Practical materia medica for nurses; with an appendix containing poisons and their antidotes, with poison-emergencies; mineral waters; weights and measures; dose-lists; and a glossary of the terms used in materia medica and therapeutics

Appendix

CONTAINING POISONS AND THEIR ANTIDOTES, WITH POISON- EMERGENCIES ; MINERAL WATERS; WEIGHTS AND MEASURES; DOSE-LIST; AND A GLOSSARY OF THE TERMS USED IN MATERIA MEDICA AND THERA- PEUTICS

BY

Emily A. M. Stoney

Graduate of the Training-School for Nurses, Lawrence, Mass. ; late Head

Nurse, Mercy Hospital, Chicago, Illinois; late Superintendent of

Training-School for Nurses, Carney Hospital, South

Boston, Mass. ; Author of " Practical

Points in Nursing "

PHILADELPHIA, NEW YORK, LONDON

Ooovilg'ht Entry

/\A>UA, b - 1 q d if CLASS »- XXc. No.

% r i> i l

COPY B

ItMtff

1901, and September, 1902. Revised, entirely reset, electrotyped,

printed, and recopyrighted June, 1904.

Copyright, 1904, by W. B. Saunders & Company.

ELECTROTYPED BY WE8TOOTT & THOMSON, PHILADA,

PRESS OF W. B. SAUNDERS, PHILADA.

TO

Arthur Stuart Allen, M. D

THIS VOLUME IS DEDICATED

BY

THE AUTHOR

Preface To The Second Edition

The second edition of this volume has been largely rewritten. While the arrangement of the subject-matter has not been changed, numerous alterations and additions have been made in order to bring the book thoroughly abreast with the times, and to make it a more complete guide to those engaged in nursing.

PREFACE,

In preparing the following pages for publication, it has been my endeavor to make them as practical as possible, including only the source of the drugs, their action and uses, dosage, and the symptoms and treatment of poisoning.

They constitute the notes of a series of lectures delivered as a companion, so to speak, to " Practical Points in Nursing," and have been arranged in alphabetical order for a more ready reference.

The first part of the book is devoted to the general considerations and classification of drugs.

The second part, to the subject-matter proper of the lectures.

The third part, or appendix, contains Poison-emergencies, Poisons and their Antidotes, Emetics, Mineral Waters, Weights and Measures, Dose-list, Glossary, etc.

The doses of all drugs have been given in both the Apothecaries' and Metric Weights.

In compiling the notes, free use has been made of the works of Hare, Potter, Brunton, Bruce, Thornton, the lectures on " Poisons " by Dr. William H. Devine, the lectures on " Materia Medica and Therapeutics " by

8 PREFACE.

Professor Arthur R. Edwards, of the Northwestern University Medical College, and my own notes of three courses of clinical lectures.

My thanks are due to Dr. Arthur Stuart Allen for his great assistance in revising the notes, and to Professor Frank Marion Kindig, of the Northwestern University Medical College, for assistance with the proofs and for his suggestions and criticisms, which have been invaluable.

EMILY A. M. STONEY.

Part I General Considerations And The Classi- Fication Of Drugs

INTRODUCTORY.

Materia medica is that branch of medical science which treats of the remedies employed in medicine, their origin, names, modes of preparation, administration, doses in which they may be given, and their physiologic and toxicologic actions*

Remedies are divided into two classes — local and general. A local remedy acts on a particular organ or part ; a general remedy acts on the whole system.

I/Ocal remedies are divided into four classes :

1. Those which affect the function of a part, such as anesthetics, cathartics, cholagogues, diuretics, emmenagogues, diaphoretics, expectorants, oxytocics, and sialagogues.

2. Those which affect the organization of a part : caustics or escharotics, epispastics or vesicants, and rubefacients.

3. Those which have a mechanical action : emollients, demulcents, and protectives.

4. Those which act on extraneous matter within the organs : absorbents, antacids, anthelmintics, disinfectants, and solvents.

