Medicinal Preparations
In his list of medicinal preparations, Buchan makes comments in many of the sections about the different types of preparation and when each should be used. I have extracted these comments into a single page for ease of reference.
Balsams
THE subject of this section is not the natural balsams, but certain compositions, which, from their being supposed to possess balsamic qualities, generally go by that name.
This class of medicines was formerly very numerous, and held in great esteem: modern practice, however, has justly reduced it to a very narrow compass.
Bolus
AS boluses are intended for immediate use, volatile salts andother ingredients improper for being kept are admitted into their composition. They are generally composed of powders, with a proper quantity of syrup, conserve, or mucilage. The lighter powders are commonly made up with syrup, and the more ponderous, as mercury, &c. with conserve; but those of the lighter kind would be more conveniently made up with mucilage, as it increases their bulk less than the other additions, and likewise occasions the medicine to pass down more easily.
Cataplasms
CATAPLASMS possess few or no virtues superior to a poultice, which may be so made, as, in most cases, to supply their place. They are chiefly intended either to act as discutients, or to promote suppuration; and as they may be of service in some cases, we shall give a specimen of each kind.
Clysters
THIS class of medicines is of more importance than is generally imagined. Clysters serve, not only to evacuate the contents of the belly, but also to convey very active medicines into the system. Opium, for example, may be administered in this way when it will not sit upon the stomach, and also in larger doses than at any time it can be taken by the mouth. The Peruvian bark may likewise be, with good effect, administered in form of clyster to persons who cannot take it by the mouth.
A simple clyster can seldom do hurt, and there are many cases where it may do much good. A clyster even of warm water, by serving as a fomentation to the parts, may be of considerable service in an inflammation of the bladder, and the lower intestines, &c.
Some substances, As the smoke of tobacco, may be thrown into the bowels in this way, which cannot, by any other means whatever. This may be easily effected by means of a pair of hand-bellows, with an apparatus fitted to them for that purpose.
Nor is the use of clysters confined to medicines. Aliment may also be conveyed in this way. Persons unable to swallow, have been, for a considerable time, supported by clysters.
Collyria or Eye-waters
EYE-WATERS have been multiplied without number, almost every person pretending to be possessed of some secret preparation for the cure of sore eyes. I have examined many of them, and find that they are pretty much alike, the basis of most of them being either allum, vitriol, or lead. The effects evidently are, to brace and restore the tone of the parts; hence they are principally of service in slight inflammations, and in that relaxed state of the parts which is induced by obstinate ones.
Camphor is commonly added to these compositions; but as it seldom incorporates properly with the water, it can be of little use. Boles, and other earthy substances, as they do not dissolve in water, are likewise unfit for this purpose.
Confections
CONFECTIONS containing above sixty ingredients are still to be found in some of the most reformed dispensatories. As most of their intentions, however, may be more certainly, and as effectually answered by a few glasses of wine or grains of opium, we shall pass over this class of medicines very rightly.
Conserves
EVERY Apothecary's shop was formerly so full of these preparations, that it might have passed for a confectioner's warehouse. They possess very few medicinal properties, and may rather be classed among sweetmeats than medicines. They are sometimes, however, of use, for reducing into boluses or pills some of the more ponderous powders, as the preparations of iron, mercury, and tin.
Conserves are compositions of fresh vegetables and sugar, beaten together into an uniform mass. In making these preparations, the leaves of vegetables must be freed from their stalks; the flowers from their cups, and the yellow part of orange-peel taken off with a rasp. They are then to be pounded in a marble mortar, with a wooden pestle, into a smooth mass; after which, thrice their weight of fine sugar is commonly added by degrees, and the beating continued till they are uniformally mixed; but the conserve will be better if only twice its weight of sugar be added.
Those who prepare large quantities of conserve generally reduce the vegetables to a pulp by the means of a mill, and afterwards beat them up with sugar.
Decoctions
WATER readily extracts the gummy and saline parts of vegetables; and though its action is chiefly confined to these, yet the resinous and oily being intimately blended with the gummy and saline, are in great part taken up along with them. Hence watery decoctions and infusions of vegetables constitute a large, and not unuseful, class of medicines. Although most vegetables yield their virtues to water, as well by infusion as decoction, yet the latter is often necessary, as it saves time, and does in a few minutes what the other would require hours, and sometimes days, to effect.
