BERBERIS (Mahonia) AQUIFOLIUM
   The root of Berberis aquifolium, Pursh (Nat. Ord. Berberidaceae). Western United States from Colorado to the Pacific coast; cultivated also for ornament among shrubbery. Common Names: Oregon Grape, Mountain Grape. Principal Constituents.—Berberine, the yellow alkaloid (see Hydrastis) and two white alkaloids—berbamine and oxyacanthine. Preparation.—Specific Medicine Berberis. Dose, 1 to 30 drops. Specific Indications.—Syphilitic dyscrasia; chronic skin diseases, with blood dyscrasia with or without syphilitic taint; profusely secreting tumid mucous membranes; indigestion, with hepatic torpor. Action and Therapy.—This agent is alterative, tonic, and probably corrective to syphilitic constitutions, but without any proved specific action upon treponema. It stimulates secretion and excretion, improves digestion and assimilation; it activates the lymphatic system and ductless glands; and augments the renal secretion. It is a corrector and eliminator of depraved body fluids and assists thereby in good blood-making. In this way most likely its good effects are produced in such grave constitutional disorders as syphilis. Certainly the ravages of this disease are lessened under these circumstances and aggravated by general ill-conditions. If then syphilitic dyscrasia is benefited by this drug, and clinical results seem to show that it is, it is probably due to its general alterative effects in maintaining good elimination and good metabolic action of the organs vital to nutrition. Like hydrastis, Berberis aquifolium is an excellent peptic bitter and tonic to the gastric function, and is, therefore, a drug of much value in atonic dyspepsia, with hepatic torpor. Upon the mucosa its effects are like those of hydrastis controlling catarrhal outpouring and erosion of tissue. For this purpose it is useful in stomatitis and gastric and intestinal catarrh. Remotely it sometimes controls leucorrhoea. If these are associated with syphilis, it helps the latter to the extent that it controls these disorders. Berberis aquifolium has won its reputation chiefly as a remedy for the syphilitic taint. The more chronic the conditions or results of the disease, the more it has been praised. Some claim that if given early it will abort the tertiary stage, but this of course depends in most cases upon the resisting powers of the body and the care the patient takes of himself. Apparently berberis fortifies the resisting powers by its alterative and reparative action. The bone, mucosa, and cutaneous disorders following in the wake of syphilis seem to clear up under its persistent use, when given in appreciable doses. Whether it has any effect on the nervous damage from this taint is not yet apparent. It does, however, relieve the night pains and the shin pain of syphilitic periostitis. Syphilitic phagedena disappears under its use, and sometimes the anemia of syphilis yields to its nutritional improvement. It should be given freely in syphilitic leucoplakia of the tongue, mouth, and throat, where the mucosa is tumid and secreting excessively, and when emaciation and weakness with yellowish parchmentlike skin are evident. At all events, though probably not a direct antisyphilitic, its general effect upon waste and nutrition is so beneficial that it should invariably be associated with other treatment in chronic syphilitic diathesis. Other dyscrasiae seem to be influenced by this drug. It aids to some degree to mitigate the miseries of the consumptive, and in chronic skin diseases its internal use has hastened the effects from external medication. Eczema, psoriasis (temporarily at least), and herpetic eruptions have disappeared under its persistent use. The specific medicine should be given in doses of from 10 to 20 drops well diluted, every 3 or 4 hours.¹

BERBERIS VULGARIS
   The bark of the root and the berries of Berberis vulgaris, Linné (Nat. Ord. Berberidaceae). Europe, Asia, and the United States. Common Names: Barberry, Common Barberry. Principal Constituents.—Berberine (see Hydrastis) is the active alkaloid; others are oxyacanthine and berbamine. The berries contain malic acid. Preparation.—Tinctura Berberidis Vulgaris, Tincture of Berberis Vulgaris. (Barberry Bark, 8 ounces, Alcohol 76 per cent, 16 ounces.) Dose, 5 to 60 drops. Action and Therapy.-Barberry may be used for purposes for which berberine medication is needed. It acts much like hydrastis and could be employed for many of the uses of that scarce and high-priced drug so far as the berberine effects are required. The fluid preparations are asserted to act more kindly and more efficiently than berberine itself. It was very early used in domestic medicine for sore eyes, and later by practitioners for chronic catarrhal ophthalmias. The decoction is employed for this purpose, and is equally efficient in aphthous sore mouth. It is decidedly tonic and if pushed, purgative. Used short of its cathartic action it is of value in non-obstructive jaundice and in gastric and intestinal dyspepsia. In renal catarrh, occasioned by the presence of calculi, small doses may be given when there is burning and soreness and excess of mucus in the urinary tract.¹