The six principal avenues of medication are :

1. The mouth (stomach).

2. The rectum.

3. The cellular tissue (subcutaneous injection).

4. The skin (inunction).

5. The lungs (inhalation).

6. The denuded skin (blisters).

The Mouth. — This is the first and best means of medication. Medicines are given by mouth for their local action on the alimentary canal and to be absorbed from it. When local action upon the stomach is desired, the medicine should be given when the viscus is empty in order that it may come in contact with all parts of the gastric mucous membrane. If slow absorption is desired or it is necessary to avoid irritating the stomach, the medicine is given after meals, during the process of gastric digestion. When it is desired that absorption shall take place from the intestines, the medicine should be given from two to three hours after a meal, when the gastric digestion is almost completed and the partly digested food is being swept into the intestinal canal. The absorption of drugs from the stomach and intestines, it must be remembered, may be considerably retarded and their action diminished by the liver, because, before reaching the general circulation, medicines absorbed from the intestinal canal usually pass through the liver, and in their passage they may be partially destroyed or temporarily arrested and excreted again into the intestine along with the bile.

When given for its local action on the mouth or pharynx, medicine should be given one or two hours before or after meals ; its effect will then be more pro-

CLASSIFICATION OF DRUGS. I 3

longed than when taken immediately before meals, since there will be no danger of the drug being wiped off in the process of mastication and swallowing.

The Rectum. — When there is serious derangement of the stomach, or when, for any reason, the patient is unable to swallow, we find the rectum a most convenient avenue for absorption. When giving medicine by rectum, we must remember two things :

1. That the process of absorption is slow, but that much may be gained by giving the enema as high as possible, since the colon is less irritable than the rectum and is better fitted for absorption.

2. That the surface of the lower bowel is usually more or less covered with material which interferes with absorption, and hence it should always be first cleansed with plain water before injecting the medicine. Medicines are given by the rectum in the form of enemata, suppositories, and rectal capsules. The dose of the drug is usually twice the amount given by mouth, unless the medicine is very powerful or is capable of rapid absorption.

Hypodermic Administration (Subcutaneous Injection). — Hypodermic or subcutaneous injection means the injecting of a drug under the skin. This method is resorted to when we wish to secure certain and prompt action, as in stimulating the heart, relieving pain, and in causing emesis. The dose of a drug given hypodermically is usually one-half the quantity given by the mouth, because it enters directly into the circulation and the entire dose is acting at one time, and is not modified by altered conditions of the digestive tract.

For the subcutaneous administration of drugs we use a hypodermic syringe. The most convenient places for the injection are the outside of the arms, the forearms, the chest, the abdomen, and the thighs, the injection being made into the fleshy part, avoiding the large blood-vessels, nerves, and bone. The syringe should be cleansed by drawing through it a I : 20 solution of carbolic acid several times, followed by very hot water. The needle should be boiled in a large spoonful of water over a gas-flame. The syringe is loaded with the ordered solution, the needle is screwed on tightly, making sure that it does not leak at the junction, and the air is expelled by gently pressing the piston until a drop of the fluid escapes from the needle.

After bathing the part with a weak solution of carbolic acid (1 : 60 or 1 :4c)) or alcohol, to insure absolute cleanliness, the skin is pinched up between the thumb and forefinger of the left hand, and the needle is quickly and slantingly inserted to the depth of about half an inch, so as to reach the underlying muscle or fat, then withdrawn slightly, and the fluid slowly injected, so as not to cause discomfort. A gentle friction over the part will distribute the fluid and aid its absorption. The needle is quickly removed and the friction is kept up for a few moments. Perfect cleanliness is essential in the operation, otherwise an abscess may result or some contagious disease may be transmitted.

After the operation the syringe should be thoroughly washed by drawing through it the carbolic-acid solution and hot water. The thin wire should be kept constantly in the needle to prevent the entrance of dirt. If the syringe is in constant use, it may be kept in a solution of carbolic acid I : 20. If not often used, the syringe should be soaked every few days in hot water to prevent the packing from shrinking.

CLASSIFICATION OF DRUGS. I 5

The medicines most commonly used hypodermically are:

Adrenalin, alcohol, ammonia-water, antitoxins, apomorphin, atropin, caffein, camphor, cocain, corrosive sublimate, digitalin (soluble), ergotin, eserin or physostigmin, ether, hyoscin, morphin, nitroglycerin, pilocarpin, quinin, strychnin.

Hypodermic syringes hold from 1 5 to 30 minims.

Intravenous injection, which is the injection of fluids directly into a vein, is practised only in cases of emergency. After copious hemorrhage, saline solutions are sometimes administered by this method.

Inunction is the rubbing of an oil or an ointment into the skin, either to secure its absorption or to prevent contagion through fine scales thrown off from the skin in such diseases as scarlet fever and measles. When the inunction is employed to prevent contagion, the body should be smeared from head to foot with warm sweet oil, cacao-butter, or vaselin, and the friction should be long and thorough. About four ounces of oil are required at each rubbing. In order to promote absorption from the skin the surface should first be bathed with warm water.

