Part 20

_Used externally_, it acts as an anodyne and discutient, and is useful as a fomentation for painful tumours, rheumatic pains in the joints, and severe contusions. A pillow stuffed with hops acts as a narcotic. When the powder is mixed with lard, it acts as an anodyne dressing in painful ulcers.

_Dose_, of the _extract_, from five grains to one scruple; of the _tincture_, from half a drachm to two drachms; of the _powder_, from three! grains to one scruple; of the _infusion_, half an ounce to one and a half ounce.

700. Opium

Opium is a stimulant, narcotic, and anodyne.

_Used externally_ it acts almost as well as when taken into the stomach, and without affecting the head or causing nausea. Applied to irritable ulcers in the form of tincture, it promotes their cure, and allays pain. Cloths dipped in a strong solution, and applied over painful bruises, tumours, or inflamed joints, allay pain. A small piece of solid opium stuffed into a hollow tooth relieves toothache. A weak solution of opium forms a valuable collyrium in ophthalmia. Two drops of the wine of opium dropped into the eye acts as an excellent stimulant in bloodshot eye; or after long-continued inflammation, it is useful in strengthening the eye. Applied as a liniment, in combination with ammonia and oil, or with camphorated spirit, it relieves muscular pain. When combined with oil of turpentine, it is useful as a liniment in spasmodic colic.

_Used internally_, it acts as a very powerful stimulant: then as a sedative, and finally as an anodyne and narcotic, allaying pain in the most extraordinary manner, by acting directly upon the nervous system. In acute rheumatism it is a most excellent medicine when combined with calomel and tartrate of antimony; but its exhibition requires the judicious care of a medical man.

_Doses of the various preparations._--. _Confection of opium_, from five grains to half a drachm; _extract of opium_, from one to five grains (this is a valuable form, as it does not produce so much after derangement of the nervous system as solid opium); _pills of soap and opium_, from five to ten grains; _compound ipecacuanha powder_ ("Dover's Powder"), from ten to fifteen grains; _compound kino powder_, from five to fifteen grains; _wine of opium_, from ten minims to one drachm. _Caution._--Opium is a powerful _poison_ when taken in too large a quantity (_See_ POISONS, _pars._ 1340-1367), and thus should be used with extreme caution. It is on this account that we have omitted some of its preparations. The best antidote for opium is camphor.

701. Antispasmodics.

Antispasmodics are medicines which possess the power of overcoming the spasms of the muscles, or allaying any severe pain which is not attended by inflammation. The class includes a great many, but the most safe and serviceable are ammonia, assafoetida, galbanum, valerian, bark, ether, camphor, opium, and chloroform; with the minerals, oxide of zinc and calomel.

702. Ammonia.

Ammonia, or Sal Volatile, is an antispasmodic antacid, stimulant and diaphoretic.

_Used externally_, combined with oil, it forms a cheap and useful liniment, but it should be dissolved in _proof_ spirit before the oil is added. One part of this salt, and three parts of extract of belladonna, mixed and spread upon leather, makes an excellent plaster for relieving rheumatic pains. As a local stimulant it is well known, as regards its effects in hysterics, faintness, and lassitude, when applied to the nose, as common smelling salts.

It is used _internally_ as an adjunct to infusion of gentian in dyspepsia or indigestion, and in moderate doses in gout.

_Dose_, from five to fifteen grains. _Caution_.--Overdoses act as a narcotic and irritant poison.

[TO-MORROW, IS HIMSELF A FEAST FOR WORMS.]

703. Bicarbonate of Ammonia

Bicarbonate of Ammonia is used internally the same as _sal volatile_.

_Dose_, from six to twelve grains. It is frequently combined with Epsom salts.

704. Solution of Sesoquicarbonate of Ammonia,

Solution of Sesoquicarbonate of Ammonia, used the same as _sal volatile_.

_Dose_, from half a drachm to one drachm, combined with some milky fluid, like almond emulsion.

705. Asafoetida

Asafoetida is an antispasmodic, expectorant, excitant, and anthelmintic.

_Used internally_, it is extremely useful in dyspepsia, flatulent colic, hysteria, and nervous diseases; and where there are no inflammatory symptoms, it is an excellent remedy in hooping cough and asthma.

_Used locally_ as an enema, it is useful in flatulent colic, and convulsions that come on through teething.

_Doses of various preparations_.--_Solid gum_, from five to ten grains as pills; _mixture_, from half an ounce to one ounce; _tincture_, from fifteen minims to one drachm; _ammoniated tincture_, from twenty minims to one drachm.

_Caution_.--Never give this drug when inflammation exists.

