In one of the early prescriptions (No. 37) it was stated that when calomel is triturated with antipyrine, some corrosive sublimate is formed. The following reaction is supposed to take place: Pains were taken to explain that, as but a small proportion: of the calomel (one-tenth or less) is converted into corrosive sublimate, little hesitation need be felt in dispensing calomel and antipyrine, when the former is prescribed in small doses, as fractional parts of a grain. The above prescription may be dispensed with safety, as the prescribed dose of the calomel is but / grain, and the sublimate that will form will not exceed 1/60 or 1/100 grain. 6 As to the incompatibility between the calomel and the sodium bicarbonate, the author considers it imaginary. At any rate, for practical purposes it may be disregarded altogether, as even some of those who claim that the two chemicals are incompatible, say that it takes from six to eight weeks before any corrosive sublimate is formed. Far from considering them incompatible, I, together with the entire medical profession, consider calomel and sodium bicarbonate a very eligible combination. When calomel is prescribed in large doses, the tendency to griping seems to be distinctly obviated by the addition of a little sodium bicarbonate. This mixture, which was dispensed without a shake label, caused quite alarming symptoms towards the end. The symptoms were those of an overdose of morphine, combined with those of an excess of cyanide. The potassium cyanide reacts. with the morphine salt, precipitating it as morphine cyanide; and a small portion may be precipitated as free morphine by the potassium carbonate, which is usually present in potassium cyanide. It is best not to dispense this mixture. If it is, a shakelabel should accompany it invariably. Their synonyms, physical properties, therapeutic action, incompatibles, best combinations, antidotes, etc. By WILLIAM J. ROBINSON, PH.G., M.D. (Continuation.) Fanghi di Sclafani. A mineral substance of volcanic origin, of a lightyellow color. Its principal constituent is sulphur in a very finely div ided form. Has been used in acne rosacea—rubbed up with water and applied at night-with alleged success. Ferratin. Ferri-albuminic acid, or sodium ferro-albuminate. One of the numerous organic preparations of iron. Claimed to be identical with the form of iron as found in the liver, from which it can be easily extracted. It is prepared artificially (egg-albumen, caustic soda, iron tartrate and tartaric acid) and contains 7 per cent. of iron. Reddish brown powder, odorless and tasteless and soluble in water (there is an insoluble form.) Said to be an excellent hematinic, being readily absorbed by the system and producing no deleterious effects of any kind on the gastro-intestinal mucosa. Dose: 8 grs. 3 times a day; for children, 1 to 4 grs. Ferratose. Liquor Ferratini. Ferratin in liquid form, Ferri Alginas. (Alginate of iron.) A combination of iron with alginic acid. Brown powder, insoluble in water. Claimed to pass the stomach unchanged. Dose: 3 to 6 grs. Ferrinol. Nucleid of iron. A combination of iron with yeast nuclein, containing about 6 per cent. of Fe. Cinnamon-brown powder, soluble in warm water, from which solution it is not precipitated by the ordinary iron reagents. Hematinic. Dose: 6 to 15 grs. Ferropyrine. Ferripyrine. Contains 64 per cent. antipyrine and 36% ferric chloride. Made by mixing antipyrine with solution of ferric chloride. Orange-red powder, non-hygroscopic (ferric chloride is very much so.) Sol. in water and alcohol. While it is recommended internally in anemia, migraine, etc., its principal use should be that of a hemostatic and astringent. There are very few remedies equal to it as a local hemostatic, for which purpose it may be used pure or in 20 per cent solution. As an injection in gonorrhea 1 or 12% sol. may be used. Ferrosol. A double saccharate of ferrous (?) oxide and sodium chloride. Clear dark brown liquid. Used in anemia and chlorosis in doses of one teaspoon 3 times a day. Formaldehyde. Formic aldehyde. Oxymethylene. CH2O+Water. Formaldehyde itself is a gas and is prepared by the reduction of wood alcohol, (by passing the latter over glowing coke or platinum: CH3OH-H2=CH2O). But in pharmacy or medicine when we speak of formaldehyde, we generally understand the solution. This solution is a concentrated solution, containing about 40 per cent of formaldehyde gas (it is generally marked 40 per cent, but as a matter of fact it contains only about 34 to 36% ). Considerable confusion exist in the minds of physicians and pharmacists as to the percentage of formaldehyde. I have been frequently asked by pharmacists what they were to dispense when a physician