CLASS II-PERMANENT TONICS.

THESE remedies are essentially overrated, and what is often consigned to their supposed salutary virtues, can be accomplished only by antiphlogistic remedies, by diet, rest, or exercise.

This and the next following class of agents embrace the destructive weapons of the physical and stimulant schools of medicine.

How do tonics and stimulants operate? Certainly as alteratives, and directly upon the properties of life. They may therefore alter them injuriously as well as favorably; from which it is obvious that the changes must be for the worse, when those agents are employed where antiphlogistics are required.

The prominent distinction between tonics and stimulants is, that the former produce their influences more slowly, and generally more permanently and profoundly, than the latter, and excite the circulation less, or often only in an insensible manner. The most active of the diffusible stimulants, however, as alcoholic liquors, are more injuriously alterative (or morbific) than the tonics.

When are tonics and stimulants indicated? Only after prolonged disease; rarely when of an acute nature.

In chronic diseases, mainly for the purpose of improving some prostrate state of the stomach, and thus removing its morbid sympathetic influences, and simultaneously substituting others of a salubrious nature.

After prolonged fevers, especially the true typhus, the vegetable tonics, and stimulants, particularly the vinous, may be very important. But this is not apt to happen, if the early stages of these affections have been properly treated; and even then, the necessity of resorting to tonics is an inauspicious omen.

The ferruginous tonics are mostly adapted to chronic forms of disease; the vegetable substances to either chronic or acute.

The tonics and stimulants may be variously combined, and with each other, and the saline cathartics and rhubarb may be usefully added to the tonics, especially the vegetable, when the bowels are constipated. Antimonials may be combined when indicated by fever or inflammation.

The tonics may be repeated from twice to four times a day, in chronic disease, and more frequently in prostrated states consequent upon acute disease. (See Institutes of Medicine, p 579-583, § 890.)

TONICS,

In the order of their relative therapeutic value.

1. CINCHONA.

Its various preparations. See p. 145, No. 21, for Doses, &c. May be employed in about the same doses as there indicated.

2. GENTIANA LUTEA. Yellow Gentian.

Pentandria, Digynia.

Hab. Austria; Switzerland.-Herbaceous.

The root.

(a.) B. Gentian, 3 ij.; Orange-peel, 3 ij.; Boiling WaMacerate; strain.-Dose, 3 j. to 3 ij.

ter, 3 xij.; M.

(b.) Tinctura Gentiane Composita.

Tincture of Gentian.-Dose, 3 ss. to 3 ij.

Compound

(c.) Extractum Gentiana. Extract of Gentian.Dose, grs. x. to 3 ss.

(d.) Gentianina. Gentianin, proximate.-R.Gentianin, grs. xvj.; Alcohol, 3 j.; M.-Dose, 3 ss. to 3 ij., twice or thrice daily. Effects like the Tincture.

3. GENTIANA CATESBEI.

Pentandria, Digynia.

Blue Gentian. The root.

Hab. Southern States.--Herbaceous.

Very similar to No. 2. Formulæ and doses the same. Also, several other Species.

4. COCCULUS PALMATUS. Colombo.

Diccia, Hexandria.

Hab. Mozambique.-Herbaceous.

The root.

B. Colombo, 3 ij.; Boiling Water, 3 viij. Macerate; strain.-Dose, 3 j. to 3 ij. May be associated with chalybeates, alkalies, or other vegetable tonics.

(a.) Tincture of Colombo.-Dose, 3 j. to 3 ij. May be added to bitter infusions, and to effervescing medicines, when given to check vomiting.

5. PICRÆNA EXCELSA (Quassia Excelsa). Quassia. The wood.

Decandria, Monogynia.

Hab. Jamaica and the Carribean Islands.-Tree.

R. Quassia, j.; Boiling Water, 3 viij. Macerate; strain.-Dose, 3 j. to 3 iij. May be combined as No. 4. (a.) Tincture of Quassia.-Dose, 3 ss. to 3 ij.

(b.) Compound Tincture of Quassia.-Dose, 3 ss. to 3 ij.

Also, QUASSIA AMARA. Surinam Quassia.

Decandria, Monogynia.

A large shrub, rather rare, yields the best quassia, and is the original officinal species.

6. AGATHOTES CHIRAYTA. Chiretta.

See p. 151, No. 38, for Dose, &c.

7. POTASSE FERRO-TARTRAS.

and Iron.

Tartrate of Potash

Comp. Tartrate of Sesquioxide of Iron, 48.18. Tartrate of Potash, 51.82=100.

Dose. Grs. x. to 3 ss., in solution or bolus.

Incomp. Vegetable astringents, strong acids, Lime Water, Acetate of Lead.

8. TINCTURA FERRI SESQUICHLORIDI.

Ferri Muriatis.

Tincture of Muriate of Iron.

Comp. Iron, 34.15. Chlorine, 65.85-100.

Tinctura

Dose. Ten to thirty drops, gradually increased to

3 j. or 3 ij. (See Astringents.)

Incomp. Alkalies, earths, and alkaline carbonates, astringent vegetables.

9. FERRI OXYDUM NIGRUM.

Black Oxide of Iron.

Comp. Iron, 72.5. Oxygen, 27.5=100.

Dose.

Grs. v. to xx.

10. FERRI SESQUIOXYDUM. Sesquioxide of Iron. Red or Peroxide of Iron.

Comp. Iron, 70.27. Oxygen, 29.73=100,

Commonly, but incorrectly, called the Carbonate of Iron.

As a tonic.-Dose, grs. x. to 3 ij. Employed for ticoloureux, and other neuralgic affections, in doses of 3 ss. to 3 ss.

Incomp. Acids and acidulous salts.

The Hydrated Sesquioxide of Iron is reputedly the best antidote for poisoning by arsenic.

11. MISTURA FERRI COMPOSITA. Griffith's Myrrh Mixture.

B. Myrrh, 3 j.; Carb. Potash, 3 ss.; Water, 3 x.; Sulph. Iron, grs. xxv.; Spirit of Mint or of Nutmeg, 3 ij. to 3 iv.; Clarified Sugar, 3 j.; M.-Dose, of Mixture, 3 ss. to 3 ij., three or four times a day. May be also made into pills.

A mixture of incompatibles in which a double decomposition takes place, and results in the formation of a useful compound.

In the foregoing preparation the Iron exists in the state of Carbonate, but which, by exposure to the air, is gradually converted to the Sesquioxide of Iron.

12. FERRI PHOSPHAS. Phosphate of Iron.

Comp. A mixture of the phosphates of the two oxides of iron. Dose. Grs. v. to x.

13. FERRI SULPHAS. Sulphate of Iron. Vitriolated Iron.

Comp. Protoxide of Iron, 25.7. Sulphuric Acid, 28.9. Water, 45.4=100.