Part 116

=Confection of Scam'mony.= _Syn._ CONFEC'TIO SCAMMO'NII (B. P.), ELECTUA''RUM SCAMMO''NII (Ph. D.). _Prep._ (B. P.) Scammony, in fine powder, 24 parts; ginger, in fine powder, 12 parts; oil of caraway, 1 part; oil of cloves, 1/2 part; syrup, 24 parts; clarified honey, 12 parts; rub the powders with the syrup and the honey into a uniform mass, then add the oils and mix.--_Dose_, 10 gr. to 30 gr.; as a warm cathartic, and in worms, &c.

=Confection of Scurvy Grass.= (P. Codex.) Fresh leaves of scurvy grass, 1 oz.; sugar, 3 oz. Beat to a pulp and pass through a hair sieve.

=Confection of Sen'na.= _Syn._ LEN'ITIVE ELEC'TUARY, ELEC'TUARY OF SENNA; CONFEC'TIO SEN'NÆ (Ph. L. & D.), ELECTUA''RIUM SEN'NÆ (Ph. E.), L. _Prep._ 1. Senna, 8 oz.; corianders, 4 oz.; rub them together, and by a sieve separate 10 oz. of the mixed powder; also boil figs, 1 lb., and fresh liquorice, bruised, 3 oz., in water, 3 pints, until reduced to one half; press, strain, and evaporate the strained liquor in a water bath to 24 fl. oz.; then add sugar, 2-1/2 lbs.; dissolve, and further add, prepared tamarinds, cassia, and prunes, of each 1/2 lb.; remove from the heat, and when the whole has considerably cooled, add the sifted powder, by degrees, and stir until the whole is thoroughly incorporated.

2. (Ph. E.) Senna, 8 oz.; corianders, 4 oz.; liquorice root, 3 oz.; figs and pulp of prunes, of each, 1 lb.; white sugar, 2-1/2 lbs.; water, 3-1/4 pints.

3. (Ph. D.) Senna leaves, in fine powder, 2 oz.; corianders (in fine powder), 1 oz.; oil of caraway, 1/2 dr.; mix, and add them to pulp of prunes, 5 oz.; pulp of tamarinds, 2 oz.; brown sugar, 8 oz.; water 2 fl. oz.; previously brought to a smooth paste by the heat of a water bath.

4. (Ph. B.) Boil figs, 12 oz., and prunes, 6 oz., gently in distilled water, 24 oz., in a covered vessel for hours, then, having added more distilled water to make up the quantity to 24 fluid ounces, add tamarinds, 9 oz., and cassia pulp, 9 oz.; macerate for two hours, and press the pulp through a hair sieve, rejecting the seeds, &c. Dissolve refined sugar, 30 oz., and extract of liquorice, 3/4 oz., in the mixture with a gentle heat; and while it is still warm, add to it gradually senna in fine powder, 7 oz., and coriander in fine powder, 3 oz., and stir diligently until all the ingredients are thoroughly combined. The resulting confection should weigh 75 oz.

_Uses, &c._ Confection of senna is a gentle and pleasant purgative, and well adapted for persons suffering from piles, and as a laxative during pregnancy. The dose is 1 dr. to 1/2 oz., taken at bedtime or early in the morning.

_Obs._ There is no one pharmacop[oe]ial preparation which it is more difficult to obtain of good quality than confection of senna. The absolute cost of an article prepared according to the directions of the Colleges is greater than the price at which many wholesale houses are vending the drug. Dr Paris very truly remarks, that "the directions of the Pharmacop[oe]ia are very rarely followed." Considerable quantities are manufactured, into which unsound and spoilt apples enter as a principal ingredient; whilst the substitution of jalap for the whole, or a portion of the senna, is a very common practice. We have seen the following forms employed in the trade.

5. Powdered senna' pulp of tamarinds, cassia, and prunes, of each 1-1/2 lb.; powdered corianders, 3/4 lb.; Spanish juice, 1/2 lb.; simple syrup, 12 lbs.

