves further study to determine its status as 
a remedy for nervous disorders, and especially its control over visceral 
neuralgias. 
^THER. 
A liquid composed chiefly of ethyl oxide l(C2H5)2O]. 
Description.-A mobile, colorless and transparent liquid, having a characteristic 
ethereal odor, and a burning, sweetish taste. Somewhat soluble in water, but mixes 
with fixed or volatile oils, and alcohol or chloroform. It should be kept in a cool situation, 
away from light and from fire, in partly filled, sealed containers. A fresh can should always 
be opened for producing anaesthesia. Dose, 5 to 60 minims on ice (by mouth); half the 
full dose, hypodermatically. 
Preparation.-Spiritus Athens, Spirit of Ether, Hoffmann's Drops. Dose, 30 to 60 
minims. 
Specific Indications.-Pain, or convulsive action, with feeble circu- 
lation, and cool, pallid face; headache, with enfeebled circulation. To 
produce anaesthesia, for the performance of surgical, gynecological and 
obstetrical operations. 
157 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Toxicology.-Ether has a profound depressive action 
upon the central nervous system and a primary stimulating effect upon the 
circulation. Upon the former the sequence of its effects is precisely the 
same as that of chloroform, impressing first the sensory areas of the cere- 
brum, then successively the sensory and motor tracts of the cord, and 
finally the sensory and motor cells of the medulla, all in the order named. 
To affect the nerve trunks it must be directly applied to them. Upon the 
circulation, when administered in ordinary amounts, it is one of the most 
rapid and most fleeting of stimulants, acting upon the vascular functions in 
an almost opposite manner to that of chloroform. It raises blood pressure 
by direct action upon the heart and by increasing vaso-motor activity; 
chloroform depresses vaso-motor control. Only in very large doses is ether 
a cardiac and circulatory depressant. Ether first stimulates and sub- 
sequently depresses the respiratory center. When death occurs under its 
use breathing is usually arrested before the heart pulsations cease. Temper- 
ature is very greatly lowered by ether. In the blood it increases the pro- 
portion of leucocytes, and slightly the number of red cells, but with a 
decidedly impoverished haemoglobin value. Ether is eliminated chiefly 
by the lungs and to a large extent by the kidneys, having a profound irritant 
action upon the latter. 
Locally applied, ether produces rubefaction, and sometimes vesication 
if its evaporation be prevented; but it acts as a refrigerant, occasioning 
a great degree of cold, when suffered to evaporate. Ether taken by mouth 
has at first a sweetish taste, followed by great heat and pungency. In 
moderate doses it acts powerfully on the mouth, throat, and stomach, 
allays spasm, and relieves flatulence, without increasing arterial action. 
After the burning in the stomach has subsided, a cooling sensation, quickly 
diffusing itself throughout the system, is experienced. It first excites the 
cerebral functions, then depresses. In somewhat larger doses it causes in- 
toxication. The heart's action is increased, the face becomes flushed, the 
surface warm, and in a very short time sweating takes place, similar to, 
yet less transient than, that from alcohol, and quickly followed by a sense of 
contentment and mental quietude, associated with a desire to sleep. Seldom 
does its effect last more than one hour, even when two fluid drachms have been 
swallowed. Individuals may become so accustomed to taking ether that 
large quantities may be consumed in a day. Intoxication from ether 
drinking is reported common in Ireland {British Medical Journal, 1890). 
Life has not been directly destroyed by ether as a fluid, but several deaths 
have resulted from inhalation of the vapor. In very large doses it causes 
nausea, increased flow of saliva, giddiness, and suspension of sensation and 
voluntary motion. 
The phenomena produced by the inhalation of ether are mainly as 
follows: When first inhaled, some faucial irritation is produced, as well as 
cough and shortness of breath. The extremities prickle; exhilaration, 
with talkativeness, or laughing, crying, praying, or raging, with a sense 
of lightness, is felt, and gradually all the senses are blunted or perverted, 
that of pain being lost before that of touch. Gradually consciousness is 
lost, and gradual muscular relaxation, sometimes preceded by tetanic 
rigidity, takes place. The circulation and respiration are quickened, 
158 INDIVIDUAL DRUGS. 
though the latter is somewhat shallower than when normal; warmth of 
skin with perspiration ensues, as well as contraction of the pupil. Con- 
tinuing the inhalation, complete insensibility and muscular relaxation take 
place, the breathing becomes slow, deep, and even stertorous, the pulse slow 
and feeble, the pupil dilated, the cutaneous surface moist, cool, and livid or 
cyanotic. Stertorous breathing is the signal that respiratory paralysis is 
approaching. Death from ether is due to respiratory paralysis; rarely from 
paralysis of the heart. (For a more detailed account of the order of an- 
aesthesia, see page 160.) 
Therapy.-External. When applied locally, as a refrigerant, allowing 
it to evaporate, ether is useful in nervous and other headaches, in external 
inflammations, strangulated hernia, etc. As a rubefacient, it may be em- 
ployed where this effect is indicated, by checking its evaporation. The 
spray of ether, directed upon painful parts, has been used as a local an- 
aesthetic, as well as for minor operations, especially the opening of abscesses 
and for paracentesis. It has been largely supplanted by ethyl chloride for 
such purposes. Sprayed upon the lumbar region, it eases the pains of labor; 
and uterine contraction, with the control of hemorrhage, may be ac- 
complished by spraying it on the lower part of the abdomen. Applied by 
vapor, or upon a pledget of cotton, it relieves earache, and combined with 
camphor and inserted into carious dental cavities, it controls toothache. 
Pediculi pubis are destroyed by it, and it is fatal to ascarides when used by 
rectal enema. 
Internal. Ether is narcotic, stimulant, antispasmodic, refrigerant, 
and carminative. Its antispasmodic and stimulating properties render it 
efficient in spasmodic asthma, flatulent colic, hiccough, subsultus tendinum, 
cramp of the stomach, nervous headache, sick headache attended with 
double vision, nausea or vomiting, lowness of spirits, gastrodynia, hysteria, 
dyspnoea, and cardiac palpitation. It is also useful to overcome the painful 
spasms occasioned by urinary or biliary calculi, during their passage through 
the ducts or tubes; for this purpose it is often given with oil of turpentine. 
As an antispasmodic, it is useful in all forms of spasmodic action, unattended 
by inflammation, as chorea, epilepsy, tetanus, etc. 
Ether has been subcutaneously injected in sciatica, lumbago, and other 
neuralgias, in sudden syncope, and in the prostration following pulmonary 
and post-partum hemorrhages, convulsions, and in chloral and opium 
poisoning, etc. The quantity injected should be from 10 to 15 minims, and 
care should be had not to inject deeper than the fascial tissues. When a 
quick diffusible stimulant is needed, ether is the most useful drug. Though 
its action is fleeting, it diffuses rapidly and tides over emergencies until less 
fugacious medicines can be made to act. 
On account of its emulsifying properties when combined with fatty 
matter, as codliver oil, ether has been used to aid digestion and tissue pro- 
duction, in phthisis. By stimulating the gastric and duodenal tracts, it 
secondarily influences the pancreatic secretions, which then readily act 
upon the emulsified oil, making its digestion more perfect, and thereby 
adding to the nutrition of the body. 
Ether should be administered in ice cold water or capsule. It is too 
irritating to the fauces to be given in any other way. 
159 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Ether alone or with camphor is one of the best rapid stimulants to 
administer in shock and poisoning and the stage of collapse in low fevers 
and in Asiatic cholera. 
Inhalation.-Ether was the first agent to be used, as a general anaesthetic 
by inhalation, for the performance of great surgical operations. Under par- 
tial anaesthesia, Dr. John C. Warren, at the request of a Boston dentist, Dr. 
W. T. G. Morton, performed a severe surgical operation at the Massachusetts 
General Hospital, October 15, 1846. On the succeeding day, Prof. Hay- 
ward operated upon a patient under full anaesthesia. Dr. C. T. Jackson, 
of Boston, at once informed Dr. Warren that he had first imparted to 
Morton a knowledge of its value in the painless extraction of teeth, which 
was the use Dr. Morton had made of it. Dr. Crawford Williamson Long, 
of Georgia, probably first used sulphuric ether as a general anaesthetic, but 
failed to publish his use of it before others had recorded their employment 
of it. Ether, in America, is the most widely employed drug to anaesthetize 
patients about to undergo surgical operations, no matter how severe, and 
either it or chloroform is now universally employed for this purpose. 
Being adapted to the whole range of operations, it is unnecessary to enumer- 
ate them here. Not only is it used to produce anaesthesia and analgesia, 
but to overcome spasm and muscular resistance. For the latter purpose, 
it is of great value as an aid in reducing luxations and fractures and herniae. 
To mitigate the pangs of labor it is useful, but chloroform is preferable, 
as its vapor is not inflammable, and it may be used near lights, but avoiding 
close contact with the open flame. Besides the majority of the conditions for 
which it is internally given (see page 159), it may be inhaled for the relief of 
dysmenorrhea, hydrophobia, puerperal and other convulsions, whooping- 
cough, laryngismus stridulus, spasmodic croup, mania, delirium tremens, 
etc. In puerperal eclampsia, it should be used to control convulsive action 
until appropriate remedies may be given. In the hysteria following child- 
birth, it is an excellent antispasmodic, as well as in infantile convulsions 
not depending "upon a morbid irritability of the nervous system with organic 
change" (Locke). Distressing after-pains are safely and quickly overcome 
by a few whiffs of ether, and the same procedure relieves nervous headache. 
Lead colic is relieved, both by the rectal enema of ether and by its inhala- 
tion. 
Anaesthesia.-The induction of surgical anaesthesia by both ether and 
chloroform passes through three stages: (1) lessened consciousness; (2) 
excitement; (3) complete insensibility or anaesthesia. 
First Stage. Usually, and especially under ether there is a momentary 
feeling of suffocation, and a sense of warmth beginning in the face and head 
and extending over the body. The senses gradually lose their activity, 
sound and voices appear distant, and the patient perceives objects mentally 
or actually, as through a mist or veil. Objects may run the changes of color 
and there is some pulsation or throbbing felt in the head. Fancied noises, 
as of rushing of wind or water, or ringing, hissing, roaring, or pounding in 
the ears, are experienced. A feeling of stiffness and inability to move the 
limbs follows, and the stage of approaching unconsciousness is at hand. 
160 INDIVIDUAL DRUGS. 
During this preliminary action the pulse is more or less quickened (prob- 
ably partly due to the anxiety of the patient), the face flushed, the pupils 
dilated, and the respiration somewhat accelerated, or it may be irregular 
during the suffocative stage, when sometimes the breath may be held, and 
later be followed by a deep gasp. Coughing frequently occurs with ether. 
If this becomes severe and the breathing is very irregular and choking, 
great care should be exercised and the anaesthetic withdrawn or more air 
admitted. 11 is in this stage that many fatal accidents have occurred. Under 
no circumstances should any surgical work be performed at this stage, 
even though there is usually at this time some blunting of sensation. This 
stage is no bar, however, to the use of the anaesthetic to mitigate the pangs 
of labor. Usually this period, except the suffocation first experienced, 
is one of pleasurable sensations to the patient. 
Second Stage. The second stage, that of excitement, varies greatly 
according to the subject; ranging from a mere tremor, or rigidity of the 
extremities, with irregular breathing, to violent muscular and mental efforts. 
The patient attempts to rise or push away the mask and attendants, and 
violent muscular contractions occur in every part of the body. His struggles 
may be so strenuous as to require the combined efforts of several assistants 
to control them. This is more especially the case with ether: though not 
absent in some cases with chloroform. Singing, shouting, raging, praying, 
crying, laughing, or cursing may be indulged in at this stage, the pleasanter 
disorganized thoughts and incoherent expressions usually taking place 
under chloroform, and the vulgar and even obscene utterances under ether. 
The latter especially may excite the patient to become amorous, pugnacious, 
lascivious, extremely vulgar, and reveal long kept secrets; and these 
phenomena frequently occur in those whose lives are above reproach and 
who when normal are models of deportment, morality, and manners. 
On the other hand, fear of death, abuse of physicians and attendants, and 
serious irreligious thoughts previous to anaesthetization may shape the un- 
conscious behavior of the patient, whose performance is most likely due to 
some dream-producing state of the temporarily ungeared mind. During 
this stage the pulse is accelerated, the face reddened and suffused and often 
cyanotic, respiration more or less irregular according to the amount of 
struggling indulged in by the patient, and the pupil still more or less dilated. 
This is the time to carefully continue the administration of the anaesthetic, 
removing the mask from time to time, while the greatest violence and ir- 
regular breathing are manifested. Muscular relaxation now takes place, and 
the third stage-anaesthesia-is reached. It must be borne in mind that 
during this stage, when respiration has been violent and insufficient, and 
is then followed by a deep gasp and full inspiration a larger quantity of 
anaesthetic is suddenly inspired and there is grave danger of overdosing. 
By removing the mask entirely, or withdrawing it to a greater distance, 
usually this danger will be obviated. 
Third Stage. This stage is marked by complete unconsciousness, 
with relaxation of the muscles and contraction of the pupils, which do not 
respond to light. Should dilation of pupils take place after contraction 
it is a signal of grave danger. The corneal reflex is now abolished and the 
conjunctiva may be touched without flinching on part of the patient, 
161 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
or closure of the eyelids. The appearance of the face is that of a death- 
like calm, pale under chloroform, but suffusedly dark red or cyanotic under 
ether. The breathing, though regular, is slow and of little depth, but must 
be carefully watched. Indeed, at all times the state of respiration is the 
surest guide to safety or danger, though the pulse and the pupil should 
never be disregarded. Stertorous breathing is always a danger signal 
necessitating the withdrawal or change in manner of administration. 
It heralds approaching respiratory paralysis, and may be due to over- 
dosing or to the falling of the relaxed tongue back upon the epiglottis. 
When short of stertor, breathing is calm and the cornea is insensitive and 
muscular relaxation not too profound, the proper stage for surgical operation 
has been reached. This stage having been attained, anaesthesia may be 
prolonged by the repeated and intermittent inhalation of very small 
quantities of the chosen anaesthetic, but it must not be forgotten that the 
pulse and respiration may gradually become weaker and that body heat is 
invariably being dissipated at this time, hence the necessity for a warm 
operating room, and sometimes warmth about the body and extremities. 
During any stage of anaesthesia it should not be forgotten that danger is 
imminent at any moment and that eternal vigilance is the price of life. 
When the patient is returning to consciousness, the pupils gradually dilate, 
the reflexes become established, muscular power is regained, and a stage of 
excitement returns and may last for minutes or hours. Very frequently 
vomiting is severe, and water especially should not be given the patient 
until this action is past. Vomiting is more likely to occur and to be more 
persistent under chloroform than ether. During the progress of the second 
and third stages an enormous quantity of saliva and bronchial mucus may 
impede respiration, and the harshness and succussion in breathing may be 
mistaken for stertor. On the other hand this should not give the administra- 
tor a false sense of security, and he should distinguish between this ob- 
struction to breathing and the paralytic stertor. Wiping the mouth clear 
of these obstructions will generally enable him to differentiate them, though 
the dry, snoring character of stertor can hardly be mistaken. After ether 
anaesthesia in the child or the old, the excess of bronchial mucus is so 
abundant, says Hare, that there "is danger of the patient drowning in his 
own secretion." Atropine in full dose, before or during this stage, 
may obviate this danger. After the stage of post-anaesthetic excitement, the 
patient usually remains in a state of somnolence, or even more perfect and 
calm slumber which may last for several hours, and upon awakening there 
is usually no remembrance of what has taken place during anaesthesia. 
Sometimes the opposite condition prevails-wakefulness, with persistent 
dizziness, nausea, and vomiting. 
Choice of Anaesthetic.-(1) Chloroform is more agreeable but far 
more dangerous than ether, and when a choice is possible the latter should 
be employed. 
(2) Next in order of value, for brief operations, is nitrous oxide gas 
(see Nitrogenii Monoxidum), the safest of all general anaesthetics. 
(3) Chloroform is generally preferred to ether in obstetrical manipula- 
tions. 
162 INDIVIDUAL DRUGS. 
(4) When general anaesthesia must be produced and there is no other 
available method of painlessly performing operations: 
Chloroform should be used (1) in obstetrics; (2) in hot climates; (3) where 
a large number are to be anaesthetized, as in wrecks or battle; (4) when 
acute bronchitis or bronchial catarrh exists in children or adults; (5) 
in nephritis (regarded by some as more dangerous than ether) and serious 
kidney insufficiency; (6) in aneurism; (7) when the vessels are athero- 
matous; (8) in arteriosclerosis; and (9) rarely and cautiously in valvular 
diseases of the heart in the absence of cardiac degenerations. 
Chloroform should not be used (1) in fatty heart; (2) in dilated heart; 
(3) in lymphatic subjects with lymphoid growths; (4) in adenoids; (5) in di- 
abetes and diabetic coma; (6) in acetonuria. 
Ether should be used (1) by preference where there are no con- 
traindications to general anaesthesia and for long operations; and (2) in 
valvular disease of the heart. 
Ether should not be used in (1) nephritis and renal insufficiency; (2) 
in uraemia; (3) in pulmonary oedema; (4) in pneumonia and bronchitis; (5) 
in atheroma of the vessels; (6) in arteriosclerosis; (7) in aneurism; (8) 
in apoplexy; and (9) in brain tumors or abscess (in the last four on account 
of increase of blood pressure). 
Neither chloroform nor ether should be used in (1) fatty and other de- 
generations of the heart; (2) diabetes or diabetic coma; (3) advanced phthisis; 
(4) anemia and chlorosis with proportion of haemoglobin below 50 per cent; 
(5) oedema of the glottis; and (6) in old topers with a weak heart-muscle; 
(7) usually in epilepsy and chorea; and (8) in feeble and obstructed heart, 
though they have been given where only valvular lesions exist, without 
change in the heart-muscle, or cardiac ganglia, with apparent safety. 
Warnshuis {Principles of Surgical Nursing} quotes Bevan as having 
"most admirably summed up the present-day attitude of surgeons in the 
determination of the choice of anaesthetics as follows: 
"a. Drop ether should to-day be chosen as the standard general an- 
aesthetic when a prolonged anaesthetic is desired with relaxation and un- 
consciousness. 
"6. Intrapharyngeal ether should be chosen in mouth and jaw cases 
when it is desirable to remove the anaesthetist and anaesthetic apparatus 
from the operative field. 
"c. Gas should be chosen in short anaesthesias in which unconsciousness 
is desired, and in special cases, such as kidney insufficiency. 
"d. Local infiltration anaesthesia should be chosen when the surgeon 
has the full co-operation of the patient and the field of operation can be 
completely anaesthetized.'' 
Administration.-Preparedness and eternal vigilance are the watch- 
words for anaesthetization. The following instructions should be observed: 
1. The patient should be thoroughly examined physically and the 
urine tested previous to anaesthetization, to insure that no contraindications 
to administration are present. 
2. The patient's fears should be allayed and confidence gained. 
163 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
3. When possible anaesthesia should be induced before going into the 
operating room. 
4. All instruments and appliances to be used at the operation should 
be concealed from the patient's view. 
5. All necessary implements and instruments and restoratives to be 
used in case of accident should be at hand and in readiness for use; and also 
out of the patient's sight. These should include a hypodermic syringe, in 
good working order, or loaded; strychnine, atropine, camphor in oil, and some 
active preparation of digitalis; also ammonia and nitrite of amyl; and proper 
forceps for drawing out the tongue should it fall back upon the larynx. 
6. No talking nor noises, nor rattling of instruments should be allowed. 
7. There should be an abundance of warm fresh air in the operating room. 
8. Have at hand a towel or basin to receive vomitus; and if vomiting 
occurs see that the head is not raised but turned to the side, that no particles 
of anything may enter the trachea. 
9. Remove false teeth, chewing gum, tobacco, or other material 
from the mouth before beginning anaesthetization. 
10. Bare the neck and chest that respiration may be unembarrassed, 
and closely watched. 
11. Loosen all constricting garments or coverings about the body 
so that respiration may be unimpeded, and the circulation unobstructed. 
12. Do not administer, if by choice, immediately after a full meal 
(danger of persistent vomiting), or after a long fast (danger of acetonuria). 
13. Anoint the nostrils and lips with petrolatum to prevent irritation 
and swelling. 
14. Cover the eyes with a wet cloth to prevent irritation of the 
conjunctiva. 
15. A hypodermatic injection of morphine previous to administration 
is said to render the process of inhalation quieter, and to lessen, and in 
some instances prevent, the stage of spasm and rigidity nearly always 
present in the strong and robust, while it is also believed to antagonize the 
paralytic action of the chloroform, and to prevent the shock succeeding 
anaesthetization and the operation performed. 
16. The "drop by drop'' method upon an Esmarch inhaler should be 
used by preference. 
17. The administration should never be pushed; it is always dangerous 
at best; gradual anaesthesia should be sought always. 
18. Respiration should be closely watched, for it gives the earliest and 
most reliable warning of approaching vaso-motor depression, or paralysis 
of heart or lungs. 
19. Heat should be applied to the patient's body and limbs, if practi- 
cable, when marked lowering of temperature occurs, especially with ether. 
20. Chloroform and ether should be absolutely pure; only approved 
and labeled anaesthesia qualities should be used. 
21. Chloroform should not be used near open gas or coal flames lest 
decomposition take place with the liberation of irritant poisonous gases 
(chlorine, hydrochloric acid, and carbonyl chloride). Good ventilation, 
and a cloth wetted with ammonia being in the room lessen the danger 
from such decomposition. 
164 INDIVIDUAL DRUGS. 
22. Ether should not be used near a flame lest an explosion result. 
Ether should not be used nearer than six (6) feet from an open light and 
always below the level of the flame. Ether, being heavier than air, settles 
low. This and the preceding caution (21) is necessary on account of the 
necessity of using chloroform and ether in the home. 
23. Not more than 2 per cent chloroform vapor should be used; 
there should be at least 98 per cent of air. 
24. Under ether 70 per cent of ether vapor and 30 per cent of air are 
the best proportions for administration. 
25. The mask should be held from 3 to 6 inches from the face with 
chloroform; closer with ether. 
26. Operation should never be begun until the corneal reflex is abol- 
ished, as shown by the insensitive conjunctiva, and muscular relaxation 
has set in. Disregard of these has caused many deaths, through reflex 
stoppage of the heart under the stimulus of the scalpel. Extreme muscular 
relaxation is undesirable and generally dangerous. 
27. No matter how trivial the operation it should not be begun until 
the proper anaesthesia stage is reached. 
28. In operations about the mouth blood must not be allowed to 
enter the air passages. 
29. In the aged and in those who have a weak heart or existing acute 
pulmonary disease the greatest of caution should be exercised. 
30. Only a trained anaesthetist should administer anaesthetics. 
31. The anaesthetist should confine himself solely to his work, and 
absolutely pay no attention to the operation, or other distractions. 
32. Wilcox has well epitomized the situation in these words: "It should 
always be remembered that from satisfactory anaesthesia to toxic mani- 
festations there is but a very short distance and a brief time." 
Resuscitation from Anaesthesia Accidents from Chloroform and Ether. 
It cannot be too strongly emphasized that great care should be ex- 
ercised in the administration of these anaesthetics. Never more than 
2 per cent of chloroform should be present in the inspired air, whereas the 
air may contain from 60 to 70 per cent of ether usually with safety. Death 
may occur suddenly from cardiac paralysis under ether, though asphyxia 
is the usual cause of death; under chloroform circulatory paralysis or 
paralysis of breathing may be the cause. Such being the case, artificial 
respiration, while indicated in both accidents, more often succeeds in re- 
suscitating the paralysis of breathing by ether. The ansesthetist constantly 
and carefully should watch the respiratory movements, and, as far as 
possible, the pulse. Sudden pallor of the countenance and sudden and com- 
plete dilatation of the pupils are signs of gravest danger. Stertorous breath- 
ing is the danger signal of respiratory paralysis, and when it occurs the 
anaesthetic should be withdrawn at once and the chest vigorously slapped 
(Howe) until respiratory movements become free again. Ether is much 
safer than chloroform because failure of respiration, the usual cause of 
ether death, is easier to rectify than circulatory paralysis, which is farther 
beyond the power of the physician to remedy. In either case every ap- 
proved method of artificial respiration should be instituted at once. 
165 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
If the accident be due to threatened respiratory paralysis the counte- 
nance will be flushed or cyanotic. Then the recumbent attitude should be 
maintained. If due to circulatory embarrassment the face assumes a sudden 
and peculiar shade of pallor. Then the body should be immediately in- 
verted head downward. This allows blood to pass freely to the brain, 
arouses vaso-motor activity and relieves the heart. If the patient is still 
breathing, even ever so little, inhalation of ammonia or nitrite of amyl 
should be used, and atropine, strychnine, and digitalis injected at once. 
The two latter in the order named are probably the most valuable. The 
use of alcohol is questionable, as small quantities do no good and large 
amounts aid in embarrassing respiration. External heat should be applied 
and cold affusions avoided. Ether injections are advised in cardiac pa- 
ralysis from chloroform, but obviously they should cautiously be employed; 
in most instances omitted. Adrenalin, on account of asserted tendency 
to cause ventricular fibrillation, should not be employed. Under any 
circumstances, arising from either chloroform or ether poisoning, artificial 
respiration should not be forgotten. It has resuscitated after an hour of 
almost complete dissolution. Rhythmic compression and relaxation of the 
chest should be performed in as close imitation of natural breathing as 
possible. The tongue should be grasped by the tip with forceps and rhyth- 
mically drawn in and out several times a minute. The lower jaw should 
be elevated and held forward, and all mucus should be cleared from the 
mouth constantly. Forcible and sudden dilatation of the anal sphincters has 
been successful in arousing from chloroform narcosis, operating probably 
by stimulation of the sympathetic and exciting vaso-motor activity. 
In chloroform poisoning Hare advises that, while the head is held downward, 
bandaging of the limbs and abdominal compression by compresses should 
accompany artificial respiration. Opening the abdomen and massaging the 
heart has been advised when other means fail; during abdominal operations 
this can easily be resorted to. 
Children bear chloroform anaesthesia better than adults; women 
better than men (1 to 6); feeble persons and those reduced by long illness 
better than the robust and healthy. The latter is disputed by some. It 
seems, also, that anaesthesia for operations upon diseased parts is better 
borne than when employed after accidents. Probably the shock and 
terror attending the latter have much to do with the untoward action of 
the anaesthetic. 
The vomiting after chloroformization often may be relieved by the 
inhalation of vinegar. When acetonuria occurs large doses of sodium 
bicarbonate are indicated. 
Comparison of Ether and Chloroform.-Chloroform has been very 
largely used by inhalation as an anaesthetic agent, and from the small 
quantity required, the promptitude with which it influences the system, 
its rather pleasant action, its more agreeable and less persistent odor, its 
moderate price, and the facility with which it may be administered, many 
in some sections of this country, notably the South and East, prefer it to 
ether, notwithstanding its greater danger. On the continent it seems to be 
losing ground, ether being preferred. The fact that chloroform is a much 
166 INDIVIDUAL DRUGS. 
more dangerous aneesthetic, producing fatal results about four or five times 
as often as ether, makes the latter the more desirable anaesthetic to use in all 
operations where it is desired to produce general anaesthesia. The majority 
of surgeons, and many of those who use chloroform, admit the greater safety 
of ether. Dr. Thomas Jones, of St. George's Hospital, London, who, in the 
course of eleven years, had administered chloroform to over 6,000 in- 
dividuals, declared that if he were unfortunate enough to have to be anaes- 
thetized, nothing could induce him to take chloroform. Howe admin- 
istered chloroform in 5,000 cases without a death; Laurie (in India) reports 
a series of upward of 40,000 without a single death. In obstetrics, however, 
chloroform is remarkably free from dangerous results, much more so than 
in any other condition, and is always preferred to ether in obstetrical 
manipulations. 
A comparative table will show the advantages of ether over chloroform, 
while it will be observed that if equally as free from danger as the former, 
the latter, from its pleasanter and prompter effects, would be far preferable 
to the former. 
Ether 
Unpleasant odor. 
Unpleasant to inhale. 
Inflammable, and can not well be used 
around fire and lights. 
More irritant to the air passages. 
May be given more rapidly. 
Air should be excluded as much as possible 
while administering. 
Its vapor may be inhaled almost in full 
strength, about 70 per cent being mostly 
employed. 
Reduces temperature several degrees. 
More apt to occasion pugnacity, or lascivi- 
ous or vulgar talk. 
Increases arterial tension. 
Not contraindicated by mere feebleness of 
heart. 
More irritant to the kidneys and lungs. 
Action less prompt and more transient. • 
Comparatively free from danger. 
Kills chiefly by respiratory paralysis; occa- 
sionally by heart failure. 
Danger easily detected by color of face 
and ears, and state of pulse in sufficient 
time to resort to artificial respiration, by 
which death may be averted. 
Death occurs in proportion of about 1 to 
16,000. 
Claimed seldom to be dangerous when prop- 
erly administered. 
Should always be preferred in long opera- 
tions. 
Less used in obstetrics. 
Accredited with a larger number of post- 
anaesthesia deaths. 
Chloroform. 
Agreeable odor. 
Pleasant to inhale. 
Non-inflammable and ordinarily safe around 
fire and lights. In direct contact with gas 
flames it decomposes, liberating chlorine, 
carbonyl chloride and hydrochloric acid, 
all poisonous irritants. 
Less irritant to the air passages. 
Must be slowly administered. 
Air to the extent of at least 98 per cent should 
be mixed with the anaesthetic vapor. 
Not more than 2 per cent with the inhaled 
air is safe. 
Less reduction of temperature. 
More apt to render the ideas and visions 
pleasurable, the incoherent talk being of a 
pleasant and not vulgar character. 
Decreases arterial tension. 
Not admissible in weak or fatty heart. 
Less irritant to the renal and pulmonary 
tissues. 
Effects more prompt and more prolonged. 
Always dangerous. 
Kills chiefly by circulatory paralysis; some- 
times primarily by asphyxia. 
Danger signs, as of pulse, pallor, etc., ex- 
hibited as quickly as with ether, but too late 
to be of value if cardiac paralysis has oc- 
curred. 
Death occurs in proportion of about 1 to 
3,000. 
Admitted to be dangerous, even by its advo* 
cates. 
Preponderance of opinion in favor of never 
using where ether may be employed. 
Preferable in obstetric manipulations. 
Has fewer post-anaesthesia deaths. 
167 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
^THYLIS BROMIDUM. 
Ethyl Bromide. (Formula CH3CH2Br.) 
Description.-A colorless fluid of a chloroform-like odor, and neutral reaction. It 
should evaporate rapidly and leave no fatty feeling when poured upon the hand. It de- 
composes readily in sunlight, air, or when near a flame. It should, not be confounded 
with ethylene bromide, a dangerous chemical. 
Action and Therapy.-Owing to its instability, and its depressing 
qualities this substance is an undesirable, though potent, anaesthetic. It 
acts rapidly, a few whiffs causing general anaesthesia. It has been advised 
for short operations, examinations, and painful gynecological manipula- 
tions; but is totally unsuited for major operations. Bromide of ethyl 
mitigates the pangs of labor, but chloroform is safer. The practice of 
allowing the patient to anaesthetize herself by holding the mask, upon the 
presumption that she will drop it when overcome, is to be condemned as 
careless and favoring lack of diligence on part of the operator. Death has 
frequently occurred from this drug, especially when used in dentistry; in 
other instances, tetanic nervous disturbances have ensued. It should, 
therefore, be little favored as an anaesthetic. The method of using it is to 
place the full dose (45 minims to 3 fluidrachms) upon the inhaler at once 
and administer in close contact with the mouth and nose. 
2ETHYLIS CHLORIDUM. 
Ethyl Chloride; Hydrochloric Ether.-(Formula: CHS CH, Cl). 
Description.-A very volatile mobile colorless liquid having a characteristic ethereal 
odor and a sharp burning taste. It vaporizes at ordinary temperatures. Caution.- 
Ethyl Chloride is very inflammable and must not be used near an open flame or fire. 
Action and Therapy.-External. Employed chiefly as a local anaesthetic 
for transient effect and quick minor operations, as incising the skin, opening 
abscesses, boils, etc., and to some extent in dentistry to obtund the gums 
so that forceps may be painlessly applied. It is sprayed upon the parts by 
means of a specially constructed tube, the heat of the hand and the com- 
pression of the tube being sufficient to eject a small stream of vapor through 
a pin-hole opening in the glass. Freezing takes place almost at once, and 
after its effects are over some aching pain is experienced, as is usual after 
refrigeration, and sometimes sloughing occurs. It is a most useful office 
adjunct for local use. 
Internal. Ethyl chloride also produces general anaesthesia when 
inhaled. Insensibility takes place rapidly and is very fleeting, so that major 
operations cannot be performed under it. But it has an advantage over 
ether or chloroform in that small operations not justifying the use of the 
latter can be performed and the patient recover immediately upon removal 
of the mask. In this way time is saved and detention of the patient is not 
necessary. It is not suitable when muscular relaxation is desired, for it 
seldom produces such an effect. It is claimed that it occasions very little 
change in the pulse or breathing, nor does it affect the pupillary or corneal 
reflexes, except in the very young. The quick return to consciousness, and 
the relative infrequency of vomiting, are claims of advantage made for it. 
It must not be assumed, however, that it is without danger, for deaths in 
about the same proportion as for chloroform have occurred from its use. 
When cyanosis occurs the administration of the anaesthetic should be 
stopped at once; and an unfortunate quality of it is that when accidents 
168 INDIVIDUAL DRUGS. 
take place from it they happen very suddenly. Ether is always to be 
preferred to this anaesthetic. In administering it a specially constructed 
mask is used, or an improved one may be made, so that the vapor can be 
passed directly down upon a pad of absorbent cotton or gauze and deeply in- 
haled. The mask should at first be closely applied, and later air admitted. 
Not over 30 to 45 minims should be required, or used upon children; nor 
over 60 to 75 minims for strong adults. The container is often graduated 
so that the amount consumed may be estimated. 
AGAR. 
A dried substance of mucilaginous character abstracted from several species of sea 
weeds (marine algae) growing along the coast of Asia. Most of it comes from Japan. Dose, 
1 to 4 drachms. 
Common Name: Agar-agar. 
Description.-Agglutinated membranous pieces, tough or brittle accordingly as it is 
damp or dry. The pulverulent form is most commonly used. It is a coarse, buff-colored 
granular powder, having practically no odor or taste. It swells to a soft magma in the 
presence of water. 
Action and Therapy.-Agar has no action upon the human body 
nor is it in turn affected by the digestive ferments or intestinal flora. It 
has the property of absorbing moisture and swelling to a soft mass, and for 
this purpose is given in constipation as a mechanical laxative; rendering 
the best service when intestinal secretion is scanty, and in consequence, the 
feces are abnormally dry. From one teaspoonful to two heaping table- 
spoonfuls may be given once or twice a day in dry form alone, or mixed 
with some cereal at meal-time. Biscuits, bread, and crackers are prepared 
from it and may be procured in the general trade. Agar is also used as a 
culture medium in making labaratory cultures. 
The fungus Amanita muscaria, Persoon; (Agaricus muscarius, Linne.) (Nat. Ord. 
Fungi.) An extremely poisonous fungus found in the pine forests of Europe. 
Common Name: Fly Agaric. 
Principal Constituents.-Muscarine, a deadly alkaloid, and pilzatropin, its physiologic 
opposite. 
Preparations.-1. Tinctura Agarici, Tincture of Agaricus (Fresh fungus, 3j; strong 
alcohol, Oj). Dose, 1/30 drop. 
2. Muscarine. Dose, 1/30 to 1/12 grain. 
Action and Toxicology.-The chief toxic action of agaricus is probably 
due to muscarine, which produces ptyalism, weeping, vomiting, depressed 
circulation, difficult breathing, muscular weakness, minutely contracted 
pupils, tetanic contraction of the viscera with subsequent relaxation of the 
bowels, when violent peristalsis takes place, paralysis and death. Mus- 
carine is the direct antagonist to atropine. 
Closely allied to Agaricus is Amanita phalloides, Fries or Death Cup. 
Common in the United States and the cause of many fatal poisonings. 
Gastro-enteritis with choleraic diarrhoea occurs, with death within two to four 
days. It contains muscarine and a toxalbumen phallin, both of which are 
deadly agents. While salt abstracts the latter, there is no known antidote 
after it has been absorbed. 
AGARICUS. 
169 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Therapy.-Agaricus is seldom used, but possesses undoubted power over 
the secretions and the nervous system. The chief uses that have been 
made of it, and for these even the muscarine sulphate or nitrate have been 
mostly employed, are in colliquative night-sweating from debilitating dis- 
eases, and profuse sweating in the daytime; and to restrain the excess of 
urine in polyuria, or so-called diabetes insipidus. 
Scudder suggested a tincture of the fresh fungus for "involuntary 
twitching of the muscles of the face, forehead, and even of the eyes, so that 
objects are not well seen because they seem to move; drawing of the tissues 
of the forehead and nose; pressing pain in the occiput and an inclination 
to fall backward." Webster thought it useful in typhoid conditions and 
spinal irritation when there is "tremor, restlessness, and desire to get out 
of bed." These indications are of homoeopathic origin and have been but 
little followed by Eclectic practitioners. 
Muscarine is used in atropine and belladonna poisoning, sometimes being 
employed in place of eserine (physostigmine). 
AGRIMONIA. 
The whole plant of Agrimonia Eupatoria, Linne (Nat. Ord. Rosaceae). A common 
perennial in the United States, Canada, Europe, and Asia. Dose, 5 to 60 grains. 
Common Names: Agrimony, Stickwort, Cockleburr. 
Principal Constituents.-Tannin and a volatile oil. 
Preparations.-1. Infusum Agrimonice, Infusion of Agrimony (gj to Water, Oj). 
Dose, 2 to 3 fluidounces. 
2. Specific Medicine Agrimonia. Dose, 5 to 60 drops. 
Specific Indications.-Deep-seated colicky pain in lumbar region 
with uneasy sensations reaching from kidneys and hips to the umbilicus; 
atony or irritation of the urinary tract, with muddy, ill-smelling urine. 
Action and Therapy.-A mild tonic and astringent, indicated as above- 
mentioned, and of considerable value in cystic catarrh and nephritic irrita- 
tion from the presence of gravel. It is also sometimes used as a gargle, and 
internally for mucous profluvia from any of the mucous structures of the 
body. The infusion is especially useful. We have known it to give relief 
in abdominal pain due to faulty intestinal digestion. Dribbling of urine 
in old persons is said to be relieved by agrimony. 
ALCOHOL. 
Spirit of Wine. 
A liquid containing a fixed amount of absolute (Ethyl) alcohol (C2 H5. OH). 
Description.-A mobile transparent and colorless liquid, volatile, of slight aromatic odor, 
and a sharp burning taste. It mixes with water, chloroform or ether, glycerin and many oils. 
It should be kept in a cool place, away from fire, and in closed containers. 
Preparations.-1. Alcohol Dilutum, Diluted Alcohol (Proof Spirit). Equal parts 
by volume of alcohol and water. 
2. Alcohol Dehydratum, Dehydrated Alcohol (Absolute Alcohol). 99 or more 
per cent pure C? H6 OH. 
3. Spiritus Frumenti, Whisky, 44 to 55 per cent absolute alcohol. 
4. Spiritus Vini Gallici, Brandy, 44 to 55 per cent absolute alcohol. 
5. Vinum Album, White Wine, 9 to 15 per cent alcohol. 
6. Vinum Rubrum, Red Wine, 9 to 15 per cent alcohol. 
7. Vinum Xericum, Sherry Wine, 15 to 22 per cent alcohol. 
8. Vinum Portense. Port Wine. 15 to 24 ner cent alcohol. 
170 INDIVIDUAL DRUGS. 
Specific Indications.-Collapse and sudden depression of the vital 
powers; prostration, with soft, feeble pulse; hurried respiration and ir- 
regular heart action; prostration with dry tongue, low muttering, or wan- 
dering delirium, tremor, subsultus, and insomnia; delirium tremens of the 
depressive type when the gastric powers fail. Antidote to phenol. 
Action and Toxicology.-Applied to the skin, alcohol causes a cooling 
sensation, but if evaporation be prevented heat and irritation follow. 
If too long in contact, inflammation may result. The skin and mucosa are 
hardened by it, and the latter corrugated, owing to coagulation of albumen 
and the abstraction of water from the tissues. Some fat is also removed. 
When first applied to the skin it contracts the arterioles, excites, and then 
paralyzes the peripheral nerves, and may therefore act as a slight anaesthetic. 
Taken into the stomach in small amounts it whets the appetite, provokes the 
flow of gastric juice, and increases digestive power and absorption. Owing to 
the dilatation of the arterioles, slight congestion of the mucous tissues 
occurs, by which all the digestive secretions-salivary, buccal, and gastric-are 
increased. If continuously used, however, this excessive secretion results in 
a catarrhal state, and continuing induces atrophic changes in the gastric 
glands with hyperplasia of the gastric connective tissue. Pepsin is pre- 
cipitated by it and thus adds to the digestive impairment. The resultant 
gastric catarrh causes sour stomach, heart-burn, eructations, and the pe- 
culiar retching and morning vomiting of the drunkard. 
Within the last few years studies upon alcohol have completely re- 
versed the former conception of its effects upon the nervous system and the 
circulation. Instead of stimulation, depression is its dominant action. The 
effects of moderate doses differ from large amounts in degree only. The 
apparent effects from alcohol are increased cerebral activity, the senses 
seemingly becoming more acute and the mental actions more energetic, 
and a corresponding increase of activity of the general economy takes place. 
Now we are told that this activity is not real, but only apparent; that in- 
stead of stimulation the brain and nervous system are depressed-and 
that the real condition is one of loss of control due to "depression of the 
inhibitory nervous apparatus." Hare declares "that so far as the brain is 
concerned, it does not increase the vigor of thought nor its depth, nor does 
it enable a man to work out a problem that is difficult. On the contrary, it 
benumbs the activity of the mental process." In large doses it is generally 
accepted that the brain and cord are depressed, and that muscular sense 
and tactile power are impaired; and that, through general loss of sensation, 
there is perverted mental action and judgment, incoordination of movement 
which results in staggering and uncertain motion, and the person is said 
to be drunk. 
In small amounts alcohol increases the heart's action probably through 
depression of the inhibitory apparatus. It also contracts the splanchnic 
and intramuscular arterioles while the capillaries of the skin are dilated. 
This causes flushing of the skin. A betterment in the distribution of the 
circulation and the protecting and increased bacteriolytic power of the 
blood under alcohol administration is now thought to be the important 
action in disease, instead of the stimulation formerly taught. 
171 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Taken in moderate amounts alcohol is scarcely eliminated, but is 
destroyed in the body by oxidation. It thus imparts force and energy. 
It refreshes the exhausted system and by yielding this force acts in lieu of 
food, though it is not known to contribute to the building of a single cell or 
fibre of the animal structure. It also acts as food in that it retards, by its 
own oxidation, similar destruction of fats and proteids of the body, and 
thus retards tissue waste. Bodily heat is created by the oxidation of 
alcohol, but heat radiation, through increased capillary circulation and 
dilatation, and depression of the vital powers prevent a rise in temper- 
ature. Large doses quickly lower the body heat; and this is more pro- 
nounced if fever be present. Taken in quantities too large to be "burned 
up" in the body, alcohol is eliminated by the lungs and skin and the kidneys 
and bowels. 
Contrary to popular notion, alcohol does not protect from the in- 
fluence of cold. This is shown by the experience of Arctic explorers; and by 
the ease with which drunkards are frozen to death. Nor does it protect one 
from the effects of heat. The facility with which topers are attacked by 
and succumb to sunstroke, heat exhaustion, and epidemic disorders, proves 
conclusively the deleterious effects of its habitual use; injuries do not heal 
so readily in the inebriate as in the temperate, chloroform is not well borne 
by them, nor can they as well withstand the shock of surgical operations. 
On the other hand, enormous quantities of alcohol may be ingested by those 
unaccustomed to it, when meeting with accidents, or suffering from the 
effects of hemorrhages, bites of insects and serpents, when suddenly de- 
pressed, and in convalescence from acute diseases. Infants and old persons 
bear alcoholics well. 
Toxicology.-Acute Alcoholism. In acute poisoning by alcohol cere- 
bration is suspended and profound insensibility takes place. The pulse is 
rapid and feeble, the face pale, the pupils usually dilated and muscular 
prostration is complete. Breathing may be stertorous, but not so strongly 
as in opium narcosis. Finally there is arrest of breathing and the heart 
becomes paralyzed. A person "dead drunk" should be treated as if poisoned 
and not allowed to "sleep off" the effects. 
It is sometimes extremely difficult to differentiate between acute 
alcoholism and apoplexy, cerebral concussion and opium poisoning. As 
alcohol is so widely used in one form or another, the odor upon the breath 
cannot be relied upon as diagnostic. As a rule in alcoholism the skin is cool; 
in apoplexy and opium poisoning, warm or hot; in the latter two the pulse 
is slow and full, pupils contracted (opium) or unequally dilated (apoplexy), 
and unconsciousness is complete; there is facial palsy and exalted temper- 
ature in apoplexy. 
The treatment consists in emptying the stomach by means of the 
stomach-pump, if possible, and the administration of aromatic spirit of 
ammonia or spirit of mindererus, followed by digitalis and strychnine 
hypodermatically. If the skin is cold and clammy, atropine also should be 
used. Artificial heat should be applied, with cold applications to the back 
of the head. In mild cases a half ounce of vinegar will often quickly restore 
the patient. 
172 INDIVIDUAL DRUGS. 
Chronic Alcoholism takes on two types so far as the final pathological 
results are concerned: sclerotic and steatotic degeneration. The liver re- 
ceives the brunt of the effects and fatty and atrophic changes take place, 
with associated gastric and constitutional malnutrition. Few organs 
escape. Cirrhosis of the liver, chronic nephritis, degenerative heart disease, 
and many other tissue changes occur. The mentality deteriorates and 
moral degradation reaches a low ebb. Peripheral neuritis and subsequent 
paralysis are common. The appearance of chronic alcoholics is well known 
and pitiable. The sodden pallor and fatty bestiality of the one, and the 
purplish, red-faced and pimply besotten countenance and swollen blue lips 
of the other, are types so common as to be easily recognized. If not too far 
advanced some good may be done if careful home treatment under strict 
surveilance is carried out, but as a rule institutional treatment is most 
successful, if one can find a sanitarium where honest treatment is accorded 
the patient. 
Therapy.-External. Alcohol is a local antiseptic, rubefacient, refriger- 
ant and astringent according to the manner of its application. Strong 
alcohol has less germicidal power than when diluted. Applied to the skin 
and its evaporation prevented by means of compresses, it acts as a local 
stimulant and rubefacient; if allowed to evaporate or its volatilization 
hastened by fanning, it is refrigerant. Used in the last-named manner it is 
a good cooling agent for bruises and contusions and inflamed, swollen, 
and rheumatic joints. Diluted about one half, it provides a good dressing 
for orchitis, arthritis, bruises, and superficial inflammations, Liniments 
containing it are frequently effective rubefacients to assist in relieving pain 
and aiding absorption of inflammatory products in so-called chronic 
rheumatism, lumbago, myalgia, pleurodynia, and similar disorders. 
Absolute alcohol will quickly prevent cauterization by phenol or 
carbolic acid. Washing the skin with alcohol to which has been added a 
small portion of a solution of alum hardens the tissues and prevents bed 
sores and excoriations. Used in full strength, alcohol is a fair hemostatic 
for the oozing of blood in abrasions. Applied to aural polypi and unhealthy 
granulations of the tympanum, it causes their shrinkage by condensing the 
albumen and abstracting water. Care should be taken not to dry out the 
membrana tympani. Foltz considered absolute alcohol a specific for tym- 
panic cholesteatoma. A solution of boric acid in absolute alcohol is an ideal 
cleansing lotion and healing application in purulent otitis media. 
A wash of alcohol and water forms a good antiseptic for aphthous 
ulcers and some forms of sore throat. Touching a tender spot in incipient 
sore throat with pure alcohol will sometimes immediately cause a dis- 
appearance of the soreness. 
Internal. Formerly the use of alcohol as an internal medicine was 
very extensive as well as abusive. Now the tendency is toward restriction, 
or the absolute discard of it altogether. The fact of the matter is that it 
should occupy a middle ground; and like every other agent that has been 
employed with any good results at all, it has its place in medicine, and that 
place is specific. Concerning the use of alcohol one should neither be 
swayed by the opinions and statistics of its advocates nor the maledictions of 
its opponents. Sound therapeutic iudgment should be exercised by the 
173 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
administrator himself. He should recognize that alcohol is a two-edged 
blade and may cut for good or for worse. He must realize that it is a habit- 
forming agent and one popularly and gratefully accepted, and therefore 
dangerous. Indiscriminate use will bring its penalties, and upon the phy- 
sician too often rests the blame for its ill results. 
Alcohol is an emergency remedy or temporary expedient. It should 
never be used unless absolutely indicated. Even though it may do much 
good, it may be very unwisely used in doing that good. As a rule its use 
should be avoided in young adults and adolescents, lest a habit be begun. 
It is a medicine chiefly for acute disease. There are, however, a few chronic 
conditions in which it may be given safely and beneficially. In old persons, 
with failing powers and lack of appetite, given for a brief period in small 
doses alcohol makes the patient better by increasing the desire for food 
and the function of digestion. In advanced phthisis and cancer (except 
of the stomach or liver) it gives comfort and promotes assimilation and rest. 
In these states of great debility and wasting of tissue it acts both as a food 
and a conservator of power. As long as it favors digestion, acts kindly, and 
lessens rapid waste it is doing good. If it occasions unpleasant symptoms 
it will aggravate the general condition, especially in phthisis. We do not 
believe it is ever indicated in incipient phthisis, and in this stage it can 
sometimes do incalculable harm. It is a matter of clinical record that 
many cases of tuberculosis have their incipiency in the continued use of 
alcoholics and the carelessness which the habit induces. While in ad- 
vanced phthisis it may or may not shorten the duration of life, it gives rest 
and comfort, and no habit is fixed that can in any way harm the sufferer. 
A half ounce or less of whisky or brandy may be given in milk or eggnog; 
or if cod-liver oil is being assimilated, it may be given with it. In the 
gastric debility of old persons, its use should be discontinued as soon as the 
appetite and digestion begin to improve, and only very small amounts 
should be given at any time. 
As a rule alcohol should be restricted to sudden depression in acute 
disease; and to those accustomed to its use in health who, suddenly at- 
tacked by an acute invasion, would suffer greater danger or die if the ac- 
customed alcoholic were entirely withdrawn. In pneumonia, and in 
low fevers in such individuals, the complete withdrawal of alcohol may 
mean death. In delirium tremens of the depressive type its sudden denial 
spells disaster, if the trouble depends chiefly upon the failure of the stomach 
to take and appropriate food. In such instances alcohol is an imperative 
necessity, and small doses must be given at short intervals until the gastric 
irritability is overcome and food is retained. If possible it should then be 
quickly replaced with capsicated broths or other easily assimilated nutri- 
ment. If the delirium is such that the force of the inebriation is spent upon 
the cerebrum directly without much disturbance of the gastric function, 
alcohol will aggravate the disorder. 
In low forms of fever, alcohol sometimes determines the difference be- 
tween life and death. If there is great prostration and impending collapse, 
with rapid, soft and feeble pulse, and the tendency is toward fainting, and 
there is low muttering delirium, subsultus, dry tongue, and sleeplessness, 
the patient must be stimulated or he will die. Nothing so quickly improves 
174 INDIVIDUAL DRUGS. 
this depression as alcohol. If, under its use, the pulse becomes stronger, 
slower, and increased in volume, the delirium is calmed, the tongue and 
skin become moist and sleep is induced, the drug is doing good; if the 
unpleasant symptoms grow worse, it should be discontinued at once. The 
dose should be small-much smaller than has generally been advised in the 
past, when it was directed, in pneumonia and fevers, to give alcohol until 
it could be smelled upon the exhaled breath. From 2 to 4 drachms, repeated 
as necessary, is far more effectual and manifestly safer than 1 or 2 ounces. 
Alcohol is to be given in sudden collapse from hemorrhage or from 
shock. It is usually given in fullest dose in the depression and collapse 
caused by bites of serpents and stings by poisonous insects. We believe 
that its use is often unwisely overdone in these conditions; nevertheless 
it is a custom that is not likely to be eradicated for some time to come. 
Here as elsewhere in collapse and depression small but repeated doses 
are more rational than the large amounts, for it must be remembered that 
alcohol is always depressant-somewhat depressing to some parts of the 
system in all doses and certainly powerfully depressant in excessive quanti- 
ties. 
A whisky sling frequently breaks up an acute invasion of the lungs 
by a cold, or pleuritic attack induced by exposure and chilling of the surface. 
The diaphoretic effects from the dilatation of the cutaneous capillaries and 
the revulsion of blood from the viscera to the skin, the patient being kept 
in bed, are most effectual. If of microbic infection, as in true lobar pneu- 
monia, it will have no effect toward aborting the illness. As such conditions 
can be met, however, by a stimulating diaphoretic or by the special seda- 
tives, alcohol should not be used when these are available, for the habit- 
forming qualities of the drug must ever be kept in mind. 
Alcohol has been advised as the best theoretical antidote for poison- 
ing by phenol or carbolic acid, and it has also been more recently con- 
demned as useless except for external use in such accidents. It will take the 
crucial tests of time and clincial use to determine its value in this respect. 
ALETRIS. 
The rhizome of Aletris farinosa, Linne, gathered after the plant has flowered (Nat* 
Ord. Haemodoraceae). United States. Dose, 5 to 60 grains. 
Common Names: Blazing Star, Star Grass, Starwort, False Unicorn root. 
Preparation.-Specific Medicine Aletris. Dose, 5 to 60 drops. 
Action and Therapy.-Owing to the confusion that has long existed 
resulting from the unwitting substitution of aletris for Helonias (Chamae- 
lirium) the virtues of the latter, as a remedy for various disorders of the 
female reproductive organs, have been ascribed also to the former. It is 
probably nothing more than a gentle stomachic and tonic, and as such may 
be employed to promote the appetite and aid digestion. It is accredited 
with value in atonic dyspepsia, with flatulence and borborygmus. Even 
the carminative effects thus ascribed would seem to belong to helonias 
rather than to aletris, which is neither bitter nor aromatic like the former. 
175 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ALLIUM. 
The bulb of Allium sativum, Linne (Nat. Ord. Liliaceae). Sicily, Asia Minor, and 
Central Asia; cultivated also in the United States and Europe. Dose, 1 to 2 drachms. 
Common Name: Garlic. 
Principal Constituents.-Chiefly an acrid volatile oil, containing sulphur compounds. 
Preparations.-1. Syrupus Allii, Syrup of Allium. Dose, 1 to 2 fluidrachms. 
2. Succus Allii, Juice of Allium. Dose, 1 fluidrachm. 
Action and Therapy.-External. Stimulant and rubefacient. Garlic 
poultice, like that of the onion, may be applied with benefit in acute respira- 
tory and abdominal inflammations. It sometimes excites a flow of urine 
in atony of the bladder, and in gastro-intestinal catarrh it is as efficient as 
the spice poultice. Applied to the feet it has been successful as a revulsant 
in brain and cerebro-spinal disorders of children, associated with con- 
vulsions. 
Internal. Expectorant and diuretic. The juice or the syrup (made 
by covering bruised garlic with sugar) is often effectual in common colds, 
especially when tending to become chronic or frequently repeated. It 
should not be used when there is marked irritation or inflammation. As a 
food, garlic is a stimulant to digestion if not used to excess. As such it is a 
common ingredient of certain meat sausages. 
ALLIUM CEPA. 
The fresh bulb of Allium Cepa, Linne (Nat. Ord. Liliacese). Common in cultivation 
everywhere. 
Common Name: Onion. 
Principal Constituent.-A colorless oil, composed chiefly of a sulphur compound 
(C6 H12 S2). 
Preparations.-1. Tincture of Red Onion. 5 to 60 drops. 
2. Syrup of Onion. Dose, 1 to 2 fluidrachms. 
Action and Therapy.-External. Onion is rubefacient. A poultice 
of onion with vinegar gives relief to inflamed corns and bunions. Roasted 
onion makes an efficient poultice for acute broncho-pulmonic inflammations, 
especially of young children, when local applications are desired. Onion 
poultices are objectionable only when made too heavy, carelessly applied, 
or when applied to open surfaces. 
Internal. Onion is stimulant, expectorant, and diuretic. A syrup of 
onion, prepared by drawing the juice with sugar, is a very effectual expecto- 
rant cough medicine for infants, young children, and old persons. If given 
in moderate quantities it is very soothing; if too freely administered it 
may cause nausea and disorder digestion. It, together with the onion 
poultice, are among the good things inherited from domestic medication, 
and might well be considered in preference to less safe and less depressing 
pulmonic medication. A tincture of red onion is useful in gravel and other 
urinary disorders with passages of blood, pus, and mucus. The dose is 
from 5 to 10 drops in water. It is sometimes given with an equal quantity 
of tincture of Xanthium Strumarium. 
176 INDIVIDUAL DRUGS. 
ALNUS. 
The recent bark of Alnus serrulata, Aiton (Nat. Ord. Betulacese). A shrub of the 
United States east of the Mississippi River. 
Common Names: Tag Alder, Red Alder, Black Alder, Smooth Alder, Common Alder. 
Principal Constituents.-Oils, tannin, and resins. 
Preparations.-1. Decoctum Alni, Decoction of Alnus (bark §j, Water, Oj). Dose, 
1 to 2 fluidrachms. Chiefly used as a local application. 
2. Specific Medicine Alnus. Dose, 1 to 60 drops. 
Action and Therapy.-External. The decoction is one of the best of 
local applications for rhus poisoning. We have observed rapid cures with it. 
It stains the skin. It is also a useful wash for nursing sore mouth of mothers, 
and should be given internally at the same time. 
Internal. A good remedy to promote waste and repair and to improve 
nutrition. It is astringent and a bitter tonic, of use in gastric indigestion, 
with relaxed stomach walls and imperfect peptic function. Its alterative 
properties are best displayed in pustular eczema and recurrent crops of 
boils. Passive haematuria is sometimes controlled by its astringent action. 
The dried juice of the leaves of several species of Aloe: (1) Aloe Perryi, Baker; (2) Aloe 
vera, Linne; (3) Aloeferox, Miller. (Nat. Ord. Liliacese). Barbadoes, Africa and the Orient. 
Common Names: (1) Socotrine Aloes; (2) Curagoa Aloes; (3) Cape Aloes. 
Description.-(1) Yellow-brown or black-brown masses, aromatic, bitter, and nause- 
ous, half of which is soluble in water; powder, deep brown; aqueous solution yellowish. 
(2) Orange to black-brown masses, waxy, not aromatic; more than half soluble in water; 
powder, deep red-brown; aqueous solution, purplish red. (3) Red-brown or greenish-black, 
smooth, glassy masses, more than half soluble in water; powder, greenish-yellow (fresh), 
light brown (old); aqueous solution, pale yellow. Dose, 1 to 8 grains. 
Principal Constituents.-Aloin (CH Hw), resin, and volatile oil. 
Preparations.-(1) Aloinum, Aloin (a very bitter, yellow-to-dark-yellow, finely- 
crystalline powder, soluble in water, slightly in ether). Dose, 1/12 to 1/2 grain. 
2. Piluloe Aloes, Pills of Aloes. (Each pill contains 2 grains of Aloes.) Dose, 
1 to 2 pills. 
3. Tinctura Aloes, Tincture of Aloes (10 per cent of Aloes). Dose, 15 to 60 minims. 
Specific Indications.-Atony of the large intestine and rectum; mucoid 
discharges, prolapsus ani, ascaris vermicularis (Scudder). Difficult evacua- 
tion of the lower bowel when not due to fissure or inflammation. 
Action.-Aloes is a slow-acting stimulating purgative, probably affect- 
ing only the lower bowel, notably the rectum. In small doses it is laxative. 
It strongly increases colonic peristalsis, but does not greatly increase the 
secretions of the intestinal glands, consequently the stools are feculent 
rather than watery, unless the dose be large. As it takes from 10 to 15 
hours to operate, it should be administered in the early evening so that 
evacuation may occur in the morning. When given alone it causes con- 
siderable griping and often rectal fullness and heat. These may be 
modified by giving it in pill with soap or an alkaline carbonate, or with 
hyoscyamus, belladonna, or carminatives. Sulphate of iron slightly restrains 
its action and ipecac increases it. Applied to a denuded surface it operates 
the same as if taken internally, and administered to a nursing mother it 
purges the sucking child. By its stimulating action upon unstriped fibre, 
as of the bowel and uterus, and its tendency to excite the pelvic circulation 
producing pelvic congestion, it proves emmenagogue. It is a purgative for 
ALOE. 
177 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
torpor and debility, and should not be given to plethoric persons, nor when 
gastro-enteritis, or actively inflamed hemorrhoids are present; nor when 
pregnancy exists. 
Therapy.-Aloes, in 1/2 to 1 grain doses, is a gastric stimulant of value 
in atonic indigestion, with obstinate constipation. It has had a large 
vogue as an after-dinner pill, but is now little used for that purpose. As a 
rule it is a good agent for use in atonic chronic constipation, but should 
never be exhibited in cathartic doses for this purpose. Aloes, or its de- 
rivative, aloin, is usually an ingredient of many favorite laxative pills, 
composed of varying amounts of either drug in combination with bella- 
donna, strychnine, and ipecac, and sometimes with the addition of capsicum. 
One of the best of these is the "Lapactic pill." When sulphate of iron is 
indicated in chlorosis and anemia, aloes is generally combined with it. It 
has the effect of restraining the constipating action of the chalybeate. 
Aloes and iron are both very useful in delicate women who are subject to 
amenorrhoea or menorrhagia, with pelvic and intestinal torpor, poor ap- 
petite, and a weak circulation. As most of these cases are profoundly 
constipated, the explanation of the combination may be found in the laxative 
action of the aloes. When hemorrhoids are due to feeble venous return, 
small doses of aloes or aloin may improve conditions, but it should never 
be given when there is active hemorrhoidal inflammation. In very small 
doses aloin is useful in rectal prolapsus, due to pelvic debility and general 
ill-health. It is still a debatable question whether aloes influences the flow 
of bile. When, however, jaundice is coexistent with torpor of the hemor- 
rhoidal veins, it may be improved by laxative doses of aloes or aloin. 
Aloes is a decidedly useful but much abused medicine in chronic or habitual 
constipation. As stated above only slightly laxative amounts should be 
used. When a purgative is needed for bowel impaction in the insane- 
particularly in hypochondriasis and melancholia-aloes is probably the 
best that can be given. The improvement in the mental state often will 
be commensurate with the betterment of the intestinal torpor. 
The decorticated dried root of Althaa officinalis, Linne (Nat. Ord. Malvaceae), a plant of 
salt marshes, river banks, and moist, sandy soils. Europe, Asia, Australia, and Eastern 
United States. 
Common Name: Marshmallow. 
Principal Constituents.-Mucilage, starch, pectin, and asparagin, an odorless and color- 
less crystallizable body identical with althein and agedolite, found also in many other plants. 
Preparations.-1. Infusum Althaa. lufusion of Althaea. Dose, Freely. 
2. Decoctum Althaa. Decoction of Althaea. Dose, Freely. 
3. Syrupus Althaa. Syrup of Althaea. Dose, fl to fl 3iv. 
Therapy.-External. A soothing application to inflamed surfaces; 
and may be used as an injection for dysentery, acute vaginitis, and the 
acute stage of gonorrhea. A favorite gargle for irritated throat. Applied 
upon a compress, it is reputed to be comforting to painful piles. 
Internal. An excellent lenitive and demulcent diuretic employed to 
soothe irritated and inflamed mucous surfaces, in hoarseness, cough due to 
faucial irritation, gastro-intestinal irritation and inflammation, and as a 
soothin? drink in vesical and renal irritation and inflammation, acute 
ALTHAEA. 
178 INDIVIDUAL DRUGS. 
cystitis, strangury and gravel. If the mucilage chiefly is desired, an infusion 
should be prepared with cold water; if starch, with some mucilage is 
needed, a decoction. It may be given freely. A syrup of marshmallow 
is a good vehicle for pectoral medication. 
ALUMEN. 
Alum.-(Formulas: (1) Ammonia Alum [Al NH4 (SO4)2. 12 H2 OJ. 
(2) Potassium Alum [AIK (SO4)2. 12H2 O]. The variety should be stated on the label. 
Description.-Large crystals or fragments, or a white powder, colorless and odorless, 
with a sweetish astringent taste. Soluble in water, the Ammonia Alum being less readily 
dissolved than the Potassium type. 
Preparations.-1. Alumen Exsiccatum (Exsiccated Alum), Dried Alum, Burnt Alum 
(Alumen Ustum). A white, odorless, granular, hygroscopic powder, having the char- 
acteristic taste of alum. It is largely anhydrous and should not contain more than 10 
per cent of moisture; and the label should state whether it is prepared from Ammonium 
or Potassium Alum. 
2. Liquor Alumini Acetatis, Solution of Aluminum Acetate. For local use. 
Action.-Alum corrugates the skin and mucosa by precipitating 
albumen and decreasing secretion. Moreover, it penetrates the epiderm 
and attacks the albumen in the deeper tissues, causing contraction of the 
blood vessels and surrounding structures, and coagulation of the blood. 
It is, therefore, powerfully astringent and styptic. Small doses of it con- 
stipate, larger amounts (30 to 60 grains every 3 or 4 hours) cause purgation, 
while if the same quantities be given every 10 or 15 minutes it acts as 
a mechanical or irritant emetic. An ounce of alum in solution killed a man. 
The symptoms were those of an intense gastro-enteritis. Alum is not readily 
absorbed by the alimentary tract. Only when given intravenously does it 
appear to produce remote general effects-chiefly upon the kidneys, in- 
testines and brain, causing degeneration, paralysis or convulsions, and 
death. It should never be used intravenously on account of the possible 
occurrence of a fatal thrombosis or embolism. 
Therapy.-External. Alum is astringent, styptic, and mildly es- 
charotic. Applied in full strength it will repress exuberant granulation. 
For this purpose it is the best agent to condense overgrown flesh around 
so-called "ingrown toe nail." Any sharp or irritating fragments of nail 
should be removed, under as aseptic precautions as is possible, the parts 
cleaned of pus and other secretions, and a small quantity of powdered alum 
packed in the cleansed pocket. It will cause marked shrinking and hardening 
of the parts, and subsequent trouble may be avoided by careful attention of 
the toilet of the nail. Alum may also be used to reduce the swelling of over- 
riding gums and to destroy "proud flesh" in ulcers and burns. It must be 
remembered that alum attacks the enamel of the teeth, therefore its use 
upon the mouth and fauces must be guarded. In dilute solutions alum 
promptly checks ptyalism when not due to a paralytic state of the parotid 
duct. For the restraint of excessive secretion from any of the mucous 
surfaces a solution of 30 to 120 grains to the pint of hot water may be used 
as a wash. The use of a solution of alum one day and of borax the next is 
very effective in controlling leucorrhoea with lax vaginal walls. It is some- 
times useful in gonorrhoea and gleet, when employed in weak dilutions. 
For relaxed conditions of the fauces and uvula it is often most effectual. 
179 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
A very weak solution-about 20 grains of alum to the pint of sterile water 
-provides an admirable wet-dressing for the after-treatment of superficial 
burns and scalds. It is antiseptic, represses undue secretion and over- 
granulation, and minimizes the formation of scar-tissue. Alum, in hot or 
cold solution as preferred, is useful in pruritus vulvae and pruritus ani. 
Dissolved in water, and alcohol subsequently added, alum makes a splendid 
lotion for bed sores, as well as to prevent them. The same may be used as a 
wash for frost-bites, chilblains, pedal, manual, and corporeal sweating. 
It is especially useful for colliquative night sweats and for bromidrosis. 
Alum lotions and ointments are valued by some for moist eczema, labial 
and preputial herpes, purpura, and in ulcerative stomatitis. The use of 
alum solutions for relaxation and soreness of the throat is not always ad- 
visable on account of imprisonment of deleterious matter, thus increasing 
the possibility of general infection. A severe bronchitis sometimes follows 
the use of an alum gargle or spray. 
Alum in powder or strong solution is a prompt and efficient local 
hemostatic when the vessels can be reached by it. It acts by coagulating 
the blood, precipitating albumen and constringing the surrounding tissues, 
and by furnishing a crystalline mechanical support upon which the blood 
may clot. It may thus be used for capillary bleeding from cuts, small 
wounds and bites, spongy bleeding gums, for bloody oozing after the 
extraction of teeth, in epistaxis and upon bleeding hemorrhoids. 
Internal. Internally, alum is astringent, hemostatic and emetic. 
As an emetic from 30 to 60 grains may be given well diluted or with molasses. 
It is seldom used for this purpose, but may be employed early in cases of 
narcotic poisoning when other emetics are not at hand. It is better adapted 
for spasm of the glottis and croupal conditions when secretions are free and 
loose. Even for such purposes it is now seldom employed. It is, however, 
exceedingly valuable in acute lead poisoning, which like other soluble sul- 
phates it also antidotes. It is the best known agent for acute lead colic 
(colica pictonum). From 30 to 60 grains may be given every 3 hours. 
While a powerful astringent of tissues in moderate or large doses, it never- 
theless provokes intestinal secretion; and in small doses it sometimes 
relieves constipation where there is marked atony due to habitual distention 
of the bowels with gas. For this purpose the following is advised: 1$ Alum 
gr. ij or iij, water §iv. Mix. Sig. One teaspoonful every 2 hours. For 
cough with tickling and irritation of the fauces King advised a mixture of 
alum 3j, water and syrup of tolu aa § ij, camphorated tincture of opium 3 j. 
Mix. Give a tablespoonful 3 or 4 times a day. In the absence of other 
hemostatics, alum may be used to control hemorrhage from the stomach. 
Liquor Alumini Acetatis is a clear colorless solution of an acetous 
odor and sweetish astringent taste. It contains from 7.5 to 8 per cent of 
basic aluminum acetate. It is a strong astringent solution used by some 
physicians in rhus poisoning, erysipelas, forming stage of boils and car- 
buncles, and upon septic wounds of the extremities. It should be dis- 
pensed in proportion of 1 fluidounce of the solution diluted with 7 fluid- 
ounces of distilled water. As it decomposes easily, it should be used only 
with the latter. 
180 INDIVIDUAL DRUGS. 
AMMONII BENZOAS. 
Ammonium Benzoate.-(Formula: NH4C7H5O2). 
Description.-Plate-like crystals, or a crystalline white powder; to the taste saline, 
bitterish, and subsequently acrid, and having no odor or but a faint aroma of benzoin. 
It gradually decomposes in the air, evolving ammonia. It dissolves freely in water or gly- 
cerin, and less readily in alcohol. Dose, 5 to 30 grains. 
Action and Therapy.-Ammonium benzoate is a mild antiseptic 
diuretic acting upon the bladder contents much like benzoic acid. It is 
to be used where there is renal torpor, with scanty, pungent, dark-red 
urine loaded with ropy mucus and phosphatic sediment. In the urinary 
incontinence of the aged, with irritation of the neck of the bladder and 
in subacute cystitis, accompanied by headache, debility, and pain in the 
loins and limbs, it may be given with hope of amelioration. From 5 to 15 
grains, well diluted with water, should be administered 2 or 3 times a day. 
AMMONII BROMIDUM. 
Ammonium Bromide.-(Formula: NH4 Br.). 
Description.-A white granular or crystalline powder, or in transparent crystals, with 
a sharp, salt-like taste, and no odor. This salt absorbs moisture, but not enough to liquefy it. 
It is freely soluble in water and less readily in alcohol; more easily when each of these 
solvents is hot. Dose, 1 to 30 grains. 
Specific Indications.-Tinnitus aurium from quinine; convulsive 
movements; convulsive cough. 
Action and Therapy.-Ammonium bromide fulfills practically the same 
purposes as Potassium Bromide, which see. It is less depressing, however, 
than that salt, but somewhat more irritant to the stomach. In very large 
amounts or if long continued it will produce the unpleasant results of the 
excessive use of bromides in general-comprehended in the condition known 
as Bromism. 
Locke advised bromide of ammonium for insomnia due to cerebral 
excitement. Foltz recommended it for nervous twitching or jerking of the 
eyelids and muscles of the eye, and for nervous deafness, and to relieve 
tinnitus aurium caused by the alkaloids of cinchona. Scudder used it as a 
nerve stimulant to enfeebled cerebral circulation, and to relieve irritation of 
the brain and spinal cord resulting in convulsions. He preferred it to other 
drugs in the treatment of epilepsy, employing it to remove predisposition 
to it, to control the attacks, and to prevent their recurrence. 
Bromide of ammonium is useful in whooping cough, associated with 
convulsive action of the chest muscles or epileptiform movements of the 
limbs. Doses of 1 grain for each year of the child's age may be given 
several times a day. 
AMMONII CARBONAS. 
Ammonium Carbonate. 
A mixture of Ammonium Carbonate (NH4 HCO3) and Ammonium Carbamate (NH4 
NH2 CO2) in such proportions that the yield of NHS is about one-third the per cent of the 
whole. 
Description.-Hard, heavy, translucent, white masses, having the sharp taste and the 
pungent odor of ammonia. When exposed to the air it becomes lighter in weight, and 
leaves opaque, porous and easily crushed lumps, or a white powder. It thus loses both 
ammonia and carbon dioxide; therefore it should be kept in close containers. For full 
medicinal value only the translucent masses should be used; for antacid purposes the friable 
lumps or the powder may be employed. Cold water slowly dissolves it, but hot water 
decomposes the salt, while alcohol dissolves out the carbamate. Dose, 1 to 10 grains. 
181 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Feeble pulse, pale or dusky surface, cold skin, 
difficult breathing, shock; respiratory and cardiac collapse; syncope; 
as a stimulant in low fevers when alcohol is inadmissible (see also Aqua 
Ammonia). Broken down constitution, with feeble vitality and acidity 
of the stomach; cough, with viscid, scanty and difficult expectoration. 
Action and Toxicology.-Ammonium carbonate is quickly absorbed 
and diffused in the blood, probably increasing its fluidity. It is eliminated 
chiefly by the kidneys, some of it unchanged, some as nitric acid, but most 
of it as urea. To a lesser degree it passes out by way of the lungs and the 
skin. It augments the secretions of the kidneys, skin and bronchi. Moder- 
ate doses (10 to 15 grains) increase the force and volume of the circulation, 
with sometimes a sense of fullness and throbbing in the head. In health 
it is said to slightly elevate the temperature. Ammonium carbonate should 
not be administered for long periods, for besides neutralizing the acid of the 
gastric juice and causing diarrhoea and other disturbances, it impairs the 
blood, lessening its power to absorb oxygen, with symptoms resembling 
scurvy, and promotes tissue-waste to such a degree as to cause pallor, 
debility and emaciation. 
In small doses ammonium carbonate is an energetic nervous, circula- 
tory and respiratory stimulant, and antispasmodic. In large doses it is a 
powerful irritant poison, provoking gastro-intestinal inflammation, with 
pulmonary congestion and oedema. The antidotes for poisoning by it are 
dilute acids (vinegar, lemon juice, acetic or hydrochloric acids well diluted) 
with demulcents and protectives to allay the after-effects. 
Therapy.-External. Ammonium carbonate, in crushed lumps, 
placed in suitable small bottles and saturated with ammonia water and 
compound spirit of lavender constitutes "Smelling Salts", a favorite in- 
halation for debilitated persons who are subject to attacks of fainting, 
nervous headache, and spasms. Sometimes essence of cloves is added. 
Internal. Ammonium carbonate is a decided but fleeting stimulant, 
diaphoretic and expectorant. In doses of 20 to 30 grains it is emetic. 
Like water of ammonia it may be exhibited in collapse and shock with 
failure of heart-action and breathing. It is largely used for the depression 
following general anaesthesia, particularly in children. To such it may be 
given in 2 or 3 grain doses in a diluted syrup of acacia, or in milk. In low 
fevers, with great debility and exhaustive discharges, as in typhoid fever, 
it may be administered when collapse threatens or supervenes and when 
alcohol is inadmissible. Used in this state it is invaluable to tide the patient 
over the stage of depression. It improves the condition of the skin, strength- 
ens the nervous functions, quiets irritability of the brain, and permits the 
patient to sleep. In fact, it is one of the best of temporary stimulants in 
prostration from any disease. It is useful in the algid stage of cholera and 
has cut short attacks of congestive chill. When the circulation is weak 
and there is cerebral anemia it may be given in insomnia and to good 
advantage in delirium tremens. The cases to which it is adapted are those 
in which the delirium is mild but extremely depressing, never violent, and if 
stimulation of some sort is not forthcoming the patient will die from 
exhaustion. With bitter tonics and peptics, as nux vomica, hydrastis, and 
capsicum, it reduces the craving for alcoholics and relieves the gastric 
182 INDIVIDUAL DRUGS. 
sinking spells of inebriates, so that food can be better tolerated. It is also 
useful, though less valuable than the solution of ammonium acetate, as a 
quick sobering agent in acute alcoholism. Many appreciate its worth to 
control the sour stomach, sick headache, and the depression of spirits 
following an occasional debauch. 
Ammonium carbonate is a valuable antacid. It gives quick relief in 
acidity of the stomach and headache and other disturbances resulting from 
such perversion of the gastric fluids. Locke rightly declared that "in 
broken-down constitutions, with greatly diminished vitality, when an 
antacid is needed, this is the best known remedy." Five grains are to be 
given in sweetened water. 
Fabulous claims have been made for this salt and for water of am- 
monia as antidotes to the venom of serpents and reptiles. It probably has 
no antidotal effect upon the poison, but is useful nevertheless, with al- 
cohol used with judgment, to sustain the heart power and breathing until 
the depressing effects of the venom shall have been spent. 
In the latter stage of pneumonia, ammonium carbonate is valuable to 
sustain the circulatory and nerve force, and to liquefy viscous pulmonic 
secretions; and in acute bronchitis and broncho-pneumonia, both in children 
and old persons it is invaluable as a stimulating expectorant, particularly 
in the late stages when bronchial dilation is marked and difficult expectora- 
tion is experienced, though the tubes are filled with glutinous secretion. 
By liquefying the latter it renders them easy of disposal. It has a limited 
use in measles and scarlet fever, when the eruption is tardy or in retroces- 
sion, and a sour stomach and low vitality are complications. In the former 
it sometimes mitigates the cough and favors easier expectoration. Added 
to infusion or syrup of boneset, hoarhound, spikenard, or elecampane, with 
fluid extract of licorice it provides good cough medicine for the bronchial 
irritation and pulmonic catarrh of old age. 
Ammonium carbonate has been advised, upon good grounds, as a remedy 
in cystinuria. It is also a physiological stimulant, opposing the action of 
overdoses of aconite, veratrum, tobacco, alcohol, and hydrocyanic acid. 
For most of the conditions named needing stimulation ammonium 
carbonate and ammonia water, or the aromatic spirit of ammonia, may be 
used interchangeably. However, the water of ammonia is best suited to 
hypodermic or intravenous use, though the carbonate is employed also for 
the latter purpose. When so used they should be injected remotely, as 
into the legs, so that they are well distributed in the blood before reaching 
the heart, as ammonium compounds in concentration have been known to 
stop the heart instantly when reaching that organ. For antacid purposes 
the carbonate is to be preferred, though all three preparations have decided 
antacid properties. 
AMMONII CHLORIDUM. 
Ammonium Chloride. Muriate of Ammonia. (Crude) Sal Ammoniac. (Formula: 
NHt Cl.) 
Description.-A slightly hygroscopic granular or crystalline, white, odorless powder, 
having a cooling, but sharp, salt-like taste. Dose, 1 to 10 grains. 
Specific Indications.-Dusky redness of the surface, easily effaced but 
slowly returning; tight tickling cough with scant secretion; viscous 
tenacious sputum with difficult expectoration; hepatic and gastric torpor. 
183 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action.-Unlike the majority of the ammonium salts the chloride does 
not appreciably affect breathing or the circulation. At least it has no such 
stimulating qualities in these directions as is possessed by the carbonate or 
the water of ammonia. In diseased conditions, however, it notably clears 
up a dusky skin due to a faulty capillary flow. On the mucous membranes 
it has a most decided stimulating effect, increasing and liquefying the 
mucus, particularly of the bronchial surfaces. After absorption the chloride 
shares the fate of other ammonia compounds. This salt notably increases 
the liquids and the solids of the urine, especially urea, but not uric acid. 
While some of it is eliminated in the saliva, the greater portion passes by the 
renal route. In moderate doses, it may be taken for a considerable period, 
but finally digestion and nutrition become impaired, with coated tongue, 
loss of appetite, pain, vomiting, diarrhoea, and emaciation. Very large 
doses have caused prostration and typhoid conditions, while long continued 
in such amounts hematuria, epistaxis, petechial spots in the mucosa, and 
blebs upon the skin have been observed. 
Therapy.-External. Ammonium chloride is a stimulating discutient. 
It forms a good basis for liniments when not in itself contraindicated and 
when a non-greasy embrocation is desired. King used it largely in this man- 
ner, incorporating with it any desired medicament. The solution (5 ss to 
water § viij) makes an excellent application for ecchymoses. It acts with re- 
markable quickness in palpebral ecchymosis, and if applied early will prevent 
extensive discoloration. It cools and allays itching in rhus poisoning, and 
relieves the pruritus of prurigo. A saturated solution, hot or cold as desired, 
forms a good discutient and pain-relieving lotion for inflammatory swellings, 
rheumatic joints, swollen bursae, sprains, bruises and contusions. It is less 
agreeable where the skin is broken or in cuts and wounds, for which there 
is better treatment. Applied in orchitis and epididymitis it reduces swelling 
and relieves pain, provided a proper support be given the scrotum. Ap- 
plied by means of hot compresses it relieves acute wry-neck, hemicrania, 
and localized neuralgias. When vaporized, by means of heating a small 
quantity in a metal dish or spoon, or by atomization of its solution, it has 
been used with good effect in chronic laryngitis and fetid chronic bronchitis. 
Internal. Chloride of ammonium is an important remedy in bronchial 
affections, the exanthemata, and in some gastric and hepatic disorders. 
The most direct indication is that of capillary stasis accompanying any dis- 
order. The surface circulation is impaired, with dusky redness of the skin 
from embarrassed blood flow and not from septic conditions. When the 
duskiness is effaced by drawing the finger across the skin, the pallid streak 
is slowly replaced by a return of the dark color. As a capillary stimulant 
sometimes it is very effective in scarlatina, in which it favors the process of 
eruption and tends to prevent post-scarlatinal dropsy. It acts similarly in 
measles, and in addition renders the dry cough less distressing. 
It is a very important remedy in broncho-pulmonic inflammation both 
acute and chronic. For the dry, tight, rasping, or the sharp, violent cough 
with dryness of the throat it is a splendidly effective medicine. In acute 
bronchitis it may be used to assist in raising overabundant viscous secre- 
tions, while in chronic bronchitis it is most valuable to relieve cough by 
liquefying the tenacious mucus and facilitating its expectoration. It may 
184 INDIVIDUAL DRUGS. 
be rendered agreeable in these conditions and more acceptable to the 
stomach by giving it with the fluidextract of licorice or syrup of tolu or of 
wild cherry. In catarrhal or broncho-pneumonia of children or old persons 
it is frequently indicated and greatly ameliorates the distressing cough. 
Small doses relieve reflex cough from gastric and hepatic torpor, with 
sluggish abdominal circulation. Chronic, rasping, tight cough with but little 
secretion and precipitated by titillating or tickling sensation in the larynx 
is promptly relieved by the following: 1$ Ammonium Chloride 3ij, San- 
guinarine Nitrate gr. i, Spirit of Lavender Compound fl§ij, Syrup q. s. 
flgiv. Mix. Filter through cotton. Sig. One teaspoonful every 3 hours. 
Ammonium chloride is useful in chronic gastritis, with pain and hyper- 
acidity, in catarrhal jaundice, in chronic hepatic congestion, and in biliary 
catarrh. It is also of service sometimes in "biliousness," 30 grains being given 
in a full glass of hot water. The same solution is said to quickly forestall an 
attack of delirium tremens; and the salt so given is a well-known treatment 
for acute alcoholism to quickly sober the patient. It is less effective for 
this purpose, however, than the solution of acetate of ammonium. Rarely 
neuralgia is relieved by ammonium chloride, particularly the hepatic and 
ovarian varieties. 
AMMONII IODIDUM. 
Ammonium Iodide.-(Formula: NH* I). 
Description.-Very small, colorless crystals or a granular white powder, hygroscopic, 
having no odor, but a sharp salty taste. Upon exposure to light and air (especially when 
moist) iodine and ammonia are liberated, the salt becoming yellow or yellowish brown. 
It is then unfit for medicinal use. It is readily dissolved by water, alcohol, and glycerin. 
Dose, 1 to 10 grains. 
Specific Indications.-Localized dull pain in the head, with muscular 
incoordination, feeble or sluggish circulation, and nervous depression, 
especially when caused by a syphilitic dyscrasia. 
Action and Therapy.-Ammonium iodide acts much like iodide of 
potassium, but is more stimulating, and like that salt is adapted to the 
treatment of the secondary and tertiary stages of syphilis and of glandular 
swellings. Many regard it as particularly useful in the dull headache of 
syphilis with feeble or sluggish circulation, dizziness, and difficult muscular 
coordination. The pain is confined to a small area that can be practically 
covered by the finger tip. It has also relieved pericranial headache as- 
sociated with feeble circulation and cerebral excitement. Foltz advised its 
use in syphilitic ear diseases, regarding it as one of the most valuable 
remedies in suppurative otitis media, with depression. 
AMYGDALUS. 
The leaves and bark of the twigs of Amygdalus Persica, Linne (Nat. Ord. Rosaceae). 
Native to Persia. Cultivated everywhere. 
Common Name: Peachtree. 
Principal Constituents.-The glucosid amygdalin, which in the presence of water and 
emulsin splits into hydrocyanic acid and other bodies. Hydrocyanic acid can be obtained 
from most parts of the tree. 
Preparations.-1. Infusum Amygdali, Infusion of Amygdalus. Prepared by satu- 
rating the freshly scraped inner bark of the twigs (3j) in cold water (Oj). It must not be 
boiled. Dose, 1 fluidrachm to 1 fluidounce. 
2. Specific Medicine Amygdalus. (Made from the green young twigs and leaves.) 
Dose. 1 to 30 drops. 
185 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Gastric and abdominal tenderness, with irrita- 
tion and congestion, and pointed tongue with reddened tip and edges and 
prominent papillae, nausea, and vomiting. 
Therapy.-Used according to indications as given above, the infusion 
is a reliable sedative for gastric irritation with vomiting, particularly in 
children, and in the irritable stomach of phthisis. Scudder valued it in the 
vomiting of cholera infantum. We believe the failure of many to obtain 
results from amygdalus in vomiting is due to the use of alcoholic prepara- 
tions instead of the infusion; and the latter is of no value unless prepared 
daily from the fresh green inner bark and leaves. We have both succeeded 
and failed with it according to the cause of the gastric disturbance. It is of 
less value for cough than wild cherry or hydrocyanic acid. For the latter 
the infusion or the specific medicine may be used. 
AMYLIS NITRIS. 
Amyl Nitrite.-(Formula: C5 Hn NO2). 
A liquid four-fifths of which is represented by the above formula. It decomposes 
readily and must be kept from light and air in a cool situation, either in sealed ampules or 
pearls, or in glass-stoppered bottles. 
Description.-A very volatile and inflammable, transparent, yellowish fluid, having an 
ether-like and fruity odor and a sharp aromatic taste. It mixes with alcohol or ether, but is 
nearly insoluble in water. Unless carefully preserved, it is an uncertain medicine. Dose, 
1 to 5 minims (usually 1 to 3) by inhalation. 
Specific Indications.-Angina pectoris, with high arterial tension;cold, 
pallid surface; nervous spasms; nervous headache with pallor, and dyspnoea 
from cardiac disorders, all with high blood-pressure due to vaso-spasm. 
Action and Toxicology.-Next to prussic acid, nitrite of amyl is the 
most rapidly active sedative and nervo-muscular depressant used in 
medicine. Like all of the nitrites, of which it is the most rapid and most 
fugacious in action, its most notable effect is great dilation of the blood 
vessels and rapid lowering of blood pressure. So quickly is the drug ab- 
sorbed, by inhalation, that these effects occur almost instantly. These 
results are probably due to a slight depression of the vaso-motor centers 
and of the peripheral vaso-motor nerves, but most largely to a direct action 
on the musculature of the vessels, both arterial and venous. The sudden 
fall of blood pressure, together with cardio-centric inhibition, causes the 
heart to beat rapidly and tumultuously. While the main action upon the 
heart is depressant, very small doses are said to stimulate. The sensory 
tract of the spinal cord is but little affected by moderate doses, but the 
dominant action is upon the motor side, and in large doses upon the motor 
nerves and cerebral motor cortex. Temperature is lowered by nitrite of 
amyl probably through the combined effects of deficient oxidation, im- 
pression of the heat-producing and heat-dissipating centers, and the vast 
vascular relaxation caused by it. It changes the haemoglobin of the blood 
into methaemoglobin, and impairs the ozonizing power of that fluid, which it 
changes from arterial red to a deep-chocolate color. Amyl nitrite is 
rapidly absorbed and quickly eliminated, chiefly by the lungs and the 
kidneys, the flow of urine being slightly increased by it according as the 
blood-pressure in the renal organs is more or less affected. When death 
occurs from its use it is due to centric respiratory paralysis. 
186 INDIVIDUAL DRUGS. 
Upon inhaling nitrite of amyl there is experienced flushing of the face, 
dizziness, rapid beating of the temporal and carotid vessels, throbbing pain 
and heat in the head, very rapid heart-action, and gasping breathing. 
There is often a sense of suffocation and the condition appears much like 
the beginning of asphyxia. The face and membranes are dusky, though 
there is occasionally marked pallor. Muscular power is completely abol- 
ished and the patient sinks helpless. Death is not common from this drug, 
but one case having been noted, but alarming results are sometimes pro- 
duced. Recumbent position, systemic emetics (if swallowed), and artificial 
respiration are indicated, together with rapidly acting stimulants, such as 
ether and ammonia followed by atropine, strychnine, or digitalis. In 
order to cause a revulsion of blood to the surface a mustard bath has been 
advised, with the ice cap applied to the head. 
Therapy.-Nitrite of amyl is the remedy for extreme arterial tension, 
except where there is advanced cardiac or cerebral degeneration. It is 
the best and quickest palliative for angina pectoris, with high blood pressure. 
Always effective for temporary use, there are those who believe it to favor a 
final cure, though this cannot reasonably be hoped for. In dyspnoea due 
to valvular disease of the heart, cardiac hypertrophy, and in heart failure 
from many causes it relieves by decreasing the arterial obstruction to the 
heart's action by the general vascular relaxation it causes. In heart failure 
from fright, or nervousness, or anaesthesia, and in syncope, it may be 
cautiously inhaled in single whiffs. If it does not relieve at once it should 
be discontinued, for damage will result from pushing its effects. Hare 
declares amyl nitrite the best remedy, by inhalation, for hemoptysis. 
It relieves by the vascular dilatation produced, particularly of the splanchnic 
circulation, bleeding the patient into his own vessels, and thus partially 
diverting the flow of blood from the lungs. It should not, however, be 
pushed too vigorously. 
Nitrite of amyl relaxes spasm, both general and local and of both the 
voluntary and involuntary muscles. It is one of the agents to be used in 
tetanus and in poisoning by strychnine or nux vomica, being given in the 
latter during the intervals of repose, on account of the victim's inability 
to inspire it during the respiratory cramp of the convulsion. In either 
condition it may also be given hypodermatically. Amyl nitrite will cut 
short impending attacks of epilepsy when the aura is present. The patient 
knowing his liability to seizure, and having "the pearls'' at hand may 
crush one and inhale it. It is of little value during attacks, except in those 
instances of many repeated spasms (status epilepticus) when the agent 
frequently controls the seizures and prevents immediate recurrence. In 
the cases in which it succeeds there is high arterial pressure. By inhala- 
tion this drug is frequently effective in hysteria, hystero-epilepsy, spas- 
modic asthma, and obstinate hiccough, all with vaso-motor contraction, and 
sometimes in whooping-cough, infantile convulsions, and laryngismus 
stridulus. It should be used upon small children only in extreme cases, and 
then with the greatest of caution. While amyl nitrite is effective in con- 
trolling puerperal eclampsia, with high blood pressure, it should not be so 
used on account of its liability to permit post-partum hemorrhage because 
of the great relaxation of the uterine musculature caused by it. It re- 
187 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
lieves after-pains, but the same caution must be observed as with puerperal 
convulsions. The drug gives temporary relief from neuralgic or spasmodic 
dysmenorrhoea, in full-blooded women. 
Sick headache and migraine, when due to vaso-spasm or to anemia, 
are relieved by amyl nitrite. It should be employed only when the face is 
pale, and in moderate doses. For the nausea and headache and other dis- 
turbances of the menopause, with cardiac palpitation and flushes of heat 
followed by perspiration, Locke advised the following: I| Amyl Nitrite 
gtt. xv, Alcohol 3 j. Mix. Sig. Dose 1 to 10 drops on sugar 3 times a day. 
Nitrite of amyl is asserted to abort pernicious malarial fever, or con- 
gestive chill, if given during the algid stage, and a similar use for it under 
like conditions has been suggested in Asiatic cholera. It is also reputed 
effectual to prevent and to cure seasickness. Apparently it is of value in 
chronic interstitial nephritis to prevent convulsions and to relieve the heart 
in its efforts to propel the blood against abnormally strong arterial re- 
sistance. Its status in chloroform narcosis is not well established. Though 
it has been successfully used in single whiffs, the preponderance of opinion 
is that it is an unsafe expedient. 
AMYLUM. 
The fecula or starch of the seed of Zea Mays, Linne (Nat. Ord. Gramineae). (Formula: 
c6H10o6). 
Common Name: CornStarch. 
Description.-Irregular, angular, white masses, or a fine, white powder; inodorous, 
with a slight but characteristic taste. Insoluble in alcohol and cold water. When boiled 
with 15 parts of water and cooled, it yields a whitish, translucent jelly (starch paste). 
Preparation.-Glyceritum Amyli, Glycerite of Starch. 
Action.-A carbohydrate food contributing to the production of 
animal-heat, and when consumed in too large quantities for long periods 
increases fat and gives rise to flatulence and gastric acidity. Under the 
same conditions it may cause sugar to appear in the urine. 
Therapy.-External. A valued dusting powder for intertrigo, ery- 
sipelas and irritated skin, and as starch-water (diluted starch paste) a 
useful demulcent for inflammatory disorders of the lower bowel and a 
medium for rectal medication. The glycerite alone (or as a vehicle for other 
medicaments) is a bland and non-irritating application to relieve the heat of 
eczema, erythema, excoriations, and other irritated or inflamed disorders of 
the skin. 
Internal. The antidote for iodine poisoning. Diluted starch paste 
may be used as a lenitive after other forms of irritant poisoning, and as a 
mucilage for the administration of medicines. 
ANEMOPSIS. 
The root of Anemopsis californica, Hooker (Nat. Ord. Saururacese). A native peren- 
nial of wet places in Southern California and Northern Mexico. Dose, 1 to 60 grains. 
Common Names: Yerba mansa; Yerba del mansa. 
Principal Constituents.-A heavy aromatic oil (5 per cent) and tannic acid. No 
alkaloid has been found in it. 
Preparation.-Specific Medicine Anemopsis. Dose, 10 to 60 drops in syrup. 
188 INDIVIDUAL DRUGS. 
Action and Therapy.-Reputed astringent, tonic, carminative, and 
anti-emetic. A mucous membrane stimulant for catarrhal conditions of the 
respiratory, gastro-intestinal, and genito-urinal tracts. It has given good 
results in bronchial cough and nasal catarrh. In the latter affection, 
Munk uses it largely as a spray to the nose and throat, employing from 
10 to 30 drops of the specific medicine to slightly glycerinated water. It has 
a reputation for relieving the excessive discharges of chronic gonorrhoea, 
acting somewhat like cubeb. 
ANISUM. 
The dried ripe fruit of Pimpinella Anisum, Linne (Nat. Ord. Umbelliferse). Egypt 
and Western Asia; cultivated in Southern Europe. Dose, 5 to 40 grains. 
Common Names: Anise,Aniseed. 
Principal Constituents.-A volatile oil (Oleum Anisi) composed chiefly (95 per cent) 
of the stearopten anethol (C10H12O), which, upon oxidation, yields anisic acid (C8H8O8) 
Preparations.-1. Oleum Anisi, Oil of Anise. Derived from Anise (above) or from 
Star Anise (Illicium verum, Hooker, Nat. Ord. Magnoliacese.). The botanical origin must 
be stated on the label. Oil of Anise is a highly refractive, colorless or light-yellow liquid, 
having the taste and odor of anise. It is freely dissolved by alcohol. Dose, 1 to 5 drops 
on sugar. 
2. Infusum Anisi, Infusion of Anise (Anise, 5 i j or 5iij; Boiling Water, Oss.). 
Dose, 1 to 2 fluidrachms. 
3. Spiritus Anisi, Spirit of Anise. Ten per cent Oil of Anise in Alcohol. Dose, 
1/2 to 1 fluidrachm in hot water. 
4. Aqua Anisi, Anise Water. Dose, 5j to §j. 
5. Specific Medicine Anise. Dose, 3j in water. 
Specific Indication.-Flatulence, with colicky pain. 
Action and Therapy.-Anise is an agreeable stimulating carminative 
employed principally for the relief of nausea, flatulency, and the flatulent 
colic of infants. Anise imparts its odor to the milk of nursing mothers. 
It is an ingredient of Paregoric (Camphorated Tincture of Opium), and is 
largely used to impart to or correct flavor in medicinal preparations, espe- 
cially cough mixtures. For infants the infusion is the best preparation and 
it should not be sweetened. The spirit (1/2 to 1 fluidrachm) given in hot 
water is more agreeable and effective for older children and adults. The 
oil (1 to 5 drops) on sugar may be used by the latter, if desired. 
The flower-heads of Anthemis nobilis, Linne, (Nat. Ord. Compositse). Collected from 
cultivated plants. 
Common Names: Roman Chamomile, Chamomile, English Chamomile. 
Principal Constituents.-A stimulating oil (Oleum Anthemidis') and resin; and tannin. 
Preparations.-1. Specific Medicine Anthemis. Dose, 1 to 60 drops. 
2. Oleum Anthemidis, Oil of Anthemis. Dose, 5 to 15 minims (on sugar). 
3. Infusum Anthemidis, Infusion of Anthemis; (Anthemis, gss; Water, Oj). 
Dose, 1 to 4 fluidounces. 
Therapy.-The cold infusion is reputed stomachic; the hot infusion 
diaphoretic (1 to 2fl5), and emetic (5 to 12 fl3); the oil carminative. The 
cold infusion may be used in gastric debility, with flatus; the hot infusion 
to relieve colds due to sudden cutaneous chilling, and in dysmenorrhoea to 
check pain and facilitate the flow. The oil may be employed for a like 
purpose, and for intestinal cramps and colic due to flatulency. Anthemis 
is little used. 
ANTHEMIS. 
189 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ANTIPYRIN A. 
Antipyrine, Phenazone, Phenyldimethylpyrazolon.-(Formula: CUHI2ON2). 
Description.-A nearly odorless and feebly bitter salt occurring as a white crystalline 
powder, or in plate-like crystals. It dissolves readily in water, alcohol, or chloroform, and 
less readily in ether. It should be carefully preserved. Dose, 1 to 10 grains (the usual 
dose is 3 to 5 grains). 
Specific Indications.-Pain and spasm; high temperature in surgical 
and puerperal fevers; migraine. 
Action.-Antipyrine is a powerful antipyretic, general analgesic, 
local anaesthetic, and even in small amounts has antiseptic qualities. It 
delays fermentation, and in large amounts destroys some germs. On man 
it is extremely uncertain and erratic in its effects. Even small doses have 
occasioned alarming symptoms-the chief of which is a peculiar lividity 
of the countenance, attended with profuse sweating and collapse. It 
depresses the circulation more or less in all doses; at least it cannot be 
said ever to stimulate the heart. In medicinal doses it slightly reduces 
temperature in health, but very powerfully in fevers. This effect is inde- 
pendent of sweating, occurring whether diaphoresis takes place or not, or 
when it is prevented by atropine and like agents. Reduction of tempera- 
ture is probably chiefly due to the direct effects of the drug upon the 
nervous heat-controlling mechanism of the body, most likely decreasing 
heat-production and stimulating heat-dissipation. Doses short of toxic 
have, as a rule, little effect upon respiration, nor does any appreciable 
change in the blood occur. In toxic amounts, however, methaemoglobin 
appears in the urine, the brain is first stimulated and then depressed, the 
spinal nerves, both motor and sensory, are paralyzed, and the respiratory 
centers are first stimulated, then depressed, and finally paralyzed, pro- 
ducing death. Blood pressure is increased by large doses and depressed by 
lethal quantities. The drug has been detected in the salivary secretion and 
in human milk; it may, therefore, affect nursing infants. The chief path of 
elimination is the renal, the drug appearing in the urine within 30 minutes 
and being wholly eliminated, mostly unchanged, in from 24 to 30 hours. 
It diminishes the secretion of urine, however, and decreases the output of 
nitrogenous products of tissue waste. Even in doses regarded medicinal, 
antipyrine has occasioned coldness, copious sweating, irregular heart action, 
vomiting, and other signs of depression bordering on collapse. 
The usual symptoms from physiological doses (not more than 20 
grains) are a languid and uneasy feeling, blueness of lips and finger tips, 
sometimes cyanotic pallor, dyspnoea, chilliness, cold clammy hands and very 
cold feet. Profuse general sweating follows. Hysterical phenomena are not 
uncommon, and there appears a rubeoloid eruption lasting about five days, 
followed by slight desquamation. The eruption sometimes assumes an 
erythematous character, or severe urticaria, or dermatitis, with oedema, 
or watery blebs and bloody blisters may follow its use. Occasional symp- 
toms are: tinnitus and fullness of the head similar to that produced by 
quinine, convulsions, coryza, burning in mouth and fauces, laryngeal com- 
plication, cough, gastro-enteritis, and mental dullness-more rarely vomit- 
ing, diarrhoea, stupor, general neuralgic pains, and dysuria. 
190 INDIVIDUAL DRUGS. 
A lethal dose produces dizziness and tremors, distressing head symp- 
toms, increased pulsation, profuse sweating, cyanosis, marked reduction of 
temperature, oppressed and stertorous breathing, exaggerated reflexes, 
somnolence, coma, profound insensibility, pupillary dilatation, convulsions, 
and death. The latter is due to centric respiratory paralysis. 
The treatment of antipyrine poisoning embraces the application of 
heat, resort to forced respiration, and the administration of stimulants- 
ether, alcohol, ammonia, and atropine hypodermatically. Inhalation of 
oxygen may be necessary. 
Therapy.-External. Antipyrine is a local anaesthetic and antiseptic, 
and a hemostatic of considerable power. Injected hypodermatically it 
produces local anaesthesia lasting several days. It is not likely to produce 
abscess if pure and aseptically employed-but causes at first considerable 
pain. As a hemostatic it may be used in epistaxis and to control capillary 
oozing after operations, and as an antiseptic it may be applied to small 
wounds and to cancerous and other ulcers to relieve pain. Only small 
quantities should be used and small areas so treated, lest poisonous ab- 
sorption takes place. 
Internal. Antipyrine has been used as an analgesic, nerve sedative, 
antispasmodic, antipyretic, antigalactagogue, and to restrain secretions 
from the kidneys and bowels. Its chief value is in its power to control pain 
and spasm. It markedly reduces temperature in febrile states, but the 
preponderance of fast-accumulating evidence, even in the old school where 
it has been most largely used, shows it to be wholly undesirable as an anti- 
pyretic. While its power to reduce temperature is undisputed, it is well 
known that it does not, in the least, shorten the course of any of the febrile 
disorders, and is open to the serious objection of favoring cardiac depression 
and collapse, and tends to increase the difficulty upon which many fevers 
depend in causing the retention in the system of "nitrogenous products of 
tissue waste," whose elimination is prevented by its restraining power over 
renal activity. 
It does apparent good, however, in surgical fever following operations 
and in puerperal septicaemia, with intensely high temperature. Here it 
should be employed to reduce the temperature somewhat, but it must not be 
carried too far. In the high temperature of respiratory lesions it is said to 
be of some value, as in pneumonia and pleurisy, but its employment should 
be discouraged. The special sedatives are much to be preferred. It has 
no action upon the diseased structure, except to relieve pain and lower 
temperature. Undoubtedly, the many cases of "heart failure" are due 
largely to the indiscriminate use of this and other coal-tar derivatives. 
Antipyrine has been used to control the febrile phenomena of phthisis, but 
the unpleasant and debilitating sweating produced more than overbalances 
the good it may do. Neither should its use in thermic fever (congestive 
form) from sun-stroke be encouraged, as has been advised, and it should 
never be employed in that from heat exhaustion. 
Diarrhoea, diabetes mellitus and insipidus, and other excessive secre- 
tions, except of the skin, have been restrained by its use. Epilepsy, purely 
functional, tetanus, asthma, and other spasmodic disorders, have been 
treated by it with both success and failure. Chorea and whooping cough, 
191 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
however, seem to be more amenable to it, and it is accredited with easing 
the paroxysms and shortening the duration of the latter disease. 
Its best field of action is in painful and spasmodic disorders. In 
migraine and other forms of headache, especially of neuralgic character, it 
is especially effective. However, much danger attends its constant em- 
ployment, as prolonged prostration and debility have followed such use. 
It is unquestionably cumulative. It is used largely to control pain in 
sciatica, tetanus, dysmenorrhcea, gravel, locomotor ataxia, neuritis, rheu- 
matism (muscular and articular), arthritis (rheumatic), gout, angina pectoris, 
renal and hepatic colic, syphilis, neuralgia of zoster, and to allay itching 
and burning pain of cutaneous disorders. Palpebral neuralgia, sclero- 
choroiditis, episcleritis, iritis, keratitis, irido-choroiditis, pain after cataract 
operations, toxic amblyopia, and floating bodies in the vitreous humor, are 
among the eye affections in which it has been used, though it is not looked 
upon with special favor by our ophthalmologists. 
The large doses formerly recommended-75 to 90 grains and sub- 
sequently 15 to 50 grains-are never now given. The dose should not, at 
any time, exceed 15 grains, and 5 grains is about the best dose for average 
purposes. For young children give 1 grain every hour until 3 doses have 
been taken. It may be administered in mint water, aromatic syrup, or 
coffee. Subcutaneously, 5 grains is the safest maximum dose. It has also 
been given by enema and suppository. Tablets are unsatisfactory as they 
often fail to disintegrate. 
The virus of the Apis mellifera, Linn&, or Common Honey Bee. 
Preparation.-Specific Medicine Apis. Dose, 1/30 to 5 drops. 
Specific Indications.-Constant desire but inability to urinate, the 
urine being deep-red; vesical and urethral irritation, with scanty secretion 
of dark red urine; hot, dry, burning, itching or stinging surfaces; itching 
with burning of the surface, particularly of the urinary passages and 
genitalia; puffiness, especially of the mucosa, as if stung, with or without a 
tendency to oedema; hives; faucial and tonsillar inflammation, with marked 
oedema, the tissues appearing like bags of clear water. 
Action and Therapy.-Apis is decidedly diuretic and probably somewhat 
alterative and diaphoretic. Small doses of it relieve irritation of the urinary 
tract and this is its most specific effect. Larger doses stimulate the kidneys 
and cause an increased flow of urine. Even though inflammation exists, the 
small dose is effectual in allaying irritation. The most direct indications 
for apis are the hot, dry, burning or itching surfaces, and the constant 
desire to urinate, the urine being concentrated and of a deep-red color. 
Under these circumstances it is one of the most certain of diuretics. It 
may be used both in suppression and retention of urine, from atony. It is 
very useful for urethral and cystic irritation, both in man and woman, when 
there is burning or stinging pain, and constant and annoying tenesmus. 
For that form of cystic irritation, with frequent calls to urinate, experienced 
by women, from sudden checking of cutaneous secretion, or just after 
menstruation, it is one of the most valuable of medicines. Sometimes it is 
greatly aided by eryngium or gelsemium, as indicated. By its power of 
APIS. 
192 INDIVIDUAL DRUGS. 
relieving renal irritation and engorgement, thereby increasing function, it 
often aids in relieving in anasarca, ascites, and hydrothorax when the kid- 
neys are not diseased, and the watery accumulations are not due to malig- 
nant and other organic changes. Though often a self-limited disorder, apis 
hastens the removal of post-scarlatinal dropsy, and in both measles and 
scarlet fever it relieves the urinary irritation and skin discomfort so often 
present. Occasionally it gives relief in cystitis, and rarely in chronic 
nephritis, though it does not cure the latter. 
Apis is invaluable in oedematous sore throats, and in those in which 
puffiness apparently involving the submucosa appears. The angina of 
scarlet fever is sometimes of this type. In that form of rheumatism having 
the specific indications for apis, it proves a valuable adjuvant to other 
treatment. 
In some skin affections apis is extremely useful. It has no peer in 
most cases of acute urticaria, when there is much soreness and itching. 
It relieves swollen oedematous pudenda and vulvar inflammation, while in 
vesicular erysipelas it is a medicine of prime value. The parts are tensive, 
burning, or stinging, with lancinating pain and marked dermal irritation. 
Apis is the most satisfactory agent we have used for the urticaria following 
the use of antitetanic serum. 
Apis has a limited place in gynecological medicine. In simple acute 
ovarian congestion and inflammation, and sometimes in menstrual ir- 
regularities, associated with genital puffiness and pudendal itching, and a 
sense of fullness and tenseness, apis serves a very useful purpose. 
APOCYNUM. 
The root of Apocynum cannainnum, Linne (Nat. Ord. Apocynaceae) gathered in 
autumn after the leaves and fruit have matured. Grows throughout the United States. 
Dose, 1 to 20 grains. 
Common Names: Bitter Root, Canadian Hemp, and improperly, Indian Hemp. 
Principal Constituents.-A resinous principle-apocynin, and a yellow glucoside, 
apocynein; and apocynamarin, or cyno toxin, or cymarin, all of which resemble digitalis 
glucosides in action. 
Preparations.-1. Specific Medicine Apocynum. Dose, 1/4 to 20 drops. Usual 
form of administration: I) Specific Medicine Apocynum, gtt. x to 5j; Water, giv; Mix. 
Sig. One teaspoonful every 1 to 3 hours. 
2. Decoctum Apocyni, Decoction of Apocynum (root to Water, Oj). Dose, 
1 to 2 fluidrachms. 
Specific Indications.-Watery infiltration of cellular tissue-oedema 
-with weak circulation and general debility; skin blanched, full, smooth, 
and easily indented; puffiness under the eyes; eyelids wrinkled, as if parts 
had been recently swollen; feet full and oedematous, pitting upon pressure; 
constipation, with oedema; urine scanty and circulation sluggish; boggy, 
watery uterus; full relaxed uterus with watery discharge; profuse menor- 
rhagia, too often and too long continued; passive hemorrhages, small in 
amount and associated with pedal oedema; mitral and tricuspid regurgita- 
tion, with rapid and weak heart action, low arterial tension, difficult 
breathing, cough, and tendency to cyanosis. 
Action.-Apocynum acts powerfully upon the heart, slowing its action 
and raising arterial tension. The cardiac muscle appears to be directly 
stimulated by it as are probably the arterial coats. Contraction of the 
renal arteries also takes place, so that while less blood passes at a time 
193 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
through the kidneys, the act of filtration is more perfect and marked 
diuresis results. Though long known that diuresis was one of its most 
prominent results, the knowledge that this is due to the better cardiac 
pressure and arterial tonus, rather than to the increased intrinsic secreting 
power of the renal glomeruli, is the result of pharmacologic investigation in 
recent years, particularly the work of Horatio C. Wood, Jr. The general 
effects upon man of full doses of apocynum are nausea, and sometimes 
vomiting and purging, succeeded by copious sweating. The pulse is then 
depressed, and in some a disposition to drowsiness is observed until relieved 
by vomiting. The powdered drug causes sneezing. The small doses em- 
ployed in Eclectic therapeutics seldom occasion any of the above-named 
symptoms save that of severe watery purging, which may occur suddenly, 
when the drug has been administered persistently for several weeks. 
Therapy.-No remedy in the Eclectic materia medica acts with greater 
certainty than does apocynum. In former times it was employed in heroic 
doses chiefly for its hydragogue cathartic and diuretic effects. Early in 
the last century it was employed by the botanic practitioners for the relief 
of dropsy. Later the Eclectic school developed its specific uses in dropsy 
and affections of the heart and circulation. Like many similar drugs, the 
powder was employed as a sternutatory in the days when it was believed 
that such effects as the increasing of the nasal discharges was the best way 
to relieve headaches and certain catarrhal affections. Again, it was recom- 
mended in diaphoretic doses, for the relief of intermittent and remittent 
fevers, and in pneumonic involvements, conditions in which it is now seldom 
or never thought of. It is rarely employed nowadays as a cathartic, and 
then only in dropsical conditions, as other hydragogues have been similarly 
used. Such is the use of it advocated by the authors of the regular school 
of medicine, by those who use it at all; and from such a use arises the 
criticisms frequently indulged in in condemnation of the drug. Eclectics 
do not use it in this manner. Specific medication has established that 
this action is not necessary, for when specifically indicated it promptly 
removes effusions without resorting to cathartic doses. Consequently it 
finds little use as a cathartic, except very rarely as recommended by Goss, 
for the removal of ascarides. 
To use apocynum intelligently and successfully, the prescriber must 
recognize, first, that debility is the condition in which it exerts its specific 
and beneficial effects-debility of the heart and circulatory apparatus, of the 
kidneys, of the capillaries of the skin particularly. In such a state it will 
prove a remedy; under opposite conditions it is likely to prove an aggrava- 
tion. The patient with a strong, rope-like, hard, and quick pulse is not the 
patient for apocynum. On the other hand, the feeble pulse, soft and of 
little force, indicates its selection as the remedial agent. The atonic state 
which readily permits of exudation from the blood vessels is the ideal 
condition which we seek to remedy with apocynum. It is a vascular stimu- 
lant. Such results one would not expect to obtain if there were circulatory 
obstruction or active fever. The only apparent exception, in which it is 
adapted to active conditions, is that reported by Webster of its efficacy in 
active inflammation of the upper pharyngeal and post-nasal tract, where, he 
declares, it rivals phytolacca in its results. One can not expect apocynum 
194 INDIVIDUAL DRUGS. 
to reconstruct wornout tissues or to restore damaged vascular valves. 
We must not hope to work miracles with it where there are such structural 
lesions as incurable or malignant organic diseases of the heart, liver, or 
kidneys. Yet in these conditions, when debility and subcutaneous, watery 
exudation are strong factors, it alone is a powerful remedy to relieve urgent 
symptoms and to put into action that portion of sound tissue that remains. 
The most we can hope for is an amelioration of the symptoms, and a notable 
decrease of the watery accumulation may be looked for. Under these cir- 
cumstances we have removed enormous dropsical swellings with it, giving 
quick relief from dyspnoea and thereby allowing the patient to obtain rest 
in the recumbent position. Still it did not cure, and in many such instances 
death mercifully removes the victim before extensive infiltration can again 
take place. Digitalis, cactus, strophanthus, and convallaria often aid its 
action. It is a singular circumstance, mentioned by Krausi, and which we 
have also observed, that apocynum seldom has any effect upon patients 
who have been subjected to paracentesis. In our opinion this is due to the 
advanced stage of the disease, usually reached by the time it is necessary 
to tap; for tapping is seldom regarded a curative measure, and is resorted 
to in the later stages of ascites to give temporary relief. It is then too late 
for any drug to gain a satisfactory foothold. Moreover, apocynum is less 
effective in ascites than in oedema or anasarca, for the latter is most likely 
to depend upon circulatory failure, whereas the former may depend most 
largely upon malignant or obstructing tumors. 
The chief indication for apocynum is watery fullness of tissues as if 
infiltrated and accompanied by debility. This may be shown in the puffy 
eyelids, the swollen feet and ankles or other parts, which pit upon pressure. 
The skin is usually blanched, sometimes streaked with pinkish lines, full, 
smooth, and glistening. If the case be chronic or subacute, the more active 
the drug appears. With these conditions it may confidently be relied upon 
to cure curable cases or to give relief in incurable maladies, whether they are 
revealed in simple oedema or anasarca, ascites, or dropsy of any of the 
serous cavities, or dropsy following scarlatina or malarial poisoning. In 
both of the latter conditions it is unusually effective. When such accumula- 
tions, functional in origin and due chiefly to vascular weakness, accompany 
atonic stomach and bowel disorders, as gastric and intestinal dyspepsia, 
and in syphilis, it is a signally useful drug. In rheumatism, arthritis, and 
sciatica, with oedema, or even if but slight puffiness of the part be present, it 
renders valuable aid to antirheumatics or other appropriate remedies. 
Acute and chronic hydrocephalus, with spreading sutures, protruding 
fontanelles, and puffy eyelids, have yielded to the curative action of apocy- 
num. It has been recommended in cerebro-spinal meningitis during the 
stage of effusion. In watery leucorrhcea, passive menorrhagia, irritable and 
congested uterus, prolapsus uteri, uterine subinvolution, and in some cases 
of amenorrhoea, in all of which debility is marked and the pelvic tissues are 
heavy, lax, and sodden, and there is slight infiltration about the ankles, 
apocynum has cured when remedies ordinarily directed in gynaecological 
practice have failed to relieve. For the renal congestion of the second 
stage of tubular nephritis Gere found it to be the best remedy. Others 
assert its usefulness in the nephritis of pregnancy with albumen in the 
195 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
urine. Our experience with apocynum leads us to believe it less valuable 
in dropsies with albumen waste than in those without it but dependent 
most largely upon circulatory embarrassment. 
Apocynum is of very great value in diseases of the heart and circulation 
-a fact recognized and acted upon in Eclectic therapy years ago. Its action 
in giving tone to the heart muscle and vessels, and its use in cardiac disorders, 
was the subject of comment by Scudder, Locke, Ellingwood, Freeman, 
Waterhouse, Webster, and others. Angina pectoris, attended with oedema, 
and praecordial oppression of smokers, are relieved by it. Krausi calls at- 
tention to its utility in mitral regurgitation, and speaks of it as the king of 
remedies in tricuspid regurgitation, with rapid and feeble cardiac action, 
low arterial tension, cough, dyspnoea, pulsating jugulars, general cyanosis, 
scanty and high-colored urine, and general dropsy. He also refers to it as 
giving no special aid in aortic diseases. 
The observation made by Krausi that apocynum increases secretion and 
excretion by way of the kidneys, whereas digitalis, after twenty-four hours, 
causes a retention of urea, is an important one, and should not be lost sight 
of. This ought to make it a valuable agent in uraemia and conditions de- 
pending upon faulty elimination of that body. Within a few years the 
internal and the hypodermatic use of apocynum directly upon the nerve is 
said to have promptly relieved sciatic neuritis. 
The observations of a single reporter on the use of the first dilution of 
apocynum in not over one-drop doses every two hours as a remedy for 
obesity, is worthy of consideration and seems rational as the classic in- 
dications are noted. However, one must not be too optimistic concerning 
the power of a medicine to reduce fat, nor must anasarca be mistaken for 
obesity. In these cases the pulse lacks strength, though it is rapid; the 
temperature is inclined to subnormal in the morning and slightly above 
normal in the evening; the tongue has a dirty-white coating; the appetite 
is poor, the abdomen full and doughy to the touch; and there are gaseous 
eructations from the stomach and expulsion of flatus from the bowels. 
Occasionally there are night-sweats, and the ever-present indication for 
apocynum, oedema of the extremities, is constant. 
APOMORPHINjE HYDROCHLORIDUM. 
Apomorphine hydrochloride.-(Formula: C17 Hn NO2 HC1). 
The hydrochloride of an artificial alkaloid prepared from morphine by dehydration. 
Description.-Very small, white or grayish-white, shining needle crystals, acquiring 
a greenish tint upon exposure to light and air, of a feebly bitter taste, no odor, and soluble 
equally in water and alcohol (about 45), but sparingly soluble in chloroform and ether. 
It should be kept in small, dark, amber-colored bottles. Only the crystalline form should be 
used; an amorphous form is said to contain dangerous impurities. Solutions of apomor- 
phine acquiring an emerald-green color (in 100 parts of water) should be rejected; and 
solutions for use should always be freshly prepared. Dose, as expectorant, 1/200 to 1/30 
grain; as an emetic (by mouth), 1/20 to 1/8 grain; hypodermatically, 1/12 to 1/8 grain. 
Children should not be given doses to exceed 1/24 grain. 
Specific Indications.-To provoke prompt emesis in the early stage 
of alkaloidal and other forms of acute poisoning. 
Action.-A dangerously depressing drug, sometimes producing death 
in very small doses. The chief effects are pronounced sedation, circulatory 
depression, dizziness, pallor, cold sweat, and profound collapse, with loss 
196 INDIVIDUAL DRUGS. 
of consciousness. Usually, however, copious vomiting takes place, and the 
foregoing symptoms are then relieved. Sometimes, after emesis, dangerous 
syncope may occur; and rarely deep sleep and faintness may follow if 
emesis does not result. Stimulants should be given and heat applied in 
cases of collapse from its use. 
Therapy.-This salt was first produced by Matthiessen and Wright in 
1869. It is the promptest, and usually indicated, emetic for the early stage 
of alkaloidal and other forms of acute poisoning when the stomach pump 
is not available, or cannot be employed. As its action is centric it should 
be used hypodermatically (1/8 gr.), and vomiting usually results almost 
immediately. In narcotic poisoning, if not used before absorption has 
taken place, it may fail to produce emesis. When not contraindicated by 
debility it may be employed to unload the stomach of offending food 
causing spasm or gastralgia. Emetic doses of it sometimes cut short 
attacks of hysteria, hystero-epilepsy, hiccough, and relax rigid os uteri; 
and small doses have been recommended to subdue acute maniacal delirium 
and delirium tremens and thus produce sleep. It is frequently used also 
as an expectorant, but on account of its tendency to provoke profuse 
watery bronchial secretion its selection is inadvisable, except in occasional 
cases of acute bronchitis and broncho-pneumonia, chronic catarrhal bron- 
chitis, and bronchial asthma, when extreme dryness of the membranes is 
present. Apomorphine is often effectual to empty the stomach in acute 
alcoholism, when the subject is robust and there is no evidence of im- 
pending circulatory failure or pulmonary oedema. Eclectic physicians 
rarely employ it except as an emetic in poisoning; and it should never 
be used upon children (upon whom it acts badly) for any purpose, if other 
emetics can be made to act. Besides, the Eclectic materia medica is too 
rich in effective and safe expectorants to risk the employment of an agent 
so dangerously depressant as apomorphine. 
AQUA AMMONIAS. 
Ammonia Water. 
An aqueous solution of about 10 per cent of NHS. 
Description.-A colorless, clear liquid, having a strongly alkaline or caustic taste and 
the characteristic pungent odor of ammonia. It turns litmus paper blue. Readily soluble 
in water. As Ammonia Water deteriorates, it must be kept in glass-stoppered bottles 
made of hard, lead-free glass, and in a cool place. Dose, 5 to 30 minims, largely diluted. 
Specific Indications.-Shock, collapse, and depression, with feeble 
circulation, dyspncea and cold, clammy skin; asphyxia from suffocating 
gases; as a stimulant in poisoning by depressing drugs (see also Ammonii 
Carbonas). Pallor, livid lips, dilated or immobile pupils, and weak circula- 
tion; depression from stings and bites of insects and serpents. 
Action and Toxicology.-Internally small doses of ammonia water 
do not sensibly affect the healthy individual, but are prompt in showing 
their effects in low states of the nervous system. Tension in the head, 
exhilaration of spirits, increased strength with greater activity of the skin, 
and functions of the kidney and bronchi, are observed. These effects are 
not followed by depression. (For other effects of ammonium salts, see 
Ammonii Carbonas.) 
197 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Stronger ammonia water applied to the skin occasions heat and burning 
pain, with redness and vesication. If in large amounts and long applied, 
a painful and gangrenous ulcer results, difficult to heal. The vapor inhaled, 
produces sneezing, coughing, burning of the nasal passages and increased 
lachrymation, and in contact with the eye causes burning pain and con- 
junctivitis. The inhalation of the gas, if strong and in sufficient quantity, 
may produce choking, inflammation of the mouth and broncho-pulmonic 
tract, and quickly causes oedema of the glottis, with death resulting from 
asphyxia in a very few minutes. If the person is unconscious, the inhalation 
may cause death by asphyxiation. 
When swallowed large doses cauterize the parts over which they pass, 
and visceral inflammation, with local oedema and destruction of tissue, 
follows. If oedema of the glottis has not taken place, death may be delayed 
for several hours. Death may be produced by very moderate amounts, 
while the swallowing of excessive quantities has been followed by recovery. 
If the patient survives, convalescence may be tedious and protracted. 
The antidotes to ammonia are diluted acids-vinegar, lemon, or orange 
juice; sour cider, and acetic and hydrochloric acids. If used at once, they 
prove effective by converting the ammonia into harmless salts. If not 
used early cauterization will have occurred, and only further action can be 
stopped by them. Bland oils may retard action by saponification of the 
ammonia, and milk may retard by diluting the poison and protecting the 
surfaces. Gastro-enteric symptoms must be met by the usual methods, 
with lenitives and protectives; and opiates to subdue pain. In poisoning 
by inhalation, the best antidote is the vapor of hydrochloric acid cau- 
tiously inhaled. 
Therapy.-External. The vapor of ammonia water, inhaled, is com- 
monly employed as a quick-acting stimulant to revive persons from fainting, 
asphyxia, and sudden collapse from shock and circulatory and respiratory 
failure. It is also inhaled for the relief of the nervous headache of anemia 
and debility, palpitation of the heart, and hystero-epileptic attacks. When 
given by inhalation to unconscious persons great care must be taken not to 
administer it too freely or too close to the nostrils lest its irritant action 
produce inflammation and oedema of the upper respiratory tract. Am- 
monia is of great service in poisoning by depressing drugs. It should be given 
by inhalation, internally and intravenously, as indicated. By intravenous 
injection ammonia water has promptly antidoted the toxic effects of 
hydrocyanic, privy, and illuminating gases, and extreme alcoholic intoxica- 
tion. The vapor of ammonia cautiously inhaled is the antidote to poison- 
ing by inhalation of bromine. 
Ammonia water is rubefacient and may be applied, with local re- 
striction, for derivative effects. It should not be allowed to blister. It 
forms a useful topical application to stings of bees and wasps and to bites 
of reptiles, spiders, bed-bugs, fleas, and other insects. The following pro- 
cedure gives the most relief of any means we know of for the irritating 
pruritus caused by attacks of the almost invisible summer pests, such as 
"chiggers," mites, and other tormentors. Strip and prepare for a general 
bath and plunge beneath the water so as to wet the whole body. Have at 
hand a solution of 2 or 3 ounces of ammonia water in a quart of warm water. 
198 INDIVIDUAL DRUGS. 
Quickly sponge the body with this solution and immediately immerse and 
proceed with the bath. This relieves the distressing itching and irritation 
and probably kills any of the living insects that can be reached by the 
treatment. For the lesions where "chiggers" have burrowed, full strength 
ammonia water touched upon the spot gives relief. 
Ammonia water is a component of many stimulating liniments for 
contusions, swellings, superficial aching, and neuralgic and rheumatic pains. 
If not actually beneficial to the flesh, its strong odor and the glow produced 
have at least a strong psychologic value. It is frequently admixed with 
olive oil, for this use, and sometimes with turpentine, camphor, yolk of egg, 
and other substances. The area of application of such liniments should not 
be too closely covered for fear of producing blisters. Nor should they be 
allowed to come in contact with the scrotum on account of the agonizing 
pain they cause upon that specialized form of skin. 
Internal. In medicinal doses, diluted ammonia is one of the quickest 
and most satisfactory diffusible cardiac and respiratory stimulants. As 
such it is largely used in cases of depression, shock, and collapse with 
threatened failure of the heart-action and breathing. Its effects, however, 
are very transient, but last long enough to tide the patient over critical 
periods until more lasting stimulants can be made to act. It may be 
exhibited in the cardio-respiratory failure following general anaesthesia, in 
syncope, asphyxia, tendency to spasm from difficult breathing, spasmodic 
asthma, hysteria, and hystero-epilepsy. As an antacid in sour stomach its 
action is positive and it similarly helps disorders caused or augmented in 
severity by such gastric perversion, as sick headache, heart-burn, palpita- 
tion of the heart, and spasms. In the collapse and gastric disorders re- 
sulting reflexly from the retrocession of cutaneous eruptions it frequently 
aids by restoring the eruptions and by stimulating the patient generally. 
Its employment in the depression from poisonous bites is common practice. 
It should not be injected subcutaneously on account of its tendency to 
cause abscess. When used intravenously a vein in the leg should be selected 
so that the heart may not be suddenly stopped by direct contact with the 
ammonia. For its effects in low fevers and other conditions of depression 
it may be used for the same indications that prevail when ammonium 
carbonate is effective. In fact, for most purposes they may be used inter- 
changeably. (See remarks under Ammonii Carbonas.) 
AQUA HYDROGENII DIOXIDI. 
Solution of Hydrogen Dioxide, Solution of Hydrogen Peroxide.-(Formula: H2 O2). 
Description.-An odorless and colorless liquid, having a slightly acidulous taste, and 
producing a peculiar sensation and froth in the mouth. It should not be heated on account 
of its tendency to decompose. Age and protracted agitation also cause it to deteriorate. 
A fresh preparation should always be demanded. 
[Concentrated hydrogen dioxide is a colorless and odorless, bitter and astringent 
liquid, capable of irritating, bleaching and blistering the skin. It mixes with water in all 
proportions. The above preparation contains about 3 per cent, by weight, of the con- 
centrated dioxide, or the equivalent of 10 volumes of available oxygen.] 
Action.-Hydrogen dioxide is a powerful oxidizer yielding oxygen to 
all oxidizable substances, especially blood, pus, and other body-fluids, 
giving off its gas so profusely that brisk effervescence or foaming occurs. 
199 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
This makes it a useful cleansing and deodorizing agent. It is non-poisonous, 
externally used, and is an antiseptic of fleeting power, as it acts only so long 
as it is giving off oxygen, an evolution very rapidly accomplished. It 
probably destroys pus germs. At any rate it is most active in disintegrat- 
ing pus and it dissolves false membranes. It also softens cerumen. When 
injected into the system it is dangerous, causing paralysis or death by the 
formation of emboli. Taken into the stomach it is probably of little action, 
for it is so readily decomposed that in all probability it is destroyed by the 
contents of that viscus. That it imparts oxygen to the blood when so ad- 
ministered lacks satisfactory proof. It is decidedly antiputrefactive, 
checking putrefaction only after it has begun, and is of no use to prevent 
such changes on account of its instability in contact with tissues. It 
leaves a film of coagulated albumen after its foaming action, and is therefore 
of less value in fresh wounds on account of searing over the surface than in 
old wounds in which it destroys unhealthy secretions. Hydrogen peroxide 
is a common bleaching agent to "blondine" the hair. 
Therapy.-External. Hydrogen dioxide is the best and most rapid 
pus destroyer. It is non-toxic and may be applied freely to open surfaces, 
either full strength or diluted for this purpose. It should never, however, 
be forced into or applied to cavities without a large or free outlet, for the 
enormous distention of liberated gas will force infection into parts beyond the 
already infected area. It should, therefore, seldom be used in the aural 
canal, lest pus be forced into the attic and mastoid cells, or in the urethra 
for fear of spreading infection into the prostate or bladder. Used properly 
and with possibility of free exit it is a most valuable agent for the one great 
purpose of destroying and forcing out pus from pus-infected areas. It has 
no practical value in freshly incurred wounds or injuries, a practice so com- 
mon among the laity. The fleeting character of its antiseptic action pre- 
cludes all possibility of its usefulness in such conditions. It can have no 
other value here than that of forcing out blood and detritus-materials 
that can be removed better by other means. 
For putrid and pus-bathed surfaces and ulcers hydrogen dioxide is dis- 
tinctly valuable. It is one of the very best cleansing applications both to 
destroy and remove false membrane. It should be used with a swab or 
sprayed from a glass-tipped atomizer. Metal tips decompose the dioxide. 
In ozaena it deodorizes and cleanses, but unless there is free exit for the gas 
it will cause some discomfort. The mouth should be kept well open while 
using that no infection be forced into the eustachian passages and the an- 
trum. It should also be used in the nose in small amounts, well diluted, 
and slowly applied lest frontal sinus and ethmoid infection result. When 
other agents not possessing this expansile power can be used they should 
be selected in preference to the dioxide. It is a useful spray for all forms of 
tonsillitis, infectious sore throat, and the angina of scarlet fever. It 
cleanses purulent discharges from the eyes, and fetid secretions from the 
mouth and that arising from fetid bronchitis. As a toilet wash for the 
mouth it is useful in tuberculosis of the lungs and throat; used in pyorrhea 
it helps to dislodge and cleanse the pus from the infected dental sockets. 
If the teeth have cavities or fillings it may cause some pain. 
200 INDIVIDUAL DRUGS. 
Boils, carbuncles, abscesses, open sinuses (except where extension of 
infection can be made to reach delicate organs) may be treated with it. 
It cleanses chancres so that indicated treatment may be more effectual. 
In gonorrhoea in the female it is very valuable to precede a thorough douch- 
ing with hot water, after which irrigation with solution of permanganate of 
potassium may be performed. It is of doubtful safety in gonorrhoea in the 
male for obvious reasons, and we should hesitate to use it in the bladder or 
uterus, or in disorders of the ears. The stings of insects are said to be 
rendered painless by spraying hydrogen dioxide on the lesions. 
Fresh powder stains may be removed by the application of this agent, 
if the powder-pockets be well opened to allow the extrusion of the blackened 
particles by the expansion caused by the gas. This solution bleaches hair 
to a light yellow, and is sometimes used to remove morph. It is also said to 
restrain the excessive growth of hair in hirsuties. Hare declares it is the 
best agent to soften plaster-of-Paris dressing to allow of easy cutting, and 
for the painless removal of adhesive plaster, spraying close to the junction 
of skin and plaster as the latter is being pulled off. 
Internal. We can conceive of no conditions under which hydrogen 
dioxide should be useful as an internal medicine. It is not, however, 
poisonous when so given, and it has been said to give relief in obstinate 
vomiting, administering it in small sips at a time. Ellingwood argues in 
favor of its use in the drinking water for typhoid fever patients, and the 
employment of it in a 10 per cent hot water enema occasionally to wash out 
the bowels. Under these conditions we would fear distention of the bowels 
with possible rupture of the ulcerated portions of the intestines. He also 
advises it in disorders of children, with fetid diarrhoea, bad breath, or 
tympanites. 
AQUA ROSAL. 
Rose Water. 
Stronger Rose Water mixed with an equal part of distilled water, immediately before 
dispensing. 
Description.-A clear aqueous preparation having the pleasant odor of roses. [Stronger 
Rose Water is a saturated, aqueous distillate from the flowers of the hundred-leaved rose 
(Rosa centifolia, Linne, Nat. Ord. Rosaceae). It is colorless and should have only the odor 
and taste of fresh rose petals.] 
Action and Therapy.-External. A cooling, non-irritating and slightly 
astringent collyrium. As a perfume preparation it is of much value in 
cosmetic lotions and washes, and the Stronger Rose Water (Aqua Rosae 
Fortior) is an ingredient of Ointment of Rose Water (Unguentum Aqua 
Rosa), or so-called Cold Cream. Equal parts of Rose Water and Glycerin 
is a favorite perfumed lotion for chapped hands, lips, and face. 
The bark of the root of Aralia hispida, Linne (Nat. Ord. Araliacese). A perennial 
undershrub of the eastern section of the United States. Dose, 1 to 30 grains. 
Common Names: Dwarf Elder, Wild Elder, Bristle-stem Sarsaparilla. 
Preparations.-1. Specific Medicine Aralia. Dose, 1 to 30 drops. 
2. Decoctum Araliae, Decoction of Aralia (5 ss to water, Oj). Dose, 2 to 4 fluidounces. 
Specific Indications.-Anasarca and oedema, with constipation. 
Action and Therapy.-Sometimes a surprisingly effective agent for the 
removal of anasarca dependent chiefly upon renal inactivity or renal 
ARALIA. 
201 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
irritation. Moreover, it often fails. It is, however, useful as a mild renal 
stimulant and laxative, and occasionally gives a good account of itself in 
the treatment of gravel. 
The root of Aralia racemosa, Linne (Nat. Ord. Araliaceae). Found in rich woodlands 
and rocky situations in the eastern half of the United States. 
Common Names: Spikenard, American Spikenard, Spignet, Pettymorrel. 
Principal Constituents.-Resin and a trace of an aromatic volatile oil. 
Preparation.-Specific Medicine Spikenard. Dose, 5 to 40 drops in syrup or water. 
Specific Indications.-Irritative cough of debility with excessive secretion. 
Action and Therapy.-A pleasant aromatic stimulating expectorant 
for chronic pulmonic affections, with cough from marked irritation and 
excessive catarrhal secretions. The syrup is a really valuable cough remedy 
in greatly debilitated subjects. When used in very small amounts the 
specific medicine is an agreeable flavor for syrupy cough mixtures. A 
number of apocryphal uses have been recorded for it, but outside of its 
good effects upon the respiratory and renal mucosa it has nothing to com- 
mend it. 
ARALIA RACEMOSA. 
ARGENTI NITRAS. 
Silver Nitrate.-(Formula: Ag.NOs). 
Description.-Transparent colorless crystals, odorless but having a bitter, caustic 
and metallic taste. If in contact with organic material, or the crystals are exposed to light, 
they deepen to gray or grayish-black in color. Readily soluble in water, less so in alcohol, 
and scarcely in ether. Dose, 1/20 to 1/4 grain. Seldom employed internally in Eclectic 
practice. 
Preparation.-Argenti Nitras Fusus, Moulded Silver Nitrate. Fused Nitrate of Silver. 
Lunar Caustic. White cones or pencils, otherwise possessing the characteristics of silver 
nitrate, of which they contain about 95 per cent. Used as a cauterant. 
Action and Toxicology.-Applied to the tissues silver nitrate precipi- 
tates albumen and coagulates fibrin, an albuminate of silver being formed. 
This leaves a filmy white pellicle, which upon exposure to light becomes 
dark and quickly dries. Its application causes intense smarting or burning 
pain. Ulceration and sloughing may follow its use as a caustic, but the 
mitigated stick and the solutions are very superficial in action, penetration 
being limited by the deposited albuminate. Silver salts turn the tissues 
dark or black, which stains may be permanent if their applications are often 
repeated. The internal effects of silver salts, after absorption, upon the 
nervous system, circulation,' respiration, and other vital processes are not 
well determined. 
When swallowed, pain, burning, and vomiting, and other distressing 
symptoms of an irritant poison are experienced. The vomitus is dark 
colored, or turns dark upon exposure to light. The lips and membranes, 
at first whitish, rapidly turn black. There may be cold, clammy sweat, 
feeble pulse, anaesthesia, unconsciousness, loss of muscular power, and 
convulsions. Death takes place either from gastro-enteritis or from respira- 
tory paralysis of centric origin. 
The chemical antidote for poisoning by silver salts is chloride of 
sodium or common salt. It forms an insoluble chloride of silver. The 
stomach-pump mav be used, or an emetic if it will act. Heat should be 
202 INDIVIDUAL DRUGS. 
applied to the body. Opiates may be needed to quiet pain, and demul- 
cents, such as milk, starchwater, and oils, may be given to retard the action 
of the silver, to protect the membranes and to relieve irritation. 
Argyria.-The chief effects from its long continued use, even in small 
doses, is a peculiar dark shade of the conjunctivae, and a dark line upon the 
gums, followed by a dingy slate-colored discoloration of the skin, giving a 
peculiar cadaverous appearance. This condition, known as argyria, is 
permanent, and though iodide of potassium and other agents have been used 
for its removal, little success has attended such efforts. This phenomenon 
is produced by the deposition of metallic silver, or some of its organic salts, 
in the pigmentary layer of the skin. The deposit takes place in every 
tissue of the body except the epidermis. 
Therapy.-External. Silver nitrate is a superficial escharotic, and in 
solution sedative and astringent. It is one of the few metallic astringents 
that may be applied no matter how great the inflammation. As an es- 
charotic it should be employed only for superficial destruction. For deep 
cauterization it has no value; nor should it be applied in deep wounds, 
narrow cavities, or sinuses. It is no longer used as a delimiting agent in 
erysipelas and is less valuable as an application than tincture of chloride 
of iron. 
In full strength, or as mqulded nitrate, or in strong solutions, it may be 
used to destroy warts, fungous granulations, and upon spongy gums, 
chancres, sluggish ulcers, canker sores, fissures of the tongue and lips, 
septal ulcers, mucous patches, and to cauterize uterine ulceration and 
erosion, with free discharge and boggy tissues. Applied to the punctured 
pustules it is said to prevent pitting in small-pox. 
By encircling boils with it and touching the crown of the lesions 
it may abort the furuncles, especially of the eyelids and aural canal. A 
strong solution (25 per cent) is said to abort felons, orchitis, and 
epididymitis. 
A 4 or 5 per cent solution may relieve itching of the vulva and anus. 
A 25 per cent solution or the moulded caustic may be used to cauterize and 
stimulate healing in rectal fissure. Strong solutions are less painful than 
weak ones. A reddened surface with threatened bed sores may be treated 
with a 2 to 4 per cent solution with the probability of preventing erosion. 
Silver salts are fatal to the gonococcus. A weak solution (2 to 4 per 
cent) may be used as a douche in gonorrhoea of the female, after first 
swabbing the vaginal walls with a solution of similar strength. It is also 
used as an initial injection for gonorrhoea in the male. If it does not help 
at once, it usually aggravates the discharge. Organic silver salts-protargol, 
argyrol, silvol, etc., and similar semi-proprietary preparations-have largely 
supplanted the nitrate for this purpose though they are less energetic. 
Silver nitrate in 1 per cent solution is instilled into the eyes of the 
newborn to prevent ophthalmia neonatorum, and a 2 per cent solution after 
infection has taken place. This prophylactic precaution (practically 
Crede's method) of the use of silver or similar salts in the eyes of the new- 
born is now required by law in many States of the Union. Weak solutions 
of silver nitrate are very useful in purulent conjunctivitis and constitute the 
best treatment for gonorrhoeal ophthalmia. In trachoma a 25 per cent 
203 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
solution may be painted upon the granulations and its excessive action 
checked by a solution of common salt. Silver salts should not be used in 
the eye unless the cornea is intact, for fear of producing a permanent 
corneal opacity as a result of the deposition of silver. 
In 1/4 to 4 per cent solution silver nitrate is reputed effective in ca- 
tarrhal and chronic suppurative otorrhea. It should not be dropped in the 
ear, but used by means of a suitable applicator. Neither should the use of 
the stick be attempted in the ear lest it break and a portion become lost in 
the middle ear. The salt may, however, be fused upon a platinum wire and 
thus used to lightly touch the edges of a perforation of the drum membrane. 
It usually causes prompt healing and closure. Aural polypi may be re- 
moved by silver nitrate. 
In certain skin diseases silver nitrate may be used very effectively to 
control itching and destroy parasitic organisms. It has been employed 
successfully in various types of tinea, in prurigo, lichen, psoriasis, chronic 
eczema, eczema of the external auditory canal, and pemphigus, employing 
solutions ranging from 2 to 4 per cent in strength. Itching of the aural 
canal is relieved by weak solutions of it. 
The use of a weak wash of silver nitrate has been advised in acute and 
chronic pharyngitis and other inflammations of the throat and fauces. 
The practice has little to commend it, and many other agents are safer and 
more effectual. 
In all instances in which it is proposed to employ strong silver nitrate 
solutions a solution of common salt should be at hand to limit or check its 
action at once when desired. Fresh stains of nitrate of silver may be re- 
moved from garments by first treating them with tincture of iodine and dis- 
solving out the compound so formed with solution of sodium hyposulphite. 
Cyanide of potassium or mercuric chloride will also remove silver stains, 
but they are dangerously poisonous to handle. 
Internal. In Eclectic practice the internal employment of silver 
nitrate is believed to be seldom justified; and then only when it will ac- 
complish results that other medicines fail to achieve. It should never be 
given for long periods under any circumstances, nor should it be considered 
in nervous affections. Probably of all conditions in which it does good, 
gastric ulcer is chief. It may also be administered temporarily in hyper- 
chlorhydria and chronic catarrh of the stomach accompanied by sour 
eructations and vomiting after partaking of food. It is, without doubt, 
effective in chronic intestinal ulceration. When desired to affect the bowels 
it must be given in a keratin-coated pill so that it will not be liberated until 
the alkaline secretions of the intestines dissolve the coating. In chronic 
dysentery, with ulceration, intense tormina and tenesmus, and pinkish 
mucoid or blood-streaked evacuations it may be used when other agents 
fail; and in the chronic diarrhoea of intestinal ulceration with pinkish or 
blood-stained discharges. The doses should be from 1/12 to 1/8 grain. 
In rare instances it relieves the prolonged irritation of unyielding cases of 
cholera infantum, and assists the recuperative powers of the membranes 
when feeble. The dose should range from the 1/100 to 1/30 grain for this 
purpose. 
204 INDIVIDUAL DRUGS. 
Substitutes for Silver Nitrate. 
The following substitutes are in common use. None are as active as silver nitrate, 
but are safer and pleasanter in effect. 
Argyrol.-A proprietary proteid silver salt (silver vitellin), containing 30 per cent of 
metallic silver. It occurs in black hygroscopic scales, freely soluble in water and forming a 
dark solution which stains fabrics brown or black. Corrosive sublimate in solution (1 to 500) 
removes the stain. Argyrol is a non-irritating antiseptic, disinfectant, germicide and anti- 
pruritic of less force, however, than silver nitrate, for which it is used as a substitute in eye, 
throat, urethral and vaginal disorders. It is especially advised as an injection in gonorrhoea 
(5 to 15 per cent solution), and in cystitis (10 to 25 per cent); as an instillation in oph- 
thalmia neonatorum and other purulent ophthalmias (25 per cent) and as a topical applica- 
tion in pruritus vulvae et ani (20 per cent). 
Silvol, a practically non-toxic proprietary compound of silver, closely related to 
argyrol, occurring as lustrous black granules, slightly hygroscopic, and freely soluble in 
water. Solutions from 2 to 50 per cent are used for exactly the same purposes as argyrol, 
to supplant the need for silver nitrate. Sometimes used in ointment, though it is insoluble 
in oils and fats. 
Protargol is also a proprietary proteid silver compound, representing about 8 per cent 
of metallic silver. It is a yellow powder readily soluble in water. Employed for the same 
purposes as argyrol and silvol, and in about the same per cent solutions. 
The fresh corm of Arisama triphyllum, Torrey (Nat. Ord. Aracese). Common in 
damp woods and wet situations in North and South America. 
Common Names: Indian Turnip, Jack-in-the-Pulpit, Dragon Root. 
Principal Constituents.-Starch, potassium and calcium salts, particularly raphides 
of calcium oxalate and possibly another acid principle. 
Preparation.- Tinctura Arisama, Tincture of Arisaema (Corm, Bviij; Dilute Alcohol, 
Oj). Dose, 1 to 5 drops. Only the tincture of the fresh corm is of any value. 
Action.-The fresh corm has no effect upon the unbroken skin. When 
bitten or chewed it is fiercely irritant, causing a persistent and intensely 
acrid impression on the tongue, lips, and fauces, something like that of a 
severe scald, with considerable pricking. Slight inflammation and tender- 
ness may follow. This effect is thought to be due to the raphides of calcium 
oxalate present. Milk mitigates the distressing sensation. 
Therapy.-Arisaema has been recommended for a variety of disorders, 
chiefly of the respiratory tract, and as a stimulant in low forms of fever, 
when delirium is marked and the membranes are inflamed and the tongue 
red, painful and swollen. It is seldom used for these purposes. It is, 
however, of real value in severe forms of sore throat, intensely painful, 
swollen and fetid, with deep or purplish-red membranes similar to that of 
the angina of scarlet fever. It is also useful in chronic laryngitis aggravated 
by singing or public speaking, and accompanied by hoarseness and loss of 
voice, burning and sense of constriction in the throat, and thin ichorous 
discharge from the nose. A strong tincture of the fresh corm may be given 
in drop doses every half to one hour, and a throat wash of one drachm of the 
tincture to a half glass of water may be used freely. 
ARISAMA. 
The dried flower-heads of Arnica montana, Linne (Nat. Ord. Composite). A perennial 
of Siberia and the cooler parts of Europe; also found in Northwestern United States. 
Dose, 1 to 10 grains. 
Common Names: Arnica, Leopard's Bane. 
Principal Constituents.-Arnicine (Cn HM O2), a golden-yellow body, a volatile oil, and 
angelic and formic acids. 
Preparations.-1. Specific Medicine Arnica. Dose, \/\ to 10 drops. 
2. Tinctura Arnica, Tincture of Arnica. Locally. 
ARNICA. 
205 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-"Muscular soreness and pain from strain or 
overexertion; advanced stage of disease, with marked enfeeblement, weak 
circulation, and impaired spinal innervation; embarrassed respiration; 
lack of control over urine and feces; sleeplessness from impeded respiration; 
and dull praecordial pain from 'heart strain'; muscular pain and soreness 
when the limbs are moved; tensive backache, as if bruised or strained; 
cystitis, with bruised feeling in bladder, as from a fall or blow; headache, 
with tensive, bruised feeling and pain on movement; hematuria, with dull, 
aching, lumbar pain; or from overexertion. Debility with enfeebled cir- 
culation." (American Dispensatory.} 
Action.-Arnica is a decided irritant to the skin, under some cir- 
cumstances producing marked dermal irritation, deepening into an ery- 
sipelatous or acute eczematous inflammation, with pustules and blisters, 
and often grave constitutional symptoms. In this respect the alcoholic 
preparations of the flowers are most active, and for this reason full strength 
preparations should not be used upon the skin, nor as a rule should any 
preparation of arnica be used upon cuts or injuries causing a breaking of the 
skin. Under the latter conditions dangerous inflammation, with vesication, 
has occurred. Persons of sensitive skin, and it is said gouty subjects, are 
most susceptible to this untoward action of the drug. 
Medicinal doses of arnica slow the heart, slightly raise arterial pressure, 
and stimulate the vagi. Poisonous doses operate reversely and paralyze the 
vagal centers. Intermediate but large doses produce heat in the throat, 
nausea and vomiting, dyspnoea, headache, lowering of temperature, and 
sometimes convulsive movements. With toxic doses these effects deepen 
into unconsciousness, motor, sensory and vagal paralysis, coma, and death. 
Death is said to have been caused by two ounces of tincture of arnica. 
Therapy.-External. Arnica, in tincture or fomentation, has long been 
a popular but by no means safe discutient to prevent and discuss inflam- 
matory swellings, and to relieve the soreness of myalgia and the effects of 
sprains, bruises, and contusions. It is often serviceable to remove ecchy- 
moses, and it gives grateful relief to sore muscles that have undergone much 
strain and exertion. A glycerite has been effectually used upon bites of 
mosquitoes and other insects. Preparations of the root are less liable to 
excite dermatitis, and the infusion of the flowers is less irritant than the 
tincture. After applying the latter, which should always be well diluted, 
the surface should not be covered or bandaged, so that evaporation may 
take place freely. 
Internal. Arnica is a greatly unappreciated medicine. It has a pro- 
nounced action upon the medulla and spinal cord which can be invoked 
to good advantage in states of depression. The keynote for arnica is spinal 
and vagal enervation. It should be brought into service when there is 
deficient nervous response, sluggish vascular power, and in almost all con- 
ditions in which prevails the triad-torpor, debility, and depressed func- 
tion. In the advanced stages of exhausting diseases, where spinal in- 
nervation is poor, control over the sphincters lost, and there is feeble 
respiration due to central vagal impairment, it is a most important stimu- 
lant. It should be used when breathing can be carried on chiefly only by force 
of the will, and becomes weak and shallow when the patient drops into 
206 INDIVIDUAL DRUGS. 
sleep; or when the sleeper awakens with a start on account of dyspnoea 
when automatic respiratory action alone is depended upon. Such a state 
occurs in the low stage of typhoid and other fevers, and in lobar pneumonia. 
In such conditions arnica is most useful and compares well with strychnine 
or atropine, or phosphorus, none of which are so safe as arnica. Arnica will 
prove useful in the depression occasioned by extreme forms of diarrhoea and 
dysentery when the discharges escape control. In so-called typhoid 
pneumonia-which is but pneumonia with typhoid conditions-marked 
asthenia, feeble circulation, great depression, low muttering delirium, 
picking at the bed clothes, and dry tongue loaded with foul mucus and 
sordes, it is a most valuable auxiliary to other treatment. In the hectic 
fever of phthisis, with exhausting diarrhoea and excessive sweating, it often 
proves the needed stimulant and antihydrotic. 
Arnica is a stimulant of great power in anemia, with weak heart and 
capillary feebleness, and marked depression, diarrhoea and drospy, but 
no inflammation. During mild forms of so-called chronic rheumatism, 
with cold skin and general debility it will stimulate the nervous system, 
restore normal warmth, re-establish restrained secretion, and thus relieve 
pain. In painful, bruised or subacute inflammatory disorders arising from 
injury, with marked lowering of nerve tone, muscular aching and chilly 
sensations, arnica is a remedy of power to give comfort and hasten resolu- 
tion. When myalgia is caused by exposure, or when muscular soreness and 
pain are due to strain, overexertion, or sudden jars or blows, the administra- 
tion of arnica internally, in small doses of the specific medicine preferably, 
and the diluted tincture applied locally are among the most serviceable 
of measures. 
Arnica frequently relieves "heart-strain" due to exertion, overwork, 
or from long marching. It also benefits in the heart debility that follows 
severe strain, worry, or excitement. Dull aching pain in the praecordia, 
due to lifting or when working against vibrating machinery, as in shoe 
making, is dissipated by small doses of arnica. For lame back, backache 
and feelings of soreness and debility of the back, when accompanied by 
nervous depression and poor circulation, arnica is one of the most direct of 
remedies. Lumbago, when due to muscular strain or falls, is relieved by 
arnica. Its action is increased by rhus, macrotys, or sometimes gelsemium. 
When dependent upon a loaded bowel, venous relaxation in the hemorrhoidal 
circulation, piles, fissures, sagging of the abdominal contents, pelvic weak- 
ness, or a neuritic state of the lumbar plexus, arnica is of little or no value. 
Indeed, in some of these conditions it may only result in an aggravation of 
the nervous unrest so frequently attendant upon lumbago, and allied pain- 
ful disorders. 
We have used arnica most successfully in paraplegia and hemiplegia 
after all evidence of acute inflammation or recent injury has passed. It is 
especially to be remembered in sphincteral paralyses, so common after long 
illness in which spinal enervation has played an important role. Nervous 
headache of depression and debility frequently is relieved by arnica, and 
some believe it to be the best agent for amaurosis, a rather ill-defined ocular 
disturbance. 
Should the patient to whom arnica is administered appear to become 
nervously excited and restless, or show gastric irritability, its use should 
be discontinued. 
207 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ARSENI TRIOXIDUM. 
Arsenic Trioxide, Arsenic, White Arsenic, Arsenous Acid, Arsenous Oxide. 
A compound that should contain nearly 100 per cent of pure arsenous trioxide (As2 O3). 
Description.-A white opaque powder; or in glass-like, transparent and colorless 
masses, or in porcelain-like opaque masses, or in pieces, glass-like, coated with an opaque 
crust. The glassy form gradually becomes opaque when exposed to moist air. Odorless, 
soluble in water, glycerin, and sparingly soluble in alcohol and ether. Dose, 1/15 grain to 
1/100 grain. 
Preparations.-1. Liquor Potassii Ar senilis, Solution of Potassium Arsenite, Fowler's 
Solution. (Contains 1 per cent of arsenic trioxide.) Dose, 1 to 5 minims (usual dose, 1 
minim.) 
2. Liquor Arseni et Hydrargyri lodidi, Solution of Arsenous and Mercuric 
Iodide, Donovan's Solution. (Contains 1 per cent each of arsenous iodide and mercuric 
iodide.) Dose, 1 to 3 minims. (Usual dose, 1 minim). 
3. Liquor Sodii Arsenatis, Solution of Sodium Arsenate (a substitute for Pearson's 
Solution; contains 1 per cent of dried sodium arsenate). Dose, 1 to 5 minims (usual dose, 1 
minim). 
4. Liquor Acidi Arseniosi, Solution of Arsenous Acid. (Contains 1 per cent 
of arsenic trioxide.) Dose, 1 to 5 minims. 
Specific Indications.-Dull, muddy or sallow or pallid, inelastic skin; 
irregular periodicity in malarial cachexia; caseous and tubercular deposits; 
scaly, vesicular, or tubercular skin diseases; pale and expressionless tongue 
(sometimes long, dry, and pointed); flabby muscles, and cold extremities; 
general lack of nerve force, with soft and easily compressed pulse, and 
impaired sympathetic innervation; imperfect nutrition, with glandular 
deposits; imperfect nutrition and skin diseases dependent thereon; de- 
generation of tissue; and malaria failing to respond to quinine 
Action.-Applied to the unbroken skin arsenic has very little effect, 
and only when long or frequently in contact does it produce redness and 
various eruptions. If, however, the epidermis be removed, or an abrasion, 
wound, or sore is present it acts as a powerful escharotic. From any 
absorbable part it is readily absorbed and passes quickly through the blood 
and lymph to every part of the body. No matter how absorbed in any 
considerable amounts, its first effect is to produce a violent gastro-enteritis. 
It is eliminated by all the secretions and excretions, but chiefly by the bowels 
and the kidneys. When not in toxic amounts it is held in storage in the 
liver, muscles, bones, and even the brain. From there it gradually passes 
into the genera! circulation again, finally to be eliminated chiefly in the urine, 
and to a lesser extent in the bile, sweat, milk, and feces. It may take months 
to wholly free the tissues of it. 
In very small amounts arsenic probably stimulates the heart, in larger 
amounts it depresses that organ, and through vaso-motor action lowers 
arterial pressure and causes extreme dilatation of the capillaries, especially 
of the splanchnic area. It even paralyzes the latter, and by some its poison- 
ous effects are thought to be due to this action, causing oedema, ecchymosis, 
the shedding of shreds of epithelium, and a profuse choleraic or "rice water" 
diarrhoea. Indeed, without a history of arsenic poisoning or its use as a 
medicine, it is extremely difficult, except by chemical investigation, to dis- 
tinguish some cases of arsenical poisoning from Asiatic cholera. The action 
of arsenic on the blood of man and the nervous system is not well under- 
stood. In small doses it probably stimulates blood-making, and upon the 
nervous system a large dose produces paralysis by its effects the upon nerve- 
208 INDIVIDUAL DRUGS. 
centers, the nerves and the muscles. In small doses it stimulates respira- 
tion, but in large doses is a respiratory paralyzant. In small amounts it 
checks tissue-waste and decreases nitrogenous elimination, while large and 
toxic doses reverse these processes. 
Arsenic is a poison to all forms of life. As it acts most powerfully upon 
the higher organisms it is of little practical germicidal value. Animal 
tissues are almost indefinitely preserved by it, and it has been largely used 
to preserve cadavers and anatomical specimens. In minute doses it may 
be taken for a prolonged period without apparent ill results. Moreover, 
toleration for it can be established. In such doses it accelerates the circu- 
lation and is tonic to the nervous system. It enables one to take active 
exercise with but little fatigue and without materially interfering with 
respiratory action. Certain arsenic eaters among the Styrians become 
habituated to its use, the maidens to clarify their complexion and enhance 
their charms, and the men to increase respiratory power, endurance, and 
virility. These arsenic eaters have been known to consume as much as 
4 to 10 grains daily, an amount sufficient to kill several persons unac- 
customed to the drug. They are careful, however, not to drink water for 
some time after taking it. 
The first active symptoms occurring from small doses sufficient to be 
subjectively appreciated are those of gastro-intestinal irritation-anorexia, 
nausea, abdominal distress, diarrhoea, and sometimes headache. When a 
constitutional effect is obtained there will be a puffiness or slight oedema 
of the eyelids, mostly observed after sleep, and which, if the use of the drug 
be persisted in, results in more pronounced oedema and even a widespread 
anasarca. These are near toxic effects and constitute a warning to cease 
arsenic medication. Indeed, its use should never be continued after the 
puffiness about the eyes is observed. 
Toxicology.-In large doses, arsenic is one of the most violent of 
poisons, producing in overdoses, nausea, vomiting, burning pain of the 
throat and stomach, soon extending over the whole of the abdomen. Al- 
though under certain circumstances a large amount of arsenic has been 
swallowed without any serious effects, yet as a general rule it is con- 
sidered that death may be produced by 1 or 2 grains of it taken at a dose. 
A larger quantity may cause vomiting so quickly as to expel it from the 
stomach before its deleterious action fairly commences; and a distention 
of the stomach with food has prevented it from proving fatal. When emesis 
is caused by its poisonous action, the matters vomited may be bilious or 
tinged with blood; occasionally there will be no pain or vomiting. There 
is very apt to be a sense of heat, dryness, and constriction of the throat, 
with incessant thirst and great difficulty of swallowing. When the bowels 
are inflamed the abdomen is tense and hard, with loose, bloody stools, 
tenesmus, heat, and excoriation of the anus. The urine may be diminished 
or suppressed; pulse quick, small, feeble, and irregular; heart beating irregu- 
larly with palpitation; breathing laborious and often painful; tongue dry and 
furred; frequently with tremblings, cramps, and delirium previous to death; 
occasionally dark spots or an eruption on the surface will be present. The 
symptoms are by no means uniform, and will vary with different individuals; 
there may be faintness, or actual syncope, convulsions, paralysis, great 
209 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
prostration, coma, etc. In some cases death may ensue without any severe 
or well-marked symptoms. A peculiarity of some of the apparently mild 
cases is a "remission" of symptoms after a day or two, leading to false 
security and snap prognosis, only to be followed by a recrudescence of 
symptoms and death after six or seven days. 
In poisoning by arsenic empty the stomach as quickly as possible 
by means of lavage or the stomach-pump and the non-depressing emetics- 
preferably zinc sulphate or mustard, and hasten the action by tickling the 
throat and fauces with a feather or the finger. Lobelia or ipecac should not 
be used as they are too slow and favor absorption of the poison by occasion- 
ing prolonged nausea. The best antidote is the freshly precipitated ferric 
hydroxide, given freely and repeatedly in tablespoonful doses. The stomach 
should be repeatedly washed out while this preparation is being given. In 
case it cannot be obtained quickly the physician should prepare it as follows: 
Take any quantity of tincture of chloride of iron, or of Monsel's Solution 
in any quantity of water and precipitate it with ammonia water until a 
slight odor of ammonia can be smelled upon a wooden spatula or stick. 
Quickly filter with plenty of water, through a cloth or towel, and administer 
the brown magma freely. Oxide of magnesia is also an antidote, or it may 
be used as the precipitant in preparing the foregoing magma, which must 
always be made fresh. The Ferri Hydroxidum Cum Magnesii Oxido is 
equally efficient and lacks the irritating presence of ammonia. It is pre- 
pared by precipitating solution of ferric sulphate by magnesia, and is the 
official antidote to arsenic. Heat must be applied, friction used, demulcent 
drinks given and opiates to relieve pain. Collapse should be treated by 
hypodermatics of ether and brandy; and large draughts of water given to 
flush the kidneys. Castor oil should be administered if there is evidence of 
the poison having reached the intestinal canal. 
Chronic Poisoning. This may occur as the result of acute poisoning 
insufficient to produce death, and in those who work where they are ex- 
posed to arsenical pigments. When arsenic is taken in small doses, continued 
for a long period, but acting as a slow poison, "there will be a gradual sinking 
of the powers of life, without any violent symptom; a nameless feeling of 
illness, failure of the strength, an aversion to food and drink, and all the 
other enjoyments of life." Among the many symptoms which have been 
observed in such cases, the following are the principal: flatulence, heat or 
pain in the stomach and bowels, loss of appetite, thirst, nausea, vomiting, 
purging, or a looseness of the bowels, with griping; the tongue furred, 
mouth and throat dry and constricted, and sometimes salivation. The 
pulse will be quick, small, and often irregular; a dry cough, with oppressed 
respiration; wasting of the body; very irritable stomach, immediately re- 
jecting anything taken into it. Headache, giddiness, wakefulness; irrita- 
tion of the conjunctiva, the patient frequently complaining of a feeling like 
a hair or cobweb in the eye, with redness, swelling or pricking of this organ; 
the limbs painful, feeble, trembling, subject to numb sensations, cramps, or 
convulsions. An eruption on the surface (herpes common), falling off of 
the hair and nails; swelling of the face and feet, and gradual sinking of the 
patient, with consciousness perfect to the last, or perhaps coma, or delirium. 
Myelitis, arsenical polyneuritis, and arsenical paralysis, lasting long but 
210 INDIVIDUAL DRUGS. 
eventuating in recovery, may result from chronic arsenical poisoning. 
Chronic poisoning by arsenic, in the absence of a history of the case, is very 
difficult of diagnosis. Its treatment consists in the withdrawal of the drug, 
or the removal of the patient from his work, arsenic antidotes used, and 
treating the patient as necessity dictates. Convalescence is long and tedious, 
and frequently interrupted by intercurrent ailments. 
Therapy.-External. Arsenic has been used for the removal of dermal 
growths, such as warts, and for onychia maligna and epithelial cancer. 
Except in rare instances such use should be condemned, as the danger of 
poisoning by absorption is very great and the process slow and painful. 
Moreover, in these days of surgical precision it is wholly unnecessary. 
Arsenic, in the form of various pastes, constitutes the basis of most so-called 
"cancer cures" exploited by advertising "cancer specialists." Arsenic is 
commonly employed by dentists to insert into dental cavities for the 
destruction of the nerve pulp. This it does less by its corrosive action than 
by the intense inflammation it causes, resulting in slow death of the nerve. 
This method is painful, often consuming several days, and the arsenic is 
usually combined with creosote, or carbolic acid and morphine or other 
pain-obtunding agents. From 1/60 to 1/30 grain is inserted and covered 
and held in the cavity by a rubber packing. 
Internal.-The therapeutic field of arsenic and its solutions is limited, 
but positive. It is seldom prescribed in Eclectic practice merely as a re- 
constructive agent unless certain well-defined indications are present. Be 
it in cachectic conditions, in gastro-intestinal disorders, in diseases of the 
skin, or in general debility, arsenic is too powerful an agent to be prescribed 
hit or miss. But when indicated by the specific indications, it is one of the 
most direct of our specific resources and a potent agent for good. As 
worked out and now thoroughly verified by clinical experience, arsenic is of 
value when the skin has a dirty hue and lacks elasticity. When pinched 
between the fingers, the fold remains for some time without regaining 
normal smoothness. The natural spring-like action of the healthy skin is 
lost and the dermal tissues return sluggishly to their normal position when 
so treated. A low condition of the blood with a tendency to the deposi- 
tion of cacoplastic material-imperfect albuminoids-caseous and yellow 
tubercular formations, tissue degeneration, and impaired nutrition are the 
general states in which it is indicated. It should never be used where there 
is irritability and erethism of the nerve-centers, particularly of the sym- 
pathetic system. 
Under the first condition mentioned, arsenic, in the form of arsenous 
trioxide, or preferably Fowler's Solution, may be confidently administered 
during attacks of intermittent fever with irregular periodicity and dry and 
pointed tongue. The best results are obtained when quinine fails, and where 
the anemia and general cachexia are more pronounced than the febrile dis- 
turbance. Chronic agues best express the condition, perhaps, and the 
intervals between attacks are long and the malarial cycle irregular. The 
pulse is weak and compressible, the limbs cold, the tongue pale and ex- 
pressionless (sometimes dry and pointed), the tissues flabby, and the 
fires of life burning low. Not only does it act well in such cases, but it 
frequently proves prophylactic to malarial invasions. 
211 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
In obstinate neuralgias, especially the intermittent neuralgias de- 
pendent upon a malarial cachexia, arsenic is a most important agent, 
relieving when quinine fails, and when pain relievers are inadvisable and 
would have no specific antimalarial effects. It is most effective in those 
forms involving the fifth cranial and the intercostal nerves, though, as a 
rule, it is useful in most idiopathic neuralgias, as such types are invariably 
born of debility, or anemia, or some state of cachexia. The value of 
arsenic in chorea dependent upon a malarial taint, or on chlorotic anemia, 
cannot be gainsaid. Though large doses are advised and sometimes per- 
missible, the smaller doses are preferable, where the specific indications for 
arsenic are present. Fowler's Solution is the best form of arsenic for choreic 
incoordination. 
Though the action of arsenic upon the blood is not well understood, 
it is evidently a blood-maker when used in minute doses. It is certainly 
a powerful vital stimulant and improves nutrition. Therefore, it is employed 
as a reconstructive in anemia, whether due to malaria, dyspepsia, chlorosis, 
losses of blood, post-puerperal depression, or great constitutional debility. 
The nerve forces are always depressed when arsenic is required. It gives 
the best results of any agent in pernicious anemia, in leucocythemia, splenic 
leukemia, and pseudo-leukemia (Hodgkin's disease). In all of these con- 
ditions it should be given in small doses and promptly discontinued upon the 
appearance of puffiness of the eyelids; nor should it be administered for 
long periods lest arsenical polyneuritis be induced. 
When sharply indicated, as noted above, arsenic acts favorably in 
gastro-intestinal disorders. It is one of the most certain remedies in various 
forms of vomiting. These are chiefly in chronic inebriates, in chronic 
gastritis, in malarial disorders, and more rarely in the vomiting of preg- 
nancy, and still more frequently in that associated with phthisis. Its 
value in diarrhoea is well established, the drug being best indicated in 
attacks immediately provoked by the intake of food. In the vomiting and 
diarrhoea of cholera infantum it is one of the most certain of medicines. 
It is to be selected when there is great enfeeblement, with thin and frequent, 
non-mucoid stools. In atonic diarrhoea, with imperfect digestion, and 
followed by periods of depression it is distinctly serviceable, as it is also 
in the serous diarrhoea of bottle-fed infants affected with chronic intestinal 
catarrh. For most of the gastro-intestinal disorders the following is the 
best form of administration. 1$ Fowler's Solution, gtt. v to x; water, 
fl g iv. Mix. Sig. One teaspoonful every 2 or 3 hours. 
Arsenic is of unquestionable utility in atonic dyspepsia, in chronic 
catarrhal duodenitis with jaundice, in chronic gastritis with burning 
sensations and due to the retrocession of cutaneous eruptions, in semi- 
chronic dysentery with impaired vitality of the mucosa, and in chronic 
mucous colitis. In gastric ulcer and schirrus of the stomach it may be 
given to relieve pain, vomiting, and diarrhoea. There is no question but that 
it retards the growth of cancer and sarcoma before the ulcerative stage, 
but it has no curative effect on these growths. When gastric disorders are 
chronic and of malarial origin and the patient is greatly debilitated, the 
more effective arsenic seems to prove. 
212 INDIVIDUAL DRUGS. 
Surprisingly good effects come from the use of arsenic in the pre- 
tubercular, especially those phthisically inclined, with depraved secretions 
and frequently recurring attacks of coughs, colds, coryza, and exacerbations 
of chronic nasal catarrh. In subjects once called scrofulous, probably near 
tubercular at least, it promptly benefits when the specific indications are 
observed. Scudder, Locke, and Howe were strong advocates of arsenic in 
pulmonary tuberculosis. The latter was partial to veratrum in this affec- 
tion, considering it and arsenic our two best ameliorating medicines. His 
favorite prescription, which became largely employed in Eclectic practice, 
is as follows: Fowler's Solution, f!5ss; Syrup of Lactophosphate of 
Calcium, fig vj; Mix. Sig. One teaspoonful 3 times a day every other day. 
Arsenic is the most widely used dermatological medicine. Skin dis- 
eases have long been treated with it, some to their benefit, others to their 
detriment. When, however, the specific indications as pointed out are 
present, or when the skin lesions are associated with an irregular phase of 
malaria, or when nutrition is imperfect and there are glandular enlarge- 
ments, or degeneration of tissue, or infiltration with scaliness, then good 
results may be expected from arsenic medication. It should never be used, 
however, and in fact is seldom indicated when the skin is acutely inflamed, 
or when moist eruptions prevail. It is the remedy for dry, and never for 
weeping skin conditions. The types best benefited are the dry and scaly, 
the vesicular, the tubercular, and sometimes the pustular forms. Under 
these restrictions it is variously useful in eczema, impetigo, ichthyosis, 
elephantiasis, warty excrescences, corns, lupus, pityriasis, lepra, and some 
forms of prurigo. It is the best agent in lichen planus, and is said to be use- 
ful in lichen ruber, a disease seldom seen in this country. For pemphigus 
it is the most direct remedy, while in psoriasis it first aggravates and then 
causes a disappearance of the eruption. In the latter disease, however, the 
tendency to perpetual chronicity, with remissions, during which the dis- 
ease is in abeyance, must be kept in mind. It is the consensus of opinion, 
observing the dictum of Duhring, that, as a rule, arsenic is of little value in 
diseases of the skin located in the deeper cutaneous layers, but rather is 
to be used in those involving the superficial strata. Many chronic ulcera- 
tions, however, yield to arsenic when the specific indications are closely 
followed. It sometimes relieves the itching of diabetes mellitus, and of 
pruritus ani et vulvae. 
Arsenic Preparations and Substitutes (See also Arsphenamine). 
Donovan's Solution is of benefit in secondary syphilis when the tongue is small and 
unduly red. It may be used in syphilitic ulcerations, skin blemishes, and articular nodosities 
of syphilitic origin. Syphilitic taint is little influenced by arsenic alone. The dose is from 
1 to 5 drops. 
Quinine Arsenate (2x trit.) 2 or 3 grains four times a day is advised by Webster in 
chlorosis associated with metrorrhagia and choreic movements, and in the anemia of malarial 
cachexia. It is also generally accepted as valuable in neuralgias and chorea dependent on 
miasmatic influence. 
Arsenic Bromide has some claims to efficiency in epilepsy and has been advised in 
diabetes mellitus. Clemen's Solution may be given in doses of 1 to 3 drops, well diluted, 
after meals. 
Copper Arsenite has been largely used in the watery diarrhoeas of infants, in cholera 
infantum, infantile dysentery, and similar affections. It has no special advantage over 
arsenic in similar disorders. One 1/100 of a grain is added to 4 fluidounces of water, of 
which doses of a teaspoonful may be given every 2 to 4 hours. 
213 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Atoxyl (Sodium Arsanilate-NH2 Ce H4 OAs OH. ONa.) contains somewhere near 
30 per cent of metallic arsenic and is rated as about one fortieth as poisonous as Liquor 
Potassii Arsenitis, or Fowler's Solution. It is a white crystalline powder of a faint saline 
taste, soluble in 6 parts of water and about 120 parts of alcohol. Atoxyl is reputed a specific 
for trypanosomiasis, in which it appears to have been more successful than any remedy 
hitherto employed. It is especially praised for its effects in that form known as "sleeping 
sickness." Atoxyl, however, does not cure, but greatly alleviates the symptoms. Gradually 
the parasites which are at first killed by it are followed by others which appear to become 
immune to it and eventually remain resistant to the treatment. While in the blood the 
trypanosomes are easily destroyed, those which are harbored in the lymph-glands and 
in the central nervous system seem beyond its power to reach. From these foci the supply 
of constantly and increasingly resistant forms becomes freshly supplied to the blood and 
thus keeps the disease alive. Atoxyl also attacks the spirillium of relapsing fever, and is 
effectual in African tick fever, and in all stages of syphilis. It has been supplanted in the 
latter, however, by arsphenamine, both as an antisy^hilitic and trypanocide. Atoxyl is 
dangerously poisonous in one respect-it produces optic nerve atrophy, resulting in perma- 
nent blindness, and this is not preventable by stopping the administration of the drug. 
Hence physicians are discarding it rapidly. Besides, it has occasioned dryness of the 
throat, dizziness, headache, fever, vomiting, and diarrhoea, colic, nephritis, and paralysis 
of the lower extremities. These, together with its proneness to cause blindness, are certainly 
sufficient to cause one to be wary in its use. The purpose in introducing atoxyl was to find 
an agent destructive to the protoplasm of the parasite without proving dangerous to the 
protoplasm of the host, but evidently in some respects the effort must be recorded as a 
failure. We are advised that the proper dose is that which destroys the trypanosome but 
falls short of occasioning blindness. As this is a risky venture physicians will do well to 
avoid the drug altogether, especially as more effective other organic arsenic preparations are 
available. The dose ranges from 1 1/2 grains to 5 grains in 10 per cent solution per day, 
given hypodermatically. Hare gives the proper dose (hypodermatically and intramuscularly) 
for all the diseases mentioned as 7 grains in a 5 to 15 per cent sterilized solution, on two 
successive days, followed by intervals of ten days' rest. 
Arsenobenzol (Dioxy-diamido-arsenobenzol dihydrochloride). Salvarsan (discarded 
German name). "606". (Formula: HC1 NH2 OHC6 H3 As. or As C6 Hs OHNH2 HC1 -|- 
2H2 O). A synthetic organic compound of arsenic. 
Description.-A fine, yellow, crystalline, hygroscopic powder, freely soluble in water, 
methyl alcohol, and in glycerin, less soluble in alcohol (ethylic) and insoluble in ether. 
Owing to ready change through oxidation into a more poisonous compound it is kept in 
vacuum ampules. When opened the compound should be used at once, for it becomes 
powerfully toxic when exposed. After opening none of it should be saved for future use. 
Dose, 1 to 9 grains in specially-prepared solution for injection (see below). 
Action and Toxicology.-Injected into the muscles, severe pain, pro- 
longed induration, swelling, and sometimes sloughing occur. Intra- 
venously used it is less apt to produce, in most instances, any marked 
symptoms. Sometimes, however, severe pain, chills, and nausea follow, 
or headache, dizziness, nausea, and malaise, with fever, take place. Vomit- 
ing, diarrhoea, and jaundice, shortness of breath, great nervous unrest, and 
muscular tremor have been produced, as well as profuse sweating and 
various skin eruptions. The more severe intoxications show facial oedema 
and cyanosis, with mental confusion, tetanic convulsions, collapse, and 
coma ending in death. Meningitis and encephalitis with attendant fever 
and subsequent coma have been the result in some instances, and seemingly 
nephritis, with anuria, in a few. Disturbances of hearing and paralysis of the 
facial and spinal nerves have been noted. Arsphenamine appears to be 
eliminated in the urine and feces, first as arsenic and later as inorganic arsenic 
compounds. About 25 percent of it is unaccounted for, but in all probability 
it is stored up in the tissues, notably those of the liver, bone marrow, and 
kidneys, as such depositions have been observed in animals. Arsenic has 
ARSPHENAMINE. 
214 INDIVIDUAL DRUGS. 
been detected in the tissues for ten days after the administration of arsphen- 
amine. This compound is destructive to protozoa and especially the 
spirilla, trypanosomes, and spirocheta, and devitalizing to the Treponema 
pallida in the body fluids. 
Therapy.-Arsphenamine is Ehrlich's famous "606" so-called because 
he made 605 compounds before he reached this product, which he hoped 
would prove a specific cure for syphilis. Chemically it is "Arsenobenzol," 
or more specifically " Dioxy-diamido-arsenobenzol dihydrochloride". It 
depends for its virtues upon its arsenic content, which corresponds to 31.57 
per cent of metallic arsenic. It appears to be able to destroy the Treponema 
pallida-the micro-organism of syphilis, in the body but not in the test- 
tube, or as it is stated, "in vivo but not in vitro". The process is a compli- 
cated one, taking place somewhat after the biologic process of complement- 
fixation. 
Arsphenamine is unquestionably the most rapidly acting antagonist 
of the spirocheta of syphilis-the Treponema pallida. The hope that it 
would prove curative in the single large dose, as at first employed, was never 
realized. While the most brilliant results sometimes occur from its use in 
even a few hours or few days, especially in clearing up and sterilizing the 
visible lesions of syphilis, it fails to completely eradicate the luetic infection. 
It is now recognized that it must be given at long intervals in order to pro- 
duce even partial results. Very rarely, in the first days after infection 
shows it seems to have jugulated the disease at once; but this time only can 
prove. More usually the symptoms gradually return, and the recognized 
tests for the presence of the treponema reveal the fact that these creatures are 
renewing their vigor and activity. While the early furor was going on concern- 
ing its absolute curative power, this infallibility was not credited by Eclectic 
physicians, and the relative value of the drug was weighed and the probable 
return of the symptoms predicted by the more conservative of them. 
Many also scouted the probability of its value at all. Time, however, has 
established its status in medicine, and it is now quite generally conceded 
that it has undoubted power over the spirochetes, though that power is but 
one of control and limitation of activity rather than that of cure. Con- 
servative syphilologists have from the beginning contended that the usually 
recognized antisyphilitic treatment is necessary conjointly with the 
occasional injection of arsphenamine. It is a most active remedy in syphilis, 
seldom a cure for lues; and it is best adapted to the predestructive phases 
and must not be. expected to do the impossible-to regenerate destroyed 
tissue. Hence it fails in the remote and ultimate, or parasyphilitic stages 
involving bone destruction and nervous degeneration caused by the disease. 
In view of what has been said and experience attests, arsphenamine acts 
best in the early stage of syphilis, the earlier the better, when the chancre is 
present and there are mucous patches and cutaneous syphilides. It is 
usually prompt in impressing fulminant cases. In recent infections its 
effects have been little short of marvelous, but as the disease progresses- 
from week to week-so wanes the power of the drug to stay its ravages. 
Used very early the organisms fail to show in the initial lesions, and these 
heal rapidly. The mucous plaques and the skin blemishes quickly fade 
awav. When secondaries occur, however, then the drug's action must be 
215 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
fortified by that of older antisyphilitics. Of these the practitioner of the 
dominant school relies almost exclusively upon the mercurials. The Eclectic 
does not deny the antiluetic and devitalizing effect of the latter upon the 
spirochetes, but deplores their abuse and consequent destructive effects 
upon their host. Often, perhaps oftener than formerly, Eclectics use 
tentatively small doses of mercury, as did Scudder in employing Donovan's 
solution; Howe in advising biniodide, and others various other preparations 
of mercury. But these were always sparingly and guardedly employed, 
and only when well marked indications were present and not merely be- 
cause the disease was syphilis. This, of course, was before the spirochetes 
were known. The majority of Eclectics preferred, and some still employ 
vegetable alteratives and the iodides, and sometimes gold and sodium 
chloride. A few now use mercury because they are not obsessed by the fear 
that was born of the knowledge of the abuse of mercurials in the early 
days, when these salts were so destructively employed and made the life 
of the syphilitic a living death. Nowadays, owing to much greater care and 
smaller dosage, mercurial salivation and tissue destruction are rarely 
observed, and the more progressive physicians of all schools use any remedial 
agent that will hasten a cure with the least possible harm to the body. 
This is indeed a phase of specific medication. Therefore many are ration- 
ally using the newer arsenic compounds, arsphenamine and neo-arsphena- 
mine, together with their own peculiar antisyphilitic medication, whether 
it be purely organic, or the iodides and mercury compounds. 
Arsphenamine appears to be effective in any stage of syphilis so far as 
clearing up ulceration is concerned. Gummata of the skin are bettered by it, 
but it has less effect upon those of the viscera. In syphilis of the nervous 
system, with degeneration, it practically has been a failure, if indeed it has 
not often provoked an aggravation of symptoms. In acute syphilitic 
brain lesions it should be used with the greatest caution, and had better 
not be used at all on account of the active inflammation it may induce. 
Arsphenamine is said to be equally effective in some protozoal diseases, 
as framboesia (yaws) and malaria, and in the spirillar forms of infection, 
as relapsing fever, sleeping sickness (a form of trypanosomiasis), and in 
Vincent's angina. In the latter it is used locally in powder, as by injection 
alone it cannot invade the necrotic tissue of the throat. In malaria it 
is less effective and far more poisonous than quinine. 
The method of employing arsphenamine is largely one of choice on 
part of the administrator. Three methods are in vogue, all by injections: 
(1) Intramuscular; (2) subcutaneous; (3) intravenous, (and rarely, per 
rectum). The first is quite commonly followed but is regarded as less 
desirable than the last, which is the method followed by a large majority 
of physicians. The subcutaneous method has been almost abandoned. 
As the preparation of the drug requires the utmost care and as the dosage 
as to quantity and time varies greatly under different conditions, the student 
is advised to consult special treatises for these methods before attempting 
the use of arsphenamine. The test of effectiveness is the final failure of the 
Wassermann reaction in infected cases, followed by a negative luetin reaction, 
made at long and stated intervals until these tests show a complete absence 
of spirochetes. This may cover a period of months and sometimes years. 
216 INDIVIDUAL DRUGS. 
Many deaths have occurred from arsphenamine treatment, some prob- 
ably due to faulty preparation or administration, and others directly to the 
drug itself-no matter how carefully prepared or how carefully used. It is 
by no means always a safe medicine. Some of the deaths are probably due 
to a phlebitis, releasing thrombi which finally reach the heart and stop its 
action-or more commonly to defective kidneys, or when these organs have 
been permanently damaged by the previous use of mercurials. This latter is 
freely admitted by old school authorities. 
Arsphenamine is contraindicated in great emaciation and malnutrition, 
in status lymphaticus, Addison's disease, in myocarditis, and advanced 
degeneration of the heart, vessels, or brain, coronary sclerosis in the old 
and feeble, and those suffering from diabetes or severe nephritis, ulcer of 
stomach, in advanced tuberculosis, carcinoma, and in acute cerebral 
syphilis. 
Administration.-Stated briefly, the following are some of the methods 
of using arsphenamine: 
1. By intramuscular injection into the buttocks, using a suspension of 
the drug in a neutral fluid. This is the most common manner of employing 
the neutral suspension. While said to be less irritating than either an acid 
or a clear alkaline fluid-form, necrotic tissue-masses, with sloughing, have 
resulted. It is not now so popular a form of administering arsphenamine 
as in the beginning of its therapy. 
2. The use of the acid solution (arsphenamine dissolved in warm 
water or warm salt solution) is seldom resorted to at the present time be- 
cause it is the most irritating and toxic form and produces both pain and 
local death of the tissues. When employed it was by subcutaneous and 
intramuscular injection. 
3. A mono-acid form (aqueous solution half neutralized with alkalD 
is also very irritating and now seldom used. 
4. Oil and paraffin suspensions, though not highly irritating nor 
seldom causing necrosis, are too slow in action for most cases. They are 
sometimes employed, however, upon infants and in those in which a very 
slow absorption is intended. If used at all it is best to employ ready- 
prepared products in sealed ampules than for the operator to prepare them 
himself. 
5. By far the best form of administration for the majority of cases is 
the intravenous injection by gravity (sometimes by syringe) of the dilute 
alkaline solution of the disodium salt in distilled water or in normal salt 
solution. 
Few attempt nowadays to sterilize the patient with a single large dose 
of arsphenamine. A number of smaller doses are preferred-0.3 Gm. (5 grain) 
to 0.5 Gm. (7 grains) of arsphenamine or of neo-arsphenamine being given 
once or twice a week until from three to ten or a dozen doses have been ad- 
ministered, the limit being determined by the clinical effects and serologic 
tests. It should be borne in mind that a Wassermann test made within a 
week of the last injection is not expected to be of much value, while a later 
test may be confirmatory or negative according to the effect of the treat- 
ment. The giving of mercury coincidentally with the injections is con- 
demned by the best syphilologists as dangerous and sometimes fatal: 
217 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
if used, it must be some time after an injection of the arsenic salt. If 
arsphenamine be given after mercurial treatment, or in "mixed treatment'', 
renal irritation may result in the retention of arsenic side-products which 
may prove fatal. Wechselman emphatically declares that "the conjoint 
use of salvarsan with heavy mercurial treatment is dangerous. If one will 
use the combined treatment, then let him give mercury very carefully 
many days after giving the last salvarsan injection, but he should not 
reverse the rule" (Kolmer, Infection, Immunity, and Specific Therapy). 
At no time is the arsphenamine treatment without danger and the 
greatest precaution should be taken in every instance of its use. It is 
the better policy to have the drug administered by one who specializes 
in syphilology. Arsphenamine is regarded as a more efficient spirocheticide 
than neo-arsphenamine, but the latter is the more convenient, can be 
given in lesser bulk, and is more easily prepared for use. In every 
case to which either is to be administered the stomach should be empty, 
the bowels cleared by a purge or enema, and the urine examined for 
albumen and casts, and for sugar. After the administration the patient 
should rest over night under observation, the dose having been given 
preferably in the late afternoon or early evening. Sometimes an exception 
to this rule is permissible in the cases of the use of neo-arsphenamine in 
the robust, when but an hour or two's rest is required. 
An approved method of administering arsphenamine is the following: 
After carefully examining the ampule to see that it is intact and that the 
salt is a yellow powder (not gray or brownish) and wiping it with alcohol, 
the neck is filed and broken and the contents dusted upon the surface of 
sterile, freshly distilled water (about 50 mils or c. c.) contained in a proper 
flask and already brought to the boiling point. Caustic soda solution 
(15 per cent) kept in a non-soluble glass container is now to be added 
drop by drop until neutralization is effected-as is known by the use of 
exactly enough of alkali to form a clear solution. A single extra drop of 
alkali may be added to take care of any precipitate upon cooling. Any 
further excess acts as an irritant. According to Citron the following 
quantities of alkali will be required for exact neutralization: 8 drops of 
15 per cent sodium hydroxide solution for 0.2 Gm. of arsphenamine; 
12 drops for 0.3 Gm.; 15 or 16 drops for 0.4 Gm.; 19 or 20 drops for 0.5 Gm.; 
23 or 24 drops for 0.6 Gm. The finished product of fluid for 0.6 Gram 
(9 grains) of salvarsan should be, according to Kolmer, about 200 mils 
(6 1/4 fluidounces), or for 0.4 Gram (6 grains) about 150 mils (5 fluidounces): 
though injected very slowly it may be given in 30 to 50 mils (1 to 1 7/8 
fluidounces). Kolmer believes that there is no advantage in salt solution 
over distilled water, but that if the former is desired, the arsphenamine 
should be dissolved first in the distilled water, neutralized, and then the 
desired volume arrived at by the addition of sterile 0.5 per cent solution of 
chemically pure sodium chloride. 
By whatever method arsphenamine is used, each vessel and piece of 
apparatus should be thoroughly sterilized. The prepared solution, when 
ready for injection, should be poured into the gravity apparatus, passing the 
fluid through sterile gauze to filter out any extraneous or insoluble matter, 
as bits of glass, etc. The apparatus for injection will vary with the case 
218 INDIVIDUAL DRUGS. 
and the taste of the operator. Some use a two-cylinder outfit-one tube 
each for arsphenamine and for salt solution, the use of either or a mixture 
of the two being permitted at will by means of a three-way stop cock. 
Others use a single cylinder such as is employed in administering normal 
salt solution. All the precautions should be observed, and the technique 
as for intravenous injections in general should be followed. Care should 
be had that none of the arsphenamine comes into direct contact with peri- 
venous tissue, preferably by using salt solution preceding and following 
that of the drug. The administration should consume from 10 to 20 
minutes, the patient lying upon a couch or operating table. The dose of 
arsphenamine for men is from 0.4 to 0.6 Grammes (6 to 9 grains); for 
women 0.25 to 0.5 Gm. (4 to 8 grains); in poorly nourished, weak adults, 
0.3 to 0.4 Gm. (3 to 6 grains); infants, 0.024 to 0.04 Gm. (1/3 to 2/3 grain); 
older children, 0.2 to 0.3 Gm. (3 to 4 grains). Remember always that the 
drug must be prepared only immediately before it is to be injected. 
In all arsphenamine medication the smaller doses repeated at proper 
intervals are favored above the full doses. 
Neo-arsphenamine (discarded German name, Neo-salvarsan-Ehrlich's 
914) is a yellow crystalline powder forming a neutral solution with water, 
in which it is very soluble. Exposed to air it readily oxidizes. Its arsenic 
content is about 20 per cent. For injection it must be dissolved in warm 
distilled water and used at once lest it change quickly into the poisonous 
paramidophenolarsenic oxide. Unlike arsphenamine it does not require the 
addition of an alkali. The dose for both intramuscular and intravenous use 
is from 1 to 20 grains dissolved in about an ounce of warm (not hot) sterile 
water, according to age and condition: the average for an adult being about 
7 grains. Before intramuscular use the part may be desensitized by the 
injection of a few drops of a 1 per cent solution of procaine. This salt is 
less toxic than arsphenamine, and also probably correspondingly less effective. 
It has occasioned chills and fever, depression of the heart action, and 
anuria. It is used by many in preference to arsphenamine because of its 
lesser poisonous qualities and its ease of preparation, no alkali being required 
in preparing the solution. The latter should not be shaken strongly in 
preparation, as agitation seems to favor oxidation-a change to be carefully 
guarded against. It has the same contraindications as arsphenamine. 
Administration.-Neo-arsphenamine, on account of its ready solubility 
and the non-necessity of alkalinization, may be added to the proper quantity 
of sterile, warm, freshly distilled water (100 to 150 mils) and gently agitated, 
when a clear solution will result. At no time should the solution be strongly 
heated, nor should hot water be used in its preparation. After filtration into 
the injecting apparatus it is then ready for use. While best administered in 
any suitable gravity apparatus, neo-arsphenamine is often injected by means 
of a large-sized Luer's syringe, a process that must be slowly and carefully 
conducted. Dose, 0.6 to 0.9 Gram (9 to 14 grains); in the same ratio for the 
weak and malnourished as for arsphenamine. The more common dosage 
of neo-arsphenamine is 0.6 Gm. (9 grains), for three or more injections at 
SUBSTITUTE FOR ARSPHENAMINE. 
219 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
intervals of a week or more. For a carefully-worked out consideration of 
Salvarsan and Neo-salvarsan therapy the reader is referred to Kolmer's 
"Infection, Immunity, and Specific Therapy." 
Important precautions in administering A rsphenamine and Neo-arsphenamine have been 
issued (1919) by the United States Public Health Service of the Treasury Department, as 
follows: 
Experience has shown that the untoward results occasionally associated with the 
administration of arsphenamine are due in a large measure to the use of too highly con- 
centrated solutions of the drug, to too rapid administration, and to insufficient care in 
rendering the solution slightly alkaline. 
The reader, therefore, may be interested in studying the following instructions just 
issued to medical officers of the Public Health Service regarding the administration of 
arsphenamine and neo-arsphenamine. Careful observance of the precautions here de- 
scribed will reduce the number of reactions from the use of these drugs. 
General Directions.-The ampule, before opening, should be immersed in 95 per cent 
alcohol for 15 minutes in order to detect any crack or aperture not primarily recognizable. 
(Should such a breach be discovered, the contents of the ampule should be discarded.) 
Arsphenamine.-(1) Solution. Cold, boiled, freshly distilled water should be used 
in all cases except in the case of "arsenobenzol" made by the Dermatological Research 
Laboratory, in which case hot water is required. No more solution should be prepared 
at one time than can be given in 30 minutes. 
(2) Neutralization and alkalinization of the above solution.-With a graduated pipette 
or burette add 0.9 cc. of normal NaOH for each 0.1 Gm. of the drug (i. e., 5.4 cc. for each 
0.6 Gm.). The alkali should be added all at once and should quickly convert the acid salt 
solution of arsphenamine into the alkaline salt solution, or the disodium salt of the 
arsphenamine base. (The solution of arsenobenzol, which is hot, should be cooled before 
adding the alkali.) This represents slightly more alkali than just enough to redissolve the 
precipitate formed by the addition of this reagent. 
The alkali used should be standardized against normal acid. Normal NaOH is a 4 per 
cent solution of the c. p. product. However, if made on the basis of weight, it may be con- 
siderably less than this strength, hence the necessity for titration. It could be made up in 
amount sufficient for a month's use if kept in a well-stoppered bottle and exposed to the air 
for only a few seconds at a time when using the solution. It should be kept in a bottle that 
has been used for NaOH solution for some time, so that all action it causes in the glass will 
have occurred. Where it is impossible to have this made up at the station, it will be fur- 
nished upon request from the Hygienic Laboratory. Should the NaOH solution become 
cloudy or contain a precipitate, it should be discarded. 
(3) Concentration of the drug.-It is desired to emphasize the fact that the concentra- 
tion of the drug should not be greater than 0.1 Gm. to 30 cc. of final solution. The practice 
of using concentrated solution is not only in direct conflict with the instructions on the 
circular, but carries a distinct hazard to the patient. 
(4) Method of injection.-The gravity method only should be used. Where several 
patients are to be injected from the same solution, the container for the solution should be 
graduated. If not already graduated, this can be done in a few minutes by sticking on a 
strip of adhesive plaster and marking the graduations on this. A convenient way to do 
this is to have each mark represent 30 cc., with a long mark for each 180 cc.; then, if the 
volume is made up so that each 0.1 Gm. of drug is contained in each 30 cc., the doses can 
be given accurately. It is a great convenience to have a glass stopcock near the glass 
tubing, which serves as a window just above the needle in order to control the rate of 
injection. If no stopcocks are at hand, the rate can be controlled by the size of the needle 
and the height of the column of fluid. A No. 18 or 20 B. & S. gauge is the best sized needle. 
(5) Rate of injection.-Operators should pay particular attention to the rate of adminis- 
tration and in no case should it exceed 0.1 Gm. of drug (30 cc. of solution) in two minutes. 
This point is especially emphasized because it is believed that excessive rapidity of adminis- 
tration accounts for more unfavorable results in the use of arsphenamine than any other 
one thing. 
Neo-arsphenamine.-The principal precautions to be observed in the administration of 
neo-arsphenamine are: 
(1) Only a single ampule should be dissolved at a time. This drug must not be dis- 
solved in bulk to be given to a series of patients. 
(2) Cold water only should be used. 
(3) The dilution should be not stronger than 0.1 Gm. of the drug in 2 cc. of freshly 
distilled water 
(4) A very small needle should be used, and the time of injection of the dose should 
not be less than five minutes. 
220 WILD GINGER 
(Asarum canadense) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Wild Ginger is of more interest to pharmacy than to medicine. Still it was an important early 
medicine in domestic simpling and in later Eclectic professional use. It enters considerably 
into diaphoretic infusions and is used as a stimulating expectorant and as a flavor in pectoral 
preparations. Note the position of the flower, close to the ground, for the convenience of 
fertilization by means of crawling insects. (See also Virginia Snakeroot.) INDIVIDUAL DRUGS. 
ASAFCETIDA. 
A gum-resin derived from the rhizome and rootlets of Ferula Asafatida, Linne; 
Ferula foetida, Regel, and other species of Ferula (Nat. Ord. Umbelliferae). Persia and 
other parts of Western Asia. Dose, 1 to 10 grains. 
Common Names: Asafetida, Gum Asafetida. 
Principal Constituents.-A volatile oil and a bitter resin to both of which its virtues 
are mostly due; also gum. The unpleasant odor is due to the presence in the oil of allyl 
sulphide chiefly. 
Preparations.-1. Emulsum Asafoetida, Emulsion of Asafetida (Milk of Asafetida). 
Dose, 1 fluidrachm to 1 fluidounce. 
2. Tinctura Asafoetidce, Tincture of Asafetida. Dose, 5 to 30 drops. 
Specific Indications.-"Nervous irritation, with mental depression, 
headache, and dizziness; hysteroidal conditions; convulsive disorders from 
purely functional wrongs of the stomach, gastro-intestinal irritation, with 
flatulence and palpitation of the heart; dry, deep, choking bronchial 
cough" (American Dispensatory'). 
Action.-Asafetida is a general excitant causing quickened breathing 
and heart-action, genito-urinary irritation, increased sexual desire, and 
mucous feces. It also increases the bronchial secretion. In overdoses it 
may cause dizziness and headache. 
Therapy.-Asafetida is carminative and antispasmodic, and is a very 
useful nervine for functional spasmodic affections. It is especially adapted to 
neurotic individuals subject to hysterical or emotional attacks, usually at- 
tended by flatulent distention of the abdomen. In gastric discomfort with 
flatulence and nervous excitability, and in the flatulent colic of children and 
flatus due to intestinal indigestion of old persons, asafetida is extremely 
satisfactory. Tympanites occurring during fevers is often relieved by it, 
for its carminative influence is especially effective upon the lower bowel. 
Owing to its expectorant qualities it is occasionally serviceable in the 
bronchitis of the aged, in which secretion is free but the power to ex- 
pectorate is weak. It is also an ideal sedative for the nervous cough follow- 
ing the active stage of whooping cough. It relieves the nervous irritability 
of dentition. On the whole asafetida is a simple and efficient remedy best 
adapted to disorders with nervous depression, more or less feebleness, and 
particularly if associated with constipation, flatulence, or tardy or imperfect 
menstruation. Asafetida is contraindicated by inflammation. It may be 
given in emulsion, tincture, or pill or capsule. 
ASARUM. 
The rhizome and rootlets of Asarum canadense, Linne (Nat. Ord. Aristolochiaceae). 
A native perennial of the United States found in rich soils in woods, mountains, and along 
road sides. Dose, 5 to 30 grains. 
Common Names: Wild Ginger, Indian Ginger, Canada Snakeroot. 
Principal Constituents.-An acrid resin, a spicy volatile oil, and thought to contain 
among other fractions, methyl-eugenol, a principle not before found in nature. 
Preparations.-1. Tinctura Asari, Tincture of Asarum. Dose, 1/2 to 2 fluidrachms. 
2. Infusum Asari, Infusion of Asarum (gss; Water, Oj). Dose, ad libitum. 
3. Syrupus Asari, Syrup of Asarum. Dose, fl 3j to fl 3ij. 
Action and Therapy.-A very pleasant stimulating carminative, 
diaphoretic and emmenagogue, of considerable value in amenorrhcea from 
recent colds, in atonic dysmenorrhcea, and in flatulent colic. A warm infusion 
is a very good diaphoretic with which to "break up a cold". Asarum may 
221 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
be added to cough mixtures, and with syrup forms a very agreeable vehicle 
for the administration of pectoral medicines to be used in the chronic coughs 
of debility to aid expectoration. It is contraindicated by gastro-intestinal 
inflammation. 
The root of Asclepias tuberosa, Linn6 (Nat. Ord. Asclepiadaceae). United States and 
Canada. Dose, 5 to 60 grains. 
Common Names: Pleurisy Root, Butterfly Weed, Orange Swallow-wort. 
Principal Constituents.-Resins and a glucoside. 
Preparation.-Specific Medicine Asclepias. Dose, 1 to 60 drops. (Usual form of 
administration: Specific Medicine Asclepias, gtt. xx, to 5ij; Water, giv. Mix. Sig. 
One teaspoonful every 1 or 2 hours.) 
Specific Indications.-"Pulse strong, vibratile; skin moist; pain acute, 
and seemingly dependent on motion" (Scudder). Skin hot and dry, or 
inclined to moisture; urine scanty; face flushed; vascular excitement 
marked in the area supplied by the bronchial arteries; inflammation of 
serous tissues; gastro-intestinal catarrhs due to recent colds. 
Action.-The physiological action of asclepias is not extensive, but 
important. Asclepias slows the action of the heart and lowers arterial 
tension. It especially relieves local hyperaemia by vaso-motor control. 
Through some unexplained, though probably circulatory regulating action 
upon the sweat-glands it produces a true diaphoresis, including the 
elimination of both solids and liquids, the latter sparingly and almost 
insensibly. Its regulation of the true secretion of the skin more nearly 
resembles that of normal or insensible perspiration than that caused by 
any other diaphoretic, corallorhiza possibly excepted. 
Therapy.-Asclepias is one of the most important medicines for 
broncho-pulmonic inflammations and catarrhs, and an agent for re-establish- 
ing suppressed secretion of the skin. It is the most perfect diaphoretic 
we possess, so completely does it counterfeit the normal process of in- 
sensible perspiration. When the secretion of sweat is in abeyance it restores 
it; when colliquative it restrains it through its effect of promoting normal 
functioning of the sudoriparous glands. It may be indicated even though 
the patient be freely perspiring, for sometimes when the liquid excretion is 
abundant there is a retention of the solid detritus, the removal of which is 
one of the effects of asclepias. By softening and moistening the skin, temper- 
ature is safely reduced. Asclepias never causes an outpouring of drops of 
sweat. If such occurs, it is due to bundling with bed-clothing, or the too 
copious administration of either hot or cold water with it. Given in al- 
coholic preparations, in the usual small doses, it merely favors the re- 
establishment of natural secretion. While asclepias is serviceable when the 
temperature is high, it does its best work when heat is but moderately 
exalted, and when the skin is slightly moist, or inclined to moisture, and the 
pulse is vibratile and not too rapid. In fact, in febrile and inflammatory 
disorders asclepias is not a leading remedy, but is largely a necessary ac- 
cessory. If the pulse be rapid and small, aconite should be given with it; 
if rapidly bounding, large and strong, veratrum. While useful in disorders 
of adults, especially old persons, asclepias will be most often indicated in 
diseases of infants and children. While it acts best when strictly indicated, 
it is almost never contraindicated in acute respiratory affections. 
ASCLEPIAS. 
222 INDIVIDUAL DRUGS. 
In acute chest diseases asclepias is useful to control cough, pain, 
temperature, to favor expectoration, and restore checked perspiration. 
When cough is dry and there is scant bronchial secretion, asclepias stimu- 
lates the latter and thus relieves the irritation upon which the cough 
depends. In chest disorders requiring asclepias our experience verifies the 
classic indications for it. 
The asclepias condition in broncho-pulmonic disorders shows either a 
hot and dry skin, or there is pungent heat of the skin with inclination to 
moisture, the pulse is usually full and active and even may be bounding, 
much as when veratrum is indicated. The face is flushed, there is, in 
children particularly, marked restlessness, and more or less febrile reaction. 
In chest disorders there is pain upon motion-pleural pain-and the cough is 
short, hacking, barking, rasping, and nervous-and restrained as much as 
possible on account of the pain and soreness it occasions. Bronchial 
secretion is arrested, though that of the skin may be in evidence. The 
early Eclectics were neither dreaming nor romancing when they voiced 
their verdict concerning the great value of pleurisy root in pleuritic and 
other chest affections. 
With the conditions named asclepias is of the very greatest value in 
acute coryza, la grippe, acute bronchitis, pleuro-pneumonia, and pneu- 
monia, both catarrhal and croupous. Its use should be begun early, usually 
in association with other agents sure to be indicated, and continued through 
the active stage; and if a dry cough persists it should still be continued and 
used freely. There is no kindlier cough medicine than asclepias, and when 
fever is present it is an ideal aid to the special sedatives. Asclepias should 
form an important part of the medication in acute pleurisy and pleurodynia, 
conditions in which it is most efficient and in which it first earned a thera- 
peutic reputation. It may need to be fortified by the intercurrent use of 
aconite or bryonia, or both, and in any case it will enhance the value of these 
agents. 
In pneumonia and in bronchitis asclepias is best adapted to the acute 
stage, where the lesions seem to be extensive, taking in a large area of the 
parenchyma of the lung or the bronchial structures and the mucosa. Web- 
ster declares it best adapted to control vascular disturbances in the area 
supplied by the bronchial arteries, and suggests that by reserving it for 
this use we shall lessen its liability to confusion with other appropriate 
remedies. In the convalescent stage of pneumonia and other respiratory 
lesions, when expectoration is scanty and dyspnoea threatens, small doses 
of asclepias are helpful. It renders a similar service in dry, non-spasmodic 
asthma. The dose for these purposes should be about 5 drops of the specific 
medicine. 
Asclepias is an admirable or adjuvant remedy for the acute catarrhal 
states of the broncho-pulmonary or gastro-intestinal tracts when pro- 
duced by recent colds. Full doses will sometimes "break" ordinary colds. 
Asclepias, euphrasia, and matricaria are the best three agents for "snuffles" 
or acute nasal catarrh of infants. In the irritable mucosa and distressing 
cough of phthisis it is a suitable agent, being also useful to control the 
excited circulation and excessive sweating, as well as being sedative to the 
stomach. In the acute gastro-intestinal disorders of a catarrhal type, 
223 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
especially in the very young who are impressed by the variable weather of 
the summer season, asclepias in small doses frequently proves a helpful 
remedy. It is adapted to those of weak constitutions, sensitive stomach, 
and alternate attacks of diarrhoea or dysentery. These disorders fre- 
quently occur in wet seasons, or when a cold, wet spell quickly follows the 
exhaustive heat of very hot seasons. By aiding the checked perspiration 
less of a burden is put upon the internal organs, and this is the work which 
asclepias does. It sometimes relieves flatulent colic in infants and headache 
in children due to disordered digestion. The fractional doses are preferred. 
Asclepias is of special utility in measles for at least three purposes: 
It alleviates the distressing cough, assists in an early determination of the 
eruption, and controls the present and after catarrhal phenomena. Though 
not often thought of in glandular and skin disorders, it is an ideal medicine 
in mumps and sometimes in mastitis, while for skin affections with excessive 
cutaneous dryness it assists other agents by its moistening diaphoresis. 
Altogether asclepias is one of the most kindly acting and safest agents 
in the materia medica for one that accomplishes so much. One can scarcely 
do harm with it. 
For pleural pain employ specific medicine asclepias in hot water pre- 
ferably, using from ten to thirty drops in an ounce of hot water, every half 
hour, or hour. Carried too far it may cause nausea and vomiting, especially 
if the doses are large and the water merely warm. For cough and other pur- 
poses, employ the specific medicine in the usual way, in cold water, alone or 
in combination with other indicated agents. As a pectoral and expecto- 
rant the compound emetic tincture, which contains asclepias, administered 
in water, syrup or glycerin, or suitable proportions of either of the latter 
two with water, is very effectual in dry chronic forms of cough. 
ASCLEPIAS CORNUTI. 
The root of Asclepias Cornuti, Decaisne (Nat. Ord. Asclepiadaceae). Common in rich 
soils throughout the United States. Dose, 1 to 60 grains. 
Common Names: Milkweed, Common Milkweed, Silkweed, Wild Cotton. 
Principal Constituents.-The milky juice contains a caoutchouc-like body. The root 
contains a glucoside, not yet fully determined and a volatile oil and a bitter principle. 
Preparation.- Tinctura Asclepiadis Cornuti, Tincture of Asclepias Cornuti (gviii; 
Alcohol, Oj). Dose, 5 to 60 drops. 
Action and Therapy.-External. It is a common practice among the 
laity to remove warts by the application of the fresh, milky juice of the 
plant. Krausi believed it effective in removing small epitheliomata. 
Internal. As the root possesses tonic, diuretic, and anthelmintic 
properties it may be used occasionally for the functions indicated. The 
heart-action is stimulated by it, and it has been suggested as a useful remedy 
in muscular rheumatoid affections, acting much like macrotys. Con- 
stipation is said to be favorably influenced by it, and in full doses it is 
recommended to expel intestinal worms. The drug deserves study. 
The young "shoots" or turiones are a favorite pot-herb or "greens" 
in some sections of our country. 
224 INDIVIDUAL DRUGS. 
ASCLEPIAS INCARNATA. 
The root of Asclepias incarnata, Linne (Nat. Ord. Asclepiadaceae). Common in 
damp and wet grounds throughout the United States. Dose, 1 to 60 grains. 
Common Names: Flesh-colored Asclepias, Swamp Milkweed, Swamp Silkweed, 
White Indian Hemp, Rose-colored Silkweed. 
Principal Constituents.-A fixed and a volatile oil, two acrid resins, and an unstable 
amorphous alkaloid asclepiadine, resembling emetine in action. 
Preparation.-Specific Medicine Swamp Milkweed. Dose, 1 to 60 drops. 
Action and Therapy.-Diuretic and vermifuge. There is good reason 
to believe this agent a good diuretic to be substituted for digitalis in cases 
of oedema dependent upon cardiac insufficiency. Its action is similar to that 
of foxglove, without the irritating effects upon the gastric membranes. In 
fact, in small doses it is a stomachic and of some value in chronic catarrh 
of the stomach. In powder, 10 to 20 grains, 3 times a day, it is said to expel 
lumbricoids. 
ASEPSIN 
The trade name of a proprietary compound prepared from wintergreen oil. (Formula: 
C8 H7O3 Na.) 
Description.-A definite sodium compound occurring as a white, crystalline powder, 
of a sharp sweetish taste, and the agreeable odor and flavor of wintergreen oil. Completely 
soluble in hot and cold water; nearly insoluble in cold alcohol, chloroform, and ether, but 
soluble in boiling alcohol and ether. Alkaline in reaction, and decomposed by nearly all 
acids, producing oil of wintergreen. Dose, 1/10 to 1/2 grain, rarely 1 grain. 
Preparations.-1. Solution of Borated Asepsin (Fearn), (Asepsin, 5j; Glycerin, 
fl3ij; Sodii Boras, 3j; Aqua Destillata, fl^vj. Triturate the asepsin with the glycerin 
added by fractions. Dissolve the Borax in the Distilled Water, and lastly, mix the two 
solutions by agitation). For internal and external use. 
2. Asepsin Soap. A pure tallow soap into which is incorporated borax and 
asepsin. A fine detergent and antiseptic soap, especially useful for the infant's toilet and 
for use in dry, scaly, rough skin, and where sebaceous secretion is faulty. It may be had in 
transparent or in opaque form. 
Specific Indications.-Fermentation and putrefaction; pale tongue or 
dusky discoloration of throat and tongue; fermentative dyspepsia with 
atony, flatulence, and colicky pain; tympanites; borborygmus; feeble 
capillary circulation, with tendency to breaking down of tissue. 
Action.-Asepsin, in solution, imparts a sense of slipperiness to the skin. 
It slightly liquefies albumen. A 10 per cent solution causes warmth in the 
skin, while stronger solutions are irritant, reddening the epiderm and im- 
parting a sense of stiffness. It does not, however, harden the integument. 
Solutions of 20 per cent or more are mildly caustic, but do not leave a scar, 
nor dry the secretions. Mucous tissues are energetically attacked by it, 
imparting to them a strong feeling of warmth, and taken internally it causes 
an appreciable rise in temperature. It quickens breathing, increases the 
secretion of urine, to which it imparts its odor, and produces mildly in- 
creased perspiration. Large doses cause intense burning in the stomach, 
with dryness of the fauces. Both heat and dryness are felt in the rectum 
upon defecation. Asepsin is not readily absorbed unless minutely triturated 
with starch or milk sugar, but passes through the bowels as a methyl 
salicylate. When absorbed it may be detected in the urine, both by its 
odor and by the tests for salicylic acid. The digestive ferments are not 
affected by it; on the contrary, minute doses of it appear to encourage 
digestion. 
225 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Asepsin is powerfully antiseptic, antiputrefactive, and anti-fermenta- 
tive. It is also decidedly and agreeably deodorant. It checks alcoholic 
fermentation in cider. Watkins' comparative experiments with beef, fish, 
and mutton in solution respectively in distilled water, mercuric chloride 
and asepsin proved that asepsin retarded change three times as long as the 
bichloride, and without the alteration of the texture of the tissues pro- 
duced by the latter; and that asepsin checked the decomposition already 
occurring in a fragment removed from one of the other solutions. 
Therapy.-External. Asepsin is a fine local antiseptic and detergent. 
It may be used before slight operations to cleanse the parts. After thor- 
oughly removing the asepsin and completely drying the surface, iodine may 
then be applied. Solutions of asepsin may be used to cleanse crushed and 
machinery injuries of dirt and grease. Wounds treated with a weak solution 
of asepsin, or asepsinated distillate of hamamelis, heal quickly and kindly. 
For contusions, cuts, scratches, abrasions, and lacerations, and particularly 
cuts from glass, thorns, or barbed wire or old tin, all of which seem to pro- 
duce excessively painful ragged injuries, the following lotion is unexcelled: 
Asepsin, gr. xx; Echafolta, fgss; Distillate of Hamamelis, Distilled 
(or boiled) Water, aa, q. s., f§iv. Mix. Sig. Apply freely on sterile gauze. 
After the pain has been controlled by Carron oil and the parts cleansed with 
asepsinated water, an ointment or cerate of asepsin may be applied to 
burns and scalds to promote healing, with less likelihood of resulting in 
cicatrization than by almost any other form of treatment. The parts 
should never be allowed to become dry. Sometimes a wet dressing is 
preferred for small burns. Ten grains of asepsin may be added to equal 
parts of water and distilled witch hazel to make 4 ounces and applied upon 
gauze. As a wash for foul ulcers, mammary abscesses, cracked nipples, 
empyema, and ulcerating buboes an aqueous solution of the desired strength 
is both cleansing and deodorant. For fetid feet and offensive armpits it 
is an excellent deodorizer, and dusted full strength upon cancerous 
growths it almost completely masks the stench. A 20 per cent solution of 
asepsin will remove vegetative growths. 
Many skin diseases requiring thorough cleansing and alkaline medica- 
tion may be well treated with a solution, glycerite or ointment of asepsin. 
It is especially useful in rhus poisoning, porrigo, chronic eczema, and 
crusta lactea. A solution of asepsin is deodorant and stimulating to old tibial 
ulcers, and an asepsin ointment gives great relief in pruritus ani and some- 
times comfort in itching piles. 
A solution of asepsin alone or combined with hamamelis, sodium 
sulphite, or potassium chlorate is very effectual in tonsillitis and the angina 
of scarlet fever; and assists materially in the removal of the false membrane 
in diphtheria. For the soreness sometimes following tonsilectomy the fol- 
lowing gives relief from pain and promotes rapid healing: Asepsin, gr. x; 
Glycerin, f3ijJ Tincture of Myrrh, f$j; Water, q. s.;f§iv. Mix. Sig. 
Use as a spray every hour until relieved. An albolene solution of asepsin and 
menthol is useful in coryza and nasal catarrh, and ozaena, and controls the 
distressing sneezing and itching in periodic hyperesthetic rhinitis (hay fever). 
Or an ointment of 5 to 10 grains of asepsin in 1 ounce of petrolatum may be 
used. In extreme necessity 1 grain of cocaine hydrochlorate may be added. 
226 INDIVIDUAL DRUGS. 
A solution of asepsin, alone or with menthol, makes a good mouth 
wash in fevers, and especially for the insane, who are prone to allow particles 
of food to accumulate in the mouth and give rise to dental caries and 
foul breath. It may be combined in powdered or liquid dentifrices. 
The asepsinated myrrh solution mentioned previously is a good dentifrice 
when there are spongy gums and in pyorrhea alveolaris. Fearn used an 
asepsinated borax for similar purposes, as well as a wash for foul discharges 
from the bladder and for purulent conjunctivitis. Previous to dental 
operations asepsin may be used as a cleansing wash, and sprinkled in the 
water before mixing it may be used in preparing plaster for taking im- 
pressions for teeth. It gives an agreeable flavor and prevents nausea. 
After pelvic operations and in obstetrical practice solutions of asepsin 
are of great worth to deodorize and cleanse. For foul smelling leucorrhoea 
the solution of borated asepsin is agreeable and effective; and it is sometimes 
useful as an injection in gonorrhoea in both man and woman. 
Asepsin Soap.-An unirritating soap for cleansing the skin and for use 
in enemata and douches for gynecological and obstetrical purposes. Useful 
for the removal of dandruff, crusts, and greasiness of the scalp, and to 
hasten desquamation after the eruptive fevers. Used also in dry scaly 
eczema, in rhus poisoning, acne, comedones, milium, herpes, seborrhea, 
impetigo, pruritic and parasitic skin diseases, and as a wash for ulcerations. 
The lather may be allowed to dry upon the surface, or after 15 to 30 minutes 
may be removed by hot or cold water, as indicated. Used in this manner 
it is the most effective agent to remove the brownish scurfy scales from the 
scalp of infants, first softening the surface with olive oil. 
Internal. When not contraindicated asepsin may be added to water- 
dispensed medicines as a flavor and preservative. With resinous medicines 
it serves to make clearer mixtures and appears to render them more efficient. 
Such is the case with podophyllum and macrotys. It should not be added 
to solutions containing large amounts of toxic alkaloids, as of aconite, 
belladonna, gelsemium, or opium, lest its strong alkalinity cause precipita- 
tion so that the patient's life may be endangered by getting a large quantity 
of the precipitated alkaloids in the last doses of the medicines. 
As an antifermentative and corrector of putrefaction asepsin has been 
used in typhoid fever, cholera infantum, diarrhoea and dysentery with fetid 
evacuations. The dose must be minute lest increased temperature be 
provoked. In fractional doses it favors digestion when sluggish, and when 
eating is followed by disagreeable and offensive ructus. A good form of 
administration is: Asepsin, gr. v to xv; Sodium Bicarbonate, §j; Trit- 
urate well. Sig. Dose, 1 to 3 grains. A clean white tongue, pale or dusky 
mucosa, gastric fermentation, flatulence and tympanites are the indications. 
Magnesia may be substituted for the bicarbonate when the latter increases 
the distress by sudden liberation of carbon dioxide. In gastric disorders it 
may be combined with many peptics and correctives as ingluvin, nux 
vomica, hydrastis, sodium sulphite or potassium chlorate. Asepsin and 
magnesia may be given in gastric ulcer with excessive hyperchlorhydria, and 
in gastric carcinoma to overcome the stench. Catarrhal forms of stomach 
and intestinal dyspepsia are sometimes benefited by it; and that unpleasant 
227 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
rolling of gases in the intestines (borborygmus) so common and so annoy- 
ing to women is best relieved by asepsin. 
Like all the salicylates, asepsin is useful in acute articular rheumatism. 
It may be given with the other salicylates to modify their taste and increase 
their value, but cannot be given alone in sufficiently large doses to be 
effective in controlling the disease, without increasing the fever and acting 
as a gastric irritant. Thomas reports the effective use of asepsin in an 
alarming case of uterine hemorrhage from a fibroid tumor, in which the 
patient was gradually becoming anemic and dropsical. A teaspoonful of a 
solution of 10 grains of asepsin in four ounces of water was administered 
every half hour or hour during the hemorrhage and four times a day during 
the interval. 
The rhizome of Dryopteris Filix-mas and of Dryopteris marginalis, Asa Gray (Nat. 
Ord. Filices). World-wide ferns of the Northern Hemispheres. Dose, 1 to 4 drachms. 
Common Names: (1) Male Fern; (2) Marginal Shield Fern. 
Principal Constituents.-Oils, resins, filicin, and filicic acid, the poisonous principle. 
Preparation.-Oleoresina Aspidii, Oleoresin of Aspidium (Oleoresin of Male Fern). 
Dose, 30 grains but once a day. Do not give with oils. 
Action and Toxicology.-When freely absorbed the oleoresin causes 
nausea, vomiting, purging, severe abdominal pain, headache, dizziness, 
muscular prostration, tremors, cramps, dyspnoea, cold perspiration, cyanosis, 
collapse, and death. In some cases amblyopia results, and permanent 
visual and aural disturbances have resulted from its toxic action. Unless 
the doses are excessive or frequently given, or given with oil, as castor oil, 
such accidents are less likely to occur. The treatment consists in stimula- 
tion by ammonia and purging by Epsom salt. 
Therapy.-A most certain taenicide, effectually removing tapeworm, 
especially the Bothriocephalus latus and the Tania solium, and said 
to be less effective upon the Tania medio-canellata. Prepare the patient 
in the usual manner over night for the administration of taenicides by 
purging and fasting. In the morning administer 30 grains of the oleo- 
resin in capsules or flavored emulsion, follow at midday with a full meal 
without fats, and in the evening give a brisk saline cathartic. Under no 
circumstances must oils, especially castor oil, be given with it during the 
treatment. They favor absorption of the filicic acid, thought to be the 
toxic principle. Aspidium is seldom used; the oleoresin being preferred. 
The latter is also effectual against the hook-worm ( Uncinaria americand). 
ASPIDIUM. 
ASPIDOSPERMA. 
The dried bark of Aspidosperma Quebracho-bianco, Schlechtendal (Nat. Ord. Apocy- 
naceae). An evergreen tree of Chili and the Argentine Republic. Dose, 5 to 60 grains. 
Common Name: Quebracho. 
Principal Constituents.-Six alkaloids: Aspidospermine (C22H30N2O2), Aspidosperma- 
tine (C22H28N2O2), Aspidosamine (C22H28N2O2), Quebrachine (C21H26N2O2), Hypoquebra- 
chine (C21H26N2O2), and Quebrachamine, the latter sometimes absent. 
The commercial amorphous Aspidospermine is a mixture probably of all the alkaloids 
or is chiefly Aspidosamine. 
Preparations.-1. Fluidextractum Aspidospermatis, Fluidextract of Aspidosperma, 
(Fluidextract of Quebracho). Dose, 5 to 60 drops. 
2. Aspidospermine. 1/4 to 1/2 grain. 
228 INDIVIDUAL DRUGS. 
Specific Indications.-Dyspnoea of functional origin, with or without 
emphysema; face pale, anxious and livid; lips cyanotic; pulse small, 
soft and compressible, irregular or intermittent; cardiac palpitation with 
cough. 
Action.-The various alkaloids of quebracho act more or less antago- 
nistically to each other, but the chief good effect is the increase in depth and 
regulation of the rate of respiration. It should not be used intravenously. 
Therapy.-Querbacho is a remedy for dyspnoea when not due to pro- 
nounced organic changes. Being a centric stimulant to the pneumogastric 
it affects chiefly the cardiac and pulmonary plexuses, and is a remedy of 
power in imperfect oxygenation with a disturbed balance between the 
pulmonic circulation and the action of the heart. It is used in cardiac and 
renal asthma, emphysema, the dyspnoea of capillary bronchitis and of 
chronic pneumonia, advanced bronchitis, phthisis, bronchial asthma and 
uncomplicated asthma with insufficient cardiac force. It relieves the 
cough of la grippe, when associated with dyspnoea. From 5 to 60 drops of 
the fluidextract may be given in water or plain or aromatized syrup. 
ATROPINA. 
Atropine. 
A solanaceous alkaloid derived chiefly from Belladonna.-(Formula: C17H3SO3N.) 
Description.-Odorless, white, prismatic crystals, easily dissolved by alcohol or 
chloroform, less soluble in ether or glycerin, and sparingly in water. It should never be 
tasted except in great dilution and then with extreme caution. Dose, 1/200 to 1/100 grain 
(average dose, 1/120 grain). 
Preparation.-Atropina Sulphas, Atropine Sulphate. Odorless, efflorescent, micro- 
scopic crystals, or a white powder readily soluble in water, glycerin, or alcohol, sparingly 
soluble in chloroform and almost insoluble in ether. Observe the same cautions as for Atropine 
(see above). This salt is preferred to Atropine on account of its greater solubility in the 
commonly-employed solvents. Dose, 1/200 to 1/60 grain (average dose, 1/120 grain). 
Action.-Belladonna and atropine are cerebral excitants and arrestors 
of secretion, and their dominant full action is that of depression or paralysis 
of the peripheral nerve terminals. The general action from small, medium, 
and toxic doses are given under Toxicology. It will be observed that 
small doses stimulate, medium doses suppress secretion by depression of the 
terminal nerves, full medicinal doses cause a febrile state, while toxic amounts 
paralyze. The rapidity of the heart's action is due, first, to stimulation of 
the sympathetic cardiac ganglia (accelerator) and, secondarily, to paralysis 
of the terminal filaments of the vagus-a state of increased motor activity 
with decreased inhibitory power. The capillaries are contracted by 
belladonna, but in poisonous doses dilated, allowing a fall of blood-pressure, 
and being due to paralysis of the muscular layers of the vascular coats, and 
not to cardiac depression. The latter takes place only when the drug is 
given in overwhelming doses. While full doses of atropine or of bella- 
donna cause dilatation of the capillaries of the skin, they contract those of 
the splanchnic circulation, a fact taken advantage of in the treatment of 
shock. Owing to vaso-motor paresis, the temperature falls from toxic 
doses. Atropine causes mydriasis when taken internally by being carried 
in the blood-current directly to the eye and there acting, as when locally 
applied, by causing paralysis of the terminals of the oculo-motor nerve, and it 
is thought also by stimulating peripheral filaments of the sympathetic. It 
229 MATERIA MEDICA, PHARMACOLOGY. AND THERAPEUTICS. 
destroys the power of accommodation and strongly increases intra-ocular 
tension, a fact to be remembered in treating those having or disposed to 
glaucoma. 
Atropine, by its control over the peripheral nerve-terminals, checks 
all the secretions of the body, except those of the kidneys and the bowels. 
Even small amounts entirely stop the salivary output and probably have 
a partially similar action upon the gastric and pancreatic juices and the bile. 
As the nasal, faucial and bronchial glands are similarly affected there occur 
the marked hoarseness, thirst, and dysphagia so characteristic of the drug. 
The innervation of the sudoriparous glands is depressed so that dryness of 
the skin results. Upon the secretion of milk, however, the repression is only 
partial, as the mammary glands are capable of functioning independent of 
nervous assistance. 
The voluntary muscies are but little or not at all affected by atropine; 
involuntary or non-striated muscles are strongly depressed by it. Atropine is 
said to lessen peristalsis, as it slows the action of all tubular organs. Some- 
times, immediately after injecting or giving atropine, the intestinal move- 
ments are quickened. This has been explained by declaring that the inhibi- 
tory endings of the splanchnic nerves are depressed before those of the motor 
control. However, as the musculature of the bowels has an activity en- 
tirely independent of nerve control, movements are not greatly interfered 
with and cathartics and other irritants cause free action even under bella- 
donna administration, the latter chiefly serving the purpose of blunting 
the sensory terminals and thus preventing griping and tormina. While 
even small doses of atropine cause some primary dryness of the gastro- 
intestinal tract, there is some reason to believe that through the complex 
nerve action mentioned above it also allows of secretion, for slight laxative 
effects often follow it and belladonna. Atropine increases tissue waste and 
is itself eliminated very quickly and almost wholly by the kidneys. The 
urine so charged is capable of dilating the pupil of another animal or person. 
Locally, atropine when applied with penetrating solvents, paralyzes 
the sensory nerve terminals so that it proves both anodyne and ansesthetic. 
The sensory control is not so apparent when the drug is given internally, 
though it tends to lessen pain caused by irritant cathartics. 
Except in degree, the toxic effects of belladonna and its chief alkaloid- 
atropine-are practically identical. Small doses cause dryness and con- 
striction of the throat, with possibly disordered vision and such unpleasant 
head symptoms as vertigo and confusion of ideas. Moderate doses provoke 
a greater degree of dryness of the mouth and throat, on account of which 
there follows marked difficulty in swallowing. The pulse is slowed, the 
pupils dilated, accommodation defective, and vision confused. The skin 
becomes dry and hot and a considerable rise of temperature may take place. 
When, however, a dose large enough to produce vaso-motor paresis is 
taken, the temperature falls. 
Toxicology.-Large and toxic doses greatly increase the dryness and 
dysphagia and giddiness, the patient reels or staggers when he walks, 
there is great thirst, and sometimes drowsiness and nausea and vomiting 
occur. The saliva now becomes suppressed, breathing is rapid, and dilation 
of the pupil extreme. Vision is either lost, or indistinct, and double. The 
230 INDIVIDUAL DRUGS. 
pulse-rate may be doubled and the volume is full and hard. A character- 
istic scarlet efflorescence, resembling that of scarlatina, but lacking the 
punctations and subsequent desquamation of the latter, now overspreads 
the countenance and progresses upon the neck and body. This redness is 
usually bisected by a whitish streak leading from the angles of the mouth 
to the cheek bones, giving to the face a rather grotesque appearance. The 
eyes are brilliant and staring, and the conjunctitivse may be congested. 
A peculiar active delirium accompanies and is of an illusional and loquacious 
character. The victim, though oblivious of his surroundings, sees visions, 
entertains spectres, has fancies and hallucinations, and other phantas- 
magoria, and gives way to laughter and gayety; again the cerebral dis- 
turbance may be of a wild, maniacal type, with furious delirium and fighting 
propensities. Loss of speech often occurs early, though repeated move- 
ments of the tongue and lips indicate the efforts to articulate. Purging, 
vomiting, and unsuccessful attempts to micturate are frequent, though 
not constant symptoms of belladonna poisoning. Finally, with (rarely) or 
without convulsions, occurs a complete abolition of function, stupor sets 
in, the pulse becomes rapid and weak, the limbs cold, and death results 
from centric respiratory paralysis. Should the patient recover he seldom 
recollects any of the circumstances of his illness. A livid or cyanotic counte- 
nance is seldom observed in poisoning by atropine. 
Extreme dryness of the throat and mouth, dysphagia, scarlet efflores- 
cence, without puncta, widely dilated pupils, staring eyes, suppression 
of urine, and talkative or wild delirium should lead one to suspect bella- 
donna poisoning. In medication the first four symptoms should be a 
warning to cease the administration of belladonna or its alkaloid. Death is 
not very common from atropine poisoning, though, owing to its wide use, 
toxic results are frequent. In countries where belladonna grows children 
are often poisoned by eating its berries. 
