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Ol. Amygdale Amaræ.
Tinct. Gentianæ Comp.
Compounding the Mixture is a matter of no slight importance, and one which is best learned at the dispensing counter, though a few directions may not be out of place. In the case of the simplest form of mixture, where two or more fluid preparations are prescribed together, the only operations required are the measuring of the several ingredients and pouring them into the designed vial. In doing this the compounder should pursue a regular and definite order of procedure. Taking in his left hand a graduate of sufficient capacity to hold the whole quantity prescribed, he should walk along the shelves, and with the right hand pour from the stock-bottles the requisite quantity of each ingredient in the order in which they are entered on the prescription. A skillful clerk will hold the graduate between the thumb and first finger, the prescription between the second and third fingers, and the stopper of the stock-bottle between the little finger and the hand, leaving his right hand free for the manipulation of the bottles containing the ingredients.
When an actively poisonous agent is ordered it should always be the last thing put into the mixture. Attention to this rule will prevent the danger of the toxic substance being put in twice.
The order in which the ingredients are put together is not of so much importance in compounding a simple mixture as in the case of an emulsion, and the order of the prescription can usually be followed, with the exception noted in the preceding paragraph. Still, when several alcoholic preparations, syrups and waters are ordered together, it is good practice to first mix the alcoholic fluids, then to add the syrups and finally the water, so as to avoid the precipitation of resinous principles which would occur if the alcoholic solutions were added to the water. Distilled water should always be used, in order to insure uniformity in taste and appearance, and also as a matter of purity and cleanliness. All mixtures should be well shaken before being labelled.
Solids which are comparatively insoluble or only slowly soluble require to be rubbed up in a mortar with one or more of the fluid ingredients. Glass mortars are much employed for this purpose, and many compounders mix all the ingredients in such a mortar before transferring them to their vial. Vegetable powders (as Rhubarb, Ipecac, etc.), or finely pulverized inorganic substances, are often ordered in intimate mixture with water, thickened with mucilage or syrup. In such cases the mixture should be made in a porcelain or wedgewood mortar, enough mucilage or syrup being added at first to make a thick paste, and after this is rubbed smooth the water may be gradually added during the continued process of mixing. This process will answer for all inorganic substances in powder, except Magnesia, which is best mixed by being thrown on the surface of the water, and after it has sunk to the bottom as a uniform sediment the other ingredients may be added, and the whole well shaken. Froth upon the surface of the liquid, which often arises after agitation, and may prevent the corking of the bottle, will quickly subside on the addition of a few drops of alcohol.
The following are samples of prescriptions for medicines to be administered in mixture form :-
Bismuth Mixture for Children.
Misce. Signa. A teaspoonful every hour in choleraic diarrhoea.
R. Bismuthi Subcarbonatis,
Quinine Mixture for Children.
B. Quinine Sulphatis (pulv.), 3 ss.
Emulsions (Emulsiones),-are mixtures containing an oil or a resinous substance in a state of minute subdivision, and suspended in water by the aid of some viscid excipient, as gum, soap, alkali, or yolk of egg.
NATURAL EMULSIONS comprise two classes of substances,-(1) those emulsions which exist ready formed in nature, as milk, yolk of egg, the milky juices of plants, etc.; and (2) the mixtures formed by rubbing up gum-resins (as Ammoniacum, Myrrh, Asafetida) with water. Each of the latter substances contains, together with its resin, enough gum to make a perfect emulsion when triturated with water. The manufactured emulsions are simply imitations of the natural ones, sufficient gum being added in case of a resinous substance to cause its suspension in the aqueous diluent.
Emulsification consists in the division of the oily or resinous substance into very minute globules, and surrounding each globule with a thin envelope of the excipient. If properly done the globules will remain mechanically suspended in the water, without any tendency towards recombination. Milk is the best illustration of a natural emulsion, its butter existing in the aqueous portion as very minute globules, each surrounded by a thin
film of casein. Yolk of Egg is a dense emulsion, consisting of oil suspended in water by means of albumen.
THE EXCIPIENTS which may be used for emulsification are the following, arranged in the order of their most frequent employment, viz. :—
Mucilage of Acacia,-used for oils and resins. Powdered Acacia is even better, being made into a mucilage by the process of emulsification; such a mucilage having the advantage of being perfectly fresh when incorporated with the other ingredients. To give uniformly good results the following proportions in parts by weight should be used, viz. :— Gum Acacia, Water.
part of Fixed Oils or Copaiba requires,
I "Oil of Turpentine
Mucilage of Tragacanth,—may also be used for oils and resins, but it has not proved so satisfactory as the preceding. The same may be said of powdered Tragacanth.
Vitellus, Yolk of Egg, is an excellent agent for emulsifying oils, but mixtures made with it must be used within a few days, as they will not keep long. One yolk will emulsionize an ounce of fixed oil, and is about equal to half an ounce of Acacia. It is best suited to emulsions of cod-liver oil intended for immediate administration. The official Mistura Chloroformi is an emulsion made with yolk of egg. Glyceritum Vitelli or Glyconin is an official preparation consisting of glycerin and yolk of egg. (See ante, page 408). One ounce of it will emulsify three ounces of fixed oil.
Liquor Potassa,-may be used for oils, the resulting compound being however a soap rather than an emulsion. Copaiba is usually emulsified by using both a gum and an alkali; a similar process being employed for many of the fixed oils.
Tincture of Senega,--will emulsify fats and oils very efficiently, and even in very small quantities, mx' emulsifying an ounce of fixed oil.