6. As the above, but omitting the cassia pulp, and adding 2 lbs. more tamarind pulp. Both these articles are labelled "P. L." and sent out as genuine, and that when no competition as to price exists. The cheaper article is made as follows:--

7. Common prunes and tamarinds, of each 16 lbs.; treacle, 3/4 cwt.; species (a compound of senna dust and small senna, mixed with 3 lbs. of coriander seeds, and strengthened with jalap; all ground to a fine powder), 18-1/4 lbs. To this is frequently added, of rotten or inferior apples, 1/4 cwt., which are pulped with the prunes and tamarinds. This article is commonly labelled "CONF. SENNÆ VER." by its manufacturer.

=Confection of Sponge.= _Syn._ ELEC'TUARY OF BURNT SPONGE; CONFEC'TIO SPONGII, C. S. US'TÆ, L. _Prep._ 1. Burnt sponge, 3 parts; confection of orange peel and hips, of each 1 part; simple syrup, q. s.

2. (St. B. Hosp.) Burnt sponge, made into a confection with syrup of orange peel. The first form produces the most agreeable confection.--_Dose_, of either, 1/2 dr. to 2 dr., twice or thrice daily; in scrofula, &c.

=Confection of Steel.= _Prep._ 1. CONFEC'TIO FER'RI SESQUIOX'IDI, L.--_a._ From confection of orange and sesquioxide of iron (Ph. L.), of each 2 oz.; white sugar, 3 oz.; syrup, 1-1/2 oz.; mix.--_Dose_, 1 dr. to 3 dr.

_b._ (St. B. Hosp.) Sesquioxide of iron, 1 oz.; treacle, q. s.--_Dose_, 1/2 dr. to 1 dr. Both are given in the usual cases wherein iron is indicated; especially in anæmia, chlorosis, and amenorrh[oe]a.

2. (CONFEC'TIO FER'RI TARTARIZA'TI.--St B. Hosp.) Cream of tartar, 1-1/2 oz.; tartrate of iron, 2 dr.; ginger, 1 dr.; treacle, 2-1/2 oz., or q. s.--_Dose_, 1 dr. to 2 dr., 2 or 3 times daily.

=Confection of Sul'phur.= _Syn._ BRIMSTONE AND TREACLE; CONFEC'TIO SULPHU'RIS, L. _Prep._ 1. Sublimed sulphur, 2 oz.; treacle, 4 oz.--_Dose._ A spoonful night and morning for a week or longer, as an alterative or purifier of the blood; in skin diseases, &c.

2. (St. B. Hosp.) Precipitated sulphur, 1 oz.; cream of tartar, 2 dr.; honey or treacle, 2 oz. As the last.

3. (B. P.) Sublimed sulphur, 4 oz.; cream of tartar, 1 oz.; syrup of orange peel, 4 fl. oz.--_Dose_, 1 to 2 dr.; as a laxative, in piles, gonorrh[oe]a, &c.

=Confection of Tin.= _Syn._ CONFEC'TIO STAN'NI, L. _Prep._ (Hosp. Form.) Powdered tin, 1 oz.; confection of roses, 2 oz.; mix.--_Dose_, 2 to 4 dr., every morning; in worms.

=Confection of Turpentine.= _Syn._ CONFEC'TIO TEREBINTH'INÆ, L. _Prep._ (B. P.) Oil of turpentine, 1 fl. oz.; liquorice powder, 1 oz.; triturate together, then add clarified honey, 2 oz.--_Dose_ and _use_, as the last.

=Confection of Worm-seed.= _Syn._ CONFEC'TIO CIN'Æ, C. S. CINÆ. L. _Prep._ 1. (Ph. Slesvico-Holsat. 1831, and Ph. Suec. 1845.) Worm-seed, 2 oz.; heat it in a pan over a gentle fire, add white sugar, boiled to a low candy height, 4 oz.; and stir together until they become dry; then pick out those seeds which are covered with sugar, and repeat the process with the others.

2. Powdered worm-seed and syrup of orange peel, equal parts.--_Dose_, 1 to 2 dr., night and morning, followed by a brisk purge; in worms.

=CONFEC'TIONERY.= See CANDIES, DROPS, LOZENGES, SUGAR, &c.

=CONGELA'TION.= The conversion of a substance from the fluid to the solid state by the abstraction of heat. See ICE and REFRIGERATION.

