SYRUPUS ACIDI CITRICI (syrup of citric acid) contains 10 parts of the acid in the 1000 of the preparation.

LIMONIS SUCCUS (lemon-juice), OLEUM LIMONIS (oil of lemons), and SPIRITUS LIMONIS (spirit of lemon-essence of lemon) are also official.

ACIDUM TARTARICUM (tartaric acid) is rarely used in medicine, except as an ingredient of Seidlitz powders.

(C) ON THE SEXUAL ORGANS.

ORDER I.-APHRODISIACS.

What are aphrodisiacs?

Aphrodisiacs are medicines used to excite the functions of the genital organs when they are morbidly depressed.

What medicines are used for this purpose?

When the nutritive functions are not properly performed, the tonics or alteratives, especially phosphorus, zinc phosphide, the phosphates and hypophosphites, the salts of iron, gold or arsenic, and cod-liver oil are used. When there is an absence of sexual desire, small doses of opium, very minute amounts of alcohol, cannabis Indica, musk, or small doses of camphor may be useful by stimulating the cerebral centres. If impotence be due to want of erectile power, the tonics and alteratives are of use, as are also agents acting on the genital centre in the lumbar portion of the spinal cord and agents which either determine a flow of blood to the part by increasing the general or local circulation or which, by contracting the veins, aid in producing and maintaining erection. Thus, nux vomica or its alkaloid, the cardiac stimulants, hamamelis, ergot, cantharides and myrrh are useful in this condition. Good hygiene, cold baths, proper food and sea air and bathing, electricity, and moral means are important. The above medicines have either been considered already or will be found in their appropriate places.

ORDER II.-ANAPHRODISIACS.

What are anaphrodisiacs?

Anaphrodisiacs are medicines which are used to depress the sexual functions when they are morbidly excited.

What medicines are employed for this purpose?

Morbid excitation of the sexual organs is treated by medicines which depress the functions of the body generally, as nauseants and purgatives, or those which, by depressing the brain or spinal cord, will prove sedative to centres governing these organs: thus full doses of opium or of camphor will depress the cerebral centre, while potassium or ammonium bromide (very useful), monobromated camphor, iodine and the iodides, potassium nitrate, ammonium chloride, belladonna, tobacco, and conium act more especially on the spinal centre and nerves.

Medicines diminishing the circulation of the parts will also prove advantageous, as the cardiac sedatives or full doses of digitalis and the bromides. Cocaine locally applied acts by contracting the vessels and diminishing the secretions of the sensory nerves.

Other agents used for this purpose are the local use of cold, general blood-letting, a low diet, avoidance of stimulation, and the withdrawal of blood to other parts of the body, as by hard mental work or exercise with the upper extremities.

ORDER III.-OXYTOCICS.

What are oxytocics?

Oxytocics are medicines which are employed to increase the power of a contracting uterus, thus aiding in the expulsion of its contents.

Name the medicines belonging to this order.

Ergot; hydrastis; hydrastinine hydrochlorate; gossypii radicis cortex, and quinine.

What is ergot?

ERGOTA-ERGOT.

Ergot is the sclerotium of Claviceps purpurea (Nat. Ord. Fungi), replacing the grain of Secale cereale (Nat. Ord. Graminacea), or, in other words, it is a fungus growing from the diseased ovary of rye. "When more than a year old it is unfit for use."

What does it contain?

The exact chemical composition of ergot is still a matter of doubt, but the latest researches seem to show that it contains a resinoid substance, sphacelinic acid, and a neutral principle, cornutin, which together represent the value of the drug.

What are its physiological effects?

The effects of ergot are chiefly manifested on the uterus of the pregnant female and on the circulation. In the non-pregnant, small doses produce no perceptible effect; moderate doses slow the heart, probably by stimulating the peripheral fibres of the vagi, and enormously increase the blood pressure by stimulating the vaso-motor centres. Large doses cause nausea and vomiting, increased peristalsis and purging. Toxic doses depress the heart by acting directly on its muscle or contained ganglia, and lower the blood-pressure, partly by its action on the heart and partly from depression of the

vaso-motor centres.

When poisonous doses are given to animals, there is salivation, vomiting and sometimes diarrhoea, rapid pulse and respiration, dilated pupil, trembling, great thirst, prostration, paraplegia, convulsions and death. The nervous symptoms appear to be due to action on the nerve centres.

Ergot possesses the property of causing contraction of all nonstriated muscular fibres: thus it contracts the arterioles, increases intestinal peristalsis, and increases the power as well as the duration of the uterine contractions during labor, but does not always originate them during pregnancy or at other times, except immediately prior to and after parturition.

