A practical treatise on materia medica and therapeutics

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Preface To The Eleventh Edition

In preparing this edition I have corrected some typographical and other errors, and have added various new articles which will, I hope, improve the interest and value of the work. In this, as in all previous issues, the practical character of the work as a storehouse of facts relating to Materia Medica and Therapeutics has been preserved.

I have not been unmindful of the present tendency of pharmacological literature. An increasing disposition is discernible to develop the physiological side, to enlarge the domain of experimental work, and to interpret conditions in man by hasty and sometimes crude observations on the inferior animals. On the other hand, empirical knowledge, supported by careful clinical work, and improved by sound induction, should continue to be an important element in the structure of any therapeutical system.

I have again to thank my readers and constant friends for their approval of the successive issues of my Treatise.

E. B.

Philadelphia, Pa., 1903.

Preface To The Tenth Edition

In sending forth the tenth edition of this work, I can do no less than thank my readers for this evidence of the esteem in which they continue to hold it. To render this edition still more worthy, I have added accounts more or less full of the newer remedies, have inserted a special article, though succinct, on prescription writing, and have made changes at various points to correct errors that have been overlooked, and to supply omissions of necessary matter. To accomplish these objects with as little increase of space as possible, I have stricken out references at various places. These are the less to be deplored as medical libraries are becoming more numerous and readily accessible, and this kind of information is sufficiently conveyed to the intelligent reader by the mention of the names of the more important contributors.

In the prefaces to the eighth and ninth editions respectively, my views regarding the admission to the work of the rapidly increasing new remedies have been sufficiently given. As the next decennial revision of the United States Pharmacopoeia is near at hand (1900), we may look for some authoritative action then, whereby the present state of uncertainty may be finally terminated.

Roberts Bartholow, M. D.

1527 Locust Street, Philadelphia, July, 1899.

vii

Preface To The Ninth Edition

In preparing the ninth edition it has been found necessary to enlarge the work by forty-five pages. Additions and alterations have been made at all points to dispose of the new material which the rapid development of pharmacology has contributed to the science and art of therapeutics. Much of this matter consists of accounts, more or less full, of the synthetical remedies which organic chemistry has produced and is producing in increasing numbers. For the most part these medicaments are proprietary, and are not therefore to be found in the official list of the United States Pharmacopoeia. Receiving special designations often suggestive of their mode of action, they cease to be known by the technical nomenclature, and, under patent protection, are the property of the manufacturing chemist. When, by the substitution process, a remedy is evolved that seems likely to possess certain powers, it is placed in the hands of some friendly investigator to study its physiological actions, and it is then duly exploited by the manufacturer. It is undeniable that many important contributions have been thus made to practical medicine ; but it is equally true that many have not sustained the pretensions of their promoters, and have either failed entirely of recognition or have only in part justified the extravagant claims made for them. The whole subject is yet hardly in a state to select out of the mass those that time and further clinical experience must justify. As in nearly every instance these remedies are derived from the aliphatic (fatty) and aromatic series of organic compounds, it is not surprising that there should be in respect to many of them considerable similarity in the mode and x PEEFACE TO THE NINTH EDITION.

character of their actions. In the absence of an authoritative tribunal to decide on the remedies for recognition and use, I have employed my own judgment in selecting those for treatment in this work. Time will determine the value of those taken up for consideration : some will continue in favor ; the failures will be eliminated.

I must again give expression to the gratitude I feel over the long-continued success of the work ; for the disappearance of successive large editions is the best evidence of appreciation by my* readers and of approval by the organs of professional opinion.

Roberts Baktholow, M. D.

1527 Locust Street, Philadelphia,

August, 1896.

Preface To The Eighth Edition

The decennial revision of the United States Pharmacopoeia involves so many changes in remedies and formulae, that a treatise on Materia Medica must of necessity be newly edited to make it conform to the only official standard. I have, accordingly, revised my work, have changed the formulae as required by the new Pharmacopoeia, and have added to the list of remedies many that have only recently appeared. In so doing I was brought face to face with the important question of admitting proprietary medicaments. The Convention for the Revision of the Pharmacopoeia, at its last session in Washington, instructed the committee to whom the' work of revision was intrusted to omit from the work all proprietary remedies or preparations. Those instructions were obeyed, and only those synthetical products not proprietary were given a place in the list of remedies. As a member of the Revision Committee I coincided in the propriety of this action, and I may seem inconsistent now that in my treatise I have admitted many of the remedies in question. But the functions and sphere of the two works differ. The Pharmacopoeia is an official guide for pharmacists and physicians, and must therefore pursue a conservative course in admitting new remedies, and refuse its countenance to those of proprietary origin, either secret or protected by letters patent. A treatise on Materia Medica should, as a rule, be governed by the same considerations ; but in the case of the new synthetical products, so important are their attributes, so largely have they come into use, and so great is the demand for true information regarding them, that a text-book would be considered wanting in thoroughness and completeness if xii PKEFACE TO THE EIGHTH EDITION.

it contained no reference to the more important of them at least. I have therefore given an account, more or less complete, of various members of the group. It is the less necessary to include all that have been proposed and used to some extent in medical practice, since not all have proved useful, and many agree so closely in their actions that one may be substituted for another in the treatment of the morbid states to which they are adapted.

