The cyclopaedia of practical medicine : comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc. / Edited by John Forbes, Alexander Tweedie, John Conolly.

Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: The cyclopaedia of practical medicine : comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc. / Edited by John Forbes, Alexander Tweedie, John Conolly. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    perty of the mustard proves beneficial after its emetic operation is over. In the atonic form of gout, also, in which no irritation is more hurtful than that arising from crude undigested matters in the stomach, a mustard emetic may prove highly beneficial, or at least the substance employed to excite vomiting, in such a case, should be of a warm stimulant kind, the operation of which is not followed by debility. For the same reason, no emetic is so well suited for cases of malignant cholera as mustard. 2. Camomile Flowers. A strong tepid infusion of these flowers is powerfully emetic, when ad- ministered in doses of from f.5iii to f.5iv ; and a weaker infusion is well adapted for promoting the action of other emetics, when the stomach is weak and Ukely to be oppressed by the use of tepid water. 2. Asarabaca. This plant owes its emetic pro- perty to a combination of acrid oil and cytissina.* It is very seldom employed, as it loses much of its emetic power by drying and keeping. 4. Emetina [Entetia]. A more common indi- rect emetic than either of the three substances already mentioned is emetina, as contained in the roots of ipecacuanha, (cephaelis ipccacuanha.f) This principle operates more quickly as an emetic than the root which yields it, and its action is fol- lowed by sweating and a tendency to sleep. It has not been much employed in this country, but the French physicians prefer it to ipecacuanha. It is ordered in a solution of four or five grains in six fluidounces of water, of which two fluidounccs are ordered to be taken every half hour until full vomiting is procured. That it operates on the nerves through the medium of absorption has been demonstrated by injecting a minute portion of it into the jugular veins, the cavity of the pleura, the tissue of the muscles, and the anus of a dog; in all of which modes of applying it, vomiting is produced. If it be over-dosed, danger- ous, sometimes fatal effects ensue: when the latter occur, it excites inflammation of the mucous membrane of the alimentary canal, and the lungs are found gorged with blood, and approaching to hepatization. The best antidote is infusion of * This peculiar principle received its name from liaving been first ohtained from the seeds of tlie cytissus labur- num by MM. Chevallier and Lassaigne. In a separate state it is of a yellow colour, has a nauseous bitter taste, attracts moisture from the air, dissolves readily in water, less so in alcohol, and is totally insoluble in ether. It is better known from its negative than its positive quali- ties, as none of the re-agents which usually precipitate hitter vegetable infusions make the least change in it; nor does it display either acid or alkaline properties. t Emetina is procured from ipecacuanha by treating the powdered root with cold distilled water until it ceases to take up any more soluble matter. This watery infusion is then to be concentrated by evaporation in a water bath; subcarbonate of magnesia added to it in excess, and the evaporation continues to dryness ; after which it is to be treated with strong alcohol, and the extract thus procured again treated with water, and eva- porated to dryness. In its pure state emetina is white, pulverulent, unalterable in the air, scarcely soluble in cold water, soluble in hot water and in alcohol, but not in ether. Its taste is slightly bitter, and it displays alka- line properties. It is usually, however, procured in the form of brown scales, semi-transparent, with an odour resembling caromel, and a bitter, slightly acrid taste. It is a compound of carbon, hydrogen, oxygen, and nitro- gen. Gallic acid, and infusion or tincture of galls pre- cipitate from its solutions in an insoluble form; and it is also thrown down by tincture of iodine, subacetate of lead, bichloride of mercury, and muriate of tin. When 't is separated from the inicacuanha, what remains is fnett It was discovered by M. Pelletier in 1817. galls, which, by forming an insoluble precipitate with the emetina, neutralizes and renders it inert. 5. Ipecacuanha root, radix cephaelis ipecacu- anha, which owes its emetic properties to the principle just described, has been known in Europe as an emetic since the middle of the seventeenth century.<: It is administered in the form of powder, infusion in water, and solution in wine. The powder is the cortical part of the root, the central or ligneous part being inert : it should be of a bright grey colour, have a nauseating dis- agreeable odour, and a bitter acrid taste which remains in the throat.§ In doses of from Qi to ^ss it produces full vomiting. If ^ss of the pow- der be triturated with f.5vi of water, and f.^ii of the solution administered at the distance of half an hour, full vomiting generally follows the second dose. The vinous infusion is chiefly ordered for children in doses of f.^ii, repeated every fifteen minutes until vomiting be produced. When ipecacuanha in any form is taken into the stomach, its first effect is on the mucous membrane, as a local irritant: it is, however, partially digested in the stomach, and the emetina thus separated is absorbed and produces that simultaneous action of the muscles of the abdo- men, the thorax, and the diaphragm, which con- stitutes vomiting. But, sometimes, in the largest doses, it fails to produce this cflect; a circum- stance, which, if the drug be genuine, can otily be attributed to idiosyncrasy. In administering ipecacuanha, or its active principle, as an emetic, it may be given with the intention of either sim- ply unloading the stomach, or of acting sympa- thetically on more distant organs after it has per- formed its emetic effect. When prescribed with the first intention, it frequently operates also on the bowels, owing to some of it being forced be- yond the pylorus in the first effort of vomiting; and on this account, when added to jalap, the purgative properties of this drug are much aug- mented. When it is desirable to extend its ac- tion after vomiting, this part of its operation should be less aided with tepid water than when vomit- ing only is required ; the result is a powerful de- termination to the surface and copious perspira- tion, from the continuation of nausea after its emetic effect has ceased. The question has fre- quently been discussed, whether ipecacuanha and tartar-emetic may be indifferently employed as an emetic ? The answer is not difficult. In choos- ing between these emetic substances, we must be guided by the condition of the system, and the nature of the disease, as well as the intention for which the emetic is prescribed. In intermittents, if the frame of the patient be delicate, ipecacuanha is to be preferred ; if it be robust, capable of bear- ing full vomiting with impunity, and without suf- fering from the subsequent debilitating effects of profuse sweating, the antimonial preparations will be found most useful. In continued fever, in se- lecting an emetic we must not only prefer that which will produce full vomiting, but which will excite also that state of the surface which may i The name of the root is a compound of two Peru- vian words, ipe signifying root, and Cuanha the name of the place where it was first found. § Owing to a peculiar idiosyncrasy, some persons are afiicted with severe dyspnoea by the odour of ipecacu- anha. (See AsTu:^A)