ARMY MEDICAL LIBRARY WASHINGTON
Founded 1836
Section
Number I.C..L
Fobm 113c, W. D.. SCO •'• 3—10543 (Kevised Juno 13. 1936)
\
■
MATERIA MEDIOA.
MATERIA MEDIC A,
THE USE OF STUDENTS.
JOHN B. BIDDLE, M.D.,
PROFESSOR OF MATERIA MEDICA AND GENERAL THERAPEUTICS IN THE JEFFERSON MEDICAL
COLLEGE, MEMBER OF THE AMERICAN PHILOSOPHICAL SOCIETY, FELLOW OF THE
COLLEQEOF PHYSICIANS, ETC., ETC.
WITH ILLUSTBATIOUS.
7oyrfa>
PHILADELPHIA:
LINDSAY & BLAKISTON.
1865.
QV I8(
Entered, according to Act of Congress, in the year 1865,
BY LINDSAY & BLAKISTON,
In the Clerk's Office of the District Court of the United States for the Eastern District of Pennsylvania.
SHERMAN 4 CO., PRINTERS.
PREFACE.
A second edition" of the author's Review of Materia Medica having been called for, he has revised and enlarged it, and adapted it to the last edition of the U. S. Pharmacopoeia. Numerous additions have been made to the list of articles treated of, and the work has been remodelled and, in many parts, rewritten. Although not designed to take the place of the more voluminous and systematic treatises upon the sub- ject, it is believed that it will be found to contain a succinct account of all the articles of the Materia Medica in use in this country, and to furnish a suit- able textbook to the courses of lectures delivered upon the branch. It is illustrated by representations of most of the important indigenous and naturalized plants.
The author begs leave respectfully to renew his dedication of the work to the gentlemen in attend- ance upon the various medical schools in the United States.
Philadelphia, October, 18G5.
CONTENTS.
PAGE
Remedies— Definition of, . 17
Division of, 17
PAKT I.
MECHANICAL KEMEDIES.
General Bloodletting, 17
Leeches and Cups, .......... 18
Setons and Issues, .......... 19
Bandages, Frictions, Acupuncture, 19
PAKT II.
IMPONDERABLE REMEDIES.
Light, 20
Heat, 20
Cold, 21
Electricity, 22
PAKT III.
PHARMACOLOGICAL REMEDIES, OR MEDICINES.
Medicines — Definition of,
Modus Operandi of,
Circumstances which modify the Effects of, Forms in which they are used, ....
"Weights and Measures,
Effect of Age, Sex, Temperament, Idiosyncrasy, Habit
&c., upon,
Parts to which Medicines are appliod, . Classification of Medicines,
23 24 26 26 34
35 36 39
Vlll
CONTENTS.
Class I. — Neurotics, Order I. Narcotics,
Opium, .
Lactucarium,
Belladonna, .
Stramonium,
Hyoscyamus (Henbane)
Tabaeum (Tobacco),
Lobelia,
Conium (Hemlock),
Aconitum (Aconite),
Extractum Cannabis (Extract of Hemp),
Humulus (Hops),
Dulcamara (Bittersweet),
Acidum Hydrocyanicum (Hydrocyanic Acid),
Potassii Cyanidum (Cyanide of Potassium),
Oleum Amygdalae Amarae (Oil of Bitter Almond)
Camphora (Camphor), . Order II. Ethereal Anaesthetics, .
^Ether (Ether), .
Chloroformum (Chloroform), Order III. Antispasmodics, .
Assafcetida (Assafetida),
Galbanum, ....
Ammoniaeum (Ammoniac),
Valeriana (Valerian), .
Cypripedium,
Scutellaria (Skullcap), .
Dracontium (Skunk-Cabbage),
Moschus (Musk), .
Castoreum (Castor),
Oleum Succini (Oil of Amber),
Oleum iEthereum (Ethereal Oil),
Spiritus ^Etheris Compositus (Compound Spirit of Ether), Order IV. Tonics, .
Vegetable Tonics, Simple Bitters,
Quassia,
Simaruba,
Coptis (Goldthread),
Gentiana (Gentian),
Frasera (American Columbo),
Sabbatia (American Centaury), Calumba (Columbo),
PAGE
40 40 40 47
48 51 52 54 56 58 60 61 62 64 64 66 66 67 70 70 73 76 76 78 78 79 80 80 80 81 82 82 83
83 84 85 86
86 87 88 89 89 90
CONTENTS.
IX
*)>
Chiretta,
Xanthorriza (Yellow- Eoot), Aromatic Bitters, .....
Serpentaria (Virginia Snakeroot),
Anthemis (Chamomile),
Cotula (Mayweed),
Matricaria (German Chamomile),
Eupatorium (Thoroughwort),
Absinthium ("Wormwood), .
Magnolia, .....
Liriodendron (Tulip-Tree Bark),
Angustura (Angustura Bark),
Cascarilla,
Canella,
Achillea (Yarrow),
Angelica, Astringent Bitters,
Cinchona (Peruvian Bark), .
Cornus Florida (Dogwood), .
Salix (Willow), .
Prunus Virginiana (Wild Cherry Barl
Nectandra, . Mineral Tonics, .
Ferri Prseparata (Preparations of Iron),
Cupri Prseparata (Preparations of Copper),
Zinci Praeparata (Preparations of Zinc),
Argenti Praeparata (Preparations of Silver),
Bismuthi Subnitras (Subnitrate of Bismuth),
Cadmii Sulphas (Sulphate of Cadmium),
Acida Mineralia (Mineral Acids), Order V. Astringents, .... Vegetable Astringents,
Acidum Tannicum (Tannic Acid),
Acidum Gallicum (Gallic Acid), .
Galla (Nutgall), ....
Catechu,
Kino,
Krameria (Ehatany), .
Haematoxylon (Logwood), .
Quercus Alba (White Oak Bark),
Quercus Tinctoria (Black Oak Bark),
Geranium (Cranesbill),
Uva Ursi,
Chimaphila (Pipsissewa),
Granati Fructus Cortex (Pomegranate Eind),
Eosa Gallica (Eed Eose), ....
CONTENTS.
Ammonia)
Rosa Centifolia (Pale Eose), Diospyros (Persimmon),
Tormentilla (Tormentil), Rubus (Blackberry Root),
Heuchera (Alum-Root),
Creasotum (Creasote), . Mineral Astringents, .
Plumbi Praeparata (Preparations of Lead)
Alumen (Alum), . Order VI. Stimulants,
Diffusible Stimulants, .
Alcohol, ....
Vinum (Wine),
Spiritus Vini Gallici (Brandy),
Ammoniae Praeparata (Preparations of Aromatics,
Capsicum (Cayenne Pepper),
Piper (Black Pepper), .
Cinnamomum (Cinnamon),
Myristica (Nutmeg), .
Macis (Mace),
Caryophyllus (Cloves),
Pimenta (Pimento),
Oleum Cajuputi (Cajeput Oil),
Oleum Terebinthinae (Oil of Turpentine)
Zingiber (Ginger),
Cardamomum (Cardamom), .
Calamus (Sweet Flag), .
Gaultheria (Partridge-Berry),
Aurantii Cortex (Orange Peel)
Arnica,
Those belonging to Nat. Ord. Lamiacea?,
Those belonging to Nat. Ord. Apiaceae, Order VII. Sedatives,
Digitalis (Foxglove), ....
Veratrum Viride (American Hellebore),
Veratrum Album ("White Hellebore), .
Gelsemium (Yellow Jasmine),
Antimonii Prseparata (Preparations of Refrigerants, ....
Potassae Nitras (Nitrate of Potassa), ,
Sodae Boras (Borate of Soda),
Potassae Citras (Citrate of Potassa),
Liquor Ammoniae Acetatis (Solution of Acetate of Ammonia),
Antimony
PAGE
138
139
139
139
139
140
141
141
145
146
147
147
149
149
150
152
152
153
154
155
155
156
157
157
158
158
159
160
161
162
162
163
164
165
165
167
168
169
169
173
173
174
175
176
CONTENTS. XI
PAGE
Spiritus iEtheris Nitrosi (Spirit of Nitrous Ether), . 176
Acida Vegetabilia (Vegetable Acids), .... 176
Order VIII. Spastics, 178
Nux Vomica, 178
Ignatia, 180
Toxicodendron (Poison Oak), 181
Ergota (Ergot), 181
Gossypii Radix (Cotton Eoot), 183
Class II. — Eccritics, 183
Order I. Emetics, 183
Vegetable Emetics, ........ 185
Ipecacuanha, ........ 185
Sanguinaria (Bloodroot), 186
Euphorbia Corollata (Large Flowering Spurge), . 188
Euphorbia Ipecacuanha (Ipecacuanha Spurge), . . 188
Gillenia, 189
Sinapis (Mustard), 189
Mineral Emetics, 190
Order II. Cathartics, 190
Laxatives, .......... 192
Manna, 192
Cassia Fistula (Purging Cassia), 193
Oleum Oliva? (Olive Oil), 193
Oleum Amygdalae Dulcis (Oil of Sweet Almond), . 193
Oleum Eicini (Castor Oil), 194
Sulphur 195
Saline Cathartics, 196
Magnesia, 196
Magnesia? Carbonas (Carbonate of Magnesia), . . 197
Magnesia? Sulphas (Sulphate of Magnesia), . . 197 Liquor Magnesia? Citratis (Solution of Citrate of
Magnesia), ........ 198
Soda? Sulphas (Sulphate of Soda), .... 198
Manganesii Sulphas (Sulphate of Manganese), . . 199
Soda? Phosphas (Phosphate of Soda), .... 199
Potassa? Sulphas (Sulphate of Potassa), . . . 200
Potassa? Bitartras (Bitartrate of Potassa), . . . 200
Potassa? Tartras (Tartrate of Potassa), . . . 201 Potassa? et Soda? Tartras (Tartrate of Potassa and
Soda), 201
Mild Acrid Cathartics, 202
Rheum (Rhubarb), 202
Aloe (Aloes), 205
Leptandra, 207
Senna, 207
Cassia Marilandica (American Senna), . . . 209
xii ' CONTENTS.
PAGE Olrt
Drastic Cathartics,
91 A
Jalapa (Jalap),
Podophyllum (May Apple), 211
Scammonium (Scammony), 212
Helleborus Niger (Black Hellebore), . . . .213
Colocynthis (Colocynth), 213
Gambogia (Gamboge), 214
Elaterium, 215
Oleum Tiglii (Croton Oil), 215
Mercurial Cathartics, 2* '
Enemata, 218
Order III. Diaphoretics, 218
Alterative Diaphoretics, 22A
Sarsaparilla, ......•• 220
Aralia Nudicaulis (False Sarsaparilla), . . . 222 Guaiaci Lignum et Kesina (Guaiacum Wood and
Guaiac), ......... 222
Mezereum (Mezereon), ...... 223
Sassafras, ......... 224
Order IV. Diuretics, 224
Scilla (Squill), 226
Colchicum, 228
Erigeron (Fleabane), 230
Apocynum Cannabinum (Indian Hemp), . . . 231
Taraxacum (Dandelion), ...... 232
Juniperus (Juniper), 233
Carota (Carrot Seed), 233
Cantharis (Cantharides), 234
Order V. Blennorrheas, ........ 235
Senega (Seneka), 236
Cimicifuga (Black Snakeroot), ..... 238
Allium (Garlic), 239
Scilla (Squill), 240
Terebinthina (Turpentine), 240
Copaiba, ......... 244
Cubeba (Cubeb), 245
Matico, 247
Pareira (Pareira Brava), ...... 247
Buchu, 248
Myrrha (Myrrh), 248
Benzoinum (Benzoin), ...... 249
Balsamum Peruvianum (Balsam of Peru), . . . 251
Balsamum Tolutanum (Balsam of Tolu), . . . 251
Order VI. Emmenagogues, ....... 252
Sabina (Savine), 253
CONTENTS. Xlll
PAGE
Euta (Eue), 254
Eubia (Madder), 254
Class III. — Haematics, 254
Order I. Haematinics, 254
Order II. Alteratives, 255
Hydrargyri Praeparata (Preparations of Mercury), . 256
Iodinium (Iodine), 271
Potassii Iodidum (Iodide of Mercury), . . . 273
Brominium (Bromine), 274
Oleum Morrhuae (Cod-liver Oil), .... 275
Arsenici Praeparata (Preparations of Arsenic), . . 278 Calcis Phosphas Praecipitata (Precipitated Phosphate
of Lime), 282
Ammoniae Murias (Muriate of Ammonia), . . . 283
Potassae Chloras (Chlorate of Potassa), . . . . 283
Potassae Bichromas (Bichromate of Potassa), . . 284
Potassae Permanganas (Permanganate of Potassa), . 285
Calx Chlorinata (Chlorinated Lime), .... 286
Liquor Sodae Chlorinatae (Solution of Chlorinated Soda), 286
Order III. Antacids, 286
Potassae Praeparata (Preparations of Potassa), . . 288 Sodae Praeparata (Preparations of Soda), . . . 290 Lithiae Praeparata (Preparations of Lithia), . . 292 Ammoniae Praeparata (Preparations of Ammonia), . 293 Magnesiae et Calcis Praeparata (Preparations of Mag- nesia and Lime), ....... 293
Class IV. — Topical Medicines, 295
Order I. Irritants, ......... 295
Eubefacients, ......... 295
Sinapis (Mustard), 296
Capsicum (Cayenne Pepper), ..... 298 Oleum Terebinthinae (Oil of Turpentine), . . .298
Linimentum Ammoniae (Liniment of Ammonia), . 299
Pix Burgundica (Burgundy Pitch), .... 299
Pix Canadensis (Canada Pitch), 300
Epispastics, .......... 301
Cantharis (Cantharides), ...... 302
Cantharis Vittata (Potato Flies), . . . .306
Aqua Ammoniae (Water of Ammonia), . . . 306
Suppurants, 306
Oleum Tiglii (Croton Oil), 306
Unguentum Antimonii (Antimonial Ointment), . 307
Escharotics, 307
Argenti Nitras (Nitrate of Silver), . . . .308
Potassa, 308
XIV CONTENTS.
PAGE
Potassa cum Calce (Potassa with Lime), . . . 309
Acidum Chromicum (Chromic Acid), . . . 309
Acidum Arseniosum (Arsenious Acid), . . . 310 Zinci Chloridum (Chloride of Zinc), . . . .310
Liquor Hydrargyri Nitratis (Solution of Nitrate of
Mercury), ........ 310
Hydrargyri Chloridum Corrosivum (Corrosive Chlo- ride of Mercury), ....... 310
Potassa? Bichromas (Bichromate of Potassa), . .311
Acida Mineralia (Mineral Acids), .... 311
Order II. Demulcents, ........ 311
Acacia (Gum Arabic), ...... 313
Tragacantha (Tragacanth), . . . . . .315
Linum (Flaxseed), ....... 315
Ulmus (Slippery Elm Bark) 316
Sassafras Medulla (Sassafras Pith), .... 317
Althsea (Marshmallow), 317
Sesami Folium (Benne Leaf), ..... 318
Glycyrrhiza (Liquorice Boot), ..... 319
Extractum Glycyrrhizae (Liquorice), .... 319
Cetraria (Iceland Moss), 320
Chondrus (Irish Moss), 321
Maranta (Arrow-Boot), 321
Canna, 323
Tapioca, 323
Sago, 323
Hordeum (Barley), ....... 324
A vena Farinse (Oatmeal), 325
Oryza (Eice), 325
Salep, 326
Amylum (Starch), 326
Gelatina (Gelatin), 326
Adeps (Lard), 327
Sevum (Suet), 327
Cetaceum (Spermaceti), ... ... 327
Cera (Wax), . 327
Oleum Theobromae (Oil of Theobroma), . . .327
Glycerina (Glycerin), 328
Collodium (Collodion), 329
Liquor Guttae Perchae (Solution of Gutta Percha), . 329
Fermentum (Yeast), 329
Mel (Honey), 329
Order III. Anthelmintics, ..... 330
Spigelia (Pinkroot), 331
Chenopodium (Wormseed), . . . 333
CONTENTS. XV
PAGE
Santonica, 334
Azedarach, 334
Mucuna (Cowhage), 335
Filix Mas (Male Fern), 335
Granati Radicis Cortex (Bark of the Pomegranate
Root), 336
Oleum Terebinthinse (Oil of Turpentine), . . .336
Calomel, 336
Brayera (Koosso), 336
Rottlera (Kameela), 337
Pepo (Pumpkin Seed), 337
MATERIA MEDICA.
The agents employed in the treatment of diseases are denominated Remedies, and the branch of medicine which is devoted to their consideration is termed Materia Me- dica. Remedies may be divided into Hygienic, Mechanical, Imponderable, and Pharmacological agents.
Hygienic Remedies are usually treated of in works spe- cially devoted to the subject.
PART I.
MECHANICAL REMEDIES.
Mechanical Remedies belong chiefly to Surgery. A few agents of this class are, however, employed in the practice of medicine, and are included in the Materia Me- dica. They are bloodletting (general and local), setons, issues, bandages, friction, and acupuncture.
1. General Bloodletting is performed principally by venesection or phlebotomy, which is usually practised on the median-cephalic or basilic veins of the arm — sometimes also on the external jugular and other veins. Arteriotomy is occasionally resorted to, on the temporal artery, in ce- rebral affections.
2
18 MATERIA MEDICA.
Bloodletting is employed, to moderate vascular excite- ment, reduce inflammatory action, relieve congestion, allay spasm and pain, relax the muscular system, promote ab- sorption, and arrest hemorrhage; and for these purposes it is our most available therapeutical resource. So power- ful and exhausting an agent is, however, always to be resorted to with caution and discrimination ; is not to be unduly repeated, even in inflammatory cases ; and is sel- dom or never proper in diseases of a typhoid tendency, or where a tubercular diathesis is suspected, or in extreme infancy and old age.
2. The Local Abstraction of Blood is practised by means of leeches and cups. The leech (hirudo) is an aquatic worm, common throughout Europe, America, and India. The European leech (h. medicinalis), is of a blackish or grayish green color on the back, from two to three or four inches in length, and is characterized by six longitudinal dorsal ferruginous stripes, the four lateral ones being interrupted or tessellated with black spots. The Ameri- can leech (h. decora), is usually from two to three inches long, and is of a deep green color, with three longitudinal dorsal rows of square spots. Both the imported and indi- genous leech are employed in this country, but the latter makes a smaller incision, and is preferable in infantile cases. When the discharge of blood from leech-bites is excessive, it may be arrested by pressure, by compresses of lint, the application of alum, creasote, solution of sub- sulphate of iron, and other styptics, or by touching the wounds with nitrate of silver; and if these means fail, the wounds may be sewed.
In the operation of cupping, cupping-glasses and a scari- ficator are employed. The removal of atmospheric pres- sure, by the application of glasses partially exhausted of air, produces a determination of blood to the capillaries of a part, and it is 'afterwards readily drawn by scarification. When blood is not abstracted, the operation is termed dry
MECHANICAL REMEDIES. 19
cupping, and is a valuable revulsive agent. The topical ab- straction of blood by leeches and cut cups combines the advantages of depletion and revulsion. Leeches are em- ployed in external inflammations, in situations where cups are inadmissible, and in infantile cases. Cups are gener- ally preferable in internal inflammations, from their more decided revulsive influence. When blood is drawn by leeches, its continued flow may be promoted by the appli- cation of warm fomentations to the wounds.
3. Setons (Setacea) and Issues (Fonticuli), are employed when a permanent counter-irritant effect is desired. A seton is established by passing through the iutegument a seton-needle, armed with a skein of silk; or, a piece of tape, or a strip of sheet lead may be used for the purpose. An issue is made with a cauterant, usually potassa ; and after the slough has separated, a discharge is maintained by the introduction of an issue-pea, for which purpose a common dried pea is used, or a dried unripe Curacoa orange.
4. Bandages are employed, in the practice of medicine, to promote the absorption of dropsical effusions. For the same purpose, strips of adhesive plaster may be applied to the chest, in chronic pleurisy and empyema, as in the treat- ment of fractured ribs.
5. Frictions are useful as revellents, and as local stimu- lants. They may be employed either with the dry hand, or with horse-hair gloves, or with liniments.
6. Acupuncture consists in the introduction into the body of fine, well-polished, sharp-pointed needles. It is a useful remedy in rheumatism, neuralgia, local paralysis, &c, and is sometimes conjoined with electricity, when the operation is known as Electro-puncture.
20 MATERIA MEDICA.
PART II.
IMPONDERABLE REMEDIES.
Under this head are included Light, Heat, Cold, and Elec- tricity.
1. Light (Lux), exercises an important influence in the organized world as a vivifying stimulus. It is useful as a therapeutic agent, in diseases dependent on imperfect nu- trition and sanguification ; and the exposure of the surface of the hody to its action, as far as nudity is compatible with proper warmth, promotes the regular development and strength of the organs. On the other hand, in many dis- eases the stimulus of light is injurious, and darkness is re- sorted to as a sedative and tranquillizing agent.
2. Heat (Calor), applied to the human system in mode- rate amount, acts, both locally and generally, as an excitant; in intense degree, it destroys vitality and organization. It is employed as a local excitant and revulsive, by means of hot bottles, hot bricks, the hot foot-bath, &c, and as an ap- plication to painful and inflamed parts, in the form of poultices and fomentations. As a general application, heat is chiefly resorted to in the form of the water-bath and va- por-bath. The warm bath, at a temperature from 92° to 98° F., is used as a relaxant in dislocations, hernise, spasm, infantile convulsions, croup, &c, and also for its action on the skin in rheumatic and chronic cutaneous affections. The hot bath has a temperature of from 98° to 112°, and is a powerful excitant iu cases of exhaustion, asphyxia, or suf- focation, and is employed also in old paralytic and rheu- matic cases. The hot air-bath, at a temperature of from 98°
IMPONDERABLE REMEDIES. 21
to 130°, is useful as an excitant and revellent, and is em- ployed in cases of internal congestion, and in rheumatic, neuralgic, and cutaneous affections. The hot vapor-bath is adapted to the same class of cases as the hot air-bath, and exerts also a diaphoretic and relaxing influence.
The destructive agency of heat is resorted to for the pur- pose of vesication, as by the application to the skin of a metallic plate heated to 212° by immersion in boiling water ; and of cauterization, by the employment' of redhot iron, or of moxa. Hot iron (known as the actual cautery), is used chiefly as a styptic. The term moxa is applied to small masses of combustible matter, which are burnt slowly in contact with the skin, with a view to a revulsive effect in deep-seated inflammations, nervous affections, &c.
3. Cold (Frigus). — The application of cold to living bodies produces a diminution of vital activity, attended by reduction of the temperature and volume of the part, with contraction of the bloodvessels and other tissues, and sus- pension of the secretions and exhalations. The application of excessive or prolonged cold is followed by the torpor and death of the part. When it is applied in moderation and for a short period, reaction generally takes place, with a return and even increase of temperature, volume, color, and sensibility.
Cold is employed therapeutically, with a view to both its primary and secondary eflects. The primary action of cold is. depressing and sedative. As a sedative agent, it is used, 1. To lessen vascular and nervous excitement and preter- natural heat, as by the use of cold lotions and spongings in fevers, the ice-cap in cerebral affections, the shower-bath in insanity, the bladder filled with ice to the spine in epi- lepsy, &c. 2. To constringe the tissues, promote the coagulation of the blood, and lessen the volume of parts ; hence the local application of ice or cold water to abate in- flammation, check hemorrhage, cure aneurism, and reduce strangulated hernise. 3. To produce local anaesthesia in
22 MATERIA MEDICA.
surgical operations, by means of a freezing mixture topi- cally applied.
The secondary effects of cold are the reverse of the pri- mary effects, and are obtained by the employment of a less intense degree of cold. They are resorted to, 1. To invig- orate the system, as with the cold shower-bath and plunge- bath. 2. To rouse the system, as by cold affusions in coma and asphyxia. 3. To recall the vital properties to frost- bitten parts. 4. To effect local excitation, as by the application of the cold douche to rheumatic and paralyzed limbs.
Cold liquids and ice are taken into the stomach as refrige- rants in fevers. They are introduced into the rectum and vagina, to check hemorrhage and allay irritation ; and cold water, injected into the impregnated uterus, is among the most certain means of inducing premature delivery.
