EXTEMPORANEOUS PREPARATIONS. 497 in fine powder, and rolled into a long cylinder by the aid of a broad-bladed spatula, until the mass is of a length corresponding to the divisions on the tile-scale which represent the number of pills to be made. The mass should then be placed along the scale, and a cut made through it with the spatula at each division of the scale, the pieces being at once rounded separately into pills by the thumb and two fingers of each hand. A pill-machine is often employed, consisting of two metal plates having semicylindrical grooves on one side, and set into wooden boards, the whole forming a convenient apparatus for rolling the mass and then cutting it into the required number of pills by one movement. The pills are then left to dry upon the slab while the label is being written, after which they are placed in a pill-box, or in a widemouthed bottle if they contain volatile ingredients, and surrounded by a conspergative powder (Lycopodium, powdered Chalk, dusted Talc), to prevent their adhering together or losing their shape. EXCIPIENTS used in pill-making are seldom mentioned in the prescription, but are usually left to the choice of the compounder. Some substances need no excipient, but may be made at once into pills; such being the softer Extracts and some Gum-resins, the former if too hard only needing a little water, and the latter a few drops of spirit to soften them to the required degree of plasticity. Every druggist has his favorite pill-excipient, many using a paste made of powdered Tragacanth 1, Glycerin 31⁄2 and Water I part, while others use Extract of Malt, or a mixture of Syrup and powdered Acacia, for general use. Powdered Tragacanth to give tenacity, Glycerin to keep the mass soft, and Water to develop the adhesive qualities of many ingredients, will answer for fully nine-tenths of all the cases which occur in practice. These three excipients should stand on the dispensing counter ready for use, and all ready-made pastes or mixtures should be discarded, as being slovenly, dirty and liable to change. The excipients described below are those in general use, and are arranged in the order of their comparative importance, viz. : LIQUID EXCIPIENTS. Glycerin,—is a very valuable excipient, as it continually attracts moisture from the atmosphere, and pills made from it do not get hard. It should be used always for Quinine pills. Glycerites of Starch or Tragacanth are generally useful excipients. The former is official, the latter is made in the proportion of 3ss to the 3. Glucose, is a good excipient, being colorless, adhesive, and not readily volatilized at ordinary temperatures. Since its introduction by Mr. Lascheid for this purpose it has steadily grown in favor. Honey,-may be used for dark-colored substances. It should be evaporated to one-half its bulk, and then if mixed with a little Tragacanth, it makes an excellent excipient for insoluble powders. Extract of Malt,-is a pretty fair excipient, but has the disadvantage of its dark color. Syrup, is a fair excipient for powders, but it should not be used for metallic salts, especially Calomel, which it reduces in a short time. Syrup of Acacia is good where there is little room left for the excipient, but if kept long, pills made with it become very hard and insoluble. Mucilage of Acacia,-is very adhesive, but not same reason as given for the syrup. good excipient for the Water, is only used alone as an excipient when the ingredients possess sufficient adhesiveness to be developed by the water. Such are the following powders: Aloes, Rhubarb, Kino, Tannic Acid, Opium, Squill, Asafetida,— also Citrate of Iron, Sulphate of Berberine, etc. Alcohol, is used to soften Camphor, Compound Extract of Colocynth, Guaiac, resinous extracts, gums, etc. SOLID EXCIPIENTS. Tragacanth,—is an excellent excipient, especially for substances which are too soft, giving them body and elasticity. Acacia, is added to give more adhesiveness than can be obtained from viscid liquids alone. Pills made with it are generally very hard. It is used for Nitrate of Silver, which may explode if mixed with vegetable extracts or glucose. Soap,-is the best for resinous and fatty substances, increasing the solubility of the former. It is more employed in the official pills than any other excipient, but should not be used for substances which are