=CONGESTION.= "A common condition of disease in an undue flow of blood into any part, or accumulation within it. The vessels seem to lose the power of emptying themselves, which they possess in health. Congestion, although an effect of both visitation and inflammation, may exist irrespective of either. Two forms of it are distinguished, active and passive. The first is when some excitement causes the blood to pass more rapidly into a part than its vessels can transmit out of it; the second when from some inherent debility the vessels cannot get rid of the fluid ordinarily thrown into them. Congestion of organs disturb their functions, and through them the general health."

=CONGLU'TINUM (Bracy Clarke's).= Sulphate of zinc (white vitriol), 4 oz.; dissolved in water, 1 pint. Used as an astringent lotion in veterinary practice, and much diluted with water (a dessert-spoonful to 1/4 pint or more of water), as a collyrium in chronic inflammation of the eyes.

=CO'NIA.= C_{8}H_{15}O. _Syn._ CO'NINE, CON'ICINE. An alkaloid, discovered by Gieseke in hemlock. It exists in every part of the plant, but is present in the largest quantity in the seed.

_Prep._ (Gieger.) The seeds of hemlock, or their alcoholic extracts, is distilled with water and potassa. The conia passes over into the receiver, and floats on the top of the water, which also contains a little conine in solution. It is purified in the way directed for the volatile bases. (See ALKALOID.) When the alcoholic extract is employed, about half its weight of potassa should be used.

_Prop., &c._ Pure conia is an oily-looking liquid, smelling intensely of hemlock, or rather of a combination of the odours of tobacco and mice; volatile at common temperatures; reddens turmeric; boils at about 340° Fahr., but readily distils over with water at 212°; sp. gr. ·89; with the acids it forms salts, some of which are crystallisable. Six lbs. of fresh and 9 lbs. of dried seeds yielded 1 oz. of conia. (Gieger.) Forty lbs. of the ripe but green seeds yielded 2-1/2 oz. of hydrated conia. (Christison.)

Conia is remarkably poisonous. 1 drop, placed in the eye of a rabbit, killed it in 9 minutes; 5 drops, poured into the throat of a dog, killed it in less than a minute. It has been employed in some convulsive and spasmodic diseases, but is now seldom used medicinally. "The patient cries, the contortions, and the rigidity of the limbs, which have always preceded death (caused by conia), leave no doubt as to the cruel pains which this kind of poisoning brings on." (Boutron-Chalard and Henry.) The treatment may be that recommended under ACONITE and HEMLOCK.

=CONSERVATEUR FUR HAARBLEINDE.= A preventive of hair diseases (Edm. Bühligen, Leipzig). Consists of 10 grammes tinct. arnica, 5 grammes glycerine, 10 grammes spirit, and 60 grammes water. (Schädler.)

=CON'SERVE.= _Syn._ CONSER'VA, L. Recent vegetable matter, as flowers, herbs, roots, fruit, and seed, beaten with powdered sugar to the consistence of a stiff paste, so as to preserve them as nearly as possible in their natural freshness. Conserves are made both by the confectioner and the druggist; by the first as SWEETMEATS; by the other chiefly as vehicles for more active medicines. The London College of Physicians now includes both conserves and electuaries under the general head of CONFECTIONS. The term appears, however, in some cases, scarcely appropriate. The word confection has a more general application, and implies any sweetmeat or composition in which sugar is the principal ingredient. See CONFECTION and ELECTUARY.

=Conserve of Ac'etate of Potas'sa.= _Syn._ CONSER'VA POTAS'SÆ ACETA'TIS, L. _Prep._ (Bories.) Acetate of potassa, 1/2 oz.; sulphate of soda, 1 dr.; juices of scurvy grass, fumitory, and dandelion, of each 2 oz. (reduced to one half by gentle evaporation?; sugar, q. s. to make a conserve. A teaspoonful 2 or 3 times daily, as a diuretic aperient; in obstruction of the bowels, &c.

=Conserve of Al'monds.= See CONFECTIONS.

=Conserve of Angel'ica.= _Syn._ CONSER'VA ANGEL'ICÆ, L. _Prep._ (Giordano.) Fresh angelica root, 2 parts; water, 16 parts; macerate for a few hours, clarify the liquor, add sugar, 3 parts; cook the root in the syrup, and preserve it in this state (confection), or dry it (to a candy). Used as an agreeable tonic, stomachic, and carminative.

