Therapeutics

A number of carminative drugs have other striking actions for which they are of importance in therapeutics, and these we shall study in detail elsewhere. The following is an arrangement in therapeutic groups:

1. As anticolics (in intestinal and uterine cramps). Especially employed for infants are anise, peppermint, and dill water, and for adults the distilled liquors, essence of ginger, spirit of peppermint, aromatic spirit of ammonia, and Hoffmann's anodyne (the compound spirit of ether).

2. As odors and flavors - anise, bitter almond, caraway, cinnamon, coriander, fennel, lavender flowers, lemon, nutmeg, orange-peel, peppermint, spearmint, rose, and vanilla. Of the waters, the dose is 1 dram (4 c.c.); of the spirits, 5 minims (0.3 c.c.).

3. As correctives of irritant cathartics - the oils of anise, caraway, cloves, coriander, fennel, and peppermint. Of the oil, J minim (0.015 c.c.), or of the drug, 1 grain (0.06 gm.), to each dose.

4. For tympanites, as in typhoid fever, pneumonia, or following operations. By mouth, oil of turpentine, 10 minims (0.07 c.c.) in capsule, or asafetida, 5 grains (0.03 gm.) in pill or tincture. By rectum, oil of turpentine, 1/2 ounce (15 c.c.), or tincture of asafetida or spirit of peppermint, 1 dram (4 c.c.), added to a soapsuds enema or to 8 ounces or more of infusion of chamomile (an aromatic bitter).

5. As anthelmintics - oil of chenopodium and oil of thyme or thymol.

6. As stimulants to mucous membranes of nose and throat - eucalyptol, camphor, and menthol, mixed together and inhaled, or diluted with liquid petrolatum and used as a spray.

7. As antiseptics and anesthetics - oil of cloves or oil of cinnamon in decayed tooth, a drop on cotton. Eugenol, the stearopten of oil of cloves, is also used.

8. As counterirritants - camphor, capsicum, and menthol, and the oils of mustard, rosemary, and turpentine.

9. As stimulants in chronic skin diseases, such as eczema - the oils of cade and tar in the form of ointment.

10. As stimulants to the growth of hair - the oil of mace.

11. As antirheumatics - methyl salicylate and the oils of birch and wintergreen, externally as a liniment, and internally in 5-minim (0.3 c.c.) capsules.

12. As antihysterics - asafetida, camphor, musk, sumbul, and valerian.

13. As anti-asthmatics - powdered cubebs smoked in cigaret form.

14. As bronchial stimulants (and perhaps antiseptics) - creosote, 5 minims (0.3 c.c.), oil of turpentine, 10 minims (0.7 c.c.), terebene, 10 minims (0.7 c.c.), and syrup of tar, 1 dram (4 c.c.).

15. As diuretics - oil and spirit of juniper; the fluidextracts of buchu and uva-ursi, 1 dram (4 c.c.).

16. As urinary antiseptics - the oils of copaiba, cubebs, and sandalwood, and balsam of copaiba, 5 minims (0.3 c.c.).

17. As emmenagogues - apiol, from oil of parsley, and the oils of pennyroyal, rue, savine, and tansy, 3 minims (0.2 c.c.).

18. In leprosy - chaulmoogra oil, 5 minims (0.3 c.c.), increased gradually to 30 minims (2 c.c.) two or three times a day by mouth, or 15 to 75 minims subcutaneously every few days. Rogers uses chaulmoogric (gynocardic) acid in 2 per cent. solution intravenously, beginning with 1/10 grain (0.006 gm.) and increasing to 3-grain (0.05 gm.).

For simple carminative action the spices are much used, and usually in combinations of several carminatives, as in the compound tinctures, compound spirits, and the aromatic fluidextract. A favorite hospital dose for flatulence is compound spirit of ether, aromatic spirit of ammonia, compound tincture of lavender, and spirit of chloroform, of each, 15 minims (1 c.c.).

