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remainder of the basis being added gradually, until the whole is thoroughly incorporated. A warm mortar may be required for hard extracts. Soluble salts should be triturated with a little water before adding the excipient. Camphor needs a little alcohol to enable it to be pulverized; and Iodine should be rubbed to a fine powder, then a little alcohol added and finally the excipient by degrees. Iodide of sulphur requires persevering work with a small portion of olive oil. Borax should be triturated with glycerin and Red Oxide of Mercury with distilled water. A bone or horn spatula should be used for all ointments, as steel or iron blades will injure many substances, particularly alkaloids, free acids, tannin or iodine, and several of the mercurial salts. Volatile substances should be added last, and quickly worked in, so that their evaporation may be as slight as possible.
Ointments are dispensed usually in amber-colored glass pots with wooden or metallic covers, or in porcelain jars called Gallipots. In hospital and dispensary practice the common chip pill-box is used, but soon becomes excessively dirty and disagreeable to handle.
R. Cerati Cantharidis, q. s.
Extende supra Emplastrum Resinæ hujus formæ et magnitudinis.
Sig. Blistering Plaster, to be applied over the region of the heart.
Plasters (Emplastra),—are rarely prepared extemporaneously, the official and many other ones being produced on a large scale by the manufacturers, and kept in stock by all druggists. As a consequence the compounding and spreading of a plaster by the pharmaceutist has become a lost art. The official plasters are enumerated and described on page 441, and may be ordered by prescription in the manner illustrated below. Blisters may be produced by the application of any preparation of Cantharides sufficiently strong for the purpose. Either of the official Cerates of Cantharides (see page 155), may be spread on Adhesive Plaster (Emplastrum Resinæ), making a blistering plaster; or Cantharidal Collodion (see page 155), may be painted over the surface. Plasters are usually ordered by the square inch, but a model of the shape and size may be drawn on paper, and the plaster be directed to conform thereto, as in the first of the following prescriptions. Two of the official Papers (Chartæ) are practically plasters, viz.-Charta Cantharidis and Charta Sinapis.
Counter-irritant and Anodyne.
R. Charta Sinapis,
Emplas. Belladonnæ, ää 3" x 6". Sig. Apply the mustard paper first, to be followed by the plaster when the surface has been well reddened.
Poultices (Cataplasmata),-are usually prepared at the residence of the patient, the ingredients only being ordered from the druggist. They are generally employed as a means of applying heat and moisture to a certain portion of the body, but are sometimes medicated with anodyne, counter-irritant or disinfectant agents. Poultices are not official in the U. S. Pharmacopoeia, but are in the British, the following list including all so recognized :
Cataplasma Carbonis,-Wood Charcoal 1, Crumb of Bread 4, Linseed Meal 3, Boiling Water 20 parts.
Cataplasma Conii,-Hemlock-juice 1, evaporated to half its volume, Linseed Meal 4, Boiling Water 10 parts.
Cataplasma Fermenti,-Beer Yeast 3, Wheaten Flour 7, Water at 100° F., 3 parts. Cataplasma Lini,-Linseed Meal 2, Boiling Water 5 parts, mixed with constant stirring.
Cataplasma Sinapis,—Mustard, Linseed Meal, Boiling Water and Water, of each a sufficiency. Cataplasma Soda Chlorinatæ,—Solution of Chlorinated Soda 1, Linseed Meal 2, Boiling Water 4 parts.
Paints (Pigmenta),—are preparations for external use, which cannot be classed with the preceding. They are generally prescribed in skindiseases, for use over inflamed joints, or for application to the throat with a camel's-hair brush.
R. Alcoholis, Saponis Viridis,
M. et fiat pigmentum.
R. Olei Tiglii,
Vapors (Vapores) and Inhalations (Inhalationes),—are medicines in the form of a vapor, a gas or an atomized spray, to be inhaled by the patient for their local action on the respiratory tract. The well-known steam-atomizer is the agent by which most of these preparations are administered, though many substances may be inhaled from the surface of hot water, from a sponge in a bottle surrounded by a hot cloth, or from a heated shovel. They are prescribed in the usual manner, as follows:
M. Sig.-Paint on once in 3 days.
The official Charta Potassii Nitratis, Nitre-paper (see ante, page 330), is a preparation intended for use as an inhalation, its vapors while burning being taken into the lungs.
