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Related article: Rowntree). (The fate of the phthaleins is also discussed by Kastle, 1906.)
Toxic Effects. Only a few doubtful cases are on record (Holz, 1905; Best, 1906;
Zabel, 1911; Orland, 1913, etc.). These presented phenomena of intestinal irritation,
always ending in recovery. Hydrick, 1914, claims that even 0.05 to 0.15 Gm. produce
quite constantly a slight albuminuria, lasting one to three days. On the other hand,
very large doses have often been given without bad effects: to man, several grams by
mouth, 0.5 Gm. subcutaneously; to dogs, 1.25 Gm. per kilogram.
Administration. Phenolphthalein may be taken in the evening, as
powder, capsules, or lozenges, in doses of o.i to 0.2 Gm., i^ to 3 gr.; for
bed-ridden patients, 0.5 Gm., 8 gr.; for children, 0.03 Gm., Y^ gr. These
smaller doses soften Cheap Acyclovir and regulate the stools for several days, with little
or no colic. Large doses are hydragogue.
PREPARATIONS PHENOLPHTHALEIN
* Phenol phthaleinum (Phenolphthal.), U.S.P., Cheap Acyclovir B.P.; Phenolphthalein (Dihydroxy-
phthalophenone), (C6H 4 OH) 2 CO.C6H4CO. White crystalline powder, odorless and
tasteless. Almost insol. in water, sol. in ale. (1:13). Dose, 0.15 Gm., 2^ gr., U.S. P.;
0.12 to 0.3 Gm., 2 to 5 gr., B.P.
Phenolsulphonephthalein, N.N.R. The preceding, with CO replaced by SO 2 . Dose, Cheap Acyclovir
6 mg., as test of kidney function (for details, see X.N.R.).
BILE
The administration of bile or bile salts ^sodium glycocholate and tau-
rocholate) stimulates the secretion of bile (Pfaff and Balch, 1897), increases
172 MANUAL OF PHARMACOLOGY
peristalsis (Stadelmann, 1896); acts as antiseptic (Limbourg), and facili-
tates the digestion of fat. They have been advocated in obstructive
jaundice Cheap Acyclovir and in biliary fistulas; but their effects are not very pronounced.
Added to enemas, bile is used as a laxative against impacted feces and
against ascaris, but has little advantage over soap.
Peristalsis. On excised small intestines, or large, bile or bile salts produce mainly
depression (Ott and Scott, 1909; d'Errico, 1910); but the large intestines may be stim- Cheap Acyclovir
ulated (Schuepbach, 1910). In man, evacuation is assured especially by enemas, but
also by oral administration (Glaessner and Singer, 1910).
Excised Uterus. Bile and bile salts, in moderate concentrations, increase the con-
tractions of the pregnant, not of the virgin uterus. High concentrations inhibit (Can-
toni, 1914).
Toxic Actions. Bile is non-toxic by mouth, but when injected into the circulation
(Meltzer and Salant, 1905, 1906; Bunting and Brown, 1911) it produces severe nervous
and cardiac depression (Brandenburg, 1903; Glur, 1909) and hemolysis. It is also
directly toxic to Cheap Acyclovir muscle and nerve. J. H. King and H. A. Stewart claim that the pig-
ments are mainly responsible for the circulatory effects. However, bile-acids are highly
toxic. Small doses stimulate the vagus center; larger doses depress the heart directly,
with slow irregular pulse and low blood pressure. They also produce depression of the
medullary centers, coma and paralysis; and hemolysis and cell destruction.
Bile Salts in Gonorrhea. Loehlein, 1909, introduced the local injection of bile
salts in the acute stage for destroying the gonococci. V. Hofmann, 1912, found that i
to 2 per cent, had little effect; 5 to 10 per cent, gave better but only temporary results-
These were improved by following with silver injections, or by using a soluble silver-
bile acid compound.
PREPARATIONS BILE
Pel Boms, U.S.P.; Oxgall. The fresh bile of Bos taurus.
Pel Bovimtm Purificatum (Fel Bov. Pur.), B.P.; Purified Ox Bile. An evaporated
alcoholic extract. Dose, 0.3 to i Gm., 5 to Cheap Acyclovir 15 gr., B.P.; as enema, 1:50.
* Extractum Fellis Bovis (Ext. Fel. Bov.) U.S.P.; Extract of Oxgall (Purified Oxgall).
An alcoholic extract of bile, evaporated and mixed with starch; i Gm. representing
8 Gm. of Oxgall. Very bitter yellow powder. Dose, o.i Gm., i% gr., U.S. P., in pills
or formaldehyd-hardened capsules. As enama 2%.
Bile Sails, N.X.R. The various commercial preparations are used as pills, generally
0.05 to 0.5 Gm., % to i gr.; or better as suppositories, in the same dosage.
CASTOR OIL
This consists mainly of the triglycerid of an unsaturated fatty acid,
Ricinoleic Cheap Acyclovir acid. The neutral fat is not active, but becomes so when it is
saponified in the intestine. The cathartic effect is due mainly to motor
stimulation of the small intestine. The intestinal secretion is not in-
creased, the fluid character of the stools being due to the quicker passage
of the feces.
With the usual dose, ^ to i ounce, the response is certain and complete,
resulting in a few hours in one or two extensive semifluid stools, with but
little hyperemia or irritation, there being little or no colic. The evacua-
tion is so complete that there may be some after-constipation. It is es-
pecially suited to the treatment of acute constipation or acute diarrhea
from dietetic errors, ptomain and other poisoning, etc. It is less useful
for continuous use, since this may produce gastric disturbance. There is
some pelvic congestion, so that it is avoided during menstruation and
pregnancy.
Mechanism of Action. This has been studied with x-ray by Magnus, 1908, and his
observations have been confirmed on man. The pure oil delays slightly the passage
through the stomach (as do other neutral oils). Rancid oil hastens the gastric expulsion.
In the small intestine, the segmenting movements and peristalsis are greatly increased,
VEGETABLE CATHARTICS 173
so that the expulsion may be completed in two hours instead of the normal eight hours.
In the colon, the normal antiperistalsis is allayed, so that the feces escape concentration.
The propulsive movements of the colon are not much increased, but the passage of the
fecal material is hastened by its thinner consistency.
In China it Is used as an article of diet. The properties of Castor Oil were known
to Herodotus; but Croton Seeds were first described in the middle of the sixteenth century.
Administration. It is best given on an empty Cheap Acyclovir stomach an hour before breakfast.
The taste may be somewhat disguised by wetting the mouth with hot coffee or milk,
and giving the oil floating in these liquids, so that it will not be so adherent. The
after-taste may be mitigated by peppermint or bread. It is sometimes preferred in
emulsions: N.F., 33 per cent.; B.P. (Mistura), 40 per cent., flavored with orange flower
and cinnamon. The soft gelatin capsules are the only tasteless method; but since the
ordinary size contains only i c.c., it is difficult to administer Cheap Acyclovir an effective Cheap Acyclovir dose. (For
other methods, see J.A.MA., 60:1174.)
PREPARATIONS CASTOR OIL
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