706. Galbanum

Galbanum is stimulant, antispasmodic, expectorant, and deobstruent.

_Used externally_, it assists in dispelling tumours when spread upon indolent leather as a plaster, and is useful in weakness of the legs from rickets, being applied as a plaster to the loins.

_Employed internally_, it is useful in chronic or old-standing rheumatism and hysteria.

_Doses of preparations_.--Of the _gum_, from ten to fifteen grains as pills; _tincture_, from fifteen minims to one drachm. It may be made into an emulsion with mucilage and water.

707. Valerian

Valerian is a powerful antispasmodic, tonic, and excitant, acting chiefly on the nervous centres.

_Used internally_, it is employed in hysteria, nervous languors, and spasmodic complaints generally. It is useful in low fevers.

_Doses of various preparations_.--_Powder_, from ten grains to half a drachm, three or four times a day; _tincture_, from two to four drachms; _ammoniated tincture_, from one to two drachms; _infusion_, from two to three ounces, or more.

708. Peruvian Bark

Bark, or, as it is commonly called, Peruvian bark, is an antispasmodic, tonic, astringent, and stomachic.

_Used externally_, it is an excellent detergent for foul ulcers, and those that heal slowly.

_Used internally_, it is particularly valuable in intermittent fever or ague, malignant measles, dysentery, diarrhoea, intermittent rheumatism, St. Vitus's dance, indigestion, nervous affections, malignant sore throat, and erysipelas; its use being indicated in all cases of debility.

_Doses of its preparations_.--_Powder_, from five grains to two drachms, mixed in wine, water, milk, syrup, or solution of liquorice; _infusion_, from one to three ounces; _decoction_, from one to three ounces; _tincture_ and _compound tincture_, each from one to three drachms.

_Caution_.--If it causes oppression at the stomach, combine it with an aromatic; if it causes vomiting, give it in wine or soda water; if it purges, give opium; and if it constipates give rhubarb.

709. Sulphuric Ether

Sulphuric Ether is given internally as an antispasmodic in difficult breathing and spasmodic asthma; also in hysteria, cramp of the stomach, hiccough, locked jaw, and cholera. It is useful in checking sea-sickness.

_Dose_, from twenty minims to one drachm.

_Caution_.--An overdose produces apoplectic symptoms.

[TO-DAY HE'S CLAD IN GAUDY, RICH ARRAY]

710. Camphor (2)

Camphor is given internally as an antispasmodic in hysteria, cramp in the stomach, flatulent colic, and St. Vitus's dance.

_Dose_, from two to twenty grains.

711. Opium (2)

Opium is employed internally in spasmodic affections, such as cholera, spasmodic asthma, hooping cough, flatulent colic, and St. Vitus's dance.

_Dose_, from one-sixth of a grain to two grains of the solid opium, according to the disease.

712. Oxide of Zinc

Oxide of Zinc is an antispasmodic, astringent, and tonic.

_Used externally_, as an ointment, it forms an excellent astringent in affections of the eyelids, arising from relaxation; or as a powder, it is an excellent detergent for unhealthy ulcers.

_Used internally_, it has proved efficacious in St. Vitus's dance, and some other spasmodic affections.

_Dose_, from one to six grains twice a day.

713. Calomel

Calomel is an antispasmodic, alterative deobstruent, purgative, and errhine.

_Used internally_, combined with opium, it acts as an antispasmodic in locked jaw, cholera, and many other spasmodic affections. As an alterative and deobstruent, it has been found useful in leprosy and itch, when combined with antimonials and guaiacum, and in enlargement of the liver and glandular affections. It acts beneficially in dropsies, by producing watery motions. In typhus it is of great benefit when combined with antimonials; and it may be given as a purgative in almost any disease, provided there is not any inflammation of the bowels, irritability of the system, or great debility.

_Dose_, as a deobstruent and alterative, from one to five grains, daily; as a cathartic, from five to fifteen grains; to produce ptyalism, or salivation, from one to two grains, in a pill, with a quarter of a grain of opium, night and morning.

_Caution_.--When taking calomel, exposure to cold or dampness should be guarded against, as such an imprudence would bring out an eruption of the skin, attended with fever. When this does occur, leave off the calomel, and give bark, wine, and purgatives; take a warm bath twice a day, and powder the surface of the body with powdered starch.

714. Tonics.

Tonics are given to improve the tone of the system, and restore the natural energies and general strength of the body. They consist of bark, quassia, gentian, camomile, wormwood, and angostura bark.

715. Quassia

Quassia is a simple tonic, and can be used with safety by any one, as it does not increase the animal heat, or quicken the circulation.

