AURANTII AMARI CORTEX
   The dried rind of the fruit of Citrus Aurantium amara, Linné (Nat. Ord. Rutaceae). Dose, 5 to 30 grains. Common Names: Bitter Orange Peel (of Bitter Orange, Bigarade Orange, Seville Orange). Principal Constituents.— Hesperidin, a crystalline, bitter glucoside; isohesperidin, water soluble; aurantiamarin, the bitter principle; and a volatile oil. Preparation.—Tinctura Aurantii Amara. Tincture of Bitter Orange Peel. Dose, 1/2 to 2 fluidrachms. Therapy.—Stimulant, carminative and tonic, but used chiefly as a flavoring agent. This preparation is contained in both Compound Tincture of Cinchona and Compound Tincture of Gentian. ¹

AURANTII DULCIS CORTEX
   The outer rind of the ripe, fresh fruit of Citrus Aurantium. sinensis, Gallesio (Nat. Ord. Rutaceae) Common Names: Sweet Orange Peel (of Sweet Orange, Portugal Orange, China Orange). Principal Constituents.—Oil of orange (Oleum Aurantii); other constituents same as in Bitter Orange Peel. (Orange Juice [from the pulp of the fruit] contains citric acid, sugar and mucilage.) Preparation.— Tinctura Aurantii Dulcis, Tincture of Sweet Orange Peel. Dose, 1 fluidrachm. This agent is used in the preparation of Syrupus Aurantii or Syrup of Orange—a syrup containing also Citric Acid. Specific Indications.-(For Orange juice). Deep red tongue, with brown to black coating; scurvy. Therapy.—Sweet Orange Peel. Slightly stimulant, carminative, and tonic. Used almost wholly as a flavoring agent. It makes an elegant addition to acid solution of iron dispensed in syrup. It is also an agreeable addition to the bitter infusions, as of quassia or Peruvian bark. Sweet Orange Juice. The juice of the orange is a light refrigerant article of diet, and is especially useful where the bowels are sluggish in action, and during convalescence from illness, as well as to be given during fevers and the exanthemata where acids are craved. It is par excellence the remedial agent in scurvy of infants, as well as adults, and if given early will abort this unpleasant disorder. Like all acids, orange juice is best indicated when the patient's tongue is deep-red or coated brown, black, or any intermediate color. ¹

BUCHU (Barosma)^AGBE2
   The dried leaves of (1) Barosma betulina (Thunberg), Bartling and Wendland, or of (2) Barosma serratifolia (Curtis), Willdenow. (Nat. Ord. Rutaceae.) South Africa. Dose, 5 to 60 grains. Common Names: Buchu; (1) Short Buchu; (2) Long Buchu. Principal Constituents.—A volatile oil, with a penetrating peppermint-like aroma, yielding diosphenol (C14 H22 O3), or barosma camphor, which may be obtained in colorless needles, of a peppermint taste. Preparation.—Specific Medicine Barosma. Dose, 1 to 60 drops. Specific Indications.—Abnormally acid urine, with constant desire to urinate with but little relief from micturition; vesico-renal irritation, with catarrhal secretion; copious mucous or muco-purulent discharges; cystorrhea. Action.—Buchu increases the appetite, slightly quickens the circulation, and disinfects the urinary tract. It has but slight effect upon the renal organs, but such as it has is to stimulate slightly the output of both liquids and solids. It acts feebly upon the skin, increasing secretion. Large dose may produce gastro-enteritis and strangury. Therapy.—Buchu is an aromatic stimulant, tonic, and urinary antiseptic. As a diuretic its action is not pronounced, but it is frequently used with other agents, as citrate or acetate of potassium, digitalis, or spirit of nitrous ether, which make it more efficient for the purposes of renal depuration. Buchu disinfects the urinary tract, imparting its aroma to the urine, and is to be used only in chronic conditions when there is an excess of mucus, or muco-purulent and acid urine, with vesico-renal irritation. Acid and muddy urine, loaded with urinary salts, and continual urging to urinate with but little relief from the effort, are the cases in which buchu renders good service. Under these circumstances it may be given in chronic cystitis, pyelitis, urethritis, prostatitis, lithaemia, and chronic vesical irritation. For catarrh of the bladder it is frequently effective, and in long standing irritation of the viscus, particularly in old persons, “buchu and iron” once a popular fad, is really of service. Rx Specific Medicine Barosma, 3 1/2 fluidounces; Tincture of Chloride of Iron, 1/2 fluidounce. Mix. Sig.: One teaspoonful 4 times a day in a wineglassful of infusion of hops, or of sweetened water. Occasionally it is used in dyspeptic conditions and in bronchial catarrh, but for these disorders we have far better remedies. Buchu renders the urine dark, the latter depositing a brownish precipitate. It should never be used in acute disorders.¹

