B M 330 na THB DMINISTI^TION OP Dl^GS William Sckleif * * UfO. BlOCMWflSTRY ©EEfc The Administration of Drugs. • • » . A Guide for the Pharmaceutical Laboratory. BY William Schleif, Ph. G., M. D., '1 Instructor in Pharmacy at the University of Pennsylvania. Philadelphia : Press of Avil Printing Company, i8q8. BIOLOGY LIBRARY G COPYRIGHT. 1898, WILLIAM SCHLEIF, M. D. ^ fN MEMOR/AM ^ THE ADMINISTRATION OF DRUGS. A GUIDE FOR THE PHARMACEUTICAL LABORATORY. The study of drugs in their natural, crude state, properly belongs to materia medica. This embraces every substance used in the treatment of disease, from the dried leaf or root to the synthetic compound of the chemist, treating of its origin, ap- pearance, physical and chemical characteristics, while the physi- ological effect in proper and improper dose, together with the real value of the remedy in disease, is referred to the domain of therapeutics. Medicinal agents differ as widely in their physical properties as they vary in their action on the economy, and hence it becomes of some importance to know how to administer each and every one for the production of the greatest effect. This is the mission of pharmacy. Briefly stated, it is the science which teaches us how to administer a remedy in a form consistent with the maximum amount of physiological action and the least amount of inconvenience to the patient. This form is dependent upon the character of the drug, selected so as to combine not only efficiency, but as far as possible permanency, palatability, appearance and concentra- tion; in other words, to join with the desired medicinal action pharmaceutical perfection. For purposes of administration, medicinal substances are conveniently divided into gases, liquids and solids. All of these belong to one of three classes: 1 . Those of inorganic or mineral origin. 2. Those of vegetahle or animal origin. 3. Orgaiiic drugs other than those of vegetahle or animal origin. Gases form a small and rather unimportant class. They are readily given by inhalation, enter the blood quickly by rea- son of the large area exposed in the capillaries of the lungs, and (3) act more promptly tlian do either liquids or solids. More raretv'. gases liave been given for medicinal effect by introduc- tion into, tbe rectum; Ov-casionaliy they are administered dis- sdlvqd iiV JJouicis, by way of the stomach. The number of gases used in medicine is so small that it can almost be disregarded, though a certain number of volatile liquids are really admin- istered by inhalation, and properly belong to this class. The amount of medicinal action obtained from any given drug depends upon the more or less complete manner in which it is absorbed, the rapidity with which this is effected, and to a less extent, upon the rate with which it is eliminated. Absorp- tion and elimination usually bear a definite ratio to each other, so that a substance which enters the circulation quickly will leave the system in a comparatively short space of time. Gases act most promptly, liquids rank next in efficiency, and solids are the slowest of all to produce their effect. The number of gases is limited, and a few very volatile liquids are so easily obtained in the state of vapor that they can be given by way of the lungs; but the largest number of both liquids and solids admit of but one route of introduction — that of the stomach. The full his- tory of any drug placed in the stomach depends on its solubility in the gastric or intestinal fluids, and the rate with which it is excreted by the emunctories, chiefly the kidneys, the lungs and the skin. Pharmacy obviously cannot influence elimination, but it can materially assist the rapidity of absorption, and increase the medicinal value of a drug by presenting it in as soluble a form as possible, ready to enter the circulation when it is placed within the body. This soluble form is most perfectly attained by dissolving the drug in a liquid, preferably one which will mix readily with the contents of the stomach or bowel, which is unirritating and possesses no well-pronounced chemi- cal action on the drug itself, nor marked medicinal effect on the system. Accordingly, solution is the best method of administer- ing a drug internally, the few instances of gases and volatile liquids given by inhalation excepted. But this is not the only way in which drugs can be prescribed. They may be given in suhstajice, in their natural, crude state, or in the form of powder, provided they possess the following characteristics: I. They should be tasteless, or at least have no disagreeable or nauseating effect on the palate. 2. They must remain unaffected in air, neither attracting nor losing moisture. 3. They should be non-volatile. 4. The dose should be small enough not to render the sub- stance objectionable by its bulk. This refers particularly to solids, though liquids should answer practically to the same requirements, except that the latter may be volatile and do not need to be permanent in air. The administration of a solid in the form of pov^der presents the advantage of increasing many times the surface exposed to the solvent action of the fluids in the body. Inorganic or mineral substances may be given in solution, or if they are insoluble, in some of the various ways to which powders are adapted. The administration of chemical sub- stances becomes a fairly easy task, as it is usually possible to prepare them in a pure state. They are seldom subject to mate- rial change, and their reactions are well known. The organic compounds other than those of animal or vegetable origin include the long list of synthetic carbon com- pounds, which have become of such great importance during the last few years. Many of these are very useful in medicine, and may be prescribed according to the same rules governing the administration of all other remedies in the form of solution or of powder, but exception must be taken in regard to their exhibition simultaneously with other medicinal substances. These synthetic compounds are characterized by very complex formulae; they are usually stable and permanent, but as their reactions are only partially known, it becomes a safe rule to prescribe them uncombined, except in the case of a few mixtures which experience has proven to be entirely harmless. Vegetable or animal drugs are of a nature requiring special preparation before they reach the patient. The animal drugs are few in number, while those derived from the vegetable king- dom comprise a very large list, such as roots, barks, leaves, fruits, flowers, and the like. Almost without exception, they must be given in doses so large and bulky that the patient would object to taking them in substance. All vegetable or animal drugs owe their properties to a class of substances collec- tively known as proximate principles. This is a rather indefinite term, merely indicating a compound of vegetable or animal origin, isolated by the chemist and made up, in a more or less complex ratio, of several or all of the following elements: Car- bon, Hydrogen, Oxygen, Nitrogen; occasionally Phosphorus, Sulphur and Iron. The principle may be the most powerful poison or a perfectly inert substance therapeutically; strych- nine and gum are both members of this class. Because of this variety of compounds contained in plants, it becomes necessary, first of all, to determine which one of them represents the thera- peutic action of a particular drug; secondly, to separate this constituent from those which have no action of their own, or which directly interfere by some opposing physiological efTect. In many cases the active principles are known, and in such instances are employed in a pure condition. Strychnine is the totanizing principle of nux vomica; it can be readily prepared and used in an isolated form in preference to the same ingredi- ent represented in tincture of nux vomica, where it is associated with another active substance — brucine. In other cases, one principle does not represent the full virtue of a drug: digitalis ow^es its cardiac and diuretic properties to no less than four principles, and we must direct our attention toward producing a preparation containing all of these. Digitalis may be given in the form of the powdered leaf, but it is more in accord with elegant pharmacy to separate the active, soluble constituents from the dried residue of plant tissues by extraction with a liquid; we therefore pre- fer the infusion or the tincture. Woody fibre is a natural constituent of all vegetable drugs, and as it has no medicinal value of its own, is directly objectionable because it increases the bulk of the dose. This can better be appreciated when it is remembered that two and one-half grains of quinine, or five grains of total alkaloids, represent about one hundred grains of cinchona bark, and that before the discovery of the active prin- ciples, it was necessary to administer a large bulk of the pow- dered bark to get the effect of a few grains of quinine. Woody fibre, or cellulose, is insoluble in ordinary menstrua, and remains behind in the process of extraction; but other sub- sta'>.ces. equally inert, are soluble in the liquids used in phar- macy, and therefore appear in pharmaceutical preparations together with the active constituents. Such soluble inert prin- ciples, universally present in all plants, are tannic acid, gum, starch, albumen, coloring matter and extractive. They neither add to, nor materially hinder, the physiological effect of the active principle, but are objectionable because they increase, distinctly, the liability of the preparation to spoil. This tendency to decomposition is common to all drugs of animal or vegetable origin, and stands in striking contrast to the stability usually shown by the inorganic substances. So marked is this property that the statement can safely be advanced that all vegetable or animal drugs deteriorate in time. This rule has a very few, nota- ble exceptions. Just as absorption is favored by solution, so decomposition is hastened when vegetable principles are in a fluid form, and it becomes still more true that all liquid pharma- ceutical preparations of vegetable or animal drugs tend to decom- pose; their medicinal value is inversely as their age. This rule has no exceptions. Summing up our knowledge of the properties possessed by vegetable drugs, it follows as a natural sequence that the most rational and scientific method to employ them in a concentrated, permanent and reliable form lies in the use of the active prin- ciple. Unfortunately, the active constituents of vegetable sub- stances are in many instances insufficiently understood, or reside in several principles, so that we are compelled to employ the preparations. Not only do the latter vary in quality according to age, but the large class of vegetable drugs whose chemical nature has thus far not been accurately determined necessarily present marked variations even at the time of collection, and we have no reliable way of judging their value except by actual therapeutic test of individual specimens. But the quality of such drugs can be estimated to a certain limited extent by their external appearance and physical properties, while the strength of the solid or liquid preparations can be regulated at least as far as their percentage composition is concerned. It is for this purpose that we have the pharmacopoeia. This is a book of reference for both physician and pharmacist, issued to regulate the quality of important medicinal substances and their most popular preparations; with us, it is published by a committee of pharmacists and physicians, the representatives of medical and pharmaceutical organizations throughout the country. Pharmacopoeias appear in all civilized countries, and are issued under government authority except in the United States, 8 lhong:li our own jr-overnmcnt has acce])tecl the United States pharniacopctia. Sonic of the states, among them New York, Ohio and Pennsylvania, have made its use compulsory by state legislation. The large number of new drugs continually appear- ing makes a revision necessary every ten years, many of the older remedies passing out of use from time to time. The policy of our pharmacopoeia is distinctly against patented or proprie- tary compounds of any kind, irrespective of their value in medi- cme, and therefore drugs like antipyrin, phenacetin and sulfonal are not officially recognized. A substance is said to be official when it is admitted into the pharmacopoeia; officinal, when it is used to some extent, but not sufficiently popular to merit such a distinction. Drugs appear in the pharmacopoeia by their official name, English name, synonym, followed by the botanical name, if the substance be of vegetable origin, and by the symbolic formula if the drug be a chemical. The official name invariably appears in Latin, not only because this is, in general, the unchanging language of science, but also because it has long been that of medical nomen- clature. The official title is produced in as brief a manner as possible, unless some very good reason required a deviation. Digitalis means "the leaves of Digitalis purpurea, collected from plants of the second year's growth." It would be unnecessary to say Folia Digitalis, or Digitalis folia, as no other part of the same plant is official. Such a course becomes imperative when a plant con- tributes two parts, as Belladonna, where the two terms, ''Bella- donn?e folia" and. "Belladonnas radix," have been introduced. The singular number is always preferred, according to ancient medical custom, though the official definition may indicate a plural ; as, Coca, the leaves of Erythroxylon Coca. Official names may be divided into three classes: Those (i) of regetahh drugs, (2) of chemicals and (3) of preparations. A vegetable drug is specified usually by selecting the genus or generic name of the plant: Digitalis, from Digitalis purpurea; Aconitum, from /Vconitum napellus. More rarely, when com- mon use had sanctioned a certain name, this was selected even though it defined the species: Belladonnse folia. Belladonnas radix, both from Atropa Belladonna; Nux Vomica, the seed of Strychnos Nux Vomica. In a few cases the entire botanical name was retained: Rhus glabra, "the fruit of Rhus glabra," and Rhamnus Purshiana, "the bark of Rhamnus Purshiana;" the first to distinguish the drug from Rhus Toxicodendron, the sec- ond to differentiate between Rhamnus Purshiana and Rhamnus Frangula, both official (the latter as Frangula). In the naming of chemicals, the basylous, metallic or electro-positive element is placed first: Potassii bromidum, Sodii chloridum, for Potassium bromide and Sodium chloride. An attempt is made to indicate the chemical composition, unless this interferes with brevity, from complexity of the molecule. Preparations are named by placing first the class and next the drug, as Tinctura Zingiberis and Extractum Ergotae. Those preparations containing two or more ingredients are termed compound, and the adjective coinpositus (a, um) follows the name of the class and most important medicinal constituent. This is done when the number of ingredients is so large that the official title would be rendered inconveniently long by mention- ing all of them. Compound Tincture of Benzoin contains ben- zoin, purified aloes, storax and balsam of tolu, in alcohol; benzoin forms the chief ingredient, and therefore the prepara- tion is officially known as Tinctura Benzoini Composita. If the compound preparation contain but two active sub- stances, both enter into the official name, as Pulvis Ipecacuanhae et Opii, Dover's powder, or the powder of ipecac and opium. This contains also eighty per cent of sugar of milk, beside ten per cent, each of powdered opium and ipecac; as the sugar forms merely the diluent, it is omitted in the official name. Following the Latin official title is the English official name. This has been selected with equal care. With plants it is usually the Anglicized Latin name; in the case of chemical substances and of preparations, a translation of the latter. Cin- chona, potassium cyanide and compound tincture of gentian will serve as examples. Special efforts are being made to bring this English official title into exclusive use, in preference to the Synonym, or name by which a drug is known to the general public. This fails utterly in being either brief, descriptive, or scientific, and is not infrequently applied to several drugs with widely different medical properties. Snake root may mean cimicifuga, asarum canadense, senega, or serpentaria; there is lO nothing to recommend it but a fancied resemblance common to many rliizomes and rootlets. The same applies to preparations. Black drop properly means the vinegar of opium, and black draught the compound infusion of senna. Both terms have been interchanged, with fatal results, a mistake which could never have happened with the proper use of the English official titles. Symbolic formulae express in the briefest and most definite manner the actual composition of a compound, and follow the official name in the case of chemicals. The molecular weight is also appended. An official definition becomes necessary in the case of vegetable drugs, to identify the part of the plant and the botani- cal source. Hyoscyamus is defined as "the leaves and fiowering tops of Hyoscyamus niger Linne (nat. ord. Solanacese), collected from plants of the second year's growth." The botanical name, Hyoscyamus niger (genus and species), is followed by the name of the botanist and the natural order. The official description consists of a short statement of the physical properties of the drug; brief mention of possible adulterations and tests for iden- tity is made. Certain rules have been adopted in regard to the orthog- raphy of botanical names. The name of the species begins witli a small letter, except in the following cases: First, when the name formerly denoted a genius; second, when it is derived from the name of a person ; and third, when it is an indeclinable noun, or a combination of a noun or an adjective. <2) r. o ■\yv\.\. - ^ (J TABLES OF WEIGHTS AND MEASURES. APOTHECARIES' OR TROY WEIGHT. Pound. Troyounces. Drachms. Scruples. Troy Grains. ^1b j/'y = ^J2^ = 96 = 288 = 5760 n^j = E = 24 = 480 3^ = gr, 20 AVOIRDUPOIS WEIC^T. Pound. Ounces. Drachms. Troy Grains. R) I = 16 = 256 =^ 7000 OZ. I = 16 = 437.5 dr. I = gr. 27.343 The agothecaik:sI or troy_weight_is generally used in the United States in prescription practice. The pound (lb., Hbra) contains 5760 grains ; the ounce (S, uncia) 480 grains ; the drachm (5, drachma) 60 grains, and the scruple (9, scrupulus) 20 grains (gr., granum plur. grana). The avoirdupois pound is in common use in commercial transac- tions. This pound is larger than the apothecaries' pound, containing 7000 grains, but is subdivided into 16 ounces instead of 12, as in the troy system, each ounce containing 437.5 grains, instead of 480. The pound is abbreviated lb., the ounce oz. (or av. oz.), the drachm dr., and the grain gr. The avoirdupois drachm is rarely employed. The sign lb. is an abbreviation for libra and unfortunately stands for both the troy and the avoirdupois pound. The troy pound, however, is rarely employed in medicine, and in ordinaiy commer- cial use the sign lb. specifies an avoirdupois pound of 7000 grains. APOTHECARIES' OR WINE MEASURE. Gallon. Pints. Fluidounces. ] Cong. I = 8 = 128 = O I = 16 = The gallon (Cong., congius) contains 23 i cubic inches. It is subdivided into 8 pints (or 4 quarts). Each pint (O, octarius) (11) idrachms. Minims. 1024 = 61440 128 -= 7680 8 = 480 foi = "l 60 contains i6 fluidounces (f3, fluiduncia) ; the fluidounce contains 8 fluidrachms (f5, fluidrachma), and the latter is again subdivided into 60 minims ("i, minimum). IMPERIAL MEASURE (BRITISH PHARMACOrOEIA). Gallon. Pints. Fluidounces. Hluidrachms. Minims. 1 = 8 = 160 = 1280 = 76,800 I = 20 = 160 r= 9,600 I = 8 =: ^80 I — 6o The pint of the apothecaries' or wine measure contains 7680 minims, each fluidounce containing 480 minims. The pint of dis- tilled water, at 15.6° C. (60° F.), weighs 7291.2 grains, the fluid- ounce 455-7 grains. The imperial fluidounce of distilled water, at the same temperature, weighs as much as one avoirdupois ounce, or 437.5 grains. The apothecaries' and avoirdupois systems of weights, and the apothecaries' system of measure, are all used in this country ; therefore three ounces of different values must be considered — the apothecaries ' ounce of 480 grains, the avoirdupois ounce of 437.5 grains, and the fluidounce (of water) of 455.7 grains. Imperial fluidounces and gallons are not employed in the United States. The apothecaries' fluidounce measures 480 minims, but a fluidounce of water weighs 455.7 grains at 15.6° C. (60° F.); a minim is therefore a little lesstTian a grain (of water), though the weight of the minim is, of course, directly dependent upon the specific gravity of the liquid. Note. — For the correct estimation of percentage solutions, it is necessary to make use of the cipher 455.7 instead of 480, for the fluidounce, and of 7291.2 for the pintinstea"d of 7680, because a true percentage expresses ther number of grams of the substance in 100 grai7is of water, and not the amount contained in 100 ininivis, the minim not equaling the grain. A 4 per cent solution of cocaine therefore represents 4 grains of cocaine hydrochlorate in 100 grains of water, or 18.2 grains in the fluidounce (4 per cent, of 455.7). A I : 1000 bichloride of mercury solution will contain 7.2 grains of the corrosive chloride in the pint of water (7291.2 h- iooo). A ^ grain solution of cocaine represents 4 grains of cocaine hydro- chlorate in the fluidounce of water (4 in 455.7) and therefore con- tains less than i per cent (.87 per cent). n^fi.ifi^. u^^ /^^^ f\1 r 13 In administering medicine to patients, it has always been customary to make use of certain domestic measures, and this is done at the present day in the great majority of instances. The following is a list of domestic measures and their approximate equivalents : Teacupful = f Siv (Poculum, vel pocillum). Wineglassful = f ^ij (Cyathus vinarius). yr; Tablespoonful = f 5ss (Cochlear amplum vel magnum). Dessertspoonful = f 5ij (Cochlear modicum vel medium). Teaspoonful = f 3j (Cochlear parvum vel cochlearium). Drop varies from j^ to i ^ minim (Gutta). Modern teacups, tablespoons, dessertspoons and teaspoons average about one-third more than these equivalents, hence there is a great advantage in using the accurately graduated medicine glasses furnished by many pharmacists. As the directions to the patient are always written in English, in this country, the Latin expressions denoting teaspoons, etc., are very rarely made use of The drop (gutta) is a variable quantity, its size depending on the density and Winnsisten re of the liquid and the% urface it is dropped from. The drop is frequently regarded as the equivalent of a min- im and this is approximately correct in the case of water, but does not answer for any other liquids. As a rule, the size of a drop is larger when the preparation is aqueous, than when it is alcoholic, and it is larger in viscid or sticky liquids, than in those which are less dense and more mobile. Many other factors influence the volume of a drop — so the ordinary medicine dropper, when held in a vertical position, will yield from three to four drops for every single one obtained by dropping the same liquid from the horizontal position. The size and shape of the lip of the bottle, the quantity of the liquid contained, and the temperature of the latter all exert their influence. At present, there seems to be no remedy for this evil and the only reliable plan to prescribe liquids in minute dose is to order them in minims and add a sufficient quantity of some other liquid to make the individual dose a teaspoonful or other easily measured quantity. THE METRIC SYSTEM. The metric or decimal system was introduced to supplant the various systems in common use and furnish, at the same time, the convenient form of calculation found in decimal arithmetic. All the older systems were referable to the grain as the unit — this was originally a grain of wheat, taken from the middle of the ear, an absolutely arbitrary standard for comparison. The metric system has for its standard, the meter, or the ^juiKTiTUiro' ^^ P^''^ ^^ ^^^ earth's circumference at the poles (or the TomJFinnF ^^ P^*"^ ^^ the distance from the equator to the pole). This is the unit of the measure ot length. The measure of capacity is derived from the measure ot length by cubing the tenth part of a meter, producing the liter. The unit of weight is obtained by cubing the one-hundredth part of a meter, filling it with water and weighing it at the temperature of its greatest density, 4°C.; it is called \.