_Used internally_, in the form of infusion, it has been found of great benefit in indigestion and nervous irritability, and is useful after bilious fevers and diarrhoea.

_Dose_, of the _infusion_, from one and a half to two ounces, three times a day.

716. Gentian

Gentian is an excellent tonic and stomachic; but when given in large doses, it acts as an aperient.

It is _used internally_ in all cases of general debility, and when combined with bark is used in intermittent fevers. It has also been employed in indigestion, and it is sometimes used, combined with sal volatile, in that disease; but, at other times alone, in the form of infusion. After diarrhoea, it proves a useful tonic. Its infusion is sometimes applied _externally_ to foul ulcers.

_Dose_, of the _infusion_, one and a half to two ounces; of the _tincture_, one to four drachms; of the _extract_, from ten to thirty grains.

717. Camomile.

The flowers of the camomile are tonic, slightly anodyne, antispasmodic, and emetic.

They are _used externally_ as fomentations, in colic, faceache, and tumours, and to unhealthy ulcers.

They are _used internally_ in the form of infusion, with carbonate of soda, ginger, and other stomachic remedies, in dyspepsia, flatulent colic, debility following dysentery and gout. Warm infusion of the flowers acts as an emetic; and the powdered flowers are sometimes combined with opium or kino, and given in intermittent fevers.

_Dose_, of the _powdered_ flowers, from ten grains to one drachm, twice or thrice a day; of the _infusion_, from one to two ounces, as a tonic, three times a day: and from six ounces to one pint as an emetic; of the _extract_, from five to twenty grains.

[TO-MORROW, SHROUDED FOR A BED OF CLAY.]

718. Wormwood

Wormwood is a tonic and anthelmintic.

It is _used externally_ as a discutient and antiseptic.

It is used _internally_ in long-standing cases of dyspepsia, in the form of infusion, with or without aromatics. It has also been used in intermittents.

_Dose_, of the _infusion_, from one to two ounces, three times a day; of the _powder_, from one to two scruples.

719. Angostura Bark

Angostura Bark, or Cusparia, is a tonic and stimulant. It expels flatulence, increases the appetite, and produces a grateful warmth in the stomach.

It is _used internally_ in intermittent fevers, dyspepsia, hysteria, and all cases of debility, where a stimulating tonic is desirable,

## particularly after bilious diarrhoea.

_Dose_, of the _powder_, from ten to fifteen grains, combined with cinnamon powder, magnesia, or rhubarb; of the _extract_, from three to ten grains; of the _infusion_, from one to two ounces.

_Caution_.--This drug should never be given in inflammatory diseases or hectic fever.

720. Astringents.

Astringents are medicines given for the purpose of diminishing excessive discharges, and to act indirectly as tonics. This class includes catechu, kino, oak bark, log wood, rose leaves, chalk, and white vitriol.

721. Catechu

Catechu is a most valuable astringent.

It is _used externally_, when powdered, to promote the contraction of flabby ulcers. As a local astringent it is useful in relaxed uvula, a small piece being dissolved in the mouth; small, spotty ulcerations of the mouth and throat, and bleeding gums, and for these two affections it is used in the form of infusion to wash the parts.

It is _given internally_ in diarrhoea, dysentery, and hemorrhage from the bowels.

_Dose_, of the _infusion_, from one to three ounces; of the _tincture_, from one to four drachms; of the _powder_, from ten to thirty grains.

_Caution_.--It must not be given with soda or any alkali; nor metallic salts, albumen, or gelatine, as its property is destroyed by this combination.

722. Kino

Kino is a powerful astringent.

It is _used externally_ to ulcers, to give tone to them when flabby, and discharging foul and thin matter.

It is _used internally_ in the same diseases as catechu.

_Dose_, of the powder, from ten to fifteen grains; of the _tincture_, from one to two drachms; of the _compound powder_, from ten to twenty grains; of the _infusion_, from a half to one and a half ounce.

_Caution_.--Kino is used in combination with calomel, when salivation is intended, to prevent, by its astringency, the action of the calomel on the bowels, and thereby insure its affecting the constitution.-- (See CATECHU [para. 721]).

723. Oak Bark

Oak Bark is an astringent and tonic.

It is _used externally_ in the form of decoction, to restrain bleeding from lacerated surfaces. As a local astringent, it is used in the form of decoction, as a gargle in sore throat and relaxed uvula.

It is _used internally_ in the same diseases as catechu, and when combined with aromatics and bitters, in intermittent fevers.

_Dose_ of the _powder_, from fifteen to thirty grains; of the _decoction_, from two to eight drachms.

724. Logwood

Logwood is not a very satisfactory astringent.