Preparations

1. The volatile oils (the Latin name is given in the genitive) are: Allspice (pimentae), anise (anisi), birch (betulae), bitter almond (amygdalae amarae), cade (cadini), cajuput (cajuputi), caraway (cari), chenopodium (chenopodii) cinnamon (cinnamomi or cassiae), cloves (caryophylli), copaiba (copaibae), coriander (coriandri), cubeb (cubebae), dwarf pine needle (pini pumilionis), erigeron (erigerontis), eucalyptus (eucalypti), fennel (foeniculi), juniper (juniperi), lavender (lavandulae), lemon (limonis), mustard (sinapis), nutmeg (myr-isticae), orange-peel- (aurantii), pennyroyal (hedeomae), peppermint (menthae piperitae), rose (rosae), rosemary (rosmarini), sandalwood (santali), sassafras (sassafras), savin (sabinae), spearmint (menthae viridis), tar (picis liquidae rectificati), thyme (thymi), turpentine (terebinthinae), wintergreen (gaultheriae).

2. The waters (aquae) are: Anise, bitter almond, camphor, cinnamon, fennel, orange-flower (aurantii riorum), stronger orange-flower (aurantii riorum fortioris), peppermint, rose, stronger rose, spearmint.

3. The spirits (spiritus) - the simple are: Bitter almond of 1 per cent. strength, dose, 8 minims (0.5 c.c.); of 10 per cent. strength, camphor, cinnamon, peppermint, and spearmint; of 5 per cent. strength, juniper, lavender, and wintergreen. The compounds are: Aromatic ammonia (ammonia, lemon, lavender, and nutmeg), compound ether (ethereal oil and ether), compound juniper (juniper, caraway, fennel), and compound orange (orange-peel, lemon, coriander, anise). The compound spirit of ether (Hoffmann's anodyne) is no longer official.

4. The Elixirs

These are sweetened and aromatic, more or less alcoholic liquids. Aromatic elixir (elixir aromaticum) contains the compound spirit of orange, and the elixir glycyrrhizae is aromatic elixir with the addition of 12 per cent. of fluidextract of licorice. The liquors and cordials, as creme de menthe, absinthe, Benedictine, etc., are elixirs. (See Alcohol.)

5. Stearoptens used by themselves are: Benzaldehyde, from oil of bitter almonds; cinnaldehyde, from oil of cinnamon; euca-lyptol, from oil of eucalyptus; eugenol, from oil of cloves; menthol, from oil of peppermint; methyl salicylate, from oil of birch or wintergreen, and also manufactured synthetically; safrol, from oil of sassafras, and camphor.

6. The Spices

The spices are not only aromatic, but more or less hot and biting. Some of them yield no oil and depend for their action on resinous ingredients. They are allspice (pimentae), calamus (calami), cinnamon, cardamom, cloves (caryophylli), ginger (zingiberis), black pepper (piperis), and red pepper (capsici).

7. The simple aromatic tinctures are: Asafetida, bitter orange-peel (aurantii amari), sweet orange-peel (aurantii dulcis), capsicum, cardamom, cinnamon, ginger, lemon-peel (limonis corticis), musk (moschi), valerian, vanilla.

8. The compound tinctures are: Compound tincture of cardamom (tinctura cardamomi composita), containing cardamom, cinnamon, and caraway.

Compound tincture of lavender (tinctura lavandulae composita), containing oil of lavender, oil of rosemary, cinnamon, cloves, and nutmeg.

Ammoniated tincture of valerian, a tincture of valerian made with aromatic spirit of ammonia as the menstruum.

9. The fluidextracts are: Bitter orange-peel, buchu, cubebs, eucalyptus, ginger (zingiberis), sumbul, uva-ursi, and the aromatic fluidextract (fluidextractum aromaticum). The last is a fluid-extract of aromatic powder (pulvis aromaticus) which contains cinnamon and ginger, each, 35 parts, and cardamom and nutmeg, each, 15 parts.

Doses

These vary somewhat. Where the drugs have no other marked quality, their carminative doses are: Powdered drug, 15 grains (1 gm.); oils, 5 minims (0.3 c.c.); waters, 1 dram (4 c.c.); spirits, 10-30 minims (0.7-2 c.c.); tinctures, 30 minims (2 c.c.); aromatic fluidextract, 30 minims (2 c.c.).