Tincture of Quillaia (Soap bark),—is a good emulsifier for oils, and is much used in Europe for this purpose.
Milk, is used to emulsify Scammony in the Mistura Scammonii, which is official in the British Pharmacopoeia.
Syrups, Confections and Extracts,—may be used in making emulsions, but are rarely so employed.
Soap,-is occasionally used for emulsifying Oil of Turpentine.
THE METHOD of preparing an emulsion which experience has shown to be the best, is as follows:-Add the oil, resin, etc., to a proper quantity of the excipient, and mix both thoroughly in a wedgewood mortar. Then add enough water to equal one-half the weight of the previous mixture, and triturate the whole rapidly and unceasingly until the emulsion is homogeneous and of a whitish color. Next, add the remainder of the water slowly, with continual stirring; finally incorporating the other ingredients, if any.
Emulsions are sometimes flavored and at the same time colored, with such a preparation as the Compound Tincture of Cardamom; but they present a better appearance when perfectly white. Alcoholic preparations should not be added in large quantity to emulsions made with Acacia or Yolk of Egg, as alcohol will precipitate the emulsifying agent. Volatile Oils require admixture with a fixed oil before being made into an emulsion. Soluble salts should never be prescribed with emulsions of oils. Acids are incompatible with mixtures which have been emulsified by an alkali. Mucilage used for emulsions should always be freshly prepared.
The following examples of prescriptions for emulsions will represent those generally met with:
Cod-Liver Oil Emulsion.
R. Olei Morrhuæ,
Ac. Phos. Dil.,
Aq. Amygd. Amar. ad.,
Bromide of Ammonium.
Bromide of Lithium.
Bromide of Potassium.
Elixirs (Elixiria), -are mixtures containing alcohol, water and sugar, with certain medicinally active ingredients, and supposed to be so prepared as to be particularly palatable, which is seldom true. There is one official elixir, Elixir Aurantii (see ante, page 124), which may be used as a basis for the extemporaneous prescribing of these preparations. The manufacturers have put on the market a great variety of elixirs, and most druggists keep a stock of them on hand prepared in the shop; but they may be ordered by prescription just as any other mixture would be. The substances generally used in this form are as follows:—
Liq. Potassæ, .
Iron, Tincture of the Chloride.
Valerianate of Ammonium.
Many of these agents are combined with each other, as in the Elixir of Bismuth and Strychnine; Elixir of Calisaya, Iron and Strychnine; Elixir of Gentian with Tincture of Chloride of Iron; Elixir of Iron, Quinine and Strychnine, etc., etc.
A Draught (Haustus),—is an extemporaneous mixture consisting of a single dose, and usually ordered in a vial containing from one to two fluidounces.
Effervescing Draught is one of the best known. It is prepared by neutralizing a watery solution of Potassium Bicarbonate with Lemon juice or Citric Acid, and may be drunk during effervescence. When the CO, has escaped it is a solution of Potassium Citrate in water, and corresponds to the official Mistura Potassii Citratis, or Neutral Mixture. (See ante, page 330.)
Black Draught is another well-known preparation of this class. It is official as Infusum Sennæ Compositum. (See ante, page 372.)
A Drink (Potus),—is a solution or a mixture intended to be used ad libitum, and generally consists of a Potassium or Sodium salt; or a mineral acid, in dilute solution, sweetened and flavored.
The "Imperial Drink" is made after the following formula: R. Potassii Bitartratis, 3ij; Olei Limonis, mv; Aquæ Bullientis, q. s. ad 3 xx. M. Fiat potus. Sig.-Use as a drink.
A Gargle (Gargarysma),—is a mixture or solution for application to the pharynx or the mouth (mouth-wash). It should never contain any active drug, which would produce dangerous symptoms if swallowed; nor any agent which would injure the teeth or the mucous membrane. Gargles are ordered and compounded in the same manner as mixtures. They usually contain astringent or disinfecting salts (Alum, Borax, Sulphate of Zinc, Chlorate of Potassium), with a vegetable astringent, and often Honey. The following formula will illustrate prescriptions of this class:
R. Tr. Guaiaci Ammoniatæ,
Tr. Cinchona Comp., .
Aquæ, q. s., ad Fiat gargarysma.
R. Sodii Boratis, .
ää 3 ij.
Lead-water and Laudanum.
R. Liq. Plumbi Subacetatis, . . 3j.
Fiat lotio. Sig.-Lotion.
A Lotion (Lotio) or Wash,-is a solution or mixture of medicinal agents, intended for external application; and usually consists of some soluble, astringent salt, dissolved in water, with perhaps some glycerin or alcohol. A Fomentation (Fotus) is a similar preparation used hot. A Collyrium is an eye-wash, and generally contains a soluble astringent salt dissolved in rose-water or distilled water, in the proportion of gr. j-iv to the 3. The only official preparation suitable for a lotion is the Liquor Plumbi Subacetatis Dilutus, or Lead-water. A well-known anodyne, refrigerant and astringent lotion is that represented by the first two of the following prescriptions.
R. Aluminis, .
ǎa 3 ss.
M. Fiat collyrium. Sig.-Eye-water;
a few drops to be put into the eye three or four times daily.
Lead and Opium Wash.
R. Liq. Plumbi Subacetatis,
R. Zinci Sulphatis,
Collyrium of Four Sulphates.
aa gr. j.
Aqua Destillatæ, .
M. Fiat collyrium. Sig.-For use with brush to palpebral conjunctivæ, and to be washed off with clean water.
Liniments (Linimenta), -are mixtures intended for external applica