Diuretics.

Refrigerant Diuretics.

Potassium Salts, (See page 66),—especially the Acetate, Bitartrate, Carbonate, Citrate and Nitrate. They should be largely diluted with water, that fluid of itself having very considerable diuretic power.

Potassii Acetas, Potassium Acetate,—Dose, gr. x-xxx.

Hydragogue Diuretics.

Spiritus Aetheris Nitrosi, Spirit of Nitrous Ether, Sweet Spirit of Nitre, (See page 137);—is diuretic in a dose of ʒij-iv, but is generally employed as an adjuvant to more powerful agents of the same class.

Mistura Glycyrrhizae Composita,—contains 3 per cent. of it.

Digitalis, Foxglove, (See page 104),—as a diuretic, gr. iij of the powdered drug daily, in divided doses, increased by a grain daily. The infusion may be used in corresponding doses. A poultice of ℥j of the fresh leaves, over the abdomen, for eight hours, will also be efficient.

Infusum Digitalis, Infusion of Digitalis,—Dose, ℥ss-j, twice daily.

Scilla, Squill, (See page 112),—Dose of the powdered drug, gr. j-iij.

Tinctura Scillae,—Dose, ♏︎v-xxx.

Acetum Scillae,—Dose, ♏︎x-ʒj.

Scoparius, Broom, (See page 111),—also its alkaloid Sparteine.

*Decoctum Scoparii, (℥j to the pint),—Dose, ℥j every 3 hours.

*Sparteinae Sulphas, Sparteine Sulphate,—Dose, as a diuretic, gr. j-iij, thrice daily; for cardiac action, gr. 1/16-¼.

Strophanthus, (See page 107),—Dose, of the tincture (1 in 20) ♏︎v-x, or ♏︎ss-ij, frequently repeated; of Strophanthin, gr. 1/120-1/60.

Cimicifuga, (See page 109),—Dose of the tincture, ♏︎xv-ʒj.

Convallaria, (See page 110),—Dose of the infusion, ℥ss-ij.

Cocaine, (See page 126),—Dose of the Hydrochlorate, gr. ⅛-¼.

Caffeine, (See page 128),—the Citrated Caffeine in doses of gr. v.

Hydrargyrum, (See page 78). The Mild Chloride a very efficient diuretic, especially in cardiac affections; dose, gr. ss-j. The Hydrarg. cum Creta, with Pulv. Digitalis and Pulv. Scillae, gr. j of each, in pill thrice daily, is a classical and efficient diuretic.

Stimulant Diuretics.

Apocynum, Canadian Hemp,—the root of Apocynum cannabinum. Is a valuable diuretic in doses of gr. xv; in larger doses it is a hydragogue cathartic and an emetic. It has been used with benefit in anasarca and ascites. The active principle, Apocynin, is a good expectorant in ¼ to ½- grain doses.

Buchu, the leaves of Barosma betulina and other species of Barosma. Contains a Volatile Oil, and perhaps Barosmin, a bitter principle.

Extractum Buchu Fluidum, ♏︎x-ʒj.

*Infusum Buchu, ℥ss-ij.

Capsicum, Cayenne Pepper,—the fruit of Capsicum fastigiatum. Contains Capsicin, a peculiar liquid principle; also a Volatile Alkaloid.

Oleoresina Capsici, ♏︎j-v.

Tinctura Capsici, ♏︎x-ʒj.

Extractum Capsici Fl., ♏︎v- ʒss.

Emplastrum Capsici.

Chimaphila, Pipsissewa,—the leaves of Chimaphila umbellata. Contain Chimaphilin, a crystalline principle, also Arbutin, Tannin, etc.

Extractum Chimaphilae Fluidum,—Dose, ʒss-ij.

Copaiba, Balsam of Copaiba,—the oleo-resin of various species of Copaifera. Contains a Volatile Oil and a Resin composed chiefly of Copaibic Acid. Differs from the true balsams in that it contains no Cinnamic Acid.

Massa Copaibae, Dose, gr. x-ʒj.

Oleum Copaibae, Dose, ♏︎v-xv.

Cubeba, Cubeb,—the unripe fruit of Piper Cubeba. Contains Cubebin, a neutral principle, a Volatile Oil which may be separated into Cubebene, a camphor, and Cubeben; also a Resin which contains Cubebic Acid.

Oleoresina Cubebae, ♏︎v-xxx.

Oleum Cubebae, ♏︎v-xx.

Tinctura Cubebae, ʒss-ij.

Trochisci Cubebae, j-iij.

Extractum Cubebae, Fluidum, ♏︎v-xxx.

