Presented by Dr. 0. T. Fellows CALIFORNIA COLLEGE OF MEDICINE A HANDBOOK OF USEFUL DRUGS A Selected List of Important Drugs Suggested for the Use of Teachers of Materia Medica and Therapeutics and to Serve as a Basis for the Examination in Therapeutics by State Medical Examining and Licensing Boards PREPARED UNDER THE DIRECTION AND SUPERVISION OF THE PHARMACY AND OF THE AMERICAN MEDICAL ASSOCIATION , PRESS OF THE AMERICAN MEDICAL ASSOCIATION 535 North Dearborn Street, Chicago 1914 [AUTIIOEITY TO USE FOB COMMENT THE PHARMACOPEIA OF THE UNITED STATES OF AMEEICA, EIGHTH DECENNIAL REVISION, IN THIS VOLUME, HAS BEEN GRANTED BY THE BOARD OF TRUSTEES OF THE UNITED STATES PHARMACOPEIAL CONVENTION. WHICH BOARD OF TRUSTEES is IN NO WAY RESPONSIBLE FOR THE ACCURACY OF ANY TRANSLATION OF THE OFFICIAL WEIGHTS AND MEASURES, OR FOR ANY STATEMENT AS TO THE STRENGTH OF OFFICIAL PREPARATIONS.] COPYRIGHT, 1913 AMERICAN MEDICAL ASSOCIATION PREFACE It is generally recognized that a considerable proportion of the articles in the Pharmacopeia of the United States and in the National Formulary are worthless or superfluous. Repeated efforts have been made to eliminate at least the more objec- tionable of these articles. These efforts, however, have failed because they have uniformly encountered the objection that the articles or preparations are used by some physicians and therefore should be recognized and authoritatively defined. The Council on Medical Education and the Confederation of State Examining and Licensing Boards have been trying to restrict instruction and examination in materia medica to the more important drugs. These efforts have suggested the desirability of selecting a fundamental list of drugs with which all medical students and practitioners might be expected to be familiar and to which, therefore, state examining and licensing boards might largely or entirely confine their exam- inations in materia medica. HOW THE LIST WAS PREPARED A committee of the Council on Medical Education of the American Medical Association prepared a list of the more important medicaments which was submitted to the members of the National Confederation of State Medical Examining and Licensing Boards. The confederation endorsed the prin- ciple and appointed a committee to compile a list which would answer the needs of the state examining and licensing boards. In pursuance of its fundamental aims to secure the devel- opment of a more scientific and rational system of thera- peutics, the Council on Pharmacy and Chemistry took up this matter. Largely basing its selection on the conclusions of the committee of the Confederation of State Licensing and Examining Boards, it compiled a preliminary list which it submitted for general discussion. This list was sent to teachers of pharmacology and therapeutics, to deans of medical 4 USEFUL DRUGS schools, to the secretaries and members of state medical exam- ining and licensing boards, and to others presumed to be interested in the subject, with a request for criticism and suggestions. The replies received were compiled and analyzed and a revised list prepared and again submitted. The list was further considered and revised by the Council on Phar- macy and Chemistry and was then published in a preliminary form under the title "Useful Remedies." The object of pre- senting the book in a tentative form was to obtain further opinions regarding the list and especially suggestions for making the permanent book of the most practical value to all concerned. The present book has been prepared on the basis of infor- mation, advice and suggestions brought out by the preliminary work above referred to. It presents a brief but practical dis- cussion, from the modern viewpoint, of the properties, phar- macologic action, therapeutic uses and dosage of the drugs in the list. As it contains products the value of which is gen- erally recognized it is hoped that the book may serve as a text on which teachers of materia medica and therapeutics may base their instruction, and state examining boards their examinations. It is confidently predicted that an intelligent and critical use of these selected drugs will prove their general sufficiency and show that many drugs now discussed in text-books are superfluous and that many newly discovered or widely exploited proprietary preparations have no advantages over those contained in this book. In discussing pharmacologic action the endeavor has been to present the essentials, giving the details of physiologic action only when they have an evident bearing on the thera- peutic uses. The latter have been given concisely, but it is hoped in sufficient detail so that no important uses have been overlooked. In dosage the average doses of the pharmacopeia have been given except in those instances in which the impor- tance of the drug makes it necessary to enter more into detail. USEFUL DRUGS 5 Especial attention has been paid to the various methods of administration and it is hoped that the occasional sugges- tions for the choice of vehicle will be of service to beginners in prescription writing. For the same reason the strength of local applications has been carefully indicated. In giving apothecary and metric doses the attempt to give exact equiv- alents has not been made. So far as possible, the use of round numbers has been encouraged. In spelling the book conforms to the style of THE JOURNAL of the American Medical Association, except that the official names of the U. S. Pharmacopeia have been retained in the titles. ABBREVIATIONS The following abbreviations occur in the text: U. S. P. The Pharmacopeia of , the United States of America, Eighth Revision. N. F. The National Formulary of Unofficial Preparations. Third Edition. N. N. R. New and Nonofficial Remedies, 1913. STATEMENT OF SOLUBILITY For ease of reference the solubility of official articles is indicated in approximate terms in accordance with the follow- ing equivalents: Substances that are soluble in less than 1 part of solvent = very soluble. From 1 to 10 parts of solvent = freely soluble. From 10 to 100 parts of solvent = soluble. From 100 to 1,000 parts of solvent = slightly soluble. From 1,000 to 10,000 parts of solvent = very slightly soluble. From 10,000 to 100,000 parts of solvent = nearly insoluble. More than 100.000 parts of solvent = practically insoluble. USEFUL DRUGS Acacia. Acacia, U. S. P., Gum Arabic. A gummy exudation from Acacia Senegal and other species of acacia. PROPERTIES : Acacia occurs in colorless or pale yellowish, opaque, brittle, inodorous tears or fragments which are com- pletely soluble in water but practically Insoluble in alcohol. Mucilago Acaciae. Mucilage of Acacia, U. S. P. A 34 per cent, solution of Acacia in a mixture of water and lime-water. ACTION AND USES : Acacia and its mucilage are used as demulcents and suspending agents in the making of emul- sions and mixtures. Acetanilidum Acetanilid, U. S. P., C H 3 NH ( CH 3 CO ) . Acetanilid is the monacetyl derivative of anil in, C H 5 NH 2 . PROPERTIES : Acetanilid is an odorless, crystalline powder, having a slightly burning taste. It is only slightly soluble in water (1:180), but freely soluble in alcohol (1:2.5). INCOMPATIBILITIES: Acetanilid is incompatible with spirit of nitrous ether. It forms a semiliquid mass when triturated with chloral or antipyrin. ACTION AND USES : Acetanilid is analgesic, antipyretic and, in excessive doses, a cardiac depressant. These effects are probably due to para-aminophenol, into which it is converted in the body. The pulse is at first quickened and later slowed by a direct action on the heart muscle. Moderate doses have little effect on the temperature of normal animals and men, but such doses cause a marked reduction of the temperature in fever. Large doses, or small doses taken habitually, convert hemoglobin into met- hemoglobin and may destroy the red blood-corpuscles. In poisonous doses acetanilid produces cyanosis, abnormal reduction of temperature, coldness of the extremities and profuse sweating. In individuals with an idiosyncrasy toward the drug similar symptoms may be produced by small doses. Its use should be avoided in patients Avho are debilitated from any cause. Acetanilid is effective for the relief of headache and neuralgic pain, but is not suited to the treatment of pain caused by inflammation. DOSAGE: 0.20 gm. or 3 grains, ft is well to begin with 0.10 gm. or about 2 grains and to repeat cautiously. For- merly mixtures of acetanilid with caffein or ammonium 8 salts were advised on the supposition that the cardiac depression would thus be avoided, but this does not seem to be the case. Investigation has shown that acetanilid is rendered somewhat more toxic by caffein, but sodium bicarbonate renders it less poisonous. The drug should be used cautiously and only for definite indications. Acetanilid has been widely exploited in the form of varying mixtures under different names as a cure for all pain. Many so-called headache powders contain it, but its indiscriminate use in this way is dangerous. It may be administered dry in the form of powders, cachets or capsules; because of its slight solubility it should not be massed in pills or compressed into tablets unless the tablet is crushed with the teeth before swallowing or unless the tablet will disintegrate rapidly in the stomach. Acetphenetidinum. Acetphenetidin, U. S. P., Phenacetin, C 6 H 4 ( OC 2 H 5 ) .NH ( CH 3 CO ) . Acetphenetidin differs from acetanilid in containing the ethoxyl group C 2 H 5 0. PROPERTIES : Acetphenetidin occurs as white, crystalline scales or a crystalline powder. It is odorless and tasteless. It is only slightly soluble in water (1:925) but soluble in alcohol (1:12). INCOMPATIBILITIES: The same as ioP acetanilid. ACTION AND USES: These are similar to those of acetan- ilid, but it is supposed to be somewhat safer. Its analgesic, antipyretic and cardiac depressant effects, like those of acetanilid, are due to the formation of para-aminophenol, and its possible advantage over acetanilid is probably due* to the fact that this decomposition occurs more slowly. It is best administered in the form of powders, cachets or capsules. Since the enactment of the Food and Drugs Act, June 30, 1906, acetphenetidin has frequently displaced acetanilid as the active agent in proprietary mixtures for the relief of headache and other pain. Its relation to acetanilid sug- gests similar caution in its use. DOSAGE: A full dose is 0.50 gm. or 7% grains. It is well to begin with 0.30 gm. or 5 grains, and repeat every three hours if needed for a few doses. When small doses fail to relieve headache, larger doses are also usually ineffectiye. Acidum Aceticum. Acetic Acid, U. S. P. A solution containing 36 per cent, by weight of absolute acetic acid (H.CLHaO,) =CH 3 COOH. (In some European countries a preparation comparable to glacial acetic acid, U. S. P., containing 99 per cent, of absolute acetic acid, is known as acetic acid, and the article that is official in the U. S. P. as "diluted acetic acid" is sometimes described as acetum or vinegar.) USEFUL DRUGS 9 Diluted Acetic Acid, U. S. P., contains 6 per cent, of absolute acetic acid. PROPERTIES : Acetic acid is a clear, colorless solution. In all of its forms it is freely miscible with water. ACTION AND USES : Acetic acid, as such, is not ordinarily used internally, but when administered in the diluted form it is mildly diaphoretic and diuretic. Externally it is a caustic, rubefacient and parasiticide. Acidum Acetylsalicylicum. See under Aspirin. Acidum Benzoicum. Benzoic Acid, U. S. P. An organic acid, (HC 7 H 6 2 ) = C C H 5 .COOH, obtained from benzoin, by sublimation, or prepared artificially. PROPERTIES : Benzoic acid occurs as colorless, or almost color- less, lustrous scales or needles having an odor resembling benzoin. when obtained from the latter, and a pungent, acid taste. It is only slightly soluble in water (1:281), but is soluble in alcohol (1:1.8). It reacts with alkali hydroxids, and carbonates to form water-soluble benzoates. ACTION AND USES: Benzoic acid is a mild antiseptic and diuretic. It is excreted in the urine in the form of hippuric acid (benzoyl glycocoll). Clinically it is of little value. DOSAGE: 0.5 gm. or 7y 2 grains. It is preferably dispensed in the form of powder and may be enclosed, dry, in cap- sules or cachets. It is more frequently used in the form of soluble compounds (see Sodii Benzoas). Acidum. Boricum. Boric Acid, U. S. P. Boracic Acid (obso- lete) (H 3 B0 3 ) =B(OH),. PROPERTIES : Boric acid forms transparent, colorless scales or a light, unctuous, very fine powder. It is odorless, has a faintly bitter taste and is slowly soluble in water (1 :18) and soluble in alcohol (1:15). ACTION AND USES : Boric acid is a mild antiseptic. It has been occasionally administered internally, but with little effect, in cystitis. Externally it is frequently used as a dusting powder, either alone or combined with diluents such as starch or talcum, or with active substances such as acetanilid, salicylic acid or iodoform. It is also widely used as a wash or lotion, especially for catarrh of the mucous membranes, cystitis, conjunctivitis, pharyngitis, etc., usually in simple aqueous solutions containing from 2 to 4 per cent, of boric acid. This is one of the most frequently used lotions for conjunctivitis. It is also very useful for irrigating the bladder in cystitis. It is used in the form of glycerite of boroglycerin in washes and injections. The ointment is mildly antiseptic but is chiefly used as a pro- tective dressing. Glyceritum Boroglycerini. Glycerite of Boroglycerin, U. S. P. A glycerin solution representing 30 per cent, of boric acid. 10 USEFUL DRUGS Unguentum Acidi Borici. Ointment of Boric Acid, U. S. P. A 10 per cent, mixture of boric acid with paraffin and white petrolatum. Acidum Citricum. Citric Acid, U. S. P. A tribasic organic acid, H 3 C 8 H 5 T ,H 2 O, usually prepared from the juice of limes or lemons. PROPERTIES : Citric acid forms colorless, transparent crystals : odorless and having an agreeable purely acid taste. It is very soluble in water (1:0.54) and freely soluble in alcohol (1:1.5). ACTION AND USES: Citric acid may be used as a substi- tute for lemon-juice. Like the other organic acids, it is oxidized in the system to carbonic acid, so that its acid effects are "much reduced. If an alkaline carbonate be added an effervescing mixture is obtained which gives the thera- peutic effects of the alkalies. DOSAGE: 0.5 gm. or iy 2 grains. It may be prescribed in the form of syrupus acidi citrici or as lemonade. Acidum Diaethylbarbituricum. See under Veronal. Acidum Hydrochloricum. Hydrochloric Acid, U. S. P.. Muriatic Acid. A fuming corrosive liquid containing 31.9 per cent, of hydrogen chlorid, HC1. Acidum Hydrochloricum Dilutum. Diluted Hydrochloric Acid, U. S. P. A solution containing 10 per cent, of hydrogen chlorid. HC1. PROPERTIES : Diluted hydrochloric acid is a colorless, odorless, strongly acid aqueous solution ; freely miscible In all proportions with water or alcohol. INCOMPATIBILITIES : It is incompatible with alkalies, car- bonates and oxids, with which it reacts to form chlorids, and with the soluble salts of silver and of lead, forming insoluble silver chlorid and lead chlorid. ACTION AND USES: Hydrochloric acid is the acid of the gastric juice, the average normal stomach contents contain- ing approximately 0.2 per cent. It is necessary to the diges- tive action of pepsin and acts as an antiseptic in the stomach. By checking fermentation and putrefaction in the stomach it tends to prevent these processes in the intestine. Diluted hydrochloric acid is used for the treatment of diseases of the stomach characterized by a deficiency of acid in the gastric juice on the theory that it replaces the acid lacking in the secretion. To restore the acidity of the stomach contents to the normal average would require much larger doses than are commonly given. It seems prob- able, therefore, that the acid as ordinarily given acts mainly as an appetizer and tonic. The utility of hydrochloric acid in achylia gastrica is more manifest in the nervous forms USEFUL DRUGS 11 and in the earlier stages of the organic variety. In some cases it causes distress and should be discontinued. There is some evidence to show that the continued administration of the acid is capable of increasing the gastric secretion. Hydrochloric acid also exerts a favorable influence on the secretion of the pancreatic and intestinal juices. Hydrochloric acid is also of service in intestinal putre- faction, especially when the gastric digestion is impaired. It is indicated in achylia gastrica for the diarrhea caused by the irritant action of undigested meat and the putre- faction of proteins which have escaped gastric digestion. DOSAGE: 1 c.c. or 15 minims in about half a glass of water. It should be given after meals and the dose repeated at the end of an hour. Five drops in a wineglassful of water after meals are often sufficient. Acidum Hydrocyanicum Dilutum. Diluted Hydrocyanic Acid, U. S. P. This preparation in all the leading pharmacopeias of the world, is now uniformly directed to contain 2 per cent, of hydrogen cyanid, HCN. PROPERTIES : It occurs as a colorless liquid of a characteristic odor resembling 1 that of bitter almonds. On account of its poison- ous character it should be tasted only with great caution. Hydro- cyanic acid is freely miscible with water and with alcohol. INCOMPATIBILITIES: It gradually decomposes on exposure to light and is incompatible with salts of iron, silver and mercury. ACTION AND USES : Hydrocyanic acid is said to be seda- tive in small doses and has been widely used as an addi- tion to cough mixtures, and as an anti-emetic. On account of its poisonous properties and the readiness with which it decomposes, it is no longer used to the same extent as formerly. DOSAGE: 0.1 c.c. or 1.5 minims (not drops). Acidum Nitricum. Nitric Acid, U. S. P. A liquid containing about 68 per cent., by weight, of hydrogen nitrate, HN0 3 . PROPERTIES : Nitric acid is colorless, fuming, very caustic and corrosive and has a peculiar, somewhat suffocating odor. It is miscible with water in all proportions, dissolves mercury and most other metals with evolution of red fumes and stains woolen fabrics and animal tissues a bright yellow. INCOMPATIBILITIES: Like other inorganic acids, it is incompatible with alkalies, the alkali carbonates, many of the salts of organic acids, and, because of its oxidizing properties, with all readily oxidizable substances. Its addi- tion to organic liquids (alcohol, etc.), is apt to give rise to explosive reactions. ACTION AND USES : Nitric acid is a powerful caustic, used for removing warts and small nevi and for cauterizing 12 USEFUL DRUGS chancroids and other sores and bites of rabid animals, but its action is very painful and not readily controlled. When nitric acid is used as a caustic, the surrounding healthy tissue should be coated with petrolatum and the acid applied on the end of a rod of glass or wood. Acidum Salicylicum. Salicylic Acid, U. S. P. An organic acid, HC 7 H 5 3 = C 6 H 4 .OH.COOH, generally prepared synthetically from phenol. PEOPEETIES : It occurs as fine, white needles or a bulky, white crystalline, odorless powder, possessing a sweetish, subsequently acrid taste. Salicylic acid is only slightly soluble in water but freely soluble in alcohol or in ether. Salicylic acid reacts with alkali hydroxids and carbonates to form water-soluble salts. With solution of ferric chlorid it gives a deep purple color. INCOMPATIBILITIES: It is incompatible with salts of iron and with spirit of nitrous ether. ACTION AND USES : Salicylic acid is an antiseptic. It is quite irritant to mucous membranes and somewhat corro- sive. Internally it has the actions described under sodium salicylate, in which form it is commonly employed. Exter- nally it has been used as an application in pruritus, urticaria, bromidrosis and in some forms of eczema; also in the form of ointments and collodions to soften and remove corns and warts. DOSAGE: Internally it is best given in the form of soluble salicyla'tes. (See Sodium Salicylate.) Externally it is applied as an astringent in from 1 to 2 per cent, alcoholic solution or ointment; as an antiseptic, antiparasitic and keratolytic agent, in 2 to 5 per cent, dusting-powder, or ointment, and as a strong keratolytic in proportions up to 20 per cent., best dissolved in collodion. Continuous application to the skin may occasion slight corrosion. Acidum Tannicum. Tannic Acid, U. S. P., Tannin. An organic acid, HC U H 9 8 , obtained from nutgall. PEOPEETIES : Tannic acid occurs as a light yellowish, amor- phous powder, gradually turning darker when exposed to air and light. It has a faint, characteristic odor and a strongly astringent taste. Tannic acid is very soluble in water, alcohol and glycerin. INCOMPATIBILITIES: It is incompatible with alkalies, alkaloids, salts of iron and of most other metals, albumin and gelatin. With all these substances it reacts to form insoluble compounds. ACTION AND USES : Tannic acid is used as an astringent and hemostatic. Internally it has been chiefly employed in the treatment of diarrhea. It is but little used with infants or children. It should be employed not as the prin- cipal curative agent, but as an occasional adjunct to proper dietetic and physical remedies when the discharges are unduly profuse. Its astringent action, however, often causes nausea and vomiting, and hence some one of the protein USEFUL DRUGS 13 combinations is better for action on the intestine. Local applications of tannic acid are frequently made to inflamed mucous membranes, especially in pharyngitis. It is fre- quently employed as a local application in the treatment of hemorrhoids in the form of a 20 per cent, ointment or as a suppository containing 0.3 gm. or 5 grains. DOSAGE: 0.3 gm. or 5 grains. Glyceritum Acidi Tannici. Glycerite of Tannic Acid, U. S. P. A 20 per cent, solution of tannic acid in glycerin. DOSAGE: 1 c.c. or 15 minims corresponding to 0.2 gm. or 3 grains of tannic acid. This preparation is chiefly used externally and affords a convenient agent for making dilute solutions for local use. For local applications solutions con- taining from 0.5 to 2 per cent, of tannic acid are appropriate. To prevent the astringent action of tannic acid on the gastric mucosa, various organic combinations of tannic acid have been prepared which resist the action of the gastric juice to a greater or less extent and escaping solution in the stomach, do not become active until they reach the intestine. Tannalbin. Tannalbin, N. N. R., Albumin Tannate. It is insoluble in gastric juice and becomes effective when it reaches the intestine. DOSAGE: 2 gm. or 30 grains. Aconitum. Aconite, U. S. P. The tuberous root of Aconitum napelkis L. ACTION AND USES: Aconite slows the pulse and thus lowers the blood-pressure. The nervous system is first stimulated and then depressed. Death occurs from respira- tory paralysis. Locally applied, aconite causes paralysis of the sensory nerve endings. Aconite is used internally as a cardiac depressant, anti- pyretic and diaphoretic, especially in sthenic fevers of short duration or in the initial stage only of other diseases. It should be avoided in fevers accompanied by cardiac weak- ness. The danger from the depressing action of aconite on the heart makes it an undesirable agent to use as a cardiac depressant. It is being used less and less. Tinctura Aconiti. Tincture of Aconite, U. S. P. One hundred c.c. represent 10 gm. of the drug in approxi- mately 65 per cent, of alcohol. Externally it is useful as a local application for the relief of neuralgic pain. DOSAGE: 0.2 c.c. or 3 minims should be given hourly until the desired effect on the pulse is secured. Locally the tincture may be applied over the affected nerve, or a 14 USEFUL DRUGS liniment containing 10 per cent, of the tincture may be prescribed. Application to mucous membranes should be carefully avoided. The local application of the tincture is dangerous, as too much absorption may occur. Adeps. Lard, U. S. P. True fats, chiefly those of animal origin, form an impor- tant class of ointment bases. They are especially valuable when penetrating ointments are desired for softening the skin for inunctions, etc. Lard is the chief fat thus used. Like all animal fats, it is very liable to become rancid. To mitigate its odor and to hinder the occurrence of rancidity the following preparation is used: Adeps Benzoinatus. Benzoinated Lard, U. S. P. Benzoinated lard is made by incorporating with lard 2 per cent, of benzoin and straining. Adeps Lanae Hydrosus. Hydrous Wool Fat, U. S. P., Lanolin. This preparation is made by mixing the purified fat of sheep's wool with water in a proportion not to exceed 3 parts of the latter to 7 parts of the former. Lanolin is used as an ointment base. It has the advantage that it does not become rancid, but its odor and consistence are disagreeable. The old statements that it is more readily absorbed than other ointments has not been borne out by experience. Adnephrin, Adrenalin. See Epinephrin. Aether. Ether, U. S. P. A liquid composed of about 96 per cent., by weight, of absolute ether, (C 2 H 3 ) 2 O, and about 4 per cent, of alcohol, C&0H. PROPERTIES : It is volatile, inflammable, and the vapors, which are .about two and one half times as heavy as air, are danger- ously explosive when mixed with air. Ether is soluble in water (1:10), readily soluble In alcohol, and when administered inter- nally is usually directed to be dispensed in the form of an alco- holic solution. ACTION AND USES: Ether is used mainly by inhalation for the production of anesthesia. It depresses all parts of the central nervous system, causing loss of sensation, loss of consciousness and abolition of the reflexes. The vital cen- ters of the medulla are involved very late in the poisoning. a fact which enhances the safety of this anesthetic. The respiration is affected first. Later there is depression of the vasomotor center and consequent fall of blood-pressure. Ether does not produce a marked effect on the heart, but its first action is a moderate reflex stimulation, while in poisonous doses it depresses the heart. In the administra- tion of ether as an anesthetic at night, caution should be exercised to have the ether at a distance and, if possible, below any fire or flame, to avoid setting fire to the heavy USEFUL DRUGS 15 inflammable vapors. For anesthesia a pure ether, preferably anhydrous, should always be used. Administered internally it is an anodyne, sedative, carminative and antispasmodic. DOSAGE: 1 c.c. or 15 minims. Spiritus Aetheris, U. S. P. A 32.5 per cent, alcoholic solution. DOSAGE: 4 c.c. or 1 fluidram well diluted or on cracked ice. Spiritus Aetheris Compositus, U. S. P. One hundred c.c. contain ether, 32.5 c.c.; alcohol, 65 c.c.. and ethereal oil, 2.5 c.c. DOSAGE: 4 c.c. or 1 fluidram, best given on a lump of sugar. On account of its transient action the dose may be repeated once in half an hour if needed. Aether Nitrosus. Used only in the form of: Spiritus Aetheris Nitrosi. Spirit of Nitrous Ether, U. S. P.. Sweet Spirits of Niter. A solution of not less than 4 per cent, of ethyl nitrite. C 2 H 5 N0 2 , in alcohol. PROPERTIES : A pale yellowish liquid having a fragrant ethereal and pungent odor and a sharp burning taste. It is miscible with alcohol or water. It rapidly deteriorates. INCOMPATIBILITIES: It is incompatible with acetanilid, antipyrin, potassium iodid and sodium salicylate. ACTION AND USES: Spirit of nitrons ether is popularly used as a weak diuretic and diaphoretic. Its efficiency is doubtful. It is frequently prescribed in mixtures with other diaphoretics, notably the solution of ammonium acetate. DOSAGE: 2 c.c. or 30 minims or half a teaspoonful. Aethylis Chloridum. Ethyl Chlorid, U. S. P. PROPERTIES : It is a colorless and very volatile liquid having an agreeable odor and a sweetish, burning taste. It should be preserved in hermetically sealed glass tubes and kept in a cool place remote from light or fire. ACTION AND USES: Ethyl chlorid is widely used in the form of spray to produce a local anesthesia for minor opera- tions. When inhaled it produces prompt anesthesia, suitable for very short operations, but even then not without danger of producing accidents similar to those of chloroform. Because of these dangers and the difficulty of handling, it is now rarely used for general anesthesia. Aethyl-Morphinae Hydrochloridum, Ethyl-Morphin Hydro- ' chlorid, N. N. R., Dionin. PROPERTIES : Ethyl-morphin is an artificial base obtained by the action of ethyl iodid on morphin in the presence of an alkali. It occurs as a white, microscopically crystalline powder, odorless and having only a slight bitter taste. Ethyl-morphin hydro- 16 USEFUL DRUGS chlorid is freely soluble in water and in alcohol, but practically insoluble in ether and in chloroform. ACTION AND USES: When administered internally, its action is intermediate between those of morphin and codein, but it is claimed that it does not produce constipation, nausea or lassitude and that it promotes healing after operations and injuries. It is the conclusion of careful observers, however, that, for internal use, it possesses no advantage over codein. When applied to the eye this drug causes a local vaso- dilation, terminating in acute conjunctival edema. The chemosis thus produced is employed for its analgesic and curative effects in conjunctivitis, corneal ulcer, acute glau- coma, iritis, scleritis and other inflammatory diseases of the uveal tract. The greater the edema of the conjunctiva, the more decided is its analgesic action. DOSAGE: 0.015 gm. or % grain. Externally it is commonly employed in a collyrium in strength varying from 5 to 10 per cent. The strength may be increased to 20 per cent., and it is sometimes used in powder form. The ophthalmol- ogist should make the first application and determine the minimum strength of solution which will produce the neces- sary chemosis. This dose should not be increased until it loses its effect. The action of the remedy may be regarded as sufficient as long as its application is followed by chemo- sis, redness and burning sensations for from one to two minutes afterward. Under these circumstances it may be instilled once a day. The patient should be instructed that the swelling of the conjunctiva is necessary to the thera- peutic action of the remedy and that no harm to the eye will ensue from its use. In cases of corneal opacity ethyl-morphin hydrochloric! has been applied to the eye in the form of powder. It may also be used as an ointment in strength varying from 1.5 'to 5 per cent. Alcohol. Alcohol, U. S. P. In European pharmacopeias it is usually designated as Spiritus, and varies considerably in strength. PROPERTIES : The official U. S. P. alcohol is a colorless volatile liquid containing about 94.9 per cent by volume of absolute ethyl alcohol, C 2 H 6 OH, and 5.1 per cent, by volume of water. It has a characteristic odor and burning taste and is miscible in all proportions with water, ether or chloroform. In addition to alcohol, the U. S. P also describes absolute alcohol, used as a laboratory reagent, etc., and also diluted alcohol (approximately 50 per cent.) used in pharmacy as a menstruum. ACTION AND USES: Externally, alcohol is a rubefacient and astringent, and by its evaporation, a refrigerant. It is used to harden and cleanse the skin; as a mild counter- irritant, (soap liniment), etc. In the concentration of 70 per cent, it is markedly antiseptic and is employed in sur- gery especially as Tincture of Green Soap, to cleanse the skin of patient and operator. USEFUL DRUGS 17 Internally, it is a narcotic, excessive doses depressing and paralyzing the central nervoiis system. Small doses produce euphoria, stimulate respiration, moderately dilate the cuta- neous and splanchnic vessels, and modify the circulation. It is burned in the body and thus serves to a restricted extent as a source of energy. Alcohol is employed as a diffusible stimulant, diuretic, diaphoretic and hypnotic. In well-selected cases, especially in patients accustomed to its use, it may be very valuable; otherwise it is apt to do more harm than good. In practice it is usually administered in the form of whisky, brandy, wine or other alcohol-containing beverages. It is generally accepted, however, that the aromatic principles in these several articles are even more toxic than is alcohol itself, and these beverages are therefore more poisonous than equal amounts of alcohol diluted with water. In pharmacy alcohol is used as a solvent and, for adminis- tering medicines, is largely used as a vehicle in the form of: Elixir Aromaticum. Aromatic Elixir, U. S. P. An aromatic and sweetened liquid containing about 25 per cent, of alcohol, by volume. Aloes. Aloe, U. S. P. The inspissated juice of various species of Aloe is included in all the pharmacopeias. It is used in its original form, as a watery extract or as a purified extract known as aloin. PROPERTIES : Aloes differs considerably in color and appear- ance, but in all its forms it has a rather characteristic odor and a nauseous, very bitter taste. Aloes is partially soluble in water. ACTION AND USES : Aloes belongs to the emodin group of cathartics acting on the large intestine. It is believed to cause pelvic congestion and to have an emmenagogue action. Its action is said to be enhanced by the addition of soap and iron. Its purgative action is slow, evacuation occurring only after some hours, the stools being soft, seldom watery. Aloes is adapted to the treatment of constipation by daily laxative action, but should rarely be used as a purgative, because of its tendency to cause griping. Because of the pelvic congestion it produces, aloes is contra-indicated in pregnancy and in- the presence of hemorrhoids. It is an appropriate remedy in functional amenorrhea if the produc- tion of pelvic congestion is deemed advantageous. DOSAGE: The purgative dose of aloes is from 0.15 to 0.3 gm. or from 2 to 5 grains. For the treatment of chronic constipation smaller doses, 0.03 to 0.05 gm. or ^ to 1 grain, should be used. A preparation of belladonna is usually combined with it. Extractum Aloes. Extract of Aloes, U. S. P. DOSAGE: 0.10 gm. or 2 grains. 18 USEFUL DRUGS Aloinum. Aloin, U. S. P. DOSAGE: Purgative dose 0.05 gm. or 1 grain. In the treatment of chronic constipation aloin is frequently given in doses of from 0.005 to 0.02 gm. or 1/10 to 1/3 grain in combination with extract of belladonna and strychnin. gm. or c.c. 0015 gr. 1/40 02 gr. 1/3 006 gr. 1/10 15 Strychninae sulphatis .... Aloinae Extract! belladonnae .... Mix and make 1 pill or tablet. Take 1 after supper or at bedtime ; if at bedtime, with plenty of water and a cracker, or at least never on an empty stomach. ' Alumen. Alum, U. S. P. Crystallized potassium aluminum sulphate, AlK(S0 4 )o, 12H 2 O. PROPERTIES : Alum occurs as colorless crystals or a white powder without odor, but having a strongly astringent taste. It is freely soluble in water, practically insoluble in alcohol. It con- tains about 45 per cent, of water of hydration, which can be removed by heat, the product being exsiccated alum. INCOMPATIBILITIES: Alum is incompatible with alkalies and carbonates, which react with it with the formation of insoluble aluminum hydroxid. It is also incompatible with salts of lead because it precipitates the insoluble lead sul- phate. ACTION AND USES: Alum is astringent, styptic and hemo- static, but is seldom administered internally. DOSAGE: Alum solution may be used as a gargle (from 1 to 5 per cent.) but it is somewhat injurious to the teeth; it may be given as an injection in gonorrhea (from 0.5 to 1 per cent.) and as a lotion in skin diseases (1 per cent.). Alumen Exsiccatum. Exsiccated Alum, U. S. P. A powder representing about twice its weight of the crystallized alum; it is sometimes used externally as a dusting powder or in the form of ointments. Alumini Acetas. Aluminum Acetate. Used principally in the form of: Liquor Alumini Acetatis. Solution of Aluminum Acetate, N. F. PROPERTIES : A clear, colorless solution, containing from 7.5 to 8 per cent, of basic aluminum acetate, having an acetous odor and a sweetish, astringent taste. ACTIONS AND USES: Solution of aluminum acetate is used extensively at the present time as a mild astringent and antiseptic. Because of the readiness with which this solution is decomposed it is advisable to dilute it with water only. Applied to the skin it should be diluted from four to nine times. USEFUL DRUGS 10 AMMONIUM COMPOUNDS Ammonium compounds are divisible into two classes. In the first class the ammonium is combined with a strong acid such as hydrochloric or sulphuric. These form stable, neu- tral salts which act largely by their salt action. In tin- second class, the ammonium is combined with a weak acid radical such as hydroxyl or the radical of carbonates. These compounds are unstable, decomposing readily with liberation of ammonia. Such compounds produce reflex effects by the irritating action of the ammonia evolved. All ammonium compounds used in medicine are soluble in water and the carbonate and hydroxid have a strong alkaline reaction. ACTION AND USES : Ammonium salts, when injected into the circulation, stimulate the central nervous system, but they are so rapidly excreted or converted into urea that they cannot produce systemic action when taken by mouth, even though they are absorbed very readily. Their effects are, therefore, entirely local. Ammonium acetate was believed to be diaphoretic, but probably has little value. The neutral salts are rather irritant and thus cause a mild stimulation of the mucous membanes, explaining the use of ammonium chlorid as an expectorant. With ammo- nium carbonate, this effect is reinforced by its alkaline reaction, through which it liquefies and dissolves mucus. Ammonia (NH 3 ). A gas which is very soluble in alcohol and water with formation to some extent of NH 4 OH. Water of ammonia and the several preparations containing it are strongly alkaline. INCOMPATIBILITIES : It is incompatible with acids, neu- tralizing them and forming the salts of ammonium. It is also incompatible with the soluble salts of many metals because it precipitates from these solutions the hydroxid of the metals. Thus ammonia water with solution of ferric chlorid produces an insoluble precipitate of ferric hydroxid. Solutions of ammonia are also incompatible with the salts of alkaloids from which they liberate the alkaloid. Thus ammonia water added to a solution of strychnin sulphate produces a precipitate of the insoluble alkaloid strychnin. ACTIONS AND USES : Ammonia internally in the form of water of ammonia or of aromatic spirit of ammonia is stimulant, because the ammonia escaping irritates the mucous membranes of the nose and of the stomach and causes a reflex increase in the force of the heart and in the blood-pressure. Little, if any, of the gas is absorbed by the respiratory tract. Externally, ammonia is used as a counterirritant. It reddens the skin but does not blister, unless applied in concentrated solution. 20 USEFUL DRUGS Aqua Ammoniae. Ammonia Water, U. S. P. An aqueous solution, containing about 10 per cent, by weight of ammonia (NH 3 ). On standing, this solution loses ammonia and hence should be kept in well- stoppered bottles and should frequently be tested by the pharmacist to insure its complying with the pharmacopeial require- ments. Ammonia water is a colorless liquid, having a very pungent, characteristic odor and a caustic, soapy taste. It is freely miscible with water and alcohol. Ammonia water is used chiefly for counterirritation in the form of: Linimentum Ammoniae. Ammonia Liniment, U. S. P. A mixture of ammonia water 35 parts, alcohol 5 parts and a fatty oil 60 parts. Ammonii Acetas. Ammonium Acetate. Used chiefly in the form of: Liquor Ammonii Acetatis. Solution of Ammonium Acetate, U. S. P. An aqueous solution containing about 7 per cent, of ammonium acetate. It is made by dissolving ammonium carbonate in diluted acetic acid. It is a clear, colorless liquid, having a mildly saline, acidulous taste and an acid reaction. It is incompatible with alkaline hydroxids and carbonates, which liberate ammonia. ACTIONS AND USES: Solution of ammonium acetate was formerly credited with diaphoretic and diuretic powers, but they are very weak. It is used in fevers and infections to promote sweating. DOSAGE : 15 c.c. or 4 fluidrams, which can be repeated once in two or three hours. Ammonii Carbonas. Ammonium carbonate, U. S. P. Ammonium carbonate consists of a mixture of ammonium bicarbonate and ammonium carbamate. PROPEKTIES : It occurs as white, hard masses, having a strong odor of ammonia and a sharp, saline taste. On exposure to the air the salt loses both ammonia and carbon dioxid. Ammonium carbonate is slowly but freely soluble in water, the ammonium carbamate being thereby converted into normal ammonium car- bonate. Alcohol dissolves the carbamate and leaves the bicar- bonate. INCOMPATIBILITIES: Ammonium carbonate is incompati- ble with acids, which decompose it, forming salts of ammo- nium and evolving carbon dioxid (CO 2 ). It precipitates the carbonate or the hydroxid of most metals and the insol- uble alkaloids from solutions of their salts. ACTION AND USES: Ammonium carbonate is largely decomposed (hydrolyzed) when dissolved in water, and its solutions are irritant to mucous membranes from the action of the ammonia set free. It is used by inhalation or in USEFUL DRUGS 21 solutions as a reflex or diffusible stimulant in syncope, or arrest of respiration, and as a liquefying expectorant in bronchitis. DOSAGE: 0.25 gm. or 4 grains, dissolved in sufficient water to avoid too great irritation, which may result in nausea and vomiting. On the other hand, as the action of the remedy depends on its irritating qualities, it should not be too greatly diluted. Spiritus Ammoniae Aromaticus. Aromatic Spirit of Ammonia, U. S. P. A solution of ammonium carbonate with some free ammonia and aromatic oils in alcohol. ACTION AND USES : The same as those of Ammonium Carbonate. DOSAGE: From 1 to 5 c.c. or 15 to 60 minims, suitably diluted with water. As the stimulating action is of short duration a moderate dose may be repeated in from fifteen minutes to half an hour. Ammonii Chloridum. Ammonium Chlorid, U. S. P., NH 4 C1. PROPERTIES : Ammonium chlorid usually occurs as a white, crystalline powder, without odor, having a cooling, saline taste. It is freely soluble in water (1:2), and soluble in alcohol (1:50), its aqueous solutions being neutral or very slightly acid to litmus. INCOMPATIBILITIES : Ammonium chlorid is incompatible with alkaline hydroxids and carbonates, which liberate ammonia. It precipitates the insoluble chlorids of silver and of lead from solutions of the salts of those metals. ACTION AND USES: Ammonium chlorid is said to be absorbed more quickly than any other salt, and in general has saline properties. Its principal activity is as an expec- torant, though it is slightly diuretic and diaphoretic. Its vapors have been used for inhalation in cases of nasopharyn- geal catarrh and as an expectorant in bronchitis. For this purpose it may also be generated in a special apparatus by the union of the vapors of strong hydrochloric acid and ammonia water. DOSAGE: From 0.30 to 1 gm. (from 5 to 15 grains), repeated every two or three hours, or less frequently, depending on the size of the dose. Its taste is best concealed or modified by administering it in a sour mixture as : IJ Ammonii chloridi 5 Syrupi acidi citric! 50 gm. or c.c. 5 iss fl.Sii fl.5iv Aquae q.s ad 100 M. et Sig. : A teaspoonful, in water, every two hours. To the preceding prescription codein sulphate may be added, if desired. The amount of citric acid should be diminished when the prescription is for a child, and after the child has taken a dose of it he could be given a piece of chocolate or a simple peppermint or wintergreen lozenge. 22 USEFUL DRUGS NITRITES The Nitrites used in medicine are certain salts or esters of nitrous acid and possess a common pharmacologic action. This group also includes certain organic nitrates which are reduced to nitrites in the organism. The chief members are amyl nitrite, sodium nitrite and glycerol nitrate (glyceryl trinitrate or nitroglycerin ) . The characteristic action of this group is vasodilatation with a fall of the blood-pressure. The members differ chiefly in the rapidity and duration of their effects, amyl nitrite being the quickest, though its action is of correspond- ingly short duration. Amylis Nitris. Amyl Nitrite, U. S. P. PROPERTIES : A liquid containing about 80 per cent, of amyl (chiefly iso-amyl) nitrite. It should be kept in hermetically sealed glass bulbs or in dark, amber-colored, glass-stoppered vials. in a cool, dark place. Amyl nitrite is a clear, yellowish liquid of a peculiar, ethereal, fruity odor and a pungent, aromatic taste. It is very volatile even at low temperatures, and is inflam- mable. It Is practically insoluble in water, but miscible in all proportions with alcohol or ether. ACTION AND USES : When given by inhalation, amyl nitrite produces an almost instantaneous dilatation of the peripheral blood-vessels, shown by redness of the skin begin- ning in the head and neck, rapidly spreading over the body and sometimes extending to the lower extremities. This is promptly followed by a dilatation of the splanchnic and other vessels so that the blood-pressure soon falls. The lowered pressure increases the heart-rate. There is a feeling of fulness in the head, often accompanied by headache. The breathing is rapid. With excessive doses unconsciousness may supervene, and convulsions may occasionally occur after toxic doses. Large doses kill by respiratory paralysis. It may produce methemoglobin in the blood and cause the excretion of sugar in the urine. As much as 0.6 c.c. may be inhaled without dangerous results. The effects of the medicinal administration of amyl nitrite are very transient. It is employed to relieve spasm in epilepsy, sometimes averting an expected paroxysm. It is also used to relax the spasm of the blood-vessels in angina pectoris and in other painful affections in which there is reason to believe that the pain depends on arterial spasm. Amyl nitrite is given to reduce the blood-pressure in cases in which hemorrhage is due to the rupture of a blood- vessel in the lungs, brain or other organ in consequence of elevated blood pressure, but in hemorrhage with normal blood-pressure it may do harm. It has been used with favorable results in bronchial asthma. DOSAGE: 0.2 c.c. or 3 minims, by inhalation. It is con- veniently carried in the form of glass pearls, each pearl containing a dose. When required the pearl is crushed in the handkerchief ami the contents inhaled. USEFUL DRUGS 23 Amylum. Starch Corn-Starch, U. S. P. The starch grains obtained from the fruit of Zea mays occur in the form of powder or irregular, angular, white masses, insoluble in both water and alcohol, but swelling into a colloidal "paste' 5 when boiled in water. ACTION AND USES: Dry starch is used as a dusting and drying powder and also as a diluent for other more active substances. The mucilage produced on boiling, with water or glycerol is employed as an emollient and protective; as a cataplasm, and as an antidote to iodin poisoning. The starches from other cereals, from cassava and the potato have practically the same medicinal properties as corn- starch. Antimonii et Potassii Tartras. Antimony and Potassium Tartrate, U. S. P., Tartar Emetic. Antimony and potassium tartrate is a double salt of antimony and potassium with the radical of tartaric acid. PROPERTIES : It occurs as a white powder or as colorless trans- parent crystals, becoming white and opaque on exposure to the air. It is soluble in water, but practically insoluble in alcohol. INCOMPATIBILITIES: It is incompatible with alkalies and their carbonates, tannic acid and astringent preparations generally. ACTION AND USES : Antimony and Potassium Tartrate, when applied to the skin, gives rise slowly to inflammatory changes, with pustules and ulceration, which is somewhat difficult to limit. The ointment formerly employed as a pustulant counterirritant is now rarely used. Internally it produces local irritation of the gastro- intestinal tract, and thereby nausea and vomiting with marked prostration. If absorbed, symptoms very similar to those produced by poisonous doses of arsenic are observed. The therapeutic uses of tartar emetic are almost entirely confined to the treatment of the first stage of acute laryn- gitis and bronchitis. It should be avoided in cases marked by depression. When it is given, the object should be to increase secretion and facilitate the expulsion of sputum. The administration of tartar emetic should not be carried beyond the production of slight nausea. For the production of vomiting other agents are preferable. DOSAGE: As an expectorant small doses should be used, beginning with 0.001 gm. or 1/60 grain, which may be repeated hourly, taking care to avoid too great depression. The emetic dose is 0.03 gm. or % grain. Vinum, Antimonii. Wine of antimony, U. S. P. One hundred c.c. contain 0.4 gm. of antimony and potas- sium tartrate in white wine fortified by alcohol. This preparation is practically identical with the antimonial wine official in other countries. 