AMYL NITRIS.

PHYSIOLOGICAL ACTION AND THERAPEUTICS.

99

66

The bitter and sweet varieties of the species Amygdalus communis differ in action only through the agency of the principle Amygdalin contained in the former. The Sweet Almond is demulcent and nutritive, while the fixed oil expressed from either variety is a bland application, having the same action as Olive Oil. The action of the Bitter Almond and its oil is due to the Hydrocyanic Acid contained in them (see ante, p. 68).

The EXPRESSED OIL OF ALMOND is demulcent, and in doses of gj-ij a mild laxative. It is used externally for excoriations, chapped hands, and inflammatory skin affections, and is applied to the ear in earache. The cake remaining after the expression of the fixed oil from the sweet almond is ground into flour, and used in the form of biscuits for diabetics as a substitute for bread, as it contains no starch.

The OIL OF BITTER ALMOND is used as a flavoring agent, and may be employed locally or internally in lieu of Hydrocyanic Acid. The Syrup is somewhat sedative, but is generally used as a demulcent or for flavoring purposes. The Mixture is used in catarrhal affections and as a vehicle for cough-mixtures. The poisonous character of the Bitter Almond and its essential oil (Oleum Amygdala Amaræ) should be kept in mind.

AMYL NITRIS, Nitrite of Amyl, C,H,,NO,,-is a clear, yellowish liquid, of ethereal and fruity odor, aromatic taste, and neutral or slightly acid reaction, extremely volatile, insoluble in water but freely. soluble in alcohol, ether, chloroform and benzin. It is produced by the action of Nitric or Nitrous Acid upon Amylic Alcohol, and when impure may have Nitric or Hydrocyanic Acid in it. Dose internally m4-j dissolved in alcohol,-by inhalation mij-v; but larger doses are probably safe.

Unofficial Analogue.

Nitroglycerinum,—Nitroglycerin, Glonoin, Trinitrin, Trinitrate of Glyceryl, CH2(NO3)3,—is a clear, oily liquid, insoluble in water, but soluble in alcohol, ether, oils, etc., produced by the action of nitric and sulphuric acids upon glycerin. Is a dangerous explosive, and should not be kept in stronger solution than 1 per cent. Dose, moto or more, according to susceptibility.

Unofficial Preparations of Nitroglycerin.

Tinctura Nitroglycerini, Tincture of Nitroglycerin,-a 1 per cent. solution in alcohol. Dose, m1⁄2-x. The strong tincture sold by the homoeopathic pharmaceutists and official in their American Pharmacopoeia is a 10 per cent. solution, or ten times the strength of the above. It is an extremely dangerous preparation, both as an explosive and as a medicine. (See American Homœopathic Pharmacopeia, 2d ed., Boericke & Tafel, 1883, page 235.)

Tabelle Nitroglycerini, B. P.,-Tabella Trinitrini,-are tablets of chocolate, each containing gr. To of pure Nitroglycerin. Dose, j–ij.

Other Nitrites.

Sodii Nitris, Nitrite of Sodium, and Potassii Nitris, Nitrite of Potassium (both unofficial), are used as substitutes for Amyl Nitrite and Nitroglycerin. The former is a white,

granular powder, deliquescent, with a cool, saline taste, very soluble in water, is made by heating Sodium Nitrate, and has the formula NaNO,. Dose, gr. 1⁄2-v, according to individual susceptibility.

Ethyl Nitrite, CH,NO,,-constitutes 5 per cent. of Spiritus Ætheris Nitrosi. (See ante, page 80.)

PHYSIOLOGICAL ACTION.

NITRITE OF AMYL and the other NITRITES agree closely in their general action, producing great vascular dilatation by paralyzing either the sympathetic system, the vaso-motor centre or the muscular coat of the arterioles, which, is yet undecided. They cause tumultuous action of the heart by relaxing its inhibition ;--lowered respiration, from paralysis of the respiratory muscles and impairment of the ozonizing function of the blood; -diminution of sensation, motility, and reflexes ;-a sense of heat, but lowered body-temperature; also throbbing pain in the head, beating carotids, quickened pulse, flushed face and vertigo.

The effect of an ordinary inhalation of Amyl Nitrite on man is very transitory, excepting the headache, which may last several hours. Of the nitrites it is the most prompt but least enduring in action, and is best administered by inhalation. It causes sugar to appear in the urine and increases the quantity voided. Mixed with blood it forms methæmoglobin, which is not so readily deoxidized as hæmoglobin, and under its influence the blood in the body becomes of a dark chocolate color both in the arteries and in the veins.

NITROGLYCERIN acts similarly, but less promptly, and its action is more enduring. Its headache is of intensely frontal character, and persists for hours after the other effects have passed off. It is more suitable for internal administration.

NITRITE OF SODIUM is also slower in action than Amyl Nitrite, and does not cause so much throbbing headache as Nitroglycerin. It may be given in solution with water.

The action of all these agents is probably due to the Nitrous Acid contained in them.