The treatment of belladonna poisoning should be prompt. If seen early, 
emetics, the stomach-pump, lavage tube, and tickling the throat to provoke 
emesis should be resorted to at once. The irritant or local emetics, as 
mustard, zinc sulphate (20 grains), or powdered ipecac, may be used; if 
the case is seen before absorption has taken place, or if there is not much 
depression 1/8 grain of apormorphine hydrochloride may be given sub- 
cutaneously. As imperfect chemical antidotes, tannin and animal charcoal 
or solution of iodine may be useful. Strychnine should be injected to 
sustain respiration, and artificial heat and forced respiration should be 
resorted to. If the heart is not weak, pilocarpine, or eserine (physostigmine), 
may prove physiologically antagonistic, but they should be used with care. 
While by no means a settled fact that morphine and atropine are in all 
respects antagonistic, with the probabilities in favor of their being but 
partially so, it is still recognized that morphine may be judiciously em- 
ployed as an antidote to belladonna and atropine. If used, one should be 
governed by the pupillary response, giving it in small doses until contraction 
is gradually induced. If there is a tendency to pulmonary oedema the greatest 
caution should be observed in its use. Purgatives, such as castor oil, are 
useful to free the intestines from the poison, and sweet spirit of nitre to 
facilitate its removal by way of the kidneys. During the attack retained 
231 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
urine should be drawn by catheterization to prevent resorption of the atro- 
pine. One half grain of atropine killed a middle-aged man, death being 
delayed until the sixth day; 1 grain hypodermatically proved fatal to an- 
other. 
Therapy.-External. Atropine sulphate is used locally to relax spasm, 
alleviate pain, and as a mydriatic and cycloplegic. For most external 
applications, except in ophthalmic practice, belladonna is to be preferred 
to atropine, being more controllable and less likely to induce toxic effects. 
Atropine sulphate is employed oftener than any other agent except 
homatropine hydrobromide, in ocular therapeutics as a cycloplegic to relax 
or paralyze accommodation and as a mydriatic to dilate the pupils where a 
prolonged effect is desired to facilitate examinations of the interior of the 
eye and to determine refraction. Especially is atropine used upon examining 
the eyes of young persons. If not necessary to maintain these effects 
except for short duration, homatropine hydrobromide, or sometimes cocaine, 
is used in its stead. That the latter dries out the cornea and damages it 
must ever be kept in mind. When a drug is needed to prevent or break up 
adhesions, or to prevent contraction of the iris, or its protrusion into or 
through corneal ulcers, atropine is by far the agent of choice. It is largely 
employed in the operation for cataract. In iritis it is the drug to be used 
from start to finish. In central perforating corneal ulcer it should be 
employed sufficiently strong and often enough to keep up a continuous 
ciliary paralysis, thereby insuring full dilatation of the pupil and to pre- 
vent the iris from adhering to the ulcerated cornea. Iritis following cata- 
ract operation is prevented by atropine, and it should be used in deep in- 
terstitial keratitis. In the acute stage of phlyctenular keratitis it may be 
applied to check the flow of tears and relieve the sensitiveness to light, but 
its use should be discontinued as soon as the acute inflammation has sub- 
sided. It may be very carefully used in ophthalmia neonatorum, when 
the cornea becomes hazy, to prevent involvement of the cornea and deeper 
tissues of the eye. In all these conditions a one per cent solution is pre- 
ferred, a few drops being instilled until proper effects are produced and 
maintained. Only freshly prepared sterile solutions should be employed; 
and even when every precaution has been observed atropine will some- 
times irritate violently, producing "atropine conjunctivitis". Under 
such conditions, homatropine hydrobromide is substituted by many. 
Atropine should not be used when there is glaucoma; in phlyctenular 
keratitis after subsidence of the acute inflammation; in keratitis with 
superficial vascularity; in marginal corneal ulcers; in all cases of hyper- 
tension of the globe of the eye; and should not be used if there can be any 
other choice in old persons, on whom it is frequently dangerous, and in 
whom it may produce glaucoma. 
Atropine, in 2 to 4 per cent warm solution, instilled into the aural 
canal, relieves the pain of earache, non-suppurative otitis media, and dif- 
fuse inflammation of the canal. While it is a pain and spasm-relieving drug, 
it is less manageable in acute mammitis and in spasms of the sphincters and 
the tubular organs of the body than extract of belladonna. 
Internal. As a general medicine atropine is sometimes used to fulfil 
many of the purposes for which belladonna is prescribed. It does not, 
232 INDIVIDUAL DRUGS. 
however, fully represent the action of the latter, is less controllable and not 
so satisfactory. Therefore, its substitution for the parent drug has not been 
looked upon with favor by Eclectic physicians. It has been reserved for 
special conditions and as an emergency remedy. Atropine, like belladonna, 
has five well-defined fields of action: to relieve purely nervous pain; to 
relax painful spasms of unstriped muscles; to arrest excessive secretion of 
sweat, saliva, and milk; to contract the splanchnic capillaries in shock; 
and to a lesser extent (internally) as a mydriatic, though its local action 
for this purpose is greatly preferred. Atropine is an efficient drug in purely 
nervous neuralgia, and may be given to relieve the intercostal, trifacial, and 
the sciatic forms, being useful in the order named, though it often fails in 
the latter. In other painful visceral neuroses, as gastralgia, enteralgia, and 
uterine and ovarian neuralgia, atropine sometimes promptly relieves. 
The more purely nervous the type, the better it acts. Atropine is used 
largely to control excessive ptyalism and to check colliquative sweating 
of phthisis and other debilitated conditions. 
Administered hypodermatically, atropine sulphate is one of the most 
valued vaso-stimulants in shock, and in cases where collapse of the respira- 
tory and cardiac functions is threatened. It is also used to support breath- 
ing, and as the physiological antidote in acute poisoning by morphine 
(opium), eserine (physostigmine), muscarine (mushroom poisoning), and 
pilocarpine; and to sustain the respiration in strychnine poisoning and 
chloroform and ether narcosis. It is frequently administered with morphine 
to modify the unpleasant action of that alkaloid, and before anesthetiza- 
tion with chloroform, to lessen excitement, protect respiration, and to 
prolong the action with a lesser quantity of the anaesthetic. 
AURANTII AMARI CORTEX. 
The dried rind of the fruit of Citrus Aurantium amara, Linne (Nat. Ord. Rutaceae). 
Dose, 5 to 30 grains. 
Common Names: Bitter Orange Peel (of Bitter Orange, Bigarade Orange, Seville 
Orange). 
Principal Constituents.- Hesperidin, a crystalline, bitter glucoside; isohesperidin, 
water soluble; aurantiamarin, the bitter principle; and a volatile oil. 
Preparation.- Tinctura Aurantii Amara. Tincture of Bitter Orange Peel. Dose, 
1/2 to 2 fluidrachms. 
Therapy.-Stimulant, carminative and tonic, but used chiefly as a 
flavoring agent. This preparation is contained in both Compound Tincture 
of Cinchona and Compound Tincture of Gentian. 
AURANTII DULCIS CORTEX. 
The outer rind of the ripe, fresh fruit of Citrus Aurantium sinensis, Gallesio (Nat. Ord. 
Rutacese). 
Common Names: Sweet Orange Peel (of Sweet Orange, Portugal Orange, China 
Orange). 
Principal Constituents.-Oil of orange {Oleum Aurantii); other constituents same as 
in Bitter Orange Peel. {Orange Juice [from the pulp of the fruit] contains citric acid, sugar 
and mucilage.) 
Preparation.- Tinctura Aurantii Dulcis, Tincture of Sweet Orange Peel. Dose, 
1 fluidrachm. This agent is used in the preparation of Syrupus Aurantii or Syrup of Orange 
-a syrup containing also Citric Acid. 
233 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-(For Orange Juice). Deep red tongue, with 
brown to black coating; scurvy. 
Therapy.-Sweet Orange Peel. Slightly stimulant, carminative, and 
tonic. Used almost wholly as a flavoring agent. It makes an elegant 
addition to acid solution of iron dispensed in syrup. (See Liquor Ferri 
Acidi.) It is also an agreeable addition to the bitter infusions, as of quassia 
or Peruvian bark. 
Sweet Orange Juice. The juice of the orange is a light refrigerant 
article of diet, and is especially useful where the bowels are sluggish in 
action, and during convalescence from illness, as well as to be given during 
fevers and the exanthemata where acids are craved. It is par excellence the 
remedial agent in scurvy of infants, as well as adults, and if given early will 
abort this unpleasant disorder. Like all acids, orange juice is best in- 
dicated when the patient's tongue is deep-red or coated brown, black, or 
any intermediate color. 
AURI ET SODII CHLORIDUM. 
Gold and Sodium Chloride. 
A mixture of equal parts, by weight, of anhydrous Gold Chloride and anhydrous 
Sodium Chloride, representing when dried, not less than 30 per cent of metallic gold. 
Description.-An odorless, orange-yellow powder of a saline and metallic taste, 
deliquescent in damp air, and freely soluble in water. Dose, 1/60 to 1/10 grain. 
Specific Indications.-Hereditary and acquired syphilis with tongue 
abnormally red and contracted; hyperplasia of tissue. 
Action.-Gold salts act very much like those of mercury. Small doses 
improve the appetite and digestion, full doses cause gastric irritability, loss 
of appetite, and nausea. Long continued use produces fever (auric fever), 
ptyalism without ulceration or tenderness of the gums, and its further 
effects are nervous erethism and the constitutional conditions similar 
to those induced by corrosive sublimate. The sexual organs are stimulated 
to excess by them and menstruation rendered abnormally free. They are 
eliminated chiefly by the kidneys, though to some extent by the skin and 
bowels. Poisoning by them is treated with the same antidotes and in the 
same manner as for mercury compounds. 
Therapy.-Gold and sodium chloride was formerly used to a con- 
siderable extent in chronic interstitial nephritis, and later in mental (hypo- 
chondriacal) and bone and periosteal disorders. It is probably most effective 
when these are occasioned by luetic infection. Outside of some introduced 
uses from homoeopathic sources, especially in eye and ear disorders, the 
chief use of the drug in Eclectic medicine has been in the secondary and 
tertiary phases of syphilis and the skin lesions depending upon a syphilitic 
diathesis. It seemingly acts best when the tongue is contracted and 
redder than normal and the skin circulation fairly active. When buboes are 
present they are of the indolent and nonsensitive variety. The preferred 
doses are from 1/60 to 1/10 grain, from 1 to 3 times a day, administered in 
pill or capsule. It is a very little used drug. 
234 INDIVIDUAL DRUGS. 
AVENA. 
The unripe seed of the Avena sativa, Linne, and the farina derived from the ripened 
seed (Nat. Ord. Graminaceae). Probably indigenous to Sicily and to an island off the 
coast of Chili. Cultivated everywhere. 
Common Names: Oat, Common Oat. 
Principal Constituents.-Starch, oil, albumen, potassium and magnesium salts, 
silica, and a nitrogenous body, avenine. 
Preparations.-1. Avenoe Farina, Oatmeal. Chiefly a food and to prepare oatmeal 
water. 
2. Tinctura Avena, Tincture of Avena. (Cover best unripe oats [in milk] 
with strong alcohol.) Dose, 1/2 to 2 fluidrachms. 
3. Specific Medicine Avena. Dose, 1/2 to 2 fluidrachms. 
Specific Indications.-Nervous exhaustion; nervous debility of con- 
valescence; cardiac weakness of nervous depression; nocturnal losses 
following fevers and from the nervous erethism of debility; nervous head- 
ache from overwork or depression. 
Action and Therapy.-Oatmeal water is sometimes useful to dilute 
"baby foods" and milk when children are not well nourished and suffering 
from summer diarrhoeal disorders. It is also used as a demulcent drink 
in diarrhoea and dysentery of adults. When so used, it should be about 
the consistence of milk. 
Oatmeal gruel, when not otherwise contraindicated, as in diabetes 
mellitus or amylaceous indigestion, is an excellent and easily digested food 
in convalescence from exhaustive illness. It may be sweetened if desired. 
A paste, made by moistening a small quantity of oatmeal, held in the 
hands, with water, will soften roughened skin of the palms and fingers; 
and also remove the odor of some substances, as iodoform. 
Tincture of Avena is a mild stimulant and nerve tonic. It is regarded 
by many as a remedy of some importance for nervous debility, and for 
affections bordering closely upon nervous prostration. It seemingly acts 
well in the exhaustion following typhoid and other low fevers and is thought 
to hasten convalescence, particularly where there is much nervous involve- 
ment and enfeebled action of the heart. In the nervous erethism or the 
enervated conditions following fevers and giving rise to spermatic losses 
it is sometimes effectual, but it seldom benefits such a state when due to 
prostatic irritation, masturbation, or sexual excesses. It may be given to 
relieve spasms of the neck of the bladder; and in some cases of relapsing 
rheumatism. Webster asserts it is useful, not as an antirheumatic, but for 
the debility underlying the rheumatic diathesis, so that the patient is less 
affected by meteorologic influences. Probably its chief value as a medicine 
is to energize in nervous exhaustion with or without spasms. It is useful in 
headache from exhaustion or overwork, or the nervous headache of men- 
struation. It is not a remedy of great power and will be found effective, 
probably, in but few of the conditions mentioned. However, many agents 
of this type sometimes, in exceptional cases, accomplish that which no other 
remedy seems to do. To fortify some of the claims made for this remedy 
is to unwisely challenge the credulity of physicians of bedside experience. 
The much-heralded reputation of this drug to enable the morphine habitu£ 
to throw off the habit has not been sustained. In our own experience we 
have utterly failed to accomplish any good with it in any form of drug 
habit. 
235 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
BALSAMUM PERUVIANUM. 
A balsam obtained from Toluifera Pereira (Royle) Bailion. San Salvador in Central 
America; called Balsam of Peru because first exported to Europe from Peru. 
Common Names: Balsam of Peru, Peru Balsam. 
Description.-A dark brown, heavy fluid of syrupy consistence, without stickiness 
and non-hardening in the air, and having a vanilla-like odor, and an acrid, bitter persistent 
taste. It is soluble in alcohol and chloroform. 
Principal Constituents.-Cinnamein or benzylic cinnamate (C9 H7 (C7 H7) O,) constitutes 
60 per cent of Peru balsam. Other constituents are vanillin, styracin, a fragrant oil and 
a large proportion of resin. 
Action.-Skin eruptions have been produced by applying the balsam 
to the skin, as hives, eczema, and erythema; sometimes the latter results 
from its internal use. These effects are thought to be due largely to im- 
purities in the factitious drug, which is oftener sold than the genuine balsam. 
A good and true product allays dermal irritation and that of the mucosa, 
and has decided antiseptic and parasitic properties. Large doses cause 
gastro-intestinal irritation, with vomiting and diarrhoea. Internally it 
causes increased circulation, some cutaneous warmth, and augments the 
flow of urine and the bronchial secretions. It is excreted by the respiratory 
mucosa, skin, and kidneys, upon which it probably exerts an antiseptic 
effect. 
Therapy.-External. Balsam of Peru is a good parasiticide and has 
given the best of satisfaction in scabies and for the destruction of lice. For 
the former it may be combined with the sulphurated ointments, or may 
be used alone, with an oleaginous and petrolatum base (balsam, 25 parts; 
olive oil, 50 parts; petrolatum, 100 parts). We prefer the former prepara- 
tions. The latter combination is useful in pediculosis, both to kill the nits 
and the lice. Balsam of Peru, either full strength or in desired dilution 
with oils or petrolatum, may be used to cure ringworm of the scalp and 
other forms of tinea, in chronic eczema, and is splendidly effective in senile 
and other forms of pruritus, especially pruritus vulvse, and in chilblains. 
As a stimulant to ulcers of low vitality and pus-oozing granulations follow- 
ing operations, and similar conditions in burns, abscesses, and wounds, the 
old-time use of the balsam has been revived in surgery, applying it in 5 to 
15 per cent solutions in castor oil, and covering well with several layers of 
gauze to allow of free drainage. This method is one of the best forms of 
treatment for old tibial ulcers, due to varicosis, but the patient must be 
compelled to rest the leg in a horizontal position for some weeks in order 
to insure results. The same solution may be poured into small granulating 
sinuses, produced by drainage tubes, that refuse to heal. Beef marrow, 
1 ounce; quinine, 10 grains; and balsam of Peru, 1 drachm, has been 
advised in alopecia. 
Internal. Balsam of Peru is a stimulating expectorant and is of some 
value to restrain secretion in the bronchorrhoea of the aged. It has a similar 
restraining effect upon catarrhal conditions of the gastro-intestinal and 
renal tracts and is sometimes of advantage in stubbornly resisting gonorrhoea. 
Peru balsam should not be used in inflammatory or febrile conditions; and 
its use should be discontinued if it produces gastro-intestinal irritation. 
236 INDIVIDUAL DRUGS. 
BAPTISIA. 
The recent root and leaves of Baptisia tinctoria, Robert Brown (Nat. Ord. Legumi- 
nosse), a perennial shrub-like plant, indigenous to North America. 
Common Names: Wild Indigo, Indigo Weed. 
Principal Constituents.-A poisonous alkaloid baptitoxine (baptising); two glucosides, 
baptisin, non-poisonous, and baptin, laxative and cathartic; and a yellowish resin. Bapti- 
toxine is identical with cystisine, ulexine, and sophorine, toxic principles found in other 
active plants, and resembles sparteine in its action upon the heart. 
Preparations.-1. Decoctum Baptisia, Decoction of Baptisia. (Recent root of Baptisia 
gj, Water Oj.) Dose, 1 to 4 drachms; employed chiefly as a local application. 
2. Specific Medicine Baptisia.-Dose, 1 to 20 drops; as a topical wash or dressing, fl 3 j 
to fl 3 ij to water Oj. Usual form of administration-. I) Specific Medicine Baptisia, gtt. xx; 
Water, fl§iv. Sig.: One teaspoonful every 1 to 2 hours. 
Specific Indications.-Fullness of tissue, with dusky, leaden, purplish 
or livid discoloration, tendency to ulceration and decay (gangrene); sepsis, 
with enfeebled circulation; fetid discharges with atony; stools resembling 
"prune juice" or fetid "meat washings"; face swollen, bluish, and resembling 
one having been frozen or long exposed to cold; typhoid conditions. 
Action.-Large doses of baptisia may provoke dangerous emeto- 
catharsis, sometimes so violent as to induce gastro-enteritis. The evacu- 
ations are soft and mushy, and the effort is often accompanied by a general 
bodily discomfort or soreness. Profuse viscid ptyalism also occurs. Small 
doses are laxative; and the drug also appears to stimulate the intestinal 
glands to secrete more freely and probably increases hepatic secretion. 
Baptitoxine is said to quicken the breathing and accelerate and strengthen 
the heart-beat; but in toxic doses it paralyzes the respiratory center, thus 
causing death by asphyxiation. 
Therapy.-External. Locally the decoction and the specific medicine 
baptisia (diluted with water) are effective as washes and dressings for 
indolent and fetid as well as for irritable and painful ulcers, inflammations 
with full or swollen and dusky tissues, and tendency to destruction, aphthous 
and nursing sore mouth, mercurial gingivitis, sore nipples, and ulceration 
of the cervix uteri, with foul, sanious, or muco-purulent leucorrhoea. Its 
internal exhibition hastens its local action in these conditions. 
Internal. Internally, baptisia is indicated in pathological conditions 
characterized by feeble vitality, suppressed or vitiated secretions, and sepsis 
with a disposition to disintegration and death of tissues. These indications 
are manifest in the peculiar appearance of the parts affected, of the mem- 
branes, and of the patient as a whole. There is a peculiar duskiness of a bluish 
or purplish hue of the skin and mucous structures, and usually there is fetor. 
The face has a bluish, swollen appearance, with expressionless countenance, 
like one who has been long exposed to cold. There may be ulcers of an 
indolent character, with bluish or purplish edges. The excretions are 
fetid-those of the bowels being dark and tarry, or resembling the "washings 
of raw meat or prune juice." Baptisia is not, as a rule, a remedy in acute 
diseases showing great activity, but rather for disorders showing marked 
capillary enfeeblement and tendency to ulceration-in fact, a condition of 
atony. It is contraindicated by hypersemia; indicated by capillary stasis. 
Baptisia is important for its influence upon typhoid conditions. It is 
quite generally regarded as one of our most effective antityphoid agents. 
237 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Here we encounter the dusky appearance of the skin and membranes, the 
sleek, beefy tongue with pasty coating, the fetor of mouth, sordes upon 
teeth and lips, and the sluggish capillary flow. Its usefulness in typhoid 
or enteric fever is one of record. One or more of the foregoing symptoms 
will be present with the addition of the characteristic pea-soup, meat 
washings or prune juice stools, or tar-like viscous evacuations, showing the 
admixture of decomposed blood. In fact, it is likely to be indicated by any 
form of persistent diarrhoea accompanying this type of fever. Typho- 
malarial fever, which is most generally predominantly typhoid, is equally 
influenced for good by baptisia. Typhoid dysentery and typhoid pneu- 
monia, so called, are helped by it just in proportion to the typhoid element 
present. In dysentery the greater the evidence of intestinal ulceration the 
stronger the call for baptisia. 
For septic conditions other than typhoid, baptisia is distinctly useful. 
In putrid forms of sore throat, with great stench and full, dusky tissues, 
the angina of scarlet fever, and tonsillitis, with sluggish circulation and 
fetid exudate, and also when necrotic, baptisia holds a high rank as a 
remedy. It is often valuable as an aid in the treatment of diphtheria, but 
alone should not be relied upon to conquer this vicious disease. When 
most useful the tissues will be swollen, dusky, or blanched, the secretions 
free, and the parts sloughing. Indeed, the most important indication for 
the drug is the tendency to disintegration of tissues. Baptisia is very 
valuable in putrid ulcerations of the nasal passages-in fetid catarrh, 
ozama, and similar disorders with stench and turgidity. Under these cir- 
cumstances it overcomes the putrescency, restrains the discharge, and 
promotes healing of the ulcerated surfaces. 
In all of the local disorders mentioned, baptisia should be given in- 
ternally as well as applied locally. 
Diethylamalonylurea, Barbitonum, Veronal (the German name discarded in America). 
A chemical compound of urea. 
Description.-A fine white crystalline powder, odorless and having a faint bitter taste. 
Soluble in about 150 parts of water. Dose, 5 to 10 grains (in capsule, conseal, or cachet). 
Preparation.-Barbital Sodium (discarded German name, Medinal). More soluble 
than barbital (1 in 5 of water), therefore it can be more conveniently given in solution by 
mouth, rectum, or subcutaneously. Used same as barbital, but acts more rapidly because 
more quickly absorbed. Dose, 5 to 10 grains in sweetened water, capsule, or tablet; 7 grains 
(hypodermatically). 
Specific Indication.-Insomnia with nervous excitability. 
Action and Toxicology.-This drug is reputed to have no action upon 
the blood or breathing, and to resemble trional in effect. In ordinary 
doses it has no after-effects, and loses in power when given nightly for a 
fortnight or more. Very full doses occasion staggering gait, tremors, and 
hallucinations; while excessive doses (exceeding 150 grains) produce death 
after a prolonged sleep. A lethal dose subcutaneously injected disorders 
the heart action and breathing becomes irregular, the Cheyne-Stokes type 
comes on and death terminates a long period of sleep. 
Therapy.-This drug is decidedly hypnotic and to some degree allevi- 
ates pain. It is almost entirely used for the relief of nervous insomnia, in 
which it is reputed to act safely and satisfactorily when the indicated 
dosage is not exceeded. 
BARBITAL. 
238 INDIVIDUAL DRUGS. 
BELLADONNA. 
The (1) dried root and the (2) dried leaves and tops of Atropa Belladonna, Linne 
(Nat. Ord. Solanaceae). Europe and Central Asia; also cultivated. Dose, (1) 1/4 to 1 
grain; (2) 1/4 to 2 grains. 
Common Names: Deadly Nightshade, Dwale. (1) Belladonna Root (Belladonna 
Radix); (2) Belladonna Leaves (Belladonna Folia). 
Principal Constituents. I he poisonous alkaloids atropine (see Atropina), hyoscyamine, 
belladonnine, and hyoscine. There is much confusion concerning the constituents of bella- 
donna, hyoscyamine, with conversion products, probably being the chief alkaloid. This is 
readily convertible in atropine. The alkaloids probably exist as malates. 
Preparations.-1. Specific Medicine Belladonna (prepared from the root). Dose, 
1/20 to 1 drop. Usual method of administration-. 1$ Specific Medicine Belladonna, gtt. 
v to x; Water, flgiv. Mix. Sig.: One teaspoonful every 1 to 3 hours. 
2. Unguentum Belladonnce. Ointment of Belladonna. (This is prepared from the 
Extract of Belladonna, which in turn is prepared from Belladonna leaves. Tincture of 
Belladonna is also prepared from the leaves, while the fluidextract is prepared from 
the root.) 
Specific Indications.-Dull expressionless face, with dilated or im- 
mobile pupils, dullness of intellect, drowsiness with inability to sleep well 
whether there is pain or not; impaired capillary circulation either in skin 
or mucous membranes; dusky, deep-red or bluish face and extremities, 
the color being effaced by drawing the finger over the parts, the blood 
slowly returning in the whitish streak so produced; circulation sluggish, 
with soft, oppressed, and compressible pulse; cold extremities; breathing 
slow, labored, and imperfect; hebetude; the patient sleeps with eyes 
partially open; coma; urinal incontinence; free and large passages of 
limpid urine; fullness and deep aching in loins or back; spasm of the in- 
voluntary muscles. In 3x dilution the indications are: Pallid counte- 
nance, with frequent urination; nervous excitation, with wild and furious 
delirium. Large doses: mydriatic. 
Action.-The action of Belladonna depends largely upon its chief 
alkaloid Atropine. (See Atropina). 
Therapy.-External. Belladonna, and more rarely atropine, may be 
applied for the relief of pain and spasm, and especially for spasmodic pain. 
A lotion of belladonna (5 to 10 per cent) may be used to allay itching in 
general pruritus, eczema, and urticaria. The tincture, painted upon the feet, 
controls local bromidrosis. A weak lotion is effectual in general hyper- 
hydrosis and in the colliquative sweating of phthisis and other debilitating 
diseases. The ointment and liniment may serve a similar purpose. This 
use of belladonna is less desirable, however, than other medication on 
account of the dryness of the throat and mouth, and the ocular disturbance 
it is likely to occasion. 
Ointment of belladonna and the liniment are extremely useful in local 
inflammations and swellings, having a wide range of efficiency. Thus 
they may be applied to painful and swollen joints, forming abscesses, 
incipient and recurrent boils, buboes, hemorrhoids and fissures, inflamed 
glands, and in neuralgia, chronic rheumatism, lumbago, myalgia, pleu- 
rodynia, the chest pains of pulmonary tuberculosis, and in acute mastitis. 
In many of the surface conditions mentioned the plaster may prove most 
effectual. The liniment is especially useful to alleviate cramps in the calf 
of the leg. 
239 MATERIA MEDICA, PHARMACOLOGY AND THERAPEUTICS. 
The ointment is effectual in relaxing rigid os during labor, and carried 
into the urethral canal of male or female it relaxes spasmodic constriction 
of that canal and cystic spasm and relieves pain. Rubbed on the under 
surface of the penis it has given marked relief in chordee. A suppository of 
belladonna relieves spasmodic dysmenorrhoea and may be applied either 
in the vagina or the rectum. A similar application, with or without tannin 
or geranium, may be inserted into the vagina for painful menstruation, 
with leucorrhoea. The liniment and the ointment may be used as anti- 
galactagogues and are especially serviceable after weaning the child or when 
mastitis threatens. All local applications of belladonna should be made 
with judgment and carefully watched lest poisonous absorption take place. 
In many of the conditions mentioned the conjoint internal use is advisable 
-provided the specific indications for the drug are present. 
Therapy.-Internal. Belladonna is employed in Eclectic Therapeutics 
in doses which produce exactly the opposite effects from the gross or 
physiologic and toxic action. Large doses paralyze; small doses stimulate. 
While employed for its physiological effects in some instances, the chief 
use of the drug with us is in conditions showing impairment of the capillary 
circulation in any part of the body with congestion or tendency to blood 
stasis. The size of the dose is of great importance in administering bella- 
donna. Ordinary drachm doses of a dilution of 5 to 10 drops of the specific 
medicine in four ounces of water meet conditions of dullness, hebetude, 
and congestion, as first pointed out by Scudder. Others claim that the 
use of infinitesimal doses, of the 3x dilution, acts promptly in conditions 
of nervous exaltation, with great irritability and impressionability of all the 
senses; in some cases the hyperaesthesia amounts to delirium and it is 
then claimed to be most efficient to control both mild and furious outbreaks 
of delirium. Others again (and this agrees with our personal experience) 
find marked pallor of the surface, with contracted pupils, the indication 
for minute doses of the drug. Following a law which appears to be com- 
monly borne out in therapeutics, that opposite effects are produced by large 
or by minute doses respectively, belladonna seems a possible therapeutic agent 
in many varied conditions. The cases, however, in which belladonna appears 
to have rendered the best service are in those in what might be called 
medium doses, as advised by Scudder, in which the drug is employed to 
overcome dullness, hebetude, expressionless countenance, tendency to 
congestion, dilated pupils, and a dusky redness effaced upon pressure, the 
blood slowly returning. For specific medication purposes the drug should 
not be given in doses sufficient to produce mydriasis. At the risk of repetition 
of some of the conditions and to make the belladonna picture more com- 
plete, we quote from a former article in the American Dispensatory: 
The first and great use for belladonna in specific doses is for congestion. 
It is a prompt remedy in throbbing congestive headache, or nervo-con- 
gestive headache; or a dull, heavy headache with a feeling of drowsiness, 
as if, were it not for the pain, the patient would drop off to sleep. When a 
dull, dusky or livid condition of the surface showing capillary feebleness 
and hebetude is threatened in typhoid fever or in pneumonia, belladonna 
is of the greatest importance as a stimulant, and in the latter assists in 
sustaining the respiratory function. While it is a remedy for blood-stasis in 
240 INDIVIDUAL DRUGS. 
any part of the body, due to dilation of the capillaries, it is perhaps more 
pronounced in its effects when the impairment of the circulation takes place 
in the nerve centers. It is the first remedy to be used when there is cerebral 
or medullo-spinal congestion as evidenced by dullness and coma. Though 
oftenest demanded in acute diseases, it is of equal value in chronic cerebral 
disorders with dizziness, drowsiness, and dull heavy aching or fullness in 
the head. When the eye is dull and the pupil dilated, and drowsiness is 
marked, and there are other signs of congestion that may lead to engorge- 
ment of the brain, a threatened attack of apoplexy may be warded off by 
the timely use of small doses of belladonna. 
Belladonna is a remedy for pain and for spasm. It sometimes relieves 
deep-seated pain, as in facial, intercostal, visceral and sciatic neuralgia. 
If there is an elevation of temperature, it should be associated with aconite 
if the circulation is much excited. It is better, however, to relieve spas- 
modic pain of the involuntary muscles of the tubular organs-spasm of 
the anus, uterine, cystic, urethral, and other visceral spasms. If any of the 
parts can be reached it is well to apply the drug locally at the time it is 
given internally, but care must be had not to overdose the patient. Its 
value in spasmodic dysmenorrhoea, when otherwise specifically indicated, 
is unquestionably great. 
Belladonna is conceded one of the best of our remedies for whooping- 
cough. It will fail here unless otherwise specifically indicated. Spasmodic 
cough alone does not indicate it; there must be the tendency to congestion 
and the capillary impairment to make it act beneficially. No remedy, 
probably, cures pertussis, but many shorten its duration, lengthen the in- 
tervals between paroxysms, and render it less severe. Belladonna is one 
of the best for this purpose. When cough is purely nervous and when 
due to irritability of the tubular musculature it is an important drug. 
This is shown in its power to relieve nervous cough from laryngeal irritation 
and in spasmodic asthma. 
Belladonna relaxes spasm. It sometimes overcomes constipation in 
this manner, has served fairly well in spasmodic constriction of the bowels, 
and has relieved both pain and spasm in lead colic and spasmodic in- 
testinal colic. When epilepsy is associated with congestive symptoms it 
has assisted other remedies to lessen the severity and lengthen out the 
intervals of attack. The same is true in chorea. Little dependence can be 
placed upon it in puerperal convulsions, a condition for which it has been 
commended. 
Few medicines act better in severe sore throat with redness, rawness, 
swelling, intense soreness, difficult swallowing, and dryness of the throat, with 
or without fever. Usually aconite is to be given with it. In such conditions 
it will promptly do good in tonsillitis, especially of the quinsy type, and in 
pharyngitis and faucitis. If there is an associated coryza it will relieve it, 
though it acts more promptly in acute coryza when the throat inflammation 
is absent and it can be given in slightly larger doses than are required for 
general specific purposes. Many maintain it valuable in diphtheria and 
believe that it interferes with the formation of the membranes. We question 
its value for that purpose, though it certainly helps to sustain the breathing 
and circulatory powers in a disease threatened from the very start with a 
241 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
depression of these functions. In acute inflammations, such as non- 
vesicular erysipelas, with deep redness of the skin, capillary impairment, and 
sense of burning, belladonna should be given with confidence. It acts best 
where the inflammation is very superficial and does not subsequently 
extend deeply into the subcutaneous tissues. 
The value of belladonna in the exanthemata ranks with the most 
certain of therapeutic results. It is practically always indicated in scarlet 
fever and very frequently in measles. Chicken-pox does not so often de- 
mand it; while in the congestive stage of small-pox it is claimed to be a 
most certain aid for many therapeutic purposes. We rely upon it abso- 
lutely in scarlatina, and the more malignant the type the more it is in- 
dicated. We do not recall a case of scarlet fever in which we have not 
employed it, and always with the desired effect. Often no other agent has 
been required. Its use should be begun early. It then brings out the 
eruption, re-establishes the secretions of the kidneys and bowels, alleviates 
the distressing throat symptoms, and protects against congestion and 
subsequent nephritis. The dose must be small, however. If too large 
it favors congestion. Never more than teaspoonful doses of a dilution of 
5 to 10 drops of the specific medicine in four ounces of water should be 
given every 1 or 2 hours. More often from 2 to 5 drops in the mixture are 
preferable. It serves much the same purpose in measles, and helps also 
to control the cough. After the eruption has appeared it is less often 
demanded in the latter disease, but in scarlet fever it may be needed from 
start to finish. When one observes the power of belladonna to arouse the 
patient from a stupid or drowsy state, or even from unconsciousness, or 
sees it quiet delirium, bring out the eruption, and incite the kidneys to 
natural action, the power of small doses of powerful medicines becomes 
convincing even to the most skeptical who believe only in near-toxic or 
physiological actions of drugs. The action of belladonna in scarlet fever 
is one of the strong arguments in favor of specific as compared to gross 
medication. To accomplish desired results without the least danger with 
a drug capable of great damage constitutes true or specific medication. 
Belladonna meets many of the complications attending or following scarlet 
fever, and is probably a preventive of many unpleasant sequelae. While 
especially a child's remedy it should be cautiously used. We have ob- 
served the scarlatinoid rash from very minute doses of belladonna. 
Many physicians believe that minute doses of belladonna are pro- 
phylactic against scarlet fever. This view is shared by many good thera- 
peutists, among them Scudder, Fyfe, Ellingwood, and many others. Perhaps 
it is a matter of faith, but we have never had reason to feel it an established 
fact. Whether true or not, we do believe, however, that an advantage 
will have been gained by its early administration should an attack of scar- 
latina ensue, and certainly it can do no harm if given in infinitesimal doses. 
Belladonna stimulates and at the same time relieves the irritability of 
weakened conditions of the kidneys and bladder. Under its influence both 
watery and solid constituents are increased. It is the remedy for enuresis 
in small children when the fault depends upon poor pelvic circulation or 
chronic irritability of the bladder. It is best adapted to diurnal dribbling 
of urine. When due to a "cold," and there is marked pallor, and dullness 
242 INDIVIDUAL DRUGS. 
of the eye so characteristic in children with enuresis, and the patient voids 
urine every quarter or half hour, belladonna is promptly helpful. 
Belladonna is a remedy of power in acute congestion of the kidneys, 
and in the early or congestive stage of kidney disorders tending to chro- 
nicity. It is indicated by the sense of fullness, weight and dragging in the 
loins. In the early stage of tubular nephritis, and in scarlatinal nephritis, 
and in fact in renal capillary engorgement accompanying or following any 
disease, belladonna is a remedy of first importance. 
It is one of the best of remedies for polyuria or so-called diabetes in- 
sipidus. A belladonna plaster should be applied while giving the remedy 
internally. Sometimes quite full doses are required to effect results. Full 
doses are also required to check the colliquative sweating of phthisis 
pulmonalis and other debilitating diseases, and its well-known quality of 
causing dryness of the mouth is taken advantage of in mercurial and other 
forms of salivation, especially the ptyalism of pregnancy. 
Spermatorrhoea, with feeble pelvic and genital circulation, is some- 
times better treated by belladonna than any other remedy. In such a 
state pulsatilla is a valuable aid to the belladonna. 
It is sometimes effectual in urticaria, especially when sluggish cutane- 
ous circulation is a prominent feature. 
BENZOSULPHINIDUM. 
Benzosulphinid, Saccharinum, Saccharin, Glusidum, Gluside. (Formula: C. FL COSO, 
NH). 
The anhydride of orthosulphamido-benzoic acid prepared from toluene, a coal tar 
derivative. 
Description.-In white crystals or crystalline powder, of an intensely sweet taste, and 
practically no odor. Its sweetening power is 300 times that of cane sugar. Soluble in water, 
about 300 parts, more readily in hot water and alcohol, slightly soluble in ether or chloro- 
form, and readily in alkaline hydroxides, ammonia water, and sodium bicarbonate, in the 
latter with the evolution of carbon dioxide. On account of its more ready solubility the 
sodium salt is usually employed for general prescribing (see below). Dose, 1 to 3 grains. 
Preparation.-Sodii Benzosulphinidum, Sodium Benzosulphinid-Sodium Saccharin, 
Soluble Saccharin. The sodium salt of saccharin prepared by neutralizing an aqueous solu- 
tion of the latter with sodium carbonate or bicarbonate, and slowly crystallizing the product. 
Colorless, efflorescent crystals or white crystalline powder, odorless or faintly aromatic, 
and intensely sweet. Very soluble in water (1 1/2) and alcohol (50). Dose, 1 to 3 grains. 
Action and Therapy.-External. Sometimes used as a lotion for 
aphthae oris and ozaena. 
Internal. An antiseptic used chiefly for its sweetening power, in lieu 
of sugar, in food and drink for diabetics and the obese, and in other in- 
stances where sugar is not permissible. Little effect is observed on the 
secretions of the body, or the circulation, or nutrition. Saccharin passes 
from the body unchanged almost wholly by way of the kidneys, where it 
exerts antiputrefactive powers of value in urinary disorders with purulent 
urine and in cystitis with ammoniacal urine. It is also effective in fermenta- 
tive disorders of the stomach and bowels with flatulent distention. The 
very small quantity required for ordinary sweetening purposes is not likely 
to act deleteriously, though it has been held to have retarded the secretion 
of the digestive ferments-ptyalin, pepsin, and trypsin-thus interfering 
with salivary', stomachic, and pancreatic digestion, when it is given in 
243 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
amounts exceeding 5 grains a day used persistently. It is not used much as 
a medicine. Being partially eliminated by the saliva, it is apt to leave a 
persistently unpleasant taste. Soluble Saccharin is the most convenient 
for general purposes. Saccharin may also be used to partially mask the 
taste of quinine, guaiac, and cod-liver oil. 
BERBERIS. 
The root of Berberis aquifolium, Pursh (Nat. Ord. Berberidaceae). Western United 
States from Colorado to the Pacific coast; cultivated also for ornament among shrubbery. 
Common Names: Oregon Grape, Mountain Grape. 
Principal Constituents.-Berberine, the yellow alkaloid (see Hydrastis) and two white 
alkaloids-berbamine and oxyacanthine. 
Preparation.-Specific Medicine Berberis. Dose, 1 to 30 drops. 
Specific Indications.-Syphilitic dyscrasia; chronic skin diseases, with 
blood dyscrasia with or without syphilitic taint; profusely secreting 
tumid mucous membranes; indigestion, with hepatic torpor. 
Action and Therapy.-This agent is alterative, tonic, and probably 
corrective to syphilitic constitutions, but without any proved specific 
action upon treponema. It stimulates secretion and excretion, improves 
digestion and assimilation; it activates the lymphatic system and ductless 
glands; and augments the renal secretion. It is a corrector and eliminator 
of depraved body fluids and assists thereby in good blood-making. In this 
way most likely its good effects are produced in such grave constitutional 
disorders as syphilis. Certainly the ravages of this disease are lessened 
under these circumstances and aggravated by general ill-conditions. If 
then syphilitic dyscrasia is benefited by this drug, and clinical results 
seem to show that it is, it is probably due to its general alterative effects 
in maintaining good elimination and good metabolic action of the organs 
vital to nutrition. 
Like hydrastis, Berberis aquifolium is an excellent peptic bitter and 
tonic to the gastric function, and is, therefore, a drug of much value in 
atonic dyspepsia, with hepatic torpor. Upon the mucosa its effects are like 
those of hydrastis controlling catarrhal outpouring and erosion of tissue. 
For this purpose it is useful in stomatitis and gastric and intestinal ca- 
tarrh. Remotely it sometimes controls leucorrhcea. If these are associated 
with syphilis, it helps the latter to the extent that it controls these disorders. 
Berberis aquifolium has won its reputation chiefly as a remedy for the 
syphilitic taint. The more chronic the conditions or results of the disease, 
the more it has been praised. Some claim that if given early it will abort 
the tertiary stage, but this of course depends in most cases upon the 
resisting powers of the body and the care the patient takes of himself. 
Apparently berberis fortifies the resisting powers by its alterative and repar- 
ative action. The bone, mucosa, and cutaneous disorders following in the 
wake of syphilis seem to clear up under its persistent use, when given in 
appreciable doses. Whether it has any effect on the nervous damage from 
this taint is not yet apparent. It does, however, relieve the night pains 
and the shin pain of syphilitic periostitis. Syphilitic phagedena disappears 
under its use, and sometimes the anemia of syphilis yields to its nutritional 
improvement. It should be given freely in syphilitic leucoplakia of the 
244 INDIVIDUAL DRUGS. 
tongue, mouth, and throat, where the mucosa is tumid and secreting 
excessively, and when emaciation and weakness with yellowish parchment- 
like skin are evident. At all events, though probably not a direct anti- 
syphilitic, its general effect upon waste and nutrition is so beneficial that 
it should invariably be associated with other treatment in chronic syphilitic 
diathesis. 
Other dyscrasiae seem to be influenced by this drug. It aids to some 
degree to mitigate the miseries of the consumptive, and in chronic skin 
diseases its internal use has hastened the effects from external medication. 
Eczema, psoriasis (temporarily at least), and herpetic eruptions have dis- 
appeared under its persistent use. The specific medicine should be given 
in doses of from 10 to 20 drops well diluted, every 3 or 4 hours. 
The bark of the root and the berries of Berberis vulgaris, Linne (Nat. Ord. Ber- 
beridaceae). Europe, Asia, and the United States. 
Common Names: Barberry, Common Barberry. 
Principal Constituents.-Berberine (see Hydrastis) is the active alkaloid; others are 
oxyacanthine and berbamine. The berries contain malic acid. 
Preparation.- Tinctura Berberidis Vulgaris, Tincture of Berberis Vulgaris. (Bar- 
berry Bark, 5 viij, Alcohol, 76 per cent, Oj.) Dose, 5 to 60 drops. 
Action and Therapy.-Barberry may be used for purposes for which 
berberine medication is needed. It acts much like hydrastis and could 
be employed for many of the uses of that scarce and high-priced drug so 
far as the berberine effects are required. The fluid preparations are as- 
serted to act more kindly and more efficiently than berberine itself. It was 
very early used in domestic medicine for sore eyes, and later by practitioners 
for chronic catarrhal ophthalmias. The decoction is employed for this 
purpose, and is equally efficient in aphthous sore mouth. It is decidedly 
tonic and if pushed, purgative. Used short of its cathartic action it is of 
value in non-obstructive jaundice and in gastric and intestinal dyspepsia. 
In renal catarrh, occasioned by the presence of calculi, small doses may be 
given when there is burning and soreness and excess of mucus in the urinary 
tract. 
BERBERIS VULGARIS. 
BETANAPHTHOL. 
Betanaphthol, Naphthol. 
A monohydroxyphenol of Naphthalene, a phenol occurring in coal tar but usually 
prepared artificially from naphthalin. (Formula: C10 H7 OH.) 
Description.-Permanent, colorless or faintly buff-colored shiny scales, or a crystalline 
white or yellow-white powder, with sharp taste, and weak phenol-like odor. Soluble freely 
in alcohol and ether, less so in glycerin or olive oil, and sparingly in cold water, but quite 
freely in boiling water. Dose, 4 to 8 grains. 
Action and Therapy.-External. Betanaphthol is deodorant, anti- 
septic, and antifermentative. Either in vapor or solution it is quite irritant, 
and its injudicious use as a topical agent has produced nephritis. Strong 
solutions in water or alcohol fissure the skin. A 10 to 15 per cent ointment 
has proved efficient in scabies, but it acts better when combined with 
sulphur ointment and balsam of Peru. It is also efficient in pruritus, 
prurigo, psoriasis, acne, pediculosis, ichthyosis, herpes, and lupus ery- 
thematosus when not actively inflamed, but it has proved too irritating 
245 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
for use in eczemas. A soapy solution has been employed in ozaena with 
apparent benefit. Weak solutions (5 per cent) have been advised in 
trachoma and in purulent ophthalmia, but it appears to be extremely 
irritating and is especially contraindicated where there is ulceration of the 
cornea. 
Internal. Betanaphthol is an intestinal antiseptic, the bismuth salt 
(bismuth betanaphthol) being usually preferred. About 8 grains is the 
usual dose, repeated several times a day. Its chief use is to prevent fermen- 
tation in diarrhoea, dysentery, gastric and intestinal dyspepsia. As it 
frequently causes irritation of the stomach it is advised (except in gastric 
catarrh and gastric dilatation) in keratin-coated pills, so that it will not act 
until it reaches the intestines. Its tendency to readily cause acute nephritis 
should be constantly kept in mind, and this circumstance has militated 
against its becoming popular with Eclectic physicians. It is said to be 
second only to thymol in value for the destruction of the hook-worm, from 
10 to 30 grains being a sufficient daily amount. Naphtalin has been used for 
similar uses to those of Betanaphthol. It is the commonly used "tar 
camphor'' or "moth balls." 
BISMUTHI SUBNITRAS 
Bismuth Subnitrate. 
Description.-An odorless and nearly tasteless white powder; though slightly absorbing 
moisture from the air it is nearly insoluble in water, nor does alcohol dissolve it. Both 
hydrochloric and nitric acids readily effect its solution. Dose, 1 to 15 grains. 
Related Salts are Bismuth Betanaphthol (Dose, 1 to 15 grains); Bismuth Subcarbcnate, 
Bismuth Subgallate (Dermatol), and Bismuth Subsalicylate, the dose of each ranging 
from 1 to 15 grains. (See also Liquor Bismuthi.) 
Specific Indications.-Elongated, red, pointed tongue, especially 
reddened at tip and edges; gastric uneasiness, with heat or pain from irrita- 
tion; pyrosis, with acrid or acid eructations; intestinal irritation, with 
irritative diarrhoea; nausea and vomiting; gastric ulcer; morbid gastric 
sensitiveness. Locally, a soothing protective. 
Action.-The insoluble preparations of bismuth have a feebly metallic 
taste, and, owing to the formation, it is claimed, of bismuth sulphide, 
give a blackish coat to the tongue. While the subnitrate acts chiefly as a 
local agent, it is also somewhat absorbed, for it has been detected in the 
blood, and in the urine and other secretions. Very likely some of its specific 
influence is so exerted. The peculiar pasty taste upon the tongue and in the 
mouth, even after it has been administered in sugar-coated pills so as not to 
touch the buccal tissues, is further proof that a portion of it at least is 
absorbed. The chief action, however, is its protective agency upon the 
mucous linings of the stomach and intestines, allaying irritation by distribut- 
ing over the surface a practically insoluble coating of unirritating material, 
and, while not a true astringent, it somewhat restrains the secretions, and 
acts as an absorbent of excess of acids present. It does not coagulate the 
gastro-intestinal mucus. Bismuth is excreted by the intestines, and in 
the urine, and milk, while a portion of it seems to be stored up by the liver. 
Upon the unbroken skin bismuth subnitrate has no physiologic effect. 
In ordinary doses it is practically innocuous. While but slowly absorbed 
and as slowly excreted when applied to the mucous surfaces and given 
246 INDIVIDUAL DRUGS. 
internally, it seems to be more readily absorbed from raw or abraded 
surfaces and in such instances has given rise to severe toxic symptoms. 
When such absorption occurs in large amounts it occasions aphthous, and 
sometimes gangrenous, sore mouth, a black discoloration of the mucous 
surfaces, beginning first around the teeth and extending to all the buccal 
and faucial membranes, ptyalism, nausea and vomiting, dysphagia, painful 
intestinal catarrh and diarrhoea, and in some instances desquamative 
nephritis, with tube casts and albuminous urine. Many of the poisonous 
effects formerly attributed to bismuth compounds were probably due to 
the presence of arsenic, and sometimes lead and antimony, that contami- 
nated the European bismuth ores. Those from South America are said to 
be free from arsenic and now purer salts of bismuth are obtainable. 
When given internally in overdoses, subnitrate of bismuth produces 
unpleasant symptoms, as pain in the stomach, sickness, emesis, derange- 
ment of the bowels, giddiness, insensibility, etc., for which the remedies are 
albuminous and mucilaginous draughts, milk injections, and warm fomen- 
tations. These effects are said not to be produced by pure bismuth sub- 
nitrate, but have been attributed to the named impurities. It is probable 
that some such effects are possible from even the pure drug. The long- 
continued use of the subnitrate of bismuth occasions symptoms of scorbutus. 
After death from disorders in which bismuth has long been used, a bluish 
discoloration in portions of the small intestines has been observed, and, 
owing to the formation of sulphides, the colonic and rectal membranes may 
be stained black. 
Therapy.-External. Bismuth subnitrate (or the subcarbonate or 
subgallate) is a valuable antiseptic dessicant and protective for irritated 
and inflamed surfaces. It also inhibits the growth of bacteria by absorbing 
the moisture in which they flourish. It is an excellent dry-dressing for 
abrasions, excoriations, erythematous patches, and small wounds. Its 
use in the latter must be guarded, and the quantity small; nor should it 
ever be used on extensively wounded surfaces. It is the most comforting 
of applications for the painful excoriations and intertrigo of infants, caused 
by irritating discharges. It not only soothes but protects from absorption. 
Oils and fats are useful before excoriation takes place, but afterward are 
often extremely painful. Petrolatum mixes with the excretions. Bismuth, 
however, sheds the discharges, protects the parts, soothes the irritability 
of the skin, and is cleanly. Sometimes the chafed surface may be previously 
washed with a weak solution of borax or alum, and carefully dried, not by 
rubbing, but by patting the parts with a soft cloth. 
Dusted upon irritables ulcers, bismuth subnitrate gives prompt relief. 
Applied to aphthae, nursing sore mouth, and other sores of the mouth due 
to stomach disorders it gives comfort, and its external use should be ac- 
companied by its internal administration. It is one of the best of dry 
applications for bedsores, superficial burns, chapped hands and lips, cracked 
nipples, fissured anus, vesicular eczema and in variola (with carbolic acid). 
For most of these conditions it may also be used in ointment or glycerinated 
lotion. For bedsores we have found nothing to excel the following: 
Bismuth Subnitrate, Pulverized Camphor, Boric Acid, aa 5 b Ointment 
of Rose, and Hydrous Wool Fat aa 5ij. Mix. Sig.: Apply upon smooth 
247 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
linen. Ulcers of the septum nasi, after mild cauterization, may be well- 
dressed with bismuth subnitrate, 3ij, in glycerin, 3ij- Locke advised as 
a cosmetic lotion for rough and pimpled skin: Bismuth Subnitrate, 
3ij; Glycerin, fl 3 ij; Rose Water, fl 5 ij. Apply to the face, after carefully 
cleansing with water and Asepsin Soap. 
Internal. Subnitrate of bismuth has a soothing, antiseptic, and sub- 
astringent effect upon irritated and inflamed mucous surfaces, making it an 
ideal remedy in irritative forms of dyspepsia, especially in run-down con- 
stitutions, and in acute and chronic gastritis, gastralgia (unless purely 
neuralgic), pyrosis, and water-brash, especially when due to lactic and 
butyric fermentation. In gastro-intestinal disorders it is best adapted to 
states of morbid sensitiveness as shown by the long pointed and red tongue, 
especially reddened at tip and edges, uneasy sensations with heat in the 
stomach, or excessive gastric acidity, with nausea, vomiting, or eructations 
of acid or acrid fluids, and irritative or serous diarrhoea. In these conditions 
many prefer the Liquor Bismuthi(Solution of Ammonio-Citrate of Bismuth). 
If the diarrhoea is most largely mucous a purge of castor oil should first be 
given so that the bismuth salt can the more readily reach the surface of the 
mucosa. In the gastritis and gastro-intestinal catarrh of young children 
it is a most valuable drug. One to 3 grains may be given every 3 hours, 
suspended in water, or mucilage of tragacanth. Acacia should not (as a 
rule) be used, as it forms a lumpy mass with bismuth. 
Bismuth subnitrate is one of the most certain agents in gastric ulcer, 
both to control pain and to contribute to a cure. It is less valuable in 
gastrodynia when purely neuralgic than when due to irritation or inflamma- 
tion. Cancer of the stomach is not cured by this salt, but it gives great 
comfort in controlling the attendant pain and giving rest. 3 Bismuth 
Subnitrate, 3j to 3 i j; Morphine Sulphate, gr. j. Mix. Ft. Powders, 
No. 12. Sig.: One powder every 6 hours, or as needed. If to be given with 
sodium bicarbonate for water-brash and sour stomach the subcarbonate 
is preferable, on account of the possible distention caused by greater 
liberation of carbon dioxide through the interaction of the subnitrate and the 
soda salt. In chronic diarrhoea it is serviceable in doses of 5 to 20 grains 
every 2 hours; and in the diarrhoea attending typhoid fever and phthisis 
it may be given in 5-grain doses; sometimes with small doses of magnesium 
oxide and gum acacia, 3 grains of each. Locke prescribed the following for 
the chronic diarrhoea of phthisis and general tuberculosis: 3 Bismuth 
Subnitrate, 5j; Cinnamon Water, fl 3 ij. Mix. Sig.: One or two teaspoonfuls 
every 3 hours. A milk diet with 5 grains of this salt was effectual during the 
Civil War to control the diarrhoea due to exposure so common to camps and 
military life. Other bismuth salts, as the subgallate, subcarbonate and 
subsalicylate, have no special advantages over the subnitrate. 
Bismuth salts are quite extensively used for diagnosis, by Roentgenogra- 
phy, of the stomach and intestines, usually being administered in buttermilk 
or soup. Large amounts are necessary and some instances of poisoning have 
resulted therefrom. Owing to its equal efficiency and cheapness pure barium 
sulphate has largely supplanted bismuth subnitrate for radiograph work. 
The action of the hydrogen sulphide in the bowels, for which bismuth 
has a great avidity, causes the feces to appear black. 
248 INDIVIDUAL DRUGS. 
BOLETUS. 
The fungus Polyporus officinalis, Fries {Boletus laricis, Jacquin). (Nat. Ord. Fungi.) 
Asia, Eastern Europe, and Central America. 
Common Names: White Agaric, Purging Agaric, Larch Agaric. 
Principal Constituents.-Agaric Acid (Agaricin) (C16 H30 O5+H2O), resins, 79 per cent 
and agaricol. The purging constituent is a red resin (C15HMO4). 
Preparation.-Specific Medicine Boletus. Dose, 1/2 to 5 drops. 
Derivative: Agaricin. Dose, 1/10 to 1/3 grain. 
Specific Indications.-Ague with alternate chills and flushes of heat; 
impaired nutrition and feeble cerebral circulation; colliquative sweats. 
Action and Therapy.-This fungus is remarkable for the high per cent 
(79) of resins it contains. It is a decided nerve stimulant and antiperiodic. 
Boletus is but little used, but occasionally will be needed in irregular inter- 
mittents, not reached by quinine medication and presenting alternate 
chills and flashes of heat, accompanied by a heavy bearing down pain in 
the back. The patient perspires freely at night and has a yellow-coated 
tongue, bitter taste, capricious appetite, slight fever, and has for some time 
been experiencing a dull, languid feeling. It may also be used in cases of 
impaired nutrition with feeble cerebral circulation. To some extent it 
controls diarrhoea, cough, hectic fever, rapid circulation, and the profuse 
night-sweats of phthisis. The dose for these purposes is from the fraction 
of a drop to 5 drops of the specific medicine. For the last named use- 
that of controlling colliquative sweating, agaric acid or agaricin, as it is 
more commonly called, is one of the most effectual of antihydrotics. In 
1/3 grain doses it controls the thirst, cough, and the excessive sweating of 
consumptives. 
Bromine. 
The element Bromine {Symbol, Br.). 
Description.-A heavy dark, brownish-red, mobile liquid, irrespirable and violently 
irritating to the eyes and lungs; soluble in water and chloroform, and in ether and alcohol, 
being slowly decomposed by the latter two. 
Action and Toxicology.-Applied to the skin bromine is cauterant and 
may produce gangrenous ulceration. It is a very violent irritant poison, 
producing aspiration pneumonia when inhaled and gastro-enteritis when 
swallowed. As it is almost impossible to swallow it, most toxic cases will 
be those that inhale it. In internal poisoning the stomach should be washed 
out and a brisk alkaline purgative given. The gastro-intestinal inflam- 
mation should be treated symptomatically. 
For poisoning by inhalation the cautious inhalation of ammonia is the 
antidote. Workmen in bromine keep near at hand bottles of ammonia 
water to be dashed to the floor and broken in case of accident through 
the spilling of bromine. 
Therapy.-External. Used almost wholly upon hospital gangrene, 
and occasionally in alcoholic dilution (1 to 3) upon cancer of the womb, 
and sometimes for the destruction of chancre and chancroid. Occasionally, 
though rarely at the present day, it is inhaled as a deodorant and disin- 
fectant in fetid diphtheria. 
BROMUM. 
249 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
BRYONIA. 
The root of Bryonia dioica, Jacquin, and Bryonia alba, Linne. (Nat. Ord. Cucur- 
bitaceae.) Europe. 
Common Names: Bryony, Bastard Turnip, Devil's Turnip, etc. 
Principal Constituents.-Probably a colorless, very bitter glucoside, bryonin is the chief 
active body in bryonia. 
Preparation.-Specific Medicine Bryonia. Dose, 1/20 to 5 drops. Usual method of 
administration: Specific Medicine Bryonia, gtt. v to x; Water, A^iv. Mix. Sig.: 
One teaspoonful every 1 to 3 hours. The smaller doses are preferred for specific medication. 
Specific Indications.-Sharp cutting pain, or tearing pain from serous 
inflammation; tenderness on pressure; tearing pain with sore feeling in 
any part of the body and always aggravated by motion; moderately 
full or hard wiry vibratile pulse; headache from frontal region to occiput; 
soreness in eyeballs upon movement; hyperaesthesia of scalp or face; 
irritating, hacking or racking cough or provoked by changes of air; lethargy 
short of dullness; tired, weary or apathetic feeling, too tired to think; 
perspiring on slight movement. 
Action.-The fresh root of bryonia is a strong irritant, and when bruised 
and kept in contact with the skin blisters it. When taken internally in over- 
doses it causes severe gastro-enteritis, and has caused death. The chief 
symptoms are uncontrollable diarrhoea and vomiting, dizziness, lowered 
temperature, dilated pupils, cold perspiration, thread-like pulse, colic, 
and collapse. Large but less than fatal doses sometimes cause bronchial 
irritation with cough, hepatic tenderness, increased urination with vesical 
tenesmus, cerebral fullness and congestion, jaundice and depressed action 
of the heart. These effects are never experienced from the small medicinal 
doses. Tannin is said to counteract the untoward effects of bryonia. 
Therapy.-Bryonia, practically unused in the dominant school, and 
much employed by Homeopathists, is regarded by Eclectic physicians as 
an indispensable agent. Personally, we use few agents more frequently 
than bryonia. It is a remedy for debility and the long train of miseries 
accompanying it, and in acute diseases it is of first importance as a remedy 
for pain and inflammation in serous membranes. The bryonia patient is 
weak and perspires readily upon the slightest movement. The stereotyped 
assertion, "aggravated by motion," and learned by us from the Homeo- 
paths, is a true dictum when applied to bryonia cases. Though not neces- 
sarily dull, the patient is lethargic in the sense that he does not wish to 
move lest he aggravate his condition. There is no dullness or hebetude 
as with belladonna, but the patient is tired, languid, and torpid, and though 
much awake has little inclination to move about. 
Bryonia patients, except in the acute infections, often display a 
deficiency of nervous balance and with this may or may not be associated 
the bryonia headache-pain from the frontal region to the occipital base; 
thinking is an effort and the patient is irritable if disturbed. Temperature 
may be slightly increased, and the tissues contracted. Pressure elicits 
extreme tenderness and soreness, especially when the viscera are involved. 
Bryonia is of especial value in fevers, and is decidedly a remedy for the 
typhoid state. Many cases of severe typhoid fever may be carried through 
250 INDIVIDUAL DRUGS. 
with no other medication than bryonia in very small doses. In fact, it is a 
medicine that gives the best results from minute doses. In fevers the pa- 
tient is decidedly apathetic, the secretions are scant and vitiated, the nervous 
system markedly depressed, and the tendency is toward sepsis and delirium. 
The victim cares little whether he recovers or dies. There is a dry tongue, 
sordes, a deepened hue of the tissues, capillary circulation is sluggish, and 
there may be frontal headache. Chilliness is not uncommon, and there is a 
tendency to sweat easily. In such cases it proves a mainstay during the pro- 
longed fever, and never does the patient harm. 
In diseases of the respiratory tract and pleura, bryonia heads the list of 
useful remedies. The well-known indications given by the founder of 
specific medication hold good, to-wit: "A hard, vibratile pulse, flushed 
right cheek, frontal pain extending to the basilar region, and irritative 
cough." It is a splendid agent for cold in the chest. It is the most de- 
cidedly efficient remedy we possess for acute pleurisy, being usually given 
with, or in alternation with, the indicated special sedative-aconite (quick, 
small pulse), or veratrum (full, bounding pulse). It promptly meets the 
sharp, lance-like pain, or the cutting or tearing pain, all made worse upon 
movement. Not only does it subdue pain, but the temperature is lowered 
and capillary obstruction is overcome, thus freeing the disordered circula- 
tion. After the acute symptoms have subsided, it may be continued alone 
for a long period, to prevent, or to absorb, effusion. In these cases the 
apathy observed in the febrile diseases is absent, the pain and circulatory 
excitation throwing the patient into a condition of nervous excitement, 
which is quite readily controlled by bryonia. While of great value in all 
forms of pleurisy, it is particularly valuable in that form that comes on 
insidiously. In pleuro-pneumonia, it should be given to promote absorption 
of exuded serum. In la grippe, it is one of the best of remedies, both for the 
cough and the debility. We use it confidently in pneumonia to control 
pain, when present; but above all, to allay the harsh, harassing cough. 
Bryonia is an excellent agent for cough brought on by use of the voice, or 
by motion of any kind, as walking, swallowing food, entering a warm room, 
and for that form of cough induced by tickling sensations in the throat, or 
when excited by vomiting. The cough which bryonia relieves is laryn- 
gotracheal ; it is most frequently dry, hacking, rasping or explosive, showing 
its origin in irritation or erethism. Tensive or sharp pains are almost 
always present, and the secretion, if there is any, is small in quantity and 
of whitish or brown, frothy mucus, sometimes streaked or clotted with blood. 
It is one of the most efficient remedies in la grippe, for the cough, pain, and 
the headache, and in bronchitis, bronchopneumonia, and even phthisis, all 
with blood-streaked expectoration, it is a great aid in relieving the dis- 
tressing, hacking cough. 
Bryonia is an invaluable agent in the treatment of peritonitis. In 
peritonitis, from septic causes, as in puerperal peritonitis, it will only aid; 
a surgical or cleansing process will prepare the way for its use. The pain 
indicating it is colic-like, attended with marked tensive tenderness. Similar 
conditions indicate its employment in cholera infantum and typhomalarial 
fever. In synovitis it is one of the most certain drugs to relieve pain and 
251 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
remove effusion. Nor should bryonia be neglected in the treatment of 
pericarditis, in which it will help to control inflammation and to prevent 
and absorb effusion. Recent reports confirm its earlier reputation as a 
remedy of the first value in cerebro-spinal meningitis. 
Disorders of the liver and gall apparatus frequently call for the small 
doses of bryonia. It is especially serviceable when there is jaundice, deep 
orange-colored urine, and soreness upon pressure. There may or may not 
be an accompanying headache. A peculiarity of the tongue that we have 
seen bryonia clear up in these cases is a semi-transparent coating of the 
organ, appearing like a wash of buttermilk. When the liver capsule is in- 
volved, with sticking or cutting pain, bryonia will materially help to bring 
about a healthy condition. The prolonged use of bryonia and aconite in 
small doses has given us better results in cholecystitis than anything we 
have ever used, and we believe it has often warded off surgical intervention. 
Bryonia is a strong aid in the medicinal treatment of appendicitis. In 
indigestion, where the food lies heavily like a stone, bryonia is often very 
effective. Scudder valued it for relief of abdominal pain and tenderness in 
typhomalarial and zymotic fevers, and with ipecac or euphorbia in similar 
conditions in cholera infantum. 
For mammitis, aconite, bryonia and phytolacca are our three best 
remedies. The first two are to be employed when the inflammation is 
marked, and the glands are swollen and tender and feel knotted. Phyto- 
lacca is always indicated in this trouble. Both bryonia and phytolacca 
are equally effective in orchitis and ovaritis, with tenderness upon 
pressure. 
Bryonia is a remedy of much value in the treatment of acute rheuma- 
tism, being best adapted to those cases where the joints are stiff and swollen. 
Locke declared it the most certain remedy for rheumatic swelling of the 
finger joints. As a remedy for headache, bryonia has long enjoyed a well- 
earned reputation. There is frontal pain (some claim on the right side 
chiefly), sometimes rheumatoidal; again, it may be from a disordered 
stomach, or a hemicrania, with sharp, tearing pains and a tender scalp. 
Occasionally it relieves facial neuralgia, but ordinarily it can not be relied 
on in that complaint. All bryonia headaches are made worse by motion. 
Bryonia is sometimes useful in rheumatic iritis, and in partial deafness 
from pressure of swollen glands after scarlet fever, or from colds. A very 
true indication for it is soreness of the eyeballs, upon movement, occurring 
in any acute disorder. The best bryonia preparation is specific medicine 
bryonia. For all the uses mentioned above, from one to ten drops may be 
added to a half-glass of water, and of this mixture a teaspoonful may be 
given every one to two hours. 
Finally, but in larger doses than are required for the preceding uses, 
bryonia (up to drop doses) is one of the best agents to overcome infantile 
constipation due to difficult digestion of cow's milk and in other forms of 
constipation, where the stools are dry and scybalous. 
In former years, when it was the prevailing belief that insanity was 
caused by indwelling evil spirits, drastic cathartics were invoked for their 
removal. In England large doses of a syrup of the fresh juice of bryonia 
were given. Hence the oft-recurring reference to bryonia in literature as 
a cathartic-a use to which it is never put in Eclectic Therapy. 
252 INDIVIDUAL DRUGS. 
BUCHU. 
The dried leaves of (1) Barosma betulina (Thunberg), Bartling and Wendland, or of 
(2) Barosma serratifolia (Curtis), Willdenow. (Nat. Ord. Rutacese.) South Africa. Dose, 
5 to 60 grains. 
Common Names: Buchu; (1) Short Buchu; (2) Long Buchu. 
Principal Constituents.-A volatile oil, with a penetrating peppermint-like aroma, 
yielding diosphenol (CUH22O3), or barosma camphor, which may be obtained in colorless 
needles, of a peppermint taste. 
Preparation.-Specific Medicine Barosma. Dose, 1 to 60 drops. 
Specific Indications.-Abnormally acid urine, with constant desire to 
urinate with but little relief from micturition; vesico-renal irritation, with 
catarrhal secretion; copious mucous or muco-purulent discharges; cystor- 
rhea. 
Action.-Buchu increases the appetite, slightly quickens the circulation, 
and disinfects the urinary tract. It has but slight effect upon the renal 
organs, but such as it has is to stimulate slightly the output of both liquids 
and solids. It acts feebly upon the skin, increasing secretion. Large dose 
may produce gastro-enteritis and strangury. 
Therapy.-Buchu is an aromatic stimulant, tonic, and urinary anti- 
septic. As a diuretic its action is not pronounced, but it is frequently used 
with other agents, as citrate or acetate of potassium, digitalis, or spirit of 
nitrous ether, which make it more efficient for the purposes of renal depu- 
ration. Buchu disinfects the urinary tract, imparting its aroma to the 
urine, and is to be used only in chronic conditions when there is an excess 
of mucus, or muco-purulent and acid urine, with vesico-renal irritation. 
Acid and muddy urine, loaded with urinary salts, and continual urging to 
urinate with but little relief from the effort, are the cases in which buchu 
renders good service. Under these circumstances it may be given in 
chronic cystitis, pyelitis, urethritis, prostatitis, lithsemia, and chronic 
vesical irritation. For catarrh of the bladder it is frequently effective, and 
in long standing irritation of the viscus, particularly in old persons, "buchu 
and iron" once a popular fad, is really of service. I| Specific Medicine 
Barosma, fl^iijss; Tincture of Chloride of Iron, fl§ss. Mix. Sig.: One 
teaspoonful 4 times a day in a wineglassful of infusion of hops, or of 
sweetened water. Occasionally it is used in dyspeptic conditions and in 
bronchial catarrh, but for these disorders we have far better remedies. 
Buchu renders the urine dark, the latter depositing a brownish precipitate. 
It should never be used in acute disorders. 
CACTUS. 
The fresh, green stems and the flowers of Cactus grandiflorus, Linne. (Cereus grandi- 
florus, Miller and DeCandolle.) Native of Mexico and the West Indies; grows also in 
Italy; cultivated in greenhouses in the United States. 
Common Names: Night-blooming Cereus, Large-flowering Cactus, Sweet-scented 
Cactus. 
Principal Constituents.-Cactus has not been satisfactorily analyzed. 
Preparation.-Specific Medicine Cactus. Dose, 1 to 10 drops. 
Specific Indications.-Impaired heart action, whether feeble, irregular, 
or tumultuous; cardiac disorders with mental depression, praecordial 
oonression. and apprehension of danger and death: nervous disorders with 
253 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS, 
feeble heart action; tobacco-heart; hysteria with enfeebled circulation; 
vertex headache; vaso-motor spasms. 
Action.-Cactus impresses the sympathetic nervous system, and is 
especially active in its power over the cardiac plexus. In sufficiently large 
doses it acts as an intense irritant to the cardiac ganglia, producing thereby 
irritability, hyperaesthesia, arrythmia, spasm and neuralgia of the heart, 
and even carditis and pericarditis. According to E. M. Hale, M.D., it acts 
upon the circular cardiac fibers, whereas digitalis acts upon all the muscular 
fibers of the heart. Like the latter, as a secondary effect of over-stimulation, 
it may induce heart-failure. The tincture, in large doses, produces gastric 
irritation, and also affects the brain, causing confusion of mind, hallucina- 
tion, and slight delirium. In excessive doses, a quickened pulse, constrictive 
headache, or constrictive sensation in the chest, cardiac pain "with palpita- 
tion, vertigo, dimness of sight, over-sensitiveness to noises, and a disposition 
to be sad or to imagine evil, are among its many nervous manifestations. 
Melancholia often follows such action. It is contended by many that the 
mental, cerebral, gastric, and other effects are secondary to and dependent 
largely upon the primary effects of the drug upon the heart; others believe 
its action depends chiefly upon the nervous system. 
Therapy.-Cactus is the remedy for enfeeblement of the heart. An 
old school writer of prominence has said of it that cactus is the only remedy 
that will quicken a slow heart. While there are some who declare cactus 
totally inert as a medicine, there are others who claim for it great value 
even in structural alterations of the heart. The verdict of Eclectic practi- 
tioners, who are the largest users of the drug, is that cactus is a remedy 
chiefly for functional disorders of the heart due to nervous origin. It is, 
therefore, a nerve remedy primarily and a heart remedy secondarily. 
Eclectics have also noted that it improves the nutrition of the heart- 
muscle and thus is, in a measure, a structural remedy also. By improving 
the nutrition of the organ it is possible, in some instances, to correct struc- 
tural abnormalities. Valvular troubles have been noted to gradually dis- 
appear under its prolonged administration. Unlike digitalis it does not 
disorder the stomach nor is it cumulative. Cactus acts upon the vessels 
through the vaso-motor apparatus. 
The peculiar state of the nervous system in cardiac diseases, calling for 
cactus, is quite characteristic. There is a marked mental depression, often 
amounting to hypochondria and fear of impending death. Associated with 
these are praecordial weight and oppression and difficult breathing. The 
control over the nervous system is somewhat like that of pulsatilla, and the 
effects of cactus are usually permanent. 
In medicinal doses, cactus diminishes the frequency of the pulse, and 
increases the renal secretions, and is, therefore, sedative and diuretic. 
According to Scudder (Specific Medication), it neither increases nor depresses 
innervation; that it is neither stimulant nor sedative. Locke, on the other 
hand, believes it sedative, but not depressant (Syllabus of Materia Medico). 
In such doses it does not appear to weaken the nervous system in the least. 
The special field for cactus is diseases of the heart. Its influence upon 
the heart is manifested when the disorder is functional; organic conditions 
are only benefited in a measure. However, some who are antagonists of 
254 INDIVIDUAL DRUGS. 
Eclectic medicine, who are generally skeptical regarding the virtues of plants 
which do not possess unusually powerful properties, consider cactus as a 
valuable agent in mitral regurgitation, due to valvular lesions. In our 
school, however, let us repeat, it is recognized chiefly as a functional 
remedy, and one of the best of cardiac tonics. There is no doubt but that the 
continued use of the drug tends to increase cardiac nutrition and waste, and 
in this way may benefit cases with structural lesions. The influence of 
cactus is believed to be exerted almost wholly upon the sympathetic 
nervous system, through the superior cervical ganglia, expending its force 
in regulating the action of the heart and controlling the cerebral circulation, 
thus giving increased nutrition to the brain. It is the remedy for most 
functional cardiac irregularities, as palpitation, pain, cardiac dyspnoea, 
intermission in rhthym, etc. Even in structural heart-wrongs, the majority 
of unpleasant symptoms are partly due to disordered innervation, and this 
condition is corrected by cactus. It does not seem to make any difference 
whether the heart-action be feeble, violent, or irregular, provided it be due 
to lack of innervation, associated with mental depression, or in excitable or 
nervous individuals, the remedy relieves, because its tendency is to promote 
normal rhythmic action of the cardiac muscle. Aortic regurgitation is nearly 
always benefited by it and it is useful in progressive valvular weakness, but 
is contraindicated in stenotic conditions. In spasm of the heart-muscle, 
and in cardiac pain of a constrictive character, as if the organ were held 
with a strong band, it is often the most prompt of all cardiac remedies. It 
is a good remedy in the heart troubles produced by tobacco, probably 
benefiting oftener than any other medicine. 
Cactus is a valuable remedy for the heart symptoms of neurasthenia. 
During the menstrual period and at the menopause, nervous women 
frequently experience unpleasant cardiac disturbances of a functional 
character. These are relieved by cactus. Few agents excel it in menstrual 
headache, and headache in women with pressure on top of the head. For 
nervous menstrual headache, Locke recommends: 1} Specific Medicine 
Cactus, gtt. x to xxx; Aquae, fl^iv. Mix. Sig.: Dose, a teaspoonful 3 or 4 
times a day. When the heart is enfeebled from long illness, as in con- 
valescence from typhoid or other fevers, cactus is invaluable. Even in 
incurable conditions of the heart it seldom fails to give some relief. It 
rarely relieves angina pectoris, and neuralgia of the heart, and is sometimes 
useful in endocarditis and pericarditis following debilitating diseases. 
The heart-debility induced by overwork, strains, over-enthusiastic athletes, 
soldiers on the march and "hikers", and that accompanying or following 
masturbation finds relief in cactus. When associated with cardiac weakness 
and irregularities, and in so far as they depend upon these conditions, 
cactus has been found useful in cerebral congestion, mental derangements, 
irritable bladder, renal congestion, oedematous condition of the limbs, and 
anasarca. When a vigorous and healthy action of the heart obtains under 
its use these troubles pass away. 
Cactus is recommended in visual defects of an asthenopic character, 
and in exophthalmic goitre, due to functional heart disease; tinnitus aurium, 
from the same cause, is benefited by it. These eye and ear disorders are not 
benefited by it when the cardiac disorder is of an organic nature. 
255 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
CAFFEA. 
The seeds of Caffea arabica, Linne (Nat. Ord. Rubiaceae). Native of Arabia-Felix 
and Ethiopia; and extensively cultivated in Asia and America between the north and 
south latitudes of 56°. 
Common Name: Coffee. 
Principal Constituents.-The chief constituents are caffeine (C8H10N4O2. H2O); a 
volatile aromatic oil; caffeol is also present in minute quantity and upon it depends the 
aroma of coffee; and caffeo-tannic acid. 
Preparations.-1. Infusum Caffea, Infusion of Coffee. Dose, 2 to 8 fluidounces. 
2. Specific Medicine Coffea. Dose, 1 to 60 drops. 
Specific Indications.-Feeble circulation, with threatened heart-failure; 
sense of exhaustion; headache, with cerebral hyperaemia or congestion. 
Action.-Coffee is a decided cerebral stimulant and energizer. It also 
increases reflex activity of the spinal cord. Used moderately it is a mild 
bitter stomachic, stimulating the appetite and facilitating digestion. 
There is reason to believe that it increases hepatic activity and it promotes 
peristalsis, thereby favoring a free action of the bowels. Coffee slightly 
accelerates the circulation. Under its use the intellect is quickened to an 
extraordinary degree, thinking is facilitated, ideas flow freely, the reason- 
ing faculty is sharpened, and an enormous amount of mental and physical 
work may be accomplished. The action of hot coffee upon the cerebro- 
spinal system is especially evident when a person is exhausted by mental 
strain or physical exertion. Coffee removes drowsiness after a heavy meal, 
and may produce wakefulness that will last for several hours. If coffee be 
withheld from one who is accustomed to its stimulus, physical and mental 
exhaustion become so severe as to interfere with intellectual pursuits or 
bodily endurance under exertion, and a profound headache may be ex- 
perienced. Coffee probably retards tissue waste, and is, therefore, a con- 
servator of force. 
The excessive use of coffee causes irritability, dejection of spirits, 
muscular weakness and trembling, watchfulness, dizziness, headache, and 
ringing noises in the ears; and flatulence, sour stomach with heart-burn 
and eructations, and disordered action of the bowels. Probably the hepato- 
gastric symptoms-"coffee biliousness"-is due largely to the empyreumatic 
oil present in coffee; the nervous symptoms chiefly to the caffeine it con- 
tains. Therefore preparations from which the latter has been removed 
are just as likely to produce stomach disorders as regular coffee. 
The stimulating effects of coffee are most largely due to caffeine. 
This alkaloid is one of the most rapidly acting cerebro-spinal stimulants 
and probably the nearest of any drug to a physiologic energizer of the 
intellectual brain. It sharpens the intellect wonderfully, and increases 
particularly the reasoning faculties rather than the imaginative. It operates 
without after-fatigue and renders the person capable of great mental 
achievement and physical endurance. Workmen do more work under 
coffee, and soldiers stand long marches under the stimulus of the caffeine it 
contains. Large doses produce excitation of the spinal cord, and if carried to 
full action exaggerate the reflexes, making the person exceedingly nervous. 
No harm, however, is done to any organ by coffee or by caffeine, and no 
after-fatigue or exhaustion follows, provided neither be given to the extent 
of interfering with the taking of food nor of preventing rest or sleep. Caf- 
feine excites muscular contractility, and powerfully stimulates respiration. 
256 INDIVIDUAL DRUGS. 
Upon the circulation it heightens blood pressure and quickens the con- 
traction of the heart. These are accomplished through its action upon the 
vaso-motor control and upon the heart muscle itself, its effects upon the 
latter taking origin at the veno-auricular junction, and extending from 
thence to the auricle and the ventricle. Caffeine increases the output of 
both the solids and the fluids of the urine, by dilating the renal blood- 
vessels and by direct action upon the renal epithelia. The tissue-waste 
of the body is thought to be restrained by caffeine, thus making it a con- 
servator of force and energy. Caffeine is believed to be oxidized and 
destroyed in the body. The common non-alcoholic beverages of mankind 
(except coca)-coffee, tea, cocoa, kola, mate and guarana-owe their grateful 
stimulus to caffeine or related alkaloids. The theine of tea is practically 
caffeine. All of them relieve fatigue, increase mental acuity, endurance 
and the capacity for exertion without being followed by fatigue or exhaustion. 
Therapy.-Coffee in strong infusion is given both by stomach and 
rectum in opium poisoning. It should be made fresh and as strong as 
possible. The warmth adds to its efficiency. A cup of strong, hot coffee 
is often an effectual sobering draught in acute alcoholism, and small and 
repeated amounts will sometimes ward off an attack of delirium tremens. 
Coffee is a gratefully refreshing agent for headache due to cerebral hyper- 
aemia or congestion, as shown by red face and injected eyes, but will be 
likely to aggravate a neuralgic headache when the face is pale. Strong 
coffee sometimes cuts short an attack of asthma, and checks hiccough. It 
is the most refreshing stimulant that can be used in the exhaustion of low 
fevers of a typhoid type and in the debility following other acute disorders, 
particularly if the patient was previously accustomed to its use as a bever- 
age. In fact, coffee should never be wholly withheld in acute disorders 
when it has been a factor in the patient's daily dietary. For its stimulating 
effect in fatigue and nervous exhaustion and calming action in nervous 
excitation of debility, coffee should be freshly prepared and drunk hot, 
preferably without sugar or cream; for use in narcotic poisoning very 
strong, "black coffee'' may be given freely, both by mouth and per rectum. 
(For the uses of Caffeine, see Caffeina). 
CAFFEIN A. 
Caffeine, Theine. 
(Formula: C8 H10 N4 O2. H2 0.) 
A weak basic principle derived from the seeds of Caffea arabica, Linne (Nat. Ord. 
Rubiaceae), or from the leaves of Thea sinensis, Linne (Nat. Ord. Ternstroemiaceae); or 
synthetically manufactured. 
Description.-Fleece-like matted masses of flexible, silky needle crystals, having a 
glistening appearance, bitter taste and no odor. It loses water of crystallization in dry air; 
and dissolves readily in chloroform, and less easily in water or alcohol, and sparingly in 
ether. Dose, 1 to 5 grains. 
Preparations.-1. Caffeina Citrata, Citrated Caffeine (Caffeine Citrate). A white, 
weakly bitter and acidulous tasting, odorless powder, soluble in water. Should contain 
nearly half its content of anhydrous caffeine. Dose, 1 to 10 grains. 
2. Caffeina Citrata Efferuescens, Effervescent Citrated Caffeine. A white powder 
effervescing when added to water. Contains about 2 per cent of anhydrous caffeine. Dose, 
1/2 to 2 drachms. 
3. Caffeince Sodio-Benzoas. Caffeine Sodio-Benzoate. A feebly bitter, odorless 
white powder, freely soluble in water (separates on standing) and less readily in alcohol. 
Dose, 1 to 10 grains (by mouth); 1 to 3 grains (hypodermatically). 
257 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Tendency to heart-failure, particularly from 
shock or surgical operation; sense of exhaustion; headache of congestion 
or hyperaemia, with red face and injected conjunctivae. 
Action.-For the action of Caffeine, see Caffea. 
Therapy.-Caffeine is one of the most powerful of cardiac energizers 
and diuretics. It does not, however, exactly duplicate the action of digi- 
talis, though it is frequently given in place of that agent, or where for one 
reason or another the latter fails or is contraindicated. Often the one is 
substituted for the other, though digitalis is the more powerful and better 
cardiac stimulant. Both together sometimes act better than each singly. 
When, however, dropsy depends upon cardiac insufficiency, caffeine should 
be given the preference, and it often succeeds when digitalis fails. 
Caffeine is useful in weak and irregular action of the heart. It may be 
employed when digitalis fails to do the work required of it or when its 
irritant action upon the stomach is feared. It is much to be preferred when 
there is myocardial degeneration, and in cardiac insufficiency in pneumonia, 
la grippe, and other acute infectious diseases. In acute pulmonary edema 
it is one of the best of drugs; it should be given hypodermatically, prefer- 
ably in the form of the Sodio-benzoate. 
Caffeine is a most important remedy for dropsy of cardiac origin, 
provided there is no marked renal irritation and the kidneys are capable of 
functionating. Its value as a diuretic is due to the fact that it acts not only 
upon the circulation, but chiefly upon the epithelia of the secreting tubules. 
It should not, however, be used in any form of acute nephritis. In chronic 
parenchymatous nephritis it often succeeds in causing diuresis when 
digitalis and other diuretics fail. In chronic interstitial nephritis it should 
be used when the right ventricle dilates, the urine decreases, shortness of 
breathing develops, and dropsy appears. It must be remembered, however, 
that in using it in renal dropsy that it or any other agent can only be useful 
so far as there are undestroyed cells to functionate, and that it will help just 
so far as the active cells can be stimulated to increased action. Such an 
obstacle is not encountered in uncomplicated renal dropsy where only 
passive congestion of the epithelia is present. The diuretic effects of caf- 
feine require smaller doses than are necessary to produce its cerebral and 
cardiac effects. 
Caffeine alone or with acetanilid or phenacetin, or with' bromides, is 
frequently employed for the relief of migraine or idiopathic headache, when 
there is cerebral hyperaemia as shown by red face and injected conjunctivae. 
It usually aggravates neuralgic headache due to cerebral anemia, with 
pale countenance. 
Caffeina Sodio-Benzoas or Caffeine Sodio-Benzoate. This is a mixture 
of equal parts of caffeine and of sodium benzoate, and is designed especially 
for hypodermatic use, as caffeine alone can not be so employed. It is freely 
soluble in water. It is especially useful in weak heart action following 
operations, and when the pulse is rapid and feeble and the urinary output 
is so scant as to amount almost to anuria. The dose per mouth is pref- 
erably from 1 to 2 grains; hypodermatically, 1 grain. 
Caffeine Sodio-Salicylate is also used hypodermatically. Dose, 1 to 2 
grains. 
258 INDIVIDUAL DRUGS. 
CALAMUS. 
The rhizome of Acorus Calamus, Linne (Nat. Ord. Aroideae). Common in wet and 
muddy grounds everywhere in the Northern Hemisphere. Dose, 5 to 40 grains. 
Common Name: Sweet-flag. 
Principal Constituents.-Resin, aromatic essential oil, and a bitter glucoside, acorin 
(C35 H^) Oe)' 
Preparations.-1. Specific Medicine Calamus. Dose, 5 to 30 drops. 
2. Syrupus Calami, Syrup of Calamus. Dose, 30 to 60 drops. 
Action and Therapy.-Carminative, sialagogue, excitant, and slightly 
tonic. Useful as "breath perfume," and in flatulent colic, atonic dyspepsia, 
feebleness of the digestive organs; and in the form of syrup as an agreeable 
vehicle for less pleasant medicines. The fresh root shaved thin, transversely, 
may be candied by boiling in syrup, draining, and allowing it to dry. In 
this form it is a delicious confection. Calamus may also be given in the form 
of a syrup or by adding the specific medicine to the required amount of 
simple syrup. 
CALCII BROMIDUM. 
Calcium Bromide. (Formula: Ca Br2.) 
Description.-A very deliquescent, odorless, granular, white salt, of a sharp salt-like 
taste. Very soluble in water and alcohol. It should be kept in well closed containers. 
Dose, 5 to 30 grains. 
Specific Indications.-Insomnia with or without nervous irritability; 
sleeplessness due to cerebral congestion; anemia; nervous debility from 
malnutrition. 
Action and Therapy.-This agent is sedative and hypnotic, and is said 
to act with more promptness and without the depression and production of 
skin blemishes caused by the corresponding potassium salt. It is adapted 
to anemic individuals with or without determination of blood to the brain 
when nervousness and sleeplessness result from worry, close application to 
business, or to hysteria. In 1/2 grain doses it is a good hypnotic for irritable 
children. It is sometimes a good remedy in congestive headache. It also 
may be given with advantage to anemic children, administering it in syrup 
of lactophosphate of calcium. 
CALCII CHLORIDUM. 
Calcium Chloride. 
A hydrated form of Calcium chloride, containing at least 75 per cent of pure Ca Cl2. 
Description.-Odorless, very deliquescent, white or slightly translucent fragments, 
granules or sticks. Very soluble in hot and cold water, and less so in alcohol. Dose, 5 to 15 
grains (average, 8 grains). 
Specific Indications.-Lymphatic glandular enlargements; slow in- 
flammations, with cacoplastic deposits; bad breath, with dirty, pasty 
coat on tongue (Scudder); dyspepsia of scrofulous children, with enlarged 
tonsils, bad breath, irregular bowel movements, capricious appetite, and 
restlessness in sleep. 
Action.-In large doses calcium chloride is a decided poison, causing 
nausea, vomiting, and sometimes purging, quickened pulse, praecordial 
anxiety, faintness, muscular weakness, tremor and vertigo. Toxic doses 
powerfully impress the nervous system, producing tremors, contracted 
pulse, spasms, paralysis, unconsciousness, and death. 
259 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Therapy.-When given carefully in doses not sufficient to irritate the 
stomach this agent promotes secretion from the skin, mucous surfaces and 
kidneys, and may be exhibited in disorders of scrofulous children, who are 
often near-tubercular, to fulfill the specific indications as given on page 259. 
In adults a dose of twenty grains in aromatized water, an hour after meals, 
is said to be effectual in controlling general itching. Even moderate doses 
occasion thirst; therefore it should be given well diluted. Persistent dull 
headache in lymphatic listless patients, with poorly coagulable blood, is 
reported to have been relieved by it. 
Calcium chloride is a decided blood coagulant and as such is much used 
at present, and with good results upon those who bleed easily. When 
bleeders or hemophiliacs or those suffering from purpura are capable of 
absorbing the agent, it may assist in controlling the hemorrhage. In 
the large majority of cases of hemophilia and purpura, however, it fails to 
make any impression. Its use must be intermittent upon those disposed 
to bleeding, as in hemorrhoids, giving the agent for several doses, then 
discontinuing for a week, and then resuming its administration, for too 
continuous use favors decrease of coagulability. It also relieves urticaria 
when induced by too free indulgence in acid fruits. In so-called cyclic 
functional or physiologic albuminuria, when albumen escapes from the 
blood, yet there is no renal structural involvement, calcium chloride seems 
to offer both diagnostic and curative advantages. It has no effect upon the 
albuminuria of chronic nephritis. When calcium chloride is not tolerated 
by the stomach, or is evidently not absorbed, its use may be replaced by 
Calcium Lactate. The latter (1 to 30 of water) but not the chloride (which 
is too irritant) may also be used hypodermatically. 
CALCII HYPOPHOSPHIS. 
Calcium Hypophosphite. 
(Formula: Ca (P H2 O2)2). 
Description.-Permanent colorless scales, crystals or a powder, without odor, but having 
a nauseous, bitter taste. It is readily soluble in water, but not in alcohol. Dose, 2 to 10 
grains, 2 or 3 times a day. 
Action and Therapy.-Probably an alterative and restorative. Scudder 
and others believed this remedy one of value in depression of the nervous 
system in chronic diseases. It tones digestion, relieves atony and irritation 
of the respiratory organs, checks cough, and improves respiration, blood 
making, and nutrition. It is very largely used in the compound syrup of 
the hypophosphites in scrofulosis and tuberculosis of the lungs. It is a more 
rational drug in pretubercular conditions than in established phthisis. 
It is also useful where there are unhealthy deposits in the cellular tissues 
causing slight inflammations. 
CALCII IODIDUM. 
Calcium Iodide. Iodide of Lime. 
(Formula: Ca I2). 
Description.-Very deliquescent, pearly lamellae, or a powder of a yellowish-white 
color. It decomposes readily and must be kept in closed containers. Dose, 1 to 3 grains. 
260 INDIVIDUAL DRUGS. 
Action and Therapy.-Iodide of Calcium arrests putrefaction and 
deodorizes the stools. It acts chiefly upon the glandular system and is 
deemed especially serviceable in cervical adenopathies, and in enlargements 
of the bronchial glands, giving rise to persistent cough. In the chronic 
bronchitis of scrofulous children it has been given in 1 to 3 grain doses 
(or in lx, 2x, or 3x trit.) with asserted success. A dark-colored or brown 
"iodide of lime" has been used very largely as a remedy for croup 
Precipitated Calcium Phosphate, Bone Phosphate. 
(Formula: Ca3 (PO4)2). 
Description.-A light amorphous, white, odorless and tasteless powder; almost in- 
soluble in cold water and decomposed by boiling water. Dose, 1 to 30 grains. 
Preparation.-Syrupus Calcii Lactophosphatis, Syrup of Calcium Lactophosphate. 
Dose, 1 to 4 fl 3. 
Action and Therapy.-Calcium phosphate has been given in states of 
malnutrition of bone and in tardy union of fractures on the theoretical 
inference that it will supply the needed calcium to be used in bone con- 
struction. It probably has little action in this respect. However, some 
have declared it valuable in malnutrition of the osseous, dental, and con- 
nective tissues, and speak of its good results in anemia, strumous disorders, 
rickets, profuse discharges, leucorrhoea, and the debility following child- 
bearing. A syrup of calcium phosphate has been used as a chemical food. 
Syrup of Lactophosphate of Calcium is a reconstructive for use in cases 
of general and nervous debility. It was one of the few remedies valued by 
Howe, who used it largely as a vehicle for Fowler's solution, in tuberculosis of 
the lungs, and strumous disorders in general. 
Calcium Lactate is sometimes employed for calcium medication, in 
doses of from 1 to 15 grains. 
Calcium Glycerophosphate is a nerve reconstructive, and is given in 
doses of 1 to 8 grains. It dissolves in water and is almost tasteless. 
CALCII PHOSPHAS PR2ECIPITATUS. 
CALCII SULPHAS EXSICCATUS. 
Dried Calcium Sulphate, Plaster of Paris. 
A powder prepared from native gypsum by carefully heating until about three- 
fourths of its water has been expelled. 
Description.-A fine white powder without taste or odor. When mixed with half its 
weight of water it forms a smooth cohesive paste which rapidly hardens. 
Uses.-Plaster of Paris is used in the preparation of plaster bandages 
to be applied as an immovable surgical dressing and of molds for the 
preparation of casts and models. Plaster bandages are applied to fractured 
limbs and ribs, and to limit mobility in spinal deformities. Many object 
to plaster dressings for fractures on the ground that the parts are so con- 
cealed as to prevent frequent inspection, and that shortening, strangulation, 
and other accidents may happen if unskillfully applied. By applying them 
in sections, however, they can be removed, or at least opened, and thus 
allow inspection if so desired. 
261 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
CALCII SULPHIDUM CRUDUM 
Calx Sulphurata, Sulphurated Lime, Crude Calcium Sulphide, Hepar Sulphuris Cal- 
careum, Hepar Calcis, Hepar Sulphur. 
A mixture of at least 55 per cent of Calcium monosulphide (Ca S), together with un- 
changed Calcium Sulphate (Ca SO<) and carbon in varying proportions. 
Description.-A pale-gray or yellowish powder, having a nauseous alkaline taste and 
a faint odor of hydrogen sulphide, and gradually decomposing upon exposure to the air. 
Slightly soluble in cold water, and more soluble but slightly decomposed by boiling water; 
insoluble in alcohol. Dose, 1/20 grain to 2 grains. 
Preparation.- Trituratio Calx Sulphurata (2x), Trituration of Sulphurated Lime (2x). 
Dose, 2 to 5 grains. 
Specific Indications.-Inflammation of cellular or connective tissue 
with tendency to suppuration; or to hasten the latter when established in 
order to save extensive tissue infiltration or destruction; successive crops 
of boils or styes; lymphatic torpor, with tendency to form pus; feeble re- 
cuperative powers after exhaustive purulent discharges; scrofulous subjects 
with tendency to purulent destruction of the lymph nodes. 
Action and Therapy.-Hepar sulphur is antipyic and alterative. 
It is valued for its power over cellular and cutaneous inflammations, with 
suppuration or tendency to suppurate. If used early it aborts suppuration 
in boils and adenitis of non-syphilitic type. If not used until suppuration 
begins it hastens the process. It is one of the best agents in recurrent 
furuncles of the aural canal, and before or after suppuration in acute 
otitis media. Foltz valued it highly in ciliary blepharitis, purulent affections 
of the cornea, conjunctiva, and deeper structures of the eye, in dacryocystitis 
and in crops of styes. The more scrofulous the subject, the better hepar 
sulphur acts. 
Calx sulphurata is a valuable agent in purulent bronchitis and for the 
pus-bearing expectoration sometimes following pneumonia, expecially where 
small areas of pus infection linger long after the active phase of the disease 
has passed. For repeated colds in catarrhal subjects, with heavy and 
purulent discharges, and in leucorrhoea of a similar type, this agent should 
be given in small and repeated doses. For chronic skin diseases, showing 
purulent destruction, with oft recurring pimples, it is a very useful drug. 
It sometimes cures acne, but more often aggravates it; and it has some 
effect in eczemas that take on a pustular character. The dose should be 
small in instances in which this drug is to be used for specific purposes, for 
large doses often produce some of the conditions sought to be cured by it. 
While exceedingly effective in many cases, it often signally fails in others 
appearing to be of exactly the same type as those benefited. 
CALENDULA. 
The florets of Calendula officinalis, Linne (Nat. Ord. Composita?). Southern Europe 
and the Orient; largely cultivated as a garden flower. Dose, 1 to 60 grains. 
Common Names: Marigold, Garden Marigold, Marygold. 
Principal Constituent.-A tasteless yellow body, calendulin. 
Preparations.-1. Specific Medicine Calendida. Dose, 1 to 60 drops. For local 
use, from full strength to 10 per cent aqueous solutions. 
2. Borated Calendula (Boric Acid, 5j; Specific Medicine Calendula, fl3j- Mix). 
Freely as a dusting powder. 
Action and Therapy.-External. Calendula is believed to stimulate 
vaso-motor contraction and selectively to influence the skin and mucous 
262 INDIVIDUAL DRUGS. 
tissues. After the manner of using arnica it is employed largely as a vulner- 
ary. It is non-irritating and non-poisonous. Its advocates claim that it 
reduces the probability of gangrene occurring, prevents or lessens the 
formation of pus, and promotes the prompt healing of wounds, with the 
least possible cicatrization. It has been applied after the removal of 
epitheliomata with asserted benefit, and as an application to gangrenous 
and indolent ulcers, with capillary impairment, it is said to have stimulated 
replacement by healthy tissues. A wash (1 part of Specific Medicine 
Calendula to 4 parts of sterile water) has been advised as very effective to 
promote reconstruction or to reduce tumefaction and discharges, as in- 
dicated, in abscess cavities, burns and scalds (to lessen scarring), acne, 
ulcerative skin diseases, vaginitis, cervicitis, endometritis, vaginal abrasions, 
erosion of the os uteri, non-specific urethritis, gonorrhoea, leucorrhcea, 
lacerated perineum, and uterine subinvolution. As a rule, in most of these 
disorders, its internal use has been advised at the time of using it locally. 
Ecchymoses are reputed to have been quickly removed by it, and it is 
claimed that it opposes varicoses. Diluted with rose water to suit the 
purpose, it may be employed in mild conjunctivitis and in some aural in- 
flammations. In purulent otitis media the borated calendula is preferred. 
The powder should be lightly insufflated but not packed into the canal, so 
as to insure free drainage. Borated Calendula may be dusted upon ex- 
coriations and sore nipples; and an oil solution of calendula (Calendula, 
fl 3 j or fl 5 ij to Liquid Petrolatum, fl § j) may be sprayed into the nose for 
the relief of nasal catarrh, with raw and tender membranes, or irritable 
throat. Thomas cured an inveterate case of crural ulcer in an old man 
by the use of zinc oxide ointment into which was incorporated Specific 
Medicine Calendula. Zinc ointment alone failed to achieve results. 
Internal. Through its supposed action as a local and general vaso- 
motor stimulant it has been advised internally to reinforce its local action, 
particularly in old ulcers, varicose veins, capillary engorgement of tissues, 
and chronic suppurative and catarrhal conditions. Splenic and hepatic 
congestion are said to have been benefited by it. While of unquestioned 
value in all of the local conditions named it has been much overrated, and 
its real medicinal worth obscured by extravagant praise. 
The root of Jateorhiza palmata (Lamarck), Miers (Nat. Ord. Menispermaceae). A 
climbing perennial, the Kalumb of the Southeast coast of Africa. Dose, 1 to 30 grains. 
Common Names: Columbo, Colombo, Columba. 
Principal Constituents.-Calumbin (C^HnOu), a bitter principle, berberine (C2oHn NO<) 
with columbic acid, and columbine, a possible white alkaloid, may be present. No tannin 
is present. 
Preparations.-1. Infusum Calumboe, Infusion of Calumba. Dose, 1 to 2 fluidounces. 
2. Specific Medicine Calumba. Dose, 5 to 30 minims. 
Specific Indications.-Enfeebled stomach with indigestion, or feeble 
digestion; anorexia and debility. 
Action.-This is a type of the pure, simple bitters which contain 
practically no oil or tannin, are not astringent and have no general effect, 
but act reflexly upon the stomachic and salivary functions by first irritating 
the mucous membrane and taste buds of the tongue. This action is quite 
CALUMBA. 
263 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
transitory, so that in administering bitters they should be given immediately 
before meals. Their effect upon the stomach is to increase local circulatory 
dilation, a freer flow of gastric juice, increase of mucus, and increased 
muscular action. On account of the action upon the flow of mucus they 
should not be administered for too long a period lest gastric irritability 
and consequent impaired digestion result. 
Therapy.-The least irritating and one of the best of the simple 
bitters and of especial value in atony of the stomach with poor appetite 
and feeble digestion. It is especially valuable in convalescence from 
acute fevers and other disorders in which there is lack of desire for food and 
poor digestion, with pain or without pain, immediately upon eating. 
After the active stage of cholera morbus, cholera infantum, acute diarrhoea, 
and dysentery it may be given to promote the appetite and digestion. 
When desired calumba may be combined with magnesia, bicarbonate of 
soda, senna, ginger, and aromatics, to meet special indications, particularly 
when flatulence and constipation are present. 
Calumba and the allied bitters should not be given in acute or sub- 
acute inflammatory conditions of the stomach, nor during acute fevers, 
nor when digestion is merely impaired, but the appetite remains good. 
It is largely ineffectual also when organic disease of the stomach prevents 
the normal outflow of gastric juice. When given, the small doses are pref- 
erable to large ones; and on account of the absence of tannin, iron salts 
may be given with calumba, if so desired. In some respects calumba 
resembles hydrastis in its local action, and indirectly, by favoring better 
digestion, the quality of the blood is improved, hence its value in anemia 
during convalescence. 
CALX. 
Lime, Caustic Lime, Quick Lime, Burned Lime, Calcium Monoxide. 
Lime prepared by burning white marble or the purest varieties of native calcium 
carbonate (Formula: Ca 0). 
Description.-Hard white or grayish-white masses, granules, or white powder, grad- 
ually attracting moisture and carbon dioxide from the air and falling to a white powder 
(slaked lime); of a sharp caustic taste, but without odor. Sparingly soluble (over 800) 
in cold water and about half as soluble in hot water; insoluble in alcohol. 
Preparations.-1. Liquor Calcis. Solution of Calcium Hydroxide (Lime Water, 
Aqua Calcis). Dose, fl 3j to fl 5j. 
2. Linimentum Calcis. Lime Liniment (Carron Oil). Equal volumes of Lime Water 
and Linseed Oil, mixed, when needed, by agitation. To be applied liberally. 
Specific Indications.-Infantile stomach and bowel disorders, with 
green stools and vomiting of sour, curdled milk; indigestion from food 
decomposition and lactic acid fermentation; cellular inflammation, with 
pus; crops of boils. 
Action and Therapy.-External. Lime is a powerful caustic depilator, but 
is now seldom employed for such purposes. It is a good destroyer of noxious 
material, and may be thrown into vaults, cellars, drains, and similar places 
to arrest putrefaction. 
A milk of lime (lime made into a thin paste with water) is a cheap and 
effective deodorant and disinfectant of the feces in infectious diseases. 
The vapor of slaking lime is sometimes useful in croup. 
Lime Water is astringent and styptic, but not caustic. It has been 
applied to a variety of skin disorders, but has little value for such a purpose. 
264 INDIVIDUAL DRUGS. 
As a topical application in diphtheria it may have a feeble disinfectant 
action. It is sometimes useful, added to the douche, for acid leucorrhoea. 
Lime Liniment, better known as Carron Oil, is probably the best im- 
mediate application for burns, and particularly for extensive burns and 
scalds. It is a freshly-prepared, calcareous soap and may be poured freely 
upon the burned surface and covered with bandages and a layer of cotton 
to exclude the air. After the smarting has ceased it should be removed 
and other indicated dressings applied. No application for burns is so safe 
and satisfactory as Carron Oil, except, possibly, the lately introduced use of 
paraffin coatings. 
Internal. Lime water is antacid, and exerts some astringent action upon 
the mucosa of the stomach and bowels. It is used largely to prevent changes 
in milk in infant feeding, often being plied without rhyme or reason. When 
really indicated, however, it is efficient in preventing lactic fermentation, 
pyrosis, and sour fecal evacuations. Vomiting, during artificial feeding, is 
often relieved by adding lime water to the food, and in infantile dyspepsia 
with the passage of green sour stools, and the child vomiting curdled milk, 
it is of great value. It is also useful in thrush, though less valuable than 
sodium bicarbonate. When bottle-fed babies have acid diarrhoea, lime water 
sometimes checks it. 
Lime water often allays irritability of the stomach, with sour belching 
and nausea and vomiting, in tuberculosis and in fermentative dyspepsia. 
It may be given in milk, or diluted with water. It also relieves the copious 
diarrhoea that sometimes attends these diseases. 
Lime water has a specific action upon the subcutaneous tissues and is of 
great value in successive crops of boils and other cellular inflammations 
with tendency to suppuration. It should form a part of the treatment of 
acne when due to faulty nutrition or to gastric disorders with lactic fermenta- 
tion from the decomposition of food. Lime water is a good and useful 
medicine, but often abusively employed, and without regard to specific 
action. 
CALX CHLORINATA. 
Chlorinated Lime, Calx Chlorata, Chloride of Lime (improperly), Bleaching Powder, 
Calcium Hypochlorite. 
A compound resulting from the interaction of chlorine and calcium hydrate. It 
should yield not less than 30 per cent of chlorine. 
Description.-A granular white or grayish-white powder, exhaling the odor of hypo- 
chlorous acid or chlorine, and having a repulsive saline taste. It moistens and gradually 
decomposes upon exposure to the atmosphere. It is only partially soluble in water and 
alcohol. 
Action and Toxicology.-Applied to the skin chlorinated lime is actively 
irritant and may act as a feeble caustic. In dilution it is desiccant and 
counteracts gangrenous tendencies. Large doses, swallowed, cause gastric 
heat with nausea, vomiting, and purgation. Children sometimes ac- 
cidentally swallow it when it is left within their reach by washerwomen, by 
whom it is largely employed for bleaching clothes. The treatment for over- 
doses of it is that of gastro-intestinal irritation and inflammation. 
Therapy.-External. This agent, when well diluted, forms an excellent 
deodorant and antiseptic wash for foul conditions, hyperhidrosus, and 
unpleasant exhalations. From 20 to 40 grains to the ounce of water pro- 
vides a good application to fetid sore throat and ulcerated gums, and may 
265 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
be used to relieve frost-bites. A good and cheap disinfecting deodorant for 
ulcerating carcinomata may be prepared by dissolving 1/2 ounce of chlorin- 
ated lime in 1 pint of water. Chlorinated lime, moistened and placed in 
saucers in several places in the sick room, is a cleanly deodorant and 
safe disinfectant. The liberated chlorine reaches every crack and 
cranny and if there is sufficient moisture in the air it will attack 
offending micro-organisms. Owing to its bleaching qualities it must not 
be used upon colored clothing, but may be employed to disinfect bedding 
and white muslin garments. It may also be added to excreta and sputum 
before casting them into the public sewers. When used to disinfect rooms 
it is best to generate the chlorine by adding the chlorinated lime to con- 
tinuously boiling water, with a little sulphuric acid added to the solution. 
The room should be tightly closed. Under these circumstances the liber- 
ated chlorine is one of the cheapest and best of germicides and is much to 
be preferred to carbolic acid and similar bodies. Sprinkling chlorinated 
lime in damp passage-ways and cellars will effectually disinfect them. 
The chlorine should not be inhaled, lest aspiration pneumonia result. 
Internal. Teaspoonful doses every 2 or 3 hours, of from 20 to 40 grains 
of chlorinated lime in an ounce of water, and sweetened, if desired, may be 
given as an internal antiseptic where there is bad breath, pallid, dirty 
tongue, with pasty coating, and lymphatic glandular enlargements and 
slow inflammations, with cacoplastic deposits; also in inflammation of the 
cellular tissues, with a tendency to sloughing. Thus it is useful in boils and 
acne, and gratefully deodorizing in some cases of dysentery and fevers 
with a typhoid tendency. It proves very useful in fetid diarrhoeas when 
the above indications are observed. 
CAMBOGIA. 
A gum-resin obtained from Garcinia Hanburii, Hooker filius (Nat. Ord. Guttiferse). 
Siam, Cochin-China, and Cambodia. Dose, 1 to 3 grains. 
Common Names: Gamboge, Camboge. 
Description.-Grayish, orange-brown, cylindical fragments, without odor and acrid to 
the taste. In powder it is light yellow. Soluble partially in alcohol. 
Principal Constituent. -A purgative resin (cambogic acid). 
Action and Therapy.-Gamboge is a drastic hydragogue cathartic. 
It is never used alone, but in pills, with other substances, chiefly where 
dropsical conditions prevail and it is desired to treat them by purgation. 
It is exceedingly active and has caused death by gastro-enteritis. Full 
doses should never be given, but repeated small doses in pills or in alkaline 
solutions, until results are obtained. Alkalies best counteract its drastic 
effects. 
A stearopten (having the nature of a ketone) derived from Cinnamomum Camphora 
(Linne), Nees et Ebermeier (Nat. Ord. Lauracese). China and Japan. 
Common Names: Camphor, Laurel Camphor, Gum Camphor (it is not a gum). 
Description.-Tough, translucent white lumps or granules, having the pungent taste 
known as camphoraceous, and an aromatic penetrating odor. It dissolves freely in alcohol, 
chloroform, ether, and fixed and volatile oils; very slightly in water. Camphor is readily 
pulverized by triturating it with a few drops of alcohol, chloroform, or ether. Dose (by 
mouth), 1 to 5 grains; (hypodermatically) 1 to 3 grains. 
CAMPHORA. 
266 INDIVIDUAL DRUGS. 
Preparations.-1. Spiritus Camphora (10 per cent), Spirit of Camphor. Dose, 1 to 
30 drops. 
2. ^4gt«z Camphora. Camphor Water. Dose, 1 to 4 fluidrachms. 
3. Linimentum Camphora. Camphor Liniment (Camphorated Oil) (Composed of 
Camphor, 200 parts; Cottonseed Oil, 800 parts). Dose, 10 to 30 drops. For external 
use chiefly. 
4. Cer alum Camphora. Camphor Cerate. (Composed of Camphor Liniment, White 
Wax, White Petrolatum, and Benzoinated Lard.) For external use. 
Action.-Camphor causes a local dilation of the capillaries of the skin, 
producing warmth, redness, and sometimes itching. Slight anaesthesia 
follows. It causes smarting and hyperaemia of the mucosa, and if applied 
strong may cause considerable irritation. In this manner it has pro- 
duced gastric ulceration. In small doses camphor warms the stomach, 
stimulates secretion, increases peristalsis, and expels flatus. Large doses 
may induce vomiting. Camphor is readily absorbed, both from application 
and inhalation. It is largely changed in the body and is eliminated in the 
urine as campho-glycuronic acid. In moderate doses camphor directly 
stimulates the heart-muscle, causing slower and stronger contractions and 
increased arterial pressure, but after large doses the pressure falls. Respira- 
tion is slightly stimulated by it, large doses causing slower and deeper 
breathing. In general it may be said that small doses of camphor stimulate, 
while large quantities depress, or even paralyze. This is true of all the 
functions it affects. The action of small doses upon the nervous system 
is to produce a feeling of slight exhilaration or contentment. Large doses 
excite the higher cerebral and medullary centers and then paralyze them; 
poisonous doses occasioning more or less of the following symptoms: 
oesophageal and gastric pain, vomiting, headache, dizziness, mental con- 
fusion, drowsiness, delirium, and stupor; feeble, running, or intermittent 
pulse, cold skin, cold sweat, and muscular weakness followed by rigidity 
and epileptiform convulsions, collapse and death. The type of convulsions 
shows its effects to be chiefly upon the cerebral cortex, though it acts also 
progressively on the medulla, causing death by respiratory paralysis. 
Camphor does not affect all persons alike. Some may pass directly into 
drowsiness, insensibility, and stupor, followed by death. If taken for long 
periods, even in moderate doses, camphor gives rise to a state of mental 
confusion. Opium and repeated small doses of alcohol are the best an- 
tagonists of the untoward effects of camphor. 
Therapy.-External. Camphor is stimulant, rubefacient, antipruritic, 
and feebly antiseptic. Owing to its agreeable odor and pleasant stimulating 
effects it is largely used, as a powder, in lotions, and ointments, or rubbed 
up with other solids to produce anodyne and antiseptic liquids. In this 
manner, when triturated with chloral hydrate, menthol, phenol, thymol, 
and similar bodies, ideal liquid antiseptics are obtained for use upon wounds, 
neuralgic and other painful areas. 
Powdered camphor is an ingredient of tooth powders and pastes and 
dusting powders for skin diseases. Alone or with zinc oxide, talc, or pre- 
cipitated chalk it may be used upon bed-sores with decided relief. Such 
combinations are valuable in intertrigo, chronic eczema, urticaria, and 
zoster. Many snuffs contain powdered camphor, and it is useful to stimulate 
sluggish ulcers. Sprinkled upon the face it is used to control itching and to 
prevent pitting in small-pox. The spirit is a household embrocation for the 
267 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
relief of pain and itching, and it is used largely, alone, or in liniments and 
embrocations, for the relief of pain, stiffness, soreness and swelling, as in 
myalgia, facial and other neuralgias, and upon rheumatic joints, deep inflam- 
mations, chronic indurated glands and other indurations, sprains, con- 
tusions, and inflammatory swellings. An ethereal tincture of camphor is 
said to give relief in erysipelas. Inhaling the spirit, or camphor dropped 
into hot water, gives relief in nervous headache, and often aborts acute 
colds, coryza, and influenza, giving respite from the excessive secretion and 
the accompanying headache. A solution of camphor in liquid petrolatum 
(usually with menthol) is a popular spray for similar uses, and for laryn- 
gitis, pharyngitis, chronic nasal catarrh and hypertrophic rhinitis. The 
spirit, the liniment, or camphorated oil are favorite applications for tender- 
ness and pain, chilblains, toothache, and acute mastitis: in the latter it 
tends to suppress the milk. The spirit is in common use as a lotion for 
headache in nervous individuals with feeble circulation, and tendency to 
fainting. The oil, by injection, is sometimes effectual in removing seat- 
worms. So-called "camphor-ice" is a soothing, camphorated petrolatum 
preparation for labial herpes. 
Internal. Camphor is used to allay nervous excitement, subdue pain, 
arrest spasm, and sometimes to induce sleep. It is an important remedy in 
many disorders of neurotic women and children, being frequently most 
effective as a nerve sedative, antispasmodic, and carminative in nervous 
nausea and vomiting, flatulence, hiccough, and tendency to spasms or faint- 
ing. It is especially serviceable in palpitation of the heart due to gaseous 
distention of the stomach, or to nervous irritability. In occipital headache, 
from mental strain, or overstudy, small doses of camphor, together with the 
consentaneous use of it locally, frequently give prompt relief. 
Camphor taken and inhaled may abort "cold in the head," or alleviate 
it when established. It checks the sneezing, copious, watery secretions and 
lachrymation and relieves the nasal and frontal headache. It similarly 
benefits in the acute coryza of epidemic influenza, or la grippe. As an in- 
gredient of cough mixtures, such as camphorated tincture of opium, it 
contributes much toward relieving irritation, pain, oversecretion, and the 
associated nervous unrest. In very small doses it is useful in the bronchitis 
of the aged, while it helps greatly when depression attends slowly resolving 
cases of acute capillary bronchitis. 
The most important use for camphor is in adynamic depression attend- 
ing or following exhausting diseases. In typhoid, typhus, and other low 
forms of fevers and low grades of inflammation, with a quick irritable 
pulse, great restlessness, tremor, morbid watchfulness, dry skin, low mutter- 
ing delirium and subsultus tendinum, it is one of the most active stimulating 
sedatives in the materia medica. Similar conditions sometimes occur in acute 
infectious diseases, as the exanthemata, in acute endocarditis and par- 
ticularly in acute lobar pneumonia. For this profound depression 15 drops 
of a 10 per cent sterile oil or ether solution (both are sold in sealed ampoules) 
may be used hypodermatically and repeated as needed. The latter is similarly 
employed in shock and threatened collapse attending surgical operations. 
In addition to the above-named preparations, solutions of camphor 
in alcohol, as well as a thirtv per cent camphorated sesame oil, have been 
268 INDIVIDUAL DRUGS. 
used in shock and collapse, and in lobar pneumonia. Indifferent results 
attend their use in many instances. In fatal cases, where such stimulation 
has been attempted, the death throes of the patient seem often to be ag- 
gravated. It is a common observation that patients to whom "camphor in 
oil'' has been given, "die hard." 
Camphor is largely used, usually with other pain-relieving agents, or 
with aromatic oils, as cajuput, in serous diarrhoea, cholera morbus, and 
Asiatic cholera, in all when profoundly depressive. It is also useful (usually 
with opium, as in the diaphoretic powder, or with morphine, as in Tully 
powder) for spasmodic dysmenorrhea in nervous women, though the 
opiate content should not be oft repeated, nor long continued, nor given 
with the patient's knowledge of its use. Camphor frequently relieves 
menstrual headache, with great nervous depression. It is also useful to 
control irritation due to the passing of catheters and the strangury that 
sometimes results from the use of cantharidal blisters. King believed 
camphor an antidote to strychnine poisoning, supporting his views by the 
results he had observed on animals. In combination with bromides, camphor 
has given relief in the late stages of chordee. 
Camphoric Acid, in doses of 15 to 40 grains, preferably in cachet or 
capsule, given a few hours before bedtime, is one of the most effective 
drugs for the colliquative night-sweats of phthisis. 
CAMPHORA MONOBROMATA. 
Monobromated Camphor. 
(Formula: [Ortho-monobromcamphor] Cw Hu OBr.). 
Description.-A colorless powder, needle crystals or scales, having a mildly camphor- 
like taste and odor; unalterable in the air, but eventually decomposable if kept in the sun- 
light. Practically insoluble in water, but readily dissolved by chloroform, ether, or alcohol. 
Specific Indications.-Simple insomnia, with or without nervous 
headache; mental excitement; mild mania; mild delirium; hysteria; in- 
fantile convulsions, especially to prevent recurrence. 
Action and Therapy.-Camphora monobromata is a nerve sedative 
acting more like camphor than it does the bromides. It is useful to give 
rest and quiet mental excitement. It sometimes relieves pain and promotes 
sleep. It is effective in simple insomnia. The pain relieved by it is mostly 
that caused by nervousness, and the muscular twitchings those due to the 
same cause. While useful in convulsions, it is less valuable than chloroform 
and other anti-convulsives during attacks, but is especially valuable to pre- 
vent their recurrence. This is largely the case in the convulsions of dentition 
and childhood. While it may quell the wild delirium of acute alcoholism, 
it is not adapted to intense and protracted forms of delirium tremens. 
It has been successfully used in mild spasms, mild hysteria, headache of 
hysteria, mild forms of acute mania with great restlessness and slight fever, 
nervous palpitation of the heart, whooping cough, asthmatic and cardiac 
dyspnoea, and neuralgic cystitis. Good results have been secured from its 
use in nymphomania, satyriasis and spermatorrhoea, all with nervous 
excitability. It relieves simple prostatorrhoea when due to irritation and not 
to catarrhal cystitis; and is especially effective in chordee and urethral 
irritation, or fever produced by divulsion, or the passage of instruments 
into the urethra. 
269 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Monobromated camphor sometimes relieves the headache, backache, 
and restlessness of la grippe, and the pain of lumbago, when associated with 
marked mental irritability and sometimes slight elevation of temperature. 
The dried flowering tops of the female plant of Cannabis sativa, Linne, or the variety 
indica, Lamarck (Nat. Ord. Moraceae). Asia, East Indies, and cultivated in other parts 
of the world, notably in the United States. 
Common Names: Guaza, Ganjah, Gunjah, Ganga; Indian Hemp (Cannabis indica) 
when derived from the Indian plant. 
Principal Constituents.-Not well determined. The following have been noted: 
Cannabin, an active brown resin, and cannabinon, a soft resin. 
Preparation.-Specific Medicine Cannabis. Dose, 1/2 to 10 drops. 
Specific Indications.-Marked nervous depression; irritation of the 
genito-urinary tract; burning, frequent micturition; painful micturition, 
with tenesmus; scalding urine; ardor urinae; wakefulness in fevers; 
insomnia, with brief periods of sleep, disturbed by unpleasant dreams; 
spasmodic and painful conditions, with depression; mental illusions; 
hallucinations; cerebral anemia from spasm of cerebral vessels; palpitation 
of the heart, with sharp, stitching pain; and menstrual headache, with 
great nervous depression. 
Action.-The principal seat of action of cannabis is upon the in- 
tellectual part of the cerebrum. In many respects its effects parallel those 
of opium and its chief alkaloid. Without doubt it is the most perfect 
psychic stimulant known to medicine. Certain Orientals become addicts 
to it, consuming it in the form they call haschisch (whence comes the term 
assassin), and under its influence many crimes and offenses have been 
committed, as well as with it. Eastern potentates are said to have dosed 
their fanatic followers with it. It produces an agreeable semi-delirium 
taking on the character of a sense of well-being and exhilaration-a state 
highly coveted by its devotees, who call it loftily "the increaser of pleasure," 
"the laughter mover," "the cementer of friendship," and "the cause of a 
reeling gait"-all indicative of its physiologic influence. These haschisch 
debauches are joyful affairs, and while usually devoid of injurious conse- 
quences, may be followed by catalepsy and depressive and maniacal in- 
sanity, from which, however, the victim recovers fully in time. 
In some respects the effects of cannabis on the nervous system are 
peculiar. It causes an apparently contradictory, consentaneous stage of 
stimulation and depression-a state somewhat simulated by morphine. 
The sensations that follow the effects of cannabis vary greatly with the 
temperament and the peculiarities of the patient, and with his environ- 
ment. Almost invariably they are pleasurable. An emotional state of 
happiness even to ecstacy is experienced, with an endless procession of 
beautiful visions coming and going, and over which the patient indulges 
in merriment and even hilarity. So pleasurable becomes his sensations 
that he may break into boisterous laughter and antics of a ridiculous 
character, the nature of which he fully comprehends, but is wholly unable 
to prevent. Gradually passing into a dream-like stage, he talks, volubly, 
brilliantly, with ever-recurring changes of topic, little coherence of thought, 
and a perverted judgment. His imagination carries him into ludicrous 
CANNABIS. 
270 INDIVIDUAL DRUGS. 
ideas and strange actions, he has notions of grandeur and greatness, and 
moments are exaggerated into aeons of time. He lives a "life-time in a 
minute." Endless phantasms of beauty and delight pass before his dis- 
torted mental vision. A singular peculiarity is a state of "double con- 
sciousness" or dual personality which possesses him in which he imagines he is 
both himself and some one else, and he behaves accordingly. He becomes 
affectionate to the extreme, both to himself and to others, and altogether he 
is a very happy individual leading a very full and infinitely extended life. 
Finally drowsiness overtakes him and he drops into a heavy sleep, 
which may last for hours, and from which he awakens with no other dis- 
comfort than a ravenous hunger. In this last stage the pupils are dilated, 
muscular power in abeyance, and partial anaesthesia prevails. While the 
ultimate effects of the drug in some result in tremor, great weakness, loss 
of appetite and convulsions, no deaths have been known to occur in man 
from this drug. 
The effect upon Caucasians is less pronounced than that described, 
which is experienced chiefly by Orientals. In the former the stage of exhilara- 
tion and phantasmagoric inebriation may be very brief or entirely absent, 
the patient passing successively through heaviness and numbness of the 
limbs, heat in the head, giddiness, a pleasurable pricking of the whole body, 
drowsiness, and deep sleep. With some individuals pressure upon the 
skin is said to excite a sense of burning, and the subsequent anaesthesia may 
become so profound that the patient, when standing, is not conscious of 
contact with the ground. 
One young man to whom we administered cannabis amused himself 
by repeatedly jumping over the foot of his bed, laughing with great glee over 
his capers. 
Therapy.-The therapeutic effects of cannabis vary under different 
conditions. It stimulates in depression and sedates when there is irritation. 
It lessens pain-especially spasmodic pain-allays spasm, improves the 
appetite, causes a feeling of contentment and rest, and produces sleep. 
If pushed too rapidly or in too large doses, exhilaration of spirits, inebria- 
tion with phantasms, illusory delirium, and sometimes strong aphrodisia 
precede sleep. A peculiarity in many individuals taking cannabis is the 
voracious appetite induced. The effects of cannabis are far less powerful 
and less disturbing to the general system than those of opium, and it does 
not, like the latter, restrain the secretions nor produce itching. If anything 
the urine is increased by cannabis and constipation does not occur. 
The keynote indication for cannabis is marked depression of the 
nervous system usually with insomnia. Secondly, it allays irritation of the 
urino-genital tract and relieves pain. For the first condition it is invaluable 
in more or less painful conditions in which opium seemingly would be 
indicated, but in which, on account of its tendency to restrain normal 
secretions, would be inadmissible. In fact, cannabis exerts far less re- 
straining power over the secretions than do most similar anodynes. Be- 
sides, it favors good digestion and dispels gloom and foreboding. As a pain 
reliever it is more potent than as a sleep producer, as for some unknown 
reason even good qualities of cannabis often fail in insomnia when they 
271 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
succeed perfectly in blunting pain. As a remedy for pure insomnia without 
pain it is less valuable than many other hypnotics. It is, however, often 
useful in the sleeplessness of depressive insanity. 
Depressive headache, particularly migraine, is one of the types of pain 
in which cannabis is exceedingly effective. Its use is often advantageously 
preceded by gelsemium. These cases are those that come on with much 
excitability and hyperaemia, followed by depression. It is in the depressive 
stage that cannabis is useful. Spasmodic neuralgic pains are helped by it. 
It is particularly indicated in the vague pains of indigestion, in depressive 
nervous headache, nervous gastralgia, gastric neuralgia, gastric ulcer and 
carcinoma (in the latter two, when opium disagrees), the pains of irritative 
diarrhoea, neuralgia of the face, neuralgia of the pelvic viscera, so-called 
chronic rheumatism, endometritis, subinvolution, after pains, and amenor- 
rhoea, all with nervous depression and despondency. It is sometimes useful in 
the painful paroxysms of locomotor ataxia and sciatica, but as a rule is not 
powerful enough to subdue these and the severe cramp colic induced by the 
passage of calculi, unless given in doses large enough to produce other 
unpleasant effects. Morphine is by far the better agent for the relief of 
pain in renal and hepatic colic. Cannabis gives relief in painful and 
spasmodic dysmenorrhoea, marked by much nervous debility; and it is 
accredited with having promptly checked functional menorrhagia. 
Cannabis is a remedy for convulsive and irritative forms of cough. 
It is especially comforting in the latter stages of phthisis and for the cough 
of senility, with senile catarrh. In both instances the cough is harassing, 
expectoration heavy and difficult, and rest and sleep are disturbed. While 
effective in whooping cough there are better agents for use in children than 
cannabis. Cannabis aids in depressive hysteria; quiets excessive move- 
ments in paralysis agitans, and in some cases of chorea; and sometimes 
quiets a palpitating heart. It relieves itching in many skin disorders, and 
especially the pruritus of the aged. 
It is, perhaps, in genito-urinary disorders of a subacute and chronic 
inflammatory type that the usefulness of cannabis is most strongly displayed. 
With the properly-selected sedative it meets the wants of a pain reliever 
and nerve soother in urethritis, whether idiopathic or specific. Gelsemium, 
aconite, and cannabis are, perhaps, more frequently indicated than other 
internal agents in acute gonorrhea. Locke invariably prescribed the 
following: 3 Specific Medicine Aconite, gtt. x; Specific Medicine Can- 
nabis, Specific Medicine Gelsemium, aa fl5j; Simple Syrup; Water, 
ad fl§iv. Mix. Sig.: One teaspoonful every three hours. This relaxes 
spasmodic tension, relieves ardor urinae, reduces fever and inflammation, 
and does much to prevent chordee, and to control it when present. In 
chronic nephritis cannabis is useful when there is much pain in the back 
and when blood is passed in the urine. Cannabis is sometimes useful in 
spermatorrhoea when accompanied by worry, gloomy foreboding, and general 
mental and physical depression. Having some aphrodisiac action it may be 
given with strychnine to restore sexual power lost through excesses, but not 
when due to organic changes. It is of supreme importance in surgical fever 
due to the passing of the catheter or bougie, or from operations upon the 
urethral tract. In chronic cystitis, chronic irritation of the bladder, dysuria, 
272 INDIVIDUAL DRUGS. 
painful micturition, and strangury, it is a drug of very great value. In all 
instances a good preparation of cannabis must be used, for a poor quality 
is worse than useless. 
CANTHARIS. 
The dried beetles, Cantharis vesicatoria (Linne), De Geer. (Ord. Coleoptera.) South- 
ern Europe. Dose, 1 grain. 
Common Name: Spanish Fly; Synonym: Cantharides. 
Principal Constituents.-Crystallizable Cantharidin (Ci0 H12 O4) and a volatile oil are 
said to be the active or vesicating principles. 
Preparations.-1. Specific Medicine Cantharis. Dose, 1 to 10 drops. 
2. Ceratum Cantharidis. Cantharides Cerate. (Blistering Cerate.) Epispastic. 
3. Coilodium Cantharidatum. Cantharidal Collodion, (Blistering Collodion, Vesicat- 
ing Collodion). Epispastic. 
Specific Indications.-Vesical irritation; paresis of the vesical sphincter; 
dribbling and involuntary expulsion of urine; teasing desire to urinate, 
accompanied with tenesmus. 
Action and Toxicology.-Applied to the skin cantharis first reddens 
then slowly blisters. Its final action may be so intense as to cause slough- 
ing and gangrene; or by absorption to cause strangury and acute nephritis. 
Small doses stimulate the excretion of urine; large doses are destructively 
irritant. The earliest symptom from moderate doses is irritation of the 
urino-genital tract, with strangury and burning pain. If continued, or the 
dose is large, blood and albumen appear in the urine. Large doses produce 
all the intense agonies of a violently destructive gastro-enteritis and acute 
inflammation of the kidneys and bladder; with final suppression of urine 
and death from uremia. Intense burning pain, soreness and tenderness of the 
abdomen, excessive burning thirst, profuse ptyalism, with cadaverous 
odor of the breath, rapid breathing, small thready pulse, griping and 
purging, profuse urination followed by suppression, exceedingly painful 
micturition drop by drop, priapism, violent sexual desire, and seminal emis- 
sions are among the awful results of a toxic dose of cantharis. Six (6) 
grains of powdered cantharides is the smallest amount known to have pro- 
duced death. Cases of poisoning are almost always confined to those 
who take cantharis to produce abortion. 
There is no known chemical or physiologic antidote to cantharis. 
Poisoning by it must be treated on general principles, with opiates to 
control pain. When non-toxic doses have produced strangury it may be 
relieved by opium and camphor, and large draughts of water. 
Therapy.-External. As a vesicant cantharis acts kindly as compared 
with some other agents. It is sometimes used as a derivative in deep-seated 
inflammation, to absorb inflammatory products, and to relieve local pain, 
as in intractable neuralgias and persistent headache. In Eclectic therapy 
the use of blisters is scarcely ever deemed advisable, or even necessary. 
Certainly they should not be used in states of great debility following 
grave illness, or the exanthems, nor when renal congestion or inflammation 
is present. Cantharis has been used in lotions to promote the growth of 
hair. Howe advised it with bay rum, specific medicine uvedalia, and 
Fowler's solution, for this purpose. Others have used the cantharidal 
collodion, painted upon the scalp about every two weeks, to encourage the 
growth of hair in alopecia circumscripta, with asserted success. 
273 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Internal. Cantharis has a limited use in modern specific therapeutics. 
In very small doses it is a decided stimulating diuretic and special sedative 
to the bladder. One must be very careful, however, to avoid irritant doses. 
It is the remedy for vesical irritation, to allay teasing desire to urinate and 
the tenesmus accompanying it. It is one of the most certain remedies for 
the day-time enuresis of women, particularly the middle-aged, when due to a 
paretic condition of the sphincter vesicae; and in women and children with 
irritable bladders or weak sphincters, in whom coughing, sneezing, or 
exertion cause an involuntary expulsion of urine. It is equally effective in 
men who pass their urine with difficulty or dribbling, and intense scalding 
heat. In minute doses it may be cautiously used in the late stages 
of acute desquamative nephritis, where the kidneys are weak and function- 
ate sluggishly, every little exertion seeming to produce an increase of 
albumen in the urine. It has also been advised for the torpid kidney action 
in the chronic parenchymatous nephritis of inebriates, in pyelitis, and in 
chronic cystitis. Used carefully in renal medication it may accomplish great 
good; but when recklessly employed it is a dangerous medicine, producing 
or aggravating the very conditions sought to be relieved by it. 
Cantharis promotes menstruation in atonic amenorrhcea with marked 
depression. It also increases the sexual appetite and has been used to 
strengthen the procreative functions. Old gleet and prostatorrhoea are first 
awakened and aggravated and then relieved by it. Its internal use has 
been advised in some chronic skin diseases, such as psoriasis, prurigo, lichen, 
and eczema; upon what grounds we are not advised. 
CAPSELLA. 
The freshly dried plant Capsella Bursa-pastoris, Moench (Nat. Ord. Cruciferae). 
A common weed, native of Europe, but naturalized everywhere. 
Common Names: Shepherd's Purse, Shepherd's Sprout. 
Principal Constituents.-Resin and a volatile oil. 
Preparations.-1. Specific Medicine Capsella. Dose, 1 to 60 drops. 
2. Infusum Capsellce. Infusion of Capsella, (Fresh herb, 3j to water Oj). Dose, 
Freely. 
Specific Indications.-Passive hemorrhages; irritation of urinary 
organs with phosphatic deposits; prolonged and oft-recurring menorrhagia 
with almost colorless flow. 
Action and Therapy.-Capsella acts chiefly upon the urinary tract, 
being a mild stimulating diuretic. The infusion, tincture and specific 
medicine are all efficient, but the green plant is most active. Owing to its 
mild astringency it has been employed in hematuria, diarrhoea, bleeding 
piles, and indigestion and dyspepsia of an atonic type. Slightly stimulant 
it sometimes aids when simple measures are desired in amenorrhcea. In 
chronic menorrhagia, with a too long or too frequent and almost colorless 
flow, it is said to have given positive benefit. Its chief value is to relieve 
irritative and atonic disorders of the urinary tract, with constant desire to 
urinate, and especially if associated with phosphatic deposits or passive 
hemorrhage. 
274 INDIVIDUAL DRUGS. 
CAPSICUM. 
The ripe fruit, dried, of Capsicum frutescens, Linne (Nat. Ord. Solanaceae). Tropical 
America; also cultivated in most tropical countries. Dose, 1 to 2 grains. 
Common Names: Cayenne Pepper, Guinea Pepper, Red Pepper, African Chillies, 
Bird Pepper. 
Principal Constituents.-Fixed oil, resin, fats, and the rubefacient and acrid principle 
capsaicin (C» Hh NO2) and a volatile oil, capsicin. 
Preparations.-1. Specific Medicine Capsicum. Dose, 1/10 to 2 drops, very largely 
diluted. 
2. Tinctura Capsici, Tincture of Capsicum. Dose, 1/10 to 10 minims. 
3. Emplastrum Capsici. Capsicum Plaster (Composed of Oleoresin of Capsicum 
and Rubber Plaster). Rubefacient. 
Specific Indications.-Marked depression and debility, with feeble 
pulse and repressed secretions; pale membranes with scanty, viscous 
secretion; tongue dry, harsh, and mouth and salivary secretions suppressed 
or scanty; atonic dyspepsia of drunkards; alcoholic delirium of the de- 
pressive type; congestive chill; colic, with abdominal distention; debility 
with faulty gastro-intestinal functioning in the aged. 
Action.-Locally capsicum is decidedly irritant, causing dermal heat 
and redness. It does not vesicate, however, unless long and closely applied 
to the mucosa. The oleoresin is much more active and causes sharp burning 
pain and may destroy the epidermis. 
Capsicum is a pure, energetic and permanent stimulant. In large 
doses it produces vomiting, purging, pains in the stomach and bowels, 
gastro-enteritis, giddiness, strangury, and a species of intoxication and 
enfeeblement of nerve power. Smaller doses give warmth to the stomach 
and excite a hyperaemic state of the gastric mucosa, with increased secretion 
and accelerated movement of the musculature of the stomach and bowels. 
It slightly increases the urine, and is mostly eliminated by the kidneys. 
Therapy.-External. Tincture of Capsicum is an important topical 
stimulant, rubefacient and counter-irritant. By its revulsive action it often 
relieves local pain. Painted upon chilblains it quickly gives relief. The pure 
tincture alone, or mixed with glycerin or mucilage of acacia, may be used. 
Applied to an aching tooth it either relieves or aggravates, according to the 
sensitiveness of the nerve or the degree of inflammation present. We have 
used it with great satisfaction for pain coursing along the spermatic cord in 
the lower quadrant of the abdomen. It must not, however, be allowed to 
come in contact with the tender skin of the scrotum. The tincture has been 
painted upon the scalp to excite the growth of hair in alopecia. With or 
without glycerin or mucilage of acacia it may be used to clear up ecchymoses. 
Dry capsicum in the shoes was one of Scudder's favorite means of warming 
cold feet. Diluted tincture of capsicum, or capsicum with vinegar, and 
sometimes with salt, is a common and useful stimulating gargle for slug- 
gish forms of sore throat, and sometimes apparently aborts tonsillitis. 
Capsicum may be used for many of the revulsant effects required of mustard. 
It does not blister nor cause strangury when so applied. Either the tincture 
painted upon the part or the capsicum plaster may give relief to so-called 
chronic rheumatic pains, and be applied in lumbago, pleurodynia and 
intercostal neuralgia. A stupe of hot water and capsicum applied to the 
nape of the neck sometimes relieves the headache of debility. 
275 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Internal. Capsicum is a pure stimulant to the heart and circulation, 
giving increased force and slightly augmented frequency to the pulse. 
One thoroughly acquainted with the action of capsicum can scarcely com- 
prehend why physicians seek for habit-forming stimulants which do in- 
finite harm when so simple and efficacious and pure a stimulant as cap- 
sicum may be had. Used within proper dosage it can scarcely do harm, 
and generally results in incalculable good. Not merely for temporary pur- 
poses is capsicum efficient, but its effects are more or less permanent. 
Naturally it should be selected for atonic conditions and avoided where 
irritation or active inflammation is present. Nevertheless, in low grades 
of inflammation and fever, with sluggish blood current, it is a most efficient 
and necessary stimulant when given in small doses. 
The infusion of capsicum is a simple domestic remedy for acute colds, 
sore throat and hoarseness. Small doses of the tincture are of the utmost 
value in debility with deficient gastric action. When the membranes are 
pale, relaxed or flabby, and secretion is impaired or scanty and viscous, 
capsicum will do more than any other agent to rectify the condition and 
prepare the way for the action of other medicines. Even where the tongue 
is dry and elongated and parched from lack of secretion, and the glands of 
the mouth are inactive, no agent is superior nor safer than capsicum. 
It has, therefore, wide usefulness in disease-acute, subacute, or chronic. 
For chronic gastric catarrh it may be used occasionally, but should not be 
long continued lest it increase the malady sought to be improved. It is in- 
valuable in some cases of atonic dyspepsia, with deficient secretion. It is 
often promptly effective in gastric flatulence, and is an agent of great value 
to prevent the accumulation of gases in both stomach and intestines. A 
mixture of capsicum, vinegar, and salt will sometimes prove a good anti- 
emetic if given in small doses diluted with cold water. 
Capsicum should be largely used in low forms of fever-the more 
depressed the type the more it is needed. It is then of great advantage to 
maintain the equilibrium of the secretions and the circulation. Capsicum 
stimulates the appetite, aids digestion, facilitates peristalsis, and is, there- 
fore, both stimulant and tonic to the gastro-intestinal tract. It thus main- 
tains the integrity of those functions-an important desideratum during 
fevers and in convalescence therefrom. In grave cases of typhoid fever, 
with almost complete suppression of natural secretions, we would be at a 
loss without capsicum. It sometimes checks a congestive chill, and in 
intermittent fever it aids the action of quinine and other antiperiodics. 
Capsicum is of very great value in alcoholic delirium. If secretions 
are suppressed and food can not be taken, or if sleep can not be induced in 
delirium tremens, one faces an extremely dangerous and perhaps fatal 
issue. But if secretions can be re-established and food be retained, sleep is 
very apt to follow. Then the battle against death is won. For this purpose 
no agent will accomplish so much as capsicum. It may be given at first in 
frequent small doses in hot water; then as the stomach responds, in larger 
doses in a good, strong beef broth. While capsicum is best in subacute 
forms of delirium tremens and not the violent and boisterous type-it 
sometimes is needed after the latter to satisfy the craving for stimulants, to 
overcome the sinking sensations at the pit of the stomach, to prevent 
276 INDIVIDUAL DRUGS. 
morning nausea and vomiting, to restore tone, and to render the stomach 
tolerant of food. There is scarcely any danger of giving an overdose of 
capsicum in dipsomania, as large quantities are swallowed with evident 
relish and without ill results by confirmed dipsomaniacs. Some cases must 
have alcohol, but most cases respond to capsicum. Then nux vomica, 
hydrastis, black haw, hydrochloric acid, and other peptics may follow. 
Capsicum is of value in many functional nervous troubles with debility 
and repressed secretions, and for the aged it is one of the few medicines 
that should be widely heralded for its power to stimulate and preserve 
gastric tone and prolong life. In the debility of the young or old, but 
particularly in old persons, when the body-heat is low, vitality depressed, 
and reaction sluggish, it is an agent of power for good. Tired, painful 
muscles, stiffened joints, and relaxation of tissue are common conditions in 
the elderly that are, in a measure at least, helped by capsicum. 
Capsicum in very small doses is said to control irritation and stimulate 
renal capillary activity in chronic renal congestion. In similar doses it 
may relieve sluggish hemorrhoids, diarrhoea and dysentery, with tenacious 
muco-bloody stools, with tenesmus and burning, associated with cramp- 
like action of the bladder. These cases are usually encountered in in- 
dividuals with a lax habit of body. For chronic, non-burning hemorrhoids 
with torpor and constipation, or relaxation, Locke advised I) Capsicum, 
gr. ij; Aloes, gr. 1/4. Mix. Make 1 pill. 
Capsicum, internally administered, will frequently check frontal 
neuralgia, particularly if of malarial origin. It is best to give a few prepara- 
tory doses and then follow with quinine associated with it. One of our 
favorite medicines for masked malarial conditions is an hydrochloric acid 
solution of quinine with capsicum added. 
If called upon to say when capsicum is most valuable, we would limit 
it to: (a) An agent to re-establish repressed or suppressed secretion; (b) 
to a medicament for the gastric incompetence of the aged; (c) and to a 
saving remedy in most cases of acute alcoholism. The dose of capsicum for 
most purposes need not be large, from the fraction of a drop of a good 
tincture to ten drops; or the specific medicine not to exceed 2 drops. 
Only in extreme conditions, as in delirium tremens, are large doses, even 
in excess of ten drops, required. Fluid preparations of capsicum are to be 
preferred to powdered capsicum for internal use on account of the rectal 
discomfort occasioned by the latter. Food for the aged and debilitated 
may be well fortified with capsicum, and frequently sauces, catsup, and like 
preparations containing it will be found grateful to such patients. 
Charcoal prepared by burning soft wood. It must be kept in tightly-closed vessels. 
Common Names: Charcoal, Wood Charcoal; Synonym: Carbo Vegetabilis. 
Description.-A tasteless and odorless non-gritty black powder. 
Preparation.- Trituration of Carbo Vegetabilis (1 to 100). (Carbo Veg.) Dose, 1 to 
30 grains. 
Specific Indications.-Gaseous fermentation and fetor; pulse feeble; 
pallid skin with doughy and tumid abdomen; expressionless, pale tongue, 
with spots of denuded coating; passive hemorrhages, and profuse secretion. 
CARBO LIGNI. 
277 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-External. Absorbent, deodorant and dis- 
infectant, but not antiseptic. It is used very largely to deodorize foul 
ulcers, carcinomata, and gangrene, possessing the advantage of being 
an odorless deodorant. It is frequently added to poultices and is an in- 
gredient of some tooth powders. A rectal injection of charcoal has checked 
hemorrhage from the bowels. 
Internal. Its absorbent and deodorant properties make charcoal a 
splendid agent to absorb putrid gases from the stomach and bowels. It is 
indicated by offensive breath and disagreeable belching. In acidity of the 
stomach, gastric distention, nausea and vomiting, sick headache with 
gaseous belching, fetid diarrhoea, and sometimes in the acid vomiting of 
pregnancy, charcoal is a most effective agent. It may be combined, plain 
or aromatized with oil of peppermint, with sodium bicarbonate in acidity 
of the stomach, with bismuth subnitrate in marked irritation and diarrhoea, 
with ginger in the flatulence of atony, and with rhubarb or magnesia when 
constipated. Though supposed to have no general effects on account of 
not being absorbed, Scudder strongly advocated it for passive hemorrhage, 
using the second decimal trituration of carbo vegetabilis. His statement 
is worth recording. "The specific use of charcoal is to arrest hemorrhage 
from the bowels. It has been used in enema, 3ss to 5j, finely powdered, 
to 4 ounces of water, thrown up the rectum. Why this checks it I can 
not tell; that it does it I have the evidence of my own eyes. For several 
years I have employed the second decimal trituration as a remedy for 
passive hemorrhage with the most marked benefit. I employ it in threatened 
hemorrhage during typhoid fever; in menorrhagia, especially when chronic; 
in prolonged menstruation; the watery discharge that sometimes follows 
menstruation; hemorrhage from the kidneys; hemorrhage from the 
lungs; and in some cases of leucocythaemia. A good indication for this 
remedy is a small pallid tongue with lenticular spots, and with this it may 
be given in any form of disease." (Specific Medication.} 
Charcoal, like animal charcoal (Carbo Animalis}, is sometimes given in 
alkaloidal poisoning with a view to precipitating and retarding the poison 
until it can be removed from the stomach. Its effectiveness is doubted. 
It may also be used in haematemesis, and frequent foul discharges from the 
intestinal tract. The pulse is feeble, the belly-wall tumid and doughy, the 
tongue expressionless and pale with little coating and lenticular spots, or 
the coating may lift in patches. 
CARDAMOMI SEMEN. 
The dried, recently decapsulated fruit of Elettaria Cardamomum, White et Maton. 
(Nat. Ord. Zingiberaceae.) Mountainous coasts of Malabar. Dose, 5 to 60 grains. 
Common Names: Cardomom Seeds, Cardamom, Cardamon. 
Principal Constituents.-A fragrant camphoraceous bitter volatile oil, composed chiefly 
of terpenes (Cio Hi6). 
Preparations.-1. Specific Medicine Cardamon. Dose, 10 to 60 drops. 
2. Tinctura Cardamomi Composita. Compound Tincture of Cardamom (Carda- 
mon, Cinnamon, Caraway, Cochineal, Glycerin, and Alcohol). Dose, 30 to 60 drops. 
Action and Therapy.-Carminative. All preparations are useful in 
flatulent colic, and to flavor tinctures, syrups, and other medicines, par- 
ticularly alkaline mixtures, the compound tincture imparting to these an 
agreeable taste and color. 
278 INDIVIDUAL DRUGS. 
CARTHAMUS. 
The florets of Carthamus tinctorius, Linne (Nat. Ord. Compositae). Egypt and the 
Mediterranean countries, but cultivated in Europe and the United States. 
Common Names: Safflower, Dyer's Saffron, Bastard Saffron, American Saffron. 
Principal Constituents.-Two beautiful coloring principles, Safflor yellow, and a red, 
carthamin or carthamic acid (Cu H16 O7). The latter is a valuable dye. 
Action and Therapy.-Chiefly employed in domestic medicine in hot 
infusion as an emmenagogue for amenorrhoea due to recent colds; and to 
determine the eruption in scarlet fever and measles. It is somewhat 
diaphoretic and laxative, and is little used by physicians. 
The fruit of Carum Carvi, Linne (Nat. Ord. Umbelliferae). Europe and Asia and 
cultivated everywhere. Dose, 10 to 60 grains. 
Common Names: Caraway, Caraway Seed, Caraway-Fruit. 
Principal Constituent. -A volatile oil (Oleum Cari). 
Preparations.-1. Oleum Cari, Oil of Caraway. Dose, 1 to 5 drops. 
2. Specific Medicine Caraway. Dose, 10 to 60 drops. 
Action and Therapy.-An aromatic carminative and gentle stomachic; 
both the fruit and the oil are of value in flatulent colic and to flavor 
medicinal compounds. 
CARUM. 
CARYOPHYLLUS. 
The unexpanded flowers (dried flower-buds) of Eugenia aromatica (Linne), 0. Kuntze. 
(Jambosa Caryophyllus (Sprengel) Niedenzu). (Nat. Ord. Myrtaceae.) Cloves Island, 
Moluccas, and cultivated in Africa, East and West Indies, and Brazil. Dose, 5 to 10 grains. 
Common Names: Clove, Cloves. 
Principal Constituents.-A pungent acrid and aromatic volatile oil (Oleum Caryophylli), 
composed principally of eugenol (Ci0Hi2O2); eugenin, and caryophyllin, which is isomeric 
with camphor. 
Preparations.-1. Oleum Caryophylli, Oil of Clove. Dose, 1 to 5 drops. 
2. Specific Medicine Cloves. Dose, 1 to 10 drops. 
Action.-Irritant to the skin and mucosa, causing redness and burning 
followed by partial anaesthesia. It is typical of the class of volatile oils, 
most of which act similarly. It excites the salivary secretions and stimulates 
digestion by impressing the nerves of smell and taste, dilating the gastric 
vessels, provoking the flow of gastric juice, and inducing increased peristalsis 
of both stomach and intestines, thus causing eructations of gas and flatus. 
The latter is no doubt aided by its decided antiseptic qualities. Like all 
aromatic oils large doses may provoke gastro-enteritis. Oil of clove modifies 
the griping effects of many medicines. Eugenol acts similarly to oil of clove. 
Therapy.-External. Oil of Clove obtunds dental pain and sometimes 
earache. Used pure or in ointments or liniments it relieves local pain, as 
in neuralgia, and in chronic eczema it allays itching, and is sometimes 
added to embrocations to give them an agreeable odor. Diluted with alco- 
hol, it may be used to kill pediculi. 
Internal. Oil of clove is carminative and stomachic. It often re- 
lieves nausea and vomiting, gastric pain, and flatulent distention of stomach 
or bowels. When cardiac palpitation and pain depend upon gastric dis- 
tention, oil of clove frequently relieves it. 
Eugenol. Derived from oil of clove and other sources may be given in 
doses of 1 to 3 minims. 
279 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
CASCARA SAGRADA. 
The dried bark of Rhamnus Purshiana, De Candolle (Nat. Ord. Rhamnaceae). A 
shrub of Northern Idaho and the Pacific coast. Dose, 5 to 30 grains. 
Common Names: Sacred Bark, Chittem Bark. 
Principal Constituents.-Several resins, a volatile oil, and cascarin, a glucoside thought 
to be identical with frangulin obtained from Frangula. 
Preparations.-1. Specific Medicine Cascara. Dose, 15 to 60 drops. 
2. Extractum Cascara Sagrada, Extract of Cascara Sagrada. Dose, 4 to 8 grains. 
3. Fluidextractum Cascara Sagrada, Fluidextract of Cascara Sagrada. Dose, 10 
to 60 minims. 
4. Fluidextractum Cascara Sagrada Aromaticum, Aromatic Fluidextract of Cascara 
Sagrada. Dose, 10 to 60 minims. 
Specific Indications.-Constipation due to neglect or to nervous and 
muscular atony of the bowels; minor ailments, dependent solely upon 
constipation, with intestinal atony. 
Action and Therapy.-Cascara is a simple and practically non-griping 
purgative, acting with but little or no prostration and never causing a 
watery stool. It has, moreover, a tonic action upon the stomach and 
bowels, and does not produce an after constipation. It is the most popular 
and most efficient agent for chronic constipation, and may be given for a 
considerable time without increase of dosage. In fact, the dose may be 
gradually decreased from day to day often with the result of completely 
curing the constipation. Cascara is adapted to cases of atony of the in- 
testines. When other simple ailments depend upon constipation they may 
often be remedied by cascara. It is an efficient purgative in pregnancy, in 
hemorrhoids with loss of rectal tone, in atonic dyspepsia with costiveness, 
and in sick headache due to atonic sluggishness of the bowels. Gastric and 
duodenal catarrh, with jaundice, are often rectified by cascara, and it has 
given good results in chronic diarrhoea when accompanied by hepatic torpor. 
Only preparations of old cascara bark are desirable; the fresh bark is 
emetic and otherwise disturbing. The taste of cascara is extremely bitter. 
This may be modified to a large degree by the addition of fluidextract of 
licorice and spirits of anise and sassafras. The aromatic fluidextract is a 
pleasant preparation and has less of a tendency to cause griping. A good 
laxative is the following: 1$ Specific Medicine Cascara (or the Fluidextract 
of Cascara), fl 5ij; Fluidextract of Licorice, fl^ss; Essence of Anise, fl3 j; 
Simple Syrup, q. s. fl^vj. Dose-. One half to one teaspoonful at bedtime. 
If a more profound action is desired a half drachm of Specific Medicine 
Podophyllum may be added. 
CASSIA MARILANDICA. 
The leaves of Cassia marilandica, Linne (Nat. Ord. Leguminoseae). An American 
perennial herb of the eastern half of the United States. 
Common Names: American Senna, Wild Senna. 
Principal Constituent.-A body resembling cathartin, and thought to contain chryso- 
phan. 
Preparation.-Infusum Cassia Marilandica Compositum. Compound Infusion of 
American Senna (Leaves, 3 j; Coriander Seeds, 3 j; Boiling Water, Oj). Dose, 4 to 5 fluid- 
ounces. 
Action and Thefapy.-An excellent cathartic that may be used as a 
substitute for senna. 
280 CATNIP 
(Nepeta Cataria) 
Courtesy of Mr. Moritz Fischer 
Photo by Moritz Fischer, Cincinnati, Ohio 
Catnip is perhaps the most celebrated of domestic simples. Notwithstanding the aspersions 
cast upon it as a "grandmother's panacea" for fretful babies, it is, nevertheless, a splendid 
calmative remedy that might well take the place of more powerful nerve sedatives. INDIVIDUAL DRUGS. 
CASTANEA. 
The leaves of Castanea dentata (Marshall), Sudworth, collected in September or 
October while still green (Nat. Ord. Cupuliferae). Native of Asia Minor, naturalized in 
Europe and America. 
Common Name: Chestnut. 
Principal Constituents.-A mucilaginous principle, extracted by hot and cold water, 
but not by alcohol; an astringent body, a sweet substance, and potassium, calcium, mag- 
nesium and iron salts. 
Preparations.-1. Infusum Castanea, Infusion of Castanea. (Leaves, gj; Boiling 
Water, Oj.) Dose, flSiij to fl^ij. 
2. Fluidextractum Castanea, Fluid Extract of Castanea. Dose, fljss to fl 3ii. 
Action and Therapy.-The freshly prepared infusion of the leaves is a 
remedy for paroxysmal or convulsive cough. For some unexplained reason 
it is sometimes one of the most effective medicines for whooping cough. 
In many cases it acts remarkedly well, while in others its effects are not 
so apparent. It is seldom, however, that it does not do some good. The 
infusion (which is by far the best preparation) may be sweetened if de- 
sired, and given freely to the patient several times a day. 
The bark, pod, and seeds of Catalpa bignonioides, Walter. (Nat. Ord. Bignoniaceae). 
A tree of the southern United States. 
Common Names: Cigar Tree, Bean Tree. 
Principal Constituents.-The seeds contain tannin, resin, and fixed oil. 
Preparation.-Specific Medicine Catalpa. Dose, 1 to 20 drops. 
Action and Therapy.-Said to be useful in chronic bronchial affections 
with dyspnoea and asthma, and in functional heart disorders. Its exact 
therapy has not been determined. 
CATALPA. 
CATARIA. 
The leaves and flowering tops of Nepeta Cataria (Nat. Ord. Labiatae). A common 
perennial of Europe, and naturalized in the United States. 
Common Names: Catnip, Catmint, Catnep. 
Principal Constituents.-An aromatic volatile oil and a bitter body. 
Preparations.-1. Infusum Cataria, Infusion of Cataria. (Catnip, gj to Water, Oj). 
Dose, ad libitum. 
2. Specific Medicine Nepeta. Dose, 10 to 60 drops. 
Specific Indications.-Abdominal colic, with constant flexing of the 
thighs; writhing and persistent crying; nervous agitation. 
Action and Therapy.-A safe and valuable, though simple carminative, 
diaphoretic (in warm infusion), and tonic (cold infusion). A splendid 
quieting agent for fretful babies, and carminative and antispasmodic for 
abdominal pain with flatulence. When marked nervous agitation precedes 
menstruation in feeble and excitable women and the function is tardy or 
imperfect, this simple medicine gives great relief. It is especially valuable 
for the nervous irritability of dyspeptics, nervous headache, atonic amenor- 
rhoea and dysmenorrhoea, and wards off nervous or hysterical attacks. 
The warm infusion is an admirable remedy to break up "common colds" by 
diaphoresis, and to determine eruptions to the skin in the exanthemata. 
If less ridiculed and more used, in place of far less safer remedies, "catnep 
tea" would be found a very useful medicine for women and children. It 
281 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
should not be sweetened. Where the added effects of alcohol are needed, 
or when the freshly dried herb cannot be obtained, the specific medicine 
may be used in place of the infusion. 
The rhizome and roots of Caulophyllum thalictroides (Linne), Michaux (Nat. Ord. 
Berberidacese). In rich woods in the eastern half of the United States. 
Common Names: Blue Cohosh, Squaw-root, Pappoose-root. 
Principal Constituents.-An indifferent alkaloid caidophylline (not to be confused with 
the resinoid "caulophyllin,") and an active glucoside of the saponin type, leontin. 
Preparations.-1. Specific Medicine Caulophyllum. Dose, 1 to 10 drops. 
2. Leontin (Lloyd's), a 1 per cent solution of leontin, the emmenagogue principle of 
caulophyllum. Dose, 5 to 15 drops in syrup or sweetened water. 
3. Syrupus Mitchella Compositus, Compound Syrup of Mitchella (Compound Syrup 
of Partridge berry). Dose, fl$i to flgiv. 
Specific Indications.-Uterine pain with weight and fullness and pains 
in the legs; sense of pelvic congestion; sluggish labor pains; as a partus 
praeparator. 
Action and Therapy.-Caulophyllum was at one time largely used 
as an antispasmodic, emmenagogue, parturient, diuretic, diaphoretic and 
expectorant, all of which properties it possesses in greater or less degree, 
according to its manner of use. It unquestionably acts with some force 
upon the reproductive organs of women, overcoming pain and tenderness 
in debilitated subjects. It seems best adapted to uterine debility arising 
from chronic inflammatory conditions. In many respects it resembles 
macrotys, both upon the reproductive organs and in controlling rheumatoid 
pain. For many years it was a favorite remedy for false pains and after- 
pains. It, like macrotys, facilitates child-birth. Both agents produce 
contractions most like those of the natural labor process. In this respect 
they were often used to replace tetanic-acting ergot when that agent was so 
popular and so damaging as an oxytocic. It may be used to assist labor 
when delay is due to weakness, fatigue, or lack of uterine power, or when 
the tissues feel full, as if congested. The skillful use of forceps has largely 
supplanted drugs of this type, yet there are many cases in which they 
might still be used with greater safety than forceps. As an ingredient of 
the Compound Syrup of Mitchella (Mother's Cordial), it is still relied 
upon by some physicians as a good partus praeparator. 
Caulophyllum is a good emmenagogue. It may be used where there 
is congestion with irritation, and the natural functions are badly performed. 
In troubles dependent upon such irregularities, it has given fair results, 
though macrotys has supplanted it for most conditions. Metritis, endo- 
metritis, amenorrhcea, dysmenorrhoea, ovaralgia, ovaritis, rheumatism 
of the uterus, menstrual cramps, uterine subinvolution, and spasmodic 
retention of urine have all been favorably influenced by caulophyllum. It 
is of some, though minor, value in spasmodic urinary and gastro-intestinal 
disorders. 
Leontin (1 per cent solution of the emmenagogue principle of caulophyl- 
lum) has been successfully prescribed for amenorrhcea, dysmenorrhoea, and 
chlorosis. The dose of leontin is 5 to 15 drops in syrup or sweetened water. 
CAULOPHYLLUM. 
282 BLUE COHOSH 
(Caulophyllum thalictroides) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Blue Cohosh, one of the celebrated Cohoshes of the American Indian, figured largely in early 
Eclectic therapy, especially in obstetrical and gynecological therapeutics. It is one of the 
distinctive drugs of aboriginal and domestic origin and of Eclectic development. INDIVIDUAL DRUGS. 
Compound Syrup of Mitchella may be given for weeks as a uterine 
tonic preceding labor. It seems to have both a real and a psychic influence 
that will redound to the benefit of the prospective mother. It is also a 
good uterine tonic for debility and uterine feebleness in the childless, and 
assists in the recuperation of strength and rapid involution of the womb 
following labor. The dose of the syrup is from fl 3 ii to fl 3 ss, 2 or 3 times a 
day. 
CEANOTHUS. 
The root, root-bark, and leaves of Ceanothus americanus, Marshall (Nat. Ord. 
Rhamnacese.) A small shrub indigenous to the United States, particularly in its western 
section, growing in barrens and dry woodlands. Dose, 5 to 20 grains. 
Common Names: Red Root, New Jersey Tea. 
Principal Constituents.-Tannin, a volatile oil, resin, ceanothus-red, and a white 
alkaloid ceanothine. 
Preparation.-Specific Medicine Ceanothus. Dose, 1 to 20 drops. 
Specific Indications.-Sufficiently given below. 
Action and Therapy.-Astringent and sedative. This drug is reputed 
efficient in gastric and hepatic disorders dependent upon splenic enlarge- 
ment, especially when caused by malarial influence. It has given good 
results in splenic hypertrophy, with expressionless countenance and sallow, 
doughy skin; also in splenic congestion and subacute splenitis, the pain 
of which is not much aggravated by pressure. Other indications for 
ceanothus are deep-seated splenic pain, with or without splenic enlarge- 
ment, and sympathetic painful states depending upon spleen pathology; 
also non-inflammatory catarrhal conditions with abundant secretions. 
During the American Civil War the decoction was used by the soldiers for 
"ague cake" or malarial splenitis. 
Yellow wax bleached by exposure to air, light, and moisture. (See Cera Flava.) 
Common Name: White Wax. 
Description.-A yellowish-white solid, translucent in thin layers, having an insipid 
taste and a faint but not rancid odor. It dissolves readily in volatile and fixed oils and 
fuses with fats and resins. 
Preparation.-Cera turn, Cerate, (Simple Cerate). (White Wax 3, Benzoinated Lard 
7.) (See also Adeps Benzoinatus.) 
CERA ALBA. 
CERA FLAVA. 
A peculiar concrete substance prepared by melting and purifying the honey-comb of the 
Apis mellifera, Linne, or Common Honey Bee. 
Common Names: Yellow Wax, Beeswax. 
Description.-A yellowish to gray-brown solid, of a honey-like odor and faint 
balsamic taste. It is brittle when cold and breaks with a granular fracture. Soluble in 
ether, chloroform and fixed and volatile oils. 
Uses.-Both white and yellow wax are principally employed in the 
making of ointments, cerates, and plasters, to impart to them proper con- 
sistence and tenacity. 
283 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Cerium Oxalate. 
A mixture of several oxalates of rarer elements. 
Description.-A white or pinkish powder, odorless and tasteless, and unaltered by 
exposure to the air. Insoluble in water, alcohol, or ether. Dose, 1 to 10 grains (usual dose 
1 to 3 grains every 3 hours.) 
Specific Indications.-Nausea and vomiting of pregnancy. 
Action and Therapy.-Cerium oxalate is anti-emetic and has been 
used to allay reflex vomiting of uterine origin, and less effectively in that 
depending upon simple gastric irritation, or destructive processes going on 
in the stomach. Its chief reputation rests upon its supposed power to allay 
the nausea and vomiting of pregnancy, a condition in which it fails more 
often than it succeeds. It is also given for seasickness with occasional good 
results. Acting somewhat like bismuth it is effectively employed to allay 
the gastric irritability due to dyspepsia, phthisis and other wasting diseases. 
Scudder used it with apparent success in ulcerated cervix uteri and uterine 
irritation with leucorrhoea, administering the 2x trituration. Webster asserts 
it (6 grs. every hour) is useful in dysmenorrhoea in robust, fleshy women, 
with scanty menses, and spasmodic, colicky, or tenesmic pain before or at 
the beginning of the flow. It is difficult to understand how it can affect the 
uterine functions, as it is thought to be practically unabsorbed by the 
stomach. 
CERII OXALAS. 
CEREVISL® FERMENTUM. 
The ferment obtained in the brewing of beer. 
Common Names: Beer Yeast, Brewer's Yeast, Barm. 
Description.-A thick, glutinous, foam-like fluid of wine-acid odor, and unpleasant 
taste. It is a complex mixture of water, alcohol, salts, saccharo-mucilaginous extracts, and 
the yeast plant, the Saccharomyces cerevisia. It does not dissolve in, but mixes with water. 
It is an unstable body, and should be used only when fresh. Dose, 1 drachm to 1 ounce. 
Therapy.-External. Yeast poultices, in combination with elm and 
charcoal, have been particularly effective as emollient and antiseptic 
applications to boils and carbuncles, where poultices are at all admissible. 
Internal. Yeast, in drachm doses, 3 times a day has been given with 
unquestioned advantage to those suffering from recurrent crops of boils. 
It has also been advised in the same or larger dosage, taken immediately 
before meals, in diabetes mellitus to modify the abnormal production of 
sugar, or to destroy it. Through ingenious advertising it has recently 
become popular with the laity as a so-called "vitamine-bearing" substance. 
CETACEUM. 
A concrete fat-like material obtained from the head of Physeter macrocephalus, Linner 
the Sperm Whale of the Pacific and Indian Oceans. 
Common Name: Spermaceti. 
Description.-Partly translucent white masses, somewhat grease-like to the touch, 
and turning yellow and becoming rancid upon long exposure to the atmosphere. It has 
scarcely any odor and a mild, bland taste. It dissolves in boiling, but scarcely in cold, 
alcohol; is insoluble in water; and soluble in ether, chloroform, and oils. 
Therapy.-External. Emollient. By pulverizing by trituration with 
a small portion of alcohol it may be used as a dusting powder for the feet 
and other parts liable to friction. It is an ingredient of many useful oint- 
ments and cerates. 
284 INDIVIDUAL DRUGS. 
Internal. Demulcent. It was once given with sugar and in emul- 
sion for coughs and colds and gastro-intestinal troubles. 
CHELIDONIUM. 
The whole plant of Chelidonium majus, Linne (Nat. Ord. Papaveraceae). Europe; 
naturalized in waste places in the United States. Dose, 1 to 60 grains. 
Common Names: Celandine, Great Celandine, Tetterwort. 
Principal Constituents.-Chelerythrine (identical with the alkaloid sanguinarine), 
chelidonine (stylophorine), and malic and chelidonic acids. 
Preparation.-Specific Medicine Chelidonium. Dose, 1 to 15 drops. 
Specific Indications.-Full, pale, sallow tongue and membranes; 
skin sallow, sometimes greenish; hepatic congestion; jaundice due to 
swollen bile ducts; sluggish liver action with light pasty stools; reflex 
cough from hepatic pain; fullness with tensive or throbbing pain in the 
right hypochondrium, with dull pain radiating to the right shoulder; 
melancholia, headache and stomach disorders depending upon imperfect 
hepatic function. 
Action and Therapy.-External. The fresh juice of chelidonium applied 
to the skin produces rubefaction, inflammation and vesication. It will 
destroy verrucous growths. 
Internal. Internally, in full doses chelidonium is a drastic hydragogue 
purgative, operating much like gamboge. Though reputed to be of some 
value locally as a stimulant and vulnerary, its present use is confined almost 
wholly to disorders hinging on imperfect or faulty hepatic function. It 
also appears to act somewhat upon the spleen, probably including most of 
those parts of the splanchnic area supplied by the chylopoietic vessels 
and the branches of the solar plexus. 
Chelidonium is one of the best remedies for biliary catarrh resulting 
from hepatic congestion and for jaundice occasioned by swelling of the bile 
ducts, as a result of subacute inflammation. The best guide to its use is the 
tenderness and tensive or throbbing pain of the hypochondrium with dull 
pains extending to beneath the right shoulder blade. While there is more or 
less localized pain, there is no general abdominal pain as a rule. The skin 
and membranes have the usual appearance of hepatic obstruction, the 
stools are clay-colored, the urine cloudy and pale with rather high specific 
gravity, or it may be loaded with bile. Sometimes there is oedema of the 
extremities. Under these conditions we have seen chelidonium clear up dis- 
tressing conditions and prolong the intervals between attacks of gall-stone 
colic. In one severe case of gall-stone colic, which was but a repetition of 
many preceding ones, no other attacks followed the use of chelidonium, 
the patient being under observation for many years, and occasionally 
taking a dose of the medicine. It is not a remedy for the paroxysms of 
hepatic colic, but to prevent or repair the condition upon which they 
depend. 
When hemorrhoids, splenic congestion, dyspepsia, headache, migraine, 
supra-orbital neuralgias and cough are dependent mostly upon the liver dis- 
orders helped by chelidonium, they are proportionately relieved by the 
action of chelidonium upon the latter. The greatest drawback to cheli- 
donium is its horribly nasty taste. 
285 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
CHELONE. 
The herb, and especially the leaves, of Chelone glabra, Linne (Nat. Ord. Scrophulari- 
aceae). Damp soils in the United States. Dose, 5 to 60 grains. 
Common Names: Balmony, Snakehead, Turtlebloom, Turtlehead. 
Principal Constituents.-An unnamed glucoside and the usual constituents of plants. 
Preparation.-Specific Medicine Chelone. Dose, 5 to 60 drops. 
Action and Therapy.-A useful remedy for gastro-intestinal debility 
with hepatic torpor or jaundice. Dyspeptic conditions attending convales- 
cence from prostrating fevers are often aided by it, and it should be studied 
particularly for vague and shifting pain in the region of the ascending colon, 
attended with persistent uneasiness and sometimes tormina. We have 
used it for these conditions with satisfaction. The infusion (5ss to 
Water, Oj) in small doses, is effective, though disagreeably bitter. 
CHENOPODIUM. 
The fruit and oil of Chenopodium ambrosioides anthelminticum, Linne (Nat. Ord. 
Chenopodiacese). Waste places throughout the United States. 
Common Names: American Wormseed, Wormseed. 
Principal Constituent.-A volatile oil, Oleum Chenopodii. 
Preparation.-Oleum Chenopodii, Oil of American Wormseed. A colorless or pale 
yellowish oil with the disagreeable odor and taste of wormseed. Dose, 5 to 10 drops. 
Specific Indications.-Lumbricoid worms; hook-worm. 
Action and Therapy.-A safe and certain vermifuge for the removal of 
the lumbricoid or round worm (as caris lumbricoides). After proper prepara- 
tion, by fasting and purging, the powdered seeds (10 to 30 grains) or the oil 
(10 drops) may be mixed with syrup or emulsion of acacia and syrup, 
administered on an empty stomach, and followed by a saline purge or 
castor oil one or two hours afterward. The oil may be given in capsule to 
older children and adults. It is not contraindicated by irritation of the 
bowels. Oil of chenopodium has recently been found to be completely 
effective in the removal of the hook-worm (Ankylostoma Uncinafia, or 
Uncinaria Americana). 
CHIONANTHUS. 
The bark of the root of Chionanthus virginicus, Linne. (Nat. Ord. Oleaceae.) United 
States from Pennsylvania southward. Dose, 5 to 30 grains. 
Common Names: Fringe Tree, Old Man's Beard, Snowdrop Tree. 
Principal Constituents.-Chionanthin and saponin. 
Preparation.-Specific Medicine Chionanthus. Dose, 5 to 30 drops. 
Specific Indications.-Icteric hue of skin and conjunctiva; dull 
hepatic pains and tenderness or soreness upon deep-pressure; light clay- 
colored, or frothy yeast-like stools; sallow, dirty-looking skin with hepatic 
tenderness and expressionless eyes; intense cutting pain from liver to navel, 
attended by nausea, vomiting, and great prostration; icteric coloration 
without pain; the urine stains the clothing yellow; colic, with green stools; 
jaundice, with pale watery alvine discharges and intense itching of the skin; 
pain simulating colic, extending from liver region over the whole abdomen; 
tympanites; and presence of sugar in the urine. 
Action and Therapy.-Medicines that actually and positively in- 
fluence the liver and its secretions are not numerous, notwithstanding that 
for many years much misdirected attention was bestowed upon that greatly 
286 INDIVIDUAL DRUGS. 
abused and usually very innocent organ. "Liver-tapping" virtues, now quite 
forgotten, were ascribed to mercurials and many other powerful drugs. 
Those that have weathered the campaign and been found to have a lasting 
reputation have been vegetable drugs chiefly and of either domestic origin 
or of Eclectic development. None more deserves a place among these than 
chionanthus. 
There are two prime indications for chionanthus-jaundice as shown 
by the icteric hue of the skin and conjunctiva, and hepatic colic with sore- 
ness in the region of the liver. The pain is dull, heavy, and in the right 
hypochondrium, with a sense of weight and fullness, there is soreness even 
on light pressure and deep-seated tenderness on strong pressure, the feces 
are light in color and float upon water, the urine scanty and orange-tinted, 
there are occasional hectic flushes, and sometimes diarrhoea, with frothy, 
yeast-like stools. 
Chionanthus is the most positive remedy for simple jaundice not 
dependent upon malignant or other organic changes in the liver and its 
appendages. It relieves portal congestion promptly, and is therefore a 
logical remedy for hepatic engorgement. Whether it is a remedy for jaundice 
associated with gall-stones, or dependent thereon, has been a question of 
dispute. Practically it seems to act in any instance where the imprisoned 
bile can be liberated by reducing the attendant swelling and congestion. 
In complete obstruction it fails, as do other remedies. One effect of chionan- 
thus is to attenuate the bile, and there can be little doubt that it prevents 
the formation of biliary calculi. When the concretions are small and pass 
with a fair degfee of ease, we believe it beneficial; but when they are 
strongly impacted it is doubtful whether chionanthus has any influence 
upon them or power to dislodge them. But in jaundice depending upon 
functional inactivity and other forms of mechanical obstruction, it is the 
first remedy to be considered. In a single case of Weil's disease that came 
under our care, it was a most efficient remedy, echinacea being alternated 
with it to control septic manifestations. For the acute catarrhal jaundice 
of children and the jaundice of the new born, it acts more favorably than 
any remedy known to us. 
When gastric and duodenal troubles depend upon deficient action of the 
liver, chionanthus is most frequently indicated. It is useful then in chronic 
intestinal inflammation, in chronic duodenitis, chronic gastritis, the irrita- 
tion of stomach and bowels due to high living, and is a remedy of consider- 
able value in the gastro-intestinal and hepatic disorders of dipsomania. 
It has been asserted by many whose large experience entitles them to 
credence that chionanthus is a potent and satisfactory medicinal aid in 
glycosuria, when the glycogenic function of the liver is at fault. While it is 
believed to have some effect upon the functions of the pancreas, it is probably 
of little value in that worst form of diabetes mellitus in which the cells of 
Langerhans are destroyed. It should be given renewed study in the glyco- 
suria of obesity and when sugar intolerance alone, and not starch disturb- 
ances, create what so often passes for diabetes. These are rather prediabetic 
conditions, if tending in that direction at all, but even if untreated might 
never reach the true diabetic state. There is good reason to believe that 
the prolonged use of chionanthus will be of much benefit in such cases. 
287 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
CHIMAPHILA. 
The leaves or whole plant of Chimaphila umbellata (Linne), Nuttall. (Nat. Ord. 
Ericaceae.) North temperate region of the Northern Hemispheres, and in the United 
States, in dry shady woods. 
Common Names: Pipsissewa, Prince's Pine, Ground Holly. 
Principal Constituents.-Chimaphilin (C24 H21 O4), and arbutin (C24 H32 O44. H2 O). 
Preparations.-1. Infusum Chimaphilce, Infusion of Chimaphila (§ss to Water, Oj). 
Dose, 1 to 4 fluidounces 
2. Specific Medicine Chimaphila. Dose, 5 to 60 drops. 
Specific Indications.-Scanty urine, but excessive voiding of mucus, 
muco-pus, or bloody muco-pus; smarting or burning pain upon urination; 
chronic vesical catarrh, with marked debility. 
Action and Therapy.-Chimaphila is both an antiseptic diuretic and a 
positive alterative. It does not derange but seems to favor digestion, and 
has a good influence upon the processes of nutrition. In chronic affections 
of the renal tract with large mucous, muco-purulent or purulent discharges 
it is of the utmost value. Thick and ropy urine, such as is voided by old 
people and in cases of chronic cystitis, with a pinkish or reddish sediment of 
mucus, pus, blood and "brick dust'' is an especial indication for it. Some- 
times it is of value for the urinary disorders following gonorrhoea. Purulent 
discharges from a pyelitis, or due to calculous irritation, also guide to the 
selection of this simple but effective urinary antiseptic, sedative, and diuretic. 
Albumin has disappeared under its use, though the cases were but in- 
cipient cases of albuminuria. Not much hope should be expected from it in 
confirmed nephritis. It is often useful in chronic prostatic irritation and 
in some cases of prostatitis, particularly those associated with chronic 
catarrh of the bladder. The agent should be used preferably in infusion and 
for a continued time. If desired, specific medicine chimaphila may be 
employed dispensed in water, with some glycerin. However, when used 
in this way it precipitates and is unsightly, and a better way is to dispense 
it in bulk with directions to dilute it freely when used. The dose of specific 
medicine chimaphila is from ten to twenty drops diluted every two, three 
or four hours, according to the urgency of symptoms. As a tonic and 
alterative we have used it for a long time with the greatest of satisfaction. 
A recent writer in the old world has credited chimaphila, in doses as given 
above, with causing the disappearance of sugar in glycosuria. Chimaphila 
is a neglected remedy that may well take the place of other agents of 
questionable safety. 
Hydrated Chloral, Chloral Hydrate; Chloral (improperly) nearly pure, C2 H Cl O3. H2O. 
Description.-Transparent colorless crystals having a strongly caustic and bitter taste 
and a penetrating and unpleasant aromatic odor. Easily soluble in water, alcohol, 
ether, chloroform, olive oil, and oil of turpentine. Dose, 1 to 30 grains, the usual doses 
being 5 to 15 grains. 
Specific Indications.-Insomnia from cerebral hyperaemia; pulse soft 
and temperature normal or somewhat increased; headache, with cerebral 
hyperaemia; spasms, when not associated with debility or depression; 
delirium tremens, in the absence of fatty heart, and with great cerebral 
excitation; hot, dry skin, elevated temperature, and flushed face; nausea 
CHLORALUM HYDRATUM. 
288 INDIVIDUAL DRUGS. 
and vomiting from cerebral hyperaemia; surgical fever, with excitement and 
delirium; poisoning by strychnine; tetanus. 
Action and Toxicology.-Chloral hydrate is a topical irritant. If kept 
in contact with the skin it causes redness and inflammation; if applied to 
the mucosa rubefaction, burning pain and acute inflammation may result. 
Upon denuded surfaces or wounds it is powerfully irritant, and under some 
conditions it may vesicate. Injected into the rectum it causes heat, irrita- 
tion and sometimes ulceration; subcutaneously it produces pain and 
sloughing. Liebreich and others once taught that chloral was broken up 
in the blood into chloroform and salts of formic acid. That view is no 
longer held, as it is known to circulate in the blood as chloral and is elimi- 
nated by the kidneys as urochloralic acid, unless given in excessive quantities; 
in which instance some unchanged chloral is voided. The view also now 
prevails that probably chloral has but little influence upon the blood, in 
any-sized doses. 
As a rule, small medicinal doses do not appreciably affect the circula- 
tion or respiration, but profoundly affect the cerebrum, producing quiet 
and refreshing slumber very similar to that of normal sleep. It is, however, 
most uncertain in its effects upon the heart and breathing, and even small 
doses have been attended with very alarming prostration and sometimes 
death. If more than 20 grains are given, depression becomes evident- 
the vaso-motor centers and the heart-muscle being directly affected, so 
that the pulse becomes slow and weak, or races and becomes thready. 
Chloral is never absolutely safe, and even when it is least expected it may 
cause respiratory paralysis and death. 
The dominant action of chloral is upon the higher cerebral cells, 
producing sleep; upon the motor neurons of the cord, abolishing muscular 
movement and reflex action; and upon the medullary centers of breathing 
and circulatory control. These are affected in the order named, so that 
each can be impressed, by selected dosage, in downward progression. It 
appears to have but little effect upon the sensory ganglia, but if given in 
excessive quantities it may cause general anaesthesia. Chloral probably 
produces sleep by inducing cerebral anemia. It not unfrequently causes an 
erythematous rash followed by desquamation, and more frequently a 
purpuric eruption. 
Subjectively chloral produces the following general effects: Hot 
pungent taste, increased salivary flow, gastric warmth, and increased 
appetite. If the dose be large, vomiting may result. The patient falls into 
a quiet sleep from which he can be aroused to take nourishment or to 
respond to calls of Nature, when he again sinks into slumber, usually without 
dreams, and upon awakening no unpleasant after-effects are experienced. 
In this respect chloral has the advantage over opium and many other 
hypnotics. Large doses of chloral induce profound narcotism, with abolish- 
ment of muscular power, reduced temperature, and loss of sensation and 
the reflexes. Lethal doses cause slow breathing, weak, thready, fluttering 
pulse, soon lost to the touch, a sinking sensation, complete muscular relaxa- 
tion, pallid and livid countenance, cold sweat, and deep coma from which 
there is no awakening. Then follows centric paralysis of breathing and the 
circulation, and the victim dies aneesthetized and paralytic. 
289 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Death from chloral reveals, upon post-mortem examination, meningeal, 
cerebral, spinal, and pulmonary congestion, with a distended right heart. 
The treatment of acute chloral poisoning is similar to that for narcotics. 
As a peculiar coldness pervades the victim, artificial heat should be applied 
to the extremities, and to the praecordium. Alcohol, ether, or ammonia in 
repeated small doses may be given by the mouth, rectum, or subcutaneously. 
Friction, flagellation with wet towels, faradization, or galvanism to the 
region of the diaphragm, cold applications to the head and neck, artificial 
respiration, and hot coffee, or caffeine to sustain the heart, should be ad- 
ministered. Atropine, digitalis (by mouth or by rectum), and strychnine 
should be given hypodermatically to sustain the breathing and circulation. 
Amyl nitrite may be cautiously applied to the nostrils, but its effects must 
be closely watched. 
Chloralism. Chloral hydrate is taken by some individuals until the 
chloral habit is formed. Chronic chloralism presents serious disturbances, 
the chief among which are the following: The chloral habitu& is a voluble 
talker, speaking in a quick and excitable manner; the eyes are irritable and 
hyperaemic, though brilliant. Tinnitus, sudden dizziness, wakefulness with 
irritability and great nervous unrest, are experienced, and the victim can 
not sleep without the hypnotic effects of the drug. Mental hebetude, 
melancholia, loss of memory, hallucinations, and maniacal excitement, are 
among the nervous symptoms. The person is easily tired and has no 
capacity for exertion; efforts at work are prostrating, and all the voluntary 
movements are irregular and uncertain. There may be no appetite, or if 
present it is always capricious, digestion is very feeble and attended with 
dyspnoea when the stomach is full, and the stools light and pasty, showing 
a lack of bile, though the latter stains the urine, which may also contain al- 
bumen. The heart-action becomes progressively feeble and irregular, and 
rashes and purpuric spots may appear on the skin. 
Chronic chloralism is best treated by gradually lessening the quantity 
of the drug consumed; nourishing and easily digested food, and tonics, 
particularly iron salts, should be exhibited. Cathartics should be oc- 
casionally resorted to. Cannabis indica is said to aid the stomach, and 
lessen the appetite for chloral. As calmatives to the nervous system, 
lupulin and hyoscyamus may be used, while strychnine is indicated as a 
nerve stimulant. 
Therapy.-External. A glycerin solution of chloral (20 grains to the 
ounce) was valued by Locke to dissolve diphtheritic deposits. Solutions 
(1 to 100) have been applied to ulcerated cancers of the breast and uterus, 
and to gangrenous ulcers to control fetor, as well as in diphtheria (1 in 300), 
and bromidrosis of the hands and feet (1 to 150). Solutions (1 in 20) allay 
itching in prurigo, eczema, and other pruritic skin disorders and may be 
applied to tinea, scald-head, pityriasis (scalp), and other parasitic cutaneous 
affections. Chilblains and bunions are relieved by a 5 per cent solution, and 
small burns and scalds may be treated with chloral and Carron oil (1 in 16). 
A 5 per cent solution destroys excessively purulent granulations of the 
tympanum and the bases of aural polypi. Chloral should be used with great 
caution, however, in diphtheria, in which the heart is necessarily in danger 
290 INDIVIDUAL DRUGS. 
at all times, and upon denuded surfaces, lest absorption result in acute 
chloral depression. 
Camphor-Chloral is useful to mitigate pain when applied behind the 
ear in mastoiditis; and it and the following preparation may be used as a 
local anaesthetic for neuralgic pains: 1$ Camphor, 3iv; Menthol, 5j; Chloral 
Hydrate, 3j; Oil of Gaultheria, fl3j; Alcohol, q. s. fl3ij. Mix. Apply 
topically but do not cover. A liquid anodyne and counter-irritant, prepared 
by rubbing up equal parts of chloral, menthol and camphor, gives relief in 
myalgia, lumbago, intercostal neuralgia, pleurodynia, and sometimes in 
sciatica. Some prefer a plaster containing powdered chloral as more 
effective in the latter disorder, though care must be taken not to destroy the 
skin. 
Internal. Chloral is one of the purest of hypnotics. Its chief uses 
should be to induce sleep and allay spasms. With but few remedies is it so 
absolutely essential to know the proper indications, for if used when con- 
traindicated it takes but very little of chloral to kill. It is contraindicated 
always when there is an anemic condition of the brain. It can not safely 
be given to old topers, nor should it be used where the heart-walls are thin 
or where fatty degeneration of the organ is established. All cases of marked 
depression are warnings not to give chloral. On the other hand, when in- 
dicated, no remedy is more useful nor more satisfactory in its results. 
An active hypercemic state of the brain is an indication for chloral, and 
particularly if there be sleeplessness from nervous excitement but not from 
pain. Its use here is the same as that of potassium bromide, which it 
exceeds in efficiency. If sleeplessness be due to pain, it is less efficient than 
opium. 
Three important indications are fulfilled by chloral: It produces sleep, 
relaxes spasm, and to a limited extent relieves pain. In sleeplessness, and 
more especially when the insomnia is the result of brain exhaustion, from 
previous mental or moral excitement, or in sleeplessness and excitement 
where opium or other narcotics are objectionable, as in acute mania, delirium 
tremens, hysteria of plethoric women, etc., chloral is indicated, but it 
should be remembered that it is not to be administered to persons greatly 
enfeebled, nor to those who are subjects of any dyspnoeic or cardiac affec- 
tions. 
While chloral is a dangerous remedy in the depression of confirmed 
inebriates, it is of value in delirium tremens, where opium would be in- 
admissible. The condition admitting it is one of over-stimulation of the 
brain and nerve centers, while in the opposite condition, where the brain 
suffers from a want of stimulation, it is inadmissible, while opium and 
alcohol act beneficially. Chloral is to be used where there is great excite- 
ment, dry skin and tongue, increased temperature, and flushed face. The 
pale face, feeble circulation, muscular relaxation, and surface bathed in 
perspiration are contraindications to its employment. 
Chloral is one of the most certain anticonvulsive remedies in tetanus 
and in poisoning by strychnine or nux vomica. About 20 grains of chloral 
should be given with 40 to 60 grains of potassium bromide, by mouth, if 
possible; if not, by rectum, preferably dissolved in starch water. If 
spasm prevents such administration the patient should be anaesthetized by 
291 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
choloroform to allow their administration and retention. This does not 
always lessen the severity of the spasms, but renders them less frequent. 
Unfortunately, like every other remedy in these fearful conditions, it 
frequently fails. Care should be had that lethal effects are not produced by 
the antidote. It is a prompt remedy for obstinate hiccough. 
Chloral, although not effecting recovery, sometimes restrains the 
violence of the convulsions in epilepsy and chorea and the muscular move- 
ments in paralysis agitans. As the latter usually occurs in enfeebled 
individuals, we should regard the advisability of its use with suspicion. 
It should be cautiously used if at all in infantile convulsions, though 
frequently effective and better borne by children than by adults. The 
dose should not exceed one grain with double the quantity of sodium or 
potassium bromide. For these convulsions and for whooping cough there 
are many safer drugs than chloral. Chloral will quiet nervousness and 
produce sleep in fevers. Surgical fever is the best type in which to 
employ it. It should have no place in the adynamic fevers, such as 
typhoid and typhus fevers. 
While chloral relieves pain to some extent, it takes large and compara- 
tively unsafe doses, hence in the many painful states in which it has been 
previously used it may well be replaced by more direct anodynes. The 
same is true of its use in spasms, with pain, as in the passage of renal and 
hepatic calculi, strangulated hernia, and to relax muscular rigidity in 
order to facilitate the setting of fractures; other antispasmodics are safer 
and to be preferred. 
Small doses of chloral relieve vomiting. Used either by mouth or by 
rectum the vomiting of pregnancy has yielded to it. Thomas advised it 
in the gastro-intestinal disorders of children, with nausea and uncontrollable 
vomiting due to cerebral hyperaemia. Very small doses are to be used-1 to 4 
grains added to 2 ounces of water or syrup, and a teaspoonful of the mix- 
ture given every half hour, as indicated. Scudder recommended chloral in 
1 grain doses, with hydrastin (berberin) in irritable dyspepsia. It sometimes 
relieves the vomiting of seasickness. Chloral (10 grains), with specific 
medicine hyoscyamus (10 drops), sometimes relieves the wretched headache 
of the menopause, with insomnia, in robust women. 
Chloral hydrate in doses of from 15 to 20 grains, repeated as needed, 
and continued no longer than necessary to produce results, is favored by 
some to facilitate parturition. It is said to regulate contractions, lessen 
their severity, favor dilation of the os, and control the mental apprehension 
and nervous excitement. It is less valuable in after-pains. Some have 
also advised it in puerperal eclampsia, in which it often succeeds, but its 
effects must be closely guarded. 
Chloral hydrate is not used in subcutaneous injection (except in 
strychnine poisoning), as its action is too irritating and apt to be followed 
by troublesome abscesses, and should it be injected into the veins its in- 
fluence upon the heart and lungs is of a dangerous nature. Internally, for 
an adult, its ordinary dose varies from 10 to 30 grains, to be repeated every 
1, 2, or 3 hours, as indicated; children, who stand chloral better than 
adults, also require much less, say, as many grains for a dose as there are 
years of the child's age. The dose, however, may vary from 5 to 10 grains 
292 INDIVIDUAL DRUGS. 
as a hypnotic, which, in severe cases, may be increased to 20 or 30 grains. 
Liebreich recommends 7 grains as the dose for children; for adults from 
25 to 30 grains, where short intervals of sleep are required, and repeated 
every 2 or 3 hours, and in cases where more determinative effects are de- 
manded at once (as in strychnine poisoning and tetanus only), from 60 
to 120 grains at once. As a rule it is better to prescribe moderate and fre- 
quently-repeated doses rather than one large dose. The best form of its 
administration is in distilled water, being well diluted, 1 part of the hydrate 
to 50 of water. When the dose is large, its bitter, pungent taste may be 
corrected by the addition of some syrup, tincture of orange, or by giving it in 
mucilage. There is some evidence of cumulative effects having been pro- 
duced by chloral. In painful states, morphine, when not otherwise contrain- 
dicated, is often administered in conjunction with chloral hydrate. Al- 
kaline additions to it must be avoided, and the chemical constituents of the 
food taken before or after its administration should be taken into con- 
sideration. It may be given in some aromatized syrup, to conceal its taste. 
When used in enema, the saturated solution should be mixed with some 
mucilaginous, albuminous, or oleaginous fluid. Chloral hydrate has been 
incorporated in suppositories. 
Chloralose.-This is an acrid, nauseous, habit-forming compound of anhydrous chloral 
and glucose. Though milder its action is said to be like that of chloral. As it sometimes 
produces unpleasant symptoms-nervousness, diplopia, tremors, and even catalepsy and 
tetanic movements-it is not a desirable medicine. When used at all, it is for functional 
insomnia, sleep obtaining in about one-half hour. The dose is from 2 to 7 grains, the 
smallest dose being recommended first, particularly for women (Hare). It should be 
administered in capsules, followed by milk or water. 
Chloralamine (Chloral formamide) is an odorless crystalline substance, of a bitter 
taste, and soluble in water (20), and more readily in alcohol (1.5). A substitute for chloral, 
but less depressing to the circulation and less irritant to the stomach and kidneys. It has 
the advantage over chloral in that it also controls pain. Chloralamine has been recom- 
mended where chloral is useful, but especially in nervous wakefulness, neuralgia, and the 
pain of tabes dorsalis; and as "chlorobrom" (combination of equal parts of chloralamine 
and potassium bromide) to relieve insomnia in the melancholic and acute maniacal forms 
of insanity. 
Charteris advised this combination in seasickness, the patient first inducing the 
bowels to move by means of a cholagogue, then boarding the ship, taking the dose and 
going to bed at once and obtaining sleep. Upon awakening the likelihood of nausea is said 
to have been averted. 
Chloretone (Acetone-chloroform). Colorless crystals of a camphoraceous odor, 
slightly dissolved by water, and very readily by alcohol. Antiseptic and anaesthetic. Used 
like chloral, but said to be unlike it in that it does not depress the breathing or circulation, 
nor irritate the stomach, being rather a sedative to the latter. It has been used with good 
effect in vomiting, to prevent post-ether vomiting (5 to 10 grains before anesthetization), 
and seasickness (3 to 5 grains 3 times a day); also to relieve pain in gastralgia and gastric 
ulcer; and locally, alone or with boric acid in 10 per cent ointment, for the relief of pain in 
burns, scalds, excoriations, ulcers, and lacerations, etc. With oil of cloves or ether it 
obtunds pain in toothache when applied to the cavity of the tooth. It is not incompatible 
with antipyrine, and both together have been given for neuralgia and nervous unrest. 
A 1 per cent solution (in alcohol, 15; water, 85) has been used to induce local anaesthesia; 
by rectum (5 j in oil) it is of asserted value as a palliative in tetanus. Headache sometimes 
follows large doses of chloretone. Dose, 5 to 20 grains in capsules. 
RELATED PREPARATIONS. 
CHLORAL BUTYLICUM. 
Obtained by the interaction of chlorine and acetic aldehyde. (Formula: C4 H6 C1O8 
+ H2O). 
Common Name: Butyl-Chloral Hydrate. 
Description.-Scaly crystals of a warm and bitterish taste, soluble in hot water, 
alcohol, ether, and glycerin; less soluble in cold water (1 in 50). Dose, 3 to 20 grains. 
293 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-A powerful drug producing an anaesthetic and 
soporific state without impairment of the circulation, breathing, or temper- 
ature, and while motion is more or less impeded by it, it conserves muscular 
tone so that a person under its influence may sleep deeply while sitting 
upright. It is used as a palliative in trigeminal neuralgia, and tic-doulou- 
reux, and in insomnia when chloral is inadmissible. It is contraindicated by 
weak heart, cerebral hyperaemia, or gastro-intestinal irritation. Small 
doses, 3 to 5 grains, should be given until pain is relieved, and the larger 
doses for sleeplessness. They may be administered in glycerin, or syrup 
of licorice, or peppermint. Great care should be had in its use. It is scarcely 
employed in Eclectic practice. 
Chloroform. 
Nearly pure CH Cl3 with a small per cent of alcohol. 
Description.-A mobile and inflammable colorless and clear liquid of a sharp, hot, 
and sweet taste, and a peculiar but pleasant ethereal odor. It mixes with alcohol or ether, 
and is sparingly soluble in water. Dose, 1 to 10 minims. 
Preparations.-1. Aqua Chloroformi, Chloroform Water. Dose, fl 5j to fl5j. 
2. Spiritus Chloroformi, Spirit of Chloroform. Dose, 5 to 60 minims. 
3. Linimentum Chloroformi, Chloroform Liniment. 
Specific Indications.-To produce anaesthesia for surgical purposes; 
to alleviate pain; to relax spasm and control convulsions; to dissolve 
biliary calculi (?); to check severe and protracted chills (gtt. x to xx.). 
Action and Toxicology.-The chief action of chloroform is upon the 
nervous system, producing after the manner of alcohol and ether, but with 
some variation, a progressive intoxication comprising a stage of diminished 
consciousness, one of excitement, and a third of complete unconsciousness. 
There takes place a progressive depression and paralysis of the "highest 
cerebral functions, those of self-control, and passing downward through the 
lower intracranial divisions. The spinal cord is affected before the medul- 
lary centers, which are the last part of the nervous system to become 
paralyzed" (Cushny). Hare gives the order of progression as first "the 
sensory part of the brain, then the sensory part of the spinal cord, then 
the motor tract of the cord, then the sensory paths of the medulla oblongata, 
thereby producing death from failure of the vaso-motor center, and of the 
respiratory center unless, as rarely occurs, the heart has already succumbed 
to the drug." 
Much discussion has been had as to the method in which chloroform 
produces death, the belief formerly prevailing that it was nearly always 
due to cardiac paralysis. The first (1889) and second (1890) Hyderabad 
Commissions combated this view of its action upon the heart, and claimed 
that the lungs were the organs mainly and primarily involved. The ex- 
periments of this body were performed in India and upon dogs. European 
and American observers have vigorously combated this theory of primary 
respiratory paralysis, the majority of deaths in Europe and America re- 
sulting apparently from cardiac paralysis. J. A. MacWilliam {British 
Medical Journal, 1890) claimed that chloroform directly affects the heart 
substance, and that death from cardiac failure is the rule, the manner of 
failure being due to a more or less sudden dilatation of both sides of the 
CHLOROFORMUM. 
294 INDIVIDUAL DRUGS. 
heart, with marked enfeeblement of that organ, the feeble state and dis- 
tention of the heart, which is unable to propel the blood, explaining the 
failure of artificial respiration to revive the patient. He showed that 
respiration may continue for several minutes after the heart has ceased to 
beat. The ground occupied by Wood (1890), Laborde (1890), Reeve, 
Dunlop, and others, is probably nearest to a correct solution of the lethal 
action of the drug. According to these observers, death may take place 
either from primary cardiac or from primary pulmonary paralysis, either 
taking place independently of the other. Hare, however, has conclusively 
shown that the usual cause of death from chloroform is vaso-motor de- 
pression, allowing "the blood to pass too freely from the arterioles into 
the great bloodvessel areas which exist in the capillaries and veins, and as a 
result the man is suddenly bled into his own vessels as effectually as if 
into a bowl." He concludes, therefore, that while "chloroform without 
doubt acts as a powerful depressant poison to the respiratory center and the 
heart in the same manner as it paralyzes all living protoplasm when applied 
in excess, that when properly given by inhalation it produces a death 
equivalent to that resulting from hemorrhage, which is a failure of the 
respiration not so much from direct depression of the respiratory center as 
from its deprivation of blood; and while the tendency of the drug is to 
depress and dilate the heart, just as it dilates the vessels of which the heart 
is merely a highly specialized part, the failure in the pulse is due to vaso- 
motor palsy, the patient becoming pulseless because the heart has no blood 
to pump." 
Locally applied chloroform acts as an irritant and anaesthetic to the 
sensory nerve trunks, but no such effects, or at least but little, are pro- 
duced by its inhalation. Scarcely any impression upon the blood is pro- 
duced by inhalation of the vapor. Temperature, however, is lowered, 
but to a less degree than under ether. Elimination of the drug takes place 
rapidly by way of the lungs chiefly, which are likely to be irritated and 
inflamed if the quantity be large. Prolonged chloroformization is said 
to produce degenerative changes of a fatty character, and sometimes with 
necrosis, in the tissues of the vital organs, not greatly unlike that resulting 
in phosphorus poisoning. Some believe with Meyer and Overton, that 
chloroform induces anaesthesia through its property of causing solution 
of the lipoid or fatty matter within the brain cells. The symptoms produced 
by chloroform under its various applications are as follows: 
I. Externally, Internally, and Subcutaneously. Chloroform applied 
to the skin reddens it, and if evaporation be prevented, tingling, burning, 
and vesication are apt to result. Injected subcutaneously in small amounts 
(10 to 20 minims) it causes some pain at first, followed by numbness, which 
is succeeded by complete anaesthesia of the part, the tissue around the 
puncture becoming first puffy and then indurated, the induration persisting 
for many days. Taken internally, it has a sweetish, hot, and pungent taste, 
and if undiluted, may cause severe irritation or inflammation of the mucous 
tissues. Hence it is customary to administer it in emulsion or as chloroform 
water. Heat and inflammation, followed by oedema of the larynx, may 
occur if the concentrated vapor be inhaled during the act of swallowing the 
drug. In the stomach warmth is first experienced, followed by a cold 
295 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
sensation, and if the drug is not well diluted, a severe gastritis may ensue. 
Effects not unlike those after the ingestion of alcohol or ether follow when 
chloroform is taken in moderate amounts into the stomach-an increased 
circulation, fullness of the head, giddiness, mental confusion, and brief 
cerebral excitement or inebriation, succeeded by sleep. About 1 drachm 
subcutaneously, or 1 or 2-drachm doses by mouth, induce a soporific state, 
which obtains very slowly, but is singularly prolonged, the drug presum- 
ably being very gradually absorbed into the blood. Such a sleep is not ac- 
companied by anaesthesia, for the patient may be very easily aroused, and 
will again lapse off into sleep. The pulse is slightly slowed, while a re- 
duction in temperature to the extent of 1° or 2° F. is generally effected. 
A dose of 1/2 fluidounce has occasioned alarming symptoms, among which 
are convulsions, trismus, partial pupillary dilatation, insensibility, retarded 
and stertorous breathing, frothing at the mouth, livid countenance, bloody 
stools, and feeble or irregular pulse. Blood may be ejected from the 
stomach also. Taken in lethal doses, profound stupor, insensibility, and 
death result. Death results from vaso-motor paralysis, asphyxia, or from 
cardiac paralysis, or from these and inflammation of the stomach combined. 
Under chloroform poisoning the pupils may either be contracted or dilated. 
Usually vomiting occurs, though after large doses no vomiting has taken 
place. The smallest fatal dose recorded is "a drachm or two," which 
killed a boy of 4 years in 3 hours; 6 to 7 drachms is the smallest fatal dose 
in an adult. A fluidounce has frequently killed, and the time required to 
produce death generally ranges from 1 hour to 8 days (Taylor, Medical 
Jurisprudence). 
The post-mortem appearances are congestion and inflammation'- 
congestion of the brain and pulmonic structures, and congestion, inflam- 
mation, and ulceration of the gastric portion of the gastro-intestinal tract 
-the intestinal portion usually presenting nothing marked except some 
congestion and the odor of the drug. The bronchi are bathed with 
sanguineous mucus or muco-pus. Coagulation of the blood is prevented, 
that liquid being found unusually fluid in the vessels. The post-mortem 
appearances are not, as a rule, constant. Poisoning by swallowing chloro- 
form must be met by emetics, the stomach-pump, or lavage tube; the 
further treatment is that of narcosis by inhalation (which see under ^Ether). 
On account of its burning taste and pungency, chloroform is rarely selected 
for suicidal purposes. 
II Inhalation and Ancesthesia. The effects usually occasioned by 
anaesthetic doses of chloroform are, whizzing and pulsation in the head, 
a change in the apparent color of objects, pleasurable ideas and visions, loss 
of consciousness, incoherent talking or muttering, and sometimes loud or 
noisy respiration, muscular relaxation, and complete insensibility to pain, 
from whatever cause. A minute or two generally suffices to occasion 
anaesthesia, which will last for several minutes, but may be continued for 
an indefinite period by carefully repeating the inhalation at certain intervals 
of time, as its influence is observed to be decreasing. Sometimes, from the 
coughing produced, or other circumstances, it may require a long time 
before its anaesthetic effect is induced. This may be obviated by holding 
it, at first, a little farther distant from the nostrils, that it may be better 
296 INDIVIDUAL DRUGS. 
mixed with atmospheric air, and then gradually approaching it to them. 
Its anaesthetic influence is succeeded by somnolence, or a calm slumber, and 
usually there is no remembrance of incidents which happen during the 
anaesthesia. 
The full anaesthetic effects of chloroform are always attended with 
great hazard. It has been administered to an extent sufficient to produce 
torpor of the nerves of sensation without completely destroying conscious- 
ness, so that, in some cases of childbirth, it may be unnecessary to risk the 
production of an entire suspension of the mental powers. Always, however, 
it is unsafe to perform even the most trivial operation until complete un- 
consciousness has been effected, a majority of the fatal accidents from 
chloroform inhalation having been observed in minor operations where in- 
complete anesthetization had been practiced. It is probable that the 
fatalities attending the extraction of teeth, etc., are in part due to the fact 
that the drug was inhaled in the sitting posture; and that many deaths 
from chloroform have been hastened by fear. For inhalation only the 
purest chloroform should be used. About a fluid drachm is the quantity 
generally used at a time for inhalation, and this should be renewed every 
3 or 4 minutes until the required effect takes place. The only apparatus 
needed to inhale chloroform is a handkerchief, closely, but not too tightly, 
rolled up, and held in the hand, having a concavity into which the choloro- 
form is poured, and then placed several inches from and not immediately 
in contact with the mouth and nose. A better method is to use the Esmarch 
inhaler. A quantity of common air should always be allowed to enter the 
lungs with the chloroform vapor. It is never safe to administer chloroform 
vapor in greater proportion than 2 per cent, the rest being atmospheric air. 
It should be remembered that the vapor of chloroform is heavier than air, 
so that it should not be held too close to the nostrils, lest the air should be 
wholly replaced by it. As soon as the requisite amount of insensibility 
occurs, its inspiration should be discontinued, and only carefully repeated 
when there is too early a restoration to consciousness. Epileptics, those 
laboring under fatty or degenerative disease of the heart, those predisposed 
to apoplexy, or cerebral determinations, and persons who have recently lost 
much blood, or the very anemic, or diabetics, should not be placed under the 
anaesthetic influence of chloroform. It should never be administered 
immediately after a hearty meal, as it may cause vomiting; and when the 
pulsations fall below 60, the inhalation should be stopped. Operation 
should not be attempted until the cornea is insensitive and muscular 
relaxation has set in. Some, however, prefer to wait for muscular relaxation, 
stopping short of stertorous breathing. (For details of administration, 
comparison with other anaesthetics, and other directions, see TEther.) 
Chloroform Habit. Chloroform continuously consumed for the purpose 
of producing inebriation, as it often is, is more pernicious in its effects and 
more intractable to treat than the opium habit. Enormous quantities, as 
much as a pound, have been consumed in a day, but life can not long resist 
such amounts. Occasionally only acute symptoms lasting a week or so, and 
characterized by hallucinations of sight and sound, noisy delirium and 
furious maniacal raving may be the effects. More often, however, a chronic 
form ensues, with mental irritability, melancholia, or hypochondriasis, 
297 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
delirium, and early decay of the intellectual powers. The worst phases of 
moral depravity may also be exhibited. Fortunately, this use of the drug 
soon destroys its victims. 
Therapy.-External. Chloroform is antiseptic and anaesthetic. A few 
drops added to urine or to other organic fluids prevent fermentative and 
putrefactive changes due to micro-organisms. Being hemostatic it may 
be applied upon cotton to arrest small superficial hemorrhages. As a 
rubefacient and anodyne, liniment of chloroform is effective for the relief 
of myalgic, neuralgic, and rheumatic pain. The vapor of chloroform 
applied directly to the part will sometimes relieve the pangs of sciatica and 
the suffering from myalgia, lumbago, and nervous headache. Where the 
area is small, as in the latter, a little chloroform may be poured into a watch- 
glass and the latter inverted upon the part, as the temple. Applied in this 
way, or upon a folded handkerchief, it is effectual in localized neuralgias, 
as of the face. The vapor should be kept in contact until the pain is relieved. 
Locke recommends as an efficient liniment for the relief of pain: 3 Chloro- 
form, fl^vj; Tincture of Aconite, fl^ii; Spirit of Camphor, fl 3 ijss; Glycerin, 
flgss. Mix. Sig.: Apply with friction. Another excellent liniment is the 
following: 3 Chloroform, Tincture of Aconite, aa fl3 j; Soap Liniment, fl^ii. 
Mix. Sig.: Apply on flannel. Thirty minims of chloroform, mixed with 5 
drachms of lard, have been employed as an ointment in cutaneous eruptions 
of a papular character, and lotions containing chloroform give relief in 
urticaria. When applied to the uninjured skin there is no necessity for 
diminishing the strength of chloroform; a pledget of cotton moistened 
with it may be applied to the part, and its volatilization may be retarded 
by covering this with several thicknesses of gauze. In earache, from acute 
catarrh of the middle ear, the vapor may be cautiously passed into the 
external meatus by means of an insufflator or a common clay pipe; the 
escape should not be prevented, however, lest the part be blistered. There- 
fore it should not be introduced on cotton. In both mastodynia and mam- 
mitis its local action has given relief. Applied to the epigastrium it has 
relieved cholera morbus, and over the abdomen has allayed painful affec- 
tions and spasms of the viscera. Rheumatic toothache may be palliated 
at least by rubbing the gum with chloroform, while camphorated chloroform 
will often alleviate pain from dental caries, if applied to the cavity on cotton. 
Deep subcutaneous injections, first employed by Bartholow, have been 
used to give relief in neuralgias, particularly of the trifacial and sciatic 
nerves. The injection should be deep, and near the sheath of the nerve 
trunks. Induration follows wrhere the needle is introduced, and occasionally 
abscess. Injection into the gums is asserted to frequently cause gangrene. 
Deep injections are by no means safe or popular practices. Ointment of 
zinc oxide to which is added one-eighth part of chloroform is said to give 
relief in rectal ulcer and pruritus ani. 
Internal. Internally, chloroform is a stimulant, sedative, antispas- 
modic, and anaesthetic. It has been used successfully as a relaxant in 
asthma, spasmodic cough, hysteria, and to allay the pain in atonic quinsy, 
lead colic, biliary or renal colic, passage of renal calculi, gastralgia, gastric 
ulcer, atonic dyspepsia, cancer, neuralgic affections, and to avert chills in 
intermittents. It may be administered in doses of from 30 to 80 drops in 
298 INDIVIDUAL DRUGS. 
solution of gum Arabic, or in a mixture of water and yolk of egg, repeating 
the dose if required every 1/2 hour, hour, or 2 hours, until it has given 
relief. Spirit of chloroform is a good and pleasant preparation. The solution 
of camphor in chloroform is a pleasant form of administering that medicine. 
Nausea and vomiting where no inflammation is present, as of sick 
headache, seasickness, pregnancy, etc., may often be relieved by giving from 
2 to 5 drops of chloroform on sugar. Added to cough mixtures it aids in 
controlling nervous cough. Internally, a full dose administered just before 
the chill may cut short a paroxysm of intermittent fever, and a few drops 
of chloroform, or better of chlorodyne, sometimes arrests the symptoms of 
Asiatic cholera. While inhalations of chloroform are inadmissible in old 
topers and in delirium tremens, its internal use is valuable where marked 
depression is present. 1$ Chloroform, fl$j; Diluted Alcohol, flgjss; Tinc- 
ture of Capsicum, fl 5 jss. Mix. Sig.: Teaspoonful doses in water. From 
10 to 15-drop doses of the same are useful in flatulent colic and hiccough. 
Some have recommended chloroform in teaspoonful doses every hour 
during the pain, and 3 times a day subsequently, as a solvent of cholesterin 
in biliary calculi. Though it undoubtedly does not reach nor dissolve 
the calculus, it certainly relaxes the spasm of the tube through which it 
passes, thus effectually allaying the pain. Its local action, in such large 
doses, upon the gastro-intestinal canal is apt to be too irritant for this 
purpose, however, and there are better ways to treat hepatic colic. The 
same may be said of its similar use to remove tapeworm. 
Chloroform water, or a few drops of chloroform added to mixtures of 
water-dispensed medicines, will preserve them for several days. Chloroform 
water is especially useful as a vehicle for cough mixtures and carminatives. 
Inhalation. Chloroform was in use as an internal remedy for years 
before it became known as an anaesthetic. It was, however, used by in- 
halation in a case of pulmonic embarrassment as early as 1832. At the in- 
stigation of Mr. Waldie, of Liverpool, who had experimented with it in 
1838-9, it was adopted and used first as an anaesthetic in November, 1847, 
by Sir James Young Simpson, M.D., of Edinburgh, who had been looking 
for a substitute for ether. 
Chloroform is used by inhalation to produce (1) general anaesthesia, 
(2) to relax spasm, (3) to alleviate pain. Its largest use is to cause surgical 
anaesthesia, so that every form of operation may be painlessly performed. 
Either chloroform or ether are usually used in all major operations. The 
selection is largely a matter of preference with the surgeon. Wilcox has well 
stated that "the experience of the anaesthetist is more important than either 
anaesthetic or inhaler." All concede, however, that when neither is other- 
wise contraindicated (by conditions mentioned elsewhere) ether is by far 
safer than chloroform, and the former is rapidly displacing the latter as 
the anaesthetic of choice. Chloroform was once the most popular of the 
general anaesthetics. (For comparison of ether and chloroform, method of 
administration, indications, and contraindications, see these topics under 
/Ether. Many forms of apparatus for the administration of anaesthetics, 
single or combined (chloroform; ether, oxygen, nitrous oxide, etc.) are on 
the market and in use, chiefly in hospitals. As these require special ma- 
299 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
nipulation, and should be used only by those having special training in 
their use, consideration of them has been omitted in this work.) 
Chloroform is usually preferred to ether in obstetrical manipulations, for 
several good reasons. Experience has shown it to be far safer in obstetric 
emergencies than when used in any other condition. Moreover, unlike 
ether it is not explosive should it come into contact with an open flame; 
it is pleasant to inhale; women do not dread but rather welcome it; less 
of it is required; the heart is not damaged because in pregnancy that organ 
is slightly overcompensated, and the frequently recurring contractions 
stimulate the vaso-motor control, thus antagonizing the great danger from 
the drug. When labor is normal, brief, and not very painful, its use should 
be avoided. If, however, the opposite be true, no drug is more beneficial and 
none will be more greatly appreciated by the woman. In first labors it 
should be used with great care. It is seldom necessary to carry it to complete 
anaesthesia; in fact, it should seldom be carried beyond the stage of merely 
blunting sensibility. It mitigates the pains, though it does not interfere 
with the force and frequency of the contractions, when not pushed too far, 
while it promotes relaxation of rigid parts. Pushed too far it interferes with 
the contractions and favors hemorrhage. Its use aids the easy performance 
of the required obstetric operations, as turning, applying forceps, changing 
positions, extracting retained placentae, or other manipulations, unless the 
patient be enfeebled by hemorrhage. If in the latter case it must be em- 
ployed, it should not be used to complete unconsciousness. In turning, 
enough must be given to suspend uterine action, while in forceps delivery 
enough should be administered to quiet the patient, or if necessary, to 
accomplish relaxation of the muscles. In instrumental interference it 
tends to prevent shock. In craniotomy, symphyseotomy, or Caeserian 
section, the woman should be fully under the influence of the vapor. In 
most cases of labor a few whiffs of chloroform are allowed by many ob- 
stetricians just as the head is emerging from the vulva. 
Chloroform is of great value in facilitating diagnosis, where a thorough 
examination is necessary. It prevents pain, thoroughly relaxes the parts, 
and does away with any objections that might otherwise be made by the 
patient. It is especially useful to aid in determining obscure abdominal, 
genito-urinary, pelvic, and rectal disorders, and in examining and reducing 
fractures and dislocations and replacing hernia by taxis. 
Spasmodic respiratory neuroses are relieved by inhalation of chloro- 
form. In the same manner it may be used in the various forms of colic- 
bilious, flatulent, renal, etc.: dysmenorrhcea, neuralgia, tic-douloureux, 
cancer, and other painful states. For these purposes full anaesthesia is 
never required. It may be employed in conditions of excitement, as in 
hysteria, puerperal mania (when not due to cerebral hemorrhage), chronic 
insanity, and maniacal excitement, and is extremely valuable in many 
spasmodic disorders of the muscular and nervous systems, many of which 
are also painful. Thus it is one of the best agents in hiccough, convulsive 
hysteria, chorea, tetanus, hydrophobia, and other convulsive disorders. 
In asthma, though it may not cure, it is unfailing as a palliative. It loses its 
power, however, after many repetitions of its use. It relieves severe whoop- 
ing-cough and convulsions arising from cough. In larvngismus stridulus 
300 INDIVIDUAL DRUGS. 
its effects are prompt. In infantile convulsions it is certainly one of the 
best drugs to overcome the spasm, so that indicated drugs may be given 
to avert a return of the convulsive attacks. During the passage of gall 
stones and renal calculi, it not only relieves pain, but relaxes the spas- 
modically contracted tubes, thus facilitating the passage of the offending 
body. It is by far the best agent to control uremic spasms or convulsions 
from the same cause following scarlatina, while it stands at the head of all 
agents to check puerperal eclampsia. Veratrum should be given internally 
and morphine be hypodermatically injected. By the use of chloroform 
time is gained in which to administer other and appropriate remedies. It 
should not be forgotten as an aid to control the spasms in poisoning by 
strychnine. When no organic disease of the heart exists, the inhalation of 
chloroform will relieve angina pectoris, but the condition of the heart should 
be carefully ascertained before risking the agent. Amyl nitrite, followed 
by lobelia, is preferable. A few whiffs of chloroform will sometimes abort 
a malarial chill and thus time is gained for the action of antiperiodics. 
The dose of chloroform is from 2 minims to 2 drachms; spirit of chloro- 
form, from 10 to 60 minims, well diluted; chloroform water, 1/2 to 2 fluid- 
ounces; emulsion of chloroform, 1 to 5 drachms. For anaesthesia, by in- 
halation, the amount will be indicated by the effects produced. 
Acidum Chromicum. Chromic trioxide, Chromic acid. (Formula: Cr. O3.) 
An anhydride prepared from acting upon potassium bichromate with sulphuric acid. 
Description.-Beautiful deep purplish-red needle or prismatic crystals, odorless, very 
deliquescent and freely soluble. It forms brown-red to orange yellow solutions according 
to the degree of concentration. It must be kept in glass-stoppered bottles and never 
allowed to come into contact with organic matter (anything that will burn), such as cork, 
sugar, tannic acid, alcohol, or with glycerin, or with sweet spirit of niter, as dangerous 
explosions may occur. Caution.-It should never be dissolved in any other fluid than water, 
for physician's uses. 
Action and Toxicology.-Chromic acid is destructive to all lower forms 
of life. It is one of the strongest coagulants of albumen, and applied to the 
skin is exceedingly corrosive, producing a deep eschar, which falls off in 
about two days, leaving a granulating base which heals readily. When pure 
it causes but little pain. Swallowed, chromic acid destructively corrodes the 
mucosa over which it passes and may cause perforation of the stomach. 
Intense pain in throat and stomach and bloody vomiting and purging are 
the chief symptoms. Death has resulted from its too free use upon con- 
dylomata of the vulva and buttocks. The treatment of poisoning by it 
is that for toxic gastro-enteritis-emesis, or better lavage, with soap, 
alkaline carbonates, or heavy magnesia in large quantities of milk. De- 
mulcents and pain-relieving agents may be used in the after-treatment. 
Workmen who handle the acid are often the subjects of nasal septum 
perforation through accidental contact with the agent. 
Therapy.-External. A dangerous, though effective, stimulating dis- 
infectant for indolent and syphilitic ulcers, employing solutions of from 
1 /2 to 1 per cent. The latter are especially valued by some for the mucous 
patches of syphilis. It should be used only upon very small areas. Its 
CHROMII TRIOXIDUM. 
301 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
chief use, and it is very effective, is to remove dermal growths, particularly 
corns and warts. A 25 per cent solution is mostly employed for this purpose. 
It should be applied preferably with a glass rod. The chief reason for 
including chromic acid in this work is to call attention to its poisonous 
effects and their treatment, as the acid constitutes the chief ingredient of 
the "corn cures" of itinerant vendors. 
CHROMII SULPHAS. 
Chromium Sulphate, Sulphate of Chromium. (Formula: Cr2 (SO<) 3. 18 H2 O.) 
Description.-Odorless, violet crystals, soluble in hot and cold water and alcohol. 
The solution in cold water has a violet color; when dissolved in hot water or alcohol the 
color is green. Dose, 4 to 20 grains. 
Specific Indications.-Fibroid degeneration; neurotic tendency. 
Therapy.-Chromium sulphate is a comparatively new remedy and is 
still under trial. It seems to be useful in fibroid degeneration and in neu- 
rotic or neurasthenic tendency. Chronic interstitial nephritis is not curable, 
for the destroyed renal glomeruli can not be replaced. Still many of the 
unpleasant symptoms can be relieved and the sound portions of the 
kidneys be conserved and made to functionate better by close attention 
to diet and care, and the judicious use of suitable medicines, of which 
there are not many for this purpose. Dash, from several years use of 
chromium sulphate, in 4 grain doses 4 times a day, has been able in many 
cases to lessen the excessive output of urine, raise the specific gravity, lower 
blood pressure, and improve the general condition of the patient. For its 
use in exophthalmic goitre he does not speak so encouragingly as others, 
some of whom laud it for its control over the tachycardia particularly. In 
enlarged prostate it seems to have reduced the size of the gland, with 
amelioration of the urinary obstruction, patients that have been catheterized 
daily having been enabled, after a few months use of chromium sulphate, 
to urinate freely in the normal way. It should be further studied for its 
effects in neurasthenia. 
Chrysarobin. 
A mixture of principles derived from Goa Powder (a deposit in the wood of Vouacapoua 
Araroba (Aguiar), Druce. Nat. Ord. Leguminosae. 
Description.-A very irritating tasteless and odorless micro-crystalline brownish to 
orange-yellow powder; soluble in chloroform and ether, less easily in alcohol, and practically 
insoluble in water. Dose, 1/30 to 1 grain; seldom used internally. 
Preparation.- Unguentum Chrysarobini, Chrysarobin Ointment (6 per cent). 
Action.-Chrysarobin is a deep-acting and powerful local irritant 
and vegetable parasiticide. It produces erythema and inflammation and 
sometimes furuncular dermatitis, with subsequent desquamation. If 
applied to the face it may cause palpebral oedema and conjunctivitis. It is 
probably somewhat absorbed and may irritate the kidneys also, occasioning 
albumen in the urine. Chrysarobin stains the skin a dull yellowish or pur- 
plish brown, and the hair a yellowish color. If no soap or alkali has been 
previously used the stain may be removed by a weak solution of chlorinated 
lime (bleaching powder). It is intensely destructive to fungous organisms. 
Taken internally it may induce a vicious watery diarrhoea, with repeated 
vomiting. It imparts to the urine a yellow color. 
CHRYSAROBINUM. 
302 INDIVIDUAL DRUGS. 
Therapy.-External. This agent, often under the wrong name of 
chrysophanic acid, is used, like araroba, from which it is obtained, upon 
skin diseases caused by the vegetable fungous parasites-notably those of 
the ringworm group. When it can be avoided it should not be used upon 
the face or scalp on account of the irritation it produces and its possible 
inflammatory effects. If, however, failure to destroy tinea, when occurring 
in these regions, is the result of the use of other agents, chrysarobin may be 
employed as a last resort. It should be carefully applied only to the dis- 
eased part. Ointments have been used, but they are less manageable than 
solutions, and the official ointment is many times too strong for safety. 
Wilcox advises a solution of 1 part of chrysarobin in 7 parts of chloroform, 
into which an equal quantity of petrolatum is stirred. This may be applied 
accurately with a brush and by being more easily limited lessens the stain- 
ing. The diseases in which it may be used are tinea tonsurans, tinea cir- 
cinati, mentagra, psoriasis (said to be the best local application), and in 
acne rosacea1. The parts should be thoroughly washed to remove grease 
and scales before applying chrysarobin. If soap has been used it should be 
removed with alcohol before making the application, lest coloration be 
intensified. Chrysarobin is especially valuable in ringworm of the scalp and 
in alopecia circumscripta, but must be used with extreme care for fear of 
producing intense inflammation. It has been applied also for the destruction 
of pediculi, but we have other equally efficient and far safer parasiticides. 
CINCHONA. 
I. Cincnona.-The dried bark of Cinchona Ledgeriana, Moens; Cinchona Calisaya, 
Weddell, and hybrids of these with other species of Cinchona yielding not less than 5 per 
cent of cinchona alkaloids. (Nat. Ord. Rubiaceae.) South American Andes, wild and to 
some extent cultivated in South America; cultivated in Java, India, Jamaica, and other 
countries. Dose, 1 to 30 grains. 
II. Cinchona Rubra.-The dried bark of Cinchona succirubra, Pavon, or of its hybrids 
yielding not less than 5 per cent of alkaloids of Red Cinchona (Nat. Ord. Rubiacese), Ecuador. 
Common Names: (1) Yellow Peruvian Bark; (2) Red Cinchona Bark. 
Principal Constituents.-Quinine, quinidine, cinchonine, cinchonidine-all important 
crystalline alkaloids; quinamine, an important alkaloid; kinic (quinic) acid, kinovin (quin- 
ovin), cinchotannic acid (astringent); cinchona red (coloring agent); and a volatile oil 
(aroma). 
Preparations.-1. Specific Medicine Cinchona. Dose, 1 to 30 drops. (This prepara- 
tion is prepared from Cinchona Calisaya or Calisaya Bark.) 
2. Fluidextractum Cinchona, Fluidextract of Cinchona. Dose, 5 to 30 drops. 
3. Tinctura Cinchona, Tincture of Cinchona. Dose, 10 to 60 drops. 
4. Tinctura Cinchona Composita, Compound Tincture of Cinchona. (Red Cin- 
chona, Bitter Orange Peel, Serpentaria.) A modern substitute for and sometimes wrongly 
called "Huxham's Tincture of Bark". Dose, 5 to 60 drops. 
Specific Indications.-Periodicity and, like quinine, effective when 
the pulse is soft and open, the tongue moist and cleaning, the skin soft and 
moist, and the nervous system free from irritation. (If opposite conditions 
prevail, cinchona will be likely to aggravate.) Empyema; gastric debility; 
anemia and debility from chronic suppuration; afternoon febrile con- 
ditions, weakness, with pale surface, loss of appetite, feeble digestion, and 
deficient recuperative powers. 
Action and Therapy.-(See also Quinines Sulphas.)-External. Anti- 
seotic and astringent. A poultice of the bark has been successfully used 
303 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
upon fetid and gangrenous ulcers, and where such an application has 
been thought necessary upon suppurating and sloughing felons. 
Internal. Cinchona is tonic, antiperiodic, slightly astringent, and 
mildly antiseptic. In small doses it is a good stomachic, but must not be 
long continued. Large doses irritate and cause an unpleasant excitement 
of the stomach and bowels, with retching and vomiting. It has occasioned 
symptoms closely resembling the paroxysms of intermittent fever, and 
produces a general state known as Cinchonism: Throbbing headache, 
tinnitus aurium and temporary deafness. Outside of a slight astringent 
effect, the action of Cinchona is that of its chief alkaloid, quinine (see 
Quinines Sulphas'), which has completely supplanted the bark in almost 
all conditions in which the former was once used. While cinchona will ac- 
complish the same results as quinine, the latter is more prompt and direct 
and more easily administered. 
Cinchona is useful in functional derangements of the stomach, im- 
proving digestion, and imparting vigor and tone to the nervous and mus- 
cular systems in diseases of general debility and in convalescence from 
exhausting illness. While for some unexplainable reason occasionally 
acting more advantageously in malarial fevers than quinine itself, in most 
instances the alkaloidal salts have almost entirely supplanted cinchona 
in these disorders. Cinchona may be used in preference to its alkaloids 
when a tonic effect only is required and periodicity is lacking, or after 
hemorrhages or exhaustive discharges, as in empyema, or when an astringent 
tonic is needed; in the debility following low and exhausting fevers; in 
anemia and debility from chronic suppuration; and to arrest profuse and 
debilitating night sweats in one suffering from general debility with poor 
recuperative powers. 
The same indications and contraindications should be observed as for 
the administration of quinine, which see. 
CINNAMOMUM. 
I. Cinnamomum Saigonicum. Dried bark of an undetermined species of Cinna- 
momum. Chiefly from China. 
II. Cinnamomum Zeylanicum. Dried bark of cultivated Cinnamomum zeylanicum, 
Breyne. (Nat. Ord. Lauraceae.) Ceylon. 
Common Names: Cinnamon; (1) Saigon Cinnamon; (2) Ceylon Cinnamon. 
Principal Constituents.-A volatile oil {Oleum Cinnamomi), tannin, and sugars. 
(Oil of Cinnamon of medicine is Cassia Oil {Oleum Cassias') derived from Cinnamomum 
Cassia (Nees), Blume.) 
Preparations.-1. Specific Medicine Cinnamomum. Dose, 5 to 60 drops. 
2. Oleum Cassia, Oil of Cinnamon (Cassia Oil), a yellowish or brownish fluid be- 
coming darker and denser by age and exposure, and having the odor and taste of cinnamon. 
Dose, 1 to 5 drops. 
Specific Indications.-Passive hemorrhages. 
Action and Therapy.-Cinnamon is an aromatic stimulant, carmina- 
tive and astringent. Besides it possesses marked internal hemostatic power. 
That this is not wholly due to the tannin contained in the bark is shown by 
the prompt action of the tincture of the oil. Oil of Cinnamon has properties 
which make it nearly specific for certain conditions. While no tests have 
been made that convinces one of its power over germ-life, there seems to be 
no question that some such germicidal action is exerted by it in acute 
infections, as "common colds," and as la grippe or epidemic influenza. 
304 INDIVIDUAL DRUGS. 
Aromatic bodies, like cinnamon and camphor, have been overlooked in 
recent years, though the use of the latter has been revived as an antiseptic 
stimulant in pneumonia. That they possess antibacterial virtues we believe 
will be found true should investigations be made of them in that line. 
Cinnamon imparts a flavor to unpleasant medicines and may be used to 
preserve them from rapid changes. Medicines dispensed in but few drops 
in a half glass of water will not keep sweet long at any time and will quickly 
sour in summer time. A few drops of Specific Medicine Cinnamon added 
to such mixtures give an agreeable sweetness and aroma and will help the 
medicine to preserve its balance for several days. Children invariably like 
the flavor. Even cinnamon can be overdone, however. It should not be added 
day after day for a long period lest the stomach revolt and the taste recoil. 
Nor should much be put in mixtures for little children, for if overdone it 
smarts the mouth severely; nor should it be employed when the mouth is 
irritated or ulcerated. When too much has been added the oil of cinnamon 
separates and floats upon the surface, and if thus given it is decidedly 
irritant. If the medicine to which it has been added in over-amount is 
too valuable to throw away, the excess of cinnamon may be easily removed 
by lightly sweeping over the surface with a clean piece of bibulous paper- 
blotting paper or filter paper-or a firm, non-crumbling piece of bread. 
