Chapter III: Their Form of Prescription (1)

In our extemporaneous directions, it is necessary to apportion with accuracy the quantity of active materials which we may wish each pill to contain, and since the proportion of the _constituent_ can rarely be exactly defined, the equable division of the whole mass, into a given number of pills, will be safer than defining the weight of each pill.

A pill, the bulk of whose ingredient is vegetable matter, ought not to exceed five grains in weight, but where the substances which compose it are metallic and ponderous, it may without inconvenience weigh six or even eight grains.

TROCHISCI. _Troches_, or _Lozenges_.

As these are regarded as objects rather of confectionary than of pharmacy, the London and Dublin Colleges have not condescended to notice them; the Edinburgh Pharmacopœia, however, contains several formulæ for their preparation; and as the form of lozenge offers a very commodious and efficacious method of administering certain remedies, the theory of its operation deserves some notice in the present work. It is principally useful in cases where it is an object that the remedy should pass _gradually_ into the stomach, in order to act as powerfully as possible upon the pharynx and top of the trachea, as in certain demulcents or astringents; for instance, _Nitre_, when intended to operate in relaxed or inflamed states of the tonsils, is best applied in this manner; so is _Sulphate of Zinc_ in chronic coughs, attended with inordinate secretion. In order to retard as long as possible the solution of the lozenge in the mouth, it ought to be composed of _several_ demulcent substances, such as farinaceous matter, sugar, gum, and isinglass; for such a mixture will be found to answer the purpose better than any _one_ of these articles taken by itself; thus the farinaceous matter will prevent the sugar and the gum from being too soon dissolved; the viscidity of the sugar and gum will prevent the farinaceous matter from being swallowed as soon as it would otherwise be; and the isinglass will give a softness to the whole, and thus prevent any sharp points from stimulating the membrane.

SUPPOSITORIA. _Suppositories._

This form of preparation is very ancient, and although it has of late years fallen into disuse, it affords an efficacious mode of administering many powerful remedies, and in some instances of producing effects which the same medicine would not command if given in any other form: besides which, it is found that after the stomach by long use has lost its susceptibility to the action of medicine, such a substance will operate with fresh and unabated force if applied to the rectum. There are two great indications which _Suppositories_ are calculated to fulfil, _viz._

1, _The alleviation of pain and irritation_, especially when it arises from diseases of the bladder, prostate gland, uterus, and other parts in the vicinity. Abortion may be thus frequently prevented. To fulfil these intentions, a mixture of opium with two parts of soap, will be found eligible. I can recommend such an application from a well grounded experience in its efficacy.

2, _The production of Catharsis_. In cases of Apoplexy, from the counter-irritation which these remedies are likely to occasion, much advantage may arise; and in the failure of more common measures, they may be applied with certain success in the cure of Ascarides; see _Formula 146_. Where a very efficient Suppository is required, one or two grains of _Elaterium_ rubbed up with eight grains of hard soap, will present us with a combination of great utility.

ELECTUARIA. _Electuaries._

This is an ancient form of prescription; for although the term “_Electarium_” is first used by Cælius Aurelianus, yet the ἐκλὶκτον of Hippocrates, and the _Antidotus_, _Confectio_, _Mithridatium_, _Diascordium_, _Opiatum_, _Orvietanum_, _Philonium_, _Theriaca_, and _Requies_ of other authors, were all Electuaries. They differ from _Conserves_ in this, that the sugar in the latter preparations is in a greater proportion, and is intended to _preserve_ the ingredients; whereas in the former, it is merely intended to impart convenience of form; see _Confectiones_. Electuaries are in general, _extemporaneous_ preparations, composed of dry powders, formed into a proper consistence by the addition of syrup, honey, or mucilage; when however the latter substance is employed, the electuary very soon becomes dry and hard: and when common syrup is used, the compound is apt to candy, and in a day or two to grow too hard for use; this is owing to the crystallization of the sugar; Deyeux therefore states, that the syrup should be previously exposed to the heat of a stove so long as it forms any crystals, and that the residual liquor, which from the presence of some vegetable acid has no tendency to crystallize, may then be advantageously applied;—_Melasses_ or Treacle may in some cases be employed, and from experiments which I have repeated with some care, I am enabled to state that the peculiar flavour of this liquid is entirely removed by a simple operation, which consists in diluting it with an equal weight of water, and then boiling it with about one eighth part of powdered charcoal for half an hour, when the liquor is to be strained, and reduced by gentle evaporation to a proper consistence;[301] and moreover it appears, that active vegetable powders retain their characteristic qualities when immersed in _treacle_, longer than in any other excipient.

In selecting and prescribing this form of exhibition, the following general rules should be observed.

I. Those substances which are nauseous, deliquescent, which require to
be given in large doses, or which are incapable of forming an
intimate union with syrup, as _fixed oils_, _balsams_, &c. should
never be prescribed in the form of an electuary.

II. The quantity of syrup directed must be regulated by the nature and
specific gravities of the substances which enter into their
composition, viz.

1. _Dry Vegetable Powders_ require twice their weight of syrup, or
of honey.

2. _Gummy and Resinous Powders_ require an equal weight.

3. _Hard Mineral Substances_ should be formed into an electuary
with some conserve, as they are too ponderous to remain
suspended in syrup. It deserves also to be noticed, that in
consequence of the readiness with which metallic preparations
undergo change, it will be generally adviseable to keep the
active ingredients in the form of powder, and to add them to
the syrup only just before they are required; the Electuary of
the French Pharmacopœia, which is commonly called “_Opiata
Mesenterica_,” will furnish a good example, “_quantumvis molle
fuerit recens, progressu temporis, ob ferrum quod ipsi inest,
mirè indurescit_.”

LIQUID FORMS.

MISTURÆ. _Mixtures._

These preparations are generally _extemporaneous_, in which different ingredients are mingled together in the liquid form, or, in which solid substances are diffused through liquid, by the medium of mucilage or syrup: for prescribing mixtures the following general rules may be laid down.

I. Substances which are capable of entering into chemical combination,
or of decomposing each other, ought not to be mixed together,
unless it be with a view of obtaining the new products as a
remedy.

II. Transparency is not a necessary condition,[302] and hence
insoluble powders may be advantageously introduced into mixtures,
if the following precautions be observed.

1. They must be divisible and mechanically miscible in the liquid.

2. They must not possess too great a specific gravity.

3. They must not render the liquid too mucilaginous or thick;
_thus_, f℥j _should seldom contain more than_ ʒss _of a
vegetable powder_, ℈ij _of an electuary_, _and conserve_; _or_
grs. xv, _or_ ℈j _of an extract_.

III. The taste, the smell, and the general aspect of the mixture
should be rendered as pleasant as possible; _thus milk covers the
taste of bark, of the tinctures of guaiacum and valerian, and that
of lime water_; _and a light decoction of the liquorice root
disguises a bitter taste more effectually than sugar_.

The Physician may also produce occasional changes in the
appearance of his mixture, in order to reconcile a delicate taste
to its continuance; he never ought however to alter the essential
part of plans which he finds advantageous.