24 USEFUL DRUGS DOSAGE: 1 c.c. or 15 minims, equivalent to 0.004 gm. or 1/15 grain of antimonium and potassium tartrate. As an expectorant smaller Closes such as 0.2 c.c. or 3 minims should be employed. Apomorphmae Hydrochloridum. Apomorphine Hydrochlorid, U. S. P. The hydrochlorid of an artificial alkaloid prepared from morphin by the abstraction of one molecule of water. PROPERTIES : Apomorphin hydrochlorid occurs as minute, grayish-white prisms, having a slightly bitter taste and acquiring a greenish tint on exposure to light and air. It is soluble in both water and alcohol. If the salt imparts at once an emerald-green color to 100 parts of water it should be rejected. The amor- phous form may contain dangerous impurities. INCOMPATIBILITIES : It is precipitated by alkalies and the other alkaloidal reagents. Solutions decompose rather readily. ACTION AND USES: The chief action of apomorphin is the production of vomiting with its usual accompanying symptoms, including nausea with increase of saliva and other secretions, depression of the circulation, sweating, etc. It sometimes produces respiratory paralysis, even in small doses. The drug is used chiefly as an emetic. For this purpose it has the advantage that it acts on the vomiting center, independently of a local action on the stomach. It produces a prompt emptying of the stomach with little subsequent sickness, unless the dose is large. It is therefore a useful emetic in poisoning, if the stomach-tube cannot be employed. It has been advised for the expulsion of foreign bodies from the air-passages. As an expectorant it is inferior to other nauseants. It is said to be sometimes useful in asthma. Small doses (0.002 gm., 1/30 grain) are hypnotic, especially in acute alcoholism. DOSAGE: The emetic dose is 0.005 gm. or 1/10 grain, given preferably by hypodermic injection. This may be repeated at ten-minute intervals until effective, but it should be remembered that in some cases apomorphin produces toxic effects without causing vomiting, and a dose of 0.004 gm. or 1/15 grain is said to have produced death in a person enfeebled by chronic bronchitis; 0.012 or 1/5 grain may be given to robust patients at the first dose if the urgency of the case demands it, but care should be exercised in the use of these doses. As an expectorant the proper dose is from 0.001 gm. to 0.002 gm. or from 1/60 to 1/30 grain, repeated once an hour or once in two hours, with the avoidance of more than slight nausea. Antipyrina. Antipyrine, U. S. P. This substance is described in the British Pharmacopeia as phenazonum and in the German Pharmacopeia and some USEFUL DRUGS 25 other European pharmacopeias as pyrazolomim phenyldi- methylicum. PROPERTIES : Antipyrin occurs as a colorless, almost odorless, crystalline powder or tabular crystals having a slightly bitter taste. It is very soluble in water and freely soluble in alcohol. INCOMPATIBILITIES: Antipyrin is incompatible with spirit of nitrous ether, or other nitrites, tannic acid and tannic- acid containing preparations. Mixed dry with sodium sali- cylate, it liquefies on standing. ACTION AND USES : Antipyrin is an antipyretic and analgesic, acting similarly to acetanilid. It is used for the relief of pain, chiefly when of a neural- gic character. It is not suited to the treatment of the pain caused by inflammation. Antipyrin is now seldom used as an antipyretic. Locally, it is used sometimes as a hemostatic. It is a valuable anti- spasmodic for use with children for pertussis, bronchitis, etc. It is dangerous, however, in preparations sold directly to the laity. DOSAGE: 0.25 gm. or 4 grains, given with even greater caution than acetanilid and acetphenetidin. It is best- administered by itself in simple solution, or in powders, capsules or cachets. Aqua. Water, U. S. P. Water is described by the Pharmacopeia as potable water in its purest obtainable state. Water used for medicines should be sterile; it is preferable to use: Aqua Destillata. Distilled Water, U. S. P. Distilled water is described as a colorless, limpid liquid, without odor or taste, and perfectly neutral to litmus paper. For some purposes (in making solutions of salvar- san, for example), it is essential that it be freshly distilled. Ordinary distilled water frequently is not sterile. AQUAE WATERS The official medicated waters are aqueous solutions of volatile substances. The aromatic waters are saturated solutions of volatile oils. They are used as vehicles for the more active, water-soluble drugs. For preparations included in this list see: Aqua Ammoniac, under Ammonia. Aqua Camphorae, under Camphora. Aqua Chloroformi, under Chloroformum. Aqua Cinnamomi, under Cinnamomum. Aqua Destillata, under Aqua. Aqua Hydrogenii Dioxidi. See under Hydrogenii Diox- idum. Aqua Menthae Piperitae, under Mentha Piperita. Aqua Rosae, under Rosa. Argenti Nitras. Silver Nitrate, U. S. P., Lunar Caustic. PROPERTIES : Silver nitrate, AgNO 3 , occurs in colorless, crystal- line tables, becoming gray, or grayish black on exposure to light 26 USEFUL DRUGS in the presence of organic matter. It is odorless and has a bit- ter, caustic, and strongly metallic taste. It is very soluble in water and soluble in alcohol. INCOMPATIBILITIES: Silver nitrate is incompatible with soluble chlorids, bromids and iodids, with which it forms the corresponding very insoluble salts of silver. It is also incom- patible with soluble carbonates and hydroxids, which precipitate the oxid of silver, and with all organic drugs and reducing agents. ACTION AND USES : Silver nitrate is an antiseptic and germicide, destroying many micro-organisms in solutions of a strength of 1 : 1,000 and preventing their growth in a strength of 1 : 10,000. Weak solutions are astringent to mucous membranes and strong solutions are caustic when applied to mucous membranes, denuded surfaces, and, in some cases, to the normal skin. When taken internally silver nitrate is believed to hinder the secretion of the gastric juice, especially when the degree of acidity is excessive. Silver nitrate is used as a mild caustic to wounds, ulcers and exuberant granulations. It is applied as an astringent and antiseptic in catarrhal infections of the mucous mem- branes. Internally it is sometimes employed as an astringent in diarrhea, but its use for this purpose is not to be recom- mended. It has been advised for the treatment of gastric ulcer and to reduce the gastric secretion in hyperchlorhydria. Its internal use for some time may be followed by its deposition in the skin, producing the condition known as argyria. DOSAGE: As a caustic, silver nitrate is used in the form of fused silver nitrate. This should be moistened before use and should be held with forceps or in a suitable holder. Care should be taken to limit its action to the affected part. In applications to mucous membranes the following strengths of solution in water are most suitable: To the conjunctiva a strength of 4 per cent, may be applied in small quantity and the action stopped by addi- tion of solution of sodium chlorid. This method of use is applicable to cases of severe conjunctivitis, especially gonorrhea!. For the prevention of gonorrheal conjunctivitis in the new-born a drop of 2 per cent, solution should be instilled into the eye as soon as practicable after delivery. For other diseases of the conjunctiva, solutions varying in strength from 0.2 to 2 per cent, are sometimes used, but it is probable that other astringents are safer and quite as useful. To the larynx, application is made of solutions contain- ing from 2 to 10 per cent, of silver nitrate. For the urethra, it is employed in the strength of from 1 : 10,000 to 1 -.2,000, and a solution of the strength of 1 : 5,000 may be injected into the bladder. A solution of USEFUL DRUGS 27 from 1 : 2,000 to 1 : 1,000 is used as a gastric douche in hyperchlorhydria and gastric ulcer, followed after two min- utes by a solution of sodium chlorid which is thoroughly mixed with the silver solution and then washed out of tho stomach. Solutions of silver nitrate should always be made witli distilled water, and the mucous membranes to which they are to be applied should receive a preliminary cleansing to remove mucus, pus, food, etc., which might interfere with its action. The action may be stopped by sodium chlorid solution. Internally the salt may be given in pill form, preferably mixed with kaolin and massed with petrolatum. The aver- age dose is 0.01 gin. or 1/5 grain. This dose may also be given in solution when the direct effect on the stomach is desired. If the stomach contains acid it would be- con- verted into silver chlorid; hence it should be given on an empty stomach. Argenti Nitras Fusus. Molded Silver Nitrate, U. S. P. A white, hard solid generally in the form of pencils or cones. A small amount of silver chlorid is added in tho process for the purpose of toughening the mass. Argenti Proteinas. Silver Proteinate; see Protargol, N. N. R. Aristol. See Thymolis lodidum. Arseni Trioxidum. Arsenic Trioxid, U. S. P., As 2 O s . Formerly official as arsenous acid. PROPERTIES : Arsenic trioxid occurs as an opaque, white powder or in irregular masses of two varieties, one amorphous, the other crystalline, opaque and colorless like glass. Arsenic trioxid is very slowly soluble in water and practically insoluble in alcohol (1:30 to 1:100). It dissolves quite readily in solu- tions of acids or alkalies. INCOMPATIBILITIES : Solutions of arsenic are incompatible with salts of iron and of magnesium, lime-water and vege- table astringents. ACTION AND USES: Local External Effects and Uses: Arsenic trioxid applied to denuded or ulcerated tissue has a mildly caustic action which is quite painful. It has been used as a caustic, especially to malignant growths, but the painful character of the applications, the danger of absorp- tion, and the uncertain extent of the destructive action have justly limited its use. Internal Actions : Ars'enic trioxid irritates the mucous membrane of the stomach and intestines. Toxic doses cause nausea and vomiting and colicky pains in the abdo- men. It produces a diarrhea of a watery character resem- bling that of cholera. In small doses it produces fatty degeneration of the liver and other internal organs; large doses produce great depression, and collapse may ensue. Arsenic in therapeutic doses is employed in the treatment of neuralgia. It is thought to be especially adapted to 28 USEFUL DRUGS cases of a periodic character. It is also useful in the treatment of chorea. Larger doses, especially if long con- tinued, may cause peripheral neuritis. Arsenic stimulates the action of the blood-forming organs, especially the bone- marrow. It is especially useful in the treatment of per- nicious anemia, leukemia and Hodgkin's disease. In these diseases it must be used in as large doses as can be borne. While improvement occurs in these conditions under the use of arsenic it is usually only temporary. Many skin-diseases are favorably influenced by proper doses of arsenic. It acts by stimulating the skin, in such cases as usually require external stimulating applications. It is also of service in lesions due to disturbances of inner- vation in which the skin is usually poorly nourished. The following skin affections may be mentioned as likely to be benefited by arsenic: psoriasis, lichen planus, chronic eczema, pemphigus, dermatitis herpetiiormis, chronic urticaria and disturbances of the sweat function. On the other hand, acute inflammatory conditions of the skin are made worse by arsenic. Arsenic is recommended in chronic bronchitis and emphy- sema. It has been used with apparent good results in tuberculosis. Too great dependence, however, should not be placed on it in the latter affection. It is used in asthma by way of the stomach and in the form of cigarettes. Arsenic is a powerful remedy against protozoal affections. These include malaria, syphilis and relapsing fever. In the form of arsenic trioxid it has been used successfully in malaria, particularly in the chronic form and in malarial cachexia. See Salvarsan. DOSAGE: For ordinary affections of metabolism or for a tonic influence the dose may vary from 0.001 to 0.002 gm. or 1/60 to 1/30 grain. In diseases of the blood the dosage should be regulated according to the effect, but it is well to use as large doses as the patient will tolerate. Arsenic may be used in increasing doses until symptoms of mild intoxication appear. One may begin with 0.005 gm. or 1/20 grain of arsenic trioxid three times daily, and increase by 0.001 gm. or 1/60 grain three times daily. In using Fowler's solution the initial dose may be 3 minims three times daily and increase by 1 minim three times daily. A slight toxic action is indicated by nausea, colicky pains or a puffiness under the eyes. The presence of albumin in the urine may also be observed. Such symptoms may make advisable the temporary withdrawal of the remedy. Liquor Potassii Arsenitis. Solution of Potassium Arsenite, U. S. P., Fowler's Solution. An aqueous solution containing potassium arsenite, cor- responding to 1 per cent, of arsenic trioxid. DOSAGE: 0.2 c.c. or 3 minims. USEFUL DRUGS 29 This solution is often somewhat alkaline and is therefore incompatible with alkaloidal salts. This is avoided in the following : Liquor Acidi Arsenosi. Solution of Arsenous Acid., U. S. P. An aqueous solution containing the equivalent of 1 per cent, of arsenic trioxid with 5 per cent, of hydrochloric acid. DOSAGE: 0.2 c.c. or 3 minims. Liquor Arseni et Hydrargyri lodidi. Solution of Arsenous and Mercuric lodids, U. S. P. Commonly designated as Donovan's solution; represents 1 per cent, of arsenous iodid and 1 per cent, of mercuric iodid. DOSAGE: 0.1 c.c. or 1% minims. Asafoetida. Asafetida, U. S. P. A gum resin obtained from the roots of Ferula foctida and probably other species of Ferula,. PBOPERTIES : A good quality of asafetida should contain not less than 50 per cent, of matter soluble in alcohol and should yield not more than 10 per cent, of ash. The gum of asafetida is freely soluble in cold or hot water and is present in sufficient amount to suspend in the form of a permanent emulsion the accompanying resin and volatile oil. ACTION AND USES: Asafetida is used in the treatment of hysteria, acting probably by its odor. It is also car- minative. DOSAGE: 0.25 gm. or 4 grains preferably in pill form. In tympanites an emulsion may be used as an enema. The emulsion is made by triturating 4 gm. of a good quality of the drug with 100 c.c. of water until a uniform emulsion results. The strength may be varied to meet individual requirements. Aspidium. Aspidium, U. S. P., Male Fern. The dried rhizome of several species of Dryopteris; used only in the form of: Oleoresina Aspidii. Oleoresin of Aspidium, U. S. P. An oleoresin prepared by extracting aspidium with acet- one, evaporating and recovering the solvent. PROPERTIES : The most important constituent of male fern is fllicic acid. ACTION AND USES: Ordinarily the active constituents of aspidium are not absorbed and produce no symptoms except some nausea. If absorption occurs, violent symptoms of poisoning may ensue. The symptoms are excessive vomiting and purging, great weakness, spasms in the extremities, convulsions, stupor deepening into coma and collapse. Dis- turbances of sight and hearing may occur and permanent blindness sometimes follows. Jaundice has been observed. 30 USEFUL DRUGS Oleoresin of aspidium is used as a teniacide against ordi- nary tapeworm, but it is said to be more efficient against the Bothrioccphalus than against ordinary tenias. DOSAGE: 2 gm. or 30 grains is given by the Pharmacopeia, but most authorities recommend a larger dose. The dose should be proportioned to the strength and health of the patient. Robust males can take as much as 8 gm. or 2 liuidrams, while women should be given smaller doses and special caution should be exercised in administering the drug to anemic or debilitated persons. Children of 4 years may take 4 gm. or 60 grains. Before this remedy is given, the alimentary canal should be emptied by a light diet or fasting for twenty-four hours and the administration of a saline cathartic in the morning before the anthelmintic is given. The drug should be given early in the morning and is best directed to be taken in capsules containing 0.3 gm. or 5 grains, or in the form of emulsion. The total quantity may be given in divided doses at intervals of fifteen minutes and the last dose followed in three hours by a saline laxative. Castor oil or other fixed oils should not be given, because they favor the absorp- tion of the active principle. A dose of 8 gm. or 2 drams has been fatal to a child and 25 gm. or 6 drams have several times proved fatal to adults. Aspirin. Aspirin, N. N. R., Acetyl salicylic Acid, C 6 H 4 0(CH 3 CO) COOH. The acetic acid ester of salicylic acid. PEOPEETIES : Aspirin occurs as a crystalline, odorless powder with a faintly acidulous taste. It is slightly soluble in water (1 :100) and freely soluble in alcohol. ACTION AND USES: Aspirin acts like salicylic acid and the salicylates, but is claimed to be less disturbing to the stomach. It is used as an antipyretic, analgesic and anti- rheumatic. It is much used for the relief of headache and other painful affections. DOSAGE: 0.3 to 1 gm. or 5 to 15 grains, repeated once in 3 hours until symptoms of salicylism (ringing in the ears, etc.) are noted. Atoxyl. See Sodii Arsanilas. Atropina. Atropine, U. S. P. An alkaloid obtained from Atropa belladonna and from other solanaceous plants. PROPERTIES : The alkaloid itself is only slightly soluble iu water and is usually prescribed in the form of one of Its salts, which are readily soluble. INCOMPATIBILITIES: Solutions of atropin are stated to be incompatible with alkalies. While no precipitate of the alkaloid would form, unless the solution were more concen- trated than those ordinarily used in medicine, the alkaloid in the presence of alkalies is likely to be decomposed. USEFUL DRUGS 31 Solutions of the alkaloid are also incompatible with tannic acid, with LugoPs solution, and with potassiomercuric iodid, which precipitate compounds of the alkaloid, and with salts of mercury, such as the chlorid, which decomposes it. ACTION AND USES: Atropin and the related alkaloids act on the sympathetic and especially on the autonomic nerv- ous system. If the ordinary stimulation of these nerves causes motor or secretory activity, the use of atropin will inhibit it, and if the normal action of the nerve is inhibitory, atropin removes the inhibition. The alkaloid produces a cerebral stimulation which shows itself by quickened thought and speech, eventuating in a peculiar talkative delirium with hallucinations. Larger doses produce unconsciousness and occasional convulsions. Atropin checks the secretion of saliva so that the mouth and throat become dry. This dryness is due to some extent to a similar effect on the mucous secretions of the mouth, throat and nose. As an application of this action, the drug is occasionally used to check excessive secretion of saliva in ptyalism, mercurial salivation, etc. It is also used in coryza, especially in the first stage, to lessen the congestion and excessive secretion of the nasal mucus. It is held by some to be very useful in sore throat. It is used in case of excessive expectoration in bronchitis, bronchorrhea, etc. It also checks the secretion of saliva and mucus during anes- thesia in operations on the throat, larynx, etc. Atropin lessens the secretion of hydrochloric acid by the stomach. It is given for this purpose in hyperchlorhydria, gastric ulcer, etc. While it has a decided effect on the secre- tion, its use should not be continued for a long time. It lessens the secretion of the pancreatic juice, or at least pre- vents the increase that follows the ingestion of physostigmin and other drugs, but does not prevent the action of secretin. It is doubtful whether it has any effect on bile. It is said not to affect the secretion of intestinal mucus. It relaxes spasm of the intestinal musculature and in small doses favors the normal peristalsis. It is therefore of great service in spasmodic affections of the stomach and intestine. It may be prescribed in colic, painful spasms due to gastric, duodenal or intestinal ulcers, spastic constipation, etc. It is a service- able anodyne in gall-stone colic and may render the use of morphin unnecessary. In small or moderate doses it acts as a respiratory stim- ula^t, but large doses cause respiratory paralysis. It may be employed with good effect in cases in which the respira- tion is embarrassed from other than mechanical agents. It is used for this purpose in morphin poisoning, but it should be administered with great care on account of the respiratory depression caused by large doses. To obviate the effect of morphin on the respiration it is given with the latter drug in hypodermic injections. It has also been given with morphin as a preliminary to anesthesia by ether; in such, cases it also serves to lessen the salivary and bron- chial secretions. 32 USEFUL DRUGS By paralyzing the vagus endings atropin increases the rapidity of the heart-beat. Its depressant action on the vagus is made use of in the diagnosis of certain disturbances of the cardiac rhythm, particularly bradycardia. If the slow pulse is due to an organic lesion of the conducting mechanism (heart-block), it will persist in spite of the action of atropin, but if it is due to vagal stimulation, an increased rate usually results from an effective dose. Atropin in moderate doses relaxes the blood-vessels of the skin so that the skin, especially of the face and upper extremities, becomes red, sometimes showing an eruption closely resembling that of scarlet fever. In larger doses it contracts the vessels of the splanchnic area and raises the blood-pressure. In still larger doses a general fall of blood- pressure occurs, accompanied by a very rapid and feeble pulse. It is not, however, an essential heart tonic. The secretion of sweat is reduced by atropin. It is used for the suppression of night sweats, especially in pulmonary tuberculosis. A single dose given at night may be followed the next night by a larger dose if the first was not successful. The use of atropin for this purpose should be deferred as long as practicable and discontinued as soon as may be on account of disturbing influence on digestion. Atropin produces dilatation of the pupil, paralysis of the accommodation and consequent disturbance of vision by a local action on the oculo-motor nerve endings in the iris. When the drug is taken internally the effect is due to the atropin circulating in the blood, and is bilateral. When the drug is applied locally the action is unilateral unless some general absorption takes place or some of the solution is introduced into the other eye by accident. To produce these actions, atropin is employed in solution dropped into the conjunctival sac for the purpose of facil- itating the examination of the eye with the ophthalmoscope. The dilatation of the pupil also serves as a diagnostic mea- sure in case of iritis as the pupil dilates irregularly in this disease. The wide dilatation of the pupil also tends to prevent its adhesion to the cornea or lens. Sufficient absorption may take place from lotions dropped into the conjunctiva to produce general symptoms and even to cause toxic effects. Atropin is sometimes used externally in the form of oint- ment of belladonna for the relief of certain forms of neural- gia, especially those in which pain results from local condi- tions of the nerve or surrounding tissues. It has been advised for local use in the rectum to relieve the pain of hemorrhoids or fissure. It is an old remedy for enuresis, but must be regarded in most cases as a purely empirical treatment to be used after investigation has shown the absence of organic lesions which may be remedied in other ways. It is used for vesical spasm due to irritable neck of the bladder. While the action of atropin on the milk is not entirely established, it is quite generally used locally in mammitis, USEFUL DRUGS 3:* galactorrhea and when it is desired to check the secretion of milk. DOSAGE: Unpleasant symptoms indicating the beginning of its physiologic effects are produced in some people by 0.0005 gm. or 1/125 grain. It is best, therefore, to begin with half this dose, 0.00025 gm. or 1/250 grain. Doses can be repeated once in two hours until distinct physiologic effects are produced. For the treatment of the stomach the remedy should be given in solution about fifteen min- utes before the meal. For action on the bowels it is com- monly given at bedtime. The same time is also chosen when giving it for night sweats. When atropin is being administered the patient or his friends should be warned of the possible appearance of slight toxic symptoms. The first indication is usually dry- ness of the throat. Some dimness of vision is also likely to be experienced. Serious poisoning usually begins with rapid pulse, flushing of the skin, talkative delirium, marked dilatation of the pupils, some elevation of the temperature and dryness of the throat and skin. This is followed more or less quickly by unconsciousness, prostration, paralysis of the voluntary muscles and marked vasomotor paralysis. Atropinae Sulphas. Atropine Sulphate, U. S. P. PROPERTIES : Atropin sulphate occurs as a white, crystalline powder or microscopic crystals which are odorless, but , have a very bitter, nauseating taste. Atropin sulphate is very soluble in water (1:0.38) and in alcohol (1:3.7). INCOMPATIBILITIES : Atropin sulphate is incompatible with alkalies and their carbonates and with the precipitants of alkaloids generally. DOSAGE: 0.4 mg. or 1/160 grain. See Atropin. Bacterial Vaccines. See Vaccina. Balsamum Peruvianum. Balsam of Peru, U. S. P. A balsam obtained from a tree, Toluifera Pereirae; it contains traces of cinnamic and benzoic acids and their esters and resins. ACTION AND USES : Balsam of Peru is not used inter- nally, but is sometimes applied in ointment or in alcoholic solution or mixed with castor oil as a stimulant to indo- lent wounds and ulcers to promote the formation of granu- lations and the process of cicatrization. Balsam of Peru is much used as a parasiticide in diseases of the skin, such as 'scabies. In scabies a 4 p?r cent, petrolatum ointment of Balsam of Peru, with the same amount of sulphur, chalk and green soap may be used. It should be applied freely at night and in the morning over all of the affected areas. The strength of this mixture can be doubled in obstinate cases. Balsam of Peru can be painted over portions of the body at night, 34 USEFUL DRUGS followed by a bath in the morning. In rare instances, however, Balsam of Peru produces violent dermatitis. Isamum Tolutanum. Balsam of Tolu, U. S. P. A balsam obtained from Toluifera Balsamum, a tree indige- nous to New Granada. PROPERTIES : Balsam of Tolu occurs as a yellowish-brown, plastic solid, becoming brittle when old, dried or exposed to cold. It is very soluble in alcohol, but nearly insoluble in water. ACTION AND USES: Balsam of Tolu like balsam of Peru is expectorant and stimulant; it is not used externally at the present time. The use of balsam of Tolu in medicine is largely restricted. It is used as one of the ingredients of compound tincture of benzoin and as a flavor or pleasant vehicle in the form of: Syrupus Tolutanus. Syrup of Tolu, U. S. P. A saturated solution of the aromatic constituents of bal- sam of Tolu in syrup. ACTION AND USES: Syrup of Tolu is much used as a vehicle for expectorant mixtures. DOSAGE : 16 c.c. or 4 fluidrams. Belladonnae Folia. Belladonna Leaves, U. S. P. The dried leaves of Atropa Belladonna, yielding by the process outlined in the pharmacopeia, not less than 0.3 per cent, of mydriatic alkaloids, chiefly hyoscyamin. ACTION AND USES: The active principle of belladonna acts like atropin. Belladonna leaves are narcotic, anodyne, anti- spasmodic and mydriatic, the medicinal value being due to the contained mydriatic alkaloids. Tinctura Belladonnae Foliorum. Tincture of Belladonna Leaves, U. S. P. One hundred c.c. represent 10 gm. of the drug. INCOMPATIBILITIES: The tincture should not be prescribed with alkalies. DOSAGE: 0.5 c.c. or 8 minims, representing approximately 0.00015 gm. or 1/400 grain of mydriatic alkaloids. Extractum Belladonnae Foliorum. Extract of Belladonna Leaves, U. S. P. A hydro-alcoholic extract of belladonna leaves. DOSAGE: 0.01 gm. or 1/5 grain, corresponding approxi- mately to 0.00015 gm. or 1/400 grain of mydriatic alkaloids. Emplastrum Belladonnae. Belladonna Plaster, U. S. P. This represents approximately 30 per cent, of extract of belladonna. The commercial and widely used plasters are not identical with that described in the pharmacopeia in other than alkaloidal content. USEFUL DRUGS 35 ACTION AND USES: The application of extract of bella- donna to the skin secures a local anodyne effect which is employed for the relief of rheumatic and neuralgic pains and soreness. It is a serviceable application in acute inflamma- tory conditions. Belladonna plaster is often used to relieve palpitation of the heart. DOSAGE: Plasters are not commonly made by pharmacists, but are supplied already spread by the manufacturers. They are usually prescribed by the size according to the area of skin to be covered. Unguentum Belladonnae. Belladonna Ointment, U. S. P. An ointment containing 10 per cent, of extract of bella- donna in a mixture of hydrous wool fat and benzoinated lard. Benzoinum. Benzoin, U. S. P. A balsamic resin obtained from several species of Styrax trees indigenous to Siam, Sumatra and Java. PROPERTIES : Benzoin contains, benzole acid, cinnamic acid and resins which are soluble in alcohol and to some extent at least in oils and fats. Tinctura Benzoinae Composita. Compound Tincture of Ben- zoin, U. S. P. A mixture of the alcohol-soluble constituents of benzoin. 10 gm.; aloes, 2 gm.; storax, 8 gm, and balsam of Tolu, 4 gm., in sufficient alcohol to make 100 c.c. ACTION AND USES: Compound tincture of benzoin is used as an application to the inflamed mucous membrane of the throat and bronchi by inhalation. It is soothing and acts as a stimulating expectorant. It is frequently administered by adding a teaspoonful to a glassful of boiling water and inhaling the vapor. It is also used as an addition to lotions of glycerol and water. It is useful as a stimulant and pro- tective for ulcers, bedsores, cracked nipples and fissures of the lips, anus, etc. Benzosulphinidum, Benzolsulphinid, Saccharin, U. S. P. The anhydrid of ortho-sulphamid-benzoic acid (Benzo- sulphonic-imid ) . PROPERTIES : Benzosulphinimid is a white, crystalline powder, nearly odorless, having an intensely sweet taste even in dilute solutions. It is soluble in alcohol (1 :25), but only slightly soluble in water (1:250). The addition of an alkali materially increases the solubility of saccharin in water by formation of a salt, and it is often prescribed mixed with an equal quantity of sodium bicarbonate or in the form of a sodium salt known as "soluble saccharin." Saccharin is about 500 times as sweet as sugar, but has a slightly different taste which is generally objected to after continued use. ACTION AND USES: Saccharin has no pronounced phar- macologic effect. It slightly retards the action of the diges- tive ferments and in very large doses intravenously produces some depression and stupor. The saccharin administered is excreted almost unchanged in the urine. 36 USEFUL DRUGS It is used as a substitute for sugar in the food of dia- betics. It must be remembered that saccharin has no food value. Some observers believe it to be always harmful. DOSAGE: 0.2 gm. or 3 grains. It may be mixed with an equal weight of sodium bicarbonate to insure its solubil- ity. A % -grain tablet is the most useful. A Betanaphthol. Betanaphthol, U. S. P. (Naphthol, U. S. P. 1890). Betanaphthol is a phenol found in coal-tar, but usually manufactured from naphthalene. PROPERTIES : It occurs as colorless, or pale buff-colored, crystal- line laminae or a crystalline powder, having a faint phenol-like odor and a sharp, pungent, but not persistent taste. It is only very slightly soluble in water, 1 :950, but is very soluble in alcohol (1:0.61). ACTION AND USES: Betanaphthol is irritating to the skin or mucous membranes when applied in solution. If absorbed in considerable amount it may cause nephritis by irritation of the kidneys. It tends to destroy the red blood-corpuscles and has been known to produce changes in the retina and opacity of the lens. It is a powerful anti- septic, several times stronger than phenol. Betanaphthol is applied externally as a parasiticide and antiseptic. Internally it has oeen much used as an intes- tinal antiseptic, but its utility is limited because of the danger of poisonous consequences from its possible absorp- tion. It has also been used as an anthelmintic for the treatment of hookworm disease. DOSAGE: 0.1 to 0.3 gm. or 2 to 5 grains. It is best given in powder or capsules. Externally it may be used in the form of ointment. i Bismuthi Subcarbonas. Bismuth Subcarbonate, U. S. P. A basic carbonate of bismuth of somewhat varying com- position, some specimens being more basic than others. PROPERTIES : Bismuth subcarbonate is practically insoluble in water or alcohol. It is decomposed by hydrochloric or nitric acid, giving a copious effervescence of carbon dioxid and producing a chlorid or nitrate of bismuth which enters into solution. When such a solution is diluted with water the insoluble basic chlorid (oxychlorid or subchlorid) or basic nitrate of bismuth is precipi- tated. Bismuth subcarbonate is readily decomposed by the acid of the gastric juice, but in this case while the acid is neutralized, an insoluble oxychlorid of bismuth remains, coating the stomach and thus acting therapeutically in the same manner as the original subcarbonate would. INCOMPATIBILITIES: It is incompatible with sulphids, sulphur, acids and acid salts. ACTION AND USES: Bismuth subcarbonate acts like other insoluble salts of bismuth. For its uses see Bismuth Sub- nitrate. In roentgenography it is to be preferred to bismuth subnitrate because of the fact that it cannot srive rise to USEFUL DRUGS 37 nitrite poisoning, which has occasionally happened when large doses of the subnitrate were used. DOSAGE: 0.5 gm. or 7% grains. Bismuth! Subgallas. Bismuth Subgallate, U. S. P., Dermatol. A basic gallate of bismuth of somewhat varying composi- tion, containing bismuth equivalent to from 52 to 57 per cent, of bismuth oxid. PROPERTIES : Bismuth subgallate occurs as an amorphous, bright yellow powder without odor or taste. It Is practically insoluble in water and in alcohol, but is decomposed by hydro- chloric, nitric or sulphuric acid if heated. It is also decomposed by alkali hydroxids. INCOMPATIBILITIES : Bismuth subgallate is incompatible with acids, alkalies, sulphids and sulphur. ACTION AND USES : Bismuth subgallate was introduced under the name of "Dermatol" for treatment of skin dis- ease. Its action and uses are similar to those of Bismutli Subnitrate, which see. DOSAGE: 0.25 gm. or 4 grains. Bismuth Subnitras. Bismuth subnitrate, U. S. P. Bismuth subnitrate is a basic bismuth nitrate of some- what varying chemical composition. PROPERTIES : Bismuth subnitrate occurs as a heavy, white, odorless and almost tasteless powder. It is practically insoluble in water and in alcohol and is little affected by weak acid solu- tions. Hydrochloric acid of the usual strength of the gastric juice decomposes only a small amount in the course of several hours. Hydrochloric or nitric acid, if not too dilute, decomposes it, producing the chlorid or nitrate, which enters into solution ; but when this solution is diluted with water the insoluble basic chlorid (oxychlorid or subchlorid) or basic nitrate (subnitrate) is precipitated. Basic bismuth nitrate is rendered more basic, by the action of alkali until finally it is converted into bismuth oxid, a nitrate of the alkali metal being formed. Under some circumstances the nitrate radical may be reduced to nitrite, especially by the putrefactive bacteria of the large intestine. INCOMPATIBILITIES: It is incompatible with acids, tan- nins, sulphids and sulphur. With soluble carbonates and bicarbonates in the presence of water there is a liberation of carbon dioxid, a formation of insoluble bismuth com- pound, and the nitrate of the alkali metal. With iodids a double decomposition has been noted with the formation of the red basic iodid of bismuth and the nitrate of the metal whose iodid was used. ACTION AND USES: Soluble bismuth compounds, as a rule, become converted in the presence of water into insolu- ble basic compounds. Most of the preparations used in medicine are already in the basic form. (As the action of bismuth preparations depends on the action of an irisol- 38 USEFUL DRUGS uble powder, there is no object in prescribing a soluble salt.) The salt most frequently used is bismuth sub- nitrate; but since it sometimes produces poisonous effects, the subcarbonate is the preferable salt. All the compounds of bismuth used in medicine produce essentially the same effects. Bismuth subnitrate is not appreciably affected by the gastric juice and does not materially lessen its acidity. When given in considerable doses it coats the mucous mem- brane and acts as a mechanical protective. It thus prevents the action of the digestive secretions and of irritating foods or other substances on the mucous membrane. The same is true of its effect on the mucous membrane of the intestine. It is not absorbed in the stomach. It undergoes chemical changes in the intestine and is probably absorbed there to some extent though seldom in sufficient quantities to produce symptoms of poisoning. It is excreted almost entirely by the cecum and other parts of the large intestine. It is turned black in the large intestine, probably from con- tact with sulphids. It seems to exert an astringent effect on the gastro-intestinal mucous membrane. When applied to the skin it acts mechanically, but on wounds and ulcers, as on mucous membranes, it acts as a protective, astringent and antiseptic. It is absorbed from wounds to a larger extent than from mucous membranes. A number of cases of poisoning have been so caused. Bismuth subnitrate and other insoluble salts of bismuth are used in irritation of the stomach and intestines for their protective and astringent powers. They are useful to allay vomiting from gastric irritation. In the same manner they serve to check diarrhea, especially that aris- ing from the ingestion of irritating foods. They are useful in hyperacidity and ulcer of the stomach by coating and pro- tecting the mucous membrane. They are also employed in catarrh of the stomach and intestines. They may be given for the same purpose in ulcerative enteritis. Externally the subnitrate and subcarbonate are used as protective and antiseptic applications in skin diseases and as applications to ulcers or suppurating wounds and to promote the healing of old sinuses and fistulous tracts. In the latter case the bismuth is used in the form of a paste, combined with petrolatum and wax. A number of cases of poisoning have been reported due to the absorption of the bismuth; hence care must be exercised in its use and on the appearance of toxic symptoms, such as a blue line on the gums, headache, nausea and stomatitis, the bismuth should be removed from the fistula by the injection of warm olive oil. DOSAGE: 1 gm. or 15 grains. For the treatment of ulcer much larger doses are used. Externally it is used freely as a dusting powder or in ointment. Very large quantities are used for the purpose of outlining the stomach and intestines by roentgenography and by the fluoroscope. but the occasional occurrence of nitrite poisoning has led to a preference of the subcarbonate or oxychlorid for USEFUL DRUGS 30 Roentgen-ray work. Poisoning by nitrites is indicated by vasomotor paralysis, tachycardia and asphyxia due to the formation of methemoglobin. Bismuth! Subsalicylas. Bismuth Subsalicylate, U. S. P. PROPERTIES : Bismuth subsalicylatc occurs as a white or nearly white amorphous crystalline powder, odorless and tasteless. It is practically insoluble in cold water ; on prolonged boiling with water a portion of the salicylic acid passes into solution with the formation of a more basic bismuth salicylate. INCOMPATIBILITIES : It is decomposed by hydrochloric acid or nitric acid: a more basic insoluble compound remain- ing. Alcohol also decomposes bismuth subsalicylate with accompanying solution of the liberated salicylic acid. The compound is also incompatible with alkali carbonates and bicarbonates, tannin and salts of iron. ACTION AND USES : Bismuth subsalicylate, like other salts of bismuth, is protective and astringent; it has also been recommended to some extent as an intestinal anti- septic. Because of the ease with which it is decomposed it is best prescribed in the form of powders, capsules or cachets. DOSAGE: 0.25 gm. or 4 grains. CACHETAE CACHETS Cachets, or wafers, are made by pressing a mixture of flour, or starch and water between hot iron plates, and are used much in the same way as capsules for enclosing dry and powdered drugs, but are usually of much greater capacity. They have the advantage over capsules of being more readily dissolved and despite their comparatively large size are easily swallowed if previously dipped into water or if floated on a tablespoonful of water. Caffeina. Caffein, U. S. P. A feebly basic alkaloid obtained from the dried leaves of Thea sinensis or from the dried seeds of Coffea arabica and also found in other plants. Tea contains from 1 to 4 per cent, of caffein; coffee from 1 to 2 per cent. PROPERTIES : Caffein is trimethyl-xanthin. It occurs as white silky, glistening needles, usually matted together in fleecy masses, odorless and having a bitter taste. It is soluble in water (1 : 50) and in alcohol (1 :50). The solubility in water is materially increased by the addition of sodium benzoate or sodium salicylate. ACTION AND USES: Small doses of caffein act on the nervous system, stimulating the psychic centers, the respira- tory and vasomotor centers and the reflexes. It modifies the circulation by stimulating the heart, and relaxing the vessels by direct action. The flow of urine is increased. Muscular contraction is facilitated and fatigue lessened. Excessive doses produce insomnia, nervousness, headache, palpitation and nausea or vomiting, especially in susceptible 40 USEFUL DRUGS persons. They lessen the capacity for mental or muscular work. Toxic doses may produce tetanic convulsions and cardiac dilatation. CIRCULATION: Caffein has a rather complex and, there fore, somewhat inconstant action. In therapeutic doses th* 1 pulse may be quickened or slowed. The blood-vessels tend to dilate by the peripheral action and to contract by the central action. The dilatation probably predominates in most cases, but the blood-pressure rises slightly by increased force and output of the heart. This increased output and lessened resistance tend to produce a more rapid flow of blood, and this results in an increased flow of urine. These effects make caffein especially efficient in some cases of car- diac dropsy, although it is generally inferior to digitalis. The cardiac stimulation is also useful in temporary cardiac weakness. By the Germans, and by many physicians in this country, caffein is looked on as the most valuable drug for the treatment of circulatory failure in acute infectious processes, such as pneumonia, peritonitis, scarlet fever, etc. A disadvantage in the use of large doses is the cere- bral stimulation produced, which often prevents sleep. Some authors do not approve of the use of caffein as a cardiac remedy, but believe that its utilities are confined to its diuretic action. Caffein is used as a nervous stimulant in cases of nerve exhaustion. It is useful in collapse by causing rise of blood-pressure and stimulating the respiration. It may bv used in narcotic poisoning in the form of hot coffee, or by itself, for its effect on the respiratory system. It is espe- cially useful in opium poisoning, and it may be used in alcoholic poisoning on the same principle. It relieves some forms of headache, but in the congestive form it may increase the difficulty. It is excreted by the kidney partly under its own form, partly as mono- or dimethyl-xanthin. It does not increase the amount of uric acid in the urine. DOSAGE: The dose of caffein varies from 0.06 gm. to 0.3 gm., or about 1 to 5 grains. When given in the form of coffee a cup made from a tablespoonful (15 gm.) would contain from 0.1 to 0.2 gm. or from \ l /> to 3 grains. The alkaloid may be given in the form of powder or in capsules or cachets. In combination with equal parts of sodium benzoate or sodium salicylate it dissolves readily, and may be given hypodermically or administered by mouth. Caffeina Citrata. Citrated Caffein, U. S. P. A mixture of equal parts of caffein and citric acid. PROPERTIES : Citrated caffein is a white odorless powder hav- ing a slightly bitter taste and an acid reaction. It is more readily soluble than the alkaloid but is not adapted for hypo- dermic use. DOSAGE: 0.1 gm. or about 2 grains. USEFUL DRUGS 41 Caffeinae Sodio-Benzoas. Caffein Sodio-Benzoate, N. F. A mixture of equal parts of caffein and sodium benzoate. PROPERTIES: It is freely soluble (1 : 2) In water and is well adapted for administration in solution either by mouth or hypo- dermically. DOSAGE: 0.10 gm., or about 2 grains. Calcii Carbonas Praecipitatus. Precipitated Calcium Carbo- nate, U. S. P., Precipitated Chalk, CaC0 3 . Calcium carbonate, obtained by precipitating a solution of a salt of calcium by a soluble carbonate, collecting and washing the precipitate and drying. PROPERTIES : Precipitated calcium carbonate is a fine white powder without odor or taste. It is practically insoluble in water, but dissolves to a considerable extent in water contain- ing carbon dioxid. It is decomposed by acids, forming a salt of calcium and giving off carbon dioxid with effervescence. ACTION AND USES : Calcium carbonate neutralizes the acid of the gastric juice, chlorid of calcium being formed and absorbed to some extent. If the stomach contains no acid it may escape solution and absorption. When absorbed the action is that of the soluble salts of calcium, which will be described under Calcium Chlorid. Calcium carbonate is used chiefly as an antacid. For this purpose it is used as the base of many