=Conserve, Antiscorbu'tic.= _Syn._ CONSER'VA ANTISCORBU'TICA, L. _Prep._ (Selle.) Horse-radish, water-cress, and water-trefoil, orange-juice, and radish-juice, equal parts; powdered white sugar, q. s. to make a conserve. In scurvy, &c.

=Conserve of A''rum.= _Syn._ CONSER'VA A''RI, C. A. MACULA'TI, L. _Prep._ From fresh arum tubers (cuckow-pint or wake-robin), 1/2 lb.; sugar, 2-1/2 lbs. As a diuretic and attenuant in dropsy, or as an expectorant in chronic coughs.--_Dose_, 1/2 teaspoonful, gradually increased.

=Conserve of Broom.= _Syn._ CONSER'VA SCOPA''RII, L. _Prep._ (Van Mons.) Broom flowers, 1 part; sugar, 2 parts.--_Dose_, 1/2 to 2 teaspoonfuls, 2 or 3 times a day; in dropsy, gout, rheumatism, &c.

=Conserve of Hips.= See CONFECTION.

=Conserve of Lavender.= _Syn._ CONSER'VA LAVENDU'LÆ, L. Lavender flowers, 1 part; powdered lump sugar, 3 parts; beaten together to a smooth paste. Used to sweeten the breath. In a similar way conserves are made from various other leaves and flowers; but mostly with only twice their weight of sugar, when they are not very odorous or active.

=Conserve of Lem'on Peel.= _Syn._ CONSERVA LIMO'NIS, C. L. CORT'ICIS, L. As CONFECTION OF ORANGE PEEL.

=Conserve of Mal'lows.= _Syn._ CONSER'VA MAL'VÆ, L. From the flowers, as CONSERVE OF LAVENDER.

=Conserve of Or'ange Peel.= See CONFECTION.

=Conserve of Pep'permint.= See CONFECTION.

=Conserve of Rose'mary.= _Syn._ CONSER'VA ROSMARI'NI, L. As CONSERVE OF LAVENDER.

=Conserve of Roses.= 1. See CONFECTION.

2. (ACIDULA'TED CONSERVE OF ROSES CONSER'VA RO'SÆ AC'IDA, L.) _Prep._ (Hosp. F.) Confection of roses and powdered gum, of each 1 oz.; sulphuric acid, 1 dr. to 1-1/2 dr.; (diluted with) water, 2 dr. An excellent substitute for tamarinds.

=Conserve of Sav'in.= _Syn._ CONSER'VA SABI'NÆ, L. _Prep._ (Ph. Han.) Fresh savin, 1 part; sugar, 2 parts. As an emmenagogue, in amenorrh[oe]a, &c. Three parts of sugar make a better conserve.

=Conserve of Scurvy Grass.= _Syn._ CONSER'VA COCHLEA''RIÆ, C. C. HORTEN'SIS, L. _Prep._ (Ph. Aust. 1836.) Fresh scurvy grass, 1 lb.; sugar, 3 lbs. Stimulant and antiscorbutic.

=Conserve of Sea Worm'wood.= _Syn._ CONSER'VA ABSINTH'II MARITI'MI, L. _Prep._ (Ph. L. 1788.) From sea wormwood, as the last. As a stomachic bitter and vermifuge; in dyspepsia, &c.

=Conserve of Sloes.= _Syn._ CONSER'VA PRU'NI SYLVES'TRI, L. _Prep._ (Ph. L. 1788.) From the pulp of the fruit, 1 part; sugar, 3 parts. Astringent. Useful in simple diarrh[oe]a, &c.; either alone or combined with chalk.

=Conserve of Squills.= _Syn._ CONSER'VA SCIL'LÆ, L. _Prep._ (Ph. L. 1788.) Fresh squills, 1 oz.; sugar, 5 oz. Diuretic, attenuant, and expectorant; in dropsy, chronic coughs, &c.--_Dose_, 10 to 20 gr.

=Conserve of Tam'arinds.= _Syn._ CONSER'VA TAMARIND'ORUM, L. _Prep._ (P. Cod.) Tamarind pulp, 2 oz.; white sugar, 3 oz.; evaporate by the heat of a water bath to the consistence of honey.

