GLYCERINUM
   Glycerin, Glycerol. A liquid composed most largely of a trihydric alcohol (C3H5(OH)3) obtained by the processes of hydrolysis and distillation of fats, both animal and vegetable, or of fixed oils. Description.—A thick, syrupy, colorless liquid having a sweet and warming taste and a faint but agreeable odor. It has a great avidity for moisture, becoming appreciably thinner upon long exposure to the atmosphere. It mixes with water or alcohol; and is insoluble in ether, chloroform, and fixed and essential oils. Dose, 1/2 to 2 fluidrachms. Preparation.—Suppositoria Glycerini, Suppositories of Glycerin. Action.—Glycerin is a powerful hygroscopic. So great is its avidity for water that it will readily abstract moisture from the tissues to which it is applied. It is also slightly irritant to the skin and mucous surfaces, and considerably so to abraded surfaces. The discomfort quickly subsides, however, and it then acts as an antiseptic and protective emollient to the skin. It is a demulcent to mucous tissues. Applied to the rectum it provokes evacuation, both by its irritating and dehydrating effects. Glycerin kills parasites, both cutaneous and intestinal, and allays itching, probably by its protective, antiseptic, and hygroscopic powers. Glycerin is rapidly absorbed by the intestines and is mostly oxidized in the body. By some it is thought to be, in some measure at least, a food, and indirectly a conservator of fats through its effects of increasing the non-nitrogenous reserve of the body. It is also believed to increase energy. Upon the glycogenic function its effects are still in doubt, many contending that it reduces the sugar when in excess in the body. Glycerin is laxative and in very large amounts acts not unlike alcohol, producing a similar intoxication and like gastric effects. It is also said to favor the elimination of uric acid. Therapy.—External. The bland and practically unirritating character of pure glycerin, in the presence of a little water, its permanence when exposed to the air (except absorption of moisture), and the completeness with which it shields the parts make it the most largely used external application in a great variety of local disorders. Its protective unctuousness without being greasy, its splendid and extensive solvent powers, its ability to hold in close contact to the tissues powders and other medicines that would dry and fall off if applied with alcohol or water, its antiseptic and emollient properties, and its antipruritic qualities, make it an indispensable vehicle. It is freely miscible with water and most ointment bases, and dissolves or holds in suspension the most commonly used external medicines. It should never be applied full strength, however, except where its dehydrating effects chiefly are desired. Through its great greed for water it readily removes moisture from the tissues, leaving them hardened and more likely to crack. A little water should be added to it for local use, or the parts may be moistened and left wet before its application. Only pure glycerin should be used. Equal parts of glycerin and water, or preferably rose water, form an elegant and emollient cosmetic lotion for chapped hands, lips, and face cracked or sore nipples, excoriated and chafed surfaces, and swollen hemorrhoids. A few grains of borax sometimes add to its efficiency. Compound tincture of benzoin and glycerin is also a pleasant application. For those exposed to winds and storms, and who have their hands much in water, the following is splendidly effective: Rx Glycerin, 2 fluidounces; Carbolic Acid, 10 grains; Tincture of Arnica Flowers, 1/2 fluidounce; Rose Water, enough to make 4 fluidounces. Mix. Sig.: Apply after thoroughly washing and rinsing the hands, and while they are still wet. Sometimes lobelia may be used in place of the arnica. Glycerin, added to poultices, renders them soothing and keeps them moist. It forms a good application to boils, carbuncles, small abscesses, and to local edemas, as of the prepuce. Here it may be used pure for its antiseptic and dehydrating effects. Mixed with alcohol (1 part), glycerin (3 parts), it makes a useful and “drawing” application for boils, and an antiseptic stimulant for foul ulcerations. A mixture of glycerin and water in proportions to suit the case may be used as a toilet wash for the mouth in fevers, to keep the tongue and lips soft and pliable, and to remove sordes and other viscous secretions. It also reduces the thirst occasioned by