TEXT  BOOK
        MEDICAL STUDENTS OF JEFFERSON COLLEGE,








              ATTENDING THE LECTURES OF THE








»->>     PROFESSOR OF MATERIA MEDICA AND BOTANY.








                   THIRD SESSION,







                        1827-8.
I 
 
OUTLINES
                    Of

          LECTURES

                    OS

   MATERIA MEDICA AND  BOTANY,

                DEUYERED IN

JEFFERSON  MEDICAL  COLLEOE
                PHILADELPHIA.
BY WILLIAM P. C. BARTON, M. D.
              YOLUME I.



          PHILADELPHIA:

     PUBLISHED BY JOSEPH G. AUNER,
BOOKSELLER AND STATIONER, 333 MARKET STREET.
            X. TOWN, PRINTER.
                 1827.           5 
                 .    v.  i


 £|fl«<erj» District of Pennsylvania, to wit !

               BE IT  REMEMBERED,  That  on the  sixtb
            day of October, in the fifty-second year of the Inde-
            pendence of the United States of America. A.  D.
            1827,.William P. C. Barton, M.  D. of the said Dis-
            trict, hath deposited in this office, the Title of a
            Book the right whereof he claims as author, in the
 words following, to wit:                             „


  ,l Outlines of lectures on Materia Medica and Botany, delivered
in Jefferson Medical College, Philadelphia, by William P. C. Bur-
ton, M. D."


  In conformity to the act of the Congress of the United States^
intituled " An act for the encouragement of learning, by secur.
ing the copies of maps, charts, and books, to the authors and
proprietors of such copies during the times therein mentioned."
AikI also to the act, entitled  " An act supplementary to an act,
entitled " An act for the encouragement of learning, by secur-
ing the copies of maps,  charts, and books, to the authors and
proprietors of such copiesduring the times therein mentioned,"
and extending the benefits thereof to the arts of designing, en-
graving, and etching historical and other prints."

                                  D,  CALDWELL,

            Clerk of the Eastern District of Pennsylvania.
 
                TO THE

MEDICAL  PROFESSION,

                  IN THE

            UNITED STATES.
   It has been stated, that this work is not designed for the
 Profession—that it  has  no pretensions, other than already
 stated : but it gives me great satisfaction to inform my Medical
 Brethren of the United States, that I possess, and will  forth-
 with publish,  a work on the same subject, of exalted preten-
 sion; of the strongest possible claims to sustain that pretension,
 and their extensive, nay, I venture to believe, their universal
 patronage.  I  mean the MAMrscniPT Lectures of my late uncle
 Dr. Benjamin  Smith Barton, for more than twenty years Pro-
 fessor of Materia Medica and Botany; and two years Professor
 of the Practice of Physic and the Institutes of Medicine, in the
 University  of  Pennsylvania; an institution which confessedly
 owes much of its reputation and celebrity to his long exercised
 talents, as one if its most gifted teachers.
  To all who know—and all who know any thing of the Med-
 ical History of our country, do know—the genius, the indus-
 try that ceased only with his life, and the learning of that  great
 man, compared with whom, viewing him on the zenith as he is,
 many of us who are now teachers of medicine and especially
 we  who are writers on Materia Medica, are in the nadir of the
 sphere oflearningand science—all who know  this will receive
it as no incredible declaration, that a work of greater erudi-
tion on any subject, could scarcely be expected from the pen 
XIV
ADDRESS.
 of any one man.  It will be found a work not issued from the
 press in the exuberant pruriency to keep out of view the la-
 bours of his predecessors, after its author " had delivered thrcr
 courses of lectures on this science," not the work of one " very
 unexpectedly called to teach the Materia Medica  in the Uni-
 versity of Pennsx lvania," who had " entered on the enterprize
 with none of the advantages which would have  been derived
 from the previous study of the subject with  this precise and
 definite view"—not the production of one who  "was pressed by
 the class" (nor twenty-one classes) " that had formerly attend-
 ed him, with an earnestness which he could not  well resist, to
 prepare a  work on the  Materia Medica, or in  other  words to
 print his  lectures"—it  is not such a work,  of  such an  one,
 goaded against his -will to hazard  his reputation  by  premature
 publication even by reluctantly yielding to the irresistable solici-
 tations of those endeared  to him by  attendance  on three
 courses.
   But it will be found  a work deliberately prepared for the
 public, in the last years of his life, by one who  entertained ele-
 vated opinions ot what a man should issue from the press,  who
 might derive, or expect to derive solid reputation  by his work —
 of one who after six years previous devotion to the studv of Bo-
 tany and to teaching it in  the University,  devoted upwards of
 twenty years study,  reflection, and practice of his profession,
 with annual, monthly, nay daily important additions and revi-
 sions, (as I can attest from observation during my pupilage with
 him,) to render his  lectures worthy of  the  public  eye—a
 work enriched by the toil of the midnight closet directed by the
 best talents.   In short it  will be seen to be the work  of one,
 who, in designing it as a publication of authority and erudition,
 did  not reckon without his  host—a work which must create
 imperishable fame for the memory of its gifted, and its better
 than gifted, its learned and toilsome author, while it will shew
 by comparison, the nothingness of such works  as owe all their
 merit to furtive surreption—will unquestionably,  constitute for
 the profession, a rich source of information, and a depository of
important facts.  Can it be otherwise, being the  result of the 
ADDRESS.
XT
 concentrated labours of a moiety of a life devoted to acquiring
 a thorough knowledge  of, and full qualification for teaching
 the subject to which it pertains? It embodies more facts than
 in the course of my life's reading, I have met in catenation on
 any single subject—besides being enriched by the result of the
 observations of the eminent practitioners of this country.
   Such are the MSS. of Dr. Barton*—I  have rescued them from
 oblivion, if not destruction.   I have done so, because I felt it
 a duty to the medical profession of our country—to give the
 rich contribution to our medical science; and above all, because
 I shall have been the instrument of executing the last wish of
 their illustrious  author, from whom I received on his death
 bed,  a declaration in the last words I heard him utter, that he
 believed they would give honour to his memory and the name ;


  *  I trust T possess sufficient candour,  and sufficient judgment
 of the subject, to give a correct opinion of the intrinsic value
 of these writings; and  to preclude the  idea that any interest in
 this property could  compromit the one,  or warp the other, in
 the above estimate of their importance.   As  there are some,
 however, whose reputation is involved in suppression or pub-
 lication of  the MSS. and  who would not hesitate to  circulate
 the idea, that such personal interest had swayed me to over-
 rate their excellence, I subjoin an extract from my life of Dr.
 Barton, written and published by appointment and request of
 the Medical Society  of this city,  (which published their decla-
 ration of the faithfulness of that essay)—written at a time I did
 not possess, nor ever dreamed of possessing,  either the MSS.
 or any the  least personal interest in them.
  "To this chair of materia medica Dr. Barton was shortly after
 appointed, being then  but just turned of thirty years of age,
 and having been  professor of natural history  and botany near
 six years.  And here, gentlemen, beghisand rests the high pro-
 fessional reputation of Dr. Barton in medicine.  To the impor-
 tant lectures on this subject, continued by him till the period
 when the loss of  one of the great pillars of this medical school
afforded him an opportunity of a translation to the vacant chair
of the practice of physick, is entirely attributable the present
conspicuous elevation  of the  materia medica professorship in
this University.   Those who have attended the lectures of the
late professor on this point of medical science, can bear  hon-
ourable and powerful testimony in favour of their importance,
their learning, their usefulness."—FiD. 1816. 
XVI
ADDRESS.
and that they were the only writings of which he desired a
posthumous publication.  I hold the sacredness of such a wish
ot such a man, inviolable.  And since it has, by an extraordi.
nary and unlooked for course  of events, fallen to my  lot to
possess them as my own property, with a full right to preserve,
burn, or publish them, I seize with avidity on the Jirst favoura-
ble opportunity of giving them to  the public—though I was
never destined by their author to inherit nor edit them—nor
:iny the least valuable of his  Manuscripts.  Never till  I pur-
abased them did I possess one line of his writings, save his let-
ters to me and my father.   Were I without any other motive
however,  the single fact of my being a public teacher of Ma-
teria Medica in a new and rising institution, would impel me to
the course I have taken ;  having too much regard for solid rep-
utation, to retain unpublished lectures on the subject I teach-
well assured, that a man who cannot by his individual exertion,
sustain his own reputation  and that of the school he  belongs
to, so far as those individual exertions have any thing to do with
it, without the borrowed aid of the unpublished labours of an-
other,  is unfit to be trusted, and unworthy of his place.  These
MSS. were left by Dr. Barton, (after being prepared by  his
own hand for publication, with directions to the printer  for ar-
rangement) to  his son Thomas Pennant Barton, Esq. who with
proper filial respect, parted with them to an  eminent  Booksel-
ler of this city,  whose subsequent misfortunes led to their sup.
pression.   The MSS. bear the printers' marks of having been
composed to the extent of a form or two.  I never saw these
lectures since I was a student with their author, until within a
year past, when I accidentally learned they were under the
counter of a store-keeper in the  lower part of the city,  where
they had been for some time, among his dry-goods. •  I did not
hesitate to purchase them of him, without any idea, from  the
manner they had passed  into  his hands, they could  be com-
plete, for a sum, which, considering the risk of mutilation, was
 considerable.   My engagements last winter in delivering my
 first full  course  of lectures on Materia Medica and Botany,
in Jefferson College, deprived me of the leisure of arranging 
ADDRESS.
xv ii
rendering  legible,  and perusing these valuable MSS.  This
was the toil of three months of the last Spring.   When it is
recollected that they were chiefly written on small pieces of
paper, backs of letters, covers of pamphlets,  proof-sheets, his
son's college exercises and copy-hooks, and even small pieces
of pasteboard,  snatched up at the moment a fact  occurred
worth recording, were smoaked, torn and dirty—this work will
not appear an  inconsiderable  one.  It required perseverance
and toil —much of the MSS. was washed free of dirt in water,
trimmed, pasted and pressed, and finally arranged by the pag-
ing of the authors own hand and by his  different directions to
the printer.  Within a month or two past they have been com-
pletely bound  and form twenty-four volumes, -without  the loss of
a single material -word.  They  are in a more completely legible
condition than they ever were : and I shall be happy to exhibit
them to any of my medical brethren who desire to inspect them.
By the printers calculations, who had counted the words in each
'ecture,  (a labour very necessary in MSS. written on pieces of
paper from the size  of two inches by  four  or five, to  half a
sheet) it appears that the aggregate words in the MSS. amount
t o 482,640 and will make 1050 large closely printed octavo pages
in small type.  According to the common plan of printing En-
glish medical works they would make  from eight to ten octa-
vo volumes.
  These  lectures embody every thing  known relative to the
subject of materia medica  and therapeutics, up to the period
of Dr.  Barron's death, having received numerous  additions.
after his translation to the chair of the practice.  Eleven years
have elapsed since his demise.  In order therefore to add the
result of this periods improvements in the science of materia
medica, I have collected  all the important  knowledge of the
past eleven years, which I propose to add, as a supplement,
containing a digested view of the science since his death up to
the period  of  publication.  If the profession  shall deem me
competent  to  this task, the  work may be fairly tendered to
their patronage, as a rich system of materia medica, calculated
to meet atl the expectations which may be formed of its value. 
XviU                  ADDRESS.

It is contemplated that the supplement will contain 150 or 200
closely printed pages.  The whole may therefore be comprised
in three volumes ot 400 large  closely printed  pages in small
type.   I have only  further to add, that I am prepared dispose
ef an edition, equal to supply the demand of the United States
and Europe, retaining the copy-right mv self,  to any Booksellers
in Philadelphia, New York, Boston or Baltimore.  The work to
be put to press forthwith, and  printed in this city under  my
own supervision.  As an inducement to the trade to undertake
the work, it is quite fair to remark, that the attachment of  Dr.
Barton's pupils to him, chiefly grounded on  the  value of Ins
instruction, renders it probable that few physicians educated
in the iViversity  of Pennsylvania between the year 1794 when
he was appointed Professor,  and the year 1816 when he died,
will decline to possess themselves of a copy—and his fame in
Europe,  especially on the continent, W'H render his work
eagerly sought  after there.  Added to which  will be  the
common chances of sale, and my own annual patronage of the
work,  in the College where I teach the subject it treats of.
  Having, for the information of Booksellers made these facts
known, I have only to observe that I shall  prefix a re-print of
my biography of Dr. Barton, now out of print, to the work,
and afford a model of the best likeness extant,  for an engrav-
ing.  1 need but further remark, that to my medical brethren
of the United Stases, I shall  be obliged  for their patronage,
and I cannot but believe that every  physician educated in the
University of Pennsylvania, during the period of his istruclioir,
will possess himself of the work. 
CONTENTS.
                                                    Page.
Synopsis of a course of Lectures on Materia Medica and
  Botany,    -     -    ■  „......7
Means used  to ascertain the medicinal virtues of Substan-
  ces,     ..........17
Confusion in the Materia Medica by sv nonyms of vegetable
  articles,.........19
Causes which m dify doses of medicines,  -    -    -   - 19
Different classifications of the subject,                    20
General Stimulants, what.......24
\ocal Stimulants, what      ......   24
 hitlines of Therapeutic Lectures on Antacids,     -   - ?6
........................................................... Antispasmodics,  -   28
                                   Anthelmintics,    - 30
                                   Aromatics,  -     -   38
                                   Astringents,  -   - 44
                                   Their medical-use,   47
                                   Cathartics,  -     -   52
                                   Diseases  in which 1
                                     purging is neces-^-57
                                     sary or useful,  - j
                                   Demulcents,  -   - 59
                                   Diaphoretics,     -   65
                                   Their medical use,   67
                                   D.luents,     -   -73
                                   Diuretics,           76
                                    Their medical use,  80
                                   Emetics,      -   - 81
                                   Their medical use,   95
                                   Emmenagogues,  -  luO
                                   Etnmollients,   -    115
                                   Epispastics, -     *  118
                                   Medical  use of  7  .„,.
                                   Blisters,          >
133
Errhines or Ster- )
  nutatories,     $
Their medical use,   134 
XX
CONTENTS.
162
                                                     Page.
Outlines ofTherapeutic Lectures on Escarotics,      -    1^8
......,.................................................Expectorants,      -  141
                                  linemata,        -     156
                                  Inhalations,   -    -  160
                                  Medical use of
                                   Inhalations,
                                  Issues,     -    -    J 64
                                  Litiiontriptics,      £167
                                   Antilithics,        5 *78
                                  Amilithic Practice,    :82
                                  Narcotics,    -    -   185
                                  Refrigerants,     -     190
                                  Topical  Refrigerants,  192
                                  Kubifacients,       -  194
                                  Sedatives,       -     196
                                  Setons,       -    -  197
                                  Sialogogues,     -     199
                                  Salivant Masticatories, 200
                                  Tonics,       -    -  202
                                  Recapitulation   -     204
                                  Classification of meO
                                  dicaments inlieu of >  206
                                  Murray's,         j
                                  Classification of ad-")
                                  ventitiousremedies I  _,_
                                  not  medicaments, [
                                  Section 1st.       J
                                  Ditto Section 2d.  '    214
                                  Ditto Section 3d.      216
                                  Restorative Dietetics,  217
                                  Detail  of propor-
                                  tions  of articles of
                                  Materia Med.from
                                  the animal  vegeta-
                                  ble  and  mineral
                                  kingdoms,        _,
                                  Toxic61ogy,      -     219
                                  Incompatibles,        220
V218 
           SYNOPSIS
       OF A COURSE OF LECTURES

                   ON
MATERIA MEDICA AND BOTANY.
  Preliminary lectures discussive of as much of the
history of the subject, as may be essential  to the
elucidation of the course; and showing the intimate
connexion of the  principles  of  Botany  with the
Materia  Medica—The  proofs  of this  connexion
deduced from the steps of discovery  of  the vege-
table medicines, following the tracts of  botanical
researches ; and the confusion in the vegetable ar-
ticles without the perspicuous and discriminative
language of Botany, &c. &c.
  The subject divided  into,
  A. Materia Medica proper.
  B. Moral regimen as a therapeutic agent.
  C. The influence of such physical causes as may
be therapeutically applied.
  D. Such as may be resorted to as prophylactics.
  E. Restorative dietetics.
  F. Toxicology.
  G. Botany.
  A. Includes  introductory discussions on the
means  of ascertaining the virtues of remedies:
        A 
8
the action of medicines on the body,  and the mode
of their  operating,—the  application of the prin-
ciples  of medical chemistry  and  medical  bota-
ny.   The natural history,  systematic classifica-
tion,  botanical and  chemical characters and pro
perties,  synonymes, demonstrative  elucidations,
medicinal properties and effects,—of all the articles
legitimately recognised as medicines of repute and
efficacy.  Their doses, pharmaceutic preparations,
peculiarities of operation in idiosyncratic consti-
tutions:  their therapeutic application sustained by
copious  practical illustrations.   The articles are
considered under a divisional scheme, less extend-
 ed and more simple  than  the  usual division by
writers on the subject.  The classes  are expung-
ed, because it is believed they cannot be  claimed
 as comprising articles of such specific  effects  as
 each class itself would imply and require.
   B.  Comprises a philosophic investigation of the
 vast assemblage  of neglected  moral remedies,  or
 restoratives,  acting on the physical  constitution
 through the intervention of the moral attributes of
 man.  A scrutiny of  the influence and  effects of
 the passions and emotions and of religious and po-
 litical temperance, in curing, or aiding in the cure of
 diseases. The necessity of a study of these, in their
 varied  inflections  towards  and transmutations
 into other passions  and emotions of greater or less
 ^sanative effect, in order to be possessed of the ju-
 dicious command of their remediate powers.  The 
9
influence of temperance and intemperance of what-
ever kind, vices, habits, and necessary occupations
of life, on the general system, leading to  a con-
sideration  of the n;anner  in  which these, or most
of them, may  usefully be enlisted as therapeutic
agents.   Illustrations and proofs adduced from
savage and civilized life, from the histories  of mil-
itary campaigns,  naval enterprises, and the pa*
cine attitude of national,  sectional and municipal
governments. The sanative effect of certain public
and  private  amusements considered in therapeutic
view.  The genial influence of music, on valetudina-
rian constitutions, considered:  the  invigorating
and curative power of its practical exercise illus-
trated  and  proved.   The  like  influence  of the
higher spheres of belle-letter exercises, on the dis-
ordered systems of the talented and gifted, inves-
tigated.  The tonic and  curative power of cer-
tain oral and vocal practices, proved by practical
illustrations  and facts.   In  a word, an attempt
made to prove that the physician too often resorts
to the materia medica, proper, for his medicaments,
instead of drawing largely  on those  kinder and
more  grateful, and  equally curative remedies,
which a reflective  scrutiny of the  moral  condition
of his patient,  and his susceptibility of moral in-
fluence, would place at his disposal.
  C.  Under this section two surveys are taken of
physical causes: a. in relation to their influence
on the moral disposition of man, thus indirectly or 
10
remotely acting with sanative and curative effect,
on the disordered  corporeal system,  b.  In refer-
ence to their direct agency  by palpable influence,
on the diseased constitution.   In the subsection a
their approximation to moral influences is pointed
out.  These causes are the changes of the seasons,
the transient conditions arid  vicissitudes of the
weather, and their vexatious discomfitures; custo-
mary and therefore unnoticed exposure to heat, cold,
moisture,  and electric aridity of the air, operating
imperceptibly, on  sensitive  constitutions through
the associative mental powers,  or through the dis-
sociative freaks of capricious minds on the temper
and disposition of the  individual, and consequent-
ly on  his corporeal frame.   They  are to be found
also in  the  same customary and unnoticed expo-
sure to varying temperatures  in  apartments at
home or abroad, during the hours of business, plea-
sure or pastime: all modified by the sex and age
of the  patient,  by his nativity to  the soil, or his
foreign  birth  and usages,  and  in the latter case
by his greater or less approach to entire  acclama-
tion; finally, in every instance qualified by the tran-
quil state of mind usually accompanying compe-
tency of the necessaries of life.  These indirect
physical causes, affect chiefly the constitutional
temperaments of keen-passioned and intellectual
subjects;  the phlegmatic  and unlearned, escape
their influence.   As they manifestly exert no incon-
siderable controul over the performance of visceral 
11
 functions, they may,  by a close attention to their
 peculiar influence, be brought to operate remediatc-
 ly, according to circumstances  attending, and the
 peculiarities and propensities of the individual un-
 der care or advice.  Like poisons, which under ri-
 gid and experienced controul,  are  the best medi-
 cines, these indirect physical causes, can be thera-
 peutically directed or applied.
   The subsection b grasps at all those direct physi-
 cal influences to  which the healthiest frame  is in
 some degree subjected, but which especially direct
 their  energy to the weak points of the constitution,
 and creeping stealthily, but  surely, into the in-
 most  recesses of the animal frame,  exert cither an
 energetic sanative agency, or  a pernicious and
 fatal  influence, according as they are received on
 guard, or unwarily surprise.   The  therapeutic
 application  of these direct  physical causes,  pre-
 supposes the indispensable knowledge in  the phy-
 sician, of their noxious, as well as  salubrious ef-
 fects, and the multitudinous changes rung  upon
the full-toned  system, by  the endless vascillations
of their perpetual moving spring and power.  Such
knowledge the discussions on  these  points, aim at
communicating to the  student.
  The outlines of these great and physical agents
may  be  drawn briefly by enumerating,
   1st, And most essential, exercise;
  £d, Diet;
  3d, Dress;
      A  2 
12
  4th,  Bodily evacuations;
  5th,  Natural  rest;
  6th,  Celibacy and marriage.
  The  first is considered as a Herculean remedy,
and is noticed  in all its different kinds,  under the
effect of change of scene,  location,  time, and cli-
mate;—sometimes necessarily affected and modifi-
ed or altered  in salubrious  efficacy, even by  a
change of existence under a  form of government
more genial to the political temperament and views
of the individual.  In the division of exercise, the
different kinds of gestation are considered in refer-
ence to their peculiar efficacy ;—sea and land jour-
neys, gymnastic exercises,  and the manly sports,
bodily  labour as  exercise,  and  the playing on
musical instruments which require  exertion, with
the same view.
  The second is  diet; its sufficiency, inordinancy
and  regularity in the time of repletion considered
—its liquid and solid proportions.
  The third physical agent is dress: its  necessary,
but neglected aptitude to clime, season, and vicissi-
tudes  of  weather, therapeutically inquired into.
Connected with it,and consentaneous with its effect,
personal cleanliness, by ablution, and different kinds
of bathing, swimming as uniting ablution and exer-
cise. Dress here considered as participating also in
a moral influence, thus healthfully aiding its  phy-
sical agency. Its restorative and invigorating effect
 on the system through the medium of the taste and 
13
the fancy noticed ; also its peculiar influence on the
chronic complaints of children and young persons.
An attention to  this subject proved to be  impor-
tant from the records of naval and military disci-
pline,  and by practical illustrations, derived from
the lower and highest  orders of society.
  The fourth view extends to the curative  powers
of regularity in obeying or coaxing the natural di-
gestion and evacuations of  the body ;  by overcom-
ing torpor,  or sluggish  action of the chylopoitic
viscera, shewn to act curatively by the associative
actions of the mind ; and conversely,  injuriously
and perniciously, by indulging in the  dissociative
actions ; or discomposing and distractive passions,
emotions, propensities and  occupations. The effect
of sea voyages and land travelling, in promoting or
retarding these associative and dissociative actions
influencing the body.  The effect of bodily purifi-
cation and dress as  adjuvants to  the  therapeutic
agency of regular alvine and cystal evacuations.
In short, the combined effect of physical and moral
causes  in relation  to  the  point considered,  and
proved to go hand in hand.
  The fifth, insists on  the curative efficacy  of judi-
cious quietude of body, and respite from mental and
corporeal labour; and the quantum of healthy sleep,
to be measured as a medicine, by a scale graduated
to the  peculiarities  of the system,  and existing
condition of the patient.   An endeavour made to
shew,  that,   with this, as  other physical  causes, 
                      14
neglect of, and familiarity with its influence, have
passed by its curative powers, to get the more
readily to the absolute medicaments of the materia
medica.
  The sixth, enquires into the diseases prejudiced
or benefited  by celibacy and marriage.   The tem-
perament of the individual necessary to be circum-
spectly scrutinized, before either can be pronoun-
ced as a remedy  for valetudinarian debility  or
disorder, or for paroxysmal  acute disease.  The
country, clime, government and laws,  and  above
all,  the  individuals predisposition to hereditary
mental or bodily taint,  necessary to be well known,
to justify a  strenuous recommendation against the
will of the  patient, to either  of these remedies.
In a word, the moral temperament, education,  and
habits of the patient,  greatly  affort the curative
powers of celibacy  and matrimony, in such  di-
seases or disorders as they are  supposed to cure or
restore.
   D.  This section comprises  as  much of causes
noticed under C,  as can be used to guard  against
the attacks  of endemial or epidemic diseases.  The
stimuli which act on the irritative actions: prophy-
 lactic diet, and beverages; dress, gestation, gym-
 nastic exercises, bathing, balsamic odours, etc. etc.
   E.   Most writers and teachers have divided the
 materia medica into two main  divisions: aliments
 and medicines; the first embracing things  'icnomi-
 nated nutrients, having the power of nourishing the 
15
 system and supplying its solids and fluids with their
 requisite pabulum.  It is not difficult to see the in-
 convenience of this division. Many of the articles of
 diet, as tea and coffee,  are, strictly speaking, sub-
 jects of the class nutrientia, yet they possess deci-
 ded medicinal and even narcotic powers. Aliments
 have been considered,  in reference to their easy or
 difficult digestion ; or, as they are called to supply
 solid or fluid parts  of the system; or, as they fur-
 nish  a large or small quantity of nourishment.   In
 either of  these  views  the  arrangement  of such
 nutrient articles  under the subject which profess-
 edly treats of the medicinal articles, is objectiona-
 ble.   Hence  E,  comprises a  history of those
 dietetic  substances,  only, natural or artificial,
 which are peculiarly suited  to  the restoration of
 convalescents;  and  thus stand midway between
 aliments and medicines.  The peculiarity  of their
 effects pointed out; the necessity of understanding
 the culinary processes used for preparing them for
use, insisted on.  In  short, as much of the cssen
tial  part  of nutrients treated of, as  physicians
ought to know, or at least, as students can  be sup-
posed to acquire.
  F.   Comprises a history of poisons, with a de-
velopment of their  effects on the animal functions.
The symptoms produced by them, when peculiar or
specifically induced, considered.   An enquiry into
the existence of  antidotes, considered as agents
endued with specific power to counteract the nox- 
lb
„ms effects of poisons, and by that specific agency
to reinstate  the perverted or injured functions in
their physiological regularity.  An attempt made
to reduce the reputed antidotal remedies, to a lim-
ited number, capable, under various combinations
and  circumstances, of opposing  temporary  sus-
pension to the dangerous inroads of poisons, until
they can be removed altogether, by mechanical or
medicinal means.  A unity of proximate  princi-
ples proved to exist in many of the plants termed
poisonous ;  and a similar unity  shewn  in those
reputed as the antidotes.
 ' G.   This section embraces as much of the prin-
 ciples of terminology and classification,  natural
 and  artificial, as is deemed subsidiary to the im-
 mediate acquaintance of the student with Materia
 Medica ; in other words, the principles and details
 of Medical Botany,  so set forth,  that an amalga-
 mation of them with the details of  materia medica
  proper, so natural and useful, will be found easy
  to the student. 
A.
Subsection * —-means  used  to ascertain the medicinal
              virtues of substances.
   1.  Chemical examination, how far to be relied
on, when most fallible, and the sources of this fal-
lacy.
   The utility of chemical analysis assailed by the
celebrated Mariotte more than a  century  and a
quarter ago, on the ground of the existence of the
same principles in medicinal and poisonous plants ;
affected also by the experiments of  the Abbe Fon-
tana  on  the  venom of the viper and gum arabic,
which yielded the same chemical results.   The de-
ception of those views, their inapplicableness to the
point discussed.  The present mode  of investiga-
ting by chemical analysis, highly useful, develop-
ing the proximate principles of plants.  To  chem-
istry  is  owing the pharmaceutical adaptation of
menstruums of appropriate powers, in solving the
virtues of medicines and conveying them into the
system by adjuvant vehicles.
  2. Botanical affinity  is that similitude found to
subsist,  between vegetables that are distinct from 
lb
each other, in the parts of their fructification.  1 he
analogical structure of plants to  each other has
given rise to adjudging the possession of analogous
virtues.  These affinities most to be relied on in the
natural families of plants, in which  not only the out-
line characteristic of features, is preserved through-
out the various genera grouped under these natu-
ral families, but, a coincidence of anatomical struc-
ture and physiological office observed, throughout;
a similarity in the peculiar juices,  of the secretory
vessels, and sometimes even the geographical range
of habitation,  indicative of  analogy.    Botanical
affinity considered under these extended views, is
to be relied on ; the exceptions  rare  and anomal-
ous.
   The different natural orders, or natural families,
which are pervaded, throughout,  with the most stri-
king physiognomouical and anatomical similitude,
noticed ; and an enquiry into Decandolle'sopinions
on the deduction to be made in  reference  to their
medical virtues, from these data.    These enqui-
ries predicated on our actual experience of coinci-
dence in certain orders or families, and the medi-
cinal virtues of all the species  of the genera per-
taining to those families.  They are  pursued also
with the  intent to aid the student in prosecuting
the analysis of the  American Materia Medica.
   3. The sensible qualities of the substances em-
ployed, have likewise been a fruitful criterion for
adjudging the medicinal virtues.  Fallacious  in
the extreme,  in many instances, yet in a majority
leading to judicious results and  investigations.
   4.  The absurd  doctrine of signatures, now to-
tally disused.
   Definition of the doctrine of signatures or resem-
bling tokens, and illustrations of it.   The history
of this doctrine, in the writings of Porta,  an ita' 
19
ian botanist,  who flourished in the sixteenth ceri
tory.   The vestiges of its hallucinative dogmas
still before us, in the names of many officinal and
other plants ;  for example: Dentaria, tooth-wort—
Pulmonaria, lung-wort—Euphrasia, eye-bright—
Hepatica,  liver-wort, &c. &c.   Evidences of a
taint  of this  doctrine perceivable in the  latin
work of Schoepf, as late as  1787 ; as well as in
many  anonymous publications of physicians,  on
the virtues of  vegetable medicines.
  An enquiry  into the causes which have retarded
the investigations of medicines, generally.
  A particular enquiry into the causes  which have
retarded the investigation of  the Materia Medica,
of the United  States.
                  Sv.bseclion /3.

   An  attempt to  point  out the  confusion  which
has arisen in the  Materia Medica  from the ne-
 f;lect of synonymes; and the caprice  of authors,
 n prefering one name to another,  without add-
ing  and  perpetuating  the  synonmyn  by  which
the article  he designated was  known to  others.
The depreciation of medicines of value,  in the es-
timation of practioners, traced often to this source ;
and to the inevitable substitution of one article for
another, owing to  confusion of  names.  .
                  Subsection y.

  General considerations  on the  constitutional
moral  and  physical causes,  and  modes  of  Hv-
    B 
20
ing,  which modify  the  established doses of med-
icines,  in  numerous instances.    The  necessity
insisted on, of being alive to all those qualify-
ing  and exasperating influences,  in order fairly
to obtain the medicinal value of any substance of the
Materia Medica.
                 Subsection  o.

  The alphabetical order  used in preference to
the common method of teaching and  writing on
the Materia Medica.   Reasons  of this preference
detailed from the following outlines:—
  A long course of study of the Materials of the sci-
ence,  has fully brought to my view the endless ano-
malies, paradoxical assumptions, and contradictory
results, arising from any attempt to  classify the
articles termed Materia Medica, by any of the com-
monly adopted systems.                     *
   Bcerhaave arranged the numerous Medicaments
according to the order of his botanical system.  Lin-
naeus followed the  order  of his  sexual system
throughout his Materia Medica. The injudicious na-
ture of these arrangements proved, by an exposition
of the discordant materials brought together.  Dr.
Murray in his  Apparatus Medccaminum,  followed
the order of botanical affinity.  Instances of hetero-
geneous articles brought together under  this sys-
tem,  by illustrations from all the orders.
   The arrangement of Cullen,  that one,  which of
 all the attempts  at scientific classification, is the
 most highly wrought, and carefully digested, pro-
 duces perpetual discordancies of  theory and prac-
 tice : of data and results ; of assumed discipline and
insubordinate irruptionslnto the ranks of division— 
al
 in a word, they produce a distracting embarass-
 ment in the students' mind and memory ; and, un-
 less he be wary indeed, will taint  his practical
 views,  with ill-digested and perverted  ideas of the
 power of  the remedies he is  to use.   The revised
 system of Cullen by the late Professor Barton,
 considered, and shewn to be obnoxious to  the obr
 jections presented by  the first outline.
   A consideration of Dr. Young's sectional division
 into chemical, \ ital, and insensible agents: and sub-
 sectional  classification into those causing perma-
 nent, partial  and transient action ; and those that
 primarily, and secondarily diminish action or sen-
 sation ; and finally, those which are absolute speci-
 fics.
   The utter incompetency of this apparently suffi-
 cient and  certainly beautiful arrangement,  to
 meet all the exigencies of the distracting materials
 it is intended to group and generalize,  fully shewn
 by illustration.  The terse and comprehensive, and
 also beautiful, because brief system  of Darwin,
 inquired into ; and its like inaptitude to grasp at all
 the projecting angles and irregularities of the code
 of medicaments, proved.
   The classification  of Dr. Murray  into general
 and local stimulants; chemical remedies ; mechan-
 ical remedies ; with the subscctional division of the
 general stimulants into diffusable and permanent,
 seems at the first view, to be as nearly unexception-
 able as  any scheme  of classification which could
 be devised.  It doubtless, is so, taking into view
the present state of medical science.   It has been
adopted, by a late  writer*  on the elements of
Therapeutics  and  Materia  Medica.   The order
has  been  disadvantageously  perverted,  though
* Dr. Chapman. 
■22
The principles of  Murray's  classification  are^pir*
sued, with the exception of an insulated position
for mercury.   It  is evident that the author of that
work,  is not  satisfied with the existing systems of
classification  ; and intimates in the preface of  the
first edition,  that the plan proposed by Dr.  Bibb,
in 1801,* of arranging medicines en the principle of
their affinities to  the several systems of the body,
xs much more natural ; and  if opportunity is even
offered him, he will attempt to establish that sys-
tem.  Bibb's  system is predicated on the arrange-
ment of a system  by Dr. Rush—his proposition is
objectionable; more so than Dr. Murray's—rea-
sons detailed in  the lectures.   Dr.  Granville's
arrangement  has  been  adopted  by Dr.  Eberle
in his Elements.   In a word, as  none  of the pub-
lished systems meet my  views, for correctness and
truth,  it only remains for me to  notice one, long
since discarded, which I shall endeavour to  revive
in these lectures.
  Newman and Lewis proposed an alphabetical  ar-
rangement.   This,  with some variation relating to
rlie different  parts  of the plant,  was  adopted by
Alston and Vogel.  It is likewise used in Dispen-
satories, and  in Paris' admirable  work, the Phar-
macologia.  I adopt the simple arrangement of  the
alphabet in these lectures.  1 discard all  the sys-
tems of classification just noticed ; hut, after treat-
ing fully  of  every  article  under its  proper  lit-
eral head, shall reduce the whole  by tabular dispo-
sition,  according to the most prominent properties
they evince, to the system of Murray, of general
and local stimulants, chemical  and  mechanical
remedies.
   The object  of lectures is to inform the student oi
the history, virtue  and effects of medicines. The

  * See his printed Inaugural Thesis, Ua. ofPemuof that yea:. 
23
 method  which enables him  to acquire these points
 of knowledge with the least distraction, and the
 most certainty ; is, without doubt, the proper me-
 thod.  Eleven years habit of teaching the Materia
 Medica,  has assured me of the total inutility  of
 the common methods of arrangement in teaching;
 and the never-ending perplexities encountered by the
 student, owing to the repeated returns of the same
 article into the lecturers discourse,  for some vir-
 tue or effect possessed by it,  besides that for which
 it had already been classed and treated of.   The
 pupil tires and  is perplexed,  the  teacher flags  at
 perceiving the weariness and confusion of his tyro,
 and mutual embarrassment ensues. The alphabetical
 method is, to speak without figure, as clear as A.
 B. C; never burthens  the students memory by a
 repetition of any call on it by the same articles ;
 and encourages him by a reflection on the fact, that
 when the teacher leaves the discussion of any ar-
ticle of the course, he is done with it.  When he de-
sires to refresh his  memory by his notes, they too
have a unity of subject in consonance  with  the
singleness of his teachers discourse.
                  Stibsection £

   The preceding  objections are not to  the terms
used  to  designate the properties or operation  of
medicines, as emetics, tonics, &c.  but to the feasi-
bility, consistently with fitness and utility in teach-
ing, of arranging the medicaments of the Materia
Medica,  under classes designating such emetic, to-
nic or other effect, when in fact the  substances so
classified,  are  endued with manifold effects, re-
      B  2 
24
quiring their  insertion in like  manner in other
classes.
  In order to the clear understanding of the termi-
nology of the science  of  Materia  Medica,  (for
terminology it may with propriety be termed:) I.
shall enter at once into a therapeutic general lec-
ture on each of the classes designated  by this ter-
minology.  The.e therapeutic  lectures properly
precede the alp  abetical disposition and consid-
eration of the medicaments themselves.
                 Subsection s.

