T

MITHRIDAT AND THERIAC.

(Concluded.)

HE fame which the theriac of Andromachus attained as an antidote soon led it to be regarded as a universal panacea. Indeed, so great was the esteem in which it was held that edicts were issued by the colleges of medicine and the magistrates regarding the purchase and keeping of the ingredients that entered into its composition; and the actual compounding of the theriac became a public function. Thus, we find an ordinance issued in the city of Nuernberg in 1547, commanding that Mithridat, Theriac and other “fuernembsten Arzeneycn" are not to be prepared by the apothecaries until after a commission of physicians had inspected the ingredients and certified to their good quality. Hieronymus Brunschwyk writes in the sixteenth century:

"When Theriac is to be made, each of its component parts should be exposed for at least two months in a public place, as at Venice, so that the wise men and the doctors may inspect them, and decide whether or not they are fit for use."

We know that in the seventeenth contury Moise Charas never prepared Theriac save under the eyes of the magistrates of Paris, the court physicians, and delegates representing the school of Medicine, a practice which was continued until near the end of the eighteenth century and which was attended with great solemnity, as is proved by the following public notice, issued at Paris in 1776:

"Theriac of Andromachus.-The Company of Apothecaries at Paris shall expose to public view all of the drugs which enter into the composition of Theriac. The drugs will be opened in the presence of the magistrate and the School of Medicine on Monday, September 23, 1776, at precisely three o'clock,

in the Company's garden and laboratory, Rue d'Arbalete, Faubourg St. Marcel.

"The whole shall be exposed for fifteen days, every day from 3 P. M. until 6 P. M., after which exposure we shall proceed to the preparation of this antidote in the presence of the worshipful magistrates and of the Faculty of Medicine." An Interesting Sample of Polypharmacy.

Among the many writers on this supposedly wonder working preparation was a famous Italian physician named Guilelmo Rondeletti, who after an elaborate description of the ingredients gives the formula for the Theriac which was officially adopted by the learned doctors of Montpellier. This is so curious a piece of polypharmacy that we reproduce it in the original Latin: Rp.

Pastillorum Scillinorum, drachmas XLVIII

Pastillorum Theria

Polij cretens
Seselios
Styracis
Seminis Apii
Thlaspi
Ammeos
Chamaedryos
Chamaepitos
Succi hypocisthidis
Nardij Gallicae
Radicis Gentianae
Anisi

Mel Athamantici
Seminis foeniculi
Terrae lemniae
Chalcitidis

Amomi

Acori

Phu Pontici
Carpobalsami

Hyperici
Acaciae

Gummi

Cardamomi, an

drachmas IV

Seminis dauci

Galbani
Sagapeni

Onoponacis

Bituminis
Castorei

Centaurij tenu
Aristolochiae tenuis,
aa drachmas II
Mellis Attici
Vini Falerni q. s.

The first three ingredients contained twenty-three substances, and the Theriac, therefore, was a compound of eighty-five

simples. It is perhaps needless to say that an article of this kind was extremely expensive, and utterly beyond the reach of the poor. For their benefit a simpler preparation, composed of only thirteen. ingredients was made; and this, we fancy, was every bit as efficacious as the more elaborate one.

The fourth Austrian Pharmacopoeia had a formula for "Theriaca Andromachi" calling for twelve ingredients; but this preparation was merely an aromatic electuary possessed of no medicinal value. The days of polypharmacy are past, and it is inconceivable that a day will ever come when combinations like Mithridat and Theriaca Andromachi will be restored to the proud place which they once upon a time occupied in the official books of standards.

THORIUM PASTE,

Fred M. Dearborn describes this in the Habuemannian Monthly. Like all thorium studies, he says, we start with thorium oxide known as thoria, and by

precipitation and other chemical manipulation thorium X, a highly radio-active substance, is supposedly produced. The protoxide and sulphate of lead, sulphuric acid and a small amount of hydrochloric acid are used to complete the preparation. This semi-liquid paste is creamy in consistency, and greyish-white in color; separates when standing into a lower layer of the metallic elements and an upper layer of liquid, acid in reaction, caustic in action and translucent.