tooth-powders. It is given in the form of powder as an antacid in acid gas- tritis, hyperchlorhydria and gastric ulcer. In -prescnoing it for such affections its power to check diarrhea and the astringent power with which it. is credited should be born- in mind. It is especially appropriate to cases in which there is hyperacidity with accompanying diarrhea and in diarrhea with acid fermentation. It may be used in skin-diseases as a dusting-powder to neutralize acid secretions and to protect the skin. Calcium carbonate is the appropriate antidote to oxalic acid as it neutralizes the acid with the formation of the insoluble oxalate of calcium. It is also a suitable antidote to other corrosive acids and has the advantage that an excess can be given without doing harm. DOSAGE: From 1 to 3 gm. or irom 15 to 45 grains. The fine powder can be given to adults in teaspoonful doses as no harm is to be feared from moderate excess. One gram will neutralize 0.730 gm. of absolute HC1, or approximately the amount of free HC1 in 500 c.c., or 1 pint of stomach contents having 40 degrees of free acidity. Calcii Chloridum. Calcium Chlorid, U. S. P., CaCl,. PROPERTIES : Calcium chlorid occurs as white, translucent fragments, which are odorless and have a sharp saline taste. It is very deliquescent and should be kept in well-stoppered bot- tles. It is freely soluble in water (1 : 1.3) and also in alcohol 42 USEFUL DRUGS INCOMPATIBILITIES: Soluble carbonates, phosphates and sulphates produce a precipitate of the corresponding insolu- ble salts of calcium. ACTION AND USES: The chlorid is more irritating to the stomach than other salts of calcium and it should always be given well diluted. It is absorbed slowly and imperfectly ; in the intestine it may be converted into the insoluble car- bonate or phosphate, and the greater part of the calcium is excreted in this form. Calcium salts are sedatives to muscle and nerve action when absorbed. A lack of calcium in the tissues is believed to be a factor in the development of nervous irritability, tetany and other forms of convul- sions. Large intravenous doses of calcium act somewhat like digitalis. It is also believed to increase the coagulabil- ity of the blood under certain conditions, but not often. These effects, however, are not produced when calcium is given by the mouth. There is no lack of calcium in the system under ordinary diet. It is therefore doubtful whether calcium chlorid has much if any systemic action when administered by mouth. It is used, however, in hemophilia, typhoid fever and other hemorrhagic conditions, with the idea of increasing the coagulability of the blood. Direct observations of the coagulation time have given contra- dictory, but generally negative results. The clinical evi- dence is not very strong, but the drug is at least harmless. Calcium chlorid is also administered, apparently with benefit, against urticaria and serum rashes. When injected directly into the blood, calcium salts depress the nervous and muscular systems, while the inacti- vation of calcium by the injection of oxalates and citrates produces convulsions. This is the basis of an as yet unproved hypothesis that certain forms of nervous irritability are due to disturbed calcium metabolism. DOSAGE: 05 gm. or 7% grains. Calcium chlorid is best administered in dilute solution sweetened with syrup or elixir. Calcii Hypophosphis. Calcium Hypophosphite. U. S. P., Ca(PH 2 O 2 ) z . PROPERTIES : Calcium hypophosphite occurs as colorless, trans- parent prisms, small lustrous scales or a white crystalline pow- der, which is odorless and has a nauseous, bitter taste. It is freely soluble in water (1 :65) and practically insoluble in alcohol. INCOMPATIBILITIES: It is incompatible with iodids and oxidizing agents. Caution should be observed in dispensing calcium hypophosphite as explosion is liable to occur when it is triturated or heated with nitrates, chlorates or oxidiz- ing agents. ACTION AND USES: It was formerly thought that hypo- phosphites were of special value because the phosphorus was in a less highly oxidized form than in the phosphates. There is no experimental and no convincing clinical evi- USEFUL DRUGS 43 dence for this belief. Calcium hypophosphite has merely the action of other soluble salts of calcium. (See calcium chlorid. ) DOSAGE: 0.5 gm. or 7% grains. Calcii Lactas. Calcium Lactate, N. N. R. PROPERTIES : Calcium lactate occurs in white crystalline masses or powder, and is odorless and tasteless. It is soluble in water (1:10) but very slightly soluble in alcohol. INCOMPATIBILITIES : It is incompatible with carbonates, sulphates and other compounds forming insoluble calcium salts. ACTION AND USES : Calcium lactate has the pharmacologic action of other soluble calcium salts (see Calcium Chlorid) but is less irritating than the chlorid and, therefore, espe- cially suitable for hypodermic use. DOSAGE: 0.5 gm. or 7% grains. Calcii Phosphas Praecipitatus. Precipitated Calcium Phos- phate, U. S. P., Ca,(P0 4 ) 2 - PROPERTIES : Precipitated calcium phosphate occurs as a bulky, white, amorphous powder that is odorless and tasteless. It is practically insoluble in water and in alcohol, but is soluble in hydrochloric or nitric acid. ACTION AND USES : Because of the fact that calcium phosphate forms much the greater portion of the mineral matter of the human body, it has been supposed to be indicated in a variety of conditions. There is little or no evidence that it is of special value or has any advantages over calcium carbonate. It may be administered in the form of powder or in a complex mixture by dissolving it in a suitable acid. DOSAGE: 1 gm. or 15 grains. Calx. Lime, Calcium Oxid, U. S. P., CaO. PROPERTIES : Calcium oxid occurs as hard, white or grayish- white masses, which, in contact with the air. gradually attract moisture and carbon dioxid and fall to a white powder ; it is odorless and has a caustic taste. Calcium oxid is converted into calcium hydroxid on the addition of water, and this is slightly soluble in cold water (1:760), less soluble in hot water and practically insoluble in alcohol. Milk of lime is calcium hydroxid mixed with water in the proportion of 1 part of lime to 4 of water. ACTION AND USES: Lime as calcium hydroxid is a fairly active germicide. It will neutralize acids, forming soluble salts of calcium. On account of its cheapness lime is much used as a dis- infectant. In the form of milk of lime or whitewash, it is a serviceable application to privies or to the infected walls of rooms. It is especially useful for the disinfection of excreta. Freshly prepared milk of lime should be added 44 USEFUL DRUGS in volume equal to that of the material to be disinfected, the mass thoroughly mixed and allowed to stand for two hours before disposal. Liquor Calcis. Lime-water, Solution of Calcium Hydroxide, U. S. P. A saturated solution of calcium hydroxid containing about 0.14 per cent, of Ca(OH).;. PROPERTIES : Lime-water is a clear, colorless liquid without odor, and has an alkaline, bitter taste. Lime-water absorbs car- bon dioxid from the air, readily forming the insoluble calcium carbonate, and leaving the solution weaker in consequence. The Pharmacopeia gives a convenient method of assay, and there is no excuse for the pharmacist who dispenses an inferior prepar- ation. The strength of lime-water should be preserved by keep- ing an excess of lime in the bottom of the container. When the lime-water is to be used the clear supernatant liquid should be decanted. INCOMPATIBILITIES: Lime-water is incompatible with acids and with carbonated, or ordinary hard water. ACTION AND USES: Lime-water is antacid and astringent and is often used as an addition to milk for both adults and children. The usual proportion is 1 of lime-water to 4 of milk, but a mixture of equi.l parts may be given. This is administered in small doses to allay nausea and vomiting. It is also used for diarrhea. Lime-water is used externally in the treatment of burns. DOSAGE: 15 c.c. or about 4 fluidrams, containing approxi- mately 0.02 gm. or y s grain of calcium hydroxid. Linimentum Calcis. Lime Liniment, U. S. P. This is more popularly known as Carron oil from the name of the iron works, in England, where it originated. PROPERTIES : It is essentially a mixture of equal parts of a bland fixed oil and lime-water of official strength. The Pharma- copeia at present directs the use of linseed oil, but this has no advantages over some of the more limpid, and less odorous fixed oils, and by some is thought to be less desirable. ACTION AND USES : Lime Liniment is applied to burns by spreading it on cloths and applying to the surface. It should be renewed frequently in order to prevent the dress- ing from adhering. Calx Chlorinata. Chlorinated Lime, Chlorinated Calcium Oxid. U. S. P., Bleaching Powder. Bleaching powder, often improperly called chlorid of lime, is a variable compound resulting from the action of chlorin on calcium hydroxid. It should contain not less than 30 per cent, of available chlorin, that is, chlorin which is set free by the action of an acid. ' PROPERTIES : Chlorinated lime occurs as a white or grayish- white granular powder, having a chlorin-like odor, and a repuls- ive saline taste. It is only partially soluble in water or alcohol. ACTION AND USES: Chlorinated lime is a disinfectant of about equal value with lime and is used in the same way. USEFUL DRUGS 45 A 5 per cent, solution is a convenient strength for ordi- nary use. It is being used quite extensively as the source of chlorin for treating contaminated drinking-waters. A fresh solution of about 0.5 per cent, strength should be added to the water to be treated, in the proportion of about 250 gallons per million gallons of water. Liquor Sodae Chlorinatae. Solution of Chlorinated Soda, U. S. P., Labarraque's Solution. An aqueous solution of sodium hypochlorite and sodium chlorid containing at least 2.4 per cent, of available chlorin. It is made by decomposing a solution of chlorinated lime with sodium carbonate and removing the insoluble calcium carbonate formed. ACTION AND USES: Solution of chlorinated soda, like chlorinated lime, is used chiefly as a disinfectant and anti- septic. Diluted with from 15 to 20 parts of water it may be used as a spray, gargle or wash. DOSAGE: 1 c.c. or 15 minims. Camphora. Camphor, U. S. P. A ketone C fl H 16 CO obtained from Cinnamomum Camphora. purified by sublimation. PROPERTIES : Camphor occurs as white translucent masses of a tough consistence and a crystalline structure, readily pulveriz- able in the presence of a little alcohol, ether or chloroform ; it has a characteristic odor and a pungent taste. It is very slightly soluble in water but freely soluble in alcohol, ether, chloroform and in fixed and volatile oils. ACTION AND USES : Camphor stimulates the central nervous system, especially the medullary centers, and the circulation; locally it is mildly irritant and antiseptic. In toxic doses it produces delirium followed by unconscious- ness with epileptiform convulsions. It has been used as a nerve depressant in epilepsy and convulsions, but owing to its stimulating action this use seems irrational. Camphor tends to increase the blood-pressure. The effects on animals are complex and rather inconstant, but clini- cally large doses of camphor improve the pulse in impend- ing cardiac collapse, probably by cardiac . stimulation. For this reason it is used as a circulatory and respiratory stimu- lant in cases of collapse, syncope, cardiac failure, etc. It should be administered hypodermically, 0.5 c.c. of a 10 per cent, sterile solution in olive oil being injected every fifteen minutes for four doses if needed. The antiseptic action of camphor is utilized in gargles and mouth washes. It is also given in dyspepsia as a carminative, and is used in the first stage of colds and other infections of the respiratory tract. It acts internally as a diaphoretic. Locally camphor causes a loss of tone of the peripheral blood-vessels, and thus produces marked redness of the 46 USEFUL DRUGS skin. It has also a local anesthetic action. It is employed, for its mild rubefacient and counterirritant effects, as an ingredient of liniments. DOSAGE: 0.10 gm. or about 2 grains. The average dose of camphor is commonly given as 2 grains, but when a prompt cardiac or central action is demanded, much larger doses may be required. It may be given in an oily or alcoholic solution or in pills, capsule* or cachets. Aqua Camphorae. Camphor Water, U. S. P. A saturated solution of camphor in distilled water. It is a very weak preparation. Camphor water is often used as a vehicle for collyria. DOSAGE: 10 c.c. or about 2 fluidrams (containing 0.04 gm. or y 2 grain of camphor). Spiritus Camphorae. Spirit of Camphor, U. S. P. One hundred c.c. contain 10 gm. camphor in alcohol. DOSAGE: 1 c.c. or 15 minims. Linimentum Camphorae. Camphpr Liniment, U. S. P. Camphorated Oil. One hundred c.c. contain 20 gm. camphor in cottonseed oil, but a more limpid oil may be preferred, particularly if the preparation is to be used for hypodermic injection. Cannabis Indica. Indian Cannabis, U. S. P. The dried flowering tops of the pistillate plants of Cannabis sativa, grown in the East Indies and gathered while the fruits are yet undeveloped, and carrying the whole of their natural resin. Much, if not all, of the available drug fails to comply with the official requirements. ACTION AND USES : Cannabis Indica is a narcotic poison which stimulates the psychic functions and produces delir- ium of a pleasant character and a rapid succession of ideas which cause the time to seem very long. From this condi- tion the patient passes into melancholy and then into a deep sleep. An aphrodisiac effect is reported in some cases. In many cases the primary stimulating stage is quite short and often absent. On account of the sleep resulting from this drug, it has been recommended as a hypnotic, but in general the use of cannabis indica as a hypnotic is not advisable. While it has not been known to produce fatal results, the effect on dogs indicates that it is not entirely safe, and the possibility of formation of a habit should be borne in mind. DOSAGE: The preparations are best given by themselves, the extract in the form of pills and the tincture diluted or mixed with water at the time of administration. Extractum Cannabis Indicae. Extract of Indian Cannabis, U. S. P. USEFUL DRUGS 47 DOSAGE: 0.01 gm. or 1/5 grain. Tinctura Cannabis Indicae. -Tincture of Indian Cannabis, U. S. P. One hundred c.c. represent 10 -gin. Indian oannabis in alcohol. DOSAGE: 0.5 c.c. or about 8 minims. Cantharis. Cantharides, U. S. P. The beetle Cantharis vesicatoria, Spanish fly, thoroughly dried. ACTION AND USES : Cantharides is very irritating to the intestinal canal, producing hyperemia of the mouth and throat and vomiting. It is readily absorurd from tho intestinal canal and produces marked irritatioij of the kid- neys. The nephritis affects, at first, the glomeruli and sub- sequently the urinary tubules. In its passage through the urinary channels, it irritates the mucous membranes of the bladder and urethra and produces a desire to urinate, some- times amounting to strangury. Cantharides is also a local irritant to the skin and produces blisters. It may be absorbed from the skin in sufficient quantities to cause nephritis. Cantharides has been used for treatment of chronic nephritis and incontinence of urine. Only minute doses should ever be given for these affections, and as soon as any evidence of vesical irritation arises the remedy should be suspended. Many physicians believe that canthar- ides should never be used internally. The local irritant action of Cantharides is the basis of its use for the treatment of baldness, but it is of little benefit in that condition. It is used for baldness in the form of tincture greatly diluted with alcohol (from 1:15 to 1:30) or in ointments. The chief use of Cantharides is as a vesicant. It is contra-indicated in nephritis, and when vesication is desired in nephritis, another agent such as ammonia or chloroform should be selected. It may be used to produce redness and counterirritation in quantities not sufficient to blister. When the irritation is carried just to the point of beginning vesication, the result is known as a flying blister. The counterirritation may be rendered continuous by a succession of such "flying" blisters. Ceratum Cantharidis. Cantharides cerate, U. S. P. This contains 32 per cent, of cantharides. Ceratum cantharidis may be used for the purpose of vesication, but the blistering plasters commonly put up by manufacturers have a slightly different base. When cantharides is applied for the purpose of vesication a blister will usually be formed in the course of six hours. Vesica- tion can sometimes be hastened by removing the cantharides plaster after a few hours and applying hot poultices. Blisters should not be applied directly over an inflamed part. 48 USEFUL DRUGS The following application has been suggested for baldness: 3ij ni.xv B Tr. cantharid 8 Tr. capsici 1 Alcoholis 45 Aq. ros ad 150 M. Capsicum. Capsicum, U. S. P. The dried, ripe fruit of Capsicum fastigiatum. ACTION AND USES: Capsicum is carminative, stimulant and rubefacient. It is frequently prescribed in atonic dys- pepsia, especially in cases due to chronic alcoholism. Such use should be cautious and not long continued. DOSAGE: 0.05 gm. or about 1 grain. Externally it is frequently used in the form of liniment, preferably a simple mixture of the tincture with the official soap liniment. The tincture mixed with an equal quantity of glycerol is used as a gargle in tonsillitis, pharyngitis, etc. Capsicum plaster is a suitable preparation for the relief of neuralgia, muscular rheumatism, etc. Tinctura Capsici. Tincture of capsicum, U. S. P. One hundred c.c. represent 10 gm. of the drug in approxi- mately 90 per cent, alcohol. DOSAGE: 0.5 c.c. or 7 l / 2 minims. CAPSULAE CAPSULES Capsules, either hard or soft, are made of gelatin molded oA'er a suitable object. Hard capsules, made in different sizes, have long been used for administering liquids as well as solids, while soft capsules, containing an admixture of glycerol to the gelatin, are used extensively for oils and oleoresins or solutions of active drugs in oils. Carbo Ligni. Charcoal, U. S. P. Prepared from soft wood and very finely powdered. PROPERTIES : Charcoal is a black, odorless and tasteless pow- der, free from gritty matter. ACTIONS AND USES: Locally charcoal is employed as a deodorant for fetid ulcers, etc., usually as a poultice. Because of its well-known property of absorbing and condensing gases, charcoal has long been administered in various forms of gastric disturbance, the prescribers evi- dently losing sight of the fact that when thoroughly wet it almost entirely loses its property of absorbing gases. It is used to indicate the length of time food remains in the alimentary tract. Charcoal administered with the test diet causes the feees formed from that diet to have a black color. It is also commonly used to distinguish the periods of diet in metabolism experiments. USEFUL DRUGS 40 DOSAGE: 1 gm. or 15 grains. Preferably administered in cachets or capsules. Cardamomum. Cardamom, U. S. P. The dried nearly ripe fruit of Elettaria repens. ACTION AND USES: Cardamom is used as an aromatic, carminative and stomachic. Tinctura Cardamoini. Tincture of Cardamom. Represents 20 per cent, of cardamom in diluted alcohol. This preparation should not be confounded with compound tincture of cardamom, which is a comparatively weak solu- tion of the soluble constituents of cardamom, cinnamon and caraway in diluted alcohol, colored red with cochineal. DOSAGE: 5 c.c. or ] nuidram. Caryophyllus. Cloves, U. S. P. The dried flower buds of Eugenia aromatica. Oleum Caryophylli Oil of Cloves, U. S. P. A volatile oil distilled from cloves consisting largely (80 per cent.) of eugenol. PROPERTIES : Oil of cloves occurs as a colorless or pale yellow, thin liquid, becoming darker and thicker by age. Oil of cloves is freely soluble in alcohol, but nearly insoluble in water. ACTION AND USES : Oil of cloves is antiseptic and aro- matic. It is frequently used as a carminative and externally as counterirritant. In dental practice it has long been used as an anodyne. DOSAGE: 0.2 c.c. or 3 minims on granulated sugar or in some emulsion, on shaved ice or in capsules. To relievo toothache it should be dropped on a small piece of cotton and inserted into the cavity in the tooth, if one is present. For external use it is usually diluted with 2 or 3 parts of fatty oil. CATAPLASMATA POULTICES Poultices are soft solid preparations used for the purpose of applying heat and moisture to localized areas of the body. This application of heat induces a superficial hyperemia which is believed to influence the circulation of underlying parts. The poultices may also be made the means of apply- ing counterirritant drugs. A long-continued application tends to cause relaxation of the skin and to render it flabby. Cera Alba. White Wax, U. S. P., is the bleached form of: Cera Flava. Yellow Wax, U. S. P. A solid substance prepared from the honeycomb of the bee, Apis mellifera. In medicine wax is chiefly used to stiffen ointments. 50 USEFUL DRUGS CERATA CERATES Cerates are solid ointment-like preparations containing sufficient wax to prevent them from melting at the tem- perature of the body. For the preparation included in this list see : Ceratum Cantharidis, under Cantharis. CHARTAE PAPERS Medicated papers are pieces of absorbent paper that have been treated with medicinal substances or suitably sized paper coated with a layer of the medicinal substance. For the preparation included in this list see : Charta Sinapis, under Sinapis. Chloralum Hydratum. Hydrated Chloral, U. S. P. Chloral Hydrate. A crystalline solid, CC1 3 CH ( OH ) , the hydrate of trichlor- acetaldehyd (chloral), CC1 3 .CHO. PROPERTIES : Hydrated chloral occurs as colorless and trans- parent crystals, having an aromatic penetrating odor, and a bit- terish, caustic taste. It is very soluble in water, alcohol or ether. INCOMPATIBILITIES: Hydrated Chloral is incompatible with alkalies and alkali carbonates, which cause the forma- tion of chloroform. In mixtures containing hydrated chloral, an alkali, bromid and alcohol, a compound of chloral believed to be chloral alcoholate sometimes separates. ACTION AND USES: Hydrated chloral acts on the central nervous system, producing a feeling of weariness followed by quiet sleep in which the pulse and respiration are slowed in the same manner as in normal sleep and the reflexes are not abolished. From this sleep the person can readily be awakened. Larger doses produce more rapid and deeper unconsciousness and abolition of reflexes. There is slowing of the respiration and fall of blood-pressure. The cuta- neous vessels are dilated and a marked fall of temperature occurs. With fatal doses death occurs ordinarily by paral- ysis of the respiratory center but sometimes by paralysis of a weakened heart. Hydrated chloral is therefore to be used with special caution in cases of a weakened heart or blood-vessels. Hydrated chloral is a very reliable hypnotic in insomnia due to nervous excitation. It is not so valuable when the sleeplessness is primarily due to a painful affection. In such cases morphin or codein is preferable. At times it may be combined with opium or morphin. It should not be used when there is a degeneration of the heart-muscle. In other cases of heart disease and in arteriosclerosis it may be given cautiously. Hydrated chloral may be given in moderate doses as a nervous sedative, especially in conjunction with the bromids. USEFUL DRUGS 51 Hydrated chloral is also a valuable remedy to relax spasm. For this purpose it is often used in the first stage of labor to overcome rigidity of the os uteri. It is valuable in tetanus, in which it must be given boldly to overcome the convulsions. In delirium in fever it may be administered in small doses. It should not be given, however, if the delirium can be controlled by other means. It is useful as an antispasmodic in obstinate cases of hiccup. Hydrated chloral is a good antidote to strychnin. DOSAGE: From 0.30 to 1.30 gm. or from 5 to 20 grains dissolved in water and given on cracked ice. The dose may be repeated in three hours, if needed, but the condition of the pulse and respiration should be carefully watched when large doses are given. While hydrated chloral has the reputation of being espe- cially dangerous, this refers to large doses. Smaller doses. 0.3 gm. or 5 grains, are about as effective as the ordinary doses of other hypnotics and relatively safe. Habit forma- tion is quite common, perhaps more so than with some other hypnotics. Chloroform. Chloroform, U. S. P. A liquid consisting of from 99 to 99.4 per cent, of chloro- form, CH.Cls, and from 0.6 to 1 per cent, of alcohol, C.,H 5 OH. added as a preservative. Chloroform is now largely made by the decomposition of chloral by alkalies. PROPERTIES : Chloroform occurs as a heavy clear, colorless and mobile liquid, of a characteristic odor, and a burning sweet taste. It is but slightly soluble in water (1 :200), but is mis- eible, in all proportions, with alcohol, ether and the fixed and volatile oils. INCOMPATIBILITIES : Chloroform should be protected from the light by storing in a dark place or in dark well -stoppered bottles. It readily deteriorates under the influence of heat, light and air, and the decomposition products must be avoided in the use of this product in general anesthesia. For this reason the vapors should not be allowed to come in contact with a flame. ACTION AND USES: Chloroform acts locally as a pene- trating and fairly powerful irritant, which may blister if its evaporation is prevented. It is used in liniments. Taken by mouth, small doses are carminative, anodyne and anti- septic; it is therefore used in gastric fermentation and colic. Large doses are sometimes employed as a vermifuge, but are rather dangerous. Excessive doses produce uncon- sciousness and coma, similarly to the results of its inhalation. Its main use is by inhalation, for the production of general anesthesia. The excitement stage is similar to that with ether, but of shorter duration and therefore less unpleasant. It is much more dangerous, however, most acute fatalities occurring by stoppage of the heart early in the administration. This danger is lessened by atropin. 52 USEFUL DRUGS The anesthetic stage is also more dangerous than with other, there being a gradual but progressive fall of blood pressure, even if the administration is carefully managed. The fall is due to depression of both the cardiac muscle and vasomotor center. The respiratory center is also more depressed. If an excessive concentration is given, death occurs, in this stage usually by stoppage of respiration; but since the heart and vasomotor center are also greatly weakened, recovery is more difficult than with ether. Some- times, especially in cardiac disease, the heart may be the first to give out. The irritant actions on the kidneys and respiratory tract are probably about the same as with ether. Prolonged administration is especially dangerous, often producing death after several days by so-called delayed chloroform poisoning. This is characterized by general fatty degeneration, especially marked in the liver, which may pass into a condition analogous to acute yellow atrophy. Chloroform is distinctly less safe as an anesthetic than ether and should be employed only when ether is unavail- able or its use inadmissible for some reason. Chloroform is held by many physicians as specially suitable for anes- thesia in children and during childbirth. It is frequently given to relieve pain in the stomach or bowels, especially pain of a colicky nature. DOSAGE: From 0.05 to 0.3 c.c. or from 1 to 5 minims. Chloroform may be prescribed in a variety of forms. The Pharmacopeia includes : Aqua Chloroformi. Chloroform water, U. S. P. A saturated aqueous solution of chloroform containing approximately 1 part in 200. DOSAGE: It may be made extemporaneously by adding a few drops of chloroform to a glass of water, shaking well and allowing the excess to subside. A teaspoonful contains approximately 0.02 c.c. or Vs minim of chloroform. The average dose of chloroform water is 15 c.c. or 4 fluidrams. Spiritus Chloroformi. Spirit of Chloroform, U. S. P. One hundred c.c. contain 6 c.c. of chloroform in alcohol. DOSAGE: 2 c.c. or 30 minims containing 0.12 c.c. or 2 minims of chloroform. Linimentum Chloroformi. Chloroform Liniment, U. S. P. A 30 per cent, solution of chloroform in soap liniment. Chromii Trioxidum. Chromium Trioxid, U. S. P., Cr0 3 . This is more popularly, though incorrectly, termed chromic acid and should contain not less than 90 per cent, of Cr0 3 . PROPERTIES : Chromium trioxid occurs as needle-shaped crys- tals or prisms of dark purplish-red color and metallic luster ; it is odorless, destructive to animal and vegetable tissue, deliques- cent in air and very soluble in water (1:0.5), USEFUL DRUGS 63 INCOMPATIBILITIES : Because of its powerful oxidizing properties chromium trioxid should not be brought in contact with alcohol, glycerol or other oxidizable substances or explosion may result. ACTION AND USES: In medicine chromium trioxid is used only as a caustic either in the solid form or in aqueous solu- tion. Holt recommends in nasal hemorrhage from ulcer of septum to touch the ulcer with chromium trioxid. Chrysarobinum. Chrysarobin, U. S. P. A neutral principle extracted from Goa powder, a sub- stance found deposited in the wood of Vouacapoua Araroba. PROPERTIES : Chrysarobin is a pale orange-yellow, micro- crystalline powder, tasteless, odorless and irritating to the mucous membrane. It is very slightly soluble in water, but rather more soluble in alcohol and partially soluble in fats. ACTION AND USES: Chrysarobin is antiseptic and anti- parasitic and a powerful irritant to the skin. It is a more powerful stimulant than tar and must be used with cor- respondingly greater caution, except in dermatoses in which the production of an acute inflammatory reaction is not especially to be dreaded. It is employed in the treatment of fungus diseases of the skin but is also of especial use in chronic inflammatory dermatoses to produce a healthy reaction. Chrysarobin is used externally in ointment or solution in the strength of from 2 to 10 or even 20 per cent. In the weaker proportions it is often quite as effective as in the stronger and does not excite acute dermatitis. Chrysarobin stains the skin brownish, the hair greenish- yellow, the nails reddish-brown. Its use about the head should be avoided. It also stains clothing a walnut-brown. This stain can be removed by dilute solution of caustic soda or solution of chlorinated soda. Unguentum Chrysarobini. Chrysarobin Ointment, U. S. P. Representing a solution of about 5 per cent, of Chrysarobin in benzoinated lard. Cinchona. Cinchona, U. S. P. The dried bark of different species, principally hybrids, of Cinchona yielding not less than 5 per cent, of anhydrous cinchona alkaloids, the chief of which is quinin. ACTION AND USES: The preparations of cinchona are seldom used to obtain the systemic effects of quinin. They are mostly employed as bitter tonics. (See Quinin.) Tinctura Cinchonae. Tincture of Cinchona, U. S. P. One hundred c.c. represent about 20 gm. cinchona in a mixture of alcohol, water and glycerol. DOSAGE: 4 c.c. or 1 fluidram. 54 USEFUL DRUGS Tinctura Cinchonae Composita. Compound Tincture of Cinchona, U. S. P. One hundred c.c. represent 10 gm. red cinchona with bitter orange peel and serpentaria, as aromatics, in a mixture of alcohol, water and glycerol. DOSAGE: 4 c.c. or 1 fluidram. Cinnamomum. Cinnamon, U. S. P. The commercial drug is the dried bark or inner bark of different species of Cinnamomum. ACTION AND USES: In medicine it is largely used as an aromatic or carminative preferably in the form of: Oleum Cinnamomi. Oil of Cinnamon, U. S. P. A volatile oil containing about 75 per cent, of cinnamic aldehyd and occurring as a yellowish liquid having the * characteristic odor of cinnamon and a sweetish spicy and burning taste. It is freely soluble in alcohol but only very slightly soluble in water. DOSAGE: 0.05 c.c. or 1 minim. Aqua Cinnamomi. Cinnamon Water, U. S. P. A saturated solution of oil of cinnamon in distilled water ; it is largely used as a vehicle. DOSAGE: 15 c.c. or 4 fluidrams. Cocaina. Cocaine, U. S. P. An alkaloid obtained from several varieties of Coca. PROPERTIES : Cocain forms large colorless prisms, having a slightly bitter taste and producing on the tongue a temporary numbness. It is only slightly soluble in water (1 : 600), soluble in alcohol (1 :5), and also soluble in fixed oils, but insoluble in petrolatum and lard. The hydrochlorid is freely soluble in water. INCOMPATIBILITIES : Solutions of cocain or of any of its salts after being kept a long time, or on boiling, are hydrol- yzed more or less completely into ecgonin, benzoic acid and methyl alcohol. Solutions of cocain cannot be sterilized by boiling without some loss, but the amount of decomposi- tion is so small as to be insignificant. ACTION AND USES : Cocain paralyzes the peripheral nerves when applied locally, causing loss of sensation, and also contracts the blood-vessels. The mucous membrane becomes pale from local constriction of the vessels. When injected into a nerve or around the nerve sheath, anesthesia of the region to which the sensory fibers of the nerve are dis- tributed is produced. By injecting a solution of cocain into the spinal canal anesthesia of the greater part of the body can be produced, but this method has often resulted in serious accidents or fatalities and is not to be recommended, despite the reported successful use by individuals who have become expert in recognizing and combating untoward symptoms. USEFUL DRUGS 55 Cocain produces first stimulation and then depression of the different segments of the central nervous system, beginning with the brain and extending to the spinal cord and the medulla. The stimulation of the brain has generally passed into depression before that of the spinal cord has begun so that when considerable doses have been given the symptoms may consist of a mixture of stimulation and depression. Stimulation of the brain is shown by increased psychic activity, loss of sense of fatigue, insomnia and muscular irritability. Depression is shown by somnolence, stupor and finally coma. Convulsions frequently occur owing to cerebral action. Respiration is at first quickened, it may have a Cheyne- Stokes character and later symptoms of respiratory paraly- sis appear. The heart may be temporarily stimulated, but is later paralyzed. The pulse is accelerated by nervous stimulation. The blood-pressure is raised by small doses but later falls from vasomotor paralysis. The temperature may be increased by cocain. Cocain is a mydriatic acting both locally and centrally. The dilatation is not so complete as that produced by atro- pin, and reaction to light is not abolished. The therapeutic use of cocain is derived almost exclu- sively from its anesthetic properties. It is much used to secure bloodlessness and anesthesia of the mucous mem- branes of the conjunctiva, nose and pharynx. In the eye it is said to increase the action of other alkaloids. It has an injurious action on the cornea in certain cases, producing desquamation of the epithelium and causing a keratitis. It is said that the danger of such injury can be minimized by closing the eyes for some time after cocain instillations. A moist compress may also be applied when strong solutions are used. The possible danger of absorption of the drug from the conjunctiva should not be forgotten. Cocain may be used as an anesthetic in operations on the eye and is considered better than any of its substitutes by many ophthalmologists. In the nose cocain is used for astringent purposes in early stages of coryza and other inflammations in which it renders nose breathing easier by reducing the swelling of the tur- binated bodies. It is also employed for the checking of hemorrhage. For anesthetic purposes it is advantageously combined with solution of an epinephrin salt. Hemorrhage of capillary origin is particularly amenable to the use of cocain. The painful deglutition and other inconveniences of laryngeal tuberculosis may be alleviated by local applica- tions of cocain solutions to the ulcerated areas. A more effectual method is the injection of cocain solution into the sheath of the superior laryngeal nerve. Cocain has been much used by local application to. the nasal mucous mem- brane or by insufflation for the relief of asthma. Swabbing 56 USEFUL DRUGS the pharynx with a solution of cocain is sometimes employed to facilitate the swallowing of the stomach tube. Such an application, however, is seldom needed. Cocain has been employed as an anti-emetic when vomit- ing depends on local irritation, but it should not be used for this purpose. It may be applied as a local anesthetic to hemorrhoids, but should be used with caution. DOSAGE: For internal use the dose is 0.03 gm. or y 2 grain. As a local application to mucous membranes it is usually employed in the form of cocain hydrochlorid in a solution of the strength of from 2 to 10 per cent., the average being about 4 per cent. In the stronger solutions it should be used cautiously for fear of poisoning from the alkaloid absorbed. In the vagina and rectum 10 per cent, solutions may be used, but it is not safe to use solutions stronger than from 1 to 2 per cent, in the urethra. Cocainae Hydrochloridum. Cocaine Hydrochloride, U. S. P. The neutral hydrochlorid of the alkaloid cocain. INCOMPATIBILITIES: It is incompatible with alkalies, sodium borate and zinc sulphate. DOSAGE: 0.03 gm. or y 2 grain. Codeina. Codeine, U. S. P. An alkaloid obtained from opium or prepared from inor- phin by methylation. PROPERTIES : Codein occurs as white, nearly translucent crystals or a crystalline powder, odorless and having a faintly bitter taste. Codein is soluble in water (1:88), and freely soluble in alcohol 1:12. ACTION AND USES : Codein is analgesic, hypnotic and sedative. During recent years it has come to be used widely in place of morphin, particularly as a sedative. As an analgesic it is of value chiefly against abdominal and pelvic pain; it is largely used for cough. Codein is recom- mended by some authorities in place of opium in the treat- ment of diabetes. DOSAGE: 0.03 gm. or y z grain. Codeinae Phosphas. Codeine Phosphate. U. S. P. A salt that is freely soluble in water ( 1 : 2.25 ) and only slightly soluble in alcohol (1:261). It is preferred for hypodermic use. DOSAGE: 0.03 gm. or y 2 grain. Codeinae Sulphas. Codeine Sulphate, U. S. P. Soluble in water (1:30) and very slightly soluble in alco- hol (1:1,035). DOSAGE: 0.03 m. or J /4 grain USEFUL DRUGS 57 Colchici Semen. Colchicum Seed, U. S. P. The seed of Colchicum autumnale, assaying not less than 0.55 per cent, of colchicin. ACTION AND USES: Colchicum produces marked irritation of the intestines, leading to looseness of the bowels with much pain and watery stools. It may produce severe inflammation and collapse. The collapse is believed to be due to the intestinal irritation and not to a central action. It also produces marked irritation of the kidney, which may lead to severe nephritis. Colchicum seed is said to be antineuralgic and analgesic. By many it is considered to be a specific in acute gout, controlling the pain and cut- ting short the attack. It may be given to prevent the occurrence of gouty attacks, and it is recommended by some to continue it in smaller doses after the attack. Tinctura Colchici Seminis. Tincture of Colchicum Seed, U. S. P. One hundred c.c. represent 10 gm. colchicum seed in approximately 55 per cent, alcohol; it should assay approx- imately 0.05 per 'cent, of colehicin. It is similar to but not identical with the international standard tincture of colchicum seed. DOSAGE: 2 c.c. or 30 minims. In acute gout the dose is from 10 to 30 minims of the tincture once every four hours until some decided evidence of its action, such as nausea or slight purging, is induced. Severe purging should be avoided. Colchicum is of little value in rheumatism. COLLODIA COLLODIONS Collodions are solutions of pyroxylin (guncotton) in a mixture of ether and alcohol, or of acetone, and are intended for external application. For the preparations included in this list see the fol- lowing : Collodium. Collodion, U. S. P. A solution containing, in 100 c.c., 4 gin. of pyroxylin, or guncotton, in a mixture of 3 volumes of ether and 1 vol- ume of alcohol. It is used as a protective and a vehicle chiefly in the form of: Collodium Flexile. Flexible Collodion, U. S. P. A mixture of collodion with Canada turpentine (5 per cent.), and castor oil (3 per cent.). The addition of the small proportion of castor oil makes the resulting film clastic and more tenacious. The turpentine is superfluous and is probably retained for sentimental reasons. 58 . USEFUL DRUGS Colocynthis. Colocynth, U. S. P. Bitter Apple. The peeled dried fruit of Citrullus colocynthis. from which the seeds should be separated and rejected in making pharmacopeial preparations. Colocynth belongs to the class of one-time popular hydra gogue cathartics whose use appears to be on the decline. It is used in making: Extractum Colocynthidis. Extract of Colocynth, U. S. P. DOSAGE: 0.03 gm. or % grain. Extractum Colocynthidis Compositum. Compound Extract of Colocynth, U. S. P. A complex mixture of extract of colocynth with aloes and other drugs. DOSAGE: 0.5 gm. or 7% grains. The latter is one of the four preparations used in making the compound cathartic pills of the U. S. P. CONFECT10NES CONFECTIONS Confections, conserves or electuaries were formerly used extensively, and usually occur as soft,' pasty solids con- sisting of active drugs mixed with sugar or honey. Copaiba. Copaiba, U. S. P. An oleoresin derived from one or more South American species of Copaiba. PROPERTIES : Copaiba is a pale yellow to brownish-yellow liquid. having 1 a peculiar, aromatic odor, and a persistent, bitter and acrid taste. It is practically insoluble in water, partially soluble in alcobol, and freely soluble in fixed and volatile oils. ACTION AND USES: Copaiba is a mild stimulant, laxa- tive and diuretic. It is chiefly excreted by the kidneys, partly by the bronchial mucous membrane, both of which it stimulates. It is also excreted by the skin and some- times produces an eruption closely resembling that of measles. It is slightly antiseptic. Copaiba is sometimes used in chronic bronchitis as a stimulating expectorant. It is chiefly used in gonorrhea! urethritis, being applicable only in the chronic form of the disease. It may be given in conjunction with oil of sandal or the oleoresin of cubeb. DOSAGE: 1 c.c. or 15 minims in capsule or emulsion, four or five times a day. Creosotum. Creosote, U. S. P. A mixture of phenols and phenol derivatives, chiefly guaiacol and creosol, obtained during the distillation of wood-tar, preferably that derived from the beech. PROPERTIES : It occurs as a colorless or slightly yellowish, highly refractive, oily liquid, having a penetrating smoky odor and a burning, caustic taste. Creosote is slightly, but not com- USEFUL DRUGS 59 pletely soluble in water (1:140), and miscible in all proportions with absolute alcohol ; owing to its disagreeable odor and taste, it is seldom administered in the form of solution or mixture. ACTION AND USES : When given internally creosote acts similarly to phenol. It is antiseptic and is one of the few drugs which appear to have a just claim to be useful as intestinal antiseptics. It is used to some extent externally for its antiseptic power. It is sometimes applied locally for leukorrhea and other infections of the mucous mem- brane. It has been given as a stimulant expectorant in chronic bronchitis and in tuberculosis. Experiments show that it does not affect the viability of the tubercle bacilli in the lungs. Some observers assert that its favorable action in tuberculosis is due to the production of intestinal antisepsis. It must be remembered, however, that its value in tuberculosis has not been determined beyond doubt Less reliance is placed on it than formerly. DOSAGE: 0.2 c.c. or 3 minims three times daily. It is preferably administered in the form of pills or capsules. If it impairs the appetite and disturbs digestion its use should be abandoned. Cresol. Cresol, U. S. P. A mixture of the three isomeric cresols obtained from coal-tar, freed from phenol, hydrocarbons and water. Cresol occurs as a straw-colored, refractive liquid, having a phenol-like odor and turning 1 yellowish-brown on exposure to the air. It is soluble in water (1 : 60) and miscible in all pro- portions with alcohol, petroleum benzin, ether and glycerol ; it is miscible with soap solutions and with solutions of alkali hydroxids, yielding an economical form of disinfectant. ACTION AND USES: Cresol is an active poison resembling phenol in its effects. Its germicidal power is approximately four times as great as that of phenol. DOSAGE: 0.05 c.c. or 1 minim. As a disinfectant it may be used in solutions varying in strength from % to 1 per cent. It is usually employed in the form of: Liquor Cresolis Compositus. Compound Solution of Cresol, U. S. P. A mixture of equal parts of cresol and a solution of a potassium soap. ACTION AND USES : Compound solution of cresol has about twice the germicidal power of pure phenol. On account of its saponaceous character it is much used for the disinfec- tion of the skin, for lubricating the hands, and for vaginal douches. DOSAGE: As a douche and for washing wounds, solutions containing from 1 to 5 per cent, are appropriate. Cupri Sulphas. Copper Sulphate, U. S. P., CuS0 4? 5H,0. PROPERTIES : Copper sulphate forms large, transparent, deep- blue crystals, odorless, having a nauseous, metallic taste. Copper sulphate is freely soluble in water (1:2.2) but only slightly soluble in alcohol (1:400). 