\\q gramme. The multiples and subdivisions of the metric system are indi- cated by Greek and Latin prefixes ; the multiples are Deca, Hecto, Kilo and Myria, each increasing in the ratio of lo, so that a Kilometer represents looo meters. The subdivisions are indicated by the Latin prefixes, deci, centi and milli, each decreasing in the ratio of 10; a millimeter is the ytot th part of a meter. Myriameter (Mm.) 10,000 Myrialiter (Ml.) 10,000 Myriagramme (Mg.) Kilometer (Km.) 1000 Kiloliter (Kl.) 1000 Kilogramme (Kg.) Hectometer (Hm.) 100 Hectoliter (HI.) 100 Hectogramme (Hg.) Decameter (Dm.) 10 Decaliter (Dl.) 10 Decagramme (Dg.) Meter (m.) i Liter (1) i Gramme (Gm. ) Decimeter (dm.) -^ Deciliter (dl.) xV Decigramme (dg.) Centimeter (cm.) -j^^ Centiliter (cl.) x^tt Centigramme (eg.) Millimeter (mm.) iTny^ Milliliter (ml.) y^^ Milligramme (mg.) The denominations most commonly used are the millimeter (mm), the centimeter (cm.) as the measures of length. A mikromilli- meter, or the yoVit^^ P*^^^ ^^ ^ millimeter, is occasionally employed in microscopic work. The liter and milliliter, commonly called cubic centimeter, are found to be convenient measures of capacity, and the milligramme, centigramme, gramme and kilogramme are regarded sufficient as measures of weight. (14) 15 The equivalents of the decimal system, in inches, pints and grains, are as follows : Meter (m.) 39-37 +inches. Liter \l.) 2.113-l-pints, or 33.81-t-fluidouuces (a little more than a quart). Gramme (Gm.) 15.432-l-graius. Orthography. — The pharmacopoeia has adopted the terms meter, liter and gramme, and not, as recommended by the Ameri- can Metric Bureau, meter, liter and gram; the original French orthography reads metre, litre and gramme. The word gramme was retained in preference to gram, because the latter can be so easily mistaken for grain, and the abbreviation Gm. has been selected in preference to gm,, because it is more readily distin- guished from gr. The United States pharmacopoeia has adopted the metric sys- tem for all of its formulae, indicating liquids by cubic centimeters (C.c.) and solids by grammes (Gm.). PHARMACEUTICAL MENSTRUA. A menstruum is any liquid employed in extracting the soluble constituents of a drug and necessarily enters into the composition of every liquid preparation. An analysis of the pharmacopoeia shows that 8i per cent, of all preparations are Hquids, illustrating the importance of presenting medicinal substances in a soluble form. Arranged according to their menstrua, the 3 1 5 liquid prepa- rations officially recognized appear as follows: Classes of official preparations made with each /' menstruum. Alcohol 6 Water 9 Ether i Glycerin i Alcohol and Ether . i Oil I Oleic Acid i Diluted Acetic Acid . i Total number of Approximate preparations percentage of made with each the entire menstruum. number. 190 60. 100 31-7 6 1-9 6 1-9 4 1.2 4 1.2 3 .9 2 .6 21 315 Of the 128 solid preparations, 38 require the use of a men- struum, 27 of these being made with alcohol and the remaining 1 1 with water. The above table expresses the relative value of the different liquids used in extracting medicinal substances, whenever any degree of permanency in the finished product is desired. This is required of the great majority of ofificial preparations, but in ordi- nary extemporaneous* pharmacy water forms the greater bulk, at least, of most liquid prescriptions ; these are usually to be taken by the patient in a period covering from a few days to a week or so. For official pharmacy, the typical menstruum is a liquid which removes all the activity of a vegetable substance and leaves all the inert constituents ; has no therapeutic action itself, yields perma- nent preparations and such that are perfect in appearance, are palata- ble and sufficiently concentrated not to inconvenience the patient •Compounded at the order of the physician (,tx tempore). (16) U^* X-'U-tHtc^'^^—^ CWl^^-^^--^^^^ 17 by a bulky dose. None of the liquids mentioned possess all of these advantages, but alcohol more nearly approaches the standard than any other menstruum known — it is a good solvent for active principles, almost without exception, and a relatively poor one for those without value ; it readily yields preparations clear and brilliant in appearance, rendered permanent by its pronounced antiseptic properties and palatable because of their concentration. The only serious objection to a more extended use of alcohol is its own therapeutic effect, which, in the case of certain dilute tinctures (like the compound tincture of gentian or the tincture of valerian), may not only completely overshadow the medicinal action of the remedy, but lead to the production of the alcoholic habit. This is offset, to a great extent, by the ready solubility of most active principles in alcohol, so that preparations rich in the drug and relatively weak in alcohol are easily obtained ; in all cases diluted alcohol is intro- duced where it does not affect the therapeutic value of an official preparation, and the proportion of alcohol reduced to the mini- mum amount consistent with pharmaceutical perfection. Obvi- ously, a tablespoonful of a tincture made with diluted alcohol (com- posed of equal volumes of alcohol and water) produces a result equivalent to that of a half ounce of whiskey, plus the peculiar properties possessed by the drug dissolved. In all but a few of the alcohoHc liquids of the pharmacopoeia, the dose ranges from a drop to a teaspoonful, and the physiological action of the spirit becomes a secondary consideration because of the small percentage contained in each dose. Alcohol forms the menstruum of the tinctures, fluid extracts and spirits, and is contained in smaller amount in wines, elixirs, and some liniments. Water has none of the advantages of alcohol and but one prop- erty to recommend its general use in official pharmacy, /. e., that of having no pronounced action of its own when given in the doses of pharmacopoeial preparations. Water has a wide range of solvency, but this is rather against than for its use, as it takes up many principles medicinally inactive — starch, albumen, coloring matter, extractive, gum — which do harm because of their own insta- bility in solution. Pharmaceutically, its preparations lack perfect transparency, decompose easily and must be given in large doses, which are therapeutically more uncertain than those containing alcohol as a menstruum. Waters, solutions, infusions and decoctions i8 arc made with a menstruum solely of water, while syrups, honeys, mucilages, emulsions and mixtures are largely aqueous preparations. Ether is used in the manufacture of oleo-resins. Aspidium, capsicum, cubeb, lupulin, pepper and ginger owe their activity to both oil and resin, and ether is a good solvent for both of these classes of principles — the drugs are extracted with ether and the latter recovered by distillation, leaving the active principles in the form o^ the most concentrated preparations of these drugs which we possess. Ether dissolves all oils, whether they are volatile or fixed, all fats, but not all resins. Mixed in the proportion of three volumes to one volume of alcohol, ether forms the solvent for pyroxylin or gun-cotton in the official collodions. Glycerin enters into the composition of the glycerites. It is a valuable solvent for many medicinal principles, but increases the solution of inactive substances, such as gum, albumen and color- ing matter, to such an extent that its use as an addition to alcoholic or aqueous menstrua is limited. Glycerin has well-marked hygro- scopic properties, so that it has been added to extracts and pill- masses to prevent them from drying. Oil forms the basis of four of the nine official liniments. Its application in pharmacy is restricted entirely to preparations for external use.* Oleic Acid differs from oils by being entirely soluble in alcohol. It is more readily taken up by the skin than most fatty or oily sub- stances, and is the basis of the oleates, three of which are official. Diluted Acetic Acid is the menstruum employed in the manu- facture of the two official vinegars. This acid has some antiseptic power even in diluted form, but its preparations are not as perma- nent as those made with alcohol, and have been almost completely replaced by them. Reviewing the above menstrua, it will be seen that alcohol is preferred whenever permanency is required; that water is selected as the basis of most extemporaneous prescriptions because it offers no disturbing medicinal qualities, and because permanency is not so necessary as in the case of pharmacopoeial preparations. Comparing the physical properties of the menstrua regarding volatility, we find that ether boils at 37° C., alcohol at 78° C. and water at 100° C., so that preparations requiring the use of heat for • With the single exception of Oleum Phosphoratum, or phosphorated oil. (3) 19 purposes of evaporation or distillation will be more injured by the use of water than by the use of alcohol, because the temperature is necessarily higher. Ether is excluded from more general use on account of its marked medicinal properties, and permissible only as a solvent to be completely removed by evaporation (as in the case of oleo-resins). The other menstrua are so rarely used as to scarcely demand mention. BIOCHEMISTRY DEPT. PHARMACEUTICAL PROCESSES. In order to prepare drugs in a form adapted for administration, certain processes are made use of in pharmacy. The following is a list of those which are most important: Desiccation, Evaporation, Maceration, Exsiccation, Distillation, Digestion, Granulation, Precipitation, Percolation, Sublimation, Solution, Trituration. Filtration, Desiccation is the process of drying medicinal substances. Vegetable drugs contain large amounts of moisture at the time of collection, and drying becomes necessary to render them permanent, and to make pulverization possible. A great reduction in bulk takes place at the same time. Occasionally, even inorganic sub- stances are dried to reduce their bulk ; the process is then called exsiccation (alumen exsiccatum, ferri sulphas exsiccatus). Granulation is the process of obtaining 2. chemical in the form of a coarse powder. This is usually done by evaporating a solu- tion to dryness, with constant stirring. The object of granulation is to furnish crystalline substances in a form facilitating solution. Sublimation is the process by which a volatile, solid substance is converted into the form of vapor and the latter condensed to a fine powder. Evaporation is the volatilization of liquids. Distillation is the process of converting a volatile liquid into the form of vapor and of condensing the latter to the liquid state. The process is carried out in an apparatus called a still, which is supplied with a worm or condenser. Precipitation is the process of obtaining solids in the form of a fine powder by throwing them out of solution in solid form. The official calcii carbonas praecipitatus may be taken as an example of this process. In its preparation solutions of calcium chloride and of sodium carbonate are mixed in equivalent quan- tities ; mutual decomposition takes place, calcium carbonate being precipitated, while sodium chloride remains in solution. The (20) 1 (X "^j^^^('\jKyi.^<^M^ uOt^/XXjic^ i^yCy^L^^-^^ 21 precipitate is collected on a filter and washed until free from sodium chloride. The dried precipitate forms the official pre- cipitated calcium carbonate ; like other powders obtained by this method, it is in finer form that it is possible to obtain it by pulveri- zation. All of the processes mentioned thus far are seldom employed by the retail pharmacist, while he frequently makes use of the following : Solution. — In pharmacy, this term is used when a fluid or solid substance is mixed with a Hquid, without the loss of the transparency of the latter. It is the process most frequently em- ployed in extemporaneous pharmacy ; in official pharmacy, it is used in the preparation of many of the solutions, spirits, waters and syrups. Filtration is the process of separating liquids from suspended insoluble particles by passing them through a porous medium. In pharmacy, the latter is unsized paper and the object sought is to obtain the liquid in a perfectly transparent condition. Maceration is the process of extracting medicinal substances by allowing them to remain in contact with a liquid for a specified length of time. The preparation of a tincture by this process may be described as follows : The comminuted drug is placed in a bottle, the required amount of menstruum is poured over it and the whole is allowed to stand for a period of from one to two weeks, the bottle being frequently shaken ; at the end of this time the mixture is filtered. The disadvantage of this method lies in its slowness, its advantage in that of thorough exhaustion; no special skill is required on the part of the operator. Digestion is maceration at a moderate temperature. It is rarely employed. Percolation is the process of exhausting drugs by displa ce-^ 'ment The powdered substance is moistened with the menstruum and allowed to swell, to satisfy its capillarity; it is then packed in ( a receptacle, called a percolator, and exhausted by the gradual de- scent of the liquid through the powder. For the successful execu- tion of this process it is necessary that the drug be of uniform V fineness, the degree of comminution depending on the physical character of the drug, the density of the menstruum and the quan- 22 tity of drug employed. These factors will also influence the amount of force used in packing the powder after the latter has been moistened with the menstruum. A certain degree of swelling always takes place as the result of this moistening, because the drug again takes up some of the moisture it has lost in the drying previous to pulverization. A pledget of absorbent cotton is now inserted into the neck of the percolator and the powder is packed, in successive layers, in a uniform manner. A quantity of the men- struum is then poured over the powder, care being taken not to stir up the surface ; this is best prevented by covering the upper layer of the drug with a sheet of filtering paper. When the liquid begins to drop from the lower orifice, the process may be interrupted, sufficient liquid added to cover the surface, and the whole left to macerate for a specified length of time. At the end of this period, the liquid is allowed to flow, drop by drop, from the lower orifice, and sufficient liquid is added, from time to time, to keep the powder continually covered with menstruum, until the process is completed. If the first portions are not clear, they are returned until the liquid issues in a transparent condition, before any more menstruum is added. Theoretically, percolation is a perfect process ; it can be made practically so by careful observance of all the precautions mentioned. The liquid becomes specifically heavier, through the solution of solu- ble principles, as it passes through the powder and issues from the percolator in a saturated condition. Each successive portion becomes lighter in color and contains less of the active constitu- ents of the drug as determined by taste, odor, color and specific gravity; when the process is finished, nothing but menstruum should be left in the drug, together with the insoluble principles of the latter. Obviously, the full extraction of the drug depends largely upon the skill of the operator, and becomes relatively an easier task as the proportion of menstruum to drug increases ; thus a tincture is more easily prepared so as to contain all the soluble constituents of a medicinal substance than the more concentrated fluid extract. For this reason, the pharmacopoeia directs macera- tion to precede percolation in many instances and in the manufacture of fluid extracts, orders percolation to be continued until the drug is exhausted, without regard to the total quantity of menstruum required. '^ ^ ^-c'v o ^ ^^^^-^ 23 Maceration is a slow and tedious process as compared to per- colation, but has the advantage of always yielding a uniform pro- duct, even in inexperienced hands. The drug is simply placed in a convenient receptacle, the liquid added and the mixture shaken occasionally. The portions of the liquid in contact with the drug gradually become saturated with its soluble constituents, but become specifically heavier and no new portions of menstruum act on the substance, unless the whole is occasionally mixed by shak- ing ; at the end of the specified period of time, the liquid requires filtration. Percolation yields at once a clear, finished product, with a great saving of time. It is therefore preferred in the pharmaco- poeia wherever the physical character of the drug permits this form of extraction ; in many cases maceration is combined with it. The latter process is selected when the medicinal substance is very soluble in the menstruum, or where it becomes too pasty or other- wise unsuitable to allow the passage of a solvent. Trituration is the process of reducing solids to a fine powder by means of a mortar and pestle. VEGETABLE ACTIVE PRINCIPLES. Vegetable drugs owe their activity to a class of substances usually known as active principles; these differ from proximate principles merely by the fact that the latter is a more general term and embraces also vegetable principles which are physiologically inert. In all cases, if the action of a drug is found to reside in one principle, it is best to separate this and employ it in a concentrated and pure form ; as it is impossible in many instances to trace the therapeutic value of a vegetable substance to a single compound, the liquid preparations are made use of instead. The intelligent exhibition of vegetable drugs in the form of active principles or of preparations requires a knowledge of the physical properties of such substances and especially of their behavior toward solvents. The most important classes of active principles and their best solvents may be tabulated as follows : Active Principle. Solvent. Volatile Oils Alcohol, very slightly soluble in water. Resins Alcohol, insoluble in water. Balsams Alcohol, insoluble in water. Oleo-resins Ether. Alkaloids Alcohol or water (or diluted alcohol) Glucosides Bitter Principles " " " Neutral Principles Fixed Oils Ether, chloroform, benzin ; are insolu- ble in alcohol. Volatile (or Essential) Oils are vegetable principles which can be distilled unchanged in the presence of water or steam. They form the odorous principles of many plants, so that in France they are known by the name of essences; they are readily dissolved by alcohol with the production oi spirits -dLXidi are only slightly soluble in water; the latter is distinctly flavored by the addition, the preparation then being known as a medicated water. Volatile oils, in contra- distinc- tion to fixed oils, do not leave a permanent greasy stain on paper ; medicinally, they are active irritants in concentrated form and must (24) 25 be given in emulsion or capsule. Chemically, they are compounds of hydrogen and carbon (hydro-carbons) ; a more limited number contain oxygen in addition and a few contain sulphur. Resins are complex organic compounds, the type of which is colophony or ordinary rosin. They are brittle solids, fusible at higher temperatures and then readily miscible with oils and fats. Resins are soluble in alcohol and insoluble in water, so that they precipitate when the latter is added to an alcoholic solution.* Alkalies transform them into soaps. A few are soluble in ether. Rcsinoids were formerly extensively prescribed by the eclectic school of practitioners — they were prepared by precipitating tinc- tures with water and were active in those cases in which the active principle resided in a resin and inert in the great majority ot instances, as relatively few drugs owe their virtues to this class of substances. Resins possess some preservative action. Balsams are resinous substances, containing one or more of the aromatic acids (benzoic or cinnamic acid). They are soluble in alcohol and have some antiseptic properties. Oleo-Resins are mixtures of volatile oils and resins and par- take of the characteristics of each class. The official oleo-resins are made by exhausting the drug with ether and distilling off the latter ; they represent the activity of the respective drugs in very concentrated form and are given in small dose. Glucosides are peculiar substances which split up under the action of mineral acids, alkalies or vegetable ferments, so as to form glucose and a new principle ; this second principle is a different compound from the original glucoside. Few drugs owe their activity to this class of compounds, though occasionally they are very energetic remedies. Digitalis contains a number of glucosides, and strophanthus yields the powerful glucoside strophanthin. Santo- nin and salicin are official glucosides. Alcohol and water form equally efficient menstrua for the solution of these principles, and diluted alcohol is usually adopted for their extraction. Bitter Principles are characterized by a bitter taste and tonic properties ; they readily dissolve in alcohol, water or diluted alcohol. Neutral Principles are devoid of any decided chemical properties and, as a rule, have no marked toxic action. Picrotoxin, * As in the preparation of the official resin of podophyllum and resin of scammony. 