A DRAUGHT differs merely from a mixture in quantity; it is usually taken at once, and should not exceed f℥iss; it should be always preferred when,

1. _The remedy is to be taken in a precise dose._

2. _Whenever it is liable to spontaneous decomposition._

3. _Whenever the action of the atmosphere occasions change._

In apportioning the dose of mixtures, the following proportions are admissible, although not perfectly accurate. A TABLE SPOON full (_Cochleare Amplum_) f℥ss. DESSERT SPOON (_Cochleare Mediocre_) more than fʒij. TEA SPOON (_Cochleare Minimum_) fʒj. A WINE GLASS (_Cyathus_) although very variable, may be estimated as containing f℥iss. The custom of measuring the dose of a liquid by dropping it from the mouth of a phial is very erroneous;[303] it will therefore be proper to dilute an active medicine that is to be so apportioned, with at least a triple quantity of water, that its real dose may not be essentially altered by any slight variation in the quantity.

The temperature at which a liquid medicine should be given may perhaps merit a few observations. In general, the ordinary degree of heat is that which will best answer the intention, but in cases of dyspepsia, the sense of weight and uneasiness, which often follows a dose of medicine, will be prevented by giving it in a tepid state. This remark will apply to the administration of the _Decoction of Sarsaparilla_; Refrigerants should of course be given as cool as possible; Camomile Infusion, and other vegetable Ptisans, which are designed to promote the operation of an emetic, will be more efficient when warm. In delicate chlorotic females I have sometimes found chalybeate draughts not only more efficacious, but less distressing to the stomach, when exhibited in a tepid state.

ENEMATA. _Clysters._[304]

_“Lavamenta.”_

This form of applying a medicine furnishes the practitioner with many valuable resources, although the remedy has not escaped its due share of persecution. Paracelsus bestowed upon it the epithet “_turpissimum medicamentum_,” and Van Helmont that of “_pudendum medicorum subsidium_.”

It is calculated to fulfil the following indications, viz.

1. _To promote the tardy operation of a Cathartic, or to evacuate the
bowels, where, from delicacy of stomach, medicines cannot be
retained, or from debility of body they cannot be safely
administered._

In the administration of a remedy of this kind, there are two essential circumstances, independent of the _strength_ of its ingredients, which will modify its activity, viz. IMPULSE and QUANTITY, by which we obtain the stimulus of distention; warm water without any adjunct may thus be made the means of overcoming those unrelenting obstructions, which had refused obedience to more common measures: Clysters, however, when most forcibly urged, rarely reach beyond the sigmoid flexure of the colon, and yet when the largest quantity of fluid which the bowels will admit is introduced with considerable impulse, the local impression is so powerful that it is at once extended by the medium of sympathy, through the whole of the alimentary canal, and very thorough and copious discharges result.

2. _To induce extreme relaxation:_

Which is best effected by an infusion of Tobacco. See _Tabaci Folia_.

3. _To produce Astringent and Anodyne, or Carminative effects._

Common starch, with the addition of Tincture of Opium, is the most common and convenient form for this purpose. See also _Assafœtida_, _Terebinthinæ Oleum_, and _Formulæ 8, 9, 29, 30_. In some cases the injection of _cold water_ acts as a powerful astringent, and from its impression upon the rectum, will frequently afford instantaneous relief in the piles.

4. _To destroy Ascarides._ See _Form. 164_.

5. _To act as an emollient fomentation._

6. _To convey nutriment._

In the administration of Clysters, for the fulfilment of any of the last five indications, it is obvious, that the stimulus of distention should be avoided, as being incompatible with our object; the quantity, or bulk of the solution, ought to be also carefully graduated; to prevent, for example, the opiate clyster from being too soon returned, Dr. Cullen has remarked that it seldom should be made of more bulk than that of three or four ounces of liquid, and this also of a very mild kind. In administering a bitter decoction for the cure of Ascarides, the same precaution is necessary, or the gut will suddenly contract and expel the clyster, which always acts with more certainty when allowed to remain for some time. The proportions of fluid vehicle necessary for the different stages of life, under ordinary circumstances, may be stated as follows:—An infant at its birth, or soon after, requires about one _fluid ounce_; a child between the age of one and five years, from three to four _fluid ounces_; a youth of ten or fifteen, from six to eight _fluid ounces_; and an adult may take twelve. With regard to the dose of the active ingredient of a _Lavement_, it may be estimated as triple of that taken by the mouth.

INJECTIONES.

Under this head may be comprehended the various medicinal preparations which are employed as local applications;—to the urethra for the cure of gonorrhæa, and to the vagina for that of the different discharges to which females are liable.

With respect to the former of these it has been truly observed, that “among the whole class of remedies employed for surgical purposes, there is scarcely one which has occasioned a greater diversity of opinion;” to enter however into an examination of this subject would be entirely foreign to the intention of the present work; it is only necessary to state, that for their preparation the same principles of combination, and the same chemical precautions, apply, as have been already investigated under the head _Misturæ_. In some cases the practitioner will find it useful to insure the entire solution of his active ingredient; while in others, the presence of a precipitate may enhance the efficacy of the application, as illustrated by _Form. 62_.

In the preparation of injections for the cure of female discharges, it must be remembered that, if they be of a vegetable nature, their efficacy wholly depends upon the _Tannin_ which they contain, and the prescriber must therefore take care not to invalidate the force of this principle by any incompatible additions.

And it deserves to be remembered, that as _Tannin_ has the power of coagulating animal mucus, and of forming with it an insoluble precipitate, its administration, as an injection, is liable to occasion the evacuation of whitish or ash-coloured flakes, which will come away from time to time, and excite in the patient’s mind, says Mr. Clarke, the apprehension that she is voiding portions of the internal parts of the body, unless her mind be prepared for the occurrence by a previous explanation, and which the judicious practitioner will not neglect to afford. In some cases it will be necessary to correct the irritating effect of the astringent by the addition of a demulcent, as exemplified in _Form. 61_. In applying this form of remedy an ivory syringe should be always preferred to one of pewter, whenever the solution is likely to be affected by the contact of a metal.

INHALATIONES. _Inhalations._

Under this general title may be comprehended two distinct classes of volatilized substances, _viz._

Dry Fumes (_Suffitus_), and Watery Vapours (_Halitus_).

Before we enter upon the consideration of this particular form of remedy, it may be necessary to state, generally, that it appears to be capable of affording a very expeditious and powerful mode of affecting the body by certain medicines. If the power of a remedy be so greatly modified by circumstances affecting its solubility, as we have already proved, it cannot be a matter of surprise that the still farther diminution of its cohesion should occasion a corresponding influence upon its energies; indeed it would appear that some few substances are entirely inert when applied under any other form, see _Hydrargyrum_, in the after part of this work. We are, moreover enabled by these means, to bring various bodies into immediate contact with organs, which are inaccessible to such remedies in every other state of aggregation. This observation applies more particularly to the lungs, and the subject has lately occupied the attention of a worthy and skilful physician, whose work[305] is well entitled to the serious consideration of the profession.

The practice of causing patients to inhale various volatilized substances appears to have been of very ancient date. It has been already stated in this work (p. 39) that the fumes of Orpiment were directed to be breathed by Galen, and that the practice has been adopted by practitioners of later date.[306] Few attempts of this kind however were made, until the time of our countryman Bennet, the author of “_Theatrum Tabidorum_,” who arranges volatilized substances into the two classes which have been announced at the head of the present section, _viz._ _Suffitus_, and _Halitus_. The numerous trials which have been since made with the different gases must be in the remembrance of every reader, but unfortunately, the injudicious and empirical spirit with which these inquiries have hitherto been conducted, has thrown such discredit upon the subject, that the practitioner who should resume the investigation, must be prepared to hear his understanding, or his integrity, questioned.

