Solution of pepsin is composed of saccharated pepsin in solution in water and glycerin, and acidulated with hydrochloric acid. Dose: a tea spoonful ter in die, usually after meals. The wine of pepsin is an unscientific preparation, and should not be prescribed. Boudault's (really Corvisart's) compound nutritive powder, consisting of pepsin, starch, and lactic acid, is an exceedingly uncertain preparation, and is often totally inert. Only those preparations of pepsin should be used, made by the processes above described, especially those of E. Scheffer, of Louisville, Ky. The saccharated pepsin and the glycerole are practically unchangeable.

Ingluvin is a proprietary preparation, said to be made of the gizzard of the domestic chicken by drying and pulverization. Dose, gr. v—. Эj. Ingluvin has the remarkable property of arresting certain kinds of vomiting—notably the vomiting of pregnancy. It is a stomachic tonic, and relieves indigestion, flatulence, and dyspepsia.

Recent investigations have shown that ingluvin owes its curative effects, not to any ferment corresponding to pepsin, but to a peculiar bitter principle. This result is the more satisfactory, since such an organ as the gizzard could hardly furnish the necessary quantity of a digestive ferment to effect the results now known to be produced by ingluvin.

Under ordinary circumstances, and when the object of its administration is to promote the digestive function, it should be taken after meals. When the object is to arrest the vomiting of pregnancy, it should be given before meals.

But only the successful use of this agent and the apparent sincerity of the composition as given to the public would seem to justify its mention here; but no doubt need be felt as to the propriety of using a patented preparation if there is no substitute of equal value.

Pancreatin. Pancreatic Emulsion. Liquor Pancreaticus.— Pancreatin is a mixture of the enzymes naturally existing in the pancreas of warm-blooded animals, usually obtained from the fresh pancreas of the hog (Sus scrofa, Linne. Class, Mammalia; order, Pachy-dermata).

Pancreatin occurs in transparent, brittle, yellowish scales, or a yellowish or yellowish-white or grayish powder, odorless, or having a faint, peculiar, not unpleasant odor, and a somewhat meat-like taste. It is slowly and almost completely insoluble in water, insoluble in alcohol. It digests albuminoids, converts starch into sugar in presence of alkalies; prolonged contact with acids renders it inert. In the presence of an alkali it has the power to convert proteids into peptones, to emulsionize fats, etc. As acids destroy pancreatin, it follows that the liquor pancreaticus should not be given while stomach digestion is going on, but when the chyme has entered the intestine, in about three hours after the taking of food (Roberts).

In cases of very weak digestion, Roberts suggests the employment of "peptonized" foods—i. e., foods that have been acted on by pancreatin and the proteids converted into peptones. The following formulae proposed by Roberts will be found useful in some conditions of disease:

"Peptonized Milk.—A pint of milk is diluted with one fourth water, and heated to 140° Fahr. Two or three teaspoonfuls of liquor pancreaticus, and ten to twenty grains of bicarbonate of soda, are then mixed therewith. The mixture is then poured into a covered jug, and the jug is placed in a warm situation under a 'cozy' in order to keep up the heat. At the end of an hour or hour and a half, the product is boiled for two or three minutes. It can then be used like ordinary milk."

"Peptonized Gruel.—Gruel may be prepared from any of the numerous farinaceous articles which are in common use—wheaten flour, corn-meal, oatmeal, arrow-root, sago, pearl-barley, pea-flour. The gruel should be very well boiled, and made thick and strong. It is then poured into a covered jug and allowed to cool to a temperature of about 140° Fahr. Liquor pancreaticus is then added in the proportion of a tablespoonful to the pint of gruel, and the jug be kept warm under a 'cozy' as before. At the end of a couple of hours the product is boiled and finally strained." In this process the starch is converted into sugar, and the albuminoid matters are peptonized, whence the gruel assumes a thin, watery consistence. Peptonized gruel is administered with peptonized milk.

"Peptonized milk-gruel is prepared as follows: Gruel is made in the usual way, thick and strong; to this while boiling is added an equal measure of milk. To each pint of the mixture add two or three teaspoonfuls of liquor pancreaticus and twenty grains of bicarbonate of sodium. It is kept warm for a couple of hours, then boiled for a few minutes and strained."

Synergists

Lactic and chlorhydric (muriatic), acetic, citric, and malic acids, promote the digestive activity of pepsin.

Physiological Effects

Ten grains of the saccharated pepsin, prepared by the process of Scheffer, will dissolve 120 grains of coagulated albumen in four to six hours, at a temperature of 100° Fahr. Pepsin is an essential constituent of the gastric juice, and possesses the property, especially in the presence of lactic and chlorhydric acids, of digesting the nitrogenous constituents of the food (casein, albumen, fibrin, etc.), and converting them into peptones.