Doron medicum, or, A supplement to the new London dispensatory in III books : containing a supplement I. to the materia medica, II. to the internal compound medicaments, III. to the external compound medicaments : compleated with the art of compounding medicines ... / by William Salmon ...

CHAP. XX. The Art of Compounding Medicines.

1. ALL Diseases what∣soever are cured by Medicaments (whe∣ther Simple or Compound) having a certain property, pecu∣liar appropriation, and a di∣stinct limited Temperament.

2. Therefore, When any Disease falls under Considera∣tion, in respect of Cure, you are to consider the means or nature of the Medicament by which it is to be removed, whether by alte∣ratives alone, or by medicines taking away something, or by medicines adding or restoring something: In order to which, if you have none so Artfully or Skilfully composed, as you desire, but must consti∣tute one anew, you must carefully observe the follow∣ing Rules.

3. Where Alteratives are only necessary, as in Diseases of Intemperature, you are to chuse such, as may alter the said Di∣stemper, by an opposite quality, in a certain and limited propor∣tion; and withal, by such medicaments, as (composing the said Temperament) may stronly Sympathize with the part afflicted.

Ex, gr. Suppose the Dis∣ease to be a Cephalalgia pro∣ceeding from a hot Distemper of the head: in this case you ought to use a Medicament cooling, and withal a Ce∣phalick, such an one as may be made of Lettice, Plantane,

White Poppies, Violets, Hous∣leek, &c. Suppose it should proceed from a cold Distem∣per: then you must use a Medicament healing, and sympathizing with the part as aforesaid, such as may be made of Peony, Spicknard, Be∣tony, Featherfew, Lavender, Bays, Pennyroyal, Rosemary, Anacardiums, Cubebs, Nut∣megs, &c. The like under∣stand of other parts afflict∣ed.

4. The next thing to be concluded on, is, the Degree of the Temperature in which the Medicament ought to be composed. If the Distemper be light, the Medicament need not exceed the first de∣gree, whether it be of Heat or Cold. If it causes great pain, but without Inflam∣mation, it may be composed to the second Degree of Cold. If the pain be so great, as to cause Inflamma∣tion or a Fever, you may ex∣alt it to the third degree of Cold: But if it be yet more outragious, as to cause a Frenzy, Delirium or Con∣vulsion, the Medicine ought to exceed to the 4th. degree.

5. Contrariwise, if the Dis∣ease proceeds of Cold: If it causes but a small Obstru∣ction and Stiffness, the Me∣dicament need not exceed the first degree of Heat: If it causes Numbness with∣all, you may compose it to the second Degree of Heat: If the cold Distemper be so great, as to induce an abso∣lute loss of Feeling, or en∣dangers a Palsie or Lethar∣gy, you may exalt it to the third negree of Heat: But if it be so extream as to en∣danger the Dead Palsie, or a Gangreen, you have a ne∣cessity to use things hot in the fourth degree.

6. The same Order and Difference you must observe in Passive Qualities of Dryness and Moisture, making choice of things dry, for Diseases moist, and things moist for Discases dry; withal, chosing such things as sympathize with the parts affected.

7. These things being con∣sidered, it now remains to shew how, according to Art, to com∣pose, to exalt, or to depress a Medicament to any degree pro∣posed: Or, to find out the ex∣act

Temperament of a Medi∣cine: Or lastly, to augment or diminish the Quantities of any of the Simples, keeping the desired Degree of its Qua∣lity; all which in the fol∣lowing Sections shall be ma∣thematically explicated and demonstrated at large.

8. First, To compose a Medicine proposed in any De∣gree of Quality whatsoever.

Let the Qualities ascend from 1. to 10. so that Tem∣perature may be equal to 5. as in the following Table you see: where the upper Figures may stand for dif∣ferences to the lower Quali∣ties, o. standing for Tem∣perate: the degrees hot and dry on the left Hand; those cold and moist on the right Hand: Setting down the Differences in order, from the highest degree of Heat; and then by Alligation al∣ternate, take the alternate difference from the Degree proposed.