the dryness of the mouth. Glycerin may be used as a vehicle for lime water for application to small burns, erythema, and slight excoriations; for menthol for the relief of itching in urticaria, chronic eczema, and other pruritic conditions; for boric acid in the mild forms of facial dermatitis; for lactic acid in freckles, sunburn, and other pigmentations; for bismuth, borax, salicylic acid, phenol, boric acid, or sodium or potassium bicarbonate when their long-continued local effects are desired, especially in ulcerations and various skin diseases. A small portion of liquor potassae (1/2 per cent) may be added to it for use upon rough skin and in chronic eczema. Among the skin disorders in which it is especially useful as a vehicle may be mentioned impetigo, lichen, porrigo, psoriasis, pityriasis, herpes, and tinea versicolor (with mercuric chloride) and other parasitic affections. Glycerin (diluted) is one of the best agents to soften hardened and impacted cerumen prior to removing it by gently syringing with warm water. Any irritation caused by the hardened mass or the means of removal may be overcome by the following: Rx Colorless Hydrastis (Lloyd's), 1 fluidrachm; Glycerin, 20 drops; Distillate of Hamamelis, enough to make 1/2 fluidounce. Mix. Sig.: Apply warm to the parts by means of cotton. Glycerin is sometimes useful in otorrhea. A 5 per cent solution of phenol in glycerin upon cotton may be used for insertion into the aural canal after rupture of the membrana tympani wh¹

HAMAMELIS
   The leaves, bark and twigs of Hamamelis virginiana, Linné (Nat. Ord. Hamamelidaceae), collected in the autumn. Common in the United States. Dose, 5 to 60 grains. Common Names.—Witch-Hazel, Snapping Hazelnut, Winterbloom. Principal Constituents.—A bitter body, tannin, and a volatile oil. Preparations.-1. Aqua Hamamelidis, Hamamelis Water, (Distillate of Hamamelis, Distilled Witch-Hazel, Distilled Extract of Witch-Hazel). Dose, 5 drops to 2 fluidrachms. 2. Specific Medicine Hamamelis. Dose, 5 to 60 drops. Specific Indications.—Venous debility, with relaxed and full tissues; pallid mucosa or occasionally deep red from venous engorgement, or deep blue from venous stasis; excessive mucous flow, with venous relaxation; passive hemorrhages; prehemorrhagic states, with venous fullness; varicoses; hemorrhoids with weight and fullness; rectal prolapse; dull aching pain in pelvis, genitalia, or rectum, with perineal relaxation and fullness; relaxed or engorged and painful sore throat; gastro-intestinal irritability, with venous weakness and mucous or muco-bloody passages. Locally to inflamed, ulcerated or wounded skin or mucosa, especially where venous circulation is debilitated; contusions, bruises, and muscular soreness from exertion or exposure. Action and Therapy.—External. Witch-hazel bark and its fluid preparations are astringent. The distillate and the specific medicine are sedative and slightly astringent. The latter two form agreeably grateful and soothing applications to the skin and mucous surface in irritated and inflamed conditions and where venous relaxation is present. The specific medicine is an elegant and heavy distillate, carrying a large proportion of the oil, as compared to the ordinary distillate, and is much to be preferred where a bland and soothing yet astringent effect is required. Where more alcoholic stimulation is permitted or desired the ordinary distillate may be used. As a rule, the specific medicine is best for use upon mucous, and the distillate upon the cutaneous surfaces. Witch-hazel distillates are splendid applications for sprains, contusions, wounds and inflamed swellings, and for sunburn, tan, freckles, and dilatation of the capillaries of the skin. They are cooling and relieve smarting and pain. Used alone or combined with an equal quantity of bay rum they form an elegant face wash to remove excess of soap and heal abrasions after shaving. Witch-hazel is one of the most comforting applications for painful hemorrhoids. It may be used ice cold or hot, as preferred. Applied to the tender parts after the parturient toilet, it removes soreness of the tissues from childbirth. Rubbed upon the skin, or applied by means of compresses, it is an efficient lotion for muscular soreness and aching after severe exertion; from cold, exposure, or when due to bruises and strains. Its use should be accompanied with gentle massage. Compresses wetted with witchhazel give marked relief in acute cutaneous inflammations, chafing, and