Cinnamon is frequently employed as an ingredient of mixtures to re- 
strain intestinal discharges, and the powder with or without chalk or 
bismuth, or its equivalent in infusion has long figured in the treatment of 
diarrhoea and acute dysentery, though it does not equal in the latter con- 
dition other agents which we now use specifically. In diarrhoea it should 
be used in small doses if of the acute type, and in large doses in chronic non- 
inflammatory and non-febrile forms. It warms the gastro-intestinal tract 
and dispels flatus, being decidedly useful as a carminative. It has the 
advantage of preventing griping when given with purgatives, and it enters 
into the composition of spice poultice, a useful adjuvant in the treatment of 
some forms of gastro-intestinal disorders. 
Cinnamon has been proved in Eclectic practice to be a very important 
remedy in hemorrhages. It acts best in the passive forms. The type of 
hemorrhage most benefited is the post-partum variety, though here it has 
its limitations. If the uterus is empty and the hemorrhage is due to flac- 
cidity of that organ due to lack of contraction, then it becomes an im- 
portant agent. Then it strongly aids the action of ergot and should be 
alternated with it. If retained secundines are the provoking cause of the 
bleeding, little can be expected of this or any other agent until the offenders 
have been removed. Cinnamon should be frequently given, preferably a 
tincture of the oil, though an infusion might be useful, but it cannot be 
prepared quickly enough or be made of the desired strength. Specific 
Medicine Cinnamon is a preferred preparation. Oil of erigeron acts very 
well with it. In menorrhagia, even when due to fibroids and polypi, it has 
had the effect of intermittently checking the waste: but only a surgical 
operation is the rational course in such cases. 
Other hemorrhages of a passive type are benefited by cinnamon. 
Thus we have found it a very important agent in hemoptysis of limited 
severitv. In such cases we have added it to specific medicine ergot and 
305 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
furnished it to the patient to keep on hand as an emergency remedy. By 
having the medicine promptly at hand the patient becomes less agitated or 
frightened, and this contributes largely to the success of the treatment. 
Rest and absolute mental composure on the part of the patient and the ad- 
ministration of cinnamon have been promptly effective. If not equal to the 
emergency, then a small hypodermatic injection of morphine and atropine 
sulphates will usually check the bleeding. When used with ergot in pul- 
monary hemorrhage probably more relief comes from the cinnamon than 
from the ergot, for ergot alone is far less effective. We are told that ergot 
does not act as well in pulmonary bleeding as in other forms of hemorrhage 
because of the sparse musculature and poor vaso-motor control of the 
pulmonic vessels. But cinnamon has given results which have been entirely 
satisfactory. Hemorrhages from the stomach, bowels, and renal organs are 
often promptly checked by the timely administration of cinnamon. 
COCA. 
The dried leaves of Erythroxylon Coca, Lamarck, and its varieties. (Nat. Ord. Ery- 
throxylacese.) South American Andes-Peru, Bolivia, and Chili. Dose, 60 to 240 grains. 
Common Name: Coca. 
Principal Constituents.-Cocaine (erythroxyline-see Cocaina). 
Preparation.-Fluidextractum Coca, Fluidextract of Coca. Dose, 5 to 30 minims. 
Specific Indications.-Defective innervation, with dizziness; impaired 
digestion; pain in back of the head, and fatigue; gastric pain; inordinate 
hunger and thirst; exhaustion during convalescence from long illness. 
Action and Therapy.-The action of coca depends very largely upon 
the cocaine it contains, therefore the physiological effects are recorded under 
that subject (see Cocaina Hydrochloridum). From time immemorial 
the people of the Andes, particularly in Peru, Bolivia, and Chili, have 
used coca leaves as other nations use stimulating table beverages; and 
when undergoing long journeys and hard work the natives are accustomed 
to chew the leaves with lime or some other alkaline substance, in order 
to endure hunger and fatigue, which it enables them to do with remark- 
able certainty. These uses of the plant led to its adoption into medicine 
as a remedy for neurasthenia and other disorders, with nervous weakness 
and muscular debility. 
Coca is a remedy to be used temporarily only for defective innervation. 
Though the appetite is apparently normal, digestion is imperfect, and there 
is an associated occipital and post-cervical pain, dizziness, and inability to 
stand for any great length of time. The mental faculties are sluggish and 
tired-brain fag-and thinking is difficult and despondency a common 
condition. If there is gastric pain or discomfort it is relieved by coca 
probably through the obtunding power of cocaine upon the nerve filaments 
of the stomach. As compared with cocaine this power is feeble, as is coca 
in all its effects, still there is sufficient of the alkaloidal influence exerted to 
make coca a remedy to be used with great circumspection. In nervous 
debility it may be carefully employed for a brief period, especially in con- 
valescence from exhausting fevers and other diseases in which a per- 
sistent nervous depression follows. While of some value in chorea and 
repeated attacks of hysteria, it should not be used when any other agent can 
306 INDIVIDUAL DRUGS. 
be made to serve the purpose. In fact, there is no more wisdom or justifica- 
tion in employing coca preparations for simple functional maladies because 
of mere nervous discomfort than there would be in prescribing opium for 
similar purposes. Both lead to pernicious habits, with a train of miseries 
to which the victim finally succumbs. 
An occasional dose of 10 to 15 drops of the fluidextract will sometimes 
overcome insomnia caused by gloom and worry, and very rarely it helps 
one over an attack of asthma. It may be used for any length of time de- 
sired in gastric carcinoma to relieve the irritability and pain. Its chief use, 
if employed at all, will be for very temporary exhibition in the debility 
following fevers, or for a more prolonged use in advanced phthisis, to give 
rest, quiet gastric irritability, and aid breathing. For all prolonged states 
of mental depression, as neurasthenia, hypochondria, melancholia, de- 
pressive insanity, etc., its administration should not be encouraged, and as a 
remedy for the opium and other drug habits it has no place in medicine on 
account of the habit-forming dangers of coca itself. 
To sum up some of the beneficial results of temporary coca medica- 
tion would be to include its influence as a circulatory and respiratory 
stimulant, a restorative of strength after exhaustive acute diseases or 
operations, in sudden nervous exhaustion and insomnia, in painful indiges- 
tion, headache from exhaustion, and in migraine. In all of these it should 
be used for but short periods, and any symptoms of cocainism should be a 
warning to cease its administration. The fluid medicines may be used in 
moderate doses. The habit of using coca wines is but a mild form of coca- 
ino-alcoholic tippling. 
COCAINA. 
Cocaine. 
(Formula: Cw H2i O4 N). 
An alkaloid derived from Erythroxylon Coca, Lamarck, and its varieties. (Nat. Ord. 
Erythroxylacese.) 
Description.-Large odorless and colorless crystals or a crystalline white powder. 
Soluble in chloroform, ether, alcohol, and olive oil; sparingly dissolved by water. Dose 
(maximum), 1 grain; as a rule the dose should not exceed 1/4 grain; and never more than 
that as an initial dose. 
Action and Therapy.-(See Cocainae Hydrochloridum.) 
COCAINE HYDROCHLORIDUM. 
Cocaine Hydrochloride. 
(Formula: Cn H2i O4 N. HC1.) 
Description.-Permanent odorless transparent crystals, lustrous flakes, or as a white 
crystalline powder. Very soluble in water or alcohol; and less readily in chloroform. 
Dose (maximum), 1 grain. The usual dose should not exceed 1/4 grain, and never more 
than this amount as an initial dose. 
Specific Indications.-To produce local anaesthesia; to facilitate ex- 
aminations and to perform minor operations; intractable vomiting; pain 
of gastric cancer. 
Action.-Coca and its alkaloid, cocaine, administered internally induce 
a certain degree of exhilaration and a sense of pleasure and enable one to 
do an increased amount of physical and mental labor. Full doses of cocaine 
particularly cause, in the beginning, a state of cheerfulness and content- 
ment in some cases, of restlessness, nervous excitement, fear and terror in 
others. Sometimes there is a feeling as of passing from earth into the air. 
307 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
When consciousness becomes lost, the unconscious state may be only ap- 
parent but rather an anaesthetic condition. When the stage of cheerful 
inebriation occurs, insensibility to hunger and the power to endure fatigue 
are strikingly displayed and muscular power is undoubtedly increased. 
The record of cocaine is one of stimulation and depression. Small and 
moderate doses stimulate, large doses depress, while lethal doses paralyze. 
Locally applied, cocaine is a profound anaesthetic acting by depressing the 
sensory nerve endings. When so used even small doses produce complete 
analgesia and restricted anaesthesia. 
Taken internally, cocaine, by a series of activities involving the vagal 
and sympathetic cardio-inhibitory centers, the heart muscle itself, and 
probably the vascular walls, increases and then slows the pulse rate, and 
heightens and afterwards lowers arterial pressure. The depth and rate of 
breathing are increased by small doses, while large amounts depress and 
finally paralyze, so that death results from respiratory failure. While the 
cerebrum is strongly attacked by cocaine the spinal cord is but little affected, 
large doses being required to depress the sensory tract sufficient to produce 
local anaesthetic or even analgesic effects. It differs very markedly in this 
respect from the results obtained when subcutaneously injected, or when 
applied to the mucosa. Voluntary muscular tissue is stimulated by cocaine 
so that enormous physical tasks may be accomplished. Peristalsis is first 
excited and then restrained by it, the renal functions are but slightly 
affected, tissue-waste is lessened, and if the dose be very large the tempera- 
ture is greatly increased. Small doses powerfully excite the cerebrum, 
inducing mental exhilaration, with a mild sense of contentment and ease, 
increased intellectual activity, and a stimulated imagination. If carried 
too far a cheerful inebriation and delirium result. Lethal doses, however, 
depress the cerebral centers, and stupor and epileptoid convulsions occur. 
Cocaine decreases the elimination of urea, and the drug is mostly oxidized 
in the body, that which is excreted passing out by way of the renal organs. 
Scarcely any effect is produced by cocaine when applied to the unbroken 
skin. Injected subcutaneously or applied to the mucosa, cocaine is a 
powerful local vaso-constrictor, producing very great ischaemia, followed after 
a time by vascular relaxation and local congestion. Very quickly complete 
analgesia and anaesthesia result, so that absolutely no pain is experienced 
from cutting operations, though tearing is said to be felt severely. Neither 
does it alter the sense of cold and heat, for unwarmed instruments applied 
to the anaesthetized parts are distinctly felt. The combined action upon the 
sensory terminals, the vaso-constriction, and the local pressure oedema 
when injected into (not beneath) the skin, contribute to produce the anaes- 
thesia. The parts are first blanched, but as the effects wear off they become 
decidedly reddened, owing to the secondary dilatation of the blood vessels. 
The amount required to affect the mucosa depends entirely upon the density 
of the tissues, the delicate structures of the conjunctiva favoring rapid 
absorption and the denser mucosa of the vagina, rectum, and urethra 
being affected very much more slowly. For some reason its use in the 
urethra has been attended with poisonous consequences more often than 
in any other region of the body. In addition to anaesthesia strong but 
comparatively transient mydriasis is produced by cocaine with but very 
308 INDIVIDUAL DRUGS. 
little disturbance of accommodation. If used too strong or too often it has 
a tendency to dry and otherwise damage the corneal epithelia. 
Toxicology.-Acute cocaine poisoning varies in different individuals. 
It usually includes the following phenomena: Nausea and vomiting, and if 
the patient is still conscious, a sensation of heat and dryness of the mouth 
and throat; pulse very rapid, small and thready, or slow and feeble, with 
cyanosis. At first respiration is quickened, but finally becomes slower and 
shallow and labored. There is great mental and nervous excitement, 
muscular trembling and epileptiform convulsions, sometimes hallucinations, 
dizziness, and violent headache occur. Stupor takes place and breathing 
ceases, centric paralysis having resulted in asphyxia. 
The treatment consists in inhalations of amyl nitrite or chloroform and 
the administration of chloral and bromides to control the convulsions; and 
the use of ammonia, ether, and strychnine or atropine to support the failing 
circulation and respiration. Morphine is said to be a perfect antidote to 
poisoning by cocaine. 
Chronic Cocainism (Cocamania). Cocaine habitues suffer from a 
miserable drug intoxication equally, if not more disastrous, than that re- 
sulting from opium. The victim has unexplained attacks of pyrexia, is ema- 
ciated and feeble, and suffers from various disturbances of the circulation. 
The mind becomes weak and erratic, the victim sleeps poorly and often is 
troubled by persistent wakefulness, disagreeable visual and mental hallu- 
cinations and delusions, and sinks into the utmost depths of moral deg- 
radation. Like all kinds of drug fiends, his word is absolutely not to be 
relied upon, particularly when it concerns his habit. Delirium and acute 
mania are not uncommon results, and crimes of the most dangerous and 
revolting character are committed upon sudden impulse. Cocaine habitues 
are said to suffer a peculiar dermal formication like that of crawling or 
creeping insects or worms beneath or upon the skin. This state is known in 
slang parlance as "cocaine bugs." Cocaine should not be abruptly with- 
drawn from these victims lest they suddenly collapse. Institutional treat- 
ment is the only possible way of handling cocamania. Singularly many 
physicians, who should know better, become cocaine fiends chiefly through 
its local self-use in nose and throat treatment. Cocaine fiends are often the 
victims of the conjoint habitual use of opiates, alcohol, and cocaine-the most 
horrible drug trinity-and the most pitiable of all drug-afflicted creatures. 
Therapy.-External and by Injection. Cocaine, and its substitutes, 
especially procaine, are the most important of the local anaesthetics. They 
may be applied to mucous surfaces or to denuded parts, or injected hypo- 
dermatically wherever the circulation can be controlled by ligature or 
otherwise. Of cocaine, solutions of from 1 to 6 per cent are used, but for 
most purposes the 2 or 3 per cent solutions mostly are employed. While 
sometimes used to relieve local pain and reduce venous turgesence, it acts 
poorly where there is much inflammation. When injected into inflamed 
parts it is much more difficult to obtain complete anaesthesia. 
Cocaine is the most important anaesthetic for use upon the eye, for the 
purposes of controlling pain or photophobia, to render the removal of 
foreign bodies painless, and to prepare the ocular field for superficial and 
deep operations. Iridectomy, cataract operation, ocular tumors, and 
309 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
trachomic masses may be removed absolutely without pain under its 
effects, except that a sharp sting may be felt when the iris is withdrawn 
and snipped in iridectomy. From 3 to 4 drops of a 1 to 4 per cent (2 or 3 
per cent usually preferred) solution may be instilled into the eye every 
3 or 4 minutes until the field is anaesthetized. Stronger solutions should not 
be used, nor should cocaine instillation be frequently repeated on account 
of the corneal degeneration that sometimes results from it, probably through 
the ischaemic effects on the conjunctival blood-supply, and the drying of 
the corneal layers. Under cocaine anaesthesia most of the operations upon 
the eye, ear, nose, and throat may be performed with facility. 
Cocaine, and preferably procaine, may be used to anaesthetize the field 
of operation for the opening of mammary and other abscesses, the removal 
of small tumors and growths, for the amputation of the fingers and toes, 
and sometimes for the repair of hernia. With cocaine, wherever it is 
possible, a rubber band should be made to constrict the parts and thus 
confine the circulation within the operative area. After completing the 
operation the band should be allowed to remain in situ for a short while, 
and the imprisoned blood supply allowed to drain from the parts, thus 
minimizing the chances of cocaine absorption. As a rule, not over 1/4 to 1/2 
grain of cocaine should be employed. If a 1 to 10,000 or 20,000 adrenalin 
solution be used with the cocaine, less bleeding while operating is likely to 
occur and anaesthesia is more readily maintained. Cocaine, as a rule, 
should be used only where small incisions or operations are to be per- 
formed. Rarely, however, in profound illness and in emergencies the 
abdomen may be opened under cocaine, or preferably, procaine anaesthesia. 
Moreover, for many of the operative procedures, excepting those of the 
eye, procaine (novocaine) has largely supplanted the use of cocaine. 
Incisions are best performed under preliminary preparation by the 
Infiltration Method of Schleich. This consists in the injection, by the 
hypodermatic needle, of a special preparation of cocaine into the skin, 
point by point, so that the resulting wheals overlap one another. In this 
way the combined effect of local pressure oedema, contraction of the vessels, 
and the obtunding effects of the cocaine, render the line of punctures a 
perfectly anaesthetic field for incision. The injection must be made into 
and not through the skin. After the surface is so prepared deeper injections 
may be made, if desired. Schleich advised solutions of three strengths, vary- 
ing only in the quantity of cocaine hydrochloride used:-weak (1/10 grain); 
medium (1 grain); and strong (2 grains). These are respectively dis- 
solved in 2 fluidounces of a sterile solution of 1/5 grain of morphine hydro- 
chloride and 2 grains of sodium chloride. The medium strength solution 
is that usually employed. This method is especially advised for incisions 
where it is difficult to confine the circulation to a restricted area. 
All sorts of dental surgery, from the extraction of teeth and bony 
spiculae to obtunding cavities for filling, as well as most operations upon the 
nose, ear, and eye, may be done under cocaine anaesthesia; and some 
varieties of vaginal plastic work may be successfully accomplished with its 
aid. In most severe operations, however, general anaesthesia is to be 
preferred; and especially if the individual is of a very nervous temperament, 
though no pain is felt, for consciousness of the fact that an operation is 
310 INDIVIDUAL DRUGS. 
being performed and an apprehension of harm may interfere greatly with 
the success of the work of the operator. Cocaine anaesthesia should not, 
as a rule, be used upon children, where fear may prevent successful opera- 
tive results even though the pain is obtunded; nor is it advisable to risk 
its use upon hysterical individuals. Cocaine is invaluable sometimes to 
desensitize passages, so that instruments may be passed readily and ex- 
aminations facilitated. 
The use of cocaine to reduce turgescence of the turbinates and mild local 
inflammations, and in other hypersesthetic conditions of the nose, as in 
hay fever, is effectual, but should be largely discouraged. Under no cir- 
cumstances should the patient be furnished with cocaine solutions or oint- 
ments, with a knowledge of the identity of the drug; it is better that the 
physician make such applications himself and then he can control the 
amount and the length of time they are to be used. The cocaine habit has 
been most readily and most generally acquired under the use of the drug 
as a nasal medicament. 
While cocaine is a mydriatic, it is not generally employed as such except 
for the purpose of examining the fundus of the eye when it is desirable not 
to have the pupil dilated for a long period. For most refraction work 
homatropine hydrobromide or atropine sulphate is to be preferred. 
Cocaine mydriasis lasts about a day, and unlike that caused by atropine 
can be overcome at once by the instillation of a few drops of a 1/2 per cent 
solution of eserine. Nor is cocaine of much value in iritis, because it does not 
produce forcible dilation of the iris with the same persistence that atropine 
does. 
Internal. The cocaine habit is readily acquired and not easily broken. 
Therefore cocaine should have little part in internal medication or be long 
applied where absorption can take place to the detriment of the patient. 
The Eclectic profession has been insistent in its opposition to the free and 
reckless use of habit-forming drugs, hence the internal use of cocaine has 
found little favor with it, notwithstanding its efficiency as a respiratory and 
cardiac stimulant and to relieve local irritation and pain of the gastric 
mucosa. Rarely it may be employed to control intractable vomiting, as in 
sea sickness and malignant diseases of the stomach. Its use is justified in 
yellow-fever to control emesis. While it may relieve the vomiting of preg- 
nancy (applied locally to the os uteri at the same time), it should only be 
temporarily employed when other means have been exhausted. It will 
relieve the pain of gastric ulcer and cancer of the stomach, but it takes 
almost poisonous doses to produce such effects. In the latter its use is 
justifiable, as it may be in any incurable condition, in which life can last 
but a short time, and in which it can give any relief from suffering. In the 
adynamia of low fevers it has a stimulating effect, and if the usual means 
fail to arouse the depression a single dose is not inadmissible; the same is 
true in angina pectoris, and in the adynamic stage of pneumonia in the aged, 
when it will assist the action of strychnine. It should never be used, as has 
been advised, in hypochondria and neurasthenia and other depressive 
mental states, and as a remedy to cure the alcohol and opium habits it has 
nothing to commend it, as such a continuous use of it is sure to establish the 
cocaine habit, equally as pernicious as those it is sought to cure. 
311 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
COCAINE SUBSTITUTES. 
Since the introduction of cocaine for local anaesthesia the latter has come into ex- 
tended use through rapid evolution of methods and substitutes. The first of these was 
eucaine, not much employed now. Byall odds the best and safest is procaine (novocaine), 
except for instillation into the eye or in operations upon the nose and throat. Owing to the 
fact that it only produces complete anaesthetic effects when injected, it is unsuitable and 
insufficiently effective when merely applied to the conjunctiva and the nasal mucosa. 
(See below.) 
Quinine and Urea Hydrochloride (Quininae et Ureae Hydrochloridum), having the 
appearance and taste of quinine, very soluble in water or alcohol, is administered hypo- 
dermatically in the average dose of 15 grains once a day. It should be largely diluted and 
even then is said to be slowly absorbed and not wholly free from causing irritation, and 
sometimes tetanus. The intravenous use is preferred by some operators. It has found 
favor as a remedy for the shrinkage of internal piles. 
Procaine (discarded German name, Novocaine) is a colorless crystalline synthetic 
soluble in water and sterilizable without change. Less powerful and more transient in 
anaesthetic effect, it is also accepted as being but one-seventh as poisonous as cocaine, and 
one-third as toxic as eucaine. However, by delaying its absorption by its conjoint ad- 
ministration with adrenalin it is apparently as efficient as cocaine for general purposes. 
Its effects are confined to the nerves solely and does not include the neighboring tissues. 
Neither does it cause marked irritation, hyperaemia, constriction of the blood vessels, or 
mydriasis. This makes it in many respects, together with its relative lower toxicity, pref- 
erable to cocaine, except in eye, nose, and throat work. In fact, procaine is fast dis- 
placing cocaine as a local anaesthetic, being now preferred by surgeons for even quite ex- 
tensive operations, even to abdominotomies. Procaine is employed almost exclusively as a 
substitute for cocaine to produce local anaesthesia, by topical and tissue infiltration and 
intraspinal methods. As with other anaesthetics, the latter is inadvisable. For extensive 
tissue infiltration a normal saline solution of 1/4 to 1 per cent of the drug is employed, 
usually with adrenalin. For ocular work, 1 to 10 per cent; nasal treatment, 5 per cent; 
mouth and throat, 5 to 15 per cent; and intraspinally from 30 to 45 mimins of a 5 per 
cent solution. 
Eucaine. Two preparations, Eucaine "A" and Eucaine "B", have been used as 
substitutes for cocaine. 
Eucaine "A" is a white, crystalline powder, neutral, and soluble in water. It is claimed 
that it is less toxic than cocaine, though the maximum dose (3/4 grain) of the latter should 
not be exceeded. The solution does not, it is asserted, decompose, and may be sterilized 
without injury. Claimed of less value for ocular work than the Eucaine "B", on account 
of the irritation and hyperaemia produced. The following strengths of solutions are di- 
rected : Diseases of nose, throat, and ear, 2 to 8 per cent; dentistry, 4 to 9 per cent; minor 
surgical operations, 5 per cent; solutions of greater than 9 per cent strength deposit crystals 
of the drug. 
Eucaine "B" (Beta Eucaine) is crystalline, white, neutral, and soluble in about 28 parts 
of water; hot water dissolves it more readily. Solutions non-decomposable and not affected 
by sterilization. Claimed to be slightly antibacterial, less toxic than Eucaine "A", and 
less than half as poisonous as cocaine; does not cause mydriasis and corneal, or accom- 
modation disturbances (as cloudiness of the cornea), but little vascular injection, etc. The 
strength of solutions recommended are: For ocular use, 1 to 2 per cent, about 4-drop in- 
stillations shortly before operations, prolonged and repeated applications producing 
untoward effects; infiltration ansesthesia, 1/10 to 1 per cent; genito-urinary disorders, 
1/2 to 2 per cent. 
Though conceded to be less toxic than cocaine, eucaine is reported to have produced 
intoxication through the application of 4 per cent solutions to the throat, such a case 
exhibiting "spasmodic muscular contractions of the arms and legs"; "the heart's action 
was also affected, the pulse becoming rapid and small." Nearly as efficient as cocaine; some 
regard eucaine as too irritating for ordinary application to the eye. The greatest advantage, 
it is conceded, is its value when desirable to avoid pupillary dilatation, as in the removal of 
foreign bodies (the iris acting as a background in light-colored eyes, thus aiding in the 
detection of the particle), and for use upon the eyes of the elderly with "glaucomatous 
tendency." It has one advantage in nasal operations, in that, by not causing shrinkage, it 
allows the operator to ensnare posterior hypertrophies of the inferior turbinated bone, being 
useful as well in anterior hypertrophies. Cocaine produces a marked shrinkage of the tissues. 
The hydrochloride and lactate of beta eucaine are the preparations employed. 
Tropa-cocaine.-Tropa-cocaine is an alkaloid isolated by Giesel from the narrow-leaved 
variety of Erythroxylon Coca, Lamarck, grown in Java. It is also prepared synthetically. 
The hydrochloride is principally used. It occurs in colorless crystals, soluble in water, the 
312 INDIVIDUAL DRUGS. 
solution being (claimed) more stable than the corresponding solution of cocaine hydro- 
chloride. It is reputed a local anaesthetic, differing in action from cocaine and other local 
anaesthetics in not producing irritation, hyperaemia (occasionally slight and transient 
hyperaemia), or ischemia; furthermore, it is said to be less toxic and depressing to the 
cardiac ganglia and to the heart. But little or no mydriasis results from its use. Anaesthesia 
is quickly produced, according to Silex, tenotomy having been painlessly performed in less 
than one-half minute after the application of a 3 per cent solution of the hydrochloride. 
The usual method of exhibition is the 3 per cent solution of tropa-cocaine, in a 0.6 per cent 
sodium chloride solution, 1 or 2 drops being instilled into the eye. It is scarcely used for 
any other purpose nowadays except for producing spinal anaesthesia-a dangerous procedure 
not to be encouraged, as the proportion of deaths has been about 1 to 750. 
Apothesine has been introduced as even less toxic than procaine, and to be used ex- 
actly like the latter, with or without adrenalin. It has not, at this date, come under the 
ban of the antinarcotic law, and is said not to produce a habit. Apothesine occurs in snow- 
white crystals easily dissolved by water or alcohol, and is sterilizable without decomposition, 
upon boiling. Normal saline solutions in 1 to 2 per cent strengths are employed. 
Holocaine, a derivative of phenetidine, is said to have double the anaesthetic power and 
to be less toxic than cocaine. It is also said to be a useful and unappreciated preparation. 
It acts quickly upon the conjunctiva, without causing vascular constriction or secondary 
hyperaemia, does not dilate the pupil, change intraocular tension, nor unpleasantly affect 
the corneal epithelium; hence its reputed value in keratitis and iritis. The crystalline 
hydrochloride only is soluble and should be freshly prepared and sterilized. 
Ancesthesine is a substitute claimed to be efficient and far less poisonous than cocaine. 
Stovaine, a synthetic alkaloid, occurring in brilliant scales and very soluble in water, is 
reputed equal in anaesthetic power to cocaine, and its solutions can be boiled without de- 
composition. It has produced excessive sweating, headache, vomiting, and relaxation of 
the sphincters. One (1) per cent in normal salt solution is used by subconjunctival injection, 
and a 4 per cent solution for instillations. It has been employed with disastrous results in 
spinal anaesthesia, bringing the drug and the method into discredit. It is not much employed. 
Alypin, or benzoyl mono-hydrochloride, is a white crystalline powder readily soluble 
in water. It is equal in anaesthetic power to cocaine, but like the latter it produces secondary 
congestion. Its solutions may be boiled, but not longer than five minutes. Claimed not to 
irritate, constrict the local vessels, or cause either mydriasis or change of accommodation. 
Solutions of 2 per cent strength are used in ocular therapeutics; of 10 per cent, in other 
operations. As it is equally as toxic as cocaine and is said to produce sloughing, it has 
acquired but little popularity among surgeons and oculists. 
COCCULUS 
The seeds of Anamirta panniculata, Colebrooke (Nat. Ord. Menispermaceae.) East 
India. 
Common Names: Fishberries, Indian Berries. Synonym: Cocculus Indicus. 
Principal Constituent.-Picrotoxin, a neutral and extremely poisonous principle. 
(See Picrotoxinum.) 
Preparation.- Unguentum Cocculi, Ointment of Cocculus Indicus. (Cocculus, 
crushed, 1 ounce; benzoinated lard, 8 ounces; fractionally added until well incorporated.) 
Action and Therapy.-External. (See also Picrotoxinum). A violent, 
poisonous parasiticide for animal and vegetable parasites, to destroy 
head lice and the itch mite, and relieve scald head, sycosis barbae, trich- 
ophytosis, tinea versicolor and other parasitic skin diseases. Included in 
this book chiefly because of the possibility of meeting with cases of poison- 
ing by it, as the berries, in ointment or whisky tincture, are often used by the 
laity for the destruction of lice. It must not be used on abraded surfaces, 
nor in any considerable quantity. 
Internal. Homeopaths use an attenuation of the tincture of cocculus 
as a remedy to prevent nausea and sickness incident to travel by rail or 
upon water (meralgia or sea sickness). 
Cocculus is said to be used by the natives of the East Indies to stupefy 
fish, so as to readily catch them, and it is asserted to be in use among 
brewers to add bitterness to beer and other malt beverages. 
313 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
CODEINA. 
Codeine, Methyl morphine. 
An alkaloid prepared from Opium, or prepared by methylation from morphine. 
Description.-Translucent, colorless crystals or a white crystalline powder, odorless 
and of a faintly bitter taste. It slightly effloresces in warm air. Soluble in water and more 
readily in alcohol. Dose, 1/8 to 1 grain. 
Preparations.-1. Codeince Sulphas, Codeine Sulphate. (Quite soluble in water (30); 
very sparingly in alcohol). Dose, 1/8 to 1 grain. 
2. Codeince Phosphas, Codeine Phosphate. (Very soluble in water (2.3) ). Dose, 
1/8 to 1 grain. 
Specific Indications.-A calmative where opium is apparently in- 
dicated, but not well tolerated; insomnia due to cough; cough constant and 
irritating; abdominal pain; diabetes. 
Action and Therapy.-Codeine is anodyne and hypnotic. It restrains 
the output of urine in polyuria and the amount of sugar in diabetes. Some- 
times it fails in both, but as a rule it has a favorable action in these two 
disorders. It is an ideal sedative for irritating cough and is frequently an 
ingredient of cough mixtures. When such are to be used in phthisis or 
other incurable diseases, codeine is both safe and effectual. But for transient 
disorders it should be employed sparingly and for but brief periods, as it is 
a habit-forming drug. Codeine is indicated in many irritable and painful 
conditions in which morphine or opium are seemingly indicated, but in 
which they are not well tolerated. It is, in many respects, much kindlier in 
action than those preparations-seldom causing heavy sleep, perspiration, 
skin eruptions, obstinate constipation, retching and vomiting, or other 
gastro-intestinal disturbances, when given in the smaller doses. From 
1/2 to 1 grain will relieve pain and spasmodic action without acting as a 
soporific. It is preferable to morphine after abdominal operations to relieve 
pain and give rest. As a temporary anodyne it may be given in neuralgia, 
gastralgia, ovarian pain, and rheumatic pain; for prolonged use it is justi- 
fiable in lingering and incurable diseases, as cancer and tuberculosis, to 
relieve pain and give rest and sleep. For this purpose, provided it is 
effectual, it is to be preferred to opium or to morphine. In beginning 
codeine medication the smaller doses (1/3 gr.) should always be given. 
COLCHICUM. 
The dried (I) root and (II) seed of Colchicum autumnale, Linne. (Nat. Ord. Liliaceae.) 
England and other parts of Europe. Dose, Corm, 1 to 5 grains; seed, 1 to 5 grains. 
Common Names.-I. Colchicum Corm (Colchici Cormus); II. Colchicum Seed 
(Colchici Semen). 
Principal Constituent.-The powerful alkaloid Colchicine (see below.) 
Derivative.-Colchicina, Colchicine. A very toxic alkaloid occurring as pale yellow 
scales or powder, practically odorless. It should not be tasted. Soluble in water. The 
salicylate is sometimes employed. Dose, 1/300 to 1/100 grain. 
Preparation.-Specific Medicine Colchicum. Dose, 1 to 10 drops. 
Specific Indications.-Acute gout; rheumatism, without much fever, 
occurring in gouty individuals; tearing pain, aggravated by heat. 
, Action and Toxicology.-Upon the skin and mucosa colchicum is 
irritant, causing smarting and redness, sneezing and conjunctival hyper- 
aemia. Small doses increase the secretions of the skin, kidneys, liver, and 
bowels. Large doses are dangerous, producing gastric discomfort, nausea 
314 STONE-ROOT 
(Collinsonia canadensis) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Stone-Root is a medicine of importance in the evolution and upbuilding of Specific Medication, 
It is a drug chiefly of Eclectic development. 
Courtesy of Mr. Moritz Fischer INDIVIDUAL DRUGS. 
and vomiting and purging, and violent peristalsis with much intestinal 
gurgling. Poisonous doses produce a violent gastro-enteric irritation, with 
symptoms much like those of cholera-agonizing griping, painful muscular 
cramps in the legs and feet, large but not bloody evacuations of heavy 
mucus and serum, thready pulse, collapse, and death. Toxic doses are 
almost sure to kill in spite of efforts to save life, the patient dying a slow, 
painful, and agonizing death, the final act of which is respiratory paralysis. 
Consciousness remains to the end. 
The reputed antidote is tannin freely administered with plenty of water 
and followed by the use of emetics or the stomach pump. Opium may be 
given to relieve pain, atropine to sustain breathing, and artificial heat to 
maintain bodily warmth. 
Therapy.-Colchicum is an extremely dangerous medicine and should 
be used with the greatest of caution. It is the remedy for acute gout, 
temporarily giving quick relief if administered short of purgation. For 
some unknown reason attacks recur more frequently when colchicum has 
been used, though it almost magically relieves the paroxysms. It is 
useful for disorders depending upon a gouty diathesis, though it is less 
effectual in chronic gout than in the acute form. In rheumatism, pure and 
simple, it usually has little or no value, though we have had excellent results 
after failure with the usual antirheumatics, in cases where pain persisted 
in one part for longer periods than usual, in acute articular rheumatism 
with but little fever. These cases resembled gonorrhoeal arthritis and were 
accompanied by a leucorrhoeal discharge, but were not gonococcic. In most 
cases the fingers, wrists, and abdomen were the most painful locations. 
Some have advised it in so-called chronic rheumatism when the patient is 
known to have occasional gouty attacks. We have seen it do good in 
rheumatoid arthritis; a condition much more prevalent in this country 
than genuine gout, a disease rarely encountered in America. In rheumatoid 
headache and in rheumatic iritis colchicum is sometimes of value when 
occurring in one with swollen joints, with or without effusion, and attended 
by tearing, muscular pain, aggravated by heat. Subacute and chronic 
sciatica are asserted to have been relieved by colchicum when the pain is 
sharp, shooting, tearing, or dull, from back to hips and down the legs, 
fever being absent. 
In rheumatic conditions colchicine salicylate in doses of the 1/128 grain 
is often more serviceable than colchicum. 
COLLINSONIA. 
The fresh root and plant of Collinsonia canadensis, Linne. (Nat. Ord. Labiatae.) 
Damp and rich soils of woods from Canada to Florida. 
Common Names: Stone-root, Rich-weed, Horse-balm, etc. 
Principal Constituents.-Resins and volatile oil. 
Preparations.-1. Specific Medicine Collinsonia. Dose, 1/10 to 30 drops. 
2. Aromatic Collinsonia (prepared from the plant). Dose, 1 to 30 drops. 
Specific Indications.-Irritation, with a sense of constriction in the 
larynx, pharynx or anus; sense of constriction with tickling in the throat, 
with cough arising from use of the voice; a sensation as if a foreign body were 
lodged in the rectum, with a painful contraction of the sphincter and peri- 
neum: sense of contraction in the rectum, with constioation due to vascular 
315 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
engorgement of the pelvic viscera; scybalous feces; sticking pains in the 
heart, larynx or bladder; contracted abdomen; vesical tenesmus; hemor- 
rhoids; varicocele; follicular tonsillitis, with chronic hypertrophy of the 
faucial glands; any condition with weight and constriction, with or with- 
out heat. 
Action.-Collinsonia affects chiefly the venous system and the mucous 
membranes, particularly the hemorrhoidal venous circulation. It also 
stimulates the vagi, relieving irritation of the parts to which they are dis- 
tributed, and is believed to strengthen the action of the heart. Small doses 
of the green root produce emesis, and sensible doses of the fluid prepara- 
tions cause an increase in urine and slightly that of the skin. 
Therapy -Collinsonia is a remedy for venous stasis and for irritation of 
the mucosa. Chiefly it meets one prime condition and the many dis- 
orders dependent thereon. This is atony of the venous circulation, whether 
due to relaxation of the blood vessels or to lack of tone in the venous side 
of the heart. Therefore its best results are obtained in conditions showing 
feeble or sluggish venous and capillary flow. Under these conditions it 
specifically improves impairment of the mucous membranes, appearing to 
be most active in disorders of the throat and rectum, though venous stasis 
in any organ or part is corrected by it. 
Collinsonia is the most effective medicine we have for that form of 
laryngitis known as "minister's sore throat"-a hyperaemic or congestive 
state, with tenderness, hoarseness, and cough brought on by intensive 
speaking or singing. It is common among public speakers, singers, auction- 
eers, hucksters, and others compelled to use the voice beyond the ordinary. 
It is also valuable in other forms of laryngitis, with congestion or hyperaemia 
of the vocal apparatus, in chronic bronchitis, pharyngitis, tracheitis, and 
aphonia, all depending upon irritation associated with venous debility. 
1$. Specific Medicine Collinsonia, fl5ij to fl^j; Simple Syrup, q. s. fl^iv. 
Mix. Sig.: One teaspoonful every 3 or 4 hours. 
Foltz advised it in the early stage of middle ear disorders, with free non- 
purulent secretions, and when complicated by follicular pharyngitis and 
hypertrophied Luschka's glands. 
For many of the throat disorders Aromatic Collinsonia is preferred by 
some prescribers. 
The second great use for collinsonia is in rectal venous debility. Here 
the smaller doses are more effectual. In hemorrhoids it usually does not 
cure, though it may do so early in their course. It is to be used when there is 
vascular engorgement of the pelvic viscera, with a sense as if a foreign 
body were lodged in the rectum, causing constant uneasiness and affecting 
the nervous system profoundly. There is weight, heat, and dull pain, with 
or without scybalous constipation, or sometimes with partly semifluid and 
partly scybalous feces. The only rational procedure is to have the dis- 
turbing hemorrhoids surgically removed, but if this cannot be done, or the 
patient will not consent, then recourse to collinsonia will give us much 
relief as can be obtained from any safe medicine. Collinsonia relieves, to a 
lesser extent, subacute proctitis, the tenesmus of mild types of dysentery 
and diarrhoea and rectal pain following operations, as well as that of fissures, 
fistulae, and allied conditions, though much reliance cannot be placed upon 
316 INDIVIDUAL DRUGS. 
it for any of these conditions, except in the hemorrhoids of the type de- 
scribed. It does, however, relieve discomfort in the rectum without ap- 
parent lesion other than that of vascular engorgement. 
Many value collinsonia in gastro-intestinal irritation with torpor of the 
portal circulation, irritation of the mucous membranes, and loss of appetite. 
Indigestion, spasmodic pain, gastric catarrh, and irritative dyspepsia, all 
with more or less constipation, appear to be benefited by collinsonia. By 
increasing innervation and relieving irritability it proves useful in atonic 
dyspepsia, with poor abdominal circulation. 
Irritation of parts supplied by the vagi is relieved by small doses of 
collinsonia. Thus it ameliorates some cases of asthma, chronic cough, and 
the cough attendant upon disorders of the heart. Some value it in mitral 
regurgitation and in rheumatism of the heart. In all conditions the dilated 
capillaries showing passive engorgement will guide to its use. It was 
formerly regarded a remedy for gravel, but is little valued for that purpose 
now further than to relieve irritation and discomfort when gravel gives rise 
to pelvic vascular debility. Cases of varix of the vulva have been reported 
as modified, but not cured by it; the same is true of varicocele and varicose 
veins of the legs. 
In whatever disorder collinsonia is helpful, there is always a sense of 
weight and constriction, venous engorgement, dilated capillaries, and mus- 
cular atony. 
COLLODIUM. 
A solution of Pyroxylin or Soluble Gun Cotton (40), in ether (750), and alcohol (250). 
Common Name: Collodion. 
Description.-A thickish, colorless liquid of neutral reaction and ether-like taste and 
odor. It should be kept in securely-corked vials. 
Preparations.-1. Coilodium Flexile, Flexible Collodion. (Contains Collodion, Cam- 
phor, and Castor oil). Resembles collodion in appearance and odor. When evaporated 
it forms a film which is barely contractible and is elastic. 
2. Coilodium Cantharidatum, Cantharidal Collodion, (Blistering Collodion, Vesicating 
Collodion). Flexible Collodion containing Cantharides. An epispastic. 
Action and Therapy.-Collodion upon evaporation forms a so-called 
artificial epidermis. It may be used where local pressure is desired to limit 
the supply of blood and thereby control inflammation and pain, as in 
incipient boils, in orchitis and epidymitis, mastitis, chilblains, and small 
sprains; also as a protective to abraded or cut surfaces when about to handle 
decayed substances, as in dissecting. It is also often used, with questionable 
wisdom, upon wounds, particularly of the scalp, and on bites, stings, 
abrasions, and ulcers, presumably for protection. It prevents drainage, 
however, and possibly confines infecting material, thus favoring further 
absorption. Its best use is to protect the tissues before damage, when 
about to handle noxious substances. 
Flexible Collodion may be used where compression is not desired, but for 
the protective uses to which collodion is adapted. It does not crack and 
is pliable. 
Cantharidal Collodion is used when a small blister is desired. It is 
scarcely ever needed. 
A Styptic Collodion containing alcohol and tannic acid was at one time 
official. It was applied to small wounds, especially of the scalp, to control 
bleeding. 
317 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
COLOCYNTHIS. 
The dried, peeled pulp of the fruit of Citrullus Colocynthis (Linne), Schrader. (Nat. 
Ord. Cucurbitacese.) Mediterranean basin of Europe, Asia, and Africa. Dose, 1 to 5 grains. 
Common Names: Colocynth, Bitter Apple, Bitter Cucumber, Colocynth Pulp. 
Principal Constituent.-The bitter active glucoside colocynthin (C66H34O23). 
Preparation.-Specific Medicine Colocynth. Dose, 1/30 to 5 drops. 
Specific Indications.-Pain of a cutting, twisting, boring, or tearing 
character, and if of the bowels, a desire to go to stool; visceral neuralgia, with 
cutting pain; dysentery, with tormina and small passages of mucus, or 
diarrhoea with mucoid passages and intense cutting pain; colicky pains 
anywhere in the abdomen (minute doses); distressing accumulations of 
gas; constipation with dry scybala and griping pain in the lower bowel 
(larger doses). 
Action.-Colocynth is a decided local irritant. In small doses it is a 
stomachic bitter, exciting an increased flow of gastric juice. In even 
moderate doses it is a violent hydragogue cathartic, producing copious 
watery evacuations, and sometimes violent emesis, tormina, and bloody 
stools. It may cause death from gastro-enteritis. The powder or the 
tincture applied to a raw surface or to the abdomen will purge as if given by 
the mouth. Colocynth, in small doses, increases the renal function. 
Therapy.-Colocynth is a powerful hydragogue cathartic, but is seldom 
employed as such in Eclectic practice. Except in minute doses it should not 
be given alone, at least never to the extent of causing purging. It is com- 
monly administered with other cathartics in pill form, the compound 
extract of colocynth being preferred, and its violence controlled by hyoscy- 
amus or belladonna. When so employed it is usually in melancholia and 
hypochondriasis with sluggish hepatic and intestinal action, with large 
fecal accumulations; and sometimes to produce local pelvic effects and 
thereby stimulate menstruation in atonic amenorrhoea. It has been largely 
employed in ascites from all causes, but while actively cathartic, it is less 
desirable than some other hydragogue cathartics. It should never be so 
used in the aged and where there is great debility or gastro-intestinal in- 
flammation. It is very rarely employed in Eclectic therapy for dropsical 
effusions. 
Specifically, colocynth is a remedy for visceral pain of a sharp, colicky 
character-cutting, darting, cramping, or tearing pain. The fractional dose 
only should be used. In sharp "belly ache" attending stomach and bowel 
disorders, colocynth is splendidly effective when the patient feels cold, weak 
and faint, and the pain is so great as to cause him to flex his body upon his 
thighs. Even when neuralgic or rheumatoid, such a condition is promptly 
relieved by colocynth. 
In atonic dyspepsia, with bitter taste, bitter yellow eructations, bloating 
after eating, with sharp, griping or cutting pain in the umbilical region 
minute doses give excellent results. When gaseous accumulations cause 
disturbances of breathing, or cardiac palpitation, with loud belching and 
expulsion of flatus, and nausea and vomiting are present, colocynth should 
be given with prospects of prompt relief. 3- Specific Medicine Colocynth 
(1 x dilution), gtt. j to x; Water, flgiv. Mix. Sig.: One teaspoonful every 
3 or 4 hours. Where there is a lack of nortnal secretion 5 drops of tincture 
of capsicum may be added to the mixture. 
318 INDIVIDUAL DRUGS. 
With similar symptoms minute doses act well in cholera infantum; 
in chronic diarrhoea with slimy stools and tympanites; in diarrhoea from 
overeating or improper food; and in dysentery with great tormina, tenesmus 
and cutting pain, with ineffectual efforts at stool it is one of the most certain 
of agents to relieve. In intestinal and hepatic torpor, with bloating and 
dry scybalous stools it should be given in somewhat larger doses (1/4 to 1 
drop of Specific Medicine Colocynth). When persistent headache depends 
upon the stomach and bowel perversions named above it is often corrected 
by colocynth. In that form of lumbago and sometimes pressure sciatica, due 
to gaseous accumulations in the bowels, colocynth, capsicum, and bryonia 
should be considered. The dose should not be large enough to purge. 
Colocynth is useful in neuralgia of the viscera in the parts supplied by 
the splanchnic nerves, as neuralgic colic. Other nerve endings seem to 
respond to it, for it relieves ovarian neuralgia, orchialgia, and sometimes 
neuralgia of the fifth nerve, when the characteristic cutting pain prevails. 
It should be given also when colicky pain precedes or accompanies amenor- 
rhcea. 
CONDURANGO. 
The bark of Gonolobus Cundurango, Triana (Marsdenia Condurango, Reichenbach) 
(Nat. Ord. Asclepiadaceae). South America, especially Ecuador. 
Common Names: Cundurango, Eagle Vine, Mata-peroo. 
Principal Constituent.-A supposed glucoside condurangin, giving also alkaloidal 
reactions. 
Preparation.-Fluidextractum Condurango, Fluidextract of Condurango. Dose, 
5 to 30 drops. 
Action and Therapy.-A drug of considerable power, introduced into 
medicine in 1871 as a cure for syphilis and cancer of the stomach, in both 
of which it has but an unsustained reputation. It is thought, however, by 
competent clinicians, to have some retarding effect upon the latter, by its 
favorable action upon the mucosa. Most probably it is little more than a 
pain reliever in mild gastralgia and a tonic in gastric debility. It is usually 
administered in the form of a wine (flgss. to fl3j), or the fluidextract 
(5 to 30 gtt.); sometimes a decoction (bark, gss. to Water, Oj, boiled down 
to Oss) is given in tablespoonful doses 3 times a day. A little hydrochloric 
acid is suggested by Hare to be given with it in gastric carcinoma on account 
of the absence of that acid in the gastric juice under such conditions. 
Condurangin acts powerfully upon the nervous system, inducing in 
animals, impaired appetite, vomiting, ptyalism, muscular weakness, con- 
vulsions, and paralysis. 
The full grown fruit, gathered green, of Conium maculatum, Linne (Nat. Ord. Um- 
belliferae). Europe and Asia; naturalized in the United States. 
Common Names: Hemlock, Poison Hemlock, Spotted Hemlock. 
Principal Constituents.-Five alkaloids of which the intensely poisonous liquid 
coniine (C8HnN) is most important; the others are: conhydrine (CgHnNO), pseudo- 
conhydrine (CsHnNO), methyl-coniine (C9Hi#N), and ethyl-piperidine (CtH^N). 
Preparation.-Specific Medicine Conium. 1/30 to 3 drops. 
Specific Indications.-Nervous excitation and excessive motility, with 
or without pain; neuralgic pain; pain in the aged, and when there are caco- 
olastic deposits; gastric pain; nervousness and restlessness; mild maniacal 
CONIUM 
319 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
excitement; persistent spasmodic or hacking cough; enfeebled state of the 
sexual organs, with late and scanty menstruation. 
Action and Toxicology.-Conium does not affect the intellectual portion 
of the brain; and it acts but feebly on the spinal cord. It does, however, 
powerfully depress the peripheral motor endings, and in excessive amounts, 
the sensory terminals. Only very large doses affect the circulation and the 
respiration, when blood pressure falls and respiration becomes paralyzed. 
The latter is the cause of death by conium and is due to the combined re- 
sults of depression of the respiratory center in the medulla and the nervo- 
muscular paralysis of the muscles of respiration. Involuntary muscles are 
not affected by conium, nor is the heart-muscle or nerves appreciably 
affected. 
Full doses of conium produce dryness of the throat and thirst, nausea, 
dizziness, sinking at the stomach, numbness, muscular relaxation, and 
depression of the circulation. Toxic amounts cause staggering gait, mus- 
cular heaviness and prostration, with failure of locomotion, ascending 
paralysis, difficult and labored articulation, dyspnoea, dilated pupils, 
palpebral ptosis, and convulsions terminating in death. In rare instances 
coma ensues, but usually consciousness and the intellect remained unim- 
paired until death. The most marked symptoms of poisoning are the 
staggering gait, drooping eyelids, and ascending muscular prostration. 
In poisoning by conium the emetic may be used, but it is preferable to 
repeatedly wash out the stomach by means of the stomach pump. Artificial 
respiration and heat are to be used, and strychnine, atropine and digitalis, 
as well as the diffusible stimulants, to sustain respiration and the circulation. 
Therapy.-External. Locally applied extract of conium, or the pow- 
dered drug, relieves the pain of cancerous growths and ulcers. Locke 
advised, 1$. English Extract of Conium, 3 i j; Petrolatum, 5vj. Mix. 
Apply locally. 
Internal. Conium is a remedy for excessive motility and for pain. 
It also favors sleep, not because it is a hypnotic like opium, but because it 
relieves pain when that is the cause of the sleeplessness, or when due to an 
excitable action of the heart. It is also a remedy for the restlessness, 
with or without pain, associated with reproductive weakness, or due to 
sexual excesses. With this is a state of apathy, frequently frigidity in the 
female, and imperfect menstruation and leucorrhoeal discharges. The 
mentality is disturbed, often to the verge of mania. In such mild forms of 
nervous unrest and excitability small doses of conium will render good 
service. 
Chorea is one of the incoordinate disorders that is sometimes relieved 
by conium, but not all cases respond to it. It has been advised in tetanus, 
but is insufficient except in doses which would be equally as dangerous as 
the disorder itself. It is better adapted to control the excessive movements 
of hysteria and mania, but in the former having little effect upon the 
psychic phase of the disorder. It has been used in teething, when twitching 
of the muscles is present, in laryngismus stridulus, also in whooping- 
cough, but we have safer and more satisfactory remedies for these affections. 
Some cases of epilepsy due to masturbation have been relieved by conium, 
and it lessens the movements of paralysis agitans. 
320 INDIVIDUAL DRUGS. 
As a remedy for pain conium is fairly efficient, but it takes fair-sized 
doses to accomplish results. As the terminals of the sensory and motor 
nerve.s are directly affected by the drug, it is best adapted to peripheral 
pain with excessive mobility. Thus it relieves spasmodic neuralgia, neural- 
gia from carious teeth, ovarian neuralgia, and gastralgia. In gastric ulcer 
it is quite efficient and safe, while for relief of pain and to give rest it is a 
most important drug in gastric carcinoma. If there is much destruction of 
tissues it is less effective, but tends to keep the surrounding part obtunded 
and muscularly quiet, notwithstanding the statement that it has no con- 
trol over involuntary musculature. In the intestines, however, it does not 
seem to lessen peristalsis, and is therefore not constipating, like opium and 
morphine. Conium has been used for so-called chronic rheumatism, 
especially in the aged, who complain of muscular soreness and joint pains, 
with loss of sleep. Given within bounds it may relieve and can do no 
harm. Sometimes it relieves pruritus, especially the senile form so distress- 
ing to old people and preventing rest and sleep. 
Conium sometimes reduces glandular swellings. It frequently causes 
the disappearance of nodular masses in the axillary and mammary glands. 
By some it has been assumed that these are carcinomatous. There is no 
evidence of it having been of any service in dissipating ulcerating growths 
of the breast; therefore it is safe to assume that such nodules as are in- 
fluenced by conium are probably not cancerous, but more than likely of a 
strumous character. At any rate we are not justified in delaying necessary 
measures by a long course of conium medication with uncertain prospects 
of relief in undoubted scirrhus of the breast. It may, however, be applied 
and be given to relieve pain even when a cure is not possible. It relieves 
the pain of swollen mammae during the menstrual periods and mitigates 
the distress of spasmodic dysmenorrhoea. 
In acute mania conium sometimes acts with great promptness. While 
occasionally subduing violent cases it is best adapted to those with mild 
excitability, great restlessness, with more or less wandering of the mind- 
much like the low delirium attending prostrating fevers. In fact, it is often 
useful, but must be carefully exhibited, in true typhomania, with subsultus 
tendinum. The field for conium in nervous disorders is still open to 
exploration, with the prospect of finding it adapted to a wide variety of 
nervous affections with excitation and muscular impressibility. 
CONVALLARIA. 
The rhizome and rootlets of Convallaria majalis, Linne. (Nat. Ord. Liliaceae.) 
Common Name: Lily of the Valley. 
Principal Constituents.-Two glucosides: convallamarin (CmHuOu), a bitter, crystal- 
line powder, and convallarin (C34H620h), the acrid principle. 
Preparation.-Specific Medicine Convallaria. Dose, 1 to 10 drops. 
Specific Indications.-Cardiac irregularities due to mechanical im- 
pediments; mitral insufficiency; feeble circulation and low arterial tension; 
dropsy of cardiac origin; palpitation and vehement heart action, with 
arrythmic movements, dyspnoea, and diminished arterial pressure; feeble, 
quickened pulse, with capillary obstruction. 
321 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-In its effects upon the human circulation con- 
vallaria closely resembles that of its more powerful congener, digitalis, 
without, however, causing the unpleasant disturbances occasioned by that 
drug. Unlike digitalis it is not cumulative, nor is it distinctly poisonous. 
Moreover, it has a laxative action, and like digitalis, increases diuresis 
secondarily, by its effects upon blood pressure. 
Like digitalis, convallaria may be used where there is feeble circulation 
and low blood-pressure. While digitalis is the more often indicated, some- 
times convallaria is more effective on account of the disturbing extra- 
vascular effects of the former. Convallaria appears to act best in those 
cases of circulatory failure in which there is imperfect circulation within 
the heart itself and probably due to capillary resistance or peripheral 
circulatory enfeeblement. By relieving the latter the cardiac embarrass- 
ment is removed. Convallaria slows the pulse and gives increased force 
to the heart-beat. It undoubtedly tones the heart muscle and strengthens 
its action. By the double action of augmenting the power of the heart and 
the tone of the vessels, as well as by its secondary7 effect of increasing renal 
activity, it acts extremely well in dropsy of cardiac origin. Palpitation and 
irregular heart movements, dyspnoea, diminished urinary secretion, al- 
bumen, hepatic fullness and engorgement, and oedema-symptoms of this 
form of cardiac insufficiency, gradually disappear under small and con- 
tinued doses of this drug. Moderate doses calm cardiac excitement, such 
as is due to overexertion and the excessive use of tobacco. Cardiac arryth- 
mia and hurried action of the heart are especially benefited by it. 
The heart irregularities corrected by convallaria are not those due to 
organic degeneration, but rather those of an obstructive character, due to 
mechanical causes, as when the mitral valves are involved. Thus it is 
especially valuable in mitral insufficiency, with its attendant dyspnoea and 
palpitation. When acting favorably the heart action becomes slower and 
stronger, normal rhythm is established, arterial pressure increased, respira- 
tion deepened, and the sense of suffocation, with the distressing and painful 
desire for air, is dispelled. A drug that will bring about these results and do 
it kindly is an ideal heart stimulant, and such is convallaria. Convallaria 
relieves the sense of praecordial oppression and faintness that so frequently 
follows prostrating diseases. Not alone is it a heart tonic, but a gastric 
tonic as well. Therefore it is indicated by the cardiac debility that follows 
typhoid fever, la grippe, acute articular rheumatism, and other heart- 
enfeebling diseases. When a heart stimulant is needed during acute 
rheumatism, convallaria is, as a rule, preferable to digitalis, and it is often 
valuable in the early stages of rheumatic carditis and endocarditis, using it 
in fractional doses. Convallaria is of less service in stenosis of the aorta 
than in mitral disorders. 
The rhizome of Corallorhiza odontorhiza, Nuttall. (Nat. Ord. Orchidaceae.) Rich 
woods in eastern half of the United States. Dose, 1 drachm. 
Common Names: Coral Root, Chicken Toe, Crawley, Dragon's Claw. 
Principal Constituents.-Has not been analyzed, but probably contains potassium 
nitrate. 
Preparations.-1. Tinctura Corallorhiza, Tincture of Coral Root. (Coral root, §iv; 
Dilute Alcohol [or Whisky] Oj.) Dose, 1 to 2 fluidrachms. 
2. Infusum Corallorhiza, Infusion of Coral Root. (Crushed rhizome, 5ss; Boiling 
Water. Oi). Dose. 1 to 2 fluidounces. 
CORALLORHIZA. 
322 INDIVIDUAL DRUGS. 
Specific Indications.-General prostration, malaise, hacking cough, loss 
of appetite, reduced weight, pleuritic pain, bronchial irritation and low 
pyrexia. 
Action and Therapy.-This is the most perfect diaphoretic we know of, 
duplicating the natural process of perspiration when given in small doses, 
and increasing the watery contents when administered in hot infusion. 
It even excels asclepias, is pleasant to the taste, acts kindly upon the 
stomach, and lacks the heart depressing qualities of jaborandi. It was once 
largely used in fevers. Its principal use is in subacute inflammatory dis- 
orders of the respiratory tract, being especially valuable in the declining 
stages of bronchopneumonia, of a low but inactive type, with much de- 
pression, prostration after cough or effort, copious, heavy expectoration, 
and general debility. For convalescence from such states and after bron- 
chitis, la grippe, and pneumonia it is an ideal remedy. In those of a phthis- 
ical build-the hippocratic type, much hacking cough, loss of weight, 
lack of appetite, poor digestion, pleuritic pains, and general prostration- 
yet not actually consumptive, it is one of the best tonics we have ever 
employed. The appetite is the first to respond, cough and pain cease, there 
is better action of the kidneys and skin, and general recuperation gradually 
takes place. For dry bronchial irritation, with wheezing, tightness of the 
chest, paroxysms of irritable cough, together with a dry or inactive skin, 
coral root is extremely effective. In respiratory debility corallorhiza acts 
slowly but surely. A hot infusion promotes menstruation and suppressed 
lochia and relieves after-pains, but as many other agents operate equally 
as well this agent is too expensive to use for these purposes. It is to be 
regretted that its extreme scarcity makes corallorhiza an almost unob- 
tainable drug. 
An oleoresin derived from species of Copaiba growing in South America. Dose, 5 to 
30 drops. 
Description.-A viscid, pale-yellow or brownish-yellow liquid, without or with a 
faint fluorescence (green), and having a bitter, acrid, and persistent taste, and a distinctive 
aroma. Soluble in chloroform, ether, dehydrated alcohol, and volatile or fixed oils; partly 
soluble in alcohol; insoluble in water. 
Specific Indications.-Vesical pressure and tenesmus, frequent urging 
to urinate, the urine passing in drops; itching, burning or smarting in the 
urethra after urinating; urethral mucoid discharges; laryngeal irritation; 
cough, with thick tenacious sputum, accompanied by loud rales. 
Action.-Copaiba is a stimulating antiseptic when applied to the skin 
and mucosa. Small doses taken internally act as a stimulant and anti- 
septic diuretic. It restrains excessive mucous discharges. When swallowed 
it causes gastric warmth, unpleasant eructations, and sometimes nausea 
and vomiting. Continued use impairs the digestive processes. It is 
readily absorbed, imparting its odor and bitterness to the secretions. 
While apparently eliminated by all the emunctories, it is chiefly passed 
in the urine in company with glycouronic acid. Large doses occasion gastro- 
enteritis and haematuria. A transient measles-like eruption on the skin, with 
unpleasant formication and itching, or an erythematous, urticarial or bullous 
outbreak may occur from its use. It is not determined whether this is due 
to elimination-irritation, or to gastric disturbances produced bv the drug. 
COPAIBA. 
323 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Therapy.-External. Copaiba is sometimes applied to frost-bites and 
chilblains, sore nipples, old ulcers, and anal fissures, and to fistulous tracts 
to soften hardened edges and surfaces; also in sluggish chronic skin af- 
fections when a stimulating antiseptic action is desired. 
Internal. Copaiba is a remedy for excessive mucous discharges after the 
subsidence of acute inflammation. For this purpose it is rarely used in 
chronic bronchitis, especially when coincident with a catarrhal condition 
of the bladder. It is of much value in intractable gonorrhoea in the male 
to reawaken a dormant infection and recreate the active symptoms, after 
which the smaller doses are used to restrain the discharge and antisepticize 
the membranes. It should never be used in the acute inflammatory stage 
of gonorrhoea, with pronounced urethral irritation and profuse secretion. 
This stage should be treated with 3- Specific Medicine Aconite, gtt. x; 
Specific Medicines Gelsemium and Cannabis, aa fl 5 j; Simple Syrup, q. s. 
fl5 iv. Mix. Sig.: One teaspoonful every 3 hours. Having used the 
required local application, and rendered the urine bland by the use of small 
doses of sodium bicarbonate well diluted, employ the following after the 
acute phase has subsided: 1$ Copaiba, fl3j; Alcohol, flgj. Mix. Dose, 
5 to 10 drops in sugar and water 4 times a day. If chronic or unduly pro- 
longed use the following: Copaiba; Spirit of Nitrous Ether, aa fl^ss; 
Liquor Potassse; Essence of Cinnamon, aa fl5j; Mucilage of Acacia; Simple 
Syrup, aa fl§j. Mix. Sig.: One teaspoonful after each meal. Copaiba 
only helps gonorrhoea when brought in direct contact with the parts 
affected, as it does when passed in the urine. For this reason it is more 
effectual in the male than the female in whom at least a part of the in- 
fection is vaginal. It is also less valuab e by injection than when used in- 
ternally. The foregoing treatment is Locke's method, and is adapted to 
otherwise unconquerable cases. Most cases of gonorrhoea are now readily 
cured by more modern means. 
The rhizome and rootlets of Coptis trifolia, Salisbury. (Nat. Ord. Berberidaceae.) A 
plant of dark, cold swamps and sphagnous woods, found in Siberia, Greenland, and Iceland, 
and in the United States, following the Appalachians as far south as Alabama. 
Common Names: Gold Thread, Mouth Root, Canker Root. 
Principal Constituents.-Two alkaloids: berberine (yellow) and coptine (white). It is 
devoid of starch, tannin or resin. 
Preparations.-1. Decoctum Coptis, Decoction of Coptis. (Coptis, 5ii, to Water, 
gviij.) Dose, 2 to 6 fluidrachms. Used freely as a local wash. 
2. Tinctura Coptis, Tincture of Coptis. (Coptis, §j; Diluted Alcohol, Oj.) Dose, 
30 to 60 drops. 
Specific Indications.-Aphthous ulceration; atonic dyspepsia; thrush. 
Action and Therapy.-External. The most effective application for 
thrush in infants. The decoction should be freely applied and at the same 
time given internally. The infusion or the tincture may be used, with or 
without hydrastis, in aphthous ulcers of the mouth. 
Internal. Coptis is a pure bitter and one that ought to be more generally 
used. It ranks with quassia, calumba, gentian, and similar agents in 
efficiency and may be used for many of the purposes for which hydrastis is 
employed. Its use in the stomachic disorders associated with, preceding 
or following thrush is the most certain in therapy, and its internal employ- 
ment hastens the local cure, which it quickly accomplishes. Coptis is a good 
COPTIS. 
324 INDIVIDUAL DRUGS. 
stimulant for atonic indigestion and dyspepsia, with deficiency in the normal 
flow of the peptic juices. 
CORIANDRUM. 
The dried, ripe fruit of Coriandrum sativum, Linne. (Nat. Ord. Umbelliferae.) Italy, 
and cultivated in other parts of the world. Dose, 20 to 60 grains. 
Common Names: Coriander, Coriander Fruit, Coriander Seed. 
Principal Constituent.-An aromatic oil (Oleum Coriandri). 
Preparation.-Specific Medicine Coriander. Dose, 10 to 60 drops. 
Action and Therapy.-Stimulant and carminative; but mostly used as 
an adjuvant or corrigent to other medicines. 
CORNUS. 
The bark and root-bark of Cornus florida, Linne. (Nat. Ord. Cornaceae.) A beautiful 
flowering tree of the United States. Dose, 5 to 60 grains. 
Common Names: Dogwood, Flowering Dogwood, Flowering Cornel. 
Principal Constituents.-A bitter principle, cor nine, and 3 per cent of tannin. 
Preparation.-Specific Medicine Cornus. Dose, 1 to 60 drops. 
Action and Therapy.-Cornus is tonic and feebly antiperiodic. In times 
of scarcity it has been used in lieu of cinchona, or when cinchona or quinine 
is not tolerated. Its tonic properties may be utilized after fevers, par- 
ticularly of the periodic type; and it is said to be useful in headache from 
quinine, pyrosis, and general exhaustion. It is adapted to cases with feeble, 
relaxed tissues, with weak pulse and sub-normal temperature. It has been 
suggested as useful in gastric ulcer. The preferred doses are from 5 to 20 
drops. 
CORYDALIS. 
The tubers of Dicentra canadensis, DeCandolle. (Nat. Ord. Fumariacese.) Eastern 
half of the United States, in rich soils of woods. Dose, 10 to 60 grains. 
Common Names: Turkey Corn, Squirrel Corn, Wild Turkey Pea. 
Principal Constituents.-The alkaloid corydaline (not the resinoid corydaliri), resin, 
and fumaric acid. 
Preparation.-Specific Medicine Corydalis. Dose, 10 to 60 drops. 
Action and Therapy.-Once a very popular Eclectic medicine, corydalis 
seems to have fallen into unmerited neglect. It is decidedly alterative and 
tonic. While not distinctly antisyphilitic, it may be used among other 
alteratives for the syphilitic dyscrasia and for scrofulosis, and the at- 
tendant evils that accompany such debility. In atonic leucorrhoea in strum- 
ous subjects it may be exhibited with good effect, and it may be given as a 
tonic in digestive atony with dysentery or diarrhoea in pot-bellied children 
with foul breath and poor digestion. It should be revived as a remedy 
to promote waste and repair. 
CRATJEGUS. 
The ripe fruit and bark of (1) Crataegus Oxyacantha, Linne, and (2) other species of 
Crataegus. (Nat. Ord. Rosaceae.) 1. England and other parts of Europe and in Central 
and Northern Asia; 2. America. 
Common Names: (1) English Hawthorn, May; (2) Haw, Red Haw, Hawthorn, 
Thorn. 
Principal Constituents.-The fresh bark contains a water soluble, crystallizable, bitter 
body, little soluble in alcohol. The flowers of the English hawthorn contain trimethylamine 
(N [CH3] 3), a circulatory depressant. 
Preparation.-Specific Medicine Crataegus. Dose, 5 to 60 drops. 
325 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Tentatively the indications for crataegus may be 
stated thus: Cardiac weakness, with valvular murmurs, sighing respira- 
tion, or other difficult breathing, especially when associated with nerve 
depression or neurasthenia; mitral regurgitation, with valvular insufficiency; 
cardiac pain; praecordial oppression; dyspnoea; rapid and feeble heart 
action; marked anemia, associated with heart irregularity; cardiac hyper- 
trophy; and heartstrain, due to over-exertion or accompanying nervous 
explosions. 
Action and Therapy.-The bark, fruit and leaves of several species of 
the genus Crataegus have in the past been used as astringents and tonics. 
Though a well-known wild shrub of thickets and commonly cultivated 
hedge and ornamental plant, the English hawthorn seems to have largely 
escaped the exact investigators of medicinal plants until a quite recent date. 
In fact, crataegus is one of the most recently introduced medicinal agents 
of plant origin. Furthermore, it is distinctive in occupying almost wholly 
a position in cardiac therapy, though recognized to some extent as a general 
tonic. Investigators are divided as to its activity, some claiming it only 
as a functional remedy, while others go so far as to claim it curative of many 
heart irregularities, even in the presence of an actual organic disease of that 
organ. Among the conditions in which crataegus is accredited with good 
work are angina pectoris, endocarditis, myocarditis, and pericarditis, 
valvular incompetency with or without enlargement of the rings, rheumatism 
of the heart, dropsy depending on heart disorders, neuralgia of the heart, 
tachycardia, and in atheromatous conditions of the vessels. The exact in- 
dications are as yet none too well determined, enthusiastic admirers of the 
drug having unwittingly overestimated its power. There is no doubt, 
however, of its value in many of the conditions mentioned, especially the 
functional types; and there can be no question as to its value as a tonic to 
the heart-muscle. It is not poisonous, has no cumulative effect, and 
apparently from reports of a large number now using it, may be useful to 
control many of the symptomatic results depending upon a badly functionat- 
ing or tired heart. Crataegus has been suggested to rest that organ and 
thereby guard against arteriosclerosis. It is a new remedy still on trial; 
and as yet with no rational explanation of its reputed powers. The smaller 
doses are suggested as more likely to succeed than full doses. 
Creosote, Creasote. 
A liquid obtained in the distillation of wood tar, and composed chiefly of a mixture of 
phenols and their derivatives, principally guaiacol and creosol. It should be carefully kept 
in dark-amber, tightly-stoppered bottles. Dose, 1 to 8 minims. Creosote derived from 
Beech wood-tar is preferred by many clinicians. 
Description.-A highly refractive, oily, nearly colorless or yellowish liquid, having 
a sharp caustic and burning taste, and a peculiarly penetrating and smoke-like odor. 
Creosote mixes with alcohol, ether, and oil; and is but very slightly soluble in water. 
Action and Therapy.-Creosote is antiseptic and antipruritic. It 
relieves itching more perfectly than does carbolic acid. Its persistent and 
disagreeably penetrating odor, however, has militated against it, so that it is 
seldom used where the former may be applied. Creosote upon cotton may 
be packed into the cavity of a carious tooth, provided the nerve is exposed, 
CREOSOTUM. 
326 INDIVIDUAL DRUGS. 
to relieve toothache, almost immediately stopping pain. A solution 
(1 to 200) daily sprayed upon the tonsils will often prevent the recurrent 
winter attacks of tonsillitis in children predisposed to such invasions. In 
the form of Aqua Creosoti (1 part of creosote to 100 of freshly boiled distilled 
water) it may be used as a lotion, or injection for many of the purposes 
for which phenol is similarly employed (see Phenol). The vapor of creosote, 
generated from hot water or from mixtures of alcohol (1 to 3), chloroform, 
or other solvents, or from distribution on cotton placed in a properly 
devised inhaler, is largely employed in subacute laryngitis, subacute 
bronchitis, and in pulmonary tuberculosis chiefly to check excessive purulent 
expectoration. It is very effective when used in this manner, and is also of 
service to control or mask the fetor of ozaena. This, in fact, is the best use 
for creosote. It should not be used in acute inflammations, nor when there 
is a tendency to pulmonary hemorrhage. 
Internal. The physiological effects of creosote are very similar to those 
of phenol and treatment of excessive doses is the same as for that drug. 
(See Phenol.) Small doses of creosote sometimes relieve nausea. In fer- 
mentative dyspepsia caused by excessive indulgence in sugars and sweets, 
and in yeasty fermentation, with pyrosis and pain, it is of signal value. 
It checks fermentation through its antiseptic action and obtunds the 
gastric nerve-terminals by its anaesthetic power. 
Since 1873, when Reichenbach proposed creosote for the cure of 
pulmonary consumption, it has been sporadically revived from time to time 
for various purposes in the treatment of that disease. Time has proved its 
futility as a specific germicide, however, in that dread plague, and no one 
with practical experience now believes it to have the least effect upon the 
tubercle bacillus within the body. The most it can do is to favor expectora- 
tion, lessen fetor of the excretions, and if not carried too far, stimulate 
digestion. The apparent good it has accomplished as an antiseptic ex- 
pectorant is more than offset by the disturbing action it has had upon the 
stomach; for to produce much effect it must be given too long and in doses 
too large to insure the safety of good digestion. When taken for a prolonged 
period the patient becomes possessed of a disgust for medicine and food, 
and gastro-intestinal irritation becomes so pronounced as to induce nausea, 
vomiting and diarrhoea, with the nervous depression that results from such a 
condition. It is far better, in consumption, to resort to milder means which 
conserve the powers of digestion than to risk the use of any medicine which, 
given beyond the narrowest bounds, creates a barrier to good digestion and 
assimilation. It were better to confine the use of creosote wholly to in- 
halations, which really do some good, and dispense altogether with its 
internal exhibition in phthisis. Much of the good that has followed its 
employment has come from the concurrent use of oils and fats, good hy- 
gienic measures, and properly selected foods. 
Some prefer to use Creosote Carbonate, a sticky liquid but of scarcely 
any taste or odor. The dose is from 1 to 20 grains. Creosote is one of the 
fetishes of medicines, the failure of which to fulfill the preposterous claims 
of its advocates has helped largely to encourage faith in the so-called art 
of drugless healing. 
327 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
CRETA PRA)PARATA. 
Prepared Chalk, Drop Chalk. (Formula: CaCO»). 
Chalk, prepared from native calcium carbonate by processes of levigation, elutriation, 
and drying. 
Description.-A white or grayish-white, non-crystalline powder, or conically moulded 
drops, without odor or taste. Insoluble in water and alcohol; produces salts in solution 
by the action of acetic, hydrochloric or nitric acid, with strong effervescence. Dose, 15 to 
60 grains. 
Preparations.-1. Pulvis Creta Compositus, Compound Chalk Powder. (Prepared 
Chalk, Acacia, Pulverized Sugar.) Dose, 30 to 60 grains. 
2. Mistura Creta, Chalk Mixture. (Compound Chalk Powder, Cinnamon Water, 
Water.) Dose, 4 fluidrachms. 
Related Salt. Calcii Carbonas Pracipitatus. Precipitated Calcium Carbonate, Pre- 
cipitated Chalk. A fine white tasteless and odorless powder. Dose, 15 to 60 grains. 
Action and Therapy.-External. Prepared chalk is antacid, astringent, 
detergent, and sedative to the mucous membranes, and is frequently in- 
corporated into liquid and powdered dentifrices. It forms a good dusting 
and absorbing powder to prevent chafing and excoriations, and for use 
upon skin diseases, and in excessive sweating; and as an absorbent and 
protective for burns and ulcers. Precipitated calcium carbonate is too gritty 
for use in tooth-powders. 
Internal. Prepared and precipitated chalk are antacid, astringent and 
absorbent and act well in acidity of the stomach and in acid diarrhoea. 
Chalk mixture, with camphorated tincture of opium, is much used in 
diarrhoea with acid stomach and sour eructations and stools. Its use 
should be preceded by a saline purge or castor oil. It is little employed in 
Eclectic practice. 
CROCUS. 
The stigmas of Crocus sdtiva, Linne (Nat. Ord. Irideae). Asia Minor; much cultivated 
in Europe. 
Common Name: Saffron. 
Principal Constituents.-Contains the glucoside crocin (polychroit-C44H70O28) and 
picro-crocin or saffron bitter (CssHeeOn). 
Preparation.-Tinctura Croci. Tincture of Crocus. Dose, 1 to 60 drops. 
Action and Therapy.-Reputed diaphoretic and emmenagogue, this 
agent was formerly used in amenorrhoea, dysmenorrhea, and suppression 
of the lochia. Five-drop doses of the tincture of crocus is advised for 
menorrhagia, with dark clotted losses; and the infusion (Saffron, 5i; hot 
water, Oj), in doses of 1 to 3 fluidounces to hasten the appearance of the 
eruption in measles. It must not be confounded with "Dyer's Saffron" 
(Carthamus tinctorius), which see under Carthamus. It may be used to color 
tinctures orange yellow, but it is too expensive for that purpose. 
CUBEBA. 
The unripe, full-grown fruits of Piper Cubeba, Linne, fil. (Nat. Ord. Piperaceae.) 
Java, Borneo, Sumatra, Prince of Wales Island, and other isles of the Indian Ocean. Dose, 
5 to 30 grains. 
Common Names: Cubeb, Cubebs. 
Principal Constituents.-A volatile oil (Oleum Cubeba), cubebin (inactive), cubebic 
acid, and cubeb resin, the latter two forming a soft resin with diuretic properties. The 
irritant, stimulant, and carminative properties are possessed by the volatile oil. 
Preparations.-1. Specific Medicine Cubeba. Dose, 1 to 30 drops. 
2. Oleoresina Cubeba, Oleoresin of Cubeb. Dose, I to 15 grains. 
3. Oleum Cubeba, Oil of Cubeb. Dose, 1 to 15 minims. 
328 INDIVIDUAL DRUGS. 
Specific Indications.-Gonorrhoea after discharges have almost ceased; 
enfeebled conditions of the large intestine and rectum; subacute inflamma- 
tion of the urinary passages; urethral burning and scalding of urine in 
women; debility with profuse mucous discharges. 
Action and Therapy.-Cubeba is mildly stimulant, expectorant, stom- 
achic and carminative. It arrests excessive mucous discharges, particularly 
those of the urethra. Large doses quicken the pulse and increase its volume, 
and sometimes elevate the temperature; occasionally it causes nausea, 
vomiting, burning pain, griping and purging. Not uncommonly it pro- 
duces a rash-like cutaneous eruption. It is eliminated by the urine and by 
the bronchial membranes, increasing normal and restraining abnormal 
secretions. It imparts its peculiar aromatic odor to the urine and to the 
breath. 
Cubeb is employed to restrain mucous discharges after the subsidence 
of active inflammation, and usually after active discharge has nearly 
ceased. In late stages of intractable gonorrhoea in which there persists a 
small amount of flow, and in gleet, 30 grains of the powdered berries may 
be administered to awaken activity-to produce a substitutive inflamma- 
tion-after which the case appears to improve. The drug should be pushed 
until urination is painful, and then lessened from day to day until a cure 
is effected. 
While contraindicated in acute inflammation, cubeba is often of service 
in so-called chronic inflammations, especially in cystitis, and in chronic 
inflammatory states of the urethra in women. It first aggravates and then 
cures. The greater the debility the more it is indicated, and urethral 
burning is the chief indication for it. The urethral scalding sensations 
frequently experienced by women upon urinating, especially at the menstrual 
period, is greatly relieved by it, as is irritation and burning of the vulva. 
In these cases there is usually constant urging to pass urine, the effort being 
attended with much pain. Five (5) drops of Specific Medicine Cubeba 
should be given every 3 or 4 hours. The same dosage will often remedy 
nocturnal incontinence of urine in children. 
Cubeba is useful in chronic sluggish sore throat, with relaxed mem- 
branes and over-secretion. From 5 to 10 drops of the specific medicine 
should be given suspended in syrup, and the same dose upon sugar is useful 
in chronic atonic respiratory catarrhs, with profuse expectoration, and for 
nasal catarrh. 
Smoking cubebs is a popular method of treating nasal catarrh and hay 
fever. Care must be had not to blister the roof of the mouth, an untoward 
effect that is produced by the oil in a good quality of cubeba. 
CURCUMA. 
The rhizome of Curcuma longa, Linne (Nat. Ord. Zingiberaceae). Southern and 
eastern Asia, and extensively cultivated in China, Hindustan, and other countries. 
Common Names: Turmeric, Curcuma. 
Principal Constituent.-Cur cumin, a yellow coloring matter. 
Preparation.-Specific Medicine Curcuma. (A coloring agent.) 
Action and Uses.-While turmeric is a mild aromatic stimulant, it is 
almost wholly used as a test for alkalies, and to color ointments and other 
oharmaceutical oroducts. 
329 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
cusso. 
The female inflorescence of Hagenia abyssinica (Bruce), Gmelin (Nat. Ord. Rosaceae). 
Abyssinia. Dose, 4 to 5 drachms. 
Common Names: Kousso, Kusso, Kooso, etc. 
Principal Constituent.- Kousin (brayerin or taniin). 
Preparations.-1. Infusum Kousso, Infusion of Kousso. Dose (see below.) 
2. Specific Medicine Kousso. Dose, 1 to 2 fluidrachms. 
Action and Therapy.-Taeniacide and purgative. Kousso is among the 
rarely used though efficient anthelmintics for the removal of tapeworm. 
Being more or less irritant to the gastro-intestinal tract it is not always 
well retained by the stomach. About 4 to 5 drachms of the flowers are to be 
suspended in water, or made into an infusion, and taken in two or three 
doses at short intervals upon an empty stomach. Some prefer the fluid- 
extract in doses of 2 to 4 fluidrachms. Kousso is liable to fail unless made 
fresh and in prime condition. 
The rhizome and rootlets of Cypripedium pubescens, Swartz; and of Cypripedium 
parviflorum, Salisbury. (Nat. Ord. Orchidaceae.) Rich woods of the United States. Dose, 
5 to 60 grains. 
Common Names: (1) Ladies' Slipper, Yellow Ladies' Slipper, American Valerian, 
Yellow Mocassin Flower, Nerve Root; (2) Small-flowered Ladies' Slipper. 
Principal Constituents.-A volatile oil, tannin and gallic acids, a volatile acid, resins, 
and inorganic salts. 
Preparation.-Specific Medicine Cypripedium. Dose, 5 to 60 drops. 
Specific Indications.-Insomnia, nervous irritability, neuralgia and 
delirium, all from atony; restlessness and muscular twitching, typhomania 
and tremors in low forms of fever; wakefulness from mental unrest; men- 
strual irregularities, with despondency; tendency to dementia at the 
climacteric; mental depression from sexual abuse. 
Action and Therapy.-All of the species of Cypripedium resemble 
valerian in their effects. They are excellent nerve stimulants for weak 
women and nervous children. They improve a feeble circulation and in- 
crease the innervating power of weakened nerve centers. Though compara- 
tively feeble agents, they are nevertheless important medicines, being of 
that type of drugs which silently do great good without marked physi- 
ological disturbance. 
Cypripedium is an ideal tranquilizer for states of nervous excitability 
or irritability depending upon atony. It dispels gloom, induces a calm and 
cheerful state of mind, and by thus inducing mental tranquillity favors 
restful sleep. When nervous irritability is caused reflexly by pelvic disorders 
it is especially a useful drug. If due to organic disease it is less effectual 
than in merely functional disorders. 
We value cypripedium highly for the hypochondria of the menopause. 
We have been able to accomplish more with it than any drug except pulsa- 
tilla in worry, with fear of disaster or insanity, in women passing through 
this phase of life. It is useful in melancholia and sleeplessness due to 
menstrual irregularities, after prolonged and severe pain, and in those the 
result of nocturnal losses. It relieves the nervous unrest attending gleet, 
and the sexual erethism of debility. In the typhomania and tremors of 
low fevers it is a safe and often effectual drug, but like all others in these 
conditions it frequently fails to give relief. It acts well after long sieges 
of exhausting diseases to give nerve tone and allay the nervous manifesta- 
CYPRIPEDIUM. 
330 SMALLER YELLOW LADY'S SLIPPER 
(Cypripedium parviflorum) 
Photo by Frank H. Shoemaker 
Lincoln, Nebraska 
Courtesy of Prof. Rufus A. Lyman, 
University of Nebraska 
As Cypripedium, this plant and its variety (Gray's Bot.) Cypripedium pubescens (Larger 
Yellow Lady's Slipper) constitute the type of nervine most popular in Indian, domestic, 
botanic, and Eclectic practice. Cypripedium is believed by some to be our best single drug 
for the relief of uncomplicated chorea, sharing this distinction with Valerian and Macrotys. INDIVIDUAL DRUGS. 
tions of general debility. An excellent soothing syrup for irritable children, 
especially during dentition, was proposed by Scudder: 1$. Specific Medicine 
Cypripedium; Compound Tincture of Lavender, aa fl 5 iij; Specific Medicine 
Lobelia, fl^ji Simple Syrup, q. s. fl^iij. Mix. Sig.: Dose, 5 to 20 drops. 
If nausea occurs lessen the amount of, or omit the lobelia. 
CUPRI ACETAS. 
Cupric Acetate, Copper Acetate. (Formula: Cu (C2H3O2) 2 4"H2O.) 
Description.-Dark-green, small, prismatic crystals, inclining to a bluish color, efflores- 
cent, of a nauseous, metallic taste, and faint acetous odor. It dissolves in water and 
alcohol. 
Preparations.-1. Tinctura Cupri Aceti Rademacheri, Rademacher's Tincture of 
Copper Acetate. Dose, 1/20 to 1 drop. 
2. Specific Medicine Cuprum. Dose, 1 /20 to 1 drop. 
Specific Indications.-Skin tawny, dirty, yellowish, greenish, pallid 
or waxy; parts usually red are pale or greenish; tongue broad, uncoated, 
and pale; sluggish bowel action, with colorless discharges, or if loose, 
with pale rice-water stools; anemia, without much loss of flesh, and dirty, 
greenish tinge of skin; chlorosis; tissues full, soft and doughy; skin pale 
and transparent after hemorrhages or exhaustive discharges. 
Therapy.-Scudder was the chief advocate of copper medication in 
the Eclectic school, advising it chiefly as a blood-maker. A favorite method 
was the administration with the food of pickles prepared by the old-fashioned 
method in copper kettles. He also favored the tincture of the acetate as 
devised by Rademacher. The conditions in which it sometimes acts 
beneficially are anemia, chlorosis and leucocythemia, with general weakness, 
flabby flesh, and full but soft pulse. Under its influence the flesh becomes 
firmer and general blood-making is improved. The indications are those 
set forth above. Copper salts in minute doses are sometimes useful in the 
dry scaly skin eruptions in which arsenic is useful. 
CUPRI SUBACETAS. 
Subacetate of Copper, Cupric Subacetate, Verdigris. 
Description.-An impure mixture of several basic acetates of copper, occurring in 
irregular greenish-blue or bluish-green lumps, interspersed with light-green blotches, of a 
styptic, nauseous, coppery taste, and when powdered, of a disagreeable acetous odor. 
Water partially dissolves it, at the same time decomposing it. It is best used in powder 
or ointment. 
Action and Therapy.-External. Verdigris is poisonous and its effects and 
antidotes are those of copper poisoning. (See Cupri Sulphas.} This salt is 
used only externally. It is useful in powder form, to remove syphilitic 
verrucse, fungous growths, and callous edges; and, in ointment, as a 
parasiticide in various forms of tinea, especially that of ringworm of the scalp. 
CUPRI SULPHAS. 
Copper Sulphate, Blue Stone, Blue Vitriol. (Formula: Cu SO4. 5 H2O.) 
Description.-Large, deep-blue, transparent crystals, slowly efflorescent in the air; 
or a blue, granular powder. Copper sulphate has no odor, but is nauseous and metallic 
to the taste. It dissolves freely in water and sparingly in alcohol. Dose, 1/20 to 1/2 grain; 
as an emetic, 3 to 5 grains. 
Action and Toxicology.-Copper sulphate is irritant, astringent, and 
corrosive. Very minute quantities destroy low forms of plant life, it being 
now a common custom to kill algae in ponds and typhoid germs in water 
supply with copper salts. In moderate doses it causes vomiting. Large 
amounts produce gastro-enteritis, with violent vomiting and purging, and 
331 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
resulting in corrosion of the mucosa. Other symptoms of poisoning are 
headache, spasms, jaundice, cold clammy skin, failing respiration and 
circulation, delirium, coma, and arrest of the secretion of urine. Death is 
rare from this salt, and when it does occur it is usually sometime after its 
ingestion, the breaking down of tissues being a secondary result of the 
primary congestion. Copper salts appear to have an affinity for the 
haemoglobin of the blood, forming with it a compound known as cupro- 
haemol. Copper is stored in the liver chiefly, and in the spleen, kidney 
and thyroid, and is excreted by the bowels, the urine, the milk, and the 
saliva. It may be absorbed from denuded surfaces. In cases of poisoning 
use pure reduced iron, yellow prussiate of potassium (ferrocyanide of potas- 
sium), empty the stomach by means of the stomach pump, or apomorphine 
hydrochloride hypodermatically and give demulcents and albumens freely. 
Treat after-symptoms symptomatically. 
Chronic Copper Poisoning. Workers in copper, though not acutely 
poisoned by it, through constant exposure to the copper dust and its im- 
purities, become somewhat anemic and experience lassitude, vertigo, 
headache, aphonia, profuse greenish perspiration, tremors, and catarrhal 
and gastro-intestinal disturbances. The gums present a peculiar greenish 
or olive-colored line. This condition of chronic poisoning is best com- 
bated by frequent saline cathartics, dilute phosphoric acid (10 to 15 drops) 
before meals, and the liberal use of milk. 
Therapy.-External. Copper sulphate crystal has been used upon 
granular lids and is a relic of barbaric treatment. It is, however, quite 
effective, and probably less painful than silver nitrate. It is best adapted 
to granular conjunctivitis and to the transitional stage from acute to 
chronic trachoma, with pale, indolent follicles, and in very chronic trachoma 
with cicatricial tissue and granulations undergoing atrophy. The same 
treatment may be applied in tinea tarsi. It may also be used upon sluggish 
ulcers, warts, fungoid growths, callous edges, and chancre. Most of these 
uses are, however, archaic, and are only resorted to in rare instances at the 
present day. A 10 per cent solution destroys fungous growths (thrush) 
in the ear, and is a good cauterant after the removal of tympanic steatomata. 
A lotion (1 to 250) is a good astringent for granular diseases of the eye, and 
for chronic conjunctivitis (1 to 500). Stronger solutions (1 to 200) are 
useful as washes for malignant sore throat, leucorrhoea, and as a wet dressing 
for rhus dermatitis. A hot rectal injection (2 grains to the pint) of copper 
sulphate is said to kill the endamceba causing amoebic dysentery. 
Internal. Copper sulphate in doses of 3 to 5 grains is a quick and efficient 
emetic in narcotic poisoning. It acts without nausea and depression. If it 
fails, however, it must be quickly removed from the stomach, lest irritant 
after-effects result. It is especially valued in phosphorus poisoning. Small 
doses of copper sulphate (1/2 to 1 grain) have been advised in actinomycosis, 
and very small doses in chronic diarrhoea in exhausting diseases, with muco- 
bloody and partially feculent feces. Scudder believed it a blood-maker and 
advised it for the same purposes as for Acetate of Copper. (See Cupri Acetas). 
Drinking-water supply of springs and reservoirs suspected of containing 
typhoid germs should be treated with copper sulphate in the proportions of 1 
part of the salt to 5,000,000 to 50,000,000 of water. These proportions are 
harmless to human beings and animals, but destructive to typhoid bacilli. 
332 INDIVIDUAL DRUGS. 
DIASTASUM. 
Diastase. 
A mixture of starch-converting enzymes derived from the infusion of malt. 
Description.-An amorphous yellowish-white powder, or translucent scales, without 
taste or odor; soluble in water (turbid); practically insoluble in alcohol. It should convert 
into sugar not less than 50 times its weight of potato starch. Dose, 5 to 15 grains. 
Specific Indications.-Faulty digestion of starch; amylaceous dys- 
pepsia. 
Action and Therapy.-Diastase is a digestant of starch, converting 
that substance into sugar in the stomach when the acid content of the 
gastric juice is not over o.i per cent. It also digests starch in the mouth. 
The chief use of diastase is in so-called amylaceous dyspepsia and to split 
the starches in infant feeding where starch gruels are employed. It acts 
similarly to pancreatin and is used for much the same purposes. 
DIGITALIS. 
The leaves of Digitalis purpurea, Linne (Nat. Ord. Scrophulariaceae), carefully dried 
and preserved away from light, in close containers. Europe; cultivated in Europe and to 
some extent in America. Dose, 1 to 2 grains. 
Common Names: Foxglove, Purple Foxglove. 
Principal Constituents.-The glucosides digitoxin (very toxic and cumulative), digitalin, 
digitalein, digitonin, and digitin (inert); digitalic and antirrhinic acids, volatile oil, etc. 
There are no positively determined alkaloids in digitalis. 
Preparations.-1. Specific Medicine Digitalis. Dose, 1/5 to 1 drop. 
2. Infusum Digitalis. Infusion of Digitalis. (A cinnamon-flavored, 11/2 percent, 
infusion). Dose, 1 to 2 fluidrachms. 
3. Tinctura Digitalis, Tincture of Digitalis (10 per cent of drug). Dose, 1 to 10 drops. 
Doses of Digitalis Glucosides:-Digitoxin, 1/300 to 1/64 grain; digitalin (crystallizable), 
1/300 to 1/100 grain, (amorphous and German), 1/100 to 1/30 grain, (digitalin is so variable 
that it should not be used; it may be very actively poisonous, or may be nearly inert); 
digitalein (water soluble), 1/200 to 1/100 grain. 
Specific Indications.-Weak, rapid, and irregular heart action, with 
low arterial tension; broken compensation; weak, rapid, flaccid pulse; 
weak heart sounds; dusky countenance, with dyspnoea, cough, jugular 
fullness, and weak cardiac action; oedema, anasarca, or ascites with scanty 
supply of dark-colored urine, with weak heart action; renal congestion; 
irritable heart with weak action; heart made to beat rapidly but feebly 
by slight excitement; continuous labored breathing with weak pulsation; 
renal and cardiac dropsy; desquamative nephritis, with weak heart; capil- 
lary hemorrhage; poisoning by aconite, muscarine, or the nitrites. 
Action.-The dominant action of digitalis is upon the circulation, 
but it has no perceptible effect upon the blood. Full or even moderate 
doses may excite nausea and vomiting, and a greenish or yellowish diarrhoea. 
These effects are preceded by considerable prostration. If the stomach is 
already irritated, or there is gastro-intestinal irritation, these disturbances 
are more certain to occur. Only in toxic amounts does digitalis affect the 
respiration, first slowing and deepening, and finally accelerating the breath- 
ing. Neither do other than poisonous doses impress the nervous system, 
and then it lessens reflex activity through stimulation of Setschenow's 
center of inhibition in the medulla, and is followed by depression of the 
spinal cord and motor nerve trunks and by eventual paralysis of the 
muscles. These extreme effects on the nervous and respiratory systems 
333 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
have only been noted in animals; apparently they do not take place in man. 
Therapeutic doses, however, stimulate the cardiac inhibitory and vaso- 
motor centers of the medulla. Digitalis, in moderate doses, has little or no 
effect upon temperature, but poisonous doses lower it. When fever is 
present, however, it actively reduces the body heat, yet it is not a good 
nor safe antipyretic. It has been conclusively proved that high temper- 
ature prevents digitalis from slowing the pulse. 
In moderate doses digitalis slows the heart-action, increases the 
force of the pulse, and from these effects chiefly, raises blood-pressure. 
The diastole is prolonged and the systole is increased in vigor. The result 
of the stronger systole is to reduce the number of pulsations. Not only 
does the retarded diastole give more rest to the heart, but it is followed 
by a better contraction of the heart-muscle and some constriction of the 
arterioles, so that the blood-current is reduced in size and the quantity of 
blood sent out through the systemic arteries is lessened. The narrowed 
arterial resistance and the stronger systolic contraction are the chief 
causes of increased blood-pressure, though to a limited extent, especially 
when larger doses are given, the vaso-motor apparatus exerts some control, 
as does also a direct impression of the drug upon the walls of the vessels. 
All of the above effects are those of stimulation, never of depression, and 
digitalis, in such doses, is therefore a heart stimulant and heart tonic. 
When carried to extremes the tonic effects may be overreached, and then 
the condition verges into exhaustion from over-stimulation of the heart- 
muscle and from a failure of the normal impulse conduction from auricle 
to ventricle. This is particularly evident when a person taking full and 
repeated doses of digitalis suddenly collapses when raised from a recumbent 
to a sitting posture. So powerful is the effect upon the heart-muscle that 
tetanic contraction may occur and prevent a passage of blood through the 
heart, the tonic spasm resulting in syncope; and the exhaustion and 
syncope are so great as sometimes to prove fatal. 
The effects of digitalis may be conveniently studied under three heads, 
or stages, representing, however, but continuous action under normal and 
increased dosage rather than three actually separate conditions: (1) The 
therapeutic; (2) the toxic; and (3) the extreme toxic or lethal stages. 
(1) In the therapeutic stage the rhythm is slowed and the ventricles 
empty themselves more perfectly and by their increased force pump more 
blood into the vessels. The diastole being greatly prolonged and the force 
of the systole increased, there is produced a larger though less frequent 
pulse wave. The auricles are less affected than the ventricles, but on the 
whole the heart does more work, and were it not for the increased resistance 
in the vessels and lessened number of contractions more blood would be 
propelled into the body. As it is, the current is carried more completely to 
the extremities of the capillaries, and altogether the circulation is improved. 
(2) The second stage is sometimes absent. It takes place when the 
drug is given in overdose or for a continuous period without rest. The 
pulse becomes very slow and irregular. The ventricle dilates more com- 
pletely, thus prolonging the diastole; the systole becomes erratic in force, 
the auricular contractions approach failure, or become greatly at variance 
in rhythm with those of the ventricles. The action is rapidly going through 
334 INDIVIDUAL DRUGS. 
the transitional passage from the therapeutic to the extreme toxic stage. 
Now follows interference with the normal transmission of impulse and 
contractile wave from the sino-auricular node by way of the bundle of His. 
Some or all of the waves fail to pass from the auricles to the auriculo- 
ventricular junction (heart-block) and thence to the ventricles, the 
result being that incoordinate action develops. The ventricles, failing to 
receive the normal impulse, may fail to contract; or if they contract, do so 
by originating their own impulse. This, then, being at variance, both as to 
origin and time, with that of the auricle, causes one or more skipped beats 
(dropped beats), the ventricles usually contracting about half as many 
times as the auricles. This action progressing and increasing, the third or 
deeply toxic stage sets in. 
(3) The third stage is marked by rapid ventricular action and con- 
sequent racing of the pulse, which becomes extremely irregular and often 
shuttle-like in action. This is due to increased excitability of the heart- 
muscle to such a degree that centric nervous inhibition no longer lias any 
control over the heart. The arrythmia between auricle and ventricle is 
exaggerated and double, and triple extra-systoles spontaneously are de- 
veloped. The final result is such a disorganized coordination or confusion 
of action that the circulation cannot be maintained-a state well named 
delirium cordis-and the heart finally stops in extreme dilation. 
The effects of the first stage are due largely to vagal inhibitory activity 
and to direct action of the drug upon the heart-muscle itself. The second 
stage is due to excessive inhibition, while the heart-muscle seems to play a 
minor part; the third stage is attributed solely to spontaneously increased 
excitability of the heart-muscle, which rapidly increases the arrythmia, 
occasions the extra-systolic beats, and lastly fibrillation. Throughout 
digitalis intoxication the ventricles contract in unison, as do also the auricles, 
but the disparity in action between the auricles and ventricles displays a 
great variation from each other in rhythm. 
Having the foregoing effects of digitalis in view, it is clear that it acts 
directly upon the heart-muscle, affecting the rate and rhythm of its action. 
It regulates contractility, irritability, and directs the conductivity of the 
contractile impulse by way of the aurico-ventricular bundle of His, when- 
ever these functions are faulty. It also influences the nutrition of the 
heart permanently by allowing a more perfect supply of blood to the walls 
of the organ itself through the coronary circulation. The slowing of the 
disastole is due to stimulation of the vagus, both at its origin in the medulla 
and at its termination in the heart. The increased blood pressure is due 
chiefly to causes named above and to the vaso-motor control and the 
effects of the drug upon the vascular walls. Therefore we may sum up the 
medicinal action of digitalis upon the circulation as one of stimulation, 
giving both power and rest to the heart by prolonging the intercontractile 
period, and making its action more deliberate, and in its inhibition of the 
pneumogastric, slowing and strengthening the pulse. 
Digitalis often increases the flow of urine, but many affirm that digitalis 
has no direct diuretic power. In health it is known to generally lessen the 
secretion of both the solid and fluid constituents of the urine. Some 
contend that it slightly increases the flow of urine. It is more than probable 
335 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
that, when diuresis is the result, it is in cases in which a diminished secretion 
of urine is due to debility or some other form of cardiac embarrassment. 
Others, however, maintain different views, and Brunton asserts that 
diuresis produced by it in dropsy is due to a special action of the drug 
upon the Malpighian bodies, and not to augmented blood pressure alone. 
In overdose digitalis may cause spasm of the renal vessels, with consequent 
anuria and symptoms of cumulation. In woman, digitalis, like ergot, 
causes contraction of the uterine fibers of an enlarged or gravid uterus, 
thereby arresting hemorrhage; in man it primarily lessens the supply of 
blood to the erectile tissues of the penis, preventing or enfeebling erections 
and consequently diminishing the venereal desires. 
The manner of elimination of digitalis is unknown, it being the general 
belief that it is taken up by some tissue in the body or becomes oxidized. 
At any rate none can be detected in the urine. Nor is there unanimity as 
to the question of tissue waste, some declaring it to increase, others to de- 
crease the output of urea. 
Digitalin, digitalein, and digitoxin are powerful heart-muscle stimu- 
lants; digitalin also stimulates the vagus; all three cause a rise in blood 
pressure through vaso-motor action. Digitonin seems to oppose these 
glucosides, acting as a check, for it depresses both the heart-muscle and the 
vagus. 
Toxicology.-In connection with the toxic symptoms above noted, 
attention may be directed to the special signs of digitalis poisoning. These 
are, first, a slow, full pulse reduced to about half the number of normal beats, 
followed shortly by a tumbling or hobbling dicrotic pulse, or a shuttle-like 
action, with tumultuous heart-beat. In short of lethal doses the pulse 
may remain full and slow as long as the patient remains recumbent, but 
immediately upon rising it becomes rapid and irregular. There is nausea, 
occasionally anxiety and salivation, a sense of weight, or constriction, 
obtuse pain in the head, giddiness, disordered vision, mental disturbance, 
and rarely spectral illusions; not unfrequently a huskiness of the voice is 
present, the result of irritation of the fauces, trachea, etc. The nausea pro- 
duced by digitalis, and more quickly by digitalin and digitoxin, is preceded 
by malaise, faintness, and depression, and is exceedingly distressing. 
Vomiting temporarily relieves it, the vomited material being first dark- 
green, afterward yellow. Prostration becomes so great that the individual 
can not stand without help, and an intense disgust for food is experienced. 
Familiar objects are unrecognizable-a disturbed vision with yellowness 
or blueness supervening. Persons are recognized only by their voices. 
These effects, if not fatal, may last several days, the sleep being disturbed 
by nightmare and general unrest. Finally sound sleep and a voracious 
appetite quickly restore the individual to normal health. Exophthalmos 
occurs in many instances and the sclerotic is said to take on a peculiar 
bluish, pearl-like appearance. Death, when it occurs, is usually preceded 
by coma. Poisoning from cumulative doses early recognized usually clears 
up upon discontinuing the use of the drug. 
Poisoning by digitalis may be produced by 1/16 grain of digitalin 
(equal to 8 grains of good powdered digitalis leaves), and Taylor {Medical 
Jurisprudence, page 229) states that doses of from 1/4 to 1/2 grain would 
336 INDIVIDUAL DRUGS. 
probably produce death. If a true and uniform digitalin could always be 
obtained there would be much less uncertainty concerning its strength and 
value. Cold, belladonna, ergot, etc., increase the activity of digitalis, 
while aconite opposes its action. The latter is now considered the best 
and most available physiologic antagonist. According to Bartholow, the 
most complete antagonist to digitalis, physiologically speaking, is saponin. 
Strychnine is also a physiological antagonist. 
The poisonous effects of digitalis are best counteracted by first evacuat- 
ing the stomach by the free use of warm liquids and mechanical emetics, 
if any of it is supposed to remain in the stomach, and then administering 
brandy, wine, opium, black coffee, ammonia, ammonium carbonate, or other 
stimulants, with sinapisms to the wrists and ankles. Both external and 
internal heat should be used. A solution of tannic acid is of service, by 
forming an insoluble tannate of digitalin. Preparations containing tannin, 
such as tea, etc., may be given. After death from digitalis the gastric 
membranes were found partially inflamed and the meninges of the brain 
much injected (Taylor). 
Therapy.-External. A poultice prepared from bruised digitalis leaves 
and warm water, or the tincture incorporated into a warm flax-seed poultice, 
has given relief in renal congestion and urinary suppression. It is a danger- 
ous procedure, however, as there is no way of determining the quantity 
absorbed, and death has been known to result from excessive urination and 
exhaustion. 
Internal. William Withering, in 1785, after ten years of experimenta- 
tion-and clinical uses of digitalis in dropsies-begged leave to submit, 
among others, the following "inference": "That it has a power over the 
motion of the heart to a degree yet unobserved in any other medicine, 
and that this power may be converted to salutary ends." Thus was dig- 
italis prophetically introduced into legitimate practice as a heart medicine. 
Digitalis is preeminently the foremost heart medicine of to-day. It 
slows and strengthens the contractions, prolongs the intercontractile pe- 
riod, and thus gives both rest and power to that organ. It also contracts 
the capillaries to some degree, and chiefly through a more forceful output 
raises arterial tension, or as more commonly stated, raises blood pressure. 
There is also good reason to believe that through the influence of the vagi, 
which are probably trophic as well as inhibitory nerves, it improves the 
coronary blood supply and nutrition of the heart-muscle, though in this 
respect it has little or no advantage over cactus. Digitalis also has some 
value as a diuretic in disease, but it probably does not so act, to any degree 
at least, in health. Digitalis is the remedy for rapid and feeble heart action, 
with lack of propulsive power, lowered arterial tension, and deficiency of the 
urinary secretion. Therefore it is extremely valuable where there is a loss 
of, or broken, compensation, in moderate and acute dilatation, with mitral 
insufficiency, or in dilatation of the right heart, resulting from valvular 
(tricuspid) insufficiency, in weakness of the heart due to shock, injury, 
hemorrhage, aconite or mushroom or other poisoning, and in the heart 
weakness following low and septic fevers and pneumonia, in mitral stenosis, 
and regurgitation, and in debility of the heart-muscle. 
337 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
The true remedial power of digitalis is displayed in the treatment of 
asthenic heart diseases. It is one of the few drugs that act upon and correct 
organic changes in the heart structure; for among the other effects it will 
make the human pump fit its valves. Its power to cause strong and steady 
contractions of the cardiac muscle with consequent adaptation of the rings, 
or auriculo-ventricular orifices, its ability to raise blood-pressure, and in 
many instances its capability of increasing the renal function, make it 
by far the most generally useful of heart remedies. Locke was right when 
he declared digitalis "the true opium for the heart." It sedates (through 
stimulation) and gives comfort, steadies the heart-action, relieves dyspnoea, 
gives rest and sleep when disturbed by faulty circulation, and in dropsical 
conditions due chiefly to cardiac inefficiency assists in reducing oedema. 
The indications are distinct and must be followed: the weak, rapid, and 
irregular heart, feeble propulsion and low arterial tension. Harm nearly 
always comes from its use, even when used in ordinary doses, when there is a 
strong, vigorous heart action, with high blood pressure. Digitalis is there- 
fore a remedy for cardiac asthenia and organic debility. A caution worth 
mentioning is that physicians often judge heart action merely by "taking 
the pulse", and are thereby deceived as to the true condition of the heart. 
There are times when the pulse may be almost imperceptible, and yet, 
when the ear is placed to the chest wall it will detect a hard-working heart, 
which has all or more contractile force than it can maintain. Vaso-motor 
control is at fault and then digitalis will do harm rather than good. 
Digitalis is of great value in chronic valvular cardiac disease, with 
failing or broken compensation, but it must be used with judgment, observ- 
ing the need in the weak, fast, and irregular pulse, deficient urination, and 
dropsy. When hypertrophy of the heart overbalances dilatation, and 
evidences of arterial hyperaemia are present, digitalis is likely to aggravate 
the condition, or otherwise do harm. 
Digitalis medication is most effective probably in mitral insufficiency, 
with regurgitation, provided there are no pericardial adhesions restraining 
its effects, or advanced myocardial degeneration. It overcomes the ven- 
tricular strain dependent upon pulmonic vascular resistance, and helps, 
by contracting the ventricle rings, to attain a more perfect closure of the 
mitral valves. 
In mitral stenosis, so often associated, as it is, with degeneracy of the 
heart structure, digitalis is a less useful remedy and may even cause harmful 
effects. When a failure of the right ventricle can be ascertained, and there 
is dropsy with anuria, it may be used, and probably to good effect. Theo- 
retically the drug should do good in mitral stenosis, for it gives, under normal 
structural integrity, more power to the ventricular contractions, and by 
prolonging its relaxation allows a greater time for the blood to pass from 
the upper to the lower chamber, but the diseased myocardium may prevent 
it doing good work. 
In tricuspid stenosis and insufficiency, with regurgitation, it is regarded 
as less useful than in mitral affections, but when the valves are not diseased 
and there is simply ventricular dilatation, it may be of use. In these con- 
ditions, when the cardiac action is weak and rapid, pressure low, and there is 
cough, shortness of breath, dusky countenance, pulsating jugulars, scant, 
338 INDIVIDUAL DRUGS. 
high-colored urine, and general oedema, it may be used to advantage. 
Sometimes it has induced pulmonary hemorrhage. 
Digitalis is generally regarded as less useful, rarely indicated, and 
even generally harmful in aortic stenosis. If, however, there is dropsy 
and evidence of back pressure in the lungs, it may sometimes do good. 
In aortic regurgitation it is generally held to be harmful, but there 
are conditions which require nice discrimination as to its use. If there is 
great ventricular dilatation giving rise to mitral insufficiency, and when 
sudden dilatation with symptoms of venous stasis appears, and there is 
praecordial pain, dyspnoea, and great anxiety,'the drug is held by some to 
do good, though it must be tentatively given and its effects carefully watched. 
In all varieties of aortic valvular disease, the greatest of care and vigilance 
should be exercised in the giving of digitalis. The indications of heart 
weakness and irregular pulse should be strictly observed. 
In the treatment of all valvular disorders less therapeutic value is 
attached to the consideration of valves affected than to the condition of the 
heart-muscle itself. When so weak as to cause dilatation, and this effect 
has been brought about by valvular insufficiency, the drug is generally 
indicated. 
Digitalis has long been the best remedy for rapid and unequal circula- 
tion, with a confusion of weak and vigorous but rapid pulsations. The 
cause, however, of this state has only recently been determined. This is 
now familiar as "auricular fibrillation," a condition exhibiting an exceedingly 
irregular and fast pulse, varying greatly in rhythm and power. Some of the 
ventricular contractions prove too feeble to force the blood-current into the 
aorta, while others are so vigorous as to cause large and full pulses. All of 
this occurs in the greatest confusion and without any regulated sequence. 
A rollicking, tumbling and jumbled irregularity of the radial pulse is the 
clinical evidence of this state. Fibrillation is caused by a disturbance of 
conductivity and is the result of the occurrence of a multitude of im- 
pulses generated in the auricle, throwing that chamber into a continual 
condition of incoordination, preventing the normal discharge of blood into 
the ventricle. These erratic impulses proceed downward into the ventricle 
with discordant irregularity, and thus cause an intercharge of weak and 
strong pulsations and a badly confused action of the whole heart. Not 
immediately fatal, the general health after some time may become under- 
mined unless relief be given, and sudden and alarming rapidity of the 
pulse, and grave danger to the circulation and to life ensues. 
Digitalis is the best-known remedy for this state, being practically 
specific, and this control of conditions under the drug is one of the most 
certain of therapeutic effects. Fibrillation is not due to vagal inhibition, 
but evidently originates in the cardiac muscle. Most likely it is occasioned 
by extreme malnutrition of the heart. Full doses of digitalis are required, 
and under them the pulsations are rapidly reduced to less than half in num- 
ber, and they become augmented in power and volume and are more 
uniformly timed. This action of digitalis is one of control and not always 
curative, for the determining causes of fibrillation may persist through life 
and the drug must consequently be frequently and long invoked to main- 
tain a fairly regulated circulation. It must be known, however, that over- 
339 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
doses of digitalis sometimes bring on a state similar to if not identical with 
auricular fibrillation, when the heart has shown no such disturbance before 
the drug was taken. In such cases the dose must be lessened or the drug 
entirely withdrawn and strophanthus or convallaria substituted for it. 
Digitalis is of value in irritable heart with palpitation from overwork, 
heart strain, and the arrythmia of simple dilatation, in moderate degrees of 
ventricular dilatation, and cardiac asthenia. It is especially commended 
for the irritable heart of soldiers brought on by long marches and fighting 
whereby the inhibitory control is lost or lessened and exhaustion of the 
heart-muscle is imminent. When palpitation is purely nervous, it is of 
little value; cactus is then a better remedy. It also fails often in paroxysmal 
tachycardia, which is also mostly a nervous phenomenon. In Grave's 
disease, it is not curative, but sometimes rectifies the cardiac irregularity. 
In functional palpitation arising from imperfect digestion it sometimes 
controls the heart symptoms, but gives little or no relief if the trouble is 
purely nervous, nor does it aid the stomachic disorder. 
Cardiologists agree quite generally that digitalis is contraindicated in 
beginning or partial heart-block, which it tends to increase; that it is useless, 
and may be harmful in sinus arrythmia; that it is of doubtful value in 
pulsus alternans, especially doing harm if there is myocarditis, with sclerosis 
of the coronary arteries; and in paroxysmal tachycardia, in which, however, 
it may benefit by retarding conduction if the beats are of sinus node or 
auricular origin, but is bad medication if they are of ventricular inception. 
Digitalis is also of questionable value in auricular flutter. In fact, in our 
own opinion, in all forms of arrythmia great care must be had in the use of 
this powerful drug, and in most of them it had better be withheld, except in 
auricular fibrillation, in which its effects are all that may be desired. 
The dictum, so much heard at present, to "digitalize your patient", 
must be followed with judgment, for digitalis cases, it must be remembered, 
are those which are helped greatly or moderately, those in which no good 
effect may be expected, and those in which it is dangerous, or at least 
harmful. One should not use digitalis indiscriminately, but with rare 
judgment and according to the specific indications, especially taking into 
account primarily the condition of the heart-muscle and its ability to meet 
the conditions imposed upon it. 
To sum up its cardiac therapy, digitalis is useful in the following con- 
ditions: In structural heart lesions, as dilated heart with mitral incom- 
petence, in mitral stenosis and regurgitation, and in dilated right heart with 
tricuspid incompetence, and in relative or positive debility of the cardiac 
muscle. The mechanical trouble in most instances is a state of ischaemia, 
or lack of sufficient arterial blood in the left heart, while in the right heart 
and the entire systemic and pulmonic circulation there is venous stasis. 
Digitalis increases the power of the auricles and ventricles to empty them- 
selves; prolongs the inter-contractile intervals, thus allowing the auricles 
sufficient time to more perfectly send the blood current into the ventricles. It 
restores and regulates a mechanical compensation or balance in the circula- 
tory organs. It controls fibrillation by inhibiting conductivity. The general 
symptoms leading to its selection are a weak, rapid, and irregular pulse, 
low arterial tension, cough, dyspnoea, pulsation of the iugular veins, a 
340 INDIVIDUAL DRUGS. 
cyanotic countenance, deficient urination, the secretion being high-colored, 
and oedema. 
We have herein named many of the faulty anatomic conditions of the 
heart in which digitalis is useful, but as exact physical diagnosis is not 
always easy it is better for the practitioner to depend upon the symptoms 
of weak action than to attempt hair-splitting anatomic diagnoses. Lack 
of propulsive power due to heart debility is the best indication for digitalis. 
This, together with threatened or actual failure of compensation, covers in 
brief the great need of digitalis therapy. One should never lose sight of the 
fact that the integrity and relative power of the heart-muscle are of paramount 
consideration over that of the condition of the heart valves. 
Digitalis is generally considered contraindicated in simple compensa- 
tory hypertrophy, aortic stenosis, extensive fatty, fibrous, or other de- 
generations of the heart-muscle, aneurism, and atheromatous or other 
structural changes in the arteries. As a rule it should not be employed in 
the heart affections of old age, or when dilatation is excessive, and particu- 
larly when there is a flabby state of the heart-muscle with suspected de- 
generative changes. 
Cushny {Pharmacology') takes issue with some of the usual cautions 
given above, declaring that, while digitalis often fails in excessive degenera- 
tive conditions, it has no deleterious effect upon them. Neither does he 
fear rupture of the arterial walls or the presence of high blood pressure in 
renal and arterial diseases. He believes a greatly increased blood pressure 
is not likely under digitalis, nor is its occurrence to be regarded as a bar 
to the use of the drug, provided the special indications of "venous stasis, 
oedema, or deficient urine" are present. He presumes that, in some cases, 
the high blood pressure "arises from excessive activity of the vaso-con- 
strictor center inducing mesenteric contraction in an attempt to maintain 
the blood supply to the brain; this involves an abnormal resistance to the 
circulation and imperfect nutrition of various organs. Digitalis by increas- 
ing the efficiency of the heart improves the blood supply of the brain, and 
the activity of the vaso-constrictor center is abated, leading to a more 
normal state of the circulation and often to a lower arterial tension." 
Notwithstanding this optimistic reasoning, physicians will do well to be 
extremely careful in the administration of digitalis in myocardial and 
vascular degenerations. 
Bastedo {Materia Medica, etc.) declares that "the drug's efficiency is 
not to be estimated by its effects on arterial pressure", and that it is not 
contraindicated in aortic aneurysm, aortitis, or arteriosclerosis, but that 
"its use would depend upon the needs of the heart." 
Under some circumstances digitalis proves a most certain but slow 
diuretic. It is most generally held that the diuretic effect of digitalis is the 
result of its secondary action. If, however, the view entertained by some 
that it has also a special action upon the renal glomeruli be true, the reason 
for its well-earned reputation as a remedy in dropsy will be more apparent. 
Digitalis has long been known as an efficient eliminant where the dropsical 
condition was dependent upon cardiac irregularities and upon renal con- 
gestion. When the trouble is cardiac in origin, it relieves by strengthening 
the heart action and producing capillary contraction. When of renal 
341 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
origin, obstructing the circulation, it relieves at least the tension of the renai 
capillaries, thus lessening engorgement and bringing about absorption and 
diuresis. In general dropsy it is indicated by the distressing dyspnoea, 
especially when in the recumbent posture, fullness and pulsation of the 
jugulars, pale or dusky countenance, scanty and high-colored urine, and 
quick, feeble, fluttering, and irregular pulse. When known to be associated 
with the cardiac lesions in which digitalis is indicated, it seldom fails to 
remove the dropsical effusion. It relieves chronic nephritis by lessening 
vascular tension in the renal capillaries, and in granular degeneration of the 
kidneys it is said to benefit by lessening the proportion of solids excreted, 
while the quantity of fluid is increased. While of doubtful utility in scarla- 
tina, it is very serviceable in the anasarcous condition sometimes following 
that disease. Many, however, regard it of doubtful safety in nephritis, 
and this is probably true of chronic nephritis without great cardiac im- 
pairment, but when the heart is greatly at fault and contributing to the 
intensity of the malady then digitalis should be of some service. Digitalis 
has no influence for good upon dropsy of hepatic origin, or in pleural effusion. 
Rheumatism, with threatened heart failure, is sometimes relieved 
by digitalis. Owing to its power of preventing erections, by limiting the 
supply of blood to the erectile tissues, it has rendered good service in 
nocturnal seminal pollutions, particularly when the extremities are cold, 
the erections feeble, and the emissions oft-occurring. 
Digitalis is not valued by us as a febrifuge. Its effect upon the gastro- 
intestinal tract is so unpleasant as to make it of doubtful value to lower 
temperature. As a sedative, therefore, in fevers and inflammations, its use 
is not to be commended. It has been claimed that it is of great service in 
scarlatina, both for the purpose of producing sedation and keeping the 
kidneys active, thus tending to avert post-scarlatinal dropsy and uraemia. 
That it will do this without some heart debility being present also, is by no 
means well established, while, on the contrary, its unpleasant, nausea- 
provoking properties make it an undesirable remedy. It is better after 
dropsy has set in. The same is true of it in typhoid and other fevers, 
though it may be used to strengthen a weak heart following these in- 
fections. 
Digitalis is of value in the second stage of lobar pneumonia to preserve 
the integrity of the heart and circulation, when through swelling and 
exudation in the respiratory tract venous stasis is set up in the capillaries 
and the right heart dilates and the ventricle is incapable of forcing the 
blood current through the pulmonic vessels. Signally useful when this 
stage attains, it is a mistake to give it before such an accident occurs on the 
presumption that it will forestall the catastrophe. No drug, and certainly 
no potent drug, should be administered for any purpose until the indica- 
tions show the need of it. Under similar conditions it is sometimes of 
value in acute bronchitis and bronchopneumonia in children. 
As an antihemorrhagic digitalis has no special advantages, while it is 
open to the objection of forcibly pumping the blood; though in capillary 
bleeding from large surfaces it is sometimes said to be useful. 
Digitalis is useful as an antidote to aconite poisoning, but is very slow 
in action, having to be first preceded by rapidly acting stimulants. It may 
342 INDIVIDUAL DRUGS. 
also be used to antidote the nitrites, and with atropine in muscarine (agar- 
icin) poisoning. 
Administration.-When given in large or in overlapping doses, digitalis 
may suddenly precipitate alarming conditions. This is due to inequality 
in the rate of absorption and elimination or destruction of the drug in the 
body. This state is the much feared "cumulative action," the possibility 
of which should never be forgotten when administering digitalis. The 
moment the appetite fails and the urinary secretion becomes diminished 
and the pulse becomes very slow and irregular, and headache, faintness 
and extreme prostration supervene, with sometimes nausea and vomiting, 
the drug at once should be discontinued. To avoid cumulative effects of 
digitalis it is customary to skip a day or two out of every week in its ad- 
ministration. Digitalis is slowly absorbed, and often much of it is destroyed 
in the gastro-intestinal tube. When through failure to be largely destroyed, 
or when through irritation of the tract more is absorbed than is apparent, 
the balance between absorption and the usual slow elimination is over- 
weighted and cumulation occurs. When full doses of digitalis are being 
administered the patient should be kept recumbent in bed and not allowed 
to arise even to respond to the calls of nature. Failure to observe this 
precaution has resulted in sudden death from syncope. 
When the desire is both to impress the heart and eliminate dropsical 
effusion the infusion of digitalis is the preferred preparation, as it is also in 
auricular fibrillation. Sometimes, however, a good digitalin, which should 
be employed only subcutaneously, is preferred when a quicker action is 
desired, but the variability of this product should always be taken into 
consideration. 
Digitalis contains no alkaloid. At least five glucosides are present, 
some of which are intensely poisonous; some relatively negative; while 
one, so far as the matter is understood, antagonizes the other four. Be- 
sides two acids, the other constituents are those of plants in general. 
Under the name digitalin, the glucoside said to most nearly resemble 
in action the whole plant, several preparations have appeared in the drug 
mart from time to time which have little agreement either in action or 
qualities. Discordant views of the value of such preparations, or of such 
preparations of the whole plant as are standardized to contain a certain 
percentage of certain of its active glucosides, illustrate forcibly that the 
experiences of careful clinicians should weigh more in the selection of a 
preparation of digitalis than should the dictum of the laboratory man with 
test-tube and guinea pig records, valuable as they may be in some directions. 
That preparation of digitalis which gives the desired therapeutic results 
with the least toxic impression is the safest and most sensible agent to 
employ, regardless of its glucosidal constituents and percentage. 
Only such digitalins as are prepared by the processes of Schmiedeberg 
are favored by the best clinicians; the so-called German and French 
digitalins are unreliable, as they are all more or less mixtures of digitalin 
and other glucosides while the first is probably devoid of digitalin altogether, 
and is said to be in reality digitonin (saponin). Homolle's and Nativelie's 
digitalins are no longer favored by the majority of physicians. It is asserted 
that the "digitalone" devised by Houghton is a fat-free, standardized 
343 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
composite of all the properties of digitalis; each ampule for hypodermatic use, 
equaling 16 minims, and each tablet from 3 to 16 minims, of tincture of digita- 
lis. Digifolin, also representing the whole drug, acts very effectively in some 
cases when the tincture or infusion cannot be employed. However, for 
most purposes the crude drug in infusion, and the tincture, are the pre- 
ferred preparations; in Eclectic medicine the specific medicine is most 
largely used and is fully representative of the best therapeutic virtues of 
good digitalis leaves, though less toxic than some other alcoholic prepara- 
tions of the drug. The tincture made from the green drug, though less 
toxic than that made from the dried drug, is preferred by some. 
DIOSCOREA. 
The rhizome of Dioscorea villosa, Linne (Nat. Ord. Dioscoreaceae). A vine found 
throughout the United States. Dose, 5 to 60 grains. 
Common Names: Wild Yam, Colic Root. 
Principal Constituents.-An acrid, alcohol-soluble resin, and a substance closely allied 
to saponin. 
Preparations.-1. Decoctum Dioscorea, Decoction of Dioscorea (Dioscorea, 3j; 
Water, Oj). Dose, 2 to 6 fluidounces. 
2. Specific Medicine Dioscorea. Dose, 5 to 60 drops. 
Specific Indications.-Bilious colic; other spasmodic colicky contrac- 
tions; skin and conjunctivae yellow, with nausea and colicky pain; tongue 
coated, stomach deranged, and paroxysmal pain in the abdomen; twisting 
or boring pain, radiating from the umbilical region, with spasmodic con- 
traction of the belly-muscles; colic with tenderness on pressure, which 
gives relief to the spasmodic action. 
Action and Therapy.-The decoction of dioscorea has been wonder- 
fully effective in some cases of bilious colic and has signally failed in others. 
If it does not give relief in a half hour it is not likely to succeed. The 
specific medicine administered in hot water has the same effect. Dioscorea 
is probably less anodyne than antispasmodic, and it is due to the latter 
action that colic is relieved. Not alone does it succeed in cases of bilious 
colic, but it acts similarly in paroxysmal pain, with contraction of the mus- 
cular tissues, in cholera morbus, indigestion, and dysenteric tenesmus. 
Ovarian neuralgia and spasmodic dysmenorrhoea sometimes yield quickly 
to it. In all disorders it seems best adapted to irritable and excitable con- 
ditions and is less efficient when due to atony. Though dioscorea has been 
used largely for nearly a century, its true place in therapeutics is still un- 
determined, probably because so many impossible claims have been made 
for it. Hepatic colic depends upon so many different conditions that it 
may help some cases quickly while others are unaffected by it. When 
large gall-stones are attempting to pass it is probably without power to 
relieve. Morphine is a better relaxant and is anodyne. Dioscorea seems 
best adapted to paroxysmal pain due to contraction of the nonstriated 
musculature of tubular organs, when brought on by any irritant or form of 
irritation. It does not dissolve calculi. Usually, while there is much 
tenderness in cases requiring dioscorea, the distress is gradually relieved 
by pressure. 
344 WILD YAM 
(Dioscorea villosa) 
Photo by Frank H. Shoemaker, 
Lincoln, Nebraska 
Courtesy of Prof. Rufus A. Lyman, 
University of Nebraska 
Wild Yam came into prominence in the middle period of Eclecticism as a remedy for "bilious 
colic," and before the days of gall-bladder surgery was largely used to produce relaxation and 
thus relieve pain. In the light of present-day pathology of gall-bladder infections and calculi, 
it is needless to say that it is now but little relied upon, except occasionally to relieve the symp- 
tom of abdominal spasmodic pain; most gall-bladder pathology being subjected to surgical 
operation. SKUNK CABBAGE 
(Symplocarpus fcetidus) 
Photo by Frank H. Shoemaker, 
Lincoln, Nebraska 
Courtesy of Prof. Rufus A. Lyman, 
University of Nebraska 
Skunk Cabbage held an important place in early domestic botanic and Eclectic medication, 
and is still an ingredient of preparations inherited from the pioneers of Eclecticism. A crude 
figure of it appeared in John Josselyn's "New England's Rarefies" (1672), and is probably the 
earliest drawing of this curious plant. Only the flowering spathe, which pierces the ground 
in earliest spring, appearing before the leaves, is shown in the above illustration. INDIVIDUAL DRUGS 
DRACONTIUM. 
The rhizome, roots and seeds of Dracontium fastidum, Linne (Nat. Ord. Aracese). 
A peculiar plant found in moist grounds in the United States. Dose, 10 to 40 grains. 
Common Names: Skunk Cabbage, Skunk Weed, Pole Cat Weed, Meadow Cabbage. 
Principal Constituents.-A peculiar evanescent volatile substance, resin and volatile oil. 
Preparation.- Tinctura Dracontii, Tincture of Dracontium (fresh root, 5 viij; Alcohol, 
Oj). Dose, 1/2 to 2 fluidrachms. 
Action and Therapy.-In large doses dracontium will cause nausea and 
vomiting, dizziness, headache, and impaired vision. In small doses it is a 
stimulant, expectorant, and antispasmodic. It very markedly relieves 
nervous irritation with tendency to spasmodic action, making it a remedy 
of some value in nervous irritability, asthma, and whooping cough, and in 
chronic coughs and catarrhs. The drug needs restudy from a therapeutic 
standpoint, for it undoubtedly possesses a marked action upon the nervous 
system. Only preparations from the fresh root are of any value. Skunk 
cabbage was an ingredient of many early Eclectic medicines, and is still a 
constituent of Acetous Emetic Tincture, Compound Emetic Powder, and* 
Libradol, the magma representing the latter compound. 
DROSERA. 
The herb Drosera rotundifolia, Linne (Nat. Ord. Droseraceae). A small plant of the 
fly-trap family found in boggy situations of Eastern North America and Europe. 
Common Names: Sundew, Round-leaved Sundew. 
Principal Constituents.-Probably citric acid and a ferment capable of converting 
albumens into peptones. 
Preparation.-Specific Medicine Drosera. Dose, 1/10 to 10 drops. 
Specific Indications.-Expulsive or explosive spasmodic cough, 
with dryness of the air passages; cough of measles; whooping cough; un- 
controllable, irritating cough. 
Therapy.-Drosera, preferably in small doses, is of great value in the 
spasmodic dry cough characteristic of measles, and to a lesser extent for 
that of whooping cough and the irritability of the larynx following the latter. 
There may be simple irritation, particularly centered in the larynx, or in- 
flammation may be present. It also relieves the tickling sensation in that 
organ giving rise to spasmodic cough. To a lesser extent it is useful in 
the coughs of bronchitis, incipient phthisis, spasmodic asthma, and in 
nervous or sympathetic cough occurring reflexly from other diseases. 
It probably acts upon the vagus. 
DUBOISINA. 
Duboisine. 
The alkaloid obtained from the leaves of Duboisia myroporoides, Robert Brown (Nat. 
Ord. Solanaceae), the Corkwood elm or Ngmoo of Australia and New Caledonia. Dose, 
1/100 to 1/50 grain. 
Preparations.-1. Duboisince Sulphas, Duboisine Sulphate. Dose, 1/100 to 1/50 grain. 
2. Duboisince Hydrochloridum, Duboisine Hydrochloride. Dose, 1/100 to 1/50 grain. 
Action and Therapy.-External. The sulphate of this alkaloid is 
sometimes used as a substitute for atropine as a mydriatic. Like atropine, 
it is contraindicated by glaucoma and diseases of the fundus of the eye 
on account of its power to increase intraocular tension. It is a more rapid 
mydriatic and paralyzes accommodation more quickly than atropine and is 
less irritant to the conjunctivae. 
345 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Internal. Duboisine is very similar to, if not identical with, hyoscya- 
mine, and the physiological effects of it are practically the same as those 
of the alkaloids of belladonna, hyoscyamus and stramonium. Sulphate of 
duboisine is an effective antagonist of muscarine and has been successfully 
employed in poisoning by mushrooms. It also checks colliquative sweat- 
ing. It is reported prompter in action than atropine, and is said to be a 
better calmative and hypnotic in states of mental excitement. The mor- 
phine habit, paralysis agitans, and especially the excitability and insomnia 
of the insane have been treated with it. Administered in the smaller doses 
twice a day it is said to produce quiet, refreshing sleep. It frequently 
causes gastric disturbances, especially vomiting without previous nausea, 
and undoubtedly decreases the secretion of urine, hence it should be used 
with care and judgment. 
DULCAMARA. 
The young branches of Solanum Dulcamara, Linne (Nat. Ord. Solanaceae). A vine 
common in Europe and the United States. Dose, 1 to 30 grains. 
Common Names: Bittersweet, Woody Night-Shade, Scarlet-Berry, Violet-Bloom. 
Principal Constituents.-The alkaloid solanine and the glucoside dulcamarin. 
Preparation.-Specific Medicine Dulcamara. Dose, 1 to 30 drops. 
Specific Indications.-Scaly skin affections; acute disorders due to 
cold and dampness; deficient capillary circulation; depressed secretions 
of the skin with urinous odor; coldness and blueness of the extremities; 
fullness of tissues with tendency to oedema. 
Action and Therapy.-Dulcamara is an active agent capable of pro- 
ducing poisonous effects. These are those of the belladonna type, differing 
only in minor particulars. Cutaneous redness and congestion of the 
kidneys are especially apt to result from immoderate doses. Children are 
sometimes poisoned by eating the berries of the plant. Scudder suggested 
dulcamara in small doses in "cases of chronic disease in which the cir- 
culation is feeble, the hands and feet cold and purplish, with fullness of 
tissues and tendency to edema." Locke advised it in acute disorders brought 
on by cold, dampness, and exposure. Using it in fractional doses he 
suggested its value in acute catarrhal disorders proceeding from cold or 
suspended cutaneous function; in suppression of the menses with nausea, 
headache, and chilly sensation, the flow having been arrested by a cold; 
in vesical catarrh, aggravated by dampness; catarrhal headache from 
acute colds; nasal catarrh; retrocession of eruptions, or primarily to 
develop the eruptions; and in dyspnoea, cough and pain in the chest due 
to exposure. Those who dwell or work in damp or cold quarters, especially 
children, are frequently the victims of catarrhal diarrhoea, and acute 
and chronic rheumatism. Such patients are benefited by dulcamara given 
in fractional doses. Larger doses (medium) are effective in some cases of 
acute mania, nymphomania and satyriasis, acting as do the more powerful 
of the group of solanaceous drugs. It will be observed that the therapeutic 
uses of dulcamara are closely allied to those of belladonna, minus the 
profound impression derived from atropine. 
Dulcamara should be remembered as a possible remedy in chronic 
skin diseases of a pustular, vesicular or scaly type, particularly the latter. 
It mav also be tried in pudendal itching 
346 PURPLE CONE FLOWER 
(Brauneria angustifolia [Echinacea angustifolia]) 
Photo by Prof. E. L. Newcomb, University of Minnesota 
Courtesy of the Wm. S. Merrill Co., Cincinnati, Ohio 
Echinacea is the most renowned of medicinal plants of late introduction into medicine. Res- 
cued from threatened commercial exploitation as an alexipharmic against serpent venom, it 
was introduced into legitimate medicine by Professor John King, to whose attention it was 
called by Dr. H. C. F. Meyer, of Pawnee City, Nebraska, the discoverer of its virtues. It is 
now regarded one of the best of vegetable antiseptics, and enters largely and increasingly 
into present-day Eclectic therapy. INDIVIDUAL DRUGS. 
ECHINACEA. 
The dried root of Brauneria angustifolia, Linne (^Echinacea angustifolia [DeCandolle], 
Heller). (Nat. Ord. Compositae.) In rich prairie soils of western United States, from 
Illinois westward through Nebraska and southward through Missouri to Texas. 
Common Names: Narrow-leaved Purple Coneflower, Purple Coneflower, Coneflower. 
Principal Constituents.-Minute traces of an unimportant alkaloid and an acrid body 
(1/2 to 1 per cent), probably of a resinous character linked with an organic acid. The 
latter is the chief active principle of the drug. 
Preparations.-1. Specific Medicine Echinacea. Dose, 1 to 60 drops, the smaller 
doses being preferred. Usual method of administration: I). Specific Medicine Echinacea, 
fl3j to fl3ij; Water, q. s. fl^iv. Mix. Sig.: One teaspoonful every 1 to 3 hours. 
2. Echafolta. (A preparation of Echinacea freed from extractive and most of the 
coloring matter. It also contains a small added quantity of tincture of iodine. The label 
states that is iodized). Dose, 1 to 60 drops. Usually administered the same as the 
specific medicine; except when iodine is contraindicated, or is undesired. 
3. Echafolta Cream. An ointment for external use. 
Specific Indications.-"Bad blood"; to correct fluid depravation, 
with tendency to sepsis and malignancy, best shown in its power in gan- 
grene, carbuncles, boils, sloughing and phagedenic ulcerations, and the 
various forms of septicaemia; tendency to formation of multiple cellular 
abscesses of a semi-active character and with pronounced asthenia; foul 
discharges with emaciation and great debility; dirty-brownish tongue; 
jet-black tongue; dusky, bluish or purplish color of the skin or mucous 
tissues, with a low form of inflammation. It is of special value in typhoid 
states, in which it is indicated by the prominent typhoid symptoms- 
dry tongue, sordes on tongue and teeth, mental disturbances, tympanites 
and diarrhoeal discharges-and in malignant carbuncle, pyosalpinx, and 
thecal abscesses. 
Action.-The physiological action of echinacea has never been satis- 
factorily determined. It has been held to increase phagocytosis and to 
improve both leukopenia and hyperleucocytosis. That it stimulates and 
hastens the elimination of waste is certain, and that it possesses some anti- 
bacterial power seems more than probable. Upon the mucous tissues 
echinacea causes a quite persistent disagreeable tingling sensation some- 
what allied to, but less severe, than that of prickly ash and aconite. It 
increases the salivary and the urinary flow, but sometimes under diseased 
conditions anuria results while it is being administered. In the doses 
usually given no decided unpleasant symptoms have been produced; 
and no reliable cases of fatal poisoning in human beings have been re- 
corded from its use. Occasionally bursting headache, joint pains, dry 
tongue, reduced temperature and gastro-intestinal disturbances with 
diarrhoea are said to have resulted from large doses of the drug. 
Therapy.-External. Echinacea is a local antiseptic, stimulant, 
deodorant, and anaesthetic. Alcoholic preparations applied to denuded 
surfaces cause considerable burning discomfort, but as soon as the alcohol 
is evaporated a sense of comfort and lessening of previous pain is experienced. 
Its deodorant powers are remarkable, especially when applied to foul 
surfaces, carcinomatous ulcerations, fetid discharges from the ears, and in 
347 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
gangrene. While not wholly masking the odor of cancer and gangrene it 
reduces it greatly, much to the comfort of the sick and the attendants. 
Echinacea is useful as an application where decay is imminent or taking 
place, reparative power is poor, and the discharges saneous and unhealthy. 
It is especially valuable in sluggish ulcers, bed sores, stinking tibial ulcers, 
and ulcers of the nasal mucosa, due either to ozaena or to syphilis. The 
greater the tendency to lifelessness and dissolution of the tissues and the 
more pronounced the fetid character of the discharges, the more applicable 
is echinacea. Used by spray it is effective to remove stench and to stimulate 
repair in tonsillitis, the angina of scarlatina, and though not alone capable 
of curing diphtheria, either by external or internal use, it stimulates the 
near-necrosed tissue to activity and overcomes the fetid odor, thus con- 
tributing in a large measure to aid more specific agents. A 10 to 50 per 
cent solution may be used to cleanse abscess cavities, to apply to ragged 
wounds from barbed wire, tin, and glass, wounds which for some 
reason are very painful and heal sluggishly. For this purpose we prefer 
1$. Echafolta (or Echinacea), fl^j; Asepsin, gr. xv; Tincture of Myrrh, 
fl 3 ij; Sterile Water, q. s. fl^iv. Mix. Apply upon sterile gauze, renewing 
at reasonable periods. This also makes a good mouth wash for foul breath 
and to remove odor and stimulate repair in pyorrhea alveolaris, spongy 
and bleeding gums, and aphthous and herpetic eruptions. Echinacea is 
sometimes of value in eczema, with glutinous, sticky exudation, and 
general body depravity; to give relief to pain and swelling in erysipelas, 
mammitis, orchitis, and epididymitis; to allay pain and lessen tume- 
faction in phlegmonous swellings; and to dress syphilitic phagedena. Asa 
local application to chilblains it has done good service, and in poisoning by 
Rhus Toxicodendron is relied upon by many as one of the best of local 
medicines. We have found it especially useful in dermatitis venenata after 
denudation of the cuticle when ulcers form and the neighboring glands 
swell. Echinacea has a greater record for success than any single medicine 
for snake bites and insect bites and stings, and it may be used full strength 
to relieve the intolerable itching of urticaria. Some have asserted that it 
will abort boils. For the treatment of carbuncle, after thoroughly incising, 
a 50 per cent solution to full strength echinacea or echafolta may be freely 
used, syringing the channels with it. This gives great relief from pain 
and insures a quicker recovery. 
For all the above-named purposes either echinacea or echafolta may 
be used: the latter is usually preferred where a cleanlier appearance is 
desired. Moreover, in most of the conditions named repair takes place 
much sooner and in better form if the remedy is given internally con- 
comitantly with its external use. 
Internal. Echinacea is stimulant, tonic, depurative, and especially 
strongly antiseptic; it is in a lesser degree anaesthetic and antiputrefactive. 
The necessity for remedies that possess a general antiseptic property and 
favor the elimination of caco-plastic material is most marked when one 
is treating diseases which show a depraved condition of the body and its 
fluids. Such a remedy for "blood depravation,'' if we may use that term, 
is echinacea. No explanation of its action has even been satisfactorily 
given, and that a simple drug should possess such varied and remarkable 
348 INDIVIDUAL DRUGS. 
therapeutic forces and not be a poison itself is an enigma still to be solved, 
and one that must come as a novelty to those whose therapy is that of 
heroic medicines only. If there is any meaning in the term alterative it is 
expressed in the therapy of echinacea. For this very reason has a most 
excellent medicine been lauded extravagantly and come near to damnation 
through the extravagant praises of its admirers. 
Echinacea is a remedy for autoinfection, and where the blood stream be- 
comes slowly infected either from within or without the body. Elimination 
is imperfect, the body tissues become altered, and there is developed within 
the fluids and tissues septic action with adynamia resulting in boils, car- 
buncles, cellular tissue inflammations, abscesses, and other septicaemic 
processes. It is, therefore, a drug indicated by the changes manifested in a 
disturbed balance of the fluids of the body resulting in tissue alteration: 
be the cause infectious by organisms, or devitalized morbid accumulations, 
or alterations in the blood itself. It is pre-eminently useful in the typhoid 
state, and many physicians administer it regardless of any other indication 
throughout enteric fever as an intercurrent remedy. Echinacea is especially 
to be thought of when there are gangrenous tendencies and sloughing of the 
soft tissues, as well as in glandular ulcerations and ulcers of the skin. It is 
not by any means a cure-all, but so important is its antiseptic action that 
we are inclined to rely largely on it as an auxiliary remedy in the more 
serious varieties of disease-even those showing a decided malignancy- 
hence its frequent selection in diphtheria, small-pox, scarlet fever, typhoid 
fever and typhoid pneumonia, cerebro-spinal meningitis, la grippe, uraemia, 
and the surgical and serpent and insect infections. Foul smelling dis- 
charges are deodorized by it and the odor removed from foul smelling 
ulcers and carcinomata, processes not alone accomplished by its topical 
use but aided greatly by its internal exhibition. In puerperal fever, cholera 
infantum, ulcerated sore throat, nasal and other forms of catarrh and in 
eczema and erysipelas it fulfills important indications for antisepsis. 
Echinacea was introduced as a potent remedy for the bites of the 
rattlesnake and venomous insects. It was used both externally and in- 
ternally. Within bounds the remedy has retained its reputation in these 
accidents, it probably having some power to control the virulence of the 
venom, or to enable the body to resist depression and pass the ordeal 
successfully; nevertheless fatalities have occurred in spite of its use. 
For ordinary stings and bites its internal as well as external use is advisable. 
In the acute infectious diseases echinacea has rendered great service. 
Throughout typhoid fever it may be given without special regard to stated 
periods, but wherever a drink of water is desired by the patient, from 5 to 10 
drops of Specific Medicine Echinacea may be given in it. Having no toxic 
power, and acting as an intestinal antiseptic, this use of it is both rational 
and effective. Cases apparently go through an invasion of this disease 
with less complications and less depression when the drug is so employed. 
The same is true of it in typhoid-pneumonia, septicaemia, and other septic 
fevers. It has the credit of regulating the general circulation, and par- 
ticularly that of the meninges in the slow forms of cerebrospinal meningitis, 
with feeble, slow, or at least not accelerated pulse, temperature scarcely 
above normal, and cold extremities; with this is headache, a peculiar 
349 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
periodic flushing of the face and neck, dizziness, and profound prostration 
(Webster). It is evidently a capillary stimulant of power in this dreaded 
disease, in which few remedies have any saving effect. Echinacea has aided 
in the recovery of some cases of puerperal septicaemia. Obviously other 
measures are also required. In non-malignant diphtheria, echinacea, both 
locally and internally, has appeared to hasten convalescence, but in the 
light of present day therapeutics it is folly to expect echinacea to cure 
the malignant type. A wide experience with the drug in such cases con- 
vinces us that we are leaning upon a slender reed when we trust alone to 
such medicines as echinacea and lobelia in malignant diphtheria. As 
many non-malignant cases tend to quick recovery, the use of good remedies 
like echinacea undoubtedly hastens the process. But to assume that it will 
cure every type of the disease because it succeeds in aiding the milder 
forms to recover is to bring a good medicine into unmerited discredit. 
Moreover, when these claims were originally made, and probably in good 
faith, there was no exact means of establishing the bacterial nature of the 
disease, hence many tonsillar disorders were called diphtheria. The latter 
were, of course, benefited by it, for in tonsillitis, particularly the necrotic 
form with stinking, dirty-looking ulcerations, it is an excellent remedy. 
Echinacea is said to be a good agent in a malignant form of quinsy known 
as "black tongue''; and in "mountain fever", closely allied to and often 
diagnosed as typhoid fever. 
Echinacea is justly valued in catarrhal conditions of the nasal and 
bronchial tracts, and in leucorrhoea, in all of which there is a run-down 
condition of the system with fetid discharge, and often associated with 
cutaneous eruptions, especially of an eczematous and strumous type. 
Chronic catarrhal bronchitis and fetid bronchitis are disorders in which 
it has been used with benefit, and it is said to ameliorate some of the un- 
pleasant catarrhal complications of pulmonary tuberculosis, and particu- 
larly to render easier expectoration in that form known as "grinder's 
consumption". Patients suffering from common nasal and bronchial 
catarrhs have been greatly improved by echinacea when taking the drug 
for other disorders. Its stimulating, supporting and antiseptic properties 
would make echinacea a rational remedy for such disorders, particularly 
if debility and general tissue depravity were coexistent with the catarrh. 
As a rule echinacea is of little or no value in agues, yet physicians of 
malarial districts assert it is of benefit in chronic malaria when of an asthenic 
type. Altogether likely its value, if it has any, lies in the betterment of the 
asthenia, rather than to any effect it may have upon the protozoal cause of 
the disease. In so-called typho-malarial fever it does good just in proportion 
as the typhoid element affects the patient. Both it and quinine would be 
rational medication. 
Echinacea possesses no mean antifermentative power, and by its 
local anaesthetic effect obtunds pain. When an offensive breath, due to 
gaseous eructation, and gastric pain are present, it proves a good medicine 
in fermentative dyspepsia. The symptoms are aggravated upon taking 
food. It is also serviceable in intestinal indigestion with pain and debility 
and unusually foul flatus, and has been recommended in duodenal catarrh. 
We can see no reason why it should not have some salutary effect in both 
350 INDIVIDUAL DRUGS. 
gastric and duodenal ulcer, for it antagonizes putrefaction, tissue solution, 
and pain. In ulcerative stomatitis and nursing sore mouth, in both of 
which it is very effectual, it should be used both internally and locally. 
When dysentery, diarrhoea, and cholera infantum occur in the debilitated 
and the excretions are more than commonly foul, both in odor and shreds 
of tissue, echinacea is a serviceable adjunct to other treatment. 
The dose of either specific medicine echinacea or echafolta ranges 
from 1 to 5 drops; larger doses (even 60 drops) may be employed, but 
small doses are generally most efficient if frequently repeated. They may 
be given in water or syrup, or a mixture of water and glycerin, as: 3 Spe- 
cific Medicine Echinacea, flgj to fl3ij:Water, q. s., fl^iv. Mix. Sig.: 
Teaspoonful every 1/2 or 1 hour in acute cases; every 3 or 4 hours in 
chronic affections. If these preparations are to be dispensed in hot weather, 
or are to be used in fermentative gastro-intestinal disorders, the substitu- 
tion of 1 /2 ounce of pure glycerin for 1 fluidounce of the water is advisable. 
Echafolta (now iodized) should be given internally only when 
iodine is not contraindicated, or is desirable. Formerly, before being iodized, 
it was used internally in the same manner and for the same purposes as 
Echinacea. The Echafolta should be reserved for external use. 
Echafolta Cream is an admirable form in which to use Echafolta, 
where an ointment is desired, being a useful unguent in the various skin 
disorders in which Echafolta or Echinacea is indicated. 
ELATERIUM. 
The feculence of the juice of the fruit of Ecballium Elaterium (Linne), A. Richard. 
(Nat. Ord. Cucurbitaceae.) A trailing vine of southern Europe. 
Common Names (of fruit): Squirting Cucumber, Wild Cucumber, Wild Balsam 
Apple. 
Description.-Light, brittle, flat flakes, pale-gray with a greenish or yellowish tinge, 
a tea-like odor, and an intensely bitter taste. 
Principal Constituent.-The neutral purgative principle elaterin (C2oH2806) present 
to the extent of 20 to 25 per cent. 
Preparation.-Specific Medicine Elaterium. Dose, 1 to 20 drops. 
Derivative.-Elaterinum, Elaterin. (Odorless, very bitter, and slightly acrid, white 
scales or crystals; permanent in the air. Very soluble in chloroform; sparingly in alcohol, 
and almost insoluble in water.) Dose, 1/40 to 1/8 grain. Of the Trituratio Elaterini 
(elaterin, 1; sugar of milk, 9), 1/4 to 1/2 grain. 
Specific Indications.-Chronic cystitis with pain in the neck of bladder, 
the urine passes in a torrent, and after micturition there is violent cramp- 
like aching extending from the bladder into the pelvis and thighs; deep 
soreness or tenderness in the bladder, perineum, or throughout the pelvis, 
with tenesmic voiding of mucus or muco-pus-laden urine; dropsies of 
plethora; cerebral congestion; pulmonary oedema. 
Action and Therapy.-Elaterium is the most powerful and the best 
of the hydragogue cathartics. As such it is indicated only in individuals 
strong enough to stand depletion, and is always contraindicated in the 
weak and feeble. Overdoses-even a few grains-may produce a diffuse 
gastro-enteritis, with violent vomiting, cramps, and watery purgation. In 
medium doses only copious watery stools are produced, but with con- 
siderable depression. The treatment for excessive action of elaterium is 
that for gastro-enteritis in general. 
351 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
In medium doses elaterium has been, and is still to a lesser extent, 
used as a dehydrating cathartic in chronic dropsies of hepatic or abdominal 
origin, and in chronic nephritis. When the liver is involved, with con- 
gestion or torpor, it may be given with podophyllin; if there are heart 
complications, with digitalis. It is quite certain to reduce the ascites; but 
when the latter is dependent on destruction of tissue, it does not, of course, 
cure the disease, of which the dropsy is but a symptom. It is often useful 
in dropsy after scarlet fever, if the patient is not greatly exhausted; and it 
is more especially indicated when uraemic convulsions threaten or are present. 
Elaterium is a useful purgative when a revulsive is needed in cerebral 
congestion. 
The small dose of elaterium is preferred for other specific purposes. 
Elaterium is the remedy for chronic inflammation of the bladder, as first 
announced by King. When indicated the urine rushes from the urethra 
as in a torrent and is accompanied by constant pain radiating from the 
neck of the bladder to the surrounding tissues, and micturition is followed 
by violent pelvic and femoral cramps. This condition is frequently as- 
sociated with general pelvic dragging and tenderness, and the urine is 
characteristic of chronic subacute inflammation-ropy with mucus or muco- 
pus. The dose should be small enough not to provoke emesis or catharsis. 
The usual prescription is: I) Specific Medicine Elaterium, gtt. x to xx; 
Water, q. s., flgiv. Mix. Sig.: One teaspoonful 3 or 4 times a day. 
For hydragogue purposes Elaterin is preferred by some physicians, 
though elaterium, notwithstanding its impurities, seems to be more generally 
efficient than its derivative. 
EPIGtEA. 
The leaves of Epigaa repens, Linne (Nat. Ord. Ericaceae). A small, trailing, shrubby 
plant of the eastern half of the United States. Dose, 5 to 60 grains. 
Common Names: Trailing Arbutus, Gravel Weed, Gravel Plant, Ground Laurel, 
Mayflower. 
Principal Constituents.-The glucosides arbutin (C12Hi60t), urson (C2oH6202), and 
ericolin (CmHsoOs); and tannin. 
Preparation.-Specific Medicine Epigcea. Dose, 5 to 60 drops. 
Specific Indications.-Uric and lithic acid deposits; debilitated and 
relaxed bladder, with mucus in the urine; irritable vesical membrane; 
voiding of urine containing blood or muco-pus. 
Action and Therapy.-Trailing arbutus is a useful diuretic when the 
urine is loaded with deposits of red, sandy material, mucus or muco-pus. 
It renders the urine less irritating, and is valuable to relieve irritation of 
the mucous membranes, vesical tenesmus, dysuria, and strangury. The 
urine is of higher than normal gravity and may contain, besides deposited 
salts, lithic acid gravel and broken down blood. It is especially useful 
where the bladder wall becomes dense and irritated and the condition easily 
lapses into a chronic muco-purulent cystitis. The specific medicine or the 
fluidextract may be given in hot water. 
Trailing arbutus is one of the plants fast disappearing from our flora, 
owing to its reckless gathering by wood-despoiling vandals. Thus a beau- 
tiful wild flower, as well as a good medicine, is threatened with extermina- 
tion. 
352 INDIVIDUAL DRUGS. 
EPILOBIUM. 
The leaves and tops of Epilobium angustifolium, Linne, and Epilobium palustre, Linne 
(Nat. Ord. Onagracese). North America. Dose, 10 to 60 grains. 
Common Names: 1. Willow Herb, Great Willow Herb, Rose Bay, Wickup. 2. 
Wickop, Swamp Willow Herb, Marsh Epilobium. 
Principal Constituents.-The plants have not been satisfactorily examined. 
Preparations.-1. Infusum Epilobii, Infusion of Epilobium (3j to water, Oj). Dose, 
2 fluidrachms to 1 fluidounce. 
2. Specific Medicine Epilobium. Dose, 10 to 60 drops. 
Specific Indications.-"Diarrhoea with colicky pain; feculent dis- 
charges with tenesmus; diarrhoea with contracted abdomen; chronic 
diarrhoea with harsh, dirty-looking, contracted skin"; diarrhoea of typhoid 
fever; typhoid dysentery. 
Action and Therapy.-Epilobium is a remedy for the diarrhoea of 
debility and irritability of the intestinal mucosa. It is the most certain 
and kindly remedy we have ever used to control the diarrhoea of typhoid 
fever; and the experience covers a period of years. The diarrhoea does not 
entirely cease, but becomes reduced to fewer movements and of an increased 
consistence. 
It has long been recognized as a valuable agent in "camp or army 
diarrhoea"; and in domestic practice it is in common use in some parts of 
the country to check the summer diarrhoeas of young children-muco- 
enteritis, enterocolitis, gastro-enteritis, and cholera infantum. The ex- 
perience of physicians justifies these claims. The indication is greenish 
discharges of half-digested food and mucus. It is equally useful in chronic 
dysentery and in that of a typhoid type. In most cases of intestinal irrita- 
tion it acts well, and is indicated by a slick, contracted tongue with nearly 
effaced papillae and pinched emaciated features. It is also of service in 
impaired digestion with uneasy sensations in the abdomen, sometimes 
amounting to pain and even colic, and accompanied by a persistent di- 
arrhoea. The infusion is the best preparation. It may be prepared in the 
usual way, and aromatized with essence of peppermint and preserved with 
a small quantity of glycerin. 
EPINEPHRINA. 
Adrenalin, Epinephrin(e), Suprarenin. 
The blood-pressure-raising, active principle of dried suprarenal glands of the sheep and 
other animals (suprarenalum siccum). (Formula of Hydrated Epinephrine, C9Hi3ObN4- 
1/2 H20.) 
Description.-An odorless, feebly bitter, fine, white or yellowish crystalline powder. 
Owing to its scanty solubility in water it is usually marketed in 1 to 1000 solution. It 
must be carefully kept, as it oxidizes readily, and dilute alkaline solutions destroy it. 
Preparations.-Adrenalin Chloride in 1 to 1000 solution. Dose, 5 to 15 minims of the 
solution. Sometimes lesser solutions up to 1 to 10000 are used, when the dose will cor- 
respond. When aqueous solutions are wanted one of its salts is prescribed; when an oily 
preparation is employed the base is used. 
[Suprarenalum Siccum, Dried or Dessicated Suprarenals, from which the epinephrine 
(adrenalin) is extracted, are the cleaned, fat free, dried suparenal glands of animals, and 
for medicinal use occur as a light, noncrystalline, yellowish-brown powder, soluble partially 
in water. Dose, from 2 to 8 grains; the average dose, 4 grains]. 
Action.-The dried suprarenal gland, chiefly through the active 
principle, adrenalin (epinephrine), is a powerful angio-stenotic. The latter 
body is the most powerful known astringent and hemostatic, besides being 
353 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
a most energetic stimulant to the heart. Either the gland or the adrenalin, 
which is now chiefly used, when applied to mucous surfaces acts at once 
upon the muscular coats of the capillaries, causing extreme constriction 
or ischaemia, so that the tissues immediately become blanched and prac- 
tically bloodless. As a rule, this is not followed by such pronounced re- 
laxation and congestion as takes place after the similar application of 
cocaine, though it does sometimes occur. Though adrenalin does not 
relieve pain, it prolongs the obtunding effects of cocaine by limiting its 
action to the part to which it is applied by constricting the surrounding 
vessels. Hypodermatically used it increases the tone of the whole muscular 
system, probably by stimulation of the sympathetic nerve endings in the 
muscles. The splanchnic blood supply is constricted by it probably through 
both centric and peripheral vaso-motor control. Blood pressure is raised 
enormously, but briefly and immediately, and the pulse is slowed by it. 
Owing to the fact that vessel contraction and heart stimulation do not 
occur simultaneously, the latter being delayed, cardiac paralysis with 
dilatation may occur; fatal issues have been attributed to this incoordinate 
action. The vessels of the lungs are said not to be affected by adrenalin, 
nor unless locally applied is the action upon the veins of the body im- 
portant. Increased urination from high blood pressure is caused by it, and 
the uterine muscles and vessels are contracted. While the blood vessels 
of the brain appear to be affected but little by it, increased blood pressure 
in the general circulation makes it dangerous where atheroma or arterio- 
sclerosis exists lest a cerebral hemorrhage from rupture be produced. 
Unpleasant results have also followed the local use of adrenalin, probably 
due to its depressing effect upon protoplasm and the prolonged vascular 
relaxation sometimes following its first constricting effects. When these 
occur hemorrhage may come on, or sloughing take place at the place of 
injection. Death has followed the use of adrenalin, being caused either 
by acute dilation of the heart, or centric paralysis of respiration. 
Therapy.-External. Adrenalin is used largely for its constricting 
effects in small local hemorrhages, and in minor surgical operations. By 
limiting the circulation it prolongs the anaesthesia of cocaine and procaine, 
and prevents their general absorption and consequent poisoning of the 
nervous system. It is very largely used to render operations practically 
bloodless, especially those of the nose and throat and ears. For local 
constriction and limitation it is combined with local anaesthetics in visceral 
operations to prolong anaesthesia and prevent bleeding at the abdominal 
incision. Applied locally to the mucous membranes it reduces engorge- 
ment of the turbinates and of congestive conjunctivitis, but its use maybe 
followed by reactive congestion worse than the original swelling. It gives 
temporary relief from the distressing sneezing and coryzal discharges of 
hay fever. For the latter purpose an oily spray (1 to 10000) is preferred. 
Internal. Adrenalin and dried suprarenals should not be given by 
mouth, as they are readily decomposed in the stomach, and probably 
prevent their own absorption by their rapidly constringing local action. 
Neither should the suprarenals be used subcutaneously for fear of septic 
poisoning, as they readily become putrid. Only the adrenalin preserved 
in solution (it is not stable when dry) should be used hypodermatically. 
354 INDIVIDUAL DRUGS. 
Adrenalin is to be employed whenever sudden circulatory collapse 
occurs from any cause, and particularly in that taking place during opera- 
tions, or when shock threatens. It should then be administered with normal 
salt solution. It is also invaluable when sudden relaxation threatens or 
occurs from chloroform ancesthesia. Indeed, for surgical shock and chloro- 
form collapse it is the most important agent now in use to overcome the 
vascular relaxation, and should then always be given with the saline solution. 
Its intravenous use is looked upon with suspicion on account of the cardiac 
and pulmonic accidents that may follow, or rupture of the cerebral vessels 
from the profoundly intimate action. 
Adrenalin (10 minims of 1 to 1000 solution) has been advised to cut 
short attacks of bronchial asthma, and it is also advised in opium and 
morphine poisoning. We would advise that it be retained for use in surgery 
only, and that a solution of the adrenalin and an isotonic salt solution be 
prepared beforehand to be ready for mixture in case of emergency. 
EQUISETUM. 
The plant, Equisetum hyemale, Linne (Nat. Ord. Equisetaceae). A peculiar leafless 
plant found throughout the northern and western parts of the United States in damp and 
wet situations. Dose, 5 to 60 grains. 
Common Names: Scouring Rush, Horse Tail, Shave Grass. 
Principal Constituents.-A large amount of silica, a soft green resin, and equisetic acid 
(aconitic acid). 
Preparation.-1. Specific Medicine Equisetum. Dose, 5 to 60 drops. 
2. Infusum Equiseti. Infusion of Equisetum. Dose, 1 to 2 fluidounces. 
Specific Indications.-Cystic irritation; tenesmic urging to urinate; 
nocturnal urinal incontinence; renal calculi. 
Action and Therapy.-Equisetum is diuretic and astringent. It is 
asserted to greatly relieve irritation due to the presence of gravel and the 
tenesmic urging to urinate in acute inflammations of the genito-renal tract. 
When the bladder becomes so irritable that the patient, upon dropping to 
sleep, loses control over the urine it is said to be specially serviceable. It 
has restrained hematuria and is of service in acute prostatitis and in the 
prostatorrhcea which follows it. The infusion (§j to Water, Oj) is the 
preferred preparation. 
ERECHTITES. 
The entire plant and oil of Erechtites hieracifolia, Rafinesque (Nat. Ord. Compositae). 
A rank weed throughout the United States. 
Common Name: Fireweed. 
Principal Constituent.-A volatile oil (Oleum Erechtitis). 
Preparation.-Oleum Erechtitis, Oil of Fireweed. Dose, 5 to 10 drops. 
Specific Indications.-Catarrhal states and passive hemorrhages; 
"albuminurea, dropsy, pale waxy skin, swelling of the feet, scanty urine" 
(Watkins). 
Action and Therapy.-True oil of fireweed (much that is sold is oil of 
fleabane) improves the appetite and digestion, stimulates the functions of 
the gastro-intestinal glands and pancreas, and causes free and full al vine 
evacuations, rendering it useful in chronic constipation, especially when 
acid fermentation and flatulence are present. Its ultimate effect upon the 
circulation is to raise vascular tension. It is eliminated most largely by the 
355 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
lungs, and to a lesser extent by the kidneys and skin. The class of dis- 
orders it benefits are those attacking the bronchial and renal mucosa, it 
being effective in relieving chronic bronchitis, pulmonic catarrhs with cough, 
and genito-urinary catarrh, pyelitis, and cystitis. It has been suggested in 
chronic nephritis, with pale, waxy skin and pedal oedema. For this purpose 
the dose should not be over one drop of the oil. in emulsion well diluted. 
Usually the oil is administered on sugar. 
ERGOTA. 
The sclerotium of Claviceps purpurea (Fries), Tulasne (Class Fungi), replacing the grain 
of rye {Secale cereale, Linne; Nat. Ord. Graminaceae). It should be carefully dried and kept in 
close containers with a few drops of chloroform or of carbon tetrachloride to protect it from 
the ravages of insects. Europe, chiefly from Spain and Russia. 
Common Names: Ergot, Ergot of Rye, Spurred Rye, Spur, Smut Rye. 
Description.-Purplish-black or brownish-black curved and tapered cylindraceous 
bodies, obscurely angled and furrowed and breaking with a short fracture, exhibiting a 
pinkish, reddish-white, or grayish-white interior. To the taste it is disagreeably oily, and 
has a peculiar, somewhat fish-like odor. Dose, 5 to 60 grains. 
Principal Constituents.-Until recently the chemistry of ergot seems to have been 
almost hopelessly confused. It is now known to contain several alkaloids, the chief of which, 
in point of activity, is ergotoxine (C35HnOoNs), believed to be the hydrate of the inactive 
ergotinine (C35N39O6N6). Ergamine (histamine) is another energetic constituent, while 
tyr amine, though powerful, is less active than the latter. To these alkaloids is attributed 
the action of ergot. Ergotine, ecboline, cornutine, sphacelinic acid, sphacelotoxine, secalo- 
toxine, chrysotoxine, and other bodies once thought to be important, may, in the light of 
present chemical conceptions of the constituents of ergot, be practically ignored. 
Preparations.-1. Specific Medicine Ergot. Dose, 1 to 60 drops; for hemorrhage 
and in labor, full doses. 
2. Lloyd's Ergot (for hypodermatic use). Dose, 5 to 60 drops. In hemorrhage and 
in labor, full doses. 
Specific Indications.-Active hemorrhage; post-partum hemorrhage 
(full doses); uterine inertia; congestion or hyperaemia of any part; venous 
fullness; mental apathy; dullness, hebetude, and tendency to coma; 
feeble circulation, cold surface, pallor, and dilated (sometimes contracted) 
pupils; fullness and uneasiness of genitalia, with or without oedema; hemi- 
plegia and paraplegia, with hyperaemia or congestion; congestive headache; 
hyperaemic or congestive eye and ear disorders; slight otorrhcea with turgid 
drum-head. 
Action.-Unless administered in toxic amounts ergot has no ap- 
preciable effect on the general nervous system, except to stimulate the 
vaso-motor center of the medulla and the uterine centers of the hypogastric 
plexus of the spinal cord. It has, however, an important controlling power 
over the circulation through its dominant action-that of stimulation of the 
circular fibers of non-striated muscle. It is thought to have less action 
upon the heart, as that is a specialized form of muscle differing materially 
from that of the vessels. Wood declared that the heart is distinctly de- 
pressed by the direct contact of the drug when reaching that organ. The 
general consensus of opinion, however, inclines to the belief that the heart is 
affected chiefly by the back pressure exerted by the constricting action of the 
drug upon the arterioles. The effects of ergot appear to be greatest upon the 
smaller parts of the vessels. Ergot has practically no effect upon the 
voluntary or striated muscle fibers. 
356 INDIVIDUAL DRUGS. 
The first effect of ergot upon the circulation is to lower blood pressure. 
Then by its vaso-constricting power it raises arterial tension. This action 
is thought to be due to a slight stimulation of the vaso-motor centers, but 
much more completely to its direct power over unstriped muscular fiber. 
In fact, the one great over-shadowing power of ergot is this vaso-con- 
striction of involuntary musculature which is exhibited in its action upon 
two groups of organs, viz.: the circulatory vessels and the hollow viscera. 
This gives to ergot its great power to control hemorrhage, and its propulsive 
force in labor. Ergot acts to a limited extent upon the non-gravid uterus, 
much more powerfully upon the gravid womb, and with great force when in 
parturient action. This is believed to be due most largely to its direct action 
upon the uterine musculature, but aided to some extent by stimulation of 
the hypogastric plexus and the terminals of the hypogastric nerves at the 
uterine myo-neural junction. Though ergot is said to fail to initiate 
uterine contraction in the very early months of fetal life, and is therefore 
incapable of inducing abortion, the facility with which this crime is com- 
mitted with ergot alone seems to controvert this stand. It is perhaps more 
difficult to produce its effects in this way than when mechanical interference 
has first been resorted to. Upon the stomach ergot acts as an irritant and 
often produces nausea and vomiting. While peristalsis is increased by ergot, 
the secretions of the skin, kidneys, salivary and mammary glands are 
decreased by ergot. 
Though ergot is said to have but little effect upon the general nervous 
system, it is known to produce a peculiar form of chronic poisoning of a 
spasmodic or convulsive type, and another, probably due to emboli, of a 
gangrenous character. 
Toxicology.-Ergot produces both acute and chronic poisoning. In 
Acute Ergot Poisoning there is nausea and vomiting, severe thirst, violent 
headache, slow, followed by rapid pulse, coldness of the surface, stupor and 
purpuric blotches. These cases are almost invariably the result of its use 
by women as an abortifacient. The main treatment is that of acute gastro- 
enteritis. To sustain the circulation, cardiac stimulants as caffeine, coffee, 
or amyl nitrite may be administered and heat applied to the body. Single 
large doses of ergot seldom kill; fatal results come only after long con- 
tinued use of small doses. 
Chronic Ergotism assumes two forms: the pathologic features of which 
do not differ greatly in some respects except in their terminations. It is 
common among the peasantry of Europe, who subsist on rye bread. The 
disease is thought to be due to contamination of the latter with ergotized grain. 
Spasmodic or Convulsive Ergotism develops successively with weari- 
ness, inordinate hunger, vomiting, and diarrhoea, headache, formication, 
numbness, mental torpor, drowsiness, dimness of sight, headache, tinnitus 
aurium, tonic and tetanic muscular contractions, and ends in convulsions. 
Sometimes it terminates in insanity and death. 
Gangrenous Ergotism is marked by exhaustion, voracious appetite, 
dilated pupils, dimness of vision, formication, cyanosis, muscular contrac- 
tion, and aching. It terminates in moist or dry gangrene of various parts 
of the body, but most frequently of the fingers and toes. This form is often 
fatal and is sometimes accompanied by cataract. 
357 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Therapy.-External. Lloyd's ergot (non-alcoholic) is an exceedingly 
good constringing drug in conjuctival congestion, keratitis, follicular con- 
junctivitis, incipient trachoma, and other conjunctival disorders with 
great vascularization. From 15 to 30 drops are added to 1 fluidounce of 
sterile water and instilled. It is also sometimes used by insufflation with 
boric acid (5j to fl3j), in purulent otitis media, with little discharge and 
a turgid tympanic membrane. Care should be had not to occlude the aural 
passage and thus prevent drainage. Fluid preparations of ergot applied 
to incipient boils sometimes abort them, and in acne seborrhcea, acne 
rosacea, and urticaria they have some ameliorating effect. Hemorrhoidal 
bleeding may be controlled by suppositories containing ergot, and powdered 
ergot sprinkled upon bleeding cancerous ulcerations has effectually con- 
trolled the seepage. 
Internal. Ergot was formerly very extensively employed in obstetrical 
practice to effect the rapid and forcible delivery of the child. As the 
uterine contractions produced by ergot are totally unlike the smooth, 
regular and intermittent action of those of normal labor, the drug proved 
a vicious and damaging medicine. Its vise-like compression frequently 
caused the death of the child by asphyxia, or rupture of the womb, or 
retention of the secondines, with subsequent sepsis. The contractions 
induced by ergot are violently tonic and tetanic, with scarcely an interval 
of repose, and never relaxing until the child is expelled or an accident 
occurs. They also continue for some time after the expulsion of the child, 
with the result of sometimes causing hour-glass contraction or otherwise 
imprisoning the placenta. It took many years for physicians to discover 
that in their heroic use of ergot they were fighting directly against nature. 
Proviso was always observed, however, that the os was sufficiently dilated, 
the presentation correct, and that there existed no disparity between the 
size of the fetal head and the pelvic outlet. Still the results were often bad 
and ergot continued in its trail of tragedy. 
Present-day obstetricians have but one indication for the use of 
ergot in obstetrics-threatened or alarming hemorrhage. They contend, 
and rightly, that the womb should be absolutely empty of child and placenta 
before ergot should be administered. As alarming hemorrhages, except 
in placenta praevia, are nearly always post-partum, ergot is then perfectly 
safe and the best agent that can be administered. There are some, however, 
who still Contend for the use of ergot when hemorrhage occurs or is threat- 
ened before the child is fully born. They do not use it until the head is 
extruded, and marked uterine inertia is evident. Even in such cases, 
while it contracts the vessels and the womb, it is liable to trap the secund- 
ines, and prompt use of the forceps and manual cleansing of the uterine 
cavity would appear to be the more rational procedure, ergot being given 
as soon as the placenta is removed. In the hands of a competent manipu- 
lator forceps are incomparably safer than ergot. If hemorrhage occurs 
after the uterus is completely emptied, a full dose of Lloyd's or other good 
preparation of ergot should be given hypodermatically, the womb manipu- 
lated by the Credo method, and other indicated measures employed. 
The routine custom of giving a dose of ergot after every case of par- 
turition, even when the womb is completely empty, for the purpose of 
358 INDIVIDUAL DRUGS. 
forestalling a possible hemorrhage, and in the absence of uterine inertia, 
is to be condemned. Increased after-pain is in itself a protest against the 
indiscriminate use of a remedy so productive of harm as ergot. Ergot 
should never be administered on suspicion, but only when there is present 
or impending complications demanding its exhibition. 
Ergot has been given, with only fair results, to promote the absorption 
or expulsion of polypi, and submucous uterine fibromata. Only very small 
neoplasms are thus affected, and then never when they are located outside 
the uterine body, or subperitoneally. For uterine subinvolution, however, 
ergot is one of the best and promptest of remedies, and is more especially 
indicated if there is also passive bleeding. 
Ergot contracts the sphincters, notably that of the bladder. Large 
doses will so strongly affect the latter that retention of urine occurs. In 
ordinary doses, however, it may be given with good results in incontinence 
of urine and other bladder affections with relaxation or weakness of sphincter 
control. From 10 to 15 drops of the specific medicine may be given in water 
and repeated as needed, or the following prescription by Locke may be 
administered. 3 Specific Medicine Ergot, fl 3 ss; Specific Medicine Barosma, 
fl^j; Simple Syrup, fl^ijss. Mix. Sig.: One teaspoonful every 4 hours. 
When cystic paralysis is due to overdistention of the bladder ergot fre- 
quently restores the power of the organ to contract. 
Amenorrhoea is sometimes cured by ergot. The cases in which it 
does good display relaxed tissue and congestion; under similar circum- 
stances it frequently aids in leucorrhcea. Spermatorrhoea, with tur- 
gescence of the erectile tissue, is sometimes bettered by small doses of ergot, 
though it frequently fails. 
Ergot is used largely for other than post-partum forms of hemorrhage. 
It is least valuable, perhaps, in hemoptysis, for vaso-contriction cannot well 
take place because the bronchial arteries are composed most largely of 
elastic in place of nonstriated muscular tissue and there are practically no 
vaso-motor nerves to control the pulmonic arterioles. Experience bears out 
this anatomical barrier to successful hemostatic control by vaso-constrictors 
like ergot. Nevertheless ergot is generally given in pulmonary hemorrhages, 
but usually in combination with other agents, which probably obscure its 
inefficiency. A favorite prescription with us in passive hemoptysis con- 
tains ergot selected, perhaps, with the hope that it may have some un- 
explained influence; at least the combination has been exceedingly efficient. 
B Specific Medicine Ergot (or Lloyd's Ergot), fl3ij; Specific Medicine 
Cinnamon; Specific Medicine Lycopus, aa fl^ss. Mix. Sig.: Twenty (20) 
drops in water every half hour until relieved. Locke advised the following: 
B Specific Medicine Ergot, gtt. x; Ipecac, gr. ss; Gallic Acid, gr. ij. Mix. 
Sig.: Give at one dose and repeat as needed. He advised the same for the 
hemorrhage of typhoid fever and in post-partum hemorrhage. In hem- 
atemesis ergot should be given preferably by hypodermatic injection, 
as it is more likely to increase the bleeding by inducing vomiting if given 
by mouth. Ergot is sometimes useful in epistaxis and in hematuria, though 
in all other forms of hemorrhages it is far less certain than in uterine hem- 
orrhage. 
359 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Ergot is of very great efficiency in metrorrhagia, in congestive men- 
orrhagia, and in excessive menstruation when shreds of membrane are 
passed. Dysentery with passages of blood is benefited by small doses of the 
drug. In purpura hemorrhagica and in hemophilia ergot often fails to act, 
probably because the fault is in the blood rather than the vessels. It is 
certainly of less value in these disorders than hydrastis and geranium. 
Ergot has been given for its contractile power over blood vessels to reduce 
the size of small aneurisms, which it sometimes does; it is most useful in 
small aneurismal sacculations of the cerebral vessels. Occasionally its 
external employment, combined with its local effects, controls the bleeding 
of and relieves hemorrhoids. 
Ergot is a valuable remedy in nervous affections when prescribed for 
those of a hyperaemic or congestive character. It is always contraindicated 
by anemia. In congestive headache it is especially effective. For mi- 
graine it is useful where there are suffused eyes, flushed face, and full pulse. 
In fact, the indications for vascular disturbances in nervous diseases are 
very similar to those for belladonna and the results are very much the same. 
Ergot may be given to advantage where there is "enfeebled capillary cir- 
culation with tendency to congestion, especially of the nerve centers." 
The direct indications are dull, full eyes, with dilated pupils, fullness of the 
veins, slow pulse, sighing respiration and tendency to coma. Following 
these guides it is one of the few remedies upon which hope of relief may be 
based in epidemic cerebro-spinal meningitis. It is especially helpful in 
acute myelitis, in spinal congestion, in cerebral hyperaemia from any cause, 
and in paraplegia, with the characteristic vascular sluggishness. In 
mental disorders ergot frequently benefits-especially in acute, and even in 
chronic mania, with lucid intervals. Some of these disorders depend upon 
minute aneurismal sacculations in the cerebral vessels. Such are more apt 
to be relieved than other forms of maniacal excitement. When any mental 
aberration depends upon intracranial congestion or obstruction, with 
bleeding from the nose, dizziness and hebetude, or headache, and tinnitus, 
due to intracranial miliary aneurisms, ergot renders most efficient service. 
Owing to the great variations in ergot, according to its age and manner 
of keeping, the drug frequently disappoints. For this reason only good, 
fresh ergot or preparations of it prepared by reliable firms should be used. 
Preferably it should be standardized, as most of its uses are in accordance 
with its known physiologic power of contracting unstriped muscular fiber. 
No one of the constituent principles abstracted from ergot fully and satis- 
factorily represents the drug, though the so-called ergotins, all varying 
more or less, come the nearest to duplicating the action of the ergot itself. 
ERIGERON. 
The whole plant of Erigeron canadense, Linn£ (Nat. Ord. Compositae). A common 
and troublesome weed through the northern and central parts of the United States. 
Common Names: Canada Fleabane, Colt's Tail, Pride Weed, Scabious. 
Principal Constituents.-A volatile oil (Oleum Erigerontis), and tannic and gallic acids. 
Preparations.-1. Specific Medicine Erigeron. Dose, 1 to 60 drops. 
2. Oleum Erigerontis, Oil of Erigeron. Dose, 5 to 30 minims, on sugar. 
Specific Indications.-(Oil) capillary or passive hemorrhages- 
hematuria, hemoptysis, epistaxis, hematemesis, and metrorrhagia; "pain- 
360 INDIVIDUAL DRUGS. 
ful diseases of the kidneys and bladder, and in diseases of the mucous mem- 
branes attended by free discharges" (Scudder). Infusion, choleraic dis- 
charges, sudden, gushing, and watery, attended with thirst and cramping 
pain, and sometimes streaked with blood. 
Action and Therapy.-Erigeron restrains excessive bowel and kidney 
discharges. An infusion is a deservedly popular remedy for profuse summer 
diarrhoeas of infants, especially that of cholera infantum and gastro- 
enteritis. It is indicated by the suddenly gushing and copious evacuations, 
with cramps, or with but little pain, but often with the presence of slight 
amounts of blood. The infusion is better than alcoholic preparations for 
these purposes; besides it supplies water to take the place of the natural 
fluids so greatly depleted by the discharges. It is also useful in dysentery 
with passages of mucus and blood. As a remedy for slight hemorrhages, 
as from the bowels and kidneys, it is rather weak, but sometimes effectual; 
the oil is a much surer acting hemostatic. Both may be used as a diuretic 
in gravelly conditions as well as in chronic nephritis, when the urine is 
tinged with blood, or even where passive hemorrhage is present. It has 
restrained the pathologic flow of urine in polyuria, or so-called diabetes 
insipidus. 
The oil of erigeron is a good internal hemostatic. It sometimes checks 
quite severe uterine hemorrhages, and for very small oozings of blood it is 
one of the very best agents to control the flow. It is also indicated in 
epistaxis and moderate bleeding from the stomach, bowels, and kidneys. 
Given in syrup it is useful as a cough medicine when there is bloody ex- 
pectoration. 
ERIODICTYON. 
The dried leaves of Eriodictyon californicum (Hooker and Arnott), Greene (Nat. Ord. 
Hydrophyllaceae). A shrubby plant of California and northern Mexico. Dose, 5 to 30 
grains. 
Common Names: Yerba Santa, Mountain Balm. 
Principal Constituents.-Resin, volatile oil, the glucoside ericolin, and eriodictyonic acid. 
Preparation.-Specific Medicine Yerba Santa. Dose, 5 to 30 drops. 
Specific Indications.-"Cough with abundant and easy expectora- 
tion" (Scudder). "Chronic asthma with cough, profuse expectoration, 
thickening of the bronchial membrane, loss of appetite, impaired digestion, 
emaciation" (Watkins). 
Action and Therapy.-A stimulating expectorant having a kindly and 
beneficial action upon digestion. It is to be employed where there are 
excessive catarrhal discharges of the bronchial and renal tracts. It may 
be used where there is chronic cough with free secretions, as in chronic 
bronchitis, bronchorrhcea, humid asthma, and the cough of phthisis. 
Some cases of chronic catarrh of the stomach and catarrhal cystitis have 
been successfully treated with it. 
The rhizome of Eryngium yuccafolium, Michaux (Nat. Ord. Umbelliferae). A swamp 
and wet prairie plant found from Virginia to Texas. Dose, 10 to 40 grains. 
Common Names: Eryngo, Water Eryngo, Button Snakeroot, Rattlesnake's Master, 
Corn Snakeroot. 
Principal Constituents.-(Has not been analyzed.) 
Preparation.-Specific Medicine Eryngium. Dose, 5 to 40 drops. 
ERYNGIUM. 
361 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Burning pain, with renal, vesical or urethral 
irritability; painful micturition, with frequent urging to urinate; frequent, 
scanty and scalding urination; scanty urine, with frequent and ineffectual 
attempts to urinate; deep-seated pain in bladder extending into the loins; 
profuse mucous discharges. 
Action and Therapy.-The root of eryngium, when chewed, causes a 
profuse flow of saliva; in large doses it is emetic. Its chief properties are 
those of a diuretic and expectorant. While of considerable value in chronic 
laryngitis and bronchitis with free and abundant secretion of muco-pus, 
it is of most service in irritation of the bladder and urethra, with itching, 
burning, and constant urging to urinate. It is also useful in dysuria with 
tenesmus. For that condition in women during or following menstruation, 
or during the menopause, when sudden chilling throws the burden of ex- 
cretion upon the kidneys, it is invaluable to control the bladder symptoms- 
as fullness, burning, itching, frequent attempts at urination, or when every 
movement of the body is accompanied by the involuntary passing of urine. 
We know of no remedy that acts so promptly and satisfactorily in such 
conditions. In the male it relieves uneasy sensations, with burning and 
itching throughout the vesical, prostatic, and urethral tracts, especially 
when following gonorrhoea or gleet. It is not contraindicated by inflam- 
mation and is of great value in acute cystitis, with deep-seated, burning 
pain, and where normal secretion is scanty and pathologic catarrh is more 
abundant. It acts well with apis or gelsemium, with the latter especially 
when there is a hypersemic state of the bladder. It relieves the burning 
pain of urination in gonorrhoea. It is indicated to relieve the difficulties of 
voiding urine from the presence of gravel and of chronic nephritis; and it 
restrains the excessive discharges of chronic cystitis. When spermatorrhoea 
is provoked by urethral irritation, eryngium serves to limit the frequency 
of losses. 
Sometimes eryngium will be found useful in digestive disorders, with 
persistent gastric irritation and mucous diarrhoea. In these cases the tongue 
is red and tender, nausea is marked, and there is a strong disgust for food. 
EUCALYPTUS. 
The leaves of Eucalyptus Globulus, Labillardiere. Collected from the older parts of the 
tree. (Nat. Ord. Myrtaceae.) A native tree of Australia; cultivated elsewhere. 
Common Name: Blue Gum Leaves. 
Principal Constituents.-A volatile oil (Oleum Eucalypti) composed largely of eucalyp- 
tol (cineol) (Ci0Hi8O), and a resin. 
Preparations.-1. Oleum Eucalypti, Oil of Eucalyptus (contains a large proportion, 
not less than 70 per cent, of eucalyptol). It is colorless or pale yellow, aromatic and pun- 
gent, and has a spicy, cooling taste. Dose, 1 to 10 drops. 
2. Eucalyptol, a neutral body derived from the oil. It is a colorless, spicy, aromatic 
fluid, with a cooling taste. Dose, 1 to 10 drops. 
3. Specific Medicine Eucalyptus. Dose, 5 to 30 drops. 
Specific Indications.-Cold extremities and cold perspiration; perspira- 
tion during chill; sense of coldness and weight in the intestines; chronic 
mucous or muco-purulent discharges; pus in the urine; pasty, bad-smelling 
tongue; fetid excretions; fetid sore throat; fetid catarrhal states of the 
broncho-pulmonary tract; chronic ague with exhaustive discharges. 
362 INDIVIDUAL DRUGS. 
Action.-Eucalyptus, and its oil and derivative, are gentle stimulants 
when given in small doses. Large doses are irritant and may cause gastro- 
intestinal inflammation and renal congestion. Muscular prostration 
occurs from overdoses. Blood pressure is lowered by full doses. All the 
secretions are stimulated when these agents are given in medicinal amounts. 
All preparations of Eucalyptus are considered antiperiodic and the planting 
of groves and trees in miasmatic swamps and low grounds is thought to 
render the air free from malarial miasm. The probabilities are that the 
enormous quantities of water absorbed by these trees does good by drying 
the swamps and thus making them poor breeding places for malaria-bearing 
insects. It is said that a part of the deadly Roman Campagna has been 
rendered habitable by the introduction of Eucalyptus groves. 
Therapy.-External. Eucalyptus preparations are antiseptic and 
disinfectant. They may be sprinkled or sprayed upon offensive material 
and used to disinfect and deodorize the sick room. They also may form an 
ingredient of antiseptic poultices and ointments. Dropped upon hot 
water, or used in suitable oil dilution in sprays, they are useful as throat and 
pulmonary antiseptics and stimulants. Eucalyptol is especially much 
employed in subacute inflammations and chronic diseases of the broncho- 
pulmonic tract, with fetor, relaxation and abundant secretions. Used 
upon cancerous surfaces they mask the fetid odor and give some relief from 
pain. The following is an ideal vaginal wash for offensive leucorrhcea: 
I|. Sea Salt, 1 lb.; Fluidextract of Eucalyptus or Specific Medicine Euca- 
lyptus, fl^ss. Mix in a glass or tin container. Sig.: One tablespoonful to 
1 pint of hot water, and inject with a glass syringe. All preparations of 
eucalyptus may be used from full strength to any desired dilution upon old 
ulcers, wounds, gonorrhoeal discharges, ozaena, septicaemia, and gangrene; 
all with free but fetid discharges. Inhalations of them are especially useful 
in pulmonary gangrene. 
Internal. Eucalyptus is a fine stimulating expectorant for broncho- 
pulmonary catarrhal disorders, when no very active inflammation is 
present. It restrains discharges, facilitates expectoration, and deodorizes 
and antisepticizes the sputum. Chronic bronchitis, bronchorrhcea, and the 
debility, with difficult expectoration, lingering in the wake of broncho- 
pneumonia and lobar pneumonia are conditions in which it is of very 
great value. 
Agents of this type, which may be compared to the turpentines, and 
which influence the respiratory membranes, usually are valuable for similar 
uses in the urino-genital tract. Thus we find eucalyptus an alterative and 
antipyic in pyelitis and in catarrhal and purulent cystitis, particularly in the 
aged. Being eliminated by all the mucous surfaces, it exerts its anti- 
septic influence upon them in all parts of the body. While the oil and eu- 
calyptol are popular with many, we prefer the specific medicine or the 
fluidextract for most purposes. 
Eucalyptus is a stimulating antiseptic for the angina of scarlatina, for 
which by some it is administered internally. This should be done with great 
care, however, for the drug is liable to produce congestion of the kidneys, one 
of the dreaded complications which is easily provoked in the acute exan- 
themata. If acute desquamative nephritis is present it should not be 
363 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
employed; in the advanced stage of chronic nephritis with very marked 
fetor in the urine, and scanty secretion of urine, very small doses of eu- 
calyptus may be cautiously tried. Eucalpytus and its preparations are 
distinctly contraindicated when acute inflammation of any part exists. 
The antimalarial properties of eucalyptus are taken advantage of in 
cases of malarial infection that do not respond to quinine or in which the 
quinine has an otherwise undesired effect. The more chronic the cases- 
without distinct cycles-the better the drug seems to act. It is also natu- 
rally used for many of the complications or results of chronic malarial 
cachexia, as periodic headache and neuralgia. It is only in occasional cases 
of malarial fever that it does a great deal of good, especially acting best 
if there are exhaustive discharges, but it is never without some beneficial 
power. It is not to be compared to cinchona medication in the ordinary 
run of malarial fevers. Used according to indications as given above, 
eucalyptus is a very satisfactory and pleasant medicine. It is best given 
in syrup or glycerin. 
EUONYMUS. 
The bark of the root of Euonymus atropurpureus, Jacquin (Nat. Ord. Celastrinaceae). 
A small shrub or bush of the United States. Dose, 5 to 60 grains. 
Common Names: Wahoo, Indian Arrow-wood, Burning Bush, Spindle Tree. 
Principal Constituents.-A bitter glucoside euonymin, closely resembling digitalin; 
asparagin, and euonic acid. (Euonymin should not be confounded with the resinoid of the 
same name employed by the early Eclectics.) 
Preparation.-Specific Medicine Euonymus. Dose, 5 to 60 drops. 
Specific Indications.-Yellow-coated tongue; anorexia; indigestion and 
constipation, due to hepatic torpor; prostration with irritation of the 
nerve centers; periodic diseases, to supplement the action of quinine. 
Action and Therapy.-Wahoo sharpens the appetite, improves diges- 
tion, stimulates the hepatic function, and increases nutrition. It has 
decided laxative properties and is to some extent antiperiodic. Locke 
declared it one of the few good stomach tonics. Its antimalarial influence 
is best displayed after the chill has been broken by quinine. It may then 
be given as a tonic, and it materially assists in preventing a recurrence of the 
paroxysms. However, it is not a major remedy in intermittents, and 
general tonic effects are chiefly to be expected. It acts much better in the 
gastric debility following intermittent fevers than during the active attacks. 
Euonymus is a good stomachic bitter in atonic dyspepsia with malarial 
cachexia, or when due to faulty and torpid action of the liver. Many value 
it in so-called chronic ague, and in the constipation and gastric debility 
associated with or following it. Euonymus is a neglected bitter. 
EUPATORIUM. 
The flowering tops and leaves of Eupatorium perfoliatum,Tinne (Nat. Ord. Compositae). 
Swamps and low meadows throughout the United States. Dose, 5 to 60 grains. 
Common Names: Boneset, Thoroughwort, Indian Sage, Ague Weed, Through-Stem, 
Thorough-Wax, Crosswort, Vegetable Antimony. 
Principal Constituents.-Volatile oil, tannin, and a soluble, bitter glucoside-eupatorin. 
Preparations.-1. Specific Medicine Eupatorium. Dose, 5 to 60 drops. 
2. Infusum Eupatorii, Infusion of Boneset. Dose, 1 to 4 fluidrachms. 
364 BONESET 
(Eupatorium perfoliatum) 
Courtesy of Mr. Moritz Fischer 
Photo by Moritz Fischer, Cincinnati, Ohio 
Boneset is the most valuable of the Eupatoriums, and has long been a leading medicine in 
domestic simpling -as an emetic, diaphoretic, and antiperiodic. In every great invasion of 
influenza it has rendered signal service. It is largely of Eclectic development and is now re- 
garded as one of our important medicines. INDIVIDUAL DRUGS. 
Specific Indications.-Large full pulse, the current showing little 
waves; skin hot and full, with a tendency to become moist, even during the 
progress of fever; deep-seated aching pain (so-called "bone pains") in muscles 
and periosteum; cough, embarrassed breathing, and pain in the chest; urine 
turbid and urination frequent; influenzal cough and aching pain. 
Action.-Eupatorium, in small doses, acts as a simple bitter; in large 
doses it is emetic. Given in hot infusion it causes both emesis and profuse 
diaphoresis; sometimes catharsis also results. In cold infusion, or small 
doses of the alcoholic preparations, it is tonic and aperient. It also has 
marked but unexplainable antimalarial properties. 
Therapy.-Eupatorium is an old American drug that has found its 
way into general medicine through aboriginal and domestic usage. Formerly 
it was a favorite emetic and was successfully used at the outset of fevers of 
the bilious remittent and intermittent types. Its antiperiodic properties 
were well known and used to advantage in ague districts many years ago. 
Its property of relieving deep-seated pain was also early recognized, obtain- 
ing for it the vulgar name of "Boneset". It is now seldom, or never, used 
as an emetic chiefly because emetics are not often employed, and also on 
account of the bitterness of the drug and the quantity of infusion required. 
Its thoroughness as such, however, cannot be questioned, and it has no 
poisonous or depressing qualities. Eupatorium is now used in malarial 
affections of the irregular and masked types, and particularly those not 
benefited by quinine. The chill and succeeding fever are slight, the skin 
dry, and not, as a rule, followed by perspiration; there is deep-seated, 
aching pain, as if "in the bones", praecordial oppression, and great thirst. 
If, however, the fever lasts all day, slight sweating may occur at night. 
An added indication in ague is vomiting, especially of much bile. Formerly 
the hot infusion was given to emeto-catharsis, and followed during the inter- 
mission with tonic doses of the cold infusion. This is now known to be 
unnecessary, full doses, short of nausea, of the alcoholic preparations being 
fully as efficient. Malarial headache, with irregular intermittence, is also 
relieved by small doses of the drug. 
Eupatorium is an admirable remedy "to break up a common cold," 
especially when accompanied by deep-seated, aching pain and slight or 
no fever. If there are pleuritic pain and hoarseness, it is also valuable. 
In every epidemic of influenza it has been used with great advantage. 
During the severe pandemic of 1918-19 it was one of the safest and most 
successful remedies employed and contributed much to the successful 
management of the disease under Eclectic treatment. By many it came 
to be used as a prophylactic, persons taking it freely apparently escaping 
attack. Notwithstanding this, its prophylactic power, if it has any, is as 
yet unexplained and should not be seriously relied upon. That cases were 
rendered milder, deep-seated pain promptly relieved, cough and respiratory 
irritation lessened, and recovery expedited under the liberal administra- 
tion of eupatorium is a matter of record. It is especially valuable to 
relieve the intolerable backache and pain in the limbs. Eupatorium often 
relieves periosteal pain of a neuralgic type, particularly if associated with 
malarial infection, but it renders no service in that caused by inflammation 
or by syphilitic or other organic changes in the periosteum. 
365 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
In respiratory affections boneset is efficient to relieve cough, acting 
best in that occurring in the aged and debilitated, where there is an abun- 
dance of secretion, but lack of power to expel it. It also relieves hoarseness, 
and sometimes benefits in humid asthma. It is one of the best of medicines 
to relieve the irritable cough of measles, but care must be taken not to push 
its effects to nausea and vomiting. For children it is best administered in 
an aromatized syrup. In pneumonia it relieves chest pains and cough, and 
for these purposes may be employed in the early stage of acute lobar, but 
more effectually in broncho-pneumonia. After the active stages have 
passed it again becomes useful to allay the irritable after-cough and to 
assist in expectoration when bronchorrhcea occurs. Being tonic and 
stomachic, when given in small doses it improves the appetite and digestion 
and thus favors a more rapid and perfect convalescence. 
The root of Eupatorium purpureum, Linne (Nat. Ord. Compositae). Low meadows 
and woods of the United States. Dose, 5 to 60 grains. 
Common Names: Queen of the Meadow, Gravel Weed, Gravel Root, Joe Pye Weed. 
Principal Constituents.-Volatile oil and a resin (eupatorine). 
Preparations.-1. Specific Medicine Gravel-Root. Dose, 1 to 60 drops. 
2. Decoctum Eupatorii Purpureii, Decoction of Gravel Root (5 j to Water, Oj). Dose, 
1 to 3 fluidounces. 
Specific Indications.-Vesical irritation; incontinence of urine, painful 
and frequent urination; pain and weight in loins extending to the bladder; 
scant and milky urine with admixture of blood and mucus. 
Action and Therapy.-While of some value in chronic gastro-intestinal 
irritation, with catarrhal secretion, and in some forms of cough, with free 
expectoration, the chief use of gravel-root is to relieve chronic irritation of 
the urinary passages. For this purpose it is one of the most satisfactory of 
medicines. It is adapted to cases in which there is constant urging to pass 
urine, accompanied by a sense of obstruction, and the excretion is mixed 
with mucus and blood. Though not curative, it is often invaluable in 
chronic nephritis, to meet many of the unpleasant urinary symptoms. 
For the uric acid diathesis gravel-root is one of the best of drugs. It will 
not, as has been claimed, dissolve gravel, but by its diuretic action it eliminates 
those particles which may form the nuclei of larger concretions. Besides, 
its effects upon irritated or inflamed parts due to such deposits when present 
is to soothe and heal them. It especially relieves the deep-seated pelvic 
perineal aching common to sufferers from cystitis and subacute prostatitis. 
For passive hematuria it is one of the best drugs we possess. When hydra- 
gogues have been used to deplete the body in ascites, gravel-root, by stim- 
ulating diuresis, greatly retards the re-establishment of the effusion. 
Gravel-root relieves the urinary disturbances of pregnancy so far as 
difficulty in voiding urine is concerned. It is also very useful in prostatitis, 
acting best after the acute inflammatory condition has been subdued. 
Gravel-root is a neglected drug and often should be employed in 
urinary disorders where less efficient and more harmful agents are dis- 
played. High-colored urine, with blood and solids and voided with pain, 
and milky-looking urine, should lead one to hope for good results from its 
use. If the specific medicine is administered it should be given in hot 
EUPATORIUM PURPUREUM. 
366 INDIVIDUAL DRUGS. 
water. The decoction is often the best form of administration. It acts 
well with the special sedatives, and if fever is present or the skin is hot, dry, 
and constricted it may be given with aconite or gelsemium. 
EUPHORBIA COROLLATA. 
The bark of the root of Euphorbia corollata, Linne (Nat. Ord. Euphorbiaceae). Dry 
fields and woods of Canada and the United States. 
Common Names: Large Flowering Spurge, Blooming Spurge, Milk Purslane, Snake 
Milk. 
Principal Constituents.-Resin, caoutchouc, and probably euphorbon. 
Preparation.-Specific Medicine Euphorbia. Dose, 1/10 to 10 drops. 
Specific Indications.-Persistent gastric irritation; irritative diarrhoea 
of catarrhal discharges, with debility; long-pointed tongue, with prominent 
papillae; uneasy sensation in the stomach; cholera infantum, with hot, 
tumid abdomen and constant desire to defecate, the stools being greenish 
and irritating; irritation of the respiratory tract, especially the glottis, 
with persistent cough and tough and tenacious secretion. 
Action and Therapy.-In full doses euphorbia is a comparatively mild 
emetic; in overdoses it causes drastic emeto-catharsis. It was formerly 
used to fulfill the purposes of an emetic and purgative in dropsical con- 
ditions. It is now used chiefly in small doses for irritation of the gastro- 
intestinal and respiratory tracts. It often relieves diarrhoea and dysentery, 
with full and tenesmic passages. It is especially useful in cholera in- 
fantum, with hot, tender abdomen and constant desire to go to stool, the 
discharges being greenish and irritating. Euphorbia is a good gastro- 
intestinal sedative and tonic, and is most effective when the tongue is red, 
long and pointed, and there is persistent vomiting. In moderate doses it 
may be used in obstinate constipation, with evidence of gastric irritation. 
Euphorbia is contraindicated by active inflammation. 
Bowles (Eclectic Medical Journal, 1921, page 459) praises Euphorbia 
as an excellent sedative for persistent, irritative cough following influenza, 
and that due to chronic catarrhal inflammation of the larynx and pharynx. 
The glottis seems especially irritable and the cough is exasperating- 
worse from riding or walking in the cold air, or is aggravated by exertion 
after a full meal. There is but little secretion, and that is tough, tenacious, 
and glutinous, and requires persistent hawking to aid in its expectoration. 
One or two drops may be taken upon the tongue and slowly swallowed; 
or 40 drops of Specific Medicine Euphorbia may be added to 4 ounces of 
water, and of this a teaspoonful may be taken every 2 hours. Bowles also 
used it, with phytolacca and phosphate of hydrastin, to reduce enlarged 
tonsils following tonsillitis. 
The American species of Euphorbia furnish a rich field for restudy. 
Formerly some of them were quiet extensively used as medicines, but seem 
to have been crowded out by similarly-acting foreign drugs. 
The chief indications for Euphorbia are: profuse mucous discharges, 
whether from the pulmonic, gastro-intestinal, or urino-genital mucosa; 
or the tough, glutinous tracheo-broncho-pulmonic secretions, with irritation. 
367 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
EUPHORBIA HYPERICIFOLIA. 
The entire plant Euphorbia hypericifolia, Linne (Nat. Ord. Euphorbiaceae). A common 
weed in rich soils of gardens and waste places throughout the United States. 
Common Names: Large Spotted Spurge, Garden Spurge. 
Principal Constituents.-Tannin, gallic acid, and a caoutchouc-like body. 
Preparation.-Specific Medicine Spotted Spurge. Dose, 1 to 10 drops. 
Specific Indications.-Gastro-intestinal irritation with greenish and 
irritant passages. 
Action and Therapy.-True, testing this plant upon himself, found the 
infusion to produce a full frontal headache, similar to but less severe than 
that caused by macrotys, with an unpleasant fullness with oppression at the 
epigastrium, and a sense of languor and drowsiness. Intense constipation 
followed. He concluded that it is a cerebral stimulant, and secondarily a 
sedative to the brain and sympathetic nervous system. 
The drug is valuable in gastro-intestinal irritation with watery and 
mucoid discharges, having been used most successfully in cholera infantum, 
cholera morbus, muco-enteritis and dysentery, after the acute inflammation 
has subsided. For the first-named child's disorder it is one of the most 
certain of sedative-astringents. 
The bark of the root of Euphorbia Ipecacuanha, Linn6 (Nat. Ord. Euphorbiaceae). 
A perennial found in dry sandy soils on the Atlantic seaboard from Long Island south and 
west to the Middle States. 
Common Names: American Ipecac, American Ipecacuanha, Wild Ipecac, Ipecac 
Spurge. 
Principal Constituents.-An active resin and euphorbon. 
Preparations.-1. Fluidextractum Euphorbice Ipecacuanhce, Fluidextract of Euphorbia 
Ipecacuanha. Dose, 1 to 10 drops. 
2. Tinctura Euphorbice Ipecacuanhce, Tincture of Euphorbia Ipecacuanha (5viij to 
Alcohol, 76 percent Oj). Dose, 1 to 10 drops. ( Usual form of Administration.-Tincture of 
Euphorbia Ipecacuanha, gtt. xx, Water, q. s. flgiv. Mix. Sig.: One teaspoonful every 
2 or 3 hours.) 
Action and Therapy.-This is an old American medicine that was 
formerly employed as a substitute for ipecac. It is less active than Eu- 
phorbia corollata, but like it produces emeto-catharsis. In small doses it 
quiets irritation of the mucous membranes, proving useful in both gastro- 
intestinal and bronchial disorders. The indications and uses are practically 
the same as those given for Euphorbia corollata, which see. Besides, it 
has been advised in irritative dyspepsia, and jaundice with obstinate 
hepatic torpor. For the latter purposes the larger doses are to be employed. 
EUPHORBIA IPECACUANHA. 
EUPHORBIA PILULIFERA. 
The whole plant Euphorbia pilulifera, Linne (Nat. Ord. Euphorbiaceae). A plant of 
tropical climes and throughout the gulf states of the United States. 
Common Names: Pill-bearing Spurge, Cat's Hair, Queensland Asthma Weed. 
Principal Constituents.-Resins of a glucosidal character, tannin, and salts of po- 
tassium, sodium, magnesium, and silica. 
Preparation.-Specific Medicine Asthma Weed. Dose, 1 to 30 drops. 
Specific Indications.-Spasmodic and dyspnoeic breathing with 
bronchial irritation. 
368 INDIVIDUAL DRUGS. 
Action and Therapy.-A remedy for spasmodic asthma and coughs of 
a convulsive character due to recent colds. It is somewhat anodyne as 
well as antispasmodic and expectorant, and is asserted useful in the irrita- 
tive, teasing, and paroxysmal coughs of the chronic bronchitis of old persons 
and consumptives. It is also said to relieve dyspnoea of cardiac origin and 
to be of some use in emphysema. It may be administered in syrup, if de- 
sired. 
EUPHRASIA. 
The plant Euphrasia officinalis, Linne (Nat. Ord. Scrophulariaceae). Europe and 
America. Dose, 1 to 30 grains. 
Common Name: Eyebright. 
Principal Constituents.-An acrid, bitter principle and a volatile oil. 
Preparation.-Specific Medicine Euphrasia. Dose, 1 to 60 drops. 
Specific Indications.-Acute catarrhal diseases of the eyes, nose, and 
ears; fluent coryza with copious discharge of watery mucus. "Secretion 
of acrid mucus from tjie eyes and nose with heat and pain in the frontal 
sinus" (Scudder). 
Action and Therapy.-An admirable remedy for acute catarrhal in- 
flammations of the nasal and ocular membranes, with profuse, watery 
secretion or abundant flow of acrid mucus, and attended with heat, pain, 
burning, and sneezing. It is one of the most certain agents in acute coryza 
and in mucous ophthalmia, with abundant lacrimation. It is equally effective 
when acute catarrhs extend to the ears through the Eustachian passages, 
and are attended by earache, headache, sneezing, and coughing. Eu- 
phrasia is useful both to prevent and to relieve, in the early stages, acute 
frontal sinusitis. During or following measles it controls the distressing 
catarrhal symptoms. In all disorders its most direct indication is profuse 
watery discharge with acute inflammation or irritation. It is less valuable 
in the catarrhal disorders of the gastro-intestinal tract. 
Euphrasia is a striking example of a simple drug that has acquired a 
great and exaggerated reputation in folk-medicine. Euphrasia means 
"good cheer, or delight," and refers to its reputed "effects upon the spirits 
through its benefits to the sight" (Millspaugh). It once enjoyed a 
great but unsustained reputation as a cure for all diseases of the eye, 
even becoming the theme of the poet's pen-Milton referring to it in 
Paradise Lost, as purging "the visual nerve." It came into Eclectic 
medication from Homoeopathic sources, but with some modifications 
of symptomatology. The characteristic symptom calling for it is acridity 
of the discharges, and this is emphasized by Homoeopathic writers. It 
matters little whether the discharges be thin and watery, or thick and 
yellow-they are free, biting and excoriating, making the lids red and sore. 
It is essentially a remedy for catarrhal states and for superficial, not deep, 
eye disorders. Accumulation upon the cornea of sticky mucus befogging 
vision is a euphrasia indication. With such ocular disorders is usually more 
or less coryza, which may be far less hot and biting, or may be bland. 
The drug has proved especially useful in the epidemics of la grippe in recent 
years to control the profuse lachrimation. Euphrasia sometimes proves 
serviceable in hay fever, having the characteristic discharges above 
mentioned. 
369 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
The leaves and branches of Fabiana imbricata, Ruiz and Pa von (Nat. Ord. Solanaceae). 
A Chilean tree-like shrub. 
Common Name: Pichi. 
Principal Constituents.-Resin, fabianine (?), a supposed alkaloid, and an aesculin-like 
body. 
Preparation.-Fluidextractum Fabiana, Fluidextract of Fabiana. Dose, 5 to 60 drops. 
Action and Therapy.-A remedy for functional catarrhal diseases of 
the stomach, kidneys, and bladder. Like all the terebinthinates when 
given in small doses, it is of some value in vesical pain with frequent urina- 
tion, cystic irritation, with dysuria and vesical tenesmus, and in nocturnal 
urinal incontinence. It is asserted useful in acute albuminuria, with blood in 
the urine, and due chiefly to renal hyperaemia, but should be avoided in 
chronic nephritis. Pichi has no curative effects upon pathologic tissues, 
but is a remedy for functional defects alone. 
FABIANA. 
FARINA TRITICI. 
The sifted flour of the grain of Triticum sativum, Lamarck (Nat. Ord. Graminaceae). 
Common Names: Wheat Flour, Common Flour. 
Principal Constituents.-Starch, vegetable albumin, and proteids of gluten, (gluten- 
fibrin, mucedin, and gliadini), and a small amount of allantoin. 
Derivative.-Furfures Tritici, Bran. 
Action and Therapy.-External. Bread made of wheat flour is an 
excipient of some pills, and forms the basis of the bread and milk poultice. 
Wheat-flour paste well thinned is emollient and may be used per rectum 
for the administration of medicines in colitis. Rarely wheat flour is used as 
a dusting powder for burning and itching surfaces, as in urticaria, erysipelas, 
sunburn, and mixed with molasses promptly relieves the pain in burns and 
scalds. Infusion of bran is a useful emollient for rough skin, and assists in 
removing the odor of such agents as iodoform. 
Internal. A thinned paste of wheat flour is demulcent and may be 
used to protect an irritated stomach and oesophagus in cases of irritant and 
corrosive poisons. In the absence of starch it may be used to antidote 
poisoning by iodine. Bran, mixed with stewed fruits or baked in a biscuit 
or cake, is a common mechanical laxative for habitual constipation, often 
proving more effective than medicines. 
FEL BOVIS. 
Oxgall, Oxbile. The fresh bile of Bos Taurus, Linn£ (Family, Bovidae), the Common Ox. 
Description.-A brown-green or dark-green, disagreeably bitter, and somewhat 
viscous liquid, having a peculiarly unpleasant taste. Neutral or slightly alkaline in reaction. 
Used in preparing Extract of Oxgall. 
Principal Constituents.-Bile acid salts (glycocholates and taurocholates), and bile 
pigments (bilirubin, biliverdin, bilifuscin, etc.), and cholesterin. 
Preparation.-Extractum Fellis Bovis, Extract of Oxgall, (Powdered Extract of Oxgall). 
Dose, 1 to 5 grains. 
Action and Therapy.-Common oxgall is used by the laity for the gall- 
stone diathesis, and the purified form by physicians whenever there is a 
deficient supply of normal bile, particularly in chronic constipation with 
clay-colored stools, in jaundice and in intestinal dyspepsia, due to hepatic 
torpor. 
370 INDIVIDUAL DRUGS. 
FERRI ARSENAS. 
Iron Arsenate, Ferrous Arsenate. (Formula: Fe32AsO4.) 
Description.-An amorphous, odorless and tasteless olive or blue-green powder; 
insoluble in water and alcohol. Dose, 1/16 to 1/12 grain. 
Action and Therapy.-This was at one time thought to retard cancerous 
growths, but time has proved it of no value for that purpose. It is chiefly 
used in anemic persons with herpetic and dry, scaly skin diseases, and in 
the anemia following, or associated with, chronic diarrhoea. 
FERRI BROMIDUM. 
Ferrous Bromide, Bromide of Iron. 
(Formula: FeBr2). 
Description.-A deliquescent salt of a yellow color, having an extremely styptic taste, 
and very soluble in water. Like iodide of iron it is unstable and should be employed in the 
form of a syrup, as sugar tends, in a measure, to prevent its decomposition. 
Preparation.-Syrupus Ferri Bromidi, Syrup of Bromide of Iron. Dose, 1/2 to 1 
fluidrachm. 
Action and Therapy.-External. An ointment of Bromide of Iron, 
Glycerin, aa, 1 part; Adeps, 14 parts, is sometimes used as a resolvent for 
scrofulous swellings and various glandular enlargements. 
Internal. A syrup in doses of 1/2 to 1 fluidrachm is given at the same 
time that the above local treatment is being applied. It is also advised as a 
resolvent in cutaneous diseases with glandular involvement, and in anemia 
with chorea. It is uncertain, somewhat toxic, and has little to commend it. 
Saccharated Ferrous Carbonate, Saccharated Carbonate of Iron. 
Description.-A greenish-brown, odorless powder, gradually oxidizing on exposure 
to air, and having at first a sweetish, followed by a weak iron-like taste. Soluble partially 
in water, but completely dissolved by hydrochloric acid, with effervescence, forming a clear 
greenish-yellow liquid. Dose, 5 to 20 grains in pill. 
Related Preparations. 1. Massa Ferri Carbonatis, Mass of Ferrous Carbonate 
(Vallet's Mass). A greenish-gray, soft, pilular mass, becoming greenish-black or blackish 
on exposure, and having a strongly ferruginous taste. Dose, 3 to 5 grains in pill. 
2. Pilulce Ferri Carbonatis, Pills of Ferrous Carbonate. (Blaud's Pill. Pills of Iron.) 
Dose, 1 to 5 pills. 
There are many modifications of Blaud's Pill, and compounds de- 
signed to form the Blaud Pill Mass upon contact with water and the con- 
tents of the stomach. Besides they are also compounded with active agents 
like strychnine, quinine, etc. 
Action and Therapy.-This is one of the most useful forms of iron. 
Blaud's pills are especially valuable in anemia, with involvement of the re- 
productive tract of women-especially disordered menstruation, either too 
frequent, or altered in character, or when not appearing regularly, and 
associated with general debility and low nerve tone. In the latter in- 
stance the compound pills of the Blaud type, containing nerve stimulants, 
of which there are numerous kinds, are the most effectual. If they con- 
tain arsenous acid they should not be administered after palpebral oedema 
appears. The general uses of carbonate of iron are those mentioned under 
Ferri Subcarbonas, which see. 
FERRI CARBONAS SACCHARATUS. 
371 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
FERRI CHLORIDUM. 
Ferric Chloride, Chloride of Iron, Perchloride of Iron, Sesquichloride of Iron. 
(Formula: FezCl8+12H2O). 
Description.-An orange-yellow, crystalline salt, without odor, or having but a weak 
odor of hydrochloric acid. It is powerfully styptic to the taste. Very deliquescent upon 
exposure to the air. Freely and completely soluble in water, alcohol, and by ether and 
glycerin. Unstable in the light, being reduced to ferrous chloride. 
Action and Therapy.-Ferric Chloride is used only in solution as Liquor 
Ferri Chloridi and as Tinctura Ferri Chloridi (which see). 
FERRI DIALYSATUM. 
Dialyzed Iron, Liquor Ferri Dialysatus. 
Description.-A deep red solution, almost devoid of taste, odorless, and freely miscible 
with distilled water, glycerin, or syrup. Dose, 10 to 20 drops. 
Action and Therapy.-A preparation of negative physical properties 
and physiological effects, introduced as being a ferric compound most nearly 
like the iron in the blood. It has been recommended to antidote poisoning 
by arsenic. It is, however, none too certain in this respect. Dialyzed iron 
was probably the first inorganic colloid used in medicine. 
FERRI ET AMMONII CITRAS. 
Iron and Ammonium Citrate, Ammonio-Citrate of Iron, Soluble Citrate of Iron,. 
Soluble Ferric Citrate, Ammonio-Ferric Citrate. 
Description.-This compound occurs in transparent, thin, garnet-red scales. It has 
no odor, but a saline and weak ferruginous taste. In the presence of moisture it deliquesces. 
Alcohol does not dissolve it, but it is easily soluble in water. 
Action and Therapy.-Ammonio-citrate of iron is among the best 
preparations of iron, and one that is unirritating, pleasant to the taste, and 
soluble in water, wine, or syrup. It is an excellent tonic, being especially 
good for children. It is not unpleasant, does not restrain the bowels, and 
is very readily assimilated. It is most largely used in anemic conditions 
of children and women. The skin is pale and translucent and membranes 
pallid, respiration quickened, appetite morbid, and the patient restless and 
nervous. For a child from five to ten years old, give doses of from two to 
five grains three times a day, dissolved in a teaspoonful of water or syrup. 
It is a good chalybeate in atonic dyspepsia, with marked anemia and 
irritability of the stomach. If not well assimilated, gentian may be given 
with it. It is a good agent in scrofulous conditions of children, and in 
tabes mesenterica, given in doses of from two to five grains in syrup three 
times a day. In chlorotic females the same sized dose given with a bitter 
tonic improves the blood, appetite, and general strength. 
FERRI ET AMMONII SULPHAS. 
Iron and Ammonium Sulphate. Ammonia Ferric Sulphate. Ammonio-Ferric Alum. 
Iron Alum. (Formula: [(NH4)2Fe2(SO4)4. 24H2O)] 
Description.-Odorless, pale violet crystals having an acid, styptic taste, and efflor- 
escent upon exposure to air. Very soluble in water, insoluble in alcohol. Dose, 3 to 15 
grains. 
Action and Therapy.-Iron alum was introduced by W. Tyler Smith 
as the most effective iron salt for leucorrhoea, with anemia. He advised 
3 to 15 grains, in infusion of calumba, or water, repeated three times a day. 
372 INDIVIDUAL DRUGS. 
It is extremely astringent, more so than ordinary alum, and is less stimulat- 
ing than the other ferric salts. Potassio-ferric alum is a similar compound 
and known also as Iron Alum. It is used for the same purposes as the 
ammonio-ferric alum. 
Iron and Ammonium Tartrate, Ammonio-Tartrate of Iron. 
Description.-This salt forms in slightly deliquescent, thin, transparent scales, from 
garnet to red-brown in color. Its taste is sweetish and feebly ferruginous, and it is devoid of 
odor. Insoluble in alcohol, but very easily dissolved by water. Dose, 5 to 10 grains. 
Action and Therapy.-This is a mild tonic. It has the advantage of 
being very soluble in water and is unirritating and pleasant to the taste. 
It may be given in pill, capsule, or syrup in doses of from 1 to 10 grains. 
FERRI ET AMMONII TARTRAS. 
FERRI ET POTASSII TARTRAS. 
Iron and Potassium Tartrate, Potassio-ferric Tartrate, Tartarated Iron. 
Description.-Odorless, thin, transparent, garnet-red to reddish-brown scales, having 
a slightly ferruginous, sweetish taste; slightly deliquescent in the air. Very soluble in 
water; slightly in alcohol. Dose, 5 to 20 grains. 
Action and Therapy.-Owing to the large proportion of iron, the 
pleasant taste, mild astringency and kindly action upon the stomach and 
bowels, this salt is regarded one of the most desirable of the scaled com- 
pounds of iron. It is given in solution before meals. 
FERRI ET QUININE CITRAS. 
Iron and Quinine Citrate, Soluble Iron and Quinine Citrate. 
Description.-Thin, transparent, greenish or golden-yellow scales, odorless, and of a 
bitter, mild, iron-like taste; slowly deliquescent in damp air. Slowly and completely 
soluble in cold water and but partially soluble in alcohol. Dose, 5 to 10 grains. 
Action and Therapy.-Tonic and antiperiodic; and especially useful 
in the anemia following malarial fevers. Give 5 to 10 grains in capsule, 
aromatic solution, or syrup, repeated three times a day after meals. 
FERRI ET STRYCHNINE CITRAS. 
Iron and Strychnine Citrate. 
Description.-Thin, transparent, garnet-red to yellowish-brown scales; without odor, 
and of a bitter, slightly ferruginous taste; deliquescent in damp air. Soluble in water; 
partially soluble in alcohol. Dose, 1 to 3 grains. 
Action and Therapy.-Five grains of this scaled salt contains 1/20 
grain of strychnine. It is useful in nervous debility, dyspepsia in atonic 
subjects, chlorosis, and suppressed menstruation. From 1 to 3 grains in 
pill or capsule may be given before meals. It should not be given in solution. 
A similar preparation is the Ferri et Quinince Citras cum Strychnina 
or Iron and Quinine Citrate with Strychnine. Five grains contain 1/20 
grain of strychnine and 1 grain of quinine. The dose is 1 to 3 grains. 
373 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
FERRI FERROCYANIDUM. 
Ferric Ferrocyanide, Prussian Blue, Ferrocyanide of Iron, Insoluble Prussian Blue. 
Description.-A beautiful, deep-blue, bulky powder, devoid of taste, and insoluble 
in water. Dose, 1 to 5 grains. 
Action and Therapy.-This is tonic and is believed by some to be 
antiperiodic. It is usually given with quinine. Such a mixture constituted 
the once celebrated "Eclectic blue powder", and was used in periodic 
disorders regardless of the presence of fever. Administered in doses of 
about 3 grains four times a day. 
FERRI HYDROXIDUM CUM MAGNESII OXIDO 
Ferric Hydroxide with Magnesium Oxide. Ferric Hydrate with Magnesia. Arsenic 
Antidote. 
To be freshly prepared as needed from the following: 
Bottle No. 1. Dissolve 1 3/4 ounces of Ferric Sulphate in 3 1/2 ounces of water and 
keep the liquid in a large well-stoppered bottle. 
Bottle No. 2. Rub 2 1/2 drachms of Magnesium Oxide in cold water until a smooth, 
thin mixture results. Transfer this to a large bottle holding about 1 quart, and dilute the 
mixture with water until the bottle is about two-thirds filled. When the antidote is wanted, 
shake the magnesia mixture to a homogeneous, thin magma, add to it the iron solution, 
and shake them together until a uniform smooth mixture results. 
The diluted solution of ferric sulphate, and the mixture of magnesia, should always 
be kept on hand, ready for immediate use. 
This preparation, intended as an antidote to arsenic, is a mixture of ferric hydroxide, 
magnesium hydroxide, and magnesium sulphate. It should be freshly prepared so that the 
ferric hydroxide will be in its most efficient condition, and not impaired, as is certain to be 
the case if the preparation be kept for a length of time. It is not necessary to separate the 
liquid from this preparation, as none of the ingredients are in any way caustic or objection- 
able, the magnesium sulphate present being desirable as a cathartic to carry off by the 
bowels such portions of the insoluble arsenical compound as may not be ejected in the act of 
emesis, or removed by the stomach-pump. As an excess of magnesia is used in preparing 
it, acidity is avoided. 
Specific Indication.-Acute poisoning by arsenic. 
Action and Therapy.-Antidote to acute arsenical poisoning. It 
should be administered like the ferric hydroxide, freely in tablespoonful 
doses. The magnesia itself is somewhat antidotal to arsenous acid, besides 
acting as a cathartic. 
FERRI HYPOPHOSPHIS. 
Ferric Hypophosphite, Iron Hypophosphite. 
(Formula: Fe26 (PH2O2).) 
Description.-A permanent, odorless and nearly tasteless white or grayish-white 
powder, but slightly soluble in water, but more readily in hypophosphorous acid, or warm, 
strong solution of an alkaline citrate. Dose, 5 to 10 grains. 
Action and Therapy.-Sometimes used in anemia with cerebral en- 
feeblement. It is given in powder or pill, but preferably in syrup. 
FERRI LACTAS. 
Ferrous Lactate, Lactate of Iron. (Formula: FefCsHsChF-MHsO) 
Description.-Pale, greenish-white crusts, consisting of small needle crystals, having 
a slight peculiar odor, and a mild, sweetish, ferruginous taste. Soluble in water (40), 
boiling water (12); also insoluble in alcohol. Dose, 5 grains. 
Action and Therapy.-An efficient chalybeate in anemia, and amen- 
orrhoea and dysmenorrhcea in persons of low vitality. From 1 to 3 grains, 
gradually increased, may be given, in solution, every 3 or 4 hours. It has 
no special advantages over the old milder iron salts. 
374 INDIVIDUAL DRUGS. 
Ferric Hydrate, Ferric Hydroxide, Hydrated Oxide of Iron, Hydrated Peroxide of 
Iron, Hydrated Sesquioxide of Iron. 
Description.-A brownish-red magma, completely dissolving, without effervescence, 
in hydrochloric acid. This compound must be prepared, as needed, as it will not retain its 
antidotal powers if it has been made for any considerable length of time. Every physician 
should be prepared to make this compound. To prepare it proceed as follows: "Mix either 
solution of ferric chloride or solution of ferric sulphate with four times its bulk of cold 
distilled water, and add to this, with constant stirring, ammonia water until the latter is 
in slight excess. Drain the precipitate on a muslin strainer and wash it well with cold 
distilled water.'' (Lloyd's Chemistry of Medicines, p. 311.) Ordinary drinking water may 
be employed if distilled water be not at hand, and if great hurry is necessitated the magma 
need not be washed, but may be administered freely at once. 
Action and Therapy.-This agent is the antidote to arsenic poisoning. 
It converts arsenious acid into arsenite of iron, a comparatively harmless 
salt. It and the Ferri Hydroxidum Cum Magnesii Oxido (which see) are 
the best antidotes known in these cases. In poisoning with arsenic evacuate 
the stomach as soon as possible, then give this magma in tablespoonful 
doses. If the stomach can not be promptly emptied do not wait, but ad- 
minister the antidote liberally. Thirty-five parts are needed to neutralize 
one part of arsenic. 
FERRI OXIDUM HYDRATUM. 
FERRI PHOSPHAS. 
Ferric Phosphate, Soluble Ferric Phosphate, Phosphate of Iron, Soluble Phosphate of 
Iron. 
Description.-Apple-green scales, transparent, and having no odor, but an acidulous 
and feebly saline taste. Insoluble in alcohol, but readily soluble in water. It is apt to be 
dark in color if exposed to light. Dose, 1 to 10 grains. 
Action and Therapy.-This is a nerve tonic. It may be used in cases 
of debility, with anemia and marked nervous depression bordering on 
neurasthenia, preferably in doses of 5 grains. 
FERRI PYROPHOSPHAS. 
Soluble Pyrophosphate of Iron, Pyrophosphate of Iron with Sodium Citrate. 
Description.-Thin, apple-green, transparent scales, odorless, and of an acidulous, 
slightly saline taste; permanent in dry air when excluded from light, but becoming dark 
and discolored on exposure to light; freely soluble in water, insoluble in alcohol. Dose, 
5 grains. 
Action and Therapy.-A good salt of iron, to be given when mild iron 
compounds are indicated. Its ready solubility makes it popular for ad- 
dition to syrups and solutions. It has no harsh or unpleasant effects. 
From 2 to 5 grains may be given three times a day. 
FERRI SUBCARBONAS. 
Ferrous Subcarbonate, Iron Carbonate. 
Description.-A yellowish-red or reddish-brown powder, but slightly disagreeable 
to the taste. Insoluble in water, but soluble with slight effervescence in hydrochloric acid. 
It should not be of a red color, else it has been overheated in preparation. Dose, 1 to 5 
grains, 3 times a day. 
Action and Therapy.-In small doses an unirritating tonic, but large 
doses produce dyspeptic symptoms. Given with simple bitters, in chlorosis, 
and with aloes in atonic amenorrhoea. In the anemia of hysteria it may be 
administered with valerian, Scutellaria and camphor; in chorea, with marked 
anemia, with valerian and macrotys. Combined with hydrastin and cap- 
sicum it is useful in atonic dyspepsia and gastric catarrh with anemia; 
375 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
and it sometimes cures the condition favoring recurrent crops of boils 
in weak, bloodless and pallid persons. It is not so good a preparation as 
Vallet's Mass (Massa Ferri Carbonatis) or the Blaud pill (Pilulce Ferri 
Carbonatis), and is less used at the present day than the other forms of iron 
carbonate. 
FERRI SULPHAS. 
Ferrous Sulphate, Sulphate of Iron, Green Vitriol. 
(Formula: FeSOrj-THjO.) 
Description.-Large, pale, bluish-green, prismatic crystals, odorless, and having a 
saline and powerfully styptic taste. In dry air the crystals effloresce. If on exposure to 
damp air it acquires a brownish-yellow coating (basic ferric sulphate) it should be rejected 
for medicinal purposes. Soluble in cold and boiling water, but not soluble in alcohol. 
Dose, 1/2 to 5 grains. 
Preparations.-1. Ferri Sulphas Exsiccatus, Dried Ferrous Sulphate (approximately 
FeSOi+SFLO). Contains about sixty-five per cent of the above salt, and is a grayish- 
white powder, slowly but completely dissolved by water. Dose, 2 to 5 grains. 
2. Ferri Sulphas Granulatus, Granulated Ferrous Sulphate. A pale, bluish-green, 
crystalline powder. Dose, 2 to 5 grains. 
Action and Therapy.-External. A solution of 30 grains of ferrous 
sulphate in a pint of water is one of the best lotions for the relief of dermatitis 
venenata caused by poison ivy. Unfortunately it stains. A solution of 2 
grains in a pint of water forms a useful injection for rectal prolapse, bleeding 
piles, and atonic leucorrhoea. A stronger solution may be used as a wash 
for weeping eczema, venereal sores, and in uterine and rectal cancer to 
restrain bleeding and to remove the foul odor. The impure salt-copperas 
-is an inexpensive disinfectant and deodorant for sinks, drains, cesspools, 
vaults, and latrines; and to sprinkle around where flies breed, as in damp 
places and manure piles. 
Internal. Sulphate of iron is one of the best of the chalybeates in 
anemia or chlorosis of young women where the menstrual function is sup- 
pressed or impaired on account of the poor quality of the blood. A pill or 
capsule containing 1 grain each of ferrous sulphate, myrrh, and aloes is 
especially effective, particularly if there is also obstinate constipation. 
In chronic malarial dyscrasia this form of iron is responded to quickly when 
given with eupatorium, arsenic, or quinine, as best indicated. Polyuria 
and the disposition to passive hemorrhages are sometimes relieved by 
ferrous sulphate. It has no effect upon true diabetes other than to improve 
the composition of the blood when the hemoglobin content is deficient. In 
large doses it irritates the bowels and causes diarrhoea; in small doses it is 
often most beneficial in the chronic diarrhoea of anemia. The dried sul- 
phate of iron is the best form for internal use. 
Ferric Valerianate, Iron Valerianate, Ferric Valerate. 
Description.-Permanent, dark brick-red, non-crystalline powder, of variable chemical 
composition, having the odor of valerianic acid, and a mildly styptic taste. Soluble in 
alcohol; insoluble in cold water and decomposed by hot water, setting free the valerianic 
acid. Dose, 1 to 3 grains. 
Action and Therapy.-A rather feeble medicine, sometimes used as a 
nerve tonic in various nervous disorders with anemia or chlorosis, such as 
hysteria, chorea, and neuralgias. Excitability or irritability of the nervous 
system is the condition in which it acts best. 
FERRI VALERIANAS. 
376 INDIVIDUAL DRUGS. 
Iron. (Symbol Fe.) 
Description.-Bright, fine iron wire forms the bases of the many iron preparations in 
medicine. For consideration of Iron Preparations, see under respective Ferrum Salts. 
Specific Indications.-Anemia due to deficiency of haemoglobin, 
with debility; deficiency of good blood (anemia), or a watery condition of 
the blood (hydraemia); debility, feebleness and inertia of the organs of the 
body; muscular atony and relaxation, with soft, lax or flabby condition of 
the tissues (Pareira); "solid bluish (sometimes deepening to purplish) color 
of the mucous membranes and tongue'' (Scudder). 
Action.-Metallic iron, as such, has no effect upon the body. When 
solutions of its salts, notably the chloride, sulphate, and nitrate, and to a 
lesser extent its other compounds, come into contact with the abraded 
epiderm, the albumen of the tissue is precipitated and an astringent effect 
is strongly displayed. When in contact with the blood and the secretions, 
it coagulates them by a similar action. In this way iron is a decided local 
hemostatic. Moreover, its salts are more or less antiseptic, germicide, disin- 
fectant, and deodorant. The teeth are blackened by iron probably through 
the union with sulphur and tannin contaminating the mouth; the enamel 
is corroded by the acid content of many of its salts. 