Hot and dry.	9. 8. 7. 6. 5. 4. 3. 2. 1.	cold & moist.
4. 3. 2. 1. 0. 1. 2. 3. 4.

Ex. gr. Simples hot in 3. tem∣perate; cold in cold in 1.3. what quantities must be taken of each, to compose a Medicine cold in 2? Answer, 1 part hot in 3. 1. part temperate. 1. part cold in 1.6. parts cold in 3. See the Exam∣ple.

2 Cold	3 Hot.	3	8	1	1
0 Temp.	5	1	1
1 Cold.	4	1	1
3 Cold.	2	321	6

Exa. 2. Simples hot in 4. hot in 2. hot in 1. cold in 1. cold in 2. cold in 3. What quan∣tities of each will make a Me∣dicine Temperate? Answer. 3 parts hot in 4. 1. part hot

in 2. 2 parts hot in 1. 2 parts cold in 1. 1 part cold in 2. 4 parts cold in 3. as by the Operation you may see: Or by the second Operation, 3 parts hot in 4. 2 parts hot in 2. 1 part hot in 1. 1 part cold in 1. 2 parts cold in 2. 4 parts cold in 3. both ways the quantity of the Me∣dicine is 13.

Temp.	4 hot	5	••	3	Or thus	temp.	4 h.	5	9	3
2 hot	••	1	2 h.	7	2
1 hot	••	2	1 h.	6	1
1 cold	••	2	1 c.	4	1
2 cold	••	1	2 c.	3	2
3 cold	••	4	3 c.	2	4

9. Secondly, To find out the exact Temperament of a Medi∣cine, dispose the Simples in∣to one row, with their quan∣tities, against which set their qualities; then multiply each quantity by its own quality, and substract the Sum of the facts of hot from cold, moist from dry, or contrariwise, which divide by the Sum of Quantities; the Quota's are the resultment, which is always of the same with the greater Product.

Example 1. Tragea fortis Schroderi. ℞ Piperis nigri ʒxvj. cal. 4. sic. 4. Zinzibe∣ris ʒj. cal 3. sic. 3. Croci op∣timi, ʒj. cal. 2. sic. 1. Cary∣ophillorum ʒij. cal. 3. sic. 3. Galangae, ʒij. cal. 3. sic. 2. quid Temperamentum?

Hot	16 ʒ	4	64	81	(3 ¼ ½ Hot.
1 ʒ	3	3
1 ʒ	2	2
2 ʒ	3	6	22
2 ʒ	3	6
22	81

Dry	16 ʒ	4	64	78	(3 6/11 Dry.
1 ʒ	3	3
1 ʒ	1	1
2 ʒ	3	6	22
2 ʒ	2	4
	22		81

Answer.

• 3 11/22 deg. hot.
• 3 6/11 deg. dry.

See the Operation.

Examp. 2. What is the Temperature of a Medicine having Simples ʒvj. of one hot in 3. moist in 2. and ʒvj. of another, cold in 1. dry in 3?

Hot	6 ʒ	3	18	12	(1 hot.
Cold	6 ʒ	1	6	12
	12		12

Moist	6 ʒ	2	12	6	(½ dry.
Dry	6 ʒ	3	18	12
	12		6

Answer.

• 1 deg. hot.
• ½ deg. dry,

See the operation

The like Order you must observe as (in this second Ex∣ample) in other cases where the Medicament is more com∣posed.

10. Thirdly, To augment or diminish the Quality of a Medicine to any degree propo∣sed.

Alligate alternately the Quality of the Medicine proposed, with the degree of the Simple, with which you desire to raise or depress it: then say, as the higher Alternate different is to the lower, so the Quantity of the Medicine which you would raise or depress to the quantity of the Simple (whose quantity you alliga∣gated) which shall raise or depress the Medicine in qua∣lity, to the degree desired.