4. Electricity (Electricitas). — The electric current acts as an excitant to the nerves both of sensation and motion. It influences to some extent, also, the secretions, through its action on the nerves distributed to the secreting organs ; and it affects the circulation, by inducing contractions of the heart. A powerful charge of electricity produces violent and frequently fatal effects on the central nervous system.
The various forms of electricity are resorted to for their stimulant effect in a number of nervous affections. It is chiefly used in cases of local and functional paralysis, which are independent of lesion of the nervous centres. It has also been employed with occasional good effect in amauro- sis, nervous deafness, neuralgia, photophobia, chronic rheu- matism, chorea, hysteria, and other neuroses, and to excite uterine contractions. From its influence on the secretions, it has been prescribed as an emmenagogue, to overcome constipation, to promote the biliary secretion, and to heal ulcers. In the form of electro-magnetism, it is a powerful excitant in the coma resulting from narcotic poisons, and
PHARMACOLOGICAL REMEDIES. 23
in asphyxia generally, and is probably the most active remedy that can be exhibited in these cases.
For medicinal purposes, electricity is obtained from three sources :
1. Friction, as in the common electrical machine.
2. Chemical action, as in the voltaic battery.
3. Magnetism, either of temporary magnets, as in the coil machines, or of permanent magnets, as in the electro- magnetic machines.
PART III. PHARMACOLOGICAL REMEDIES.
Pharmacological Remedies, or Medicines, are sub- stances, not essentially alimentary, which, when applied to the body, so alter or modify its vital functions, as to be rendered applicable to the treatment of diseases.
The term Materia Medica is, strictly speaking, limited to that portion of Therapeutics devoted to the consideration of medicines. Pharmacy is the department of Materia Medica which treats of the collection, preparation, preser- vation, and dispensation of medicines.
To the student of medicine, the objects of examination in relation to medicines are, — the sources from which they are derived; the mode in which they are prepared and brought to market ; their sensible qualities, and also their chemical composition and relations ; their physiological effects, or the effects which they are capable of producing in healthy individuals ; their therapeutical effects, or those which they produce in morbid states of the system ; and lastly, the doses, modes of administration, and preparations
24 MATERIA MEDICA.
(extemporaneous and officinal), under which they are ad- ministered.
The effects of medicines take place either in the parts to which they are applied, or in distant parts of the system. The former are termed local or topical effects ; the latter, re- mote or constitutional effects.
MODUS OPERANDI OF MEDICINES.
The medium through which the influence of medicines is exerted on remote parts of the body, or their modus operandi (as it is usually termed), was long a contested point. Until within a comparatively recent period, it was main- tained that medicines and poisons transmitted their impres- sions from the parts receiving them to distant parts, by means of a communication through the nerves. But it is now generally admitted, that the absorption or passage of the medicinal or poisonous molecules into the blood is neces- sary to their action on parts remote from the seat of im- pression.
While, however, it is well established, that the character- istic action of medicines is transmitted to the parts influ- enced, exclusively through the medium of the circulation, it is undeniable that the functions of the nervous system may be secondarily excited by a local medicinal impression. The number of agents which operate in this manner is, however, very limited.
The action of medicines by absorption is proved by a va- riety of facts.
They are detected in many parts of the system, remote from that to which they have been applied, having been found in the blood, the solids, and the excretions, after being taken into the stomach. If the circulation be interrupted, the influence of a poison cannot be transmitted ; while its effects have been obtained, when applied to a wound in the foot of an animal, after all parts of the extremity have been severed, except the artery and vein. In confirmation of
MODUS OPERANDI OF MEDICINES. 25
the doctrine of absorption, may be cited also the admitted facts, that the remote effects of medicines or poisons are promoted or retarded by circumstances which promote or retard absorption ; that the blood of poisoned animals is found to possess poisonous properties ; that the fluids and solids acquire medicinal properties after the use of medi- cines (as the milk of nurses) ; that the specific effects of medicines are produced by their injection into the blood ; and that medicines disappear from closed cavities into which they are introduced.
After their absorption into the blood, medicines circulate with it, penetrate through the capillaries to the various or- gans, and are afterwards thrown out of the system with the excretions. Some medicines produce changes in the con- dition of the circulating fluid. Others have a specific action upon some one or other of the organs of the body. And in passing out of the system, most medicines act as stimu- lants to the organs by which they are thrown out.
The absorption of medicines is effected principally by the veins, and in some degree also by the lymphatics and lac- teals. The medicinal particles penetrate or soak through the interstices of the tissue with which they are placed in contact, and are thence diffused through the circulation. To a limited extent, medicinal substances probably penetrate all the tissues of the part to which they are applied, and in this way the activity of medicines is most decided upon the organs contiguous to the seat of application.
It is objected to the theory of the operation of medicines by absorption, that certain poisons act with a rapidity in- compatible with their previous introduction into the circu- lation. This is, however, not the fact, as the action of the most violent poisons (hydrocyanic acid, for example), is never wholly instantaneous ; and careful experiments have shown that the velocity of the circulation is sufficient to diffuse a poison through the blood in a shorter space of time than its effects are ever observed on the system.
26 MATERIA MEDICA.
CIRCUMSTANCES WHICH MODIFY THE EFFECTS OF MEDICINES.
The circumstances which modify the effects of medicines relate both to the medicines and to the human system.
1. The properties of medicines are modified by the soil in which they grow, by climate, cultivation, age, and the season of the year at which they are gathered.
2. Medicines are more active, because more readily ab- sorbed, in a state of solution than in a solid state.
3. Soluble medicines are often rendered inert by a che- mical reaction which converts them into insolubles : in this way antidotes modify the effects of poisons.
4. Differences in dose greatly modify the effects of medi- cines.
5. Pharmaceutical modifications have an important in- fluence on the efficacy of medicines. They may be exhibited in the solid, semi-solid, liquid; and aeriform states : "
In the solid state they are administered in the shape of powders, pills, lozenges, and confections.
In the liquid state, they are administered in the shape of mixtures, solutions, medicated waters, infusions, decoctions, tinctures, spirits, wines, vinegars, syrups, honeys, and oxy- mels.
In the semi-solid, or soft state, they are applied externally, in the form of liniments, ointments, cerates, plasters, and cataplasms.
In the form of gases and vapors, medicines are used for purposes of inhalation.
SOLIDS.
Powders (Pulveres). The form of powder is usually se- lected for the administration of medicines, which are not very bulky, nor of very disagreeable taste, which have no corrosive property, and which do not deliquesce rapidly on exposure. Deliquescent substances, and such as contain a
FORMS IN WHICH MEDICINES ARE USED. 27
large proportion of fixed oil, should always be recently pul- verized, as they are liable to spoil when kept. Other sub- stances, employed in the form of powder, are usually pulverized on a large scale. For the purpose of pulverizing drugs in small quantity, the physician makes use of a pestle and mortar, of iron, brass, glass, Wedgwood ware, or mar- ble. Various means are resorted to, to facilitate the oper- ation of powdering, and care should be taken to separate the inert portions and impurities.
The lighter powders may be administered in water or other thin liquid. The heavier powders require a more consistent vehicle, as syrup, treacle, or honey.
Pills (Pilulce), are small globular masses, of a size that can be conveniently swallowed. The form of pill is suitable for the exhibition of medicines which are not bulky, and are of disagreeable taste or smell, or insoluble in water. Deliquescent substances should not be made into pills, and those which are efflorescent should be previously deprived of their water of crystallization.
Some substances are readily made into pills, with the ad- dition of a little water or spirit. Very soft or liquid sub- stances require the addition of some dry inert powder, as bread-crumb, or powdered gum Arabic, to reduce them to a proper consistence.
Heavy powders are mixed with some soft solid, as con- serve of roses, or with a tenacious liquid, as treacle, or syrup. When the pilular mass is properly prepared, it is rolled with a spatula into a cylinder of uniform thickness, and is then divided into the required number of pills, with the hand, or more accurately, with a pill machine. The pills are rolled into spherical form between the fingers ; and to prevent adhesion, are dusted with some dry powder, as powdered liquorice root or carbonate of magnesia. To conceal the taste and smell of pills, they are sometimes coated with gelatin, collodion, mucilage, sugar, &c. Pills
28 MATERIA MEDICA.
which have been long kept, may pass unchanged through the stomach and bowels, and are therefore objectionable.
Troches or Lozenges (Trochisei), are small, dry, solid masses, made of powders with sugar and mucilage, and in- tended to be held in the mouth and allowed to dissolve slowly. Mucilage of tragacanth is usually employed in pre- paring lozenges.
Confections (Confectiones), are soft solid preparations, made with some saccharine matter. They are subdivided into Conserves and Electuaries : the former consist of combi- nations of recent vegetable substances and refined sugar, beat into a uniform mass ; the latter are extemporaneous mixtures of medicines, usually dry powders, with syrup, honey, or treacle.
LIQUIDS.
Mixtures (Misturce), are preparations of insoluble sub- stances, suspended in water by means of gum Arabic, sugar, the yolk of eggs, or other viscid matter. When the suspended substance is oleaginous, the mixture is termed an emulsion.
Solutions (Liquores), are solutions (chiefly aqueous) of non-volatile substances, which are wholly soluble in the menstruum employed. In making solutions, and all other aqueous preparations, the water used should be fresh river, rain, or distilled water, and free from saline impurities.
Medicated Waters (Aquce), are preparations consisting of water holding volatile or gaseous substances in solution. Many of them, having been made by distilling water from plants containing volatile oil, were formerly termed distilled waters. In place of distillation, trituration with carbonate of magnesia (afterwards separated by filtration) is now em- ployed to impregnate water with volatile oils.
FORMS IN WHICH MEDICINES ARE USED. 29
Infusions (Infusa), are partial solutions of vegetable sub- stances in water, obtained without the aid of ebullition. They are made with both hot and cold water : the former extracts the soluble principle more rapidly and in larger proportion ; the latter is preferred, when the active princi- ple would be injured by heat, or when it is desirable not to take up some matter, insoluble at a low temperature. In- fusions have been usually made by pouring water upon the substances to be infused, and allowing it to remain upon them for some time : when the process takes place at a heat of from 60° to 90°, it is termed maceration ; wdien at a heat of from 90° to 100°, digestion. Of late years, a more effi- cient mode of extracting the medicinal virtues of plants has been introduced, termed percolation. In this operation, the medicinal substance is coarsely powdered, and placed in an instrument called a percolator, in the lower part of which is fitted a porous or colander-like partition or diaphragm. The powder is then saturated with water or other men- struum, till it wall absorb no more; and, after they have remained some time in contact, fresh portions of the men- struum are added, till the required quantity is employed. The fresh liquid, as it is successively added, percolates the solid particles of the medicinal substance, driving the pre- viously saturated liquid before it ; and in this way com- pletely exhausts the substance to be dissolved. An ordinary glass funnel answers very well for percolation ; and a cir- cular piece of muslin or lint, pressed into the neck by means of a cork with notched sides, forms a good dia- phragm,— care being taken to interpose a similar piece of muslin, moistened slightly with the menstruum, between the diaphragm and powder.
Decoctions (Decocta), are partial solutions of vegetable substances in water, in which the active principles are ob- tained by ebullition. This is a more rapid and active mode of extracting the virtues of plants than by infusion. But it is objectionable when the proximate principles are vola-
30 MATERIA MEDICA.
tile at a boiling heat, or undergo decomposition by ebulli- tion. In making decoctions, ebullition should be continued for a few minutes only, and the liquid should be allowed to cool slowly in a close vessel. As they are apt to spoil, they should be prepared only when wanted for use.
Tinctures (Tincturce), are solutions of medicinal sub- stances in alcohol or diluted alcohol. Ammonia and ethe- real spirit are also sometimes employed as solvents; and solutions in these menstrua are called ammoniated tinctures and ethereal tinctures. Alcohol or rectified spirit (of a sp. gr. 0.835, according to the U. S. Pharmacopoeia), is em- ployed in making tinctures of substances nearly or quite insoluble in water, as the resins, essential oils, camphor, &c. Diluted alcohol or proof spirit (consisting of equal measures of officinal alcohol and water) is preferred, when the substance is soluble both in alcohol and water, or when some of its ingredients are soluble in the one menstruum and some in the other. Tinctures have been usually pre- pared by maceration or digestion, more commonly by the former process, and a period of two weeks is recommended for its duration. It should be conducted in well-stopped glass vessels, which should be frequently shaken ; and when the maceration is completed, the tincture should be sepa- rated from the dregs by filtration. The U. S. Pharmaco- poeia now recommends percolation in making most tinctures, and in the hands of skilful pharmaceutists, this process is preferable, as the most thorough mode of exhausting medi- cinal substances; but where the operator cannot trust himself, it is better to recur to the old process of maceration. Tinctures should be kept in bottles accurately stopped, to prevent evaporation, which might seriously increase their strength.
The form of tincture is adapted to the exhibition of me- dicines, which are to be given in small quantity, and it affords a convenient mode of graduating doses. In pre- scribing large and continued doses of tinctures, the stimu-
FORMS IN WHICH MEDICINES ARE USED. 31
lating effects of the alcohol which they contain must be borne in mind.
Spirits (Spiritus), are alcoholic solutions of volatile prin- ciples, properly speaking procured by distillation, but now usually prepared by dissolving the volatile principles in alcohol or diluted alcohol. The spirits of the aromatic vegetable oils are used to give a pleasant odor and taste to mixtures, to correct the nauseating and griping effects of cathartics, and also as carminatives and stomachics.
Wines ( Vina), are solutions of medicinal substances in sherry or other white wines. They are more liable to decom- position than tinctures, and are of variable strength ; but they are in some cases preferred from the less stimulating character of the menstruum, which has also sometimes an increase of solvent power from the acid which it contains.
Vinegars (Aceta), are infusions or solutions of medicinal substances in vinegar or acetic acid, which is a particularly good solvent of many vegetable principles, as the organic alkalies.
Honeys (Mellita), are preparations of medicinal sub- stances in honey. In oxymels, a combination of honey and vinegar is employed. Neither of these preparations are now much used.
Syrups (Syrupi), are preparations of medicinal substances in a concentrated solution of sugar. The term syrup (syrupus), or simple syrup, is applied to a solution of sugar (thirty-six troyounces) in water (Oij fSxij), dissolved with the aid of heat. Medicated syrups are usually made by in- corporating sugar with vegetable infusions, decoctions, ex- pressed juices, fermented liquors, or simple aqueous solu- tions. They may also be prepared by adding a tincture to simple syrup, and afterwards evaporating the alcohol ; or,
32 MATERIA MEDICA.
by mixing the tincture with sugar in coarse powder, and dissolving the impregnated sugar, after evaporation, in the necessary proportion of water. Syrups are apt to be spoiled by heat, and should be made in small quantities at a time.
By the evaporation of the solutions of vegetable princi- ples, a very useful class of preparations termed Extracts (Extracta), is obtained. They are prepared from infusions, decoctions, tinctures, and vinegars ; and sometimes, in the case of recent vegetables, from the expressed juices of plants, usually diluted with water. Extracts, prepared by the agency of water, are termed watery extracts ; those by means of alcohol, alcoholic extracts ; those by means of acetic acid, acetic extracts. The evaporation of extracts is gen- erally continued, till they have a pilular consistence. "Within a few years, however, these preparations have been employed in the liquid form, under the name of Fluid Ex- tracts [Extracta Fluida), which have the advantage of con- venience of administration, and of being prepared at a less degree of heat. They are more liable than the solid ex- tracts to spontaneous decomposition ; and this difficulty is usually counteracted by means of sugar. In making the fluid extracts, alcohol, diluted alcohol, and acetic acid are the menstrua resorted to. The portion of the solvent which remains after evaporation, contributes in some de- gree to the preservation of the preparation.
The Oleoresins (Oleoresince), are extracts obtained by the agency of ether, which consist of fixed or volatile oils, holding resins and sometimes other active matters in solu- tion. They retain a liquid or semi-liquid state, upon the evaporation of the liquid employed in their preparation, and have the property of self-preservation.
FORMS IN WHICH MEDICINES ARE USED.
SEMI-SOLIDS.
Liniments (Linimenta), are oily preparations designed for external use, usually thicker than water, but always liquid at the temperature of the body.
Ointments ( Unguenta), are preparations of a consistence like that of butter, made with lard or some other fatty sub- stance. They are fitted for application to the skin by friction or inunction. Most of the ointments become ran- cid, when long kept, and it is therefore best to prepare them only as wanted for use.
Cerates (Cerata), are made of oil or lard, mixed with wax, spermaceti, or resin, with the addition of various medicinal substances. They are of harder consistence than ointments, and do not melt when applied to the skin. Simple Cerate, or Cerate of Lard (Ceratum Adipis), consists of one part of white wax and two parts of lard.
Plasters (JEmplastra), are adhesive at the temperature of the body, and must generally be heated to be spread. Some substances have sufficient consistence and adhesiveness to be made directly into plasters. Usually, however, medi- cinal substances when employed in this form, are mixed with Lead Plaster or Litharge Plaster (Emplastrum Plumbi), a compound of olive oil and litharge. Plasters are prepared for use by spreading them upon sheepskin, linen, or mus- lin, with a margin a quarter or half inch broad.
Cataplasms, or Poultices (Cataplasmata), are soft moist substances, intended for external use. The common emol- lient poultice, employed to relieve inflammation and pro- mote suppuration, is made by mixing bread-crumbs with boiling milk, or powdered flaxseed with boiling water.
3
34
MATERIA MEDICA.
GASES AND VAPORS.
When employed in this form, medicines are administered by inhalation. This may be effected either by diffusing the gas or vapor through the air to be respired by the patient; or by inclosing it in a bag or bottle with a suitable tube, through which the patient may breathe ; or, when ethereal vapors are employed, by saturating a sponge or handker- chief with the ether, and applying it to the mouth and nos- trils of the patient ; or the fumes of burning medicinal substances may be inhaled, by means of cigarettes or pipes, variously contrived.
WEIGHTS AND MEASURES.
In prescribing and dispensing medicines, the following are the weights and measures employed in the United States, with their signs annexed.
The pound, lb 1 The ounce The drachm The scruple
TROY WEIGHT.
contains
Twelve ounces, ^. Eight drachms, 3. Three scruples, T). Twenty grains, gr.
The term pound should be avoided in formulas, owing to the clanger of mistakes from confounding the troy pound with the heavier avoirdupois pound; and large weights should be expressed in troyounces.
The gallon, C 'j The pint The fluidounce The fluidrachm
WINE MEASURE.
' Eight pints, O.
contains
Sixteen fluidounces, fg. Eight fluidrachms, 13. Sixty minims, njj.
Liquid measures are sometimes prescribed by drops,
CIRCUMSTANCES MODIFYING EFFECTS OF MEDICINES. 35
which, however, vary in quantity according to the nature of the liquid, and the shape and size of the vessel from which it is dropped. Approximate measurements are also frequently employed in prescribing the less powerful li- quids : thus a teacup is used for fSiv, or a gill ; a wineglass for f§ij ; a tablespoon for f§ss ; a teaspoon for £5j.
A variety of circumstances, relating to the human or- ganism, modify the effects of medicines.
Age exerts a most important influence in this particular. Children are more susceptible than adults ; and, in advanced age, also, smaller doses are required than in the prime of life. No general rule can be laid down for the adaptation of the doses of medicines to different ages, as the different susceptibilities to the influence of different medicines are unequal at the same age. Thus, infants are peculiarly alive to impressions from opium, while, in the case of calomel and castor oil, they will bear much larger proportional doses.
Dr. Young's scheme for graduating the doses of medi- cines to different ages answers very well in prescribing : "For children under 12 years, the doses of most medicines must be diminished in the proportion of the age to the age
2 increased by 12 ; thus, at two years to 4, viz. : ^—72 = h
At 21, the full dose may be given."
Sex, temperament, and idiosyncrasy, all modify the effects of medicines. "Women require somewhat smaller doses than men ; and during menstruation, pregnancy, and lactation, all active treatment, which is not imperatively demanded, should be avoided. To persons of a sanguine tempera- ment, stimulants are to be administered with caution, while in cases of nervous temperament, the same care is to be observed in the employment of evacuants. Idiosyncrasy renders many individuals peculiarly susceptible or insus- ceptible to the action of particular medicines, as mercury, opium, &c.
Habit diminishes the influences of many medicines, espe-
36 MATERIA MEDICA.
cially narcotics ; and not a few diseases produce a remarka- ble insusceptibility to medicinal action.
The influence of race, climate, occupation, and the imagi- nation upon the effects of medicines is often decided, and deserves attention in prescribing.
PARTS TO WHICH MEDICINES ARE APPLIED.
Medicines are applied to the skin, to mucous membranes, to serous membranes, to wounds, ulcers, and abscesses, and they are injected into the veins.
1. To the Skin. — Medicines are applied to the skin both for their local and general effects. As their influence on dis- tant organs is the result of their absorption, this function is usually assisted by friction, or by removal of the cuticle, when medicines are applied to the skin to affect remote parts of the system.
The application of medicines to the skin by friction is occasionally resorted to, but its results are slow and uncer- tain ; and when we wish to affect the system through the agency of the skin, the preferable method is to apply the medicine to the dermis denuded of the cuticle.
This is termed the endermic method, and the cuticle is usually removed by means of a blister. The medicine is applied to the denuded dermis in the form of a powder ; or, if very irritating, it may be incorporated with gelatine, lard, or cerate. This method is useful in cases of irritability of the stomach, of inability to swallow, or where we desire to influence the system rapidly, and by every possible ave- nue, or where it is of importance to apply the medicine near the seat of disease. The dose is to be two or three times the amount which is administered by the stomach.
Another method of applying medicines through the skin, is by inoculation. In this method, a medicine is introduced, as in vaccination, by means of a small, sharp lancet, or a small syringe may be employed, by which the medicinal substance is introduced beneath the skin in a liquid state.
PARTS TO WHICH MEDICINES ARE APPLIED. 37
Medicines, which are operative in small doses, are intro- duced in this way.
2. To the Mucous Membranes. — Medicines are applied to all the gastro-pulmonary and genito-urinary mucous sur- faces.
a. To the conjunctiva, they are applied for local eifects only, and are termed collyria, or eye-washes.
b. To the nasal or pituitary membrane, they are applied usually for local purposes ; sometimes, however, to irritate, and excite a discharge, when they are termed errhines ; sometimes, also, to produce sneezing, with a view to the expulsion of foreign bodies from the nasal cavities, when they are termed sternutatories.
c. To the mucous membrane of the mouth and throat, medi- cines are applied almost exclusively for local purposes. When in solution, they are termed gargarismata or gargles. Powders are introduced by insufflation.
d. To the Eustachian tubes, washes are applied in local affections.
e. On the aerial or tracheobronchial membrane, medicines produce a very decided influence, both local and general. Liquid substances are introduced into the air-passages by means of a sponge or syringe, in the treatment of chronic inflammations of the larynx. Various substances are inhaled with advantage in phthisis, chronic bronchitis and laryngi- tis, asthma, &c, while the most powerful effects are produced on the system by the absorption of ethereal vapors and gases through the pulmonary surface.
/. The gastro-intestinal mucous membrane, of all parts of the body, is most employed for the exhibition of medicines. The stomach, from its great susceptibility, its active absorb- ing power, and the numerous relations which it has with almost every part of the body, is the chief recipient of me- dicinal agents. The rectum is, however, also frequently employed for various purposes, as to relieve disease of this or of neighboring organs, to occasion revulsion, to produce alvine evacuations, to destroy ascarides, and when for any reason it is desirable to spare the stomach.
38 MATERIA MEDICA.
It is usually recommended, that the dose of medicines, introduced into the rectum for constitutional effects, should be two or three times greater than when taken into the stomach. In the case of active, soluble medicines, how- ever, especially narcotics, it is most prudent to give the same amount by the rectum as by the mouth.
Solid substances introduced into the rectum vare termed suppositories ; they are best made with cocoa butter. Liquids introduced into the rectum are termed clysters, lavements, injections, and enemata. Soluble substances, when thus ap- plied, are usually dissolved in water ; insoluble substances are suspended in some mucilaginous vehicle. When the enema is to be retained, it should be from one to four fluidrachms in quantity. When it is introduced to act upon the bowels, its bulk may be from twelve to sixteen fluidounces for an adult, six to eight fluidounces for a youth of twelve, three to four fluidounces for a child of one to five years, and a fluidounce for a newly-born infant. Various instruments are used for the administration of ene- mata, as the pipe and bladder, the ordinary syringe, the self-injecting apparatus acting by gravity, and the elastic bottle and tube. Gaseous matters have also been thrown into the rectum — tobacco-smoke, for example, — to relieve obstruction of the bowels.
g. To the urino-genital and vagino-uterine membranes, appli- cations are made exclusively for local purposes.