When finely divided metallic iron, or its organic or inorganic salts, are 
swallowed, they are attacked by the gastric juice and converted at least 
partially into chloride, the possible exception being chloride of iron itself. 
A further change into an albuminate is then thought to take place. Passing 
into the duodenum still another change of at least a portion of it is effected, 
a carbonate of iron resulting. In this portion of the bowel iron is absorbed 
by the duodenal epithelia and taken up by the leucocytes, which carry it 
into the blood current by the pathway of the lymph spaces, mesenteric 
glands and thoracic duct and deposit it in the spleen to undergo some 
elaboration into blood-making material. Carried by the blood current it is 
then stored in the liver and the bone marrow, where further changes take 
place to await the needs of the blood in the special form of hemoglobin. 
That which is not required is slowly given up by its depositories and elimi- 
nated into the intestinal canal, in the colon and rectum to pass away in the 
feces. The latter are blackened by the hydrogen sulphide in the intestines, 
and possibly by tannin, when present, and become more or less hardened. 
As iron is usually given to excess when administered medicinally, much of 
it passes unabsorbed by way of the stools. In health but little change in 
the blood is caused by administered iron, the intake from food and excretion 
about balancing each other, though some believe it to cause plethora. In 
anemia, however, its effects are very pronounced, resulting in a marked 
increase in the number of red discs and in the increase in hemoglobin. 
The hemoglobin-bearing action of the leucocytes is very great where the 
deficiency is in the quality of the blood, and less where there is decrease 
of quantity, as in hemorrhage and other causes than essential anemia or 
simple chlorosis. 
When taken for some time in small doses, iron salts strengthen and 
sometimes accelerate the pulse, improve digestion, and stimulate function 
generally. When taken to too great an extent they produce more or less 
FERRUM. 
377 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
thirst, pain, or fullness in the head, increased temperature, dizziness, labor- 
ious breathing, and unpleasant vascular disturbances in the limbs. 
The indications for the use of the preparations of iron are "debility, 
feebleness, and inertia of the different organs of the body, atony (marked 
by a soft, lax, flabby condition of the solids), and defect of the red corpuscles 
of the blood-as where there is a general deficiency of this fluid (anemia, 
oligaemia) or a watery condition of it (hydraemia)." 
These indications of Pareira, uttered nearly a century ago, perhaps, 
can not be improved upon at the present time. Scudder regarded the deep, 
solid, blue discoloration of the mucous tissues and tongue, the coloring 
sometimes deepening to purplish, as the best indication for iron and its 
salts. Probably anemia is the best indication for iron, especially where the 
supply of red corpuscles is gradually and permanently diminished. If the 
loss is due to hemorrhages or other debilitating effects, and the digestive 
function is in good operation, food would probably be more beneficial than 
iron; but when the digestion and assimilation are impaired, iron becomes a 
most important remedy. Not only does it increase the number of red 
discs, but causes them, when pallid and shrunken, to become florid and 
plump; their oxygen-carrying powers are increased and better assimilation 
and nutrition is the result. On the other hand, in anemia, after the proper 
number and condition of red discs have been attained, its further ad- 
ministration becomes harmful, and, while iron is an important factor in the 
treatment of this condition, it must not be forgotten that it should con- 
stitute only a part of the treatment, and that proper food and hygienic 
measures should go hand in hand with its administration. Some contend 
for, and it has been the custom for years to give iron in enormous doses. 
Inasmuch as but a very little iron can be assimilated and elaborated in the 
blood, it would appear that the smaller doses would be less apt to provoke 
gastro-intestinal irritation, thus favoring their absorption. For this reason 
many prefer the small and even the minute dose, for all excess over that 
which is elaborated is discharged in the feces, and undoubtedly large doses 
harm by provoking constipation and other effects not calculated to im- 
prove digestion and assimilation. Eclectic physicians, as a rule, have 
favored the small doses. 
When iron is not assimilated and when provocative of gastric disorders, 
it does harm, and this is particularly the case in certain nervous disorders and 
particularly in epilepsy. In nervous disorders, it should not be employed 
unless there is clearly an impoverished condition of the blood. The prepara- 
tions of iron are contraindicated in fever, acute inflammation, congestion 
of important organs, active hemorrhages, intestinal irritation, in persons 
subject to determinations of blood to the head or affected with habitual 
constipation. Iron and its compounds are, of course, only palliative in 
structural diseases, as cancer, interstitial nephritis, tuberculosis, etc. 
Active hemorrhage, as a rule, contraindicates the use of iron. Menorrhagia, 
however, when profuse and watery, is benefited by it, as well as cases of 
scanty menses with a pale flow. In both instances the blood is lacking in 
red discs. Passive hemorrhages, on the contrary, are well treated with iron 
salts, particularly those made astringent by their union with the acidulous 
radical of the mineral acids. Tincture of chloride of iron and the acid solu- 
378 INDIVIDUAL DRUGS. 
tion of iron are valuable to lessen albuminuria in chronic nephritis. Iron 
is of value in malarial disorders, only in those cases in which the trouble has 
lasted long enough to induce a marked impoverishment of the blood itself. 
Ferrocyanide of iron, however, is thought by some to have some power 
for good in malaria. Iron is therefore applicable where the blood is poor 
in quality through a deficiency of its red corpuscles, and when associated 
with this there is marked debility, nervous depression, exhaustive discharges, 
and feeble digestion. Bearing in mind the indications, it is useful in the 
following disorders in which its salts have been efficiently employed: 
Chorea, hypertrophy of the spleen, neuralgia, uterine debility, scrofula, 
leucorrhoea, rachitis, anemic and chlorotic conditions, chronic discharges 
from enfeebled and relaxed mucous tissues, chronic paralysis, atonic 
dyspepsia, albuminuria, desquamative nephritis, diabetes, etc. 
The therapeutical influence of the several medicinal salts of iron are 
nearly the same, but where they become improved or qualified by union 
with other agents, reference will be made thereto under their respective 
captions. As a rule, in erysipelas the tincture of the chloride is preferred; 
the iodide is preferred as an alterative; the salicylate in fetid intestinal 
discharges; the phosphate in nervous depression; in excessive anemia 
the stronger preparations like the chloride, sulphate, and acid solution of 
iron; in ordinary debility the ammonio-citrate, citrate of iron and potas- 
sium, or the pyrophosphate, all with or without the addition of quinine 
or strychnine, etc., are usually selected. When iron is in the form of 
ferrous oxide it is generally more active than where it is present as a ferric 
oxide. The various salts of iron and their doses are given under their 
respective heads. 
FERRUM REDUCTUM. 
Reduced Iron, Iron by Hydrogen, Quevenne's Iron, (Symbol Fe.). 
Prepared by passing hydrogen gas through a hot tube containing freshly prepared, 
clean ferric oxide. 
Description.-A fine, lusterless, grayish-black powder, devoid of odor and taste, and 
unalterable in dry air. Neither water nor alcohol dissolves it. When poured upon a paper 
in the form of a conical pile, and a lighted match is applied to the summit of the heap, 
it should take fire and burn with a red glow. Should it fail to be completely ignited, it has 
partly changed to an oxide, and is of no value as a medicine. Dose, 1 to 10 grains. 
Action and Therapy.-Reduced iron is tonic and may be given where 
iron in a finely divided state is required. It causes unpleasant eructations 
of gas; otherwise it is a useful chalybeate for anemia and chlorosis. It may 
be combined with the bitter tonics as gentian, calumba, and cornus, and 
given in capsule. It is an imperfect antidote for acute poisoning by copper 
compounds. For this purpose 10 grains may be administered suspended 
in water. 
FICUS. 
The fleshy receptacle of Ficus Carica, Linne, bearing fruit on its inner surface. (Nat. 
Ord. Urticaceae.) Persia and Asia Minor; cultivated in all mild latitudes. 
Common Name: Fig. 
Action and Therapy.-External. Emollient. A roasted, boiled, or raw 
fig is exceedingly efficient to hasten suppuration in gum boil, boils in the 
nose or ears and elsewhere, and in buboes and carbuncles. The great 
surgeon, Billroth, employed a poultice of dried figs and milk to overcome 
the stench of cancerous and fetid ulcers. 
379 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Internal. Nutritive, demulcent, and aperient. Figs are frequently 
resorted to by individuals inclined to constipation. An elegant aperient 
confection is employed by the laity under the homely name of "fruitcake." 
It is prepared by pounding together in a mortar equal quantities of figs, dates, 
raisins, prunes, and senna leaves. This is wrapped in tinfoil, and sliced off 
and eaten according to the requirements of the individual. 
The ripe fruit of Faniculum vulgare, Miller (Nat. Ord. Umbelliferae). Dose, 10 to 30 
grains. 
Common Names: Fennel, Fennel Seeds, Sweet Fennel. 
Principal Constituent.-A sweet volatile oil. 
Preparations.-1. Infusum Faniculi, Infusion of Fennel (gr. lx to Water, Oss). 
Dose (infants), 1 fluidrachm; (adults), 2 fluidounces. 
2. Specific Medicine Fennel. Dose, 10 to 60 drops. 
Action and Therapy.-A splendid carminative and stimulant for 
flatulent colic in babies. It should not be sweetened with sugar, as it is 
sufficiently sweet in itself, while added sugar defeats the purpose for which 
it is being administered. Hot fennel tea is not an unpleasant remedy for 
amenorrhoea, and for suppressed lactation. Fennel is often used as a 
corrigent of unpleasant medicines. It is an ingredient of Compound 
Licorice Powder. 
FCENICULUM. 
FRANCISCEA. 
The root and stem of Franciscea uniflora, Pohl (Nat. Ord. Solanaceae). A tropical 
American shrub. 
Common Names: Manaca, Vegetable Mercury. 
Principal Constituents.-A weak alkaloid mana cine, and probably gelsemic acid. 
Preparation.-Fluidextractum Franciscea, Fluidextract of Franciscea. Dose, 10 to 60 
drops. 
Action and Therapy.-Diuretic and probably alterative. It is em- 
ployed along the Amazon for rheumatism and syphilis. It is capable of 
producing gastro-enteritis and death. Manaca has been proposed for 
rheumatism confined more to the muscles and tendons than to the articular 
forms, acting best when there is dull, heavy pain, soft skin and the absence 
of fever. It is thought to act somewhat like guaiac. 
The dried bark of Rhamnus Frangula, Linne (Nat. Ord. Rhamnaceae). Collected at 
least one year before being used. A shrub of wet situations in Europe, Siberia, and Northern 
Africa. Dose, 2 to 60 grains. 
Common Names: Buckthorn, Alder Buckthorn. 
Principal Constituents.-The glucoside frangulin (rhamnoxanthin) and emodin, both 
only found in old bark. 
Preparations.-1. Specific Medicine Frangula. Dose, 20 to 60 drops. 
2. Elixir Frangula, Elixir of Frangula (Fluidextract of Frangula, 1 part; Elixir of 
Orange, 4 parts). Dose, 1 to 2 fluidrachms. 
Action and Therapy.-Fresh frangula bark causes emeto-catharsis 
and colicky pain. The dried bark is purgative only. A remedy for chronic 
constipation, a dose of 20 drops of the fluidextract, or a fluidrachm of the 
elixir, being repeated three times a day. 
FRANGULA. 
380 INDIVIDUAL DRUGS. 
The plant Frankenia grandifolia, Chamisso and Schlectendal (Nat. Ord. Frankeniaceae). 
Native of California and sandy soils of adjacent Pacific Coast. 
Common Name: Yerba reuma. 
Principal Constituent.-Tannin (6 per cent). 
Preparation.-Fluidextractum Frankenice, Fluidextract of Frankenia. Dose, 5 to 25 
drops. 
Action and Therapy.-Used both internally and by injection or spray, 
for catarrhal diseases and other discharges from the mucous membranes, 
diarrhoea, vaginal leucorrhoea, gonorrhoea, and gleet, and the different types 
of catarrh. It is little used. 
FRANKENIA. 
FRASERA. 
The dried root of Frasera carolinensis, Walter (Nat. Ord. Gentianaceae). A striking 
plant found in the Middle and Southern States, west of the Alleghenies. Dose, 5 to 60 grains. 
Common Name: American Columbo. 
Principal Constituents.-Gentiopicrin, gentistic acid, and berberine. (?) 
Preparation.-Specific Medicine Frasera. Dose, 5 to 60 drops. 
Action and Therapy.-The recent root is reputed cathartic and emetic. 
When dried it is a simple, mild tonic to be used like the simple bitters. 
Scudder regarded it as a stimulant to the circulation and to the vegetative 
functions. Its persistent use in moderate doses is said to have overcome 
obstinate constipation; like the other simple bitters, it may be of some 
value in chronic catarrhal dyspepsia. From 5 to 60 drops of Specific 
Medicine Frasera, well diluted, may be given every four hours. 
FRAXINUS. 
The dried bark of Fraxinus sambucifolia, Lamarck, and Fraxinus americana, Linn6 
(Nat. Ord. Oleaceae). Forest trees of northern United States and Canada. Dose, 10 to 60 
grains. 
Common Names: 1. Black Ash, Elder-leaved Ash. 2. White Ash. 
Principal Constituent.-A bitter alkaloid in minute quantity. 
Preparation.-Specific Medicine Fraxinus. Dose, 10 to 60 drops. 
Action and Therapy.-Probably of some value in uterine subinvolu- 
tion, with pelvic heaviness and dragging pain, and soreness and headache 
at the vertex and occipital base of the skull. That it will cure uterine 
tumors, as has been claimed, is extremely doubtful and lacks sufficient 
proof to be given credence. Its relative, the White Ash, is said to be 
cathartic. 
FUCUS. 
The marine plant Fucus vesiculosus, Linne (Nat. Ord. Fucoideae). A perennial sea- 
weed. 
Common Names: Bladder-wrack, Sea Wrack, Kelp-ware, Black-tang, etc. 
Principal Constituents.-Sodium and potassium salts of iodine, bromine and chlorine. 
Preparation.-Specific Medicine Fucus. Dose, 5 to 30 drops. 
Action and Therapy.-Fucus, once exploited as a remedy for obesity, 
is no longer relied upon for that purpose. It has, however, alterative 
properties, probably due to the haloid elements it contains, and deserves 
study for its influence upon waste and nutrition. It is somewhat diuretic, 
and is believed to give tone to lax muscular fibers. Fatty degeneration of the 
heart has been benefited by it, and it relieves irritation and chronic in- 
flammation of the bladder. Its power of lessening irritation and congestion 
has led to its successful use in acute desquamative nephritis. From 5 to 20 
drops should be taken every 3 or 4 hours. 
381 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
GALIUM. 
The herb Galium aparine, Linne, and other species of Galium (Nat. Ord. Rubiaceae). 
Common in moist grounds in Europe and the United States. 
Common Names: Cleavers, Goose-Grass, Catch-Weed, Bedstraw. 
Principal Constituents.-Rubichloric, gallitannic, and citric acids. 
Preparations.-1. Infusum Galii, Infusion of Galium (3j to Water, Oj). Dose, 
1 to 4 fluidounces. 
2. Specific Medicine Galium. Dose, 5 to 60 drops. 
Specific Indications.-Dysuria and painful urination in febrile and 
inflammatory states; renal and cystic irritation with burning; "nodular 
growths or deposits in skin or mucous membranes" (Scudder). 
Action and Therapy.-Galium is a useful refrigerant diuretic in fevers 
and inflammations, and to relieve dysuria with pain and scalding or burning 
in the urethra or neck of the bladder. It may be used as a sedative diuretic 
in scarlet fever. It is undoubtedly alterative and may be exhibited in 
scrofulous disorders, but has been unwisely claimed as a remedy for car- 
cinomatous growths. 
Galium tinctoria is aromatic and has been recommended in the spas- 
modic cough of asthma and chronic bronchitis. The best use for these 
drugs is as diuretics. 
GALLA. 
An excrescence on Quercus infectoria, Olivier, and other allied species of Quercus 
(Nat. Ord. Fagaceae), caused by the punctures and deposited ova of the Cynips tinctoria, 
Hartig. 
Common Names: Nutgall, Galls. 
Principal Constituents.-Tannin (24 to 80 per cent) and gallic acid (1 1/2 per cent). 
Preparations.-1. Pulvis Gallce, Pulverized Galls. Dose, 5 to 20 grains. 
2. Unguentum Gallce, Ointment of Nutgall (20 per cent nutgall). 
Action and Therapy.-Galls are astringent and owe this property to 
the large quantity of tannic acid they contain. As an internal medicine 
and largely for external purposes they have been supplanted by gallic and 
tannic acids, which see. Galls, however, are considered especially effective 
in hemorrhoids, being preferred by many as a local application, in ointment, 
in preference to the acids named. They are commonly associated with 
opium for the same purpose. 
GAMBIR. 
An extract prepared from the leaves and twigs of Ourouparia Gambir (Hunter), Baillon 
(Nat. Ord. Rubiaceae). Sumatra, Ceylon, and countries bordering the Straits of Malacca. 
Dose, 1 to 30 grains. 
Common Names: Gambir, Gambeer, Terra Japonica, Pale Catechu. 
Description.-Irregular masses or cubes, reddish-brown, pale brownish-gray or light 
brown, friable, crystalline, and breaking with a dull earthy fracture, bitterish with sweet- 
ish after-taste, no odor and great astringency. Dose, 15 grains. 
Principal Constituents.-Catechutannic acid (35 to 40 per cent) the active astringent; 
catechin (catechuic acid) probably inert; and pyrocatechin. 
Preparations.-1. Trochisci Gambir, Troches of Gambir (Gambir about 1 grain, 
Sugar, Tragacanth, and Orange-flower Water). 
2. Tinctura Gambir Composita, Compound Tincture of Gambir (Gambir and Cinna- 
mon). Dose, 1 fluidrachm. 
Action and Therapy.-External. Gambir is powerfully astringent. 
It restrains excessive discharges, overcomes relaxation and congestion, 
and checks local hemorrhages. Gambir is now used in place of catechu 
382 INDIVIDUAL DRUGS. 
(extract of wood of Areca Catechu) as it carries practically the same bodies 
in more available form, though it contains less tannin than that extract. 
It may be used in relaxed sore throat, relaxed uvula, and the relaxation 
and congestion of the fauces common to speakers and singers. A gargle 
or the troches may be employed. It is rarely used, by injection, in leucor- 
rhoea, and in powder or tincture to control epistaxis. It is a good astringent 
for congested and spongy gums. 
Internal. The powerfully astringent properties of gambir are utilized 
in the control of serous diarrhoeas. If there is much mucus present a 
purge of castor oil is advised, to be followed by the gambir alone, or with 
camphorated tincture of opium. It is seldom used in modern Eclectic 
practice. 
GAULTHERIA. 
The leaves of Gaultheria procumbens, Linne (Nat. Ord. Ericaceae). Damp woods and 
sandy soils of eastern third of the United States. 
Common Names: Wintergreen, Teaberry, Mountain Tea, Boxberry. 
Principal Constituents.-An aromatic volatile oil (Oleum Gaultheria); arbutin, ericolin 
and urson. 
Preparations,,-1. Oleum Gaultheria, Oil of Wintergreen. True Oil of Wintergreen; 
composed of about 96 per cent of methyl salicylate. Dose, 5 to 15 drops. 
2. Specific Medicine Gaultheria. Dose, 5 to 20 drops. 
3. Spiritus Gaultheria, Spirit of Gaultheria (Essence of Wintergreen-5 per cent of 
oil in alcohol). Chiefly a flavor essence. 
Related Oil.-Methylis Salicylas, Methyl Salicylate or Artificial Oil of Wintergreen. 
This is prepared synthetically and sold under the name of Oil of Wintergreen. Its source 
must be stated on the label. It ranges from colorless to yellowish or reddish and has the 
odor and taste of wintergreen. Dose, 5 to 15 drops. 
Specific Indications.-Irritation of the bladder and prostate gland; 
undue sexual excitement, and early stage of renal inflammation. 
Action.-Oil of wintergreen has identically the same physiological 
action as salicylic acid except that in poisonous doses it is more certain to 
produce coma. The symptoms of toxic doses are drowsiness, cerebral con- 
gestion with throbbing of the carotids, delirium, contracted or dilated 
pupils, visual disturbances, tinnitus aurium, paresis, somnolence, and coma 
preceding death. Autopsy reveals congestion of the stomach, duodenum, 
and the kidneys. 
Therapy.-External. Oil of wintergreen in full strength may be 
applied to carious teeth to relieve toothache. In full strength, or in suit- 
able dilution with olive oil or cottonseed oil, it provides a good pain- 
relieving application for acute articular and chronic rheumatism and in 
gonorrhoeal arthritis. If used very strong the skin may subsequently 
exfoliate. Applied to denuded surfaces it is readily absorbed and may 
produce toxic effects. 
Embrocations containing oil of wintergreen are valuable for local 
inflammatory swellings, neuralgic pain, pleurodynia, myalgia, itching, and 
swelling and stiffness of the joints. The following are a few of many such 
liniments: (1) Oil of Gaultheria, fl5iij; Oil of Olive, q. s., fl§vj. Mix. 
(2) Oil of Gaultheria, fl 5 iij; Salicylic Acid, gr. xx; Alcohol, fl § i j; Oil 
of Olive, q. s., fl^vj; Mix. Shake when used. Especially useful upon 
rheumatic joints. (3) Oil of Gaultheria, fl3iij; Chloroform Liniment, 
Soap Liniment, aa fl^ii. Mix. Shake when used. For painful surfaces. 
383 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
(4) Oil of Gaultheria, fl 5 ij; Asepsin, gr. xv; Echafolta, Alcohol, aa, fljijss. 
Mix. Valuable for application to cuts, bruises, and diluted with water as 
a mouth wash. 
Internal. Specific Medicine Gaultheria, or an infusion (Leaves, 3j 
to Water, Oj), has a specific action upon the urino-genital tract, relieving 
irritation and subacute inflammation. This action is especially exerted 
upon the neck of the bladder and in the prostatic urethra. It does not 
greatly increase the secretion of urine, but renders its voiding easier by 
alleviating the sphincteric irritation. It is, therefore, a remedy for dysuria. 
In incipient renal inflammation it sometimes does good, and in acute tubal 
nephritis it is asserted to have given benefit even where blood and tube 
casts are passed. Considerable good has been accomplished with it when 
spermatorrhoea and sexual excitement are caused by urethral irritability 
and prostatic fullness. The specific medicine may be administered in 5 to 
15 drops doses in water 3 or 4 times a day. Some physicians have advised 
both gaultheria and its oil for the relief of hepatic congestion and in sluggish 
vascularity and engorgement of the intestinal glands, as well as to relieve 
hemorrhoids by overcoming congestion of the portal vessels. 
Oil of gaultheria has aromatic and antiseptic properties. It consists 
most largely of methyl salicylate, over 90 parts at least, and is therefore 
analogous to salicylic acid and the salicylates in its effects. Large doses 
depress the heart just as the salicylates do; large doses also cause nausea 
and vomiting. Used within bounds, short of sufficient to induce gastric 
derangement, it is very useful where an anti-rheumatic is demanded and in 
cystic disorders with putrescent urine. Too long continued, however, it 
may induce renal irritation, and this must be carefully guarded against. 
Urine that was ammoniacal and putrescent a few hours after passage has 
been followed, after the administration of twenty drops of the oil, by an 
output that remained free from putrefaction for twelve days. One part of 
the oil in about two hundred of urine has preserved the latter from change 
for eighteen days. Hence the value of this oil in cystitis with putrescent 
urine. While few agents should be administered with digitalis, oil of winter- 
green is a grateful adjuvant and does not impair the usefulness of the foxglove. 
If for any reason sodium salicylate disagrees with rheumatic patients, oil 
of wintergreen, which is less likely to contain deleterious by-products, may 
be given. It is useful in all types of acute rheumatism in which salicylic 
acid or the salicylates are effective. Those most benefited are the acute 
inflammatory rheumatism and so-called gonorrhoeal rheumatism, a specific 
gonorrhoeal arthritic infection. Small doses have relieved facial neuralgia 
and tic douloureux; and sometimes it exerts a soothing and antiseptic 
effect in acute gonorrhoea. The oil may be administered in olive oil or in 
the form of the spirit (essence) mixed with sweetened water. 
The essence is of service in dry, persistent bronchial cough, and the 
specific medicine in cough with considerable bronchial secretion. It is also 
useful in the colic of infants. 
Gaultheria is an agent of special value as a flavoring agent and pre- 
servative for water-dispensed medicines in the summer season. For this 
purpose it should be widely used. The spirit (50 parts of oil of gaultheria 
to 950 parts of alcohol) is the preferred form for this purpose. 
384 INDIVIDUAL DRUGS. 
Gelatin. 
A purified glue prepared by boiling gelatinous animal tissues in water and purifying, 
evaporating and drying the product. 
Description.-A non-crystalline solid in sheets, flakes, shreds, or powder; without 
color or slightly yellowish, and having a feeble characteristic taste. Unalterable in dry air, 
but readily decomposes when moist or in solution. Insoluble in alcohol, fixed or volatile 
oils, ether, chloroform or cold water, but swelling and softening in the latter, 5 to 10 per cent 
of which it absorbs; soluble in hot water, glycerin, and acetic acid. It is largely employed 
in making gelatin capsules for the tasteless administration of medicines. 
Preparation.-Gelatinum Glycerinatum, Glycerinated Gelatin. 
Action and Therapy.-Styptic and protective. Gelatin may be used 
in the treatment of some forms of eczema and nasal catarrh; and as a 
soothing protective in rectal affections. It enters into the pharmacal 
preparation of capsules, lozenges, wafers, suppositories, court plasters, 
and as a coating for pills. Its intravenous or hypodermoclytic use (of 
about 3 ounces of a 1 per cent sterile solution) to increase blood coagulation 
in aneurism or hemorrhage is less in favor than formerly, now that coagulin 
and similar ready prepared biological preparations are available. 
Internal. Gelatin is demulcent and may therefore be used as a lenitive 
after cases of irritative poisoning. While having some antidotal power over 
iodine and bromine and the alums, it is undesirable on account of the length 
of time required to prepare it properly for use. As a proteid food it is 
prepared largely in various ways for feeding the sick, and owing to its 
freedom from the formation of indol it has been advised as a part of the 
diet in intestinal putrefaction showing marked indicanuria. 
GELATINUM. 
GELSEMIUM. 
The dried rhizome and roots of Gelsemium sempervirens (Linne), Aiton (Nat. Ord. 
Loganiaceae). Dose, 1/10 to 1 grain. 
Common Names: Yellow Jasmine, Yellow Jessamine, Carolina Jasmin. 
Principal Constituents.-Two bitter alkaloids-crystallizable gelsemine, the paralyzing 
agent, and amorphous gelseminine, a very toxic and tetanizing principle, and a volatile oil. 
There is also present gelseminic acid (peta-methyl-cesculetin). 
Preparation.-Specific Medicine Gelsemium. Dose, 1/10 to 10 drops. Usual method 
of administration: 3 Specific Medicine Gelsemium, gtt.xto 3j; Water, q. s., flgiv. Mix. 
Sig.: One teaspoonful every 1 to 3 hours. 
Specific Indications.-Hyperoemia; bright eyes, contracted pupils, 
great heat, and nervous unrest; mental irritability; insomnia, with nervous 
excitation; pain over the whole head; tremulousness, with great nervous 
excitement and high temperature; irritation of urinary tract; dysuria, with 
scant secretion of urine; arterial throbbing, with exalted sensibility; pinched, 
contracted tissues; convulsions, with hyperaemia; thin, dry, unyielding os 
uteri, with dry and hot vaginal walls. 
Action.-Gelsemium acts chiefly upon the spinal cord, first impressing 
the sensory tract, even to the extent of producing complete anaesthesia; 
later, its dominant action occurs, that of expending its force on the motor 
neurons, causing paralysis of motion. Sometimes this sequence is reversed. 
Upon the higher brain it has but slight effect, but upon the motor filaments 
of the nerves of the head, particularly the third and sixth cranial pairs, 
its action is profound. This is well shown by the resultant palpebral 
ptosis and relaxation of the jaw. Respiration is first stimulated, then 
385 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
depressed. Moderate doses do not appreciably disturb the circulation. 
Toxic doses, however, depress both the pulse rate and the blood pressure. 
In man convulsions do not occur. Both gelsemium and gelsemine, when 
dropped into the eye, cause violent dilation of the pupil, with accompanying 
paralysis of accommodation. The mydriasis is not so lasting as that from 
atropine. Gelsemium is quickly absorbed and spends its force in about 
three hours. The alkaloid gelsemine, correspondingly more active, is 
eliminated unchanged by way of the kidneys. Death from gelsemium is 
due to asphyxia. Gelsemium does not affect all human beings alike, 
some being but slightly influenced by it while others are profoundly 
impressed. The smallest active doses (ranging from 5 to 15 minims of the 
specific medicine or fluidextract, according to susceptibility) occasion a 
languid sense of ease and slight lowering of the force and frequency of the 
pulse. Larger doses induce a desire to lie down, and cause vertigo, disturbed 
sight, and sometimes orbital pain. Continued small doses may, after 
several hours, provoke vomiting; otherwise it has little or no effect upon the 
stomach or bowels. 
Toxicology.-Toxic doses produce extreme muscular relaxation and 
prostration, double vision (sometimes blindness), widely dilated and im- 
movable pupils, internal squint, and the eyelids droop and are raised with 
difficulty, or complete paralytic palpebral ptosis occurs. Often the patient 
sinks in his tracks, or if he stands he staggers. Sensibility is greatly im- 
paired, the jaws drop and speech fails. Breathing becomes slow, labored, 
and shallow; the pulse rapid, weak, and thready; the skin is wet with 
cold sweat, and the body-heat markedly depressed. Drowsiness may be 
felt, but consciousness is usually retained until just before death, evidence 
that the higher cerebral centers are but slightly involved. Death takes 
place from centric respiratory paralysis, and almost simultaneous arrest 
of the action of the heart. 
The cardinal symptoms of poisoning by Gelsemium, therefore, are 
ptosis, diplopia, dropping of the lower jaw, and absolute muscular prostration. 
In poisoning by gelsemium or its alkaloids, the emetic or stomach 
pump should be used if the patient is not too weak. Tannic acid (or strong 
infusion of store tea) should be administered, external heat applied, and 
artificial respiration attempted as soon as breathing shows signs of failure. 
Stimulation of the respiratory function should be enforced by the hypo- 
dermatic use of atropine, and that of the heart by ammonia, ether, alcohol 
and digitalis, the first three in the order named, to sustain the organ until 
the digitalis, which should be given at once, can act. 
It has been asserted that morphine completely antidotes the poisonous 
effects of gelsemium. As gelsemium poisoning is quite rare the antidotal 
treatment is none too well established and is, therefore, based mostly on 
general principles. 
Therapy.-Gelsemium is primarily the remedy for acute hypercemia of 
the brain and spinal centers. All through the woof and warp of its therapy 
runs the thread of nervous excitation and unrest; and often fever, spasm, 
and pain. In proper doses it relaxes high nervous and muscular tension. 
By diminishing the velocity of the blood current to the head and spinal 
386 INDIVIDUAL DRUGS. 
tract it prevents spasmodic action. It is, therefore, a remedy for hyper- 
aemia; never a remedy for congestion. It is the specific agent for relief in 
the nervously excited and highly feverish state, for the child with hot head 
and tremulous and jerky muscles, for great restlessness with elevation of 
temperature; for the touchy and grouchy but feverish individual who 
magnifies his ailments; and for those who dread even the simple ordeals 
and trials of life. The most direct indication for its employment is exalta- 
tion of nervous function. It is contraindicated by a weak heart and feeble 
circulation. As an antispasmodic it stands unrivaled save by lobelia and 
bromide of potassium, with both of which it acts kindly and harmoniously. 
"The flushed face, bright eye, contracted pupil, increased heat of head, 
great restlessness and excitation'' are the classic indications for it as first 
formulated by Scudder, and these stand among the truest of specific 
guides ever recorded for the use of a medicine. 
Though not classed as an antipyretic, gelsemium softens blood pressure, 
slowly reduces the pulse, and overcomes hyperaemia associated with exalted 
nervous action, thus making it indispensable in some kinds of inflammation 
and fevers. This period of excitement usually obtains early in the febrile 
state. When this nervous tension has been relieved by the drug, then its 
usefulness is practically at an end. To continue with it would imperil the 
integrity of the heart, which, while apparently but little affected during 
health, appears to be readily endangered by it during the advanced stages 
of febrile process. Only in sthenic fevers is it indicated; never when the 
heart is weak or degenerate or the patient is prostrated by debility. A soft, 
open pulse, moist skin, cleaning moist tongue and nerve calm being essential 
to the effective use of quinine, gelsemium is administered in the febrile 
stage of malarial or intermittent fevers to produce these effects and prepare 
the way for the kindly action of that great antiperiodic. This it does with 
directness and dispatch. Even before this preparatory use gelsemium 
alone was employed in these diseases with asserted success by early 
Eclectic practitioners, and in doses which we of to-day would hesitate to ad- 
minister. In other forms of fever, as remittent and so-called bilious types, 
which tip the balance one way or the other toward malarial fever or typhoid 
fever, the drug is efficient if the indications above noted are strictly observed. 
For the febricula of children, with great and tremulous agitation, high fever, 
headache, and near spasmodic explosiveness, it is unsurpassed both to allay 
the fever and to give rest and sleep. Scudder remarks that in fevers 
"we find many times that its influence is very decided; it causes relaxation 
of the system; the pulse is less frequent and softer; the respiration is slower; 
the skin becomes cooler, soft and moist; there is less determination of 
blood to the head, and if there is pain in it, it is reduced or entirely ceases, 
while at the same time we frequently notice an increased secretion of urine." 
In typhoid or enteric fever its use should be more guarded. When of the 
robust type with vigorous onset, it is serviceable if used early, but when the 
slightest evidence of enfeeblement of the heart or disintegration of the 
blood is apparent it should be withheld at once. Under such circum- 
stances we have seen a rapidly dicrotic and irregular pulse and prostration 
ensue, even though but small doses were being administered. By no certain 
means can this result be whollv attributed to the drug, vet surelv the stage 
387 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
for gelsemium medication has then passed. In puerperal fever it is useful 
as long as exalted nervous tension calls for it. 
As stated gelsemium is a remedy of marked usefulness in the sthenic 
fevers of childhood. The more these tend to convulsive complications the 
stronger becomes the indication for this agent. Infants, however, are 
quite susceptible to the drug and the dose for them should be minute- 
even fractional. In inflammatory bowel disorders of children, particularly 
during dentition, it is one of our most direct medicines, and is then most 
potent in enteritis, gastro-enteritis, cholera infantum, and diarrhoea and 
dysentery, both with tenesmus-all of which derangements are so often the 
blight of the child's second summer. Here the direct guide will be the 
exalted nervous tension, the increased heat of head and body, the brilliant, 
shifty eyes, great restlessness, and the near explosive state. If convulsions 
occur, then larger doses will control the spasms. 
Observing the indications undeviatingly gelsemium will be found one 
of the best remedies for the spasms of childhood, or infantile convulsions. 
Though single remedies are preferred in Eclectic practice, the following 
combination is the most effectual we have used for such attacks: Specific 
Medicine Gelsemium ;Specific Medicine Lobelia, aa, fl3j; Potassium Bromide, 
3 j; Water q.s. fl5 iv. Mix. Sig.: One teaspoonful every five minutes until the 
spasms cease. Then administer one teaspoonful of the solution every two 
hours for one or two days. The bowels should be thoroughly emptied by 
a copious enema of soapy water and the child immersed in a warm bath 
(tested by the attendant's bare elbow), with a cold pack to the head. If 
the convulsions are due to gastro-intestinal abuse, the spasms are soon 
controlled; if they are the precursors of infectious or other diseases, and 
centric in origin, an advantage will have been gained by the early use of the 
gelsemium. 
Gelsemium is an important sedative in the early stage of acute bron- 
chitis, broncho-pneumonia, lobar-pneumonia, and pleurisy. In pneumonia 
it is less often required than veratrum, but in all acute respiratory inflam- 
mations, of a sthenic type, it may be required to meet the nervous mani- 
festations and to give rest. In acute febrile and inflammatory diseases it is 
frequently effective in quieting delirium and overcoming insomnia. This 
is particularly evident in la grippe. Of the few remedies that offer any 
therapeutic hope in acute cerebro-spinal meningitis and acute poliomyelitis 
gelsemium has been favorably considered. Its administration should not 
be continued in the former when effusion takes place, nor in the latter 
when paralysis is established. 
Gelsemium is a remedy for pain, provided it is dependent upon or 
associated with nervous tension. For pain in the weak and apathetic it 
has no value. It has fully justified its reputation in simple neuritis and 
various types of neuralgia when there is hyperaemia, nervous irritability and 
sharp, muscular twitching. Under these conditions it may be used in 
intercostal neuralgia (often the precursor of herpes zoster), ovarian neu- 
ralgia, and is sometimes effectual in sciatic neuritis or neuralgia, though too 
much reliance must not be placed upon it in this affection. If sciatic and 
other forms of neuritis are purely nervous and hyperaemic, it is most likely 
to be of service, but if dependent upon sugar toxaemia, pressure, injury, 
388 INDIVIDUAL DRUGS. 
loaded csecum, or pelvic sublaxation, other measures must be resorted to. 
The best results from gelsemium in neuralgia are obtained in trigeminal 
or facial neuralgia, dependent upon cold, dental caries, or peridental in- 
flammation. Toothache in apparently sound teeth, but with violent 
throbbing from active circulation, frequently yields to this drug. Liberal 
doses of gelsemium are required to ease neuralgic pain. It gives relief in 
recent tic douloureux with active circulation in the head, but when the 
Gasserian ganglion becomes permanently impaired it fails, as do other 
medicines. Surgical relief is then the only rational procedure. In acute 
inflammatory rheumatism gelsemium is serviceable chiefly to allay ex- 
citement and to some extent alleviate the pain. It is adapted only to the 
initial stage and when sthenic conditions prevail, and then only as an aid 
to the more direct antirheumatic remedies. It is one of the commonest and 
best remedies for myalgia due to the strain of muscular exertion, or to 
recent colds from exposure to inclement weather. 
Various forms of headache yield to gelsemium. It is best adapted to 
nervous headache with active circulation and throbbing pain. Occasion- 
ally it serves well in migraine, but is less effectual than the synthetic anal- 
gesics. It is more efficient when headache is caused by eye-strain. 
Limited to the indications of nervous excitement with increased 
vascularity and spasmodic or colicky pain, gelsemium is of very great 
utility in dysmenorrhoea in robust subjects, as it is also in so-called uterine 
colic. Full doses are required. It acts favorably, when similarly indicated, 
in ovaritis and metritis, and in salpingitis before suppuration sets in; 
after that it is of no other value than to quiet the nervous phenomena. 
Scanty urine, with hyperaemic irritation of the renal organs and urinary 
passages, is a direct indication for gelsemium. It should then be given 
preceding or with the desired diuretics. Renal suppression is then promptly 
relieved by it, but not when there is congestion, for which belladonna 
is far more effectual. For the dysuria of spasmodic urethral stricture it is 
the remedy. It allays the irritation and temperature excited by the passage 
of catheters, bougies, and divulsors. We rely upon it in cystic irritation 
from cold when the urging to pass urine is frequent and the passage difficult. 
For this purpose, together with apis or eryngium, it gives the happiest 
results in this annoying complaint in women. It may also be satisfactorily 
employed for suppression of urine in hysterical women. In acute nephritis 
it is one of the surest remedies, and is just as serviceable in acute cystitis 
when due to colds and not dependent upon the retention of putrid urine. 
Its relaxant powers sometimes facilitate the passage of small renal calculi 
and cystic gravel. 
In the inflammatory stage of gonorrhoea no agent is more salutary 
than gelsemium. It prevents and relieves chordee, eases urination, and gives 
comfort when burning and irritation are pronounced. For this purpose it 
may well be combined with cannabis and aconite as follows: Specific 
Medicine Gelsemium, fl5j; Specific Medicine Aconite, gtt. x; Specific 
Medicine Cannabis, fl3j; Water, q. s., flgiv. Mix. Sig.: One teaspoonful 
everv two or three hours. 
389 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Obstetric therapy would be impoverished without gelsemium. One 
should not be reckless with it, however, as many believe that it favors 
hemorrhage. Our experience does not verify this view. It is the remedy 
to relax rigid os when the rim is thin and unyielding, holding the head as 
in a vise, and there is dryness of the parturient canal. It very promptly 
removes this impediment, favors normal secretion, and facilitates labor. 
In fact, all sphincters acutely contracted are relaxed by full doses of gel- 
semium. During labor it is most valuable to overcome the great restless- 
ness, fear, and excitement experienced by nervous women, and by its 
calmative power rectifies jerky and ineffectual contractions. It also 
mitigates the severity of the pain and relieves the sense of heat and dryness 
complained of by the patient. Indeed, this is one of the most praiseworthy 
effects of this drug. It also controls after-pains and the nervous agitation 
that follow a few days after parturition. For puerperal convulsions it is 
inferior only to veratrum and shares with this drug and morphine and 
chloroform in being the most generally effective remedies in this form of 
eclampsia. In no way does it interfere with the recently introduced Fischer's 
alkaline intravenous treatment. 
GENTIANA. 
The dried rhizome and roots of Gentiana lutea, Linne (Nat. Ord. Gentianaceae). Com- 
mon in the mountainous regions of southern and central Europe. Dose, 10 to 30 grains. 
Common Names: Gentian, Gentian Root. 
Principal Constituents.-Gentiopicrin, an active, bitter glucoside, associated with 
gentisic acid or gentisin (Ci4Hio06). No tannin is present but a coloring matter which is 
darkened by iron compounds. 
Preparations.-1. Infusum Gentiana, Infusion of Gentian. Dose, 1 fluidrachm to 
1 fluidounce. 
2. Specific Medicine Gentiana. Dose, 5 to 30 drops. 
3. Tinctura Gentiana Composita, Compound Tincture of Gentian. (Contains Gentian 
10 per cent, Bitter Orange Peel, and Cardamon.) Dose, fljss to fl 3j. 
Specific Indications.-Sense of epigastric depression, with physical 
and mental weariness; atony of stomach and bowels, with imperfect di- 
gestion. 
Action and Therapy.-Gentian is one of the best of the simple bitter 
tonics, for the action of which compare Calumba. In large doses, however, 
it is capable of deranging digestion, with the production of nausea, vomiting, 
and diarrhoea, and fullness of the pulse, with headache. It is contra- 
indicated in gastric irritability or inflammation. 
The chief use of gentian is to promote the appetite and improve 
digestion in states of chronic debility. This it does when given in moderate 
doses. For atony of the stomach and bowels, with feeble or slow digestion, 
it is an ideal stimulating tonic; and after prolonged fevers and infections, 
when the forces of life are greatly depressed and recovery depends upon 
increased power to assimilate foods, gentian may be used to improve 
gastric digestion and thus hasten the convalescence. Gentian is especially 
useful in anorexia, in the dyspepsia of malarial origin, and in subacute 
gastritis and intestinal catarrh. The infusion and the compound tincture of 
gentian may be used alone or as vehicles for other medicines. 
390 INDIVIDUAL DRUGS. 
GERANIUM. 
The rhizome of Geranium maculatum, Linne (Nat. Ord. Geraniacese). Common in 
the rich soils of woods and low grounds in the United States. Dose, 5 to 60 grains. 
Common Names: Cranesbill, Wild Cranesbill, Crowfoot, Spotted Geranium. 
Principal Constituents.- Tannin (10 to 28 per cent, according to season) and gallic 
acid (in dried root). 
Preparations.-1. Decoctum Geranii, Decoction of Geranium (gss to Water, Oj). 
Dose, 1 to 2 fluidounces. 
2. Specific Medicine Geranium. Dose, 5 to 60 drops. 
Specific Indications.-Relaxed mucous tissues with profuse debilitating 
discharges; chronic mucous diarrhoeas; chronic dysentery; diarrhoea with 
constant desire to defecate; passive hemorrhages; gastric ulcer. 
Action and Therapy.-Geranium is one of the simple and much neg- 
lected of the early Eclectic medicines. It is an ideal astringent and for 
conditions requiring such an action it is preferable to many other con- 
stringing drugs. Geranium is indicated in subacute and chronic bowel 
disorders when the evacuations are abundant and debilitating. It is 
especially adapted to relaxation of the mucosa following inflammation. 
For the summer diarrhoeas of older children, and especially the cholera 
infantum of infants, it is splendidly effective after the bowels have been 
thoroughly cleansed of undigested and decomposed contents. For in- 
fantile use we prefer the decoction in milk. If that does not agree, small 
doses of the specific medicine in water may be employed. When dysentery 
tends to chronicity, the thorough use of magnesium sulphate followed by 
geranium will render good service. 
Geranium is of some value in passive hemorrhages, as haematuria, 
hemoptysis, and menorrhagia. It is only useful in the first two when the 
blood lost is small in amount, and in the latter when bleeding is prolonged, 
but merely oozing. Though a useful agent in relaxed conditions with 
catarrhal discharges other than those of the bowels, as chronic pharyngeal 
catarrh, relaxed uvula, leucorrhoea, etc., it is no more valuable than other 
tannin-bearing drugs, and is often inferior to tannic acid itself. 
Geranium is of specific value where long saturation of the mucosa 
with unhealthy catarrhal secretions favor a tendency to destruction of 
tissue. We have found it to quickly cure aphthous ulceration of the mouth 
attended by gastric acidity and acid diarrhoea. For gastric ulcer it is one 
of the best therapeutic means we possess. Geranium, hydrastis, mangifera, 
bismuth subnitrate and mangesium oxide, singly, or in indicated association, 
have proven the most effective agents in our experience for the medicinal 
relief of curable cases. They restrain hypersecretion, correct excessive 
acidity, check hemorrhage, and relieve pain; sometimes healing appears to 
progress rapidly under their influence. 
GLUCOSUM. 
Glucose, Liquid Glucose, Syrupy Glucose. 
A syrupy liquid, composed chiefly of dextrose (dextro-glucose) and dextrin. It is 
obtained by the incomplete hydrolysis of starch. 
Description.-An odorless or nearly odorless, sweet, syrupy liquid, of a little or no 
color. It is sparingly dissolved by alcohol, but water dissolves it freely, the aqueous 
solution being neutral or slightly acid to litmus paper. Dose, 2 to 6 fluidounces of 6 to 30 
per cent solutions of glucose. 
391 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Shock; acidosis. 
Action and Therapy.-Glucose is an easily digested nutrient, ferment- 
able, and comparing in food value closely to sugar. Diuretic properties 
have been ascribed to it, and it is said to protect against fatty degeneration 
produced by the administration of general anaesthetics. Glucose, in 6 to 10 
per cent solutions, has proved serviceable, given by enteroclysis, in dropsical 
effusions, provided the kidneys are not badly damaged, and in uraemic 
eclampsias, and other affections with faulty elimination of urine. Intra- 
venously administered, in solutions of 10 to 30 per cent, it has been very 
successful in surgical shock. One of its most important fields of usefulness is 
in infant feeding (2 to 3 fluidounces of 6 per cent solution per rectum), and 
in the same strength solution (6 ounces) intraperitoneally to prevent 
acidosis in malnourished infants. Acetone quickly disappears under such 
use of it. 
GLYCERINUM. 
Glycerin, Glycerol. 
A liquid composed most largely of a trihydric alcohol (C3H6(OH)3) obtained by the 
processes of hydrolysis and distillation of fats, both animal and vegetable, or of fixed oils. 
Description.-A thick, syrupy, colorless liquid having a sweet and warming taste and 
a faint but agreeable odor. It has a great avidity for moisture, becoming appreciably 
thinner upon long exposure to the atmosphere. It mixes with water or alcohol; and is 
insoluble in ether, chloroform, and fixed and essential oils. Dose, 1/2 to 2 fluidrachms. 
Preparation.-Suppositoria Glycerini, Suppositories of Glycerin. 
Action.-Glycerin is a powerful hygroscopic. So great is its avidity for 
water that it will readily abstract moisture from the tissues to which it is 
applied. It is also slightly irritant to the skin and mucous surfaces, and 
considerably so to abraded surfaces. The discomfort quickly subsides, how- 
ever, and it then acts as an antiseptic and protective emollient to the skin. 
It is a demulcent to mucous tissues. Applied to the rectum it provokes 
evacuation, both by its irritating and dehydrating effects. Glycerin kills 
parasites, both cutaneous and intestinal, and allays itching, probably by 
its protective, antiseptic, and hygroscopic powers. Glycerin is rapidly 
absorbed by the intestines and is mostly oxidized in the body. By some 
it is thought to be, in some measure at least, a food, and indirectly a con- 
servator of fats through its effects of increasing the non-nitrogenous reserve 
of the body. It is also believed to increase energy. Upon the glycogenic 
function its effects are still in doubt, many contending that it reduces the 
sugar when in excess in the body. Glycerin is laxative and in very large 
amounts acts not unlike alcohol, producing a similar intoxication and like 
gastric effects. It is also said to favor the elimination of uric acid. 
Therapy.-External. The bland and practically unirritating character of 
pure glycerin, in the presence of a little water, its permanence when exposed 
to the air (except absorption of moisture), and the completeness with which 
it shields the parts make it the most largely used external application in a 
great variety of local disorders. Its protective unctuousness without 
being greasy, its splendid and extensive solvent powers, its ability to hold 
in close contact to the tissues powders and other medicines that would dry 
and fall off if applied with alcohol or water, its antiseptic and emollient 
properties, and its antipruritic qualities, make it an indispensable vehicle. 
It is freely miscible with water and most ointment bases, and dissolves or 
392 INDIVIDUAL DRUGS. 
holds in suspension the most commonly used external medicines. It 
should never be applied full strength, however, except where its dehydrat- 
ing effects chiefly are desired. Through its great greed for water it readily 
removes moisture from the tissues, leaving them hardened and more likely 
to crack. A little water should be added to it for local use, or the parts 
may be moistened and left wet before its application. Only pure glycerin 
should be used. 
Equal parts of glycerin and water, or preferably rose water, form an 
elegant and emollient cosmetic lotion for chapped hands, lips, and face, 
cracked or sore nipples, excoriated and chafed surfaces, and swollen 
hemorrhoids. A few grains of borax sometimes add to its efficiency. 
Compound tincture of benzoin and glycerin is also a pleasant application. 
For those exposed to winds and storms, and who have their hands much 
in water, the following is splendidly effective: I) Glycerin, fl § i j; Carbolic 
Acid, gr. x; Tincture of Arnica Flowers, fl^ss; Rose Water, q. s., giv. Mix. 
Sig.: Apply after thoroughly washing and rinsing the hands, and while they 
are still wet. Sometimes lobelia may be used in place of the arnica. 
Glycerin, added to poultices, renders them soothing and keeps them 
moist. It forms a good application to boils, carbuncles, small abscesses, 
and to local oedemas, as of the prepuce. Here it may be used pure for its 
antiseptic and dehydrating effects. Mixed with alcohol (1 part), glycerin 
(3 parts), it makes a useful and "drawing" application for boils, and an 
antiseptic stimulant for foul ulcerations. A mixture of glycerin and water 
in proportions to suit the case may be used as a toilet wash for the mouth 
in fevers, to keep the tongue and lips soft and pliable, and to remove sordes 
and other viscous secretions. It also reduces the thirst occasioned by the 
dryness of the mouth. 
Glycerin may be used as a vehicle for lime water for application to 
small burns, erythema, and slight excoriations; for menthol for the relief of 
itching in urticaria, chronic eczema, and other pruritic conditions; for 
boric acid in the mild forms of facial dermatitis; for lactic acid in freckles, 
sunburn, and other pigmentations; for bismuth, borax, salicylic acid, 
phenol, boric acid, or sodium or potassium bicarbonate when their long-con- 
tinued local effects are desired, especially in ulcerations and various skin 
diseases. A small portion of liquor potassee (1/2 per cent) may be added 
to it for use upon rough skin and in chronic eczema. Among the skin dis- 
orders in which it is especially useful as a vehicle may be mentioned im- 
petigo, lichen, porrigo, psoriasis, pityriasis, herpes, and tinea versicolor 
(with mercuric chloride) and other parasitic affections. 
Glycerin (diluted) is one of the best agents to soften hardened and 
impacted cerumen prior to removing it by gently syringing with warm water. 
Any irritation caused by the hardened mass or the means of removal may 
be overcome by the following: 1$ Colorless Hydrastis (Lloyd's), fl5j; 
Glycerin, gtt. xx; Distillate of Hamamelis, q. s., fl^ss. Mix. Sig.: 
Apply warm to the parts by means of cotton. Glycerin is sometimes useful 
in otorrhoea. A 5 per cent solution of phenol in glycerin upon cotton may be 
used for insertion into the aural canal after rupture of the membrana tympani 
when tenderness around the ear persists. It acts by dehydration, reducing 
the swelling and facilitating a more complete drainage from the middle ear. 
393 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Either glycerin or the glycerite of boro-glycerin are favorite agents for 
the depletion of the tissues in congestive and subacute inflammation of the 
womb. 
It should be applied upon tampons so as to remain in contact for 
several hours, and then be followed by a hot (not warm) douche. The same 
treatment gives good results in uterine subinvolution. A small quantity 
of pure glycerin, or the glycerin suppository, is very effective in provoking 
a movement of the bowels when the feces are below the sigmoid flexure. 
For a small child it is one of the most effectual methods for overcoming 
constipation, with lack of rectal response to the calls of nature. Care 
should he had to see that the syringe tip is perfectly smooth, and any irrita- 
tion caused by the glycerin may be due to using the enema too frequently 
or to the use of an impure glycerin. As a rule, 1/2 drachm properly and 
carefully injected is followed at once by a fecal evacuation. Diluted 
glycerin is sometimes useful to prevent bed-sores. 
Glycerite of Starch is a useful application in ichthyosis, and glycerin 
pastes are more cleanly and effective than those made with petrolatum 
or fats. Montgomery advises a paste made as follows: Starch, Zinc Oxide, 
of each 1 part; Glycerin, 2 parts. Prepare without boiling. This forms a 
white paste of paint-like consistence, adherent, non-greasy and pliable, and 
may be applied by spreading with the hand. It holds the parts like a 
splint, allowing discharges free egress, while it does not interfere with the 
natural secretions. It is especially designed for papular skin eruptions. 
A large proportion of the good derived from the magma-poultices, such 
as "Antiphlogistine", etc., are due to the antiseptic and dehydrating 
qualities of the glycerin they contain. 
Internal. Only pure glycerin should be used for internal use. Glycerin 
is invaluable as a flavoring and sweetening preservative for water-dispensed 
medicines. Especially is it demanded in the summer season. From 1 to 2 
drachms are sufficient for most four-ounce mixtures, depending somewhat 
upon the quantity of alcohol or other preservative agents present. In 
special cases of diabetes it may be used as a substitute for sugars. While 
somewhat laxative it is seldom so used in Eclectic practice, and if selected 
would be indicated only where either constipation or diarrhoea is de- 
pendent upon fermentative changes. There are, however, cases of hemor- 
rhoids, both bleeding and non-bleeding, in which it may be used as a laxa- 
tive; and these are accompanied by fermentative action in the stomach 
and bowels. Glycerin is sometimes useful in fermentative dyspepsia, with 
flatulence and constipation, relieving largely by its antiseptic and de- 
hydrating effects. Glycerin, well diluted with iced water, makes a fairly 
good diink for low forms of fever, where putrefaction is shown by the dry 
tongue, foul breath and sordes. Its value as a nutritional measure, in place 
of cod-liver oil and other fats, is open to grave doubt, with the probabilities 
in favor of its uselessness. Its employment as a food for diabetics, and in 
phthisis and other wasting diseases, has practically lost prestige, though 
in the first named many believe it useful to check, in some degree at least, 
the excretion of sugar. The common custom of taking glycerin, rock 
candy, and whisky for common coughs and colds is nothing less than a 
popular form of mild alcoholic tippling. 
394 INDIVIDUAL DRUGS. 
GLYCYRRHIZA. 
The dried rhizome and roots of Glycyrrhiza glabra typica, Regel et Herder (Spanish 
Licorice), or of Glycyrrhiza glabra glandulifera, Regel et Herder (Russian Licorice), (Nat. 
Ord. Leguminosse). Southern Europe and western Asia; cultivated. Dose, 5 to 60 grains. 
Common Names: Licorice, Licorice Root, (1) Spanish Licorice Root, (2) Russian 
Licorice Root. 
Principal Constituents.-The sweet glucoside glycyrrhizin (C24H36O9), asparagin, 
glycyramarin and an acid resin. 
Preparations.-1. Specific Medicine Glycyrrhiza. Dose, 5 to 60 drops. 
2. Fluidextractum Glycyrrhiza, Fluidextract of Glycyrrhiza. Dose, 30 drops. 
Derivative: Glycyrrhizinum Ammoniaium, Ammoniated Glycyrrhizin. Very sweet, 
odorless, dark-brown or red-brown scales; soluble in alcohol or water. It is derived from 
glycyrrhiza and combined with ammonia. Dose, 1 to 8 grains. 
Action and Therapy.-Glycyrrhiza root is demulcent, laxative, and 
expectorant. It acts upon mucous surfaces, lessening irritation and re- 
lieving coughs, catarrhs, and irritation of the urinary tract. The powdered 
extract is sometimes used to give solidity to pills, and the powdered root 
as a dusting powder for the same. The fluidextract is an agreeable flavoring 
agent for other medicines and soothing to irritated bronchial surfaces. The 
bitterness of cascara, quinine, aloes, quassia, the acridity of senega, guaiac, 
and the taste of ammonium chloride and sodium salicylate are more or less 
masked by the fluidextract. Licorice root is an ingredient of Compound 
Licorice Powder. (See Senna). 
GOSSYPIUM. 
The bark of the root and the hairs of the seed of Gossypium herbaceum, Linne, and 
of other species of Gossypium (Nat. Ord. Malvaceae). An Asiatic plant extensively culti- 
vated, especially in southern United States. Dose, 5 to 60 grains. 
Common Names: (1) Cotton-Root Bark; (2) Cotton, Cotton Wool. 
Principal Constituents.-The root-bark yields a red resin called gossypic acid (8 per 
cent) and volatile oil and tannin. 
Preparations.-1. Specific Medicine Gossypium. Dose, 5 to 60 drops. 
2. Gossypium Purificatum, Purified Cotton (Absorbent Cotton). (Cotton freed from 
impurities and deprived of fatty matter.) 
3. Oleum Gossypii Seminis, Cottonseed Oil. A pale, yellow, odorless or nearly odor- 
less oil, having a bland taste; slightly dissolved by alcohol and miscible with ether, chloro- 
form, petroleum, and benzin. Dose, 1/2 to 2 fluidounces. 
Specific Indications.-(Uterine inertia; preparations of fresh root-bark 
-large doses.) Tardy menstruation with backache and dragging pelvic 
pain; fullness and weight in the bladder, with difficult micturition; sexual 
lassitude with anemia; hysteria, with pelvic atony and anemia. 
Action and Therapy.-External. Absorbent cotton is of mechanical 
use only in practice. A cotton jacket is preferred by many to poultices 
and magmas for use in acute lung diseases. It maintains an even protection 
from changes of temperature, and slight moisture usually accumulates under 
it, thus making it serve the purpose, without the weight and dangers, of the 
poultice. Cotton is widely used in surgical practice for sponging and 
dressings, to take up secretions, to protect painful surfaces in burns and 
scalds, and to prevent the ingress of atmospheric microbic invasion. It is 
a comforting application to rheumatic joints, usually being applied over 
some oleaginous application. Upon raw surfaces oils or some lubricant 
should be first applied and then the parts encased in cotton. If allowed to 
become stiff and hard it acts as any other foreign body. Cotton is used for 
395 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
vaginal tampons, but they should be removed after a few hours use, as they 
become exceedingly foul and veritable hotbeds of infection. For packing 
wounds and cavities and similar surgical uses gauze is preferred to cotton. 
Cotton is a good medium by which to apply antiseptic and dusting powders. 
Internal. Fresh cotton-root bark is emmenagogue. It is useful in 
tardy menstruation, with much backache and dragging pelvic pain. Owing 
to its undoubted power upon the uterine musculature it is of value in uterine 
subinvolution and is asserted to have reduced the size of fibroids. It 
probably acts much in the same manner as ergot, though far less powerfully. 
It has the advantage, however, of being practically non-poisonous. In 
uterine inertia during labor it is said to act well, though it is seldom brought 
into requisition. The reputed use of the decoction as an abortifacient 
by the cotton-district negresses is common knowledge. Fortunately the 
fresh root is not everywhere available, if it really possesses ecbolic proper- 
ties, for old bark is said to be valueless for any purpose. 
Webster employs gossypium in hysteria in children and adults. He 
reports it efficient in screaming children, morose women, and girls with 
uncontrollable laughter, as well as in those assuming muscular rigidity. 
These adult cases undoubtedly depend upon menstrual derangements. 
Cotton Seed Oil. This is a bland, nutritious, and wholesome digestible 
oil, used as a food and emollient; and employed in pharmacy, medicine, 
and surgery for many of the purposes for which olive oil is used. (See 
Oleum Olivce.) 
GRANATUM. 
The dried bark of the stems and roots of Punica Granatum, Linne (Nat. Ord. Puni- 
caceae). India, southwestern Asia, and the Mediterranean shores; naturalized and culti- 
vated in warm latitudes. Dose, 30 grains. 
Common Names: Pomegranate, Pomegranate Root Bark. 
Principal Constituents.-Pelletierine or punicine (1/2 per cent), methyl-, pseudo-, and 
isopelletierine, all alkaloids, and punico-tannic acid (20 per cent). 
Preparations.-1. Pelletierince Tannas, Pelletierine Tannate. (Contains in varying 
proportions, in admixture, the four alkaloids mentioned above.) A pale-yellow, non- 
crystalline powder, without odor, and an astringent taste. Soluble in alcohol and less 
readily in water. Dose, 4 grains. 
2. Decoctum Granati, Decoction of Pomegranate Bark (see below). 
Specific Indications.-Taeniacide and taeniafuge for the destruction and 
expulsion of tapeworm. 
Action.-Pomegranate preparations, in large doses, causes nausea and 
vomiting, flatulence and intestinal pain. Notwithstanding the large amount 
of tannin it contains, such action is frequently followed by diarrhoea. Other 
effects are tremors, muscular weakness, and cramps in the extremities, 
dizziness, mental confusion, drowsiness, diplopia and mydriasis, and other 
ocular disturbances. The tannate kills the tapeworm easily, but has far 
less effect upon other intestinal parasites. The associated alkaloids, sold 
as pelletierine, constitute an exceedingly active combination, capable of 
producing paralysis of the motor nerves. The tannate, probably owing to 
its slow solubility, is less liable to disturb the system, but is equally effective 
as a taeniacide. 
Therapy.-When pomegranate decoction can be retained by the 
stomach it is a certain specific for the destruction and expulsion of tape- 
worm. When this preparation cannot be used, the tannate, which is far 
396 INDIVIDUAL DRUGS. 
more easily administered, may be substituted. A semi-proprietory prepara- 
tion called "granatin" is a salt of pelleterine in solution, and is a very effective 
destroyer. It is sold ready for administration as a single dose. Locke's 
method of treating tapeworm is popular with Eclectic physicians. The 
decoction he advised is prepared as follows: Press 8 ounces of the coarse 
bark into a vessel and pour upon it three pints of boiling water; boil, 
strain, and then boil again until but one pint remains. A brisk cathartic 
should be given at night and a light breakfast allowed in the morning. 
In the middle of the forenoon four ounces of the decoction should be ad- 
ministered. In order that this may pass quickly into the intestines and its 
absorption be prevented, as far as possible, a fluidrachm of fluidextract of 
jalap aromatized with oil of anise or oil of cinnamon should be given with 
the dose. In two or three hours the dose should be repeated. When the 
bowels begin to move administer a copious enema, and remove the worm 
in a vessel filled with warm water so that it may float freely and not be 
broken. If nausea and vomiting occur upon first giving the decoction, 
lemon juice should be given and the recumbent position maintained. 
When pelletierine preparations are administered a light milk diet in the 
evening is followed in the morning by a saline purge, and then the combined 
alkaloids administered. In about one hour another dose of the purgative 
should be given. Epsom salt, fluidextract of jalap, or castor oil may be used 
as the cathartic. If the tannate is employed it may be administered in 
capsule. 
The dried leaves and flowering tops of one or several species of Grindelia-as Grindelia 
camporum, Greene; Grindelia cuneifolia, Nuttall; or Grindelia squarrosa (Pursh), Dunal. 
(1 and 2) Marshes of California; (3) Western plains. Dose, 5 to 40 grains. 
Common Name: Grindelia. 
Principal Constituents.-A saponin-like resin {grindelin'), volatile oil, and an alkaloid 
grindeline. 
Preparation.-Specific Medicine Grindelia. Dose, 5 to 40 drops. 
Specific Indications.-Asthmatic breathing with sense of soreness and 
rawness; harsh, dry cough; dyspnoea with cyanosed countenance. Locally, 
rhus poisoning; old indolent ulcers. Grindelia squarrosa: malarial cachexia 
with splenic congestion. 
Action.-The grindelias have a bitter, acrid taste, leaving an un- 
pleasant, persistent, acrid sensation in the mouth and cause an increased 
flow of saliva. The kidneys are excited by them and diuresis is increased, 
while upon the bronchial membranes they produce a primary increase of 
secretion followed by a lessened expectoration and diminution of the rate 
of breathing. They are eliminated by the bronchi and the kidneys. 
Marked relaxation of the bronchi is produced by grindelia. 
Therapy.-External. Grindelia promotes reparation in damaged 
conditions of the epithelium. It is especially valuable in chronic skin 
diseases with feeble circulation and tendency to ulceration. For indolent 
ulcers a lotion of the specific medicine (fl5 ii to Water, Oj) may be applied 
freely upon compresses. It stimulates growth and heals the ulcers. Grin- 
delia similarly applied is one of the best of applications in rhus dermatitis. 
GRINDELIA. 
397 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Applied to chronic eczema of the vesicular type it has been credited with 
many cures. Webster asserts it is of value in malignant ulceration, as epi- 
theliomata of the mucosa and the skin. This is claiming much and awaits 
confirmation from the experience of others. 
The leaves of grindelia, smoked alone or mixed with stramonium, 
lobelia, or potassium nitrate, have been used successfully to relieve the 
paroxyms of spasmodic asthma. 
Internal. Grindelia is a remedy for asthmatic breathing, with pectoral 
soreness and a sense of rawness. The accompanying cough is dry and 
harsh and the breathing labored, causing in plethoric individuals a dusky 
coloration of the face. In some cases it promptly stops the paroxysms of 
asthma, and in others apparently has no effect. It is useful in subacute and 
chronic bronchitis, especially in old persons, and in bronchorrhoea and 
emphysema. 
Grindelia squarrosa is credited with antimalarial properties and to 
relieve splenic congestion and hypertrophy of malarial origin. The in- 
dications are dull pain with fullness over the spleen, sallow skin, debility 
and indigestion, with gastric distress. 
The bitter taste of grindelia is best disguised by chloroform. 
GUAIACOL. 
Methyl Pyrocatechin. (Formula: C7HsO2). 
Description.-A colorless or yellowish crystalline solid, or a strongly refractive liquid, 
having an aromatic taste and odor, sparingly soluble in water, but freely dissolved by 
glycerin. It is prepared from wood-tar creosote, and synthetically from catechol or from 
ortho-anisidin. Dose, 5 to 15 drops. 
Preparation.-Guaiacolis Carbonas, Guaiacol Carbonate. A white crystalline powder 
almost insoluble in water, but soluble in alcohol (60), chloroform (1), and ether. Dose, 
5 to 20 grains. 
Action and Therapy.-Applied to the skin during pyrexia, guaiacol is 
capable of profoundly lowering the temperature. A depression of over 
seven degrees has been noted. It is exceedingly dangerous when em- 
ployed in this manner, causing chills, excessive sweating and collapse. 
Guaiacol was introduced into medicine to take the place of creosote be- 
cause it acts more kindly upon the stomach and is less apt to irritate the 
bowels and the kidneys. Under the mistaken notion that it will destroy 
or cripple the tubercle bacillus, or combine with its toxins, it has been 
quite extensively, and often indiscriminately, employed in pulmonary 
tuberculosis. The objects sought-to lessen cough, restrain excessive 
sweating and diarrhoea, and restrict expectoration-have been realized in 
some cases. The good that it has done is probably due to its favoring im- 
proved digestion and consequently bettering nutrition. Its germicidal power 
over the tubercle bacillus still lacks substantiation. Inhaled from hot 
water and taken internally it has benefited cases of acute and chronic 
bronchitis, with fetid expectoration. Painted upon the tonsils early in 
acute follicular tonsillitis it is said to abort the infection. As creosote 
water sprayed upon the throat daily in susceptible individuals wards off 
throat inflammations, the suggestion to use guaiacol seems reasonable. 
Guaiacol is an intestinal antiseptic and in very small doses, one or two 
grains, it may be used in typhoid and other toxaemic fevers. It is also 
398 INDIVIDUAL DRUGS. 
antipyretic, but under no circumstances should it be used as such, especially 
by the method of painting it upon the surface. It is as depressing as the 
coal-tar antipyretics. The long continued use of guaiacol is open to the 
same objections as those applying to creosote, which see. 
Guaiacol is largely used in the intravenous treatment of phthisis, in 
association with salicylic acid and other agents. While many favorable 
reports of improvement have been made, the status of these drugs or of this 
form of treatment is not as yet established and seems to grow less in favor 
as time passes. 
Guaiacol carbonate is thought to be better borne by the stomach and is 
given for the same purposes as guaiacol. It is of some value in fermentative 
dyspepsia, and fetid bronchitis. Guaiacol salicylate is used for similar 
purposes. Where the patient can tolerate these drugs they may be given 
for months at a time. 
GUAIACUM. 
The resin of the wood of Guaiacum officinale, Linne, or of Guaiacum sanctum, Linne 
(Nat. Ord. Zygophyllaceae). West Indian trees. Dose, 5 to 30 grains. 
Common Names: Resin of Guaiac, Guaiac. 
Description.-Greenish, gray-brown fragments, masses or tears of a balsamic odor 
and slightly acrid taste. Usually admixed with fragments of vegetable tissues. Easily 
soluble in alcohol, ether and chloroform. Dose, 5 to 15 grains. 
Principal Constituents.-Three resins: guaiaconic acid (70 per cent), guaiacic acid, and 
guaiaretic acid. 
Preparations.-1. Specific Medicine Guaiacum. Dose, 5 to 30 drops. 
2. Tinctura Guaiaci Ammoniata, Ammoniated Tincture of Guaiac (Guaiac, 20 per 
cent, in Aromatic Spirit of Ammonia). Dose, 10 to 30 drops. 
Specific Indications.-Dryness and stiffness of the throat with tumid, 
swollen tonsils, painful deglutition and dribbling of saliva; incipient 
tonsillitis (early); rheumatic pharyngitis. 
Action and Therapy.-External. The ammoniated tincture or the 
dilution of the specific medicine (1 to 3 of alcohol), added to water, acts 
efficiently as a gargle or preferably a wash, for the forms of sore throat 
mentioned below. 
Internal. Guaiaic once had considerable vogue as a remedy for 
syphilis, but is practically out of use in that disease at the present day. 
It was also much used in rheumatism, in which it has a better claim to 
efficiency. Guaiac is laxative, expectorant, and diaphoretic. When it 
fails to act upon the skin it usually stimulates the kidneys. Large doses 
may occasion gastro-intestinal inflammation. It has somewhat of an anti- 
septic action, which is extended to the secretions caused by it. 
The chief uses for guaiac are in rheumatic pharyngitis or rheumatic 
sore throat and incipient tonsillitis, with angry, red, raw-looking surfaces, 
where the parts appear to be severely inflamed or greatly congested. The 
latter may be the type which is the forerunner of an attack of acute inflam- 
matory rheumatism-the tonsils being the foci of infection. In such cases 
it acts better than in other forms of amygdalitis. While seemingly indicated 
in active conditions in sore throat and in chronic rheumatism, it is best 
adapted to passive conditions-cold hands and feet, feeble circulation, and 
vital depression. In general plethora or inflammation of the gastro- 
enteric tract it is usually contraindicated. Guaiac has been much em- 
399 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ployed in chronic sore throat of syphilitic origin. The best form of ad- 
ministration is a fourfold dilution of specific medicine, mixed with syrup 
and water. Stronger preparations than this diluted tincture precipitate 
heavily. 
GUARANA. 
A dried paste, chiefly consisting of the crushed or pounded seeds of Paullinia Cupana, 
Kunth (Nat. Ord. Sapindaceae), yielding not less than 4 per cent of caffeine. A shrubby 
vine of northern and western Brazil. 
Common Name: Guarana. 
Description.-Cylindrical, dark reddish-brown sticks, paler internally, and admixed 
with fragments of seeds and integuments. Slight odor, and feeble astringent, bitter taste. 
Partly soluble in water and in alcohol. Dose, 15 to 30 grains. 
Principal Constituents.-Caffeine, volatile oil, saponin, and tannin. 
Preparation.-Specific Medicine Guarana. Dose, 10 to 30 drops. 
Specific Indications.-Headache with pallor, weak circulation, the 
pain aggravated by exertion; sick headache (migraine), with cerebral 
anemia; menstrual headache, with cerebral anemia; mental exhaustion 
or depression; headache from dissipation. 
Action and Therapy.-Guarana is a gentle excitant acting very much 
like tea and coffee. It is valuable where the brain becomes exhausted or 
depressed through mental overwork, or when the body is fatigued or ex- 
hausted. It must be carefully used as it sometimes causes difficult urina- 
tion. Neither should it be employed in neuralgias that are aggravated by 
stimulation of the heart. It is indicated only in atonic conditions. 
Guarana is a remedy for the relief of nervous headache, or those forms 
following menstruation or drunkenness. The face is pale, the pulse feeble, 
the eyes dull and expressionless, and nausea is prominent. Every move- 
ment causes an aggravation of the pain, the patient is mind-weary, and 
cerebral anemia is always present. It sometimes relieves lumbago, and 
while contraindicated in sthenic neuralgias it sometimes relieves occipital 
neuralgia when the indications are as given above. Temporary paralysis of 
the motor oculi nerve, followed by headache, has been relieved by it. In 
headaches the doses of 20 to 30 drops of the specific medicine should be 
given. 
GYNOCARDIA. 
The seeds and oil of Gynocardia odor ata, Robert Brown (Nat. Ord. Bixinaceae). An East 
Indian tree. See Preface; also The National Geographic Magazine, March, 1922; p. 243. 
Common Names: Chaulmoogra, Chaulmugra. 
Principal Constituent.-A granular oil (Oil of Chaulmugra) containing gynocardic 
acid. It has an acrid taste. Dose, 2 to 3 drops. 
Action and Therapy.-Oil of chaulmugra has given surprisingly good 
results in leprosy; and it has often failed. The dexterity with which it has 
been adulterated has probably stamped the medicine with an uncertain 
reputation. It is used both locally and internally. Many other uses, 
chiefly local, are ascribed to it, but the agent is seldom employed in this 
country, though it is of interest to physicians going to countries where 
leprosy abounds. 
400 INDIVIDUAL DRUGS. 
HAEMATOXYLON. 
The heart-wood of Hcematoxylon campechianum, Linne (Nat. Ord. Leguminosese). 
Jamaica and the West Indies. 
Common Name: Logwood. 
Principal Constituents.-Tannin and hcematoxylin, an alkaloidal indicator. 
Preparations.-1. Decoctum Hcematoxyli, Decoction of Logwood (Logwood, 5j; 
Water, Oj). Dose, 1 to 2 fluidounces. 
2. Extractum Hcematoxyli, Extract of Haematoxylon. Dose, 5 to 30 grains. 
3. Specific Medicine Logwood. Dose, 5 to 30 drops. 
Action and Therapy.-A mild, unirritating astringent and tonic formerly 
much used in chronic diarrhoea and summer complaint of children, and in 
passive hemorrhages, and colliquative sweats. It is now seldom employed. 
The leaves, bark and twigs of Hamamelis virginiana, Linne (Nat. Ord. Hamamelidaceae), 
collected in the autumn. Common in the United States. Dose, 5 to 60 grains. 
Common Names.-Witch-Hazel, Snapping Hazelnut, Winterbloom. 
Principal Constituents.-A bitter body, tannin, and a volatile oil. 
Preparations.-1. Aqua Hamamelidis, Hamamelis Water, (Distillate of Hamamelis, 
Distilled Witch-Hazel, Distilled Extract of Witch-Hazel). Dose, 5 drops to 2 fluidrachms. 
2. Specific Medicine Hamamelis. Dose, 5 to 60 drops. 
Specific Indications.-Venous debility, with relaxed and full tissues; 
pallid mucosa or occasionally deep red from venous engorgement, or deep 
blue from venous stasis; excessive mucous flow, with venous relaxation; 
passive hemorrhages; prehemorrhagic states, with venous fullness; varicoses; 
hemorrhoids with weight and fullness; rectal prolapse; dull aching pain in 
pelvis, genitalia, or rectum, with perineal relaxation and fullness; relaxed 
or engorged and painful sore throat; gastro-intestinal irritability, with 
venous weakness and mucous or muco-bloody passages. Locally to in- 
flamed, ulcerated or wounded skin or mucosa, especially where venous 
circulation is debilitated; contusions, bruises, and muscular soreness from 
exertion or exposure. 
Action and Therapy.-External. Witch-hazel bark and its fluid prepara- 
tions are astringent. The distillate and the specific medicine are sedative and 
slightly astringent. The latter two form agreeably grateful and soothing 
applications to the skin and mucous surface in irritated and inflamed 
conditions and where venous relaxation is present. The specific medicine 
is an elegant and heavy distillate, carrying a large proportion of the oil, as 
compared to the ordinary distillate, and is much to be preferred where a 
bland and soothing yet astringent effect is required. Where more alcoholic 
stimulation is permitted or desired the ordinary distillate may be used. 
As a rule, the specific medicine is best for use upon mucous, and the distillate 
upon the cutaneous surfaces. 
Witch-hazel distillates are splendid applications for sprains, con- 
tusions, wounds and inflamed swellings, and for sunburn, tan, freckles, and 
dilatation of the capillaries of the skin. They are cooling and relieve 
smarting and pain. Used alone or combined with an equal quantity of bay 
rum they form an elegant face wash to remove excess of soap and heal 
abrasions after shaving. Witch-hazel is one of the most comforting ap- 
plications for painful hemorrhoids. It may be used ice cold or hot, as 
HAMAMELIS. 
401 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
preferred. Applied to the tender parts after the parturient toilet, it removes 
soreness of the tissues from childbirth. Rubbed upon the skin, or applied 
by means of compresses, it is an efficient lotion for muscular soreness and 
aching after severe exertion; from cold, exposure, or when due to bruises 
and strains. Its use should be accompanied with gentle massage. Com- 
presses wetted with witch-hazel give marked relief in acute cutaneous in- 
flammations, chafing, and especially in mammitis. 
Incised wounds, ragged cuts from glass or tin, barbed wire injuries, 
and crushed fingers are quickly relieved of pain and heal rapidly when the 
following is applied: 3 Echafolta, fl^ss; Asepsin, gr. xv; Specific Medicine 
Hamamelis, Water, aa, q. s., fl^iv. Mix. Apply upon gauze. A similar 
preparation, with but two drachms of the echafolta, or the distillate with 
menthol, makes a good dressing for burns and scalds. Glycerin and hama- 
melis, equal parts, or equal parts of Specific Medicine Hamamelis and Lloyd's 
Colorless Hydrastis give excellent results in irritation and inflammation of 
the aural canal due to inspissated cerumen, or to efforts to remove the latter. 
Sprayed upon the throat the specific medicine or the distillate, suitably 
diluted, is a useful and sedative astringent for angry and deep red sore- 
throats, with relaxation of membranes; or in pharyngitis, faucitis, and 
tonsillitis, with hyperaemia or congestion. The specific medicine is especially 
soothing and astringent in congestive nasal catarrh. Few local washes give 
greater relief in the angina of scarlet fever than those of which witch- 
hazel forms a part. They relieve pain, cleanse the parts, and constringe the 
relaxed tissues and dilated vessels. It may also be added to local washes 
for use in diphtheria. 
Together with colorless hydrastis, or other non-alcoholic hydrastis 
preparations, with or without a grain of alum or of zinc sulphate, it is a 
most effective collyrium for acute conjunctivitis, with dilated conjunctival 
vessels. Especially is it effective in vernal conjunctivitis. The same 
combinations are exceedingly useful as an injection in gonorrhoea, after the 
acute symptoms have subsided and a catarrhal state has supervened. 
Internal. Hamamelis has an important tonic effect upon venous 
debility, acting upon the coats of the veins throughout the body. Unlike 
some vascular remedies its action is not merely local, but extends throughout 
the whole venous system. It is therefore a remedy of much value in 
varicoses, hemorrhoids, and passive hemorrhages. When indicated, the 
tissues are pallid and relaxed, and in some instances deep red, due to 
venous engorgement. There is a sense of fullness or thickening and weight 
and congestion. These are especially prominent in the type of hemorrhoids 
benefited by hamamelis. It is of some value in oozing of blood from the 
mucosa, in passive bleeding from the nose, lungs, and stomach, but is a 
better remedy for the venous relaxation that precedes these hemorrhages 
and which renders their occurrence easy. It is of less value in hemoptysis 
than lycopus, and is adapted to such cases as are benefited by geranium 
and erigeron. 
Hamamelis is a decidedly useful remedy in congestive conditions with 
marked tissue debility. It should be given a fair trial in congestion of the 
ovaries, with dull aching pain and sense of weight and fullness; in chronic 
congestive conditions of the uterus, with soft and flabby cervix and patulous 
402 INDIVIDUAL DRUGS. 
os; in uterine subinvolution; and in leucorrhcea, with sponginess of the 
vagina and tendency to prolapsus of the womb; and in prolapse of the 
rectum, with venous fullness. It frequently relieves in varicocele, with 
sense of weight and dragging. 
Hamamelis should also be given in nasal catarrh and ozaena, with con- 
gestion and tendency to recurring epistaxis, and thickened and relaxed 
mucosa, with abundant mucous or muco-purulent discharge; and in 
chronic inflammation of the fauces, pharynx, and larynx with sluggish 
venous circulation, and greatly relaxed tissues. For chronic diarrhoeal, 
and sometimes acute bowel disorders, as cholera infantum and dysentery, 
it is promptly curative when much mucus is passed, and especially if the 
passages are tinged with blood. In all cases in which it is indicated there is 
debility of the venous circulation and relaxation of the mucosa; and where 
possible it should be used concurrently internally and locally. 
The leaves and tops of Hedeoma pulegioides (Linne), Persoon (Nat. Ord. Labiatae). 
Common in American woods and waste places. Dose, 5 to 60 grains. 
Common Names: Pennyroyal, American Pennyroyal, Squawmint, Tickweed. 
Principal Constituent.-A fragrant volatile oil {Oleum Hedeoma). 
Preparations.-1. Specific Medicine Pennyroyal. Dose, 5 to 60 drops. 
2. Oleum Hedeoma, Oil of Pennyroyal. Dose, 2 to 10 drops. 
3. Infusum Hedeoma, Infusion of Pennyroyal (3 j to Water, Oj), ad libitum. 
Specific Indications.-Amenorrhcea of long standing, with pallor and 
anemia and dark circles around the eyes; the patient complains of languor, 
lassitude, takes cold easily, has pain in back and limbs, and exhibits full, 
prominent veins (Hennell); suppressed lochia. 
Action.-Oil of pennyroyal produces toxic effects when given in over- 
doses. A drachm caused severe headache, difficult swallowing, intense 
nausea, severe retching without emesis, intolerable bearing down, labor- 
like pains, abdominal tenderness, constipation, dyspnoea, semiparalysis of 
the limbs, and nervous weakness and prostration. 
Therapy.-External. Oil of Pennyroyal is rubefacient and relieves 
the itching of insect bites. It is useful in embrocations for rheumatic pain. 
It is sometimes applied to the hands and face to protect against mosquitoes, 
fleas, and other insects. A cloth saturated with oil of pennyroyal may be 
hung in sleeping apartments to repel such insects. 
Internal. Oil of Pennyroyal is useful in nausea, stomach cramps, 
flatulent colic, and amenorrhcea in debilitated subjects. It is frequently 
used to prevent griping from other medicines. It may be given upon sugar 
or in emulsion. It and the dilution in alcohol are also credited with calm- 
ative properties in spasmodic cough, whooping cough, and in hysteria from 
menstrual debility. A drachm of the specific medicine given in hot water 
is the most certain agent we possess to restore suppressed lochia. The 
infusion is a popular and pleasant remedy for acute colds. It acts chiefly 
as a diaphoretic, and for this effect it is one of the most certain of 
medicines; and a relic of domestic methods once in favor among physicians, 
as well as the laitv. 
HEDEOMA. 
403 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
HELLEBORUS. 
The root of Helleborus niger, Linne (Nat. Ord. Ranunculaceae). Subalpine woods of 
central and southern Europe. Dose, 1 to 10 grains. 
Common Names: Black Hellebore, Christmas Rose. 
Principal Constituents.-Two toxic glucosides, helleborin (acting upon the heart and 
as a drastic cathartic), and helleborein (narcotic). 
Preparation.-Specific Medicine Helleborus. Dose, 1/10 to 3 drops. 
Action and Therapy.-Hellebore is a powerful gastro-intestinal and 
nerve poison, and produces death by convulsions and exhaustion. Small 
doses stimulate the heart. Large doses are drastically cathartic, and in 
this way it exerts also emmenagogue effects. Helleborus was once largely 
used as a revulsive in various types of insanity, but is no longer employed 
for such a purpose. In minute doses it may be employed to increase 
cardiac power and arterial tension and slow rapid action of the heart. 
It increases renal activity and has caused rapid disappearance of non- 
compensatory symptoms in heart disorders. It is also suggested when 
there are jelly-like passages in bowel affections. Scudder advised it as an 
emmenagogue when the patient is annoyed by flashes of heat, burning of the 
surface of the thighs and nates, and sensitiveness of the pelvic and perineal 
tissues. Properly used it might prove of advantage in hypochondria de- 
pendent upon reproductive atony. The dose should be fractional. 3 Spe- 
cific Medicine Helleborus, gtt. v; Water, A^iv. Mix. Sig.: One tea- 
spoonful every two to four hours. 
HELONIAS. 
The rhizome of Chamcelirium luteum, Gray (Helonias dioica, Pursh)-(Nat. Ord. 
Melanthaceae). Abundant in woodlands, meadows, and wet places in some parts of the 
United States. Dose, 10 to 30 grains. 
Common Names: Blazing Star, Unicorn Root, Starwort, Drooping Starwort, Devil's 
Bit. 
Principal Constituent.-A yellowish, bitter principle, chamodirin. 
Preparation.-Specific Medicine Helonias. Dose, 10 to 30 drops. 
Specific Indications.-Sense of weight, congestion, or expulsion of the 
pelvic contents, with mental torpor, despondency, or irritability; gastric 
and other disturbances reflexly due to pelvic relaxation; strong, sticky 
leucorrhoea; pelvic fullness with discharge. 
Action and Therapy.-Tonic, diuretic, and vermifuge. (For relation to 
Aletris, compare Aletris.') Helonias is a valuable uterine tonic, specifically 
adapted to uterine weakness in which relaxation of tissue is so great as to 
give the sensation of downward pressure, dragging or expulsion-or as the 
patient expresses it, "a sensation as if everything in the pelvis would fall 
out or be expelled." Marked irritability and despondency are often 
associated with such disorders, and when menstruation occurs there is a 
feeling of undue fullness, as if the womb and rectum were distended with 
blood, and about to be pushed out of the body. There is associated aching 
and propulsive pain. In anemic cases the drug is useful in amenorrhoea, 
and in leucorrhoea should be given internally, while hot antiseptic and 
astringent injections are used locally. Helonias is said to correct sexual 
lassitude in both sexes, and to have checked nocturnal losses due to excesses 
and associated with enfeebled body, impaired memory, and mental apathy. 
404 INDIVIDUAL DRUGS. 
In chlorotic anemia dependent in a measure upon uterine and ovarian 
weakness, it is also asserted to be very serviceable, and reputed to improve 
loss of appetite, indigestion, and malassimilation when aggravated by sexual 
weakness. It is also said to relieve the nausea and vomiting of pregnancy, 
to prevent miscarriages, and to correct gastric complications of albuminuria. 
The leaves of Anemone acutiloba, Lawson, and of Anemone Hepatica, Linne (Nat. Ord. 
Ranunculaceae). Common in rich woods in the United States. Dose, 5 to 60 grains. 
Common Names: Liverleaf, Liverwort, American Liverleaf, Kidney Liverleaf (A. 
Hepatica), Heart Liverleaf (A. acutiloba). 
Principal Constituents.-Tannin, mucilage, and a bland oleoresin. 
Preparation.-Specific Medicine Hepatica. Dose, 1 to 60 drops. 
Specific Indication.-Irritation and hypersecretion of mucous mem- 
branes. 
Action and Therapy.-A mild, mucilaginous astringent, used sometimes 
to allay bronchial irritation, with free secretion and similar conditions of 
the gastro-intestinal tract. It may be exhibited when there is subacute or 
acute inflammation, and in cough with expectoration of bloody mucus. 
It is one of the negative medicines that occasionally meets special con- 
ditions when more energetic agents, seemingly indicated, would aggravate. 
It came into use under mistaken identity for another plant and acquired a 
great reputation for virtues it did not possess. The infusion may be given 
liberally. 
HEPATICA. 
HEXAMETHYLEN AMINA. 
Hexamethylenamine, Urotropin, Formin, Aminoform. 
(Formula: (CH2)6N4.) 
Description.-Colorless, lustrous crystals, or a white powder, without odor, and of a 
sweetish taste. It is of an alkaline reaction, and when heated evolves a fishy odor. Very 
soluble in water, cold or hot; or alcohol, and less so in ether. Dose, 1 to 8 grains (usual 
dose, 4 grains). 
Action and Therapy.-Urotropin is a urinary antiseptic. In the body 
it has no effect as hexamethylenamine, but when dissociated into its 
original components-ammonia and formaldehyde-the latter acts as an 
inhibiting agent upon microbial organisms and thus exerts its antiseptic 
power. To obtain the best effects from urotropin the urine must be acid, 
particularly if colon bacilli are present, and while said not to act so well in 
the presence of alkaline urine, because of the readiness with which the 
formaldehyde unites with ammonia, it seems nevertheless to clear up 
cloudy urine when alkaline and pus-laden, and phosphates and amorphous 
urates are present. When desired to produce the proper medium for its best 
action the urine may be rendered acid by first giving acid sodium phosphate. 
The formaldehyde seems to be liberated mostly in the bladder, and has 
consequently been most effective in purulent cystitis, ammoniacal urine, and 
pyelitis, and in the passing of the urine its influence is extended to gonor- 
rhoeal infection. It is used also in posterior urethritis and prostatitis when 
occasioned by the latter or other pus infections. For sterilization of the 
urine in typhoid fever it is believed to prevent cystitis, which sometimes 
occurs, through the resorption of typhoid bacilli, and to be a good pre- 
cautionary measure to prevent the infection of others through this secretion 
405 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
finding its way into sources of public water supply. Urotropin is asserted 
to be a most effectual drug in phosphaturia; and, while used, it seems less 
valuable in some forms of gravel, calculi and gouty concretions, notwith- 
standing the fact that formaldehyde forms soluble compounds with uric 
acid. 
Outside of its urinary effects, and in the hope that formaldehyde dis- 
infection may be possible in other fluids, it has been advised in such disorders 
as are associated anatomically with the secretion of cerebro-spinal fluid, 
nasal mucus, the bile, and pancreatic juice. Here the attempt at prophy- 
laxis as well as treatment has been made. Therefore it has been advised, 
and sometimes seemingly successfully used, in acute coryza, acute anterior 
poliomyelitis, cerebro-spinal meningitis, influenza, and gall bladder in- 
fections. If the therapeutic results are to be expected solely from the 
liberation of the formaldehyde, which is a powerful disinfectant, it is 
obvious that it can only act when the medium is such as to cause the 
freeing of that body. As such is only positively known to occur to any great 
degree, at least, in the urine, it would appear that only such disorders as 
can be attacked through that excretion would be benefited. This also 
accords with the generality of clinical experience, although some are en- 
thusiastic over its reputed activity in meningeal infections. When general 
infections are caused by colon bacilli it is said to be a certain remedy. 
Urotropin in large doses, or long continued, causes, through the 
formaldehyde irritation, discomfort and pain along the urinary tract, 
accompanied by excessively acid urine, headache, ringing in the ears, ab- 
dominal distress and diarrhoea, and a rubeloid eruption. These are the 
signals to discontinue the drug or to use it less frequently, or in smaller 
doses. The ordinary dose for an adult is 10 to 30 grains three times a day 
in a glass of water or carbonated water. Lesser doses should be given to 
children. 
HIPPOCASTANUM. 
The bark and fruit of &sculus Hippocastanum, Linne (Nat. Ord. Sapindacese). 
Asia and Europe; planted in United States. Dose (bark), 1 to 60 grains; (rind of nut) 
1 to 10 grains. 
Common Name: Horse Chestnut. 
Principal Constituents.-ALsculin, the glucoside giving fluorescence to watery and al- 
kaline solutions, argyrcescin, and a sternutatory, saponin (aphrodcescin). 
Preparation.-Specific Medicine Horse Chestnut. Dose, 1/10 to 10 drops. 
Specific Indications.-Vascular engorgement, with dull, aching pain 
and fullness, throbbing of the vessels, and general malaise; visceral neu- 
ralgia; disturbances reflex from vascular congestion of the rectum. 
Action and Therapy.-The action and therapeutic uses of hippo- 
castanum are closely similar to those of ^sculus, which see. By some it is 
believed to have a somewhat stronger action upon the venous circulation. 
It is often a remedy of value in neuralgia of the abdominal and pelvic 
viscera, when there is plethora. It is a remedy for congestion and en- 
gorgement, and not for active conditions. Uneasy and throbbing sensa- 
tions, with dull, aching pain in any part of the body, but especially in the 
hepatic region, is an indication for it. It may be used for non-bleeding 
piles when full, purple and painful, with a feeling as if a foreign body is in 
406 INDIVIDUAL DRUGS. 
the rectum; there may also be itching and heat, or simply a sense of un- 
easiness or discomfort. When proctitis and neuralgic pain come from this 
engorged hemorrhoidal state it is effective, as it is also in reflex disorders 
depending upon the rectal involvement-such as headache, spasmodic 
asthma, dyspnoea, dizziness, and disturbed digestion. 
HOMATROPINE HYDROBRO MIDUM. 
Homatropine Hydrobromide, Homatropine Bromide, Homatropine Hydrobromate. 
(Formula: CisHaiNOj. HBr.) 
Description.-A white crystalline powder, or small prismatic crystals, odorless, and 
soluble in water and alcohol. Great caution should be used in tasting it, and then only in 
very dilute solutions. Dose, 1/120 grain. 
Action and Therapy.-This salt acts much like atropine, causing a 
quite full dilatation of the pupil, but having less of a paralyzing influence 
upon accommodation. As compared with atropine the mydriasis is transient, 
lasting usually not more than a day, while that from the former persists 
for several days. It is therefore preferred for diagnostic purposes and in 
refraction work, while atropine is more valuable where prolonged my- 
driasis is desired, as in iritis. It is especially valued in eye work in middle- 
aged individuals. Like atropine it is contraindicated in glaucoma or in 
tendency to increased ocular tension. A one-per-cent solution is usually 
preferred for ophthalmic purposes. 
HORDEUM. 
The decorticated seeds of Hordeum distichon, Linne (Nat. Ord. Graminacae). Native 
of central Asia; cultivated in all tropical and temperate climes. 
Common Name: Barley. 
Principal Constituents.-Maltose, dextrin, fatty matter, starch and proteids. It con- 
tains no gliadin, as does wheat, hence no gluten can be obtained from it. After germination 
it yields diastase (maltine), a starch-digesting body. 
Preparation.-DecoctumHordei, Decoction of Barley (Barley Water). Dose, ad libitum. 
Action and Therapy.-Outside of its food value in broths, barley is 
useful as a demulcent and drink for fever patients and those suffering from 
diarrhoeal complaints. Barley flour, made into a thin pap, is useful in 
infant feeding, and a decoction of barley provides a soothing injection for 
rectal inflammations and a medium for the conveyance of medicines into 
the bowels in dysentery. It is also a good gastric lenitive after acute 
poisoning by irritants. 
HUMULUS. 
The strobiles of Humulus Lupulus, Linne (Nat. Ord. Urticaceae). Europe and Asia; 
common in cultivation. 
Common Names: Hops, Hop. 
Principal Constituents.-Lupulin (see Lupulinum), hop-bitter acid, humuli-tannic 
acid, resins, volatile oil and asparagine, trimethylamine, and choline. 
Preparation.-Specific Medicine Humulus. Dose, 1 to 60 drops. 
Specific Indications.-(See Lupulinum.') 
Action and Therapy.-External. A "hop-pillow" is a favorite device 
for procuring sleep. The odor of the hop has a decidedly sedative influence 
upon some individuals, relieving headache and producing sleep; in others 
it produces intense headache, with nausea and vomiting. Probably the 
407 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
psychic effect has much to do with its value in insomnia. A hot "hop bag" 
applied to the face is a favorite domestic cure for neuralgic face ache, and 
a "hop poultice" has anodyne properties. 
Internal. This is a remedy to relieve nervous excitability in fevers 
and to induce sleep. It also checks fermentation of the stomach contents 
and thus proves useful in fermentative dyspepsia with acid eructations. 
For other uses see Lupulinum, which has superseded hops largely as an 
internal medicine. 
HYDRANGEA. 
The root of Hydrangea arborescens, Linne (Nat. Ord. Saxifragaceae). A handsome 
shrub along streams and in damp, rocky situations in the southern and middle-west states 
of this country. Dose, 5 to 60 grains. 
Common Names: Wild Hydrangea, Seven Barks. 
Principal Constituents.-The glucoside hydrangin (CS4H260n), saponin, resins, and 
fixed and volatile oils. 
Preparation.-Specific Medicine Hydrangea. Dose, 5 to 60 drops. 
Specific Indications.-Vesical and urethral irritation, with gravel; 
difficult urination; deep-seated renal pain; bloody urine; irritation of the 
bronchial membranes. 
Action and Therapy.-Hydrangea is diuretic and sedative to cystic 
and urethral irritation, with passage of gravelly urine. It does not dissolve 
gravel, but is believed to be of value in preventing their formation, especially 
alkaline and phosphatic concretions. It should be administered in hot water. 
Hydrangea may be used in any renal disorder with dysuria, blood in the 
urine, or deep-seated pain in the region of the kidneys. It is not con- 
traindicated by inflammation and may be employed with safety in acute 
nephritis. It is especially serviceable in alkaline urine and in bladder 
irritation of the aged with tendency to catarrh. Unquestionably hydrangea 
has a kindly action upon the mucosa of the urinary organs and it has 
alterative properties making it useful in strumous diseases. 
HYDRARGYRUM. 
Mercury, Quicksilver (Symbol, Hg.). 
Description.-A silver-white liquid element, odorless and tasteless, very heavy, and 
when divided cohering in globules. 
Preparations.-1. Hydrargyri Chloridum Corrosivum, Corrosive Mercuric Chloride 
(Corrosive Sublimate, Bichloride of Mercury, Mercuric Chloride). HgCU. Heavy crystals 
or masses, or a white powder, permanent, odorless, and of a strongly metallic taste. (Should 
not be tasted, as it is intensely poisonous.) Soluble in alcohol, glycerin, and less so in water 
and ether. Dose, 1/100 to 1/20 grain. 
2. Hydrargyri Chloridum Mite, Mild Mercurous Chloride (Calomel, Mercurous 
Chloride). HgCl. A permanent odorless and tasteless, impalpable powder. Insoluble in 
water, alcohol, or ether. Dose, 1 to 5 grains (laxative); 1/4 grain (alterative); of 3 x 
trituration, 2 to 3 grains. 
3. Hydrargyrum Ammoniatum, Ammoniated Mercury (White Precipitate). Odorless 
and permanent, white, easily powdered pieces, or a white powder; taste earthy, followed by 
styptic metallic sensation. It is not dissolved by water or alcohol. Used locally chiefly in 
Unguentum Hydrargyri Ammoniati. 
4. Hydrargyri Protonitras, Protonitrate of Mercury (Mercurous Nitrate). Easily 
decomposable. A constituent of Brown Citrine Ointment. 
5. Hydrargyri lodidum Flavum, Yellow Mercurous Iodide (Yellow Iodide of Mercury, 
Protoiodide of Mercury, Mercurous Iodide). An odorless and tasteless, non-crystalline, 
bright-yellow powder. It gradually decomposes in the presence of light. Insoluble in 
alcohol or ether, and nearly insoluble in water. Dose, 1/30 to 1/4 grain. 
408 INDIVIDUAL DRUGS. 
6. Hydrargyri lodidum Rubrum, Red Mercuric Iodide (Biniodide of Mercury, Red 
Iodide of Mercury, Mercuric Iodide). A permanent, odorless and almost tasteless, scarlet- 
red, non-crystalline powder; nearly insoluble in water, sparingly soluble in alcohol or ether, 
and very much less soluble in chloroform. Dose, 1/200 to 1/10 grain (see below). 
7. Hydrargyri Oxidum Flavum, Yellow Mercuric Oxide (Yellow Oxide of Mercury). 
A heavy, impalpable, pale orange-yellow, non-crystalline powder; without odor; taste, 
metallic; permanent in air, but when exposed to light becomes darker in color. Not 
soluble in alcohol and almost insoluble in water. Used locally chiefly in Unguentum 
Hydrargyri Oxidi Flavi. 
8. Hydrargyri Salicylas, Mercuric Salicylate (Mercuric Subsalicylate). Dose, 1/15 
to 1/8 grain. 
Specific Indications and Uses.-I. Corrosive Stiblimate. Tongue small, 
contracted, elongated, and pointed, and of normal color, or of increased 
redness, and prominent papillae; urine must be normal in specific gravity 
and deposit no sediment; circulation good; lips of good color, and skin 
elastic (Scudder). Impaired mucous membrane of colon and rectum in 
chronic dysentery and cholera infantum, with ulceration, pain, tenesmus, 
and semipurulent discharges (Webster). 
II. Calomel. Tired, apathetic, or lethargic condition, with marked 
drowsiness in daytime, and sleeplessness at night. Locally, to sluggish 
corneal ulcers and pale chancroids covered with a pultaceous secretion. 
Action.-In the metallic state mercury is inert as a medicine except 
when in a state of minute division; but its oxides and other compounds 
possess exceedingly active properties. Metallic mercury, undivided, may 
be taken in considerable amount, acting by its weight merely as a purgative. 
If, however, it be retained in the intestinal tract so as to form soluble salts, 
or if in prolonged contact with the skin, it will produce the constitutional 
effects. Thus the blue ointment and mercuiial plaster have caused alarm- 
ing symptoms. The vapor of metallic mercury is exceedingly poisonous. 
Murrell records an account of the wrecking, near Cadiz, of a vessel, and the 
recovery of several tons of quicksilver by the crew of an English man-of-war, 
whereby 200 of the crew were sickened, with two fatalities, besides the 
destruction of animals, fowls, and roaches, all in consequence of the rotting 
of the sacks containing the metal. From the vapors from a fire in the 
quicksilver mines at Idria, over 900 individuals residing in the vicinity 
were attacked with trembles. 
Almost all the mercurial preparations act in the same way, possessing 
sialagogue, deobstruent, alterative, etc., properties, the character and 
degree of which are diminished or augmented by the medicines used in 
combination with them. These effects, however, are rarely increased 
physiological effects, but pathological in character. Bartholow, in con- 
sidering the action of the mercurials upon the glandular system, very 
properly observes that "these actions of mercury should not be regarded 
as a physiological stimulation of the intestinal glands, in the sense that the 
foods are stimulant to these organs. The action is pathological, and the 
products of the action are pathological" {Materia Medica, page 248). The 
mercurials, when long continued, and, in many instances but few doses, 
with some very susceptible constitutions, induce a succession of very serious 
symptoms ushered in by tenderness when the teeth are compressed against 
each other, spongy and readily bleeding gums, swollen tongue, intolerably 
fetid breath and profuse ptyalism or salivation. This is the signal that 
no more of the drug should be used. Continued use is followed by ema- 
409 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ciation, general debility, oedema, tremor of the limbs, diseased liver, pain in 
the bones, caries, palsy, ulcerations of the pharynx and other parts, gan- 
grenous ulceration of the mouth and face, and a sort of scorbutic marasmus. 
It also occasionally produces a febrile condition, with profound prostration 
(mercurial erethism), profuse prespiration, several forms of skin disease (as 
eczema, herpes), inflammation or congestion of the eye, fauces, or peritoneum, 
nodes, enlargement of the inguinal, axillary, mesenteric, parotid, pancreatic, 
etc., glands, together with various painful and nervous attacks. The jaws 
become the seat of necrosis, as a result of infection through primary periosteal 
ulceration, the teeth drop out, and as a general dissolution of the tissues 
takes place the victim dies. 
Before the vigorous fight of the Eclectics against the mercurials as 
cholagogues, it was the prevailing opinion that these salts, particularly 
calomel, increased the natural secretions of the liver, thereby causing an 
augmented flow of bile. Reliable experimentation by pharmacologists 
has proved the claims of our practitioners to be largely true. While it is still 
admitted by some that corrosive sublimate is slightly stimulant to the liver, 
the majority deny even to this salt cholagogue powers. That calomel has 
no such action is now universally acknowledged. "There is, in fact," says 
Cushny, "no sufficient experimental or clinical evidence that the liver is in 
any way affected directly by mercury. The 'biliousness,' which is so often 
relieved by calomel or the blue pill, is due, not to the liver, but to disorder 
of the alimentary tract." If an increased flow of bile into the intestinal 
canal does sometimes take place under the action of the mercurial, it is 
caused, as with croton oil, by the reflex contraction of the gall-bladder and 
duct, due to the duodenal irritation produced. This was the view held by 
Bartholow, among others. The long-continued use of mercury has caused 
an altered biliary secretion, and has even checked hepatic activity. Practical 
studies upon women with biliary fistula, notably those of Pfaff, Balch and 
Joslyn, confirm the suspected fact that calomel and corrosive sublimate both 
invariably rather diminish than increase the flow of bile. 
Briefly, the distinctive effects, aside from the general mercurial im- 
pression, of mercury and its chief salts are as follows: Metallic mercury, 
undivided, is a mechanical purgative; in a divided state, as in gray powder, 
blue mass, and blue ointment, it becomes an active agent capable of all the 
untoward effects of this class of agents. Blue pill readily causes salivation, 
calomel less frequently. The general action of calomel closely resembles 
that of mercury in the divided state. Calomel probably passes for the 
most part into the intestines, where the alkaline secretions convert it into 
oxide of mercury. Mercuric chloride, mercuric iodide, mercuric cyanide, 
and mercuric nitrate are exceedingly energetic and toxic agents. Some of 
the mercurials, particularly the corrosive chloride and the biniodide, are 
energetic germicides. The anthrax spores are destroyed by the first in a 
solution of 1 to 1000, in the blood 1 to 8000. It also quickly destroys in- 
fusoria (1 to 50000). Mercury in dilution "(1 to 200000) destroys spir- 
ochetes in the test-tube" (Cushny). 
While largely employed as a germicide, "there is no question that 
the germicidal power of corrosive sublimate has been much overestimated" 
(Cushny). This agrees with the views of Eclectic physicians. 
410 INDIVIDUAL DRUGS. 
In 1846, in the Western Medical Reformer, Dr. John King published a 
paper on the "Modus Operandi of Mercury" in an attempt to give to Eclectics 
a scientific basis for explaining the action and effects of mercurials. King's 
paper was published at a time when nearly all the authorities of the old 
school disclaimed any knowledge of the manner in which mercury operated 
physiologically or chemically. The chemical theory he advanced, that it is 
converted into an oxide, though vaguely hinted at by others, became the 
prevailing theory for many years. Much dissension is shown at the present 
day over the question as to the form in which mercury enters the circulation, 
some contending as an oxyalbuminate, or with Miahl of France, that all 
mercury compounds are transformed into the bichloride in the stomach and 
bowels, and uniting in the blood with sodium chloride, become converted 
into a double chloride of sodium and mercury; or with Henoch of Germany, 
that an albuminate is produced, or as claimed by Voit, also of Germany, a 
chloroalbuminate. It is generally accepted that it is eliminated as an 
albuminate. "All these theories," says Hare, "as to its absorption are 
open to grave criticism." Therefore it would appear that with all the en- 
lightenment possible, from the advantages of chemical and physiologic 
equipment of to-day, we are little nearer an explanation of the modus 
operandi of the mercurials than was the scientific physician nearly three 
quarters of a century ago. King's theory as to its absorption as an oxide 
lacked but a step to that now accepted by many-that it enters the cir- 
culation as an oxyalbuminate. It must be remembered that the chemistry 
of the albumens is of much more recent elaboration. The value of his paper 
consists in exhibiting the fact that the early Eclectics were not wholly un- 
cultivated nor ignoramuses, as some would have us believe, but that such 
leaders as King were thoroughly grounded in the chemical knowledge of the 
day and that the mass of Eclectic physicians welcomed scientific explana- 
tions. 
As stated above the internal modus operandi of the mercurials is still 
not well understood. In the stomach they probably form an albuminate, 
which, though insoluble in water, is readily dissolved by chloride of sodium 
and by an excess of albumen. Minute doses are said to increase the red 
blood discs; large doses destroy the blood discs, reduce fibrin, and poison 
the heart. Mercurials have a special affinity for the glandular structures. 
This is well marked in their action upon the salivary glands. The former 
practice of "touching the gums," or producing profuse salivation (mercurial 
ptyalism), has been, largely through the stand taken by the Eclectic school, 
abandoned. This disagreeable condition, which formerly produced untold 
misery, exhibited itself in its worst form by an enormous increase of thick, 
ropy albuminous saliva, subsequently becoming thin and watery, and 
amounting to several pints in a day. Then followed extensive ulceration, 
or gangrenous stomatitis of the cheeks and adjacent structures, with tender 
and swollen glands, sloughing of the cheek and gum, allowing the teeth to 
fall out and the jaw to become carious. Practical medicine has no greater 
stain upon her escutcheon than the memory of the horrors of acute mer- 
curialism, as formerly practiced. So profound was the condition of mer- 
curial cachexia, hydrargyrism, or mercurial erethism from continued doses 
of these drugs, that profound marasmus, anemia, and excessive purging 
411 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
soon led the victim to an untimely grave. This condition was frequently 
accompanied by the mercurial tremor, neuralgia, paralysis, or epileptiform 
convulsions. Scrofulous individuals and those laboring under renal affec- 
tions are said to be more susceptible to the untoward action of the mercurials, 
while children are less readily salivated. 
Artisans who are employed as gilders, and who work in looking-glass, 
thermometer, and barometer factories, and miners of quicksilver, are 
afflicted with a somewhat different form of mercurialism, marked features 
of which are prostration and anemia, mercurial fever, pustular or vesicular 
eruptions, jerky, stammering speech, convulsions, and particularly a 
peculiar form of muscular weakness denominated "the trembles." These 
tremors (or "shaking palsy") manifest themselves first in the upper limbs, 
then in the legs, and finally in the trunk. They are readily brought on, 
gradually increase in extent and severity, and are quite persistent and 
uncontrollable. The prehensile movements lack precision, and the lower 
extremities, in walking, tremble as if strung on wires. (For a graphic 
account of this condition, see Murrell's Manual of Materia Medica and 
Therapeutics, 1896, p. 204.) 
Toxicology.-Only the soluble salts of mercury cause acute poisoning. 
The prolonged use of these even in non-poisoning doses gradually induce 
chronic poisoning, as do the internal and local use of the less soluble prepara- 
tions. This chronic form is known as "mercurialism". 
Taken internally, corrosive sublimate is an active, corrosive poison, 
acting very quickly, and producing in overdoses a coppery, metallic taste, 
and violent burning pain in the mouth, throat, oesophagus, and stomach; 
great difficulty of swallowing, sense of suffocation, nausea, violent vomiting, 
increased by everything taken into the stomach; the pain soon becomes 
diffused over the whole abdomen, which becomes very sensitive to pressure; 
violent purging, often of blood; great anxiety; flushed (occasionally pale) 
and even swollen countenance; restlessness; pulse quick, small and con- 
tracted; cold sweats; burning thirst; short and laborious breathing; 
urine frequently suppressed; and finally stupor, coma, convulsive move- 
ments, partial paralysis, or paraplegia, and death. Fainting often precedes 
death. Sometimes before death ensues, if time enough has elapsed, there 
may be profuse salivation, ulceration of the mouth, fetor of the breath, and 
other secondary mercurial symptoms. The mouth and oesophagus appear 
whitish, as if having been painted with silver nitrate solution (Taylor). 
On inspection after death, the membranes of the mouth, throat, and 
oesophagus are softened and whitish or bluish-gray, and show marked in- 
flammation, while the stomach and bowels will be found excessively in- 
flamed, sometimes with patches of ulceration or gangrene. (Arsenic 
lesions are confined chiefly to the stomach and bowels.) Corrosive sublimate 
poisoning differs from arsenical poisoning in the metallic taste produced, in 
the violent symptoms almost immediately occurring, and in the evacuations 
being more often mixed with blood. If death is produced quickly, the 
symptoms closely resemble those of cholera; if several days elapse before 
death, the symptoms are more like dysentery, with violent tenesmus and 
shreddy, blood-mixed mucous discharges (Taylor, Medical Jurisprudence'). 
412 INDIVIDUAL DRUGS. 
In poisoning by corrosive sublimate, death may not take place for 
several days. Such cases invariably show a total inactivity of the renal 
organs due to acute nephritis, in which, while the whole kidney is con- 
gested and glomeruli are inflamed, the most characteristic feature is necrosis 
of the tubules. Death usually occurs in from 1 to 5 days, though it may 
occur earlier or later, having been known to take place in less than 1/2 hour. 
The smallest dose known to have killed (a child) is 3 grains; it is thought 
that from 3 to 5 grains or less will kill an adult (Taylor). Death may occur 
from the external application of the drug to tumors, ulcers, etc.; and serious 
symptoms have followed from the use of the solutions even when the skin 
is unbroken. 
In the bodies of persons, who, during life had employed mercury or 
some of its preparations, either internally or externally, metallic mercury 
has been found, as in the bones, brain, pleura, liver, cellular tissue, lungs, 
kidneys, etc. It has also been detected in the secretions of patients who 
were under its influence, as in the perspiration, urine, saliva, bile, gastro- 
intestinal secretions, and in the fluids of ulcers. 
The salivation and gangrenous inflammation of the mouth occasioned 
by mercurials are best overcome by astringent infusions, as tincture of 
myrrh, both taken internally and used as a gargle, and the administration 
of chlorate of potassium. Its constitutional effects are best remedied by 
vegetable alteratives with iodide of potassium, tonics, attention to the 
excretions, exercise, etc.; though it is rarely the case that a perfect recovery 
of health ensues where the system has suffered considerably from the effects 
of the mercury. 
In the treatment of cases of poisoning by corrosive sublimate, the anti- 
dotes must be given promptly, without the least delay. Give the white and 
yolks of eggs, well beaten with water; milk, or a mixture of wheat flour, 
oat-meal, or barley-meal, and water; these form a compound whose chem- 
ical action on the tissues is slight when compared with that of the poison. 
One egg is said to be required for every 4 grains of corrosive sublimate 
swallowed. The above, as well as mucilaginous drinks, should be given 
freely until relief is afforded; and as soon as possible the stomach should be 
evacuated by the stomach-pump, and subsequently be well washed out. 
Chemical antidotes, or those which decompose the poison, or form harmless 
compounds with it, should also be used. Recently the sulphide of calcium 
(Wilm's Antidote) has been introduced as an antidote to the slow poisoning 
by mercuric chloride, with a varying degree of success; and a combination 
of sodium phosphite, grs. 6, and sodium acetate (Carter's Antidote), has 
been successfully used. After the poisonous symptoms have been over- 
come, any inflammation which may remain must be treated on general 
principles. 
Eclectics and Mercury.-The object of introducing into this book 
mercury and its salts is to show the small use of them in our practice, and 
the therapeutic values that have been placed upon them by our physicians; 
as well as to give a record of their effects for historic purposes and a knowl- 
edge of their poisonous action and treatment. 
It is the common impression among those not of our faith in medicine 
that the use of mercury in any of its forms is proscribed in the Eclectic 
413 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
school. As a matter of fact, one of the cardinal principles of Eclecticism 
now, as heretofore, is the liberty to use medicines of any kind and from any 
source, provided they do good and specific service in the treatment of the 
sick. Bending to authority has never been a practice with Eclectics, whose 
independence in thought and action has always been conspicuously char- 
acteristic. For this they were ejected from the folds of the dominant 
school, and this it was that gave birth to Eclecticism. Never, we assert, 
did the teachers and writers of our school, who in any sense may be re- 
garded as leaders, proscribe the use of mercury. It was the abuse of it that 
was fought. It is true that there have been some who have felt it their duty 
to make a war of extermination upon the mercurials, but those few were 
inconspicuous as compared with the great mass of practitioners who only 
viewed with alarm the baneful effects of the drug when promiscuously 
and lavishly employed. In this connection let us recall the assertion 
published by us a few years ago, and emphasize it by its reproduction 
here: 
"Mercury and its preparations have been little employed by Eclectic 
physicians, and have even been absolutely proscribed by many members 
of the Eclectic school. While it is true that the use of the drug has been 
discouraged by the teachers and writers of our school, it is also true that 
their ground of opposition is well taken, for these are drugs so pernicious in 
their effects, as ordinarily employed, that their abuse should be strongly 
guarded. They should only be used when the specific indications for their 
employment can be unmistakably pointed out. Therefore it is desirable 
that we reiterate what has been declared again and again by the leaders and 
teachers of the Eclectic school, that it is not the use, but the abuse of mercury 
to which objection is made. The earlier Eclectics, many of whom would 
not use mercury in any form, sought to find substitutes for the mercurials 
(as with podophyllin, etc., for hepatic disorders), for, as stated by King 
in the original preface to the American Dispensatory (page 8), 'there is no 
single remedy known to man which has produced a greater amount of 
mischief by its indiscriminate use than mercury; nor is there any other 
drug which has done one-hundredth part as much to create a prejudice 
against scientific medicine, to destroy the confidence of the community in 
its practitioners, and to repel them from the physicians to the nostrum 
dealer.' That the Eclectic fathers were justified in their objections to the 
viciously injudicious employment of mercurials prevalent in regular med- 
icine in the early days of our school, is now evident from the position taken 
by many of the most conspicuous old-school authors of to-day, and by the 
very conservative use of the drug at present by old-school physicians, as 
well as by their kindlier feelings toward their professional rivals, whose 
opinions relating to some practices and problems in therapy do not agree 
with their own." 
"Corrosive sublimate is little used by Eclectic practitioners, either as an 
internal or external remedy. Nor is its use as extensive among practitioners 
of the dominant school as it was some years back. In fact, in reviewing the 
old-school works upon practice and materia medica of the past and present, 
one is struck with the comparative conservatism in the use of these prepara- 
tions as compared with former times." 
414 INDIVIDUAL DRUGS. 
In the dominant school mercury has four chief uses-(1) as an anti- 
syphilitic; (2) as a purge; (3) as an antiseptic; and (4) as an antiphlogistic. 
All Eclectics do not deny its antisyphilitic action, but generally deplore its 
destructive action upon the body. They sometimes use it as a germicide, 
but never as a purge nor as an antiphlogistic. 
Therapy.-External. Externally corrosive sublimate is antiseptic and 
germicide. It destroys pediculi, and in the form of solution or ointment is 
sometimes employed in parasitic skin affections, in acne, pityriasis, chloasma, 
freckles, and pruritus vulvae. In the treatment of wounds, and in general 
surgical, gynaecological, and obstetrical manipulations, it is almost never 
used. The solutions employed for general antiseptic purposes should 
never be stronger than 1 in 2000. Solutions of 1 to 10000 in vaginal in- 
jections during operations have produced violent toxic effects. Death has 
resulted from solutions of 1 to 1500 employed in surgical operations. Many 
fatalities have occurred from its employment even in dilutions of 1 to 6000, 
when used in the peritoneal cavity and in other operations on the viscera. 
Used in this way it frequently produces albuminuria. For these reasons, 
corrosive sublimate solutions are fast being discarded by the few of our 
school who adopted them a few years ago and they are now very rarely 
used by Eclectic surgeons. 
Externally, solutions of corrosive sublimate have been advised as a 
collyrium (1 to 1000 to 1 to 10000), in various affections of the eye, as 
ophthalmia neonatorum, acute catarrhal conjunctivitis, phlychtenular 
conjunctivitis, keratitis, xerosis, trachoma, lachrymal blenorrhcea, and 
hypopyon keratitis (Foltz). Corneal opacities have resulted from its local 
use. Washes (1 to 1000 to 1 to 4000) have been recommended in sup- 
purative otitis media, furuncles, diffuse otitis media, and in operations for 
mastoid disease. A wash composed of solutions of borax and corrosive 
sublimate is asserted signally useful in the treatment of cracks, fissures, and 
other sores affecting the face, corners of the mouth, behind the ears, etc., 
in children. 
Yellow Wash {Lotio Flava) is sometimes used as an application to 
venereal, scrofulous, and phagedenic ulcers. When employed, it should be 
well shaken and used in the turbid state. 
Internal. Internally, corrosive sublimate has been employed to some 
extent by Eclectic physicians. Scudder, who opposed its use chiefly 
because of the lack of discrimination on the part of physicians, believed 
that if rightly studied, mercury might fill a valuable place in medicine, but 
only in chronic diseases {Specific Medication, page 179). He stated that if he 
were administering it, he would be guided by the small, contracted, elon- 
gated, and pointed tongue, of natural or more than usual degree of redness, 
with prominent papillae. The urine should be of normal specific gravity, 
depositing no sediment, the lips of good color, the circulation good, and the 
skin elastic. He declared the mercurials were contraindicated by a pale 
mouth and tongue with absence of papillae, pale and full fauces, tonsils, and 
palate, shiny red spots over the tongue, pallid, expressionless face, full lips, 
and increased secretion of saliva. 
Webster advocates the use of corrosive sublimate 3 x (adults) to 6 x 
trituration (children), in 2-grain doses every 2 or 3 hours, for its effects upon 
415 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
the mucous membrane of the colon, the vitality of which has been impaired 
by long-continued inflammation in chronic cholera infantum and dysentery. 
Ulcers of the colon and rectum form, the evacuations are semipurulent, and 
convalescence lingering. He claims that it lessens the pain and tenesmus, 
checks the evacuations, and restores normal energy to the parts. The 
ordinary doses of mercuric chloride range from 1/16 to 1/8 grain. The dose 
preferred by Webster is 2 grains of the 3 x trituration for adults, and of the 
6 x trituration for children. Foltz employed 1/100 to 1/60 grain doses in 
syphilitic eye disorders. In ear disorders he advised it internally in 1/200 
to 1/100 grain doses in syphilitic suppurative otitis media, and in internal 
ear affections. 
Therapy of Other Salts of Mercury.-Calomel. External. Calomel forms an excellent 
topical application in corneal ulcer of a sluggish character. It should be freely dusted upon 
the lesions. Phlyctenular conjunctivitis may be similarly treated. Foltz warns us that it 
should not be used when corneal ulcers are forming, or when they are enlarging. He uses 
calomel to provoke irritative action in superficial corneal opacities, thereby inducing repara- 
tive action. Calomel is a good application in syphilitic chancre and chancroid, particularly 
the latter. Scudder employed it in such lesions when the sores were pale and coated with a 
pultaceous secretion. Dose of calomel for specific effects, 2 or 3 grains of the 3 x trituration, 
3 times a day. The use of calomel internally or locally is contraindicated while taking 
iodide of potassium, lest it be converted into iodide and iodate of mercury. 
Internal. Calomel is seldom used in the Eclectic practice as a purgative, though some 
employ it in 1/10 grain doses with 1/2 grain of sodium bicarbonate followed by a laxative, 
as an intestinal antiseptic in the bowel disorders of children. In minute doses it has been 
recommended by Webster {Dynamical Therapeutics'), in lethargic states characterized chiefly 
by a long-continued tired feeling, associated with marked diurnal drowsiness and noc- 
turnal wakefulness. The patient, though apparently in good health, awakens tired in the 
morning, is averse to exertion of any kind, and retires at night still tired, and the drowsiness 
is of such a pronounced character as to require much effort to remain awake. Such a con- 
dition, he states, often follows malarial infection, though he does not consider that it 
depends upon such a cause. The trouble must be idiopathic and not dependent upon 
"sympathetic local trouble". The dose is 2 or 3 grains of the 3 x trituration, 3 times a day. 
Ammoniated Mercury (Hydrargyrum Ammoniatum) or White Precipitate is some- 
times used in the form of a mild ointment for parasitic skin diseases, especially tinea; 
also occasionally in dry eczema and psoriasis of a chronic type. It is especially serviceable 
in impetigo contagiosa, and is very rarely used in ophthalmia tarsi. It is now rarely used 
in Eclectic practice, but is a constituent of the once popular old Eclectic Ophthalmic Balsam. 
Nitrate of Mercury (Mercurous Nitrate). In Eclectic practice Brown Citrine Oint- 
ment was advised by Scudder and others in chronic eczemas, sycosis, barber's itch, and in 
some cases of pruritus {Specific Medication). 
Biniodide of Mercury (Red Mercuric Iodide, Hydrargyri lodidum Rubrum). Mercuric 
iodide is an active poison, nearly as powerful as corrosive sublimate. This is the preparation 
usually selected by Eclectic physicians when a mercurial is to be employed in constitutional 
syphilis, and in cutaneous, ocular, and aural affections, depending on a syphilitic taint. 
Its use was particularly advocated by Howe. The minute doses are usually preferred. 
The indications are those given under mercuric chloride (which see). In diseases of the 
eye, of syphilitic origin, as in syphilitic iritis, it has given results when iodide of potas- 
sium has failed. Similar results are obtainable in keratitis, choroiditis, choroido-retinitis, 
etc. Locally, it has been employed chiefly as Panas' solution, as in incipient trachoma, and 
in phlyctenular and catarrhal conjunctivitis. This solution (mercuric iodide 1 part, ab- 
solute alcohol 400 parts, and distilled water 20000 parts) is sometimes employed as an 
irrigating fluid for use previous to operations upon the eye, as in iridectomy, removal of 
cataract, etc. Diseases of the internal and middle ear, when of specific origin, often yield 
to the judicious use of this drug. 
A solution of it, 6 grains to a fluidounce of distilled water, has been used as a lotion to 
scrofulous and syphilitic ulcers, etc.; a weak ointment in obstinate ophthalmia tarsi, with 
thickening of the meibomian glands. Mercuric iodide may be administered in pill, tritura- 
tion, or in solution in alcohol, or ether, to be administered in water. The dose ranges from 
1/1000 grain to 1/4 grain, the doses of 1/200 to 1/60 grain usually being preferred by our 
physicians. 
Protiodide of Mercury. Sometimes used by those who favor mercurials in syphilis. 
Webster advises the 3 x trituration (dose, 2 or 3 grains) for its specific action upon the larynx 
to relieve hoarseness and croup. {Dynamical Therapeutics, page 407). 
416 GOLDEN SEAL 
(Hydrastis canadensis) 
Photo from History of the Pharmacopeial Drugs, by John Uri Lloyd 
By Courtesy of H. K. Mulford Co. 
Golden Seal ranks with Macrotys in holding a high place of honor in Eclectic therapeutics. 
First used by the American Indian as a body-stain (yellow puccoon), then by the people at 
large; it finally came to be one of the most important of plant drugs of Eclectic development. 
Near extermination in the wild state by drug gatherers and the encroachment of civilization 
upon its native haunts have necessitated attempts at cultiv ation of this important and costly 
drug. INDIVIDUAL DRUGS. 
Yellow Oxide of Mercury is not employed as an internal medicine, but is valued by us 
as a local application especially in ocular and aural therapeutics. For ciliary blepharitis the 
ointment is probably the best local application, especially in chronic cases. The dried 
scales should be softened and removed by means of an alkaline wash, as of potassium 
bicarbonate, and the lids dried. Then the ointment should be thoroughly applied to the 
margins of the lids. If too strong, marked irritation and conjunctival hypersemia maybe 
produced. Foltz states that in phlyctenular keratitis in children it is indicated in nearly all 
cases (Webster's Dynamical Therapeutics'). The ointment is also advised in corneal maculae, 
indolent corneal ulcers, conjunctival granulations, xerosis, episcleritis, and pannus. Foltz 
declares it of negative value in suppurative otitis media, but has obtained good results from 
its use to heal the tympanic lesion after the cessation of the discharge. Yellow Oxide of 
Mercury, gr. xxx, Petrolatum 5j. Mix. An ointment containing 2 per cent each of the 
yellow oxide and morphine sulphate in connection with dry heat is reputed efficient in the 
early stage of furuncular inflammation of the external auditory canal. 
HYDRASTIS. 
The dried rhizome and roots of Hydrastis canadensis, Linne (Nat. Ord. Ranunculaceae). 
United States and Canada in rich, shady woods. (Chiefly Ohio, Indiana, Kentucky, and 
West Virginia.) 
Common Names: Golden Seal, Yellow Root, Yellow Puccoon, Orange Root. 
Principal Constituents.-Three alkaloids: berberine (yellow); and hydrastine and 
canadine, both white. 
Preparations and Derivatives.-1. Specific Medicine Hydrastis. Dose, 1 to 30 drops. 
2. Colorless Hydrastis (Lloyd's). Dose, 1 to 15 drops. Largely employed locally. 
3. Hydrastine Muriate (Hydrochlorate of Berberine). A yellow powder. Dose, 1 to 5 
grains. 
4. Hydrastin (Resinoid), not now used. 
5. Hydrastin (Combined Hydrastin). Only substance now sold as hydrastin. 
6. Hydrastina, Hydrastine. (Alkaloid, both natural and synthetic.) Permanent 
white or creamy crystals or powder, almost insoluble in water; soluble in chloroform; 
less so in alcohol. Dose, 1/12 to 1/3 gr.; average dose, 1/6 grain. 
7. Hydrastina. Hydrochloridum, Hydrastine Hydrochloride (Hydrastine Chloride). 
White or cream-colored powder, odorless, hygroscopic, very soluble in alcohol and water. 
Dose, 1/12 to 1/3 grain; average dose, 1/6 grain. 
8. Hydrastinince Hydrochloridum, Hydrastinine Hydrochloride (Hydrastinine Chlo- 
ride). Odorless, light-yellow crystals or powder, very soluble in water and alcohol. Dose, 
1/4 to 1 grain; average dose, 1/2 grain. 
9. Liquid Hydrastis (non-alcoholic). Dose, 1 to 20 drops. 
Specific Indications.-Catarrhal states of the mucous membranes un- 
accompanied by acute inflammation (except in acute purulent otitis media); 
relaxed tissues, with profuse secretion of thick and tenacious yellowish or 
greenish-yellow muco-pus; relaxation and ulceration of tissues of mouth 
and throat; imperfect recovery from diarrhoea or dysentery, with mucous 
discharges and relaxation; aphthae, ulceration, or erosion of mucous 
surfaces; atonic gastric irritability; irritation of mucous surfaces, with 
feeble circulation; muscular soreness aggravated by pressure; passive 
hemorrhages from the pelvic organs; ice water dyspepsia; skin diseases 
depending upon gastric wrongs which also indicate hydrastis. 
Action.-Extensive experiments by pharmacologists show that Hy- 
drastis alkaloids, particularly hydrastine, are actively poisonous to certain 
animals, producing spinal convulsions followed by paralysis, lowered blood 
pressure succeeded by a marked rise, and death. Upon man, however, no 
so-called physiological effects of any moment have been observed. In the 
ordinary medicinal doses it certainly is not a poison to human beings. 
No cerebral effects have been observed in either animals or man; and 
judging from clinical effects it probably increases contraction of special non- 
striated muscles, as it controls uterine hemorrhage in women and has an 
417 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ecbolic effect upon the lower mammals. Schatz explains this by asserting 
its power upon the unstriped fibers of the arteries and denying its effects 
upon other tubular muscular structures. It has also been assumed, but not 
experimentally proved, that it slightly increases hepatic secretion in man. 
Therapy.-External. Hydrastis is one of our most efficient topical 
medicines when applied in disorders of the mucous membranes; and is 
occasionally of service upon the skin. It is of most importance perhaps in 
ophthalmic practice, being a thoroughly effective subastringent and sooth- 
ing agent in acute and subacute catarrhal and follicular conjunctivitis. 
For this purpose, and indeed for most topical effects, the colorless prepara- 
tions are preferred. Lloyd's Colorless Hydrastis in particular is to be 
commended, for it is both non-staining and non-alcoholic and has almost 
completely replaced the formerly used hydrastin and berberine preparations. 
The same medicament may be used in superficial corneal ulcer, ciliary 
blepharitis, and in simple trachoma. While signally useful in these affec- 
tions of the eye appendages, hydrastis is of no value in intraocular disorders. 
Inspissated cerumen may be readily softened by colorless hydrastis, 
thus facilitating its removal by water. It also controls the irritation of the 
aural canal when due to the presence of hardened wax. Eczema of the 
external auditory canal has been cured by it. In both acute and chronic 
otitis media it may be employed hopefully when there is a purulent or muco- 
purulent discharge and granulations do not exist. 
Hydrastis preparations are among the most successful remedies in 
catarrhs of the nose and throat. It should be used both locally and in- 
ternally in catarrhal and follicular pharyngitis, subacute forms of simple 
catarrhal sore throat following tonsillitis, subacute rhinitis, naso-pharyngeal 
and retro-pharyngeal catarrh, and in ulcerated naso-pharyngeal passages. 
It sometimes aids in the cure of syphilitic ulceration of the upper breathing 
tract. For catarrhal hypertrophy and engorgement of the turbinates it is 
often effective. The abundant discharge and thickened Schniederian 
membranes will guide to its selection. Locke advised it for nasal catarrh 
with thick, tenacious mucus and almost constant frontal headache. When 
thick gelatinous masses from the pharyngeal vault constantly drop into 
the throat, causing hacking cough and nausea, hydrastis given internally 
and as an ingredient of a local wash gives very satisfactory results. In all 
catarrhal affections of the upper respiratory tract, hydrastis should be 
administered for a prolonged period to obtain the best results. Hydrastis 
is valued by some as a topical reducer for chronically enlarged tonsils, but 
like most medicines recommended for that purpose it fails far oftener than 
it succeeds. 
Hydrastis is universally admitted to be a most valuable topical agent 
in gonorrhoea. It is best adapted after the first and acute stage has passed, 
though it is not contraindicated at any time during the course of the 
infection. The preparation preferred is the colorless, though other hydrastis 
preparations, particularly berberine and hydrastin salts are useful, but 
objectionable on account of their staining qualities. Zinc sulphate in- 
creases the usefulness of the drug and quicker results can be obtained by 
instituting the treatment with a single irrigation with some mild silver salt, 
in order to destrov the eonococci. Care should be had not to use either 
418 INDIVIDUAL DRUGS. 
the silver or zinc compounds too strong or too freely lest stricture be 
produced. The great advantage of the hydrastis treatment alone is that, 
while perhaps slower, it never produces and probably prevents stricture. 
Hydrastis is especially valuable in the late stage of gonorrhoeal urethritis, 
popularly known as gleet. 
Leucorrhoea, both vaginal and uterine, is well treated with washes 
containing hydrastis, with or without the addition of indicated cleansing 
and astringent agents. It heals cervical erosion, which is frequently the 
source of the abnormal secretion. Jeangon valued it locally for this purpose 
and to remove light papillary vegetations. As there is usually relaxation 
and debility, some form of hydrastis should be given internally at the same 
time. Locke praises hydrastis as a wash for ulceration of the bladder 
due to chronic cystitis. 
Hydrastis preparations are effective in skin disorders depending upon 
gastro-intestinal debility, with imperfect digestion. Here the local use 
should be accompanied by its internal exhibition. Such disorders as 
sluggish cutaneous ulcers, acne, eczema of the scrotum, and eczema of the 
anus and marginal area, and other orifices of the body come under its in- 
fluence when used in this manner. It is commonly employed locally to 
give tone to the rectal tissues, being especially useful in prolapse of the 
rectum and sometimes relieves non-ulcerating hemorrhoids. In fissures of 
the anus, rectal ulcers, and proctitis it is a very painful application, and 
unless very carefully used and in small amounts it may provoke the very 
conditions sought to be relieved by it. Such conditions readily rebel against 
continuous stimulating and tonic treatment when irritability and sensitive- 
ness are pronounced. 
In most conditions, save those of the conjunctiva, hydrastis gives the 
best topical results when also administered internally. 
Internal. Clinically hydrastis is known to stimulate the salivary, 
gastric, and intestinal secretions, and, to a slight extent, that of bile. It cer- 
tainly has a most decided action on mucous surfaces, and is one of the most 
effective of bitter tonics. It sharpens the appetite and promotes digestion. 
Disorders of a subacute character and atonic states with increased flow 
of mucus are the types benefited by hydrastis. It is preeminently a 
mucous membrane remedy, allaying irritation when present, toning relaxa- 
tion and correcting catarrhal tendencies. It should be considered when 
subacute and chronic inflammation with free secretion are present. For 
aphthous stomatitis it is equaled only by coptis and phytolacca; and is 
then to be used in the less active forms bordering on chronicity. For gastric 
irritability it is one of our best remedial resources, but should not be used 
when the stomach is acutely inflamed. The more the tendency toward 
chronic debility with oversecretion the more effective is hydrastis. It first 
relieves the irritation, then restrains the secretions, and finally gives tone to 
the gastric membranes. Without question it is our best single drug for 
chronic gastric catarrh, or so-called chronic gastritis. In that form due to 
alcoholic abuse, in which occurs the morning vomiting of drunkards, with 
disgust for food and craving for stimulants, hydrastis, with or without 
capsicum and nux vomica, gives incomparable results. In this aftermath 
of chronic alcoholism success attends this treatment in just so far as the 
419 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
patient may be prepared to take and assimilate nourishment. Usually the 
hydrastis is more efficient with capsicum, and the latter may be given in 
liberal quantities of beef soup or other easily digested food regularly ad- 
ministered. Bartholow, one of the great therapeutic authorities of his time, 
and one who was largely responsible for the introduction of hydrastis and 
other Eclectic medicines into the materia medica of the regular school, 
went so far as to declare that in sufficient doses of the tincture or fluid- 
extract hydrastis is probably the best substitute for alcoholic beverages 
when it is desired to abandon the use of spirituous stimulants. Small doses 
of specific medicine hydrastis are indicated in that form of dyspepsia 
accompanied by the belching of putrescent gases, and followed by weakness 
or sense of "goneness" at the pit of the stomach. It also relieves an un- 
pleasant distress just below the sternum, amounting almost to an internal 
itching and causing one to constantly shift or contract the muscles of the 
epigastric region. This condition is largely due to gastric irritation with 
distention by gases, and is promptly relieved best by colorless hydrastis, 
although the specific medicine is effective. When irritability is marked in 
stomachal debility small doses of the fluid preparations are to be preferred, 
but when there is but little irritability larger doses may be used, or hy- 
drastin or berberine salts may be given immediately after meals. Specific 
medicine hydrastis, or Lloyd's colorless hydrastis, both in doses of 10 drops 
before meals and at bedtime, are the best agents we have employed in ice- 
water dyspepsia, a peculiarly American complaint due to the immoderate 
use of iced drinks and ices. For gastric ulcer no treatment should be con- 
sidered without a fair and generous trial of hydrastis, geranium, and bismuth 
subnitrate. In the treatment of stomach disorders with hydrastis or its 
derivatives, the fact must be kept prominently in mind that it is only in 
conditions of atony, with gastric irritability or subacute inflammatory 
symptoms, with increased secretion, that the drug is of any benefit. Acutely 
inflamed tissues, so far as the gastro-intestinal tract is concerned, absolutely 
prohibit its employment. 
Hydrastis, though most effective in gastric disorders, is valuable in 
certain affections of the accessory digestive organs. It is of unquestioned 
worth in catarrhal states of the intestines and gall duct, in duodenal 
catarrh aggravated by neighboring biliary concretions, and in chronic 
constipation due to debility and imperfect action of the intestinal glands. 
Its use must be persisted in for a long period. It is a serviceable tonic for 
enfeeblement of the gastro-enteric tract of infants and children, as well as 
adults, and offers support in convalescence from severe and depleting 
intestinal discharges, debilitating stomach and bowel disorders, the pros- 
tration occasioned by fevers and other acute affections, and hemorrhage. 
It is asserted of value in hepatic congestion. It is a question, however, 
whether it has any marked specific action upon the liver proper, and that 
benefit, if any, derived from it in hepatic disorders is largely due to its 
salutary effect upon the duodenum and bile duct and its properties of a 
general tonic. 
Hydrastis controls passive hemorrhage. It is not adapted to copious 
active hemorrhages, as gastric and post-partum hemorrhages, but in those 
forms only of renal, uterine, or pulmonary bleeding in which small quantities 
420 INDIVIDUAL DRUGS. 
of blood are passed at a time and are recurrent in form. It is adapted to 
and is successful in rare cases to restrain bleeding and to reduce the size 
of uterine fibroids, and similarly in uterine subinvolution. In passive 
hemorrhages occurring in virgins and during the climacteric it is dis- 
tinctly useful. Good results have followed its intercurrent use in congestive 
dysmenorrhoea, menorrhagia, and metrorrhagia, chiefly functional in 
character. It is a comparatively slow-acting drug in most forms of hem- 
orrhage, but its effects are permanent. 
Hydrastis, locally to relieve pain and retard growth, has been advised 
in carcinomata, particularly mammary cancer. While its general alterative 
and tonic properties and control over circulatory engorgement may make it 
a desirable general or supporting agent in carcinomatous cachexia, it is 
folly, in the light of present-day knowledge of this malignant scourge, to 
hope for any appreciable results from hydrastis, certainly not for a cure. 
HYOSCYAMUS. 
The leaves and flowering or fruiting tops of Hyoscyamus niger, Linne (Nat. Ord. 
Solanaceae). Europe; naturalized in waste places in the United States. Dose, 2 to 10 grains. 
Common Name: Henbane. 
Principal Constituents.-Two alkaloids: Hyoscyamine (C17H23NO3), probably identical 
with duboisine (from Duboisia) and daturine (from Stramonium); and hyoscine {scopolamine) 
(CnHnNOJ. 
Preparation.-Specific Medicine Hyoscyamus. Dose, 1/10 to 20 drops. 
Derivative. Hyoscyamince Hydrobromidum, Hyoscyamine Hydrobromide (Hyoscya- 
mine Bromide). Dose, 1/200 grain. 
Specific Indications.-Nervous irritability, with unrest and insomnia; 
dilated pupils and flushed face, accompanied by debility; fright and 
restlessness in sleep; night terrors; loquaciousness; garrulousness; destruc- 
tiveness; busy muttering delirium, or singing, talkativeness, amusing 
hallucinations and illusions, particularly in fevers; choking sensations; 
the insomnia of debility, exhaustion, or insanity; the excitability of the 
insane/urethral irritation in the feeble, with urging to urinate; rapid, 
palpitating heart action; muscular spasms; spasmodic pain; sharp, dry 
nervous cough, aggravated by the recumbent position. A remedy to relieve 
pain, spasm, and nervous unrest in the aged and the infant, and in the 
anemic and the debilitated. 
Action.-The physiological actions of hyoscyamus, belladonna, 
stramonium, and duboisia are quite similar, differing chiefly in degree and 
less in quality. They produce the same dryness of the throat, flushing of 
the face, dilatation of the pupils, quickening of the respiratory and heart 
action, illusions, hallucinations and delirium. While the alkaloids of these 
drugs also act in the same general manner, there are shades of difference 
which make some variation in effects. Thus hyoscine (scopolamine) acts 
somewhat as a check upon its associated hyoscyamine in the parent drug, 
the latter alkaloid being more closely allied to atropine in action. This 
check upon the latter makes hyoscyamus less excitant and less furiously 
deliriant than its congeners and it is less likely to cause cerebral hyperaemia. 
Under hyoscyamus the primary stimulation observed under belladonna 
and stramonium and their alkaloids may be absent, or at least it is of very 
much shorter duration and subdued character, so that under its influence 
421 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
sleep is induced without much previous excitement. This is of great 
advantage in the treatment of the insane. 
There is little observable difference between atropine and hyoscyamine 
upon the mechanism of ocular accommodation, but the latter sometimes 
fails to produce mydriasis. There is also but little variation in their effects 
upon the heart or breathing. Scopolamine (hyoscine), however, is said to 
cause stronger mydriasis and more quickly than atropine, though it is of 
shorter duration. Hyoscyamine is more hypnotic and less deliriant than 
atropine, but this is probably due to the presence of hyoscine in commercial 
hyoscyamine. It is well-established knowledge that scopolamine is more 
depressant to the higher cerebral centers than either hyoscyamine or atropine, 
and that even smaller amounts act decidedly as a hypnotic. Hyoscyamine 
acts more powerfully upon the peripheral nerves, hence hyoscyamus is a 
better agent than belladonna to combine with cathartics to lessen griping 
and tormina. Moreover, it does not restrain secretion and is likely to 
prove more or less laxative. 
Great care must be observed, however, in the use of hyoscine and hy- 
oscyamine. The former, in particular, in large doses dangerously depresses 
respiration, and if in any case it must be given in full doses its effects upon 
breathing should be closely watched. 
The symptoms of poisoning by hyoscyamus and its alkaloids are 
sufficiently similar to those named under belladonna for diagnosis, and the 
treatment is the same as there recommended. 
Therapy.-According to the dose in which it is administered hyoscy- 
amus is a cerebral stimulant or a cerebral sedative. It is largely used 
under conditions in which opium would be indicated, but is not acceptable 
on account of the constipation, nausea, and headache induced by it. 
Hyoscyamus does not, like opium, restrain secretion, and proves laxative 
rather than constipating. Hyoscyamus is a safer drug for old persons and 
children than belladonna or opium. As a remedy for pain it is relatively far 
weaker than the latter, but should be preferred in mild attacks and especially 
in such when associated with spasmodic tubular contractions. 
Hyoscyamus is the remedy for nervous irritability and irritation 
(small doses), and mental excitation with great motility (large doses). 
Hyoscyamus allays spasm and relieves pain. It is a better agent 
for spasmodic disorders and peripheral pain than belladonna, but less 
effective than opium. Where it can be made to control the pain, however, 
it should always be preferred to the latter. Hyoscyamus is a better remedy 
for spasm, especially tubular and sphincteric spasm, than for pain, but if the 
latter is caused by the former it is doubly efficient. It cannot be relied upon, 
however, for very severe paroxysms of either pain or spasm such as attend 
bad cases of calculi colic-either biliary or renal. But it does very well in 
the milder attacks. In all painful and spasmodic conditions it takes rather 
full doses, except in states characterized by nervous irritation with feeble 
circulation-in other words, in nervous depression rather than in nervous 
excitability-; then small doses act specifically. Properly selected accord- 
ing to this depression or the contrary, and in doses to meet each condition, 
it is extremely useful in spasmodic dysmenorrhcea, flatulent colic, gastro- 
dvnia. spasmodic bowel disorders, painful hemorrhoids, spasmodic cvstic 
422 INDIVIDUAL DRUGS. 
pain, spasmodic asthma, and whooping cough. As a remedy for pain it 
will usually be found to meet depressed conditions best. Hence its value 
in nervous headache, the headache of debility, the vague pains of so-called 
chronic rheumatism, idiopathic neuralgia, visceral pain, urethral pain, and 
that of herpes zoster. The more these cases show nervous irritation, 
weak circulation, tendency to anemia, and constant but not violent 
unrest, the better they are helped by small doses of the drug. 
Hyoscyamus quiets that form of irritability akin to pain but not 
amounting to actual pain, such as irritation of the bladder and urethra with 
tendency to sphincteric spasm. Here nerve force is low and under similar 
conditions it relieves the ever-annoying urging to urinate accompanied by 
tenesmus that is so often associated with diurnal as well as nocturnal 
incontinence of urine, and in the cystic troubles of the aged and women 
during the menopause.^ In combination with camphor it has'long held a 
reputation for the relief of nervous erethism produced by the passage of 
instruments into the urethra. 
Cough, whether occurring in acute or chronic disorders, is controlled 
by hyoscyamus. The more spasmodic or convulsive the better it acts, 
though for some reason it is not as effective in whooping cough as stramo- 
nium, solanum, or belladonna. Probably none of these agents act any too 
well because there is some causative factor other than spasm, probably of a 
bacterial character. It relieves the short, dry, explosive cough of bronchitis. 
It relieves most irritable dry coughs, nervous cough, and harassing bronchial 
cough, caused or made worse upon lying down. It may be given for long 
periods, preferably in syrup of wild cherry, to relieve the cough and nervous- 
ness and thus promote rest in phthisis. In most of the forms of cough 
mentioned medium doses must be employed, except where nervous and 
physical depression is very marked. Hyoscyamus, in the small dose, is 
often the best agent to use in pneumonia, with dry cough and sub-delirium 
with widely dilated pupils. 
Hyoscyamus is one of the most important agents in nervous and 
mental diseases. In the small doses it meets the depressive types; in full 
doses the excitable and furious manias. One of the chief uses of the drug 
(usually in this instance, hyoscyamine, or perferably hyoscine) is to pro- 
duce sleep in acute mania. If of the violent, furious and destructive type, 
with great mental and motor excitability, full doses of hyoscine should be 
given. But if of the sub-delirious or mildly aberrative form, the smaller doses 
of hyoscyamus are to be preferred. Often both drugs fail to overcome the 
insomnia, in which instance wider wakefulness ensues and the patient paces 
the floor until the effect of the drug is spent. Full doses are usually required 
in delusional insanity, epileptic mania, recurrent mania, and puerperal mania 
-all with sleeplessness and great mental excitement. On the contrary when 
in such disorders as nymphomania following childbirth, and due more to 
delirium than to passion, and in puerperal mania, in both of which there is a 
feeble pulse, exhaustion, continuous but mild mental agitation, and nervous 
unrest, then small doses of the parent drug give the best results. Small doses 
of hyoscyamus are also to be preferred in the insanities, and in the delirium of 
acute diseases, when the patient indulges in singing, continuous talking, or low 
muttering delirium, or when garrulous and quarrelsome, but not violent. 
423 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
When insomnia depends upon mere excitability, or when it is needed 
to relieve restlessness and unpleasant dreams during sleep, small doses 
of hyoscyamus are splendidly effective. These conditions often occur 
during the acute diseases of children and are promptly met by the drug. 
For the wandering delirium of exhaustion-the typhomania of typhoid 
fever, it is often the best calmative we can employ. The patient feels that 
he is away from home and friends and constantly asks and makes an effort 
"to go home". In hysteria with frequent voiding of small quantities of urine 
hyoscyamus should be given in fractional doses. 
If it is borne in mind that all of the solanacese in true therapeutic doses 
produce effects opposite from those of their gross physiologic action, it will not 
be difficult to apply them specifically. If strong sedation is needed, the large 
doses are to be given; if stimulation, the small doses. For violent maniacal 
excitement the alkaloids are preferable: for mild forms, hyoscyamus. 
Hyoscine is sometimes used in attempts to cure the opium habit. For 
the violent excitement following the complete withdrawal of the drug it 
is useful, but it should not be given continuously. It should be regarded 
here as an emergency remedy and so employed. It is an easy matter to 
permanently damage the intellect with the powerful solanaceous alkaloids. 
(See also Scopolaminoe Hydrobromidum.) 
The leaves and flowering tops of Hypericum perforatum, Linn6 (Nat. Ord. Hyper- 
icacese). Europe and America. 
Common Name: St. John's Wort. 
Principal Constituents.-Volatile oil, a resin, tannin, and hypericum red, a resinous red 
coloring principle. 
Preparation.- Tinctura Hyperici, Tincture of Hypericum (herb, Sviij; Alcohol, 
76 per cent, Oj). Dose, 1/4 to 30 drops. 
Specific Indications.-Spinal injuries, shocks, and concussions; throb- 
bing of the body without fever; spinal irritation, eliciting tenderness and 
burning pain upon slight pressure; spinal injuries and lacerated and punc- 
tured wounds of the extremities, with excruciating pain; hysteria. Locally 
as a vulnerary. 
Action and Therapy.-External. St. John's Wort is valued by many 
practitioners as a vulnerary, much as arnica is employed. Therefore it has 
been used extensively as a local application to bruises, contusions, sprains, 
lacerations, swellings, ecchymoses, and in acute mammitis. 
Internal. Hypericum is said to be diuretic and sedative, and as such 
has been used in chronic urinary disorders, particularly suppression of urine. 
It undoubtedly has a strong influence upon the nervous system. Used 
according to the indications named above, many physicians believe it useful 
to relieve the painful effects of spinal concussion, shocks, etc., and to pre- 
vent tetanic complications. It will take pretty strong proof to convince 
most practitioners of the present day of any such virtue as true antitetanic 
properties in this simple drug. The internal uses as given above are based 
chiefly upon homoeopathic symptomatology, and the drug has gained little 
favor in the Eclectic school of practice. It has, without question, a value 
in nervous disorders and should be more fully studied and tested, but 
miraculous powers should not be hoped for from it. 
HYPERICUM. 
424 INDIVIDUAL DRUGS. 
ICHTHYOLUM. 
Ichthyol, Ammonium Ichthyol, Ammonium Ichthyol Sulphonate. 
A sulphur-bearing preparation derived from a bituminous mineral, containing fos- 
silized remains of prehistoric sea life. Tyrolese mountains of Europe. 
Description.-A reddish-brown, syrupy liquid, with a bituminous taste and odor. It 
mixes readily with fats and petrolatum, and is soluble in water, partly dissolved by alcohol 
and ether, and wholly soluble in them when the two are mixed. It contains about 10 per 
cent of sulphur. Dose, 1 to 20 minims. 
Action and Therapy.-External. Ichthyol has been used as a local 
application for almost every possible skin lesion imaginable, but has finally 
come to be valued mostly in a few acute inflammatory conditions, in which 
it seems to act with great force and efficiency. Thus it is preferred by many 
over all other topical agents for erysipelas. It quickly relieves pain and 
burning and limits the spread of the infection. Applied to acutely inflamed 
joints, as in acute articular rheumatism, it proves anodyne and sedative, 
and appears to hasten the reduction of the swelling and mitigate the 
severity of the inflammation. Ichthyol is also used in chronic skin dis- 
eases when thickening of the true skin takes place, as in acne, eczema, 
psoriasis, old ulcers, lupus and keloid. It may be applied to contusions, 
sprains, chilblains, frost bites, burns and scalds, intertrigo and urticaria, 
and in lymphatic and tonsillar swellings, with more or less relief. Many 
gynecologists employ it as a suppository or ointment for the absorption of 
pelvic exudates, especially those occurring around the uterus. While water- 
solutions of ichthyol are sometimes employed, for most purposes mentioned 
above, an ointment of 20 to 25 per cent of ichthyol with petrolatum, or 
preferably wool fat, is preferred. Ichthyol is not used internally in Eclectic 
therapeutics. 
IGNATIA. 
The seed of Strychnos Ignatia, Lindley (Nat. Ord. Loganiacese). Philippine Islands. 
Dose, 1 to 2 grains. 
Common Name: St. Ignatius Bean. 
Principal Constituents.-Strychnine and brucine, the former predominating; and 
igasuric acid. 
Preparation.-Specific Medicine Ignatia. 1/20 to 5 drops. ( Usual method of ad- 
ministration: Specific Medicine Ignatia, gtt. v to xv; Water, flgiv. Mix. Sig.: One 
teaspoonful every 1 to 3 hours.) 
Specific Indications.-Atony and nervous debility; (see also below.) 
Action and Therapy.-Ignatia acts very much like nux vomica and 
may be used in conditions similar to those benefited by it. As it contains 
a considerable amount of brucine, it is thought to have a distinctive field in 
medicine. The specific guide for ignatia is atony and nervous debility. 
From the views of those who believe it superior to and even different in 
action from nux vomica we have outlined the following conditions in which 
it is said to be effective: General nervous atony; disposition to grieve; 
congestive headache; deep-seated, dull, dragging pain in the loins and 
back, or right hypochondrium; hysterical, choreic, epileptoid, or hypo- 
chondriacal manifestations arising from general nervous and muscular 
debility; muscular twitchings, particularly of the face and eyelids; dullness 
of the special senses, particularly asthenopia, and of hearing; wandering 
pelvic pains; sexual frigidity; dysmenorrhoea, with colic-like pain and 
heaviness of the womb; coldness of the extremities, with burning of the 
425 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
soles of the feet. It will be observed that many of these symptomatic 
guides are derived from homoeopathy. Observing the indications applicable 
it is believed useful in atonic dyspepsia, gastralgia, sick headache, disorders 
of the female reproductive organs, and nervous depression with pain. 
Though the composition of ignatia is similar to that of nux vomica, there 
may be a different molecular constitution in the two drugs, accounting for 
the varying shades of therapeutic activity ascribed to the two medicines. 
IMPATIENS. 
The plants Impatiens pallida, Nuttall; and Impatiens fulva, Nuttall (Nat. Ord. Gerani- 
aceae). Moist shady places and rich soils in the United States. 
Common Names: Balsam Jewel Weed, Balsam Weed, Jewel Weed, (1) Pale Touch- 
Me-Not, (2) Speckled Touch-Me-Not. 
Preparation.-The bruised, fresh plant. 
Action and Therapy.-External. Refrigerant and sedative. The fresh 
juice of the crushed Impatiens gives prompt relief in the dermatitis of 
rhus poisoning if used early. It also quickly relieves the intolerable sting- 
ing produced by nettles. As these plants usually grow contiguously 
the balsam can be procured and applied at once. The relief is almost 
magical. The bruised plants may also be used to relieve the pain of acute 
engorged hemorrhoids. 
INULA. 
The root of Inula Helenium, Linne (Nat. Ord. Composita?). A common roadside 
and pasture weed in Europe and America. Dose, 1 to 60 grains. 
Common Names: Elecampane, Scabwort. 
Principal Constituents.-Resins, inulin (30 to 40 per cent), a starch-like body, and 
helenin (Alant camphor). 
Preparations.-1. Specific Medicine Inula. Dose, 1 to 60 drops. 
2. Syrupus Inuloe, Syrup of Inula, (Specific Medicine Inula, fl 5 j; Syrup, Oj). Dose, 
1 to 4 fluidrachms. 
Specific Indications.-"Cough of a teasing and persistent character 
accompanied by substernal pain and profuse excretion; atony of abdominal 
viscera with engorgement and relaxation; catarrhal discharges." (American 
Dispensatory, 1900.) 
Action and Therapy.-Inula is an aromatic, stimulating expectorant and 
tonic. It is one of the old but neglected remedies of early domestic and 
eclectic development, and has recently been revived as a remedy of 
promise in chronic pulmonic disorders. As it acts kindly upon the stomach, 
it proves tonic and favors digestion and assimilation. It seems especially 
adapted to chronic disorders with excessive mucous discharges. It has long 
been valued in chronic catarrhal states of the bronchi, bladder, and vagina, 
and particularly in chronic endometritis with discharge of glairy mucus. 
It relieves some cases of humid asthma and controls night sweats. 
Inula is of greatest service in bronchial irritation, with cough of a 
persistent, teasing character, with copious expectoration. We have for 
many years used and valued the syrup advised by Locke, and prepared as 
follows: Take Elecampane, 5j; Boiling Water, Oj. Boil until but 8 ounces 
remain; add 1/2 pound of white sugar. This is especially useful in chronic 
bronchitis, with profuse excretion of mucus or muco-pus, and in the cough 
persisting after la grippe and the severest forms of colds. 
426 ELECAMPANE 
(Inula Helenium) 
From "Music of the Wild," by Gene Stratton Porter 
By Courtesy of the Publishers, The Caxton Press. 
Elecampane, once popular as a domestic and botanic drug and conspicuous in early Eclectic 
therapy as a cough medicine, has quite lately been revived as a remedy of importance in pul- 
monary tuberculosis. INDIVIDUAL DRUGS. 
From time to time reports have come to press that helenin and other 
constituents of inula are fatal to the tubercle bacillus. In 1900 we recorded 
in the American Dispensatory the statement that "helenin is accredited 
with a fatal action upon the tubercle bacillus by Korab, Blocq, and others." 
Locke, in his lectures, emphasized the value of Inula in phthisis, and noted 
particularly its value to control the night sweats of that disorder. This was 
recorded in Locke's Syllabus in 1895. More recently, since hypodermatic and 
intravenous medication have come into vogue, inula, together with echinacea, 
has been reinvestigated and advised as a potent drug for its influence upon 
pulmonary tuberculosis. This work is still in the experimental stage, but 
with promise at least of amelioration of symptoms and gain of weight in 
some cases and a marked lessening of cough and secretion. Over-enthusiastic 
reports must be received with judgment, and not too much hoped for until 
more complete knowledge of its power over tuberculosis is proved or dis- 
proved. The value of the drug, internally administered, so far as ameliora- 
tion of distressing symptoms is concerned, is unquestioned, but so far we 
are skeptical concerning its power to destroy the tubercle bacillus within 
the body. 
IODOFORMUM. 
Iodoform, Triiodomethane. (Formula: CHI3.) 
Description.-A lemon-yellow powder or shining crystals; slightly sweetish, iodine- 
like taste; and a peculiar offensively penetrating odor, clinging to fabrics and receptacles 
for very long periods. It dissolves in chloroform or ether, less readily in olive oil, alcohol, 
or glycerin, and very slightly in water. Dose, 1/2 to 5 grains. 
Preparation.- Unguentum lodoformi, Iodoform Ointment (10 per cent). This should 
usually be diluted for most purposes. 
Action and Toxicology.-Ordinarily when applied to sound or to broken 
skin, wounds, ulcers, and mucous membranes, iodoform is nonirritating 
and acts as a topical anaesthetic. When given internally in average doses, 
or as ordinarily employed externally, little effect is produced upon the active 
processes of life, but when used in excessive amounts upon wounded sur- 
faces, as in cavities, it has produced serious toxic symptoms and even death. 
Some persons are more susceptible than others, and the aged more so than 
younger adults and children. 
Occasionally local poisoning occurs from dressings of iodoform, an 
erythematous, papular, or eczematous eruption being caused, and sometimes 
vesicles filled with an orange-colored serum. Contrary to formerly accepted 
views iodoform is not fatal to germ life, organisms seeming to lose none of 
their activities in its presence. When in contact with moist wounds, how- 
ever, iodine is liberated and this may have some antiseptic effect. Ap- 
parently secretions are restrained and the wounds dessicated by absorption 
by iodoform dressings, and in this way surgical results of value have been 
obtained from their use. Iodoform is slowly eliminated in the urine as 
iodide and iodate of sodium with some free iodine, and in the saliva as 
sodium iodide. 
Moderate doses of iodoform occasion headache, nausea and vomiting, 
and the unpleasant taste and odor of the drug become intolerable. The 
olfactory sense is also perverted. Large doses occasion vertigo, restlessness, 
and insomnia, with quickened pulse, almost amounting to tachycardia, 
and a sharp rise in temperature of several degrees. The patient shows great 
427 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
anxiety, mental confusion, and depression which progresses into melan- 
cholia with hallucinations, followed by a delirium and maniacal excitement, 
disproportionate in duration and intensity to that occasioned by any other 
drug. Finally haematuria or anuria, sphincter paralysis, collapse, and death 
ensue. Maniacal delirium is the most characteristic feature of the majority 
of cases, though in some there is an absence of cerebral excitement, and 
drowsiness, stupor, coma, cold, livid skin, and collapse come on at once. 
Death takes place through simultaneous paralysis of heart and lungs. 
Fatty degeneration of the viscera is the most pronounced post-mortem 
finding. 
In treatment of iodoform poisoning the drug should be withdrawn at 
once. If from local application the parts should be washed with alkaline 
carbonate solutions or bromide of potassium. Sodium bicarbonate should 
be given for internal poisoning, together with bromide and acetate of potas- 
sium, or lemonade. 
Therapy.-External. Notwithstanding the assertion that iodoform 
is not a germicide its value as a surgical dressing is unquestioned and it is 
still employed by many operators. Its abominably persistent odor has been 
its greatest drawback, coupled with its occasional poisoning from absorption. 
Several substances have been incorporated with it to destroy or to mask 
its odor, with more or less success. Among these may be mentioned oils 
of camphor, eucalyptus, clove, cinnamon, bergamot, thyme, lavender, 
sassafras, and peppermint; and camphor, thymol, and cumarin. The 
odor may also be removed from the operator's hands by means of a solution 
of tannic acid, flaxseed meal in water, vinegar, chloroform, or ether, or by 
first putting a few drops of turpentine on them and then washing with soap 
and water. 
According to the purpose desired, iodoform is used pure as a dusting 
powder (not over 30 grains at a time); or as advised by Locke (iodoform 
100, thymol 1, sugar of milk 200); or in glycerinated lotion (iodoform 1, 
glycerin 4). Murrell advised a good mixture (iodoform, 3 j; oil of eucalyptus, 
fl 3 j; soft and hard petrolatum, aa Sijss). Olive oil solutions (10 to 25 
per cent) are employed in cavities; collodion solutions (5 to 10 per cent) for 
wounds; and carbasus iodoformata or iodoform gauze (10 to 50 per cent) 
for dressings, packing, and drainage. Suppositories, bougies, and other 
ways have been devised for applying it for special purposes. Ointments 
usually carry from 5 to 10 per cent of iodoform. 
Iodoform is an efficient dressing for simple, gunshot and infected 
wounds, and for abdominal operations involving the peritoneum and 
intestines and the pelvic organs of woman. For soft chancres it is still 
largely used, as well as for painful, syphilitic phagedena, many preferring it 
to other dessicants in spite of its odor. It cannot well be employed in 
private practice because of this "give away" quality. It is one of the best 
applications to tuberculous ulcers, and the oil emulsion is largely employed 
in tubercular caries. 
Iodoform benumbs rectal sensibility, and is therefore a most useful 
agent to incorporate in ointment or suppository for the relief of pain in 
rectal ulcer or fissure, in painful hemorrhoids, to relieve pruritus, and to 
render defecation painless. There is no better obtunder in tubercular, 
428 INDIVIDUAL DRUGS. 
syphilitic and cancerous ulceration of the rectum to allow the patient to have 
painless evacuations and to give rest to the parts. 
Formerly iodoform was used in a variety of aural and ophthalmic 
disorders with hypersecretion and fetid odors, and in ozaena and syphilitic 
ulcers of the nasal region. Other agents lacking odor have supplanted it 
for these purposes. Occasionally it is still employed by insufflation in laryn- 
geal phthisis. The formula of Murrell is an effectual one:I) Iodoform, Boric 
Acid, aa 3 ij; Menthol, gr. x; Calcium Phosphate, q. s. 3 j. All in very fine 
powder. Mix. A 4 per cent solution in turpentine has also been inhaled 
with relief in laryngeal and pulmonary tuberculosis and in bronchiectasis. 
From 3 to 5 drops may be used at a time. 
Internal. Iodoform is scarcely ever employed internally as formerly, 
when it was thought that it would prove a potent remedy in tubercular, 
syphilitic, strumous, and other infectious diseases. It is scarcely needful 
to say that it has proved wholly disappointing for these purposes. 
IODOLUM. 
Iodol, Tetraiodopyrrol. 
A derivative of pyrrol through its interaction with iodine in the presence of alcohol. 
(Formula: C4I4NH.) 
Description.-A pale, grayish-brown, crystalline powder, odorless and tasteless; 
soluble in alcohol, ether, and fixed oils, and chloroform (105); almost insoluble in water. 
Dose, 1 to 4 grains. 
Action.-Iodol has a quite superficial caustic action, leaving on 
ulcerated surfaces a whitish pellicle. It is rather slowly absorbed, and for 
that reason has been preferred to iodoform, for which it was introduced 
as a substitute. It has an advantage over the latter in possessing no odor, 
and is said not to produce coryza nor stomatitis. Large doses cause 
poisonous symptoms like those of iodoform, and its prolonged use has 
occasioned fatalities, fatty degeneration of the visceral organs preceding. 
Iodol is decomposed in the body and passes in the urine as iodides. 
Therapy.-External. Iodol has been advised in powder, gauze, oint- 
ment (10 per cent), bougie, etc., as a substitute for iodoform, being safer 
because less rapidly absorbed. A 10 per cent collodion solution has been 
employed to abort erysipelas. The powder is also insufflated for the relief 
of tubercular laryngitis. 
Internal. The powder, in doses of 5 to 30 grains a day, has been 
advised in lieu of potassium iodide, in the tertiary stage of syphilis. 
Iodine. 
The nearly pure element iodine (Symbol I). 
Description.-Heavy, brittle, bluish-black scale or plate-like crystals, volatilizing 
at the ordinary temperatures. The taste is acrid, and the odor distinctive and persistent. 
It imparts an evanescent stain to the skin. It is soluble in alcohol, less readily in glycerin, 
and very sparingly in water. It dissolves freely in chloroform or ether, or in water to 
which iodides have been added. Dose, 1/50 to 1/10 grain. 
Preparations.-1. Tinctura lodi, Tincture of Iodine. (Contains, according to 
U. S. P., about 7 per cent of iodine and 5 per cent of potassium iodide.) Dose, 1 to 3 minims. 
2. Liquor lodi Compositus, Compound Solution of Iodine (Lugol's Solution-5 per 
cent iodine; 10 per cent potassium iodide). Dose, 1 to 5 minims. 
3. Unguentum lodi. Iodine Ointment (Iodine, Potassium Iodide, Glycerin and 
Benzoinated Lard). For external use. 
IODUM. 
429 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Toxicology.-Iodine stains the skin and is a pronounced 
but slowly acting irritant. Its effects penetrate quite deeply. After a 
thorough application the cuticle usually exfoliates. The excess of iodine 
may be removed by alcohol, and the coloration by sodium hyposulphite or by 
ammonia water. Iodine is rapidly absorbed, appearing in the urine very 
shortly after being swallowed and in the sweat and the milk, always as 
hydriodic acid or as other iodides. A nursing infant may acquire iodism 
from the milk of its mother taking iodine or its salts. The internal effects 
of iodine are not well known. Under its use better nutrition results, but it 
is not thought that it directly assists in bloodmaking or in stimulating 
nutrition. The good effects probably arise from its alterative action, 
which materially assists in the removal of worn-out tissues-in other 
words, it increases "retrograde metamorphosis". Long continued use of 
iodine may induce wasting of the testicles and the mammary glands, 
conditions which may be permanent, or from which recovery may take place 
after a long period. 
In large doses iodine is a violent irritant poison, producing gastro- 
enteritis. Acute pain, vomiting and purging, great thirst, strong metallic 
taste, profuse salivation, rapid and feeble pulse, death-like pallor and 
complete anuria are the chief symptoms of acute iodine poisoning. Prostra- 
tion is profound and death results from respiratory paralysis. If death does 
not take place shortly it may be delayed for several days, when it occurs 
from the severe inflammation and fatty degenerative changes. 
In poisoning by iodine, starch is the chemical antidote. It should be 
given with the emetic and freely afterward. Flour paste may be used if 
starch is not at hand. Preferably the starch should be scalded with boiling 
water and then diluted with cold water, so that the union of iodine and 
starch can more easily result in the production of non-toxic iodized starch. 
External heat should be applied and respiration and circulation sustained 
by such stimulants as alcohol, ammonia, ether, digitalis, strychnine, 
caffeine, or atropine. A milder form of poisoning occurs from excessive 
doses of iodine and the iodides, or from their prolonged use, or in sus- 
ceptible individuals. It is known as Iodism. (See Potassii lodidum.) 
Therapy.-External. Tincture of iodine is one of the best of local 
irritants and absorbents, and is also antiseptic and antipruritic. Within 
recent years it has come into great prominence as an agent for sterilization 
of the skin previous to operations. Even large areas, as the whole ab- 
dominal surface, are subjected to this precaution. Water should not be 
previously applied as it lessens the penetrability of the antiseptic. Painted 
upon the parts in this manner it renders the field of operation absolutely 
aseptic. Iodine is now used to prevent infection arising from scalp wounds 
and crushed fingers, where all sorts of dirt, hair, grease, and other debris are 
ground into the tissues. It should be painted freely upon the parts and 
swabbed into the injured tissues. It may also be used upon poisoned 
wounds and snake-bites. 
Tincture of iodine may be painted upon swollen and painful surfaces, 
and used to reduce engorgement in adenitis. A good method is to paint 
the tincture around the swelling, while the ointment is used within the circle. 
This should be done early, when it may prevent the formation of pus. 
430 INDIVIDUAL DRUGS. 
If pus has already formed it will do no good. Iodine may be painted upon 
synovitis, in which it may at first seemingly aggravate. But subsequently 
resolution is hastened by it. It is also useful to stimulate absorption in 
chronic arthritis and to reduce swelling or alleviate pain in chronic muscular 
rheumatism, in chronic neuritis, and in muscular chest pains not involving 
the pleura or the intercostal nerves. Painted upon the upper chest region it 
sometimes relieves the persistently hacking cough of chronic bronchitis 
or laryngitis and removes the muscular soreness attendant upon coughing. 
It may also be applied to tender points of the chest wall in phthisis to 
remove the soreness. 
Iodine destroys soft and spongy granulations, and stimulates repair in 
old tibial ulcers. It may also relieve pain and limit swelling and destruction 
of tissue in boils, carbuncles, felons, and buboes. Applied to frost bites, 
chilblains, and non-suppurating bunions it gives great relief; the ointment 
or solution in collodion is to be preferred. For maceration of the skin, 
with soreness between the toes, whether due to tissue contact or of parasitic 
origin, iodine is one of the best of applications. It causes a little smarting, 
but that soon passes away, the skin exfoliates and the parts are healed. 
Iodine is one of the surest parasiticides in skin disorders of the ring- 
worm type, in favus, and has given fair results in psoriasis. Painted upon 
and around the inflammatory area in erysipelas it limits the invasion of the 
infection. There is no special advantage in the use of iodine upon sprains 
and contusions unless effusion has taken place. In that event it hastens 
absorption and resolution. 
Iodine may be used cautiously upon spongy gums with loosening of the 
teeth. We have seen unpleasant sores follow such applications. A very 
weak, watery solution should be used, if any. It serves a better purpose 
for the reduction of chronic indurations of the cervix uteri. 
Injections of iodine into cysts, purulent cavities, etc., is inadvisable, 
as too many dangerous results have followed such a procedure. It is, how- 
ever, still used by some who retain barbarous methods as an irritating in- 
jection for the cure of hydrocele. It cures by producing inflammatory 
surfaces which, in healing, obliterate the cavity. 
In applying iodine the tincture should be painted upon the part until 
the skin is thoroughly saturated, and then not repeated until desquamation 
and complete healing take place. Under no circumstances should it be 
painted upon denuded surfaces, except the slight denudation between the 
toes above referred to. For glandular swelling the ointment is preferable 
to the tincture. The vapor of iodine is sometimes employed in diphtheria 
and respiratory affections, but not much good is accomplished thereby. 
Internal. Iodine as an internal medicine has been largely supplanted 
by the metallic iodides and the syrup of iodide of iron. It is, however, 
occasionally administered in states of perverted nutrition when of a 
strumous type and marked by adenopathy. Only in slow and sluggish 
conditions is it admissible, and if the glandular inflammation or induration 
be active and inclined to suppurate iodine will aggravate the condition. 
Iodine should be given as close to meals as possible, and preferably in some 
bland oil or syrup, and the doses should always be small. While con- 
traindicated in ordinary pulmonary tuberculosis, it is said to be useful in 
431 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
so-called "fibroid phthisis". The status of iodine medication in goitre is 
still a matter of study, most cases of the exophthalmic type probably 
being due to some disturbance caused by the natural iodine in the tissues. 
The preponderance of opinion seems to point to limiting its use to cases 
of goitre with simple hypertrophy of the connective stroma, and that it 
is harmful in the cystic and vascular forms. Scudder favored the use of 
the following in sexual debility: 3 Tincture of Iodine, gtt. xx; Simple 
Syrup, fl 3 iv. Mix. Sig.: One teaspoonful after meals and at bed time. 
IPECACUANHA. 
The root of (1) Cephaelis Ipecacuanha (Brotero), A. Richard, or of (2) Cephaelis 
acuminata, Karsten (Nat. Ord. Rubiaceae). Brazil and other parts of South America. 
Dose, 1 to 20 grains. 
Common Names: Ipecac, (1) Rio Ipecac, (2) Cartagena Ipecac. 
Principal Constituents.-The alkaloids emetine (C30H44N2O4), cephaeline (C28H33N2O4), 
cephaelic (ipecacuanhic) acid, volatile oil, tannin, etc. 
Preparations.-1. Pulvis Ipecacuanhce, Powdered Ipecac. Dose, 1 to 20 grains. (Usual 
emetic dose, 10 to 15 grains.) 
2. Specific Medicine Ipecac. Dose, 1/30 to 20 drops (for specific purposes the frac- 
tional dose is employed). 
3. Syrupus Ipecacuanhce, Syrup of Ipecac. Dose, 1 to 20 minims (expectorant); 
2 to 4 fluidrachms (emetic). 
4. Alcresta Ipecac. Dose, 1 tablet daily. 
Specific Indications.-Irritation with long and pointed tongue, with 
reddened tip and edges, and accompanied by nausea and vomiting, with or 
without fever; irritation with increased secretions; irritation of stomach, 
bowels, bronchial tubes, bronchioles, and pulmonic air cells, and nervous 
system; irritative diarrhoea; dysentery, with the ipecac tongue; acute 
bowel disorders with increased secretion; hypersecretion of bronchial fluid 
with mucous rales (minute dose); diminished expectoration (medium doses); 
irritative cough, with or without dyspnoea; hoarseness from coughs and 
colds; hemorrhage; menorrhagia (medium doses); as an emetic when the 
stomach is overloaded or in foul condition, with broad, flabby and slimy 
tongue (full doses). 
Action.-Ipecac, in material amounts, is irritant to the skin and 
mucosa. Applied by inunction it excites irritation, and produces vesicular 
and pustular eruptions and sometimes ulcers. When inhaled it causes heat 
and violent sneezing. In susceptible individuals the powdered drug excites 
pronounced attacks simulating asthma, the chief symptoms being great 
dyspnoea, with wheezing respiration and cough, and marked anxiety and 
prostration. This is often accompanied by violent and prolonged sneezing 
and spitting of blood, and followed usually by a free expectoration of mucus. 
In doses of less than 1 grain, ipecac is a gastric tonic and hepatic stimulant. 
Large doses (15 grains or more) are emetic. If emesis fails catharsis may 
result; or both emesis and purgation may be produced by it. Ipecac feces 
are peculiar-bilious and mush-like. From 3 to 10 grains of the powdered 
drug will cause nausea, with more or less depression of the pulse, languor, 
diaphoresis, and increase of mucous secretion. As an emetic it is fairly slow 
(15 to 20 minutes), active and thorough, causes much nausea and mus- 
cular straining, and the ejection of a large quantity of mucus. A state of 
tolerance may be established by the prolonged use of ipecac. Though said 
to have no appreciable effect upon the circulation, the therapeutic action of 
432 INDIVIDUAL DRUGS. 
small doses seems to controvert this statement, a stimulating effect accepted 
in Eclectic therapy as special sedation resulting. 
Emetine has produced death by gastro-intestinal inflammation and 
cardiac paralysis. 
Therapy.-The field of therapeutic activity of ipecac is restricted 
chiefly to the digestive and respiratory tracts, and to some extent to the 
blood vessels, acting as a hemostatic. It is decidedly irritant to mucous 
surfaces, particularly that of the nasal passages, and in some individuals 
will precipitate an attack simulating spasmodic asthma. It increases 
biliary activity, is expectorant in small doses, and emetic in full doses, and 
there is evidence that it possesses antiseptic qualities. 
Ipecac is used chiefly for five great purposes: (1) In full doses as an 
emetic; (2) in small doses as a nauseant expectorant; (3) to check active 
hemorrhage; (4) to check vomiting; (5) and as employed mostly in Eclectic 
therapy, to control irritation and inflammation of the mucous passages of 
alimentation and respiration. 
The chief specific indications are: (1) The full, broad tongue, heavily 
coated, with constant nausea or vomiting. Here it should be used in full 
doses as an emetic; (2) irritation of digestive tract, with long, pointed, 
reddened tongue and tendency to nausea, vomiting, diarrhoea or dysentery; 
(3) scanty expectoration, with irritative cough and hoarseness; (4) active 
hemorrhage. 
The conditions demanding the specific use of ipecac are those showing 
irritation, capillary engorgement, and hypersecretion. 
As an emetic ipecac is not suited for emergency cases, such as poison- 
ing, if other more suitable and more rapid emetics can be procured. Zinc 
sulphate or apomorphine is more prompt and more certain in poison 
cases, especially narcotic poisoning. But for the purpose of relieving the 
stomach of its contents when overloaded, or when food is fermenting and 
undergoing faulty digestion, and the tongue is heavily coated, the breath 
foul, and nausea or vomiting imminent, a full emetic dose of ipecac is 
justifiable and efficient. In this way it often relieves gastric distress and 
pain, being of very great value in acute indigestion, and checks bilious 
attacks with sick headache due to the causes mentioned. 
One of the therapeutic facts long ago recognized by those whose eyes 
are not otherwise open to the utility of specific medication is that ipecac 
(though a common emetic), in very small doses, is one of the best of anti- 
emetics. This is most easily accomplished when the tongue is red and 
pointed and shows evidence of irritation. There are other cases, however, 
in which the nausea depends upon foul accumulations in the stomach. 
The tongue is then broad, flabby, and slimy, and nausea is pronounced. 
In such instances a full emetic dose may be given, and if nausea and vomit- 
ing then persist it may be followed by minute doses. This usually is 
effective. Ipecac in small doses is one of the recognized agents of value in 
the nausea and vomiting of pregnancy. 
Ipecac is often lost sight of as a remedy for active hemorrhage. Of 
course, it operates best where the quantity of blood lost is small. We have 
seen most excellent results follow its use in hemoptysis and in the hemor- 
rhage from gastric ulcer. It should not be given in doses large enough to 
433 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
cause emesis. In typhoid fever it is less valuable than carbo-vegetabilis or 
gallic acid, but may be used for the bloody discharges of dysentery. It 
may also be exhibited in nosebleed, haematuria and in menorrhagia, in the 
latter case often doing excellent service when given in a single full dose. 
The greatest value of ipecac lies in its beneficient effect upon irritation 
of the gastric and intestinal mucosa. The long, pointed tongue, with red- 
dened tip and edges, the uneasiness and pain, the tendency to diarrhoea 
and particularly to dysentery, and the disposition to nausea are so com- 
pletely met by it as to give it prominence among the specific medicines for 
acute diseases of stomach and bowels. If there is fever, it should be given 
with the indicated sedative, usually aconite. It is especially a remedy for 
summer disorders of children. It, together with aconite and magnesium 
sulphate, forms the best treatment for acute dysentery with muco-sanguin- 
eous passages. For this purpose we have used it invariably and always with 
complete success. 
Ipecac in large doses (20 to 60 grains), administered after a preceding 
dose of opium to produce sedation, is considered one of the most certain 
methods of meeting amoebic or tropical dysentery and preventing the sub- 
sequent formation of hepatic abscess. This is followed every four hours 
with twenty-grain doses, tolerance having become established until the 
peculiar mush-like ipecac stools are produced. 
Ipecac finds a prominent place in acute gastric irritation, in gastric 
inflammation, in acute hepatitis, in enteritis, and particularly in cholera 
infantum of the irritative type. It is especially useful in acute mucous 
diarrhoea and in the diarrhoea of dentition. In all abdominal conditions 
requiring ipecac there is the characteristic tongue-long, with reddened tip 
and edges, and prominent papillae. There is tenderness upon pressure, and 
the patient is noticeably irritable, and easily disturbed by noises. There is 
vascular irritability and marked hyperaesthesia. All the faculties are pre- 
ternaturally acute and the patient extremely sensitive. In such cases no 
remedy will render better service than ipecac, given in small doses. Often 
there is the white line around the mouth, contraction of tissue, with pinched 
countenance; and even if there is no fever, there is a suggestion of ap- 
proaching nervous explosion, so great is the hyperaesthesic condition of the 
little patient. In such instances it is decidedly calmative, relaxant and 
soothing; but the dose must be guarded to keep it below the nauseant point. 
A new field for ipecac and its alkaloid particularly is the endamcebic 
infection, pyorrhoea alveolaris. The specific medicine may be used around 
the teeth or emetine injected; and it has been suggested that ipecac prepara- 
tions form a part of the daily mouth wash. The use of alcresta ipecac has 
produced some remarkable results in pyorrhoea. However, it has become 
established that there are different types of pyorrhoea, and that the emetine 
treatment often fails, and its early reputation as a specific has not been 
sustained. Still it is the most useful treatment so far advised, and will be 
used until a better one can be devised. 
Ipecac is used less, perhaps, as an expectorant in Eclectic practice than 
by members of the dominant school. Still, where there is a short, irritative 
cough, with lack of secretion (nauseant doses), and in cases with excessive 
secretion (stimulant doses), small doses of ipecac are decidedly useful. 
434 INDIVIDUAL DRUGS. 
It is also valuable in harsh, croupal cough and in explosive cough and in 
irritable conditions brought on by too frequent or violent use of the voice. 
Thus it finds a place in the treatment of common colds, bronchitis, broncho- 
pneumonia and pneumonia, la grippe, and in the cough of measles. Taken 
internally and sprayed locally, it is one of the greatest remedies for hoarse- 
ness due to atony of the vocal cords, and for aphonia due to either irritation 
or atony of the vocal apparatus. It must not be expected to cure such con- 
ditions when due to a tubercular larynx, but many such cases may be 
temporarily ameliorated by such treatment. It is less valuable in croupous 
conditions than lobelia, but if used in the various forms of croup, emesis 
should be gradually (not suddenly) provoked by repeated moderate doses. 
The dose of ipecac as an emetic is 15 to 20 grains, in plenty of warm 
water. For other purposes the following usual prescription may be used: 
3 Specific Medicine Ipecac, gtt. v to xv; Water, A^iv. Mix. Sig.: One 
teaspoonful every 2 or 3 hours, as indicated. 
IRIS. 
The rhizome and roots of Iris versicolor, Linne (Nat. Ord. Iridaceae). Common in 
wet places in the United States. Dose, 5 to 20 grains. 
Common Names: Blue Flag, Larger Blue Flag, Fleur de Luce. 
Principal Constituents.-Volatile oil, a whitish-yellow resin, a trace of an alkaloid, 
and a comphoraceous body. 
Preparation.-Specific Medicine Iris. Dose, 1 to 20 drops. 
Specific Indications.-Enlarged, soft and yielding lymphatic enlarge- 
ments; thyroid fullness; splenic fullness; chronic hepatic disorders, with 
sharp, cutting pain, aggravated by movement; clay-colored feces, with 
jaundice; nausea and vomiting of sour liquids, or regurgitation of food, 
especially after eating fats or rich pastry, or ice cream; watery, burning 
feces; rough, greasy skin, with disorders of the sebaceous follicles; abnormal 
dermal pigmentation. 
Action.-Iris stimulates the glands of the body to increased activity 
and impresses the nervous system. In large doses it is emeto-cathartic, 
acting violently, the vomitus being acid and the catharsis watery and 
persistent and accompanied by colic and rectal heat. Iris increases the 
hepatic and pancreatic secretions, as well as those of the intestines. Iris 
also salivates, but without injury to the gums and teeth. Salivation from 
vegetable sialagogues may be differentiated from that caused by mercury 
by the absence of mercurial fetor and lack of sponginess of the gums or 
loosening of the teeth. Neuralgic pain is said to be produced by iris when 
given in large doses; and when even moderately full therapeutic doses are 
administered it produces a more or less persistent belly-ache and mild 
catharsis. Iris is capable of causing gastro-enteritis resulting in death. To 
be effective iris preparations must be made from prime, heavy, resinous 
root-stocks; when old and light, like tan-bark, iris produces neither physi- 
ologic nor therapeutic effects. 
Therapy.-External. Specific Medicine Iris has been painted upon 
goitre with good results, though it is effectual in but few instances, and the 
type is not as yet well defined. It is also advised as an efficient local treat- 
ment for psoriasis, chronic itching eczema, various types of tinea, prurigo, 
435 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
and crusta lactea. In all of the preceding disorders the drug should be 
given internally while being applied externally. 
Internal. Iris is alterative and cholagogue. It exemplifies as fully as 
any drug the meaning of the term alterative as used in Eclectic therapy. 
Perhaps this is best expressed to-day by saying that it corrects perverted 
metabolism. Iris, in small doses preferably, quietly stimulates the glandular 
structures of the body, both the glands with outlets and the ductless glands. 
It promotes waste and excretion, two processes necessary before repair can 
well take place. In broad terms it is a remedy for "bad blood'' and im- 
perfect nutrition. The term "bad blood" or blood dyscrasia has, as a rule, 
little relation to the blood itself, but pertains chiefly to imperfect lymphatic 
elimination and faulty retrograde metamorphosis. Iris impresses the 
thyroid function, is of great value in the adenopathies of syphilis and skin 
affections, with imperfect functioning of the lymphatic system resulting in 
enlarged lymph nodes. Hepatic torpor, splenic fullness, and jaundice, with 
clay-colored stools are influenced for good by it, the drug acting quietly 
as an alterative when given in small and repeated doses. 
Iris should be used in the various cachexias-lymphatic, scrofulous 
and syphilitic. It proves more or less useful in some cases of goitre or 
enlarged thyroid, whether the enlargement be constant, or merely the tem- 
porary fullness associated with the menstrual function, normal or ab- 
normal. When it does good it is chiefly in reducing enlargement, and 
appears to have but little influence upon the tachycardia and other dis- 
turbances of hyperthyroidism. As a rule, soft glandular enlargements are 
best treated with iris, and hard enlargements with phytolacca. However, 
iris is sometimes surprisingly effective in goitre, while more often it seems 
to fail completely. The exact type most benefited has never been clearly 
defined. In order to obtain satisfactory results at all, the use of the drug 
must be continued over a period of several months. In exophthalmic 
goitre it may be given early, but without great hope of doing more than to 
affect the bodily glandular functions, thereby improving the general health 
of the patient. The same may be said for it in Addison's disease, in which it 
has sometimes benefited, but has not, of course, cured. Iris is often useful in 
splenic fullness, and ovarian and uterine turgescence in cachectic individuals. 
Minute doses of iris relieve gastric irritation, with nausea, vomiting, 
and gastralgia. In like doses it is sometimes useful in cholera infantum, 
and in either diarrhoea or dysentery, both with large, slimy evacuations, 
repeated small doses have proved very effectual. Still for all these bowel 
troubles it is far inferior to ipecac. It is quite certain, however, to relieve 
sick headache dependent upon indigestion, and bilious headache, with 
nausea and sour and bitter vomiting, and clay-colored stools. In fact 
one of the most important uses for iris is in that complex condition in- 
cluded in the elastic denomination "biliousness". For regurgitation of 
fatty foods or pastries it is especially effective. In hepatic congestion, with 
constipation, and sharp-cutting pains, increased by motion, iris frequently 
gives relief. When constipation depends upon hepatic and intestinal torpor 
and in duodenal catarrh, with jaundice and clay-colored feces, iris should be 
considered as a possible remedy. Aching pain, with pressure beneath the 
scapulae, usually dependent upon hepatic wrong, is relieved by 1 to 5 drop 
doses of specific medicine iris. 
436 INDIVIDUAL DRUGS. 
JACARANDA. 
The leaves of Jacaranda procera, Sprengel (Nat. Ord. Bignoniaceae). A tree of Guiana 
and Brazil. 
Common Names: Carob Tree, Caroba, Caaroba. 
Principal Constituents.-Carobin, carobic acid, several resins, a balsam, and tannin. 
Preparation.-Specific Medicine Jacaranda. Dose, 5 to 20 drops. 
Action and Therapy.-In its native habitat carob is reputed anti- 
syphilitic, but has attained no such reputation in this country. A few, 
however, have used it for the late manifestations of syphilis, as eruptions 
and ulcerations. Watkins suggested its use in the epilepsy of masturbators 
and in those of feeble mentality with voracious appetite. 
JALAPA 
The dried tuberous root of Exogonium Purga (Wenderoth) Bentham (Nat. Ord. 
Convolvulaceae). A vine of Eastern Mexico. Dose, 10 to 30 grains. 
Common Name: Jalap. 
Principal Constituents.-A resin (Resina Jalapa) composed chiefly of jalapurgin 
<C«Hioo032) (convolvulin or jalapin) and a soft acrid resin. 
Preparations.-1. Resina Jalapa, Resin of Jalap. Yellowish-brown or brown 
masses or fragments, or a yellowish-gray or yellowish-brown powder, permanent, of a faint 
but peculiar odor, and somewhat acrid to the taste. Soluble in alcohol. Dose, 2 grains. 
2. Pulvis Jalapce Compositus (U. S. P.), Compound Powder of Jalap. (Jalap, 35; 
Potassium Bitartrate, 65.) Dose, 20 to 60 grains. (Locke advises Ginger, 3ij, in 3 viij 
of this preparation to prevent griping.) 
3. Pulvis Jalapce Compositus (Eclectic), Compound Powder of Jalap (Eclectic), or 
Antibilious Physic. (Senna, 3ij; Jalap, 3j; Cloves or Ginger, 3j.) Dose, 60 grains (in 
hot water allowed to cool and then sweetened). 
4. Specific Medicine Jalap. Dose, 5 to 20 drops. 
Specific Indications.-Intestinal torpor and constipation from de- 
ficient secretion of the intestinal glands; pain and griping in the lower 
bowel. 
Action and Therapy.-Jalap is an irritant cathartic operating ener- 
getically and producing large liquid stools. It gripes considerably and some- 
times causes nausea and vomiting. Large doses produce violent hyper- 
catharsis, sometimes resulting in death. It is a safe and thorough cathartic 
when no inflammation of the gastro-intestinal tract exists, and may be 
used where a derivative action, with full stools, is indicated. In small 
closes (5 grains daily) it may be employed to relieve constipation due to 
inactivity of the intestinal glands or where hard fecal masses are impacted 
in the rectum. Movements are facilitated by the secretion induced. It 
is a useful revulsive in cerebral congestion, and may be used in hemor- 
rhoidal conditions with constipation when a stimulating cathartic cannot 
be employed. 
The chief use of jalap is for the relief of dropsy from any cause. It 
is commonly used with cream of tartar, which increases both the cathartic 
and diuretic effects. It should not be given for any great length of time, for 
the depletion finally has a depressing effect upon the heart. Though con- 
traindicated in inflammation of the intestinal tube, it may be used when 
there is inflammation of the biliary apparatus, and when a cathartic is 
needed at the onset of fevers. The Antibilious Physic and that modification 
of the compound powder as advised by Locke are desirable forms in which 
to use Jalap. Jalap alone purges in about 3 to 4 hours. 
437 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
JEFFERSONIA. 
The rhizome of Jeffersonia diphylla, Barton (Nat. Ord. Berberidaceae). A handsome, 
vernal, flowering plant throughout the eastern half of the United States. 
Common Names: Twinleaf, Rheumatism Root. 
Principal Constituents.-A large proportion of an undetermined white alkaloid, 
saponin, and a trace of berberine. 
Preparation.- Tinctura Jeffersonia, Tincture of Jeffersonia. (Jeffersonia, 8 ounces; 
Alcohol (76 per cent), Oj.) Dose, 10 drops to 1 fluidrachm. 
Action and Therapy.-As indicated by one of its trivial names this 
plant has been used in chronic forms of rheumatism. Its exact status is not 
well determined, but it is undoubtedly alterative and has some effect upon 
the general nervous system, allaying excitability and irritability. Watkins 
declared it efficient in pain in the head with dizziness and feeling of tension. 
Locke mentions it as useful where rheumatism is located chiefly in the 
muscles of the back, and in bronchitis and constitutional chronic catarrh, 
especially in the aged. 
JUGLANS. 
The bark of the root of Juglans cinerea, Linn6, collected .in the autumn (Nat. Ord. 
Juglandaceae). A forest tree of North America. 
Common Names: Butternut, White Walnut. 
Principal Constituents.-A fixed oil, and orange-yellow juglandic acid, a body closely 
resembling chrysophanic acid. 
Preparations.-1. Specific Medicine Juglans. Dose, 1 to 30 drops. 
2. Extractum Juglandis, Extract of Butternut. Dose, 1 to 30 grains (usually 1 to 
5 grains). 
Specific Indications.-Chronic constipation; gastro-intestinal irrita- 
tion, with sour eructations, flatulence, and either diarrhoea or constipation 
dependent thereon; diarrhoea and dysentery with tenesmus and burning 
and fetid discharges; hepatic torpor; chronic pustular or vesicular skin 
disease, discharging freely; eczema. 
Action and Therapy.-In small doses juglans is a mild intestinal 
stimulant and laxative; in large doses it is emeto-cathartic. It also possesses 
alterative properties. As a laxative its action is kindly, rarely producing 
griping or after-debility, and resembling that of rhubarb, but it does not 
produce subsequent constipation. Being a mild gastric stimulant it is 
often of service in gastric irritation and atonic dyspepsia, and in indigestion 
with deficient glandular secretion, sour eructations and flatulent distention. 
These conditions are often accompanied by a burning and tenesmic diar- 
rhoeal or dysenteric discharge. Laxative doses of juglans relieve the latter 
annoyances. A full laxative dose of extract of butternut was a favorite 
early-day treatment of malarial infection or "ague" in the western States, 
where the pioneers also used it successfully for rheumatic pain in the 
back-probably lumbago due to overloaded intestines. For these purposes 
it is now a neglected medicine. 
Juglans has a specific action upon skin disorders of a pustular or 
vesicular type, and especially those that are eczematous or related in any 
measure to a strumous diathesis. The dose need not be sufficient to 
produce free bowel action, but should be large enough to induce some 
intestinal secretion. Small doses of the specific medicine (1 to 5 drops) are 
438 INDIVIDUAL DRUGS. 
best for this purpose. As a laxative the extract is preferable, in doses 
of 1 to 5 grains; sometimes up to 30 grains. 
JUNIPERUS. 
The fruit (berries) of the Juniperus communis, Linne (Nat. Ord. Coniferae). An ever- 
green tree of Europe and America. 
Common Names: Juniper, Juniper Berries. 
Principal Constituents.-A volatile oil (Oleum Juniperi) and an amorphous body, 
juniperin. 
Preparations.-1. Infusum Juniperi, Infusion of Juniper (Berries, 3 j; Boiling Water, 
Oj; let stand one hour). Dose, 2 to 4 fluidounces. 
2. Oleum Juniperi, Oil of Juniper. Colorless, faintly green or yellow oil of the juniper 
taste and odor. It should be kept protected from light in amber-hued bottles and in a cool 
place. Dose, 2 to 15 minims. 
3. Spiritus Juniperi, Spirit of Juniper (5 per cent oil). Dose, 5 to 60 minims. 
4. Spiritus Juniperi Compositus, Compound Spirit of Juniper (Oils of Juniper, Cara- 
way, Fennel, Alcohol, and Water). Dose, 1 to 4 fluidrachms. 
Specific Indications.-Renal atony with catarrhal and pus discharges; 
non-inflammatory irritability of the neck of the bladder. 
Action and Therapy.-Juniper is a gastric stimulant and a stimulating 
diuretic to be used in atonic and depressed conditions, usually in chronic 
affections of the kidneys and urinary passages with catarrhal or pus-laden 
discharges. It is especially valuable in renal atony in the aged, with per- 
sistent sense of weight and dragging in the lumbar region. In uncomplicated 
renal hyperaemia or congestion, when the circulation is weak and no fever 
or inflammation is present, the careful use of juniper will relieve, and if 
albumen is present it may disappear under its use. It is often of great 
value in chronic nephritis, catarrh of the bladder, and chronic pyelitis to 
stimulate the sluggish epithelia and cause a freer flow of urine to wash 
away the unhealthy secretions. It is sometimes of value after scarlet fever 
or in the late stages when the kidneys are not yet inflamed, and after acute 
nephritis when the renal tone is diminished and secretion of urine is im- 
perfect. Under no circumstances should it be used when there is active 
inflammation. The infusion is extremely useful in irritation of the bladder 
with recurrent attacks of distressing pain and frequent urination in women 
during the menopause and apparently due to taking cold. The infusion of 
juniper is the best preparation for most purposes. A pint may be taken in 
a day. When an alcoholic stimulant is needed in the above-named condi- 
tion the spirit or compound spirit may be used. The oil is often efficient in 
non-inflammatory prostatorrhoea and gleet. Juniper preparations are 
frequently exhibited in chronic structural diseases of the heart, liver, and 
kidneys, to stimulate the sound tissues to functionate and relieve the 
attendant dropsy. Usually they are combined with agents like citrate or 
acetate of potassium or with spirit of nitrous ether. In these conditions 
they must be used with judgment and caution. No preparation of juniper 
should be given in doses larger than recommended above, as suppression 
of urine, strangury, haematuria, or even uraemic convulsions may result 
from its use. 
439 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
KALMIA. 
The leaves of Kalmia latifolia, Linne (Nat. Ord. Ericaceae). A beautiful shrub of 
mountains and damp situations in the United States. 
Common Names: Mountain Laurel, Laurel, Sheep Laurel, Lambkill, etc. 
Principal Constituents.-A neutral, poisonous principle, andromedotoxin (CjiHsiOw), 
arbutin, resin, and tannin. 
Preparation.-Specific Medicine Kalmia. Dose, 1 to 20 drops. 
Specific Indications.-Fugitive rheumatic pains; aching pain in the 
back; pain upon movement of the eyeballs; excited circulation; cardiac 
palpitation reflex from gastro-intestinal irritation; chronic syphilitic 
cachexia. 
Action and Therapy.-King valued kalmia in constitutional syphilis, 
with excited heart-action and rapid circulation. Being a sedative it is said 
to allay fever and inflammation, and it is credited with power to relieve 
symptoms due to cardiac hypertrophy. It is also a remedy for aching pain, 
shifting rheumatic pain, aching pain in the back during menstruation, and 
ocular pain upon movement of the eyes. Palpitation of the heart excited 
reflexly by gastro-intestinal disturbances is sometimes relieved by it. 
It is said to be most valuable when the disorders above mentioned are 
associated with a syphilitic taint. Kalmia has never obtained a very 
important place in medicine, though it possesses strongly toxic properties. 
KAMALA. 
The glands and hairs from the capsules of Mallotus philippiensis (Lamarck), Muller 
Arg. (Nat. Ord. Euphorbiaceae). A small Asiatic, African, and Australian tree. Dose, 
30 to 60 grains. 
Common Names: Kamala, Kameela, Spoonwood. 
Principal Constituent.-Rottierin or kamalin, a crystalline principle. 
Preparation.-Specific Medicine Kameela. Dose, 30 to 60 drops. 
Action and Therapy.-In doses of 2 to 4 drachms kamala purges, with 
griping, nausea and vomiting, and the production of four to fifteen evacua- 
tions. The alcoholic preparations act more kindly and uniformly. Its 
chief use is that of a taenicide expelling the tape-worm entire, but with 
such force that the head sometimes remains. Full doses of the specific 
medicine should be given every three hours until five or six doses have 
been taken. It also expels lumbricoids and ascarides. 
KINO. 
The self-dried juice of Pterocarpus Marsupium, Roxburgh (Nat. Ord. Leguminosae). 
A tree of the mountains of the Malabar coast of Hindustan. Dose, 10 to 30 grains. 
Common Names: Kino, Gum Kino. Synonym: Resina Kino. 
Principal Constituents.- Kinotannic acid (75 per cent), kinoin, pyrocatechin, kino-red, 
and gum. 
Preparation.- Tinctura Kino, Tincture of Kino. Dose, 1 to 2 fluidrachms. 
Action and Therapy.-External. Sometimes used as an astringent 
wash in soreness and relaxation of the uvula and the pharynx, and as an in- 
jection in leucorrhoea and gonorrhoea; also as a stimulating application to 
indolent ulcers. 
Internal. A good astringent for pyrosis and chronic serous diarrhoea 
and that occurring in opium habitues, and in the diarrhoea of phthisis. 
440 INDIVIDUAL DRUGS. 
The seeds of Sterculia acuminata, Palisot de Beauvais (Nat. Ord. Sterculiaceae). A tree 
of western Africa. Dose, 5 to 30 grains. 
Common Names: Kola, Kola Nut, Female Kola, Cola, Bissy-Bissy. 
Principal Constituents.-Caffeine (theine) 3 per cent, and a small amount of the- 
obromine, kola-red, and kolatannic acid. 
Preparation.-Fluidextractum Kola, Fluidextract of Kola. Dose, 5 to 30 drops. 
Specific Indications.-Nervous and muscular depression with cerebral 
anemia. 
Action and Therapy.-The physiological action of kola closely dupli- 
cates that of caffeine and the caffeine-bearing drugs. It is, therefore, a 
remedy for muscular and nervous depression due to cerebral and spinal 
anemia. It is useful in hysteria, mental gloom, neurasthenia, and the 
diarrhoea of debility. It may be used in acute alcoholism, but is of no value 
in chronic inebriation, and it sustains one attempting to break away from 
the tobacco-habit. It relieves nervous irritability of the stomach, often 
checking the nausea of pregnancy and the vomiting of seasickness. Its 
action in chronic diarrhoea must be due to its power over irritation, as 
there is not sufficient tannin in the drug to cause much astringency. Like 
caffeine it is useful in the neuralgia of debility, in migraine, smoker's heart, 
and cardiac irritability. These are all cases needing stimulation and of 
the cerebral anemic type. The chief indications for it are difficult breath- 
ing, irregular heart action, and valvular insufficiency. After long spells of 
illness it may be used when there is mental depression, tendency to faint, 
poor appetite and digestion, great nervous irritability, and profound 
muscular debility. 
KOLA. 
KRAMERIA. 
The root of Krameria triandra, Ruiz et Pavon, and of Krameria Ixina, Linne (Nat. 
Ord. Polygalaceae). Small suffruticose plants of South America and the West Indies. Dose, 
10 to 30 grains. 
Common Names: Rhatany, Ratanhia. 
Principal Constituent.-Ratanhia-tannic acid (krameria-tannic acid), an amorphous 
red powder present to the extent of 8 to 18 per cent. 
Preparations.-1. Specific Medicine Krameria. Dose, 10 to 60 drops. 
2. Extractum Krameria, Extract of Krameria (Extract of Rhatany). Dose, 10 to 
20 grains. 
Action and Therapy.-External. Astringent and hemostatic. A 
splendid agent alone or with myrrh, for spongy and bleeding gums and to 
preserve the teeth. In ointment it is a good application for bleeding piles, 
and in ulcer of the rectum and fissure of the anus. 
Internal. Tannin-bearing drugs often act better as astringents than 
tannin itself. Rhatany is one of these agents. It is powerfully astringent 
and somewhat tonic. Immoderate doses may induce constipation with 
slight dyspeptic symptoms. Internally it has been used in passive hemor- 
rhage, mucous and serous diarrhoeas, incontinence of urine, leucorrhoea, 
prostatorrhoea and colliquative sweating. It has been advised in the 
diarrhoea of opium habitues and in dyspepsia and gastric catarrh with full, 
relaxed skin. 
441 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
LACTUCARIUM. 
The dried or concrete milk-juice of Lactuca virosa, Linne (Nat. Ord. Compositae). 
South and Central Europe. Dose, 5 to 20 grains. 
Common Name: Lettuce Opium. 
Principal Constituents.-Lactucin (CnHuCX), lactucerin (lactucone), lactucopicrin, 
lactucic acid, and a comphoraceous volatile oil. 
Preparations.-1. Tinctura Lactucarii, Tincture of Lactucarium, (50 per cent strength). 
Dose, 30 to 60 drops. 
2. Syrupus Lactucarii, Syrup of Lactucarium (prepared from Tincture). Dose, 
fl 3 j to fl 3 iij- 
Action and Therapy.-A non-constipating calmative and feeble 
hypnotic, sometimes proving useful in insomnia from mental overwork and, 
as a syrup, in the cough of phthisis. Even garden lettuce (Lactuca sativa) 
relieves irritation of the broncho-pulmonic membranes and has a tendency 
to induce drowsiness. Lactucarium is often inert; when a good preparation 
can be obtained it is fairly sedative for irritable children. 
LAPPA. 
The root and seeds of Arctium Lappa, Linne (Nat. Ord. Compositae). Europe, Asia, 
and America. Dose, 5 to 60 grains. 
Common Name: Burdock. 
Principal Constituents.-The glucoside lappin, fixed oil, inulin, and an altered tannin 
called phlobaphene. 
Preparations.-1. Specific Medicine Lappa. Dose, 1 to 60 drops. 
2. Tinctura Lappa Seminis, Tincture of Lappa Seeds, (Seed, giv; 75 per cent 
Alcohol, Oj.) Dose, 1 to 60 drops. 
Specific Indications.-Feeble cutaneous circulation; dry, scaly skin 
eruptions; aphthous ulcers; recurrent boils and styes; urinary irritation; 
psoriasis. 
Action and Therapy.-Lappa is a potent but neglected alterative and 
diuretic. It relieves urinary and bronchial irritation, favors the elimination 
of waste material, and secondarily proves tonic. Lappa is especially valu- 
able in psoriasis, crusta lactea, stubborn eczema, obstinate ulcers, and in 
catarrhal and aphthous ulcerations. It is one of the best of agents for 
recurrent boils and styes. Bronchial cough, with much irritation of the 
pulmonary tract, is relieved by it, and it is sometimes beneficial in dyspepsia 
due to irritation of the stomach in cachectic individuals. As it gently 
stimulates the kidneys and promotes waste it should be largely used in 
strumous and cachectic conditions, with tendency to dry, scaly, cutaneous 
eruption and low grades of cellular inflammation, with feeble circulation 
in the skin. 
LAVANDULA. 
The flowers of Lavandula vera, De Candolle (Nat. Ord. Labiatae). Dry sterile soils of 
mountainous elevations in southern Europe and northern Africa; cultivated in the United 
States. 
Common Names: Lavender, Lavender Flowers. 
Principal Constituents.-A volatile oil (Oleum Lavandulae) containing linaolool acetate, 
linalool (CioHuO) and cineol or eucalyptol. 
Preparations.-1. Spiritus Lavandula, Spirit of Lavender (5 per cent oil). Dose, 
10 to 60 minims. 
2. Tinctura Lavandula Composita, Compound Tincture of Lavender. (Compound 
Spirit of Lavender.) (Contains Oil of Lavender, Oil of Rosemary, Clove, Myristica, 
Saigon Cinnamon, Red Saunders, Alcohol, and Water.) Dose, 10 to 60 drops. 
442 CULVER'S PHYSIC 
(Veronica virginica [Leptandra virginica]) 
Photo by Frank H. Shoemaker, 
Lincoln, Nebraska 
Courtesy of Prof. Rufus A. Lyman, 
University of Nebraska 
No reference to early Eclectic drugs would be complete without mention of Culver's Root 
(Leptandra). From it John King isolated "leptandrin," one of the few good "resinoids." 
The latter was for many years popular as a cathartic, but is seldom so employed at the present 
time. Indeed, leptandra is but a landmark in early domestic and Eclectic therapy. INDIVIDUAL DRUGS. 
Action and Therapy.-External. Spirit of lavender is an agreeable and 
soothing lotion for the headache of debility and in fevers. The compound 
tincture is frequently added to carbonate of ammonium, and constitutes 
"smelling salts" for the relief of headache and tendency to fainting. 
Internal. Oil of lavender, the spirit and the compound tincture are 
delightful stimulants and carminatives. They are extensively employed to 
allay gastric uneasiness and nausea, in flatulent colic, hysteria, nervous 
debility, general languor and tendency to fainting. For nervous and weak 
individuals, who faint easily and are prone to hysterical seizures, they are 
simple and safe preparations. The compound tincture is added to many 
mixtures to give color, and all of the lavender preparations are used as cor- 
rigents and adjuvants of less agreeable medicines. Scudder valued the 
compound tincture in nervous irritability in children, and incorporated it 
in a "soothing syrup" described under Cypripedium, which see. 
LEONURUS. 
The tops and leaves of Leonurus Cardiaca, Linne (Nat. Ord. Labiatae). Asia, Europe, 
and common in the United States. 
Common Name: Motherwort. 
Principal Constituents.-Resins, a bitter principle, and probably an alkaloid. 
Preparation.-Infusum Leonuri, Infusion of Leonurus. (3j to Water, Oj). Dose, 2 
to 4 fluidrachms. 
Action and Therapy.-A simple emmenagogue and antispasmodic, 
evidently having considerable control over the nervous system. It has 
been advised in nervous debility with irritation and unrest, tendency to 
choreic movements or spasms, pelvic and lumbar uneasiness and pain, 
and in bearing-down pains and the discomforts incident to debility of the 
female reproductive organs. A warm infusion may be used in amenorrhoea, 
and King praised it for the restoration of suppressed lochia. It deserves 
restudy to determine its value in nervous affections. 
LEPT ANDRA. 
The rhizome and rootlets of Veronica virginica, Linne (Leptandra virginica, Nuttall), 
(Nat. Ord. Scrophulariaceae). A tall perennial plant indigenous to the eastern half of the 
United States. Dose, 10 to 60 grains. 
Common Names: Culver's Root, Black Root, Culver's Physic, Bowman Root, Tall 
Speedwell, etc. 
Principal Constituents.-A resinoid called leptandrin, formerly used but now largely 
discarded by Eclectic practitioners, and a bitter principle. 
Preparation.-Specific Medicine Leptandra. Dose, 1 to 60 drops. 
Derivative.-Leptandrin (Resinoid). Dose, \/^ to 2 grains. ' 
Specific Indications.-Tenderness and heavy pain in the region of the 
liver, with drowsiness, dizziness, and mental depression; skin, yellow; 
tongue coated white; bitter taste, nausea, frontal headache and cold ex- 
tremities; thirst with inability to drink; diarrhoea with half-digested 
passages, or clay-colored stools; enfeebled portal circulation, with lassitude, 
gloom, and mental depression. 
Action and Therapy.-Leptandra is a gastro-hepatic and intestinal 
stimulant. The fresh root is viciously cathartic and has produced bloody 
stools and abortion. Drying, however, deprives the drug of its drastic 
443 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
quality and it becomes a safe cholagogue, laxative, and cathartic. Ap- 
parently in ordinary doses it strengthens the functional activity of the 
intestinal glands, does not debilitate nor produce large stools, and if the 
circulation is feeble, with a tendency to stasis, it has a decidedly tonic effect- 
Leptandra is a remedy for intestinal atony-especially duodenal 
atony associated with hepatic torpor. It has been employed in dysentery 
and chronic diarrhoea, dependent upon constipation of the upper bowel, or 
upon imperfect elaboration of the food. These cases are accompanied by 
dizziness, headache, visceral pain, mental depression and cold extremities. 
In atony of the stomach and liver with the preceding and the following 
symptoms it is decidedly stimulant and tonic. There is a dry, hot skin, with 
cold feet, abdominal plethora, pale, white coated or furred broad and thick 
tongue, heavy or dull aching in the hepatic region and the left shoulder, and 
a bitter, disagreeable taste. In fact with any of the preceding symptoms- 
and yellowness of the skin and conjunctiva and nausea, leptandra will 
prove very useful in atonic dyspepsia, acute hepatitis, acute duodenal 
catarrh, diarrhoea of half-digested aliment, muco-enteritis, and chronic 
enteritis. It will be evident from the guides given that leptandra is a remedy 
for the complex known as "biliousness". It aids chionanthus, and some- 
times podophyllin to dissipate jaundice. In the early period of Eclectic 
medicine it was valued in typhoid fever, when ushered in with constipation 
and before marked involvement of Peyer's patches had become established- 
It is questionable whether any laxative should be resorted to in such 
conditions-an enema is to be preferred. But for pre-typhoid symptoms, 
not amounting to enteric fever, its use is justifiable and even beneficial. 
Leptandra is better as a laxative in malarial fever and prepares the system 
for the more kindly reception of antiperiodic medication. It is no longer 
employed in anasarca and ascites, better agents having supplanted it- 
It is a good medicine and its field of usefulness has narrowed down to 
gastro-hepato-duodenal atony, and attendant or resulting disorders, in 
which it proves an admirable stimulant and corrective. It acts well with 
hydrastis, podophyllum, chionanthus, dioscorea, or chelidonium when these 
are also indicated. It is especially valuable in the diarrhoea of dentition. 
The nervous irritability may be controlled with matricaria and the follow- 
ing administered: I| Compound Syrup of Rhubarb and Potassa, flSiij; 
Specific Medicine Leptandra, fl3j. Mix. Ten to 20 drops every hour until 
the diarrhoea ceases. Glyconda may be substituted for the neutralizing 
cordial, if sugar is contraindicated. 
LEUCANTHEMUM. 
The whole plant of Chrysanthemum Leucanthemum, Linne (Nat. Ord. Composita). 
Introduced into America from Europe. 
Common Names: Ox-eye Daisy, Field Daisy. 
Principal Constituents.-Probably an acid, aromatic, volatile oil, and a bitter principle- 
Preparation.-Infusum Leucanthemi, Infusion of Leucanthemum. Dose, freely. 
Action and Therapy.-An infusion of leucanthemum is tonic and should 
be considered in cases of colliquative sweating in which it is not desirable 
to use the active antihydrotics, as atropine, muscarine, or camphoric acid. 
444 INDIVIDUAL DRUGS. 
The rhizomes of several species of Liatris (Nat. Ord. Compositse). Middle and southern 
United States. Dose, 10 to 60 grains. 
Common Names: Button Snake Root (L. spicata); Blazing Star (L. squarrosa); 
Gay Feather (L. scariosa); Deer's Tongue (L. odoratissima). 
Principal Constituents.-Resins, volatile, bitter principle, and in some coumarin 
(QH«O2), a principle having a vanilla odor. 
Preparation.-Infusum Liatridis, Infusion of Liatris(gj toOj). Dose, 1 to 4 fluidounces. 
Action and Therapy.-This drug is stimulant, bitter tonic, diuretic, 
and emmenagogue. It is sometimes used as a gastric tonic in dyspeptic 
conditions associated with renal inactivity. Rarely it is used to relieve 
pain in spasmodic bowel complaints and colic in children, in backache in 
adults, and to relieve dysmenorrhoea. It is seldom employed. Button 
snake root derives its name from its traditional Indian reputation as a local 
alexipharmic (freshly-bruised root) for rattle-snake bite, a myth, it is 
needless to say, as yet unverified. 
LIATRIS. 
LIGUSTRUM. 
The bark and leaves of Ligustrum vulgare, Linne (Nat. Ord. Oleaceae). A beautiful 
shrub in woods and thickets in the eastern half of the United States; also cultivated. 
Dose, 10 to 60 grains. 
Common Names: Privet, Privy, Prim. 
Principal Constituents.-The glucoside ligustrin (syringin), a bitter crystalline body, 
Ugustron, and an amorphous bitter, syringopikrin. 
Preparation.-Decoctum Ligustri, Decoction of Privet (5j to Water, Oj). Dose, 
1 to 4 fluidounces. 
Specific Indications.-Aphthous sore mouth; relaxed sore throat. 
Action and Therapy.-External. Next to coptis the most useful 
application for thrush in infants and of value in pallid sore throat with 
tissue relaxation, and in aphthous sore mouth. 
Internal. An astringent tonic of much value in ulcerative and catarrhal 
conditions of the mucous membranes of the stomach, bowels, and renal 
tract. 
The whole plant of Lilium tigrinum (Nat. Ord. Liliaceae). Native of Japan and China, 
but largely cultivated. 
Common Name: Tiger Lily. 
Preparation.-Specific Medicine Tiger Lily. Dose, 1 to 10 drops. 
Action and Therapy.-This remedy has been acquired from Home- 
opathy and is reputed slowly effective in controlling uterine irritation and 
congestion, being employed also to allay the nausea of pregnancy and of 
uterine irritability, in congestive dysmenorrhoea, and chronic ovarian 
neuralgia with darting, burning pain in the ovaries. It is also said to be 
of service when pelvic weight and prolonged lochia accompany a tardy 
recovery from parturition and in the bearing-down discomfort incident 
to prolapsus uteri. 
LILIUM. 
445 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
LIMON. 
The juice and outer rind of the fresh ripe fruit of Citrus medica Limonum (Risso), 
Hooker filius (Nat. Ord. Rutaceae). Northern India, and cultivated in subtropical countries. 
Common Name: Lemon. 
Principal Constituents.-A pale-yellow or greenish-yellow, fragrant oil (Oleum Li- 
monis); and a bitter principle, hesperidin (C22H26O12). 
Preparations.-1. Limonis Succus, Lemon Juice. This may be prepared by slightly 
boiling strained lemon juice to remove mucilage, etc., and pouring it into previously 
sterilized bottles filled to the neck; fill the neck with pure olive, sweet, or almond oil, and 
cork tightly. Keep the bottle in an upright position. This, while slightly bitter, will keep 
for several weeks. Another method is to add 10 per cent of brandy to the strained juice. 
Dose, 1/2 to 4 fluidounces. 
2. Limonis Coxtex, Lemon Peel. A flavoring agent only. 
3. Oleum Limonis, Oil of Lemon. Pale-yellow or greenish, having the taste and 
odor of lemon peel. If it has the odor of turpentine it should not be used. Average Dose, 
1 to 5 minims. 
Specific Indications.-Elongated, reddened tongue with prominent 
papillae; scorbutus; fevers with red, long tongue; excessively red, inflamed 
surfaces in inflammatory rheumatism, with alkaline urine and long, red 
tongue, thinly coated white. 
Action and Therapy.-Lemon juice and citric acid (see also Acidum 
Citricum) are the best known prophylactics and curative remedies for 
scurvy (scorbutus). The juice may be given in doses of 1/2 to 2 ounces 
a day as a preventive, and in doses of 2 to 4 ounces, three times a day, as 
a cure. The action of lemon juice and citric acid is not exactly identical, 
probably owing to the presence in the former of mucilage and citrate of 
calcium, but for most purposes requiring the acid, lemon juice is used and 
preferred. For preparation of the juice for long voyages, see above {Prepara- 
tions). Diluted lemon juice may be used in obstinate hiccough, hepatic 
torpor and acute jaundice when the tongue is red and the urine alkaline. 
Under like conditions it is useful in acute articular rheumatism when the 
parts inflamed are deeply red and the general indications for acids are 
present. Lemon juice upon sugar will alleviate distressing cough, es- 
pecially a persistent explosive cough, with spasmodic contraction of the 
throat upon lying down; when relief comes a slight translucent, jelly-like 
mass is expectorated. Lemonade is a delightfully refreshing refrigerant 
drink for fever patients when acids are indicated and bowel conditions will 
permit the use of large quantities of acidulated fluid. It also sometimes 
relieves sick headache, and a hot lemonade is a popular remedy to break up 
a "cold". 
LINUM. 
The ripe seeds of Linum usitatissimum, Linne (Nat. Ord. Linacese). Levant and south- 
ern Europe; cultivated. 
Common Names: Flaxseed, Linseed. 
Principal Constituents.-Mucilage, a fixed, viscid oil (Oleum Lini), proteids (25 per 
cent), and a minute trace of amygdalin. 
Preparations.-1. Oleum Lini, Linseed Oil, (Oil of Flaxseed, Raw Linseed Oil). A 
yellowish oil of a bland taste and peculiar odor, gradually thickening and darkening in 
the air and acquiring a strong taste and odor. Dose, 1/2 to 1 fluidounce. Raw (not boiled) 
oil only should be used. 
2. Farina Lini, Linseed Meal, (Flaxseed Meal). For poultices. 
Action and Therapy.-External. Flaxseed and its oil are emollient. 
A flaxseed poultice (Cataplasma Lini) applied early upon inflamed and 
446 INDIVIDUAL DRUGS. 
painful surfaces will relieve pain, cause relaxation, and sometimes resolu- 
tion. If applied after pus begins to form it will hasten suppuration. Deep- 
seated inflammation can often be aborted by the judicious use of a flaxseed 
poultice. The danger of favoring sepsis when used upon open or abraded 
tissues should be borne in mind. Equal parts of linseed oil and lime water 
form Carron Oil, the best primary dressing for burns and scalds (see Aqua 
Calcis). Linseed meal added to the wash water will assist in removing 
the odor of iodoform from the hands. 
Internal. An infusion of the seeds (gss to Boiling Water, Oj) is an 
excellent demulcent forming a pleasant mucilaginous drink for inflamed or 
irritated membranes. It is especially useful in gastro-intestinal and renal 
inflammations, and as a lenitive after acute poisoning by irritants. The 
addition of licorice root or lemon juice and sugar makes of the foregoing 
an agreeable linctus for irritative coughs and acutely inflamed bronchial 
mucous membranes. Linseed oil is a good laxative and is sometimes used 
as an enema to remove ascarides. Hemorrhoids have been cured by the 
laxative influence of linseed oil given in daily repeated doses of 1 to 2 ounces. 
Linseed oil may be given freely in poisoning by alkalies, when other bland oils 
are not at hand. 
LIQUIDAMBAR. 
The balsamic exudate or concrete juice of Liquidambar styraciflua, Linne (Nat. Ord. 
Hamamelacese). The sweet-gum tree of the United States, Mexico, and Central America. 
Common Name: Sweet Gum. 
Description.-An opaque, almost black, soft, adhesive, resinous mass, or hard masses 
breaking with a resinous fracture, of the pleasant odor of benzoin, and a bitterish, pungent, 
benzoinic taste. It softens in warm weather; becomes hard in cold weather. Soluble in 
alcohol, ether, chloroform, and fats and oils. Dose, 1 to 15 grains. 
Principal Constituents.-The resin styrol, cinnamic acid, styracin, and storesin, a com- 
plex alcohol. 
Action and Therapy.-External. King highly valued an ointment of 
liquidambar and lard or tallow, equal parts, as a softening and antiseptic 
application to ulcers and in anal fistulae with indurated edges, and especially 
for indolent ulcers and old sores upon the legs. Like many balsamic 
preparations it is said to benefit in parasitic skin diseases, as ringworm of 
the scalp and porrigo scutulata. It is also reputed to give relief in hemor- 
rhoids. It should be tried in anal fissure, as it acts without causing pain. 
To render it more efficient, though probably at the risk of causing some pain, 
we would suggest the addition of a small amount of salicylic acid. 
Internal. Like most balsams it is effectual in chronic coughs and 
catarrhs. 
Solution of Ammonium Acetate, Spirit of Mindererus. 
Description.-A clear, mildly saline and acidulous liquid, without color, free from 
empyreuma, and acid in reaction. It should be freshly prepared. It should contain at 
least 7 per cent of ammonium acetate, with a small proportion of acetic and carbonic acids. 
To prepare it: 5 parts of good, heavy, translucent lumps of ammonium carbonate are to 
be added to 100 parts of diluted acetic acid and stirred until dissolved. The dose is 1 to 6 
fluidrachms. It is usually dispensed, for use with children, with an equal amount of simple 
syrup, and given in doses of 1 to 2 fluidrachms. 
Specific Indications.-Impaired capillary circulation, with tardy 
eruption in the exanthemata; acute alcoholism; sick headache with 
depression. 
LIQUOR AMMONII ACETATIS. 
447 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-External. Applied upon compresses, solution of 
ammonium acetate sometimes gives relief in the early stage of mammitis, 
orchitis, epididymitis, mumps, and to resolve glandular engorgement. 
Internal. This solution is refrigerant in small doses, and diaphoretic 
and diuretic in large doses, the latter properties being increased by its 
combination with spirit of nitrous ether. It is sometimes useful in fevers 
and inflammations, when temperature is not very high. Its chief value, 
however, is in the exanthems when the circulation is feeble and the eruption 
tardy, while in the declining stages, with depression of the nervous system, 
dry skin, and renal inactivity, it may be given in half-drachm doses to re- 
establish secretion. We value it greatly in measles for these purposes and 
to alleviate the dry cough and liquefy the bronchial secretions. It is a 
useful stimulant where alcohol cannot be tolerated, and when such stimulus 
is needed in the stage of depression in typhoid and other low fevers no safer 
agent can be used. It does not disturb the brain, but when operating 
kindly quiets delirium and permits sleep. In acute bronchitis and in 
broncho-pneumonia it ranks in efficiency with chloride of ammonium. In 
the initial stages of acute catarrh of the naso-bronchial tract and in in- 
fluenza to control cough and favor expection, drachm doses may be given 
every two or three hours. It is a popular and quite certain medicine to 
quickly sober a drunken individual, and for this purpose excels the other 
ammonium compounds. Two or three drachms should be given in a large 
quantity of water. An agreeable form of administration is equal parts of 
solution of ammonium acetate and syrup. 
LIQUOR FERRI ACIDI. 
Acid Solution of Iron (Howe's), Acid Iron. 
Description.-A clear, amber-colored solution, prepared by triturating in a mortar 
ferrous sulphate (2 parts) and adding water (10 parts) and nitric acid (1 part). It should 
not be heated. Owing to unexplainable changes which occur in its reactions, it is difficult 
to make successive batches of this solution having the same appearance and characteristics. 
It has a pleasantly acid, styptic and ferruginous taste. Dose, 2 to 5 drops. 
Specific Indications.-Pale, wax-like skin, with cherry-red mucous 
membranes. 
Action and Therapy.-There are many Eclectics, and we are among 
them, who still believe iron to be a useful hematinic. While iron has been 
needlessly and recklessly exploited and in many instances has thus been 
brought into discredit, yet there is no medicine capable of greater good if 
judiciously and specifically administered. Of all the preparations of iron- 
ferric and ferrous, scaled salts and so-called organic iron of more recent 
introduction-there is none, in our opinion, that meets the requirements 
for iron medication as fully as the acid solution of iron, devised and 
introduced by Howe. 
Acid solution of iron fulfills the uses of an acid and of iron. We find it 
invaluable in the debility following the stress of the winter season where 
simple anemia is marked. Pale, sallow girls with cherry red but unhealthy- 
looking lips, are especially the types largely benefited. During erysipelas 
and for the debilitv following an attack we value it above all other acents. 
448 INDIVIDUAL DRUGS. 
When specifically indicated it proves a good hematinic and restorative in 
chlorosis, anemia, chlorotic anemia, general debility, phthisis, after ex- 
haustive purulent discharges, and other wasting diseases, and in chronic 
catarrhal affections. It may be dispensed in bulk, with directions to give 
two drops in water every three or four hours. Those who prefer it sweetened 
may have it in syrup of orange so measured that a teaspoonful will carry 
two drops. A favorite prescription is: I| Acid Solution of Iron (Howe's), 
fl$j; Syrup of Orange, fl^iv. Mix. Sig.: One teaspoonful preferably 
before meals and at bedtime. (The syrup of orange we prefer is that made 
by adding a fluidrachm of a hydro-alcoholic tincture of orange oil prepared 
by macerating the freshly-peeled outer rind of the sweet orange in equal 
parts of alcohol and water. It does not acquire a turpentine-like taste 
when added to acid medicines as does the syrup prepared from commercial 
oils of orange.) We also find acid solution of iron to be a good adjuvant to 
nux vomica or strychnine and to quinine, which may be dissolved in it, 
and to Fowler's Solution, converting the arsenic into a soluble acid prepara- 
tion. 
LIQUOR FERRI CHLORIDI. 
Solution of Ferric Chloride, Solution of Iron Perchloride. 
Description.-A reddish-brown liquid of acid reaction, an acid, strongly styptic taste, 
and a faint odor of hydrochloric acid. Dose, 1 to 10 minims, well diluted. 
Action and Therapy.-External. This is a powerful styptic for 
localized hemorrhages due to accident or to operations, though it is only 
used where no other means can be devised, as when pressure or ligature can- 
not be applied. A 3 to 5 per cent solution may be employed. It has been 
effectively used in uterine hemorrhage, but not always with safety. It 
should only be employed as a last resort. It is better adapted to bleeding 
after the removal of tonsils, though adrenalin and similar bodies have now 
largely displaced its use. It should be remembered, however, for such an 
emergency and where other hemostatics fail. Chloride of iron will remove 
dense, confluent granulations from the tympanum with less pain than is 
occasioned by silver nitrate. It may also be used diluted for diphtheria, 
rectal prolapse, sweating feet, chilblains, ivy poisoning, chancre, fetid and 
weeping ulcers, and gangrene. 
Loeffler's Solution, used very extensively as an antiseptic application 
to the throat in diphtheria and other forms of infectious sore throat, is 
composed of Menthol (10 parts), Solution of Ferric Chloride (4 parts), 
Alcohol (60 parts), and Toluol, q. s., to make 100 parts. Apply it to the 
affected part with a cloth- or cotton-tipped probang, or by means of an 
atomizer, every three or four hours. 
Internal. Solution of Chloride of Iron is seldom used internally, the 
tincture being preferred. However, in intractable colliquative and choleraic 
diarrhoea it is sometimes useful; and to control hematemesis. From 5 to 
10 drops, very largely diluted, may be employed as needed. Its internal 
use is of little value in hemorrhages below the stomach, for it is largely com- 
bined with the albumen of the food, which destroys its hemostatic power. 
It has been used with asserted benefit in pharyngeal diphtheria, both as an 
internal and topical medicine. 
449 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
LIQUOR FERRI ET AMMONII ACETATIS. 
