Chapter 19 of 70 · 3971 words · ~20 min read

Part 19

This medicine may be dissolved in warm water, mint, or common tea. The powder can be kept for use in a wide-mouthed bottle, and be in readiness for any emergency. The druggist may be directed to treble or quadruple the quantities, as convenient.

654. Aperient Pills.

To some adults all liquid medicines produce such nausea that pills are the only form in which aperients can be exhibited; the following is a useful formula:

i. Take of compound rhubarb pill a drachm and one scruple, of powdered ipecacuanha ten grains, and of extract of hyoscyamus one scruple; mix, and beat into a mass, and divide into twenty-four pills; take one or two, or if of a very costive habit, _three_ at bedtime.

ii. For persons requiring a more powerful aperient, the same formula, with twenty grains of compound extract of colocynth, will form a good purgative pill. The mass receiving this addition must be divided into thirty, instead of twenty-four pills.

655. Black Draught.

The common aperient medicine known as black draught is made in the following manner:

i. Take of senna leaves six drachms, bruised ginger half a drachm, sliced liquorice root four drachms, Epsom salts two and a half ounces, boiling water half an imperial pint. Keep this standing on the hob or near the fire for three hours, then strain, and after allowing it to grow cool, add of sal volatile one drachm and a half, of tincture of senna, and of tincture of cardamoms, each half an ounce. This mixture will keep a long time in a cool place. _Dose_, a wineglassful for an adult; and two tablespoonfuls for young persons about fifteen years of age. It is not a suitable medicine for children.

656. Tonic Aperient.

The following will be found a useful medicine for persons of all ages.

i. Take of Epsom salts one ounce, diluted sulphuric acid one drachm, infusion of quassia chips half an _imperial_ pint, compound tincture of rhubarb two drachms. _Dose_, half a wineglassful twice a day.

657. Infants' Aperient.

The following may be used with safety for young children.

i. Take of rhubarb five grains, magnesia three grains, white sugar a scruple, grey powder five grains; mix. _Dose_, for an infant from twelve to eighteen months of age, from one-third to one-half of the whole.

ii. A useful laxative for children is composed of calomel five grains, and sugar a scruple, made into five powders. _Dose_, half of one of these for a child from birth to one year, and a whole one from that age to three years.

658. Flour of Brimstone

is a mild aperient in doses of about a quarter of an ounce; it is best taken in milk. Flour of brimstone, which is also called sublimed sulphur, is generally put up in ounce packets at 7d.; its wholesale price is 4d. per pound.

[A SPARK MAY RAISE AN AWFUL BLAZE.]

659. Medicines.

Preparations of them.--The following directions are of the utmost value in connection with the DOMESTIC PHARMACOPOEIA, DISEASES, PRESCRIPTIONS, and POISONS.

_They will be found most important to emigrants, attendants upon the sick, and persons who reside out of the reach of medical aid, sailors, &c., &c. They contain instructions not only for the compounding of medicines, but most useful hints and cautions upon the application of leeches, blisters, poultices, &c._

660. Articles Required for Mixing Medicines.

_Three glass measures_, one to measure ounces, another to measure drachms, and a measure for minims, drops, or small doses.

A _pestle and mortar_, both of glass and Wedgwood-ware.

A glass funnel.

Glass stirring rods.

A _spatula_, or flexible knife, for spreading ointments, making pills, &c.

_A set of scales and weights_.

_A small slab of marble_, or porcelain, for making pills upon, mixing ointments, &c.

661. Medicine Weights and Measures.--_Weights_.

When you open your box containing the scales and weights, you will observe that there are several square pieces of brass, of different sizes and thicknesses, and stamped with a variety of characters. These are the weights, which may now be explained.