The medicines of this class are all intended for immediate use.
Distilled Waters
A GREAT number of distilled waters were formerly kept in the shops, and are still retained in some Dispensatories. But we consider them chiefly in the light of grateful diluents, suitable vehicles for medicines of greater efficacy, or for rendering disgustful ones more agreeable to the palate and stomach. We shall therefore insert only a few of those which are best adapted to these intentions.
The management of a still being now generally understood, it is needless to spend time in giving directions for that purpose.
Draughts
THIS is a proper form for exhibiting such medicines as are intended to operate immediately, and which do not need to be frequently repeated; as purges, vomits, and a few others, which are to be taken at one dose. Where a medicine requires to be used for any length of time, it is better to make up a larger quantity of it at once, which saves both trouble and expence.
Electuaries
ELECTUARIES are generally composed of the lighter powders, mixed with syrup, honey, conserve, or mucilage, into such a consistence that the powders may neither separate by keeping, nor the mass prove too stiff for swallowing. They receive chiefly the milder alterative medicines, and such as are not ungrateful to the palate.
Astringent electuaries, and such as have pulps of fruit in them, should be prepared only in small quantities; as astringent medicines lose their virtues by being kept in this form, and the pulps of fruits are apt to ferment.
For the extraction of pulps it will be necessary to boil unripe fruits, and ripe ones if they are dried, in a small quantity of water till they become soft. The pulp is then to be pressed out through a strong hair sieve, or thin cloth, and afterwards boiled to a due consistence, in an earthen vessel, over a gentle fire, taking care to prevent the matter from burning by continually stirring it. The pulps of fruits that are both ripe and fresh may be pressed out without any previous boiling.
Emulsions
EMULSIONS, beside their use as medicines, are also proper vehicles for certain substances, which could not otherwise be conveniently taken in a liquid form. Thus camphor, triturated with almonds, readily unites with water into an emulsion. Pure oils, balsams, resins, and other similar substances, are likewise rendered miscible with water by the intervention of mucilages.
Extracts
EXTRACTS are prepared by boiling the subject in water, and evaporating the strained decoction to a due consistence. By this process some of the more active parts of plants are freed from the useless, indissoluble earthy matter, which makes the larger share of their bulk. Water, however, is not the only menstruum used in the preparation of extracts; sometimes it is joined with spirits, and at other times rectified spirit alone is employed for that purpose.
Extracts are prepared from a variety of different drugs, as the bark, gentian, jalap, &c.; but as they require a troublesome and tedious operation, it will be more convenient for a private practitioner to purchase what he needs of them from a professed druggist, than to prepare them himself. Such of them as are generally used are inserted in our list of such drugs and medicines as are to be kept for private practice.
Fomentations
FOMENTATIONS are generally intended either to ease pain, by taking off tension and spasm, or to brace and restore the tone and vigour of those parts to which they are applied. The first of these intentions may generally be answered by warm water, and the second by cold. Certain substances, however, are usually added to water, with a view to heighten its effects, as anodynes, aromatics, astringents, &c. We shall therefore subjoin a few of the most useful medicated fomentations, that people may have it in their power to make use of them if they chuse.
Gargles
HOWEVER trifling this class of medicines may appear, they are by no means without their use. They seldom indeed cure diseases, but they often alleviate very disagreeable symptoms; as parchedness of the mouth, foulness of the tongue and fauces, &c. they are peculiarly useful in fevers and and sore throats. In the latter, a gargle will sometimes remove the disorder; and in the former, few things are more refreshing or agreeable to the patient, than to have his mouth frequently washed with some soft detergent gargle.
One advantage of these medicines is, that they are easily prepared. A little barley-water and honey may be had any where; and if to these be added as much vinegar as will give them an agreeable sharpness, they will make a vey useful gargle for softening and cleansing the mouth.
Gargles have the best effect when injected with a syringe.