00 USEFUL DRUGS INCOMPATIBILITIES: Copper sulphate is incompatible with soluble salts of lead, which precipitate the insoluble sulphate of lead; with fixed alkalies and alkaline carbon- ates, which precipitate copper hydroxid or copper carbon- ate; with iodids, which form insoluble cuprous iodid with liberation of iodin, and with vegetable astringents con- taining tannin. ACTION AND USES: Copper sulphate is astringent in small doses and irritant in large doses, producing nausea and vomiting. Copper sulphate in small amounts exerts- a germicidal action in water containing algae, fungi or bac- teria of the colon group; but when organic matter is abundantly present the germicidal action is greatly weak- ened. Externally copper sulphate acts as an astringent, stimulant or mild caustic according to the strength of the application. Copper sulphate is used as a mild caustic in trachoma. It was formerly much used as an astringent in conjunc- tivitis. It is sometimes used as an emetic but is not to be recommended except in phosphorus poisoning, in which it acts by precipitating an insoluble compound of phos- phorus and copper. It is occasionally prescribed for chronic diarrhea. DOSAGE: As an astringent in diarrhea, 0.01 gm. or 1/5 grain; as an emetic, 0.3 gm. or 5 grains, not to be repeated. As a caustic it is applied as the solid crystal or in pen- cils made by fusing 1 part of potassium alum and 2 parts of copper sulphate. When applications are made to trach- omatous lids the affected parts of the everted lid should be touched lightly with the copper stick and the eye washed out afterward with lukewarm water. Collyria containing from 1 part in 1,000 to 1 in 100 may be used. DECOCTA DECOCTIONS Decoctions are aqueous preparations made by boiling veg- etable substances in water and then straining. Diacetyl-Morphinae Hydrochloridum. Heroin hydrochlorid. N. N. R. The hydrochloric acid salt of diacetyl-morphin, a base formed by the action of acetic anhydrid on anhydrous morphin. PROPERTIES : Heroin hydrochlorid occurs as a fine crystalline powder, odorless and having a bitter taste. Diacetyl-morphin hydrochlorid is freely soluble in water and In alcohol. INCOMPATIBILITIES: It is incompatible with alkaline carbonates and hydroxids and also with strong acids, being quite readily decomposed. ACTION AND USES: Diacetyl-morphin hydrochlorid resem- bles morphin. but it affects the brain less and depresses the respiration more. It is only slightly constipating. Repeated USEFUL DRUGS 61 use is likely to produce a habit, as with morphin. The sudden withdrawal of the drug from habitue's may occasion dangerous respiratory failure. The use of heroin is resorted to by some cocain habitue's who cannot procure their favor- ite drug. Diacetyl-morphin hydrochlorid is used as a respiratory sedative to relieve cough. It is perhaps somewhat more effective, but has no important advantage over morphin. It is not so valuable as morphin for the relief of pain. DOSAGE: 3 mg. or 1/20 grain. DIGITALIS SUBSTANCES This group includes as its most important members digi- talis, strophanthus and squill. Others of the group are of minor importance. The drugs of the group increase the tone of the heart and arterial muscles and stimulate the vagus mechanism. In this way they slow and regulate the heart-beat, increase the cardiac output, and thus improve the circulation without affecting the blood-pressure directly. They are em- ployed to secure compensation in valvular lesions, relieving the congestion, dyspnea, edema and other distressing symp- toms and increasing the flow of urine. When administered by mouth, their absorption is slow and somewhat uncertain and their effects are correspondingly delayed and cumula- tive, so that they must be carefully watched. Overdoses produce nausea, vomiting, diarrhea, headache, cardiac irreg- ularities and heart-block. The emetic action of ordinary doses is not due to local irritation, as commonly supposed, but is central and therefore cannot be avoided by rectal or intravenous administrations, or by the use of special prepa- rations or isolated principles. Digitalis. Digitalis, U. S. P. The dried leaves of Digitalis purpurea. Digitalis contains a number of glucosidal principles, the most important of which are digitoxin, digitalin and digitalein, the actions of which are essentially similar. A number of preparations of these glucosids are on the market, but many are of uncer- tain composition, and since they have not yet demonstrated any superiority over good preparations of the whole drug, the latter are to be preferred. Digitalis is a fairly stable drug, and those preparations that are made with high per- centages of alcohol retain their full activity with little alteration for several years. Aqueous solutions deteriorate very rapidly. ACTION AND USES: Digitalis, either in substance, or as one of the preparations referred to hereafter, is a cardiac tonic and diuretic. (See the preceding.) Digitalis is useful whenever the systole of the heart is insufficient on account of incomplete exertion of its mus- cular power. It causes the heart to empty itself more completely and prevents it from dilating excessively during 62 USEFUL DRUGS diastole. It is useful in decompensated valvular disease, in dropsy from weak heart-action and in constantly irregular pulse, which is due to fibrillation of the auricle. DOSAGE: 0.065 gm. or 1 grain, in powder or pill. Digi- talis is a drug of variable strength, and hence a physiolog- ically standardized preparation should be used. No percep- tible effect is to be expected in less than twenty-four hours after oral administration. A slowing of the pulse indicates the beginning of its physiologic action; nausea and vomiting coming on during the administration of the drug are usually due to a commencing toxic action. If the vomiting is due to other causes, the administration of the digitalis may be continued best by a different channel, such as the rectum or the veins, or by hypodermic injection. For hypodermic and intravenous injections special preparations must be used, for which N. N. R. should be consulted. OVERDOSAGE: As an overdose of digitalis or cumulative effects are most readily detected by a study of the pulse and heart-action, a patient who has been given digitalis should be kept under close observation. As a rule, the conditions which require digitalis also require that the patient stay in bed. Symptoms of digitalis poisoning are shown by nausea and vomiting, sometimes great gastro-intestinal irritation, with pain and diarrhea, a very slow pulse, followed by a rapid and feeble one, or heart-block and marked prostration. The heart may become irregular and sudden changes in position may result in great aggravation of the condition and sometimes in sudden death. On the occurrence of any of these symptoms, the administration should be suspended. Aside from its use in powder or pills, digitalis is used largely as : Infusum Digitalis. Infusion of Digitalis, U. S. P. One hundred c.c. represent the water-soluble constituents of 1.5 gm digitalis partially preserved by alcohol ( 10 per cent.). It should be freshly prepared. DOSAGE: 8 c.c. or 2 fluidrams. Tinctura Digitalis. Tincture of Digitalis, U. S. P. One hundred c.c. represent 10 gm. digitalis in diluted alcohol. DOSAGE: 1 c.c. or 15 minims. Diphtheria Antitoxin. See Serum Antidiphthericum. Elaterinum. Elaterin, U. S. P. A neutral principle obtained from elaterium. a substance deposited by the juice of the fruit of Ecballium Elaterium. 1'uqpEUTiES Elaterin occurs as minute, white hexagonul scales or prismatic crystals, without odor and having a slightly acrid, bitter taste. It' is practically insoluble in water and only 'slightly soluble in alcohol (1 :262). USEFUL DRUGS 63 Recent investigations would appear to indicate that the commercial substance is extremely variable in composition, and this is in keeping with clinical observations, many lots of the drug being found to be practically inert. Elat- erin should not be confounded with elaterium. ACTION AND USES: Elaterin is a powerful hydragogue cathartic, causing profuse watery evacuations with com- paratively little pain. It is used in dropsy, convulsions, puerperal eclampsia, etc. If used too freely or in debilitated persons it may produce dangerous weakness. DOSAGE: 0.005 gm. or 1/10 grain. ELIXIRIA ELIXIRS Elixirs are sweetened, aromatic, alcoholic liquids similar to cordials and having probably the same origin. For preparations included in this list see : Elixir Adjuvans, under Glycyrrhiza. Elixir Aromaticum, under Alcohol. EMPLASTRA PLASTERS Plasters are a class of solid preparations for external use and serve either as simple adhesives or as counter- irritants. The official plasters are practically never used but are replaced by the commercial plasters made on a large scale by machinery, which have as a base a mixture of rubber, with solvents or diluents. For preparation included in this list see: Emplastrum Belladonnae, under Belladonnas Folia. EMULSA EMULSIONES EMULSIONS Emulsions are aqueous preparations in which oils or resins are suspended by means of mucilaginous substances. ENEMATA CLYSTERS An enema, or clyster, is a liquid preparation intended to be injected into the rectum. Epinephrina. Epinephrin, N. N. R. The 'blood-pressure-raising principle of the suprarenal gland, also produced synthetically, is official in the French, Italian and Belgian Pharmacopeias as adrenalin and in the German Pharmacopeia and the supplement to the Nether- lands Pharmacopeia as suprarenin. In N. N. R. the follow- ing synonyms are enumerated: adnephrin, adrenalin, supra - capsulin, suprarenalin and 1 -suprarenin synthetic. PROPERTIES : Chemically eplnephrin Is described as 1, 2-di- hydrory^-methylamino-ethyl-^-ol benzene, C 8 H 3 (CHOH.CH 2 NH- CH 2 ), a substance with feeble basic properties, occurring in the suprarenal gland of the sheep or other animal. As commercially obtained it is a finely crystalline white or yellowish powder, odorless and slightly bitter. The free base is practically insolu- 04 USEFUL DRUGS ble in water and is usually dispensed in the form of an aqueous solution, 1 :1,000, of one of its salts. Epinephrin is oxidized readily and is thus destroyed in dilute alkaline solution. ACTION AND' USES: Epinephrin excites the action of the sympathetic nerves in such a way as to produce a variety of effects according to the function of the part supplied by the nerve. It produces a sudden rise of blood-pressure by contraction of the arterioles. The pulse is slowed by an action on the vagi. The heart is stimulated directly, but the resistance offered by the contraction of the blood- vessels is such that at times the heart is unable to overcome it and suffers passive dilatation. The rise of blood-pressure which results from the action of this drug is very transient, lasting, as a rule, not more than five minutes. When given by the mouth it produces no evident effect on the circula- tion, but it is readily absorbed from the mucous membranes of the nose, mouth, urethra, vagina and rectum, producing local contraction of the blood-vessels. Very large doses are tolerated when given hypodermically on account of the slow absorption due to the constriction of the blood-vessels of the part into which it is injected. It acts promptly after intravenous injection, but it appears, to be rapidly elimi- nated or destroyed or its action is neutralized by antagonistic influences on the sympathetic ganglia. Epinephrin dilates the pupil, and this dilatation was employed at one time as a measure of the amount of epinephrin present in the blood, serum or other liquid. It inhibits the peristaltic movements of the intestine and increases the secretion of saliva and other glands which receive their nerve-supply from the sym- pathetic. Epinephrin may produce hyperglycemia and glyco- suria, and its continued use may cause a degeneration of the internal coats of the arteries. The chief therapeutic use of epinephrin is to constrict the peripheral blood-vessels by local application. In this way it may be used to diminish hyperemia of the conjunc- tiva, to reduce swelling of the turbinated bodies and to arrest hemorrhage from the mucosa of the upper respiratory tract. It is successful only in capillary or small arterial bleeding, as it cannot stop a large vessel hemorrhage. It is used to prevent hemorrhage in operations on the eye, nose, ear, etc. For the arrest of hemorrhage it must Ifc applied directly to the bleeding vessels or congested area. If the blood washes it away the application may fail because it has not time to act. It may be swallowed to check hemorrhage from the stomach, but the chances of success are Email because a quantity of liquid is usually present in the stomach which dilutes the remedy so that it is useless. It should never be given for internal, concealed hemorrhage, because it is never desirable to raise blood-pressure in internal hemorrhage. Epinephrin is employed in conjunction with local a nes tlictics, especially cocain, to limit the absorption of the USEFUL DRUGS 65 anesthetic and secure a more efficient local action. It has been used in asthma both by applying a spray to the nose or throat, or by the absorption of a tablet, powder or solu- tion from the tongue, and also by hypodermic injection. DOSAGE: Epinephrin or one of its salts is employed in solutions of a strength of from 1 : 10,000 to 1 : 1,000. For internal administration the dose of a 1 : 1,000 solution is from 5 to 10 drops. When an oily vehicle is to be used the base itself is prescribed, but when aqueous solutions are wanted one of the salts should be employed. Ergota. Ergot, U. S. P. The sclerotium of Claviceps purpurea, replacing the grain of rye. E'rgot appears to owe its activity to two active principles, ergotoxin (hydroergotinin) and hyclroxyphenyl- ethylamin. The latter substance is closely related to epi- nephrin both in composition and in pharmacologic action. ACTION AND USES: The several active principles of ergot have somewhat different actions, but the total effect is as follows : Ergot causes powerful tonic, sometimes tetanic contrac- tions of the uterus. It slows the pulse by stimulating the cardio-inhibitory centers. It also produces contraction of other involuntary muscles such as those of the blood-vessels, stomach and intestines, the bladder, etc. It seems to have a specially beneficial effect on acute congestions of the central nervous system. Extreme and long-continued contraction of the blood- vessels, especially of the extremities, may lead to gan- grene. Some animals do hot show this action, while others are very susceptible. The most common use of ergot is to prevent post- partum hemorrhage. For this purpose a full dose is often given as soon as the second stage of labor terminates, but it is much safer to give it after the placenta has been expelled. Its use during labor should be avoided as it may cause rupture of the uterus or asphyxia of the child. It is an effective remedy for "after-pains." Ergot is much used for hemorrhage from the uterus in menorrhagia and metrorrhagia. Its use for hemorrhage from other internal organs is not rational, as it increases blood-pressure and tends to prolong rather than check the bleeding. It is asserted to be a good remedy for congestions in various regions. It has been recommended for the treat- ment of the early stage of acute pneumonia and also for pulmonary congestion in typhoid fever. It is at times useful in diabetes insipidus. In colliquative night-sweats due to relaxation of the blood-vessels, ergot is an efficient remedy. DOSAGE: 2 gm. or 30 grains. It is sometimes admin- istered in the form of powder. 66 USEFUL DRUGS Fluidextractum Ergotae. Fluidextract of Ergot, U. S. P. (Extraction Ergotae Fluidum, Pharm. 1890). A hydro-alcoholic extract of ergot similar to, but not identical with, the international standard fluidextract of ergot. DOSAGE: 2 c.c. or 30 minims. Eucalyptus. Eucalyptus, U. S. P. The dried leaves of Eucalyptus Globulus collected from the older parts of the tree. Eucalyptol. Eucalyptol, U. S. P. An organic oxid (cineol), obtained from the volatile oil of Eucalyptus Globulus and from other sources. PEOPEBTIES : Eucalyptol occurs as a colorless liquid, having a distinctly camphoraceous odor, and a pungent, spicy and cooling taste. Eucalyptol is soluble in all proportions in alcohol, but is practically insoluble in water. DOSAGE: 0.3 c.c. or 5 minims. Oleum Eucalypti. Oil of Eucalyptus, U. S. P. The oil distilled from the fresh leaves of eucalyptus, and yielding not less than 50 per cent, of eucalyptol ( cineol ) . PROPERTIES : Oil of eucalyptus occurs as a colorless or pale yellow liquid, having a somewhat camphoraceous odor, and a pungent, spicy and cooling taste. It is miscible in all propor- tions with alcohol, but practically insoluble in water. ACTION AND USES: Eucalyptol and oil of eucalyptus are antiseptic and expectorant. For internal use they are preferably administered in the form of capsules, and for local application in the throat or nose are used either in the form of oil sprays or are directed to be inhaled in the form of vapor from boiling water. Oil of eucalyptus, 2 c.c.; chloroform, 3 c.c. and castor oil, 40 c.c., mixed and taken in two portions at half-hour intervals, is being recommended as an anthelmintic for uncinariasis. DOSAGE: 0.5 c.c. or 8 minims. EXTRACTA EXTRACTS Extracts are soft solid or powdered preparations made by evaporating a solution of the soluble ingredients of vegetable drugs at a low temperature. For preparations included in this list see: Extractum Aloes, under Aloe. Extractum Belladonnae Foliorum, under Belladonnae Folia. Extractum Cannabia Indicae. under Cannabis Indica. Extractum Colocynthidis and Extractum Colocynthidis Compositum, under Colocynthis. Extractum Gentianae, under Gontuuiu. USEFUL DRUGS 67 Extractum Nux Vomicae, under Nux Vomica. Extractum Opii, under Opium. Extractum Rhamni Purshianae, under Rhamnus Purshiana. Extractum Rhei, under Rheum. Fel Bovis. Oxgall, U. S. P. The fresh bile of Bos taurus. Fel Bovis Purificatum Purified Oxgall, U. S. P. A ' yellowish-green, soft solid, or at the present time more frequently a yellow or greenish-yellow powder, havinir a peculiar odor and a bitter taste. ACTION AND USES : Purified oxgall is reputed to be an intestinal antiseptic, cholagogue and laxative. The bile salts are held to be the most powerful stimulants to the secretion of bile. DOSAGE: 0.5 gm. or iy 2 grains. It is best administered in the form of pills or in gelatin capsules which have been treated with a solution of formaldehyd. Ferri Carbonas. Ferrous Carbonate. PROPERTIES : Ferrous carbonate is made by precipitating a solution of a soluble ferrous salt by a soluble carbonate. Such a precipitate tends to give off carbon dioxid, absorb oxygen and change rapidly into a basic carbonate, and finally into ferric hydroxid. Various pharmaceutical processes have been devised to prevent such a change. The principal of these are the prepa- rations described below as Vallet's mass (massa ferri carbonatis) and Eland's pills (pilulae ferri carbonatis). ACTION AND USES: The action of all forms of iron is essentially the same so far as the action of the iron ion is concerned. When an iron salt is received into the stom- ach it may be converted into a chlorid, but this is further changed during the process of digestion. The original form in which the iron was combined seems to make little or no difference in regard to the extent or the form in which it is absorbed. A large part of the iron ingested passes through the intestines without being absorbed. A smaller portion is absorbed, mainly through the lymph, and is deposited for a time in the blood-making organs, chiefly the spleen, where it is retained for an indefinite time as "reserve iron." Some of this supply is used in forming hemoglobin, which enters into the red blood-corpuscles. The rest is eliminated by the mucous membrane of the large intestine and only traces by the kidneys. Iron is not eliminated by the bile. The presence of iron in the blood in the amount resulting from medicinal administration produces no recognizable changes in normal individuals. Its salts with the stronger acids may act as gastro-intestinal irritants and astringents. The only therapeutic action attributable to the iron ion is the improvement in the number of red blood-cells and in the amount of hemoglobin in them. For this purpose it is , 68 USEFUL DRUGS indicated in anemia and in diseases of the blood in which anemia is a factor, such as leukemia. It is chiefly of value in anemia following hemorrhage, in chlorosis and in sec- ondary anemias. In pernicious anemia it seems to be use- less, but may be given along with arsenic. Massa Ferri Carbonatis. Mass of Ferrous Carbonate, U. S. P. It is better known as Vallet's mass. It contains ferrous carbonate, with honey and sugar as preservatives, and sodium sulphate resulting from the process of manufacture. DOSAGE: 0.25 gm. or 4 grains. Pilulae Ferri Carbonatis. Pills of Ferrous Carbonate, U. S. P. These are popularly known as Blaud's pills. They consist of ferrous carbonate, potassium sulphate and sugar, with a smaller proportion of tragacanth and althea to make a mass. Each pill represents approximately 0.06 gm. or 1 grain of ferrous carbonate. They should be made fresh when wanted. DOSAGE: 2 pills. Ferri Chloridum. Ferric Chloride, U. S. P. FeCl,. Used in medicine principally in the form of: Tinctura Ferri Chloridi. Tincture of Ferric Chloride, 17. S. P. It is a hydro-alcoholic solution of FeCl 3 , containing not less than 13.28 per cent, of the anhydrous salt, corresponding to about 4.5 per cent, of metallic iron. PROPERTIES : Tincture of ferric chlorid is a bright brownish liquid, having a slightly ethereal odor, a very astringent taste and an acid reaction, miscible in all proportions with either water or alcohol. INCOMPATIBILITIES : It is incompatible with alkalies, alkali carbonates and with tannin, and the vegetable astrin- gents. These give an inky color to the mixture. Tincture of ferric chlorid is also incompatible with iodids, from which it liberates iodin. ACTION AND USES: Tincture of ferric chlorid is an astringent and is used in applications to the throat. It may be employed as a hematinic. It is also sometimes given in infections like erysipelas, but it is doubtful if it has any special value in this disease. DOSAGE: 0.5 c.c. or 8 minims, freely diluted. Care should be taken to prevent injury to the teeth. Equal parts of the tincture, glycerol and water form a useful local application in acute tonsillitis. Ferri et Ammonii Citras. Iron and Ammonium Citrate. U. S. P. USEFUL DRUGS 60 It should contain the equivalent of 16 per cent, metallic iron. PROPERTIES : It forms thin, transparent, garnet-red scales, without odor, having a saline, mildly ferruginous taste ; deliques- cent in moist air. It is freely and roadily soluble in water, but practically insoluble in alcohol. ACTION AND USES: Iron and ammonium citrate is one of the more widely used of the soluble preparations of iron. It may be directed to be dissolved in water, aro- matic elixir, wine or syrup. It has been given hypoder- mically. DOSAGE: 0.25 gin. or 4 grains. Ferri lodidum. Ferrous Iodide, FeL. Ferrous iodid is a very unstable compound, easily under- going oxidation. In order to preserve it in the ferrous condition it is commonly used in medicine in the form of syrup. Syrupus Ferri lodidi. Syrup of Ferrous Iodide. U. S. P This is a syrup liquid containing about 5 per cent, by weight of FeI 2 and practically identical with the international stand- ard syrup of ferrous iodid. PROPERTIES : Syrup of ferrous iodid occurs as a transparent pale green or yellowish green liquid, having a sweet, strong, ferruginous taste and an acid reaction. INCOMPATIBILITIES: The syrup is very susceptible to oxidation, and is incompatible with alkali carbonates, acid salts and vegetable astringents. On exposure to light the cane-sugar of the syrup undergoes gradual inversion. ACTION AND USES: Syrup of ferrous iodid has the gen- eral properties of both iron and iodin. DOSAGE: 1 c.c. or 15 minims, containing approximately 0.008 gm. or % grain of iron and 0.04 gm. or % grain of iodin. Ferri Phosphas Solubilis. Soluble Ferric Phosphate, U. S. P. PROPERTIES : Soluble ferric phosphate should contain the equi- valent of 12 per cent, of metallic iron and occurs in thin, bright- green transparent scales without odor, and having an acidulous, slightly saline taste. It is freely soluble in water, but practically insoluble in alcohol. INCOMPATIBILITIES : Strong acids decompose it with formation of the astringent ferric compound of the acid used. Like other soluble salts of iron it is incompatible with alkalies, alkali carbonates and vegetable astringents. ACTION AND USES : Soluble ferric phosphate has been recommended for the administration of iron in soluble form, it may be dissolved in water and flavored with simple elixir or sweetened with syrup. DOSAGE: 0.25 gm. or 4 grains. 70 USEFUL DRUGS Ferri Sulphas. Ferrous Sulphate, U. S. P., FeS0 4 ,7H.,0, Green Vitriol. PROPERTIES : Ferrous sulphate occurs as large, pale bluish- green crystals, without odor, having 1 a saline, styptic taste and efflorescent in dry air. It is freely soluble in water (1:0.9), but practically insoluble in alcohol. ACTION AND USES : Ferrous sulphate is seldom adminis- tered in medicine as such, but is used chiefly for pharma- ceutical purposes, in the making of ferrous carbonate. The sulphate was formerly used extensively as" a disinfectant and deodorant but is now seldom so employed. DOSAGE: 0.2 gm. or 3 grains. Ferri Sulphas Exsiccatus. Exsiccated Ferrous Sulphate, U. S. P. One hundred parts represent approximately 150 parts of the crystalline substance. PROPERTIES : Exsiccated ferrous sulphate occurs as grayish- white powder, having the chemical properties of ferrous sulphate and being slowly but completely soluble in water. Ferrum. Iron, U. S. P. Metallic iron is used pharmaceutically in the production of preparations of iron, but in medicine is used chiefly in the form of : Ferrum Reductum. Keduced Iron, U. S. P. PROPERTIES : Reduced iron should contain not less than 90 per cent, of iron. It occurs as a very fine, grayish-black powder, without odor or taste, and permanent in dry air. It is insoluble in water or alcohol. DOSAGE: 0.065 gm. or 1 grain. Reduced iron is still widely used as a hematinic and is given preferably in the form of pills or powders, enclosed in capsules or cachets. FLUIDEXTRACTA FLUIDEXTRACTS Fluidextracts are liquid preparations of uniform and def- inite strength made so that each cubic centimeter represents the soluble ingredients of 1 gm. of the crude drug. For preparations included in this list see: Fluidextractum Ergotae, under Ergota. Fluidextractum Glycyrrhizae. under Glycyrrhiza. Fluidextractum Hydrastis, under Hydrastis. Fluidextractum Ipecacuanhae, under Ipecacuanha. Fluidextractum Rhamni Purshianae, under Rhamnus Purshiana. Fluidextractum Rhamni Purshianae Aromaticum, under Rhamnus Purshiana. Fluidextractum Sennae, under Senna. Fluidextractum Viburni Prunifolii, under Viburnum Pru- nifolium. USEFUL DRUGS 71 Formaldehydum. Formaldehyd, CH 2 0. Formaldehyd is the aldehyd of formic acid, HCOOH. Formaldehyd is commonly obtained by oxidation of methyl alcohol. It is used in medicine in the form of : Liquor Formaldehydi. Solution of Formaldehyde, U. S. P., often referred to in literature under the proprietary name, formalin. PROPERTIES : Solution of formaldchyd is an aqueous solution containing not less than 37 per cent, of formaldehyd, CH 2 O. It is a clear, colorless liquid, having a pungent odor and caustic taste. Solution of formaldehyd is miscible in all proportions with water -and alcohol. On standing it sometimes loses its trans- parency, its cloudiness being due to the separation of paraformal- dehyd, a polymerization product of formaldehyd. Paraformalde- hyd is also frequently formed on evaporation of the solution. Paraformaldehyd is a solid which is largely changed again into formaldehyd on heating. INCOMPATIBILITIES : Solution of formaldehyd is incom- patible with oxidizing agents and with alkalies. With ammonia it forms hexamethylenamin. ACTION AND USES: Formaldehyd is a powerful germi- cide, especially valuable in the form of gas because of its penetrating power, but it is active only in the presence of an abundance of moisture. The solution is germicidal in the strength of from 1 to 2 per cent, (percentages refer to amounts of absolute formaldehyd, HCOH), but it may require from twenty to thirty minutes for it to act. In a strength of 1 : 5,000 it restrains the growth of many organisms, and in many cases a strength of 1 : 20,000 or 1 : 30,000 is sufficient to prevent the multiplication of bac- teria. It is useful as a preservative of urine, although its reducing properties interfere with copper tests for sugar, and it is likely after the urine has stood some time to cause a precipitation of albumin, if present. It hardens tissues and is used in histology for this pur- pose. It has a similar hardening effect on the living skin; it is very irritating and if repeatedly or continuously applied produces reddening, inflammation and necrosis. It is applied to the skin to restrain unilateral and excessive sweating. From 1 to 10 per cent, solutions in alcohol are appropriate for this purpose. It is sometimes used for the disinfection of the hands, in connection with a solution of soap. The use of formaldehyd for the preservation of food has been quite commonly condemned on account of the disturb- ance of digestion which often follows its ingestion. The principal application of formaldehyd is in room dis- infection. For this purpose the vapor must be generated in a tightly closed room, containing plenty of moisture. Sev- eral methods have been described for generating the vapor, the most convenient being by the use of potassium perman- 72 USEFUL DRUGS ganate which, when added to the solution, by decomposing a part of the formaldehyd, generates sufficient heat to vapor- ize the remainder. For an ordinary-sized room 2 pounds of potassium permanganate are placed in a vessel of at least 25 quarts' capacity and a mixture of 1 quart of formaldehyd solution and 1 quart of water poured on it. Intense heat is generated by the reaction of the two chemicals, and by this heat the formaldehyd is vaporized. The heat is so great as sometimes to cause fire, against which due precautions should be taken. When the mixture has been made the operator should leave the room instantly. After the disinfection is complete the irritating fumes can be neu- tralized by ammonia. Gelatinum, Gelatin, U. S. P. The purified air-dried product of the hydrolysis of certain animal tissues, as skin, ligaments and bones, by treatment with boiling water. An amorphous, more or less transparent solid, usually shredded or in thin sheets ; colorless or with a slight yellowish tint, ino- dorous, and having a slight, characteristic, almost insipid taste. Unalterable in the air when dry, but putrefying rapidly when moist or in solution. Gelatin is practically insoluble in cold water, but swells and softens when immersed in it, gradually absorbing from five to ten times its weight of water. It is soluble in boiling water, acetic acid and glycerin, but is prac- tically insoluble in alcohol, ether or chloroform. INCOMPATIBILITIES : Gelatin is coagulated by tannin, chlorin, bromin, and mercuric chlorid. If a solution of gela- tin be mixed with formaldehyd, the gelatin is rendered hard and insoluble after evaporation and drying of the residue. ACTION AND USES: Gelatin is largely used as a food product, though its full value in this respect has probably been exaggerated. It has also been used to some extent in solution for hypodermic injection to promote the formation of clot in aneurysms, and to arrest hemorrhage. There is, however, serious danger of infection from its use. Even boiling will not insure sterility as it may contain tetanus spores which are not destroyed by simple boiling. In phar- macy gelatin is used for the coating of pills, the making of gelatin capsules, gelatin disks, glycogelatin pastilles and for the making of glycerinated gelatin used as a base for suppositories. Gentiana. Gentian, U. S. P. The dried rhizome and roots of Gentiana, lutea. ACTION AND USES: Gentian is one of a large class of substances with a bitter taste which have the power of stimulating the appetite and may possibly stimulate the secretion of the gastric juice. Experiments show that this effect is not due to an appreciable extent to a direct action on the mucous membrane of the stomach, but arises reflexly from the action of the medicine on the nerves in the mouth, chiefly those of taste. USEFUL DRUGS 73 Gentian and other bitters in moderate doses given a short time (five to fifteen minutes) before meals are useful in the treatment of loss of appetite, deficiency of the gastric secretions, chronic or subacute catarrhal gastritis, etc. Tinctura Gentianae Composita. Compound Tincture of Gen- tian, U. S. P. A hydro-alcoholic tincture representing 10 per cent, of gentian with bitter orange peel and cardamom used for flavor. DOSAGE : 4 c.c. or 1 fluidram. Extractum Gentianae. Extract of Gentian, U. S. P. An aqueous extract of gentian evaporated to pilular con- sistence. DOSAGE: 0.25 gm. or 4 grains. Glandulae Thyroideae Siccae. Desiccated Thyroid Glands, U. S. P. The thyroid glands of the sheep, freed from fat, and cleaned, dried and powdered. PROPERTIES : Desiccated thyroid gland is a yellowish, amor- phous powder, having a slight, peculiar odor, and containing the active constituent of the thyroid tissue. It is partially soluble in water. The preparation should be standardized to contain 0.2 per cent, of iodin in organic combination. ACTION AND USES : Dried thyroid gland acts chiefly if not entirely through a compound of iodin contained in it; the substance known commercially as "iodothyrin" seems some- times, but not always, to represent the full activity of the gland. When given in therapeutic-ally active doses thyroid causes an increase of the nitrogen of the urine and a decrease in weight; it usually increases the absorption of oxygen and the elimination of carbon dioxid. It is one of the very few drugs which can properly be called stimulants of metabolism. The loss of weight is at first due to loss of water, then to increased metabolism of adipose tissue, although there is also an increased breaking down of pro- tein unless the diet '-ontains an abundance of protein. With larger, or long-continued doses there is a very rapid action of the heart, nervousness, tremors, headache, flushing of the surface, sweating and much more pronounced loss of weight. Thyroid gland is of service in cases marked by deficient action of the gland. The most striking results are obtained in cretinism and myxedema and in the condition known as cachexia thyreopriva, due to the removal of the thyroid gland. The beneficial effects are seen in the improved con- dition of the skin, the reestablishment of perspiration and of a normal temperature, increased diuresis and loss of weight, improvement in the mental condition and, in young subjects, renewed growth, especially of the long bones and of the hair. In many cases after the more severe symptoms of hypothyroidism have disappeared, remarkably small doses 74 USEFUL DRUGS suffice to keep the patient in an almost normal state; it is often necessary, however, to continue such small doses indefinitely. Thyroid is efficacious in many cases of milder degrees of hypothyroidism ; but these are often difficult to diagnose. In some forms of goiter the function of the thyroid is defective and the administration of the dried gland is indi- cated; but in most cases of goiter its use is condemned. Thyroid has been much used in obesity, but it is indicated in only a small proportion of cases and it should be given in moderate amounts so as not to do harm by the destruction of proteins. The effects, which are marked at first, are not permanent. Thyroid gland has been used with reported success in various skin diseases, such as psoriasis" and eczema, and also in certain cases of amenorrhea. DOSAGE: 0.05 gm. or 1 grain should be given as the initial dose three times daily, increasing gradually until improvement is noted; its administration should be discon- continued if toxic symptoms apppear. The patient should be careful of exertion and should take sufficient protein in his diet to compensate for increased loss of nitrogen from the action of the drug. The remedy may be given in powder, cachets or capsules. A dose of 0.6 gm. or 10 grains should rarely be exceeded. Glycerinum. Glycerin, U. S. P., Glycerol, C 3 H 5 (OH) 3 . A liquid obtained by the decomposition of vegetable or animal fats or fixed oils. Glycerin occurs as a clear colorless liquid, of a thick, syrupy consistence, smooth to the touch, odorless, sweet to the taste and producing a sensation of warmth in the mouth. It is readily miscible with water or alcohol. PROPERTIES AND USES: Glycerin is used in medicine chiefly as a solvent in preparing glycerites, and as a sweet- ening agent or vehicle in place of syrups. Suppositoria Glycerini. Suppositories of Glycerin, U. S. P. Each suppository contains approximately 3 gm. or 45 grains of glycerin gelatinized by means of hard soap. ACTIONS AND USES: A glycerin suppository, or glycerin itself, when introduced into the rectum tends to absorb water from the surrounding tissues and to cause increased peristalsis by reflex action, thus acting as a prompt laxa- tive. GLYCERITA GLYCERITES Glycerites are solutions of medicinal substances in gly- cerin. For preparations of this type included in this list see: Glyceritum Acidi Tannici, under Acidum Tannicum. Glyceritum Amyli, under Amylum. Glyceritum Boroglycerini, under Acidum Boricum. Gelatinum Glycerinatum, under Gelatinum. USEFUL DRUGS 75 Glycerylis Nitras. Glyceryl Trinitrate, Nitroglycerin, Trini- trin. Glonoin. A compound of glyeeryl with nitric acid obtained by the action of nitric acid on glycerol in the presence of sulphuric acid. PROPERTIES : Nitroglycerin is a moderately volatile explosive liquid slightly soluble in water, but quite soluble in alcohol. ACTION AND USES: Although a nitrate, nitroglycerin has the physiologic action of nitrites but acts more slowly than amyl nitrite. It may be given when it is desired to effed a steady reduction of the arterial pressure, but it gradually becomes inefficient. For this purpose it may be prescribed in arteriosclerosis, and in nephritis in which a high blood- pressure is a prominent symptom. It is used with success in some cases of angina pectoris. It is sometimes combined with digitalis in order to neutralize the contraction of the arterioles by the digitalis under the belief that therapeutic doses of digitalis exert a pronounced vasoconstrictor action. Spiritus Glycerylis Nitratis. Spirit of Glyceryl Trinitrate, U. S. P., Spirit of Nitroglycerin (Spiritus Glonoini, Pharm. 1890). An alcoholic solution containing 1 per cent, by weight of glyeeryl trinitrate. PROPERTIES : Spirit of Glyceryl Nitrate is a clear, colorless liquid, having the odor and taste of alcohol. Caution should be exercised in tasting it, since even a small quantity of it is liable to produce violent headache. DOSAGE: 0.05 c.c. or 1 minim two or three times a day. Glycyrrhiza. Glycyrrhiza, Licorice Root, U. S. P. The dried rhizome and root of Glycyrrhiza glabra (Span- ish licorice), or of Glycyrrhiza glandulifera (Russian licorice). Used in medicine chiefly as a vehicle and princi- pally in the form of: Fluidextractum Glycyrrhizae. Fluidextract of Glycyrrhiza. U. S. P. [Extractum Glycyrrhizse Fluidum, Pharm., 1890]. An aqueous extract of glycyrrhiza preserved by means of glycerin and alcohol. AVERAGE DOSE: 2 c.c. or 30 minims. A simple mixture of 12 c.c. of fluidextract of glycyrrhiza and 88 c.c. of aromatic elixir is official in the U. S. P. as "elixir adjuvans." Glycyrrhiza in the form of powder is used as a flavoring agent and vehicle in connection with: Pulvis Glycyrrhizge Compositus. Compound Powder of Gly- cyrrhiza, U. S. P. A mixture of senna (18 gm.), glycyrrhiza (23.6 gm.), sulphur (8 gm.). oil of fennel (0.4 gm.), and sugar (50 gm.). 76 USEFUL DRUGS ACTION AND USES: Pulvis Glycyrrhizae Compositus has been widely used as a laxative. DOSAGE: 4 gm. or 60 grains, administered mixed with a suitable liquid, preferably milk. Guaiacol. Guaiacol, U. S. P. Guaiacol, is one of the chief constituents of beechwood creosote. PROPERTIES : Guaiacol is a colorless or nearly colorless crystal- line solid, melting at 28.5 C. (83.3 F.) or a refractive liquid, having an agreeable aromatic odor. It is soluble in water (1 :53), and miscible with alcohol in all proportions. ACTION AND USES: Guaiacol is antiseptic and germicidal, but to a less degree than creosote. When rubbed on the skin it is absorbed. When given in this way it is an active antipyretic, but its action is not easily controlled. It is an intestinal antiseptic and also an expectorant. It is not excreted by the lungs, however. DOSAGE: Guaiacol may be given in emulsion or in the form of capsules. The initial dose should be 0.1 c.c. or about 1% minims, gradually increased to 0.6 c.c. or 10 min- ims, if well borne. It is sometimes applied to the pharynx as a 50 per cent, solution in glycerin. The local use of guaiacol as an antipyretic is not to be recommended on account of the symptoms of collapse which sometimes follow these applications. Guaiacolis Carbonas. Guaiacol Carbonate, U. S. P. (C 7 H,0), C0 3 . Guaiacol carbonate is a white crystalline powder of neu- tral reaction, almost tasteless and odorless. It is practi- cally insoluble in water, but is soluble in alcohol. It is decomposed readily with the liberation of guaiacol. INCOMPATIBILITIES : It is incompatible with alkaline hydroxids. ACTION AND USES: Guaiacol carbonate is inactive until decomposed with the liberation of guaiacol. This occurs only in the presence of putrefactive organisms so that in the intestine it acts only when an antiseptic is needed and the excess fails to be absorbed and is excreted with the feces. Consequently it is ordinarily not poisonous. It is used inter- nally as a tasteless and non-poisonous substitute for guaiacol. DOSAGE: 1 gm. or 15 grains. It may be given in pow- ders, capsules or cachets. Heroin Hydrochloric!. See Diacetylmorphinae Hydrochloridum. Hexamethylenamina. Hexamethylenamin, U. S. P. This preparation is also known under several trade names, of which aminoform, formin and urotropin are included in N. N. R. USEFUL DRUGS 77 Hexametliylenamin is hexamethylenetetramin, (CH 2 ) 6 N 4 , a compound produced by condensation of ammonia and for- maldehyd with the elimination of water. PROPERTIES : Hexamethylenamin forms colorless, lustrous, odorless crystals, freely soluble in water (1 :1.5) and alcohol (1:10). The aqueous solution has an alkaline reaction. Hex- amethylenamin is a base which combines with acids to form salts. These salts tend to lose formaldehyd, and most acids decom- pose the base completely with the liberation of formaldehyd. Even in aqueous solution a slow separation of formaldehyd occurs. The basic properties cf hexamethylenamin are so pro- nounced that it displaces ammonia and other weak bases from their combinations. INCOMPATIBILITIES : Hexamethylenamin is incompatible with acids which liberate formaldehyd and with salts of ammonium from which it separates ammonia. Acid salts like acid sodium phosphate and combined acids like acetyl- salicylic acid (aspirin) react with it like other acids. It is also incompatible with tannin and mercuric chlorid, which precipitate hexamethylenamin. ACTION AND USES : Hexamethylenamin produces no marked physiologic effects except those of formaldehyd, to which it gives rise. It is excreted in the urine, the bile, the cerebro- spinal fluid and other serous fluids and by the mucous mem- branes of the respiratory tract and, of the middle ear. When the urine is acid hexamethylenamin is decomposed, yielding formaldehyd. This product exercises a strong antiseptic action on the mucous membrane of the genito-urinary tract. When the urine is alkaline the decomposition does not occur. Formaldehyd is an excellent solvent of uric acid, and hexa- methylenamin has been used in the hope of dissolving uric acid calculi, tophi, gravel, etc., and has been thought to increase the elimination of uric acid. Its use for this pur- pose, however, has practically been abandoned. The chief use of hexamethylenamin is as a urinary anti- septic. It tends to free the urine from micro-organisms, and in many cases causes pus to disappear. It is of great value as a prophylactic in operations on the urinary organs. It is valuable in cystitis, pyelitis, etc. It is employed as a prophylactic in the bacilluria of typhoid fever: Some advo- cate its routine use to prevent the occurrence of this compli- tion. It has been recommended to prevent the onset of nephritis in scarlet fever. As it has produced albuminuria and hematuria in some cases, it should be used with caution in cases in which inflammation of the kidney is present or anticipated. In view of its excretion into the spinal canal, it has been recommended in cerebrospinal meningitis and in poliomyelitis. There is a tendency to extend its employment to infections of the respiratory tract and to the treatment of catarrh of the intestine and biliary passages. Favorable reports have been made of its use in rhinitis, otitis, bronchitis, etc., but further investigations are necessary to establish its efficiency. There is no good reason to expect a therapeutic action from it in alkaline mediums. 