26 the neutral principle of cocculus indicus (or fish berries), is an excep- tion and forms a violent poison. The neutral principles are soluble in alcohol, water or diluted alcohol. Fixed Oils are liquids of vegetable or animal origin which are insoluble in water and alcohol,* but soluble in ether, chloroform, ben- zin, benzol and carbon disulphide. Chemically, they are mainly com- posed of olcin, a compound of oleic acid and glycerin, and are decomposed by alkalies with the formation oi soaps and free glycerin ; they leave a permanent greasy stain on paper. As a rule, fixed oils do not represent the activity of drugs and occasionally interfere with the extraction of the soluble constituents of oily seeds; exception- ally, they are very active. Such examples are croton oil, castor oil and cod-liver oil, which have marked medicinal virtues. Fixed oils are usually administered without any addition — when their oily taste is too nauseating, they are combined with acacia and water in the form of emulsion, or may be enclosed in capsules. Some of them are absorbed at least in part by the skin. Alkaloids are by far the most important class of active princi- ciples found in plants. With few exceptions, they are active medicinal agents, in over-dose violent poisons, and in almost all instances are the active principles of plants which contain them. Chemically, they are the organic counterparts of the alkalies of inor- ganic chemistry — like these, they turn red litmus paper blue and combine with acids to form salts. With the exception of a few liquid and volatile alkaloids — notably coniine, sparteine, lobeline and nicotine — which contain no oxygen, they are solid, non-volatile and are made up of carbon, hydrogen, nitrogen and oxygen ; the latter are usually white and crystalline or amorphous. All alka- loids are soluble in alcohol, usually in chloroform, benzol, benzin and occasionally in ether ; they are commonly almost insoluble in water. Their salts, on the other hand, show directly opposite properties in their relation to solvents — they are readily soluble in water, and dissolved with greater difficulty by alcohol, chloroform, benzin, benzol and ether. It is for this reason that the salts are in- variably preferred to the alkaloids themselves when they are given internally ; so common has this practice become that when we speak of quinine and morphine, we mean the sulphate of quinine and the sulphate of morphine. To illustrate the relative solubility * Castor Oil is the only fixed oil freely soluble in alcohol. (4) 27 of the alkaloids and their salts, quinine and morphine may betaken as examples, comparing them with their sulphates : Water. Alcohol. Quinine 1670 parts 6 parts Quinine Sulphate 740 " 65 " Quinine Bisulphate 10 " 32 " Morphine 4350 parts 300 parts Morphine Sulphate 21 " 702 " It will be seen that the addition of sulphuric acid makes qui- nine sulphate still more soluble ; this is true of any acid, so that a few drops of hydrochloric acid added to a mixture containing quinine, will increase the solubility of the latter. It is equally true that an addition of an alkali or an alkaline salt to a solution of an alkaloidal salt in water causes a precipitation of the alkaloid, because the latter is again made insoluble when the acid is removed from it by chemical decomposition. Ammonia will precipitate quinine from a solution of the bisulphate in water, because the alkaloids are feeble bases and ammonia, as the stronger base, unites with the sulphuric acid to form ammonium sulphate ; precipitation occurs because the liberated quinine is almost insoluble in water. It is not necessary that the alkali shall be as pronounced in basic properties as ammonia, but many inorganic salts, though chemically neutral, are really alkaline to test-paper and will precipitate alkaloids from the solutions of their salts. Borax, the sodium borate, and sodium bicarbonate are really acid salts according to their formulae, but alkaline to litmus ; they decompose solutions of alkaloidal salts, with the deposit of the alkaloid. The following substances, in addition, will precipitate alkaloids from their solutions : Tannic acid, potassio-mercuric iodide (formed when potassium iodide and mercuric chloride are brought together in solution), auric chloride, phospho-molybdic acid and picric acid. All of these, except tannic acid, are rare chemicals and are interest- ing chiefly in establishing the identity of an alkaloid. Tannic acid, however, is a constituent found in nearly all plants (though to a variable degree) and appears in all infusions, decoctions, tinctures, extracts and fluid extracts. If such a preparation is mixed with a solution of an alkaloid, an insoluble tannate of the latter is formed ; so constant is this reaction that tannic acid constitutes a valuable antidote in the treatment of poisoning by toxic drugs containing 28 alkaloids, although the resulting tannate is slowly soluble in the gas- tric contents and must be removed by emetics or the stomach-tube. The iodides and bromides of alkaloids are soluble with great difficulty and are precipitated when iodides and bromides are prescribed with alkaloids in solution. The great danger in dis- pensing such a prescription lies in the fact that precipitation may not be immediate and the alkaloid be present in a quantity so small that it escapes detection unless the preparation is carefully exam- ined — the patient may pour off, carefully, all of the supernatant liquid and take all of the alkaloid intended for the whole prescription, in a single dose. Such occurrences have been followed by fatal effects in several instances. Alkaloids may be administered by one of the following methods : 1. By solution. 2. In the form of mixture. 3. In powder form, 4. In pill form. 5. Hypodermatically, As quinine (in the form of quinine sulphate) is the alkaloid most frequently employed, it may be taken as an example, although it differs from most other members of this group by a relatively large dose. Quinine may be given by any of the methods stated, I, In solution. — There is no doubt that this is the most efficient method of administering an alkaloid, if it is to be given by way of the stomach. It is open to the objection that alkaloids usually possess a bitter or acrid taste, which in many cases is so pro- nounced that no vehicle will completely mask it. The following prescription will illustrate the administration of quinine in solution : B Quininae Sulphatis 5ij Acidi Sulphurici Diluti f 5iij Syrupi Eriodictyi f^iij Solve. Signa: A teaspoonful four times a day. The syrup of eriodictyon (or yerba santa) or the syrup of orange (made from the tincture of the frcsJi peel) are excellent 29 vehicles to disguise the bitter taste. One and one-half minim of diluted sulphuric acid (or other dilute acid) to each grain will suffice to render the quinine perfectly soluble. 2. As a mixture, in suspension. — The following formulae will illustrate this form of administration : R R Quininae . . . gr.xxxvj Quininae Sulphatis . . 5ij Acaciae .... 3-^s Acaciae 5^3 Syrupi Aurantii . f 5iij Extract! Glycyrrhizae Misce. Signa : A teaspoonful Fluidi f 3ij to a child 2 years Aquae Ammoniae . . gtt.x old. Syrupi quantum sufficit ut fiant f 5iij Misce, Signa : A teaspoonful four times a daj'. The first formula contains the alkaloid in preference to the sulphate. In this case it is desirable to make the quinine less soluble, so as to hide its bitter taste more effectually. The second formula contains fluid extract of licorice. This owes its persistent sweet taste to glycyrrhizm, which is insoluble in acid, but readily soluble in alkaline media. The addition, there fore, of a few drops of ammonia, will render the glycyrrhizin more soluble, while the quinine becomes less soluble, increasing the sweet and decreasing the bitter taste of the preparation. 3. In the form of powder. — Quinine in the form of powder is very efficient and not unpleasant to the taste when enclosed in a cachet of wafer-sheet. The powder may also be mixed immediately before administration with a little syrup of eriodictyon (yerba santa), syrup of licorice, or covered with chocolate, 4. In pill form, — Quinine is prescribed more frequently in the form of pills than any other drug, and can be conveniently exhib- ited in this way. Quinine pills are made in large quantities by the manufacturing pharmacist; the sulphate is also extensively used in the form of compressed tablets. All machine-made pills and tablets are uncertain as to composition, age, solubility, and hence medi- cinal value — an extemporaneous preparation is much more certain in action, but even this method of administration must rank last in the order of efficiency when compared with the administration in the form of solution, mixture or powder. 30 5- Hypodcrmatically. — This is really a sub-division of the first method. Quinine is rarely p;iven hypodcrmatically because of its large and bulky dose, though occasionally this method is resorted to in emergencies, when the effect is quickly desired. A solution may be made as follows : B Quininae Sulphatis 5i gr.xx Liq. Acidi Tartarici (ad saturandum) f5iss Aquam ad fSss Misce. Signa: For hypodermatic use. Dose, f5i = 20 grains. With the exception of quinine and caffeine, all the official alkaloids are typically suited for hypodermatic administration — they are soluble in water, are unirritating and given in small doses. For this purpose, it is best to rely on the hypodermatic tablets of the manufacturer — the dose of many alkaloids is so minute that accuracy cannot be obtained by the ordinary prescription balance, while the chance of error is materially lessened by the preparation of large quantities. Hypodermatic tablets are readily soluble and usually very reliable. PRINCIPLES FOUND IN ALL PLANTS. Certain principles are common to all plants ; these are usually inert medicinally, but interesting because they appear in liquid preparations and are the most frequent cause of pharmaceutical in- compatibility. Those occurring most frequently may be arranged in a table like the following : Prmciple. Solvent. Tannic Acid, Glycerin, alcohol, water. Gum, Water, insoluble in alcohol. Starch, Albumen, " Extractive, " much less soluble in alcohol. Coloring Matter, ..•*.. " u u u Cellulose (Woody Fibre), . . Insoluble in ordinary menstrua. Tannic Acid is a constituent of nearly all vegetable drugs, but is classed among inert principles unless present in quantities large enough to stamp the substance as an active astringent. As tannic acid is soluble in alcohol and water, it is contained in all alcoholic and aqueous preparations of vegetable substances, and by its action on iron and the alkaloids, frequently renders tinctures, infusions, decoctions and fluid extracts incompatible with solutions containing either of these substances. In both instances the action is chemi- cal ; in the first through the precipitation of an inky tannate of iron, in the second through the formation of an insoluble tannate of the alkaloid. Tannic acid, if present in considerable amount in tinctures or fluid extracts, is very apt to cause precipitation in time ; in some cases this is so marked that the entire liquid becomes a gelatinous mass. The addition of glycerin prevents or retards this precipitation and is frequently made to astringent tinctures. Gum is almost inert medicinally. It is characterized by form- ing a viscid liquid (mucilage) with water and by being insoluble in strong alcohol. Starch appears only in infusions or decoctions, as it is not soluble in alcohol or cold water. It swells to a paste in hot water (31) 32 yields a blue color with iodine, and is converted into dextrin and glucose by dilute acids and certain ferments. Starch is medicin- ally inert and decomposes rapidly in aqueous solution. Albumen. — Plants contain nitrogenous principles which resem- ble the albumens found in animals. Most of the vegetable albumen is soluble in cold water, but precipitated by boiling. In solution, it is subject to decomposition, like gum, starch, coloring matter and extractive ; like these substances, it possesses no medicinal value. Coloring Matter is present in all vegetable drugs and is more soluble in water than in alcohol, so that aqueous preparations are darker than those containing alcohol as a menstruum. Extractive is the unclassified residue left after determining all of the principles mentioned. It is more soluble in water than in alcohol and is very soluble in glycerin. PULVERES— POWDERS. A simple method of administering many drugs is in the form of powder. For this purpose, a substance may be soluble or insolu- ble ; it must be non-nauseating or non-irritating, and the actual bulk of the individual dose should not exceed a volume easily swallowed. It must be neither deliquescent, efflorescent, nor volatile. Officially, powders are recognized as pulveres, and rnay be svnple or compound. The only simple powder recognized by the pharmacopoeia is Pulvis Opii, the official name, in all other instances, indicating the drug irrespective of its state of fineness. Exception was taken in the case of opium, because ordinary crude opium loses a large percentage of water in drying previous to pulverization, and therefore contains proportionately a much greater amount of morphine. All other pharmacopoeial powders are compound, i. e., contain more than one ingredient. In dispensing substances in the form of powder, it is customary to reduce them to the proper degree of fineness in a mortar, ensur- ing perfect sub-division ; to divide the entire amount into the re- quired number of parts by distributing it evenly over a number of powder-papers and finishing by folding each paper securely over the enclosed powder. Two methods are in vogue which differ merely as to the manner of folding. In prescription work, it is not necessary to weigh each powder separately, but sufficiently accurate results are obtained by dividing the powder into little heaps on the specified number of papers and equalizing the amounts with a spatula. The finished powders are conveniently dispensed in sliding pasteboard boxes. Five of the nine official powders are much used ; they are as follows : Pulvis Cretae Compositus (Compound Chalk Powder). — Contains Prepared Chalk, Acacia and Sugar. A mild ant-acid, used in the preparation of the Compound Chalk Mixture. Pulvis Effervescens Compositus (Compound Effervescing, or Seidlitz Powder). — The white paper contains 35 grains of Tartaric Acid, the blue paper a mixture of 40 grains of sodium bicarbonate and of two drachms of potassium and sodium tartrate (Rochelle (33) 34 salt). It is administered by dissolving each powder, separately, in a half-tumblcrful of water, mixing the solutions and drinking while effervescence continues. A very agreeable, saline laxative, in which carbonic acid gas is set free by the action of the tartaric acid on the sodium bicarbonate, forming sodium tartrate. The Rochellc salt remains unchanged. ..Dose, from one to two powders. PuLVis Glycvrrhizae CoMPOSiTUS (Compound Licorice Pow- der). — A favorite laxative, containing senna, glycyrrhiza, washed sul- phur, oil of fennel and sugar ; the senna and sulphur acting as cathartics, the oil of fennel as a corrective, while the sugar and glyc}Trhiza make the preparation more palatable. The dose is from one to two teaspoonfuls, preferably mixed with hot water and cooled ; this renders the draught less griping. PuLVis Ipecacuanhae et Opii (Powder of Ipecac and Opium, or Dover's Powder). — Represents lo per cent, each of ipecac and opium, with 80 per cent, of sugar of milk as the diluent; in full doses of 10 grains, acts as a valuable diaphoretic. PuLVis Jalapae Compositus. — The compound powder of jalap is a safe hydragogue cathartic in doses of 20 to 30 grains. It con- tains 35 per cent, of powdered jalap with 65 per cent, of powdered potassium bitartrate (cream of tartar). AQUAE— WATERS. Waters or aquae are solutions of volatile principles in water. Eighteen waters are official and, with four exceptions, they are in- tended as vehicles for the administration of more powerful medi- cines. The exceptions are: Aqua Ammoniae (Water of Ammonia, erroneously called Spirit of Hartshorn). — Contains 10 per cent, of gaseous NH3. Aqua Ammoniae Fortior (Stronger Water of Ammonia). — Contains 28 per cent, of NH3. Both are cardiac stimulants, when used in doses of 10-15 minims, imicJi diluted. Aqua Chlori is a 4 per cent, solution of chlorine gas in water. Used as a disinfectant and antiseptic. Aqua Hydrogenii Dioxidi holds in solution 3 per cent, of pure HoOji is a powerful, non-poisonous antiseptic, and especially valuable because of its pus-destroying qualities. Ten waters are solutions of volatile oils in water, and the pre- scriber may select any of the following according to taste: Anise BIOCHEMISTRY DEPT. (5) 35 Cinnamon, Fennel, Peppermint, Spearmint, Bitter Almond, Orange Flower or Rose. Creosote, Camphor and Chloroform water have a slight medicinal action, but are mainly intended as diluents; those containing volatile oils, have a slight carminative effect. Note. — Volatile oils form the aromatic principles of many- plants. They are liquids, usually lighter than water, have a char- acteristic odor of their own, are soluble in alcohol, sparingly in water (though sufficiently so to impart their flavor to it) and can be distilled unchanged in the presence of the latter. Volatile oils do not leave a permanent greasy stain on paper. They are carmina- tive in action, and are obtained by distillation with water or steam, by expression and more rarely by solution. Official waters are prepared by distillation or solution. Distil- lation yields the best products, because by this method the oil distils in a fresh condition and impregnates the water sufficiently with its odor ; this process is so inconvenient that it is used only in the preparation of orange flower and rose water. Solution is the process employed in the manufacture of the other official waters. Mere agitation with water dissolves creosote and oil of bitter almonds with the production of the respective waters, but most of the oils are not so readily soluble. Fine sub- division and consequent extension of surface is brought about: 1. By triturating the oil with an insoluble powder like magne- sium carbonate (U. S. P., 1870), or precipitated calcium phosphate (U. S. P., 1890). 2. By spreading the oil on cotton (U. S. P., 1880). In the first instance, water is added slowly and the whole filtered ; in the second, the cotton is packed and percolated with water. Calcium phosphate is preferred in the present pharmaco- poeia because of its complete insolubility. Magnesium carbonate yields a brilliantly clear water, but a trace of dissolved carbonate may render the preparation incompatible with delicate chemical mixtures. Waters may be prepared extemporaneously by the following (official) formula : Olei Cinnamomi C. c. 0.2 (= circa gtt. iv) Calcii Phosphatis Praecipitati . Gm. 0.4 (= gr. vj) Aquae Destillatae quantum suf- ficit ut fiant C. c. lOO.O (= f Siij foiij) 36 Triturate the precipitated calcium pliosphate with the oil. Add the water gradually, and filter (through a plaited filter), adding enough water, through the filter, to make lOO c. c. By substituting the corresponding volatile oils, any of the other waters may be obtained. Rose and orange flower water are always distilled from the fresh flowers, while aqua ammoniae, aqua ammoniae fortior and aqua hydrogenii dioxidi are prepared by the manufacturing chemist. Camphor water is made by satu-. rating absorbent cotton with a spirit of camphor, drying spontane- ously to drive off the alcohol, packing in a funnel and percolating with water. Chlorine water is distilled water saturated with the gas. Note. — The pharmaceutical differs from the chemical filter by being folded so as to expose all of its surface and thus hasten filtra- tion. In pharmacy the filtrate is desired, in chemistry the precipi- tate. Waters are intended as vehicles, and with the exception of the four above mentioned, are given in doses of one-half to one fluid ounce. LIQUORES— SOLUTIONS. LiQUORES (Solutions) are solutions of non-volatile substances in water, with the exception of those preparations classified as syrups, infusions and decoctions. Naturally, this admits of a large variety of preparations, and no general rules are applicable. Solution may be effected by simply dissolving the substance in water, or by chemical solution, in which the original nature of the principles dissolved is thoroughly changed, and a new substance, with new reactions and uses, produced. The preparation of a saturated solution of lime in water, the official liquor calcis (lime-water), is an example of the first class, that of simple solution; in the preparation of the oflficial liquor magnesii citratis, magnesium carbonate is dissolved in an aqueous solution of citric acid, both losing their identity, with the formation of a new compound, magnesium citrate, and the evolution of carbonic acid gas. The latter is true chemical solution. Many of the liquores are active and poisonous, as liquor potassii arsenitis. Fowler's solution. . 37 Of the twenty-four official solutions, the following deserve special attention : Liquor Calcis (Solution of Lime). — The ordinary lime-water, a saturated solution of calcium hydrate in water. A useful, mildly alkaline preparation, frequently added to milk to make it more digestible. Dose f 5i — foiv. Liquor Iodi Compositus (Compound Solution of Iodine, or Lugol's Solution). — Contains 5 per cent, of iodine in a 10 per cent, solution of potassium iodide in water. Used wherever a stronger preparation than the normal saturated solution of iodine in water is desired, the potassium iodide increasing the solubility of the iodine. Liquor Plumb: Subacetatis Dilutus (Diluted Solution of Subacetate of Lead). — Commonly called lead-water. Is made by diluting three parts of Goulard's extract with 97 of water. A sedative lotion, often combined with laudanum, as lead-water and laudanum. Liquor Potassae is a 5 per cent, solution of potassium hydrate in water ; used where a pronounced alkaline effect is desired. These four liquores are made by simple solution ; the following are prepared by chemical solution : Liquor Ammonii Acetatis (Solution of Ammonium Acetate, or Spirit of Mindererus). — A freshly prepared solution of ammonium acetate containing free carbonic acid gas. A mild diuretic and diaphoretic in doses of foi — f 5ss. Liquor Ferri et Ammonii Acetatis (Solution of Iron and Ammonium Acetate). — This is Basham's mixture, a mild diuretic. Dose foi — foiv. Liquor Ferri Subsulphatis, or solution of Ferric Subsulphate, is used under the name of Monsell's solution to stop hemorrhage when mechanical means cannot be applied. Liquor Magnesii Citratis (Solution of Magnesium Citrate), the popular citrate of magnesia, is a pleasant saline laxative. The dose is one half of a bottleful at bed time, followed by the remainder in the morning, if necessary. The bottles measure twelve ounces, and the solution is effervescent by being saturated with carbonic acid gas. It should be freshly prepared. Liquor Plumbi Subacetatis is interesting chiefly because lead-water is prepared from it. This solution is known as Goulard's Extract, is a poison and intended only for external use. 38 MISTURAE— MIXTURES. This term is commonly applied to liquids which contain two or more ingredients ; in pharmacy it is restricted to aqueous prepara- tions containing some solid substance in suspension, intended for internal use. Only four mixtures are official, and none of these are permanent preparations. Three are important : MiSTURA Cretae (Chalk Mixture). — A convenient method of administering a mild astringent antacid; given in doses of f5i-f5iv, and contains compound chalk powder, cinnamon water and water. MisTURA Ferri Composita (Compound Iron Mixture). — This is Griffith's mixture, which contains ferrous carbonate in sus- pension. Dose, fSi-fSij. MiSTURA Glvcyrrhizae Composita (Compound M xture of Glycyrrhiza). — The well-known " brown mixture," which has long been used as a basis for cough mixtures. Contains extract of glycyrrhiza, acacia, sugar, wine of antimony (6 per cent.), spirit of nitrous ether, camphorated tincture of opium (12 per cent.), and water. This is the most permanent of its class. The dose is f 5i-f 5j. Mixtures admit of a limited range of usefulness ; like most aqueous preparations, they spoil rapidly, are unpalatable, unsightly, and must be given in doses so bulky that they are very apt to nauseate the patient. The term mixture is not applied to a clear solution. INFUSA— INFUSIONS. Infusions are liquid preparations made by extracting vegetable substances with either hot or cold water, without boiling, Pharma- ceutically and therapeutically they are poor preparations, because they undergo early decomposition, are never clear and brilliant, and finally, though water has a wide range of usefulness as a solvent, it furnishes much less concentrated preparations than does alcohol. Infusions are prepared by pouring hot water over the drug, macerating in a tightly closed vessel until the liquid cools, and straining. One infusion, the infusion of wild cherry, is made by percolat- ing the drug with cold water. Only four infusions are official and this may be taken as an index of their popularity. Formerly they were much used in this country; to-day they are rarely prescribed. 