What is ergotism?

When ergot is used continuously in large amounts as an article of diet, it produces a condition of chronic poisoning, which manifests itself either by gangrene (usually dry, but occasionally moist and attended with septicemia) or by tetanic spasms.

What are the medicinal uses of ergot?

Ergot is used as an oxytocic in small doses in uterine inertia during the second stage of labor, when there is no resistance either on the part of the bony canal or the soft parts of the mother. When thus administered, it energizes the uterine contractions, but if given in

large doses it renders them tetanic and continuous, thus greatly increasing the danger both to the mother and child.

To prevent post-partum hemorrhage by contracting the uterus, and thus compressing the uterine sinuses, it is invaluable, but had better be withheld until the placenta has left the uterine cavity, as prior to this it will tend to imprison the placenta by contracting the cervix. After the uterus is empty, it may be given in full doses, either by the mouth or hypodermically.

It has been used to induce premature labor, but is at best an uncertain remedy for this purpose. To arrest hemorrhage in cases of threatened abortion, ergot is worse than useless, unless the uterus is emptied. In these cases, by contracting the cervix, it imprisons the ovum, and thus, by preventing its escape, keeps the uterus distended. If given at all in these cases, its administration should be conjoined with the application of vaginal tampons. It is also given to aid the expulsion of uterine polypi.

As a hæmostatic, it is used in all hemorrhages where surgical means of arrest cannot be employed, and is often given as an adjuvant to their local treatment. In menorrhagia, epistaxis, hemorrhage from the gums, and in broncho-pulmonary, intestinal or renal hemorrhage it is very efficient. In hæmatemesis, it is not so serviceable. In purpura, it acts beneficially. From its influence in contracting blood vessels, it has been used in the early stages of pneumonia and other inflammatory affections, in spinal congestions, in cerebro-spinal meningitis, and for the cure of internal aneurisms. It has been injected hypodermically near the seat of disease for the cure of varices, hemorrhoids, and impotence due to dilatation of the dorsal vein of the penis. It may be employed with great advantage, either internally or hypodermically, to reduce the size of an enlarged spleen. In glycosuria and in polyuria it does good, and, from its influence on unstriped muscular fibres generally, it is useful in relaxation of the sphincters, diarrhoea, dysentery, spermatorrhoea, uterine subinvolution, and to diminish the size of subperitoneal uterine fibroids.

What are the preparations of ergot and their doses?

EXTRACTUM ERGOTE (extract of ergot) is five times as strong as the fluid extract; dose gr. v-xv (0.3-1.0). It may be used hypodermically, dissolved in water and filtered.

EXTRACTUM ERGOTE FLUIDUM (fluid extract of ergot), dose mv-f3iv (0.3-15.0).

VINUM ERGOTE (wine of ergot) contains 15 per cent. of powdered ergot; dose f3j-iv (4.0-15.0).

What is hydrastis?

HYDRASTIS.

Hydrastis is the rhizome and roots of H. canadensis, yellow root or golden seal (Nat Ord. Ranunculaceae). It has been already considered under the Bitter Tonics (q. v.).

HYDRASTINÆ HYDROCHLORAS-HYDRASTINE HYDROCHLORATE. What is this substance?

It is the hydrochlorate of an artificial alkaloid produced by the oxidation of hydrastine, and has been found to produce powerful uterine contractions, stimulating also the muscular fibres of the heart, arterioles, and intestines. It probably stimulates the voluntary muscles, but in a lesser degree.

In fatal doses it depresses powerfully the entire motor nervous tract and causes death by respiratory failure.

It has been used with success in menorrhagia and metrorrhagia and other uterine hemorrhages.

It is also recommended as a heart tonic. Dose gr. -j (0.016– .0.065).

GOSSYPII RADICIS CORTEX-BARK OF COTTON ROOT.

What is gossypii radicis cortex?

It is the bark of the root of Gossypium herbaceum and other species of Gossypium (Nat. Ord. Malvacea).

Given to animals, it first slows and then quickens the cardiac action, which is always enfeebled by first stimulating and then paralyzing the cardio-inhibitory apparatus and depressing the cardio-motor ganglia. It stimulates and then depresses the vaso-motor centres, causing a rise, but subsequently a fall, in the blood pressure. It stimulates non-striated muscular fibres, and appears to excite rhythmical contractions of the gravid uterus and to increase their power when present. It depresses the reflex centres of the cord, and causes