3. To Serous Membranes. Irritating solutions are injected into the cavity of the tunica vaginalis testis, in hydrocele, and into the hernial sac, in hernia, for the purpose of pro- ducing adhesion of the sides of the sacs.
4. To Ulcers, Wounds, and Abscesses, medicines are ap- plied chiefly for their local efl'ects. The absorbing power of these surfaces is to be kept in mind in such applications.
5. The injection of medicines into the Veins has been occa- sionally practised. The operation is, however, objection- able, from the danger of introducing air into the circulation ; and it is seldom resorted to, except in the case of transfusion of blood after uterine hemorrhage.
THE CLASSIFICATION OF MEDICINES. 39
THE CLASSIFICATION OF MEDICINES.
In treating of the articles of the Materia Medica, some writers have classified them according to their natural pro- perties, others according to their action on the human sys- tem. To the student of medicine, a classification based upon the sensible qualities or natural affinities of medicines can be of little value, since it associates articles of the most opposite remedial properties. A classification of medicines founded on a similarity of action on the animal economy is more desirable and useful, and various arrangements of the Materia Medica have been attempted on this basis. They are all, to some extent, necessarily imperfect, owing partly to the diversified effects of medicines, and partly to our ignorance of the real nature of many of the modifica- tions which they produce upon the tissues. Still, the ad- vantages of some arrangement of this kind are so numerous, that it cannot well be dispensed with.
The following classification will be found to include the more ordinary and generally received divisions of the Ma- teria Medica, and to present the articles in convenient groups for therapeutic application.
Medicines may be divided into —
<- Narcotics, Anaesthetics, Antispasmodics, Tonics, Astringents, Stimulants, Sedatives, - Spas tics. C Emetics, Cathartics, Diaphoretics, Diuretics, Blennorrhetics, Emmenagogues.
III. Those which modify the blood, or Hce. I . , . '
., ' ,. < Alteratives,
matics (from a/^a, the blood). . .,
{Irritants, Demulcents, Anthelmintics.
. Those which have a special action on the nervous system, or Neurotics (from vsvgov, - a nerve).
II. Those which have a special action on the secretions, or Eccritics (from «*§/»•/?, secre- tion).
40 MATERIA MEDICA.
CLASS I. — N EUROTICS. ORDER I. NARCOTICS.
Narcotics (from vapxew, to stupefy), are medicines which im- pair or destroy nervous action. When administered in not immediately poisonous doses, they often produce at first a moderate degree of excitation ; but this is rapidly followed by diminished activity in the functions of innervation. The different narcotics have most of them some special peculi- arity of action ; but they all agree in exerting a sedative or stupefying influence on the motor, sensor, and intellec- tual functions. Hence their therapeutic employment, to remove muscular spasm, relieve pain, allay cerebral or spinal irritability, and procure sleep.
The influence of this class of medicines upon the system is rapidly diminished by habit ; and when administered for a length of time, they are to be given in gradually-increas- ing doses.
When employed to relieve pain, they are termed anodynes; when employed to procure sleep, hypnotics or soporifics.
OPIUM.
Opium (from ono^, juice), is the concrete juice of the un- ripe capsules of Papaver somniferum (Nat. Ord. Papave- racere). The opium poppy is a native of Persia, but is cul- tivated in various parts of Asia, in Europe, and in the United States. It is an annual plant, with a round, leafy stem, from two to four feet or more in height, and large four-petaled flowers. There are two prominent varieties of this species : the black poppy, with violet-colored or red flowers, brown or blackish seeds, and globular capsules ; and the white poppy, with white flowers and seeds, and ovate capsules; but these varieties run into each other under cultivation.
OPIUM. 41
The ripe capsules (papaver) are from au i^ch and a half to two inches or more in diameter, and contain a good deal of opium. They are sometimes given to children in the form of syrup, and are applied externally as an anodyne emollient, in the form of decoction. The seeds are desti- tute of narcotic properties, and are used in Europe as an article of diet, and for the manufacture of an oil.
Opium is obtained from incisions in the half-ripe cap- sules. The juice, which exudes from the incisions, is scraped off" after drying, generally with more or less of the epidermis, and is sometimes sent into market unmixed, as a choice variety. The opium of commerce is, however, commonly made by adding the dried juice, obtained by incision, to an extract prepared from a decoction of the leaves, the whole being kneaded together, formed into cakes, and wrapped in fresh poppy leaves.
The commerce of the United States is supplied with opium almost exclusively from Asiatic Turkey. This is known in the market as Smyrna or Turkey opium, and comes in irregular rounded or flattened cakes, covered with the capsules of a species of Rumex.
A large amount of opium is cultivated in British India, for consumption in India and China, but it is not found in our markets. The Persian opium is another variety, but it does not reach the United States. Much opium was formerly obtained from Upper Egypt, in the neighborhood of Thebes, but its production was for a long time aban- doned, though within the last twenty years again intro- duced. Successful attempts have been made with the cul- tivation of the poppy in England and other parts of Eu- rope, which have resulted in the production of good opium. Very fair specimens have also been made in the United States ; but the great source of our supply of opium has long been, and still is, the Turkish dominions.
The best opium should have a fine chestnut color, an aromatic, strong, peculiar smell, and a dense consistence — becoming, however, harder and darker by being kept. It
42 MATERIA MEDICA.
should be moderately ductile, break with a deeply notched fracture, and, when drawn across white paper, should leave an interrupted stain. The taste is very bitter, and some- what acrid, and when chewed it excites irritation in the mouth and throat. It is inflammable, and imparts its vir- tues to water, alcohol, and diluted acids — but not to ether.
Chemical Constituents. — Opium contains a great variety of chemical constituents, the most important of which is the alkaloid Morphia, which exists chiefly in combination with an acid called meconic. Other principles found in opium are the alkaloids, narcotina and codeia, — narceina, meconin, paramorphia, papaverina, opiania, porphyroxin, gum, ex- tractive, resin, oil, &c. Morphia is the priuciple upon which the narcotic effects of opium essentially depend, and, with its salts, is officinal in all the pharmacopoaias.
Narcotina exists in opium, chiefly in the free state, and, being insoluble in water, is left behind when the drug is macerated in this menstruum. It occurs in white, taste- less, inodorous, needle-like crystals, which are soluble in ether. At one time it was thought to possess a portion of the narcotic properties of opium, but it is now admitted to be inert in this respect. Its salts have been used in In- dia as antiperiodic tonics, in the treatment of intermittent fevers.
Codeia has been found to possess some narcotic and anti- spasmodic properties, but its great expense has prevented its introduction into general use.
Opiania is said to be decidedly narcotic, resembling mor- phia in its action. It exists only in small amount, and lit- tle is known as yet about it.
Incompatibles.— Alkalies, and astringent infusions con- taining tannic and gallic acids, are incompatible with opium; the former precipitate morphia from its soluble combination, while the latter form with it an insoluble compound.
Tests. — T. of the chloride of iron strikes a red color with meconic acid; nitric acid colors morphia red; iodic acid
OPIUM.
43
colors it reddish-brown, and if starch is added, forms a blue compound; ammonia precipitates it from solution; and tannic acid forms with it an insoluble precipitate.
Physiological Effects—When taken in a medicinal dose, opium at first moderately excites the circulation, increases the temperature of the skin, and agreeably exhilarates the intellectual functions. The stage of excitement is, how- ever, of short duration. The pulse soon sinks below the normal standard, susceptibility to external impressions is diminished, the faculties of the mind become confused, and consciousness is finally lost in sleep. All the secre- tions are diminished, except that of perspiration, which is heightened; muscular contraction is lessened; and in some persons nausea and vomiting are produced ; occasion- ally an itching and miliary eruption of the skin occurs.
When a poisonous dose is taken, the stage of excite- ment is wanting ; giddiness and stupor rapidly come on, with diminution in the frequency, though not in the ful- ness of the pulse ; and these symptoms are soon followed by an irresistible tendency to sleep, and finally by coma. The breathing is heavy and stertorous, the pulse slow and oppressed, and the pupils are contracted. If relief is not afforded, the pulse sinks, the muscular system becomes relaxed, and death ensues, preceded sometimes by violent convulsions.
In cases of poisoning from opium or its preparations, the stomach should be immediately evacuated by the stomach- pump, if possible, or by emetics. The direct emetics are best for this purpose, as the sulphate of zinc (20 to 30 grains), or the sulphate of copper (5 to 10 grains). A large teaspoonful of mustard, ar a tablespoonful of powdered alum, answers very well as an emetic. Every means should be taken to arouse the patient from his lethargy ; cold affusions, counter-irritation to the nape of the neck and extremities, flagellation to the palms of the hands and soles of the feet, and, best of all, when the coma is pro-
44 MATERIA MEDICA.
found, the electro-magnetic battery, constitute our chief re- sources in this emergency. Artificial inflation of the lungs is also to be practised. The use of belladonna and of strong coffee has also been found efficacious ; and stimuli may be used to support the system. The poisonous action of opium appears to be entirely directed to the nervous sys- tem, no local lesions being found after death.
Opium is largely used as an habitual stimulant in Orien- tal countries, and to some extent in Europe and the United States. The effects of indulgence in this species of intoxi- cation are of the most destructive character upon both the physical and mental faculties.
Medicinal Uses. — Of all the articles of the Materia Me- dica, opium enjoys the widest range of therapeutic appli- cation. From its properties of assuaging pain and inducing sleep, it is useful in almost all diseases ; and it is positively contraindicated only where there is a tendency to apoplexy or coma, or where there exists an idiosyncrasy with respect to its effects. As an anodyne in painful malignant ulcers and severe injuries, we have no substitute for opium ; and, as an hypnotic in mania-a-potu, and in the wakefulness and cerebral irritability of fever, it is equally invaluable. From its power of relaxing muscular spasm, it is our most effi- cient resource in tetanus, colic, and spasm of the stomach, bowels, biliary ducts, ureters, neck of the bladder, &c. In dysentery and cholera it forms the basis of every variety of treatment, partly for its diaphoretic effects, but princi- pally for its action in arresting both the secretions and pe- ristaltic motion of the bowels. In pulmonary and gastric irritability, colica pictonum, peritonitis, rheumatism, gout, neuralgia, typhus, gangrene, convulsive diseases, diabetes, &c, opium is also constantly employed.
Administration. — The ordinary dose of opium as an ano- dyne and hypnotic is one grain. Much larger doses are, however, called for in many diseases ; and, when it is ad- ministered for a length of time, the dose must be gradu-
opium. 45
ally increased. To infants and very old persons, it is to be given with great caution.
Opium is administered in the form of powder or pill. It is easily powdered when thoroughly dried, and the pills should always be made from the powder. The powder is sometimes used endermically, and is also sprinkled on irri- table ulcers. In the form of suppositories it is also applied to the rectum.
The following are the officinal preparations of opium:
Tinctura Opii (Tincture of Opium) Laudanum. Pre- pared by macerating two troyounces and a half of powdered opium in diluted alcohol Oij. When long kept, particu- larly if exposed to the air, it becomes thick from evapora- tion of the alcohol, and its strength is much increased. Dose : rr^xiij, or 25 drops, equivalent to a grain of opium. There are 120 drops in in f5j. Laudanum is much used in the form of enema.
Tinctura Opii Camphorata (Camphorated Tincture of Opium). Paregoric Elixir. Prepared by macerating sixty grains of opium in diluted alcohol Oij, with benzoic acid, oil of anise, clarified honey, and camphor. Dose : f gss, or a tablespoonful, containing rather less than a grain of opium. A favorite preparation for children. 5 to 20 drops may be given to an infant.
Tinctura Opii Deodorata (Deodorized Tincture of Opium) contains the same proportion of opium as laudanum. In preparing it, a liquid watery extract of opium is first made, which is then washed with ether. The ether is afterwards separated, the residue dissolved in water, and mixed with enough alcohol to preserve it. The narcotina as well as the odorous and many other injurious ingredients of opium are thus got rid of. A new but valuable preparation. Dose, the same as that of laudanum.
Tinctura Opii Acetata (Acetated Tincture of Opium). Prepared by macerating two troyounces of opium, in vinegar fSxij, and alcohol Oss. Dose, rn?x, or 20 drops.
Acetum Opii ( Vinegar of Opium). Black Drop. Pre-
46 MATERIA MEDICA.
pared by saturating diluted acetic acid with opium, mixed with nutmeg, saffron, and sugar. Dose, 7 to 10 drops.
Vinum Opii (Wine of Opium). Sydenham's Laudanum. Prepared by macerating two troyounces of opium in sherry wine Oj, with cinnamon and cloves. Dose, the same as that of laudanum.
Extractum Opii {Extract of Opium). Made by evapo- rating the aqueous solution. Dose, gr. \.
Confectio Opii (Confection of Opium). Opium beaten up with honey and spices. Dose, grs. xxxvj.
Trochisci Glycyrrhiza et Opii (Troches of Liquorice and Opium). Much used in Philadelphia under the name of Wistar's cough lozenges. Made with opium, liquorice, gum arabic, sugar, and oil of anise. Each troche contains one-tenth of a grain of opium.
Emplastrum Opii (Opium Plaster). Made by mixing opium with Burgundy pitch and lead plaster.
Pulvis Ipecacuanha Compositus (Compound Powder of Ipecacuanha). This powder, well known under the name of Dover's Powder, is made by rubbing up sixty grains of opium and ipecacuanha each, with a troyounce of sulphate of potassa; the salt being employed to promote the minute division and thorough intermingling of the opium and ipe- cacuanha. Dover's powder is a most valuable anodyne diaphoretic, extensively prescribed in diarrhoea, dysentery, rheumatism, bronchitis, pneumonia, &c. Dose, gr. x, con- taining gr. j of opium and ipecacuanha each.
Pilule Opii (Pills of Opium). Sixty grains of opium, made into sixty pills, with twelve grains of soap. Each pill contains a grain of opium. Kept in the shops, as hard old opium pills are sometimes preferred in cases of irritable stomach.
Pilule Saponis Composite (Compound Pills of Soap). Sixty grains of opium made into a pilular mass, with half a troyounce of soap. Useful for the administration of small doses. One grain of opium is contained in five of the mass.
LACTUCARIUM. 47
Morphia and its Preparations. — Morphia exists in opium chiefly in combination with meconic acid. The meconate of morphia is separated from the other constitu- ents of the drug by successive macerations in water. Al- cohol and solution of ammonia are then added to the wa- tery solution, by which the salt is decomposed, the ammo- nia precipitating the morphia, and the alcohol seizing the coloring matter as soon as it is separated from the alkali. The crystals of morphia, which are formed, are afterwards boiled in alcohol, and the solution is filtered through animal charcoal.
Morphia occurs in colorless crystals, which are inflam- mable and dissipated by heat. It is without smell, but very bitter ; scarcely soluble in water or ether, but is solu- ble in boiling alcohol. From its insolubility, it is not em- ployed medicinally, except in combination with acids.
Morphle Sulphas (Sulphate of Morphia), Morphine Ace- tas (Acetate of Morphia), Morphia Murias (Muriate of Morphia), are the oflicinal salts of morphia, made by satu- rating the alkali with sulphuric, acetic, and muriatic acids. They are all freely soluble in water, and produce analogous medicinal effects, the sulphate being, however, most em- ployed in this country. The salts of morphia possess the anodyne, hypnotic, antispasmodic, and diaphoretic proper- ties of opium, and are considered less apt to produce head- ache and nausea, or other unpleasant effect. They are peculiarly adapted to the endermic method of application. Dose, one-sixth to one-fourth of a grain. A solution of the sulphate of morphia is officinal, and is much prescribed (Liquor 3Iorphio3 Sulphatis). It contains one grain to f5j of water. Dose, f5j-ij.
LACTUCARIUM.
Lactucarium is the concrete juice of Lactuca sativa, the Garden Lettuce (Nat. Ord. Cichoraceffi), and is obtained from incisions in the plant, before the flower-stem shoots.
48 MATERIA MEDICA.
Another and inferior mode of procuring it is by expres- sion and evaporation of the expressed juice. It is found in the shops in roundish, hard masses, of a reddish-brown color, with an opiate smell, and a bitter, unpleasant taste. An active principle termed lactucin is said to have been isolated.
' Effects and Uses.— Lactucarium possesses the anodyne and hypnotic qualities of opium, with a slight sedative action on the circulation, but it is an uncertain preparation. It may be given where opium disagrees from idiosyncrasy in the patient. Dose, gr. x. The syrup is the most eligible form of administration. Dose, two or three fiuidrachms.
BELLADONNA.
Belladonna Folium, Belladonna Leaf; Belladonnas Eadix, Belladonna
Boot.
Atropa Belladonna, or Deadly Nightshade [Nat Ord. Solanaceae), is a European perennial plant, with herbace- ous, branched, downy stems, about three or four feet high, large ovate leaves, of a dull-green color, and drooping, bell-shaped, purple flowers. The whole plant possesses narcotic properties, but the leaves and root only are offi- cinal. When fresh, the leaves have an unpleasant smell, and a sweetish, subacrid, slightly nauseous taste. When dried they retain this taste, but have scarcely any odor. The dried root is long, round, from one to several inches in thickness, branched, of a reddish-brown color, of little odor, and a feeble sweetish taste.
The narcotic properties of belladonna depend on the pre- sence of an alkaloid termed atropia, which is found in all parts of the plant. It is a white, crystalline, odorless sub- stance, with a bitter, acrid taste, soluble in alcohol and ether, more so in chloroform, and partially soluble in water. It is a most energetic poison, producing analogous effects to those of belladonna, but much more powerful. Lat- terly, atropia has been a good deal employed medicinally
BELLADONNA. 49
as a substitute for belladonna, on account of its greater certainty. The dose to begin with for internal use is about one-thirtieth of a grain in solution. As a collyrium, to dilate the pupil, a solution of a grain in four fluidrachms of water, with a few drops of acetic acid, may be employed, and a drop of the solution applied to the eye. A tincture (atropia gr. j, diluted alcohol fsss) is used for the same pur- pose— dose, for internal use, 8 drops. And a sulphate of • atropia and an ointment are also employed.
Physiological Effects of Belladonna. — In small doses, the effects of belladonna are those of an anodyne narcotic, with little or no action on the circulation, or on any of the secre- tions, except a peculiar dryness of the mouth and throat. In larger doses it causes dilatation of the pupils, loss of vision, giddiness, constriction of the throat, difficulty of degluti- tion and articulation, nausea, with occasionally vomiting and purging, and sometimes a red eruption. When ex- cessive doses are taken, these symptoms are aggravated, and terminate in maniacal delirium, coma, syncope, and death, often preceded by convulsions. Dissections show that the action of the poison is not confined to the cerebro- spinal system, but that it is attended by inflammation of the digestive organs. Cases of poisoning from belladonna are to be treated by evacuation of the stomach, cathartics, and, if coma occurs, by the electro-magnetic battery. Lime- water and the alkaline solutions have been found useful. Applied to the eyebrow, belladonna causes dilatation of the pupil.
Medicinal Uses. — Belladonna is one of our most highly- esteemed anodyne and antispasmodic remedies. It is des- titute of hypnotic effect, and, on the contrary, has a ten- dency to occasion wakefulness. In the treatment of neu- ralgia it ranks at the head of the narcotics, and is extensively employed both alone and in combination with the sulphate of quinia. It should be given until dryness of the throat, dilatation of the pupil, and some disorder of vision are produced. Its powers of allaying spasm have
4
50 MATERIA MEDICA.
been found very efficacious in the treatment of whooping- cough. As a discutient of cancerous indurations, it has enjoyed some reputation, but any good effects in these cases have probably been owing to an anodyne and not a resolvent influence. In mania, and many diseases of the cerebro-spinal system, especially epilepsy, it has been occa- sionally employed with advantage. In asthma, constipa- tion, iritis, and as a prophylactic against scarlatina, it is also resorted to. As a preventive of scarlatina, it was origi- nally proposed from its power of affecting the throat and skin, and respectable authority is not wanting in confirma- tion of its efficacy in this particular. It is used, too, in cases of poisoning by opium.
As a topical remedy, belladonna is employed principally to produce dilatation of the pupil in operations for cataract, iritis, and prolapsus iridis. It is applied in the form of ex- tract or ointment to the eyebrow, temple, or conjunctiva, and produces dilatation in a few minutes. The topical ap- plication of belladonna has been suggested in France to relieve rigidity of the os uteri in labor, but the practice has not found favor in Great Britain or the United States.
Administration. — The dose of the powder of the root or leaves is gr. j, to be repeated and increased till dryness of the throat, dilatation of the pupil, and dimness of vision are produced. It is most frequently exhibited in the form of extract (or inspissated juice) of the leaves. Dose, £ to J a grain, to be repeated and increased. The tincture (four troyounces of the leaves to diluted alcohol Oij — dose, 15 to 30 drops) and the alcoholic extract are also officinal. For ex- ternal use, a plaster (Emplastrum Belladonna?), made with the extract and resin plaster, and an ointment ( Unguentum JBelladonnce), are employed.
STRAMONIUM.
51
STRAMONIUM.
Stramonii Folium, Stramonium Leaf; Stramonii Semen, Stramonium
Seed.
Fie. 1.
Datura Stramonium, or Thorn Apple, sometimes called Jamestown weed (Nat. Ord. Solanacese), is an annual in- digenous plant, which grows very abundantly in waste grounds in all parts of the world. It has a forked, branch- ing stem, from three to six feet high, ovate, toothed leaves, large funnel-shaped white or purplish flowers, which ap- pear in midsummer, and ovate capsules, filled with nume- rous kidney-shaped, brownish-black seeds. The odor of the plant is strong and disagreeable, and its taste bitter and nauseous. It loses these properties very much when dried, but the process does not appear to weaken its narcotic cpialities. The Leaves and Seeds are officinal, but the seeds are most powerful from containing most daturia.
The active principle of Stramonium is an alkaloid termed daturia, which possesses properties analogous to those of atropia.
The physiological effects of stramonium are closely allied
52 MATERIA MEDICA.
to those of belladonna, with a more marked action on the secretions. From its common occurrence in every part of the country, cases of poisoning from this weed are very frequent, particularly with children, who are fond of swal- lowing the seeds. The treatment laid down for the relief of poisoning from belladonna is applicable to these cases.
The medicinal uses of stramonium are similar to those of belladonna. It is prescribed internally in neuralgia, whooping-cough, mania, and epilepsy ; and 1n spasmodic asthma the leaves have been smoked with great relief. The practice is, however, dangerous in aged or apoplectic persons. Topically, stramonium is used by oculists to dilate the pupils and diminish the sensibility of the retina to light; and it is an excellent anodyne application, in the form of cataplasm and ointment, to inflammatory tumors, irritable ulcers, bed sores, and hemorrhoids.
Administration. — The dose of the powdered leaves is gr. ij ; of the seeds, a grain, to be repeated and gradually increased till narcotic effects are produced. Dose of the extract of the leaves (an inspissated juice), and of the alcoholic extract, gr. j , to commence with. The tincture (four troyounces of the seeds to diluted alcohol Oij ; dose 20 to 40 drops), and the ointment, made by mixing the extract with lard, are also officinal.
HYOSCYAMUS HENBANE.
Hyoscyami Folium, Henbane Leaf; Hyoscyami Semen, Henbane Seed.
Hyoscyamus niger, or Henbane (Nat. Ord. Solanacese), is a native of Europe, and is naturalized in the northern parts of the United States. It grows to the height of about two feet, with large, sinuated, pale-*green leaves, and flowers of a straw-yellow color. The whole plant has narcotic properties; but the leaves and seeds only are officinal. Henbane should be gathered when in flower; and, when fresh, has a strong, offensive narcotic odor, and a mucila-
HENBANE.
53
ginous, unpleasant, slightly acrid taste ; but it loses most of these qualities in drying. The seeds are of a yellowish- Fig. 2.
gray color, with something of the odor of the plant, and have an oleaginous, hitter taste. The active properties of the plant depend upon a peculiar alkaloid principle, termed hyoscyamia, nearly identical in its action with atropia, but more soluble in water.