CALUMBA (Jateorhiza palmata)^JAPA2
   The root of Jateorhiza palmata (Lamarck), Miers (Nat. Ord. Menispermaceae). A climbing perennial, the Kalumb of the Southeast coast of Africa. Dose, 1 to 30 grains. Common Names: Columbo, Colombo, Columba. Principal Constituents.—Calumbin(C42H44O14), a bitter principle, berberine (C20H17NO4) with columbic acid, and columbine, a possible white alkaloid, may be present. No tannin is present. Preparations.—1. Infusum Calumbae, Infusion of Calumba. Dose, 1 to 2 fluidounces. 2. Specific Medicine Calumba. Dose, 5 to 30 minims. Specific Indications.—Enfeebled stomach with indigestion, or feeble digestion; anorexia and debility. Action.—This is a type of the pure, simple bitters which contain practically no oil or tannin, are not astringent and have no general effect, but act reflexly upon the stomachic and salivary functions by first irritating the mucous membrane and taste buds of the tongue. This action is quite transitory, so that in administering bitters they should be given immediately before meals. Their effect upon the stomach is to increase local circulatory dilation, a freer flow of gastric juice, increase of mucus, and increased muscular action. On account of the action upon the flow of mucus they should not be administered for too long a period lest gastric irritability and consequent impaired digestion result. Therapy.—The least irritating and one of the best of the simple bitters and of especial value in atony of the stomach with poor appetite and feeble digestion. It is especially valuable in convalescence from acute fevers and other disorders in which there is lack of desire for food and poor digestion, with pain or without pain, immediately upon eating. After the active stage of cholera morbus, cholera infantum, acute diarrhoea, and dysentery it may be given to promote the appetite and digestion. When desired calumba may be combined with magnesia, bicarbonate of soda, senna, ginger, and aromatics, to meet special indications, particularly when flatulence and constipation are present. Calumba and the allied bitters should not be given in acute or subacute inflammatory conditions of the stomach, nor during acute fevers, nor when digestion is merely impaired, but the appetite remains good. It is largely ineffectual also when organic disease of the stomach prevents the normal outflow of gastric juice. When given, the small doses are preferable to large ones; and on account of the absence of tannin, iron salts may be given with calumba, if so desired. In some respects calumba resembles hydrastis in its local action, and indirectly, by favoring better digestion, the quality of the blood is improved, hence its value in anemia during convalescence.¹

COPTIS
   The rhizome and rootlets of Coptis trifolia, Salisbury. (Nat. Ord. Berberidaceae.) A plant of dark, cold swamps and sphagnous woods, found in Siberia, Greenland, and Iceland, and in the United States, following the Appalachians as far south as Alabama. Common Names: Gold Thread, Mouth Root, Canker Root. Principal Constituents.-Two alkaloids: berberine (yellow) and coptine (white). It is devoid of starch, tannin or resin. Preparations—1. Decoctum Coptis, Decoction of Coptis. (Coptis, 2 drachms, to Water, 16 ounces.) Dose, 2 to 6 fluidrachms. Used freely as a local wash. 2. Tinctura Coptis, Tincture of Coptis. (Coptis, 1 ounce; Diluted Alcohol, 16 ounces) Dose, 30 to 60 drops. Specific Indications.—Aphthous ulceration; atonic dyspepsia; thrush. Action and Therapy.—External. The most effective application for thrush in infants. The decoction should be freely applied and at the same time given internally. The infusion or the tincture may be used, with or without hydrastis, in aphthous ulcers of the mouth. Internal. Coptis is a pure bitter and one that ought to be more generally used. It ranks with quassia, calumba, gentian, and similar agents in efficiency and may be used for many of the purposes for which hydrastis is employed. Its use in the stomachic disorders associated with, preceding or following thrush is the most certain in therapy, and its internal employment hastens the local cure, which it quickly accomplishes. Coptis is a good stimulant for atonic indigestion and dyspepsia, with deficiency in the normal flow of the peptic juices.¹