39 tho:'gh they are still largely employed in England and on the Continent. Water is a poor solvent for vegetable principles at best, and as other classes of preparations offer advantages and none of the disadvantages of infusions, the latter have been almost entirely replaced by alcoholic preparations, like the tinctures and fluid extracts. It must not be forgotten, in this connection, that hot water, in the large dose of the old-fashioned teas, has both diapho- retic and diuretic properties, and probably has added much to the reputation attained by some of the herbs formerly employed ; also, that infusions (and decoctions) must, of necessity, be freshly prepared and are not of doubtful age as are the tinctures and fluid extracts. The pharmacopoeia directs that the strength of infusions, when not otherwise specified by the pharmacopoeia or physician, shall be 5 per cent. The dose of infusions ranges from f 5j to many ounces, according to the character of the drug employed. Two official infusions are often prescribed : Infusum Digitalis (Infusion of Digitalis or Fox Glove), repre- sents I Yz per cent, of the leaves and some cinnamon water as a flavor. It is preferred by many practitioners, in doses of f 5i-f 5iv, to the tincture of digitalis, and seems to possess greater diuretic powers. Infusum Pruni Virginianae (Infusion of Wild Cherry), is made by percolating the drug with cold water. Saturated with sugar, it forms the well-known syrup of wild cherry. DECOCTA— DECOCTIONS. Decocta (or Decoctions), are made by boiling vegetable drugs with water. Like infusions, decoctions are now rarely used — both decompose readily and altogether have only one factor to recom- mend them, that of recent preparation. Decoctions present all the disadvantages common to infusions in accentuated form, as heat is employed in their production, with loss of volatile ingredients and change in those which are not dissipated at higher temperatures. Neither of the official decoctions is important and the pharmacopoeia specifies the strength of non-official preparations of this class to be 5 per cent, with the caution that the percentage of the drug in decoctions of energetic or powerful substances be specially pre- scribed by the physician. The drug is to be boiled for fifteen 40 minutes, expressed, strained and sufficient water added, through the strainer, to produce the required measure. The dose of decoctions is from f.^ss-fSj, or even more. SYRUPI— SYRUPS. Syrups are solutions of medicinal principles in water containing sugar. Thirty-two are official, proving that they still are a favorite class, though used to a less extent than formerly. They may be simple, flavoring, or medicated, their sweet taste facilitating admin- istration and indicating their use as vehicles, mild adjuvants or correctives ; a few contain active medicinal ingredients. They are made by solution with heat, by agitation without heat, by the simple addition of a medicating liquid to syrup. The first method is used w^hen the drug is not injured by heat, and its active principle is not volatile ; the second process is employed when heat is contra- indicated and the third method is resorted to when the medicating substance is liquid. The following is a list of the most important official syrups : Syrupus (Syrup, or Simple Syrup). — Employed merely as a vehicle and contains about two- thirds of its weight of sugar. Syrupus Ferri Iodidi (Syrup of Ferrous Iodide). — Contains lo per cent, of ferrous iodide. Is employed as an efficient altera- tive, especially valuable in the treatment of the wasting diseases of children. Dose, tt^x to f5i. Syrupus Rubi Idaei (Syrup of Raspberry). — Made from fer- mented raspberry juice. A pleasant basis for administering bitter or nauseating remedies. Syrupus Scillae contains acetic acid, as it is made from the vinegar of squill. A stimulating expectorant, given in doses of 5 to 30 "I. The above syrups are made by solution with heat ; the follow- ing are made by the addition of the medicating liquid to the syrup : Syrupus Acidi Citrici (Syrup of Citric Acid, or Syrup of Lemon). — Made by flavoring a dilute solution of citric acid in syrup with spirit of lemon. A pleasant vehicle. Syrupus Ipecacuanhae contains 7 per cent, of fluid extract of ipecac, a little acetic acid, and glycerin. Used as a relaxing expec- torant in the second stage of bronchitis. Dose, 5 to 10 min. 41 Syrupus Sarsaparillae Compositus (Compound Syrup of Sar- saparilla). — Contains the fluid extracts ot sarsaparilla, glycyrrhiza and senna, flavored with the oils of sassafras, anise and gaultheria. Has been much used as a basis in anti-syphilitic mixtures for the exhibition of mercury and potassium iodide. Syrupus Scillae Compositus (Compound Syrup of Squill), is commonly known as hive syrup, or Coxe's hive syrup. Contains squill, senega and two parts of tartar emetic in looo parts, and is therefore a dangerous compound when used by the laity. Dose, from 10 drops to foi- A depressing expectorant. Syrupus Senegae (Syrup of Senega). — Much used to-day as an expectorant, more stimulating than ipecac and less so than terebene or creosote. Dose, m v. to f 5i. Syrupus Tolutanus (Syrup of Tolu). — Represents the aro- matic properties of balsam of tolu in the form of a pleasant vehicle. Syrupus Zingiberis (Syrup of Ginger). — A favorite correc- tive. Syrups made by dissolving sugar in the medicating liquid : Syrupus Aurantii (Syrup of Orange). — Like syrup of lemon, is used as a vehicle, but unhke the latter, is made from the tincture of the fresh peel ; a very agreeable preparation. Syrupus Hypophosphitum (Syrup of Hypophosphites). — Con- tains the corresponding salts of calcium, potassium and sodium, with a little diluted hypophosphorous acid. Given in doses of foi or more, in wasting diseases. Syrupus Pruni Virginianae (Syrup of Wild Cherry). — A very popular syrup, made by dissolving sugar in an infusion of wild cherry. Contains a trace of hydrocyanic acid and of oil of bitter almonds, with the bitter principle and some tannic acid derived from the bark. Though not actively medicinal in itself, it is proba- bly the most popular basis for cough mixtures to-day because of its very agreeable flavor. Mellita, Honeys and Mucilagines (Mucilages) have as their basis respectively, honey and some gummy substance. Formerly more popular, these two classes have fallen into disuse to-day because of their proneness to acid decomposition ; in the case of honey the vinous and then acetous fermentation is apt to occur, while muci- lages undergo the lactic acid fermentation. Honeys afford a convenient method of administering drugs to children, though they 42 are no more agreeable and less permanent than the syrups. There are only three official honeys and four oflFicial mucilages. Mucilage of acacia is the most important member of this class ; it is some- times employed as a demulcent in the intestinal complaints of chil- dren, but finds a wider range of usefulness in the emulsification of oils. EMULSA— EMULSIONS. Emulsa (Emulsions) are a(]ucous preparations intended for internal use, which contain oil or resin in suspension. This is brought about by the aid of some mucilaginous or other adhesive substance. Emulsions are white, opaque liquids, which, under the microscope, are seen to consist of small globules of oil, each sur- rounded by a fine film of some viscid material, which prevents the drops from running together. Milk furnishes an example of a natural emulsion, in which the butter represents the fat and casein the adhesive material, the latter enveloping as a thin membrane the fatty matter. In preparing butter, the churning breaks up the envelope of casein and the globules run together to form larger masses. In emulsification the aim is in the opposite direction ; it is to dash the oil into fine globules and then to prevent these globules from uniting by covering each one of them with a film of viscid material; this is usually a gum of some kind, preferably gum acacia. But four emulsions are officially recognized, and none of these are used to any extent. Emulsions are, however, frequently pre- scribed as extemporaneous preparations, and though they do not keep well as a class, at least one emulsion, that of cod liver oil, is made in large quantities by the manufacturer. It can often be tolerated when the pure cod liver oil is nauseating, and will keep fairly well if kept in full bottles, well corked, in a cool place. The object in exhibiting an oil in the form of an emulsion is usually to make it more palatable and less nauseating, though in some in- stances crude oils are better borne than their emulsions. It must be remembered, that emulsions are not made to contain more than 50 percent, of the oil, and in many instances, do not represent more than 25 per cent, because the resulting preparation becomes too thick for convenient administration. (6) ^ 43 At least three methods can be employed to emulsify an oil ; in all of them a nucleus of oil, gum and water, in certain proportions, is formed, which can then be diluted at will. In the first method a mucilage, of the consistence of the oil, is first made, and the oil added, drop by drop, with thorough trituration. Occasionally, when the mass becomes too thick to be worked properly, small portions of water are added, and the additions of water and oil made alternately until the whole assumes the appearance of rich cream. This nucleus, when properly made, should crack under the pestle and can be diluted, without separation, to the required percentage. The proportions of oil and acacia used, are four of the former and one of the latter, with enough water to make the mucilage as dense as the oil. The acacia should be granulated and not powdered. A simple way of forming the nucleus is to take four parts of oil, one part of acacia, and two parts of water, mix the finely powdered acacia intimately with the oil, and add the two parts of water, all at once, constantly stirring. In the third pro- cess the ingredients may be mixed at once in a mortar, provided that the following ratio is observed : Oil, 4 parts ; gum, 2 parts ; water, 3 parts. It will be observed that in the first method no statement is made concerning the amount of water used in the nucleus (this depending on the judgment of the operator), but that it presents the smallest amount of acacia, the largest appearing in the third formula. As the gum especially endangers the permanency of the preparation, the manufacturer adds as little acacia as possible, and prefers the first method. The other two formulae never fail to produce a good emulsion, and are frequently selected when these compounds are ordered extemporaneously. As gum is soluble in water and not in alcohol, emulsions do not mix with tinctures or other alcoholic preparations, except to a very limited degree. i Volatile oils may be emulsified by mixing them with an equal bulk'of some bland fixed oil, and then treating them precisely like a fixed oil. Some gum resins furnish emulsions by mere trituration with water, as they contain sufficient gum to hold the resin in suspension. The official emulsion of asafetida will serve as an example. Occa- sionally substances other than oils and resins are emulsified : chloroform can be made to combine with water through the agency of gum tragacanth to form emulsum chloroformi. 44 GLYCERITA— CiLYCERITES. Glycerita (or Glycerites) are preparations containing medi- cinal substances dissolved in glycerin. Six are official and four of these are used extensively : Glvceritum Acidi Carbolici (Glycerite of Carbolic Acid). — This is a 20 per cent, solution in glycerin and illustrates the ready solubility of the phenol in this menstruum. Pure carbolic acid is soluble in 15 parts of water, but this concentration is not always readily attained, so that samples of a 1:20 (or 5 per cent.) aqueous solution frequently show globules of undissolved acid, which impart irritating if not corrosive properties to the mixture. Previous dilution with glycerin renders the acid perfectly soluble. Glyceritum Acidi Tannici (Glycerite of Tannic Acid). — Synonym glycerole of tannin. A deep green solution, affording a ready means of applying this popular vegetable astringent in con- centrated form and combining with this the depleting properties of the glycerin. Much used as a local application to mucous surfaces. Glyceritum Boroglycerini (Glycerite of Boroglycerin). — A saturated solution of boric acid in glycerin, uniting the antiseptic powers of both agents. Useful where a mild, unirritating antiseptic is desired ; it is always diluted with water before use. Glyceritum Hydrastis (Glycerite of Hydrastis) represents the medicinal virtues of the drug. Dose, f 5j-f 5ij- ELIXIRIA— ELIXIRS. Elixiria (or Elixirs) to-day are preparations of pleasant flavor for the exhibition of medicinal substances in dilute form. Formerly they were often therapeutically active preparations, but at present they are made aromatic and so palatable that the percent- age of alcohol contained in each dose becomes a therapeutic factor. Therefore only two elixirs were made official, aromatic elixir and elixir of phosphorus ; the former intended as a vehicle, the second as a means of giving phosphorus (f 5j contains -g^^- grain). Of the unofficial elixirs, perhaps the most popular are the elixir of ammonium valerianate and the elixir of iron, quinine and strych- nine. The dose of elixirs is usually f5i. 45 SPIRITUS— SPIRITS. Spiritus (Spirits). — A spirit is an alcoholic solution of a vola- tile principle. Twenty-five are official and most of them are prepared by simple solution ; one, the spirit of nitrous ether, is made by chemical reaction, three are made by maceration, and two by distillation. Fourteen are solutions of volatile oils in alcohol. With the exception of spirit of glonoin (min. j ) and spirit of phosphorus (used to make the elixir of phosphorus), the average dose of official spirits may be stated at f 5ss, diluted with water. The most important spirits of the pharmacopoeia are : Spiritus Aetheris Compositus (Compound Spirit of Ether, or Hoffmann's Anodyne). — A quickly acting anodyne and carmina- tive in gastric and intestinal colic. Contains alcohol, ether, and ethereal oil. Dose, f5ss-f5i. Best taken on sugar, or with ice water. Spiritus Ammoniae Aromaticus (Aromatic Spirit of Ammonia). — Contains ammonium carbonate beside NH3, flavored with aromatic oils. A quickly acting cardiac and gastric stimulant in doses of f5ss-f5j, diluted with water. Spiritus Aetheris Nitrosi (Spirit of Nitrous Ether, or Sweet Spirit of Nitre). — A weak solution of ethyl nitrite, which represents, to a certain degree, the effect of the nitrites on the circulation, in addition to being diaphoretic and diuretic. Dose, f5ss-f5ij. Spiritus Camphorae (Spirit of Camphor). — Ten per cent, ot camphor dissolved in alcohol. Rarely used internally, much employed externally as a liniment. Spiritus Chloroformi (Spirit of Chloroform). — A safe sedative in nausea or bronchial irritation in doses of min. v-f 5ss. Contains 6 per cent, of chloroform. Spiritus Glonoini (Spirit of Glonoin, or Nitroglycerin). — A I per cent, solution of trinitroglycerin. A valuable cardiac stimulant and vaso-motor dilator. Dose, min, j. Spiritus Limonis and Spiritus Menthae Piperitae (are popularly known as Essence of Lemon and Essence of Peppermint). — Much used as a flavor and carminative. Both are alcoholic solu- tions of the volatile oils. Spiritus Frumenti (Whiskey) and Spiritus Vini Gallici (Brandy) are chiefly interesting because they are prepared by distillation. Pharmaceutically, diluted alcohol is preferred. 46 ^^ TINCTURAE— TINCTURES. TiNCTURAE (or Tinctures) may be defined as alcoholic solutions of non-volatile substances. Seventy-two tinctures are official and all but three are made from vegetable substances; tincture of iodine and tincture of ferric chloride are prepared from inorganic drugs, the first by dissolving iodine in alcohol, the second by diluting the solution of chloride of iron with the same menstruum. One official tincture is made from an animal drug — the tincture of musk. Tinctures are prepared by maceration, percolation, solution and dilution. Percolation is preferred wherever it is possible to extract the soluble principles of a drug by displacement; maceration becomes necessary when the physical character of the drug does not permit employment of this process. Tincture of benzoin and tincture of asafetida are instances where the resins are so soluble in alcohol that it is impossible to moisten and pack them in a percolator to be extracted in the usual manner, the pow^der becoming a pasty mass which prevents any liquid from passing. Such substances must be introduced into a convenient receptacle and macerated with the liquid for some days, at the end of this time requiring filtration. In all instances the amount of alcohol introduced into the men- struum is made as small as is compatible with permanency and proper medicinal action. EXTRACTA FLUI DA— FLUID EXTRACTS. Fluid Extracts (or Extracta Fluida) are concentrated tinctures, though they differ from the latter in their mode of manu- facture. They are always of definite strength, one minim repre- senting one grain of the crude drug, or one c.c. equaling a gramme. Therefore they are lOO per cent, in strength, practically the liquid equivalents of the solid drug, and represent all its active constituents, with this convenient relation of volume for weight. Because of the greater concentration of fluid extracts, it becomes necessary to adopt additional measures to fully extract the drug, so that previous to percolation, maceration is always resorted to. The liquid is then allowed to pass slowly through the powder, and the first -^ to -^^ of the percolate reserved and set aside. Then the powder is perco- lated to exhaustion ; this last weak percolate, irrespective of its 47 quantity, is now evaporated to a soft extract, the process taking place in a still, with a worm or other condenser attached, to recover the alcohol. Finally the soft extract is dissolved in the reserved por- tion and a sufficient quantity of menstruum added to produce a volume equal in bulk to the quantity by weight of the drug employed. At first sight the uniform relation of dose, the small bulk of the latter, and the pharmaceutical perfection of the finished product, would seem to justify the exclusive use of the large num- ber of fluid extracts official in our pharmacopoeia, the largest number of any one class. Unfortunately, heat must be employed in the official process. The apparatus for the recovery of alcohol is expensive and the whole method is adapted only for use on the large scale, so that it be- comes necessary to draw wholly on the manufacturer for the supply. As a consequence, an indefinite period of time has elapsed before the fluid extract reaches the consumer. Theoretically, fluid extracts seem to be ideal preparations : practically, tinctures are preferred by most practitioners. Comparing the two classes, it is necessary to consider the following facts : 1. All vegetable principles in solution tend to undergo a change in time. 2. Heat injures all vegetable principles in direct proportion to the temperature employed and the length of exposure, especially if they are in solution, or in contact with a menstruum. It dissipates all principles which are vola- tile. 3. All precipitates occurring in liquid preparations of vegetable substances, though largely composed of inert material, show a well-marked tendency to carry down at least a portion of the active ingredient ; the chemical nature of the latter is changed by this precipitation, so that the preparation is weakened, even though it is dispensed in an unfiltered condition. The advantages of fluid extracts over tinctures are supposed to be their concentration, so that a reduction in the amount of alcohol and the volume of the dose is obtained, and in a uniform and convenient relation of volume for weight. From the standpoint ot the prescriber, these supposed advantages have not been realized ; tinctures have been found to represent the medicinal activity of 48 drugs with <];reater certainty. The reasons for this are probably the following : Tinctures vary in strength from 5 to 50 per cent, (usually 10, 1 5 or 20 per cent.), and the larger amount of menstruum they con- tain makes it more likely that all of the active principle is extracted from the drug; they are prepared entirely by a cold process, are less apt to precipitate because they contain less of the drug, are more recently prepared and almost without exception are suffi- ciently concentrated to be given in doses so small that the thera- peutic effect of alcohol does not manifest itself. All this is supported by abundant clinical evidence. It is a noticeable feature in connection with the use of fluid extracts that the dose in minims always exceeds slightly that of the crude drug in grains, and not, as theoretically aimed at, minim for grain. Whether this is due to insufficient extraction, the employment of heat in the process of manufacture, to the uncertain age of the preparation, or to a com- bination of these factors, is not readily ascertained ; at any rate, tinctures prepared by diluting fluid extracts have not the same medicinal value as tinctures prepared from the drug. Tincture oi digitalis is certainly a superior preparation to the fluid extract, though both are made with the same menstruum of diluted alcohol. The average dose of fluid extracts may be stated as 10 min.; that of the poisonous fluid extracts as i m. The average dose of the tinctures is f5i and 10 min. for the poisonous tinctures, except the tinctures of aconite and veratrum viride, the dose of which is i to 3 min. As tinctures and fluid extracts are used only where the respective drugs are indicated, only a few important compound tinctures will be considered separately. TiNCTURA Cardamomi Composita (Compound Tincture of Cardamom) contains cardamom, cinnamon, caraway and cochineal. A very pleasant, attractive preparation, colored bright red from the cochineal. Frequently prescribed as an aromatic addition to pre- parations, or used as a placebo. TiNCTURA Catechu Composita (Compound Tincture of Cate- chu) is flavored with cinnamon ; diluted with water it was formerly much used as an injection in gonorrhoea. TiNCTURA CiNCHONAE CoMPOSiTA (Compound Tincture ot Cinchona. Huxham's Tincture). — A popular tonic, combining the virtues of cinchona bark with bitter orange peel and serpentaria. Dose, f 5'-iv. »l 49 TiNCTURA Benzoini Composita (Compound Tincture of Ben- zoin) has been used for many years as Turlington's Balsam, Friar's Balsam, or Balsam de Malta, for its stimulating expectorant effect. Contains aloes, storax, balsam of tolu and benzoin. Is prescribed internally or in the form of an inhalation, dropped on hot water. TiNCTURA Gentianae Composita (Compound Tincture of Gen- tian) contains gentian, bitter orange peel and cardamom, and closely resembles Stoughton Bitters. It is used as a simple tonic in doses of f 5i-iv, though in the latter dose there is some danger of acquir- ing the alcoholic habit. VINA— WINES. ^Ur- ViNA (or Wines) may be defined pharmaceutically as prepara- tions made with a menstruum of wine. Two of them are non- medicated, Vinum Album and Vinum Rubrum. These contain from 10 to 14 per cent, of alcohol. Although additional alcohol is added for the extraction of drugs, wine is not as good a menstruum as diluted alcohol would be. Of official wines the following are still used to-day : Vinum Antimonii (Wine of Antimony) contains ^ per cent, of tartar emetic, and is used both as a sedative expectorant and as an emetic. Dose, 10 to 30 min., in larger doses emetic. Vinum Colchici Radicis (Wine of Colchicum Root) has been a favorite means of administering this drug to gouty patients. Dose, 10 min. to 30 min. Vinum Ferri Amarum (Bitter Wine of Iron) contains the soluble citrate of iron and quinine flavored with tincture of sweet orange peel and sweetened with syrup. A mild ferruginous tonic. Dose, f 5ii-iv. ACETA— VINEGARS. ^ Aceta (or Vinegars) are medicated vinegars. Diluted acetic acid is used as the menstruum, and although it possesses some antiseptic properties it does not furnish a good basis for prepara- tions; for this reason vinegars have fallen into disuse and as a class are unimportant. But two are official. 