Effects and Uses. — The effects of henbane on the system much resemble those of belladonna. They differ from those of opium in their comparatively feeble hypnotic effect, and in their relaxing influence on the bowels. In large doses, it causes dilatation of the pupil, delirium, loss of vision, &c. In cases of poisoning, the same treatment is to be pursued as for belladonna and stramonium. Hen-
54 MATERIA MEDICA.
bane may be used remedially, in the same diseases, as bel- ladonna and stramonium, than which it is, however, less active. It has been administered also from the earliest days to palliate cough, where opium is objectionable from its constipating or nauseating influence. Externally, it is employed in the form of cataplasm or fomentation to pain- ful swellings and ulcers ; and it may be used to dilate the pupil, in the same manner as belladonna.
Dose of the powdered leaves, gr. v to gr. x ; of the seeds, somewhat less. The extract (an inspissated juice of the leaves) is the preferable form of administration ; it is of a dark olive color, and extremely variable quality. Dose, gr. v to gr. x. Tincture (four troyounces to diluted alcohol Oij), dose f5j. An alcoholic extract is also officinal.
TABACUM TOBACCO.
Nicotiana Tabacum, or Virginian tobacco (Nat. Ord. Sola- naceae), is a native of the warm countries of America, but is now extensively cultivated in most parts of the world. It is an annual plant, growing to the height of from three to six feet, with large, oblong, pointed, hairy, pale-green leaves, and light-greenish, funnel-shaped flowers, expand- ing above into rose-colored segments. The dried leaves are the portion used. They have a yellowish-brown color, a strong, peculiar, narcotic odor, and a bitter, nauseous taste. The darker colored leaves are the strongest.
The virtues of tobacco are imparted to alcohol and wa- ter, and depend on the presence of an alkaloid called nicotia, which is found in all parts of the plant. It is a colorless liquid, of a feeble odor, when cold, but irritant, when heated, and of an acrid, burning taste, and is a most ener- getic poison. From the dried leaves is also obtained a concrete volatile oil, termed nicotianin, which is probably the odorous principle of the plant, and an empyreumatic oil, which gives the peculiar smell to old tobacco pipes. Both of these principles are poisonous.
TOBACCO. 55
Physiological Effects. — On persons unaccustomed to its use, tobacco, in small doses, produces a slight sedative ac- tion, with nausea, swimming in the head, increased flow from the kidneys, and sometimes, also, from the bowels. In larger doses, it induces vomiting and purging, a sensa- tion of sinking at the pit of the stomach, giddiness, disor- der of vision, the pupils, however, being little affected, de- pression of the circulation, great relaxation of the muscu- lar system, coldness of the surface, and other symptoms of prostration ; and, when excessive doses have been taken, these symptoms become more violent, and are followed by convulsions, paralysis, coma, and death. Cases of poison- ing are to be treated on the principles applicable to other cases of narcotic poisoning ; the diffusible stimuli are to be freely given.
The habitual use of tobacco as an exhilarant is well known. When taken to excess, it frequently develops disorders of the stomach, heart, and nervous system.
Medicinal Uses. — Tobacco is employed in medicine, chiefly with a view to its action on the muscular system — its anodyne and hypnotic properties being relatively fee- ble. In various spasmodic diseases, particularly in colic, ileus, strangulated hernia, constipation from spasmodic constriction, tetanus, spasm of the neck of the bladder and the glottis, and asthma, it is a remedy of great value. It has been also successfully applied to the treatment ot poisoning by strychnia. Medicinally, tobacco is to be em- ployed with caution, as it occasionally acts with dangerous energy.
Administration. — Tobacco is not given by the stomach, owing to its emetic properties. It is usually applied to the rectum, in the form of infusion (5j— Oj of boiling water, one-third to be given at a dose), or tobacco-smoke may be introduced into the rectum. It may also be smoked for medicinal effect, or applied locally in the form of cata- plasm. An ointment ( Unguentum (abaci), made by mixing finely powdered tobacco with lard, is a useful application
56
MATERIA MEDICA.
to indolent ulcers and some cutaneous affections, particu- larly tinea capitis. The oil (Oleum labaci), is sometimes mixed with ointments.
LOBELIA.
Lobelia inflata, or Indian tobacco (Nat. Ord. Lobelia- cese), is a very common annual or biennial indigenous
Fig. 3.
plant, growing to the height of from six inches to two feet, with a fibrous root, an erect, hairy stem, ovate ser-
LOBELIA. 57
rated leaves, pale-blue flowers, and ovoid, inflated capsules. It flowers from July till the appearance of frost, and should be gathered about August and September. All parts of it are active, but the leaves and capsules are most so. It has an unpleasant smell, and, when chewed, an acrid, burning, nauseous taste, which is at first faint, but soon becomes excessive. Water and alcohol extract the virtues of lobelia, which contains a volatile alkaloid principle, lobelina, analogous to nicotia.
Physiological Effects. — Lobelia produces effects on the system resembling those of tobacco, acting in small doses as a sedative, nauseant, diuretic, and diaphoretic ; in larger doses as an energetic emetic ; and in still larger doses as an active acro-narcotic poison, resembling tobacco in its influence. It was employed by the aborigines, and has always been a popular empirical remedy.
Medicinal Uses. — Lobelia is sometimes classed among emetics, but its action in this particular is too violent for its safe administration. It is chiefly employed, by regular practitioners, with a view to its antispasmodic properties, for the relief of asthma, and is given in small doses, gra- dually increased, until headache or nausea ensue. It may also be used as an enema, to fulfil the same indications as tobacco.
Administration. — Lobelia is given in substance, tincture, and infusion. The dose of the powder as an antispasmodic, is gr. j to gr. iij ; as an emetic, gr. v to gr. xx. The best form, particularly in asthma, is the tincture (four troyounces to diluted alcohol Oij), which may be given in the quan- tity of f5j, to be repeated as occasion may require.
Acetum Lobelle ( Vinegar of Lobelia), is a good prepara- tion, in which the alkaloid is fixed by the acetic acid ; it is of the same strength, and may be given in the same doses as the tincture.
58
MATERIA MEDICA.
Conium maculatum, or Hemlock (Nat. Ord. Apiaceae), is a biennial European plant, naturalized in many parts of the United States. Its stem is erect, from three to five feet high, round, smooth, and often spotted with purple. The leaves are large, bright-green, and repeatedly compound ; the flowers are small, white, and arranged in umbels, ap- pearing in June and July. The whole plant is narcotic and virulent, and has a fetid, heavy odor. The leaves are the only portion used in medicine. They should be gathered when the plant has done flowering, and kept in vessels from which the air and light are excluded. Plants growing in sunny situations and warm climates are most active. When well preserved, the dried leaves have a fine green color, and the characteristic smell and bitterish taste of the fresh herb, though less powerfully.
HEMLOCK. 59
The active principle of hemlock is a peculiar alkaloid termed conia, which exists in larger proportion in the seeds than the leaves. It is a yellowish, oily fluid, sparingly so- luble in water, and freely so in alcohol and ether ; and is a highly energetic poison even in very small doses.
Physiological Effects. — The action of hemlock in medicinal doses is purely narcotic, without either sedative or stimu- lant influence. In large doses, it causes nausea, vertigo, dimness of vision, relaxation of the muscles; and in poison- ous quantities, dilatation of the pupils, difliculty of speech, delirium or coma, paralysis, and finally convulsions and death. It appears to have little or no hypnotic effect.
Medicinal Uses. — It is employed chiefly as a general and topical anodyne, to relieve the pain of malignant tumors ; and, though probably destitute of the deobstruent powers which have been ascribed to it, exerts a remarkable pal- liative influence upon painful chronic indurations. It has been also recommended as an antispasmodic in whooping- cough, asthma, and even tetanus ; and it is used externally as a cataplasm to cancers and other irritable ulcers. Co- nium is the cicuta of Hippocrates, Galen, and Pliny, and is supposed to have been the poison administered to Socrates and Phocion.
Administration. — The officinal preparations of this medi- cine are the powder, tincture, and extract. The dose of the powdered leaves is gr. iij to gr. iv, twice a day, to be rapidly increased, till vertigo or nausea ensue. The extract (inspis- sated juice) may be given in the same doses ; it is an un- certain preparation, and should be rejected unless it have a strong and penetrating odor. A tincture (four troyounces to diluted alcohol Oij, dose f 5ss, f 5j), a fluid extract, and an alcoholic extract, are also used.
60 MATERIA MEDICA.
ACONITUM — ACONITE. Aconiti Folium, Aconite Leaf; Aconiti Kadix, Aconite Boot.
Aconitum Napellus, Aconite, Wolfsbane, or Monkshood (Nat. Ord. Ranunculacese), is a native of the mountainous parts of Europe. It is a perennial, herbaceous plant, with % fusiform root, a simple erect stem, growing usually to the height of from two to four feet, palmate, deeply cleft leaves, and large, dark, violet-blue flowers. The leaves and root
O 7 7
are both used, but the root is the more powerful. They have little or no smell ; but their taste is bitterish and ac- rid, and when chewed they occasion a peculiar feeling of tingling and numbness, in the tongue and interior of the mouth. These properties are impaired by long keeping, and the plant loses its medicinal efficacy. Other species of aconite possess similar poisonous qualities to those of the A. ISTapellus. The active principle of aconite is an alkaloid named aconitia, which is officinal.
Physiological Effects. — Taken in small doses, aconite pro- duces a sensation of numbness in the head, face, and ex- tremities, with a sedative action on the circulation, and more or less nausea and muscular debility. In larger doses, its effects are those of an acro-narcotic poison ; gastric irrita- tion, purging, contraction or expansion of the pupils, numb- ness or paralysis of the limbs, syncope, convulsions, and death. In case of poisoning, the stomach is to be thor- oughly evacuated, and stimulants, externally and internally, are to be freely administered.
Medicinal Uses. — Aconite is a powerful and valuable re- medy in the treatment of neuralgia, chronic rheumatism, gout, and other painful diseases, as might be inferred from its benumbing effects on the system. From its sedative in- fluence on the circulation, its employment has been sug- gested to reduce inflammatory action, and as a remedy in hypertrophy of the heart. It is, however, an uncertain and occasionally a very violent agent ; and its exhibition in doses
EXTRACT OF HEMP. 61
large enough for au antiphlogistic influence is hardly free from danger. As a topical anodyne, in neuralgia, it has no superior.
Administration. — The dose of the powdered leaves is gr. j to gr. ij ; of the alcoholic extract of the dried leaves, gr. J to gr. j ; of the tincture of the leaves (four troyounces to di- luted alcohol Oij), 20 to 30 drops ; of the tincture of the root, which is by far the best preparation (twelve troy- ounces to alcohol Oij), 5 to 10 drops. These doses are to be repeated twice or thrice daily, and cautiously increased, till the effects of the medicine are apparent. The tincture and alcoholic extract may be used externally.
Aconitia is prepared from an aqueous solution of an alcoholic extract of aconite root, by the addition of sulphuric acid (which converts the natural salt of aconitia into a sul- phate) ; it is then freed of its oily and resinous portions by means of ether, the alkaloid is subsequently precipitated with ammonia, then redissolved by ether, and again sepa- rated from this menstruum by evaporation. It is a white, amorphous powder, with a tinge of yellow, without smell, of a bitter, acrid taste, and produces in the mouth a sense of numbness. It is partially soluble in water, and is readily dissolved by alcohol, ether, and chloroform.
Aconitia is an exceedingly virulent poison, more power- ful when pure than hydrocyanic acid. It is scarcely adapted to internal use, as even one-fiftieth of a grain has produced alarming results. As a topical agent in neuralgia and rheumatism, it has been employed with great success in alcoholic solution (gr. i-ij to f 5j), or as an ointment (gr. ij to lard 5j, rubbed up with alcohol gtt. vj).
EXTRACTUM CANNABIS — EXTRACT OF HEMP.
"An alcoholic extract of the dried tops of Cannabis sativa — variety Indica," was introduced into the Materia Medica in the edition of the IT. S. Pharmacopoeia preceding the last. Cannabis sativa, or Hemp {Nat. Ord. Cannabi-
62 MATERIA MEDICA.
naceEe) is a native of Persia and the northern parts of India, and is cultivated in Europe, and in the United States. Narcotic virtues appear to exist only in the Cannabis In- dica, or Indian variety of the plant, although there is no difference in the botanical characters of the several varieties.
The medicinal properties of the plant reside in a resin- ous substance, which exudes from glands upon the surface of the stalks and leaves, and the extract is made by evapo- rating a tincture of the dried tops. Under the name of purified extract of hemp, the U. S. Pharmacopoeia directs a preparation made by evaporating a tincture of the crude extract, thus securing greater uniformity of strength. Ex- tract of hemp is of a dark, olive-green color, a fragrant nar- cotic odor, and a bitter, acrid taste. It is soluble in alcohol and ether, but not in water. The resin, which is probably the active principle, has received the name of cannabin.
Effects and Uses. — The medicinal properties of Cannabis Indica are narcotic and antispasmodic, and in India both the herb and resin are extensively used as intoxicating ex- hilarants, under the name of haschisch. In large doses it is sedative, producing relaxation of the muscles, heavy sleep, and abatement of pain, without much affecting the secre- tions ; but opinions are by no means settled in the United States and Great Britain as to its effects. It has been chiefly extolled as an antispasmodic in traumatic tetanus, and has been employed with success in other spasmodic diseases, chorea, hysteria, &c, and as an anodyne in rheu- matism, gout, neuralgia, &c. It has also been given with advantage as an hypnotic in mania-a-potu ; and its powers of exciting uterine contractions, and of checking uterine hemorrhagic discharges, are highly spoken of. Dose, from half a grain to two or more grains.
HUMULUS — HOPS.
Hops are the strobiles of Humulus lupulus, or Hop-vine {Nat. Ord. Urticacese), a climbing vine, indigenous in Eu-
hops. 63
rope, and probably also in North America, with serrated, rough leaves, and greenish-yellow flowers. The medicinal portion is the fruit, or strobiles, which are also largely employed in the preparation of malt liquors, and are known as hops. They consist of thin, somewhat translucent, veined, leaflike bracts or scales, of a greenish-yellow color, a strong, fragrant, narcotic odor, and a bitter, aromatic, slightly as- tringent taste. Near their base are two small, round, dark seeds, covered with aromatic glands or grains, which are the active portion of the hops, and are termed liqmlin. They are separated by threshing, rubbing, and sifting the scales, and constitute about a sixth part of their weight.
Lupulin is officinal, and consists of rounded or reniform, rather transparent grains, of a cellular texture, and a gol- den-yellow color. It is slightly soluble in water, and com- pletely so in alcohol, and is composed of a volatile oil, a bitter principle termed lupuliie, resin, and other matters. The scaly bracts contain a small portion of lupulinic mat- ter.
Effects and Uses. — Hops are narcotic and tonic. The narcotic properties probably reside in the volatile oil, and the tonic properties in the bitter principle. They are said, also, to possess antaphrodisiac properties, and sometimes prove diuretic. The odorous emanation is employed as an hypnotic by means of the hop-pillow. Internally, they are given to relieve restlessness, induce sleep, and allay pain, and are also much employed for their stomachic and tonic effect. The combination of tonic and narcotic virtues ren- ders hops an excellent remedy in mild forms of mania-a- potu. Topically, they are employed in the form of fomen- tation or poultice, as a resolvent or discutient, in painful swellings and tumors.
Administration. — Hops are given in the form of infusion (half a troyounce to boiling water Oj), and tincture (five troyounces to diluted alcohol Oij), dose, f5j to fSiij.
The best preparation for internal use is Lupulin, in the dose of gr. v to gr. xij, in powder or pills. The tincture
64 MATERIA MEDICA.
of lupulin (four troyounces to alcohol Oij) may be given in the dose of f5j to foij. The fluid extract is a concentrated tincture, containing the virtues of an ounce of lupulin in a fluidounce. The oleoresin also is officinal— dose, gr. ij to v.
DULCAMARA BITTERSWEET.
The stalks of Solanum Dulcamara, the Woody Night- shade, or Bittersweet (Nat. Ord. Solanacese), a European vine, naturalized in the United States, possess combined narcotic and diaphoretic properties. They are of a green- ish-gray color, about the thickness of a quill, and have, when fresh, an unpleasant odor, which they lose by drying. Their taste is at first bitter, afterwards slightly acrid and sweet. The active principle is a poisonous alkaloid termed solania, which has been found also in Solanum tuberosum, or common potato, and S. nigrum, or black nightshade.
Effects and Uses. — In small doses, the most obvious ef- fects of Bittersweet are an increase in the secretions from the skin and mucous surfaces, with some diminution of sensibility. In excessive doses it is an acro-narcotic poison. It is principally used in the form of decoction (a troyounce to water Ojss boiled to Oj), in painful cutaneous affections, and also in chronic catarrh, rheumatism, and gout. An extract and fluid extract are both officinal.
ACIDUM HYDROCYANICUM DILUTUM — DILUTED HYDROCYANIC ACID.
Hydrocyanic acid, known also as cyanhydric acid, and prussic acid, is found in a variety of vegetable substances, as the bitter almond, peach kernels and leaves, wild cherry, cherry laurel, &c. It is employed in medicine only in a state of extreme dilution ; and the diluted acid is obtained by the action of sulphuric acid and water on the ferrocya-
DILUTED HYDROCYANIC ACID. 65
nide of potassium, or, when wanted for immediate use, by the action of muriatic acid and water on cyanide of silver.
Diluted hydrocyanic acid is a colorless, volatile liquid, with a peculiar odor, and a cooling, somewhat irritating taste. It undergoes decomposition if exposed to the light, and should be kept in bottles covered with black paint or paper. It contains two per cent, of the anhydrous or con- centrated acid.
The anhydrous acid is a colorless, transparent, very vo- latile and decomposable liquid, with a powerful, peculiar odor, and a cooling, afterwards burning, taste. Both wa- ter and alcohol dissolve it readily. It consists of one eq. of cyanogen and one of hydrogen. Its presence in a sus- pected mixture may be detected by the addition of a solu- tion of nitrate of silver, which throws down a white, curdy precipitate of cyanide of silver, distinguishable by its ex- haling the peculiar odor of prussic acid on the addition of muriatic acid ; or (the best test) the hydrocyanic acid may be converted into hydrosulphocyanate of ammonia by the addition of bihydrosulphate of ammonia, and the salt thus formed yields a deep blood-red color upon the addition of a sesquioxide salt of iron.
Physiological Effects. — When taken in medicinal doses, gradually increased, hydrocyanic acid occasions a bitter taste, increased flow of saliva, irritation in the throat, nau- sea, headache, giddiness, faintness, disorder of the vision, and tendency to sleep. The pulse is sometimes accele- rated, but more commonly depressed. In a poisonous dose, hydrocyanic acid arrests life with fearful rapidity, and is one of the most energetic poisons known, one or two drops of the pure acid being sufficient to destroy a dog in a few seconds. When not immediately fatal, it pro- duces great and sudden prostration, trismus, difficult and spasmodic respiration, dilatation and immobility and some- times contraction of the pupils, convulsions, &c. The best antidotes are ammonia and its carbonate, chlorine, and a
5
66 MATERIA MEDICA.
mixture of sulphate of iron (gr. x to water fgj), tincture of chloride of iron (f5j), and carbonate of potassa (3j), in wa- ter (fSj or ij); cold affusions and, if necessary, artificial respiration are to be resorted to.
Medicinal Uses.— Hydrocyanic acid is a valuable narcotic agent in allaying spasm, pain, and nervous irritability in a variety of disorders, and is much used to relieve cough, particularly in phthisis pulmonalis, and for its antispas- modic virtues in asthma and whooping-cough. It is, moreover, a most efficacious remedy in gastrodynia, and in neuralgic affections of the bowels, and also in chronic vomiting. Topically, it is employed as an anodyne in neuralgia, and in various forms of cutaneous diseases (f3j to water Oj-Ojss).
Dose of the officinal acid, one or two drops, to be re- peated and gradually increased by a drop, till some effect is perceptible. When it is taken for a length of time, care should be observed to have the medicine, as renewed, of uniform strength ; and it is best, in using a fresh sample, to return to the minimum dose.
Potassii Cyanidum [Cyanide of Potassium), is used as a substitute for hydrocyanic acid, and has the advantage of being a more uniform chemical product, and less liable to undergo decomposition. It occurs in white, opaque, amor- phous masses, having a sharp, somewhat alkaline and bit- ter-almond taste, and its solution yields the odor of hydro- cyanic acid, when exposed to the air. It is very soluble in water, and sparingly so in alcohol. Its medicinal and poisonous effects are the same as those of hydrocyanic acid. Dose, gr. i in half an ounce of distilled water, to be re- peated and increased. The addition of a few drops of some vegetable acid frees the hydrocyanic acid, and the same effect is produced by the acids of the stomach.
Oleum Amygdala Amar^e (Oil of Bitter Almond), con- tains hydrocyanic acid, and may be used for the same
CAMPHOR. 67
purposes. It is obtained by distillation from the fruit of Amygdalus communis, variety Amara {Nat. Ord. Amyg- dalese), and is of a yellowish color, with a bitter, acrid, burning taste, and the peculiar odor of the bitter almond, which is different from that of hydrocyanic acid. It is heavier than water, slightly soluble in it, and soluble in alcohol and ether. Its effects upon the system are closely analogous to those of hydrocyanic acid, and its strength is about four times that of the diluted officinal acid. Dose, for internal use, a quarter to half a drop, in emulsion ; as an external application, one drop to a fluidounce of men- struum. Bitter Almond Water is used as a vehicle for nar- cotic medicines. Dose, half a fluidounce.
Strupus Amygdala (Syrup of Almond), made from both the sweet and bitter almonds, is slightly impregnated with the virtues of hydrocyanic acid, and is a pleasant vehicle for cough mixtures.
CAMPHOKA — CAMPHOR.
Camphor is a peculiar concrete surstance, derived from Camphora officinarum, or the Camphor Laurel (Nat. Ord. Lauracere), a large evergreen tree of China, Japan, and Cochin-China. All parts of the tree are strongly impreg- nated with camphor, which is obtained from the roots and branches by sublimation. In this state it is known in commerce as crude camphor, and consists of dirty grayish grains, adhering in crumbling masses. The crude cam- phor, as imported from Canton, is not found in the shops, until it is refined by resublimation with lime, when it is termed refined camphor.
This occurs in large hemispherical or convex-concave cakes, perforated in the middle. It is solid at ordinary temperatures, soft, and somewhat tough, but may be readily powdered by the addition of a few drops of alco-
68 MATERIA MEDICA.
hol. It is translucent, has a strong, fragrant odor, and an aromatic, bitter, afterwards cooling, taste. It is volatile, highly inflammable, lighter than water, and very slightly soluble in it, but soluble in alcohol, ether, chloroform, oils, and acids. Water, added to the tincture, precipitates the camphor.
A valuable camphor is known in the East, which is found in a-concrete state in the cavities and fissures of the trunk of Dryobalanops Camphora, a tree of Borneo and Suma- tra. The Borneo camphor occurs in small fragments of crystals, which are transparent, brittle, and harder than the laurel camphor. An oil, or liquid camphor, is also ob- tained from the Dryobalanops, which is more highly es- teemed in Oriental countries than the camphor itself.
Camphor is composed of carbon, hydrogen, and oxygen (CjoHgOj). It has been considered to be an oxide of a hy- pothetical base called cam.ph.ogen or camphene, which is isomeric with the oil of turpentine. When heated, it yields an oil, called oil of camphor. By passing hydrochlo- ric acid into oil of turpentine, a substance is obtained called artificial camphor.
Physiological Effects. — The topical action of camphor is irritant. After its absorption, its efi'ects, in small doses, are moderately stimulant, exhilarant, and anodyne, with a determination to the skin. In large doses, it causes con- siderable disorder of the cerebro-spinal system, and gene- rally depression of the circulation ; and in excessive quan- tity, it acts as a powerful acro-narcotic poison, occasioning burning heat in the stomach, violent convulsions, and ma- niacal delirium. It is also an anaphrodisiac. In cases of poisoning, after evacuating the stomach, opium, wine, &c, are to be administered.
Medicinal Uses. — From its combined narcotic and diapho- retic powers, camphor is a valuable remedy in the treat- ment of dysentery, and is much employed in this disease, either in combination with opium, or as a substitute for the latter. In the early stages of cholera, and in flatulent
CAMPHOR. 69
diarrhoea, it is also greatly prescribed. As a diaphoretic stimulant and antispasmodic, it is useful in the low stages of fever and in typhoid conditions of the system generally. In many forms of mental disorder, it calms irritability, re- lieves despondency, and induces sleep. And it has no superior among the anodynes, in allaying irritation or pain of the genito-urinary organs, as in dysmenorrhea, uterine after-pains, strangury, nymphomania, chordee, &c. From its anodyne and sudorific properties, it is also applicable to the treatment of chronic rheumatism and gout. JExter- nally, camphor is employed as an anodyne in rheumatism, and as a discutient in chronic inflammatory affections.