        GENERAL STIMULANTS.

  An enquiry into the nature and effect of a stimulant;
the grounds on which it is so denominated ; the phy-
siological subserviency to its impulses, and perma-
nent or transient susceptibility of its impressions. In
how far a stimulant impulse may be considered within
the compass of the healthy performance of functions
—when the approach of stimulant impulse to dan-
gerous or  fatal disproportion to the powers of life
commences—how this point of jeopardy  is guarded
or entrenched by habits, idiosyncracy, or neutrali-
zed by  counter stimulants applied to less danger-
ous parts of the system.
                 Subsection $.

          LOCAL STIMULANTS.

  A consideration of what they are ; in what they
may legitimately be distinguished from stimulants of 
25
a general character; the circumstances which may-
convert the one into the other considered   The pe-
riod of life,  the  state of the system, the sex and
occupation or  habits of the patient, which all to-
gether conspire,  or  separately tend to modify or
change,  the impetus, force,  and  permanence of
local stimulants.
  The danger  of employing them without refer-
ence to these circumstances.
  The necessity of a knowledge of the principles
of elementary and medical chemistry,  in order to
lead to a knowledge of the incompatible  substan-
ces improper  to  be administered with the chemi-
cal remedies as refrigerants, antacids, lithontriptics
and escarotics.
  The utility  and importance of a knowledge of
the anatomy and physiology of  the viscera, to un-
derstand the  art  of prescribing the mechanical
remedies with propriety and effect. 
INT.]
2ti
OUTLINES OF THE GENERAL  THERAPEUTIC
               LECTURES.
                 ANTACIDS.

  Remedies endued with the chemical neutralizing
power of correcting the undue,  if not morbid pre-
sence of gastric acidity.   They act healthfully by
producing an innoxious compound within the living
system, which takes place of the morbid cause of
disorder,  existing from the presence of a hurtful
agent. Their action is chemical, and, owing to the
same principles  of neutralizing  union  inherent
in their comminglement out of the body.  A disen-
gagement of carbonic gas from the stomach, occurs
by the use of any carbonated alkali,  as an antacid ;
and the neutral salt produced in consequence of the
administration of any antacid, is purgative or oth-
erwise, according to the agent employed; highly ne-
cessary to advert to this fact, in the use of remedies
of this power;—since gastric acid disorder, is  ac-
companied by the two opposite states of the bow els:
wasting laxity, and flatulent, painful constipation.
In the latter case lime used for its antacid property,
as is common inform of lime-water, would aggra-
vate perhaps, and  certainly not remove the evil—
while the neutral salt produced by exhibiting  mag-
nesia, would purge,  and  vice versa.    Whether
gastric acidity  be induced by a perverted secretion
of the stomach itself, thus preventing the healthy
effect of the bile in digestion, or by an acetous fer-
mentation carried on in the stomach and bowels
from the unfitness of the patients diet to his assim-
ilative powers;  the constitutional  diseases,  and
distressing disorders and irregularities of the di- 
27
[ant-
gestive system are numerous, perplexing,  and ob-
stinate in the extreme.  These affections in adults,
and particularly  infants,  noticed  in  detail;  the
gouty taint a  fruitful concomitant, if  not cause of
it: the kidneys involved  in  this form of gastric
acidity,  and the  urine always changed  from its
healthy proportions of constituent principles; this
is never  or rarely, the  case in infantile gastric
acidity.   The reasons  pointed out.  These reme-
dies  indicated in chlorosis, in combination  with
medicines of emmenagogue  power.  In  cardial-
gia, should be united with tonics. The effect of sed-
entary habits, and the depressing passions, as envy,
hatred, malice,  &c. in  engendering the gastric
acidity.   The total inefficacy of antacid medicines,
in chronic cases depending on moral causes.  The
effective  power  of remedies  of antacid  virtue,
most conspicuous in recent,  or acute  cases.  The
efficacy of  antacid diet considered ; its compara-
tive utility  with  antacid  medicaments contrasted.
The bearing of the Broussaisan doctrines of ente-
ritis, gastro-enteritis, &c. on the antacid practice,
whether by diet or medicines, enquired into.  The
danger of  this system,   shewn, in the treatment
it leads to in gastric acid disease and  disorders. 
ANT.]
^8
ANTISPASMODICS.
  These are substances  capable  of arresting and
subduing undue muscular actions, called spasm—
in the excess of inordinancy, termed convulsion; and
of assuaging pain, not by the mere production of bo-
dily quietude, but yet unaccompanied by that high
state of insensibility induced by substances of  nar-
cotic power.  I am of opinion that all the remedies
usually  denominated antispasmodics,  do more or
less induce mental insensibility, or rather apathy.
Their operation in allaying pain differs from  that
of narcotics, which, more certainly have this effect,
-—by involving the sensorium in a less degree.  The
effect of musk,  galbanura, assafcetida, castor, am-
monia, saffron,  cajeput oil,  valerian, &c. &c.  in
controling muscular spasm, has always appeared
to be accompanied by some transient insensibility ;
nor can I well conceive of a substance of unequivo-
cal antispasmodic virtue, commanding the actions
of muscles but through the same  channel from
which they derive the moving spring of their healthy
action.  Exemplifications of the narcotic  effect of
all antispasmodic substances given.  The remedies
under consideration, are not singly that  set char-
acterized  by the virtues  of musk, assafcetida, &c.
but comprise a vast assemblage  of  other  medica-
ments,  whieh  have an equally powerful effect in
controling the associative actions of the mind and
body, but which are arranged by those who classify
the articles of the Materia Medica,  under othei
classes.   These are narcotics, tonics, diaphoretics. 
                        ^                 Tanx*
 emetics, cathartics, diuretics,  &c. &c. from all of
 uluch, articles endued with the power of anlispas

 cond'LT of7  "V .^ I™"' aCC0,'di»S ^
 disordered    F   ,nd.,vl*ua.1 system spasmodically
 disordered.   Excessive irritability from watchful-
 ness, the angry passions, the sudden abstraction of
 a customary stimulus  as  in  mania  a potu,  &c
 may produce spasm, wounds, and irritation in in-
 fante, from indigestible food, dentition, worms? &c.
 and irtW an,d St °CCUrS in ^Mic babh
 and m delicate females, attended, if not induced by
 a state of extreme debility  or want  of tone in the
 general system.  In these different states of the sys-
 tern the remedy  which is to cure the spasm,  and
 must therefore be considered  an  antispasmodic,
 must vary,—it may be a simple tonic, or an astrin-
 gent tonic, a cathartic, an anthlementic, a diaphor-
 etic, an emetic, blood-letting, the cold bath, bran-
 dy,  a  narcotic,  as opium  or  camphor, or moral
 discipline, and  mental castigation  and  reform.
 1 he subject  pursued in detail, shewing eventuallv
 the  inutility of  classifying the articles  of  the
 science, which so intermingle with  each other,
 their respective properties.
   An enquiry into the  circumstances which contra-
 indicatc the  absolute  antispasmodic substances
 in cases  where  spasmodic disease  or  derange-
 ment exists.   The  difference between tonic'ami
 clonic  spasm.  A glance at the  "spasm of  the
 extreme  cuticular  vessels,"  the  foundation  of
 Cullens  Theory of Fever,  and his  remedies  and
rationale of their operation.  A designation of the
diseases in which the narcotics,  as antispasmodics,
arc preferable to any other. 
ANT.]
30
ANTHELMINTICS.
  Various parts of the human body form a domi-
tflium  for  different  parasitic animals, but they
chiefly infest the stomach  and bowels.  The an-
cients were well acquainted with the worms infest-
ing our bodies,  and both, Hippocrates  and Galen
have written concerning them.  In modern times,
this subject has been more noticed and the habits of
the intestinal and stomach worms and the disorders
these  parasitic  pests produce  have   constituted
fruitful sources of investigation ; indeed, there
seems  nothing  further to be developed  as far  as
regards the characteristic  traits of the different
kinds,  or as far as concerns their manners, though
there still  exists and  probably ever will,  a confu-
sion of the symptoms  of worms and those of other
diseases.  As regards the animalcule, &c.  few are
settled in the opinion relative to the cause of ex-
istence, or necessity  or use of these parasites,  or
whether they be  entirely  peculiar to and form a
necessary part of our bodies,  or arc wholly extra-
neous to it.   There  is much  reason to infer the
truth of both these latter positions. Of those para-
sites which appear naturally to belong to us, may
be instanced, millions of animalcule, or organised
molecules, observed  in some  of our fluids.  Ob-
servations on the mesenteric blood, and  s, masculi-
num, &c.  The  animalcule alluded to, are always
present, only die  with us, and if they do not, and
it is not ascertained that they do, aid in the perform-'-
ancc of any function, they still  may be said to  be 
31                 [ART:
 congeners.   The extraneous parasites are the lar-
 vae of different lepidopterous insects, beetles,  flics,
 butterflies,  gad-flies  and others, infecting  intes-
 tines, nares &c. &c.  Inquiries into the manner of
 their introduction,  whether by food or otherwise:
 cases detailed of those whose mode of life exposes
 them to these larve: hair  worm of Laplanders,
 from marshy water, &c. &c.   These larve not so
 common to human  species but every  where infect-
 ing horses, sheep and other  cattle, and those chief-
 ly who attend on them.   To the head of extraneous
 parasites may be added the Guinea  worm  which
 insinuates itself into the flesh  of the human body.
 A third kind of parasites infests our bodies, which
 in all its varieties  has  attracted much attention
 with  physicians, because of  the annoying and even
 fatal  disease they produce—intestinal and stomach
 worms.   For their  destruction,  various are  the
 medicaments of reputed power: as these have been
 supposed endued with a specific noxious property,
 they have been denominated  anthelmintics. An en-
 quiry whether there be  any  such  specific property
 inherent in  any of the remedies usually employed,
 or whether they do not  act by their common evac-
 uant  property, and in many instances by the  in-
 vigorating  effect  of their   bitter tonic quality.
 Different opinions  are  entertained respecting the
 pristine formation within our bodies, or extraneous
 origin from without, of  these parasites.  Perhaps
 both opinions are correct, the  reasons  why.   As
 the different anthelmintic medicines  possess very
 different powers, (according to the commonly  re-
 ceived opinions of practitioners,) in disgorging or
 destroying the different kinds of worms, it is highly
 requisite that all the  genera and species, with the
 concomitant  morbid derangement  they induce,
-should be well  known by students, that they may
         C 
ANT.]                 32
be the better prepared to hear of the articles sup-
posed to be suited to the  expulsion or destruction
of each; and that they may know when to apply
either of the  numerous remedies  reputed to pos-
sess anthelmintic virtues.   These considerations
are the more interesting to the student, and require
the more of his attention, from the fact, that not-
withstanding all the attention which has been paid
to this subject, by enlightened men, it is a melan-
cholly truth, that but little of certainty has resulted
beyond the clear exposition  of the natural history
of these animals.   We still  know, comparatively
with the  laborious  investigations on the subject,
hut  little  of  the general  pathology of  worms:
little of the symptoms  thry immediately  excite.
What is known the  student should possess himselt
of thoroughly.  Before detailing the heads of these
points of discussion, it is necessary to know that
the intestinal canal is  infested by five different
 kinds of worms.
   1. The Lumbricus teres,  or round worm:  Re-
 sembles the   common earth worm, but  presents
 many discrepancies of structure,  is from  8 to 15
 inches long,   infesting chiefly the jejunum  and il-
 eum, is sometimes  erratic, proceeding  to the sto-
 mach, throat and mouth, mostly  in  pairs, not un-
 frequently thirty or forty have been found togeth-
 er, and  rarely solitary. Affect the system under
 15,  most generally under 8  years,  and  rarely
 adults.
    2 and 3. The tenia, or tape-worm, so called from
 its resemblance to tape ; is very long, from 20 to 30
 feet, and cases much longer have been reported: in-
 fests the upper part of the intestines of children and
  adults, feeding on chyle. Sometimes solitary, gen-
  erally imagined to be always so.  not strictly true.
  Dr. Nitret mentions a woman who discharged 18.
  JThe detached joints of one kind resemble gourd 
13
[ant-
seed, and hence  called vermes cucurbitinus,  each
joint incorrectly  supposed to be endued with in-
dependant  life.   It  is  the first of two kinds and
called the broad tape worm,  (taenia lata and Bo-
thriocephalus  latus.)  occasionally ending in two
processes one larger than the other,  most general-
ly in one.   Its head resembles that of the  second
species,  called tenia solium, or long tape-worm.
The. immense length of the tape-worms, (Roerhaave
saw one 30 ells long, and Brera mentions one in the
cabinet of the University of  Pavia more than 230
feet long,) together' with their tcnariousness of po-
sition,  renders it extremely  difficult to dislodge
them entire.   When their partial extrusion  from
the  body takes  place,  the  residual  articulations
speedily increase, and  reproduce all the  distres-
sing symptoms, peculiar to their presence.   Not-
withstanding  their usual tenacity of lodgement,
they sometimes are spontaneously discharged,  ei-
ther partially or entire, by  stools, from persons
who had not previously experienced any premoni-
tory signs of their existence.   Instances mentioned
of their having dropped from a person, by any ex-
ertion in walking.  The gourd-seed tenia is read-
ily known from  the other by  having a small aper-
ture (osculas,  little mouths) on the centre or  mid-
dle of the flatened surface and only on  one  side,
this species seldom parts  with its joints, but the
other does  very frequently.    The joint of the
gourd-seed worm are easily  separated irom  each
other when the  animal is alive, each  joint thus
separated has  the power of retaining life a consid-
erable time.   Tape worm  infects the smaller in-
testines chiefly, and it sometimes  occupies so large
a space of the jejunum as to give the sensation to
the patient of  a ball rolling about, when he turns
in bed.   They however sometimes  get into the 
AKT.j
o4
stomach ;  the case of a Dutch peasant is recorded
by  Van  Doevern, who vomited 40 ells of tape
worm.  Emetics sometimes thus dislodge them by
the mouth.  These horrible animals are more com-
mon in some countries than others: in Switzerland,
Russia and  Germany are  frequent, more than in
Britain and the  United States.  They not only
infest  very young  children  but  according  to
records, have  been found  in the  alimentary  ca-
nal of the fetus in utcro.
  The 4th species  of parasitic worm,  is the as-
caiis vermicularis, or thread-worms:—these are
about half an inch in length, of a yellowish white
colour, and remarkable quick and  agile  in their
movements.  They  domiciliate  in  the  mucus and
thin feces of the colon and  rectum, chiefly  the
latter—feeding most likely, on  the mucus.  They
are occasionally erratic, having been found in the
vagina, and about the thighs.
  The 5th species of parasitic worm is the trichuris,
or Tricocephalus  dispar,  long  thread-worm.  It
is a spiral worm, from an inch  to an inch and
a quarter  or two inches in length,  marked  exter-
nally by numerous  transverse annulatcd lines:—
one part of the body terminates in  a slender hair-
like coil,  the other  end  in a  spiral convolution
ending in a broad  obtuse hook, which  has been
compared  to the pistil of liliaceous flowers.  From
this extremity the animal puts forth a tube invested
in a sheath.; it  is formed generally in the cecum
or ileum.
  The disorders which arise from these worms, are
numerous  ; and in infancy, not  seldom  fatal. The
similarity of the symptoms they produce, to those of
teething,  is striking—not  always  easy to distin-
guish between the one and the other ; also to those
of dyspepsia, from which they are in like manner. 
35
[ant.
 with difficulty distinguished.   Children troubled
 with any of  the  species,  complain  of  a gnaw-
 ing,  uneasy  sensation  at the  stomach,  which
 eating appeases.   The appetite is capricious—in-
 ordinate—sometimes voracious ; belly hard, tumid
 ■—morbid vigilance, hiccup, disturbed sleep, grind-
 ing of the teeth,  starting from  sleep with terror
 and  screaming,  head-ache,  vertigo, convulsions,
 feverishness.  thirst, foul tongue, bad taste  in the
 mouth, foetid breath, nausea, constipated bowels and
 tenesmus,  or looseness, with filmy threads and mu-
 cus, puffed upper 1 ip. These are the chief symptoms
 induced in children ; but there are often anomalous
 signs of the presence of  these pests, as squinting,
 slow emaciation,  sallow or livid countenance, pro-
 truded eyes, inflamed tarsi picking the nose from the
 sympathetic irritation of the lining membrane; he-
 morrahagesfrom the lungs, the brain, the uterus and
 the nostrils ;  a short, dry, sympathetic cough, or
 pains in the breast, without corresponding affection
 in respiration ; unhealthy urine, and all the symp-
 toms  of  chronic hydrocephalus.    Indeed,   it
 is often  quite impossible to distinguish between
 ihe symptoms of  this  cerebral  disease and  those
 of worms, and there is little doubt,  that one
 is often treated for the other  ; and that the consti-
 tutional disturbance produced by worms is so va-
 rious and extended, that much obscurity must ever
 attend the treatment*  Ascarides produce chiefly
 local disturbance:  a heat and constant itchingabout
 the anus,  which is teasing and intolerable in the
 extreme.  Bowel  affections are occasionally pro-
 duced by them, such as slimy stools, tenesmus and
 cutting pains: vertiginous head-ache, itching of
nostrils,  convulsive  cough and  dyspeptic disease
 are  more  rare concomitants:---all  exasperated
 towards evening.   Brera, is of opinion that t}<t
       C 2 
ANT.]                  35

tenia may be known from the round  worm (which
produces colic and rending  pain ;) by a pain in the
belly with a turning motion and weight in the side,
as if produced  by some living thing; occasional
pricking or biting sensation in the stomach; the bel-
ly swelling at intervals and suddenly subsiding; yo*
racious appetite,  unattended by a  corresponding
well fed appearance,  but by emaciation and feeble-
ness of the limbs; a feeling of constriction in the
nose,  vertigo, vomiting, and  " an uneasy feeling
on hearing music, particularly that  of the organ."
   From the preceding train of symptoms,  it will
readily be seen that the remedies*  supposed fit to
counteract the constitutional disturbance  of these
parasites, must be various: most of them act so man-
ifestly by their drastic cathartic property, or purg-
ing effect, as castor oil,  that there seems little pro-
priety in calling such, anthclmentics. Some are sup-
posed to act mechanically,  as  tin, cowhage. cold
water, which produces asphyxia in  the  animal,
when  applied to it alive out of the body;  the fixed
and volatile oils: castor oil and turpentine, are also
 supposed thus to act—erroneous.
   The tenia seldom  resists turpentine.  Bitters
 affect chiefly the round worm ; while alkaline and
 irritating enemata most readily dislodge ascarides.
   As I have discarded the classification of medica-
 ments altogether, in these lectures, it is scarcely
 necessary to observe any thing relative to  the ar-
 ticles  ranged  improperly  under  the class now
 noticed, by writers and teachers who adopt classi-
 fication.   For m\ own part, I somewhat doubt  a
 specific anthelmintic property as pertaining to a
 single worm-remedy.   It would not be difficult to
 shew, that they  rather act by other  properties
 in their effect of destroying worms.   There are few
 cathartics, and few bitters, ajul few astringent ton;* 
37
[ant
ics which will not more or less remove worms. The
cold bath, external frictions, exercise,  bitter arti-
cles of food, as tansy pudding, and olives,  &c. all
act against them.   The physician will err who as-
sails his infested patient only by direct vermifuges.
The longer rout  of  constitutional invigoration,
will most  surely  enable him  to  reach his end.
Erroneous impressions are entertained with regard
to the influence of certain kinds of diet in the pro-
duction of worms:—sugar,  for example,  is sup-
posed capable of generating them.  On the other
hand, there is as  much  reason to consider it an
anthelmintic,  as many other substances called so.
A well directed, generous diet, is  inimical to the
formation,  growth,  or  tenacious  lodgment  of
worms ; a spare and meagre  regimen, whether from
poverty or mistaken views  of  health,  favours
their existence, and renders  their continuance cer-
tain,  and their disturbance distressing and fatal. 
ABO.]
38
AROMATICS.
  Substances possessed of  fragrance, and whicii
quickly excite a sensation of pungency and warmth
in the mouth, and  when swallowed,  also in the
stomach, and thence diffusing a continued stimula-
ting effect on the general system.   They are more
or less tonic.   Some  writers  separate them from
tonics in a class named  as above.  In Murray's
arrangement thev  are disposed of under the class
of stimulant tonics, without a sub-class providing
for their aromatic property.  This appears to me a
defect in his classification, which has properly been
noticed by Dr. Paris, as such.   Simple tonics are
characterized,  not only  by more bitterness, but
have a more permanent effect.  The operation of
aromatic stimulants is more vehement and evanes-
cent; their tonic effect, though continued for a time,
is certainly  not permanent.  Their proximate prin-
ciple is moreover different, consisting  perhaps al-
together in  active essential oils, and not alkaline    •*
bases—and  the chief  effective benefit  they render
in substance, may be procured from the exhibition
of these essential oils in small quantities alone, or
variously made into emulsions or mixtures.  I can
conceive of  no propriety,  if classification is aimed
at according to a similitude in effects,  of arrang-
ing with such articles as  chincona and  calumba
which I will assume  as types of the class of tonics,
any of the  following substances: Winters' bark,
cinnamon, cassia, canella alba,  cloves, all of the
natural family piperides, angelica root, lauvus ben- 
                       S9                  [aro.

 zoin, (spice-bush) sassafras, cascarilla bark, nutmeg
 and its anllus or investing substance, mace—rarda-
 mon, anise,  fennel, coriander, dill  and  cummi:;
 seeds, all the species of menthe and monarde, ma-
 ny of which yield a camphor as narcotic as  com-
 mon camphor, lavender, rosemary, marjoram, pen-
 nyroyal,  dittany, &c. &c.   While on  the other
 hand it must be acknowledged that ginger,  cala-
 mus, Kempferia rotunda,   serpentaria,  cuntray-
 erva,  asarum canadense,  and other  articles  of
 secondary power, while they are  endued with  a
 manifest  aroma,  and  stimulant  tonic  property,
 do nevertheless, yield  little or no essential oil;
 and require to be administered either in substance,
 infusion or tincture.  In so far they appear to hold
 a middle station between the aromatics first men-
 tioned, and the simple tonics, and bitter, or bitter-
 astringent tonics:  the  former  being profitably
 and properly resorted  to through the medium  of
 their essential oleaginous and  volatile principle,
 while  the  latter can alone develop any remediate
 invigorating influence,  by a mode of exhibition
 widely different.   These observations tend to sus-
 tain the position  I have taken in these  lectures,  of
 the nugatory efforts at classification.  Surely if the
 preceding substances are all tonics, they are so by
 very diverse proximate principles, no less than by
 extremely discrepant modes of acting on the living
 system ; and any attempt to unite them in one class
 is as unsatisfactory as subversive of the very prin-
ciples of classification assumed.  The only rational
disposition of the articles called tonics, is, I think,
into sub-classes of:
  1. Simple  tonics.
  2. Bitter tonics.
  3. Astringent tonics.
  4. Aromatic tonics, yielding essential oil. 
ARO.}
40
  5.  Warm tonics, or those possessing aroma, but
yielding no essential oil ; or. if any, not communi-
cating the whole of the effects to the system,  as
when exhibited in its native state of existence in the
substance itself.
  The latter sub-division of aromatic tonics into
two sub-sections, would accord  with  the pharma-
ceutical propriety of their exhibition as medicines.
To conclude,  I  shall, in the tabular  view to be
given, of the articles of our  subject,  according to
the characteristic and useful property  they may
severally  contain, so modify Murray's arrange-
ment,  as to secure the above sub-division  of his
class of tonics.  This I believe to be a better dis-
tribution than that taught by  the late  Professor
Barton, which was a modification of  Dr. Cullen's
arrangement.
   Most of  these aromatics are the native growth
of the tropics, none of high latitudes,  though a few
are found in the north-western part of  North Amer-
ica,  and countries of similar constituted climate.
The essential oils of nearly all, have  some proper-
ties  in common  with each other, which properly
come under the chemical consideration of the sub-
ject.   Medically viewed,  they are,   when  given
internally,  warm,  stimulating  and grateful from
their fragrance ; and hence act as cordials and not
seldom as antispasmodics. Some one of them enters
into all carminative mixtures ; and they  all grate-
fully reconcile to our taste, the offensiveness of other
drugs with which they are mixed  in prescriptions.
As they excite the brain and  sanguiferous  system,
it is requisite to avoid  them  in any considerable
quantity, in cases where  either  is  unhealthfully
roused.
   In the treatment of all exhausting  affections of
the bowels, as cholera morbus,  particularly when 
41
[aro.
these affect children, they constitute a sudden and
effectual remedy against collapse.  They assuage
the rending pains of colic, and of the stomach, from
any cause which may not have induced inflamma-
tion, both safely and  \*. ith promptness. They check
undue vomiting, whether spontaneous or from  the
over-action of an emetic medicine.  Those of them
which are used as condiments, form an essential
part of the restorative  diets and  stimulating bev-
erages of convalescents; and, in  a state of  debil-
ity enable the digestive powers to assimilate farin-
aceous and other food, which might, without them,
create flatulence and pain, during the process  of
digestion.   If moderately  used,  they  are health-
ful to all persons of delicate habit,  and.if at any
period  some  excess  may,  without  injury,   be
committed in  their  dietetic use,  it will be  found
that during the  debilitating  effects  of excessive
heat fn summer, in warm  climates, this excess is
most easily borne.   During the higli range of the
thermometer  even in  our own climate, I  am of
opinion,  we resort too sparingly in our iiets and
beverages, to  these  grateful cordials.  And this
too,  I  think,  from  an  unwarrantable prejudice
against them,  originating in a false idea of their
properties and effects.   I  have done  much good
in the treatment of intermittents, by the liberal em-
ployment of dietetic condiments,  as cayenne pep-
per, pimento, nutmeg and mace.
   Externally  applied, the  aromatic essential oils
arc considerably acrid and inflaming.   They stim-
ulate the skin excessively, and the oil  of cloves
even acts as an escarotic.  The  oil of origanum
(oil  of horscmint,) is exceedingly powerful as a
rubefacient,  and  has been beneficially applied to
stimulate the rigidity of articular chronic rheuma-
tism, and restoring the joints to their freedom. Ex 
ARO.]
42
ternally applied in substance to the belly, a combi-
nation of these articles under  the name of pulvis
aromaticus, is one of those preparations,  the in-
gredients of which are at hand in almost every fam,
ily, peculiarly suited to arrest the dangerous gush-
ing evacuations by  simultaneous vomiting  and
stool,  which occur in the sudden and vehement
attacks,  attended  with  icy coldness of nose, ears
and  extremities of  fingers   and  toes,  of that
fatal disease, cholera infantum.  I have in numer-
ous instances had occasion to believe the life of
my little patients were snatched from the grasp of
death, by the promptness and vigour of this  ap-
plication.   In the  dry belly-ache,  which  I  have
witnessed in sailors, this remedy has, in my hand,
proved equally prompt and useful.  Aromatics  are
much used  as odontalgic  remedies.  Their effect
on the nervous system is manifest.  Indeed some
instances of excessive action  on the  brain  have
been  reported.   The hypnotic power  of nutmeg
in the East Indies, is  noticed by Bontius, as a
frequent occurrence ; and in the records of German
medical literature, some extraordinary effects on
the nervous system, have been noticed, as produ-
ced by this  aromatic.  Cullen speaks of having
accidentally seen the soporific  and stupifying pow-
er of the same substance.  In cases of gout affect-
ing the stomach, attended with that  coldness of
the extremities  and  unbalanced  action  of   the
sanguiferous system, appertaining to that affection,
I have seen an infinite  deal  of benefit, from  the
liberal employment of aromatics of the most  in-
tense activity, as oil of cloves: and I know of noth-
ing so  well calculated to reinstate the stomach in
in that healthy action so much perverted by the
use of balsam copseva,  as ginger  in*some form,
ur cinamon tea.  In fact, a habitual resort to arc 
4o
[AROv
matics, singly or in combination with other medi-
cines, in along course of practice, predicated on the
the daily experience I have witnessed of their benefi-
cial effects, emboldens me to say, that too little at-
tention is paid to their condimental effects,  and too
sparing a use made of their medicinal properties, by
the majority of physicians.   The full  investigation
of their practical application, is therefore strong-
ly recommended to students.
D 
AST.]
44
ASTRINGENTS.
  Astringent remedies are substances which con-
stringe the living animal fibre, and consentaneous-
ly invigorate the system.  In the arts they are vari-
ously used.   Ihey condensate  the  dead animal
fibre in certain processes, as the tanning of leather.
  There are numerous aspects in which the class
of medicines possessing an astringent  property,
may be viewed, each  presenting much difficulty
and uncertainty.   Among them  their mode of op-
erating  is particularly perplexing.   Cullen and
Spielman commence their treatises of the Materia
Medica  with this class.   Many  attempts  have
been made to abolish  it,  the reasons  alleged for
such design: reasons why  it might be abolished,
even from those  works in which the system of
 classification discarded  in these lectures,  is pur-
 sued.   The substances could readily be disposed
 of under the classes of tonics,  &c. Cullen's opin-
 ion in relation to  the mode of operating of this
 class of medicines,  discussed.   He believed they
 acted chemically upon  living, as  they  do upon
 dead matter in the process of tanning.  Difference
 of the action  of astringents  on  dead and living
 matter, evidenced in the certain addition of weight
  they make to the former, and the very inconsidera-
  ble quantity absorbed, by the living system, when
  an astringent liquor is applied externally to any
  part of it.  Notice of Davys' experiments relating
  to the augmented weight  of hides  by the absorp- 
45
[AST.
tion of tannin and extractive,  existing in  the
oak bark.   Experiments of Rousseau,  Klapp,
Dangerfield and Muzzy noticed. Seems unquestion-
able that astringent fluids are,  like other  fluids
applied externally, taken into the system  in part,
by  cuticular ingress, but not in sufficient quantity
to affect the gelatinous fluids they  would meet with
in the living as well as in the dead body: would be
resisted by cuticular blood vessels, &c.  The living
principle seems to resist the effect of tanning; ex-
emplified in  the condition of animals existing even
in a torpid state,  exposed to the action of astrin-
gent matters.   The effect of astringent peat-moss
upon human bodies; of astringent  infusions,  &c.
on  butchers meat.  Effect of bark  in arresting
gangrene ; does so by operating on the adjacent
living fibre.  Not fair to infer it does this by as-
tringent property,  since camphor, assafoetida and
other substances, destitute of astringency,  pro-
duce the same effect-  Even the most powerful as-
tringents  will not  arrest gangrene.   Mr. James
Moores' experiments noticed.   He renders it pro-
bable that oak bark  does  not cause  contraction
of the  living fibres.   Effect of alum in corru-
gating the papille of the tongue noticed, Darwin's
rationale  of that effect.    In a word, the action of
astringents  on  living, and dead matter, is  dif-
ferent, as in the case of other medicines, for ex-
ample lunar caustic.
  Effect of astringent  solutions applied to lactife-
rous plants.  Opinion entertained by some that  as-
tringent bodies operate chiefly on the part to  which
they^are  applied and  are rarely communicated to
remote parts of the system through the medium
of nervous or muscular influence—erroneous:  the
daily operation  of astringents  in  the treatment
of diseases,  opposed to such an idea.  Dr. Hebev 
 1ST.]                 4G

 dens' notions concerning the use of astringents in
 hemorrhages, tainted with this idea; the theory at
 variance with effects of sugar  of lead, &c. in ar-
 resting pulmonary and uterine hemorrhages, and
 hence leads to  injudicious  practice.    Madder
 unites an astringent with a colouring  matter,  the
 latter has been proved  to be carried  into the cir-
 culation ; it is no violent supposition, that the as-
 tringency of this  or any  other article,  may in
 like manner, be taken up by the lacteals,  though
 in small quantities.   The beneficial effects of as-
 tringents on the body, cannot be explained by  the
 idea of their astringency being taken through the .
 course  of the circulation,  because one  or two
 grains of quinine will  avert the  approach of an
 expected paroxysms of intermittent within a short
 time after its exhibition, and two or three grains of
 sugar of lead, will command an excessive uterine
 hemorrhage,  in half an hour after it has  been
 given.  The time and quantity  in both instances
 too inconsiderable to suppose their agency to seek
 she track of the  circulation.  They  operate dif-
 ferently.  They act probably by impressions made
 >n the stomach and intestines primarily, and thence
 are conveyed by some of the operative influences
 of the living system, quickly to the solids and fluids.
 Hunter and Darwin's recently purloined doctrines
 of sympathy a very  convenient rationale, though
 near half a century old.
  Woodhouse's,  Seguin's, and Dr. John M. Walk-
 er's (Viit.) experiments  relative to the  astringent
principle, noticed:—
  For the opinion of the first, see his   edition of
 Chaptall's Chemistry. ^Cultivation deprives many
plants of a part of their astringent principle.  Ac-
cording to Hatchet, a factitious astringency may be
produced by treating various vegetables with nitric 
                       47"                 [AST.

acid.   Method  of  detecting this  principle  in
plants: by application  to mouth, and by  effects
on  living animal body,  by solution of copperas,
&c.   Cullen's  opinion  relative  to  the degree  of
corrugation induced in the mouth, as a criterion of
the intensity of the  astringent power in the  sub-
stance used.
  The  astringent principle resides in cortex and
liber of most oaks and peruvian barks: in the liber of
many trees and shrubs, the cortex of which possessee
little or none of it; in the  roots of numerous plants,
as the ratanhy  root, alum  root,  tormentil,  rose
tree,  geranium  maculatum, &c.   In the wood of
many trees,  as logwood ; in  the  leaves of many
plants,  as shumach,  common green tea, &c;  in
the excressences which form the nidus of insects,
as oak-apple, aleppo-galls, &c. in the latter it ex-
ists united with a peculiar acid which has received
the name of gallic acid.   This was once supposed
to be the astringent principle ; not correct; galls
do not contain more of this acid principle than other
astringent vegetables: Higgins' experiments shew
that some species of shumach contain  more than
other vegetables, yet analised.  Chemical proper-
ties of gallic  acid.
        MEDICAL USE OF ASTRINGENTS.