662. Troy Weight.

Medicines are made up by troy weight, although drugs are bought by avoirdupois weight. There are twelve ounces to the pound troy, which is marked lb.; the ounce, which contains eight drachms, is marked [*ounce]i. [looks like a z on top of a 3]; the drachm, containing three scruples, is marked [*drachm]i. [looks like a 3]; and the scruple of twenty grains is marked [*scruple]i. [looks like a backwards C with a horizontal cross-bar]. The grain weights are marked by little circles, thus:

------- |o o| Five | o | Grains |o o| -------

Each of the grain weights, in addition to the circles denoting their several weights, bears also the stamp of a crown. Care must be taken not to mistake this for one of the numerals. Besides these weights there are others marked [*scruple]ss, which means half a scruple; [*drachm]ss, meaning half a drachm; and [*ounce]ss, meaning half an ounce. When there are ounces, drachms, or scruples, the number of them is shown by Roman figures, thus:--i. ii. iii. iv. v., &c., and prescriptions are written in this style.

663. Measures.--Liquid

Liquid medicines are always measured by the following table:

60 minims......... \ / 1 fluid drachm. 8 fluid drachms | are | 1 fluid ounce. 20 fluid ounces... | contained | 1 pint. 8 pints.......... / in \ 1 gallon.

And the signs which distinguish each are as follows:--c. means a gallon; o a pint; _fl_ [*ounce], a fluid ounce; _fl_ [*drachm], a fluid drachm; and m, a minim, or drop. Formerly drops used to be ordered, but as the size of a drop must necessarily vary, minims are always directed to be employed now for any particular medicine, although for such medicines as oil of cloves, essence of ginger, &c., drops are frequently ordered.

664. Specific Measuring Vessels.

In order that Medicines may be measured Accurately, there are graduated glass vessels for measuring ounces, drachms, and minims.

665. Approximate Measures.

When proper measures are not at hand, it is necessary to adopt some other method of determining the quantities required, and therefore the following table has been drawn up for that purpose:

These quantities refer to ordinary sized spoons and vessels. Some cups hold half as much more, and some tablespoons contain six drachms. A medicine glass, which is graduated so as to show the number of spoonfuls it contains, should be kept in every family.

[TO-DAY, MAN LIVES IN PLEASURE, WEALTH AND PRIDE.]

666. Process of Making Medicines.

To Powder Substances.--Place the substance in the mortar, and strike it _gently_ with direct perpendicular blows of the pestle, until it separates into several pieces, then remove all but a small portion, which bruise gently at first, and rub the pestle round and round the mortar, observing that the circles described by the pestle should gradually decrease in diameter, and then increase again, because by this means every part of the powder is subjected to the process of pulverization. In powdering substances, making emulsions, and whenever using a mortar, the pestle should always travel _from the right to the left_.

667. Preparation and Assistance.

Some substances require to be prepared in a particular manner before they can be powdered, or to be assisted by adding some other body. For example, camphor powders more easily when a few drops of spirits of wine are added to it; mace, nutmegs, and such oily aromatic substances are better for the addition of a little white sugar; resins and gum-resins should be powdered in a cold place, and if they are intended to be dissolved, a little fine well-washed white sand mixed with them assists the process of powdering. Tough roots, like gentian and calumba, should be cut into thin slices; and fibrous roots, like ginger, cut slanting, otherwise the powder will be full of small fibres. Vegetable matter, such as peppermint, loosestrife, senna, &c., requires to be dried before it is powdered.

668. Care of the Mortar.

Be careful not to pound too hard in glass, porcelain, or Wedgwood-ware mortar; they are intended only for substances that pulverize easily, and for the purpose of mixing or incorporating medicines. Never use acids in a marble mortar, and be sure that you do not powder galls or any other astringent substances in any but a brass mortar.

669. Sifting.

Sifting is frequently required for powdered substances, and this is usually done by employing a fine sieve, or tying the powder up in a piece of muslin, and striking it against the left hand over a piece of paper.

670. Filtering.

Filtering is frequently required for the purpose of obtaining clear fluids, such as infusions, eye-washes, and other medicines; and it is, therefore, highly important to know how to perform this simple operation. First of all take a square piece of white blotting paper, and double it over so as to form an angular cup. Open out this filter paper very carefully, and having placed it in a funnel, moisten it with a little water. Then place the funnel in the neck of the bottle, and pour the liquid gently down the side of the paper, otherwise the fluid is apt to burst the paper.

671. Maceration.

Maceration is another process that is frequently required to be performed in making up medicines, and consists simply in immersing the medicines in _cold water_ or spirits for a certain time.