Applied Therapeutics may be studied either with the various therapeutic agents as the objects of chief consideration, as in the first part of this work; or with the different diseases and morbid conditions forming the objects of study in respect to their modification and treatment by medicines. In the following pages the latter method is followed, the therapeutics of each affection being exhibited in the form of an Analyti cal Index to the recognized text-books of the day. Every indication for the use of a drug, or statement regarding its value, is followed by the initial (in parentheses) of its author: these references enabling the book to be used as an index to the authorities, for more strict differentiation between indicated remedies,-while the brief analyses given include enough to make each section a complete synopsis of the most advanced therapeutics of the disease forming its title.
The principal authors to whom references are made, and the various initials indicating them, are comprised in the following list:
REFERENCES AND BIBLIOGRAPHY.
(A.) Aitken.-The Science and Practice of Medicine.
(Ag.) Agnew.-The Principles and Practice of Surgery.
(B.) Bartholow.-Materia Medica and Therapeutics.
(Br.) Brunton.-Pharmacology, Therapeutics and Materia Medica.
(C.) Carter.-A Practical Treatise on Diseases of the Eye, edited by Green. (CI.) Clarke.-A Manual of the Practice of Surgery.
(D.) Druitt.—A Manual of Modern Surgery.
(E.) Emmet.—Principles and Practice of Gynecology.
(El) Ellis.-A Practical Manual of Diseases of Children.
(H.) Hamilton.-Nervous Diseases, their Description, etc.
(M. & P.) Meigs and Pepper.-Diseases of Children.
(Pf.) Piffard.-Materia Medica and Therapeutics of the Skin.
(S.) Stille.-Therapeutics and Materia Medica.
(St) Sturgis.-The Student's Handbook of Venereal Diseases.
(W.) Wood, H. C.-Therapeutics, Materia Medica, etc.
Besides the above-named, occasional references are made to other works by the same authors. References will also be found, with names in full, to Anstie, BrownSéquard, Clymer, Cohen, Da Costa, Fordyce-Barker, Gross, Hammond, Hilton, Lister, Mitchell, Nélaton, Noyes, Nussbaum, Ricord, Roosa, Simpson, Thomas, and others. When a statement is not followed by any reference it is to be understood as coming from the writer of this book.
The saline and hydragogue cathartics are of value in congestion of the portal circulation (B.). Saline Mineral Waters, especially the purgative saline waters, as Vichy and Saratoga, in plethora of the abdominal viscera (B.). Grape-cure has helped many cases, particularly those of hepatic engorgement and sluggish portal circulation; is best used after a preliminary course of powerful mineral waters (P.). Aliment is very important. A dry diet is particularly indicated in cases of dyspepsia and hepatic enlargement due to excessive beer-drinking. Avoid much bread, also salted or twice-cooked meats, rich sauces, solid vegetables, especially cucumbers, soups and fruits. Biscuits, fresh meat, lemons, fish, fowl and game, may be used. [Compare HEPATIC CONGESTION, OBESITY.]
Opium, cautiously in threatened abortion, is often very valuable (Wa.) ;-the tincture, mxx-xxx by rectum (Parvin);—Opium to check uterine action and Ergot to restrain hemorrhage (B.). Ergot, small tonic doses give excellent results in threatened abortion (P.). Tannin, combined with Opium and Ipecac (W.). Cimicifuga, to prevent miscarriage when uterus is irritable and prolapsed (R.). Savine, the dried powder of the leaves, gr. xv-xx, thrice daily, one of the most powerful remedies against the hemorrhage indicative of approaching abortion (Wa.);—the tincture in doses of 5 to 10 drops, every 2 to 3 hours, useful against the hemorrhage (P.). Viburnum Prunifolium, in threatened and habitual abortion, has a very high reputation. Aurum Chloride, to avert the tendency to habitual abortion (B.). Iron, with Potassium Chlorate, throughout the pregnancy, when fatty degeneration the cause of habitual abortion (McLane). Tamponade, of the cervix uteri, with cotton or sponge, dipped in vinegar or glycerin, when abortion is inevitable and it is desirable to hasten it and restrain hemorrhage. Empty uterus thoroughly with the finger, placentaforceps liable to do harm (Barker). Abortifacients, see pages 48 and 236. Quinine and Ergotin, of each gr. ij in pill every 3 hours, the routine abortifacient of many irregular practitioners. Only by the production of such violent irritation of the abdominal and pelvic organs as generally endangers life, can the pregnant uterus be stimulated to expel its contents (P.). The abortifacient effect of Savine and other drugs cannot be obtained unless by the administration of a quantity sufficient to endanger life (B.).