Mercurial Inunction. — The method of applying mercury to the skin is resorted to when the stomach is intolerant of drugs, or when, administered by mouth in full doses, they do not favorably modify the symptoms.

The mercury passes through the skin without producing any irritation, and is absorbed into the circulation, where the general effects of the drug are produced. The ointment should be rubbed on those parts where the skin is thin and the function of absorption is greatest, such as the inner sides of the thighs and the armpits.

The order of application differs somewhat. One method is as follows : On the first evening the patient takes a hot bath and puts on fresh underclothing. The second evening a piece of ointment about the size of a small nut is thoroughly rubbed into the skin of the inner side of the right thigh. On the third evening the left thigh is taken, and then, on successive evenings, the left armpit and the right armpit.

Dr. William H. Devine gives the following order :

First evening, the buttocks.

Second evening, the thighs.

Third evening, the side of the chest, but not the armpit.

Fourth evening, the internal surface of the arms and forearm.

Fifth evening, the back and abdomen.

Sixth evening, omit treatment.

Seventh evening, bathe, change underclothing, and resume treatment.

The ointment remaining after the rubbing, which should be continued for fifteen minutes, should be left on the skin, and the patient should wear the same underclothing night and day. By taking one part each evening irritation from the excessive friction is avoided. When applied to children, it is a good plan to put the ointment on a piece of flannel and to fasten the flannel to the part with a bandage. There is then no danger of the child spreading the ointment over other parts of the body. Fresh ointment should be put on the flannel every day, even if the latter appears soiled. The nurse should wash her hands thoroughly after each application, since absorption may take place through the skin of the hands.

CLASSIFICATION OF DRUGS. \J

Inhalation. — Inhalation is the method of administering a drug in the form of a vapor or gas through the respiratory tract. This method is especially employed for the administration of very volatile drugs, which are absorbed rapidly through the lungs, such as ether, chloroform, amyl nitrite, and ammonia. By this means also an agent can be brought into direct contact with the mucous membrane of the mouth, nose, throat, larynx, and bronchial tubes. Inhalations may be dry or moist.

Dry inhalations may be taken from a heated shovel or plate. The drug is placed on the shovel, and a paper cone is made, the broad end of which is placed over the drug, while the vapor is inhaled from the narrow end.

Moist Inhalations. — Moist inhalations are employed to soothe the throat and trachea when these parts are inflamed, dry, and irritated. In the absence of a steaminhaler the vaporized substances may be inhaled from a tea- or a coffee-pot standing over a lamp placed by the bedside, or the solution may be put into a pitcher or a tin pan, covered with a perforated paper, through which the patient may inhale the vapor. The patient should breathe quite naturally, taking in the vapor through the mouth, then closing the mouth, and allowing it to escape through the nose, breathing five or six times in succession before intermitting the inhalations.

If the patient is not in bed, he should inhale the vapor in the evening before retiring, or if done in the daytime, he should remain indoors subsequently for about half an hour to prevent taking cold. The inhalation of moist air, which is sometimes ordered in croup, diphtheria, and after tracheotomy, may be secured by keeping kettles of boiling water in the room or by placing small pieces of unslaked lime in pans of water.

Bndermic Medication. — This consists in the production of a blister, the removal of the epidermis, and the application of the drug in the form of a powder, ointment, or solution to the denuded surface.

This method is now rarely used, except in cases in which it is desirable to combine the counterirritant action of the blister with the local sedative effect of morphin.

Absorption of Medicines. — The rapidity of absorption depends upon four things :

1. The State of the Circulation. — If the circulation is active, absorption is active ; if depressed, as in shock, for instance, absorption is slow.

2. The Physical State of the Medicine. — A drug given in a soluble form is usually absorbed more quickly than when given in an insoluble form. Drugs given in solution are more quickly absorbed and have greater effect than when given in pill or powder form. Alcoholic solutions are generally more quickly absorbed than watery solutions.

