Hypodermic Health Dictionary

Adrenaline is the secretion of the adrenal medulla (see ADRENAL GLANDS). Its e?ect is similar to stimulation of the SYMPATHETIC NERVOUS SYSTEM as occurs when a person is excited, shocked or frightened. In the United States Pharmacopoeia it is known as epinephrine. It is also prepared synthetically. Among its important effects are raising of the blood pressure, increasing the amount of glucose in the blood, and constricting the smaller blood vessels.

Adrenaline has an important use when injected intramuscularly or intravenously in the treatment of ANAPHYLAXIS. Many patients prone to this condition are prescribed a pre-assembled adrenaline-containing syringe and needle (Min-i-Jet, Epipen) and are taught how to self-administer in an emergency. Adrenaline may be applied directly to wounds, on gauze or lint, to check haemorrhage; injected along with some local anaesthetic it permits painless, bloodless operations to be performed on the eye, nose, etc. Nowadays it is rarely, if ever, used hypodermically and is no longer given to treat ASTHMA. In severe cardiac arrest, adrenaline (1 in 10,000) by central intravenous injection is recommended. It can be given through an endotracheal tube as part of neonatal resuscitation.... adrenaline

A small glass container having one end drawn out into a point capable of being sealed so as to preserve its contents sterile. It is used for containing solutions for hypodermic injection.... ampoule

A pre?x meaning below, under, or less than normal: for example, hypotension (low blood pressure) and hypodermic (under the skin).... hypo

Medicines are drugs made stable, palatable and acceptable for administration. In Britain, the Medicines Act 1968 controls the making, advertising and selling of substances used for ‘medicinal purposes’, which means diagnosing, preventing or treating disease, or altering a function of the body. Permission to market a medicine has to be obtained from the government through the MEDICINES CONTROL AGENCY, or from the European Commission through the European Medicines Evaluation Agency. It takes the form of a Marketing Authorisation (formerly called a Product Licence), and the uses to which the medicine can be put are laid out in the Summary of Product Characteristics (which used to be called the Product Data Sheet).

There are three main categories of licensed medicinal product. Drugs in small quantities can, if they are perceived to be safe, be licensed for general sale (GSL – general sales list), and may then be sold in any retail shop. P (pharmacy-only) medicines can be sold from a registered pharmacy by or under the supervision of a pharmacist (see PHARMACISTS); no prescription is needed. P and GSL medicines are together known as OTCs – that is, ‘over-thecounter medicines’. POM (prescription-only medicines) can only be obtained from a registered pharmacy on the prescription of a doctor or dentist. As more information is gathered on the safety of drugs, and more emphasis put on individual responsibility for health, there is a trend towards allowing drugs that were once POM to be more widely available as P medicines. Examples include HYDROCORTISONE 1 per cent cream for skin rashes, CIMETIDINE for indigestion, and ACICLOVIR for cold sores. Care is needed to avoid taking a P medicine that might alter the actions of another medicine taken with it, or that might be unsuitable for other reasons. Patients should read the patient-information lea?et, and seek the pharmacist’s advice if they have any doubt about the information. They should tell their pharmacist or doctor if the medicine results in any unexpected effects.

Potentially dangerous drugs are preparations referred to under the Misuse of Drugs Act 1971 and subsequent regulations approved in 1985. Described as CONTROLLED DRUGS, these include such preparations as COCAINE, MORPHINE, DIAMORPHINE, LSD (see LYSERGIC ACID

DIETHYLAMIDE (LSD)), PETHIDINE HYDROCHLORIDE, AMPHETAMINES, BARBITURATES and most BENZODIAZEPINES.

Naming of drugs A European Community Directive (92/27/EEC) requires the use of the Recommended International Non-proprietary Name (rINN) for medicinal substances. For most of these the British Approved Name (BAN) and rINN were identical; where the two were di?erent, the BAN has been modi?ed in line with the rINN. Doctors and other authorised subscribers are advised to write titles of drugs and preparations in full because uno?cial abbreviations may be misinterpreted. Where a drug or preparation has a non-proprietary (generic) title, this should be used in prescribing unless there is a genuine problem over the bioavailability properties of a proprietary drug and its generic equivalent.