Solution of Iron and Ammonium Acetate, Basham's Mixture. 
Description.-An aromatic, red-brown, sweetish-saline liquid, having a faint after- 
astringency. It is composed of Tincture of Chloride of Iron, Dilute Acetic Acid, Solution 
of Ammonium Acetate, Aromatic Elixir, Glycerin, and Water. Preferably Basham's 
Mixture should be freshly prepared when needed. Dose, 1 to 4 fluidrachms, well diluted 
with water. 
Action and Therapy.-Diaphoretic and diuretic. A popular remedy for 
the anemia of both acute and chronic interstitial nephritis; some believe 
it most efficient in tubular nephritis. 
LIQUOR FERRI SUBSULPHATIS. 
Solution of Ferric Subsulphate, Monsel's Solution, Solution of Basic Ferric Sulphate. 
Description.-A deep, reddish-brown, odorless or nearly odorless liquid, of acid 
reaction, and strongly acid and styptic taste. It mixes with water and alcohol without 
decomposing. Dose, 2 to 10 minims. 
If this solution be evaporated near escaping steam a light yellow mass is left behind, 
which, when reduced to a powder, is known as Monsel's Salt. It is a styptic and is used 
for the same purposes for which the solution is employed. 
Action and Therapy.-External. A powerful but almost unirritating 
coagulant of blood and albumen. It produces a voluminous clot, which 
continues to enlarge for hours after its application, and becomes hard and 
firm. It is employed chiefly upon superficial wounds, when it instantly 
stops bleeding, and in hemorrhages of the mouth, nose, and throat, and after 
operations upon these parts, where it is impossible to apply pressure or to 
ligate the vessels. Like all the iron styptics it produces unpleasant irrita- 
tion of the nose when used in epistaxis. A better procedure, if possible, 
is to plug the nostrils with plain sterile gauze. Gangrene has followed the 
local application of iron subsulphate in rare instances. Like solution of 
perchloride of iron it has been used in alarming uterine hemorrhage, but is 
never a safe agent for that purpose. 
Monsel's Salt is very deliquescent and may be used, like the solution, 
as a styptic. 
Internal. Subsulphate of iron is seldom used internally. In 1 to 5 
drop doses, well diluted, it may be given to check hematemesis. 
LIQUOR FERRI TERSULPHATIS. 
Solution of Ferric Sulphate, Solution of Tersulphate of Iron. 
Description.-A nearly odorless, deep yellowish-brown fluid, acid in reaction, and 
having a sour and strongly styptic taste. It mixes with water and alcohol in all amounts 
without change. Dose, 3 to 10 drops. 
This solution should be kept on hand for the preparation of the antidote to arsenic. 
Action and Therapy.-External. A fairly unirritating styptic, when 
well diluted, which may be used to control bleeding from small surfaces. 
A pledget of cotton saturated with it may be pushed up in the nostril to the 
bleeding surface to stop epistaxis; or it may be used as a spray. Like all 
iron styptics it is less desirable than plugging the nose with gauze, because 
of the hardness of the clot formed, and subsequent irritation and danger of 
sepsis from decomposition of blood and mucus. 
Internal. May be used in doses of 5 to 15 drops, well diluted, in 
hemorrhage from the stomach, and in the same dilution, by injection, for 
bleeding from the rectum. 
450 INDIVIDUAL DRUGS. 
LIQUOR FORMALDEHYDI. 
Solution of Formaldehyde. 
An aqueous fluid containing not less than 37 per cent, by weight, of CH2O or H.CHO, 
with varying quantities of methyl alcohol to prevent chemical changes. It must be kept 
protected from light in a moderately warm situation. 
Description.-A transparent, colorless or nearly so, irritating and irrespirable fluid, 
pungent to the nostrils and caustic to taste. It mixes with water and alcohol. Upon long 
standing in the cold it may become cloudy. 
Action.-Formaldehyde destroys low forms of life, as bacteria and 
spores, probably by uniting with the amides of protein substances. Un- 
fortunately it has no lethal action upon bedbugs, lice, roaches, and fleas, 
though it renders the atmosphere uncomfortable for mosquitoes, moths, 
and flies. It hardens histological specimens without destroying their cell 
formation or causing them to become brittle, or to refuse to take stains. 
Milk is preserved by very weak dilutions (1 to 32000), and slightly stronger 
solutions prevent the growth of the yeast plant. The urine passed by one 
who has taken minute quantities of formaldehyde or formaldehyde-liberat- 
ing compounds will remain undecomposed for several days. Applied to the 
skin it causes no discomfort to speak of, but, like phenol, it leaves the 
surface roughish white, and after a while, insensitive. Its vapor, even in 
minute quantity, is extremely pungent, causing respiratory irritation, with 
pain, sneezing, and lacrimation. Its internal effects are not well estab- 
lished, except that it deodorizes the excretions and produces a sort of 
intoxication. Some believe it poisons the blood, disturbing the balance 
and chemistry of the red corpuscles. It is largely, if not wholly, excreted 
in the urine. 
Uses as a Disinfectant.-Formaldehyde gas, on account of its anti- 
bacterial and germicide power, has been of late years the most extensively 
used house, furniture, garment, and fabric disinfectant. Its vapor is so diffus- 
ible that it reaches every crack and cranny, and may be used where mercuric 
chloride or phenol cannot be made to reach, and where sulphur and chlorine 
are destructive. While much investigation has been carried on to de- 
termine its penetrating properties, the conclusion has been reached that it 
is chiefly of value as a surface disinfectant. It is therefore to be used in 
vacated sick rooms, sleeping apartments, cellars, schools, libraries, etc., 
but probably is of little value for disinfecting the interior of books, dense 
piles of clothing and fabrics, etc. Formaldehyde gas disinfection has been 
practiced for the last fifteen or twenty years by Boards of Health, in 
houses, after infectious diseases, the vapor being applied through openings 
in doors while the cracks around doors and windows are sealed with gummed 
paper. A special vaporizer is used for the purpose. Now all druggists carry 
vaporizing lamps and candles of formaldehyde which may be used by the 
laity. Within the past two or three years there has been a revulsion in the 
practice of house disinfection, scientists having proved to their satisfaction 
that such a process fails to disinfect and adds greatly and unnecessarily to 
the public expense. Without doubt there is a middle ground; disinfection 
probably being best accomplished when a certain amount of moisture is also 
present. 
Greatly exaggerated claims have been made in favor of the great 
disinfecting powers of formaldehyde upon pathogenic germs of death- 
451 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
dealing diseases, which are not substantiated in actual practice. It is an- 
other instance of damning the reputation of a good agent by over-praise. 
Excreta can be deodorized and disinfected by formaldehyde solution, 
and its use upon clothing worn by patients with the exanthemata and other 
infectious diseases is justified. It probably has no advantage here over 
milk of lime, or solution of chlorinated lime, except where the latter two 
may destroy color or fabric. 
Therapy.-External. A1 per cent solution of formaldehyde may be used 
as a surgical wash, and as a germicide, disinfectant, and deodorant. A slightly 
stronger solution has been advised as a vaginal wash for gonorrhoea in the 
female, and to be applied by swabbing, or upon tampons for fungous blenor- 
rhagic endometritis. It is little used now, as formerly, to wash out the 
pelvic and abdominal cavities after operations, particularly for pus tubes. 
Its value as a deodorant for the fetid discharges of carcinomata is well 
established. Full strength formaldehyde may be painted upon bites of 
gnats, mosquitoes, and bedbugs. It has no special advantage here over 
less hardening applications. A wash is useful for fetid sweating of the feet 
and axillae, or for sweating from any part of the body where it is desired to 
harden lax tissue. It should not, however, be carried out to the extent of 
"tanning the skin'' over large surfaces, as has been advised. Ringworm is 
said to be destroyed by formaldehyde, though it has failed in our hands in 
deep forms of that affection. Psoriasis, lupus, and acne indurata are also 
said to be benefited by it. Its use as a lotion or vapor in respiratory in- 
fections and in ocular diseases has not found much favor among Eclectic 
practitioners, nor is it used by them internally. 
LIQUOR MAGNESII CITRATIS. 
Solution of Magnesium Citrate. 
Description.-A colorless, pleasantly acidulous liquid without bitterness, and the 
agreeable flavor of carbonated lemonade. It should have no sediment. Dose, as laxative, 
6 to 8 fluidrachms; as a cathartic, 6 to 12 fluidounces. 
Action and Therapy.-Solution of citrate of magnesia should always be 
prepared fresh and is best given in broken doses of 4 to 6 fluidounces. 
It is an agreeable and popular laxative and can be taken by those who have 
a repugnance to Epsom salt. It is best given in repeated doses and may be 
used in subacute but not in actively inflammatory and febrile conditions, 
and for the relief of abdominal fullness, with flatus, and in sick headache 
due to gastro-intestinal indigestion. 
LIQUOR SODE CHLORINATE. 
Solution of Chlorinated Soda, Labarraque's Solution. 
An aqueous solution of chlorine compounds of sodium, capable of yielding not less than 
2.5 per cent of available chlorine. 
Description.-A clear, pale greenish fluid, having a weak chlorine odor and an un- 
pleasant alkaline taste. Dose, 1/2 to 1 fluidrachm, well diluted. 
Action and Therapy.-External. One of the best agents to cleanse 
soiled garments and wash up the sick room. If left exposed to the air it 
gives off a small portion of chlorine gradually that penetrates every crack 
and crevice of the apartment. Diluted it forms a useful gargle for fetid 
sore throats, and a wash for foul ulcers, carcinomata, leucorrhoea, and in 
452 INDIVIDUAL DRUGS. 
unhealthy and slowly healing skin diseases. It is not so powerful as chlorin- 
ated lime for disinfection of excretions and bedding. 
Internal. In large doses, Solution of Chlorinated Soda is an irritant 
poison; in small doses an efficient gastro-intestinal antiseptic in conditions 
of great prostration, with dry, brown-coated tongue and exhaustive and 
offensive discharges. It is particularly useful in the diarrhoea of typhoid 
fever, where sepsis is very marked. Remarkable improvement has resulted 
from its use, in small doses, well diluted. It also is useful in glandular 
enlargements, with foul conditions of the secretions of the body; it lessens 
temperature, clears up the foul tongue, and the patient arouses from the 
mental depression accompanying the profound prostration. A similar effect 
is produced in the diarrhoea of phthisis. 
LITHII BENZOAS. 
Lithium Benzoate. 
(Formula: LiCyHsCh.) 
Description.-A permanent, light, white powder or small crystalline scales, without 
odor, or a faint benzoin fragrance, and a cooling, sweetish taste. It is very soluble in water 
and alcohol. Dose, 1 to 30 grains. 
Specific Indications.-Fetid breath, bad taste, and imperfect nutri- 
tion, associated with persistent urinary irritation; lumbar uneasiness 
extending to the bladder, the urine voided bearing mucus and earthy 
phosphates, and the perineum feeling full and tense with frequent attempts 
at micturition, the urine being passed with difficulty; gout. 
Action and Therapy. Like other benzoates this agent is valuable in 
chronic irritation and inflammation of the bladder with ammoniacal urine 
due or not to gravelly deposits. It is also believed to have some effect in 
preventing gouty paroxysms and has been accredited with preventing the 
formation of hepatic calculi. The latter has not been sufficiently proven. 
Its alkalizing and antiseptic effects are of considerable value and it favors 
elimination of viscous and unhealthful waste products. 
LITHII BROMIDUM. 
Lithium Bromide. 
(Formula: LiBr.) 
Description.-A very deliquescent, odorless, granular, white salt, with a sharp, bitter- 
ish taste. Very soluble in water, and freely in alcohol. Dose, 5 to 15 grains. 
Specific Indications.-Flushed face; mental depression; insomnia due 
to mental and physical exhaustion; insomnia from cerebral congestion; 
severe interscapular pain; renal inactivity; mild epileptic seizure; tinnitus 
aurium, with temporal pain. 
Action and Therapy.-This salt, of all the bromides, is the richest in 
bromine, carrying 92 per cent of that element, and next to the potassium 
salt is the most depressant of the group. As a hypnotic it excels all the 
bromides. Its lithontriptic properties are nil. While it has no depressing 
action upon the heart to speak of, it should not be used in anemic patients, 
in extreme debility, or where fatty or weak heart is evident. It is chiefly 
employed as a hypnotic in wakefulness from active cerebral circulation, 
and that due to worry and overwork, both physical and mental. Like 
hydrobromic acid it relieves tinnitus aurium and is effectual when that 
453 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
symptom is associated with pain in the temporal region. In common with 
all the bromides it is used also for epileptic seizures, but is not equal to the 
potassium or sodium compounds for that purpose. To some extent it is 
used in chronic rheumatism and gout with urinary deposits, notwith- 
standing the small amount of lithium it contains. 
Lithium Carbonate. 
(Formula: Li2CO3). 
Description.-A white, odorless, light powder, alkaline to the taste, and permanent 
in the air. More soluble in cold (78) than in hot water (140). Dose, 4 to 12 grains. 
Specific Indications.-Indigestion and acid eructations, with urinary 
deposits; articular swellings with gouty deposits; gout. 
Action and Therapy.-The physiological effects of lithium are be- 
lieved to be intermediate between those of sodium and potassium, but in 
medicinal doses it produces no profound symptoms in man. Carbonate of 
lithium and the citrate, which is ultimately voided as carbonate, cause a 
marked increase in the flow of urine, which is rendered strongly alkaline. 
They are believed to increase nitrogenous elimination. The extravagant 
claim that lithium salts would dissolve uric acid in the system has not been 
sustained, no matter how successfully they act in the test tube; nor is the 
once-believed theory that they form biurates in the body fluids still main- 
tained. Aside from these biochemical suppositions the clinical use of them 
continues with apparently good effects in tendency to form sandy and 
gravelly deposits and in gout and gouty arthritis, much of the good prob- 
ably being due to the large amount of water taken with them, thus ridding 
the body of broken-down waste. They seem to have greater affinity for 
acid phosphate deposits than for uric acid. The good results of drinking 
lithia waters could possibly be obtained partially by the free use of plain 
water, and some of the results obtained at lithia springs resorts must be 
attributed to rest from care and worry and to changed environment. 
It sometimes relieves indigestion with acid eructations in patients who void 
sandy and gravelly urine. We have observed a whole family affected with 
diffused seborrhcea of the body from drinking commercial lithia water. 
The skin lesion promptly disappeared upon discontinuing the use of the 
water. 
LITHII CARBONAS. 
Lithium Citrate. 
(Formula: Li3C6H5O7.4H2O.) 
Description.-A white or granular powder, having a cooling, feebly alkaline taste, 
and no odor; deliquescent in moist air; very soluble in water (1.5) and slightly in alcohol. 
Dose, 1 to 10 grains. 
Preparation.-Lithii Citras Effervescens, Effervescent Lithium Citrate. Dose, $ss to 
3»L 
Specific Indications.-Indigestion and acid eructations, with urinary 
deposits; articular gouty swellings; gout. 
Action and Therapy.-More agreeable than carbonate of lithium and 
more readily soluble. Its use is the same as for that salt, as it is ultimately 
converted into the carbonate in the body. Large and continued doses are 
apt to produce cardialgic dyspepsia. The effervescent salt furnishes a 
nleasantlv acidulous form of administration. 
LITHII CITRAS. 
454 INDIVIDUAL DRUGS. 
Lithium Salicylate. 
(Formula: LiCjHsOa.) 
Description.-An odorless, white or grayish-white powder, having a sweetish taste; 
deliquescent in moist air, and freely soluble in water and alcohol. Dose, 1 to 8 grains. 
Specific Indications.-Rheumatic diathesis, with urinary deposits of 
sand and gravel. 
Action and Therapy.-This salt contains more of the salicylic acid 
radical than sodium salicylate, but is regarded as less depressing. Full 
doses produce the characteristic salicylic tinnitus and impairment of hear- 
ing, dizziness, and headache, and a persistently painful and distressing 
diarrhoea has resulted from immoderate doses. Lithium salicylate is 
preferred by some physicians to the sodium compound in treating acute, 
subacute, and chronic articular rheumatism, acting best in the chronic 
varieties with associated gouty diathesis. It may also be exhibited, like the 
other lithium salts, in gout and phosphatic and uric acid gravel, if given 
largely diluted with water. 
LITHII SALICYLAS. 
LOBELIA. 
The leaves, tops, and seeds of Lobelia inflata, Linne (Nat. Ord. Lobeliaceae). Abundant 
in the United States. Dose, 1 to 60 grains. 
Common Names.-Lobelia, Indian Tobacco, Wild Tobacco, Puke Weed, Emetic 
Weed, Emetic Herb, Vomit Weed, etc. 
Principal Constituents.-The unstable liquid alkaloid lobeline, combined with lobelic 
acid; fixed and volatile oil, and an unimportant nonbasic substance, inflatin. The so-called 
lobelacrin of Enders is probably lobeline lobeliate. 
Preparations.-1. Specific Medicine Lobelia. Dose, 1/10 to 60 drops. ( Usual form 
of administration: 3 Specific Medicine Lobelia, gtt. v to xxx; Water, q. s. fig iv. Mix. Sig.: 
One teaspoonful every 1 to 3 hours.) 
2. Subculoyd Lobelia. Dose, 1 to 30 drops. Designed chiefly for hypodermatic use. 
3. Pulvis Lobelia. Compositus, Compound Powder of Lobelia (Emetic Powder). 
Contains Lobelia (6), bloodroot (3), skunk cabbage (3), ipecac (4), capsicum (1). Dose, 
as an emetic, 2 drachms in broken doses of 1/4 to 1/2 drachm, in warm water, every 15 
minutes. Used chiefly locally. 
4. Tinctura Lobelice Composita, Compound Tincture of Lobelia, (Acetous Emetic 
Tincture, Expectorant Tincture). Dose, fl5ss to fl5hi. 
5. Libradol. For external use. 
Specific Indications.-Fullness of tissue, with full veins and full 
arterial flow; full labored and doughy pulse, the blood current moving with 
difficulty; short, labored breathing; sense of suffocation; dyspnoea with 
praecordial oppression; pain in chest of a heavy, sore, or oppressive 
character; pulmonary apoplexy (full dose); mucous accumulations in the 
bronchi; dry croupal cough, with scant or oversecretion; asthmatic 
seizures; short, lancinating pain radiating from heart to left shoulder and 
arm; spasmodic muscular contraction; muscular rigidity; infantile con- 
vulsions from irritation of the bowels, or from respiratory obstruction; 
hysterical convulsions; rigid os uteri with thick doughy and unyielding rim; 
perineal and vaginal rigidity during labor; angina pectoris (full doses). 
Action.-Lobelia apparently acts upon the central nervous system, 
the myoneural junction of the muscles of volition, and the sympathetic 
nerve ganglia, and by some is classed with the nicotine group in pharma- 
cological effects. It is a powerful gastro-intestinal irritant, producing 
emesis. Should it fail to vomit, which is rare, purgation may result. In 
large doses a state of near-collapse is induced. Small doses act upon the 
455 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
cardiac inhibitory apparatus, slowing the heart action, but this is followed 
by a more or less accelerated pulse. During the depressive stage blood- 
pressure is lowered, but subsequently becomes increased. Small doses 
stimulate, and large doses paralyze the respiratory centers and the vagal 
terminals and ganglia in the bronchi and lungs, death, when it occurs 
(in animals), resulting from respiratory paralysis (asphyxia). Lobelia is 
most largely eliminated by the kidney, though some is thought to be 
excreted by the skin. 
If lobelia be chewed it causes an acrid, prickling, and persistently 
pungent sensation in the throat and fauces, accompanied by slight nausea 
and a feeling of warmth and distention along the esophageal tract and in the 
stomach. The sensation is not very unlike that produced by tobacco. The 
salivary glands and those of the mouth are impressed, pouring out 
saliva and mucus in abundance. A sense of epigastric depression succeeds, 
followed by profound nausea, and if the amount chewed be large enough, 
severe and thorough emesis results. The gastric mucus is secreted in great 
abundance and ejected with the contents of the stomach. The emetic action 
of lobelia is extremely depressing, and is usually accompanied by profuse 
perspiration. Oppressive prostration, relaxation of the muscular system, 
and a languid pulse accompany the emetic stage. The depression, however, 
is of short duration, and is immediately followed by a sense of extreme 
satisfaction and repose. Under its action the mental powers are unusually 
acute, and the muscles are powerfully relaxed. The circulation is en- 
feebled by large and strengthened by small doses, and the bronchial secre- 
tions are augmented. 
Lobelia, in the ordinary sense of the term, is not a lethal poison. 
Undoubtedly its injudicious use has and might produce death, but the 
same is true of many other drugs that are not ordinarily considered as 
poisons. That the alkaloid lobeline will kill animals has been fully demon- 
strated. A drop of the alkaloidal solution placed upon the tongue of a 
strong, healthy man instantly vomited him. To this property of its 
alkaloid is undoubtedly due the failure of lobelia to act upon man as a 
lethal agent. Its emetic action is so prompt and decided that the con- 
tained alkaloid does not, under ordinary circumstances, produce fatal 
results. Given in cases in extremis, the resulting exhaustion from repeated 
emesis would very likely hasten death, but death would be more likely due 
to the act of vomiting exhausting the patient than to any poisonous effect 
of the lobelia. 
Therapy.-External. Infusion of lobelia, or the alcoholic preparations 
diluted and constantly applied by means of compresses, are among the most 
efficient applications in rhus poisoning. A lotion or a poultice (with flax- 
seed or elm) often relieves insect bites and stings, articular pain, the pain 
of bruises and sprains, and sometimes causes relaxation in strangulated 
hernia, and relieves the discomfort of erysipelatous inflammation. Pow- 
dered lobelia sprinkled upon a larded cloth and applied warm, or the 
compound emetic powder similarly used, is an invaluable local application 
to the chest in acute thoracic diseases, and gives marked relief from pleural 
and muscular pains and alleviates the sense of suffocation and fullness ac- 
companied by a feeling of soreness within the chest. Libradol is a more 
456 INDIVIDUAL DRUGS. 
cleanly application and owing to the presence of glycerin is more or less 
dehydrating, thus making it a preferable application in swellings, bunions, 
and inflammatory affections of the joints. Libradol, or a lotion of equal 
parts of glycerin and the specific medicine, provides a grateful application to 
relieve pain and reduce tumefaction in orchitis and epididymitis; the lotion 
is the more easily applied. 
Libradol is an exceedingly efficient local application in many disorders, 
to relieve pain and reduce local inflammations. It is not a cure-all, but 
covers two definite fields of action-the relief of disease conditions pre- 
senting: 
(1) Pain and inflammation, with or without exudation, as occur in 
pneumonia, broncho-pneumonia, bronchitis, croup, pleurisy, acute pharyn- 
gitis, tonsillitis, orchitis, ovaritis, arthritis, synovitis, inflammatory rheuma- 
tism, boils, and bunions. 
(2) Localized pain, along nerve courses, in joints, and in the muscular 
structures, as in some forms of rheumatism (subacute, non-inflammatory, 
articular, etc.), lumbago, facial, subscapular, and intercostal neuralgia, 
pleurodynia, and neuritis. 
The specific indications for Libradol are: Pain with or without swelling 
or inflammation; inflammation with serous or mucous exudation; sharp, 
lancinating pain in the chest, aggravated by respiratory or other movements; 
congestion and engorgement of parts; dyspnoea; soreness in the pectoral 
region; dull, aching pain; subcutaneous and thecal inflammations; pain 
of syphilitic nodes and lymphatic swellings. 
Pul vis Lobeliae Compositus or Compound Emetic Powder is seldom used 
for the purpose indicated by its name-a purpose for which it was originally 
intended and which it admirably fulfills. It is for its effects when applied 
locally in broncho-pulmonic affections that it is so highly valued and that 
has caused it to outlive many other old Eclectic compounds. How it 
acts-how it can produce the results it does-remains yet a mystery and 
can not easily be explained scientifically, but that it does act, and very 
decidedly, is a well attested clinical fact, and its certainty makes it a 
remedy that we will not be likely to part with. It is the first application 
thought of by many when desiring an outward application in acute bronchitis, 
pleurisy, pneumonia, pleurodynia, and soreness of the pectoral walls. 
A well-larded cloth is sprinkled with the powder. This is then well warmed 
and applied directly to the chest. Goose fat probably is the best penetrating 
medium for its exhibition, and singularly recent scientific tests of the 
penetrability of fatty bodies has yielded the highest place to goose fat. 
Once more has science recognized the wisdom of the domestic medication- 
ists, whose only claim to skill rested on their discriminatory clinical observa- 
tion. The emetic powder may be freely used without danger of unpleasant 
consequences. It takes the place of the heavy poultices and thus gives 
little or no discomfort to the patient. If a cotton jacket (best prepared by 
lining an undershirt or waist with a uniform layer of cotton) be worn over 
the larded cloth the effects are all that can be desired from external ap- 
plications. Petrolatum is substituted for other greases by some physicians. 
457 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Internal. From the early days of Eclecticism lobelia, through Thom- 
sonian introduction, has been a valued medicine. Many properties were 
once ascribed it of which little note is now taken. Its chief uses, however, 
were as an emetic, expectorant, and antispasmodic, fulfilling all of these 
offices to the admiration of its prescribers. As an emetic it was regarded as 
not only prompt but efficient, but in order to render it safer and more 
efficacious, it was often combined with other substances, notably capsicum 
and ipecacuanha. Either as an expectorant or emetic, as the urgency of 
cases required, it was in free use in croup, whooping cough, asthma, dyspnoea 
simulating asthma, and pneumonia. In fevers it was used as a relaxant and 
to modify the circulation. When used as an expectorant it was usually 
combined with tincture of bloodroot, syrup of senega, wine of ipecac, or 
oxymel of squill. Doses of lobelia sufficient to excite nausea and relaxation 
were employed in epilepsy, chorea, cramps, hysteria, tetanus, strychnine 
poisoning, and other convulsive attacks. Internally, or by enema, it was 
largely employed to overcome rigidity of the uterus during labor, but its 
specific applicability, as now known, was not then differentiated. As a 
relaxant, when employed by rectal enema and in fomentations, it was 
highly regarded in treating strangulated hernia and other intestinal ob- 
structions; and to release muscular contracture in tedious labors, and to 
facilitate the setting of fractures and reducing of dislocations. In extreme 
cases, oil of lobelia was employed and entered into liniments for severe 
neuralgic and rheumatic complaints. The infusion was used in ophthalmia; 
the tincture locally in sprains, bruises, rheumatic pains, erysipelatous and 
similar inflammations, eczema and other cutaneous diseases, and in poison- 
ing by ivy. Poultices of lobelia were similarly employed. These were the 
days prior to the advent of specific medication through which a better 
understanding of the use of lobelia was acquired. Of these uses only the 
occasional employment still survives for the same purposes in croup, asthma, 
whooping cough, dyspnoea, children's convulsions, rigid os, and the local 
surface disorders named. 
Lobelia is nauseant, emetic, expectorant, relaxant, antispasmodic, 
diaphoretic, sialagogue, sedative, and, secondarily, occasionally cathartic 
and diuretic and astringent. It is in no sense a narcotic. As an emetic 
lobelia is now seldom employed. In selected cases where a systemic emetic 
effect is desired it may still be employed with benefit. By a systemic 
emetic we mean one which, like lobelia, not only causes emesis, but reacts 
profoundly upon the nervous, circulatory, and secretory apparatus of the 
whole body, so that marked relaxation takes place and the stomach yields up 
a great quantity of thick, ropy mucus. Such an effect is sometimes desirable 
as a preparatory treatment for the better receptivity of medicines that 
would otherwise remain unabsorbed by the stomach, or when antiperiodics 
act indifferently or irritatingly unless a good cleaning of the stomach and re- 
laxation of nervous tension are first insured. This is notably true of quinine, 
and often of the special or arterial sedatives. Though momentarily depress- 
ing, the reaction is decidedly beneficial, and it may well be used when 
depression is not too great to begin with, and the tongue is expressionless 
and foully coated at the base. In such instances we believe it should still 
be used in emetic doses in some chronic disorders of the stomach, and 
458 INDIVIDUAL DRUGS. 
especially in the incipient stage of intermittent and other allied fevers. 
We have seen it arouse from a general sluggish condition of atony those 
who have been ill for months and start them on the way to better health. 
When the emetic action of lobelia is desired, small doses of specific medicine 
lobelia, or of the powder in warm water, should be frequently administered 
until profound nausea is induced; then the medicine should be pushed 
rapidly to emesis. Large draughts of warm (not hot) water will hasten its 
action and render the act of vomiting easier. Lobelia should never be 
given to children or the old and feeble as an emetic; nor is it admissible in 
ordinary cases of poisoning, where depression may be increased by it. 
Such are to be treated with stimulating emetics. 
The powerfully relaxant properties of lobelia make it an efficient drug 
where the spasmodic element is a factor. As of old, nauseant doses may be 
given to relax hysterical convulsions, worm convulsions, the convulsions of 
dentition, and other convulsive disorders of children. When mildly asthenic, 
lobelia may be used alone; when sthenic, bromide of potassium or gel- 
semium may be given with it. Usually, however, the indications are 
present for all three medicines. The best combination of drugs we have 
personal knowledge of for the relief of convulsions of childhood caused by 
errors of diet, such as the ingestion of half-comminuted bananas, nuts, or 
shredded cocoanut cakes, or of fresh flour dough, is the following: Py 
Specific Medicine Lobelia, Specific Medicine Gelsemium, aa fl 3 j; Potassium 
Bromide, 5j; Water, q. s. A^iv. Mix. Sig.: One teaspoonful every five 
minutes until complete relaxation is insured; then every two hours for a 
day. The warm bath and the enema should not be neglected. If con- 
vulsions are due to dentition or to the onset of infectious diseases, good will 
have been accomplished by placing the system in repose and giving a better 
receptibility for other medication. Lobelia is of little value in epileptic 
convulsions, and is rarely of service in tetanus. It has been used in strych- 
nine poisoning, but is not to be commended, especially if given late, lest 
attempts at emesis provoke the already greatly excited reflexes and pre- 
cipitate repeated paroxysms; and less than emetic doses would have 
absolutely no value. In puerperal eclampsia, in which it has also been 
advised, it is not to be compared with veratrum, gelsemium and chloro- 
form in efficiency. When intestinal obstructions are due to a spasmodic 
state of the intestines it may be of service, as in intussusception and fecal 
impaction; and it may relax and relieve a strangulated hernia. Too much 
time must not be consumed in attempts at medication in these serious dis- 
orders, and an early resort to surgery is advisable. Spasmodic colic in 
both adults and children is sometimes quickly relieved by lobelia. In 
fact very small doses prove the very best treatment in colic of very young 
infants. For spasmodic croup and spasmodic asthma lobelia in nauseant 
doses is without a peer in drug therapeutics. 
Lobelia is the drug for angina pectoris, neuralgia of the heart, and 
pulmonary apoplexy. Though evanescent in its action, large doses of 
specific medicine lobelia (about 20 drops) may be administered with the 
expectation of relieving the patient. The dose may be repeated as neces- 
sary. Lobelia is a cardiac stimulant, therefore we class it with the sedatives, 
for all arterial or special sedatives in medicinal (small) doses are heart 
459 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
stimulants. When the circulation exhibits a markedly slow pulse-wave 
it will be better corrected by lobelia than by any other drug. In fact the 
most prominent indication for lobelia is the full, oppressed, sluggish, 
doughy pulse. Associate this with praecordial oppression, thoracic pain, 
difficult breathing, soreness or bruised feeling within the chest, nausea with 
tongue heavily coated at the base, fullness of tissue, and we have before us 
a fair range of the action of the drug. It is a good remedy in cardiac 
congestion. 
Lobelia is of specific value in obstetrical practice. It powerfully sub- 
dues muscular rigidity. It is one of the remedies to overcome a rigid os 
during parturition, and at the same time it relaxes the perineal tissues, 
thus defending the parts against lacerations. This specific effect of lobelia 
has won many converts to specific medication. This it does when there is 
fullness of tissue-a thick, doughy, yet unyielding os uteri; when, however, 
the edge of the os is thin and closely drawn, sharp like a knife edge, full 
doses of gelsemium are indicated. For this antispasmodic action lobelia may 
be given in nauseant doses, preferably in hot water, by mouth and by rectum. 
Lobelia is a stimulant to the sympathetic nervous system. It im- 
proves innervation of the parts supplied by both the pneumogastric and 
sympathetic nerves. The appetite and digestion are augmented by it and 
peristalsis of the whole gastro-intestinal tube greatly stimulated. All 
this it does best in small and repeated doses; and for these specific purposes 
it should be so employed and not for its nauseating and emetic effects, 
which it causes by pushing this stimulation to its limit. The conditions 
in which such violent and disturbing action is desired are sufficiently set 
forth above. Specific medication has proved that lobelia is indicated by the 
full, slow, labored, and doughy pulse, showing that the blood current moves 
with difficulty. Over the chest, and particularly in the praecordium there is 
a sense of oppression and weight and often a dull, heavy pain or soreness 
of an oppressive character and always associated with difficulty in breathing. 
Mucous rales in the bronchi are prominent and the cough is aggravating, 
but followed by free and full expectoration. The tongue is full, pallid, 
broad and flabby-expressionless, nausea is a common indication, and sick 
headache with nausea frequently encountered. The sympathetic and the 
vagus are always below par when lobelia is indicated. With any or several 
of these indications lobelia proves most valuable in the gastric and respira- 
tory disorders named below. Even in this specific field comes partly 
its beneficent action in angina pectoris, though relaxation even to nausea 
apparently intensifies its ameliorating effects. 
The small dose of lobelia is of distinct value in atonic types of indi- 
gestion and dyspepsia. In similar doses it may relieve sick headache due to 
gastric derangement, and is then indicated by a feeling of "qualmishness" 
and nausea. Though sometimes overlooked when we are seeking a drug to 
overcome intestinal atony, experience has proved lobelia, continued for 
some time in moderately small doses, to be one of the best agents at our 
command to gradually relieve habitual constipation. 3 Specific Medicine 
Lobelia, gtt. j or ij, every 2 or 3 hours. This is accomplished by improving 
the innervation and peristalsis, and stimulating the secretions of the 
intestinal glands, as lobelia is in no sense a laxative in such doses. Admin- 
460 INDIVIDUAL DRUGS. 
istered with podophyllin and other cathartics it tends to prevent the after- 
constipative results that frequently follow the use of "bowel persuaders" 
when given in purgative amounts. 
Lobelia is of value in common colds with a dry, irritative cough. 
It ranks with the best of antiasthmatics, and is equally serviceable in 
spasmodic asthma and in humid asthma, with scanty secretion in the 
first and over-secretion in the latter. In asthma, which is but a symptom 
of some grave body wrong, the urine should be examined for albumin, 
which, together with the asthmatic paroxysms, are sometimes the only 
early evidence pointing to nephritis. Nasal obstructions and deformities 
requiring removal by the nasal specialist should also be taken into account, 
as well as other causes for reflex excitation. With these absent lobelia is 
signally effective; it often fails in part or altogether when these abnormal- 
ities remain uncorrected. Lobelia is an equally certain remedy for the relief 
of spasmodic croup and the asthmatic form of acute laryngitis in children. 
In lobar pneumonia and in broncho-pneumonia it renders good service when 
there is much congestion and breathing is greatly oppressed. In chronic 
respiratory disorders it is valuable either to increase or decrease secretion, 
accordingly as the fuller or lesser doses are used, and to relieve cough. 
For coughs, when dry, barking, or hacking, or when loud mucous rales 
are heard, but there is difficulty in raising the sputum, lobelia may be em- 
ployed alone, or in mixtures or syrups as indicated. For chronic coughs 
requiring lobelia a good form is the compound liniment of stillingia (which 
see), which contains the so-called oil of lobelia. For the cough of measles, 
when a sluggish circulation and imperfect eruption are factors, it proves 
useful in quieting the laryngeal irritation, controlling the catarrhal 
features, and more perfectly bringing out a tardy efflorescence. In both 
scarlet fever and measles, lobelia, by causing determination of blood to 
the skin, promotes the eruption when tardy and re-establishes It when 
retrocession occurs. It modifies many cases of whooping cough where 
abundant secretions of a stringy character almost strangle the sufferer. 
In short lobelia is a most admirable respiratory stimulant when the mucous 
membranes are dry, or when relaxed and secretion is free but difficult of 
expectoration. It should not be forgotten as one of the most valuable 
medicines in all stages of la grippe and epidemic influenza, as a vital stimu- 
lant, to regulate an imperfect circulation, and to control cough and ex- 
pectoration. It is an admirable drug in post-grippal catarrhs, following the 
specific indications as given. Lobelia is seldom indicated, nor is it well 
borne, in advanced pulmonary tuberculosis. 
It has been assumed by some that lobelia possesses the properties of an 
antitoxin in the sense that that term is now employed in biologic medica- 
tion. This assumption we believe to be unwarranted without definite and 
exact biological experimentation. Such unsupported vagaries bring into 
discredit otherwise good and efficient drugs. That quite remarkable results 
have been obtained from its use in grave blood-disorganizing and specific 
diseases seem probable. But lobelia is essentially a vital stimulant, and 
this property, more than an antitoxic action as now understood, better 
explains its beneficent effect in diphtheria and other depressing septicaemic 
diseases. 
461 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Hypodermatic Use. For the so-called antitoxic and other general 
action, lobelia, hypodermatically administered, has come into prominent use 
in late years in many of the disorders for which the drug is given internally. 
In this manner the probability of nausea and vomiting is lessened, while its 
relaxant properties seem not to be diminished. In spasmodic asthma it 
sometimes gives prompt relief, and we have observed its effects most 
beneficially in gall-stone colic of a continuously nagging, though not very 
severe, type. We have also observed a remarkable increase of urine from 
the drug used in this way. To catalogue the conditions in which many 
have obtained asserted good effects would be to restate all the uses of 
lobelia given in this article, except that of emesis. 
The subject of hypodermatic medication, involving a large number 
of vegetable medicines, has been purposely omitted from this work. The 
author is unalterably opposed to this too general practice because of the 
dangerous reactions that occur often enough to make one cautious. 
Thoughtless, and often unscrupulous, commercialism in medicine on the 
part of a few has brought about a demand from physicians for these 
hypodermatic forms of medicines, and to meet this demand reputable manu- 
facturers of drugs have unwillingly yielded and have supplied a score or more 
of such preparations. Realizing that such preparations under the best 
of pharmacal care are liable to deleterious change or disintegration, or to 
the development of toxic material, the thoughtful manufacturer is unwilling 
to continue the supply of such drugs. Certain vegetable proteins may, and 
often do, become as obnoxious and dangerous as some animal proteins, and 
may produce allergic, or anaphylactic effects, as well as direct poisoning; 
and occasionally the most unhappy and near fatal consequences have 
resulted. Apparently lobelia and ergot are the safest of these preparations 
and they should not be recklessly or unnecessarily used, when other methods 
of medication may be just as effectually employed. 
Acetous Emetic Tincture. Like the Compound Emetic Powder, this 
agent is now seldom employed as an emetic. On the contrary its reputa- 
tion rests on its value as a remedy in coughs, colds, and broncho-pulmonic 
complaints. It is of service when the indications are present for both lobelia 
and sanguinaria. These drugs are more effective when tinctured with a 
certain proportion of vinegar, hence the superiority of this compound over 
the plain tinctures. Emetic tincture added to syrup will often render 
good service when a cough mixture for irritative cough, with deficient 
secretion, is desired. The dose of the tincture is from 20 to 60 drops. 
Tobacco (Nicotiana Tabacum, Linne) and Nicotine. Tobacco was once used to a con- 
siderable extent upon painful inflammatory swellings and to relax strangulated hernia. 
It is seldom employed as a drug at the present day. When unaccustomed to its use in 
chewing and smoking it acts profoundly, causing vomiting and great depression; toleration 
is soon established. Nicotine is of toxicological interest chiefly, but rarely it is used to 
subdue pain. A solution of the combined alkaloids of tobacco, containing 1 per cent of 
nicotine, is on the market as Dynamyne, a preparation devised by Lloyd and Howe. It 
is a green-colored hydro-alcoholic liquid designed for external use only, a solution of 1 to 4 
fluidrachms in a pint of water being applied by means of a compress upon localized inflam- 
mations, and to relieve the pains of neuralgia, pleurodynia, rheumatism, felons, abscesses, 
etc. Some persons are very susceptible to nicotine, hence this preparation must be used 
with great caution, and care should be had in handling or inhaling it. A combination of 
tobacco alkaloids is an ingredient of LibradoL 
RELATED MEDICINE. 
462 INDIVIDUAL DRUGS. 
Lupulin. 
The glandular powder separated from the strobiles of Humulus Lupulus, Linne 
(Nat. Ord. Urticacese), the common Hop. (See Humulus.) 
Description.-Brownish-yellow (becoming yellowish-brown), resinous granules, having 
the aromatic odor and bitter taste of hops. It is readily inflammable, and deteriorates 
upon long keeping. Dose, 5 to 20 grains in capsule or pill. 
Preparation.-Specific Medicine Lupulin. Dose, 5 to 30 drops. 
Specific Indications.-Nervousness, irritability, disposition to brood 
over trouble, delirium, insomnia, cerebral hyperaemia; genital and mental 
irritability associated with spermatorrhoea; fermentative dyspepsia, with 
acid eructations. 
Action and Therapy.-Lupulin is administered in disorders for which 
infusion and tincture of hops were formerly given. It is a remedy for 
nervousness, to allay irritation and to produce sleep. It gives a sense of 
mental tranquillity which makes it a valuable agent in nervous unrest due 
to nocturnal seminal emissions, and relieves irritation of the genital tract 
when associated with the latter. It relieves irritation of the bladder, with 
frequent urination, and is quite efficient in chordee. When delirium 
tremens is accompanied by cerebral hyperaemia it is of considerable service. 
Insomnia due to nervous debility or to worry, or headache associated with 
active cerebral circulation, is benefited by lupulin; while for painful 
conditions it may be employed when they depend upon nervous debility. 
For the latter reason it has been given with success in dysmenorrhoea, and 
other painful conditions of the uterus and in after-pains. Lupulin checks 
fermentative changes in the stomach, thus proving useful in yeasty indiges- 
tion with acid eructations and dilation of the stomach, and in the head- 
ache due to such gastric disturbance. 
LUPULINUM. 
The spores of Lycopodium clavatum, Linne (Nat. Ord. Lycopodiaceae) or Club Moss, 
a creeping perennial found in most parts of the earth; gathered mostly in Germany, Russia, 
and Switzerland. 
Description.-An odorless and tasteless, very mobile, light-yellow powder, impervious 
to but floating on cold water, sinking when boiled with water, and burning with a sudden 
flash when in contact with flame. 
Principal Constituents.-Nearly 50 per cent of greenish-yellow fixed oil; sugar, 
2 to 3 per cent, and a trace of monomethylamine (CH3NH2). 
Preparation.-Specific Medicine Lycopodium. Dose, 1/10 to 30 drops. 
Specific Indications.-Extreme sensitiveness to the touch; urine de- 
posits red sandy or phosphatic particles and readily stains the clothing; 
water-brash; borborygmus. 
Action and Therapy.-External. Lycopodium forms a good protective 
and absorbent dusting powder for irritated and inflamed surfaces, for 
which purpose it is largely used in excoriations, intertrigo, herpes, erysipelas, 
dermatitis, eczema, ulcers, etc. Possessing moisture-repellant qualities it is 
used in preparing pills of hygroscopic chemicals, to facilitate the manipula- 
tion of pill masses, and to keep pills from adhering to each other. It is also 
employed as the pulverulent base of many insufflations. 
Internal. According to Scudder, lycopodium is adapted to disorders 
showing "extreme sensitiveness of the surface; sensitiveness of a part and 
care to prevent it being touched; slow, painful boils; nodes or swellings; 
LYCOPODIUM. 
463 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
external sensitiveness of the organs of special sense, with pale, livid, or dirty 
complexion." 
Lycopodium is of much value in obscure forms of malarial fever, with 
afternoon exacerbations, and deep-red, scanty urine, which readily stains 
the garments. The fever is not active, but very depressing and intractable, 
and may be accompanied by sore throat, colic, diarrhoea, dysentery, or 
constipation. Used according to the specific indications, it is a useful 
gastric sedative, when in addition there is a sense of fullness and tenderness 
of the stomach. It often proves effective in pyrosis and fermentative in- 
digestion, with borborygmus. 
Lycopodium frequently relieves renal disorders with blood in the 
urine, and is of service in catarrh of the bladder in adults with painful 
micturition and gritty concretions. It should be given a fair trial in the 
lithic acid diathesis, when the passage of urine is attended by pain and 
red, sand-like particles are voided. The small dose, from the fraction of a 
drop to five drops of the specific medicine, is the most advantageous form 
of administration. 
LYCOPUS. 
The whole herb Lycopus virginicus, Linne (Nat. Ord. Labiatae). Common in shady, 
moist and boggy places throughout the United States. Dose, 1 to 60 grains. 
Common Names: Bugle Weed, Sweet Bugle, Paul's Betony. 
Principal Constituents.-Tannic and gallic acids, a crystallizable glucoside, resin, and 
a volatile oil. 
Preparation.-Specific Medicine Lycopus. Dose, 1 to 60 drops. 
Specific Indications.-Vascular excitement, with rapid, tumultuous 
action of the heart, but lacking power; hemorrhage, passive and in small 
quantities, resulting from determination of blood to the lungs, kidneys, 
or gastro-intestinal canal; chronic debilitating cough, with weak and rapid 
heart action and expectoration of mucus or muco-pus; morbid vigilance and 
wakefulness, with inordinately active but weak circulation; albuminuria 
with the above characteristic circulatory disturbances; polyuria and some 
cases of diabetes with rapid heart action. 
Therapy.-Lycopus is sedative, subastringent, and tonic. No other 
drug exactly duplicates its value in circulatory disturbances. Apparently 
its force is chiefly expended on the vascular structures and the sympathetic 
nervous system. Its sedative action is most certain when the circulation is 
excited-even tumultuous-with lessened cardiac power. This evident 
want of heart-energy, with quickened velocity, is the most direct indication 
for lycopus. For this purpose especially it is greatly valued in the ad- 
vanced stages of acute diseases with great debility, and in chronic diseases 
with frequent pulse. Its action upon the stomach is kindly, and being a 
mild gastric tonic the appetite is sharpened and digestion facilitated. 
Normal secretion is favored by it, and blood-making and nutrition improved. 
Upon the cardio-vascular system it has been compared in action to digitalis, 
though it is far less powerful than that drug, and besides is non-poisonous 
and not cumulative. The influence of lycopus extends to all parts under 
control of the vegetative chain of nerves. 
Lycopus is preeminently useful in passive hemorrhage, when the 
bleeding is frequent and small in amount. Thus it has acted well in epistaxis, 
hematemesis, hematuria, metrorrhagia, and intestinal bleeding. Its greatest 
464 INDIVIDUAL DRUGS. 
utility, however, is in passive pulmonary hemorrhage (hemoptysis). It prob- 
ably acts by controlling the rapidity of the blood-current. In the first-named 
hemorrhages it may also act upon the unstriped muscular fibers, but in the 
pulmonary form these smooth fibers are largely absent in the small vascular 
terminals where the bleeding is most likely to occur. Therefore the control 
over the velocity of the circulation, and not its vaso-motor effects, seems the 
most rational explanation of its control in bleeding from the lungs. What- 
ever the cause of its action, it is nevertheless most decidedly effective. 
Lycopus, by lessening irritation, allaying nervous excitement, and 
slowing and strengthening the heart, and consequently reducing fever and 
pain, is often successfully used in acute pulmonic complaints. It is more 
valuable, however, in chronic lung affections, to fulfill the same purposes, 
besides controlling or tending to prevent hemorrhage. In chronic bronchitis, 
with copious expectoration, and in chronic interstitial pneumonia, it has 
rendered good service. While by no means to be rated as an antitubercular 
agent, its card io-vascular control and antihemorrhagic power make it an 
agent of unrivaled worth in those who show every evidence of tending 
toward a phthisical end, and we believe it will do as much as a medicine 
can do to stay the distressing ravages of pulmonary tuberculosis. When 
established it aids in relieving cough, pain, fever and the rapid and excited 
heart action. In pulmonary hemorrhage we have frequently used with it 
specific medicines ipecac and cinnamon with the happiest of results. The 
chief guides to its selection in respiratory therapeutics are the hemorrhage 
and circulatory excitability. 
In heart disorders, both functional and organic, lycopus should not be 
disregarded. It may be used where digitalis cannot be employed on account 
of its offensive action upon the stomach. Administered to patients suffering 
from endocarditis and pericarditis it has sometimes subdued the inflamma- 
tion. It is a good remedy in cardiac palpitation, dependent upon irritation 
of the cardiac nerve centers, or when arising from organic lesions. It is 
best adapted to those forms of heart disease characterized by irritability, 
irregularity, and weakness, with dyspnoea and praecordial oppression. 
Lycopus powerfully increases the contraction of the non-striated muscular 
fibers, particularly those of the heart and arteries, hence its value in cardiac 
dilatation and hypertrophy-conditions which have been known to undergo 
marked improvement under its administration. It quickly relieves the 
suffering and anxiety nearly always experienced in heart diseases; and is of 
especial value to relieve the rapid heart action of excessive smokers. 
Lycopus is a remedy for morbid vigilance and insomnia attendant 
upon either acute or chronic diseases; and is especially serviceable when 
sleep is prevented by the exaggerated force of the heart. It has been ill- 
advised, and is largely over-rated, for the cure of diabetes and the relief of 
chronic nephritis. The most it can do in these conditions is to allay un- 
pleasant heart symptoms and quiet nervous unrest. It has favorably in- 
fluenced the circulatory aberrations in exophthalmic goitre, but far more 
often it has failed. Painful and distressing forms of indigestion are some- 
times relieved by it, and it has been employed with advantage in simple 
diarrhoea (lientery), dysenteric diarrhoea, and especially in the diarrhoea 
of phthisis, and the gastric disturbances of the drunkard. 
465 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
The rhizome and rootlets of Cimicifuga racemosa (Linne), Nuttall (Nat. Ord. Renun- 
culaceae). A conspicuously handsome perennial widely found in rich woodlands of the 
eastern half of the United States. Dose, 1 to 20 grains. 
Common Names: Black Snakeroot, Black Cohosh, Rattleweed. 
Principal Constituents.-No alkaloidal principles have been isolated from the drug, 
but it yields a mixture of resins upon which, according to some, the virtues of the plant 
depend. An impure mixture of the resins is variously known as cimicifugin, macrotin, or 
macrotyn, and was one of the early Eclectic resinoids. Though not without value, the latter 
is now scarcely ever employed. 
Preparation.-Specific Medicine Macrotys. Dose, 1/10 drop to 20 drops. 
Specific Indications.-Heavy, tensive, aching pain (Scudder); pain char- 
acterized as rheumatic-dull, tensive, intermittent, drawing, and seeming 
as if dependent upon a contracted state of the muscular fibers; soreness 
of muscular tissues, as if one had been pounded or bruised; the so-called 
rheumatoid pain; stiff neck; aching of whole body from colds, the onset 
of fevers, or from muscular exertion; lumbago; bruised feeling of muscles 
of the forehead, with stiffness of the ocular muscles; soreness and stiffness 
of the throat with sense of muscular drawing in the pharynx and fauces; 
muscular pains in the loins, thigh, or back, of a drawing character; deep- 
seated boring and tensive pains; rheumatoid dyspepsia, associated with 
rheumatism of other parts, and in those having a rheumatic diathesis 
who experience dull, aching pain and tenderness in stomach and bowels, 
with tendency to metastasis, and aggravated by food and drink, 
the stomach feeling as if painfully contracting upon a hard body or 
lump; the soreness and aching intestinal pains of abdominal grip, when of 
rheumatoid type; sore, bruised sensation in the respiratory tract; chronic 
muscular rheumatism; ovarian pains of a dull aching character; dragging 
pains in the womb, with sense of soreness; the dull tensive pains incident 
to reproductive disorders of the female, as well as the annoying pains ac- 
companying pregnancy; false pains; after-pains; weak, irregular uterine 
contractions during labor; irregular, scanty, or delayed menstruation, 
with dull pain and muscular soreness; chorea, with absentio mensium; and 
rheumatism of the uterus. 
Action.-Upon man moderate doses of cimicifuga give slowly increased 
power to the heart and a rise in arterial pressure. Large doses impress the 
cerebrum decidedly, and probably other parts of the nervous system not yet 
definitely determined-occasioning vertigo, impaired vision, pupillary 
dilatation, nausea, and vomiting of a mild character, and a reduction in the 
rate and force of the circulation. A condition closely resembling delirium 
tremens is said to have been produced by it. Full doses cause a severe 
frontal headache, with a dull, full or bursting feeling. This headache is the 
most characteristic effect observed when giving even therapeutic doses. 
While large amounts may poison, no deaths have been known to occur from 
its use. The physiological action has been well determined upon animals, 
but it gives no hint as to the possible relationship of the drug to its practical 
therapy and clinical worth, admitted as valuable by practitioners of all 
schools of medicine. 
In small doses cimicifuga increases the appetite and promotes digestion. 
Larger amounts augment the gastro-intestinal secretions. It is excreted 
MACROTYS. 
466 BLACK COHOSH 
(Cimicifuga racemosa) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Under the drug name of Macrotys, Black Cohosh has held a conspicuous place in Eclectic 
pharmacy and therapy from the beginning of the school, and to-day is of equal popularity. 
It is one of the Indian Cohoshes, adopted first by "regular" practitioners, but almost simul- 
taneously taken up and almost wholly developed by the Eclectic school of practice. Indeed, 
it stands to-day, as it has for decades, as a leading Eclectic drug. INDIVIDUAL DRUGS. 
by both the skin and kidneys, imparting to the urine the peculiarly earthy 
odor of the drug. It also stimulates the bronchial secretion, making it a 
serviceable though not pronounced expectorant. That it acts upon the 
uterine, and possibly other smooth muscular fibers of the tubular organs 
or the nerves supplying them, is evident from its known power of in- 
creasing and normalizing weak and erratic contractions during labor. It 
also stimulates the function of menstruation and is said to increase the 
venereal propensity in man. 
Therapy.-Macrotys is primarily a remedy for rheumatoid and myalgic 
pain and in disorders of the reproductive organs of women. It apparently 
possesses sedative, cardiac, anodyne and antispasmodic properties, and is 
an ideal utero-ovarian tonic. Macrotys was introduced into Eclectic 
medicine by King in 1844 as a remedy for acute rheumatism and neuralgia 
with such success that it gradually came to be recognized as a leading 
medicine for these disorders. The extensive list of indications given on page 
466 shows sufficiently its general scope of application. While many still 
regard it as one of the first of antirheumatics, others, and we are among the 
number, regard it as less fully an antirheumatic than as an anodyne for 
pain simulating rheumatism, or the so-called "rheumatoid pain". The 
original indication as enunciated by Scudder is "heavy, tensive, aching 
pain". This is essentially different from the exquisitely sensitive and acute 
pain of acute articular rheumatism. It is not to be understood that it is of 
no value in this affection, but that it is of greater worth as an associate 
remedy. It assists in relieving the pain, but rheumatism is, without doubt, 
an infectious disorder and needs something more directly antagonistic to 
the infecting agent, and the salicylates prove better than any others for this 
purpose. As a matter of fact, the indications for both macrotys and sodium 
salicylate are usually present. As they do not interfere with each other, 
they may be judiciously given together, and administered in this manner 
aid the action of each other so that lesser doses of the salicylates are re- 
quired. I| Sodium Salicylate, 5ij; Asepsin, gr. x; Specific Medicine 
Macrotys, fl 3 i to ij; Fluidextract of Licorice, fl5ii; Water, q. s., A^iv. 
Mix. Sig.: One teaspoonful every two or three hours as seems to be de- 
manded. 
When pain persists in spite of this medication, and fever is active, 
aconite, veratrum or gelsemium, particularly the first named, produces a 
marked change in the activity of the disease. Fever subsides, secretion 
becomes reestablished, pain is markedly decreased, and sleep, that has 
been impossible, is permitted. That it protects the heart and strengthens it 
during rheumatic invasions seems established. In so-called rheumatism 
of the heart and rheumatic endocarditis it may be given with expectation 
of relief, and in diaphragmatic rheumatism, pleurodynia, intercostal and 
other neuralgias its pain-relieving effects are apparent. Gastralgia, en- 
teralgia, mediastinal pain, tenesmic vesical discomfort, pain in the orbits 
and ears, when acute and rheumatoid in character, derive quick relief from 
macrotys. When diseases of the ear are associated with rheumatism, 
macrotys aids in giving relief, as it does in neuralgia in the same area when 
accompanied by stiffness of the faucial and pharyngeal muscles. It is the 
remedy in acute muscular pain, such as occurs in the myalgias of the chilly 
467 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
seasons of the year, in torticollis, and in the pains, tensive and contractive, 
due to changes of weather and muscular exertion. Here macrotys is often 
the only agent needed. If febrile reaction occurs, either aconite or veratrum, 
as indicated, or possibly gelsemium, may be alternated with it. 
According to Webster cimicifuga is a remedy for dyspeptic mani- 
festations when due to rheumatoid states of the gastro-intestinal canal, or 
when associated with rheumatism of other parts of the body. It should be 
remembered in those cases where there is a dull or aching pain and tendency 
to metastasis, made worse by taking food or drink, and when the walls of 
the stomach seem to be contracting upon a hard lump, the patient having 
a rheumatic tendency or history. 
In the acute infectious and non-infectious diseases it is a most im- 
portant drug to relieve the muscular discomfort. Macrotys and eupatorium 
in liberal doses are the best remedies for the intense muscular aching and 
bone-breaking pains experienced at the onset of the rheumatoid type of in- 
fluenza, and in other forms of la grippe. In the respiratory forms they also 
relieve cough and bronchial soreness. The amelioration of pain is prompt 
and enduring, and unlike aspirin and the coal-tar products, the drug is 
absolutely without danger to the heart or nervous system. Should a sense 
of fullness in the frontal region or a bursting headache be occasioned by 
full doses, it quickly subsides, with no after-effects, upon withdrawal of 
the drug. 
For headache, whether congestive or from cold, neuralgia, dysmenor- 
rhoea, or from la grippe, macrotys is often promptly curative. In eye 
strain from over-use of the eyes, giving rise to headache, and associated with 
a sensation of stiffness in the ocular muscles, or a bruised feeling in the 
muscles of the frontal region, macrotys is one of the most successful of 
remedies. As a palliative agent in phthisis pulmonalis, good results are 
obtained, in that it lessens cough, soothes the pain, especially the "aching" 
under the scapulae, lessens secretions and allays nervous irritability. In 
the cerebral complications of the simple and eruptive fevers, especially in 
children, its action is prompt and decisive. It uniformly lessens the force 
and frequency of the pulse, soothes pain, allays irritability, and lessens the 
disposition to cerebral irritation and congestion. In febrile diseases espe- 
cially, it induces diaphoresis and diuresis. In the exanthemata it is a valuable 
agent, controlling pain, especially, it is asserted, the terrible "bone aches" 
of smallpox, rendering the disease much milder. In scarlatina and measles 
it relieves the headache and the backache preceding the eruptions. 
Macrotys is a very important drug in the therapeutics of gynaecology. 
It is a remedy for atony of the reproductive tract. In the painful conditions 
incident to imperfect menstruation its remedial action is most fully dis- 
played. By its special affinity for the female productive organs, it restores 
suppressed menses. It is even a better remedy in that variety of amenor- 
rhoea termed "absentio mensium". In dysmenorrhoea it is surpassed by no 
other drug, being of greatest utility in irritative and congestive conditions 
of the uterus and appendages, characterized by tensive, dragging pains, 
resembling the pains of rheumatism. If the patient be despondent and 
chilly, combine macrotys with pulsatilla, especially in anemic subjects. In 
the opposite condition associate it with gelsemium. It is a good remedy for 
468 INDIVIDUAL DRUGS. 
the reflex "side-aches" of the unmarried woman; also for mastitis and 
mastodynia. Macrotys relieves soreness and tenderness of the womb 
when aggravated by walking or jarring of the organ when descending steps; 
and through its tonic power helps to reduce uterine subinvolution. It 
should be remembered in so-called rheumatism of the uterus, and in uterine 
leucorrhoea, with a flabby condition of the viscus. When there is a dis- 
ordered action or lack of functional power in the uterus, giving rise to 
sterility, cimicifuga has been known to do good. Reflex mammary pains 
during gestation are relieved by it, and in rheumatic subjects it promptly 
relieves ovatalgia and ovarian neuralgia, the pain being of an aching 
character. For the latter condition it is one of the best remedies known. 
Orchialgia and aching sensations of the prostate are conditions some- 
times relieved by macrotys, and as a tonic and nerve sedative it is not 
without good effects in spermatorrhoea. Its effects are less apparent upon 
the male reproductive organs, however, than those of the female. 
Macrotys has proved a better agent in obstetrical practice than ergot 
except for the control of hemorrhage. It produces natural intermittent 
uterine contractions, whereas ergot produces constant contractions, thereby 
endangering the life of the child, or threatening rupture of the uterus. Where 
the pains are inefficient, feeble, or irregular, macrotys will stimulate to normal 
action. For this purpose full doses should be given in hot water; many still 
prefer a decoction of the root for this purpose. Unfortunately it is less em- 
ployed than formerly since pituitrin has come into use. Its simulation of 
normal parturient efforts, however, makes it still the ideal regulator of 
uterine contractions during labor. It is an excellent "partus prseparator" 
if given for several weeks before confinement. It is a diagnostic agent to 
differentiate between spurious and true labor pains, the latter being increased, 
while the former are dissipated under its use. It is the best and safest 
agent known for the relief of after-pains, and is effectual in allaying the 
general excitement of the nervous system after labor. 
Macrotys has a powerful influence over the nervous system, and has long 
been favorably known and accepted as the best single remedy for chorea. 
It may be used alone or with valerian, equal parts. More especially is it 
useful when the incoordination is associated with amenorrhcea, or when 
the menstrual function fails to act for the first time. Its action is slow, but 
its effects are permanent. It has been used successfully as an antispasmodic 
in hysteria, and as an aid to treatment in epilepsy when due to menstrual 
failures: and in spasmodic asthma and kindred affections, nervous excit- 
ability, and pertussis. In the latter it sometimes proves better than any 
other drug, and especially if the child is one subject to periodic choreic 
seizures. As the heart is never injured, but on the contrary is strengthened 
and toned by macrotys, the drug is very valuable as an auxiliary to other 
agents in nervous affections, particularly when the latter depend upon, or 
are associated with chorea. 
The usual form of administration is: 3 Specific Medicine Macrotys, 
gtt. x to xxx; Water, q. s., fl^iv. Mix. Sig.: One teaspoonful every two 
hours. In most instances the fuller doses, short of producing headache, 
are the most effective, and the maximum amount given in this prescription 
may be considerably increased (fl3j or fl 3 ij) for adults. 
469 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
MAGNESII CARBONAS. 
Magnesium Carbonate. 
A mixture of hydrated magnesium carbonate and magnesium hydroxide which, 
according to the U. S. P., should correspond to not less than 39.2 per cent of magnesium 
oxide nor contain more than 0.8 per cent of calcium oxide. 
Description.-Permanent, white, easily broken masses, or a white bulky powder, 
odorless and with a feebly earthy taste. Almost insoluble in water and alcohol. Dose, 
3j to 3ii- 
Preparation.-Magma Magnesice, Magnesia Magma (Milk of Magnesia). A thick, 
white liquid containing magnesium hydroxide suspended in water. It is prepared by the 
interaction of magnesium carbonate, sodium hydroxide, and water. Dose, fl3j to fl3»v. 
Action and Therapy.-Magnesium carbonate is antacid and purgative 
if in contact with an acid in the gastro-intestinal canal. If no acid is 
present it does not purge. This may be conveniently supplied by adding it 
to lemonade and drinking it while it is effervescing. As an antacid it is 
effectual but not so useful for infants as the oxide, on account of the libera- 
tion of carbon dioxide, which, though in itself somewhat quieting to pain, 
is overbalanced in this direction by the painful distention it may cause. 
It is to be used for acid conditions of the stomach, with constipation and 
sick headache, and (chiefly in mineral waters) in the uric acid diathesis. 
It is sometimes useful in acid diarrhoea, and long administered is said to 
remove cutaneous hypertrophies, such as warts. 
Milk of Magnesia (Magma Magnesiae) is a favorite laxative for 
infants and children, especially the bottle fed, and for alkalinizing the blood 
in renal and nutritional disorders to prevent or overcome acidosis. 
MAGNESII OXIDUM. 
Magnesium Oxide, Magnesia, Light Magnesia, Calcined Magnesia. 
(Formula: MgO.) 
Description.-A bulky, very fine, white, odorless powder, having an earthy taste; 
water scarcely dissolves it. On exposure it slowly absorbs moisture and carbon dioxide. 
Dose, 10 to 60 grains. 
Action and Therapy.-External. Used chiefly as an absorbent dusting 
powder. 
Internal. Light magnesia is an ingredient of the Arsenic Antidote 
(Ferri Hydroxidum cum Magnesii Oxidd), which see. Though possessing 
the properties of heavy magnesium oxide, it is less employed internally 
on account of its bulkiness. Its uses are the same as for Magnesii Oxidum 
Ponderosam, which see. Dose, as a laxative, 30 to 60 grains; children, 
5 to 10 grains; as an antacid, 10 to 30 grains. 
MAGNESII OXIDUM PONDEROSAM. 
Heavy Magnesium Oxide, Heavy Magnesia. (Formula: MgO.) 
Description.-A very fine, dense, white powder, without odor and of an earthy taste, but 
does not readily unite with water to form a gelatinous hydroxide (difference from light 
magnesia). 
Specific Indications.-Gastro-intestinal acidity, pyrosis, heart burn; 
excoriating feces; constipation with acidity. 
Action and Therapy.-Heavy magnesium oxide is antacid and laxative, 
producing feculent and somewhat deodorized stools, If there is an excess 
of acid present in the stomach the passages are thinner. As a laxative it is 
slow (5 or 6 hours) but mild and thorough, and seldom causes any griping. 
470 INDIVIDUAL DRUGS. 
It requires the presence of an acid to make it act efficiently, therefore it is 
to be selected when both an antacid and laxative are required as in acidity 
of the stomach and constipation, with or without headache. It is valuable 
in pyrosis, and the gastric acidity sometimes accompanying pregnancy. If 
given too freely or too long it may form concretions in the stomach and 
bowels. This may be obviated by an occasional dose of lemon juice or of 
lemonade. It is a splendid laxative and agent to offset hyperacidity 
accompanying gastric ulcer. Sick headache, with sour stomach, and the 
nausea and vomiting of pregnancy are often cut short by a few doses of 
magnesia oxide. In atonic dyspepsia with acidity and constipation, from 
5 to 10 grains of rhubarb, 2 grains of ginger, and 20 to 40 grains of magnesia 
are effective in overcoming the constipation and correcting the hyper-acid 
state. When young children void green and excoriating feces, 5 grains of 
magnesium oxide and 2 grains of rhubarb are very effective. 
MAGNESII SULPHAS. 
Magnesium Sulphate, Epsom Salt, Bitter Salts. (Formula: MgSO4.7H2O.) 
Description.-Small colorless crystals or needles, of a saline and somewhat cooling, 
bitter taste. It slowly parts with water of crystallization and becomes whiter. Very 
soluble in cold and hot water. The crystals closely resemble those of zinc sulphate, but 
are moister and lack the metallic taste of the latter. 
Specific Indications.-Dysenteric, mucoid, or muco-sanguineous alvine 
discharges, passed with tenesmus and tormina; blood-streaked mucoid 
stools; fecal obstruction; acute lead poisoning or painter's colic. 
Action and Therapy.-Applied locally solutions of Epsom salt soften 
and cleanse the skin, and facilitate the natural function of that organ. 
A good cosmetic lotion for use after shaving may be prepared by simple 
solution of the crystals in water (3 ij to Oj), plain or glycerinated or fortified 
with hamamelis, bay rum, or rose water. Applied to old and slimy shin 
ulcers and ulcerated ankles, with deep red or purplish-red, and scaly or 
mummified tissues, due to varicosis of the veins of the leg, or to eczema 
rubrum, a lotion of Epsom salt persisted in cleanses the sores and stimulates 
the circulation and the production of healthy granulation. A sponge bath 
containing the salt in strong solution gives comfort and reduces temperature 
in fever and local inflammations, and while said to be but slowly and very 
little absorbed by the skin seems to favor elimination through that channel 
to the relief of the kidneys in chronic interstitial nephritis. A magnesia 
hot sponge bath imparts a sense of well-being after physical exertion. When- 
ever autoxemia is present or when metabolic processes are imperfect, as in 
chronic malarial infections and diabetes, with inactivity of the skin, which 
looks dry, muddy, and infiltrated, a hot sponge bath of magnesium sulphate 
will arouse the dormant functions and promote elimination of self-generated 
poisons. 
Fomentations of a strong solution of the salt give comfort in erysipelas 
and dermatitis when the skin is dry, hot, and swollen; and applied hot 
give relief in acute inflammatory rheumatism, arthritis, epididymitis, 
neuralgia, neuritis, sciatica, tonsillitis, and croup. Persistent use of the 
magnesium sulphate solutions has been advised to remove cicatrices of the 
skin and cornea, and warts, and an injection of the same is useful in gonor- 
471 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
rhoea of both male and female. Bathing with a solution of Epsom salt and 
allowing it to dry on the skin is said to defend one absolutely from the 
visitations of "chiggers". Epsom salt baths should contain about one-half 
pound to the gallon of water. 
Internal. Magnesium sulphate is an active refrigerant cathartic and 
diuretic. It produces free, watery evacuations, at the same time augmenting 
the secretion of urine. If taken on an empty stomach it acts within one or 
two hours; and by many is preferred in hot (not warm) water for quick 
and efficient action. It is not readily absorbed and probably acts, through 
salt-action, by abstracting the watery constituents from the intestinal 
circulation. When a derivative effect is desired, as in dropsy of various 
types, the drug is given in as concentrated a form as possible, using just 
enough water to thoroughly dissolve the salt, and is most effectual if given 
in broken doses. Its tendency to nauseate may be obviated by the addition 
to it of four or five drops of sulphuric acid, and its taste may be masked 
by coffee. With the addition of the acid its refrigerant effects are lessened 
and its tendency to gripe or irritate the rectum, or to interfere with the 
appetite and digestion, are greatly diminished. As a rule Epsom salt should 
not be administered to old persons and to the feeble on account of the 
possibility of causing a chill, especially in cold weather. 
Under ordinary circumstances magnesium sulphate is an ideal hydra- 
gogue cathartic in febrile and inflammatory affections when constipation 
exists. It is frequently used in broken doses to effect a liquefaction of the 
stool when there are impacted feces, especially in the caecum and right 
ascending colon, with tendency to inflammation and elevated temperature. 
In peritonitis it is preferred to other purgatives on account of its depleting 
and refrigerant catharsis. It is one of the most commonly used purgatives in 
ascites. It is best given in smaller doses, a drachm or two in a small amount 
of water several times a day. Magnesium sulphate is among the preferred 
cathartics for use previous to surgical operations. No other saline cathartic 
can be given so long and so safely as magnesium sulphate. As a rule, how- 
ever, the dose administered is too large (1 to 2 ounces), and doses of 2 to 4 
drachms in hot water or in hot or cold lemonade are equally as efficient and 
less exhausting. As an occasional cleansing agent it should be given inter- 
currently with cascara, taraxacum, and other agents to overcome habitual 
constipation. 
Sulphate of magnesium is one of the best of medicines for acute dys- 
entery. If there is marked constipation with only mucoid discharges a 
drachm may be given in water, and after fecal matter appears in the stools 
the salt may be continued in about two grain doses until the trouble sub- 
sides. If not so constipated at the beginning the following is the best form 
of administration: I) Magnesium Sulphate, 3j; Specific Medicine Aconite, 
gtt. iij; Specific Medicine Ipecac, gtt. v to x; Water (or Peppermint Water), 
q. s., fl^iv. Mix. Sig.: One teaspoonful every hour. This seldom fails to 
overcome the constipation of the upper bowel, reduce the fever and inflam- 
mation of the lower bowel, relieve the tormina and tenesmus, check the 
flow of mucus, and arrest any hemorrhagic manifestations that may be 
present. It is one of the surest of specific means for this disease. Larger 
doses are said to be valued in amoebic or tropical dysentery, with full doses 
472 INDIVIDUAL DRUGS. 
of ipecac, given until the mushy stools of the latter are in evidence. We 
invariably employ sulphate of magnesium in muco-colitis of children, 
when the stools contain much mucus, barely stained a pinkish color by blood, 
but which cannot be readily recognized as blood. In small doses it often 
proves serviceable in urticaria. 
A full purge of salts is indicated in cerebral vascular engorgement, 
oedema of the brain, or intracranial pressure from excess of meningeal 
fluid. It is also useful in uraemia in conjunction with other measures. 
The claim has been made that fractional doses of magnesium sulphate or 
the oxide (1/10 to 1/2 grain), once or twice a day for several weeks, are 
effectual in removing warts. For acute lead poisoning, with lead colic, the 
administration of full doses of magnesium sulphate acidulated with sulphuric 
acid is the universally recognized and best treatment. 
The intraspinal use of magnesium sulphate for the control of tetanus 
and allied disorders has been attended with fatalities and has not as yet 
become an approved treatment. 
MANGANI DIOXIDUM PR2E CIPIT ATUM. 
Precipitated Manganese Dioxide. 
Description.-A permanent, fine, heavy, black powder, odorless and tasteless, not 
dissolved by water or alcohol. Dose, 1 to 8 grains. 
Action and Therapy.-Manganese dioxide is said to be useful in gastric 
ulcer and in amenorrhcea and dysmenorrhoea in anemic individuals. As an 
alterative it has been advised in slow-healing skin affections in strumous 
subjects, particularly in those who suffer from pyrosis and other gastric 
disturbances and have a tendency to chlorosis. It should be given in the 
smaller doses. It is not readily absorbed, but in large amounts may pro- 
duce poisonous symptoms. 
MANGANI SULPHAS. 
Manganese Sulphate. 
Description.-Colorless or pale rose-colored, transparent crystals, without odor, and 
having a slightly bitter and astringent taste. Slightly efflorescent in dry air. Very soluble 
in water; insoluble in alcohol. Dose, 1/2 to 5 grains. 
Specific Indications.-Ascites, with hepatic disease, and when the 
result of alcoholism; lax, pendulous abdomen; pale, dirty, leaden-hued 
skin; diarrhoea; small, mucous passages, with tormina and tenesmus. 
Action and Therapy.-Large doses of manganese sulphate produce 
severe catharsis and sometimes gastro-enteritis. Small doses are stimulant 
to the liver and intestinal glands. It may be given in ascites due to hepatic 
diseases, and especially when occurring in old topers. Scudder advised 
it in small doses in disorders exhibiting a pallid, dirty, leaden-colored 
tongue, with gastric fullness, sluggish bowel action, and lax, pendulous 
abdomen; in minute doses (in lx or 2x trit.), when the tissues are old and 
feeble and heart action and circulation weak. 
473 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
MANGIFERA. 
The inner bark of the root and tree of Mangifera indica, Linne (Nat. Ord. Anacardi- 
aceae). A native East Indian fruit tree; naturalized in the West Indies. Dose, 5 to 60 grains. 
Common Name: Mango. 
Principal Constituents.-Tannic acid (17 per cent) and an acrid oil. 
Preparation.-Specific Medicine Mangifera. Dose, 5 to 60 drops. 
Specific Indications.-Feeble, relaxed tissues; mucous discharges; 
chronic dysentery with muco-purulent discharges; red, congested or 
inflamed fauces. 
Action and Therapy.-External. Mangifera forms a soothing, astringent 
gargle for acute or chronic inflammation of the fauces, especially when full, 
red and congested and intensely painful. It may be used also to alleviate 
inflammatory conditions of the mucosa of any part of the body or upon 
excoriations of the skin. Especially is it effective in acute pharyngitis and 
the follicular and phlegmonous forms of tonsillitis. Too much has been 
claimed for it in diphtheria, though its use as an adjuvant is not inap- 
propriate, especially if there is either much redness and pain, or relaxation 
of tissue. In acute rhinitis it may be used as a douche; and in acute in- 
flammation of the uterine cervix it has been employed with advantage. 
For use upon the nose and throat about two drachms of specific medicine 
mangifera may be added to two ounces of water. 
Internal. Owing probably to its tannic acid, and somewhat to other 
inherent principles, mangifera is a useful drug in relaxation of mucous 
tissues, associated with catarrh and diarrhoea and feeble capillary circula- 
tion. It appears to be best adapted to entero-colitis and watery diarrhoea. 
Many value it in passive hemorrhages from the nose, uterus, stomach, 
intestines, and lungs; and some good therapeutists have declared it of 
value in hemophilia. One should not, however, expect much in the latter 
disorder from a drug whose hemostatic properties are evidently mostly 
due to its tannin. Mangifera is one of the pleasantest forms of administer- 
ing the latter, which may be of a special type, as there are many tannins. 
It agrees well with the stomach and seems to promote the appetite and 
digestion, and apparently is non-constipating. When not contraindicated 
syrup is a fairly good vehicle for mangifera in throat affections. 
The concrete saccharine exudation of Fraxinus Ornus, Linne (Nat. Ord. Oleacese). 
A tree of southern Europe. Dose, 1 drachm to 2 ounces. 
Common Name: Manna. 
Description.-Irregular, flattened, longish pieces, of a yellowish-white exterior and 
nearly white interior, somewhat porous and crystalline-like, having a peculiar odor, a taste 
sweet followed by feeble bitterness and acridity. It should not contain more than four- 
tenths part of irregular, yellowish-white, resin-like fragments. 
Principal Constituents.-Mannite (90 per cent) with sugar (10 per cent). 
Action and Therapy.-Nutritive in small doses and mildly laxative in 
larger amounts. In doses of one to three drachms for infants and one to 
two ounces for adults it makes a very pleasant laxative when administered 
in milk. It is suitable for the constipation of pregnancy. It sometimes 
causes flatulency and griping. This may be obviated by giving with it any 
warm aromatic. 
MANNA. 
474 INDIVIDUAL DRUGS. 
MARRUBIUM. 
The leaves and tops of Marrubium vulgare, Linne (Nat. Ord. Labiatae). Europe; 
naturalized in America. Dose, 5 to 60 grains. 
Common Names: Horehound, Hoarhound. 
Principal Constituent.-A bitter principle marrubiin (CsoH^Os). 
Preparations.-1. Specific Medicine Marrubium. Dose, 1 to 60 drops. 
2. Syrupus Marrubii Compositus, Compound Syrup of Hoarhound. Dose, 1 to 4 
fluidrachms. 
Specific Indications.-Chronic irritation of the bronchial membrane 
with cough and catarrh. 
Action and Therapy.-Hoarhound is a stimulating expectorant and 
tonic, and is adapted to both acute and chronic irritation of the larynx and 
bronchial tract, and gives added power to respiration. In small doses it 
is a gastric tonic of considerable value, but given too freely it will act as an 
emetic and cathartic. A hot infusion is diaphoretic; a cold infusion, diuretic. 
Hoarhound, usually in the form of a syrup, is useful in hoarseness, coughs, 
and colds that do not clear up rapidly, chronic bronchial catarrh, and 
humid asthma. The specific medicine may be used in atonic dyspepsia, 
especially when associated with bronchial debility. The compound syrup 
is an agreeable and efficient expectorant for chronic cough. Hoarhound 
candy is a popular remedy for irritation of the throat with cough. 
MATICO. 
The leaves of Piper angustifolium, Ruiz et Pa von (Nat. Ord. Piperaceae). A Peruvian 
shrub. 
Common Names: Matico, Matico Leaves. 
Principal Constituents.-A bitter principle, maticin, and an aromatic camphoraceous 
volatile oil. 
Preparation.- Tinctura Matico, Tincture of Matico (5ijss to Diluted Alcohol, Oj). 
Dose, 1 to 2 fluidrachms. 
Action and Therapy.-An aromatic, bitter stimulant of reputed value 
in catarrhal states, particularly of the stomach and genito-urinal tract. 
It is seldom used. 
MATRICARIA. 
The dried flower-heads of Matricaria Chamomilla, Linne (Nat. Ord. Compositae). 
Wastes of Europe, Asia, and Australia. Dose, 1 to 60 grains. 
Common Names: German Chamomile, Wild Chamomile. 
Principal Constituents.-A dark-blue, aromatic, volatile oil (Oleum Chamomilla 
ALthereum) and possibly a crystallizable, bitter, anthemic acid, and a crystalline alkaloid 
anthemidine. 
Preparations.-1. Specific Medicine Matricaria. Dose, 1 to 60 drops. 
2. Infusum Matricarice, Infusion of Matricaria (3ss to Oj). Dose, 1 to 4 drachms. 
Specific Indications.-Nervous irritability, with fretfulness, peevish- 
ness, impatience, and discontent; morbid sensitiveness to pain and ex- 
ternal impressions; sudden fits of temper when menstruating; muscular 
twitching; fetid, greenish feculent alvine discharges, or when the stools 
are green and slimy, or of mixed whitish curds and green mucus, associated 
with flatulence, colic, and excoriation of the anal region; if a child, the head 
sweats easily and the discomforts of teething, flatulent colic, etc., are 
transient and intermitting, and the nervousness is relieved by being carried 
about in the arms. 
Therapy.-According to dose and manner of use, matricaria is a 
stimulant diaphoretic and nerve sedative. Its calmative action is so 
475 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
satisfactory that even the skeptic in therapeutics becomes a convert to 
the fact that there is great therapeutic energy in some simple agents which, 
by usual tests, fail to show decided so-called physiological action. Mat- 
ricaria, simple and safe as it is, is remedially potent. Could it more generally 
have taken the place of "soothing syrups", so largely destructive to infant 
life, the history of baby mortality might have been a less appalling story. 
No child need be laid in its grave because of its administration. 
Matricaria, better known to some as chamomilla, is pre-eminently a 
child's remedy, especially for the very young child. It has two well-marked, 
specific fields of action-(1) on the nervous system, subduing irritability; 
and (2) on the gastro-intestinal tract, allaying irritation. Its influence is 
well seen upon the infant during the period of dentition. In such con- 
ditions it is adapted to the restless, peevish, irritable, discontented, and 
impatient infant, who is only appeased when carried about in order to 
quiet its nervousness and unrest. The child needs both sympathy and 
matricaria, both sound measures in infant therapeutics. In such children 
it may be equally a remedy for constipation or diarrhoea. In the former 
case, there is usually hepatic tenderness. In the latter, the discharges may 
be variously characterized-watery and greenish, slimy, green and slimy, 
or yellow and white lumps of undigested curds, giving them the well- 
known name of "eggs and greens". Such stools usually excoriate the child 
severely, and are accompanied by colicky pain of greater or less severity. 
The urine is passed with difficulty, and there is more or less bloating of the 
abdomen. Flatulence is often marked, and the surface is alternately 
flushed and pale. Under such irritable conditions it proves a useful remedy 
in infantile dyspepsia, and when teething the child cries out in sleep and 
there is sometimes a tendency to convulsions. This condition it may ward 
off by controlling the nervous excitation, but it is of little value after con- 
vulsions occur. Sometimes a gently laxative dose of sodium phosphate 
preceding or accompanying the matricaria will enhance the efficacy of the 
latter. Matricaria is useful for the swelling of the breasts in the new- 
born (usually with phytolacca), and in the involuntary passage of urine 
in the young. For the flatulent colic of early infancy it is one of the safest 
and most effectual medicines. For this purpose it should not be sweetened. 
Matricaria is invaluable in some affections of nervous women, a field 
in which it is too frequently neglected, perhaps not being considered a 
powerful enough medicine. In woman or child it is a nerve sedative, and 
adapted to irritation and not to atony. In the latter months of pregnancy 
it frequently allays false pains, cough, nervous muscular twitching, and 
other unpleasant nervous phenomena. In amenorrhoea and dysmenor- 
rhoea, with weighty feeling in the uterus and tympanites, it often relieves, 
as it does in cases presenting sudden explosions of irascibility, and in those 
having cramping or labor-like pains and meteorism. The hot infusion is 
particularly useful in suppressed menstruation from colds, and often 
controls earache and facial neuralgia from the same cause. The matricaria 
patient is extremely and morbidly susceptible to pain, is hyperaesthetic, and 
the nervous apprehension is all out of proportion to the actual pain suffered. 
This remedy should be resorted to when one is tempted to employ opiates 
and other more powerful pain relievers. 
476 INDIVIDUAL DRUGS. 
MEL. 
A saccharine substance deposited in the honey comb by the Apis mellifera, Linne 
or Honey Bee (Family Apidae). 
Common Name: Honey. 
Description.-A thick, viscous, syrupy, yellowish or yellow-brown fluid, clear when 
fresh, but losing its translucence with age and depositing crystals. It has an intensely 
sweet, feebly acrid taste, and a distinctive odor. 
Principal Constituents.-Lsevulose (fruit sugar), dextrose (grape sugar or glucose) 
and sucrose (cane sugar), with the first named predominating; also a trace of formic acid\ 
Preparations.-1. Mel Depuratum, Clarified Honey. 
2. Mel Boracis, Borax Honey (Borax, Glycerin, Honey). 
3. Mel Rosce, Rose Honey (Fluidextract of Rose mixed with Clarified Honey). 
Dose, fl3j to fl3ij. 
Action and Therapy.-External. Honey is sometimes incorporated in 
poultices for mammitis, fissured nipples, boils and carbuncles, and is added 
to gargles for irritated conditions of the fauces. Honey of borax and honey 
of rose are preparations frequently recommended for aphthous ulcers of the 
mouth and female genitalia. Our experience has led us to regard honey 
as a barbarous application in sore mouth of infants and young children on 
account of the vicious smarting it causes. The borax, in weak solutions, 
is equally as efficient. 
Internal. Honey is nutritious, demulcent, diuretic and antiseptic; 
sometimes it proves laxative. Though extensively used as a food it some- 
times occasions unpleasant symptoms, as pyrosis, a peculiar and per- 
sistent bellyache, flatulent colic, head symptoms and occasionally diar- 
rhoea and urticaria. It is sometimes incorporated in cough mixtures as an 
agreeable demulcent, and is occasionally used to allay irritation of the 
urinary passages. 
The leaves and flowering tops of Melilotus officinalis, Willdenow (Nat. Ord. Legumin- 
osse). A common weed found everywhere in the United States. Dose, 1 to 30 grains. 
Common Names: Yellow Sweet Clover, Yellow Melilot, Yellow Melilot Clover. 
Principal Constituents.-An active substance of a vanilla-like odor, coumarin, as- 
sociated with melilotic acid; orthocoumaric acid, and a volatile oil, melilotol. 
Preparation.-Specific Medicine Melilotus. Dose, 1 to 20 drops. 
Specific Indications.-Idiopathic, atonic headaches and chronic 
neuralgias; coldness, tenderness, lameness or marked soreness of tissues; 
painful menstruation or menstrual colic with soreness and coldness; ovarian 
neuralgia. 
Action and Therapy.-Melilotus is a remedy for pain associated with 
a sensation of coldness of the extremities and marked tenderness, lameness, 
or soreness to the touch. With these indications it is very effectual in some 
cases of ovarian neuralgia and dysmenorrhoea. Though it may relieve 
headache due to gastric disorders, it is best adapted to painful states not 
resulting from reflexes, but rather those of an idiopathic type. Following 
the specific indications it has proved a remedy of worth in menstrual and 
intestinal colic, gastralgia, neuralgia of the stomach, visceral neuralgia, 
painful dysuria, and sciatic neuritis. It frequently cuts short recurrent 
neuralgia when induced by cold, and benefits in rheumatoid lameness or 
soreness. 
MELILOTUS. 
477 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
MENISPERMUM. 
The rhizome and roots of Menispermum canadense, Linn6 (Nat. Ord. Menispermaceae). 
In woods and hedges in the eastern half of the United States. Dose, 5 to 60 grains. 
Common Names: Yellow Parilla, Canadian Moonseed, etc. 
Principal Constituents.-Berberine in small quantity and a large amount of a bitter, 
white alkaloid, menispine; tannin, gum, and resin. 
Preparation.-Tinctura Menispermii, Tincture of Menispermum (Rhizome, 5viii; 
Alcohol (76 per cent), Oj). Dose, 5 to 60 drops. 
Specific Indications.-"Skin brown, tongue coated at the base, tip red, 
irregular appetite, constipation" (Scudder). 
Action and Therapy.-Yellow parilia is little used, though possessing 
decidedly active tonic properties. Full doses increase the volume of the 
pulse, sharpen the appetite, and prove laxative. Excessive doses cause 
emeto-catharsis. It is a good laxative, bitter and alterative, and may 
be used with benefit in strumous and chronic arthritic inflammations, 
when accompanied by fullness of the lymphatic nodes and weak digestion. 
Its possible value in leucocythemia has been suggested. 
MENTHA PIPERITA. 
The leaves and tops of Mentha piperita, Smith (Nat. Ord. Labiatae). Europe and the 
United States. Dose, 60 to 120 grains. 
Common Names: Peppermint. 
Principal Constituents.-A volatile oil (Oleum Mentha Piperita) and menthol. 
(See Menthol.) 
Preparations.-1. Oleum Mentha Piperita, Oil of Peppermint. (A clear, colorless 
oil having the strong odor and taste of peppermint and giving a sensation of cold when air 
is drawn into the mouth or water is drunk; soluble in alcohol.) Dose, 1 to 10 drops. 
2. Aqua Mentha Piperita, Peppermint Water. Dose, 1 fluidrachm to 1 fluidounce. 
3. Spiritus Mentha Piperita, Spirit of Peppermint (Essence of Peppermint-10 
per vCnt oil). Dose, 5 to 60 drops. 
Derivative.-Menthol. (See Menthol.) 
Specific Indications.-Gastrodynia, flatulent colic, difficult digestion. 
Action and Therapy.-External. Oil of Peppermint is rubefacient and 
anodyne. It is used alone or in combination with other oils for the relief of 
neuralgia and toothache, in both of which it is often very efficient. Its 
external use has been somewhat superseded by menthol, the camphoraceous 
body to which oil of peppermint owes most of its virtues. Still it is used 
largely to relieve local pain, especially that of burns and scalds. 
Internal. Peppermint infusion is a very grateful agent to allay nausea 
and vomiting, and to break up a cold. It forms a part of the well-known 
Neutralizing Cordial. The essence is a common and unexcelled carminative 
for gastrodynia and the flatulent colic of children, and is used extensively 
to modify the action and mask the taste of other medicines. Applied by 
atomization, essence of peppermint and alcohol, equal parts, frequently 
eases the pain of tonsillitis and gives relief in the cough of acute bronchitis 
and pneumonia. 
478 SPEARMINT 
iMentha spicata [Mentha viridis]) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Spearmint is one of the chief two mints that has figured largely in the pharmacy and medication 
of the Eclectic, as well as other schools of medicine. The other mint, Peppermint (Mentha 
piperita), which yields Menthol, closely resembles the above in appearance, though is coarser 
and grows chiefly along and in running water courses. INDIVIDUAL DRUGS. 
MENTHA VIRIDIS. 
The leaves and tops of Mentha spicata, Linne {Mentha viridis, Linne). (Nat. Ord. 
Labiatae.) Wild in Europe, and introduced into the United States, growing abundantly in 
damp grounds; cultivated. Dose, 60 to 120 grains. 
Common Name: Spearmint. 
Principal Constituents.-A volatile oil {Oleum Mentha Viridis), resin, and gum. 
Preparations.-1. Oleum Mentha Viridis, Oil of Spearmint. Dose, 1 to 10 drops. 
2. Spiritus Mentha Viridis, Spirit of Spearmint (Essence of Spearmint). Dose, 
5 to 60 drops. 
3. Aqua Mentha Viridis, Spearmint Water. Dose, 1/2 to 1 fluidounce. 
4. Infusum Mentha Viridis, Infusion of Spearmint (Spearmint, 3j to Water, Oj). 
Dose, ad libitum. 
Specific Indications.-Scanty secretion of high-colored urine; simple 
nausea. 
Action and Therapy.-Spearmint is used much like peppermint, though 
it is somewhat inferior as a carminative. It is especially valuable to allay 
nausea, particularly that following a sick headache. The warm infusion 
is a very agreeable and simple medicine for an acute cold. Spearmint is one 
of the surest and kindliest diuretics if given in cold infusion; or the essence 
may be used well diluted with cold water. We frequently employ it to 
render acetate of potash more effective as well as pleasanter to take. The 
spearmint increases the watery flow; the potash salt the solids of the urine. 
Spearmint may be used in strangury, suppression of urine, and scalding of 
urine, with difficult micturition. 
Menthol. 
A secondary alcohol obtained from the oil of Mentha piperita, Linne, or from other 
oils of mints. It should be kept in well-stoppered bottles, and in a cool place. 
Description.-Colorless needle or prismatic crystals with a strong odor and taste 
characteristic of peppermint, very soluble in alcohol, ether, and chloroform, and slightly 
soluble in water. It gives a feeling of warmth when tasted, followed by a sensation of 
cold when air is inhaled or water is drunk. Dose, 1/8 to 2 grains. 
Specific Indications.-Pruritus; nausea and vomiting. 
Action and Therapy.-External. Menthol is a local antiseptic, an- 
aesthetic and antipruritic. It is used with great success in various disorders 
attended with itching and pain. It may be used alone or rubbed up with 
camphor, chloral hydrate, or phenol in combinations desired, and painted 
upon painful surfaces or employed to obtund the pain in a carious tooth. 
In alcoholic or oil solution it is an unexcelled application for the itching of 
hives, pruritus vulvae et ani, eczema, ringworm, or herpes zoster. For 
pain and cellular inflammations it is very effectual in burns and scalds, 
insect bites and stings, earache, neuralgia, boils, carbuncles, and the 
surface pains of sciatica. The pain of local and superficial neuralgias 
and of arthritis, simple, rheumatic, or gonorrhoeal, may be relieved by paint- 
ing upon the affected surface a combination of hydrated chloral, thymol, 
and menthol. A 20 per cent mentholated petrolatum may be used as a 
stimulating agent when there is a lack of cerumen in the auditory canal, and 
for boils in that passage a 20 per cent oil solution is very comforting. A 
10 to 20 per cent solution in liquid petrolatum or olive oil gives relief in 
coryza and hay fever, or may be sprayed into the larynx for the relief of the 
distressing oain of larvngeal tuberculosis. An albolene sprav of menthol 
MENTHOL. 
479 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
is largely employed in inflamed and irritable conditions of the nose and 
throat-ozaena, catarrhal sore throat, asthma, chronic bronchitis, and 
whooping cough. The vapor is useful to allay harassing and irritable 
bronchial cough. 
Internal. Minute doses of menthol relieve nausea and vomiting, as of 
pregnancy and seasickness. It is sometimes of value in hiccough. It 
should not be used in large doses internally because of the profound nervous 
disturbances it may occasion. 
METHYLTHIONIN^ CHLORIDUM. 
Methylthionine Chloride, Methylene Blue. 
Description.-Deep green, crystalline powder, or bronze-lustrous crystals; freely 
soluble in water and alcohol and less so in chloroform, the solutions being a deep blue. 
Dose (average), 2 1/2 grains. This compound should not be confounded with Methyl 
Blue or Pyoktanin, these being for local use only. Dose, 1 to 4 grains. 
Action and Therapy.-Reputed antiseptic, anodyne, hypnotic, and 
diuretic. Its chief use has been to clear the urethra of gonococci, in which 
it sometimes appears to be successful. It stains the urine a deep blue, 
gradually changing it to a greenish-blue or sea-water tint before the color 
is completely discharged. A single dose leaves its impress upon the urine 
for several days. This property has made it of diagnostic value to test the 
rate of renal excretion. Intramuscular injection of one grain in ten minims 
of water should show the color of the drug in the urine in fifteen to twenty 
minutes and persist for thirty-six hours. For a similar purpose it is injected 
into the pleural and peritoneal cavities to determine whether the effusion 
is being removed. The method employed is to inject from one to three 
grains and administer a purge. If the kidneys are healthy and no color 
appears in the urine, the presumption is that absorption is not taking place 
because of occlusion by means of inflammatory exudates. 
Methylene blue, though less powerful than quinine, is said to destroy 
the malarial plasmodia and to have been effective in intermittent malarial 
fever, when quinine is badly borne or is unsuccessful. It has been used also 
as an anodyne and calmative in migraine, alcoholic neuritis, and to 
relieve the pains of locomotor ataxia; and to allay excitement in mania 
and in paretic dementia it has given rest simulating that of natural sleep. 
Should methylene blue occasion headache, nausea, dizziness or strangury, 
a dose of powdered nutmeg (about 20 to 30 grains) is said to correct these 
unpleasant symptoms. Its former use to relieve pain and shrink malignant 
growths is now seldom invoked. The dose of methylene blue is one to four 
grains, in capsules, every four hours; children, less in proportion and only 
in malarial affections. 
The whole plant of Mitchella repens, Linn& (Nat. Ord. Rubiaceae). Dry woods, hem- 
lock forests, and damp places in the United States. Dose, 5 to 60 grains. 
Common Names: Partridgeberry, Squawberry, Squaw-vine, Checkerberry, Deer- 
berry, One-berry. 
Principal Constituent.-An undetermined saponin-like body. No alkaloid, glucoside, 
nor volatile oil present. 
Preparations.-1. Specific Medicine Mitchella. Dose, 5 to 60 drops. 
2. Syrupus Mitchellce Compositus, Compound Syrup of Partridgeberry (Mothers' 
Cordial). (Contains Mitchella, Helonias, Viburnum Opulus and Caulophyllum, Brandy, 
Sugar and Essence of Sassafras.) Dose, 2 to 4 fluidounces, 3 times a day. 
MITCHELLA. 
480 HORSE MINT 
(Monarda punctata) 
Photo by Frank H. Shoemaker, 
Lincoln, Nebraska 
Courtesy of Prof. Rufus A. Lyman, 
University of Nebraska 
Horse Mint is a type of plant-drug once valued in infusion as an aromatic stimulant in domestic 
and early Eclectic medication. In support of the therapeutic acumen of the early Eclectics it 
has recently come into renewed pharmacal prominence as one of the sources of Thymol, a de- 
rivative of great importance in the treatment of hookworm. INDIVIDUAL DRUGS. 
Specific Indication.-As a partus praeparator. 
Action and Therapy.-Based upon the practice and traditions of the 
American Indians this plant was eagerly adopted into domestic and early 
botanic and Eclectic therapy. It is believed by some to have a salutary 
influence upon the pregnant woman, easing many of the distresses incident 
to her condition, giving a sense of well-being and strengthening her for the 
ordeal of child birth. If it has any virtue it lies in quieting nervous irrita- 
bility and giving a psychologic balance throughout the latter months of 
pregnancy. There seems to be reliable testimony to the effect that it 
assists in sustaining against miscarriages where such accidents have pre- 
viously occurred. As a female regulator it has also had many devoted 
advocates. The Mother's Cordial is a popular and more rational prepara- 
tion. 
MONARDA. 
The leaves and flowering tops of Monarda punctata, Linne (Nat. Ord. Labiatae). 
Indigenous to the greater part of the United States, in sandy fields and barrens. 
Common Name: Horsemint. 
Principal Constituent.-A volatile oil (Oleum Monarda), a pungent, aromatic, yellowish 
to yellowish-red or brown oil; soluble in alcohol, and depositing the stearopten thymol 
(CioH13OH) (monardin) (25 to 56 per cent). 
Preparations.-1. Oleum Monarda, Oil of Monarda. Dose, 2 to 5 drops, on sugar. 
2. Infusum Monarda, Infusion of Horsemint, (5j to Water Oj.) Dose, flgss to flgij. 
Derivative.-Thymol. (See Thymol.) 
Action and Therapy.-External. Locally applied the oil is rubefacient, 
and if too closely or long applied painfully vesicant. It has been successfully 
used in local neuralgias. 
Internal. Infusion of monarda has long been a popular remedy for 
retarded menstruation from cold. Both the plant and its oil, which is 
sharply pungent and diffusive, are stimulating, carminative, antiemetic, 
and diuretic; in hot infusion diaphoretic. Both may be used to relieve 
nausea and vomiting even when there is diarrhoea, in flatulent distention 
of the bowels, in the tympanites of typhoid fever, and the catarrhal vomit- 
ing of the drunkard. It checks the serous diarrhoea of debility, and tends 
to promote rest and sleep from exhaustion when associated with nervous 
excitation. Monarda has recently come into renewed prominence as an 
available source of thymol, now largely used as the most generally effective 
agent against hookworm. Oil of Monarda is an ingredient of domestic 
preparations lauded for their asserted effectiveness in pertussis. 
MYRICA. 
The bark and wax of Myrica cerifera, Linne (Nat. Ord. Myricaceae). Dry woods and 
open fields from Canada to Florida. Dose, 5 to 60 grains. 
Common Names: Bayberry, Waxberry, Candle Berry, Wax-Myrtle. 
Principal Constituents.-Tannic and gallic acids, resins, bayberry tallow (from fruit), 
32 per cent; myricinic and lauric acids. 
Preparation.-Specific Medicine Myrica. Dose, 1 to 60 drops. 
Specific Indications.-Profuse mucous discharges, with atony of the 
circulation; sore mouth and sore throat. 
Action and Therapy.-External. Bayberry, in powder, decoction, or 
specific medicine, may be applied for the relief of spongy, flabby, and 
bleeding gums, the sore throat of scarlatina with enfeebled and swollen 
481 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
tissues, and to aphthous and indolent ulcerations. As an injection it is 
valued by some in atonic leucorrhoea. 
Internal. Bayberry is a stimulating astringent. In full doses it is 
emetic. It is a remedy of considerable value in relaxed and flabby conditions 
of tissues with hypersecretion. In small doses (2 to 5 drops of specific 
medicine) it stimulates the gastro-intestinal glands, favors digestion and 
imparts tone, thereby increasing blood-making and nutrition. In doses of 
5 to 20 drops it is a decided gastric stimulant, and as such may be used in 
chronic gastritis. It is also of value in chronic catarrhal diarrhoea, muco- 
enteritis, and typhoid dysentery, though the latter is not encountered as 
much as in former years. It may be given internally, as well as used 
locally upon the throat, in scarlet fever, in the latter stages, when a flabby 
and enfeebled rather than highly inflammatory condition exists. As a rule 
bayberry should not be employed in active conditions, but rather in de- 
bility of the mucosa, with feeble venous flow and full, oppressed pulse. 
MYRISTICA. 
The ripe seeds of Myristica fragrans, Houttuyn, deprived of their testa (Nat. Ord. 
Myristicaceae). Molucca Island; and cultivated in the tropics. Dose, 5 to 15 grains. 
Common Name: Nutmeg. 
Principal Constituents.-A fixed (25 to 30 per cent) and a volatile oil {Oleum Myristica, 
2 to 8 per cent). Dose of volatile oil, 1 to 5 drops. 
Preparation.-Specific Medicine Nutmeg. Dose, 1 to 15 drops. 
Action and Toxicology.-An aromatic stimulant and carminative in 
small doses; larger doses produce nervous sedation and are soporific. 
Death has resulted from large doses (more than three drachms), the chief 
symptoms being headache, coldness, and collapse, drowsiness and in- 
disposition to muscular movements. Diuresis is apt to be increased, though 
in one case it was entirely suppressed. (See author's report of case of 
poisoning in Eclectic Medical Journal, 1891, page 125.) 
Therapy.-External. An ointment containing the finely powdered 
nut, or the volatile oil sometimes proves obtundant to painful piles. Grated 
upon a larded cloth and applied warm we have found it to give prompt 
and grateful relief in soreness of the chest attending an acute cold or the 
beginning of acute respiratory inflammation. It may also be used as a 
spice poultice to the abdomen in painful bowel affections from cold. A 
liniment of oil of nutmeg (1) and olive oil (3) is regarded by some as an 
efficient parasiticide for mild types of ringworm. 
Internal. Both the powdered nut and the oil are good carminatives 
and may be used to allay nausea, vomiting, and gastric pain, and to check 
flatulent colic and serous diarrhoea. The grated nut is in frequent domestic 
use to flavor foods for the sick, and it and the oil in prescription pharmacy 
to aromatize sleeping mixtures. 
MYRRHA. 
The gum-resin obtained from one or more varieties of Commiphora (Nat. Ord. 
Burseraceae). Region of Gulf of Aden and the Red Sea, Africa, and Arabia. Dose, 1 to 15 
grains. 
Common Names.-Myrrh, Gum Myrrh. 
Description.-Brownish-yellow or reddish-brown tears or masses, covered with a 
brownish-yellow dust; taste: bitter, acrid, and aromatic; odor: balsamic. Soluble in 
alcohol; forms an emulsion with water. Dose, 1 to 30 grains. 
482 INDIVIDUAL DRUGS. 
Principal Constituents.-A resin, myrrhin, 23 to 40 per cent; a volatile oil, myrrhol, 
2 to 8 per cent; gum, 40 to 60 per cent, and a bitter principle. 
Preparation.- Tincture, Myrrha, Tincture of Myrrh (Myrrh, 20 per cent). Dose, 
1 to 30 drops. 
Specific Indications.-Mucous membrane pale and lax; tonsils en- 
larged and spongy; throat pale and tumid; chronic bronchitis with profuse 
secretion of mucus or muco-pus, difficult to expectorate; soreness and 
sponginess of the gums; ptyalism; weight and dragging in pelvis in females; 
leucorrhcea; muscular debility. 
Action and Therapy.-External. Myrrh is the best local application for 
spongy and bleeding gums and is effective in mercurial and other forms of 
salivation. The tincture may be diluted with about 6 to 10 parts of water. 
It may also be used with benefit when the throat is sore and exhibits 
aphthous or sloughing ulcers, and in chronic pharyngitis with tumid, pallid 
membranes and elongated uvula. In spongy, enlarged tonsils it is an ideal 
topical medicine. After the removal of tonsils the following gives great 
relief from pain and deodorizes the fetor: Tincture of Myrrh, fl3ss; 
Asepsin, gr. x; Echafolta, fl3ij; Glycerin, fl 3 ij; Water, q. s., flgiv. Shake. 
This may be applied by means of an atomizer. This combination is also a 
good mouth wash and dentifrice and minimizes the possibility of pyorrhoea 
alveolaris. Myrrh, in powder, is often added to dentifrices. 
Internal. Myrrh is a stimulant to mucous tissues and should not be 
used, as a rule, in active inflammatory conditions. Small doses promote 
digestion and prove antiseptic to the intestinal canal. Large doses quicken 
the pulse, raise the temperature, cause gastric burning, great sweating and 
prostration; vomiting and purgation may follow. Myrrh is a remedy for 
enfeebled conditions with excessive mucous secretion, exhibiting its re- 
straining power especially upon the bronchial and renal mucosa. It is of 
much value in chronic bronchitis with relaxation of tissues, profuse, un- 
healthy and exhausting secretion and difficulty in raising the sputa. Locke 
advised the following: Compound Tincture of Myrrh and Capsicum, 
fl3ijJ Syrup of Wild Cherry, Syrup of Senega, aa, fl3ij- Mix. Sig.: One 
teaspoonful every three hours. This acts kindly upon the stomach and 
sustains the strength of the patient. The same combination often relieves 
the asthma of the aged. 
Myrrh is useful in chronic gastritis and atonic dyspepsia, with full, 
pale tongue and membranes, and frequent mucous stools accompanied by 
flatulence. It acts well with the simple bitters, especially gentian. 
Myrrh is probably emmenagogue, though much of its reputation as 
such has been acquired in anemic states in which it has been administered 
conjointly with iron and aloes. It is used in diseases of women when there 
is weight and dragging in the pelvis and leucorrhcea; and in suppression of 
the menses in anemic girls. For the type of amenorrheea dependent upon 
uterine torpor and constipation Locke advised the following: 3 Myrrh, 
gr. xxx; Aloes, gr. x; Macrotin, gr. x. Mix. Ft. Pil, No. 20. Sig.: One or 
two pills, three times a day. Myrrh is an ingredient of the celebrated 
Griffith's Mixture (Mistura Ferri Composita) for the amenorrheea of chlo- 
rosis and other forms of anemia; and of the Compound Pills of Rhubarb 
fPihilae Rhei Comoositae). 
483 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
NITROGENII MONOXIDUM. 
Nitrogen Monoxide, Nitrous Oxide, Nitrous Oxide Gas, Laughing Gas. 
(Formula: Na20.) 
Description.-A colorless, slightly odorous and sweetish gas, compressed into metallic 
cylinders for convenient use. It dissolves somewhat in water especially at low temperatures. 
Specific Indication.-To produce transient anaesthesia for very quick 
operations. 
Action.-Among anaesthetics nitrous oxide stands remarkable for its 
quickness and brevity in action, and its comparative safety. The death 
rate from this agent is estimated at 1 in 100,000. Though seldom fatal, 
occasionally untoward results follow its administration, among them being 
convulsions, coma lasting several days, paralysis, hysteria, and albuminuria, 
though these effects are exceedingly rare. The first effect of the inhalation 
of nitrous oxide gas is a general stimulation of the body with accelerated, 
strong pulse, quick, shallow breathing, a tingling sensation throughout the 
system, uncommon mental activity, and a pale countenance. After in- 
haling the gas for a period less than two minutes in duration, stertorous 
breathing ensues, the face becomes cyanotic, and loss of consciousness and 
sensation follows. If the inhalation be withdrawn before the latter effects 
are produced, a stage of intoxication is induced. Muscular rigidity or 
twitchings are sometimes observed, and occasionally hysterical manifesta- 
tions and erotic actions take place. The high state of excitement pro- 
duced, causing the individual to sing, make speeches, or to laugh im- 
moderately, has given to this agent the popular name of "laughing gas." 
Occasionally one becomes violent under its influence. Its effects are 
quickly over as soon as the gas is withdrawn. Anaesthesia is produced by 
the direct action of the gas upon the cerebral cortex, and in part to the 
deprivation of oxygen supply to the blood during its administration. 
It has no effect upon the heart and blood, but arterial pressure is increased 
indirectly by the asphyxia produced. Unlike ether or chloroform, complete 
anaesthesia may obtain often without the abolishment of the corneal reflex. 
Therapy.-Nitrous oxide was discovered by Priestley in 1776. It 
remained of interest to the experimental chemist only until some time after 
Sir Humphrey Davy, in 1800 (^Elements of Chemistry, by Lavoisier, 1802, 
Vol. II), discovered its wonderful anaesthetic action when inhaled. Then 
it became a curiosity, and under the name of laughing gas, remained such 
until Dr. Horace Wells (1844), of Hartford, Conn., first used it to annul 
pain during the extraction of teeth. Nitrous oxide is used by inhalation 
only, and is obviously employed only where transient or quick operations 
are to be performed. It may be safely administered to young or old, and 
scarcely any condition, except atheromatous arteries, contraindicates its 
use. The operative stage may be known by the loss of sensation (see above) 
when the conjunctiva is touched, and by the stertorous breathing. It is 
best inhaled by a mouth-piece having a valve to permit expiration, the 
apparatus being connected by tubing to the container, which is generally a 
rubber bag, or wrought-iron cylinder. The nostrils should be held closed. 
The chief use to which it has been put up to recent years is in dentistry to 
allay the pangs of teeth extraction. Opening of abscesses, operations for 
cataract, and other operations requiring not more than 20 minutes' time, 
484 INDIVIDUAL DRUGS. 
may be performed under its influence. It has been used to mitigate the 
sufferings of labor, to relieve neuralgia and other painful affections. The 
difficulty of transporting the containers makes this anaesthetic of little value 
outside of hospitals and the physician's and dentist's office. The brevity 
of its effects preclude its use in prolonged operations. Owing to the erotic 
dreams sometimes produced by it a third person should always be present 
when it is administered to women, many innocent operators having been 
unjustly charged with violating the proprieties of life under the mistaken 
anaesthesia impressions or sexual hallucinations of the patient. 
Within recent years nitrous oxide has been used quite extensively for 
beginning anaesthesia, to be later completed under ether or chloroform. 
It prevents the unpleasant preliminary effects of those drugs, owing to its 
quickness in producing the anaesthetic stage. This is of particular advantage 
to women and children who are nervous and apprehensive. Nitrous oxide 
has been revived in hospitals as an obtundant to mitigate the pains of child- 
birth, but in many surgical operations is being supplanted by a mixture of 
nitrous oxide and oxygen, or of nitrous oxide, oxygen, and ether, by which 
operations can be prolonged indefinitely with just sufficient anaesthesia to 
avoid the profound effects of ether or chloroform alone. Special measuring 
and mixing apparatus is employed in its administration. The latter methods 
are ideal, bringing the patient quickly under control and keeping him just 
"under" with marked composure and without the distressing facial ap- 
pearance caused by the two great anaesthetics-chloroform, and especially 
ether, when given alone. 
NUX VOMICA. 
The dry, ripe seeds of Strychnos Nux vomica, Linne (Nat. Ord. Loganiacae). According 
to the U. S. P. it should contain at least 2.5 per cent of nux vomica alkaloids. India, along 
the Coromandel Coast, Ceylon, and other parts of the East Indies. Dose, 1/20 to 2 grains. 
Common Names: Poison Nut, Dog Button, Quaker Buttons. 
Principal Constituents.-The powerfully poisonous alkaloids strychnine (C21H22O2N2) 
and brucine (C23H26N2O4) in union with igasuric acid. Loganin, a glucoside, is inert. 
Preparations.-1. Specific Medicine Nux Vomica. Dose, 1/30 to 5 drops. {Usual 
form of administration: Specific Medicine Nux Vomica, gtt. v to xv; Water, q. s. A^iv. 
Mix. Sig.: One teaspoonful every 1 to 3 hours.) 
2. Tinctura Nucis Vomicae, Tincture of Nux Vomica. Dose, 1 to 15 minims. 
Specific Indications.-Atonic states; tongue pallid and expressionless, 
uncoated, or with a yellowish pasty coat; yellowness of conjunctivae; 
yellow or sallow countenance, and yellowish or sallow line around the 
mouth; fullness and dull pain in the right hypochondrium; pain in the 
right shoulder, with colicky pain, pointing toward the umbilicus; men- 
strual colic; constipation; diarrhoea of atony; functional forms of paralysis. 
Action.-In small doses strychnine (and nux vomica) has but little 
apparent effect other than that of a powerful bitter and general tonic. 
Larger doses greatly stimulate and still further heighten bodily tone. 
Full medicinal doses increase reflex action, quicken the rate of respiration, 
and enlarge the capacity of the lungs, augment the force, rate, and volume 
of the pulse, raise arterial pressure, give increased sharpness to sight, 
hearing, and smell, and cause general irritation and excitement. It acts 
directly upon the heart-muscle and its ganglia, stimulating them, but its 
lethal doses depress. The arterial rise is due to vaso-motor stimulation. 
485 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
It is one of the most powerful of respiratory stimulants, acting through 
the centric center of respiration, and not only increases the rate and power 
of breathing, but enlarges the lung capacity. Its action upon the nervous 
system is chiefly upon the ganglionic cells of the motor tract of the spinal 
cord, and in poisonous doses causes such profound irritation or excitement 
as to render them extremely responsive to the slightest stimuli, resulting 
in tetanic convulsions. Most likely it also feebly stimulates the sensory 
tracts and slightly increases the power of nerve conduction. Upon the 
cerebrum it is almost without action, except possibly to stimulate to 
greater acuity the nerve centers of the special senses. Temperature is 
scarcely affected by ordinary doses of strychnine. While a portion of 
strychnine is oxidized in the body, the drug is excreted by the kidneys 
unchanged and as strychnic acid. 
Strychnine, brucine, and nux vomica are all extremely energetic poisons, 
acting as such chiefly by excessive stimulation of the spinal cord and the 
medulla. Strychnine is the most powerful and quickest, brucine consider- 
ably less so, while nux vomica is slower than strychnine, but almost identical 
in action, and if the quantity be sufficient, equally certain to cause death. 
The slightest observable effects from small doses of these drugs occasion 
slight twitching of the muscles of the arms and legs, especially during sleep. 
This is accompanied by restlessness, some anxiety, quickening of the pulse, 
and generally slight sweating. Sometimes the action of the bowels is in- 
creased, and there is a greater quantity of urine secreted, which is voided 
with more than ordinary frequency. The sexual passions may be excited. 
In larger doses, but not large enough to kill, a sense of weakness and heavi- 
ness is experienced, with depression of spirits, trembling of the limbs, and a 
slight rigidity or stiffness upon attempted movement. Inability to maintain 
the erect position is common, and a light tap upon the ham, given sud- 
denly, will be followed at once by a slight spasm, and the patient will no 
longer be able to stand. These are toxic and near-lethal effects. Lethal 
doses bring on the most violent of spasms and death (see below). 
The long-continued use of strychnine, in excessive amounts, tends to 
impair the digestive organs, and while small doses favor diuresis, large 
quantities impair that function by producing spasms of the bladder muscles. 
Toxicology.-Lethal doses of nux vomica or strychnine produce at 
first marked uneasiness and restlessness, with more or less of a sense of 
impending suffocation. Tremors of the whole body are observed. Sud- 
denly there is violent starting of the muscles, and the ensuing convulsions are 
of such great violence as to throw the patient off the bed, or to a considerable 
distance. Nearly all the muscles are affected at the same time; the 
exception being, perhaps, of those of the jaws, which become locked last. 
The risus sardoniciis is present and gives to the countenance a fiendish 
expression. Opisthotonos to an extreme degree takes place, the body 
resting upon the head and heels, with the hands clenched and the feet 
inverted. The convulsion is distinctly tetanic and is followed by a brief 
period of rest, during which the patient suffers acutely from pain, weariness, 
and rending of the limbs. He is conscious at all stages of the poisoning 
except just preceding death. During the intervals of repose from the 
convulsions there is acute sensibility and dreadful alarm. Upon the re- 
486 INDIVIDUAL DRUGS. 
newal of attack the patient may cry out from the violence of the spas- 
modic grip upon the respiratory organs. The slightest sound, draught of 
air, or beam of light will at once renew the convulsions. The spasms 
succeed each other rapidly, death usually taking place after three or four 
convulsions. Death may occur during the interval from exhaustion, or 
paralytic asphyxia, or during the vise-like grip upon the respiratory muscles 
and the heart from cramp asphyxia. The body stiffens after death and this 
rigidity has been known to persist for months. 
The smallest doses known to have produced death are 30 grains of 
nux vomica (equal to about 1 seed, or 1/3 grain of strychnine); 3 grains of 
the extract of nux vomica; and 1/16 grain (child) and 1/2 grain of strych- 
nine (adult). Death usually occurs in about two hours, or may be delayed 
for six hours. If six hours have elapsed without death the patient is likely 
to recover. 
In poisoning by strychnine (or nux vomica) the patient must be kept 
absolutely quiet. No noises should be permitted, nor even a draught of air 
be allowed to strike the body, nor a strong beam of light the eye. Emetics 
are only admissible very early before convulsions have occurred. If the 
patient is seen immediately after taking the poison the stomach should be 
repeatedly washed out with a solution of permanganate of potassium, or of 
tannin, or strong table tea. If an emetic is to be used apomorphine is to 
be preferred. Lard, sweet oil, milk, or charcoal may be given with a view 
of enveloping the poison and retarding its absorption. Chloroform is the 
best agent to control the convulsions, but should be administered between 
spasms while the patient is able to inhale. No inhalation can take place 
during the convulsions. Amyl nitrite is also useful. Large doses of bro- 
mide of potassium (60 grains) and chloral hydrate (30 grains) may be 
given per rectum. King believed camphor antidotal to strychnine and 
cited its saving effects upon animals to prove his contention. Artificial 
respiration is useful, but if resorted to the body must be grasped firmly as it 
is then less likely to excite spasms than is light and superficial contact with 
the skin. If a very large dose of the poison has been swallowed death is 
almost inevitable as its action is usually in full force in fifteen minutes, and 
as a rule, long before medical aid can be procured. Circumstances, however, 
alter the rapidity of poisoning, as the manner of taking the drugs, the 
contents of the stomach, and the facility for absorption, hence every effort 
should be made to sustain life even in apparently hopeless cases. Nux 
vomica poisons more slowly than the strychnine salts. 
Therapy.-As a rule nux vomica is more largely used in disorders of the 
gastro-hepatic tract than is strychnine; while strychnine is more generally 
preferred for hervous, sexual, and bladder disorders. For cardiac and 
respiratory dyspnoea, shock, and other emergencies, strychnine, hypo- 
dermatically administered is by far the quicker and better procedure. In 
all the conditions named on pages 488 and 489 (and these have been 
sufficiently pointed out) either nux vomica or the alkaloidal salts may be 
used, with the almost complete preference for the nux vomica in the 
stomach and bowel disorders. For the uses of the alkaloid in disorders 
of the nervous system see Strychnines Sulphas. 
487 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Nux vomica should not be given for long periods without intervals of 
rest, and strychnine should be reserved for an emergency remedy and never 
given, as it is, too frequently, for long periods as a nerve bracer. Remember, 
it is a powerful stimulant, but stimulates to exhaustion, causes prolonged 
erethism, and often invokes a low-running fever. The best dose of nux 
vomica for general purposes is the fractional, at most not to exceed one 
drop of the specific medicine. 
Nux vomica is the most important remedy for atony and relaxation 
of the stomach and bowels and disorders dependent thereon. The con- 
dition is never one of irritation from offending food, or from active hyper- 
aemia, or ordinary congestion, and with rare exceptions of inflammation, 
even of subacute type. But there is very marked nervous irritability due 
to atony of the muscular coats, irresponsive glandular action, and depression 
of spinal and vagal innervation. The tongue is pale and expressionless, 
and may be pasty and have a yellow coating. There may or may not be 
nausea or vomiting, or both, there is a sallow or yellow border around the 
mouth, a general sallow complexion, and evident hepatic malfunction. 
Quite often the conjunctivae are yellowish, there is pain extending to beneath 
the right shoulder blade, and a colicky type of intestinal pain with flatulence, 
pointing from the gall-bladder to the umbilicus. With some, or the totality 
of these indications, it proves a remedy of great power in a variety of 
digestive and intestinal wrongs, among which may be named simple atonic 
indigestion, pyrosis, flatulent colic, nervous gastric debility, chronic 
diarrhoea, cholera infantum, muco-enteritis, and chronic non-inflammatory 
diarrhoea. In the three last named disorders, the child is weak, apathetic, 
and listless, the stools pass unnoticed and painlessly, or perhaps may be 
preceded by a slight umbilical colic. For colic, nux vomica is second only to 
colocynth, and preferable when the above indications are present. 
Nux vomica is one of the best agents for so-called chronic gastritis 
of various types and origins, but all of an atonic character. With other 
bitter peptics, especially hydrastis, it is especially valued in chronic atonic 
dyspepsia. 3 Specific Medicine Nux Vomica, gtt. x; Glycerin, fl3ij; 
Phosphate of Hydrastin (or Specific Medicine Hydrastis, fl30, gr. x; 
Water, q. s., fl $iv. Mix. Sig.: One teaspoonful every four hours. 
The pale tongue, bad taste and pallor about the mouth will guide to its 
selection. In rare cases in which the tongue is of normal redness it may be 
alternated with hydrochloric acid in minute doses. When the liver in- 
volvement is prominent-with yellow, pasty tongue, hepatic tenderness and 
icteric coloration of the eye, Specific Medicines Leptandra or Chionanthus 
may be substituted for the hydrastis preparations. Not alone does nux 
vomica overcome the irritability upon taking food, but it overcomes dilation 
of the organ from relaxed musculature and the associated flatulent dis- 
tention. Drop doses of the specific medicine in a full glass of cold water 
taken upon an empty stomach upon arising in the morning, and insistence 
upon an absolutely rigid adherence to a regular time for attempting defeca- 
tion, will aid marvelously toward a cure of obstinate habitual constipation. 
Drop doses several times a day is also good medication in the dyspepsia of 
inebriates, with loss of digestive power and relaxation, and either stubborn 
constipation or oft-recurring diarrhoea. Nux vomica will sometimes re- 
488 INDIVIDUAL DRUGS. 
lieve spasmodic conditions of the bowels when due to lack of peristalsis, 
with obstinate constipation, and it also occasionally relieves colic and 
costiveness caused by lead. But few doses of nux vomica, given in hot 
water, will be required to cut short an attack of infantile colic when due to 
torpid digestion; and the remedy is direct in relieving borborygmus in 
women with relaxed and weak abdominal walls and intestinal ptosis. It is 
sometimes of greater advantage when given in trituration with milk sugar, 
carbo-vegetabilis and asepsin, when fermentation of food with belching of 
gases is prominent. 
In that form of so-called congestion of the hepato-splenic circuit due 
to weakness and sluggish portal circulation the drug is promptly effective. 
The congestion here is not active, but rather a stagnation due to atony and 
poor innervation. Nux vomica is the most commonly employed remedy to 
relieve that condition comprehended in the general and somewhat vague 
term "biliousness", a state best described by the totality of gastro-hepatic 
symptoms included in the specific indications at the head of this article. 
It should be borne in mind that in the stomach and bowel disorders re- 
quiring nux vomica or strychnine, there is always a feeble and sluggish 
circulation, capricious appetite, faulty digestion, irregular bowel action, 
and depressed spinal and sympathetic innervation. When these are 
present it is a most decidedly beneficial remedy. Glyconda or neutralizing 
cordial is a good vehicle for the administration of nux vomica to children 
when sugar is not contraindicated. 
Nux vomica, and more particularly strychnine, are the leading remedies 
for amblyopia due to alcohol and tobacco; and both are valuable in eye 
strain, especially of the type of muscular asthenopia. Aggravations of eye 
and ear disorders, when due to general systemic atony, are nearly always 
mitigated by it. Foltz declared it the best remedy for purulent otitis 
media with general lack of tone, and advised it in chronic conjunctivitis and 
phlyctenular keratitis due to the same cause. 
Both nux vomica and strychnine are very serviceable in the urinal in- 
continence of children, and of the aged, when due to a relaxed or paralyzed 
sphincter, with feeble circulation. Conversely both are remedies for 
paralytic retention of urine; and in catarrh of the bladder with marked 
muscular and nervous depression. Both stimulate the sexual organs and 
have, therefore, been given with varying success in impotence, spermator- 
rhoea, and sexual frigidity of women. When coupled with abstention from 
sexual excesses good results are observed. When there is anemia, con- 
stipation, and general torpor, then these drugs, together with iron, some- 
times rectify amenorrhoea. With cramps, chilliness, and premature flow, 
and where there is great bodily weakness, they may be administered for 
the relief of dysmenorrhoea and in menstrual colic, while for leucorrhoea 
with heavy yellow discharges and marked nervous debility they greatly 
assist other specific measures in restoring a normal condition. 
Nux vomica is a valuable auxiliary in the treatment of chronic alco- 
holism, especially in those of a robust constitution, but with great nervous 
excitability and disposition to indulge in periodical sprees. We have given 
the following with excellent results: B Specific Medicine Belladonna, gtt. 
xx; Specific Medicine Nux Vomica, gtt. xxx; Specific Medicine Capsicum, 
gtt. x; Water q. s. fl^iv. Mix. Sig.: One teaspoonful every four hours. 
489 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
(ENANTHE. 
The root of CEnanthe crocata, Linne (Nat. Ord. Umbelliferae). A poisonous swamp 
plant of western and southern Europe. Dose, 1/8 to 1/2 grain. 
Common Names: Water Hemlock, Water Lovage, Hemlock Dropwort, Dead Tongue, 
Water Drop wort. 
Principal Constituent.-An exceedingly toxic resin, soluble in alcohol but not in water. 
Preparation.-Specific Medicine CEnanthe. Dose, 1/20 to 1/2 drop. 
Action and Therapy.-Small doses of oenanthe (5 drops of the specific 
medicine) may cause violent headache, dizziness, delirium, and other 
unpleasant symptoms. The fresh plant produces gastro-enteritis and 
convulsions, often with fatal results. It has been advocated for use in 
epilepsy, but its exact symptomatology has never been satisfactorily de- 
termined. It must be used in fractional doses, never to exceed 1/2 minim. 
It probably acts best when there is anemia of the brain, and has been 
suggested in maladies resulting from malnutrition and anemia of the 
cerebrum and cord. 
The whole plant of CEnothera biennis, Linne (Nat. Ord. Onagraceae). A common plant 
in waste places in the United States. Dose, 5 to 60 grains. 
Common Names: Evening Primrose, Tree Primrose. 
Principal Constituents.-Tannin and an abundance of mucilage; also potassium 
nitrate and aenotherin, a mixture of substances not well determined. 
Preparation.-Fluidextractum CEnothera, Fluidextract of CEnothera. Dose, 5 to 60 
drops. 
Specific Indications.-Dirty, sallow, full and expressionless skin and 
tongue, the latter being unnaturally large; face dull and apathetic, and 
patient gloomy and despondent; dyspepsia with vomiting of food, gastric 
distress, and frequent desire to urinate. 
Action and Therapy.-CEnothera is but little used, but has been sug- 
gested by Scudder as useful in gastro-hepato-splenic disorders, with the 
symptoms named above. Webster believes it may prevent ulceration of 
Peyer's patches. It is probably of some value in gastric distress following 
meals, with the gloomy and melancholic state of mind which frequently 
accompanies dyspeptic conditions. It has also been advised in pelvic 
fullness and torpor in women. Undoubtedly it does relieve the desire to 
frequently pass urine and has been used after gonorrhoea for this purpose. 
(ENOTHERA. 
OLEUM CADINUM. 
Oil of Cade, Cade Oil, Juniper Tar Oil, Oleum Juniperi Empyreumaticum. 
A product of the dry distillation of the wood of Juniperus Oxycedrus, Linne (Nat. 
Ord. Pinacese). 
Description.-A brownish or dark-brown, clear, thick fluid, having a tarry odor, and 
a burning empyreumatic, bitterish taste. Almost insoluble in water, partly soluble in 
alcohol, and wholly in chloroform and ether. It mixes well with fats and petrolatum. 
Action and Therapy.-Oil of Cade is often used as an ingredient of 
liniments and ointments for chronic skin diseases of the scaly and moist 
types, as eczema, psoriasis, and prurigo, and in parasitic disorders, as 
favus and various types of ringworm. For favus a soapy embrocation 
composed of four parts each of alcohol and soft soap and one part of oil 
of cade is said to be convenient and effectual. The persistent and pene- 
trating odor of oil of cade is a drawback to its use, and the oil should not be 
emploved in acute affections of the skin. 
490 INDIVIDUAL DRUGS. 
OLEUM CAJUPUTI. 
Oil of Cajuput, Oil of Cajeput. 
A volatile oil distilled from the leaves and twigs of several varieties of Melaleuca 
Leucadendron, Linne, notably the varieties Cajeputi, Roxburgh, and minor, Smith (Nat. 
Ord. Myrtaceae). The white or broadleaved tea tree of the Moluccas and adjacent islands. 
Description.-A light, thin, bluish-green liquid (after rectification colorless or yellow- 
ish) having an agreeable and decidedly camphoraceous odor, and a bitterish aromatic taste. 
With an equal volume of alcohol it forms a clear solution. Dose, 1 to 10 drops. 
Principal Constituents.-Cajuputol (Cineol or Eucalyptol) (CioHieO) (over 65 per cent), 
a constituent of many oils; terpineol and a small quantity of terpenes. 
Preparations.-1. Mistura Cajuputi Composita, Compound Cajuput Mixture (Hunn's 
Drops; sometimes called Hunn's Life Drops and Compound Tincture of Cajeput). Contains 
oils of cajuput, clove, peppermint, and anise, of each 1 fluidounce dissolved in 4 fluid- 
ounces of alcohol. A popular antispasmodic during the Cincinnati cholera epidemics of 
1849-51. Dose, 10 to 60 drops well diluted, or in syrup, mucilage, brandy, or sweetened 
water. Large and repeated doses will cause gastro-intestinal inflammation. 
2. Linimentum Cajuputi Compositum, Compound Cajuput Liniment (oils of cajuput, 
sassafras, and hemlock, aa §j; soap, q. s., Fiat linimentum). 
Action and Therapy.-The compound liniment of cajuput is a useful 
stimulant and discutient. It is principally used in mammitis. The com- 
pound tincture of cajuput is effective in the relief of pain, as neuralgia, 
pleurodynia, myalgia, chronic joint inflammations, and in nervous head- 
ache. The oil applied to the cavity of a carious tooth sometimes relieves 
toothache. 
Internal. Oil of cajuput may be used for the same purposes as the 
other aromatic oils, chiefly as a stimulating carminative to relieve in- 
testinal pain, spasmodic colic, and cramps, and to alleviate hiccough, 
nervous vomiting, and congestive dysmenorrhoea. It is also a good stimu- 
lant in the cough of phthisis, and chronic forms of bronchitis and laryn- 
gitis. 
The Compound Cajuput Mixture is a most valuable agent in cholera 
morbus, being used by Eclectic practitioners oftener than any other med- 
icine, except in severe cases when the conjoint use of morphine is necessary. 
OLEUM CHENOPODIL 
Oil of Chenopodium, Oil of American Wormseed. 
A volatile oil obtained from Chenopodium ambrosioides anthelminticum, Linne (Nat. 
Ord. Chenopodiaceae). Naturalized in the United States. 
Description.-A colorless or pale-yellowish oil having a penetrating and persistent 
disagreeable taste and odor. Soluble in alcohol. Dose, 1 to 6 drops. 
Specific Indications.-Ascarides, hookworm. 
Action and Therapy.-One of the most efficient but disagreeable 
tasting of anthelmintics, being especially useful for the removal of as- 
carides or roundworms. Two (2) or three (3) drops may be given on 
sugar, in emulsion, or in capsules two or three times a day before meals, 
for two to five days, and followed by a brisk cathartic. Intestinal irritation 
and inflammation is not a bar to its use notwithstanding that it is a stim- 
ulant to both the circulation and nervous system. It is said to succeed 
better than thymol in hookworm (uncinariasis) and, unlike that agent, can 
be given in association with castor oil, the latter also increasing its effi- 
ciency. Oil of chenopodium forms the basis of several popular "worm 
nostrums". It is also diaphoretic, diuretic, and expectorant. 
491 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
OLEUM MORRHU2E. 
Cod Liver Oil, Cod Oil, Oleum Jecoris Aselli, Oleum Hepatis Morrhuae. 
A fixed oil obtained from the fresh livers of Gadus Morrhua, Linne, and other species 
of Gadus (Family Gadidae). The common codfish of the North Atlantic waters. 
Description.-A thin, pale-yellow oil having a slightly fishy odor, and a non-rancid, 
fishy taste. Soluble in chloroform and ether, but very slightly in alcohol. Dose, 2 to 8 
fluidrachms. 
Principal Constituents.-Olein (70 per cent), palmitin, and stearin, free fatty acids, 
gaduin, and morrhuol, a crystalline substance containing biliary substances, vitamines, and 
traces of iodine and bromine. Oil from fresh livers does not contain the so-scalled alkaloids 
of codliver oil, which are cadaveric decomposition products found mostly in the brown oils. 
Preparation.-Emulsum Olei Morrhua, Emulsion of Cod Liver Oil. (Rub 500 parts 
of Cod Liver Oil with 125 parts of Acacia, in a dry mortar, add 250 parts of Water, and 
continue the trituration. Now add 100 parts of Syrup and 4 parts of Methyl Salicylate 
(or Oil of Wintergreen or any desired flavor) with enough water to make 1000 parts.) 
This is essentially the methods and proportions recommended in the U. S. P. 
Specific Indications.-Malnutrition, loss of flesh, poor assimilation, 
and marasmus. 
Action.-Cod liver oil is readily absorbed when rubbed into the skin. 
When taken internally it is more readily absorbed and more easily as- 
similated than most oils or fats, and thus contributes to increase the fats 
and the weight of the body. It is easily oxidized, and is more of a food 
than a medicine. Nevertheless if it contributes to the body iodine and 
bromine and phosphorus, it is also of much worth as a medicine. When it 
agrees with the stomach it unquestionably nourishes the body. 
Therapy.-External. Applications of cod liver oil may be employed in 
rhagades, chaps, excoriations and fissures, and in chronic scaly skin diseases. 
Inunctions of the oil are useful, though disagreeably offensive, in states of 
general malnutrition, especially marasmus and rickets in children, and 
tuberculosis and chronic debilitating skin diseases, attended by wasting of 
tissues. 
Internal. Cod liver oil is nutritive and alterative, and is both a food 
and a medicine in conditions of defective nutrition. When it can be toler- 
ated by the stomach, or the patient, it can be relied upon to give good 
results. If, however, it provokes nausea and vomiting, disgust or diar- 
rhoea, it is certain to be harmful. As a fat-producing agent it has excelled 
in digestibility all other fats which have been proposed as substitutes for it. 
When kindly received and tolerated it increases the quantity of red blood 
cells, improves the appetite and digestion, adds flesh and strength, gives a 
fuller and better pulse, and greatly improves nutrition. 
Cod liver oil does the most good in wasting diseases and conditions of 
malnutrition, such as are met in tuberculosis and scrofula, rickets, maras- 
mus, chronic bronchitis, chronic rheumatism, arthritis, and synovitis and 
osseous caries in strumous subjects. Aside from its value in rickets (usually 
with phosphorus), in well-selected cases, it seems to distinctly increase 
resistance to the invasion of respiratory diseases. It is especially valuable, 
when tolerated, in the pre-tubercular, giving power to resist the tubercular 
invasion. In chronic joint diseases and in tabes mesenterica, with emacia- 
tion, hard abdomen, offensive breath, and cough it is especially desirable. 
It does not cure, but letards consumption, or at least enables the patient to 
live longer and with greater comfort. Clearlv it is a remedv for imoaired 
492 INDIVIDUAL DRUGS. 
digestion, defective assimilation, and imperfect nutrition. It is frequently 
advantageous in advanced syphilis and brain disorders with failing nutrition, 
and sometimes aids in neuralgia by giving strength to the system. 
Occasionally the emulsions are more acceptable, but as a rule patients learn 
to prefer the pure oil in small doses. Teaspoonful doses are better than 
larger ones. The taste may be made tolerable by adding a pinch of salt, or 
by eating a fragment of smoked herring after taking the oil. Some advise 
brandy, but this is more likely to finally disorder digestion. Experience 
has shown that it is unwise to administer oils in milk, coffee, or other com- 
mon beverages because of the disgust for those necessities so often 
engendered. 
Olive Oil, Sweet Oil. 
A fixed oil obtained from the ripe fruit of Olea europcea, Linne (Nat. Ord. Oleaceae). 
The olive tree of Asia and southern Europe; cultivated. 
Description.-A pale yellow or light greenish-yellow oil, of slight odor and taste, 
followed by feebly acrid after-taste. Slightly dissolved by alcohol, but miscible with chloro- 
form and ether. Dose, 2 fluidrachms to 2 fluidounces. 
Principal Constituents.-Olein (72 per cent), palmitin (28 per cent), and arachin. 
Action.-Emollient and demulcent, nutritive and mildly aperient. 
Applied to the skin it is protective and softening, and when accompanied 
by massage is readily absorbed and appropriated by the system. When 
swallowed it has little effect in the stomach other than that of a lubricant, 
but is, partly at least, emulsified and saponified upon reaching the in- 
testines. Here it parts with its olein which becomes a part of the general 
fat of the body, while excessive quantities pass by way of the intestines and 
the unassimilated absorbed portion, by way of the renal tract. In contact 
with the conjunctiva olive oil is irritating. 
Therapy.-External. Sterile olive oil is a good lubricant for sounds, 
bougies, and catheters. To facilitate the passage of a catheter inject through 
it into the urethra warm olive oil to distend the passage. Masseuers some- 
times employ it in their manipulations of the body, but it is less useful than 
wool fat or cacao butter. It is the safest oil to drop into the auditory canal 
to kill live insects and facilitate their removal afterward by syringing with 
warm water. It deprives the insects of oxygen, thus causing their death. 
Olive oil is sometimes applied to burns and scalds, but is less valuable than 
lime liniment (Carron Oil). Applied warm it gives relief from the pain of 
insect stings and bites. It may be used for anointing bruises and excoria- 
tions, and is especially useful to prevent excoriations from acrid discharges. 
It causes too much smarting, however, to use upon the chafed surfaces of 
infants. Poured over the surface it mitigates the pain and unites to chem- 
ically form a soap in cases of external poisoning by caustic alkalies. It is 
sometimes comforting in sunburn and other acute forms of dermatitis. 
Dropped warm into the aural canal it frequently relieves earache, but has 
no advantage over warm water for this purpose. Injected into the rectum 
it removes ascarides, and sometimes soothes when so used in dysentery and 
colitis. It is the most commonly employed softening agent for cutaneous 
crusts, such as those of eczema, seborrhcea, favus, and psoriasis. Inunc- 
tions of olive oil may be used in malnutrition and wasting diseases,but are 
OLEUM OLIWE. 
493 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
far less valuable than cod liver oil for this purpose. It is, however, readily 
absorbed and thus serves as a food. In the desquamative stage of the 
eruptive diseases it relieves burning, itching, lowers temperature by quieting 
the patient, and prevents the dissemination of infective scales. It is 
particularly useful in scarlet fever. Olive oil is frequently used as the 
carrier of local anodynes and anaesthetics, as morphine, menthol, camphor, 
phenol, etc. A warm, olive-oil solution of camphor is a most effective agent 
in mastitis, both to relieve the tensive pain and to lessen the secretion 
of milk. It enters largely into the formation of ointments, cerates, lini- 
ments, and plasters. 
Internal. In doses of one to two ounces olive oil may purge, but it is 
often uncertain and ineffective as a laxative. When one is inclined to 
dyspepsia it tends to increase the digestive difficulty. It is commonly 
given to infants as a laxative in constipation, but while it sometimes relieves 
it more often disturbs by creating a mild dyspepsia. Pediatricians now 
generally hold it more harmful than useful in infantile constipation. It 
may, however, be used by adults exposed to opportunities for lead constipa- 
tion and in lead poisoning, to prevent absorption of, and overcome the 
constipating effect of the metal. While of undoubted utility in some cases 
of cholelithiasis, by indirectly causing a greater increase in the watery 
constituent of the bile, it is probably of no other value in the gall-stone 
diathesis. Certainly it does not dissolve the concretions in the gall duct 
no matter how readily it may affect the solution of cholesterin outside the 
body. In the intestines it is converted into a soap, and saponaceous par- 
ticles have been mistaken for expelled gall-stones. Notwithstanding, it is 
extensively used and advised by physicians to the extent that the laity now 
consider it the great essential in the treatment of gall-stone disease. The 
effect of its long-continued use is to derange both the stomach and the 
bowels. We have seen a persistent diarrhoea follow the prolonged use of 
the oil. 
Olive oil may be given immediately in poisoning by alkalies and other 
irritant substances. With the first it combines by saponification, and in the 
latter acts as a demulcent. It should not, however, be given in either phos- 
phorus or cantharides poisoning, as the activity of these substances through 
oil solution is decidedly increased. 
OLEUM RICINI. 
Castor Oil. 
The fixed oil obtained from the seeds of Ricinus communis, Linne (Nat. Ord. Euphor- 
biacese). An East Indian plant; cultivated. 
Description.-A pale yellow or nearly colorless viscid oil, having a faint odor, and a 
bland, somewhat acrid, and nauseating taste. Dose, 2 to 8 fluidrachms. 
Principal Constituents.-The glyceride of ricinoleic acid (ricinolein), fixed oils, and the 
non-purgative ricinine. 
Specific Indications.-Pain and irritation in the intestines from 
irritating or undigested food; intestinal, subacute inflammation, with 
colic, and watery or mucoid passages. 
Action.-Applied externally castor oil is non-irritating, protective, 
and somewhat emollient. When swallowed it does not irritate the stomach, 
and the nausea induced is probably due to the odor and the persistence of 
494 INDIVIDUAL DRUGS. 
the unpleasant clinging contact of the oil in the mouth. Upon entering the 
small intestines it is split by the pancreatic juice into glycerin and ricinoleic 
acid, and the latter induces the purgative action. Rubbed into the ab- 
domen castor oil will also cause purgation. After the first hardened feces are 
removed the stools become liquid and are passed without pain or tenesmus. 
Castor oil seeds are poisonous, twenty having killed a child. 
Therapy.-External. Castor oil is protective and slightly stimulating 
to denuded surfaces, and may be dropped into the eye after burns have 
caused an ocular ulcer. Equal parts of castor oil and balsam of Peru have 
been used successfully upon old, sluggish ulcers, as of the shins, and in the 
treatment of hypergranulation following pus infection after abdominal 
operations; also in healing the ulcers from burns, wounds, and abscesses. 
Internal. Castor oil is one of the mildest and most satisfactory cathar- 
tics, and with the exception of sulphate of magnesium is the most commonly 
employed purgative. It has no irritant effect upon the stomach and 
operates usually in four or five hours. It is probably the best laxative for 
children to cleanse the intestinal tract of tainted or undigested food, 
poorly masticated nuts, and mucoid accumulations. It is very effective in 
dysentery to prepare the way for more specific medicines, especially when 
there is evident constipation of the upper bowel. It may prove the best 
agent where hardened feces are the cause of a mucoid diarrhoea. The best 
preliminary treatment of entero-colitis in children is a purge of castor oil, af- 
ter which indicated remedies have a much better opportunity to act. Owing 
to its thorough yet mild and unirritating character it is the most suitable 
laxative for constipation of children and for pregnant women before and 
after labor, before and after abdominal and pelvic operations, and when 
inflamed hemorrhoids are present. After its use in irritative diarrhoea no 
other agent will be needed, for the provocative cause having been removed, 
the natural tendency of the oil is to cause constipation. Castor oil is not a 
good remedy for chronic constipation, for it cannot be used for prolonged 
periods without detriment to the patient, and probably an aggravation of 
the costive condition. But for an occasional purge in constipation pre- 
liminary to the use of cascara and other better laxatives for continued use 
nothing is better than a free dose of castor oil. In cases where there is a 
semipasty and tenacious light-colored stool with burning at voiding and 
persisting for weeks, and there is much semi-colicky uneasiness or soreness 
in the bowels and frequent desire to defecate, castor oil is the best purge that 
can be used. A single dose usually rectifies the trouble. Castor oil may be 
used even in inflammatory and febrile conditions. 
Castor oil may be employed to assist in the expulsion of worms, giving it 
before and after vermifuges and taeniacides. It should not, however, be 
given if aspidium (male fern) has been used, for it increases the poisonous 
absorption of the latter. 
The great drawback to castor oil is its nauseous taste, which may be 
more or less disguised by peppermint and other aromatics. Peppermint 
lozenges may be eaten immediately before and after swallowing it; it has 
been advised in coffee, sweet cider, ale, milk, and broth, but we do not favor 
the giving of nauseous medicines in common beverages and foods, lest a 
disgust for the latter be engendered. The following is the best method we 
495 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
know of for administering castor oil: Squeeze into a suitable warmed glass a 
small quantity of orange juice, and thoroughly rinse the inner surface of the 
glass with it. Place the dose of oil upon the juice and cover with more 
juice. Then having moistened the mouth completely with a portion of the 
orange juice quickly swallow the mixture within the glass. If this is well 
carried out the oil will not adhere to the mucosa nor will it be tasted. 
When a strong purgative is needed, equal parts of aromatic syrup of rhu- 
barb (or neutralizing cordial or glyconda) and castor oil may be given in 
doses of one to two fluidounces. 
Oil of Santal, Oil of Santal Wood, East Indian Oil of Santal, Oil of Sandalwood. 
A volatile oil distilled from the wood of Santalum album, Linne (Nat. Ord. Santal- 
aceae). A small tree of southern India and the Indian Archipelago. 
Description.-A pale yellow, thickish, oily liquid having the taste and odor char- 
acteristic of sandalwood; soluble in alcohol. Dose, 1 to 15 drops. 
Principal Constituent.-An alcohol santalol (Ci6H26O). 
Action and Therapy.-Oil of santal closely duplicates the effects of oil 
of copaiba and oil of cubeb, and will sometimes cause gastro-intestinal 
disturbances. It is, however, less irritant and pleasanter to take than 
those oils. It may occasion a red papular eruption upon the skin and the 
conjunctivae. Oil of santal is eliminated chiefly by the urinary and bronchial 
tracts, acting upon them as a stimulant and disinfectant. It is chiefly 
used in gonorrhoea after the active stage has passed. Occasionally it is 
employed in chronic bronchitis and bronchial catarrh with fetid expectora- 
tion, in pyelitis, chronic cystitis, chronic mucous diarrhoea, and in urethral 
hemorrhage. 
OLEUM SANTALI. 
Oil of Turpentine, Spirit of Turpentine, Turpentine Oil. 
A volatile oil distilled with water from the concrete oleoresin derived from Pinus 
palustris, Miller, and other species of Pinus. (Nat. Ord. Pinaceae.) United States and 
Europe. 
Description.-A thin colorless liquid having a characteristic taste and odor, becoming 
more intense with age and by exposure. Soluble in alcohol and glacial acetic acid. It 
readily dissolves resins, wax, sulphur, iodine, and phosphorus. 
Principal Constituents.-A mixture of several terpenes each having the formula CmHu. 
Among them are pinene, phellandrene, camphene, dipentene, and limonene; some ses- 
quiterpenes and the fragrant ester bornyl acetate (borneol). American oil of turpentine 
contains principally dextro-pinene (australene), while French oil of turpentine is chiefly 
laevo-pinene (terebentene). Oil of turpentine emulsifies with mucilage 2 parts and water 
16 parts, by thorough trituration. 
Preparation.-Linimentum Terebinthina, Turpentine Liniment. Prepared by melt- 
ing and mixing together 350 parts of oil of turpentine and 650 parts of rosin cerate. 
Action and Therapy.-External. Oil of turpentine may be used for 
most of the purposes named under Rectified Oil of Turpentine. However, 
the latter is the least likely to cause unpleasant effects. 
Internal. This preparation should not be used internally; only when 
rectified is it fit for internal medication. (See Oleum Terebinthince Recifica- 
tum.) 
OLEUM TEREBIN THIN2E. 
496 INDIVIDUAL DRUGS. 
OLEUM TEREBINTHINCE RECTIFICATUM. 
Rectified Oil of Turpentine, Rectified Turpentine Oil. 
Description.-A thin colorless liquid corresponding to the properties described under 
Oleum Terebinthince, which see. Dose, 1 to 20 drops. ( Usual dose, 5 drops.) 
Preparation.-Emulsum Olei Terebinthince, Emulsion of Oil of Turpentine. Dose, 
1/2 to 2 fluidrachms. 
Specific Indications.-Internal. Dry, deep red, glazed and cracked 
tongue, with sordes, muttering delirium, rapid feeble pulse, repressed 
secretions, tympanites and hemorrhage; relaxed and enfeebled mucosa with 
excessive catarrhal discharges. 
External. Pain and meteorism. 
Action and Toxicology.-Oil of turpentine is rapidly absorbed by the 
skin, which it irritates and reddens, and if long in contact, may produce 
vesication or ulceration. These untoward effects are more apt to occur 
if the oil be applied hot or with friction. Applied to the skin it imparts 
warmth and dilates the peripheral vessels. Upon the mucous tissues its 
warmth is more intense and may amount to smarting pain and produce 
congestion. Swallowed it imparts the same glowing warmth from mouth to 
stomach, excites secretion, checks flatulence, induces peristalsis, and if the 
amount be large, provokes diarrhoea. Its ingestion causes the skin to feel 
hot, the circulation is slightly accelerated and arterial tension increased. 
Being quickly absorbed it appears in the urine almost immediately after 
being swallowed or inhaled, imparting to that excretion the characteristic 
odor of violets. The vapor is irritating to the breathing passages, and, as 
also when taken, induces a sense of intoxication and dizziness. The secre- 
tion of the kidneys is increased, and prolonged use or overdoses may cause 
irritation, and inflammation of those organs, and hematuria. Poisonous 
amounts cause bloody urine, severe strangury, priapism, intolerable aching 
in the loins, acute nephritis, cyanosis, dilated pupils, gastro-enteritis, and 
collapse. Some individuals are very susceptible to the effects of turpentine, 
and, in a few, vesicular or papular rashes of an eczematous type have 
occurred. 
Therapy.-External. Turpentine is rubefacient and counter-irritant 
and to some degree antiseptic and hemostatic. Locally applied it is valu- 
able to assist in relieving deep-seated and other inflammations, as in 
pleurisy, pneumonia, bronchitis, laryngitis, pharyngitis, peritonitis, arthritis, 
and other congestive and inflammatory disorders; and to alleviate pain in 
sciatica, myalgia, pleurodynia, and various neuralgias. For these purposes 
equal parts or one-fourth part of turpentine may be mixed with hot lard 
or olive or cotton-seed oil, and applied by hand, with or without friction, 
as desired. It must be borne in mind that friction intensifies the local 
effect of the oil. A more effectual method is to apply a flannel cloth wrung 
from hot water and upon which has been sprinkled a few drops of turpen- 
tine. Another but more complicated procedure of preparing a "turpentine 
stupe" is to wring a flannel out of very hot water by twisting it in a towel 
until it ceases to drip. Then dip the cloth in turpentine which has been 
heated in a tin container immersed in another vessel of very hot water 
and wring out all excess of the oil. (Caution: Turpentine must not be 
heated on a stove or over a flame; it is highly inflammable.) Turpentine 
stupes are to be applied as hot as can be borne, and as soon as any discomfort 
497 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
or pain is felt are to be immediately removed, lest blistering occur. Turpen- 
tine, applied full strength, or diluted with a bland oil, may be used to 
relieve chilblains and bunions and to stimulate repair in sluggish ulcers and 
bed sores. Combined with linseed oil it has been advised for small burns 
and scalds, but as this method is painful and absorption great it is not to be 
commended. Liniments containing turpentine may give relief to in- 
flamed joints in acute articular rheumatism, swollen and inflamed glands, 
and are popular in domestic practice for the relief of temporary lameness and 
muscular soreness. It is of great service locally, together with its internal 
use, to prevent and control meteorism in typhoid fever and puerperal 
peritonitis. In all inflammations with tense skin great care must be 
taken not to cause blistering by it. The vapor of turpentine is said to be 
fatal to the itch mite; and the oil vaporized from hot water gives relief in 
croup and chronic bronchitis. It may be used as an adjunct to treatment 
in diphtheria for its antiseptic and stimulant properties, and particularly in 
the membranous form of laryngeal diphtheria, in which it contributes in 
some measure to the loosening and expulsion of the membrane. 
Internal. For internal use only the rectified oil of turpentine should be 
used. Turpentine is employed as a diffusible stimulant, antiseptic, and 
antihemorrhagic. It is also an anthelmintic and taeniafuge. Very small 
doses are stomachic, and as a warming carminative it is useful to relieve in- 
testinal flatulence. Turpentine has a twofold action, which is important. 
It stimulates to normal secretory activity when there is a lack of intestinal 
secretion due to a semi-paretic state of the alimentary canal; and it re- 
strains excessive secretion when due to lack of tone. It is always a remedy 
for atony and debility; never for active and plethoric conditions. In 
typhoid or enteric fever it is the best remedy known to prevent tympany 
and ulceration. It is indicated when the tongue is dark red, glazed, or 
brown-coated, hard, dry, and cracked, and there are sordes upon it, as well 
as upon the teeth. In this stage ulceration is active, hemorrhage im- 
pending or present, temperature high, pulse small, wiry and rapid, the 
mind wanders, and the urine is scanty, concentrated, and very dark. In 
this state there is marked depression of innervation, putrefactive gases are 
formed, hemorrhage imminent, prostration is great, mentality disordered, 
and the patient is at a very low ebb. When this condition prevails no other 
medicine offers such hope of relief as turpentine. From five to ten minims 
may be given in emulsion every two or three hours. In tardy convalescence 
from enteric fever, when ulcers of Peyer's glands stubbornly refuse to heal 
and diarrhoea continues or frequently recurs, and hemorrhage still threatens, 
turpentine may be given to stimulate repair and will do as much as any 
medicine can to hasten recovery. When hemorrhage does occur during the 
progress of the fever, turpentine by its hemostatic action assists in con- 
trolling manageable cases. The external use of the drug (see above) should 
accompany its internal administration. 
Turpentine is of value in other hemorrhages of the gastro-intestinal 
tract-notably that accompanying ulceration of any part of the small 
intestines, with flatulent distention. It frequently renders good service in the 
hemorrhage of gastric and duodenal ulcer; and it may succeed in some cases 
of hematuria and menorrhagia. As these cases are seldom or never hemor- 
498 INDIVIDUAL DRUGS. 
rhages of plethora, but are of the passive variety that occurs in the weak 
and anemic subject with a disposition to tissue dissolution and relaxed 
blood vessels, turpentine is clearly indicated and its record justifies its 
claim to efficiency. Turpentine is also one of the few drugs that have been 
effectual in hemorrhagic transudation into the skin and mucosa, as in 
purpura and scurvy, and it has a limited usefulness in haemophilia. 
In renal disorders turpentine is generally contraindicated; certainly 
so in irritation and inflammation. It may, however, be used when a 
deficient secretion of urine depends wholly upon general debility; and in 
chronic disorders, when active inflammation has long passed, and in chronic 
nephritis, where active inflammation is seldom present, it may be neces- 
sary to employ a powerful stimulating diuretic. Turpentine may best 
serve the purpose. It must be remembered, however, that in all kidney dis- 
orders there is the ever-confronting danger of provoking suppression of 
the urine. Turpentine has been advised in pyelitis, pyo-nephritis, and 
hydro-nephritis, both for its stimulating and pus-limiting antiseptic effect. 
It is of more certain service in chronic cystitis and gleet, both with ex- 
cessive mucous discharge. 
As an anthelmintic and taenicide such large doses of turpentine are 
required as to render such use inadvisable; and its local employment for 
ascarides is too painful and less desirable in every way than weak salt 
solutions or infusion of quassia. 
Old oxidized oil of turpentine and French oil of turpentine are reputed 
antidotes in phosphorus poisoning. 
OLEUM THEOBROMATIS. 
Cacao Butter, Oil of Theobroma, Butter of Cacao. 
A concrete fixed oil expressed from the roasted seeds of Theobroma Cacao, Linne 
(Nat. Ord. Sterculiaceae), South America. 
Description.-A yellowish-white, solid oil having a bland taste suggestive of chocolate, 
and a slight but agreeable odor. Slightly soluble in alcohol, readily in boiling dehydrated 
alcohol, and freely in ether or chloroform. It is composed chiefly of the glycerides, stearin 
and olein, with small quantities of laurin, palmitin, and arachin; and slight amounts of 
formic, acetic, and butyric acid compounds. The alkaloid Theobromine (CjHgCbNi) is 
sometimes present. 
Action and Therapy.-External. Cacao butter is emollient, and 
inasmuch as it does not readily turn rancid may be used for the protection 
of abraded or excoriated surfaces, and by inunction massage to improve 
the general nutrition of feeble infants and invalids. Owing to its melting 
at the temperature of the body it is an admirable base for suppositories for 
applying local medication in rectal, vaginal and uterine disorders. 
Croton Oil. 
A fixed oil expressed from the seeds of Croton Tiglium, Linne (Nat. Ord. Euphor- 
biaceae). East Indies and Molucca and Philippine Islands; cultivated in Europe and 
China. 
Description.-A pale yellow or brown-yellow, somewhat viscid oily liquid, slightly 
fluorescent and having a feeble but characteristic odor. It should not be tasted, and must 
be handled with extreme care for it causes a papular eruption. Soluble freely in oils, ether, 
and chloroform, and slightly (more readily if old) in alcohol. Dose, 1 drop. 
Principal Constituents.-Many (9 at least) glycerides of volatile acids, of which 
crotonoleic acid (C6H8O2) is the chief; fatty acids free and combined; a non-purgative 
but vesicant resin, crotonol (C18H2sOi). 
OLEUM TIGLII. 
499 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Toxicology.-Croton oil is a violent irritant causing 
erythematous redness, intense burning pain, and an eruption of small 
vesicles which readily become pustular. Edematous inflammation may 
follow. Owing to umbilication of some of the vesicles the eruption may be 
mistaken for that of small-pox, but there is considerable variation in size, 
thus distinguishing them from that disease. Internally a single drop will 
quickly cause purgation. Even its external use has been followed by 
catharsis. An overdose produces marked gastro-intestinal inflammation 
accompanied by pain, griping, vomiting, and hydragogue catharsis, bloody 
stools, and death. Usually the vomiting prevents a fatal issue. In poison- 
ing by it free emesis should be provoked, and opiates should be given for the 
pain and to restrain purgation, and demulcents to control the irritability 
of the mucosa. In case collapse threatens, external heat should be applied 
and heart stimulants be given subcutaneously. 
Therapy.-External. Croton oil is now seldom used externally, and its 
reckless use by the profession of years ago was one of the causes that led 
to the opposition which resulted in the formation of the Eclectic school 
in medicine. 
Internal. Croton oil is remarkable as a rapidly acting and certain 
drastic cathartic, reserved chiefly as an emergency remedy when other 
cathartics fail. The smallness of the dose (one to two drops in bread) and its 
prompt and thorough effects make it the most useful purgative for the 
insane and the unconscious (place a drop far back upon the tongue), and as 
a revulsive in cerebral congestion and apoplexy, to lower intracranial 
blood pressure through dilation of the vessels of the bowels. It is the 
most efficient purgative in lead colic with obstipation, obstinate constipa- 
tion when no inflammation is present, fecal impaction without intestinal 
obstruction, and in comatose states as a revulsive. It may be used in 
puerperal eclampsia and in uremia for its derivative effects. Croton oil 
usually acts upon the bowels in less than an hour and occasions much 
borborygmus. As a rule it does not greatly debilitate the patient. It is not 
a good cathartic in dropsical conditions because it cannot be repeatedly 
administered without harm. Neither should it be used, if possible to 
avoid it, in children and the feeble and pregnant, nor where hemorrhoids, 
intestinal or renal inflammation, or peritonitis are present. 
OPIUM. 
Opium. 
The milky exudate, air dried, obtained by incising unripe capsules of the growing plant 
Papaveris somniferum, Linne; and its variety, album, De Candolle (Nat. Ord. Papaver- 
aceae). Asia Minor chiefly; also some other parts of Asia, Europe, and Africa. Cultivated. 
Description.-Rounded, flattened, grayish-brown masses, showing a dark-brown, 
lighter-streaked interior, and having a somewhat nauseous bitter taste, and a peculiar 
narcotic odor. When fresh it is more or less plastic; when kept it becomes hard and brittle. 
Opium masses are of variable sizes and usually coated with adherent poppy leaves, and 
often with the fruits of a species of Rumex used in packing for transportation. The U. S. P. 
requires that normal, moist opium should contain not less than 9.5 per cent of anhydrous 
morphine. Dose, 1/4 to 2 grains. {Average dose, 1 grain.) 
Principal Constituents.-Opium contains nineteen or twenty alkaloids, some of which 
are combined with meconic acid, forming meconates, some with sulphuric acid, some free, 
as narcotine, a weak base. Those of medicinal interest are: (1) Morphine (C17H19NO3.H2O), 
anodyne and narcotic (see Morphina)-, (2) Codeine (C18H21NO3.H2O), (see Codeina)-, 
(3) Narcotine (Anarcotine) (C22H23NO7); (4) Narceine (C23H29NO9); Thebaine (C19H21N3O) 
Papaverine (C20H21NO4); and Pseudo-morphine (C34H36N2O6). 
500 INDIVIDUAL DRUGS. 
Other alkaloids are: rhoeadine, cryptopine, codamine, laudanine, lanthopine, meconi- 
dine, protopine, hydrocotarnine, laudanosine, oxynarcotine, gnoscopine, tritopine, and 
xantholine. Besides these are the non-alkaloidal constituents: meconic acid, meconin, 
meconoisin, opionin; volatile oil and other common plant constituents and inorganic salts. 
Preparations.-1. Opii Pulvis, Powdered Opium. A fine light-brown powder. 
Should contain 1/2 per cent more, but not more than 1 per cent more, of anhydrous morphine 
than opium (see page 500). The U. S. P. permits the reduction of morphine content higher 
than indicated by the use of any inert diluent. Dose, 1/4 to 2 grains (average, 1 grain). 
2. Opium Deodoratum, Deodorized Opium. Should be of same morphine strength 
as Opii Pulvis (see above). Dose, 1/4 to 2 grains (average, 1 grain). 
3. Opium Granulatum, Granulated Opium. Same morphine content as Opii Pulvis 
(see above). Used in the preparation of tincture of opium and deodorized tincture of 
opium. Dose, 1/4 to 2 grains (average, 1 grain). 
4. Pulvis Ipecacuanha et Opii, Powder of Ipecac and Opium (Compound Powder 
of Ipecac, Dover's Powder). A grayish-white or pale-brown powder containing 10 per 
cent each of opium and ipecac. (Ten (10) grains represent 1 grain of opium or about 1/8 
grain of morphine.) Dose, 1 to 20 grains. 
5. Pulvis Ipecacuanha et Opii Compositus, Compound Powder of Ipecacuanha and 
Opium (Diaphoretic Powder, Beach's Diaphoretic Powder). (Contains Opium (10), Cam- 
phor (40), Ipecac (20), Bitartrate of Potassium (160). (Each ounce of this powder contains 
19 grains of Opium. Each ten (10) grains, therefore, represents nearly 1/2 grain of opium 
(accurately, 11 1/2 grains contain 1/2 grain of opium), 2 grains of camphor, 1 grain of 
ipecac.) Dose, 2 to 10 grains. 
6. Tinctura Opii, Tincture of Opium (Laudanum). Contains 10 per cent of opium, 
almost the equivalent of 1 per cent of morphine. (Therefore 10 minims equal about 1 grain 
of opium, or approximately 1 /8 grain of morphine.) Dose, 1 to 30 minims. (The large 
amounts should never be used as initial doses.) 
7. Tinctura Opii Deodorati, Deodorized Tincture of Opium. Same strength as 
Tincture of Opium. Dose, 1 to 30 minims. (The large doses should never be used as an 
initial dose.) 
8. Tinctura Opii Camphorata, Camphorated Tincture of Opium (Paregoric). About 
4/100 per cent opium. Paregoric is about 20 times weaker than Laudanum (Tincture of 
Opium) as it contains about 1/4 grain of opium in each fluidrachm. This is practically 
equivalent to 1/40 grain of morphine. Dose: For infants, 5, 10, to 20 minims; for adults, 
1 to 4 fluidrachms. 
Morphina, Morphine. Permanent colorless or white fine needles or crystalline powder, 
without odor and very sparingly soluble in most ordinary solvents. Dose, 1/12 to 1/4 
grain (average, 1/8 grain). 
Morphina Hydrochloridum, Morphine Hydrochloride (Morphine Chloride). Perma- 
nent and odorless silky needles, or cubical masses or crystalline white powder, readily 
soluble in hot or cold water; soluble also in glycerin. Not soluble in chloroform or ether. 
Dose, 1/12 to 1/4 grain (average dose, 1/8 grain). 
Morphina Sulphas, Morphine Sulphate. Permanent and odorless, white, silky and 
feathery needle crystals, freely soluble in hot or cold water; not soluble in chloroform or ether 
Dose, 1/12 to 1/4 grain (average dose, 1/8 grain). 
Codeina, Codeina Phosphas, and Codeina Sulphas, see under respective heads. 
Specific Indications.-Opium and Morphine Salts. Pulse soft and 
open, or when waves are short, and it gives a sensation of fullness and 
always lacking hardness, skin soft, tongue moist, face pale, eyes dull and 
expressionless and immobile or dilated; permanent glycosuria with prostra- 
tion of powers; pain in incurable diseases. 
Morphine Salts. (In addition to above.) Unbearable pain; pulmon- 
ary hemorrhage; gall-stone and renal colics; pain, with spasm; pain and 
shock from accidents or acute poisoning; angina pectoris; to prevent shock 
from surgical operations; in obstetrics to relax and quiet nervous appre- 
hension (use with discrimination). 
Action.-The dominant action of opium is due chiefly to its contained 
morphine and is spent upon the cerebro-spinal tract, quieting the functions 
of the cerebrum and exciting those of the spinal cord. In man the most 
profound effect is upon the cerebrum; in animals upon the cord. Upon 
CHIEF OPIUM ALKALOIDS AND THEIR SALTS. 
501 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
the brain, if the dose be small, the first effect is a temporary excitation 
followed by depression resulting in sleep; if the dose be large the stage of 
excitation may be absent. When absorbed the drug is a depressant to the 
sensory filaments, benumbing them against pain, and finally the motor 
nerves come under its depressing power. While the exact cause of its pain- 
relieving properties is not definitely known, it is believed to be due to its 
depressive effect upon the cerebral perceptive centers and upon the con- 
ducting paths of the cord. 
Through whatever channel opium or its alkaloid, morphine, is intro- 
duced into the body-by stomach, subcutaneously, or intravenously, by 
rectum, or a wound or abrasion, its chief and dominant effect is upon the 
higher cerebral centers finally producing depression. Upon the unbroken skin 
it probably has no action; but when applied to mucous surfaces it is readily 
absorbed. Children and old persons are profoundly affected by the drug, 
and women, as a rule, are more susceptible than men. Nursing children 
may become narcotized by the milk of a mother who takes opium, and 
infants have been known to die within a day or two after birth when de- 
prived of the effects of the drug as acquired in intra-uterine life. 
In small doses opium does not appreciably affect the circulation. 
Full doses, however, stimulate the vagi, both centrally and peripherally, 
causing a slow action of the heart, the force of which is also increased by 
direct stimulation of the heart-muscle and the intracardiac ganglia. To 
the increased heart action is due the rise in blood pressure. Toxic doses 
paralyze both the pneumogastrics and the heart, the pulse then becoming 
excessively rapid and weak. 
The effect of morphine upon the respiration is very important, and 
therein lies its danger as a lethal agent. In very small doses it is said to 
stimulate respiration, but large doses powerfully depress breathing, and in 
fatal opium poisoning death is usually due to asphyxia through centric 
respiratory paralysis. 
Morphine causes profound myosis when given in full doses. This is 
due to stimulation of the oculo-motor centers. Usually just preceding 
death paralysis of these centers results in dilation of the pupils. 
Opium diminishes all the secretions except that of the sweat. That 
normal diaphoresis remains unabated or is increased is probably due to 
dilation of the blood vessels of the skin. Opium causes retention, rather 
than suppression, of the urine, though the secretion of the urine is thought to 
be somewhat inhibited by the drug. Opium very pronouncedly checks the 
secretions of the intestines and arrests peristalsis, chiefly by stimulation 
of the splanchnic inhibitory nervous apparatus. The result is constipation. 
On the other hand toxic doses may paralyze the inhibition and thus stimu- 
late peristalsis. 
Opium moderately elevates temperature unless the dose be toxic. 
In that event the body-heat is reduced. Opium limits tissue-waste by de- 
creasing the output of urea and other nitrogenous detritus. 
Probably most of the morphine ingested is oxidized in the body; 
that which is eliminated, partly as morphine, is voided by way of the 
stomach and kidneys. Morphine is rapidly eliminated into the stomach 
502 INDIVIDUAL DRUGS. 
when a poisonous dose is taken, so that it is well to bear this fact in mind 
and prevent its reabsorption by frequently washing out that organ. 
Very small doses of morphine, or its equivalent of opium, induce a 
primary stimulation or excitation which may or may not be followed by a 
sedative effect. Medium doses augment the size and slow the velocity of 
the pulse, increase cutaneous heat, render the mind active, and produce a 
general sedative effect upon the whole body. The higher brain centers are 
profoundly impressed, the intellectual faculties becoming sharper, ideas 
more brilliant, precise, and under control, the power of application more 
intense, and the conversational propensities stimulated. The imaginative 
and creative faculties are, if anything, exaggerated, while judgment, 
steadiness and co-ordinate thought and reasoning seem to be more in 
abeyance than usual. If the dose be small this stage is never passed. 
Under large or full doses, however, this state of excitation and well-being 
abates, leaving a calm, careless, indifferent, and pleasurable sensation, 
with a series of fleeting ideas, succeeded, after a longer or shorter interval, 
by a dream-filled sleep which may last for several hours. Upon awakening 
the patient may complain of dizziness and nausea, trembling, headache, 
and loss of appetite. Most of the secretions will have become more or less 
suspended and constipation induced, though the sweat glands will retain 
their activity. From this state the patient awakens when the drug has 
spent its force, and if the drug be not repeatedly resorted to no harm will 
have been done. If there is pain the patient will have lost all sensibility to 
it while under the influence of the drug, for morphine is the most perfect 
analgesic known. If the dose be large the sleep from morphine may be 
dreamless. 
Toxicology.-When a toxic dose of morphine or opium has been taken 
there occur symptoms which may be grouped under three stages: 
The first, or stage of excitation, may be absent; or if present, be of very 
short duration. 
In the second stage, depression speedily comes on with a full and slow 
pulse, suspension of the cerebral functions, overpowering drowsiness 
followed by a deep sleep with slow and stertorous breathing, suffused, 
flushed or cyanotic countenance, strongly contracted pupils, warm dry skin, 
and muscular prostration. The patient may be aroused by shaking, flag- 
ellation, or loud shouting, but as soon as undisturbed sinks again into a 
deep slumber. If he is not kept awake and breathing stimulated, he passes 
almost imperceptibly into the final or lethal stage. 
In the third or lethal stage coma is absolutely complete. The face, 
at first turgid or livid, becomes pale and the lips livid, the extremities are 
cold, the pupils minutely contracted (pin-point myosis), the dry skin gives 
way to the sweat of death, the breathing becomes progressively slower 
and slower, shallow and labored, until it finally ends in a soft or almost 
imperceptible respiration. Death then takes place from respiratory paraly- 
sis or asphyxia, though the heart stops almost immediately after breathing 
ceases. 
The treatment of acute opium poisoning must be prompt and un- 
remitting. Owing to the fact that the vomiting centers and the peripheral 
nerves of the stomach are depressed by toxic doses of opium, emetics do 
503 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
not act well. They should be tried, however, as well as other means of 
inducing vomiting, as tickling the throat, etc., but should not be relied 
upon. Washing out the stomach by lavage is to be preferred, and 
should be repeated at short intervals because morphine is readily elimi- 
nated from the blood-current into the stomach, and continuation of the 
poisoning may be maintained through its reabsorption. In the meantime a 
solution of potassium permanganate (3 to 5 grains in a half pint of water) 
should be given to destroy the morphine, and strong black coffee admin- 
istered freely by mouth and by rectum. Tannic acid only imperfectly 
precipitates the morphine, and some of its salts not at all. The all-im- 
portant necessity is to keep the patient breathing, as depression of respira- 
tion is the most dangerous feature of opium poisoning. For this purpose 
strychnine sulphate (1/30 to 1/10 grain) preferably, or atropine or cocaine 
is to be used. Ammonia or alcohol may be needed to support both the 
heart and respiration. While death probably does not take place because 
of the deep sleep or narcosis, it is absolutely necessary to keep the patient 
awake in order to have his co-operation and voluntary effort to keep up 
breathing, and thus fight the depression of the respiratory centers. The 
patient should be walked between two attendants constantly, and flag- 
ellated with hot and cold wet towels, or switches, artificial respiration 
performed or the faradic current applied to the skin. In all of these efforts, 
however, human limitations must be considered, and there is no necessity 
for bruising or lacerating the flesh, or pushing annoyance to exhaustion of 
the patient. The latter only favors deeper narcosis, and if the patient 
goes to sleep his voluntary efforts to breathe by sheer will power are lost 
and death is the penalty. To prevent reabsorption of the drug from the 
urine, catherization should be resorted to several times. 
Therapy.-External. Notwithstanding the fact that opium and its 
alkaloids in watery solutions are probably not absorbed by the skin, and 
therefore do not impress the peripheral cutaneous nerves, lead and opium 
wash (Tinctura Opii, Liquor Plumbi Subacetatis aa, fl3 ij; Aquae, q. s. Oj) 
is a common application intended to subdue pain and act as a local sedative 
in contusions, sprains, bruises, articular inflammations, and in erysipelas 
and other local inflammations. For this purpose it has never attained 
popularity among Eclectic practitioners. This practice has been well 
expressed by Wilcox as "simply a concession to popular sentiment". 
Upon mucous structures, however, the anodyne effects of opium are 
more perfect. In suppository or ointment opium is often included to 
relieve pain in hemorrhoids and anal fissures and to check reflex vomiting. 
Sometimes solutions of morphine are used in painful ophthalmias and as 
an injection for gonorrhoea. It has nothing to commend it for either 
purpose, and its use in this manner is not wholly unattended by danger. 
Internal. The therapeutic virtues of opium are due chiefly to mor- 
phine and but little to the associated alkaloids, excepting codeine. To the 
narcotine is due the occasional tetanic action of the drug. The uses given 
below, therefore, will apply to both morphine (chiefly) and opium (where a 
slower effect is desired), and to the latter when specifically stated. 
The therapeutic uses may be conveniently grouped under the fol- 
lowing necessities: (1) To relieve pain and distress; (2) to allay peripheral 
504 INDIVIDUAL DRUGS. 
irritation and inflammation; (3) to restrain excessive or hyper-secretion; 
(4) to control spasm and convulsions; (5) to stop hemorrhage; (6) to pro- 
duce sleep; (7) to cause diaphoresis; (8) to maintain strength under systemic 
strain and to favor metabolic functioning. 
While both opium and morphine may be used arbitrarily for the relief 
of severe pain, they should for most other purposes, and even for pain, 
when possible, be employed with due regard for their specific indications. 
To prescribe them intelligently it should be remembered that "the patient 
with the hard, small pulse, the dry tongue, dry contracted skin, the flushed 
face, bright eye, and contracted pupil, is always injured, temporarily at 
least, by the administration of opium. On the contrary, the patient will 
be benefited when the pulse is soft and open, or when small the waves are 
short, and it gives a sensation of fullness and always lacking hardness, the 
skin is soft, the tongue moist, the face pale, and the eyes dull, expressionless, 
immobile, and dilated.'' Under these conditions pain and spasm are much 
more readily controlled and the so-called effects of idiosyncrasy are mini- 
mized. While nearly always pain yields to morphine and its use may be 
absolutely imperative, it yields much better and kindlier and to smaller 
doses when the indications as given are present, and with less general 
harm to the patient. For other uses than for the relief of pain, as far as 
possible one should be governed by the established specific indications. 
As the chief therapeutic value of opium resides in morphine, the alkaloid 
will be preferred except where opium or one of its combinations is desig- 
nated. 
Morphine (usually administered in the form of the sulphate) is the best 
and most certain remedy for pain. As such, however, it should be reserved 
for emergency uses and not be prescribed for slight and ill-defined condi- 
tions, for persistent, protracted, or oft-recurring neuralgias, for ordinary 
menstrual distress, or for long-continued pain from any cause or of any 
character, except in incurable diseases. In most painful states, except 
excruciating paroxysmal pain, other agents should be used if possible, and 
morphine only as last resort. In neuralgias, with the possible exception of 
sciatic neuralgia and tic douloureux, other drugs, such as aconite, gelsemium, 
rhus, arsenic, acetanilid or phenacetin are far preferable, not because they 
are equally as analgesic, but because they do not engender a pernicious 
habit-a condition sure to be established when morphine is given for 
more than a very brief time for a temporary purpose. 
For pain with spasm morphine is the most certain and most effectual 
remedy known. It is absolutely imperative for the relief of severe gall 
stone or renal colics. Not only does it relieve the excruciating suffering, 
but it relaxes the gall duct and the ureters, so that the concretions, if at all 
voidable, may be more readily passed. As a rule, such concretions as give 
rise to spasmodic pain are voidable, else they would not be small enough to 
engage in the passages, and the paroxysmal pain, shifting in position, is a 
fair indication that they are passing. During these ordeals the patient should 
be kept under the full influence of the drug, one-fourth to one-half grain 
of morphine sulphate being given hypodermatically, and repeated as needed, 
until the distress has abated. Patients suffering from severe pain stand 
opiates in doses that would prove disastrous under other conditions; still 
505 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
the doses should not be so closely plied that an overdose is duplicated 
near the termination of the passage of such concretions; the latter 
usually passing in from thirty-six to forty-eight hours. 
Morphine may be used to relieve the pain and quiet nervous agitation 
and relax muscular contraction in fractures, lead colic, and the crises of 
locomotor ataxia. In angina pectoris it is probably the most useful remedy. 
While contraindicated in ordinary congestion and inflammation of the brain 
and meninges, it may prove the only agent that will give relief from the 
intense pain of acute simple meningitis (early stage before effusion) and 
in cerebro-spinal meningitis or "spotted fever". It is sometimes necessary 
in acute peritonitis, especially when traumatic, where the pain is intolerable 
and bowel movements aggravate, and in acute appendicitis, when nothing 
else will relieve. After an undoubted diagnosis has been made and a case 
is to be operated upon, morphine is permissible to quiet the pain, relax 
rigidity, prevent shock, and allay the agitation and apprehensiveness of the 
patient. It should not, however, be used too early or, if possible, in the first 
attack of acute catarrhal appendicitis to the extent that the symptoms 
may be so obscured as to mislead the patient and the physician as to the 
true condition of the disease. If other expedients can be employed morphine 
should be withheld, as far as possible, in appendiceal inflammations. 
In very severe gastralgia morphine with bismuth gives prompt relief, 
but should not be repeatedly used in oft-recurring attacks. It is sometimes 
demanded in ulcer of the stomach, especially if hemorrhage occurs. In 
cancer of the stomach, or any other organ of the body, it is a most merciful 
drug, and there should be no compunction concerning its use after an un- 
questioned diagnosis has been made by every means of precision possible, 
including radiography. 
Morphine is to be employed as necessity dictates, to alleviate the pain 
from irritant poisons, and of severe burns and scalds, both external and in- 
ternal. 
Morphine is frequently employed preceding the use of anaesthetics, 
especially chloroform, to increase their efficiency, allow lesser dosage, and 
to prevent shock. More recently the tendency has been to discourage this 
use of the drug on account of the shallow breathing induced by it, thus 
retarding the prompt induction of proper anaesthesia. After operations 
small doses may be given to produce rest, quiet pain and agitation, and to 
prevent shock and irritative febrile reaction. Frequently codeine serves 
the purpose better than morphine and is less restraining to the secretions. 
It is the custom with many obstetricians to inject one-eighth grain of 
morphine during the severer periods of the ordeal of parturition. It gives 
rest, relaxes a rigid os, and stimulates normal contractions; besides it gives 
comfort and assurance to the woman, and many contend that it in no way 
harms either the mother or the child. Personally, however, we believe 
that it often narcotizes the child and results in a deeply cyanosed state and 
stupor from which it is difficult to resuscitate the child. Many of these 
cases are attributed to imperfect anatomic evolution of the circulatory 
tract (blue babies), when in fact they are morphinized babies. 
Opium and morphine induce sleep in insomnia from almost any cause; 
but they should not be so employed except where sleeplessness is due to 
506 INDIVIDUAL DRUGS. 
pain. Other forms of insomnia yield to safer hypnotics. It may, however, 
be needed in the insomnia of acute melancholia, and in that accompanying 
distressing incurable heart-disease, with pain and dyspnoea, and in the sleep- 
lessness of phthisis and cancer. If excitement is great in maniacal condi- 
tions with insomnia, morphine alone may aggravate, and chloral will act 
better. Sometimes a small dose of the former may be combined with a 
less than usual dose of the latter and become effective in producing sleep, 
the combination acting better than either drug given alone. 
Both opium and morphine may be used to relieve peripheral irritation, 
such as gives rise to cough and asthmatic seizures, and in chronic bronchitis 
and phthisis. Sometimes codeine is preferable to either. For cardiac 
asthma and bronchial asthma, without pulmonary oedema, morphine is the 
promptest remedy that can be used. The state of the kidneys, however, 
should be determined, and if the renal functions are bad the drug must be 
cautiously employed, if at all. Morphine and deodorized tincture of 
opium are sometimes of value, in small doses, to relieve acute attacks of 
vomiting, but they should not be employed where nausea is of daily or 
frequent occurrence, as in that of pregnancy. In fact, opiates have little 
or no control over the latter condition. Morphine is a remedy for spas- 
modic and paroxysmal dyspnoea, especially that experienced upon assum- 
ing the reclining position. It is of no value for continuous and persistent 
shortness of breath, and examination in such instances will usually reveal a 
chronic kidney disorder which makes the use of the drug inadmissible. 
When constipation is due to a spasmodic contraction of the unstriped 
musculature of the intestines, morphine is distinctly useful. This is par- 
ticularly evident in the results obtained from it in lead constipation. 
Sometimes a similar condition of cystic spasm is responsible for retention 
of urine; then morphine also relieves. 
Morphine is a drug of preeminent importance in convulsions. It is by 
far the most generally useful remedy in puerperal eclampsia. Here it is 
not contraindicated by the usual restrictions for its employment. In 
traumatic tetanus the patient should be kept fully under the influence of 
morphine. 
Morphine must be avoided if possible in uraemic convulsions due to 
chronic nephritis, with uraemic or cardiac dyspnoea, or in uraemic insomnia. 
When uraemic eclampsia occurs in acute nephritis it may be cautiously 
used if other agents prove ineffective. 
Opium is of value in delirium tremens, but has been recklessly used. 
As one looks back over the history of therapy it appears that many deaths 
from this complaint can be attributed to this drug alone. This is largely 
owing to the enormous doses that were used and the utter disregard of specific 
conditions. If the dipsomaniac cannot take food or cannot sleep he will 
die; if there is kidney disease, opium will probably kill; if there is a flushed 
countenance, blood-shot eyes, wild and furious delirium, pain in the head, 
red, dry and turgid tongue, and full bounding pulse, opium is likely to kill 
the patient. If, on the contrary, the skin is relaxed and moist, the circula- 
tion feeble, the face pale and the tongue moist and dirty, opium is a safe 
drug. The dose should not exceed one-eighth grain of morphine, or one- 
fourth grain at the most, every four or six hours, until sleep is induced. 
507 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Opium and morphine are much less commonly used than formerly in 
acute inflammations. Sometimes they are demanded in acute pleurisy and 
in pericarditis, and no drug so effectually helps as a single small dose of 
morphine in the excruciating pain of acute articular rheumatism that does 
not readily yield to the salicylates, macrotys, or bryonia. Both the dia- 
phoretic and Dover's powder are useful here, and the former is the less likely 
of the two to provoke nausea. Formerly opium and its alkaloid were much 
employed to allay inflammation and quiet peristalsis, as well as to annul 
pain, in acute peritonitis, but of late years it has fallen into disuse. 
Opium, preferably to morphine, is used in one form or another in 
excessive diarrhoeal and other exhaustive discharges. When a persistent 
summer diarrhoea, with much undigested food, or an intractable mucous 
diarrhoea is first treated by thorough catharsis, then opium may be given, 
by mouth, to restrain further abnormal secretion. It has, however, proved 
a pernicious drug in the hands of those who unwisely use it under all con- 
ditions when safer specific means would have been far more effectual. 
It is a good drug, however, in persistent serous diarrhoea. An injection of 
morphine is the promptest drug for the relief of cholera morbus. Together 
with the compound tincture of cajuput this forms our best treatment. 
While minute doses have been advised in cholera infantum, the drug should 
under no circumstance or in any dose be administered to infants. In 
Asiatic or true cholera an injection of morphine (one-eighth grain) often 
checks the cramps, vomiting, and rice-water discharges. In choleraic 
diarrhoea, rendering one very prone to attacks of true cholera during epi- 
demics of the latter, Locke advised: 3 Tincture of Opium, Spirit of Camphor, 
Spirit of Peppermint, Tincture of Kino, aa, fl 3 j; Tincture of Capsicum, 
fl^ss; Neutralizing Cordial, fl^iijss. Mix. Sig.: One teaspoonful every 
half hour in severe cases; three times a day in mild attacks. 
Opium is a useful drug in polyuria, especially that of true diabetes, in 
which the drug restrains both the quantity of urine and the output of 
sugar. For this purpose its continuous use is permissible only in confirmed 
glycosuria, and it should not be employed in cases in which sugar temporarily 
appears in the urine. Only in incurable conditions, in which every consider- 
ation for consequences has been invoked, should opium be used in sugar 
diabetes. Then it is perfectly permissible, provided it gives comfort and 
rest to the patient. By many it is considered the best drug in diabetes, the 
disease establishing a tolerance for the opium, and it is given in ascending 
doses as long as it does good and meets urgent conditions. Singularly 
it is far less effectual in simple polyuria or so-called diabetes insipidus. 
Probably its effect in giving rest to the nervous system accounts for its 
value in diabetes mellitus. 
Diaphoretic Powder.-We unreservedly assert our preference for this 
opiate, when an anodyne of this class is to be used. It will not take the 
place of morphine when pain is intense and must be quickly relieved; but 
it may be employed (whenever opium is indicated by the open pulse and 
moist tongue) to relieve the milder degrees of pain. It acts without the 
deleterious effects derived from morphine and other opium preparations. 
Though this product has been modified from time to time, it contains 
to-day, as in the original formula by Dr. Beach, powdered camphor, opium, 
508 INDIVIDUAL DRUGS. 
ipecac and potassium bitartrate-in such nicely balanced proportions that 
the system is gradually prepared for the action of its chief ingredient- 
opium. Being a decided sedative, both of temperature and nervous ex- 
citation, it may be used even where there is a high degree of fever. It is 
unquestionably the best pain-reliever for continuous use in pleurisy and 
pneumonia. The ipecac allays irritation, and if the doses be not too large 
or too often administered it will not usually cause nausea or emesis. Dia- 
phoretic powder, as the name indicates, promotes activity of the skin. 
Diaphoretic powder not only relieves pain, but quiets nervous irritability, 
allays cough, facilitates expectoration, and thus proves an ideal sedative. 
It is the best remedy of its class for children. Diaphoretic powder, with 
an equal bulk of bismuth subnitrate, is the best remedy we have found for 
profuse irritative diarrhoea and for the watery diarrhoea of intestinal 
la grippe. When the patient cannot rest and there are no contraindications, 
it may be employed to restrain excessive diarrhoea in typhoid fever and to 
relieve nervous unrest and promote sleep. Taken early and in rather free 
doses it will check a cold. It strongly assists macrotys in the relief of myalgic 
and rheumatic pains, being the safest anodyne with which to relieve the pain 
in acute inflammatory rheumatism. There are few cases of inflammatory 
and painful conditions in which it will not give relief, and that without the 
danger attendant upon the use of many of the anodynes. It is an ideal 
anodyne and relaxant in various forms of colic and in severely painful 
menstruation. It should not, however, be used every month, or for the 
milder attacks of pain, lest a habit be induced. In that form of menstrual 
pain or ovarian irritation attended with great nervous excitability simulat- 
ing hysteria, the powder infused in hot water and given hot in quite liberal 
doses will bring about relief quicker than any agent we know of. Singularly, 
when administered very hot its tendency to provoke nausea is slight, but 
when given lukewarm or when warm drinks follow its administration, 
emesis is very apt to be induced. It is of especial value in after-pains. 
Its effectiveness as a preparator for the administration of quinine is one of 
its many virtues. The ordinary dosage is from two to ten grains in cold 
water, repeated as the necessity of the case demands. Diaphoretic powder, 
known in Eclectic pharmacy as the Pulvis Ipecacuanha et Opii Compositus 
of the American Dispensatory, was introduced by Dr. Wooster Beach, and 
was undoubtedly a modification of the celebrated Dover's powder. 
Dover's Powder.-"Dover's powder, according to the dose administered, 
is an excellent stimulant, sedative, anodyne, and narcotic. It has a better 
action than either of its chief ingredients administered separately. It is a 
very good agent to improve the quality of the skin, the necessary moisture 
being induced by the ipecac to insure the favorable action of opium, for 
the specific indication for the latter is a moist skin and tongue, and soft, 
open pulse. As a pain-relieving agent and to promote sleep, it may be 
used where opium alone would not be tolerated. Though profuse perspira- 
tion may be produced by it, it is also capable of checking that secretion as 
shown by the favorable action of five-grain doses of the powder given to 
control the colliquative sweats of phthisis. It should be given a half hour 
before the sweating begins. Dover's powder sometimes causes sickness at 
the stomach, and should never be followed immediately after its administra- 
509 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
tion with warm drinks, but they may be used later, if desired. As a pain- 
reliever, or stimulant to the internal organs, or as a hypnotic, it is admissible 
when there is no nausea, inflammation of the brain, or high temperaure. 
It is an efficient drug in rheumatism, the incipient stage of inflammations, 
and to control cough. Hot applications to the abdomen and five-grain doses 
of Dover's powder with one grain of camphor, every one half or one hour, 
give marked relief in dysmenorrhoea. Without camphor, it is very efficient 
in amenorrhoea from cold, being used together with external heat. It allays 
nervous excitation in cases of abortion, and assists in controlling uterine and 
pulmonary hemorrhages; two or three grains of the powder, with a like 
quantity of quinine, forms an efficient treatment in neuralgia, with hot, 
dry skin. In dysentery, it assists the action of other remedies, as well as 
controlling peristaltic movements, while in irritative diarrhoea, after a mild 
laxative, it controls any spasmodic bowel complications that may super- 
vene. It may be used in enteritis, both to control the inflammation and the 
movements of the bowels. It is useful in the early stage of renal catarrhal 
inflammations and in granular degeneration of the kidneys, chiefly for the 
purpose of maintaining a good circulation and a moist condition of the skin. 
Dose, two to ten grains, preferably in capsules." (From a previous article 
by the author in the American Dispensatory.') 
Heroine (heroin) is diacetylmorphine, an artificial alkaloid formed from morphine 
by the displacement of two hydroxyls by acetyl. It is a white, odorless, crystalline powder, 
of slight taste, and soluble in alcohol and very sparingly in water. The hydrochloride is 
very soluble in both water and alcohol and has a bitter taste. Owing to its greater solubility 
it is preferred to heroin. In general its action is much like that of morphine, but it is more 
depressant to the breathing function. On the cerebrum it has an action between that of 
morphine and codeine, depressing the brain more than does the latter. It is more dangerous 
than morphine and, like the latter, is also a habit-forming drug. In man, as well as animals, 
when poisoning occurs from it, excitement and convulsions take place. Heroine is elimi- 
nated to some extent by the bowels, but chiefly unchanged by the kidneys. Heroine is said 
not to stupefy or to induce constipation. It is mostly employed as a respiratory sedative 
to restrain excessive cough, and is suggested for uraemic dyspnoea. The smaller amounts 
are more efficient than large ones-from 1/20 to 1/6 grain, three times a day, being the 
usual dose. 
Dionine (Dionin) is ethylmorphine, an artificial derivative of morphine. It is a 
yellowish-white, crystalline powder, of a faintly bitter taste, but without odor, soluble in 
8 parts of water or 22 of alcohol. It lacks the narcotic power of morphine, but possesses its 
analgesic properties. It is employed as a substitute for the latter in gastric and intestinal 
ulcer, or cancer, and in suppository for painful diseases of the rectum. It does not nauseate 
like morphine. Though of no greater value than codeine, it has the power to relieve chest- 
pains and severe cough. From 1 to 5 per cent solutions may be instilled upon the con- 
junctiva to relieve pain in keratitis, iridocyclitis, and glaucoma. It does not anaesthetize 
the parts, but acts simply as an analgesic or local anodyne. The dose of dionine is from 
1/4 to 3/4 grain. 
Cotarnine Hydrochloride is prepared from narcotine, one of the alkaloids of opium. 
Under the name of "stypticin" it is employed internally to arrest oozing capillary hemor- 
rhages, such as occur in menorrhagia and metrorrhagia, and locally in epistaxis. Its action 
is very similar to that of hydrastine. The dose by mouth is 1/2 to 4 grains; hypodermatically 
1/2 to 2 grains. 
RELATED DRUGS. 
OXYDENDRON. 
The leaves of Oxydendron arboreum, De Candolle (Nat. Ord. Ericaceae). A handsome 
tree of the eastern third of the United States. Dose, 1 to 60 grains. 
Common Names: Sourwood, Sourwood Tree, Sorrel Tree. 
Principal Constituents.-No satisfactory analysis has been made of sourwood leaves. 
Preparations.-1. Specific Medicine Oxydendron. Dose, 1 to 60 minims. 
2. Extr actum Oxydendn. Extract of Sourwood. Dose, 3 to 6 grains. 
510 INDIVIDUAL DRUGS. 
Specific Indications.-Anasarca, ascites, and other forms of dropsy; 
urinary difficulty of old men; painful, burning micturition, with scanty flow 
of urine. 
Action and Therapy.-Sourwood is a cooling diuretic and a tonic to 
relaxed capillaries. It is said to give relief in bowel disorders caused by a 
hyperaemic condition of the viscera, or to colds. It relieves the unpleasant 
urinary troubles of old men, when due to prostatic and cystic disorders of 
an atonic type-with painful micturition, scanty urine, meatal burning, and 
blood in the urine, the latter passing drop by drop. Its reputation rests largely 
upon its asserted value in anasarca and other forms of dropsical effusion, 
conditions in which it has been somewhat overrated. 
PAN AX. 
The root of Ar alia quinquefolia, Decaisne and Planchon (Nat. Ord. Araliaceae). Middle 
and northern United States in rich woods; becoming exceedingly scarce; also cultivated. 
Do^e, 5 to 60 grains. 
Common Name: Ginseng. 
Principal Constituents.-Not well determined; resinous and probably an amorphous 
yellow principle which has been named panaquilon. 
Preparation.-Specific Medicine Panax. Dose, 1 to 60 drops. 
Specific Indications.-Nervous dyspepsia; mental and other forms of 
nervous exhaustion from overwork. 
Action and Therapy.-A mild, stimulating tonic whose effects are 
observed only after quite a long period of administration. It is a feeble 
nerve stimulant and as such is adapted to nervous exhaustion of a mild 
type from too close application to work, and to mild forms of nervous 
dyspepsia and slight stomachic debility. As a medicine it acts kindly and 
quietly, giving a grateful sense of comfort to the stomach. 
PANCREATINUM. 
Pancreatin. 
A mixture of enzymes (chiefly amylopsin, trypsin, and steapsin) obtained from the 
pancreas of the Sus scrofa var. domesticus, Gray, or Common Hog, or of the Bos taurus, 
Linne, or Ox. 
Description.-An amorphous cream-colored powder having a faint but not offensive 
odor, and a meat-like taste. Slowly but not wholly soluble in water, and not in alcohol. 
It should not be heated, and it changes gradually under exposure to the air. It should 
convert not less than twenty-five times its weight of starch into soluble carbohydrates. 
Dose, 2 to 15 grains. 
Specific Indications.-Intestinal indigestion, with diarrhoea of fatty 
or chylous feces, accompanied by flatulence, nausea, vomiting, and ab- 
dominal pain; in diseases of the mesenteric glands. 
Action.-In the presence of alkaline fluids, and below a temperature 
of 140° F (60° C) pancreatin converts starch into sugar, digests albuminoids 
and protein bodies, emulsifies fats, and coagulates and peptonizes milk 
and peptonizes gruels and articles of diet prepared from the above-named 
substances. It does not act well in an acid medium and is slowly decom- 
posed by mineral acids, and promptly destroyed by a higher heat than 
that given above. Pancreatin and pepsin should not be given in com- 
bination. 
511 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Therapy.-Pancreatin is largely used as an enzymic digestant for the 
predigestion of food, for stomachic or rectal alimentation. By diluting four 
parts of milk with one part of water and using one part of pancreatin to four 
parts of sodium bicarbonate and keeping the mixture at a temperature of 
not more than 150° F (65.5° C) for fifteen minutes, digestion is accom- 
plished. The ferment should then be destroyed by heating to the boiling 
point and the finished preparation kept upon ice until used. If digested 
for longer than fifteen minutes the preparation becomes bitter and is then 
objectionable for stomachic feeding. If desired for rectal feeding it may be 
digested for an hour. The practice of using nutritive enemata is growing 
less and less popular. 
A combination of pancreatin and sodium bicarbonate is employed in 
achylia gastrica. As nature has provided pancreatic juice for intestinal 
use in the conversion of chyme into chyle one can scarcely see the wisdom of 
giving pancreatin in stomachic disorders, for some change must take place 
in the ferment under such circumstances. This change is, of course, 
obviated to some extent by giving it with an alkaline salt, as sodium bi- 
carbonate. It is, however, very useful in intestinal indigestion and dyspepsia 
where starches and fats are imperfectly elaborated; and where fatty or 
chylous diarrhoea takes place, with more or less flatulence and abdominal 
distress. It is of much service in the intestinal dyspepsia of children who 
are fed chiefly upon milk and an amylaceous diet, and in consequence of 
imperfect digestion suffer from diarrhoea and emaciation. In some cases 
of chronic pancreatitis it has benefited by supplying the deficiency oc- 
casioned by the lessened supply of the natural ferment. To be effective 
it should be administered from two to four hours after meals. Pancreatin 
has been injected into the bladder to dissolve blood-clots in that viscus. 
Trypsin, one of the ferments in pancreatin, has been advised in diabetes. 
It has no control over the disease process, but assists in the digesting of fats 
and proteids and thus benefits these cases indirectly when pancreatic 
involvement has lessened the normal supply of the enzyme. It also is 
used to dissolve diphtheritic membrane. 
Papayotin, Caricine, Papoid. 
A digestive ferment obtained from the fruit of the Carica Papaya, Linne (Nat. Ord. 
Passifloraceae). The South American Papaw tree. 
Description.-An amorphous white or yellowish-white powder, odorless, and practically 
tasteless. It dissolves in water and glycerin, has strong peptonizing powers, and acts in 
all media-acid, neutral, or alkaline-and best in the presence of a small amount of fluid. 
Dose, 1 to 5 grains. 
PAPAIN. 
Caroid.-A concentrated, digestive agent derived from the West Indian Papaw 
(Carica Papaya). It is an amorphous, nearly tasteless powder, of a pale yellow color, 
readily soluble in glycerin and water. Glycerin solutions keep indefinitely, while water 
solutions must be prepared fresh every three hours. It is marketed in powder, tablet, 
tablet combination, and in essence forms. 
Action.-The milky juice of the tree bark and the fruit (from which 
papain is derived) are decidedly active and capable of producing violent 
cutaneous inflammation and a corrosive effect upon the mucous tissues, 
causing violent purging. It expels worms and is said to occasion abortion. 
RELATED PREPARATION. 
512 INDIVIDUAL DRUGS. 
Therapy.-External. Both the milky juice and papain destroy warts, 
corns, sinuses, and the scaly and horny tissues of chronic skin diseases. 
A five per cent solution has been employed to dissolve diphtheritic and other 
false membranes. It must be applied directly to the exudates. Papain 
is usually used in an alkaline combination. 
Internal. Papain is a vegetable pepsin, digesting proteid, but not 
starchy substances. It has been used in atonic and fermentative dyspepsia 
with painful acid eructations, flatulence and constipation. It has been less 
used than the animal ferments, because of the variable quality of the 
ferment as found in commerce. The juice of the fruit is an active anthel- 
mintic (lumbricoids) and taeniacide. 
Caroid is a digestive enzyme acting in neutral, acid, or alkaline media. 
In this respect it differs from the animal ferments (pepsin in acid media and 
pancreatin in alkaline media), which can only be used where natural con- 
ditions are just right for their action. It perfectly digests milk and eggs and 
meats. Caroid acts in both stomach and intestines, one of its best prop- 
erties being a cleansing of the extraneous mucus from the gastro-in- 
testinal surfaces, thus leaving them in a better absorptive condition, and 
adapted for the natural digestive secretions to come in better contact with 
the food. Moreover, its action is not suspended nor interfered with by drugs 
and chemicals, including intestinal antiseptics-many of which destroy the 
animal ferments. It is, therefore, useful in infant feeding where food is 
vomited, and dyspeptic and catarrhal states of the alimentary tract of adults. 
Locally the powder may be used to clean foul ulcers; which it does promptly. 
Dose of Caroid, 1 to 5 grains: of Essence of Caroid, 1 to 4 fluidrachms 
(adults); 1/2 to 1 fluidrachm (children). Each fluidrachm of the essence 
contains 11/2 grains of caroid. 
PARAFFINUM. 
Paraffin. 
A purified mixture of hydrocarbons, obtained usually by chilling, pressing, and purify- 
ing the high-fraction distillates from petroleum. 
Description.-An odorless and tasteless, colorless or white mass, more or less trans- 
lucent, and separating from solution in crystalline form. To the touch it is slightly greasy. 
Freely soluble in ether, petroleum, benzin, volatile oils, and most warm fixed oils; slightly 
in dehydrated alcohol; insoluble in water and alcohol. 
Therapy.-Used chiefly as the basis for protecting ointments for 
wounds, sores, and burns. Owing to its lack of solubility in ordinarily used 
solvents it is not suitable for use in drug-bearing ointments. Paraffin in- 
jections have come into use in subcutaneous corrective or cosmetic surgery, 
being particularly employed in deformities of the nose. By means of spray 
it has become a war-treatment remedy for wounds and burns. 
PARALDEHYDUM. 
Paraldehyde. 
A polymeric form of acetaldehyde. 
Description.-A transparent, colorless fluid of a burning afterward cooling taste, and a 
strong, pungent and characteristic but not unpleasant odor. Soluble in water, and less so 
in boiling water; and mixes freely with alcohol, chloroform, ether, and fixed and essential 
oils. Dose, 5 to 60 minims. 
Action.-Paraldehyde is a powerful hypnotic, producing sleep by 
depressing the higher cerebral centers. Carried further it depresses the 
513 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
reflexes, finally abolishing them, and paralysis and anaesthesia result. Cir- 
culation and respiration are slowed by it; in fact its action very much 
resembles that of chloral, but it is much less depressing and it may be given 
with comparative safety even when heart disorders exist. Paraldehyde is 
rapidly absorbed and is eliminated chiefly by the kidneys and lungs, the 
breath having the odor of that of one in drunkenness. While it sometimes 
nauseates, it seldom impairs the appetite. If long continued it may produce 
nutritional disturbances like those from chloral, as rashes, mucous irritation 
and gastric catarrh, and ulcerations about the nails and orifices. Very large 
doses may cause death by respiratory paralysis. 
Therapy.-Paraldehyde is used to produce sleep, acting best when 
wakefulness is pronounced rather than when the patient enjoys the custom- 
ary sleep. If pain is present, or fever exists, or there is much or ordinary 
worry it is apt to fail. In simple insomnia, however, it is usually promptly 
effective, the result being a peaceful and rather natural slumber, from which, 
upon awakening, the patient experiences no headache nor fatigue. The 
chief use of paraldehyde as a hypnotic is for the insane, being best adapted 
to mental excitement or agitation, mental exhaustion or delirium, and 
being less effectual in the melancholias and dementias. It has been very 
useful in acute mania with much agitation and insomnia, and in delirium 
tremens under like indications; sometimes it is useful in chorea and epilepsy, 
but chiefly to give rest when sleeplessness is a feature. Polyuria is said to 
be relieved by it. While usually safe even in heart affections, its 
prolonged use is contraindicated in cardiac dilatation accompanied by 
emphysema. 
The great drawback to paraldehyde is its unpleasant burning taste. 
It may be administered in water, syrup, or glycerin, preferably aromatized 
with spirit of orange. A good elixir is the following, advised by Wearn: 
Paraldehyde, three parts; Alcohol, ten parts. Solve. Add Orange-flower 
Water, four parts; Simple Syrup, ten parts, and enough Distilled Water 
to make thirty-two parts. Color with five minims of burnt sugar. 
PAR"EIRA. 
The root of Chondodendron tomentosum, Ruiz et Pavon (Nat. Ord. Menispermaceae). 
A vine of Brazil and Peru. Dose, 5 to 30 grains. 
Common Names: Pareira-brava, Pareira Root. 
Principal Constituents.-Tannin, and a white and a yellow alkaloid, the latter similar 
to berberine. The white alkaloid pelosine, found in undetermined species and in false pareira- 
brava, is identical with berberine and buxine. 
Preparation.-Specific Medicine Pareira. Dose, 1 to 30 drops. 
Specific Indications.-Irritation of the urinary tract, with abdominal 
tenderness; frequent desire to urinate with pain in urethra and glans upon 
urinating; chronic cystitis and pyelitis. 
Action and Therapy.-Pariera is mostly employed as a tonic diuretic, 
in chronic inflammation of the bladder, and of the kidneys with excretion 
of pus. The indications, as given above, should be observed in its use. It 
is not often employed. 
514 INDIVIDUAL DRUGS. 
PASSIFLORA. 
The root and stem-base of Passiflora incarnata, Linne (Nat. Ord. Passifloraceae). South- 
ern United States. Dose, 5 to 120 grains. 
Common Names: Passion Flower, May Pop. 
Principal Constituent.-Traces of an alkaloid. 
Preparation.-Specific Medicine Passiflora. Dose, 1 to 120 drops. 
Specific Indications -Irritation of brain and nervous system, with 
atony; insomnia from worry or overwork, or from febrile excitement; 
sleeplessness in the young and the aged; convulsive movements; hysteria; 
infantile nervous irritability; dyspnoea; palpitation of the heart from 
excitement or shock. 
Action and Therapy.-Passiflora is used chiefly in spasmodic affections 
and as a rest-producing agent. While somewhat hypnotic but acting 
slowly, it is better as a nerve calmative, rest resulting from its quieting 
influence, and sleep following in consequence of this rest rather than 
through any narcotic effect of the drug. It is one of the best agents we 
possess to allay restlessness and overcome wakefulness, when the result of 
exhaustion, with cerebral fullness, or due to the nervous excitement of 
debility. It is admirably adapted to young children and old persons to 
promote rest and sleep, and it acts similarly when sleeplessness is caused by 
worry, overwork-physical and mental-or due to the exhaustion of fevers. 
Few remedies are better to produce sleep during typhoid fever. The sleep 
induced by the restful influence of passiflora is a quiet, peaceful slumber, 
undisturbed by any unpleasantness, and the patient awakens calm and 
refreshed. Our experience with passiflora has shown it to be slow in pro- 
ducing sleep, and usually more effective in the second twenty-four hours 
than the first. Even small doses of it may cause nausea and vomiting. 
When this occurs its use should be discontinued. For the nervous phe- 
nomena and unrest accompanying la grippe, passiflora is a safe and often 
effectual remedy. 
When due to atony, passiflora may relieve pain though its anodyne 
properties are not marked. It is occasionally useful in nervous forms of 
headache due to debility, and in certain neuralgic pains associated with the 
process of menstruation. Reflex pains during pregnancy and the meno- 
pause may be relieved by it. 
Passiflora is antispasmodic. If given when the aura is felt it may 
ward off or mitigate an attack of epilepsy, but is of no value when the 
seizure takes place. It is a better remedy to limit spasms of childhood, and 
has thus been successfully exhibited in trismus nascentium, and convulsions 
from dentition, or the presence of worms. It may be used with some 
degree of success in preventing spasm during meningeal disorders, in chorea, 
and hysterical convulsions. While more or less effectual in most varieties 
of spasm when established, except in epilepsy, it is a far better agent for 
intercurrent use to control the irritability which precedes and often 
provokes the convulsive explosions. It has been greatly lauded in tetanus, 
but little reliance should be placed upon so feeble an agent in so grave a 
condition. Whooping-cough is often mitigated by passiflora, and for 
spasmodic asthma it frequently proves one of the most effective of remedies. 
515 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
PENTHORUM. 
The whole herb of Penthorum sedoides, Linne (Nat. Ord. Crassulaceae). A perennial 
herb in wet situations in the United States and Canada. Dose, 1 to 60 grains. 
Common Names: Virginia Stone-crop, Ditch Stone-crop. 
Principal Constituent.-Tannin. 
Preparation.-Specific Medicine Penthorum. Dose, 1 to 60 drops. 
Specific Indications.-Chronic pharyngeal and nasal disorders, with 
dryness, fullness, and irritation and a purplish, congested appearance; 
catarrhal inflammations with profuse secretions; gastric catarrh, catarrhal 
diarrhoea; sponginess of the gums. 
Action and Therapy.-External. A wash for catarrhal surfaces, pro- 
ducing an astringent effect but no corrugation of the tissues. 
Internal. While of some value in catarrhal diarrhoea, this is a remedy 
best adapted to chronic catarrhal and congested states of the posterior 
nares and pharyngeal vault. It should be used locally while it is being 
administered internally; and quick results are not to be expected. 
The dried, ripe seed of the cultivated varieties of Cucurbita Pepo, Linn6 (Nat. Ord. 
Cucurbitaceae). A native of the Levant; extensively cultivated. Dose, 1 ounce. 
Common Name: Pumpkin Seed. 
Principal Constituents.-A large amount of fixed oil (over 40 per cent) and a taeniafuge 
principle-a greenish-brown, acrid resin-; fatty acids and two proteids-myosin and 
vitellin. 
Specific Indications.-Tape-worm; round worm; ardor urinse. 
Action and Therapy.-An emulsion of pumpkin seeds prepared by 
rubbing one ounce of the crushed seeds with eight fluidounces of water, 
taken husks and all, after preparatory catharsis and fasting, is a safe and 
often efficient agent for the expulsion of tape-worm. A dose of castor oil 
should follow the administration of the emulsion. Sometimes oleo-resin 
of malefern is given with it, the concoction being sweetened if desired. 
Pepo will also remove round worms. The ethereal oil, in two drachm doses, 
has been similarly employed, but is less efficient than the whole seeds. 
An infusion of pumpkin seed is useful as a lenitive and diuretic in scald- 
ing of urine, strangury and other irritative urinary disorders. 
PEPO. 
PEPSINUM. 
Pepsin. 
A mixture containing a proteolytic ferment or enzyme, obtained from the glandular 
coat of the fresh stomach of the Sus scrofa var. domesticus, Gray, or common domesticated 
Hog. 
Description.-White, pale yellow, or yellowish lustrous scales, or a white or cream- 
colored powder, non-crystalline, without offensive odor, and having a feebly acid or saline 
taste; slightly hygroscopic; soluble in about fifty parts of water, the solution being some- 
what opalescent; but nearly insoluble in alcohol, chloroform, or ether. It should digest 
not less than 3,000 times its weight of freshly coagulated and disintegrated egg albumen. 
Dose, 2 to 15 grains. 
Preparations.-1. Pepsinum Saccharatum, Saccharated Pepsin (Pepsin, 10; Sugar of 
Milk, 90). Dose, 10 to 60 grains. 
2. Pepsencia (Essence of Pepsin, Fairchild). Dose, 10 to 60 drops. 
Action.-Long before the introduction of pepsin into therapeutics it 
was the domestic custom to use the dried inner lining of the gizzard of fowls 
516 INDIVIDUAL DRUGS. 
in derangements of the digestive organs to allay nausea and to aid digestion. 
This powdered membrane constitutes Inglwuin, a modern pharmacal prepa- 
ration of greater purity than the domestic product, the virtues of which de- 
pend upon the pepsin it contains. Pepsin digests proteid foods, converting 
them successively into soluble proteids, albumoses, and peptones. This is 
accomplished only in an acid medium. Thus hydrochloric acid when in the 
proportions normally existing in the gastric juice favors this action, but 
when the acid content reaches 0.3 per cent, pepsin ceases to act; nor will 
it act in an alkaline medium. Pepsin and pancreatin should not be given 
in combination; nor should either be used to the extent that the stomach 
and bowels become deprived of their natural functions-that is, the sub- 
stitution of artificial for natural digestion. Nor should pepsin be given to 
those who suffer from disintegrating disorders of the stomach, as ulcer or 
carcinoma, since the digestant power of the enzyme acts destructively upon 
the tissues. In such instances food should be predigested with pepsin and 
thus avoid the direct action of the latter upon the tissues. 
Therapy.-Pepsin is of value as an aid to digestion, or rather to produce 
artificial digestion, where there is an inadequate secretion of gastric juice. 
It is therefore of value in indigestion or dyspepsia under such conditions. 
It appears to be more useful for infants who suffer from gastric derangements 
preceding or during dentition; and in infants artificially fed upon cow's 
milk and in whom digestion proceeds badly. In such children's disorders 
it corrects nausea and vomiting, diarrhoea, and tumidity of the abdomen, 
and aids in recovery from the emaciation so often an accompaniment of 
such a condition. For this purpose small doses of pepsin immediately after 
feeding, followed in less than a half hour by a very weak dose of hydro- 
chloric acid, is useful; or Fairchild's Essence of Pepsin (Pepsencia) is a 
good preparation. Pepsin is occasionally useful in achylia gastrica. Some- 
times it relieves sick headache due to gastric acidity, or will prevent a 
customary attack of it if given in full dose immediately after the meal. 
In the tardy digestion following debilitating diseases it is often of distinct 
service, but it should not be given for so prolonged a period as to deprive 
the stomach of its own natural privilege of digesting the food. When there 
is reason to believe that there is an insufficient proportion of hydrochloric 
acid in the gastric juice, pepsin in powder should be followed in a half hour 
by the necessary quantity of the former to insure good digestion. 
Nutritive enemata or food (as eggs and meats) for stomachic alimen- 
tation may be predigested by means of pepsin. 
PETROLATUM. 
Petrolatum, Petrolatum Ointment, Petroleum Jelly. 
A purified mixture of semi-solid hydrocarbons derived from petroleum. 
Description.-I. Petrolatum. A yellowish to light amber unctuous mass, having 
only a slight fluorescence, and without or almost without odor or taste; neither water nor 
alcohol dissolves it; freely soluble in ether, chloroform, turpentine, benzin, and most oils. 
II. Petrolatum Album. White Petrolatum (White Petroleum Jelly). A white or 
slightly yellowish, greasy mass; has similar solubilities to the above. 
III. Petrolatum Liquidum. Liquid Petrolatum (Liquid Paraffin, Mineral Oil). 
A transparent, colorless fluid, odorless and tasteless when cold, and when heated having not 
more than a faint petroleum odor. It should be free or practically free from fluorescence. 
In addition to the solubilities mentioned under Petrolatum, it will itself dissolve camphor, 
menthol, thymol, and many other substances. It is to be had in two forms varying in vis- 
cositv tests: 1. Heavy Liquid Petrolatum. 2. Light Liquid Petrolatum. 
517 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-External. Petrolatum and white petrolatum 
are chiefly used as protectives and as ointment bases, for which they are 
admirably adapted. For the carrying of substances for deep penetration 
they are not desirable. They do not become rancid, nor are they easily 
affected by acids, alkalies, or reducing agents. Being unirritating they may 
be used as emollients and protectives in irritated conditions and inflam- 
mation, but cause some smarting upon chafed surfaces, particularly in the 
intertrigo of infants. White petrolatum, placed between the lids, is one of 
the best agents to use in burns of the conjunctiva and cornea, either from 
direct heat or alkalies. Liquid petrolatum, under various trade-names, 
is a good vehicle for other medicaments, or may be used alone, in inflam- 
matory conditions of the nose, throat, and bronchi. It should be used by 
atomization. 
Petrolatum in all the forms is a good lubricant for the hands and for 
instruments. Rubbed into the scalp (not on the hair alone) once a week, 
it is very effectual in preventing the falling of hair. 
Internal. Petrolatum is sometimes given internally to alleviate 
cough. Liquid petrolatum has come into use as a lubricant for the in- 
testinal tract in habitual and obstinate constipation, due to intestinal 
stasis. It has no inherent cathartic effect and acts only by softening the 
feces and lubricating the tract, and is thought to limit autoinfection. It is 
conceivable that it may readily derange the stomach and even the bowels, 
by preventing the natural activities of the mucosa. Sometimes it causes a 
slight nausea and sense of heaviness and discomfort in the bowels. From 
two to eight fluidrachms may be used at bed time, or broken doses may be 
given during the day. 
PETROLEUM. 
Petroleum, Rock Oil, Naphtha. 
A bituminous combustible fluid issuing from the earth. 
Description.-Coal Oil or Kerosine. This is the only petroleum product that we would 
recommend for use for purposes named below. It is a clear, bluish, fluorescent liquid, 
very volatile and having a distinctive, well-known odor. 
Action.-Coal oil is emollient and will blister if applied to the skin and 
covered. We have seen the chest-tissues slough to the bones from such an 
application for the relief of a cold. When swallowed, as it is sometimes 
by children or drunken persons, it produces vomiting, dizziness, fullness, 
constriction and pain in the head, burning and thirst, faintness, palpitation 
of the heart, pallor, coldness, and sweating, weak pulse, collapse, and some- 
times somnolence. It seldom kills, except in very large doses of a sulphur- 
bearing variety, when death results from gastro-enteritis. 
Therapy.-External. Petroleum is only mentioned here on account of 
its very great certainty in destroying pediculi-head, body, and genital. 
Care should be had not to blister the tissues. Wiping the hair thoroughly 
with a cloth saturated with the oil and subsequently washing with soap and 
water is one of the most efficient means of killing both lice and nits in the 
hair. A similar treatment quickly destroys pediculi pubis. 
518 INDIVIDUAL DRUGS. 
The dried, ripe fruit and root of Petroselinum sativum, Hoffman (Nat. Ord. Umbel- 
liferse). Native of Europe; cultivated in all moderate climes. 
Common Names: (1) Parsley Fruit, Parsley Seed; (2) Parsley Root. 
Principal Constituents.-(Root.) An essential oil containing Apiol; (Fruit) Fatty 
oil (22 per cent), volatile oil (oil of parsley) containing apiol and lavo-pinene. 
Preparation.-Decoctum Petroselini, Decoction of Parsley. Dose, 1 to 4 fluidounces. 
Action and Therapy.-Decoction of parsley root is an active diuretic, 
as is also the oil (three or four drops). Both relieve urinary irritation, and 
have been extensively employed to relieve dropsical effusions when the 
kidneys are in a condition to respond, especially when the oedema follows 
scarlet fever. 
Apiol is an active emmenagogue. When of good quality, doses of seven 
to fifteen grains are capable of producing effects similar to those of coffee- 
cerebral excitement with feeling of vigor and composure, and warmth in the 
stomach. Large doses (thirty to sixty grains) occasion intoxication, giddi- 
ness, flashes of light, ringing in ears, and headache similar to that resulting 
from cinchona. It is used almost entirely for the treatment of amenorrhoea, 
due to ovarian inactivity. It should be administered in doses of seven to 
ten grains, three times a day for a week or so previous to the expected time 
of menstruation, and given oftener when the menses appear. It relieves 
pain by increasing the flow when menstruation is scanty. Owing to the 
uncertain quality of apiol preparations they frequently fail to produce any 
emmenagogue effects. A liquid apiol (Oleoresina Petroselini) is to be 
preferred, given in doses of eight to twelve minims. 
PETROSELINUM. 
Phenol, Carbolic Acid. 
(Formula: C6H5OH.) 
Phenol is hydroxy benzene derived from coal tar, or produced synthetically. 
Description.-Colorless, aromatic, needle-crystals, separate or interlaced, or a crystal- 
line mass at first white, but often acquiring a reddish coloration. In contact with the skin 
or mucosa it causes pain followed by anaesthesia, and produces a whitish eschar. It has a 
sharp, sweet taste, but should not be tasted. If liquefied by heat or when liquid from 
summer heat, and a small proportion of water is added, about 5 to 8 per cent, it will remain 
liquid. It dissolves in about fifteen parts of water, and very freely in glycerin, alcohol, 
chloroform, ether, and oils. An equal part of glycerin renders it miscible in all proportions 
with water. Dose, 1/10 to 2 grains, largely diluted. 
Preparation.-Phenol Liquefactum, Liquefied Phenol, (Liquefied Carbolic Acid). Phenol 
liquefied by heating in a water bath and adding one tenth part of distilled water. If heated 
in the bottle the stopper must be removed. It is a colorless fluid having the taste, odor, 
and action of phenol. Dose, 1/10 to 2 minims, largely diluted. When an aqueous dilution 
is desired an equal quantity of glycerin should first be added to it, after which it can be 
mixed with water in all proportions. 
Specific Indications.-A broad, moist tongue; cadaverous odor of 
the breath; yeasty fermentation. 
For External Use.-"Fullness and relaxation of tissues. Whenever 
there is retraction, shrinking, and dryness it will prove harmful" (Scudder). 
Action.-Carbolic acid acts destructively on the skin and mucosa, dam- 
ages the renal tract, and profoundly depresses the nervous system. Unless 
given in toxic amounts, however, the internal administration of phenol 
produces no appreciable effects. Toxic doses paralyze the vaso-motor 
apparatus and depress the heart, stopping its action in diastole. Through 
PHENOL. 
519 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
stimulation of the respiratory center in the medulla and the vagal terminals 
in the lungs, large doses cause full, difficult and hurried breathing. The 
cerebrum is depressed by excessive doses and stupor comes on. The motor 
nerves and the muscles do not seem to be greatly impressed by it, but the 
peripheral sensory nerves are first depressed and then paralyzed when the 
acid is applied locally. Though scarcely affecting temperature in health, 
even small medicinal doses markedly lower the temperature during fevers, 
as Hare declares, "by diminishing heat-production and increasing heat- 
dissipation." Carbolic acid is mostly eliminated by the kidneys, which are 
irritated and inflamed by it, when given in injudicious doses, leaving 
the body as sodium-potassium phenol-sulphonate, glycuronic acid, and 
hydrochinone. A little of it passes unchanged, and a portion of the acid 
is undoubtedly oxidized in the body. The dark color imparted to the urine 
is probably due to the presence of the hydrochinone, an oxidation product 
of phenol. 
Carbolic acid is destructive to insects and the lower forms of life. 
A one-per-cent aqueous solution will destroy the "virulence of ordinary 
septic and purulent matters, of the tubercle bacillus", and in contact for 
hours will destroy "some of the organisms related to putrefaction." A two- 
per-cent aqueous solution "is required to destroy the infection of vaccine 
or of glanders" (Wood). Spermatozoa and the higher infusoria are destroyed 
by solutions of 1 to 2,500 (Dougall). It takes two days' immersion in solu- 
tions of five per cent to destroy the spores of anthrax. It checks fermenta- 
tion and prevents the formation of molds in vegetable infusions or juices, 
and preserves animal tissues from decomposition. 
To the taste carbolic acid is hot, purgent, and sweetish. Applied to 
the skin of man it produces a burning sensation, followed by numbness and 
later by anaesthesia. A peculiar whitish eschar is formed, which eventually 
becomes brown, and may terminate in a slough. When swallowed it 
precipitates the albumen of the tissues producing corrugated, whitish 
patches upon the lips and fauces, the esophagus and the orifices and folds 
of the stomach. It readily diffuses itself into the blood, producing pro- 
nounced depressant effects upon the nervous system, as vertigo, pallor, and 
pupillary contraction. The pulse becomes feeble, very rapid or abnormally 
slow, and breathing is impeded. In lethal doses these effects are intensified 
and include those mentioned below. 
Toxicology.-Carbolic acid is one of the quickest and most fatal poisons 
known, being equalled in intensity and rapidity only by prussic acid and 
its salts. When large amounts have been swallowed the victim may drop 
at once and die, or the effects may last for some hours before the inevitable 
outcome. If not in sufficient doses to kill at once, the usual symptoms of 
toxic gastro-intestinal inflammation result. Fatal poisoning has been pro- 
duced by injections of even weak solutions of the acid into the serous 
cavities, and many deaths have been recorded from absorption from 
phenol dressings applied to open wounds. 
When a fatal dose has been swallowed, stupor, followed by profound 
unconsciousness, at once comeson, the skin is cold, livid, and bathed in sweat, 
breathing becomes rapid, short and shallow, and often stertorous and gasp- 
ing, the heart's action grows gradually feebler, and death ensues from 
520 INDIVIDUAL DRUGS. 
respiratory paralysis. Constant phenomena of poisoning by phenol are a 
minutely-contracted pupil, and a dark-greenish, blackish, or smoky hue of 
the urine. It is often difficult to distinguish between apoplexy and phenol 
poisoning until the autopsy reveals the odor and corrosive effects. Ordi- 
narily a history of having taken a drug, either by accident or by declared 
suicidal intent, the whitish eschars and the odor of the acid (if case is seen 
early) will aid in the diagnosis. Death has occurred in three minutes and 
has been delayed for sixty hours. Usually death takes place in from one 
to six hours. The fatal dose is not definitely known, but one drachm has 
been known to kill a man, while a child died from one-fourth teaspoonful 
of the solution (one to five). 
In poisoning by phenol soluble sulphates-sodium sulphate (Glauber's 
salt) and magnesium sulphate (Epsom salt)-or pure alcohol, or cider 
vinegar, all well diluted, should be freely administered immediately. Soap 
suds, egg-albumen, milk, flour and water, and olive or sweet oils may be 
given closely following the preceding antidotes, and then quickly removed by 
means of the stomach pump. Emetics are apt to fail; moreover, they are 
likely to invite rupture of the corroded stomach. Saccharate of lime, by 
forming an insoluble compound with the acid, is advised by some as one 
of the best of the chemical antidotes. Atropine, said to be physiologically 
antagonistic, should be given subcutaneously to the extent of maintaining 
mydriasis, to prevent collapse, and ether, brandy, caffeine or camphor 
may be used hypodermatically to sustain the heart. Friction, artificial 
respiration and heat will aid in restoring restorable cases. Notwithstanding 
both confirmation and denial of the efficacy of sodium sulphate or mag- 
nesium sulphate, they should be given, as they can do no harm even if they 
fail of antidotal effects. They will do some good in recoverable cases by 
increasing elimination by the bowels and kidneys. The use of absolute 
alcohol and of vinegar has been suggested upon the evidence of their power 
to efface the corrosive effects of the acid upon the skin, and upon the 
mucous membranes of the mouth. As the latter is available in every 
household it certainly should be given a fair trial. Both alcohol and 
vinegar are useless unless given immediately after ingestion of the poison. 
If a large lethal dose has been taken death will result before aid can be 
given, or will probably result in any event. Ordinarily very little hope 
should be held out when any sized lethal dose has been swallowed and 
some time has elapsed before treatment. 
In case of recovery the sulphates should be continued in small doses 
for several days to antidote any remaining traces of the acid, and the after- 
treatment should be that of toxic gastro-enteritis and nervous exhaustion. 
Therapy.-External. Carbolic acid is an azymotic and antiseptic, but 
its disinfectant property is inferior to that of many other agents ranking, 
in fact, among the poorest. It is also a local anaesthetic, escharotic, and anti- 
pruritic. The crude product containing cresylic acid is more effective for 
disinfecting purposes than the pure phenol. Both may be used in strong 
solutions to disinfect soiled linens, bed clothes and garments of the sick, 
to wash rooms in which the sick have lain, and to rid beds of vermin. 
They are also useful to deodorize toilets, bed-pans, and drains. For the 
disinfection of surgical instruments, carbolic acid is less used than formerly 
521 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
on account of blunting the cutting edges and the unpleasant effects 
upon the hands of the operator, diminishing the tactile sense and endanger- 
ing the circulation of the fingers. And its use as a local anaesthetic for 
minor operations for which it is effective, is largely obsolete since cocaine 
has come into use. Some, however, still prefer it for that purpose. It is no 
longer used as an antiseptic spray, as instituted by Lister, for the prevention 
of infection from the atmosphere in surgical operating rooms. Nor is it 
often applied, as formerly to wounds and abrasions, except occasionally 
to septic wounds. 
Caution.-Dilute solutions of phenol should never be used upon the 
fingers or the toes. The more dilute the more dangerous, as there is just 
enough of the acid to act upon the vaso-motor control of the blood-vessels. 
Contraction of the vessels occurs (ischaemia) and is so prolonged that 
gangrene results. 
Phenol in full strength may be used to anaesthetize the crowns of small 
abscesses prior to liberation of the pus. It may be injected into car- 
buncles in their incipiency, sometimes aborting them. Very little is re- 
quired. The points of boils may be touched with it prior to opening them 
and the cavities lightly swabbed after evacuation. Care must be had not 
to use enough to poison, and by keeping well within the necrotic area 
poisonous absorption is not apt to take place. As a cauterant it may be used 
in indolent or gangrenous ulceration, small hemorrhoids, poisoned wounds, 
fistula in ano, syphilitic and other warts, mucous patches, soft chancre, 
lupus, carbuncle, and boils. Touching the pulp of a decayed tooth with it 
and protecting the parts by a loose packing, often relieves toothache. 
The glycerite (one to four) is an effective application to acute eczema- 
tous dermatitis of the face and neck. It should be quickly brushed upon the 
affected parts and immediately removed by alcohol. It is painful, turns 
the tissues temporarily whitish, and is followed by exfoliation. It usually 
promptly checks the dermatitis. The glycerite is a common cauterant and 
stimulant for ulcers of the uterine cervix, for endocervicitis and endometri- 
tis, all chronic and with offensive discharges. The glycerite may be applied 
to uterine cancer to relieve pain and destroy fetor. It also removes cauli- 
flower excrescences, and rarely may be employed as a mild caustic in 
diphtheria, malignant sore throat, and apthous stomatitis. 
The aqueous solution of the glycerite (3 per cent) is useful upon 
gangrenous and other foul ulcers and when applied to necrosis of the bones. 
A 1 per cent solution makes a cleansing and pain-relieving mouth wash and 
gargle for aphthae, tonsillitis, diphtheria, ulcerative pharyngitis, and septic 
sore throat. A similar solution forms an effective vaginal douche for leu- 
corrhoea, ulcerative cervix uteri, endocervicitis, gonorrhoea, in the female; 
vulvitis in the young, and where there are fetid discharges. It should, as 
a rule, be avoided as a wash for gonorrhoea in the male and in cystitis. 
A one-half per cent solution of the glycerite has been advised to remove 
seat-worms, but there are safer and simpler agents for this purpose. 