3. The Part to Which the Drug is Applied. — Absorption is quickest from serous membranes, next from intercellular tissue, and slowest from mucous membranes. The vascularity and rate of absorption from intercellular tissue are greater on the inner sides of the arms and legs than on their outer surfaces. Medicine given upon an empty stomach is more rapidly absorbed because it comes in contact with all parts of the mucous membrane and is not impeded by the presence of food. For instance, wine taken with dinner may have little effect, whereas the same amount taken on an empty stomach may produce intoxication. Absorption is more certain and rapid when the drug is given hypodermically than when given by the mouth or rectum, because it enters directly into the circulation and is not subjected to modification by altered conditions in the stomach and intestine. In the alimentary canal there is not only the condition of the circulation to be considered, but also the fulness or emptiness of the stomach and intestine, the condition of their epithelial covering and of their nervous supply. Certain conditions in these organs may not only delay, but entirely prevent, absorption. The more rapid the absorption or the slower the excretion of any drug, the greater will be its effect. Absorption from the lungs is rapid on account of their large blood-supply.

4. The Power the Drug has of Passing Rapidly Through a Living Membra?ie. — In order to be absorbed from the stomach or intestines, or in any way to enter the circulation except by direct injection, the drug must pass through walls of capillaries or lymphatics, and hence must be in solution or in a finely divided state, as in emulsion. But, in addition to this, the osmotic action of the animal membranes is evinced more markedly in the absorption of some drugs than in others, owing, probably, to inherent properties of their own, irrespective of solubility.

Cumulative Action. — Some drugs are excreted from the body so slowly that the whole of one dose is not excreted before the next one is given ; consequently the amount present in the body gradually increases, and after a while severe symptoms may appear, due to the accumulation of the poison in the body. This is called "cumulative action."

The duration of the action of drugs depends chiefly upon the rapidity or slowness of their elimination from the body.

Idiosyncrasy. — Idiosyncrasy is a peculiarity of constitution whereby certain individuals are affected by a drug or agent in a manner entirely different from the ordinary. Thus, in some the smallest dose of quinin produces ringing in the ears and deafness ; in others shell-fish produces hives, etc.

Dosage. — Age, Weight, and Sex. — The dose of a drug is regulated by the age, weight, and sex of the patient. The dose for a child is one-seventh of that for an adult ; the dose for a woman is usually smaller than that for a man. Heavy, muscular persons require larger doses, as a rule, than those who are delicate.

Method of Administration. — The dose given hypodermically is usually one-half to one-quarter of that given by the mouth, and the dose given by rectum is usually twice the amount given by mouth.

Disease. — In illness the dose is increased or decreased according to the severity of the disease or the urgency of the case. Thus, very large doses of morphin are tolerated in severe pain, because the action of the drug is spent in overcoming the pain. In cases of grave shock larger doses of stimulants are given than would be required in conditions of slight depression of the circulation. Pregnancy, menstruation, and lactation modify the doses of some drugs.

Combinations. — If a drug be given to antagonize the toxic effects of another drug, its dose may be larger than its ordinary therapeutic dose. The ordinary dose of the sulphate of atropin is jfa of a grain, while in opium-poisoning as much as from -fa to fa of a grain may be given. Calomel can be given more freely if a saline cathartic be given with it to prevent its cumulative effects.

In the purgative pill consisting of aloes, belladonna, and strychnin aloes is a mild purgative, acting chiefly on the lower portion of the intestines ; belladonna increases peristalsis and checks the griping excited by the aloes, while strychnin acts as a general tonic to the stomach and intestines, exerting its chief influence on the nervous system.

Another instance is the combination of morphin and chloral given in insomnia. Chloral depresses the heart, and cannot be given in full doses when the heart is weak ; morphin not only produces sleep, but stimulates the heart and depresses the respiration : hence small doses of each are given together to produce sleep, so that neither the heart nor the respiration suffers.

Temperature. — Some drugs are more rapidly eliminated in hot weather than in cold, because the skin is more active. In hot climates larger doses are given than in cold climates, because the heat assists elimination.

Toleration and Habit. — When a patient has been taking a drug for some time, the system becomes accustomed to it and can tolerate a large dose without injury. This toleration may continue until the habit of taking the drug is formed.

CLASSIFICATION OF DRUGS.

Alteratives. — Medicines which, without exerting any perceptible action on any particular organ, modify the processes of nutrition and thus restore the normal functions of the body :

Mercury. Iodids. Iodin.

Arsenic. Iodoform. Ichthyol.

Guaiac. Gold. Sarsaparilla.

Cod-liver oil. Iodol. Thyroid extract.

Colchicum.

