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NOTICE

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IMPORTANT CHANGE IN THE STRENGTH OF OPIUM AND ITS PREPARATIONS.

The revision of the U. S. Pharmacopoeia of 1880, now just issued, makes a great increase in the strength of the officinal opium; and as it does not make a corresponding change in the proportions of the formulas for the preparations, these all become very much stronger, the principal liquid preparations being about one-half stronger.

In the instructions of the Convention to the Committee of Revision, see page xxii, the Convention directs that "in the liquid opium preparations, excepting paregoric, the strength of 10 per cent. shall be adopted, if found advisable." This has been found advisable and has been adopted, and had the strength of opium remained as before this change would have increased the strength of the preparations about 10 per cent., as stated in the "Table exhibiting differences of strength," found at page 454. But this statement, if regarded alone, is misleading, because this is not the entire difference in strength, nor the greatest difference. The real or entire difference is this one plus the difference in strength of the powdered opium used in the formulas; while the difference in strength of powdered opium is very indefinite in both Pharmacopoeias. It is only less indefinite in the new one because there it is possible to get an average strength, which average is about 40 per cent. above the minimum strength of the revision of 1870.

This change is a very much needed step in the right direction, and if it can be promptly made known and be generally recognized its advantages will soon be realized. There has always been much confusion and uncertainty in the strength of opium and its prepara

tions, because the strength of the officinal opium was so indefinite, and for a time this confusion may be increased; but if the new Pharmacopoeia be followed, the results must be important in the interest of more accurate medication by this very important drug. The Pharmacopoeia of 1870 says that its "opium when dried at 212° until it ceases to lose weight, should yield at least 10 per cent. of morphia by the officinal process." This "officinal process" is the Staples process, which, although by no means the best process of assay, does, under careful management, give account of nearly all the morphia. A powdered opium slightly above this 10 per cent. standard gives, by the 1870 formulas, to officinal Tincture, and Deodorized Tincture of Opium a strength of 4 grains of morphia, equivalent to 5.33 grains of crystallized sulphate of morphia in each fluidounce, and this has been considered to be the officinal strength of these preparations, and has been adopted in the practice of the writer for many years, the Compound Solution of Opium being made of this same strength.

The present Pharmacopoeia of 1880, just issued, says its powdered opium "should contain not less than 12 nor more than 16 per cent. of morphine when assayed by the process given under opium."

This process of assay in the hands of this writer, and probably in the hands of most other pharmacists, does not give an account of all the morphia in opium by from 1 to 2 per cent. So that the true application of the Pharmacopoeia definition in ordinary practice gives an opium which really contains 13 to 17 per cent. of morphia, the average being 15 per cent. But if its preparations be made by its new formulas, a 12 per cent. powder will give them 5.44 grains of morphia in each fluidounce, while, if a 16 per cent. powder be used, the preparations will contain 7.25 grains, a difference much too great for any accurate therapeutic application. Hence the adoption by the writer of a uniform and definite intermediate proportion of 6 grains in each fluid ounce, equivalent to 7.5 grains of sulphate of morphia; and this is just one-half more than the old standard of 4 grains in each fluidounce. The new standard gives one grain of morphia in each 80 minims, or one grain of sulphate of morphia in each 64 minims, making 16 minims the equivalent of a quarter of a grain of the sulphate.

This uniform proportion will give very effective and accurate preparations well adapted to that precision of dosage that best guards against over-effects.

If heretofore the full anodyne dose of Tincture, Deodorized Tinc

ture, or Compound Solution of Opium, has been 24 minims, or say 38 drops, representing a quarter of a grain of sulphate of morphia, the corresponding dose of the new preparations will be 16 minims, or say 25 drops.

This is a large and important change of dose, and, although not perhaps very dangerous under ordinary circumstances if unrecognized, yet it would add its hurtful effects to the too common overdosing by opium and its preparations, and headaches, nausea, etc., would be more severe.

It is now, of course, more important than ever that the label of every package of opium and its preparations should give the morphia strength of its contents; and each pharmacist and physician should carefully examine the labels to know just which they are dispensing and prescribing, whether the 1870 or the 1880 preparations. In the use of powdered opium they have long been subjected to variations as great as these without knowing it, but the liquid preparations, which are far more largely used, were rarely over 4 grains to the fluidounce, and were generally below this. And it is possible, if not very probable, that in common practice they will continue to be of such strengths, despite the authority of the Pharmacopoeia, and the labels will not have the strength stated. on them.

There are, however, many pharmacists who, with the writer, will strive to uphold the present change of standard, and who, as their old stocks of the former strength give out, will replace them by the new with revised labels.

Of course, a pound bottle of the new preparations will be equal to a pound and a half of the old, and will cost as much, but there will be a saving in the cost of bottles, transportation and storage room, and the country practitioner will carry a better supply in his pocket case. But by far the greatest advantages will be the smaller dose and improved accuracy of the preparations, and therefore the improved medication under their use, whilst no serious accidents need occur if ordinary caution be taken.

In physicians' prescriptions where, for example, Deodorized Tincture of Opium is ordered, the figures "1870" or "1880 " should be added, and he should give his dispensing pharmacist the liberty of using whichever preparation he might have in the proper proportion of 1 to 1 until the change becomes established. That is, it 24 minims of the 1870 should be ordered, the pharmacist should

use instead 16 minims of the 1880 if he happens to have the new and not the old strength.

As the old preparations and the new are identical, excepting the morphia strength, it is only necessary to dilute two measures of the new preparations with one measure of menstruum to reduce them to the exact strength of the old preparations.

For diluting the Tincture of Opium, or the Deodorized Tincture of Opium, diluted alcohol should be used.

For diluting the Compound Solution of Opium alcohol should be used.

It will, of course, be some time before the new strengths get into anything like general use, but it is to be reasonably expected that the careful and thoughtful physicians and pharmacists will at once seek to avail themselves of them, and the sooner the better if with due care and knowledge.

This note is hastily written in order to publish it at the earliest opportunity, the whole object being to give prompt notice that all opium preparations made in strict accordance with the new Pharmacopoeia of 1880 will be about one-half stronger than they were formerly, and that this writer will so make them.

Although, by courtesy of the Committee of Revision, the proof sheets of the new revision passed through the writer's hands before the publication of the work, he failed to realize the extent of this change until he came to make the preparations in question by the new formulas, which are now authoritative for strength.

It is, therefore, not improbable that others might overlook them, and hence the utility of a prominent and prompt notice, and it is hoped that the medical and pharmaceutical journals will at once give the subject a prominent place in their pages.

EPIDERMIC MEDICATION.

Epidermic medication as here considered is not medication of the skin for diseases of the skin, but medication by absorption through the healthy skin in contradistinction to medication by absorption through the mucous membranes of the primæ viæ, and in contradistinction to hypodermic medication. Epidermic medication

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