The Preparation of Remedies.
Success in practice necessitates the employment of good medicines. Much of the uncertainty of medicine is due to the bad quality of the drugs sold in the market. When remedies are unreliable, the physician soon loses faith, and reaches the condition of a cathartic, quinine, morphine and whisky doctor. He fails so often with the medicines of the Pharmacopoeia, that he deems it useless to study them.
It is true that the drugs of the market are adulterated in every possible way, and that preparations are of all degrees of worthlessness. Even chemicals must bear the name of some responsible house, and the cork sealed with their seal to give a reasonable assurance of their purity. Whilst with preparations of vegetable remedies it is still worse, and we can safely say that nine out of every ten are unfit for our use.
To have a good remedy from the vegetable kingdom it is necessary that it be gathered at the proper season, in the right locality, and that it be carefully preserved. With the majority of remedies it is necessary that they be prepared from the fresh crude material; as it is gathered, partly dried, wholly dried, but always recent. Some few may be dried and stored for future preparation.
We now prepare nearly all vegetable remedies with alcohol, and the larger number in the form of tincture (good fluid extracts are tinctures). That the physician may be certain as to the quality of these remedies when he makes his purchases, it is well that he should prepare some of them himself. Office pharmacy is profitable in this way if in no other.
It may be very simple. You gather the agent in the season when its virtues are greatest, pound it up in a mortar, if you have one, on a board with a hatchet or hammer if you have no mortar, put it in a glass or glazed vessel that can be tightly stoppered, cover it with twice its weight of alcohol (76 to 98 per cent, as the crude article contains resinous substances), and let it stand fourteen days. It is now ready for use. Pour off the tincture, express all you can get out of the drug, and if you want a very nice article, filter through paper. Your Pharmacist turns up his nose at the crude process, but it won't turn up when he is shown the product and has it compared with the "fluid extracts" on his shelves. It is a sound and reliable remedy, and will give success in practice.
The process of percolation is a nicer method, and the one we advise, and it also is so simple that the doctor can hardly go astray in it. The crude material, if green or partly dried, is finely powdered up; if dry, is ground or powdered, and being wetted with alcohol is packed in a tin or glass percolator. The percolator may be a perforated diaphragm, or its lower part may contain tow; in either case it may be stopped with a cork. The material is now thoroughly wetted, and in twenty-four hours the cork may be removed, and the fluid allowed to pass through. Two parts by weight of alcohol to one of the crude drug is the proportion advised, and this may be poured into the percolator gradually, as the tincture passes.
The skilled pharmacist can prepare a fluid preparation which will represent the drug ounce for ounce. Yet the majority of preparations sold will not come up to the standard of eight ounces to the pint. What we care for first is the quality of the remedy, its strength is a secondary matter. Yet we want our tinctures as strong as may be, that it can be carried readily in our pocket cases.
Chemicals should be bought of well-known parties, and bear the label of a first class manufacturing house. If a medicine carries the name of such a house as Powers and Weightman, we feel satisfied with it. The sophistication is so great in the market that we can not trust others. I have seen Santonine sold that contained eighty per cent. of chlorate of potash. Morphia that was adulterated one fourth, one-half, three-fourths, with cinchonidia; Quinine that was three-fourths cinchonidia; even bitartrate of potash would be one-half or two-thirds inert or foreign matter, and so all through the list.
It is advised that "proprietary articles," compounded articles, elixirs, peptics, and "fancy pharmacals" of all kinds be severely let alone. If the physician is capable of practising medicine, he is capable of selecting his own remedies, and making his own combinations for the case he has in hand. It is well, also, to look with suspicion upon "new remedis" advertised and pushed by manufacturing establishments. The introduction of a new remedy is the work of time, and it should come by and through physicians, not drug houses.