prescribed: Formaldehyde 1%, or Formaldehyde, 5%, etc. Does it mean that the solution was to contain 1 or 5% of formaldehyde gas or 1 or 5% of the commercial formadehyde solution? Similar questions have been asked by physicians when coming across such expressions in literature. To make the matter clear, I will say that the commercial solution is referred to. When a doctor orders a 1% solution of formaldehyde, 1 part of the commercial 40% solution is to be mixed with 99 parts of water; similarly with other strengths. Formaldehyde solution is a clear colorless liquid, of a very pungent odor and taste. One of our most powerful disinfectants and antiseptics. Its field of application is constantly widening. As a disinfectant it may be sprinkled in 2 to 5 per cent solution over the room, or clothes saturated with the solution may be hung about. But a more convenient method is by the use of the various lamps and disinfectors in which formaldehyde is generated by heating paraformaldehyde (triox. methylene). Thirty to forty grains (2 to 21⁄2 Gms.) are required for each 35 cubic feet of air space. While the results of formaldehyde disin fection are very satisfactory on surface objects, it is said to be less efficient in disinfecting mattressess, pillows, etc. the vapors not penetrating thoroly. The vapor is also claimed to be of some value in whooping cough and phthisis. In the latter disease it is also used in 1 to 2% spray or inhalation. In surgery and as a general antiseptic it is used in 4 to 2% solutions. In otitis media it is recommended in 1% solution as an injection (5 drops of formaldehyde solution to 1 oz. of water); in eye washes, in 1/10% solution (1 drop to 2 ounces); in hyperidrosis (excessive perspiration of the feet) 1 to 30% solution. (For harden, ing histological specimens, 4 to 10% solutions are used). Within the past two years reports have appeared on the use of formaldehyde in inoperable malignant growths,lupus, etc. Dr. Wm. Mitchell of Bradford, England (Brit. Med. Journal, No. 1989) reports the case of an ulcerating sarcoma of the cheek, as large as a man's fist, and giving rise to severe uncontrollable hemorrhages. The best styptic combinations would arrest the hemorrhage for 2-3 hours only, and it seemed that the only resource left would be tying the external or common carotid. A 20 per cent solution of formaldehyde was applied to the raw surface on a pledget of cotton, and not only was the hemorrhage quickly and effectually stopped, but on the next day the tissue was necrosed and hardened inward to nearly a quarter of an inch from the surface, so that the doctor could cut it away. Cutting away of the hardened tissue and fresh application of formaldehyde was repeated daily and the final results were good. The application of formaldehyde is quite painful, but can be mitigated by a previous application of cocaine or eucaine.—Its intravenous employment in septicemia has not given very encouraging results. (To be Continued.) * DEPARTMENT OF MATERIA MEDICA AND THERAPEUTICS * Ipecachuana Alkaloids. Dr. R. B. Wild (Lancet, London, No. 4,123) strongly recommends the use of emitine in preference to ipecac. In a paper published several years ago he suggested that the salts of cephaleine or emetine be employed for certain clinical purposes in lieu of the unreliable galenical ipecac preparations. Since that time the British Pharmacopoeia has ordered that the liquid preparations of ipecac be standardized to total alkaloids. However, the two alkaloids present so much difference in many respects that ipecac preparations continue to remain unsatisfactory. It has been shown that while two samples of ipecac root may each contain about 2 per cent. of total alkaloid, there may be 72 per cent. of emetine and 25 per cent. of cephaleine in the Brazilian, and 40 per cent. emetine with 56 per cent. cephaleine in the Columbian, thus actually reversing the relative proportions. It is, therefore, desirable to employ salts of these alkaloids in the interests of accurate medication. Dr. Wild has during the past seven years employed salts of cephaleine and emetine for clinical purposes and has every reason to be satisfied with the change. The hydrochlorate and hydrobromate of emetine are stable salts and can be given in small and convenient doses for expectorant, depressant or emetic purposes. The alkaloids are best given internally, as local irritation follows their subcutaneous injection. Cephaleine hydrochlorate is less serviceable than emetine salts in bronchitis and other catarrhal conditions. Cephaleine is so powerful an emetic as to make it very difficult to regulate the doses for other purposes without producing nausea and sickness. In one patient 1/100 grain every 4 hours caused