ANTAGONISTS AND INCOMPATIBLES.-Tannic acid, by forming an insoluble tannate with the alkaloid, retards but does not prevent its absorption. When a lethal quantity has been taken, emetics and purgatives are required, and demulcents may be freely administered. Opium and the alcoholic substances antagonize the depression of the heart's action.

SYNERGISTS. Such alkaloids as produce gastro-intestinal irritation and depress the action of the heart, e. g., veratrine, aconitine, etc., are synergistic. Therapeutically considered, emetics, purgatives, alkalies, promote the activity of colchicum.

PHYSIOLOGICAL ACTIONS.-Colchicum imparts its virtues to water, alcohol, and ether. It has a bitter taste, and excites the flow of saliva. In small doses it increases the mucous and glandular secretion of the stomach and intestines, and probably also of the liver, kidneys, and skin. If the dose be large but still medicinal, colchicum produces a feeling of epigastric heat, nausea, and vomiting, depression of the cir culation, muscular feebleness, headache. It frequently purges, producing copious watery stools, and is generally held to increase the discharge of biliary matters. It increases the flow of urine, of the solid constituents (urea, uric acid, etc.), as well as of the water, and promotes the cutaneous transpiration. In toxic doses colchicum produces all of the local as well as the systemic effects of an irritant poison, viz. acute abdominal pain, profuse watery and choleriform discharges, suppression of urine, feeble pulse, cold sweat, coldness of the extremities. The intellect remains unaffected until carbonic-acid poisoning supervenes. The muscular cramps which have beer. occasionally observed are probably due to the great loss of fluid from the system. When colchicine is injected subcutaneously, gastro-intestinal inflammation is produced, showing that it has a selective action on this tissue.

:

This view of the action of colchicum has been fully confirmed by Dr. Roy. The strongly accentuated impression on the mucosa of the intestine is due, he affirms, to its elimination by this membrane and the profuse watery discharge as a transudation.

THERAPY.-Colchicum is indicated when rapid wasting of tissue and prompt elimination of the products of waste are required. Its use at the present time is almost entirely restricted to the treatment of gout in its various manifestations. It relieves the pain, diminishes the swelling, and shortens the duration of an attack of acute gout. In order to accomplish these results, it is not necessary that the more harsh and violent physiological effects of the drug be produced. Sufficient quantity of colchicum should be given to ir rrease secretion from the skin, the intestinal mucous membrane, and the kidneys, but nausea and vomiting should be avoided. Combination with an alkali increases the therapeutical effect of colchicum: R Spts. ammoniæ aromat., 3 xiij;

vini seminis colchici, 3 iij. M. Sig.: A teaspoonful every three hours, until some physiological effect is produced. The following is a formula used at the London Hospital for gout: R Tinct. colchici seminis, m xx; potassii bicarbonat., grs. x; aquæ pimentæ, 3j. M. Sig. A draught. The following modification of Scudamore's prescription is in use at University College Hospital: R Tinct. colchici seminis, m xv; magnesii carb., gr. vj; magnesii sulph., grs. xxx; aquæ menth. pip. ad j. M. Sig. A draught. After the more acute symptoms of the gouty attack have subsided, the following was recommended by Sir Henry Halford: R Ext. colchici acet., gr. vj; pulv. opii et ipecac. comp., ext. colocynth. comp., āā gr. xij. M. Ft. pil. no. xij. Sig. One pill night and morning. The efficiency of colchicum is increased by combination with digitalis: R Ext. colchici acet., gr. x; pulv. digitalis, ext. colocynth. comp., aa j. M. Ft. pil. no. xx. Ft. pil. no. xx. Sig. One pill tirice or thrice a day.

:

The active principle, colchicine, is, there is reason to believe, more successful in gout than any of the preparations of the crude drug. R Colchicinæ, gr. j; ext. colocynth. comp., 3 ss; quinine sulph., 3 iij. M. Ft. pil. no. lx. Sig. One every four hours.

In the so-called rheumatic gout, colchicum with alkalies is extremely serviceable. Attacks, without decided pain and inflammation, of soreness of joints, which have been the seat of gouty attacks, or about which nodosities have been deposited, are relieved by colchicum.

Constipation, hepatic congestion, and headache, due to torpor of the portal circulation, occurring in gouty subjects, are quickly relieved by a combination of colchicum and saline purgatives. The plethoric and overfed without being gouty, suffering from the same group of symptoms, are relieved by the same means. Inflammations of internal organs occurring in gouty subjects, for example, gouty bronchitis and rheumatic pneumonia, are best treated with prescriptions containing a preparation of colchicum. The following prescription is recommended by Greenhow in gouty bronchitis: R Potassii iodidi, ammonii carbonat., ää j; vin. colchici seminis, 3j; tinct. scillæ, tinct. hyoscyami, a 3 ij; aquae camphora q. s. ad iij. M. Sig.: A tablespoonful three times a day.