LIMON
   The juice and outer rind of the fresh ripe fruit of Citrus medica Limonum (Risso), Hooker filius (Nat. Ord. Rutaceae). Northern India, and cultivated in subtropical countries. Common Name: Lemon. Principal Constituents.—A pale-yellow or greenish-yellow, fragrant oil (Oleum Limonis); and a bitter principle, hesperidin (C22H26O12) Preparations.—1. Limonis Succus, Lemon juice. This may be prepared by slightly boiling strained lemon juice to remove mucilage, etc., and pouring it into previously sterilized bottles filled to the neck; fill the neck with pure olive, sweet, or almond oil, and cork tightly. Keep the bottle in an upright position. This, while slightly bitter, will keep for several weeks. Another method is to add 10 per cent of brandy to the strained juice. Dose, 1/2 to 4 fluidounces. 2. Limonis Cortex, Lemon Peel. A flavoring agent only. 3. Oleum Limonis, Oil of Lemon. Pale-yellow or greenish, having the taste and odor of lemon peel. If it has the odor of turpentine it should not be used. Average Dose, 1 to 5 minims. Specific Indications.—Elongated, reddened tongue with prominent papillae; scorbutus; fevers with red, long tongue; excessively red, inflamed surfaces in inflammatory rheumatism, with alkaline urine and long, red tongue, thinly coated white. Action and Therapy.—Lemon juice and citric acid are the best known prophylactics and curative remedies for scurvy (scorbutus). The juice may be given in doses of 1/2 to 2 ounces a day as a preventive, and in doses of 2 to 4 ounces, three times a day, as a cure. The action of lemon juice and citric acid is not exactly identical, probably owing to the presence in the former of mucilage and citrate of calcium, but for most purposes requiring the acid, lemon juice is used and preferred. For preparation of the juice for long voyages, see above (Preparations). Diluted lemon juice may be used in obstinate hiccough, hepatic torpor and acute jaundice when the tongue is red and the urine alkaline. Under like conditions it is useful in acute articular rheumatism when the parts inflamed are deeply red and the general indications for acids are present. Lemon juice upon sugar will alleviate distressing cough, especially a persistent explosive cough, with spasmodic contraction of the throat upon lying down; when relief comes a slight translucent, jelly-like mass is expectorated. Lemonade is a delightfully refreshing refrigerant drink for fever patients when acids are indicated and bowel conditions will permit the use of large quantities of acidulated fluid. It also sometimes relieves sick headache, and a hot lemonade is a popular remedy to break up a “cold”.¹