SUFFITUS. _Fumes of Burning Substances._ The particular forms of pulmonary disease in which Tar fumes appear to be most serviceable, are of the chronic kind; where an inflammatory diathesis prevails, or any tendency to hæmopthysis exists, the practice cannot be said to be free from danger. In treatment of hooping cough the inhalation of tar fumes have been also said to be beneficial. For the mode of applying this remedy, see _Pix Liquida_.

The practice of smoking the roots of _Stramonium_, _Tobacco_, &c. might with propriety be noticed under this head. With the respect to the former of these remedies, much has been said and written, and asthmatic patients have occasionally expressed a belief in its palliative powers; in my own practice however, I have never met with any success that has inspired my confidence. See _Stramonii Herba_.

HALITUS. _Aqueous Vapours._ In certain catarrhal affections, when accompanied with painful and difficult expectoration, benefit may be occasionally obtained from the inhalation of the steam of hot water, or of vinegar and water, the acid in this case assisting the expectoration, while the whole acts as an emollient and soothing application to the tender and inflamed vessels of the internal surface of the bronchial tubes. The same practice is also highly serviceable in Cynanche Trachealis, and Tonsillaris.

In Pneumonia, after the violence of the arterial excitement has been reduced by depletory measures, the inhalation of the steam of hot water, or decoctions of emollient herbs, will often contribute to the support of an easy expectoration.

It has been already stated under the history of Expectorants (_page 106_), that in certain dry states of the air, the evaporation of water in an artificially warmed apartment, is frequently attended with considerable relief to the pulmonary patient.

In Dyspnæa, attended with a spasmodic condition of the pulmonary organs, vapours impregnated with sulphuric æther have been recommended for inhalation. Dr. Pearson also states that the efficacy of such an application is materially enhanced by dissolving in it a portion of the extract of Conium. Dr. Bôotcher of Copenhagen, has lately announced the utility of vapours of camphor, in complaints affecting the cavities of the nose, throat, and chest. He states that in the worst case of stoppage of the nose from catarrh, a piece of camphor need only be kept for a few minutes before it, to obtain great relief; the same application has been known to produce good in Cynanche Tonsillaris.

In order to apply such inhalations we may employ the inhaler invented by Dr. Mudge, or if that instrument be not at hand, the spout of a tea pot, or a common basin with an inverted funnel, will be found very convenient substitutes.

REMEDIES OF EXTERNAL APPLICATION.

This class of medicinal agents formerly comprised a much wider range of forms than it at present contains; such as numerous _Epithems_; _Vapours_; _Aromatic Bags_; _Medicated Quilts_, _&c._

The external remedies of the present day may be divided into two orders, viz.

1. Those whose effects are entirely _local_, as exemplified in the
application of certain _refrigerating_ embrocations, _stimulating_
cataplasms, and _astringent_ unguents.

2. Those which excite general effects, or produce an influence upon
parts remote from those to which the remedy is more immediately
addressed, as illustrated by the operation of mercurial liniments
and unguents, or by the general tonic effects of adhesive
plaisters.

With respect to the former of these divisions it is unnecessary to multiply our remarks; the objects which they embrace belong more particularly to the department of surgery, and from the investigation of the different modes and forms of external application we shall hereafter derive very ample and instructive illustrations. In considering the objects of the latter division, a very interesting and important question immediately suggests itself for our consideration—How far a medicinal substance, when locally applied to the surface of the body, may be capable of affecting the general system, or some of its more remote parts?—the experienced practitioner will feel no hesitation in admitting numerous proofs of the existence of such agency; and it would seem probable that topical applications may produce general effects by several distinct modes of operation, viz.

1. _By exciting an impression on the nervous system._

2. _By modifying the cuticular discharge._

3. _By being absorbed into the circulation._

In considering the different forms of external applications, it will appear that, for their extemporaneous construction, preparation, and application, the same scientific knowledge, practical skill, and pathological acumen will be required, as we have already stated to be so indispensably requisite to enable the physician to prescribe, and the pharmaceutist to prepare the various remedies intended for internal administration; although in regard to the former, it may be stated generally that the prescriber will more frequently be called upon to exercise that species of knowledge and address which enables the practitioner to impart a convenient and efficient _consistency_ to his remedy; for an external application is far more dependent upon this circumstance for its efficacy, than one intended for internal use.

LOTIONES:

Remedies of a liquid nature, designed for external application.

Under this generic term, which strictly signifies a _wash_, may be comprehended several species of medicines, calculated for the fulfilment of different indications, as EMBROCATIONES, COLLYRIA, FOMENTA, LINIMENTA, &c. In some instances these applications are entirely local in their effects, as where a morbid action of the skin is changed by a stimulating lotion, as exemplified in the cure of Psora by the _decoction of Hellebore_, or the relaxed vessels of the tunica conjunctiva of the eye, by an astringent collyrium; in other cases, they operate upon parts not in contact with the remedy, through the medium of sympathetic communication, as where cholic and disorders of the bowels are abated by the application of warm fomentations to the surface of the abdomen, or where paralytic affections are relieved by pumping cold water on the part affected.

EMBROCATIONES. These, as the term[307] denotes, are compositions of spirit, decoctions, infusions, or other liquids, applied by _sprinkling_ or rubbing them on an affected part.

LINIMENTA[308] are understood to differ from embrocations in consistence, the former being of an oily, or mucilaginous density, which increases their efficacy by imparting a certain emollient power, in addition to their other virtues. In popular language, however, liniment and embrocation are generally considered synonymous terms. They constitute a valuable class of remedies, and the observations which Dr. Percival has offered on their utility well merit the attention of the medical practitioner. “Volatile and antispasmodic liniments are highly useful remedies, and it is to be lamented that external applications of this kind are not more frequently employed, for there is just reason to apprehend that powerful effects might be expected from them in various diseases.” In chronic affections of the viscera, such applications appear highly serviceable, not only from the friction to which they give origin, but from the influence of that species of sympathy which appears to depend upon the mere proximity and continuity of parts, and which, as Sir Gilbert Blane has observed, is particularly displayed “in the containing on the contained parts, as that of the integuments on the subjacent viscera.”

COLLYRIA[309].—Liquid applications to the eyes. The Pharmacopœia Chirurgica contains several different formulæ for lotions of this kind, some of which are simply astringent, while others combine also the virtues of a stimulant.

CATAPLASMATA.[310] _Poultices_, or _Pultices_.

External applications of a pulpy, and somewhat coherent or tenacious consistence.

They are generally extemporaneous preparations, and are calculated to answer several different indications, viz.

1. As STIMULANTS, e. g. _Cataplasma Sinapis_, L. D. which generally
inflames the surface to which it is applied so much as to raise
blisters; common salt also, _muriate of soda_, constitutes the
active ingredient of a poultice which has lately been brought into
considerable repute for the reduction of indolent strumous
swellings and enlargements of the glands.[311]

2. ANTISEPTICS—_Cataplasma Fermenti_, L. (see p. 159.) A powerfully
antiseptic cataplasm may be also made by stirring finely powdered
charcoal into a common linseed meal poultice. A cataplasm of the
boiled carrot, beat into a pulp, has been likewise found very
effectual in sweetening foul ulcers.

3. SEDATIVES. The most efficient of these are composed of _Conium_,
_Digitalis_, or _Hyoscyamus_, and are eminently serviceable in
cancerous and scrophulous sores of a highly irritable and painful
nature, to diminish their sensibility and correct the acrid
discharges. See _Form. 18_.