GERANIUM^GERAN
   The rhizome of Geranium maculatum, Linné (Nat. Ord. Geraniaceae). Common in the rich soils of woods and low grounds in the United States. Dose, 5 to 60 grains. Common Names: Cranesbill, Wild Cranesbill, Crowfoot, Spotted Geranium. Principal Constituents.—Tannin (10 to 28 per cent, according to season) and gallic acid (in dried root). Preparations.—1. Decoctum Geranii, Decoction of Geranium (1/2 ounce to Water, 16 fluidounces). Dose, 1 to 2 fluidounces. 2. Specific Medicine Geranium. Dose, 5 to 60 drops. Specific Indications.—Relaxed mucous tissues with profuse debilitating discharges; chronic mucous diarrheas; chronic dysentery; diarrhoea with constant desire to defecate; passive hemorrhages; gastric ulcer. Action and Therapy.—Geranium is one of the simple and much neglected of the early Eclectic medicines. It is an ideal astringent and for conditions requiring such an action it is preferable to many other constringing drugs. Geranium is indicated in subacute and chronic bowel disorders when the evacuations are abundant and debilitating. It is especially adapted to relaxation of the mucosa following inflammation. For the summer diarrheas of older children, and especially the cholera infantum of infants, it is splendidly effective after the bowels have been thoroughly cleansed of undigested and decomposed contents. For infantile use we prefer the decoction in milk. If that does not agree, small doses of the specific medicine in water may be employed. When dysentery tends to chronicity, the thorough use of magnesium sulphate followed by geranium will render good service. Geranium is of some value in passive hemorrhages, as haematuria, hemoptysis, and menorrhagia. It is only useful in the first two when the blood lost is small in amount, and in the latter when bleeding is prolonged, but merely oozing. Though a useful agent in relaxed conditions with catarrhal discharges other than those of the bowels, as chronic pharyngeal catarrh, relaxed uvula, leucorrhea, etc., it is no more valuable than other tannin-bearing drugs, and is often inferior to tannic acid itself. Geranium is of specific value where long saturation of the mucosa with unhealthy catarrhal secretions favor a tendency to destruction of tissue. We have found it to quickly cure aphthous ulceration of the mouth attended by gastric acidity and acid diarrhea. For gastric ulcer it is one of the best therapeutic means we possess. Geranium, hydrastis, mangifera, bismuth subnitrate and mangesium oxide, singly, or in indicated association, have proven the most effective agents in our experience for the medicinal relief of curable cases. They restrain hypersecretion, correct excessive acidity, check hemorrhage, and relieve pain; sometimes healing appears to progress rapidly under their influence.¹

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

HYDRASTIS^HYDRA2
   The dried rhizome and roots of Hydrastis canadensis, Linné (Nat. Ord. Ranunculaceae) United States and Canada in rich, shady woods. (Chiefly Ohio, Indiana, Kentucky, and West Virginia.) Common Names: Golden Seal, Yellow Root, Yellow Puccoon, Orange Root. Principal Constituents.—Three alkaloids: berberine (yellow); and hydrastine and canadine, both white. Preparations and Derivatives.—1. Specific Medicine Hydrastis. Dose, 1 to 30 drops. 2. Colorless Hydrastis (Lloyd's). Dose, 1 to 15 drops. Largely employed locally. 3. Hydrastine Muriate (Hydrochlorate of Berberine). A yellow powder. Dose, 1 to 5 grains. 4. Hydrastin (Resinoid), not now used. 5. Hydrastin (Combined Hydrastin). Only substance now sold as hydrastin. 6. Hydrastina, Hydrastine. (Alkaloid, both natural and synthetic.) Permanent white or creamy crystals or powder, almost insoluble in water; soluble in chloroform; less so in alcohol. Dose, 1/12 to 1/3 gr.; average dose, 1/6 grain. 7. Hydrastinae Hydrochloridum, Hydrastine Hydrochloride (Hydrastine Chloride). White or cream-colored powder, odorless, hygroscopic, very soluble in alcohol and water. Dose, 1/12 to 1/3 grain; average dose, 1/6 grain. 8. Hydrastininae Hydrochloridum, Hydrastinine Hydrochloride (Hydrastinine Chloride). Odorless, light-yellow crystals or powder, very soluble in water and alcohol. Dose, 1/4 to 1 grain; average dose, 1/2 grain 9. Liquid Hydrastis (nonalcoholic). Dose, 1 to 20 drops. Specific Indications.