=Conserve of Vi'olets.= _Syn._ CONSER'VA VIO'LÆ, C. V. ODORA'TÆ, L. _Prep._ (Soubeiran.) Flowers, 1 part; sugar, 3 parts; beat to a paste. Demulcent and laxative; used as a purge for infants, and by ladies to perfume the breath.

=Conserve of Wa'ter-cress.= _Syn._ CONSER'VA NASTUR''TII, L. _Prep._ (Ph. Græca, 1837.) From fresh water-cresses, as the last. In scurvy; taken _ad libitum_.

=Conserve of Worm'wood.= See CONSERVE OF SEA WORMWOOD.

=CONSTIPA'TION.= _Syn._ CONSTIPA'TIO, OBSTIPA'TIO, L. Surgeons distinguish between costiveness and constipation. The first applies to that condition of the body in which the bowels act tardily, and in which the fæces are abnormally and inconveniently indurated; the last implies the absence of the proper alvine evacuations. The one rapidly undermines the health; the other destroys life in a period varying from a few days to three or four weeks. In popular language, however, the words are frequently used synonymously. The use of bread containing alum, and water containing much lime (very hard water), and especially the want of sufficient exercise, are common causes of constipation.

_Treatment._ When the affection is merely accidental or occasional, a dose of some aperient or cathartic is the only treatment necessary; but when it is habitual it calls for further attention. Great benefit may generally be secured by adopting a diet free from astringents, and consisting of a large portion of green vegetables and ripe fruit; particularly avoiding the use of over-cooked, salted, or dried animal food. Brown bread may be eaten, as it acts as a gentle laxative, from the bran it contains. The occasional use of aperient and emollient enemata may be had recourse to; but their habitual administration, as well as that of purgative medicines generally, by the mouth, is not to be recommended. The bowels, accustomed to the continual use of stimulants, act but languidly or scarcely at all without their application. In females, especially of the higher classes, the want of proper exercise is commonly the chief cause of this affection. With such persons a short walk, two or three times daily, will often do wonders, particularly if a little ripe fruit, a few raisins or tamarinds, or, still better, 2 or 3 drum figs, be occasionally eaten. In some cases of obstinate constipation a cold-water dressing, placed over the pit of the stomach or the abdomen, will cause the bowels to act in the course of an hour or two. When the inactivity of the bowels arises from a deficiency of bile (one of the most common causes), no remedy is more natural, or more effective, than inspissated ox-gall. In cases complicated with nervous, hypochondriacal, or hysterical affections, in chlorosis, dyspepsia, depraved appetite, and numerous other ailments, this remedy frequently succeeds, after the most active articles of the materia medica have been tried in vain.

In the treatment of the constipation of infants, castor-oil (1/2 teaspoonful occasionally), or manna 1/4 to 1/2 oz., sucked at will, may be given. The introduction (very gently) of a little slip of writing paper, parsley stalk, or suet, is a method sometimes adopted successfully by nurses. Friction on the stomach and bowels with the warm hand, or a piece of soft flannel, should also be employed. See GALL, PURGATIVE, &c.

_Treatment for Animals._ Mr Finlay Dun prescribes laxative clysters, aloes, or oils. Calomel for horses; croton and gamboge for cattle. Salts, calomel and jalap, castor oil, linseed oil, and emetics for carnivora. Oil of turpentine by mouth or rectum; clysters of tobacco, nux vomica, electricity.

_Treatment for Horses._ When the animal is constipated administer 4 dr. of aloes and 1 dr. of calomel, rubbed down with gruel; inject soap and water every hour, taking care to let the horse have walking exercise, and to apply friction to the belly. If, after twelve hours, no effect is produced, let the aloes and calomel be repeated, with the addition of three or four drops of croton oil and a wine-glassful of spirit of nitre, ether, gin, or whisky.

=CONSTITUTION BALLS=, Vegetable (A. H. Bôldt). Two parallelopiped hard brown balls, each of which weighs 58 grammes, and is made by melting together 2 parts of aloes and 1 part coarsely powdered gentian. (Hager).

=CONSUMP'TION.= See PHTHISIS.