As the new Pharmacopoeia has employed the metric system .in its weights and measures, it becomes necessary for all systematic works treating of the Materia Medica to follow its example. That my readers unacquainted with the metric system, may have no difficulty, I have added in a brief appendix a tabular statement of the equivalents of weights and measures from one Troy ounce down, for which I am indebted to the Pharmacopoeia.

I venture the expression of my belief that this new edition will prove still more worthy of the remarkable favor which the work has enjoyed from its first appearance.

Roberts Bartholow, M. D. 1527 Locust Street, Philadelphia, October, 1893.

Preface To The First Edition

To offer to the medical profession a new treatise on Materia Medica and Therapeutics may appear to be a labor of supererogation. The medical literature of this country is already well provided with able and elaborate works on this subject. The learned and encyclopedic volumes of Stille, based on the empirical method, and the modern and scientific work of H. C. Wood, based on the physiological method, leave almost nothing to be desired. Entertaining such a profound respect for the work of my American colleagues, it may well be inquired why I have ventured to add a new book to those already existing in this department of medical knowledge. A belief, which I trust will not be regarded as egotism, that I have earned the right to address the medical profession, has moved me to the preparation of this work. Several years a teacher of Materia Medica and Therapeutics, I have necessarily formed opinions as to the kind of information which should be contained in a treatise on this subject. As far as such a course of experiment is practicable, I have demonstrated in my lectures the actions of remedies on animals. I have conducted in my private laboratory many independent investigations, and have contributed in this way, I submit with diffidence, some original knowledge to the subject of therapeutics. The information thus acquired has been supplemented by twenty-two years of clinical experience as a practitioner of medicine. Under these circumstances, I am induced to believe that my professional brethren, and medical students, will hold that I am entitled to a hearing.

A volume on Materia Medica and Therapeutics should, in these days, present some new features of importance if it would worthily occupy a place alongside of the excellent works now accessible to American readers. An examination of this treatise will disclose the fact that it differs from other works in its scheme of classification, xiv PREFACE TO THE FIRST EDITION.

in the subjects discussed, and in the very practical character of the information. In the present state of our knowledge, it is impossible to make a classification free from defects, and I do not claim for mine that it is superior to others — only that its simplicity is a point in its favor. As respects the subjects treated of, it will be seen that the most elaborate section is that on aliment, and that remedies have been introduced not usually referred to by therapeutical writers. In the treatment of individual agents, I have, usually, adopted the description of the " United States Pharmacopoeia," and have omitted botanical and chemical details, unless they are necessary to elucidate physiological questions, or to facilitate intelligent prescription-writing. All pharmaceutical questions are most thoroughly handled in the " Dispensatory " of Wood and Bache, and this kind of knowledge is more the province of the druggist than of the physician.

In describing the physiological action of drugs, two methods may be pursued : to present in chronological order a summary of the opinions of various authorities on the subject in question ; or, to condense in a connected description that view of the subject which seems to the author most consonant with all the facts. I have adopted the latter plan, from a conviction of its advantages for the student, and of its utility for the practitioner. The authorities which I have utilized in making up my opinions are placed at the end of each article, in order to avoid interruptions in the methodical descriptions.

As respects the therapeutical applications of remedies, I have, as far as practicable, based them on the physiological actions. Many empirical facts are, however, well founded in professional experience. Although convinced that the most certain acquisitions to therapeutical knowledge must come through the physiological method, I am equally clear that well-established empirical facts should not be omitted, even if they are not explicable by any of the known physiological properties of the remedies under discussion.

My best acknowledgments are due to John Chatto, Esq., the learned Librarian of the Koyal College of Surgeons, London, for numerous courtesies extended to me during my visits to Lincoln's- Inn-Fields. Eoberts Bartholow.

120 West Seventh Street, )

Cincinnati, Ohio, June, 1876. \

Table Of Contents

PAGE

Schema 1

PART I. Routes by which Medicines are introduced into the Organism .... 5

1. Through the External Integument 5

2. Through the Internal Integument 6

Insufflation 6

Inhalations 8

Atomization 9

Forms of Medicines .11

Enteroclysis 14

3. By the Subcutaneous Areolar Tissue 16

Injection of Organic Liquids 21

Hypodermatoclysis 23

Infiltration Anaesthesia (Schleich's Method) 24

4. By the Veins 25

Transfusion of Blood . 27

Arterial Transfusion . . . . .30

Transfusion of Milk 30

Peritoneal Transfusion .31