   Of the use of astringents in diseases:—best given
in substance, when the stomach will bear that form
—otherwise, should be given in the pharmaceutical
liquid preparations.   Astringency is fixed  in sub-
stances containing it; of course the absence of
volatility in  this property,  renders it nugatory to
employ the distilled waters of astringent medicines.
  Watery  and spirituous menstrua take  up the
astringency of substances, subjected to their action;
     D 2 
ASl'.j
48
Cullen imagined a partial decomposition in case.-
of decoction,  and hence prefered infusion.    Dr.
JVlorveau suggested ether as a solvent for astrin-
gency, as best adapted to convey that  principle
most* readily  into the system.   Astringents long
used in intermittents. The most effective remedies
for these affections,  are characterized by more or
less astringency.  The best are those containing as-
tringency and bitterness  combined.  Astringents
used in weakness from whatever cause—often in-
juriously.    In certian  dropsies,  generally with
benefit, where there is no great degree of  febrile
action.   The late  Professor  Barton  advocated
their use, even where fever was present; a practice,
according to my  own experience of doubtful pro-
priety, never having seen good effects from it.
   The efficacy of astringents  is chiefly evidenced
in the cure of the profluvie.  They are used to
check serous evacuations from  the  bowels, fluor
albus, gonorrhoea and  gleet, and  the  excessive
discharges  of other organs.  It  is supposed by
many that  they do  this, rather  by their tonic
property than their immediate  astringent virtue.
Their power in checking hemorrhages  from  the
 lungs nose, stomach, bowels  and  uterus, while
 it is undeniable, presents one of the most difficult
 subjects for medical ratiocination,  which  occurs
 in the whole science of Materia  Medica, and the
 modus operandi of its subjects.   Their exhibition
 not safe, without close attention to the state of the
 circulation; indeed with regard to  hemorrhages,
 astringents arc absolute and relative.  A very dif-
 ferent substance  as  an astringent  is required to
 check that bleeding,  called active accompanied
 with a tonic contractile power of the arteries, and
  that  called  passive  which  happens  during  an
  atonic or relaxed condition of the same  vessels. 
49
[AST.
Cases in which blood-letting must precede the use
of astringents.   Applied externally in hemorrha-
ges,  astringents  are called styptics.   These are
numerous, of ancient date, and  some of them pow-
erful and effective.
   Astringents were formerly much used in dysen-
tery,  in which disease their efficacy has been stren-
uously opposed by Cullen and  others.   They are
inadmissible in  this disease  as it occurs  in  a
variable and intemperate climate: under a tropical
sun, they are useful, and proper in  the second-
ary stage, and under an intermitting type of fever,
particularly the astringent tonics.
   These remedies have been much used at antili-
thics  and certainly some of the class,  though not
those which are  most  conspicuously  intense  in
their  astringency, are serviceable in calculous af-
fections, as the uva ursi.
   The  most ancient employment of astringents,
was most probably as a cure  for intermtttent fe-
vers:  those of the purest kind, do  not appear so
well  calculated for this purpose, as those connect-
ed with bitterness.  Cullens' opinion respecting the
efficacy of the salts of iron, as astringents, in that
debilitated  condition of  the  system,   preceding
dropsy, considered.   This practice  at variance
with the later  received pathology  of  that disease
as taught by Rush and supported more recently by
Ayre.  The practice of  exhibiting  mineral as-
tringents in solution, by  injection, to  check inor-
dinate evacuations of the urethra, nearly obsolete,
reasons why dangerous.   Vegetable  astringents
given in pyrosis,  colliquative sweats of consump-
tion,  and the wasting sweats  of autumnal fevers,
with benefit. Metallic astringent collyria, as of lead
zinc  and  copper, used  in certain  kinds  of  op*
thalraia with benefit; often injudiciously resorted 
AST.]
50
to, at too early a period of the disease.  The ef-
ficacy of a  certain  vegetable  astringent pith,  in
the same affections.   Solutions  of acetate of lead,
used  in phlegmonous inflamation ;  in  erysipelas,
its effects.  Vegetable and mineral astringents use-
ful in scurvy.   Different modes of  application in
which I have  found them serviceable in  that dis-
ease, at sea, and  on laud.    Have also been  ad-
vantageously used in the neuroses, as tetanus, cho-
rea, epilepsy, asthma, pertussis : for these diseases
cinchona, misletoe, bistort, the salts of  ii on. cop-
per,   zinc  and  tin,  have  been  prefered ;  not so
useful as the  narcotic  stimulants  in these  affec-
tions.  In  plethoric epilepsy,  certainly  hurtful; in
hysteria the mineral astringents useful, acting  as
antispasmodics  in subduing  clonic  spasm.   Of
doubtful effii acy in  asthma,  unless  in  lax female
habits,  where it occurs as a symptom of hysteria.
In that case, as in anginose affections  from other
causes, as gout, &c. they are  serviceable, and  my
experience  warrants the  assertion.   Their effica-
cy in hooping-cough, cannot be supported,  unless
invigorating exercise in cold air. be considered  as
acting by its astringing influence.
   In  cutaneous diseases,  astringents  have  long
been favourite remedies, internally and externally
exhibited:—as the itch,  scald-head, psoriasis, and
other leprous  affections.   They succeed  where
every thing else has failed.   In these and in other
affections,  they enhance  the  power  of mercurial
medicines.   Kino ointment,  in psoriasis ;  mer-
curial ointment with powdered kino.  Astringents
have  been used in  rickets; if  any are serviceable,
the metallic astringents should be used ; in scrofu-
la, astringent  bitters  used ; atonic  state of lym-
phatic system, often relieved by them.  Powdered
vegetable astringents  always  are  the bases  of 
51
[AST.
quack remedies for cancers and cancerous ulcers—■
how  used.   In  hemorrhoids,  galls in  form of
ointment  useful;  other astringents  answer  the
same purpose; in indolent ulcers, and the ulcers
from burns,  astringent vegetable infusions,  as
washes,   important;  astringent  gargles,  their
use,  efficacy  and danger; of alum in diebetes;
Dr. Gregory's notice  of its effect in that disease.
Selle, Meade and Dover, recommended this astrin-
gent as a cure for it. Summary of the comparative
efficacy of mineral, metallic, and vegetable astrin-
gents, for the diseases glanced at in the foregoing
notes.   General remarks on the  whole class, with
notice of other and secondary  effects.
  Astringents have been said  by Darwin, under
his class sorbentia,  to create  costiveness ; not al-
ways correct.    Galls purge ; alum purges;  and
hark purges.   Effects of astringent infusions in
striking a black colour with iron ;  catechu an ex-
ception, not containing any thing but pure tannin
uncombined with gallic acid.  Native astringents
in the United  States,  numerous  ; and some pecu-
liar in their operation,  and important articles of
the Materia Medica. 
CAT. J                 #2
CATHARTICS.
  Substances which promote or increase the natu^
ral peristaltic action of the intestines : or, exhibi-
ted in their established dose, induce that excess of
alvine evacuation called purging.  They have been
divided into laxatives, which are characterised by
a very mild evacuation of  the contents of the bow-
els ;  and purgatives,  which in addition  to this
evacuating effect, stimulate the exhalents of the
intestines, and cause a considerable influx of fluids
from them, which are continued for some time to
be passed per amim.   They likewise communicate
a stimulant and rousing impulse to the v\hole sys-
tem.  Those which  cause all these effects  in the
highest degree of intensity, are again sub-classed,
as drastic purgatives.
  The laxatives may be said to  be local stimulants
—the purgatives  general stimulants;  and  the
drastic  purgatives,  general and  vehement stimu-
lants.  The laxatives in  reference to their power
and effect in promoting thf general health, are tran-
sient stimulants ; the simple purgatives, impulsive
and more  continued  stimulants: the drastic pur-
gatives, persistent stimulants.   They are all suited
to peculiar states of the  healthy and disordered
constitution.   The  importance of these  remedies
requires no comment.  Promoting  and insuring
that intestinal regularity and functional  perform-
ance of  an important set of organs, without which
health cannot  exist,  they at  once are the great
key to unlock all the irregularities of the body, and 
53
[cat.
by a timely expurgation of their prejudicial pre-
sence in the physiological system, to restore its jeo-
pardized healthy action, and avert, or even remove
disease.   Purgatives not only increase serous and
mucous discharges from the exhalent vessels of the
inner  coat of the  intestines,  and the excretory
ducts of their mucous glands, but they vehemently
stimulate the adjacent viscera to a healthy action,
as the liver and pancreas.   Of the different reme-
dies calculated to produce  each of these several
effects, more than others of the same class.  Of the
peculiar effect of saline purgatives, formerly called
hydrogogues; of the mineral, of the mechanical, of
the dietetic laxatives.  Of those stimulating parti-
cular sections of the whole intestinal tube, as aloes,
colocynth, gamboge, scammony, rroton oil, colchi-
cum, hellebore, &c.  of the peculiarity  of operation
in jalap, in the mercurial purgatives, in the nar-
cotic purgatives,  in  the purgative effect of antimo-
nials; of emmenagogue purgatives,  their peculi-
arity.  Dr. Hamilton's opinion canvassed, "That
the different species of purgative medicines do  not
possess distinct powers over the different species of
matter to be evacuated."  Of Paris'  opinion that
the ancient division  of this class into hydragogues,
cholagogues,  &c. ought to be revived.  Of the in-
utility and  inconvenience of repeating for any
length of time, what have been  called the astrin-
gent or tonic  purgatives: as rhubarb.   Of the  ad-
vantages in a medical point of view,  of  changing
from one article  of this class to another, in cases
where  permanent or long continued purging may
be  deemed requisite.   Of the  mistaken drastic
effect  of  some purgatives:  as aloes   Of their
contra-indication in  pregnancy, and  the opinions
on  this  point, of  distinguished practitioners  of
midwifery. 
CAT.]
54
   Effect of purges during the menstrual flux ; cau-
tion necessary to be observed at this time.  Effect
of drastic purges in cases of great debility of the
bowels; will  induce  marasmus,  if too often re-
peated, and render the bowels morbidly irritable
and liable to be operated on by a cause inadequate
to move them in  good health.  Cathartic  medi-
cines  may be variously combined to attain a union
of the peculiar efficacy  of  each  ingredient of the
combination ;  advantages  to be  obtained by  a
knowledge of  this part of the subject.
  Purges produce sleep  ever  in maniacs.   They
raise the pulse under certain circumstances.   Hux-
ham says he found them to do so in  the Devonshire
colic : Sir Wm.  Fordyce made the same observa-
tion in most, putrid fevers ;  Dr. Rush likewise ob-
served this:—Notice of his locked-up excitement.
Produce hilarity of mind by removing  collections
of feces from  the  intestines; constipation always
creates despondency  and  gloom.   An enquiry
whether cathartics are taken into the course of
the circulation?  Many  articles   of diet purge;
and as their nutrient property is undoubtedly taken
up, there seems  reason  to infer that the cathartic
property may.  Rhubarb  most evidently  taken
into the circulation ;  its colouring matter pervades
the urine;  there is no proof that  this colouring
matter  is distinct from  its purgative, the whole
root containing it abundantly.  A reason in favour
of the absorption, derived from the effect of  pur-
gatives taken by nursing women,  on the bowels of
infants at the breast.   They also effect the urine,
both by augmenting its flow and altering its com-
position.  The general diuretic  effect  of purges,
noticed.'
  Purges applied to open and running issues, often
operate cathartically on the person thus subjected 
55
[cat.
lo their application.   Effect of aloes and  castor
oil applied to the belly of children and adults,
noticed.   Hellebore said always to purge, if ap-
plied to  an issue.   Query.  Is  the quantity of a
cathartic  thus absorbed, granting that it  is ab-
sorbed, sufficient to purge?  C.  P. Berger gives
an instance of a man  purged by smelling a medi-
cine.   I have  known an officer puked by mention-
ing ipecacuanha, to which he  had an aversion;
both accounted for by association.   Persons under
the operation  of cathartics are readily  injured by
cold and  exercise ;  reasons  why.  Dr.  Gregory
lays much  stress on  this  fact.  Perhaps  in the
treatment of  certain fevers, where cool  air is an
important remedy in itself, an equal degree of in-
jury cannot be apprehended  from  exposure to its
influence during the operation of cathartics.  Ef-
fect  of cold affusions,  in evacuating the bowels,
as in colica pictonum, and other affections with tor-
pid action of  the intestines
   The  nitro-muriatic  bath  to  the legs, purges.
Walking barefoot on a cold pavement or marble,
and enemata of cold water, have removed consti-
pation.  Some persons from idiosyncracy particu-
larly liable to be purged by getting wet feet.  Dif-
ferent constitutional susceptibilities of intestinal
action, require  very diverse doses  of cathartics.
Many  females are readily purged by one or  two
grains of  assafoetida, and powerfully by  a small
quantity  of molasses, or rye mush,  or an egg, or
shell-fish, as lobster and  crabs; others again are
scarcely  assailable  in  this  effect,  by the most
drastic medicines.   Seamen and persons at sea re-
quire larger doses of the same medicines than other
persons.   Pregnancy renders the operation  of ca-
thartic medicines  more difficult.   Climate influ-
ences the susceptibility  of the bowels  to be acted 
CAT.]
56
on by cathartics.  Doses requisite in the tropics
and in high northern latitudes.   Large doses used
by army  and navy  surgeons of the East Indies.
Different methods of employing cathartics,  as  in
the suppository, substance, tincture,  infusion, in-
jections.  Injecting  fumes of certain narcotics  as
cathartics ;  attended with danger.
  Diseases in which these different forms are resor-
ted to.  Effect ofepispastics, as  aids to purging  in
obstinate  constipation ;  either over  the belly,  or
remote from  it; even on the extremities. Of ileus.
Effect of gestation of certain kinds in resisting the
operation  of cathartics.   Sea-voyages. Equitation
to those unaccustomed to it, first induces costivc-
ness; when habitual keeps the belly open.   Effects
of equitation observed in the dragoon recruits under
my care, in the beginning of the war.  Hyper-ca-
tharsis, in what kind of temperaments most likely
to occur.    Previous blood-letting  enhances the
activity of purgatives,  and  these latter promote
the action  of  diuretics.   How and under  what cir-
cumstances they do this.
  Purgatives diminish the  action of  the sanguif-
erous system,  remove torpor in its operations, and
restore its balance of power ; they  determine the
circulation from the  head to the extremities.  The
two-fold manner in which this is effected, noticed.
They promote the absorption of fluids, from in-
ternal  cavaties.   In like manner produced by a
two-fold operation.  How  they  excite absorption
in cases of dropsical effusion.  They increase the
portal circulation. 
                       5?                  [cat.

 OF  THE DISEASES  IN WHICH PURGING IS NECES-
                SARY OR USEFUL.

   This is a fruitful topic ; the practice of purging
 for disease as ancient as the earliest efforts toward
 medical aid.   Even animals are guided by instinct
 to the purgative  grasses  and plants.  Instances
 given.   Purgatives essential in  all inflammatory
 diseases, in their incipient stage at least.  They
 are truly antiphlogistic remedies.
   In  the diseases  called neuroses;  particularly
 chorea, and hysteria, and in some cases of epi-
 lepsy.   In chlorosis, and those disorders generally
 which occur during, or accompany puberty of both
 sexes.   Eminently useful and curative  in typhus
 fever;  in scartatina.  In both of which the axio-
 matic observation of Dr. Hamilton is  of golden
 weight:  "I beg to caution  against the common
 association of purging,  with the use of  purgative
 medicines." Of their effect in obviating or remov-
 ing the dropsical effusions which occur in  the last
 stage of scarlatina.   Of purgatives in marasmus,
 occasioned by worms, effectual : when from impov-
 erished  diet,  of doubtful  use.   In hematemesis,
 when supposed  reasonably, to be a vicarious he-
 morrhage.   In all  cases of hysteria,  requisite.
 Io dysentery,  important, being continued.   In
 exanthematous diseases, highly essential.
   In puerperal fever and common  peritoneal in-
 flamation, the  bowels are torpid ; require brisk
 purgatives,  especially in the commencement. The
 Broussaisan doctrines  oppose  this  practice.   Of
 the particular kind of purgatives, useful  in acute
 rheumatism ; and  the necessity of  adhering to a
 certain  kind  in gout.   Hydrocephalus  internus,
in addition to early and copious blood-letting, re-
quires early and vehement purgatives; of less ac- 
CAT.J                  58

count in the advanced stage of the disease. Reasons
for attacking the bowels in this  direful malady,
deduced from the symptoms, supposed causes, and
post-mortem  examinations.  In  apoplexy, useful.
In palsy, when useful.  In gutta sercna. their ef-
fect. Of the use of purgatives in surgical practice.
In hyprocondriasis, indispensable.   This disorder
in females, accompanied by hysteria,  already no-
ticed as requiring cathartics, as rhubarb and  as-
safoetida united.  In the treatment of all dropsies,
cathartics  in union with  other medicines of dif-
ferent  virtues,  as  diuretic, tonic and astringent,
&c. indispensible.   In a word, without purgatives
there are few serious diseases,  involving the vis-
ceral functions, and in any degree  impairing  or
suppressing  them,  which   can  be  judiciously
treated.  The  necessity instilled,  of the student
becoming thoroughly acquainted with the peculi-
arities of operation, in all the different subjects
of this class.   General rules necessary to be ob-
served in the administration of cathartics of what-
ever description. 
59
JDEM-
DEMULCENTS.
  Substances capable  of protecting the  sensible
surfaces of the  body from the action of acrid  ex-
traneous matter presented to them from without, or
engendered  by disease within the system.  This
they do mechanically, for the most part, by in-
viscating the acridity of the  irritating cause, by
reason of their mucilaginous or oleaginous nature.
The whole of the subjects of  this class, are refera-
ble  to two sections;  mucilages  and  expressed  or
bland oils.   I have noticed the class in pure cour-
tesy to preceding writers and teachers.   It is per-
haps the most objectionable  group  of the whole
system of medicamental classification, not to say
absurd.  It is quite impossible for me to conceive
any semblance of reason for grouping  under  a
distinct class,  a  number of  substances, which
present in  the  very outset, an opposing barrier to
their just retention under such a class—for, beyond
the palpable mechanical effect of the bland  sub-
stances, as acacia gum. in allaying the irritation of
the partially inflamed glottis and trachea, in cough,
and the exasperated inflammation of cynanche tra-
chealis, I  know of no substance which, consistent-
ly with any correct notions of physiology, can be
recognised as demulcents.  What demulcent pro-
perty,  or  in other  words, what iuvisiating  in-
fluence can  flaxseed tea,  taken for gonorrhoea, ex-
ert, on the inflamed  and discharging surface of the
urethra?  Will it be said the bland mucilage and
oil  of this article, which is more a nutritive beve
       E 2 
DEM.]
60
rage, than a medicament, can be  presented to the
diseased  urethra after traversing the circuitous
track of the circulatory, absorbent, digestive or
secreting vessels, or perhaps  the whole  of them,
in its pristine state of viscidity?  Surely such an
idea is not tenable.   True it is,  as  Dr.  Murray
has observed,  the secreting vessels do some times
render substances which have been thus digested,
absorbed, and acted on by the secretory viscus, in
this state of pristine character;  and it cannot be
doubted from  the evidences given in the urine of
this fact, that the kidnies especially do this:  but
the subjects they select for this preservation of
individuality of property, are widely  different in
nature from the bland  oils and gums.  It is  when
very active substances, characterized by the inten-
sity and persistance of their distinguishing property
is presented to their secretory office.  And for the
most part it is the colouring matter, or odoriferous,
or saline quality, that mainly appears unchanged in
the secretion of the urine.   The same observation
is applicable  to the excrementitious evacuations,
after certain active or  strongly marked aliments or
medicines have been taken into the stomach  ; and
also to  the transpiratory office  of the  skin.    I
am aware indeed, that when gum-arabic  has been
given in considerable quantity to infants and child-
ren, as is frequently done, the gummy nature of the
article is detected  in  the  discharges per anum ;
a circumstance which has led  Dr. Paris to a very
incorrect pronunciation of the  insusceptibility of
pure gum (ununited he says with the  bitter princi-
ple!) to yield to the assimilative functions: and he
misquotes in corroboration of this remark the asser-
tion of a  late author,* that  " it frequently passes
through the bowels, very little changed, as I have
* Dr. Chapman. 
61
[dem.
 witnessed a  " thousand times."  In justice to the
 author thus materially misquoted, on  a point too,
 I think, of practical  importance,  I  here correct
 Dr. Paris, by refering him to the different editions
 of the ''Therapeutics" for the substitution of •• an
 hundred times,"  instead of  a  «• thousand9* which
 lessens  the strength of his corroboration on the
 authority quoted, ten percent:  or, in other words
 his position on the authority assumed, is ten  fold
 less important than he imagined.   And even his
 authority  admits the  nutritive (and consequently
 easily assimilated  quality) of the article in ques-
 tion, by quoting  Hasselquists report in its favour.
 I am the more desirous to remove this  error sup-
 ported  by such alarming round  numbers by  Dr.
 Paris, from my total discredit of the correctness
 of any  opinion, from whatever source emanating,
 which impugns the nutrienyiature of this invalu-
 able substance, in the  treatment  of certain  bowel
 complaints  of children emaciated by  a long con-
 tinuance of an enervating complaint.   The truth
 is, gum-arabic is never thus passed wholly unassimi-
 lated. even in diseased constitutions—much, less in
 those of a healthy  condition ; but it is natural to
 suppose, that in the impaired if not depraved con-
 dition  of the digestive  functions, in  those cases
 in which it has generally been directed as aliment,
 that some portion of it,  over what might be equal to
 the demands of the system  thus suffering under
 weakened digestive powers, should be excrementi-
 tiously passed.  I have seen this often myself, from
 the use of what I supposed to be  gum-arabic,  but
 which  was probably sophisticated:  but, neverthe-
less, a due and sufficient quantity has, in such cases,
been taken  up and appropriated to  supporting
the  sinking powers of  life.   That this  has been
the  case in numerous instances under my own care, 
OEM.j
62
some  very strikingly  verifying this  supporting
power,  was proved, because for weeks at a time,
the little patients received no other aliment u'/mf-
erer: and yet the disease  mended, and  the consti-
tutional powers  were reinstated,  during the free
use of the gum, and during the very time I ob-
served the  diapers to be  stiff when dry,  from the
gummy  nature  of the stools.  But, even  in these
cases  I have been disposed to believe that the ar-
ticle was not pure, but  adulterated during its pul-
verization, by a resembling gum,  very difficult of
digestion, and far less, if at all capable, of support-
ing the powers  <>f life  by its nutritive quality—
gum-senegal.  A strong predilection in early life,
unaffected by subsequent  experience, in favour  of
the soothing and healing nature, and nutritive qual-
ity of gum acacia, has led me to many experiments
and much satisfaction with  it:  nor am 1 disposed
at this time to  admit  that   the genuine  gum  is
surpassed in susceptibility of digestion, where the
bowels are affected,  and much emaciation exists,
by any article in the whole Materia Medica. Lind
tells us, that with the negroes along the banks of
the Niger, it is almost  their only food;  and that
the Moors live entirely on it when their  crops of
rice and millet fail.  These  are examples of nu-
merous  reports in favour  of the nutritive property
of the gum in question,  which  will be  detailed
when treating of the article.  Fordyce  has said
that the  nutrient principle of vegetables  resides
in their mucilage and gum. The nutritive property
of sugar and oil is admitted; and the salubrious ef-
fect of acid in diet, also acknowledged.   Where
then are we to look for a nutrient, if gum-arabic,
which is not a simple substance,   but  contains a
gum. an oil, a  mucilage, a sugar and  an acid,
does not yield such?—With  respect to the demul- 
63                 [dem.
cent property of gum-arabic, I am not prepared
to speak so confidently, but subscribe to the pithy
remarks of Cullen  on this head.  He disclaims a
belief in the power of its " correcting the acrimo-
ny  that occasions  coughing,"  and  its supposed
power of " reaching the  urinary passages,  and
there to cover  any acrimony  prevailing  in  the
urine," and that " gum-arabic as an internal de-
mulcent, can be of no service beyond the alimen-
tary canal"-and that from " innumerable trials, he
never  observed  the effects of gum-arabic  in  the
mass of blood, or in the excretions derived from it."
And he further  remarks, that in ardor  urine he
has  been often disappointed in  its effects and had
" found that two pounds of water or watery liquors,
added to the drink, would be of more service than
four ounces  of gum-arabic  taken without  such
addition."   The demulcents then are fairly resol-
ved, I think, into this nothingness ; and their repu-
ted efficacy in diarrhoea, dysentery, calculus and
gonorrhoea, stands a baseless fabric of misconcep-
tion and error,  In short,  the class  itself,  is,  as I
have advanced in the outset of these observations,
if not an absurd at least a very unnecessary one;
and the subjects it comprises, as, (besides those
already discussed,) liquorice, isinglass, spermaceti
and wax, may be disposed of under  the  head of
expectorants.  The  other gums and mucilages, and
the  amylaceous fecule, as starch,  tapioca, sago,
salep,  arrow-root,  wheat-flour, together with olive
oil,  under  the  section, of  restorative  dietetics.
Flaxseed,  slippery elm  bark,  althee flowers,
mallows, almonds. &c.  &c.  under the class of
Diluents.   Without better grounds,  than it ap-
pears to me  exist at present, the class should be
expunged,  and in my tabular distribution of medi-
caments, I shall so modify Murrays arrangement, 
DEM.]                64
as to meet  this disposition.  In  the mean while
these hints will enable you to understand and ap-
preciate the views and practice of medical writers,
who  think  and practice in obedience to the be-
lief in demulcent remedies. 
65
[dIa-
DIAPHORETICS.
   Medicines  which augment the natural  transpi-
ration of the skin.   They are divided into  two
sections, according to the moderate or high grade
of their action,  called diaphoretics and  sudorijics.
Those which excite the skin so slowly, that its per-
spirable fluid may be evaporated by its contact with
the air. and thus rendered insensible to observa-
tion,  except by the soft state of the surface,  or by
very close inspection, are refered to the first sec-
tion.   Those which produce  that  copious  fluid
discharge,  which  we  call sweat, are disposed of
under the second.   The only difference   hich ap-
pears to exist between these substances, is in their
mode of acting on the exhalents of the skin.   The
same emunctories are liberated  by both;  but in the
caseof sweating, visibly and excessively.  Thcreare
many methods of exciting the skin, which may all
be comprised under three heads, physical, mechan-
ical and medical. 1st. By external and mechanical
means. 2d.  By  internal agents which increase the
velocity of the general circulation, and thereby ex-
cite the action of all the parts of the body.  3d.  By
internal medicines which do not dothis but enter the
circulation,  and thus reach the cuticular vessels; or
merely stimulate some one, two, or more  of the vis-
cera, with which the skin sympathises, as forexam-
ple, by a draught of cold water taken suddenly into
the stomach, when the system is at par in its healthy
excitement.   For  if it is otherwise the skin  is not 
DIA.J
60
reached  by its  impulse,  but general injury,  or
local disorder will ensue.   As for example, when
cold water  is drank  largely, by  a person over-
heated, in  which  case the powers of life are sub-
dued, and death or infinite injury will result.
   Among the first means of exciting the skin may
be ranked exercise in  all  its various kinds; unu-
sual bodily labour,  the flesh-brush, or other fric-
tions ;  flagellation, stimulating lotions applied,
cold affusion, the warm and cold  bath, new flan-
nel, increased quantity of clothing, external heat.
All these will be affected  in the promptness and
extent of their action,  by the state of  the  atmos-
phere, in reference to its aridity or humidity.
  Among the second  means may  be ranked, the
carbonate of ammonia, guiacum, and the like ; al-
cohol, and all the different wines and malt liquors,
together with other fermented beverages contain-
ing spirit, as cider,  &c
  Among the third means may be  placed,   all the
saline  diaphoretics  and  mercurial preparations,
sulphur,  some of the balsams,  nauseating  doses
of the emetic medicines,  especially ipecacuanha
and the antimonial salts  preparations and phar-
maceutical compounds, &c.    it  is questionable
whether the subjects of these last two sections are
much influenced by atmospheric influence.   Cer-
tainly they do not obey its power, in any thing like
the same degree as do the means ranged under the
first section.  They, however, require  the  obser-
vance of certain cautions  and rules, when admin-
istered with a medical  view.  The main features
of these, are derived from  a know ledge of the fact,
that a very elevated state  of the skin, (when it is
102 or 108 degrees of Far.) an energetic sanguif-
erous excitement, indicated by a full,  hard, and
bounding pulse, a purging  state  of the bowels, 
67
[dia,
(in febrile systems) and the patient being dressed
and out of bed,  are adverse  to any  artificial ex-
citement of the skin,  by the means grouped under
the second and third heads of the preceding  sec-
tional arrangement of diaphoretics.   It is there-
fore obvious, that whatever shall, under the ex-
isting circumstances, tend to obviate these oppo-
sing or discouraging influences, will be proper to
be done, in order to ensure the cutaneous transpi-
ration to the extent desired.   It is frequently im-
possible to open the skin, until the arterial excite-
ment be reduced by venesection, or previous and
equivalent purging.   And if these do  not reduce
the high temperature  of the skin, it would be idle
to attempt  sweating, by internal medicines or ex-
ternal heat, the latter tending  only to increase  a
temperature of the superficies already too exalted.
Cold affusions only, will here effect it.   My expe-
rience with the ardent  fever of a warm climate,
attended with  an excessively  dry and  hot skin,
enables me to speak confidently on this point.   •
    OF THE MEDICAl USE  OF DIAPHORETICS.