=CONTA'GION.= By 'contagion' is usually meant the communication of disease by means either of actual contact or through a medium, such as the air. By some a contagious disease is regarded as one arising from direct contact only, in contradistinction to an infectious one, which is believed to act at a distance. See DISINFECTANT.

=CONTU'SION.= A hurt, or injury to the flesh, such as might be caused by a blunt instrument or by a fall, without breach or apparent wound. For treatment, see BRUISE.

=CONVALESCENCE.= Convalescence may be described as the period between the cessation of an attack of serious illness and the restoration, if not to a perfect, to an accustomed state of health. Convalescent patients should particularly guard against excess in eating or drinking, or unnecessary and imprudent exposure to cold or damp weather, during this interval, as well as against premature exertion of the limbs or voice; such and all of which are acts of imprudence that may give rise to a return of the disease. In order to avoid this latter risk, as well as to aid in complete recovery, repose both of body and mind are generally needed, more particularly in the earlier stages of convalescence.

It should be borne in mind that convalescents from many infectious diseases, such as measles, scarlet fever, smallpox, typhus, &c., are much more likely to propagate these diseases than when they are labouring under them in the acute form. During the period of their recovery the skin and other organs are throwing off the poison in large quantities, and thus exposing those in contact with, or in the near neighbourhood of the convalescent, to the great and imminent risk of contagion. Even if not contagious himself, the convalescent's clothes, if they be the same as those worn by him during his illness, may also convey the disease.

=CONVULSIONS.= Spasmodic contractions of the muscles producing motions of the limbs, generally accompanied with unconsciousness. Convulsions occur at all periods of life, but in adults they are only symptoms of other diseases. In children they are very common. They are of frequent occurrence in teething; and a swollen and inflamed state of the gums is said to excite them. Dr Gardner, in his very useful work, 'Household Medicine,' says they may be brought on by "improper food, _e.g._ the milk of a nurse suffering from some violent emotion. At the siege of Berlin nearly all the suckling children died of convulsions." They may also be induced by feverish attacks, hooping-cough, strong purgatives, or suppressed eruptions. In the case of a dangerous attack of convulsion no time should be lost in sending for a medical practitioner. Pending his arrival, the patient should be placed as promptly as possible in a hot-water bath. A better plan is to loosen all the dress, to place the child across the arms, and sway it up and down gently, and to allow cool air to play on the face and chest; give an enema of soap and water, and apply mustard plasters for a few seconds only to the pit of the stomach. If these fail to give relief, apply leeches (number according to the age) to the temples, and cold to the head. Lance the gums if inflamed. When the fit is over keep the head cool. If there have been white stools, give a grain or two of calomel, and repeat it every three or four hours for three or four times until the stools become green or dark. Keep the bowels open by castor oil, and let the patient be put on a milk diet. The latter part of the above treatment is inserted for the benefit of the emigrant or other individual having no means of obtaining proper medical aid.

=COPAHINE.= Copaiba balsam made into a mass with wax and powdered cubebs, divided into hard egg-shaped pills weighing 5 decigrammes each and sugar coated.

=COPAHINE MEGE DE JOZEAU.= A fixed quantity of copaiba balsam is mixed with concentrated nitric acid, and constantly stirred as long as effervescence continues. The oxidised balsam is then washed, first with warm then with cold water, till the washings cease to have an acid reaction. From one part of this balsamum copaivæ acido nitrico correctum with 1/10 part powdered cubebs, 1/10 part bicarbonate of soda, 1/16 part calcined magnesia, with some mucilage, a mass is prepared and divided into oval pills, which are afterwards coated with sugar, mixed with gum and carmine.

=COPAI'BA.= _Syn._ COPAI'VA, COPAIVA BALSAM, CAPIV'I, BALSAM OF CAPIV'I; COPAI'BA (Ph. L. E. & D.), L.; BAUME DE COPAHU, Fr.; COBAIVA BALSAM, Ger. "The oleo-resin, of a brown colour, obtained by incision from the trunk of Copaifera multijuga." (B. P.) Most of the balsam of commerce is obtained from Para and Maranhao. It is packed in casks containing from 1 to 1-1/2 cwt. each, or in large bottles, or in cylindrical tin boxes.