Part 6

Whisky is made by subjecting fermented grains to distillation. Rum is made by distilling fermented molasses. Gin is prepared by distilling fermented grain and adding oil of juniper berries to the distillate.

Brandy is a spirit produced by the distillation of a wine.

Whisky, rum, gin, and brandy contain from 40 to 50 per cent. of alcohol. The dose of each is from 1 to 4 drams (4-15 c.c.).

Beer, ale, and porter are made from an infusion of malt—that is, fermented barley, flavored with hops. They each contain from 4 to 6 per cent. of alcohol.

In large doses alcohol in any form causes mental excitement, delirium, loss of co-ordination, and finally stupor and coma. Death may result from paralysis of the heart or respiration.

=Aloes.=—This is cathartic and stimulant, and is given in chronic constipation, amenorrhea, and atonic dyspepsia. The laxative dose is from ½ to 2 grains; the purgative and emmenagogue dose is 2 to 5 grains.

=Ammonia.=—This is a gas employed medicinally in the form of a watery solution (water of ammonia) or an alcoholic solution (spirit of ammonia).

These preparations are used internally as heart stimulants, respiratory stimulants, gastric antacids, and externally as counterirritants. The dose of the Aromatic Spirit (Spiritus Ammoniæ Aromaticus) is from ½ to 1 dram (2-4 c.c.), well diluted. Large doses of ammonia preparations cause burning pain in the throat and abdomen, vomiting, purging, and collapse.

=Antipyrin.=—This drug has about the same action and uses as acetanilid, and may be given in the same dose.

=Antitoxin of Diphtheria.=—This is obtained from healthy horses which have been rendered artificially immune to diphtheria from having received a prolonged course of treatment with diphtheria toxin in doses gradually increased. The immunity is due to the formation in the blood of a substance which in some way counteracts the poison or toxin of the disease. This substance is known as the antitoxin. It exists in the serum of the blood, and so far has not been separated from it. The dose of the serum is measured in units, a unit being ten times the amount of antitoxin required to save the life of a guinea-pig which has been injected with 100 fatal doses of diphtheria toxin.

Antitoxin acts both as a curative and a preventive remedy. Since its introduction the mortality of diphtheria has been reduced more than one-half. The curative dose is from 2000 to 5000 units, to be repeated in from six to twelve hours, if necessary. The prophylactic dose is 500 units. The protection afforded is only temporary, lasting from two to three weeks.

The injections are sometimes followed by a rise of temperature, pain in the joints, or a cutaneous rash, but these symptoms are without serious significance.

=Aspirin.=—This is acetyl-salicylic acid and is used like sodium salicylate in rheumatism and pleurisy, and as an antipyretic and analgesic. Dose, 5 to 15 grains.

=Atropin.=—See Belladonna.

=Belladonna.=—This drug owes its activity to the alkaloid atropin. It is employed internally to stimulate the respiration; to stimulate the circulation; to allay local spasm, as in asthma and whooping-cough; to check excessive secretion, as in the night-sweats of phthisis; and to stimulate peristalsis in atonic constipation. Locally, it is employed in the form of solutions of atropin to dilate the pupil of the eye, and in the form of a liniment or plaster of belladonna as a sedative application in various inflammatory conditions. Toxic doses of belladonna cause dilatation of the pupils, dryness of the throat, quickening of the pulse and respiration, delirium, and a diffuse red rash resembling that of scarlatina.

The dose of atropin is from ¹/₁₅₀ to ¹/₅₀ grain (0.00043-0.0013 gm.); of the Tincture of Belladonna (Tinctura Belladonnæ), 5 to 20 minims (0.3-1.2 c.c.); of the Extract of Belladonna (Extractum Belladonnæ), ⅛ to ¼ grain (0.008-0.016 gm.).

=Bismuth.=—The insoluble preparations of the metal—subnitrate, subcarbonate, and subgallate—are used internally as mild antiseptics, sedatives, astringents, and antacids in various inflammatory diseases of the stomach and bowel. They are scarcely poisonous when taken internally in any amount. The usual dose of any one of the preparations named is from 5 to 30 grains (0.3-2 gm.) in dry powder or stirred in milk or water.