Where proprietary – commercially registered

– names exist, they may in general be used only for products supplied by the trademark owners. Countries outside the European Union have their own regulations for the naming of medicines.

Methods of administration The ways in which drugs are given are increasingly ingenious. Most are still given by mouth; some oral preparations (‘slow release’ or ‘controlled release’ preparations) are designed to release their contents slowly into the gut, to maintain the action of the drug.

Buccal preparations are allowed to dissolve in the mouth, and sublingual ones are dissolved under the tongue. The other end of the gastrointestinal tract can also absorb drugs: suppositories inserted in the rectum can be used for their local actions – for example, as laxatives – or to allow absorption when taking the drug by mouth is di?cult or impossible – for example, during a convulsion, or when vomiting.

Small amounts of drug can be absorbed through the intact skin, and for very potent drugs like OESTROGENS (female sex hormones) or the anti-anginal drug GLYCERYL TRINITRATE, a drug-releasing ‘patch’ can be used. Drugs can be inhaled into the lungs as a ?ne powder to treat or prevent ASTHMA attacks. They can also be dispersed (‘nebulised’) as a ?ne mist which can be administered with compressed air or oxygen. Spraying a drug into the nostril, so that it can be absorbed through the lining of the nose into the bloodstream, can avoid destruction of the drug in the stomach. This route is used for a small number of drugs like antidiuretic hormone (see VASOPRESSIN).

Injection remains an important route of administering drugs both locally (for example, into joints or into the eyeball), and into the bloodstream. For this latter purpose, drugs can be given under the skin – that is, subcutaneously (s.c. – also called hypodermic injection); into muscle – intramuscularly (i.m.); or into a vein – intravenously (i.v.). Oily or crystalline preparations of drugs injected subcutaneously form a ‘depot’ from which they are absorbed only slowly into the blood. The action of drugs such as TESTOSTERONE and INSULIN can be prolonged by using such preparations, which also allow contraceptive ‘implants’ that work for some months (see CONTRACEPTION).... medicines

Anything pertaining to the loose cellular tissue beneath the SKIN: for example, a subcutaneous injection (see HYPODERMIC).... subcutaneous

An instrument for injecting ?uid into, or withdrawing ?uid from, a body cavity, tissue or blood. Syringes come in di?erent sizes and some are specially designed for use in a particular site – for example, for withdrawing CEREBROSPINAL FLUID. The basic design is the same: a calibrated barrel with a plunger at one end, while the other end has a nozzle to which a hollow needle can be attached. Most syringes are disposable, plastic, presterilised and packed in sealed containers. Injections can be given under the skin, into muscle, into a vein or into the cerebrospinal ?uid. The term hypodermic, though literally meaning under the skin, is now used to describe most syringes.... syringe

Disruptive termination of pregnancy before twenty-eighth week. Too premature expulsion of contents of the pregnant womb may be spontaneous, habitual, or by intentional therapy. Untimely onset of uterine contractions with dilation of cervical os (mouth of the womb) dispose to abortion. Essential that services of a suitably qualified doctor or obstetrician be engaged. It would be his responsibility to ensure that the embryo (unborn baby) and the placenta (after birth) are completely expelled.

Alternatives. Tea: equal parts – Agnus Castus, Ladysmantle, Motherwort, Raspberry leaves, 1-2 teaspoon to each cup boiling water; infuse 5-10 minutes; 1 cup 2-3 times daily.

Tablets/capsules. Cramp bark, Helonias.

Powders. Formula. Combine Blue Cohosh 1; Helonias 2; Black Haw 3. Dose: 500mg (two 00 capsules or one-third teaspoon) thrice daily.

Practitioner. Tincture Viburnum prunifolium BHP (1983), 20ml; Tincture Chamaelirium luteum BHP (1983) 20ml; Tincture Viburnum opulus BHP (1983), 20ml; Tincture Capsicum, fort, BPC 1934, 0.05ml. Distilled water to 100ml. Sig: 5ml tds pc c Aq cal.

Black Cohosh. Liquid Extract Cimicifuja BP 1898, 1:1 in 90 per cent alcohol. Dosage: 0.3-2ml. OR: Tincture Cimicifuja, BPC 1934, 1:10 in 60 per cent alcohol. Dosage: 2-4ml.