50 OLEORESINAE— OLEORESINS. '^""^'^ Oleoresinae (or Oleorcsins) arc the only class of preparations made with ether. Oils and many resins are soluble in ether, so that this liquid furnishes a convenient menstruum for the extraction of a few drugs, which owe all their activity to these two classes of principles. Six oleoresins are official and in each case they represent the strongest preparations of the drugs they are made from. They are prepared by exhausting the drug with ether, and distilling ofl the latter until a thick liquid remains. Oleokesina AsriDii (Oleoresin of Aspidium, or Male Fern), is the preparation always selected to exhibit the taenifuge properties of this important drug. The dose is from f 5ss to f 5i, usually given in emulsion. Oleoresina Cubebae (Oleoresin of Cubebs) is selected when this drug is given in conjunction with copaiba in the treatment of gonorrhoea. Best administered in the form of capsules. There are three classes of liquid preparations for external use ; the liniments, oleates and the collodions. LINIMENTA— LINIMENTS. A-Mr- Linimenta (or Liniments) ate liquid preparations intended for external use, containing as a basis oil or alcohol. They are applied to the skin for their counter-irritant effect, and usually are mixed extemporaneously at the order of the physician. The pharmacopoeia recognizes nine (9). Four of these are often prescribed : LiNiMENTUM Calcis (Lime Liniment, or Carron Oil), is a mix- ture of equal volumes of solution of lime (lime-water) and raw linseed oil. Extensively used as a dressing for burns. LiNiMENTUM Camphorae (Camphor Liniment, frequently called Camphorated Oil), is a 20 per cent, solution of camphor in cottonseed oil. Usually employed externally ; more rarely hypodermatically for its cardiac stimulant effect. LiNiMENTUM Chlorofokmi (Chloroform Liniment) contains 30 per cent, of chloroform, witii 70 per cent, of soap liniment. (7) !i 51 LiNiMENTUM SAPONis(Soap Liniment) is perhaps the most popu- lar liniment in use, and contains soap, camphor, oil of rosemary, alcohol and water. LiNiMENTUM Saponis Mollis (Liniment of Soft Soap, or Tinc- ture of Green Soap), is used by the surgeons in preference to ordi- nary hard soap for its more rapid detergent effect It is a solution of potassa (soft) soap in alcohol, scented with oil of lavender. fc -^ OLEATA— OLEATES 3 Oleata (or Oleates) are solutions of medicinal substances in oleic acid. Three are official, one of which, the oleate of mercury, is occasionally used to obtain the constitutional effect of the drug. It is a 20 per cent, solution of yellow mercuric oxide in oleic acid. Oleic acid was at one time supposed to be more rapidly absorbed by the skin than any other base. Like many oily preparations oleates become rancid. ^ COLLODIA— COLLODIONS. Y CoLLODiA (or Collodions) are solutions of gun-cotton in a mix- ture of ether and alcohol, and are intended for external use. Sim- ple collodion makes a good dressing for small wounds, the ether and alcohol evaporating and leaving a thin, contracting film of gun- cotton, which adheres tightly to a dry surface. Collodium Flexile is made flexible by the addition of Canada turpentine and castor oil. EXTRACTA— EXTRACTS. ExTRACTA (or Extracts) are solid preparations prepared by evap- orating solutions of vegetable principles nearly to dryness. Thirty- three are official, so that they rank next in importance to tinctures and fluid extracts. In most cases the menstruum is alcohol ; the remainder are prepared with water, and in one case water of ammo- nia, in another acetic acid is added to the latter. One extract is an 52 inspissated juice. In all cases the menstruum dissolves inert sub- stances with the active principle, the former constituting the bulk of the dry extract. This class forms always the strongest pharma- ceutical preparation of any drug, the dose being smaller than that of the tinctures, fluid extracts, etc., and necessarily always smaller than that of the drug itself Theoretically, they ought to form the most valuable prepara- tions on our official list, as they are concentrated, permanent, easily administered (in pill form) and readily prepared. In practice they have been found to vary exceedingly in therapeutic strength. The reasons for this are apparent : granting that the percentage of active principle contained in a drug does not vary to a considerable degree, the amount of inactive matter taken up by the menstruum and collectively known by the term of extractive, certainly does and to an indefinite extent. Two samples of the same drug may assay the same amount of active constituent, and yet yield totally different amounts of extracts when their infusions or tinctures are evaporated. Again, an aqueous menstruum will dissolve a larger proportion of extractive and yield a larger quantity of extract than an alcoholic one, simply because water is a better solvent for the inert matter contained in plants than is alcohol, the aqueous extract being bulky and relatively weak, the alcoholic one concentrated and medicinally more active. This refers to extracts made from the same drug. Moreover, though extracts are supposed to be solid preparations, they commonly retain a certain proportion of moist- ure ; the amount of the latter is also bound to vary within certain limits, as the pharmacopoeia merely specifies to evaporate to a pilular consistence. It is evident that the manufacturer may vary the quality of an extract considerably by selecting a menstruum more productive of quantity than of quality, so that the only reliable guide to the value of any individual specimen lies in the therapeutic test. Finally, the prolonged application of heat injures the activity of all vegetable preparations, and extracts cannot be made without evaporation at an elevated temperature. The advantages of extracts are their small bulk and small dose ; their permanence and convenient form for administration in pill masses, so that extracts are still very popular in spite of their uncertain strength. The dose of extracts may be stated as gr. i ; that of the poisonous solid extracts as gr. ^. 53 RESINAE— RESINS. Resinae (or Resins) are solid preparations made from drugs which owe their activity to resinous principles. Rosin, the resin obtained from turpentine, may be taken as the type — they are all soluble in alcohol and insoluble in water, therefore precipitate when resinous tinctures are added to water. Five resins are "official — of these the resins of jalap, podophyllum and scammonium represent the full medicinal activity of the respective drugs and therefore are given in small dose; TRITURATIONES— TRITURATIONS. Triturationes (or Triturations). — These are made by incorpo- rating ten parts of medicinal substance with ninety parts of pow- dered sugar of milk. Only one trituration is official — Trituration of Elaterin. Dose, gr. ^ as a hydragogue cathartic. Triturations have lately been put up in tablet form by the manufacturer and are then known as tablet triturates. PiLULAE (or Pills) are globular, ovoid or lenticular bodies of such size that they can be readily swallowed. They are preferably made extemporaneously, so that only fifteen formulae are made official. Pills are the most popular of all solid preparations, as they afford a ready means of giving substances unpleasant to the taste. Naturally, only those substances are suitable for administra- tion in pill form which neither attract nor lose moisture in air, are not corrosive, not volatile, or given in doses exceeding three grains for vegetable drugs and five grains for mineral substances. Most drugs of vegetable origin exceed the limit of three grains and make a pill too bulky to swallow ; for this reason their solid extracts are used, particularly because these preparations are pharmaceutically well adapted to be formed into pill masses. 54 In order to combine substances so that they can be shaped into pills they must be physically so constituted that they form a mass which is adhesive, plastic, and has a certain degree of firmness ; — adhesive, so as to unite the ingredients ; plastic, that the mass may be worked readily ; and firm, so that the finished pills retain their shape. Few substances possess all these requirements. If a combination of several medicinal substances does not supply the desired qualities, an excipicnt must be added to produce a mass. This excipient may be either Hquid or solid, should be inert medicinally and furnish the lacking qualities with as little increase in the size of the individual pill as possible. It may be defined as the substance added to a pill mass to bind the ingredients together. Water, alcohol, mucilage of acacia, glycerin and glucose may be mentioned among the liquids, while acacia, confection of rose, crumb of bread and soap are used as solid excipients. The advantages in the use of a liquid excipient are that the resulting pills remain small, while solid excipients are preferred where it is desirable to increase the bulk of the pill, as in those cases where a powerful alkaloid is subdivided into doses so minute that it would be inconvenient to dispense them without such addition. In the making of a pill mass the ingredients are thoroughly mixed in a mortar, those substances which are not already in a fine state of subdivision having been previously ground to a very fine powder. The excipient, if it be a liquid, is now added, drop by drop, and the mass thoroughly kneaded with the pestle until it assumes the proper plasticity, the latter depending in great meas- ure on the care exercised at this particular stage. The mass is then transferred to a pill tile and rolled into a cylinder of unifofm thickness and convenient length. This cylinder is divided into the required number of parts and each segment made perfectly round by rolling it between the thumb and first two fingers. — Many pharmacists prefer to use the pill machine ; this is essentially a contrivance for cutting the cylinder and giving the finished pill at once the rounded form. After finishing the pills they are usually dusted with some suitable powder to prevent them from sticking together in the box, powdered licorice root, althaea, lycopodium or powdered sugar being usually preferred for this purpose. The selection of the dusting powder and of the excipient is in nearly all cases left to the 55 pharmacist, as the proper choice depends upon the mass, though a few general rules are applicable to all cases — the excipient should be of such a nature that the pill does not become hard and insoluble in a reasonable length of time. Many medicinal substances are to-day compressed by suitable machines into little discs of lenticular shape, known as compressed pills or compressed tablets, while the ordinary round pills are also prepared by the manufacturer on the large scale ; the latter are commonly coated with gelatin or sugar, more rarely with gold or silver leaf It is evident that saving of time and labor is thus obtained with a great reduction in the price of the finished product; furthermore, that much more accurate subdivision must be the rule with the manufacturer in the case of those substances of which each pill contains only a minute dose, than it is possible with the retail pharmacist, working with the ordinary facilities of the prescription counter. But the disadvantages of machine-made products are as apparent in the case of pills as they are with most manufactured preparations, and it wiU be seen that the ready-made pill must, as a rule, be inferior to the one prepared extemporaneously. Firm com- pression by machines makes some powders almost insoluble, and the ordinary pill, made with liquid excipients, not uncommonly becomes so hard with age that it will pass through the entire diges- tive tract without dissolving. It is true that questionable solubility is a fault common to either preparation, but freshly prepared pills ought to be preferred to manufactured products, except in the case of those powerful substances which are given in doses so small that the ordinary prescription balance will not weigh them. The latter are best dispensed in the form of the hypodermatic tablets, prepared by the manufacturer, as these must of necessity be soluble and are usually very reliable. Extracts are typically suited for pill masses, and are almost exclusively given in this way. As they are made with a menstruum of alcohol or water, it is best to rub them up with a small quantity of the liquid used in their preparation before incorporating the rest of the ingredients. Volatile oils may be given in pill form if mixed with other substances to no greater extent than ^ drop in each pill. Very oxidizable chemicals, like potassium permanganate, may be given in an excipient like cacao butter, petrolatum or resin 56 cerate, while crumb of bread may be used to take up powerful liquids, like croton oil and volatile oils. Confection of rose is well adapted where a bulky excipient is desired, while soap forms a useful addition to pills containing resinous substances. When pills are intended for intestinal medication they may be coated with kerat in, a substance prepared from the wing cases of insects and characterized by being soluble in alkaline and insoluble in acid media, so that pills coated in this manner escape the gastric juice to be dissolved in the intestinal secretions. The official pills deserving mention are as follows : PiLULAE Aloes et Mastiches (Pills of Aloes and Mastic). — These are the well-known Lady Webster's dinner pills, in which 2 grains of purified aloes are combined with gr. ^ of mastic and red rose. The mastic probably retards solution and thereby in- creases the laxative action of aloes on the lower bowel. PiLULAE Catharticae Compositae (Compound Cathartic Pills) contain compound extract of colocynth, mild mercurous chloride, extract of jalap and gamboge, and are very much employed because the combination of several purgatives decreases their irritant effect, while the calomel has a special depleting influence on the liver. The average adult dose is three pills, each pill weigh- ing 3 grains. PiLULAE Ferri Carbonatis (Pills of Carbonate of Iron). — The famous Blaud's pills, much used in the treatment of chlorosis. When freshly prepared they contain ferrous carbonate. Dose, i to 3 pills. PiLULAE Ferri Iodidi (Pills of Ferrous Iodide), usually known as pills of iodide of iron. Each pill contains about gr. i of ferrous iodide, and gr. \ of reduced iron. They are coated with balsam of tolu and ought to be recently prepared. Dose, i to 3 pills. PiLULAE Opii (Pills of Opium). — Each contains a full dose, or gr. I of powdered opium. PiLULAE Phosphori (Pills of Phosphorus). — The dose is one pill, representing y^^ of a grain of phosphorus, if carefully pre- pared. They should have the peculiar matchy odor of phosphorus if crushed, showing that it is contained in an unoxidized con- dition. 57 MASSAE— MASSES. Massae (or Masses) are pill masses kept on hand by the phar- macist. Three are official, two of which are frequently employed. Massa Ferri Carbonatis (Mass of Ferrous Carbonate), the well-known Vallet's mass, contains the ferrous carbonate and is prescribed in anaemic conditions. Dose, 3 to 5 grs. Massa Hydrargyri (Mass of Mercury, or Blue Mass), contains T,^ per cent, of metallic mercury in a pleasantly flavored excipient. Is given as a cathartic and to produce the constitutional effect of mercur)^ It is one of the mildest of all the mercurial preparations. Dose, 5 to 15 grs. as a cathartic. CONFECTIONES— CONFECTIONS. CoNFECTiONES (or Confcctions) are the remnants of the old- fashioned conserves and electuaries. They were originally intended to serve as an agreeable method for administering powerful medi- cines. Two are recognized by the pharmacopoeia. CoNFECTio RosAE (Confection of Rose) is a popular excipient when it is desired to increase the bulk of a pill. -4 UNGUENIA-— OINTMENTS. ^ ^ Unguenta (or Ointments) are preparations containing some fatty substance as a basis adapted to be applied by inunction. In general they may be said to meet three indications : 1. For the systemic exhibition of a remedy. 2. For local effect. 3. To act as a mere protective dressing. A few remedies produce their constitutional effect as readily when rubbed into the skin in the form of ointments as when they are introduced into the stomach, excepting that a longer period of time is required. Mercurial ointment is a notable example and fur- nishes a sure method of ptyalizing a patient without disturbing the digestive tract. Many substances have been recommended as bases for ointments, but practically only three have stood the test of time ; these are lard (and suet), lanolin, and petrolatum, and each may be said to answer certain indications. 58 Lard maybe taken as the type of the animal fats, and furnishes an excellent basis for ointments, but unfortunately shares the property common to all vegetable and animal fats, that of becoming rancid. Careful investigations as to the relative absorptive power of the skin for various fatty preparations are still lacking, but it seems rational to suppose that lard (or suet) is more readily taken up by the skin than lanolin or the vegetable bases, because of the well- known fact that animal fats, as a rule, are readily taken up in the digestive tract and assimilated, while vegetable oils are scarcely acted upon at all under the same conditions. — Lanojin is the puri- fied fat of sheep's wool and was at one time highly recommended because of its apparent rapid and complete absorption by the skin. In addition it does not become rancid. It appears improbable that lanolin should be a better basis than lard, the former being largely composed of cholesterin, a product excreted by the skin and not at all acted upon by the digestive juices when placed within the body, , /KiH/t-w^ It forms the bulk of the so-called gall stones and must be regarded "^^^"^ as an excretory product. Much of the constitutional effect obtained from a medicated ointment depends upon the thoroughness with which it is rubbed into the skin, and the results obtained from the use of lanolin are probably due to the more tenacious character of the latter, and to the fact that a portion of the cuticle was removed during the application. At any rate, lard and suet have always been preferred in the manufacture of mercurial ointment, which is the best illustration of the applicability of a drug to the skin for producing its systemic effect. Lard is made more permanent by the addition of the soluble constituents of benzoin, a preparation known as benzoinated lard, which is preferred as a basis in 14 of the 23 official ointments. When lard itself is too soft, the addition of yellow wax gives it a firmer consistence, as in the official ointment or unguentum. The following of the official formulae deserve mention : Unguentum (or Ointment). — Used whenever a preparation more firm than pure lard is desired. Unguentum Aquae Rosae (Ointment ot Rose Water). — Known as cold cream, and contains spermaceti, white wax, ex- pressed oil of almond and stronger rose water, with a little borax to whiten the preparation. Employed for its softening effect on the skin. (8) 59 Unguentum Belladonnae (Belladonna Ointment). — Used to obtain the anodyne effect of belladonna and to check secretion. Frequently combined with mercurial ointment. Unguentum Hydrargyri (Mercurial Ointment). — Blue oint- ment is extensively employed to obtain the constitutional effect of mercury by inunction. It is best prescribed in 5ss-i papers, and is to be rubbed well into the skin by the patient himself The cus- tomary remedy in pediculosis pubis. Unguentum Zinci Oxidi (Ointment of Zinc Oxide). — Popularly known as zinc ointment. Used wherever a mild astringent and desiccating effect is desired. Owing to the tendency of fatty substances to become rancid, ointments are almost of necessity extemporaneous preparations. Petrolatum is a basis resembling fat, but which is really a hydrocarbon, and of such firm chemical character that it can be distilled unchanged with sulphuric acid. It is absolutely permanent in air, and has become a popular excipient for those ointments which are intended merely as local or protective dressings : it is no more absorbed by the skin than it is assimilated when placed within the system. Many chemicals can be combined with it, and it is of such consistence that it readily melts at the temperature of the body. Ointments are prepared by reducing the solid ingredients to a fine powder, mixing this with a portion of the fatty basis, and finally incorporating the rest of the latter, the process being conducted in a mortar or on a pill tile. When a solid fat i" to be added for greater firmness, the ointment is made by fusing the several ingre- dients at as low a temperature as possible, and stirring it until it congeals. Care should always be taken that any solid substance be reduced to a very fine powder, so that the finished preparation be perfectly smooth ; also that the ointment is perfectly free from ran- cidity, as otherwise it will cause positive harm by direct irrita- tion. Petrolatum of itself constitutes a good dressing for wounds, if rendered sterile by a temperature of 240° F. for one hour. It is prac- tically made aseptic by heat and sulphuric acid during the process of purification, but becomes reinfected before it reaches the con- sumer. Five per cent, of carbolic acid may be added to it to make it antiseptic, and the addition of boric acid converts it into the boric ointment which is used so extensively in minor surgical work. 6o TROCHISCI— TR OCHE S. ?