Carbolic acid has been used in several forms of conjunctivitis and in 
keratitis, and in aural inflammation. Such a use is inadvisable and not al- 
together safe. Cotton saturated with a 5 to 10 per cent glycerin solution 
of phenol may be inserted into the aural canal after rupture of the drum in 
522 INDIVIDUAL DRUGS. 
acute otitis media, when pain and swelling persist. The glycerin reduces 
the swelling by dehydrating the tissues, and the phenol allays pain and acts 
as an antiseptic. 
A full strength to a 25 per cent solution of phenol in glycerin or 
oil has been effectually used hypodermatically in hydrocele and to cure 
hemorrhoids. For the first purpose thuja is to be preferred, and while 
yielding as fair results as other injection fluids its use in the latter has been 
attended with serious and even fatal consequences. 
Carbolic acid is a very important topical medicament in skin diseases. 
It is mildly anaesthetic, antipruritic, and parasiticide, being most effective in 
disorders arising from the presence of vegetable and animal parasites. The 
glycerite in nearly full strength or diluted to suit the needs may be applied 
in pediculosis, scabies (less valuable than sulphur or Peru balsam), pityr- 
iasis, tinea versicolor, tinea tonsurans, lichen ruber and lichen planus, 
psoriasis, erythema, trichophytosis genito-cruralis, impetigo, prurigo, 
moist and itching eczema, dermatitis and lepra. A solution of the glycerite 
(about 1 to 20 or 30) is invaluable in general pruritus, and especially in that 
form known as winter itch and in the itching caused by jaundice. An 
ointment (10 grains to the ounce) is sometimes preferred in skin disorders, 
or the acid is added to ointments of other cutaneous remedies. 
In small burns and scalds a one-half per cent solution in olive oil 
has proved very effectual, both to relieve pain and promote healing. Bites 
and stings of insects may be similarly treated. 
The hypodermatic injection of a 2 per cent solution of carbolic acid 
has been advised in tetanus, not more than from five to fifteen grains being 
given in a day. The fearful mortality of this disease justifies the employ- 
ment of even such severe measures. 
Dobell's Solution, a carbolized and glycerinated alkaline solution, is a 
favorite wash for acute and chronic nasal catarrh and for the coryza of 
influenza. 
Phenolized Camphor (melted crystals of phenol, 1; camphor, 3) is a 
useful and painless application to incipient tonsillitis, and to abrasions, 
slight wounds, and small burns and scalds. 
An inhalation of carbolic acid is valued in pulmonary gangrene. A 2 
per cent spray may be serviceable in coryza, fetid bronchorrhoea, influenza, 
nasal catarrh, ozaena, ulcerated sore-throat, chronic pharyngitis and chronic 
bronchitis. In phthisis not more than one-half per cent solution should be 
so employed, and even then it should be discontinued if it causes faintness, 
giddiness, or trembling, with an increased weakness of the pulse. For most 
of the preceding conditions the spraying by Dobell's solution may be 
substituted. 
Internal. The use of phenol internally is almost wholly confined to 
fermentative stomach and bowel disorders. It is indicated by a putrescent 
or cadaverous odor of the breath and a broad, moist tongue. "It is con- 
traindicated by a pinched or contracted condition and a long, dry, and 
pointed tongue" (Scudder). Though none too desirable as an internal 
medicine, it may be cautiously employed in the following conditions, 
stopping the use of the acid upon the appearance of smoky urine or drowsi- 
ness: Vomiting or diarrhoea due to fermentation of food in the stomach or 
523 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
bowels, or to the ingestion of unsound food-stuffs; vomiting from yeasty 
fermentation, with the presence of sarcinae or torulae or both; nervous 
vomiting from gastric irritability; gastric pain (gastrodynia) following 
eating; flatulence from decomposed food or imperfect digestion; offensive 
breath from putrefactive changes in the stomach; and sometimes in cholera 
infantum and scarlatina anginosa, being especially cautious with young 
children, and giving it to them only in the minutest doses. Bismuth aids 
its action in diarrhoeas, and for general purposes the following may be ad- 
ministered: H Glycerite of Phenol (Liquefied Phenol, 1; Glycerin, 4), 
gtt. v to xxx; Water, fl^iv. Mix. Dose, One teaspoonful every two to four 
hours; children should have much smaller amounts. 
SUBSTITUTES FOR PHENOL. 
Creolin is a dark-brown, syrupy fluid obtained from soft coal and is one of the liquid 
cresols or cresylic acids-coal-tar derivatives. It is recommended as a substitute for 
carbolic acid, though it is liable to produce the same type of poisoning. Accredited with 
antiseptic and germicidal powers, it has been chiefly employed in hand preparation in 
obstetrics, and for vaginal, cystic, and nasal irrigations. Being an emulsified suspension 
it mixes cloudy but perfectly with water. Solutions of 1 to 2 per cent strength are usually 
preferred. It may also be employed in foul ulcerations, upon fetid feet, in ozaena, and 
purulent otorrhcea, in solutions ranging from one part in 100 to one part in 1,000. 
Lysol is prepared from a certain fraction of tar oil saponified by an alcoholic solution 
of fat. It is a clear, brownish, oily liquid, having the odor of creosote, and imparting to 
flesh and instruments a slippery feel. It mixes clear with water and is preferred over creolin, 
in that instruments may be seen in its solutions. Poisoning is possible from it as from 
phenol, whose action it possesses. It is largely used by some for obstetric cleansing and in 
vaginal douches. Much irritation is often caused by its injudicious employment, especially 
by long-continued use for the vaginal toilet. Solutions of 1 to 2 per cent are generally 
employed. 
Liquor Creolis Compositus or Compound Solution of Cresol (the latter a mixture of 
isomeric cresols from coal tar, occurring as a colorless or straw-colored fluid gradually be- 
coming yellowish-brown when long exposed to light) is designed to take the place of creolin, 
lysol, solved, solutol, and similar cresol proprietary preparations on the market. It is 
composed of 50 per cent of cresol, the rest being alcohol, linseed oil, potassium hydroxide, 
and water. It is intended for use as a wash and dressing in obstetrics, infected wounds, and 
suppurative conditions, periostitis, and osteoperiostitis of the feet. Like all cresol prepara- 
tions it produces poisoning similar to that from phenol (carbolic acid). Compound solution 
of cresol is used in dilutions of 1 to 20 to 1 to 1,000. 
Trikresol (a combination of ortho-, meta-, and paracresol) occurs as a white liquid of a 
creosote odor, forming clear solutions in water up to about 2 1/2 per cent. It is said to be less 
poisonous than phenol and not to benumb the skin. It is regarded by some as a useful 
collyrium (1 to 500 or 1 to 1,000); and is occasionally used in 1 per cent solution in general 
surgery. It is the preservative agent in some of the commercial antitoxins and sera. 
PHENOLPHTHALEINUM. 
Phenolphthalein. 
A derivative of phenol. (Formula: C20H14O4.) 
Description.-A permanent, white, or slightly yellowish-white powder, tasteless and 
odorless, soluble in alcohol and sparingly in water. Solution turns red upon addition of 
alkalies. Dose, 2 to 5 grains; average dose, 2 1/2 grains. 
Action and Therapy.-This agent, through solution in the bowels owing 
to the presence of alkali and bile, provokes a mild laxative effect, which may 
continue for several days. This prolongation is due to the fact that some 
of it, being absorbed from the bowels, into the blood, passes to the liver, and 
there in contact with theibile is liberated into the intestines, continuing its 
action until it is all excreted. It is eliminated chiefly by the bowels, though 
some passes by way of the urine, to which, if the latter be alkaline, it imparts 
a bright pink color. Phenolphthalein, in one or two grain doses, given at 
524 INDIVIDUAL DRUGS. 
bed time, causes without pain or griping, a free and normal passage of 
feces. It may be used for a long time without harm, and is recommended^ 
either alone or with aloes, as a remedy for habitual constipation. 
PHENYLIS SALICYLAS. 
Phenyl Salicylate, Salol. 
(Formula: C13H10O3.) 
Description.-This is the phenyl ester of salicylic acid and derives its name, salol, from 
the first syllable of the word saZicylic and the last syllable of the word pheno/. It is a white, 
faintly aromatic, crystalline powder, having a peculiar characteristic taste; very soluble in 
alcohol, ether, chloroform, and oils, but very sparingly in water. Dose, 5 to 15 grains, but 
not more than thirty grains per day. 
Specific Indications.-Turbid ammoniacal urine, with renal torpor 
(when the kidneys are intact); gastro-intestinal fermentation; rheumatism,, 
with functional renal inactivity; choleraic discharges. 
Action.-Through the agency of the pancreatic juice, salol is split up in 
the small intestines into salicylic acid (about 60 per cent) and phenol 
(40 per cent). Therefore, if the dose be very large the toxic effects of these 
two agents respectively may be expected. (See Acidum Salicylicum and 
Phenol.) Without question the more dangerous product is the carbolic 
acid (phenol), the effect of which may be recognized by the smoky urine 
(carboluria), one of the prominent symptoms of poisoning by salol. Cir- 
cumstances seem to control the action of salol; if the pancreatic fluid be 
abundant, or the dose large, or the kidneys inactive, toxic symptoms 
come on quickly, and as the drug is slowly absorbed and slowly eliminated 
large doses or overlapping doses may be cumulative. The kidneys are 
extremely susceptible to this drug, and it should never be given when there 
are known acute or chronic structural diseases of these organs. Salol 
has produced confirmed albuminuria; hence in view of these known con- 
ditions and the power for harm that may be exerted by its decomposition 
products, the drug should not be recklessly employed. Should diarrhoea 
be induced by it the renal effects are less likely to occur. Other untoward 
symptoms are urticaria, herpes, vomiting, persistent anorexia, sweating, and 
the intoxicating effects of salicylic acid (salicylism). Salol gives to the 
teeth a peculiar sensation, as if being coated with rubber. It is, as a rule, 
not irritant to the stomach. 
Therapy.-External. Salol, triturated with starch (1 to 5 or 6) or in 
aqueous dilution of its alcoholic solution, may be used as a germicide and 
antiseptic in fetid catarrh (by insufflation or spray), stinking ulcers, sy- 
cosis, pustular eczema, impetigo contagiosa, and other skin diseases. It 
can only be effective when in the presence of alkaline secretions or fluids. 
Locke advised equal parts of starch and salol dusted upon the skin to relieve 
the burning and lessen the inflammation in erysipelas. 
Internal. Salol is a good antirheumatic and efficient intestinal anti- 
septic. Owing to the fact that it does not dissolve in the stomach it is 
often used to advantage in acute rheumatism when salicylic acid and the 
salicylates cannot be employed on account of disturbing gastric comfort 
and digestion. It is, however, not so effective as these salts, and necessarily 
acts much slower as it is not dissociated into its components until it reaches 
the alkaline field of the intestines. We have found it of value in subacute 
525 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
arthritic pain and swelling of the fingers in the middle aged and aged, a 
condition probably due either to the intestinal absorption of putrefactive 
products, or to faulty functioning of the kidneys. Salol is also useful in 
sore throats of the type that usher in rheumatic attacks, and in muscular 
rheumatism from cold and exposure. Lumbago has been relieved by it 
either when chiefly myalgic or due to pressure of intestinal gases; and the 
same is true of sciatic neuritis. Chronic pharyngitis of lithemic subjects 
is often quickly relieved by salol. It likewise benefits in neuralgias due to 
exposure. Salol is sometimes useful in rheumatic headache and influenza, 
but, as a rule, it is used in the latter affection without rhyme or reason, as 
it is frequently in ordinary colds, and often with no benefit and probably 
with harm. 
Salol is a perfectly satisfactory drug in intestinal toxaemia due to fer- 
mentative and putrefactive changes of the contents of the bowels, and it 
corrects the intestinal indigestion so often caused by these changes. Even 
pernicious anemia of the milder type and presumably dependent upon 
intestinal decomposition is said to be improved by this drug. Fetid diar- 
rhoea, chronic colitis, acute fermentative diarrhoea and dysentery, biliary 
catarrh, and similar conditions are benefited through the antiseptic action 
of the compound. The diarrhoea of typhoid fever may be similarly treated, 
provided the alkalinity of the intestinal contents is not greatly reduced 
and the kidneys are intact and functioning. It is one of the few drugs that 
is asserted to have proved successful in Asiatic cholera. 
Salol is also a urinary antiseptic. It is safe when there is no organic 
lesion of the kidneys; it is even useful in pyelitis, provided the secretory 
cells of the organ are not inflamed or destroyed. It should be used with 
caution, however, even in infection of the urinary tract, and then usually 
in connection with alkaline diuretics. It should especially be avoided in 
any acute renal inflammation threatening the integrity of the kidney. 
Many rely on it in acute gonorrhoea for its property of rendering the urine 
antiseptic. Locke advised it to render the urine acid and to prevent and 
correct decomposition in cystitis. 
PHOSPHORUS. 
Phosphorus. 
A non-metallic element obtained from calcium phosphate by reduction with charcoal 
(U. S. P.). (Symbol P). 
Description.-A nearly colorless, waxy, translucent solid of about the consistence of 
beeswax, whose surface gradually becomes red, white and sometimes black. It has a 
disagreeable, distinctive odor and taste, but should not be tasted except when highly diluted. 
Exposed to air it gives off white fumes, which are luminous in the dark, and if exposed 
may take fire spontaneously. The fumes have the odor of garlic. When heated with 
hydrogen it changes to the non-poisonous red amorphous phosphorus. While almost in- 
soluble in water, it imparts to it the characteristic phosphorus odor and taste. Soluble 
freely in carbon disulphide and chloroform, less freely in absolute ether, and more sparingly 
in dehydrated alcohol. 
Phosphorus must be carefully preserved under water, in strong, well-closed con- 
tainers, in a secure and moderately cool place, protected from light" (U. S. P.). Dose, 
1 /240 to 1 /60 grain; minute doses are preferred by Eclectic physicians. 
Preparation.-Specific Medicine Phosphorus, Dose, 1/30 to 5 drops. 
Specific Indications.-Nervous exhaustion; general atony; vesical 
and prostatic irritation, with mucoid discharges; sense of fullness and 
dragging in the perineum; sense of weariness in lower extremities; mucoid 
526 INDIVIDUAL DRUGS. 
rectal discharges; low muttering delirium in low fevers, with involuntary- 
discharges; chronic bronchial and pulmonic affections, with heat, dryness, 
hacking cough, and difficult expectoration of muco-purulent or sanguineous 
sputum; rusty sputum; pulmonary hyperemia; pinkish countenance with 
staring eyes; expressionless pasty tongue; insufficiency of the internal recti 
muscles of the eye; sexual debility. 
Action and Toxicology.-In minute doses, and properly diluted, 
phosphorus becomes absorbed and acts as a stimulant and tonic to the 
nervous, vascular, and secreting organs. It excites the mental faculties and 
the sexual feelings, raises the temperature of the skin, increases the fre- 
quency and volume of the pulse, and promotes the secretions. Cell growth, 
particularly of the skin and bones, is quickened by it. In large doses, it 
operates as a poison, causing gastro-enteritis, becomes absorbed, and 
produces tissue changes and convulsions, insensibility, and death. Fatty 
degeneration of the liver and heart are chief among its results. According 
to Mialhe, the absorption of phosphorus (and also of sulphur) is due to the 
fatty matters contained in the alimentary substances, which, after affecting 
its solution, serve as the vehicle for its introduction into the economy. 
The phosphorus so absorbed may remain several days within the body 
without undergoing any sensible change, as its union with the fatty matters 
enables it to almost completely escape the action of the chemical agents 
with which it comes in contact, and to diffuse itself throughout the system 
in the same manner as poisons soluble in water. Hence the reason for the 
phosphorescence and the garlicky odor observed at the autopsy of persons 
who have been poisoned by phosphorus. Phosphoretted hydrogen acts 
similarly, as when introduced into the blood, it gives rise to the produc- 
tion of water, and to a precipitate of phosphorus in a state of minute division 
eminently suited for the development of its deleterious action. 
Acute Phosphorus Poisoning.-As a poison, phosphorus acts both 
locally (as an irritant) and specifically. The symptoms of acute poisoning 
from the ingestion of phosphorus are as follows: Within a few minutes, or, 
more generally, after a few hours, the victim experiences a disagreeable, 
onion-like, or garlicky taste, and the breath is observed to be alliaceous. 
Burning pain (not intense) in the stomach, with a sense of oppression in 
that organ, follows, and there is general malaise and eructations of garlicky 
vapors of the drug. The vapors may show luminosity if the room be dark. 
Vomiting of luminous, coffee-colored, yellowish, or bilious material is com- 
mon, and often violent and frequent. The abdomen is hot, distended, and 
tender upon palpation. Purging is not a common occurrence (constipation 
at first being the rule), but when taking place the stools are loose, dark, or 
bloody and painful. The stools are often phosphorescent in the dark. 
When death occurs early, the symptoms rapidly intensify until collapse, 
followed by death, takes place. Should death be delayed, however, for 
several days, as is frequently the case, and particularly when active symp- 
toms are late in developing, jaundice supervenes and becomes rapidly 
progressive. The irritant symptoms usually subside, forming an apparent 
intermission for the better, but the danger is as great as ever. The pulse 
and temperature, which are at first above normal, soon become subnormal, 
great prostration ensues, the pulse becomes feeble and rapid, and some- 
527 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
times the radial pulse is almost imperceptible, the skin is cold, the urine 
scanty, albuminous, and contains tube-casts. Fatty degeneration of the 
liver and kidneys has taken place. At this stage the stools are usually 
abundant and dark-greenish or bloody. The skin may show hemorrhagic 
areas and petechial spots, and wounds or sores upon the surface bleed 
freely and easily. The nervous symptoms follow the establishment of 
jaundice. Coma ensues, associated with jactitation or convulsive muscular 
movements, and death occurs usually about five or six days after the in- 
gestion of the poison. In phosphorus poisoning, death does not usually 
take place until several days have elapsed. The shortest period on record 
is one-half hour (Habershon, in Taylor's Medical Jurisprudence}. Less than 
one grain (1/8 grain, Wormley) has caused death. Only white or ordinary 
phosphorus is poisonous, red or amorphous phosphorus being non-toxic. 
Locally, phosphorus produces dangerous burns quite difficult to heal. 
The pregnant woman invariably aborts when poisoned by phosphorus. 
Chronic Phosphorus Poisoning.-When phosphorus vapors come in 
direct contact with bone, necrosis of the part generally results. Formerly 
it was quite common for those manufacturing lucifer matches to be thus 
affected (particularly the jaw bones), but improved methods and industrial 
laws have largely overcome the danger from this source. This necrosed 
condition is now believed to be rare, unless the phosphorus can come into 
direct contact with the bare bone, as through carious teeth, or ulcers of the 
mouth. However, it has been known to produce caries of the teeth, with 
abscesses, and thus become extended to the alveolar processes. The fore- 
going bone effects and the following symptoms constitute chronic phos- 
phorus poisoning: Nauseous eructations, vomiting, purging, burning pain 
in the stomach, hypersensitiveness to cold, stiffness, numbness, and pain 
in the limbs and joints, wasting, dyspepsia, straw-colored or grayish skin, 
and hectic fever, with respiratory irritation and cough. The patient may 
die of the effects of the phosphorus direct, or he may die of dyspepsia or 
phthisis. The chief post-mortem changes from phosphorus poisoning are 
fatty degeneration of the liver, heart, kidneys, and other organs, as well as 
of the voluntary muscles; some surface disorganization of tissue may be 
observed, chiefly in the stomach. The blood is thick and dark-colored. 
The liver is deep-yellow, interspersed with reddish patches, and altogether 
closely resembles the effects of yellow atrophy of the liver, which disease 
poisoning by phosphorus most nearly resembles. The whole interior of the 
body is phosphorescent, and the luminosity may persist for months. 
Treatment of Phosphorus Poisoning.-In poisoning by phosphorus the 
stomach should be evacuated as speedily as possible. For this purpose 
sulphate of copper, which is itself reputed one of its best chemical antidotes 
(forming the black phosphide of copper), may be given in 2 or 3-grain 
doses, every five minutes, until vomiting ensues. Apomorphine hydro- 
chloride may be used subcutaneously if desired, to induce emesis. After 
vomiting has freely occurred, small doses of the copper sulphate (2 grains) 
should be continued every half hour, so that any free phosphorus may be 
converted into the black phosphide, at the same time endeavoring to prevent 
further vomiting by means of ice or of small doses of morphine sulphate. 
After full emesis by copper sulphate, copper carbonate followed by vinegar. 
528 INDIVIDUAL DRUGS. 
has been successfully used as an antidote. Thornton declares that copper 
sulphate antidotes only in doses themselves dangerous. Following the 
use of the copper sulphate, administer French oil of turpentine, 2 fluidrachms 
of which may be given in mucilage of acacia every fifteen minutes until one 
ounce is taken. Old (ozonized) oil should be preferred. Ordinary turpentine 
is not effective unless old or ozonized, and is even dangerous on account of 
its phosphorus solvent properties. Indeed, in phosphorus poisoning no 
albuminous or oily bodies (except French oil of turpentine) should be given, 
lest by their attenuation of the poison they favor its toxic action. Per- 
manganate of potassium and hydrogen peroxide are said by recent writers 
to be the most effectual antidotes. Acidulated laxative drinks are advis- 
able, with abstinence, or, at all events, a prohibition of any kind of food 
containing fatty matter. After the use of the antidote free purgation 
should be produced by means of magnesium sulphate, magnesium citrate, 
or Rochelle salt. No remedy is effective as an antidote after degeneration 
of tissue has begun. The best preventives of chronic phosphorus poisoning 
among those engaged in the manufacture of lucifer matches are a wetted 
sponge over the mouth, good ventilation of the factory, and personal 
cleanliness. 
Therapy.-Though accredited with various therapeutical properties, 
phosphorus may be said to be chiefly a remedy for nerve exhaustion with 
prostration of the vital powers. Though a powerful nerve stimulant, it is 
still a question whether its action is temporary, tiding the patient over a 
critical period, or whether it primarily produces a permanent tonic effect. 
That its effects are but temporary is the view held by most observers, and 
tonic effects follow this reassertion of nerve power. The cases for phos- 
phorus are those of atony, adynamia, debility, low nerve force, or nerve 
exhaustion. The phosphorus patient is weak, digestion and blood-making 
are imperfect, the glandular secretions and the excretions are defective, 
there is languor, lassitude, sexual debility in the adult, brain-fag, and 
general apathy. Sympathetic innervation is below par, the skin is dull and 
inactive, the tongue lifeless in appearance, and the whole system shows a 
lack of activity and evidence of imperfect elaboration of the blood, and 
defective nutrition of the nerve centers. In such conditions, through its 
primary stimulating power, it may prove tonic and restorative. Locke says 
of phosphorus that "it bears the same relation to the nervous system that 
iron does to the blood." 
Bearing in mind the indications above given, phosphorus becomes an 
important remedy in many nervous diseases. It was early employed as a 
stimulant in convulsive and old paralytic cases, and for progressive loco- 
motor ataxia, though it is now seldom or never used for these disorders. 
In all such cases inflammation should be absent. When paralysis of spinal 
origin is functional, it is often more serviceable than strychnine (Locke). 
It frequently proves the best remedy for long-standing, obstinate neuralgia, 
particularly in the aged. In such cases nerve exhaustion is a marked 
symptom. It occasionally benefits in epilepsy with the same nerve debility, 
or when due to sexual excesses, or abuse. Ordinarily, however, it is of little 
value in this disease. In neurasthenia, due to debility or to physical or 
mental overwork, or to sexual weakness, and in degenerative nerve-changes 
529 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
due to senility, it often proves a good remedy. When insomnia is due to 
cerebral anemia, phosphorus may sometimes give rest and sleep, and it oc- 
casionally proves useful in the debility due to acute and chronic alcoholism, 
the morphine habit, and in melancholia, dementia, and hysteria. For mental 
failure, mental aberrations, paralysis agitans due to imperfect nutrition or 
to degenerative changes, and in atheroma of the cerebral vessels, the 
remedy has been highly endorsed. Obviously, it never cures nor does much 
good in shaking palsy (paralysis agitans). Though not an analgesic proper, 
it relieves pain of a neuralgic and rheumatic character, particularly rheu- 
matic headache, when due to great debility, and when the pain suddenly 
subsides in some other part of the body and quickly attacks the head. 
It is a fairly good remedy for intercostal neuralgia in the debilitated, and a 
good agent for the relief of nervous headache in similar subjects. 
Phosphorus in minute doses (specific medicine, gtt. iij to v in aqua, 
fl 5 iv; teaspoonful every hour) is a valuable agent in low grades of pneumonia 
and bronchitis. It acts better in the second stage of pneumonia than aconite. 
It is an agent of great power in lung hepatization. In chronic pneumonia 
with secretion of muco-pus and expectoration of blood-the patient hasten- 
ing on to consumption-this remedy or the hypophosphites will sometimes 
be of service. In the extreme debility of typhoid pneumonia, no agent is 
more efficient than phosphorus. Rust-colored sputum is one of the strongest 
indications for phosphorus; hacking, dry cough in the early stage of phthisis 
is also an indication for this drug. Chronic bronchitis, with bloody and 
muco-purulent expectoration and chronic laryngitis, with marked dryness 
and sense of heat in the throat, and associated with nervous depression, 
call for small doses of phosphorus. Pleurisy, in some subjects, and especially 
in the chronic form, may require phosphorus to assist in the absorption of the 
effusion. In such cases the patient is extremely weak, the pulse feeble, 
tongue pasty, and appetite and digestion much impaired. Phosphorus has 
been successfully used as a stimulant to the nervous centers in low fevers 
with low, muttering delirium, unconsciousness, and in involuntary passage 
of the fecal and urinary discharges. It is also useful as a cutaneous stimu- 
lant in some exanthematous diseases in which the eruption has receded from 
the skin. Ten or 20 minims of specific medicine phosphorus, added to 4 
fluidounces of water, and given in teaspoonful doses every two, three, or 
four hours, is declared by Scudder very useful in cholera infantum where 
there is nervous exhaustion, the discharges from the bowels being slimy 
and frothy, with tympanites. 
Minute doses of phosphorus have been advised, chiefly in conjunction 
with arsenic, for boils, carbuncles, scrofulous abscesses, acne, herpes zoster, 
scald-head, lepra, lupus, psoriasis, fistulae, osseous caries, and enlarged 
glands. In the so-called scrofulous diathesis it is sometimes useful, and in 
such a state it relieves leucorrhoea, chlorosis, nasal catarrh, colliquative 
sweating and debilitating discharges in phthisis, especially the diarrhoea 
of phthisis. 
The sexual and urinary apparatus are impressed by phosphorus. Its 
effects in sexual weakness are probably not due so much to a special affinity 
for these parts as to its general stimulating effect upon the body at large. 
However, it appears to improve the circulation and innervation of the genito- 
530 INDIVIDUAL DRUGS. 
urinary tract, and it is a good remedy to improve vesical, prostatic, and 
testicular irritation, whether arising from or associated with sexual ex- 
cesses (Scudder). It has given good results in "chronic cystitis, chronic 
prostatitis, enlarged and pendulous testes, gleet, chronic ovaritis, and 
vaginitis" (Scudder). To these we may add chronic irritation of the kidneys 
and ovaries, and atonic dysmenorrhoea; also chronic nephritis, with atony 
and the voiding of milky urine. "In the treatment of disease from sexual 
abuse, as in involuntary seminal emissions with marked atony and morbid 
irritability, it is the very best remedy known" (Locke). It has long been 
used as a remedy for impotency due to excesses or to debility of the sexual 
organs or of the system in general. 
In ocular and aural therapeutics, phosphorus is sometimes useful. Thus, 
in functional inner ear disorders, associated with general neurasthenia, it 
occasionally benefits, and it is credited with quieting tinnitus aurium. 
The dose is about 1/100 grain, 4 times a day (Foltz). In eye affections 
it frequently aids in a cure, particularly if there be a scrofulous or tuber- 
cular taint. It often quickly relieves retinal hyperaemia and retinitis. It 
has also benefited disseminated choroiditis and retinochoroiditis. Foltz 
{Dynamical Therapeutics} declares that it will rapidly increase visual acuity 
in functional or reflex amblyopia, provided no morbid process is present, 
and that it is the best remedy for insufficiency of the internal recti and 
paralysis of the ocular muscles. The dose for this purpose is from 1/200 
to 1/100 grain. Others have pronounced it a good remedy for asthenic 
amaurosis of functional character. 
Phosphorus has been endorsed as a remedy for pernicious anemia, 
but often fails. Locke advises minute doses of phosphorus for "muscular 
weakness, as in children who are slow in learning to walk." In fatty 
degenerations of various organs it has been advised, but must be used 
with great care and the dose must be minute. It is especially a good 
remedy for osteomalacia and rickets, and for the tardy union of fractured 
bones. 
Phosphorus may be given in solution in alcohol, ether, olive, almond, 
or cod-liver oil, chloroform, glycerin, or in pill. The dose of phosphorus 
ranges from 1/250 grain, cautiously and gradually increased to 1/16 grain, 
from 1/100 to 1/60 grain being the usual range of dosage. Elixir of phos- 
phorus, 15 minims to fl5j-(1/260 to 1/65 grain); phosphorated oil (1 per 
cent phosphorus), 1 to 10 minims; specific medicine phosphorus is the 
form usually employed in Eclectic practice, the most common prescription 
reading: 1$ Specific Medicine Phosphorus, gtt. v to xx, Water, fl^iv. Dose, 
1 teaspoonful every two to four hours. One minim of specific phosphorus 
represents 1/240 grain of white phosphorus. As phosphorus appears to 
accumulate in the system, its action should be carefully watched, and as 
soon as vomiting, diarrhoea, or other symptoms of derangement of the 
digestive organs appear, the use of the remedy should be temporarily 
ceased, and, after two or three days, be again commenced with the smallest 
dose, as before. Indeed, when no symptoms whatever manifest themselves, 
it will be prudent to cease its administration every fifteen or twenty days, 
recommencing its use in four or five days, and so on. 
531 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
PHYSOSTIGMA. 
The dried, ripe seed of Physostigma venenosum, Balfour (Nat. Ord. Leguminosae). 
A climbing perennial, native of Calabar, in the Gulf of Guinea, on the western coast of 
Africa, and around the sources of the river Coma, near Gabon. River banks. Dose, 
1 to 3 grains. 
Common Names: Calabar Bean, Ordeal Bean, Ordeal Bean of Calabar. 
Chief Constituents.-Physostigmine or eserine, a very poisonous base; calabarine, less 
poisonous and probably a decomposition product of the former; eseridine, eseramine, all of 
which are alkaloids; and phytosterin, closely resembling animal cholesterin. 
Preparation.-Specific Medicine Physostigma, 1/30 to 5 drops. (For specific purposes 
in nervous disorders the small fractional doses are preferred.) 
Specific Indications.-Feeble and tremulous pulse, cool surface, cold 
extremities, and contracted pupils; or pupils dilated, with small, rapid 
pulse; mental torpor in cerebro-spinal meningitis; difficult breathing with 
sense of constriction; meteorism. 
Action and Toxicology.-Calabar bean is a spinal paralyzant, the 
brain being apparently unaffected by it. It is also probably a direct 
muscle poison, though this is doubted by Wood. The motor and reflex 
centers of the cord are depressed, and finally paralyzed by it when given in 
poisonous doses. It also acts upon some of the medullary centers. The 
nerves are apparently not much affected by it, though some contend that 
it first stimulates and then destroys the excitability of their terminals in the 
muscles. Unstriped muscular tissue and the glands are stimulated by it, and 
peristalsis greatly exaggerated and intestinal secretion increased. It 
lengthens the diastolic pause, thus slowing the heart-beat and increasing its 
power, probably through its action upon the heart-muscle itself, or by 
stimulating the vagal terminals and the cardiac ganglia. Arterial tension is 
first raised by it; then lowered. When dyspnoea occurs it is thought to be 
due to the tetanic action of calabarine, which is present in variable propor- 
tions in commercial extracts of physostigma, thus rendering the latter 
undesirable preparations. Physostigma and its alkaloids are eliminated 
chiefly in the urine, the latter being then capable of producing poisonous 
effects when tested upon the eyes of animals. Physostigma kills by centric 
respiratory paralysis. 
Physostigma (and physostigmine [eserine] more powerfully) reduces 
intraocular tension and strongly contracts the pupils, the myosis taking 
place in a few minutes and lasting from six to twelve hours, and sometimes 
to a lesser degree for several days. It temporarily increases the power of 
accommodation for close vision, which action may be followed by spasm of 
accommodation. These effects often cause severe pain, which may continue 
for hours. Much diversity of opinion prevails as to the manner in which the 
drug acts upon the eye. Wood believes its ocular effects are caused by 
"local peripheral influence;" "that there is a simultaneous stimulation of 
the oculo-motor nerve-ending and paralysis of the peripheral sympathetic 
nerve-ending." As the pupil is known, in overwhelming doses, in human 
poisoning, to dilate he concludes: "that when the alkaloid is in sufficient 
amount the primary oculo-motor stimulation is followed by oculo-motor 
palsy". The view that the drug acts by constricting the vessels of the iris, 
or the view of Schmiedeberg, that eserine acts directly by stimulation of the 
iris muscle, is no longer generally held, though Hare still maintains the latter 
532 INDIVIDUAL DRUGS. 
view. In fact, the whole range of physiological action of physostigma and 
its alkaloids is discordantly voiced by experimental investigators. 
Full doses in man produce extreme prostration and muscular weakness, 
loss of mobility, dizziness, slow, feeble and irregular pulse, nausea, and some- 
times vomiting. Severe diarrhoea often takes place and the pupils are usually 
contracted. If the alkaloid or the extract be applied to the conjunctiva 
close contraction takes place, even though atropine has previously pro- 
duced dilatation; and the effects are confined only to the eye so treated. 
Poisonous doses increase the foregoing symptoms, with the addition of 
muscular tremors or fibrillary twitchings (confined only to portions of the 
muscle), the reflexes are abolished, respiration and circulation are extremely 
depressed, and the victim dies of paralysis of the medulla-center of respira- 
tion. 
The treatment of poisoning by physostigma and its alkaloidal salt 
consists in the hypodermatic administration of a full dose of atropine 
sulphate, the best-known physiologic antidote (prompt emesis and tannic 
acid if the poison has been swallowed), the application of external heat, and 
respiratory and cardiac stimulation by means of alcohol, ether, ammonia, 
digitalis, and strychnine. Wood suggests the availability of the antagoniz- 
ing effect of pilocarpine (which by some is regarded equally as antidotal as 
atropine) in doses proportionate to the quantity of poison ingested. 
Therapy.-External. Extract of physostigma for local use in ocular 
diseases has been entirely replaced by physostigmine. (See Physostigmines 
Salicylas.) 
Internal. Physostigma, in medicinal doses, has scarcely any effect 
upon the circulation, and but little on breathing. The secretions of the 
salivary, sweat, intestinal and mammary glands are increased by it. (See also 
Physostigmines Salicylas.) The drug is employed chiefly to reduce 
spasm and give tone to relaxed muscular walls of the stomach and bowels, 
and in the smaller doses in inflammatory diseases of the meninges. It has 
failed to sustain the reputation once accorded it in chorea, epilepsy, trismus 
neonatorum, and puerperal convulsions and reflex paralysis. In traumatic 
tetanus it has failed more often than it has benefited, but charity is held 
out in the view that probably inert preparations have been responsible for 
its failure, and the drug has not therefore had a fair trial. It is one of the 
suggested antidotes for strychnine poisoning, the alkaloid being preferred. 
For all of the above purposes the physiological doses have been advised. 
In minute doses, however, physostigma gives favorable results in 
certain diseases of the brain and spinal cord. The usual prescription for 
this purpose is: Specific Medicine Physostigma, gtt. v; Water, fl^iv. 
Mix. Sig.: Dose, one teaspoonful every two to four hours. The indica- 
tions are a cool skin, cold extremities, feeble tremulous pulse, and con- 
tracted pupils. Occasionally the dilated pupils will guide if associated 
with a rapid, small and tense pulse. It is one of the few agents which has 
exerted a favorable influence in cerebro-spinal meningitis, the dull intellect, 
pupillary contraction, and small, weak pulse leading to its selection. 
Physostigma, in the form of the extract or the specific medicine, may 
be used in weakened states of the gastro-intestinal canal, when giving rise 
to dilatation, visceral ptosis, and flatulence. Thus it is indicated in gastric 
533 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
and intestinal dilatation, fecal accumulation, and sometimes in tympanites, 
catarrh of the intestines and bladder, and constipation, with hard, dry feces. 
Nux vomica aids its action in intestinal atony, a state present in all of the 
above-named disorders. On account of its action upon the smooth mus- 
cular fibres of the intestines it is sometimes an ingredient of pills for the 
treatment of constipation. Owing to its stimulant action upon the bronchial 
muscular fibres it may be used in chronic bronchitis with bronchial dilation, 
with dyspnoea, bronchial asthma and emphysema, to assist by its contractile 
force in expelling mucus. For the respiratory disorders quite full doses are 
required, and other agents, more kindly in action, are preferred in Eclectic 
practice as stimulating expectorants. From 1/20 to 1/10 grain of the 
extract is sufficient for the effect upon the bronchial and intestinal mus- 
culature. The same, or eserine (1/60 grain) has been used for excessive 
sweating, as in the night sweats of phthisis. Wood reports a case of phan- 
tom tumor, associated with intestinal dyspepsia, asserted to have been 
cured by it. 
PHYSOSTIGMINE SALICYLAS. 
Physostigmine Salicylate, Eserine Salicylate. 
The salicylate of an alkaloid obtained from Physostigma. (Formula: CuHnNjOi 
C7H.OS.) 
Description.-Colorless or scarcely yellowish, long, glistening crystals, without odor and 
very bitter. Upon long exposure to light and air it acquires a reddish tint, and should, 
therefore, be kept in small, dark, amber-colored, well-stoppered vials, and in a dark place. 
Soluble in water and boiling water and alcohol. Dose, 1/100 to 1/40 grain. Solutions for 
ocular use, 1 to 2 grains to the ounce of distilled water; a few drops of which are to be 
instilled until the desired effect is produced. 
Specific Indications.-Locally, to induce contraction of the pupil in 
mydriasis or injuries to the eye; corneal ulcers, iridal prolapse. Internally, 
strychnine, belladonna and atropine poisoning; meteorism; intestinal 
stasis from post-operative paresis. 
Action.-(See Physostigma.') 
Therapy.-External. Physostigmine salts, usually spoken of by 
ophthalmologists as "eserine salts", are the universally used myotics. 
While the sulphate is the most soluble, it deliquesces easily, and the salicy- 
late is usually preferred. Solutions should be prepared as needed, as they 
readily decompose. Applied to the conjunctiva, solutions of eserine salts 
occasion transient smarting and lachrimation, followed shortly by con- 
traction of the pupils, an effect lasting several hours. Use of the eye for 
accommodation occasions severe pain. 
Physostigmine salicylate is the best local agent to reduce intraocular 
tension, overcome mydriasis, and improve the accommodative power of the 
eye for distant vision. It is used when for any reason it is desired to 
counteract the mydriasis from atropine or other causes, though it is less 
powerful as a myotic than atropine is strong as a mydriatic. Therefore 
full doses must be used. It is the remedy to reduce intraocular tension in 
the early stages of glaucoma. Where alternate contraction and dilatation 
to prevent adhesions are required, it may be used to fulfill the first indication. 
It is especially valuable to control excessive ocular tension after injuries 
to the eye, in peripheral or sclero-marginal ulceration of the cornea, 
particularly when non-vascular and the recuperative powers are feeble, 
534 POKE 
(Phytolacca decandra) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Poke has figured conspicuously in domestic and Eclectic medicine from a very early day. Its 
certainty as a remedy in glandular swellings has contributed greatly to the establishment 
and dissemination of the truth of the theory and application of specific medication. It contains 
a very large proportion of potassium nitrate. INDIVIDUAL DRUGS. 
and in prolapse of the iris, and in hypopyon ulcers. Persistent spasm of the 
muscles of accommodation are overcome by it, and it is sometimes used to 
control neuralgic pains in the eyeball. In corneal ulcerations, in the 
absence of iritis, it is sometimes more effectual than atropine. 
Internal. (See also Physostigmaf) Internally or hypodermatically 
administered physostigmine salicylate (or sulphate or hydrobromide) may 
be used after operations where the bowels fail to move on account of 
intestinal paresis and in meteorism. The dose should be large, about 1 /30 
grain, given with 1/30 grain of strychnine sulphate or nitrate. It is also 
used for the relief of intestinal and gastric dilatation, with accummulation 
of gas and feces, as well as in catarrhal states of the tubular organs composed 
of non-striated muscular tissue. For this purpose it has been used in hu- 
moral or bronchial asthma, chronic bronchitis with dilated musculature 
and difficulty in expelling mucus, and for the same purpose in emphysema. 
King advised physostigmine in sexual impotence with premature ejacula- 
tion upon attempting coitus. Eserine salts are frequently prescribed for 
colliquative sweating as in the night sweats of phthisis. When difficult 
expectoration is concomitant the careful use of the drug is justifiable, but 
for hyperhidrosis alone we have better agents. Physostigmine is antago- 
nistic to atropine and has, therefore, been suggested as an antidote in bella- 
donna or atropine poisoning. 
The recently dried root and fruit of Phytolacca decandra, Linne (Nat. Ord. Phyto- 
laccaceae). North America, along roadsides and fences, and in clearings and uncultivated 
fields; grows also in northern Africa, southern Europe, China, the Azores, and Sandwich 
Islands. Dose, 1 to 20 grains. 
Common Names: Poke, Poke-root, Poke Weed, Garget, etc. 
Principal Constituents.-Root: A remarkably large amount of potassium, a body 
closely resembling saponin, and the alkaloid phytolaccine. Berries: A purplish-red powder 
(the coloring body), indifferent phytolaccin, and phytolaccic acid. 
Preparations.-1. Specific Medicine Phytolacca. (Prepared from the root.) Dose, 
1 to 20 drops. (Usual form of administration: Specific Medicine Phytolacca, gtt. x to xxx; 
Water, fl5iv. Mix. Sig.: One teaspoonful every one, two or three hours. 
2. Tinctura Phytolacca Recentium, Green Tincture of Phytolacca. (Fresh, recently 
dried root, 3 viij; Alcohol (76 per cent), Oj.) Dose, 1 to 30 drops. 
Specific Indications.-Pallid mucous tissues with ulceration; sore 
mouth, with small blisters on buccal mucous surfaces and tongue; sore lips, 
pallid and with separated epidermis; fauces full and mucous surfaces pallid, 
sometimes livid, with swollen tonsils and whitish or ashen-gray tenacious 
exudate; aphthae; imperfect glandular secretion; faucial, tonsillar or 
pharyngeal ulceration; secretions of mouth impart a white glaze over 
mucous membranes and tongue; white pultaceous sloughs at angles of 
mouth or lining the cheeks; hard painful glandular enlargements; pallid 
sore throat with cough and difficult respiration; mastitis; orchitis; parotitis; 
soreness and swelling of mammary glands; diphtheroidal sore throat; and 
fatty degeneration. 
Action.-Physiologically, phytolacca acts upon the skin, the glandular 
structures, especially those of the mouth, throat, sexual system, and very 
markedly upon the mammary glands; also upon the fibrous and serous 
PHYTOLACCA. 
535 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
tissues, and mucous membranes of the digestive and urinary tracts. It is 
principally eliminated by the kidneys. Applied to the skin, either in the 
form of juice, strong decoction, or poultice of the root, it produces an 
erythematous, sometimes pustular, eruption. The powdered root when 
inhaled is very irritating to the respiratory passages, and often produces a 
severe coryza, with headache and prostration, pain in chest, back, and 
abdomen, conjunctival injection and ocular irritation, and occasionally 
causes violent emeto-catharsis. Upon the gastro-intestinal tract doses of 
from 10 to 30 grains of it act as an emetic and drastic cathartic, producing 
nausea which comes on slowly, amounting almost to anguish, finally after 
an hour or so resulting in emesis. It then continues to act upon the bowels, 
the purging being prolonged for a considerable length of time. It is seldom 
used for emeto-cathartic purposes, on account of its tardy action, which, 
when established, continues for some time. It rarely causes cramps or pain. 
Large doses produce powerful emeto-catharsis, with loss of muscular power 
-occasionally spasmodic action takes place, and frequently a tingling or 
prickling sensation over the whole surface. Dimness of vision, diplopia, ver- 
tigo, and drowsiness are occasioned by large doses not sufficient to produce 
death. Phytolacca slows the heart's action, reduces the force of the pulse, 
and lessens the respiratory movements. It is a paralyzer of the spinal cord, 
acting principally on the medulla. In poisoning by this agent tetanic con- 
vulsions may ensue. Death results from carbonic acid poisoning, the result 
of respiratory paralysis. 
The treatment of poisoning by phytolacca is that of gastro-enteritis. 
Therapy.-External. A poultice of poke root has given relief to felons 
and mammary inflammation. If used early resolution may take place; 
if suppuration occurs it will hasten that process. Locke advised the specific 
medicine with glycerin (fl 5 ij to fl3 j) for external use in mammitis. The 
same preparation occasionally heals sore nipples, and an ointment has been 
used successfully in scaly forms of eczema, in glandular engorgement, and 
may give relief in some cases of hemorrhoids, and in goitre. In most 
instances its local use should be accompanied by its internal exhibition. 
Internal. Medicines which act directly upon the glandular structures 
are not numerous. Among those that do so act, none is more direct than 
phytolacca. Phytolacca belongs to that class of remedies which is de- 
nominated alteratives. Whether such terms as the latter are justifiable in 
the light of present-day progress may be open to question. The experience 
of many years with phytolacca with success in what has been understood 
to be alterative effects, is a matter of Eclectic record. That it powerfully 
impresses the glands of the skin, lymphatic system, buccal, faucial, nasal, 
and sexual systems, and particularly the tonsils, ovaries, testicles, and 
mammary glands, we are well satisfied. The periosteal and other fibrous 
tissues are also acted upon by it, and there is no doubt but that it has more 
or less influence over the deposition of fats, its favorable action in fatty 
degeneration of the heart entitling it to consideration. 
Phytolacca is pre-eminently a remedy for swollen or engorged glands 
and adenitis. It is of undeniable value in conditions which might be con- 
veniently classed as the dyscrasias-scrofulous, syphilitic, and rheumatic. 
It is not a direct antisyphilitic in the sense that it will destroy treponema, 
536 INDIVIDUAL DRUGS. 
but for the train of ills due to the ravages of that disease as shown in the 
glandular and skin nvolvement it is among the most useful of drugs. When 
ulcerations result from the same cause it is particularly effective. It has 
long been used in various mixtures designed as antisyphilitics, which are, 
of course, but general alteratives. In those vague conditions, with pain 
and swellings at the joints, probably arthritic, and associated with swellings 
of the lymph glands, passing current under the elastic name of chronic 
rheumatism, phytolacca has acted most satisfactorily. It is, however, of 
little or no value in acute articular rheumatism. 
Without phytolacca we should be at a loss to know how to treat 
glandular affections undergoing swelling or inflammation. Its most direct 
indication is hard, painful enlargement of the glands with associated pallid 
mucous membranes. It is not so direct a remedy for suppurating glands. 
It is of signal value in mumps, and inflammation of cervical, axillary, and 
inguinal glands, when not due to tuberculosis. Even then its influence is 
often shown by its power to reduce the glands more or less, but exceedingly 
slowly; while in those enlargements due to syphilis its effects are more 
prompt and decided. Its beneficial control over tonsillitis and swelling of the 
submaxillary glands is well known. In acute mastitis phytolacca is by far 
our best remedy, and its action is hastened by its conjoint administration 
with aconite and bryonia. This treatment, with mechanical support, 
gentle withdrawal of the milk, if possible, or sometimes strapping of the 
gland with adhesive plaster may avert suppuration. After surgical meas- 
ures for the liberation of pus the use of phytolacca should be continued to 
reduce any remaining engorgement of the organ. Sore nipples and mam- 
mary tenderness, and morbid sensitiveness of the breasts during menstru- 
ation are relieved by phytolacca, and it is decidedly useful in the mammary 
swelling which sometimes occurs in infants. 
Though its action upon the reproductive glands is less decided than 
upon other specialized glands and upon the lymphatic nodes, it is not 
without value sometimes in orchitis and ovaritis. It is most effectual in the 
former when the inflammation is occasioned by the metastasis of mumps. 
Phytolacca has aided in the reduction of goitre, but ordinarily it is little to 
be relied upon for that purpose; iris is more effective, and that fails far 
oftener than it succeeds, except in the soft varieties. 
Phytolacca is important in dermatological practice. It destroys the 
"itch" insect, consequently it is of value in scabies, though it is by no means 
as effectual as sulphur. The condition which calls for it internally in skin 
diseases is one of indolent action of the skin, usually associated with vitiated 
blood and hard glandular enlargements. There may be scaly, vesicular, 
pustular, or tuberculous eruptions, and lymphatic enlargements with pain. 
The skin may be inflamed, but does not itch because there is not activity 
enough in the part. It is often indicated in chronic eczema, syphilitic 
eruptions, psoriasis, tinea capitis, favus, and varicose and other ulcers of the 
leg. Associated with iris, it is a valuable agent in fissures, boils, carbuncles, 
dermal abscesses, and ulcerations of the outlets of the body. For skin dis- 
eases it should be employed internally and locally. Specific Medicine 
Phytolacca, fl^ss; Water, fl^iv. Sig.: Teaspoonful every three hours. 
Locally: R Specific Medicine Phytolacca, fl3ij; Glycerin, fl3 j. Mix. Apply. 
537 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Phytolacca is useful in acute and chronic mucous affections, as in 
tracheitis, laryngitis, chronic catarrh, and especially in those affections 
where there is a tendency to the formation of false membrane. There is a 
pallid, somewhat leaden-colored tongue, with but little coating, being a 
slick, glutinous coat, if covered at all. The mucous membranes present 
whitish erosions, or vesicular patches. With these conditions it may be 
employed in follicular tonsillitis, follicular pharyngitis, stomatitis, aphthae, 
nursing sore mouth, or ordinary sore mouth, and syphilitic faucial ulcer- 
ations. It should be taken internally and used locally as a wash. It is 
one of our most valuable agents in sore throats resembling diphtheria, 
but is not curative in genuine diphtheria showing the presence of the Klebs- 
Leoffler bacillus. It may be and should be used conjointly with anti- 
diphtheritic measures, however, to stimulate the mucous membranes, pro- 
mote glandular activity and assist in loosening the membrane. Phytolacca 
acquired a reputation at one time as a positive remedy for diphtheria. 
That was before the presence of the bacillus was determinable by laboratory 
methods. It is largely possible that many border-line cases were then 
called diphtheria, as some streptoccoccic inflammations are now until 
bacteriological investigations prove otherwise. Even in true malignant 
types its use was an improvement over old-time treatment and the claims 
of those who advocated it for diphtheria were reasonably just. But time 
has clarified the situation, and now we use it as a valuable auxiliary remedy 
for sore throat with exudation. 
Phytolacca has been suggested to prevent and to cure gastric ulcer, 
and the suggestion seems fairly reasonable provided the general specific 
indications are observed, and the case is one long preceded by debility and 
catarrhal hypersecretion. It has relieved headache due to gastric acidity. 
Its usefulness in nephritis with the voiding of albuminous urine is open to 
question, if not exceedingly doubtful, and the reputation of an extract of the 
juice of the berries for the reduction of obesity has not been sustained. 
Single results from the use of any remedy in any of the difficultly curable 
diseases do not justify the too common practice of asserting its wholesale 
utility for such disorders. We prefer a tincture prepared from the freshly 
dried root for internal administration. 
PICROTOXINUM. 
Picrotoxin. (Formula: C3oH34Oi3.) 
A neutral principle obtained from the seed of Anamirta paniculata, Colebrooke (Nat. 
Ord. Menispermaceae), and probably other species of Cocculus. Climbing plant of Mala- 
bar, the Eastern Islands, etc., of the East Indies. 
Description.-Colorless, flexible, glistening, prismatic crystals, or a micro-crystalline 
powder, permanent, odorless, and having a very bitter taste. Sparingly soluble in water, 
more readily in boiling water, and freely in alcohol; very slightly dissolved by ether or 
chloroform. Dose, 1/150 to 1/64 grain. 
Action.-The dominant action of cocculus and its neutral principle is 
upon the medullary centers of respiration, circulation, and vaso-motor 
control, causing accelerated breathing, slowing of the pulse, and also causing 
cardiac palpitation and marked rise in arterial pressure. All the secretions 
are increased by picrotoxin; and nausea, vomiting, and gastro-intestinal 
irritation follow its use. Toxic and even fatal results have come from 
538 INDIVIDUAL DRUGS. 
eating but few of the berries, and similar results have resulted from absorp- 
tion of the poison from the application of the ointment to abraded surfaces. 
Dizziness, twitching of the muscles, trembling, alternate clonic and tonic 
convulsions, insensibility and coma ensue from poisonous doses; death, 
while the victim is still unconscious, takes place through respiratory 
paralysis. 
In the treatment of poisoning by cocculus and picrotoxin give an 
emetic, administer anticonvulsives, as chloroform and chloral, apply heat, 
and inject cardiac stimulants, such as ether, alcohol, ammonia, and digitalis. 
Therapy.-External. Picrotoxin is a parasiticide of great power, de- 
stroying both animal and vegetable parasites. An ointment of 1 grain 
of picrotoxin and 100 grains of benzoinated lard may be cautiously used to 
destroy the head louse (pediculus capitis) and the itch mite (acarus scabei) 
and to relieve trichophytosis, tinea versicolor and porrigo scutulata, and 
other parasitic affections. It shozdd not be used on abraded or open surfaces, 
nor in any abundance, lest poisoning should occur. (See also Cocculus f 
Internal. No longer is picrotoxin used for spasmodic diseases. Some- 
times it alleviates menstrual headache of the migraine type and relieves 
nervous dysmenorrhoea if given a couple of days before the flow is expected. 
Its chief use is to restrain colliquative sweating, especially the night sweats 
of phthisis. Though a slower anhydrotic than atropine it does not cause the 
disagreeable throat and skin dryness produced by the latter, and often 
succeeds when that alkaloid fails. The dose for this purpose is about 
1/100 grain. Fearn used the 3x trituration in doses of 2 grains. Others 
advise similar doses every two hours during the evening, or a single dose of 
picrotoxin (1/100 grain) for three or four days. Its influence when once 
established is said to last from ten to fourteen days. 
The dried leaflets of (1) Pilocarpus Jaborandi, Holmes; or (2) Pilocarpus microphyllus, 
Stapf (Nat. Ord. Rutacese). Brazil and Paraguay. Dose, 20 to 60 grains. 
Common Names: Jaborandi, (1) Pernambuco Jaborandi, (2) Maranham Jaborandi. 
Principal Constituents.-The powerful liquid alkaloid pilocarpine (ChHi6N2O2) ; 
a colorless, viscid oil, isopilocarpine; a volatile oil chiefly pilocarpene (C10HI6); and pilo- 
carpidine (CioHuN202) in Pilocarpus Jaborandi only. 
Preparation.-Specific Medicine Jaborandi. Dose, 1 to 60 drops. 
Derivatives.-Pilocarpince Hydrochloridum, Pilocarpine Hydrochloride. Translucent, 
colorless and odorless crystals of a feebly bitter taste; hygroscopic in the air. Very soluble 
in water and alcohol, less soluble in chloroform, and not at all in ether. Dose, 1/12 to 1/6 
grain by mouth; 1/24 to 1/8 grain (hypodermatically). 
Pilocarpince Nitras, Pilocarpine Nitrate. Permanent, shining, odorless crystals, 
very soluble in water and less so in alcohol; insoluble in chloroform and ether. Dose, 
1/12 to 1/4 grain (by mouth); 1/24 to 1/8 grain (hypodermatically). 
Specific Indications.-Deficient secretion; marked dryness and heat of 
skin and mucosa; muscular pain; muscular spasms; pain with puffiness 
of tissues; urinal suppression, the urine being of high specific gravity and 
deep color; pulse full, hard, sharp and strong, with deficient secretion; 
increased temperature with dry skin and membranes; sthenic forms of 
fever; marked restlessness due to lack of secretion; ptyalism, with stomatitis; 
inflammatory rheumatism, with swollen and painful parts, and dry mem- 
branes and skin; soreness and stiffness of joints in subacute rheumatism; 
dry, harsh cough; tenacious sputum; renal dropsy with deficiency of urine; 
PILOCARPUS. 
539 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
uraemia; uraemic poisoning, with convulsions; itching, with jaundice; increased 
ocular tension; deafness due to deficient aural secretion; alopecia; poisoning 
by atropine or belladonna; colliquative sweating (minute dose). 
Action and Toxicology.-Jaborandi and its alkaloid, pilocarpine, are 
the most powerful excitants of the secretions of the peripheral secretory 
glands known. In full doses they cause an enormous outpouring of sweat 
and saliva, and to a lesser degree stimulate the lachrymal, nasal,faucial, 
and bronchial secretory apparatus, and to a still lesser extent those of the 
stomach and intestines. Even the modified secretory organs of the aural 
canal are indirectly affected by them and the quantity of cerumen increased. 
The growth of hair and intensification of its color are stimulated by their 
internal action as well as when locally applied. By most pharmacologists 
the effect of these drugs upon peripheral secretion is attributed to the 
direct action upon the terminals of the peripheral nerves and not to any 
impression per se upon the epithelial secretory cells. This they prove by 
completely checking them with atropine, known to act upon the same parts 
but in exactly an opposite manner. Cushny declares that both act upon an 
intermediary receptor interposed between the nerve and cells at the myo- 
cellular junction, and that neither the nerve nor the cells are directly im- 
pressed. These bodies are stimulated by pilocarpine and muscarine 
(agaricine) and depressed or paralyzed by atropine. It is generally con- 
ceded that while atropine is the complete antagonist of pilocarpine, which 
chiefly acts in the manner described and to a very limited extent upon the 
central nervous system, on the other hand pilocarpine is, therefore, not a 
complete antagonist of atropine. The action of pilocarpine upon the in- 
voluntary muscles is caused in the same manner as upon the sudoriferous 
glands-by impressing the myo-neural receptors. 
Moderate doses of these drugs have scarcely any effect upon the 
central nervous system, and pilocarpine is less apt than jaborandi to cause 
gastric and intestinal discomfort. Both, however, appear to increase 
peristalsis and in full doses may cause a persistent watery diarrhoea, with 
straining or tormina after the diarrhoea ceases. Upon the eye myosis is 
produced by both the local and internal use of them, and spasm of the 
accommodation also occurs. In large doses they are cardiac depressants, 
probably affecting the heart muscle and to some degree vagal inhibition. 
The extent to which the vaso-motor system participates in first causing 
increased and then lowered blood pressure is not satisfactorily known. 
Full doses cause cardiac arrythmia, and increase the number of heart- 
beats greatly, but render them weaker. The uterus, spleen, and bronchi 
contract under the influence of these drugs. Temperature, though at first 
considerably increased, falls when sweating has become well established. 
This action is more marked during fevers than in health. After the termi- 
nation of sweating temperature regains its normal status, usually at once, 
but is sometimes delayed for several hours. As a rule, the secretion of milk 
is believed to be unaffected by pilocarpine, but contrary to what might be 
anticipated, where there is a diminished lacteal secretion, it apparently in- 
creases the supply. 
One or two drachms of powdered jaborandi infused in a cupful of boil- 
ing water and taken at one dose will in about ten to twenty minutes cause 
540 INDIVIDUAL DRUGS. 
a tingling of the skin with marked redness of the surface. This sensation is 
first experienced in the face, but soon extends to the whole surface of the 
body, and is quickly followed by an abundant perspiration, which is apt to 
last for four or five hours. Almost simultaneously with the sweating the 
secretion of saliva increases to such an extent as to greatly embarrass 
speech, the person being obliged to assume an inclined position that the 
escape of saliva may be facilitated. During this stage from one to two pints 
of saliva and even more may be secreted, and usually there will be in ad- 
dition an augmentation of the bronchial and lachrimal flow. The saliva 
contains an abundance of ptyalin and salts and readily converts starch into 
sugar. At times the mucous glands of the intestines are so stimulated and 
peristalsis so increased as to cause diarrhoea, and it is not a rare circum- 
stance that the submaxillary glands enlarge and become painful. Nausea 
and vomiting (less likely with pilocarpine), vertigo, hiccough, heaviness of 
the head, and contraction of the pupils may take place. From the com- 
mencement of perspiration the face becomes pale, the pulse temporarily 
fuller and more frequent; the pulsations become irregular, and with persons 
laboring under cardiac affections, a kind of asystole is observed. The effects 
of these drugs occur more readily in adults than in children, the latter in 
fact standing their action much better than adults. In using these med- 
icines to produce diaphoresis it is not necessary to use warm drinks or 
other usual aids toward facilitating the sweating. During the sudorific 
action of jaborandi the quantity of urine is lessened, to a greater or lesser 
extent, and micturition frequently proves painful. As urea exists to a large 
extent in the saliva and sweat caused by jaborandi (no uric acid being 
found), a diminution of it occurs in the urine voided; but, after sweating, 
it gradually returns to its normal figure in the urine. It would appear that 
the drug does not increase combustion in the body. Dryness of the mouth 
and throat, with a sense of fatigue and depression, most usually follows the 
cessation of its active effects. Administered in divided doses, jaborandi, 
instead of acting as a diaphoretic and sialagogue, becomes an active diuretic. 
The conclusions then are that jaborandi and its alkaloid exert a strong 
special influence upon the sudoriferous and salivary glands, and (in small 
doses) upon the renal glomerules, which stimulates their functional ac- 
tivity. 
Pilocarpine, the active principle of jaborandi, has an action nearly 
identical; however, it causes less salivation, less vomiting, and is more 
certain in its effects. The hydrochloride and the nitrate of this alkaloid 
are used; they may be employed internally, or by subcutaneous injections. 
In poisoning by jaborandi or pilocarpine, death is not apt to result except 
where an existing grave cardiac disease renders the patient a victim to 
exhaustion. Atropine is the physiologic antagonist to its sudoriferous and 
muscular effects; morphine overcomes the nausea and diarrhoea and pain; 
strychnine, caffeine and digitalis may be required to support the heart. 
Therapy.-External. Externally applied pilocarpus and pilocarpine are 
accredited with the rather singular effect of causing the hair to become darker 
in color, and to stimulate the growth of that appendage it is frequently 
employed in alopecia. The specific medicine, fluidextract, or the alkaloid, 
may be used in lotions with soap liniment and cologne; or the latter, with 
541 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
or without cantharides, may be incorporated with a lanolin base. The 
specific medicine may be applied in dry eczema, and to allay inflammation 
in erysipelas, mumps, mastitis, orchitis, epididymitis, and swollen and 
painful joints. Pilocarpine, being a strong myotic, is coming to be preferred 
to physostigmine (eserine) in eye affections, though acting slower and less 
profoundly than the latter, but with less irritation. In fact, it is a most 
valuable myotic in all conditions of the eye in which there is increased 
intraocular pressure. Locally used pilocarpine lessens pain from excessive 
use of the eyes, and alleviates congestive conditions. By some it is pre- 
ferred to eserine in glaucoma. After traumatism, with increased ocular 
tension, the latter as well as pain is relieved by the local use of pilocarpine 
hydrochloride. Instilled in the eye it is also useful in keratitis and phlycten- 
ular conjunctivitis, both in the early stage. 
Internal. Jaborandi is diaphoretic, sialagogue, myotic, sedative, 
diuretic and antispasmodic, according to the manner of employing it. 
The keynote to its therapy is arrest of secretion whether it be of the glands 
of the skin, the glands of special ferments, or the glands of the mucous 
tracts. Oversecretion due to weakness of the glands is also corrected by it, 
and the debilitating or unhealthful outpour controlled. In other words, like 
many other drugs having a single though apparently a double action, it 
tends to stimulate normal secretion by correcting faulty functioning as 
manifested in either deficiency or hypersecretion. It is also of value in the 
early stage of acute inflammations, particularly of the skin, respiratory 
organs, and in acute rheumatism. When given too freely in the latter it 
may produce vomiting and excessive sweating. Then it should be dis- 
continued. As the regulation of abnormal secretion has ever been a cardinal 
feature of Eclectic therapeutics, the adoption of pilocarpus has given us a 
remedy capable of great good, but one which, on account of its depressing 
action on the heart and the debility occasioned by excessive diaphoresis, 
must be used with judgment and care. 
Pilocarpus was once used for many purposes for which it is now dis- 
carded. Among these were dropsies of various origin. At the present day 
its eliminative powers are sought only in dropsy of renal origin, not to cure 
the disease producing it, but to unburden the system of watery accumula- 
tion and to some extent of poisonous and convulsive irritants. Occasion- 
ally it is used in the attempt to remove pleural effusions, but other agents are 
better. Owing to its depressing action upon the heart and the danger of 
inducing pulmonary oedema it should not be employed in dropsies of 
cardiac origin. Such deaths as have occurred from pilocarpus and its 
alkaloid have been caused by these two accidents. While it is generally 
advised that it is safe in the early stages of acute Bright's disease, most 
clinicians are extremely cautious or do not use it at all in chronic paren- 
chymatous nephritis nor in any advanced form of nephritis, especially in 
those past middle life. Pilocarpine is the one great theoretical and ap- 
parently practical drug for uraemic convulsions, relieving the kidneys of 
their burden by placing it upon the skin, whereby a large amount of fluid 
together with urea and toxins are eliminated. In this condition it is ex- 
pedient to quicken its action by hot drinks, heat to the surface of the 
body, and the aid of enveloping blankets. One-twelfth to one-sixth grain 
of pilocarpine nitrate may be given hvpodermatically. 
542 INDIVIDUAL DRUGS. 
Since these earlier and still established uses for pilocarpus the drug has 
come into prominence in Eclectic practice chiefly through the writings of 
Webster, Ketchum, and Foltz. Added to its diuretic and sudorific qualities, 
jaborandi is sedative and antispasmodic, many preferring it to veratrum for 
the former purpose, and to lobelia or gelsemium for the latter. The indica- 
tions for this drug, specifically considered, may be summed up as follows: 
It is a remedy for sthenic conditions, and must be avoided, or its use care- 
fully guarded, in weakened conditions of the heart. Jaborandi is efficient in 
disorders exhibiting a dry, hot skin, with febrile reaction, especially when 
accompanied by acute suppression of the secretions; dry, parched mouth; 
full, strong, hard, and sharp pulse; deficient renal activity with deep-red 
urine, scanty in quantity and of high specific gravity; restlessness, and, 
with any of these symptoms, pain. Jaborandi is claimed by Webster to 
be adapted to almost any febrile or inflammatory condition, sthenic or 
asthenic, with or without a dry skin. Most observers, however, prefer to 
limit its use to sthenic conditions only. 
As a remedy for pain and inflammation jaborandi has been highly 
endorsed in mammitis, with dry skin and suppressed lacteal secretion, in 
acute articular inflammation and acute articular rheumatism, the joint 
being extremely painful and swollen. In erysipelas with dry skin and eleva- 
tion of temperature it is especially valued, and is also locally applied. 
Webster declares that in cerebro-spinal meningitis it has no equal. This 
view has not been universally endorsed. In rheumatic affections its value 
is enhanced by its power to eliminate urea and uric acid from the system. 
Jaborandi is indicated by stiffness, soreness, and swelling of the joints, 
whether the parts show redness or pallor. Many declare it one of the most 
important agents to use in the early stage of acute inflammatory rheumatism. 
One of its chief indications in such disorders is puffiness of the tissues. Its 
action should not be carried to extremes, however, and the ever-present 
danger of cardiac depression should be kept in mind. Jaborandi has 
proved a useful drug in exanthematous diseases with tardy appearance or 
tendency to retrocession of the eruption, and by this action has been thought 
to avert the danger of post-scarlatinal dropsy. For acute (preferably) or 
chronic muscular pain, pleurodynia, lumbago, and muscular spasm, it 
sometimes proves a most efficient drug. The specific indications must, of 
course, be observed. 
Jaborandi is recommended for cough when the throat is very dry and 
secretion checked. It is well recommended in bronchial asthma and whoop- 
ing-cough with dryness of the respiratory passages. Small doses relieve 
"winter cough," and the cough of chronic bronchitis with lack of secretion, 
and dry, irritable, hoarse cough. In the early stage of bronchitis, and in the 
congestive stage of pneumonia, it rapidly relieves the local inflammation, 
and reduces the fever if it be given in diaphoretic doses. Some employ it in 
the attempt to abort acute lobar and lobular pneumonias, and sometimes 
it is effective at least in limiting the damage done by a violent sudden in- 
vasion. Here again the caution concerning the heart depression and the 
danger of pulmonic oedema must be remembered, and the drug used with 
extreme good judgment. In respiratory troubles it does best service 
when associated with other indicated remedies, as bryonia, asclepias, 
543 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
lobelia, etc. In acute tonsillitis with secretion of tenacious pharyngeal 
mucus it serves an excellent purpose. Foltz valued it highly in pharyn- 
gitis sicca. When exudation has taken place in pleurisy, jaborandi is one 
of the best agents to effect the removal of the fluid and promote resolution. 
Some value it to increase secretory activity. It finds also a place in the 
treatment of dry croup and laryngismus stridulus. In laryngeal diphtheria 
(so-called membranous croup), if the child is strong, jaborandi may be 
administered in doses sufficient to increase the secretions of the throat, 
and thus loosen the false membranes. Many, however, cannot stand its 
action, and only in the sthenic cases, and never in the debilitated, should it 
be attempted. The well-known toxic effect of diphtheria in inducing 
cardiac and vaso-motor paralysis renders the use of any possible circulatory 
depressant inadvisable. And this is true of jaborandi in the doses neces- 
sary to induce free secretion. 
Jaborandi has given good service in metastatic and gonorrhoeal 
orchitis, ovaritis, and metritis, the specific indications for it being present. 
Both internally and locally it sometimes alleviates in parotitis (mumps). 
Jaborandi is one of the most useful of agents in properly selected cases 
of la grippe or epidemic influenza, and of catarrhal fever. In fact the drug 
acts admirably as a non-stimulating diaphoretic and sedative in many 
inflammatory and febrile conditions, provided the stomach is not too 
irritable to retain the medicine. It is sometimes used like gelsemium to 
prepare the system for the kindly action of quinine in intermittent fevers. 
It should never be used in adynamic fevers, such as typhoid fever. 
Small doses of pilocarpus restrain excessive secretion. This is well 
exhibited in its successful use in controlling some cases of polyuria (diabetes 
insipidus), colliquative night sweats, and ptyalism and the consequent 
aphthous stomatitis induced by the latter. In the first named its action is 
enhanced by ergot. 
Acting upon the theory that the act of parturition is favored by free 
diaphoresis, jaborandi and its alkaloid have been successfully used in cases 
of tedious labor due to a rigid, hard os uteri. In these cases the pains are 
severe yet ineffectual, the skin dry, pulse full, sharp, and hard, and there is 
some febrile reaction. These conditions are rectified by diaphoretic doses 
of the drug. They are, however, rarely employed for this purpose. 
Rarely in diaphoretic doses, it may do good in the albuminuria of 
pregnancy. 
Many skin disorders of a dry character appear to be benefited by the 
internal (and external) use of jaborandi. Among these are eczema, pruritus, 
particularly when occurring in a jaundiced skin, prurigo, hyperhydrosis 
pedum and psoriasis. (See also External Uses.) 
The late Dr. Foltz was an enthusiastic advocate of the use of jaborandi 
in eye, ear, nose, and throat disorders, particularly where there is a lack of 
the natural secretions of these parts. Full doses of jaborandi contract the 
pupils, impair accommodation, diminish intraocular tension, and increase 
secretion. Locally applied, the action is similar, the effects upon the pupil, 
however, being much less pronounced when the drug is internally ad- 
ministered. Foltz praised it in rheumatic iritis, and for the absorption of 
"non-organized vitreous opacities". In iritis he always used it, and be- 
544 INDIVIDUAL DRUGS. 
lieved that it shortened the duration of the disease, and if adhesions were 
present, assisted in their absorption. Optic neuritis, retinal detachment, 
choroiditis, episcleritis, tobacco and alcoholic amblyopia, and atrophy of 
the optic nerve are also conditions in which he advised its use. Others have 
advised it in hemorrhages and plastic exudations of the retina, hemorrhage 
into the vitreous humor, floating bodies in the vitreous, glaucoma, and corneal 
opacities. For ocular affections Foltz advised as a dose from three to ten 
drops of specific medicine jaborandi, every two or three hours; and as a 
collyrium, one to two grains of pilocarpine hydrochloride to two fluidounces 
of water. In ear disorders jaborandi improves by increasing the secretions 
of the aural cavities and canals. Unhealthy cerumen is frequently restored 
to its natural condition by the continued use of small doses of jaborandi. 
Jaborandi is the best remedy in non-suppurative inflammation of the 
middle ear, of the proliferous type (Foltz), and it proves a good drug for 
nervous deafness, deafness following scarlet fever and diphtheria, and with 
appropriate adjunct specific treatment, in inner ear diseases of syphilitic 
origin (Foltz). The alkaloidal salts (1/3 to 1/6 grain subcutaneously) 
have been employed in these disorders, but the specific medicine jaborandi 
is to be preferred in doses of three to ten drops every three or four 
hours. 
Pilocarpus and its alkaloidal salts have been used to counteract the 
poisonous effects of belladonna, atropine, stramonium, daturine, and poison- 
ous bites or stings, and in ptomaine poisoning from canned fish and meats. 
In the latter instances it has no antidotal power, but favors elimination of 
the offending material. While failing to completely counteract the toxic 
effects of atropine, it nearly always relieves the unpleasant dryness of tissues 
following the use of that alkaloid or of belladonna. 
Where depressing effects are produced by jaborandi, as sometimes 
occurs where there is valvular disease or fatty degeneration of the heart, 
or morbid pulmonic circulation, strychnine hypodermatically may sustain 
the heart-action. Digitalis, cactus, caffeine, or strophanthus may also be 
used. The profuse sweating may be checked by atropine. When pilocarpine 
acts like atropine, such effects are probably due to contaminating jaborine. 
In cases where the internal exhibition of jaborandi by mouth occasions 
nausea or vomiting, this may be avoided in giving the dose by rectal 
enema. Coffee is also said to prevent its nauseating effect. 
The dose of jaborandi in infusion (45 grains to 2 fluidounces of water) 
is 1 fluidounce, which may, if necessary, be repeated every ten or fifteen 
minutes; of the fluidextract, from 10 drops to 1 drachm; of specific medicine 
jaborandi, 1 to 30 drops;of pilocarpine or its salts, internally, from 1/4to3/4 
grain; by subcutaneous injection, 1/20 to 1/4 grain, in solution. 
Pilocarpine.-The alkaloid pilocarpine is used in the forms of hydro- 
chloride and nitrate in the same diseases as the infusion and alcoholic 
preparations of the leaves. The effects of the alkaloid are said to be more 
certain than when the leaves are used, and the tendency to nausea and 
vomiting is greatly diminished. Pilocarpine may be used in many of the 
aforementioned disorders, although jaborandi is generally preferred by the 
Eclectic physicians. 
545 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
PIMENTA. 
The nearly ripe fruit of Pimenta officinalis, Lindley (Nat. Ord. Myrtaceae). South 
America and West Indies, particularly Jamaica. Dose, 10 to 30 grains. 
Common Names: Allspice, Pimento, Jamaica Pepper. 
Principal Constituents.-An essential oil (Oleum Pimenta) and an aromatic green resin. 
Preparation.-Specific Medicine Pimenta. Dose, 2 to 30 drops. 
Action and Therapy.-A pungent, aromatic stimulant and carminative, 
but used chiefly as a flavoring agent. The oil, in doses of two to five drops, 
is sometimes given in flatulence and other conditions in which essential oils 
are usually displayed. 
PIPER. 
The unripe berries of Piper nigrum, Linne (Nat. Ord. Piperaceae). East Indies. Dose, 
1 to 15 grains. 
Common Names: Pepper, Black Pepper. 
Principal Constituents.-Piperine (Ci7Hi9NO3); oil of pepper, the chief constituent 
of which is laevo-phellandrene; and the alkaloid chavicine. 
Preparation.-Tinctura Piperi, Tincture of Pepper (5 viij to Alcohol, Oj). Dose, 
1 to 30 drops. 
Derivative.-Piperinum, Piperin. (A neutral principle derived from Pepper and allied 
plants.) Dose, 1 to 8 grains. 
Specific Indications.-Gastric atony; congestive chills. 
Action and Therapy.-Black pepper may be used as a corrigent of 
griping medicines. Combined with quinine it is frequently of service in 
intermittents, especially when congestive chill takes place. Piperin was 
once advised for the same purpose, but is less effective than the tincture of 
pepper; and even this frequently fails. Black pepper has carminative proper- 
ties, and is useful in flatulence, and rarely may be used in gastric atony in 
those unaccustomed to the free use of pepper as a condiment. 
The root of Piper methysticum, Forster (Nat. Ord. Piperaceae). South Sea Islands. 
Dose, 5 to 60 grains. 
Common Names: Kava-Kava, Ava, Ava-Pepper Shrub, Intoxicating Long Pepper. 
Principal Constituents.;-Starch (50 per cent), methysticin (Ci6HhO6), the methyl ester 
of methysticic acid; kavahin (methylene protocatechuic aldehyde, identical with helio- 
tropin or piperonal); and the chief active principle, an acrid resin (2 per cent) separable 
into the local anaesthetic alpha-resin and the less active beta-resin. 
Preparation.-Specific Medicine Piper Methysticum. Dose, 5 to 60 drops. 
Specific Indications.-Irritation, inflammation, or debility of the 
urinary passages; chronic catarrhal inflammations; vesical irritation and 
inflammation; vesical atony; painful micturition, strangury, and dysuria; 
gonorrhoea, slow and intractable; gleet; anorexia; gastric atony; pale and 
oedematous tissues, with scanty or irregular flow of urine, and indisposition 
to exertion; dizziness and despondency; neuralgia, idiopathic or reflex. 
Action.-Piper Methysticum stimulates the Salivary but not the 
cutaneous glands, and strongly excites the kidneys to watery diuresis, 
proportionately less solid material being voided in the urine. Upon the 
stomach it acts much like the stimulant bitters, increasing the appetite, 
and produces neither diarrhoea nor dysentery. The central nervous system 
is stimulated by it to a species of intoxication, somewhat resembling but 
PIPER METHYSTICUM. 
546 INDIVIDUAL DRUGS. 
differing, however, from that caused by ethylic inebriation. Large doseswill 
cause a drowsy and reserved intoxication, with confused dreams. The taste 
being agreeable, it is said one easily becomes a proselyte to its seductive 
qualities. The intoxicating drink prepared from it by the natives of certain 
Pacific islands induces an intoxication of a reserved drowsy character 
attended with confused dreams. Its long-continued use by them has caused 
more or less obscuration of vision and a dry, cracked, scaly and ulcerated 
skin, and lesions closely allied to leprosy. 
Therapy.-Piper methysticum, "the intoxicating long pepper", is not 
an old medicine, though under the name of kava-kava and closely similar 
appellations it has been used in the preparation of a disgusting ceremonial 
drink among certain South Sea Islanders from early times. As a medicine 
it has the fourfold quality of being stimulant, sialagogue, tonic, and an- 
aesthetic. Its field of action is upon the sensory nerves and mucous tracts 
of the body, more especially those of the genito-urinal and gastro-intestinal 
tubes. 
Piper methysticum is an appetizer and tonic to the gastro-intestinal 
organs, this influence being especially marked when associated with urinary 
disorders. The patient is pale, the urinary product inconstant in quality; 
the tissues, especially of feet and legs, are oedematous; patient is indisposed 
to exertion, and has the general appearance of one with Bright's disease, 
yet there is no albumen nor evidence of any particular disease. Such 
symptoms clear up quickly under this remedy, and the appetite is quickly 
restored. Piper methysticum augments digestion and promotes better 
assimilation. The glandular activity of the digestive tract is increased, 
natural secretion and excretion favored, constipation is overcome, and hem- 
orrhoids, if present, are reduced. It also exerts a marked curative influence 
in chronic intestinal catarrh. 
The best known remedial action of this drug is upon the genito-urinal 
tract, in which, through presumably decreasing the blood supply by con- 
tracting the capillaries, it allays irritation with its consequent pain in urina- 
tion, difficult micturition, and inflammation with discharges of mucus or 
muco-pus. Its reputation as a blennostatic in gonorrhoea is well sustained, 
but, as with all remedies, the specific condition must be present for its best 
results. It relieves in that form of acute gonorrhoea which is sluggish, 
tardy in responding to treatment, and tending toward the establishment of 
gleet. It is also a good agent in gleet. In the more acute cases it favorably 
assists the action of gelsemium, belladonna, and macrotys; while if there 
is marked debility it may be given with nux vomica or strychnine. Piper 
methysticum increases the power to urinate and, through its anaesthetic 
qualities, alleviates pain in the bladder and urethra, hence its value in 
debilitated and irritated conditions of those organs. It thus becomes an 
effective remedy sometimes in dysuria, painful micturition, strangury, 
chronic inflammation of the neck of the bladder, acute urethritis, noc- 
turnal enuresis of old and young when due to muscular atony, and old 
feeble cases of catarrh of the bladder. It is also of some value in acute 
vaginitis, chronic bronchitis, rheumatism, and dropsy due to renal in- 
efficiency. 
547 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Piper methysticum is a remedy for neuralgic pain, especially of the 
branches of the 5th nerve. It sometimes relieves ocular and aural neuralgia, 
toothache when not due to dental caries, neuralgia of the stomach and in- 
testines, and neuralgic and spasmodic dysmenorrhoea. Such reflex neural- 
gias as abdominal neuroses due to prostatic, urethral, or testicular diseases, 
or pectoral neuralgia arising reflexly from nervous dyspepsia are cases for 
the exhibition of Piper methysticum. 
PIPERAZINUM. 
Piperazine. (Formula: C4Hi0N2.) 
Description.-Crystalline, colorless masses, or lustrous, glass-like tabular crystals; 
very deliquescent and absorbs carbon dioxide from the air. It has no distinct taste and is 
soluble in water and less so in alcohol. Dose, 3 to 5 grains. 
Action and Therapy.-Piperazine forms, theoretically, piperazine 
urate in the body, and as this compound is very soluble and readily elimi- 
nated it has been claimed that piperazine is a remedy for the uric acid diathe- 
sis. As such it is advised to prevent the formation of renal and vesical 
calculi, especially phosphatic and oxalic concretions. It should be ad- 
ministered largely diluted, or given in carbonated water, in doses of three 
to five grains, every three to five hours. When there is a persistent over- 
secretion of uric acid, in a scanty flow of urine with high specific gravity, 
brick-dust deposits, and dry skin, muscular aching, and nauseous headache, 
the drug may prove useful in acute articular rheumatism and in rheumatoid 
arthritis, and troubles hinging on these conditions, as rheumatic peri- 
carditis. It has also been used in pyelitis. 
- Lycetol (Dimethylpiperazine tartrate) is similarly used in lithaemic 
states. It is more permanent than the former. Dose, 15 to 30 grains a day, 
well diluted. 
PISCIDIA. 
The bark of the root of Piscidia Erythrina, Jacquin (Nat. Ord. Leguminosae). West 
Indies and rarely in Florida. Dose, 5 to 60 grains. 
Common Name: Jamaica Dogwood. 
Principal Constituent.-The chief active body is piscidin (C29H24O8), a neutral principle. 
Preparation.-Fluidextractum Piscidia, Fluidextract of Piscidia. Dose, 10 to 60 drops. 
Specific Indications.-Insomnia and nervous unrest; spasm, pain, 
and nervous irritability; migraine, neuralgia. 
Action and Toxicology.-Jamaica dogwood controls pain and pro- 
duces sleep by its narcotic action. It increases salivary and cutaneous 
secretion, slows the pulse, first increases then lowers arterial tension (due 
to the heart weakening), dilates the pupils, reduces reflex activity, may 
induce convulsions, and proves narcotic to man and animals. Nausea, 
vomiting, and convulsions have followed a half-drachm dose of the fluid- 
extract. Death, in animals, is caused by either heart failure or respiratory 
paralysis. 
Therapy.-External. Reputed to relieve toothache due to exposed 
dental pulp, alveolar abscess, or peridental inflammation, and has been 
advised locally for the relief of pain in hemorrhoids. 
Internally. Jamaica dogwood is used to relieve pain, overcome spasm, 
allay nervous excitability, and produce sleep. It may be cautiously used 
548 INDIVIDUAL DRUGS. 
in the insomnia of the aged and in those of an excessively nervous tempera- 
ment. By many it is advised where opium would be used to control pain, 
but for any good reason is not desirable-in neuralgias, painful spasms, tic- 
douloureux, sciatica, enteralgia, dysmenorrhcea, and the pains of fractures 
and carcinoma. It has aided some cases of spasmodic and reflex cough. 
In whooping-cough, in which it has been advised, it should be used with 
great caution. Foltz advised it in neuralgia of the eyeball and in supra- 
orbital neuralgia, and others speak well of results with it in inflammatory 
and painful affections of the eye and ear. It has never been used to a great 
extent by Eclectic physicians; and in children and the feeble it should be 
employed with caution on account of its tendency to produce convulsions, 
even though it may satisfactorily relieve pain. 
PITUITRIN. 
Pituitrin. 
An extract of the fresh posterior lobe of the pituitary gland of animals. 
Under this trade-name a pituitary extract has come into legitimate practice and the 
name is used here as a headin g chiefly because it is the preparation most often mentioned in 
current medical literature. However, there are several good standardized proprietary 
preparations of a similar type-such as Infundibulin, Hypophysin, Pituglandol, etc., and 
the definite chemical Hypophysin Sulphate, all of which relatively have much the same 
action and effects. In order to have a definite standard the U. S. P. authorizes two forms 
of pituitary preparation-one dry, the other liquid. The latter and the various fluid 
pituitary extracts are very similar. 
Preparations.-1. Pituitrin and those named above. Dose, 5 to 15 minims intra- 
muscularly. 
2. Hypophysis Sicca (U. S. P.), Dessicated Hypophysis. The cleaned, dried and 
powdered posterior lobe of the pituitary body of cattle. It is a non-crystalline, yellowish 
or greenish powder, of a peculiar odor, and is but partly dissolved by water. Dose, 1/4 to 1 
grain (the usual dose being 1/2 grain). 
3. Liquor Hypophysis (U. S. P.), Solution of the Hypophysis (Solution of the Pituitary 
Body). Contains the water-soluble principles of the fresh posterior lobe of the pituitary 
body of cattle. It is a clear, colorless or nearly colorless fluid, of a slight but characteristic 
odor. Dose, 5 to 20 minims (average dose, 15 minims). 
Specific Indications.-To accelerate labor in simple uterine inertia, 
when there are no contraindications to a free and speedy delivery; in 
placenta prsevia after dilation and rupture of membranes; post-partum 
hemorrhages when uterus is empty of everything but blood; shock; hypo- 
pituitarism. 
Action.-Pituitrin (and other forms of pituitary extracts) acts upon 
muscular tissues of the involuntary varieties, causing strong contraction. 
This is most intense upon the uterine musculature, and in intestines, and to 
a considerable extent upon the heart-muscle and the peripheral arterioles. 
Apparently it has less effect upon the large vessel trunks, and on the kidney 
vessels it seems to have a dilating action. The effects of pituitrin, outside 
of increased diuresis, and possibly quickening of galactagogue power, are but 
little observed when the drug is given by mouth. It acts most powerfully 
when given intravenously, and next in force when administered sub- 
cutaneously. Very like adrenalin it raises blood pressure, but more slowly, 
and never abruptly and is maintained longer. Under its influence peristalsis 
is markedly increased and uterine contractions come on strongly within a 
few minutes, the relaxation between contractions being less perfect than 
normally. Its effects are not believed to be upon the nervous mechanism 
but upon the uterine muscle itself, and it appears to stimulate the organ 
549 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
whether pregnancy exists or not. Pituitrin is mostly eliminated by the 
kidneys, which it usually stimulates to markedly increased diuresis. The 
latter action is as yet unexplained-some believing its affects to be due to 
general increased blood pressure; others to a specific action upon the secre- 
tory cells. Singularly, a repeated dose of pituitrin fails to affect blood pres- 
sure after it has once raised it and it has again returned to its normal state. 
While the various pituitary extracts act somewhat similarly, there appears 
to be some variation. Thus hypophysin has the essential physiologic 
properties of the extract of the macerated posterior lobe, especially ex- 
hibiting hypertensive and cardio-tonic effects. Pituitrin is less hypertensive 
but more strongly cardio-tonic. Hypophysin sulphate is said to combine 
all the good features of the ordinary extracts with few undesirable effects. 
The most toxic preparation is pituglandol, and the least poisonous, hypo- 
physin. (See Narrower, Practical Hormone Therapy.) 
Therapy.-Pituitrin, in the light of present knowledge, should be 
used only as an emergency remedy. Its most important field is in obstetrics 
to facilitate and accelerate labor, and after labor to control hemorrhage 
due to faulty contraction of the uterus. To a great degree it has supplanted 
ergot as an oxytocic. It is best adapted to, and is a safe agent in simple 
uterine inertia. It should only be employed, however, when the presenta- 
tion and positions are normal, the tissues soft and dilatable, the cervix 
dilated at least to the size of a quarter of a dollar, the head actually engaged 
in the brim, and the pelvic diameters of such dimensions as to permit of 
normal delivery. Assured that these conditions are present and that 
uterine contractions lag, cease after having been active, or fail completely 
to come on; or there is danger of hemorrhage or exhaustion under the fore- 
going conditions, a single dose of fifteen minims (1 c.c.) of pituitrin may be 
administered hypodermatically. In from three to five minutes contractions 
will begin, and while increasingly powerful and persistent are said to more 
nearly resemble those of normal effort than are occasioned by ergot. Labor 
is rapidly terminated where pituitrin is given. Some obstetricians advise 
the drug also in breech presentations when the pelvic diameters are large, 
but good judgment would favor the forceps or other means lest asphyxia- 
tion of the child occurs. In no instance should it be used, as has been 
advised, in the first stage of labor to force dilatation. This is more safely 
accomplished by morphine, gelsemium or lobelia, which by quieting ap- 
prehension and excitement, as well as by relaxant effects favors a gradual or 
more nearly normal dilation than is possible through the powerfully con- 
tractive urge of pituitrin. Nor should the reprehensible practice be fol- 
lowed of using pituitrin to establish the diagnosis between false and true 
labor pain, thus needlessly increasing the discomfort and misery of the 
expectant mother. Some also advise it in face presentation when the 
pelvis is roomy and unobstructed. Chloroform and other general anaesthetics 
do not appear to retard the action of pituitrin. While non-poisonous and 
incapable of doing constitutional harm (except nephritis, with high blood 
pressure, be present), when wrongly used it may cause unnecessary pain 
and suffering, rupture the cervical and perineal tissues, and asphyxiate the 
child. In this respect the cautions applicable to ergot hold good. But 
when clearly indicated and there is a clear and unobstructed passage-way, 
550 INDIVIDUAL DRUGS. 
and parturient relaxation and adjustment are normal, pituitrin may convert 
a tedious labor of hours duration into a rapid delivery within an hour's time. 
Pituitrin is advised in Caesarean section as soon as the womb is com- 
pletely emptied of fetus, placenta, and membranes; to favor involution after 
abortion and miscarriages, under similar conditions; in menorrhagia and 
metrorrhagia, not dependent upon inter- or intrauterine growths; and 
almost any form of uterine bleeding except when due to carcinomata, in the 
latter of which it does harm. It has also been advised in post-partum 
cases, as well as after gynecologic and other operations, to assist in the 
expulsion of urine in urinal retention due to atony of the bladder, and to 
release impaction of the bowels by its powerful stimulation of peristalsis. 
While it is effective in post-partum hemorrhage it is not better than good 
ergot preparations, but by sensitization of the uterus allows the latter to 
act more forcefully. A combination of ergot and pituitary extract are 
most effective (Watson). 
Pituitrin may be used as a circulatory stimulant in collapse, and 
is probably the best vaso-motor stimulant in and to prevent surgical shock. 
It is valuable in intestinal torpor due to handling the bowels during ab- 
dominal operations, and to relieve the meteorism and "gas pains" due to 
lack of peristalsis under such circumstances. It has also been advised 
for the tympanites occurring in acute infectious diseases. Some advocate 
its use in that form of polyuria known under the old name of diabetes 
insipidus, a condition now believed to be due to disorders and disturbances 
of the hypophyseal gland. While it accelerates the production but probably 
does not increase the quantity of milk, its use as a galactagogue is not 
feasible because it cannot be given to effect by mouth, and it is not advisable 
to use it often subcutaneously. This also holds true of its use as a diuretic. 
Many physicians contend that the full dose of fifteen minims (1 c.c. or mil.) 
is too large and that they obtain far better results from seven and one-half 
minims (1/2 c.c. or mil.). The statements herein apply to the various 
preparations of the posterior lobe of the pituitary gland, as well as to pituitrin. 
Contraindications to the use of pituitary extracts manifestly are: 
general hypertension, hyperpituitarism, and most cases of epilepsy. Whether 
or not they may induce arterial degeneration as has been asserted, or will 
damage the kidneys, causing hematuria and glomerulitis, as has also been 
charged, remains to be definitely proved. 
PIX LIQUIDA. 
Tar, Pine Tar. 
A liquid obtained by the destructive distillation of the wood of Pinus palustris, 
Miller, and other species of Pinus (Nat. Ord. Pinaceae). 
Description.-A blackish-brown, viscid, semiliquid, amorphous substance, but grad- 
ually becoming granular and opaque; odor empyreumatic and terebinthinate, taste sharp 
and tarry. Slightly soluble in water, with a brownish color and acid reaction. Mixes with 
alcohol, ether, chloroform, and oils. Upon distillation it yields oil of tar and pyroligneous 
acid. Dose, 5 to 15 grains. 
Principal Constituents.-Oil of turpentine, creosote, phenol, catechol, xylol, toluol, 
acetic acid, acetone, methyl alcohol, and at least ten resins. 
Preparations.-1. Oleum Picis Liquidce Rectificatum, Rectified Oil of Tar. Dose, 
3 to 5 minims. 
2. Aqua Picis Liquidce, Tar Water. Dose, 1 to 3 fluidounces every four to six hours. 
3. Syrupus Picis Liquidce, Syrup of Tar. Dose, 1 to 2 fluidrachms. 
551 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action.-Tar is irritant and antiseptic. Upon prolonged application 
tar acne may ensue, and in some instances it has produced poisoning similar 
to that of phenol. Internally it excites the circulation and the secretions, 
especially of the kidneys and lungs, and acts as an antiseptic to those tracts, 
thus proving diuretic, disinfectant and expectorant. Overdoses produce 
headache, indigestion, black vomit and stools, and blackish urine with 
blood and albumen and a decided tar-like odor. 
Therapy.-External. Tar is chiefly used as an antipruritic and anti- 
parasitic. It is of use in scaly skin diseases, and in various preparations it 
has been applied in psoriasis, chronic eczema, prurigo, porrigo, lichen, 
sycosis, lupus vulgaris and erythematosus, pemphigus, tinea capitis and 
other forms of ringworm, scabies, and boils. Some persons are very 
susceptible to tar, an erythema following the application of even dilute 
preparations of it. 
Internal. Tar water, or syrup of tar, may be used in bronchial cough, 
and to prevent the recurrence of boils, in chronic urinary catarrhs, and in 
eczema and psoriasis (together with its external use). Tar should not be 
given to those having a disposition to hemorrhages. Syrup of wild cherry 
added to tar water or the syrup of tar makes a useful cough remedy for 
chronic bronchitis. 
The whole plant of Plantago major, Linne (Nat. Ord. Plantaginaceae). A very common 
weed everywhere, especially in lawns and along roadsides, growing in rich soils. 
Common Names: Plantain, Rib Grass, Ribwort. 
Principal Constituents.-Resin, and citric and oxalic acids. 
Preparation.-Specific Medicine Plantago. Dose, 1 to 60 drops. 
Action and Therapy.-External. The crushed leaves very promptly 
relieve the distressing symptoms caused by punctures from the horny 
appendages of larvae of lepidoptera and the irritation produced by certain 
caterpillars, as well as the stings of insects and bites of spiders. The 
promptness with which it relieves the burning pain of wounds caused by 
the first named and dissipates the rapidly spreading erythema, as we have 
personally experienced, leads us to believe it may be of value in erysipelas, 
and should be tried when that disease occurs in the summer season when 
the fresh plant can be obtained. The alcoholic preparations have been 
advised as topical applications in toothache, when due to a sensitive pulp, 
and in earache. 
Internal. Plantago is reputed useful in bed wetting in children, due to 
relaxation of the vesical sphincter, with copious discharge of pale urine. 
PLANTAGO. 
PLUMBI ACETAS. 
Lead Acetate, Sugar of Lead (Formula: Pb(C2H3O2)2T3H2O). 
Description.-Transparent, colorless, shining crystals, or heavy, white, crystalline 
masses or granular crystals having a sweetish-astringent and subsequent metallic taste and a 
slight acetous odor. Easily soluble in hot and cold water, and less so in alcohol. Dose, 
1 to 4 grains. 
Preparations.-1. Liquor Plumbi Subacetatis, Solution of Lead Subacetate (Gou- 
lard's Extract). A sweet astringent, colorless fluid. 
2. Liquor Plumbi Subacetatis Dilutus, Diluted Solution of Lead Subacetate (Lead 
Water). A 4 per cent solution of the preceding solution. Both are used topically only. 
552 INDIVIDUAL DRUGS. 
Action and Toxicology.-Outside of being sedative and astringent, 
this salt in a single medicinal dose seldom has any other marked action. 
A large dose occasions poisoning, as does its continuous use. (See below.) 
Acute Lead Poisoning.-Lead is a poison, though not specially active, 
and when taken internally it is absorbed, and may be detected in the fluids 
and solids. The soluble lead salts are most apt to produce acute poisoning 
and the insoluble compounds chronic poisoning, and this sequence is scarcely 
ever reversed. The nitrate is the most poisonous salt, the acetate the least. 
In acute lead poisoning there is a burning, prickling sensation in the fauces, 
thirst, dryness of tissues, gastric uneasiness and vomiting of whitish, 
curdy or milky-looking material, and severe intermittent colic relieved by 
pressure. Obstinate constipation is the rule. The abdomen is tense, with 
the skin retracted and cold. The stools are dark or black, due to the 
formation of lead sulphide. If protracted, the nervous system is involved, 
giddiness, torpor, and coma sometimes being present, while numbness, 
cramps of calves of the leg and inner side of thighs, and paralysis may take 
place. A blue line may sometimes be observed upon the gums, but it is less 
likely to be found than in chronic poisoning. Treatment. For acute 
poisoning the soluble sulphates in large quantities are the antidotes. Epsom 
salt (magnesium sulphate)and Glauber's salt (soldium sulphate) are the best 
and most convenient. The emetic or stomach pump should be used, 
opiates given to relieve pain, and hot applications applied to the abdomen 
and feet. 
Chronic Lead Poisoning or Plumbism.-When the system is impreg- 
nated with lead (chronic lead poisoning) it produces a leaden discoloration 
of the gums, teeth, and mucous membrane of the mouth (also found in 
bismuth absorption), a peculiar lead taste and odor, jaundice, emaciation, 
and a feeble, irregular state of the circulation, the pulse being often re- 
duced to forty or forty-five beats per minute. The "blue line" on the 
gums when present is a most characteristic symptom of chronic lead 
poisoning. In large doses, or when continued for some time in small doses, 
lead gives rise to certain abdominal pains, termed lead colic; sharp pains in 
the limbs, unaccompanied by either redness or swelling, and which are in- 
creased by motion, and diminished by pressure, and are frequently ac- 
companied by hardness, and cramps in the affected parts, and which condi- 
tion is termed lead arthralgia; lead paralysis, which attacks the extremities, 
more commonly the upper, and which appears to affect the extensor muscles 
principally, the hands being bent or dropped (wrist-drop') and the arms 
dangling by the side. There may also be a paralysis of sensation. They 
brain may also become affected with what is termed lead encephalopathy, 
manifested by furious or tranquil delirium, more or less profound coma, or 
convulsions. Neuritis and multiple neuritis are not uncommon results. 
Painters' colic (colica pictonum) is a peculiar affection attacking painters and 
other workers in lead. Its most characteristic symptoms are severe colic 
with a sense of sinking about the region of the navel, and a peculiar form of 
paralysis allowing the hands to drop (wrist-drop). General paralysis may 
occur, the skin becomes yellow, and on the abdomen retracted, constipation 
is obstinate, emaciation marked, the blue line is pronounced, and if severe 
enough epileptoid convulsions ending in death may ensue. When coma 
553 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
or convulsions occur death is very apt to follow. Painters and workers in 
lead are more commonly poisoned, but occasionally families are poisoned 
by drinking water from new lead pipes (allowing solutions of sulphuric acid 
or soluble sulphates to stand in the pipes will prevent this); typesetters are 
prone to lead-poisoning, and flour has been known to contain enough lead 
(from repairing holes in the mill stones with the metal) to act as a poison. 
Lead chromate used to color pastry has produced serious results. 
Treatment. In cases of chronic poisoning by lead, the antidotal treat- 
ment is to place the patient in a bath made by dissolving in a wooden tub 
sulphide of potassium, four ounces in thirty gallons of warm water, which 
converts the lead on the surface to a black sulphide, which must be removed 
by means of soap and water and a good stiff brush. This should be 
repeated every few days until the skin no longer becomes discolored by the 
sulphuretted bath. Internally, water acidulated with sulphuric acid 
should be drunk; or solutions of the sulphates of sodium or magnesium 
(less effectual than in acute poisoning), or of alum. The latter, in two-grain 
doses, with full doses of morphine or opium are said to be specific for lead 
colic. In lead constipation, opium, by releasing muscular contraction of the 
intestines, is sometimes the only successful medicine. Iodide of potassium 
should be given to render the lead with which it comes in contact more 
soluble by forming double salts, so that it can be more readily passed from 
the system. The latter salt is by far the best and most common antidote 
now employed for chronic lead poisoning. From five to twenty grains, 
well diluted, should be given three times a day. The bowels must be kept 
regular by castor oil, to which croton oil may be added if necessary; opiates 
may be given to relieve pains and cramps, and overcome constipation; 
tonics to improve the strength when there is much debility; and nux 
vomica or strychnine, with electricity and friction, massage or shampooing, 
to overcome the paralysis. 
Therapy.-External. Lead acetate is sedative, astringent and styptic. 
When applied locally it usually blanches the skin. Solutions of about one 
to six grains are popular as injections for the control and restraint of 
gonorrhoea. If unwisely used and there is ulceration of the urethral canal 
they may contribute to the formation of stricture. Used in the proportion 
of one-half grain to the ounce of alcohol, it is a very effectual remedy in 
simple dermatitis, and for dermatitis venenata or poisoning by ivy. As 
ordinarily used in solution in water it is less effectual in rhus poisoning; 
the alcohol contributes to the removal of the poisonous principle and aids 
in a more rapid cure. Sometimes hydro-alcoholic solutions may be employed. 
If much excoriation exists care should be had lest lead be absorbed with toxic 
effects. Lead solutions should not be used upon the eyes, as was formerly 
the custom, as corneal opacity has resulted when so used in corneal ulcer and 
abrasions. 
Other lead solutions (subacetate, as Goulard's extract, and the diluted 
form, lead water) are sometimes employed upon painful hemorrhoids and 
inflammatory surfaces, in urticaria, and cutaneous hyperaesthesia. Lead 
water and opium has been largely employed upon painful sprains and 
similar injuries. These solutions are rarely used by Eclectic physicians. 
Internal. Acetate of lead is an efficient astringent and sedative, but 
554 MAY APPLE 
(Podophyllum peltatum) 
Photo by Frank H. Shoemaker, 
Lincoln, Nebraska 
Courtesy of Prof. Rufus A. Lyman, 
University of Nebraska. 
A renowned plant-drug, closely intertwined with the pharmacal and medical history of Amer- 
ican Eclecticism. From it Professor John King first prepared and introduced "resin of podo- 
phyllum." The latter was subsequently named "podophyllin" by Dr. William Stanley Merrill. 
Though always a valued drug in Eclectic therapy, singularly podophyllin became more popular 
with and more largely used by practitioners of the "regular school" than by those of Eclecticism. INDIVIDUAL DRUGS. 
in large doses is irritant. An overdose is generally followed by vomiting, 
thus usually preventing severe poisoning, and few deaths have ever oc- 
curred from it when administered therapeutically. Eclectic physicians, 
however, seldom employ lead salts internally. It has been advised for the 
control of serous diarrhoea (with camphor and opium) not yielding to 
simpler remedies, to control hemorrhage and pain in gastric ulcer, and in 
uncontrollable colliquative diarrhoeas of tuberculosis. Obstipation may 
be produced by it when desirable, after surgical operations upon the ano- 
rectal segment of the bowels. 
PODOPHYLLUM. 
The dried rhizome and roots of Podophyllum peltatum, Linne (Nat. Ord. Berberidaceae). 
Rich woods and thickets of North America. Dose, 5 to 30 grains. 
Common Names: May Apple, Mandrake, Lemon Apple, Wild Lemon, Raccoon Berry. 
Principal Constituents.-Resin of podophyllum (see below) and podophyllic acid, a color- 
ing substance; podophyllotoxin, the purgative principle of the resin exists free in the 
rhizome. 
Preparations.-1. Specific Medicine Podophyllum. Dose, 1/10 to 30 drops; fractional 
doses preferred. 
2. Elixir Podophylli, Elixir of Podophyllum. Dose, fl3ss to fl5i. 
Derivative.-Resina Podophylli, Resin of Podophyllum (Podophyllin). A light brown 
to greenish-yellow, amorphous powder turning darker when heated above 77° F, or when 
exposed to light. It has a faint peculiar odor and feebly bitter taste. It is very irritating to 
the conjunctivae and to other mucous membranes. Soluble in alcohol, chloroform and ether. 
It consists chiefly of the purgative principle podophyllotoxin mixed with podophyllic acid 
(80 per cent), other minor resins, and a yellow, coloring body, podophylloquercitin. Resin 
of podophyllum was first isolated and used by Dr. John King. Dose, 1/30 to 1/2 grain. 
Preparation.- Trituratio Podophylli, Trituration of Podopohyllin (1 to 100). Dose, 
5 to 10 grains. 
Specific Indications.-I. Podophyllum. Podophyllum is specifically 
indicated by fullness of tissues, and particularly by fullness of superficial 
veins; oppressed full pulse; dirty yellowish coating of tongue and dizziness. 
It is contraindicated by pinched features and tissues, contracted skin and 
tongue. 
II. Resin of Podophyllum (Podophyllin). Podophyllin is specifically 
indicated by fullness of tissues, fullness of veins, sodden, expressionless 
countenance, dizziness, tongue coated dirty yellowish-white, heavy head- 
aches, indisposition to bodily exertion, intestinal atony, with sense of weight 
and fullness, full open pulse; ''pain deep in ischiatic notches;" and as an 
ideal cholagogue; clay-colored stools, floating upon water; stools, hard, dry, 
and accompanied by distended abdomen and colicky pain. It is con- 
traindicated by pinched features, and small, wiry pulse, or when the pulse 
has a sharp stroke. 
Action and Toxicology.-Applied continuously podophyllum and its 
resin cause irritation and suppuration of the skin and subcutaneous tissues; 
inhaled they provoke sneezing and violent coryza, and drug workers hand- 
ling either are sometimes affected with conjunctival inflammation. The 
green rhizome or large doses of the dried drug (30 to 60 grains), or its resin, 
produces violent emeto-catharsis and gastro-enteritis. Smaller doses are 
cathartic; and doses short of catharsis induce ptyalism. Hence the names 
once applied-"vegetable mercury" and "vegetable calomel". Both un- 
doubtedly increase the secretion of bile, notwithstanding the many state- 
555 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ments to the contrary. This is most apt to occur from the small dose which 
stimulates, and less likely from a drastic dose which hurries the drug through 
the intestinal canal. Even the latter is said to cause a flow of biliary 
secretion, probably by emptying the duodenum and producing a derivative 
effect. All the intestinal glands are stimulated by podophyllum; and the 
catharsis, like that from jalap, is slow, sometimes from ten to twelve hours 
(podophyllin, four to ten), and even a day elapsing before purgation takes 
place. Then it is likely to persist several days and if the dose be large to 
occasion debilitating hydro-catharsis. Very little tormina is caused by 
them compared with the thoroughness of their action. This may be pre- 
vented, in a measure, by administration with leptandra, hyoscyamus or bel- 
ladonna and aromatic carminatives, such as ginger, cloves, etc. When the 
resin is precipitated by alum in its preparation, it is more apt to gripe; 
common salt intensifies its action and cream of tartar increases the hydra- 
gogue effect; alkalies favorably modify or check its activity. Podophyllin 
(resin of podophyllum) is correspondingly more energetic than the parent 
drug. The evacuations of podophyllum purgation are copious, prolonged, 
and dark or bile-stained in color. 
Overdoses of podophyllum, or its resin, produce hyper-emesis, drastic 
hyper-catharsis, with griping and tormina, and large doses have caused 
death by gastro-enteritis. Even moderate doses, when contraindicated, 
occasion painful and griping irritation and inflammation. 
Therapy.-I. Podophyllum. Podophyllum is a certain but slow 
cathartic; it is also alterative. Unlike most strong cathartics the effects 
are quite permanent and the tone of the intestines improved. It may 
be used in nearly all cases in which podophyllin is useful, though there are 
some conditions where the former gives better results than the latter. 
(Compare Resina Podophylli on page 557). These conditions we will briefly 
notice. It is conceded that as an alterative it is infinitely more decided in its 
action than the resin. It exerts a strong influence upon the glandular 
system. Associated with proper hygienic measures and the indicated tonics 
and other alterative drugs, it will give good results as an aid to elimination 
of broken-down products in the secondary phase of syphilis, in so-called 
chronic rheumatism and in scrofula. The dose should be small, not suf- 
ficient to produce any marked intestinal activity. In stomach troubles, 
podophyllum is often superior to podophyllin. It acts as a gentle stimulant 
tonic, improves the appetite, and is particularly valuable in atonic dyspepsia, 
gastric and intestinal catarrh, and atonic forms of indigestion, when the 
patient complains of dizziness, loss of appetite, and heavy headache. There 
is indisposition to exertion, the movements being heavy and sluggish, the 
tongue is dirty and flabby, and the superficial veins, abdomen, and tissues 
in general are characterized by fullness. Its action on the liver renders it 
particularly serviceable where gastric disturbances are due to hepatic 
torpor. In stomach disorders, hydrastis, mix vomica and other tonics and 
peptics may also be indicated and associated with this drug. Podophyllum, 
iris, chionanthus and chelidonium are excellent agents for that rarely 
occurring affection, chronic hepatitis. By its slow and thorough action, yet 
permanent in its effects in restoring and maintaining the normal hepatic 
and intestinal secretions, podophyllum is one of the very best agents to 
556 INDIVIDUAL DRUGS. 
overcome habitual constipation, and more especially if it be due to portal 
engorgement. The small dose should be given and continued until the 
evacuations become regular and normal. Formerly this drug was much 
employed in bilious, remittent and intermittent fevers. Cathartic and 
sometimes emeto-cathartic doses were employed with the result of pro- 
ducing so profound an impression on the hepatic function and on the portal 
circle and general glandular system that, it is asserted, the disease was 
often aborted, or at least rendered milder and of short duration. It is 
never so employed at the present day. When at the inception of fevers 
a cathartic is needed, which, however, is not often, specific medicine pod- 
ophyllum may be combined with compound syrup of rhubarb and potassa 
(neutralizing cordial), or to render it milder, lobelia, ipecac, leptandra, 
hyoscyamus or belladonna may be administered with it. Though rarely 
now used as a cathartic in dropsy, if selected at all, it should be given with 
cream of tartar. Further uses of this drug are identical with those of pod- 
ophyllin, some preferring to employ interchangeably one for the other for 
the purposes named here and under Podophyllin. The usual medicinal 
dose of specific medicine podophyllum ranges from one to ten drops. Dose 
of the powdered root (almost never used), as a cathartic, from ten to thirty 
grains; of the tincture, from ten to sixty drops; as a sialagogue and altera- 
tive, from one to five grains of the powder, or from one to ten drops of the 
tincture. 
II. Resin of Podophyllum (Podophyllin). Podophyllin possesses the 
cathartic properties of the crude drug in an exalted degree. While it is slow 
in action, it is certain in its results. Some persons are so susceptible to the 
action of the drug, that a dose of one-half grain will actively purge them. 
The ordinary cathartic dose of this resin generally requires from four to 
ten hours to act, but this action is quite persistent, often producing 
copious alvine discharges for one to two days, and when over leaves the 
intestines in a normal condition, seldom being followed by the after- 
constipation so common from the use of ordinary purgatives. As with the 
crude drug the cathartic action of podophyllin is increased by-common salt. 
From four to eight grains operate as an active emeto-cathartic, with 
griping, nausea, prostration, and watery stools; from two to four grains, as a 
drastic cathartic, with nausea and griping; from one-half to two grains 
generally operate as an active cathartic, leaving the bowels in a soluble 
condition; in very small doses, it is gently aperient and alterative. In 
doses of one-half or one grain, it is one of our most valuable cholagogue 
cathartics, operating mildly, yet effectually and very persistently arousing 
the biliary and digestive apparatus to a normal action. It also exerts a 
favorable influence on the cutaneous functions, producing and maintaining 
a constant moisture on the skin. In doses of from one-eighth to one-half grain, 
or rather in doses insufficient to purge, it is strongly but quietly alterative, 
and will induce ptyalism in some persons. This drug should not be given in 
bulk, but should be combined with ginger, hyoscyamus, leptandra, or some 
form of alkali, which renders it less liable to nauseate or gripe. Should 
catharsis be too severe, an alkaline solution, with aromatics, by mouth, 
will check it. A popular and good method of preparation is that of triturat- 
ing it with milk sugar (lactin). This not only obviates, to a certain extent, 
557 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
its irritant action, but singularly increases its purgative qualities. During 
its administration, all articles of food difficult of digestion should be avoided. 
According to Locke podophyllin prepared by alum water is apt to gripe. 
Eclectics long made use of this resin in cases where mercurials were used 
by other practitioners, and found the result vastly in favor of resin of 
podophyllum. It appeared to fulfill all the purgative indications, at least, 
for which mercurials were recommended and used. 
It is not, however, for its cathartic use that podophyllin is most valued 
by the Eclectic profession, but rather for its specific effect when given in 
small doses. Properly administered it is a stimulant to the sympathetic 
nervous system, acting principally upon the parts supplied by the solar 
plexus. It improves digestion and blood-making and stimulates normal 
excretion. For its action upon the liver, repeated small doses of the tritura- 
tion (1 to 100), or a daily pill of podophyllin (1/20 grain) and hydrastin 
(1/4 grain) is much to be preferred to its cathartic dose. It should be 
given in the same manner when its action on the pancreas and spleen 
is desired. 
The value of podophyllin in small doses, in gastric and intestinal dis- 
orders, has not been as well appreciated as it deserves to be. It has a 
specific action on forms of stomach and bowel trouble with atony, char- 
acterized by full and relaxed tissues, with mucous discharge. The case is 
never one of loss of function from irritability, but from atony. In the summer 
disorders of children, especially cholera infantum, it often will be indicated, 
and is quick to restore normal action when the bowels are loose, with 
passages of mucoid, slimy material. The movements of the child are 
sluggish, the tongue is coated a dirty yellowish-white, the superficial veins 
are full, and the countenance is dull and expressionless. In chronic types 
of disease, associated with feeble digestive power, which is but little im- 
proved by the ordinary stomach tonic, this drug renders excellent service. 
The trouble is usually atony of the upper part of the small intestines, and the 
stimulant dose of triturated podophyllin corrects the difficulty. Pod- 
ophyllin is a favorite anti-constipation remedy. It is equally valuable in 
costiveness of the young child and in the aged. In very young babies this 
trouble will yield to: Podophyllin (2 x trit.), gr. xxx; Brown Sugar, 3ii; 
Water, flgiv. Mix. Sig.: Teaspoonful four times a day. For adults the 
daily use of from one to two of the podophyllin and hydrastin pills (1/20 
and 1 /4 grain) will generally be sufficient to gradually overcome the trouble. 
The cathartic dose should never be employed for the relief of constipation, 
or when a cholagogue action is required. When the stools are hard and 
grayish-white or clay-colored, and float upon water, the remedy is especially 
effective, as it is also in dry stools, with tympanitic abdomen and wander- 
ing, colicky pains. Flatulent colic of children, when associated with con- 
stipation, will readily yield to small doses of this drug, while as a remedy 
for dysentery and both acute and chronic diarrhoea, all of the recurring 
type and accompanied by portal sluggishness and hepatic torpor, few 
remedies will excel it. Dyspepsia, with atony and thickened mucous mem- 
branes secreting abundantly, calls for stimulant doses of podophyllin. The 
head feels full, the tissues and veins appear full and doughy, the skin is 
sodden, and a dirty coating covers the tongue from tip to base. R Pod- 
558 INDIVIDUAL DRUGS. 
ophyllin, 1/20 grain, three times a day. Cardialgia, accompanied by con- 
stipation, sometimes yields to the trituration (1 to 100). 
This drug has been justly valued in hepatic disorders. In that state 
ordinarily known as "biliousness," this drug or specific medicine iris can 
usually be depended upon. Indeed, they act well in combination. There is 
dizziness, a bitter taste, the stools show an absence of bile, and greenish, 
bitter material is vomited. Podophyllin is often indicated in both acute 
and chronic hepatitis, though usually contraindicated in inflammations of 
the gastro-intestinal tract. Fullness in the region of the liver, with aching 
under the scapulae and in the back of the neck, with dizziness, usually calls 
for this drug. In catarrhal jaundice with clay-colored stools it may be 
alternated with chionanthus. In the unpleasantness attendant upon the 
retention or passage of biliary calculi, and in mild forms of cholecystitis a 
purge of podophyllin may assist in relieving distressing symptoms or in 
aiding the passage of the concretions. It is not, however, a drug to be 
relied upon unaided, either for a cure or to remove the calculi, but rather 
to improve the secretion and elimination of bile. When indicated there is 
great pain in the region of the gall bladder coursing to the left and down- 
ward. Sometimes there is constipation, as often diarrhoea. There is a bad 
taste, and the patient is jaundiced. I| Podophyllin, gr. ij, at night, followed 
in the morning with a large quantity of olive oil. In hemorrhoids, de- 
pendent on biliary insufficiency with portal inactivity, it may be given in 
alternation with sulphur, the podophyllin being particularly desired when 
there is constipation with tenesmus. The small dose alone is required, from 
1/20 to 1/10 grain, three or four times a day. 
Podophyllin may give good service in cough accompanied by bronchor- 
rhcea, especially if it be associated with gastric catarrh. Here minute doses 
of sulphur are also valuable. In heart disease, when aggravated by hepatic 
inactivity and portal torpor, the cardiac remedy may be rendered more 
efficient if associated with minute doses of this drug. It has long been 
recognized as serviceable in the rheumatic diathesis, when the patient is 
sallow and inactive, presents fullness of tissue, and complains of dull pain 
and heaviness in the right hypochondrium. In renal disorders, when the 
general specific indications for its use are present, it will usually restore the 
secretory power of the kidneys. 
Podophyllin has long enjoyed the reputation of exerting a powerful 
action upon the lymphatic glandular system. It acts quietly but effectively 
as an alterative, one of the best in the whole domain of medicine, at the same 
time aiding and improving the digestive process. It was formerly, and is 
still with many, a favorite remedy in secondary and tertiary syphilis as an 
eliminant of broken-down material. Ellingwood declares it a good remedy 
for persistent pustular conditions, eczema, and cracked or fissured skin. 
Podophyllin is a remedy for pain, according to Scudder-deep-seated 
pain in the ischiatic notches. It has served a good purpose in inflamma- 
tions (when not of the digestive tract), accompanied by great constipation. 
Here the cathartic action is required, as it is also in the forming stage of 
febrile diseases, with the exception of typhoid fever, in which it is not to be 
commended, notwithstanding it was a prominent medicine in the so-called 
Woodbridge and other supposed abortive forms of treatment for enteric 
559 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
fever. In malarial cachexia, small doses of podophyllin may be alternated, 
or given with cinchona or quinine. For all of the preceding uses specific 
medicine podophyllum may also be used, but the dose must be correspond- 
ingly larger. For the gastric disorders many prefer it to the resin. Younkin 
advises cathartic doses (1/6 grain, every two hours, with ten grains of 
potassium bitartrate) for the relief of gonorrhoeal epididymitis. The dose 
of podophyllin, as a cathartic, is from 1/2 to 2 grains; as an alterative 
and stimulant, 1/100 to 1/10 grain; as a cholagogue, 1/20 to 1/10 grain. 
A good form in most disorders requiring the small dose, is the following: 
3 Podophyllin Trituration (1 to 100), gr. v to xxx; Water, flgiv. Dose, one 
teaspoonful every one to three hours. 
POLYMNIA. 
The root of Polymnia Uvedalia, Linne (Nat. Ord. Composite). Central United 
States to Florida. Dose, 5 to 30 grains. 
Common Names: Uvedalia, Bear's Foot, Leaf Cup. 
Principal Constituents.-A dark-brown, acrid resin and a straw-colored, balsam-like 
resin. 
Preparations.-1. Specific Medicine Polymnia. Dose, 1 to 30 drops. 
2. Unguentum Polymnice, Ointment of Polymnia (Uvedalia Ointment). Fresh 
Polymnia, 8; Lard or mutton tallow, 16. Light green in color. 
Specific Indications.-Full, sodden, inelastic, flabby tissues; splenic 
and hepatic enlargement, with fullness, weight and burning in the hypo- 
chondriac and epigastric regions; congestion and impairment of the functions 
of the organs supplied by the coeliac axis; impaired blood-making with 
tumid abdomen; low, inflammatory deposits. 
Action and Therapy.-External. Uvedalia stimulates the growth of 
hair. Scudder advised the following hair tonic: Specific Medicine 
Polymnia, fl3ij; Bay Rum, fl^vj. Mix. Sig.: Rub thoroughly into the 
scalp once or twice a day. Howe added to this lotion Tincture of Cantharis, 
fl 5 ij, and Fowler's Solution of Arsenic, fl 3 ij. Uvedalia ointment may be 
used, rubbed warm and well into the abdomen, for the reduction of en- 
gorged spleen (ague cake); the specific medicine must be administered 
internally at the same time. Its discutient powers have been taken ad- 
vantage of in other painful swellings due to low inflammatory deposits and 
in mammitis particularly, scrofulous enlargement of the lymphatic glands, 
and spinal irritation. 
Internal. Polymnia is one of the best of the spleen remedies reducing 
engorgement of that organ best when due to malarial cachexia. To a lesser 
degree it has a similar effect upon the liver. Its special field of activity is 
upon the parts supplied with blood by the coeliac distribution. It is thought 
to favor a better splenic participation in blood-making; and may well be 
further studied for its influence upon all the ductless glands. In atonic 
dyspepsia and chronic gastritis depending upon a general cachexia, most 
often malarial, with a sluggish gastric and hepatic circulation, and attended 
by full, heavy, burning sensation it is often of signal benefit. It is still 
undetermined whether it exerts a specific influence upon leucocythemia; 
but it is certain that the correction of splenic and hepatic wrongs by this 
drug cannot but exert a beneficial effect. To be of any service in affections 
of the ductless glands it should be administered for a prolonged period. 
560 INDIVIDUAL DRUGS. 
Scudder valued it for uterine subinvolution and hypertrophy of the cervix, 
when indicated by the sodden inelastic condition, pallid tissues and im- 
paired circulation above referred to. Large doses of polymnia are said to 
produce painful emeto-catharsis, gastro-intestinal inflammation, convul- 
sions and death. 
POPULUS. 
The bark of the Populus tremuloides, Michaux (Nat. Ord. Salicaceae). Lower Canada 
and northern and middle United States. Dose, 1 to 30 grains. 
Common Names: American Poplar, American Aspen, Quaking Aspen. 
Principal Constituents.-Populin and salicin (which see). 
Preparation.- Tinctura Populi, Tincture of Populus (saturated). Dose, 1 to 30 drops. 
Specific Indications.-Marked debility with digestive impairment; 
tenesmic action after urination. 
Action and Therapy.-A neglected remedy of considerable value in 
debility of the urinary tract and of the digestive organs. It acts best in 
small or fractional doses. When so given it is of value in tenesmic action of 
the bladder immediately following urination. Owing to the salicin and 
populin present it has had a considerable reputation in malarial fevers and 
should be more generally employed as a post-febrile tonic. 
Sulphurated Potassa, Liver of Sulphur, Hepar Sulphuris. 
A mixture of polysulphides and thiosulphate of potassium. 
Description.-Irregular liver-brown pieces when fresh, becoming successively greenish- 
yellow and gray through absorption of moisture, oxygen and carbon dioxide. It has a 
bitter, acrid and alkaline taste, and the disagreeable odor of sulphuretted hydrogen. Very 
soluble in water and only partially (sulphides) in alcohol. Dose, 1 to 10 grains. 
Action and Therapy.-External. In the form of a wash or the ointment, 
sulphurated potassa is useful in skin diseases of a parasitic character, 
especially scabies. It is also occasionally used in chronic forms of eczema, 
and in psoriasis. It is seldom used internally. 
POTASSA SULPHURATA. 
POTASSII ACETAS. 
Potassium Acetate, Acetate of Potash. (Formula: KC2H3O2.) 
Description.-A hygroscopic, white powder or crystalline masses of a satiny luster, 
without odor or having but a faint acetous odor and possessing a warming saline taste. 
Very deliquescent on exposure to the air, and very soluble in both water and alcohol. Dose, 
10 to 60 grains. 
Specific Indications.-Retention of worn-out material in the body; 
imperfect renal elimination of broken-down solids; deposits of cacoplastic 
material, giving rise to inflammations and fever; tongue pallid, with light, 
pasty fur; scanty urine, with dull headache; sluggish lymphatic elimination; 
hepatic torpor; rheumatism with swollen joints, dirty tongue, and elevated 
temperature. 
Action.-Potassium acetate is one of the mildest of the potassium salts, 
scarcely producing any irritation of the stomach, and only in large doses 
may it prove laxative. It does not neutralize the gastric juice. When in 
the body it becomes decomposed and enters the blood stream as a carbon- 
ate. In this manner it increases the alkalinity of the blood and the urine, 
and proves decidedly diuretic. This quality was recognized long before its 
561 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
chemical change was understood, and from this circumstance it was once 
popular under the name sal diureticus. 
While potassium acetate is a typical diuretic, it is not of great value 
when dropsy is a symptom except, perhaps, in that temporary form follow- 
ing scarlatina and other acute infectious diseases; or following obstructive 
hepatic disorders of non-malignant type. It is also advised in general 
dropsy due to faulty heart action. Only when the kidneys are intact 
should it under any conditions be expected to favor improvement. An 
occasional dose is useful to cleanse the renal tract in syphilis and gonorrhoea, 
and it aids materially in the removal of effete matter which is causing, pro- 
longing or aggravating many of the skin eruptions, especially acne, boils, 
and carbuncle. Potassium acetate has been used with more or less success 
in the uric acid diathesis and for urinary calculi. Probably the only form 
of the latter in which it succeeds is that in which there are multiple particles 
agglutinated by mucus. By removing the latter disintegration is ac- 
complished. It is by no means likely that it has any solvent action upon 
the calculi alone. 
Years ago much was heard about the renal depurant. The importance 
of such an agent was strongly impressed upon us, and we do not think the 
matter was overrated. We are sure that we have since greatly profited by 
the lessons then enforced. It was in the days when the phrase "to increase 
retrograde metamorphosis" was popular among physicians, a process that 
stood in some, but only partial, relation to what we now speak of as cor- 
recting the "errors of metabolism". Elimination of effete and deleterious 
matter was the object-as justifiable now as then. One of the ways in 
which the elimination of the broken-down products of life can be encour- 
aged is through the renal function. Formerly, we believe, more care was 
taken in producing kidney elimination, when simple and kindly remedies 
were used, in contrast with some of the stronger antiseptic eliminants, like 
urotropin, etc., of present-day renal therapy. The eliminant employed was 
called by the Eclectic the renal depurant. It was a good name and it was 
good medication. Seemingly, however, the remedies and the procedure 
have been much neglected by present-day physicians. 
In treatment by means of the renal depurant it was argued that it was 
impossible to make good blood when there was in it old and effete ma- 
terial, and it was impossible to improve the nutrition of an organ until 
the old and broken-down tissues could be gotten rid of. There is truth in 
these premises; truth largely proved by the good results obtained by using 
safe and gentle medicines, in carefully gauged doses, for accomplishing the 
purification. 
The typical renal depurant was, and is, potassium acetate. Sodium 
acetate is a close second, but has never become very popular in America. 
When the body is loaded with unhealthy material, giving rise to fullness 
of tissues, vertigo, pain, or to unhealthy deposits, or to the favoring of 
the deposition of tubercle, or to the manifestations of that near relative of 
tuberculosis-scrofula-if, indeed, that be not tuberculosis of the lym- 
phatics; and when desirable to eliminate the detritus accompanying or fol- 
lowing chronic malarial impression, fevers, and particularly rheumatism, 
rheumatoid grout and neuritis, potassium acetate should bv no means be 
562 INDIVIDUAL DRUGS. 
overlooked in the selection of remedies for eliminative and corrective effects. 
Its value in many conditions of recurring pain, so often attributed, without 
good reason, to rheumatism, and even in true rheumatic arthritis, we be- 
lieve it a most helpful agent and one that should enter into treatment 
as an adjunct at least. The observing patient, who is taking potassium 
acetate, will tell you that when the urine passes it seems to be thick and 
smooth and flows easily as if it were removing some soft mucus-laden 
material. Certain it is that it increases the output of solids. Therefore, 
its occasional use should be of great advantage in keeping the body clear 
of such detritus as can be safely removed by renal action-material that 
paves the way for chronic nephritis and arteriosclerosis. Patients of 
middle age should have an occasional dose of the salt when the urinary 
product is scant and high-colored. 
In uric acid gravel it is believed to prevent the formation of crystals 
by rendering the urine alkaline-a condition in which it is not possible for 
the concretions to form. Locke was partial to a combination of this salt 
with salicylic acid for acute articular rheumatism, when the tongue is dirty, 
the joints greatly swollen, and the temperature elevated. 3 Potassium 
Acetate, 3vi;Salicylic Acid, 3ij; Water, flgiv. Mix. Sig.: One teaspoonful 
in a wineglass of water every three or four hours. Others have found it, 
given alone well diluted, of value in so-called chronic rheumatism. 
The unpleasant taste of the acetate has been the greatest drawback to 
its use. When given in water alone it is very unpleasant. It may be given 
in simple elixir, but one should avoid, as far as possible, too much alcohol 
in the cases needing renal depurants, and some object to the sugar. In the 
standard elixirs, containing buchu, corn silk and oil of sandal wood, with 
the potassium acetate, one is compelled to give a number of medicines not 
desired, and perhaps contraindicated. Where both are indicated, and they 
usually are, the following is a good form of administration: Potassium 
Acetate, 3i; Essence of Mentha Viridis, fl3i; Simple Elixir, fl3ij; Water, 
q. s., fl^iv. Mix. Sig.: Take at one dose. Plenty of water always should 
be given with potassium acetate. When dispensing it in solution (if to be 
taken within a few days, for it changes upon being kept long) we frequently 
add the essence of spearmint, both for its preservative effect and to increase 
the watery element in elimination. Potassium acetate increases the output 
of solids; spearmint the output of water. If the patient cannot renew his 
prescription frequently, the salt, which is deliquescent, should be given him 
in bulk, in a closely-stoppered bottle, with directions to dissolve a given 
quantity in a large quantity of water. From thirty (30) grains to four (4) 
drachms may be given in twenty-four hours, if need be, but we prefer about 
one drachm a day for several days, with a rest of a few days, resuming the 
medicine as needed. 
Potassium Bicarbonate, Bicarbonate of Potash. (Formula: KHCO3.) 
Description.-Permanent, transparent, colorless crystals, or a granular white powder, 
without odor but having a saline and feebly alkaline taste; freely soluble in water, but 
almost insoluble in alcohol. Dose, 5 to 30 grains. 
Specific Indications.-Leaden pallor of tongue and mucosa, and 
tremulous action of voluntary muscles; debility out of proportion to dis- 
eased conditions. 
POTASSII BICARBONAS. 
563 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-External. Potassium bicarbonate, well diluted, 
is an excellent and unirritating material for softening and removing scales 
upon the palpebral margins in ciliary blepharitis, and for cleansing the 
aural canal of scaly deposits. It may also be used upon the skin to allay 
irritation and itching in dermatitis, especially that caused by Rhus Toxi- 
codendron and by sunburn. 
Internal. This salt is antacid and diuretic. It is less irritating and 
pleasanter in action than the carbonate and the liquor potassae. While it is 
usually less effective where a strong antacid is required than the correspond- 
ing sodium salt, it is preferable for little children when given in small doses 
and well-diluted. When there is a tendency to the formation of uric acid 
it may be used with good effect, and in those types of rheumatism, arthritis 
and gout, with which uric may also be associated. In atonic dyspepsia, 
with mild hyperacidity, and the disposition to butyric fermentation, 
potassium bicarbonate is an agent of value, as it is also in biliary disorders 
aggravated by imperfect emulsification of fats and obstruction'to the free 
flow of bile into the duodenum. Under such conditions it acts favorably in 
duodenal catarrh, catarrhal jaundice, and as an aid in preventing the 
formation of hepatic calculi. Its chief use in biliary disorders is to attenuate 
the bile and cleanse the mucosa, the same attenuating action being observed 
in its effects in chronic bronchitis, especially in the aged, in which it liquefies 
the sputum and renders it less tenacious. We have found the bicarbonate 
one of the most effective agents in malnutrition and marasmus of infants. 
We give it in minute doses usually in solution with a very small proportion 
of citric acid. This, of course, converts it into a slightly carbonated 
solution of potassium citrate. Potassium bicarbonate should preferably 
be given in the smaller doses well diluted. It is the alkaline ingredient of 
compound syrup of rhubarb and potassa (Locke's formula) or neutralizing 
cordial. 
POTASSII BICHROMAS. 
Potassium Bichromate. (Formula: K2Cr2O7.) 
Description.-Large, orange-red crystals, permanent and odorless, and having a 
bitter, metallic taste; freely soluble in water, more readily in boiling water; insoluble in 
alcohol. Dose, 1/30 to 1/3 grain. Usually the 3x trituration is employed in doses of 
2 or 3 grains every 2 to 4 hours. 
Specific Indications.-Irritation of respiratory organs, with hoarseness 
or aphonia; harsh, croupal cough, with scanty expectoration, or thick 
tenacious sputum, dyspnoea, and subacute inflammation; hoarseness and 
aphonia from enforced or prolonged use of the voice; dyspepsia with gastric 
catarrh and yellow-coated tongue; tendency to ulceration with sticky or 
stringy discharge. 
Action and Toxicology.-In excessive doses this salt is a violent irritant 
and corrosive poison, and may quickly produce death. An ounce is said 
to have killed in a half hour, insensibility quickly following its ingestion; 
and two drachms of the salt have proved fatal. Habitually applied to the 
skin, in solution, it causes papules followed by pustules, finally terminating 
in deeply penetrating sloughs. Calico printers, who use this material, 
suffer from ulcers upon the hands and destruction of the nasal membranes 
and seotum from inhaling its dust. The chief symptoms of poisoning by 
564 INDIVIDUAL DRUGS. 
potassium bichromate are: vomiting of dark hemorrhagic mucus, violent 
pain in the belly, purging, excessive thirst, cold skin, feeble speech, with 
rapid feeble pulse, hurried breathing, coma, heart failure, collapse, and 
death. If death does not take place there may be suppression of the urine 
for several days. The treatment is that for irritant corrosive chemicals in 
general. (Compare Chromium Trioxide.} 
Therapy.-External. Like chromic acid this salt is cauterant and 
antiseptic, and though milder may be used for many of the topical purposes 
for which the acid is employed. Warts and excrescences may be painlessly 
removed, chiefly by absorption, by a concentrated solution of it (30 to 60 
grains to water, fl 3j), with but little or no sloughing or unmanageable 
ulcerations. It has also been used in dry gangrene. A strong solution is an 
effectual application in acute trachoma with large granulations. 
Internal. This remedy has come into Eclectic therapy through those 
who have studied Homoeopathic materia medica and therapeutics, and have 
made a rational selection from that source. In the early part of the century 
now passed it was advocated by many as an efficient agent in diphtheria, 
but a sufficient differentiation of the varieties of sore throat and the indi- 
cations for the drug were not fully recognized. Membranous croup was 
not then so universally accepted as a form of diphtheria (laryngeal) as now, 
and while the agent is a good medicine for ordinary croup with tenacious 
secretion and for ulcerated forms of sore throat with sticky or stringy 
exudates, it does not in the least fulfill the requirements in genuine diph- 
theria. In the attenuations up to the 3x trituration, or the decimal solution, 
it is a useful agent in broncho-pulmonic troubles with sticky, tenacious 
mucus difficult to raise, and in ulcerated conditions of the throat and nose 
of a sluggish character and like secretions. A post-pharyngeal ulceration, 
with sticky, blackish crusts, occurring during a case of typhoid fever, was 
quickly removed by potassium bichromate 2x internally, and a spray of a 
2 per cent solution of the crude salt. The most satisfactory results we have 
ever obtained in the treatment of acute coryza with profuse lachrimation 
and bland nasal discharges, was obtained from adding one drachm of a 
2 per cent solution to four ounces of water, the dose being a teaspoonful 
every two hours. 
This salt frequently relieves hoarseness and aphonia, with exudation 
and cough, laryngeal irritation with hoarseness and dryness of tissues, and 
the hoarseness resulting from cold, singing, or speaking. Hard, dry, rasping, 
bronchial cough is another indication for it. Webster asserts its value to 
relieve the cramping rheumatoid pains attending muco-enteritis and acute 
diarrhoea occurring in cold weather; while others value it for its recupera- 
tive power in bowel and stomach disorders tending to ulceration-especially 
that resulting from chronic diarrhoea and dysentery, when the colon be- 
comes the seat of destruction. Again it has been recommended for gastric 
catarrh when the tongue is coated yellow. As an alterative Foltz believed 
it useful in croupous conjunctivitis and indolent corneal ulcer, with stringy 
secretions, and in granulated lids with tenacious discharges. 
In disorders of the respiratory tract we have administered this salt in 
syrup, as follows: T| Potassium Bichromate gr. ij, Syrup fl5 iv. Mix. Sig.: 
One teaspoonful every one to three hours, as needed. 
565 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
POTASSII BITARTRAS. 
Potassium Bitartrate, Cream of Tartar. (Formula: KHCJLO,.) 
Description.-Permanent colorless or slightly opaque crystals, or a gritty, white, odor- 
less powder, with a pleasant acidulous taste. Soluble in boiling water, and much less 
so in cold water; almost insoluble in alcohol. Dose, 5 to 60 grains. 
Action and Therapy.-Potassium bitartrate is a hydragogue saline 
cathartic and diuretic, rendering the blood thicker by the abstraction of 
serum and causing some thirst. It is largely excreted by the bowels and 
kidneys, but a portion of it is converted into carbonate, thus rendering the 
urine alkaline. Inasmuch as it does not gripe when given in moderate doses, 
it has long been valued in various forms of dropsy to remove the watery 
accumulations. In full doses it usually produces rather prolonged watery 
purgation, and only when excessive amounts are given does it cause any 
distress. For post-scarlatinal dropsy Locke advised: IJ Potassium Bi- 
tartrate, gss; Juniper, $ss; Boiling Water, Oj. Infuse. Filter after allow- 
ing to stand for two hours and give a wineglassful three or four times a day. 
Cream of tartar and sulphur form one of the popular laxatives for 
hemorrhoids, prolapsus ani, and as a "spring medicine to thin the blood". 
As a matter of fact it tends to concentration rather than an attenuation of 
that fluid. In this manner it is valued when one is subject to boils, pimples, 
and constipation, especially if plethoric. 
Cream of tartar, in solution, sweetened and flavored with lemon, forms 
an agreeable, acidulous fever beverage. It may also be added to ordinary 
lemonade for the same purpose. 
POTASSII BROMIDUM. 
Potassium Bromide, Bromide of Potash. (Formula: K Br.). 
Description.-Permanent, colorless or white, cubical crystals, or a granular, white 
powder, without odor, and having a sharp salty taste; very soluble in water, soluble in 
glycerin, and sparingly in alcohol. Dose, 1 to 60 grains. 
Specific Indications.-Plethora, with vascular and nervous excitation; 
headache, or insomnia, with throbbing pain and fullness of the cerebral 
vessels, and great mental excitation; restlessness and nervousness in sthenic 
conditions; disorders associated with a vigorous circulation, without fever; 
extreme susceptibility to external impressions; spasmodic contraction of 
the muscles; epileptic seizures from sexual irritation or from irritation of 
the cerebral cortex; strong sexual excitement; spermatorrhoea of the 
plethoric; satyriasis; nymphomania; violent mania; purely reflex nervous 
vomiting; sea-sickness. 
Action.-Locally, when applied in Concentrated form, bromide of 
potassium is decidedly irritant to the mucous tissues. In ordinary amounts 
it will obtund the faucial tissues so that contact will not cause nausea or 
vomiting. 
Bromides are rapidly absorbed when given internally; and very slowly 
eliminated. A single dose of one-half drachm has been asserted to have been 
detected in the urine after sixty days. Hence they may be regarded as pos- 
sible cumulative salts when too vigorouly administered. When the kidneys 
are inactive they are more pronounced in their effects. In the case of the 
potassium salt, on account of its potassium base, damage is likely to occur 
566 INDIVIDUAL DRUGS. 
from its use when nephritis is present. If the alimentary canal is in an 
irritable condition bromides are apt to induce diarrhoea. 
The bromides all resemble each other in action, except as slightly 
modified by their base. While most of them are sedative, slight stimulation 
is accredited by some to the ammonium salt. Taken as a whole the group, 
in full doses, produces drowsiness, sleep and a marked repression of all the 
nervous reflexes. These salts distinctly depress the motor and intellectual 
areas of the cerebral cortex; and while probably having but little effect 
upon the medulla, they have a marked depressive or sedative action upon the 
sensory pathways of the spinal cord, and to a lesser extent upon the motor 
neurons. The result is a decided lessening of reflex action, and, as Hare 
states, "a decrease in the ability to recognize pain". The action of the 
bromides is not one of abolition of function, but rather one of depression. 
Upon the nervous system the effects are observed in inverse order to the 
natural development of function; i. e., depression is manifested in a de- 
scending type from the higher brain downward along the cord. 
The effects of the bromides upon the brain are noteworthy, diminishing 
mental activity and blunting the interpretation of the senses. While 
perception is not interfered with and impulses probably reach the brain 
in the usual way, they are not valued proportionately. The individual has 
little interest in what the brain perceives, and the tendency is an apathetic 
approach to drowsiness and sleep. The latter, attained, is not refreshing, and 
never profound, and the victim awakens with a more or less confused mind, a 
state which may persist for hours. Dullness, sometimes headache, slowness 
of thought and speech, a lapsing memory, and disposition to confuse sen- 
tences or to omit words are not uncommon effects of bromides before or after 
inducing sleep. The bromides render the mucous tracts of the throat and 
the genital organs somewhat insensitive, and the anaphrodisiac effect is pro- 
nounced. Unless the dose be very large or oft repeated little effect is ob- 
served upon the heart and circulation, nor is breathing much affected except 
by excessive doses. Toxic doses, however, strongly depress the respira- 
tory center in the medulla. Bromides may irritate the stomach, particularly 
if already irritable, and either by this effect or through depressing reflex 
action may retard digestion by causing a slower secretion of gastric juice. 
Only enormous amounts affect the body temperature. Bromides are taken 
up freely by the plasma of the blood, like the chlorides, whose action they 
resemble in many ways, and are found in and eliminated in all the fluids of 
the body-the tears, sweat, urine, semen, bronchial mucus, milk, and feces 
-being mostly discharged very slowly and unchanged by the kidneys. 
Tissue waste is retarded by the bromides, though the renal secretion is 
usually increased. The nursing infant may be impressed by the bromated 
milk of its mother. 
Bromism.-This term has been applied to the effects of chronic poison- 
ing by the bromides through overdosing or overlapping dosage. In this 
condition all the untoward effects noted above are intensified. The prin- 
cipal changes observed are an unpleasant bromic fetor of the breath, with 
reddened and swollen fauces, and eruptions of acne which may pustulate, 
abscess, or become ulcerated. Sometimes erythematous or eczematous 
lesions prevail. Bodily and mental exercise is imperfect, the victim shows 
567 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
feeble intellectuality, weak memory, confusion of statement or slow and 
stammering speech, or incoherence in diction, indulges in meaningless or 
silly laughter, has cold skin and extremities, is breathless and easily fatigued 
upon exertion, tremulous and uncertain in locomotion, and has a complete 
repression of the sexual function with genital relaxation. Disordered 
menses are common; as is pulmonary and gastric catarrh, with diarrhoea 
or constipation. A lethargic, sleepy state approaching beastiality predom- 
inates, and finally some of these wrecks of humanity lapse into a fever and 
coma and death mercifully removes them. 
Therapy.-External. Owing to its property of blunting the sensibility 
of the mucous membranes bromide of potassium may be sprayed upon the 
fauces and pharyngeal vault to facilitate the use of the laryngoscope, the 
passage of the lavage tube, and of esophageal bougies; and for the intro- 
duction of instruments into the urethra. Cocaine has now largely displaced 
it for this purpose; but where that obtundant cannot be used or where it is 
especially dangerous, as it is sometimes in the urethra, the potassium salt 
may be substituted. Its external use in ointment for the reduction of 
goitre has been entirely superseded by iodine. Solutions of the salt, and 
sometimes an ointment, will give relief from the intense itching of pruritus 
ani, and particularly when associated with anal fissure. 
Internal. Bromide of potassium is an important but much abused 
medicine. It is sedative and hypnotic. The specific purpose of its em- 
ployment is to control irritation of the nervous system, with or without 
spasms, in the robust individual, with full and strong circulation and easily 
excitable musculature. It is never a good remedy for the debilitated and 
anemic, but for the sthenic conditions arising in the plethoric individual. 
Though not an analgesic, it helps one to bear pain, or even gives relief from 
pain when it is due chiefly to nervous excitation. Keeping these facts in 
mind it is not difficult to apply this medicine without harm, provided 
thought and care be used in considering the limitations of the patient. 
The great field for potassium bromide is in spasmodic disorders in full 
blooded, excitable persons. It is generally conceded to be the most suc- 
cessful agent for the control of epilepsy. Occasionally a case is cured by it, 
but as a general rule it is only a controlling medicine limiting the frequency 
and force of the attacks. Unfortunately it brings some of the beneficiaries 
almost to the verge of bestiality in order to control the seizures and keep 
them in abeyance. If any other agent can be found to check the convul- 
sions it should be used in preference to a bromide pushed to the limit, yet 
no other agent is so universally used nor so successful as this one. Extreme 
care then should be exercised in its use, employing no more of the salt than 
is absolutely needed, for it is a melancholy fact that physicians often 
carry to excess the employment of an effective agent until its legitimate 
use becomes an abuse. Bromide of potassium is pre-eminently one of the 
abused medicines. Unquestionably potent in epilepsy and often the only 
effective drug, we cannot expect it to cure when the malady depends upon 
organic lesions or tumors, nor upon unrectified sexual disorders, as phimosis, 
or other surgically remediable conditions. But in cases where there is extreme 
susceptibility to external impressions together with plethora, or where the 
trouble is precipitated by mere genital irritation, or fright, or irritability 
568 INDIVIDUAL DRUGS. 
of the cerebral cortex, bromide of potassium offers the only and best means 
of controlling the seizures known to medicine of to-day. From fifteen to 
forty grains, well diluted, may be given four times a day, and continued 
until the system is saturated, which will usually be apparent from the 
induction of acneiform eruptions, dullness, and the beginning stages of 
symptoms of depression. Then smaller doses may be given daily and even 
after long lapses between attacks, or when the disorder is apparently cured 
it is advised to continue the drug in small amounts for several years. 
Give it in combination with stomachics and tonics, as calumba, or if any 
heart irritability develops and we are obliged to continue the drug, digitalis 
may be used to support the cardiac function. When epilepsy is well under 
control it is advisable to occasionally omit the drug for a brief period to 
rest the system and especially the digestive organs from its influence. 
Small doses of arsenic are credited with preventing or lessening the tendency 
to acne. Bromide of potassium is more effectual in grand mal than in 
petit mal. 
Bromide of potassium is an admirable temporary remedy to control 
or assist in controlling the convulsions of childhood, especially those de- 
pendent upon disorders of the gastro-intestinal tract and dentition. There 
are usually the bromide indications present-cerebral fullness and plethora. 
Removing any irritating material from the stomach and bowels (by enema), 
the following may be given to control and to prevent a return of the attack: 
I) Potassium Bromide, 3j; Specific Medicine Lobelia, Specific Medicine 
Gelsemium, aa, fl5j; Water, q. s., A^iv. Mix. Sig.: One teaspoonful 
every five minutes until the spasms are controlled; then every two hours 
for a day. These spasmodic attacks often usher in the fevers of childhood, 
or occur during their progress. In such instances by reducing the blood 
pressure and the frequency of the circulation and allaying the nervous 
hyperaesthesia it proves an arterial sedative and assists to a quick recovery. 
Small doses sometimes allay vomiting due to irritability of the gastric 
mucosa; and in the enteralgia of children, with intense colicky pain and 
contracting or knotting of the intestines, purely nervous in character and 
with spasm threatening, it is very prompt in giving relief. Spasmodic 
esophageal stricture is sometimes relieved by it. In tetanus and tetany it is 
a useful drug, though in the former its use must be coupled with that of the 
more powerful antispasmodics, as chloral and chloroform. Even then but 
little hope should be held out in a disorder so universally fatal. Large 
doses may be given per rectum usually in combination with chloral hydrate. 
In tetany (or tetanus neonatorum) the dressing of the cord should carefully 
be attended to, and the bromide given to control as far as possible the 
spasmodic condition. In puerperal convulsions it may be employed in 
conjunction with veratrum, both of which are indicated when the cir- 
culation is full and vigorous. Alone, it has little value in this disorder. 
Bromide of potassium is one of the most frequently employed agents 
for the relief of nocturnal seminal emissions when occurring in the full- 
blooded excitable individual. It does not benefit, but on the contrary 
may do harm, to the pale, bloodless person with general relaxation and cold, 
clammy extremities. It renders the best service when the victim is in other- 
wise fairlv eood health, but who from lascivious dreams, vascular excite- 
569 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ment, and nervous irritability of the ejaculatory ducts is an easy prey to 
confirmed spermatorrhoea. The venereal excitation may approach that of 
satyriasis, and not infrequently in nymphomania it is our best remedy. 
It is, therefore, a drug for sexual hyperaesthesia with determination of blood 
to the genitalia. Rather full doses, twenty to forty grains, well diluted, 
may be given four times a day, or sufficient to control the cases in hand. 
Hysteria is relieved by this salt when dependent upon sexual excite- 
ment of the type described and when accompanied by facial muscular 
twitching, and abdominal or uterine throbbing. It is the best agent we 
have used for the "hot flushing" and other nervous phenomena complained 
of by plethoric women during the menopause. Small doses only are re- 
quired. It is one of the best drugs to control chordee during or following 
an acute gonorrhoea, and priapism occurring in infants and youths is 
subdued by it. 
Bearing in mind the specific indications, the drug is especially effective 
in nervous palpitation of the heart, in the night terrors of children, vomiting 
of pregnancy (occasionally) when purely nervous and not due to stomachic 
wrongs, somnambulism, tinnitus from the effects of quinine, in the delirium 
of fevers, in cerebral and cerebro-spinal meningitis, in urethral fever from 
operative measures, and in the amblyopia of the intemperate. It is 
conceded one of the best remedies for sea-sickness, beginning its use in small 
doses several days before sailing. Elixir of bromide of potassium will often 
quickly overcome drunkenness and is a favorite remedy in the Eastern States 
for mastering the effects of a "jag". In delirium tremens it is a most im- 
portant remedy, when vascular and nervous excitement is great; it will 
do damage in the opposite condition. In this disorder it acts well with 
chloral, from twenty to forty grains of the former being administered with 
ten to twenty grains of the latter, as needed. Thus it is effectual where 
opium would be contraindicated. Bromide of potassium sometimes relieves 
in acute mania, with violent manifestations; and it is often a reliable 
medicine in acute puerperal mania. 
Congestive headache is relieved by potassium bromide, but it must 
be remembered that a bromide habit is readily acquired. Therefore, if 
other agents can be employed for victims of oft-repeated headaches the 
bromides may well be omitted. The same is true of insomnia. When of a 
sthenic type, but without headache, it assists the patient to sleep by calm- 
ing the irritability and subduing the activity of thought, which alone is 
often responsible for the sleeplessness. It is most applicable when insomnia 
is due to worry, grief, or mental strain, or work; it is less effective and nearly 
always fails when insomnia is due to pain, though it helps one to feel the 
pain less acutely. An exception is where the pain is that of migraine, and 
in some cases of neuralgia. It is hypnotic but not analgesic. 
Headache due to eye-strain is relieved by ten to fifteen grain doses 
every three hours, but as Foltz cautions, its protracted use is charged with 
causing recurrent corneal ulcers. Combined with caffeine it is frequently 
a most effective remedy for migraine. 
Many physicians use bromide of potassium (or of sodium) in whooping- 
cough, irritable laryngeal cough, in laryngismus stridulus, and in the laryn- 
geal crises of locomotor ataxia; and in acute laryngitis to limit the appre- 
ciation of pain and allay hoarseness. 
570 INDIVIDUAL DRUGS. 
POTASSII CARBONAS. 
Potassium Carbonate, Salt of Tartar. (Formula: K2CO3). 
Description.-An odorless, granular, white powder having a strong alkaline taste; 
very deliquescent and feebly soluble in cold and hot water, but insoluble in alcohol. Dose, 
5 to 30 grains well diluted with water. 
Specific Indications.-Leaden pallor of tongue and mucosa; muscular 
tremors; debility all out of proportion to other symptoms; articular pain. 
Action and Toxicology.-Carbonate of potassium, in concentrated 
solution, is an energetic caustic poison, destroying any portion of the gastro- 
intestinal canal it may reach. The chief symptoms are burning pain, 
prostration and vomiting (sometimes bloody), and if death does not occur 
shortly extreme emaciation may ensue, accompanied by constant irritation 
of the stomach and bowels. The antidotes are mild acids, as lemon juice or 
vinegar, to destroy the alkaline properties of the carbonate, or fixed oils to 
saponify the salt. 
Therapy.-External. Sometimes used in baths and in ointment or 
lotion for obstinate skin disorders with excessive seborrhoea. 
Internal. Antacid and diuretic. Though seldom used, it may, like the 
bicarbonate, be employed to overcome acidity of the stomach, and in 
urinary disorders showing a disposition to lithaemia. It is indicated oc- 
casionally in conditions presenting the indications noted under Specific 
Indications (see above). It should always be well diluted. Potassium 
carbonate is chiefly used in the preparation of the citrate and other salts of 
potassium. 
Potassium Chlorate, Chlorate of Potash. (Formula: KC103.) 
Description.-Permanent, lustrous and colorless, prismatic crystals or plates, or a 
granular white powder, without odor and having a saline taste. Soluble in cold and hot 
water or glycerin, but almost insoluble in alcohol. 
Caution.-Potassium chlorate should not be heated, triturated, or concussed with any 
organic substance (sugar, cork, dust, powdered vegetable drugs, etc.). A safe rule to 
observe is never to triturate it in dry form with anything that will burn. It is a powerful 
oxidizer and under such circumstances will explode. Dose, 1 to 15 grains. 
Specific Indications.-Puerperal sepsis; troubles arising from de- 
composition of fragments of placenta, blood-clots, and absorption of lochia; 
fetid lochia; fetid breath; fetor as of decaying flesh; pallid tongue, with 
pale or bluish membranes; ulceration of mucosa with foul discharges; 
tender gums and mouth with fetid salivation; tongue dirty, coated and thick; 
cough with purulent expectoration; discharges with a cadaverous odor. 
Action and Toxicology.-Potassium chlorate is stimulant and dis- 
infectant to mucous surfaces. It breaks up readily in the presence of septic 
material, oxygen being liberated. The old idea that it yielded oxygen to the 
blood is now thoroughly disproved and it is known to be eliminated un- 
changed from the body, and that largely by the salivary glands. Small 
doses have no effect upon the stomach and bowels; large doses may oc- 
casion very painful gastro-enteritis with prolonged vomiting. Death has 
resulted from this effect, and then the mucosa has been swollen and ecchy- 
motic. In the blood, large doses cause disintegration of the corpuscles and 
the formation of methaemoglobin, giving to that fluid a chocolate color. 
POTASSII CHLORAS. 
571 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Death may occur from asphyxia, from weakness of the heart, or more 
generally from uraemia. While large doses may kill in a few hours, generally 
death takes place after several days. Usually actual primary nephritis 
does not occur, but the uraemia and secondary nephritis result from the 
blocking up of the renal tubules with broken-down brown masses of de- 
stroyed blood discs. After death the liver, kidneys, and spleen may be 
found enlarged, softened, and gorged with disintegrated blood. Poisonous 
doses produce headache, faintness, great thirst, intense renal pain, vomiting, 
chills, reduced temperature, anemia, jaundice and cyanosis. The urine is 
almost or fully suppressed, dark chocolate in color, albuminous, and 
loaded with casts and broken-down discs. The treatment consists in 
washing out the stomach preferably with alkaline solutions, the use of such 
lenitives as mucilages of elm or acacia, and white of egg, or milk, cardiac 
and respiratory stimulants, and after subsidence of the active symptoms, the 
free use of fluid to rid the kidneys of obstructive debris. Hot baths aid the 
treatment. 
Therapy.-External. Chlorate of potassium when used in solution is 
one of the best of local cleansing and deodorizing agents for the purpose of 
removing unhealthy deposits giving off a cadaverous odor. Its local action 
is greatly aided by the coincident use of small doses of it internally. Not 
only is it an antiseptic, but it has gently stimulating properties. It is espe- 
cially applicable where the mucous surfaces show an accumulation of 
vitiated secretion, mucous patches, follicular ulcerations or any unhealthy 
and foul-smelling deposit. It may be sprayed upon the parts in pharyngitis, 
follicular tonsillitis, ulcerated tonsils, and in combination with tincture of 
chloride of iron and hydrochloric acid, it is highly efficient as a local medica- 
ment in diphtheria. The nascent chlorine liberated is the medicinal factor. 
In sluggish ulcerations it may be dissolved with hydrastin (never mix dry for 
fear of explosion) or with specific medicine hydrastis, in plenty of water. 
Locally, potassium chlorate solution forms one of the most useful 
washes for ulcerated mouth, especially that due to drugs or local irritants. 
It is particularly useful in mercurial stomatitis and salivation, but small 
amounts should be used lest the renal condition already produced by the 
mercurial be aggravated by the additional untoward action of the chlorate. 
When aphthous ulceration is due to a disordered stomach, or from the 
effects of too free use of canned tomatoes and similar foods, it is of less 
value than hydrastis, neutralizing cordial, phytolacca, berberis, internally, 
or coptis or ligustrum locally. But for tissue destruction of the mucous 
tracts due to inflammation, infectious or otherwise, potassium chlorate may 
be relied upon with confidence. In many cases of sore throat, mucous 
patches, tonsillar exudation, and sore mouth and tongue of smokers it does 
excellent service. The hydrastis and chlorate wash is more effective than 
the latter agent alone. For the distressingly painful and destructive 
aphthae of consumptives preventing the patient from taking food, Locke 
advised T$ Saturated Solution of Potassium Chlorate, fl§iv; Colorless 
Hydrastis, Glycerin, Syrup of Morphine, Simple Syrup, aa, fl^j. Mix. 
Sig.: One teaspoonful every three hours. A wash of it is soothing for ulcera- 
tion due to the pressure and abrasion from false teeth. For local use upon 
the mouth and throat a solution of 1 to 50 or 1 to 100 is sufficiently powerful. 
572 INDIVIDUAL DRUGS. 
Internal. Almost every writer upon materia medica has given the 
classic caution that potassium chlorate provokes renal irritation and in- 
flammation. It is unquestionably true that the large doses, as was the case 
with most chemicals when this agent was first employed, caused the poison- 
ous symptoms so frequently quoted. Quoted, we say, because we believe 
it more largely a quotation than a statement of actual experience. Almost 
daily employment of this drug for a quarter of a century gives one the 
right of testimony, and we can testify solemnly and truthfully that, when 
used as the Eclectic uses it, it has never caused the least aberration of the 
renal function. It takes but little of potassium chlorate to be effective, and 
from five to twenty grains to four ounces of water, given in teaspoonful 
doses every two, three or four hours, as indicated, is sufficiently strong for 
remedial purposes. A long experience with such solutions has given us 
confidence in its efficacy and no fear of harmful results. 
It is for its internal action that we value potassium chlorate most. 
There is nothing under the sun, when given internally, so certain to remove 
stench from secretions of the body which have undergone changes and have 
a decidedly cadaveric odor. No matter what the diseased condition, when 
we encounter this odor the patient is given potassium chlorate; invariably 
good results are obtained so far as the deodorizing process is concerned. 
Without question it is the best agent for offensive lochia, and, while it has 
been our policy not to give medicines without a positive indication, in 
obstetrics we have made it the exception to give a small quantity of potas- 
sium chlorate to forestall the odor so likely to supervene. There is no need 
of the obstetric chamber smelling like a charnel house if the patient be given 
a small portion of this medicine during the puerperium. When there is 
known to be a retention of placental and other debris, these should, of 
course, be removed mechanically. 
In offensive leucorrhcea we have found potassium chlorate equally 
effective. In foul-smelling diarrhoea it has occasionally been useful, but not 
of such value as in other odoriferous states. We have known it to correct 
fetid urine in cystic inflammation, and this, too, without the least damage 
to the kidneys. Notwithstanding its safety in general when given in doses 
above advised, one should be cautious about using it during or after scarlet 
fever, lest nephritic complications ensue, or when the mucous tissues are 
dry and secretion is scanty. In the use of potassium chlorate we have 
always been guided by the cadaverous odor-a veritable stink reminding 
one of the dissecting room-of the secretions and excretions. We have 
never found it of value to supply oxygen to the blood in anemia, as some 
have reported. 
POTASSII CITRAS. 
Potassium Citrate. (Formula: K3C1H5O7.H20.) 
Description.-Prismatic, transparent crystals, or a granular, white powder, devoid of 
odor but having a cooling, saline taste; deliquescent in the air; very soluble in water; 
freely dissolving in glycerin but not alcohol. Dose, 5 to 30 grains. 
Preparations.-1. Liquor Potassii Citratis, Solution of Potassium Citrate. Dose, 
1 fluidrachm to 1 fluidounce. 
2. Potassii Citras Effervescens, Effervescent Potassium Citrate. Dose, 60 to 120 
grains. 
573 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS- 
Specific Indications.-Irritability and acidity of the stomach in 
marasmic infants. 
Action and Therapy.-Solution of potassium citrate is an agreeable 
refrigerant preparation often used as a vehicle for the arterial sedatives. 
It acts mildly upon the bowels, kidneys, and skin, increasing their secretions. 
In the blood it is converted into a carbonate, thus increasing the alkalinity of 
that fluid and rendering acid urine alkaline. It may be used to allay irrita- 
bility of the stomach, as an adjuvant to other medicines in acute bronchitis, 
and in moderate doses of the salt (20 grains) in incontinence of urine due to 
concentrated acid urine. We have found this salt in very dilute solution 
one of the best agents to overcome repeated vomiting from irritability and 
acidity of the stomach in marasmic infants. It should be well diluted. 
As a fever drink it may be used freely, first sweetening it to taste. An 
agreeable extemporaneous form is prepared by adding the juice of one- 
half lemon and a half ounce of water to a solution of one drachm of potas- 
sium bicarbonate in four ounces of cold water. Mix the two solutions and 
administer while effervescing. Uric acid diathesis may be improved by 
potassium citrate, which may also be employed as a refrigerant diuretic in 
fevers, post-scarlatinal dropsy, and in general dropsies due to cardiac 
weakness. It is, however, of no special value in dropsy of the body cavities. 
POTASSII ET SODII TARTRAS. 
Potassium and Sodium Tartrate, Rochelle Salt. (Formula: KNaC4H4O64-4H2O.) 
Description.-Transparent, colorless crystals, or a white, odorless powder, having a 
cooling, saline taste. Slightly efflorescent in dry air; very soluble in water, and almost 
insoluble in alcohol. Dose, 60 to 180 grains. 
Preparation.-Pulvis Effervescens Compositus, Compound Effervescing Powder 
(Seidlitz Powder). Blue Paper contains Potassiun and Sodium Tartrate, and Sodium 
Bicarbonate. White Paper contains Tartaric Acid. Dose, a set of the two powders, each to- 
be separately dissolved in a half glass of water and the two solutions mixed just before 
swallowing. 
Action and Therapy.-A mild, cooling laxative in moderate doses; 
purgative in large doses. It should be given well diluted with water. 
When administered in a small dose, well diluted, it is absorbed and renders 
the urine alkaline. Hence it is used sometimes in acidity of the urine 
(avoiding it if phosphates are present), and in acute rheumatic fever, with 
acid urine. Rochelle salt is an ingredient of the well-known Seidlitz Powder 
(see above) used largely by the laity in lieu of magnesium sulphate, when 
a brisk, watery catharsis is desired. 
Potassium Hydroxide, Caustic Potash, Potassium Hydrate, Potassa. (Formula: 
KOH.) 
Description.-An odorless, dry, white or nearly white salt, occurring in fused masses, 
or in sticks, of a hard and brittle consistence and breaking with a crystalline fracture. 
Upon exposure to air it absorbs carbon dioxide and moisture and becomes deliquescent. 
It is very soluble in water and alcohol. Owing to its tendency to destroy tissues and form 
soaps with fats it should be handled with great caution. 
Preparation.-Liquor Potassii Hydroxidi, Solution of Potassium Hydroxide. (Liquor 
Potassse, Solution of Potassa.) Dose, 5 to 30 minims largely diluted. 
Specific Indications.-Frequent and difficult urination with sense of 
perineal constriction; strangury; leaden pallor of tongue and mucosa; 
POTASSII HYDROXIDUM. 
574 INDIVIDUAL DRUGS. 
feeble, tremulous muscles; fullness of muscular tissue; debility all out of 
proportion to the diseased condition. 
Action and Toxicology.-Salts of potassium, if given for any great 
length of time or in enormous doses, have a distinctly depressive action 
upon the heart and the central nervous system. This effect is widespread, 
extending even to the muscular system. The cord seems especially sus- 
ceptible to their influence, and both motor and sensory depression results; 
the brain also suffers to some extent, while in ordinary medicinal doses, 
not too long administered, such effects are not often met with, still it is 
well to bear in mind this depressive influence in cases of weak heart or in 
various disorders of that organ. 
Caustic potash is powerfully corrosive. Applied to soft animal struc- 
tures it first dehydrates and then rapidly disorganizes them, combining 
with the fatty constituents to form soap. This is followed by extensive 
inflammation and subsequent deep sloughing. Swallowed it is an intense 
irritant and corrosive poison, causing intense burning pain throughout the 
gastro-intestinal tract, acrid caustic taste, vomiting of alkaline and bloody 
material, diarrhoea, delirium, spasm, and cold, clammy surface. Death 
quickly follows if the dose is large and not vomited; if not immediate it may 
result later, even after months, from the effects of inflammation and ulcer- 
ation, and subsequent stricture of the esophagus, causing starvation. 
The long-continued use of potassa may occasion symptoms resembling 
scurvy. 
The chemical antidotes to poisoning by caustic potash are the acids, 
as vinegar and lemon-juice. Acids in themselves corrosive should be 
avoided. Fats and oils may be administered freely to combine with the 
potash and to protect the tissues. Opiates may be given to allay pain. 
The subsequent gastro-enteritis may be treated in the usual way with 
lenitives and protectives. Emetics should not be used lest rupture of the 
softened tissues takes place. 
Therapy.-External. Caustic potash and the liquor potassae are used 
to soften coms, bunions, warts, and callosities, and to destroy fungous 
granulations and soften the nail in the treatment of overgrown toe-nail. 
Added to sulphur ointments it materially aids in softening the burrows in 
the treatment of scabies. 
Internal. Caustic potash, in the form of liquor potassae, is sometimes 
administered as an antacid, for which it is less useful than the bicarbonates. 
It is more effectual as an agent to alkalinize the urine, and as such has been 
employed considerably in the tendency to uric acid formation, in acidosis, 
in rheumatism and gout, and in the strangury accompanying gonorrhoea. 
On account of its power to lessen the viscosity of secretions, it is sometimes 
added to cough mixtures to be administered in chronic bronchitis. As a 
rule, it should be given midway between meals. 
POTASSII HYPOPHOSPHIS. 
Potassium Hypophosphite. (Formula: KPH2O2.) 
Description.-Very deliquescent, opaque, white plates or crystalline masses, or a 
granular, white powder; without odor but having a sharp saline taste. Very soluble in 
water, and less freely in alcohol. Dose, 2 to 15 grains. 
Specific Indications.-Atony, with pallor of tongue and mucosa; 
575 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
muscular soreness, tenderness, pain or lameness; chronic cough, with 
pectoral pain and irritation, pulse weak and rapid; emaciation. 
Action and Therapy.-Potassium hypophosphite improves digestion, 
blood-making, and nutrition; and relieves tenderness and lameness of the 
muscles. In the form of the syrup it is quite popular as a remedy for 
laryngeal and bronchial irritation with cough, and as a reconstructive for 
those inclined to phthisis and chronic bronchitis. 
POTASSII IODIDUM. 
Potassium Iodide, Iodide of Potash. (Formula: KI.) 
Description.-Colorless and transparent, or more or less opaque or white cubical 
crystals, or a granular, white powder, having a pungent, saline, afterwards bitterish or 
metallic taste; slightly deliquescent in moist air; permanent in dry air. Very soluble in 
water and glycerin, and somewhat less in alcohol. Dose, 1 to 20 grains (usual dose from 1 
to 5 grains, preferably at meal time). 
Specific Indications.-Pale, leaden-colored, rather full tongue; dryness 
of the mucosa; nocturnal pains; tertiary and late secondary syphilis, with 
above-mentioned tongue; blue line on gums (chronic lead poisoning); 
adenopathy. 
Action.-Iodide of potassium is quickly absorbed and very rapidly 
eliminated, though a small portion may be retained in the body; and if 
repeated in overlapping doses, or in continuous use, it may become cumula- 
tive. It has been detected in the urine within a quarter of an hour after its 
administration. While most of the drug is eliminated in the urine, it may 
also pass into the saliva, perspiration, tears, and the milk. A moderate 
dose with most individuals merely disturbs digestion, and augments the 
output of urine. Large doses, however, cause nausea and vomiting, with 
burning in the stomach, and diarrhoea. A not uncommon effect of even 
small doses in susceptible individuals is a condition simulating "summer 
catarrh". Being excreted by the air passages partially it sets up a most 
violent coryza, with bronchorrhoea and swelling and congestion, and even 
inflammation of the pharynx and larynx and conjunctivae. The action may 
be so severe as to inflame the frontal and maxillary sinuses and to produce 
hoarseness, shortness of breath, oedema of the larynx, impairment of sight 
and speech, and a paretic condition of the organs of speech. This peculiar 
form of iodism once experienced is not readily forgotten, and sleep is practi- 
cally out of the question while it is in force. According to some prescribers 
small doses more often excite these symptoms than fuller doses, and if the 
drug be given with the meal it is less apt to cause "iodide punishment". 
Iodide of potash is usually well tolerated, however, if syphilis is present, 
though even that disease does not always prevent iodic discomfort. 
Iodine, and the iodides in particular, if given for a long period 
produce a train of symptoms known as iodism. This is usually present in 
the coryzal form, with frontal headache, sneezing, soreness of the throat, 
lachrimation, and ptyalism, but it may also produce decided skin and con- 
stitutional symptoms. Thus it is not uncommon for indurated acne to 
appear, and less commonly urticaria, watery or bloody blisters, and iodic 
purpura. Hydroa, or very painful large watery or bloody blebs, sometimes 
form, with fatal consequences. Iodic skin lesions often show a violaceous 
576 INDIVIDUAL DRUGS. 
coloration so striking that once seen it is easily identified afterward. As a 
rule iodism subsides rapidly upon the withdrawal of the drug. Sucklings 
may become emaciated from the milk of mothers who are being treated 
with iodides. 
In some instances, probably through a toxic effect upon the thyroid 
glands, decided symptoms of Grave's disease, cardiac palpitation, tachy- 
cardia, tremor, loss of weight, and excessive sweating have come from the 
abuse of iodides; and cases of atrophy of the mammae and testicles, and 
profound cachexia and emaciation have been reported from their im- 
moderate use. Iodide of potassium is likely to do harm when the kidneys 
are chronically diseased, and at all times should be cautiously used when 
renal inactivity is pronounced. While- so small a dose as five grains may 
produce great discomfort, as high as five hundred grains have been given 
daily in cases of tertiary syphilis, without iodic aggravation. 
Therapy.-Iodide of potassium is a widely used and useful remedy, 
but one recklessly given and often without rhyme or reason. When not 
indicated, or better when contraindicated, as in chronic nephritis, it may do 
irreparable harm. It is, perhaps, one of the best of so-called alteratives or 
agents which "increase retrograde metamorphosis", forming in some 
instances, as in metallic poisoning, double salts, and in others being elimi- 
nated with the broken-down tissues of the body. When its action is pushed 
beyond the therapeutic limits then it attacks the healthy tissues and does 
harm. The axiom laid down by Scudder is a fairly good one, though not 
always absolutely to be followed; i. e., that it should be selected when there 
is a "broad, pallid, leaden-colored tongue, rather full. With this indication, 
it is a very certain antisyphilitic, whilst with a red and contracted tongue 
it is pretty sure to do the patient injury." 
The use of the term antisyphilitic as here employed should be regarded 
relatively. The drug is probably not an antisyphilitic in the sense that it 
destroys the treponema, but in effect it proves a remedy against conditions 
prevailing late in the course of the disease. Were it a true antisyphilitic it 
should prove effective in the very inception of the infection. As a matter 
of fact it is never useful or effective in the early stage of syphilis, but in the 
tertiary stage, or in the later period of the secondary stage just as it is about 
to pass into tertiary, is when iodides prove most valuable medicines. In the 
parasyphilitic conditions-in syphilis of the nervous system it is the most 
commonly used drug. Thus it is relatively useful in arteriosclerosis, paretic 
dementia and locomotor ataxia, but it is successful only in so far as there 
is still sound tissue to act upon. It is frequently used by syphilologists 
as a diagnostic measure in syphilis, lesions promptly responding if that 
disease is present. 
While this is unquestionably the most generally useful drug in syphilis 
(acting equally as efficiently as mercury and without the damage caused by 
the latter), it is likely to do harm if given in the early stage, and this point 
cannot be too strongly emphasized. It does no good so far as the disease 
is concerned, and produces a profound effect, not needed at this period, upon 
the tissues. Good care and hygienic measures are to be preferred. In the 
late secondary stage it may be given preferably in syrup of stillingia, with 
or without iris, phytolacca, berberis aquifolium, or podophyllum, as in- 
577 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
dicated. At this period the doses need not be large. In the tertiary mani- 
festations, however, full doses are required and are well tolerated, especially 
if there are ulcerative and periosteal complications. Even here iodism 
should be avoided, if possible, lest it add to the damage already caused by 
the ravages of the disease. Ulcerative syphilitic destruction, caries, peri- 
ostitis, nocturnal "bone-pains", nocturnal neuralgias, gumma, fibrous thick- 
enings and deposits, inflammatory in character, about the joints, upon 
nerve trunks and tendons, and in the periosteal membranes, and in all 
disorders having as an underlying basis syphilitic dyscrasia come well 
within the field of usefulness of this salt. Almost invariably the indications 
as given by Scudder lead to the best results. 
Iodide of potassium has been largely used in so-called chronic rheuma- 
tism. It is of no value in acute articular rheumatism. In rheumatoid ar- 
thritis it is frequently effective, and it or the syrup of the iodide of iron is 
among the valuable medicines in gonorrhoeal arthritis. Probably most of 
the cases of chronic rheumatism benefited by the drug are those having 
a syphilitic taint or dependent upon chronic metallic poisoning. Occasion- 
ally it is of value in sciatica and lumbago, but fails oftener than it succeeds 
in giving relief. 
Iodide of potassium is the most certain remedy in chronic lead, mer- 
curial or arsenical poisoning. Often the conditions are at first aggravated, 
but eventually yield to the drug. Not more than twenty grains should be 
given in a day. 
Glandular swellings in ill-nourished children frequently yield promptly 
to this salt, or better to syrup of iodide of iron. In actinomycosis it is 
usually the drug of preference. Owing to its probable action upon fibrous 
tissue it has been advised in hepatic cirrhosis, but apparently does good only 
in the early stages; similarly it may do good in chronic interstitial nephritis. 
In parenchymatous nephritis it is sure to damage the patient, and should 
not be used even though syphilis is present. Nor should it be given to con- 
sumptives in whom it usually proves an aggravation, except in the rarer 
cases of fibrous phthisis. 
Iodide of potash is invaluable in recurrent bronchial asthma, with 
tenacious secretions and the presence of Curschmann's spirals. It is a good 
intercurrent remedy to ward off the attacks, as it is also in angina pectoris, 
being second only to the nitrites in preventing the recurrence of seizures of 
the last-named affection. In asthma it liquefies the secretions and thus aids 
expectoration. For this reason it is also frequently serviceable in dry forms 
of cough, and in congestive and purulent types of bronchitis. As soon as 
the secretions become attenuated the dose should be lessened lest debility 
ensue. Probably this salt is as useful as any agent in promoting absorption 
of excessive fluid in pleurisy and pericarditis. For mechanical effects 
and on account of a thickening effect upon the blood it has been advised 
in aortic aneurism, but has proved of but little value. 
When skin diseases depend upon a syphilitic origin this agent is one 
of the most certain to give relief. Even in those conditions denominated 
.scrofulous-in which glandular enlargements accompany the skin lesions- 
it is a most effectual drug. Eye disorders-corneal ulcer and rheumatic 
and syphilitic iritis-are well treated with five grain doses of the iodide at 
578 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
each meal. Iodide of potassium may be given, well diluted, in water or 
milk, or in syrup of stillingia, sarsaparilla, or wild cherry. 
POTASSII NITRAS. 
Potassium Nitrate, Nitre, Saltpetre. (Formula: KNO3.) 
Description.-Large transparent, colorless, six-sided crystals, or a white, crystalline 
powder; no odor; of a saline taste imparting coolness to the mouth. Very soluble in 
water; less soluble in alcohol (620). Dose, 2 to 15 grains. 
Specific Indications.-Renal atony, with scanty urine and difficult 
breathing; acute rheumatism with excessive tenderness; aching testicular 
pain; asthmatic breathing (vapor). 
Action.-Potassium nitrate disorders the blood when taken in full 
doses for a continued period of time, that medium becoming thinner, the 
white corpuscles increased, and the red discs rendered paler. General 
lassitude, fatigue on exertion, mental and physical indisposition, with a 
weak and slow pulse, bruised sensation in the joints, and a disposition to 
drowsiness have been observed from it. One ounce in concentrated solu- 
tion has caused death by inducing violent gastro-enteritis. 
Therapy.-External. Inhaled from burning bibulous paper saturated 
with a solution of this salt and dried, great relief is often experienced in 
spasmodic asthma. Together with lobelia, stramonium and similar plants, 
it is an ingredient of many popular "asthma powders" and "cigarettes". 
Internal. Potassium nitrate is diuretic and refrigerant, and is some- 
times of value in acute inflammatory rheumatism, with excessive tender- 
ness. It should be given in five to twenty grain doses, largely diluted. 
King valued it for aching of the testicles in masturbators and those ad- 
dicted to excessive venery. 
POTASSII PERMANGANAS. 
Potassium Permanganate, Permanganate of Potash. (Formula: KMnO4.) 
Description.-Slender crystals, dark purple in color, almost opaque by transmitted 
light, and of a blue, metallic lustre in reflected light; no odor; and when dissolved having 
a sweetish, afterwards disagreeable, nauseous, astringent taste. Freely soluble in water, 
but decomposed by alcohol. Dose, 1 to 2 grains. 
Caution.-This salt must not be brought into contact, either dry or in solution, with 
organic or readily oxidizable substances. (See Potassii Chlor as.It should only be used in 
simple solution in water; although pills made up with kaolin or paraffin have been advised. 
Mixed in any other way it is likely to explode. 
Specific Indications.-Locally. Flabby, pale, unhealthy and half- 
rotten granulations; fetid surfaces; swollen, infiltrated surfaces with lack 
of reparative power; low inflammations, with infiltration of connective 
tissues; inflammation, with low vitality and inclination to slough; watery, 
ichorous pus; to abort boils and felons (used very early); phlegmonous 
erysipelas. 
Internally. Atonic amenorrhoea, with mental depression and pelvic 
weight. 
Action.-Used full strength upon most tissues this salt is caustic; and 
concentrated solutions may cause dermal irritation and corrosion. When 
the skin is broken a hot, smarting pain is felt. In contact with proteids it is 
quickly decomposed, giving up some of its oxygen, in consequence of which 
579 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
it proves a powerful oxidizing poison to protoplasm. Owing to its easy 
decomposability it does not penetrate deeply, but upon the surface of the 
skin and mucosa it acts as an efficient but fleeting antiseptic. It is a 
good deodorizer, and to some degree a disinfectant. Internally it produces 
a disagreeable heartburn and gastric uneasiness with a sense of substernal 
pressure. Its taste is sweetish and disagreeable, and on account of its easy 
destructibility it is not readily absorbed. It stains the tissues and fabrics 
brown. 
Therapy.-External. Used locally, in proper dilution, potassium 
permanganate is stimulant, deodorant, and disinfectant. As a general 
cleansing antiseptic for surface purposes it is safe and preferable to many 
of the more toxic agents. As a local wash in all forms of sore throat-specific, 
diphtheritic, or otherwise-this agent is one of the very best. If its use is 
begun early in threatened tonsillar inflammation, within four or five hours 
after the first uncomfortable sensations are felt, it frequently aborts a dis- 
tressing tonsillitis. If that disorder gets a half day's start, it has been 
our experience that few, if any, agents are capable of aborting it. But it 
may be aborted if permanganate of potash is used at the very outset. A 
weak solution of not over 2 per cent strength may be used as a spray or 
wash every three hours. We do not favor gargling on account of its violence 
and the congestion caused by such an effort. Gargles often defeat their 
intended purpose. The act of gargling causes a strangulation of parts with 
increased congestion. Rinsing does no such harm. Swabbing the parts is 
liable to cause trauma, and thus an added complication is to be feared. 
As a wash, water should be made slightly more than a decided pink colora- 
tion with the salt, and used preferably slightly warmed. Where cold is de- 
sirable it may be used in iced water. Unfortunately its peculiar taste is 
decidedly nauseating to some, but most persons can use it without dis- 
comfort. Once every three hours is usually sufficiently often to use it 
unless the parts are extremely fetid, when every hour is none too often. 
In case tonsillitis progresses, no better wash can be used to control local 
conditions, and the same may be said of it in other forms of throat in- 
flammation, as quinsy, pharyngitis, faucitis, and in the more infectious 
diphtheria. Nothing more quickly removes stench and causes quick slough- 
ing of tonsillar exudates than this agent. 
Potassium permanganate should be used by irrigation (1 part to 2,500 
of water) in gonorrhoea in both male and female. It may be necessary to 
use a mild silver solution at first, but the bulk of the treatment should be 
by irrigation with solution of this salt. It is painless in less than 5 per cent 
solutions and effectively deodorizes and cleanses the diseased parts. For 
leucorrhcea it is one of the most effective of douches, but to cure must be 
persisted with for some time. Potassium permanganate is used to cleanse 
minor wounds, to dress sluggish and foul-smelling ulcers of any type, and 
to deodorize stinking feet (bromidrosis). It is useful also, used almost full 
strength, to relieve the distress of rectal ulcer or fissure, and in weaker 
dilutions to cleanse the parts when discharging, and to remove odor and 
allay itching. Many cases of ivy poisoning may be quickly cured by a lotion 
of about 5 to 10 per cent strength; moreover, it promptly allays the burning 
and itching. It is one of the agents which gives local relief in erysipelas. 
580 INDIVIDUAL DRUGS. 
Weir-Mitchell is authority for the statement that the permanganate 
is effective as an antidote to snake bite. It should be applied in powder 
before the venom is absorbed, or immediately injected in strong solution 
into and around the wound. We rely upon it wholly for the cleansing of 
carbuncles and have had old tibial ulcers of years' standing heal under its 
local application, together with rest in bed. In carbuncle a solution of one 
part to two of water may be injected after thorough incision. Some treat 
felons in a similar manner. Ozaena, cancer of the tongue, necrosis of the jaw, 
stomatitis, the angina of scarlatina, etc., are similarly cleansed and deodorized 
by this solution. Gauze saturated with a strong solution may be used to 
mask the odor of carcinoma. As a deodorant, stimulant to sluggish tissues, 
and to alleviate inflammation of the throat and other mucous passages, we 
regard it as indispensable. Its greatest drawback is its staining quality, 
but the stains may be removed from garments and other fabrics by a 
very dilute solution of sulphuric acid or of oxalic acid, quickly and 
thoroughly rinsing them afterward to prevent destruction of the materials. 
Some surgeons use potassium permanganate for hand sterilization 
previous to operating. The hands and forearms are thoroughly scrubbed 
for several minutes, then rinsed and immersed in a saturated solution of 
potassium permanganate for three minutes. This stains a deep brown. 
This color is then removed by immersion in a warm saturated solution of 
oxalic acid. Many follow this (Welch-Kelly method) with rinsing in sterile 
water and subsequent immersion in a solution of mercuric chloride 
(1 to 5,000). The latter procedure is apt to be hard on the hands. 
Scudder (Specific Medication) defined the indications for the topical uses 
of this salt as follows: "Where the tissues are swollen from infiltration into 
the connective tissue. In case of wounds we will notice that the edges are 
swollen and the process of repair stops. The infiltration continuing, the 
pus becomes watery and ichorous, granulations pale and flabby; the parts 
separate, and finally slough. In inflammation we have very nearly the 
same indications-the inflammation always being of low grade, and show- 
ing infiltration of cellular tissue." Locke (Materia Medicd) briefly puts the 
indications as "fetid surfaces with granulations half rotten and half alive." 
Internal. This salt is seldom used internally by Eclectic physicians. 
It has, however, sound endorsement as a chemical antidote for the vegetable 
alkaloids, notably morphine, and for poisoning by phosphorus. If used at 
once it may destroy morphine before it can be absorbed. If already 
absorbed it may destroy that which is excreted into the stomach afterward- 
a process which is known to take place with many poisonous substances. 
A solution of two grains for every grain of morphine swallowed is advised. 
Rarely it may be used in amenorrhoea from cold or from fright, when there 
is mental depression and pelvic weight. Usually the dose required (about 
2 to 5 grains) is sufficient to cause gastric irritation and severe pain, so that 
there is no advantage to be gained, especially when there are so many safer 
and pleasanter specific agencies to restore retarded menses. It has also been 
advised to reduce excessive fat and for the flatulent dyspepsia, often 
suffered by the obese. For most internal purposes it is not a safe and 
satisfactory agent. 
581 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
PRINOS. 
The bark and berries of Prinos verticillatus, Linne (Nat. Ord. Aquifoliaceae). Moist 
woods and streams throughout the United States. Dose (bark), 5 to 60 grains. 
Common Names: Black Alder, Winterberry. 
Principal Constituents.-Resin, tannin, and an amorphous, bitter principle. 
Preparation.- Tinctura Prini, Tincture of Prinos (Bark, 3 viii to Alcohol (76 per cent), 
Oj). Dose, 5 to 60 drops. 
Action and Therapy.-Black alder is tonic, astringent and alterative, 
and especially effective as the latter. Many alterative syrups contain 
black alder. The berries are cathartic and vermifuge. Tincture of black 
alder and specific medicine hydrastis form an excellent tonic in atonic 
dyspepsia, when debility is marked and there is a tendency to diarrhoea. 
PRUNUS VIRGINIANA. 
The stem-bark of Prunus serolina, Ehrhart (Prunus Virginiana, Miller), collected in 
the autumn and carefully dried (Nat. Ord. Rosacese). Woods of eastern half of the United 
States. Dose, 5 to 60 grains. 
Common Names: Wild Cherry, Wild Black Cherry Bark. 
Principal Constituents.-Amygdalin (acted upon by water yields hydrocyanic acid, 
oil of bitter almond, and glucose); emulsin (destroyed by heating), and tannic acid. 
Preparations.-1. Specific Medicine Prunus. Dose, 5 to 60 drops. 
2. Syrupus Pruni Virginiana, Syrup of Wild Cherry. Dose, 1 to 2 fluidracnms. 
Specific Indications.-Weak, rapid circulation; continuous irritative 
cough, with profuse muco-purulent expectoration; cardiac palpitation from 
debility; cardiac pain; dyspnoea; loss of appetite and gastric irritability. 
Action and Therapy.-Wild cherry is an excellent sedative and tonic, 
quieting irritation of the mucosa, terminal nerves, and lessening violent 
cardiac action dependent upon weakness. When a tonic and sedative is 
desired that will not unduly excite the circulation, wild cherry is a most 
useful drug. As such it may be used in atonic dyspepsia, and in con- 
valescence from fevers and inflammations, especially after pleurisy, pneu- 
monia, and la grippe. While the syrup is an effectual and popular prep- 
aration, the cold infusion is better for these purposes. 
Wild cherry in syrup is an admirable sedative for cough, acting much 
like hydrocyanic acid and even better, besides it is more controllable. 
For the cough of phthisis it is one of the most satisfactory agents, and the 
syrup is in common use as a vehicle for other cough remedies. In phthisis 
it not only relieves irritation and cough, but it gives a certain amount of 
power, and restrains colliquative sweating and diarrhoea. Wild cherry may 
be used in most cases of irritation of the mucosa with or without hyper- 
secretion in any part of the body-pulmonic, gastro-intestinal and renal. 
Wild cherry is very efficient in uncomplicated palpitation of the heart, 
and where digitalis is required it lessens the irritative action of the latter 
upon the stomach. Wild cherry would be more valued if properly prepared. 
The cold infusion (sweetened, if desired) should be preferred; boiling 
temporarily destroys its value, and unless a good quality of bark, carefully 
preserved, is used, the svrup may have little value. 
582 INDIVIDUAL DRUGS. 
PTELEA. 
The bark of the root of Ptelea trifoliata, Linne (Nat. Ord. Rutacese). A common shrub 
of the United States, especially west of the Alleghenies. Dose, 5 to 30 grains. 
Common Names: Wafer Ash, Shrubby Trefoil, Wing Seed, Hop Tree. 
Principal Constituents.-Resins, a volatile oil, a berberine-like bitter, and arginine 
(C6HuN4O2). 
Preparation.-Specific Medicine Ptelea. Dose, 1 to 30 drops. 
Specific Indications.-Asthmatic dyspnoea; chronic diseases with con- 
striction of chest and short breathing. 
Action and Therapy.-Ptelea is regarded by some as second only to 
hydrastis as a tonic. It acts as a sedative to irritated membranes, and is 
said to be tolerated by the stomach when other tonics might aggravate. 
The field in which it has been mostly used is in convalescence from fevers, 
debility resulting from gastro-intestinal irritation, and in asthmatic seizures 
accompanied by a sense of constriction in the thorax. 
PULSATILLA. 
The recent herb of Anemone Pulsatilla, Linn6, and of Anemone pratensis, Linne, 
collected soon after flowering (Nat. Ord. Ranunculaceae). Southern Europe and Asia. 
Common Names: Pasque-Flower, Passe-Flower, Meadow Anemone, Wind Flower. 
Principal Constituents.-A yellow, acrid oil, yielding anemone camphor, a vesicating 
principle easily decomposing into anemonin (CwHgOO and isoanemonic acid. 
Preparation.-Specific Medicine Pulsatilla. Dose, 1/10 to 10 drops. {The usual form 
of administration: 3 Specific Medicine Pulsatilla, gtt. v to xxx; Water, q. s., fl^iv. Mix. 
Sig.: One teaspoonful every 2 or 3 hours.) 
Specific Indications.-Nervousness with despondency, sadness and 
disposition to weep, without being able to tell why, or to weep while asleep; 
unnatural fear; fear of impending danger or death; morbid mental ex- 
citation associated with physical debility; marked depression of spirits; 
insomnia, with nervous exhaustion; pain, with debility; headache, with 
nervousness, not dependent on determination of blood to the head; neuralgia 
in anemic nervous subjects; mental depression and gloom over reproductive 
wrongs and disturbances, as spermatorrhoea, and tardy and insufficient 
menstruation (with sense of fullness and weakness in back and hips); 
nervous collapse, due to overwork, sexual indulgence, masturbation, 
or to the excessive use of tobacco; amenorrhoea, with chilliness and mental 
depression; dysmenorrhoea, with gloomy mentality and chilliness; pain 
from exposure to winds; epiphora; styes; deep-seated heavy pain in the 
globe of the eye; jumping toothache from abscess near the dental pulp; 
stomach disorders from indulgence in pastries and fats; pasty, creamy, or 
white coating upon the tongue, with greasy taste; thick, bland, and in- 
offensive mucous discharges; alternating constipation and diarrhoea, with 
venous congestion. 
Action.-Topically applied, the fresh plant of pulsatilla is irritant, and, 
if kept long in contact with the skin, may vesicate. When chewed, it 
produces a benumbing sensation and tingling formication, somewhat like 
that produced by aconite or prickly ash. Taken internally in overdoses, it 
is a gastric irritant, producing a sense of rawness, burning pain in stomach, 
with endeavors to vomit, all accompanied by marked prostration. A 
sense of constriction and tightness of the chest, with chilliness, marked 
583 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
weakness, and some congestion, has been produced by large doses. Full 
doses depress the action of the heart, lower arterial tension, and reduce 
temperature. Sensory and motor paralyses have followed very large doses 
of pulsatilla, while toxic doses may produce mydriasis, stupor, coma, and 
convulsions. In medicinal doses, pulsatilla increases the power and regulates 
the action of the heart, and gives a better character to the pulse rate, 
particularly slowing the irritable, rapid and feeble pulse due to nervous 
depression. It improves the sympathetic system and cerebral functions, 
and especially strengthens sympathetic innervation, this action being very 
marked in troubles of the reproductive organs of the male and female. 
Therapy.-External. The value of pulsatilla has been emphasized in 
"jerking" or "jumping" toothache, usually due to the formation of a pus 
cavity near the nerve. Full strength specific medicine pulsatilla, or diluted 
one-half with water, is applied besides giving the drug internally. This 
treatment is also commended as "especially useful in inflammations caused 
by dead teeth, and the inflammatory, painful, and unpleasant conditions 
of the pulp cavity in those in which the nerve has been destroyed." 
Internal. Though not of Eclectic origin, pulsatilla is one of the most 
important medicines in Eclectic therapy. For certain nervous phases, both 
in acute and chronic diseases, no remedy can exactly duplicate its action. 
It is most largely employed in nervous conditions of the debilitated, par- 
ticularly women and children, in mental disorders, and in stomach derange- 
ments and disorders of the reproductive tract with debility and faulty 
nutrition of the nerve-centers. All through the indications for pulsatilla 
run depression and irritability with melancholy and sadness, and a dis- 
position to look upon the dark side of life. With this gloomy mentality 
there is more or less of restlessness. The patient is easily inclined to weep, 
is unsettled and the mind wanders. Thought is concentrated with diffi- 
culty, the pulse is soft, open, and weak, and altogether the patient is 
miserable and despondent. Scudder, who introduced it into Eclectic 
practice, declared its most important use is to allay irritation of the nervous 
system in persons of feeble health, thus giving sleep and rest, preventing 
unnecessary expenditure of nerve force, and by this means facilitating the 
action of tonics and restoratives. He found it to be most certain in its 
action in feeble women and men who have become nervous from sedentary 
habits or mental overexertion, as well as in the nervousness and restlessness 
of masturbators, or persons addicted to the excessive use of tobacco. He 
also declared it the remedy for nervous women when there is debility and 
faulty nutrition of the nerve centers. 
Pulsatilla, though a remedy of wide applicability, is particularly 
adapted to conditions in which the depressed mind is a prominent factor. 
A gloomy mentality, a state of nerve depression and unrest, a disposition 
to brood over real or imagined trouble, a tendency to look on the dark side 
of life, sadness, mild restlessness, and a state of mental unrest generally 
denominated in broad terms "nervousness", are factors in the condition 
of the patient requiring pulsatilla. As stated before, the pulsatilla patient 
weeps readily, and the mind is inclined to wander-to be unsettled. The 
pulse requiring pulsatilla is weak, soft, and open, and the tissues have a 
tendency to dryness (except when the mucous tissues are discharging 
584 INDIVIDUAL DRUGS. 
thick, bland material), and about the orbits the parts appear contracted, 
sunken, and dark in color. The whole countenance and movements of the 
body depict sadness, moroseness, despondency, and lack of tone. Hysteria 
of the mild and weeping form may be a symptom. The complex is one of 
nervous depression, the nutrition of the nerve centers is at fault. With 
such symptoms, pulsatilla may be confidently prescribed in the conditions 
and disorders enumerated in this article. 
Pulsatilla may be given to induce sleep when there is great exhaustion 
and opiates are inadmissible. If the insomnia depends upon determination 
of blood to the brain, pulsatilla will not relieve, but when due to nervous 
exhaustion it is a prompt remedy to give rest, after which sleep obtains. 
Where sleep is disturbed by unpleasant dreams, and the patient awakens sad 
and languid, pulsatilla should be given. 
Pulsatilla has a large field of usefulness in troubles incident to the 
reproductive organs of both sexes. As an emmenagogue, it serves a useful 
purpose in amenorrhoea in nervous and anemic subjects, with chilliness a 
prominent symptom. When menstruation is suppressed, tardy or scanty 
from taking cold, or from emotional causes, pulsatilla is the remedy. In 
dysmenorrhcea, not due to mechanical causes, and with the above-named 
nervous symptoms, few remedies are more effective. Leucorrhoea, with a 
free, thick, milky or yellow bland discharge and pain in the loins, and 
particularly in scrofulous individuals, calls for pulsatilla. It is useful in 
mild forms of hysteria, where the patient is weak and weeps, has fears of 
impending danger, and passes large quantities of clear, limpid urine, and 
menstruation is suppressed. The long-continued use of pulsatilla as an 
intercurrent remedy is accredited with curative effects in uterine colic, but 
it is of no value during an attack. Pulsatilla frequently relieves in ovaritis 
and ovaralgia with tensive, tearing pain. Sluggish, ineffectual, and weak 
labor-pains are sometimes remedied by this drug, though it is seldom used 
for this purpose since more active agents have come into use. It frequently 
alleviates pain when dependent on or associated with debility, and some- 
times when due to acute inflammation. In epididymitis and orchitis, 
whether due to gonorrhoeal infection or to metastasis from mumps, it is 
quite universally employed by practitioners of all schools of medicine. Here 
the dose should be large. The dark-red, congested, enlarged, and sensitive 
testicle indicates it. It relieves the pains of orchialgia, and subdues mam- 
mary swelling from the metastasis of mumps. Pulsatilla increases sexual 
power, but lessens morbid sexual excitement. It is especially valuable in 
relieving urethral irritation and consequent spermatorrhoea and prostator- 
rhoea. In these troubles it overcomes the nervous apprehension so fre- 
quently a troublesome feature. It also alleviates the nervous irritability 
accompanying or produced by varicocele. In gonorrhoea, particularly of the 
chronic type, pulsatilla is of value when the urethral membrane is swollen. 
Many unpleasant conditions of the urinary apparatus are relieved by pul- 
satilla, as frequent but ineffectual attempts at urination, the bladder 
giving a sensation as if bloated; dribbling of urine from movement, the 
dysuria of pregnancy, and in involuntary micturition from colds or from 
nervous debility. 
Pulsatilla is a useful remedy in headache of various types. It relieves 
585 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
frontal headache from nasal catarrh; nervous headache, particularly when 
due to gastric disturbances, with greasy taste; menstrual headache, with 
chilliness and suppressed menses; bilious and gastric headaches, of a dull 
and heavy character, with greasy taste and nausea; and headache due to 
uterine irregularities or to a rheumatic diathesis. These headaches are all 
of anemic character-the opposite of those relieved by gelsemium. Con- 
stipation in the hysterical female sometimes yields to nux vomica and 
pulsatilla, and the latter has a pleasing action in some forms of indigestion 
and dyspepsia. These are the cases in which there is a thick, creamy 
paste upon the tongue and a greasy taste. Such troubles are frequently 
brought about by indulgence in pastries and fatty food. Pain is not 
marked, but there is pyrosis and greasy eructations, gastric distention, 
uneasy gnawing sensations in the stomach, and chilliness may be a pro- 
nounced symptom. The patient is nervous, sad, and may have a soft, 
yellow diarrhoea. For such cases pulsatilla is an excellent remedy. It is 
also said to relieve alternating constipation and diarrhoea with venous 
congestion. 
Though ordinarily not a remedy for acute inflammations (contraindi- 
cated in gastro-intestinal inflammation), there are some conditions where 
small doses of pulsatilla are beneficial when the usual symptoms calling for 
the drug are present. These are acute inflammation of the nose, fauces, 
larynx, or bronchi. It is especially effective in the secondary stage of 
acute nasal catarrh, when the naso-pharynx is affected and there is a sense 
of rawness and moisture, and an abundant discharge of thick, yellow, bland, 
inoffensive mucus or muco-pus. Pulsatilla often serves a good purpose in 
asthma superinduced by pregnancy, or by suppressed menses, and it 
favorably influences whooping-cough in properly selected cases. So-called 
"stomach cough" is frequently cured by pulsatilla. For the secondary 
stage of common colds, when the Eustachian tubes feel stuffed and occluded, 
with a moderate degree of deafness, pulsatilla alternated with gelsemium 
provides a most beneficial treatment. 
Pulsatilla is a very important remedy to control the catarrhal symptoms 
of the exanthemata; it also allays the irritability frequently accompanying 
these disorders. In measles, it has done good service in checking the coryza 
and profuse lachrimation, as well as the dry, tight, painful cough, and when 
retrocession of the eruption has taken place, it has reversed this unpleasant 
condition. It relieves the nervous irritability in varicella. 
Pulsatilla is a most efficient drug in real and imaginary cardiac affec- 
tions. It has proved useful in cardiac hypertrophy and in dilatation of the 
venous heart. It is especially effective in functional heart disorders with 
giddiness, imperfect voluntary motion, impaired vision, and with a symptom 
described as a sense of pressure over the larynx and trachea, with imperfect 
respiratory movement, and sense of impending danger; these symptoms are 
not unfrequently associated with functional heart disease, dyspepsia, 
uterine disease, or over-excitation of the sexual system, and are generally 
very unpleasant and annoying. It often relieves that form of venous con- 
gestion which stops short of inflammation, as in threatened ovaritis, orchitis, 
varicocele, and crural phlebitis. Varicocele and other varicoses are some- 
times improved bv its administration with other indicated remedies. Its 
586 INDIVIDUAL DRUGS. 
chief advantage, outside of some control over the venous structure, is the 
relief it gives from the nervous complications. It has been used to good 
advantage for the relief of the nervousness attending hemorrhoids, and has 
some control over the venous congestion causing them. Pulsatilla gives 
prompt relief in earache, brought on by cold, wet, and exposure to winds. 
For this purpose it is the best drug we have used. There is an absence of 
fever, the pulse is open and soft, the child sobs, the face is pale, the tissues 
full and waxen, the pain is intense and frequently paroxysmal and tearing 
in character-evidently a neuralgic condition, for physical signs of local 
disturbance are seldom observed. In purulent otitis media, with thick, 
yellow, bland discharge, and impaired hearing and tinnitus aurium, pul- 
satilla is the indicated remedy. 
One of the earliest uses of pulsatilla was for the relief of "amaurosis, 
cataract, and opacity of the cornea", conditions in which the reputed value 
of pulsatilla is very much overrated. There is a condition, sometimes 
known as "nervous blindness", which has been benefited by pulsatilla, and 
this is probably that formerly referred to under the elastic term amaurosis. 
Pulsatilla has-an excellent record as a remedy for hordeolum or "stye". 
It also relieves promptly when the conjunctiva is hyperaemic and vision 
weakened, especially after reading, or from sexual abuse or sexual excesses, 
and in profuse lachrimation from exposure to winds or when in the wind. 
It should be used locally (gtt. x to aqua, fl 3 ij) and also given internally in 
small doses. In chronic conjunctivitis, with bland, yellow discharges, in 
scrofulous individuals, or due to the exanthemata, and in ophthalmia 
with like discharge, pulsatilla has been used with success. It relieves deep- 
seated, heavy pain in the globe of the eye, and has been recommended in 
inflammation of the lachrymal sac. 
Pulsatilla has been used with varying degrees of success in rheuma- 
tism, when the pains were shifting and relieved by cold and aggravated by 
warmth. Depression of spirits is here a prominent feature. It has also 
aided in restoring the flow of milk in agalactia in nervous and fear-depressed 
women, whose breasts were painful and swollen. The dose of specific 
medicine pulsatilla is from a fraction of a drop to ten drops, administered 
in water; of anemonin, 1/20 to 1/4 grain. 
The whole plant of Pyrola rotundifolia, Linne (Nat. Ord. Ericacese). Damp and 
shady woods in the United States. Dose, 5 to 60 grains. 
Common Names: Canker Lettuce, Shin Leaf, False Wintergreen. 
Principal Constituents.-Ericolin, arbutin, urson, tannic, gallic and malic acids, etc. 
Preparations.-1. Infusum PyroIce, Infusion of Pyrola (5j to Water, Oj). Dose, 
1 to 2 fluidounces. 
2. Tinctura Pyrola, Tincture of Pyrola ($viij to Alcohol (76 per cent), Oj). Dose, 
1 to 60 drops. 
Specific Indication.-Irritation of urinary tract. 
Action and Therapy.-External. A splendid but much neglected agent 
in infusion, as a wash for sore throat and aphthous ulcerations of the mouth. 
Internal. As it has similar properties to uva ursi and chimaphila and 
exerts a similar antiseptic action, it is of much value in urinary disorders 
with irritation and tendency to ulcerations and sepsis. The urine contains 
much mucus and sometimes blood. 
PYROLA. 
587 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
QUASSIA. 
The wood of Picrasma excelsa (Swartz), Planchon (Nat. Ord. Simarubaceae). A tall tree 
of Jamaica and neighboring islands. Dose, 10 to 30 grains. 
Common Names: Quassia, Quassia Wood, Bitter Wood. 
Principal Constituent.-The bitter substance quassiin (quassin). 
Preparations.-1. Infusum Quassia, Infusion of Quassia (3j to $xij of cold water). 
Dose, 1/2 to 2 fluidounces. 
2. Specific Medicine Quassia. Dose, 1 to 30 drops. 
Action and Therapy.-Quassia is a bitter stomachic and tonic. A cold 
infusion (1 to 100 of cold water) used as an injection is one of the most 
useful agents to remove ascarides. An acidulated infusion may be employed 
to lessen the craving for alcoholics. For this purpose the wood may be 
extracted with vinegar and administered in drachm doses in a glass of water. 
Specific medicine quassia may be given in doses of one to thirty drops, in 
water, for impairment of the appetite in feeble and emaciated persons. 
Cold infusions of the chips are to be preferred to hot, as less extractive 
matter is drawn out. 
Quassia is not without danger, and established doses must not be 
exceeded. Even rectal injections of it have caused collapse in a child. 
Having no tannin, quassia may be given with iron, if desired. 
The bark of Quercus alba, Linne (Nat. Ord. Cupuliferae). Indigenous. Dose, 5 to 20 
grains. 
Common Names: Oak Bark, White Oak Bark. 
Principal Constituent.-Tannic Acid (quercitannic acid). 
Preparations.-1. Decoctum Querci, Decoction of Oak Bark (Quercus 5j, Water Oj). 
Dose, 1 to 2 fluidounces; used chiefly locally. 
2. Specific Medicine Quercus. Dose, 5 to 20 drops. 
Specific Indications.-Relaxation of mucosa, with unhealthy dis- 
charges; ulcerations with spongy granulations. 
Action and Therapy.-External. Oak bark depends chiefly for its 
virtues upon the tannin it contains. However, it sometimes proves more 
agreeably effectual than the acid when used in decoction or poultice upon 
ill-conditioned ulcers, with stinking, spongy granulations, in gangrene, 
as an astringent for relaxed uvula, with flabby or ulcerated sore throat, 
and as an injection for leucorrhoea, prolapsed rectum and hemorrhoids. 
The bark of (Quercus tinctoria, Bartram (Black Oak), has similar properties, 
but is objectionable on account of its staining quality. 
Internal. Oak bark is astringent. Combined with aromatics, as 
cinnamon or nutmeg, the decoction is often an effectual means of checking 
serous diarrhoea and intestinal hemorrhages. In small doses it is a general 
tonic for debility, with tendency to relaxation of tissue and looseness of the 
bowels. In dysentery with a tendency to chronicity and not yielding 
readily to ordinary treatment the bowels may first be flushed by means 
of castor oil or magnesium sulphate, after which the decoction of oak bark 
mav complete the cure. 
QUERCUS. 
588 INDIVIDUAL DRUGS. 
QUIN IN A. 
Quinine. (Formula: C20H24O2N2. 3H2O.) 
An alkaloid derived from the bark of Cinchona species (Nat. Ord. Rubiacese). 
Description.-An odorless, white powder, of micro-crystalline character, having an 
intensely bitter and persistent but slowly developing taste, and losing water of crystalliza- 
tion in dry air. It is very soluble in alcohol, chloroform, or ether, but almost insoluble in 
water. On the latter account the salts of quinine are preferred for medicinal use. Dose, 
1 to 20 grains. 
Preparations.-1. Quinines Sulphas, Quinine Sulphate. Light, white, silky, lustrous 
crystals, easily compressible, without odor and having a very bitter, persistent taste. 
In dry air it loses its lustre, and exposed to light becomes brownish. Soluble in glycerin, 
less readily in alcohol, and sparingly in water. Dose, 1 to 20 grains. Large doses of this 
and the following salt are only employed in malarial fevers. 
2. Quinines Bisulphas, Quinine Bisulphate. Colorless or whitish, odorless needles 
or crystals, very bitter, efflorescent, and gradually turning yellow in the light. Very 
soluble in water, less so in glycerin or alcohol. Dose, 1 to 20 grains. 
3. Quinines HydroMoridum, Quinine Hydrochloride (Quinine Chloride). Silky, 
white, lustrous needles, without odor and of an intensely bitter taste. Efflorescent. Readily 
soluble in chloroform, alcohol, or glycerin, and somewhat less in water. Dose, 1 to 20 grains. 
4. Quinines Dihydrochloridum, Quinine Dihydrochloride. A very bitter, odorless, 
white powder, very readily soluble in water and less so in alcohol. Dose, 1 to 20 grains. 
5. Quinines Salicylas, Quinine Salicylate. Odorless and colorless, bitter, needle 
crystals. It is unaffected by air, but may become pinkish with age. Scarcely soluble in 
water, but fairly soluble in alcohol, glycerin, or chloroform. Dose, 1 to 20 grains. 
6. Quinines Tannas, Quinine Tannate. A non-crystalline, light-yellow or yellow- 
white, odorless powder, having practically no taste, or but a slight bitterness with astring- 
ency. It is but slightly dissolved by water, but a little more readily by alcohol. Dose: 
As it is usually administered to children, the dose ranges from 1 to 5 grains. It is an un- 
satisfactory preparation. 
7. Quinines Hydrobromidum, Quinine Hydrobromide (Quinine Bromide). Very 
bitter, odorless, light, silky, white crystals; efflorescent; soluble readily in alcohol, chloro- 
form, glycerin, and less readily in ether or water (about forty parts). Dose, 1 to 20 grains. 
8. Quinines et Drees Hydrochloridum, Quinine and Urea Hydrochloride (Quinine 
and Urea Chloride). Colorless crystals, or a granular, white, very bitter powder, un- 
changeable in the air. Very easily dissolved by water or alcohol. Dose, 1 to 20 grains; for 
hypodermatic use 15 grains, employing not more than one dose a day. 
Specific Indications.-Periodicity, pulse soft and open, tongue moist 
and cleaning; skin soft and moist, and nervous system free from irritation; 
intermittent and remittent fevers; periodical neuralgia; enfeebled innerva- 
tion. 
Action.-Quinine is a general protoplasmic poison; it is, moreover, 
antiputrefactive and antiseptic. Unlike other powerful alkaloids, instead of 
showing a selective affinity for a single or few forms of living matter it acts 
upon the protoplasm generally of a great majority of the forms of living 
organisms, first stimulating and interfering with nutrition and subsequently 
depressing and accomplishing their destruction. Thus it acts upon the 
amoebae and upon infusoria, and greatest of all, upon the sporozoon, 
which is the cause of malarial intermittent fevers-the plasmodium malariae. 
Cinchona bark was applied to ulcers for antiseptic and antiputrefactive 
purposes by Sir John Pringle as early as 1765. In various strengths, quinine 
checks fermentation in milk, urine, alcoholic fluids, etc., and prevents 
decomposition of the same. 
Upon denuded surfaces, quinine acts as an irritant. To the taste 
quinine sulphate is extremely bitter. It does not fully represent Cinchona, 
whose associated principles possess properties not present in quinine alone. 
In small doses, quinine is a nervous and vascular stimulant. In large doses, 
it is a sedative and muscular and cardiac depressant, and if given in suf- 
589 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
ficient amounts, which, however, must be very large, it is capable of pro- 
ducing death. Upon entering the stomach, quinine is dissolved by the 
gastric fluid, such portions as are not dissolved passing into the intestines, 
where the alkaline juices also precipitate such portions of the dissolved 
salt as may come into contact with them. In small doses, the movements 
of the stomach are increased, and the flow of gastric juice augmented. 
Large doses check the flow of the latter and cause irritation of the stomach. 
If the stomach be already irritable, even small doses of quinine or cinchona 
increase the difficulty. In immoderate quantities, it first constipates and 
then causes diarrhoea. Upon the blood, quinine appears to impress the 
haemoglobin, impairing its function, with the result of lessening the oxidiz- 
ing (ozonizing) powers of the blood. The activity of the white blood- 
corpuscles is also said to be inhibited or lessened, and the discs even de- 
stroyed by this salt. It has also been shown that the amoeboid movements 
of these bodies are inhibited. Small doses increase the action of the heart, 
while large doses depress it. The feeble cardiac movements, from large 
doses, are due to its action upon the cardiac motor ganglia; the vaso-motor 
system is also depressed by it. In health, very little effect is produced upon 
the body-heat by quinine, though in febrile conditions it tends to bring 
down the temperature. How this occurs is still a matter of debate. Prob- 
ably it has no specific effect in reducing heat production and increasing 
dissipation, but acts rather through its killing power over the infective organ- 
isms causing the fever, as in malarial attacks; for it is certainly an uncertain 
antipyretic in other febrile disorders. Quinine has a tendency to restrain the 
cutaneous secretions. 
The cerebrum is stimulated by small doses of quinine, and either 
a hyperaemic or congested state of the brain induced. Large doses, however, 
produce a partial anemia of the organ, due to contraction of the arteries 
and feeble heart-action. After death the brain is found to be engorged with 
blood. Deafness is a common result after the injudicious use of quinine, 
but it is seldom permanent. The optic nerve and retina, through ischaemia, 
become perfectly white, resembling white atrophy, and temporary blindness 
results. Occasionally, permanent atrophy of the nerve, with blindness, 
remains. Upon the spinal cord, the chief effects are a lessening or abolish- 
ment of reflex excitability. This is attributed not to a primary action 
upon the cord, but to stimulation of Setchenow's center of inhibition, 
situated at the base of the brain. Quinine first stimulates the lungs, in- 
creasing the respiratory functions. Toxic doses, however, produce dysp- 
noea and a variety of abnormal respiratory movements, finally ending in 
death, with symptoms of asphyxiation. The spleen is contracted by 
quinine, and upon the uterus it probably has no power to originate con- 
tractions, though it appears to assist normal uterine contractions when 
they have once begun. For this purpose it is valued in feeble and inter- 
mittent uterine action during labor. Notwithstanding this, it is the general 
opinion that it is a perfectly safe agent to administer in threatened abortion, 
due to malarial influence, or occurring in malarial districts. 
Quinine rapidly diffuses itself into the blood in proportion to the 
quantity taken. It is found in all the secretions, the tears, the saliva, milk, 
sweat, and urine. Though some of it is orobablv eliminated bv the bowels. 
590 INDIVIDUAL DRUGS. 
and a large portion undergoes destruction in the body, the chief amount- 
at least nearly one half-passes out by way of the kidneys (unchanged 
and as dihydroxyl quinine), hence the irritant effects sometimes produced 
upon the urinary tract. In acute inflammation of the renal organs, it 
increases the difficulty and may give rise to complete suppression, or to 
retention of urine. Small doses increase the elimination of urea, uric acid, 
and creatinin, while the excretion of these products is diminished by larger 
doses. It may appear in the urine in fifteen minutes, but is not wholly 
eliminated for about three days; hence the danger of overlapping doses. 
Quinine occasionally produces skin eruptions, among which may be men- 
tioned erythema, urticaria, herpes, roseola, and rarely purpura. 
Small doses of quinine, frequently repeated, act as a stimulant tonic, 
strengthening the pulse, increasing muscular force, and invigorating the 
tone of the nervous system. In some persons it induces headache, nausea, 
or irregular action of the bowels, effects generally obviated by combining 
it with morphine; and these disturbances will be almost certain to follow 
if gastro-enteric irritation preexists. Large doses, as twenty grains, or one- 
half drachm, produce many unpleasant symptoms, and ought never to be 
used, except in the malignant conditions hereafter mentioned. Among 
these may be named sickness and pain at the stomach, mental confusion, 
giddiness, flushed countenance, palpitation, a sense of fullness, throbbing, 
and distention in the head, intense weighty headache, ringing in the ears, 
vomiting, numbness in the feet, twitchings of the limbs, deafness, blindness, 
delirium, and nervous excitation and restlessness. If this amount be ad- 
ministered for several days, muscular debility, with tremulousness, unsteady 
gait, somnolence or apathy, obtuse sensibility, and dilated pupils, may also 
be present. In toxic doses, deafness and blindness may be complete, the 
limbs become powerless, and unconsciousness supervene. Upon dis- 
continuing the use of the quinine, the effects gradually pass off; occasionally, 
however, the aural and ocular disturbances persist for some time if the 
drug has been long administered. It is seldom that the severer symptoms, 
above mentioned, are observed, for, as soon as slight cinchonism has been 
produced, known by giddiness, a buzzing or ringing in the ears, slight 
headache, etc., the drug is usually discontinued. 
Therapy.-External. Quinine sulphate is decidedly antiseptic, and 
an aqueous solution of it (1 to 60, 100, or 200) has been advised as a spray 
for the relief of hay-fever. Many popular hair tonics contain quinine. 
The bisulphate is sometimes employed as an injection in gonorrhoea, and 
a solution of the sulphate may be applied to diphtheritic deposits. By 
far the most important use of quinine locally is that peculiar to Eclectic 
practice, quinine inunction, as follows: 
Quinine Inunction.-How much quinine is absorbed or whether any 
changes take place in the salt when used by inunction are not definitely 
known, but therapeutic results are very apparent and the method is ex- 
tremely satisfactory. The administration of quinine to children is not 
agreeable to them. The various concealing mixtures have little to recom- 
mend them. Admixture with some disguisers unquestionably produces 
some changes in the character of the medicament, and results are not nearly 
so satisfactory as by the old-fashioned method of inunction. We find it the 
591 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
method of administering quinine to children, in whom small doses only are 
required, and we have never observed any of the unpleasant head symp- 
toms from it when so employed. In the use of quinine by inunction we 
observe the same specific indications as for its internal administration- 
a soft skin, often inclining to moisture; a soft, moist tongue, open pulse 
and febrile exacerbations of a decidedly remittent or intermittent type. 
We often find the periodic character in ailments not distinctly malarial, as 
in acute bronchitis and broncho-pneumonia. When malaria is manifestly 
present, then it is especially desirable. It is in children chiefly that we em- 
ploy inunction, while for adults we prefer the internal use of an acid solution 
of quinine. 
The inunction is prepared and used as follows: Mix two drachms of 
quinine sulphate with two ounces of ointment of rose water. Apply about 
a level teaspoonful, divided into parts, to the skin of the axilla or the fold 
of the groin, where it is readily absorbed, two or three times a day. Benzoin- 
ated lard or aromatized goose fat may be used instead of cold cream, but the 
latter is an agreeable and effective base; petrolatum is less desirable. The 
physician who has never used quinine by inunction will be agreeably 
surprised at its efficacy. Besides, most people are apt to feel that much 
more good is being accomplished when local treatment is advised, and it 
forestalls their desire to apply all sorts of objectionable topical applications. 
Internal. Formerly the known physiological action of quinine shed but 
little light upon the practical application of the drug. No absolute explana- 
tion was given of its manner of action in malarial and other periodical fevers. 
That it antagonized a miasmatic poison was generally accepted; and it had 
been hinted at by scientists of world fame and obscure doctors of the back- 
woods, that these fevers might be caused by an animalcule (as it was then 
called), a parasite, or some low form of organic life, the multiplication of 
which quinine prevented, and the destruction of which it accomplished. The 
matter was finally definitely settled, however, by the discovery, by Laveran, 
in 1890, of the sporozobn-the Plasmodium malaria-and the proof that 
it was the infecting agent. Binz, in the late sixties, declared, what had 
been long known to practical bedside clinicians, that the infecting agent 
(whatever it might be) was probably antagonized by quinine. In spite of the 
long use of cinchona and its alkaloids in intermittents this specific toxicity 
toward the provocative cause was but slowly accepted. Later it was 
shown experimentally that quinine could destroy it in the human system, 
as well as in the test-tube, and that when isolated these protozoa have been 
killed by so dilute a solution as one part of quinine in 20,000 parts of water. 
Quinine is the great remedy for malarial or intermittent fevers. It is now 
seldom employed in other fevers without periodicity, except as a tonic to 
prevent prostration. Malarial fevers are now known to be caused by the 
infective process of the life cyle of the Plasmodia of malaria, three types of 
which are concerned in the infection, with the result that three types of 
disease result. The protozoa enter the red blood discs, mature, bud, and 
escape as spores into the blood-plasma. Enormous broods of these new 
bodies now infest the life stream ready in turn to plunge into new red 
corpuscles. This process causes the phenomena of chill and fever and 
reaction and intermission, the two former occurring when sporulation is. 
592 INDIVIDUAL DRUGS. 
taking place and the current is filled with the invading hordes, and the 
latter when they are safely ensconced in the safe haven of the intact cor- 
puscle. The chill and fever recur at regular intervals just in proportion as 
the proper stage of parasitic development and splitting up is reached. 
When infection is single, simple fever results; when double or multiple, 
irregular paroxysms and intermittency occur. Quinine can attack these 
parasites with greatest effect when the spores are out of their retreat in the 
cells, and if supplied to the blood a few hours before a paroxysm is expected 
it is ready at hand and able to attack and destroy the invading parasites. 
Sometimes this may be accomplished just after the temperature begins to 
fall, provided the drug can be absorbed quickly enough. The rational pro- 
cedure in treatment then is to keep the blood charged with quinine, for in 
this way not alone are most of the newly liberated spores crippled and 
destroyed, but the few remaining protozoal spores that have escaped and 
are ready to renew their ravages in a subsequent invasion are trapped and 
destroyed also. Given after all active paroxysms have been subdued and 
the sporozoa apparently subjugated, it is the better part of wisdom to 
administer enough of quinine to keep the blood saturated and ready for 
defense for several weeks to come. This takes but small doses and is not 
apt to harm the body; but is very likely to rid the stream of the last in- 
vading parasite. Fortunate it is that a general protoplasmic poison like 
quinine is capable, in sufficient doses, of coming into direct contact with and 
killing the lower form of life in the blood stream of a higher form without 
toxic damage to the latter. 
Physicians of all schools of practice unite in pronouncing quinine a 
most important and indispensable drug. Few will deny, we believe, that 
it is also a medicine capable of harmful results if carelessly and indis- 
criminately employed. The nervous system in particular is so pronouncedly 
impressed by quinine and its salts that the best judgment and care should 
attend their exhibition. Despite the fact that quinine has been used so 
long, and often so successfully as a medicine by the physicians of all schools, 
in the hands of no class of practitioners has it attained the degree of success 
that it has in the practice of Eclectics. This we assert with pardonable 
pride and at the risk of being accused of medical egotism. 
In the earlier days of Eclecticism quinine was administered by Eclectic 
physicians "in all febrile diseases, without regard to the violence of the fever, 
or to the degree of congestive enlargement of the liver or spleen". The aim 
was invariably to affect the head-to produce cinchonism. This also has 
been essentially the practice of members of the Regular school. The 
Eclectics, however, were careful to advise that previous to its administra- 
tion "any symptoms of irritability, wakefulness, or restlessness must be 
first subdued". In this, at least, they approached the present use of the 
drug and the proper conditions for its administration as now viewed by the 
specific medicationist. Such was its status in the past, but since the de- 
velopment of specific medication there has been a better understanding of 
the adaptability of quinine to disease conditions; and while regarded at 
the present day as an invaluable remedy when indicated, we find far less use 
for it than formerly in Eclectic therapeutics. The practice of promiscuously 
and unqualifiedly prescribing quinine as a febrifuge, as an antiperiodic,, 
593 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
or as a tonic, is confined chiefly to the few who have not yet learned the 
better methods of specific medication for direct effect. When indicated, 
quinine, like any other indicated drug, should act kindly and pleasantly. 
The system should not be subjected to great shock in order to produce its 
remedial effects. In rare conditions only, such as congestive chills, is it 
necessary to carry the patient to cinchonism. In truth, the most salutary 
results are always attainable when the drug acts gently and without dis- 
turbing the head or sense of hearing. 
In the Eclectic school, from the very first periodicity has been the 
keynote for the employment of quinine. To-day the modern Eclectic 
knows that periodicity alone will not guide him unerringly to the selection 
of quinine as the specific remedy. There must be something more, some 
associated condition besides periodicity to enable him to cure or ameliorate 
with quinine. The study of specific medication at the hands of masters 
long ago gave him the indications-not periodicity alone-which may 
require quinine, arsenic, boletus, ceanothus, or some other so-called anti- 
malarial drug-but periodicity, with a soft and open pulse, a moist and soft 
skin, a moist and clean or cleaning tongue, and a nervous system free from 
marked irritation. The older Eclectics many times practiced specific 
medication unwittingly, though they had not yet formulated the indications, 
when they employed the emetic or the diaphoretic preparatory to admin- 
istering quinine. They knew that it acted best after such preparation, and 
they tacitly recognized the indication when they directed "that any symp- 
toms of irritability, wakefulness, or restlessness must first be subdued" 
before giving the drug, though they erred, as we now look at the matter, in 
believing, as did their rivals in practice, that the head must be affected daily 
in order to cure the sick with quinine. 
On the contrary, observation has shown that when quinine is employed 
where there is marked nervous excitation, a dry tongue, a dry skin, and a 
frequent hard and sharp pulse, an aggravation of conditions is most likely 
to result. This, at least, has been the repeatedly recorded experience of 
specific medicationists. 
Malaria uncomplicated, fortunately, most often presents the proper 
conditions for quinine; hence the frequency of cures with it. Ordinarily it 
is the best remedy for congestive chill and for malignant intermittents. 
Should the stomach be in a condition not to receive it kindly, it may be 
administered with capsicum or black pepper. To be effective large doses of 
quinine must be used, and without regard to time, ten to twenty grains quar- 
ter-hourly until forty to sixty grains are taken (Locke). In remittent fever, 
when indicated, it is a prompt and decided remedy given in the larger or smal- 
ler doses during the intermission accordingly as the disease is of a malignant 
or non-malignant type. It is seldom indicated and is of rare usage in 
typhoid fever, lest it damage the vascular and nervous systems, irritate the 
stomach and bowels, and provoke diarrhoea. With pronounced indications, 
as given above, however, it proves a safe and valuable remedy in this disease, 
and is then usually effective in small doses combined with hydrochloric acid. 
This is especially true if prostration be imminent, as it is also in pneumonia- 
a disease in which quinine is so largely used by practitioners of the Regular 
school, and so sparingly employed by Eclectics. Quinine is occasionally 
594 INDIVIDUAL DRUGS. 
of value in puerperal fever, septicaemia, and diphtheria. It is particularly 
useful for the debility following surgical diseases, where the discharges are 
copious and exhausting. It also tends to check the formation of pus. Some 
times it is indicated in infectious and influenzal pneumonia, not for anti- 
pyretic effects, but rather for its antibacterial properties. 
The mixed type of fever, known as typhomalarial, is benefited by 
quinine in proportion to the predominance of the malarial infection, and 
less effectual as the typhoid element predominates. 
All agues are not cured by quinine, but as a rule, when uncomplicated 
they yield to it; nor is it always curative in the malarial cachexia, and it 
often fails when arsenic or eupatorium succeeds. Generally, however, it 
proves useful in disorders depending upon a malarial origin. It is useful in 
enlarged spleen or ague-cake. It is frequently of value in children's diseases 
occurring in malarial districts, particularly when periodic in type. Other 
diseases supervening in one subject to ague are often benefited by the 
judicious use of quinine. Thus it forms the whole or a part of the treatment 
in muscular pain, rheumatism, etc. We have had excellent results in severe 
rheumatic conditions of the shoulders, wrist, and fingers from the use of a 
weak, hydrochloric acid solution of quinine sulphate to which is added 
specific medicine capsicum. Quinine aids macrotys and other antirheu- 
matics. It is a remedy for periodical neuralgia and periodical headaches. 
In view of their origin and the power of the drug over the plasmodia, there is 
now no doubt that quinine possesses prophylactic powers long claimed for it 
to prevent malarial manifestations. 
The rule for the administration of quinine as an antiperiodic is as 
follows: ''Whenever an acute disease exhibits periodicity, we administer 
the agent during the intermission, or when there is the least excitement of 
the circulation; but if this cannot be done, owing to the shortness of the 
intermission, we give it during the reaction" (Scudder, Materia Medica, 
page 436). If given when a chill is on, it is likely to aggravate it; while 
during the sweating stage, it is neither necessary nor productive of much 
good. As to the manner of administration, there is some difference of 
opinion-some preferring broken doses, others the single dose. Scudder, 
after getting the patient in the proper condition, preferred to give a single 
dose of ten grains in one or two ounces of water, using sufficient sulphuric 
acid to effect a solution. This he believed to be the most certain and 
pleasantest method of administration. Locke advised from fifteen to thirty 
grains, depending upon the condition of the patient, five-grain doses being 
administered during the intermission, every three hours, so that the last 
dose may be taken an hour before the expected chill. The following solu- 
tion was recommended by Locke: 3 Quinine Sulphate, $i; Diluted Hydro- 
chloric Acid, gtt. xxx; Water, fl$ii. Mix. Dose, a teaspoonful or more 
every three hours; each teaspoonful contains about four grains of quinine. 
It is still advised by some that a fifteen-grain dose be given, timed to meet 
the moment of sporulation (which takes place simultaneously in a single 
invasion), but as a rule the method of administering broken doses for con- 
tinuous saturation is more often recommended and thought to be more 
generally effective. 
That the nervous system is profoundly affected by quinine, is evident 
595 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
from the great damage done by the improper and untimely administration 
of the drug. When indicated, however, it is one of the most important of 
stimulants of the cerebro-spinal centers. In many chronic forms of disease, 
with impaired nutrition and functional torpor, quinine, administered ac- 
cording to its indications, will, in small doses (1/2 to 2 grains), restore the 
proper innervation and aid in a cure. In fact, in chronic affections there 
are two main conditions in which it always does good, and those are cases 
with enfeebled innervation, as mentioned, and those of malarial infection, 
with "obscure periodicity" (Scudder). Not only does it stimulate the 
cerebro-spinal centers, but so impresses the sympathetic ganglia that 
waste and excretion are better performed, and digestion, nutrition, and 
blood-making are improved. Thus it is frequently combined with iron and 
strychnine in general debility. A useful preparation for this purpose is the 
"compound tonic mixture". Quinine, in small doses, is effectual in dyspep- 
sia, depending upon a nervous derangement of the stomach. It antagonizes 
erysipelas. In intermittent neuralgia, with severe pain, and particularly 
when affecting the fifth nerve, quinine, combined with small doses of 
morphine, is one of the most certain of drugs. The colliquative sweating of 
pulmonary affections is checked by the following: 3 Quinine Sulphate, 
gr. xxx; Aromatic Sulphuric Acid, A5ss; Water, fl^iv. Mix. Dose, a tea- 
spoonful three times a day, the last dose being taken at bedtime (Locke). 
As a tonic, sulphate of quinine is useful in diseases with an enfeebled state 
of the system, and especially in the debility resulting from exhausting 
diseases; in chlorosis and in anemia it should be given with acid solution 
of iron or the milder scaled salts of iron. Quinine is, with some physicians, 
the remedy most relied upon in sunstroke. 