78 USEFUL DRUGS DOSAGE: 0.3 gm. or 5 grains three or four times a day in half a glass of water. Homatropinae Hydrobromidum. Homatropine Hydrobromide. U. S. P. The hydrobromid of an alkaloid, tropin mandelate, pro- duced synthetically. PROPERTIES : It usually occurs as a white, odorless, crystalline powder, having a bitter taste. It is freely soluble in water (1:5.7) and soluble in alcohol (1:32.5). INCOMPAIBILITIES : Homatropin hydrobromid has the ordi- nary incompatibilities of the salts of alkaloids. ACTION AND USES: The actions of homatropin are iden- tical with those of atropin, except for the fact that the mydriasis produced by it occurs more promptly and dis- appears in about eighteen hours. When applied freely to the conjunctiva it may be absorbed so that the bitter taste can be perceived, but the throat does not become dry as after atropin. The effect of this drug is increased by mix- ture with cocain. DOSAGE: 0.0005 gm. or 1/125 grain. Homatropin is used chiefly as a mydriatic in place of atropin. It may be used in aqueous solution of 2 per cent, strength, or a drop of a 1:500 solution may be introduced into the conjunctival sac every five minutes for five times to produce a maximum dilatation in three-quarters of an hour. This will return to normal in from fourteen to eighteen hours. Hydrargyri Chloridum Corrosivum. Corrosive Mercuric Chlo- ride, U. S. P., Corrosive Sublimate, HgCl 2 . PROPERTIES : Mercuric chlorid occurs in the form of heavy colorless crystals or a heavy white powder having an acrid and persistent metallic taste. It is permanent in the air. It is very slowly soluble in water (1:13), and freely soluble in alcohol (1:3). Ammonium chlorid, sodium chlorid, tartaric acid and citric acid enhance its solubility in water. INCOMPATIBILITIES : Mercuric chlorid is precipitated from its solutions by albumin, but redissolves in an excess of the albumin solution. Albumin in the form of egg-white forms the most useful antidote to corrosive sublimate, but a great excess should be avoided and the antidote should be followed by an emetic. Mercuric chlorid is incompatible with soluble carbonates and hydroxids, forming insoluble mercuric oxid, and with iodids, forming mercuric iodid or complex mercuric iodids. It is incompatible with many alkaloids and other organic compounds. It is reduced to calomel or metallic mercury by iron, zinc and reducing agents in general. It dulls and tarnishes surgical instruments. ACTION AND USES: Mercuric chlorid is chiefly used as a germicide and an antiseptic. It is also sometimes used as a specific antisyphilitic agent. In a proportion of 1:20.000 it kills non-spore bearing bacilli and in the proportion of USEFUL DRUGS 79 1 : 300,000 inhibits the growth of many bacteria. Spores of Bacillus anthracis are killed by a solution of 1:1,000. Its disinfectant action is limited by its deficient penetration and by the fact that it is greatly reduced by combination with organic matter. Mercuric chlorid is irritant to the skin, setting up a dermatitis. A sufficient amount may be absorbed from the skin to produce serious poisoning. The effects of the poison when absorbed from the skin or mucous membranes are seen in gastro-intestinal irritation, diarrnea, frequent foul-smelling and bloody passages resembling those of dysentery, various nervous symptoms, irritation of the kidneys with albumin and casts in the urine, marked weak- ness, etc. When taken in poisonous doses by the mouth it produces, in addition, irritation and ulceration of the mouth and throat, vomiting and corrosion of the mucosa of the stomach and intestines. Salivation and swelling and ulcera- tion of the gums sometimes occur. Dilute solutions of mercuric chlorid are used by hypoder- mic or intramuscular injection in the treatment of syphilis. The injections must be repeated daily and have the dis- advantage of causing considerable pain. Mercuric chlorid is used as a local application to the skin in some forms of skin disease, sometimes as an anti- septic, but also for the purpose of producing exfoliation of the epidermis. It is sometimes used in 1 per cent, alcoholic solution as an application to corneal ulcers. In the propor- tion of 1 : 5,000 it may be added to collyria to prevent fungus growths. DOSAGE: From 0.002 to 0.01, or from 1/30 to 1/6 grain, in solution or in pill form. As an antiseptic application it may be used in solutions varying in strength from 1:20,000 to 1:2,000. For disinfection of clothing a solution of 1:1,000 may be used. To excite dermatitis and exfoliation, solu- tions varying in strength from 1:1,000 to 1:200 may be used, but caution should always be exercised in employing the stronger solutions for fear of absorption of the poison. The injection of mercuric chlorid solutions into the body cavities should be undertaken only with the greatest caution. Hydrargyri Chloridum Mite. Mild Mercurous Chloride, U. S. P., Calomel, HgCl. PROPERTIES : Mild mercurous chlorid is a white impalpable powder, becoming yellowish-white on trituration with strong pressure, odorless, tasteless and permanent in the air. It is practically Insoluble in water, alcohol or ether. It undergoes changes when exposed to the action of light or under the influ- ence of alkaline chlorids, bromids or iodids, by which mercuric salts are more or less rapidly formed. The mercuric salt enters into solution in combination with the salt of the alkali metal present. Alkaline hydroxids convert it into mercurous oxid ; ammonia forms with it a mixture of mercury and mercuric ammonium chlorid. INCOMPATIBILITIES: Calomel is incompatible with alkalies, with oxidizing acids like nitric acid and also with soluble bromids and iodids. The fear that non-oxidizing acids like 80 USEFUL DRUGS hydrochloric acid will form mercuric chlorid from it is unfounded. Calomel is not incompatible with such acids. ACTION AND USES : Mild mercurous chlorid is not irritating to the mucous membrane of the mouth, esophagus and stomach, but it provokes bowel movements by a slow action. This action has been thought to be due to a partial change into a mercuric salt or a protein compound. The absorption of the mercuric salt may produce symptoms of subacute mercurial poisoning. The chief indications of toxic effects are pain in the abdomen, loose passages, salivation, loosen- ing of the teeth, swelling, soreness and ulceration of the gums, foul breath and general malaise. Calomel, was formerly supposed to have a cholagogue action, but it does not increase the quantity of bile secreted, although by its cathartic action it may increase temporarily the amount poured into the intestine. The stools resulting from the action of calomel are frequently greenish, result- ing from changes in the bilirubin; this is partly because the bilirubin in the intestinal contents, being hurried through the colon, fails to undergo the change into urobilin which normally occurs. The change in color may also be due in part to the formation of mercuric sulphid. Calomel is used for a special effect on the gastro-intestinal tract which is sometimes attributed to an antiseptic action. It is thought to be of special value as a cathartic in gastro- enteritis and at the beginning of mild catarrhs of the stomach and intestines. It is also frequently used to empty the bowels in conjunction with the more active salines in cases of infection, or toxemia. It is sometimes useful in small doses to check vomiting and is frequently administered as a laxative when the stomach is irritable because it is retained better than other cathartics. It is useful as an intestinal antiseptic. Calomel is sometimes an excellent diuretic in cardiac dropsy. It is of much less value in other forms of dropsy. It is sometimes applied externally to sluggish ulcers, and is used by insufflation on the cornea for ulceration or opac- ities, phlyctenular conjunctivitis, etc. DOSAGE: Only a small portion of the calomel is absorbed, so that minute doses are generally effective. From 0.005 to 0.02 gm., or from 1/10 to 1/3 grain may be given every half hour or hour until from 0.1 to 0.2 gm., or from 1 to 3 grains have been given. The calomel should be followed in a few hours or the next morning by a saline cathartic. When calomel is used externally, care should be taken that no iodids are administered internally at the same time, because the presence of iodids in the secretions, for example, tears, may cause the formation of a mercuric salt and induce great irritation. Hydrargyri lodidum. Flavum. Yellow Mercurous Iodide, U. S. P., "Protiodid of Mercury." Hgl, formerly also called "Green lodid of Mercury." USEFUL DRUGS 81 PEOPERTIES : Mercurous lodid is a bright yellow, amorphous powder, odorless and tasteless. By exposure to light it becomes darker, in proportion as it undergoes decomposition into mer- curic iodid and metallic mercury. It is almost insoluble in water and wholly insoluble in alcohol. INCOMPATIBILITIES: Mercurous iodid is incompatible with oxidizing agents, alkalies and the haloid salts of the alkali metals (chlorids, bromids or iodids), which tend to decom- pose it with the formation of mercuric salts. Alkali iodids decompose mercurous iodid with formation! of metallic mercury and soluble alkali mercuric iodid. ACTION AND USES: Mercurous iodid is used to secure the constitutional effects of mercury, especially in the treat- ment of syphilis. Its effects are much the same as those of calomel, although it is not so likely to produce diarrhea or salivation as the latter preparation. DOSAGE: In syphilis mercurous iodid is best given in pill form in doses gradually increasing until slight toxic symp- toms appear in the form of pain in the abdomen, diarrhea, salivation, etc. During its administration careful attention should be given to cleanliness of the mouth and skin. The teeth should be kept in good order, and soreness of the gums should be the signal for interrupting temporarily the administration of the remedy. The initial dose should not exceed 0.015 gm. or 14 grain in the form of tablets, pill or powder, three times a day after meals, and this should be increased by the addition of 0.008 or % grain daily to the limit of tolerance. Hydrargyri lodidum Rubrum. Red Mercuric Iodide, U. S. P.. "Biniodid of Mercury," HgL. PROPERTIES : Mercuric iodid is a scarlet-red powder, odorless and tasteless, and permanent in the air. It is nearly insoluble in water, but slightly soluble in alcohol (1:116). It is rendered soluble in the presence of soluble iodids, such as an equal w_eight of potassium iodid with formation of potassium mercuric iodid. INCOMPATIBILITIES : Red mercuric iodid is incompatible with alkalies and their carbonates and alkaloids and their salts. ACTION AND USES: Mercuric iodid is used as an anti- septic and germicide. It is more powerfully antiseptic than mercuric chlorid It may be applied in potassium iodid solution. It is also used for the internal administration of mercury. A solution of mercuric iodid in sodium iodid (mercuric iodid 1 gm., sodium iodid 3 gm., water to make 100 c.c.) has also been used as a means of administering mercury by intramuscular injection. DOSAGE: 0.003 or 1/20 grain three times a day. It is frequently formed for internal administration by the pre- scription of a mixture of corrosive chlorid of mercury and potassium iodid. Gm. or c.c. H Hydrargyri chloridi corrosivi 0|060 Potassii iodidi 6100 Aquae 100| [M.] 82 USEFUL DRUGS Hydrargyri Oxidum Flavum. YelloAV Mercuric Oxide, U. S. P., HgO. PROPERTIES : Yellow mercuric oxld is a light orange-yellow, amorphous powder, odorless and having a somewhat metallic taste. It is permanent in the air, but turns darker on exposure to light. It is nearly insoluble in water and in alcohol. INCOMPATIBILITIES: Yellow mercuric oxid is incompatible with acids, which dissolve it, forming mercuric salts. ACTION AND USES: Yellow mercuric oxid is employed externally as a stimulant and parasiticide. Its chief use is in blepharitis, phlyctenular conjunctivis, etc., in which it acts as a stimulant. DOSAGE: Yellow mercuric oxid should be used in the strength necessary to stimulate without producing unneces- sary irritation. An ointment varying in strength from 0.5 to 2 per cent, should be prescribed. Some ophthalmologists recommend even weaker preparations. Unguentum Hydrargyri Oxidi Flavi. Ointment of Yellow Mercuric Oxide, U. S. P. A 10 per cent, mixture of yellow mercuric oxid, with water, hydrous wool-fat and petrolatum. DOSAGE: For use in the eye it should be diluted with from 10 to 100 parts of petrolatum so as to reduce the per- centage of mercuric oxid to from 1 to 0.1 per cent. Hydrargyri Salicylas. Mercuric Salicylate, N. N. R. A mercuric salt of salicylic acid in which one atom of mercury is combined with one molecule of salicylic acid. PROPERTIES : Mercuric salicylate is a white amorphous powder, tasteless, odorless and neutral to litmus paper. It is nearly insoluble in water or alcohol, but soluble at the ordinary tem- perature in solutions of sodium hydroxid or sodium carbonate with the formation of a double salt. INCOMPATIBILITIES: Mercuric salicylate is incompatible with iodids and (probably) other halogen salts. ACTION AND USES : Mercuric salicylate is used as an anti- septic and for producing the internal actions of mercury. It is much used by hypodermic or intramuscular injection in the treatment of syphilis. DOSAGE: Mercuric salicylate is given by intramuscular injection in a 10 per cent, suspension in liquid paraffin; 0.6 c-c. or 10 minims of this suspension are injected once in four days. It is held by some clinicians that the introduc- tion of sufficient mercury by the mouth to eradicate syphilis thoroughly is practically impossible. Hydrargyrum. Mercury, U. S. P. PROPERTIES : Metallic mercury in its ordinary form is a shin- ing, silver-white, volatile and fluid metal without odor or taste In its massive form it has comparatively little physiologic action and is not poisonous even in large quantities. When it has been reduced to a fine state of subdivision it is capable of absorption USEFUL DRUGS 83 either by the skin or raucous membranes, and then produces the ordinary pharmacologic effects of its salts. It is also very active in the form of vapor. Mercury is widely used in the form of the following mixtures : Hydrargyrum Cum Creta. Mercury with Chalk, U. S. P., "Gray Powder." A powder containing 38 per cent, of mercury with clarified honey and prepared chalk. PROPERTIES : By long shaking and trituration of the mercury with the other ingredients it is reduced to so fine a state of subdivision that distinct globules cannot be seen with a lens magnifying- 4 diameters. The preparation then forms a light gray, slightly adhesive powder, with little odor, and a slightly sweetish taste. ACTION AND USES: This preparation is used in general in the same way as calomel, but it is less irritating to the intestines and in some cases does not move the bowels because of the antagonizing influence of the chalk. It is often used to secure the constitutional effects of mercury in cases of infantile and hereditary syphilis. DOSAGE: 0.250 gm. or 4 grains contain approximately 0.1 gm. or 1% grains of metallic mercury. Massa Hydrargyri. Mass of Mercury, U. S. P., "Blue Mass." A mixture of 33 per cent, of mercury with glycyrrhiza, althea, glycerin and honey of rose. The mercury is reduced to such fine division that globules are not visible under a magnification of 10 diameters. ACTION AND USES: The effects and indications for this preparation are much the same as those of calomel. It may be used for laxative effects. DOSAGE: 0.250 gm. or 4 grains. Unguentum Hydrargyri. Mercurial Ointment, U. S. P. A mixture of 50 per cent, of mercury with prepared chalk, benzoinated lard and 2 per cent, of oleato of mercury. The mercury is reduced by trituration to such fineness that globules are no longer visible under a lens magnifiying 10 diameters. Unguentum Hydrargyri Dilutum. Blue Ointment, U. S. P. Blue ointment is made by mixing approximately 2 parts of mercurial ointment with 1 part of petrolatum. It represents approximately 33 per cent, of metallic mercury and conforms to the strength, though not to the composition of the inter- national standard for mercurial ointment. ACTION AND USES: Mercurial ointment is a parasiticide; it is employed for the destruction of lice, but other measures are more cleanly and less calculated to cause irritation. The rubbing of mercurial ointment into the skin allows the absorption of a part of the mercury, thus securing its con- 84 USEFUL DRUGS stitutional effects. This is regarded by some authorities as the most efficacious method of treating syphilis except the intravenous or hypodermic method. Inunction has the great advantage of leaving the digestive tract undisturbed. DOSAGE: 2 gm. or 30 grains of the ointment should be rubbed into a chosen area of the skin at night, and the part anointed should be cleansed by washing in the morning. A new area of the skin should be chosen for inunction the next evening. The ointment may be spread on cloths and bound on a part of the skin liable to some friction. If der- matitis is excited by this method of application it will subside rapidly as a rule on washing with a warm alkaline lotion and dusting with some bland powder. If irritation seems likely to arise the ointment may be diluted with an equal part of hydrous wool fat. Hydrargyrum Ammoniatum. Ammoniated Mercury, U. S. P. A mercuric ammonium chlorid produced by the precipita- tion of a solution of mercuric chlorid by a solution of ammonia; it should represent not less than 78 nor more than 80 per cent, of metallic mercury. PROPERTIES : Ammoniated mercury forms white pulverulent pieces or a white amorp_hous powder, having an earthy, after- ward styptic and metallic taste. It is practically insoluble in water or in alcohol, but is gradually decomposed by washing with water. It is readily soluble in warm acids with decompo- sition. It also dissolves in cold solution of ammonium carbonate. Ammoniated mercury is chiefly used in the form of: Unguentum Hydrargyri Ammoniati. Ointment of Ammo- niated Mercury, U. S. P. A mixture of 10 per cent, of ammoniated mercury with white petrolatum and hydrous wool-fat. ACTION AND USES: Ammoniated mercury in the form of an ointment of from 2 to 10 per cent, is much used as an antiseptic and local stimulant. In the strength of from 3 to 5 per cent, it is an efficient and non-irritating application for small areas of suppurating dermatitis. In stronger pro- portions (from 8 to 12 per cent.) it is a useful stimulating ointment for exciting a healthy inflammatory reaction, as in psoriasis. In seborrhea it may be applied after removal of crusts, in the form of a 2 per cent, ointment. Hydrastis. Hydrastis, U. S. P., Golden Seal. The dried rhizome and roots .of Hydrastis canadcnsis, yield- ing when assayed by the process given in the U. S. Pharma- copeia not less than 2.5 per cent, of hydrastin. ACTION AND USES : Hydrastis is bitter and possesses the tonic and appetizing properties of other bitters. In addition it has been asserted that it has a special influence on mucous membranes, promoting their nutrition and favoring their return to a normal condition. For this property there USEFUL DRUGS 85 is no experimental evidence, and in the opinion of some its existence is doubtful. The action of hydrastis on the circulation is not well understood, but it is believed that the drug stimulates the circulation and raises the blood- pressure. It has a stimulating influence on the uterus, and has been employed to check menorrhagia and metrorrhagia. Fluidextractum Hydrastis. Fluidextract of Hydrastis, U. S. P. A solution of the soluble constituents of hydrastis in a mixture of glycerin, alcohol and water. One hundred c.c. should contain 2 gm. of hydrastin. Hydrastis contains also berberine, an alkaloid having the properties of a simple bitter. Hydrastinin is an artificial alkaloid derived from hydras- tin. It has marked, influence in raising blood-pressure and a stimulating influence on the uterus much greater than hydrastin, from which it is derived. It is chiefly employed to check uterine hemorrhage. DOSAGE: The dose of fluidextract of hydrastis is 2 c.c. or 30 minims; hydrastin can be given in doses of 0.01 gm. or 1/5 grain. Hydrastinin hydrochlorid is given in doses of 0.03 gm. or % grain. Hydrogenii Dioxidum. Hydrogen Dioxide, Hydrogen Peroxid. Hydrogen dioxid or peroxid is a compound of hydrogen and oxygen, H,(X, of syrupy consistency, which has a strong tendency to decompose into water and oxygen in the pres- ence of oxidizable substances and of ferments capable of carrying oxygen. It is soluble in water, alcohol and ether. It decomposes readily when heated. Strong solutions are much more stable. Aqua Hydrogenii Dioxidi. Solution of Hydrogen Dioxide, U. S. P. A slightly acid, aqueous solution of H 2 2 (approximately 3 per cent.) corresponding to about 10 volumes of available oxygen. PROPERTIES : Solution of hydrogen dioxid is a colorless liquid without odor, but having a slightly acidulous taste and producing a peculiar sensation and thick froth in the mouth. ACTION AND USES: By its power of giving off oxygen it becomes a germicide and is employed as a non-toxic anti- septic application to suppurating wounds, inflamed mucous membranes, etc. It is employed as a topical application in the throat in diphtheria and other inflammatory exudates. DOSAGE: Solution of hydrogen dioxid is usually applied diluted with from 1 to 4 volumes of water. It should be used with care in deep cavities. A free opening for the ' escape of foam and gas should be provided. 86 USEFUL DRUGS Hyoscyamus. Hyoscyamus, U. S. P., Henbane. The dried leaves and flowering tops of Hyoscyamus niger. Tinctura Hyoscyami. Tincture of Hyoscyamus, U. S. P. One hundred c.c. represent the soluble constituents of 10 gm. of Hyoscyamus in diluted alcohol, and contain approximately 0.007 gm. of mydriatic alkaloids, chiefly hyoscyamin and scopolamin. ACTION AND USES: The uses of tincture of hyoscyamus are similar to those of tincture of belladonna. It is thought to be more sedative to the nervous system. DOSAGE: From 0.6 to 2 c.c. or from 10 to 30 minims. Ichthyol. Ichthyol, N. N. R., Ammonium Sulpho-ichthyolate. Ichthyol is an aqueous solution of the ammonium salts of sulphonic acids prepared from the distillate from bituminous shales found in the Tyrol and elsewhere. These shales contain the fossil remains of fishes. PROPERTIES : Ichthyol is a reddish brown to brown-black syrupy liquid having a characteristic empyreumatic odor and burning taste. It is miscible in all proportions with water, glycerol or oils, but is incompletely soluble in alcohol. Its aqueous solution has a faintly acid reaction. ACTION AND USES: The actions of ichthyol are not well understood. It penetrates the unbroken skin to a certain extent. It is said to act as a vasoconstrictor on mucous surfaces. It has a mildly antiseptic action. On account of its content of sulphur it is credited with alterative properties. It is applied to the skin in inflammatory conditions such as erysipelas, acne vulgaris, rosacea, lupus erythematosus. etc., to lessen hyperemia. It has also been used internally, but it is impossible at present to determine its true value. It has no specific action in tuberculosis, although it has seemed to increase appetite and strength in some cases. It has been tried with some apparent success in angioneurotic edema. It is used as a local remedy in gynecologic affections to relieve hyperemia and pain. DOSAGE: The application of pure ichthyol to the skin is somewhat irritating, but a solution of 25 per cent, strength is generally not irritating. In chronic rheumatism a 50 per cent, ointment has been used locally. In gynecology it is combined with glycerol 1 : 10. Internally it may be given in solution or in the form of pills. The dose is from 0.2 to 2 c.c. or from 3 to 30 minims. INFUSA INFUSIONS Infusions are aqueous preparations made by pouring hot or cold water over a vegetable drug and allowing the mixture to stand for a definite period and then straining. For the preparation included in this list see: Infusum Digitalis, under Digitalis. USEFUL DRUGS 87 lodoformum. lodoform, U. S. P. lodoform is tri-iodomethane, CHI 3 , and is usually prepared by the action of iodin on alcohol or acetone in the presence of alkali or alkali carbonate. PROPERTIES : lodoform forms a fine, lemon-yellow powder or lustrous crystals having a peculiar, very penetrating and per- sistent odor, and an unpleasant, slightly sweetish and iodin-like taste. It is very slightly soluble in water (1:10,000), soluble in alcohol (1 :50), and very soluble in ether (1 :5 approximately). It is also somewhat soluble in fixed oils. INCOMPATIBILITIES: It is incompatible with calomel, silver salts, chlorates and nitrites. ACTION AND USES: lodoform is a local anesthetic and an antiseptic. When absorbed through the skin or from denuded surfaces it produces intoxication, which is not evident until after the lapse of some time. When swallowed it is partly decomposed with the production of iodids, which produce their ordinary effects. Part of the drug is absorbed, how- ever, in a form of combination not yet understood, and pro- duces symptoms that are different from those ordinarily caused by iodin. lodoform is slowly excreted, iodin com- pounds appearing in the urine for several days after a single dose. The symptoms are restlessness, anesthesia, sometimes unconsciousness, occasional convulsions, hallucinations and delusions of persecution, rapid pulse and elevated tempera- ture; in many cases collapse, coma and death may follow. The physiologic actions of iodoform afford no rational basis for its internal vise. Externally it is used as an anti- septic and stimulant in surgical tuberculosis. Several odor- less organic compounds of iodin have been devised as sub- stitutes for iodoform, but they are uniformly less actively antiseptic. DOSAGE: 0.25 gm. or 4 grains. It is usually applied externally in the form of a dusting-powder, but may be used in the form of emulsion, as an ointment or as a surgical dressing in the form of gauze. For the relief of hemorrhoids it should be given in the form of suppositories. lodum. Iodin, U. S. P. PROPERTIES : Iodin is a heavy, bluish-black, dry and friable solid crystallizing in rhombic plates, having a metallic luster, a distinctive odor and a sharp and acrid taste. It is readily vola- tile. It is very slightly soluble in water (1:5,000), but soluble in alcohol (1 :10). It is also soluble in solutions of iodids. INCOMPATIBILITIES : Iodin is incompatible with alkalies and alkali carbonates, the alkaloids, with tannin and other vegetable astringents and with most volatile oils, partic- ularly the terpene-containing oils. ACTION AND USES: Cutaneous: Iodin irritates the skin, causing a sensation of heat and itching. In concentrated solutions it may cause blistering, or even corrosion, but it acts more slowly than many other irritants. It penetrates 88 USEFUL DRUGS into the deeper layers of the skin and small quantities are absorbed. lodin is applied to the skin for the purpose of exciting congestion of the underlying tissues. This congestion is supposed to cause the absorption of exudates. Its action is probably overrated. It is also used by surgeons for the disinfection of the skin, for which it is considered to be the most desirable agent. The application is made by painting the tincture over the part to be disinfected. The skin must be dry; wet applications should not be used previously. It is also used in various skin diseases for the purpose of producing an acute inflammatory reaction in the skin, and to cause the destruction of bacteria. Its effect on bacteria below the epidermis is probably due to the inflammatory reaction which it excites rather than to any direct action on the bacteria. For the prevention of tetanus it is recom- mended to apply to the skin about the wound a 3 per cent, alcoholic solution of iodin and to the wound pieces of gauze soaked in the same solution. INTERNAL. Iodin is more irritating to mucous membranes than to the skin. It is seldom used internally because of the irritating action on the stomach and intestines. This irritation may be so great as to excite a suppurative gas- tritis. The irritating action on the intestines may cause diarrhea. Small quantities of iodin are converted in the intestines into iodids and absorbed in this form. In some cases there is formed, also, a protein compound of iodin. After absorption iodin acts like the iodids (see Potassium lodid). In cases of iodism, produced by the use of elemen- tary iodin, there is tachycardia and irritation, of the nervous system, but not so much affection of the skin and respi- ratory tract as is seen after the administration of the iodids. Iodin should rarely be used internally; in treatment of obstinate vomiting the tincture has been recommended in doses of from 0.03 to 0.05 c.c. or from % to 1 minim com- bined with the same quantity of phenol, given in a little water. LOCAL USES: In the diseases of the eye iodin is some- times used as a caustic agent and germicide to corneal ulcers of the simple type. It should be applied by means of a pointed toothpick soaked in the solution and used very cautiously. For the treatment of chronic granular pharyngitis, in acute follicular tonsillitis, and in cases of middle ear catarrh associated with granular pharyngitis, it may be applied mixed with glycerol and combined with other remedies. The following formulas may be used: c.c. I* Tinct. iodi 3| m xlviii Glycerin! 30 1 3 j-nv U Tlnot. iodi Tinct. ferri chlor. Glycerinl aa causation of the constipation which results from the admin- istration of the drug. The drug has no local analgetic action and its use locally for the relief of pain is irrational. The systemic actions of morphin are greatly dependent on the dose used. The smallest doses producing therapeutic effects result in the relief of pain; somewhat larger doses cause definite cerebral depression leading to more or less profound and prolonged sleep. Some persons react peculiarly to morphin, showing one or more of the following symptoms: Cerebral excitation is, 96 USEFUL DRUGS perhaps, more common in women than in men, but it is usually mild and of short duration, soon giving place to the depressant action of the drug. Nausea and even vomiting not infrequently result from the systemic administration of a small dose. In some persons nausea is a very pronounced after-effect of the drug, lasting, at times, for hours. The drug probably exerts a decided effect on the heart, through the vagus mechanism, chiefly influencing the rhythm, which may become irregular. The rate may be slowed con- siderably after large doses, but morphin does not endanger life through its cardiac action. Morphin causes a marked constriction of the pupil when given in moderate doses, and this phenomenon is often used as a gage for the cessation of its administration in cases in which large doses are necessary. It has no local miotic action when dropped into the eyes. The respiratory center is depressed by relatively small doses of morphin such as are too small to be hypnotic. Use is made of this action in the treatment of persistent and troublesome cough, but it should be remembered that if the cough is "productive," the depression of the cough reflex may lead to a dangerous retention of the secretions of the inflamed mucosa. Morphin is used chiefly as an analgetic in conditions of severe acute pain, and its use should be very guarded on account of the great danger of the formation of the morphin habit. In surgical conditions in which the alleviation of severe pain may obscure the course of the disease and lead to the unwarranted postponement of an operation, morphin should not be used, or only in very small doses and with circumspection. In chronic conditions associated with pain morphin should not be used, as the formation of the habit is almost certain to result from its prolonged administra- tion. Exceptions to this generalization are to be found in such conditions as inoperable .cancer, etc., in which the con- dition is hopeless and at the same time the cause of much suffering. Morphin should not be used for the relief of pain in persons of a neurotic or hysteric temperament, unless absolutely unavoidable. In general, it may be said that morphin should not be used for the relief of pain when any satisfactory relief can be obtained by the use of other drugs. Morphin, in moderate doses, is very useful in pain of cardiac origin. Morphin may be used to relieve the attacks of asthma and to lessen dyspnea from other causes, but caution should be exercised that the slowing of the respiration does not embarrass the heart. It should be used cautiously in the pain and dyspnea of uremia, as it interferes with elim- ination by the kidney and bowel. Since the introduction of the coal-tar hypnotics and those of the chloral group, the use of morphin as a pure hypnotic has become exceptional. Morphin, in the form of opium, is often given as a dia- phoretic, the well-known Dover's powder being the prepara- tion commonly used. USEFUL DRUGS 07 Habituation to morphin is readily established, and this habit is one of the most difficult to break. The indiscrim- inate use of morphin and preparations containing it by physicians is a common cause of the habit, and too great discrimination in its use can hardly be urged. Overdoses of morphin lead to intoxication which may result fatally. The symptoms begin with the usual depres- sion which deepens into sleep. The pupils become extremely constricted. Respiration becomes slow; the sleep deepens into coma from which the patient can be aroused with difficulty at first; later he cannot be aroused at all, and the respiration sinks to as low as three or four per minute. The heart is somewhat weakened and its rate is slowed. Death results from respiratory failure. The treatment of morphin poisoning is not germane to this work, but its proper execution will often save a patient who is deemed hopeless. Morphin is excreted largely through the alimentary tract, including the stomach. Some of the morphin thus excreted may be reabsorbed into the circulation; hence, in cases of poisoning, the use of frequent gastric lavage with perman- ganate of potassium, to destroy the morphin, is an impor- tant measure. Even after the hypodermic administration of the drug it is excreted by way of the gastro-intestinal tract. Morphin is also used to lessen secretion and check peris- talsis in diarrhea. For this purpose opium appears to be more efficient than morphin. In the administration of morphin the danger of forming a habit should never be forgotten. DOSAGE: 0.01 gm. or 1/6 grain. Smaller doses from 0.005 to 0.008, 1/12 to 1/8 grain, are often sufficient. The mini- mum fatal dose is 0.06 gm. or 1 grain. *Morphinae Hydrochloridum. Morphine Hydrochloride, U. S. f P. PROPERTIES : Morphin hydrochlorid occurs as white crystals or as a crystalline powder, odorless and having a bitter taste. It is soluble in water (1 :17) and in alcohol (1:42). DOSAGE: 0.01 gm. or 1/6 grain. Morphinae Sulphas. Morphine Sulphate, U. S. P. PROPERTIES : Morphin sulphate occurs as white, feathery crys- tals or in cubical masses, odorless, permanent in the air and having a bitter taste. It is soluble in water (1 : 15.3), but only slightly soluble in alcohol (1:465). DOSAGE: 0.01 gm. or 1/6 grain. Morrhuae Oleum. Cod-Liver Oil, U. S. P. A fixed oil obtained from the fresh livers of Gadus morrhua. PROPERTIES : Cod-liver oil occurs as a pale yellow, thin, oily liquid having a peculiar, slightly fishy, but not rancid odor, and a bland, fishy taste. ACTION AND USES: Cod-liver oil is generally considered to be tonic and nutrient, but its value probably depends entirely on its nutritive property. It is preferably admin- 98 USEFUL DRUGS istered in the form of a recently prepared emulsion, though many persons are able to take the oil as food in the same way that olive oil is used. Alcoholic preparations of the so-called active principles of cod-liver oil have no demon- strated therapeutic action. MUCILAGINES MUCILAGES Mucilages are aqueous solutions of gums or the mucilagin- ous principles of vegetable substances. For the preparations included in this list see: Mucilago Acaciae, under Acacia. Myrrha. Myrrh, U. S. P. A gum resin obtained from 'Commiphora Myrrha. Used occasionally in the form of powder, and also used as a car- minative, in connection with aloes, in the form of pills. ACTION AND USES: Myrrh is astringent and carminative. It is used largely as an ingredient in mouth washes and gargles for relaxed throat and spongy gums. DOSAGE: 0.5 gm. or 7% grains. Tinctiira Myrrhae. Tincture of Myrrh, U. S. P. One hundred c.c. represent 20 gm. myrrh in alcohol. DOSAGE: 1 c.c. or 15 minims. For use in the mouth dilute with an equal volume of water. Nux Vomica. Nux Vomica, U. S. P. The dried, ripe seed of Strychnos Nux-vomica, containing, when assayed by the process given in the U. S. P., not less than 1.25 per cent, of strychnin. ACTION AND USES : The pharmacologic action of, nux vomica is e'ssentially the same as that of the strychnin which it contains. The preparations of nux vomica are used as stomachic tonics, and occasionally as respiratory and nerve stimulants. For the latter purpose the salts of strychnin are generally preferred. (See Strychnin Sulphate.) Extractum Nucis Vomicae. Extract of Nux Vomica, U. S. P. An acetic acid extract of nux vomica purified by precipi- tating with alcohol and containing, when assayed by the process given in the U. S. P., 5 per cent, of strychnin. DOSAGE: 0.015 gm. or *4 g ra in> preferably given in the form of pills; 0.020 gm. or % grain contains 0.001 gm. or 1/60 grain of strychnin. Tinctura Nucis Vomicae. Tincture of Nux Vomica, U. S. P. A solution of extract of nux vomica in a mixture of alcohol and water; it should assay 0.1 gm. of strychnin in 100 c.c. DOSAGE: 0.6 c.c. or 10 minims. USEFUL DRUGS 99 When the tincture is used as an appetizer, its effect depends largely on the psychic stimulation produced by the bitter taste, and the dose may vary from 0.05 c.c. to 0.6 c.c. or from 1 to 10 minims. If it is desired to obtain the effect of strychnin, it is to be remembered that 0.6 c.c. or 10 minims contain approximately 0.6 mg. or 1/100 grain of strychnin. OLEATA OLEATES The official oleates are solutions of alkaloids or metallic oxids in oleic acid. OLEA PINGUA FIXED OILS AND FATS Fixed oils and fats are neutral esters of vegetable or animal derivation being compounds of acids (chiefly oleic, palmitic and stearic) with glycerol. For fixed oils included in this list see: Oleum Lini, under Linum. Oleum Morrhuae, under Morrhuae, Oleum. Oleum Ricini, under Ricini, Oleum. Oleum Theobromatis, under Theobromatis, Oleum. Oleum Tiglii, under Tiglii, Oleum. OLEA VOLATILIA VOLATILE OR ESSENTIAL OILS Volatile or essential oils are liquids derived from plants and may contain or consist of neutral principles, aldehyds, ketones. phenols, esters or compound ethers. For volatile oils included in this list see-. Oleum Betulae, under Methylis Salicylas. Oleum Caryophyli, under Caryophyllus. Oleum Cinnamomi, under Cinnamomum. Oleum Eucalypti, under Eucalyptus. Oleum Gaultheriae, under Methylis Salicylas. Oleum Menthae Piperitae, under Mentha Piperita. Oleum Rosae, under Rosa. Oleum Santali, under Santali, Oleum. Oleum Sinapis Volatile, under Sinapis. Oleum Terebinthinae, under Terebinthina. OLEORESINAE OLEORESINS Oleoresins are thick liquid preparations consisting of vola- tile oils and resins extracted from vegetable substances by ether, acetone or alcohol. For the preparation included in this list see: Oleoresina Aspidii, under Aspidium. Opium. Opium, U. S. P. The concrete, milky exudation obtained by incising the iinripe capsules of Papaver somniferum. ACTION AND USES: The action of opium closely resembles that of morphin. It, however, is absorbed more slowly and is more constipating and hence is preferred in the treatment 100 USEFUL DRUGS of the gastrointestinal tract, especially for the purpose of checking diarrhea. Opii Pulvis. Powdered Opium, U. S. P. Yielding, when assayed by the official process, not less than 12.5 per cent, of crystallized morphin. DOSAGE: 0.065 gm. or 1 grain, containing about 0.008 gm. or about y s grain of morphin. Suppositories of opium have no advantage on account of local action. \ Extractum Opii. Extract of Opium, U. S. P. Yielding, when assayed by the official process, 20 per cent, of crystallized morphin. DOSAGE: 0.03 gm. or % grain. Tinctura Opii. Tincture of Opium, Laudanum, U. S. P. A solution of the soluble constituents of opium in diluted alcohol. One hundred c.c. contain not less than 1.2 and not more than 1.25 gm. crystallizable morphin. -DOSAGE: 0.5 c.c. or 8 minims. Tinctura Opii Deodorati. Tincture of Deodorized Opium, U. S. P. Essentially a tincture of opium that has been deodorized by means of purified petroleum benzin. DOSAGE: 0.5 c.c. or 8 minims. Tinctura Opii Camphorata. Camphorated Tincture of Opium. Paregoric, U. S. P. Each 100 c.c. represent powdered opium ( 0.4 gm. ) , benzoic acid (0.4 gm.), camphor (0.4 gm.), oil of anise (0.4 c.c.), glycerol (-4 c.c.), in diluted alcohol (to make 100 c.c.). DOSAGE : 8 c.c. or 2 fluidrams, containing 0.004 gm. or 1/15 grain of morphin. Pulvis Ipecacuanhae et Opii. Powder of Ipecac and Opium. U. S. P., Dover's Powder. A mixture of ipecac (10 gm.), powdered opium (10 gm.) and sugar of milk (80 gm.). ACTION AND USES: Dover's Powder is used chiefly for its diaphoretic effect. DOSAGE: 0.5 gm. or 7^ grains, containing 0.006 gm. or 1/10 grain of morphin. Oxygenium Compressum. Compressed Oxygen, N. N. R. Gaseous oxygen, 2 , in a compressed state. PROPERTIES : Compressed oxygen occurs as a colorless, odorless and tasteless gas. slightly soluble in water and neutral to ordi- nary indicators. This gas is not inflammable, but supports combustion much more vigorously than does air. USEFUL DRUGS 101 ACTION AND USES: Compressed oxygen is administered for the purpose of relieving difficult respiration in cases of mechanical hindrance to the ingress of air to the lungs. It is also mixed with nitrogen monoxid as an anesthetic agent. Pancreatinum. Pancreatin', U. S. P. A mixture of the enzymes naturally existing in the pan- creas of warm-blooded animals, usually obtained from the fresh pancreas of the hog, Sus scrofa, or the ox, Bos taurus Samples on the market contain much extraneous matter. PROPERTIES : Pancreatin occurs as a cream-colored, amorphous powder, having a faint, peculiar, not unpleasant odor, and a somewhat meat-like taste. It is partially soluble in water and should contain not more than 10 per cent, of insoluble matter. It Is practically insoluble in alcohol. Commercial samples com- monly contain no steapsin, and other ferments may be present in traces only. ACTION AND USES: Pancreatin is used chiefly for the pre- digestion of protein and starchy foods. Since it is destroyed by the action of the gastric juice, its use for the digestion of food in the stomach is illogical, if the stomach contains any acid. In cases of achylia gastrica in which no hydro- chloric acid is secreted, it may be given to secure the diges- tion of the food in the stomach. In such cases it is well to administer a small amount of an alkali, such as sodium bicarbonate, in order to neutralize any acidity that may be present. In view of the poor quality of pancreatin on the market its use is not to be recommended. The attempt is sometimes made to further the digestion of protein in the intestines by the administration of pan- creatin in pills or capsules coated so as to prevent the action of the gastric juice. The drug may be used in this manner in cases in which it is believed that the secretion of the pancreas is lacking or deficient, but this method is not usually very successful. DOSAGE: 0.5 gm. or 7^ grains. Pancreatin may be administered internally in the form of salol-coated pills or in gelatin capsules that have been treated with formaldehyd. Paraffinum Paraffin, U. S. P. A mixture of solid hydrocarbons, obtained by chilling and pressing the higher distillates from petroleum and purifying the solid press-cake so obtained. It is practically insoluble in water or in alcohol. ACTION AND USES: Paraffin is used in surgery for pros- thetic purposes. It is injected into the tissue to fill the place of parts which have been destroyed by trauma or pathologic processes. When used for this purpose, the melting-point of the product is important. A preparation melting at from 41 to 45 C. (105.8 to 113 F.) is most suitable. Its use for this purpose is not without danger. 102 USEFUL DRUGS Paraldehydum. Paraldehyd. U. S. P. Paraldehyd, C H 12 3 , is a polymer of acetaldehyd, CH S .CHO. PROPEKTIES : Paraldehyd is a colorless, transparent liquid, hav- ing a strong characteristic but not unpleasant or pungent odor, and a burning or cooling taste. It is soluble in water (1 :8) and miscible in all proportions with alcohoj. ACTION AND USES: Paraldehyd is hypnotic and anti- spasmodic. It has no direct action on the circulation, except that it dilates the blood-vessels. It acts rapidly and pro- duces a sleep which closely resembles natural sleep. It is very valuable when a rapid action is desired. The dis- agreeable odor of paraldehyd, persisting in the breath of the patient, interferes with its use in many cases. It may cause a habit very similar to that induced by alcohol. DOSAGE: 2 c.c. or 30 minims. Preferably administered with cracked ice or ice-water. Pelletierinae Tannas. Pelletierine Tannate, U. S. P. A mixture of the tannates of alkaloids obtained from Punica Granatum. PROPERTIES : Pelletierin tannate occurs as a light yellow, odorless, amorphous powder, having an astringent taste and a weak acid reaction. It is only slightly soluble in water (1 :235), but soluble in alcohol (1 :12.6). ACTION AND USES: Pelletierin tannate is used as an anthelmintic and teniafuge, especially in cases of cestode infection. DOSAGE: 0.25 gm. or 4 grains. Preferably administered in the form of capsules. The alimentary canal should be emptied as completely as practicable by a mild purge (castor oil or a saline), a light diet on the previous day and fasting on the morning on which the anthelmintic is given. This remedy should be followed in two hours by a purge (castor oil). Not more than 0.3 gm. or 5 grains of pelletierin tan- nate should be given, as this amount has produced paralysis. Pepsinum. Pepsin, U. S. P. A proteolytic ferment or enzyme obtained from the glan- dular layer of the fresh stomach of the hog, Sus scrofa. PROPERTIES : Pepsin occurs as pale yellow, transparent or trans- lucent scales or grains, or as a cream-colored, amorphous pow- der, free from any offensive odor and having a slightly acid or saline taste. It is soluble, or almost entirely soluble in water, the solution having- more or less opalescence ; it is practically insoluble in alcohol. ACTION AND USES: Pepsin acts only in an acid medium. It is useful to secure the digestion of protein food in the stomach. It is seldom indicated, because the gastric juice usually contains sufficient pepsin to perform gastric diges- tion. It may be given in conjunction with hydrochloric acid in those cases of acute dyspepsia in which there is an absence of free hydrochloric acid in the stomach contents. In chronic cases it should be given only when the acid and pepsin are USEFUL DRUGS 103 both lacking. As a rule, even when acid is absent, the pepsin is still secreted and digestion will occur normally if hydro- chloric acid is given without pepsin. In achylia gastrica. pepsin is a valuable addition to the hydrochloric acid, which is usually prescribed. DOSAGE: 0.25 gin. or 4 grains. Petrolatum. Petrolatum. U. S. P. A mixture of hydrocarbons, obtained by distilling off the lighter and more volatile portions from petroleum, and purifying the residue. PROPERTIES : Petrolatum occurs as an unctuous mass, of about the consistence of an ointment, varying in color from white to dark amber. ACTION AND USES: Petrolatum is used chiefly as a base for ointments. It is sometimes employed as a lubricant, for which purpose only a sterile product should be used. Petrolatum Liquidum. Liquid Petrolatum, U. S. P. A mixture of hydrocarbons, obtained by distilling off most of the lighter and more volatile portions from petroleum, and purifying the liquid residue. PROPERTIES : It occurs as a colorless or very slightly yellowish, oily, transparent liquid, without odor or taste, but giving off, when heated, a faint odor of petroleum. It is practically insol- uble in water and only slightly more soluble in alcohol. ACTION AND USES: Liquid petrolatum is used as a vehicle for medicinal agents for external application. It is also given internally, largely for its mechanical action as an emollient in constipation. It is not absorbed by the intes- tine and has no nutritive properties. Phenacetin. See under Acetphenetidin. Phenol. Phenol, U. S. P. (Acidum Carbolicum, Pharm. 1890) C 8 H 5 OH. Hydroxybenzene, obtained from coal-tar by fractional dis- tillation and subsequent purification or made synthetically. PROPERTIES : Phenol should contain not less than 98 per cent, of C 6 H B OH. It occurs as colorless, interlaced or separate, needle- shaped crystals, having a characteristic somewhat aromatic odor. When copiously diluted with water it has a sweetish taste, with a slightly burning aftertaste, and, when undiluted, cauterizes and whitens the skin and mucous membranes. Phenol is soluble in water (1 :20) and miscible with alcohol in all proportions. ACTION AND USES: Phenol is antiseptic and germicide. A solution of 1:850 will prevent the multiplication of bacteria. A 1 per cent, solution will usually destroy non-sporulating bacteria in a few minutes at ordinary temperature, but a 5 per cent, solution fails to destroy anthrax spores after twenty-four hours' exposure. Phenol is taken as the type or standard for comparing the activity of disinfectants. The phenol coefficient means the relative strength of a disinfectant, as compared with a solu- tion of phenol acting on the same organism and for the same length of time. 104 JSEFUL DRUGS Phenol is escharotic when applied to the skin, turning the skin and tissues white. If a finger or other extremity is sur- rounded with dressings wet even with a dilute solution of phenol, gangrene is liable to occur. Phenol acts as a local anesthetic. In consequence of this property it is employed to relieve itching. It may be used in the strength of 1 per cent, in solution or in ointment. Internally, phenol has been used as an antiseptic in mouth- washes, gargles and sprays. It was formerly employed as an antiseptic in fermentation in the stomach, but it should not be used for this purpose. It is sometimes given with success to check obstinate vomiting. It is not so useful as an intestinal antiseptic as some other remedies, particularly salol. The injection of phenol into the rectum for the destruction of parasites is dangerous and has sometimes resulted fatally. Superficial burns from the action of phenol should be treated by the application of alcohol, glycerol, ether or oils to remove the poison. In phenol poisoning the stomach may be washed out by diluted alcohol, which should be completely removed by washing with water. If left in the stomach the alcohol may favor the absorption of phenol. Phenol Liquefactum. Liquefied Phenol, U. S. P. A liquid composed of not less than 86.4 per cent., by weight, of C 6 H 5 OH. and about 13 per cent., by weight, of water. PROPERTIES : Liquefied phenol is a colorless liquid which may develop a slight reddish tint on keeping, having a characteristic, somewhat aromatic odor and the general chemical and physical characteristics of phenol. DOSAGE; 0.05 c.c. or 1 minim. Phenolphthalein. Phenolphthalein, N. N. R. A product of the interaction of phenol and phthalic auhydrid. PROPERTIES : Phenolphthalein occurs as white, or grayish- white crystals or as an amorphous powder ; slightly soluble in water and freely soluble in alcohol. Its solutions in acid liquids are colorless, but turn led when the liquid is made alkaline. ACTION AND USES: Phenolphthalein acts as a purgative, but appears to possess no further physiologic action, except that it may cause some irritation of the rectum and lower bowel. DOSAGE: The dosage must vary according to its effect, from 0.05 gm. to 0.5 gm., or from 1 to 8 grains. A case of mild poisoning is reported from taking 1 gm. (15 grains). Phenylis Salicylas. Phenyl Salicylate. U. S. P. (Salol, Pharm. 