■--<: Trochisci (or Troches) are lozenges ; medicinally they are employed to convey drugs that produce their effect by slow solution in the mouth. Thislclass is prepared almost exclusively on the large scale, and differs from compressed tablets merely by the fact that the latter are intended to be swallowed whole. The fol- lowing official troches are used for mild medicinal effect, each one containing small proportions of the respective drugs : Troches of ammonium chloride, troches of glycyrrhiza and opium (Wistar's lozenges), troches of potassium chlorate, and troches of santonin (worm lozenges). ^ CERATA— CERATES, if Cerata (or Cerates) are somewhat firmer than ointments, so that they may be spread on linen or other material. Two of the official six cerates are used to some extent. Ceratum Cantharidis (Cantharides Cerate) is ordered by the physician when he desires to prescribe a blister. The size of the latter is indicated as follows : B Emplastrum vesicatorium 2' x 2' S. Apply locally. Dr. . Ceratum Resinae (Resin Cerate, or Basilicon Ointment) is used as a gently stimulating application to old ulcers and burns. \EMPLASTRA— PLASTERS. 1^ Emplastra (or Plasters) are preparations for external use, of such consistence that they soften, but do not melt at the tempera- ture of the body. They are spread on some suitable material and are much used by the laity, though they are rarely prescribed by the profession. The most popular of the thirteen ofificial plasters are those of arnica, belladonna, capsicum, mercury, isinglass, lead, resin and soap. Of these, isinglass and resin plaster are more commonly ilOCHEMfSTRY DEPT. 6i known by the names of court and adhesive plaster ; the latter is also known as surgeon's adhesive. The use of plasters by physi- cians to-day has almost narrowed down to purposes of support and protection only, and the preparation of plasters is in the hands of the large manufacturers. Man)^ therapeutists entirely disclaim any medicinal effect on the part of plasters. CHARTAE— PAPERS. Chartae (or Papers) are prepared by impregnating paper with a medicinal substance. Both official papers are much used. Charta Potassii Nitratis (Potassium Nitrate Paper, or Salt- petre Paper), is an efficient remedy for the temporary rehef of asthma. It is made by saturating unsized paper with a concentrated solution of potassium nitrate. The dried paper burns slowly and the nitrous fumes given off, when inhaled, cause a relaxation of the spasm during the asthmatic spell. Charta Sinapis (Mustard Paper) is made by spreading pow- dered black mustard on paper; it should be dipped in warm water before it is applied to the skin for its counter-irritant effect. SUPPOSITORIA— SUPPOSITORIES. Suppositories are cone-shaped bodies, weighing about i gramme, intended for administration per rectum. Occasionally they are employed to medicate the urethra and vagina; the urethral s,\x^- pository weighs about i gramme and is pencil-shaped, while the vaginal suppository weighs about 3 grammes and is globular in shape. Rectal suppositories may be said to meet three different indi- cations : 1. To unload the bowel. <^H <^^^ ' 2. To medicate surrounding structures. (i^j^-^i^^-'yyMy^ru 3. To produce a constitutional effect. CC^^v^'^ The official glycerin suppositories illustrate the first class. They produce their laxative effect by irritating the mucous coat of the rectum. 62 Drugs like camphor, chloral, etc., may be given by suppository to subdue irritation of the surrounding organs ; the use of camphor by suppository in the treatment of chordee will serve as an example. The systemic effect of a remedy can in many instances be obtained by introducing the substance into the rectum, though the action is slower and a relatively larger dose is required than when the drug is administered by way of the stomach. This method is preferred when there is great irritability of the stomach, when the patient is delirious and in case the bulk of the dose is too great or the remedy too irritating to admit of hypodermatic administration. Suppositories may be made by moulding, by rolling, or by^ confipressjon. In the preparation of the moulded suppositories the ingredients are fused together at as low a temperature as possible and the liquid mass poured into specially constructed moulds, which have been chilled thoroughly and which are absolutely dry. This is best accomplished by placing the moulds on ice and allow- ing them to become perfectly cold ; then the mould is freed perfectly from moisture and the melted mixture poured in carefully. Each separate compartment is filled to overflowing to allow for contrac- tion in the mass as it cools. The moulds are replaced on the ice and again thoroughly chilled before being opened. The finished suppository should be of such a nature that it melts readily at the temperature of the body, but remains perfectly solid at ordinary temperatures. The best basis is found in oil of theobroma, the official Oleum Theobromatis ; it is the fixed oil ex- pressed from the seed of Theobroma Cacao, or the "chocolate nut." The oil consists of a mixture of fats, having an agreeable chocolate- like odor and characterized by melting to a thin liquid at the tem- perature of the body, but congealing to a perfectly firm, hard solid a few degrees below this point. In the hottest summer weather, it becomes necessary to incorporate with the oil of theobroma a small amount of stearin, so that the suppositories do not melt before in- troduction. Suppositories are conveniently dispensed in pasteboard boxes fitted with compartments, with the caution that they be kept in a cool place. Rolled suppositories are prepared by incorporating the medi- cinal substance with the "cacao-butter" in a mortar, and shaping the mass into a cylinder similar to the one made in the manufacture of 63 pills. The cylinder is cut into sections, and each section given the required form by manipulation with the fingers. Pressed supposi- tories are made by mixing the mass in a mortar and then pressing it into proper shape by compression in a small machine. The ad- vantage claimed for rolled and pressed suppositories is that no heat is used in their preparation, but oil of theobroma melts at so low a temperature that by careful manipulation little danger of injury arises from this source. The moulded suppository always presents the neatest appearance, if carefully prepared. Suppositories are usually made extemporaneously at the order of the physician, though large quantities of glycerin suppositories are prepared by the manufacturer. They contain sodium carbon- ate and stearin if made by the official process. CAPSULAE— CAPSULES. (Unofficial) Capsulae (Capsules) form a safe and convenient method of exhibiting remedies offensive to the taste or nauseating to the stomach. They are used for the administration of liquids or solids and are made of gelatin, which dissolves easily in the gastric juices and has no medicinal action of its own. Volatile oils and similar irritating liquids are especially suited for administration in this form, and large quantities of oil of sandalwood, oil of cubebs and of copaiba are thus prepared by the manufacturing pharmacists. Capsules may also be filled extemporaneously with powders at the direction of the physician. For this purpose the capsule is made of two parts, a body and a cap ; the body is filled with the powder and the cap is firmly applied, care being taken to carefully wipe off any adhering powder from the capsule. Several methods are employed to fill capsules : in one a mass is made of the powder, this is divided into little cylinders and each cylinder enclosed in a capsule. A preferable method consists in introducing the dry pow- der, either by means of a little funnel (capsule filler) or by picking it up with the body of the capsule, after sub-dividing it into the required number of parts. Capsules present the advantage over pills of containing a dry powder, which is at once mixed with the gastric contents by disin- 64 tec^ration of its gelatin covering ; also, on account of the facilit\- with which capsules can be swallowed, a much larger bulk of anv substance can be conveniently administered in that shape, than in the form of pills. CACHETS. ^^ y. (Unofficial) Cachets, or cachets de pai?i, are concave di.scs of wafer-sheet, so constructed, that two can be joined together to enclose a dry powder. They represent, beyond question, the most elegant method of administering bitter or nauseating substances and offer the additional advantage that a relatively large dose can be taken in this manner — ten grains of quinine sulphate can be enclosed in a cachet and swallowed more easily than a five grain pill of the same drug. Cachets are made from wafer-sheet ; they are filled by dampening the free edge of one disc, introducing the dry pow- der and applying a second disc, so that its concave surface corres- ponds to that of the first. A little pressure will cause them to cohere and the powder is enclosed firmly in a material, which is brittle and firm when dry, but soft, slippery and perfectly soluble when moistened by a liquid. The cachet is taken by suspending it for an instant in water (until it softens), placing it upon the tongue and taking immediately, a mouthful of water, when the cachet will slip down as readily as a raw oyster. The principle reason why cachets are not more universally employed lies in their expense; their preparation in ordinary quan- tities necessitates the use of high-priced apparatus.* A simple and inexpensive method to reach the same end, lies in the use of the wafer-sheet sold by pharmacists. The patient is directed to float a piece of this wafer-sheet, of suitable size, on a glassful of water; as soon as it softens, to pick it up carefully from below with a spoon, and to place the dry powder in the hollow produced ; the free edges of the sheet are now folded carefully over the powder, and the whole may be swallowed before the latter has a chance to dissolve. *'rhe name konseals has been suggested for the cachets filled extemporaneously by the appHvatusof an American firm. IN COMPATIBILITY . Medicinal s ubstances are said to be incompatible when they do not mix w ithout change in their chemical^ p hysical, or th erapeut ic p^^-^ — '^^ properties. Accordingly, all incompatibilities may be divided into three classes : / I. Chemical. J II. Physical. / III. Therapeutic. Chemical incompatibility results when chemical substances are combined, which mutually precipitate each other, form explosive compounds, liberate volatile ingredients, or react in any manner so as to form new compounds. Obviously, the range of chemical incompatibility includes the whole field of chemistry and a knowl- edge of the latter is absolutely necessary to avoid the combination of conflicting substances ; nearly all the commonly occurring mix- tures which are troublesome, may be arranged under one of the following subdivisions : 1. Chemicals which form explosive compounds. 2. Solutions of chemicals, which when mixed, form insoluble precipitates. 3. Salts of the alkaloids with alkalies, and with many of their salts, particularly their carbonates, iodides and bromides. 4. Mineral acids with salts of weak or volatile acids, such as the carbonates, acetates, etc. 5. Alkaloids, albumen and gelatin, with tannic acid and with preparations containing the same (infusions, decoctions, tinctures and fluid extracts). 6. Preparations containing free acetic, citric, or tartaric acid, with carbonates. 7. Vegetable infusions, decoctions, tinctures and fluid extracts containing tannic or gallic acids with preparations of iron, and of the metals in general. An instance of the first class, the formation of explosive com- pounds, is found when readily reducible substances, like potassium chlorate or potassium permanganate, are triturated with sulphur or organic matter, which is readily oxidized. (65) 66 2. The precipitation of one substance by another, in solution, is usually unintentional, but may be intentional, as in the following prescriptions : LoTio Nigra (n. f).* BLACK WASH. Hydrargyri Chloridi Mitis 5j gr- iv Aquae f5ss Liquoris Calcis quantum sufficit ad Oj Misce secundum artem. Signa : Shake well. Use as a wash. Lead Water and Laudanum. ^ . . . Liquoris Plumbi Subacetatis f^ss Tincturae Opii fiss Aquam ad Oj Misce. Signa : Shake well. For external use. In the first prescription the black mercurous oxide precipitates • in the second, the precipitate is of indefinite composition but con- tains active constituents. Neither of these formulae will permit filtration without loss in therapeutic effect. 3. Precipitation of an alkaloid occurs when an alkali or alkaline salt is added to a solution of the former : Ammonii Carbonatis 3Jiss MorphinaeSulphatis gf- ij Aquae Menthae Piperitae f Jiv Misce. Signa : A teaspoonful every four hours. The danger of such a prescription lies in the separation of the alkaloid — if the mixture is not well shaken before each admin- istration, all the morphine may be taken in the last dose. *National Formulary. This contains a number of unofficial, but well-known and largely nsed formulae, recommended by the American Pharmaceutical Association. (9) ( 67 ■' 4- Mineral acids liberate the chemically weak or volatile acids, as in the following prescription : Sodii Salicylatis 3ijss Acidi Sulphurici Aromatici • . . . . f5ij I Aquae Menthae Piperitae . . quantum sufficit ad f^iv Misce. Signa : A teaspoonful every four hours. The salicylic acid is set free and precipitated, because it is sparingly soluble in water (450 parts). 5. Alkaloids, albumen and gelatin are precipitated by tannic acid. Morphinae Sulphatis .... gr. j Tincturae Catechu Compositae f 5ij Syrupi Zingiberis, Aquae Menthae Piperitae partes aequales ut fiant . f ^ij Misce. Signa : A teaspoonful three times a day. Tannate of morphine is precipitated by the tannic acid con- tained in the compound tincture of catechu. 6. Preparations containing free acetic, citric or tartaric acid, are incompatible with carbonates. The following have often been im- properly prescribed together : B Ammonii Carbonatis 3ij Ammonii Chloridi 3ij Syrupi Scillae fSj Syrupi Pruni Virginianae f 3ij Misce. Signa : A teaspoonful four times a day. Syrup of squill is made from the vinegar of squill and contains acetic acid ; this decomposes the ammonium carbonate, with evolu- tion of carbonic acid gas. Syrup of garlic is another expectorant syrup made from a vinegar and furnishes the same reaction. 7. Vegetable preparations are incompatible with solutions con- taining iron or the heavy metals in general. This is one of the most common forms of improper combination, as nearly all infusions. 68 decoctions, tinctures and fluid extracts contain tannic acid, which yields an inky precipitate with iron. B Potassii Acetatis 3 'iss Tincturae Digitahs f 3 '•''S Liquoris Ferri et Ammonii Acetatis fSviij Misce. Signa : A tablespoonful after meals. The tannic acid of the tincture combines with the iron of the Basham's mixture, forming an inky preparation. The remedy would be to omit the iron, using instead the solution of ammonium acetate, and to give the iron separately. Physical INCOMPATIBILITY arises when precipitation takes place in preparations without chemical change. This is usually due to a change in the menstruum ; it occurs when alcoholic preparations, such as tinctures, fluid extracts and spirits are mixed with liquids containing water, as the solutions, waters, infusions and decoc- tions. Alcohol especially precipitates albumen, gum and starch from aqueous solutions, while resins are especially insoluble in water. It follows, therefore, that the degree of precipitation is largely dependent on the percentage of alcohol in the alcoholic liquid and that of water in the aqueous preparation ; also, that it is most pronounced w^ien a resinous tincture is added to an aqueous liquid. Occasionally, precipitation occurs when tinctures are mixed which only differ slightly in the percentage of alcohol they con- tain ; it takes place, in most cases, when tinctures are mixed which differ considerably in the amount of alcohol contained in their men- struum. The precipitate may be active or inert according to circum- stances ; it is usually inert, though every deposit occurring in pharmaceutical preparations has a tendency to carry down a part, at least, of the active principle. Often the combination of decoc- tions, infusions, solutions and waters, with tinctures, fluid extracts and spirits, results only in the precipitation of gum, starch, albumen, coloring matter, or other inert material and the mixture may be filtered without serious loss in therapeutic strength ; at other times active ingredients, like the resins, may be thrown out of solution and the preparation must be dispensed in an unfiltered condition, with the directions to shake well before usingf. 69 The following formula is an example of physical incompati- bility : Pepsini 5i Tincturae Nucis Vomicae fjiij Tincturae Gentianae Compositae quantum sufficit ad f^vi Misce. Signa : A teaspoonful before meals. Pepsin is insoluble in a strongly alcoholic medium and forms a coagulum, which cannot be mixed with the liquid. Therapeutic incompatibility occurs when substances are prescribed together which have opposite physiological effects. PRESCRIPTION WRITING. A prescription is the written statement of the physician to the pharmacist for the compounding of one or more medicines, together with the directions to the patient for taking them. This is the present acceptance of the term, though in former times it included all the directions given as to the treatment of the patient, whether medicinal or otherwise. Latin has always been the medium of communication between the physician and the apothecary, and it is the universal custom in nearly all civilized countries to employ the conventional official Latin names in addition to certain peculiar phrases which have been handed down to us by custom. The advantage of this is apparent; such a prescription calls for the same ingredients the world over ; the Latin title is brief and definite, is not liable to change and always defines a certain drug with no possibility ot mistake, as in the case of the synonyms in common use. Further- more, it is sometimes necessary to keep a patient in ignorance of what he is taking, on account of peculiar prejudices occasionally met with. The prescription in its simplest form, written in the English language, may appear as follows : Take of Ammonium Bromide 30 grains. Antipyrin 5 grains. Solution of Potassium Arsenite .... 5 minims. Peppermint Water, sufficient to make one tablespoonful. This is a single dose. The formula is to be given in the treatment of epilepsy and must be administered continuously for weeks or even months. Therefore, the above proportions must be multiplied, preferably so as to fill one of the vials of standard size found in all drug stores: these are of yi, i, 2, 3, 4, 6, S and 16 ounces capacity. We will suppose that a 6 ounce vial has been (70) 71 selected. This contains twelve tablespoonfuls. The formula, with certain other additions found in the typical prescription, will now read : For Mr. . Take of Ammonium Bromide . . 30 grains X 12 = 360 grains. Antipyrin 5 grains X 12 = 60 grains. Solution of Potassium Arsenite 5 min. X 12 = 60 minims. Peppermint Water, suffi- cient to make . . y^ fluidounce X 12 = 6 fluidounces. Dissolve and mix. Label : A tablespoonful in the morning and evening, after meals. I. 29. '98. Dr. . This is to be translated into Latin. It is customary to use the signs denoting the quantity and to reduce the latter down to the lowest possible denomination. The Latin names for the ingredi- ents are Ammonii Bromidum, Antipyrinum,* Liquor Potassii Arsenitis and Aqua Menthae Piperitae ; "take of" becomes "recipe," and " sufficient to make six fluidounces" is translated " quantum sufficit ad (or, ut fiant) f ovi." " Label " becomes " Signa," " dissolve and mix," " Solve et misce." The prescription is preceded by the name of the patient, and the signature of the physician appears below, with the date. Recipe is abbreviated R. It is the imperative mood, second person singular, of recipio, recipere and is followed by the accusative case. Properly speaking, the prescription reads : Take six drachms (or 360 grains) of Ammonium Bromide — Recipe drachmas sex Ammonii Bromidi, in accordance with the rules of classic Latin grammar. The quantity is almost invariably expressed by the conventional symbols, gr., 9,t 5, ^, lb., "l, f3, fS, Oj, thus effect- ing a considerable saving of time; the names of the drugs are always in the genitive case, unless the quantity be omitted. Finally, instead of calculating the actual amount of Peppermint Water necessary to produce the required volume, f I vi, we simply say " quantum sufficit ad (or, ut fiant) f S vi," making in all six fluid * Or Phenazonum, British Pharmacopoeia. This coal-tar product is not official in our Pharmacopoeia, because it is a proprietary article. t 9, the scruple i'i rapidly passing out of use. There is too much likelihood of mistaking it for a carelessly written 5 and gr. xx are usually found quite as convenient. 72 ounces or 12 tablespoonfuls ; each tablespoonful contains the proper amount of each ingredient. The quantities are denoted by the symbols and Latin numerals; the latter should be legibly written, the i's carefully dotted and the last i lengthened into a j, for greater accuracy — thus, gr. viij, grana octo. Measure is expressed by the prefix f before the symbol f5, f5, and in this country solids are generally prescribed by weight, and liquids by measure. Follow- ing this, are the directions to the compounder " dissolve and mix,'' or " solve et misce," and the " signatura " or directions to the pa- tient, with the signature of the physician, and the date. The finished prescription, in unabbreviated Latin, may be cor- rectly written as follows : For Mr. . R Ammonii Bromidi 5vi Antipyrini 3 ' Liquoris Potassii Arsenitis f 5 i Aquae Mcnthae Piperitae . . quantum sufficit ad f ,5vi Solve et misce. Signa : A tablespoonful in the morning and evening, after meals. I. 29. '98. Dr. . This is a complete prescription, distinguished as compound from the formula containing but one ingredient and hence called simple. The different parts of a typical prescription have received the following names : 1. The^Syp_EgscRiPTiONj or heading. 