Analgesics.— (See Anodynes)

Anesthetics. — Agents which destroy sensation. There are two varieties — local and general. General anesthetics act on the central nervous system and destroy sensation throughout the whole body. Local anesthetics destroy the sensibility of a part by direct action on the peripheral nerves :

General Anesthetics.

Ether.

Chloroform.

Nitrous oxid.

Ethyl bromid.

Ethyl chlorid.

Local Anesthetics.

Cocain.

Eucain.

Ether.

Ethyl chlorid.

Ice.

Carbolic acid.

Menthol.

Chloral-camphor.

Orthoform.

Aconite.

Antacids. — Agents which neutralize acids. They are divided into direct and remote.

Direct antacids lessen acidity in the stomach. Remote antacids have little power over the acidity in the stomach but, by being oxidized in the blood, they are excreted as carbonates in the urine and so lessen its acidity :

Direct.

Lime-water.

Chalk.

Liquor potassae.

Liquor sodae.

Aromatic spirits of ammonia.

Sodium bicarbonate.

Magnesia.

Magnesium carbonate.

Bismuth subnitrate.

Remote.

Lithium carbonate.

Lithium citrate.

Potassium bicarbonate.

Potassium citrate.

Potassium acetate.

Potassium bitartrate.

Potassium tartrate.

Anodynes — Analgesics. — Agents which relieve pain. They are divided into general and local. General anodynes when taken internally affect the whole system. Local anodynes affect the part to which they are applied, some by lessening the excitability of the sensory nerves and some by reducing the local circulation :

Local. General.

Moist and dry heat. Opium.

Extreme cold. Morphin.

Ice. Antipyrin.

Aconite. Phenacetin.

Opium. Acetanilid.

Morphin. Bromids.

Belladonna. Cannabis indica.

Cocain.

Ether-chloroform.

Iodoform.

Chloroform.

Chloral-camphor.

Anthelmintics. — Remedies used to kill or expel intestinal worms, the chief of which are round-worms, tape-worms, and thread-worms.

For round worms — santonin, spigelia, or chenopodium.

For tape-worms — cusso, filix-mas, turpentine, thymol, pelletierin, kamala, or pumpkin-seed.

For thread-worms — enemata containing lime-water, quassia, sodium chlorid, or vinegar.

Antiperiodics. — Agents which are employed for the purpose of preventing or curing malaria, the attacks of which are apt to occur periodically. They are also termed antimalarials.

Quinin and other cinchona Methylene-blue. alkaloids. Warburg's tincture.

Arsenic.

Antipyretics or Febrifuges. — Agents which reduce the temperature of the body :

Antipyrin. Aconite. Cold bath.

Acetanilid. Nitrous ether. Cold pack.

Phenacetin. Guaiacol. Cold enema.

Quinin. Cold douche.

The application of cold by bathing, douching, or sponging is the best way of lowering temperature, because of its stimulating effect upon the circulation and nervous system.

Antiseptics. — Agents which hinder or prevent the development of germs without necessarily destroying them. They are used internally and externally.

Corrosive sublimate.

Naphthol.

Carbolic acid.

Naphthalin.

Formalin.

Creolin.

Hydrogen peroxid.

Lysol.

Boric acid.

Iodoform.

Salicylic acid.

Iodol.

Sulphurous acid.

Aristol.

Potassium permanganate.

Thymol.

Silver compounds.

Many volatile oils (eucalyptus, thyme, mint, etc.). Antihydrotics or Anhydrotics. — Agents which lessen the secretion of sweat :

Atropin. Belladonna. Sulphuric acid.

Cold. Picrotoxin. Camphoric acid.

Antisialics. — Agents which decrease the flow of saliva. The chief antisialic is atropin.

CLASSIFICATION OF DRUGS.

Antispasmodics. — Agents which prevent or allay spasm of the voluntary or involuntary muscles :

Ether.

Hoffmann's anodyne.

Bromids.

Chloral.

Valerian.

Asafetida.

Musk.

Chloroform.

Amyl nitrite.

Camphor.

Alcohol.

Opium.

Hops.

Belladonna.

Lobelia.

Antipyrin. Monobromate of camphor. Bromoform.

Antisymoties. — Agents which arrest fermentative processes. (See Antiseptics and Disinfectants})

Antiphlogistics. — Medicines and means which reduce inflammation :

Counterirritation. Cold. Purgation.

Rest (recumbent position). Bleeding. Mercury. Opium. Aconite. Antimony.