Squaw Vine (mother’s cordial) is specific for habitual abortion, beginning soon after becoming pregnant and continuing until the seventh month. Also the best remedy when abortion threatens. If attended by a physician for abortion, a hypodermic of morphine greatly assists; followed by Liquid Extract 1:1 Squaw Vine. Dosage: 2-4ml, 3 times daily.

Liquid extracts. Squaw Vine, 4 . . . Helonias, 1 . . . Black Haw bark, 1 . . . Blue Cohosh, 1. Mix. Dose: One teaspoon every 2 hours for 10 days. Thereafter: 2 teaspoons before meals, 3 times daily. Honey to sweeten, if necessary. (Dr Finlay Ellingwood)

Abortion, to prevent: Cramp bark, (Dr John Christopher)

Evening Primrose. Two 500mg capsules, at meals thrice daily.

Diet: High protein.

Vitamins. C. B6. Multivitamins. E (400iu daily).

Minerals. Calcium. Iodine. Iron. Selenium, Zinc. Magnesium deficiency is related to history of spontaneous abortion; magnesium to commence as soon as pregnant.

Enforced bed rest. ... abortion – to prevent

An acute infectious disease caused by Gram positive Corynebacterium diphtheria by droplet infection. Incubation: 2-4 days. Isolation.

Symptoms: low grade fever, malaise, sore throat, massive swelling of cervical lymph glands, thick white exudate from tonsils, false membrane forms from soft palate to larynx with brassy cough and difficult breathing leading to cyanosis and coma. Toxaemia, prostration, thin rapid pulse. Throat swabs taken for laboratory examination. See: NOTIFIABLE DISEASES.

Treatment. Bedrest. Encourage sweating.

Recommendations are for those parts of the world where medical help is not readily available and may save lives. Alternatives:–

1. Combine: Tincture Echinacea 3; Tincture Goldenseal 2; Tincture Myrrh 1. Dose: 30-60 drops in water, two-hourly.

2. Combine equal parts: Tincture Lobelia; Tincture Echinacea. Dose: 30-60 drops in water, two-hourly.

3. Combine Tincture Poke root 2; Tincture Echinacea 3. Dose: 30-60 drops in water, two hourly.

4. G.L.B. Rounseville, MD, Ill., USA. I have treated diphtheria since 1883. I have treated diphtheria until I am sure the number of cases treated run into four digits. I have never given a hypodermic of antitoxin on my own initiative, nor have I ever lost a case early enough to inhibit conditions. I have depended upon Echinacea not only prophylactic but also as an antiseptic . . . In the line of medication the remedies are: Aconite, Belladonna, Poke root and Cactus grand, according to indications. But remember, if you are to have success, Echinacea must be given internally, externally and eternally! Do not fear any case of diphtheria with properly selected remedies as the symptoms occur. Echinacea will also be your stimulant, diaphoretic, diuretic, sialogogue, cathartic and antipyretic. (Ellingwood’s Physiomedicalist, Vol 13, No 6, June, 1919, 202)

5. Alexander M. Stern MD, Palatka, Florida, USA. Combine: tinctures Echinacea 1oz, Belladonna 10 drops, Aconite 10 drops. Water to 4oz. 1 teaspoon 2-hourly.

6. F.H. Williams, MD, Bristol, Conn., USA. I took a case which had been given up to die with tracheal diphtheritic croup. I gave him old-fashioned Lobelia (2) seed and Capsicum (1) internally and externally and secured expulsion of a perfect cast of the trachea without a tracheotomy.

7. Gargle, and frequent drink. To loosen false membrane. Raw lemon juice 1, water 2. Pineapple juice. Teas: Red Sage, fresh Poke root. Cold packs – saturated with Echinacea (Tincture, Liquid Extract or decoction) to throat.

Note: Capsicum and Lobelia open up the surface blood flow of the body thus releasing congestion on the inner mucous membranes.

Diet. Complete lemon-juice and herb tea fast with no solid foods as long as crisis lasts.

To be treated by a general medical practitioner or hospital specialist. ... diphtheria

A health scheme that enables intravenous drug abusers to exchange used hypodermic needles for new, sterile ones.