especially in mammitis. Incised wounds, ragged cuts from glass or tin, barbed wire injuries, and crushed fingers are quickly relieved of pain and heal rapidly when the following is applied: Rx Echafolta, 1/2 fluidounce; Asepsin, 15 grains; Specific Medicine Hamamelis and Water, enough to make 4 fluidounces. Mix. Apply upon gauze. A similar preparation, with but two drachms of the echafolta, or the distillate with menthol, makes a good dressing for burns and scalds. Glycerin and hamamelis, equal parts, or equal parts of Specific Medicine Hamamelis and Lloyd's Colorless Hydrastis give excellent results in irritation and inflammation of the aural canal due to inspissated cerumen, or to efforts to remove the latter. Sprayed upon the throat the specific medicine or the distillate, suitably diluted, is a useful and sedative astringent for angry and deep red sorethroats, with relaxation of membranes; or in pharyngitis, faucitis, and tonsillitis, with hyperaemia or congestion. The specific medicine is especially soothing and astringent in congestive nasal catarrh. Few local washes give greater relief in the angina of scarlet fever than those of which witchhazel forms a part. They relieve pain, cleanse the parts, and constringe the relaxed tissues and dilated vessels. It may also be added to local washes for use in diphtheria. Together with colorless hydrastis, or other non-alcoholic hydrastis preparations, with or without a grain of alum or of zinc sulphate, it is a most effective collyrium for acute conjunctivitis, with dilated conjunctival vessels. Especially is it effective in vernal conjunctivitis. The same combinations are exceedingly useful as an injection in gonorrhea, after the acute symptoms have subsided and a catarrhal state has supervened. Internal. Hamamelis has an important tonic effect upon venous debility, acting upon the coats of the veins throughout the body. Unlike some vascular remedies its action is not merely local, but extends throughout the whole venous system. It is therefore a remedy of much value in varicoses, hemorrhoids, and passive hemorrhages. When indicated, the tissues are pallid and relaxed, and in some instances deep red, due to venous engorgement. There is a sense of fullness or thickening and weight and congestion. These are especially prominent in the type of hemorrhoids benefited by hamamelis. It is of some value in oozing of blood from the mucosa, in passive bleeding from the nose, lungs, and stomach, but is a better remedy for the venous relaxation that precedes these hemorrhages and which renders their occurrence easy. It is of less value in hemoptysis than lycopus, and is adapted to such cases as are benefited by geranium and erigeron. Hamamelis is a decidedly useful remedy in congestive conditions with marked tissue debility. It should be given a fair trial in congestion of the ovaries, with dull aching pain and sense of weight and fullness; in chronic congestive conditions of the uterus, with soft and flabby cervi¹

THUJA
   The branchlets and leaves of Thuja occidentalis, Linné (Nat. Ord. Cupressaceae). Indigenous to Canada and the United States, on the rocky borders of streams and lakes, and in swamps. Common Names: Arbor Vitae, Yellow Cedar, False White Cedar, Tree of Life. Principal Constituents.—Oleum Thuja, (Oil of Arbor Vitae), having a camphoraceous odor and tansy-like taste, and composed of dextro-pinene, laevofenchone, and dextro-thujone; a bitter glucoside, pinipicrin, and thujin(C20H22O12), an astringent, yellow glucoside closely related to quercitrin. Preparations.—1. Specific Medicine Thuja. Dose, 1 to 30 drops. 2. Aqueous Thuja. Dose, 1 to 40 drops; chiefly used locally. 3. Long’s Thuja, An Ointment of Thuja. Specific Indications.—Vesical irritation and atony; enuresis due to atony; urinal incontinence in children due to a weak bladder; dribbling of the urine in the aged, not due to paralysis or growths; urine expelled upon exertion as coughing, etc.; catarrhal flow from bladder or genitalia of male or female; chronic prostatitis; warty excrescences, and dry forms of eczema. Locally: fissured anus, prolapsus ani, pruritus in mucous membranes; venereal discharges; trachoma; warts; naevi; urethral caruncles; and hydrocele. Action.—In small doses thuja is tonic and increases the activities of the kidneys. Large doses may provoke the irritant effects common to the turpentines and balsams. It has been asserted to have caused abortion, a doubtful effect, but attributed secondarily to violent gastric and intestinal irritation, resulting from excessive amounts of the drug. In many respects it resembles the activities of savin; though unlike the latter it is not a poison. Therapy.