4. REFRIGERANTS. In the formation of a cataplasm for this purpose we
must avoid the introduction of substances that are slow conductors
of caloric; suppose for example our object is to apply the
_sub-acetate of lead_ in this form, it will in such case be
judicious to mix the linseed meal, with oatmeal, or crumb of
bread; for if the former substance be used singly, it is liable,
from its tenacity, to become hard and dry, and in that state to
augment the temperature which it was designed to diminish.

5. EMOLLIENTS.—(The _modus operandi_ of these agents is explained at
p. 142.) For which purpose the common farinaceous poultice is the
most eligible, made by soaking slices of bread in milk, and
simmering them together over a gentle fire until they are reduced
to the proper consistence, which ought to be such as to prevent
its spreading farther than is designed, and yet not so hard as to
occasion any mechanical irritation; the whole is then to be beat
smooth with a spoon, and applied as warm as the patient’s feelings
will readily admit. Some practitioners have doubted the propriety
of milk as an ingredient in this composition, and have preferred
water as an excipient, not only because the former is very liable
to turn sour, but because it does not possess greater powers as an
emollient than water; the observations of the editor of the
Pharmacopœia Chirurgica upon this question are judicious, and
worthy our notice; “the objection,” he says, “will certainly hold
good whenever stale milk is made use of, or if the same poultice
be kept too long applied; but if the milk be fresh, and the
poultice renewed night and morning, we do not know any thing that
occasionally gives such ease and comfort to the patient as this
form of cataplasm. If water be substituted for milk, the poultice
is seldom of sufficient tenacity; it is true that this
inconvenience may be remedied by the addition of a little linseed
meal, but in some instances the meal appears to fret and irritate
the skin so much, that patients undergo considerable uneasiness
from this cause; an objection to which the cataplasm of bread and
milk is seldom subject, especially if it be not applied too hot.”

Every substance, whether liquid or solid, may become an ingredient in
this species of composition, and although judicious and
experienced surgeons have of late very considerably improved the
form of their cataplasms, yet the principles of medicinal
combination, which it has been the object of the present work to
investigate and expound, will suggest many important hints for the
farther extension of their utility; and although the direction of
them is more frequently left to the nurse than to the medical
practitioner, yet in adapting them to each particular occasion
some share of chemical address may be necessary; we have already
seen that attention must be paid to the selection of ingredients,
with respect to their powers of conducting heat, and it is evident
that care must be taken not to reduce into pulp, by decoction,
substances that contain volatile principles; while in the
preparation of active liquids to be subsequently mixed with
linseed meal, it is equally evident that we must be directed by
the chemical nature of their composition.

EMPLASTRA. L.E.D. _Plasters._

These are solid and tenacious compounds, adhesive at the ordinary heat of the human body; they owe their consistence to different causes, viz.

1. _To a due admixture of wax or fatty matter_, _and resin_, e. g.
_Emplast: Ceræ_, &c.

They may be said to differ only in _consistence_ from liniments, ointments, and cerates; Deyeux[312] accordingly proposes to distinguish them by the appellation of _Solid Ointments_.

2. _To the chemical combination of the semivitreous oxide of lead with
oils or fat_, e. g. _Emplast: Plumbi_.

3. _To the chemical action of the component parts of the plaster on
each other_, as _Emplast: Ammoniaci_, &c.

Plasters are generally kept in rolls, wrapped in paper, and when to be used they are melted and spread on leather; in performing this operation the practitioner ought not to apply a heat above that of boiling water; for if metallic oxides be present, the fatty matter will, at a higher temperature, reduce them, in consequence of the powerful affinity of oil for oxygen at an exalted temperature; and if aromatic substances enter as ingredients they will thus suffer in their strength, besides which the fat itself will undergo a very injurious change by a mismanaged application of heat, and the plaster will be less adhesive.

They are employed as remedies to answer two general indications; _mechanically_, to afford support to muscular parts and to prevent the access of air; and _medicinally_, to operate as stimulants, discutients, rubefacients, or anodyne applications. That by affording an artificial support to the various parts of the body, by the application of plasters, we are capable in certain diseases of effecting much benefit, is a truth to be explained upon the principles of physiology, and is daily confirmed by the results of practice; thus by giving support to the muscles of the back, how frequently the stomach is steadied and strengthened? Diseases of the kidneys are in the same way very frequently relieved by tight bandages around the loins; the existence of an intimate connexion between the external and internal parts is strikingly exemplified by the distressing effects which are often experienced in weak habits, such as sickness, giddiness, and other uneasy sensations, from a want of any usual compression, as that of stays, under-waistcoats, &c. The support afforded to persons who have been tapped in Ascites is another instance. I have also lately met with a case in which a morbidly relaxed state of the bowels had harassed the patient for several years, and set at defiance every astringent medicine; upon the application, however, of a tight bandage around the abdomen, the healthy action of the intestines has been completely restored. Sir Gilbert Blane has suggested the trial of mechanical compression of the head in the cure of Hydrocephalus, and several cases, apparently favourable, have been published. Dr. Thackrey of Cambridge has related a very interesting history in support of the practice, and judiciously recommends the substitution of straps of adhesive plaster for the bandages of cloth originally proposed by Sir Gilbert. In reasoning upon this treatment, it will be found strictly conformable with the soundest principles of physiology, and with those views in particular, for the illustration of which I have here directed the reader’s attention to the subject. Where our object is simple support, we should of course select a plaster which is the most adhesive and the least irritating. Many plasters which have gained great celebrity for their curative virtues will be found to owe all their powers to their adhesiveness, such is the _Emplastrum Oxidi Ferri Rubri_ of the Edinburgh Pharmacopœia, for it is impossible that the iron should communicate any tonic effect. The same observation applies to many of those empirical plasters which have at different times acquired so great a share[313] of popular applause. In the cure of sore legs[314] the importance of adhesive strapping is generally acknowledged, and on such occasions nothing is superior to the _Emplastrum Resinæ_.

FORMULÆ

IN

ILLUSTRATION OF THE SUBJECT

OF

Medicinal Combination.

“_Longum est iter per Præcepta, breve et efficax per Exempla._” SENECA.

A COLLECTION OF FORMULÆ
INTENDED TO ILLUSTRATE THE FOREGOING PRECEPTS,
and to furnish the inexperienced Prescriber
WITH A SERIES OF
_USEFUL AND INSTRUCTIVE LESSONS_.

EXPLANATION OF THE KEY LETTERS.

The _Modus Operandi_ of the different elements of each formula is designated by a KEY LETTER, or _Symbol_, which is printed in a different type, (thus =B=) and placed in the margin opposite to each. This letter refers to a corresponding one in the Synopsis, and thereby shews the division containing an exposition of the principles upon which the operation of the ingredient is supposed to depend.

Two or more KEY LETTERS denote that the element against which they are so placed has several modes of operation, whilst the order in which the letters succeed each other, serves to shew the relative importance of them.

Where any one of the letters is _small_, _i. e._ not a capital, it denotes that the operation which it is intended to express is only _incidental_ to, or subordinate in, the general scheme of the combination.

When any number of elements are included within a _vinculum_ or bracket, it is intended to shew that they operate but as one substance, or, that the virtues of each are not independent of the other; in this case the KEY LETTER within the bracket expresses upon what principle this unity depends, whilst that on the exterior shews the action of such a combination upon the base, or the part which it performs in the general scheme of the Formula.