   Health we  know,  consists in the due perform-
ance of all the functions of the body.  I assume
therefore, as an undeniable truth, that whichsoever
of these is disturbed,  is productive of disease or
disorder,  which will be proportionable to the de-
gree of interruption which has occurred.   It need
hardly he observed, that as the whole exterior sur-
face is designed to perform a transpiratory func-
tion, the skin,  from its very extent and exposure to
those vicissitudes  and natural causes  whieh  can
aid,  support, lessen, check, and altogether extin-
      F 
1>1A.J
66
guish the peculiar secretion thus  thrown  off in a
state of heakh, must be  peculiarly liable  to meet
with injurious impediments to its executive office.
Suppressed  perspiration  is  therefore a  fruitful
cause of disease,  and what we familiarly  call,
taking cold, is often the effect of this restraint on the
cutaneous function.  When it occurs, the balance
of circulatory and secerning regularity is deranged
or destroyed,  and the disorder or disease super-
vening, is not entirely removed, until the unbal-
anced actions  of the body, are reinstated in  their
due efficiency.  Nearly all the acute diseases, are
attended with a disordered state of the skin, for
the reasons already given.  Hence the use of those
remedies and means  which experience has taught
us are calculated to  achieve so important  a resto-
ration of healthy action,  has been coeval  with the
earliest practice of medicine.  The common-sense
view of the subject, has met  the reasoning and
observing faculties of mankind  generally: and  in
consequence,  sweating medicines have ever been
among the most popular and general remedies  in
domestic practice.   They have certainly from this
cause,  been injudiciously applied, and doubtless,
 often dangerously.  The records of medicine which
shew the transitions of practice, according to the
prevailing theories and dogmas of the day, prove,
 that this abuse of diaphoretics  has  not been con-
 fined to the unlearned and the vulgar.   Unfortu-
 nately the  members of the profession of  medicine
 in the days  of Van  Helmot,  took a conspicuous
 stand  in  this ill-judged misuse of a set  of  reme-
 dies which we justly esteem,  under proper regu-
 lation, invaluable.  The diseases  to which they
 arc applicable are various: and are both  acute and
 chronic.  Their  efficacy is conspicuous  in dysen-
 tery, and some  other bowel affections; in acute
 rheumatism after the inflammatory stage has been 
69
[UIA,
 smartly assailed by bleeding and other depletion.
 In gout they are of dubious efficacy, except under
 circumstances of great constriction  of the skin,
 when I have  known them, if of the lenient kind,
 productive of decided benefit.  In the  phlegmasie,
 they are  dangerous  often, and  always  hurtful,
 if early resorted to,  and before a previous system
 of requisite depletion: aggravating the sufferings
 of the  patient and causing tedious convalescence,
 if they do not induce worse Consequences.  Judi-
 ciously interposed  in  reference to time and pre-
 vious treatment, they arc beneficial.  In remittent
 and  continued fevers,  diaphoretics always, and
 rarely  sudorifes, afford important curative aid.
 Many have reported  favourably of their  efficacy
 in yellow fever.   My experience with that disease
 in a climate to which it is endemical, as well as in
 some cases in our own,  does not enable me to sus-
 tain these  records.  Neither can I, from the views
 of the pathology of the disease which I entertain,
 think, that they can be fairly estimated  as very
 important  remedies in this  disease.   I am aware,
 however,  that critical sweats have happily termi-
 nated its course: and I  am also disposed to  be-
 lieve that cases do occur,  in which, contrary  to
 the usual issue, they may be particularly required.
 But,  the  stomach, the  chief seat of this disease,
 is too vehemently attacked, to  be generally  ac-
 cessible  by  the  circuitous rout,  or  sympathet-
 ic  accordance even,  of  the  remote  cuticular
 surface. Not so in typhus fever;  I would say ship
 or jail fever.  Much experience with this disease,
 in the navy and army service, early convinced  me
 of the necessity of vigilantly looking  to the skin,
 and regarding its irregular and perverted actions,
 with great  attention.   Here there is no cure, until
its softness and  function is restored.   I cannot, 
DIA.]                 ?0
however, consider ship fever,  as precisely identic
cal with the typhus of Armstrong.  I have ithe
alms-house of this city,  and in  private pactice
met with and treated, the  fever that  author so
admirably  describes : but on  ship-board,  anil at
the lazeretto, and in fever wards established undei
my care for the reception of army recruits during
our war, I have alone met with the typhus grav.or
of Cullen, or ship, jail, or camp fever.  In these sit-
uations I have  repeatedly  used and profited  by
diaphoretics.   In the disease of Armstrong 1 have
depended more on early  blood-letting  and  long
continued purgative  medicines  in small doses.
The skin returned to its duty after, or during the
use of these means.
   Plague has been universally  treated by diapho-
retic remedies; yet Cheuot deprecates, and De Mer-
tens, who wrote of the plague of Moscow, of  1771,
omits to  mention these as remedies. We fortunate-
ly know nothing of the disease.   In diabetes, a di-
sease I have  never treated, and only twice  seen,
cases have been reported of their curative effect;
but these appear to  be insulated.  Many authors
speak favourably of them in dropsy ; to me  there
appears so much more obvious a path  to pursue,
in attempts to cure this disease, that  I shall dis-
miss this part of the subject by the remark, that,
though diaphoretics may occasionally  be useful,
here, it will be more by accidental propriety, than
a  general necessity attendant  on  the  disease.
For my own part,  I have never attached impor-
tance to their use in this disease, general or local.
In  syphilitic rheumatism  and syphiloid  disease,
in mercurial  disease, and in siphylis, diaphoretics
form a part  of  the  general practice of our time.
 The details of this subject will be entered on fully
 in these lectures, under the head of the particular 
                       7*                  [DIA.

 diaphoretics  used.   In perverse and unrelenting
 affections of the  skin, diaphoretics are indispen-
 sable.  In cholera infantum I cannot but remark,
 there is too much latitude assumed,  in the recom-
 mendation of even mechanical diaphoretics,  with-
 out designating the two very opposite conditions of
 the skin attendant on this affection.  I have had
 my share of experience with this frightful malady.
 I dread it, yet seek it, wherever I can have an op-
 portunity of  observing its career,  from my fixed
 opinion, that it is little understood,  comparatively
 with the attention it has  elicited  and most seri-
 ously claims: and still  less happily treated.  I
 have, it is true,  seen numerous cases  in which a
 restoration of the healthy functions of thi skin,
 was simultaneous with a happy change in the pa-
 tients danger.  But I have also seen innumerable
 cases in which the skin  was morbidly open; ra-
 pidly transuding a  cold  and clammy secretion,
 while in every other  symptom,  an  exact accord-
 ance was  observed,  with  those cases, in  which
 constriction, heat, and dryness of the surface pre-
 vailed: and conditions of the skin,  intermediate
 between these extremes have  not  unfrequently
 presented themselves in  cases the most alarming
 and fatal.  I  would  not be understood to deter
 you from adventitious means of protecting the skin
 in this  disease, from  pertinacious morbid  action,
 but simply to  guard  you against trusting impli-
 citly, or even  with confidence, to diaphoretics of
 whatever kind.  The intelligence and experience
 of  the  medical attendant,  can  alone, afford  the
proper  information on  this  point.   Indeed this
 remark is equally applicable to the numerous con-
 tradictory testimonies with reference to the use of
diaphoretics in some  of the affections already spe- 
DIA.]
72
cified: and in many others which will be hinted at
in the  course of these lectures.  To conclude,
diaphoretics,  though doubtless much misused, are
among the important remedies in the treatment of
most of the diseases of our every day practice. 
73                  fanS.
DILUENTS.
   Watery liquors which increase the fluidity of
the blood, and render several of the secreted and
excreted  fluids  less  viscid.   Water, as  has been
correctly remarked  by  Dr.  Murray,  is  the only
proper diluent: but different substances are added,
not to enhance its properties, but to render it agree-
able or demulcent.   The different  mineral waters
natural or artificial; toast and water slightly acidu-
lated with vinegar, currant or guava jelly, tama-
rinds, barberry, dewberry, blackberry and  rasp-
berry jams ;  weak lemonade,  apple-water, orange
w ater ; barley and rice water, so weak as to be
simply clouded by the barley, grain, or rice meal;
and numerous similar preparations  which  vary acr
cording to the facility of procuring, and popular
predilection for,  certain acid and acidulous  fruits
—are all  diluents.  It need not be  remarked  that
they  all contain principles of nutriment; and  are
hence peculiarly important in practice where,  from
the inflammatory  nature of the disease, it is impor-
tant to avoid the stimulus of solid nourishment. Na-
ture indicates the propriety of administering  these
articles, and in a state of coldness too, in all febrile
diseases, which are attended generally with excess-
ive thirst. It is supposed they act beneficially by dilu-
ting the chyme and the chyle, and also the bile in the
intestines, by which dilution it is rendered Icssacrh 
DIL.]
74
monious.   However this be,  it is indubitable that
diluents are important  aids  in  the cure of many
febrile complaints, and  should never  be lost sight
of by the  practitioner.   When given warm, they
aid in a striking manner, the salutary operation of
other remedies, as diuretics and diaphoretics. They
are useful in all urinary disorders, relieving ardor
urine of gonorrhea, and the pain of strangury.
When this affection occurs in consequence  of in-
flamed bladder, it is obvious they are well calcula-
ted to promote the healthy restoration of the part,
by obtunding  that acridity of the urine increased
to an intolerable degree by the general febrile ex-
citement of the system, in which  the kidnies sym-
pathise.   Formerly great errors  prevailed in ref-
erence to the propriety of giving  cold drinks in
fevers, of whatever  kind:  but in our day the ra-
tional observance o£ the calls of nature, in a dis-
eased state of  the  system,  has secured  to many a
thirsting patient, suffering from the exacerbation of
an ardent fever, that salubrious and grateful medi-
cine a  glass of cool water ; and physicians are no
longer incredulously listened to when they accede
to a patients request for this beverage,  by  stating
to the attendants, that it is a proper and requisite
pabulum for his feverish system wasting from  the
devastating inroads of a burning fire within.  Who
that has ever felt the assuaging effect of this reme-
dy, under such circumstances, would deny it to
his patient? The only modification of diluents, in
the treatment  of  febrile diseases, necessary to be
observed  by the practitioner, is in reference to the
quantity given at one time,, where  the stomach is
irritable,  and  might endure a  little, but would re-
ject much, of any fluid, unless exhibited at frequent
intervals: and also to avoid giving them cold, when
the skin is open,   In this state of the body, if it be 
75
[dil.
desirable, from the previous dryness and heat of the
skin to keep it free, diluents should be given tepid:
and, if we desire to keep up the diaphoretic action,
they  should be  given warm.   The use of co-
pious draughts of warm water  in  promoting the
operation of an emetic, is well known: and in-
deed, by distension alone, with this fluid,  vomi-
ting may often be very  serviceably excited and
kept up until the quiescence of the stomach under
the last draught,  indicates that  all is well.  More
of this subject in another  and more proper place.
In  short, diluents are important remedies:  and
the practice of that great physician so keenly sat-
irized in Gil Bias, under the  name of Dr. San-
grado, and who cured all diseases by bleeding and
warm water,  was not justly obnoxious, at least in
my opinion, to the severity of the satire.   The dil-
uents here noticed constitute  the class  of attenu-
antia, or attenuant remedies, of Culien:  and.  dis-
posed in  some rank or other, they will be found to
occupy a stand,  in  all systems of classification.
Cullen has refered  to his  class however, articles
which I cannot deem true diluents; he  first  sets
down water, and then follow (with some qualifying
remarks of his own, sustained by the experiments
of Sir  John Pringle,)  alkaline medicaments, neu-
tral salts, (with his opinion  of doubtful claim,) soap,
sugar, honey,  liquorice and the dried saccharine
fruits.   The last four are properly referable to
demulcents,  and thither I discharge them. 
DIU.]
76
DIURETICS.
  Medicines which increase or promote the action
of the urinary organs.  They do this  by various
occult  modes of operating,  and are character-
ised  by much uncertainty.   The  precise  course
by which the impulse of these remedies or agents,
reach the  kidnies,   so  as to establish  there  au
increased excitement of their secerning  function,
is by  no means clearly ascertained: and it seems
questionable from the very nature of the subject,
whether it ever can be  satisfactorily  resolved.
Speculation,  grounded  on  close  observation  of
their physiological  and  curative  effects, has not
been wanting.   Much ingenuity  and talent has
been expended on the jarring and irreconcileablc
facts involved in the agency of these  medicines;
and still much  of what is generally received  as
established truth, in  reference to the manner of
operating,  remains, if not absolutely conjectural,
at least far from independent of disputation.  The
different original opinions promulgated by publi-
cation and  taught in schools on this point, may be
reduced to:—
   1st.  That  which supposes that diuretics enter
by absorption into the course of the  circulation,
where after a time they are applied to the kidnies,
which are thus,  by their agency, stimulated to  in-
creased action.  This was the idea of  Cullen,
taught in his lectures, and maintained in his work. 
77                 [diu.
  2d. That which supposes their action  indepen-
dent of absorption,  and ascribable to a sympa-
thetic action either upon the lymphatics and upon
the kidnies, or upon both ; the primary  impulse
being given to the stomach.  This  was the idea of
the late Professor  Barton, and always taught  by
hiin in his lectures  on  the Materia Medica, for
twenty years.   He extended it to the generality of
diuretics, and  opposed the theory of Cullen.   Yet,
though he did  not admit the absorption of canthar-
ides, digitalis, squill,  &c. &c. he believed that
some few of the class might be thus taken into the
circulation, as rhubarb and  madder:  and always
admitd d that some of the saline  particles of the
neutral diuretic salts, might, and in all probability
were, taken into the blood-vessels by the  lacteals.
Dr. Chapman has  adopted the   theory of  Dr.
Barton; taught it in  his lectures on  Materia Medi-
ca, and it appears in his publication on therapeu-
tics ; discarding as Dr. Barton.did, Cullen's theo-
ry  of their absorption  with preservation of their
individuality of diuretic power, into the blood ves-
sels.  Dr Chapman's  intrenchment  of this theo-
ry however, by the bulwark of moral and  physical
causes, operating as  diuretic agents, appears to me
not only futile and unphilosophical, but unrequired
by  any  inherent  imbecility of the theory itself.
The operation of moral  and physical causes on the
corporeal functions,  bears  no analogy  to the med-
icamental stimulus of extraneous substances intro-
duced into  the system.  The  emotion of horror
and disgust at the sight  of a dissected  cadaver
or a cancerous ulcer or a surgical operation,  on
sensorial sensibility  as  yet unreconciled to  such
objects,  which is a moral influence—and a crowded
and overheated apartment  which is a physical one
—both occasionally act on the physiological system 
 diu.]                  78

 so as to produce a sickened stomach and vomiting,
 in which  all the phenomena occur pertaining to
 the inverted act of the stomach by an emetic intro-
 duced into it.  Yet it would not surely be correct to
 reason  on the  modus operandi of medicamental
 emetics  introduced   into the  system,  operating
 in  whatever way,  by  their  material presence,
 from any effect which  horror or disgust or foul
 air evinces, on the disturbed sensorial  function,
 involving sickness and  vomiting in  the instances
 given.  The vomiting under these circumstances,
 is effected by  an immaterial  agent inscrutably
 called  into action by  an untouched, or distant
 material object of disgust, or a partially poisonous
 inhalation of the lungs.
  The third opinion relative to the operative man-
 ner of diuretics, is a participatory junction of the
 two preceding.   It  supposes that some diuretics
 operate after the first  mentioned manner, and
 others after the second mode.  Many  support this
 two-fold theory.  Dr. Eberle  has adopted  it  in
 his elements of therapeutics and Materia Medica.
 This joint opinion maintains still less unity of ac-
 tion.  It  supposes
  1st.  That some diuretics  act primarily on the
 urinary organs,  in two  ways, a by stimulating
 the secreting vessels  of  the  kidnies, by  contact,
 while the  substances themselves are unsusceptible
 of decomposition in transitu,  b By thus stimula-
 ting the renal vessels, undergoing decomposition
 in transitu.
  2d. c That others act primarily on the absor-
 bents, and secondarily on the kidnies.
  3d. That others again act primarily on the sto-
mach and first  passages,  and secondarily on the
absorbents, which is  effected in three different
 modes of action,  d By diminishing arterial action 
79
[diw.
and increasing that of absorption. cBy increasing
the tone  of the body in general, and that  of the
absorbents in particular.  / By producing cathar-
sis, and  thereby increasing the action of the exha-
lents directly and that of the absorbents indirectly.
It will readily be  perceived, that this fourth sup-
position  of the mode of action pertaining  to diu-
retics, embraces the three first theories.  And in
truth though  still, (from anomalous  effects  which
occasionally are presented by the operation of this
class of  remedies irreconcilable  to  it,)  liable  to
objections—it  is by far the best digested theory.
It'seems to meet, too, more than either of the others,
the physiology  involved in the  operation of this
mysterious class of remedies.   For these reasons
I adopt  it, and shall pursue  the arrangement of
the different  diuretics predicated on it  by Dr.
"Paris,
   To a  therefore  will be  refered, potass,  nitrate
of potass,  oil of turpentine, juniper,  (berries and
its spirit gin)  cantharides  and  the  like.   To 6
acetate of potass, super tartarateof potass,  squill,
colchicum, balsam copaiva. tops of Spanish  broom,
(spartium).  To c mercury. To d digitalis, tobac-
co and the  like.  To e the bitter tonics, &c. &c.
To/elaterium, jalap and  the like.
   Of the simultaneous exhibition of acidulated dil-
uents with diuretics, to ensure and  promote their
 action.  Of the circumstances and condition of the
 system  which retard diuresis, or prevent  it alto-
 gether from  following the exhibition of its medi-
 ical agents—as the state of the skin, the bowels,
 the blood vessels, the weather, clothing, &c. &c.
 Rules for giving these remedies.
G 
DIU.]
80
     OF THE MEDICAI USE OF DIURETICS*.

  These remedies are important in many diseases,
but chiefly  in all the varieties of dropsy: diluent
drinks necessary aids here.  They are employed
beneficially in all diseases  of the  urinary organs,
nephritis, gout,  sometimes  in rheumatism.  Com-
bined with  sudorifics they have been said to  be
very serviceable in pulmonary diseases.  Used in
ulcers of the legs attended by oedema,  in scurvy,
elephantiasis. 
SI
[eme.
EMETICS.
   .Agents capable of inverting the natural action of
 the stomach,  so as to cause an ejection of its con-
 tents by  the mouth.
   This is their primary effect, and there are cer-
 tain emetic substances,  the  operation  of  which
 ceases by producing it.
   Their secondary effects,  chiefly observed  to fol-
 low what I would call searching emetics, are:
   1. The inverted or upward peristaltic action of
 the duodenum and even the upper portion of the je-
 junum, by  which their contents  are  thrown into
 the stomach, and thence by its continued  inverted
 action ejected by the mouth.
   2. The impulse conveyed to the gall  bladder,
 and biliary ducts,  by -which their contained bile is
 directed into the duodenum, thence to the  stomach
 and upward and outward as before.
   Their  proximate effects, are:—
   1st. An abatement of the force of the general cir-
 culation,  and a restoration of equilibrium to its im-
 pulses.
   2d.  A consentaneous relaxation of the cuticular
 vessels, by which the skin is opened to a diaphor-
 etic action.
   3d. A relaxation, owing to the impulsive action
 of the respiratory organs,  of the turgid  and in-
 flamed vessels  of the exterior surface  of the bron-
 chia and trachea,  by which expectoration of their
 contained healthy or morbidly increased  mucous
 secretion  supervenes.
   Their proximate consecutive effects, are:—
   1st. An increased downward peristaltic action of
 the intestines,  which  is produced  by some emetics
in a greater degree than by others. 
BME.]                *2

  2d.  Temporary  languor of the physical and
moral svstem.
  3d. Profound sleep, and subsequent  healthy re-
action—transient, or more or less permanent,  in
proportion to the intensity of the existing diseased
actions for which the remedy  has  been prescribed.
Their remote consecutive effects, are:—
  1st. An increased  circulation in  the liver, owing
to the general impulse given to the abdominal vis-
cera.
  2d. Invigorated pow ers of digestion, (unless the
emetics have been too often repeated.)
  Their durable consecutive effects are:—
  1st. A resuscitated energy  of the previously de-
pressed  mental  faculties, "(unless much morbid
cerebral excitement had prevailed.)
  2d. A Beneficial change in  the moral constitu-
tion of the individual, perceived in a greater or less
degree,  in proportion as his  temperament should
be choleric or billions, or phlegmatic.   The iras-
cible becoming less peevish and ireful, the man of
phlegm less heavy and churlish.  To recapitulate:
I have arranged the effects of emetics into
   1. Their primary,
   2. Their secondary,
   3. Their Proximate
   4. Their proximate consecutive,
   5. Their remote consecutive,
   6„ Their durable consecutive.
   All of these, however, have reference in point of
 time, from the  first vomiting act, to a few days or
 a week, or at farthest two weeks.  After thi*.  the
 curative and healthy  impulses of the act of  full
 vomiting may be supposed to  have passed away and
 the system  to have  returned to its  usual rou-
 tine of susceptibilities  of ordinary  health,  dis- 
83
[eme.
order or disease.   These  effects too  are  drawn
from the action of full vomiting on a system rather
disordered than diseased:  and,  in  so far  as the
fourth extends, may be considered faithful even in
diseased as well as disordered systems which may
require  one repetition or more of the remedy. The
fifth can only refer to  systems slightly disordered,
or to valetudinarian constitutions,  in which cases
the emetics require to  be  now and  then repeated.
  Having thus given a definition of emetics, by a
detail of their effects,  I proceed to  state that it is
a numerous aggregation of agents,  acting by mul-
tifarious peculiarities,  and should,  in my opinion,
be  disciplined.  For want of a  better division I
shall separate  these vomiting agents into three
classes, and  each class  into sections. The first
two classes and section-d,  of the third class, em-
brace those agents employed  medically, in  acute,
and such chronic diseases  as are usually deemed
tractable. The residue of the third  class embraces
those  agents  resorted  to in obdurate chronic dis-
eases, and never in acute disorders.

Class   1.—Those  which act  primarily and idio-
             pathically on the stomach, compri-
             sing three  sections.
          § a.—Such  as produce this effect inde-
             pendently of nauseous  taste or fla-
             vour, or the stimulus  of over-disten-
             sion from quantity, or unusual tem-
             perature.
          § 6.—Such  as produce this effect inde-
             pendently of nauseous  taste or fla-
             vour, but by  the stimulus of over-dis-
             tension from quantity  and unusual
             temperature.
          § c—Such  as  produce  this effect  by
      G 2 
EME.]                 84
            uniting a nauseous taste  or flavour,
            with the stimulus of distension from
            quantity and unusual temperature.
Class  2.—Those which act secondarily  or sym-
            pathetically on the stomach, by con-
            tinuous or direct sympathetic impulse
            from parts  connected by  structure
            and office with it, as the seat of pri-
            mary impulse.
          The  subjects  of  this  class  are me-
            chanical  agents used  to  induce
            vomiting by the stimulus of irritation
            to the fauces and gullet.
Class 5.—Those which act secondarily or sym-
             pathetically on the stomach,  by re-
             verse  sympathetic impulse from the
             brain  or nervous system, as the seat
             of primary impulse:
          §  d—Such as produce this effect medi-
             cally, being substances termed med-
             icaments ;  or  articles  of  luxury,
             acting on the physiological system
             unaccustomed to their stimulus; and
             ceasing to invert the  action of the
             stomach when reconciled  to it  by
             habit.
          § c—Such as produce this effect physi-
              cally, being natural agents acting on
              the physiological  system  unaccus-
              tomed to their stimulus; and ceasing
              to  invert the  action of the stomach
              when reconciled to it by habit.
          § f—Such as produce this effect physi-
              cally, being artificial agents acting
              on the physiological system unaccus-
              tomed to their stimulus; and ceasing
              to invert the action of the stomach
              when reconciled to it by habit. 
85
[eme.
   I have not proposed this division of the class of
emetics, from any desire to offer something entirely
new, which it is,but because an attentive considera-
tion of  the immense number of important agents
usually thrown into one group under the head of
emetics, has led me to believe a philosophical view
of their various effects and modes of action, would
lead the student to a more extended regard of their
inestimable use, than if they are, as is always done,
grouped according to the unity of their physiologi-
cal effect.  It presents their powers to his mind in
such various  lights and shades, so disposed, that
the mind's eye can rest on that distance or object of
the entire picture, which may suit his contempla-
tive and reflective powers, in times of need.  For
he will  assuredly find, in the course of his prac-
tice, ample occasion to  be well versed in all  the
varieties of this important assemblage  to adopt
some  one or  more of them to  the exigencies and
peculiarities  of the subjects  for their operation.
The physician who confines his ideas of emetics to
the simple effect of tartar emetic or ipecacuanha
is but rudely versed in the philosophy of  his  pro-
fession  ; and I will go  farther, is but slenderly
stocked with  requisite  knowledge of one of the
leading and  effective parts of his  art.   This sub-
ject will be extensively canvassed  in the lectures.
In the mean while  it may suffice to give examples
of the different classes and sections  of emetics, first
proposed.

Class  1.   § a—Tartar emetic, sulphate of copper
                and the like.
           $ b—Warm water and the like.
           § c—Weak infusion of mustard, horse-
                radish,  chammomile flowers, car- 
EME.]
86
                duous benedictus, strong infusion
                of green  tea,  boneset and the
                like.
Class 2.   The probang, and finger, to the gullet:
                feathers and straws to the fauces.
Class 3.   § d—I.  Narcotics,  as   opium  2nd
                tobacco  taken as snuff, as a mas-
                ticatory, or inhaled by smoke.
           § e—Overheated apartments and the
                like; violent running.
           § /—Super-abundant clothing  unap-
                propriate to the season or weath-
                er ; the  warm  pediluvium  and
                warm bath ; sailing, swimming,
                riding backward in  a carriage,
                whirling and the like.
  The stomach is not only sickened and propelled
to vomiting by emetics, but there arc moral impul-
ses which produce the same effects on the physio-
logical system, by acting impetuously on the mental
sensibility,  and  thence  by reverse  sympathetic
action physically on the stomach.   For example:
sudden gushes of the depressing passions ; distress-
ing intelligence; sudden disappointment of long ex-
pected good; judicial sentence of death, or reprieve;
sudden  injury done to those we love, beyond the
mind's impulse of probable controul or relief, with-
in our power.  The sight of disgusting and  repul-
sing objects ; as  cadavera and dissections, &c. &c.
  The last observations  are made here simply to
call  to the student's mind, that there are suscepti-
bilities of inverted action in the  stomach, in some
persons, far greater than in others ;  and generally,
those liable to be thus morally affected, are, from
their mawkish sensibility easily  acted on,  by any
of the preceding classes of emetic agents. 
87
[eme.
  Having thus stated  the effects of emetics and
the susceptibilities of the system to an inverted ac-
tion  of the stomach, I proceed to consider by what
dissociated or perverted train of actions, the im-
pulse is achieved: of  what  in  other words has
been called,  and most  incorrectly and unphiloso-
phically, the mechanism  of vomiting.  Different
opinions are entertained on this subject, by physi-
ologists.  Whatever difference of opinion how ever
may  have existed or may still exist, in relation to
the catenated actions necessary to produce vomi-
ting, most writers seem to admit that it is a com-
plicated process.  Among those who  have main-
tained the unity of action, is Majendie, who attrib-
utes  it altogether to the  agency of the brain, and
regards the stomach as  a passive instrument in the
act,  directed  mechanically  to its  inverted  pro-
pulsive effort, by the abdominal muscles stimula-
ted to a  peculiar action by  the seusoriutn.  His
experiments as detailed in his memoir to the Royal
Institute of Fiance in 1812,  noticed.  Dr. Paris
appears to lean to this assumption of sensorial in-
fluence, to  explain  thif act;  but by  reasoning
which  I cannot deem  valid.  He observes that
wounds and  contusions of the head,  of such vio-
lence as to suspend sensorial energy ; and profound
inebriation, which has,  for a time a similar effect,
—both render the stomach inaccessible by the arti-
ficial stimulus of emetics however vigorously used.
But  that  in  incipient intoxication,  and  under
circumstances of less  violent  wounds  or  contu-
sions of the  same part, the " irritability of the
stomach  is less paralysed,  and vomiting under
such  circumstances is excited by the slightest
causes.''   I  assume it as a  fact  grounded  on
my own observation  of numerous cases  of vio-
lent  wounds,  and  forcible  contusions   of  the 
EME.]
88
head, that the shock to the  system is universal.
They do not produce a singleness of paralysed con-
dition in any one organ.  The brain,  the nervous
system,  the catenated actions of respiration, the
stomach, the bowels, the cutaneous sensibility, the
voluntary and involuntary muscles, even the action
of the heart and  arteries.—all  participate  in the
concussive injury, at least  for a time,  which is  of
longer duration, or shorter  continuance,  in pro-
portion to the degree of intensity of the violent inju-
ry.  Is it therefore to be argued,  because, in this
condition of the whole system, the stomach obeys
not the artificial presence of  an unusual stimulus
as of the  emetic with which }t may  be  forcibly
gorged, that it  does  not evidence its retrocessive
action,  because that action depends on  the  brain,
which, in these cases is palsied?  The stomach  in
its actions, doubtless sympathises with the harmo-
nious equipoise of all  the parts  of the  general
whole; and certainly does sympathise especially
with the brain ;  but when all these parts  are thus
invaded by a concussive injury, how can  its qui-
*sertoe under tire presence*of  an emetic, be refered,
singly,  to the  injurious invasion  of the  cerebral
and  nervous functions?  This is  assuming what
fact  will  not warrant;  and  does  not  prove that
vomiting  depends  on the brain.   I  apprehend
a  similar  universality  of  dissociated,  or sus-
pended actions, takes  place in  profound drunk-
enness.   The  paralysing  influence of the nar-
cotic spirit, not only  places  the healthy  func-
tions in suspension or temporary paralysis,  but it
does so universally. And if. from any idiosycracy,
the brain should partake less of this paralysis on
its powers of reasoning, than in its ability to con-
troul or direct the voluntary muscles, as  is not
unfrequently the case—the stomach is in such cases 
                       89                 [eme.
 equally insensible to the stimulus of an emetic,  as

 theenhtto? ,IOSS °f SP.,,SOria,  P°wer accompanies
 the obtunded or paralyzed corporeal functions.
 This could not be the case,  if Dr. Paris' position
 were true.   Neither can I  see  reason toadm™
 that in  case of incip.ent intoxication, or slighter
 wounds, or contusions of the head, the stomach is
 in  a  state  of such increased excitabilitv,  that
   vomiting under such circumstances is excited bv
 the slightest  causes."   Who has  not  observed
 spontaneous vomiting to occur frequently in cases
 ol excessive intoxication? And who does not know-
 that vomiting, accompanying, or soon following a
 wound or contusion of the head, affords an indi-
 cation of the great violence done  to the brain,  and
 trom which indeed an unfavourable augury is gen-
 erally, ami seldom incorrectly derived"?
   Dr  Chirac also conceived the stomach, to be
 a passive instrument under  controul of the abdo-
 minal muscles and diaphragm in the process under
 notice, as much so as aglyster-bagunder pressure
 of the hand of the operator,  in throwing the con-
 tents into the rectum.  Some French writers  de-
 clare the abdominal muscles unrequired to effect
 vomiting ; and that the contents of the stomach can
 be discharged after their action is taken away.
 Rosenstein and Schuize  believe the stomach to be
 universally active, but that the diaphragm  by its
 compression of that  viscus,  causes puking.   Mr.
 Haighton's  experiments  noticed.   He  believed
 from them that the diaphragm and abdominal mus-
 cles are essential and effective ^ but that these  un-
 aided by the stomach itself as an active agent, cannot
 induce the action. Both are therefore, in his opinion
 required  to operate in unison.  Dr. Brian Robin-
son's and Cullen's theories  noticed.   Mr.  John
Hunter's sympathetic theory of the effect of vomit- 
eme.]                 98

ing in hernia humeral is, stated.   Opinion of Dar-
win respecting the cause of vomiting. Experiments
and opinions of M. Maingault. Professor Portal,
M. Bourdon, on the same subject.  In short,  the
physiology involved  in this mysterious but natural,
though not customary action o! the stomach, must
from  the  very occult  nature of the  process, be
chiefly speculative.  The  phenomena are visible
enough ; the cause or  causes of them involved in
much obscurity ; and.  though well devised,  and
judiciously conducted experiments have  been  in-
stituted by ingenious and  qualified  physiologists,
to elucidate this process, still its ultimate results
are all  that are  indisputably known.   A  more
useful subject of enquiry  to the student, will be
found in the study  of the  phenomena, effects,  ir-
regularities,  and  therapeutic application of  the
agents usually employed  to  effect  the important
susceptibility of the  stomach  to be evacuated of
its contents ; and of the general system to be cura-
tively or beneficially approached by thatevacuation,
through effects produced by it.   To a discussion of
these points I shall therefore pass on, after noticing
some miscellaneous facts embraced in the general
view.
   The function of vomiting, is natural to man and
various brute animals.   Birds vomit, particularly
the camiverous birds of prey.  Fishes vomit, and
some amphibia.  Of the  mam alia, the horse cannot
vomit or be  artificially made to do so. The reasons
for this  deduced from  his anatomical structure ;
vomiting sometimes  dangerous ;  in what kind of
systems and temperaments to be cautiously resort-
ed to. In what diseases dangerous. Rupture of the
oesophagus  has  been produced by  it;  instances
given.   Comparative  ease of  the operation to 
91
[eme.
infancy,  adolescence  and  age;  phenomena of
vomiting described.—Of  sea-sickness.
  This may be a proper place to take some notice
of nausea maritima, or sea-sickness ; an affection
attended with  much  vomiting at times.
  Having drawn up some account of the phenomena
of this  affection when at sea, I subjoin them here
from  my notes to Gregory  on Climate.  It will
enable you, should you enter on practice without
having  experienced or witnessed this affection, to
know in what cases sea-sickness may be resort-
ed to as a therapeutic agent.
   " When a person goes to sea for the first time, he
is commonly  affected immediately upon his coming
into blue water, as sailors term it, w ith slight gid-
diness of the head and a sense of tightness across
the forehead; considerable and distressing nausea;
a sense of  motion in the stomach, and soon after
violent, copious and convulsive vomiting.  These
effects generally continue for a few  days,  during
which time they are most  aggravated by  an up-
right position of the body  below decks, and less
severe while inhaling the free air on deck,  and in
an horizontal  position  of the body when  below.
The nausea  is always painfully increased by the
odour of cooked meats ;  and especially by the dis-
agreeable  and peculiar  smell of the bilge  water
pumped up at a regular hour, every evening. The
odour from this putrid water is so  nauseous and
subtle,  that it insinuates itself into all  parts of the
vessel: and while its power on the surrounding air
is at its height, it equally affects with disagreeable
feelings, the veteran seaman and the tyro in sail-
ing, producing on  the latter however, infallably,
the most violent and convulsive puking.  The mo-
tion of a vessel through the water is vehement,
II 
EME.]                 92

rapid,  sometimes irregular,  and  in  turbulent
weather,  much  interrupted  by sudden lurches.
That a violent commotion is communicated to the
system  by these combined motions  mustt seem
evident to every one, but the peculiar  effects and
operation of  it upon the  mind and body  of the
person who may  be the subject of it, can only be
thoroughly known by those who have experienced
it in their own persons.   It must seem  clear how-
ever, to every reflecting mind, that  as this  motion
of the vessel is  constant, though in a greater or
less degree,  a person at  sea  must be sensible of
some permanent  effect  on the system, liable  to
to augmentation and diminution in  proportion  as
the weather is calm  or turbulent.  This accord-
ingly is the case, and there are few persons  who
are not affected  by  costiveness, not only  imme-
diately after going to sea,  but in some degree sub-
ject to  it all the time they continue there.  This
effect I believe to be in no way dependant on.  or
in consequence of the peculiar aliment that is gen-
erally eaten at sea,  but owing solely to the  contin-
ual  impulse  communicated to the stomach and
intestines by the rolling, tossing about and pitching
of the vessel.   1 infer this from the fact, that this
costiveness exists in a greater degree, in persons
sailing in small vessels, of which the motion is
short,  quick, and pitching, than in  larger vessels,
as in frigates, where it is long and less often re-
peated  in a given time.  Now  though the more
violent affection of the  stomach  for the most part
goes off after four or five days, or at farthest in a
week or ten days,  there  is nevertheless a certain
kind of  affection of that organ,  and which indeed
is in a degree communicated  to the system gener-
 ally, that comes on  during every heavy blow.   A
 sensation is felt when the ship lurches or pitches 
93
[eme.
forward as if one was falling,  and upon the ri-
sing of the vessel upon the waves again, as if one
was raised with it.   This  sensation, which is
felt in the greatest degree when there is a cross or
head sea,  or when the ship, going before the wind,
lurches from  side  to  side, communicates  to the
abdominal muscles a convulsive and sudden action,
so that the whole contents of the  abdomen are  com-
pressed and expanded alternately  with the rising
and falling of the ship.   This compression conse-
quently operates on the diaphragm, forcing that
muscle upwards in  the same violent and convul-
sive manner, so that the viscera of the thorax are
also sensibly compressed  and expanded with the
lurching and righting of the vessel.  T. he?,f C«CCt?
as I have before remarked, are produced with every
new turbulence of the sea; and as they are totally
independent  of the nausea and  sickness before
mentioned, may be considered  as the more per-
manent effects of sailing.  One  other effect of the
vessel's motion, is the constant and novel action of
the muscles of the body,  principally those of the
lower  extremities,  to  preserve  an equipoise and
prevent falling   The centre of gravity constantly
altering as respects locality,  a continual and cor-
responding action  of  the muscles, to preserve an
equilibrium,  is  of course necessary;  and  this
continual  action  of the  muscles,  novel, sudden
and energetic, is the most permanent of the effects
of sailing.  It is the  exercise arising from  this
action  of the muscles,  that brings  such invigora-
tion to the debilitated patient,  and this  action
never ceases to be  necessary during the slightest
motion of the sea, except in a horizontal position
of the  body, and even then, in blowing weather
one is frequently  awakened from  sleep by  an in-
voluntary exertion to avoid being thrown from the
berth.   I  have uniformly observed that those per- 
EME.j                 94
sons who were slightly affected, or affected not at
all, with vomiting, or nausea, suffered excessively
from an affection of the mind, and frequently from
acute pain in the head,  which  was always con-
siderably aggravated by  the violent pitching of the
ship.   Such  are the effects of sailing upon the
system  as I have observed  them, both in  small
vessels as packets, sloops of war,  and in larger
ones as frigates.  I have never witnessed but three
very distressing cases of  sea-sickness,  one a land-
man on board  of the frigate  United States, in
whom  great  emaciation,  loss of appetite, and  a
habitual convulsive retching,  which  continued
after the ship came to anchor: and  the other two,
which were on board  of  the  Essex, are particu-
larly mentioned in my " Treatise on Marine Hos-
pitals, &c."  p. 153.
   " The exercise of sailing  is not only performed
in a fine healthy and pure air,  but it is constant
in itself.  The veteran seaman has the same con-
tinual  action of nearly  all the muscles  of the
body, perpetually  exerting its salutary effects on
the system, as the young sailor is subject to.   But
the mind loses in the first instance, by the influence
of habit, its  consciousness of this continued exer-
tion of  the muscles.   In  the latter case the exer-
cise  and consequences of  sailing, are so novel
and positive, that the mind dwells on them with
more attention,  until  time and habit produce  also
on the new sailor, the same unconsciousness of the
perpetual exertions of the body to preserve its pro-
per position, and to prevent falling prostrate with
every pitch of the vessel. The  same unconscious-
ness of the operations of the mind and the synchro-
nous  action   of the muscles  of the  body, takes
place in many of,our common actions, which from
long practice  are so adroitly performed that we
frequently are inclined to believe them, and they 
95
[eme.
 ordinarily  appear to others, to be involuntary:
 Thus for example the successive rapid  and almost
 imperceptible movements  of the fingers, and the
 syncronous actions of the  muscles of the tongue,
 mouth and  lips, in  playing on the German flute,
 seem after long practice, to be independent of any
 act of the mind,  since we are inclined  to think it
 cannot produce  such vehement and  rapid opera-
 tions.   Yet  here, each movement  of the fingers
 and every action of the  muscles before mentioned,
 are the effect of a  distinct  and vivid act of voli-
 tion."
   " This continual exercise of the  muscles then
 when  a  ship is under sail,  and which  I  have be-
 fore remarked is in some measure performed even
 during sleep, is one of the most salutary effects of
 sailing.   By means then of this gentle and regular
 exercise, the circulation of the blood is vigorously
 promoted through every part of the body, produ-
 cing so healthy an  action in the minute vessels of
 the surface, that a uniform and copious perspira-
 tion is effected.  This is carried off as fast as it
 is exhaled from the surface  of the body,  by the
 change of atmosphere and the perpetual  succes-
 sion of its stimulating effects on the skin.   Hence
 it is that there  is always so intense and impatient
 an appetite felt at sea ; for the food taken into the
 system after undergoing the customary alterations,
 speedily pass off,  that is, the  liquid  portion of it,
by perspiration."
          MEDICAL USE OF EMETICS.