We will take the second Example at Sect. 8. whose quality is temperate, and raise it to one degree of Heat: what quantity must be added more of that which is hot in 4. to make the Augmentation of its Quality. Answer. ʒ 4 ⅔. as by Sect. 9. you may easily prove.

	6	5	3	Or thus.		1	0	3
9	1	4	1
3.	1.	13.	4⅓.	3.	1.	13.	4⅓.

11. Fourthly, To augment or diminish in quantity any Medicine, keeping its first pro∣portion and quality.

As the Sum of the quan∣tities of the Simples, is to the Augmentation or Dimi∣nution, so is the quantity of each particular to its Aug∣mentation or Diminution desired.

12. Fifthly, To find what quantity of any Ingredient is contained in any part of a Composition.

As the quantity of the. Composition to the part gi∣ven, so the quantity of the Ingredient in the whole, to the quantity contained in the part proposed: Or thus, As the quantity of the whole Composition, to the quantity of the Ingredient in the whole: the part proposed, to the quan∣tity of the said Ingredient, con∣tained in the said part.

13. If the Cure of the dis∣ease requires a Medicine, which may take away something, which we call Purgatives; you are to consider the part or parts afflicted, the matter afflicting: and by what ways and manner the diseased matter may be carried off.

14. From the Considera∣tion of the parts afflicted, you are to make choice of a pur∣gative, simpathizing with those parts, by cap. 11. sect. 10, & 11. From the morbi∣fick matter, the quality of the purging materials, by cap. 11. sect. 19. § 1. From the place, the kind of the Purge is known, or the way and mannor, by which the morbifick matter may be car∣ried out.

15. The first two Conside∣rations are fully discussed in cap. 11, and 12. aforegoing: the last only remains to be en∣enquired into; for some Dis∣eases require Catharticks, some Emeticks, some Diu∣reticks, some Sudorificks, some Ptarmicks, some Sa∣livaticks; and that accor∣ding either to the scituation or place of the Disease; or else according to the malig∣nity or contumacy of the Effect.

16. If the Seat of the Disease be in the upper Ven∣tricle or Head, Catharticks and Ptarmicks, chiefly solid Errhines, are of admirable use: If the matter lodges in the Bronchia of the Lungs, or the Stomach, an Emetick is required: If in the Guts or Bowels Cathartick Potions, and Clysters: If in the Reins or Bladder, Openers and Diureticks: If in the Joynts and extream parts, Cathar∣ticks, Emeticks and Sudori∣sicks: If in the habit of the whole Body, Sudorificks are of singular use; but chiefly after Salivation, or the o∣ther kinds of Purgation: If in the Mass of Blood, there is required the alternate use of Openers, Diureticks, and Sudorificks, whereby the se∣rous and windy matter is taken away, both by Urine and Sweat. Lastly, if the Seat of the Disease is in the Superficies of the Flesh or Skin, as in Apostems, Buboes, and the like, all manner of Purgation is to be forborn, except that which drives the matter outward; of which kind are all Diapho∣reticks.

17. If the Disease be con∣tumacious and malign, as the French Pox, Salivation, (if discrectly used) may be pro∣sitable; so also in some o∣ther stubborn and rebellious Diseases, as the Gout, Scia∣tica, &c. Catharticks effect much in diseases recent, and in such Bodies which have not been used to much Phy∣sick. But if the Disease i•• Chronick, or of long Stand∣ing, and deep rooted, especial∣ly in some remote part, as in an excruciating Sciatica, E∣meticks are of wonderful force (if aptly chosen) and sometimes perform Cures e∣ven

to a miracle. In Diseases of the Reins and Bladder, as also in a Hydrops, Diureticks seem to be the most proper Remedies: but in their use, you must be exceeding cautious, lest you bring fresh Coals to put out the Fire. First, open the passage by Apperitives. Secondly, make them very slippery with O∣leaginous things, such as are Oyl of Sweet Almonds, Nuts, &c. Thirdly, exhibit the Diuretick with an oily Body: lest the force of the Diuretick should heap up much matter together, and making the Obstructions greater, should kill instead of curing.