Juniperus, Juniper,—the fruit of Juniperus communis. Contains Juniperin, a non-crystalline principle, also a Volatile Oil, etc.

Oleum Juniperi, ♏︎v-xx.

Spiritus Juniperi, Dose, ʒj-iv, or ℥j.

Spiritus Juniperi Compositus, Gin,—Dose, ʒj-iv, or ℥j.

Oleum Cadini, Oil of Cade, Empyreumatic Oil of Juniper,—locally.

Matico, the leaves of Piper angustifolium. Contain a Volatile Oil and a Resin, also Artanthic Acid, and Tannin.

Extractum Matico Fluidum, ʒss-ij.

Tinctura Matico, ℥ss-ij.

Pareira, Pareira Brava,—the root of Chondodendron tomentosum. Contains Buxine, an alkaloid principle, also called Cissampeline, or Pelosine.

Extractum Pareirae Fluidum,—Dose, ʒss-j.

Piper, Black Pepper, the unripe fruit of Piper nigrum. Contains Piperin, a feeble principle (official), also a Resin and an Essential Oil.

Oleoresina Piperis, ♏︎¼-j.

Piperinum, Piperin,—Dose, gr. j-x.

Taraxacum, Dandelion,—the root of Taraxacum officinale. Contains two principles,—Taraxacin, bitter, amorphous; and Taraxacerin, crystalline. The French call it "Pissenlit."

Extractum Taraxaci,—gr. v-xxx.

Extr. Taraxaci Fl.,—ʒj-℥j

Uva Ursi, Bear-berry,—the leaves of Arctostaphylos Uva-ursi. Contain Tannic and Gallic acids, and three principles—Arbutin, neutral, bitter, crystalline; Ericolin, bitter, amorphous; and Ursone, neutral, tasteless, and crystalline. Dose of the powdered leaves, gr. x-ʒj.

Extractum Uvae Ursi Fluidum,—Dose, ♏︎x-ʒj

Zea, Corn Silk, (Stigmata Maydis),—the styles and stigmas of Zea Mays, the Maize or Indian Corn. It is diuretic, demulcent and antiseptic, and is highly recommended in cystitis, as a mild diuretic in cardiac and renal affections, and as a corrective of nocturnal incontinence of urine. Dose, of the fluid extract, ʒj-ij,

Physiological Action of Diuretics. The Refrigerant Diuretics modify rather than increase the urine, and exercise a sedative action upon the heart and circulation. Used to excess they depress the heart and impoverish the blood. Potassium Chlorate is a decided renal irritant, and should never be used as a diuretic. Hydragogue Diuretics increase the water of the urine largely, and in general act by raising arterial pressure, either—(a) throughout the body, or (b) locally in the kidneys. This they accomplish in various ways, direct and indirect,—increasing the action of the heart,—contracting the efferent vessels so as to raise the pressure in the glomeruli,—dilating the afferent vessels, etc. The Stimulant Diuretics are largely eliminated by the kidneys, and act upon the entire genito-urinary mucous membrane by local irritation, which in excess causes inflammation and symptoms of a violent character, as strangury, bloody urine, etc. All the members of this group should be used with great caution.

Therapeutics of Diuretics. These agents are employed in medicine for certain definite purposes, viz.:—(1), to remove fluid from the tissues and cavities of the body in cases of dropsy;—(2), to promote the elimination of waste-products and other poisons from the blood;—(3), to maintain the action of the kidneys;—and (4), to dilute the urine, and to alter morbid conditions of that excretion. For the last-named purpose, the best agent is Distilled Water, acidulated with CO₂. For use in—

Dropsies from Cardiac Disease,—the most efficient diuretics are Digitalis and its congeners, also Caffeine, Squill, etc., which act on the general vascular system. Their action is always aided by a little Massa Hydrargyri.

Dropsy from Renal Disease,—Broom, Juniper and Nitrous Ether, are the most reliable diuretics.

Dropsy from Cirrhosis of the Liver,—Copaiba is the best of the diuretics, when the kidneys are healthy.

Elimination of Waste-products from the blood,—Potassium salts, especially the Nitrate and Bitartrate,—also Juniper, Caffeine, etc.

As Adjuvants to Diuretics, when pressure on the uriniferous tubules, or venous congestion, prevent their action,—paracentesis abdominis, purgation, cupping over the loins, and even venesection, are often necessary to start the action.

A Compend of Materia Medica, Therapeutics, and Prescription Writing, 1902, by Sam'l O. L. Potter, M.D., M.R.C.P.L.