  Probably  among the earliest remedies, from an
observance of the beneficial effects of spontaneous
      H 2 
EME.]                 96

vomiting.  Savage nations well acquainted with
these.   Of the prejudices  against emetics.   Im-
portant remedies in febrile diseases in which their
use is of ancient date.  Preparatory to  the bark
and  quinine now  much  used: reasons  why ;  of
their use as nauseatives and diophoretics, in inter-
mittent and remittent fevers.  Indicated or contra-
indicated according to the character of the climate,
and  state of  the season.    An  enquiry whether
emetics may  be  safely  used  in   cerebral dis-
eases?   or  disorders  with  cerebral  determina-
tion? Of their use in epilepsy ; also in apoplexy.
Supposed injurious in hydrocephalus.  Useful in
dysentery; ipecacuanha preferable to antimonials as
recommended by Sir George Baker and others, or
vitriol commended by Mosely.  Of their use in
diarrhea; in cholera infantum. Of Richter, Franks
and other  German  author's  recommendation
of these remedies in diabetes.  They are employed
in acute rheumatism; in what manner they can do
good here, stated.  In regular inflammatory gout;
their efficacy doubted.  Scudamore opposes their
use, except under certain circumstances detailed.
Of  the emetic  powers  of  eau  medicinale;  how
much of its good  effect in gout depends on this
property.  Of the curative powers of emetics in
sick-head-ache.   Serviceable in gutta serena and
inveterate cases of opthalmia.   Dr. Sanders', Dr.
Robert Dawson's experience in opthalmia.   Sir
Wm. Adams  used them in opthalmia  of Egypt.
How they promote absorption.  Have been used in
 dropsies; anasarca  and ascites, especially.  Of
 diuretic emetics in these diseases.   Of Lieutaud's
 prescription in hydrothorax.  Benefits from emet-
ics in jaundice  and obstructed biliary ducts.  Of
 their  efficacy  in  exanthematous diseases.    Are
 indispensible in croup ;  but never to  be depended
 on to  the exclusion  of bleeding, except in slight 
97                [eme.
cases.  Of their effect in  combination  with  other
remedies in cynanche maligna necessary; often re-
peated,  in hooping-cough.    Of  their effect  in
typhus pneumonia.  Of Dr. Armstrong's and Dr.
Potter's experience with emetics in typhus.  Of their
efficacy in hcemoptisis; of Dr. Cullen's distrust of
them in  that hemorrhage.   Of emetics in asthma.
Have been much used in consumption.  Imitations
of sea-sickness by certain emetic  treatment;  nu-
gatory ;  reasons why.  Emetics useful in  forming
stage of  phthisis pulmonalis.  In certain  cases of
palsy, emetics have been much used.   Of the dry-
vomit ; its peculiarities.  Dr. Herberden's opinion,
that in hemiplegia we should in no instance excite
vomiting by strong  medicines; he thought them
useful by appeasing nausea, and removing offensive
substances from the  stomach.   The French phy-
sicians are very partial to the exhibition  of these
remedies in this disease, and place great depend-
ance on them.  M. Serres and M.  Lerminier used
solution of tartar emetic in large quantities of water.
The use of emetics in hemiplegia not common in
Britain.   Of the efficacy of these remedies, in that
disease there are numerous writers who advocate,
and  as  many who condemn them.   Sydenham,
Forthergill, Pitcaim,  Kirkland, Selle, Crowfoot,
Catherwood, Burserius, Quarin, and  Sir Gilbert
Blane, and in fact numerous other authors of less
note,  have  advocated their employment;  while
others contend they are injurious and  dangerous,
among whom are Cullen, Langslow, Cheyne, For-
estus and many others.   Of the detumescence  of
scrophulous tumors by emetics  and sea-sickness.
Of Mr.  John Hunter's treatment of hernia humo-
ralis by  emetics.  Of the cutaneous  diseases  in
which these remedies have been used beneficially.
Of their application as anthelmcntics,  in  cases of
erratic worms; of their application as emnaena- 
EME.]
98
gogues.  Very important  remedies in maniacal
and morose hyteria.  Of the application of emetics
in cases of  strangulated  hernia ;  and obdurate
luxations.  Of emetics in  mania, h>pocondriasis,
and in puerperal mania.   Of Dr. Joseph Klapp's
treatment  of mania  a potu. by  emetics.  An en-
quiry into its comparative efficacy with the narcot-
ic treatment.   Dr. Klapp's opinion, that narcotics
are inadmissible except  in cases of complete ex-
haustion or hyper-catharsis, from the operation of
emetics acting on the bowels.  Others advocate
opiates after the vomiting.   Remarks on the differ-
ence of treatment of this  disease  by physicians.
Of  the importance of emetics to relieve infantile
indigestion ; ipecacuanha  the best.   These reme-
dies prevent and relieve convulsions depending on
this  cause.   Equally necessary  to relieve  the
stomach of a  surfeit.  Of their efficacy in gastric
debility, owing to  excess of acid,  followed by
antacids and  mild  pure  bitters,  like calumha.
Even in obstinate  constipation  are  salutary, and
of ancient application.    Stoll.  Sims, Sumeire,
Deplace, Dr. Hosack,  and  other authors highly
commend them in torpor of the alimentary  canal.
Emetics have been recommended to  prevent con-
stitutional  injury arising from the bites of venom-
ous serpents.   Sprengel's  account of cases of the
bites of Italian vipers, cured by these remedies.
In  conclusion: the varied employment of the ar-
ticles and  agents of this class,  constitutes an im-
portant and essential part of the curative  art of
medicine ;  and they are  the most active and  indis-
pensible agents in  Toxicology.  A notice  of the
peculiarities of operating, pertaining to the differ-
ent emetics; the importance of the student inform-
ing himself on these points.
  Finally: of pumping the stomach ;  the different
instruments and apparatus for this purpose.   The 
99
[eme.
cases in which it may  be preferable to awaiting
the operation even of the most impetuous emetics.
Of the mode of  using the  apparatus, and  the
absolute necessity  of being well acquainted with
the mode of using  them, and of adroitness in the
operation* 
EMM.]
100
EMMENAGOGUES.
  Medicines and agents which excite and promote
the menstrual evacuation ; it is supposed they are
capable of effecting this, when that flux is retained
or suppressed.   This class is  still  retained by
writers on medicaments,  notwithstanding the ac-
knowledged faithlessness of the restorative agency
of the articles in the disordered function of the ute-
rus, for removing which they have been supposed
specifically appropriate. Among those who most de-
precated the idea of such specific action, was Cullen.
He has unequivocally expressed his doubts of the ex-
istence, in any medicine then known, of a peculiari-
ty of action tending to affect that organ in any es-
pecial manner.   The older writers, however, have
swelled their  books  with  long  lists of articles
under this appellation.  When we advert to the
variety of causes which  have an agency  in the
retention of the menses at a period of life w hen they
ought, in  the  natural course of  physiological
action, to appear ;  or, when  having, in due time
made  their appearance,  have  become  morbidly
suppressed ; when we  reflect how widely discre-
pant from any thing like  unity,  these causes em-
brace ;  and that they are as frequently  moral  as
physical and morbid,—we cannot surely, without
great circumspection and  hesitancy, admit  that
material agents of a medical nature, are adequate
to remove the evil, from whatever source originat-
ing ;  or lessen its prejudicial influence on the gen 
                      101                [EMM.

eral system.  Much less forward should we be to
admit that they do this, even when they effect it,
by  any  specific agency.  Our reluctance to  admit
the reality of such powers in material substances,
is justified by the experience of any one whose op-
portunities  of practice with them,  have been  fre-
quent, with aim at their usually accredited power,
in cases at all difficult, perplexing or obdurate.  It
requires but an ordinary share of observation to de-
tect the fallacy of any remediate expectation found-
ed on an idea of specific agency or determination of
effect on the uterus. At least this remark may very
safely be extended to nine tenths of the substances
and agents employed as emmenagogues.   The ac-
tion of  even the remaining tenth  part,  is not so
strikingly and unequivocally marked by such un-
erring  and peculiar action,   as  to demand for
them the epithet of specific agents.  I am borne out
in these observations by the majority of practition-
ers  of ten years standing.   My own conviction of
their truth, together with my belief in the fruitful
production of uterine derangements by pure moral
causes more than physical, has fixed  my belief in
the irrationality of retaining as a separate class of
remedies, numerous substances, which,  if they act
as the name of the class requires they should,—do
so,  by  collateral  and  devious  influences,  from
which,  as a seat of action.,the uterus is, in as many
instances remote, as adjacent or contiguous.  The
class under notice has, for these reasons, always
appeared to me untenable,  and egregiously  at va-
riance w ith any of that persistency or certainty of
action in its subjects, called for by its name and
the assumed principle of foundation.  It is no new
observation, that under the head of general  stimu-
lants or tonics, and cathartics affecting the pelvic
portion, of the  bowels, all emmenagogues may be 
EMM.]
102
 arrayed.  Murray has suggested this long  ago,
 but has still serv ilely  pursued the previous track
 of others,  in retaining the class.   I shall venture
 to modify his arrangement by disposing of emmen-
 agogues in a manner hereafter to  be seen.  In the
 mean while let me observe, it is no inconsiderable
 corroboration of the propriety of this expurgation
 of the unstable class, that the only medicine which
 beyond all disputation or denial, does exert an im-
 pulsive, sudden  and  specific action on the uterus,
 is destitute of the power, or at least very  rarely
 evinc es it, of sanatively reinstating the uterine evac-
 uation, when retained or suppressed by any cause
 independent of conception or pregnancy.  If these
 substances which are conjectured to act specifically
 on the uterus, did impel or promote  its secreted
 redundant fluid,  by  such specific controul of its
 actions, where should we so naturally look for an
 efficient remedy in all cases whether of retention or
 suppression; whether of mild or exasperated cha-
 racter,—as to Ergot, which in a manner so plain,
 in a degree of force so vehement, in a time so short
 as to preclude any idea of circulatory absorption
 and hence secondary agency, proves its specific ac-
 tion on the uterus?  Will it be said that it cannot
 act  as  an  emmenagogue, because  the excessive
 velocity and force of its action,  excite a constrict-
 ing spasm on the already rigid mouths of the  ute-
rine disgorging vessels?  The very intensity of
 its action would enable  us to graduate its dose to
 the degree of obduracy of the disturbance.   It is
 we know,  no kind of qualifying  reason against
admitting the emetic power of tartarized antimony,
that in an undue quantity it paralizesthe stomach,
 and kills the subject by  its noxious presence,  like
arsenic or other corroding poisons. 
103
[emm;
   That constitutional preparatory treatment  is
 requisite to ensure the action of what are termed
 emmenagogues, is known by every practitioner who
 has attended to the  subject; and it seems  as ne-
 cessary in using those of activity as any other.  I
 am sustained in this by a  distinguished author,
 whose opinion bears with peculiar force on  this
 point, because he speaks of emmenagogues as agents
 of specific virtue.   Speaking of the effect of gua-
 iucum in restoring suppressed catamenia,  and  of
 its want*  of  success  in the hands of some  of his
 brother practitioners, Dr.  Dewees states that they
 had neglected to " place the system  in a proper
 situation for  its use," by the treatment he pursues ;
 remarking that he  ««almost always  reduces the
 pulse lower  than for madder or cantharides;  this
 he observes,  " is easily effected, by the loss of a
 little more blood than in the  other cases ; purging
 more freely,  and insisting on a low diet for a few
 days."*   The  doctor in  many other passages,
 shews that these general remedies are habitually
 used by him preparatory to  what he believes the
 specific emmenagogue, chosen for the particular
 case.  I cannot however, but view the latter as one
 of the train of general remedies employed, suited
 by its  peculiar stimulant energy, to  rouse  the
 whole system, and by  this  means  its parts.  Of
 the latter the uterus  is one,  participating  in  the
 general healthy  restoration. This view by no
 means can weaken  our confidence in  the vol. tr.
 of guaiacum,  so strenuously recommended,  or,
 in any  other medicine of similar effect.   But
merely adjusts what it is impossible for me to help
believing, a misnomer of the  commended remedy,
which may mislead less experienced practitioners

  * Dewees on the Diseases of Females, Phila. 1826. p. 79.
        I 
EMM.]                104

than  the  author, to depend  solely on  its specific
power.   This  indeed, appears  to  have been the
fact in reference to this very article, with which
others have failed  to  do  what  has been effected
under management  of Dr. Dewees.  and  1  may
here  add, in some few instances under my  own,
simply  because they "neglected to  prepare the        \
system," in other words, merely because they al-
lowed to guaiacum  a specific  virtue it does not
possess.
   In  order to form a correct estimate of the  mode
of operating pertaining to these remedies,  it  is      ^
proper to notice the sympathizing  morbid de-
rangement,  mental and physical,  which  attends        j
 catamenial  suppression  or  retention, the re-
 moving which  must ever precede or follow a rein-
 stated functional regularity  of the uterus.  It is
 not denied, that though a state of general  debility
 attends this irregularity of uterine function, that
 numerous cases  occur in which a condition of the
 system the very opposite exists—a plethoric state
 of the blood-vessels, and rigid tone of the  general
 system.  This however, does not give rise to  a cor-
 responding vigour of bodily health  But on the con-
 trary, a concealed and enervating tendency to feeble       •
 action', lurks under this deceptive full toned  habit,
 and  shews itself on the slightest bodily exertion.      *
 However different then to appearance  these oppo-
 site  attending conditions  of uterine  derangement
 may be;  and however  different  the  method of
 cure most certainly is,  I assume it as undeniable
 that the mental and nervous  system is  deeply       <
 involved in both.    Hysteria  in  all  its protean
 forms assails  both.  Mental despondency accom-     - *
 panies both.  In short, all those numberless moni-
  tions, which too faithfully announce that a general      *
  invasion of health has been accomplished,  by  the 
105
[emm.
disturbed and broken up condition of this central
garrison—this regulating  spring,  of all  female
\ igour.  And it  is but too ev ident, that unless it
be timely regained and  intrenched, a total loss of
health and  even a forfeiture of female  destiny to
propagate the species,  will  be inevitable.  When
the importance to the  female of a restored regu-
larity  is considered : when the variety of morbid
symtoms arising from  that irregularity is  taken
into view, it is evident, that general or constitu-
tional  remedies, are for the most part, those which
alone are adequate to cure a train of constitutional
morbid affections,  notwithstanding the  single seat
of original  disorder.    The true emmenagogues
will consequently be found  to be,  as the case may
be of  lax or sthenic habit,  or other condition  of
the system may require—the following:
   1. Simple tonics particularly some metallic  salts,
as iron,  with or without aromatics, bitter tonics ;
2. drastic cathartics with  or  without aromatics;
3. frequent emetics, succeeded by some of the prece-
ding; 4. blood-letting; 5. even stimulating diuretics,
as cantharides and balsam copaiva; 6. and best of
all,  according to the experience of one of the most
distinguished accoucheurs and experienced practi-
tioners of this country,* vol. tr: gum guaiacum.
7. Also ptisans of some of the verticillate,  as
penny-royal, dittany, balm,  horehound, marjoram,
the mints, rosemary.   Some of the tetradynamie,
as  mustard-seed, infusion of  horseradish,  &c.
8.  Many  of  the antispasmodics,  as the  fetid

  * ««I have for nearly seven and thirty years, almost daily
used this medicine, in suppressed catamenia; and more espe-
cially in those of long standing,  without its haying failed in
any case proper for its use—more cannot be said of a medi-

       JOewees on the Diseases of Female*, Phila. 1826. p. 80. 
EMM.]
106
gums, assafcetida,  galbanum, sagapenum ; castor,
and  other articles  of  this class as our  native
symplocarpus fetida, &c.   9. Some sialagogues,
as mercury,  either used  as an alterative to ef-
fect  ptyalisim,  or as a cathartic ;  10. some of the
asperifolie. as madder; 11. of thecorymbifere, as
tansey and boneset; 12. of the bulbose, as saffron ;
13.of the stimulating expectorants, as senega, snake
root; 14. some of the con i fere, as savin, infusion of
cedar berries, &c.   15.  Many essential oils, as of
rue,  cajeput, cloves, cinnamon, sassafras, penny-
royal, &c.  16. some stimulating dietetic beverages,
strong coffee, weak spirit of juniper, and infusion
of the  berries.    These  constitute the medical
means.   Then follow the  physical, as exercise of
different kinds,  gestation,  equitation and  exer-
citation in  invigorating amusements as dancing,
jumping the rope, &c. Then mechanical remedies,
as flesh-brush,  frictions, ligatures sto the thighs,
&c.  Then  local stimulating  remedies,  as sem-
icupium of salt water, the warm, simple or medicated
pediluvium; general tepid, warm, and cold bathing,
vapour  bath,  sea-bathing,  fomentations to  the
pubes;  temperate and regulated diet.   Then  fol-
low moral  means.  These are  overlooked in too
many cases, which  have their original  uterine
disturbance  altogether induced  by intemperate
indulgence of the depressing passions as jealousy,
envy, hatred, revenge ;  of depressing emotions as
grief, 'disappointment in marriage, love, or  ex-
cessive  ambition of whatever kind.  These may
and often do affect the talented,  the high-minded,
and in society the respectable and elevated female ;
but a train of baser passions and  emotions controuls
and  taints  the uterine system of the lower orders,
unrestrained for the most  part by decency  or
education.   These  are lust and  its consecutive
indulgence,  intemperance  in  the  pleasures  of 
107
[emm.
 venus,  lascivious  practices  of a  criminal  and
 unnatural kind ; impetuous and unrestrained gusts
 of rage, jealousy  and  revenge ;*  reckless  sur-
 render  to  immoderate eating and  drinking.  In
 short the whole moral system, in its unchastened
 aberrations, and  licentious   indulgences,  is not
 unfrequently a cause of  retention and suppression
 of the catamenia,  as well as  productive  often, of
 dysmenorrhea, and menorrhagia.   When this mo-
 ral inordinancy is the morbid agent, in cases under
 our care,  in vain  will we  seek material  medica-
 ments to effect  the cure,  without at the same time,
 using the  restraining influence  of  moral castiga-
 tion and reform, by our  own  advice or the influ-
 ence of friends.  I  am aware that  it is  only the
 educated female  whose mind  is to be reached by
 these representations of  the cause of her  malady:
 but even the abandoned  and  profligate do some-
 times surrender their vices at  the shrine of health.
 It is our duty to aid such in their return to a  less
 vicious  life.
  From the preceding view of the causes of uterine
 derangement and  the various  means of palliation
 and cure, for palliation is not unfrequently all we
 can effect ;  it is plain, that as I have advanced in
 the outset,  they act by  any  thing  but a specific
 force directed to the uterus, and it is equally clear
 and conclusive, that there is no just or even rational
 foundation for the existence or retention of such a
 class as emmenagogues.  Such at least is my view,
 and such my reasons for it.  As it is my duty to
teach  what  1  believe,  I therefore instruct  the
 student  to dissociate from his mind in the  study of
medicaments, that unphilosophical and  misleading
class.   He  will find it  thrown out of Murray's

  * These also produce menorrhagia.
      I  2 
EMM.]
108
arrangement at the end of the section A of these
lectures.
  It may be proper here the better to understand
the force of the preceding outlines, to state, that
the disgorging office of the uterus, expels  a fluid
which was  formerly  deemed  a simple evacuation
of  redundant  blood   from a  plethoric  viscus,
obeying  the  vicissitudes  of  lunar  influences,
venereal desires, concoctive fermentation,  &c. &c.
Among the distinguished writers who deemed this
discharge a periodical hemorrhage of a plethoric
viscus was Cullen.   The opinion which refers  to
the uterus a glandular  office, and  esteems the
catamenia as the secreted product of that secerning
function, and as a fluid of unique properties, is now
entertained by many physiologists.  The originat-
ing of this theory has been refered severally  to
Bordieu,  Sanders and Mr.  John  Hunter.  Dr.
Craven's, inaugural dissertation  published  in
Edinburgh in 1778,  which  I have not seen, is said
to contain it.  It is found in  Bordieu's  " Traites
des Glandcs," and Allen in his synopsis medicine,
develops it, as the theory of an author not named
by him.   But it is an opinion of much earlier date,
than the period at which either of the authors just
named, wrote or published.   It is clearly promul-
gated in the work of Rammazini as early as 1770,
and he speaks of it  as nothing new, and  without
 claiming to himself  the fact of having originated
 it.  Dr. Dewees, who contends for  the existence
 of a mucous lining  of the uterus,  with the power
 of performing what mucous membranes do perform
 elsewhere, does not believe that the catamenia are
 " a mere exudation from the internal surface of the
 uterus, constituting  a species of hemorrhage," but
 to be a " genuine secretion," from that membrane.
 He believes the change wrought upon the coagula- 
103
[emm.
ting lymph of blood from the common mass deter-
mined to this part, by  which  alteration  it is
deprived  of its  susceptibility of coagulation,  is
ow ing to " some peculiar mode of arterial action,"
similar to the alteration which takes place in the
blood from  the presence in the system of scurvy,
yellow fever and  small pox, &c. or death from a
blow on the stomach.  Hence he infers that as
"the same effect" (the eradicating of coagulating
susceptibility) " is produced by the uterine arteries
during  the  menstrual process, this  process  may,
with  much  propriety, be termed a secretory pro-
cess."  Without at  this moment stating my own
views  of  the  menstrual blood, (for blood I still
believe it) in reference to the secretory process by
which it is supposed to be engendered, I beg here to
deprecate this mode of  reasoning on the cause of
a physiological healthy and natural function,  by
unnatural (or morbid) physiological results, which
owe their institution to  an extraneous cause inimi-
cal to healthy  function,—to a cause  absolutely
morbid, as the effects which follow that cause.  It
appears to me a  mode  of  false reasoning, for its
data have  no relevancy  to the point at issue ;
however correct the inference from  the  insulated
facts pertaining  to the diseased condition  spoken
of,  may be.   That small pox, scurvy, yellow  fever
and a blow  on the belly, are followed by  an
anomalous,  and surely a morbid change in the co-
agulating property of the blood,  proves certainly
that diseased action can have  that effect: but I
apprehend can never prove, that, because a similar
unsusceptibility to coagulate pertains to menstrual
blood, it is hence  a  secretion.   Such an inference
would lead, and pursuing it does lead, to refering
a morbid acting power in the vessels of the uterus,
similar to the morbid acting power of scurvy, &c. 
EMM.]
110
But this conclusion inevitably tends to a point the
farthest from Dr. Dewees' opinion  in  relation to
the flux in question—that it is a morbid process.  In
truth  I cannot help thinking,  that, the undenied
fact of material  differences between common and
menstrual  blood  in their  component parts,  to-
gether with  the  fact that no vicarious hemorr-
hage is a suecedaneum for the catamenial flux,  has
led to inferences beyond the necessity or merits of
the case.  That this process is not a hemorrhago
of common blood I believe: but, that it is a genu-
ine secretion does not appear to me made out, either
by the facts or arguments adduced to support that
notion.  Farther—more of a secreting office is as-
signed to the uterus, as the opinion of Mr. Hunter,
than appears to me belongs to that opinion.
  In an extract from  his  lectures which he fur-
nished to  be published in Johnson's Midwifery, he
has asserted  clearly his  doubt of the identity of
catamenial and venous  or arterial blood: but from
his own words it does not  appear  to me,  by any
means certain,  that he deemed the catamenial
discharge, an absolute secretion of the uterus;  but
rather as a  superabundant flow  of pure blood
(which he deemed possessed  of vitality) derived from
the common source "changed, separated, or thrown
off, from  the common mass, by an  action of  the
vessels of the uterus, in a process similar to secre-
tion, by  which  action the blood" (the  common
blood in plethoric presence in the uterus) " having
lost its  vital principle, does not coagulate."   It
does appear to me, that this theory of Mr. Hun-
ter is misapprehended by  those who appear only
to have glanced at it, and  incorrectly  suppose he
admitted that the uterus was a gland in Mo.  But
that anatomical glandular structure, which is seen
in other parts of the system,  is entirely wanting
in this.   And it is no proof that its comparative 
ill                [emm.
 destitution of a congeries of vessels which consti-
 tutes all true glandular structures, should not for-
 bid our considering  it a  true secreting  viscus,
 that  " a few vessels,* creeping through the coats
 of the stomach, can  secrete the gastric liquor."
 It is purely conjectural, in what manner the gastric
 liquor is secreted;  and surely  no one ever called
 the stomach a  true gland, simply because a pecu-
 liar fluid  generated by some occult process of the
 system, is  found in  it and essential to  its appro-
 priate office.   The supposed analogy derived  from
 the asserted absence of glandular structure in ve-
 getables, which secrete nevertheless, gums, oil, &c.
 by the same  writer,f is totally  nugatory.  The
 assertion betrays a  want of acquaintance w ith the
 anatomical structure and physiology of vegetables,
 which should  have been known  before such analo-
 gical illustration was  enlisted.   The  existence in
 vegetables of  absolute  glandular structure,  ana-
 tomically analogous to glands in the animal system,
 is not a matter of surmise, but visible, plain, demon-
 strable.   Nay more, the execretory ducts of these
 glands, and patulous extremeties of their vessels,
 by which in numerous instances, their gums, re-
 sins,  narcotic  juices, poisonous  secretions,   &c.
 are thrown out to the surface of the leaves, stems,
 nectaries and  other  parts  of  plants, are easily
 traced,   by  slight  adventitious scrutiny,   and
 brought fairly to  view.  The fistulous opening
 in the hairs of nettles, at the base of each of which
 is a gland secreting a pungent and irritating fluid;
the patulous openings in the leaves of the cistus
creticus,  which throw  out from  the glands with
which they are continuous, the common labdanum

  * Dr. Chapman, Therapeutics, Emmenagogues.
  f Dr. Chapman,   ibid.        ibid. 
EMM.]
112
of the  Materia  Medica;  the same structure  in
glaucous plants  which covers them with a resi-
nous secretion: a similar  structure  in the leaves
of the myrica cerifera, or wax bearing mvrtle,  by
which  they are covered  with a green  ceratious
deposition ; but above all, thestucture of the necta-
ries of all  plants,  particularly in the strobiles of
common hops, which throw  out  at the base of
the squame, a secreted narcotic bitter resin, called
by Dr. A. W. Ives lupulin ; and the nectaries of the
melianthus major,  which  contain,  as a fluid  is
contained in a cup, half a dram or more of honey—
are a few instances of thousands  which  might be
adduced, to shew that the glandular structure not
only exists in vegetables, but that it is, by its ex-
cretory ducts and other circumstances, a structure
anatomically  similar  to  animal glands.    The
verisimilitude is palpable.   Indeed,  it is not only
upon the irrelevancy and insufficiency of this sup-
posed  analogy of simple structure  in the uterus
and in  vegetables which secrete acids, mucilages,
gums,  resis  oils, &c.  that I believe  too  much
of a glandular office is assigned to the uterus, in
the production of the catamenia.  There is really
no sufficient foundation in the anatomy of the part,
for ascribing so much of its function, to the elimina-
tion of a  species of  blood, different it  is true in
many  essential points, from  common blood, but
nevertheless   sufficiently  resembling it,  to  have
eluded the observation of many men of distinguish-
ed acumen and  knowledge.  The truth seems to
 me  to  lie midway  between these two  extremes,
 where indeed that penetrating physiologist,  Mr.
 Hunter, saw it.  And the kind of change effected
 by the agency of the uterus  in common  blood
 determined to it in a super-abundant quantity, and
 in periodical rc£<«larity, by some inscrutable neces- 
113
[emm.
sity  of the  female  oeconomy,  may probably be,
as Mr. Hunter called it.  by a process similar to
that  of a gland, but neither requiring, nor indeed
receiving that degreee of refined  secretion from
common  blood, which true glands  perform.   It is
admitting as much as the peculiarities of the cata-
menial blood require, and as the anatomical struc-
ture of  the orjan from  which it is disgorged,
permits.  It is admitting rather more than for my
own part I am willing to admit, while I have be-
fore my  mind's eye, the general plethoric state of
the  female  constitution,  immediately  preceding
this  evacuation.   In short, I must confess  Cul-
len's opinion is not without some strong claims  ;
and, if I do not yield absolute acquiescence in it,
it is because  my mind  leans to  a participatory
union of some of the points of it,  with some part
of the idea  of Hunter.
   The liability of the uterus to glandular diseases
as scirrhus  and cancer, is no proof as Dr. Chap-
man infers it to be, that it  is, or ought  to  be
considered a gland: since  the  stomach, which is
none, is liable to the same affections.  The con-
volutions of its  large  and thin coated  arteries,
may more reasonably be accounted for by the des-
tined necessity of distension of the whole  organ
in pregnancy, and of its parts of course, than by
assigning  to  this structure a  glandular office;
nature would provide by this structure of the blood
vessels a facility for such  distension.   The rigid-
ity and narrowness of the veins by which the blood
 '•returns with difficulty," is also accounted for by
the evident  necessity of a considerable presence of
blood  in the  viscus, to  supply its demand during
pregnancy ; and since that state is not always pre-
 sent, in the same individual, and not at all in the 
EMM.]                 114