Administration. — The medium dose, in substance, is gr. v to gr. x; but it may vary from gr. j to 3j. It is best given in emulsion, made by rubbing up the camphor with loaf sugar, gum arabic, myrrh, and water. The form of pill is objectionable, from the difficulty with which it is dissolved in the gastric liquors.
Aqua Camphors (Camphor Water), is made by rubbing up camphor with a few drops of alcohol, and subsequently with the carbonate of magnesia and water. The carbo- nate is used to promote the solution of the camphor, and is afterwards separated by filtration. Dose, fSj (contain- ing about gr. iij) to f§ij or iij. The spirit (four troy ounces to alcohol Oij), is chiefly used as an embrocation, but it may be given internally, where the stimulus of the alco- hol is not objectionable, in the dose of gtt. v to f5j.
Linimentum Camphors (Camphor Liniment), consists of camphor (1 part), dissolved in olive oil (4 parts) : a mild embrocation.
Linimentum Saponis (Soap Liniment), is made by mix- ing soap and camphor with oil of rosemary, in alcohol and water. It is a yellow oleaginous liquid, and is used as an anodyne and gently rubefacient application, in gouty and rheumatic pains, sprains, bruises, &c.
Oleum Camphors (Oil of Camphor), the volatile oil ob- tained from Camphora oflicinarum, is a light reddish-brown
70 MATERIA MEDICA.
fluid, with the odor and taste of camphor. It has medicinal properties similar to those of camphor, but is more stimu- lant, and therefore especially adapted to affections of the stomach and bowels. Dose, 2 or 3 drops. It is used also externally.
ORDER II. — ETHEREAL ANAESTHETICS.
The term, Anaesthetics (from a, non, and a"<rOrjaiq^ sensa- tion), properly speaking, includes all agents which diminish sensibility and relieve pain. It has, however, been used to denominate a class of ethereal remedies, which are ap- plied by inhalation, and produce such a condition of tem- porary insensibilit}T, as to prevent pain during surgical ope- rations and parturition.
The vapors usually employed as anaesthetics, are those
Of SULPHURIC ETHER and CHLOROFORM.
Nitrous oxide gas, and the vapors of several ethers have been also used for this purpose. Amylen, a product of amylic alcohol or fusel oil, has been lately introduced as an anaesthetic, but it is highly dangerous. Hydride of amyl has been also proposed.
.ETHER ETHER.
Sulphuric ether is prepared by the distillation of alcohol and sulphuric acid, and is afterwards rectified by redistilla- tion with solution of potassa. For inhalation, however, it is further purified by being shaken with water, by which it is freed from alcohol, and this, as well as acid contami- nations, are afterwards removed by the agency of chloride of calcium and freshly calcined lime. Thus purified, it is designated as ^Ether Fortior— Stronger Ether.
Although commonly termed sulphuric ether, in allusion to the sulphuric acid used in its preparation, yet ether con-
ETHER. 71
tains no sulphuric acid. By the action of -the acid upon alcohol, this substance, which is chemically a hydrated oxide of ethyl, is deprived of the elements of water, and is converted into the oxide of ethyl or ether, for which the formula is C4II50.
Ether is a transparent, colorless liquid, with a strong, fragrant odor, and a hot, pungent taste. It wholly evapo- rates in the air, so rapidly as to cause a considerable de- gree of cold, is very inflammable, combines with alcohol and chloroform in every proportion, and dissolves in ten times its volume of water. The sp. gr. of pure ether is 0.713, of JEther fortior, 0.728.
Effects and Uses when Swallowed. — When taken into the stomach, ether produces a combined stimulant and nar- cotic effect, the stage of excitement being, however, very transient. It has long been employed as an antispasmodic and anodyne remedy in asthma, angina pectoris, hysteria, cramp of the stomach and bowels, spasm of the gall ducts, &c. ; and from its combined stimulant and antispasmodic virtues, it has been found useful in the latter stages of ty- phus, attended by subsultus tendinum, &c. As a topical anodyne, ether is a very good application in nervous head- ache and earache ; and from its refrigerant effects, it has been used in the reduction of strangulated hernias, and as a cooling lotion in cerebral affections. If evaporation be repressed, when it is applied locally, it acts as a rubefa- cient, and may be employed for 6ounter-irritation.
Dose, f 5ss to f 5j, to be increased when habitually used. It may be incorporated with water, by rubbing it up with spermaceti, in the proportion of two grains to a fluidrachm of ether, or it maybe given in capsules of sugared gum.
Effects and Uses when Inhaled. — "When the vapor of ether is absorbed into the system through the pulmonary surface, the nervous functions are successively and progressively af- fected. The mental faculties and volition' become first im- paired; insensibility and unconsciousness rapidly supervene, during which susceptibility to pain is lost; and the patient lies
72 MATERIA MEDICA.
in a trance-like sleep, resembling death. This condition is often preceded by one of excitement, during which patients sometimes moan, sing, rave, or present pugnacious mani- festations. In the beginning of etherization, the circulation is accelerated, but it is afterwards depressed. The period of intoxication lasts from five to ten minutes, and the pa- tient ordinarily recovers without serious inconvenience; although headache, nausea, drowsiness, and languor some- times ensue for a few hours. Occasionally, congestion of the brain or lungs, cataleptic rigidity with prolonged insen- sibility, and, in females, hysterical phenomena ensue after etherization ; but these effects are uncommon, and it is be- lieved that death has never followed the use of ether, when care has been taken to admit atmospheric air into the lungs along with the ether. During the stage of insensibility, convulsive twitches or muscular rigidity are occasionally noticed ; the breathing is sometimes stertorous ; the iris becomes fixed; the pupils are dilated; the eyeballs are upturned ; and the orbicularis palpebrarum does not con- tract when touched. Insensibility to pain in some cases takes place before unconsciousness ; and when patients are recovering from the latter state, the mental faculties are often completely restored, while insensibility to pain con- tinues.
Since the year 1846, the inhalation of ether, first resorted to in our own country, has been practised very generally in all parts of the world, with the greatest success, for the prevention of pain in surgical operations ; and its use has been also extended with the happiest results to the relief of pain in labor.
It should not be exhibited where disease of the heart or brain, or serious obstruction of the lungs exists, or when from any cause there is unusual tendency to syncope, and precaution should be taken to guard against asphyxia ; but when administered with proper care and discrimination, it is attended with little or no danger or unpleasant results of any kind.
CHLOROFORM. 73
The quantity of ether necessary to effect etherization is about two ounces ; and it may be conveniently applied by means of a soft sponge or handkerchief. The sponge is usually adjusted in shape to the projection of the nose, and after being soaked in warm water, and squeezed dry, is saturated with pure ether. It is then applied to the nos- trils, the mouth being left free to receive atmospheric air ; and if irritability of the air-passages occur, this is to be gradually overcome. From three to five minutes are re- quired to produce anassthezation, and its occurrence is known by closure of the eyelids (if they have been previ- ously open), failure to respond to questions, and muscular relaxation. The sponge is then to be removed, and may be reapplied from time to time if necessary.
Etherization has been also resorted to in a variety of mor- bid conditions, in which the administration of narcotics and antispasmodics has been found useful. It exerts a power- ful control over the violent types of spasmodic disease, and has been prescribed with the greatest advantage in hysteria, tetanus, poisoniug from strychnia, asthma, chorea, convul- sions, puerperal eclampsia, whooping-cough, dysmenor- rhea, and almost every description of spasm ; and as a relaxant in the reduction of dislocations.
CHL0ROFORMUM — CHLOROFORM.
Chloroform is obtained from the distillation of alcohol with chlorinated lime, but, for medical use, the chloroform of commerce requires purification, which is accomplished by shaking it with sulphuric acid. This destroys the chlorinated pyrogenous oil, which contaminates the chloro- form, and the sulphurous acid formed and the water present are afterwards removed by means of alcohol and carbonate of potassa.
Purified Chloroform (Chloroformum Purificatum) is a colorless, very volatile liquid, of a bland, ethereal odor, and
74 MATERIA MEDICA.
a hot, aromatic, saccharine taste. It is not inflammable, is slightly soluble in water, and freely soluble in alcohol and ether. It has extensive solvent powers, dissolving cam- phor, the fixed and volatile oils, most resins and fats, iodine, bromine, the organic alkalies, &c. Sp. gr. from 1.49 to 1.494. It is, chemically, a terchloride of formyl, C2HC13.
Physiological Effects. — The effects of chloroform on the system are analogous to those of ether, but much more rapid and powerful. It is, however, destitute of the excit- ant properties of ether, and acts as a sedative narcotic. When inhaled, in the dose of a fluidrachm or more, it rapidly induces, anaesthetic sleep, with great relaxation of the muscles, and the most complete insensibility to painful agents. The period at which insensibility occurs varies from fifteen seconds to two minutes ; and it continues usually between five and ten minutes, and may be prolonged considerably, by renewals of the inhalation. The patient usually recovers without recollection of what has occurred during the state of insensibility, and with few or no un- comfortable sequelae.
The administration of chloroform has, in some cases, been attended with fatal syncope. This has ordinarily oc- curred with such rapidity as to render remedial interference unavailing; but, at the slightest approach of symptoms of the kind the patient should be placed in a recumbent po- sition, cold affusions should be applied, and, above all, electro-magnetism should be resorted to. It would be pro- per always to have an electro-magnetic machine ready for use, when chloroform is inhaled.
Topically applied, and when its evaporation is prevented, chloroform acts as an irritant, and soon vesicates the skin — powerfully diminishing painful impressions during its application.
Medicinal Uses.— Chloroform is prescribed by the stomach as an anodyne and antispasmodic, in all the cases to which ether is applicable, and has the advantage of a more agree- able taste. It has been found particularly useful to relieve
CHLOROFORM. 75
the pain and vomiting of cancer of the stomach. It has been also extolled as an antiperiodic in the treatment of intermittent fevers. Externally, it is used as a topical ano- dyne, and also as a stimulating application to foul and in- dolent ulcers, and occasionally for its constitutional effects.
Dose, from f5ss to f5j,in sweetened water or mucilage; to be repeated. As an anti-neuralgic liniment, f 5j to f §ij of camphor liniment ; or as a rubefacient and anodyne, un- diluted, on linen, covered with oiled silk, to prevent evapo- ration. As a wash or gargle, f 5j or ij to water Oj.
The introduction of chloroform, as an anaesthetic, took place shortly after that of ether ; and, from its greater in- tensity of action, its freedom from irritating effects on the bronchial mucous membrane, and its more agreeable odor, it has been extensively used, particularly in Great Britain, to the exclusion of ether. A number of fatal cases have, however, occurred from the inhalation of this agent, where its administration did not appear in any way counter-indi- cated ; and it can scarcely be considered a perfectly safe remedy. It is employed as an anaesthetic, anodyne, and antispasmodic, to fulfil the indications to which ether is ap- plicable. In midwifery, it is probably less dangerous than in the operations of surgery, owing to the counteracting influence of the pains of labor upon the nervous system ; and no fatal case is recorded from its employment during parturition.
The dose for inhalation is a fluidrachm, to be repeated in two minutes, if anaesthesia be not produced ; and its effects may be renewed from time to time, without injury. It may be applied on a handkerchief, held near the nose or mouth, care being taken to allow a proper admixture of atmospheric air.
A solution of chloroform in ether has been used in the United States, but from the unequal volatilization of the two liquids, it must be difficult to modify their effects by combination.
Spiritus Chloroformi (Spirit of Chloroform), is a solution
76 MATERIA MEDICA.
of one part of chloroform in six parts of alcohol ; a conve- nient form for internal exhibition. Dose, f3ss-f5j.
Liniment of Chloroform is made by mixing three parts of chloroform with four parts of olive oil.
Mixture of Chloroform is made by mixing chloroform, in which camphor is dissolved, with water, by the interven- tion of yolk of egg. Dose, f§ss-f5j.
ORDER III. ANTISPASMODICS.
Antispasmodics are medicines that allay irregular nervous action. Their effects upon the economy in a state of health are not very decided, and are limited to a slight stimulation of the circulation, and exhilaration of the mental faculties. Their influence is, however, strikingly shown in certain deranged conditions of the nervous system, particularly in those forms of spasm which depend upon idiopathic or primary nervous disorder. They are also useful in many varieties of mental disturbance, as wakefulness, hypochon- driasis, and even insanity, and are often preferable to nar- cotics in the treatment of these cases, from their compara- tive freedom of action on the brain.
ASSAFC3TIDA — ASSAFETIDA.
Assafetida is the concrete juice of the root of Narthex Assafoetida (Nat. Ord. Apiacese). This plant is a native of Persia, and has a large, tapering root, the size of a man's leg, with long, lanceolate leaves, springing directly from the root, and an erect stem, from six to nine feet in height, rising from the midst of the leaves. The drug is obtained from incisions made into the root, or by taking successive slices of it. The exuded juice is scraped off, hardened in the sun, and afterwards packed for exportation. It occurs in masses of various size, consistence, and color, but is
ASSAFETIDA. 77
usually whitish, intermixed wi'th darker spots, and becomes reddish, and finally brown, by exposure to the air. It is sometimes soft and adhesive, at other times hard and brit- tle, and is not readily powdered, except at a low tempera- ture. It breaks with a waxy lustre, and the best samples appear to be composed of irregularly-shaped tears. Its taste is unpleasant, bitter, and acrid ; its odor powerful, al- liaceous, and fetid.
Assafetida is a gum-resin, united to a volatile oil. The gum is dissolved by water ; and the mucilage thus formed suspends the resin and volatile oil. The resin and volatile oil are soluble in alcohol ; but the tincture becomes milky on the addition of water, owing to the separation of the resin.
Physiological Effects. — Assafetida is a moderate excitant and exhilarant, and exerts a marked influence upon morbid conditions of the nervous system. It also stimulates the mucous secretions generally, and increases the peristaltic action of the bowels. Its volatile oil is absorbed, and the odorous principle is recognized in the secretions, especially in the perspiration.
Medicinal Uses. — No medicine is more highly esteemed as a direct antispasmodic than assafetida. It is much re- sorted to in the various forms of hysteria, and is particu- larly valuable in relieving the mental depression which constitutes one of the protean types of this disorder. In other spasmodic diseases, as chorea, asthma, whooping- cough, &c, it is a favorite remedy with many practitioners ; and, from its combined expectorant and antispasmodic pro- perties, it is particularly adapted to spasmodic pectoral af- fections. In certain diseases of the abdominal viscera, as flatulent colic and costiveness, assafetida is often useful as an antispasmodic and laxative enema. It is also prescribed as a stimulating emmenagogue, when the uterine disorder is attended with a disturbance of the nervous functions.
Notwithstanding its disagreeable odor, this drug is largely used as a condiment in Asia ; and even in the re-
78 MATERIA MEDICA.
.fined cookery of Europe its' flavor is admired. Many per- sons take it habitually for its exhilarant effects ; and, when used as a medicine, it generally becomes acceptable.
Administration.— Dose, gr. v to &j, in pill. It is most frequently given in the form of mixture (Mistura AssafcB- tida?, — 5ij, rubbed gradually with water Oss), — dose, fgss to fSj, repeated; or as an enema, fSij to fgiv. This mix- ture, from its whiteness and opacity, is sometimes called lac assafcetidce, or milk of assafetida. Pills of assafetida, made by beating up assafetida with soap and water, are officinal, each pill containing 3 grs. of the gum-resin. The tincture (four troyounces to alcohol Oij — dose f5j), is a good prepa- ration, where the alcohol is not objectionable. A plaster (which contains also galbanum), is used externally in whooping-cough and catarrh.
GALBANUM.
Galbanum is the concrete juice of an unknown Eastern plant. It is met with in the form of tears, or more com- monly in lumps, of a brownish color, and has a peculiar balsamic odor, and a hot, bitter, acrid taste. It is a gum- resin united to a volatile oil. Its effects are similar to those of assafetida, but less active ; and it is chiefly em- ployed externally, as a stimulant and resolvent to indolent swellings. The compound pills of galbanum (which contain also myrrh and assafetida) are used as antispasmodic and emmenagogue. Galbanum forms the basis of the com- pound galbanum plaster.
AMMONIACUM — AMMONIAC.
This is the concrete juice of Dorema Ammoniacum (Nat. Ord. Apiacese), a plant of Persia. It comes in tears or lumps, of an irregular shape, yellowish on the outside, whitish within, is moderately hard and brittle, and has an
VALERIAN. 79
unpleasant, bitter, and rather acrid taste, with a pecu- liar smell, somewhat like that of galbanum. It is a gum- resin, with a little volatile oil. Its effects are similar to those of assafetida; but it is seldom used, except as an antispasmodic expectorant in chronic catarrh. Dose, gr. x to xxx. A mixture and plaster are officinal.
VALERIANA — VALERIAN.
Valeriana officinalis, or Wild Valerian [Nat. Orel. Vale- rianacese), is a perennial European plant, growing to the height of three or four feet, with serrated leaves, and small, reddish-white fragrant flowers. The root is the portion used, and consists of numerous long, slender, cylindrical fibres, attached to a rough, tuberculated head. The color of the dried root externally is yellowish or brown, and in- ternally white ; when powdered, it is yellowish-gray. It has a peculiar, powerful odor, of which cats are fond, and a bitterish, subacrid, aromatic taste. Water and alcohol extract its virtues, which depend on the presence of a vola- tile oil, from which a peculiar colorless, volatile acid, called valerianic, may be separated.
Effects and Uses. — Valerian generally acts as an ener- getic excitant and antispasmodic, although at times it makes but a feeble impression on the system. It is much used as a nervous excitant and antispasmodic in the va- rious forms of hysteria, and occasionally, also, in epilepsy, chorea, hemicrania, hypochondriasis, delirium tremens, &c.
Dose of the powder, from 5ss to 5jss, three or four times a day ; of the infusion (half a troy ounce to Oj of water), f 5j to ij ; of the tincture (four troyounces to diluted alcohol Oij), f5j ; of the arnmoniated tincture (four troyounces to aromatic spirit of ammonia Oij — an excellent preparation), f5j to ij ; of the fluid extract, f5j ; of the alcoholic extract, gr. x to xxx ; of the oil, 4 or 5 drops.
Ammonia Valerianas ( Valerianate of Ammonia). — This
80 MATERIA MEDICA.
salt, made by combining valerianic acid with ammonia, occurs in snow-white, pearly crystals, of an odor like vale- rianic acid, and a sharp, sweetish taste. It is soluble both in water and alcohol. Much employed in neuralgia, hys- teria, chorea, epilepsy, &c. Dose, gr. ij-viij, given in coated pills; or an elixir, prepared with aromatics, may be used.
CYPRIPEDIUM.
The root of Cypripedium pubescens, or yellow lady's- slipper, a common indigenous plant, growing to the height of one or two feet, possesses mild antispasmodic proper- ties, and has been used as a substitute for valerian. Dose of the powdered root, gr. xv, three times a day. An infusion and tincture are also used : by precipitating the tincture, an oleoresin is obtained, of which the dose is half a grain to three grains.
SCUTELLARIA — SKULLCAP.
The herb of Scutellaria lateriflora {Nat. Ord. Labiatee), an indigenous perennial herb, growing to the height of one or two feet, with ovate, acute, dentate, petiolate, opposite leaves, and small pale-blue flowers, is considered by many American practitioners to possess valuable antispasmodic properties. An infusion (two troyounces to boiling water Oj) may be taken ad libitum ; and a fluid extract is also used.
DRACONTIUM — SKUNK CABBAGE.
Dracontium fcetidum, Symplocarpus foetidus, or Skunk Cabbage (Nat. Ord. Orontiacese), is an indigenous plant, growing in moist situations, which flowers in April and May, and afterwards sends up numerous large and luxu- riant leaves. The fresh root has a strong, fetid odor, and an acrid taste, but loses these properties by being kept. ' It is stimulant, antispasmodic, and narcotic, and is employed in hysteria, asthma, chronic catarrh, &c. Dose, gr. x to xx
MUSK. 81
gradually increased. It is also given in the form of infu- sion. The leaves are used in the country to keep up the discharge from blistered surfaces, and to stimulate indo- lent ulcers.
The well-known articles Tea and Coffee (Thea and Caffea), possess antispasmodic and exhilarant properties.
MOSCHUS — MUSK.
Musk is a peculiar concrete substance obtained from Moschus moschiferus, or the Musk Deer, an animal rather larger than the goat, and resembling the deer in its charac- ters, which inhabits the mountainous portions of Central Asia. The musk-bag is found only in the male, and lies between the umbilicus and prepuce. It is an oval pod, about two and a half inches long, and one and a half broad, flat on one side, and convex and hairy on the other, and in the full-grown animal contains from 5jss to 5vj, of a liquid secretion, which, when dried, is musk. Two kinds are known in commerce, the China and the Russia Musk, the former of which is much the stronger.
Musk occurs in grains or lumps concreted together, of a reddish-brown color, and has usually some hairs of the pod mixed with it. It has a powerful diffusive, aromatic odor, and a bitterish taste. Tt is inflammable, leaving a light spongy charcoal. On analysis, it yields ammonia and a variety of other constituents, but the odorous principle has not been isolated. It is partially soluble in water and alcohol, and completely so in ether.
Owing to its high price, musk is greatly sophisticated. Sometimes artificial pods are met with, which may be dis- tinguished from the genuine, by the absence of the remains of the penis and of an aperture in the middle of the hairy coat. The musk itself is more frequently adulterated, by mixture with dried blood, and a variety of substances. Indeed, little if any genuine musk is found in the shops.
Effects and Uses. — Musk is a powerful excitant and anti-
6
82 MATERIA MEDICA.
spasmodic, without much effect on the cerebral functions. If a pure article could be obtained, it would have no supe- rior as a direct antispasmodic in the treatment of essential nervous disorders — hysteria, epilepsy, chorea, and hic- cough, and as a combined excitant and antispasmodic in the latter stages of typhus. But it is now little prescribed, owing to the difficulty of procuring it good.
Administration. — It may be given in the form of bolus or emulsion. Dose, gr. x, to be repeated every two or three hours.
An article, termed Artificial Musk, is made by the addition of one part of rectified oil of amber to three parts of nitric acid. It resembles musk both in sensible and medicinal properties, and has been prescribed in its stead, in the same dose.
CASTOREUM — CASTOR.
This is a peculiar concrete substance, found in mem- branous follicles, which exist between the anus and exter- nal genitals of the Castor fiber, or Beaver. It occurs in the form of solid unctuous masses, contained in pairs of sacs about two inches in length, of a brownish-black color externally, and of a reddish-brown color internally. It has a peculiar, penetrating, disagreeable smell, and a bitter, acrid, nauseous taste. It is soluble in alcohol and ether.
Effects and Uses. — Castor is moderately excitant and an- tispasmodic, and is very analogous in its effects to musk. It is not much used. Dose of the substance, gr. x to gr. xx ; of the tincture (two troyounces to alcohol Oij), f5j to f5ij.
OLEUM SUCCINI RECTIFICATUM — RECTIFIED OIL OF
AMBER.
Amber, Succinum, is a sort of fossil resin found in va- rious parts of the world, and comes to this country from
COMPOUND SPIRIT OF ETHER. 83
the shores of the Baltic. It is a hard, brittle substance, usually translucent, and of pale golden-yellow color, insi- pid, and inodorous, except when heated. By distillation, it yields an oil which, when rectified, is employed medici- nally. The oil is nearly colorless at first, but gradually be- comes brown, has a strong, peculiar odor, and a pungent, acrid taste. It is soluble in alcohol. An acid called suc- cinic is also obtained from amber.
Effects and Uses. — Oil of amber is excitant and antispas- modic, and has been used in hysteria, epilepsy, tetanus, pertussis, and amenorrhoea. It is chiefly employed as an external application, and is a good remedy in pertussis, and convulsions of children. Dose of the oil, gtt. v to gtt. xv. For external use, it may be mixed with three or four parts of olive oil and brandy, with one part of lauda- num added.
OLEUM 2ETHEREUM ETHEREAL OIL.