Antagonists.

Ergot, Belladonna, Strychnine, Brucine, Digitalis, Picrotoxin, and all other agents which increase the functional activity of the spinal cord and sympathetic are antagonistic, though by reason of their slower rate of diffusion the antagonism may not be always available. Stimulants, artificial respiration, the alternate cold and hot douche, with cold to the head, and Ergotin or Atropine subcutaneously, are the best means to be used in cases of poisoning by the Nitrites.

THERAPEUTICS.

The inhalation of AMYL NITRITE is a useful palliative in angina pectoris, epilepsy, tetanus, and many of the respiratory neuroses, as spasmodic asthma, whooping-cough, laryngismus stridulus, etc. It is also indicated in migraine of the pale-face form, and in the cold stage of intermittents and pernicious remittents, to prevent internal congestion,-also in convul

sions of various kinds, including the puerperal. It has been sometimes used in threatened death from chloroform anesthesia, and in poisoning. by strychnine.

NITROGLYCERIN has been used with benefit in neuralgic dysmenorrhoea, sea-sickness, and in chronic interstitial nephritis, by redistributing to the kidneys their blood-supply cut off by degeneration of the renal ganglionic centres. It promptly relieves hiccough, migraine of spasmodic character, and has afforded immediate relief in neuralgia of the fifth. Its administration in angina pectoris, though not producing such prompt results as that of Amyl Nitrite, gives excellent and much more lasting effects. It is useful in the weak heart of the aged, or that from fatty degeneration, or when, as in Bright's disease, the arterial tension is above normal; also in irritable and overacting heart, which it relieves by lowering arterial tension.

NITRITE OF SODIUM has been successfully employed in angina pectoris, hemicrania, and in asthma of purely bronchial and neurotic origin. It has also proved decidedly beneficial in the abnormally high arterial tension of chronic desquamative nephritis, especially when complicated with a weakened and dilated heart.

AMYLUM, Starch, CH1O,—is the fecula of the seed of Triticum vulgare, common wheat, a plant of the nat. ord. Graminaceæ. Though wheat starch is the official kind, any other might be properly used, as the starch occurring in barley, oats, arrow-root, sago and tapioca, all of which foods were official in the U. S. P. of 1870. The last three are entirely composed of starch; wheat contains about 70 per cent., and rice 90 per cent.

Starch is a carbo-hydrate, and occurs in distinct grains, forming irregular, angular masses, white, inodorous, and tasteless, easily pulverized, of neutral reaction, and insoluble in alcohol, ether or cold water. Under the microscope the granules are seen to be lenticular in form and concentrically striated. When boiled with water it yields a whitish jelly of bluish tinge, which when cool gives a deep blue color with test-solution of iodine, the color disappearing on warming and returning on cooling.

By boiling with dilute mineral acids starch is converted into glucose, dextrin being formed as an intermediate product. Hot concentrated nitric acid converts it into oxalic acid, but cold fuming nitric acid dissolves it, forming an explosive compound. Diastase, ptyalin and pancreatin convert it into glucose. [For Glycogen, Dextrin, Cellulose and other allied substances see the article SACCHARUM in the following pages.]

Amylum Iodatum, Iodized Starch,-has of Starch 95 parts, Iodine 5, triturated with distilled water and dried. Used as a method of giving Iodine (see Iodum). Dose, 3j-3 ss.

Glyceritum Amyli, Glycerite of Starch,-has of Starch 10 parts, Glycerin 90, triturated and heated to a transparent jelly. Used as a vehicle for external applications.

Starch, though a nutritive of the first order, may be regarded as inert

medicinally. It serves as a protective and absorbent if dusted over the skin, as a vehicle for enemata, and as an antidote in iodine-poisoning. Mixed with glue it makes an excellent stiff bandage for surgical purposes.

ANISUM, Anise,-is the fruit of Pimpinella Anisum, a European plant of the nat. ord. Umbelliferæ. It occurs in ovate bodies, % inch long, hairy, of grayish color, aromatic odor, and sweet, spicy taste, resembling conium fruit in appearance. Dose, gr. x-xx.

Preparations.

Oleum Anisi, Oil of Anise, is a volatile oil distilled from Anise or from Illicium anisatum (the star anise), and represents the medicinal qualities of the plant. That from Anise congeals at 50° to 59° F., and is soluble in an equal part of alcohol. That from Illicium congeals at about 351⁄2° F. The oil is an ingredient of Tinctura Opii Camphorata, Trochisci Glycyrrhizae et Opii, and of the two following preparations. Dose, m j-v.

Aqua Anisi,-has in 500 parts I of Oil of Anise mixed with distilled water by the aid of cotton. Dose, indefinite.

Spiritus Anisi,-is a 10 per cent. solution of the oil in alcohol.

Dose, 3 j-ij.

The Volatile Oil is the active constituent of Anise. It has a slightly stimulant action on the heart and the digestive organs, and liquefies the bronchial secretion, being probably in part excreted by the bronchial mucous membrane. It is a favorite flavoring ingredient of cough-mixtures, and relieves slight intestinal colic and flatulence in children. In full doses it has a weak narcotic power.