Infusions
VEGETABLES yield nearly the same properties to water by infusion as by decoction; and though they may require a longer time to give out their virtues in this way, yet it has several advantages over the other; since boiling is found to dissipate the finer parts of many bitter and aromatic substances, without more fully extracting their medicinal principles.
The author of the New Dispensatory observes, that even from those vegetables which are weak in virtue, rich infusions may be obtained, by returning the liquor upon fresh quantities of the subject, the water loading itself more and more with the active parts; and that these loaded infusions are applicable to valuable purposes in medicine, as they contain in a small compass the finer, more subtle, and active principles of vegetables, in a form readily miscible with the fluids of the human body.
Juleps
THE basis of juleps is generally common water or some simple distilled water, with one-third or one-fourth its quantity of distilled spirituous water, and as much sugar or syrup as is sufficient to render the mixture agreeable. This is sharpened with vegetable or mineral acids, or impregnated with other medicines suitable to the intention.
Mixtures
A MIXTURE differs from a julep in this respect, that it receives into its composition not only salts, extracts, and other substances dissoluble in water, but also earths, powders, and such substances as cannot be dissolved. A mixture is seldom either an elegant or agreeable medicine. It is nevertheless necessary. Many persons can take a mixture, who are not able to swallow a bolus or an electuary: besides, there are medicines which act better in this than in an any other form.
Ointments
NOTWITHSTANDING the extravagant encomiums which have been bestowed on different preparations of this kind, with regard to their efficacy in the cure of wounds, sores, &c. it is beyond a doubt, that the most proper application to a green wound is dry lint. But though ointments do not heal wounds and sores, yet they serve to defend them from the external air, and to retain such substances as may be necessary for drying, deterging, destroying proud flesh, and such like. For these purposes, however, it will be sufficient to insert only a few of the most simple forms, as ingredients of a more active nature can occasionally be added to them.
Pills
MEDICINES which operate in a small dose, and whose disagreeable taste, or smell, makes it necessary that they should be concealed from the palate, are commodiously exhibited in this form. No medicine, however, that is intended to operate quickly, ought to be made into pills, as they often lie for a considerable time on the stomach before they are dissolved, so as to produce any effect.
As the ingredients which enter the composition of pills are generally so contrived, that one pill of an ordinary size may contain about five grains of the compound, in mentioning the dose we shall only specify the number of pills to be taken; as one, two, three, &c.
Plasters
PLASTERS ought to be of a different consistence, according to the purposes for which they are intended. Such as are to be applied to the breasts or stomach ought to be soft and yielding; while those designed for the limbs should be firm and adhesive.
It has been supposed, that plasters might be impregnated with the virtues of different vegetables, by boiling the recent vegetable with the oil employed for the composition of the plaster; but this treatment does not communicate to the oils any valuable qualities.
The calces of lead boiled with oils unite with them into a plaster of a proper consistence, which make the basis of several other plasters. In boiling these compositions, a quantity of hot water must be added from time to time to prevent the plaster from burning or growing black. This, however, should be done with care, lest it cause the matter to explode.
Powders
THIS is one of the most simple forms in which medicine is administered. Many medicinal substances, however, cannot be reduced into powder and others are too disagreeable to be taken in this form. The lighter powders may be mixed in any agreeable thin liquor, as tea or water-gruel. The more ponderous will require a more consistent vehicle, as syrup, jelly, or honey.
Gums, and other substances which are difficult to powder, should be pounded along with the drier ones; but those which are too dry, especially aromatics, ought to be sprinkled during their pulverization with a few drops of any proper water.
Aromatic powders are to be prepared only in small quantities at a time, and kept in glass vessels closely stopped. Indeed, no powders ought to be exposed to the air, or kept too long, otherwise their virtues will be in great measure destroyed.
Sinapisms
Sinapisms are employed to recall the blood and spirits to a weak part, as in the palsy and atrophy. They are also of service in deep seated pains, as the sciatica, &c. When the gout seizes the head or the stomach, they are applied to the feet to bring the disorder to these parts. They are likewise applied to the patient's soles in the low state of fevers. They should not be suffered to lie on, however, till they have raised blisters, but till the parts become red, and will continue so when pressed with the finger.