life of many, the exit  of the  influx is provided
for,  by the catamenial flow.
  To sum up the peculiarities of catamenial blood,
for blood I deem it, I would observe that it differs
in colour, in odour, in  its refusing to  coagulate,
(but gratuitously) in  its destitution of  fibrin—all
which indicate the loss of its  "vitality," as Mr.
John Hunter would say.
\ 
115                [emo-
EMOLLIENTS.
  Mechanical remedies which soften  and lubri-
cate the skin, and thence extend their  relaxing
quality to the continuous and adjacent teguments,
vascular and nervous structure.  Their agency is,
when of a watery kind, promoted by a  heat above
62 of Farenheit, and under that exaltation which
would cause the sensation of pain.  The same ob-
servation applies to bland watery  mixtures  as
milk and  water, flaxseed tea.  barley  water,  and
similar articles.  But it is  doubtful whether ad-
ditional heat be requisite to ensure or enhance the
emollient effect  of oils  or oleaginous  substances
or  mixtures.   Emollients may be water of the
raised temperatures mentioned, or in a state of
vapour, or even in a state of reduced temperature
applied by dropping or pouring it from  a distance,
by what the French  term douche.   The pumping
of cold water on an inflamed and rigid or sprain-
ed joint has the same effect of softening the part, by
the additional  power of  velocity,  by which the
parts are  mechanically excited to  a more healthy
and equable action.   Cullen's explanation of this
mode of applying water as an emollient, appears to
me incorrect; and the insufficiency of his theory of
emollients generally, to explain the action of mild
cataplasms and fomentations, is plain.   His theory
stated.   Dr. Paris attributes the tendency of these
" to the relaxing effects of heat and  moisture  on
the extreme vessels of the surface, propagated  by
contiguous sympathy to the deeper seated organs*" 
emo.J
110
  Emollients  may  also be  the  preparations  in
which heat  and moisture are so  combined with
a watery, or a watery and an oleaginous fluid,  as
to keep up the action each separately evinces when
applied to the  skin, for a considerable time.  Such
preparations are the common poultice of bread and
milk which contains a portion of olive oil or simi-
lar  substance—of flaxseed meal, of slippery elm
bark, of chammomile flowers soaked in water,
and similar  preparations.  It has been observed,
that both heat and  moistdre applied to the  skin,
have an emollient effect of greater or  less degree,
according to the long duration  or short continu-
ance  of time they are  so applied.  It is for this
reason we observe a peculiar emollient result from
poultices.  In case of applying heat, by means  of
cloths rung out of boiling water, and fomentations
of watery fluids of a less exalted temperature, but
little  benefit is derived from them, for the same rea-
son, unless they be perseveringly applied long at one      *
time.  Cullen remarks, "we can hardly everfind the
continuance  of an hour less than sufficient."  Em-
ollients may also be the application of certain fat
oils in an unctuous state, as common goose grease,
bears grease, hogs lard, suet or the  fat  of sheep      M
as prepared  for candles.  These are ready domes-
tic  applications, and are frequently  applied  by     ^
frictions, which  add, as I have already observed
in reference to the douche, an additional mechani-     ^
cal  agent.  Olive oil is one of the commonest em-
ollient applications.
  The operation of  some of the  preceding sub-
stances  to excoriated surfaces, may be explained
in the same  manner.   They also operate  by their     *
bland mucilaginous quality,  in  alraying  the force
of phlegmonous and erysipelatous affections.  The
curative and alleviative power of this class is far 
117                [emo.
from inconsiderable in numerous affections ; but
particularly those of chronic articular and mus-
cular rheumatism, contusions, burns,  and the like.
And the emollient poultice is essential in the prac-
tice of surgery. 
EPI.] ,
its
EPISPASTICS*.
  External  applications which inflame the skin,
and cause an effusion of serum under the  cuticle.
This serous deposition is contained  in large vesi-
cles, which  consist of the cuticle raised above the
true skin, and separated from it by the  contained
fluid.   It is liberated  either by  the spontaneous
rupture of these vesications, or by puncture.  The
discharge from the inflamed  and denuded  surface
then becomes,  in  a  short  time after,  puriform.
The common blistering fly produces,  thus exter-
nally  applied to  the cuticle, a  train  of effects
which  may  be  considered the type of  the  oper-
ation  of  these agents.  Every one  knows that
these effects are what in common  parle  is termed
a blister. The immediate action of cantharides
applied to the cuticle, is evidently by their stimu-
lant influence on  the cutaneous blood vessels,  ex-
citing them to increased energy and thus producing
cutaneous  inflammation.   Serous effusion by the
exhalent  extremities of these vessels, is a natural
consequence of this.   In so far, the effect of a blis-
ter is stimulating.   The subsequent conversion of
the serous discharge to a puriform one,  is  the next
natural  effort of the diseased surface,  to resolve
itself,  and restore healthy action.  The puriform
discharge continues  a short or a longer time, ac-
cording  in some measure to  the  condition of the
individual system, but chiefly in consequence of
the nature of the dressings applied.  If they be of 
119
[epi
 a soothing and healing  nature, twenty-four hours
 after the blister is first dressed, will usually bring
 about its cessation: and if of a nature approaching
 to that of the agent first used to vesicate, as fly-
 ointment or savin-ointment, the puriform discharge/
 is established,  and continues to  be thrown off in
 sufficient quantity to reduce somewhat, the general
 tone of the system.  In  this case the blister be-
 comes an artificial external drain on the body, and
 is termed a perpetual blister ; and it now ceases to
 be a stimulant.   In this state a blister is analogous
 in its effects, to setons and issues,  which are the
 proper  artificial  drains,  chiefly  differing by
 their insertion into  teguments and  muscles,  and
 by  their draining from a  more circumscribed ex-
 tent.   Here then are two opposite consequences of
 a blister—consequences generally within our con-
 trol,  and  rendering the remedy of two-fold use.
 It fortunately happens,  that where the drain of a
 perpetual or (to disuse the  improper term for one
more appropriate) a continued blister, is conceived
 useful or efficacious, the first stimulating impulse
 of the application can  do no harm.   And in cases
 where the first impulse alone is required, we pos-
sess the means of checking its commutation into
the  drain,  by a course already  pointed  out.  In
this view of epispastics it must be clear to you, that
they are important agents in medical and surgical
practice.   They have  immemorially been  much
used, from ancient experience of their efficacy in
numerous  diseases and  disorders of the visceral
system, and  for many local affections of the mus-
cular and  articular  frame.  In  certain fevers of
low type however, the wasted sensibility of  the
cutaneous system, renders it untangible  by their
power, great and certain as that power  is, under
common circumstances of morbid action.  And it
      K 2 
EPI.]
120
happens that these fevers are often curable or fatal,
according as  we can excite the skin or may  be
frustrated in our efforts to do this.  Flies being
inadequate to rouse the system through  the skin,
as already stated, a  very important augmentation
of their vesicating quality was some years ago de-
vised by my friend Dr. Hartshorne  of this city;
by which, intensity of stimulating action  and what
is equally desirable in  the peculiar cases alluded
to, a more  sudden  development  of  its effect,  is
secured  to  the  practitioner.   His improvement
consists in boiling Spanish flies in the oil of tur-
pentine ;  and  from  much  experience  with  the
decoction, I  am prepared to invite your atten-
tion to it as one  of the most  important, useful
and  desired  improvements  in  pharmacy which
has  been  made for a long  time.  The energy
of its  action meets  the close danger of the case.
Whatever value there may  be  attributed,  and
it is universally conceived  to  be great, to the
rousing action of flies,  that value  is enhanced  to
our  utmost wishes,   by the intensity  and celerity
of action pertaining to the decoction of cantharides
in turpentine.
   The channel through which the sanative agency
 of blisters is imparted to the general system,  in
 fevers and other diseases involving general  dis-
 turbance of the frame ; the manner in which their
 curative agency is exerted in the local pains of in-
 flammatory  diseases  as  peripneumony ; and  in
 remov ing swellings of the body over the  regions of
 particular viscera which  are among the sequele
 of protracted intermittents ;  and their  beneficial
 operation on articular rigidity and watery deposi-
 tions, arising from chronic rheumatism or injuries,
 —have all been fruitful sources of inquiry and dis-
 cussion.  Much diversity of opinion has been de- 
121                 [epi.
veloped on these points ;  and yet  we are not much
enlightened by the investigation.  All that seems
to be clearly ascertained in relation  to  these re-
medies, is. fortunately,  what chiefly concerns us;
their practical uses.
  Experience has funished ample knowledge on
this point ; and we  may, without any materi.il
interference with a just appreciation of their real
efficacy in various affections, leave the unsettled
points  of  modus operandi, to the ingenious-dispu-
tatious.   But. that you may not be uninformed on
the leading traits of these varied and vascillating
opinions,  I shall  briefly  enumerate the chief of
them:—
  Cullen,  in conformity with the key-note of his
theory of fever, believed  they  relaxed  spasm of
the cuticular vessels: thus helping the  cure by re-
moving  the cause,  and  consecutively  inducing
their well known diaphoretic effect; and in spas-
modic  affections, performing the part of antispas-
modics.   Many of  the  older  writers  conceived
that much of their beneficial operation was attri-
butable to the serous evacuation they induce, while
the skin is in a state of  vesication.   And as it has
been sometimes observed that  the  establishment
of puriform discharge gave  the first indication of
benefit,  it has  been surmised,  that  additional
strength  was added by  that fact,  to the idea of
their depleting quality.    By some it has been sup-
posed that blisters operate in removing local pain,
by creating a new action  in an outward part: thus
abstrating the force of morbid  excitement concen-
trated within, and inviting it to a less injurious
seat of action, leaving the internal diseased action
by that much the weaker,  and consequently iu  the
way of a spedier return to equalized healthy action.
This opinion embraces a wider range.  It extends 
epi.j                 122
to the belief that diseased excitement may be re-
moved by causing a new and different excitement,
though it may be even a morbid or at least an natu-
ral one, in the same part.   And in this way, those
who entertain it, would account for the good effects
of blisters in  assuaging erysipelatous inflamma-
tion:  while  others  attribute this  effect to their
causing a  direct evacuation of serum from the in-
flamed vessels morbidly excited in that  species of
disease.   The efficacy of these remedies in remov-
ing pain from the side when applied to it,  in pleu-
risy, has  been attributed to an increased determi-
nation to the surface, and in so doing,  deriving
morbid  excitement  from the  pleura.  Anciently
they  were supposed to convey out of the system.
by their  serous and  puriform discharge,  that
morbific matter, or acrimony, which, according to
the prevailing  doctrines of  the  day, were  the
causes of disease within the  body.  As  blisters
had been  observed  to produce  strangury: and as
the internal  use of cantharides is often character-
ized by the same effect, it  has been believed that
their active principle is absorbed,  taken  into  the
course of  the  circulation,  and by  the change it
effects in the blood,  induces the healthful stimula-
tion to the general system,  which has been observ-
ed often to follow their application.   Many more
hypothetical solutions  of the  mode of acting  on
the diseased system,  have  been suggested to ac-
count for their curative,  or alleviating effects.
They have therefore been deemed  stimulants act-
ing by their rousing energy ; evacuants,  by their
depleting  power; counter-stimulants,  or irritants,
by exciting new action  to smother the old ; revul-
sives, by  their determining  morbid action to the
surface ;  antispasmodics by their  relaxing cuta-
neous spasm;  cordials, in other words tonics, be- 
125                [EPI.
cause they invigorate the nervous system in those
miserable beings crushed by " a preponderance of
mental or corporeal infirmity or weakness;"* men-
tal  exhilarating  agents, because  the celebrated
Dunning, a barrister of the London bar  was fool
enough to put a blister on his breast  when called
" on great occasions to make the finest display  of
his powers, forensic and parlimentary, and found it
to elevate his mind."f!!! Scavengers  because they
rake up and sweep out of the system  acrimony or
morbific stuff! Herculean combatant remedies,  by
sending their little acrimonious  particles through
the pores of the skin into the blood, to battle-the-
watch with  the acrimonious  particles of morbific
matters they may meet with  there, and to drive them
vi-et armis out!! or more pacific and seductive, but
equally efficacious powers,  which genteelly knock.
at the door (the skin) and  'invite,' 'solicit,' or'draw'
to it,  the morbid destroyers within, and thus shew
them the  way to clear themselves!!!   They have
been all this—" every thing by starts but nothing
long," and yet they are,  in sooth,  after all—mere
blisters.   The preceding sketch is a  melancholly
picture of the waste of intellect and  study, with-
out one  light,  one shadow of true keeping with
the original design.   Nothing resulting to fix the
mind on a more varied or extended employment of
these agents.  That they are useful, and possess
important qualities  of a curative  nature,  experi-
ence has from an early date taught the  practitioner.
How they are  so  I cannot tell.  I might indeed
beguile you with some new hypothesis,  as wise—
likely to be current as long—as  useful practically,
—and predicated on facts as solitary and insulated
as some if not all of  the  preceding.    But  what

  •  Dr. Chapman, Therapeutics, Epispastics,
  f Dr. Chapman,     Hid.       i^d, 
EPI.]
124
would it avail ?   What do those speculations avail ?
I can in my conscience only teach you that epi-
spastics raise blisters, and blisters are serviceable,
as experience has instructed, in certain  diseases
and  affections which will  be enumerated briefly
here, and more  in detail in the lectures.   1  will
forego this duty  a moment to offer you a quotation
from the philosophic, erudite and tasteful Darwin,
who refers the class to his secernentia.
  "  But a blister acts with more permanent  and
certain effect by  stimulating a part of the skin, and
thence affecting  the whole of it, and of  the  sto-
mach by association, and thence removes the most
obstinate heartburns  and vomitings.  From  this
the principal use of blisters is understood,  which
is to invigorate the  exertions of the arterial  and
lymphatic vessels of the skin,  producing an in-
crease of insensible  perspiration, and of cutaneous
absorption ; and to increase the action of the  sto-
mach, and the consequent power of digestion ; and
thence by sympathy to excite all the other irritative
motions: hence they relieve pains of the cold kind,
which originate  from defect of motion ; not  from
their introducing a greater pain,  as some  have
imagined, but by stimulating the  torpid  vessels
into  their usual action ; and thence increasing the
action and  consequent warmth of the whole skin,
and of all the parts  which are associated with it."
  If there is a theory of the  operation of blisters
on the diseased and healthy animal system to which
I can subscribe,  it is the foregoing.   Like a jewel-
ed watch, the pivot  of its ' wheel within a wheel,'
turns on that lustrous doctrine of healthy and mor-
bid physiology—sympathy. It is a harmonious con-
sent  of associated actions, voluntary and  involunta-
ry in health: and sympathising acquiescence in dis-
ordered function, or  associated action. Brown's and
Cullen's theories, in Europe, and the " morbid ex- 
125
[epi.
citement" of Rush,  in this  country,  caused it to
slumber in the schools; but I am happy t< say it has
been revived,  adopted and implicitly followed, in
the prelections of a distinguished teacher of medi-
cine in our sister school.  That he is entitled to the
credit of being a proselyte of Darwin and Hunter,
is abundantly shewn in his therapeutic disquisitions,
and in such of his practical lectures as I have had the
pleasure to hear.  On the subject of blisters, dis-
coursing on their general action and their effect of
occasioning strangury, he chimes with Darwin, as
I have just observed,  I am inclined to do, remark-
ing, " May we not then account for it (the produc-
tion of strangury) on the principle of extended
action  through  the medium  of sympathy?  Can-
tharides are universally allowed to be one of the ar-
ticles of materia medica, which most conspicuously
display their affinity  to the urinary organs.  Ap-
plied in the form of a blister to the surface of the
body, they excite a local impression, which by vir-
tue of the consent of parts,  is propagated in the
mode I have  just mentioned.   This,  at least, is
the solution of the  difficulty which accords best
with my medical creed, and I think, too,  with the
existing state of our medical intelligence.*
       THE  MEDICAL USE OF BLISTERS.

  They are beneficial in febrile diseases when ap-
plied at the * blistering point* as Rush called it, in
their course.   This  point  pre-supposes the use of
bleeding and evacuants  which  are particularly
necessary in  fevers  of high action and local pain.

  * Dr. Chapman, Therapeutics—Epispastics. 
EPI.j
126
Blisters have been opposed in thesefeversby many
practitioners, among the most conspicuous is For-
dyce. In intermittents they often display signal re-
lief, and pave the way for bark, which, without their
previous use,  is unavailing.   They remove  local
pain, shorten the disease,  and resolve congestions
of the spleen, liver, and other viscera. In continued
fevers, their use is problematical : and at all events
great circumspection is  required to interpose  them
between  high action and  approaching  collapse.
It has been observed by  Percival, and  my own ex-
tensive experience with  fevers of a warm climate,
sustains his position, that in fevers attended with
a general  disposition  to  inflammation, without
partial or local  affection greater in one part  than
another,  blisters always act injuriously ; but that
in cases of local  inflammation with general febrile
action, they  are always  useful.  The efficacy of
these remedies in  pleurisy is  universally known.
In this acute disease, they should be defered, for
the most part, until depletion  has been used  ; yet
cases do occur in which  they maybe applied much
earlier.  There  is indeed no reason why bleeding
should not be practiced  after their application and
before  the proper period arrives at which they are
to be removed. Hydrothorax is said to follow blist-
ering the  chest  before blood-letting ;  a fact  men-
tioned  by Armstrong.   Some have recommended
the application of blisters in pneumonic disease to
the extremeties,  or between the shoulders, in pre-
ference to the chest.   I  have often  used  them in
both ways, but  give decided preference to  the
chest in  inflammation  of the pleura,  and to the
space between the shoulder blades, in congestive
states of the lungs.  In  phthisis they may be often
requisite, placed on the  breast.   In inflammatory
affections of the trachea, and larynx, and of the 
                      12"                 [EPI.

tonsils, they are important  remedies.  In  croup
they are not so serviceable as turpentine.   I need
not observe that they succeed  general and topical
blood-letting in the three first affections.   But I
have never seen  any reason to refrain from the
simultaneous rubefacient effect of turpentine with
bleeding,  in croup.   Hepatitis  in its acute or
chronic state, is another disease in which these ap-
plications  are beneficial.  I have seen much bene-
fit  from them in  the acute  form after  the use
of the blue pill.   In hydrocephalus they appear to
me never to have any good effects, applied as they
usually are to the  scalp,  in its last stages.   It is
a common practice ; it  is,  to say the  least of it
an  unnecessary one.  If they ever do good in this
affection which  I am much inclined, from what I
have seen, to doubt; it  is  when early  applied,
after the most copious blood-letting.  My experi-
ence with  this disease, has not encouraged  me to
place  much  dependence  upon them, even in the
acute stage.  If it ever be an idiopathic inflamma-
tion of the brain, which causes effusion  or at least
the symptoms of it, as developed in hydrocephalus,
it is one not likely to be reached,   by any remedy
hut general and topical blood-letting.   And on the
other hand, when it is a  symptomatic affection of
bowel irritation  or disorder accompanying denti-
tion as it is nine times out of ten, blisters are more
likely  to do good to the surface covering the abdo-
men.  This  leads me to  remark that they are in
no  affection more  important, than  in gastritis
and enteritis, after  energetic depletion  of  the
sanguiferous system.   In  dysentery   they have
immemorially been applied either  to the abdomen
or  extremities.   They often  sooth  the  painful
distress  of  the  bowels,   when   applied to  the
belly at the very time the patient endures the most 
EPI.]                 128
excruciating tormina.  For this  purpose the ex-
perience of  the East  is in favour of nitric  acid,
rather than  flies.   Their power of inducing sleep
here, I have  often  observed conspicuous,  after
opium had  failed  to produce it.  Occasionally it
does happen that  the extremities  afford the best
sites  for their operation,  and there  I have  often
applied them beneficially.  These have chiefly been
chronic cases.  It is not uncommon to  find them
recommended in cholera-morbus.  Here I prefer
to them, stimulating pungent aromatics.   Applied
to the  wrists and ankles  they check diarrhea.
In chronic rheumatism; and after the high action has
been subdued in acute inflammatory cases, tliry are
important remedies, as the experience of every
practitioner can attest.  But  in gout I am not
able to say as  much.  In  my own  practice they
have done no good here ; but very high authority
is not  wanting, in  favour of their efficacy.  It is
however declared  that in  misplaced  arthritic ac-
tion, they are serviceable  on  the part  affected.
In phrenitis, they are important,  applied to the
head ; in apoplexy to the spine and extremities,
in delirium of  low fevers, to the nape of  the neck
and often to the whole scalp. In  the early stage
of mania, and with circumspection, they do good,
but when the disease is somewhat chronic they are
unavailing  though often  perseveringly  used to
the head.  In  chronic insanity  I  have seen them
much employed by Dr.  Rush, while I  was resi-
dent  physician of the  Pennsylvania Hospital;
but I never could consider them in any other light
than prejudicial.   I have often  been surprised to
observe how manifestly  hurtful they were,  and
how frequently nearly as bad, in cases of mania,
often aggravating the  symptoms,  even after  free
bleeding always directed by Dr. Rush.  In hyste- 
129
[epi.
rical and morose mania from contumacious temper,
combined with  uterine  disorder, I have applied
them  to the sacrum, in the hospital, with benefit
in some cases.   In palsy and  gutta serena they
are applied to  the forehead over  the  supra-or-
bital  nerve ; and in chronic cases of opthalmia
applied and kept open behind the ears,  they are
universally  acknowledged beneficial.  In spasm,
or convulsions, from irritation induced by difficult
dentition, they are very important aids to the
cure.   They may be applied  to  the spine or the
temples or behind the ears. In the latter situation
they have the effect of re-establishing the sponta-
neous puriform evacuation on the  cessation of which
spasm or convulsion have appeared.  In eruptive fe-
vers they are often beneficial and needful. In small-
pox when respiration  is impeded by the swelling
of the fauces,  they  should be placed on the  neck.
They are often useful and necessary  in measles:
Dr. Armstrong's caution  noticed.   Blisters  re-
peated in succession to the parts  near an  inflamed
organ,  are pi°re useful than a single one kept
running. In some hemorrhages,  after venesection,
they restrain the bleeding, as in epistaxis, applied
to the nape of the neck and in  hemoptisis to the
chest.   In epilepsy and tetanus  they are  common-
ly used, and high authority is found to sustain  the
importance of using them in these affections; they
have  been applied to the neck,  spine  and  head.
Incontinence of urine is relieved  by their operation
on the sacrum; and applied to the same place they
have been  found to act in producing a  return of
suppressed catamenia  and in cases of retension.
Dr. Joseph Klapp particularly  recommends them
here.    They  have removed obstinate cutaneous
affections.  Dr. Physick  proposed  them to check
the advance of inflammation along  a  vein,  in- 
EPI.]
130
flamed by bleeding or other cause.  He likewise
first extensively applied them  to  arrest mortifica-
tion, though Remer had previously observed that
they appear to possess the power of arresting that
process.  They are used to resolve buboes and other
glandular tumors, as in the mamme and testes.  In
affections of the ear, they give relief placed behind
it.   In dropsies though much used they appear of
doubtful  propriety,  except  in hydrothorax.  To
the throat in scarlatina they are applied with good
effect.  To conclude these outlines of their effica-
cy in medical practice it may be observed, that
for numerous anomalous affections,  attended with
deep seated  pains or  external swellings, in sys-
tems but  little constitutionally disordered,  they are
our only  resorts after cupping and leaching; and
followed  by rubefacients or stimulating linaments,
they seldom fail.  There is no  practitioner of a
few  years standing,  who does not use them in
numerous irregular affections, besides the diseases
already  specified, in  his daily  practice.    It  is
true, they are often prescribed without benefit in
such, but it is also true,  that they rarely  do any
injury under direction of  a thoughtful and skilful
practitioner.  My brother has used the turpentine
decoction of flies, instead of blisters, in erysipelas
affecting  worn  out constitutions, where general
low action prevailed, which would render the ap-
plication of a common  blister  troublesome and
pernicious.
   Caries of the bones and joints,  or a disposition
to it, is cured by repeated blistering.  Blisters have
been applied with this view,  to disease of the hip
joint, and to white swellings:  under their applica-
tion the enlargements subside, crepitus between the
bones which is owing to the abraded cartilages,
ceases to be felt under their operation; and under 
131
[epi.
a series of vesicating applications, the joint is re-
stored to its freedom and  anchylosis prevented.
Numerous other surgical  benefits  are obtained
from these remedies, which  I need not here detail.
  They  are  contra-indicated"  by idiosyncracies,
which render  them  productive  of great distress,
by painful strangury,  great constitutional irrita-
tion,  heat of  body,  insatiable  thirst, spasm  and
convulsions.    In  peculiarly sensitive  tempera-
ments, the strangury  is excruciating, and termi-
nates in bloody urine, particularly when the blisters
are applied  contiguous to the urinary organs ; to
parts recently shaved ; and if kept on an undue time
after the vesication is raised. They are also contra-
indicated in cases of great debility, with tendency
to mortification: as low stages of petechial fever, in
which I  have in the  army  recruit  service, seen
gangrene and other distressing occurrences hap-
pen,  from their use  under  my own direction.  In
confluent small-pox, malignant measles, and other
similar diseases, they have proved  very trouble-
some to  heal,  and have even produced  gangrene
of the part.
   To relieve strangury  it  has  been proposed to
unite camphor with  the blister orannoint the part
to which it is to be applied with camphorated oil.
But there are many instances  in which  camphor
itself has induced strangury.   Uva-ursi  simulta-
neously  administered  with  the application of the
blister, was strongly recommended by the late Dr.
Barton,  to obviate this distressing affection.  It
certainly is a  practice which  often prevents the
evil, yet it  must be remembered there are  cases
in which blisters may be proper, while  the  pro-
phvlactic is  inadmissable.  Diluent drinks  have
been often prescribed with  this view: such as milk
       L  2 
epi.]                 132

and water, barley-water, gum arabic water, mu-
cilaginous fluids as decoction of mallows, infusions
of slippery elm-bark, flaxseed tea,  &c. or some
diuretic ptisans: as water-melon seed tea, parsley
root tea; tea of carrot-seeds, scabious and the like.
  Incases which admit of delay, the head should
be shaved six, eight or ten hours before the  appli-
cation of the vesicatory, and the chance of strang-
ury may be  further  lessened,  by removal of  the
blister after it has  risen, washing the part with
some bland fluid as milk and water or oleaginous
ointment and reapplying  it.   This may in partic-
ular cases, be done even in an hour or two,  when
it  has acted as a rubefacient, and in instances of
excessive pain, it may be  altogether removed at
this time and  an  emollient poultice substituted.
Twelve hours is the time usually  allotted for the
continuance of blisters  on any part of the body
except the head, on which they are allowed to re-
main double  that time.   I  really  think there are
numerous cases in which all the beneficial effects
of the  vesicating stimulus may be  obtained in six*
or eight hours, particularly on the sensitive cuti-
cle of infants and young persons.   To  me it ap-
pears that when the former have continued a half
an hour to complain by word or action, of  the
pain, a further continuance of it may be saved by a
removal  of the cause. Notwithstanding this how-
ever, it does sometimes  happen,  that  both with
children  and adults,  a time exceeding that already
specified, as the usual period  of their application
must be allowed,  to obtain all the  benefit desired.
To know when this is proper  must be the result of
observation of the case under immediate treatment. 
133
[err.
ERRHINES, OR  STERNUTATORIES.
  Substances which snuffed up the nostrils, stim-
ulate the pituitary membrane, establishing a dis-
charge from it when suppressed, and  increasing
it when it exists.
  By  contiguous  sympathy, the stimulating im-
pulse thus given to  the schneiderian  membrane,
is extended more or less vigorously to the  vicinal
parts.   Cullen has gone so  far  as to  assert that
the effect of errhines extends not only  to the ves-
sels of the neighbouring muscles, by which rheu-
matic  congestions are removed and  odontalgic
irritation allayed, but even supposes it may extend
to the  whole of the branches of the external carotid.
To this he refers their known power, in some in-
stances, of curing head-aches,  pains  of the  ear
and opthalmias.   But further, he thinks it " pro-
bable that they may operate more or  less on the
whole vessels of the head, as even a branch of the
internal carotid passes into the nose."
   Errhines create for the  most part, sneezing;
but this is by no  means a constant effect, even in
such instances as are characterized by the renewed
or increased mucous discharge.    Many however
believe, that to the convulsive catenated actions of
sneezing, which involve the  muscles of the face,
throat, tongue,  and respiration, is equally owing
the salutary  effect of  these  remedies, as to the
increase in the mucous or sero-mucous defluxion. 
ERR.]
134
  The sera-mucous  discbarge and the sneezing
are not the only  immediate effects of errhines.
When snuffed high up the nose, they stimulate, the
excretory duct of the lachrymal  sack,  and not
only cause a defluxion from it, but by continuous
sympathy propagated to the gland  itself from the
duct thus excited, an increased secretion of tears
is the result.  And this accounts for their abundant
discharge in many cases of  sneezing  artificially
excited ; and to this effect is also doubtless to be
attributed, the benefit resulting to the affections of
the eyes,  from the application of sternutatories.
The resemblance of errhines to sialagogues no-
ticed.
     OF THE MEDICAL USE OF ERRHINES.

  The employment of these   remedies,  is  now
nearly obsolete.   Formerly they were much used
in various affections, among which  may be partic-
ularly  mentioned some  varieties of gutta  serena,
as that described by Sauvages  under the  name of
amaurosis plethorica, affecting sometimes, females
labouring under  retained or suppressed catamenia
er pregnancy.   Instances  stated  of the  cure of
gutta serena by these remedies, and tlie authorities
on which they  are related.  They can be of no
service when the  paralysis  of  the  optic nerve is
owing to organic derangement or disease, as tumors
pressing upon it.  &c. Transitory amaurosis some-
times exists in combination w ith head-aches arising
from deranged digestive function—it is said 1o have
been cured by  errhines.   Deafness arising from
a peculiar  affection of the eustachian tube,  has
been relieved by errhines.  They have been said to 
135
[err.
cure or greatly relieve hemicrania: and have been
said to prevent apoplexy and palsy.   The danger
of suppressing an artificial drain from the nose by
habitual use of snuff in apoplectic habits  discussed.
Illustrations given.  Boyles  report of absorption
of cataract by euphorbium,  a powerful errhine,
stated.  The efficacy of these remedies  in opthal-
mia, stated.   Sneezing as a critical occurrence in
fevers and hydrocephalus, noticed ;  said to  be
favourable.  This effect occurred in  ten thousand
men of Xenophon's army on  the  Euxine sea, on
their recovery from the deleterious effects of poi-
sonous honey.  Mercurial errhines as  turpeth  min-
eral,  used  in polypus.    Sneezing  occasionally
dangerous,  producing  local   turgescence of the
blood-vessels, particularly of the head,  and some-
times of the chest.   Their danger is  supposed to
have given rise to the benediction on sneezing, pe-
culiar to the inhabitants of some countries.   Ne-
cessary to advert to  the fact  of their occasional
injurious tendency,  in prescribing them  for what-
ever  purpose.   Medicated snuffs noticed; their
cephalic efficacy depends on a mercurial errhine
generally,  and often on the union with common
tobacco, of powerful sternutatories  as euphorbium,
asarabacca, arum or cuckow-pint.   The latter
used by Loesecke in gutta serena with efficacy.
The medicines just mentioned, with the  vapour of
spirit of sal-ammoniac, white hellebore, marjo-
ram, lavender, orris-root,  horse-chesnut,  hedera
terrestris and  betony, are the chief subjects of this
class.   We have several indigenous plants which
possess the same errhine  property, as  helenium,
autumnale or sneeze-weed, sanguinaria canadensis,
&c.   Warm  water  snuffed up the nose acts as an
errhine.  The juice of common beet applied in the
same way  is slightly  errhine.  The  snuffing  of 
ERR.]                136

the  vapour of ether,  with laudanum,  has  also
been much used.    It acts by  stimulating  the
schneiderian membrane as the  preceding articles
do.   In some instances of annual  periodical  ca-
tarrh attended with  obstinate suppression of  the
nasal secretion, I have known it beneficial.  It is
a favourite  prescription  in such  cases  with  Dr.
Physick.   The cases related.
   " Mr. Reddelin of Weimer, has  recently com-
municated  to  the Royal  Society  of  Gottingen
through  Professor Blumenbach the following suc-
cessful treatment of croup after  the usual reme-
dies had been tried without effect.  The patient a
female aged 19, who  on the third  day after being
seized with croup was unable to  swallow,  had
began to rattle in the throat and seemed to  be
rapidly approaching her  dissolution.   Dr.   R.
insinuated by means of a quill a mixture of Span-
ish snuff and morocco* into her nostrils, and after
repeating this  mixture  a  second time  it excited
sneezing and vomiting.  They occasioned the dis-
charge of two  long membranous cylinders from
the trachea, upon  which the rattling immediately
ceased and  the  patient was rescued from suffoca-
tion."!
  To conclude: thedefluxion produced by errhines
is  commonly  evanescent;  yet it does  continue
often for  several  hours,  and occasionally   the
established  secretion  continues  in  augmented
quantity  for  several  days.  It  is  obvious, from
the preceding remarks,  that  the power  of  err-
hines is local,  though  it was  maintained  by  the
late  Dr. Barton,  that  errhines  taken into  the
stomach did occasionally  produce the same effect,
* The root of adonis autumnalis.
t Med. Chir. Review, Vol. 1, 
137                 ERR.]
in a few hours, as when topically used:  an opinion
in which I see no good reason to acquiesce.  The
facts on which he founded his belief on this point
stated. The medical application of these remedies,
is circumscribed to a few affections, and those of a
local or insulated character.   Still cases may,  and
indeed I know they do occur, for I have met with
them,in w hich errhines may advantageously be used
with palliative  if not curative effect.  They arc
however, as I have remarked in the outset, nearly
obsolete.  In other words  they are out  of fashion,
as indeed  are many more important remedies,
which  have been pushed away from sight  and use,
by that rage for panaceas,  that mania for quacks —
engendered,  fomented, and unhappily  for science
and the dignity and usefulness of tlie profession sus-
tained—by the mania of some of its own distin-
guished members!!! 
esc]
138
ESCAROTICS.
  Substances and agents which erode, destroy, or
decompose,  the solid fibre of the living body: ap-
plied to the  skin they erode it, and to ulcers or
denuded muscles, or teguements, they remove the
surface.   They  act:
  1. By their natural properties  as  the  heated
iron and  moxa  in which  case  they  are called
actual cauteries: or,
  2. By their chemical causticity, as the concentra-
ted mineral  acids, fused potash, the salts of metals
formed with  acids, as nitrate of silver, the muriate
of antimony, (or butter  of antimony,) the  nitric
oxide of quick-silver (or red precipitate,) the oxy-
muriate of the same, (or  corrosive sublimate,) the
ammoniated sub-muriate of the same, (or  white
precipitate.) The sulphate  of copper (or blue vitri-
ol:) the subacetate of copper (or erugo;) the arseni-
iius acid,  (or white oxyde  of arsenic;) the  dried
sulphate of alumine,—all of which have been called
the potential cauteries or caustics: or;
  3. By the  eroding causticity of their essential oil,
as savin or the concentrated essential  oil of cloves.
The whole assemblage have  been  called caustics,
cauteries, erodents and  escharotics.   They have
by some been divided into eroding  escharotics and
caustic escharotics.  a division grounded on the less
or greater intensity of their destructive power.
  The application of these substances is always
attended with some pain, occasionally of an exas- 
                      139                 [esc;

peratcd nature.  It is however of short duration,
leaving a sympathising inflammatory action in the
contiguous and adjacent parts, which is greater or
less in proportion to the liberal or sparing appli-
cation of the caustic,  and often some irritation of
the whole system.  Though the mineral acids are
excellent escharotics. they are seldom  used, on ac-
count of their fluidity, which  renders it difficult to
restrain their eroding action  within the bounds de-
sired.   The  dry grains of  red precipitate answer
the purpose very well,  but  the power of that sub-
stance is  lessened by its union with an  unctuous
body, as is common.  The lunar caustic  is suffi-
ciently manageable, and more frequently empjoy-
od than the common caustic, or fused potash, which
is more destructive.    The  butter of antimony,
which is the  most intense caustic known, is  liable
to the same objection as the fluid escharotics,  not
being in a solid form.  The burned alum is weak-
est of all  the escharotics.  and may be suited to
cases not requiring a great eroding power.   The
moxa is of ancient date, and its use has been re-
vived of late years  by many French  surgeons—
To Baron Larey chiefly, is to be  attributed  this
restored surgical  remedy.
  The purposes to which escharotics are applied,
are for the most part surgical. They arc employed
to remove excressencies. establish healthy action
in ulcers, remove fungous granulations and thereby
convert an ulcerated surface  into  a simple sore.
Also for establishing issues in various parts of the
body ; for exciting the fractured  ends of  ho:ies
which are indisposed to form callous, and thereby
promote union; and finally, by timid practitioners
(at least in most instances) to open buboes and as-
sesses.
       M 
ESC.]
140
  Dr. Paris remarks " the operation of these bodies
may, in general, be considered  chemical ; for ha-
ving destroyed the life of the part to which they
are applied, they cause, as if by a species of result-
ing affinity, the elements of the animal  matter to
enter into a new state of combination ; this is well
exemplified in the action  of caustic potass, where
the nascent elements thus  disengaged  by the de-
composition of the  animal substances,  reunite in
proportions to generate an oily matter, which may
be observed to  form  a  film  over the  ulcerated
surface, while the excess of nitrogen and hydro-
gen constitute  the ammonia, which is disengaged
during the action  of  the  caustic : and may  be
rendered sensible by inverting over the  surface a
small jar moistened   with muriatic  acid,  when
fumes of muriate  of ammonia,  become visible."
  A solution of lunar caustic has  lately been re-
commended to  be applied to the lining  membrane
of the upper part of the trachea in croup, to sepa-
rate the inflammatory membranous product which
is thrown out by the vessels in  exasperated cases
of that fell disease.   And  also to be applied  to
the eruptions of small pox  to  prevent deforming
cicatrization: 
(41
[EXP,
EXPECTORANTS,
   A mongrel and ill-defined class of remedies, the
effect of which every one perceives, but no one can
satisfactorily account for.   I believe the only true
expectorants are emetics.  Stimulating  diaphor-
etics often promote expectoration ; but their more
certain and constant effect  is on the  skin, hence
they  are  properly  located  already.   Many anti-
spasmodics, as assaTetida, ammoniacum,musk, &c.
facilitate  expectoration.  Yet  they  have  a  more
decided and constant character.   Should we,  for
this adventitious and by no means constant effect,
refer  them  to  the  present  class?  Some narcot-
ics, camphor for example,  are expectorants; but
tliis property in the example given (and others,) is
subsidiary to a  paramount operation on the brain
and nervous system, which  has caused it properly
to be  placed with the  deleterious class,  and not
with the present.  All the natural family  of allia-
cee, facilitate expectoration, as onions and garlic
for example.  They are, in  common with the tribe
of bulbous rooted plants,  as  the squill,  diuretic,
--more decidedly so, in many  instances, than they
are expectorant. Shall we retain  a class to re-
ceive  them for an effect not always produced, while
they have stronger claims to the  position, already
allotted to them?   The whole tribe of terebinthi-
nate,  and fragrant  balsams, as copaiva,  tolu,
peru,  elemi, &c. facilitate expectoration • they are
general  stimulants,  diuretics and  diaphoretics, 
EXP.]                 H3

more constantly than-expectorants   Blood-letting
facilitates expectoration.   A blister  will  do the
same. The diffusible general  stimulant, carbonate
of ammonia, acts in this way ; so do  many of the
acrid stimulants, as mezereon, indian turnip, senega
snake root.  Yet they have other effects more con-
spicuous, more steadily developed. Mucilages and
oleaginous decoctions are placed with expectorants.
They reach the kidnies and  skin quite as surely
as the bronchia and cells of the lungs.  In short,
not to  give  more  examples of  the  inosculating
effects of tlie subjects of this hybrid class,  I would
observe, that it is one of very obscure and unstead-
fast character,  embracing  medicines  which often
fail in producing the  effect of promoting  and fa-
cilitating expectoration; often do this, when ef-
fected, by a secondary or even more remote effect,
the primary one being that of a general stimulant
involving the lungs and its appendages as a part
of the whole thus incited to increased  action.
   These observations bear on the name,   and  on
the definitions of the class, usually given  by au-
thors.  They  will tend to shew what I have been
inculcating in these lectures, that classification is,
beyond a few aggregations,  useless,  ineffective of
the object for which it is designed, and misleading
to the student and  young  practitioner.   As I am
 not however  opposed to the employment of the
 articles arranged by writers under this class, but
on the contrary know them to be useful in practice,
 though still very second-rate  remedies,  I  shall
 sketch  the outlines of what is  thought  of their mode
 of operating, and  their efficacy; guarding you
 against receiving them as  agents of any specific
 tendency to affect the lungs and bronchia.  There
 are no  remedies of such effect.  Whatever effect
 they evince upon the respiratory organs and  func- 
1*43                 [EXP.
tions, I believe  to be  by the two fold operation
1. through  the  general circulation, by which
they incite other organs and  tissues besides the
lungs,  bronchia  and mucous lining in an equal if
not greater degree, and, 2. by the catenated chain
of sympathetic actions.
   Cullen defines expectorants  thus:  "These are
medicines which facilitate the bringing up the con-
tents of the cavity of the lungs.  This  however
must always be  done by more or less of coughing ;
but as we do not know, or at least I do not know,
of any internal medicines for exciting this, I have
confined my  definition of expectorants to be those
which  render the contents of the  bronchia to be
more easily  brought  up."    He seems  to  have
thought that there are medicines which can cxpede
the secretion of mucus in the bronchia, though they
have not come  to our knowledge.   Since he has
assumed as  postulates, that expectoration cannot
be performed but by coughing, and that  we  have
no medicines known to induce this effect  when in-
ternally administered,  and also that we  are not
able by internal  medicaments  to   augment the
quantity or change the quality of the natural, or
morbid  contents of  the  bronchia,  how  does  he
account for  the  operation of expectorants?  Dis-
carding the assertion of Senac, that mucus exists
in the mass  of blood, he infers, and every rational
view of the  subject will,  I think, justify any one
in according with him, that the class of medicines,
termed  by  some, attenuants,  cannot operate  in
diluting a morbid viscosity of that mucus in the
circulating blood and fluids, which has never been
proved to exist  in them.   Reasoning in  the same
manner with reference to expectorants, he did not
believe that  any  of them could operate in lessening
the viscosity of the mucus, poured out of the mu~
      M 2 
EXP.]
144
cous  follicles of  the bronchia and  cells of the
lungs, by being taken into the circulation.   And
since these remedies can have, for these reasons,
no power to attenuate the viscidity of the mucus,
through the rout of sanguineous circulation,  they
could still  less act in this way, in increasing the
quantity of that mucus, it not being there present
to act upon, and the tissues which secrete it being
too remote to be supposed  susceptible  of being
reached  in this manner.  Since the diseases  in
which expectorants, by common consent of opinion
and practice, are required, are those marked  by a
deficiency  of  the  mucus naturally exuding from
the lining  tissue of the lungs  and bronchia,  or a
morbid  increase in its due quantity and often with
a conjunctive augmentation of adhering tenacity to
the secreting surface with increase in its viscidity—
it is plain  he could attach no curative effect to the
operation  of  expectorants.   He does  not doubt
that the articles under this name, may diminish the
determination of excited action to the lungs and
its appendages,  and thereby lessen the morbid ac-
cumulation of their  secretion  which may  have
been produced by  that action,  or rather prevent
further  accresion to the viscid increased mass al-
ready clogging their cells and passages.  But he
believed they  effected this,  by determining to the
surface of the body  that local excitement which
caused the mischief.    That  they might readily
do this cannot be doubted by any one who has ob-
served  or reflected on the sympathetic  actions  of
the respiratory organs and the skin.   He therefore
believed they  acted,  not as  expectorants, in  the
usual acceptation of that term, but as diaphoretics.
He also supposed  an explanation of their  effects,
and the only probable one he could offer, was •* that
by increasing the secretion of the liquid that is to 
                      145                 [exp.

 afford a mucus, this, as poured from  the arteries
 into the follicles, being always a thin fluid, it may
 dilute the fluid in the follicles, and may make it
 to be poured out from these in a less viscid state,
 and may  therefore  be rendered more easy to be
 brought up by coughing,  that is, to be more free-
 ly expectorated"—yet  he does  not  ascribe any
 part of the coughing to  the agency  of the  rem-
 edy,  but deems it solely the natural effort of the
 lungs to disgorge their oppressive fluid.   We are
 thus brought to his theory of the operation of ex-
 pectorants.  And it is evidently a theory at direct
 variance with  many of the definitions of the  class
 by  authors,  and with the meaning assigned to it
 in the common parle of the profession,  it is in-
 deed, rather than a theory to account for  what he
 believes, one to render some attempt at a probable
 explanation of the belief of others.  For his own
 part he circumscribes the operation of these reme-
 dies within a very  narrow, but in my opinion a
 very proper sphere of action—simply,  that " they
 facilitate  the bringing up the contents of the cavi-
 ty of the  lungs."   After this concession to his
 opinion, you need not be told,  I do not believe in
 the specific agency  of expectorants, or that I do
 believe  the chief of them  act beneficially by  a
 course widely remote from primary action on the
 lungs;  by a course passing over numerous chords
 of sympathetic catenation, the vibrations of which,
 thus excited, are first and most sensibly perceived
 in other parts of the body than the lungs, which
 however they reach before their  oscillations have
ceased.   Dr. Paris, notwithstanding he does not
believe in the specific agency of expectorants, has
attached too much importance to the class, by  an
analysis of the various modes  by which ultimate-
ly they  act  upon the lungs:  an analysis which 
BXP.]
146
proves how little they are entitled to be considered
as any thing more than  general stimulants—nar-
cotic stimulants—antispasmodic stimulants—emet-
ic stimulants—cathartic  stimulants—in  a  word,
any other  kind  of stimulants  than such as are
endued with a  peculiar and direct operation on the
lungs  and  their appendages.   Dr. Paris could
not  have laboured more successfully to eradicate
from our lists of medicines,  the ill devised class
under notice, than by this  analysis of these varied
modes of operating,  and  the exposition  he  has
given of these devious routs, in his classification.
It bears with so much confirmatory argument on
my own views, that it is subjoined to aid me in es-
tablishing the object of the foregoing observations.

