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THE ESSENTIALS OF MODERN MATERIA MEDICA AND
BY JOHN W. FYFE, M.D., SAUGATUCK, CONN. In preparing the following pages I have dealt almost exclusively in essentials, and avoided occupying space with what might be regarded as theoretical, my object being to present a brief statement of the principles upon which modern Eclectic therapeutics are based, and such of the important facts concerning the drugs named as will enable the student of medicine to rationally employ them in the treatment of diseased conditions. The facts presented have been obtained from the experimentation and observation of many able Eclectic investigators, and from my own experience in practice. No attempt has been made to give individual credit for the material taken from the writings of others, but a general acknowledgment of indebtedness to nearly all of the modern Eclectic authors is here made.
Materia Medica is that branch of medical science which treats of the materials used as medicines.
Therapentics is that branch of medical science which treats of the curative powers of medicines and the manner of employing them in the treatment of diseases.
The action of medicines is dependent upon the selective power of cells. These cells at the commencement of their existence are It also pos
composed of protoplasm. Protoplasm, to the ordinary observer, is a very simple substance; and yet how mysterious are its processes and progress in its onward march to maturity—to that point where it becomes known as a human body containing an immortal soul.
This little mass of protoplasm at the outset contains an active principle, causing it to take on changes, to grow, and to ultimately become a living being capable of wonderful achievements. Can anyone tell what this active principle is? I think not. But that it exists (and that it is the principle essential to life) we have on every hand an abundance of evidence.
It is true that we have no positive knowledge of what life is, but we know that it exists, and it is therefore our duty as physicians to carefully study its every manifestation.
Life is first manifested in the form of a single cell, composed of a mass of protoplasm. This mass of protoplasm contains a nucleus, and the simple substance we call a cell possesses a certain power which enables it to take to itself nourishment, and in this way obtain material for its sustenance and growth. sesses the power of reproducing its kind, and of exercising all independent action necessary to its elementary form of life, and incidental to its evolution from this elementary life to its position as a part of a higher and a more complex form of life.
Man's body is composed of cells and cell derivatives, arranged in such a manner as to act in harmony — the one cell aiding the other in its specific labor incidental to its position as a part of the organism we call man. These cells work in harmony by each taking from the surrounding medium that which is adapted to its individual development and functional activity, and rejecting or carrying to the neighboring cell that for which it has no need, and which is needed for the development, repair or functional activity of another of the community of cells contained in the part or parts of the human body.
In man cell function is largely controlled by the influence of the nervous systems. Still the power of individual action by independent cells prevails, and each cell possesses the faculty of selecting that which is adapted to its individual use, without regard to the action of the other cells. Upon this selective faculty of individual cells must we ever largely depend for the beneficial results of drugs, as it is owing to this selective power that we are enabled to medicate certain portions of the body. Through this independent cell action certain structures or parts of the body possess a certain selective attraction for certain drugs, and as a result we are enabled to medicate the throat with Aconite; the thyroid, mammary and other glands with Phytolacca; the lungs and pleuræ with Bryonia; the heart with Cactus; the stomach with Ipecac; the liver with Podophyllin ; the spleen with Polymnia Uvedalia; the intestines with Magnesia ; the rectum with Collinsonia ; the uterus with Cimicifuga ; the bladder with Gelsemium; the ovaries with Pulsatilla ; the prostate with Sabal Serrulata ; and the urethra with Staphisagria.
Strength of Medicines. — The liquid medicines referred to in the “Usual Prescriptions" given in this work, when not otherwise expressly stated, are made from the recent material, and represent sixteen troy ounces of the crude drug to the pint. My experience in practice has been gained with remedies of this class. If remedies of less strength are desired, they can be obtained by mixing one fluid ounce of Lloyd's Specific Medicines (or a good Auid extract) with two fuid ounces of deodorized Alcohol. Medicines prepared in this way are elegant in appearance and efficient in strength.
Doses.—The doses recommended in the “* Usual Prescriptions” are believed to be such as will give the best results from the remedies named. The specific effects of remedies have not been obtained, as a rule, from larger doses. Medicines dispensed in water, as advised in these prescriptions, should be prepared fresh every day, and kept in a cool place.