Although colchicum is still advocated by some authorities in acute rheumatism, the general professional experience is against its use. chronic rheumatism, when the joint changes are allied in nature to those which take place in gout, it is unquestionably serviceable. Neuralgia occurring in gouty and rheumatic constitutions is often relieved by colchicum. The indications for its use are plethora, constipation, and deficient excretion of the liver, kidneys, and skin. Colchicum relieves in such cases, by setting up an eliminative process. In hepatic dropsy and cardiac dropsy, when the patient is vigorous, the gastrointestinal tract free from inflammatory mischief, colchicum may be

used with advantage as a bydragogue: R Elaterii, gr. j; spts. etheris nitrosi, ij; tinct. scillæ, tinct. colchici, aa ss; syrup. simplicis, 3j. M. Sig. A teaspoonful three or four times a day. The following combination is an excellent diuretic in dropsy: R Vini seminis colchici, ss; sol. ammonii acetat., 3 ijss; inf. petroselin, 3 v. M. Sig.: A tablespoonful every four hours. This prescription is well adapted to dropsy following scarlatina.

Colchicum is a serviceable remedy in certain cerebral disorders. Thus, it may be used in acute cerebral congestion in plethoric subjects, in uræmic intoxication, in hypochondriasis, especially when due to deficient elimination (uric acid, oxalate of lime, etc.).

The wine of colchicum-seed has frequently succeeded in curing gonorrhoea, and by Brodie a nightly dose of thirty minims was given for the relief of chordee. In the treatment of gonorrhea, the following may be used: R Vini colchici seminis, ss; sol. potassii citratis, vjss; tinct. opii deod., 3 ij. M. Sig. A tablespoonful three or four times a day in gonorrhoea.

Authorities referred to:

BRODIE, SIR BENJAMIN, Works by Mr. Hawkins, Discases of Urinary Organs,

vol. ii.

CASPAR, JOHANN LUDWIG. Practisches Handbuch der gerichtlichen Medicin. Neu bearbeitet und vermehrt von Dr. Carl Liman, Berlin, 1871, p. 570.

FULLER, DR. WILLIAM HENRY.
GREENHOW, DR. E. HEADLAM.
GUBLER, DR. ADOLPHE.

chique.

On Rheumatism, Rheumatic Gout, etc., 1874.
Chronic Bronchitis, etc.

Commentaires du Codex Medicamentarius, etc., article Col

HANBURY AND FLÜCKIGER. Pharmacographia, p. 636.
HAMMOND, DR. W. A.

p. 278.

The Amerian Journal of the Medical Sciences, January, 1859,

HUSEMANN, DRS. THEO. AND AUG. Die Pflanzens!offe, p. 493, article Colchicin. ROY, DR. CH. Archives de Physiologie, normale et pathologique. New series, vol. v, p. 656.

Sarsaparilla. Sarsaparilla. Root of Smilax officinalis and other species of smilax (Nat. Ord. Liliacea). Separeille, Fr.; Sarsaparillwurzel, Ger.

Decoctum Sarsaparilla Compositum.-Compound decoction of sarsaparilla. (Sarsaparilla, sassafras-root, guaiacum-wood, licorice-root, mezereum.) Dose, j— iv.

Extractum Sarsaparilla Fluidum.-Fluid extract of sarsaparilla. Dose, 3j3 ss.

Syrupus Sarsaparilla Compositus.-Sirup of sarsaparilla. (Sarsaparilla, guaiacum-wood, rose, senna, licorice-root, essential oils.) Dose, 3jss.

Extractum Sarsaparilla Compositum Fluidum.-Compound fluid extract of sarsaparilla. (Sarsaparilla, licorice-root, sassafras, mezereum.) Dose, 3 ss3 ij.

COMPOSITION.-An alkaloid, parilline, or smilacine. an essential oil, starch, resin, oxalate of lime, and extractive matters. From parilline, by the action of dilute sulphuric acid, is obtained parigenine, a distinct alkaloid.

ANTAGONISTS AND INCOMPATIBLES.-Alkalies favor the decomposition of the decoction and fluid extracts. As there is much starch present in the drug, free iodine should not be prescribed with the official preparations.

SYNERGISTS.-Iodine, mercury, and other so-called alteratives, increase the therapeutical activity of sarsaparilla. Warm clothing increases the action on the skin; diluents favor increased urinary discharge.