In obstetrical practice, quinine is frequently serviceable. It may be 
employed to remedy irregular and ineffective pains, and where complica- 
tions of a periodical nature arise. As with its antiperiodic virtues, small 
doses of opium associated with it increase its oxytocic power. By its tonic 
and contractile action, it minimizes the danger of post-partum hemorrhage. 
Quinine is a much abused medicine in common colds and in influenza, 
often being administered without any special indications, and generally 
resulting in creating a sense of fullness in the head and other symptoms 
of cinchonism. When, however, the specific indications are present, then, 
as in other disorders, it renders good service. 
We have had good results in the treatment of hay fever, by the internal 
administration of a solution of quinine in water and hydrochloric acid, each 
dose containing two grains of the salt, and being administered four times a 
day. 
The dose of quinine sulphate, internally, is from one-half to three 
grains, repeated every one, two, three, or four hours, as the urgency of the 
case may require. Large doses should not be employed except in remittent 
and intermittent fevers, when the dose may range from five to twenty 
grains. A popular method of administering quinine is in capsules. This, 
while pleasanter, is less effectual than the acidulated solutions. A solution 
of quinine sulphate may be made by adding twenty grains of the salt to one 
fluidrachm of aromatic sulphuric acid, and, when dissolved, add two fluid- 
ounces of water. The dose is twenty drops every hour, in about one-half ounce 
596 INDIVIDUAL DRUGS. 
of water, or syrup of ginger. We prefer the solution in hydrochloric acid and 
water, using two drachms of quinine sulphate to four fluidounces of water, 
with just enough acid to insure solution. The dose is from one-half to 
one teaspoonful, in plenty of water. Each full dose contains practically 
four grains of quinine. A number of substances has been used to mask 
the taste of quinine. Among these are liquorice, yerba santa, syrup of 
orange, and yerbazin. The practice of using tannic acid is to be condemned, 
as it converts the most of the quinine into an insoluble and practically inert 
quinine tannate. 
Quinine Bisulphate is more soluble than the sulphate and is preferred 
by some on that account. 
Quinine Hydrochloride is less liable than the sulphate to cause head- 
symptoms and other unpleasant disturbances. 
Quinine Salicylate is popular with some as a remedy for infective 
processes, as in colds, tonsillitis, rheumatism, and influenza. 
Quinine Hydrobromide is less liable to produce tinnitus and is of much 
value in hyperthyroidea; and serves in colds, tonsillar inflammation, and 
la grippe. 
Quinine and Vrea Hydrochloride is a local anaesthetic, and has been 
successfully used for the strangulation of internal hemorrhoids. Used by 
injection, either subcutaneously or submucosally, it may cause irritation, 
is absorbed slowly, and has even been charged with causing tetanus. It 
has been advised in acute infectious pneumonia, and in influenzal pneu- 
monia, in fifteen-grain doses, hypodermatically, with the hope that it 
might benefit, and especially to prevent cardiac and other complications. 
Both quinine sulphate and this salt have been useful in the elderly with 
sluggish intracranial circulation-those with tendency to arteriosclerosis 
and relaxed veins, who suffer from dizziness, mental confusion, despondency, 
headache and loss of memory. 
RESINA. 
Rosin, Colophony. 
The residue left after distilling the volatile oil from the concrete oleoresin derived 
from Pinus palustris, Miller, and other species of Pinus (Nat. Ord. Pinaceae). United 
States and Europe. 
Description.-Amber-colored, brittle, sharp, angular, translucent fragments, usually 
covered with a yellow dust, and having a slight terebinth inate taste and odor. Freely 
soluble in alcohol, ether, benzene, glacial acetic acid and oils, both fixed and volatile; 
also by the dilute solutions of the hydroxides of the alkalies. 
Preparations.-1. Ceratum Resina, Rosin Cerate (Basilicon Ointment). (Rosin, 
Yellow Wax, and Lard.) 
2. Emplastrum Resina, Rosin Plaster (Rosin Adhesive Plaster). (Rosin, Lead 
Plaster, and Yellow Wax.) 
3. Emplastrum Elasticum, (Rubber Plaster, Rubber Adhesive Plaster). Rubber, 
resins, and waxes with a farinaceous absorbent filler, mixed and spread upon cloth or other 
fabric. 
Therapy.-External. Rosin is used chiefly in ointment or plaster, and 
seldom internally. Rosin cerate is a useful application in sluggish ulcers, 
promoting granulation and healing. 
597 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
RESORCINOL. 
Resorcinol, Resorcinum, Resorcin, Metadioxybenzol, Metadihydroxybenzene (Formula: 
CH^OH),). 
A diatomic phenol obtained by the interaction of fused sodium hydroxide and sodium 
metabenzenedisulphonate. 
Description.-Colorless or almost colorless needle crystals, or a powder having a 
feeble, peculiar odor and a sweetish, afterward bitter taste. Exposed to light and air it 
becomes pinkish. Soluble in less than its own weight of water or alcohol, freely soluble in 
ether or glycerin; but slightly soluble in chloroform. Dose, 1 to 5 grains, well diluted. 
Action and Toxicology.-The effects of resorcin are somewhat similar 
to those of phenol (carbolic acid). It is a local irritant to the mucosa. 
While no lethal results in man are known to have occurred, pronounced 
toxic effects have been observed. Among them are the following: dizziness, 
deafness, muscular relaxation, profuse cold sweating, accelerated breathing 
and heart action, salivation, tinnitus aurium, disturbed vision, collapse, 
profound unconsciousness, and epileptiform convulsions. The urine be- 
comes olive green. Deep narcosis has been caused by a dose of 120 grains. 
Recovery is rapid from resorcin poisoning, the effects usually passing off 
in a day's time. Alcohol is the antidote. 
Therapy.-External. Resorcin, when applied in crystal form, is a 
painless caustic. In various solutions (1 to 10 per cent) and ointments 
(1 to 40 per cent) it is used for many purposes for which phenol is employed. 
A 1 to 2 per cent solution forms a good nasal and faucial spray frequently 
giving much relief in whooping cough and hay fever, and in nasal catarrh. 
A 3 per cent solution may be injected into the vagina for fetid leucorrhoea, 
and into the urethra and bladder for gonorrhoea and cystitis. The best 
results are obtained from the local use of resorcin in skin affections, through 
its power to remove scales, allay itching, and render the parts antiseptic. 
A glycerin solution (1 to 4) is advised to remove epidermal scales in chronic 
skin affections and for dandruff, while one containing resorcin (1), ether (1), 
castor oil (10), cologne (10), and alcohol (35), is advised by Wilcox for 
both dandruff and alopecia. An ointment (5 to 30 per cent), as indicated, 
may be successfully applied for the itching of erythematous eczema, in 
dry, scaly, seborrhoea capitis, seborrhoeal eczema, erythema, acne, pityriasis 
and erysipelas. Hare advises it, combined with zinc oxide and ointment of 
rose, for eczemas with much induration and in psoriasis, and with castor 
oil, alcohol and bay rum, in seborrhoea sicca of the scalp. Resorcin is also 
reputed valuable in such parasitic diseases as tinea and scabies. In skin 
disorders, however, it should be applied preferably in chronic disorders as 
it is most too irritant for acute affections. Some have advised it, in powder 
or in saturated ethereal solution, as a weak caustic, in papilloma, chancre, 
and in diphtheria. Its employment in the latter, as well as its use in epi- 
thelioma, at one time advised, is now replaced by more approved methods. 
Internal. Resorcin has been abandoned as an antipyretic, being too 
dangerous for such a use. It is employed chiefly internally as an antiseptic 
and antifermentative for fermentative gastric disorders, with irritation 
(1 to 2 grains every 6 hours), in cholera infantum (1/2 grain), and to relieve 
and control hemorrhage in gastric ulcer (2 to 4 grains); and occasionally in 
alternation with nux vomica, it is useful in so-called nervous dyspepsia- 
in reality the gastric irritability of neurotics. Resorcin should always be 
given largely diluted with water. 
598 INDIVIDUAL DRUGS. 
RHAMNUS CALIFORNICA. 
The bark of Rhamnus californica, Eschscholtz (Frangula californica, Gray), (Nat. 
Ord. Rhamnaceae). Sparingly in northern California and more abundant southerly in the 
Sierras, and easterly, especially in Mexico and Arizona. 
Common Names: California Buckthorn, California Coffee Tree. 
Principal Constituents.-Probably similar to those of Cascara Sagrada. 
Preparations.-1. Specific Medicine Rhamnus Californica. Dose, 10 to 30 drops. 
2. Decoctum Rhamni Californici, Decoction of Rhamnus Californica (gss to Oj). 
Dose, 3 to 6 fluidrachms every 3 or 4 hours. 
Action and Therapy.-Rhamnus californica is cathartic and anti- 
rheumatic. It sometimes is indiscriminately gathered with cascara sagrada 
{Rhamnus Purshiana) and is known to coast dealers as "thin cascara bark.'' 
As a domestic medicine it has long been used in rheumatic disorders, and its 
introduction into Eclectic medicine for that purpose is due to Webster, who 
regards it as one of the best of antirheumatics. Given short of producing a 
laxative effect, he employs it (in the decoction, tincture, and the specific 
medicine) as the most positive remedy he has ever used for rheumatism 
and muscular pain of rheumatoid character. He also advises it in long- 
standing and obstinate dysmenorrhcea, not requiring surgical rectification. 
The remedy may be administered for months, provided it is used short of 
catharsis. 
RHEUM. 
The denuded and dried rhizome and roots of Rheum officinale, Bailion; Rheum palma- 
turn, Linne, and var. tanguticum, Maximowicz, and probably other species of Chinese and 
Thibetan Rheum (Nat. Ord. Polygonaceae). Western and central portions of China and 
in Thibet. Dose, 5 to 30 grains. 
Common Names: Rhubarb, Rhubarb Root. 
Principal Constituents.-Chrysarobin (C36H26O7) (the yellow coloring glucoside, 
chrysophan or rhein) yielding chrysophanic acid (C15H10O4); the anthracene cathartic body 
emodin (Ci6Hio05); erythroretin, phaeoretin, aporetin, and the astringing principle rheo- 
tannic acid (C^sHasOu) ; and quite a proportion of oxalate of calcium giving to rhubarb its 
grittiness. 
Preparations.-1. Specific Medicine Rheum. Dose, 1/10 to 60 drops. 
2. Syrupus Rhei, Syrup of Rhubarb. Dose, 1 to 4 fluidrachms. 
3. Syrupus Rhei Aromaticus, Aromatic Syrup of Rhubarb. Dose, 1 to 4 fluidrachms. 
4. Syrupus Rhei el Potassa Compositus, Compound Syrup of Rhubarb and Potassa 
(Neutralizing Cordial). Dose, 1/2 to 4 fluidrachms. 
5. Pulvis Rhei Compositus (Eclectic), Eclectic Compound Powder of Rhubarb. 
(Equal parts of powdered rhubarb, peppermint and bicarbonate of potassium). Dose, 
1/2 to 2 drachms. 
6. Pulvis Rhei Compositus, Compound Powder of Rhubarb (Gregory's Powder). 
(Rhubarb; Magnesium Oxide, and Ginger). Dose, 5 to 60 grains. 
7. Beach's Neutralizing Mixture, Neutralizing Cordial, or Physic.-Take of rhubarb, 
pulverized, salseratus, pulverized, peppermint plant, pulverized, equal parts. To a large 
teaspoonful add half a pint of boiling water; when cool, strain, sweeten with loaf sugar, 
and add a tablespoonful of brandy. (The original formula from Beach's American Practice.) 
Dose, 1 to 4 fluidrachms. 
8. Locke's Neutralizing Cordial. (Formula.) Take of coarsely ground rhubarb, 
peppermint herb, and potassium bicarbonate, of each three ounces; boiling water, four 
pints; diluted alcohol, one pint; essence of peppermint, one-half ounce; white sugar, 
two pounds. Macerate the rhubarb, peppermint, potassium bicarbonate in the boiling 
water for two hours (do not boil) in a warm place. Strain and while still warm add the 
sugar; after the sugar is dissolved and the liquid is cold, add the diluted alcohol and the 
essence of peppermint (Locke). Dose, 1 to 4 fluidrachms. (We have found that by adding 
the potassium salt to the strained infusion of the rhubarb and peppermint a clearer 
preparation is obtained.) 
9. Glyconda.-A sugarless preparation of Neutralizing Cordial, in which glycerin is 
the sweetening and preservative agent. Dose, 1 to 4 fluidrachms. 
599 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Gastric irritation, with elongated, reddened 
tongue, and nausea and vomiting; irritative diarrhoea, with tenderness of 
abdomen on pressure; light-colored fecal discharges; gastro-intestinal 
irritation, with marked nervousness and restlessness, and screaming and 
convulsive muscular contractions. Sour-smelling discharges are relieved 
by small doses of neutralizing cordial or glyconda, while larger doses of 
either, or of specific medicine rheum or powdered rhubarb, are indicated for 
the relief of constipation with a sense of intestinal constriction and mus- 
cular contraction. 
Action.-Rhubarb is stimulant to the gastro-intestinal tract, in 
sufficient doses increasing muscular contraction, and thus, rather than by 
increase of secretion, causing a cathartic action. This is probably due chiefly 
to the anthracene body, emodin. It affects the whole intestinal tract, 
especially the duodenum, and acts most certainly in the presence of bile, 
the secretion of which it probably promotes. The latter property, however, 
is still a point in dispute. Rhubarb usually purges in from four to eight 
hours and the stools are papescent and not watery, and of a yellowish-brown 
color (due to chrysophan). Their passage is attended with mild griping. 
The rapid absorption of the coloring matter imparts to the urine a yellow 
(if acid) or a carmine (if alkaline) color; the serum of the blood and 
mother's milk are stained yellow, and the sweat has a tawny hue. The 
cathartic effect of rhubarb is succeeded by a mild astringency due to the 
rheo-tannic acid, thus making the drug a calmative after a preliminary 
stimulating catharsis. 
Therapy.-Rhubarb is an ideal laxative and cathartic according to the 
dose administered. In smaller amounts it is a gastro-intestinal stimulant 
and tonic, promoting the gastric secretions and insuring good digestion. 
As a laxative it is one of the best that can be used for children and women- 
especially the pregnant woman. As the evacuations produced by rhubarb 
are neither watery nor debilitating, when a tonic laxative is required for 
the feeble and for old people, rhubarb cannot be improved upon. 
In severe febrile or inflammatory affections of the alimentary canal 
it is usually contraindicated, but where there are enfeebled digestion and 
irritation, or where food causes distress and irregular bowel action, either 
diarrhoeal or constipating, its use is attended with excellent results. Aro- 
matics mitigate its griping tendency. In lienteric diarrhoea, and where fecal 
accumulations are to be removed, and as a laxative following parturition, 
rhubarb is perfectly safe and effective. 
In the summer diarrhoeas of children, when necessary to clear the in- 
testinal canal of slimy, acid, or other irritating material, whether there is 
diarrhoea or not, and there is both stomachic and intestinal indigestion, 
laxative doses of syrup of rhubarb, or the aromatic syrup or, perferable to 
either, the neutralizing cordial, have a most happy effect, and where other 
laxatives might leave an irritable condition and prolonged diarrhoea, 
rhubarb, through its mild after-astringency, calms the excited intestinal 
tract. Sometimes castor oil, which also cleanses and afterwards checks the 
bowels, may be given with these preparations if so desired. For the con- 
stipation of dyspeptics, with hepatic torpor, it may be given with podophyllin 
or aloes; and in ordinary constipation it is sometimes effective if admin- 
600 INDIVIDUAL DRUGS. 
istered in pill with soap, which, in a measure, prevents its after-constringing 
effect. Ten-drop doses of specific medicine rheum in a glass of cold water, 
taken before breakfast, may be effective in overcoming constipation. 
Locke advises the following during convalescence from delirium tremens: 
I) Rhubarb, Leptandfa, Gentian, aa, 5j; Ginger, 5ij; Diluted Alcohol, Oj. 
Macerate. Sig.: Dose, One teaspoonful as required. Rhubarb is not a 
suitable agent where depletion is desired. 
Rhubarb is an ideal summer gastro-intestinal remedy when not used 
as a laxative. It frequently is demanded in the practice of the specific 
medicationist to restrain bowel activity when the drug is administered in 
small doses. It thus controls diarrhoeal discharges due to gastro-intestinal 
irritation. When the tongue is red, long, narrow, and pointed, and the 
tip and edges reddened and the organ shows in its every fiber the signs of 
irritation-whether it be during summer complaint or in the papescent 
diarrhoea of indigestion-it is a remedy of first importance. Here the 
dose should not exceed two grains of powdered rhubarb or two drops of 
specific medicine rheum every one-half or one hour until the character of 
the stools changes. An excellent medium for such conditions is the neutraliz- 
ing cordial or, when sugar is contraindicated, glyconda may be substituted. 
Neutralizing Cordial.-Neutralizing Cordial is one of the very best cor- 
rectives yet devised for disorders of stomach and bowels, caused by overfeed- 
ing or change of water. It has three especial qualities: Rhubarb, through 
its specific adaptability to irritation of mucous surfaces, makes the cordial the 
ideal gastric sedative, for in such cases there is marked irritation, as shown 
by the reddened and pointed tongue. With most of these cases there is a 
fermentative state, with sourish and burning eructations, and often the 
bowel discharges contain sour and fermented material. For this condition 
there is no more pleasing antacid and corrective than potassium bicarbonate, 
though should the tongue show more pallor than redness, sodium bicarbon- 
ate may answer a better purpose. The aromatic qualities of the cordial 
derived from the peppermint oil and herb make it grateful as a carminative, 
and render it especially pleasant for children. Full doses (4 fluidrachms) act 
as a laxative, smaller doses as a corrective of irritation and acidity. 
The physician who has not an intimate acquaintance with Neutralizing 
Cordial, or the Compound Syrup of Rhubarb and Potassa, has failed to 
realize the richness and fullness of the therapeutic allies handed down by the 
fathers of our school. This preparation has been prepared under various 
formulas, but as we have stated many times, we prefer that based upon 
Beach's original formula. That which we employ with greatest confidence 
is Locke's formula, which contains rhubarb, potassium bicarbonate, pepper- 
mint herb, peppermint essence, alcohol, and sugar. However, all of the 
preparations known as neutralizing cordial are of high order and possess 
similar properties. In sufficient dose, usually a tablespoonful, all of them 
are efficient agents to clear the intestines of undigested and irritating ma- 
terial. In Eclectic practice they have largely supplanted the use of such 
agents as castor oil. They are useful to cleanse the intestinal tract in 
indigestion, both gastric and intestinal-and in fermentative and irritative 
conditions of the stomach and bowels. The remedy should be given freely 
until the color of the stools shows the characteristic color of the medicine. 
601 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Then to tone the bowels and allay irritation it may be continued in smaller 
doses at less frequent intervals. On the other hand, if the cathartic effects 
are not desired no remedy will be oftener indicated to control irritative 
diarrhoea. Here the dose should not be larger than one drachm. Neutraliz- 
ing Cordial finds a useful field in diarrhoea of undigested aliment, in watery, 
copious diarrhoea, in muco-enteritis, and in dysentery. Many physicians 
employ it as a vehicle for the administration of indicated remedies in 
stomach and bowel disorders. It is an ideal tonic to the stomach in the dis- 
orders of childhood, creates an appetite, and gives relief from pain and 
flatulence. The headache of indigestion, with sourish eructations, so 
common to children, is often cut short, as if by magic, by a laxative dose of 
Neutralizing Cordial. It is the most efficient remedy we have ever employed 
for diarrhoea induced by change of drinking water and diet when travelling. 
Neutralizing Cordial is one of the best of the compounds handed down to 
us from early Eclectic pharmacy. 
The representative sugarless substitute for neutralizing cordial is 
Glyconda, which many employ, not alone for the purposes named above, 
but as a vehicle for compatible medicines. For those who object to the 
presence of sugar in medicines, and particularly for those who are diabetically 
inclined, a glycerin preserved preparation has advantages. Where the 
tendency, even in the presence of the bicarbonate, is toward fermentation 
of the gastric contents, the glycerin preparation is sometimes to be pre- 
ferred. 
RHUS. 
The fresh leaves of Rhus radicans, Linne (Rhus Toxicodendron, Linn6) (Nat. Ord. 
Anacardiaceae). A common indigenous plant in fields, woods, and fence rows. 
Common Names: Poison Ivy, Poison Vine, Poison Oak. 
Principal Constituents.-A volatile toxicodendric acid, and the poisonous toxicodendrol, 
a non-volatile oil soluble in alcohol, and forming an insoluble lead compound with lead 
acetate, hence the use of an alcoholic solution of the lead salt to remove it and prevent 
poisoning or its extension. It is allied to cardol found in cashew-nut. 
Preparation.-Specific Medicine Rhus. Dose, 1/20 to 5 drops. 
Specific Indications.-The chief and most direct indication is the long- 
pointed tongue with prominent papillae, associated with burning heat, and 
redness and great unrest. Others are: The moderately quick, small, sharp 
pulse, sometimes wiry, sometimes vibratile; great restlessness with or with- 
out vomiting; child starts from sleep with a shrill cry as if from fright; 
tongue red and irritable, exhibiting red spots; strawberry tongue; pain over 
left orbit; burning pain; rheumatic pain aggravated by warmth; pinched 
countenance; burning pain in the urethra with dribbling of urine; acrid 
discharges from the bladder or bowels; tympanites; brown sordes; bright, 
superficial redness of the skin with burning, itching, or tingling; red glisten- 
ing erysipelas, with burning pain; redness of mucous surfaces; conjunctival 
inflammation with pain, photophobia, and burning lachrimation; inflam- 
mation with bright-red tumid surfaces and deep-seated burning pain; 
tumid red swellings; inflammation with ichorous discharges, the tissues 
seemingly melting away; old ulcers with shining red edges; induration of 
the submaxillary glands. 
Action and Toxicology.-Internally, administered in small doses, 
Rhus Toxicodendron is slightly stimulant, increasing the renal and cutane- 
602 POISON IVY 
(Rhus Toxicodendron) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Poison Ivy acquired a medicinal reputation late in the eighteenth century, and this was es- 
pecially enhanced after the appearance of the celebrated inaugural thesis of Dr. Thomas Hors- 
field, of Bethlehem, Pa., in 1798. After years of neglect it was subsequently revived, largely 
through Homcepathic use, and finally became a most important medicine in the Eclectic 
system of specific medication. It is now among the most valued of Eclectic drugs. INDIVIDUAL DRUGS. 
ous secretions, and proving feebly laxative. Employed in paralytic states 
it is reputed to have effected a return of sensation and power of movement, 
the good effects being ushered in with a sensation of pricking and burning, 
with twitchings of the affected parts. Large doses occasion stupefaction, 
or a sort of intoxication, exhibited by vertigo, impairment of the special 
senses, pupillary dilatation, chilliness, sickness at the stomach with thirst and 
burning pain, and a feeling of constriction in the temporal regions. The 
pulse becomes slow, irregular and small, the activity of the skin and kidneys 
increases, weakness, trembling, and fainting occur, and sometimes con- 
vulsions ensue. A pint of rhus berries induced drowsiness, stupor, delirium, 
and convulsions in two children who partook of them. The infusion of the 
root taken internally is asserted to have produced the characteristic local 
eruptions, besides producing a harsh cough, scanty urine, and severe gastro- 
intestinal symptoms. 
Locally, rhus is a powerful irritant poison. The toxic manifestations 
produced by the different species are of precisely the same nature, differing 
only in degree of intensity. Rhus Toxicodendron ranks next to poison 
dogwood {Rhus venenata) in point of virulence. While locally poisonous to 
some persons, others are totally unaffected by it. Many are but mildly 
poisoned by it; many more, however, show serious evidence of its great 
activity. Contact is not always necessary to obtain its effects. Indeed, 
many individuals apparently are poisoned merely by exposure to an at- 
mosphere contaminated with the toxic exhalations of the plant. This is 
especially true when the air is heavy and humid, or when the susceptible 
individual is freely perspiring. Alcoholic solution of the toxic principle 
retains its virulence for many years (Johnson). The dried leaves are, as a 
rule, inert. 
A singular feature connected with rhus poisoning is its recurrence from 
month to month, and from year to year, even when the affected individual 
is far remote from all exhalations of the plant. This was early noted by 
Barton, who personally experienced such recurrence for five successive 
years-a portion of which time was passed in Europe far from proximity to 
the plant in question. We have also observed this phenomenon. The 
smoke from burning rhus wood was noticed as early as 1720 by Sherard, 
Wangenheim, and Kalm, to produce poisonous effects. It appears that 
horses eat the plant with impunity (Barton). According to William 
Bartram, they are very fond of the leaves. Cows are wholly unaffected by 
the ingestion of the plant. Thunberg observed that sheep ate of the leaves 
of Rhus lucidum, a similar species, without harm. To dogs and guinea pigs, 
on the other hand, poison vine is fatal. The statement that the infusion of 
the leaves was administered to consumptives with non-poisonous results 
may seem contradictory, but we cannot but believe that a portion of the 
poisonous principle is volatile, in spite of the assertion that non-volatile 
toxicodendrol is the toxic agent, and consequently driven off in heating. 
The nature of poisoning by rhus has always partaken somewhat of the 
mysterious, and it has been the subject of much speculation. Various 
reasons have been assigned as to why it poisons at all, and as to why it 
affects only certain individuals. It has been customary to attribute the 
deleterious effects to emanations from the living plant. Later, Prof. Maisch 
603 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
announced a volatile substance of acid character as the offender, and 
named it toxicodendric acid. Still later, a bacterium was charged with 
creating the mischief. The latter cause, however, has now been satisfactorily 
disproved. An oil has now been isolated, and this, even when purified, 
excites exactly the same form of dermatitis as the growing plant. This 
discovery was made in 1895 by Dr. Franz Pfaff, of Harvard University. 
It is present in every part of the ivy plant, and even the dried wood is 
said to retain it. It has been named toxicodendrol, and is asserted to be in 
reality the only tangible substance found thus far to which may be at- 
tributed the toxic effects of the vine. Still, this does not explain why in- 
dividuals are poisoned when not in contact with the plants. Alcohol 
freely dissolves this oil, but water, as with oily bodies, does not, nor does it 
wholly remove it from the skin; hence the reason why washing after contact 
with ivy does not prevent the appearance of the characteristic eruption. 
Experimentation (see V. K. Chestnut, United States Yearbook of Depart- 
ment of Agriculture, 1896, p. 141) has shown that if the oil be placed upon 
the skin, and immediately removed with alcohol, but slight effects are 
observed. The longer the interval, however, the more pronounced the 
effects become. In all, the effects were less marked than when no such 
treatment was given. From the fact that several portions of the skin could 
be impressed without coalescence of the areas, it has been concluded that 
the action of the oil is wholly local, and that the poison does not enter the 
blood. We are not, however, satisfied with this view of the matter, for if 
so, how are we to explain the recurrence of the trouble after weeks and 
months, and even years, in persons who for some time have not been near 
the plants or in the neighborhood of their growth? 
The local effects of rhus are well known. Briefly stated, it occasions an 
eczematous, sometimes erysipelatoid, inflammatory eruption, characterized 
by intense itching, redness, and tumefaction, followed by burning pain, 
sympathetic febrile excitement, and vesication. The vesicles are at first 
small, closely aggregated in characteristic patches, and filled with a watery 
fluid; sometimes they become yellow, as if pus were present. Finally, as they 
mature, they rupture, when a yellow scab forms. The tongue is coated 
white, and headache and delirium are often symptoms. The effects are 
observable a short time after exposure to the poison, the affection usually 
spending its force in the course of four to five days, and is followed by des- 
quamation of the cuticle. The face and genitalia seem to be favorite 
localities for the most pronounced swelling to appear. One case of poison- 
ing by Rhus venenata came under our observation, in which the swelling of 
the face was so great as to wholly obliterate the features, giving to the 
individual a swine-like, rather than human, appearance. 
Treatment.-Domestic medication, in the shape of bruised Impatiens 
pallida and fulva (Jewel weeds) gave prompt relief. Lack of space forbids 
more than the partial enumeration of the many remedies that have been 
extolled for the cure of this malady. The chief, however, are lobelia (in- 
fusion), veratrum, gelsemium, hamamelis, grindelia, stramonium, eupa- 
torium, serpentaria, lindera, sassafras bark, dulcamara, oak bark, tannic 
acid, alnus (boiled in buttermilk), carbolized olive oil, sodium bicarbonate, 
borax, alum curd (especially to be used near the eyes), and, perhaps the 
604 INDIVIDUAL DRUGS. 
best of all, solution of ferrous sulphate (green vitriol). Sugar of lead (lead 
acetate) has long been a favorite agent for the relief of this trouble, but as it 
has most frequently been applied with water, it has very often failed to give 
relief. It has now been shown that a solution in weak alcohol (50 to 75 
per cent) often gives immediate and permanent relief. Occasionally, zinc 
and copper sulphates, oxalic acid, potassium chlorate, and other salts are 
effectual. Sodium carbonate, sodium sulphate, chlorinated lime, weak 
ammonia solution, and lime-water have been similarly employed. Echafolta 
has recently been extolled in this affection. 
In our opinion, the following are among the best: 
Aqueous solution of sodium salicylate and colorless hydrastis, freely 
applied. Aqueous solution of specific medicine lobelia, to which is added a 
little glycerin. An alcoholic solution of lead acetate sometimes relieves 
promptly. An aqueous solution of ferrous sulphate is excellent. It has the 
disadvantage of staining. A weak aqueous solution of potassium per- 
manganate often relieves remarkably, but it, too, stains the skin and linen. 
If obtainable, fresh alder bark (Alnus serrulata) in decoction gives quick 
relief in many cases. 
Another effective application is the so-called "Eclectic Wash" composed 
of lobelia, baptisia and zinc sulphate, a preparation which is now marketed 
under the name "Citcelce". 
In every instance, if much skin is involved, the diet should be light and 
cooling, and the bowels should be kept well opened to relieve the kidneys of 
some of the extra work put upon them through insufficient cutaneous action. 
In fact all treatment should be accompanied by a light, cooling diet, and 
cooling laxatives or diuretics. 
Therapy.-Rhus is a medicine for nervous irritation, nervous tension, 
and the typhoid state. Its range of application is wide but distinct. Acting 
primarily and most pronouncedly upon the nervous system, it proves 
secondarily an ideal sedative to control excited circulation. The action 
of rhus is best understood, as with other well-worked-out specific medicines 
-by its fitness for conditions rather than for disease-condition groups 
which we know as particular diseases. It is especially of great value in 
children's diseases, and as far as our observations go is less required in 
patients past fifty years of age, except as a stimulant after paralytic at- 
tacks. Its value in irritative conditions of the brain and sympathetic nerv- 
ous system, as well as in disorders of the gastro-intestinal tract, is very ap- 
parent, especially in the summer bowels affections of the young. It is a 
remedy best adapted for infants, young children, adolescents, and forthose 
in the prime of manhood and womanhood. 
The patient requiring rhus has a small, moderately quick and vibratile 
pulse, especially showing sharpness of stroke and associated with burning 
sensations. There is always a peculiar state of erethism which indicates it. 
The tongue is long and narrow, with marked redness, or reddened edges 
and tip, and prominent papillae, clearly disclosing a state of decided irrita- 
tion and involvement of the brain centers. There may be only gastric 
irritability, there may be headache, there may be a jerky condition border- 
ing closely upon a convulsive state, there may be delirium. The most 
noticeable symptom, however, is the great nervous unrest displayed, the 
605 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
little patient being excessively nervous and explosive. In this respect it some- 
what resembles the great unrest which gelsemium relieves, but the latter is 
usually accompanied by bright eyes and contracted pupils and high temper- 
ature. The gelsemium patient is hot and agitated and the mental excite- 
ment is great. With rhus the nervousness takes on the form of twitching, 
jerking, and seems motor rather than mental alone. The rhus patient 
sleeps fretfully and disturbedly, frequently starting suddenly from out its 
slumbers, and uttering a sharp, shrill cry, as if in fright-the brain cry (cry 
encephalique)-which, once heard, will never be forgotten. For the con- 
dition which this cry announces no agent is equal to rhus. Brain cry is 
often heard in grave disorders, as typhoid fever and meningitis. The rhus 
patient may have some elevation of temperature, or have normal or sub- 
normal heat. He is jerky, apprehensive, but when very ill, apathetic. 
His secretions, unless it be a diarrhoea, are in abeyance. His mouth is dry 
and the tongue is long, narrow, red at tip and edges, and inclined to dryness. 
In grave disorders indicating a dissolution of the blood there is a marked 
glutinous character to the secretions of the mouth, or they may be nearly 
absent and replaced by dry, black and fetid sordes. In this will be recog- 
nized the "typhoid state". 
The circulatory disturbance requiring rhus upon which the nervous 
phenomena chiefly depend is usually localized and not general; small areas 
of the brain or nerve centers only may have a disturbance of the blood 
supply. As a rule the marked restlessness is all out of proportion to the 
apparent circulatory derangement. Frontal pain, sharp in character, is a 
prominent indication for this drug. The rhus tongue is reddened on the 
tip and edges, and even may take on the strawberry character, typical of 
gastric irritability, typhoid, and scarlatinal states. Associate this with the 
kind of pulse mentioned, and with tympanites, brown sordes, and reddened 
mucous surfaces, and the indication is still more direct. Discharges of an 
acrid character, and ichorous flow from tissues which seem to disappear by 
mere drainage, are further guides to its use. It is a certain remedy for 
vomiting when the tongue is of the kind above referred to. In fact, great 
unrest with vomiting is one of the most direct indications for its selection. 
Rhus is of value in gushing diarrhoea, with or without vomiting. It 
has served well in cholera infantum with copious gushing, watery stools, 
both to control the discharges and to relieve irritability. In muco-enteritis 
it may be used to alleviate nervous disquietude, and to some extent to 
restrain the evacuations. During dentition it is extremely useful when the 
nerve stress borders upon the convulsive, but for the fretful and peevish 
and worn-out, teething patient matricaria is the better drug. 
Rhus is a drug of the very greatest value in typhoid fever. We have 
successfully carried many cases of enteric fever through with no other 
medicine than rhus-the indications being the dry tongue, low muttering 
delirium, sordes on the lips and teeth, and diarrhoea. Should the urine 
become suppressed its use should be stopped until renal activity is im- 
proved. In typhoid dysentery, fortunately now rare, it is often serviceable 
when associated with the head symptoms indicating rhus. Nor should 
rhus be overlooked in the treatment of remittent and intermittent types of 
fever showing a typhoid element. 
606 INDIVIDUAL DRUGS. 
Rhus is frequently a remedy for pain. The more burning in character 
the better it relieves. Thus it relieves deep and superficial neuralgic and 
neuritic pains, the pain of pleurisy, and that of cystitis. Rhus is an aid, 
seldom a master, in acute rheumatism, but it helps to control pain when of a 
burning character, and the surfaces present an erysipelatoid redness. 
There is swelling, tension, and a glistening skin. When rheumatism is 
aggravated by the warmth of the bed, rhus appears to be indicated. Acute 
cases are more benefited than so-called chronic rheumatism, though it is 
especially useful in both to control restlessness. In toothache not due to 
caries, occurring in a rheumatic subject, rhus often relieves. These cases 
are said to be aggravated by warmth or by warm liquids. There are two 
forms of rheumatism especially benefited by rhus, whether they are acute 
or chronic. One is that induced by dampness and having pain of a sub- 
acute type; the other, so-called rheumatic involvent of the fibrous tissues 
of the body-the tendons, fasciae, ligaments, and muscle sheaths. The 
latter cases are probably not rheumatic, but due to toxic impression through 
retained poisons which impress the nervous system and produce pain. 
Only indifferent results attend its use in lumbago-though it should be 
tried when general rhus indications are present. Administered for a long 
period in small doses, rhus is one of the most satisfactory drugs for the 
articular stiffness resulting from rheumatic inflammation. 
Rhus is frequently administered to relieve headache. That occurring 
in the frontal region is most amenable. Many contend that left-sided 
headache is that in which it is indicated, but we have never been able to 
verify this contention. With the rhus tongue and sharp stroke of the pulse 
and nervous tension present, we have found it to act equally well on either 
side of the head, or for that matter, upon any part of the body. The same 
may be said in neuralgia, whether in sciatic, facial, intercostal, or other forms. 
When it does relieve headache and neuralgia it usually acts promptly. 
Rhus is a valuable aid in pneumonia, bronchitis, la grippe, and phthisis, 
when the patient is extremely irritable and suffers from gastric irritation. 
With the small wiry pulse as a guide it often controls restlessness and de- 
lirium in these disorders and in adynamic fevers, which are probably 
caused by irritation and local hyper-vascularization of limited areas in the 
cerebral and other nerve centers. It is indicated in typhoid pneumonia, 
with red, glazed tongue, and offensive muco-purulent expectoration. Un- 
controllable, dry, spasmodic, and tickling cough is frequently relieved by it. 
In the exanthemata rhus appears to exert a special antagonizing in- 
fluence, for which it may be given in scarlatina and measles where the 
vital powers are greatly depressed, and in variola, with livid color of the 
surface and foul discharges. 
Rhus has been employed successfully in paraplegia without marked 
organic lesion, and in paralysis of the bladder and of the rectum. In 
paralytic states, however, it is usually of little value except in those con- 
ditions which follow attacks of rheumatism. We have, however, found 
it of great value in restoring power after hemiplegia and paraplegia. It 
should be given in liberal doses for a continued length of time. Its 
efficiency in sciatica, however, is admitted by some who think the drug 
oracticallv valueless as a medicine. 
607 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Rhus is a remedy in the various disorders of the skin presenting the 
characteristic rhus indications-redness, intumescence, and burning. 
For vivid, bright-red, glistening erysipelas, especially when confined to the 
upper part of the face, with marked puffiness, it is one of the most successful 
of remedies. In fact in acute inflammations of the skin it is often more 
serviceable than aconite and veratrum. It is of great value in herpes where 
there are burning, itching, and exudation of serum. Eczema, pemphigus, 
and many irritable and inflammatory skin affections are relieved by it 
when redness, intumescence, and burning are prominent symptoms. 
It frequently proves the indicated drug in urticaria and functional pruritus. 
Erythematous and erysipelatous inflammation of the vulva, with burning 
pain, and the itching and vulval irritation following micturition, are often 
permanently relieved by rhus. Tumid, reddened, and glistening enlarge- 
ments, and ulcerations with red glistening margins, syphilitic or non- 
syphilitic, likewise call for rhus. In the ulcerative forms the parts seem to 
melt away without sloughing. It is of much value in parotitis, and in 
swelling of the submaxillary gland with great induration few remedies are 
better (Locke). Its constitutional effects are often manifested in slow- 
forming carbuncle and carbunculous furuncles. By some rhus has been 
used internally to hasten the cure of cutaneous rhus poisoning. Of this 
antitoxic power over poisoning by itself we have never been satisfactorily 
convinced. 
In ocular therapeutics rhus is considered by many Eclectic oculists as 
an important drug. It is sometimes administered to prevent inflammatory 
action after cataract operations. Palpebral oedema with marked redness 
is said to be relieved by it, while neuralgic and other pains in the globe of 
the eye, and aggravated by motion and warmth, often vanish under its use. 
Acute and subacute forms of conjunctivitis are relieved by it on account 
of its special affinity for the blood vessels of the orbit. In the catarrhal 
ophthalmia of scrofulous children with strongly inflamed palpebral edges 
and conjunctivae and marked photophobia and burning lachrimation, the 
action of the remedy is decided and prompt. There is usually a sensation 
as of foreign particles, such as sand, etc., in the eye. 
The proper dose for specific effects, and it is scarcely employed in any 
other manner, is the fraction of a drop of specific medicine rhus, thus; 
3 Specific Medicine Rhus, gtt. v to xv; Water, fl^iv. Mix. Dose, One 
teaspoonful every hour in acute disorders; four times a day in chronic 
affections. Rhus should, as a rule, be given unmixed with any ingredient 
but water. 
The bark of the root of Rhus aromatica, Alton (Nat. Ord. Anacardiaceae). A small 
shrub of the rocky regions of eastern United States. Dose, 5 to 60 grains. 
Common Names: Fragrant Sumach, Sweet Sumach. 
Principal Constituents.-Volatile and fixed oils, tannin, and several resins. 
Preparation.-Specific Medicine Fragrant Sumach. Dose, 5 to 60 drops. 
Specific Indications.-"Stools profuse, skin cool and sallow, pulse 
small and feeble, loss of flesh, abdomen flabby, tongue pale, trembling 
and moist, trembling in lower limbs; general sense of lassitude and languor" 
(McClanahan). Painless diarrhoea; nocturnal enuresis, from weakness of 
sphincter vesicae; and malarial hematuria. 
RHUS AROMATICA. 
608 INDIVIDUAL DRUGS. 
Action and Therapy.-Rhus aromatica is a remedy for excessive dis- 
charges of urine and painless but profuse forms of diarrhoea. It is also 
serviceable in some forms of passive hemorrhage, particularly malarial 
hematuria, a disorder quite prevalent in the Southern States. Occasionally 
it will serve a useful purpose in purpura hemorrhagica and in very mild 
cases of hemoptysis of phthisis, but is a better agent for the diarrhoea and 
night sweats of that disease. 
The principal use of fragrant sumach is to control bedwetting in chil- 
dren with weak bladder. In some instances its action is more satisfactory 
than that of any other drug; in others it fails. When irritability of the 
urinary passages is due to sphincteric weakness it is usually successful; 
when due to colds, worms, and various other extraneous causes it is likely 
to prove ineffectual. Polyuria is one of the conditions markedly improved 
by this drug, and some have thought it to have a restraining effect both 
upon the hypersecretion of urine and the output of sugar in diabetes. 
Apparently it is only in exceptional cases that it displays this power, and 
too much reliance should not be placed upon it in severe cases. As an aid 
to control some of the phases of diabetes, as excessive urination, it should 
be used in conjunction with otherapproved methods. While chiefly of value 
in the enuresis of children, it sometimes proves of service in that of the 
elderly, and especially when there is much irritation, occasional passages 
of bloody urine, and evident relaxed habit of the urinary tract. It is some- 
times useful in chronic, painful, vesical catarrh. It is also useful in chronic 
bronchitis with profuse blood-streaked expectoration. 
Fragrant sumach often restrains diarrhoea of the free and painless type, 
notably in cholera infantum. In all disorders fragrant sumach should not 
be used where there is inflammation. The drug is best dispensed in glycerin 
as follows: 1} Specific Medicine Fragrant Sumach, fl^ss; Glycerin, fl3iij ss. 
Mix. Sig.: From one-half to one teaspoonful, in water, every three or four 
hours. 
The fruit, leaves and root bark of Rhus glabra, Linne (Nat. Ord. Anacardiaceae). 
Common in thickets in the United States and Canada. Dose, 1 to 30 grains (bark). 
Common Names: Smooth Sumach, Upland Sumach, Pennsylvania Sumach. 
Principal Constituents.-A large amount of tannin abounds in the bark and leaves; 
resin (bark); tannic and gallic acids, malic acid and malates, volatile oil, and red-coloring 
matter (fruit). 
Preparation.-Fluidextractum Rhois Glabra, Fluidextract of Rhus Glabra. Dose, 
5 to 60 drops. 
Specific Indications.-Relaxed mucosa, with unhealthy discharges; 
mercurial ulcerations; aphthous stomatitis; spongy gums; flabbiness and 
ulceration of tissues; ulcerative sore throat with fetid secretion. 
Action and Therapy.-External. All parts of the smooth sumach are 
astringent and antiseptic and of much value in flabbiness of tissue, with 
tendency to ulceration and unhealthy secretion. An infusion of the fruit 
provides an excellent gargle for fetid sore throat and a wash for aphthous 
ulcerations. It is a useful drug in decoction of the bark, infusion of the 
berries, or in fluidextract wherever a mild and deodorant astringent is 
required; especially is it serviceable in the spongy bleeding gums of scorbutic 
patients and that of hemophiliacs. 
RHUS GLABRA. 
609 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
RUBUS. 
The bark of the root of Rubus villosus, Aiton; Rubus canadensis, Linne; and Rubus 
trivialis, Michaux (Nat. Ord. Rosaceae). Wild and cultivated in the United States. Dose, 
5 to 60 grains. 
Common Names: (1) Blackberry; (2) Low Blackberry; (3) Low-bush-Blackberry. 
Principal Constituents.-Tannin. Fruits contain citric and malic acids; the glucoside 
villosin (in Rubus villosus) a body similar to saponin, and about 20 per cent of tannin. 
Preparations.-1. Specific Medicine Rubus. Dose, 5 to 60 drops. 
2. Syrupus Rubi, Syrup of Black Raspberry. Dose, 1 to 2 fluidounces. 
Specific Indication.-Gastro-intestinal atony, with copious watery and 
pale feces. 
Action and Therapy.-The decoction of rubus is a mild and agreeable 
astringent in watery diarrhoeas, especially in children, when the stools are 
clay-colored or pale. There is marked enfeeblement of the stomach and 
bowels, and the child is fretful, has no appetite, and there is marked pallor 
of the skin. The syrup or a spiced cordial of the bark and another of the 
fruit have been used largely in domestic practice to control intractable 
diarrhoeas. They act best after a thorough purging with castor oil or similar 
cathartic has been resorted to. Rubus strigosus (Red Raspberry) has 
similar uses. 
RUBUS IDCEUS. 
The fruit of Rubus Idceus, Linne (Nat. Ord. Rosaceae). Cultivated. 
Common Name: Raspberry. 
Principal Constituents.-Malic and citric acids, laevulose, 4.6 per cent and dextrose 
(2.5). 
Preparation.-Syrupus Rubi Idcei, Syrup of Raspberry (chiefly a vehicle). 
Action and Therapy.-An infusion of the leaves is useful in the diar- 
rhoea of relaxation, with copious watery discharges. The fruit as prepared 
in a syrup-Syrupus Rubi Idaei-is highly prized as a flavored vehicle for 
medicines and for the beautiful color it imparts to pharmaceutical mixtures. 
Diluted and iced it forms an agreeable acidulous drink for fever patients. 
A refreshing fever drink is also prepared by mixing equal parts of syrup of 
raspberry and vinegar and diluting with water to taste. 
RUMEX. 
The root of Rumex crispus, Linn6 (Nat. Ord. Polygonace ae). A common weed intro- 
duced from Europe, and found abundantly in this country in waste places, among rubbish, 
and in cultivated grounds. Dose, 5 to 60 grains. 
Common Name: Yellow Dock. 
Principal Constituents.-Yellow Dock has not been satisfactorily analyzed. 
Preparation.-Specific Medicine Rumex. Dose, 1 to 60 drops. 
Specific Indications.-Vitiated blood with chronic skin disorders; low 
glandular and cellular deposits with tendency to indolent ulcers; feeble 
recuperative power; chronic sore throat, with glandular engorgement and 
hypersecretion; cough, with shortness of breath and praecordial fullness; 
dry, irritative laryngo-tracheal cough; stubborn, dry summer cough; 
nervous dyspepsia, with epigastric fullness and pain extending into the 
chest. 
Action and Therapy.-Rumex is decidedly alterative and might be 
used more extensively for that purpose. It should especially be brought 
610 YELLOW DOCK 
(Rumex crispus) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Yellow Dock is a representative of the vegetable alteratives once highly valued in Eclectic 
medicine, having been acquired originally from domestic practice. Alteratives of this type 
are too little employed at the present and could now be restudied with advantage. Rumex 
is said to be one of the natural iron-bearing drugs, and is still highly valued as a deobstruent 
and alterative. 
Courtesy of Mr. Moritz Fischer INDIVIDUAL DRUGS. 
into requisition in depraved states of the body fluids with tendency to 
chronic skin disorders, with glandular engorgement, tendency to ulceration, 
and slow recuperative powers. It is especially valuable in strumous pa- 
tients with low deposits in the cellular and glandular tissues which break 
down easily but are very slow to repair. In small doses the specific med- 
icine is also useful in nervous dyspepsia with epigastric fullness, and pectoral 
pain from gaseous distention of the stomach. It is also serviceable in laryn- 
geal irritation, with cough of the types alluded to under Specific Indications. 
The leaves and unripe fruit of Ruta graveolens, Linne (Nat. Ord. Rutaceae). A half 
shrubby perennial introduced into American gardens from Europe. Dose, 1 to 10 grains. 
Common Names: Rue, Garden Rue. 
Principal Constituents.-A volatile oil [Oleum Rutce), coumarin, the yellow glucoside 
rutin (rutic acid), and a volatile alkaloid. 
Preparations.-1. Oleum Rutce, Oil of Rue. Dose, 1 to 6 drops. 
2. Tinctura Rutce, Tincture of Rue (fresh herb, jviii; Alcohol, Oj). Dose, 1 to 10 
drops. 
Action and Therapy.-Rue is a gastro-intestinal irritant and a poison 
to the nervous system, capable, in large doses, of causing death. It is 
emmenagogue and anthelmintic. Acting strongly upon the uterus, it may be 
given in amenorrhcea due to atony, but the dose must be small lest an 
inflammatory action be induced. It is a good vermifuge, though its dis- 
agreeable taste is a decided obstacle to its use. It has been suggested as a 
remedy for irritability of the urinary tract when due to atony, and in 
nervous disorders of a spasmodic type. On account of its ecbolic qualities 
it should not be administered during pregnancy. 
RUTA. 
SACCHARUM. 
Sugar, Sucrose. (Formula: CuHMOn.) 
A substance obtained from Saccharum officinarum (Nat. Ord. Gramineae), the sugar- 
cane, and from Beta vulgaris, Linne, var. Rapa, Dumort (Nat. Ord. Chenopodiaceae), the 
sugar beet, and other sources. Southern Asia and extensively cultivated in tropical and 
subtropical countries, notably the southern portion of the United States. 
Description.-Hard white crystals, or a crystalline white powder, without odor and 
having a pure and pleasant sweet taste. Very soluble in cold and hot water, less soluble in 
alcohol (about 1 in 175 parts), and insoluble in ether or chloroform. Permanent when kept 
dry; ferments readily in dilute solution. 
Preparation.-Syrupus, Syrup (Syrupus Simplex, Simple Syrup, Sirup). Sugar, 850; 
Distilled Water to 1,000 parts; prepared by heating and straining 
Action and Therapy.-External. Sugar is demulcent, antiseptic, and 
antiputrefactive, but not antifermentative. It enters into lotions and 
douches for nasal and throat disorders, not alone for its agreeable sweeten- 
ing quality but for its antiseptic and soothing effect. Its local use sometimes 
relieves cough, hoarseness and soreness of the throat. Sluggish and heavily 
granulating ulcers have been successfully treated with powdered sugar, and 
some have advised it for small wounds. It is used in the preparation of 
lozenges and tablets, and as a coating and ingredient of some pills. 
Internal. Internally sugar is demulcent, nutritive, and antiputre- 
factive as well as diuretic. As an article of food it is valuable but abused, 
and as it does not contain nitroven it cannot alone sustain life. Small 
611 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
amounts promote digestion. Used in large quantity it is injurious to 
digestion, readily causing fermentation and acidity of the stomach with 
flatulence and eructations of gas. Sugar intolerance is produced in some in- 
dividuals, and especially in infants, with resultant skin eruptions. In some 
adults its excessive use causes fatigue and pains simulating neuritis. It is 
contraindicated in obesity, diabetes mellitus, sugar intolerance, and in 
gastro-intestinal fermentation, with flatulence and disturbed bowel action. 
Its chief use is in the preparation of medicinal syrups, in which it prevents 
putrefactive change, and in the extemporaneous prescribing of otherwise 
unpleasant medicines. In this respect it is frequently abused, as it some- 
times prevents the full and intended action of the medicines so incorporated. 
SACCHARUM LACTIS. 
Sugar of Milk, Milk Sugar, Lactin, Lactose. (Formula: C12H22O11. H2O.) 
A peculiar crystalline sugar, obtained by evaporation and recrystallization, from the 
whey of cow's milk. 
Description.-Permanent, hard, white crystalline masses, or a white powder some- 
what gritty, without odor and having a feebly sweet taste; readily soluble in cold and hot 
water; almost insoluble in alcohol and wholly insoluble in ether or chloroform. Dose, 
1 to 6 ounces. 
Action and Therapy.-Employed chiefly for the purpose of making 
triturations, as of elaterin, podophyllin, santonin, sulphur, etc, and as an 
ingredient of Dover's and the diaphoretic powders. It has scarcely any 
effect upon the human body other than to induce increased diuresis, a 
property that some deny. It is preferable to cane sugar for sweetening 
infants' foods, though not wholly free from the tendency to cause fermenta- 
tion in the stomach. For the latter purpose it is now largely superseded 
by dextri-maltoses. When stomach disorders are non-fermentative it may 
relieve gastric irritability; and, being non-nitrogenous, it has been em- 
ployed as a food in pulmonary and other disorders where such a diet is 
desired, using it in the food. Germain See strongly advocated it in doses 
of one to six ounces diluted with water or milk, and in a concentrated 
syrup as a powerful hydragogue diuretic in dropsies of cardiac origin. 
SALICINUM. 
Salicin. (Formula: CisHi8O7.) 
A glucoside obtained from several species of Salix and Populus (Nat. Ord. Salicaceae). 
Europe; naturalized and cultivated in North America. 
Description.-Very bitter, colorless, or lustrous, white silky crystals, or a white crystal- 
line powder; without odor; soluble in water and alcohol, insoluble in ether or chloroform. 
Dose, 5 to 20 grains. 
Specific Indications.-Periodicity, with rheumatic pain or that sim- 
ulating rheumatism; acute rheumatism (with special sedatives to control 
temperature); malarial diarrhoea; dyspepsia, due to a malarial infection. 
Action and Therapy.-Salicin, though not poisonous to man, has in 
large doses produced severe symptoms-"dusky countenance, severe 
headache, nervous irritability, extreme weakness, tinnitus aurium, hurried 
breathing, tingling of the extremities, and huskiness of the voice." It 
does not reduce temperature in health, but does so in fevers, especially 
when of malarial origin. Salicin is oxidized in the body, passing in the 
urine as salicylous, salicylic, and salicyluric acids. 
612 INDIVIDUAL DRUGS. 
Salicin is a good but often neglected medicine, and is of more value 
as an antiperiodic and tonic than as a febrifuge. It is non-irritating to the 
stomach and often serves as a good bitter peptic. When quinine is not 
well borne or is contraindicated, salicin may be substituted for it, and in 
some instances it is preferable to quinine in malarial intermittent fever. 
It may also be used in lieu of salicylic acid and the salicylates in acute 
articular rheumatism, association with the special sedatives to control 
fever enhancing its value. The dose required is quite large-five to ten 
grains, sometimes thirty to forty grains, every three or four hours. Owing 
to its decomposition products, large doses may induce results bordering 
upon salicylism. As the chemical change is slowly effected, however, 
unless too frequently repeated and in very large doses, cumulation need 
not be feared. When intermittents are accompanied by rheumatic pain, 
from ten to thirty grains may relieve the distress. Good results have 
attended the use of salicin in influenza when pain and periodicity were 
present; and in this disorder it is much to be preferred over quinine. It 
may also be used to relieve periodical neuralgia of malarial or miasmatic 
origin, and attended by a feeble circulation, cold skin, and general debility. 
As a tonic to the digestive organs and general system, small doses after 
meals are of much value and should be more generally used than cinchona 
and its alkaloids. It sometimes checks the diarrhoea of phthisis and tones 
the mucous tissues when prone to excessive discharges. Salicin should be 
administered in capsule after meals, and followed by a draught of water 
or milk. 
SALIX NIGRA. 
The bark and aments of Salix nigra, Linne (Nat. Ord. Salicaceae); United States, 
particularly along streams in New York and Pennsylvania. 
Common Names: Black Willow, Pussy Willow. 
Principal Constituents.-The bark contains tannin and salicin (see Salicinum). 
Preparation.-Specific Medicine Salix Nigra Aments. Dose, 10 to 60 drops. 
Specific Indications.-Sexual erethism, irritability, and passion; 
libidinous thoughts; lascivious dreams; nocturnal emissions; mild nymph- 
omania, erotomania and satyriasis; cystitis, urethral irritation, prostatitis, 
and ovaritis, and allied disorders following in the wake of sexual abuse or 
excesses. 
Action and Therapy.-Salix nigra is a remedy of great value in a 
restricted field in therapeutics. While the bark and its preparations have 
long been recognized as possessing antiseptic and detergent properties, 
the use of the aments is of more recent date and confined almost wholly 
to the generative organs. To be of value, however, only the freshly gathered 
aments should enter into its preparations to insure medicinal results. 
Above all other uses, its greatest value is in that form of sexual erethism 
and irritability due chiefly to an irritative condition of the urethra result- 
ing in spermatorrhoea, and less in such sexual perversions as give rise 
merely to physiological losses; nor can it take the place of the knife when 
losses are due to conditions requiring surgical correction. In well indi- 
cated cases it proves a decided and valuable anaphrodisiac and tonic. 
The mental emotions play a lesser part in the disorders requiring salix 
nigra, but when the genital tract is sensitive, when the bladder becomes 
613 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
involved, and when sexual excesses and masturbation are the causal factors, 
it is a remedy of first importance. Secondarily, it is not without value where 
the mentality of the victim is at fault, but will be found to moderate 
passion and strengthen the reproductive tract when pollutions are the 
result of sexual intemperance, libidinous thoughts by day, and lascivious 
dreams by night. 
SALVIA. 
The leaves of Salvia officinalis, Linne (Nat. Ord. Labiateae). A native of Europe, but 
cultivated extensively in kitchen gardens. Dose, 5 to 30 grains. 
Common Names: Sage, Garden Sage. 
Principal Constituents.-An aromatic, volatile oil (oil of sage), the chief principle of 
which is thujone (50 per cent). 
Preparation.-1. Tinctura Salvia, Tincture of Sage (Sage, 3viij; Alcohol (76 per 
cent), Oj). Dose, 1 to 60 drops. 
2. Infusum Salvia, Infusion of Sage (gss to Water, Oj). Dose, 1 to 4 fluidounces. 
Specific Indications.-Skin soft and relaxed; extremities cold and 
circulation feeble; urine of low specific gravity; colliquative sweating. 
Action and Therapy.-Sage is a feeble tonic, astringent, and dia- 
phoretic. The infusion provides a good gargle for ulcerated and inflamed 
throat and for relaxation of the uvula. Taken warm, it produces free 
sweating, while cold sage tea, by strengthening the cutaneous functions, 
restrains excessive sweating, and for this purpose is highly valued in phthisis 
and other wasting diseases. It acts best when the skin is soft and relaxed, 
the extremities cold, and the circulation weak. It is of considerable value 
in gastric debility with flatulence, and has proved a good tonic in sperma- 
torrhoea. A good indication for salvia is urine of low specific gravity. 
SAMBUCUS. 
The flowers and the fresh inner bark of Sambucus canadensis, Linn& (Nat. Ord. Capri- 
foliaceae). An indigenous shrub growing in low, damp grounds and waste places. Dose, 
5 to 60 grains (bark). 
Common Names: Elder, American Elder. 
Principal Constituents.- Valeric acid, tannin, volatile oil, and a resin. 
Preparation.-Specific Medicine Sambucus. Dose, 1 to 60 drops. 
Specific Indications.-In skin diseases when the tissues are full, flabby, 
and oedematous, the epidermis separates and discharge of serum is abun- 
dant, forming crusts; indolent ulcers, with soft oedematous edges; mucous 
patches with free secretions; post-scarlatinal dropsy; low deposits in or 
depravation of tissues. 
Action and Therapy.-External. An ointment of sambucus has been 
successfully used in weeping eczema, and in old ulcers as a stimulant when 
the tissues are full and flabby and attended with a discharge of serum. 
Internal. Sambucus is stimulant; the flowers in warm infusion are 
diaphoretic; the cold infusion, diuretic and alterative. Preparations of 
the green inner bark are excellent agents in oedematous conditions, 
especially in skin diseases showing a tendency to ulceration, with watery 
discharges and boggy edges. The epiderm separates easily and the weep- 
ing secretions form crusts. Probably its most direct indication is deprava- 
tion of tissue, with oedema and deposits of cacoplastic material. Sambucus 
is useful in catarrhal nasal obstruction in infants and in the dropsy follow- 
614 BLOODROOT 
(Sanguinaria canadensis) 
Photo by Frank H. Shoemaker, 
Lincoln, Nebraska 
Courtesy of Prof. Rufus A. Lyman, 
University of Nebraska 
Bloodroot was one of the earliest of American plants to acquire medical distinction. It was 
included in that very early account (probably the first book on American botany) Canadensium 
Plantarum aliarumque nondum editarum Historia (1635), by the French botanist, Jacques 
Comuti. It has had a fitful career as a medicine, but is still greatly valued when prescribed 
according to Eclectic specific indications. Bloodroot is threatened with extinction by reckless 
van lalism in spring-flower gathering. INDIVIDUAL DRUGS. 
ing scarlet fever. It deserves further study in cedematous conditions. 
A strong decoction of the fresh inner bark of the root (bark 3 j, water Oij, 
boiled down to Oj) in doses of two to four fluidounces, will sometimes 
promptly empty the tissues of dropsical effusion and act slightly upon 
the bowels. 
SANGUINARIA. 
The rhizome and roots of Sanguinaria canadensis, Linne (Nat. Ord. Papaveracese), 
gathered in autumn after the leaves and scape have died to the ground. Found in woods 
and clearings and along old fences in North America from Canada to the Gulf of Mexico 
and from the Atlantic to the western boundary of the States bordering the west bank of the 
Mississippi. It is one of our most beautiful vernal flowers and is rapidly becoming scarce 
on account of the ravages of despoilers of our native flora. Dose, 1 to 5 grains (expectorant); 
15 to 20 grains (emetic; not used). 
Common Names: Bloodroot, Red Puccoon, Puccoon, Indian Paint, Tetterwort, etc. 
Principal Constituents.-Chelerythrine (forming yellow salts with acids), sanguinarina 
(forming red salts with acids), gamma-homochelidonine and protopine, all of which are 
alkaloids; alcohol soluble resin and sanguinarinic acid. 
Preparations.-1. Specific Medicine Sanguinaria. Dose, 1 to 10 drops, well diluted. 
( Usual form of Administration: R Specific Medicine Sanguinaria, gtt. v to x; Water, $iv. 
Mix. Sig.: One teaspoonful every two or three hours. 
2. Tinctura Sanguinaria Acetata Composita, Compound Acetated Tincture of 
Bloodroot (Acetous Emetic Tincture). An acetated tincture of Sanguinaria, Lobelia and 
Dracontium. Dose, 20 to 60 drops (expectorant); 1 to 4 fluidrachms (emetic). 
Specific Indications.-"Burning and itching mucous membranes, es- 
pecially of fauces, pharynx, Eustachian tubes, and ears; less frequently of 
larynx, trachea, and bronchi, occasionally of stomach and rectum, and 
rarely of vagina and urethra; mucous membrane looks red and irritable; 
nervousness, redness of nose, with acrid discharge, burning, and constric- 
tion in fauces or pharynx, with irritative cough and difficult respiration" 
(Scudder). "Feeble circulation, with coldness of extremities" (Locke). 
Action.-The physiological action of sanguinaria is pronounced. 
The powder, when inhaled, is exceedingly irritating to the Schneiderian 
membrane, provoking violent sneezing, and free and somewhat prolonged 
secretion of mucus. To the taste, bloodroot is harsh, bitter, acrid, and 
persistent, and, when swallowed, leaves an acridity and sense of con- 
striction in the fauces and pharynx, and induces a feeling of warmth in 
the stomach. In small doses, it stimulates the digestive organs, and in- 
creases the action of the heart and arteries, acting as a stimulant and 
tonic; in larger doses it acts as a sedative to the heart, reducing the pulse, 
causing nausea, and, consequently, diaphoresis, increased expectoration, 
and gentle diuresis, at the same time stimulating the liver to increased 
action. If the dose be large, it provokes nausea, with violent emesis, 
vertigo, disordered vision, and great prostration. It also increases the 
broncho-pulmonary, cutaneous, and menstrual secretions. It is a systemic 
emetic, very depressing, causing increased salivary and hepatic secretions, 
and hypercatharsis may result. When an emetic dose has been taken, 
the heart's action is at first accelerated, and then depressed. Poisonous 
doses produce violent gastralgia of a burning and racking character, which 
extends throughout the gastro-intestinal canal. The muscles relax, the 
skin becomes cold and clammy, the pupils dilate, there is great thirst and 
anxiety, and the heart's action becomes slower and irregular. Spinal 
reflexes are reduced and paralysis of the spinal nerve centers follows. Lethal 
615 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
doses produce death by paralysis of medullary, respiratory, and cardiac 
centers, death being sometimes preceded by convulsions. 
Therapy.-External. Sanguinaria is sternutatory, but is no longer 
used, as formerly, in snuff to excite secretion or to reduce polypi and other 
nasal growths and turgescence; to alleviate headache, neuralgia, or chronic 
nasal catarrh. A cataplasm of slippery elm and blood root is a favorite 
domestic remedy for frozen feet and chilblains; and an acetated decoction 
has received professional endorsement for some forms of eczema, ringworm, 
and warts. An ointment has also been successfully used in tinea. 
Internal. Sanguinaria fulfills a variety of uses according to the size 
of the dose administered. Minute doses relieve irritation, whereas large 
doses provoke such an effect. Though decidedly emetic it should never be 
used alone as such, but in combination, as in the acetous emetic tincture, 
it may, in rare cases, be used as a systemic evacuant where it is thought 
necessary to thoroughly cleanse the stomach, and to excite to activity 
sluggish hepatic and general glandular function. Such a course is one of the 
oft-neglected means once employed in prefebrile states, and was effectual 
sometimes in preventing the onset of continued and intermittent fevers. 
An occasional emetic of this type also acts well in chronic stomach dis- 
orders, with arrest of function and gaseous eructation, and succeeds in 
emptying the stomach of a great quantity of ropy mucus, thus preparing 
the way for the kindly reception of other needed remedies. 
Sanguinaria has a gentle but reliable cholagogue action, and may be 
used in hepatic torpor, congestion of the liver, and subacute and chronic 
hepatitis. In hepatic debility, where the bile is deficient or vitiated and 
the general circulation feeble, with cold extremities and in sick headache, 
catarrhal jaundice, and duodenal catarrh depending upon a like condition, 
small doses of sanguinaria are efficient. Nor should it be overlooked 
for gastric catarrh and atonic dyspepsia associated with hepatic torpor and 
circulatory enfeeblement. Drop doses of the specific medicine (well di- 
luted), every two or three hours, best meet these functional derangements. 
The alterative properties of sanguinaria are not to be underestimated. 
Bloodroot is useful in amenorrhoea in anemic and chlorotic patients 
who suffer with chills and headache, and in dysmenorrhoea in debilitated 
subjects. When due to vicarious menstruation, hemorrhage from the lungs 
is said to have been controlled by it. It may be used also for sexual debility, 
seminal incontinence and impotence dependent upon such conditions and 
relaxed genital organs. 
One of the most important fields for sanguinaria is in disorders of the 
respiratory organs. It resembles lobelia somewhat in action. It is a useful 
stimulating expectorant, but should be employed only after active inflam- 
mation has been subdued, and in atonic conditions. It favors normal 
secretory activity, restoring the bronchial secretions when scanty and 
restraining them when profuse. It is specifically indicated when chilliness 
is a dominant feature of respiratory disorders, and is further indicated by 
burning and itching of the naso-laryngeal tract, tickling or burning in the 
nasal passages, with super-abundant secretion, irritation and tickling pro- 
voking cough; and when secretions are checked it relieves dry cough by 
promoting normal moisture. Keeping the specific guides in mind it will be 
616 INDIVIDUAL DRUGS. 
found exceedingly effective in acute and chronic bronchitis, laryngitis, 
sluggish types of pharyngitis and faucitis, with deep red and irritable dry 
membranes, and in acute and chronic nasal catarrh. Too much must not 
be hoped for from its use alone in the latter, for catarrh of the nose and 
throat is not readily amenable to medication, unless the patient has the 
courage to persist in treatment in the face of many conditions disturbing to 
the nasal tract. In all such cases the general systemic treatment is a most 
important desideratum, and it is almost certain that without such care local 
treatment seldom effects a cure. Bloodroot, in decoction, has served well 
in the sluggish form of scarlatinal angina with tendency to destruction of 
tissue. It has been advised in whooping cough, but is too harsh in the 
doses required to use upon young children, and in mucous croup the same 
objection holds good. Its use as an emetic, once popular, in pseudo- 
membranous croup is also inadvisable, such a condition now being recog- 
nized as almost always a laryngeal diphtheria, and it should, therefore, 
be treated by the more approved antidiphtheritic measures. After pneu- 
monia, when debility persists and cough and viscid secretion continue 
and it is difficult to expectorate, specific medicine sanguinaria, with or 
without lycopus, wild cherry, or eucalyptus, in syrup, is one of the most 
efficient of medicines. The dose should be regulated so that the patient 
receives about one or two drops of the sanguinaria every two to four hours. 
It similarly benefits phthisical cough with difficult expectoration, but 
should be withheld if it provokes gastric irritation or nausea. It has no 
effect whatever upon the tubercular state. (See also Sanguinarince 
Nitras, Acetous Emetic Tincture, and Compound Emetic Powder.) 
Sanguinarine Nitrate. 
A salt of the mixed alkaloids of Sanguinaria. 
Description.-A crimson or brick-colored powder, according to method of preparation, 
having an acrid taste and slight blood-root odor, and intensely irritating to the mucous 
membrane. It dissolves freely in water. Dose, 1/30 to 1/4 grain. 
Preparations.-1. Trituratio Sanguinarine Nitras, Trituration of Sanguinarine 
Nitrate (1 to 100). Dose, 1 to 10 grains. 
2. Syrupus Sanguinarine Nitras, Syrup of Sanguinarine Nitrate. Extemporaneously 
prepared by adding from 1/2 to 2 grains of the salt to four fluidounces of syrup and 
water. Dose, 1 fluidrachm. 
Specific Indications.-The specific indications are: "Tickling or ir- 
ritation of the throat, with cough, burning, or irritative sensation in the 
breathing passages, with red surface and thin acrid burning or smarting 
discharges; dryness of the throat and naso-pharynx, with sharp lancinating 
pain, and a feeling as if the walls of the throat were rubbing each other; 
post-sternal constriction, or sense of uneasiness at the suprasternal notch, 
with difficulty of breathing, sense of uneasiness and burning in the stomach. 
Action and Therapy.-The action of this salt is similar to that of 
Sanguinaria, which see. For respiratory uses it is preferred by some to 
the parent drug, the syrup being the preferred form of administration. 
It is especially effective in explosive cough due to irritation at the bifurca- 
tion of the bronchi, and greatly aggravated by assuming the recumbent 
position. 
SANGUINARINE NITRAS. 
617 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
SANTONINUM. 
Santonin. (Formula: CijHi8O».) 
An anhydride or lactone of santonic acid derived from Artemisia pauciflora (Lede- 
bour), Weber (Nat. Ord. Composite), the Santonica or Levant Wormseed. Europe and 
Asia. 
Description.-Colorless, lustrous, flattened, prismatic crystals or crystalline powder, 
without odor, and at first without taste but subsequently becoming bitter. Air does not 
affect it, but upon exposure to light it turns yellow (photosantonic acid). Very soluble in 
chloroform, less so in alcohol and ether; very slightly soluble in cold and boiling water. 
Dose, 1/10 to 4 grains (adult); 1/20 to 2 grains (child). 
Specific Indications.-Worms (except tapeworm and hookworm); 
picking or rubbing at the nose; gritting of the teeth, starting or groaning 
in sleep, tumid abdomen, fetid breath, anorexia and nausea, with slimy 
stools and malnutrition; retention of urine from atony; nocturnal enuresis 
from atony; anuria of fevers; anuria from opium; anuria of the newborn; 
vesical tenesmus and strangury; deficient spinal innervation, with impaired 
respiration. 
Action and Toxicology.-Santonin in overdoses acts upon the cerebral 
cortex and stains the tissues yellow. All the tissues and fluids of the body 
capable of showing it reveal this peculiar coloration. Even in ordinary 
doses the urine is stained so that when it drops upon the clothing it leaves 
its mark. Large doses, and especially poisonous ones, cause the urine to 
assume progressively a color ranging from yellow to saffron, and if the 
urine be alkaline, reddish-purplish. This effect is of constant occurrence in 
poisoning, as is also a peculiar effect upon the vision in which objects are 
seen yellow, or green, or blue, or red. This peculiar phenomenon, once 
thought to be due to the action of air upon the santonin (Giovanni), is now 
known to be due to the staining of the alkaline serum of the humors of the 
eye, and its perceptivity by the sight centers of the brain. It is termed 
chromatopsia or xanthopsia. Poisonous doses of santonin cause gastric 
pain, dizziness, pallor, and coldness, with profuse sweating, followed by 
heat and congestion of the vessels of the head; muscular trembling, 
dilated pupils, twitching of the eyes and head, epileptiform convulsions, 
tetanic cramps, unconsciousness, and death by paralysis of the respiratory 
centers. In doses insufficient to produce convulsions or death aphasia 
sometimes occurs, and temporary, and rarely, total blindness may result. 
Sometimes symptoms resembling cholera morbus are caused by santonin, 
but it is said never to induce gastro-enteritis. Even medicinal doses some- 
times produce anuria. 
The treatment of poisoning consists in evacuation of the bowels by a 
brisk purge, artificial respiration, inhalation of chloroform or ether to 
check convulsions, and the use of ammonia, and the hypodermatic use of 
strychnine. 
Therapy.-Santonin is the best and most commonly used vermifuge 
for the expulsion of the round worm or ascaris lumbricoides. It has little 
effect upon the rectal ascaris (seat or thread worm), and none whatever 
on the tapeworm. It is probably not fatal to the round worm, but renders 
its habitation untenable. As a rule, when a single dose is given it should 
be administered upon an empty stomach, and the patient should abstain 
from food for a few hours. A purge should precede and follow its use, 
618 INDIVIDUAL DRUGS. 
and castor oil is to be preferred because it lessens the probability of poison- 
ing by the santonin. The method most in favor with Eclectic physicians 
is to give broken doses of the following: Santonin, gr. v; Podophyllin, 
gr. j; Milk-sugar, 3j- Mix. Triturate. Sig.: Divide into ten (10) 
powders and administer one (1) powder three times a day; follow with a 
purge. Should the pallor and coldness of the surface, with profuse sweating, 
dilated pupils, and a peculiar bluish countenance be observed, institute 
treatment at once to rid the stomach and bowels of the residue of the 
medicine. The mother or nurse should be warned concerning the yellow 
coloring and garment staining by the urine, to remove any apprehension 
of disorder of the kidneys. Remember that even small doses have been 
attended by convulsions, and that anuria is by no means uncommon. 
Especially is this true when commercial worm lozenges have been given, 
and failing to rapidly dissolve, have had a slowly cumulative effect. 
Santonin is a nerve stimulant and probably diuretic. It relieves that 
form of nervousness caused by worms or other irritants where the child 
picks the nose and is startled in sleep. In retention of urine due to atony 
of the bladder, and especially that occurring in the advanced stage of 
acute diseases of children, it may be given in small doses until a free flow 
of urine is restored. This is one of its most important uses. For the 
anuria of the newborn, minute doses (1/20 gr.) is one of the most certain 
of remedies (Scudder), a fact we have more than once verified. It may 
also be used to stimulate urination after childbirth, where there is difficult 
micturition, and urinal retention not due to long-continued pressure of the 
child's head upon the neck of the bladder. The anuria caused by opium is 
frequently rectified by it. Very small doses often relieve urethral irritation, 
strangury, nocturnal enuresis, dysuria from debility and vesical tenesmus. 
This it does by correcting enfeebled innervation. It also relieves irritation 
of the urethra attended with pain and scalding upon voiding urine. For all 
these purposes the dose must be fractional. Ellingwood advises it for a long 
list of troubles dependent upon reflex nervous irritation, including aber- 
rations of the digestive organs with resultant nervous excitement, cough, 
irritable heart action, and hysterical and impending convulsive attacks. 
The dose of santonin for a child ranges from 1/20 grain to 2 grains, always 
avoiding the large dose when possible; for adults from 1/4 to 4 grains; 
of the trituration (1 in 100) two or three grains. These may be given from 
one to three times a day. The fractional doses are best for the urinary 
and nervous troubles; the fuller doses as an anthelmintic. 
^oap, Hard Soap, White Castile Soap. 
Soap prepared from Sodium Hydroxide and Olive Oil. 
Description.-White or whitish, hard bars, easily cut when fresh; or a fine, yellowish- 
white powder, having a faint, non-rancid odor, and an unpleasant alkaline taste. Soluble 
in water and alcohol; more readily by the aid of heat. 
Preparation.-Linimentum Saponis, Soap Liniment (Opodeldoc), (Soap, Camphor, 
Oil of Rosemary, Alcohol, and water). This liniment is an ingredient of Linimentum 
Chloroformi (Chloroform Liniment). 
Action and Therapy.-External. Soap enters into the formation of 
some pills, as of aloes, rhubarb, gamboge, podophyllin, and other resinous 
SAPO. 
619 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
cathartics, and asafoetida, and those of compound extract of colocynth. 
Soap is detergent and with water may be used, as indicated, to remove 
scales and crusts in cutaneous diseases, but is less useful than soft soap 
for this purpose. It is to be preferred, however, where a very mild action is 
necessary, being less irritant than the softer preparation. 
Internal. Soap is irritant to the stomach, but in small doses may be 
used as an antacid, and in cases of poisoning by the corrosive mineral acids. 
Soft Soap, Green Soap. 
Made by heating Hydroxide of Potassium and Cotton Seed Oil, Water, and Alcohol. 
Description.-A soft, yellowish-white to brownish-yellow, unctuous mass, having an 
alkaline taste and a slight but distinctive odor. Soluble in water. Dose, 5 to 30 minims, 
well diluted. 
Preparation.-Linimentum Saponis Mollis, Liniment of Soft Soap (Tincture of Green 
Soap). (Soft Soap, Oil of Lavender, Alcohol.) 
Action and Therapy.-External. Soft soap is detergent and more 
irritating than hard soap, being more alkaline and containing some free 
caustic potash. It may be used in the preparation of enemas for the removal 
of seat worms and to cause an evacuation of feces. Owing to its softening 
and cleansing properties it is employed to remove dirt, crusts and scales, 
epithelia, etc., in the treatment of skin diseases. Soap liniment is a good 
vehicle for the application of other medicines to sprains, stiffened joints, 
and contusions and other swellings. 
Internal. A solution of soft soap may be administered freely in 
poisoning by the mineral acids, and in smaller amounts (5 to 30 minims, 
well diluted) in acidity of the stomach. 
SAPO MOLLIS. 
SARSAPARILLA. 
The dried root of (1) Smilax medica, Chamisso and Schlechtendal; or (2) Smilax 
officinalis, Kunth, or an undetermined species; or (3) Smilax ornata, Hooker filius (Nat. 
Ord. Liliaceae). Tropical America, Mexico to Brazil. Dose, 30 grains. 
Common Names: Sarsaparilla; (1) Mexican Sarsaparilla; (2) Honduras Sarsaparilla; 
(3) Jamaica Sarsaparilla. 
Principal Constituents.-The acrid glucoside parillin (smilacin, salseparin, or parillic 
acid) closely resembling saponin; resin and a volatile oil; and calcium oxalate, etc. 
Preparations.-1. Specific Medicine Sarsaparilla. Dose, 1 to 30 drops. 
2. Fluidextractum Sarsaparilla Compositum, Compound Fluidextract of Sarsaparilla 
(contains Sarsaparilla, Licorice, Sassafras, Mezereum). Dose, 10 to 60 minims. 
3. Syrupus Sarsaparilla Compositus, Compound Syrup of Sarsaparilla (contains 
Fluidextracts of Sarsaparilla, Licorice, Senna, Oil of Sassafras, Oil of Anise, and Methyl 
Salicylate, Alcohol, Sugar, and Water). Dose, 2 to 6 fluidrachms. 
Action and Therapy.-Sarsaparilla once held a high reputation as an 
alterative; it is now considered practically valueless. Almost the only use 
made of it at present is as a vehicle for iodides and other alteratives. 
For this purpose the compound syrup is largely preferred. Sarsaparilla 
is not wholly inert and its long-continued use may cause ulceration of the 
mucosa of the intestines. Some believe it also to possess an active cardio- 
sedative principle, probably sarsaponin. 
620 INDIVIDUAL DRUGS. 
SASSAFRAS. 
The bark of the root of Sassafras variifolium (Salisbury), O. Kuntze (Nat. Ord. Laur- 
aceae). Woods of eastern half of North America. Dose, 1 to 3 drachms. 
Common Name: Sassafras. 
Principal Constitutents.-A volatile oil (Oleum Sassafras'), sassafrid, a decomposition 
product of tannic acid, resin, and tannin. 
Preparations.-1. Sassafras Medulla, Sassafras Pith. (Insipid, light, spongy, white 
and odorless, cylindrical pieces.) 
2. Oleum Sassafras, Oil of Sassafras. Yellow or reddish-yellow liquid having the 
taste and aroma of sassafras; soluble in alcohol. Dose, 1 to 15 drops, on sugar or in emulsion. 
3. Specific Medicine Sassafras. Dose, 5 to 30 drops, in syrup or on sugar. 
Action and Therapy.-External. Oil of sassafras is rubefacient and 
obtundant, and has been used to discuss wens, and to relieve rheumatic 
and other painful conditions, as bruises, sprains, and swellings. A mucilage 
of the pith (3 ij to Water, Oj) was formerly much used in acute ophthalmias. 
An infusion of the bark is a domestic remedy for rhus poisoning. 
Internal. Sassafras tea is a popular alterative, diaphoretic, and car- 
minative. It and the oil are decidedly stimulant. The latter, like other 
aromatic oils, has been used with more or less success in cystitis with much 
mucoid flow, and in so-called chronic gonorrhoea. The mucilage of the pith 
may be used as a demulcent. From ten to fifteen drops of the oil, ad- 
ministered in hot water or upon sugar, will sometimes relieve the pangs 
of dysmenorrhoea. The chief use of sassafras oil is to flavor pharmaceutic 
syrups and other preparations. 
SCILLA. 
The inner, fleshy scales of the bulb of the white variety of Urginea maritima (Linne), 
Baker (Nat. Ord. Liliacese), cut into fragments and carefully dried. Coast of Mediter- 
ranean Basin and in Portugal and France. Dose, 1 to 3 grains; average, 11/2 grains. 
Common Names: Squill, Squills, Sea Onion. 
Principal Constitutents.-Scillitoxin, the most active principle, insoluble in water, 
soluble in alcohol, and a heart poison; scillipicrin, a bitter body, sparingly soluble in 
water; scillin, soluble in water, causing vomiting and numbness; and a bitter glucoside 
scillain. 
Preparations.-1. Specific Medicine Squill. Dose, 1 to 5 drops. 
2. Acetum Scillce, Vinegar of Squill (Squill, 10 per cent). Dose, 5 to 20 minims. 
3. Syrupus Scillce, Syrup of Squill. Dose, 10 to 60 minims. 
4. Syrupus Scillce Compositus, Compound Syrup of Squill (Hive Syrup). (Contains 
Fluidextracts of Squill and Senega, and Antimony and Potassium Tartrate.) Dose, 5 to 40 
minims. 
5. Tinctura Scillce, Tincture of Squill (Squill, 10 per cent). Dose, 5 to 30 minims. 
Specific Indications.-Chronic cough with scanty, tenacious ex- 
pectoration; dropsy dependent upon a general asthenic condition and 
without fever; scanty, high-colored urine, with sense of pressure in the 
bladder; renal overactivity with inability to retain the urine. 
Action and Toxicology.-Squill is a powerful drug acting much like 
digitalis upon the heart muscle, and probably with greater force upon the 
peripheral vessels, increasing arterial tension. It is a violent gastro- 
intestinal irritant and it disturbs the stomach more than does digitalis. 
Even small doses cause nausea and vomiting; and some individuals are so 
susceptible to its action that it cannot be taken by them in any dose. 
Squill likewise stimulates the kidneys to increased diuresis, both by acting 
upon the epithelial cells and by increasing the blood pressure within those 
organs. Bronchial secretion is increased by it. Fresh squill, when rubbed 
621 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
upon the skin, is rubefacient, and if the surface be denuded it may be ab- 
sorbed with poisonous consequences. 
Large doses of squill are violently poisonous, causing severe and 
painful vomiting and purging, gastro-intestinal inflammation, decreased, 
and sometimes bloody and albuminous urine, with strangury, and not in- 
frequently complete suppression due to the acute nephritis induced. Dull- 
ness and stupor or intermittent paralysis and convulsions ensue. Death 
usually takes place in from ten to twenty-four hours. Some contend that 
squill acts more powerfully upon the heart muscle than foxglove, and that 
by overstimulation with excessive doses cardiac arrythmia and heart- 
block may be induced. Squill, therefore, while usually causing death by 
gastro-enteritis, may establish a fatal nephritis, or cause a sudden stoppage 
of the heart. 
Therapy.-Squill is a stimulating diuretic and expectorant, and if 
given in small doses when there is general atony and special lack of tone in 
the renal and respiratory tracts it is a good medicine. It must be used, 
however, with care and judgment. If there is the least reason to suspect, 
or evidence to show, undue renal irritation or inflammation its use should 
be stopped at once. In very small doses squill allays irritation of mucous 
membranes and lessens excessive secretion. It was at one time very largely 
employed for the elimination of dropsical effusion; and still is used for the 
absorption and removal of pleural, pericardial, and especially peritoneal 
effusion, but with more care than formerly. In large ascitic collections 
in curable conditions paracentesis is a more rational measure than long and 
harsh medication by drastic renal hydragogues. 
Squill is one of the most certain remedies for dropsy of cardiac origin, 
or from congestion (not inflammation) of the kidneys; and is proportionately 
less valuable where dependent upon structural changes in the renal glands. 
Nevertheless it frequently is used in chronic nephritis to excite the surviv- 
ing cells to activity and thus increase the output of urine. When renal 
dropsy depends upon general atony of the system-the kidneys included- 
and the disorder is one of functional weakness, squill may be used with 
good effect. Its diuretic action is increased by digitalis and the alkaline 
diuretics, notably acetate and citrate of potassium. Squill, in powdered 
substance, is usually more effective than any of its preparations; therefore 
the best form of administration is by pill or capsule. When there is a feeble 
circulation the following is advisable: 3 Pulv. Scillae; Pulv. Digitalis, 
aa, gr. x. Mix. Ft. Pilulae, No. 10. Sig.: One pill after meals. Squill is 
contraindicated, even in dropsy, by a dry, hot skin, rapid circulation, 
elevated temperature, or any evidence of renal irritation or inflammation. 
But the greater the atony of the general system the more salutary its action. 
In dropsy requiring urgent relief two or three grains of squill may be given 
every three hours, withholding the medicine upon the slightest indication 
of nausea. When it acts strongly as an expectorant it frequently fails to 
cause increased diuresis. Neither should it be expected to cure when 
anasarca or ascites is caused by malignant disease or renal destruction. 
Locke employed for cardiac dropsy, with feeble heart action and weak rapid 
pulse, teaspoonful doses of infusion of digitalis to which is added two (2) 
grains of squill, or one (1) drop of specific medicine squill. 
622 INDIVIDUAL DRUGS. 
Squill has been quite generally used by some physicians for subacute 
and chronic bronchitis when secretion is scanty and viscid and expectorated 
with difficulty, and oppositely when the secretions are profuse and debili- 
tating. The dosage should be regulated according to the condition, the 
fuller doses short of nausea for the former, and minute doses for the latter. 
These results are attributed to its power to regulate normal equilibrium 
in the bronchial mucosa. When fever is absent and the sputum scanty and 
tenacious, the following is useful: 3 Syr. Scillae, A3j; Syr. Pruni virg., 
fl^iij. Mix. Sig.: One teaspoonful four (4) times a day (Locke); and 
in chronic bronchial catarrh: 3 Syr. Scillae, Syr. Senegae, aa, figj; Syr. 
Pruni virg., fl § ij. Mix. Sig.: One teaspoonful every three hours. Syrup 
of squill has been largely used and is still popular in the domestic treat- 
ment of croup, people little realizing the danger invited. We have seen it 
cause convulsions and prostration in a young child when thus employed. 
It has also been advised by physicians for emphysema. While of unquestion- 
able value in bronchial affections, one must be guarded in its employment 
lest more damage be done to the kidneys than good to the respiratory 
tract. 
SCOPARIUS. 
The tops of Cytisus Scoparius (Linne), Link (Nat. Ord. Leguminoseae). Europe and the 
United States. Cultivated. Dose, 5 to 15 grains. 
Common Names: Broom, Broom Tops, Irish Broom. 
Principal Constituents.-The volatile, oily, alkaloid sparteine (see Sparteina Sulphas), 
and scoparin, a diuretic and purgative yellow coloring body. 
Preparations.-1. Infusum Scoparii, Infusion of Scoparius. Dose, 1 to 2 fluidounces. 
2. Decoctum Scoparii, Decoction of Scoparius ($ss to Water Oj, boiled down to Oss). 
Dose, 1 to 2 fluidounces. 
Action and Therapy.-Excessive doses of broom have produced 
impaired vision, staggering gait, and profuse vomiting and purging. As 
the effects of broom are in milder degree practically those of its chief 
alkaloid, sparteine, see Sparteinoe Sulphas for further action and uses. 
When the latter is not desirable, aqueous preparations of the crude drug 
may be used; and indeed, they often succeed in causing profound diuresis 
when the alkaloid fails. As a heart tonic and stimulant sparteine sulphate 
should be preferred. 
Infusion of broom and to a greater degree the decoction, in doses of 
one ounce every three hours, are decided and certain diuretics for use in 
dropsies of cardiac origin. The action of scoparin has not been fully 
determined, but is believed to be both diuretic and purgative. Some 
believe it to be the real diuretic in scoparius. 
SCOPOLAMINE HYDROBROMIDUM. 
Scopolamine Hydrobromide, Hyoscine Hydrobromide, Scopolamine Bromide. 
[Formula: (C„HMO4N. HBr+3H,O).] 
The hydrobromide of the laevorotatory scopolamine, obtained from various solanaceous 
plants, notably from Scopola Carniolica, a plant of Southern Europe. Scopolamine is an 
alkaloid identical with and also known as Hyoscine (see Hyoscyamus). Dose, (average) 
1/200 to 1/100 grain. 
Description.-Odorless and colorless, transparent, slightly efflorescent crystals (some- 
times large). Very soluble in water and alcohol, slightly soluble in chloroform; ether does not 
dissolve it. WaT'Great care must be used in tasting it, and then only in very dilute solutions. 
623 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Toxicology.-The action of scopolamine is that of hyoscine, 
and closely allied to that of the combined alkaloids of hyoscyamus. (See 
Hyoscyamus.} The symptoms of poisoning and the treatment are the same 
as those of Atropine and Belladonna (which see). 
Therapy.-Scopolamine (hyoscine) is anaesthetic and profoundly hyp- 
notic. These properties have been invoked to aid in alleviating the pains 
of childbirth and in securing general anaesthesia for operative purposes. 
In combination with morphine these activities are intensified, less of each, 
when combined, producing greater effects correspondingly than when each 
is given alone, if indeed it is not a somewhat different effect. The use of 
these drugs to facilitate and render labor painless is of comparatively 
recent introduction. It has found many enthusiastic supporters, but as it is 
a far from safe procedure the mass of the profession ignores its power 
in this direction. When successful the patient sleeps between pains, and is 
asserted not to feel them though she is said to groan as if in pain. But 
when the ordeal is over there is no remembrance of having suffered. While 
several mishaps have occurred, as profound depression and even the death 
of the mother, it is said to be more dangerous to the child. Therefore it 
has not become generally popular and in most quarters is on the wane. 
This is the famous "twilight sleep" heralded to the world as the greatest 
boon that ever came to the parturient's relief. Some use a preparation 
containing hyoscine, morphine, and cactin (H. M. C.). All physicians 
agree in claiming that the patient must be carefully watched, and it is 
preferred that it be used in a hospital or lying-in institution in preference 
to the home. 
The method is practically as follows: When it is determined that 
labor is actually in process, a hypodermatic injection of scopolamine, 
1/150 grain with morphine, 1/6 grain, are injected together. This is not 
done until the pains are close and lasting at least a half minute. In about 
one-half hour the drugs will have produced a somnolent state which con- 
tinues between pains, the patient apparently arousing but not appreciating 
suffering when they come on. If pain, however, is actually felt and con- 
tinues to be felt, another dose of the scopolamine alone is repeated. If the 
woman still has any remembrance of pain or effort, another dose of the 
scopolamine alone is administered. The patient is pre-assured of safety 
and comfort, the room is darkened and no noises are permitted-nothing 
that will in any way startle the sleeper. Labor then progressing normally, 
the patient finally comes to without any recollection of the ordeal through 
which she has passed. 
Scopolamine (1/100 grain) and morphine (1/12 grain) have been used 
to produce general surgical anaesthesia. The drugs are administered com- 
bined in the above dosage, at intervals of one to three houis, until from 
two to four doses have been given. Then the patient is usually ready for 
the operation. It is not much favored for this purpose on account of the 
manifest danger of the method, and when the choice of etherization can be 
made. It is not likely to displace either ether or chloroform as a general 
anaesthetic. Sometimes one or two doses are administered to apprehensive 
patients when about to be anaesthetized, the completion of insensibility 
being secured by ether or chloroform. The advantages claimed for these 
624 INDIVIDUAL DRUGS. 
methods is lessening of fear, the use of smaller quantities of ether or chloro- 
form, decreased likelihood of post anaesthesia vomiting, and the induction of 
several hours sleep after the operation; the disadvantages are its uncertain 
safety, and sometimes, death. 
SCUTELLARIA. 
The fresh green herb of Scutellaria lateriflora, Linne (Nat. Ord. Labiatae). Common 
in damp situations throughout the United States. Dose, 5 to 30 grains. 
Common Names: Scullcap, Skullcap, Madweed. 
Principal Constituents.-A volatile and a fixed oil and an unnamed, bitter, crystalliz- 
able glucoside. 
Preparation.-Specific Medicine Scutellaria. Dose, 5 to 30 drops. 
Specific Indications.-Nervousness attending or following illness, or 
from mental or physical exhaustion, or teething; nervousness with muscular 
excitation; tremors; subsultus tendinum; hysteria, with inability to control 
muscular action; functional heart disorders of a purely nervous type, with 
intermittent pulse. 
Action and Therapy.-Scutellaria is calmative to the nervous and 
muscular systems and possesses feeble tonic properties. By controlling 
nervous irritability and muscular incoordination it gives rest and permits 
sleep. It may be exhibited to advantage during acute and chronic illness 
to maintain nervous balance, control muscular twitching and tremors, 
and is sometimes effectual in subsultus tendinum during grave prostrating 
fevers. Too much, however, must not be expected from it in the latter 
condition; nor can it be expected to aid much in delirium tremens, and not 
at all in epilepsy and paralysis agitans, in both of which it has been in- 
judiciously advised. It appears to be most useful in chorea when re- 
inforced by the addition of macrotys and valerian; in restlessness following 
prolonged sickness; and in functional heart disorders of a purely nervous 
character, with intermittent pulse whether accompanied or not by hysterical 
excitement. When insomnia is due to worry, or nervous irritability or 
even exhaustion, relief may be expected from it. It once had a great 
reputation as a cure for hydrophobia, based upon the reports of New Jersey 
physicians, a claim which time has totally failed to sustain. 
The whole plant of Senecio aureus, Linne (Nat. Ord. Composite). Northern and 
western parts of the United States. Dose, 5 to 60 grains. 
Common Names: Golden Senecio, Life Root, Ragwort, Female Regulator, etc. 
Principal Constituents.-Probably an acrid resin and a bitter and tannin; it has not 
been satisfactorily analyzed. 
Preparation.-Specific Medicine Senecio. Dose, 5 to 60 drops. 
Specific Indications.-Atony and relaxation of the pelvic contents, 
with dragging painful sensations; uterine enlargement, with uterine or 
cervical leucorrhcea and impairment of function; vaginal prolapse; slight 
uterine prolapse; pelvic weight and vascular engorgement; increased flow 
of mucus or muco-pus from weakness; suppressed or tardy menstruation; 
pain, soreness, and bearing down of the uterus; vicarious menstruation; 
difficult and tardy urination in both sexes. In the male tenesmic micturi- 
tion, testicular dragging, and pelvic weight. In both sexes, dyspepsia, 
SENECIO. 
625 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
with flatulence after meals; cardialgia, associated with sour stomach and 
increased flow of gastric juice. 
Therapy.-Senecio is a remedy of decided value in the treatment of 
diseases of women. It was formerly much employed, but in the onward 
movement of therapeutics seems for some reason to have passed into 
unmerited neglect. Without doubt this is due to failure to observe and 
prescribe it according to its specific indications, and somewhat to its tardy 
action. To get results from senecio it must be given in appreciable doses for 
a long period, and while slow, its results justify its use. A general relaxed 
condition of the female generative tract, with or without mucous or muco- 
purulent discharge, or vaginal or uterine prolapse, is the direct indication 
for its selection. Atony is the key to its use. The parts lack vigor and tone, 
or may be irritable and hyperaemic; at any rate, the pelvic circulation is 
poor and the whole pelvic floor seems about to let the pelvic contents 
escape. The uterine ligaments are lax, and the prolapses benefited are 
those partial displacements due to the weakening of the ligaments and 
surrounding tissues. Senecio is an ideal emmenagogue and the best single 
remedy for the amenorrhoea of debility. As such for amenorrhoea in the 
young in whom the menstrual function is not yet well established, we know 
of no better or more prompt agent than senecio. We select it with as great 
certainty as we would macrotys for muscular pain, or bryonia for pleuritic 
stitches. It matters little, however, what the non-surgical female disease, 
so long as one is guided by the indications, senecio will not be found wanting 
in power to improve or to cure. It is with certainty a leader in gynecic 
therapy. It relieves irritation, imparts tone and vigor, and restrains 
undue and vitiated secretions. Atony of the ovaries with impairment of 
function is always present in cases requiring senecio. There is also perineal 
weight and fullness, and in chronic cases an enlargement of the womb, 
with cervical leucorrhoea. Dysmenorrhoea, menorrhagia, metrorrhagia, 
chlorosis, functional sterility, leucorrhoea, dyspepsia, and the capillary 
bleeding of haematuria and the bloody discharges of albuminuria are the 
cases in which it is also especially indicated and in which more or less success 
may be expected from it. While holding the greatest reputation in diseases 
and disorders of the female, it is of some, though relatively less, usefulness 
in functional aberrations of the male reproductive organs, sometimes 
relieving pelvic weakness, with sense of dragging and testicular pain, 
and frequent and painful urination. The dose of specific medicine senecio, 
the best preparation of it, is from five to sixty drops in water, three or four 
times a day. 
The root of Polygala Senega, Linne (Nat. Ord. Polygalaceae). Indigenous to the United 
States. Dose, 5 to 20 grains. 
Common Names: Senega, Senega Snakeroot, Seneka Root, Seneca Snakeroot. 
Principal Constituent.-Saponin (Senegin). 
Preparation.-Specific Medicine Senega. Dose, 1 to 20 drops. 
Specific Indications.-Relaxed respiratory mucosa and skin, with 
deep, hoarse cough, excessive secretion; mucous rales, nausea and vomiting; 
cough of chronic bronchitis; bronchorrhcea. 
SENEGA. 
626 INDIVIDUAL DRUGS. 
Action and Therapy.-Senega has an acrid taste and leaves a disagree- 
able sensation when swallowed. In ordinary doses it is sialagogue, stimu- 
lant, diuretic, expectorant, and is reputed emmenagogue. It may be used 
in subacute forms of cough as is found in chronic bronchitis with profuse 
secretion. It is contraindicated in active febrile conditions. Dropsy of 
renal origin has been benefited by it, but it is of no value when due to 
cardiac lesions. It is little used, and then chiefly in syrups containing other 
medicaments. It is an ingredient of the once celebrated Coxe's Hive Syrup, 
a vicious preparation now represented by compound syrup of squill, and 
containing also squill and tartar emetic. 
SENNA. 
The dried leaflets of (1) Cassia acutifolia, Delile, or of (2) Cassia angustifolia, Vahl 
(Nat. Ord. Leguminosae). (1) Eastern and central Africa; (2) cultivated from eastern 
Africa to India. Dose, 60 to 120 grains. 
Common Names: Senna, (1) Alexandria Senna, (2) India or Tinnivelly Senna. 
Principal Constituents.-An amorphous, water-soluble, sulphurated glucoside- 
cathartinic acid (which may be split into cathartogenic acid and glucose), emodin, sennacrol 
and sennapicrin (water-insoluble glucosides), and chrysophanic acid. 
Preparations.-1. Specific Medicine Senna. Dose, 5 to 60 drops. 
2. Infusum Senna Compositum, Compound Infusion of Senna (Black Draught). 
(Senna, Manna, Magnesium Sulphate, Fennel, Boiling Water.) Dose, 2 to 8 fluidounces. 
3. Pulvis Glycyrrhiza Compositus, Compound Powder of Glycyrrhiza (Compound 
Licorice Powder), (Senna, Glycyrrhiza, Oil of Fennel, Washed Sulphur, Sugar). Dose, 1 to 2 
drachms. 
4. Pulvis Jalapce Compositus, Compound Powder of Jalap (Antibilious Physic). 
Contains Senna. See Jalapa. 
Specific Indications.-Flatulence and colic; a laxative for non-in- 
flammatory conditions of the intestinal tract. 
Action and Therapy.-Senna is a manageable and useful cathartic 
producing copious yellowish-brown evacuations, and causing considerable 
griping when used alone. While it influences the whole intestinal tract, 
exciting peristalsis as it passes along, the greater action is exerted upon 
the colon. This renders it a certain purgative, for by this sequence the 
whole canal is the more readily emptied. It does not produce after-con- 
stipation, as does rhubarb and some other laxatives; and it may purge a 
nursing infant when administered to the mother. Senna is neither sedative 
nor refrigerant, but if anything somewhat stimulant, and is, therefore, not 
to be given in irritated or acutely inflamed conditions of the alimentary 
tube nor when there is great debility, or hemorrhoids, or prolapse of the 
rectum. Nothwithstanding, it is effectual and safe to cleanse the bowels 
at the beginning of fevers, when such an effect is desired. It may be used 
as a laxative or more complete cathartic in children and adults when a 
severe action is not indicated. In most individuals it occasions nausea, 
tormina and flatulence when given alone, as in senna tea, but these effects 
may be mitigated by infusing it with coffee, or by the addition of cloves, 
ginger, peppermint, cinnamon, or other aromatic corroborants. Cream of 
tartar added to it increases its action, producing a hydragogue and refriger- 
ant effect, while bitters in general seem to increase its action. Senna is 
one of the anthracene group of cathartics, and its action is largely, though 
not wholly, due to the presence of cathartinic acid. The latter taken up 
627 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
by the blood, or injected, is emptied into the intestinal canal, thereby caus- 
ing or prolonging catharsis. 
Compound Powder of Jalap. A most thorough action may be ob- 
tained from the Antibilious Physic, especially in auto-intoxication, and 
intestinal toxaemia, giving rise to a violent, burning, diffuse rash, such as 
sometimes follows prolonged constipation, or the ingestion of tainted foods 
-particularly sea foods and fruit. This preparation is less irritant than 
senna alone, and unless there is very marked gastro-intestinal inflamma- 
tion, it is seldom contraindicated. The physicing dose is one drachm, in 
hot water, cooled and sweetened; or milk, lemonade, or coffee may be used 
as a vehicle. It may also be given in large-sized gelatin capsules. 
Compound Licorice Powder. A pleasant and efficient laxative in doses 
of 30 to 120 grains (average 60), given in plenty of water, at bedtime, for the 
general cleansing of the bowels of undigested material, relieving headache 
arising therefrom; and an admirable laxative for the pregnant and partu- 
rient woman, and for children. It may be given in water, or the ready- 
prepared lozenges may be used, the patient partaking also of plenty of water. 
SERENOA. 
The fruit of Serenoa serrulata, Bentham and Hooker (Nat. Ord. Palmacae). Atlantic 
Coast from Florida to South Carolina. Dose, 10 to 60 grains. 
Common Name: Saw Palmetto. 
Principal Constituents.-An aromatic oil (Oil of Saw Palmetto) and sugar. 
Preparation.-Specific Medicine Saw Palmetto. Dose, 10 to 60 drops. 
Specific Indications.-Relaxation with copious catarrhal secretion; 
lack of development or wasting of testicles, ovaries, or mammae; prostatic 
irritation with painful micturition, and dribbling of urine, especially in the 
aged; tenderness in the glands and other parts of the reproductive organs. 
Action and Therapy.-Saw Palmetto is a nerve sedative, expectorant, 
and a nutritive tonic, acting kindly upon the digestive tract and tending 
to improve the appetite, digestion, and assimilation. Its most direct action 
appears to be upon the reproductive organs when undergoing waste of 
tissue; in some nutritional way it is asserted to enlarge the breasts, ovaries, 
and testicles, while the paradoxical claim is also made that it reduces 
hypertrophy of the prostate. This can only be explained, if, indeed, it 
has such opposite effects, by assuming that it tends toward the production 
of a normal condition, increasing parts when atrophied, and reducing them 
when unhealthily enlarged. Evidence is forthcoming that it alleviates 
much of the prostatic suffering of the aged, and this is probably due to its 
relieving urethral irritation, thereby reducing a swollen condition not really 
amounting to hypertrophy. It is asserted to increase the tonus of the 
bladder, and help to better contraction and more perfect expulsion of the 
contents of that viscus. Tenesmic pain especially is relieved. It is further, 
and rationally, indicated to relieve dull aching, throbbing pain in the 
prostatic urethra and to control excessive mucoid and prostatic discharges. 
The gleety results of a badly treated gonorrhoea sometimes yield to it. 
As it tones relaxed tissue this probably explains its asserted value in so- 
called uterine hypertrophy, the latter being more properly a large, loosely 
relaxed and flabby organ, actively leucorrhoeal. It has been recorded also 
628 VIRGINIA SNAKE ROOT 
(Aristolochia Serpentaria) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Perhaps the most conspicuous and one of the earliest of plants used in American colonial 
domestic medication, the Virginia Snakeroot, notwithstanding its excellent qualities, singu- 
larly never acquired a prominent place in Eclectic therapeutics. Note the blossom 
lying close to the ground-probably a very early evolutionary type for convenience of plant 
fertilization, making easy the access of crawling insects. (See also Wild Ginger.) 
Courtesy of Mr. Moritz Fischer INDIVIDUAL DRUGS. 
that it increases the sexual appetite and restores lost power from excesses, 
in both man and woman; and to have given relief in ovaritis, ovaralgia, 
orchitis, orchialgia, and epididymitis. Its best action is that of a nutritive 
tonic to wasting organs and to control irritation and mucoid discharge. 
The rhizome and roots of (1) Aristolochia Serpentaria, Linne, and of Aristolochia 
reticulata, Nuttall (Nat. Ord. Aristolochiaceae). Eastern half of the United States; the 
latter chiefly in the southwest. Dose, 1 to 30 grains. 
Common Names: (1) Virginia Snakeroot; (2) Red River or Texas Snakeroot. 
Principal Constituents.-A volatile oil containing borneol (Ci0Hi8O) and a terpene 
(CioHu), and resins. 
Preparation.-Specific Medicine Serpentaria. Dose, 1 to 30 drops. 
Specific Indications.-Renal torpor, the result of cold; fullness of chest 
with dyspnoea; sensation of weight and dragging in the loins, with scanty 
renal secretion; severe sore throat, with tendency to destruction of tissue; 
cutaneous torpor. 
Action and Therapy.-In small doses Virginia snakeroot stimulates 
the appetite and promotes digestion; long continued it tends to derange 
digestion producing nausea, emesis and intestinal griping and tenesmus. 
In full doses it stimulates to a considerable degree, but may occasion gastro- 
intestinal discomfort with nausea, vomiting, headache, and drowsiness, 
but with disturbed sleep. The warm infusion is decidedly diaphoretic. 
Under the latter action it is sometimes useful to hasten the eruption in 
tardy exanthemata. Small doses, given for a brief period, are beneficial 
in atonic dyspepsia. After periodic fevers it may be administered with 
cinchona or quinine to overcome depression and give tone to the debilitated 
system. When renal torpor or menstrual tardiness is due to cold, ser- 
pentaria will act as a stimulant diuretic and as an emmenagogue. The 
best use for serpentaria, in our opinion, is for the severely congested but 
sluggish and very sore angina of scarlatina. It may be used both as a gargle 
and internally. As a rule, serpentaria is contraindicated by active fever 
or severe inflammation; but is a remedy of much value in atonic states. 
SERPENTARIA. 
SERUM ANTIDIPHTHERICUM. 
Antidiphtheric Serum, Diphtheria Antitoxin. 
A fluid, according to the U. S. P., separated from the coagulated blood of the horse, 
Equus Caballus (Fam. Equidae), or other large domestic animal, which has been properly 
immunized by inoculation against diphtheria toxin, and has a potency of not less than 
250 antitoxin units per mil. The standard of strength (units of antitoxic power) must be 
that established by the Hygienic Laboratory of the United States Health Service. 
[Antitoxic Unit or Immunizing Unit. "The amount of antitoxin required to neutralize 
one hundred times the quantity of the standard toxin that is sufficient to kill a guinea- 
pig weighing 200 Gm." (Dorland's Medical Dictionary).} 
Description.-A nearly odorless (except when an antiseptic preservative has been used), 
yellowish or yellow-brown, transparent or slightly clouded fluid. A granular deposit is 
sometimes present. It must be sterile, prepared from healthy animals, free from toxins 
or other bacterial products, and must not exceed 20 per cent in total solids. Not more 
than 1/2 per cent of phenol or cresol may be present as an antiseptic preservative. Dose, 
Prophylactic or protective, 500 to 1,500 units (average, 1,000 units); Hypodermatic, 3,000 to 
20,000 units (average, 10,000 units). This serum loses in potency from month to month 
and should not be used after a year old. 
629 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Other Forms of Diphtheria Antitoxin. 
1. Serum Antidiphthericum Purificatum, Purified Antidiphtheric Serum (called also 
Antidiphtheric Globulins, Diphtheric Antitoxin Globulins, Concentrated Diphtheria 
Antitoxin, Refined and Concentrated Diphtheria Antitoxin). A fluid obtained from the 
plasma (blood serum) of the horse, or other large domestic animal, immunized against 
diphtheria toxin, containing in water solution only the separated antitoxin-bearing globulins 
preserved by adding sodium chloride to make a finished solution bearing 0.6 to 0.9 per cent 
of salt. Potency, 250 antitoxic units per mil. A nearly odorless (except when preservative 
is used), transparent or slightly opalescent fluid, sometimes viscous, and having a slight 
granular or ropy deposit. It must conform to same governmental requirements as the 
ordinary serum. Dose, Protective or prophylactic, 500 to 1,500 units (average, 1,000 units); 
Hypodermatic, 3,000 to 20,000 units (average, 10,000 units). 
2. Serum Antidiphthericum Siccum, Dried Antidiphtheric Serum (Dried Diphtheria 
Antitoxin). An odorless substance in orange-colored or yellowish flakes or lumps, or a 
yellowish-white powder, forming an opalescent, slightly sticky solution with nine parts of 
distilled water. It may be more readily dissolved in more distilled water or in physiologic 
salt solution. Dried diphtheria antitoxin is prepared by evaporation of either the ordinary 
or the purified diphtheria antitoxin. It is more permanent than the solution. Potency, 
not less than 4,000 units per gramme. When ready for use it must be dissolved in water 
previously boiled and cooled, and used at once. Any remaining portion not so used must be 
discarded. Like the antitoxic sera it must conform to U. S. Government requirements. 
Dose, Protective or prophylactic, 500 to 1,500 units (average, 1,000 units); Hypodermatic, 
3,000 to 20,000 units (average, 10,000 units). 
Specific Indications.-Diphtheria (curative); suspected persons ex- 
posed to diphtheric infection (prophylactic). 
Action.-The production of both the diphtheria and tetanus antitoxin 
is effected by graded and repeated injections of the conesponding toxins of 
the diphtheria and tetanus bacilli into the horse. The creature thus be- 
comes gradually highly immune to these toxins and furnishes an abundance 
of antitoxic bodies that, when properly injected, may render the beneficiary 
immune or at least furnish it with immunizing antitoxin. From time to 
time tests are made to determine the antitoxic content of the animal's 
blood. After a period, usually of several months, the required high content 
is reached, and the horse is bled under the strictest of antiseptic precautions. 
The plasma (separated from the cellular contents of the blood) with its 
contained antibodies, when responding to the required governmental unit 
test per mil, constitutes Antitoxin. When further refined and concen- 
trated and standardized, according to U. S. Public Health Service require- 
ments, it constitutes when of fluid form, respectively, Purified Diphtheria 
Antitoxin or Purified Tetanus Antitoxin, or when dry the corresponding 
Dried Diphtheria Antitoxin or the Dried Tetanus Antitoxin. 
The cells of the human body, in order to utilize food, or similar bodies, 
throw out what are termed "receptors", having an affinity for such a food 
and that kind only, from which the body appropriates that which it needs. 
Poisons, particularly those of a protein type, such as toxins, unite similarly 
with receptors of the cells, but to kill rather than to nourish them. If, 
however, an antitoxin be administered, these receptors given off by the 
cells are met by the free-floating antibodies so furnished instead of by the 
toxins, which must unite in order to destroy, and thus is prevented the 
mastery and death of the cells by the toxins of the disease in question. 
This, then, is the reason antitoxins are administered in such diseases as 
diphtheria and tetanus-to prevent the union of disease toxins with the cells 
and thus destroy them and the life of the patient. The fight is between 
the toxin and the furnished antitoxin, and the latter embracing the former 
630 INDIVIDUAL DRUGS. 
renders it helpless and inoccuous. The immunizing effects of antitoxin 
last but a few weeks. 
Therapy.-Diphtheria antitoxin is without question the most potent 
antagonist of diphtheria. Its use has wrought a marvelous transformation 
in the therapy of that disease. In fact, in diphtheria antitoxin we have 
the one serum of established worth, and so far in the history of serology, 
perhaps, the only one of indubitable value. To be of greatest service it 
should be administered early in the disease, not later than the second day, if 
possible, and without waiting for bacteriologic findings. Many recommend 
repeated doses, ranging in time anywhere from four hours to daily, but in 
our experience seldom more than one dose has been needed. Large doses 
of the globulins (these are in reduced bulk) are more effective than small 
doses, no more disturbing, and results more prompt. In no instance should 
an old antitoxin be used, but always as fresh a product as can be obtained. 
Not alone is diphtheria antitoxin curative, but is also presumably 
prophylactic. For the latter purpose from 1,000 to 1,500 units (according 
as prospects of the situation seem to require) should be given each exposed 
child. For curative purposes not less than 5,000 units, even in the youngest 
child (very young infants seldom contract diphtheria), and if a case is very 
severe or the larynx and nasal fossae are involved, 10,000 units should be 
given as an initial dose. 
The good effects of antitoxin are observed in a day's time. The fever 
abates, the restlessness is subdued, limitation and rapid exfoliation of the 
membrane takes place, and the urinary secretion is reestablished when 
scanty. Soreness and lameness at the site of injection is to be expected, 
but it disappears in the course of a few hours. Other internal treatment 
should not be neglected, as small doses of aconite for excessive fever, 
belladonna for congestion, phytolacca for glandular engorgement, potassium 
chlorate for fetor, and echinacea for the septic state due to streptococci, 
which are often present. Locally, potassium permanganate, Loeffler's 
solution (see Liquor Ferri Chloridi), asepsin, echinacea, potassium chlorate, 
with hydrastis or peroxide of hydrogen may be used in proper solutions for 
cleansing purposes, in the form of gargles, but better as sprays and washes. 
Indeed, the local treatment should not be neglected as it is a most important 
measure. 
Antitoxins come ready prepared for immediate use, in container- 
syringes, with accompanying directions for their use. The physician has 
only to observe the strictest aseptic precautions in administering them. 
SERUM ANTITETANICUM. 
Antitetanic Serum, Tetanus Antitoxin. 
The blood serum of the horse (Equus Caballus), or other large animal immunized against 
the toxin of the tetanus bacillus. It must have a potency of not less than 100 units per mil., 
and conform in all respects to the requirements of the United States Law and United States 
Public Health Service. 
Description.-A nearly odorless (except when preservative is used), yellowish or 
yellowish-brown, clear solution or slightly cloudy with occasionally a granular deposit. 
It must be kept at a low temperature, 4.5° to 15°C (40° to 59°F). It gradually loses potency. 
Dose, Protective, 1,000 to 2,000 units (average 1,500 units); Hypodermatic, 3,000 to 20,000 
units (average, 10,000 units). 
631 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Other Forms of Antitetanic Sera. 
1. Serum Antitetanicum Purificatum, Purified Antitetanic Serum (Antitetanic 
Globulins, Concentrated Tetanus Antitoxin). The antitoxin-bearing globulins immunized 
against tetanus toxin, dissolved in physiologic salt solution. Potency not less than 100 units 
per mil. A nearly odorless (except when a preservative is present), transparent or slightly 
opalescent, more or less viscous fluid, with or without a slight granular or ropy deposit. 
It must conform to U. S. Government requirement. Dose, Same as Tetanus Antitoxin, 
see page 631. 
2. Serum Antitetanicum Siccum, Dried Antitetanic Serum (Dried Tetanus Antitoxin). 
Odorless, yellowish or orange-colored flakes or lumps, or yellowish-white powder. Solubility 
similar to that of Dried Diphtheria Antitoxin. Potency not less than 1,000 units per 
gramme. It should be used under the strictest antiseptic precautions and in same manner 
as for the latter. If properly preserved it does not lose potency like the liquid sera. Dose, 
Same as for the Antitetanic Sera, see page 631. 
Action and Therapy.-Tetanus is caused by the tetanus bacillus, 
whose liberated toxins, by acting upon the spinal cord, produce violent 
tetanic convulsions. As tetanus antitoxin antagonizes the tetanus toxin 
after the manner of the action of the diphtheria antitoxin (which see), 
the early use of the serum is invoked to prevent the spasms, if not already 
established, and to cure, if possible, after the convulsions have supervened. 
It is regarded a better prophylactic than curative agent for the reason that 
the tetanus toxin quickly reaches and combines with the nerve tissues, 
when it is too late for the antitoxin action of the antitetanic serum. An- 
other reason for its difficult action is attributed to the diverse routes by 
which the toxin and the antitoxin reach the nerve tissues-the former after 
traversing the blood and lymph currents, passing by way of the nerve fibres, 
the latter by way of the blood stream alone. This delayed union permits 
of damage before the toxins can be overwhelmed by the antibodies. If 
used very early, immediately after the wound, if possible, it is said to be 
as effective and as certain as diphtheria antitoxin; if used late, little good 
need be looked for. Every minute counts in the success of tetanus anti- 
toxin therapy. The powder may be dusted upon suspected wounds for its 
prophylactic effects. The experience of the wounded soldiers in the World 
War justifies the use of antitetanic serum in gun-shot wounds, punctures, 
injuries from splinters and nails, ragged cuts from barbed wire, tin or glass, 
and wounds contaminated with stable filth or manured garden soil. A 
prophylactic dose of antitetanic serum lasts from ten days to three weeks; 
in unusually foul wounds about a week. As a prophylactic some claim that 
this serum is more certain than the diphtheria antitoxin. Large doses 
yield 20 per cent more of recoveries than small doses. Antitetanic serums 
come put up in sealed container-syringes ready for immediate use, with 
accompanying directions. 
SINAPIS ALBA. 
The ripe seeds of Sinapis alba, Linne (Nat. Ord. Cruciferae). Asia and South Europe; 
cultivated. Dose (emetic), 1 to 3 drachms, with plenty of water. 
Common Names: White Mustard, Yellow Mustard. 
Principal Constituents.-A bland, fixed oil, average of 25 per cent; the glucoside 
sinalbin, the most important constituent, and myrosin, an enzyme which converts sinalbin 
into an acrid, and other bodies. Volatile oil of mustard is not obtained from white mustard. 
Description.-A yellowish or light, brownish-yellow powder, odorless and mildly 
pungent and acrid to the taste. Dose, 1 to 3 drachms (as an emetic). 
632 INDIVIDUAL DRUGS. 
SINAPIS NIGRA. 
The ripe seeds of Brassica nigra (Linne), Koch (Nat. Ord. Cruciferae). Asia and 
southern Europe; cultivated. Dose (emetic), 1 to 3 drachms. 
Common Names: Black Mustard, Brown Mustard. 
Principal Constituents.-Fixed oil of mustard (average of 35 per cent); sinigrin (a 
glucoside) and myrosin, which in the presence of water and distillation converts the former 
into glucose, a potassium salt, and Volatile Oil of Mustard (Oleum Sinapis Volatile'), 
(see below) an oil not derived from white mustard. 
Description.-A pale-brown or greenish-brown powder, having an acrid, pungent 
taste, and developing, when moistened, a pungent and irrespirable odor. Dose, 1 to 3 
drachms (as an emetic). 
Preparation.-Emplastrum Sinapis, Mustard Plaster. Powdered black mustard 
deprived of its fixed oil mixed with solution of rubber and spread upon paper or other fabric. 
It is to be moistened with tepid water before being applied. 
Derivative.-Oleum Sinapis Volatile, Volatile Oil of Mustard. An oil derived from 
black mustard or prepared synthetically and consisting largely of Allyl Isothiocyanate. 
A colorless or pale-yellow liquid having a very pungent and irrespirable odor and an acrid 
taste. The greatest caution should be taken when smelling this liquid; and it should not be 
tasted except when greatly diluted. Dose, 1/12 to 1/4 drop. There is no justification for 
its internal use. 
Specific Indications.-External. Deep-seated pain and inflammations; 
vomiting from gastric irritability; and repressed secretion. 
Internal. Emetic for poisoning by narcotics. 
Action and Toxicology.-Volatile oil of mustard is an extremely 
diffusible and penetrating irritant, quickly exciting heat and burning pain 
through its dilating action upon the peripheral vessels and irritation of the 
sensory nerve endings. If too long applied it will blister, and cause in- 
flammation, sloughing and deep ulceration; and not infrequently gangrene. 
To a degree local anaesthesia is produced in some instances and the patient 
is then not aware of the possible destruction of tissue. Removed in time 
only induration is caused, followed sometimes by desquamation. Mustard 
applied in the same manner acts similarly but more slowly and with gradu- 
ally increased intensity, as the volatile oil is but slowly formed from the 
moistened powder by the action of its ferment myrosin. The local action 
of mustard may stimulate reflex cardiac and respiratory activity in sufficient 
force to arouse one from an attack of fainting. Internally, mustard is a 
stimulating condiment and appetizer, and excites gastric activity and 
promotes digestion. If the amount be large, however, it is intensely irritant 
and promptly causes vomiting. This is not attended by depression, how- 
ever, owing to the fact that both the breathing and circulation are stimu- 
lated by its reflex action upon the respiratory centers and the heart. Over- 
doses may induce acute gastritis, and if long continued chronic gastric 
catarrh. The volatile oil is an intense irritant poison, producing intense 
burning pain and destruction of tissue. Profound depression, renal hyper- 
aemia, and insensibility precede death. 
Therapy.-External. The mustard plaster and the sinapism (mustard 
poultice) are popular with physicians and the laity as rubefacients and 
counterirritants to relieve deep-seated pain and inflammation, check vomit- 
ing, reestablish suppressed urine, excite and restore menstruation, to 
arouse from insensibility in narcotic poisoning, syncope and asphyxia, 
and as a derivative generally. For this purpose they should be applied 
temporarily only and their effects carefully watched. Sometimes they act 
633 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
best when applied a little remote from the actually involved tissue, and they 
are necessarily so used when the internal organs are the seat of disease. 
For the purposes named the mustard plaster or sinapism may be applied 
to the chest and the abdomen in acute inflammation of the viscera, to the 
epigastrium and spine to check persistent vomiting from gastric irritability, 
and in gastralgia, gastritis, flatulence, to the abdomen in colic, over the 
loins in suppression of urine, lumbago and backache, to the nape of the 
neck in congestive headache and cerebral congestion, to the spine, legs, 
and soles of the feet to arouse from apoplexy, stupor, and coma, to the 
praecordial region in syncope, and locally to the areas involved in myalgia, 
neuralgias, muscular rheumatism, and inflammations of the joints. They 
should be used with great care upon children and debilitated individuals. 
Never more than one fourth mustard and three fourths white or rye flour 
should be employed in either, and the strength of the poultice can be 
regulated better in this manner than by using the ready prepared plaster. 
However, for general purposes the plaster, mustard leaves or papers, are 
most convenient, always ready for immediate use, and quickly and cleanly 
applied, first dipping them in water. It must be remembered that they are 
exceedingly energetic and usually stronger than a domestically prepared 
poultice. When necessary to use extra precaution, and in children, it is 
best to interpose a moistened layer of thin fabric between the skin and the 
application. When long and gentle action is desired, about one-twentieth 
part of mustard may be incorporated into flaxseed or other poultices. 
A blanket wrung from hot mustard water is sometimes used to restore 
retrocession of eruption in the exanthems, but special care should be had 
in scarlet fever, lest the already endangered kidneys be damaged. It 
should only be used as a last resort in this disease, but is less liable to do 
harm in measles. Warm water increases the activity of mustard applica- 
tions; and the smarting sensation arising from the local use of mustard 
may be mitigated by sponging the parts with cold water, or spraying with 
ether. 
Internal. The only rational use for mustard internally is to cause 
emesis in cases of narcotic poisoning. Besides acting as a prompt emetic, 
there is the added value of reflex stimulation of the heart and breathing 
organs, and consequently no depression. It should not be used for irritant 
or corrosive poisons. Its employment would seem rational in food poison- 
ing (bromatotoxism) when there is depression of the nervous system and 
no irritation or gastro-intestinal inflammation present, provided there is 
still poisonous food in the stomach. As an emetic, from one to four tea- 
spoonfuls may be administered in plenty of luke-warm water. It acts 
promptly and thoroughly, except in cases where the vomiting apparatus is 
paralyzed. In such instances the stomach pump or lavage tube should be 
used. 
Thiosinamine. This is derived from oil of mustard or from oil of horseradish by acting 
upon it with ammonia water in the presence of alcohol and heat. Crystals form which are 
soluble in water (2) and alcohol and ether. Dose, 1/2 to 1 grain. This substance is asserted 
to have the remarkable property of dissolving keloidal and scar tissue when injected into 
the parts involved; it is also said to have some solvent effect upon them even when in- 
gested. From its local use a reaction similar to that caused by tuberculin is experienced. 
The parts become darkly congested and swollen, there is great local pain, nausea and vomit- 
Derivative of Oil of Mustard. 
634 INDIVIDUAL DRUGS. 
ing may occur, and there is a greatly increased secretion of urine. From fifteen to twenty 
minims of a 10 per cent solution in absolute alcohol are injected every third or fourth day, 
directly into keloid scars, and lupus, and other malignant growths. Hare warns that care 
be had that no possible old inflammatory focus, especially of tubercular origin, be over- 
looked in using it in lupus, lest the original malady becomes activated, natural protective 
barriers be broken down, and it induces in partly healed lesions an active inflammation. 
The reaction and absorption caused by this substance are said to be rapid when injected; 
slower when given by mouth. 
It may be used internally for the slower removal of scar tissue, induration of the tym- 
panic membrane and to absorb corneal opacities. It is said to act upon abnormal tissue in 
preference to normal, a claim that requires confirmation. More than the recommended 
doses are apt to disorder the stomach, and altogether the drug has failed, whether given 
internally or used locally, to interest those most concerned-the cosmetic surgeons. 
SODII ACETAS. 
Sodium Acetate. (Formula: NaC2H3O2+3H2O.) 
Description.-Colorless crystals, or a crystalline, granular powder, without odor 
(or slightly acetous), and having a cooling, saline taste. Warm, dry air causes it to lose 
water of crystallization. Freely soluble in water, and less so in alcohol. Dose, 20 grains to 
2 drachms. 
Action and Therapy.-Sodium acetate is less diuretic than potassium 
acetate, but has an advantage in being less deliquescent and less apt to 
provoke gastric disturbance. It is used for practically the same purposes 
as the potassium salt, but is less efficient in rheumatic conditions. Being 
converted into a carbonate in the body it alkalizes the urine. 
SODII BENZOAS. 
Sodium Benzoate. (Formula NaCrHsOj.) 
Description.-A permanent, white powder, either non-crystalline or crystalline or 
in granules, without odor, and sweetish, subastringent taste. Freely soluble in water, and 
less so in alcohol. Dose, 5 to 30 grains. 
Action and Therapy.-The action and uses of sodium benzoate are 
practically those named under Benzoic Acid, which see. By some it is 
especially valued in pharyngitis and in bladder disorders when the urine is 
strongly ammoniacal. Owing to the fact that it retards the action of 
enzymes, even when used in minute quantities, it has been objected to as a 
preservative of food, a use which was very common until very recently. 
Benzoate of sodium behaves somewhat like the salicylate of sodium in 
articular rheumatism and septic diseases, but it is far less effective. Webster 
advises its use in the albuminuria of pregnancy. Fyfe suggests its value, 
with rhubarb, as a cholagogue. 
SODH BICARBONAS. 
Sodium Bicarbonate, Baking Soda, Soda, Bicarbonate of Soda. (Formula: NaHCOa.) 
Description.-A white, odorless powder having a cooling and feebly saline taste. It 
is slowly decomposed by moist air. Soluble in cold water, but when added to hot or 
boiling water loses carbon dioxide and finally becomes sodium carbonate. Dose, 1 to 40 
grains. 
Specific Indications.-Pallid mucosa with a filmy white coat upon the 
tongue; acid dyspepsia; hyperchlorhydria; sour eructations; sour, green 
diarrhoea; cardialgia; flatulent colic with acidity; sick headache from sour 
stomach; rheumatic pain, with acid urine and sour sweat, high fever and 
sour diarrhoea; acidosis. 
635 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-External. Powdered sodium bicarbonate, or pref- 
erably a strong solution gives quick relief from pain in superficial burns 
and scalds, soothes in dermatitis from Rhus Toxicodendron, and in pruritus 
due to acid urine. A weak solution injected sometimes relieves burning 
pain in gonorrhoea, and it is an ingredient of many lotions for acute and 
chronic catarrh, both nasal and vaginal. It softens hardened cerumen 
and may be used in the solution employed when syringing for its removal. 
A 10 per cent solution is a very efficient and unirritating agent to remove 
the crusts in ciliary blepharitis. Lotions of various strengths, as desired, 
may be used upon insect bites and in urticaria and erythema. It forms a 
good mouth wash where acids have been used, and sometimes relieves sore 
throat when used as a gargle. Used too freely and too often it may provoke 
an irritation of the throat, a common occurrence during the epidemics of 
influenza, when many by way of supposed prophylaxis unwisely created 
an irritation that did not previously exist. It provides one of the best of 
douches in acid leucorrhoea. Applied by means of hot compresses it fre- 
quently gives relief in acute articular rheumatism, in cases in which its 
internal use is also indicated. 
Internal. The action of sodium bicarbonate is quite similar to that of 
sodium carbonate and potassium bicarbonate, but milder and pleasanter 
than either. It is an admirable antacid, but should not be used as such in 
infants on account of the painful distention of the stomach and bowels 
occasioned by the liberation of the carbonic acid gas. Magnesium oxide 
is preferable for children. For hyperchlorhydria in adults it is extremely 
useful. Where specifically indicated relief is immediate, but as a rule not 
permanent. It should be given about two hours after meals. In acid 
dyspepsia it is palliative when there is cardialgia, sour eructations, flatu- 
lence and vomiting, or when there are sour diarrhceal discharges. In such 
conditions it serves a temporary purpose, easing pain and distress, and 
enabling the stomach to take appropriate subsequent treatment. Un- 
doubtedly the liberated carbon dioxide assists in allaying pain by its 
carminative and obtunding effects. In stomach disorders it is frequently 
combined with bismuth subnitrate, or if atony is marked, with powdered 
ginger. It is also an ingredient of Seidlitz powder, a commonly used purga- 
tive in acid conditions of the stomach. When desired to increase the flow 
of gastric juice in achlorhydria, sodium bicarbonate may be given one half 
hour before meals. Even the frequent or continuous use of the salt for 
sour stomach will eventually increase the disorder and may establish an 
incurable dyspepsia. For sick headache due to overeating, or partaking 
of food which soon sours or becomes putrescent in the stomach, a half 
teaspoonful of soda and a third of a teaspoonful of common salt in a pint of 
barely warm water will either "settle the stomach" or act as an emetic, 
and promptly give relief. If desirable that emesis should take place, it is 
then easily provoked by tickling the fauces with the finger. We invariably 
advise this treatment in sour stomach with pain in so-called cases of 
acute indigestion. Intensely throbbing and bursting headache, due to 
similar cause, is relieved almost magically by the emetic action of "bicar- 
bonate of soda and salt". 
Sodium bicarbonate mav be used to chemically antidote poisoning by 
636 INDIVIDUAL DRUGS. 
acids when spilled upon the person. If the acids are such as are destructive 
to tissues, it should not be given internally, if any other alkaline substances 
can be procured, on account of the danger of rupturing the stomach through 
liberation of carbonic acid gas. 
Sodium bicarbonate is probably the best alkalizing agent in acidosis, 
or when it is threatened in diabetes. Its free use should be begun as soon as 
acetone is detected in the urine, even though diabetic coma is not yet 
established. As much as an ounce a day, well diluted, may be given. 
In diabetic coma, three or four ounces a day may be used, but the prob- 
abilities are that little benefit will come from any treatment. Such cases 
as have recovered have been given this salt in enormous doses; therefore, 
the presumption is that it may do good in an occasional instance. 
When an alkalizing fluid is desired other than for diabetic states, and 
especially preceding grave surgical operations, the following pleasant 
drink may be used. It is a form popular in Christ Hospital, Cincinnati, 
under the name Liberty Drink (substituted for Imperial Drink). 1$ Potas- 
sium Bitartrate, grains 160; Sodium Citrate, grains 160; Sodium Bicarbon- 
ate, grains 320; Syrup (U. S. P.), ounces 8; Water, q. s., gallon 1/2. Sig.: 
Dose, a glassful (6 ounces), acidulated with lemon juice to taste. 
The original " Soda Water"-the prototype of the popular fountain 
carbonated beverage and once a household drink, was prepared by adding 
bicarbonate of sodium dissolved in water, in one glass, to that of another 
holding a solution of vinegar, to which a little powdered ginger was added. 
The beverage was then drunk while it effervesced. 
"Imperial Drink" is prepared by dissolving potassium bitartrate, 
3jss, in boiling water, Oij, and adding sugar and grated fresh lemon peel, 
aa 3 ss. This forms an alkalizing and refreshing beverage for fever patients. 
The "A. B. C." mixture of hospitals is a solution in water, of 5 grains 
each, of acetate, bicarbonate, and citrate of potassium. 
Sodium bicarbonate is diuretic and eliminative, therefore it has 
given marked relief in articular rheumatism, with acid and heavily loaded 
renal secretion, high fever, pallid membranes, and white coated tongue. 
It should be administered internally and applied locally. It is of much 
value in urinary disorders when the urine burns, and is especially grateful 
to relieve the ardor urinae accompanying gonorrhoea. It should be largely 
diluted and drunk freely throughout the day. Sodium bicarbonate has 
given relief in biliary calculi, but is of no special value during an attack of 
hepatic colic. 
When the indications as noted above are followed, sodium bicarbonate 
is an extremely useful remedy. When given indiscriminately and long 
continued without specific indications, it may do irreparable harm. 
SODII BORAS. 
Sodium Borate, Borax. (Formula: NajB^-l-lOHsO.) 
Description.-Colorless, transparent crystals, or a white powder, devoid of odor and 
having a taste that is alkaline and slightly sweetish. It is very soluble in water and glycerin, 
but insoluble in alcohol. Dose, 1 to 30 grains. 
Specific Indications.-Persistent sore mouth; uric acid diathesis; 
travel: dvsoepsia with sense of gastric constriction; gnawing pains, un- 
637 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
easiness at stool, and urging to urinate, the discharge being finally muco-pus; 
acrid leucorrhoea. Externally. Aphthae; vulvar pruritus with whitish 
deposits; leucorrhoea with glairy or colored discharge; freckles. 
Action and Therapy.-External. Borax is antiseptic and detergent, 
and in solutions of various strengths is of great value as a wash for fetid 
and catarrhal surfaces. It is the most commonly used cleansing wash for 
leucorrhoea, acting best when the discharges are glairy, colored, and profuse. 
It enters into the composition of several preparations for nasal catarrh, and 
is the most useful salt for aphthae in any part of the body and as a part of the 
treatment in thrush in infants. Borax and sugar are sometimes used upon 
the aphthous ulcers of the mouth, or it may be combined with honey, but 
as these saccharine bodies cause severe smarting the borax alone is pref- 
erable in young children. Locke advises, for older persons and those 
with phthisis, the following: 1} Borax, 3iij; Honey, fl^ss; Infusion of Sage, 
Oj. Apply freely. It is one of the best applications to relieve vulvar 
pruritus, especially where there is sugar in the urine or when caused by 
acrid discharges. It sometimes removes freckles and other skin blemishes, 
and the deposits of pityriasis versicolor, and in the form of an ointment has 
checked falling of the hair. Scaly diseases of the skin are well-treated with 
borax, and it may be used to remove crusts in ciliary blepharitis, to cleanse 
the eye in conjunctivitis, and to remove hardened cerumen and fetid dis- 
charges from the ears. 
Internal. Borax in large doses is poisonous, its effects being similar to 
those caused by Boric Acid, which see. Internally, in proper doses, it is 
diuretic, emmenagogue, and antiseptic. It has proved a useful agent in 
fetid dysentery and the summer diarrhoea of children, and is sometimes 
effective in acrid leucorrhoea attended by dragging pain in the back. The 
dose should be small. Without doubt it does some good occasionally in 
amenorrhcea, and in membranous dysmenorrhoea. It is also given for 
dyspepsia with constant uneasiness and gnawing in the stomach, and in 
bladder disorders with decomposition of urine and tendency to gravelly 
deposits. Its chief internal use is in fetid catarrhal diarrhoea and dysentery. 
Sodium Bromide. (Formula: NaBr.) 
Description.-White or colorless salt occurring as cubical crystals or a granular 
powder, without odor and having a salty taste. Freely soluble in water and alcohol. 
Dose, 1 to 60 grains. 
Specific Indications.-Same as for Potassii Bromidum, which see. 
Action and Therapy.-The action and uses of sodium bromide are 
practically the same as those of potassium bromide, except that its activity 
is not so great as that of the latter. Moreover, it is pleasanter to the taste, 
comparatively less sedative and hypnotic, and dose for dose, not so apt to 
induce mental dullness and lethargy. It is also thought to be less liable to 
cause acneiform eruptions, fetid breath, and other phases of bromism. 
This, however, is probably largely a matter of dosage. Where a powerful 
bromide impression is desired as in epilepsy, the potassic salt is to be 
preferred. But for women and children who are robust, but nervous and 
cannot rest or sleep, the sodium salt may be administered. It is especially 
SODII BROMIDUM. 
638 INDIVIDUAL DRUGS. 
useful in plethoric individuals who are exhausted by mental and bodily 
fatigue, and for purely nervous palpitation of the heart, the result of 
masturbation or sexual excesses, alcohol and tobacco, especially the "cigarette 
habit." During the menopause it will prove useful and act more kindly than 
the corresponding salt of potassium, to control the nervous irritability. Like 
all bromides it should be given only in robust states, never in anemia and 
weakened conditions, and should be well diluted when administered. 
SODII CACODYLAS. 
Sodium Cacodylate, Sodium Dimethylarsenate. (Formula: Na(CH3)2AsO3.) 
Description.-Odorless, white, deliquescent, prismatic crystals, or a granular powder; 
very soluble in water and in alcohol. Dose, 1 to 4 grains. 
Action and Therapy.-The uses of cacodylate of sodium are practically 
those of arsenic, and it should be given for like indications. It is best 
adapted when the slower arsenical effects are required as it very slowly 
breaks up in the body. Therefore, larger doses have been possible than 
with arsenic itself. An unpleasant feature of its action is gastric irritation, 
with strong garlic-odored eructations. It has been chiefly employed by 
mouth (1 to 4 grains), and hypodermatically (1/4 to 1/2 grain), in the 
anemia and debility of tuberculosis, in Hodgkin's disease, and by intra- 
muscular injection (1 to 2 grains) to destroy the spirochaete of syphilis. 
The latter claim has not been sustained. 
SODII CARBONAS MONOHYDRATUS. 
Monohydrated Sodium Carbonate. (Formula: Na3CO34~H2O.) 
Description.-This salt is prepared by crystallizing ordinary sodium carbonate or sal 
soda, which contains ten molecules of water of crystallization, at a heat above 35°C (95°F). 
It is an odorless, white, granular, crystalline powder, with a powerful and typical alkaline 
taste. It slightly absorbs moisture in the air, and if dry and quite warm it effloresces 
and gradually becomes completely anhydrous. Very soluble in water, boiling water, or 
glycerin; insoluble in alcohol. Dose, 5 to 20 grains, well diluted. 
Action and Therapy.-External. Sodium carbonate, either the com- 
mon or the monohydrated varieties, is used in preparing alkaline baths. 
A weak solution is useful in pruritus vulvae, and in various strengths it may 
be used in dry, scaly types of skin diseases, as psoriasis, lichen, pityriasis, 
ichthyosis and eruptive disorders of the scalp, with itching. Unless used 
in very weak dilution it is less valuable in vesicular or pustular eruption. 
Its chief value consists of a slight stimulating action, and the facility with 
which it destroys acid secretions and removes sebaceous matter and dirt. 
Internal. Sodium carbonate is less used internally than formerly. 
It may, however, be employed as an antacid and diuretic. If used too long 
it may, through excessive alkalinity, induce the formation of urinary cal- 
culi; on the other hand, when largely diluted it is useful in the uric acid 
diathesis. It is less desirable than sodium bicarbonate, for the large amount 
of carbon dioxide contained in the latter helps to dissolve the phosphates 
and thus prevents the formation of phosphatic gravel. Small doses are 
sometimes useful in dry, scaly, skin diseases, when given conjointly with 
its external use. Owing to the relatively lesser amount of carbon dioxide 
evolved, it may be used in preference to sodium bicarbonate; in external 
639 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
and internal poisoning by mineral acids it is one of the recognized anti- 
dotes. 
Large doses of sodium carbonate, given for several days, have produced 
a condition of scorbutus. When this occurs or when excessive doses have 
been taken, vinegar, lemon juice, and other vegetable acids will antidote 
its action; oils also modify its destructive effects. 
SODII CHLORIDUM 
Sodium Chloride, Common Salt, Sea Salt, Table Salt. (Formula: NaCl.) 
Description.-Transparent, colorless, cubical crystals, or a crystalline, white powder, 
without odor and having a purely saline or salty taste. It usually absorbs enough moisture 
when exposed to air to become slightly hygroscopic. Very soluble in water, soluble in 
glycerin, and slightly dissolved by alcohol. Dose, 5 grains to 1/2 ounce. 
Preparation.-Liquor Sodii Chloridi Physiologicus, Physiological Solution of Sodium 
Chloride (Physiological Salt Solution, Normal Salt Solution). A solution prepared under 
sterile precautions and not to be used after forty-eight hours old. It contains 8 1/2 parts 
of salt in 1,000 parts of solution. 
Specific Indications.-Tongue broad and pale, with white coat or fur; 
broad tongue of natural color, but easily pitted by the teeth; poisoning by 
silver salts. 
Action.-The action of sodium salts is much like that of the cor- 
responding potassium group, with perhaps a less depressing influence upon 
the nervous system, the muscles, and the heart. See also Salt Action at 
end of this article. 
Therapy.-External. The application of hot salt bags is a favorite 
method of applying heat to allay local pain, as in neuralgia, headache, 
toothache, earache, colic, and dysmenorrhoea. Saturated compresses of 
solutions of salt are applied like poultices, and are much cleaner, in visceral 
inflammations. In arthritis, whether traumatic, rheumatic, or tubercular, 
they may be applied hot or cold, as desired. Hot solutions with alcohol 
(whiskey) added, are commonly employed in contusions, sprains, and 
glandular inflammations. Rarely, weak solutions are used in ophthalmias 
and in trachoma. Weak solutions, alone or in combination with alkalies 
and disinfectants, are useful in acute and chronic nasal catarrh, ozaena, 
pharyngitis, and tonsillitis; while strong, hot solutions are valuable as 
douches in leucorrhcea with much relaxation of the tissues, and in pruritus 
vulvae, and by means of compresses to bites and stings. A salt-water 
enema, made weak, is the most effectual agent against the thread worm. 
If used too strong it irritates the rectum and causes much pain. 
Internal. Sodium chloride in doses of two to four drachms will purge, 
and sometimes vomit. Still larger doses will vomit without causing prostra- 
tion. In excessive amounts for a continued time salt gives rise to hoarse- 
ness, sore throat, either constipation or diarrhoea, catarrh, thinning of the 
blood, waxy complexion, and probably permanently damages the kidneys. 
In small doses it is a condiment, food, alterative, and vermifuge. It is useful 
in chronic diseases with a pale tongue coated with a white fur. Salt given 
in sufficient quantity for the needs of the body favors the bettering of con- 
ditions in which worms become established and thrive. It is especially 
beneficial where the food decomposes, giving rise to gastralgia, acidity, 
flatulence, and constipation or diarrhoea. 
640 INDIVIDUAL DRUGS. 
Mustard and salt forms a good emetic in acute narcotic poisoning; soda 
and salt a good corrective for acid conditions of the stomach, with violent 
sick headache, due to overloading the stomach. With plenty of warm 
water and titilation of the fauces, vomiting may be readily induced and the 
stomach thus washed out. A pinch of salt should be occasionally given to 
patients with fever and other conditions in which little nourishment can be 
taken. This may mean "t'he difference between life and death"; and small 
quantities should be added to the food of bottle-fed infants suffering from 
infantile dyspepsia or cholera infantum. 
A teaspoonful or less of dry salt slowly dissolved in the mouth may 
assist in controlling haemoptysis. While the salt may have some astringent 
properties, there is no doubt that the quiet induced by demanding of the 
patient slow swallowing, together with the psychologic effect of the treat- 
ment, has much to do with its success. A solution of common salt is the 
antidote to poisoning by silver nitrate and other silver salts. Such a solu- 
tion should always be previously prepared when about to apply a silver 
salt, and thus be at hand to limit the action of the latter. 
Salt, through its so-called "salt action", possesses remarkable osmotic 
properties. Strong solutions draw fluid from cutaneous and mucous 
surfaces, and this exchange with salt is liable to produce more or less irrita- 
tion; the red blood-discs are similarly affected and shrink in and become 
crenated. Dilute solutions on the other hand cause softening and swelling 
instead of hardening and shrinking. When weaker than the plasma of 
the blood salt solutions are said to be hypotonic; when more strongly con- 
centrated hypertonic; when of equal concentration as plasma, and therefore 
exerting the same osmotic balance, they are said to be isotonic, normal or 
physiologic solutions. The latter state has been taken advantage of for 
using salt solutions to replenish lost blood and secretions, after operations 
and accidents and in diseases characterized by excessive drain upon the 
blood-plasma. Used by hypodermoclysis or enteroclysis it is considered the 
best and most reliable means of combatting shock from loss of blood, and 
in violent serous diarrhoea and Asiastic cholera. Sometimes in the latter 
disorder it has been used intravenously, adding to it some other alkali, 
as* calcium chloride or sodium sulphate or carbonate. This method, how- 
ever, is not wholly free from danger. 
Normal salt solution provokes an enormous passage of urine when used 
by intestinal lavage, and for such a diuretic purpose it has been useful in 
pneumonia, empyema and other diseases and auto-infections, and in acute 
nephritis. It should not, however, be used in chronic forms of nephritis with 
oedema. It is extremely useful in chronic colitis by washing away mucous 
detritus and allowing other applications to come into contact with the 
mucosa; a similar use may be made of it in cholera infantum and acute 
dysentery and typhoid fever. Used in this way it prevents the re- 
absorption of the putrid and toxic products which tend to prolong these 
disorders. 
The dose of salt as an alterative is from two to thirty grains; as an 
enema, one-half to one ounce to one quart of water; as a cathartic, two to 
four drachms; as an emetic, one-half to one ounce. 
641 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
CHLORINE YIELDING PREPARATIONS. 
Chloramines.-During the World War the Dakin-Carrel treatment of wounds came 
into prominence, being conspicuously notable for good results with the minimum of lym- 
phatic involvement. This consisted in the employment of a specially prepared sodium 
hypochlorite (NaO Cl) solution, for continuous disinfection. Dakin assumes, that when 
chlorine compounds come into contact with organic matter, as when used as a disinfectant, 
that the released free chlorine forms, among other bodies, substances called chloramines. 
The latter, it is contended, and not the oxygen liberated, as was once thought to be the 
case, are the active antiseptic agents. This treatment and the solutions originated with 
Drs. Alexis Carrel and H. D. Dakin and their colleagues. 
Owing to the complicated technic of preparing the Dakin-Carrel and similar solutions 
several commercial forms of chloramines are now available and much better adapted for 
use by the general practitioner. 
Notable among these disinfectants is Dichloramine-T. Chemically it is toluene- 
para-sulphondichloramine. By using it in 7 1/2 per cent solution in chlorinated petrolatum, 
or in chlorinated eucalyptol (chlorinated so as not to absorb the chlorine of the antiseptic), 
a non-irritant, slow action is obtained by which the antiseptic gradually is liberated, the 
time consumed usually being from 18 to 24 hours. Dakin's solution, as well as Dichloramine- 
T, dissolves blood clots, dead tissue, etc., hence it is advised that vessels be ligated to 
prevent or stop hemorrhage when using these antiseptics. 
Chief among the prepared compounds are Chloramine-T and Chlorazene (both water 
soluble), and Dichloramine-T (oil soluble); and as a solvent for the latter, a chlorinated 
paraffin, Clorcosane. 
All of the Chloramine preparations are for external use only-they should not be taken 
internally. 
Chloramine-T (Sodium para-toluene-sulphon-chloramine-CH3. CsHiSOjNaNCl. 
3H3O). A water-soluble, white powder, of a slight chlorinous odor, and insoluble in oils. 
Used as a germicide and disinfectant for wounds, acting like hypochlorites but with less 
irritation. Solutions of 1 to 2 per cent strength are generally employed; for use in the nose 
and throat 1/4 per cent solutions. 
Chlorazene is a brand of water-soluble Chloramine-T similar to the preceding. It is 
marketed in tablets containing 4.6 grains. When a solution is desired quickly the tablet 
should be crushed with a silver spoon or glass rod and then dissolved in water. 
Chloramine-T Paste.-A 1 per cent white and odorless "vanishing cream" paste. 
The base is neutral sodium stearate. 
Dichloramine-T (Toluene-para-sulphondichloramine-CHs.QFh.SOjNCh) is a white 
powder of chlorinous odor, and insoluble in water. Soluble in chlorcosane (about 10), 
in chlorinated eucalyptol, or in chloroform. For use in oily solution as a germicide and dis- 
infectant upon wounds (2 to 5 per cent solutions), nose and throat (1 per cent), and eyes 
(1/2 to 1 per cent). Prepare by stirring into warm chlorcosane, and cooling to desired 
temperature for use. It should be freshly prepared as a rule, but if kept the solution 
should be discarded if a precipitate not soluble upon gentle warming is present. 
Chlorcosane.-A chlorinated paraffin or oil solvent for Dichloramine-T, capable of 
holding in solution from 8 to 10 per cent of the latter. It is a yellow, tasteless, bland and 
stable oil, non-irritant and non-toxic. Solutions of from 2 to 5 per cent strength are used 
upon wounds, and 1 per cent or weaker in nose and throat work, applied by means of a 
swab or atomizer. If chlorcosane solutions of Dichloramine-T develop a precipitate that 
fails to disappear upon gently warming them, they should be discarded. Preferably they 
should be freshly prepared. 
Halazone (Para-sulphondichloraminobenzoic acid). A stable, powerful disinfectant 
for the sterilization of drinking water. It has an action similar to that of chlorine. It 
contains, besides the halazone, anhydrous sodium carbonate and sodium chloride to facili- 
tate solution. A 1/16 grain tablet is sufficient to sterilize one quart of water, the latter 
so treated being allowed to stand for an hour. It was introduced by Drs. H. D. Dakin 
and E. K. Dunham. 
SODII CITRAS. 
Sodium Citrate. (Formula: 2Na3C«HBO7-|-2H2O.) 
Description.-An odorless, white, granular powder, or small crystals, having a cooling, 
saline taste. Very soluble in water; insoluble in alcohol. Dose, 5 to 30 grains. 
Specific Indications.-Faulty nutrition in bottle-fed infants, who 
vomit heavy curds of milk; wasting and marasmic states of artificially fed 
infants; acid urine in the aged with cystic irritation. 
642 INDIVIDUAL DRUGS. 
Action and Therapy.-Sodium citrate is easily soluble in both water and 
milk, and is perfectly innocuous, being given in some cases in daily quantities 
of an ounce or more. Small doses, however, should be given to children. 
Two or three grains may be added to each ounce of milk fed to young babies. 
It has the great advantage of preventing the formation of large curds of 
milk, that by their toughness readily give rise to stomach and bowel troubles 
in infants. It is particularly indicated in children who are wasting away 
on account of faulty digestion, and in the marasmic little ones little benefited 
by other medication. Another condition which may be present in children, 
but that is more common in the old, is an acid state of the urine, giving 
rise to great irritation of the bladder and outlets. More especially is it 
recommended if there be present the colon bacillus. A full teaspoonful 
should be given in a full glass of water to adults, and smaller quantities to 
children, two to four times a day. Its alkalizing effect is powerful, it prob- 
ably being converted in the system into sodium carbonate. See also 
"Liberty Drink" under Sodii Bicarbonas. The degree of correction of 
acidity may be determined by litmus paper. Sodium citrate has also been 
used successfully in acetonuria, in the vomiting of pregnancy, and in the 
cyclic vomiting of children. Its ease of administration and harmlessness 
are strong recommendations for the further study of this drug, especially 
in the malnutrition of children. It does not act as a cathartic, nor does it 
nauseate, but, on the contrary, is quick to relieve gastric distress. 
SODII HYPOPHOSPHIS 
Sodium Hypophosphite. (Formula: NaPHjOj.HjO.) 
Description.-Small, colorless and odorless, pearly, lustrous crystals, or a granular, 
white powder, of a bitterish-sweet, saline taste. Upon exposure to moist air it quickly 
deliquesces. Very soluble in water, and less readily in alcohol. Dose, 2 to 25 grains. 
Specific Indication.-Malnutrition of the nerve centers with nervous 
depression. 
Action and Therapy.-Sodium hypophosphite is used in malnutrition of 
the nerve centers in which it opposes nervous depression. It is also useful in 
coughs accompanying chronic lung diseases, as bronchitis, and in malnutri- 
tion of the osseous tissues, with anemia. When indicated it improves the 
nutrition of the body, renders expectoration less but freer, and favors 
nerve rest. It is not curative in consumption, for which it was intro- 
duced by Churchill, but is a useful adjunct in the treatment of that disease 
to increase strength, allay cough, and modify secretion. It should be 
given preferably after meals, well diluted, or if agreeable, in syrup. 
SODII IODIDUM. 
Sodium Iodide. (Formula: Nai.) 
Description.-Colorless, cubical crystals, or a crystalline, white powder devoid of 
odor and having a saline, peculiar taste, suggestive of slight bitterness. In moist air it 
deliquesces, liberating iodine, which imparts to it a reddish color. Freely soluble in water, 
alcohol, and glycerin. Dose, 1 to 10 grains. 
Action and Therapy.-Sodium iodide is preferred by some over iodide 
of potassium, upon the belief that it is less liable to produce gastro-in- 
testinal, coryzal, and skin disturbances. It is a weaker salt than the latter, 
643 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
and is used in syphilis and eczema when the iodides are demanded but the 
system is greatly depressed. 
Sodium Nitrate, Chili Saltpetre, Cubic Nitre. (Formula: NaNOj.) 
Description.-Odorless and colorless, transparent, cubical crystals, having a saline, 
cooling, and feebly bitter taste; deliquescent in moist air; freely soluble in water and in 
about 100 parts of alcohol. Dose, 1 to 30 grains, largely diluted. 
Action and Therapy.-In full doses this drug resembles in action nitrate 
of potassium. It is mildly purgative and diuretic, contributing greatly 
toward increasing the output of urea. The indications for it, as elaborated 
by Scudder, are practically the general guides for alkalies: "A swollen and 
puffed tongue, covered with whitish or yellowish mucus; the mouth may be 
dry or moist, but the tongue must never show contraction, be elongated or 
pointed, or deep red". Also, "when the pulse is full, the surface flushed, 
slightly dusky or purplish; eyes injected, though not dry; an increased 
perspiration though the skin remains hot". These are the conditions under 
which it is said to be useful in acute diseases, though it is now rarely ad- 
ministered. 
SODII NITRAS. 
Sodium Nitrite. (Formula: NaNO2.) 
Description.-This salt occurs in three forms: as fused, white, or nearly white opaque 
masses or pencils; or as colorless, transparent crystals, or a granular powder, without 
odor but having a mildly saline taste. It is very soluble in water; sparingly in alcohol. 
Dose, 1/2 to 2 grains. 
Action and Therapy.-The action of sodium nitrite resembles that of 
amyl nitrite and nitroglycerin, except that it is less pronounced and more 
prolonged, probably on account of its slower absorption and elimination. 
While its action is more uniform when it does act, it is less certain than 
nitroglycerin to accomplish the purposes for which it is prescribed- 
chiefly that of lowering arterial tension. It may be used in angina pectoris, 
but nitroglycerin is more prompt. But when a prolonged effect is desired 
sodium nitrite may be preferred, as it is also in Raynaud's disease, to 
relieve the spastic contraction by dilating the digital arteries. It is also of 
service in headache from cerebral anemia, convulsions with high blood- 
pressure, granular disease of the kidneys, with arteriosclerosis, and in 
heart disorders with degeneration of the cardiac muscles. The general 
indications are dyspnoea, frontal headache, or dizziness. The single dose 
is usually one grain; it should never exceed two grains. 
SODII NITRIS. 
SODII PHENOLSULPHONAS. 
Sodium Phenolsulphonate, Sodium Sulphocarbolate. (Formula: NaC6H6OSOj4- 
2HSO.) 
Description.-Transparent, colorless crystals or crystalline granules, without odor 
and to the taste cooling, disagreeably saline and bitter. Very soluble in water or glycerin, 
and less so in alcohol. Dose, 1 to 8 grains. 
Action and Therapy.-Sodium phenolsulphonate is a disinfectant and 
owes its properties chiefly to the phenol present. It destroys thrush, 
and may be of value in fermentative dyspepsia and diarrhoea. It is not so 
much valued, as formerly, in infectious diseases. 
644 INDIVIDUAL DRUGS. 
SODII PHOSPHAS. 
Sodium Phosphate, Sodium Orthophosphate. (Formula: Na2HPO4+12H2O.) 
Description.-Sodium Phosphate occurs in large, colorless and odorless crystals, or a 
granular salt, of a cooling, saline taste, and gradually efflorescent in the air. It should 
be kept in well-stoppered bottles, in a cool situation. It is soluble in water and hot water, 
and insoluble in alcohol. Dose, as a restorative, 1 to 10 grains every three or four hours; 
as a laxative, 10 to 60 grains; as a cathartic, 6 to 10 drachms. Usual dose, 60 grains. 
Preparations.-1. Sodii Phosphas Exsiccatus, Exsiccated Sodium Phosphate. Sodium 
Phosphate deprived of its water of crystallization. A white granular powder. Dose, 
1 to 60 grains. 
2. Sodii Phosphas Effervescens, Effervescent Sodium Phosphate. A granular powder 
containing 20 per cent of Exsiccated Sodium Phosphate admixed with Citric and Tartaric 
Acids and Sodium Bicarbonate. This preparation is usually dispensed in original bottles, 
and should not be given out in paper or boxes, as it readily deteriorates and loses its effer- 
vescing quality. Dose, 150 grains. 
3. Specific Medicine Sodium Phosphate. A fine, white, granular powder. About 
double the strength of Sodium Phosphate and largely preferred by Eclectic practitioners. 
Dose, 1 to 60 grains. 
Specific Indications.-Deficient biliary secretion, with pale, ex- 
pressionless membranes, general malaise and inanition; tongue dirty and 
moist, with golden yellow coat, or a dry fur upon a pallid tongue; sallow 
skin, with bilious headache; jaundice; acid eructations; diarrhoea of infants 
with green and white passages, with impaired nutrition, or hard, whitish, 
pasty or spongy stools which float upon water; infantile constipation with 
malnutrition; habitual constipation of adults, with hard, dry feces, and 
deficient biliary activity. 
Action.-Sodium phosphate is laxative and cathartic, according to the 
quantity administered. It probably has also a cholagogue effect. If given 
on an empty stomach, preferably before breakfast, in a liberal amount of 
hot or cold water, a laxative dose produces a full and comparatively painless 
evacuation of the bowels, being effective usually in about six hours. Larger 
doses have a tendency to gripe. The salt may be taken for months with less 
harm than almost any other saline laxative. Being slightly alkaline it 
corrects gastric acidity and lessens the tendency to flatulence. In small 
doses (1 to 10 grains) it acts as a reconstructive, and as such has been 
advocated in various conditions of malnutrition, with evident impairment 
of the nervous system and predisposition to rachitis and caries. 
Therapy.-In laxative doses, sodium phosphate is especially effective 
in chronic constipation, due to hepatic and intestinal torpor. It is also 
valuable in diarrhoea, depending upon biliary inefficiency. By its cleansing 
action upon the duodenum, through stimulation of the intestinal glands, it 
favors a freer flow of bile and lessens the tendency to inflammation of the 
gall-bladder (cholecystitis) and the formation of gall-stones. It is also a 
satisfactory laxative for catarrhal jaundice, dependent upon the presence 
of hepatic calculi or of catarrh of the duodenum. It is of great advantage 
in the bowel disorders of bottle-fed children. There may be either diar- 
rhoea or constipation. The stools are foul-smelling and variously fluid 
and white, or green and white (curds and greens), or are voided in solid, 
chalky or pasty whitish, putty-like evacuations, evidently lacking in bile, 
and so light that they easily float upon water. There is also more or less 
colicky pain, the child is fretful and dull, and may betray muscular soreness 
upon being handled. The latter is especially true when general malnutrition 
645 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
is present. Conditions like these frequently are the forerunners of rickets 
and osseous decay, and some have thought to furnish phosphorus to the 
brain tissues and to the bones by the administration of this salt. It is a 
debatable question, however, as to whether the human system is able to 
produce the physiological union desired for this purpose. It should be 
given a fair trial in infantile dyspepsia, with capricious appetite and alternate 
diarrhoea and constipation. Clinical experience seems to justify the use of 
sodium phosphate in cases of malnutrition, malaise and nervous degeneracy, 
and it has been administered successfully in trigeminal neuralgia, neu- 
rasthenia, and in locomotor ataxia. The use of the drug, by the hypoder- 
matic method (sodium phosphate, 1 part; alcohol, 2 parts, and distilled 
water, 60 parts) in daily doses of fifteen minims, gradually increasing to 
forty-five minims, it is to be remembered, is still in the experimental stage 
and awaits further confirmation before it can be commended. Finally, it 
has been advocated in lithemia, and, administered early and persistently, 
appears to act advantageously in hepatic cirrhosis. 
Sodium Salicylate, Salicylate of Soda. (Formula: NaC7HsO».) 
Description.-Variously a micro-crystalline powder, scales, or a non-crystalline 
powder, without color or but faintly pink; odorless, and to the taste saline or soda-like, sweet 
and somewhat disagreeable. Very soluble in water or alcohol, and also dissolved by glycerin. 
Dose, 5 to 30 grains. 
Specific Indications.-Antirheumatic when the tongue is full, purplish, 
or leaden colored, showing spots where the fur is lifted; fever, not especially 
high, and the affected parts red, with some purplish discoloration, partic- 
ularly when pressed upon (Scudder); fermentative stomach and bowel dis- 
orders. 
Action and Therapy.-External. A strong solution of sodium salicylate 
(about 3 ij to Oj) is an excellent application for poisoning by ivy and 
noxious weeds, and it provides a good lotion for erysipelas. It should not, 
however, be used upon the skin if iron preparations have been previously 
employed, lest it stain the tissues a deep purple. A solution of the salicylate 
has been used locally as an adjuvant to treatment by the internal exhibition 
of the salt, or where the stomach will not tolerate the sodium compound. 
Internal (See also Acidum Salicylicum). The internal action of sodium 
salicylate is practically the same as that of salicylic acid after absorption. 
On account of the lesser solubility of the acid, and its more irritant effects 
upon the gastric mucosa, the use of the sodium salt has largely superseded 
that of the equally effective acid. Both salicylate of sodium and the acid, 
from which it is prepared, hold the indisputable rank of being the most 
effective and most generally indicated drugs in acute rheumatic infection. 
For its use in acute articular rheumatism and subacute or muscular rheu- 
matism and the train of disorders dependent upon infection by the micro- 
coccus rheumaticus, see Acidum Salicylicum (page 137). Besides the uses 
mentioned therein it is distinctly valuable in rheumatic pharyngitis, 
rheumatic ophthalmia, rheumatic iritis, and in rheumatic displacement of 
the retina, in the latter especially, to check further detachment and to 
relieve distressing symptoms. It is sometimes efficient to alleviate the pain 
SODII SALICYLAS. 
646 INDIVIDUAL DRUGS. 
in dysmenorrhoea in rheumatic women. The indications as given on page 
646 represent the chief conditions in which it may be used, though it appears 
to fit true rheumatic infection regardless of the condition of the tongue and 
other guides there noted. 
Salicylate of sodium increases the flow of bile and assists in the elimi- 
nation of uric acid and the urates. In duodenal irritation and subacute in- 
flammation which sometimes precede cholecystitis, this salt may be given 
both for its sedative and antiseptic effect. It also relieves in the milder 
forms of biliary colic when associated with inflammation of the gall-bladder 
and duodenal catarrh and dependent more upon the inflammation than the 
actual presence and passage of gall-stones. 
In acute colds and coryza of a pronouncedly grippal type, and in those 
of septic influenza, and in the frontal headache of epidemic influenza, it 
is a remedy of first importance. Chilliness, sneezing, malaise, nervous and 
muscular depression, and a sense of fullness in the frontal sinuses are direct 
indications for it. It is a logical remedy in frontal catarrhal sinusitis, and 
often relieves supra-orbital neuralgia of rheumatic origin. In pleurisy due 
to a rheumatic cachexia it should be given in alternation with aconite and 
bryonia. Its value in acute tonsillitis of all types, and particularly the 
rheumatic, is beyond dispute. Ellingwood praises sodium salicylate in 
whooping cough, giving two or three grains, three times a day, and in larger 
doses, fifteen grains, three times a day, for nervous cutaneous pruritus. 
SODII SULPHAS. 
Sodium Sulphate, Glauber's Salt. (Formula: NajSCh+lOHjO.) 
Description.-Large, transparent and colorless, prismatic crystals, or granular crystals, 
without odor and having a saline, bitter taste. It rapidy effloresces when exposed to the air. 
Very easily dissolved by water; insoluble in alcohol but soluble in glycerin. Dose, 1 grain 
to 3ss. 
Preparation.-White Liquid Physic (Sodium Sulphate, lb. ss; Water, Ojss; Nitric 
Acid, Hydrochloric Acid, aa fl5 j). Dose, 1 to 4 fluidrachms. 
Specific Indications.-Tissues pale, full and sodden; full, pallid tongue, 
easily pitted by the teeth; watery, greenish diarrhoea (3 x trit.); hepatic 
fullness and tenderness; biliousness. Large doses in dysentery, lead poison- 
ing, and poisoning by phenol (carbolic acid). 
Action and Therapy.-Glauber's salt is a mild but cooling laxative or 
purgative according to the dose administered; operating somewhat like 
magnesium sulphate. It is equally as efficient as the latter, but is less popu- 
lar on account of its disagreeable taste. As an ingredient of the "White 
Liquid Physic" it is a good purgative in acute dysentery. It is also of 
service in lead colic, and may be used freely in poisoning by phenol, for 
which it is said to be an antidote. It is still a debatable question, however, 
as to whether it really does antidote phenol poisoning, but no mistake 
will be made in administering it, for it is harmless and will at least act as a 
purge. The majority of clinicians are satisfied that it does exert a de- 
structive action upon the phenol. In chronic lead poisoning it will be 
tolerated by the stomach longer than will iodide of potassium. A favorite 
domestic laxative for chronic constipation is prepared by adding one 
pound of Glauber's salt and one ounce of essence of peppermint to one 
647 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
quart of water. Of this a tablespoonful is taken once or twice a day. The 
taste of the salt is somewhat modified by lemonade, or sweetened carbonated 
water. 
Aside from its cathartic action, sulphate of sodium has a specific effect 
in stimulating '''retrograde metamorphosis" and excretion. It is indicated 
when the tissues are pale, full and sodden, the tongue pallid, full, and 
easily pitted by the teeth. From ten to twenty grains may be given in a 
pint of water. It has been advised in small doses to prevent the formation 
of biliary calculi. Webster advises the 3 x trituration in the green diarrhoea 
of teething, cholera infantum, and ileocolitis in children. Two-grain doses 
every hour, by mouth or intravenously, are said to control capillary hemor- 
rhages even of grave import. 
Exsiccated Sodium Sulphite. (Formula: NasSOs.) 
Description.-An odorless, white powder, having a cooling, saline taste suggestive of 
burning sulphur; soluble in water, sparingly in alcohol. If exposed to air sodium sulphite 
is slowly oxidized to sodium sulphate. 
Preparation.-Specific Medicine Sodium Sulphite. Dose, 2 to 60 grains. 
Specific Indications.-Broad, pallid tongue, with white or dirty-white 
coat, and pallid mucous membranes; fetor; fermentation and putrefaction; 
(locally) parasitic skin diseases. 
Action and Therapy.-External. Sodium sulphite in saturated solution 
is an efficient agent in many parasitic diseases of the skin, as ringworm, 
pityriasis versicolor, and scabies, though it is less effectual than sulphur 
itself in the latter disorder. It will remove the stains of iodine. 
Internal. Sulphites are poisonous in very large doses, but the rapid 
change they undergo in being converted into sulphates results in frequent 
rapid recovery from very deep poisoning (Wood). They belong to the 
oldest class of disinfectants and are largely used to control or prevent 
fermentation and putrefaction. This is undoubtedly due to the liberation 
of the sulphurous acid radical, the principle upon which the remedial 
properties of all the sulphites depend. Besides this, in the case of sodium 
sulphite, there is the alkaline element present to overcome excessive acidity. 
Sulphite of sodium has been one of the most important specific med- 
icines since the introduction of specific therapy, and the prompt response to 
the action of the remedy has done as much as any one agent to insure a 
belief in the value of that form of practice. When any diseased condition is 
present, immaterial as to name, it will ameliorate or cure when a cure is 
possible, or prepare the field for the easy operation of other medicines, 
when the classic indications are observed, viz.: the broad, pallid tongue, 
with white or dirty-white coating, and extremely fetid breath, though the 
latter is not always present. Special disorders in which it will frequently 
be needed are the prefebrile stage of fevers, or during the course of typhoid, 
or other fevers, in erysipelas, tonsillitis, and other forms of sore throat, and 
fermentative and putrefactive dyspepsia and other forms of stomach and 
bowels disorders. Successful medication often depends upon the correction 
of the very conditions upon which sulphite of sodium acts favorably, for 
when the putrefactive and dirty condition is removed then other medicines 
can be absorbed and exert their fullest effects. 
SODII SULPHIS EXSICCATUS. 
648 INDIVIDUAL DRUGS. 
SODII THIOSULPHAS. 
Sodium Thiosulphate, Sodium Hyposulphite (incorrectly). (Formula: Na2S2O3+ 
5H2O.) 
Description.-Colorless and transparent, prismatic crystals, devoid of odor, but having 
a cooling and subsequently bitter taste. Dose, 5 to 30 grains. 
Specific Indications.-Fermentative dyspepsia, with yeasty vomiting; 
pallid mucous membranes, with pasty white, or dirty white exudate upon 
the tongue. 
Action and Therapy.-External. Sodium thiosulphate will remove the 
stains of iodine. A solution or an ointment (3j to water or lard, §j) forms 
a good parasiticide and has been used in pityriasis versicolor, favus, and 
sycosis, being especially useful in the first named disorder. It has also been 
found of much service in impetigo and in pruritus vulvae. 
Internal. The use of this salt internally has largely been supplanted 
by sodium sulphite. It destroys fungous and low forms of vegetation, 
hence it has been used to prevent or arrest fermentative and putrescent 
changes within or without the body; moreover, it is a good deodorant for 
putrid discharges. It has been very successfully used internally (and 
externally) in cancer for its deodorizing effects, and both internally and by 
atomization for fetid bronchitis and pulmonary gangrene. The drug is one 
of the best for water brash with frothy eructations, and containing sar- 
cinae ventriculi, and if given before acidity of the stomach has developed it 
will check fermentative changes in the stomach and bowels. In order to be 
effective, any acidity of the stomach must first be corrected. 
SOLANUM. 
The root and fruit of Solatium Carolinense, Linne (Nat. Ord. Solanacese). Waste 
places and fields in eastern half of the United States. Dose, 10 to 30 grains. 
Common Names: Horse-Nettle, Bull-Nettle, Sand Brier, Treadsoft. 
Principal Constituents.-Solanine, solanidine, solanic acid, and solnine, a crystallizable 
alkaloid isolated by John Uri Lloyd, and physically resembling hydrastine. 
Preparation.-Specific Medicine Solanum. Dose, 10 to 30 drops. 
Specific Indications.-Epileptiform convulsions of iodiopathic origin; 
hystero-epilesy; spasmodic cough. 
Action and Therapy.-Solanum is antispasmodic, and for this effect 
has been extolled as a remedy for iodiopathic epilepsy, in which extraor- 
dinary claims are made for it; and of lesser value, in petit mal. As large 
doses are required its effects may border upon the poisonous. Hare asserts 
that he has reduced the force and frequency of epileptic attacks with it; 
and most observers claim that it acts best when the attacks are severest 
at or when provoked by or occurring in the menstrual period. It has been 
used also in chorea, but not with marked benefit. We have found it a good 
modifier of the paroxysms of whooping cough. Altogether its virtues are 
much overrated. 
Sparteine Sulphate. (Formula: CuHmNj.HjSCM-SHjO.) 
The sulphate of the liquid alkaloid sparteine derived from Cytisus Scoparius (Linn6), 
Fink (Nat. Ord. Leguminosese). 
Description.-Hygroscopic, colorless crystals or a crystalline powder, without odor 
and having a feebly saline, bitterish taste. Very soluble in water and alcohol; insoluble in 
ether and chloroform. Dose, 1/20 to 1/2 grain; great variation of dosage prevails, but not 
more than 1/6 grain should be given for a beginning dose. 
SPARTEINE SULPHAS. 
649 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Specific Indications.-Functional cardiac disorders with feeble heart 
action; tumultuous palpitation of the heart; weak, irregular heart action; 
dropsy of cardiac origin. 
Action and Toxicology.-Sparteine, and scoparius from which it is 
derived, are employed to regulate weak heart action and induce diuresis, 
both of which effects they sometimes fail to accomplish. Most observers 
believe the diuretic virtues per se, if any, reside in the scorparin and not in 
the sparteine, and that if the latter causes any diuretic effect it is due to its 
property of increasing the heart's power and raising blood pressure in the 
renal organs. Scoparin has not been well investigated. Small doses of 
sparteine stimulate the heart and strengthen its ventricular contraction, 
and accelerate the pulse and raise arterial tension. Poisonous doses depress 
these functions. Small amounts also have no effect upon respiration, but 
toxic doses paralyze the respiratory centers. Sparteine probably does not 
impress the renal cells. The greatest force of sparteine is spent upon the 
nervous system, where large doses exert a profound depressing effect upon 
the brain and the motor tracts of the cord, decreasing and finally paralyzing 
the powers of motion and reflex activity. Less profound is its action upon 
man than upon animals, but the following toxic symptoms have been noted 
in the human being: dizziness, nausea, trembling and heaviness of the limbs, 
muscular incoordination, irregular heart action, and convulsions, both 
clonic and tonic, superseded by a secondary stage of nervous depression 
and general debility. 
Therapy.-Sparteine sulphate acts quickly, in from one half to three 
quarters of an hour, reaching the maximum of its power in from five to six 
hours, and its effects are sometimes prolonged for nearly a week. It is 
employed chiefly in cardiac diseases with dropsy to increase the action of 
the heart and arteries, and to regulate arrythmical movements of the former. 
It spurs the heart to increased action when abnormally slow as from ex- 
haustion (See) and gradually slows it to normal when pulsations are un- 
duly rapid (Clarke). Sparteine may be given in cases in which digitalis is 
apparently indicated, but cannot be used on account of causing stomachic 
irritation or of idiosyncrasy of the patient. It is regarded as free from 
cumulative effects. Though probably less generally valuable than digitalis, 
it may be used in heart diseases, especially where there is lack of compensa- 
tion. The affections in which it has been praised are: "irregular heart 
action from valvular lesions, or debility of the cardiac muscle; slow heart 
action due to functional exhaustion; obstructive heart disease with palpita- 
tion, and tumultuous heart action; functional palpitation (prompt results); 
mitral regurgitation, and aortic regurgitation with irritable and enlarged 
heart. In mitral stenosis its effects are less beneficial, but in exophthalmic 
goitre its action is said to be pronounced" (American Dispensatory). 
Only the fractional doses (1/20 to 1/10 grain) should be used in obstructive 
heart disease, as larger doses (1 to 2 grains) are apt to induce unpleasant 
symptoms, chief among which are praecordial tightness and pain. Rarely 
sparteine sulphate relieves cardiac asthma. In dropsy wholly dependent 
upon heart weakness it sometimes succeeds admirably, but it is inferior, by 
far, to infusion of scoparius. Neither will it nor scoparius have the least 
effect upon dropsies of renal or other origin. From one to two grains, 
650 INDIVIDUAL DRUGS. 
hypodermatically, have been advised in post-operative suppression of the 
urine (anuria), presumably with low blood pressure; and Potts has advised 
it in doses of one-half to two grains, three times a day, to control tremor in 
paralysis agitans (Parkinson's disease). Great diversity of opinion concern- 
ing dosage has been expressed by heart clinicians, from 1/64 to 1/16 grain 
up to 1/2 to 12 grains having been advised. The beginning dose should 
not exceed 1/6 grain, to be increased as circumstances warrant. Remem- 
bering its power when a good alkaloidal salt is used and its prolonged action, 
one must exercise great caution in sparteine medication. 
SPIGELIA. 
The dried rhizome and roots of Spigelia marilandica, Linne (Nat. Ord. Loganiaceae). 
Southern United States; less plentiful in northern parts of eastern half of the Northern 
States. Dose, 1 to 2 drachms for adults; less for children. 
Common Names: Pinkroot, Maryland Pink, Carolina Pink, Worm-grass. 
Principal Constituents.-A volatile alkaloid, spigeline (resembling coniine and nicotine), 
volatile oil, resin, and a bitter body. 
Preparations.-1. Specific Medicine Spigelia. Dose, 5 to 60 drops (full dose as 
anthelmintic). 
2. Fluidextractum Spigelia et Senna, Fluidextract of Spigelia and Senna. Dose, 
30 to 60 drops. 
Specific Indication.-Lumbricoids. 
Action and Toxicology.-In large doses spigelia is toxic, causing in- 
creased cardiac action, cerebral disturbances, as dizziness, dimness of vision, 
dilated pupils, facial and palpebral spasms, general convulsions and stupor. 
Purgation often results from such quantities. Catharsis minimizes the 
danger of unpleasant symptoms, therefore it is usually administered with a 
cathartic, as s^nna. 
Therapy.-Pink root is an active and very certain vermifuge, removing 
the round or lumbricoid intestinal worm. The powdered root (5 to 20 
grains for a young child; 1 to 2 drachms for an adult) or the fluidextract, 
or specific medicine in equivalent dosage may be given twice a day, to- 
gether with or followed by an active purgative. Senna is usually preferred. 
Ellingwood advises 3 Fluidextract of Spigelia, fl3ij; Santonin (powdered), 
gr. xv; Simple Elixir, q. s., fl^ij- Mix. Sig.: One teaspoonful every 
night and morning, followed on the third day by a non-irritating laxative. 
Many who are old enough will recall the days of domestic medication when 
pink and senna (popularly pronounced seeny) tea was a regular feature of 
child raising. 
Interest has been attracted to spigelia, chiefly of homoeopathic origin, 
as a remedy in heart affections, particularly endocarditis of rheumatic 
origin and to guard against relapses of cardiac rheumatism. Cardiac 
neuralgia with palpitation and pain extending along the arm is also said to 
be relieved by it. For these purposes the fractional dose is to be preferred. 
3 Specific Medicine Spigelia, gtt. x to xv; Water, fl^iv. Mix. Sig.: 
One teaspoonful every two hours. Large doses are said to debilitate the 
heart. 
651 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
SPIRITUS jETHERIS NITROSL 
Spirit of Nitrous Ether, Sweet Spirit of Nitre (Niter). 
An alcoholic solution of Ethyl Nitrite (C2H6NO2). 
Description.-A mobile, volatile and inflammable, clear liquid of a pale-yellow or 
faintly greenish-yellow tint, having a pungent ethereal, fragrant and non-acrid odor, 
and a sharp, hot taste. It readily changes when carelessly kept, losing its active constituent 
-the ethyl nitrite-and is then of no value for the purposes intended. It should be dis- 
carded if it reddens blue litmus paper (free acid) or effervesces with potassium or sodium 
bicarbonate. Dose, 1 drop to 1 fluidrachm. 
Specific Indications.-Increased temperature with frequent pulse, 
dry skin, renal inactivity and nervous irritability; nausea, flatulence, and 
intestinal spasm. 
Action and Toxicology.-Inhaled, sweet spirit of nitre has the general 
effects of the nitrites, producing arterial excitement, throbbing and dizzy 
headache, cyanosis, thready pulse, convulsions and death. Internally, 
excessive doses cause some of these symptoms, together with gastro-in- 
testinal irritation with colic and vomiting. The treatment of poisoning by 
inhalation is fresh air and artificial respiration in the recumbent position, 
dashing cold water upon the body, with hot applications to the feet, and the 
use of ammonia and other stimulants. 
Therapy.-External. To relieve pain and reduce inflammation, sweet 
spirit of nitre may be applied and allowed to evaporate (to prevent blistering), 
in local neuralgias, neuralgic headache, glandular enlargements, mumps, 
threatened boils and carbuncles, abscesses, and inflammatory swellings. 
It is of much value in rhus poisoning and the bites and stings of insects; 
and sometimes relieves the itching of urticaria. Only an acid-free prepara- 
tion should be used lest cutaneous irritation be caused by it. 
Internal. Sweet spirit of nitre is a stimulating diuretic and mild 
diaphoretic, according to the manner of using it. It is also, to some degree, 
antispasmodic. If given in iced or cold water, and the patient be lightly 
covered, it proves diuretic, though as such it often fails. If given in water 
at ordinary temperatures and the patient be well covered it induces mild 
diaphoresis, and in this manner contributes to reduce temperature in mild 
cases of fever or inflammation. Spirit of nitre is an old-time remedy once 
employed much more than at the present time. Moreover, it was often 
given in too large doses, which either aggravated or failed to meet conditions 
it was intended to relieve. As a remedy for acute and ephemeral febrile 
attacks in little children it is frequently useful, and is so used, but more 
often abused, though rarely with harm, in household practice. For this 
purpose it is less efficient than aconite. It is far less effective if fever be high 
or inflammation active than other agents; but if there is a low grade of 
fever, with marked irritation of the nerve centers, with tendency to spasm 
it will render good service. It is, therefore, more useful in asthenic than 
sthenic conditions. 
There is one condition in which we regard it as directly indicated- 
in the acute nephritis following scarlet fever. But to be safe and accomplish 
a steadily curative effect the dose must be small. A half drachm added to 
four ounces of water and the solution administered in teaspoonful doses 
every two hours will gently change the condition for the better where a 
larger amount puts too much work upon the already over-burdened kidneys. 
652 INDIVIDUAL DRUGS. 
No other agents have been more effective in this disorder, though the 
administration of apis, aconite and gelsemium produces good effects. This 
spirit was once employed for dropsy dependent upon a diseased heart, and 
less upon a diseased kidney, but there are far better agents for this condition. 
As it was usually given with squill, digitalis or potassic diuretics, it is but 
fair to presume that most of the good was accomplished by these aids. It is 
sometimes of value in the strangury of vesical irritation or debility and in 
that produced by cantharides; and to dilute the urine in ardor urinae and 
gonorrhoea, thus modifying the acridity of that secretion. In other mildly 
inflammatory states of the urinary tract it does good, and especially in 
children who suffer from painful and difficult urination. For suppression 
of urine in children it is an admirable remedy. It is harmful, however, in 
retention of urine; for being diuretic, it increases the flow into an already 
overfilled and distended bladder, causing greater discomfort and pain. 
Here the catheter is needed. Conversely it is a very acceptable and useful 
remedy, given with potassium citrate, where concentrated, acid and high- 
colored urine is the provoking cause of incontinence of urine in children. 
After the urine is cleared and non-irritating, nux vomica, belladonna, or 
rhus aromatica may be indicated to strengthen the vesical sphincter. 
Spirit of nitrous ether easily deteriorates, or changes to a most dangerous 
compound, it must be remembered, hence great care must be taken to have 
a fresh and reliable spirit. 
SPONGIA USTA. 
Burnt Sponge, Spongia Tosta. 
The skeleton of Spongia officinalis, Linne, Class: Poriphera; Order: Ceratospongia, 
roasted brown in a closed vessel and reduced to powder. Dose, 30 to 180 grains. 
Preparation.-Specific Medicine Spongia. Dose, 1 to 10 drops. 
Specific Indications.-Croup; enlarged thyroid. 
Action and Therapy.-Spongia is believed by some to have alterative 
properties depending upon iodine and bromine and associated compounds 
derived from the sea. For this purpose it has been quite largely used in 
cases in which iodine is apparently indicated, as goitre. It is thought to 
act better than iodine in some forms of the latter. Spongia is much em- 
ployed also as a remedy for laryngeal irritation, and it seems to have been 
remarkably effective in croup and croupal types of cough. 
STAPHISAGRIA. 
The ripe seeds of Delphinium Staphisagria, Linne (Nat. Ord. Ranunculacese). Mediter- 
ranean Basin; cultivated. Dose, 1 to 2 grains. 
Common Name: Stavesacre. 
Principal Constituents.-Fixed oil; a poisonous crystalline alkaloid, delphinine (CwHas 
O6N), acting like aconite; an amorphous narcotic alkaloid delphinoidine (CaaHssOjHj), 
delphisine (CwH^CLNz), a crystalline alkaloid, a slightly water-soluble alkaloid, staphisagrine 
(CmHsjOsN), and the alkaloid staphisagroine (C20H24NO4). The first three alkaloids are 
soluble in alcohol, chloroform and ether. 
Preparation.-Specific Medicine Staphisagria. Dose, 1 to 5 drops. 
Specific Indications.-"Irritation and chronic inflammatory conditions 
of the genito-urinal tract; painful, scalding micturition; prostatorrhoea; 
urinal incontinence in aged men; urethral irritation, with a sensation of in- 
653 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
complete urethral evacuation-a sensation as if a drop of urine were rolling 
along in the canal; menstrual derangements, with long intermenstrual 
intervals and prolonged flow; spermatorrhoea in anemic subjects; depression 
of spirits; hypochondriasis; hysteria, with uterine or ovarian irritation, 
despondency, moroseness, and violent outbursts of passion; black specks 
before the eyes in reading; mental irritability and restlessness in painful 
and exhaustive diseases; uterine disorders, with feeble pelvic circulation; 
deep-seated soreness, dragging and bearing-down pains; leucorrhoea; and 
painful urination." {American Dispensatory.) 
Action and Toxicology.-In small doses staphisagria quiets nervous 
irritation. In large doses it is a depressive poison, acting very much like 
aconite to which it has a close botanic relationship, but does not produce 
such intense benumbing and tingling effects as the latter. It causes de- 
cided gastro-intestinal irritation and depresses the heart and circulation, and 
the motor tracts of the cord. Its topical use has proved fatal to a child, 
and its toxic symptoms are closely analogous to those of poisoning by 
aconite. It kills by paralyzing the respiratory centers (asphyxia). One of 
its alkaloids has narcotic properties; and another, delphinine (dose 1/60 to 
1/10 grain), has an acrid and benumbing taste and an action much like 
aconitine, an action which is possessed in greatest force by the combined 
alkaloids of stavesacre. It is exceedingly poisonous. 
Therapy.-External. Locally staphisagria seeds are parasiticide and 
analgesic. Delphinine, though it should not be employed, acts upon 
painful areas like veratrine. The powdered seeds may be mixed with fats 
and applied for the destruction of pediculi. An ointment (4 parts in 20 of 
benzoinated lard) is a good form. Equally effectual and more manageable 
is an equivalent dilution of the specific medicine with vinegar, dilute 
acetic acid or ether. It must not be used unless the skin is intact, and then 
with caution as to quantity. It is also said to be fatal to the itch mite which 
causes scabies. 
Internal. Staphisagria is sedative and a remedy of limited power in 
irritation of the mucous membrane of the genito-urinary tract and some 
phases of nervous disorders. It is contraindicated by active inflammation. 
From a very early date its local application has been credited with the de- 
struction of pediculi. As Scudder recorded some years ago, the nervous 
conditions best met with staphisagria are those shown by hysteria and 
hypochondriasis with depression of spirits, despondency, moroseness, and 
violent outbursts of passion. As a rule, the sexual disorders benefited by 
staphisagria are those accompanied by nervous depression, or at least by 
marked irritability. When properly indicated, it proves useful in the 
treatment of prostatorrhcea, spermatorrhoea resulting from masturbation, 
in chronic irritation or inflammation of the genito-urinary tract resulting 
from gonorrhoea or from cold, and in prostatitis, gonorrhoeal or otherwise, 
all of these conditions being associated with depression of spirits and a sense 
of restlessness and irritation along the course of the urethra. It is especially 
useful in renal incontinence of old men with teasing desire to urinate 
frequently, and in the urinary annoyances attendant upon uterine disorders. 
It will not relieve all cases of spermatorrhoea, but if carefully prescribed, 
according to indications it will prove beneficial in the majority of cases. 
654 INDIVIDUAL DRUGS. 
The best marked indication we have found for staphisagria is a sense of 
incomplete urination with a feeling as if a drop of urine were constantly 
attempting to pass along the urethral canal. The indications for staphis- 
agria, as concisely stated by us in the American Dispensatory, are given 
on pages 653 and 654 under Specific Indications. 
STICTA. 
The lichen Sticta Pidmonaria, Linne (Nat. Ord. Lichenes). Found upon tree trunks 
and rocks in England and the eastern United States, mostly in mountainous districts. 
Common Names: Lungwort Lichen, Lung Moss, Oak Lungwort, Tree Lungwort. 
Principal Constituent.-Stictic acid, allied to cetraric acid from Iceland moss. 
Preparation.-Specific Medicine Sticta. Dose, 1/10 drop to 10 drops. 
Specific Indications.-"Pain in the shoulders, back of neck, and ex- 
tending to the occiput" (Scudder). Soreness and dull pain in the pectoral 
muscles, increased by deep breathing; irritation of the medulla, and parts 
supplied by the vagus; irritative cough; persistent dry, rasping wheezing, 
or short, hacking cough, with quick-darting pains in the thoracic walls; 
hay fever with headache; catarrhal disorders with frontal tension, sneezing, 
coryza and conjunctival hyperaemia or inflammation. 
Action and Therapy.-Sticta relieves pain and muscular soreness 
confined chiefly to the neck, head, and chest, and irritation in parts supplied 
by the vagus. Thus it proves useful in so-called subacute rheumatic pain 
extending from the shoulder to the base of the occiput, or in the chest 
walls, or the smaller joints. Muscular pain accompanying catarrhal fever 
and epidemic influenza is relieved by it. Over the various types of cough 
described under specific indications it has a controlling force, provided 
there is atony and the pneumogastric is involved. When these conditions 
prevail it has aided in the reduction of fever, and checked chills and night 
sweats, thus giving comfort in pulmonary tuberculosis. Sick headache, 
acute catarrhal disorders, whooping cough, summer colds, etc., accompanied 
by cough and muscular soreness, have been reported benefited by it. The 
pulse in sticta cases while soft, has a peculiar wire-like vibration or thrill. 
The chest soreness relieved by it simulates lameness, is increased by tak- 
ing a deep breath, and feels like that arising from a bruise or muscular over- 
exertion. 
STILLINGIA. 
The dried root of Stillingia sylvatica, Linne (Nat. Ord. Euphorbiaceae). Southern 
United States growing in sandy soils. Dose, 5 to 60 grains. 
Common Names: Queen's Root, Queen's Delight, Silver Leaf, Yaw Root. 
Principal Constituents.-Tannin, sylvacrol, an acrid resin-volatile oil; doubtfully an 
alkaloid, stillingine. 
Preparations.-1. Specific Medicine Stillingia. Dose, 1 to 30 drops. 
2. Linimentum Stillingice Compositus, Compound Stillingia Liniment (Stillingia 
Liniment). (Contains Oil of Stillingia, fl3 j; Oils of Lobelia and Cajuput, aa, fl^ss; Alcohol 
and Glycerin, aa, fl^ij.) Dose, 1 to 5 drops. 
Specific Indications.-Feeble tissues, with tardy removal of broken- 
down material, and slow reconstruction of tissues; mucosa red, glistening 
and tumid, with scanty secretion; skin lesions, with irritation and ichorous 
discharge; periosteal pain and nodes; syphilitic and strumous cachexia; 
laryngeal irritation with paroxysmal hoarse croupal cough; post-faucial 
irritation with cough; irritative winter cough. 
655 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-Stillingia is an important alterative when a good 
preparation can be procured. Much of the failure to achieve results with it 
has come from the use of medicines prepared from old and worthless 
material. Large doses of an active preparation will cause increased cardiac 
activity, excessive bronchial secretion, vomiting and bilious purging, with 
a peculiar gastro-intestinal burning sensation, and more or less resultant 
prostration. For a long time it has been praised as a remedy for syphilis, and 
discordant views are expressed by clinicians as to its value as such. We do 
not believe it antisyphilitic, but it is one of the best alteratives that can be 
exhibited in syphilitic and strumous cachexias, greatly aiding other and 
more powerful agents, as the iodide of potassium. In all phases of secondary 
syphilis-cutaneous syphilides, mucous patches, ulcers, and periosteal pain 
and nodular and glandular enlargements-it renders good auxiliary service 
through its depurative action. It must not be misunderstood, however, 
that any claim to a cure of syphilis by stillingia can be justified by past 
experience. Nevertheless, it is one of the best of remedies to modify the 
disease and assist other agents to cure. The best indication for it is the red, 
shining or glistening mucous membranes with scanty secretion, and the 
presence of retained d€bris of tissue waste with tardy repair of structure. 
While sometimes used early in syphilis, during the primary stage, 
we can see no reason for its use before broken-down products begin to appear 
as it is not per se an antisyphilitic; and experience has shown the drug to 
be of the greatest value in the secondary stage of the disorder. 
Stillingia is valuable, though less so than Stillingia Liniment (see below) 
in laryngeal irritation and cough, and other irritative states of the bronchi 
and faucial arch, with repressed secretion. Thus it may be used in chronic 
laryngitis, chronic bronchitis, the chronic coughs of the strumous individual, 
where glandular swelling and scanty elimination are evident. It is one of the 
most effectual drugs we have ever used for the irritable winter cough of the 
middle-aged and old. Stillingia may be used in chronic periosteal rheu- 
matism, so-called, of unproved origin, but probably syphilitic; and in skin 
diseases having a remote syphilitic history. 
Hare advises its use in chronic constipation to increase intestinal 
secretion, and for hemorrhoids depending upon "hepatic engorgement and 
intestinal atony. Likewise for 'pasty-looking', white, 'putty-faced' chil- 
dren, who are anemic or strumous, and who never have any appetite, or 
are subject to middle-ear trouble and general debility"; the remedy to 
be used for some time. 
Compound Stillingia Liniment. This compound produces both stimula- 
tion and relaxation. Locally applied to the throat and chest and given 
internally on sugar or in syrup this is one of the most perfect remedies for 
spasmodic and catarrhal croup of young children. A cloth wet with cold 
water applied around the neck and covered with a dry binder enhances the 
value of the treatment. Many cases of acute cold and sore throat are 
speedily arrested by the same treatment. We would be at a loss to treat 
croup and croupal coughs without this admirable heritage from the Eclectic 
pioneer physicians. Sometimes spasmodic asthma is promptly checked 
by it. Pushed too far stillingia liniment causes nausea and vomiting, but 
it is never necessary to carry it to such a stage. A few drops upon sugar, 
656 JIMSON WEED 
(Datura Stramonium) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Jimson Weed is probably the most energetic of our native Solanacese. Since the near-tragic 
event, in which its deliriant effects were evoked upon the early colonists of Virginia, it has held 
a more or less prominent place in the medication of the people and the therapeutics of the 
physician. During the World War it served the patriotic purpose in America of averting an 
"atropine famine," it having been the source of an alkaloid readily convertible into the great 
mydriatic atropine. The firm of Eli Lilly & Co., of Indianapolis, introduced this conversion 
product and supplied the needs of the hour during the great conflict. INDIVIDUAL DRUGS. 
or in glycerin or syrup, promptly relieve dry, rasping, laryngeal cough, and 
in chronic bronchial cough with either scant or profuse expectoration it 
gives splendid results. Stillingia liniment is sometimes used like other 
embrocations for lame, rheumatic, inflamed, and otherwise painful parts; 
and with very gentle massage it gives relief to the soreness of the chest- 
walls from difficult breathing experienced by consumptives, as well as the 
pains in the limbs so frequently a torture to this class of sufferers. 
The dried leaves of Datura Stramonium, Linne, or of Datura Tatula, Linne (Nat. Ord. 
Solanaceae). A common weed everywhere in the United States, especially the latter. 
Dose, 1 to 2 grains. 
Common Names: Jamestown Weed, Jimson Weed, Thornapple. 
Principal Constituents.-The chief datura alkaloids are hyoscyamine, and some atropine, 
and hyoscine. Daturine is probably a mixture of the first two. (See also Hyoscyamus and 
Belladonna.) 
Preparations.-1. Specific Medicine Stramonium. Dose, 1/30 to 5 drops. 
2. Unguentum Stramonii, Ointment of Stramonium. Best preparation is that 
carefully prepared by simmering fresh stramonium leaves with petrolatum, on a water bath, 
so that burning cannot take place. The official ointment is prepared from extract of stra- 
monium. 
Specific Indications.-Cerebral irritation; furious raging and destructive 
delirium; face deeply congested, red, and bloated; loquaciousness; restless- 
ness and fearfulness; superficial and localized pain; spasms with pain; 
convulsive cough; purely spasmodic asthma; the opium habit. 
Action and Toxicology.-The action of stramonium is closely similar 
to that of belladonna. If anything, it has a more profound effect upon the 
sympathetic system and upon the vagus. If the dose be large enough it 
will disturb the rhythm of the heart action and induce delirium, exerting 
these effects more readily and more powerfully than does belladonna. 
Stramonium is probably the most violent deliriant of the solanaceae. Its 
alkaloid daturine is closely akin to, if not identical with, hyoscyamine. 
American manufacturers are now utilizing stramonium for the preparation 
of atropine from daturine, and during the year 1917 of the great World War 
this source practically prevented an atropine famine in the American drug 
markets. 
Therapy.-External. Fomentations of stramonium leaves, or the 
bruised fresh leaves may be applied to inflamed and painful parts to reduce 
swelling and relieve pain. In this manner it is often useful in mammitis, 
orchitis, swollen joints, and painful external hemorrhoids. An ointment of 
stramonium, carefully prepared without burning it, is an excellent applica- 
tion for painful and engorged piles, or as the ointment basis for other 
agents to be used for the same purpose. It is also soothing in cutaneous 
hypertrophy around the anus with intolerable itching and sometimes semi- 
purulent secretion. It is rendered more effective by incorporating with it 
5 to 10 per cent of salicylic acid. Stramonium leaves, alone, or with tobacco, 
lobelia, grindelia, and nitrate of potassium are universally employed as an 
"asthma powder". It is used by igniting the powder and inhaling the 
vapors, or by smoking it in a pipe or in the form of cigarettes. It is among 
the most prompt of measures for the temporary relief of the paroxysms of 
purely spasmodic asthma. 
STRAMONIUM. 
657 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Internal. The specific indications for stramonium are those indicating 
impaired innervation. The face is red and bloated and of a deeper congestive 
appearance than that for belladonna; there is continual talking and the 
patient is uneasy, cannot rest well in any position, and is possessed of an 
ungrounded fear. There may or may not be furious, enraged, or destructive 
delirium. Localized and superficial pain, or spasm with pain, is experienced. 
It is also indicated by convulsive cough, and purely spasmodic asthmatic 
attacks. When the dyspnoea is dependent upon respiratory or cardiac 
lesions it is less useful. In all stramonium cases there is cerebral irritation- 
causing most often violent excitability or less frequently -depressive irrita- 
bility. The dose, therefore, should be governed accordingly; medium 
doses for the former, minute doses for the latter. In no instances are the 
full physiologic doses necessary except in the cure of the opium habit, when 
the drug may be pushed to the full limit of endurance. It remains to be 
seen whether permanent damage may be done to the intellectual faculties 
from such dosage, as is the case with atropine. 
In medicinal doses stramonium is an anodyne antispasmodic, without 
causing constipation or lessening of the excretion of urine, and will prove 
serviceable in many instances where opium cannot be given. Unlike 
hyoscyamus it does not readily produce sleep, but if sleep results from its 
administration, it is generally due to the fact that the stramonium alleviates 
the pain, or allays the nervous irritability upon which the insomnia depends. 
It is quite remarkable that a plant so closely allied to belladonna chemically 
should be so different in some of its therapeutical effects, and particularly 
in regard to alleviating pain. Thus for deep-seated pain, as of neuralgia, 
it is far less effective than belladonna, but for superficial neuralgia, and 
especially when locally applied, it is more effective than the former. It 
illustrates well the fallacy of claiming certain effects from a medicine 
because of the known physiological action of the drug-the therapeutical 
effects often being widely at variance. Bartholow well expressed the 
situation and unconsciously forecast collodial therapy when he observed: 
"Identity of chemical constitution does not always mean identity in physi- 
ological action and in therapeutic power. Differences in molecular arrange- 
ment, not appreciable by chemical analysis, may influence to a great extent 
mode of action". 
Stramonium is useful for the relief of pain, but less so in general than 
belladonna. When pain is due to irritability, as in enteralgia, gastritis, and 
enteritis, neuralgic dysmenorrhoea, spasmodic intestinal pain, tic doulou- 
reux, sciatica, and the pains of chronic rheumatism, it is useful but does not 
compare with either belladonna or hyoscyamus, either of which are 
incapable of subduing severe pain. Stramonium serves well, however, in 
headache, with dizziness and hyperacidity of the stomach, and in gastric 
headache when associated with nervous erethism and unsteadiness. 
Like hyoscyamus, stramonium meets two classes of nervous and 
mental disorders-the mentally excited, with furious delirium and motor- 
excitability; and the depression of nervous debility. The first requires 
medium doses; the last the small dose. In the acute delirium of acute 
mania it quiets the violent, boisterous and angry patient bent upon de- 
struction of everything and everybody, including himself. Equally effective 
658 INDIVIDUAL DRUGS. 
is it in the quieter and busy delirium of acute fevers. It finds a use in 
delirium tremens, nymphomania, in epilepsy followed by maniacal excite- 
ment, in hysterical mania with alternate fits of weeping and laughter, and 
in globus hystericus. 
Stramonium has been revived in recent years as a remedy to assist in 
breaking away from the opium habit, and considerable success has attended 
its use. This is now possible since the nature of the alkaloidal contents of 
this and the allied solanaceous drugs are better understood. Many years 
ago Locke advised the following formula: 1$ Specific Medicine Stramonium, 
fl^ss; Tincture of Cardamom, fl^iijss. Mix. Sig.: Begin with ten drop 
doses and increase as may be necessary. 
Stramonium is invaluable in convulsive forms of cough and should 
have wider recognition for this purpose, in which it is fully equal to hyoscy- 
amus. It is the best agent we have used to control whooping cough where 
the paroxysms are severe and bleeding from the mouth or nose occurs. 
As a general cough medicine it is better and safer than opium, because it 
does not restrain the excretions. Like atropine it is useful in hemoptysis 
brought on by fits of coughing or during spasms. 
Strontium Bromide. (Formula: SrBr2.6HsO.) 
Description.-Colorless and odorless, transparent crystals, having a saline, bitter 
taste; deliquescent in moist air; efflorescent in very dry air. Very soluble in cold and hot 
water, less so in alcohol; insoluble in ether. Dose, 5 to 30 grains. 
Specific Indications.-Nervous erethism; lactic and acetic fermenta- 
tion, with dilatation of the stomach. 
Action and Therapy.-Strontium bromide is claimed to be less irritating 
and depressing than the other bromides, and may be used where bromide 
medication is indicated, especially where necessary to avoid the peculiar 
effects of the potassium base in the potash salt. It is regarded as useful in 
gastric indigestion with hypersecretion and pain, and where lactic and 
acetic fermentation occurs, and where decomposition of food with the 
formation of gases takes place, resulting in gastric dilatation. Germain 
S6e believed it to greatly lessen the output of sugar in saccharine diabetes. 
STRONTH BROMIDUM. 
The dried ripe seeds of Strophanthus Kombe, Oliver, or of Strophanthus hispidus, 
DeCandolle, deprived of their long awns (Nat. Ord. Apocynaceae). West and east coast 
of tropical Africa. Dose, 1 to 2 grains. 
Principal Constituents.-Strophanthin (CsiH^Ou-8 to 10 per cent), a bitter glucoside 
yielding glucose and strophanthidin (see below), kombic acid, inert alkaloid ineine and tang- 
hinin. 
Preparation.- Tinctura Strophanthi, Tincture of Strophanthus. Dose, 1 to 10 drops. 
Derivative.-Strophanthinum, Strophanthin. Commercial strophanthin is a glucoside 
or mixture of glucosides occurring as a permanent white or yellowish powder, readily 
soluble in water and diluted alcohol; less soluble in absolute alcohol; and almost insoluble 
in ether and chloroform. It should not be tasted except in very dilute solution. Average 
Dose, 1/60 grain (by mouth); 1/80 grain (intravenously). 
Specific Indications.-Weak heart, due to muscular debility; muscular 
insufficiency; rapid pulse, with low blood pressure; cardiac pain, with 
dyspnoea. 
STROPHANTHUS. 
659 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action.-Externally applied, strophanthus preparations appear to 
exert no special effects unless mixed with hydrous wool fat, when the action 
of the drug is said to be apparent. The seeds, however, applied to the 
cornea produce prolonged anaesthesia (Steinbach). Three or four drops 
of a solution of strophanthin (1 to 1000) applied to the cornea also produce 
total anaesthesia, including insensibility to heat and cold (difference from 
cocaine), these sensations being the last to yield and the first to revive 
after its application. De Schweinitz and Hare found that ocular anaesthesia 
occurs only in dogs, not in man. A disagreeable irritation of the con- 
junctiva has been produced by this use of strophanthin; it has no effect on 
intraocular pressure or upon vision-accommodation. Strophanthus is a 
muscle poison. When taken internally it acts primarily upon the voluntary 
muscles, increasing their contractility, and if the dose be poisonous it 
causes tetanic paralysis, the muscles being unable to regain their former 
normal flexibility. Under its toxic influence the muscles first become 
enfeebled, then somewhat rigid, fibrillary twitchings, which are spontaneous, 
non-rhythmical and increasing contractions, somewhat similar to those of 
chorea, are observed, and finally the muscles become pallid, non-contractile 
and hard. It is these effects that render strophanthus an efficient arrow- 
poison, the muscular paralysis produced rendering the animal an easy prey 
to its pursuer. When the muscles are in extreme paralysis, lactic acid has 
been observed to replace the normal alkaline condition. Strophanthus 
muscular paralysis consists chiefly in diminishing the ability of the muscles 
to relax, and then in destroying this capability, producing a condition 
difficult to distinguish from rigor mortis. 
Strophanthus does not appear to affect either the spinal cord or to 
act upon its nerve trunks. Its specific action upon the heart is due to direct 
contact (through the blood) with the muscular fibres of that organ, and not 
to any effect upon the cardiac nerves. A large dose so increases contractility 
that a more perfect, energetic, and prolonged systole is the result, and the 
capability of the muscle to relax is lost, or so diminished that diastole can 
not take place; after death the ventricle is so completely contracted as to 
almost efface the cavity, the heart passing from life directly into rigor 
mortis. According to some it may cease either in systole or diastole. The 
caliber of the blood vessels is but little influenced by strophanthus, it 
having no effect upon the vaso-motor control. It is strongly diuretic in so 
far as lack of secretion depends upon low blood pressure, i. e., it increases 
diuresis in so far as increased blood pressure produces an increased urinary 
product. It is also thought by some to act especially upon the renal secret- 
ing structures. When one is in good physiological condition it is said tp 
have little or no diuretic action; but in diseased conditions, with low blood 
pressure, it is asserted to excel digitalis in diuretic power. 
If strophanthus be given in large doses it produces gastro-intestinal 
irritation with vomiting and diarrhoea. Small doses, however, act as a 
bitter tonic, improve the appetite, augment gastric action, and promote 
digestion. In proper doses it strengthens the heart-muscle, slows cardiac 
action, increases the interval between beats, reduces the pulse-rate, and 
powerfully increases arterial tension (but less so than digitalis), not by any 
effect (to any extent at least) upon the vessels, but by strengthening the 
660 INDIVIDUAL DRUGS. 
heart-muscle, giving increased power. Whether or not the drug is cumula- 
tive is still an unsettled question, though it probably is not unless given too 
freely in overlapping doses. The action of a good strophanthus upon the 
heart is probably greater than that of any other drug, and its active prin- 
ciple, when pure, is of far greater potency than the digitalis derivatives. 
Therapy.-Strophanthus is a remedy for weak heart from debility of 
the cardiac muscle, with lack of proper contractile power, as shown by a 
rapid, weak pulse, and very low blood pressure. The disordered action 
of the heart is due to lack of tonicity and not from weak walls due to dep- 
osition of fat, in which case the drug must be used with extreme circum- 
spection, though in small doses it has been recommended by some as a 
remedy for cardiac fatty degeneration, as it has also in atheroma of the 
arteries in the aged. It is also a remedy for praecordial pain and for cardiac 
dyspnoea. It has been strongly endorsed in heart affections with disorders 
of compensation. Strophanthus is useful in valvular heart disease only so 
far as there is muscular insufficiency, where the compensatory increase of 
muscular action is not sufficient to offset the valvular insufficiency. "It has 
been reported useful in cases of mitral regurgitation with dilatation; mitral 
stenosis with regurgitation; regurgitation with oedema, anasarca, dyspnoea, 
etc.; mitral insufficiency with palpitation, praecordial pain, cyanosis, 
dyspnoea, etc." (Annual of Eclectic Medicine and Surgery, Vol. I, page 25.) 
Schiller (ibid., page 40) says: "When the balance in the circulation has 
become impaired, as a result of insufficiency of the valves of the heart from 
organic disease with a general dropsical condition, strophanthus, although 
affording temporary relief in some cases, has failed in every case in my 
hands to reestablish the compensation. The result was the same whether 
the mitral, the tricuspid, or the semilunar valves were most involved." 
These are the cases of heart disease in which digitalis is the remedy. How- 
ever, evidence is strong to show that when the muscular insufficiency can be 
corrected in these cases then the remedy will do good service. Schiller looks 
upon the drug as a remedy for what is ordinarily termed functional heart 
disease, when not sympathetic. The heart-action is rapid or abnormally 
slow, or the rhythm is bad, a condition common in school children at 
puberty when forced to overstudy. Strophanthus is well endorsed as a 
remedy for the irritable heart of tobacco smokers, masturbators, and those 
addicted to the use of alcoholics and narcotics. 
Acute endocarditis and the reflex palpitation of neurasthenic, hysterical, 
and chlorotic subjects have been signally benefited by strophanthus, while 
it appears to give better cardiac power during or after typhoid and other 
adynamic fevers, when heart failure threatens. It should be remembered 
as a remedy for threatened cardiac failure in any disease. Full doses should 
be given for the relief of angina pectoris, and the remedy should be continued 
for a period after the attack. It is less efficient, because slower in action, 
than amyl nitrite or nitroglycerin, but may be given for more permanent 
effects after the evanescent action of these agents has passed off. In 
pulmonary congestion and in acute bronchitis or acute pneumonia it may 
be employed when there is deficient heart power. 
Strophanthus has been praised for prompt results in cardiac asthma 
and bronchial asthma, with oedema; in whooping cough it has many 
661 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
advocates. Goitre is asserted to have been cured with it, and large doses 
(8 to 25 drops of the tincture several times a day) have been said to cure a 
large proportion of cases of exophthalmic goitre, with irregular cardiac 
action. Schiller reported great relief to the heart symptoms in two cases of 
exophthalmic goitre, with disappearance of the bronchocele in one case 
(Annual of Eclectic Medical and Surgery, Vol. I, page 40). Strophanthus 
has also been lauded as a remedy for chronic nephritis, with albuminuria, in 
anasarca, and in ascites from hepatic cirrhosis. It is of little value in cedema 
and other forms of dropsy or kidney affections unless dependent upon cardiac 
disorders. 
Strophanthus does not take the place of digitalis, each having its own 
field of action. It may, however, follow the use of other heart tonics, and 
particularly those evanescent in action, as amyl nitrite and nitroglycerin. 
As it does not affect the caliber of the vessels, it may be used in preference to 
digitalis when it is not desirable to add extra work to the heart. It is well 
borne by the aged and by children. Wilcox (Materia Medico) sums up the ad- 
vantages of strophanthus over digitalis as follows: "Greater rapidity, modi- 
fying pulse-rate within an hour or two; less marked vaso-constrictor effects; 
greater diuretic powers; no disturbance of digestion from properly made 
preparations; absence of so-called cumulation; greater value in children; 
great safety in the aged." He further summarizes its uses as follows: 
"It should, therefore, be the remedy of choice for all patients in whom 
we wish to establish compensation; for arterial degeneration in which a 
remedy which causes more energetic cardiac contraction is required; for 
cardiac disease when a diuretic is necessary; for weak or irritable hearts; 
and for the treatment of cardiac disease in childhood or old age." These 
we would qualify by adding when the heart-muscle is at fault. 
Strophanthus should be avoided or very cautiously used in advanced 
muscular degeneration, in pronounced mechanical defects of the heart, and 
in fully and over-compensated hearts. Strophanthus is also contraindi- 
cated in aneurism, advanced myocardial degeneration, and in well developed 
atheroma and arteriosclerosis. Unfortunately there is a great variation in 
strength in various batches of tincture of strophanthus owing to lack of 
uniformity in the crude drug employed. The dose of tincture of strophan- 
thus is from one to ten drops; of strophanthin, 1/500 to 1/60 grain, all of 
which should be cautiously administered. 
Strychnine. 
An alkaloid derived from Nux Vomica. It may also be obtained from other seeds 
of the Loganiaceae. 
Description.-Permanent, odorless, transparent, colorless crystals, or a white, crystal- 
line powder. Its solutions are extremely bitter and should be 'tasted only with extreme 
caution, and only when they are highly diluted. Almost insoluble in water, somewhat 
soluble in alcohol, and very readily in chloroform. Dose, 1/60 to 1/20 grain. 
Preparations.-1. Strychnines Sulphas, Strychnine Sulphate. Odorless, efflorescent 
(in dry air), white or colorless crystals, or a white crystalline powder. Bitter. Observe 
precautions given under Strychnina. Freely soluble in glycerin, soluble in water and 
alcohol (more readily in these when boiling), and sparingly in chloroform. Dose, 1/60 
to 1/20 grain. 
2. Strychnines Nitras, Strychnine Nitrate. Permanent, odorless and colorless 
shining needles or a crystalline, white powder, without odor; taste bitter. See cautions 
under Strychnina. Dose, 1/60 to 1/20 grain. 
STRYCHNIN A. 
662 INDIVIDUAL DRUGS. 
Specific Indications.-Threatened shock; cardiac failure (see also 
Nux Vomica'). 
Action and Toxicology.-(See Nux Vomica.) 
Therapy.-(Compare Nux Vomica.) Strychnine is a most powerful 
stimulant, and as such is the most useful remedy for sudden depression, or 
atony of the nervous system. It is the most commonly employed stimulant 
for shock and collapse of cardiac and respiratory powers. In fact, the 
important office of strychnine is that of an "emergency remedy". It 
should never be given for long periods as a nerve bracer and stimulant to 
the heart, a too common custom which should be severely condemned. 
We cannot be too insistent in cautioning that it is an exceedingly powerful 
spinal and medullary stimulant that may stimulate to exhaustion, and 
that its prolonged use invites nervous erethism, often provokes a low- 
running fever, and causes collapse by exhaustion from over-stimulation. 
It is an admirable and most satisfactory medicine when rightly used; and 
a vicious weapon when abused. 
Like nux vomica, its parent drug, strychnine has no place in treatment 
when acute inflammation is present. An apparent exception to this dictum 
is the advanced stages of bronchitis, pneumonia, and in broncho-pneumonia, 
when the circulation becomes embarrassed from failure of the right heart, 
and secretions are abundant but there is lack of power to expectorate. 
First, strychnine is a remedy for shock from accident or surgical 
operations. The concensus of present-day opinion inclines to its use just as 
shock threatens, rather than its administration previous to operation when 
no evidence of shock is present. The former custom of using it at all stages 
of operative work is now quite generally condemned, reserving it for its 
specific use at the moment of emergency. When the heart-power suddenly 
flags, either from the anaesthetic or operation, or from accident, an intra- 
muscular injection of 1/10 grain of strychnine sulphate or nitrate should 
be given immediately, associated in most instances with 1/60 grain of 
atropine sulphate. In case of prospective need the hypodermic should be 
loaded and ready for immediate use. 
Strychnine and atropine are the most valuable stimulants for cardiac 
and respiratory failure in poisoning by alkaloids, narcotics, early stages of 
morphine, opium, chloral poisoning, or by foods, or in any case of acute 
poisoning attended with collapse of breathing and the circulation. It 
should be used in asphyxiation from gas and water, and in chloroform 
narcosis. 
In pneumonia, when the heart-power begins to fail and the circulation 
through the lungs is impeded, or life is threatened from dilation of the 
right heart, strychnine is urgently needed to tide the patient over a crisis, 
and sometimes means the difference between life and death. From 1/30 to 
1/20 grain may be given at once, and repeated as called for. Usually 
1/150 to 1/100 grain of atropine sulphate may be consentaneously ad- 
ministered. In shortness of breath from atony and where nerve power 
is so greatly depressed that the patient must breathe by voluntary effort, 
strychnine is distinctly indicated. Sometimes nux vomica will answer as 
well or better. Such a condition often occurs in typhoid fever and in asthma 
in the nervously depressed. The patient fears to go to sleep lest he be 
663 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
awakened by a sudden sense of suffocation. For this purpose strychnine 
and arnica are the two best remedies. It is frequently useful in the winter 
cough, with profuse secretion, of aged persons, though nux vomica and 
capsicum are to be preferred. Strychnine (and nux vomica) is a very helpful 
drug to use temporarily for the asthenia of typhoid fever and other low 
types of disease, when the weakness depends upon depressed spinal inner- 
vation and imperfect or feeble respiration. It is of marked utility in the 
cold stage of congestive intermittents, and in ague with atony of the 
stomach and impaired nerve force. In atonic diarrhoea, in cholera, and in 
cholera morbus it tends to prevent collapse and to restrain the evacuations. 
Nux vomica serves a similar purpose, but is not quite so prompt in 
action. 
Some form of strychnine, usually the nitrate, enters into the institu- 
tional treatment of dipsomania. More or less success attends its use 
according to the extent of the cooperation of the patient to aid in his own 
cure. 
Strychnine is a very useful but often abused remedy in diseases and 
disorders of the nervous system. Provided the inflammatory stage, if there 
be any, is passed, it is an agent of great power to strengthen depressed 
function or to restore impaired activity. If degeneration of nerve substance 
has taken place, as sclerosis, it is useless to ply the patient with strychnine 
or nux vomica, as is frequently done following severe nerve destruction. 
But if there is good reason to believe that the nervous impairment is merely 
functional, then the use of these drugs is not alone justifiable but decidedly 
beneficial. We have an instance of their good effects in the restoration of 
function, partially or completely, following hemiplegia and acute poliomy- 
elitis, provided we wait until all traces of the original cause and the in- 
flammation have passed, and we have only the results of these maladies to 
deal with. It should never be used during the course of acute or subacute 
neuritis; and it is of no value in paralysis agitans. Long after a hemiplegic 
attack it may be used to stimulate the unkilled trophic cells of the spinal 
marrow to increased activity and thus improve their nutrition. It is said 
to give the best results when the paralyzed muscles are completely relaxed, 
and asserted to be more useful in paraplegia than hemiplegia. When 
paralysis is more purely functional, as when hysteric, neurasthenic, or that 
following diphtheria or syphilis, it stimulates to functional activity; and is 
also useful after lead and arsenic paralyses. After apoplexy it is usually 
harmful on account of the increased blood pressure caused by it and the 
added danger of causing renewed hemorrhages. Strychnine should never 
be used after any form of paralysis while there are still remaining symptoms 
of congestion, myelitis, or spinal meningitis; nor should it be given any 
patient within several months after a cerebral hemorrhage, or at any time 
when there is headache, dizziness and ringing noises in the head or ears. 
It is sometimes very valuable in functional neuralgias associated with 
general debility. Strychnine is almost specific for alcoholic and tobacco 
amblyopia; and it may be used for eye conditions and for disorders of the 
bladder and reproductive tract named under Nux Vomica (which see). 
While useful in many of the gastro-intestinal disorders, nux vomica is usually 
preferred to its alkaloids. 
664 INDIVIDUAL DRUGS. 
SULPHONMETHANUM. 
Sulphonmethane, Sulphonal. (Formula: (CHs^QSOzCjIDi, or (C7H16S2O4.) 
Description.-Odorless, colorless and nearly tasteless crystals, or a crystalline powder. 
Very sparingly soluble in cold water, but quite readily in boiling water or chloroform, 
less soluble in alcohol and ether. Dose, 1 to 3 grains for a child; 5 to 20 grains for adult. 
Average, 12 grains; one to two hours before bedtime, and administered in powder, milk, 
hot water or soup. Do not give it in tablets. 
Specific Indications.-Insomnia from worry, mental excitement or 
overactivity; sleeplessness of fevers and insanity. 
Action and Toxicology.-The chief effect of sulphonal is upon the brain. 
It produces sleep but does not relieve pain. Even in large doses it has no 
effect on the circulation, and but little on respiration. Prolonged use of it 
may be deleterious to the heart and the liver. Single doses do not, as a rule, 
produce any serious results. Owing to its slow solubility and absorption 
sulphonal does not act quickly. Among the untoward effects of the pro- 
longed use of the drug are: Nausea and vomiting, gastric pain, languor, 
mental confusion, dizziness, headache, nervous exhaustion, ataxic or stag- 
gering gait, incoordination of movements, multiple neuritis, persistent 
cutaneous rashes, diarrhoea, sphincter paralysis, palsy of the lower ex- 
tremities, anuria, convulsions, and death. A single dose has caused death 
after a lapse of one or two weeks. It produces a change in the blood, when 
long taken, which is revealed by the presence in the urine of a dark reddish- 
brown substance-haematoporphyrin-an iron-free decomposition product 
of haemoglobin. This pigment causes the urine to have a deep wine color 
(haemato-porphyrinuria) and is probably due to the cumulative effects of 
the drug, for the latter, while slowly absorbed, is also more slowly elimi- 
nated. While sulphonal is largely decomposed in the body it is partly 
eliminated unchanged by the kidneys, but most of it is voided as ethly- 
sulphonic acid. 
Therapy.-Sulphonal is used solely as a hypnotic. The duration of 
sleep produced by it cannot be prejudged with certainty. As a rule, how- 
ever, it is slowly induced and quite prolonged. Pain prevents or retards 
its hypnotic action, and it is quite ineffectual if insomnia be due to heart 
disease. In fact, many declare it unsafe in the latter condition. After 
awakening from its effects the patient experiences mental and physical 
lethargy, and may remain drowsy for a day or two. When giving it for 
more than a night's use the kidneys should be watched, and if the least 
darkening or deep wine-red coloration or smokiness be observed, its use 
should be discontinued. This color may be observed upon the garments, 
which it stains, as well as in the urine. Sulphonal acts best as a hypnotic 
in insomnia due to worry or excitement, in mental overactivity and in the 
worry attending sexual derangements. In insanity and delirium tremens, 
and in mania with great excitement and nervous irritation it acts well; 
but it is better adapted to mild forms of the latter. Locke advised one to 
two grain doses as perfectly safe in the restlessness of teething, to ward 
off spasms and to produce sleep. It has given rest to drunkards who are 
nervous and on the verge but not in the throes of delirium tremens. Locke 
also advised it as a safe somnifacient in the sleeplessness of typhoid fever, 
declaring that it does not impair the nervous system. Sulphonal possesses 
less hypnotic power than chloral, but is more powerful than paraldehyde. 
665 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Probably trional and barbital are more generally effective, but sulphonal 
often acts when the others fail. The greatest comfort to the prescriber is 
the knowledge that, when given for an occasional dose, it does not depress 
the heart. Though sometimes advised to be given in capsule, the best form 
of administration is to dissolve the powder in hot water or hot tea and give 
it warm, for precipitation occurs upon cooling. It may also be given in 
milk, beef tea, or soup (delirium tremens). On account of its slow action 
it should be administered from one to two hours before bedtime; and the 
patient should not be awakened while under its influence, lest headache 
or giddiness result. He should be allowed to awaken naturally. The dose 
for a child is one to three grains; for an adult, five to forty grains, the 
average being ten to twenty grains. 
SULPHONETHYLMETHANUM. 
Sulphonethylmethane, Trional. (Formula: CsH^S^, or (CHg) (C1H»)C(SO»CJrfl)i.) 
Description.-Odorless, colorless, shiny, scaly crystals; in aqueous solution having a 
bitter taste; soluble in boiling water and cold water, and in alcohol and ether. Dose, 
10 to 30 grains. 
Action and Therapy.-Trional is a quickly absorbable and non- 
cumulative hypnotic, acting much like sulphonal, but with less likelihood of 
producing deleterious effects. It acts promptly, and while ordinarily 
perfectly safe for temporary purposes, its use should be accompanied by a 
saline laxative should the patient be inclined to constipation. If given for 
any length of time it should be omitted for several days at a time and then 
renewed, for it is only through its continued use that disagreeable after- 
effects have been observed-notably among these are suppression of urine 
and changes in the blood revealed by a dark product in the urine-giving 
to that excretion a deep red or black color (haemoporphyrinuria). Upon 
observing this coloration the use of trional should be stopped at once and 
vigorous purgation instituted. Like sulphonal it sometimes causes multiple 
neuritis, when given for a long time, even in small doses. Trional may be 
used for functional insomnias, particularly in the insane and in narcotic 
habitues. Sleep is usually induced in a half hour and continues for five or 
six hours. It is sometimes accompanied by dreams and nightmares. 
After a single dose the patient may remain drowsy for a day afterward. 
Trional should be given in hot fluids, as tea or broth, and not more than 
fifteen to thirty grains should be administered continuously. In fact, no 
hypnotic should be given without intermitting as often as possible, thus 
insuring the patient some sleep and some chance of more perfect elimination 
of drug products. 
SULPHUR. 
Sulphur (Symbol: S.) 
An element mined in various parts of the world, notably in Sicily and western and 
southern United States. 
Description and Preparations.-1. Sulphur Sublimatum, Sublimed Sulphur (Flowers 
of Sulphur), prepared by subliming crude sulphur. A fine yellow powder having a feebly 
acid taste and a faint characteristic odor of sulphur. Dose, 1 to 60 grains. 
2. Sulphur Pracipitatum, Precipitated Sulphur (Lac Sulphur or Milk of Sulphur), 
prepared by boiling sublimed sulphur with slacked lime and afterwards precipitating with 
hydrochloric acid and thoroughly washing the precipitate with pure water. An odorless 
and tasteless, nale-vellow. fine and non-crvstalline powder. Dose, 1 to 60 grains. 
666 INDIVIDUAL DRUGS. 
3. Sulphur Lotum, Washed Sulphur. Prepared by digesting sublimed sulphur with a 
dilute solution of ammonia water and finally washing with pure water. A pale-yellow 
powder without taste or odor. Dose, 1 to 60 grains. 
All three sulphurs are insoluble in water and slightly dissolved by alcohol. Turpentine, 
most oils, ether, and chloroform more readily accomplish their solution. All forms of 
sulphur when burned evolve fumes of sulphur dioxide, a suffocating and irritant gas, which 
in the presence of live steam is a powerful disinfectant and deodorizer. 
4. Unguentum Sulphuris, Sulphur Ointment. (Sublimed Sulphur, five per cent, 
and Benzoinated Lard.) 
Specific Indications.-Hemorrhoids, with severe lumbar pain, constipa- 
tion, and hard tenesmic stools, which are sometimes bloody, and the rectum 
protrudes (full doses); constipation or offensive tenesmic diarrhoea; anemia 
in scrofulous subjects where iron is ineffectual; skin blanched, iris and 
hair fading, feces and urine pale; cystine in urine; mucous discharge, with 
burning and itching; tendency to decomposition of fluids and tissues, with 
fetor; cough with profuse, thick secretion and lack of power to expectorate; 
headache, with cerebral fullness; rheumatic or darting localized pain; 
ophthalmia in the ill-nourished, with red swollen eyes. Externally. Scabies; 
scaly vesicular and papular eruptions; sores at the angles of the mouth, 
and around the nose and ears. 
Action.-Sulphur, applied to the skin, may act as an irritant owing 
to its conversion into sulphides through the action of the secretions. It is 
also an antiseptic and parasiticide. The vapor of burning sulphur (sulphur 
dioxide) is strongly irritant and may produce inflammation of the breath- 
ing organs and asphyxia. When taken in small doses sulphur is an alter- 
ative and has a special affinity for the skin and bronchial mucosa increasing 
their secretions. No sensible phenomena are produced by doses of from 
one to six grains, but larger amounts, say one drachm, excite intestinal 
action and cause small soft, pasty evacuations, which, however, are never 
watery. Sulphur renders both the stools and the perspiration insup- 
portably fetid, on account of the sulphuretted hydrogen which is formed. 
Probably the more impurities present, as excess of acid, the less pleasant 
its action; when pure it occasions no intestinal discomfort; when impure 
it causes griping. In doses of ten to twenty grains, every hour, it stimulates 
the circulation, raises the temperature, and finally induces sweating. If 
long administered the skin and breath exhale the disagreeable sulphuretted 
odor. The sweat stains yellow, and silver articles, as watches, jewelry, and 
money, coming in contact with the exhalations, are tarnished, a coating of 
silver sulphide being formed. When given to the mother sulphur may prove 
laxative to the suckling child. Excessive doses (2 drachms) given several 
times a day have produced a protracted irritation of the stomach, the 
disorder sometimes lasting for years. Two ounces, taken in a day, have 
caused fever, headache, contraction of the pupils, cold clammy sweat, vomit- 
ing, haematuria, semi-unconsciousness, and purging of bloody stools. When 
applied externally in large amounts to the broken skin or ulcers, and to 
large surfaces, it has been absorbed with unpleasant results. It should not 
be used where there is active fever or inflammation. Sulphur is eliminated 
largely as unchanged sulphur by the feces, but a considerable portion is 
converted into sulphides by the alkaline secretions of the intestines, hydrogen 
sulphide notably predominating. Some sulphates and organic compounds 
of sulphur, formed by oxidation in the blood, are eliminated in the urine. 
667 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Therapy.-External. Sulphur is a parasiticide and is the best known 
specific remedy for scabies. There are several methods of applying it, but 
the best is by anointing with sulphur ointment alone, or combinations of 
sulphur and other parasiticides. The following are good preparations: 
(1) 3 Sulphur, 5j; Potassium Carbonate, 3ij; Adeps, q. s., $iv. Mix. 
Anoint the parts thoroughly at bedtime. (Locke.) (2) Lanolin, lb. j; 
Oil of Tar, fl 5 j; Specific Medicine Veratrum, fl 3 j; Sublimed Sulphur, q. s. 
Mix. Ft. Unguent. Apply for three successive nights, omit three nights, 
then apply again in the same order, preceding each application by a thorough 
bath (Webster). (3) 3 Sulphur, 3 i j; Liquor Potassae, gtt.xv;Betanaphthol, 
5j; Balsam of Peru, 3 j; Petrolatum, q. s., §iij. Mix. Sig.: Apply every 
third night after observing the following procedure: First, give a thorough 
soap and water, prolonged bath, soft soap preferred. Rub the skin vigor- 
ously with a Turkish towel so as to break up the burrows of the itch mite. 