2. The Ins cription, or the names of the ingredients. / _j V-^ A 3. TH V Subscription^ or the directions to the apothecary. I \}^ ^ 4. T he Signature , or the directions to the patient. I - 5. The name of the patie nt, ^ have received no special r 6. The name of the physician, > name, but are equally 7. The date, J important. The name of the patient usually appears at the top of the sheet. It is often omitted, but its presence is a safeguard against possibility of mistake and there is commonly no objection on the part of the patient to its appearance on the prescription and label. Frequently medicines may be ordered for two or more .U->^' -Ld f) . <'V' t^X-^ifc 73 members of the same household. Although fatal mistakes are rare if the medicines intended for adults are interchanged, an entirely- different question arises when adults and children are prescribed for simultaneously. Not rarely the safe adult dose may kill a child and particularly is this true of opium or morphine. Special precautions should be used in such cases. The bottles may be ordered of different size and the liquids of different color, or two entirely different forms of administration may be chosen, such as the pill or capsule for one, and the liquid form for the other. The Superscription (or Heading) is composed of the abbrevi- ation R*, for the Latin word recipe (take thou). A little stroke at the end of the R is by some regarded as a remnant of the p in recipe, but most authorities refer to it as a combination of the sign of Jupiter 11 and the initial letter of the Latin imperative in question. In ancient times, when medicine was in the hands of the priests, a prayer pre- ceded the prescription ; this gradually narrowed down to the em- ployment of various symbols with similar meaning, until at the present day nothing but the stroke at the end of the R is left of the invocation to the divinity. The Inscription contains the names and quantities of the ingredients in pharmacopoeial Latin. These may be confined to a single medicinal substance, in the simple, or may represent a number, in the compound prescription. Custom plays an essential element in this, as in many other things — formerly many ingre- dients were deemed necessary for the proper action of a remedy, on the supposition that one of these would cure,, just as the charge from a shot-gun is more liable to strike than the single ball from a rifle.f To-day the tendency lies in the opposite direction. From the use of the noted Confection of Theriac, with its 365 ingredi- ents, by our ancestors, we have come down to the employment, frequently, of single remedies. In many cases this may be advisa- ble to determine the effect of a single drug, but it must not be forgotten that by proper combination the crossed action or combijied effect of several substances can be obtained to great advantage. It was more especially during the middle ages, rather than in ancient times, that the number of ingredients in prescriptions increased to an indefinite extent, for the maxim of Asklepiades reads curare cito, * In France, P or Ps, for prenez, is not uncommonly substituted. t They have not improperly been called shot-gtin prescriptions. 74 iuto, et jucuiidc, to cure quickly, safely and pleasantly; this is recjardcd, even at the present day, as the typical order of sequence in the complete inscription. The latter is subdivided into: / I. TJi g Basi s (curare) or most important medicinal substance. I 2. The Adjuvant (cito) or Assistant. 3. The Corrective (tuto) or Corrigent. 4. The Vehicle (jucunde) or Diluent.* The Basis (or main active ingredient) is the substance from which the greatest curative action is expected {citrare). In the pre- scription mentioned, ammonium bromide is relied upon to decrease or prevent the paroxysmal convulsions of epilepsy and is exhibited in///'// dose. The Adjuvant (or Assistant) is supposed to combine its own action with that of the basis, in order that it may cure more quickly (curare cito). Antipyrin possesses anti-spasmodic properties, and is added in moderate dose to augment the action of the ammonium bromide. The Corrective (or Corrigent) corrects some untoward effect obtained from either basis or adjuvant. Ammonium bromide possesses the peculiarity common to bromides, of producing an eruption of acne when administered for a prolonged period of time. Solution of Potassium Arsenite (Fowler's solution) will prevent this, and is therefore given with the bromide and antipyrin (curare tuto, safely). ^.c^^-M^.O'lxy-^-' The Vehicle (or Diluent) finally fulfills the last requirement of the maxim, that of curing pleasantly (curare jucunde). Ammonium bromide has a veiy salty taste, and to hide this as well as to counteract the effect of salines in producing nausea or indigestion. Peppermint Water is selected, so as to make the preparation as pleasant as possible. The vehicle or diluent becomes the excipient when the prescription calls for solids to be dispensed in the form of pills. Both vehicle and excipient are usually devoid of active medicinal properties and may be selected according to the taste of the prescriber or the special indications of the case. The Subscription consists of the directions to the compounder. These were formerly quite extensive, but the advance in modern pharmacy merely calls for the use of a few brief expressions. ♦The excipient, if the preparation be solid. (10) 75 Misce, fiat mistura, so've, fiat infusum, may be taken as examples. The subscription always appears in Latin. The SiGNA, SiGNATURA (or the Directions to the Patient), follow the subscription. TJiey should be written in plain English^ in unabbreviated form. This apparent deviation tromthe rule rests on a very sound basis. A well-marked element of danger is found in the writing of all prescriptions, that of the possibility of making mistakes : another arises during the compounding of the formula. The most careful prescriber and the most conscientious compounder are each liable to err occasionally and therefore the chance of mis- take should be reduced to a minimum. There are many reasons why the inscription should appear in Latin, but there is not a single good excuse why the patient should not be able to easily read the directions which are to appear on the label. The names of domestic measures in Latin are awkward and their translation multiplies the chances of error; besides, the patient usually scans the prescription closely and knows the directions by the time the latter reaches the compounder, even if he has forgotten the verbal advice as to administration. A mistake sometimes made by the pharmacist — and the one which occurs most frequently while transposing the directions — is to write table for teaspoonful, thus multiplying the dose by four. If the directions are written in English, this error is more apt to be noticed. The signature should not only be in English, but should be written out in full ; it is the only means by which the druggist can determine whether the formula contains a poisonous dose. The signature " use as directed " is careless, inelegant and dangerous ; the patient frequently forgets the verbal instructions and can obtain no clue as to the proper method of administration from the label or from the pharmacist. It forms a positive element of danger ; mistakes in the proper dosage occur more frequently than is generally supposed, but are referred back to the physician for correction if the dose is indicated in the directions ; without the latter the pharmacist has no possible way of reviewing the calcula- tions of the prescriber. Sometimes the signatura might disclose the diagnosis and in such cases can be altered to make the use of the formula less appa- rent ; so " use as a wash " may be substituted for " use as an injection." The wash may be for the eye, skin, urethra or vagina and the compounder need not be made aware of which one of these is affected. 76 Occasionally, unusual doses must be prescribed. These may be indicated by the exclamation mark, by the use of the abbrevia- tion Q. R. (quantum rectum, the correct quantity) or by under- scoring the quantity. For Mr. . For Mr. ^—. * Morphinae Sulpha- Morphinae Sulphatis . gr. viij tis gr. vjQ.R. Syrupi Aurantii . . . fSj Sacchari . . . . gr. xxiv. n/r- o- ^ „. , , ^ , ,-r . Misce. bigna : One teaspoonful Misce. Fiant chartulae No. vj. . ° , ., ^,. „. ^ , ,, „. everv tour hours until relieved. Signa : One powder at bedtime. I. 27. '98. Dr. . 1.27. '98. Dr. . ™, . ... 1 » u This prescription not to be This prescnption not to be r r J , . „ renewed, renewed unless specially ordered. These prescriptions contain one grain of morphine in each dose, or from four to six times the usual quantity. The note at the bottom prevents the patient from obtaining a renewal without the knowledge or consent of the physician. Such a procedure may become imperative when opiates are employed in the treat- ment of patients afflicted with chronic disease, to avoid the danger of contracting the morphine habit. The signature of the physiciatt and the date finish the pre- scription, which should also contain the printed address and the office hours of the prescriber. In case of doubt or actual error, much valuable time can be saved by at once referring the matter to the physician, and time is frequently of value in those cases in which unusual doses must be given. The signature of the physi- cian is best written in full. The date should not be omitted, as it may form a guide for reference. Instead of employing the full Latin official titles, it has become the custom to abbreviate largely. This habit has produced many fatal mistakes, but rather from the use of faulty or illegible abbrevi- ations than otherwise; it is not very apt to cause confusion, if the latter are properly and carefully used, though naturally the best and most elegant method is found in the use of the proper Latin terms. So Hydr. Chlor. can be interpreted Hydrate of Chloral or either of the Chlorides of Mercury, Hydrargyri Chloridum Corrosivum and (ja^ I 77 Hydrarp^yri Chloridum Mite. The corrosive chloride of mercury is a violent poison in the doses in which chloral is still safe, while the same quantity of the mild chloride of mercury or calomel is harmless. // slionld be an invariable rule to employ abbreviations only zvhcn no possible chance of doubt or error may arise front their use. The following phrases are frequently made use of in prescrip- tion writing : Fiant chartulae No. xij. Fiat massa in pilulas No. xij dividenda. Divide in pilulas xij. Dispensa in capsulis. Fiat pulvis. Dispensa tales doses No. xij. Occasionally, a single dose is ordered and the direction given to dispense a certain number of doses : R For Mr. Massa Hydrargyri, Pulveris Scillae, Pulveris Digitalis . . . . aa gr. j. Misce. Fiat pilula. Dispensa tales pilulas No. xxiv. Signa : One pill three times a day. 2. 14. '98. Dr. Official pills may be written for as follows : R For Mr. Pilulas Catharticas Compositas No. xxx. Signa : Two pills at bedtime. 2. 14. '98. Dr. In the first formula the subscription reads : Mix. Let a pill be made. Dispense twenty pills like this. In the second prescrip- tion the apothecary is directed to dispense thirty compound cathartic pills, the official name appearing in the accusative case. THE METRIC PRESCRIPTION. The use of the metric or decimal system is increasing so rapidly in this country that the United States pharmacopoeia adopted it for all of its formulae at the revision of 1890. It is, however, by no means in general use, and metric prescriptions are still rarely seen ; the importance of knowing this system, as well as the various systems in common use, is evident. There are some features connected with the decimal system which particularly qualify it for the writing of prescriptions. The two units, Gm. and C.c. are sufficient to express all the quantities usually prescribed ; these abbreviations are not likely to be misun- derstood or confounded ; calculations with these units are made as rapidly as those of dollars and cents. The disadvantages are that 10 cannot be subdivided more than once without producing a frac- tion ; in the troy system the basis of calculation is usually 8 or a multiple of the latter and 8 can be divided a number of times before it yields a fraction. Again, a mere fly-speck or speck of dust may divide or multiply the amounts by 10, 100 or 1000, though this may be obviated by the use of a comma or of the decimal line in- stead of the period. The same grammatical rules apply to the writing of metric and troy prescriptions, but the quantities are always expressed in Arabic numerals. The following are examples of prescriptions expressed in the metric weight : For Mr. For Mrs. B B Ammonii Chloridi . . Gm. 8.0 Pulveris Sennae . . Gm. 18.0 Syrupi Senegae . . . C. c. 8.0 Pulveris GlycyrrhizaeGm. 23.6 Syrupi Pruni Virginianae Sulphuris Loti . . Gm. 8.0 sufificit ad quant, . C. c. loo.o Olei Foeniculi . . . Gm. 0.4 _,. Sacchari Gm. 50.0 Misce. Signa : One teaspoonful every Misce. Dispensa in scatula. three hours. Signa : A teaspoonful in water I. 27. '98. Dr. . at bedtime. 1.27. '98. Dr. . (78) 79 Two methods may be used in writing these formulae, respec- tively known as the gravimetric and volumetric ; in the former the solids and Hquids are both weighed, in the latter the liquids are measured. Volume and weight bear a definite ratio to each other in the metric system, the cubic centimeter of water, weighing a gramme at 4°C. This is true only of water, and pharmacopoeial liquids vary extensively in specific gravity, so that the gramme loses its relation to the cubic centimeter. Glycerin has a specific gravity of 1.25, syrup of 1.3 1, alcohol of .820 and ether of .725 ; in other words 100 C. c. of glycerin will weigh 125 grammes and 100 C. c. of ether 72.5 grammes. As medicines are invariably adminis- tered to the patient by volume, it is always desirable to know the finished quantity by measure of any liquid prescription, in order to correctly estimate the number of doses contained in it. If the liquids are prescribed by weight, a calculation becomes necessary ; their specific gravities must be compared with that of water and a determination made in each case as to how much a given quantity by weight will measure. It is evident that the present custom of adhering to the use of volumetric formulae, as it is done by the pharmacopoeia and by nearly all American practitioners, is less complicated and therefore less liable to give rise to error, than the employment of the gravi- metric method which is almost universally followed in Continental Europe. It seems quite as accurate in the hands of a careful pharmacist, and it appears rational to dispense liquids by the same method by which they are administered, i. e., by volume. Gramma (plural grammata) and centimetrum cubicum have been selected as the Latin expressions for gramme and cubic centimeter, and it is recommended to adhere to the rules of Latin grammar by following the denomination by the numeral; thus, Gm. 5.0 and C. c. 5.0. The abbreviation Gm. is preferred to gm., because the latter is more easily mistaken for gr., the abbreviation of grain. GRAMMATICAL CONSTRUCTION OF PRESCRIPTIONS. A few rules of Latin grammar are applicable especially to pre- scription writing ; they may be formulated as follows : 1. The quantity appears in the accusative case (governed by Recipe). 2. The name of the drug appears in the genitive case;* if no weight or measure is expressed it appears in the accusative case. 3. Adjectives agree with their nouns in gender, number and case. Most of the pharmacopoeial nouns belong to the first, second and third declensions and change accordingly. The cases most frequently employed are the nominative, genitive, accusative and ablative. The nouns ending in a, are of the first declension and usually feminine in gender ; those ending in us, um, belong to the second declension, the first being masculine and the second neuter in gender, while the nouns of the third declension constitute the greater number of the remainder. First Declension. Singular. Nominative case, a Genitive case, ae Accusative case, am Ablative case, a Plural. Nominative case, ae Genitive case, arum Accusative case, as Ablative case, is is, is atibus, idibus, itibus The nouns of Greek derivation ending in a form a genitive of ATis and a nominative plural of ata. This applies especially to Aspi- dosperma. Enema, Gargarisma, Gramma, Theobroma and Physo- stigma. The nouns of Greek derivation ending in e, form a genitive of ES and an accusative of en — Aloe, Aloes, Mastiche, Mastiches. * Exception : J^-', Hydrargyri cum Creta 5ij, creta remaining in the ablative case. f8o) Second Declension. Third Declension. Masculine, Neuter. Sir gular. Singular. us. um as, is. is i, i atis. idis, itis um. um atem. idem. item 0, ate, ide. ite Plural. Plural, h a ates. ides. ites orum , orum atum. idum. itum OS, a ates. ides. ites 8i A few nouns terminating in us do not belong to the second declension : Rhus becomes Rhois, and Fructus, Cornus, Quercus and Spiritus are of the fourthdeclension. The latter have the same termination for the nominative singular and plural, and the genitive singular, i. e. us. The accusative singular ends in um, the ablative in u, while the accusative plural ends in us and the ablative in ibus. With the exception of Spiritus, they are seldom employed. So many different terminations are found for the nominative singular of the third declension, that no definite rules can be given ; AS changes to atis (exception Sassafras, indeclinable). The ending IS may become is, idis, eris or itis for the genitive and the indi- vidual words must be noted separately. But one noun of the fifth declension is used in prescription writing — dies, a day, as in bis in die, or ter in die, twice daily or three times a day. Words of barbarous origin do not change. Among these Sassafras, Buchu, Catechu, Matico, Kino and Cusso may be men- tioned. Adjectives must agree with their nouns in number, gender and case. Adjectives ending in us, take on the termination a for the feminine and um for the neuter gender; they are declined according to the first and second declensions. Adjectives ending in is are of the third declension, this denoting bath the masculine and feminine genders, while they take the termination e for the neuter. Adjec- tives (or participles) terminating in ens have the same ending for all genders and change according to the third declension. The following list contains the nouns and adjectives of the United States and British Pharmacopoeias : Abrus, i Acidum, i Absinthium, ii Benzoicum, i Absolutus, a, um Boricum, i Acacia, ae Carbolicum, i Acetanilidum, i Carbonicum, i Acetas, atis Chromicum, i Acetonum, i Citricum, i Acetum, i Formicum, i Achillea, ae Gallicum, i Acidum, i Hydriodicum, i Aceticum, i Hydrobromicum, i Arsenosum, i Hydrochloricum, i 82 Aciduni, i Hydrocyanicum, i (dilutum) Hydrofluoricum, i Hypophosphorosum, i Lacticum, i Nitricum, i Nitrohydrochloricum, i Oleicum, i Oxalicum, i Phosphoricum, i Picricum, i Salicylicum, i Sulphuricum, i Sulphurosum, i Tannicum, i Tartaricum, i Valerianicum, i Aconitina, ae Aconitum, i Adeps, adipis Aequalis, is, e, adj. Aether, eris Aethereum, ei Albus, a, um Albumen, inis Alcohol, indeclinable or Alco- holis Alcoholicus, a, um Alcoholisatus, a, um Allium, ii Aloe, es Aloinum, i Althaea, ae Alumen, inis Aluminum, i Amarus, a, um, Americanus, a, um Ammonia, ae Ammoniacum, i Ammoniatus, a, um Ammonium, ii Amygdala, ae Amyl, indeclinable Amylicus, a, um Amylum, i Anethum, i Animalis, is, e, adj. Anthemis, idis Antimoniali^, is, e, adj. AntimoniunJ, ii Apocynum, i Apomorphina, ae Aqua, ae Argentum, i Armoracia, ae Arnica, ae Aromaticus, a, um Arsenas, atis Arsenis, itis Arsenum, i Asafoetida, ae Asclepias, adis Aspidium, ii Aspidosperma, atis Atropina, ae Aurantium, ii Aurum, i Avena, ae Bacca, ae Balsamum, i Barbadensis, is, e, adj. Barium, ii Berberina, ae Bela, ae Belladonna, ae Benzinum, i Benzoas, atis Benzoinatus, a, um Benzoinum, i Bergamotta, ae Betula, ae Bicarbonas, atis Bichromas, atis Bimeconas, atis Bismuthum, i Bisulphas, atis Bitartras, atis Boras, atis Borax, acis Bos, bovis (II) \ c / llromidum, i Bromum, i Bryonia, ae Buchu, indeclinable Burgundicus, a, um Butvl, indeclinable Cadinus, a, um Caffeina, ae Cajuputi, indeclinable Calamina, ae Calamus, i Calcium, ii Calendula, ae Calumba, ae Calx, calcis Cambogia, ae Camphora, ae Camphoratus, a, um Canadensis, is, e, adj. Canella, ae Caninus, a, um Cannabis, is Cantharidatus, a, um Cantharis, idis Capsicum, i Capsula, ae Carbo, onis Carbonas, atis Carbonatus, a, um Carboneum, ei Cardamomum, i Carum, i Caryophyllus, i Cascara, ae Cascarilla, ae Cassia, ae Castanea, ae Cataplasma, atis Catechu, indeclinable Caulophyllum, i Centifolius, a, um Cera, ae Ceratum, i Cerevisia, ae 83 Cerium, ii Cetaceum, ei Cetraria, ae Charta, ae Chelidonium, ii Chenopodium, ii Chimaphila, ae Chirata, ae Chloral, alls Chloras, atis Chloratus, a, um Chloridum, i Chlorinatus, a, um Chloroformum, i Chondius, i Chrysarobinum, i Cimicifuga, ae Cinchona, ae Cinchonidina, ae Cinchonina, ae Cinnamomum, i Citrotartras, atis Citras, atis Citratus, a, um Coca, ae (formerly not declined) Cocaina, ae Coccus, i Codeina, ae Colchicum, i CoUodium, ii Colocynthis, idis Compositus, a, um Confectio, onis Congius, ii Conium, ii Convallaria, ae Copaiba, ae Coriandrum, i Corrosivus, a, um Cortex, icis Creosotum, i Creta, ae Crocus, i Croton, onis Cubeba, ae Cuprum, i 84 Cusparia, ae Cusso, indeclinable Cyanidum, i Cypripedium, ii Decoctum, i Decorticatus, a, um Deodoratus, a, um Despuniatus, a, um Diachylon, indeclinable Dialysatus, a, um Dilutus, a, um Dioxidum, i Disulphidum, i Digitalis, is Drachma, ae Dulcamara, ae Dulcis, is, e, adj. Durus, a, um Effervescens, entis Elastica, ae Elaterium, ii Elaterinum, i Elemi, indeclinable Elixir, indeclinable, or Elixiris, plural Elixiria Emplastrum, i Emulsum, i Enema, atis Epispasticus, a, um Ergota, ae Erigeron, ontis Eriodictyon, yi Essentia, ae Ethylicus, a, um Ethylas, atis Eucalyptol, indeclinable or olis Eucalyptus, i Euonymus, i Eupatorium, ii Expressus, a, um Exsiccatus, a, um Extractum, i Farina, ae Fel, fellis Fermentum, i Ferrocyanidum, i Ferrum, i Ficus, i and us Filix, icis Fistula, ae Flavus, a, um Flexilis, is, e, adj. Flos, oris Fluidrachma, ae Fluiduncia, ae Fluidus, a, um Foeniculuni, i Foetidus, a, um Folium, ii Fortior, oris (fortis) Frangula, ae Fructus, us Frumentum, i Fuscus, a, um Fusus, a, um Galbanum, i Galla, ae Gallicus, a, um Gaultheria, ae Gelatinum, i Gelsemium, ii Gentiana, ae Geranium, ii Glaber (bri), a, um, adj. Glonoinum, i Glusidum, i Glycerinum, i Glyceritum, i Glycyrrhiza, ae Glycyrrhizinum, i Gossypium, ii Gramma, atis (plur. grammata) Granatum, i Granulatus, a, um Granum, i Grindelia, ae Guaiacum, i Guarana, ae .