decomposed by an alkali, nor for Tartar Emetic. Bread-crumb (Mica Panis),-is an excellent excipient for Croton Oil, or other powerful liquid substances, as Volatile Oils. Confection of Rose,-is too bulky for general use, but is a good excipient for very active agents, like Strychnine, which are used in small quantity. Althea,-is good for absorbing and adhesive purposes, but is too bulky for general use. Petrolatum, Cacao Butter and Resin Cerate,-are used for oxidizable substances, as Potassium Permanganate. Kaolin,-is well adapted for Nitrate of Silver, and other substances which are easily decomposed. Liquorice, is an old excipient, but not much employed now. it may be used for oils. In powder CONSPERGATIVES,-are absorbent powders which are dusted upon the finished pills and put around them in the box or vial in which they are dispensed, to keep them from sticking together and losing their shape. Powdered Liquorice was formerly much used for this purpose, but the best conspergatives are Lycopodium, Tatt, Althea, and Rice Flour, the latter especially for white pills. SUBSTANCES SUITABLE for the pilular form of medicine are the following: Those acting in small doses. Those intended to act slowly. Heavy, insoluble substances. Those to act on the lower bowel. Vegetable extracts. Gum-resins, Balsams, Turpentine. EXTEMPORANEOUS PREPARATIONS. 499 When the basis is an unadhesive substance, one of the other ingredients should be an extract or a vegetable powder, which will form a mass by moisture alone. Attention to this rule in prescribing pills will often prevent the increase of their size by inert excipients. DIFFICULT SUBSTANCES to combine, except by peculiar treatment, are met with frequently. The following notes will cover most of these cases. Aloes,-is best treated on a heated slab with alcohol in very small quantity. Soap is the excipient in the official Pilula Aloes. Butyl Chloral Hydrate,-should be treated with a little Confection of Rose and thick mucilage. Calcium Sulphide,-should be well triturated with an equal quantity of Sugar of Milk, and then worked up with a little powdered Liquorice-root and Tragacanth Mucilage. Camphor,should be powdered with a little alcohol, and may be worked into a pill-mass with Glycerite of Tragacanth after the evaporation of the alcohol. Carbolic Acid,-requires nearly an equal part of wheaten flour or bread. crumb, with a very minute quantity of Glycerite of Tragacanth. Creasote may be made into a mass by the addition of powdered Liquorice with a very little bees' wax. If made into a pill with Oxide of Silver it will explode unless the silver salt be first diluted by trituration with Liquorice, Gentian or some other inert powder. Citrate of Iron and Quinine,—is very deliquescent with most excipients. Canada Balsam is the best for it. Copaiba,-may be made into pill-mass by the addition of a little Carbonate of Magnesium or Wax. Croton Oil,-is best worked up with bread-crumb, though powdered Liquorice and mucilage may be used. Ferrum Iodide,-in pill form requires special manipulation and protection to remain unoxidized. The official Pil. Ferri Iodidi is prepared with Iodine and Reduced Iron, has Liquorice, Sugar and Acacia as excipients, and is protected by a coating of Balsam of Tolu (see ante, page 191). In other for mulæ Acacia, Althæa, Cocoa-butter, Elm-bark and Liquorice are used as excipients. Ferri Sulphas,-is used in Blaud's Pill and in the official Pil. Ferri Compositæ, with Carbonate of Potassium, to form by mutual decomposition Ferrous Carbonate, which quickly passes into the ferric salt by exposure. Myrrh in powder and Syrup are the excipients used for the official pill. Gallic Acid,-makes a good pill with a very small quantity of Glycerin. Tannic Acid requires about one-fifth its weight of Glycerin and one-tenth of Mucilage. Phosphorus, presents the problem of combining it in pill without letting it oxidize. This is believed to be accomplished by the pharmacopoeial directions for the Pil. Phosphori, according to which the Phosphorus is dissolved in Chloroform in a test-tube, then quickly worked into a mass with Althæa, Acacia, Glycerin and Water, and finally the pills are coated by shaking with an Ethereal solution of Balsam of Tolu. Carbon Bisulphide is a better solvent, but when it is used the pill-mass retains its disgusting odor. Potassium