PILOCARPUS^PILOC
   The dried leaflets of (1) Pilocarpus Jaborandi, Holmes; or (2) Pilocarpus microphyllus, Stapf (Nat. Ord. Rutaceae). Brazil and Paraguay. Dose, 20 to 60 grains. Common Names: Jaborandi, (1) Pernambuco Jaborandi, (2) Maranham Jaborandi. Principal Constituents.—The powerful liquid alkaloid pilocarpine (C11H16N2O2); a colorless, viscid oil, isopilocarpine; a volatile oil chiefly pilocarpene (C10H16); and pilocarpidine (C10H14N2O2) in Pilocarpus Jaborandi only. Preparation.—Specific Medicine Jaborandi. Dose, 1 to 60 drops. Derivatives.—Pilocarpina Hydrochloridum, Pilocarpine Hydrochloride. Translucent, colorless and odorless crystals of a feebly bitter taste; hygroscopic in the air. Very soluble in water and alcohol, less soluble in chloroform, and not at all in ether. Dose, 1/12 to 1/6 grain by mouth; 1/24 to 1/8 grain (hypodermatically). Pilocarpinae Nitras, Pilocarpine Nitrate. Permanent, shining, odorless crystals, very soluble in water and less so in alcohol; insoluble in chloroform and ether. Dose, 1/12 to 1/4 grain (by mouth); 1/24 to 1/8 grain (hypodermatically). Specific Indications.—Deficient secretion; marked dryness and heat of skin and mucosa; muscular pain; muscular spasms; pain with puffiness of tissues; urinal suppression, the urine being of high specific gravity and deep color; pulse full, hard, sharp and strong, with deficient secretion; increased temperature with dry skin and membranes; sthenic forms of fever; marked restlessness due to lack of secretion; ptyalism, with stomatitis; inflammatory rheumatism, with swollen and painful parts, and dry membranes and skin; soreness and stiffness of joints in subacute rheumatism; dry, harsh cough; tenacious sputum; renal dropsy with deficiency of urine; uremia; uremic poisoning, with convulsions; itching, with jaundice; increased ocular tension; deafness due to deficient aural secretion; alopecia; poisoning by atropine or belladonna; colliquative sweating (minute dose). Action and Toxicology.—Jaborandi and its alkaloid, pilocarpine, are the most powerful excitants of the secretions of the peripheral secretory glands known. In full doses they cause an enormous outpouring of sweat and saliva, and to a lesser degree stimulate the lachrymal, nasal, faucial, and bronchial secretory apparatus, and to a still lesser extent those of the stomach and intestines. Even the modified secretory organs of the aural canal are indirectly affected by them and the quantity of cerumen increased. The growth of hair and intensification of its color are stimulated by their internal action as well as when locally applied. By most pharmacologists the effect of these drugs upon peripheral secretion is attributed to the direct action upon the terminals of the peripheral nerves and not to any impression per se upon the epithelial secretory cells. This they prove by completely checking them with atropine, known to act upon the same parts but in exactly an opposite manner. Cushny declares that both act upon an intermediary receptor interposed between the nerve and cells at the myocellular junction, and that neither the nerve nor the cells are directly impressed. These bodies are stimulated by pilocarpine and muscarine (agaricine) and depressed or paralyzed by atropine. It is generally conceded that while atropine is the complete antagonist of pilocarpine, which chiefly acts in the manner described and to a very limited extent upon the central nervous system, on the other hand pilocarpine is, therefore, not a complete antagonist of atropine. The action of pilocarpine upon the involuntary muscles is caused in the same manner as upon the sudoriferous glands—by impressing the myo-neural receptors. Moderate doses of these drugs have scarcely any effect upon the central nervous system, and pilocarpine is less apt than jaborandi to cause gastric and intestinal discomfort. Both, however, appear to increase peristalsis and in full doses may cause a persistent watery diarrhea, with straining or tormina after the diarrhea ceases. Upon the eye myosis is produced by both the local and internal use of them, and spasm of the accommodation also occurs. In large doses they are cardiac depressants, probably affecting the heart muscle and to some degree vagal inhibition. The extent to which the vaso-motor system participates in first causing increased and then lowered blood pressure is not satisfactorily known. Full doses cause cardiac arrythmia, and increase the number of heartbeats greatly, but render them weaker. The uterus, spleen, and bronchi contract under the influence of these drugs. Temperature, though at first considerably increased, falls when sweating has become well established. This action is more marked during fevers than in health. After the termination of sweating temperature regains its normal status, usually at once, but is sometimes delayed for several hours. As a rule, the secretion of milk is believed to be unaffected by pilocarpine, but contrary to what might be anticipated, where there is a diminished lacteal secretion, it apparently increases the supply. One or two drachms of powdered jaborandi infused in a cupful of boiling water and taken at one dose will in about ten to twenty minutes cause a tingling of the skin with marked redness of the surface. This sensation is first experienced in the face, but soon extends to the whole surface of the body, and is quickly followed by an abundant perspiration, which is apt to last for four or five hours. Almost simultaneously with the sweating the secretion of saliva increases to such an extent as to greatly embarrass speech, the person being obliged to assume an inclined position that the escape of saliva may be facilitated. During this stage from one to two pints of saliva and even more may be secreted, and usually there will be in addition an augmentation of the bronchial and lachrimal flow. The saliva contains an abundance of ptyalin and salts and readily converts starch into sugar. At times the mucous ¹

PTELEA
   The bark of the root of Ptelea trifoliata, Linné (Nat. Ord. Rutaceae). A common shrub of the United States, especially west of the Alleghenies. Dose, 5 to 30 grains. Common Names: Wafer Ash, Shrubby Trefoil, Wing Seed, Hop Tree. Principal Constituents.-Resins, a volatile oil, a berberine-like bitter, and arginine (C6H14N4O2). Preparation.—Specific Medicine Ptelea. Dose, 1 to 30 drops. Specific Indications.-Asthmatic dyspnea; chronic diseases with constriction of chest and short breathing. Action and Therapy.—Ptelea is regarded by some as second only to hydrastis as a tonic. It acts as a sedative to irritated membranes, and is said to be tolerated by the stomach when other tonics might aggravate. The field in which it has been mostly used is in convalescence from fevers, debility resulting from gastro-intestinal irritation, and in asthmatic seizures accompanied by a sense of constriction in the thorax.¹