^ 85 Gutta, ae Gutta-percha, ae Haematoxylon, i Hamamelis, idis Hedeonia, ae Hemidesmum, i Herba, ae Hirudo, inis Homatropina, ae Hordeum, ei Humulus, i Hydrargyrum, i Hydrastina, ae Hydras, atis Hydrastis, is Hydratus, a, urn Hydrobromas, atis Hydrochloras, atis Hydrocyanicum, i Hydriodicum, i Hydrosus, a, um Hyoscyamina, ae Hyoscina, ae Hyoscyamus, i Ichthyocolla, ae Idaeus, ei Illicium, ii Impurus, a, um Indicus, a, um Infusum, i Injectio, onis Inula, ae lodidum, i lodoformum, i lodum, i Ipecacuanha, ae Iris, idis Jalapa, ae Juglans, andis Juniperus, i Kamala, ae Kino, indeclinable Krameria, ae Lac, lactis Lactas, atis Lactophosphas, atis Lactucarium, ii Lamella, ae Lana, ae Lappa, ae Larix, laricis Laurocerasus, i Lavandula, ae Leptandra, ae Libra, ae Lignum, i Limo, onis Linimentum, i Linum, i Liquidus, a, um Liquor, oris Lithium, ii Lobelia, ae Lotio, onis Lotus, a, um Lupulinum, i Lycopodium, ii Macis, idis Magnesia, ae Magnesium, ii Manganum, i Manna, ae Marmor, oris Marrubium, ii Massa, ae Mastiche, es Matico, indeclinable Matricaria, ae Medicatus, a, um Medulla, ae Mel, mellis Melissa, ae Menispermum, i Mentha, ae Menthol, indeclinable or olis Methyl, indeclinable Mezereum, ei Mica, ae Minimum, i 86 Mistura, ae Mitis, is, e, adj. Mollis, is, e, adj. Morrhua, ae Monobromatus, a, um Morus, i Morphina, ae Moschus, i Mucilago, inis Myristica, ae Myrcia, ae Myrrha, ae Naphtalinum, i Naphtol, indeclinable or olis Nectandra, ae Niger (gri), nigra, nigrum, adj. Nitras, atis Nitris, itis Nitrosus, a, um Nux, nucis Octarius, ii Oleum, ei Oleatum, i Oleoresina, ae Oliva, ae Opium, ii Opulus, i Os, ossis Ovum, i Oxalas, atis Oxidum, i Oxymel, oxymellis Pancreatinum, i Papaver, eris Panis, is Paraffinum, i Paraldehydum, i Pareira, ae Pars, partis Pepo, onis Perchloridum, i Permanganas, atis Pepsinum, i Persulphas, atis Peruvianus, a, um Petalum, i Petrolatum, i Phenacetinum, i Phenazonum, i Phosphas, atis Phosphidum, i Phosphis, itis Phosphoratus, a, um Phosphorus, i Physostigma, atis Physostigmina, ae Phytolacca, ae Picrotoxinum, i Pilocarpina, ae Pilocarpus, i Pilula, ae Pimenta, ae Pinus, i Piper, eris Piperina, ae Piperitus, a, um Pix, picis Plumbum, i Podophyllum, i Ponderosus, a, um Potassa, ae Potassium, ii Praecipitatus, a, um Praeparatus, a, um Prunifolius, a, um Prunum, i Prunus, i Pulsatilla, ae Pulvis, eris Purificatus, a, um Purshiana, ae Purus, a, um Pyrethrum, i Pyrogallol, indeclinable or olis Pyrophosphas, atis Pyroxylinum, i Quantum, i Quassia, ae 87 Quercus, us Quillaja, ae Quinidina, ae Quinina, ae Radix, icis Recens, entis, adj. Rectificatus, a, u n Reductus, a, um Resina, ae Resorcinum, i Rhamnus, i Rheum, ei Rhoeas, ados Rhus, rhois Rosa, ae Rosmarinus, i Ruber (bri), rubra, rubrum, adj. Rubus, i Rumex, icis Ruta. ae Sabadilla, ae Sabina, ae Saccharum, i Saccharatus, a, um Saigonicus, a, um Salicinum, i Salicylas, atis Salol, indeclinable or salolis Salvia, ae Sambucus, i Sanguinaria, ae Santalum, i Santonica, ae Santoninum, i Sapo, onis Sarsaparilla, ae Sassafras, indeclinable Scammonia, ae Scammonium, ii Scatula, ae, a box Scilla, ae Scoparius, ii Scutellaria, ae Semen, inis Senega, ae Senna, ae Serpentaria, ae Sesamum, i Sevum, i Silicas, atis Sinapis, is Socotrinus, a, um Soda, ae Sodium, ii Solubilis, is, e, adj. Sparteina, ae Spigelia, ae Spiritus, us Spissus, a, um Staphisagria, ae Stillingia, ae Stramonium, ii Strontium, ii Strophanthus, i Strychnina, ae Stypticus, a, um Styrax, acis Subacetas, atis Subcarbonas, atis Subchloridum, i Sublimatus, a, um Subsulphas, atis Subnitras, atis Succus, i Sulphas, atis Sulphonal, alis Sulphur, uris Sulphidum, i Sulphocarbolas, atis Sulphuratu.s, a, um Sulphurosum, i Sumbul, indeclinable Suppositorium, ii Sylvestris, is, e, adj. Syrupus, i Tabacum, i Tabella, ae 88 T.imarindus, i Taraxacum, i Tartaratus, a, um Tartras, atis Tcnuior, oris (tenuis), adj. Terebenum, i Tcrebinthina, ae Terpinum, i Tersulphas, atis Theriaca, ae Theobroma, atis Thymol, indeclinable or olis Thymus, i Tiglium, ii Tinctura, ae Tolutanus, a, um Toxicodendron, dri Tragacantha, ae Triticum, i Trituratio, onis Trochiscus, i Ulmus, i Uncia, ae Unguentum, i Uva, ae Ursus, i Ustus, a, um Valeriana, ae Valerianas, atis Vanilla, ae Vapor, oris Vegetabilis, is, e, adj. Venalis, is, e, adj. Veratrina, ae Veratrum, i Viburnum, i Vinum, i Viridis, is, e, adj. Vitellus, i Volatilis, is, e, adj. Vomicus, a, um Xanthoxylum, i Zea, ae Zeylanicus, a, um Zincum, i Zingiber, eris The following is a list of the most important expressions enter- ing into the phraseology of prescription writing : Ad prep, with ace. tO, Up tO Ad libitum, at will Adde, imp. of addere, add Ana, abbr. aa, Greek prep, with gen., of each Ante, prep, with ace, before Ante cibum, abbr. a.c. , beforemeals Bene, adv., well Bis, adv. num., twice Bis in die, abbr. bis in d., twice daily Bulliens, entis, boiling Bulliat, bulliant, subj. of buUio, let it, let them, boil Capiat, subj. of capere, let him take Centimetrum cubicum, abbr- C.c, a cubic centimeter Charta, ae, paper Chartula, ae, a small paper Cibus, i, food Cochlear, aris, ) abbr. Coch., a Cochleare, aris, j spoonful Cochleare amplum | ^ ^^p J^^f^j Cochleare magnum I _i_fygg Cochleare medicum |^ spoo^nful Cochleare modicum I r=:f^ii Cochleare parvum, a teaspoonful -f3i Cola, imp. of colare. Strain ColatUS, perfect partic. of colare, strained Collyrium, ii, an eye-wash Congius, ii, abbr. Cong., a gallon ContUSUS, i, contundere, ground Cum, prep, with abl., witll Cyathus, i, a glass Da, imp. of dare, give Detur, dentur, let there be given Decoctum, i, a decoction Divide, imp. of dividere, divide Dividatur, subj., let it be divided Dividendus, ger., to be divided Dosis, is, a dose Drachma, ae, abbr, 5, a drachm Kxactus, a, um, adj., accurate Fac, imp. of facere, make Fiat, subj. of fieri, let it be made Fiant, subj. of fieri, let them be made Filtra, imp. of filtrare, filter Fluidrachma, ae, abbr. f5, a flui- drachm Fluiduncia, ae, abbr. fg, a fluid- ounce Gargarisma, atis, a gargle Gramma, atis, plur. grammata, abbr. Gm. , a gramme Granum, i, a grain Gutta, ae, a drop Guttatim, adv., by drops Haustus, i, a draught In, prep, with ace, into In, prep, with abl., m Infusum, i, an infusion Lagena, ae, a bottle lyibra, ae, abbr. ib., a pound Manipulus, i, a handful Massa, ae, a mass Mica panis, crumb of bread Minimum, i, abbr. n\^, a minim Misce, imp. of miscere, mix Mistura, ae, a mixture Numero, adv., by number Octarius, ii, a pint Per, prep, with ace , through, by Pilula, ae, a pill Poculum, i, a cup, goblet Post, prep, with ace, after Postcibum, abbr. p. c. , after meals Pro, prep, with abl., for Pro re nata, abbr. p. r. n., as occa- sion arises Pulvis, eris, a powder Quantum, quanius, a, uin, as much as Quantum sufficit, as much as suf- fices Recipe, imp. of recipere, abbr. R, take Scatula, ae, a box Secundum, prep, with ace, abbr. sec. , according to Secundum artem, ars, artis, abbr. sec. art. , according to the art Semis, semissis, abbr. ss, a half Scrupulus, i, abbr. 9, a scruple Signa, imp. of signare, sign, label Solve, imp. of solvere, dissolve Spiritus, us, a spirit Statim, adv., abbr. stat., immedi- ately Sufficit, fr. sufficere, it SUfficeS Tabella, ae, a tablet Talis, adj., such, like this Ter, adv. num., three times Ter in die, abbr. t. i. d., three times a day Tere, imp., rub. Uncia, ae, an ounce 90 TABLE OF Latin Name. English Name. Aquae. Llqnores Solutions Waters . Syrupl. Mellita. Mucilagines, Emulsiones . . Misturae Glycerita Infuaa Decocta.. Splrltua . Syrups. Honeys., Mucilages.. Emulsions. Mixtures... Glycerites., Infusions... 1^ Decoctions. Spirits Elixir or Elixiria Elixirs Tlnctnrae ! Tinctures. Extracta flnlda. Vina. CoUodia Llulmeuta . Uleata Oleo-resinae. Aceta £xtracta.. Resinae Pulvere«... Triturationes. Mas.sae Confectiones . Fllulae Trochisci Cerata Ungneuta Emplastra Chartae Supposltorla., Fluid Extracts, Wines Collodions Liniments Oleates Oleoresins Vinegars Extracts Resins Powders , Triturations.. Masses Confections.... Pills Troches Cerates Ointments Plasters Papers , Suppositories, Menstruum. Water., Water., Water. Water., Water., Principal Ingredient. Volatile. Water Glycerin.. Water Water .. Alcohol. Alcohol (Water.) Alcohol (and Water). Alcohol Alcohol and Water. lo Wine. Ale. I, Ether 3. Oil or Alcohol.. Oleic Acid Ether. Vinegar Dil. Ac. Acid. Alcohol Ale. and Water Water. Alcohol Excipient Cacao-butter. Non- volatile Sug. and med. subst Honey and med. .. subst. Gum or other muci- laginous subst. Oil Solid in suspension. Some chemical 01 drug. Med. subst , Veg. med. subst . Volatile Sug. and med. subst Veg med. subst. ... Non-volatile. Veg. med. subst. Non-volatile. Med. subst. For Internal Use. Exceptions — Aq. Amm. Aq Amm. fort. Aq. Chlori. Aq. Hydrog. Diox. Usually Always , Always Always., Always. Always . Always. Always . Gun-cotton Med. subst Alkaloid or met. oxide. Oil, resin , Veg. med. subst. Veg. drug Resin of veg. drug. Dry powd. drug Dry ingred. with powd. sug. milk. Pill-mass Aromatics Med. subst. and ex- cipient. Med. subst. and ex- cipient. Wax Lard. Lard (Wax.) Resin or other firm basis. Med. subst. on paper. ^led. subst Always.. Usually Always . Always . Always , Always , Always. Always., Always. Always . Always . Always . Always . Always . Rectal. , 91 OFFICIAL PREPARATIONS. For External Use. Occasionally . Usually. Tr. Iodine . Tr. Arnica Flowers. Always . Always . Always . Made by Retail pharmacist. Usually . Usually . Always . Always.. Usually and preferably.. Always Usually Always . Always . Usually . Usually Usually and preferably. Usually. Usually Usually and preferably. Always . Usually . Usually , Usually... ., Usually. . .. Preferably., Always I Usually and I preferably. Always I Usually and preferably. Alwaj's., Always . Usually and preferably. Made by Manufacturer. Average Dose. Aq. Amm Aq. Amm. fort. Aq. Hydrog. Diox. Usually . A few.... Cod Liver Occasionally Emuls. Oil. Occasionally . Always. Always . Usually. Alwaj's . Usually Occasionally . Extensively., Usually , Always Usually Extensively. fSss-fSj. Method of Manufacture. f Sss-fSj- fSss-f 5j.. f 5i-f 5ij.. f5j-f5iv., fSss fgss-fSj Exception — Inf. Digitalis f5i-f5iv. f Sss-f Sij f 5ss Exceptions — Spir. Glonoini, ITli-ij. Spir. Phosphori, TTlv-x. fSJ f5i Exception.s — Poisonous tinctures, lT\x Tr. Aconite \ ^- ■■■ Tr. Ver. Vir. / "'' "J lo min Exceptions — Poison, fld. extr., ITli. f3i. Exc. Poison. Wines 10 to 3on|. 1-5 mm., Vl\x gr J Exceptions — Poison, extracts, gr. % gr. i 10 grains Solution. Distillation. Solution. Usually by heat. Emulsifi cation. Admixture. Solution. Not boiled. Boiling. Solution. Distillation. Solution. Percolation. Maceration. Percolation, pre- ceded by macera- tion and followed by partial evapor- ation. Percolation. Solution. Admixture orSolu'n Solution, Percolation and evaporation. Percolation. Percolation. Maceration. Boiling. Precipitation. Trituration. Trituration. Incorporation. Incorporation. Incorporation. Incorporation. Fusion. Fusion. Cold incorp. Fusion and spread on suitable material. Paper sat. with drug. Fusion. Cold. (12) APPENDIX. 'The follovviug formulae, illustrative of the various classes of prepara- tions, have beeu found convenient for use in the Pharmaceutical Laboratory of the University of Pennsylvania. PULVIS EFFERVESCENS COMPOSITUS. U. S. P. ^'^ COMPOUND EFFERVESCING POWDER (Seidlitz Powder). Pulveris Acidi Tartaric! , gr. xxxv Disoensa in charta alba. xJuK^^) Sodii Bicarbonatis gr- xl Potassii et Sodii Tartratis . . 3ij Misce et dispensa in charta coerulea. Signa : Seidlitz Powder. Fold according to English Method. ^ AQUA CINNAMOMI. U. S. P. CINNAMON WATER. Olei Cinnamomi C. c. 0.2 .L\ cLl^l^^ly^ Calcii Phosphatis Praecipitati Gm. 0.4 _ [(.■Cy^o Aquae Destillatae quantum sufficit ut fiant . C.c. loo.o — Triturate the Precipitated Phosphate of Calcium with the Oil. Then with a part of the Water. Filter through a plaited filter and add enough Water, through the filter, to make 100 c. c. PULVIS CRETAE COMPOSITUS. U. S. P. COMPOUND CHALK POWDER. Cretae Praeparatae Gm. 6.0 S Pulveris Acaciae Gm. 4.0 "!_ Pulveris Sacchari Gm. lo.o ^^ Misce et tere exacte. Signa : Compound Chalk Powder. 93 94 MISTURA CRETAE. U. S. P. CHALK MIXTURE. Pulvtris Cretae Compositi O'ij Aquae Cinnamomi f5vj Aquae quantum sufficit ad f 5iv Misce. Signa : A teaspoonful every two hours. INFUSUM PRUNI VIRGINIANAE. U. S. P. INFUSION OF WILD CHERRY. Moisten 4 grammes of ground wild cherry bark with 6 c. c of water and macerate for one hour. Pack it firmly in a conical glass percolator and gradually pour water upon it until the percolate measures 100 c. c. Label : Infusion of Wild Cherry. ^ SYRUPUS PRUNI VIRGINIANAE. SYRUP OF WILD CHERRY. Infusi Pruni Virginianae C. c. ii.o Sacchari Gm. 17.0 Dissolve the sugar by agitation. Label : Syrup of Wild Cherry. ^ GLYCERITUPvl ACIDI TANNICI. U. S. P. GLYCERiTE OF TANNIC ACID (Glvccrole of Tannin). Acidi Tannici Gm. 5.0 Glycerini C. c. 20.0 (=Gm. 25.0) Solve. Signa: Glycerite of Tannic Acid. Heat on a water-bath until perfectlj- dissolved and a green solution is obtained. 95 TINCTURA DIGITALIS. U. S. P. TINCTURE OF DIGITALIS (Foxglove), Powdered Digitalis 68 grains (4.50 Gm.) Diluted Alcohol a sufficient quan- tity to make i fluidounce (30.0 C. c.) Moisten the powder with f 3! of Diluted Alcohol and allow it to swell. Macerate for 24 hours, then pack it firmly in a percolator. Percolate slowly with Diluted Alcohol until f^i (30 c. c.) is obtained. Label: Tincture of Digitalis. Poison ! TINCTURA FERRI CHLORIDI. U. S. P. TINCTURE OF FERRIC CHLORIDE (or Tincture of Chloride of Iron)^ Liquoris Ferri Chloridi fSij Alcohol f5vj Misce. Sifjna : Tincture of Ferric Chloride. SPIRITUS CAMPHORAE. U. S. P. SPIRIT OF CAMPHOR. Camphorae gr. xlv Alcohol fgj Solve. Signa : Spirit of Camphor. ^ LINIMENTUM SAPONIS. U. S. P. SOAP LINIMENT. Saponis Gm. 1.75 Camphorae Gm. 1.125 Olei Rosmarini C. c. 025 (circa gtt. iv) Alcohol C. c. 19.0 Aquae quantum sufficit ad . . . C. c. 25.0 Dissolve the Camphor in the Alcohol. Add the Soap and the Oil of Rosemary. Finally, add a sufficient quantity of Water to make 25 c. c. Filter the preparation. Label: Soap Liniment. 96 SUPPOSITORIA ACIDI TANNICI. SUPPOSITORIES OF TANNIC ACID. Triturate 6 grs, of Tannic Acid with lo grs. of Oil of Theo- broma (Cacao Butter). Melt 40 grs. of Oil of Theobroma on a water-bath at as low a temperature as possible. Add the first mixture to the melted oil without applying any more heat. Mix thoroughly and pour the mixture at once into moulds which have been thoroughly chilled and are absolutely dry. Wait until the moulds are again chilled before opening them. ^ UNGUENTUM ACIDI BORICI. OINTMENT OF BORIC ACID (Boric Ointment). Acidi Borici 5ss. Petrolati 5ss. Reduce the Acid to a fine powder. Incorporate oj of Petrolatum with the Boric Acid by thorough trituration and finally add the remainder of the Petrolatum, mixing thoroughly. Label: Boric Ointment LIQUOR SODII BORATIS COMPOSITUS. DOBELL'S SOLUTION. Sodii Boratis Sodii Bicarbonatis aa gr. xv Acidi Carbolici gtt. ij Glycerini f5ss Aquae quantum sufficit ut fiant fSij Dissolve the Borax and the Sodium Bicarbonate in f Jj of Water. Add the Carbolic Acid to the Glycerin. Then mix the two solutions and add a suflBcient quantity of Water to measure f3ij. 97 CALOMEL POWDERS. Hydrargyri Chloridi Mitis gr, j Sodii Bicarbonatis gr. yj Sacchari gr. viij Misce. Fiant chartulae No. vj. Signa : One powder every hour. APERIENT PILLS. Pulveris Aloes ^'Jir-y c.l-^ y ) • Pulveris Rhei ' i' Pulveris Saponis aa gr. xij Misce. Fiat massa. Divide in pilulas No. xij. Signa : One pill at bed-time. CYSTITIS MIXTURE. Potassii Bromidi Acidi Borici aa gr. xx Tincturae Belladonnae Foliorum ..... "I xij Liquoris Potassii Citratis fSij Misce. Signa : A tablespoonful every 4 hours. ^ LIQUOR POTASSII CITRATIS U. S. P. SOLUTION OF POTASSIUM CITRATE. Acidi Citrici Gm. 6.0 Potassii Bicarbonatis Gm. 8.0 Aquae quantum sufficit ad C. c. loo.o Dissolve the Potassium Bicarbonate and the Citric Acid, each, in 50 c. c. of Water. Mix the two solutions gradually and dispense after eflfervescence has nearly ceased. Label: Solution of Potassium Citrate. 98 DIURETIC PILLS. Pulveris Digitalis g^"- xij H}'drargyri Chloridi Mitis gr- xij Acaciae g^"- vj Glycerini . . = gtt. iv Aquae quantum sufficit ut fiat massa in pilulas No. xij dividenda. Signa : One pill three times a day. MISTURA SODAE ET MENTHAE. Ammonii Carbonatis gr- ij Sodii Bicarbonatis gr. xv Sacchari 5ij Olei Menthae Piperitae gtt. iij Aquae fSij Mi see. tA«, 5 (v«,. Ci-vl cK^x^d^^i c^' Signa : Soda Mint. ^'^-^j^^'i--%^(M/*^-'\ Reduce the Ammonium Carbonate to a fine powder; mix it with the Sodium Bicarbonate and the Sugar, then add the Oil of Peppermint. Tri- turate thoroughly and finally add the Water. CAPSULES. Acidi Carbolici gtt. x Pulveris Rhei gr. xviij Bismuthi Subnitratis gr. xlij Misce. Dispensa in capsulis vj. Signa : One capsule three times a day. Triturate the solid ingredients. Add the Carbolic Acid. Divide into six equal parts and fill a capsule with each. 99 EMULSIO OLEI RICINI. EMULSION OF CASTOR OIL. Olei Ricini f Sss Pulveris Acaciae Pulveris Sacchari aa 5j Olei Menthae Piperitae gtt. iij Aquae quantum sufficit ut fiant 'f Sij Misce. Fiat emulsio secundum artem. Mix the Acacia with the Sugar. Add the Oil of Peppermint and then the Castor Oil. Now add f^ij of water, all at once, and triturate until the mixture assumes the appearance of cream. Finally, add a sufficient quan- tity of Water to make f 5ij. LIQUOR AMMONII ACETATIS. U. S. P. SOLUTION OF AMMONIUM ACETATE (Spirit of Mindercrus). Ammonii Carbonatis Gm. 5.0 Acidi Acetici Diluti C c. 100.0 Solve. Signa: Solution of Ammonium Acetate. Dissolve the Ammonium Carbonate in the diluted Acetic Acid. Dis- pense after effervescence has almost ceased. ^ lOO INFUSUiM BUCHU. INFUSION OF BUCHU. Buchu contusi gr, xlv Aquae bullientis fSij Heat f 5ij of Water to the boiling point. Add the Buchu. Cover the dish and allow the mixture to macerate for 30 minutes. Strain through a straining cloth and add a sufl&cient quantity of Water, through the strainer, to make f^ij. Label: Infusion of Buchu. Tincturae Digitalis f 5i Liquoris Ammonii Acetatis f .)j Infusi Buchu fSj Misce. Signa : A teaspoonful every 2 hours. This prescription illustrates that solutions and infusions usually mix readily, as both are made with a menstruum of water and that tinctures can be added in small amount to aqueous mixtures, without serious pre- cipitation. INCOMPATIBILITY. Spiritus Camphorae fsi Liquoris Ammonii Acetatis f -Si The Camphor is precipitated, as it is only sparingly soluble in the mixture of alcohol and water produced. The prescription illustrates the incompatibility of solutions and spirits. ^ ACIDUM ACETICUM DILUTUM. U. S. P. DILUTED ACETIC ACID. Acidi Acetici C. c. 16.0 Aquae Destillatae C. c. 84.0 Misce. Signa : Diluted Acetic Acid. lOI LIQUOR FERRI ET AMMONII ACETATIS. U. S. P. SOLUTION OF IRON AND AMMONIUM ACETATE (Basham's Mixture). Tincturae Ferri Chloridi . v\.xx Acidi Acetici Diluti f 5ss Liquoris Ammonii Acetatis foiij "Ixx Elixir Aromatici f 5ij Glycerin! fo'j Aquae quantum sufficit ad f 5ij To the Solution of Ammonium Acetate (T/hlci fho(i.ln not be a.!kaline) add, successively, the Diluted Acetic Acid, the TiacLure of Ferric Chloride, the Aromatic Elixir and the Glycerin, and lastly, a saGicierli; qucuti'^y of Water to make fgij. EXPECTORANT MIXTURE. Ammonii Chloridi 5j Potassii Bromidi 5ss Tincturae Belladonnae f 5s.s Pulveris Extracti Glycyrrhizae Acaciae aa 5ss Syrupi Pruni Virginianae fSss Aquae quantum sufficit ut fiant f 5ij Misce. Signa : A teaspoonful every four hours. INTENTIONAL INCOMPATIBILITY. Plumbi Acetatis gr- xv Zinci Sulphatis gJ"- vij Aquae fS'j Misce. Signa: Use as an injection. Dissolve each salt, separately, in f gj of Water and mix the two solutions. Mutual decomposition takes place and a new compound, lead sulphate, is precipitated, while zinc acetate remains in solution; the liquid loses nearly all of its astringency. Dispense with a " Shake Well " label. I02 Sodii Salicylatis S''- ^^ Potassii Bicarbonatis gr. xl Liquoris Potassii Citratis f 5j Misce. Signa: A teaspoonful, three times a day, after meals. Incompatibility.— To f^ss of the solution add f ^ij of Tincture of Ferric Chloride. A violet-red color is produced, owing to the formation of salicylate of iron. INCOMPATIBII.T'' V — To f^^ss of the solution add f.^ij of Diluted Sulphiiric Acid. Salicylic Acid is set free and being much less soluble than Sodium S?licylate, is precipitated. Quininae Sulphatis Oss Acidi Hydrochlorici Diluti foj Tincturae Nucis Vomicae t"5i Aquae quantum sufficit ad fSij Misce. Triturate the Quinine with the Diluted Hydrochloric Acid. Add f Jj of Water, then the Tincture of Nux Vomica and finally, a suflScient quantity of Water to make f5ij. Incompatibility. — To f^i of the solution add .^ij of Ammonium Carbonate. Quinine is precipitated, because it is less soluble than Quinine Sulphate. Ammonium Sulphate remains in solution. This illustrates the incompatibility of alkaloids and alkalies. To f .5j of the solution add f^ss of Decoction of White Oak Bark. An insoluble tannate of quinine is precipitated, illustrating the incompatibility of tannic acid and the alkaloids and indicating the use of the former as an antidote to the alkaloidal poisons. I03 II Quininae Sulphatis gr. xl Extract! Glycyrrhizae 5j Sacchari 5j Aquae Ammoniae n^x Aquae quantum sufficit ad f §j Misce. Fiat mistura secundum artem. Mix the solids in a mortar with the Ammonia and f ^ij of Water; grad- ually add a sufficient quantity of the latter to make f 5J. Signa: A teaspoonful four times a day. R DECOCTUM QUERCUS ALBAE. DECOCTION OF WHITE OAK BARK. Quercus Albae contusi gr. xlv Aquae quantum sufficit ut fiant f oij Cover the White Oak Bark with f gij of cold Water (in a dish provided with a cover) and boil for 15 minutes. Strain, and pass enough Water through the strainer to make the product measure 2 fluid ounces. Label: Decoction of White Oak Bark. Acidi Carbolici "Ixl Aquae . , foss Solve. Signa : Use as an external application. Apply with a camel's hair-brush. The proportion of carbolic acid far exceeds the solubility of this drug in water; it will collect in the bottom of the bottle, may come in contact with the brush in concentrated form and exert a corrosive action on the skin. The addition of f ^ij of glycerin to the acid, previous to its dilution with water, will make it perfectly soluble. N. B. — A solution as strong as the above should never be used undiluted, even if a clear solution is obtained by the addition of glycerin. NDEX. Aceta 49 Acetic Acid, ililuted i8 Active principles, vegetable ... 24 Administration of drugs .... 3 Albumen 32 Alcohol as a menstruum .... 16 Alkaloids 26 Animal drugs 5 Apothecaries measure 11 weight II Appendix 93 Aquae 34 Avoirdupois weight 11 Balsams 25 Bitter principles .... ... 25 Black wash 66 Cachets 64 Capsulae 63 Capsules 63 Cerata 60 Cerates 60 Chartae 61 Collodia 51 Collodions 51 Coloring matter 32 Confectiones 57 Confections 57 Decocta 39 Decoctions 39 Desiccation 20 Digestion 21 Distillation 20 Domestic measures 13 Drop 13 Drugs, administration of ... . 3 deterioration of 3 Elixiria 44 Elixirs 44 Emplastra 60 Emulsiones 42 Emulsions 42 Ether as a menstruum 18 Evaporation 20 Extracta 51 fluida 46 Extractive 32 Extracts 51 Filtration 21 Fixed oils 26 Fluid extracts 46 Glucosides 25 Glycerin as a menstruum .... iS Glycerita 44 Glycerites .... 44 Grammatical construction of pre- scriptions So Granulation . 20 Gum 31 Honeys 41 Imperial measure 12 Incompatibility 65 chemical .... 65 physical .... 68 therapeutic ... 69 Inert principles 31 Infusa 38 Infusions 38 Inorganic drugs 5 Konseals 64 Lead water and laudanum ... 66 Linimenta 50 Liniments 50 Liqnores 36 Lotio nigra 66 Maceration 21, 23 Massae 57 Masses 57 Measure, apothecaries 11 imperial 12 Measures, domestic 13 Mellita 41 Menstrua used in pharmacy ... 16 Metric prescription 78 system 14 Misturae 38 Mixtures 38 Mucilages 41 Mucilagines 41 Official nomenclature S preparations, table of . 90, 91 Oils, fixed iS, 26 volatile 24, 35 Ointments 57 Oleata 51 Oleates 51 Oleic acid 18 Oleoresinae 50 Oleoresins 25 50 Organic drugs 5 Papers 61 Percolation 21 Pharmaceutical menstrua .... 16 (104) I05 PAGE Pharmaceutical process 20 Pharmacopoeias 7 Pills 53 Pilulae 53 plasters 60 Powders 4) 33 Precipitation 20 Prescription, grammatical con- struction of So Prescription, metric ...... 79 writing 72 Principles, active 24 bitter 25 found in all plants . . 31 inert 31 neutral 25 Pulveres 33 Resinae 53 Resins 25, 53 Solution 21 Solutions 36 Solutions, percentage 12 Spirits 45 Spiritus 45 Starch 31 Sublimation 20 PAGE Suppositoria 61 Suppositories 61 Synonyms 9 Syrupi 40 Syrups 40 Table of official preparations . 90, 91 Tannic acid 31 Tincturae 46 Tinctures 46 Trituration 23 Triturationes . 53 Triturations 53 Troches , _, 60 Trochisci ... 60 Troy weight 11 Unguenta 57 Vegetable active principles ... 24 drugs 5 Vina 49 Vinegars 49 Volatile oils 24, 35 Water as a menstruum 17 Waters 34 Weights and measures 11 Wines 49 THIS BOOK IS DUE ON THE LAST DATE STAMPED BELOW AN INITIAL FINE OF 25 CENTS WILL BE ASSESSED FOR FAILURE TO RETURN THIS BOOK ON THE DATE DUE. 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