Acetate,-requires Canada Balsam to secure its stability in pill form. Potassium Iodide is best manipulated by rubbing into a smooth paste with a very little water, then adding a small quantity of Liquorice powder. Potassium Permanganate should be worked up with kaolin and a very little water. Resin Cerate, Soft and Hard Paraffin and Cacao-butter are also used as its excipients. Quinine,-requires very clean hands and tools, and a colorless excipient, as Glycerin or Glucose, to make a nice looking pill. If one part of Tartaric Acid is added to four of the Quinine salt the mass will be less likely to crumble and will be of less bulk. Sulphate of Quinine may be made into small and soluble pills by simply triturating it with Aromatic Sulphuric Acid miij to each 5 grains of the salt. The moulding into pills should be done at the moment when the mass has begun to dry. A drop of syrup or honey, added at this time, will prevent the too rapid hardening of the mass. Rhubarb,-in powder makes a good mass with one-fifth of its weight of Glycerin; but Soap is the excipient ordered for the official Pilula Rhei. SUBSTANCES UNSUITED to the pilular form are: Those requiring large doses, and those which are volatile. Emetics, and other agents administered for immediate effect. Essential Oils in quantity exceeding half a drop to each pill. Oils and other bodies which require much solid matter to make a mass; except those having a very small dose, as Croton Oil. Deliquescent Salts, unless intended to be used immediately. Efflorescent Salts, unless deprived of their water of crystalliza tion. EXTEMPORANEOUS PREPARATIONS. 501 COATED PILLS are manufactured upon a large scale by the large drug houses, extensive machinery being employed for the purpose. The coating material used is either Sugar or Gelatin. The U. S. Pharmacopoeia directs that two of the officials pills shall be coated by being shaken with a solution of Balsam of Tolu in Ether, viz.-Pil. Ferri Iodidi and Pil. Phosphori. In extemporaneous pharmacy it is rarely practicable to coat pills with any thing except gold or silver leaf, and this is sometimes directed by the prescriber, the word "Deaurenter-let them be gilded being used in the subscription. To do this neatly the pills should have no trace of powder on them, but should be first coated with a trifle of fresh mucilage by rolling between the mucilage-moistened fingers, each pill being then dropped directly on to a sheet of gold or silver leaf, until a dozen or more are so deposited. The leaf and its pills are then allowed to slide into a globular boxwood shaker, or the leaf may be first placed in the shaker and the pills dropped on it there. A cautious circular movement being given to the shaker the pills are caused to travel around its walls, and when the cover is removed they will be found to have each received an even coating of the metal used. Gold leaf should always be employed for pills of Blue Mass or Asafetida, as silver is amalgamated with the former and turned black by the latter. Albumen may be used for coating small numbers of pills, which should be of very firm consistence before the coating is applied. Each pill is rolled between two fingers with a little white of egg, and then revolved in a warm pan. Another method of finishing them is, after coating with albumen, to rotate them in a tray with powdered French chalk until their surfaces become smooth and shiny. When carefully done this process gives a very nice finish. COMPRESSED PILLS, as now largely manufactured by several reliable firms, consist of various medicinal powders pressed into pill or tablet shape by machinery. They are extremely convenient preparations for the physician's use, as quite a variety can be carried in a pocket-case, and as slight pressure is sufficient to reduce them to powder, they can be dispensed with facility and accuracy of dosage. Messrs. John Wyeth & Brother, of Philadelphia, manufacture a very extensive line of these pills, including nearly all those put up in the sugar-coated or gelatin-coated form by other houses. The trade-list of this firm should be in the hands of every physician who keeps a small stock of medi. cines in his office, or who carries a pocket-case of drugs. The following list includes the most important of these preparations, the figures representing the number of grains in a pill in each case. |