The scheme is aimed at reducing the risks of infections, such as HIV and hepatitis, transmitted by the sharing of contaminated needles.... needle exchange

Accidental puncture of the skin by a contaminated hypodermic needle. Hospital staff are most likely to be at risk. Needlestick injuries carry the risk of serious infections, such as HIV and hepatitis, and need immediate attention. The wound should be cleaned thoroughly; blood tests may be needed to determine whether infection has been transmitted.... needlestick injury

Cerebrospinal fever. Inflammation of the pia mater and arachnoid covering of the brain and spinal cord. A notifiable disease. Hospitalisation. Diagnosis is difficult without a lumbar puncture. Caused by a wide range of virus, bacteria, protozoa and fungi. Three most common bacterial causes in England and Wales are N. Meningotidis, H. influenzae and streptococcus-like infection with sore throat; then fever, vomiting, headache and mental confusion; half-open eyes when asleep, delirium, sensitive to light, possibly drifting into coma. Sometimes onset is gradual over 2-3 weeks. Treatment by hospital specialist.

Poor housing and passive smoking suspected. Its association with non-germ meningitis, and inflammatory drugs is well recognised. Also caused by injury or concussion.

Commence by cleansing bowel with Chamomile enema.

Cerebrospinal relaxants indicated: Passion flower (cerebral), Black Cohosh (meningeal), Ladyslipper (spinal meningeal). (A.W. & L.R. Priest)

If patient is cold, give Cayenne pepper in honey to promote brisk circulation.

Aconite and Gelsemium. “For irritation of the meninges of the brain and spinal cord Aconite is indispensible. Combined with Gelsemium for restlessness it is an exceptional remedy. Tincture Aconite (5-15 drops) with Gelsemium (3-10 drops) hourly. Also used in combination with other agents as may be dictated by the course of the disease. (W.W. Martin MD., Kirksville, Mo., USA)

Crawley root. Decoction: 1 teaspoon to half a pint water, simmer 20 minutes. Dose: 1 teaspoon or more 3-4 times daily for children over 6 months. A powerful diaphoretic and sedative. (Dr Baker, Adrian, Michigan, USA)

Lobelia and Echinacea. Equal parts, Liquid Extract 30 drops in water every 3 hours. (Dr Finlay Ellingwood)

Lobelia, alone. Hypodermic injections of Lobelia in five cases of epidemic spinal meningitis, with complete recovery in every case. Dose: 10 drops hourly until symptoms abate, then twice daily. (Dr A.E. Collyer, Ellingwood Therapeutist)

Ecclectic School. Echinacea commended.

Before the Doctor comes. As onset is rapid, often less than 5 hours, an anti-inflammatory is justified. Teas or decoctions from any of the following: Catmint (Catnep), Prickly Ash berries, Pleurisy root, Boneset, Wild Cherry bark, Bugleweed (Virginian), Ladyslipper. When temperature abates and patient feels better: Chamomile tea or cold Gentian decoction with pinch Cayenne.

Hydrotherapy. Hot baths make patient feel worse. Sponge down with cold water.

Protective throat spray: equal parts, Tincture Myrrh and Tincture Goldenseal.

Protective gargle: 10-20 drops Tincture Myrrh and Goldenseal to glass of water.

Garlic. Dr Yan Cai, Department of Neurology, Ren Ji Hospital (affiliated to Shanghai Second Medical University), China, referred to the extensive use of Garlic in Chinese folk medicine and his hospital’s experience with Garlic products – diallyl trisulphide in particular – to treat viral infections including crypotococcal meningitis for which disease results were impressive.

Garlic appears to be a reliable preventative.

Diet. Fast as long as temperature is elevated; with fruit juices, red beet juice, carrot juice or herb teas. Note. GPs and other practitioners may help stop meningitis claiming lives by giving massive doses of Echinacea before they are admitted to hospital.

Note: The infection is often difficult to diagnose. At the end of each year (November and December) when the peak in cases approaches, every feverish patient with headache should be suspected, especially where accompanied by stiff neck.