18. The Form of the Com∣position is to be chosen accor∣ding to the place of the Dis∣ease; Let it be solid (as in Pills and Troches) for Dis∣eases in remote parts: of a middle consistency, (as Syr∣rup, Lohoch, Quiddony) for Diseases of the Mouth, Breast and Lungs: Liquid for Diseases of the Stomach and Bowels: If this cannot be, you must follow the Fantasy of the Patient: But above all (if it may be) e∣very kind of Purge ought to be given in a liquid form, and in a Spirituous Menstru∣um, or Vehicle (such as are the Tinctures of Grulin∣gius) because that it is pro∣bable, the Powers and effi∣cacy of the Compositum, are thereby received into the Veins; which by reason of the fluidity of the Salts, and spiritous nature of the Ve∣hiculum, are united to the Spirits and Vehicles of the Blood, and so dilated through the whole sangui∣nous Mass; thereby indu∣cing Struglings, Combina∣tions, Fermentations, Pre∣cipitations, and Excretions of the morbifick matter: by which Diseases of parts at a great distance, viz. cu∣taneous Diseases, Leprosi••s, Gout, Sciatica's Struma's, Melancholly, Agues, &c. are oftentimes cured, beyond expectation.

19. The strength of the Ingredients are next to be con∣sidered, which is to be fitted to the Age, Sex and Strength of the Patient, with relation also to the Power and malig∣nity

of the Disease. If it be a Child or Woman-kind, or one of a weak Constitu∣tion, or the Disease is re∣cent, gentle, and without malignity; you may chuse Ingredients of a more weak and gentle operation: But if it be a man, or one of a robust and strong Body, or the Disease is chronick, rebellious, or contagious, you must chuse things more powerful and strong: If the Patient be weak, and the Disease strong, chuse things indifferent; yet ra∣ther let the Compositum re∣spect the weakness of the Sick, than the strength of his Disease, lest by endea∣voring to destroy the Mala∣dy, so great a Chasm be opened as to let out Life: In this case, let the Medica∣ment be made gentle (espe∣cially at first) then by de∣grees increase its force; and by long and many reitera∣ted exhibitions, perform that safely in length of time, which otherwise may not be attempted without ma∣ny doubts, and absolute ap∣parent Danger.

20. The Numbers of the Ingredients, are only to respect the several Intentions for which the Medicament is compound∣ed; and herein you are to ob∣serve, 1. That those intenti∣ons be not opposite one to ano∣ther, as the Mixtion of Pur∣gatives with Astringents, Scammony with Opium &c. 2. That the chief Intentions be drawn from the chief Sym∣ptoms or Indications of Cure; that the Medicament may dispose of the morbifick matter, that way which Nature most inclines to: As if the Stomach be op∣prest and soul, to vomit: If a Cephalalgia be accom∣panied with a great Cold, and Obstructions in the Head and Nostrils, to use solid Errhins: If Wind op∣press the Stomach, to use Aromaticks: If the Bowels, Carminatives, &c. 3. That the number of the Ingredients be not need••esly increased a∣bove the number of Intentions, to avoid as much as may be Heterogenity, and Confusion in the mixture. It is a great Folly and Vanity in many men, premiscuously to jum∣ble

up many things toge∣ther, as if thereby the Dis∣ease was only to be over∣come; whereas those Com∣positions, for want of an exquisite Judgment in chu∣sing each Ingredient, be∣come many times rather hurtful than helpful to the Patient; and that great Variety of Simples, being commonly of different Pro∣perties and Natures, of∣ten enervate and weaken the Powers and Forces of each other, which in the more simple Compositions there is no need to fear.