=Bromids.=—The salts of bromin in common use are the bromids of potassium, sodium, ammonium, and strontium. The action of these is very similar. They are especially useful as depressants to the central nervous system. They are employed to produce sleep, to check convulsions, and to relieve headache and neuralgic pain. Large doses depress the heart and respiration. The continued use of the bromids causes a condition known as bromism. This is characterized by fetor of the breath, a rash on the skin, languor, and somnolence. The dose of the bromin salts is from 10 to 60 grains (0.6-4 gm.).

=Caffein.=—This is an alkaloid obtained from coffee. It is a heart stimulant, respiratory stimulant, brain stimulant, and kidney stimulant (diuretic). The dose is from 1 to 5 grains (0.06-0.3 gm.).

=Calomel.=—See Mercury.

=Carbolic Acid.=—Externally, this acid is used in weak solutions (1 : 40 to 1 : 20) as an antiseptic, and in concentrated form as a caustic. Weak solutions are also employed to allay itching in skin diseases. Internally, carbolic acid is used as an antiseptic in dyspepsia and diarrhea. Applications of carbolic acid, even when dilute, should never be prolonged, as they are liable to cause gangrene. Poisoning by carbolic acid is characterized by white patches on the lips, the odor of the drug on the breath, burning pain in the abdomen, vomiting, purging, unconsciousness, and collapse. The dose is from ½ to 3 minims (0.03-0.2 c.c.).

=Castor Oil.=—This is an oil expressed from the seed of an East Indian plant. The seeds themselves are acrid poisons. It is a mild purgative, unloading the bowels very thoroughly in from four to six hours. It may be given in flexible capsules, in emulsion, or with equal parts of lemon-juice and glycerin. The dose is from ½ to 1 ounce (15-30 c.c.).

There are two simple methods of taking castor oil without producing nauseating effects. Have the patient wash out the mouth with water as hot as can be borne, then swallow the oil, and follow this by rinsing out the mouth well with hot water. The other method is to hold a piece of ice in the mouth long enough to chill the lining membrane, swallow the oil, and rinse the mouth with ice-water.

=Chloral.=—This substance is an active depressant of the brain and spinal cord. In large doses it also depresses the heart and respiration. It is employed to produce sleep and to check convulsions. The dose is from 10 to 30 grains (0.6-2 gm.) in some agreeable syrup.

Poisonous doses cause unconsciousness, embarrassed breathing, and collapse.

=Chloralamid.=—This is a comparatively safe and reliable hypnotic, producing sleep without causing much depression of the heart or disagreeable after-effects. The dose is from 10 to 30 grains (0.6-2 gm.), well diluted. Hot liquids decompose it.

=Chloroform.=—This substance is employed by inhalation as a general anesthetic, by the mouth as a sedative in colic, neuralgia of the stomach, and obstinate cough, and externally in the form of liniment as a counterirritant in muscular rheumatism, sprains, etc. As a general anesthetic it is more powerful than ether, more readily inhaled, but not so safe. Death from chloroform is usually the result of heart failure. The dose of Spirit of Chloroform (Spiritus Chloroformi) is from 5 to 30 minims (0.3-2 c.c.); of Chloroform-water (Aqua Chloroformi), 1 to 8 drams (4-30 c.c.).

=Cinchona (Peruvian Bark).=—This is the bark of an evergreen tree growing in the tropics. It owes its medicinal properties to quinin and cinchonin, especially the former. It is used as a general tonic, as a stomachic, as a febrifuge, and as an anti-malarial. Large doses cause ringing in the ears, headache, deafness, dimness of vision, convulsions, and coma. The dose of quinin and its salts is from 1 to 30 grains (0.06-2 gm.); of cinchonin, 1 to 30 grains (0.06-2 gm.); of the Compound Tincture of Cinchona (Huxham’s Tincture), 1 to 4 drams (4-15 c.c.).