672. Digestion.

Digestion resembles maceration, except that the process is assisted by a gentle heat. The ingredients are placed in a flask, such as salad oil is sold in, which should be fitted with a plug of tow or wood, and have a piece of wire twisted round the neck. The flask is held by means of the wire over the flame of a spirit lamp, or else placed in some sand warmed in an old iron saucepan over the fire, care being taken not to place more of the flask below the sand than the portion occupied by the ingredients.

673. Infusion.

Infusion is one of the most frequent operations required in making up medicines, its object being to extract the aromatic and volatile principles of substances, that would be lost by decoction, or digestion; and to extract the soluble from the insoluble parts of bodies. Infusions may be made with cold water, in which case they are weaker, but more pleasant. The general method employed consists in slicing, bruising, or rasping the ingredients first, then placing them in a common jug (which should be as globular as possible), and pouring boiling water over them. Cover the jug with a cloth folded six or eight times, but if there be a lid to the jug so much the better. When the infusion has stood the time directed, hold a piece of _very coarse_ linen over the spout, and pour the liquid through it into another jug.

[TO-MORROW, POOR--OR LIFE ITSELF DENIED.]

674. Decoction.

Decoction, or boiling, is employed to extract the mucilaginous or gummy parts of substances, their bitter, astringent, or other qualities, and is nothing more than boiling the ingredients in a saucepan with the lid slightly raised. Be sure never to use an iron saucepan for astringent decoctions, such as oak-bark, galls, &c., as they will turn the saucepan black, and spoil the decoction. The enamelled saucepans are very useful for decoctions, but an excellent plan is to put the ingredients into a jar and boil the jar, thus preparing it by a water bath, as it is technically termed; or by using a common pipkin, which answers still better. No decoction should be allowed to boil for more than ten minutes.

675. Extracts.

Extracts are made by evaporating the liquors obtained by infusion or decoction, but these can be bought much cheaper and better of chemists and druggists, and so can tinctures, confections, cerates and plasters, and syrups: but as every one is not always in the neighbourhood of druggists, we shall give recipes for those most generally useful, and the method of making them.

676. Precautions to be observed in Giving Medicines.

677. Sex.

Medicines for females should not be so strong as those for males, therefore it is advisable to reduce the doses about one-third.

678. Temperament.

Persons of a phlegmatic temperament bear stimulants and purgatives better than those of a sanguine temperament, therefore the latter require smaller doses.

679. Habits.

Purgatives never act so well upon persons accustomed to take them as upon those who are not, therefore it is better to change the form of purgative from pill to potion, powder to draught, or aromatic to saline. Purgatives should never be given when there is an irritable state of the bowels.

680. Use of Alcohol.

Stimulants and narcotics never act so quickly upon persons accustomed to use spirits freely as upon those who live abstemiously.

681. Climate.

The action of medicines is modified by climate and seasons. In summer, certain medicines act more powerfully than in winter, and the same person cannot bear the dose in July that he could in December.

682. General Health.

Persons whose general health is good bear stronger doses than the debilitated and those who have suffered for a long time.

683. Idiosyncrasy.

By this is meant a peculiar temperament or disposition not common to people generally. For example, some persons cannot take calomel in the smallest dose without being salivated, or rhubarb without having convulsions; others cannot take squills, opium, senna, &c.; and this peculiarity is called the patient's idiosyncrasy, therefore it is wrong to _insist_ upon their taking these medicines.

684. Forms best suited for Administration.

Fluids act quicker than solids, and powders sooner than pills.

685. Best Method of Preventing the Nauseous Taste of Medicines.

Castor oil may be taken in milk, coffee, or spirit, such as brandy; but the best method of covering the nauseous flavour is to put a tablespoonful of strained orange juice in a wineglass, pour the castor oil into the centre of the juice, and then squeeze a few drops of lemon juice upon the top of the oil. The wineglass should first be dipped, rim downwards, into water, so that the interior may be wetted. Cod liver oil may be taken, like castor oil, in orange juice. Peppermint water neutralizes, to a great extent, the nauseous taste of Epsom salts; a strong solution of extract of liquorice, that of aloes; milk, that of cinchona bark; and cloves that of senna.