Apply the ointment thoroughly. Do this at bedtime. In the morning 
take a cleansing bath and put on fresh underwear and clothing. Subject 
the bedclothes and the discarded clothing to a thorough washing and 
scalding. If the fabrics are such as cannot be washed, heat them thoroughly 
in an open oven or subject them to a thorough ironing with a hot iron. 
If the itching persists, repeat the process every third day. The male insect 
does not burrow and is readily killed; but it takes vigorous treatment to 
reach the female ascarus, hence the necessity for the prolonged and softening 
baths. Should the skin become inflamed, treatment must be suspended 
until the inflammation subsides. This method may be used with all of 
the ointments named, and our preference is the last-named preparation. 
The second preparation is also useful for eczema and psoriasis. Locke 
advised the following as a hair tonic, provided the hair bulbs are not 
dead: 3 Washed Sulphur, 3j; Oil of Bergamot, gtt. x. Triturate; add 
Glycerin, fl5ij; Rose Water, q. s., flgxij. Mix. Sig.: Apply with a soft 
sponge once a day. As the odor of bergamot is somewhat objectionable 
the oil may be omitted, though it is in itself an admirable stimulant to the 
scalp. Sulphur ointments constitute the chief local applications for acne 
and comedones. Some object to them on account of the mechanical 
obstruction they cause. To obviate this Ellingwood suggests the alternate 
use of lotions of sulphur and of nitrate of potassium. A thorough face toilet 
of sulphur soap or tar soap is to be followed by rinsing with hot water and 
carefully drying with a soft cloth. Then apply a lotion of one drachm of 
washed sulphur in the morning and one of potassium nitrate in the evening, 
allowing them to dry on by evaporation. We have found steaming the face 
with hot towels, followed by cold affusion and a very mild sulphur ointment 
(sublimed sulphur, gr. xv to petrolatum, §j), to be very effectual in con- 
trolling stubborn acne. Ordinary sublimed sulphur is sometimes more 
effectual than washed sulphur, as some of the benefit undoubtedly comes 
from the impurities of the former. It appears to act best in acne associated 
with disorders of the female reproductive organs, and with sexual dis- 
turbances in the male. 
Sulphur, locally, is employed mostly in scaly, pustular and vesicular 
types of skin diseases. The ointment (10 per cent) is preferred, though it 
should frequently be reduced to half strength. The disorders most benefited 
668 INDIVIDUAL DRUGS. 
by it, besides those mentioned previously, are echthyma, impetigo, and 
psoriasis. Insufflations of sulphur are sometimes curative in acute pharyn- 
gitis, and in ulcerative sore throat; while for its antiseptic effects and to 
hasten detachment of the false membrane it is occasionally used in diph- 
theria and in follicular tonsillitis. 
Internal. Sulphur was at one time extensively used, but at the present 
day seems too often neglected. When a laxative is desired that will act 
without marked irritation or the production of excessive intestinal secre- 
tion, sulphur is one of the best that can be selected. No agent acts so well 
as a laxative in hemorrhoids, the stool produced being papescent and easily 
and plentifully voided. Again, when dry, hard and scybalous feces are an 
annoying feature, no aperient surpasses sulphur. In such disorders as 
stricture of the rectum or anal fissure it is absolutely necessary to modify 
the feces so that they may readily pass through the contracted outlet. 
For this purpose sulphur is invaluable. By strict adherence to regularity 
in attending to the toilet, with gentle urging, and the persistent use of small 
doses of sulphur for a short period, many cases of habitual constipation 
may be cured. It also provides a mild laxative for the constipation of preg- 
nancy. Either washed or sublimed sulphur may be used. 
Sulphur is undoubtedly a blood maker and a modifier of vicious states 
of the lymphatics. Its beneficial action is often obtained from the sul- 
phides occurring naturally in foods, among the best and most wholesome of 
which are eggs and onions. Condiments such as mustard, horseradish, and 
radishes also contain them. They all tend to the more perfect elaboration 
of protein tissues. Most tuberculous subjects require sulphur in some form, 
and among the best of foods for such subjects are the sulphur-bearing eggs. 
Individuals requiring sulphur medication in small doses have a 
blanched appearance of the skin, the iris and the hair fade, and in the 
middle-aged there is an early tendency to gray hair; the feces and urine are 
pale, and the latter contains cystine. If the mucous surfaces are bathed in 
a mucous flow and there are itching and burning, the stronger the indica- 
tions for sulphur. If the secretions are fetid or cadaverous, and there is 
evident tendency to decomposition of the fluids and tissues, sulphur is 
necessary, and in small doses will greatly change the character of the 
disease of which these symptoms are a part. Again, if the bile is imperfectly 
elaborated, so that it fails to exert its antiseptic effect upon the intestinal 
contents, sulphur will be of great advantage in rectifying the difficulty. 
With the foregoing guides before us, we find sulphur very valuable in 
headache due to cerebral fullness and associated with dizziness and ringing 
noises in the ears; in tendency to cracking or fissure behind the ears, at the 
angles of the mouth, and wings of the nose, so noticeable in ill-nourished and 
tuberculous children; in fissure at the anal outlet; in cracked nipples; and 
in amenorrhoea and other pelvic disorders of women, with imperfectly 
elaborated menses, the flow being semi-leucorrhoeal; and in sexual frigidity 
of the female. It is also of much value in dyspepsia with heaviness after 
meals, bad taste, pyrosis, and associated either with obstinate constipation 
or tenesmic diarrhoea, with pale and offensive feces. 
Sulphur is a most valuable but seldom considered remedy for cough, 
especially of the chronic type and that following la grippe or attending 
669 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
phthisis. At one time large doses of sulphur were commonly used in 
coughs, but the inevitable disturbances in other directions brought on by 
such large amounts led to its abandonment for that purpose. Large doses, 
however, are not necessary nor, indeed, do they act as well as minute doses. 
In our own experience the 1 to 100 trituration in five to ten grains doses has 
proved most effectual, being a splendid form of treatment for cough with 
heavy and copious secretions and lack of power to expectorate. There is 
loud rattling of mucus within the chest, and when raised it is abundant, 
thick, heavy, yellowish or greenish, and sometimes very fetid. Sulphur 
should be exhibited in chronic bronchitis, fetid bronchitis, in the latter 
stages of whooping cough in those disposed to phthisis, and in the dis- 
tressing cough of phthisis, with tenacious sputum. 
Sulphur is sometimes of value in so-called chronic rheumatism. The 
sulphur-demanding state of the body above described will indicate when it 
should be used. The same may be said of its employment in skin diseases, 
both internally and locally, the types most benefited being those of a 
scaly, pustular, or vesicular character. It is sometimes of value in localized 
pain, such as the darting and tearing pains of acute rheumatism and 
neuralgia. For pain simulating the prick of a pin it is said to be specific. 
The dried rhizome and roots of Ferula Sumbul (Kauffmann), Hooker filius (Nat. Ord. 
Umbelliferae). Northeastern and central Asia, coming into market through Russia. Dose, 
5 to 60 grains. 
Common Names: Sumbul, Musk-Root, Jatamansi. 
Principal Constituents.-A musk-odored volatile oil, aromatic resin, balsam, and 
angelic, valeric, and sumbulic acids. 
Preparation.-Fluidextractum Sumbul, Fluidextract of Sumbul. Dose, 10 to 60 drops. 
Action and Therapy.-Sumbul is a stimulating tonic to the nervous 
system, and for that purpose is employed chiefly with associated nervines, 
in asthenia and nervous depression. It is particularly adapted to neuras- 
thenia and nervous exhaustion of anemic or chlorotic women to allay 
nervous unrest and impart tone. Many physicians employ it as a nerve- 
tonic and reconstructive in convalescence from prolonged illness. 
SUMBUL. 
The root of Symphytum officinale, Linne (Nat. Ord. Boraginaceae). Europe; naturalized 
in the United States. 
Common Name: Comfrey. 
Principal Constituents.-Mucilage in quantity, tannin and asparagine. 
Preparation.- Tinctura Symphyti, Tincture of Symphytum (recent root, 3viij; 
Alcohol, Oj). Dose, 1 to 10 drops. 
Action and Therapy.-This drug is chiefly mucilaginous and used, 
therefore, as a demulcent in pulmonary, gastric, and renal irritation and in- 
flammations. With many it is a favorite for irritative cough, with bloody 
expectoration; and in mucous disorders with a tendency to hemorrhage. 
In ancient days it was lauded as a vulnerary, even to promoting the quick 
healing of fractured bones, a myth that was more recently revived in 
England because of the discovery of a principle (allantoin) found in the 
plant. 
SYMPHYTUM. 
670 INDIVIDUAL DRUGS. 
SYRUPUS FERRI IODIDI. 
Syrup of Ferrous Iodide, Syrup of Iodide of Iron. 
Description.-Syrup of Iodide of Iron is a pale, yellowish-green, transparent fluid, 
having an acid reaction, and a sweet and pronouncedly ferruginous taste. Iodide of iron 
is an unstable salt, and sugar is its best preservative. This syrup sometimes becomes of a 
deep red color if kept in the dark. The pale green color may be restored by placing the 
bottle, well filled with the syrup, where the direct rays of the sun may fall upon it. Dose, 
3 to 40 drops. 
Action and Therapy.-Iodide of iron is powerfully alterative, tonic, and 
sometimes emmenagogue. It is best administered in the form of syrup, or full 
doses of twenty to thirty drops of the syrup may be given well diluted with 
water. If given in large doses it causes gastric irritation and is objectionable. 
It is a good agent in devitalized patients when an alterative and tonic is indi- 
cated. It is most largely used in patients with low vitality, glandular enlarge- 
ments, and vicious secretions-especially in that near-tuberculous state 
denominated "scrofulous" or "strumous," for want of better names; and also 
where there is anemia dependent upon or associated with a syphilitic taint. 
Its influence is more that of iron than of iodine. It increases tone generally 
and improves the appetite and digestive power. That which is not assimilated 
is removed by the kidneys. It is a good medicine in the anemia of struma or 
of phthisis. It gives strength and increases the excretions very greatly. It is 
best given in these conditions with cod liver oil, provided either does not offend 
the stomach. Use twenty drops in teaspoonful of cod liver oil. This salt is very 
efficient in eczema with scrofulous enlargement of glands and great debility. 
Iodide of iron rarely is useful in hydrocephalus. In dysmenorrhoea with 
anemia in females of a strumous diathesis, it relieves the pain and promotes 
the discharge. Leucorrhoea, in syphilitic and so-called scrofulous patients, is 
benefited by it. Give internally from fifteen to twenty drops of the syrup three 
times a day, and use locally a wash of solution of borax. In albuminuria it is 
sometimes a good remedy. It is also of much value in secondary syphilis, and 
appears to be of distinct advantage in rheumatoid arthritis. If given in alter- 
nation with some vegetable tonic, as gentian, hydrastis, berberis, or with al- 
teratives, as phytolacca and iris, it exhibits its best action. Incontinence of 
urine in anemic children is relieved by it in doses of from five to ten drops three 
times a day. It has given fine results in chronic diseases of the liver, in stru- 
mous patients. It is one of the best remedies for pale, pasty-looking children 
with otorrhcea and other unhealthy discharges, associated with adenopathy. 
Syrup of Iodide of Iron is an effective agent when of good quality. 
Should it become changed, through any cause, so as to liberate free iodine, 
then it becomes an irritant and should not be used. Such alteration is 
manifested by a change from the pale green color to various shades of red. 
As this syrup is largely used in disorders of children, particularly those of 
a strumous type, or showing persistent adenopathy, it is essential that only 
the best quality be used, for a large part of the success of treatment of such 
cases depends upon keeping the gastro-intestinal canal free from irritation 
and capable of the most complete and easy digestion of foods. In fact, 
malnutrition is to be feared more than anything in these children, and great 
care should be had to avoid "iodine punishment." Should this occur the 
medicine should be withheld for a time and be begun anew in very small 
doses. Sometimes the administration of the syrup immediately following 
a meal will obviate such a disturbance. 
671 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
TALCUM PURIFICATUM. 
Purified Talc, French Chalk, Soapstone. 
Purified hydrous magnesium silicate, with sometimes a small quantity of the cor- 
responding aluminum salt. 
Description.-A very fine, odorless and tasteless, white or grayish-white powder, of 
slippery feel, free from grittiness and adhering to the skin. 
Action and Therapy.-Talc is soothing to irritated and chafed surfaces, 
and in dermatitis and herpes zoster. It is an ingredient of dusting powders. 
TANACETUM. 
The leaves and tops of Tanacetum vulgare, Linne (Nat. Ord. Composita). Europe; 
naturalized and cultivated in the United States. Dose, 5 to 60 grains. 
Common Name: Tansy. 
Principal Constituents.-A volatile oil {Oleum Tanaceti), and an amorphous, bitter 
tanacetin. 
Preparations.-1. Oleum Tanaceti, Oil of Tansy. Dose, 1 to 10 drops. 
2. Tinctura Tanaceti, Tincture of Tanacetum (fresh herb, 5viij, to Alcohol, 76 per 
cent). Dose, 1 to 30 drops. 
Action and Toxicology.-Oil of tansy is a gastro-intestinal and nerve 
poison, and in overdoses has caused epileptiform convulsions, profound 
coma, and death by paralysis of the breathing organs (asphyxiation). 
Lesser doses may increase the pulse rate, dilate the pupils, and cause 
severe vomiting and purging with colicky pain. Doses above fifteen drops 
are dangerous. Most deaths have occurred from its use in attempts at 
abortion. 
Therapy.-External. In use in domestic medicine as a fomentation to 
sprains and injuries, and to the abdomen in dysmenorrhoea. 
Internal. Tansy is a uterine stimulant and emmenagogue, and is a 
popular but unsafe remedy to restore arrested or delayed menstruation. 
An infusion is generally employed for this purpose by the laity. The cold 
infusion and the tincture (5 viij to Alcohol, Oj; dose, 5 to 10 drops) are 
sometimes useful as a gastric bitter in convalescence from exhausting 
diseases and in dyspeptic conditions with flatulence. 
TARAXACUM. 
The root of Taraxacum officinale, Weber, gathered in the autumn (Nat. Ord. Com- 
positae). Native of Greece and a wayside weed in Europe and the United States. Dose, 
5 to 60 grains. 
Common Name: Dandelion. 
Principal Constituents.-Inulin, sugar, loevulin, and an amorphous, bitter taraxacin. 
Preparation.-Specific Medicine Taraxacum. Dose, 1 to 60 drops. 
Specific Indications.-Anorexia, weak digestion, hepatic torpor, and 
constipation. 
Action and Therapy.-If prepared from recent root, taraxacum prepara- 
tions may be classed with the simple bitters, having in addition a slight 
laxative, diuretic and alterative action. In association with other indicated 
remedies they may be used in catarrhal jaundice, with hepatic torpor, 
chronic constipation, and in catarrhal gastritis; also as a laxative-alterative 
in autointoxications giving rise to skin disorders and aphthous ulcers. 
It is contraindicated in weak and irritable or inflammatory conditions of the 
672 INDIVIDUAL DRUGS. 
stomach and bowels, causing flatulence, pain, indigestion, and diarrhoea. 
The best preparation is an extract of the fresh root. 
TELA ARANEiE. 
The freshly spun web, free from dust, of the Tegenaria domestica, or common house 
spider, or as often employed in this country, the web of Tegenaria medicinalis, or field 
spider. Division: Homogangliata; Class: Arachnida. 
Common Names: Spider's Web, Cobweb. 
Preparation.-Specific Medicine Tela Aranea. Dose, 1 to 10 drops. 
Specific Indications.-"Debilitated subjects of neurotic tendency, 
with cool, clammy skin, protracted sensation of chilliness, with or without 
nervous complication, especially where periodicity is in evidence. Given 
when the keynote, chilliness, long-continued, is present, it is liable to 
remove accompanying neurotic complications, at the same time that it 
corrects the faulty condition of the circulation" (Webster). 
Therapy.-This is one of the very few animal substances that has 
found its way into Eclectic therapy, apis being the most noteworthy. 
When considered in the light of present-day craze for animal secretion 
medication the record pales by comparison. This use has been borrowed 
from Homoeopathy, though the spider-web has long figured in domestic 
medicine, being given in pill-form for intermittent fevers. That tela has 
power is not to be questioned. It is probably a heart, vaso-motor and 
nerve stimulant and an antiperiodic. Munk declares it indicated by "a 
persistent feeling of cold that is usually accompanied by weakness and 
often by nervousness", while Webster gives "continual chilliness, unable 
to get warm by the aid of proper clothing, apartment or fuel, emphasized 
if the skin is continually cool and clammy, and if the chilliness is quickly 
aggravated by dampness." The therapy of tela is almost wholly based upon 
the extravagant report of Pierce (E. M. J., 1886) who considered it specifi- 
cally indicated by "masked periodical diseases in hectic, broken-down 
patients; in all diseases that come up suddenly with cool, clammy skin and 
perspiration, and cool extremities; in nocturnal orgasm in either sex; 
numbness of the extremities when sitting still or lying down. It relieves 
spasms of the arterioles and stimulates capillary circulation. It relieves 
hyperaesthesia of the cerebro-spinal nerves and the great sympathetic 
that depends upon debility. It is the greatest heart stimulant in the 
materia medica, and lobelia is only second to it." In spite of these claims 
the agent has never become popular or much employed in Eclectic medicine. 
TEREBENUM. 
Terebene. 
A liquid composed of dipentene and pinene and other hydrocarbons. 
Description.-A thin colorless liquid of thyme-like odor, and aromatic, turpentine-like 
taste; soluble in alcohol, and almost insoluble in water. It should be kept cool, tightly 
stoppered, and protected from light, so as not to become acid and resinified. Dose, 1 to 6 
minims. 
Action and Therapy.-External. Locally terebene has been used suc- 
cessfully as a deodorant and protective dressing for wounds, ulcers, and 
scalds and burns. It appears to promote rapid healing. Full strength 
terebene. or dilutions with olive oil fl to 5 or 6). mav be aoolied. 
673 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Internal. Terebene is germicide, antiseptic, deodorant, diuretic, and 
expectorant. It stimulates the bronchial tract and kidneys after the man- 
ner of the essential oils and renders their secretions antiseptic. It kills 
the yeast plant and renders vaccine virus inoccuous. Its chief use is that 
proposed by Murrell-a remedy for "winter cough," and the secondary stage 
of chronic bronchitis; also of some value in emphysema and the cough of 
consumptives. In all of the forms of cough it is indicated when the 
expectoration is profuse and malodorous. When flatulence is due to yeasty 
fermentation, terebene sometimes relieves it. It may be administered in 
capsules, on sugar, in emulsion, or with other expectorant mixtures. From 
three to fifteen minims may be given three times a day, the usual dose 
being from four to six minims. 
TERPINI HYDRAS. 
Terpin Hydrate. (Formula: CioH^OHb-j-HjO.) 
The hydrate of the dihydric alcohol terpin. 
Description.-Colorless and nearly odorless, shining crystals, having a feebly aromatic 
and bitterish taste. In dry air it loses water of crystallization. Soluble in alcohol, ether, 
chloroform, and water. Dose, 1 to 4 grains. 
Action and Therapy.-Terpin hydrate acts upon the bronchial and 
renal tracts as an antiseptic expectorant and diuretic. It is employed 
chiefly in chronic bronchitis with oversecretion. Like the turpentines, 
it will relieve intestinal meteorism and assist in dispelling flatus. Over- 
doses cause renal congestion, strangury, hematuria, and albuminuria. 
Rarely it is of service in gleet and chronic cystitis. It is reputed useful as a 
palliative in both whooping cough and hay fever (full dose). The dose is 
from one to four grains, three times a day. As high as fifteen or twenty 
grains is advised by Hare in hay fever. The best forms of administration 
are in capsule, aromatized alcoholic solution, or in alcoholics with flavored 
syrups. 
THYMOL. 
Thymic Acid. (Formula: CioHhO.) 
A phenol occurring in the volatile oils of Thymus vulgaris, Linne; Monarda punctata, 
Linne (Nat. Ord. Labiatae), and Carum Ajowan (Roxburgh), Bentham et Hooker (Nat. 
Ord. Umbelliferae), and other plants. 
Description.-Large, colorless, translucent crystals, having an aromatic thymous 
odor, and a pungent, aromatic taste. It has a very slight caustic effect upon the lips. 
Very soluble in alcohol, chloroform, ether, and olive oil; and soluble in other fixed and 
volatile oils. It is sparingly soluble in water, about 1 in 1010 parts. Triturated with about 
an equal quantity of camphor or chloral it liquefies. Dose, 1 to 3 grains (antiseptic); 
10 to 20 grains (anthelmintic); usual dose, 15 grains. 
Specific Indications.-Hookworm; chyluria of filarious origin. 
Action and Toxicology.-Thymol somewhat resembles phenol (carbolic 
acid) in action and was introduced as a substitute for that agent. Its 
present high price militates against its very general employment. Thymol 
is antiseptic, deodorant, and disinfectant. It destroys the vitality of living 
and organized ferments, and prevents and arrests putrefaction. A few 
grains will preserve milk and urine, and some other animal substances, for 
weeks without change. It completely deodorizes pus and has a drying effect 
upon ulcers to which it may be applied. Its expensiveness precludes its 
use for disinfection of rooms and garments; and its usefulness is said to be 
674 INDIVIDUAL DRUGS. 
offset in a measure by its attraction for the common housefly, which appears 
to be very fond of it. Upon the mouth it produces a sharp pricking sensa- 
tion, and has a disagreeable taste. Gastric warmth, rarely vomiting, and 
sometimes diarrhoea are caused by it. Profuse sweating is occasioned by it 
and it reduces temperature, but is not a safe antipyretic. The kidneys are 
more readily damaged by it than by phenol, and the urine becomes dark 
or greenish in color or may contain albumen or blood, signals to immediately 
stop the use of the drug. Its elimination, partly changed and partly un- 
changed, is through the renal organs-thymol, hydroquinone, glycouronic 
and sulphuric acids being found in the urine. Hare states that toxic 
symptoms do not take place from less than one hundred grains of thymol 
taken in a day. 
Therapy.-External. As a deodorant, antiseptic and antiparasitic, 
thymol is useful, in solution or ointment, for certain skin disorders, as ring- 
worm and pityriasis versicolor (1 in 10 of alcohol) and in psoriasis, acne, 
alopecia, eczema, etc. (ointment, 1 to 60). A thick concentrated solution 
may be inhaled through a glass tube in diphtheria, pulmonary tuberculosis, 
bronchiectasis and gangrene of the lung to remove stench and sedate cough. 
Solutions of various strength, up to one in three hundred or in combination 
with other desirable agents, are much in use as a mouth and throat wash 
and douche for nasal catarrh. For these purposes it is especially stimulating 
and deodorant; and it is occasionally incorporated into dentifrices. Glyco- 
thymoline, a proprietary preparation, is an especially valuable alkaline 
and antiseptic detergent. 
Internal. Thymol is the best remedy yet found for the American hook- 
worm ( Uncinaria americand). It should be given in capsules or in konseals, 
and never in any substance in which it is soluble. Therefore no oils, fats, 
alcohol, chloroform, ether, should be used, and as little water as possible 
ingested during treatment. This confines the effects locally to the nidus of 
the parasite, and prevents poisoning by absorption. Fatty foods should be 
avoided, and alkalies should be withheld. A purge should be given, pref- 
erably Epsom salt; ten hours later fifteen to twenty grains of thymol 
for an adult or seven grains for a child should be administered, followed in 
three or four hours by another cathartic dose of the salt, or if preferred, a 
dose of senna. It may be necessary to repeat treatment about once a week 
as long as any nematodes are present. Webster has recorded success from 
the use of thymol in tapeworm, and others have advised it for chyluria of 
filarious origin. Thymol is occasionally useful in catarrh of the stomach 
and bowels to arrest fermentation and provoke increased digestive activity. 
THYMOLIS IODIDUM. 
Thymol Iodide, .Aristol, Dithymol-Diiodide. 
A product of the interaction of thymol and iodine in the presence of solutions of 
iodide of potassium and of sodium hydroxide. (Formula: CmHmOJj.) 
Description.-A bulky, reddish-brown or reddish-yellow powder, slightly aromatic. 
Readily soluble in ether, chloroform, collodion, and oils; sparingly soluble in alcohol, and 
insoluble in water and glycerin. It should contain not less than 43 per cent of iodine. 
It should be kept in amber-colored bottles. 
Action and Therapy.-External. Aristol is anodyne and dessicant. 
In action it more nearly resembles phenol than iodoform, for which it is used 
675 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
as a substitute. Its applications are practically the same as those for 
iodoform, but it must not be applied upon wounds and ulcers when there 
are free secretions, for under such conditions, probably through decomposi- 
tion, it increases the moisture. It has, however, given good results in acute 
and chronic suppurative otitis media and moist eczema of the aural canal. 
It has also been advised in powder and ointment, in interstitial and 
phlyctenular keratitis. Like iodoform it may be used upon syphilitic sores 
and to relieve anal distress in painful hemorrhoids, fissures, and in tuber- 
culosis and cancer of the rectum. 
THYROIDEUM SICCUM. 
Dried Thyroids, Dessicated Thyroid Glands (Glandulae Thyroideae Siccae). 
The dried and powdered fat and fascia-free thyroid glands of animals used for food, 
especially those of the sheep. They should contain no iodine or iodine compounds other 
than that which is a natural part of the normal secretions; the limit placed by the U. S. P. 
being not less than 0.17 per cent nor more than 0.23 per cent of iodine. 
Description.-A non-crystalline, yellowish powder, having a slight but peculiar taste. 
Dose, 1 to 3 grains. (Average dose, 11/2 grains.) 
Action.-Thyroid gland, either fresh or dried, is a true stimulator of 
metabolism and exerts a powerful effect upon the processes of nutrition, 
either for good or evil. This it does by furnishing a form of iodine peculiar 
to the gland itself. 
Thyroid gland causes a rapid loss of weight, due to increased protein 
waste and augmented diuresis. In overdoses or when inaptly employed it 
produces many unpleasant symptoms, even to the extent of poisoning 
(thyroidism). In obese subjects it is apt to induce glycosuria, on account of 
causing a derangement of the glycogenic function of the liver. Untoward 
effects also include tachycardia, with marked nervousness and tremors, 
flushing of the skin, headache of a congestive type, sweating, profuse 
urination, loss of appetite, diarrhoea, fugitive pains, lassitude, and marked 
loss of flesh. 
Therapy.-Thyroid gland has given the most striking results in 
diseases showing a deficiency of iodine and other glandular products of the 
thyroid of the human being, probably thyreoglobulin. It is most decidedly 
effective in myxoedema (thyroid atrophy in adults) and cretinism, and in 
well-determined forms of hypothyroidism. Where the thyroids of the 
human subject have been removed, thus depriving the body of the influence 
of the thyroid secretion, it has been administered with the result of modify- 
ing the many symptoms resulting from such deprivation. This condition 
is termed cachexia thyreopriva. 
As a rule thyroid treatment is contraindicated in ordinary goitre, 
though occasionally small doses have proved useful in some cases. These 
are assumed to be those in which the changes in the gland are passing 
from hyperplasia (thickening of connective stroma) into atrophy, or where, 
through crowding by enlargement of tissue upon the colloid cell-contents, 
secretion of iodine and thyreoglobin is interfered with. Even in myx- 
oedema care must be had not to overdose lest symptoms comparable to 
thyroidism be induced. As a rule, one grain doses, three times a day, are 
employed and continued indefinitely as long as good results. In cretinism 
(congenital absence or atrophy of the thyroid) and in cachexia thyreopriva 
676 INDIVIDUAL DRUGS. 
(extracted thyroids) it is necessary to give it throughout the patient's 
lifetime. Notwithstanding its power to reduce weight it should not be 
used as a remedy for obesity, for which it has sometimes been advised, and 
in which it has induced sugar diabetes, nor is it of value, except rarely, in 
exophthalmic goitre, a very different affection from that of other thyroid 
involvements. Various extracts, as thyroidin, have been used, but all are 
less effective than the dried glands. 
THUJA. 
The branchlets and leaves of Thuja occidentalis, Linne (Nat. Ord. Coniferae). In- 
digenous to Canada and the United States, on the rocky borders of streams and lakes, 
and in swamps. 
Common Names: Arbor Vitae, Yellow Cedar, False White Cedar, Tree of Life. 
Principal Constituents.-Oleum Thuja (Oil of Arbor Vitae), having a camphoraceous 
odor and tansy-like taste, and composed of dextro-pinene, laevo-fenchone, and dextro- 
thujone; a bitter glucoside, pinipicrin, and thujin (C20H22O12), an astringent, yellow gluco- 
side closely related to quercitrin. 
Preparations.-1. Specific Medicine Thuja. Dose, 1 to 30 drops. 
2. Aqueous Thuja. Dose, 1 to 40 drops; chiefly used locally. 
3. Long's Thuja, An Ointment of Thuja. 
Specific Indications.-Vesical irritation and atony; enuresis due to 
atony; urinal incontinence in children due to a weak bladder; dribbling of 
the urine in the aged, not due to paralysis or growths; urine expelled upon 
exertion as coughing, etc.; catarrhal flow from bladder or genitalia of male 
or female; chronic prostatitis; warty excrescences, and dry forms of eczema. 
Locally: fissured anus, prolapsus ani, pruritus in mucous membranes; 
venereal discharges; trachoma; warts; naevi; urethral caruncles; and hydro- 
cele. 
Action.-In small doses thuja is tonic and increases the activities of 
the kidneys. Large doses may provoke the irritant effects common to the 
turpentines and balsams. It has been asserted to have caused abortion, a 
doubtful effect, but attributed secondarily to violent gastric and intestinal 
irritation, resulting from excessive amounts of the drug. In many respects it 
resembles the activities of savin; though unlike the latter it is not a poison. 
Therapy.-External. Locally thuja is stimulant, subastringent, deo- 
dorant and antiseptic. It is especially useful for the restraint and reduction 
of hypertrophic changes in the mucous and cutaneous tissues. It will deaden 
and repress fungous granulations, and for this purpose may be applied to 
"proud flesh" and "ingrown nail" (both overgrown granulations). Alcoholic 
preparations of thuja may be employed to retard fungoid granulation and 
ulceration in epithelioma (does not cure), bed sores, sloughing wounds, 
fistulse, and to overcome the stench of senile and other forms of gangrene. 
It has a good record in curing papillomata and condylomata (upon the 
nates) when soft and there is foul exudation; and often succeeds in con- 
trolling venereal or genital warts. Alcoholic preparations of thuja are 
generally conceded to be the best local and kindly acting vegetable medicines 
for the dispersal of common warts or verruccse on any part of the body. It is 
applied locally and with reputed greater success hypodermatically into the 
base of the growth. Our personal experience with it for the removal of 
warts has been negative. Rarely it controls bleeding and ameliorates in 
677 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
hemorrhoids and prolapsus ani. Persisted in, though at first painful, it has 
cured fissure of the anus. Howe valued it for bulging naevi, and his once 
famous method of curing hydrocele with it is now little practiced. As 
compared with tincture of iodine or with carbolic acid it is less painful, 
but unlike the latter free from poisonous consequences through absorption. 
Howe's method was as follows: Tap and drain the tunica vaginalis testis, 
and inject two drachms of a solution of specific medicine thuja (one part) 
in warm sterile water (seven parts). Knead the tissues thoroughly so that 
the fluid is made to penetrate every part of the sac. More or less burning 
pain ensues, together with a greater or less degree of swelling; after sub 
sidence of the latter, if the procedure has been carefully executed, adhesion 
of the contact surfaces from the inflammation provoked results. Specific 
medicine thuja has been used to remove urethral caruncle and for the relief 
of chronic dry eczema of a furfuraceous character. Dropped upon hot 
water and inhaled it is of benefit in fetid sore throat, chronic and fetid 
bronchitis, bronchorrhoea, and chronic nasal and retro-nasal catarrh. In 
all of the foregoing conditions the alcoholic preparations may be employed 
from full strength to such a dilution as the individual cases demand. 
Aqueous thuja is invaluable to relieve pain and promote quick healing 
in soft pultaceous chancroids. It quickly allays pain, checks the discharge 
and odor, prevents lymphatic engorgement, and stimulates healing. It 
has no effect upon hard chancre, nor is it in any sense to be regarded as 
antisyphilitic. Wherever upon sensitive tissues the alcoholic preparations 
are inadvisable, the aqueous preparation may be substituted. It has been 
especially useful in catarrhal granulation of the cervix uteri (tampon); 
its use being preceded by a hot douche. For acute gonorrhoea the following 
injection is most valuable: 1$ Colorless Hydrastis; Aqueous Thuja, aa, 
1 part; Warm Water, 4 parts. Mix. Sig.: Inject every three hours. If 
there is much soreness add one part of Specific Medicine Hamamelis. The 
same mixture gives good results in subacute and chronic proctitis, following 
dysentery. Locally applied alone, or in the above-named combination, it 
may be used upon balanitis, herpetic ulcers, and abrasions and excoriations 
of the glans penis. As a local wash for mucous erosions in the mouth, for 
sore nipples, and for chapped hands it is pleasant and often efficient. 
Ointment of Thuja is the preferred thuja preparation for granular 
ophthalmia or simple trachoma. When the granules are soft and pultaceous 
a wetted alum pencil may be quickly passed over the everted lid, making 
but one sweep at each treatment. The parts are then dried, especially if 
the subconjunctival tissue is much infiltrated; and the ointment applied by 
means of a camel's-hair pencil. This should be done once a day. Fleeting 
pain is experienced. Absolute cleanliness should be insisted upon when 
home treatment is carried out, and constitutional remedies administered 
when conditions warrant them. 
Internal. Thuja is stimulant, subastringent, and antiseptic. Internally 
its effects resemble those of the terebinths, particularly savin, though it is 
less energetic than the latter. It is employed chiefly for its effects upon the 
mucous tracts-particularly the broncho-pulmonic and genito-urinary. 
While it has been advised (by inhalation from hot water) for hemoptysis, 
we have far better agents for this purpose; but in bronchial affections with 
678 INDIVIDUAL DRUGS. 
excessive and fetid expectoration it is of considerable value and ranks well 
with other terebinthinates. Its most specific action is upon the bladder 
controlling urinal incontinence in all forms except those excited by urinary 
concretions, paretic conditions, worms, or malignant growths. A most 
marked effect for good comes from its use for the relief of dribbling of urine 
in the aged and the young, provided paralysis does not exist in the former, 
or preputial adhesion or phymosis is not present in the latter. Doses of 
five to ten drops of the specific medicine often relieve nocturnal enuresis 
in children, when merely functional. Lack of tone in the muscularis 
mucosae appears to be the indication for it. The bladder seems too weak to 
prevent leakage, and for this debility it is especially useful when coughing 
or straining at stool, or the lifting of weighty objects causes an expulsion of 
urine. The doses mentioned also aid the local use of aqueous thuja in gleet 
when accompanied by granular urethritis. In habitual bed wetting the 
following is sometimes more effectual than thuja alone: 1$ Specific Medicine 
Thuja, gtt. xxx; Specific Medicine Belladonna, gtt. xx; Water, q. s., fl§iv. 
Mix. Sig.: One teaspoonful four times a day. Thuja gives comfort and 
relief in that unfortunate condition in old men with enlarged prostate in 
which the urine constantly dribbles, entailing much discomfort and misery, 
and producing unsightly stains upon the clothing. Whether it has any 
power to reduce an enlarged prostate has not been determined, but that it 
relieves weakness of the neck of the bladder is well established. Some 
claim that thuja is especially serviceable in cystic irritability when as- 
sociated with eczema or with gout. Like most products of the conifers, 
thuja sometimes proves emmenagogue and stimulates in atonic amenorrhoea 
when the genital tissues are flabby and lifeless. 
Tincture of Acetate of Iron. 
Description.-A transparent, claret-colored tincture having a strong chalybeate 
taste. Dose, 1 to 30 drops, well diluted. 
Specific Indications.-Pale, transparent skin, with prominent blue 
veins; dull, heavy pain in the back of the head; bluish color of tissues. 
Action and Therapy.-Tonic, astringent, and hemostatic. A very 
useful form of iron for internal administration in the anemia following 
adynamic fevers, and in anemic women with watery leucorrhoea, when the 
indications given above are observed. 
TINCTURA FERRI ACETATIS. 
Tincture of Ferric Chloride, Tincture of Chloride of Iron, Tincture of Iron, Tincture of 
Muriate of Iron, Muriated Tincture of Iron. 
Description.-A hydro-alcoholic solution of Ferric Chloride. It contains about 13 
per cent. A very astringent, styptic liquid of a bright amber color, an acid reaction, and 
a slight ethereal odor. It should be made at least three months before using and be 
protected from light. Dose, 5 to 20 drops. 
Specific Indications.-Chlorosis and anemia; erysipelatous redness, 
with glistening surfaces, deep redness of mucous tissues, approaching a 
solid blue in color; dull pain in the back of the head; swollen reddened tissues. 
Action and Therapy.-External. Tincture of chloride of iron full 
strength, or if too painful, slightly diluted with water, is a most valuable 
TINCTURA FERRI CHLORIDE 
679 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
astringent destroyer of chancre. This use of it was introduced by King, 
and has fallen into unmerited neglect. In stubborn phagedenic chancre it 
has surpassed any other medicament we have applied, and its use in this 
manner is absolutely without poisonous absorption or unpleasant after-effects 
such as follow many more powerful applications. It does not cure syphilis, 
however, and proper antisyphilitic measures must be pursued, even though 
all local trace of the infection has disappeared. Equal parts of glycerin 
and tincture of iron is the best local application in most cases of erysipelas, 
and the same diluted with water to 25 per cent strength is efficient upon 
tonsillar inflammations and diphtheritic deposits, or the tincture may be 
used in simple solution in water as a gargle. Locke advised a 25 per cent 
glycerin solution in erysipelas. Diluted with water, tincture of iron may 
be used as a dressing for sluggish ulcers and to reduce excessive granulations. 
A 5 per cent wash of tincture of chloride of iron is an effectual application 
to check the inflammation in rhus poisoning and hasten desquamation. 
Applied full strength it removes venereal warts. 
Internal. Tincture of chloride of iron is tonic, alterative, diuretic, 
astringent, and restorative. (For the general uses of iron, see Ferrum.) 
This agent is one of the strongest of the iron preparations, and is to be 
used chiefly in atonic conditions. Large doses of it are apt to disorder the 
stomach. However, it has been shown that small doses of chalybeates are 
preferable to large doses. In administering this agent, it is well to give it 
through a glass tube, avoiding, as much as possible, contact with the teeth, 
and afterward rinsing the mouth with sodium bicarbonate solution, unless 
a local effect upon the tissues of the mouth and throat is the object sought. 
The specific indications should be closely followed to give good results. 
The deep-red coloration of mucous tissues, and deep-red color in local 
diseases, are the direct indications to its use. Sometimes the coloration is 
so deep as to appear a solid blue, and there may be dull pain in the back of 
the head. When the trouble is located in the mucous tissues, as in diphtheria 
and other disorders, the local manifestations of which are in the mouth or 
throat, the tongue, fauces, and pharyngeal vault are somewhat full, and 
have a deep-red, glistening, erysipelatoid appearance. Tincture of chloride 
of iron has long been given as the most satisfactory drug in anemia, and the 
train of disorders depending upon such a condition. It is particularly 
valuable in the anemia following the great loss of blood, the quality of the 
blood not being specially impaired, but the quantity deficient. It is also of 
great value when anemia is progressive, and due to alteration in the red 
blood corpuscles, or when the result of prolonged disease. It is one of the 
most valuable chalybeates in chlorotic anemia. As a tonic, one guided 
by the specific indications will find it very useful in struma, rachitis, tabes 
mesenterica, extensive ulcerative or suppurative processes, with colliquative 
sweating and hectic fever, tabes dorsalis, asthenic dropsies, from loss of 
blood, and in amenorrhoea, with anemia. In leucorrhoea, with anemia, 
gonorrhoea (latter stages), gleet, retention of urine from spasmodic stricture 
(10 drops, frequently repeated), chronic mucous discharges from the 
urinary organs, dysuria, irritability of the bladder, in females especially, 
polyuria, and in the diarrhoea of phthisis and low forms of fevers it is a 
useful drug. The dose in these disorders should be from ten to twenty 
drops, in plentv of water, two or three times a dav. 
680 INDIVIDUAL DRUGS. 
The most direct specific results from this agent have been obtained in 
the treatment of erysipelas. It is not the remedy for all cases, but for those 
showing a deep-red, glistening surface, and having but a moderate amount 
of burning, and showing deep-redness of tongue. It reduces fever, allays 
pain and inflammation, increases the urinary flow, cleans the tongue, and 
gives rest. From five to thirty drops, well diluted, should be given every one- 
half hour, and the surface should be painted with the pure tincture, or the 
tincture diluted with glycerin (Scudder). Locke advises the following 
for local use: 3 Tincture of Chloride of Iron, fl^ss; Glycerin, flgjss. Mix. 
Paint upon the parts and cover with cotton. (See page 680.) 
Tincture of iron is of value in passive hemorrhage from bladder and 
kidneys (5 drops every 3 hours). It has been employed in post-partum 
hemorrhage, but is not equal to ergot and cinnamon. In phthisis, it checks 
hemorrhage, diarrhoea, profuse expectoration, and lessens night sweats. 
In chronic dysentery and chronic cholera infantum, with marked relaxation, 
it has sometimes proved serviceable. It occasionally relieves the dysmenor- 
rhoea of anemic subjects. As a general tonic, after severe gastric, nervous, 
malarial, or other debilitating diseases, the following has been advised by 
Ellingwood: 3 Tincture of Chloride of Iron, flSiii; Diluted Phosphoric 
Acid, flSiv; Glycerin, fl^i; Simple Elixir, q. s. flgiii. Mix. Sig.: One 
teaspoonful, in water, every two or three hours. 
In urinary affections, tincture of iron is frequently combined with 
uva ursi, buchu, or rarely with opium. In pyelitis, it lessens the quantity 
of pus, and, by its diuretic action, tends to lessen the danger of dropsy. 
In chronic nephritis, with albuminuria, it is one of the most important 
remedies, as it is in the latter stage of scarlatina, with albumen in the urine. 
It acts as a diuretic and reduces the output of albumen. In genito-urinary 
disorders, it is contraindicated, as a rule, by active inflammation. Some 
prefer the ethereal tincture in renal disorders, the dose of which is much 
smaller (3 to 5 drops). 
In chronic ague, tincture of iron may be given in conjunction with 
antiperiodics, if anemia is present. Tincture of iron has long been regarded 
as an efficient aid in the treatment of diphtheria. The tissues are swollen 
and deep-red. It may be combined as follows: 3 Tincture of Chloride of 
Iron, fl3j; Potassium Chlorate, gr. xv; Water, flgii. From one-half to one 
teaspoonful, every two hours, according to age of child. A gargle of the 
diluted tincture may be used at the same time (see page 680). Tincture of 
iron is frequently of service in disorders produced by the absorption of 
septic material. It sustains strength, and is often antagonistic to the 
poison. 
TRIFOLIUM. 
The blossoms of Trifolium pratense, Linne (Nat. Ord. Leguminosae). Cultivated 
everywhere. 
Common Name: Red Clover. 
Principal Constituents.-Resins and Tannin. 
Preparation.-Specific Medicine Trifolium. Dose, 1 to 60 drops. 
Specific Indications.-Irritability of the respiratory passages, with 
dry, explosive cough; carcinomatous cachexia. 
Action and Therapy.-Trifolium is alterative and antispasmodic. It 
681 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
relieves irritability of the respiratory tract, alleviating dry, irritable and 
spasmodic cough. Whooping cough is especially moderated by it, and it is 
frequently effective in lessening the distressing cough of measles, though in 
both disorders it fails as often as it succeeds. It also modifies cough in 
bronchitis and laryngitis. Its alterative powers are underrated, and it 
should be given where a general deobstruent effect is desired in chronic 
skin diseases, and unquestionably has a retarding effect upon malignant 
neoplasms. Though by no means curative in carcinoma, patients who have 
been operated upon for cancer are slower in redeveloping the growths when 
given tincture of trifolium daily. 
Trinitrophenol, Picric Acid, Carbazotic Acid. (Formula: C«Hj(NO»)»OH.) 
A product of the interaction of phenol-sulphonic and nitric acids. 
Description.-Light-yellow crystals or scales, without odor. Intensely bitter taste. 
It is sparingly dissolved by water, but is freely soluble in alcohol and ether. Used chiefly 
in the arts as a dye. It is explosive under rapid heat or percussion. 
Action and Therapy.-External. Picric Acid stains the skin and 
sometimes produces an erythematous rash. It has been suggested as some- 
times useful in 1 per cent solution as an application for herpes zoster and 
acute eczema, and as an injection (1 part to 100 or 200 parts of water) 
in the second stage of gonorrhoea. Its chief use, however, is that of an 
external application for the relief of burns and scalds of the first and second 
degree, when the area burned is small. It should not be used over large 
areas, nor where burns are deep, nor when there is known existence of renal 
irritation. Poisonous absorption may occur under such conditions. In 
applying it to burns all charred clothing, debris and dirt should be removed, 
the blisters pricked, and sterilized gauze saturated with a 1 per cent picric 
acid solution applied, covered with cotton, and lightly bandaged. This 
application, which dries quickly, is left in place for a few days, when a 
new application is applied for a week or so, having removed the first dress- 
ing by moistening it with the picric acid solution. Suppuration does not 
readily occur, healing is prompt, and little or no scarring results. The 
dressing causes some pain when first applied, but this quickly subsides. 
The cleanliness of this method is an argument in its favor. Rubber gloves 
should be worn by the physician or attendant while applying this agent; 
and the stain it produces may be removed with solution of lithium carbon- 
ate (3j to Water, Oj). Bethea gives the following formula for this dressing: 
3 Trinitrophenolis, gr. xj; Alcoholis, fl5iv; Aquae Dest. q. s., flgviij. 
Sig.: Use as a wet dressing as directed. A saturated solution of picric acid 
is a delicate test for albumen in the urine. 
TRINITROPHENOL. 
TRITICUM. 
The dried rhizome and roots of Agropyron repens (Linne), Beauvois {Triticum repens, 
Linne); (Nat. Ord. Gramineae). A native of Europe and naturalized in the United States, 
where it has become a nuisance. Dose, 120 to 240 grains. 
Common Names: Couch-Grass, Quick-Grass, Quitch, Dog-Grass. 
Principal Constituents.-A hygroscopic, gummy, inulin-like principle, triticin (8 to 11 
per cent), Icevulose (2 to 4 per cent), and acid malates. 
Preparations.-1. Infusum Tritici, Infusion of Triticum (Triticum, 3Water, Oj. 
Infuse one hour.) Dose, 2 to 4 fluidounces several times a day. 
2. Specific Medicine Triticum. Dose, 1 to 60 drops. 
682 INDIVIDUAL DRUGS. 
Specific Indications.-Irritation of urinary passages; pain in the back; 
frequent and difficult or painful urination; gravel; discharges of mucus and 
blood from the urethra. 
Action and Therapy.-A mild diuretic with slightly aperient proper- 
ties, and a demulcent of value in irritated conditions of the genito-urinary 
organs. It is of special value to lessen the frequency and pain of urina- 
tion-a remedy for dysuria and strangury. It may be used when inflam- 
mation is present, and is highly valued in chronic cystic irritability, cystitis, 
pyelitis, incipient nephritis, prostatitis, and in any condition in which an 
excess of mucus, pus, or blood is passed in the urine. Indirectly it acts as 
an alterative by washing away broken-down material by way of the renal 
organs. 
TUSSILAGO. 
The leaves and flowers of Tussilago Farfara, Linne (Nat. Ord. Composite). Europe, 
Asia, East Indies, and the United States. Dose, 10 to 120 grains. 
Common Name: Coltsfoot. 
Principal Constituents.-Acrid volatile oil, a bitter glucoside, resin, tannin, saponin 
and mucilage (3 to 4 per cent). 
Preparation.-Infusum Tussilago, Infusion of Tussilago. Dose, 1 to 4 fluidounces. 
Action and Therapy.-A demulcent to allay irritation of the bronchial 
and gastric mucous membrane, and of considerable value in coughs, laryn- 
gitis, bronchitis, asthma, pharyngitis, whooping cough, and gastric and 
intestinal catarrh. A coltsfoot candy is a popular confection for cough and 
sore throat. 
The dried, inner bark of Ulmus fulva, Michaux (Nat. Ord. Ulmaceae). Eastern half 
of the United States, in woods. 
Common Names: Slippery Elm, Elm, Elm Bark. 
Principal Constituents.-Chiefly mucilage. 
Preparation.-Mucilago Ulmi, Mucilage of Elm. Dose, Ad libitum. 
Action and Therapy.-External. Elm bark forms a good emollient 
poultice of lighter weight than many others and is useful where such 
applications are permitted, as upon inflamed surfaces, hemorrhoids, and 
forming abscesses. As a rule, poultices should not be applied to open 
surfaces. 
Internal. Elm bark is nutritive and demulcent. A mucilage of elm 
of good quality should be prepared with very cold water. Take shredded 
elm bark, bundle the shreds together after the manner of making a whisk 
broom, by tying one end with a long string. Suspend the bundle of bark in a 
vessel of ice water, from a support placed across the top of the container. 
A thick, ropy, mucilaginous preparation will result which is far more service- 
able than those prepared on a water bath, the common method of preparing 
mucilage of elm. 
Mucilage of elm is a splendid demulcent for irritable and irritated or 
inflamed mucous membranes, and to relieve dryness of the tissues of the 
mouth and throat, and to alleviate cough. It is one of the best agents to 
use after poisoning by irritants, to allay the distress and protect the in- 
flamed tissues. 
ULMUS. 
683 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
URTICA. 
The leaves and root of Urtica dioica, Linne (Nat. Ord. Urticaceae). Common in 
Europe and the United States. Dose, 20 to 40 grains. 
Common Names: Nettle, Stinging Nettle. 
Principal Constituents.-A volatile oil, tannic and gallic acids, and probably formic 
acid. 
Preparation.-Specific Medicine Urtica. Dose, 1/2 to 20 drops. 
Specific Indications.-Excessive mucous discharges; choleraic dis- 
charges; profuse gastric secretion, with eructations and vomiting; eczema 
of infants. 
Action and Therapy.-External. Contact with growing nettle pro- 
duces an intense stinging, probably due to an unorganized ferment in the 
hairs of the plant, though by some formic acid is believed to be the irritating 
substance. A lotion of Specific Medicine Urtica, fl 3 ij; Rose Water, q. s., 
fl 3 ij, is reported to have been effective in stubborn eczema of the face and 
scalp. The crusts should first be removed by means of olive oil and asepsin 
soap. Its internal use should accompany its external application. 
Internal. Profuse choleraic and excessive mucous discharges, as in 
cholera infantum and dysentery, are reputed to have been controlled by 
urtica, while it also has a restraining effect in gastric affections with 
excessive gastric secretion, and eructations, and vomiting. Chronic cystitis, 
with large mucous diuresis, is also asserted to have been benefited by it. 
USTILAGO. 
A parasitic fungus, Ustilago segetum Bull (Ustilago Maydis), developed on the fruit of 
Zea Mays, Linne, or Indian Corn (Nat. Ord. Fungi-Ustilagineae). Dose, 1 to 20 grains. 
Common Names: Corn Smut, Corn Ergot, Corn Brand. 
Principal Constituents.-An alkaloid ustilagine, trimethylamine, and sclerotic (mai- 
zenic) acid (probably not identical with that of ergot). 
Preparations.-Specific Medicine Ustilago. Dose, 1 to 60 drops. 
Specific Indications.-Feeble spinal and sympathetic innervation; 
feeble capillary and venous circulation; impaired circulation of cerebrum, 
with dizziness and unsteadiness; uterine derangements with excessive flow 
of blood or other discharges; lax genital tissues, with uterine pain; pain in 
top of head; uterine inertia; post partum and passive hemorrhages. 
Action.-This fungus unquestionably possesses power, acting as a 
spinal excitant and producing convulsions and destroying life either by 
tetanus or exhaustion. It dilates the pupils. Upon animals it acts as an 
abortifacient and produces a shedding of hair, hoofs and horns. Its action 
has been compared to that of ergot and nux vomica combined. 
Therapy.-Ellingwood is authority for the statement that ustilago is 
preferable to ergot as a parturient because it produces intermittent (clonic) 
instead of tonic contractions; and decreases after-pains, conduces to better 
uterine involution, and controls hemorrhage. Neither, however, is scarcely 
used by practitioners of the present day for parturient purposes. Scudder 
advised it to relieve false pains during the latter months of pregnancy, and 
other unpleasant sensations in the pelvic regions. It is also claimed that it 
arrests a too prolonged lochial flow by giving tone to the uterine wall. 
Observing the specific indications noted above, it may sometimes give relief 
684 INDIVIDUAL DRUGS. 
to the disorders arising from masturbation and nocturnal pollutions, much 
as ergot and belladonna do, and in the ovarian and menstrual derangements, 
(chiefly of excessive discharges) in women with lax pendulous abdomen, 
weak and flabby enlarged uterus, and full toneless perineal and vaginal 
tissues. It is little used, but undoubtedly could be restudied with advantage. 
UVA URSI. 
The dried leaves of Arctostaphylos Uva-ursi (Linne), Sprengel (Nat. Ord. Ericaceae). 
A perennial evergreen common in the northern part of Europe and North America. Dose, 
30 to 60 grains. 
Common Names: Uva Ursi, Bearberry, Upland Cranberry. 
Principal Constituents.-A bitter glucoside arbutin (C^HieO?), yielding hydroquinone, 
methyl-hydroquinone, and glucose; ericolin (CioHieO), ursone, tannic and gallic acids. 
Preparation.-Specific Medicine Uva Ursi. Dose, 5 to 60 drops. 
Specific Indications.-Relaxed urinary tract, with pain and bloody or 
mucous secretions; weight and dragging in the loins and perineum not due 
to prostatic enlargement; chronic irritation of the bladder, with pain, 
tenesmus, and catarrhal discharge. 
Action and Therapy.-Uva Ursi is a true diuretic acting directly upon 
the renal epithelium. Owing to the presence of arbutin it is decidedly 
antiseptic and retards putrescent changes in the urine, and acts as a mild 
disinfectant of the urinary passages. It is to be used where the tissues are 
relaxed and toneless, with dragging and weighty feeling, and much mucoid 
or muco-bloody discharge. There is always a feeble circulation and lack 
of innervation when uva ursi is indicated. It is especially valuable in 
chronic irritation of the bladder, in vesical catarrh, strangury, and gonor- 
rhoea with bloody urination. It is claimed that when cystic calculi are 
present uva ursi, by blunting sensibility, enables their presence to be more 
comfortably borne. Pyelitis and mild renal haematuria sometimes im- 
prove under the use of uva ursi. Arbutin, in its passage through the 
system, yields hydroquinone, and this body, further changed by oxidation, 
renders the urine dark or brownish-green. This should be explained to 
patients taking the drug in order to allay any unnecessary fears the phenom- 
enon may excite. 
VALERIANA. 
The dried rhizome and roots of Valeriana officinalis, Linne (Nat. Ord. Valerianacese). 
A native of Europe, but cultivated in England and the United States. Dose, 30 grains. 
Common Names: Valerian, Great Wild Valerian. 
Principal Constituents.-A volatile oil (Oleum Valeriana) composed chiefly of borneol 
and pinene, from 1 to 2 per cent, and valeric acid. 
Preparations.-1. Specific Medicine Valerian. Dose, 1 to 30 drops. 
2. Tinctura Valeriana, Tincture of Valerian. Dose, 1 to 2 fluidrachms. 
3. Tinctura Valeriana Ammoniata, Ammoniated Tincture of Valerian. Dose, 
1 to 60 drops. 
Specific Indications.-Cerebral anemia; hysteria; chorea; hemicrania, 
all with mental depression and despondency; mild spasmodic movements. 
Action and Therapy.-Valerian is a good cerebral and spinal stimulant. 
It also stimulates the gastro-intestinal secretions and favors digestion, 
unless given in too large doses or too long continued. It is one of the best 
of calmatives for that collective condition termed "nervousness". To act 
685 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
well it should be given when the brain circulation is feeble and there is 
mental depression and despondency. With such symptoms it proves useful 
in hysteria and hypochondria, nervous headache, and hemicrania. It is 
one of the best medicines we possess in the treatment of chorea. It should 
be given with an equal quantity of specific medicine macrotys, about ten 
to fifteen drops of each, three or four times a day. It controls hyperaesthesia 
better than actual convulsive attacks; therefore, it is of little value in 
epilepsy, for which it has sometimes been suggested; and in chorea it should 
be persisted in when the movements are mild, in order to prevent more 
pronounced muscular incoordination. In mental depression, due to worry 
or imaginary wrongs, valerian is an admirable drug. Owing to its volatile 
oil it is a good carminative in flatulence, with nervous unrest, and relieves 
the disagreeable sense of fullness felt after a meal by causing a rifting 
of gas. The oil and the ammoniated tincture are useful agents in fainting 
and nervous palpitation of the heart. 
The fruit of Vanilla planifolia, Andrews (Nat. Ord. Orchidaceae). A native Mexican 
vine, grown in many tropical countries, but on a commercial scale in Guadaloupe. Dose, 
1 to 10 grains. 
Common Name: Vanilla. 
Principal Constituents.-The fragrance of vanilla is due to vanillin (CgHgOs) and to the 
presence of a small quantity of balsam. 
Preparation.- Tinctura Vanilla, Tincture of Vanilla. Dose, 1 to 10 drops. 
Derivative.- Vanillinum, Vanillin, is methylprotocatechuic aldehyde, occurring natu- 
rally in vanilla beans, or may be produced synthetically from several orthodihydroxy-ben- 
zene derivatives. It forms fine white or very pale yellowish, needle crystals having the 
characteristic taste and odor of vanilla; soluble in water and freely in alcohol, glycerin, 
ether and chloroform. It forms the whitish "frost" observed on vanilla. Dose, to 1 
grain. 
Action and Therapy.-Vanilla is an aromatic stimulant, but is seldom 
used as a medicine. It is said to promote wakefulness, increase muscular 
energy, and to powerfully stimulate the sexual appetite. It is used chiefly 
as a flavoring agent for medicinal syrups and tinctures, confections, and 
pastry. 
VANILLA. 
VERATRINA. 
Veratrine, Veratria. 
A mixture of alkaloids obtained from the seeds of Asagrcea officinalis (Chamisso and 
Schlechtendal) Lindley; (Sabadilla seeds) (Nat. Ord. Liliaceae). Tropical regions from 
Mexico to Venezuela. 
Description.-A white or grayish-white, non-crystalline powder, without odor, but 
causing violent irritation and sneezing when even a minute quantity comes in contact with 
the nasal mucosa. It should not be tasted. Veratrine is slightly hygroscopic, though very 
sparingly dissolved by water (1,760 parts). It is very soluble in chloroform, alcohol and 
ether. 
Action.-Locally, veratrine (or its salts) is a violent irritant closely 
resembling aconitine in action. Applied in alcoholic solution, ointment, or 
oleate, it excites a singular sense of heat and tingling, or prickling pain, 
which, however, does not last long, but is followed by coolness and more 
or less numbness; there is seldom redness or vesication unless the prepara- 
tion is strong and applied with brisk friction. Inhaled, even in minute 
quantity, it occasions severe coryza and excessive sneezing. Muscular 
twitching has resulted from its application in ointment to the face, and 
686 INDIVIDUAL DRUGS. 
sometimes it gives rise to headache, nausea, griping, slight diarrhoea, and 
depression of the action of the heart. When swallowed it is a violent, 
irritant poison, causing great acrimony in the parts over which it passes, 
salivation, peculiar prickling numbness of tongue and mucous membranes, 
violent vomiting, profuse and sometimes bloody, and bilious diarrhoea 
(sometimes constipation); weak, irregular and quick pulse; cardiac de- 
pression; pallor of face and great faintness; cold sweats; muscular twitch- 
ing and aching pain along the spine; contracted abdomen and pupils; and 
occasionally extreme pruritus and tingling which may persist for weeks. 
In so-called medicinal doses it produces a feeling of warmth in the stomach 
and bowels, which extends to the chest and extremities. In poisoning by it, 
the stomach should be thoroughly evacuated, and tannin solutions freely 
given and pumped out. Stimulation should be resorted to to overcome the 
depression; for this purpose alcoholics, aromatic spirit of ammonia, am- 
monium carbonate, artificial respiration, etc., may be employed. 
Therapy.-External. Veratrine should be used only as an external 
application, and then rarely, in superficial functional neuralgia, myalgia, 
herpes zoster, chronic arthritis, acute gout, and other painful local inflam- 
mations. It is less effective than aconitine, but both are equally dangerous 
and great care should be exercised that it is not applied where the epiderm 
is denuded, nor should it be allowed to come into contact with or even be 
used near the eye, on account of the violent conjunctivitis caused by it. 
A 2 per cent solution in equal quantities of olive oil and oleic acid is usually 
employed. 
Internal. Veratrine should not be used as an internal medicine. 
VERATRUM. 
The dried rhizome and roots of Veratrum viride, Aiton (Nat. Ord. Liliaceae). An 
indigenous plant of swamps, low grounds, and moist meadows. Dose, 1 grain. 
Common Names: American Hellebore, Swamp Hellebore, Green Hellebore, Indian 
Poke. 
Principal Constituents.-A powerfully toxic alkaloid veratrine (C32H49NO9), or cevadine, 
ocurring in both crystalline and amorphous forms; protoveratrine (C32H51NO11), also ex- 
tremely poisonous; jervine, vertroidine, pseudojervine, rubijervine (sternutatory) and resin. 
Preparation.-Specific Medicine Veratrum. Dose, 1/20 to 5 drops. 
Specific Indications.-Pulse full, frequent, and bounding; pulse full, 
rapid, corded or wiry; pulse full, strong, and intense, with throbbing of the 
carotids; pulse rapid and beating so forcibly that sleep is prevented; tissues 
full, not shrunken, and surface flushed with blood; increased arterial 
tension, with bloodshot eyes; erysipelas resembling an ordinary inflamma- 
tion; cerebral hyperaemia; sthenic fevers and inflammations; irritation of 
nerve centers due to an excited circulation; convulsions, with great vascular 
excitement, full pulse, and cerebral hyperaemia; puerperal eclampsia; 
red stripe down center of the tongue; weight in the epigastrium, with 
forcible circulatory pulsations. 
Action and Toxicology.-Veratrum is a powerful circulatory depressant. 
The exact action of the individual alkaloidal constituents is yet unde- 
termined, as well as the effect each produces in the sum total of the effects of 
the root. According to Wood, the drug is a spinal and arterial depressant 
687 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
having no direct action upon the spinal centers; the direct action of jervine 
upon the heart-muscle, and the stimulation of the inhibitory nerves by 
veratroidine lower the pulse-rate; the force of the heart-beat is lowered by 
the direct action of jervine upon the heart-muscle, while the same con- 
stituent, according to dose, produces a more or less complete vaso-motor 
paralysis. The depression of the spinal motor centers is attributed to 
jervine. The emetic action of veratrum is said to be due to the combined 
action of veratroidine and the resin. All vaso-motor depressants and all 
agents which diminish the vital force, favor the action of veratrum. Nausea 
is always the signal for suspension of the administration of the drug. Death 
from veratrum is caused by asphyxia. 
Veratrine and cevadine are identical. The veratrine of commerce, 
however, is variable in composition, but its action is probably mostly due to 
the amount of true cevadine present. Late investigations show that most 
of the action of veratrine is that of cevadine, though veratrum does nor 
furnish the veratrine of commerce (see Veratrina). One of the peculiar 
effects of veratrine is that of muscular contracture produced when in con- 
tact with the heart and the voluntary muscles. It is exhibited in a prolong- 
ation of relaxation following the contraction of the muscle, appearing 
almost like a tetanic effect, but it is free from any rigidity or spasmodic 
quality-in reality a prolonged contraction in which there is a long and 
gradual relaxation several times longer in duration than that occurring in 
the unpoisoned muscle. 
American hellebore exerts an influence upon the system quite similar 
to that of White Hellebore (Veratrum album). Veratrine does not represent 
the action of this plant, which contains but a small proportion of this body. 
Applied to the skin, veratrum is rubefacient; and to the nose, excites 
sneezing. Small doses of veratrum appear at first not to affect the fre- 
quency of the pulse, but to lower its force; it afterwards slows the pulse, it 
becoming moderately full and soft, and remaining so, unless the patient, 
during this stage of depression, attempts to rise or make any exertion, when 
the pulse becomes very rapid, small, thready, and sometimes almost im- 
perceptible. During the stage of depression there is marked muscular 
weakness and relaxation, and nausea and vomiting take place, the contents 
of the stomach being evacuated first, and then those of the gall-bladder. 
Occasionally a watery diarrhoea is caused by veratrum, sometimes amount- 
ing to hypercatharsis, but as a rule purging is not produced. The nausea 
produced by veratrum is intense, and the vomiting severe and often per- 
sistent, making it, therefore, an unsafe emetic. The most characteristic 
action of veratrum is its effects upon the movements of the heart and 
upon vascular tonus. The pulse-rate has been lowered to thirty-five beats 
a minute with this agent, a corresponding depression of force accompanying 
this action. When such depression is reached, it is seldom that emesis can 
be prevented. In large doses it is a very dangerous agent, yet, singularly, 
fatalities from its use are rare. Toxic doses produce an exceedingly weak 
heart-action, almost indistinguishable, running pulse, reduced temperature, 
cold, clammy sweat, extreme retching and incessant vomiting, dizziness, 
faintness, failure of sight, pupillary dilatation, complete muscular prostra- 
tion, slow, shallow breathing, sleepiness, coma, and unconsciousness, with 
688 INDIVIDUAL DRUGS. 
sometimes stertorous breathing. The prompt emesis induced by this agent 
undoubtedly prevents lethal effects. 
In poisoning by veratrum, withdrawal of the drug and free stimulation 
will quickly overcome the depression. Large draughts of warm water may 
be given to encourage and assist emesis until the stomach has been thor- 
oughly washed out. This should be followed by undiluted whiskey or 
brandy to check the vomiting. Opium or morphine may be given by mouth 
or otherwise, ammonia and alcoholics may be used by enema or hypoder- 
matically, and strychnine or digitalis may be given by the latter method. 
External heat, sinapisms, friction, etc., must be utilized, and under no 
circumstances must the patient be allowed to rise from the recumbent 
position, not even to raise the head to vomit. 
Therapy.-External. Painted upon boils, felons, carbuncles, abscesses, 
inflamed acne, cellulitis, and other local inflammations, veratrum will 
frequently ease pain and facilitate resolution, or hasten suppuration. 
For erysipelas showing much tumefaction and redness, and appearing 
much like an ordinary inflammation, veratrum is one of the best topical 
applications. It should be given internally at the same time. Similarly 
used, it sometimes relieves herpes labialis and herpes zoster. It is one of 
the local medicines that occasionally relieves the dermatitis of rhus poison- 
ing. Used by means of a spray it may abort acute tonsillitis and modify 
it after it is established. But small quantities should be used. 
Internal. Veratrum is a remedy of great value and power, though 
quite transient in its effects. Small doses do good work when indicated, 
but they must follow each other at short intervals, so that a continuous 
action may be kept up. Owing to its tendency to induce gastric irritability, 
with nausea, large doses are not tolerated, and small doses are contraindi- 
cated when the tongue becomes long and pointed and reddened at the tip, 
and nausea and other unpleasant gastric phenomena are present. Veratrum 
increases secretion from the lungs, kidneys, and liver, but depresses the 
circulatory system. It is not adapted to asthenic troubles, but proves an 
admirable remedy in sthenic conditions, with the full, bounding pulse. 
Therapeutically veratrum is one of the chief special or arterial sedatives. 
The so-called sedative action of this group of remedies, so important in 
specific medication, is in reality that of gentle stimulation of the nerves con- 
trolling the heart and circulation, and depends wholly upon the manner of 
using them. In the smallest medicinal doses they are arterial or special 
sedatives; in the large doses they are cardiac and circulatory depressants, 
and are then dangerous remedies. To this group belong the trinity- 
veratrum, aconite, and gelsemium. Each has its own special field, and no 
one of them will exactly duplicate the effects of the others. Aconite and 
veratrum have been said to act similarly. In a measure only is this true, 
and there are many properties peculiar to each. To do the kindly thera- 
peutic work that veratrum accomplishes in small and safe doses would 
require a dangerous dose of aconite. Full doses of aconite will bring down 
the full, strong pulse in sthenic disorders, but it does so only in a dose 
which imperils the patient. So long as aconite is reserved for use in small 
doses for the small frequent pulse, without capillary resistance one need 
have no cause to fear its action in the least. But one must hesitate at the 
689 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
large dose required to reduce a full, vigorous pulse, for there he is taking 
an unsafe risk; besides, we have in veratrum a drug that will meet the con- 
dition better and do it without the least danger to the patient's health or 
life. A long experience has convinced us fully of the confirmation of the 
truth that the great specific indication for veratrum is the full, bounding 
pulse with or without inflammation or elevation of temperature. 
Veratrum is a remedy for sthenic conditions, whether it be a fever of any 
of the commoner types, an inflammation, iodiopathic or traumatic, or 
puerperal septicaemia, or puerperal convulsions. The prime indication is 
the full, bounding, rapid pulse, hard and rope-like in character, with or 
without fever or inflammation. It is the remedy where there is free action 
of the heart, with active capillary circulation; serous inflammation with 
hard and full pulse, or full and bounding pulse; or even with wiry or corded 
pulse. It should not be administered freely when there is gastric irritability, 
but fortunately, as a rule, when veratrum is indicated this irritability is 
not often present. The effects of veratrum are of short duration; therefore, 
it should be frequently administered in small doses for its continuous effects. 
The winter season is particularly a time when veratrum is likely to be 
needed most. The majority of cases of acute infectious pneumonia, which 
prevail most largely during the cold months, come on suddenly with the 
full, bounding pulse. Veratrum wonderfully controls the circulatory and 
febrile conditions and aids in checking the inflammatory ravages of the 
disease. It should be given in the early stages only and in the cases markedly 
sthenic. The dose should be small and frequently repeated until the temper- 
ature and circulation respond, when the pain will be found to have been 
lessened, nervous excitation allayed, secretion reestablished, and cough 
controlled. It is probably oftener indicated in acute pneumonia than any 
other agent except bryonia. In pleurisy, veratrum sometimes acts like 
magic, and in la grippe (epidemic influenza) it is, perhaps, the safest of all 
the circulatory sedatives and the most frequently indicated. At the onset 
of tonsillitis the conditions are usually sthenic and indications prominent 
for veratrum. 
Painting veratrum upon the tonsils, or using it diluted by means of a 
spray, is often a great aid in controlling the inflammation, allaying pain and 
aborting abscess (quinsy). In all acute sthenic sore throats it is a most 
valuable agent. The facility with which veratrum controls the situation 
in acute respiratory disorders of a sthenic type, is a striking confirmation 
of the truth of specific medication-the pulse slows and softens, the temper- 
ature comes down without shock, expectoration is facilitated, pain is 
allayed, cough is lessened, and the nervous unrest gives way to peace and 
comfort, and in curable cases the battle is half won at the beginning. In 
chronic lung disorders we occasionally find veratrum of use when acute 
exacerbations occur and the circulation is augumented and temperature 
heightened. But as a remedy for other purposes, except occasionally to 
control nervous unrest, we have not found it so valuable in chronic pul- 
monary troubles as others have reported it to be. Veratrum should not be 
overlooked in hemoptysis, when there is great excitement of the circulation, 
the pulse being full and bounding. Here it justifies the claims made 
for it. 
690 INDIVIDUAL DRUGS. 
Veratrum is a most important agent in acute inflammatory disorders. 
Acute articular rheumatism of a sthenic type is well treated when veratrum 
forms a part of the medication, and if endocardial or myocardial inflamma- 
tion accompanies or follows, we have never known it to do harm, but rather 
to be of benefit. In hypertrophy of the heart, accompanied or not with 
fever or inflammation, it is an ideal and safe agent. Erysipelas of the 
violent type, with full, bounding pulse and vivid redness, will find in 
veratrum one of the best medicines, using it both internally and locally. 
In peritoneal inflammation, due to blows upon the abdomen, veratrum is 
the best remedy known, and in septic peritonitis it assists greatly in con- 
trolling the circulatory excitement and inflammatory process, and con- 
tributes as much as any medicine can to a favorable termination of the 
disease. In any visceral inflammation, particularly pelvic, it is often indi- 
cated to control the blood current and modify the inflammatory action. 
Occasionally it proves valuable in gonorrhoea and to prevent or alleviate 
mastitis, orchitis, and ovaritis. 
We have used veratrum with great satisfaction in individuals whose 
lives have been such as to task the circulation to its utmost, and who have 
before them the probability of a future chronic nephritis and arterio- 
sclerosis. In these prenephritics, we will call them, a correction of vicious 
habits and the judicious use of small doses of veratrum will often avert 
disaster. If arteriosclerosis has not already obtained it may be warded 
off, the integrity of the kidneys maintained, and the life current guided 
past the point of danger. Small doses of specific medicine veratrum should 
be given for a prolonged period. 
A remarkable instance of the therapeutic power of veratrum in high 
blood pressure was in that of a man bleeding from the gums. The patient, 
a blacksmith of middle age, indulged in occasional sprees and drank more 
or less all the time. The pulse was hard and full as a rope and whipping 
along vigorously and fast, nervous agitation was extreme, and blood was 
oozing from the spongy gums around every tooth in his head. The carotids 
were pulsating strongly, the eyes bulging and injected, and the head felt 
and looked as if it would burst. Veratrum, in the ordinary dose, completely 
relieved this man in less than two hours, with no return of the trouble- 
though the patient still continued his devotions at the shrine of Bacchus. 
Veratrum may be employed in small doses for the relief of a certain 
form of nervousness. The patient has a full circulation, throbs, feels the 
beating of the heart, the abdominal aorta and the carotids. When retiring 
to rest, sleep is prevented by the throbbing pulsations in the head and ears, 
so distressing that sleep is prevented or delayed. Small doses of veratrum 
do wonders for these badly-shaken patients. 
In the treatment of the common fevers, except the febricula, we have 
not found veratrum of much service; in fact, not often indicated. In our 
experience it has rarely been needed in typhoid fever, but occasionally is 
indicated in acute malarial intermittents. In the threatened attacks of 
sunstroke (not in heat exhaustion with pallor, cool skin, and weak pulse, 
but in the robust, full blooded, overheated individual, with bounding pulse 
and rope-like circulation), a few small doses of veratrum should be given at 
intervals of ten or fifteen minutes. 
691 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
We are among those who believe that veratrum has some virtues outside 
of its power over the circulation, for it has alterative powers of great value. 
Just how it acts is not known; possibly its circulatory control aids also 
lymphatic elimination. While not prepared to go as far as did Howe in 
claiming it the only alterative in tubercular conditions, we believe it could 
be profitably restudied for its power of eliminating morbid products in 
many chronic ailments depending upon faulty elimination. Some have 
valued it in chronic bronchitis and so-called chronic pneumonia. As an 
alterative in chronic broncho-pulmonary disorders small doses of veratrum 
may be given for several days; and then omitted for a few days; or it may 
be administered every other day, syrup of lactophosphate of calcium being 
given on the days when the veratrum is omitted. 
When convulsive disorders depend upon an excited circulation, vera- 
trum may prove a useful anticonvulsive. It is sometimes of value in 
spinal irritation, with spasms, and in acute mania and cerebro-spinal 
meningitis, all with violent circulatory excitement. If accompanied by 
fever and there is hyperaemia, it may relieve neuralgic headache; otherwise 
it fails. When the pulse is full and bounding, the eyes bloodshot and 
suffused, and with a state bordering upon inflammation, it may restore quiet 
and allow sleep in delirium tremens. 
Veratrum is our most important agent to control puerperal con- 
vulsions. We have injected a half drachm of specific medicine veratrum 
every half hour for three hours in a case of post-partum eclampsia, with 
puerperal mania, with the result of being complete master of the situation. 
In this disorder the full pulse must be subdued and kept subdued until the 
convulsions cease. It is the one instance in which the large or extreme 
physiologic (near toxic) dose of veratrum is absolutely demanded. 
For the purposes above named, except where otherwise directed, 
veratrum should be given to control indications as revealed by the pulse, and 
then its administration should be stopped; and the fractional dose (15 to 
20 drops in four ounces of water; dose, a teaspoonful every fifteen, thirty, 
or sixty minutes, as required) is much more satisfactory than large doses 
at long intervals. Veratrum will slow the pulse down to a very few beats. 
Usually, however, emesis will then take place. This is why veratrum seldom 
or never poisons. Only in exceptional cases are the large doses permissible, 
as in puerperal eclampsia, in which, singularly, it seldom occasions vomiting. 
"Veratrum is less valuable than aconite in simple cardiac hypertrophy, 
though it quiets palpitation when blood pressure is high and the trouble is 
not due to valvular incompetency. It sometimes relieves the irritable 
heart of excessive tobacco users, especially when the heart action is strong 
and erratic. By retarding the velocity of the blood current and reducing 
vaso-motor tonus it does some good in aneurism. In all heart and circula- 
tory disorders, especially in hypertrophy, it does good when the pulse is 
full, strong, and intense, the carotids beat forcibly, the eyes are blood- 
shot, and there is cough, headache, and weight in the upper epigastrium, 
while the heart may beat so violently as to shake the bed, and sleep is 
entirely prevented. It relieves the excitement, the heart-action approaches 
the normal, the cough is allayed, and the patient is in every way better." 
(Locke.) 
692 MULLEIN 
(Verbascum Thapsus) 
Photo by Moritz Fischer, Cincinnati, Ohio 
Courtesy of Mr. Moritz Fischer 
Mullein, though little used at present, has in the past been of great importance in domestic 
medication-chiefly as a demulcent for coughs, and as a fomentation. Though it has never at- 
tained a great popularity among practitioners of medicine, still it has virtues to commend it. INDIVIDUAL DRUGS. 
VERATRUM ALBUM. 
The rhizome and roots of Veratrum album, Linne (Nat. Ord. Liliaceae). Europe, 
especially in the Alpine and Pyrenean districts. 
Common Names: White Hellebore, White Veratrum. 
Principal Constituents.-Protoveratrine (C32H51NO11), intensely poisonous; proto- 
veratridine, jervine (the most abundant principle), pseudo-jeruine, and rubijervine. No 
cevadine (veratrine) is present. 
Preparation.- Homoeopathic Mother Tincture of Veratrum Album. Dose, fractional 
(see below). 
Specific Indications.-Gushing, watery diarrhoea, with spasmodic or 
cramp-like action of the intestines and belly-walls; cold face, sunken eyes, 
and body covered with a cold sweat. 
Action and Therapy.-Though closely resembling Veratrum viride in 
effects, this agent is used for entirely different purposes, based upon Homoe- 
opathic usage. These are choleraic diarrhoea, cholera morbus, cholera 
infantum, and Asiatic cholera, to control the gushing discharges and check 
vomiting. The Homoeopathic mother tincture in 3x dilution in the pro- 
portion of thirty drops in four ounces of water is the usual form of ad- 
ministration, the dose being a teaspoonful of this mixture every fifteen to 
thirty minutes. It is not often used in this country. 
VERBASCUM. 
The leaves and tops of Verbascum Thapsus, Linne (Nat. Ord,Scrophulariaceae). A 
biennial common in the United States. Dose, 5 to 30 grains. 
Common Name: Mullein. 
Principal Constituents.-A volatile oil, a bitter principle, mucilage and resins. 
Preparation.-Specific Medicine Verbascum. Dose, 5 to 30 drops. 
Specific Indications.-Nervous and bronchial irritation, with cough; 
and urinary irritation with painful micturition. 
Action and Therapy.-Mullein is demulcent, diuretic and sedative. 
It is also thought to have feeble anodyne properties. A syrup of mullein, 
prepared with the addition of lemon juice, is a fairly good sedative for 
irritation of the trachea and bronchi with persistent cough. It is applicable 
to dry, hoarse coughs which annoy the patient when lying down, as well as 
to cough associated with abundant catarrhal discharges. The specific 
medicine may be used for the same purposes. A so-called oil of mullein, 
or rather mulleinized oil, prepared by steeping the blossoms in oil in the sun, 
has a fabulous reputation of being curative in earache from otitis media. 
A truer preparation is prepared by exposing the blossoms alone in a bottle 
to the heat of the sun. Owing to the small yield and the consequent high 
price it is seldom used, and probably is no more efficient than mulleinized 
oil, a concoction of very doubtful utility. 
VERBENA 
The whole plant of Verbena hastata, Linne (Nat. Ord. Verbenaceae). A common way- 
side and field weed in the United States. 
Common Names: Vervain, Common Vervain, Wild Hyssop, Simpler's Joy. 
Principal Constituents.-No satisfactory analysis has been made. 
Preparation.-Fluidextractum Verbence, Fluidextract of Verbena. Dose, 10 to 60 drops. 
Action and Therapy.-This drug is said to relieve gastro-intestinal 
693 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
irritation and stimulate menstruation. In recent years it has been lauded 
as a remedy for epilepsy characterized by cerebral anemia, instead of con- 
gestion, and therefore applicable to conditions contraindicating bromide 
medication. Its value remains to be established. 
VIBURNUM OPULUS. 
The bark of Viburnum Opulus, Linne (Nat. Ord. Caprifoliaceae). A shrub of Northern 
United States and Canada. 
Common Names: Cramp Bark, High Cranberry. 
Principal Constituents.-A bitter, neutral principle, viburnin, and valeric acid. 
Preparation.-Specific Medicine Viburnum. Dose, 5 to 60 drops. 
Specific Indications.-Cramps; spasmodic uterine pain; pain in thighs 
and back; bearing-down, expulsive pain; neuralgic or spasmodic dysmenor- 
rhoea. 
Action and Therapy.-Like black haw, this species of Viburnum is a 
uterine sedative and tonic and may be used where there is a predisposition 
to abortion, or as a partus praeparator. It is believed to have stronger anti- 
spasmodic properties than the black haw, and the special indication is 
cramps or cramp-like contraction of the hollow viscera, as well as of the 
voluntary musculature. It allays uterine irritation with a tendency to 
excite hysteria, and for spasmodic dysmenorrhoea it is highly regarded by 
competent practitioners. Briefly, the therapeutic scope of the drug covers 
cramps, especially of the calf of the leg, spasmodic uterine pain, bearing- 
down or expulsive pain, difficult, spasmodic or neuralgic dysmenorrhoea, 
spasmodic contraction of the bladder, hysteria, and some mild forms of 
convulsions. 
VIBURNUM PRUNIFOLIUM. 
The dried bark of the root of Viburnum prunifolium, Linne. The U. S.P. admits the 
dried bark of this and also of the Viburnum Lentago, Linne, or Wayfarer's Tree (Nat. Ord. 
Caprifoliaceae). Beautiful shrubs found in thickets of the eastern half of the United States. 
Dose, 5 to 60 grains. 
Common Names: (1) Black Haw, Sloe, Sloe-leaved Viburnum, Stag Bush; (2) Way- 
farer's Tree, Nanny Berry, Sheep Berry. 
Principal Constituents.-A brown, bitter resin; greenish-yellow, bitter, viburnin, valeric 
acid, tannic acid, citrates, malates, oxalates, sulphates, and chlorides of calcium, magnesium 
potassium, and iron. 
Preparations.-1. Specific Medicine Black Haw. Dose, 5 to 60 drops. 
2. Black Haw Cordial (Howe's). (Contains Black Haw, Wild Cherry, Aromatics, 
Brandy and Syrup). Dose, 1/2 to 2 fluidrachms. 
Specific Indications.-Uterine irritability and hyperaesthesia; uterine 
colic; threatened abortion; dysmenorrhoea, with cramp-like pelvic pain, 
and scanty flow; severe lumbar and bearing-down pelvic pain; painful 
contraction of the pelvic tissues; false pains and after-pains; obstinate 
hiccough. 
Action and Therapy.-Black haw is a remedy of Eclectic development 
and is praised by practitioners of all schools of medicine for its virtues in 
disorders of women. It is both tonic and antispasmodic, well-sustaining 
the time-honored meaning of those terms. While a tonic to the gastro- 
intestinal tract and a good one, black haw is better adapted to atonic states 
of the female reproductive organs, and as a sedative for spasmodic pain and 
weakness in diseases of women. As a tonic it acts kindly and is pleasant to 
694 INDIVIDUAL DRUGS. 
take. It causes no constitutional symptoms, such as sometimes come from 
the use of cinchona, nux vomica, and the more energetic tonics. It is 
agreeable to the stomach and tends to restrain unhealthy discharges. It 
allays the nervous unrest so commonly associated with pelvic weakness; 
and its effect upon cramp-like contraction of both the tubular organs and 
the voluntary musculature of the body is similar to that of cramp bark or 
Viburnum Opulus. 
As a uterine sedative and tonic, black haw is used, perhaps, oftener 
than any other drug. It seems to improve the uterine and ovarian circula- 
tion, giving better innervation and more perfect functioning, and evidently 
promotes pelvic nutrition. In relaxation of pelvic tissues, with more or less 
congestion, or tendency to undue discharges and passive hemorrhage, it is 
one of the best of medicines. For painful menstruation, whether due to 
debility with relaxation, or to engorged tissues with cramp-like pain, the 
physician will find almost daily use for black haw. Sometimes the menstrual 
flow is scanty, but more often it is profuse and accompanied by severe 
bearing down, intermittent and expulsive pains. Few agents give greater 
relief in such conditions. In cases in which the menses are imperfect in 
function and pale in quality, and there is an associated cardiac disturbance, 
usually palpitation; and in some cases of amenorrhoea, in anemic girls 
with pallor and subject to intermittent cramping pain, the action of the 
drug is very positive. It is equally valuable in chronic uterine inflammation, 
in subinvolution, in boggy, congested uterus, and for the associated leucor- 
rheal discharges. As a remedy for passive hemorrhage its use will be 
governed largely by the cause. If due to polypi, fibroid or carcinomatous 
tumors, but little can be expected from it or any other medicine. But even 
here, in combination with cinnamon, it sometimes restrains the flow. Such 
cases are surgical and should be surgically treated. Many a good medicine, 
like black haw, has been brought into discredit because of its failure to do 
what a careless or faulty diagnosis has led one to hope for from its exhibition 
or to attempting physical impossibilities with such medication. Black haw 
is a good tonic during pregnancy, and through such action proves a fairly 
good partus praeparator. It is one of the most certain remedies for noc- 
turnal cramping of the muscles of the leg. It does not act so well when due 
to pregnancy, as that is a pressure condition that can only be relieved by 
supporting the abdomen or a change of position in reclining. 
Many practitioners, whose opinions we value and whose experience 
has been wide, report success with black haw in restraining the expulsion 
of the product of conception. Our own experience leads us to doubt its 
reputed value in that condition, but this in noway disparages the statements 
of others who may have been more successful with it. Rest in bed and 
quieting agents, such as Dover's powder, may enable the product to be 
retained; perhaps black haw may aid. But we have utterly failed in every 
attempt to prevent miscarriage with the agent where there was any con- 
siderable hemorrhage or where enforced and prolonged rest was not in- 
sisted upon. If any results are to be expected from it in habitual abortion 
it must be in cases of functional debility of the reproductive organs, and 
not in those due to inherited taints or syphilitic infections, or criminal 
operative interference. We believe, however, that much may be done with 
695 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
black haw to strengthen conditions in cases having had a previous mis- 
carriage, and in uneasy, cramp-like sensations occurring during pregnancy, 
but with no considerable hemorrhage. It will, however, be of service in 
controlling the nervous phenomena associated with such threatened acci- 
dents and aid psychologically in preventing that which undue nervous 
agitation might precipitate. It is a good agent for false pains and for 
ovarian irritation and congestion. Black haw cordial is an ideal sedative 
for spasmodic dysmenorrhoea. 
Black haw is of very great value in treating those having a craving 
for alcoholic drinks. The specific medicine black haw, with essence of cin- 
namon or of cloves, or preferably Howe's Black Haw Cordial may be given. 
It relieves the discomfort experienced in the throat and the gnawing 
distress in the stomach, from which these unfortunates suffer. 
For most purposes the specific medicine black haw is given in doses 
ranging from five to sixty drops, two, three, or four times a day as indi- 
cated; the black haw cordial in doses of one half to two fluidrachms. 
The leaves and branches of Viscum flavescens, Pursh (Nat. Ord. Loranthaceae). A 
parasitic plant found upon forest trees, especially the oaks in America. 
Common Names: Mistletoe, American Mistletoe. 
Principal Constituent.- Viscin, a viscous substance also known as bird glue or bird 
lime. 
Preparation.-Specific Medicine Mistletoe. Dose, 1 to 30 drops. 
Specific Indications.-Determination of blood to the brain, flushed 
face and oft-recurring headache; paroxysms of tearing, rending neuralgic 
or rheumatic pains; weak, irregular heart-action, with cardiac hypertrophy, 
valvular insufficiency and shortness of breath. 
Action and Therapy.-Viscum has toxic properties. Vomiting and 
bloody and tenesmic catharsis, prostration, contraction of the pupils, 
muscular spasm, convulsions and coma have been reported from eating 
the plant and berries. Its action would suggest its possible value in nervous 
disorders, and it has been used like strychnine in heart disorders with feeble 
pulse, dyspnoea, oedema, and inability to lie down. It is also asserted to 
possess parturient properties, but they do not compare with those of ergot, 
and the drug is almost never used for these purposes. It should be reserved 
for the conditions mentioned under "Specific Indications", and even in 
these it needs further study. 
VISCUM. 
XANTHIUM. 
The whole plant of Xanthium spinosum, Linne (Nat. Ord. Cbmpositae). An intro- 
duced weed common along the coasts of the United States. Dose, 5 to 30 grains. 
Common Name: Spiny Clot-Bur. 
Principal Constituents.-Possibly an evanescent alkaloid and considerable nitrate of 
potassium. 
Preparation.-Specific Medicine Xanthium Spinosum. Dose, 1 to 60 drops. 
Specific Indications.-Ague, with profuse sweating; prophylactic 
against malaria, and to prevent the recurrence of chills; nervous excitation, 
with profuse sweating; bloody urine, with urination painfully tenesmic 
and freouent; urine heavilv loaded with mucus and gravelly deposits. 
696 INDIVIDUAL DRUGS. 
Action and Therapy.-Clotbur is used chiefly as a soothing diuretic, 
to allay irritable conditions of the bladder, and is especially recommended 
in chronic cystitis and haematuria. It is frequently used in conjunction 
with tincture of red onion, for irritation of the urinary tract with bloody, 
painfully voided urine loaded with mucus and gritty deposits. Its other 
uses cover the indications given above, unnatural sweating being an especial 
indication for the drug. 
XANTHIUM STRUMARIUM. 
The whole plant of Xanthium strumarium Linne (Nat. Ord. Composite). Waysides 
in the United States. 
Common Name: Broad Bur-Weed. 
Preparation.-Fluidextractrum Xanthii Strumarii, Fluidextract of Xanthium Stru- 
marium. Dose, 5 to 60 drops. 
Action and Therapy.-This agent acts much like clotbur, and has been 
used with advantage in painful urination, with scalding, and marked 
sensitiveness of the urethra and bladder, with frequent micturition. It is 
also said to be of service in hemorrhages, as passive hemorrhage from the 
bowels and the epistaxis of purpura hemorrhagica. For the last-named 
disorders it is probably of little value, though it should be tried where other 
means are unavailing. 
XANTHOXYLUM. 
The bark and berries of (1) Xanthoxylum americanum, Miller, and (2) Xanthoxylum 
Clava- Herculis, Lamarck (Nat. Ord. Rutaceae). Shrubs of North America. Dose, 5 to 60 
grains. 
Common Names: Frickly Ash; (1) Northern Prickly Ash; (2) Southern Prickly Ash. 
Principal Constituents.-A green acrid oil, a white crystallizable resin, a soft acrid 
resin, tannin, and a bitter substance thought to be an alkaloid. 
Preparation.-Specific Medicine Xanthoxylum. Dose, 5 to 60 drops. 
Specific Indications.-Hypersecretion from debility and relaxation of 
the mucosa (small doses); atony of the nervous system (larger doses); 
capillary engorgement in the eruptive diseases; sluggish circulation; tym- 
panites in bowel disorders; intestinal and gastric torpor, with deficient 
secretion; dryness of mouth and fauces, with glazed surface; flatulent colic; 
Asiatic cholera; uterine cramps and neuralgia. 
Action.-Prickly ash impresses the secretions and the nervous and 
circulatory systems. The bark, when chewed, imparts a sweetish aromatic 
taste, followed by bitterness and persistent acridity; the berries act similarly. 
The drug has remarkable sialagogue properties, inducing a copious flow of 
saliva and mucus. Swallowed, it warms the stomach and augments the 
secretion of the gastric and intestinal juices, and probably increases hepatic 
and pancreatic activity. The action of the heart is strengthened by xan- 
thoxylum, the pulse slightly quickened, and the glands of the skin are 
stimulated to greater activity. The urine is decidedly increased by prickly 
ash. 
Therapy.-Preparations of prickly ash bark are to be preferred when 
stimulant, tonic, sialagogue, and alterative properties are desired; that 
of the berries when a carminative stimulant and antispasmodic is needed, 
especially in disorders of the stomach and bowels. 
Xanthoxylum is particularly grateful in stomach disorders. It is an 
ideal gastric stimulant, and as a remedy for simple gastric atony it ranks 
697 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
well with capsicum. When food ferments readily and gaseous accumula- 
tions distend the stomach, and there is much belching, from five to fifteen 
drops of specific medicine xanthoxylum may be given, preferably in hot 
water, one hour before and one hour after meals. Both hydrastis and 
capsicum, or each of them, may be given with it, if indications are clear for 
them, and together the three agents offer comfort to those who suffer the 
distress of so-called flatulent dyspepsia. It is a remedy of much worth in 
atonic dyspepsia and in gastric catarrh, when there is enfeeblement and 
relaxation of tissues and hypersecretion. It is also of value in constipation 
when due to deficient secretion (small doses). Formerly it was greatly 
valued in spasmodic conditions of the bowels with colic, and in cholera 
morbus in weak individuals, and to restore tone and normal secretion after 
attacks of epidemic dysentery, a disease once more prevalent than at the 
present time. King introduced the tincture of the berries as a remedy for 
Asiatic cholera, in which it proved phenomenally successful; and for 
tympanitic distention of the bowels arising during peritonitis. As a rule, 
however, it should not be given in inflammatory conditions. 
As a stimulant to sluggish membranes prickly ash may be given in- 
ternally (and used locally) in dry, glazed pharyngitis with crusts of ad- 
herent, dried mucus. Of its alterative power there is no question, and 
prickly ash is an ingredient of a popular compound known as "Trifolium 
Compound", which has been extensively used in chronic syphilitic dyscrasia. 
It is not to be assumed that it has antisyphilitic virtues, but it exerts a 
favorable alterative action which renders syphilitics more amenable to 
reparation of tissues. Sometimes a tincture of prickly ash berries is the 
best drug that can be given in so-called chronic muscular rheumatism; and 
it is not without value in lumbago and myalgia. Chewing prickly ash bark 
is a domestic custom for the relief of toothache. 
Xanthoxlum should also be remembered where nerve force is low and 
in the recuperative stage from attacks of neuritis or other forms of nerve 
involvement in which function is greatly impaired but is yet capable of 
restoration. Xanthoxylum deserves further study, chiefly as an alterative. 
ZEA. 
The styles and stigmas of Zea Mays, Linne (Nat. Ord. Gramme®). The common 
Indian corn of America. 
Common Name: Corn Silk (Stigmata Maydis). 
Principal Constituents.-Volatile oil and maizenic acid. 
Preparations.-1. Infusum Zea, Infusion of Corn Silk. (Silk, gij; Boiling Water, 
Oj). Dose, Ad libitum. 
2. Specific Medicine Stigmata Maydis. Dose, 1/2 to 2 fluidrachms. 
Action and Therapy.-Zea {Stigmata Maydis) is diuretic, slightly 
anodyne, and is said to exert a stimulant effect upon the heart and blood 
vessels. The infusion, the best preparation, is an efficient stimulating 
diuretic in urinary irritation- and inflammation, pyelitis, and catarrh of the 
bladder. It is especially valued when the urine contains phosphatic and 
uric acid concretions, and there is a disposition to dropsical accumulations. 
Its action is quite positive in pyelitis, chronic cystitis and to relieve ardor 
urinae in gonorrhoea. For the bladder affections of children it is one of the 
most valued of urinary sedatives, and may be freely administered where 
698 INDIVIDUAL DRUGS. 
there is a disposition to decomposition of the urine while still in the bladder. 
The virtues are attributed mostly to the maizenic acid present. 
Precipitated Zinc Carbonate. 
Description.-An odorless and tasteless, white, impalpable powder; insoluble in 
water or alcohol. It is of a variable chemical composition. 
Action and Therapy.-Precipitated zinc carbonate, as well as a more 
impure form (prepared calamine) is feebly astringent and is employed 
chiefly as a dusting powder for infants and as a mild dessicant in chafing, 
intertrigo, simple ulcers, excoriated nipples, and abrasions. 
ZINCI CARBONAS PR^CIPITATUS. 
Zinc Chloride. (Formula: ZnCl2.) 
Description.-A very deliquescent white or whitish granular powder, or irregular 
porcelain-like masses, or molded pencils, without odor, and so intensely caustic as to 
make tasting dangerous, unless the salt be dissolved in a considerable quantity of water, 
when it has a metallic astringent taste. 
Preparation.-Liquor Zinci Chloridi, Solution of Zinc Chloride. An aqueous solution 
containing about 50 per cent of zinc chloride. 
Action and Toxicology.-In large doses chloride of zinc is a violent 
irritant poison, producing burning in the stomach, nausea, vomiting, 
dyspnoea, anxiety, small quick pulse, cold sweats, fainting, and convulsions. 
Applied undiluted to the tissues it unites with the proteins, forming difficultly 
soluble compounds; and acts as a prompt corrosive, penetrating deeply but 
limited in action to the parts to which it is applied. It is strongly anti- 
septic, and solutions of the salt are astringent and feebly haemostatic. In 
poisoning by zinc salts the stomach should be washed out and lenitives 
administered, such as demulcent drinks of starch and albumen in the form 
of milk or eggs. Lime water may also be used. 
Therapy.-External. Zinc chloride is the most commonly employed 
escharotic for the destruction of malignant growths. It is usually mixed 
with other agents to form a paste, and may be employed for the removal of 
epithelioma and carcinoma that cannot be removed by the knife, or when 
the patient will not submit to surgical measures. To be effectually de- 
structive it must be crowded into the growths until every part is reached, 
and it prevents hemorrhage by its mummifying action upon the tissues. 
The procedure is extremely painful, but is said to be less so than that with 
arsenic pastes. It is a safe escharotic as its action does not extend beyond 
the area of application. It penetrates deeply, and after a couple of weeks 
the tough and hard eschar separates, leaving a granulating surface which 
ordinarily heals rapidly. This, however, does not always cure the disease. 
Rarely zinc chloride is applied to gangrenous ulcers, and to chancre and 
chancroids, and very weak injections have been used in obstinate gonor- 
rhoea and gleet. The sulphate is more manageable, however, for injection 
purposes. 
Escatol (a combination of zinc chloride, salicylic acid and petrolatum 
in varying strengths) was devised and used by Howe for the destruction of 
warts, moles, scaly lupoid ulcers, chronic eczema, ringworm, sluggish leg 
ulcers, nasal polypus, fistulous tracts, fissure of the anus, wounds, in can- 
cerous growths, and in syphilitic ulcers of the mouth and throat. 
ZINCI CHLORIDUM. 
699 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Internal. Zinc chloride is not used as an internal medicine in Eclectic 
practice. 
ZINCI OXIDUM. 
Zinc Oxide. (Formula: ZnO.) 
Description.-A very fine, non-gritty, amorphous, white or yellowish-white powder; 
odorless and tasteless; insoluble in water or alcohol. It gradually absorbs carbon dioxide 
if exposed to the air. Dose, 1 to 10 grains. 
Preparation.- Unguentum Zinci Oxidi, Ointment of Zinc Oxide. (Zinc Salve) 20 per 
cent zinc oxide. 
Action and Therapy.-External. Zinc Oxide is a favorite dusting and 
dessicant powder, and in the form of the ointment is probably the most 
widely used protective and mild astringent in many skin affections. It is 
especially applicable to excoriations, simple ulcers, ulcers caused by burns 
and scalds, moist skin eruptions, chronic eczema, chapped surfaces, cracked 
nipples, fissures behind the ears, impetigo, and occasionally in tarsal 
ophthalmia. 
Internal. Rarely, zinc oxide is used in nervous dyspepsia when the 
tongue is broad and the abdomen full, in gastric ulcer, in chronic gastritis, 
with excessive secretion of mucus, and in colliquative night sweats. Con- 
tinued small doses produce gastro-intestinal and nervous derangements, 
and blood changes, while large quantities occasion diarrhoea, oedema and 
marasmus. 
ZINCI PHENOLSULPHONAS. 
Zinc Phenolsulphonate, Zinc Sulphocarbolate. (Formula: (C6H6O.SO3)2Zn-|-8H2O.) 
Description.-Transparent, colorless crystals or a granular powder, without odor but 
having a metallic astringent taste. Upon exposure it effloresces and may turn pink; soluble 
readily in water and alcohol. Dose, 1 to 3 grains. 
Specific Indications.-"Tongue pallid, moist, pasty and dirty" 
(Thomas); intestinal sepsis, with free, foul-smelling passages; tympanites; 
septic fever and hemorrhage in typhoid fever, and other septic bowel 
disorders. 
Action and Therapy.-External. Zinc sulphocarbolate is astringent 
and antiseptic. It is said to be superior to sulphate of zinc in injections for 
gonorrhoea. A 1 to 5 per cent solution is advised. 
Internal. The chief use for this drug is that of an intestinal anti- 
septic and for the septic fevers arising from a foul condition of the in- 
testinal tube. It checks fermentation, restrains hemorrhage, lowers temper- 
ature, and prevents and reduces tympanites. The best indication for it 
is that named by Thomas-"tongue pallid, moist, pasty and dirty". 
It may be used with benefit in typhoid fever, cholera infantum, septic 
diarrhoea, dysentery and the diarrhoea of phthisis. A trituration of equal 
parts of the salt and milk sugar, given in two to five grain doses, every 
two to four hours, is the best form for administering it. 
Zinc Phosphide. (Formula: Zn3Pj). 
Description.-A gritty, dark-gray powder, or crystalline fragments of a dark metallic 
luster, having a faint odor and taste of phosphorus. In contact with the air it slowly 
evolves a phosphorous vapor. It should, therefore, be kept in close containers. Neither 
water nor alcohol dissolves it. Dose, 1/100 to 1/10 grain. 
Specific Indications.-Cerebral anemia; brain fag, with pallid counte- 
ZINCI PHOSPHIDUM. 
700 INDIVIDUAL DRUGS. 
nance, insomnia, and depression; pain in any portion of the spinal cord; 
cerebral softening. 
Action and Therapy.-Following the indications given this drug may 
be used in conditions of debility with impaired nutrition of the brain and 
cord. It has been especially used in spinal irritation, cerebral exhaustion 
from brain-fag or anemia, in cerebral degeneration, in aphasia, locomotor 
ataxia, and paralysis agitans. As these conditions are not readily amenable 
to medication, too much must not be expected of this or any other drug. 
While some of these conditions have been improved by zinc phosphide, it has 
also utterly failed in most instances. A good method of administration is 
that of the 2x or 3x trituration in doses of one grain, four times a day. 
ZINCI SULPHAS. 
Zinc Sulphate. (Formula: ZnSO4.7H2O.) 
Description.-Transparent, colorless crystals, or a crystalline, granular powder, 
odorless but having an astringent metallic taste. It is very soluble in water and soluble in 
glycerin; insoluble in alcohol. Zinc sulphate closely resembles magnesium sulphate in 
appearance. Dose, 1 to 30 grains. 
Action.-In large doses zinc sulphate is an irritant poison causing vom- 
iting, cold extremities, fluttering pulse, and marked depression. It seldom 
causes death. In doses of ten to fifteen grains it is a rapidly acting emetic, 
and produces vomiting before nausea can take place. Moreover, it is but 
slightly depressant. 
Therapy.-External. In weak solution, one to six or eight grains to 
the fluidounce of water, sulphate of zinc forms a good collyrium for chronic 
ophthalmias, with loose tissues and flabby granulations. Though ordi- 
narily not commended for acute conjunctivitis, we have found a very dilute 
wash, one-half to one grain to the ounce, very effectual in acute catarrhal 
conjunctivitis and promptly curative in ophthalmia neonatorum. Zinc 
sulphate in very dilute solution forms a good injection for gonorrhoea, and 
together with Lloyd's Colorless Hydrastis is one of the best of gonorrhoea 
injections. 3 Colorless Hydrastis, fl3j; Zinc Sulphate, gr. ij; Water, q. s., 
flgij. Mix. Sig.: Inject and retain for a few minutes, after previous wash- 
ing out of the urethra with plain warm water. A solution may be used 
wherever an antiseptic astringent is needed and where tissues are lax and 
hypersecretion is abundant, as in leucorrhoea. 
Internal. Zinc sulphate is one of the best of emetics for narcotic 
poisoning, if given early before the nervous centers and terminal filaments 
have become obtunded. It is prompt, seldom nauseates, and causes little 
or no depression. It is also serviceable as an emetic when foreign bodies 
have lodged in the trachea. As a rule, it should not be used in poisoning 
by irritants. Sulphate of zinc was once employed for a number of nervous 
and gastro-intestinal disorders, for which it has long been discarded. 
ZINCI VALERAS. 
Zinc Valerate, Zinc Valerianate. (Formula: Zr^CsHsOj^-^HjO.) 
Description.-Pearly white scales or a white powder; to the taste sweetish, astringent 
and metallic. It has the odor of valeric acid. Soluble in alcohol and partly soluble in water. 
Dose, 1 to 3 grains. 
701 MATERIA MEDICA, PHARMACOLOGY, AND THERAPEUTICS. 
Action and Therapy.-Owing to its vile odor, zinc valerate is not a pop- 
ular salt. It has been used with varying degrees of success in paroxysmal 
neuralgia, as an antispasmodic, and to relieve pain. It is especially men- 
tioned for the relief of nervous headache, facial and sciatic neuralgia, and 
neuralgia of the spine. Watkins advised three to five grains of the 3x 
trituration in "colic, reflex from ovarian or uterine disease; headache; 
paleness; dizziness; sleeplessness; and anemia." 
The dried rhizome of Zingiber officinale, Roscoe (Nat. Ord. Zingiberaceae). Southern 
Asia; cultivated in tropical regions of Asia, Africa and America. Dose, 10 to 30 grains. 
Common Names: Ginger. (There are many kinds and grades: Jamaica Ginger, African 
Ginger, Calcutta Ginger, Calicut Ginger, Cochin Ginger, and Japanese Ginger.) 
Principal Constituents.-An aromatic volatile oil (Oil of Ginger), 2 to 3 per cent giving 
to ginger its flavor; resin, and gingerol, the pungent principle. 
Preparations.-1. Specific Medicine Zingiber. Dose, 1 to 30 drops. 
2. Oleoresina Zingiberis, Oleoresin of Ginger. Dose, 1/2 to 1 grain. 
3. Tinctura Zingiberis, Tincture of Ginger. 5 to 60 minims. 
4. Syrupus Zingiberis, Syrup of Ginger. Dose, 1 to 4 fluidrachms. 
Specific Indications.-Anorexia; flatulence; borborygmus; gastric and 
intestinal spasms; acute colds; painful menstruation; cold extremities; 
cool surface in children's diseases. 
Action.-Ginger is a local irritant and rubefacient. It causes an in- 
creased flow of saliva and gastric juice and increases muscular activity of 
the stomach and intestines. It is much used to conceal the taste of nauseous 
medicines and to prevent tormina. Ginger is sometimes used as an in- 
gredient of so-called "spice poultices". 
Therapy.-Ginger is an admirable local stimulant, sialagogue, di- 
aphoretic and carminative. Powdered ginger in a large quantity of cold 
water, taken upon retiring, will frequently "break up" a severe cold, and a 
hot infusion or ginger tea is a popular remedy for similar use and to estab- 
lish sluggish menstruation or mitigate the pains of dysmenorrhoea. Ginger 
is an excellent agent in gastric atony, and good results may be had from it 
in atonic states of the digestive tube, with loss of appetite, rolling of gases 
in the bowels, and painful spasmodic contractions of the stomach and 
intestines. In acute dysentery and diarrhoea, and in cholera morbus and 
sometimes in cholera infantum with atony and nausea, vomiting and cold 
extremities and surface, small doses of ginger preparations are extremely 
valuable. Cramps in the stomach and bowels due to undigested food or to 
cold are speedily relieved by small doses of ginger. Ginger combined with 
magnesium oxide or sodium bicarbonate is a good gastric stimulant and 
corrective in persistent flatulency with sour stomach, and given alone is 
useful for old people with feeble digestive powers and enfeebled and lax 
habit. 
Rarely, tincture of ginger or specific medicine zingiber is serviceable in 
fevers, when the salivary secretions are scanty and there is pain and move- 
ment of gases in the intestines. It relieves by stimulating secretion, the 
ultimate effect being sedative. In such states it acts much like capsicum, 
but is not so efficient. Oleoresin of ginger may be added to pills to prevent 
griping and tormina; and the syrup is an agreeable vehicle for stomachic 
and sometimes for expectorant mixtures. 
ZINGIBER. 
702 Index. 
A 
Abbreviations, words, and phrases.... 74 
Abies 112 
canadensis 112 
Absinthe 113 
Absinthin 112 
Absinthium 112 
infusion of. 112 
Absinthol 112 
Absorbability of medicines 35 
Absorbents 78, 79, 85, 87, 91 
Absorption, rate of (of medicines).... 36 
Acacia 113 
mucilage of 113 
Senegal 113 
syrup of 113 
Aceta 32 
Acetanilid (e) 114 
Acetanilidum 114 
Acetone-chloroform 293 
Acetphenetidin 116 
Acetphenetidinum 116 
Acetum scillae 621 
Achillea 117 
Millefolium 117 
Specific Medicine 117 
Achilleine 117 
Acid, acetic 117, 118 
diluted 117, 118 
glaciale 117, 118 
acetyl-salicylic 120 
achilleic 117 
aconitic 117, 355 
agaric 249 
angelic 670 
anisic 189 
anthemic 475 
antirrhinic 333 
arabic 113 
arsenous 208 
benzoic 120 
boracic 122 
boric 122 
ointment of 122 
caffeo-tannic 256 
cambogic 266 
camphoric 269 
carbazotic 682 
carbolic 519 
liquefied 519 
carobic 437 
catechuic 382 
catechutannic 382 
cathartinic 627 
cathartogenic 627 
cephaelic 432 
cetraric 655 
chelidonic 285 
chromic 301 
chrysophanic 599, 627 
cinchotannic 303 
cinnamic 447 
Acid, citric 123, 345, 382, 552 
columbic 263 
crotonoleic 499 
cubebic 328 
digallic 145 
digitalic 333 
equisetic 355 
eriodictyonic 361 
euonic 364 
filicic 228 
formic 684 
gallic 124, 382, 391 
gallitannic -.. 382 
gallotannic 145 
gelsemic 380 
gelseminic 385 
gentisic 381, 390 
gossypic 395 
guaiacic 399 
guaiaconic 399 
guaiaretic 399 
gynocardic 400 
hydriodic, diluted 130 
syrup of 130 
hydrobromic dilute 125 
hydrochloric 126 
diluted 126 
dilute, Specific Medicine 126 
hydrocyanic 185, 582 
diluted 128 
igasuric 425 
ipecacuanhic 432 
iron 448 
isoanemonic 583 
juglandic 438 
kinic 303 
kinotannic 440 
kolatannic 441 
kombic 659 
krameria-tannic 441 
lactic 130 
bacillus 131 
lactucic 442 
lauric 481 
lobelic 455 
maizenic 684, 698 
malic 245, 285 
melilotic 477 
methylene-citryl-salicylic 120 
methysticic 546 
muriatic 126 
diluted 126 
myricinic 481 
nitric 132 
nitrohydrochloric 134 
diluted 134 
nitromuriatic 134 
orthocoumaric 477 
orthohydroxybenzoic 137 
oxalic 135, 552 
parasulphondichloraminobenzoic... 642 
parillic 620 
703 INDEX. 
Acid, phosphoric 136 
dilute 136 
phytolaccic 535 
picric 682 
podophyllic 555 
Prussic, diluted 128 
Scheele's 128 
punico-tannic 396 
quercitannic 588 
quinic 303 
ratahnia-tannic 441 
rheo-tannic 599 
ricinoleic 494 
rubichloric 382 
rutic 611 
salicylic 137 
salts of bile 370 
sanguinarinic 615 
sclerotic 684 
solution of iron (Howe's) 447 
sphacelinic 356 
stictic 655 
sulphuric 141 
aromatic 141 
dilute 141 
sulphurous 143 
Specific Medicine 143 
sumbulic 670 
tannic 22, 145, 588 
glycerite of 145 
ointment of 145 
tartaric 148 
thymic 674 
toxicodendric 602 
trichloracetic 117, 119 
valeric 614, 670, 694 
Acids, organic 25 
Acidum aceticum 117 
dilutum 117 
glaciate 117 
acetylsalicylicum 120 
benzoicum 120 
boricum 122 
chromicum 301 
citricum 123 
gallicum 124 
nydriodicum dilutum 130 
hydrobromicum dilutum 125 
hydrochloricum 126 
dilutum 126 
hydrocyanicum dilutum 128 
lacticum 130 
nitricum 132 
nitrohydrochloricum 134 
dilutum 134 
oxalicum 135 
phosphoricum 136 
dilutum 136 
salicylicum 137 
sulphuricum. 141 
aromaticum 141 
dilutum 141 
sulphurosum 143 
tannicum 145 
tartaricum 148 
trichloraceticum 117, 119 
Aconine 148 
Aconite 148 
Specific Medicine 148 
tincture of 148 
Fleming's 148 
Aconitine 148 
Aconitum 148 
napellus 148 
Acorin 259 
Acorus Calamus 259 
Actaea 154 
alba 154 
Specific Medicine 154 
Action, cumulative 37 
drug, general nature 32 
effects of 32 
general nature of drug 32 
physiological 11 
salt 40 
Adeps 155 
benzoinatus 155 
lanae 155 
hydrosus 155 
Administration, methods of 40 
of medicines 36, 40 
Adonidin 156 
Adonis 156 
Specific Medicine 156 
vernalis 156 
Adrenalin 107, 353 
chloride 353 
/Esculetin 156 
jEsculin 156, 406 
/Esculus 156 
glabra 156 
Hippocastanum 406 
Specific Medicine 156 
Asther 157 
/Ethylene bromide 168 
-Ethylis bromidum 168 
chloridum 168 
Affinity, selective drug 34 
African chillies 275 
Agar 169 
-agar 169 
Agaric, fly 169 
larch 249 
purging 249 
white 249 
Agaricin 246 
Agaricol 249 
Agaricus... 169 
muscarius 169 
tincture of 169 
Agedolite.... 178 
Agents, coloring 53 
flavoring 108 
sweetening 108 
Agrimonia 170 
Eupatoria 170 
Specific Medicine 170 
Agrimony 170 
Agropyron repens 682 
Ague weed 364 
Alcohol 170 
absolute 170 
dehydrated 170 
dehydratum 170 
704 INDEX. 
Alcohol, diluted 170 
dilutum 170 
ethyl.... 170 
prescriptions for 61 
Alcoholism, acute 172 
chronic 173 
Alcresta ipecac 432 
Alder, black 177, 582 
buckthorn 380 
common 177 
red... 177 
smooth 177 
tag 177 
Aletris 175 
farinosa.. ... . 175 
Specific Medicine 175 
Alkalizers 82 
Alkaloids 22 
historic note on 23 
poisoning by 24 
Allantoin 370, 670 
Allium Cepa 176 
juice of 176 
sativum 176 
syrup of 176 
Allspice. . . 546 
Allyl isothiocyanate 633 
Alnus 177 
decoction of 177 
serrulata . 177 
Specific Medicine 177 
Aloe 177 
ferox 177 
Perryi 177 
vera 177 
Aloes, cape 177 
Curasao 177 
pills of 177 
socotrine 177 
tincture of 177 
Aloin 177 
Aloinum . 177 
Alteratives 81, 82, 84 
Althaea 178 
decoction of 178 
infusion of 178 
officinalis 178 
syrup of 178 
Althein 178 
Alum .... 179 
ammonia 179 
burnt 179 
dried 179 
exsiccated 179 
potassium 179 
Alumen 179 
exsiccatum 179 
ustum 179 
Alypin 313 
Amanita muscaria 169 
phalloides 169 
Amaroids 25 
American aspen 561 
columbo 381 
elder 614 
hellebore 687 
ipecac 368 
American ipecacuanha 368 
liverleaf 405 
mistletoe 696 
poplar 561 
saffron 279 
valerian 330 
wormseed 286 
Aminoform 405 
Ammonia alum 179 
Ammonia, muriate of 183 
water 197 
Ammoniated mercury 408, 416 
Ammonii benzoas 181 
bromidum 181 
carbonas 181 
chloridum 183 
iodidum 185 
Ammonio-ferric alum 372 
citrate 372 
sulphate 372 
tartrate of iron 373 
Ammonium acetate, solution of 447 
benzoate 181 
bromide 181 
carbamate 181 
carbonate 181 
chloride 183 
ichthyol 425 
sulphonate 425 
iodide 185 
Amygdalin 185, 582 
Amygdalis 185 
Persica 185 
Specific Medicine 185 
Amyl nitris 186 
nitrite 186 
Amylum 188 
Anaesthesine 313 
Anaesthetics 97, 101, 103 
Analgesics 97, 101 
Anamirta paniculata 313, 538 
Anaphrodisiacs 104, 105 
Anaphylaxis 106 
Anarcotine 500 
Andromedotoxin 440 
Anemone, meadow 278 
pratensis 583 
Pulsatilla 583 
Anemonin 583 
Anemopsis 188 
californica 188 
Specific Medicine 188 
Anethol 189 
Anhydrotics 85, 91, 94 
Animal charcoal 278 
extracts 107 
organs 107 
Anise 189 
star 189 
Aniseed 189 
Anisum 189 
Anodynes 97, 101, 103 
Antacids. . . . 85, 87, 91 
Antagonists 38 
Anthelmintics 79, 80, 81 
Anthemidine 475 
Anthemis 189 
705 INDEX. 
Anthemis, infusion 189 
nobilis 189 
oil of। . . 189 
Specific Medicine 189 
Antiasthmatics 96 
Antibilious physic 437, 627 
Anticonvulsants 97, 101, 104 
Antidote, arsenic 374 
Antidotes 108 
chemical 108 
Antiemetics 85, 87, 91 
Antifebrin. . . 114 
Antifermentatives 85, 88, 92 
Antigalactagogue 85, 90, 94 
Antigalactagogues 104 
Antihemorrhagics 97, 102, 104 
Antihysterics 101 
Antilithics 85, 90, 93 
Antimalarials 80 
Antimony, vegetable 364 
Antiparasitics 80 
Antiperiodics 80, 81 
Antiphlogistine 394 
Antipruritics. 97, 101, 103 
Antiputrefactives 85 
Antipyretics 81, 85 
Antipyrina 190 
Antipyrine 190 
Antiseptics 79, 81 
gastro-intestinal 85, 88, 92 
urinary 85, 90, 93 
Antisialagogues 86 
Antisialics 86 
Antispasmodics 94, 97, 101, 103 
Antitoxin . , 105 
concentrated, diphtheria 630 
diphtheria ■ • ; 107, 629 
dried, diphtheria 630 
refined and concentrated, diphtheria. 630 
tetanus 107, 631 
concentrated 631 
dried 631 
Antizymotics 80 
Aperients 88 
Aphrodisiacs 104, 105 
Apiol 519 
Apis 192 
mellifera....... 192, 283, 477 
Specific Medicine 192 
Apple, bitter 318 
lemon 555 
May 555 
wild balsam 351 
Application of medicines 40 
Aphrodaescin 406 
Apocynamarin 193 
Apocynein 193 
Apocynin 193 
Apopynum 193 
cannabinum 193 
Specific Medicine 193 
Apomorphinae hydrochloridum 196 
Apomorphine hydrochloride 196 
Aporetin 599 
Apothesine 313 
Aqua ammoniae 197 
anisi 189 
Aqua calcis 264 
camphorae 267 
chloroformi 294 
hydrogenii dioxidi 199 
menthae piperitae 478 
menthae viridis 479 
picis liquidae 551 
regia 134 
rosae 201 
Aquae 26 
aromaticae 26 
medicatae 26 
Arabin 113 
Arachin ; 493 
Aralia 201 
decoction of 201 
hispida 201 
quinquefolia 511 
racemosa 202 
Specific Medicine 201 
Arbor vitae 677 
oil of 677 
Arbutin 288, 352, 383, 440, 587, 685 
Arbutus, trailing 352 
Arctostaphylos Uva-ursi 685 
Areca Catechu 383 
Argenti nitras 202 
fusus 202 
Arginine 583 
Argol 148 
Argyraescin 406 
Argyria 203 
Argyrol 205 
Arisaema 205 
tincture of 205 
triphyllum 205 
Aristol 675 
Aristolochia reticulata 629 
Serpentaria 629 
Arnica 205 
montana 205 
Specific Medicine 205 
tincture of 205 
Arnicine 205 
Aromatic collinsonia 315 
Arseni trioxidum 208 
Arsenic 208 
antidote 374 
bromide 213 
preparations and substitutes 213 
trioxide 208 
white 208 
Arsenobenzol 214 
Arsenous oxide 208 
Arsphenamine 214, 220 
substitute for 219 
Artemisia Absinthium 112 
pauciflora 618 
Asafetida 221 
emulsion of 221 
gum 221 
milk of 221 
tincture of 221 
Asafcetida 221 
Asagraea officinalis 686 
Asarum 221 
canadense 221 
706 INDEX. 
Asarum, infusion of 221 
syrup of 221 
tincture of 221 
Asclepiadine 225 
Asclepias 222 
Cornuti 224 
flesh-colored 225 
incarnata 225 
Specific Medicine 222 
tincture of 224 
tuberosa 222 
Asepsin 225 
soap 225, 227 
solution of borated 225 
Ash, black 381 
elder-leaved 381 
northern prickly 697 
prickly 697 
southern prickly 697 
wafer 583 
white 381 
Asparagin 178, 364, 395 
Asparagine 670 
Aspen, American 561 
quaking 561 
Aspidium 228 
oleoresin of 228 
Aspidosamine 228 
Aspidosperma 228 
fluidextract of 228 
Quebracho-bianco 228 
Aspidospermatine 228 
Aspidospermine 228 
Aspirin 120 
Asthma weed, Queensland 368 
Specific Medicine 368 
Astringents -.78, 79, 85, 88, 92 
urinary 85, 90, 93 
Atomization 41 
At oxy 1 214 
Atropa Belladonna 239 
Atropina 229 
Atropinae sulphas 229 
Atropine 229, 239, 657 
sulphate 229 
Aurantiamarin 233 
Aurantii amari cortex 233 
dulcis cortex 233 
Auri et sodii chloridum 234 
Ava 546 
pepper shrub 546 
Avena 235 
sativa 235 
Specific Medicine 235 
tincture of 235 
A venae farina 235 
Avenine 235 
B 
Bacillus, lactic acid 131 
Bacterins 105, 106 
Baking soda 635 
Balm, mountain 361 
Balmony 286 
Balnea 26 
Balsam jewel weed 426 
Balsam of Peru 236 
Balsam weed 426 
Balsama 20 
Balsams 20 
solid 19 
Balsamum peruvianum 236 
Baneberry, white 154 
Baptin 237 
Baptisia. 237 
decoction of 237 
Specific Medicine 237 
tinctoria 237 
Baptisin 237 
Baptisine 237 
Baptitoxine 237 
Barberry 245 
common 245 
Barbital 238 
-sodium 238 
Barbitonum 238 
Bark, Huxham's tincture of 303 
oak . 588 
decoction of 588 
white 588 
thin cascara 599 
Barks 15 
Barley 407 
decoction of 407 
water 407 
Barm 284 
Barosma betulina 253 
camphora 253 
serratifolia 253 
Specific Medicine 253 
Basham's mixture 450 
Basic remedy 59 
Bastard saffron 279 
turnip 250 
Baths 26 
medicated 26 
simple 26 
Bayberry 481 
Beach's diaphoretic powder 501 
Bean, Calabar 532 
ordeal 532 
St. Ignatius 425 
tree 281 
Bearberry 685 
Bear's foot 560 
Bedstraw 382 
Beer yeast 284 
Beeswax 283 
Belladonna 239 
leaves 239 
ointment 239 
root 239 
Belladonnae folia 239 
radix 239 
Belladonnine 239 
Benzaconine 148 
Benzosulphinid 243 
sodium 243 
Benzosulphinidum 243 
sodium 243 
Benzoyl mono-hydrochloride 313 
Benzylic cinnamate 236 
Berbamine 244, 245 
707 INDEX. 
Berberine....244, 245, 263, 324, 381, 
417, 438, 478, 514 
hydrochlorate , 417 
Berberis 244 
aquifolium 244 
Specific Medicine 244 
vulgaris 245 
Beta eucaine 312 
Beta-methyl-aesculetin 385 
Betanaphthol 245 
Beta vulgaris var. Rapa 611 
Betony, Paul's 464 
Bigarade orange 233 
Bilifuscin 370 
Bilirubin 370 
Biliverdin...., 370 
Birch, oil of 137 
Bird glue 696 
lime 696 
Bismuth betanaphthol 246 
subcarbonate 246 
subgallate 246 
subnitrate 246 
subsalicylate 246 
Bismuthi subnitras 246 
Bissy-bissy 441 
Bitter apple 318 
cucumber 318 
orange 233 
peel 233 
principles 25 
salts 471 
Bittersweet 346 
Bitter wood 588 
Black alder 177, 582 
ash 381 
cohosh 466 
draught 627 
haw 694 
cordial (Howe's) 694 
Specific Medicine 694 
hellebore 404 
mustard 633 
pepper 546 
root 443 
snakeroot 466 
tang 381 
Blackberry 610 
low 610 
low-bush 610 
syrup of 610 
Bladder-wrack 381 
Blaud's pill 371 
Blazing star 175, 404, 445 
Bleaching powder 265 
Bloodroot 615 
compound acetated tincture of. . .. 615 
Blooming spurge 367 
Blue cohosh 282 
flag 435 
larger 435 
methyl 480 
methylene 480 
stone 331 
vitriol 331 
Boletus 249 
laricis 249 
Boletus, Specific Medicine 249 
Bone phosphate 261 
Boneset 364 
infusion 364 
Borated asepsin 225 
Borax 637 
Borneol 629 
Boroglyceride, solution of 122 
Boroglycerin, glycerite of 122 
Bostaurus., 511 
bile of.,.,, 370 
Bowman root 443 
Boxberry 383 
Bran 370 
Brandy...., 170 
Brassica nigra 633 
Brauneria angustifolia 347 
Brayerin 330 
Brewer's yeast 284 
Bristle-stem sarsaparilla 201 
Broad bur-weed 697 
Bromelin 25 
Bromine 249 
Bromism 567 
Bromum 249 
Broom 623 
Irish 623 
tops 623 
Brown mustard 633 
Brucine 425, 485 
Bryonia 250 
alba 250 
dioica 250 
Specific Medicine 250 
Bryonin 250 
Bryony 250 
Buchu 253 
long 253 
short 253 
Buckeye, fetid 156 
Ohio 156 
smooth 156 
Buckthorn 380 
aider.... 380 
California 599 
Bugle 464 
sweet 464 
weed 464 
Bulbi 15 
Bulbs 15 
Bull-nettle 649 
Burning bush 364 
Burweed, broad 697 
Butter, cacao 499 
Butterfly-weed 222 
Butternut 438 
extract of 438 
Button snakeroot 361, 445 
Butyl-chloral hydrate 293 
Buxine 514 
C 
Caaroba 437 
Cabbage, meadow 345 
skunk 345 
Cacao, butter (of) 499 
Cachetae 26 
708 INDEX. 
Cachets 26 
Cactus. 253 
Eandiflorus 253 
rge-flowering 253 
Specific Medicine 253 
sweet-scented 253 
Cade, oil of 490 
Caffea 256 
arabica 256, 257 
Caffeina 257 
citrata 257 
effervescens 257 
Caffeine 256, 257, 440, 441 
citrate 257 
citrated 257 
effervescent citrated 257 
sodio-benzoate 257, 258 
sodio-salicylate 258 
Caffeinae sodio-benzoas 257, 258 
Caffeol 256 
Cajeput, compound tincture of 491 
Cajuput, oil of 491 
compound liniment of 491 
compound mixture of 491 
compound tincture of 491 
Cajuputol 491 
Calabar bean 532 
Calabarine . 532 
Calamus 259 
Specific Medicine 259 
syrup of 259 
Calcii bromidum 259 
carbonas praecipitatus 328 
chloridum 259 
hypophosphis 260 
iodidum 260 
phosphas praecipitatus 261 
sulphas exsiccatus 261 
sulphidum crudum 262 
Calcium bromide 259 
chloride 259 
glycerophosphate 261 
syrup of 261 
hydroxide, solution of 264 
hypochlorite 265 
hypophosphite 260 
iodide 260 
lactate 260, 261 
lactophosphate 261 
monoxide 264 
phosphate, precipitated 261 
sulphate, dried 261 
sulphide, crude 262 
Calendula 262 
borated 262 
officinalis 262 
Specific Medicine 262 
Calendulin 262 
California buckthorn 599 
coffee tree 599 
Calisaya bark 303 
Calomel 408, 409, 416 
Calumba 263 
infusion of... ; 263 
Specific Medicine 263 
Calx .... 264 
chlorata... 265 
Calx, chlorinata 265 
sulphurata 262 
Camboge 266 
Cambogia 266 
Camphor 266 
barosma 253 
cerate 267 
gum 266 
ice 268 
laurel 266 
liniment 267 
monobromated 269 
phenolized 523 
tar , 246 
water 267 
Camphora ., 266 
monobromata 269 
Camphorae 20 
Camphors 20 
Cannabinon 270 
Cannabis 270 
indica 270 
sativa 270 
var. indica 270 
Specific Medicine 270 
Canada fleabane 360 
pitch 112 
snake root 221 
Canadian moonseed 478 
Canadine 417 
Candle berry 481 
Canker lettuce 587 
root 324 
Cannabin 270 
Cantharides 273 
cerate 273 
Cantharidin 273 
Cantharis , 273 
Specific Medicine 273 
vesicatoria 273 
Cape aloes 177 
Capsella Bursa-pastoris 274 
infusion of 274 
Specific Medicine 274 
Capsicain 275 
Capsicin 275 
Capsicum , 275 
frutescens...., 275 
plaster, , ,. 275 
tincture of 275 
Capsulae 26 
Capsules...., 26 
Caraway 279 
fruit 279 
oil 279 
seed 279 
Specific Medicine 279 
Carbasus iodoformata 428 
Carbo animalis 278 
ligni , 277 
vegetabilis 277 
trituration of 277 
Cardamom 278 
seeds 278 
Cardamomi semen 278 
Cardamon 278 
Specific Medicine 278 
709 INDEX. 
i Cardamon, compound tincture of 278 
' Cardiants 94, 96 
Carica Papaya 512 
Caricine 512 
Carminatives 85, 86, 91 
Caroba 437 
Carobin 437 
Carob tree 437 
Caroid.... 512, 513 
Carolina jasmin 385 
pink 651 
Carron oil 264 
Cartagena ipecac 432 
Carthamus 279 
tinctorius 279, 328 
Carum 279 
Ajowan 674 
carvi 279 
Caryophyllin 279 
Caryophyllus 279 
Cascara bark, thin 599 
sagrada 280 
extract of 280 
fluidextract of 280 
Specific Medicine 208 
Cascarin 280 
Cassia acutifolia 627 
angustifolia 627 
marilandica 280 
compound infusion of 280 
oil 304 
Castanea 281 
dentata 281 
fluidextract of 281 
infusion of 281 
Castor oil 494 
Catalpa 281 
bignonioides 281 
Specific Medicine 281 
Cataplasma lini 446 
Cataplasmata 29 
Cataria 281 
infusion of 281 
Specific Medicine 281 
Catch-weed 382 
Catechin 382 
' Catechu, pale 382 
Cathartics 85, 88, 92 
Cathartin 280 
Catmint 281 
Catnep 281 
Catnip 281 
Cat's hair 368 
Caulophyllin 282 
Caulophylline 282 
Caulophyllum.... 282 
Specific Medicine 282 
thalictroides 282 
Caustics 78, 79 
Cayenne pepper 275 
Ceanothine 283 
Ceanothus 283 
americanus 283 
Specific Medicine 283 
Cedar, false white 677 
yellow 677 
Celandine 285 
Celandine, great 285 
Cellular drugs 18 
therapy 13 
Cephaeline 432 
Cephaelis Ipecacuanha 432 
Cera alba 283 
flava 283 
Cerae 21 
Cerata 26 
Cerate.... 155 
blistering 273 
camphor 267 
cantharides 273 
rosin 597 
simple 155, 283 
Cerates 26 
medicated 26 
simple 26 
Ceratum 155, 283 
camphorae 267 
cantharidis 273 
resinae 597 
Cereus grandiflorus 253 
night-blooming 253 
Cerevisiae fermentum 284 
Cerii oxalas 284 
Cerium oxalate 284 
Cetaceum 284 
Cevadine 687 
Ceylon cinnamon 304 
Chalk, drop 328 
French 672 
mixture 328 
powder, compound 328 
precipitated 328 
prepared 328 
Chamaelirin 404 
Chamaelirium luteum 404 
Chamomile 189 
English 189 
German 475 
Roman 189 
wild 475 
Charcoal 277 
animal 278 
wood 277 
Chartae. 28 
Chaulmoogra 400 
Chaulmugra 400 
oil of 400 
tree, true. (See Preface). 
Chavicine 546 
Checkerberry 480 
Chelerythrine 285, 615 
Chelidonine .... 285 
Chelidonium 285 
ma jus 285 
Specific Medicine 285 
Chelone 286 
glabra 286 
Specific Medicine 286 
Chenopodium ambrosioides anthel- 
minticum 286, 491 
oil of 491 
Cherry, black 582 
wild 582 
Chestnut 281 
710 INDEX. 
Chicken toe 322 
Chillies, African 275 
Chimaphila 288 
infusion of 288 
Specific Medicine 288 
umbellata 288 
Chimaphilin 288 
China orange 233 
Chionanthin 286 
Chionanthus 286 
Specific Medicine 286 
virginicus 286 
Chittem bark 280 
Chloral.. 288 
butylicum 293 
formamide 293 
hydrate 288 
hydrated 288 
Chloralamine 293 
Chloralism 290 
Chloralose 293 
Chloralum hydratum 288 
Chloramines 642 
Chloramine-T 642 
Chlorazene 642 
Chlorcosane 642 
Chloretone 293 
Chloroform 294 
and ether, comparison of 166 
habit 297 
liniment 294 
or ether 162 
resuscitation from 165 
spirit of 294 
water 294 
Chloroformum 294 
Cholagogues 85, 88, 92 
Cholesterin 370 
Chondodendron tomentosum 514 
Christmas rose 404 
Chromic trioxide 301 
Chromii sulphas 302 
trioxidi 301 
Chromium sulphate 302 
Chrysanthemum Leucanthemum 444 
Chrysarobin 302, 599 
ointment 302 
Chrysarobinum 302 
Chrysophan 280, 599 
Chrysotoxine 356 
Cigar tree ,... 281 
Cimicifuga racemosa 466 
Cimicifugin 466 
Cineol 362, 442, 491 
Cinchona 303 
bark, red 303 
Calisaya 303 
fluidextract of 303 
. Ledgeriana 303 
red 303 
rubra 303 
Specific Medicine 303 
succirubra 303 
tincture of 303 
compound 303 
Cinchonidine 303 
Cinchonine 303 
Cinchonism 304 
Cinnamein 236 
Cinnamon 304 
Ceylon 304 
oil 304 
saigon 304 
Cinnamomum 304 
Camphora 266 
saigonicum 304 
Specific Medicine 304 
zeylanicum 304 
Citcelce 605 
Citrullus Colocynthis 318 
Citrus Aurantium amara 233 
medica Limonum 446 
sinensis 233 
Classes of medicines 26 
Classification of drugs, therapeutic.... 78 
Claviceps purpurea 356 
Cleavers 382 
Clove 279 
oil of 279 
Clover, red 681 
yellow melilot 477 
yellow sweet 477 
Cloves. . .; 279 
Specific Medicine 279 
Clysteria 26, 27 
Clysters 26, 27 
Cobweb 673 
Coca 306 
fluidextract of 306 
Cocaina 307 
Cocainae hydrochloridum 307 
Cocaine 306, 307 
hydrochloride 307 
substitutes 312 
Cocculus 313 
indicus 313 
ointment of 313 
Cockleburr 170= 
Codeina 314, 50L 
Codeinae phosphas 314, 501 
sulphas 314, 501 
Codeine 314, 500 
phosphate 314 
sulphate 314 
Cod liver oil 492 
emulsion of 492 
Cod oil 492 
Coffee 256 
infusion of 256 
Coffee tree, California 599 
Cohosh, black 466 
blue 282 
white 154 
Cola 441 
Colchici cormus 314 
semen 314 
Colchicina 314 
Colchicine 314 
Colchicum 314 
autumnale 314 
corm 314 
seed 314 
Specific Medicine 314 
Cold cream 201 
711 INDEX. 
Colic root A 344 
Collinsonia 315 
aromatic 315 
canadensis 315 
Specific Medicine 315 
Collodion 317 
blistering 273, 317 
cantharidal 273, 317 
flexible 317 
styptic 317 
vesicating 273, 317 
Collodions 26 
medicated 26 
simple 26 
Collodium 317 
cantharidatum 273, 317 
flexile 317 
Colloid (definition) 31 
Colloidal Specific Medicines 31 
Colloidums 26, 31 
Collyria 27 
Colocynth 318 
pulp 318 
Specific Medicine 318 
Colocynthin 318 
Colocynthis 318 
Colombo 263 
Colophony 597 
Coloring agents 53 
matter 22 
substances 108 
Colorless hydrastis 417 
Coltsfoot 683 
Colt's tail 360 
Columbin 263 
Columbine 263 
Columbo 263 
American 381 
Comfrey 670 
Commiphora (species) 482 
Common alder 177 
honey bee 283 
milkweed 224 
vervain 693 
Compound, trifolium 698 
Condurangin 319 
Condurango 319 
fluidextract of 319 
Coneflower 347 
narrow-leaved purple 347 
purple 347 
Confectiones 26 
Confections 26 
Conhydrine 319 
Coniine 319 
Conium 319 
maculatum. . 319 
Specific Medicine 319 
Conserves 26 
Considerations, general 11 
Constituents of plant drugs 13 
Convallaria 321 
majalis 321 
Specific Medicine 321 
Convallamarin 321 
Convallarin 321 
Convolvulin 437 
Copaiba 323 
Copper acetate 331 
arsenite 213 
subacetate of 331 
sulphate 331 
Coptine 324 
Coptis.... 324 
decoction of 324 
tincture of 324 
trifolia 324 
Corallorhiza 322 
odontorhiza 322 
Coral root 322 
infusion of 322 
tincture of 322 
Cordial, black haw (Howe's) 694 
mother's 480 
neutralizing 599 
Coriander 325 
fruit 325 
seed 325 
Specific Medicine 325 
Coriandrum 325 
sativum 325 
Cork 15 
Corkwood elm 345 
Cormi 15 
Corms 15 
Corn brand 684 
ergot 684 
Indian 684, 698 
infusion of 698 
silk 698 
smut 684 
squirrel 325 
starch 188 
turkey. . . 325 
Cornel, flowering 325 
Cornine 325 
Comus 325 
florida 325 
Specific Medicine 325 
Cornutine 356 
Corrigents 51 
Corrosive mercuric chloride 408 
sublimate 408, 409 
Corrosives 78, 79 
Cortices 15 
Corydalin 325 
Corydaline 325 
Corydalis 325 
Specific Medicine 325 
Cotarnine hydrochloride 510 
Cotton 395 
absorbent 395 
purified 395 
soluble gun 317 
wild 224 
wool 395 
Cotton-root bark 395 
Couch-grass 682 
Coumarin 445, 477, 611 
Cramp bark 694 
Cranberry, high 694 
upland 685 
Cranesbill 391 
wild 391 
tincture of. 
712 INDEX 
Crataegus 325 
Oxyacantha 325 
Specific Medicine 325 
Crawley 322 
Cream, cold 201 
echafolta 347, 351 
of tartar 566 
Creasote 326 
Creolin 524 
Creosote 326 
carbonate 327 
Creosotum 326 
Cresol, compound solution of 524 
Creta praeparata 328 
Crocin 328 
Crocus 328 
sativa 328 
tincture of 328 
Crosswort 364 
Croton oil 499 
Crotonol 499 
Crowfoot 391 
Cubeb 328 
oil of 328 
oleoresin of 328 
resin 328 
Cubeba 328 
Specific Medicine 328 
Cubebin 328 
Cubebs 328 
Cucumber, bitter 318 
squirting 351 
wild 351 
Cucurbita Pepo 516 
Culver's physic 443 
root 443 
Cumulative action 37 
Cundurango 319 
Cupri acetas 331 
subacetas 331 
Cupri sulphas 331 
Cupric acetate 331 
subacetate 331 
Cuprum, Specific Medicine 331 
Curacao aloes 177 
Curcuma 329 
longa 329 
Specific Medicine 329 
Curcumin 329 
Cure, mind 13 
Cusso 330 
Cycloplegics 102 
Cymarin 193 
Cynips tinctoria 382 
Cynotoxin 193 
Cypripedium 330 
parviflorum 330 
pubescens 330 
Specific Medicine 330 
Cytistine 237 
Cytisus Scoparius 623, 649 
D 
Daisy field 444 
oxeye 444 
Dandelion 672 
Daturine 421, 657 
Deadly nightshade 239 
Dead tongue 490 
Death cup 169 
Decocta 26 
Decoction of alnus 177 
althaea 178 
apocynum 193 
aralia 201 
barley 407 
coptis 324 
dioscorea 344 
geranium 391 
gravel root 366 
logwood 401 
oak bark 588 
parsley 519 
pomegranate bark 396 
privet 445 
rhamnus californica 599 
scoparius 623 
Decoctions 26 
Decoctum alni 177 
althaeae; 178 
apocyni 193 
araliae 201 
baptisiae 237 
coptis 324 
dioscoreae 344 
eupatorii purpureii 366 
geranii 391 
granati 396 
haematoxyli 401 
hordei 407 
ligustri 445 
petroselini 519 
querci 588 
rnamni californici 599 
scoparii 623 
Deer-berry 480 
Deer's tongue 445 
Definitions 11 
of therapeutic terms 70 
Delphinine 653 
Delphinium Staphisagria 653 
Delphinoidine 653 
Delphisine 653 
Demulcents 78, 79, 85, 87, 91 
Deodorants 80 
Depressants, motor 97, 99, 104 
Depurants, renal 85, 89, 93 
Derivatives of plant drugs 13, 18 
Dermatol 246 
Devil's bit 404 
turnip 250 
Dextrose 477 
Diacetylmorphine 510 
Diagnosis, Specific 54 
Classification 55 
Diaphoretic powder (Beach's) 501, 508 
Diaphoretics 85, 90, 94 
Diastase 25, 333, 407 
Diastasum 333 
Dicentra canadensis 325 
Dichloramine-T 642 
paste 642 
Diethylamalonylurea 238 
Digestants 81, 84 
713 INDEX. 
Digifolin 344 
Digitalis 333 
glucosides 333 
infusion of 333 
purpurea 333 
Specific Medicine 333 
tincture 333 
Digitalein 333 
Digitalin 333, 343 
Digitalone 343 
Digitin 333 
Digitonin 333 
Digitoxin 333 
Dimethylpiperazine tartrate 548 
Dionin (e) 510 
Dioscorea 344 
decoction of 344 
Specific Medicine 344 
villosa 344 
Diosphenol 253 
Dioxy-diamido-arsenobenzol dihydro- 
chloride 214 
Disease, serum 106 
Disinfectants 79, 81 
Dispensatory, a Ill 
American Ill 
Dispensing of medicines 50 
tables 69, 70 
Distillate of hamamelis 401 
Ditch stone-crop 516 
Dithymol-diiodide 675 
Diuretics 85, 89, 93 
Dobell's solution 523 
Dock, yellow 610 
Dog button 485 
Dog-grass 682 
Dogwood 325 
flowering 325 
Jamaica 548 
poison 603 
Donovan's solution 213 
of arsenic and mercury iodides.. 208 
Dosage.... 38 
of Specific Medicines 39 
Dover's powder 501, 509 
Dow's physic 135 
Dracontium 345 
foetidum 345 
tincture 345 
Dragon root 205 
Dragon's claw 322 
Drastics 85, 88, 92 
Draught, black 627 
Drooping starwort 404 
Drops, Hoffmann's 157 
Hunn's (life) 491 
Dropwort, hemlock 490 
water 490 
Drosera 345 
rotundifolia 345 
Specific Medicine 345 
Drug, a 11 
action, general nature of 32 
circumstances modifying 37 
effects of 33 
affinity 34 
knowledge, sources of 109 
Drug therapy 13 
tolerance 37 
Drugs, cellular 18 
constituents of plant 13 
derivatives of plant 13, 18 
individual '112 
parts of plant 13 
proximate and other principles of 
plant.. 22 
therapeutic classification of 78 
Dryopteris Filix-mas 228 
marginalis 228 
Duboisia 345, 421 
myroporoides 345 
Duboisina 345 
Duboisinae hydrochloridum 345 
sulphas 345 
Duboisine 345, 421 
hydrochloride 345 
sulphate 345 
Dulcamara 346 
Specific Medicine 346 
Dulcamarin 346 
Dwale 239 
Dwarf elder 201 
Dynamical therapeutics 13 
Dynamyne 462 
Dyer's saffron 279, 328 
E 
Eagle vine 319 
Ecballium Elaterium 351 
Ecboline 356 
Echafolta 347, 351 
cream 347, 351 
Echinacea 347 
angustifolia 347 
Specific Medicine 347 
Eclectic wash 605 
Eclectics and mercury 413 
Effects, drug, circumstances modifying 37 
Effervescent salts 26, 27 
Ehrlich's "606" 215 
Elaeopten 20 
Elaterin 351 
Elaterinum 351 
Elaterium 351 
Specific Medicine 351 
Elder.... 614 
American 614 
dwarf 201 
wild 201 
Elder-leaved ash 381 
Elecampane 426 
Electrotherapy 13 
Electuaries 26 
Elettaria Cardamomum 278 
Elimination 36 
Elixiria 26, 27 
Elixir of frangula 380 
frangulae 380 
of podophyllin 555 
podophylli 555 
Elixirs 26, 27 
(list) 77 
Elm 683 
bark 683 
714 INDEX. 
Elm, corkwood 345 
mucilage of 683 
slippery 683 
Emetic herb 455 
Emetic powder 455 
compound 457 
tincture, acetous 615 
weed 455 
Emetics 85, 86, 91 
Emetine 432 
Emmenagogues 85, 90, 94, 104 
Emodin 380, 599, 627 
Emollients 78, 79 
Empiric remedy 12 
Emplastra ... 28 
Emplastrum capsici 275 
elasticum 597 
resinae 597 
sinapis 633 
Emulsa 26, 27 
Emulsin 25, 582 
Emulsion of asafetida 221 
of cod liver oil 492 
of oil of turpentine 497 
Emulsiones 26, 27 
Emulsions 26, 27 
Emulsum asafcetidae 221 
olei morrhuae 492 
olei terebinthinae 497 
Endemic remedy 58 
Enemas 26, 27 
medicated 27 
saponated -. 27 
simple 27 
Enemata 26, 27 
English chamomile 189 
hawthorn 325 
Enteroclysis 41 
Epidemic remedy 57 
Epigaea 352 
repens 352 
Specific Medicine 352 
Epilobium 353 
angustifolium 353 
infusion of 353 
marsh 353 
Specific Medicine 353 
Epinephrina 353 
Epinephrin(e) 353 
hydrated 353 
Epinephrine 107 
Epsom salt 471 
Equisetum 355 
hyemale 355 
infusion of 355 
Specific Medicine 355 
Equus Caballus 629, 631 
Erechtites. ... 355 
hieracifolia 355 
Ergamine 356 
Ergot 356 
Lloyd's 356 
of rye 356 
Specific Medicine 356 
Ergota 356 
Ergotine 356 
Ergotinine 356 
Ergotins 360 
Ergotism 357 
Ergotoxin 356 
Erhlich's "914" 219 
Ericolin 352, 383, 361, 587, 685 
Erigeron 360 
canadense 360 
oil.. 360 
Specific Medicine 360 
Eriodictyon 361 
californicum 361 
Errhines 89 
Eryngium 361 
Specific Medicine 361 
yuccaefolium 361 
Eryngo 361 
water 361 
Erythroretin 599 
Erythroxyline 306 
Erythroxylon Coca 306, 307, 312 
Escatol 699 
Escharotics 78, 79 
Eseramine 532 
Eseridine 532 
Eserine 532 
salicylate 534 
Essence of peppermint 478 
of pepsin (Fairchild's) 516 
of spearmint 479 
of wintergreen 383 
Ether 157 
and chloroform, comparison or 166 
spirit of 157 
hydrochloric 168 
or chloroform 162 
resuscitation from 165 
spirit of nitrous 652 
Ethyl bromide 168 
chloride 168 
Ethyl-piperidine 319 
Eucaine ■ 312 
"A" 312 
"B" 312 
beta 312 
Eucalyptol 362, 442, 491 
Eucalyptus 362 
globulus 362 
oil of 362 
Specific Medicine 362 
Eugenia aromatica 279 
Eugenin 279 
Eugenol 279 
Euonymin 364 
Euonymus 364 
atropurpureus 364 
Specific Medicine 364 
Eupatorin 364 
Eupatorine 366 
Eupatorium 364 
perfoliatum. 364 
purpureum 366 
Specific Medicine 364 
Euphorbia 367 
corollata 367 
hypericifolia 368 
Ipecacuanha 368 
fluidextract of 368 
715 INDEX 
Euphorbia Ipecacuanha, tincture of... 368 
piluliferae 368 
Specific Medicine 367 
Euphorbon 367, 368 
Euphrasia. 369 
officinalis 369 
Specific Medicine 369 
Evening primrose 490 
Excitants, motor 97, 100, 104 
Excrescences 18 
Exogonium Purga 437 
Expectorants 85, 89, 92, 93 
Explosive mixtures 45 
Extract of butternut 438 
of cascara sagrada 280 
Goulard's 552 
of haematoxylon 401 
of krameria 441 
of oxgall 370 
powdered 370 
of rhatany 441 
of sourwood 510 
thyroid 107 
of witch-hazel, distilled 401 
Extracta 27 
fluida 27 
Extracts 18, 26, 27 
animal 107 
compound 27 
simple 27 
Extractum cascarae sagradae 280 
fellis bovis 370 
haematoxyli 401 
juglandis 438 
krameriae 441 
oxydendri 510 
Eyebright 369 
Eyewashes 26, 27 
F 
Fabiana 370 
fluidextract of 370 
imbricata 370 
Fabianine 370 
False unicorn root 175 
white cedar 677 
wintergreen 587 
Farina lini 446 
tritici 370 
Fats 19, 28 
Febrifuges 83 
Fecula 21 
Fei bovis 370 
Female kola 441 
regulator 625 
Fennel 380 
infusion of 380 
seeds 380 
Specific Medicine 380 
sweet 380 
Ferments 25 
Fern, male. .. 228 
marginal shield 228 
oleoresin of 228 
Ferri arsenas 371 
bromidum 371 
carbonas saccharatus 371 
Ferri, chloridum 372 
dialysatum 372 
et ammonii sulphas 372 
citras 372 
tartras 373 
et potassii tartras 373 
et quininae citras 373 
cum strychnina 373 
et strychninae citrate 373 
ferrocyanidum 374 
hydroxidum cum magnesii oxido 374, 375 
hypophosphis 374 
lactas 374 
oxidum hydratum 375 
phosphas 375 
pyrophosphas 375 
subcarbonas 375 
sulphas 376 
exsiccatus ... 376 
granulatus 376 
valerianas 376 
Ferric chloride 372 
solution of 449 
tincture of 679 
ferrocyanide 374 
hydrate 375 
with magnesia 374 
hydroxide 375 
with magnesium oxide 374 
hypophosphite 374 
phosphate 375 
soluble 375 
subsulphate, solution of 450 
sulphate, solution of 450 
basic solution of 450 
valerianate 376 
Ferrous arsenate 371 
bromide 370 
carbonate, saccharated 371 
mass of 371 
pills of 371 
iodide, syrup of 671 
lactate 374 
subcarbonate 375 
sulphate 376 
dried 376 
granulated 376 
Ferrum 377 
reductum 379 
Ferula Asafoetida 221 
foetida 221 
Sumbul 670 
Fetid buckeye 156 
Ficus 379 
Carica 379 
Field daisy 444 
Fig 379 
Filicin 228 
Fireweed 355 
oil of 355 
Fishberries 313 
Flag, blue 435 
larger blue 435 
Flavoring agents 108 
Flavors 51 
Flaxseed 446 
meal 446 
716 INDEX. 
Flaxseed, oil of 446 
poultice 446 
Fleabane, Canada 360 
Flesh-colored asclepias 225 
Fleur de luce 435 
Flores 17 
Flour, common 370 
wheat 370 
Flowers 17 
Flowering cornel 325 
dogwood 325 
Fluidextract of aspidosperma 228 
of cascara sagrada 280 
aromatic 280 
of castanea 281 
of cinchona 303 
of coca 306 
of condurango 319 
of euphorbia ipecacuanha 368 
of frankenia 381 
of glycyrrhiza 395 
of kola 441 
of oenothera 490 
of piscidia 548 
of quebracho 228 
of rhus glabra 609 
of sarsaparilla compound 620 
of spigelia and senna 651 
of verbena . 693 
of xanthium strumarium 697 
Fluidextracta 27 
Fluidextracts 26, 27 
compound 27 
(list) 76 
simple 27 
Fluidextractum aspidospermatis 228 
cascarae sagradae 280 
aromaticum 280 
castaneae 281 
cinchonae 303 
cocae 306 
condurango 319 
euphorbiae ipecacuanhae 368 
fabianae 370 
francisceae 380 
frankenia 381 
glycyrrhizae 395 
kolae 441 
cenotherae 490 
piscidiae 548 
rhois glabrae 609 
sarsaparillae compositum 620 
spigeliae et sennae 651 
sumbul 670 
verbenae .. 693 
xanthii strumarii 697 
Fly agaric 169 
Fceniculum 380 
vulgare 380 
Folia et foliola . 16 
Formaldehyde, solution of 451 
Formin 405 
Forms of medicines 26 
Formulary, a 110 
Griffith's 110 
National 110 
Fowler's solution of arsenite of potas- 
sium 208 
Foxglove 333 
purple 333 
Fragrant sumach 608 
Franciscea 380 
fluidextract of 380 
uniflora 380 
Frangula 380 
californica 599 
elixir of 380 
Specific Medicine 380 
Frangulin 280, 380 
Frankenia 381 
fluidextract of 381 
grandifolia 381 
Frasera . 381 
carolinensis 381 
Specific Medicine 381 
Fraxinus 381 
Ornus..... 474 
sambucifolia 381 
Specific Medicine 381 
Fringe tree 286 
Fructi 17 
Fruits 17 
Fucus .. 381 
Specific Medicine 381 
vesiculosus 381 
Furfures tritici 370 
G 
Gaduin 492 
Gadus Morrhua 492 
Galactagogues 85, 90, 94, 104 
Galium 382 
aparine 382 
infusion of 382 
Specific Medicine 382 
tinctoria 382 
Galla 382 
Galls..... 382 
pulverized 382 
Gambeer 382 
Gambir 382 
compound tincture of 382 
troches of 382 
trochisci 382 
Gamboge ..... 266 
Gamma-homochelidonine 615 
Ganga 270 
Ganjah 270 
Garcinia Hanburii 266 
Garden marigold 262 
rue 611 
sage 614 
spurge 368 
Garlic..... 176 
Gas, laughing 484 
nitrous oxide 162, 484 
Gases 26 
Gaultheria 383 
procumbens 383 
Specific Medicine 383 
spirit of 383 
Gay feather 445 
Gelatin 385 
717 INDEX. 
Gelatin, glycerinated 385 
Gelatinum 385 
glycerinatum 385 
Gelsemine 385 
Gelseminine 385 
Gelsemium 385 
sempervirens 385 
Specific Medicine 385 
General considerations 11 
Gentian 390 
compound tincture of 390 
infusion of 390 
root 390 
Gentiana 390 
lutea 390 
Specific Medicine 390 
Gentiopicrin 381, 390 
Gentisin 390 
Geranium 391 
decoction of 391 
Specific Medicine 391 
spotted 391 
German chamomile 475 
Germicides 79 
Ginger 702 
African 702 
Calcutta 702 
calicut 702 
cochin 702 
Indian 221 
Jamaica 702 
Japanese 702 
oil of.. 702 
oleoresin of 702 
syrup of 702 
tincture of 702 
wild 221 
Gingerol 702 
Ginseng 511 
Glands ; 18 
dessicated thyroid. 676 
Glandulse thyroideae sicca* 676 
Glauber's salt 647 
Gliadin 370 
Globulins, antidiphtheric 630 
antitetanic... .... • 632 
diphtheric antitoxin 630 
Glucose 391, 477 
liquid 391 
syrupy 391 
Glucosides 24 
Glucosum 391 
Glue, bird 696 
Gluside 243 
Glusidum 243 
Gluten 370 
Gluten-fibrin 370 
Glycamarin 395 
Glycerin...... 392 
suppositories of 392 
Glycerines 27 
Glycerinum ; 392 
Glycerite of boroglycerin 122 
glyceryl borate 122 
of starch 188, 394 
of tannin 145 
of tannic acid 145 
Glycerites 26, 27 
Glyceritum amyli 188 
acidi tannici 145 
boroglycerini 122 
Glycerol 392 
Glyceroles 27 
Glyceryl borate, glycerite of 122 
Glycocholates 370 
Glyconda 599 
Glycyrrhiza 395 
compound powder of 627 
fluidextract of 395 
glabra glandulifera 395 
glabra typica 395 
Specific Medicine 395 
Glycyrrhizin 395 
ammoniated 395 
Glycyrrhizinum ammoniatum 395 
Gold and sodium chloride 234 
thread 324 
Goldenseal 417 
senecio 625 
Gonolobus Cundurango 319 
Goose-grass 382 
Gossypium 395 
herbaceum 395 
purificatum 395 
Specific Medicine 395 
Granatum 395 
Granula 27 
Granules 26, 27 
Grape, mountain 244 
Oregon 244 
Gravel plant 352 
root 366 
decoction of 366 
Specific Medicine 366 
weed 352, 366 
Great celandine 285 
wild valerian 685 
willow herb 353 
Green hellebore 687 
vitriol 376 
Grindelia 397 
camjiorum 397 
cuneifolia. 397 
Specific Medicine 397 
squarrosa 397, 398 
Grindelin 397 
Grindeline 397 
Ground holly 288 
laurel 352 
Gruel, oatmeal 235 
Guaiac 399 
ammoniated tincture of 399 
resin of 399 
Guaiacol 398 
carbonate 398 
Guaiacolis carbonas 398 
Guaiacum 399 
officinale 399 
sanctum 399 
Specific Medicine 399 
Guarana ;. 400 
Specific Medicine 400 
Guaza..... 270 
Gum arabic 113 
718 INDEX. 
Gum, asafetida 221 
camphor 266 
kino 440 
myrrh 482 
Gummata 19 
Gummi-resinae 19 
Gum-resins 19 
sweet 447 
Gums 19 
Guinea pepper 275 
Gun cotton, soluble 317 
Gunjah 270 
Gynocardia 400 
odorata 400 
H 
Haematoxylin 401 
Haematoxylon 401 
campechianum 401 
extract of 401 
Haemostatics 102 
Hagenia abyssinica 330 
Hairs 18 
Halazone 642 
Hamamelis 401 
distillate of 401 
Specific Medicine 401 
virginiana 401 
water 401 
Haschisch 270 
Haw 325 
red 325 
Hawthorn 325 
English 325 
Heart liver leaf 405 
Hedeoma 403 
pulegioides 403 
Helenin 426 
Hellebore, American 687 
black 404 
green 687 
swamp 687 
Helleborein 404 
Helleborin 404 
Helleborus 404 
niger 404 
Specific Medicine 404 
Helonias 404 
dioica 404 
Specific Medicine 404 
Hematinics 82, 84 
Hemlock 112, 319 
dropwort 490 
oil of 112 
poison 319 
spotted 319 
spruce 112 
water 490 
Henbane 421 
Hepar calcis 262 
sulphuris 561 
calcareum 262 
Hepatica 405 
acutiloba 405 
Hepatica 405 
Specific Medicine 405 
Herbse 16 
Herbs 16 
tincture of fresh 32 
Heroin (e) 510 
Hesperidin 233, 446 
Hexamethylenamina 405 
Hexamethylenamine 405 
High cranberry 694 
Hippocastanum 406 
Histamine 356 
Hoarhound 475 
Hoffmann's drops 157 
Hog 511 
Holocaine 313 
Homatropine bromide 407 
hydrobromate 407 
hydrobromide 407 
Homatropinae hydrobromidum 407 
Honduras sarsaparilla 620 
Honey 477 
borax 477 
clarified 477 
rose 477 
Honey-bee, or virus of 192 
Honeys 26, 27 
Hop 407 
tree 583 
Hops 40/ 
Hordeum 407 
distichon 407 
Horehound 475 
Hormones 108 
Horse-balm 315 
Horse chestnut 406 
Specific Medicine 406 
Horsemint 481 
infusion of 481 
Horse-nettle 649 
Horsetail 355 
Howe's acid solution of iron 447 
black haw cordial 694 
Humulus 407 
Lupulus 407, 463 
Specific Medicine 407 
Hunn's drops 491 
life drops 491 
Huxham's tincture of bark 303 
Hydragogues 88 
Hydrangea 408 
arborescens 408 
Specific Medicine 408 
wild 408 
Hydrangin 408 
Hydrargyri chloridum corrosivum 408 
chloridum mite 408 
iodidum flavum 408 
rubrum 409 
oxidum flavum 409 
protonitras 408 
salicylas 409 
Hydrargyrum 408 
ammoniatum 408, 416 
Hydrastin 417 
combined 417 
Hydrastina 417 
Hydrastine 417 
chloride 417 
719 INDEX. 
Hydrastine, hydrochloride 417 
muriate 417 
Hydrastinae hydrochloridum 417 
Hydrastinine chloride 417 
hydrochloride 417 
Hydrastininae hydrochloridum 417 
Hydrastis.... 417 
canadensis 417 
liquid 417 
Specific Medicihe 417 
Hydrogen dioxide 199 
peroxide.... 199 
Hydroquebrachine 228 
Hydroquinone 685 
Hydrotherapy 13 
Hyoscine 239, 421, 623, 657 
hydrobromide 623 
Hyoscyamine 239, 421, 657 
bromide 421 
hydrobromide 421 
Hyoscyaminae hydrobromidum 421 
Hyoscyamus 421 
niger 421 
Specific Medicine 421 
Hypericum 424 
perforatum 424 
red 424 
tincture of 424 
Hypersusceptibility 106 
Hypodermoclysis 41, 42 
Hypophysin 549 
sulphate 549 
Hypophysis, dessicated 549 
sicca 549 
solution of 549 
Hypnotics.. 97, 100, 103 
Hyssop, wild 693 
I 
Ice, camphor 268 
Ichthyol 425 
Ichthyolum 425 
Idiosyncrasy 38 
Ignatia 425 
Specific Medicine 425 
Illicium verum 189 
Illustrations, list of 9 
Immunity 106 
Impatiens 426 
fulva 426 
pallida 426 
Incompatibility 42 
chemical 42 
list of substances 43 
pharmaceutical 42 
therapeutic 42 
Indian arrow-wood 364 
berries 313 
corn 684 
ginger 221 
paint 615 
poke 687 
sage 364 
tobacco 455 
turnip 205 
Indication, Specific 54 
Ineine 659 
Infiltration method of Schleich 310 
Infiatin 455 
Infundibulin 549 
Infusa .. 27 
Infusion of absinthium 112 
agrimony 170 
althaea 178 
American senna, compound 280 
amygdalus 185 
anise 189 
anthemis 189 
boneset 364 
castanea 281 
chimaphila 288 
coffee 256 
coral root 322 
corn silk 698 
digitalis 333 
epilobium 353 
equisetum 355 
fennel 380 
galium 382 
gentian 390 
horsemint 481 
juniper 439 
leonurus 443 
leucanthemum 444 
pennyroyal 403 
pyrola 587 
quassia 588 
sage 614 
scoparius 623 
senna, compound 627 
spearmint 479 
triticum 682 
tussilago 683 
Infusions 26, 27 
Infusum absinthii 112 
agrimoniae 170 
althaeae 178 
amygdali 185 
anisi 189 
anthemidis 189 
asari 221 
caffeae 256 
calumbae 263 
capsellae 274 
cassiae marilandicae compositum.... 280 
castaneae 281 
catariae 281 
chimaphilae 288 
corallorhizae 322 
digitalis 333 
epilobii 353 
equiseti 355 
eupatorii 364 
foeniculi 380 
galii 382 
gentianae 390 
hedeomae 403 
juniperi 439 
kousso 330 
leonuri 443 
leucanthemi 444 
liatridis 445 
matricariae 475 
menthae viridis 479 
720 INDEX. 
Infusum, monardae 481 
pyrolae 587 
quassiae 588 
salvia? 614 
scoparii 623 
sennae compositum 627 
tritici 682 
tussilago 683 
zeae 698 
Injection, intravenous 42 
intramuscular 42 
intraperitoneal 42 
intraspinal 42 
Inspissated juices 18 
Instillation 41 
Insufflation 41 
Intoxicating long pepper 546 
Introduction 11 
Inula 426 
Helenium 426 
Specific Medicine 426 
syrup of 426 
Inulin 426, 442, 672 
Inunction, quinine 591 
Iodine . 381, 429 
compound solution of 429 
Lugol's solution of 429 
tincture 429 
lodism 430, 576 
Iodoform 427 
gauze 428 
ointment 428 
lodoformum 427 
Iodol 429 
lodolum 429 
lodum 429 
Ipecac 432 
alcresta 432 
American 368 
Cartagena 432 
powdered 432 
Rio. 432 
Specific Medicine 432 
spurge 368 
syrup of 432 
wild 368 
Ipecacuanha 432 
American 368 
Iris 435 
Specific Medicine 435 
versicolor 435 
Irish broom 623 
Iron 377 
acetate, tincture of 679 
alum 372 
ammonio-citrate of 372 
and ammonium acetate, solution of. 450 
and ammonium citrate 372 
and ammonium sulphate 372 
and ammonium tartrate 373 
and potassium tartrate 373 
and quinine citrate 373 
soluble ... 373 
and quinine citrate with strychnine, 373 
and strychnine citrate 373 
arsenate 371 
bromide 371 
Iron, bromide, syrup of 371 
by hydrogen 379 
carbonate 375 
saccharated 371 
chloride 372 
tincture of 679 
dialyzed 372 
ferrocyanide 374 
hydrated oxide of 375 
peroxide of 375 
sesquioxide of 375 
hypophosphite 374 
iodide, syrup of 671 
lactate 374 
muriate, tincture of 679 
muriated tincture of 679 
perchloride 372 
solution of 449 
phosphate of 375 
soluble 375 
pills of 371 
pyrophosphate, soluble 375 
with sodium citrate 375 
Quevenne's 379 
reduced 379 
sesquichloride 372 
soluble citrate 372 
sulphate 376 
tartarated 373 
tersulphate, solution of 450 
tincture of 679 
valerianate 376 
Irritants (respiratory) 85, 89, 92 
Isohesperidin 233 
Isopelletierine 396 
Isopilocarpine 539 
Ivy, poison 602 
J 
Jaborandi 539 
Maranham 539 
Pernambuco 539 
Specific Medicine 539 
Jacaranda 437 
procera 437 
Specific Medicine 437 
Jack in the pulpit 205 
Jalap 437 
compound powder of 437, 627 
resin of 437 
Specific Medicine 437 
Jalapa 437 
Jalapin.. 437 
Jalapurgin 437 
Jamaica dogwood 548 
sarsaparilla 620 
Jambosa Caryophyllus 279 
Jamestown weed 657 
Jasmin, Carolina 385 
Jasmine, yellow 385 
Jatamansi 670 
Jateorhiza palmata 263 
Jeffersonia 438 
diphylla 438 
tincture of 438 
Jelly, petroleum 517 
white 517 
721 INDEX. 
Jervine 687, 693 
Jessamine, yellow 385 
Jewel weed 426 
balsam 426 
Jimsonweed 657 
Joe Pye weed 366 
Juglans 438 
cinerea 438 
Specific Medicine 438 
Juice, orange 233 
Juices. 26, 27 
inspissated 18 
Juniper , 439 
berries 439 
compound spirit of 439 
infusion-of 439 
oil of 439 
spirit of 439 
Juniperin 439 
Juniperus 439 
communis 439 
Oxycedrus 490 
K 
Kalmia 440- 
Specific Medicine 440 
Kamala 440 
Kamalin 440 
Kameela 440 
Specific Medicine 440 
Kavahin 546 
Kava-Kava 546 
Kelp-ware 381 
Kerosine 518 
Kidney liverleaf 405 
Kino 440 
gum 440 
tincture of 440 
Kinoin 440 
Kino-red 440 
Kinovin 303 
Knowledge, sources of drug 109 
Kola 441 
female 441 
fluidextract of 441 
nut 441 
Kola-red 441 
Kooso 330 
Kousin 330 
Kousso 330 
infusion of 330 
Specific Medicine 330 
Krameria 441 
extract of 441 
Ixina 441 
Specific Medicine 441 
triandra 441 
Kusso 330 
L 
Labarraque's solution 452 
Lactin 612 
Lactopicrin 442 
Lactose 612 
Lactuca sativa 442 
virosa 442 
Lactucarium 442 
syrup of 442 
tincture of 442 
Lactucin 442 
Lactucerin 442 
Lactucone 442 
Ladies' slipper 330 
large-flowered 330 
small-flowered 330 
yellow 330 
Laevulin 672 
Laevo-pinene 519 
Laevulose 477, 682 
Lambkill 440 
Lanolin 155 
anhydrous 155 
Lappa 442 
seeds, tincture of 442 
Specific Medicine 442 
Lappin 442 
Larch agaric 249 
Lard 155 
benzoinated 155 
hog's 155 
prepared 155 
Large-flowering cactus 253 
spurge 367 
Large spotted spurge 368 
Larger blue flag 435 
Latin, medical 61 
rules 62 
Laudanum 501 
Laughing gas 484 
Laurel 440 
camphor 266 
ground 352 
mountain 440 
sheep 440 
Lavandula 442 
vera 442 
Lavender 442 
compound spirit of 442 
tincture of 442 
flowers 442 
spirit of 442 
Laxatives 85, 88, 92 
Lead acetate 552 
subacetate, solution of 552 
diluted 552 
sugar of 552 
water 552 
Leaf cup 560 
Leaflets 16 
Leaves 16 
Lemon 446 
apple 555 
juice 446 
peel 446 
salts of 136 
wild 555 
Leontin 282 
Leonurus 443 
Cardiaca 443 
infusion of 443 
Leopard's bane 205 
Leptandra 443 
Specific Medicine 443 
722 INDEX, 
Leptandra virginica 443 
Leptandrin 443 
Lettuce, canker 587 
opium 442 
Leucanthemum 444 
infusion of 444 
Levant wormseed 618 
Liatris 445 
infusion of 445 
odoratissima 445 
scariosa 445 
spicata 445 
squarrosa 445 
Libradol 345, 455, 457, 462 
Licorice 395 
root 395 
Russian 395 
Spanish 395 
Life root 625 
Ligna et stipites 15 
Ligustrin 445 
Ligustron 445 
Ligustrum 445 
vulgare 445 
Lilium 445 
tigrinum 445 
Lily of the valley 321 
Lily, tiger 445 
Specific Medicine 445 
Lime 264 
bird 696 
burned 264 
caustic 264 
chloride of 265 
chlorinated 265 
iodide of 260, 261 
liniment 264 
quick 264 
sulphurated 262 
trituration of 262 
water 264 
Limon 446 
Limonis cortex 446 
Linalool 442 
acetate 442 
Liniment, camphor 267 
chloroform 294 
compound cajuput 491 
lime 264 
of soft soap 620 
soap 619 
stillingia 655, 656 
compound 655, 656 
turpentine 496 
Linimenta 27 
Liniments 26, 27 
succus 446 
Linimentum cajuputi compositum.... 491 
calcis 264 
camphorse 267 
chloroformi 294 
saponis 619 
mollis 620 
stillingiae compositus 655 
terebinthinae 496 
Linseed 446 
meal 446 
Linseed oil 446 
raw 446 
Linum 446 
usitatissimum 446 
Liquidambar 447 
styraciflua 447 
Liquids 26 
Liquor acidi arseniosi 208 
alumini acetatis 179, 180 
ammonii acetatis 447 
arseni et hydrargyri iodidi 208 
calcis 264 
creolis compositus 524 
ferri acidi 448 
chloridi 449 
dialysatus 372 
et ammonii acetatis 450 
subsulphatis 450 
tersulphatis 450 
formaldehydi 451 
hypophysis 549 
iodi compositus 429 
magnesii citratis 452 
plumbi subacetatis 552 
plumbi subacetatis dilutus 552 
potassse. . . . .. 574 
potassii arsenitis 208 
potassii citratis 573 
potassii hydroxidi 574 
sodae chlorinatse 452 
sodii arsenatis 208 
sodii chloridi physiologicus 640 
zinci chloridi 699 
Liquors 26, 29 
Liquores 29 
List of Illustrations 9 
Lithii benzoas 453 
bromidum 453 
carbonas 454 
citras 454 
effervescens 454 
salicylas 455 
Lithium benzoate 453 
bromide 453 
carbonate 454 
citrate 454 
effervescent 454 
salicylate 455 
Lithontriptics 85, 90, 93 
Liverleaf 405 
American 405 
heart 405 
kidney 405 
Liver of sulphur 561 
Liverwort 405 
Lobelacrin 455 
Lobelia 455 
compound powder of 455 
tincture of 455 
inflata ;; 455 
Specific Medicine 455 
subculoyd 455 
Lobeline 455 
lobeliate 455 
Loeffler's solution 449 
Loganin 485 
Logwood 401 
723 INDEX 
Logwood, decoction of 401 
Specific Medicine 401 
Lotio flava 415 
Lotiones 28 
Lotions 26, 28 
Lozenges 26, 28 
Lung moss 655 
Lungwort lichen 655 
oak 655 
tree 655 
Lupulin ..... 407, 463 
Specific Medicine 463 
Lycetol 548 
Lycopodium 463 
clavatum 463 
Specific Medicine 463 
Lycopus 464 
Specific Medicine 464 
virginicus 464 
Lysol 524 
M 
Macrotin 466 
Macrotyn 466 
Macrotys 466 
racemosa 466 
Specific Medicine 466 
Mad weed 625 
Magma 26, 28 
magnesia 470 
magnesiae 470 
Magnesia 470 
calcined 470 
heavy 470 
light 470 
magma 470 
milk of 470 
Magnesii carbonas 470 
oxidum 470 
ponderosum 470 
sulphas 471 
Magnesium carbonate 470 
citrate 452 
oxide 470 
heavy 470 
sulphate 470 
Male fern..... 228 
oleoresin of . 228 
Mallotus philippiensis 440 
Maltine 407 
Manaca 380 
Manacine 380 
Mandrake. 555 
Manganese dioxide, precipitated 473 
sulphate.... .... 473 
Mangani dioxidum praecipitatum 473 
sulphas 473 
Mangifera 474 
indica 474 
Specific Medicine 474 
Mango 474 
Manna 474 
Mannite 474 
Marginal shield fern 228 
Marigold 262 
garden 262 
Marrubium 475 
Marrubium, Specific Medicine 475 
vulgare 475 
Marrubiin 475 
Marsdenia Condurango 319 
Marsh epilobium 353 
Marshmallow 178 
Marygold 262 
Maryland pink 651 
Mass, Blaud's pill 370 
of ferrous carbonate 371 
Massa ferri carbonatis 371 
Masses 26, 28 
pili 28 
Mata-peroo 319 
Materia medica 11 
a 109 
Maticin 475 
Matico 475 
leaves 475 
tincture of 475 
Matricaria 475 
Chamomilla 475 
infusion of 475 
Specific Medicine 475 
Matter, coloring 22 
May 325 
apple 555 
Mayflower 352 
May pop 515 
Meadow anemone 583 
cabbage 345 
Meal, flaxseed 446 
linseed 446 
Measures, weights and 66 
domestic 68 
Mediate therapeutics 13 
Medical Latin 61 
rules 62 
Medication, Specific 12, 54 
Medicine, a 11 
preventive 56 
Medicines, absorbability of 35 
absorption of 36 
action of 32 
administration of 36, 40 
application of 40 
classes of 26 
dispensing of 50 
effects of 32 
elimination of 36 
pharmaceutical forms of 26 
Specific 29 
dosage of 39 
Medinal 238 
Mel..... 477 
boracis 477 
depuratum 477 
rosae 477 
Melaleuca Leucadendron 491 
Melilotol 477 
Melilotus... 477 
officinalis 477 
Specific Medicine 477 
Mellita 27 
Menispermum 478 
canadensis 478 
tincture of 478 
724 INDEX. 
Menispine 478 
Mentha piperita 478, 479 
spicata 479 
viridis 479 
Menthol 478, 479 
Mercuric chloride 408 
corrosive 408 
iodide 409 
red 409 
oxide, yellow 409 
salicylate 409 
subsalicylate 409 
Mercurous chloride 408 
mild 408 
iodide 408 
nitrate 408, 416 
Mercury... 408 
ammoniated 408, 416 
bichloride of 408 
biniodide 409, 416 
Eclecticsand 413 
nitrate. 416 
protoiodide 408, 416 
protonitrate 408 
red iodide of 409 
vegetable.. 380 
yellow iodide of 408 
yellow oxide of 409, 417 
Metadihydroxy benzene 598 
Metadioxybenzol 598 
Methods of administration 40 
Methyl blue 480 
-coniine 319 
-eugenol 221 
-hydroquinone 685 
morphine 314 
-pelletierine 396 
pyrocatechin 398 
salicylate 383 
Methylene blue 480 
Methylis salicylas..; 383 
Methylprotocatechuic aldehyde 686 
Methylthionine chloride 480 
Methylthioninae chloridum 480 
Methysticin . 546 
Mexican sarsaparilla 620 
Milfoil 117 
Milk 28 
of magnesia 470 
of sulphur j 666 
purslane 367 
sugar 612 
sugar of 612 
snake 367 
Milkweed 224 
common 224 
swamp 225 
Mind cure 13 
Mirbane, oil of 129 
Mistletoe 696 
American 696 
Specific Medicine 696 
Mistura cajuputi composita 491 
Misturae 28 
cretae 328 
Mitchella 480 
Mitchella, compound syrup of 282 
repens 480 
Specific Medicine 480 
Mixture, Basham's 450 
chalk 328 
compound cajuput 491 
dangerous explosive 45 
neutralizing (Beach's) 599 
Mixtures 26, 28 
Moccasin flower, yellow 330 
Monarda 481 
oil of 481 
punctata 481, 674 
Monkshood 148 
Monobromated camphor 269 
Monomethylamine 463 
Monsel's salt 450 
solution 450 
Moonseed, Canadian 478 
Morphina 501 
Morphine 500, 501 
chloride 501 
hydrochloride 501 
sulphate 501 
Morphinae hydrochloridum 501 
sulphas 501 
Morrhuol 492 
Moth balls 246 
Mother's cordial 480 
Motherwort 443 
Mountain balm 361 
grape 244 
laurel 440 
tea 383 
Mouth root 324 
Mucilage of acacia 113 
elm 683 
Mucilages 26, 28 
Mucilagines 28 
Mucilago acaciae 113 
ulmi 683 
Mucedin 370 
Mullein 693 
Muscarine 169 
Musk-root 670 
Mustard, black 633 
brown 633 
plaster 633 
volatile oil of 632, 633 
white 632 
yellow 632 
Mydriatics 97, 102, 104 
Myosin 516 
Myotics 97, 103, 104 
Myrica 481 
cerifera 481 
Specific Medicine 481 
Myristica 482 
fragrans 482 
Myrosin 25, 632, 633 
Myrrh 482 
gum 482 
tincture of 483 
Myrrha 482 
Myrrhin 483 
Myrrol 483 
725 INDEX 
N 
Nanny berry 694 
Naphtha. 518 
Naphthalin 246 
Naphthol 245 
Narceine 500 
Narcotics 100 
prescriptions for 61 
Narcotine 500 
Narrow-leaved purple coneflower 347 
Natural therapeutics 13 
Neo-arsphenamine 219, 220 
Nepeta Cataria 281 
Nerve root 330 
Nervines 103 
Nettle 684 
stinging 684 
Neutralizing cordial 599, 601 
Beach's 599 
Locke's 599 
mixture 599 
physic 599 
Neutral principles 25 
New Jersey tea 283 
Ngmoo 345 
Nicotine 462 
Night-blooming cereus 253 
Nightshade, deadly 239 
woody 346 
"914," Ehrlich's 219 
Nitre... 579 
cubic 644 
(niter), sweet spirit of 652 
Nitrogenii monoxidum 484 
Nitrogen monoxide 484 
Nitrous oxide 484 
gas 484 
Normal salt solution 640 
Northern prickly ash 697 
Novaspirin 120 
Novocaine 312 
Nutgall 382 
ointment of 382 
Nutgalls 145 
Nutmeg 482 
Specific Medicine 482 
Nux vomica..... 485 
Specific Medicine 485 
tincture of 485 
O 
Oak bark 588 
black 588 
lungwort 655 
poison 602 
white 588 
Oatmeal 235 
gruel 235 
water 235 
(Enanthe 490 
crocata ;; 490 
Specific Medicine 490 
CEnothera 490 
biennis 490 
fluidextract of 490 
Ohio buckeye 156 
Ointment, basilicon 597 
Ointment, belladonna 239 
boric acid 122 
brown citrine 40g 
chrysarobin 302 
Cocculus indicus 313 
iodine 429 
iodoform 427 
nutgall 382 
polymnia 560 
rose water 201 
stramonium 657 
sulphur 667 
tannic acid 145 
uyedalia 560 
zinc oxide 700 
Ointments 26, 28 
Oil, cassia 304 
castor 494 
coal 518 
camphorated 267 
Carron 264 
cod 492 
cod liver 492 
emulsion of 492 
cottonseed 395, 396 
croton 499 
mineral 517 
olive 493 
pine-needle 112 
rock 518 
sweet 493 
turpentine 496 
Oil of American wormseed 286, 491 
anise 189 
anthemis 189 
arborvitae 677 
birch 137 
bitter almond 582 
cade 490 
cajeput 491 
cajuput 491 
chaulmugra 400 
chenopodium 491 
cinnamon 304 
clove 279 
cubeb 328 
erigeron 360 
eucalyptus 362 
fireweed 355 
flaxseed 446 
Einger 702 
emlock 112 
juniper 439 
tar 490 
lemon 446 
linseed 446 
mirbane 129 
monarda 481 
mustard, volatile 632, 633 
orange 233 
pennyroyal 403 
peppermint 478 
raw linseed 446 
rue 611 
sandalwood 496 
santal 496 
wood 496 
726 INDEX. 
Oil of sassafras 621 
saw palmetto 628 
spearmint 479 
spruce 112 
tansy 672 
tar....; 551 
rectified 551 
theobroma 499 
turpentine 496 
rectified 497 
emulsion of 496 
vitriol 141 
wintergreen 137, 383 
artificial 383 
true 383 
wormwood 112 
Oils 19, 26, 28 
essential 19, 28 
fixed 19, 28 
non-volatile 19, 28 
volatile 19, 28 
Old man's beard 286 
Olea 19, 28 
europcea 493 
pinguia 19, 28 
volatilia 19, 28 
Oleates 26, 28 
Olein... 155, 492, 493 
Oleoresina aspidii 228 
cubebae 328 
petroselini 519 
zingiberis 702 
Oleoresin of aspidium 228 
cubeb 328 
ginger 702 
male fern 228 
Oleoresinae 20, 28 
Oleoresins 20, 26, 28 
(list)... 77 
Oleum absinthii 112 
anisi..;.; 189 
anthemidis 189 
aurantii 233 
cadinum 490 
cajuputi 491 
cari 279 
caryophylli 279 
cassiae 304 
chamomillae aethereum 475 
chenopodii 286, 491 
cinnamomi 304 
coriandri 325 
cubebae 328 
erechtitis 355 
erigerontis 360 
eucalypti 362 
gaultheriae 383 
gossypii seminis 395 
hedeomae 403 
hepatis morrhuae 492 
jecoris aselli 492 
juniperi 439 
empyreumaticum 490 
lavandulae 442 
limonis 446 
lini 446 
menthae piperitae 478 
Oleum menthae viridis 479 
monardae 481 
morrhuae 492 
myristicae 482 
olivae 493 
picis liquidae rectificatum 556 
pimentae 541 
ricini 491 
rutae 614 
santali 491 
sassafras 623 
sinapis volatile 636 
tanaceti 672 
terebinthinae 496 
rectificatum 497 
theobromatis 499 
thujae 677 
tiglium 499 
Olive oil 493 
One-berry 480 
Onion 176 
red 176 
sea 621 
syrup of 176 
Opii pulvis 501 
Opium ; 500 
camphorated tincture of 122 
deodoratum 501 
deodorized 501 
granulated 501 
granulatum 501 
lettuce 442 
powdered 501 
tincture of 501 
deodorized 501 
Opodeldoc 619 
Orange root 417 
bitter 233 
Bigarade 233 
China 233 
juice 233 
Portugal 233 
Seville 233 
swallow-wort 222 
sweet 233 
Ordeal bean 532 
of calabar 532 
Oregon grape 244 
Organotherapy 13, 107 
Ortho-monobromcamphor 269 
Ovis aries 155 
Ox 511 
Oxbile 370 
Ox-eye daisy 444 
Oxgall 370 
extract of 370 
powdered extract of 370 
Oxyacanthine 244, 245 
Oxydendron 510 
arboreum 510 
Specific Medicine.* 510 
Oxytocics 104, 105 
P 
Pale catechu 382 
touch-me-not 426 
Palmitin 155, 493 
727 INDEX. 
Panaquilon 511 
Panax 511 
Specific Medicine 511 
Pancreatin 25, 511 
Pancreatinum 511 
Papain 25, 512 
Papaverine 500 
Papaveris somniferum 500 
var. album 500 
Papaw tree, South American 512 
Papayotin 25, 512 
Papers 26, 28 
Papoid 512 
Pappoose root 282 
Paraffin 513 
liquid 517 
Paraffinum 513 
Paraldehyde 513 
Paraldehydum 513 
Parasiticides 80 
Parasitics 79, 80, 81 
Paregoric 122, 501 
Pareira 514 
-brava 514 
root 514 
Specific Medicine 514 
Parillin 620 
Parsley, decoction of 519 
fruit 519 
root 519 
seed 519 
Partridgeberry 480 
compound syrup of 282, 480 
Parts of plant drugs 13 
Pasque-flower 583 
Passe-flower 583 
Passiflora 515 
incarnata 515 
Specific Medicine 515 
Passion flower 515 
Paullinia Cupana 400 
Paul's betony 464 
Pea, wild turkey 325 
Peachtree 185 
Pearson's solution of sodium arsenate . 208 
Pelletierinae tannas 396 
Pelletierine 396 
tannate 396 
Pelosine 514 
Pennsylvania sumach 609 
Pennyroyal 403 
American 403 
infusion of 403 
Specific Medicine 403 
Penthorum 516 
sedoides 516 
Specific Medicine 516 
Pepo 516 
Pepper 546 
bird 275 
black 546 
Cayenne 275 
Guinea 275 
intoxicating long 546 
Jamaica 546 
red. .. 275 
Peppermint 478 
Peppermint, essence of 478 
oil of 478 
water 478 
Pepsencia 516 
Pepsin 25, 516 
essence of 516 
saccharated 516 
Pepsinum 516 
saccharatum 516 
Peptics 85, 86, 91 
Percentage solutions 69 
Peru, balsam of 236 
balsam 236 
Peruvian bark, yellow 303 
Petrolatum 511 
album 517 
heavy liquid 517 
light liquid 517 
liquid 517 
liquidum 517 
ointment 517 
white 517 
Petroleum 518 
jelly 517 
white 517 
Petroselinum 519 
sativum 519 
Pettymorrel 202 
Phaeoretin 599 
Phallin..... ... 169 
Pharmaceutical forms of medicines.... 26 
preparations, with doses 76 
Pharmacodynamics 11 
Pharmacognosy 13 
Pharmacology . 11 
Pharmacopoeia, United States 110 
Pharmacy 13 
Pheasant's eye 156 
Phenacetin 116 
Phenazone 190 
Phenol 519 
liquefactum 519 
liquefied 519 
Phenolphthalein 524 
Phenolphthaleinum ; 524 
Phenomenon, Theobald Smith 106 
Phenyldimethylpyrazalon 190 
Phenylis salicylas 525 
Phenyl salicylate 525 
Phlobaphene 442 
Phosphorus 526 
Specific Medicine 526 
Physeter macrocephalus 284 
Physic, antibilious 437, 627 
neutralizing (Beach's) 599 
white liquid 135, 647 
Dow's 135 
Physiological action 11 
Physostigma 532 
Specific Medicine 532 
venenosum 532 
Physostigminae salicylas 534 
Physostigmine 532 
salicylate 534 
Phytolacca 535 
decandra 535 
green tincture of 535 
728 INDEX 
Phytolacca, Specific Medicine 535 
Phytolaccin 535 
Phytolaccine 535 
Phytosterin 532 
Picro-crocin 328 
Picrotoxin 538 
Picrotoxinum 538 
Pill-bearing spurge 368 
Pill, Blaud's 371 
-masses 28 
Pills 26, 28 
compound 28 
ferrous carbonate 371 
iron 371 
of aloes 177 
simple 28 
Pilocarpene 539 
Pilocarpinae hydrochloridum 539 
nitras 539 
Pilocarpidine 539 
Pilocarpine 539 
hydrochloride 539, 545 
nitrate 539, 545 
Pilocarpus 539 
Jaborandi 538 
microphyllus 539 
Pilulse ferri carbonatis 371 
aloes 177 
Pimenta 546 
officinalis ...... 546 
Specific Medicine 546 
Pimento 546 
Pimpinella Anisum 189 
Pine-needle oil 112 
Pine tar 551 
Pink, Carolina 651 
Maryland 651 
Pinkroot 651 
Pinipicrin 677 
Pinus canadensis 112 
palustris . . . . 551, 597 
Specific Medicine 112 
Piper 546 
angustifolium 475 
Cubeba 328 
methysticum 546 
nigrum 546 
Specific Medicine 546 
tincture of 546 
Piperazine 548 
Piperazinum 548 
Piperin 546 
Piperine 546 
Piperinum 546 
Pipsissewa 288 
Piscidia 548 
Erythrina 548 
fluidextract of 548 
Piscidin 548 
Pitch, Canada 112 
Pith 18 
sassafras 621 
Pituglandol 549 
Pituitary body, solution of 549 
gland 549 
Pituitrin. 107, 549 
Pitzatropin 169 
Pix liquida 551 
Plantago 552 
major 552 
Specific Medicine 552 
Plantain 552 
Plant principles 22 
Plaster, capsicum 275 
mustard 633 
of Paris 261 
rosin 597 
adhesive 597 
rubber 597 
adhesive 597 
Plasters 26, 28 
Pleurisy root 222 
Plumbi acetas 552 
Plumbism 553 
Podophyllin 555, 557 
trituration of 555 
Podophyllotoxin 555 
Podophyllum 555, 556 
elixir of 555 
peltatum 555 
resin of 555 
Specific Medicine 555 
Poison dogwood 603 
hemlock 319 
ivy 602 
nut. 485 
oak 602 
tablets 26, 28 
vine 602 
Poisoning, acute, management of 45 
antidotes and treatment 46 
Poisons, list of 47 
Poke 535 
Indian 687 
root 535 
weed 535 
Polecat weed 345 
Polychroit 328 
Polygala Senega 626 
Polymnia 560 
ointment 560 
Specific Medicine 560 
Uvedalia 560 
Polyporus officinalis 249 
Pomegranate 396 
root bark 396 
decoction of 396 
Poplar, American 561 
Populin 561 
Populus 561 
tincture of 561 
tremuloides 561 
Portugal orange 233 
Posology 13 
Potash, acetate of 561 
bicarbonate of 563 
bromide of 566 
caustic 574 
chlorate of 571 
iodide of 576 
permanganate of 579 
Potassa.. 574 
solution of 574 
sulphurata 561 
729 INDEX 
Potassa sulphurated 561 
Potassii acetas 561 
bicarbonas 563 
bichromas 564 
bitartras 566 
bromidum 566 
carbonas 571 
chloras 571 
citras 573 
effervescens 573 
et sodii tartras 574 
hydroxidum 574 
hypophosphis 575 
iodidum 576 
nitras 579 
permanganas 579 
Potassio-ferric alum 373 
-ferric tartrate 373 
Potassium acetate 561 
alum 179 
and sodium tartrate 574 
bicarbonate 563 
bichromate 564 
binoxalate 136 
bitartrate 566 
bromide 566 
carbonate 571 
chlorate 571 
citrate 573 
effervescent 573 
solution of 573 
cyanide 129 
hydrate 574 
hydroxide 574 
solution of 574 
hypophosphite 575 
iodide 576 
nitrate 579 
permanganate 579 
Poultice, flaxseed 446 
Poultices 26, 29 
Powder, bleaching 265 
diaphoretic 501, 508 
(Beach's) 501, 508 
Dover's 501, 509 
emetic 455 
compound chalk 328 
effervescing 574 
emetic 345 
glycyrrhiza 627 
licorice 380, 395, 627, 628 
lobelia 455 
ipecac 432 
ipecac and opium 501 
compound 501 
ipecac, compound 501 
jalap, compound 437, 627, 628 
rhubarb, compound (Eclectic) 599 
(Gregory's) 599 
Seidlitz 574 
Powders 26, 29 
compound 29 
(list)........................... 77 
simple 29 
Preparations, pharmaceutical, with 
doses 76 
Prescription, abbreviations in 65 
Prescription blank 60 
construction of 64 
illustrative 65 
writing 60 
Preventive medicine 56 
Prickly ash 697 
northern 697 
southern 697 
Pride weed 360 
Prim . 445 
Primrose, evening 490 
tree.... 490 
Prince's pine 288 
Principles, bitter 25 
neutral 25 
plant 22 
Prinos 582 
tincture of 582 
verticillatus 582 
Privet 445 
decoction 445 
Privy . 445 
Procaine 312 
Protargol 205 
Protectives 78, 79 
Protein sensitization 106 
Protopine 615 
Protoveratridine 693 
Protoveratrine 687, 693 
Proximate principles of plants 22 
Prunus serotina 582 
Specific Medicine 582 
virginiana 582 
Prussian blue 374 
soluble 374 
Pseudo-conhydrine 319 
-jervine 687, 693 
-morphine 500 
-pelletierine 396 
Psychotherapy 13 
Ptelea.. 583 
Specific Medicine 583 
trifoliata 583 
Pterocarpus Marsupium 440 
Ptyalin 25 
Puccoon 615 
red 615 
yellow 417 
Puke weed 455 
Pulsatilla 583 
Specific Medicine 583 
Pul veres 29 
Pulvis cretse compositus 328 
effervescens compositus 574 
gallae.... 382 
glycyrrhizae compositus 627 
ipecacuanhae 432 
et opii 501 
compositus 501 
jalapae compositus 437, 627 
lobelise compositus 455 
rhei compositus 599 
Pumpkin seed 516 
Punica Granatum 396 
Punicine 396 
Purgatives 85, 88, 92 
Purging agaric 249 
730 INDEX. 
Purple coneflower 347 
foxglove 333 
Pustulants 78, 79 
Pyoktanin 480 
Pyrocatechin 382, 440 
Pyrola 587 
infusion of 587 
rotundifolia 587 
tincture of 587 
Pyroxylin 317 
Q 
Quaker buttons 485 
Quaking aspen 561 
Quassia 588 
infusion of 588 
Specific Medicine 588 
wood 588 
Quassin 588 
Quassiin 588 
Quebrachamine 228 
Quebracho 228 
fluidextract of 228 
Queen of the meadow 366 
Queen's delight 655 
root 655 
Queensland asthma weed 368 
Quercus 588 
alba 588 
infectoria 382 
Specific Medicine 588 
tinctoria 588 
Quickgrass 682 
Quicksilver 408 
Quinidine 303 
Quinina 589 
Quininae bisulphas 589 
dihydrochloridum 589 
et ureae hydrochloridum 312, 589 
hydrobromidum 589 
hydrochloridum 589 
salicylas 589 
sulphas 589 
tannas . 589 
Quinine 303 
and urea chloride 589 
and urea hydrochloride.. .312, 589, 597 
arsenate 213 
bisulphate 589, 597 
bromide 589 
chloride 589 
dihydrochloride 589 
hydrobromide 589, 597 
hydrochloride 589, 597 
inunction 591 
salicylate 589, 597 
sulphate 589 
tannate 589 
Quinotoxin 120 
Quinovin 303 
Quitch 682 
R 
Raccoon berry 555 
Rademacher's tincture of copper 
acetate 331 
Radices 14 
Radiotherapy 13 
Ragwort 625 
Raspberry 610 
black 610 
red 610 
syrup of 610 
Ratahnia 441 
Rattlesnake's master 361 
Rattleweed 466 
Reconstruct!ves 81, 82, 84 
Red alder 177 
cinchona bark 303 
clover 681 
haw 325 
mercuric iodide 409, 416 
pepper 275 
puccoon 615 
raspberry 610 
river snakeroot 629 
root 283 
Regulator, female 625 
Remedy, basic 59 
empiric 12 
endemic 58 
epidemic 57 
Resin of guaiac 399 
jalap 437 
podophyllum 555, 557 
Resina 597 
guaici 399 
jalapae 437 
kino 440 
podophylli 555 
Resinae 18, 29 
Resins 18, 26, 29 
Resorcin 598 
Resorcinol 598 
Resorcinum 598 
Respirants 94, 96 
Restoratives 81, 82, 84 
Rhamnoxanthin 380 
Rhamnus californica 599 
decoction of 599 
Frangula 380 
Purshiana 280 
Specific Medicine 599 
Rhatany 441 
extract of 441 
Rhein 599 
Rheum 599 
officinale 599 
palmatum 599 
var. tanguticum 599 
Specific Medicine 599 
Rheumatism root 438 
Rhizomata 14 
Rhizomes 14 
Rhubarb 599 
compound powder (Eclectic) 599 
(Gregory's) 599 
root 599 
syrup of 599 
aromatic 599 
Rhus 602 
aromatica 608 
glabra 136, 609 
fluidextract of 609 
731 INDEX 
Rhus, lucidum 603 
radicans 602 
Specific Medicine 602 
Toxicodendron 602 
typhina 136 
venenata 603, 604 
Rib grass 552 
Ribwort 552 
Rich-weed 315 
Ricinine 494 
Ricinolein 494 
Ricinus communis 494 
Rio ipecac 432 
Rochelle salt 574 
Roman chamomile 189 
Roots 14 
Rosa centifolia 201 
Rose bay 353 
Christmas 404 
water 201 
Rose-colored silkweed 225 
Rosin 597 
adhesive plaster 597 
cerate 597 
plaster 597 
Rottierin 440 
Round-leaved sundew 345 
Royal water 134 
Rubefacients 78, 79 
Rubijervine 687, 693 
Rubus 610 
canadensis 610 
Idaeus 610 
Specific Medicine 610 
strigosus 610 
trivialis 610 
villosus 610 
Rue 611 
garden 611 
oil of 611 
tincture of 611 
Rumex 610 
Acetosella 136 
crispus 610 
Specific Medicine 610 
Rush, scouring 355 
Russian licorice root 395 
Ruta 611 
graveolens 611 
Rutin 611 
Rye 356 
ergot of 356 
smut 356 
spurred 356 
S 
Sabadilla seeds 684 
Sacchara 21 
Saccharin 243 
sodium 243 
soluble 243 
Saccharinum 243 
Saccharomyces cerevisiae 284 
Saccharum 611 
lactis 612 
officinarum 611 
Sacred bark 280 
Saffron... 328 
American 279 
bastard 279 
bitter 328 
dyer's 279, 328 
Safflower 279 
Sage 614 
garden 614 
Indian 364 
infusion of 614 
oil of 614 
tincture of 614 
Saigon cinnamon 304 
Sal ammoniac 183 
Sal diureticus 562 
Sales effervescentes 26, 27 
Salicin 561, 612, 613 
Salicinum 612, 613 
Salicylism 138 
Salines 85, 92 
Salix nigra 613 
Specific Medicine 613 
Salol 525 
Salseparin 620 
Salt action 40 
Salt, common 640 
Epsom 471 
Glauber's 647 
Monsel's 450 
of tartar 571 
Rochelle 574 
sea 640 
solution, normal 640 
physiological 640 
table 640 
Saltpetre 579 
Chili 644 
Salts, bitter 471 
effervescent 26, 27 
lemon 136 
of sorrel 136 
smelling 182 
Salvarsan 214 
Salvia 614 
officinalis 614 
Sambucus 614 
canadensis 614 
Specific Medicine 614 
Sand brier 649 
Sandalwood, oil of 496 
Sanguinaria.. 615 
canadensis 615 
Specific Medicine 615 
Sanguinarina 615 
Sanguinarinae nitras 617 
Sanguinarine 285 
nitrate 617 
syrup of 617 
trituration of 617 
Santal, oil of 496 
East Indian 496 
wood, oil of 496 
Santalol 496 
Santalum album 496 
Santonica 618 
Santonin 618 
Santoninum 618 
732 INDEX. 
Saponin.. 286, 400, 406, 408, 438, 535, 683 
Saponins 25 
Sarsaparilla 620 
bristle-stem 201 
Specific Medicine 620 
Sassafras 621 
medulla 621 
oil of 621 
pith 621 
Specific Medicine 621 
variifolium 621 
Sassafrid 621 
Saw palmetto 628 
oil of 628 
Specific Medicine 628 
Scabious 360 
Scabwort 426 
Scarlet-berry 346 
Schleich, infiltration method of 310 
Scilla 621 
Scillain 621 
Scillin 621 
Scillipicrin 621 
Scillitoxin 621 
Scoparius 623 
decoction of 623 
infusion of 623 
Scopola Carniolica 623 
Scopolaminae hydrobromidum 623 
Scopolamine 421 
bromide 623 
hydrobromide 623 
Scouring rush 355 
Scullcap 625 
Scutellaria 625 
lateriflora 625 
Specific Medicine 625 
Sea onion 621 
wrack 381 
Secale cereale 356 
Secalotoxine 356 
Sedatives, arterial 95, 96 
cerebral a 97, 103 
gastric. ... 85, 86, 91 
genito-urinary 85, 90, 94 
heart 94, 95, 96 
nerve 97, 99 
respiratory 94, 95, 97 
special 94, 95, 96 
vasomotor 94, 95, 96 
Seeds 18 
Seidlitz powder 574 
Selective drug affinity 34 
Semina 18 
Seneca snakeroot 626 
Senecio 625 
aureus 625 
golden 625 
Specific Medicine 625 
Senega 626 
snakeroot 626 
Specific Medicine 626 
Seneka root 626 
Senna 627 
Alexandria 627 
India 627 
infusion of, compound 627 
Senna, Specific Medicine 627 
Tinnivelly 627 
Sennacrol 627 
Sennapicrin 627 
Sensitization, protein 106 
Sera et vaccina 29 
Serenoa 628 
serrulata 628 
Sero-therapy 13 
Serpentaria 629 
Specific Medicine 629 
Serum, antidiphtheric 629 
dried 630 
purified 629 
antidipthericum 629 
purificatum 630 
siccum 630 
antitetanic 631 
dried 631 
purified 632 
antitetanicum 631 
purificatum 631 
siccum 632 
disease 106 
sickness 106 
therapy 13, 105 
Serums 26, 29, 105 
Seven barks 408 
Seville orange 233 
Shave grass 355 
Sheep berry 694 
laurel 440 
Shepherd's purse 274 
sprout 274 
Shin leaf 587 
Shrubby trefoil 583 
Sialagogues 85, 86, 91 
Sickness, serum 106 
Silk, corn 698 
infusion of 698 
Silkweed 224 
rose-colored 225 
swamp 225 
Silver leaf 655 
Silver nitrate 202 
fused 202 
moulded 202 
substitutes for 205 
Silvol 205 
Simpler's joy 693 
Sinalbin 632 
Sinapis alba 632 
Sinigrin 633 
Sirup 611 
"606," Ehrlich's 215 
Skullcap 625 
Skunk cabbage 345 
weed 345 
Slippery elm 683 
Sloe 694 
-leaved viburnum. 694 
Smelling salts 182 
Smilacin 620 
Smilax medica 620 
officinalis 620 
ornata 620 
Smooth alder 177 
733 INDEX. 
Smooth buckeye 156 
sumach 609 
Smut, corn 684 
Snakehead 286 
Snake milk 367 
Snakeroot, black 466 
button 361, 445 
Canada 221 
Red river 629 
seneca 626 
senega 626 
Texas 629 
Virginia 629 
Snapping hazelnut 401 
Snow-drop tree 286 
Sapo 619 
mollis 620 
Soap 619 
asepsin 225, 227 
green 620 
tincture of 620 
hard 619 
liniment 619 
soft 620 
liniment of 620 
white castile 619 
Soapstone 672 
Socotrine aloes 177 
Soda..; 635 
baking 635 
bicarbonate 635 
salicylate of 646 
solution of chlorinated 452 
Sodii acetas 635 
benzoas 635 
benzosulphinidum 243 
bicarbonas 635 
boras 637 
bromidum 638 
cacodylas 639 
carbonas monohydratus 639 
chloridum 640 
citras 642 
hypophosphis £42 
iodidum 643 
nitras 644 
nitris 644 
phenolsulphonas 644 
phosphas 645 
effervescens 645 
exsiccatus 645 
salicylas 646 
sulphas. 647 
sulphis exsiccatus 648 
thiosulphas 649 
Sodium acetate 635 
arsanilate 214 
benzoate 635 
benzosulphinid 243 
bicarbonate 635 
borate 637 
bromide 638 
cacodylate 639 
carbonate, monohydrated 639 
chloride 640 
physiological solution of 640 
citrate 642 
Sodium dimethylarsenate 639 
hypophosphite 643 
hyposulphite 649 
iodide 643 
nitrate 644 
nitrite 644 
orthophosphate 645 
para-toluene-sulphon-chloramine... 642 
phenolsulphonate 644 
phosphate 645 
effervescent 645 
exsiccated 645 
Specific Medicine 645 
saccharin 243 
salicylate 646 
sulphate 647 
sulphite, exsiccated 648 
Specific Medicine 648 
sulphocarbolate 644 
thiosulphate 649 
Solanine 346 
Solanum 649 
carolinense 649 
Specific Medicine 649 
Solids 26 
Solutio 29 
Soluble ferric citrate 372 
gun cotton 317 
perchloride 449 
Solution of aluminum acetate 179, 180 
ammonium acetate 447 
arsenous acid 208 
arsenous and mercuric iodide 208 
basic ferric sulphate 450 
borated asepsin 225 
boroglyceride 122 
calcium hydroxide 264 
chlorinated soda 452 
cresol, compound 524 
Dobell's 523 
Donovan's 208, 213 
ferric chloride 449 
sulphate 450 
subsulphate 450 
formaldehyde 451 
Fowler's 208 
hydrogen dioxide 199 
peroxide 199 
hypophysis 549 
iodine 429 
iron, acid 448 
and ammonium acetate 450 
Labarraque's 452 
lead subacetate 552 
diluted 552 
Loeffler's 449 
Lugol's 429 
magnesium citrate 452 
Monsel's 450 
normal salt 640 
pituitary body 549 
potassium arsenite 208 
citrate 573 
sodium arsenate 208 
sodium chloride, physiological 640 
zinc chloride 699 
Solutions 26. 29 
734 INDEX 
Solutions, percentage 69 
Somnifacients 97, 100, 103 
Sophorine 237 
Sorrel, salts of 136 
tree 510 
Sourwood 510 
extract of 510 
tree 510 
Southern prickly ash 697 
Spanish licorice root 395 
Sparteinae sulphas 649 
Sparteine 623 
sulphate 649 
Spearmint 479 
essence of 479 
infusion of..., 479 
oil of 479 
spirit of 479 
water 479 
Specific Diagnosis 54 
classification of 55 
indication 54 
Medication 12, 54 
classification of . 55 
Specific Medicine achillea 117 
acid sulphurous 143 
aconite 148 
actaea 154 
adonis 156 
aesculus 156 
agrimonia 170 
aletris 175 
alnus 177 
anemopsis 188 
anise 189 
anthemis 189 
apis _.... 192 
apocynum 193 
aralia 201 
arnica 205 
asthma weed 368 
a vena 235 
baptisia 237 
barosma 253 
belladonna 239 
berberis 244 
black haw 694 
boletus 249 
bryonia 250 
cactus 253 
calamus 259 
calendula 262 
calumba 263 
cannabis 270 
cantharis 273 
capsella 274 
capsicum 275 
caraway 279 
cardamon 278 
cascara 280 
catalpa 281 
cataria 281 
caulophyllum 282 
ceanothus 283 
chelidonium 285 
chelone 286 
chimaphila 288 
Specific Medicine chionanthus 286 
cinchona 303 
cinnamomum 304 
cloves 279 
coffea 256 
colchicum 314 
collinsonia 315 
colocynth 318 
conium 319 
convallaria 321 
coriander 325 
cornus 325 
crataegus 325 
cubeba 328 
cuprum 331 
curcuma 328 
cypripedium 330 
digitalis 333 
dioscorea 344 
dosage of 39 
drosera 345 
dulcamara 346 
echinacea 347 
elaterium 351 
epigaea 352 
epilobium 353 
equisetum 355 
ergot 356 
erigeron 360 
eryngium 361 
eucalyptus 362, 364 
eupatorium 364 
euphorbia 367 
euphrasia 369 
hamamelis 401 
helleborus 404 
helonias 404 
hepatica 405 
horse chestnut 406 
humulus 407 
hydrangea 408 
hydrastis 417 
hydrochloric acil dilute 126 
hyoscyamus 421 
fennel 380 
fragrant sumach 608 
frangula 380 
fraxinus 381 
fucus 381 
galium 382 
gaultheria 383 
gelsemium 385 
gentiana 390 
geranium 391 
glycyrrhiza 395 
gossypium 395 
gravel root 366 
grindelia 397 
guaiac 399 
guarana 400 
ignatia 425 
inula 426 
ipecac 432 
jaborandi 539 
jacaranda 437 
jalap 437 
juglans 438 
735 INDEX 
Specific Medicine kalmia 440 
kameela 440 
kousso 330 
krameria 441 
lappa 442 
leptandra 443 
lobelia 455 
logwood 401 
lupulin 463 
lycopodium 463 
lycopus 464 
macrotys 466 
mangifera 474 
marrubium 475 
matricaria 475 
melilotus 328 
mistletoe 691 
mitchella 4g0 
myrica 486 
nutmeg 482 
nux vomica 485 
oenanthe 490 
oxydendron 510 
panax 511 
pareira 514 
passiflora 515 
pennyroyal 403 
penthorum 516 
phosphorus 526 
physostigma 532 
phytolacca 535 
pimenta 546 
pinus 112 
piper methysticum 546 
plantago 552 
podophyllum 555 
polymnia 560 
prunus 582 
ptelea 583 
quassia 588 
quercus 588 
rhamnus californica 599 
rheum 599 
rhus 602 
rubus 610 
rumex 610 
salix nigra aments 613 
sambucus 614 
sanguinaria 615 
sarsaparilla 620 
sassafras 621 
saw palmetto 628 
Scutellaria 625 
senecio 625 
senega 626 
senna 627 
serpentaria 629 
sodium phosphate 645 
sodium sulphite 648 
solanum 649 
spigelia 651 
spikenard 202 
spongia 653 
spotted spurge 368 
squill 621 
staphisagria 653 
sticta 655 
Specific Medicine stigmata maydis.... 698 
stillingia 655 
stramonium 657 
swamp milkweed 225 
taraxacum 672 
tela araneae 673 
thuja 677 
tiger lily 445 
trifolium 681 
triticum 682 
urtica 684 
ustilago 684 
uva ursi 685 
valerian 685 
veratrum 687 
verbascum 693 
viburnum 694 
xanthium spinosum 696 
xanthoxylum 697 
yerba santa 361 
zingiber 702 
Specific Medicines 26, 29 
historic note 30 
Colloidal 31 
Specific therapy 12 
Speckled touch-me-not 426 
Speedwell, tall 443 
Spermaceti 284 
Sperm whale 284 
Sphacelotoxine 356 
Spider's web 673 
Spigelia 651 
marilandica 651 
Specific Medicine 651 
Spigeline 651 
Spignet 202 
Spikenard 202 
American 202 
Specific Medicine 202 
Spindle tree 364 
Spiny clot-bur 696 
Spirit of anise 189 
camphor 267 
chloroform 294 
ether 157 
gaultheria 383 
juniper 439 
compound 439 
lavender 442 
compound 442 
Mindererus 447 
nitre, sweet 652 
nitrous ether 652 
peppermint 478 
proof 170 
spearmint 479 
turpentine 496 
wine 170 
Spirits 26, 31 
compound 31 
simple 31 
Spiritus 31 
aetheris 157 
nitrosi 652 
anisi 189 
camphorae 267 
chloroformi 294 
736 INDEX 
Spiritus frumenti 170 
gaultheriae 383 
juniperi 439 
compositus 439 
lavandulae..._ 442 
menthae piperitae 478 
menthae viridis 479 
vini gallici 170 
Sponge, burnt 653 
Spongia officinalis 653 
Specific Medicine 653 
tosta 653 
usta 653 
Spoonwood 440 
Spores 18 
Spotted geranium 391 
hemlock 319 
Spruce, hemlock 112 
oil of 112 
Spurge, blooming 367 
ipecac 368 
large flowering 367 
large spotted 368 
pill-bearing 368 
Specific Medicine 368 
Squawberry 480 
Squawmint 403 
Squaw-root 282 
Squaw-vine 480 
Squill 621 
Specific Medicine 621 
syrup of 621 
compound 621 
tincture of 621 
vinegar of 621 
Squills 621 
Squirrel corn 325 
Squirting cucumber 351 
St. Ignatius' bean 425 
St. John's wort 424 
Stag bush 694 
Staphisagria 653 
Specific Medicine 653 
Staphisagrine 653 
Staphisagroine 653 
Star anise 189 
grass 175 
Starch 21 
corn 188 
glycerite of 188, 394 
Starwort 175, 404 
drooping 404 
Stavesacre 653 
Stearin 155 
Stearoptenes 20 
Sterculia acuminata 441 
Sternutatories 89 
Stickwort 170 
Sticta 655 
Pulmonaria 655 
Specific Medicine 655 
Stigmata maydis 698 
Specific Medicine 698 
Stillingia 655 
liniment 655 
Specific Medicine 655 
sylvatica 655 
Stimulants 98 
cerebral.. 97, 103 
genitourinary 85, 90, 93 
heart 94, 96 
nerve 97, 98 
pancreatic 85, 88, 92 
respiratory 94, 95, 96 
vasomotor 94, 95, 96 
Stinging nettle 684 
Stomachics 85, 86, 91 
Stone-crop, ditch 516 
Virginia 516 
Stone-root 315 
Storesin 447 
Stovaine 313 
Stramonium 421, 657 
ointment of 657 
Specific Medicine 657 
Strontii bromidum 659 
Strontium bromide 659 
Strophanthidin 659 
Strophanthin 659 
Strophanthinum 659 
Strophanthus 659 
hispidus 659 
Kombe 559 
tincture of 659 
Strychnina 662 
Strychninae nitras \ 662 
sulphas 662 
Strychnine 425, 485, 662 
nitrate 662 
sulphate 662 
Strychnos Ignatia 425 
Nux vomica 485 
Stylophorine 285 
Styptics 78, 79, 102 
Styracin 236, 447 
Styrol 447 
Subculoyd lobelia 455 
Substances, coloring 108 
Succi 27 
inspissati et extracta 18 
Succus allii 176 
Sucrose 477, 611 
Sudorifics 85, 90 
Sugar 611 
cane 477 
fruit 477 
grape 477 
milk 612 
of milk 612 
Sugars.. 21 
Suggestive therapeutics 13 
Sulphonal 665 
Sulphonmethane 665 
Sulphonmethanum 665 
Sulphonethylmethane 666 
Sulphonethylmethanum 666 
Sulphur 666 
flowers of 666 
lac 666 
liver of 561 
lotum 667 
milk of 666 
ointment 667 
precipitated 666 
737 INDEX. 
Sulphur, praecipitatum 666 
sublimatum 666 
sublimed 666 
washed 667 
Sumac-bobs 136 
Sumach, fragrant 608 
Pennsylvania 609 
smooth 609 
Specific Medicine 608 
sweet 608 
upland 609 
Sumbul 670 
fluidextract of 670 
Sundew 345 
round-leaved 345 
Suppositoria 31 
glycerini 392 
Suppositories 26, 31 
Suppurants I 78, 79 
Suprarenals, dessicated 353 
dried 353 
Suprarenalum siccum 353 
Suprarenin 353 
Sus scrofa var. domesticus 155, 511 
Swallow-wort, orange 222 
Swamp hellebore 687 
milkweed 225 
Specific Medicine 225 
silkweed 225 
willow herb 353 
Sweet bugle 464 
fennel 380 
-flag 259 
gum 447 
orange 233 
peel 233 
-scented cactus 253 
sumach 608 
Sweetening agents 108 
Symphytum 670 
officinale 670 
tincture of 670 
Synergists 38 
Syringin 445 
Syringopikrin 445 
Syrup. 611 
of acacia 113 
allium 176 
althaea 178 
black raspberry 610 
bromide of iron 371 
calamus 259 
calcium lactophosphate 261 
ferrous iodide 671 
ginger 702 
hoarhound, compound 475 
hydriodic acid 130 
inula....; 426 
iodide of iron 671 
ipecac. 432 
lactucarium 442 
mitchella, compound 282 
onion 176 
orange 233 
partridgeberry, compound 282, 480 
raspberry 610 
Syrup, rhubarb 599 
aromatic 599 
and potassa, compound 599 
sanguinarine nitrate 617 
sarsaparilla, compound 620 
simple 611 
squill 621 
tar 551 
wild cherry 582 
Syrupi 31 
Syrups 26, 31 
flavored 31 
(list of) 77 
medicated 31 
simple 31 
Syrupus 611 
acaciae 113 
acidi hydriodici 130 
allii 176 
althaese 178 
asari.„ 221 
aurantii 233 
calami 259 
calcii lactophosphatis 261 
ferri bromidi 371 
iodidi 671 
inulae 426 
ipecacuanhae 432 
lactucarii 442 
marrubii compositus 475 
mitchellae compositus 282, 480 
picis liquidae 551 
pruni virginianae 582 
rhei 599 
aromaticus 599 
et potassae compositus 599 
rubi 610 
ideae. ...... 610 
sanguinarinae nitras 617 
sarsaparillae compositus 620 
scillae 621 
compositus 621 
simplex 611 
zingiberis 702 
T 
Tabellae.; 31 
Tables, dispensing and percentage.. .69, 70 
Tablet triturates 31 
Tablets 26, 31 
coated 32 
compressed 31 
hypodermic 32 
poison 26, 28 
Taeniin 330 
Tag alder 177 
Talc, purified 672 
Talcum purificatum 672 
Tall speedwell 443 
Tanacetin 672 
Tanacetum 672 
tincture of 672 
vulgare 672 
Tanghinin 659 
Tannin... 145, 391, 382 
glycerite of 145 
738 INDEX. 
Tannins 22 
pathologic 22 
physiologic 22 
Tansy 672 
oil of 672 
Tar 551 
camphor 246 
oil of 551 
pine 551 
rectified oil of 551 
syrup of 551 
water 551 
Taraxacin 672 
Taraxacum 672 
officinale.....; 672 
Specific Medicine 672 
Tartar, cream of 564 
salt of 571 
Taurocholates 370 
Tea, New Jersey 283 
Teaberry . 383 
Tegenaria domestica 673 
medicinalis 673 
Tela aranese 673 
Specific Medicine 673 
Terebene 673 
Terebenum. . 673 
Terms, definition of therapeutic 70 
Terpene 629 
Terpineol 491 
Terpin hydrate 674 
Terpini hydras 674 
Terra japonica 382 
Tetraiodopyrrol 429 
Tetterwort 285, 615 
Texas snakeroot 629 
Thea sinensis 257 
Thebaine 500 
Theine 257, 441 
Theobald Smith phenomenon 106 
Theobroma, oil of 499 
Theobromine. ........ 441, 499 
Therapeutic classification of drugs. ... 78 
Therapeutics 12 
dynamic 13 
empirical 12 
forms 12 
mediate 13 
mental 13 
natural 12 
rational 12 
suggestive 13 
terms, definitions of 70 
Therapy, cellular 13 
drug 13 
serum 13, 105 
specific 12 
vaccine 13, 105 
Thiosinamine 634 
Thorn 325 
Thornapple 657 
Thorough-wax 364 
Thoroughwort 364 
Thousand leaf 117 
Through-stem 364 
Thuja 677 
aqueous 677 
Thuja, Long's 677 
occidentalis 677 
Specific Medicine 677 
Thujin 677 
Thujone 614 
Thymol 674 
Thymol iodide 675 
Thymolis iodidum 675 
Thymus vulgaris 674 
Thyreoglobulin 676 
Thyroideum siccum 676 
Thyroid glands, dessicated 676 
extract 107 
Thyroidism 676 
Thyroids, dried 107, 676 
Tickweed 403 
Tiger lily ■ 445 
Tinctura aconiti 148 
agarici 169 
aloes 177 
arisaema 205 
arnicae 205 
asafetidae 221 
asari 221 
asclepiadis cornuti 224 
aurantii amari 233 
dulcis 233 
avenae 235 
berberidis vulgaris •... 245 
capsici 275 
cardamomi composita 278 
cinchonae 303 
composita 303 
coptis 324 
corallorhizae 322 
croci. .... 328 
cupri aceti Rademacheri 331 
digitalis 333 
dracontii 345 
ferri acetatis 679 
chloridi 679 
gambir composita 382 
gentianae composita 390 
guaiaci ammoniata 399 
hyperici 424 
iodi 429 
jeffersoniae 428 
kino 440 
lactucarii 442 
lappae seminis 442 
lavandulae composita 442 
lobeliae composita 455 
matico 475 
menispermii 478 
myrrhae 483 
nucis vomicae 485 
opii 501 
camphorata 501 
phytolaccae recentium 535 
piperi 546 
populi 561 
prini r. 582 
pyrolae 587 
rutae 611 
salviae 614 
sanguinariae acetata composita .... 615 
scillae 621 
739 INDEX. 
Tinctura strophanthi 659 
symphyti 670 
tanaceti 672 
valerianae 685 
ammoniata 685 
vanillae 686 
zingiberis 702 
Tincturae 32 
herbarum recentium 32 
Homceopathicae 32 
Tincture, acetate of iron 679 
acetous emetic 345, 455, 462, 615 
aconite 148 
Fleming's 148 
agaricus 169 
aloes 177 
arisaema 2o5 
arnica 205 
asafetida 221 
bark, Huxham's 303 
berberis vulgaris 245 
bitter orange peel 233 
bloodroot, compound acetated 615 
cajuput, compound 491 
capsicum 275 
cardamon, compound 278 
chloride of iron 679 
cinchona 303 
compound 303 
copper acetate, Rademacher's 331 
coptis 324 
coral root 322 
crocus 328 
dracontium 354 
euphorbia ipecacuanha 386 
expectorant 455 
ferric chloride 679 
gambir, compound 382 
gentian, compound 390 
ginger 702 
green soap 620 
guaiac, ammoniated 399 
iodine 429 
iron 679 
muriated 679 
jeffersonia 438 
kino 440 
lactucarium 442 
lappa seeds 442 
lavender, compound 442 
lobelia, compound 455 
matico 475 
menispermum 478 
muriate of iron 679 
myrrh 483 
nux vomica 485 
opium 501 
deodorized 501 
camphorated 501 
phytolacca (green) 535 
piper 546 
populus 561 
prinos 582 
pyrola 587 
red onion 176 
rue 611 
sage 614 
Tincture, squill 621 
sweet orange peel 233 
symphytum 672 
tanacetum 672 
valerian 685 
ammoniated 685 
veratrum album, homoeopathic.... 693 
Tinctures 26, 32 
compound 32 
Homoeopathic mother 32 
(list) 77 
of fresh herbs 32 
simple 32 
Tobacco 462 
Indian 455 
wild 455 
Tolerance, drug 37 
Toluene-para-sulphondichloramine .... 642 
Toluifera Pereirae 236 
Tongue, dead 490 
Tonics 81, 82, 84 
heart 94, 95, 96 
Toxicodendrol 602, 604 
Toxicology 11 
Toxitabellae 28 
Trailing arbutus 352 
Transfusion 42 
Treadsoft 649 
Tree lungwort 655 
of life 677 
primrose... 490 
Trifolium 681 
compound 698 
pratense 681 
Specific Medicine 681 
Triiodomethane 427 
Trimethylamine 684 
Trinitrophenol 682 
Trional 666 
Triticin 682 
Triticum 682 
infusion of 682 
repens 682 
sativum 370 
Specific Medicine 682 
Triturates 31, 32 
tablet 31 
Trituratio calx sulphuratae 262 
elaterini 351 
podophylli 555 
sanguinarinae nitras 617 
Trituration of carbo vegetabilis 277 
podophyllin 555 
sanguinarine nitrate 617 
sulphurated lime 262 
Triturationes 32 
Triturations 26, 32 
Troches 28 
of gambir 382 
Trochisci 28 
gambir 382 
Tropacocaine 312 
Trypsin 512 
Tsuga canadensis 112 
Tubera 14 
Tubers 14 
Turkey corn 325 
740 INDEX. 
Turmeric 329 
Turpentine, liniment of 496 
oil of 496 
rectified 497 
spirit of 496 
Turtlebloom 286 
Turtlehead 286 
Tussilago. 683 
decoction of 683 
Farfara 683 
Twigs 15 
Twin leaf 438 
Tyramine 356 
U 
Ulexine 237 
Ulmus 683 
fulva 683 
Unguenta 28 
Unguentum acidi borici 122 
tannici 145 
aquse rosse 201 
belladonnae 239 
chrysarobini 302 
cocculi 313 
gallze. 382 
hydrargyri oxidi flavi 409 
iodi 429 
iodoformi 427 
polymniae 560 
stramonii 657 
sulphuris 667 
zinci oxidi 700 
Unicorn root 404 
United States Pharmacopoeia 110 
Upland cranberry 685 
sumach 609 
Urginea maritima 621 
Urotropin 405 
Urson 352, 383, 587 
Ursone 685 
Urtica 684 
dioica 684 
Specific Medicine 684 
Ustilagine 684 
Ustilago... 684 
Maydis 684 
segetum 684 
Specific Medicine 684 
Uva ursi 685 
Specific Medicine 685 
Uvedalia 560 
ointment 560 
V 
Vaccine, antityphoid 107 
therapy 13, 105 
Vaccines 26, 29, 105, 106 
Vaccino-therapy 13 
Valerian 685 
American 330 
great wild 685 
Specific Medicine 685 
tincture of. 685 
ammoniated 685 
Valeriana 685 
Valeriana officinalis 685 
Vallet's mass 371 
Vanilla 686 
planifolia 686 
tincture of 686 
Vanillin 236, 686 
Vanillinum 686 
Vapors 26 
Vaso-cardiants 94, 96 
-constrictors 95, 96 
-dilators 95, 96 
Vegetable antimony 364 
mercury 380 
Vehicles 51, 108 
Veratria 686 
Veratrina 686 
Veratrine 686, 687 
Veratroidine 687 
Veratrum 687 
album 693 
Homoeopathic mother, tincture 
of...... 693 
Specific Medicine 687 
viride 687 
Verbascum 693 
Specific Medicine 693 
Thapsus 693 
Verbena 693 
fluidextract of 693 
hastata 693 
Verdigris 331 
Vermicides 80 
Vermifuges 80 
Veronal.. . .. 283 
Veronica virginica 443 
Vervain 693 
common 693 
Vesicants 78, 79 
Viburnin 694 
Viburnum Lentago 694 
Opulus 694 
prunifolium 694 
sloe-leaved 694 
Specific Medicine 694 
Vina 26, 32 
medicata. 32 
Vinegar of squill 621 
Vinegars 26, 32 
Vinum album 170 
portense 170 
rubrum.... 170 
xericum 170 
Violet-bloom 346 
Virginia snakeroot 629 
stone-crop 516 
Viruses 29 
Viscin 696 
Viscum 696 
flavescens 696 
Vitamines 492 
Vitellin 516 
Vitriol, blue 331 
elixir of 141 
green 376 
oil of 141 
Vomit weed 455 
Vouacapoua Araroba 302 
741 INDEX. 
W 
Wafer ash 583 
Wafers 26 
Wahoo 364 
Walnut, white 438 
Water, ammonia 197 
anise 189 
camphor 267 
chloroform 294 
dropwort 490 
eryngo 361 
hamamelis 401 
hemlock 490 
lead 552 
lovage 490 
peppermint 478 
rose 201 
stronger 201 
royal 134 
spearmint 479 
tar 551 
Waters 26 
aromatic 26 
medicated 26 
Wash, Eclectic 605 
yellow 415 
Washes 26, 28 
eye 26, 27 
Waxberry 481 
Waxes 21 
Wax myrtle 481 
white 283 
yellow 283 
Wayfarer's tree . 694 
Weights and Measures 66 
Wermuth 113 
Whale, sperm 284 
Wheat flour 307 
Whisky..... 170 
White agaric 249 
ash 381 
baneberry 154 
beads 154 
cohosh 154 
liquid physic 135, 647 
mustard 632 
oak bark 588 
precipitate 408, 416 
walnut 438 
wax 283 
Wickop 353 
Wickup 353 
Wild balsam apple 351 
black cherry bark 582 
chamomile 475 
cherry 582 
syrup of 582 
cotton 224 
cranesbill 391 
cucumber 351 
elder 201 
ginger 221 
hydrangea 408 
hyssop 693 
ipecac 368 
lemon 555 
tobacco 455 
Wild turkey pea 32^ 
yam 344 
Willow herb 353 
great 353 
swamp 353 
Wind flower 583 
Wine, port 170 
red 17r 
sherry 17< 
spirit of «... 170 
white 170 
Wines 26, 32 
medicated 32 
(list) 77 
Wing seed 583 
Winterberry 582 
Winterbloom 401 
Wintergreen 383 
essence of 383 
false 587 
oil of.... 137, 383 
oil, artificial 383 
true 383 
Witch-hazel 401 
distilled 401 
distilled extract of 401 
Wolfsbane 148 
Wood charcoal 277 
Woods 15 
Woody nightshade 346 
Wool-fat 15s 
hydrous 155 
purified 155 
Worm-grass 651 
Wormseed 286 
American 286 
oil of 286, 491 
Levant 618 
Wormwood 112 
oil of 112 
Wrack, bladder 381 
sea 381 
X 
Xanthium ; 696 
Specific Medicine 696 
spinosum 696 
strumarium 697 
fluidextract of 697 
Xanthoxylum 697 
americanum 697 
Clava-Herculis 697 
¥ 
Yarrow 117 
Yaw root 655 
Yeast, beer 284 
brewer's 284 
Yellow cedar 677 
dock 610 
jasmin 385 
jessamine 385 
ladies' slipper , 330 
melilot 477 
clover 477 
mercuric oxide 409 
mercurous iodide 408 
742 INDEX. 
Yellow moccasin flower 330 
mustard 632 
parilia 478 
Peruvian bark 303 
puccoon 417 
root 417 
sweet clover 477 
• , wash 415 
wax 283 
r erba del mansa 188 
mansa 188 
reuma 381 
santa... 361 
Specific Medicine 361 
Z 
Zea Mays ; 188, 684, 698 
Zinc carbonate, precipitated 699 
chloride 699 
Zinc chloride, solution of 699 
oxide 700 
ointment of 700 
phenolsulphonate 700 
phosphide 700 
sulphate 701 
sulphocarbolate 700 
valerate 701 
valerianate 701 
Zinci carbonas praecipitatus 699 
chloridum 699 
oxidum 700 
phenolsulphonas 700 
phosphidum 700 
sulphas 701 
valeras 701 
Zingiber 702 
officinale 702 
Specific Medicine 702 
743