It is _used internally_ in diarrhoea, the last stage of dysentery, and a lax state of the intestines.

_Dose_, of the _extract_, from ten grains to one drachm; of the _decoction_ from one to three ounces, three or four times a day.

725. Rose Leaves

Rose Leaves are stringent and tonic.

They are _used internally_ in spitting of blood, hemorrhage from the stomach, intestines, &c., as a gargle for sore throat, and for the night sweats of consumption. The infusion is frequently used as a tonic with diluted sulphuric acid (oil of vitriol), after low fevers, or in combination with Epsom salts and sulphuric acid in certain states of the bowels.

_Dose_ of _infusion_, from two to four ounces.

[TO-DAY, ENJOYS HIS HALLS, BUILT TO HIS MIND.]

726. Chalk

Chalk, when prepared by washing, becomes an astringent as well as antacid.

It is _used internally_ in diarrhoea, in the form of mixture, and _externally_ as an application to burns, scalds, and excoriations.

_Dose_ of the _mixture_, from one to two ounces.

727. White Vitriol

White Vitriol, or Sulphate of Zinc, is an astringent, tonic, and emetic.

It is _used externally_ as a collyrium for ophthalmia (See DOMESTIC PHARMACOPEIA, _par. 475 et seq._), and as a detergent for scrofulous ulcers, in the proportion of three grains of the salt to one ounce of water.

It is _used internally_ in indigestion, and many other diseases; _but it should not be given unless ordered by a medical man, as it is a poison._

728. Local Stimulants.

Local stimulants comprise emetics, cathartics, diuretics, diaphoretics, expectorants, sialogogues, errhines, and epispastics.

729. Emetics.

Emetics are medicines given for the purpose of causing vomiting, as in cases of poisoning. They consist of ipecacuanha, camomile, antimony, copper, zinc, and several others.

730. Ipecacuanha

Ipecacuanha is an emetic, diaphoretic, and expectorant.

It is _used internally_ to excite vomiting, in doses of from ten to twenty grains of the powder, or one to one and a half ounce of the infusion, every half hour until vomiting takes place. To make it act well and easily, the patient should drink half pints of warm water after each dose of the infusion. As a diaphoretic, it should be given in doses of three grains, mixed with some soft substance, such as crumbs of bread, and repeated every four hours.

_Dose_ of the _wine,_ from twenty minims to one drachm as a diaphoretic, and from one drachm to one and a half ounces as an emetic.

_Caution._--Do not give more than the doses named above, because, although a safe emetic, yet it is an acrid narcotic poison.

731. Mustard

Mustard is too well known to require describing. It is an emetic, diuretic, stimulant, and rubefacient.

It is _used externally_ as a poultice. Mustard poultices are made of the powder, bread crumbs, and water; or of one part of mustard to two of flour; or, especially for children, of linseed meal, mixed with a little of the powder, or having some of the powder slightly sprinkled on the surface. Sometimes a little vinegar is added under the idea that it increases the strength of the poultice, but this is not necessary. In all cases where a stimulant is required, such as sore throats, rheumatic pains in the joints, cholera, cramps in the extremities, diarrhoea, and many other diseases. When applied it should not he left on too long, as it is apt to cause ulceration of the part. From ten to thirty minutes is quite long enough.

When _used internally_ as an emetic, a large teaspoonful mixed with a tumbler of warm water generally operates quickly and safely, frequently when other emetics have failed. In dropsy it is sometimes given in the form of whey, which is made by boiling half an ounce of the bruised seeds in a pint of milk, and straining off the curd.

From three to four ounces of this is to be taken for a dose three times a day.

732. Cathartics.

Cathartics are divided into laxatives and purgatives. Manna, tamarinds, castor oil, sulphur, and magnesia are _laxatives;_ senna, rhubarb, jalap, colocynth, buckthorn, aloes, cream of tartar, scammony, calomel, Epsom salts, Glauber's salts, sulphate of potash, and Venice turpentine are _purgatives._

733. Manna

Manna is a very gentle laxative, and therefore used for children and delicate persons.

_Dose for children,_ from one to two drachms; and for _adults,_ from one to two ounces, combined with rhubarb and cinnamon water.

734. Tamarinds

Tamarinds are generally laxative and refrigerant. As it is agreeable, this medicine will generally be eaten by children when they will not take other medicines.

_Dose,_ from half to one ounce. As a refrigerant beverage in fevers it is extremely grateful.

[TO-MORROW, IN A COFFIN IS CONFINED.]

735. Castor Oil

Castor Oil is a most valuable medicine, as it generally operates quickly and mildly.

It is _used externally,_ combined with citron ointment, as a topical application in common leprosy.

