Part 9

The dose of salicylic acid or its salts (ammonium, sodium, strontium) is from 5 to 20 grains (0.3-1.3 gm.); of Oil of Gaultheria (Methyl Salicylate), 5 to 20 minims (0.3-1.2 c.c.). These preparations should be given after meals, well diluted.

The following remedies have properties like the salicylates, but are less powerful and less irritant to the stomach: Salol, dose, 5 to 20 grains (0.3-1.3 gm.); salophen, 5 to 30 grains (0.3-2 gm.); aspirin, 5 to 20 grains (0.3-1.3 gm.).

=Senna.=—This is a purgative cholagogue and is used in the constipation of children and pregnant women. Dose, in substance, 5 to 20 grains; in fluidextract or tincture, 1 to 4 fluidrams.

=Silver.=—The most important salt of this metal is the nitrate. Locally, in concentrated form, the latter is a caustic; in dilute form it is a sedative, astringent, and antiseptic. Internally, in small doses, silver nitrate is useful as an astringent and antiseptic in inflammatory and ulcerative conditions of the stomach and bowel.

The prolonged use of the drug, even in small doses, is followed by a permanent grayish discoloration of the skin (argyria) from the precipitation of the metal in the tissues.

Toxic doses of silver nitrate cause burning pain in the abdomen, vomiting of white, curdy matter, and bloody purging.

The dose of silver nitrate is from ⅙ to ½ of a grain (0.01-0.3 gm.), usually in pill form.

Several combinations of metallic silver with albumin are much used as antiseptics and astringents in inflammatory diseases of mucous membranes. They have advantage over silver nitrate in being less irritating and in not being decomposed by the juices of the tissues. The most important of these organic compounds are protargol and argyrol. They are usually applied in solutions of from 1 to 10 per cent. A soluble form of metallic silver is also employed in the form of 15 per cent. ointment, known as Credé’s ointment. It is recommended as an antiseptic in various infectious diseases.

=Spartein.=—This is an alkaloid from the broom plant. It is used to some extent as a heart tonic and diuretic in doses of from ¼ to ½ grain (0.015-0.03 gm.).

=Strophanthus.=—This is the seed of a climbing plant growing in Africa. Its action very closely resembles that of digitalis, for which it is sometimes substituted. The dose of the tincture (Tinctura Strophanthi) is from 3 to 10 minims (0.2-0.6 c.c.).

=Sulphonal.=—This artificial compound is used almost entirely as a hypnotic. In single doses it is comparatively safe and reliable, but slow in its action. Languor, headache, and drowsiness not infrequently follow its use. The repeated administration of sulphonal over several days or weeks is distinctly dangerous, being often followed by chronic poisoning. The latter is marked by a red coloration of the urine, colicky pains, profound depression, weakness, and collapse.

The dose of sulphonal is from 10 to 30 grains (0.6-2 gm.). It is best given in hot tea or hot milk, one or two hours before bedtime.

=Tannic Acid, Tannin.=—This is employed externally as an astringent and styptic, and internally as an astringent in atonic diarrheas. It is used in the form of a gargle or in troches in relaxed conditions of the throat, in solution to prevent bed-sores, and in the form of ointment or suppositories for the relief of internal piles. Dose, 1 to 10 grains.

=Trional.=—This remedy resembles sulphonal in action, and is used for the same purpose. It may also be given in the same dose and manner as sulphonal.

=Urotropin.=—This compound, prepared by the action of ammonia on formaldehyd, is employed as a powerful urinary antiseptic in doses of from 3 to 5 grains (0.2-0.3 gm.). Large doses may cause pain in the bladder, frequent urination, and bloody urine.

=Veratrum Viride.=—This is the root of a North American herb. Its action resembles that of aconite in that it depresses the heart and slows the pulse. It is, however, more nauseating than aconite, and when locally applied does not cause numbness, tingling, and anesthesia. Large doses cause vomiting, muscular weakness, dizziness, sweating, failure of pulse, and collapse. It is used as a sedative in acute inflammatory diseases to subdue overaction of the heart.

The dose of the tincture of veratrum viride (tinctura veratri viridis) is from 1 to 5 minims (0.06-0.3 c.c.).

DOSAGE.

The following general rules will aid the student in remembering the safe dose of many important preparations:

1. Tinctures of very active drugs, such as opium, digitalis, belladonna, physostigma, nux vomica, gelsemium, arnica, and capsicum may be given in doses of from 5 to 20 minims (0.3-1.2 c.c.), except the tinctures of aconite, veratrum viride, iodin, and cantharides, the dose of which is from 1 to 5 minims (0.06-0.3 c.c.).

2. Tincture of less active drugs, such as gentian, calumba, krameria, quassia, valerian, cinchona, kino, may be given in doses of from ½ to 1 dram (2-4 c.c.).

3. Solid extracts of active drugs may be given in doses of from ⅙ to ¼ of a grain (0.01-0.016 gm.).

4. Solid extracts of less active drugs may be given in doses of from ½ to 5 grains (0.03-0.3 gm.) or more.

5. Dilute acids (hydrochloric, nitric, nitrohydrochloric, sulphuric) may be given in doses of from 5 to 20 minims (0.3-1.3 c.c.), except dilute hydrocyanic acid, the dose of which is from 1 to 5 minims (0.06-0.3 c.c.).

6. All medicated syrups, except the syrup of iodid of iron and the compound syrup of squill, may be given in doses of 1 to 2 drams (4-8 c.c.) or more.

7. All infusions may be given in doses of ½ to 1 ounce (15-30 c.c.) or more, except the infusion of digitalis, the dose of which is from 1 to 4 drams (4-15 c.c.).

8. All official mixtures may be given in doses of from 1 to 4 drams (4-15 c.c.).

9. All spirits may be given in doses up to 1 dram (4 c.c.), except the spirit of nitroglycerin (glonoin), the dose of which is from 1 to 5 minims (0.06-0.3 c.c.), the spirit of phosphorus, the dose of which is from 5 to 15 minims (0.3-1 c.c.), and the spirit of bitter almond, the dose of which is from 5 to 10 minims (0.3-0.6 c.c.).