—External. Locally thuja is stimulant, subastringent, deodorant and antiseptic. It is especially useful for the restraint and reduction of hypertrophic changes in the mucous and cutaneous tissues. It will deaden and repress fungous granulations, and for this purpose may be applied to "Proud flesh" and "ingrown nail" (both overgrown granulations). Alcoholic preparations of thuja may be employed to retard fungoid granulation and ulceration in epithelioma (does not cure), bed sores, sloughing wounds, fistulae, and to overcome the stench of senile and other forms of gangrene. It has a good record in curing papillomata and condylomata (upon the nates) when soft and there is foul exudation; and often succeeds in controlling venereal or genital warts. Alcoholic preparations of thuja are generally conceded to be the best local and kindly acting vegetable medicines for the dispersal of common warts or verruccae on any part of the body. It is applied locally and with reputed greater success hypodermatically into the base of the growth. Our personal experience with it for the removal of warts has been negative. Rarely it controls bleeding and ameliorates in hemorrhoids and prolapsus ani. Persisted in, though at first painful, it has cured fissure of the anus. Howe valued it for bulging naevi, and his once famous method of curing hydrocele with it is now little practiced. As compared with tincture of iodine or with carbolic acid it is less painful, but unlike the latter free from poisonous consequences through absorption. Howe's method was as follows: Tap and drain the tunica vaginalis testis, and inject two drachms of a solution of specific medicine thuja (one part) in warm sterile water (seven parts). Knead the tissues thoroughly so that the fluid is made to penetrate every part of the sac. More or less burning pain ensues, together with a greater or less degree of swelling; after sub sidence of the latter, if the procedure has been carefully executed, adhesion of the contact surfaces from the inflammation provoked results. Specific medicine thuja has been used to remove urethral caruncle and for the relief of chronic dry eczema of a furfuraceous character. Dropped upon hot water and inhaled it is of benefit in fetid sore throat, chronic and fetid bronchitis, bronchorrhea, and chronic nasal and retro-nasal catarrh. In all of the foregoing conditions the alcoholic preparations may be employed from full strength to such a dilution as the individual cases demand. Aqueous thuja is invaluable to relieve pain and promote quick healing in soft pultaceous chancroids. It quickly allays pain, checks the discharge and odor, prevents lymphatic engorgement, and stimulates healing. It has no effect upon hard chancre, nor is it in any sense to be regarded as antisyphilitic. Wherever upon sensitive tissues the alcoholic preparations are inadvisable, the aqueous preparation may be substituted. It has been especially useful in catarrhal granulation of the cervix uteri (tampon); its use being preceded by a hot douche. For acute gonorrhea the following injection is most valuable: Rx Colorless Hydrastis; Aqueous Thuja, each 1 part; Warm Water, 4 parts. Mix. Sig.: Inject every three hours. If there is much soreness add one part of Specific Medicine Hamamelis. The same mixture gives good results in subacute and chronic proctitis, following dysentery. Locally applied alone, or in the above-named combination, it may be used upon balanitis, herpetic ulcers, and abrasions and excoriations of the glans penis. As a local wash for mucous erosions in the mouth, for sore nipples, and for chapped hands it is pleasant and often efficient. Ointment of Thuja is the preferred thuja preparation for granular ophthalmia or simple trachoma. When the granules are soft and pultaceous a wetted alum pencil may be quickly passed over the everted lid, making but one sweep at each treatment. The parts are then dried, especially if the subconjunctival tissue is much infiltrated; and the ointment applied by means of a camel's-hair pencil. This should be done once a day. Fleeting pain is experienced. Absolute cleanliness should be insisted upon when home treatment is carried out, and constitutional remedies administered when conditions warrant them. Internal. Thuja is stimulant, subas¹