[TO-DAY, LAYS PLANS FOR MANY YEARS TO COME.]

686. An Excellent Way to Prevent the Taste of Medicines

is to have the medicine in a glass, as usual, and a tumbler of water by the side of it; take the medicine, and retain it in the mouth, which should be kept closed, and if drinking the water be then commenced, the taste of the medicine is washed away. Even the bitterness of quinine and aloes may be prevented by this means. If the nostrils are firmly compressed by the thumb and finger of the left hand, while taking a nauseous draught, and so retained till the mouth has been washed out with water, the disagreeable taste of the medicine will be almost imperceptible.

687. Giving Medicines to Persons.

Medicines should be given in such a manner that the effect of the first dose shall not have ceased when the next dose is given, therefore the intervals between the doses should be regulated accordingly.

688. Doses of Medicine for Different Ages.

It must be plain to every one that children do not require such powerful medicine as adults or old people, and therefore it is desirable to have some fixed method of determining or regulating the administration of doses of medicine. Now let it be supposed that the dose for a full-grown person is one drachm, then the following proportions will be suitable for the various ages given; keeping in view other circumstances, such as sex, temperament, habits, climate, state of _general health_, and idiosyncrasy.

Age. Proportion. Proportionate Dose.

7 weeks one-fifteenth or grains 4 7 months one-twelfth or grains 5 Under 2 years one-eighth or grains 7-1/2 " 3 " one-sixth or grains 10 " 4 " one-fourth or grains 15 " 7 " one-third or scruple 1 " 14 " one-half or drachm 1/2 " 20 " two-fifths or scruples 2 Above21 " the full dose or drachm 1 " 65 " The inverse gradation

689. Drugs, with their Properties and Doses.

The various drugs have been arranged according to their properties, and the doses of each have been given. Many, however, have been necessarily omitted from each class, because they cannot be employed except by a medical man. The _doses_ are meant for adults.

690. Classes of Drugs.

Medicines have been divided into four grand classes

1. General stimulants; 2. Local stimulants; 3. Chemical remedies; 4. Mechanical remedies.

691. General Stimulants.

General stimulants are subdivided into two classes, diffusible and permanent stimulants: the first comprising narcotics and antispasmodics, and the second tonics and astringents.

692. Narcotics.

Narcotics are medicines which stupefy and diminish the activity of the nervous system. Given in small doses, they generally act as stimulants, but an increased dose produces a sedative effect. Under this head are included alcohol, camphor, ether, the hop, and opium.

693. Alcohol.

Alcohol, or rectified spirit, is a very powerful stimulant, and is never used as a remedy without being diluted to the degree called proof spirit; and even then it is seldom used internally. It is _used externally_ in restraining bleeding, when there is not any vessel of importance wounded. It is also used as a lotion to burns, and is applied by dipping a piece of lint into the spirit, and laying it over the part. Freely diluted (one part to eighteen) with water, it forms a useful eye-wash in the last stage of ophthalmia.

_Used internally_, it acts as a very useful stimulant when diluted and taken moderately, increasing the general excitement, and giving energy to the muscular fibres; hence it becomes very useful in certain cases of debility, especially in habits disposed to create acidity; and in the low stage of typhus fevers.

_Dose_.--It is impossible to fix anything like a dose for this remedy, as much will depend upon the individual; but diluted with water and sweetened with sugar, from half an ounce to two ounces may be given three or four times a day. In cases of extreme debility, however, much will depend upon the disease.

_Caution_.--Remember that alcohol is an irritant _poison_, and that daily indulgence in its use originates dyspepsia, or indigestion, and many other serious complaints. Of all kinds of spirits the best as a tonic and stomachic is _brandy_.

[TO-MORROW, SINKS INTO THE SILENT TOMB.]

694. Camphor.

Camphor is not a very steady stimulant, as its effect is transitory; but in large doses it acts as a narcotic, abating pain and inducing sleep. In moderate doses it operates as a diaphoretic, diuretic, antispasmodic, increasing the heat of the body, allaying irritation and spasm.