—Catarrhal states of the mucous membranes unaccompanied by acute inflammation (except in acute purulent otitis media); relaxed tissues, with profuse secretion of thick and tenacious yellowish or greenish-yellow muco-pus; relaxation and ulceration of tissues of mouth and throat; imperfect recovery from diarrhea or dysentery, with mucous discharges and relaxation; aphthae, ulceration, or erosion of mucous surfaces; atonic gastric irritability; irritation of mucous surfaces, with feeble circulation; muscular soreness aggravated by pressure;. passive hemorrhages from the pelvic organs; ice water dyspepsia; skin diseases depending upon gastric wrongs which also indicate hydrastis. Action.—Extensive experiments by pharmacologists show that Hydrastis alkaloids, particularly hydrastine, are actively poisonous to certain animals, producing spinal convulsions followed by paralysis, lowered blood pressure succeeded by a marked rise, and death. Upon man, however, no so-called physiological effects of any moment have been observed. In the ordinary medicinal doses it certainly is not a poison to human beings. No cerebral effects have been observed in either animals or man; and judging from clinical effects it probably increases contraction of special nonstriated muscles, as it controls uterine hemorrhage in women and has an ecbolic effect upon the lower mammals. Schatz explains this by asserting its power upon the unstriped fibers of the arteries and denying its effects upon other tubular muscular structures. It has also been assumed, but not experimentally proved, that it slightly increases hepatic secretion in man. Therapy.—External. Hydrastis is one of our most efficient topical medicines when applied in disorders of the mucous membranes; and is occasionally of service upon the skin. It is of most importance perhaps in ophthalmic practice, being a thoroughly effective subastringent and soothing agent in acute and subacute catarrhal and follicular conjunctivitis. For this purpose, and indeed for most topical effects, the colorless preparations are preferred. Lloyd's Colorless Hydrastis in particular is to be commended, for it is both non-staining and nonalcoholic and has almost completely replaced the formerly used hydrastin and berberine preparations. The same medicament may be used in superficial corneal ulcer, ciliary blepharitis, and in simple trachoma. While signally useful in these affections of the eye appendages, hydrastis is of no value in intraocular disorders. Inspissated cerumen may be readily softened by colorless hydrastis, thus facilitating its removal by water. It also controls the irritation of the aural canal when due to the presence of hardened wax. Eczema of the external auditory canal has been cured by it. In both acute and chronic otitis media it may be employed hopefully when there is a purulent or mucopurulent discharge and granulations do not exist. Hydrastis preparations are among the most successful remedies in catarrhs of the nose and throat. It should be used both locally and internally in catarrhal and follicular pharyngitis, subacute forms of simple catarrhal sore throat following tonsillitis, subacute rhinitis, naso-pharyngeal and retro-pharyngeal catarrh, and in ulcerated nasopharyngeal passages. It sometimes aids in the cure of syphilitic ulceration of the upper breathing tract. For catarrhal hypertrophy and engorgement of the turbinates it is often effective. The abundant discharge and thickened Schniederian membranes will guide to its selection. Locke advised it for nasal catarrh with thick, tenacious mucus and almost constant frontal headache. When thick gelatinous masses from the pharyngeal vault constantly drop into the throat, causing hacking cough and nausea, hydrastis given internally and as an ingredient of a local wash gives very satisfactory results. In all catarrhal affections of the upper respiratory tract, hydrastis should be administered for a prolonged period to obtain the best results. Hydrastis is valued by some as a topical reducer for chronically enlarged tonsils, but. like most medicines recommended for that purpose it fails far oftener than it succeeds. Hydrastis is universally admitted to be a most valuable topical agent in gonorrhea. It is best adapted after the first and acute stage has passed, though it is not contraindicated at any time during the course of the infection. The preparation preferred is the colorless, though other hydrastis preparations, particularly berberine and hydrastin salts are useful, b¹

LEPTANDRA (Veronicastrum virginicum)^VEVI4