The above entry is of historic interest only; more effective orthodox treatment being available. ... meningitis

n. inflammation of the liver caused by viruses, toxic substances (including alcohol), autoimmune disease, metabolic disease, or the excess deposition of fat (see nonalcoholic fatty liver disease). Infectious hepatitis is caused by viruses, several types of which have been isolated. These include hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E. Other viral causes of hepatitis include *Epstein-Barr virus, *cytomegalovirus, and rarely *herpes simplex virus. Hepatitis A is transmitted by food or drink contaminated by a carrier or patient and commonly occurs where sanitation is poor. After an incubation period of 15–40 days, the patient develops fatigue, anorexia, nausea, vomiting, arthralgia, and fever. Yellow discoloration of the skin (see jaundice) appears about a week later and persists for up to three weeks. The patient may be infectious throughout this period. Serious complications are unusual and an attack often confers immunity. Injection of *gammaglobulin provides temporary protection, but active immunization is preferable.

Hepatitis B (formerly known as serum hepatitis) is transmitted by infected blood or blood products contaminating hypodermic needles, blood transfusions, or tattooing needles, by unprotected sexual contact, or (rarely) by contact with any other body fluid. It often occurs in drug users. Symptoms, which develop suddenly after an incubation period of 1–6 months, include headache, fever, chills, general weakness, and jaundice. Treatment includes *interferon alfa and other oral antivirals (e.g. *lamivudine, *adefovir dipivoxil, entecavir). Most patients make a gradual recovery but the mortality rate is 5–20%. A vaccine is available.

Hepatitis C (formerly known as non-A, non-B hepatitis) has a mode of transmission similar to that of hepatitis B (predominantly intravenous drug abuse). Treatment is with interferon alfa, peginterferon alfa, ribavirin, telaprevir, and boceprevir.

Hepatitis D is a defective virus that can only proliferate when there is infection with hepatitis B. Patients with D virus usually have severe chronic hepatitis.

Hepatitis E is transmitted by infected food or drink and can cause acute hepatitis; it is especially severe in a pregnant patient.

Chronic hepatitis continues for months or years, eventually leading to *cirrhosis and possibly to malignancy (see hepatoma). It is usually caused by chronic viral hepatitis, alcohol, or autoimmune disease.... hepatitis

n. a slender sharp-pointed instrument used for a variety of purposes. The size and shape of needles used in surgery for stitching tissue depend on the type of surgery. Most surgical needles have suture material fused onto them (so-called atraumatic needles). Hollow needles are used to inject substances into the body (in hypodermic syringes), to obtain specimens of tissue (see puncture), or to withdraw fluid from a cavity (see aspiration; biopsy). See also stop needle.... needle

Pilocarpus jaborandi

FAMILY: Rutaceae

SYNONYMS: Pernambuco jaborandi, P. pennatifolius, iaborandi, jamborandi, arrudo do mato, arruda brava, jamguaraddi, juarandi.

GENERAL DESCRIPTION: A woody shrub up to 2 metres high with a smooth, greyish bark, large brownish-green leathery leaves containing big oil glands and reddish-purple flowers.

DISTRIBUTION: Native to Brazil; other species are found in Paraguay, Cuba, the West Indies and Central America.

OTHER SPECIES: There are many members of the Rutaceae and Piperaceae family known simply as jaborandi, such as Piper jaborandi. Others include maranham jaborandi (P. microphyllus), ceara jaborandi (P. trachylophus) and aracti jaborandi (P. spicatus).There is consequently some confusion about the exact botanical source of the oil.

HERBAL/FOLK TRADITION: Jaborandi induces salivation and most gland secretions; it was also used at one time to promote hair growth. ‘Useful in psoriasis, prurigo, deafness ... chronic catarrh, tonsillitis and particularly dropsy.’ .

ACTIONS: Antiseptic, diaphoretic, emmenagogue, galactagogue, stimulant (nerve).

EXTRACTION: Essential oil by steam distillation from the dried leaflets.

CHARACTERISTICS: An orange or yellow liquid with a sweet-herbaceous fruity odour.

PRINCIPAL CONSTITUENTS: Pilocarpine is the main active constituent; also isopilocarpine, pilocarpidine, methyl nonyl ketone, dipentene and other hydrocarbons.

SAFETY DATA: Oral toxin, skin irritant, abortifacient.

AROMATHERAPY/HOME: USE None.

OTHER USES: Various hypodermic solutions are prepared from pilocarpine: the crude oil is rarely used. Little used in perfumery or flavour work due to toxicity.... jaborandi