It is _used externally_ as a liniment when dissolved in oil, alcohol, or acetic acid, being employed to allay rheumatic pains; and it is also useful as an embrocation in sprains, bruises, chilblains, and, when combined with opium, it has been advantageously employed in flatulent colic, and severe diarrhoea, being rubbed over the bowels.

_When reduced to a fine powder_, by the addition of a little spirit of wine and friction, it is very useful as a local stimulant to indolent ulcers, especially when they discharge a foul kind of matter; a pinch is taken between the finger and thumb, and sprinkled into the ulcer, which is then dressed as usual.

_When dissolved in oil of turpentine_, a few drops placed in a hollow tooth and covered with jeweller's wool, or scraped lint, give almost instant relief to toothache. _Used internally_, it is apt to excite nausea, and even vomiting, especially when given in the solid form.

_As a stimulant_ it is of great service in all low fevers, malignant measles, malignant sore throat, and confluent small-pox; and when combined with opium and bark, it is extremely useful in checking the progress of malignant ulcers, and gangrene.

_As a narcotic_ it is very useful, because it allays pain and irritation, without increasing the pulse very much.

_When powdered and sprinkled_ upon the surface of a blister, it prevents the cantharides acting in a peculiar and painful manner upon the bladder.

_Combined with senna_, it increases its purgative properties; and it is also used to correct the nausea produced by squills, and the irritating effects of drastic purgatives and mezereon.

_Dose_, from four grains to half a scruple, repeated at short intervals when used in small doses, and long intervals when employed in large doses.

_Doses of the various preparations_.--Camphor mixture, from half an ounce to three ounces; compound tincture of camphor (_paregoric elixir_), from fifteen minims to two drachms.

_Caution_.--When given in an overdose it acts as a poison, producing vomiting, giddiness, delirium, convulsions, and sometimes death. Opium is the best antidote for camphor, whether in excess or taken as a poison. _Mode of exhibition_.--It may be rubbed up with almond emulsion, or mucilage, or the yolk of eggs, and by this means suspended in water, or combined with chloroform as a mixture, in which form it is a valuable stimulant in cholera and other diseases. (_See_ Mixtures, 556-564).

695. Ether.

Ether is a diffusible stimulant, narcotic and antispasmodic.

696. Sulphuric Ether

Sulphuric Ether is used _externally_ both as a stimulant and a refrigerant. In the former case its evaporation is prevented by covering a rag moistened with it with oiled silk, in order to relieve headache; and in the latter case it is allowed to evaporate, and thus produce coldness: hence it is applied over scalded surfaces by means of rags dipped in it.

_As a local application_, it has been found to afford almost instant relief in earache, when combined with almond oil, and dropped into the ear.

It is used _internally_ as a stimulant and narcotic in low fevers and cases of great exhaustion.

_Dose_, from fifteen minims to half a drachm, repeated at short intervals, as its effects soon pass off. Give in a little camphor julep, or water.

697. Nitric Ether

Nitric Ether is a refrigerant, diuretic, and antispasmodic, well known as "_sweet spirit of nitre_."

_Used externally_, its evaporation relieves headache, and it is sometimes applied to burns. It is used _internally_ to relieve nausea, flatulence, and thirst in fevers; also as a diuretic.

_Dose_, from ten minims to one drachm. The smaller dose taken in a little warm water or gruel is useful as a sudorific in cases of cold and chill, to induce and promote the proper action of the skin which has been checked. If a larger dose be taken, it acts as a diuretic and not as a sudorific, and so fails to produce the desired effect.

[TO-DAY, HIS FOOD IS DRESSED IN DAINTY FORMS.]

698. Compound Spirit of Sulphuric Ether

Compound Spirit of Sulphuric Ether is a very useful stimulant, narcotic, and antispasmodic.

_Used internally_ in cases of great exhaustion, attended with irritability.

_Dose_, from half a drachm to two drachms, in camphor julep. When combined with laudanum, it prevents the nauseating effects of the opium, and acts more beneficially as a narcotic.

699. The Hop

The Hop is a narcotic, tonic, and diuretic; it reduces the frequency of the pulse, and does not affect the head, like most anodynes.