nausea and vomiting within 3 days. The effect on the secretions of the nose and respiratory tract and the depressant action on the circulation are, on the other hand, less marked than those of emetine in non-nauseating doses. Finally, emetine salts are more stable. Emetine is thus preferable to cephaleine. The latter seems to be useless clinically, unless some new properties are discovered. Its emetic virtues do not enable it to compete successfully with emetine or apomorphine. A third alkaloid is known to be present in ipecacuanha root, but it seems to be comparatively inactive. Ipecacuanhic acid has also been tried experimentally and has not been found to possess any distinct pharmacologic action. [And so the staid conservative British doctors are also beginning to recognize the value of alkaloidal therapy. The world is a-moving.] Veronal. Very few, if any, of the new synthetic remedies have gained a foothold so rapidly as has veronal. So many inquiries have reached me regarding its chemical, physical and therapeutic properties that a short resumé will probaby be acceptable. Veronal is chemically diethyl-malonyl-urea. It is a white crystalline powder, of a slightly bitter taste, soluble in about 150 parts of cold water and in about 12 parts of hot water. It is best administered in some hot liquid. The dose is from 10 to 15 grs. Tho introduced but a little over a year ago, there is now quite an extensive literature on veronal. The reports are almost uniformly favorable. Dr. A. Lilienfeld reported his results with the drug in 60 cases of insomnia, in a paper read before the Berlin Medical Society, and summarized his experience with the remedy in the following statements: "In veronal we have, I might say, an infallible hypnotic which is not equalled in certainty and intensity of action by any soporific heretofore known." "I do not hesitate to characterize the discovery of veronal as a therapeutic advance; and I am convinced that it will soon gain for itself the first place in the medicinal treatment of insomnia." The drug was given an extensive trial in v. Leube's Clinic in Würzburg, in the Psychiatric Clinic in Jena, in v. Leyden's Clinic at the Charité in Berlin, in the Psychiatric Clinic of the University of Strassburg, in Prof. Mendel's Clinic in Berlin, in the Vienna General Hospital, etc., etc. The drug can, therefore, no longer be said to be in the experimental stage. The reports are practically uniformly favorable, and are to the effect that in veronal we possess a safe and reliable hypnotic, without any effect on the heart, circulation or the kidneys, and almost entirely devoid of unpleasant byeffects. In Personally I have tried the drug in about a dozen cases. The results were in every case favorable as far as the induction of sleep was concerned. several cases, however, there was slight nausea and some headache and dizziness in the morning. Nor do I believe that there is, or ever will be, such a thing as an absolutely harmless hypnotic. Artificial induction of sleep is a complicated process, the true inwardness of which we do not yet understand. But, according to the testimony of competent authorities, we possess in veronal one of the safest of all hypnotics. Where a medicinal hypnotic is indicated, it is well worthy of a trial. Treatment of Acne. Ordinary "blackheads" must be first of all mechanically expressed by means of the small instruments in use for this purpose. To soften the skin and aid the procedure, the part should be washed with water as hot as can be borne, medicated with an alkali, like sodium or potassium carbonate, in 5 to 10 per cent. strength; sodium bicarbonate, 5 per cent.; ammonium chloride, 5 to 20 per cent., or sodium borate, 5 per cent. These solutions are well tolerated by sensitive skins. If more energetic remedies are desired, soaps medicated with resorcin or naphtol are serviceable, or a paste like the following: Precipitated Sulphur. Resorcin Zinc Oxide. Wool-fat Petrolatum 21⁄2 dr. 75 grn. 1/2 oz. Or analogous combinations of naphtol, salicylic acid, ichthyol, etc., may be prescribed. Shake before using, apply at night with a hairbrush, and wash off with hot water the next morning. If the pustules are not conspicuous, as on the neck or back, they may be painted with tincture of iodine, which will often arrest the inflammatory process. In the face, the same effect will be obtained from a saturated solution of boric acid in alcohol. Internally, brewer's yeast in doses of I to 2 teaspoonfuls before meals is good in some cases. Furunculous or phlegmonous acne justifies surgical intervenAcne tion with a fine scarifier, etc. rosacea is greatly benefited by washing with hot water. Internally, the vasoconstrictors are beneficial: |