The doses given of the different preparations of the remedies named under the head of “ Doses,” are such as are used in the treatment of adults by those who employ large doses of medicine, and also when it is desired to secure a prompt and forcible effect.
The dose for hypodermic injection should be three-fourths of that needed by the mouth.
Whenever it is deemed advisable to use large doses of medicines in the treatment of children, the following will aid the young practitioner in adapting the dose to the age of the patient:
The full (or adult) dose being for persons of twenty-one (or more) years of age, the dose at fourteen years of age would be two-thirds of a full dose ; at twelve years of age, one-half of a full dose ; at six years of age, one-third of a full dose ; at one year of age one-twelfth of a full dose ; at three months of age, one-twentieth of a full dose.
This apportionment of doses has received the approval of many eminent authors, and it undoubtedly constitutes a safe guide. Still the practitioner of medicine should be ever mindful of the fact that children are very susceptible to the influence of medicines, and especially so to the action of narcotics.
The following will afford considerable aid in memorizing doses :
The dose of all poisonous tinctures is from 5 to 20 drops, except Tincture of Aconite, which is 1 to 5 drops. The dose of all dilute acids is from 5 to 20 drops, except dilute Hydrocyanic Acid, which is 2 to 8 drops. The dose of all poisonous solid extracts is one-half grain, except of Calabar Bean, which is one-sixteenth to one-fourth grain. The dose of all essential oils is 1 to 5 drops. The dose of all wines is 30 to 60 drops, except Wine of Opium, which is 5 to 15 drops. The dose of all infusions is 1 to 2 ounces, except Infusion of Digitalis, which is 2 to 4 drachms.
Approximate Measurements.—Teacups vary in size, but they commonly contain from three-and-a-half to four fluid ounces ; a tablespoon usually contains about three-and-a-half to four fluid drachms; a teaspoon from fifty to sixty drops. Where accuracy is required these measurements should not be used. Drops are not always equal to minims. A drop of some fluid substances will exceed a minim, while that of others will fall considerably short of it. Drops vary in size according to the size or form of the edge of the vessel from which they are dropped. Powerful medicines, when given in maximum doses, should therefore always be accurately measured.
Writing Prescriptions. It is the opinion of the writer that practitioners of medicine should usually dispense the medicines which they prescribe. Still occasions arise when the physician finds prescription writing a necessity. Every practitioner of medicine should, therefore, be able to write a prescription correctly, and in accordance with the custom generally followed by welleducated physicians throughout the civilized world.
The Latin language, on account of its being a dead language, and therefore not subject to changes, and the further fact that it is understood by educated druggists throughout the world, is especially adapted to prescription writing.
Physicians not familiar with the Latin language will find the following suggestions by Dr. Albert Merrell of value to them:
* Use the official or scientific titles in all cases, as expressing more fully and exactly the drug intended than is possible in all cases with the English synonyms.
“ Instead of changing its terminations to make the title and its qualifying word agree in cases, use it always with the termination given at the head of the description of each drug, and place the word denoting the form of preparation vanted after, instead of before the title. Thus instead of Tinctura Ferri Chloridi, write Ferri Chloridum Tinctura, as Tinct. Instead of Liquor Potassæ, write Potassa Liquor. Instead of Tinctura Nucis Vomicæ, write Nux Vomica Tinctura, or Tinct.
“ In this manner we first write the official title of the drug whose action is wanted, and after it the form of preparation in which it is to be given and the amount required.”
Dispensing Medicines.—The true interests of patient and doctor are best served by doctors dispensing their own medicines; and chemical and pharmaceutical science has now reached a perfection which enables the chemist and pharmacist to present the chief articles of modern materia medica in forms which make it convenient for the physician to do so. The reasons in favor of doctors dispensing their own medicines are many—too many to be here enumerated. It saves the sick money and trouble. In emergency cases, and in severe forms of acute diseases, valuable time is saved by this method, and the disease more effectually withstood as a result of the physician being able to immediately administer the needed medicine. It relieves the doctor of the possibility of becoming a party to the mistakes which occur in writing, reading and compounding prescriptions, and the misery and sorrow which almost daily result therefrom. The method also lessens drug-store doctoring, is popular with the people, and increases the doctor's practice, for the average person prefers to patronize physicians who furnish medicines with advice.