21. The Proportions of the Ingredients are sometimes to be determined by the gradati∣ons of their Temperature; of which we have spoken suf∣ficiently before, Sect. 8, 9, 10, 11, 12. and this is al∣ways to be considered when the Disease proceeds from a simple Intemperature. In all other cases the Proportions are to be determined according to the Judgment of the Physi∣cian. And herein he is to consider what he intends to make the Basis or Ground of his Composition (I mean) not in respect of the Body or Matter; but in respect of that Ingredient which an∣swers to his Principal In∣tention; As in a Hydra∣gogue Electuary designed a∣gainst Hydropical and wate∣ry Humors: I call not Ho∣ney the Basis of the Medi∣cament (though it be com∣monly of treble quantity to all the other Ingredients) but that particular Hydra∣gogue, which is principally designed to evacuate the se∣rous or watery humor. The chief material answer to the primary intententi∣on being found out, all the other particulars are to an∣swer to it, according to the exigency of those Cau∣ses which drew them into confederacy with the first.

22. The Dose of the Com∣positum is to be drawn from each particular constituting it, being a mean proportional between them all.

Exemp. gr. ℞ Sammony ℥jss. Coloquintida ℥j. Gutta Gamba, fine Aloes, A ʒvj Extract of black Hellebor. Turbith A ʒiiij. Agarick ʒij, Elaterium ʒj. ••r. mor Tarta∣ri

ʒx. Cloves, Nutmegs, Cin∣namon, Ginger, Anniseeds, A ʒiij. make all into fine Powder and mix them. What is the largest Dose of this Powder? First, consider the largest Dose, or near thereto, of each of the Cathartick in∣gredients singly, and you will find it to be of Scam∣mony about gr. xv. of Co∣locynthis ℈j. of Gutta gamba, gr. xv. of Aloes ℈ij. of extract of black Hel∣lebor ℈j. of extract of Tur∣beth ʒss. Agarick ℈ij. Ela∣terium gr. v. Secondly, find out how many of those Doses are contained in each particu∣lar. In the quantity of Scammony, you will have 48 Doses (for ℥jss = ʒxiij = gr. 720. which divided by gr. 15=48 doses:) In the Coloquintida, you will have 24 doses; (for ℥j = ʒviij = ℈xxiiij. or Doses:) In the Gutta Gamba, you will have 24 doses, in the Alocs 9 doses, in the black Hellebor 12 doses, in the Turbith 8 doses, in the Agarick 3 doses, in the Elaterum 12 doses: (the other Ingredi∣ents are put in but to cor∣rect the Purgers, &c.) Third∣ly, find out the Sum or Num∣ber of those several Doses, by adding them together: Scam∣mony 48. Colocynthis 24. Cambogia 24. Aloes 9. Hel∣lebor 12. Turbeth 8. Aga∣rick 3. Elaterium 12. All these being added together, make 140 doses. Fourthly, find out the Sum or Number contained in the whole Compo∣situm, Thus, ʒ 12 + 8 + 12 + 8 + 2 + 1 + 10 + 15 = 68 drams: These 68 multi∣plied by 60. the number of grains in a dram, produce a fact of 4080 grains, the Sum of the whole Composi∣tion. Fifthly, divide the number of Grains contained in the whole Composition, by the Sum or Number of the se∣veral Doses added together, so will the Quotus be the num∣ber of Grains for the largest Dose. So in this our Ex∣ample, the number of Grains in the whole Com∣positum, are 4080. the number of the Doses before accounted 140. by which, if you divide the said 4080. the Quotus will be gr. 29 1/7, or nearly gr. xxx. the lar∣gest

Dose, which is the thing required: from whence we conclude the aforesaid Me∣dicament may be given from gr. x. ad ʒss. according to the Age and Strength of the Patient: The like must be done in all other Com∣positions.

23. If the Disease requires Medicaments which restore something, these Intentions are necessary, 1. To open the Obstructions of the parts. 2. To strengthen the parts afflicted, chiefly the Sto∣mach. 3. To carry off the matter obstructing by Me∣dicines Oily, Balsamick, or Lenitive. 4. To nourish by strong Analepticks.

Hitherto we have only shewn the Art of Compound∣ing, by Precepts: In some of the Chapters immediately fol∣lowing; we will elucidate the same by manifold Exam∣ples.