1890). The salicylic ester of phenyl. PROPERTIES : Phenylsalicylate occurs as a white crystalline powder, having a faint aromatic odor and a slight but charac- teristic taste. It is very slightly soluble in water (1 :2.333) and freely soluble in alcohol (1:5). USEFUL DRUGS lOo ACTION AND USES: Phenyl salicylate is slightly anti- septic, but its antiseptic action is greatly increased when it is decomposed into its constituents, phenol and salicylic acid. It has very slight action in the mouth or stomach, but in the intestines it is decomposed into its constituents by the action of the fat-splitting ferment of the pancreas. After absorption, it produces the effect of salicylates, but if larger doses are given the phenyl may produce toxic effects. The urine is colored dark by the phenol excreted by the kidneys. If salol is to be used for its constitutional effects as a salicylate, it should always be remembered that about 40 per cent, of it consists of phenol. Phenyl salicylate is commonly used as an intestinal anti- septic. It is regarded by many as the best available drug for this purpose, but it is the opinion of many physicians that little benefit is to be secured by the use of intestinal antiseptics. It is impossible in practice to check all putre- faction iu the intestines, but the use of phenyl salicylate has been shown to lessen the products of putrefaction excreted in the urine. Phenyl salicylate is used in diarrhea, enteritis and in the diseases believed to be due to intoxication by the products of intestinal putrefaction. Salol is used in pharmacy for the purpose of coating enteric pills. It must be remembered that the coating of pills of moderate size entails the administration of a con- siderable dose of salol. DOSAGE: From 0.2 to 5 *>m., or from 3 to 8 grains. It is preferably administered in the form of powder and may be inclosed dry in capsules or cachets. Pills and com- pressed tablets are objectionable, because of the tendency of the substance to fuse into a hard insoluble mass. Phosphorus. Phosphorus, U. S. P. PROPERTIES : Phosphorus is a translucent, nearly colorless solid, of a waxy luster, having, at ordinary temperatures, about the consistency of beeswax. It has a distinctive and disagree- able odor and taste and should not be exposed to air. It is practically insoluble in water but slightly soluble in absolute alcohol (1:350). It takes fire readily when exposed to the air. Great care should be used in handling elementary phosphorus. It should be carefully kept under water in a moderately cool place. It should be cut, or otherwise divided, under water. It may be secured in the form of small particles by cautiously melting under water and shaking until cool. ACTION AND USES: In small quantities phosphorus stimu- lates the growth of bone and has been asserted to have a stimulating action on the nervous tissues; the latter action, however, is doubtful. Somewhat larger doses produce a fatty degeneration of the various organs which is followed by a proliferation of the connective tissue. Minute doses increase the number of red blood-cells, but do not increase the amount of hemoglobin. In larger doses phosphorus is an irritant poison, causing nausea, vomiting and sometimes diarrhea. If absorbed, the poison produces a wide-spread, fatty degeneration of the organs, but fre- 106 IjSEFUL DRUGS quently there are no symptoms for several days. This period may be followed by vomiting of blood, drowsiness, enlarged and painful liver and scanty urine. There are usually, in the latter stages, severe nervous symptoms, consisting of delirium, somnolence, coma and occasionally convulsions. In workers in phosphorus, chronic poisoning is shown by a necrosis of the lower jaw. It is believed that this necrosis is due to infection through carious teeth, which is favored by previous changes in the bone due to phosphorus. Phosphorus was formerly used as a tonic or stimulant to the nervous system, but there is no evidence that it is of service in this way. Its use is gradually being abandoned. Its action on the blood is not regarded as justifying its use in anemia. The principal use of phosphorus is to further the deposition of calcium in growing bone, or in bones undergoing repair. For this purpose it may be given in rickets. DOSAGE: 0.5 mg. or 1/125 grain. It may be administered either in the form of pills or as phosphorated oil (1:100). Physostigma. Physostigma, U. S. P. (Calabar bean). The ripe seed of Physostigma venenosum. Used commonly in the form of salts of its principal alkaloid, physostigmin (eserin). ACTION AXD USES: Physostigma stimulates the periph- eral endings of the autonomous nerves and probably acts on the musculature to enhance its response to normal stimula- tion. It also depresses the action of the spinal cord. It greatly increases intestinal peristalsis. It slows the pulse and after large doses increases the blood-pressure. It pro- duces contraction of the pupil by local action. When instilled into one eye it causes contraction of the pupil on that side and not on the other. Physostigma is used for its depressing action on the spinal cord in tetanus, strychnin poisoning and other forms of convulsions. It should be used as an adjuvant to more powerful measures and not relied on as the sole remedy. Physostigma is used to stimulate peristalsis in the para- lytic form of colic and some cases of chronic constipation. It may be employed to overcome acute obstipation, provided there is no inflammation and no mechanical obstruction. Physostigmin is used in treatment of eye diseases for the purpose of contracting the pupil and also to reduce intra- ocular tension. For the latter purpose it is serviceable in glaucoma. It is a useful remedy in peripheral ulcer of the cornea. It may be employed to hasten recovery from the effect of mydriatics, such as homatropin. Physostigminae Salicylas. Physostigmine Salicylate, U. S. P., Eserin Salicylate. PROPERTIES : Physostigmin salicylate occurs as colorless or faintly yellowish crystals, odorless and having a slightly bitter taste. It is soluble in water and in alcohol. USEFUL DRUGS 107 DOSAGE: 1 ing. or 1/60 grain. It is used in the eye in solution of the strength of from 0.1 to 1 per cent. To avoid the irritation that it some- times causes, it is preferable to give it in oily solution, or in conjunction with cocain. The following mixture may be used : :m. or c.c. Cocainae hydrochlor Physostigminae sulph 02 gr. 01 gr. 00 3 Aquae dest 10 For hastening recovery from a miotic a drop of 0.1 per cent, solution in castor oil may be employed. Physostigminae Sulphas. Physostigmine Sulphate, U. S. P., Eserin Sulphate. PROPERTIES : This salt is rather more freely soluble than the salicylate, but is also readily decomposed by exposure to light and air. DOSAGE: 1 mg. or 1/60 grain. Pilocarpus. Pilocarpus, U. S. P., Jaborandi. The leaflets of Pilocarpus Jaborandi or of Pilocarpus Microphyllus. Used chiefly in the form of a salt of its principal alkaloid, pilocarpin. ACTION AND USES : Pilocarpin stimulates the oculomotor and other autonomous nerves. It produces excessive secretion of the salivary glands and also of the sweat glands. It stimulates the unstriated muscles of the body generally and the motor system of the intestines, and causes a partial spasm of the bronchial muscles. It causes a marked slowing of the pulse and a fall of blood-pressure due to the lessened rate of the heart, but the vagus stimulation is soon followed by depression with an accelerated pulse-rate. It contracts the pupil and causes spasm of the muscles of accommodation by a peripheral action. Pilocarpus is administered internally chiefly for its diaph- oretic effect. In this action it is serviceable in certain diseases of the skin. Under its continuous use there may be a stimulation of the growth of hair in favorable cases. In doses just short of producing free diaphoresis it is sometimes of great benefit to relieve itching in generalized, acute eczema, urticaria, pruritus, etc. In diseases of the eye such as glaucoma, corneal ulcer, etc., pilocarpin is employed as a weak miotic. Pilocarpinae Hydrochloridum. Pilocarpine Hydrochloride, U. S. P. PROPERTIES : Pilocarpin hydrochlorid occurs as colorless or white transparent crystals, odorless and having a faintly bitter taste. It is very soluble in water and freely soluble in alcohol. DOSAGE: From 0.001 to 0.01 gm. or from 1/60 to 1/6 grain. 108 USEFUL DRUGS Pilocarpinae Nitras. Pilocarpine Nitrate, U. S. P. PROPERTIES : This salt is less soluble in both water and alcohol than is the hydrochloric! and has no evident advantages over that salt. DOSAGE: 0.01 gm. or 1/5 grain. Smaller doses of 1 mg. or 1/60 grain are frequently preferable. Pilulae. Pills. Pills are globular, oval or flattened bodies, of such size and consistency that they can be swallowed whole. For the preparations included in this list see: Pilula Ferri Carbonatis, under Ferri Carbonas. Fix Liquida. Tar, U. S. P. A product obtained by the destructive distillation of the wood of PinuS palustris. PROPERTIES : Tar occurs as a semiliquid, viscid, blackish-brown product having an empyreumatic odor and a sharp and empyreu- matic taste. Tar is miscible with alcohol and fixed or volatile- oils but is only partially soluble in water. ACTION AND USES: Tar is a mild irritant to the skin, and when taken internally stimulates the bronchial mucous membrane. It is employed in the form of syrup as a remedy for subacute bronchitis. Externally it is employed as a mild stimulant application to the skin. It should be used as the first remedy in changing the treatment from sedative to stimulating appli- cations. It is very useful as an antipruritic for the' relief of itching in pruritis, eczema, etc. DOSAGE: In beginning treatment with tar a dilute prep- aration should be used. The strength should be from 2 to 4 per cent., which may be tentatively increased. As an antipruritic in acute inflammatory conditions a strength of from 2 to 4 per cent, may be all that can well be used. In chronic cases it is used in the strength of from 6 to 20 per cent., and sometimes the pure tar is applied. For use as an antiseptic in skin affections the following formula may be used: B Picis liquidae 2 3 ]j Porassii hydroxidi 1 3 j Aquae 8 f-5 j This must be diluted for use. Unguentum Picis Liquidae. Tar Ointment, U. S. P. A mixture of tar (50 gm.) with yellow wax and lard sufficient to make 100 gm. This should be diluted from 10 to 20 times before applica- tion. In chronic conditions, scaly eruptions, psoriasis and ringworm it may be applied in full strength. Plumbi Acetas. Lead Acetate, U. S. P., Pb(C 2 H 3 2 ) 2 . 3H 2 (Sugar of Lead). USEFUL DRUGS 100 PROPERTIES : Lead acetate occurs as colorless or heavy white crystalline masses or granular crystals, having a faintly acetous odor and a sweetish, astringent, afterward metallic taste. It is freely soluble in water (1:2) and soluble in alcohol (1:30). INCOMPATIBILITIES : Solutions of lead salts are incompati- ble with carbonates, hydroxids, iodids, chlorids and sulphates. ACTION AND USES: The chief internal use of lead acetate is as an astringent in diarrhea. It is rarely used for this purpose for fear of lead poisoning. It may be combined with opium in the form of a lead and opium pill. DOSAGE: 0.065 gm. or 1 grain. Liquor Plumbi Subacetatis. Solution of Lead Subacetate, U. S. P. An aqueous liquid which contains in solution not less than 25 per cent, of lead subacetate, made by boiling a mixture of lead acetate, lead oxid and distilled water for half an hour. PROPERTIES : Solution of lead subacetate occurs as a clear, colorless liquid, odorless, having a sweetish, astringent taste and an alkaline reaction. DOSAGE: This preparation should be diluted from fifteen to thirty times before application. It is employed as an astringent and antipruritic in inflammatory conditions of the skin and as an application to sprains and bruises. It should not be applied to denuded surfaces and should be used with caution on the face. Podophyllum. Podophyllum, U. S. P. The dried rhizome of Podophyllum peltatum. Used in medicine chiefly in the form of: Resina Podophylli. Resin of Podophyllum, U. S. P. PROPERTIES : This preparation, popularly known as podophyllin. occurs as an amorphous powder, varying in color from grayish- white to pale greenish-yellow, turning darker when subjected to heat exceeding 35 C., or when exposed to light. ACTION AND USES : Resin of podophyllum is very irritat- ing to the mucous membrane, especially to that of the eyes. It has a slight, peculiar odor and a faintly bitter taste. It is very soluble in alcohol, but practically insoluble in water. It is used as a laxative and hydragogue cathartic, chiefly in the form of pills. It was formerly thought to exercise a special influence on the liver, but this idea has been aban- doned. It is chiefly used in small doses for the treatment of chronic constipation. DOSAGE: As a laxative in constipation small doses should be used, from 0.003 to 0.006 gm. or from 1/20 to 1/10 grain, once or twice daily. For a cathartic effect it may be given in doses of from 0.008 to 0.03 or from % to y 2 grain. Potassii Acetas. Potassium Acetate, U. S. P., KC 2 H 3 2 . PROPERTIES : Potassium acetate occurs as a white powder or in crystalline masses, odorless, and having a saline taste ; it is deliquescent on exposure to air. It is very soluble in water (1 :0.4), and is freely soluble in alcohol. 110 USEFUL DRUGS ACTION AND USES: Potassium acetate is oxidized in the organism to potassium carbonate or bicarbonate. This tends to make the blood alkaline, and the salts excreted by the kidney render the urine less acid and, after large doses. alkaline. It is a marked diuretic, increasing the amount of urine and the solids of the urine without irritation of the kidney; consequently it is preferable to other diuretics in the treatment of nephritis. An alkaline reaction favors oxidation ; hence the potassium salts which yield the carbonate on oxidation increase the processes of metabolism. An increase in alkalinity is also believed to favor the production of immunity in infections, and potassium acetate and other salts of potassium which increase the alkalinity of the urine, are useful in infections, especially such as pneumonia and rheumatism. Whenever it is desirable to make the urine neutral or alkaline, potas- sium acetate affords a convenient means of obtaining the desired result. It is useful as a diuretic in acute nephritis. Potassium salts are poisonous in excessive doses, but not enough can be administered by mouth to cause toxic effects. DOSAGE: 2 gm. or 30 grains once in three hours, for a time. The effect obtained can be determined by examining the reaction of the urine and regulating the dosage accordingly. Potassii Bicarbonas. Potassium Bicarbonate, U. S. P., KHC0 3 . PROPERTIES : Potassium bicarbonate occurs as colorless, trans- parent crystals, odorless, having a saline and slightly alkaline taste ; it is permanent in the air. It is freely soluble in water (1:3), but is practically insoluble in alcohol. IN COMPATIBILITIES : It is incompatible with acids. ACTION AND USES: Potassium bicarbonate is sometimes used to neutralize the acidity of the stomach, but sodium bicarbonate is usually preferred. It may be employed for the extemporaneous preparations of potassium acetate or potassium citrate. If a solution of acetic or citric acid or lemon juice is neutralized with potassium bicarbonate, an equivalent dose of potassium acetate or citrate is formed. Potassium bicarbonate, even when neutralized in the stomach has a tendency to render the blood alkaline and to lessen the acid of the urine. It may be given to secure the same alkaline effects for which the acetates or citrates are usually employed. Externally, potassium bicarbonate may be employed for its alkaline effects, for the purpose of softening the epidermis. DOSAGE: 2 gm. or 30 grains. Potassii Bitartras. Potassium Bitartrate, U. S. P., KHC 4 H 4 8 . PROPERTIES : Potassium bitartrate occurs as a colorless or slightly opaque or white, somewhat gritty, powder, odorless and having a pleasant acidulous taste. It is slightly soluble in water (1 :200) and nearly insoluble in alcohol. USEFUL DRUGS 111 ACTION AND USES : Potassium bitartrate is diuretic and aperient. It is used chiefly in combination with jalap as a hydragogue cathartic. See Pulvis Jalapae Compositus under Jalap. DOSAGE: 2 gm. or 30 grains. Preferably administered in the form of a powder or as a "shake" mixture. Potassii Bromidum. Potassium Bromide. U. S. P.. KBr. * PROPERTIES : Potassium bromid occurs as colorless or white cubical crystals or granular powder, odorless and having- a very strongly saline taste. It is freely soluble in water (1:1% parts), but only slightly soluble in alcohol (1:180 parts). INCOMPATIBILITIES.- It is incompatible with mineral acids or oxidizing agents and with salts of silver or lead. ACTION AND USES: Potassium bromid is a nerve sedative. It diminishes reflex excitability and depresses the motor area of the cortex. In large doses it is depressant to the circulation. When continued long it disturbs the nutrition and may produce an irritation of the skin similar to that produced by the use of iodin. Potassium bromid is used to relieve convulsions, either of cerebral or of spinal origin. For this reason it is given in epilepsy. Large doses are also given to relieve the spasms of tetanus. Potassium bromid is also useful to quiet nervous excit- ability in neurasthenia and hysteria. It may be given as an adjunct to hypnotics, such as chloral. It is said to be of value for the prevention of seasickness. DOSAGE: 1 gm. or 15 grains, preferably administered by itself in simple dilute solution. The dose of potassium bromid may be increased to 5 gm. or more if a powerful action is indicated. When the remedy is long continued it should be interrupted occasionally in order that no accumulation in the system may occur. Potassii Carbonas. Potassium Carbonate, U. S. P., K 2 C0 3 . PROPERTIES : Potassium carbonate occurs as a white, granular powder, odorless and having a strongly alkaline taste. It is very soluble in water (1:0.9), but practically insoluble in alcohol. ACTION AND USES : Potassium carbonate is antacid, but because of its strongly alkaline and caustic properties is rarely used internally unless largely diluted. Potassii Chloras. Potassium Chlorate, U. S. P., KC10 S . PROPERTIES : Potassium chlorate is explosive when mixed with oxidizable matter, and caution should be observed in manipula- L,- ing it. It occurs as colorless crystals or a white granular pow- der, odorless and having a cooling and characteristic taste. It is soluble in water (1 :16), but nearly insoluble in alcohol. ACTION AND USES: Potassium chlorate is astringent. Large doses are actively poisonous, causing disintegration of the blood-corpuscles. Potassium chlorate is much used as a mouth wash in various forms of stomatitis. It is also 112 USEFUL DRUGS employed as a gargle in the treatment of pharyngitis. Its value in these conditions, however, is uncertain. Its internal use is not to be recommended. DOSAGE: A saturated solution may be used as a mouth wash or gargle. Potassii Citras. Potassium Citrate, U. S. P., K 3 C 6 H 7 -H,0. PROPERTIES : Potassium citrate occurs as transparent, pris- matic crystals or a white granular powder, odorless, and having a cooling, saline taste. It is very soluble in water (1:0.5), but very slightly soluble in alcohol. ACTION AND USES: Potassium citrate has the same action as potassium acetate. It is less readily absorbed and con- sequently, in large doses, is more laxative. DOSAGE: 1 gm. or 15 grains. Potassii Citras Effervescens. Effervescent Potassium Citrate. U. S. P. A mixture of potassium citrate (20 per cent.) with sodium bicarbonate, tartaric acid and citric acid. DOSAGE: 4 gm. or 60 grains. Potassii et Sodii Tartras. Potassium and Sodium Tartrate, I". S. P., KXaC 4 H 4 O c .4H,O. Popularly known as Rochelle Salt. PROPERTIES : Potassium and sodium tartrate occurs as color- less, transparent crystals or white powder, odorless and having a cooling saline taste. It is freely soluble in water (1:1.2), but practically insoluble in alcohol. ACTION AND USES: Potassium and sodium tartrate is used as a saline cathartic. DOSAGE: 8 gm. or 120 grains. Pulvis Effervescens Compositus. Compound Effervescing Powder, U. S. P. Popularly known as Seidlitz powder. A mixture of sodium bicarbonate (31 gm.). potassium and sodium tartrate (93 gm.) and tartaric acid (27 gm.). The sodium bicarbonate is mixed with the potassium and sodium tartrate and the mixture divided into twelve equal parts and each part is wrapped separately in a blue paper. Each blue paper contains 7% gm. of potassium and sodium tartrate. The tartaric acid is also divided into twelve parts and each part wrapped in a separate white paper. DOSAGE: One set of two papers. Potassii Hydroxidum. Potassium Hydroxide, U. S. P., KOH. PROPERTIES : Potassium hydroxid should contain not less than 85 per cent, of KOH. It occurs as dry, white or nearly white flakes, fused masses, or in pencils, hard and brittle, showing a crystalline fracture, odorless and having a very acrid and caustic taste. It rapidly destroys organic tissues and great caution is necessary in handling. It is very soluble in watej- and freely soluble in alcohol. USEFUL DRUGS 113 Liquor Potassii Hydroxidi. Solution of Potassium Hydrox- ide, U. S. P. One hundred c.c. contain approximately 5 gm. of potassium hydroxid. ACTION AND USES: Solution of potassium hydroxid is antacid, but is seldom used internally, and when so employed should be largely diluted. Its action on the urine is similar to that of potassium carbonate, acetate or citrate. It is not regarded as so good a remedy as these. Externally it may be used to soften the epidermis for the removal of warts, corns, etc. DOSAGE: 1 c.c. or 15 minims. Potassii lodidum. Potassium Iodide, U. S. P., KI. PROPERTIES : Potassium iodid occurs as colorless or opaqua white, cubical crystals, or granulated powder, having a peculiar. faint, iodin-like odor, and a pungent, saline, afterward bitter taste. It is very soluble in water (1:0.1) and soluble in alcohol (1:12). INCOMPATIBILITIES: Potassium iodid is incompatible with mineral acids and oxidizing agents and should not be pre- scribed in solution with alkaloids or alkaloid-containing drugs. ACTION AND USES: Potassium iodid is slightly irritating to the gastro-intestinal canal, especially the stomach. After absorption ordinary doses produce no symptoms. It prob- ably undergoes some decomposition with the liberation of iodin. In large or moderate doses, long continued, it fre- quently produces symptoms of iodism. These are due to irritation of the nasal passages, the bronchi and the skin. The irritation of the nose is shown by coryza, and by pain in the region of the frontal sinus. There is considerable increase of the bronchial secretions. On the skin it produces various eruptions, generally of a papular character, which rarely become pustular. Eruption and inflammation of the skin may sometimes be so extensive as to produce constitutional depression. In iodism there are often symptoms resembling those of exophthalmic goiter tachycardia, tremor, nervous irritabil- ity, etc. Potassium iodid is regarded as an alterative. It is used as an expectorant to increase secretion in the bronchi. It is of value in subacute and chronic bronchitis. The most remarkable action of iodids is the absorption of gummatous extidates in tertiary syphilis. The iodid does not destroy the spirochetes, but possibly causes the formation of a pro- teolytic ferment that has a selective action on the round cells composing the gumma. By promoting the absorption of cellular exudates in the walls of the blood-vessels, it exerts a beneficial influence in many cases of arteriosclerosis. There is evidence that the forms of arterial disease which are improved by iodids are of syphilitic origin. A similar absorp- tive action, almost specific, is seen after administration of 114 USEFUL DRUGS large doses of iodids in the granulomatous lesions of actino- mycosis, sporotrichosis and blastomycosis. Potassium iodid is used to promote the elimination of poisons, especially the poisonous metals such as mercury and lad. DOSAGE: The dosage varies in non-syphilitic cases from 0.3 to 2 gm. or from 5 to 30 grains, but in cases of syphilis, especially in the tertiary form, much larger doses up to 5 gm. and more may be necessary. It is often advisable to begin with 5 drops of a saturated solution three times a day after meals and increase by 1 drop per day added to each dose. It should not be given on an empty stomach, but with some food, preferably liquid, such as milk. On the occur- rence of symptoms of iodism, such as coryza, papular or pustular eruptions, rapid pulse, etc., the remedy should be discontinued and resumed in smaller doses after the dis- appearance of toxic symptoms. Potassii Permanganas. Potassium Permanganate, U. S. P., KMnO 4 . PROPERTIES : Potassium permanganate occurs as slender prisms, of a dark purple color, almost opaque by transmitted light and of a blue metallic luster by reflected light, odorless and having a taste which Is at first sweet but afterward disagreeable and astringent. It is soluble in water (1 : 15) and decomposes when brought into contact with alcohol. ACTION AND USES: Potassium permanganate is deodorant, disinfectant and possibly emmenagogue. As an emmena- gogue, potassium permanganate may be given in doses of from 0.03 to 0.06 gm. (from % to 1 grain) three times a day. It has marked oxidizing properties and is used for this purpose in the treatment of certain forms of poisoning when the poison is still in the stomach. In morphin poisoning the stomach should be washed with a solution of potassium permanganate (1:2,000). The same treatment is useful in phosphorus poisoning. In cases of snake bite it may be given by hypodermic injections of a solution (1:500) in the vicin- ity of the wound. Potassium permanganate has been used to disinfect the hands in surgery. The hand is dipped into the disinfectant solution until it is a mahogany brown, and then dipped into a warm saturated solution of oxalic acid and rinsed in sterile water. It is applied externally for excessive sweating of the feet. DOSAGE: It is usually administered in the form of pills, being mixed with kaolin and massed with petrolatum. For application to the skin a solution of 1:500 may be used. Protargol. Protargol, N. N. R., Silver Proteinate. This is a compound of albumin and silver containing 8.3 per cent, of silver in organic combination. PROPERTIES : Protargol occurs as a light brown powder which is slowly but freely soluble in water (1:2). Protargol should be USEFUL DRUGS llf> protected from the light and its solutions should be made ns required. It is precipitated by cocain hydrochlorid, but this may be prevented by the addition of boric acid. ACTION AND USES : Protargol is a non-irritant bactericide and antiseptic. It may be employed in chronic gonorrhea as a non-irritant substitute for silver nitrate, and in diseases of the mucous membranes of the eye, ear, nose and throat as an antiseptic and astringent. It is largely used in the treatment of conjunctivitis. DOSAGE: It is used chiefly in the form of from 0.25 to 1 per cent, solution for instillations or injections and 1 : 1,000 to 1:2,000 solution as irrigations. Also used in the form of tampons and bougies. Solutions are preferably made by sprinkling the protargol over the surface of the required amount of cold water and setting aside until solution occurs. Primus Virginiana. Wild Cherry, U. S. P. The bark of Prunus serotina, used in medicine principally in the form of: Syrupus Pruni Virginianae. Syrup of Wild Cherry, U. S. P. Representing an aqueous extract of 15 per cent, of wild cherry bark. INCOMPATIBILITIES: As it contains tannins it is incom- patible with salts of iron. ACTION AND USES: Syrup of wild cherry is tonic and sedative and largely used as a vehicle for cough medicines. DOSAGE: 5 c.c. or 1 fluidram. PULVERES POWDERS Pharmaceutically, powders are combinations of several substances in powdered form or powdered vegetable drugs. The term "powders" is also applied to single dose quantities of a drug or mixture of drugs in powdered form wrapped separately in "powder papers." For the preparations included in this list see : Pulvis Effervescens Compositus, under Potassii et Sodii Tartras. Pulvis Glycyrrhizae Compositus, under Glycyrrhiza. Pulvis Ipecacuanhae et Opii, under Opium. , Pulvis Jalapae Compositus, under Jalapa. Pulvis Opii, under Opium. Quinina. Quinine, U. S. P. An alkaloid obtained from the bark of various species of Cinchona. PROPERTIES : Quinin occurs as white, flaky or microcrystalline powder, odorless and having a bitter taste. It is very slightly soluble in water (1 :1,750), but very soluble in alcohol (1 :0.6). ACTION AND USES: Quinin is antimalarial, antipyretic, ecbolic and is also used as a bitter tonic. Quinin is a protoplasmic poison, especially affecting the protozoa more 116 I'SKFUL DRUGS than bacteria. It is somewhat irritant to the stomach and intestines and when absorbed it causes ringing in the ears, but in moderate doses produces no other marked effects in healthy persons. In patients with fever it is antipyretic. Its solutions produce local anesthesia, especially the solution of quinin and urea hydrochloric!. In large doses it produces depression of the heart and respiration, and collapse. In toxic doses quinin may produce " more or less complete hemianopia terminating in permanent loss of sight. Moder- ately large doses of quinin act as a stimulant to the uterine muscles, but do not produce such spasmodic contractions as ergot. Quinin may be used as a tonic, like the simple bitters, for the improvement of digestion and nutrition. Its chief use is as an antiperiodic in malaria. In this disease it should be given in large doses several hours before the time of the expected chill. DOSAGE: 0.25 gm. or 4 grains. In malaria 0.6 gm. or 10 grains may be given at a dose. For ordinary use it is preferably administered in the form of capsules. For use as a bitter tonic it is given in solution. For its use as a local anesthetic see quinin and urea hydrochlorid. In medi- cine quinin is customarily used in the form of one of the official or unofficial salts. The intensely bitter taste of quinin and its soluble salts, which constitutes the greatest objection to its use, especially with children, may be masked by administering the alkaloid or the insoluble tannate in syrup of glycyrrhiza or syrup of yerba santa. Quininae Bisulphas. Quinine Bisulphate, U. S. P. The acid sulphate of the alkaloid quinin. PROPERTIES : Quinin bisulphate occurs in colorless, transpar- ent crystals or as small whitish needles, odorless and having a very bitter taste. It is freely soluble in water (1 : 8.5) and solu- ble in alcohol (1 :18). DOSAGE: 0.25 gm. or 4 grains. Quininae Hydrochloridum. Quinine Hydrochloride, U. S. P. PROPERTIES : Quinin hydrochlorid occurs as white, silky, glis- tening needles, odorless and having a very bitter taste.' It is soluble in water (1 :18) and very soluble in alcohol (1 :0.6). DOSAGE: 0.25 gm. or 4 grains. Quininae Sulphas. Quinine Sulphate, U. S. P. PROPERTIES : Quinin sulphate occurs as white, glistening crys- tals of prismatic needles, odorless and having a very bitter taste. It is only slightly soluble in water (1:720). but soluble in alcohol (1 :86). DOSAGE: 0.25 gm. or 4 grains. Quininae Tannas. Quinine Tannate, N. N. R. The tannate of the alkaloid quinin. containing from 30 to 35 per cent, of quinin. USEFUL DRUGS 117 PROPERTIES : Quinin tannate occurs as an amorphous, pale lemon-yellow, odorless powder without taste, or at most slightly bitter, with scarcely an astringency. It is only slightly soluble in water, but freely soluble in alcohol (1:3). DOSAGE: 0.5 gm. or 7% grains. Quininae et Ureae Hydrochloridum. Quinine and Urea Hydrochlorid, N. N. R. The compound of quinin hydrochlorid and urea hydro- chlorid, containing approximately 60 per cent, of anhydrous quinin. PROPERTIES : Quiniu and urea hydrochlorid occurs as white. interlaced prismatic crystals, odorless and having a very bitter taste. It is freely soluble in water (1 :1). ACTIONS AND USES : Quinin and urea hydrochlorid has the actions of quinin. It is non -irritating when injected hypodermically. Recent investigations have shown that when injected hypodermically or when applied locally to mucous membranes, it exerts an anesthetic action similar to that of cocain. It is reported that the anesthesia is in some cases prolonged for several days. Quinin and urea hydrochlorid is especially useful in the treatment of malaria by hypodermic injections. It has also been applied as a substitute for cocain in the production of local anesthesia. DOSAGE: The same as quinin. For the production of local anesthesia, injection of a solution of from 0.25 to 1 per cent, strength is said to be free from the risk of producing fibrous indurations, which sometimes occur with the stronger solu- tion. For application to mucous membranes solutions vary- ing in strength from 10 to 20 per cent, should be used. Resina . Rosin, U. S. P. The residue left after distilling off the volatile oil from ' turpentine. PROPERTIES : Rosin occurs in sharp, angular fragments, amber- colored, usually covered with a yellowish dust and at ordinary temperatures readily pulverized. It is practically insoluble in water, but soluble in alcohol, ether and the fixed or volatile oils. ACTION AND USES: Rosin is used as an ingredient of oint- ments and plasters designed to serve chiefly as stimulating applications to the skin, the simple rosin plaster being used as an adhesive plaster in minor surgery. RESINAE RESINS Resins are usually made by distilling the volatile oil from natural oleoresins or by precipitating resins from alcoholic- solutions by the addition of water. For preparations included in this list see. Resina, under Resina. Resina Podophylli, under Podophyllum. Resorcinol. Resorcinol, U. S. P. (Resorcimirn, Pharmacopeia. 1890). 118 LSEFUL DRUGS The diatomic phenol, metadihydroxybenzene, C 6 H 4 (OH) 2 . PROPERTIES : Resorcinol occurs as colorless, needle-shaped crys- tals, having a faint, peculiar odor and a sweetish, followed hy a bitter taste. It is very soluble in water (1:0.5) and in alcohol (1:0.4). ACTION AND USES: Resorcinol is antiseptic, antizymotic and antipyretic. On account of the readiness with which it causes the formation of methemoglobin and the resulting danger of collapse it is seldom administered internally. It is sometimes given to check fermentation in the stomach. Applied externally it is astringent in from 1 to 3 per cent, solutions, and keratolytic in strong proportions, from 10 to 20 per cent. DOSAGE: 0.125 gin. or 2 grains. Rhamnus Purshiana. Cascara Sagrada, U. S. P. The dried bark of Rhamnus Purshiana. ACTION AND USES: The preparations of cascara sagrada are laxative, acting mainly on the colon, and are widely used for habitual constipation. The dose can be gradually reduced without constipation following. Fluidextractum Rhamni Purshianae. Fluidextract of Cascara Sagrada, U. S. P. t One hundred c.c. represent 100 gm. of the drug in approxi- mately 40 per cent, alcohol. The presence of a bitter prin- ciple renders this preparation useful as a tonic as well as a laxative. DOSAGE: 1 c.c. or 15 minims, three times daily; smaller doses should be used if efficient for laxative effect. Fluidextractum Rhamni Purshianae Aromaticum. Aromatic Fluidextract of Cascara Sagrada, U. S. P. One hundred c.c. represent 100 gm. of the drug, which has been deprived of its bitter principle and aromatized with glycyrrhiza and compound spirit of orange. This preparation is preferred as a laxative on account of its pleasant taste. DOSAGE: From 0.6 to 2 c.c. or from 10 to 30 minims. The smaller dose may be given several times a day, the larger once daily at bedtime. Extractum Rhamni Purshianae. Extract of Cascara Sagrada. U. S. P. A powdered extract representing four times its weight of the drug. DOSAGE: From 0.1 to 0.5 gm. or from 2 to 8 grains. Rheum. Rhubarb, U. S. P. The dried rhizome of Rheum officinale is occasionally administered either in the form of powder or in the form of "cubes" or "fingers." USEFUL DRUGS 119 ACTION AND USES: Rhubarb and the extract are cathar- tics, bitter tonics and stomachics, while the aromatic tincture and the aromatic syrup are laxative and to a slight extent astringent. As cathartics they act chiefly on the colon and have a tendency to produce constipation after the initial laxative effect. Hence they are an appropriate remedy in the beginning of diarrhea as they cause the expulsion of irritating substances and promote a return to normal by their constipating influence. DOSAGE: 1 gm, or 15 grains. Extractum Rhei. Extract of Rhubarb, U. S. P. A hydro-alcoholic extract of rhubarb evaporated to a pilular consistency. DOSAGE: 0.25 gm. or 4 grains. Tinctura Rhei Aromatica. Aromatic Tincture of Rhubarb. U. S. P. Aromatic tincture of rhubarb represents rhubarb (20 gm.), cinnamon (4 gm. ), cloves (4 gm.) and myristica (2 gm. ), in a mixture of glycerol, alcohol and water to make 100 c.c. DOSAGE: 2 c.c. or 30 minims. Syrupus Rhei Aromaticus. Aromatic syrup of Rhubarb, U. S. P. For all practical purposes this represents aromatic tincture of rhubarb (15 c.c.) with sufficient syrup to make 100 c.c. DOSAGE: 8 c.c. or 2 fluidrams. Ricini Oleum (Oleum Ricini). Castor Oil, U. S. P. A fixed oil expressed from the seed of Ricinus communis. PROPERTIES : Castor oil occurs as a pale yellowish or almost colorless viscid liquid, having a faint, mild odor and a bland afterward slightly acrid and generally offensive taste. It is practically insoluble in water, but freely soluble in alcohol. ACTION AND USES: Castor oil is used as a cathartic, irri- tating both the small and the large intestine, and locally, particularly in the eye, as a demulcent. DOSAGE: 16 c.c. or 4 fluidrams. Castor oil may be administered in the form of emulsion. Emulsum Olei Ricini, N. F., a 33% per cent, emulsion, or it may be given after wetting the mouth with some hot liquid and giving the oil floating in the liquid. For this purpose milk or tea may be used. Preparations are on the market in which the taste is largely concealed by the addition of saccharin and essential oils, the castor oil itself being made more limpid by the addition of alcohol. Suspended in soda water it is easily given to children. Rosa. Rose. Rose is used in pharmacy chiefly in the form of: 120 USEFUL DRUGS Oleum Rosae. Oil of Rose, U. S. P. A volatile oil distilled from the fresh flowers of Rosa damascena. Aqua Rosae. Rose-Water, U. S. P. . A solution of the volatile oil of rose in water. ACTION AND USES: Oil of rose and rose-water are used for flavoring. Saccharum. Sugar, U. S. P. Refined sucrose obtained from various sources. Official in the form of white, dry, hard, distinctly crystal- line granules, odorless and having a purely sweet taste. Sugar is very soluble in water (1:0.5) and soluble in alcohol (1:138). ACTION AND USES: In medicine it is used as a diluent, either as sugar or in the form of: Syrupus. Syrup, U. S. P. An aqueous solution of sugar containing approximately 85 gm. of sugar in 100 c.c. of the liquid. Saccharum Lactis. Sugar of Milk, U. S. P., Milk-Sugar. Lactose. A peculiar crystalline sugar obtained from the whey of cow's milk by evaporation, and purified by recrystallization. PROPERTIES : Sugar of milk occurs as white, hard, crystalline masses or a white powder feeling gritty on the tongue, odor- less and having a faintly sweet taste. It is freely soluble in water (1:5), but practically insoluble in absolute alcohol. ACTION AND USES: Sugar of milk is used as a diluent, and also as a food, particularly in connection with modified milk for infants. It is also diuretic when given in large quantities. SALES EFFERVESCENTES EFFERVESCENT SALTS Effervescent salts are mixtures of soluble salts with sodium bicarbonate and citric or tartaric acid, or a mixtur, of the two acids, designed to yield effervescent drafts when added to water. For preparations included in this list see: Magnesii Sulphas Effervescens. under Magnesii Sulphas. Potassii Citras Effervescens, under Potassii Citras. Pulvis Effervescens, under Potassii et Sodii Tartras. Sodii Phosphas Effervescens, under Sodii Phosphas. Salvarsan. Salvarsan, N. N. R. Also known as arsenobenzol, "606", and arsenophenolamin hydrochlorid, is 3-diamino-4-dihydroxyl-l-arseno benzene hydrochlorid. Corresponds to 31.57 per cent, arsenic (As). USEFUL DRUGS 121 PROPERTIES : Salvarsan occurs as a yellow, crystalline, hygro- scopic powder, very unstable in air. It is soluble in water, yield- ing a solution with an acid reaction. ACTION AND USES: Salvarsan is useful as a specific remedy for syphilis in all stages, but is the more efficient the more recent the infection. It is especially indicated in the pri- mary stage; in the later stages it should be given in repeated doses, in conjunction with mercurial courses. In malignant syphilis, which resists mercury, it is often effi- cient. Salvarsan is efficient in the various spirillar diseases such as relapsing fever, Vincent's angina, etc. In Vincent's angina local applications' of the powder have been found useful, in addition to the intravenous administration. The drug administered intravenously cannot reach the spirilla embedded in the necrotic tissue of the throat. It has been recommended as a substitute for arsenic in anemia, particularly pernicious anemia, and in diseases of the skin which are amenable to the action of arsenic. Its use in these conditions must be regarded as still experimental. In certain cases salvarsan has produced toxic results which are equivalent to poisoning by arsenic. These have occurred more commonly after the intramuscular injections. The intramuscular injection is painful and is usually followed by a tender, inflammatory nodule, which persists for some time. After intravenous injections certain nervous symptoms have frequently arisen which have received the name of neu- rorecidiv (nervous relapse). The evidence seems to show that these nervous conditions are due not to the action of salvar- san but to the increased activity of the spirochetes. They are best treated, therefore, by a specific remedy: another dose of salvarsan or a compound of mercury. The optic neuritis which is so frequently produced by other preparations of arsenic has occurred very rarely in connection with salvarsan. The drug should be employed with great caution, however, if at all, in the presence of eye disease even when caused by syphilis. DOSAGE: 0.5 gm. or ly* grains. For subcutaneous and intramuscular injection a suspension in a neutral fluid is commonly employed. For intravenous injection a clear alkaline solution is used. The contents of a tube should be used at once after opening and under no "conditions should the contents of a tube, damaged in trans- portation, or any remnants of the powder from previously used tubes, be employed. The intravenous method is now recognized as the most suitable. Special care should be taken to see that the water used in making the solutions is freshly distilled and com- pletely sterile. Various forms of apparatus have been 122 USEFUL DRUGS devised to facilitate intravenous injections. Of these, some form of graduated gravity pipet connected with a tube fitted with a three-way stop-cock seems most suitable. Neosalvarsan is the name applied to a mixture of sodium 3-diamino-4-dihydroxy- 1-arsenobenzene-methanal - sulphox- ylate with inert, inorganic salts. The arsenic content of 3 parts of neosalvarsan is approximately equal to 2 parts of salvarsan. Solutions of neosalvarsan are more readily pre- pared; otherwise its actions and uses, as well as the precau- tions to be observed, are the same as for salvarsan. Santali Oleum (Oleum Santali). Oil of Santal, U. S. P. A volatile oil distilled from the wood of Santalum album. PROPERTIES : Oil of santal occurs as a pale" yellow, somewhat thick liquid, having a peculiar aromatic odor, and a pungent, spicy taste. Readily soluble in alcohol, but practically insoluble in water. ACTION AND USES: Oil of santal is a stimulant and anti- septic to the bronchial mucous membrane and especially to the mucous membranes of the genito-urinary tract. It is not employed in the treatment of respiratory diseases, but is used extensively in the treatment of gonorrhea. It is not suitable to the acute stages, but should be used in the subacute and chronic stages. DOSAGE: 0.5 c.c. or 8 minims. Santoninum. Santonin, U. S. P. The inner anhydrid or lactone of santonic acid obtained from santonica. PROPERTIES : Santonin occurs as colorless, rhombic prisms, odorless and nearly tasteless when first put into the mouth, but afterward develoning a bitter taste. It is very insoluble in water (1:5,300), and soluble in alcohol (1:35). ACTION AND USES: Santonin is used for its poisonous action on intestinal parasites. It is seldom absorbed to a sufficient extent to produce symptoms. When this occurs, the chief effects are yellow vision and epileptiform con- vulsions, It is used especially for its effect on roundworms. In proper doses it is a reasonably safe drug. It is frequently administered with calomel. DOSAGE: 0.065 gm. or 1 grain. As absorption is to be avoided the remedy is preferably administered in the form of coarse crystals, either inclosed in a capsule or made up into a lozenge rather than in finely powdered form. The soluble sodium santoninate should be avoided as a vermifuge. Sapo. Soap, U. S. P. Officially directed to be prepared from sodium hydroxid and olive-oil (Castile soap). PROPERTIES : Soap occurs as a white or whitish solid, hard yet easily cut when fresh, having a faint peculiar odor free from USEFUL DRUGS 123 rancidity, a disagreeable alkaline taste and an alkaline reaction It is soluble in water and in alcohol. Linimentum Saponis. Soap Liniment, U. S. P. A solution of soap, camphor and oil of rosemary in a mixture of alcohol and water. ACTION AND USES: Soap liniment applied externally is stimulant and rubefacient, but is used more frequently as a vehicle for the local application of other more active counterirritants. Sapo Mollis. Soft Soap, U. S. P. A soap prepared from potassium hydroxid and linseed oil. PROPERTIES : Soft soap occurs as a soft, unctuous, yellowish- brown mass, having a characteristic odor and an alkaline taste. ACTION AND USES: Soft soap is used principally as a detergent; being soluble in alcohol, and in mixtures of alcohol and water it is frequently used as a liquid soap. It has also been used to some extent as a vehicle for other more active medicaments to be applied in the form of an ointment. Sarsaparilla. Sarsaparilla, U. S. *P. The dried root of different species of smilax. ACTION AND USES: Sarsaparilla has long been in use as an "alterative." Practically its only active ingredient appears to be a saponin-like body, and this has been taken advantage of quite extensively in connection with the com- pound syrup of Sarsaparilla for the administration of castor oil at soda-water fountains and as a vehicle for other active medicaments. Syrupus Sarsaparillae Compositus". Compound Syrup of Sarsaparilla, U. S. P. A mixture of fluidextract of Sarsaparilla (20 c.c.), fluid- extract of glycyrrhiza (1.5 c.c.), fluidextract of senna, (1.5 c.c.), and aromatics with syrup (sufficient to make 100 c.c.). ACTION AND USES : Compound syrup of sarsaparilla is used as a vehicle. DOSAGE: 16 c.c. or 4 fluidrams. Scilla. Squill, U. S. P. The bulb of Urginea maritima. . It is occasionally administered in the form of powder. ACTION AND USES: The pharmacologic actions of squill resemble those of digitalis qualitatively, but the emetic action appears to be more prominent with squill, and this has led to its use as an emetic in the past, and it is still used as a nauseant, but it seems unwise to use a drug which affects the heart so powerfully when we have other nause- ants, such as ipecac, which probably have less undesirable side actions. 