A text-book of pharmacology and therapeutics; or, The action of drugs in health and disease, online

A TEXT-BOOK



PHAEMACOLOGY



THEEAPEUTICS



ACTION OF DRUGS IN HEALTH AND DISEASE



BY

ARTHUR R. CUSHNY, M.A., M.D., LL.I)., F.R.S.

PBOFESSOR OF PHARMACOLOGY IN THE UNIVERSITY OF LONDON; EXAMINER IN THE

UNIVERSITIES OF LONDON, MANCHESTER, OXFORD, CAMBRIDGE, GLASGOW AND

LEEDS; FORMERLY PROFESSOR OF MATERIA MEDICA AND THERAPEUTICS

IN THE UNIVERSITY OF MICHIGAN



SIXTH EDITION, THOROUGHLY REVISED



ILLUSTRATED WITH 70 ENGRAVINGS




LEA & FEBIGER

PHILADELPHIA AND NEW YORK



Kn(o'ic(l accunlinu; to the Act of Congress in I he year 1915, by

LEA & FEBIGKR,
in the Ollifc of the Librarian of Congress. All rights reserved.



Authority to use for comment the Pharmacopoeia of the United States of America
(Eighth Decennial Revision), in this volume, has been granted by the Board of
Trustees of the United States Pharmacopoeial Convention; which Board of Trustees
is in no way responsible for the accuracy of any translations of the Official Weights
and Measures, or for any statement as to strength of Official Preparations.



OSWALD SCHMIEDEBERG

DEM MeISTER, VOM ScilULER GEWIDMET



ooazTu



PREFACE TO THE SIXTH EDITION.



In this edition the space devoted to many of the less important
and less reliable drugs has been further curtailed and others have
been omitted altogether from consideration. This appears to be
in accordance with the general trend of medical progress, and thera-
peutics would probably not have suffered from an even more drastic
selection. But a text-book must not only describe the virtues of the
established remedies, but must also point out the worthlessness of
many preparations which still enjoy an unmerited popular reputation.
I would appeal to teachers and especially to the members of examining
boards to restrict further the drugs which the student has to study.
For as long as he has to learn the supposed virtues of a host of obscure
substances, he will tend to use them in practice, even if only tentatively.
This in turn necessitates their inclusion in the pharmacopoeias, which
again gives them some standing and perpetuates them as subjects of
teaching and examination. If examiners would break this vicious
circle, they would greatly lighten the burden of the student, and would
render the subject of pharmacology more attractive to him. There
is no question that the insistence on numberless preparations of drugs
of questionable value has discouraged interest in therapeutics.

On these grounds I have omitted many preparations which are
still to be found in the pharmacopoeias, but which appear to me to be
superfluous. Some chapters have been much curtailed, others recast and
expanded, all have been carefully revised. Among those which have
been much altered are the chapters on the general anesthetics, opium,
digitalis, ergot, and adrenaline. Several new chapters have been added,
among them those on the new organic arsenical compounds, on atophan
and on the pituitary extract. Extensive changes have been made
in the classification, which is now based on the organs on which
the drugs exercise their most characteristic action rather than on a
consideration of the whole of their effects. This new arrangement



vi PREFACE



honrs a closer relation to the therapeutic uses than that adopted in
former editions. A large number of drugs chiefly used for their local
action as antiseptics and dishifectants has heen collected into one group j
and discussed together. I hope that these changes, which T have found _



useful in my own classes, may prove acceptable to others.

A. U. C
London, 10 lo.



1

i



CONTENTS.



Introduction 1'

(iciicral Theories of Pharniacological Action 19

Stinnilation, Depression, Irritation .21

Distribution and Concentration .22

Elective Affinity of Drugs. Protoplasm Poisons 23

Remote, Local, and General Action .24

Salt-action 25

Conditions Modifying the Effects of Drugs 27

Metliods of Administration 32

The Chemical Characters of Drugs .36

The Pharmacopoeias and Pharmacopa-ial Preparations 39

PART I.