This preparation, known also as oil of wine, is a result of the distillation of alcohol with a large excess of sulphu- ric acid. It is a volatile liquid, of a yellowish color and peculiar odor, very sparingly soluble in water, but readily dissolved by alcohol or ether. It has antispasmodic pro- perties, but is used in medicine only as an ingredient of the compound spirit of ether.
SPIRITUS ^ETHERIS COMPOSITUS — COMPOUND SPIRIT OF ETHER.
This preparation, known as Hoffman's Anodyne Liquor, is a solution of ethereal oil (f5vj), in ether (Oss), and alco- hol (Oj). It is a volatile liquid, with a burning, slightly sweetish taste, and the peculiar odor of ethereal oil. It becomes milky on being mixed with water, owing to the precipitation of the ethereal oil.
84 MATERIA MEDICA.
Effects and Uses. — Hoffman's Anodyne has the antispas- modic and excitant effects of ether, and derives additional tranquillizing and anodyne properties from the ethereal oil present. It is much used in hysteria, and is often added to laudanum, to prevent the nausea which the latter some- times excites. Dose, f5j to f5\j, in sweetened water.
ORDER IV. TONICS.
Tonics, called also corroborants, are medicines which produce a gradual and permanent increase of nervous vigor. It is only, however, in certain conditions of dis- ease that they manifest this invigorating influence : as, in a state of health, they often act as irritants, stimulants, or even nauseants. Their local effects are similar to their general effects. They exalt the nervous functions of the parts to which they are applied, and increase their firm- ness and density. When taken into the stomach they pro- duce a twofold corroborant effect, improving the digestive powers by their local action, and strengthening the system generally by their cerebro-spinal influence.
Tonics differ from stimulants in the more permanent character of their effects : " tonics give strength, stimu- lants call it forth." The more powerful tonics are closely allied to the narcotics in their action, producing, in over- doses, giddiness, loss of sight and of hearing, convulsions, delirium, and even death. And this analogy is farther illustrated by the curative powers of tonics in the relief of painful and spasmodic diseases, as neuralgia, rheumatism, chorea, and epilepsy.
The articles of this class may be divided into vegetable and mineral tonics. The vegetable tonics are characterized by bitterness ; and it is said that they owe their bitterness and medicinal activity to a principle which has been termed bitter extractive. It is doubtful, however, whether any .such proximate principle has really been obtained. The
VEGETABLE TONICS. 85
mineral tonics unite astringent with tonic properties ; and the preparations of iron produce a further corroborant effect, by increasing the red coloring matter of the blood. The therapeutic application of tonics comprises a diver- sified range of diseases. They are employed as stomachics in dyspepsia, and as general corroborants in convalescence from acute diseases, in chronic affections accompanied by marasmus and cachexia, and in typhus and gangrene. But their most striking and valuable powers are shown in their febrifuge influence upon malarious diseases. The modus medendi here is obscure, but the curative agency is un- doubtedly due to a powerful impression upon the central organs of the nervous system. The anti-neuralgic and antispasmodic properties of tonics have already been al- luded to. They also enjoy considerable reputation in the treatment of chronic bowel-complaints, where they act by restoring tone to the debilitated intestinal tube ; and, on the other hand, they are often useful as laxatives in torpid con- ditions of the alimentary canal.
VEGETABLE TONICS.
The vegetable tonics may be arranged into three sec- tions, viz. : 1. The pure bitters. 2. The aromatic bitters, which contain a stimulant volatile oil, and are aromatic as well as tonic. 3. The astringent bitters, which contain tannic and gallic acids, and are both astringent and tonic : this group contains cinchona, the most powerful, and im- portant of the vegetable tonics. The bitter principle is found also in many medicines belonging to other classes, as rhubarb, aloes, taraxacum, &c, and gives them tonic properties.
86 MATERIA MEDICA.
SIMPLE BITTERS.
QUASSIA.
Quassia is the wood of Simaruba excelsa (Nat. Ord. Sima- rubacese), a lofty tree of Jamaica and other West Indian islands. It is imported from the West Indies in billets of various sizes, which are found in the shops in the form of chips or raspings. Externally, it is covered with a smooth, brittle bark ; the wood is white, but becomes yellowish by exposure. It has no odor, but an intense permanently bitter taste. Water and alcohol extract its virtues, which are said to depend on a neutral principle termed quassin.
The article originally known as Quassia was the root and wood of Quassia amara, a shrub of Surinam, but this does not now reach our markets. It is thought to have possessed much more decided tonic properties than the drug now found in commerce.
Effects and Uses. — Quassia is a mild tonic, free from sti- mulant or astringent effects, and is employed principally in dyspepsia, want of appetite, and other stomachic affections. It is much used to give additional bitterness to malt liquors. Dose, in powder 3j to 5j, three or four times a day; but the best form of administration is that of infusion (5ij to water Oj), in doses of fgjss to fSiij. An extract (aqueous) is given in the dose of gr. v, but it is principally used as an exci- pient for the administration of the mineral tonics. Of the tincture (two troy ounces to diluted alcohol Oij), the dose is f5j to f5ij.
SIMARUBA.
Simaruba is the bark of the root of Simaruba officinalis (Nat. Ord. Simarubaceae), a tall tree of Jamaica and many parts of South America. It occurs in long pieces of various sizes, which are much rolled or quilled, of a brownish-
GOLDTHREAD.
87
yellow color externally, and yellow internally. It contains a bitter principle, analogous to quassin, and resembles quassia in its medicinal effects.
COPTIS Cx OLD THREAD.
Coptis trifolia, or Goldthread (Nat. Ord. Ranunculacese), is a small, evergreen, herbaceous plant, resembling the
Fie. 5.
strawberry-vine, with perennial creeping roots, slender stems, round, ternate leaves, and a single small white flower, which appears through the spring till midsummer. It belongs to the northern regions of America and Asia, and abounds in swampy places in Canada and New Eng- land. The parts used are the roots, which should be gathered in autumn, and carefully dried. They are of a bright-golden color, and give the name by which the plant is commonly known. They are thought to contain the alkaloid berberina.
88 MATERIA MEDICA.
Effects and Uses.— Goldthread is a pure and powerful bitter, similar in its effects to quassia, but much more palatable, and is a very good stomachic tonic. It is also employed in New England as a topical application in aph- thous and other ulcerations of the mouth. It is usually given in the form of tincture (one troyounce to diluted alcohol Oj), in the dose of f3j, and of infusion (half a troy- ounce to water Oj).
GENTIANA GENTIAN.
Gentian is the root of Gentiana lutea or Yellow Gen- tian (Nat. Ord. Gentianacese), a perennial plant of the mountainous parts of Central and Southern Europe, grow- ing to the height of two or three feet, with broad, ovate, opposite leaves, and handsome whorled, yellow flowers. It is imported in cylindrical branched pieces, of various sizes, marked by transverse annular wrinkles and longitu- dinal furrows. Externally, it is yellowish-brown, inter- nally, brownish-yellow, and of a spongy texture. Its odor in the fresh state is peculiar and disagreeable, but when dried, feeble ; its taste is intensely bitter. Water and alcohol extract its virtues. It contains a peculiar oil and acid, pectin, sugar, and a bitter principle, termed gentianin. Other species of gentian are employed as substitutes for the yellow gentian.
Effects and Uses. — Gentian is a pure bitter, without either astringency or much aroma. In full doses, it is more dis- posed to relax the bowels than the other simple bitters ; and like others of the vegetable tonics, in excessive doses it is capable of producing narcotic effects. It is an admir- able stomachic in dyspepsia aud gastric disorders, and is also used in the various forms of constitutional debility.
Administration. — In the form of poivder, the dose is gr. x to 5ss. But it is usually given in the form of infusion (half a troyounce to water f^xiv, with diluted alcohol fgij, and orange-peel and coriander, each 5j); tincture (tinctura Gen-
AMERICAN CENTAURY.
89
tianse composita, gentian two troyounces, orange-peel a troyounce, cardamom half a troyounce, to diluted alcohol Oij), in the dose of f5j to f5ij ; extract, in the dose of gr. x to 5ss; imA fluid extract, in the dose of f5ss-j.
FRASERA — AMERICAN COLUMBO.
The root of Frasera "Walteri (Nat. Orel. Gentianaceae), an elegant plant of our Southern and Western States, may be used as a substitute for gentian and eolumbo. Dose, 5ss-5j ; or an infusion (a troyounce to boiling water Oj), may be given.
SABBATIA — AMERICAN CENTAURY.
Fig. 6.
Sabbatia angularis, American Centaury, or Centaury (Nat. Ord. Gentianacese), is a very common annual indige-
90 MATERIA MEDICA.
nous plant, with an erect stem, one or two feet high, oppo- site ovate leaves, and numerous terminal flowers of a rich rose-color, nearly white in the centre. It is found in low meadow-grounds or neglected fields in most parts of the United States, and flowers in August and September. The whole herb is officinal, and should be gathered while in flower. It has a very bitter taste, and yields its virtues to both water and alcohol.
Effects and Uses. — Centaury is a pure bitter, with no as- tringency, and very little aroma. It is an excellent sto- machic, and may be used also as a general corroborant. It is said to act as an emmenagogue when given in warm infusion, and, like the bitters generally, has had anthel- mintic properties ascribed to it. The best form of exhibit- ing it is infusion (a troyounce, to boiling water Oj), of which the dose is a wineglassful when cool ; of the powder 5ss to 5j may be given.
CALUMBA — COLUMBO.
Columbo is the root of Cocculus palmatus (Nat. Ord. Menispermacerc), a climbing plant of Mozambique, where it is known under the name of Calumb. The root consists of fleshy tubers, with numerous offsets, which are the por- tions used, the main root being too fibrous. They are sliced, strung on cords, and dried in the sun; and are found in the shops in round pieces about a quarter of an inch thick, externally of a brown, wrinkled appearance, and internally yellow. The odor is slightly aromatic, and the taste very bitter. Owing to the starch which is found in columbo, it is liable to be worm-eaten. It contains, be- sides a large proportion of starch, a peculiar azotized sub- stance, and two bitter principles, colombin and berberina. Water and alcohol take up its virtues ; and from its liabi- lity to attract moisture from the air, it should not be kept in the form of powder.
YELLOW-ROOT. 91
Effects and Uses. — Columbo is a very agreeable demul- cent tonic, particularly acceptable to the stomach, and hence well adapted to the convalescent stages of acute dis- orders of the bowels and of fevers. It is also a good pre- paration in the sickness of pregnant women, and is one of the best of the stomachics in all cases where there is unu- sual delicacy of the stomach. In its native country, it is much employed in the treatment of dysentery.
Administration. — The dose of the powder is gr. x to gr. xxx. It is best given in the form of infusion (half a troy- ounce to boiling water Oj, dose, f§j to f§ij), which should be used at once, as it is liable to spoil. Of the tincture (four troyounces to diluted alcohol Oij), f5j to f5iv may be given. Columbo is often combined with aromatics, iron, and alkalies, and is sometimes added to purgative mixtures.
Bwberina, the alkaloid found in columbo, is widely dif- fused in the vegetable kingdom, and is obtained from nu- merous plants of the natural orders Berberacem, 3Ienisper- macece, and Ranuncuiacece, as barberry, yellow-root, hydras- tis, goldthread, and others. It has been employed, in the form of muriate and sulphate, as a tonic and febrifuge, in doses of from one to ten grains.
CHIRETTA.
The herb and root of Agathotes Chirayta (Nat. Ord. Gentianacese), an East Indian plant, have been introduced into Europe, under the name of Chiretta, where it now ranks among the best simple bitters. It resembles gentian in its properties, and may be used in the same way.
XANTHORRIZA YELLOW-ROOT.
The root of Xanthorriza Apiifolia (Nat. Ord. Ranuncu- lacese), an indigenous shrub, of our Southern and Western States, is a good simple bitter, which agrees very well with the stomach.
92
MATERIA MEDICA.
AROMATIC BITTERS.
SERPENTARIA VIRGINIA SNAKEROOT.
The roots of several species of Aristolocliia are known under the name of Virginia Snakeroot. The most fami- liar is A. serpentaria (Nat. Ord. Aristolochiaceae), an her-
Fig. 7.
baceous indigenous plant, with a perennial root, composed of numerous slender fibres, arising from a knotty, brown head, one or more stems, eight or ten inches in height,
CHAMOMILE. 93
heart-shaped, pointed, yellowish-green leaves, and purple, tubular flowers, springing up close to the root. It grows in shady woods and on hill-sides, flowering in May and June ; but from the great demand for the roots, it has be- come scarce. A. reticulata is a variety found in the South- western States.
Virginia Snakeroot is found in the shops, in tufts of long, slender, matted fibres, attached to a knotty, rugged head. They are brittle, and of a yellowish-brown color. The odor is aromatic and agreeable ; the taste somewhat pungent, bitter, and aromatic. Water and alcohol extract its virtues, which depend on the presence of a volatile oil and a bitter principle. The roots of A. reticulata are very commonly substituted for those of A. serpentaria, from which they differ only in the larger size of their fibres. They are quite equal to the latter, and are even thought to contain a larger proportion of volatile oil.
Effects and Uses. — Virginia Snakeroot is a combined sti- mulant and tonic, with diuretic or diaphoretic properties, according; to the mode of its administration. It is much used in the latter stages of fevers, and in other acute dis- eases, and is frequently combined with Peruvian bark, in the treatment of intermittents. The proper form of ad- ministration is that of infusion (half a troyounce to boiling water Oj), in doses of fSj to fgij, repeated. Of the tinc- ture (four troyounces to diluted alcohol Oij), the dose is f5j to foij ; of the fluid extract, f5ss-f5j. Huxham's Tinc- ture of Bark contains Virginia Snakeroot.
AN THEMIS — CHAMOMILE.
Anthemis nobilis, or Chamomile (Nat. Ord. Asteraccee), is a small, herbaceous, trailing European plant, cultivated extensively both in Europe and this country. The flowers are the officinal portion. They consist of small spheroids, with convex, yellow disks, and numerous white, spreading
04 MATERIA MEDICA.
rays. By cultivation they become double; but in Europe the single flowers are preferred, as the tonic properties re- side in the disks, which are larger in the single-flowered wild plants. Chamomile flowers have a bitter, aromatic taste, and a strong, peculiar odor, both of which are im- parted to water and alcohol. They contain a volatile oil, bitter extractive, and a little tannic acid.
Effects and Uses. — Chamomile, in small doses, is a mild, agreeable aromatic tonic, and in large doses, acts as an emetic. The cold infusion is much employed as a sto- machic, and the hot infusion is given to aid the operation of emetics. The flowers, boiled in warm water, form a good fomentation to inflamed parts. The usual form of administration is the infusion (half a troyounce to water Oj). Dose, as a stomachic, fgij, two or three times a day, cold ; as an emetic, hot, ad libitum.
Cotula [Mayweed), Anthemis cotula, Wild chamomile, or Mayweed (Nat. Ord. Asteraceoe), an herbaceous plant, indigenous in Europe, but extensively naturalized in the United States, resembles chamomile very closely, both in botanical characters and properties, and is used as a sub- stitute for it in domestic practice.
Matricaria (German Chamomile). The flowers of Ma- tricaria chamomilla (Nat. Ord. Asteracese), an annual Eu- ropean plant, possess properties very similar to those of chamomile. They are considerably smaller than common chamomile, and have a larger proportion of disk florets compared with those of the ray. They are not much em- ployed in this country.
EUPATORIUM — THOROUGH WORT.
Eupatorium perfoliatum, Botieset, or Thoroughwort ( Nat. Ord. Asteracege), is a very common indigenous plant, grow- ing in wet grounds in every part of the United States. It
THOROUGHWORT.
95
lias a perennial root, with numerous herbaceous stems, from two to five feet high, long, narrow leaves, perforated by the stems, and numerous white flowers, which form a
Fig. 8.
flattened summit to the plant. These appear in August, continuing in bloom till October, and, with the leaves, are the officinal portion. They have a faint odor, a strongly bitter taste, are soluble in water or alcohol, and contain a peculiar bitter principle, gum, tannic acid, resin, salts, and other matters.
Effects and Uses. — Thoroughwort is a stimulant tonic, diaphoretic, and expectorant, and in large doses proves emetic and laxative. It is a good stomachic in dyspepsia, and, from its combined corroborant, expectorant, and dia- phoretic properties, is an excellent remedy in the latter stages of pneumonia and bronchitis. It is also used with
96 MATERIA MEDICA.
good effect in rheumatism, and in remittent and typhoid fevers. It should be given in infusion (a troyounce to boil- ing water Oj), f§ij of which may be taken cold, as a sto- machic, three or four times a day, and in freer warm draughts, as a diaphoretic.
ABSINTHIUM WORMWOOD.
The tops and leaves of Artemisia Absinthium, or "Worm- wood {Nat. Ord. Asteracese), a European plant, naturalized in New England, are ranked among the aromatic bitters, but are not now much employed. They may be given in infusion (a troyounce to boiling water Oj).
MAGNOLIA.
The bark of Magnolia glauca, Magnolia acuminata, and Magnolia tripelata (Nat. Ord. Magnoliacese), indigenous trees, remarkable for the beauty of their foliage, and the size and fragrance of their flowers, is officinal, and ranks with the aromatic bitters. The bark of the trunk, branches, and root, is alike officinal ; but that of the last is the most active. It contains a volatile oil, a green resin, and a pe- culiar crystallizable bitter principle. The aromatic pro- perty is impaired by drying, and is lost when the bark is long kept.
It is used as a gentle stimulant tonic, and diaphoretic, in the low stages of fever, rheumatism, &c. An infusion may be given, but the best solvent is diluted alcohol.
LIRI0DENDR0N TULIP-TREE BARK.
The bark of Liriodendron tulipifera, the Tulip-Tree, or American Poplar (Nat. Ord. Magnoliaeere), the well-known pride of the American forest, remarkable for its size, fo- liage, and beautiful tulip-shaped flowers, closely resembles
CASCARILLA. 97
that of magnolia in its medicinal properties, but is less aromatic and more stimulant. It is said to contain a pe- culiar principle, termed liriodendrin. It may be given in powder, in the dose of 3j to 5ij ; and in infusion, decoction, and tincture.
ANGUSTURA — ANGUSTURA BARK.
Angustura bark is derived from Galipea officinalis (Nat. Ord. Rutacege), a small tree of the district of country bor- dering on the Orinoco, in South America. It occurs in pieces of various lengths and sizes ; sometimes flat, some- times slightly curved, but rarely entirely quilled. Exter- nally, it is of a light-gray color, and is covered with lichens, with a soft, spongy epidermis, which is readily scraped off; internally, the color is yellowish-brown. It has a disagree- able smell, and a bitter, aromatic, somewhat pungent taste. It imparts its virtues to water and alcohol, and contains a volatile oil and a bitter principle, termed cusparin. The bark of Strychnos mix vomica has been sometimes mixed with Angustura bark, and is thence known as false angus- tura bark.
Effects and Uses. — Angustura bark is a stimulating tonic, and in large doses acts on the stomach and bowels. From its liability to adulteration with the bark of Strychnos nux vomica, it has fallen into disuse, and it has no superiority over serpentaria and others of the indigenous aromatic bit- ters. Dose, in powder, gr. x to 5ss ; of the infusion (half a troyounce to boiling water Oj), f5ij, repeated.
CASCARILLA.
This is the bark of Croton Eleuteria (Nat. Ord. Euphor- biacese), a small tree of the Bahamas and other West India islands. It occurs sometimes in the form of small, thin
7
98 MATERIA MEDICA.
fragments — sometimes in that of rolled pieces, one or two inches long, occasionally longer, and varying in size from that of a quill to that of the little finger. It is usually covered with a white rugous epidermis, and is of a brown color beneath. It has a warm, spicy, and bitter taste, and an aromatic, agreeable odor, which is particularly fragrant when it is burned. It yields its properties to alcohol, and partially to water ; and contains volatile oil, resin, and a bitter principle, called cascarillin.
Effects and Uses. — Cascarilla is a very pleasant aromatic bitter, causing neither vomiting or purging, and hence agreeing very well with the stomach. It may be given in powder in the dose of 3j to 5ss ; but this is a less agreeable form than the infusion (a troyounce to boiling water Oj), of which the dose is f§ij.
CANELLA.
This is the bark of Canella alba (Nat. Ord. Meliacese), a large tree of the West Indies and South America. It comes in quilled pieces of a whitish-yellow color, or in flat fragments, which are thicker and darker. It has an aro- matic odor, and a warm, pungent, aromatic, and somewhat bitter taste. It imparts its virtues to alcohol, and partially to water; and contains volatile oil, resin, bitter extractive, gum, &c.
Effects and Uses. — An aromatic tonic, little employed ex- cept in combination. Pubis Aloes et Canellai (Powder of Aloes and Canella), popularly known as hiera picra, consists of aloes four parts, canella one part; dose, gr. x to 3j.
ACHILLEA — YARROW.
The herb and flowers of Achillea Millefolium, Milfoil, or Yarrow (Nat. Ord. Composite Senecionidea?), a perennial
PERUVIAN BARK. 99
herb, common to the old and new continents, growing to the height of twelve or eighteen inches, with doubly pin- nale, minutely divided leaves, and whitish flowers, pos- sesses mild stimulant tonic properties, with some astrin- gency. Of the infusion, made in the proportion of an ounce to the pint, a wineglassful or more may be given. It yields a volatile oil, which has been used in the dose of 20 or 30 drops.
ANGELICA.
The root of Angelica Archangelica (Nat. Ord. Apiacege), a plant of the northern and mountainous sections of Europe, is used as a stimulant tonic, in the dose of 5ss-5j ; or an infusion may be given.
ASTRINGENT BITTERS. CINCHONA — PERUVIAN BARK.
The name Cinchona (derived from the Countess del Cinchon, wife of a viceroy of Peru) is applied to the bark of different species of Cinchona (Nat. Ord. Cinchonaccse), large trees which grow in the mountainous regions of the western portion of South America, from the nineteenth degree of south latitude to about the tenth degree of north latitude. Three principal varieties of cinchona are known in commerce : Cinchona Flava ( Yellow Bark), called in commerce Calisaya Bark, derived principally from Cin- chona Calisaya, and, in some quantity also, from C. Boli- viana ; Cinchona Pallida (Pale Bark), called in commerce Loxa and Lima Bark, derived from Cinchona Condaminea and Cinchona Micrantha; and Cinchona Rubra (Red Bark), derived from Cinchona Succirubra.
Peruvian Bark is brought to the United States from the
100 MATERIA MEDICA.
Pacific ports of South America. It is obtained by strip- ping the trunks and branches of the Cinchona trees during the dry season, and is dried by exposure to the sun, during which process it usually becomes quilled.
1. The Yellow or Calisaya Bark comes both in quilled and flat pieces. The former are from three or four inches to a foot and a half long, from a quarter of an inch to two or three inches in diameter, and of variable thickness. They have a brownish epidermis (with longitudinal wrinkles and transverse fissures), which possesses none of the virtues of the bark. The bark itself is one or two lines thick, com- pact, of a short fibrous texture, and when broken presents shining points. The flat pieces, which are derived from the large branches and trunk, are usually destitute of epi- dermis, are more roughly marked externally, and are of a browner hue than the quilled pieces. They are also less compact, less bitter, and of less medicinal virtue. The yellow bark is distinguished from the other barks by its much more bitter taste ; its comparative freedom from as- tringency; its brownish-yellow, somewhat orange color, which is still brighter in the powder ; and by containing a large proportion of quinia with very little cinchonia.
2. The Pale Bark comes in cylindrical pieces of variable length, sometimes singly, sometimes doubly quilled, from two lines to an inch in diameter, and from half a line to two or three lines in thickness — the best kinds being about the size of a goose-quill. Their exterior surface is rough, marked with fissures, and of a grayish color, owing to ad- hering lichens. Their interior surface is of a cinnamon color, and, in the finer sorts, smooth. The color of the powder is a pale fawn. The taste is moderately bitter, and somewhat astringent ; the odor feeble, but rather aromatic in the powder and decoction. The pale barks contain a much larger proportion of cinchonia than of quinia ; and, from their yielding little quinia, have fallen into disuse in the United States.
3. The Red Bark usually comes in large, thick, flat
PERUVIAN BARK. 101
pieces ; sometimes also in quills from half an inch to two inches in diameter. They are covered with a reddish- brown, rugged epidermis, beneath which is a dark-red, brittle, and compact layer, the interior parts being woody and fibrous, and of a lively brownish-red color. The taste of red bark is bitter and astringent; its odor not different from that of the other barks ; its powder is reddish. It contains considerable quantities both of quinia and cinchonia.