ANTHEMIS, Chamomile,-the flower-heads of Anthemis nobilis, a European perennial of the nat. ord. Compositæ, collected from cultivated plants. Chamomile-flowers are sub-globular, about 3/4 inch broad, having numerous white, three-toothed florets on a conical, solid receptacle, a strong but agreeable odor, and an aromatic, bitter taste; and contain a volatile oil, a camphor and a bitter principle but no alkaloid. There are no official preparations. An infusion (ziv to Oj) may be given in doses of 3j-ij.

Oleum Anthemidis, Chamomile Oil (Unofficial),-the volatile oil is of a dark blue or green color, and is composed of various ethers, the Angelates and Valerianates of Butyl predominating. Dose, m ij-x, on sugar.

PHYSIOLOGICAL ACTION AND THERAPEUTICS.

Chamomile is a stomachic tonic. It improves the appetite and aids. digestion by increasing the vascularity of the gastric mucous membrane. In large doses the warm infusion is emetic, and perhaps diaphoretic, though the latter action is chiefly due to the hot water. The oil is remarkably efficient in reducing reflex excitability in frogs, even after its excitation by Strychnine or Brucine.

Chamomile is popular in domestic practice. An infusion is used by nurses for many infantile complaints, and externally as a fomentation to relieve pain, as in colic, etc. The oil is very efficient in reflex cough, pulmonary catarrh, acute dyspepsia, diarrhoea of children, spasmodic asthma, whooping-cough, colic, and the spasmodic and pseudo-neuralgic affections of hysterical women. It should prove extremely useful in poisoning by Strychnine, from its power over reflex excitability.

The Chamomile of the homoeopaths is the Matricaria Chamomilla, or German Chamomile, official in the U. S. Pharmacopoeia as "MATRICARIA," which see.

ANTIMONIUM, Antimony, Sb.-Metallic Antimony is not official, nor is it used in medicine. It is represented, however, by the following official salts and preparations, viz. :

Compounds of Antimony and their Preparations.

Antimonii et Potassii Tartras, Tartrate of Antimony and Potassium, Tartar Emetic, 2K SbOCHO.H,O,-small white crystals or a granular powder of sweet, disagreeable metallic taste, soluble in 17 of water at 59° F., and in 3 of boiling water, insoluble in alcohol. Dose, gr. -, but after tolerance is established as high as gr. ij may be given. Is an ingredient of the two following, viz. :

Vinum Antimonii, Wine of Antimony,-has of Tartar Emetic 4, Boiling Distilled Water 60, Stronger White Wine to 1000 parts. Contains about 2 grains of Tartar Emetic to the 3, and is an ingredient of Mistura Glycyrrhizæ Composita. Dose, as a febrifuge and expectorant, mv-xv.

Syrupus Scilla Compositus, Cox's Hive Mixture, Hive Syrup (see under Scilla),—contains about 34 grain of Tartar Emetic to the 3, or more accurately 3 parts in 2000, with Squill, Senega, etc. Dose, m j-3j, cautiously in children.

Antimonii Oxidum, Oxide of Antimony, Sh2O,,—a heavy, gray powder, insoluble in water of alcohol, but readily and wholly soluble in Hydrochloric or Tartaric Acids. Dose, gr. j-iij. It constitutes/d of

Pulvis Antimonialis, Antimonial or James' Powder,-consists of the Oxide of Antimony 33 parts, with 67 of Calcium Phosphate. Dose, gr. iij-viij, every 3 hours as a diaphoretic, larger doses for emetic and cathartic effects.

Antimonii Sulphidum, Sulphide of Antimony, Sb,S,—is the native sulphide, purified by fusion, and as nearly free from Arsenic as possible,-steel gray masses, or a black, lustreless powder, insoluble in water or alcohol. Dose, gr. 1-j.

Antimonii Sulphidum Purificatum, SbS,—is purified by maceration in Aq. Ammonice, washing and drying. Dose, gr. 4-j.

Antimonium Sulphuratum, Sulphurated Antimony,-is chiefly SbS, with a very small amount of Sb2O3. A reddish-brown, odorless and tasteless powder, insoluble in water or alcohol. Is a constituent of Pil. Antimonii Compositæ. Dose, gr. j-v. Pilula Antimonii Composite, Plummer's Pills,-each pill containing gr. 1⁄2 each of Calomel and Sulphurated Antimony.

PHYSIOLOGICAL ACTION.

TARTAR EMETIC in its action represents the other official antimonial preparations, being a cardiac, arterial and general depressant, a protoplasmic poison, a systemic and local emetic, a specific gastro-intestinal irritant, an expectorant and a diaphoretic. Like Aconite, Arsenic, Hydrocyanic Acid and Potassium, it is destructive to protoplasm, destroying function in all nitrogenous tissue, and paralyzing the spinal cord, the motor