Ordinarily it should be thoroughly mixed and applied with a camel's hair brush, orange stick or narrow wooden spatula. Cotton on a probe may be used, or the end of a wooden tooth pick, if only a small quantity is desired. Experience alone will show whether the full strength is best for any particular case. If not, wash off the liquid to any extent needed and the destructive effect will be lessened in proportion as it is diluted. I have found it wise to apply

full strength to those lesions that present unbroken surfaces, such as discoid and nodular epitheliomata, nævæ, verrucæ, and lupus erythematosus. The same rule holds good where counter irritation and stimulation are desired. When ulcers and raw surfaces are to be treated, the surfaces should be dried as thoroughly as possible, usually by pressure and a degree of dilution used, consistent with the depth, extent, duration and location of the lesion. Pain at the seat of application may be experienced, lasting not longer than four hours in the more exposed lesions. Usually burning, aching and smarting are experienced in varying degrees. For extensive use, that is, in its application, to large areas of diseased. skin, a one to five per cent strength in water should be used and as the surface becomes more healthy, the strength may be increased or you may use various strengths simultaneously on different sections of the same growth. For the treatment of indolent scaly eczema and old persistent psoriasis, thorium is best. applied in lanolin, using ten to twentyfive per cent of the paste. It might be well to add that thorium paste which dries as a thin white layer should be allowed to remain as long as possible, and it is often well to paint a fresh coating over the old one unless serous discharges have loosened the former application. In cases that are very sensitive to pain, I have applied the paste to the healthy scab, hence securing a good foothold and not subjecting the patient to unnecessary suffering. These applications of thorium may remain, if undisturbed, from five days to three weeks. and may be protected by bandages, vacbecoming thoroughly dry. cination shields and other means, after

This preparation is radio-active, as can easily be proven; it has antiparasitic, antiseptic, antipruritic, escharotic and stimulatory effects. Thorium salts, no doubt, possess some special properties of their own, for it is believed that all radio

active substances have certain chemical and physical peculiarities, and many possess material advantages over radium, so it is probable that as they are better understood, their usefulness may greatly exceed that of radium, which is the only radio-active substance now largely in use. From the standpoint of radioactivity, the chief objection to salts other than those of radium, is their lack of certain rays, and their their comparative radio-active weakness, but this objection. may be removed if it can be determined just how strong, relatively speaking, the thorium X examinations are in this

formula under consideration, and to just what extent their strength may be sufficiently constant; in other words, how long will this paste retain enough radioactive power, to be useful therapeutically.

OINTMENT ROSE WATER.

Therapeutic Medicine thinks the official formula for Ointment Rose Water (Unguentum Aquae Rosae) is a good one and answers practically all pharmaceutical requirements. However, according to Valentine Schmidt, of San Francisco, there are several objections to it, namely: its cost and its instability (particularly in hot weather). He suggests replacing the expressed oil of almonds. by pure white Russian mineral oil, and the rose water by distilled water and oil of rose. The following formula has been in use for years and has given perfect satisfaction in every respect:

briskly for a few minutes, then add the oil of rose, continuing the stirring until cool.

Thus, prepared, it is a snow-white, elastic, creamy-looking ointment, which will keep almost indefinitely.

WASHED SULPHUR.

The Eclectic Review remarks that sulphur, when thoroughly washed with distilled water until the liquid has no acid reaction and then dried, becomes sulphur lotum. It is the form of sulphur commonly employed internally. The flowers. of sulphur (sulphur sublimentum) is usually employed externally and for purposes of fumigation.

This old remedy is now seldom mentioned by medical writers, but it often constitutes a good antiseptic, alterative, stimulant, diaphoretic and laxative. Some of our older practitioners may remember when the dear old grandmothers were wont to insist that it was absolutely necessary for all of the children to take sulphur and molasses at the close of the winter months. The rule was a goodsized dose every other morning for at least a week. The old ladies believed sulphur to be a "great purifier of young blood," and I am not prepared to prove that they were wrong. In chronic affections characterized by conditions usually regarded as of a scrofulous nature, sulphur has been employed with most gratifying results, and in catarrhal states of mucous surfaces following suppression of eruptions, it has proved an efficient. medicament. In skin diseases, especially when accompanied by itching, which is increased by warmth, it exercises a relieving influence, and in scabies its action is often promptly curative. In glandular enlargements sulphur constitutes a remedial agent of usefulness, but in this condition it is inferior to specific phytolacca. It has also been found of some value in secondary syphilis, and in rheumatic and gouty affections its action has given much satisfaction.

