kidneys. In febrile conditions it has a marked antipyretic effect. Cinchonism is the name given to the train of symptoms (the most characteristic of which are a sense of fullness in the head, tinnitus aurium, and slight deafness) to which large doses are liable to give rise; cutaneous eruptions are also occasionally caused. The other alkaloids resemble quinine very closely in their effects, but are weaker in their action. Quinidine is most like quinine, while cinchonine and cinchonidine have a convulsant influence.

USES.

Quinine is employed locally for unhealthy sores and infected wounds, diphtheria, otorrhoea, whooping-cough, hay-fever, gonorrhoea, chancroids and chronic cystitis. The preparations of cinchona are given in digestive troubles, especially when these are associated with a debilitated state of the system. Quinine is one of the most commonly used of all tonics. Except in the case of malarial fever, it is now comparatively seldom employed as an antipyretic. One of the most positive effects in the whole range of medicine is that of quinine, and to a less pronounced degree the other alkaloids of cinchona, in arresting the paroxysms of malarial fever; it is now known that this result is due to the directly poisonous action of the drug upon the plasmodium malaria, which infests the blood and is the specific cause of the disease. It is both curative and prophylactic; so that its regular administration in very moderate quantities will absolutely or to a large degree protect persons living in malarious regions from ague. Quinine is used in malarial neuralgia and also in neuralgias not of malarial origin. Among other affections in which it is employed may be mentioned whooping-cough, influenza, the night-sweats of phthisis, the adynamic form of delirium tremens, and various conditions associated with cerebral anæmia.

IPECACUANHA.

IPECACUANHA.-Ipecac. The dried root, to which may be attached a portion of the stem not exceeding 7 cm. in length, of Cephaëlis

Ipecacuanha (Brotero) A. Richard (Fam. Rubiacea), known commerIcially as Rio, Brazilian or Para Ipecac, or the corresponding portion of Cephaëlis acuminata Karsten, known commercially as Carthagena Ipecac; yielding, when assayed, not less than 2 per cent. of Ipecac alkaloids. Habitat.-Brazil to Bolivia and New Granada, in damp forests cultivated in India.

CHARACTERS. Rio Ipecac. In pieces of irregular length, rarely exceeding 25 cm.; stem portion 2 to 3 mm. thick, light gray-brown, cylindrical and smoothish; root portion usually red-brown, occasionally blackish-brown, rarely gray-brown, 3 to 6 mm. thick, curved and sharply tortuous, nearly free from rootlets, occasionally branched, closely annulated with thickened, incomplete rings, and usually exhibiting transverse fissures with vertical sides through the bark; fracture short, the very thick, easily separable bark whitish, usually resinous, the thin, tough wood yellowish white, without vessels; odor very slight, peculiar, the dust sternutatory; taste bitter and nauseous, somewhat acrid.

Carthagena Ipecac.-Similar to Rio Ipecac, but about one-half thicker, dull-gray externally, with thinner, merging annulæ, and the fracture surface of the bark gray.

COMPOSITION.-The chief constituents are- -(1) Emetine, СзH12Ó, from I to 2 per cent., an uncrystallizable alkaloid. It is colorless (turns yellow on keeping), odorless, bitter, and soluble in Alcohol, Ether and Chloroform, slightly soluble in water, not in caustic alkali. (2) Cephaëline, CH3N2O4, an amorphous, bitter alkaloid, colorless (turns yellow on keeping), soluble in caustic alkali, less soluble in Ether than Emetine, but freely in Alcohol and Chloroform. (3) A third alkaloid in minute quantities. (4) A mixture called Cephaëlic or Ipecacuanhic Acid. (5) Tannic acid, Volatile Oil, Starch, Gum, etc.

The proportion of each alkaloid varies in different specimens of the root, but as a rule there is twice as much Emetine as Cephaëline. Emetine hydrochlorate and hydrobromate are in the market; a solution of either in sherry, I to 3840 is of about the same strength as Vinum Ipecacuanha.

IMPURITIES.-Hemidesmus, which is cracked, not annulated. Almond Powder, occcasionally found mixed with powdered Ipecacuanha root, gives the odor of Hydrocyanic Acid when moistened.

Dose (expectorant), 0.065 gm. (65 milligm.); 1 gr.; (emetic), 1 gm.; 15 gr.

Preparations.

1. Fluidextractum Ipecacuanhæ. Fluidextract of Ipecac. By maceration and percolation with Alcohol and Water, dis

tillation of the Alcohol, addition of water to residue, evaporation and addition of Alcohol.

Fluidextract of Ipecacuanha is used to make Syrupus Ipecacuanhæ, Tinctura Ipecacuanhæ et Opii, and Vinum Ipecacuanhæ. Dose, (emetic) 1 c.c.; 15 m; (expectorant) 0.05 c.c.; 1 m. 2. Pulvis Ipecacuanhæ et Opii.-See Opium, p. 334.

3. Syrupus Ipecacuanha.-Syrup of Ipecac. Fluidextract of Ipecac, 70; Acetic Acid, 10; Glycerin, 100; Sugar, 700; Water to

1000.