124 USEFUL DRUGS Squill is used frequently to promote diuresis, which it probably does after the manner of digitalis, through its action on the heart. Squill appears to be absorbed slowly from the gastro- intestinal tract, but its emetic effects appear to be due to its action on vomiting center in the medulla, and its diuretic effects to be secondary to its action on the heart. Hence it is probable that digitalis could always be used in its place to induce an increased secretion of urine. It is quite possible that the acetic acid plays some part in the useful- ness of syrup of squill in expectorant mixtures. Squill is much used as a nauseant expectorant in the first stages of laryngitis, bronchitis, etc. DOSAGE: 0.125 gm. or 2 grains. Tinctura Scillae. Tincture of Squill, U. S. P. One hundred c.c. represent 10 gm. of squill in approxi- mately 70 per cent, alcohol. DOSAGE: 1 c.c. or 15 minims. Syrupus Scillae. Syrup of S*qiiill, U. S. P. A mixture of a diluted acetic acid extract of 5 per cent. squill with syrup. DOSAGE: 2 c.c. or 30 minims. Scopolaminae Hydrobromidum. Scopolamine Hydrobromide, U. S. P., Hyoscin Hydrobromid. The hydrobromid of an alkaloid obtained from plants of the Solanaceae. PROPERTIES : Scopolamin hydrobromid forms colorless crystals, odorless, having an acrid, slightly bitter taste, freely soluble in water (1:15) and in alcohol (1:10). INCOMPATIBILITIES: Scopolamin hydrobromid is incom- patible with alkalies and other precipitants of alkaloids. ACTION AND USES: Scopolamin resembles atropin in its influence on the nerve endings, but differs from it in having a sedative instead of a stimulating effect on the brain. It is used as a cerebral sedative in cases of mania and other forms of insanity, but must be employed with caution, as it sometimes induces a rapid fall in blood-pressure and collapse. It has been extensively used in conjunction with morphin for the production of surgical anesthesia, either as a preliminary to the use of ether or chloroform, or as the sole anesthetic. It is liable to produce dangerous depression of the respiration. Experience in these methods of anes- thesia has not been satisfactory. It has been employed as a partial anesthetic in labor, but experience shows that the effect on the fetus is sometimes disastrous, many children being born dead or asphyxiated. It is frequently used as a mydriatic and is regarded by some ophthalmologists as preferable to atropin because it USEFUL DRUGS 123 is less irritating, and produces a brief and complete cycloplegia. DOSAGE: 0.5 mg. or 1/125 grain. Senna. Senna, U. S. P. The dried leaflets of Cassia acutifolia (Alexandria senna), or of Cassia angustifolia (Indian or Tinnevelly senna). ACTION AND USES: Senna belongs to the anthraquinone- containing group of vegetable purgatives and is considered to be one of the more efficient drugs of this class. It is largely used for the treatment of chronic constipation. DOSAGE: 4 gm. or 60 grains, administered either in the form of powder or as an infusion. Fluidextractum Sennae. Fluidextract of Senna, U. S. P. A hydro-alcoholic extract, 100 c.c. of which represent 100 gm. of senna, previously treated with strong alcohol to remove the resin. DOSAGE: 2 c.c. or 30 minims. Syrupus Sennae. Synip of Senna, U. S. P. Represents a mixture of fluidextract of senna (25 c.c.) with syrup (sufficient to make 100 c.c.). .DOSAGE: 4 c.c. or 1 fluidram. See also Pulvis Glycyrrhizae Compositus, under Glycyrrhiza. SERA ET VACCINA SERUMS AND VACCINES, N. N. R. The vaccines, viruses and serums constitute one of the most important groups of drugs with which the physician ' has to deal. Some preparations of this group are specific cures for certain diseases; others are invaluable in prophyl- axis and diagnosis. The supervision of these drugs is in charge of the United States Public Health Service, which periodically makes inspections of laboratories licensed in accordance with the law passed by Congress in 1902. Anti- diphtheric and antitetanic serums are required to conform strictly to the standards which have been established by the United States Public Health Service. There being no estab- lished standard for the various other products, they are not examined for their therapeutic value in the laboratory but are tested for the amount of preservative and freedom from bacterial and toxic contaminations. The preparations of this class most widely used are the following, which will be found in their respective alphabetical positions in this book: Antidiphtheric Serum, under Serum Antidiphthericum. Antitetanic Serum, under Serum Antitetanicum. Bacterial Vaccines, under Vaccine. Tuberculin, under Tuberculinum. Vaccine Virus, under Virus Vaccinum. k 126 USEFUL DRUGS Serum Antidiphthericum. Antidiphtheric Serum, Diphtheria Antitoxin, U. S. P. A fluid separated from the coagulated blood of the horse immunized through the inoculation of diphtheria toxin. PROPERTIES : Antidiphtheric serum occurs as a yellowish or yellowish-brown, transparent or slightly turbid liquid, odorless or having a slight odor due to the presence of an antiseptic used as a preservative. The standard of strength, expressed in units of antitoxin power, must be that approved or established by the United States Public Health Service. A modification of antidiphtheric serum in concentrated form, known as antidiphtheric globulins, is now being used extensively. This is made by the removal, by precipitation with neutral salts, of most of the constituents of the serum except that fraction of the globulins bearing antitoxic potency. ACTION AND USES: Antidiphtheric serum neutralizes the toxin of diphtheria and is employed both as a curative and as a prophylactic agent in that disease. DOSAGE: The dose of diphtheria antitoxin is measured by antitoxic units. From 500 to 1,000 units are commonly given as an immunizing or prophylactic dose. For curative treatment from 3,000 to 10,000 units may be given as an initial dose and repeated at intervals of from six to twenty- four hours, if no improvement results. In urgent cases it may be given intravenously. Serum Antitetanicum. Antitetanic Serum, N. N. R. Antitetanic serum is the blood-serum of horses immunized to the toxin of the tetanus bacillus. PROPERTIES : Antitetanic serum is marketed in both liquid or dry forms. Some manufacturers prepare an antitetanic globulin ; this contains a solution of the globulins of the blood, which are* soluble in a saturated sodium chlorid solution, together with the antitoxin, and contains the latter in concentrated form. Anti- tetanic serum must conform to the standard established by the United States Public Health Service. ACTION AND USES: It is used both as a prophylactic and as a curative agent in tetanus. The dried product may be used as a dusting-powder in suspicious wounds. DOSAGE: Immunizing: 1,500 units; in tetanus; from 3,000 to 20,000 units every four to eight hours. Single large doses by the vein are sometimes more effective. Sinapis. Mustard. ACTION AND USES: Mustard is used extensively as a counterirritant. When mustard is mixed with water, the volatile oil is generated by the action of a ferment, myrosin, on a principle called sinigrin, contained in black mustard. Sinapis Nigra. Black Mustard, U. S. P. The seed of Brassica nigra. DOSAGE: As an emetic, 8 gm. or 120 grains. USEFUL DRUGS 127 Charta Sinapis. Mustard Paper, U. S. P. A coating of black mustard on rather thick, well-sized paper used in place of the domestic mustard poultice. Oleum Sinapis Volatile. Volatile Oil of Mustard, U. S. P. A volatile oil obtained from black mustard by maceration with water and subsequent distillation, yielding, when assayed by the process given in the U. S. Pharmacopeia, not less than 92 per cent, of allyl iso-thiocyanate. PROPERTIES : Volatile oil of mustard occurs as a colorless or pale yellow, limpid liquid, having a very pungent and acrid odor. Great caution should be exercised when smelling this oil, and it should not be tasted without being highly diluted. It is miscible with alcohol in all proportions, and is generally solu- ble in liquids containing alcohol. ACTION AND USES: See Sinapis. DOSAGE: 0.008 c.c. or % minim. Sodii Arsanilas. Sodium Arsanilate, N. N. R., Atoxyl. Sodium arsanilate is the sodium salt of arsanilic acid, prepared by condensing anilin and arsenic acid. PROPERTIES : Sodium arsanilate occurs as white, odorless crys- tals, having a faint salty taste and being freely soluble in water 1:6). The aqueous solution, on standing, assumes a yellowish tint. ACTION AND USES: Sodium arsanilate has been recom- mended for the conditions which are favorably influenced by arsenic. The arsenic of the acid is liberated very slowly in the system, producing the therapeutic effects of arsenic with a more continuous and less toxic action. Toxic effects have been frequently noted, however, and the use of all forms of sodium arsanilate has been followed by degenera- tion of the optic nerve, leading to blindness. This sub- stance has been used extensively in the treatment of try- panosomiasis, but the frequent cases of blindness resulting have caused its use to be almost entirely abandoned. DOSAGE: 0.08 gm. or % grain, gradually increased. Sodii Arsenas. Sodium Arsenate, U. S. P., Na 2 HAs0 4 7H,0. PROPERTIES : Sodium arsenate occurs as colorless, transparent monoclinic prisms, odorless, and having a mild alkaline taste. It is freely soluble in water (1 :12) and nearly insoluble in alcohol. ACTION AND USES: Sodium arsenate has an arsenic action and has been employed in chronic skin diseases and in parasitic diseases of the blood, usually given in the form of solution or pill. DOSAGE: 5 mg. or 1/10 grain. Sodii Benzoas. Sodium Benzoate, U. S. P., NaC 7 H 6 2 . PROPERTIES : Sodium benzoate occurs as a white, amorphous powder, odorless, and having a sweetish astringent taste. It is freely soluble in water (1 :1.6) and soluble in alcohol (1 :43). 128 USEFUL DRUGS INCOMPATIBILITIES: It is incompatible with mineral acids and with ferric salts. ACTION AND USES : Sodium benzoate has an internal action similar to that of sodium salicylate, but very much weaker, so that the latter salt is generally preferred. DOSAGE: 1 gm. or 15 grains. It is usually administered in the form of solution. Sodii Bicarbonas. Sodium Bicarbonate, U. S. P., NaHCO s . PROPERTIES : Sodium bicarbonate occurs as a white, opaque powder, odorless and having a cooling, mildly alkaline taste. It is sojuble in water (1:12) at 15 C., practically without decom- position, but above this temperature the solution gradually loses carbon dioxid, and at the boiling point of water the salt is con- verted into normal carbonate ; it is practically insoluble in alcohol. INCOMPATIBILITIES: Sodium bicarbonate is incompatible with acids and acid salts, and the solution should be made with cold water, which tends to prevent its conversion into the more alkaline carbonate. ACTION AND USES: Sodium bicarbonate is used to neu- tralize the acid of the gastric juice in hyperacidity, acid dyspepsia, etc. For this purpose it is to be preferred in cases which are not accompanied by constipation or in which there is diarrhea. It is sometimes used to render the urine alkaline in gravel, etc., but the citrate is preferable. Large doses are given by the mouth in cases of acidosis in diabetes, fevers and similar conditions. Sodium bicarbonate may be used intravenously in cases of extreme acidosis. It may also be employed with sodium chlorid for saline infu- sions in cases accompanied by edema, although edema pro- duced by large doses of alkali has been reported. It should never be injected hypodermically or intramuscularly as it may cause sloughing. Externally it is used as a mild alkaline wash. Solu- tions of sodium bicarbonate are antipruritic. A weak solu- tion is employed to soften impacted cerumen. Sodium bicar- bonate may be employed to neutralize acetic or citric acids for the extemporaneous preparation of sodium acetate or citrate. DOSAGE: 1 gm. or 15 grains. Much larger doses may be given in acidosis. As much as 60 gm. or 2 ounces may be given daily. It may be administered by a "drop enema" of a 4 per cent, solution. For intravenous injection a 6 per cent, solution sterilized by boiling and hence partly con- verted into the carbonate has been recommended. 1,000 c.c. of such a solution may be injected, but great care must be taken that none of the liquid gets outside the vein lest necrosis of the tissues occur. Sodii Boras. Sodium. Borate, U. S. P., Na 2 B 4 7 ,10H 2 O. Popularly known as borax and properly designated as sodium tetraborate. USEFUL DRUGS 129 PROPERTIES : Sodium borate occurs as colorless, transparent crystals or a white powder, inodorous, and having a sweetish alkaline taste. It is soluble in water, but practically insoluble in alcohol. INCOMPATIBILITIES: Sodium borate is decomposed by min- eral salts and is incompatible with mucilage of acacia, with the metallic salts of the mineral acids and with the salts of most alkaloids. ACTION AND USES : Sodium borate is antiseptic, astringent and detergent and is used both externally and sometimes internally in the form of solution. The continuous ingestion of small doses produces a deleterious effect. Moderate to large doses may cause nephritis. Very large doses cause gastro-enteritis, nephritis, skin eruptions, visual disturb- ances. fall of temperature, collapse and a wide-spread fatty degeneration. It is used in from 1 to 2 per cent, solution HS an eye-wash in hyperemia of the conjunctiva and catarrhal conjunctivitis. For this purpose the following formula is very serviceable: R Sod. boratis. . ............. j 5 gr. x Aq. camph ................ 10 3 ii Aq. dest. ad ............... 25 j 3 j It is sometimes used as an antipruritic solution: g 5 j Sodii boratis .............. 1 1 gr. xv Glycerin! ................... 06 nix Aquae ...................... 30 ji_iun.; jj j DOSAGE: 0.5 gm. or 7^/y grains. It may be used as a gargle. Sodii Bromidum. Sodium Bromide, U. S. P., NaBr. PROPERTIES : Sodium bromid occurs as colorless or white, cubical crystals, or a white, granular powder, odorless, and hav- ing a saline, slightly bitter taste. It is freely soluble in water (1 :2) and soluble in alcohol (1 :12.5). ACTION AND USES: Sodium bromid is used as a nerve sedative and cerebral depressant and in ordinary doses its action and uses are identical with potassium bromid, but it is said to be less irritating. See Potassium Bromid. DOSAGE: 1 gm. or 15 grains. It is administered in dilute aqueous solution. Sodii Cacodylas. Sodium Cacodylate, N. N. R. Also known as sodium dimethylarsenate. It is the sodium salt of cacodylic acid (dimethyl arsenic acid). PROPERTIES : Sodium cacodylate occurs as a white powder, very, soluble in water. The aqueous solution is alkaline toward lit- mus paper, but nearly neutral toward phenolphthalein. ACTION AND USES: The action of sodium cacodylate is similar to other arsenic compounds, but it is said to be much less toxic than the ordinary preparations of arsenic and is also less apt to cause undesirable side effects. This superi- ority is due to the slow liberation of the arsenous acid in the body. 130 USEFUL DRUGS The cacodylate has been particularly recommended in obstinate psoriasis, pseudoleukemia, diabetes, anemia, chlorosis, tuberculosis, malarial cachexia, etc. As it is sometimes decomposed in the stomach, it is pref- erable to give it hypodermically. DOSAGE: 0.03 gm. or y 2 grain. It may be administered hypodermically in aqueous solution or given by mouth in elixir or in the form of pills. Sodii Carbonas Monohydratus. Monohydrated Sodium Car- bonate, U. S. P., Na 2 C0 3 H 2 0. The form in which sodium carbonate is .now official. PROPERTIES : Monohydrated sodium carbonate should contain not less than 85 per cent, of anhydrous sodium carbonate (Is'a 2 CO 3 ). It occurs as a white, crystalline, granular powdor, odorless and having a strongly alkaline taste. It is freely soluble in water (1 : 2.9) and practically insoluble in alcohol. Sodium carbonate, as now official, contains but one molecule of water of crystallization, and is nearly twice as strong in alkaline power as the ordinary crystalline carbonate, Na 2 CO3l2H 2 O, commonly known as "sal soda." INCOMPATIBILITIES : Sodium carbonate is incompatible with acids and acid salts and with the salts of the heavy metals and of alkaloids. ACTION AND USES: Sodium carbonate is an antacid and is employed in medicine chiefly in the preparation of alkaline baths. For this purpose it may be used in the proportion of from 2 to 6 ounces for 30 gallons of water. DOSAGE: 0.25 gm. or 4 grains. Sodii Chloridum. Sodium Chloride, U. S. P., Common Salt, NaCl. PROPERTIES : Sodium chlorid occurs as a colorles or white crys- talline powder, odorless and having a purely saline taste. It is freely soluble in water (1 : 2.8) and nearly insoluble in alcohol. INCOMPATIBILITIES: Sodium chlorid is incompatible with salts of silver and lead. ACTION AND USES: Sodium chlorid is used for preparing physiologic salt solution: 9 gm. to 1,000 c.c. of sterile water. This solution is frequently referred to as normal salt solu- tion, but should not be confused with the chemical normal solution of sodium chlorid. When given by mouth in large doses sodium chlorid is emetic, and, in proper dilution, a prompt laxative. DOSAGE: As an emetic, 16 gm. or 240 grains. As a laxa- tive it is most conveniently given in 1 per cent, solution. The dose, 4 gm. or 60 grains, should be dissolved in from 0.5 to 1 liter ( from 1 to 2 pints ) of water and drunk on an empty stomach. Sodii Hydroxidum. Sodium Hydroxide, U. S. P., NaOH. PROPERTIES : Sodium hydroxid should contain not less than 95 per cent, of NaOH and not more than 2 per cent, of other inorganic substances, with the exception of water. It occurs as dry, white or nearly white flakes, fused masses or translucent or USEFUL DRUGS 131 opaque white pencils, odorless, and having a caustic taste. Great caution is necessary in tasting and handling it, as it rapidly destroys organic tissue. It is very soluble in water (1 :1) and -iu alcohol. ACTION AND USES: Sodium hydroxid has properties closely resembling those of potassium hydroxid. It is used chiefly for pharmaceutical purposes, though occasionally it is used locally as a caustic oi - in dilute solution as an alkaline wash. Solution of sodium hydroxid largely diluted has also been administered internally. Liquor Sodii Hydroxidi. Solution of Sodium Hydroxide. U. S. P. An aqueous solution containing about 5 per cent, of sodium hydroxid, NaOH. DOSAGE: 1 c.c. or 15 minims. Sodii lodidum. Sodium Iodide, U. S. P., Nal. PROPERTIES : Sodium iodid occurs as colorless, cubic crystals, or as a white, crystalline powder, odorless and having a saline and slightly bitter taste. It is very soluble in water (1 :0.5) and freely soluble in alcohol (1 :3). INCOMPATIBILITIES: Sodium iodid is incompatible with spirit of nitrous ether, bismuth salts, ferric salts, and the salts of many alkaloids. ACTION AND USES: Sodium iodid has properties closely resembling those of potassium iodid, and like sodium bromid is perhaps less irritating than the potassium salt. DOSAGE: 0.5 gm. or 7y 2 grains. For ordinary cases the dose may range from 0.3 to 1.25 gm. or from 5 to 20 grains. When employed for the energetic treatment of tertiary syphilis it is sometimes necessary to increase the dose to from 2 to 5 gm. or from 30 to 75 grains or more. It should not be given on an empty stomach but should be administered with some form of food, preferably liquid, such as milk. Sodii Nitris. Sodium Nitrite, U. S. P., NaN0 2 PROPERTIES : Sodium nitrite should contain not less than 90 per cent, of NaNO 2 . It occurs as white, or nearly white, opaque, fused masses or pencils, or colorless, transparent crystals which are odorless and have a mild saline taste. It is freely soluble in water (1 :1.1) and very slightly soluble in alcohol. INCOMPATIBILITIES: It is incompatible with oxidizing agents generally. It must be protected from contact with the air on account of its tendency to oxidation. ACTION AND USES: Sodium nitrite has the characteristic properties of the nitrites, and resembles nitroglycerin in its action, though its effect is manifested more slowly and is somewhat more lasting. DOSAGE: 0.065 gm. or 1 grain. It should be administered in solution. Sodii Phosphas. Sodium Phosphate, U. S. P., Na 2 HP0 4 ,12H,O. . 132 USEFUL DRUGS PROPERTIES : Sodium phosphate occurs as large, colorless, mono- clinic prisms, or a granular, crystalline salt, odorless, and having a cooling saline taste. It is freely soluble in water (1 :5.5), but practically insoluble in alcohol. ACTION AND USES: Sodium phosphate is used as a saline cathartic, and its mode of action has much in common with magnesium sulphate and sodium sulphate. It is less dis- agreeable, but is less active. The acid phosphate NaH 2 P0 4 is used for the purpose of rendering the urine acid. When the official phosphate is used for this purpose the equivalent amount of an acid, such as dilute hydrochloric or phosphoric, may be administered at the same time to convert it into the acid sodium phosphate. DOSAGE: 2 gm. or 30 grains dissolved in warm water. To render urine acid, from 1 to 2 gm. or from 15 to 30 grains of acid sodium phosphate may be given every two or three hours, for five or ten doses until the urine is acid. It may also be administered in liquid form by adding 4 parts of sodium nitrate, 13 parts of citric acid and a little water to 100 parts of sodium phosphate. Sodii Phosphas Effervescens. Effervescent Sodium Phos- phate, U. S. P. A mixture of exsiccated sodium phosphate, sodium bicar- bonate, tartaric acid and citric acid, representing approxi- mately 50 per cent, of sodium phosphate described above. DOSAGE: 8 gm. or 120 grains. Sodii Salicylas. Sodium Salicylate, U. S. P., PROPERTIES: Sodium salicylate occurs as white microcrystal line powder or scales, or as an amorphous, white powder, having not more than a faint pink tinge, odorless, and having- a sweetish saline taste. It is very soluble in water (1 : 0.8) and freely soluble in alcohol (1:5.5). iNcmtPATiBiLiTiES : Sodium salicylate is incompatible with acids and acid salts and with solutions of most alkaloids, notably quinin, which precipitates as the salicylate. ACTION AND USES: Sodium salicylate is the salt which is usually employed to secure the constitutional effects of salicylic acid. It is slightly antiseptic, but not so much as the free acid. It is irritant to mucous membranes, and on an empty stomach may cause pain and in large doses may produce vomiting. Large therapeutic doses produce a ringing in the ears, nausea, sometimes vomiting, occasional sweating and an increase in the amount of urine. It increases nitrog- enous metabolism, and an increased amount of uric acid is excreted in the urine. In very large doses it may produce depression of the central nervous system, rarely convulsions, a slowing and depression of the respiration, and collapse from depression of the circulation. Large doses may produce abortion, and hence the drug is contra-indicated in pregnancy. Sodium salicylate is an analgetic and is sometimes admin- istered for the relief of headache or of neuralgic pains. It is chiefly used for its effect in articular rheumatism in which USEFUL DRUGS 133 it is highly efficacious. It promptly relieves all the local "joint symptoms and the fever, but does not affect the endo- carditis. Its effects last only while the medication is kept up. It is useful in tonsillitis and other catarrhal inflammations, but has not the decided action in the ordinary infections that it has in rheumatic fever. It is used in chorea. It stimulates the secretion of bile. It produces much benefit in some forms of eye diseases, such as iritis, keratitis or glaucoma. It is of no value in gonorrhea! arthritis or in arthritis deformans. It is of little value in gout. DOSAGE: 1 gm. or 15 grains. The more efficient method it to repeat this dose every hour until salicylism occurs and then three times daily. It should be given in solution, but is sometimes administered in the form of powder inclosed in capsules or cachets, and followed by a sufficient amount of water to dilute it well in the stomach. Sodii Sulphas. Sodium Sulphate, U. S. P., Na.SOJOILO. Popularly known as Glauber's Salt. PROPERTIES : Sodium sulphate occurs as large, colorless prisms or granular crystals, odorless and haying a bitter saline taste. It is freely soluble in water (1:3) and practically insoluble in alcohol. ACTION AND USES: Sodium sulphate has long been used as a saline cathartic, but is less popular than magnesium sulphate or sodium phosphate. DOSAGE: 16 gm. or 240 grains. Sodii Sulphis. Sodium Sulphite, U. S. P., Na 2 S0 8 , 7H 2 0. PROPERTIES : Sodium sulphite occurs as colorless, transparent crystals, odorless and having a cooling, saline, sulphurous taste. It is freely soluble in water (1:2). but nearly insoluble in alcohol. INCOMPATIBILITIES : It is incompatible with mineral acids. ACTION AND USES: Sodium sulphite is antiseptic and is principally used externally as a wash. DOSAGE: It may be applied to the skin in parasitic skin diseases like scabies and favus in a solution of the strength of 1:10 or 1 dram to the ounce. A similar solution may be used as a mouth wash in aphthous stomatitis, mucous patches, or ulcers of the tonsils. Sodii Thiosulphas Sodium Thiosulphate, U. S. P. (Sodii Hyposulphis, Pharm. 1890), Na 2 S 2 O s 5H 2 0. PROPERTIES : Sodium thiosulphate occurs as colorless, trans- parent monoclinic prisms, odorless and having a cooling, after- ward bitter taste. It is very soluble in water (1 :05) and prac- tically insoluble in alcohol. INCOMPATIBILITIES: Sodium thiosulphate is incompatible with acids, iodin and chlorin. It dissolves insoluble salts of silver. 134 USEFUL DRUGS ACTION AND USES: Sodium thiosulphate is used exter- nally, in the form of a lotion, as an application for ring- worm and other parasitic skin diseases. It is extensively used in photography and has been given internally in place or sodium sulphite. It may be used to remove stains of iodin, silver nitrate, etc. DOSAGE: 1 gm. or 15 grains. It may be used in aqueous solution or ointment of 10 per cent, strength or 1 dram to the ounce. Sparteinae Sulphas. Sparteine Sulphate, U. S. P. The sulphate of an alkaloid obtained from scoparius. PROPERTIES : Spartein sulphate occurs as colorless crystals, or a crystalline powder, odorless, and having a slightly saline and somewhat bitter taste. It is freely soluble in water (1 :1) and in alcohol (1 : 2.5). ACTION AND USES: Spartein has very little action on the central nervous system and experimentally, at least, has no pronounced action on the heart. It slows and weakens the heart. It is not a substitute for digitalis and apparently is of little use. It is not diuretic, but scoparius possesses this action from the scoparin which it contains. DOSAGE: The dosage is variously given. The dose given by the Pharmacopeia is 0.01 gm. or 1/5 grain. Others recommend doses as high as 0.1 gm. or li/ 2 grains. It may be administered in the form of solution, powder or pill. SPIRITUS SPIRITS Spirits are alcoholic solutions of volatile substances; either gases, liquids or solids. For preparations included in this list see: Spiritus Aetheris, under Aether. Spiritus Aetheris Compositus, under Aether. Spiritus Aetheris Nitrosi, under Aether Nitrosus. Spiritus Ammoniac Aromaticus, under Ammonia. Spiritus Camphorae, under Camphora. Spiritus Cliloroformi. under Chloroformum. Spiritus Glycerylis Nitratis, under Glycerylis Nitras. Spiritus Menthae Piperitae, under Mentha Piperita. Stramonium. Stramonium, U. S. P. The dried leaves of Datura Stramonium. Now seldom used in medicine except as an ingredient in so-called asthma powders for smoking . Its constituents and action are similar to those of belladona. Strophanthinum. Strophanthin, U. S. P. A glucosid. or mixture of glucosids. obtained from stro- phanthus. PROPERTIES : Strophanthin occurs as a white or faintly yellow- ish powder, having an intensely bitter taste. Because of its USEFUL DRUGS 135 toxicity great caution should be used in tasting it. It is very soluble in water and in diluted alcohol, but less soluble in abso- lute alcohol. ACTION AND USES: Strophanthin is used like digitalis. It acts more rapidly and is excreted sooner and hence is regarded as preferable for administration in acute conditions and in emergencies. It is not readily absorbed from the gastro-intestinal tract; hence its oral use is not recom- mended. DOSAGE: 0.0003 gm. or 1/200 grain. It is best admin- istered intramuscularly or intravenously, only a single dose being given daily, as a rule. Strophanthus. Strophanthus, U. S. P. The ripe seed of Strophanthus Kombe. Occasionally administered in the form of powder. ACTION AND USES : Strophanthus and tincture of stro- phanthus have properties similar to those of the glucosid strophanthin, though the therapeutic results from the admin- istration of Strophanthus by mouth are more variable than the results obtained from the hypodermic or intravenous administration of strophanthin. Tinctura Strophanthi. Tincture of Strophanthus, U. S. P. One hundred c.c. represent 10 gm. Strophanthus in approx- imately 65 per cent, of alcohol. It is nearly identical with the international standard tincture of Strophanthus. DOSAGE: 0.5 c.c. or 8 minims. For intramuscular or intra- venous injection a much smaller dose should be given, not more than 0.12 c.c. or 2 minims, as a rule. Strychnina. Strychnine, U. S. P. An alkaloid obtained from nux vomica, and also obtainable from other plants of the Loganiaceae. PROPERTIES : Strychnin occurs as colorless, transparent crys- tals or a white crystalline powder, odorless and having an intensely bitter taste. It is very slightly soluble in water (1:6400) and soluble in alcohol (1:110). INCOMPATIBILITIES: The salts of strychnin are incompati- ble with alkalies, alkali carbonates, iodids, bromids, arsen- atcs and arsenites. ACTION AND USES: Strychnin stimulates the reflex activ- ity of the spinal cord, but produces little or no effect on the higher nervous centers. Both the sensory and motor centers are affected. Small doses increase the acuity of both sight and hearing. Large doses raise the blood-pressure by causing a constriction of the arterioles. It seems to have little direct effect on the heart. It stimulates the respira- tory center, increasing the rapidity of the respirations. In poisonous doses it produces tonic convulsions similar to those of tetanus, but the trismus is less marked. Between the attacks there is usually complete relaxation of the affected 136 USEFUL DRUGS muscles. The convulsions are spinal, but not cerebral in origin. Death may occur during a convulsion from fixation of the chest by spasm of the respiratory muscles or during the interval from medullary paralysis. Strychnin is used as a bitter tonic, generally in the form of a preparation of nux vomica. It is also serviceable as a tonic to the muscular system. It is chiefly employed as a respiratory stimulant in cases of depression of the respira- tory center by narcotic or other poisoning. It is used for this purpose in several diseases of the respiratory organs, such as bronchitis, especially senile, pneumonia, etc. Strychnin is much employed as a heart tonic, but in many cases improperly. It acts as a heart tonic chiefly by raising the blood-pressure. It should be used for its cardiac effect, if at all, in conditions of low blood-pressure. Thus it may be employed in pneumonia, diphtheria and other infections in which death results from the lowered blood-pressure. Even in these conditions its utility has been overestimated. It has been recommended in conditions of shock and collapse, but in the experience of some it is not effective in these conditions ( Crile ) . Strychnin is serviceable in some forms of paralysis. It is of no value when the paralysis results from an organic lesion and should not be used in conditions of inflammation of the nerve centers. It may be employed in paralysis due to poisons, such as lead, and in postdiphtheric paralysis. It is also of value in paralysis due to the cortical lesions, if used in moderate doses, to maintain the nutrition of the paralyzed muscles. In incontinence of urine, due to paresis of the vesical sphincter, it is useful, but if the incontinence depends on spasm atropin is more serviceable. Strychnin is useful in amblyopia, acting best in disturbance of vision unattended by changes visible with the ophthalmoscope, especially hysteric and neurasthenic forms. In lesions of the optic nerve it frequently produces an improvement in vision which, however, is only temporary. It is used in acute and chronic alcoholism. It is added to cathartics in the treat- ment of chronic constipation. DOSAGE: From 0.0005 to 0.005 gm. or from 1/100 -to 1/10 grain, three times a day or even as often as once in three hours. In threatening respiratory or cardiac paralysis, strychnin must sometimes be used in quite large doses. In these cases it has been advised to push the remedy until twitching of the finger-tips occurs. Too large doses, however, should not be given, as it is possible to bring about a strychnin paralysis of the respiratory center. In such cases the strychnin should always be given hypodermically. In cardiac failure, strych- nin, if given too frequently or in too large doses, may do more harm than good by causing irritability f the heart. In toxic amblyopia it is sometimes desirable to use large doses. It has been recommended to give as nluch as 1/13 grain per day (Nagel). USEFUL DRUGS 137 Strychninae Nitras. Strychnine Nitrate, U. S. P. PROPERTIES : Strychnin nitrate occurs as colorless, needle- shaped crystals, odorless, and having an intensely bitter taste. It is soluble in water (1 :42) and slightly soluble in alcohol (1:120). DOSAGE: 0.001 gm. or I/GO grain. Strychninae Sulphas. Strychnine Sulphate, U. S. P. PROPERTIES : Strychnin sulphate occurs as colorless or white prismatic crystals, or a white crystalline powder, odorless, and having an intensely bitter taste. Soluble in water (1 :31) and in alcohol (1 :65). DOSAGE: 0.001 gm. or I/GO grain. Sulphonal. See under Sulphonmethanum. Sulphonethylmethanum. Sulphonethylmethane, U. S. P., Tri- onal. Official in most foreign pharmacopeias, and usually pre- scribed in this country as trional. Chemically, it is diethyl- sulphonemethylethylmethane. PROPERTIES : Sulphonethylmethane occurs as colorless, odor- less, crystalline scales, which have a bitter taste in aqueous solu- tion. It is slightly soluble in water (1:195) and freely soluble in alcohol. ACTION AND USES: Sulphonethylmethane is a hypnotic, producing, in ordinary doses, no other symptoms than sleep. The sleep comes on in about an hour after the medicine is taken, and is usually quiet. In some cases the sleep is not secured until the next day. Sulphonethylmethane. when repeatedly taken, may pro- duce poisoning in which hematoporphyrin appears in the urine, giving it a pinkish tinge or red color. The con- tinued use of the remedy may lead to the formation of a habit. In addition to the excretion of hematoporphyrin in the urine there are lassitude, weakness, nausea and gastro- intestinal disturbance as shown by diarrhea and constipa tion. More serious symptoms then develop, including abdominal tenderness, violent vomiting, ataxia, paresis of various muscles, loss of reflexes, and finally a condition of profound collapse. This condition ends in death in about 75 per cent, of the cases. There is a nephritis which involves the glomeruli and may be hemorrhagic in character. Trional is used as a hypnotic in insomnia, but is of little use when the insomnia is accompanied by severe pain. It is also recommended as an antispasmodic in epilepsy, hiccough, chorea, etc. DOSAGE: 1 gm. or 15 grains. Owing to its sparing solu- bility, it should be given with large quantities of hot liquids. It should not be used for more than two or three days con- secutively. After this time recourse should be had to other hypnotics, if necessary. The possible appearance of hema- toporphyrin, as indicated by pink color in the urine, should be watched for and the remedy suspended on its occurrence, but it is then often too late. 138 USEFUL DRUGS Sulphonmethanum. Sulphonmethane, U. S. P. Usually prescribed in this country as sulphonal. Chem- ically, it is diethylsulphonedimethylmethane. PROPERTIES : Sulphonmethane occurs as colorless, inodorous and nearly tasteless crystals or a crystalline powder, slightly soluble in water (1:360), but soluble in alcohol (1:47). ACTION AND USES: Sulphonmethane, or sulphonal, is hyp- notic and sedative. See Sulphonethylmethane. It acts more slowly than trional and is best given about 5 p. m. DOSAGE: 1 gm. or 15 grains, given in a hot liquid. Sulphur. Sulphur. Sulphur is official in the U. S. Pharmacopeia under three headings : Sulphur Lotum Washed Sulphur, U. S. P. Sulphur Praecipitatum. Precipitated Sulphur, U. S. P. Sulphur Sublimatum. Sublimed Sulphur, U. S. P. PROPERTIES : Sulphur in any of the foregoing forms should contain from 99 to 99.5 per cent, of pure sulphur. It is a fine yellow powder, the sublimed variety having a slight odor and a faintly acid taste. The other varieties are without odor or taste and all are practically insoluble in water or in alcohol. ACTION AND USES: Sulphur becomes active in the intes- tines and on the skin by a partial conversion into hydrogen sulphid or other sulphids. These products are slightly anti- septic and are irritant, so that sulphur becomes a mild pur- gative. Sulphur is used externally as a parasiticide in cases of scabies. It is used to produce sulphur dioxid for room disinfection by burning it in the proportion of 3 pounds of sulphur to each thousand cubic feet of air space. All sur- faces and articles to be disinfected should be wet. DOSAGE: Each form, 4 gm. or 60 grains. Unguentum Sulphuris. Sulphur Ointment, U. S. P. A mixture of washed sulphur (15 gm.) with benzoinated lard (85 gm.). SUPPOSITORIA SUPPOSITORIES Suppositories are solid bodies intended to be introduced into the several natural orifices of the body for the purpose of producing systemic or local effects. . For the preparation included in this list see : Suppositoria Glycerini, under Glycerinum. Suppositories are usually made with oil of theobroma as a base. Rectal suppositories should be cone-shaped and should weight about 2 gm. or 30 grains. Supracapsulin, Suprarenalin, L-Suprarenin Synthetic. See Epinephrin. USEFUL DRUGS 13!) SYRUPI SYKUPS Syrups are strong solutions of sugar and water with or without the addition of active medicaments. For preparations included in this list see: Syrupus, under Saccharum. Syrupus Ferri lodidi, under Ferri lodidum. Syrupus Ipecacuanhae, under Ipecacuanha. Syrupus Pruni Virginianae, under Prunus Virgiiiiana. Syrupus Rhei Aromaticus, under Rheum. Syrupus Sarsaparillae Compositus, under Sarsaparilla. Syrupus Scillae, under Scilla. Syrupus Sennae, under Senna. Syrupus Tolutanus, under Balsamum Tolutanum. TABELLAE TABLET-TRITURATES COMPRESSED TABLETS Tablet-triturates are small disks made by diluting pow- dered medicaments with powdered sugar of milk or with powdered sugar, moistening the powder with sufficient alco- hol to make u paste, and pressing into suitable molds. Com- pressed tablets are medicinal substances or mixtures of sub- stances compressed to the form of disks. Tannalbin. See under Acidum Tannicum. Terebinthina. Turpentine, U. S. P. A concrete oleoresin obtained from Pinus palustris. Oleum Terebinthinae. Oil of Turpentine, U. S. P. A volatile oil recently distilled from turpentine. PROPERTIES : Oil of turpentine occurs as a thin colorless liquid, having a characteristic odor and taste, both of which become stronger and less pleasant by age and exposure to air. Oil of turpentine is practically insoluble in water, but freely soluble in alcohol (1:3), and *in all proportions of oil. For internal use the rectified oil of turpentine (oleum terebinthinae recti- ficatum) should be used. ACTION AND USES: Turpentine is antiseptic, anthelmintic and diuretic. Applied externally it is rubefacient and counterirritant. Turpentine has been used as an expectorant in cases of bronchitis characterized by free secretion. For this purpose it is now generally replaced by terpin hydrate. It is also given for the relief of flatulence and a small amount (from Va to 1 teaspoonful) may be added to enemas to increase their effectiveness. Turpentine has been thought to be efficient in cases of internal hemorrhages, but this opinion is not well founded. DOSAGE: 1 c.c. or 15 minims. It may be administered in the form of emulsion or in capsules. Terpini Hydras. Terpin Hydrate, U. S. P. The hydrate of the diatomic alcohol terpin. 140 USEFUL DRUGS PROPERTIES : Terpin hydrate occurs as colorless, lustrous, rhombic prisms, nearly odorless, and having a slightly aromatic and somewhat bitter taste. It is slightly soluble in water (1:200) and freely soluble in alcohol (1:10). ACTION AND USES: Terpin hydrate is antiseptic, diaphor- etic and diuretic. It is largely used as an expectorant in cases accompanied by free bronchial secretion. DOSAGE: 0.125 gin. or 2 grains. Terpin hydrate may b< administered in the form of powder or in capsules. As a solution, usually in the form of elixir, it requires an exces- sive amount of alcohol. Tetanus Antitoxin. See under Serum Antitetanicum. Theobromatis Oleum (Oleum Theobromatis). Oil of Theo- broma, U. S. P. Popularly known as cacao butter, a fixed oil expressed from the roasted seeds of theobroma cacao. PROPERTIES : Oil of theobroma occurs as a yellowish-white solid, having a faint, agreeable odor and a bland chocolate-like taste. It is freely soluble in ether, chloroform and benzene, solu- ble in absolute alcohol and insoluble in water. ACTION AND USES : Oil of theobroma is used in pharmacy chiefly for the making of suppositories. Also used as a lubricant in massage, and as an application to sore nipples. Theobromina. Theobromin, N. N. R. 3,7-dimethyl-xanthin, a base occurring in Theobroma cacao, and other drugs, and also made synthetically. It is closely related to caffein (1,3,7-trimethyl-xanthin). PROPERTIES : Theobromin occurs as a white, crystalline powder, odorless, and having a bitter taste. It is very slightly soluble in water, but is soluble in alcohol (1:100). ACTION AND USES: Theobromin has an action on the kid- neys and heart similar to that of caffein, but its effect on the central nervous system is less marked. Theobromin is used as a diuretic in all forms of dropsy, but it is especially useful in renal dropsy. It is non-irri- tating to the kidney. DOSAGE: 0.3 gm. or 5 grains. Theobrominae Sodio-Salicylas. Theobromin Sodium Salicy- late, N. N. R., Diuretin. A double salt of theobromiii-sodium and sodium salicylate. PROPERTIES : Theobromin sodium salicylate contains 50 per cent of theobromin and occurs as a white powder, odorless and having a saline taste. It is freely soluble in water (1:1), but is readily decomposed on exposure to carbon dioxid or by the action of acids, and must therefore be preserved in well-stoppered bottles. INCOMPATIBILITIES: Theobromin sodium salicylate is in- compatible with acids and has the other incompatibilities of salicylates. DOSAGE: 0.5 gm. or 7% grains, three times a day. USEFUL DRUGS 141 Thymol. Thymol, U. S. P. A phenol occurring in the volatile oil of Thymus vulgaris and in some other volatile oils. PROPERTIES : Thymol occurs as largo, colorless prisms, having an aromatic, thyme-like odor, and a pungent aromatic taste. It is only very slightly soluble in water (1:1,100), but very solu- ble in alcohol (1 :0.9). ACTION AND USES : Thymol is antiseptic and anthelmintic. As an anthelmintic it is used chiefly for the destruction of hookworm. DOSAGE: 0.1 gm. or 2 grains. In the treatment of hookworm disease it should be given in as finely divided state as possible in dosage of from 0.5 to 4 gm. or from 7% to 60 grains. No fats, oils or alcohols should be given at the same time, for fear of absorption of the drug. The dosage may be regulated according to age as follows: Up to 5 years of age, 0.5 gm.; up to 10, 1 gm.; up to 15, 1.5 gm.; up to 20, 2 gm.; above 20, 3 to 4 gm. Thymolis lodidum. Thymol Iodide, U. S. P., Aristol. Dithymol-di-iodid, popularly known as aristol, is obtained by the condensation of two molecules of thymol and the introduction of two atoms of iodin into the phenolic groups of the thymol. PROPERTIES : Thymol iodid contains, when dried over sul- phuric acid, 45 per cent, of iodin. It occurs as a bright, chocolate-colored, or reddish-yellow, bulky powder, with a very slight aromatic odor. It is practically insoluble in water and nearly insoluble in alcohol. ACTION AND USES: Thymol iodid, or aristol, is antiseptic and is used in place of iodoform, chiefly as a dusting-powder. It is inferior to iodoform in antiseptic action and experience with it has been disappointing. Tiglii Oleum ( Oleum Tiglii ) . Croton Oil, U. S. P. A fixed oil expressed from the seeds of Croton tiglium. PROPERTIES : Croton oil occurs as a pale yellow or brownish- yellow, somewhat viscid, and slightly fluorescent liquid, having a slight, fatty odor, and a mild, oily, afterward acrid and burn- ing taste. It is practically insoluble in water, but when fresh is soluble in alcohol. ACTION AND USES: Croton oil is a drastic cathartic and applied externally is rubefacient and vesicant. It is used mostly to procure prompt evacuation of the bowels, espe- cially in coma. DOSAGE: 0.05 c.c. or 1 minim, given in olive oil, butter. etc. It may be placed on the tongue in granulated sugar if the patient cannot swallow. TINCTURAE TINCTURES Tinctures, with a few exceptions, are alcoholic or hydro- alcoholic extractive preparations of vegetable drugs; the 142 USEFUL DRUGS tinctures of potent drugs represent uniformly 10 gm. of drug in 100 c.c. of the preparation, while tinctures of less potent drugs vary in strength, but represent usually 20 gm. For preparations included in this list see: Tinctura Aconiti, under Aconitum. Tinctura Belladonnae Foliorum, under Belladonnae Folia. Tinctura Benzoini Composita, under Benzoinum. Tinctura Cannabis Indicae, under Cannabis Indica. Tinctura Capsici, under Capsicum. Tinctura Cardamomi, under Cardamomum. Tinctura Cinchonae, under Cinchona. Tinctura Cinchonae Composita, under Cinchona. Tinctura Colchici Seminis, under Colchici Semen. Tinctura Digitalis, under Digitalis. Tinctura Ferri Chloridi, under Ferri Chloridum. Tinctura Gentianae Composita, under Gentiana. Tinctura Hyoscyami, under Hyoscyamus. Tinctura lodi, under lodum. Tinctura Lobeliae, under Lobelia. Tinctura Myrrhae, under Myrrha. Tinctura Nucis Vomicae. under Nux Vomica. Tinctura Opii, under Opium. Tinctura Opii Camphorata. under Opium. Tinctura Opii Deodorati, under Opium. Tinctura Rhei Aromatica, under Rheum. Tinctura Scillae, under Scilla. Tinctura Strophanthi, under Strophanthus. Tinctura Valerianae Ammoniata, under Valeriai.a. Tinctura Zingiberis, under Zingiber. Tragacantha. Tragacanth, U. S. P. A gummy exudation from Astragalus gummifer. ACTION AND USES: Tragacanth swells on addition of water and gradually forms a cloudy gelatinous mass. On further addition of water it forms a mucilage which is occasionally used in pharmacy in the making of emulsions and is widely used as a basis for a greaseless catheter lubricant and an application for chapped skin. TRITURATIONES TRITURATIONS Pharmacopeial triturations are active remedies diluted usually with 10 parts of sugar of milk. Trional. See under Sulphonethylmethanum. TROSCHISCI TROCHES Troches, or lozenges, are flat solid bodies intended to be dissolved in the mouth for their local effect on the mucous membrane of the mouth and the throat. Tuberculinum. Tuberculin, N. N. R. This represents the toxins of the tubercle bacillus. USEFUL DRUGS 143 PROPERTIES : Tuberculin is marketed in a variety of forms, either as a filtered extract of the bacilli or as the pulverized insoluble substance of the dead bacilli themselves. In the latter or emulsified form tuberculin is known as tubercle vaccine, and it is closely related to bacterial vaccines mentioned under Vaccina. ACTION AND USES: Tuberculin is used principally as a diagnostic agent and the characteristic properties of the trade product to be used should be studied closely before it is employed. UNGUENTA OINTMENTS Ointments are soft, fatty solids of such consistency that they are readily spread at ordinary temperatures. When intended for systemic effect they are applied by inunction; ordinarily they are used as simple protectives. For preparations included in this list see: Unguentum Acidi Borici, under Acidum Boricum. Unguentum Belladonnae. under Belladonnae Folia. Unguentum Chrysarobini, under Chrysarobinum. Unguentum Hydrargyri, under Hydrargyrum. Unguentum Hydrargyri Ammoniati, under Hydrargyrum Ammoniatum. Unguentum Hydrargyri Dilutum, under Hydrargyrum. Unguentum Hydrargyri Oxidi Flavi, under Hydrargyri Oxidum Flavum. Unguentum Picis Liquidae, under Pix Liquida. Unguentum Sulphuris, under Sulphur. Unguentum Zinci Oxidi, under Zinci Oxidum. Urotropin. See under Hexamethylenamina. VACCINA BACTERIAL VACCINES, N. N. R. Bacterial vaccines are suspensions of the killed bacteria in physiologic salt solution. Cresol is usually added as a preservative. The use of many of these vaccines is in the experimental stage. They are often prepared from cultures obtained from the individual to be treated (autogenous vaccines) ; these usually give the best results, and some authors maintain that "stock" vaccines should be used only when it is imprac- ticable to secure the autogenous agent. Bacterial vaccines are used to secure the production of an active immunity. Great care and skill are necessary for their proper use, and no definite statements as to dosage, etc., can be given. Vaccine Virus. See under Virus Vaccinum. Valeriana. Valerian, U. S. P. The dried rhizome and roots of Valeriana officinalis. ACTION AND USES: Valerian is thought to be antispas- modic and nerve sedative, but its influence is largely psychic, and in the ammoniated tincture the stimulating effects of the aromatic spirit of ammonia no doubt predominate. 