Under the name of Carthagena Barks, several common varieties of cinchona were long brought to this country from the northern Atlantic ports of South America. They were of inferior quality, and were therefore not recognized by the Pharmacopoeias ; but since the reduced supply and consequent high price of the Calisaya bark, large quanti- ties of very good bark have been imported from New Gra- nada, and are now largely used in the manufacture of quinia, under the name of Colombian barks.
Within a few years, the cultivation of several varieties of Cinchona trees has been successfully introduced into Southern India ; and valuable specimens of red bark (the product of C. Succirubra), equal to that of South America, have been sent to Europe.
Chemical Constituents. — The most important constituents of cinchona are two alkaline principles, termed quinia and cinchonia, which exist in combination with an acid called kinic. These alkalies are found in different proportions in the different barks, quinia being obtained from the yellow bark most abundantly, cinchonia from the pale bark, and the two principles in about equal proportion from the red bark. Two other valuable alkaloids, quinidia and cincho- nidia, are found (also as kinates) most abundantly in the pale and Carthagena barks; but, to a certain extent, in all. Other principles found in cinchona are tannic acid, color- ing matter, kinovic acid, starch, fatty matter, kinate of lime, lignin, &c. Gum is found in the pale bark, but not in the yellow or red barks.
Quinia is obtained in the following manner : Powdered
102 MATEKIA MEDICA.
yellow bark is boiled in water acidulated with muriatic acid, by which the alkali is separated from its combination with kinic acid, to form a soluble muriate. By the addi- tion of lime, this salt is decomposed, and quinia precipi- tated. It is separated from insoluble impurities by diges- tion in boiling alcohol, and, after being concentrated, is decolorized by means of animal charcoal. Or, it may be obtained by heating the sulphate with an alkaline solution. It is whitish, and usually flocculent, inodorous, bitter, al- most insoluble in water, but soluble in alcohol, ether, and the fixed and volatile oils. It unites with acids to form salts, the most important of which is the officinal salt, the sulphate. Quinia and its salts may be distinguished from all other vegetable alkalies and their salts (excepting qui- niclia), by striking an emerald-green color, when heated first with solution of chlorine and then with ammonia. Cinchonia is a white crystalline substance, less bitter than quinia, almost insoluble in cold water, very soluble in boil- ing alcohol, and slightly soluble in ether and the fixed and volatile oils. It is distinguishable from quinia by striking a white precipitate, when chlorine water and afterwards ammonia are added; with ferrocyanide of potassium, a yellowish-white precipitate ensues. The medicinal proper- ties of quinia and cinchonia are analogous, and the sul- phate of cinchonia is now officinal. Quinidia is isomeric with quinia, but more crystallizable and less soluble in ether ; its salts strike a white precipitate with solution of iodide of potassium. Cinchonidia is isomeric with cincho- nia. It is usually found mixed with quinidia, the mixture being known as commercial quinidia. The commercial sul- phate of quinidia (which is more soluble in water and al- cohol than the sulphate of quinia), may be used as a sub- stitute for the latter salt.
Incompatibles.— The alkalies and alkaline earths precipi- tate the alkaline principles of cinchona; tannic acid forms with them insoluble compounds.
Physiological Effects.— The topical effects of cinchona are
PERUVIAN BARK. 103
slightly irritant, and, from the tannic acid which it con- tains, astringent. Its constitutional action upon persons in health, results in a disordered condition of the stomach, and of the vascular and cerebro-spinal systems, as shown by gastro- enteric irritation, fever, headache, and giddiness. But, in persons suffering from debility, it proves a most energetic stomachic and corroborant; and over certain morbid conditions, as malarious and other fevers, it exer- cises a control more striking than is shown by any other medicinal agent, in the treatment of diseases.
Medicinal Uses. — The most important therapeutic em- ployment of bark is as a febrifuge in the treatment of fe- vers of a malarious origin. Its efficacy in these diseases was first made known to the world by the Jesuit missiona- ries in Peru, from whom it was called Jesuit's powder. The type of malarious fever in which the powers of bark are most strikingly displayed, is intermittent; the non-malig- nant and uncomplicated forms of which it rarely if ever fails to control. It may be given in these cases almost from the very onset of the attack, unless contraindicated by the presence of gastric irritability, which must be first removed by an emetic or mercurial purge. In remittent fevers, bark is scarcely less useful than in intermittents ; and most physicians who practise in malarious districts, now concur in recommending its exhibition in these fevers, as soon as it can be borne well by the stomach, without wait- ing for a remission. In the pernicious or congestive forms of intermittent and remittent fevers, the early administration of large doses of bark or its preparation, the sulphate of quinia, in combination with stimulants, is imperatively de- manded. As a prophylactic against malarious fever, the use of the preparations of bark is very efficacious. In the varieties of typhus, including that termed cerebro-spinal meningitis, the salts of quinia, in full doses, constitute the most efficacious treatment, in conjunction with abundant stimulation and nourishment. In yellow fever, the declin- ing stages of typhoid fever, the malignant exanthemata,
104 MATERIA MEDICA.
gangrene, malignant erysipelas, carbuncle, extensive sup- purations, the typhoid forms of diseases generally, the hec- tic of phthisis, acute rheumatism, diarrhoea, dysentery, and cholera, and various disorders of the nervous system, as neuralgia, tetanus, and chorea, bark and its preparations are constantly employed. It is also much used as a sto- machic and general tonic, but where gastric susceptibility exists, as in convalescence from acute diseases, some of the simple bitters are preferable. Topically, bark is employed as an astringent and antiseptic.
Administration. — The use of bark, in powder, since the discovery of the sulphate of quinia, has been very much abandoned, owing to its bulk and disagreeable taste. "When exhibited in this form, half .a troyounce to an ounce is the dose as a febrifuge, given usually in divided doses ; as a tonic, 5j- The following officinal preparations are employed : decoction (a troyounce of yellow or red bark to Oj of water, to be boiled for ten minutes, and aromatic sulphuric acid f5j may be afterwards added), dose^ fgij, repeated; infusion (a troyounce of yellow or red bark to water Oj, to which aromatic sulphuric acid f5j maybe added), dose, fgij, repeated; extract (of yellow bark), dose gr. x to gr. xxx, equivalent to 5j of bark; fluid extract (yellow), dose, f5ij, equal 5j of bark; tincture (six troy- ounces of yellow bark to diluted alcohol Oij), dose, f5j to f5iv; compound tincture or Huxham's tincture (containing red bark with Virginia snakeroot and aromatics), dose f'5j to f 5iv. In prescribing bark, opium or port wine is often given with it, when it acts on the bowels. It is also occa- sionally combined with serpentaria. And, when the sto- mach will not retain it, it has been used externally in the form of cataplasmata, pediluvia, bark-jackets, &c, though for external use, the enclermic exhibition of the sulphate of quinia is the ordinary resort.
Quinia Sulphas [Sulphate of Quinia). This salt is pre- pared by treating quinia (as obtained from yellow bark in
PERUVIAN BARK. 105
the process described at p. 102), with sulphuric acid. It occurs in fine, silky, rather flexible, needle-shaped crys- tals (interlaced among one another, or grouped in small star-like tufts), which are odorless, very bitter, and slightly efflorescent. It is soluble in boiling water, alcohol, and the diluted acids, very slightly soluble in ether and in cold water, but, by the addition of sulphuric acid, it is con- verted into a more soluble neutral sulphate. The offi- cinal sulphate is chemically a disulphate or subsulphaie, con- sisting of two equivalents of base to one of acid. Various substances are mixed as adulterations with the sulphate of quinia. They may be detected by adverting to their rela- tive solubility in different menstrua, as compared with the sulphate, or by chemical tests. Thus gum and starch are left behind by alcohol ; salicin becomes red on contact with sulphuric acid, &c.
Effects and Uses. — The effects of sulphate of quinia on the system are the same as those of Peruvian bark, and, from its being less apt to disagree with the stomach, it has to a great extent superseded the use of the latter. In large doses it produces headache, ringing of the ears, and sometimes vertigo, amaurosis, deafness, delirium, and other evidences of a powerful action on the cerebro-spinal system.
Administration. — The ordinary dose of the sulphate of quinia, as a febrifuge, is gr. xij, equal to about §j of bark, but as much as twenty grains, and even more, are often required; as a general tonic, gr. j to gr. vj. It maybe given in pill, or dissolved in some aromatic water, by the aid of aromatic sulphuric acid; also as an enema, or en- dermically. The solution has been used externally in go- norrhoea, &c. Many other salts of quinia than the sul- phate have been introduced into practice, but they possess no advantage over the officinal salt.
Quinia Valerianas ( Valerianate of Quinia), is obtained by dissolving freshly precipitated quinia in diluted valeria- nic acid. It occurs in transparent or white rhomboidal
106 MATERIA MEDICA.
crystals, of the peculiar odor of valerianic acid, and an acrid, bitter taste. Soluble in alcohol and ether, and par- tially soluble in water. It fulfils the indications of quinia and valerianic acid, and is therefore especially useful in nervous disorders.
Crude Quinia is the impure quinia obtained from the manufacturer, before separation from the insoluble impu- rities. It is a soft solid, of resinous aspect, nearly free from bitterness, and may be given to children in the same doses as the sulphate.
Quinoidia, quinodin, or amorphous quinia, is a substance ob- tained by precipitation, with an alkaline carbonate, from the mother liquor left after the preparation of sulphate of quinia. When moderately heated, it appears as a resinous mass, of a yellowish-white or brownish color, which, accord- ing to Liebig, is identical in composition with ordinary quinia, to which it bears the same relation that uncrystal- lizable sugar bears to the crystallizable. It is considered equally efficacious with quinia, but requires doses rather larger than the sulphate of quinia, than which it is much more economical.
Cinchona Sulphas (Sulphate of Gnchonia), is made from the mother waters remaining after the crystallization of sulphate of quinia. Being the most soluble of the sul- phates of the four alkaloids found in bark, it remains in solution after the sulphate of quinia, and the mixed sul- phate of cinchonidia and quinidia, have crystallized out. From the mother waters, it is precipitated by solution of soda, then washed with alcohol, next reconverted into a sulphate, and boiled with animal charcoal to decolorize it. It occurs in short, oblique, shining prisms, of a very bit- ter taste, more soluble in water than the sulphate of qui- nia, readily soluble by alcohol, and sparingly so by ether. It is a disulphate. It is now admitted to have the same remedial properties as the sulphate of quinia, but requires rather larger doses.
DOGWOOD.
107
CORNUS FLORIDA — DOGWOOD.
Cornus Florida, or Dogwood (Nat Ord. Cornaceae), is an indigenous tree, found in most parts of the United States, and growing in the Middle States to the height of
Fig. 9.
from fifteen to twenty feet. Its flowers are remarkable for large four-leaved white or pinkish involucres, which appear with us in May. The officinal portion is the bark, that of the root being preferred. It occurs in pieces of various sizes, more or less rolled, of a reddish-gray color, with occasionally a fawn-colored epidermis. Its odor is slight ; its taste bitter, astringent, and slightly aromatic. It yields its virtues to water and alcohol, and contains re- sin, a peculiar bitter principle, tannic and gallic acids, &c.
108 MATERIA MEDICA.
Effects and Uses. — Dogwood is deservedly esteemed the best substitute for cincbona among the native astringent bitters. It is somewhat stimulant, and not unfrequently disorders the stomach. Dose, in poioder, 9j to 5j ; of the decoction (a troyounce to water Oj), fSij may be given.
SALIX — WILLOW.
The bark of Salix alba, or the White Willow (Nat. Ord. Salicacese), is ranked among the astringent bitters. It is little employed, however, except in the form of salicin, its active principle, which consists of white, slender, silky crystals, inodorous, but very bitter, soluble in water and alcohol, but not in ether. It has been used as a substitute for the sulphate of quinia, but is very inferior to it as a febrifuge. As a general tonic, however, it is useful, and may be given in the dose of from gr. x to gr. xxx. The sulphate of quinia is often adulterated with salicin, but the fraud may be detected by the addition of sulphuric acid, which strikes a blood-red color with salicin.
PRUNUS VIRGINIANA — WILD-CHERRY BARK.
The wild-cherry has long been known under the name of Prunus Virginiana, which is still retained by the Phar- macopoeia. This name, however, belongs to another tree, the choke-cherry; and the wild-cherry is now properly distinguished as Cerasus serotina (Nat. Ord. Drupacese). It is a large indigenous tree, attaining a great height and size in the Southwestern States, but usually with us about twenty-five to thirty feet high. The trunk is covered with a rough blackish bark, which detaches itself semicircu- larly ; the leaves are ovate, oblong, and acuminate ; the flowers, which appear in May, are white, and are followed by fruit about the size of a pea, of a purplish black color,
NECTANDRA. 109
and a not unpleasant bitterish taste. The medicinal portion is the inner bark of the root and tree, the former of which is the more active. It is found in the shops, in pieces of various lengths and sizes, deprived of the epidermis, and slightly curved, of a reddish-brown color, and a bitter aro- matic taste.
It contains a bitter principle, resin, starch, and tannic and gallic acids, and yields on distillation a volatile oil, nearly identical with the oil of bitter almonds, which does not pre-exist in the bark, but is formed by the action of water on amygdalin, as in the almond. The leaves also yield this oil. Boiling water impairs the virtues of the bark.
Effects and Uses. — Wild-cherry bark is tonic, with some astringency, and at the same time exercises a sedative in- fluence on the nervous and circulatory systems, owing to the hydrocyanic acid, which is developed in it. It is used with excellent effect as a sedative corroborant in various forms of pulmonary irritation, particularly in the latter stages of pneumonia, and in the hectic of phthisis. It is also a useful stomachic and tonic in a variety of cases. The proper form of administration is the infusion (half a troyounce to cold water Oj), in the dose of f§ij twice or thrice daily. Of the fluid extract (alcoholic), the dose is f5j-ij. The syrup is an agreeable preparation; dose, fgss.
NECTANDRA.
The bark of Nectandra Rodiei (Nat. Ord. Lauracere), the Greenheart tree, a large tree of Guiana, and the neigh- boring countries of South America, has, within a few years been introduced into medicine, under the name of bebeeru bark. It occurs in large, flat, heavy pieces, one to two feet long, from two to six inches broad, and three or four lines thick, of a grayish-brown color on its outer sur- face, and a dark cinnamon on the inner. It nas an in-
110 MATERIA MEDICA.
tensely bitter, somewhat astringent taste, and contains tannic acid, resin, gum, &c, and a peculiar alkaloid, termed bebeerin or bebeeria. Bebeeru bark is employed as a febrifuge and tonic in South America, and the sulphate of bebeerin has been used in Europe and this country with some success in the treatment of intermittent fevers. The full dose is 3j-5j.
The roots of Geum rivale, or Water Avens, and Spi- rsea tomentosa, or Hardback (Nat. Ord. Rosacea?), and the bark of Prinos verticillatus, or Black Alder (Nat. Ord. Aquifolacege), are indigenous astringent tonics of conside- rable power.
MINERAL TONICS. PERRI PR^PARATA — PREPARATIONS OF IRON.
The preparations of Iron (Ferruginea), termed also Cha- lybeates and Martial preparations, are the most important of the mineral tonics. Besides their local tonic-astringent effect and their general corroborant action on the cerebro- spinal system, which they possess in common with the other mineral tonics, they exercise a restorative influence on the composition of the blood, by increasing the number of its coloring particles, and the amount of its solid con- stituents. Their effects are best observed in conditions of the system in which there is a want of these elements of the blood. Under the use of chalybeates, in such cases, while the digestive functions are promoted, the pulse be- comes fuller and stronger, the skin assumes a healthy tint, the lips and cheeks become more florid, the temperature of the body is increased, and the muscular strength is greatly invigorated. On the other hand, the administra- tion of the ferruginous preparations in health, or too long- continued, produces symptoms of plethora, vascular ex- citement, and a tendency to congestion and hemorrhage.
PREPARATIONS OF IRON. Ill
The diseases in which chalybeates are most serviceable, are those which depend on a deficiency of the red corpus- cles of the blood, as the various forms of ancemia, particu- larly where this is connected with irregularity of the ute- rine functions; also scrofula, tuberculosis, and cachectic conditions of the system, characterized by a pale flabby condition of the solids. Many forms of nervous disorder, as neuralgia, chorea, hysteria, and epilepsy, are very deci- dedly controlled by the preparations of iron, and they pro- bably constitute the best remedies in these affections, when attended with ansemia. Several of the preparations of iron are also much employed both as stomachics and astrin- gents.
The following are the officinal preparations of iron :
Ferrum Redactum [Reduced Iron). Metallic iron is ob- tained for medicinal purposes in the form of an impalpable powder, by reducing the sesquioxide (officinally subcarbo- nate) by passing a stream of hydrogen gas over it. It is a light, tasteless, iron-gray powder, and should be kept in a well-stopped bottle, owing to its great liability to oxida- tion. This preparation, sometimes called Quevenne's Iron, is a mild chalybeate, and is a favorite prescription with many practitioners, in the treatment qf chlorosis and other varieties of anaemia. Dose, gr. v to gr. x, three times a day, in the form of pill, made with sugar and gum ; it is sometimes prepared with chocolate in the form of lozenges.
Ferri Oxidum Hydratum (Hydrated Oxide of Iron). This preparation is made by precipitating the sesquioxide from its combination in any tersalt of iron by means of am- monia. Officinally, the tersulphate of iron is employed for this purpose. When dry, it is a reddish-brown powder, and is not considered an eligible preparation for medical use. It is kept in the shops, in the form of a soft, moist, reddish-brown magma, for use as an antidote to arsenious acid.
Ferri Subcarbonas (Subcarbonate of Iron). This salt is obtained by the double reaction of solutions of sulphate of
112 MATERIA MEDICA.
iron and carbonate of soda. It is at first a white precipi- tate; but by exposure to the air it becomes greenish, and afterwards rust-colored, being converted into the sesqui- oxide by the absorption of oxygen, and the evolution of carbonic acid. It has a disagreeable, slightly styptic taste, is insoluble in water, but readily dissolves in hydrochloric and sulphuric acids, and carbonic acid water. It is one of the most valuable of the ferruginous compounds, free from local irritation, and readily dissolved in the fluids of the stomach ; and is much employed in chlorosis, chorea, neu- ralgia, and even pertussis and tetanus. Dose, gr. v to gr. xxx, three times a day.
Trochisci Ferri Carbonatis ( Troches of Subcarbonate of Iron), made with vanilla, sugar, and mucilage of tragacanth, are a pleasant preparation; each lozenge contains about five grains of the subcarbonate.
Emplastrum Ferri (Plaster of Iron), is made with subcar- bonate of iron, le#d plaster, and Burgundy pitch.
Pilule Ferri Carbonatis (Pills of Carbonate of Iron). — Vallet's Ferruginous Pills. To protect the carbonate of iron from oxidation, it is prepared (as in the process last de- scribed) by dissolving the reacting salts in weak syrup in- stead of water ; honey and sugar being afterwards added, to preserve it unaltered and bring it to the pilular consist- ence. This preparation, from its unchangeableness, is pre- ferred to the ordinary subcarbonate, and is one of the most popular of the chalybeates. Gr. x to gr. xxx of the pilular mass may be taken in divided doses through the day.
Mistura Ferri Composita ( Compound Mixture of Iron), is a mixture of the carbonate of iron (prepared by the reaction of sulphate of iron and carbonate of potassa), with myrrh, spirit of lavender, and rose-water, and sugar to resist oxi- dation. It is a favorite chalybeate in chlorosis and ame- norrhcea. Dose, fSj to f£ij, three times a day.
Piluloz Ferri Composite (Compound Pills of Iron), are prepared with carbonate of soda, sulphate of iron, myrrh, and syrup. Dose, from two to six pills three times a day.
PREPARATIONS OF IRON. 113
Both these preparations should be made only as wanted for use.
Ferri Sulphas (Sulphate of Iron), known, in its impure state, as green vitriol or copperas, is prepared for medicinal use by dissolving iron wire in diluted sulphuric acid, with heat. It is a sulphate of the protoxide, and occurs in trans- parent, pale bluish-green crystals, of an acid styptic taste, soluble in water, but insoluble in alcohol. By exposure to the air, they effloresce, absorb oxygen, and become yel- lowish-white, from the formation of sulphate of the sesqui- oxide. When heated to 212°, they give out six of their seven equivalents of water, and are converted into a gray- ish-white mass, known as the dried sulphate. Sulphate of iron is one of the most active of the ferruginous prepara- tions, but its local effects are powerfully astringent, and in a concentrated form it acts as an irritant poison. It is preferred to other chalybeates, where there is much relaxa- tion of the solids, with excessive discharges ; but it is not so well adapted to long-continued use, on account of its local irritant action. Topically, it is employed in substance and solution, as a styptic and astringent. Dose, gr. j to gr. v, in pill; of the dried sulphate (ferri sulphas exsiccata), gr. ss to gr. iij.
Liquor Ferri Tersulphatis (Solution of Tersulphale of Iron). This preparation is made by dissolving the sul- phate (of the protoxide) of iron in a mixture of sulphuric and nitric acids with water. The nitric acid furnishes oxygen enough to the protoxide of iron to convert it into a sesquioxide, and the sulphuric acid gives the additional acid required to saturate the sesquioxide. This solution is a clear, reddish-brown liquid, of a sour, very astringent, and somewhat acrid taste. Its chief use is in making the sesquioxide of iron, and it should be kept on hand, for the preparation of the hydrated sesquioxide of iron, as an anti- dote for arsenious acid. It may be used as a styptic, but for this purpose it is inferior to the next preparation.
Liquor Ferri Subsulphatis (Solution of Subsulphate of
8
114 MATERIA MEDICA.
Iron). This solution, known as MonseVs Solution, is made in the same way as the last preparation, except that only half the amount of sulphuric acid is used ; the sesqnioxide of iron is therefore only partially saturated, and a subsalt results. It has a syrupy consistence, a ruby-red color, is inodorous, and has a very astringent but not acrid taste. It is a less irritant salt than the tersulphate, and may be used internally, in hemorrhage from the stomach and bowels, in the dose of from five to fifteen grains. Exter- nally, it is one of the most efficacious styptics we can employ.
Tinctura Ferri Chloridi (Tincture of the Chloride of Iron). This is prepared by dissolving iron wire in muri- atic acid, then in nitric acid, and afterwards adding water and alcohol. It is a tincture of the sesquichloride, though there is probably some reaction between the acid and alcohol, as the preparation has an ethereal odor. It is of a reddish-brown color, and has a sour, styptic taste. It is one of the most effective of the chalybeates, acting locally as an energetic astringent and styptic, and, in large doses, as an irritant. Its indications, both general and topical, are very analogous to those of the sulphate, with the addi- tion of some specific action on the urino-genital apparatus, which renders it applicable to the treatment of affections of these organs. Dose, trgx to rrgxxx, gradually increased to f5j or f5ij, and taken in some mild diluent.
Ferri Iodidum (Iodide of Iron). This salt is the protiodide of iron, and is made by the addition of iron filings to a mixture of iodine in distilled water. By evaporation, with as little contact of air as possible, green tabular crystals are obtained, of a styptic taste, volatile, deliquescent, and very soluble in both water and alcohol. But, by exposure to the air, the protiodide of iron undergoes decomposition: a portion of the iron parting with its iodine, and becoming oxidized. Hence, the salt is hardly fit for medicinal use, unless protected from decomposition, as in the officinal
Syrupus Ferri Iodidi (Syrup of Iodide of Iron), which is
PREPARATIONS OF IRON. 115
prepared with the addition of sugar. This is an excellent alterative tonic, combining the effects of iodine and of iron, and is particularly applicable to the treatment of scrofula, visceral engorgements, phthisis, &c. Dose, twenty to forty drops three times a day.
Pilules, Ferri Iodidi (Pills of Iodide of Iron), are made with sugar, gum arable, marsh-mallow, and balsam of Tolu. They keep very well. Each pill contains about one grain iodide of iron, and one-fifth of a grain of reduced iron.
Ferri et Potass^ Tartras (Tartrate of Iron and Po- tassa) is prepared by the addition of hydrated oxide of iron to a mixture of bitartrate of potassa in distilled water. It occurs in transparent scales of a ruby-red color, which are wholly soluble in water. The tartaric acid and potash, in combination in this preparation, render it less constipa- ting than the other chalybeates ; and, from its agreeable taste, it is adapted to the diseases of childhood. Dose, gr. x to 5ss.