Let us exemplify it by a reference to _Formula 78_ which presents us with a Purgative, in conjunction with a Stimulant. The base is _Aloes_, which is succeeded by _Scammony_, and _Extract of Rhubarb_; these substances appear by the bracket, to act in unison, a concurrence which the interior letter =B= shews to depend upon their being SIMILAR REMEDIES; the letter also on the exterior shews that its operation upon the base depends upon the same principle. We next come to powdered _Capsicum_, and _Oil of Cloves_; these ingredients are also shewn by a bracket to act in unity, and the letter =B= in the interior, denotes that it is in consequence of their possessing a similar mode of action, whilst the letter =G= on the exterior, announces that they act in the general scheme for the purpose of fulfilling a second indication; at the same time the smaller letter _e_ informs us that the combination likewise acts as a _corrector_ of the base.[315]

A SYNOPSIS
OF THE
Principles of Combination,
AS INVESTIGATED IN THE PRECEDING PAGES,
ARRANGED IN A TABULAR FORM
SO AS TO AFFORD THE STUDENT AN EASY
REFERENCE TO THE KEY LETTERS.

_A Synopsis of the Principles of Medicinal Combination._

OBJECT I.
TO PROMOTE THE ACTION OF THE BASIS.

Key Letters.

=A= A.—_By combining the several different forms, or preparations
of the_ SAME SUBSTANCE.

=B= B.—_By combining the Basis with Substances which are of the_
SAME NATURE, _i. e, which are individually capable of
producing the same effects, but with less energy than when
in combination with each other_.

=C= C.—_By combining the Basis with Substances of a_ DIFFERENT
NATURE, _and which do not exert any Chemical influence upon
it, but are found by experience, or inferred by analogy,
to be capable of rendering the stomach, or system, more
susceptible of its action_.

OBJECT II.
TO CORRECT THE OPERATION OF THE BASIS, BY OBVIATING ANY UNPLEASANT
EFFECTS IT MIGHT BE LIKELY TO OCCASION, AND WHICH WOULD PERVERT ITS
INTENDED ACTION, AND DEFEAT THE OBJECT OF ITS EXHIBITION.

=D= A.—_By_ CHEMICALLY _neutralizing, or_ MECHANICALLY
_separating, the offending ingredient_.

=E= B.—_By adding some substance calculated to guard the stomach,
or system against its deleterious effects._

OBJECT III.
TO OBTAIN THE JOINT OPERATION OF TWO, OR MORE MEDICINES.

=F= A.—_By uniting those Medicines which are calculated to produce
the_ SAME ULTIMATE RESULTS, _but by modes of operation
totally different_.

=G= B.—_By combining Medicines which have entirely different
powers, and which are required to obviate different
symptoms, or to answer different indications._

OBJECT IV.
TO OBTAIN A NEW AND ACTIVE REMEDY, NOT AFFORDED BY ANY SINGLE SUBSTANCE.

=H= A.—_By combining Medicines which excite different actions in
the stomach and system, in consequence of which_ NEW, _or_
MODIFIED RESULTS _are produced_.

B.—_By combining substances which have the property of acting_
CHEMICALLY _upon each other; the results of which are_—

=I= a. _The Formation of New Compounds._

=K= b. _The Decomposition of the Original Ingredients, and the
developement of their more active elements._

C.—_By combining Substances, between which no other change is
induced than a diminution, or increase in the_ SOLUBILITY
_of the principles in which their Medicinal virtues reside_.

=L= a. _By the intervention of Substances that act_ CHEMICALLY.

=M= b. _By the addition of Ingredients whose operation is
entirely_ MECHANICAL.

OBJECT V.
TO AFFORD AN ELIGIBLE FORM.

=N= a. _By which the_ EFFICACY _of the Remedy is enhanced_.

=O= b. _By which its_ ASPECT _or_ FLAVOUR _is rendered more
agreeable, or its mode of administration more convenient_.

=P= c. _By which it is_ PRESERVED _from the spontaneous
decomposition to which it is liable_.

NARCOTICS.

1. ℞. Extract: Hyoscyami ℈j.
Camphoræ gr. viij =B.=
Spir: Rectificat: ♏︎ij =N.=

Camphoram primum cum Spiritu in pulverem tere, deinde simul contunde et divide massam in Pilulas xij, quarum sumantur tres, omni nocte.

2. ℞. Extract: Conii ʒj
Folior: Conii exsiccat:
et in pulverem tritorum, q. s. =A.=
ut fiant Pilulæ; singulis grana duo
pendentibus.

Initio sumat æger pilulam unam pro dosi, mane et nocte; postea, binas, et deinde tres vel quatuor; et denique augeatur dosis quantum possit.

_Stoerck._

3. ℞. Opii puri gr. iv
Extract: Hyoscyam: et =B. } B.=
Extract: Conii āā gr. xv. =}=

Simul contunde, et fiat massa in Pilulas sex dividenda, e quibus sumatur una omni nocte.

4. ℞. Extract: Conii
et
Extract: Hyoscyam: (_in vacuo_ pp:) āā gr.
iij =B.=

Fiat Pil. bis quotidie sumenda.

5. ℞. Tinct: Opii ♏︎xv
Syrup: Papaveris fʒij =A.=
Spir: Cinnamom: fʒj =O.=
Aquæ puræ f℥jss =N.=

Fiat Haustus, invadente paroxysmo caloris in febribus intermittentibus sumendus.

_Lind._

6. ℞ Opii puri, et
Camphor: āā ʒss =F.=
Emplast: Lithargyri ʒij =O.=

Sit scuto pectori.

_Bree._

7. ℞. Mist: Camphoræ f℥j
Spir: Ether: comp: fʒss =B.=
Tinct: Opii ♏︎x =F. } A.=
Syrup: Papav: fʒji =}=

Fiat Haustus hora decubitus sumendus.

8. ℞. Tinct: Opii fʒj
Infus: Lini f℥vj =G.N.=

Fiat Enema.

9. ℞. Opii puri gr. ij
Mucilag: Acaciæ f℥ss =M. } N.G.=
Lactis tepefacti f℥vj =}=

Misce pro Enemate.

_Hartman._

10. ℞. Opii puri gr. j.
Pil: Galb: comp: gr. v. =M.F.=c.

Fiat Pilula, h. s. sumenda.

11. ℞. Opii puri gr. j.
Pil: Aloes cum Myrrha gr. iv. =E.M.=

Fiat Pilula, h. s. sumenda.

12. ℞. Opii puri gr. ij.
Extract: Aloes Spicat: gr. x. =E.M.=

ut fiat Massa in Pil: iij dividend: e quibus sumatur una, h. s.

13. ℞. Opii puri gr. j.
Extract: Aloes Spicat gr. iij =E.=1.=M.=
Extract: Gent: gr. v. =E.=2.

Fiat Massa in Pil: duas dividend: et sint pro dosi.

14. ℞. Opii puri gr. ij.
Saponis duri Hispan: gr. iv =L.N.=

Simul contunde, donec corpus unum sit, et fiat Massa pro Suppositorio.

15. ℞. Opii puri gr. ij.
Confect: Aromat: ʒss =G.N.=

Fiat Massa in Pilulas viij dividenda, e quibus capiatur una, quarta quaque hora.

_In Typhus._

16. ℞. Opii duri contriti gr. iv.
Aquæ bullientis f℥ijss =D.=

Infunde, prope ignem, per horam, et cola.