     A CLASSIFICATION OF EXPECTORANTS
    ACCORDING TO THEIR SCPPOSED MOI1ES OF OFKHAT10N.
CL:  I—MEDICINES WHICH  INCREASE PULMONARY
  EXHALATION, AND THEREBY DILUTE THE MUCUS
  IN THE FOLLICLES OF THE LUNGS.
     a. By removing constriction ol the Pulmonary Exhalent
         vessels.
                                      JVa-useants.
     b. By stimulating these vessels by the actual contact of a
         medicinal substance.
               Allium.                 Fatid Gums.
               Scilla ?
               The different Balsams.
CL:  IT.—MF.DTCTNES WHICH DIMINISH THE INORDI-
  NATE  FLOW OF FLUID  INTO  THE LUNGS, AND
  RENDER THE EXPECTORATION OF THE REMAIN-
  DER MORE EASY.
     a. By removing the debility of the Exhalents.
               Sulphate of Zinc.        Bitter Tonice.
     %. By increasing the power of the Absorbents.
               Digitalis.                JVicotiana.
     c. By determining to the skin by gentle diaphoresis.
                              Tartarixed Antimony.
      tf. By exciting serous discharges from the bowels.
                                Saline Pvrgutivet. 
147
[exp.
 CL; HI.--MEDICINES WHICH  OPERATE  MECHANI-
  CALLY IN  PROMOTING  THE REJECTION OF  AC-
  CUMULATED MUCUS.

      a. By stimulating the muscles of respiration.
                                     Ammonia.
      b. By exciting Vomiting, and thereby compressing the
         thoracic viscera.
                                      Emetics.

   In  reference to the first of the  classes just enu-
 merated, which embraces medicines that increase
 pulmonary exhalation, by  removing  constriction
 from  the exhalent  vessels  of the  lungs, he  as-
 sumes,  tiiat  in  pneumonia,  asthma,   and  other
 diseases of the pulmonary system,  the spasmodic
 constriction of the exhalents  of the  lungs, retards
 the exudation of the usual and necessary quantity
 of lubricating fluid  poured  out by them in a state
 of health.   This is  all true ;  at  least the effect is
 certain, however he  may account for it.   But how
 does  he propose to relieve the pulmonary  system,
 of this perverted course of  its  healthy actions?
 Is it by remedies of local impulse,  which, by that
 impulse liberate the embargoed gregations of mu-
 cous clots,  and set them adrift in the passages of
 the lungs, there to excite coughing which causes
 their  expulsion?  No.   Is  it by  attenuating  the
 viscidity of  these same clots, within the mucous
 follicles, by  the same kind of local action, thus
 bringing them to such a state of fluidity as will
 enable them  to pass the patulous and constricted
 mouths of these follicles into the  pulmonary  pass-
 ages,  that they may gain egress as above?   No.
 Is it not by suggesting for relief, the exhibition of
certain general stimulants operating on  the gene-
 ral system first, and afterwards on  the lungs as a
part,  by the relaxation of indirect debility—which
decidedly convey  by  the first impression, an im- 
EXP.]
148
pulsive excitement to many other parts of the sys-
tem, besides the pulmonary organs, and generally
indeed, in a much greater degree?   Is  it  not  by
nauseants?  What are they?   The most  stimulat-
ing emetics  in  small and divided  doses.   Why
then call them expectorants, seeing expectoration
when induced by them at all,  is only one of a series
of effects—one link of a catenated chain of associ-
ated irritative actions?
   In  regard to  his second section  of the  same
class, which comprises medicines suited to stimu-
late the pulmonary  exhalents by the actual contact
of their medicinal principle, I cannot but say there
is much gratuitous  foundation.  The instance of
garlic given by him, of a substance taken into the
circulation, and evincing a peculiar determination
to the lungs, is an unlucky one.  It is true that the
volatile and penetrating odour of this root is per-
ceptible  in the breath,  and that this is  also per-
ceived as sensibly if it have been externally applied
to the soles of the  feet, as when internally taken.
This  proves the subtle and diffusible nature of its
odoriferous principle whatever  that may be: and
further. proves  the  readiness with  which the
circulating fluids of the body convey through their
devious course,  and by their mysterious operation
—volatile odours ; but to my satisfaction it does not
prove, that  the medicinal property has a peculiar
predilection for the  lungs.  If the alliaceous odour
of the breath evidences this predilection,  as it is as-
sumed, it does—if that be the criterion of its expec-
torant effect (to use common parle) why does not this
effect supervene to the application of garlic to the
soles of the feet?   It is a disagreeable medicine to
most persons, intolerable to many, and  in some
idiosyncracies, a dangerous one, inducing convul-
sions and cerebral  hebetude.  Why  do we not in 
149
[est.
such cases, nay, in all cases, of catarrhal engorge-
ment without fever,  or with little fever, cause ex-
pectoration by applying it to the  soles of the feet?
•Will it operate on the lungs as an expectorant thus
used?  I answer from knowledge of the fact, that
it will not.   Who ever said  it would?  Yet it un-
questionably  ought to do so, if  its peculiar effect
on the lungs, (I do not deny that it  has a strong
ulterior  effect on them)  was owing to a peculiar
determination to these organs, evinced by the odour
of the  breath—which is not only Dr. Paris* posi-
tion,  but one every-day avered by  medical  men.
This is not the only  instance of gratuitous reason-
ing in Dr. Paris" observations on this section.  He
says.  "Such substances  (as  the  alliacere)  may
stimulate the exhalent vessels through which they
pass,  and by this stimulus the secretion  may  he
increased,  and  the mucus  contained in  the fol-
licles  diluted, so as to  be  poured out in a less
viscid form,  and consequently in a state to be more
easily brought up by expectoration.*" And  suppose
I say this may all not be so— are there not as many-
facts  to  inTrench this averment,   as  physiology
furnishes to  sustain his gratuitous position.   It is
after all, begging the question,  and no fair deduc-
tions can be made from reasoning so faulty.  What
are  the  medicines besides garlic,  which  he pro-
poses  as expectorants in this section?  Squill, the
balsams, the foetid  gums.    The  first  an  active
emetic,  a more certain diuretic  than most  of its
congeners in the class of diuretics; the second em-
bracing  an extensive tribe of natural vegetable
secretions, all powerfully stimulant to the general
system ; the third active antispasmodics, involving
the lungs as a part of that integrity of living mat-
ter over which  they  exercise a tranquilizing con-
trol, by the peculiarity of their inciting action on 
EXP.]
150
the sympathetic harmonies of the body.   Should
these then be dubed  by the sword and word of a
classifying  monarch, as he was who first devised
the class—mere knights of a local domain, while
they  inherit incontestable claim to  an extended
sovereignty  over the whole range of living  animal
space!
   Let us pass on to the second class of Dr. Paris*
scheme: Section a, embraces medicines which di-
minish the inordinate flow of fluid into the lungs,
by removing what 1  deem is most incorrectly con-
ceived the cause of this undue flow,—the debility
of the exhalents.   Debility, if it he one cause, is
clearly not the only, nor the most frequent  cause
of this excessive secretion  of  mucus.   Who that
has seen  the sudden  accession of tracheal inflam-
mation  in adults,  supervening  to   exposure  to
damp and  coldness with  very wet feet, in our spring
or autumn:  in which the patient is  first apprised
of his being  sick by starting from his sleep with a
sudden ejection of a deal of viscid mucus from  his
throat to prevent immediate suffocation, will refer
this to a debility of the  exhalents?  If any one do
assign such a cause,  let him look to the treatment
for the  conviction  of his  error: copious  blood-
letting,  emetics pushed  so as to prostrate the sys-
tem, open the skin, relax the entire bodily vigour ;
saline cathartics which establish, after a few hours
the reduction of inflammation by these debilitating
agents, by draining from the bowels and the  kid-
nies.  If debility be  not the cause of augmented
mucous secretion in this instance,  it does no more
clearly  appear to  me  to be so,  in  what  is
railed humoral asthma, and the  catarrh of old
people.  There is indeed not a  balanced action be-
tween the excreting and secreting  power  of the
lungs and trachea in these affections.   The former 
151
[exp.
 remaining  in  usual activity, the latter in aug-
 mented  force.  To this increased action in the
 secretory  vessels of the mucous tissue I  would
 refer the effect of an increased flow of the  mucus:
 and not to any debility in these exhalents as they
 are called.  The effort of nature, (the contemned.
 but the rational belief in the vis medicatrix naturse,
 leads me to use this language,) evinces a necessity
 to rid the surcharged  passages, of this secretion,
 in the tussis senilis,  or the cough of old people.
 Dr. Paris observes "if this excess be restrained by
 strengthening the tone of the system generally, or
 by astringing these vessels in particular, the ex-
 pectoration of the  remainder  will be  rendered
 much more easy."   The effect here implied is the
 true one supervening to tonics or astringents: but
 I apprehend the cause cannot  be, by any local
 action they exert in  rousing the  debilitated secret-
 ing tissues, for that debility does not, in my opinion
 exist—but by equalizing the excitement  of the
 general  system,  thus  invigorated by tonics and
 astringents: and consequently removing the undue
 local  excitement prevailing in the mucous  tissue.
 This  inference  is  more conformable  with  the
 known  operation  of tonics and astringents.   By
 this reasoning  I  am brought to conclude, as al-
 ready advanced, that the increased flow of mucus
 in the catarrh of old people,  in humoral asthma,
 and similar affections afflicting persons debilitated
from  age or disease,  is  owing to  an increased
 energy in the secreting vessels,  and  not to debil-
 ity.   And that the inconvenience arising from this
 excessive  engorgement depends  on an inadequacy
 in the excreting energies of the parts  involved, to
 meet the super-abundant flow.  No more happens
 here than to the kidnies  and  urinary organs, in
persons as they advance  in age.  The increased 
EXP.]
152
secretion of urine,  owing to a deficient action in
advanced life, of the discharging function of the
skin, causes perpetual micturition.  We  cannot
allow  that the  increased urine is  produced by a
debility of the secreting powers of the kidnies, but
by its increased action from the cause already men-
tioned.  The inadequacy of  the urinary organs to
retain this as long as  in earlier  life when more
general vigour pervaded  the system,  may  indeed
be owing to a debility of their excreting function ;
and in  like manner, as with  the lungs, tonics and
astringents would here bring about a  balanced
action between secretion and excretion.   The sul-
phate of zinc, indicated by Dr. Paris, as particu-
larly efficacious  in restoring the  " debility of the
exhalents," is atonic and a certain one under pro-
per management.  WThat has been  said  therefore
above,   of tonics and  astringents  generally,  is
equally applicable to this medicine.
  Section b of the second class refers to  medicines
which have the power of increasing the  action of
the absorbents, under the belief that the  "mucous
inundation  may  not depend  upon any fault in the
exhalents, but upon a torpid state of the pulmo-
nary absorbents."  These are digitalis and  to-
bacco? two  narcotics of  somewhat  diverse power
of acting on  the system.    Here I am   happy to
agree with Dr. Paris as to the cause of  the evil:
but with what propriety can the remedies  he desig-
nates for it,  be denominated expectorants?
  Section c of the same class comprises medicines
which determine to the skin  by gentle diaphoresis;
and their action in relieving the  lungs by restor-
ing that checked cutaneous discharge, on the pau-
city of total suppression  of  which,  the  lungs  are
engorged by performing, in  common with the kid-
nies, the serous  exhalations which  should have 
                       153                 [ex$.

  been conveyed out  of the body by the torpid or
  inactive emunctories of the surface.  The whole
  of Dr. Paris*  reasoning on this  point,  is  unan-
  swerably true, and  the  " well regulated  doses of
  the  compound  powder  of ipecacuan," which  he
  says, "frequently  furnish  the  oppressed  asth-
  matic with a valuable resource," I know from ex-
  perience do  have that remediate  effect.   But for
  this reason is this compound medicine, or are the
  ingredients of which it is composed, to be called
  expectorants?  Is not  this action, manifestly, by
  restoring the  sympathetic  concert of function,
  now dissociated, between  the skin, the lungs and
 the kidnies,  to  their healthy routine of action?
 Do they not do  this,  palpably, by opening the arid
 skin? And what are medicines which do  this but
 diaphoretics.    Diaphoresis  is the  primary and
 evident effect of the medicine specified and  its like:
 liberation of congestive serous or mucous engorge-
 ment of the lungs and its  appendages, the ulterior
 consecutive effect.
   Section d of the same class is predicated on the
 same principle as the preceding section, embracing
 such medicines as excite  serous discharges  from
 the bowels,  as saline  cathartics.  They  relieve
 the lungs on  the  same principle,  and avowedly,
 are not expectorants  by any  other  effect than one
 involved  in the general return they produce,  of
 regular, healthy and equalized action in the gen-
 eral system.   Why then call them so?
  We are thus led to class third comprising me-
 dicines which  operate mechanically, and the first
 section a, points to those which impart vigour to
 the respiratory muscles  engaged in the act of ex-
pectoration.   It is grounded on a fact universally
admitted, that the act of expectoration is  chiefly
voluntary.  We all know this, and an effort to 
EXP. J                 i54

::ough or screatus, when excited by the  stimulus
of mucus so to do: or an  effort to restrain either
action under pressure of the same stimulus,  will
prove it instantly.  It is supposed that when the
voluntary effort is made and is found impractica-
ble to any efficient extent, the difficulty  is tiwing
to a state of extreme debility of the muscles neces-
sary to the act—and to patients exhausted by tuber-
culous cough or ulcerated vomicas, which tire by
perpetual efforts to expectorate,  great distress is
often produced by this inability to rid the lungs of
the still oppressive load.  It is in such cases a sti-
mulant like ammonia is supposed by Dr. Paris,
to act mechanically, in promoting a rejection of the
accumulated mucus.   1 refer the effect here  to* an
evanescent tone communicated to the general sys-
tem by  the diffusible stimulant,  and not to any
mechanical action on the respiratory muscles.  The
latter mode of accounting for an evident fact, is, I
think, quite unphilosophical.   The word mechani-
cal, if in any other  than a figurative way  used,
is inappropriate and calculated to mislead.   Shall
ihe powerful, diffusible, volatile stimulant, marked
by the intensity of its action, and its known power
to pervade in a few moments the whole system—be
called an expectorant,  simply because increased,
though transitory tone, is communicated to the mus-
cles concerned in expectoration, (now worn down
with effort and fatigue,) in the sweep of its general
stimulating sway?  Here then, is no expectorant,
but by  an impulse common  to the parts of the
whole, by which excitability is renewed.
  Section & of this class  leads us to the starting
point of this canvass of Dr. Paris' classification—
emetics. They are, truly, expectorants ; they cause
coughing and screatus, by  which the present con-
tained fluids of the lungs  and trachea  are vio-
lently ejected or expectorated.   The concussion of 
                        155                 [ExP.

 the thoracic viscera during their operation, causes
 an increased excitement of all the processes of secre-
 tion and excretion, pertaining to them, which does
 not cease with the cessation of their operation.   A
 healthy equipoise of action is  kept up for  days,
 weeks,  nay often months ;  and  in their effects may
 be recognised a union of mechanical,  with physio-
 logical action.
    As a corollary to the preceding observations, I
 state, that with the exception of the class of emetics,
 and some inhalations I know of no such remedies as
 expectorants.  Neither can I conceive of any pro-
 pr iety in retaining  such a class, when it has been
 shewn how little legitimate claim it  possesses to
 the tenure it has heretofore held in all treatises on
 materia medica.   While this opinion  is ventured,
 however, it is proper that it should be stated, that
 it is on the ground not only of  the absolute  vari-
 ance between the mode of  action of the medicines
 arrayed in the class, and the course  they  should
 take  in producing their effects, were they in any es-
 pecial manner directed to the lungs so as to perform
 what their name  requires they should do ;  but also,
 because  the designating these remedies by a name
 which characterizes only  one  of their  several
 effects on the system, is calculated to mislead the
 student and young practitioner.   There is  no dif-
 ficulty in disposing of the remedies in question, if
 classification  must  be had, in places more fit for
 their reception, according to their primary action;
 while their secondary influence  on the lungs need
 not be lost sight  of  on this  account,   Opposed as
 I am  to treat of the materia medica by any of the
 common   schemes of classification,  these  latter
 remarks  are intended  to meet the objections of
 those, in reference to the individual class  under
notice, who persist in the propriety and usefulness'
      N  2 
EXP.]
156
of these systematic arrangements.   To  conclude,
the whole view of the subject, in the  light here
presented, is calculated,  I should think,  to afford
another additional, and by no means inconsequent
argument, in favour of alphabetical disposition of
medical  agents, by  which every  article may be
noticed for all its effects,  at one discussion  of its
merits, under its appropriate letter.
  The medical use of expectorants  is chiefly re-
stricted to catarrh, pneumonic disease and asthma ;
whatever other use they may  be supposed capable
of serving, must have appeared fully developed in
the course of  the preceding canvass of the  theo-
retical views  of authors on  the  subject  of their
mode of operating on the lungs.   In the exhibition
of these, for any of the diseases to which they are
supposed remediate,  an observance of such direc-
tions to the patient or his  attendants is to  be in-
forced, as may promote the diaphoresis,  the reduc-
tion of spasm,  the narcotic influence on the  ner-
vous, or the stimulant excitement of the lymphatic
systems, or whatever other primary effect, by the
consecutive operation of  which, the  lungs   are
reached.  Every proceeding  which may retard or
interfere in any manner  with these,  will be found,
if not positively prejudicial, at least calculated to
render the medicines ineffectual of the  indication,
or productive of a loss  of time and unnecessary
subjection of  the patient to useless medicines.
                  ENEMATA.

  These are watery  fluids, oily,  or mucilaginous
substances, thrown by mechanical force  into the
bowels, through the anus.  Their chief operation 
157
[exp.
is on the rectum, and they rarely can be made to
pass the sigmoid flexure of the colon.  They may
be divided into

Class 1. Aqueous clysters.
       2. Oily clysters.
       3. Mucilaginous clysters.
       4. Mixed clysters.
       5. Medicated clysters.
       6. Aeriform clysters.
The first may be either tepid, cold, or iced water ;
   operating chiefly by the stimulus of mechanical
   distension and temperature.
The second may be melted butter, washed lard, or
   goose-grease—alone or commingled with tepid
   water.
The  third may be flax-seed tea,  starch, arrow-
   root, barley-water,  decoction of mallows, slip-
   pery elm-bark,  okra,  and similar lubricating
   mucilages.
The fourth may be molasses  and water, with olive
   oil or grease—weak mutton broth, soap-suds, or
   a mixture  of any  of class third with class se-
   cond.
The fifth are class 3d, with the mucilages dense, or
   diluted, with the addition of laudanum, aloes,
   assafoetida, infusion of colocynth, castor oil; or
   6ennatea, oil of turpentine suspended in yolk of
   egg and mucilage of gum-arabic, infusion of to-
   bacco, solutions of saline cathartics, rhubarb tea,
   and indeed any  other liquid preparation of a ca-
   thartic, lime-water, &c. &c.
 Sixth, fumes of tobacco,  and other narcotic herbs.
   For administering the first five classes, common
 clyster or  injecting pipes,  of different sizes ac-
 cording to the  age of the patient, or bladders with
 an injecting pipe tied to the mouth, or caoutchouc 
EXP.]
158
bottles, are used according to convenience.  For
the last class a particular apparatus  has been de-
vised.   The distress, prostration and near danger
and  death which have resulted from the clyster
of tobacco in  the form of class 5th or 6th,  have
caused Mr.  Earle to propose  as a substitute for
either, when the peculiar effect of tobacco is want-
ed, suppositories of that  plant which can  be re-
moved on  accession of any undesired effect.
  Enemata act by distension,  by the physical ef-
fect of their temperature, or  specific stimulus of
their medicating ingredient on the bowels ; or by
all  combined, together with  an impulsive stroke
on the  chain of sympathies involved in alvine se-
cretions and dejections.   When highly medicated
with medicinal irritants,  they have been accused
of inducing  spasmodic  constriction, instead  of
evacuant  action,  thus bolting the door already
shut.   I  have known them to do this  under my
own eye.   In such cases I  have attributed the
mischief to  undue proportion of  the  prescribed
drug, by carelessness, inattention to the directions
of the  physician,  or ignorance of the  nurse  or
friends.  This induces me to observe, that a  pre-
scription should always be written for a medicated
clyster, unless in  the simple one of laudanum,  pre-
scribed among intelligent and cautious people. Or,
the medical attendant should  mix  it himself and
direct  its  exhibition.   Simple aqueous clysters
have been  efficacious in removing a spasmodic  state
of the bowels, so as to overcome ileus. The mixed
clysters are those most used in  medical and domes-
tic practice.  In the former they are used to hasten
the slow operation  of cathartics,  or  to evacuate
the bowels when the irritable state of the stomach
causes it to reject medicines.   In the later  they
are chiefly used as substitutes for cathartics.   The 
159
[EXP.
anodyne clysters are much used by physicians, but
the truly medicated injections are not as often em-
ployed in this  as  in other countries,  particularly
France.   The free operation of a clyster is attend-
ed with most of the general effects following lax-
ative medicines.   The impulsive energy given by
purgatives  to  the whole  system however, can
never be. obtained  by even active medicated  clys-
ters, as of aloes,  castor oil, colocynth.   But for
this very reason they do not produce the immediate
prostration often induced by purgatives, and hence
they may be frequently repeated within a few hours
or  during a day.  Every practitioner will ac-
knowledge the importance of these remedies, either
as absolute  or  adventitious curative agents—and
every practitioner  will also confess,  that it is much
easier to know  the precise condition of a particu-
lar patient's system and disease which may render
them appropriate  with either view, than to point
out any general rules in the  abstract, which may
suggest their propriety and efficacy in  the  treat-
ment of diseases.    For this reason I shall not
here enter into a discussion of  this point, but, in
the lectures shall endeavour by familiar illustra-
tion and remarks  to say as much as I am able, to
lead you to devote  as much attention to this class
of remedies, as its, importance demands.  With
these remarks  I dismiss the subject, refering  you
for the formulae of proportions  and measurement
graduated  to ages, to the lectures. 
INH.]
160
INHALATIONS.
  These  are the vapours  of  heated, simple, or
medicated fluids—of certain aetherial medicines—
of fragrant and  stimulating balsams, gums  and
resins—the vapour of  fused nitre—and the  fumes
of narcotic drugs.   The emollient and medicinal
principles of some of these, and the volatile stimu-
lus  of others,  are conveyed   to  an immediate
contact with the bronchia and  cells of the lungs,
by the voluntary augmentation  of the force of the
respiratory efforts, through the deep inspirations of
which the  subtle vapourable principle is drawn
into every part  of the  cellular  structure of the
lungs; or, admitted less freely, by directing the
vapour towards the  mouth  and nose, during
ordinary breathing.  When diaphoresis is desired
as an effect of these inhalations, the ordinary or
forced respiration is performed under a cover which
envelops the head and the vapourable remedy.  A
common  tea or coffee pot,  containing the heated
fluid, is  often used—the patient inhaling the va-
pour by  the  spout.   Several  kinds of apparatus
have been  devised expressly to administer these
aeriform remedies, among which, the best is that
contrived by  Dr. Mudge, who wrote on catarrh,
which he proposed to cure by these remedies.  It
is called  " Mudge's Inhaler."
  Heated bricks are also used to vaporize watery
fluids.   When  resins,  balsams, or  odoriferous
gums and substances of a similar nature are used, 
161                 [INH.
they are placed in a heated iron vessel, on  a com-
mon fire shovel heated,  and the vapour arising du-
ring liquefaction is taken in by  holding the head
over the vessel or utensil employed.
  The simple inhalations are, aqueous vapour, that
arising from vinegar, or vinegar and water.
  The medicated aqueous inhalations,  are decoc-
tions of medicinal herbs, chiefly of the verticillatse
and corymbiferse, of chammomile  flowers  with a
little ether added, and of some bitter,  astringent
plants.   The  vapour of hot  decoctions of some
roots is also used ; I have administered senega in
this way, with advantage.
  The aetherial inhalations are,  the spontaneous
volatilization  of sulphuric and  nitrous ether and
oil  of wine, weak dilutions  of aqua  ammonia,
common spirit of hartshorne, the volatile refined
vinegars of the shops, and similar volatile medi-
cines.
  The vapour of fragrant and stimulating balsams,
are, the fumes obtained from gum elemi, camphor,
benzoin,  s to rax,  olibanum,  labdanum,  common
white  rosin, burgundy  pitch,  hemlock gum, and
the terebinthinate exudations  or concretes of the
coniferse,  as tar.
  The vapour of nitre, sulphur, and quicksilver, are
obtained by heating to the point of volatilization.
The fumes  of tobacco by the pipe, or burning the
dried leaves or  segars in a close room,  by per-
sons not addicted to the habitual  stimulus of the
plant as  a  luxury.   The fumes  of stramonium
root, of the flowers  gnaphajium margaritaceum,
or common  life everlasting, and  various other ve-
getable products,  have also been medically used. 
IN H.J
162
        MEDICAL  USE OF INHALATIONS.

  These remedies  are in many instances true ex-
pectorants,  acting as mechanical irritants,  by
immediate  contact with the lining tissue of the
lungs  and  passages  unaccustomed  to  their pe-
culiar action.  Hence coughing, which is essential
to expectoration, is excited,  and brings up the in-
creased secretion which follows the application of
a local  stimulant  to the tissue  it pertains to—
and by  this increased local excitement, a  more
vigorous effort is induced in the  parts  naturally
concerned in  the act  of expectoration, by  which
the tenacious mucus already secreted and engorg-
ing the  lungs, is thrown off.
  The steam  of hot water is efficacious in reliev-
ing the  distress of  paroxysms of  asthma,  and in
inflamed tonsils and trachea ; several other inhala-
tion of class 1st. are also serviceable in the same
affections.  Tar vapours are useful in catarrh and
phthisis, and more especially in chronic bronchitis.
They cannot be employed however in acute inflam-
matory  affections  of  the lungs,  without  injury.
The inhalation of tar fumes has also been benefi-
cial in hooping cough, according to the experience
of Mr Wansbrough, of Fulham in  England, and
also  in  his hands,  other affections attended with
difficult respiration.   Vomiting as well as cough-
ing was induced in some children by them.   Dr.
Crichton, of Russia, published in 1813 an account
of some experiments made with the  vapour of
boiling tar in the cure of pulmonary consumption.
Several patients were cured  by those inhalations.
He restricts their use to that stage in which  cough
and hectic  are most exasperated, observing that
if they are  persisted in after  these are subdued,
that  practice would produce a  teasing dry cough 
103
[iNH.
and reuder the common air distressing to the pa-
tient.  Dr.  Rush  attached much  importance  to
these inhalations  in consumption.   I however am
disposed to view them, from  my own experience
of their effects under the direction of Dr. Rush, on
patients in my care in  the Pennsylvania  Hospital
in 1809, and from my  own repeated trials of them
since in public and private practice, rather as pal-
liative than curative agents in  this disease.  In the
former light I deem them important and beneficial.
Dr. Mudge has spoken of some cures of consump-
tion,  by the fumes of common resin.   The  cases
are insulated.  Nitrous  vapours have been reported
to be efficacious in  hooping cough.  Mr. Patter-
son attests their  efticacy.   Stramonium  roots cut
up and smoked in a pipe, were about 12 or 15 years
since very much used,  in asthma.   The  accounts
of the efticacy of this  kind of inhalation,  are va-
rious and contradictory.   I have extensively pre-
scribed them in the alms house of this city, in such
cases ; and in  some  instances with great benefit, in
some with less, in some without any positive ef-
fect, and in more with inconvenience to the patient.
Dr.  Eberle mentions that he has never prescribed
them with the slightest benefit.  I cannot help at-
tributing  this  to the mode of administration ; and
I shall  therefore point out, in detail, in  the lec-
tures, the proper plan.
   Tlie  respiration  of oxygen, hydrogen  and ni-
trogen  gasses,  during  the  rage  of  pneumatic
medicine, were all  reputed curative and palliative.
Some well attested cases of both  effects are to  be
found in Beddoes' work on this subject, but the dif-
ficulty  of employing  them in ordinary practice
will  ever prevent their use.
   As prophylactics, different fumigations and in-
halatious have been used.  These will  be detailed
in the  lectures.
      O 
ISS.]                  164
ISSUES.
  These  are  peas, waxed-sponge, or wax-taper,
introduced into an incision made into the teguments
in the neck, spine, arms, legs, thighs, side and other
parts of the body, by the irritation of which suppu-
ration is produced and continued as long as the ex-
traneous substance used, is kept there ; or they  may
be made by applying a small round blister the  size
of atwenty-five cent piece, or a dollar, and when the
cuticle is removed, applying lunar or what  is  bet-
ter common caustic, until a slough is produced, and
the  denuded  surface kept  running by an  irri-
tating ointment.   The  first are  common, the  lat-
ter  caustic issues.   Thus established  the  sup-
puration becomes a drain which  may be continued
for  any  length  of time, by  daily  removing, in
the  common   issue the inserted  irritant,  wash-
ing  the  wound  with  soap and water and rein-
serting the pea, &c.;  and, in  the caustic  issue,
by similar ablution and varying the nature of the
irritating dressing.  These remedies are of ancient
date.   The caustic issues were much  used  by the
Greek and  Roman practitioners, and their writers
have commended them in gout, sciatica, chronic
diseases of the pulmonary organs, the liver, spleen,
epilepsy.   They have, at this day,  lost none of
their ancient repute, but stand prominently, among
the  useful  remedies and palliatives, of the same
affections for which they were esteemed of old, and 
                       165                 [189.