Ferri Phosphas (Phosphate of Iron), is obtained by the double reaction of solutions of sulphate of iron and phos- phate of soda, and is a phosphate of the protoxide. It is a white powder, insoluble in water, but soluble in dilute acids ; by exposure to the air it absorbs oxygen, and ac- quires a blue color. Dose, gr. v to gr. x.
Ferri Pyrophosphas (Pyrophosphate of Iron), is a mixture of pyrophosphate of the sesquioxide of iron and citrate of ammonia. It occurs in apple-green scales, of an acid taste, and is very soluble in water. A good chalybeate. Dose, grs. ij-v. Given also as a syrup.
Ferri Citras (Citrate of Iron), is prepared by the addition of hydrated oxide of iron to a solution of citric acid. It is a citrate of the sesquioxide, and occurs in thin, transpa- rent pieces, of a garnet-red color, with a mild, acid, chaly- beate taste, slowly soluble in cold water, but readily soluble in boiling water. Dose, gr. v to gr. x. It is officinal also in the form of solution of citrate of iron (liquor ferri citratis), a deep reddish-brown liquid, given in doses of ten to
116 MATERIA MEDICA.
twenty drops ; and it is by evaporating this solution that the solid citrate is obtained. The addition of a few drops of liquor ammonia? converts this salt into an ammonio- citrate, which is more soluble, and possesses antacid pro- perties. Dose, the same.
Liquor Ferri Nitratis (Solution of Nitrate of Iron), is pre- pared by the gradual addition of dilute nitric acid to an excess of iron. It is a ternitrate of the sesquioxide of iron, and is a pale amber-colored liquid, with a strong, astrin- gent, acid taste. It is tonic and astringent, agreeing very well with the stomach, and is employed in the treatment of chronic diarrhoea, hsematemesis, hemorrhage from the bowels, and uterine hemorrhage, particularly when anaemic symptoms are present. Dose, gtt. x to gtt. xx, two or three times a day; in dilution.
Ferrum Ammoniatum (Ammoniated Iron), is prepared by evaporating a solution of sesquichloride of iron and muriate of ammonia. It is a mechanical mixture of these salts, and is of an orange-red color, wholly soluble in water and diluted alcohol. It contains a small and variable quantity of iron ; but is considered a valuable deobstruent in glan- dular swellings, and in large doses is aperient. It is not now officinal. Dose, gr. iv to gr. xij, or more.
Ferri Ferrocyanidum (Ferrocyanide of Iron), or Pare Prussian Blue, is obtained by the action of ferrocyanide of potassium on tersulphate of sesquioxide of iron. It is of a rich dark-blue color, without smell or taste, and is insoluble in water and alcohol. Its effects on the economy in health are not very striking ; but it has been used both as an anti- periodic tonic and in the treatment of neuralgia, chorea, Ac. Dose, gr. v, three or four times a day.
Ferri Lactas (Lactate of Iron), is made by /nixing dilute lactic acid with iron filings. It is a lactate of the protoxide, and occurs in greenish-white crystalline crusts or grains, of a mild, sweetish, ferruginous taste, sparingly soluble in water, and insoluble in alcohol. Used in chlorosis, and
PREPARATIONS OF COPPER. 117
has a marked effect in increasing the appetite. Dose, gr. x-xx, in pill, lozenge, or syrup.
Ferri et Quinine Citras {Citrate of Iron and Quinia). This salt is prepared by precipitating quinia from the sul- phate by ammonia, and afterwards dissolving it in a hot solution of citrate of iron. As found in the shops, it is probably a mixture of citrate of sesquioxide of iron, with a variable proportion of citrate of iron and quinia. It occurs in thin, transparent scales, of a reddish or yellowish- brown color, with a tint of green, not very soluble in water. It combines the virtues of its two bases ; five or six grains contain about a grain of quinia.
Ferri et Ammonia Sulphas (Sulphate of Iron and Ammo- nia). This salt, called also ammonio-ferric alum, is made by adding sulphate of ammonia to the hot solution of tersul- phate of iron. It occurs in octohedral crystals, of a pale violet color and sour astringent taste, efflorescent and soluble in water. Used in diarrhoea and chronic dysen- tery. Dose, gr. v-xv, two or three times a day.
Ferri et Ammonle Tartras ( Tartrate of Iron and Am- monia), occurs in transparent, garnet-red scales, of a sweetish taste, soluble in water, insoluble in alcohol and ether. A mild chalybeate. Dose, gr. x-xxx.
Various other combinations of iron have been from time to time introduced into the practice of medicine ; but they are needlessly multiplied. The arseniate, acetate, tannate, bromide, and valerianate, are recommended by different the- rapeutists.
cupri pr^sparata — preparations of copper.
Metallic copper is inert. The salts of copper act locally as caustics, irritants, and astringents. When exhibited in small doses, they exert a corroborant influence over the cerebro-spinal system, and are employed to fulfil the indi- cations to which tonics are applicable, as in the cure of ague, neuralgia, epilepsy, &c. In larger doses, they act as
118 MATERIA MEDICA.
emetics; and in excessive doses, they produce gastrointes- tinal inflammation, and disorder of the nervous system. They are employed therapeutically, both as external and internal remedies; externally, as stimulants, astringents, styptics, and caustics; internally, as tonics, astringents, and emetics. In cases of poisoning from the cupreous compounds, the best antidote is albumen, as white of eggs, milk, wheaten flour. The ferrocyanide of potassium is also very efficacious, forming with the cupreous compound an insoluble ferrocyanide of copper.
Cupri Sulphas (Sulphate of Copper). This salt, known as blue vitriol, is obtained by roasting the native sulphuret, or by combining copper and sulphuric acid. It occurs in fine, prismatic, blue crystals, which, by exposure to the air, effloresce slightly, and become covered with a greenish- white powder. It has a styptic, metallic taste, is entirely soluble in water, but insoluble in alcohol. It is employed as a tonic, in doses of gr. J to gr. j, or more, in pill, repeated so as not to occasion vomiting. As an astringent, it may be given in the same doses, and will be found an extremely valuable remedy in the treatment of chronic diarrhoea and dysentery, and chronic catarrh with profuse secretion. As an emetic, the dose is gr. iij to gr. v. Externally, it is used as an escharotic to fungous granulations, and in solution to arrest hemorrhages, mucous discharges, &c.
Cuprum Ammoniatum (Ammoniated Copper) is made by rubbing together sulphate of copper and carbonate of am- monia. It is probably a double compound of cuprate of ammonia and sulphate of ammonia, and has a deep azure- blue color, a styptic, metallic taste, and an ammoniacal odor. Its action is very similar to that of sulphate of copper ; but it is used principally as an antispasmodic tonic in nervous disorders, — epilepsy, chorea, hysteria, spasmodic asthma, &c. Dose, gr. J, gradually increased.
Cupri Subacetas (Subacetate of Copper), or Verdigris, occurs in pale bluish-green or blue masses or powder. The dose is gr. J to gr. I ; but it is a powerful poison in
PREPARATIONS OF ZINC. 119
an overdose, and hence is rarely given as a tonic. The powder is used as an escharotic, and an ointment is used.
ZINCI PR^PARATA PREPARATIONS OF ZINC.
Zinc in the metallic state is inert. Its compounds are very analogous in their effects on the system to those of copper, but are less energetic. They are employed topically as caustics, astringents, and desiccants ; and internally as tonics and antispasmodics, and in large doses, as emetics. In cases of poisoning (which are, however, very uncom- mon), demulcents and opiates are to be administered.
Zinci Sulphas {Sulphate of Zinc), or White Vitriol, is pre- pared by dissolving zinc in diluted sulphuric acid. It occurs in small, colorless, transparent, prismatic crystals, resembling those of sulphate of magnesia. They have a metallic, astringent taste, are soluble in water, and inso- luble in alcohol. Dose, as a tonic, antispasmodic, and astrin- gent, gr. j to gr. v ; as an emetic, it is the promptest and safest that can be given in cases of narcotic poisoning, in the dose of gr. x to gr. xx. Externally, it is much used in solution as an application to inflamed mucous membranes, in the strength of gr. j or ij to fgss of water.
Zinci Oxidum {Oxide of Zinc) is made by exposing car- bonate of zinc to heat. It is a white powder, insoluble in water, but soluble in diluted sulphuric and chlorohydric acids. It has been given as an antispasmodic tonic, in doses of gr. ij or iij, gradually increased to gr. viij or x, and is highly esteemed in the treatment of epilepsy; but it is chiefly used externally as a dusting powder, or in the form of ointment.
Zinci Acetas ( Acetate of Zinc) is made by adding zinc to a solution of acetate of lead, and occurs in white micaceous crystals, very soluble in water. It may be given internally as a tonic antispasmodic, in the dose of gr. j or ij, gradually increased ; but it is chiefly used as a topical astringent in
120 MATERIA MEDICA.
ophthalmia, gonorrhoea, leucorrhcea, &c, in the proportion of gr. ij to gr. vj, or more, to an ounce of water.
Zinci Carbonas Pr^ctpitatus [Precipitated Carbonate of Zinc), is obtained by the double reaction of solutions of sul- phate of zinc and carbonate of soda. It is a soft, white powder, similar in its action to the oxide, but is chiefly used as a dusting powder, and to make a mild astringent and desiccant cerate.
Calamina Pr^eparata (Prepared Calamine), obtained by heat from calamine, the native impure carbonate of zinc, is a pinkish powder, used as a desiccant, and in the form of a cerate, called Turner's cerate. Calamine is so frequently adulterated that it is now dismissed from the Pharmaco- poeia, though still much used.
Zinci Chloridum ( Chloride of Zinc), is made by dissolv- ing zinc in muriatic acid, — nitric acid and chalk being added to remove any iron which may have been present with the zinc. It is a whitish-gray, semitransparent, deli- quescent mass, having the softness of wax, and is soluble in water, alcohol and ether. It has been employed inter- nally in doses of gr. j or ij, as an antispasmodic tonic in chorea, epilepsy, and neuralgia. Its local action is that of a powerful caustic, and it is one of the best escharotics that can be exhibited, to produce healthy granulations in malignant or indolent ulcers, especially in lupus. It may be used as a lotion in the strength of gr. ij to f Sj of water, or dissolved in a little alcohol, or in the form of paste, made with one part of the salt to two or four of flour. A solution of the chloride of zinc is employed as an anti- septic, and is also injected into the bloodvessels of ana- tomical subjects to preserve them for dissection.
Zinci Valerianas ( Valerianate of Zinc), is prepared by the double reaction of valerianate of soda and sulphate of zinc. It occurs in white, pearly scales, having^a faint odor of valerianic acid, and a metallic styptic taste. Very slightly soluble in water, more so in alcohol. Used in epilepsy
PREPARATIONS OF SILVER. 121
i
and nervous affections, in the dose of one or two grains, repeated several times a day.
ARGENTI PRiEPARATA PREPARATIONS OF SILVER.
In the metallic state, silver is wholly inert. The only preparation which is extensively employed is —
Argenti Nitras {Nitrate of Silver). This salt is obtained by dissolving silver in diluted nitric acid. It occurs in transparent, colorless, prismatic crystals, which have a strongly metallic and bitter taste, and are wholly soluble in distilled water, and become blackened by the action of light, and organic matters. Its solution yields with chlo- ride of sodium, a white precipitate, entirely soluble in am- monia.
Physiological Effects. — The topical action of nitrate of silver is that of a caustic or corrosive ; and this effect is produced by its combining with the albumen and fibrin of the tissues. When applied to mucous membranes, it forms a compound with the animal matter of the mucus, which protects the tissues from the action of the caustic. Hence, large doses may be taken with considerable impunity by the stomach. But, in excessive quantity, it may occasion gastro-enteric irritation, with disturbance of the nervous system ; and, in these cases, the antidote is common salt (chloride of sodium), which produces, when in contact with the nitrate, nitrate of soda and chloride of silver. In medicinal doses, nitrate of silver has a specific corroborant and antispasmodic action on the nervous system ; and, after absorption, produces a peculiar blueness or slate-color of the skin.
Medicinal Uses. — Internally, nitrate of silver has been chiefly employed as an antispasmodic tonic in the treat- ment of epilepsy, and it is the most reliable remedy that can be administered in this intractable affection ; but its effect in discoloring the skin, is an objection to its pro-
122 MATERIA MEDICA.
tracted use. It is also used in chorea and gastrodynia, and as an astringent in dysentery. But it is as an external agent that it is chiefly resorted to. It is the most efficacious application that can be made to inflamed mucous mem- branes, and either in the solid form or in solution, it is employed in every variety of inflammation of this tissue. It is also extensively used to produce healthy granulations in wounds and ulcers, to arrest the progress of erysipela- tous inflammation and variolous pustules, in porrigo and other skin diseases, in strictures, and to destroy the virus of chancres and of poisoned wounds.
Administration. — The dose of nitrate of silver internally is gr. I, gradually increased to gr. iij or iv, three times a day, in pill made with some mild vegetable powder. For external use, solutions are made of various strengths, from gr. ij to 5ss, in an ounce of distilled water. An ointment is also employed.
Argenti Nitras Fusa (Fused Nitrate of Silver, Lunar Caustic). For external use, in the solid form, nitrate of sil- ver is melted and poured into small moulds.
Argenti Oxidum (Oxide of Silver), is obtained by adding solution of potassa to a solution of nitrate of silver. It is a tasteless, olive-brown powder, very slightly soluble in water. Its uses are analogous to those of the nitrate, and it is employed in epilepsy, gastrodynia, chronic diarrhoea, uterine disease, &c. It is considered to be free from lia- bility to discolor the skin. Dose, gr. ss to gr. ij, twice or thrice daily, in powder or pill.
BISMUTHI SUBNITRAS — SUBNITRATE OF BISMUTH.
This salt is prepared by dissolving bismuth in diluted nitric acid. It is a white, inodorous, tasteless powder, nearly insoluble in water. Its medicinal properties are tonic, antispasmodic, and astringent, and it has been em- ployed in intermittent fever; but it is now chiefly used to
MINERAL ACIDS. 123
allay sickness and vomiting in chronic nervous affections of the stomach, and also as an astringent in chronic diar- rhoea. Dose, gr. v to 3j, or even 5ss, in powder or pill. Externally, it is a good remedy in skin diseases in the form of ointment. The subcarbonate of bismuth — bis- muthi subcarbonas — is recommended as a substitute for the subnitrate. It is thought to be more readily tolerated by the stomach, and is more soluble in the gastric juice, but it is less astringent.
CADMII SULPHAS SULPHATE OF CADMIUM.
This salt is obtained by the reaction of sulphuric acid upon carbonate of cadmium. It occurs in transparent, co- lorless, prismatic crystals, of an astringent, austere taste, and very soluble in water In its effects on the system, it closely resembles sulphate of zinc, but it has been chiefly used in this country, as a collyrium (gr. j-ij to water fgj), and has been found very efficacious in specks and opaci- ties of the cornea.
ACIDA MINERALIA MINERAL ACIDS.
The diluted mineral acids are usually classed with tonics; but, although they exert a very considerable corroborant influence on the system, their action is in many respects peculiar and distinctive. In the concentrated form, they are corrosive. When properly diluted with water and swallowed in medicinal doses, they allay thirst, increase the appetite, and stimulate digestion. After absorption into the blood, they often produce a restorative effect in morbid conditions of the circulating fluid, and in their passage out by the secretions, act as astringents. They are employed — as tonics, usually in combination with the vegetable bitters, in intermittent, hectic, and typhoid fevers ; as astringents and styptics in hemorrhage from the
124 MATERIA MEDICA.
stomach and bowels, and in colliquative discharges; to allay febrile heat and cutaneous irritation ; as antalkalines ; and locally, as escharotics; and, in a very dilute solution, they are injected into the bladder as lithontriptics. In cases of poisoning from the mineral acids, the alkaline earths and fixed oils are the proper antidotes.
Acidum Sulphuricum (Sulphuric Acid), formerly called Oil of Vitriol, is obtained by burning sulphur, mixed with nitre, over a stratum of water contained in a chamber lined with sheet-lead. It is a dense, colorless, inodorous, corrosive liquid, which, in the concentrated form, is not employed internally, but is sometimes used externally, as a caustic. The proper antidote, in cases of poisoning from sulphuric acid, is magnesia, or solution of soap, and muci- laginous drinks should be afterwards freely administered.
Acidum Sulphuricum Dilutum (Diluted Sulphuric Acid), contains two troyounces of sulphuric acid in a pint of di- luted acid. It is given as a tonic, refrigerant, and astrin- gent, in the dose of from ten to thirty drops, three times a day, in water, and should be sucked through a quill to pre- vent injury to the teeth. This acid is a particularly valu- able remedy in typhus fevers, colliquative perspirations, and choleraic diarrhoea ; and it is the best corrective for phosphatic lithiasis. It is used externally as a gargle, and wash to ulcers.
Acidum Sulphuricum Aromaticum (Aromatic Sulphuric Acid), or Elixir of Vitriol, is made by digesting sulphuric acid and alcohol with ginger and cinnamon. It is a red- dish-brown liquid, with an aromatic odor and a pleasant acid taste ; and is an agreeable substitute for the diluted sulphuric acid, administered in the same doses.
Acidum Sulphurosum (Sulphurous Acid), is made by heating sulphuric acid with charcoal and distilled water. The sulphuric acid (S03) is deprived of an equivalent of oxygen by the charcoal, and becomes sulphurous acid (S02). It is a colorless liquid, having the smell of burn- ing sulphur, and a sulphurous somewhat astringent taste.
MINERAL ACIDS. 125
It has been only of late years employed in medicine, and is believed to have a special influence in destroying para- sitic life. Internally, it is very efficacious in sarcina ven- triculi, or yeast vomiting; close, f3j, largely diluted with water. Externally, it is used in skin diseases (particularly those of a parasitic nature, either animalcular or cryptoga- mous) — diluted with two or three measures of water or glycerine. The sulphite of soda — sodce sidphis — is used as a substitute for sulphurous acid, which is developed from the salt by any of the organic acids; dose, 5j, three times a day. The hyposulphite of soda is used for the same purposes ; dose, gr. x-xx, three times a day, and for external use, 5j, dissolved in water fsj.
Acidum ^itricum (Nitric Acid), (N06), is obtained by the action of sulphuric acid upon nitrate of potassa. When pure, it is colorless ; but as found in the shops, it is usually of a straw color, owing to the presence of nitrous acid. It is a corrosive, sour liquid, employed, in the concentrated form, as an escharotic to destroy warts and stimulate indo- lent sinuses, and diluted, as an astringent wash or gargle. Cases of poisoning from this acid are to be treated with magnesia or soap, and mucilaginous drinks. In poisoning from nitric acid, the fauces and mouth are covered with yellow eschars, while in the case of sulphuric acid, they are white or black. Internally, it is used in the form of
Acidum Xitricum Dilutum (Diluted Nitric Acid) which contains three troyounces of acid in a pint of diluted acid. This is given as a substitute for sulphuric acid, but is more apt to disagree with the stomach ; it is also employed as an alterative in syphilis. Combined wTith laudanum and cam- phor water, it is much used in the treatment of dysentery, under the name of Hope's Camphor Mixture. Dose, for in- ternal use, 20 to 40 drops, three times a day, reduced with water.
Acidum Muriaticum (Muriatic Acid), is an aqueous solu- tion of chlorohydric acid gas (II CI), and is obtained by the action of sulphuric acid on solution of chloride of sodium
126 MATERIA MEDICA.
or common salt. It is, when pure, a transparent, colorless liquid, but has often a yellow color, owing to the presence of iron or other contaminations. It has a corrosive taste, and a suffocating odor, and is an active poison, though less irritating than sulphuric and nitric acids. Magnesia or soap is the proper antidote. It is used, externally, as a caustic, and as an application in diphtheria, ulcerative and gangrenous stomatitis, &c. ; internally, in the form of—
Acidum Muriaticum Dilutum (Diluted Muriatic Arid), which contains four troyounces of acid in a pint of diluted acid. This is employed, in conjunction with the vegetable tonics, in typhus, malignant scarlatina, &c. ; also to coun- teract phosphatic deposits in the urine, to prevent the ge- neration of worms, in syphilis, in dysentery, and in some forms of dyspepsia. Dose, 20 to 60 drops, which may be given in infusion of roses.
Acidum Kitro-muriaticum (Nitro-muriatic Acid). This acid is made by mixing three parts of nitric acid with five parts of muriatic acid, and is a compound of chlorine and nitric oxide, mixed with free chlorine.- It has a golden- yellow color, and emits the smell of chlorine. Internally, it is employed in the same cases as nitric acid, and is thought to be particularly efficacious in diseases of the liver and syphilis. It should not be given with mercurials. Externally, it is used as a bath, either local or general, in oxaluria, syphilis, and chronic hepatitis, for which purpose one or two ounces of acid may be added to a gallon of wa- ter. Dose, from two to five drops, properly diluted and carefully increased.
ORDER V. — ASTRINGENTS.
These are medicines which produce contraction and cor- rugation of the tissues. Their constitutional effects are somewhat analogous to those of tonics; as, like them, they increase the tone and vigor of the body, and exercise a
TANNIC ACID. 127
control over various disorders of the nervous system. But they are chiefly employed to cure relaxation of the fibres and tissues, to subdue inflammation of superficial parts, and to arrest hemorrhage and excessive discharges from mucous membranes or other secreting surfaces. In check- ing morbid discharges from the bowels, astringents, while they diminish the secretions from the intestinal canal, do not, like opium, restrain the peristaltic movements; hence the necessity of combining them with opiates. They are divided into Vegetable and Mineral astringents. The former owe their astringency to the presence of a principle termed tannic acid, and differ from tonics in the absence of bit- terness. The mineral preparations usually classed among astringents, are those of alum and lead, and are distin- guished from the mineral astringent-tonics, by their more decided astringency and a sedative action on the nervous system.
VEGETABLE ASTRINGENTS. ACIDUM TANNICUM — TANNIC ACID.
This acid, which is the active principle of the vegetable astringents, is usually extracted from powdered galls by the action of ether. It is of a yellowish-white color, and a strongly astringent taste, is very soluble in water, and soluble, though less so, in alcohol and ether. It produces a white flocculent precipitate with solution of gelatine, a bluish-black precipitate with the salts of the sesquioxide of iron, and white precipitates with solutions of the vegetable alkalies ; and these substances are to be, therefore, consi- dered incompatible with all the vegetable astringents. There is a variety of tannic acid, obtained from catechu and some other substances, which strikes a greenish-black precipitate with the salts of iron, and is not convertible into gallic acid.
Effects and Uses. — Tannic acid is a powerful astringent,
128 MATERIA MEDICA.
and is applicable to all the cases in which astringents are useful. It is greatly resorted to, internally, in the treat- ment of diarrhoea, dysentery, cholera, hemorrhage, colli- quative sweats, &c. ; also as an enema in diarrhoea, dysen- tery, prolapsus ani, and fissure of the rectum ; and as a topical application, in inflammations and morbid discharges from mucous membranes, ulcers, &c. It is, perhaps, the best form in which the vegetable astringents can be em- ployed, owing to the certainty and minuteness of the dose in which it can be given. Dose, gr. j to gr. iij, or iv, in pill, occasionally repeated.
ACIDUM GALLICUM — GALLIC ACID.
This principle is found in many of the vegetable astrin- gents, but less uniformly than tannic acid, and is probably the result of changes which the latter has undergone. It is prepared by exposing a solution of galls to the air, when the tannic acid gradually absorbs oxygen and is converted into gallic acid. It occurs in small, silky, nearly colorless crystals, having a slight acid and astringent taste, and is soluble in boiling water, and slightly so in cold water.
Effects and Uses. — Gallic acid is a valuable astringent, which has of late been extensively employed in hemor- rhagic disorders, as uterine hemorrhage, hemoptysis, hematuria, bloody diarrhoea, &c. Both tannic and gallic acids have been found useful in albuminuria. Gallic acid has but feeble local astringent powers, and is probably con- verted into tannic acid in the blood; though in hemor- rhages, it appears to be more efficacious than the latter acid. It may be given in doses of gr. ij to gr. v, in pill, every two or three hours.
GALLA — NUTGALL.
Galls are morbid excrescences found upon Quercus infectoria, or the Gall Oak (Nat. Ord. Corylace^), a small
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tree or shrub of Asia Minor. The Gall-nuts are produced by the puncture of the buds by a fly (Cynips quercusfolii), to form a nidus