The sinapism is only a poultice made with vinegar instead of milk, and rendered warm and stimulating by the addition of mustard, horse-radish, or garlic.
The common sinapism is made by taking crumb of bread and mustard-seed in powder, of each equal quantities; strong vinegar, as much as is sufficient, and mixing them so as to make a poultice.
When sinapisms of a more stimulating nature are wanted, a little bruised garlic may be added to the above.
Syrups
SYRUPS were some time ago looked upon as medicines of considerable value. They are at present, however, regarded chiefly as vehicles for medicines of greater efficacy, and are used for sweetening draughts, juleps, or mixtures; and for reducing the lighter powders into boluses, pills, and electuaries. As all these purposes may be answered by the simple syrup alone, there is little occasion for any other; especially as they are seldom found but in a state of fermentation; and as the dose of any medicine given in this form is very uncertain. Persons who serve the public must keep whatever their customers call for; but to the private practitioner nine tenths of the syrups usually kept in the shops are unnecessary.
Tinctures
RECTIFIED spirit is the direct menstruum of the resins and essential oils of vegetables, and totally extracts these active principles from sundry substances, which yield them to water, either not at all, or only in part.
It dissolves likewise those parts of animal substances in which their peculiar smells and tastes reside. Hence the tinctures prepared with rectified spirits form an useful and elegant class of medicines, posessing many of the most essential virtues of simples, without being clogged with their inert or useless parts.
Water, however, being the proper menstruum of the gummy, saline, and sacharine parts of medicinal substances, it will be necessary, in the preparation of several tinctures, to make use of a weak spirit, or a composition of rectified spirit and water.
Vinegars
VINEGAR is an acid produced from vinous liquors by a second fermentation. It is an useful medicine both in inflammatory and putrid disorders. Its effects are, to cool the blood, quench thirst, counteract a tendency to putrefaction, and allay inordinate motions of the system. It likewise promotes the natural secretions, and in some cases excites a copious sweat, where the warm medicines, called alexipharmic, tend rather to prevent that salutary evacuation.
Weakness, faintings, vomitings, and other hysteric affections, are often relieved by vinegar applied to the mouth and nose, or received into the stomach. It is of excellent use also in correcting many poisonous substances, when taken into the stomach; and in promoting their expulsion, by the different emunctories, when received into the blood.
Vinegar is not only an useful medicine, but serves likewise to extract in tolerable perfection, the virtues of several other medicinal substances. Most of the odoriferous flowers impart to it their fragrance, together with a beautiful purplish or red colour. It also assists or coincides with the intention of squills, garlic, gum ammoniac, and several other valuable medicines.
These effects, however, are not to be expected from every thing that is sold under the name of vinegar, but from such as is sound and well prepared.
The best vinegars are those prepared from French wines.
It is necessary for some purposes that the vinegar be distilled; but as this operation requires a particular chemical apparatus, we shall not insert it.
Wines
THE effects of wine are, to raise the pulse, promote perspiration, warm the habit, and exhilarate the spirits. The red wines, besides these effects, have an astringent quality, by which they strengthen the tone of the stomach and intestines, and by this means prove serviceable in restraining immoderate secretions.
The thin sharp wines have a different tendency. They pass off freely by the different emunctories, and gently open the body. The effects of the full-bodied wines are, however, much more durable than those of the thinner.
All sweet wines contain a glutinous substance, and do not pass off freely. Hence they will heat the body more than an equal quantity of any other wine; though it should contain fully as much spirit.
From the obvious qualities of wine, it must appear to be an excellent cordial medicine. Indeed, to say the truth, it is worth all the rest put together.
But to answer this character it must be sound and good. No benefit is to be expected from the common trash that is often sold by the name of wine, without possessing one drop of the juice of the grape. Perhaps no medicine is more rarely obtained genuine than wine.
Wine is not only used as a medicine, but is also employed as a menstruum for extracting the virtues of other medicinal substances for which it is not ill adapted, being a compound of water, inflammable spirit, and acid; by which means it is enabled to act upon vegetable and animal substances, and also to dissoIve some bodies of the metallic kind, so as to impregnate itself with their virtues, as steel, antimony, &c.,