Dose, (expectorant) 1 c.c.; 15 m; (emetic) 15 c.c.; 4 fl. dr. 4. Tinctura Ipecacuanhæ et Opii.-See Opium, p. 334.

5. Vinum Ipecacuanhæ.-Wine of Ipecac. Ipecac, 100; Alcohol, 100; White Wine, 800.

Dose, 1 c.c.; 15 m.

Unofficial Preparations.

Fluidextract of

1. Trochisci Ipecacuanha (U. S. P., 1890).-Troches of Ipecac. Ipecac, 2; Tragacanth, 2; Sugar, 65 gm.; Syrup of Orange, a sufficient quantity for 100 troches. Each troche contains gr.; .02 gm. Ipecacuanha.

Dose, 1 to 6 troches.

2. Trochisci Morphinæ et Ipecacuanha (U. S. P., 1890). -See Morphine, p. 339.

ACTION.

Antiseptic; irritant; hæmostatic; expe torant; in small doses, stomachic, in large doses powerfully emetic; diaphoretic; cholagogue.

USES.

As an emetic, especially for the purpose of clearing the passages in diseases of the respiratory organs and for relieving the stomach of undigested food; in small doses as a stomachic and to check vomiting; dysentery; catarrhal jaundice; diarrhoea, especially when associated with hepatic derangement; bronchitis, winter cough, emphysema and fibroid phthisis; as a diaphoretic in acute rheumatism, suppression of menstruation, chills, and the early stages of catarrh of the respiratory passages

and of mild feverish attacks in general; hæmoptysis and other hæmorrhages.

dried bark of the root of Viburnum prunifolium Linné, or of Viburnum Lentago Linné (Fam. Caprifoliacea). Habitat.-United States, westward to Kansas and Mississippi; in thickets.

CHARACTERS.-In irregular or quilled pieces, rarely exceeding 4 mm. thick; externally dingy brown, shallowly fissured and slightly scaly; inner surface rust-brown; fracture weak, short, and uneven, the inner layer whitish, the middle rust-brown, the outer dark brown; in transverse section, groups of stone cells are readily distinguished; odor slight, peculiar; taste very bitter, somewhat astringent.

COMPOSITION.-Its chief constituents are-(1) A brown, bitter Resin. (2) Viburnin, a greenish-yellow, bitter principle. (3) Valeric Acid. (4) Tannic Acid. (5) Oxalates, Citrates and Malates.

Dose, 2 gm.; 30 gr.

Preparation.

Fluidextractum Viburni Prunifolii.-Fluidextract of Viburnum prunifolium. By maceration and percolation with Alcohol and Water, and evaporation.

Dose, 2 c.c.; 30 m.

VIBURNUM OPULUS. Synonyms.-Cramp Bark. High Bush Cranberry. The dried bark of Viburnum Opulus Linné (Fam. Caprifoliacea). Habitat.-North America, from New Brunswick westward, and southward to Pennsylvania, in low grounds.

CHARACTERS.-In somewhat transversely curved pieces, occasionally in quills, of variable length, and 0.5 to 2 mm. thick; outer surface grayish

brown, longitudinally wrinkled, with large brown lenticels and brownishblack fruit-heads of a lichen; inner surface light brown, longitudinally striate; fracture uneven, fibrous; transverse sections show several bands of bast fibres; odor slight; taste somewhat astringent and bitter. COMPOSITION.-The same as of Viburnum prunifolium. Dose, 2 gm.; 30 gr.

Preparation.

Fluidextractum Viburni Opuli.-Fluidextract of Viburnum Opulus. By maceration and percolation with Alcohol and Water, and evaporation.

Dose, 2 c.c.; 30 m.

ACTION.

Tonic; antispasmodic; diuretic.

USES.

Nervous diseases of pregnancy; to prevent miscarriage; after-pains; menorrhagia; spasmodic dysmenorrhea.

Unofficial Preparations.

SAMBUCUS (U. S. P., 1890).

1. Sambucus. Synonym.-Elder. The flowers of Sambucus canadensis Linné (Fam. Caprifoliacea). Habitat.-North America, west to the Rocky Mountains, in damp places.

CHARACTERS. The flowers, when fresh, about 5 mm. broad, and after drying shrivelled; calyx superior, minutely five-toothed; corolla originally cream-colored, after drying pale brownishyellow, wheel-shaped and five-lobed, with five stamens on the short tube; odor peculiar; taste sweetish, somewhat aromatic and bitterish.

COMPOSITION.-The chief constituents are-(1) A resin. (2) Valerianic Acid. (3) A volatile oil.

Dose, 2 to 4 gm.; 12 to 1 dr.

2. Aqua Sambuci (B. P.).-Elder-flower Water (5000 gm. to 25 litres). Distil one-fifth.

Dose, 30 to 60 c.c.; 1 to 2 fl. oz.

3. Decoctum Sambuci.-Decoction of Sambucus. 15 gm. (1⁄2 oz.) in 500 c.c. (1 pint), boiled down to 250 c.c. (1⁄2 pint). Dose, freely.