Astringents. — Agents which cause contraction of tissues and lessen secretion from mucous membranes. They are divided into two classes — remote and local. Remote astringents act on the internal organs through the circulation ; local astringents, on the part to which applied :

Remote.

Zinc sulphate.

Salts of iron.

Salts of bismuth.

Local.

Tannic acid.

Gallic acid.

Alum.

Lead acetate.

Copper sulphate.

Cardiac Sedatives. — Medicines which lessen the frequency and force of the heart's action :

Aconite. Veratrum viride. Tartar emetic. Hydrocyanic acid.

26 PRACTICAL MATERIA MEDIC A POR NURSES.

Cardiac Stimulants. — Medicines which increase the force of the heart's action. They may either increase or decrease the frequency of the pulse :

Ether.

Alcohol.

Nitroglycerin.

Caffein.

Digitalis.

Strophanthus.

Cocain.

Camphor.

Nitrite of amyl.

Adonin.

Ammonia.

Cactus grandiflorus.

Spartein.

Strychnin.

Adrenalin.

Convallaria.

Heat is one of the most powerful and most easily obtained cardiac stimulants, and, in the absence of a physician, should take precedence over all other remedies.

Carminatives. — Remedies which aid in the expulsion of gas from the stomach and intestines by increasing peristalsis and stimulating the circulation :

Oil of peppermint. Cloves. Chloroform.

Oil of turpentine. Ginger. Hoffmann's anodyne.

Oil of anise. Camphor. Asafetida.

Oil of cinnamon. Pepper. Capsicum.

Cathartics. — Agents which increase intestinal evacuations. They are divided into :

I. Laxatives. — Drugs which produce normal stools :

Sulphur.

Castor oil (small doses).

Figs.

Calomel (small doses).

Magnesia.

Cascara sagrada.

Prunes.

Tamarind.

Molasses.

Manna.

2. Purgatives are more

: active than laxatives, ar oduce large, soft stools :

Calomel (large doses).

Aloes. Senna.

Castor oil (large doses).

Rhubarb. Blue-mass,

Purgatives in small doses act as laxatives, and laxatives in large doses become purgatives.

3. Hydragogues. — Drugs which produce copious watery stools :

Epsom salt. Jalap. Rochelle salt.

Elaterium. Seidlitz powder. Sodium sulphate.

Magnesium citrate.

4. Drastics. — Drugs which produce violent action of the bowels, and in large doses cause gastro-intestinal inflammation :

Croton oil. Colocynth. Podophyllum.

Scammony. Gamboge.

5. Cholagogues. — Drugs which stimulate the secretion of the liver, causing dark stools. The following are thought to possess cholagogue action :

Mercury. Podophyllin. Ipecaa

Sodium phosphate. Euonymin. Ox-gall.

Cerebral Stimulants. — Drugs which stimulate the functional activity of the brain :

Caffein. Strychnin.

Cerebral Depressants. — Drugs which lessen the activity of the brain. Under this heading are included hypnotics, narcotics, and general anesthetics.

Counterirritants. — Drugs which produce inflammation of the parts to which they are applied. They relieve pain, reabsorb inflammatory products, and modify internal inflammatory processes. They are divided into rubefacients and epispastics, or vesicants.

Rubefacients produce merely redness of the skin :

Turpentine. Mustard. Ammonia.

Iodin. Capsicum. Chloroform.

Bpispastics, or vesicants, produce blisters :

Strong ammonia-water. Cantharides.

Tartar-emetic ointment. Croton oil.

Deliriants. — Drugs which excite the activity of the brain to such a degree as to produce delirium and sometimes convulsions :

Alcohol (in full doses). Cannabis indica.

Opium (during first stage). Belladonna.

Hyoscyamus. Stramonium.

Cocain.

Digestives. — Drugs which promote digestion by chemic action :

Hydrochloric acid. Pancreatin. Pepsin.

Diastase. Papayotin.

Bscharotics, or caustics, destroy the life of the soft tissues to which they are applied, and form a slough :

Caustic potash. Caustic soda.

Zinc chlorid. Copper sulphate.

Chromic acid. Silver nitrate.

Bromin. Sulphuric acid.

Carbolic acid. Arsenous acid.

Nitric acid. Acetic acid.

Nitrate of mercury solution.

Demulcents are substances which soothe inflamed mucous membranes. They are generally of a mucilaginous character:

Flaxseed tea.

White of egg.

Starch.

Acacia.

Olive oil.