RUTA
   The leaves and unripe fruit of Ruta graveolens, Linné (Nat. Ord. Rutaceae). A half shrubby perennial introduced into American gardens from Europe. Dose, 1 to 10 grains. Common Names: Rue, Garden Rue. Principal Constituents.-A volatile oil (Oleum Ruta), coumarin, the yellow glucoside rutin (rutic acid), and a volatile alkaloid. Preparations.—1. Oleum Rutae, Oil of Rue. Dose, 1 to 6 drops. 2. Tinctura Rutae, Tincture of Rue (fresh herb, 8 ounces; Alcohol, 16 fluidounces). Dose, 1 to 10 drops. Action and Therapy.—Rue is a gastro-intestinal irritant and a poison to the nervous system, capable, in large doses, of causing death. It is emmenagogue and anthelmintic. Acting strongly upon the uterus, it may be given in amenorrhea due to atony, but the dose must be small lest an inflammatory action be induced. It is a good vermifuge, though its disagreeable taste is a decided obstacle to its use. It has been suggested as a remedy for irritability of the urinary tract when due to atony, and in nervous disorders of a spasmodic type. On account of its ecbolic qualities it should not be administered during pregnancy.¹

XANTHOXYLUM
   The bark and berries of (1) Xanthoxylum americanum, Miller, and (2) Xanthoxylum Clava-Herculis, Lamarck (Nat. Ord. Rutaceae). Shrubs of North America. Dose, 5 to 60 grains. Common Names: Prickly Ash; (1) Northern Prickly Ash; (2) Southern Prickly Ash. Principal Constituents.—A green acrid oil, a white crystallizable resin, a soft acrid resin, tannin, and a bitter substance thought to be an alkaloid. Preparation.—Specific Medicine Xanthoxylum. Dose, 5 to 60 drops. Specific Indications.—Hypersecretion from debility and relaxation of the mucosa (small doses); atony of the nervous system (larger doses); capillary engorgement in the eruptive diseases; sluggish circulation; tympanites in bowel disorders; intestinal and gastric torpor, with deficient secretion; dryness of mouth and fauces, with glazed surface; flatulent colic; Asiatic cholera; uterine cramps and neuralgia. Action.—Prickly ash impresses the secretions and the nervous and circulatory systems. The bark, when chewed, imparts a sweetish aromatic taste, followed by bitterness and persistent acridity; the berries act similarly. The drug has remarkable sialagogue properties, inducing a copious flow of saliva and mucus. Swallowed, it warms the stomach and augments the secretion of the gastric and intestinal juices, and probably increases hepatic and pancreatic activity. The action of the heart is strengthened by xanthoxylum, the pulse slightly quickened, and the glands of the skin are stimulated to greater activity. The urine is decidedly increased by prickly ash. Therapy.—Preparations of prickly ash bark are to be preferred when stimulant, tonic, sialagogue, and alterative properties are desired; that of the berries when a carminative stimulant and antispasmodic is needed, especially in disorders of the stomach and bowels. Xanthoxylum is particularly grateful in stomach disorders. It is an ideal gastric stimulant, and as a remedy for simple gastric atony it ranks well with capsicum. When food ferments readily and gaseous accumulations distend the stomach, and there is much belching, from five to fifteen drops of specific medicine xanthoxylum may be given, preferably in hot water, one hour before and one hour after meals. Both hydrastis and capsicum, or each of them, may be given with it, if indications are clear for them, and together the three agents offer comfort to those who suffer the distress of so-called flatulent dyspepsia. It is a remedy of much worth in atonic dyspepsia and in gastric catarrh, when there is enfeeblement and relaxation of tissues and hypersecretion. It is also of value in constipation when due to deficient secretion (small doses). Formerly it was greatly valued in spasmodic conditions of the bowels with colic, and in cholera morbus in weak individuals, and to restore tone and normal secretion after attacks of epidemic dysentery, a disease once more prevalent than at the present time. King introduced the tincture of the berries as. a remedy for Asiatic cholera, in which it proved phenomenally successful; and for tympanitic distention of the bowels arising during peritonitis. As a rule, however, it should not be given in inflammatory conditions. As a stimulant to sluggish membranes prickly ash may be given internally (and used locally) in dry, glazed pharyngitis with crusts of adherent, dried mucus. Of its alterative power there is no question, and prickly ash is an ingredient of a popular compound known as “Trifolium Compound”, which has been extensively used in chronic syphilitic dyscrasia. It is not to be assumed that it has antisyphilitic virtues, but it exerts a favorable alterative action which renders syphilitics more amenable to reparation of tissues. Sometimes a tincture of prickly ash berries is the best drug that can be given in socalled chronic muscular rheumatism; and it is not without value in lumbago and myalgia. Chewing prickly ash bark is a domestic custom for the relief of toothache. Xanthoxlum should also be remembered where nerve force is low and in the recuperative stage from attacks of neuritis or other forms of nerve involvement in which function is greatly impaired but is yet capable of restoration. Xanthoxylum deserves further study, chiefly as an alterative.¹