℞. Liquoris Colati f℥j
Acid: Nitric: dilut: ♏︎x =E.=1.
Træ Aloes comp: fʒj =E.=2.

Fiat Haustus.

17. ℞. Conii foliorum exsiccat: ℥j
Coque ex aquæ oiiss ad oij
et cola.

Panni lanei hocce decocto calido madefacti, deinde expressi, parti affectæ imponantur, et sæpius renoventur.

_Collin._

_In Carcinomatous, Venereal, and sordid Ulcers._

18. ℞. Conii Folior: exsiccat: ℥ij.
Medullæ panis ℥vj =} N.O.=
Aquæ oiss =}=

Coquantur simul, ut fiat Cataplasma.

19. ℞. Extract: Conii
Extract: Hyoscyam: āā gr. v. =B.=
Mucilag: Acaciæ fʒij =N.=
Tere simul, donec quam optime misceantur, et
deinde adde,
Liquor: Ammon; Acetat: =} G.=
Aquæ puræ āā f℥ss =}=
Syrup: Rhæados fʒj =O.=

Fiat Haustus, quarta quaque hora sumendus.

_In Pulmonary irritation._

_J. A. P._

ANTISPASMODICS.

20. ℞. Tincturæ Castorei fʒj
Ætheris: Sulphurici ♏︎x =B.=
Tinct: Opii ♏︎vij =G.=
Aquæ Cinnamomi f℥iss =N.O.=

Fiat Haustus ter quotidie sumendus.

21. ℞. Moschi gr. xv
Camphoræ gr. v. =B.=
Spir: rectificat: ♏︎ij =L.=
Confect: Rosæ gall: q. s. =O.=

Camphoram primùm cum Spiritu tere, et deinde, secundum artem, fiat bolus.

22. ℞. Moschi ℈j
Acaciæ gummi contriti ʒss =M.=
Tere optime simul, et adde paulatim,
Aquæ Rosæ f℥j =O.=
Ætheris Sulphuric: fʒj =B.=

Fiat Haustus, p. r. n, sumendus.

23. ℞. Assafœtidæ ʒj
Aquæ Menth: Pip. f℥jss =L.=

Tere assafœtidam cum Aquâ paulatim instillata, donec quam optime misceantur, et deinde adde

Tinct: Valerian: Ammoniat: fʒij =}=
Tinct: Castorei fʒiij =B. } B.=
Ætheris Sulphuric: fʒj =}=

Fiat Mistura, de qua sumatur Cochleare unum amplum secundis horis.

Signetur.—_Anti-hysteric Mixture._

24. ℞. Mist: Camphoræ f℥j
Spir: Ammoniæ Fœtid: fʒss =B.=

Fiat Haustus, urgenti flatu, sumendus.

25. ℞. Valerianæ Radicis, in pulverem redact: ℈j
Tinct: Valerian: Ammoniat: =A.=
Tinct: Castorei āā fʒj =B. } B.=
Mist: Camphoræ fʒxij =}=

Fiat Haustus ter quotidie sumendus.

26. ℞. Tabaci Foliorum ℈j
Aquæ ferventis f℥viij

Macera per horam in vase leviter clauso, et cola. Fiat pro Enemate.

27. ℞. Massæ Pil: Galb: comp. gr. x.
Divide in Pilulas binas, et sint pro dosi.

28. ℞. Tinct: Opii ♏︎vj.
Vini Ipecacuanhæ fʒj =H.=
Aquæ puræ f℥j =N.=
Syrup: Simpl: fʒiij =O.=
Sodæ Sub-carbonat: gr. xxiv. =G.=

Sumat Infans sextam partem quartis vel sextis horis.

_In Tussi Convulsiva._

R. Pearson.

29. ℞. Assafœtidæ ʒij
Decoct: Avenæ f℥x =N.O.=

Misce pro enemate, secundum artem.

_In Flatulent Cholic._

_Bang._

30. ℞. Moschi gr. xij
Sacch: purificat: ℈ij =} M.=
Acaciæ Gummi contriti ℈j =}=

Simul tritis admisceantur Jusculi cujusvis tenuioris f℥iv, ut fiat enema, alternis vel tertiis horis injiciendum.

_Wall._

31. ℞. Cinchonæ lancifoliæ Corticis contriti ℥j.
Valerianæ Radicis Pul: ʒiij =G.=
Syrup: Aurantiorum q.s. =O.=

Ut fiat electuarium, cujus devoret drachmam, mane ac vesperi.

_Mead._

32. ℞. Tinct: Digitalis ♏︎x—xv
Mist: Camphoræ fʒx =F. } G.O.=
Tinct: Calumbæ fʒi =}=

Fiat Haustus, bis quotidie sumendus.

_In Palpitation of the Heart, accompanied with great nervous irritability._

TONICS.

33. ℞. Infus: Cascarillæ f℥iss
Tinct: Cascarillæ f℥ij =A.=
Tinct: Zingiberis fʒj =G.=

Fiat Haustus ter quotidie sumendus.

34. ℞. Ferri Tartarizati gr. x.
Pulv: Calumbæ gr. xv =F.=m.

Fiat Pulvis, quarta quaque hora sumendus.

35. ℞. Infusi Quassiæ fʒx
Tinct: Calumbæ fʒj =B.=
Tinct: Ferri muriat: ♏︎x =F.=

Fiat Haustus, quotidie, hora meridiana sumendus.

36. ℞. Ferri Ammoniati ʒj
Extract: Gentian: =F.M.=
et
Extract: Aloe āā ʒss =G.M.=

Contunde simul, et divide massam in Pil. xxx. quarum sumat binas ter quotidie.

_Tonic and Purgative._

37. ℞. Cinchonæ lancifoliæ contritæ ℥ss
Magnesiæ Sulphatis ʒvj =G.=

Tere optime simul, et divide in quatuor partes, ex quibus sumatur una alternis horis inter paroxysmos.

_In Intermittents._

_Cleghorn._

38. ℞. Ferri Sub-carbonatis gr. v—x.
Pulv: Valerian: ʒss =G.=
Syrup: Zingib: q. s. =E.O.=

Fiat Bolus.

39. ℞. Infusi Gentianæ comp: f℥j
Liquor: Potassæ Sub-carb: fʒss =O.L.G.=
Tinct: Cascarillæ fʒj =B.=

Fiat Haustus.

40. ℞. Cinchonæ lancifoliæ Cort: contus: ℥ss
Coque ex aquæ puræ f℥xvj
ad consumpt: dimid: adjectis sub finem coctionis,
Serpentāriæ radicis contus: ʒij =B.=
Stent per horam, et Colaturæ admisce,
Spir: Cinnamomi comp: f℥iss =E.=
Acid: Sulphuric: dilut: fʒiss =G.=

Sumantur f℥ij sexta quaque hora.

_Pringle._

41.[316] ℞. Decoct: Cinchonæ f℥iiss
Infus: Gentian: comp: f℥j =B. { B.=
Tinct: Cascarillæ fʒij ={=
Liquor: Potassæ Sub-carb: fʒij =G.1.=

Fiat Mistura, de qua sumr: Cochl: duo ampla bis de die.

42.[316] ℞. Decoct: Cinchonæ f℥vj
Tinct: Cinchonæ f℥ss =A.=
Confect: Aromat: ℈j =B. { G.E.=
Spir: Ammon: Aromat: fʒj ={=

Fiat Mistura.