PHYSIOLOGICAL ACTIONS-Much discrepancy obtains in the opinions which have been emitted in respect to the physiological actions of sarsaparilla. Surgeons generally hold to its therapeutical powers; physicians are skeptical. The physiological experiments which have been made, both with the preparations of the crude drug and with the alkaloid, have yielded negative results. Palotta's experiments, made with the alkaloid which he had discovered so long ago as 1825, indicate that eight grains of the alkaloid produce gastric disturbance, vomiting, slowing of the pulse, depression, faintness, and sweating. These results have since been in part confirmed by Cullerier. Boecker, however, making more systematic examination in accordance with modern methods, finds that sarsaparilla is devoid of physiological activity and of therapeutical power (Husemann).

THERAPY.-From the point of view of the physiological experiments it is not difficult to understand the modern incredulity in regard to the curative power of sarsaparilla. The difficulty of distinguishing between the post hoc and the propter hoc serves to account for the belief still held in some quarters, that this drug is an alterative. Popularly, sarsaparilla is supposed to have extraordinary powers as a "blood-purifier," and its large use at the present time arises from this

belief.

Almost the only use of sarsaparilla at the present time is in the treatment of syphilis. It is, of course, not adapted to the primary or to the secondary forms. The experience in its favor, even of those most confident of its powers, restricts its use to the tertiary form in debilitated subjects, who have been broken down by the combined influence of syphilis, mercurialism, and iodism. It has been further demonstrated that the best effects have been obtained by the use of large doses of the compound decoction (Allbutt). As the compound decoction contains guaiac and mezereon, it is difficult to assign the exact share of the sarsaparilla in the result. Furthermore, as a pint or more of the compound decoction must be taken in the twenty-four hours, these large draughts of a warm liquid are not without influence on the

functions of the skin and kidneys. It is extremely questionable whether sarsaparilla has any therapeutic power; it is not at all equal us an alterative to some of the remedies indigenous in the United States, to be considered hereafter.

The compound fluid extract, the compound decoction, and the compound sirup of sarsaparilla, are frequently used as vehicles for iodide of potassium and for the bichloride of mercury in secondary and tertiary syphilis.

Scrofula, chronic abscesses, necrosis of bones, old ulcers, and stremous cutaneous affections, are diseases in which sarsaparilla is supposed to be efficacious. It is more used as an adjunct to more active remedies than depended on alone.

Authorities referred to:

ALLBUTT, DR. CLIFFORD. The Practitioner, 1870, vol. i.

Gubler, Dr. AdolLPHE. Commentaires Thérap. du Codex Medicamentarius, p. 304.
HANBURY AND FLUCKIGER. Pharmacographia, p. 636, et seq.
HUSEMANN, DRS. AUG. UND THEODOR. Die Pflanzenstoffe, p. 1040.

Guaiacum.-Guaiac. Gayac, Fr.; Franzosenholz, Ger.

Guaiaci Lignum.-Guaiacum-wood. The heart-wood of Guaiacum officinale Linné, and of G. sanctum Linné (Nat. Ord. Zygophyllea). Guiaci Resina.-Guaiac. A peculiar resin obtained from Guait cum officinale.

Tinctura Guaiaci. Tincture of guaiac. (Guaiac, 200 grm.; alcohol, to 1,000 c. c.) Dose, 3 ss

3 ij.

Tinctura Guaici Ammoniata.-Ammoniated tincture of guaiac. (Guaiac, 200 grm.; aromat. spirit of ammonia, to 1,000 c. c.) Dose, 3 ss-3 íj.

COMPOSITION.-The only constituent of interest in the wood is the resin. Guaiac has a complex chemical composition. It contains guaiaconic acid (seventy per cent), guaiarec acid, guaiac beta-resin, guaiacic acid, guaiac yellow, gum, etc.

ANTAGONISTS AND INCOMPATIBLES.-Spirits of nitrous ether and the mineral acids are incompatible.

SYNERGISTS.-Agents which promote cutaneous activity are syner gistic. The action of guaiac is much aided by external warmth and warm diluent drinks.

PHYSIOLOGICAL EFFECTS.-Guaiac has a very acid and pungent taste. It excites an abundant flow of saliva. In the stomach it creates a sensation of warmth and burning, increases the secretions of the gastro-intestinal canal, accelerates the action of the heart, promotes diaphoresis, and favors the production and excretion of bronchial mu

cus.

In large doses it deranges digestion and causes gastric catarrh, and in excessive doses the series of symptoms produced by the irritant poisons, vomiting, purging, cramps, headache, giddiness, etc.