SUBSTANCES WHICH ARE CHARACTERIZED CHIEFLY BY THEIR

LOCAL ACTION .43

I. Demulcents 43

II. Emollients .46

III. Sugars and Flavoring Substances 49

IV. Simple Bitters 51

Pepper Group 53

V. Digestive Ferments 54

1. Pepsin 5o

2. Pancreatic Ferments 55

3. Vegetable Ferments 56

4. Diastase 57

VI. Volatile Oil Series 57

1. Volatile Oils Used as Flavoring Agents and Carminatives . 61

2. Camphor 65

3. Ether and Chloroform (Local Action) 69

4. Malodorous Volatile Oils 71

VII. Skin Irritants and Counter-irritation 72

1. The Turpentine Oil Group 80

2. Mustard 82

3. Cantharidin Series 83

VIII. Purgatives 87

1. Mild Aperients, the Castor Oil Group 90

2. The Anthracene Purgatives 93

3. The Jalap and Colocynth Group .96
IX. Saline Cathartics 101

X. Vegetable Astringents — Tannic Acid Series 109

XI. Bile 114



\111



COXTKXTS



XII. AiiLlicliiiintics

1. Male Fcni (Asi)itliuin, I'ilix-masj

2. Cusso

3. Pelletierine

4. Thymol

5. Santonin

XIII. Antiseptics and Disinfectants

I. Surgical Antiseptics and Disinfectants

1. Carbolic Acid

2. Cresols ... ....

3. Other Aromatic Surgical Disinfectants

4. Mercuric Perchloride ....

5. Other Metallic Disinfectants
(5. Oxidizing Disinfectants

Peroxide of Hydrogen

Other Oxidizing Disinfectants

7. Boracic Acid and Borax .

8. Potassium Chlorate ....

9. Iodine

10. Iodoform

II. Antiseptics Used Chiefly in Skin Diseases

1. Pyrogallol

2. Chrysarobin

3. Naphthol

4. Resorcin

5. Tar

III. Intestinal Disinfectants

Salol

Other Intestinal Disinfectants

IV. Gcnito-urinary Antiseptics ....

1. Volatile Oils

2. Hexamcthylentetraminc, I'rotropine

3. Minor Genito-urinary Antiseptics
V. Antiseptics in Pulmonary Disease

Creosote

VI. Disinfectants for Rooms, Furniture, Etc.

1. Formaldehyde

2. Sulphur Dioxide

3. Chlorine and Bromine

4. Other Disinfectants ....



11.5
IK)
IIS
110
120
121
124
131
131
137
138
139
139
140
140
142
143
14.5
149
149
1."j2
1.52
153
154
1.55
155
157
157
158
158
158
160
161
1()2
102

It;:;
Ki:;
165
166
168



PART II.



SUBSTANCES CHARACTERIZED CHIEFLY \\\ IlIKIH ACTION

AFTER ABSORPTION 1()9

I. Narcotics of the Methane Series 169

Alcohol-chloroform Grouj) 16".»

1. Alcohol 172

2. General Anicsthetics — Ether and C'liloroforin 195

3. Nitrous Oxide 221

4. Soporifics — Chloral Group 228
11. ( )|)iiiin Scries 236

MiuDF Drug.s of the Opium Series -' >~



CONTENTS IX

III. Caiinahis liulica 258

IV. Bromides ^^ 2()0

V. Strychnine — Nux Vomica 2(56

VI. Picrotoxin 277

VII. Caffeine ^ 280

Coffee and Tea 289

Minor Diuretics 291

VIII. Saline Diuretics 292

Peripheral Nervous Action 295

IX. Curara Group 298

Coniine 302

Gelsemium 303

Sparteine 303

X. Nicotine Group 304

Tobacco 312

XI. The Atropine Series 314

Alkaloids 330

Agaricin 335

XII. Pilocarpine and Muscarine 336

XIII. Physostigminc 345

XIV. Cocaine 350

Substitutes for Cocaine 361

Yohimbine 363

XV. Adrenaline 364

XVI. Ergot 373

XVII. Pituitary Extract 381

Other Organic Extracts (Organotherapy) 384

XVIII. Hydrastine and Hydrastinine 385

XIX. The Nitrites 387

XX. The Digitalis Scries 395

XXI. Aconitine 425

XXII. Veratrine 430

XXIII. Apomorphine 434

XXIV. Emetine (Ipecacuanha) 437

XXV. Colchicine 440

XXVI. Phenylquinohnc Carbonic Acid (Atophan) 443

XXVII. Saponin, Sapotoxin and Solanine 445

XXVIII. Prussic Acid 449

XXIX. Aspidosperma, or Quebracho 454

XXX. Quinine 455

XXXI. The Antipyretics (Acetanihde and Antipyrine Series) .... 470

XXXII. Salicylates 485

XXXIII. Toxins and Antitoxins 494

Antidiphtheritic Serum 496

Antitetanus Serum 497

Antimeningitis Serum 497

Antivenin 498

XXXIV. Benzoic Acid .499

XXXV. Some Minor Poisons 502

1. Nitrobenzol Compounds 502

2. Toluylendiamine 503

3. Benzol 503

4. Phloridzin 504



X ('