43. ℞. Ferri Ammoniat: gr. v.
Rhei Rad: Contrit: gr. iij =G.=

Fiat Pulvis ex quolibet vehiculo idoneo quotidie sumendus.

44. ℞. Cinchonæ Pulv: subtiliss:
Potassæ Super-tart: āā ℥j =G.1.=
Caryophyll: contrit: No. xxx =G.2.=

Misce, et detur drachma cum semisse tertiis horis.

_Petrie._

AROMATIC STIMULANTS.

45. ℞. Sinapeos semin: contus:
Armoraciæ Radicis concisæ āā ℥ss =B.=
Aquæ ferventis oj =N.O.=

Macera per horam, et cola.

℞. Colaturæ f℥vii
Spir: Ammon: Aromat. fʒj =B. { B.=
Spir: Pimentæ f℥ss ={=

Fiat Mistura; de qua sumr: Cochl: duo ampla ter quotidie.

_In Paralysis._

46. ℞. Lactis Vaccini oj
Sinap: Semin: contus: ℥j

Coquantur simul, donec pars caseosa in coagulum abierit, deinde coletur serum, et sumatur cyathus subinde.

_Disp: Fuld:_

47. ℞. Mist: Camphoræ f℥j
Spir: Ether: Sulphuric: fʒij =}=
Tinct: Cardamom: comp: f℥ss =}=
Spir: Anisi fʒvj =B. } B.=
Olei Carui ♏︎xij =}=
Syrup: Zingib: fʒij =}=
Aquæ Menthæ Pip: f℥vss =}=

Fiat Mistura, cujus sumantur Cochlearia duo ampla, urgenti flatu.

_In Flatulent Cholic._

48. ℞. Ammoniæ Sub-carb: ʒss
Aquæ Menth: Pip: f℥vij =N.B.=
Syrup: Aurant: f℥ss =O.=

Sumatur octava pars in languoribus.

49. ℞. Cantharid: in pulverem trit: gr. j
Ammoniæ Sub-carb: =B. } F.=
Confect: Aromat: āā gr. v. =}=
Syrup: q. s. =O.=

ut fiat bolus, quartis vel sextis horis sumendus, cum haustu Infusi Armoraciæ compositi.

50. ℞. Olei Terebinthinæ fʒij
Mellis Despumat: ℥j =} O.=
Pulv: Rad: Glycyrrhizæ, q. s. =}=

ut fiat linctus: de quo sumatur cochl: parv: nocte, maneque, cum haustu cujusvis potus tenuioris tepefacti.

ASTRINGENTS.

51. ℞. Quercus Cort: contus: ℥ss
Aquæ ferventis f℥xiij

Macera per horam, et cola.

℞. Hujus Colaturæ f℥iss =}=
Pulv: Gallarum gr x. =B. } B.=
Tinct: Catechu fʒss =}=
Tinct: Cardamom: comp: fʒss =G.E.O.=
Syrup: Cort: Aurant: fʒj =O.=

Fiat Haustus.

52. ℞. Misturæ Cretæ f℥iss
Tinct: Opii ♏︎xv. =F.1.=
Tinct: Catechu fʒj =F.2.=

Fiat Haustus, post singulas sedes liquidas sumendus.

_In Diarrhœa._

53. ℞. Aluminis Contriti gr. v.
Myristicæ Nucl: Contrit, gr. v. =E.=
Extract: Gentian: q. s, =F.O.=

ut fiat massa in Pil: ij dividend:

54. ℞. Lactis Vaccini bullient: oj.
Aluminis Contrit. ʒij.

Ebulliant simul ut fiat coagulum; coletur serum, et sumatur cyathus, subinde.

55. ℞. Gallarum pulverisat: ʒj.
Adipis præparat: ʒj =O.=

Fiat Unguentum, parti affectæ applicand:

_In Hæmorrhoidibus._

_Cullen._

56. ℞. Infus: Ros: comp: f℥iiiss
Alum: contrit: gr. x. =B.=
Oxymel fʒiij =B.O.=

Sit pro Gargarismate.

57. ℞. Plumbi Acetat: gr. iij
Opii puri gr. i. =B. } B.=
Extract: Conii gr. x. =}=

Fiat Massa in Pilulas tres dividenda; quarum sumatur una bis quotidie, superbibendo haustum ex acido acetico comp:

58. ℞. Infus: Cuspariæ f℥j
Minct: Catechu fʒj =B.=
Pulv: Ipecac: gr. x. =G.=

Fiat Haustus.

59. ℞. Zinc: Sulphat: gr. x.
Myrrhæ in pulv: trii: ʒiss =G.=
Confect: Ros: q. s, =N.O.=

ut fiant Pilulæ xx, e quibus sumantur binæ bis quotidie.

60. ℞. Tinct: Ferri Muriat: ♏︎x
Aquæ puræ f℥j. =N.=

Fiat Haustus, tertia quaque hora sumend:

_In Uterine Hemorrhage._

61. ℞. Cort: Quercus contus: ʒvj
Aquæ distillat: f℥x

Coque per sextam partem horæ, et cola.

62. ℞. Colaturæ et
Infus: Lini āā f℥iv =E.=

Sit pro injectione per vaginam.

_In Uterine Discharges attended with an irritable state of the vagina._

EMETICS.

63. ℞. Antimonii Tartarizati gr. i
Vini Ipecac: fʒij =B.=
Aquæ puræ f℥iss =N.=

Fiat Haustus.

64. ℞. Antimonii Tartarizati gr. ij
Aquæ distillatæ f℥iv =N.=

Solve—Hujus danda sunt cochlearia duo mediocria, singulis horæ quadrantibus, donec vomitus excitatus sit.

65. ℞. Pulv: Ipecac: ʒss
Antimon: Tart: gr. i =B. } B.=
Tinct: Scillæ fʒi =}=
Aquæ distillat: f℥viiss =N.=

Fiat Mistura, cujus sumat quamprimum cochlearia majora quatuor; et cochlearia duo, sexta quaque horæ parte, donec supervenerit vomitus.

66. ℞. Zinc: Sulph: ℈i
Confect: Ros: canin: q. s, =O.=
ut fiat bolus, ex pauxillo Infus: Anthemid: =O.=

hauriendus. Post quamlibet vomitionem superbibantur cyathi aliquot infusi ejusdem tepidi.

67. ℞. Tabaci Foliorum ℥j
Aquæ fontis, q. s, =N.=

Simul contunde, ut fiat epithema, regioni epigastricæ admovend:

68. ℞. Cupri Sulphatis gr. x.—℈j.
Aquæ distillatæ f℥ij =N.=

Fiat pro haustu emetico.

CATHARTICS.

69. ℞. Magnesiæ Sulphatis =}=
et =B. }=
Sodæ Sulphatis āā ʒiij =}=
Aquæ Menthæ Viridis f℥vss =N.O.=
Vini Antimon: Tart: fʒj =O.=

Fiat Mistura, de qua sumr. Cochl: duo ampla ter quotidie.

70. ℞. Infusi Sennæ f℥j
Tinct: Sennæ =}=
et =B. } E.B.=
Tinct: Jalapæ āā fʒj =}=
Potassæ Tart: ʒj =F.E.=2.
Syrup: Sennæ fʒj =A.O.=

Fiat Haustus, summo mane sumendus.

