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The principal period groups were digitalis preparations, squill, broom, juniper oil, buchu, nitrous ether spirit, and several soluble potassium salts. They were grouped by observed promotion of urine flow, rather than by one common mechanism. The following are historical adult quantities per administration, expressed in the contemporary units; they are not present-day prescriptions.
- Digitalis preparations: powdered leaves, ½–2 grains; Infusum Digitalis, 2–4 fluid drachms; Tinctura Digitalis, 5–40 minims; digitalin, 1/40–1/10 grain in the period table. Historical digitalin was not simply a modern pure digoxin product.
- Squill: powder, 1–2 grains; Pilula Scillae Composita, 5–10 grains; Tinctura Scillae, 10–20 minims; Syrupus Scillae, ½–1½ fluid drachms.
- Broom: Decoctum Scoparii, 1–3 fluid ounces; Succus Scoparii, 1–4 fluid drachms.
- Buchu: powdered leaves, 20–40 grains; Infusum Bucco, 1–2 fluid ounces; Tinctura Bucco, 1–2 fluid drachms.
- Juniper oil: Spiritus Juniperi, 10–30 minims in the 1864 commentary. This unusually concentrated spirit contains one volume of juniper oil in ten; its dose must not be borrowed from a later, weaker formula.
- Nitrous ether spirit, Spiritus Aetheris Nitrosi: 30 minims to 2 fluid drachms.
- Potassium acetate: 10–20 grains; potassium citrate: 20–60 grains; potassium nitrate: 5–20 grains; potassium tartrate: 10–60 grains; potassium hydrogen tartrate: 20–60 grains.
- Ammonium acetate solution, Liquor Ammoniae Acetatis: 10–40 minims of the concentrated British preparation, diluted for administration.
[ref]
The Essentials of Materia Medica and Therapeutics by Alfred Baring Garrod (1865). Posological table: Digitalis, Infusum Digitalis, Scoparius preparations, Bucco preparations, Spiritus Aetheris Nitrosi, potassium salts and Liquor Ammoniae Acetatis; Liliaceae: squill preparations
[ref]The Prescriber's Analysis of the British Pharmacopoeia by John Birkbeck Nevins (1864). p. 61, Spiritus Juniperi, 1 in 10 and 10–30 minims
Other recognised period agents included dandelion and copaiba. The dandelion decoction was given in quantities of 1–2 fluid ounces, its soft extract in quantities of 10–30 grains, and its preserved juice in quantities of ½–2 fluid drachms. Copaiba was given in quantities of 15–30 minims, and copaiba oil in quantities of 5–20 minims. Their historical inclusion does not establish that they are suitable substitutes for current diuretic therapy. [ref]
The Essentials of Materia Medica and Therapeutics by Alfred Baring Garrod (1865). Posological table, Taraxacum preparations, Copaiba and Copaibae Oleum
The distinction between preparations matters more than a single “dose of the plant”: an infusion, tincture, juice and powder have different concentrations. Likewise, a salt's small historical diuretic dose is not its larger purgative dose. A modern explanation also separates a direct effect on renal tubules from improved cardiac output in appropriate heart failure: digitalis preparations cannot be understood simply as agents that make every kidney excrete more water. Modern digoxin is used for selected cardiac indications, rather than as a general treatment for low urine output. [ref]
Digoxin by MedlinePlus. Why is this medication prescribed?
Decoction suits material whose useful constituents are water-soluble and withstand boiling; infusion avoids sustained boiling and can better preserve delicate or volatile constituents. The choice depends on both the plant's structure and the chemistry of the constituent being extracted.
Hard bark, wood and many kinds of root need comminution and more prolonged contact with hot water to penetrate their tissues; a decoction can assist extraction when the desired material is stable. Boiling is unsuitable when it drives off a needed volatile oil, decomposes the active constituent, or extracts an unwanted excess of starch or other material. A hard root is therefore not automatically an instruction to boil. Period examples suitable for decoction include oak bark, logwood and pareira root; appropriate infusions include aromatic cloves and chamomile. Cold infusion of calumba avoids dissolving its starch, illustrating that suitability depends on the desired selectivity of solvent extraction, not merely on whether a drug is a leaf or a root. [ref]
For an infusion, the appropriately divided drug is left in a measured solvent for a prescribed time, commonly in a covered vessel. Hot water assists extraction, while a cover reduces loss of volatile matter. Cold infusion can be chosen when heat is undesirable. The result must be strained or filtered; time, temperature, particle size and solvent quantity affect its strength. Neither method guarantees that every constituent is extracted in the same proportion.
A liquid extract is made by extracting the specified drug with a suitable solvent, separating the liquid from the exhausted material, and bringing the extract to its prescribed concentration and volume. Maceration can precede percolation; expression or washing recovers retained liquid. A percolator passes fresh solvent through a packed bed, rather than indefinitely soaking the drug in an increasingly saturated liquid. Where concentration is necessary, controlled evaporation limits damage; an alcoholic fraction can be reserved or recombined as the monograph directs. Different liquid extracts can use aqueous, alcoholic or ethereal processes. For example, the liquid extract of male fern is an ethereal extraction of a resinous and oily fraction, whereas the liquid extract of opium is compounded from a previously made aqueous extract. These are chemically different operations. There is no warrant for assigning all 1864 extracts one modern universal drug-to-extract ratio. [ref]
The Prescriber's Analysis of the British Pharmacopoeia by John Birkbeck Nevins (1864). pp. 20–21 and 42–43, differing liquid extracts and strengths; p. 15, percolation