Gelatin,

Glycerin.

Slippery elm.

Deodorants. — Remedies which destroy bad odors :

Chlorin. Hydrogen peroxid.

Formalin. Potassium permanganate.

Lime. Carbolic acid.

Charcoal.

Diaphoretics. — Remedies which increase the secretion of sweat:

Opium. Pilocarpin. Hot packs.

Alcohol. Hot baths. Vapor baths.

Warburg's tincture.

Disinfectants or Germicides. — Remedies which destroy noxious germs. The greatest disinfectant is heat; boiling water will, as a rule, destroy bacteria in from five to ten minutes. Next to boiling water steam is the most powerful agent, and next to steam, hot air. The chief chemic agents are :

Corrosive sublimate. Carbolic acid. Formalin. Chlorin. Creolin. Salicylic acid.

Thymol. Urotropin. Lysol.

Antiseptics (see p. 24) in concentrated solution are also disinfectants.

Diuretics. — Remedies which cause an increased flow of urine. They are divided into refrigerant or hydragogue diuretics and stimulant diuretics :

Stimulant. Refrigerant.

Turpentine. Potassium salts.

Buchu. Digitalis.

Juniper. Caffein.

Copaiba. Strophanthus.

Sandalwood. Squill.

Cubebs. Theobromin.

Cantharides. Scoparius.

Eucalyptus.

Uva ursi.

Benzoic acid.

Emetics. — Remedies which induce vomiting. They are divided into peripheral or stimulating emetics, which produce emesis by direct action on the stomach ; and central emetics, which produce their effect by acting upon the vomiting center in the brain :

Peripheral Emetics.

Warm water.

Mustard.

Alum.

Zinc sulphate.

Copper sulphate.

Antiemetics.

Central Emetics.

Apomorphin.

Ipecac (partly central).

Tartar emetic (partly central).

-Remedies which allay vomiting.

Their action may be either peripheral or central :

Central Antiemetics.

Morphin.

Bromids.

Peripheral Antiemetics.

Ice.

Carbonated water.

Lime-water.

Carbolic acid.

Bismuth subnitrate.

Cocain.

Hydrocyanic acid.

Ipecac (minute doses).

Chloral.

CLASSIFICATION OF DRUGS.

^mmenagogues. — Remedies which restore the menstrual flow. They are divided into direct and indirect. Direct emmenagogues are those which stimulate the uterine muscular fiber ; the indirect improve the blood and tone up the nervous system :

Indirect.

Iron.

Cod-liver oil.

Strychnin.

Purgatives (aloes).

Direct.

Potassium permanganate.

Pulsatilla.

Quinin.

Cantharides.

Myrrh.

Apiol.

Pennyroyal.

Senecio.

Expectorants. — Remedies which increase the amount of sputum formed in the air-passages, or so modify its character as to promote its expulsion with greater ease. They are divided into sedative or nauseating expectorants and stimulant expectorants.

Nauseating expectorants promote bronchial secretion, render it less viscid, and, hence, more easy of removal, and in large doses cause vomiting.

Stimulant expectorants stimulate the bronchial mucous membrane and modify and diminish expectoration :

Nauseating Expectorants.

Ipecac.

Apomorphin.

Tartar emetic.

Lobelia.

Potassium citrate.

Stimulant Expectorants.

Terebene.

Squill.

Senega.

Copaiba.

Creasote.

Ammonium chlorid.

Eucalyptus.

Oil of sandalwood.

Febrifuges. — Remedies which lower the body-temperature. (See Antipyretics.)

Hemostatics or Styptics. — Agents which arrest hemorrhage :

Alum. Tannic acid. Ferric subsulphate

Ferric chlorid. Lead acetate. (Monsel's solution).

Vinegar. Gelatin. Adrenalin.

Ergot. Hydrastis. Calcium chlorid.

Pressure. Position. Actual cautery.

Ice and heat are also hemostatics, heat being the better, as it causes the blood-vessels to shrink. Ice, by constricting the vessels, stops the hemorrhage for a while, but when removed, and the circulation is restored, bleeding may begin again.

Hypnotics. — Remedies which induce sleep :

Chloral hydrate. Hyoscin. Opium.

Bromids. Trional. Chloralamid.

Paraldehyd. Sulphonal.

Heat to the feet and abdomen.

A cup of hot cocoa and a cracker or a glass of hot milk will sometimes induce sleep by diverting the blood-supply from the brain.