It is _used internally_ as an ordinary purgative for infants, as a laxative for adults, and in diarrhoea and dysentery. In colic it is very useful and safe; and also after delivery.

_Dose_ for _infants,_ from forty drops to two drachms; for _adults,_ from half an ounce to one and a half ounces.

736. Sulphur.

Sublimed sulphur is laxative and diaphoretic.

It is _used externally_ in skin diseases, especially itch, both in the form of ointment and as a vapour bath.

It is _used internally_ in hemorrhoids, combined with magnesia, as a laxative for children, and as a diaphoretic in rheumatism.

_Dose,_ from one scruple to two drachms, mixed in milk or with treacle. When combined with an equal proportion of cream of tartar, it acts as a purgative.

737. Magnesia.

_Calcined magnesia_ possesses the same properties as the carbonate.

_Dose,_ from ten to thirty grains, in milk or water.

_Carbonate of magnesia_ is an antacid and laxative, and is very useful for children when teething, and for heartburn in adults.

_Dose,_ from a half to two drachms, in water or milk.

_Fluid Magnesia_ is a useful preparation by whose use is avoided the grittiness that is inseparable from magnesia when taken in the form of powder.

738. Senna

Senna is a purgative, but is apt to gripe when given alone; therefore it is combined with some aromatic, such as cloves or ginger, and the infusion should be made with _cold_ instead of hot water. It usually acts in about four hours, but its action should be assisted by drinking warm fluids.

_Dose,_ of the _confection,_ commonly called _"lenitive electuary,"_ from one to three or four drachma at bedtime; of the _infusion,_ from one to two ounces; of the _tincture,_ irom one to two drachms; of the _syrup_ (used for children), from one drachm to one ounce.

_Caution._--Do not give senna, in any form except confection, in hemorrhoids, and never in irritability of the intestines.

739. Rhubarb

Rhubarb is a purgative, astringent and stomachic.

It is _used externally_ in the form of powder to ulcers, to promote a healthy action.

It is given _internally_ in diarrhoea, dyspepsia, and a debilitated state of the bowels. Combined with a mild preparation of calomel, it forms an excellent purgative for children.

_Dose,_ of the _infusion,_ from one to two ounces; of the _powder,_ from one scruple to half a drachm as a purgative, and from six to ten grains as a stomachic; of the _tincture_ and _compound tincture,_ from one to four drachms; of the _compound pill,_ from ten to twenty grains.

740. Jalap

Jalap is a powerful cathartic and hydrogogue, and is therefore apt to gripe.

_Dose,_ of the _powder,_ from ten to thirty grains, combined with a drop or two of aromatic oil; of the _compound powder,_ from fifteen to forty grains; of the _tincture,_ from one to three drachms; of the _extract,_ from ten to twenty grains. The watery extract is better than the alcoholic.

741. Colocynth

Colocynth is a powerful drastic cathartic, and should never be given alone, unless ordered by a medical man, as its action is too violent for some constitutions.

_Dose,_ of the _extract,_ from five to fifteen grains; of the _compound extract,_ from five to fifteen grains; of the _compound colocynth pill,_ the best of all its preparations, from ten to twenty grains.

742. Buckthorn

Buckthorn is a brisk purgative for children in the form of syrup.

_Dose_ of the _syrup,_ from one to six drachms.

743. Aloes

Aloes is a purgative and cathartic in large, and tonic in smaller doses.

_Dose,_ of _powder,_ from two to ten grains, combined with soap, bitter extracts, or other purgative medicines, and given in the form of pills; of the _compound pill,_ from five to twenty grains; of the _pill of aloes_ and _myrrh_ from five to twenty grains; of the _tincture_, from four drachms to one ounce; of the _compound tincture_, from one to four drachms; of the _extract_, from six to ten grains; of the _compound decoction_, from four drachms to two ounces.

[TO-DAY, HE FLOATS ON HONOUR'S LOFTY WAVE.]

744. Cream of Tartar

Cream of Tartar is a purgative and refrigerant.

It is _used internally_ in dropsy, especially of the belly, in doses of from one scruple to one drachm. As a refrigerant drink it is dissolved in hot water, and sweetened with sugar, and is used in febrile diseases, care being taken not to allow it to rest too much upon the bowels.

_Dose_, as a _purgative_, from two to four drachms, as a _hydrogogue_, from four to six drachms, mixed with honey or treacle.

_Caution._--Its use should be followed by tonics, especially gentian and angostura.

745. Scammony

Scammony is a drastic purgative, generally acting quickly and powerfully; sometimes producing nausea, and even vomiting, and being very apt to gripe.