71. ℞. Extract: Colocynth: comp: ʒj
Opii puri gr. iij =G.=
Olei nucis Moschat ♏︎iv =E.=

Fiat massa in pilulas xii dividend: e quibus capiat duas, omni hora, donec bis dejecerit alvus.

72. ℞. Magnesiæ Sulphat: =}=
et =B. }=
Sodæ Sulphat: āā ℥ss =}=
Ferri Sulphat: gr. v. =G.=
Misturæ Camphoræ f℥viiss =L.O.=

Fiat mistura, de qua sumantur Cochl: duo ampla bis indies.

73. ℞. Jalapæ Radicis contrit: gr. xv.
Hydrarg: Sub-muriat: gr. v. =F.=
Confect: Ros: canin: q. s. =N.O.=

ut fiat bolus.

74. ℞. Confect: Sennæ ℥iss
Sulphur: Præcipitat: ℥ss =G.=
Syrup: Ros. q. s. =N.O.=

ut fiat Electuarium, de quo, ad nucis Moschatæ magnitudinem, capiatur, ter vel quater quotidie, donec alvus commode purgetur.

_In Hæmorrhoids._

75. ℞. Olei Ricini f℥ss
Vitelli Ovi, q. s. =O.=
tere simul, et adde
Syrup: Papaveris fʒij =B. } G.=
Tinct: Opii ♏︎v =}=
Aquæ distillatæ f℥j =L.=

Fiat Haustus tertiis vel quartis horis sumendus.

_In Cholic from Lead._

76. ℞. Magnesiæ Sulphatis ʒvj
Infusi Sennæ f℥iss =F.L.=
Tinct: Jalap: fʒj =E.F.=
Tinct: Opii ♏︎x =F. } G.=
Tinct: Castorei fʒj =}=

Fiat Haustus, ut supra, dandus.

77. ℞. Infusi Sennæ f℥ij
Sodæ Tartariz: ʒvj =F.E.=
Aquæ Cinnamomi f℥ss =E.O.=

Fiat solutio, duabus vicibus, sumenda.

78. ℞. Aloës Spicat: ℈j
Scammoneæ gr. xij =B. } F.=
Extract: Rhei ℈ij =}=
Bacc: Capsici pulv: gr. vj =B. } G.=e.
Olei Caryophyll: ♏︎v =}=

Fiant Pilulæ xvj, e quibus sumantur binæ, hora decubitus, p. r. n.

79. ℞. Pil. Hydrarg:
et
Aloes Spicat: āā ℈j =G.=

Fiat Massa in Pil: vj dividend: e quibus sumantur binæ, h. s.

80. ℞. Pulv: Aloes comp: ʒj
Pulv: Antimon: gr. v. =C.=
Saponis duri gr. x. =L.N.O.=
Decoct: Aloes comp: q. s. =O.=a.

Fiat Massa in Pilulas xx dividend: e quibus capiantur binæ ad alvum officii immemorem excitandam.

81. ℞. Extract: Colocynth: comp: gr. xxiv
Pil: Aloes cum Myrrha ʒj =F. } F.=
Hydrarg: Sub-muriat: gr. xv =}=

Fiat Massa in Pil: xx dividend: e quibus sumr una vel altera, p. r. n.

82. ℞. Sodæ Sub-carbonat: (_cryst:_) ʒiiss =}=
Potassæ Super-tart: ʒiij =K. } I.=
Aquæ puræ f℥viij =}=

Stent in lagena bene obturata per triduum, et deinde sit in promptu pro potu cathartico.

_Young._

_Medical Literature, Edit. 2, p. 481._

83. ℞. Scammoneæ gr. v.
Pulv: Rhei gr. xv =F.=
Ammoniæ Sub-carbonat: gr. v =G.E.=

Fiat Pulvis, ex vehiculo aliquo idoneo sumendus.

84. ℞. Pulv: Jalap: gr. xv
Pulv: Ipecac: gr. v =C.=
Olei Cinnamom: ♏︎ij =E.=

Fiat Pulvis, ut supra, dandus.

85. ℞. Pulv: Rhei gr. xv.
Potassæ Super-sulphat: gr. x =B.O.=
Aquæ Cinnamomi f℥j =O.=e.

Fiat Haustus.

86. ℞. Sodæ Tartarizat: ʒij
Sodæ Carbonat: ℈j =}=
Aquæ puræ f℥iss =I.K. } O.=
Fiat Haustus, cum Cochl: uno amplo Succi
Limonum =}=

In impetu effervescentiæ sumendus. Quotidie mane.

87. ℞. Sodæ Carbonatis ʒij =}=
Ferri Sulphat: gr. iij =}=
Magnesiæ Sub-carb: ʒj =} I.K.=
Aquæ puræ oss =}=
Acidi Sulphurici dilut: fʒx =}=

Infundatur primum lagenæ aqua, deinde immittantur Salina, et denique Acidum Sulphuricum; illico obturetur lagena, et in loco frigido servetur.

NOTE.—_The decompositions which take place in this formula are described in the Essay on the Art of Prescribing, p. 170. There is, however, a precaution respecting the proportion of Sulphuric acid which it is essential to remember, viz.—that it should never be added in excess; for in that case the Sulphate of Iron would not undergo the necessary decomposition._

88. ℞. Hydrarg: Sub-muriat: gr. x
Pil: Cambogiæ comp: =F. } F.=
et Extract: Colocynth: comp: āā gr. xv =}=
Syrup: Zingib, q. s. =E.=

ut fiant Pilulæ xij, e quibus sumantur binæ, hora decubitus, vel summo mane, ad alvum officii immemorem excitandam.

89. ℞. Cambogiæ Contritæ gr. iij
Sacch: purificat: ℈j =M.O.E.=

Tere optime simul, ut fiat Pulvis, tertia quaque hora sumendus, donec alvus commode purgetur.

90. ℞. Foliorum Sennæ ʒiij
Sodæ Sulphat: ℥j =F.=
Aquæ fervent: oj =L.N.O=

Infunde, et cola, ut fiat Enema.

91. ℞. Resinæ Terebinthinæ f℥ss
Vitelli ovi, q. s. =M.=
Infus: Lini f℥x =N.O.=

Tere Resinam cum vitello ovi, hisque, inter terendum Infusum Lini paulatim adjice. _Fiat Enema._

92. ℞. Potassæ Super-tart: ℥ij
Ferri Tartarizat: ʒiij =G.=
Zingib: ℈j =E.=
Syrup: Simp: q. s. =O.=

dosis ʒij ter die.

93. ℞. Confect: Sennæ ℥ij
Ferri Tartarizat: ℈ij =G.=

Fiat Electuarium, ad nucis moschatæ magnitudinem sumendum.

EMMENAGOGUES.

94. ℞. Sabinæ Foliorum exsiccat:
Zingib: rad: contus: āā ℈ss =E.=
Potassæ Sulphatis ʒss =G.M.=

M. Fiat Pulvis bis die sumendus.

95. ℞. Myrrhæ pulv: ℈j
Ferri Ammoniati gr. vj =G.=

tere simul et adde

Syrup: Zingib: q. s. ut fiat Electuarium, de quo
sumatur ad myristicæ nuclei magnitudinem bis
quotidie.

96. ℞. Mist: Ferri comp: f℥ss
Aquæ Cinnamomi f℥j =O.=

Ft. Haustus bis de die sumendus.

97. ℞. Tinct: Ferri Muriatis
Tinct: Aloes comp: āā f℥ss =G.=1.
Tinct: Castorei fʒij =G.=2.