144 USEFUL DRUGS Tinctura Valerianae, Ammoniata. Ammoniated Tincture of Valerian, U. S. P. One hundred c.c. represent the soluble constituents of 20 gm. of valerian in aromatic spirit of ammonia. DOSAGE: 2 c.e. or 30 minims. Veronal. N. N. R. Also known as diethyl-barbituric acid, diethyl malonyl urea and malourea, is 2,4,6-trioxy-5-diethyl pyramidin, a ureid derived from diethylmalonic acid. PROPERTIES : Veronal occurs as a white, crystalline powder, odorless, and having a faint bitter taste. It is slightly soluble in water (1:150) and freely soluble in alcohol (1:8). ACTION AND USES : Veronal is quickly absorbed, especially when it is given in solution. In smaller doses it induces sleep, apparently without any other effect. It is a rather slow-acting hypnotic, the hypnotic action beginning in about half an hour after its administration. In larger doses the temperature falls and animals show marked trembling and restlessness in their sleep. A number of fatalities have followed its indiscriminate use. DOSAGE: 0.3 to 0.6 gm. or 5 to 10 grains. It should never be given in the form of pills or tablets lest they fail to be absorbed. Sodii Diaethyl-Barbituras. Sodium diethyl-barbiturate, N. N. R. Also known as medinal and veronal-sodium, is the mono- sodium salt of diethyl-barbituric acid. PROPERTIES : Sodium diethyl-barbiturate occurs as a white, crystalline powder, odorless, and having an objectionably bitter alkaline taste. It is freely soluble in water (1:5). ACTION AND USES: Sodium diethyl-barbiturate, veronal- sodium or medinal has the same properties as veronal, but acts more rapidly on account of its greater solubility. DOSAGE: 0.3 to 0.6 gm. or 5 to 10 grains. Viburnum Prunifolium. Viburnum Pruni folium, U. S. P. The dried bark of the root of Viburnum prunifolium. ACTION AND USES: Viburnum prunifolium is thought to be a uterine sedative and tonic. Like valerian, however, its action, largely psychic, is probably due to its disagreeable odor and taste. Fluidextractum Viburni Prunifolii. Fluidextract of Vibur- num Prunifolium, U. S. P. One hundred c.c. represent the soluble constituents of 100 gm. Viburnum prunifolium in approximately 60 per cent, alcohol. DOSAGE: 2 c.c. or 30 minims, USEFUL DRUGS 145 VINA WINES Medicated wines are solutions of active medicaments in wine or extractive preparations of vegetable drugs made with wine as a menstruum. Because of the great variation in the composition of wine it is unsatisfactory as a men- struum for extracting vegetable drugs, and medicated wines are in fact becoming obsolete. Vinum Antimonii. See under Antimonii et Potassii Tartras. Virus Vaccinum. Vaccine Virus, N. N. R. Vaccine virus is the material obtained from skin eruptions of calves having vaccinia. The "pulp" is ground and mixed with varying percentages of glycerol. It is usually marketed in capillary tubes or. as glycerinated points. ACTION AND USES: Vaccine virus is used as prophylactic against small-pox. Zinci Acetas. Zinc Acetate, U. S. P., Zn(C,H 3 2 ) 2 , H 2 0. PROPERTIES : Zinc acetate occurs as soft, white, pearly crys- tals, having a faintly acetous odor, and in dilute solutions nn astringent, metallic taste. It is freely soluble in water (1 :2.5) and soluble in alcohol (1:36). INCOMPATIBILITIES: Zinc acetate is incompatible with alkali carbonates or sodium borate. ACTION AND USES: Zinc acetate is astringent and anti- septic. It is used principally in the form of solution as an external application, for injection, solution or collyria; rarely used internally. DOSAGE: 0.125 gm. or 2 grains. It may be used in collyria in the proportion of from 0.1 to 0.5 per cent, or from % to 2 grains per ounce. Zinci Chloridum. Zinc Chloride, U, S. P., ZnCl,,. PROPERTIES : Zinc chlorid occurs as a white or nearly white granular powder or in porcelain-like masses, irregular or molded into pencils, odorless and of such intensely caustic properties as to make tasting dangerous, unless freely diluted with water. The dilute solution has an astringent metallic taste. It is very soluble in water (1 :0.5) and in alcohol. INCOMPATIBILITIES: Zinc chlorid is incompatible with sodium borate and with alkali carbonates. ACTION AND USES: Zinc chlorid is used as an antiseptic, astringent and escharotic. Liquor Zinci Chloridi. Solution of Zinc Chloride, U. S. P. An aqueous solution containing about 50 per cent., by weight, of zinc chlorid made by dissolving granulated zinc in hydrochloric acid. Zinci Oxidum, Zinc Oxide, U. S. P., ZnO. PROPERTIES : Zinc oxid occurs as a very fine, amorphous, white or yellowish-white powder, free from gritty particles, without odor or taste. It is practically insoluble in water and in alcohol. 146 USEFUL DRUGS INCOMPATIBILITIES : Zinc oxid is incompatible with acids. ACTION AND USES: Zinc oxid is antiseptic and astringent and is widely used either alone or in combination with boric acid, bismuth subnitrate and starch as a dusting-powder and as a sedative in ointment for a variety of skin diseases. By some it is thought to be a nervine, but this is probably incorrect. It is now rarely used internally. DOSAGE: 0.25 gm. or 4 grains. Unguentum Zinci Oxidi. Ointment of Zinc Oxid. A mixture of zinc oxid (20 gm.) with benzoinated lard (80 gm.). Zinci Stearas. Zinc Stearate, U. S. P. PROPERTIES : Zinc stearate occurs as a very fine, white powder, tasteless, and haying a very faint odor, resembling that of fat. It is practically insoluble in water and alcohol. ACTION AND USES: Zinc stearate is used as a dusting- powder, but appears to have little or no advantage over Zinc Oxid. Zinci Sulphas. Zinc Sulphate, U. S. P., ZnS0 4 7H 2 0. PROPERTIES : Zinc sulphate occurs as colorless, transparent, rhombic crystals, or granular crystalline powder, without odor, and having an astringent, metallic taste. It is very soluble in water, but practically insoluble in alcohol. INCOMPATIBILITIES: Alkali carbonates, sodium borate, tannin and vegetable astringents. ACTION AND USES: Zinc sulphate is astringent, styptic and emetic. It is much used in collyria in conjunctivitis and is especially effective in that form caused by Morax- Axenfeld bacillus. It is employed as an injection in the treatment of the chronic stages of gonorrhea. DOSAGE: As an emetic, 2 gm. or 30 grains. In collyria it may be used in the strength of from 0.1 to 1.0 per cent, or from 1 to 5 grains per ounce. As an injec- tion in gonorrhea solutions varying in strength, from 0.5 to 4 per cent, may be used. Zingiber. Ginger, U. S. P. The dried rhizome of Zingiber officinale. Occasionally administered in the form of powder. ACTION AND USES: Ginger is aromatic, stimulant and a stomachic tonic. It is a servicable carminative in colic. DOSAGE: 1 gm. or 15 grains. Tinctura Zingiberis. Tincture of Ginger, U. S. P. One hundred c.c. represent the soluble constituents of 20 gm. ginger in alcohol. DOSAGE: 2 c.c. or 30 minims. TABLE SHOWING THE RECORDED SOLUBILITY OF SUBSTANCES INCLUDED IN THE LIST OF IMPORTANT MEDICAMENTS Abbreviations and signs used: dec. = decomposed; 00 = sparingly soluble or slightly soluble; 000 = insoluble; v. s. = very soluble; misc. = miscible in all proportions ; = unrecorded or uncertain. The solubility values are for distilled water at approximately 25 C. and for the official U. S. P. alcohol at the same temperature and indicate the number of parts of the solvent required to dissolve 1 part of the substance. Substance Soluble in Acetanilidum Acetphenetidinum Acidum Benzoicum Acidum Boricum Acidum Citricum Acidum Hydrochloricum Acidum Hydrocyanicum Dilutum. Acidum Nitricum Acidum Salicylicum Acidum Tannicum Acidum Tartaricum Adeps .Ether ^theris Nitrosi, Spiritus .asthylis Chloridum yEthyl-Morphinae Hydrochloridum Aloinum Alumen Alumen Exslccatum Alumini Acetatis, Liquor Ammpnii Acetatis, Liquor Ammonii Carbonas Ammonii Chloridum Amylis Nitris Antimonii et Potassii Tartras. . . Antipyrlna Apomorphlnse Hydrochloridum . . . Argent! Nitras Argent! Protelnas Arseni Trioxidum Aspirinum Atroplna Benzosulphinidum Betanaphthol Bismuthi Subcarbonas ......... Bismuth! Subgallas Bismuthi Subnitras Bismuthi Subsalicylas Caffeina Caffeina Citrata Caffelnse Sodio-Benzoas Calcll Carbonas Prseclpitatus . . . Calx Camphora Chloralum Hydratum Chrom!! Trloxidum Parts of Parts of Cold Water. Cold Alcohol. 179 2.5 925 12.0 281 1.8 18 15.3 0.54 misc. 1.55 misc. misc 308 2.0 0.34 0.23 0.71 1.67 000 00 10 misc. misc. misc. 00 misc. 120 10.50 9 000 17 000 misc. misc. misc. 4 dec. 80 00 misc. 15.5 000 v.s. 1 39.5 38.2 0.54 24.0 2 100 00 300 5 450 1.46 250 25 950 0.61 000 000 000 000 00 000 00 45.6 53.2 25.0 20.0 2 30 00 000 760 000 700 v.s. 0.3 0.2 0.5 dec. 148 USEFUL DRUGS Substance Soluble in Parts of Parts of Cold Water. Cold Alcohol. Chrysarobinum 4,812 308 Codeina 120 1.6 Codeinae Phosphas 2.25 261 Codeine Sulphas 30 1,035 Creosotum 140 misc. Cresol 60 inlsc. Cresolls Compositus, Liquor.... misc. misc. Creta Praeparata 00 000 Cupri Sulphas 2.2 400 DiacetylmorphinffiHydrochloridum 2.0 11 Elaterinum 000 262 Epinephrina 000 00 Ferri Chloridum v.s. v.s. Ferri Chlorldi. Tinctura misc. misc. Ferri Phospnas Solubilis v.s. 000 Ferri Sulphas 0.9 000 Ferri et Ammonil Cltras v.s. 000 Ferrum 000 000 Formaldehydi, Liquor misc. misc. Gelatinum 000 000 Glycerinum misc. misc. Glycerylis Nitras 000 v.s. Guaiacol 53 v.s. Guaiacolis Carbonas 000 48 Hexamethylenamina 1.5 10 Homatropinse Hydrobromidum. . . 5.7 32.5 Hydrargyri Chloridum Corrosivum 13 3 Hydrargyri Chloridum Mite 000 000 Hydrargyri lodidum Flavum.... 00 000 Hydrargyri lodidum Rubrum.... 00 116 Hydrargyri Oxidum Flavum .... 00 000 Hydrargyri Salicylas 000 000 Hydrargyrum Ammoniatum GOO 000 Hydrastina 00 135 Hydrogenii Dioxidi, Aqua misc. Ichthyol misc. lodofbrmum 9.391 46.7 lodum 5,000 10 Magnesii Carbonas 000 000 Magnesii Oxidum 00 000 Majrnesii Sulphas 1.1 000 Menthol 00 v.s. Methylis Salicylas 00 v.s. Morphina 3,330 168 Morphines Hydrochloridum 172 42 Morphinae Sulphas -. . . . 15.3 465 Pancreatinum partly sol. 000 Parafflnum 000 000 Paraldehydum 8 misc. Pelletierinse Tannas 2: > >r> 12.0 Pepslnum 50 000 Petrolatum 000 00 Petrolatum Liquidum 000 00 Phenol 19.6 v.s Phenol Liquefactum 12 misc. Phenolphthaleinum ... 600 10 Phenylis Salicylas 2,333 5 Phosphorus 000 350 Physostigminaa Salicylas 72.5 12.7 Physostigminae Sulphas v.s. v.s Pilocarplnae Hydrochloridum.... 0.3 2.3 Pllocarpinae Nitras 4 60 Pir Ldquida 00 1 Plumbi Acetas 2 30 Potassii Acetas 0.4 2 Potassii Bicarbonas 3 00 Potassii Bitartras 200 00 Potassii Bromidum 1.5 180 Potassii Carbonas , . 0.91 000 USEFUL DRUGS UO Parts of Parts of Substance Soluble In Told Water. Cold Alcohol Potassli Chloras 16 000 Potassli Citras 0.5 00 Potassli et Sodii Tartras 1.2 00 Potassii Hydroxidum 0.4 2 Potassil lodidum 0.7 12 Potassii Nitras 3.6 00 Potassli Permanganas 15 dec Quinina 1,550 0.6 uininse Bisulphas 8.5 18 uiniiiiB Hydrochloridum 18 0.6 Quininse Sulphas 720 86 Quininse et Urese Hydrochloridum 1 Quininse Tannas 800 3 Resorcino) 0.5 v.s. Saccharum 0.46 137.2 Saccharum Lactis 4.79 000 Santoninum 5,300 34 Sapo 20 2r> Sapo Mollis 4 1 Scopolaminse Hydrobromidum. . . . 1.5 16 Salvarsan vs. Sodii Arsanilas 6 125 Sodii Arsenas 1.2 00 Sodii Benzoas 1.6 43 Sodii Bicarbonas 12 000 Sodii Boras 17 (too Sodii Bromidum 1.7 12.5 Sodii Cacodylas 0.5 1 Sodii Carbonas Monohydratus. . . 2.9 000 Sodii Chloridum 2.8 00 Sodii Hydroxidum 1 v.s. Sodii lodidum 0.5 3 Sodii Nitris 1.4 50 Sodii Phosphas 5.5 000 Sodii Salicylas 0.8 5.5 Sodii Sulphas 2.8 COO Sodii Sulphis 2 00 Sodii Thiosulphas 0.35 000 Sparteinse Sulphas 1.1 2.4 Strophanthlnum v.s. v.s. Strychnina 6,400 110 Strychnin Nitras 42 120 Strychninse Sulphas 31 65 Sulphonethylmethanum 195 v.s. Sulphonmethanum 360 47 Sulphur 000 00 Terpini Hydras 200 10 Theobromina 1,700 50 Theobrominae Sodio-Salicylas. ... 1 28 Thymol 1,100 v.s. Thymolis lodidum 000 00 Veronal 145 28 Veronal-Sodium 5 Zinci Acetas 2.5 36 Zinci Chloridum 0.4 v.s Zinci Oxidum 000 000 Zinci Stearas 000 000 Zinci Sulphas 0.53 000 PHARMACOLOGIC INDEX The following classification of drugs included in the list of useful remedies according to their therapeutic use has been adapted from the text-book on pharmac- ology and therapeutics by Arthur R. Cushny. This index serves to indicate the comprehensiveness of the list and should assist in suggesting to practitioners and teachers possible additions and deletions that might be made so that the list will include all of the fairly well- established remedies that are really of use. For ready reference the titles used are those under which the drug or preparation has been included and described in the list of useful remedies. I. DBUGS APPLIED FOR THEIR LOCAL ACTION TO THE SKIN, WOUNDS OR VISIBLE Mucous MEMBRANES Corrosives or Caustics : Acidum Aceticum Acidum Nitricum Alumen Exsiccatum Argenti Nitras Arseni Trioxidum Chromii Trioxidum Hydrargyrum Ammoniatum lodum Phenol Potassii Carbonas Potassii Hydroxidum Sodii Carbonas Sodii Hydroxidum Zinci Chloridum Disinfectants and Antiseptics : Acidum Benzoicum Acidnm Boricum Acidum Salicylicum Argenti Nitras Calx Calx Chlorinata Camphora Cresol Eucalyptoi Formaldehydi, Liquor Hydrargyri Chloridum Corrosivum Hydrargyri lodidum Rubrum Hydrogenii Dioxidi, Aqua lodoformum lodum Olea Volatilia Phenol Pix Liquida Potassii Permanganas Sulphur Thymol Zinci Chloridum Astringents : Acidum Tannicum Alumen USEFUL DRUGS 151 Aluminl Acetatis, Liquor Argent! Nitras Bismuth! Subcarbonas Bismuth! Subgallas Bismuth! Subnitras Cuprl Sulphas Ferr! Chlorldum Ferrl Sulphas Plumbl Acetas Zinc! Acetas Zinc! Oxidum ZlncI Sulphas Styptics : See also Soluble Astringents. Ferrl Chlorldum Alumen Exslccatum To Contract Vessels and Reduce Hemorrhage and Swelling : Cocalna Eplnephrina Emollients: Powders: Amylum Bismuth! Subcarbonas Bismuth! Subnitras Magnesi! Carbonas Talcum Zinc! Oxidum Protectives : Adeps Adeps Lanae Cera Olea Pingua Petrolatum Local Anodynes and Analgesics for Pain and Itching : Aconltum Ammoniae, Aqua Atropina Chloroformum Cocaina Phenol Sodli Bicarbonas Local Anesthetics : Chloridum Cocalna Menthol II. DRUGS USED FOR AFFECTIONS OF THE ALIMENTARY TRACT Mouth and Throat. (See also Section 1) : Demulcent : Acacia Ammonil Chlorldum Glyerlnum Potassll Chloras To Lessen Salivation : Atropina Flavoring Substances : Acidum Cltricum Olea Volatilia Saccharum Syrupl Syrupus Syrupus Prunl Virginlanse Syrupus Tolutanus 152 USEFUL DRUGS Stomach: Digestives : Acidum Hydrochloricum Pepsinum Emetics : Antimonii et Potassii Tartras Apomorphlnse Hydrochloridum Cupri Sulphas Ipecacuanha Sinapis Sodii Chlorldum Zinci Sulphas To Lessen Irritation and Vomiting : Bismuth! Subcarbonas Bismuth! Subnitras Chloralum Hydratum Chloroformum Cocalna Codeina Diacetylmorphinse Hydrochloridum Liquor Calcis Menthol . Morphina Opium To Lessen Acidity, Antacids : Calcii Carbonas Calx (Liquor Calcis) Magnesii Carbonas Magnesii Oxidum Potassii Carbonas Sodii Bicarbonas Sodii Hydroxidum To Increase Secretion, Bitters : Cinchona Gentiana Nux Vomica Quinina Strychnina Carminatives : See also Bitters. Alcohol Camphora Capsicum Cardamomum Caryophyllus Myrrha Olea Volatllia Sinapis Zingiber Intestine: To Promote Digestion : Pancreatinum To Promote Evacuation, Purgatives : Vegetable Purgatives : Aloe Aloinum Colocynthis Elaterinum Jalapa Podophyllum Rhamnus Purshiana Rheum USEFUL DRUGS 153 Ricinl, Oleum Senna Tiglii, Oleum Saline Purgatives : Magnesii Carbonas Magnesii Citratis, Liquor Magnesii Oxidum Magnesii Sulphas Potassii Bitartras Potassii Citras Potassii et Sodii Tartras Sodii Phosphas Sodii Sulphas Mercurial Purgatives : Hydrargyri Chloridum Mite Hydrargyrum Miscellaneous : Fel Bovis Glycerinum Sulphur To Lessen Movement and Relax Spasm : Acidum Tannicum Argenti Nitras Atropiua Belladonna Bismuthi Subcarbonas Bismuth! Subgallas Bismuthi Subnitras Calx (Liquor Calcis) Morphina Opium Plumbi Acetas To Destroy Parasites, Antholrnintics : Aspidium Chloroformum Hydrargyri Chloridum Mite Pelletierinse Tannas Phenylis Salicylas Santoninum Terebinthinfe, Oleum Thymol Disinfectants and Antiseptics See also, Vegetable, Saline and Mercurial Purgatives. Phenylis Salicylas III. DRUGS USED FOR THEIR EFFECTS ox THE CIRCULATION Heart: To Strengthen Contract ion : Digitalis Strophanthinum Strophanthus To Accelerate Pulse : Atropina Caffeina To Slow Pulse : Aconitum Digitalis Strophanthinum Strophanthus Vessels: To Contract Caliber and Raise Blood-Piessure : Epinephrina Ergota 154 USEFUL DRUGS To Relax Vessels and Lower Blood-Pressure : Amylis Nitrls Glycerylis Nitratls, Spiritns Sodii Nitris To Arrest Internal Hemorrhage, Styptics : Ergota Hydrastis To allay 1>estlessness To Remove Fluid (Dropsy, Anasarca) : See also Diuretics (Kidney), Diaphoretics (Skin), Vegetab'e and Saline Purgatives (Intestine) Digitalis Hydrargyri Chloridum Mite.- Scilla Strophanthinum Strophanthus IV. DRUGS USED FOB THEIR EFFECTS ON THE GENITO-URINARY SYSTEM To Increase the Flow of Urine (Diuretics) r ^Etheris Nitrosi, Spiritus Ammonii Acetatis, Liquor Caffeina Cubeba Digitalis Hydrargyri Chloridum Mite Potassii Acetas Potassii Citras Potassji Nitras Santali, Oleum Scilla Sodii Nitris Sparteinae Sulphas Strophanthinum Strophanthus Theobromina To Render the Urine Less Acid : Potassii Acetas Potassii Bicarbonas Potassii Citras Sodii Bicarbonas Sodii Carbonas To Render the Urite More Acid : Acid Sodium Phosphate, see Sodii Phosphas Mineral Acids To Render the Urine Antiseptic : Acidum Benzoicum Acidum Salicylicum Aspirinuru Hexamethylenamina Phenylis Salicylas Sodii Benzoas Sodii Boras Sodii Salicylas Local antiseptics, etc. To Promote Menstruation, Euimenagogues : See also Vegetable Purgatives. Aloe Aloinum Myrrha USEFUL DRUGS 155 v. DRUGS USED FOR THEIR EFFECTS ON THE RESPIRATORY SYSTEM To Stimulate the Respiratory Center : Atropina Caffeina Camphora Strychnina To Reduce the Irritability of the Center in Cough : Chloralum Hydratum Chloroformum Codeina Diacetylmorphinse Hydrochloridnm Morphina Opium To Increase and Liquefy the Bronchial Secretion : Ammonil Carbonas Antimonii et Potassii Tartras Apomorphinse Hydrocbloridiim Ipecacuanha Lobelia Potassii lodldum Scilla Sodii lodidum To Lessen the Secretion of the Bronchi ( ?) Terpini Hydras To Relax Bronchial Spasm in Asthma : Amylis Nitris Atropina Belladonna Glycerylis Nitratis, Spiritus Sodii lodidum Sodii Nitris VI. DRUGS USED FOR THEIR EFFECTS ON THE CENTRAL NERVOUS SYSTEM Stimulants : (a) The spinal cord : Strychnina (b) The brain and medulla oblongata : Atropina Caffeina Camphora Depressants : (a) To paralyze sensation (general anesthetics) : ^Ethylis Chloridum Chloroformum (b) To induce sleep and rest (hypnotics or narcotics) Alcohol Chloralum Hydratum Codeina Morphina Opium Paraldehydum Scopolaminse Hydrobromidum Sulphonethylmethanum Sulphonmethanum Veronal (c) To relieve pain (analgetics or anodynes) : Acetanilidum Acetphenetidinum Acldum Salicylicum Alcohol 156 USEFUL DRUGS Antipyrina Aspirin Chloralum Hydratum Codeina Methylis Salicylas Morphina Sodii Salicylas VII. DRUGS USED TO REDUCE FEVER TEMPERATURE Acetanilidum Acetphenetidinum Acidum Salicylicum Aeon itum Ammouii Acetatis, Liqnoi Antipyrinum Aspirin Gualacol Phenol * Qulnina Sodii Salicylas VIII. DRUGS USED FOR THEIR EFFECTS ON THE LIVER To Increase the Secretion of Bile, Cholagogues : Acidum Salicylicum Fel Bovis IX. DRUGS USED FOR THEIR EFFECTS ox THE BLOOD To Increase the Hemoglobin : Arseni Trioxidum Ferri Carbonas Ferri lodidum Ferri Phosphas Solubilis Ferri et Ammonii Citras Sodii Arsanilas Sodii Cacodylas To Render the Blood Alkaline : Potassii Acetas Potassii Bicarbonas Potassii Citras Sodii Bicarbonas Sodii Carbonas Sodii Hydroxidum To Increase the Coagulability ( ?) : Calcii Chloridum Calcii Hypophosphis Calcii Lactas X. DRUGS USED FOR SPECIFIED DISEASES In Malaria : Arseni Trioxidum Quinina In Syphilis : Hydrargyri Chloridum Corrosivum Hydrargyri Chloridum Mite Hydrargyri lodidum Flavum Hydrargyri lodidum Rubrum Hydrargyri Salicylas Hydrargyrum Potassii lodidum Ralvarsan Sodii lodidum In Rheumatic Fever : Acidum Sallcylicum Aspirin USEFUL DRUGS 157 Methylis Salicylas Sodii Salicylaa In Myxedema and Some Other Thyroid Diseases : Glandulse Thyroidese Siccce In Diphtheria : Serum Antidiphthericum In Tetanus Serum Antitetanicum In Trypanosomiasis : Antlmonii et PotassII Tartras Sodii Arsanilas In Gout : Colchlcl Semen XI. DRUGS USED FOR THEIK EFFECTS ON THE SKIN Corrosives or Caustics Emollients and Protectives Local Anodynes and Anesthetics Irritants : Aconitum Alcohol Ammonia Camphora Cantharis Capsicum lodum Menthol Slnapis Terebinthinae, Oleum Tiglii, Oleum Disinfectants or Irritants Used Chiefly in the Form of Oint- ments in Parasitic Skin Diseases : Balsamum Peruvianum Benzoinum Camphora Chrysarobinum Hydrargyrum Ichthyol lodum Pix Liquida Resorcinum Sulphur Thymol Arsenic, Potassium, lodid, etc., May Be Used Internally in Skin Diseases. Drugs Administered Internally to Increase the Secretion of Perspiration, Diaphoretic or Sudoriflcs : JEtheris Nitrosi, Spiritus Antimonii et Potassii Tartras Camphora Ipecacuanha Opium Pulvis Ipecacuanha et Opii Pilocarpinse Hydrochloridum Drugs Administered Internally to Lessen Secretion of Per- spiration : Atropina Belladonna 158 USEFUL DRUGS XII. DSUGS USED LOCALLY FOE THEIR EFFECTS ON THE EYE Drugs Dilating the Pupil and Relaxing the Accommodation, Mydriatics : Atropina Cocaina Homatropina Hydrobromidum Scopolaminae Hydrobromidum Drugs Contracting the Pupil and the Ciliary Muscle, Myotics : Physostigminae Salicylas Pilocarpinae Hydrochloras OTHER PROPERTIES OF WELL-KNOWN DRUGS The following classification is taken from "Introduc- tion to Materia Medica and Pharmacology" by Oliver T. Osborne. Drugs and Preparations Which May Cause an Eruption on. or Itching of, the Skin : Antitoxin Arsenic Belladonna Bromids Chloral Copaiba lodids Opium Quinin Salicylic Acid Synthetic Compounds Volatila Oils, and drugs containing them. Drugs Which May Change the Color of the Urine : Drugs that increase its amount cause it to be lighter. Drugs that irritate the kidneys cause it to be darker. Methylene-blue causes it to be green, if acid. Phenol may cause it to be brown (same appearance as bile). Santonin causes it to be yellow, if acid ; purple, if alkaline. Senna may cause it to be red, if acid ; yellow, if alkaline. Sulphonal may cause it to be very dark. Drugs Which Color the Feces : Bismuth salts color them black or dark gray. Colchicum colors them greenish. Iron colors them black. Mercury colors them green. Purgatives cause them to be darker. Drugs Which Are Excreted with the Milk : Arsenic Bromids Hexamethylenamin lodids Lead Mercury Opium Quinin Sulphur Vegetable Cathartics Volatile Oils INDEX PAGE Acacia 7 mucilage of 7 Acetanilid -7 Acetic acid 8 Acetphenetidin 8 Acetylsalicylic acid (aspirin) 30 Achylia gastrica diluted hydrochloric acid in 10 Acid, acetic 8 acetylsalicylic (aspirin) 30 arsenous, solution of . . . 29 benzole 9 boric 9 carbolic (phenol) 103 citric 10 diethylbarbituric (see veronal) 144 hydrochloric 10 hydrochloric, diluted . . 10 hydrocyanic, diluted.... 11 nitric 11 salicylic 12 tannic 12 tannic, glycerite of 13 Acidity, to lessen 152 .Acne vulgaris ichthyol in 86 Aconite tincture of 13 Actinomycosis potassium iodid in 114 Adeps 14 benzoinatus 14 lanae hydrosus 14 Adnephrin, adrenalin (epi- nephrin) 63 Aether 14 nitrosus 15 nitrpsus spiritus 15 spiritus 15 spiritus compositus 15 Aethylis chloridum 15 A e t h y 1 - morphinae hydro- chloridum 15 Albumin tannate (tannalbin) Alcohol 16 Alcoholic poisoning caffein in 39 Alcoholism strychnin in 130 Aloes 17 extract of 17 Aloin 18 Alum 18 exsiccated 18 Aluminum acetate 18 acetate, solution of 18 .Amebic dysentery ipecac in 89 Amenorrhea desiccated thyroid glands In 73 Ammonia 19 aromatic spirit of 21 liniment 20 water 20 Ammoniated mercury (hy- drargyrum a m m o n i- atum) 84 mercury ointment of. ... 84 Ammonium acotate 20 acetate, solution of 20 carbonate 20 chlorid 21 compounds 19 sulpho-ichthyolate 86 Amyl nitrite 22 Amylum 23 Analgesics and anodynes, 151, 155 Anemia ferrous carbonate in .... 67 salvarsan in 121 sodium cacodylate in... 129 Anesthetics, general 155 local 151 Anodynes and analgesics. 151, 155 Antacids 152 Anthelmintics 153 Antidiphtheric serum 126 Antimony and potassium tar- trate 23 wine of 23 Antipyrin 24 Antiseptics and disinfectants 150, 153 Antitetanic serum 126 Antitoxin, diphtheria 126 Apomorphin hydrochlorid. . . 24 Aqua 25 ammoniac 20 camphorae 46 chloroform! 52 destillata 25 hydrogen! dioxidi 85 menthae piperitae 94 rose 120 Aquae 25 Argent! nitras 25 nitras fusus 27 Argent! proteinas (see pro- targol) 114 Aristol (thymol iodid) 141 Aromatic elixir 17 Arsenic trioxid . 27 Arsenobenzol (salvarsan) . . 120 Arsenous acid (arsenic tri- oxid) 29 acid, solution of 29 and mercuric iodids, solution of 29 Asafetida 29 Aspidium 29 oleoresin of 29 Aspirin 30 Asthma drugs to relax bronchial spasm in 155 epinephrin in 63 Astringents 150 Atoxyl (sodii arsanilas) .... 127 Atropin 30 sulphate 33 Bacterial vaccines (vaccina) 143 Balsam of Peru 33 160 INDEX Balsam of Tolu 34 Bed-sores compound tincture of benzoin in 35 Belladonna leaves 34 leaves, extract of 34 leaves, tincture of 34 ointment 35 plaster 34 Benzoic acid Benzoin 35 tincture of, compound . . 35 Benzosulphinid 35 Betanaphthol 36 Betula, oil of 94 Biniodid of mercury 81 Birch, oil of 95 Bismuth subcarbonate 36 subgallate 37 subnitrate 37 subsalicylate 39 Bitters 152 Blastomycosis 114 Blood, alkaline, drugs to ren- der 156 Blood, coagulability, drugs to increase 156 Blood, drugs, effects on the . . 156 Blood-pressure amyl nitrate, effect on . . 22 drugs to lower 154 strychnin, effect on .... 135 Blue mass 83 ointment 83 Borax (sodium borate) 128 Boric acid 9 acid, ointment of 10 Boroglycerin, glycerite of... 9 Bothriocephalus 30 Bronchial secretion, to in- crease and liquefy the. 155 secretion, to lessen .... 155 Bronchitis antimony and potassium tartrate in 23 antipyrin in 24 arsenic trioxid in 27 strychnin in 135 Bruises solution of lead subacc- tate in 109 Burns lime-water in 44 Cacao butter (oleum theo- bromatis) 140 Cachets 39 Caffein 39 citrated 40 sodio-benzoate 41 Calabar bean (physostigma) . 106 Calcined magnesia 92 Calcium carbonate, precipi- tated 41 chlorid 41 hydroxid, solution of ... hypophosphite 42 lactate 43 oxid 43 oxid, chlorinated phosphate, precipitated. 43 TAG E Calomel (hydrargyri chlori- dum mite) 79 Calx 43 chlorinata 44 Camphor 45 ' liniment 46 spirit of 46 water 46 Cannabis indica 46 extract 46 tincture 47 Cantharides 47 cerate 47 Capsicum 48 tincture 48 Capsules 48 Carbo ligni 48 Carbolic acid (phenol) 103 Cardamom 49 tincture of 49 Carminatives 152 Carron oil 44 Caryophyllus 49 oil of 49 Cascara sagrada (rhamnus purshiana) 118 aromatic fluid extract of 118 extract of 118 fluid extract of 118 Castor oil (oleum ricini) . . 119 Cataplasmata 49 Caustics or corrosives 150 Cera alba 49 flava 49 Cerates 50 Ceratum cantharidis 47 Chalk, precipitated 41 Chancroids 12 Charcoal (carbo ligni) 48 Charta sinapis 127 Chartae 50 Cherry, wild 115 Chloral, hydra ed 50 Chlorinated calcium oxid (chlorinated lime) . . 44 soda, solution of 45 Chloroform 51 liniment 52 spirit of 52 water 52 Chlorosis sodium cacodylate in ... 1 Cholagogues 156 Chromium trioxid (chromic acid) 52 Chrysarobin 53 ointment ~3 Cinchona 53 tincture of 53 tincture of, compound.. 54 Cinnamon 54 oil of 54 water 54 Circulation, drugs used for their effects on the.. 153 Titrated caffein 40 Citric acid 10 Cloves (caryophyllus) 49 oil of 49 Clysters (enemata) 63 INDEX 161 PAGE Cocaln 54 hydrochloric! 56 Codein 56 phosphate 56 sulphate 56 Cod-liver oil (morrhuae oleum) 97 Colchicum seed 57 seed, tincture of 57 Colds camphor for 45 Collodion 57 flexible 57 Colocynth 58 extract of 58 extract of, compound . . 58 Confections 58 Conjunctivitis boric add in 9 ethyl-morphin h y d r o- chlorid 15 sodium borate 128 Conjunctivitis, gonorrhea!, silver nitrate in 25 Copaiba 58 Copper sulphate 59 Corn-starch (amylum) 23 Corneal ulcer 16 Corrosive sublimate 78 Corrosives or caustics 150 Coryza atropin in 30 codein in 54 Cough . codein for 56 to reduce nerve center irritability in 155 Creosote 58 Cresol 59 solution of, compound . . 59 Croton oil (oleum tiglii) ... 141 Cupri sulphas 59 Cystitis boric acid in 9 hexamethylenamin in... 76 Decoctions 60 Demulcents 151 Depressants, central nervous system 155 Dermatitis herpetiformis ... 28 Dermatol (bismuth subgal- late) 37 Diabetes sodium cacodylate In ... 129 Diabetes insipidus ergot In 65 Diarrhea lime-water in 44 Dicetyl-morphinae hydro- chloridum 60 Digestives 152 Digitalis 61 infusion of 62 tincture of 62 D 1 o n i n (aethyl-morphlnae hydrochloridum) .... 15 Diphtheria antitoxin (see serum an- tidiphthericum) 126 drugs used in 157 strychnin in 136 PAGE Disinfectants and anti- septics 150, 153 or irritants used in para- sitic skin diseases . . . 157 Diuretics 154 Diuretin (theobrominae sodio- salicylas) 140 Donovan's solution (solution of arsenous and mer- curic iodid) 29 Dover's powder (pulvis ipe- cacuanhae et opii) . . 100 Dropsy, renal theobromin in 140 Dyspepsia camphor in 45 Ear, catarrh of iodin in 87 Eczema arsenic trioxid in 27 desiccated thvroid gland in * 73 Effervescent salts 120 Elaterin 62 Elixir, aromatic 17 Elixirs 63 Emetics 152 Emmenagogues 154 Emollients 151 Emphysema arsenic trioxid in 27 Emplastra 63 Emulsions 63 Endocervicitis iodin in 87 Enemata (clysters) 63 Enteritis, ulcerative bismuth subnitrato in. . . 37 Epinephrin 63 Epsom Salts (magnesll sul- phas) 93 Ergot 65 fluidextract of 66 Eruption on the skin, drugs which may cause an . . 158 Erysipelas ichthyol in 86 Eserin sallcylate (physos- tigminae salicylas) . . 106 sulphate (physostigminae sulphas) 107 Ether (aether) 14 nitrous 15 nitrous, spirit of 15 spirit of 15 spirit of, compound.... 15 Ethyl chlorid (aethylis chloridum) 15 Ethyl-morphin hydrochlorid.. 15 Eucalyptus 66 oil of 66 Extract of aloes 17 of belladonna leaves.... 34 of cannabis indica 46 of cascara sagrada .... 118 of colocynth . . . 58 of colocynth, compound. 58 of gentian 73 of Indian cannabis .... 46 of nux vomica 98 162 INDEX PAGE of opium 100 of rhamnus purshiana.. 118 of rhubarb 119 Extracts 66 Eye, drugs used locally for their effects on the . . 158 Fats and oils, fixed 99 Favus sodium sulphite in .... 133 Feces, drugs which color the 158 Fel bovis 67 bovis purificatum 67 Ferri et ammonii cltras 68 Ferric chlorid 68 chlorid, tincture of .... 68 phosphate 69 Ferrous carbonate 67 carbonate, mass of 68 carbonate, pills of 68 iodid 69 iodid, syrup of 69 sulphate 70 sulphate, exsiccated ... 70 Ferrum 70 reductum 70 Fever, drugs used to reduce temperature iriG Fevers solution of ammonium acetate 20 Flatulence oil of turpentine in .... 139 Flavoring substances 151 Flaxseed (linum) 91 Fluid, to remove 154 Fluidextract of cascara sa- grada 118 of cascara sagrada. aro- matic 118 of ergot 66 of glycyrrhiza 7."> of hydrastis 85 of ipecac 90 of rhamnus purshiana.. 118 of rhamnus purshiana, aromatic 118 of senna 125 of viburnum prunlfolium 144 Fluidextracts 70 Formaldehyd 71 solution of 71 Fowler's solution (potassium arsenite) 28 Galactorrhea atropin in 33 Gaultheria, oil of 94 Genito-urinary system, drugs used for their effects on the 154 Gentian 72 extract of 73 tincture of, compound.. 73 Ginger (zingiber) 146 tincture of 146 Glauber's salt (sodii sulphas) 133 Glaucoma ethyl-morphin hydro- chlorid in 15 sodium salicylate in... 132 PAGE Glonoin 75 Glycerin 74 suppositories of 74 Glyceryl nitrate, spirit of . . . 75 Glycerite of boroglycerin .... 9 Glycerites 74 Glycerol : see Glycerin 74 Glyceryl trinitrate 75 Glycyrrhiza 75 fluidextract of 75 powder of, compound ... 75 Goiter desiccated thyroid glands in 74 Golden seal 84 Gout, drugs used in 157 Gonorrhea protargol in 114 Gray powder 83 Green vitriol 70 Guaiacol 76 carbonate 76 Gum arabic 7 Headache acetanllld In 7 sodium salicylate in.... 132 Hemoglobin, drugs used to increase 156 Hemophilia calcium chlorid in 42 Hemorrhages epinephrin in 63 internal, to arrest in... 154 Hemorrhoids iodoform in 87 Henbane 86 Heroin hydrochlorid (clicetyl- morphinae hydrochlor- idum) 60 Hexamethylenamin . 76 Homatropin hydrobromid ... 78 Honeys (mellira) 93 Hookworm disease thymol in 141 Hydrargyri ammoniati un- guentum 84 chloridum corrosivum. . . 78 chloridum mite 79 dilutum unguentum ... 83 iodidum flavum 80 iodidum rubrum 81 oxidum flavum 82 salicylas 82 unguentum 83 Hydrargyrum 82 ammoniatum 84 cum creta 83 Hydrastis 84 fluidextract of 85 Hydrated chloral 50 Hydrochloric acid 10 Hydrocyanic acid, diluted... 11 Hydrogen dioxide 85 dioxide, solution of .... 85 peroxid 85 Hydrous wool fat (adeps lanae) 14 Hyoscin hydrobromid 124 Hyoscyamus 86 tincture of 86 INDEX 163 Hyperacidity bismuth subnitrate in . . 38 Hypnotics or narcotics 153 Ichthyol 80 Indian cannabis 46 cannabis, extract of ... 46 cannabis, tincture of ... 47 Infections solution of ammonium acetate in 20 Infusion of digitalis 62 Infusions 86 Insomnia hydrated chloral in .... 30 lodin 87 tincture of 89 lodoform 87 Ipecac 89 and opium, powder of. . 100 fluidextract of 90 syrup of 90 Iritis ethyl-morphin hydro- chlorid in 15 Iron (ferrum) 70 and. ammonium citrate.. 68 reduced 70 See also ferric and fer- rous compounds I rritants 157 or disinfectants used in parasitic diseases .... 157 Itching of the skin, drugs which may cause an.. 158 Jaborandi (pilocarpus) .... 107 Jalap 90 powder of, compound . . 90 Keratitls sodium salicylatc in.... 132 Labarraque's solution (liquor sodae chlorinatae) . . 45 Lanolin (adeps lanae hydro- sus) Lard (adeps) benzpinated Laryngitis antimony and potassium tartrate in 23 squill in 123 Laudanum (tinctura opii) . . 100 Lead acetate (plumbi acetas) 108 subacetate, solution of. . 109 sugar of 108 leukemia ferrous carbonate in .... 07 Lichen planus arsenous trioxid in 27 Licorice root (glycyrrhiza) . . 75 Lime 43 chlorinated 44 liniment 44 water 44 Liniment, ammonia 20 camphor 46 chloroform 52 lime (calcis) 44 soap 123 Liniments 90 PAGE Linseed oil 91 Linum 91 Liquor : See Solution. Liver, drugs for their effects on the 156 Lobelia 91 tincture of 91 Lunar caustic (argenti nitras) 25 Lupus erythematosus ichthyol in 86 Magnesia, calcined 92 Magnesium carbonate 92 citrate 92 citrate, solution of .... 92 oxid 92 sulphate 93 sulphate, effervescent . . 93 Male fern (aspidium) 29 Malaria drugs used in 156 quinin and urea hydro- chlorid in 117 quinin tannate in 116 Mammitis atropin in 32 Mass, blue 83 of ferrous carbonate ... 68 of mercury (massa hy- drargyri) 83 Masses 93 Mellita 93 Menorrhagia hydrastis in 84 Menstruation, to promote. . . 154 Mentha piperita (peppermint) 93 Menthae piperitae, aqua. ... 94 piperitae oleum 93 piperitae spiritus 94 Menthol 94 Mercurial ointment 83 Mercuric and arsenous iodids. solution of 29 chlorid, corrosive 78 iodid, red 81 oxid, yellow 82 oxid, yellow, ointment of 82 salicylate 82 Mercurous chlorid, mild ... 79 iodid, yellow 80 Mercury (hydrargyrum) ... 82 ammoniated 84 biniodid of 81 green iodid of 80 mass of 83 protiodid 80 with chalk 83 Methyl salicylate 94 Mctrorrhagia hydrastis in 84 Milk, drugs which are ex- creted with the 158 Milk-sugar (saccharum lac- tis) 120 Mixtures 95 Morphin 95 hydrochlorid 97 sulphate 97 Morrhuae oleum . 97 164 INDEX Mucilage of acacia 7 Mucilages 98 Mustard (sinapis) 126 black 126 oil of, volatile 127 paper 127 Myrrh 98 tincture of 98 Myxedema and some other thyroid diseases, drugs used in 157 Naphthol (betanaphthol) ... 36 Narcotics or hypnotics 1 Neosalvarsan 122 Nephritis potassium acetate in... 110 Nerve exhaustion caffein in 39 Nervous system, central, drugs used for their effects on the 155 Neuralgia acetanilid in 7 arsenic trioxid in 27 Nevi nitric acid in 11 Nipples, cracked compound tincture of benzoin in 35 Nitric acid 11 Nitrites 22 Nitroglycerin 7o spirit of 75 Nitrous ether, spirit of 15 Nux vomica 98 extract of 98 tincture of 98 Obesity desiccated thyroid glands in 74 Oil. carron (linimentum cal- cis) 44 castor (oleum ricini) . . 119 croton (oleum tiglii) . . . 141 linseed (oleum lini) ... 91 of birch (oleum betulae) 95 of cinnamon (oleum cin- namomi) 54 of cloves (oleum caryo- phylli) 49 of eucalyptus (oleum eucalypti) 66 of gaultheria (oleum gaultheriae) 94 of mustard, volatile (ol- eum sinapis volatile) . 127 of peppermint (oleum menthae piperitae) ... 93 of rose (oleum rosae) . . 120 of santal (oleum santali) 122 of theobroma (oleum the- obromatis) 140 of turpentine (oleum te- rebinthinae) 139 of wintergreen 94 Oils and fats, fixed 99 volatile or essential.... 99 Ointment, belladonna 35 blue (hydrargyri dilutum unguentum) 83 PACK chrysarobin o!! mercurial (unguontum hydrargyri) 8H of ammoniated mercury. 84 of boric acid 10 of yellow mercuric oxid. 82 of zinc oxid 146 sulphur 138 tar 108 Ointments 143 Oleates 99 Oleoresin of aspidium 29 Oleoresins 99 Oleum : See Oil Opium 99 and ipecac, powder of. . 100 extract of 100 powdered 100 tincture of 100 tincture of, camphorated 100 tincture of, deodorized . . 100 Opium poisoning caffein in 39 Oxgall (fel bovis) 67 purified 67 Oxygen, compressed 100 Pancreatin 101 Papers (chartae) 50 Paraffin 101 Paraldehyd 102 Paralysis strychnin in 135 Parasites, to destroy -153 Paregoric (tinctura opii cam- phorata) 100 Pelletierine tannate 102 Pemphigus arsenic trioxid in 27 Peppermint 93 oil of 93 spirit of 94 water 94 Pepsin 102 Perspiration, drugs adminis- tered to increase the secretion of 157 Pertussis antipyrin in 24 Peru, balsam of 33 Petrolatum 102 liquid 102 I'haryngitis boric acid in 9 capsicum in ". . 48 iodin in 87 Phenacetin (acetphenetidin) . 8 Phenol 103 liquefied 104 Phenolphthalein 104 Phenyl salicylate 104 Phosphorus 105 Physostigma 106 Physostigmine salicylate .... 106 sulphate 107 Pills 108 of ferrous carbonate (Blaud's) 68 Pilocarpin hydrochlorid .... 107 nitrate 108 Pilocarpus 107 INDEX 165 I'AGK Fix liquida 108 unguentum 108 Plaster, belladonna 34 Plasters (emplastra) 63 Plumbi acetas 108 Pneumonia potassium acotate in... 100 strychnin in 135 Podophyllum 109 resin of 100 Potassium acetate 109 and sodium tartrate.... 112 arsenite, solution of. ... 28 bicarbonate 110 bitartrate 110 bromid 110 carbonate Ill chlorate Ill citrate 112 citrate, effervescent .... 112 hydroxid 112 hydroxid, solution of... 113 iodid 113 permanganate 114 tartrate and antimony. 23 Poultices (cataplasmata).. . . 49 Powder, compound efferves- cing- 112 Dover's 100 of glycyrrhiza, compound 75 of ipecac and opium. . . . 100 of jalap, compound.... 90 Seidlitz 112 Powdered opium 100 Powders 115, 151 Precipitated calcium carbon- ate 41 calcium phosphate .... 43 chalk 41 Protargol 114 Protectives 151 Protiodid of mercury 80 Prunus virginiana 115 virginianae syrupus . . . 115 Pseudoleukemia sodium cacodylate in... 129 Psoriasis arsenic trioxid in 27 desiccated thyroid glands in 73 sodium cacodylate in ... 129 Pulse, to accelerate 153 to slow 153 Pulveres, pulvis ; see powder, powders 115 Purgatives, mercurial 153 saline 153 vegetable 152 Pyelitis hexamethylenamin in . . 7G Quinin 115 and urea hydrochlorid. . 117 bisulphate 116 hydrochlorid 116 sulphate 116 tannate 116 Uelapsing fever salvarsan in 120 Resin of podophyllum 109 Resins Resorcinol Respiratory system, drugs used for their effects on the Rhamnus purshiana extract of fluidextract fluidextract, aromatic . . Rheumatic fever, drugs used in Rheumatism potassium acetate in ... sodium s-alicylate in.... Rhubarb (rheum) extract of syrup of, aromatic tincture of, aromatic. . . Ricini oleum Rochelle salts (potassii et sodii tartrates) Rosacea ichthyol in Rose oil of water Rosin Saccharin (benzosulphinid) . . Saccharum lactis Salicylic acid Salivation, to lessen Salol (phenyl salicylate) . . . . Salt, common (sodium chlo- rid) Salts, effervescent Epsom (magnesii sul- phas) Glauber's Rochelle (potassii et sodii tartrate) Salvarsan . PAGK 117 117 Santal, oil of Santonin Sapo linimentum mollis Sarsaparilla syrup of, compound.... Scabies balsam of Peru in sodium sulphite in.... Scilla syrupus tinctura Scleritis ethyl-morphin hydrochlo- rid in Scopolamin hydrobromid . . . Seborrhea ointment of ammoniated mercury in Secretion, to increase Soidlitz powder (pulvis effer- vescens compositus) . Senna fluidextract of syrup of Serum, antidlphtheric antitetantc 155 118 118 118 118 156 109 132 118 119 119 119 119 112 119 120 120 117 35 120 120 12 151 104 130 120 93 133 112 120 122 122 122 123 123 123 123 33 133 123 124 124 15 124 84 152 112 125 125 125 126 126 166 INDEX PAGE Serums and vaccines 125 Silver nitrate (argent! nitras) 25 molded 26 proteinate (protargol) . . 114 Sinapis 126 charta 127 nigra 126 volatile oleum 127 Skin disease arsenic trioxid in 27 bismuth subgallate in . . 37 Skin, drugs used for their ef- f ect& on the 157 Soap 122 liniment 123 soft 123 Sodium arsanilate 127 arsenate 127 benzoate 127 bicarbonate 128 borate 128 bromid 129 cacodylate 129 carbonate, monohydrated 130 eWorld 130 diethyl-barbiturate .... 144 hydroxid 130 hydroxid, solution of . . . 131 iodid 131 nitrite 131 phosphate 131 phosphate, effervescent. 132 salicylate 132 sulphate 133 sulphite 133 tartrate and potassium. 112 thiosulphate 133 Solution, Donovan's (arsen- ous and mercuric lodids) 29 Fowler's (potassium ar- senite) 28 Labarraque's (chlorin- ated soda) 45 of aluminum acetate. ... 18 of ammonium acetate ... 20 of arsenous acid 29 of arsenous and mercuric iodids 29 of calcium hydroxid.... 44 of chlorinated soda 45 of cresol. compound .... 59 of formaldehyd 71 of hydrogen dioxid 85 of lead subacetate 109 of magnesium citrate. . 92 of potassium arsenite. . 28 of potassium hydroxid.. 113 of sodium hydroxid 131 of zinc chlorid 145 Solutions 91 Spartein sulphate 134 Sporotrlchosis potassium iodid in 113 Spasm hydrated chloral in 50 to lessen movement and relax 153 Spirit of ammonia, aromatic. 21 of camphor 46 of chloroform 52 PAGE of ether 15 of ether, compound 15 of g-lyceryl nitrate .... 75 of nitroglycerin 75 of nitrous ether 15 of peppermint (menthae piperitae) 94 Sprains solution of lead subace- tate in 109 Squill (scilla) 123 syrup of 124 tincture of 124 Starch (amylum) 23 Stimulants 155 Stramonium 134 Strophanthin 134 Strophanthus 135 tincture of 135 Strychnin 135 nitrate 136 sulphate 137 Styptics 151, 154 Sugar (saccharum) 120 of lead 108 of milk 120 Sulphonal (sulphonmetha- num) 138 Sulphonethylmethane 137 Sulphonmethane 138 Sulphur 138 ointment 138 precipitated 138 sublimed 138 washed 138 Suppositories 138 of glycerin 74 Supracapsulin, suprarenalin, 1-suprarenin synthetic (epinephrin) 63 Syrup 120 of ferrous iodid 69 of ipecac 90 of rhubarb, aromatic... 119 of sarsaparilla, compound 123 of senna 125 of squill 124 of Tolu 34 of wild cherry 115 Syphilis drugs used in 156 Tablets, compressed 139 Tablet-triturates 139 Tannalbin 13 Tannic acid 12 glycerite of 13 Tar (pix liquida) 108 Tartar emetic (antimony and potassium tartrate) . . 23 Terebinthina 139 oleum 139 Terpin hydrate 139 Tetanus antitoxin (serum antitetanicum) 126 drugs used in 157 Theobroma, oil of 140 Theobromin 140 sodium salicylate 140 Thvmol 141 * iodid 141 INDEX 167 PAGE Thyroid glands, desiccated.. 73 Tiglii oloum 141 Tincture of aconito 13 of ammoniated valerian. 144 of belladonna leaves... 34 of benzoin, compound. . . 35 of cannabis indica .... 47 of capsicum 48 of cardamom 49 of cinchona 53 of cinchona, compound. 54 of colchicum seed 57 of digitalis 62 of ferric chlorid 68 of gentian, compound ... 73 of ginger 146 of hyoscyamus 86 of Indian cannabis .... 47 of iodin 89 of lobelia 91 of myrrh 98 of nux vomica 98 of opium 100 of opium, camphorated. . 100 of opium, deodorized. . . . 100 of rhubarb, aromatic.... 119 of squill 124 of strophanthus 135 of valerian, ammoniated 144 Tinctures 141 Tolu, balsam of 34 syrup of 34 Tonsillitis capsicum in 48 Trachomatous lids copper sulphate in 59 Tragacanth 142 Trinitrin 75 Trlonal (sulphonethylme- thanum) 137 Triturations 142 Troches 142 Trypanosomiasis, drugs used in 157 Tuberculin 142 Tuberculosis sodium cacodylate in... 129 Turpentine (terebinthina) . . 139 Typhoid fever calcium chlorid in 41 ergot in 65 Ulcer of the stomach bismuth subnitrate in . . 37 Fleers compound tincture of benzoin in 35 Unguentum : See Ointment. Urea and quinin hydro- chlorid 117 Urethritls, gonorrhea copaiba in 58 PAGK Urine, drugs to render urino less acid 158 drugs which may change color of 158 Drotropin (hexamethylcna- mina) 76 Urticaria arsenic trioxid in 27 Uterine hemorrhage fluidextract of hydrastis in . 85 Vaccina Vaccine virus Vaccines and serums Valerian ammoniated, tincture of Vallet's mass Vasoconstriction, drugs for.. Veronal Viburnum prunifolium prunifolium, fluidextract of Vina Vincent's angina salvarsan in Vinum antimonii Virus vaccinum Vitriol, green Volatile or essential oils .... Vomiting, drugs to lessen irritation and Warts nitric acid for Water (aqua) ammonia camphor chloroform cinnamon peppermint rose Waters (aquae) Wax. white (cera alba) yellow (cera flava) .... Wild cherry (prunus virgini- ana) syrup of Wine of antimony Wines (vina) Wintergreen, oil of Wool fat (adeps lanae hydratcd) Zinc acetate chlorid oxid oxid, ointment of . . solution of stearate sulphate Zingiber tinctura 14.'! 145 125 14.'! 144 68 151 144 144 144 145 121 23 145 70 90 1.1 25 20 46 52 54 94 120 25 49 49 115 115 23 145 94 14 145 145 145 146 145 146 146 146 146 APR 1 9 1982 Date Due 3 1970 00374 1219 UC SOUTHERN REGIONAL LIBRARY FACILITY A 000 499 565 o QV A 512 191 American Medical Association. A handboo of useful drugs UCI CCM LIBRARY