   The rhizome and rootlets of Veronicastrum virginicum (L.) Farw., (Leptandra virginica, Nuttall), (Nat. Ord. Scrophulariaceae). A tall perennial plant indigenous to the eastern half of the United States. Dose, 10 to 60 grains. Common Names: Culver's Root, Black Root, Culver's Physic, Bowman Root, Tall Speedwell, etc. Principal Constituents.—A resinoid called leptandrin, formerly used but now largely discarded by Eclectic practitioners, and a bitter principle. Preparation.—Specific Medicine Leptandra. Dose, 1 to 60 drops. Derivative.—Leptandrin (Resinoid). Dose, 1/4 to 2 grains. Specific Indications.—Tenderness and heavy pain in the region of the liver, with drowsiness, dizziness, and mental depression; skin, yellow; tongue coated white; bitter taste, nausea, frontal headache and cold extremities; thirst with inability to drink; diarrhea with half-digested passages, or clay-colored stools; enfeebled portal circulation, with lassitude, gloom, and mental depression. Action and Therapy.—Leptandra is a gastro-hepatic and intestinal stimulant. The fresh root is viciously cathartic and has produced bloody stools and abortion. Drying, however, deprives the drug of its drastic quality and it becomes a safe cholagogue, laxative, and cathartic. Apparently in ordinary doses it strengthens the functional activity of the intestinal glands, does not debilitate nor produce large stools, and if the circulation is feeble, with a tendency to stasis, it has a decidedly tonic effect. Leptandra is a remedy for intestinal atony—especially duodenal atony associated with hepatic torpor. It has been employed in dysentery and chronic diarrhoea, dependent upon constipation of the upper bowel, or upon imperfect elaboration of the food. These cases are accompanied by dizziness, headache, visceral pain, mental depression and cold extremities. In atony of the stomach and liver with the preceding and the following symptoms it is decidedly stimulant and tonic. There is a dry, hot skin, with cold feet, abdominal plethora, pale, white coated or furred broad and thick tongue, heavy or dull aching in the hepatic region and the left shoulder, and a bitter, disagreeable taste. In fact with any of the preceding symptoms—and yellowness of the skin and conjunctiva and nausea, leptandra will prove very useful in atonic dyspepsia, acute hepatitis, acute duodenal catarrh, diarrhea of halfdigested aliment, muco-enteritis, and chronic enteritis. It will be evident from the guides given that leptandra, is a remedy for the complex known as “biliousness”. It aids chionanthus, and sometimes podophyllin to dissipate jaundice. In the early period of Eclectic medicine it was valued in typhoid fever, when ushered in with constipation and before marked involvement of Peyer’s patches had become established. It is questionable whether any laxative should be resorted to in such conditions—an enema is to be preferred. But for pre-typhoid symptoms, not amounting to enteric fever, its use is justifiable and even beneficial. Leptandra is better as a laxative in malarial fever and prepares the system for the more kindly reception of antiperiodic medication. It is no longer employed in anasarca and ascites, better agents having supplanted it. It is a good medicine and its field of usefulness has narrowed down to gastro-hepato-duodenal atony, and attendant or resulting disorders, in which it proves an admirable stimulant and corrective. It acts well with hydrastis, podophyllum, chionanthus, dioscorea, or chelidonium when these are also indicated. It is especially valuable in the diarrhoea of dentition. The nervous irritability may be controlled with matricaria and the following administered: Rx Compound Syrup of Rhubarb and Potassa, 3 fluidrachms; Specific Medicine Leptandra, 1 fluidrachm. Mix. Ten to 20 drops every hour until the diarrhea ceases. Glyconda may be substituted for the neutralizing cordial, if sugar is contraindicated.¹

PRINOS
   The bark and berries of Ilex verticillata (L.) Gray, (Prinos verticillatus, Linné) (Nat. Ord. Aquifoliaceae). Moist woods and streams throughout the United States. Dose (bark), 5 to 60 grams. Common Names: Black Alder, Winterberry. Principal Constituents.—Resin, tannin, and an amorphous, bitter principle. Preparation.—Tinctura Prini, Tincture of Prinos (Bark, 8 ounces to Alcohol (76 per cent), 16 fluidounces). Dose, 5 to 60 drops. Action and Therapy.—Black alder is tonic, astringent and alterative, and especially effective as the latter. Many alterative syrups contain black alder. The berries are cathartic and vermifuge. Tincture of black alder and specific medicine hydrastis form an excellent tonic in atonic dyspepsia, when debility is marked and there is a tendency to diarrhea.¹