Sulphur is not only a good internal medicament, but useful in the form of an ointment. An ointment may be made from thirty parts of sublimed sulphur and seventy parts of benzoined lard, by rubbing the sulphur with the lard gradually added, until they are thoroughly mixed. The ointment should be applied with brisk friction, and its application preceded and followed by warm baths. It is especially valuable in scabies.

The dose of sulphur lotum is 1 to 15 grains, but it is efficiently employed in doses of 1 to 5 grains, in trituration or in tablets. As a laxative 30 to 60 grains in milk have given satisfaction.

POISONING BY MALE FERN.

A remarkable case of poisoning by extract of male fern is reported by MagnusLevy in the Berliner Klinische Wochenschrift of March 27. A soldier took a mixture of extract of male fern and castor oil with the object of removing a tapeworm. Soon after taking the dose, the patient was seized with vomiting and diarrhoea, and some hours later cramplike pains were felt in the left leg. The knee was fixed and the foot and toes paralysed, and convulsive movements appeared in the right leg and in both. arms. The left leg gave great trouble for some six weeks, but the symptoms were eventually got under by means of potassium iodide. Writing to the Lancet, in which an abstract of the article appeared, Dr. James Burnet, of Edinburgh, points out that it is most unwise to give either male or santonin in conjunction with castor cil. The oil dissolves the vermifuge drug and causes absorption into the system, with disastrous results. Calomel or some purgative other than castor oil should be used with these drugs. The danger of administering santonin with. castor oil has been pointed out a number of times.

Pardon my failure to reply earlier to your letter of inquiry of July 11th, 1911, but I have been away and did not get a chance to attend to this before besides having an article on the subject in preparation which I hoped would be out before this and which I would have sent you at once-I shall still do so as soon as I am able. This much I am glad to tell you at once. The Nauheim Baths have been found extremely beneficial in circulatory disturbances, particularly heart-trouble. Nauheim is a bath in the Taunus in Germany to which some 50,000 people flock annually to take the baths and drink the waters. The bath is a highly charged, carbonated water; as the bubbles of gas impinge upon the bathers skin and burst, they cause a gently but pronounced glow to spread over the entire body, and evidence of a decided increase in the surface-circulation thus unloading the heart by causing the blood to flow spontaneously into the superficial vessels without the heart hav

ing to pump and force it there. It thus acts much like GLONOIN (Nitro-glycerin) and like this is useful for the relief of symptoms associated with the high tension-pulse of chronic renal degeneration (White's or any other Materia Medica will give you details and indications). That the increase in the surface-circulation is mechanical, and directly due to the impact of the exploding gas-bubbles is neatly shown by the exact demarcation of a line showing exactly how far the body, or a limb, have been immersed; everything below the line being a dark brownish red in color and everything above being the normal white color of the natural skin.

The duration of a bath is from ten to twenty-five minutes according to prescription, depending on the patient's condition and needs; short baths in the beginning, gradually prolonged as the patient's strength and tolerance increases. Such symptoms as light-headedness, vertigo, fainting-spells being of course counter indications, their absence together with proper hearts-action and pulse on the contrary permitting the longer bath. The same rules hold good as to the temperature, low (about 90°F.) in the beginning, gradually increased to higher temperatures (105 and over.) These increases in duration and temperature are to extend over the entire course of the baths which consists of twentyone in number, given at the rate of three a week, thus making the entire course of seven weeks duration.

Of course during this time the patients must be closely watched as to the symptoms above above mentioned, as to stomach-condition, proper regulation of hours of sleep and exercise, diet, constipation especially being avoided, etc., etc. I formerly gave these baths right in my office which is arranged somewhat