 for many others,  in  which the experience of mod-
 ern practitioners has found them serviceable. They
 are surgical as well  as medical remedies.   Hence
 we find them used with efficacy in scrophulous af-
 fections of the joints, particularly those of the hips:
 by some along the spine in  some place contigu-
 ous to diseased verterbrse.  They are also used for
 gutta serena ; incipient cataract.  Their  medical
 application is for various opthalmic affections, deaf-
 ness, chronic rheumatism ; rigidity and obstinate
 inflammation of  the joints  from this cause ;  to
 the back near the sacrum, for what  is called sci-
 atica;  to the same place,  for nymphomania;  to
 the spine for epilepsy and  palsy ; to the back  of
 the neck for tetanus, in which Dr. Hartshorne  of
 this city has been successful in several cases by these
 means ; to the same  site  for  chorea,  in  which I
 can,  from experience, attest their efficacy ; to the
 side for chronic enlargements of the liver and in
 protracted pneumonic disease threatening phthisis;
 to the neck for vertigo, bemicrania, hebetude and
 habitual somnolency  in phlegmatic constitutions ;
 as  succedanei for  long continued  eruptions sud-
 denly suppressed, by  reason of which the general
 health  has become  impaired—and for habitual
 hemorrhoidal flux, the spontaneous  cessation of
 which has been followed by a similar state of gen-
 eral indisposition  or  disorder.   Dr. Rogers has
 employed them  with  success to prevent habitual
 abortion  and in  leucorrhoea  and menorrhagia.
 Numerous other affections of an anomalous charac-
 ter accompanied with deep seated pain, from occult
 causes, are relieved by the salutary agency of these
 drains.  The caustic issue is, in general, prefered
to the pea-issue, in fleshy parts;  the latter  being
mostly used near  the part  affected,  in articular
derangement or disease*  I have had a great deal 
lss.J                 166
of experience with the former,  which I much pre-
fer, on many accounts, to the common issue.  On
the whole I  recommend them  to your notice,  as
valuable, and, rather too much neglected, curative
agents in  general practice.   Like the miscellane-
ous employment of epispastics, the varied affections
which  indicate their  propriety to the reflecting
physician, must be the result  of  experience and
thought in the  course of his practice,  rather than
the result of any definite rules  for their establish-
ment, suggested from the lecturer's desk. 
167
[lit.
LITHONTRIPTICS.
   Medicines supposed to be endued with the power
 of dissolving urinary calculi.  This is the prince
 of bad classes.  It is an absurd and misleading ag-
 gregation of medicines according to a  virtue they
 have not in a sin3le well  attested instance,  been
 proved to possess, when taken into the mouth or
 injected  into  the bladder by the urethra.   On the
 other hand, numerous instances are on record of
 cases of stone treated by  them,  and followed by
 a  cessation of some  portion  or the whole  of the
 irritating symptoms of its presence—which caused
 them to be pronounced solvents, since the calculus
 could not he felt by  the sound ; and yet death and
 dissection  have brought to light  the existence of
 these bodies, encysted   In the cases  relieved by
 Mrs. Stephens,  who received  a parlimentary re-
 compense  for her asserted cure  of the stone,  a
 similar envelopment  of the  calculi were found,
 plainly proving that her vaunted  remedy was in-
 capable of dissolving them.  As  it  has been  dis-
 covered by  chemists that certain  substances  in a
 state of such weak solution as  to be taken into the
 mouth and  held there, without any ill consequence,
 and even swallowed  with impunity,  are yet capa-
 ble of dissolving  different urinary  calculi  out of
 the bladder—it  has even of late years  been Con-
tended that these substances,  or if  not these, that
 some substances might  be found,  which  could,
taken by the mouth  or injected directly into the
      O  2 
LlT.j
168
bladder,  produce a similar chemical solution.  No
fact however,  has come  to  light,  which in  any
degree favours the  possibility of such destruction
by such means.  The utmost that can. even judg-
ing  from  the reports of those who lean  to the ad-
mission of such virtues  in  medicines, be  with
truth or reason admitted, is, that, what are called
lithontriptics,   may  wear  away  the   projecting
asperities of some species of calculi,  and by  ren-
dering them more smooth,  may by this effect, ren-
der them  less tormenting.   Messrs. Prevost  and
Dumas* have attempted to  solve the  stone,  while

   * "A fusible human calculus was submitted to the action of a
galvanic pile, of 120 plates, for the  space of twelve hours.
The calculus was placed in a vessel of pure water. 'I he platin-
um wires which served for poles, touched the  opposite sides of
the calculus.  During the action  of the battery the bases and
phosphoric  acid came  to their respective  poles recnmbined,
and the salt thus formed, precipitated to the bottom of the ves-
sel in the from of a fine powder.  Before the  experiment, the
calculus weighed 92 grains—after it 80 grains.  The galvan-
ism was continued till the end of sixteen hours., when the cal-
culus presented only a friable mass, which was easily  reduced
into small crystalline bodies by the slightest pressure.
   «' The result of this  experiment naturally  led to another,
 still more curious.  A calculus was fixed on a sound, between
 two platinum conductors, and the apparatus introduced into the
 bladder of a dog, by means of an incision in the urethra under
 the pubic arch.   The bladder was injected with warm water,
 which was prevented from returning.  A battery of 135 plates
 wis then brought to act on the wires.   The animal was, at
 tirst restless, but soon became quiet, and supported the action
 of the pile  during an hour.  The apparatus was cautiously
 withdrawn, and the calculus showed evident marks of  decom-
 position.  The experiment  was then renewed and continued
 six days, one hour in the morning and one in the  evening. By
 this time the calculus had become so friable that the experi-
 ment was obliged to be discontinued.   It had lost in weight
 proportionately to the other calculus.   The  animal  was now
 killed in order to examine the state of  the bladder.  Nothing
 remarkable could be discovered in this organ.
   "Our authors hope that means will be found out to apply the
 galvanic action to those calculi in the human bladder which are 
169                 [lit.
in the bladder of the living body, by the action of
the galvanic fluid, with  results  no  more encour-
aging than those which have followed the internal
exhibition  of medicinal  agents  with this view.
Those who favor the idea of lithic solvents argue,
that they are feasible remedies,  because  chemistry
has possessed us  of a solvent  for nearly every
species of  calculus out of the body—that some of
these solvents are found in the  bladder  in  a state
little if at all chemically or materially changed
from the state in which  they were  taken into the
stomach.   Now of what  avail are these facts,
against the omnipotent one that the supposed sol-
vents, under  all these advantageous chemical and
physiological circumstances, have never yet dis-
solved a  single stone in the bladder of the living
body?  As to the 'direct communication* between
the stomach and the bladder, by some  rout inde-
pendant of the circulation—notwithstanding  Sir
Everard Home's ingenious experiments on the dog,
its existence  is purely gratuitous.   He closed the
pyloric extremity of "the previously evacuated sto-
 mach of this animal  by  ligature, and  afterwards
 introduced fluids into  it tinctured by rhubarb.   He
 detected  the  colouring matter  of this  drug in  the
 urine in   thirty  minutes  after.   What does  this
 prove?   That the colouring  matter  of rhubarb
 gets into  the urine of a dog by some other chan-
 nel than through the pylorus—no more.   It might
 as well be said, that  because garlic applied to the
 soles  of the feet, discovers its odour in the breath,
 that there was a  * direct  communication" between
 the skin of the feet and the lungs.   Many are the

 composed of saline principles-but they are  aware that it
 would be quite  useless to hope for any beneficial result in ca-
 ses where the calculus consists wholly  or principally of uric
 acid "
           Med. and Chir. Rev. New Series.—Vol. I.p. 223. 
LIT.]
170
 inscrutable processes of the living animal system,
 imaginable or inconceivable, by which this,  to us
 occult  process,  might be accomplished, without
 the aid of any direct short  cut from the stomach
 to the  bladder.    Whatever communication may
 be  there,  other  than  what the eager and gifted
 eye and adroit knife Of the anatomist have brought
 to  light---must  he minute indeed.   But  if it
 were possible to be. and  were as  large as the
 Thames  tunnel,  what  would  that  avail?    Is
 it that it shall permit a passage,  scot-free of toll
 or mulct or diminution, of stone-sol vents on their
 way to the bladder to break  up  and  root  out the
 lithic pest?  Does Dr. Chapman,  who enlists this
 argument  to sustain  his position that "enough is
 ascertained,  in relation to lithontriptics,  to  war-
 rant us to  persevere  in our trials,  as well with
 those which we already have,  as with new  sub-
 stances,"* forget  what he  has himself  noticed,
 two pages preceding,  "that these solvents have
 been injected directly into the bladder through  the
 urethra,"* where «♦ it is contended thev ought to act
 on the stone and  gradually dissolve ft;"  and  that
 '« he does  not perceive why they should not. though
 the few  attempts  which have been made, afford us
 little encouragement ?"
   As to his insinuation, that the want of success
 in these experimcnts'might "be owing to their not
 having been conducted with all the care which the
 case requires,'* and his assertion that " to succeed
 in such experiments, much skill and perseverance
 is demanded.'*  I think it may verv fairly be said,
 that neither  is justified by' fact nor probability.
 I here is  no difficulty in throwing by  forcible in-
jection,  these solutions  of lithic solvents  into the
 bladder—but  allowing  that there  was,   surely

  * Therapeutics—Lithonthriptics—or Antilithies. 
171                [lit.
 when they once got there, no matter in how bung-
 ling a manner the operation may  have been per-
 formed,  that bungling would  not  deteriorate the
 chemical properties of the  injected fluid.   When
 there, it ought to act on the stone, if it were en-
 dued with a  power on it in the  living bladder,
 similar to that it has been proved to possess out of
 it.   As to any want of perseverence in these trials,
 neither the character nor zeal of the experimenters
 renders them liable to such  an imputation.  They
 were disheartened  because  of their  failure, and
 their zeal was extinguished because sufficient trials
 rendered  it  nugatory.  But this  incapacity for
 accomplishing what they  are prescribed to effect,
 of the supposed lithontriptics,  is not the only diffi-
 culty presented to the admission of such a class of
 remedies.  Not only  are  innumerable instances
 authentically related of their total inefficiency, but
 well  attested facts are not wanting of the rapid
 accresion to the calculus,  during the use of lithon-
 triptics.   Sir Everard Home  mentions the  most
 striking  examples of the latter  fact.   One  patient
 took alkaline medicine as  a  solvent for four or five
 years, and at his death three  hundred and fifty
 light spongy calculi of different sizes, nearly filled
 the bladder; another had  an increase of the symp-
 toms after taking mild and  caustic soda for some
 months,  and  was obliged to submit  to an opera-
 tion,  which brought forth a calculus  " which was
 surrounded  with a  coat  of triple phosphate one
 tenth of an inch thick,  the rest  being  a mixture of
 uric acid and phosphate."   De Haen's  case  of
palliation and final obliteration of all the symptoms
of stone,  after taking near 3 fourths of a ton of lime-
 water, near 3 fourths of a ton  fmilk, and 17 lbs. Ve-
netian soap,  in the short space  of seven months!!!
—while the calculus still  answered to the sound, 
LIT.j
172
 •ught to give lithontriptics their quietus.' No one,
 however captious,  or vituperative, would  surely
 accuse the practitioner or the patient in this in-
 stance, with a  want of perseverence J   One can-
 not but hesitate to whom to award the greatest
 praise—the Doctor for his faith and pertinarious-
 ness in opinion, or the patient for  his submission
 and fortitude.  To conclude this subject, on which
 I have already spent more words than it  is worth ;
 Cullen did not believe in these remedies, and pro-
 vided no class for their reception.   His comment-
 ator, the late Dr. Barton, added the class Antili*
 thica, but discarded from his lectures the idea of a
 veritable lithontriptic—he taught no such doctrine
 as the possibility of retaining.such an absurd class.
 Dr. Paris says "after all, however, the solvent pow-
 er of lithontriptic remedies must be very limited,
 and in advanced cases we can never expect to pro-
 cure more than palliation." Dr. Eberle observes in
 his work  on medicines *' it  is  very questionable
 whether we possess any remedies capable of dis-
 solving calculi  existing  in  the urinary organs.
 The  attempt at removing calculous  concretions by
 remedies of this kind having hitherto, proved abor-
 tive, is a fact which sufficiently warrants the scep-
 ticism  which prevails  on this subject."   Even Dr.
 Chapman who upholds these  remedies by various
 remarks to that effect  in his discourse on the class,
 in finishing the subject observes " notwithstanding
 all I have  said,  I  shall  not  absolutely  insist  on
the solvent powers of any substance,  with which
we are at present  acquainted."  I have already
fully set forth my own opinion on  the suject, and
thinking it high  time to cease the perpetuation of
a useless and misleading class, instruct you, as
far as my influence may be thought worthy to ex-
tend, that you throw the class with reference to the 
178                [lit.
reputed effects of the medicines it embraces, entire-
ly out of your studies.   I now proceed to a consid-
eration of antilithics, which in their prophylactic
effects are an useful set of remedies—first  remark-
ing that the class of lithontriptics has been no-
ticed at all, purely that I  might endeavour to re-
move erroneous  impressions you  might imbibe
concerning it. from the works of Materia Medica
which may fall in your hands.
                 antilithics.

  These are prophylactics.   They are  such med-
icinal and dietetic agents, as tend to correct a pre-
disposition to form calculus,  thus preventing lithic
conrretions.   It is supposed  they exert a still
more extended  effect, in  arresting further accre-
sion to calculus  already  formed  by subduing the
diatheses which  begun and  increased  it.  It is
possible, that these medicines and regimen,  may
avert the deposition of calculous materials suspend-
ed in the urine,  where a nucleus has not been al-
ready formed :  but the facile increase of calculus,
when that nucleus unfortunately has been estab-
lished, seems to render it very questionable wheth-
er the calculous taint in the  digestive system  can
be so entirely obliterated, as to cause the urine to
pass over and remain for some time in contact with
the surface of the existing concretion, as to leave
it without  obeying its strong affinities for its ho-
mogenous materials, by depositing some augment-
ing particles.   There  appears  to me a wide  dif-
ference between allowing antilithic  remedies  and
diet a prophylactic power, when calculus shall not
have commenced by even a minute nucleus,  and 
lit.]                 174

conceding the same preventive virtue in similar
medicines and regimen, when the  inviting cause
of deposition has actually taken its unwelcome po-
sition in  the bladder.  In the former case a single
difficulty is to be met, the latter two are opposed.
Antilithics may be equal to overcome the first, and
be justly esteemed important remedies, though they
are ineffectually applied to,  in  order  to combat
the second.   For these  reasons, and because it
seems to me that an unfounded depreciation of val-
uable remedies  and  agents, is the  natural conse-
quence in the opinion of a majority of practitioners
of an exaggerated  attribution  of powers, beyond
what they"really possess—I would restrict the defi-
nition of antilithics, to the terms of the first two
sentences of this chapter.  Before entering further
into the discussion of this subject,  it may be. pro-
per  to observe, that,  without a cotemporaneous
and  conjunctive observance of what  I  would call
antilithic regimen, mere medicamental antilithics
cannot avail much.  This remark will be found of
staunch value,  when we review the whole field of
moral, physical and dietetic causes, which conspire
to generate and perpetuate lithic predisposition.
These will be noticed in the course of the following
outlines  of a very difficult and I think in the pre-
vailing  chemico-medical aspect  of it, a very ab-
struse subject.   The important  and  instructive
bearing of chemical researches and results, on the
pathology  and  therapeutics  of diseases, is in no
instance so  conspicuously  shewn,  as  in  refer-
ence to  calculous taint, but I much fear, like all
novel and  high-wrought  theories,  the  chemico-
medical  treatment of this taint,  is pushed  some-
what beyond the line  which  separates  reason
from misguided zeal, if not infatuation.   The in-
evitable  consequence of transcending this limit to
rational  inference  and -treatment predicted on the 
                        175                 [lit.

  I'hr,ltf°.fdAe,nist,T'7in be' a total rep^iation of
  the who e theory and practice,carrying with it, in
  one condemning sweep, the judicious and the over-
  strained practice involved in the present theory of
  lithic disorders.  In medicine, as in prize-fighting,
  we should courageously and fairly, come up to the
  chalk:  a step beyond, or even half ovefit. is,  in
  both instances,  unfair  and a  fault,  casting suspi-
  cion and distrust upon  all subsequent movements.
  I cannot but think the chalk has been overstened
  by  some  writers, and gifted writers  too, on  this
  interesting subject.   That you may not, by imbi<
  bing these tenets, to their full and prejudicial ex-
 tent, compromit your future talents, industry and
 usefulness in the same involution of  over-heated
 zeal, which threatens to raze the existing chemico-
 medical  doctrine of calculus and its  generative
 taint—I shall proceed to an exposition of the princi-
 ples on  which  it is grounded and the pathology
 and practice to which it points ; and then endeav-
 our to shew my sense  of that  part of it which is
 true and feasible, and that which  appears gratui-
 tous and impracticable.   The whole, doctrine and
 its consecutive practice, is appreciable by ordinary
 intelligence ; and nothing more than sceptical at-
 tention  is required  to  understand its  merits and
 defects—its good and its evil tendency.
   A  know ledge of the constituent principles of the
 urine, is the foundation of rational antilithic prac-
 tice.   Without  understanding these  principles,
 which chemistry lias brought  to  light, the prac-
 titioner would treat  the  lithic  taint)  empirically.
 I proceed  therefore,  to call your attention to this
subject, as one greatly enlightened by the industry
and acumen of those medical chemists,  who  have
devoted  so much time with so much success, to
this difficult subject.  I need scarcely observe, that 
LIT.]                  176

the urine is not  a simple  fluid,  but  the most
heterogeneous  of all  the  animal  fluid  products.
It possesses certain  characteristics in its healthy
state; and very quick  and  manifest alterations are
made in these,  by those morbid states of the sys-
tem which affect the whole digestive process.  Yet
this visible change is not always produced by such
a state of the system  as gives us notice of  its ex-
isting disorder.  Not  unfrequently  we  have no
notice, from  our feelings,  of  the existence of any
morbid action,  although it may have been sufficient
to modify the relative proportions of the constitu-
ent principles  of the  urine.  Berzelius  analysed
the urine, and  the following are his results:

               ANIMAL PRINCIPLES.
Water.........933-00
Urea.........30-10
Lithic Acid.......•    1-0
Pure Lactic Acid, Lactate of Ammonia, and Animal
    Matters not separable from these     .   .   .   17-14
Mucus of the Bladder......      -3~2
          ALKALINE AND EARTHY  SALTS.
Sulphate of Potass.......3-71
-------of Soda       ......      316
Phosphate of Soda  .    .    .   . '   .   .    .    2-94
--------of Ammonia      .    .    .    •    •     1-65
Muriate of  Soda.......4-45
■  ■    of A"mmonia    ......     1-50
Earthy Phosphates with a trace of Fluate of Lime  .    1-0
Silex.........      -03

                                           1U00.00

   Besides these principles of healthy  urine,  Dr.
Prout observes that  in different  diseases it may
contain Albumen, Fibrin,  and the red particles  of
the blood ;  Nitric acid ; various acids,  which are
found to be modifii ations of the Lithic: Oxalic
acid ;  Benzoic acid :  Carbonic acid ; Xanthic ox-
ide*  Cystic oxide; Sugar*  Bile; and  Pus. 
177                  [liu.
Urea is peculiar to the urine: is produced by the
  action of the kidnies on the blood.   Dr.  Prout
  suggests that they get it from the  albuminous
  matter.
Lithic  or uric acid, is not found in the blood, but
  is always present in healthy  urine.  Majendie
  thinks it is obtained from the  azote of  ali-
  mentary  substances.  Dr. Prout thinks  it  is
  always in combination with  ammonia, (lithate
  of ammonia) from which  acids, even carbonic,
  separate it in the form of a red powder.
Erythic acid is  a peculiar acid so  named by M.
  Brugnatelli, obtained by  treating  pure  lithic
  acid with diluted nitric acid, applying a moder-
  ate heat.   It is in transparent colourless crys-
  tals.
Purpuric acid ; this is obtained from the the Ery-
  thic  acid crystals, treated by  Prout, while in a
  state of boiling hot  solution, with pure ammo-
  nia,  which  produces crystals  of purpurate of
  ammonia.  These heated by potass and sulphu-
  ric acid,  yield pure  purpuric acid in a yellowish
  powder.
The phosphoric acid and its compounds are  active
  agents in the production of calculi.   This acid
  often  exists in a free state in  the  urine.   In
  healthy urine it is in union with soda and ammo-
  monia, and  partly  with  lime and  magnesia;
  these last being retained in solution by excess of
  acid.

  Dr.  Prout, divides the mechanical deposites from
the urine, in three classes:
  1. Pulverulent, or Amorphous sediments.
  2. Chrystalline sediments (called gravel.)
  3. Solid concretions, (or calculi formed by con-
       cretion of class 2.) 
LIT.]
178
   The first of these classes cannot enter ;nto the
 view  of a discussion of antilithics—against the
 the formation of the second and third class, these
 antilithics are calculated prophylactically  to  be
 useful.
   The urinary calculi, according to the chemists,
 contain in their composition the following bodies:

   1.  Lithic acid.
   2.  Phosphate of lime.
   3.  Ammoniaco—magnesian phosphate.
   4.  Oxalate of  lime.
   5.  Cystic oxide.
   6.  Xanthic oxide,
       to which may be super-added, the animal in-
       gredient which cements the whole together.
   There are two taints of the digestive system: the
'lithic  acid, and the phosphatic taint.   It is  need-
 less to  observe  that  neither  of these is healthy.
 True health,  in reference to the digestive process,
 consists, in as far  as the urine  is concerned,  not
 in the absence  of an excess of the principles of
 either lithic acid, or phosphatic elements, from that
 fluid—but  in  the absence of  ability  to hold these
 excesses in such a state of  solution,   that  they
 shall  freely pass out of the body.   When such sus-
 pending power  is, by any very deranged action
 of the healthy digestion, taken away, deposition
 then takes place: and a clot of blood, the result of
 previous inflammation of the part; or  indeed any
 foreign or  morbid body,  however  small at first,
 presents a nucleus of this deposition. Herein con-r
 sists the mischief.  A continuance in the system of
 the perverted actions which  have  thus laid the
 foundation of concretion, of whatever kind, under
 either taint—allows perpetual, though very gradu-
 al accresion, until  large or small calculi are en- 
179                 [lit.
gendered.  If therefore there  be any remedies of
a medical kind, or any system of diet,  which, by
their united effects, can have  a tendency to keep
down the excess of calculous principles below the
depositing   point;  or,  which, that  having once
been  transcended  and  deposition  on  a nucleus
having taken place—are calculated to protect the
digestive function from further perverted  action;
then the first small concretion may be spontanea
ously broken up by the returned healthy action, and
passed  away—and the remedies  and  the regimen
producing these effects,  may truly be  entitled anti-
lithics.   It may here be asked, what light chemistry
has thrown on the proper application  of these anti-
lithics?  It is by affording us data in the examina-
tion of  the urine, on which to decide  as to the
presence of  one or the  other taint, or, as  it is
commonly called diathesis.  How can such an ex-
amination or analysis of the urine do this? It is by
development of  the existence of  the excess which
is called lithic acid diathesis,  or that of the phos-
phatic.   And of what use is it to know which of
these is  prevalent?  It is by  directing us to use
that set of  antilithic remedies suited to  remove or
moderate the one prevailing; for they require two
very different kinds of  remedies ; and that which
would cure or moderate the lithic acid taint, would
increase the  phosphatic,  and  vice versa.   In
other  words, some varieties  of calculous  prin-
ciples in the mine  will be liable to be affected by
acids, and  other calculous  principles  by alkalies.
The medicines therefore prescribed as antilithics,
w ill cause a cessation of morbid action in the kid-
nies, or increase that already existing, according
to the just adaption of the remedy to the prevailing
taint, or the improper selection of one ill-suited to
remove  it.   Dr.  Mavcet  has  observed,  that
      P 2 
LIT.]                  180
" whenever the lithic acid predominates, the alka-
lies are the appropriate  remedies,  but that when
the calcareous or magnesian  salts prevail,  the
acids are to be resorted to"—a  remark which pre-
supposes the recent urine to have been examined,
its  sediments scrutinized,  and.  if necessary  to
confirm our knowledge derived from such scrutiny,
an actual analysis of these sediments, by chemical
tests. It is here that the chemico-medical pathology
becomes so deeply interesting ; here that judicious
treatment becomes so materially dependant on the
enlightened view of urinary disordered  function,
presented to the  profession by the labours of Prout,
Marcet, Brande, Wilson Philip, Wollastson, Ma-
jendie, and others.
  In what  condition of the system does the lithic-
generating process originate ;  and what  practical
deductions  can be made from knowing that condi-
tion? It is  obvious that the chain of actions, which
binds all the  relative individual processes  of the
body conspiring to make the entire digestive pro-
cess as  it is called, must every link be sensible to
the contiguous and continuous morbid impulses, the
effect of which  is to  pervert  in an especial and
perceivable manner, the fluid  it is destined to se-
crete,   though  less important  aberrations  from
healthy  action  are induced in  other functions.
Whatever  course of diet, dress, habits, or whatev-
er moral causes  may, by the  individual effect of
either,  or  the collective operation of the whole,
tend  to derange, impair or destroy  the  healthy
functions of the  stomach and intestines, the liver
and the skin, must, in consequence of the catena-
tion of the  functional actions  of all  these, with
the  kidnies,  be  a cause of lithic  disease.   And
this will be the  case in a greater  or less degree,
in proportion to the presence  in, or absence from 
181
[lit.
the system, of  an original  predisposition from
hereditary,  constitutional  or accidental taint,  to
lithic  disorder.   Accordingly we find, that dys-
pepsia is  the  proximate cause of lithia;  and the
causes  of dyspepsix whether moral, physical  or
accidental, are the remote  causes of the same mor-
bid state of the system.  And whatever hereditary
predisposition may exist,  to dyspepsia, as  in per-
sons  deriving arthritic taint from  their parents,
that predisposition  will be found especially sub-
ject to lithia.   Hence gouty persons, whose diges-
tive process, in early life, is not so entirely impair-
ed by the irruptions of frequent attacks of  irregu-
lar gout: and who for that reason escape the early
promotion of lithic disease, unless  they have been
addicted  to intemperance and great irregularity of
habits—are nevertheless,  in more  advanced age,
very subject to lithic productions: because dyspep-
 sia then  supervenes to the frequent arthritic par-
 oxysms which  inevitably  make  their unwelcome
 appearance  at that climacteric.   The practical
 inference deduced  from   these  facts,  is, to  di-
 rect  our curative intention by constitutional gen-
 eral  remedies,  calculated to restore the lost, rouse
 the torpid, or reinstate the perverted  functions of
 the stomach.  And this  we are to do,  while we
 simultaneously  administer antilithic remedies, on
 the principles already mentioned—suited to remove
 altogether, or  suspend, the further production of
 lithic  urine,  by their peculiar local determination
 to the kidnies.  We are thus brohght to the  con-
 clusion,  that antilithics, as prophylactic and palli-
 ating remedies, are not empirically used ; but are
 administered on principles of correct pathology,
 chemical fitness, and philosophic intention.  As
 such I invite your attention to them;  but  do so at
 the same time that I urge a devotion to study of 
lit.]                182

the chemico-medical investigations of the authors
already mentioned ;  and, above all, to study quite
as closely, the approximating traits in these works,
to speculation somewhat too refined to be without
danger of error—to practical directions  somewhat
too  highly wrought out of overstrained chemical
results, to be easMy and profitably enlisted in our
ordinary  practice.    This, I  trust  wholesome
caution,  is not intended to convey any  detraction
from the value, either of the investigations or prac-
tice predicated on them, to the importance of both
of which I have clearly testified in  the  preceding
outlines.  Nothing can be more true,  than the
leading principles of physiognomonical  deduction
made by Lavater, in his treatise on a subject phi-
losophically  handled  by  none but himself: yet
nothing can be more absurd, unfounded and fine-
spun,  than some of his decisions in  favour,  and
predictions against intellect—founded on a thread
drawn to fragility by too many  turns of the wheel,
and too extended a walk from the spindle on which
it is wound. The warpofthechemico-physiologico-
medical  doctrines of lithia, like  the principles  of
physiognomy in Lavater, consists of th;v*ads well
disposed, and of woof fitly adjusted in the loom: but
 the filling has been too fine and too injudiciously
 interwoven,  to  render the texture of  the  fabric
 durable.
     outlines of antilithic  practice.

  Dr.  Wilson Philip has made the following de-
ductions of the effects of diet, in generating lithia.
'• 1.—That  acid and acescent matters, tend to in-
  crease the deposition of lithic acid from the urine,
  and  to prevent that of the phosphates. 
183                 [LIT.
2.__That diet composed of a large proportion  of.
  animal food tends to lessen the deposition of lithic
  acid, and to increase that of the phosphates.
3.__That every thing which promotes the action of
  the skin,  tends to prevent the deposition of lithic
  acid, and  to occasion that of the phosphates.
4___That dyspepsia tends to increase the deposition
  of the lithic acid,  and to lessen that of the phos-
  phates, both by producing acidity in  the primav
  vise and bv rendering the skin inactive.
5.—That indolence  has the same tendency both  by
  inducing dyspepsia and by lessening the activity
  of the  skin, in proportion as it impairs the vigour
  of the circulation.
6.__That an  acid passes by insensible as well  as
  sensible perspiration."
  Since these effects of diet embrace the two pre-
valent taints  of lithia, it is plainly the duty of the
practitioner to enquire minutely into the errors of
repletion, which have had the effect of disordering
or  violating wholly, the process of healthy chyh-
fication.  It  is equally his duty to enforce rigidly,
such amendment in  the unwholesome  ingesta,  as
may be calculated  to restore  the  healthy func-
tions, on the morbid aberrations of which, lithia
 depends.  But he must not stop here.  The moral
 causes already hinted at,  are actively prejudicial.
Excessive  mental exertion or excitement, griet,
 anxiety, nervous irritation induced by intemperate
indulgence of passions—all exert a ruinous action
 on the digestive functions,  and it has been shewn,
 consequently, in the production of lithia.  Physi-
 cal causes, as irregular repletion, interposed with
 protracted  fasting ; or any other irregular alter-
 nations of  excess and deficiency, take their part
 in  the morbid conditions favourable to lithial  de-
 positions.  Mechanical irritants, as injuries done 
LIT.l                 184
to the back by over-straining, blows, falls> and the
like, have, in systems characterized »v Pred.sposi
tion  to the  affections  under notice, the ettt.it oi
exciting causes, both by  causing an establishment
of some of  the  nuclei,  of calculus, engendered by
local violence,  and by inducing morbid action in
thekidnies.  On the alert to discover some or a
of the preceding  causes, the physician is l»ep»r™
with some  prospect of success  to meet them by
curative or palliative directions and  remedies.
Among the latter,  the chief alkaline are magnesia
and magnesian salts; and the alkalies,  fixed and
volatile ; the  vegetable and mineral acids,  car-
bonic acid ; the alliace* ;  some astringent diuret-
ics ; certain resinous  narcotics; many bitter ton-
ics ; all of which will be  designated for their
particular  effects,  in  the  second volume of these
 outlines. 
185
[nar.
                NARCOTICS:

                   CALLED ALSO

SEDATIVES; ANODYNES;  HYPNOTICS; SOPORIFICS.
  Substances  endued with  intense power on the
general, but especially on the nervous system and
sensorium, inducing a primary  vivid,  hut  evan-
escent excitement: and  a  secondary depression
below the point consistent with customary action
of the cerebral functions,  and vital powers,  and
hence  inducing sleep,  insensibility  and torpor.
These primary and secondary effects are perceiva-
ble in all narcotics,  properly so called,  but they
evince no determinate  relation as pertaining to
each individual substance.  The same narcotic at
one time producing but slight primary effect, with
intense secondary action: while at another the pri-
mary effect is the  most vivid, and the secondary
is disproportionately inconsequent   If particular
narcoties evince this discrepant  strength of their
first and second effects,  at different times on the
 same  person, they discover a still greater varia-
 tion in relative consequences, administered  to dif-
 ferent individuals.  There is no class of remedies
 which  is so materially  affected by peculiarities of
 constitution,  not to say idiosyncratic** ; by acci-
 dental circumstances:  by  moral and physica  ex-
 citement, as  the  one  under notice.   And I may
 assure y<u, that no class requires closer study and
 attentufn, in order  to  avail yourselves of all the 
NAll.j
186
 advantages, and to be on your guard against all the
 inconveniences,  which  its multifarious  subjects
 present. The primary stimulant operation does ap-
 pear, from its transitory effect, to be often  really
 trifling: while the depression ensuing immediately
 after, being excessive, many have denied altogeth-
 er, a stimulant effect to the substances thus acting ;
 and have called them direct sedatives.   Hence you
 will find that Cullen speaks of the subjects of this
 class,  as sedatives, refering  the  incitant power
 which he could not but  perceive belonged to their
 first impulse, to the vis medicatrix naturae,  which
 makes an effort to rid the vital powers of the intrud-
 ing agent threatening to suspend or destroy them.
 The celerity of accession of the secondary effect,
 which we designate in common parle by the  word
 narcotic, seemed to him to give much strength to
 the idea of immediate sedative action—an action
 he considered as the  sole one produced by the tribe
 of agents now  refered  to  a distinct class called
 narcotic, but which he designated as the first sec-
 tion  of his class  Sedantia,  embraceing  such
 sedatives as he maintained to act  •• more immedi-
 ately on the nervous  system" while  the second
 section  «Refrigerants,' he conceived to have  an
effect ♦* more immediately on the sanguiferous sys-
tem."   His theory of the operation of his first
section, which he also  called soporifics and  hyp-
notics, is, that as all sense and  motion are derived
from  the brain ;  and that as these medicines di-
minish  motion  and  power  not only  in parts to
which they are directly applied, and which are
remote from the brain, but also produce a similar
diminution  of sense  and motion when applied to
parts having  no  connexion  with  the  brain-
that they must do this by acting upon some matter 
                        18*                 [kar.

  in  common to the  whole nervous system.   This
  matter he maintained was " a subtle elastic fluid
  inherent in the medullary substance of the brain
  and nerves, upon the motions of which all sense
  and vital motions depend ; and by which, therefore
  motions are communicated from every one  part to
  every other of the nervous system."  He believed
  that there were certain  phasnomena which evinced
  an excessive degree or a relative paucity  of this
  fluid, at different times  ; and that  it was liable to
  be affected in  these respects  by  external  bodies
  applied to the  nerves.   He believed that narcotics
  diminished the mobility  of this nervous power, and
  that in a certain quantity they destroyed  it alto-
 gether.   This is  his theory  of the operation  of
 what he  called "narcotic sedatives."  I hope I
 shall not startle you when I  declare  my belief in
 the  existence  of •'narcotic sedatives" which act
 in some inscrutable manner on the vital powers,
 and may be, in  the manner so ingeniously accounted
 for in the beautiful hypothesis of Cullen.  I would
 incline however  to  the still more philosophic and
 beautiful doctrine  of complex and inter-sociated
 sympathies, to come at the same conclusion.  The
 fact alone, however, is all which materially inter-
 ests us  at this  time  ; and as I assume it as unde-
 niable,  that cold water  taken  suddenly into the
 stomach of  a person over heated,  and prussic acid
 given to one under any circumstances of ordinary
 existence, do produce effects not  referable to the
 same mode of action  belonging  to the incitant nar-
 cotics, I  shall  dispose of the deleterious principle
just  named in a distinct class,  in Murrays arrange-
 ment modified,  under the name of sedatives.   I
 shall assume the prussic  acid as the type of this as-
 semblage, and  it will be  perceived I am not with-
 out legitimate  resources to make a goodly number
      Q 
NAR.]
188
of such agents as act in a manner somewhat simi-
lar.   To me it has long appeared plain, that in our
pruriency to divest  our minds of old opinions in
reference to the operation of medicines,  we have
unwittingly,  but very  naturally,  fallen into  a
dilemma.   We were not satisfied with the hypoth-
eses of the writers of Cullens" time, because they
did not square with  all the effects of a multitudi-
nous class—and we in consequence  eagerly seized
on the •• incitantia" of Darwin, to lead us from the
difficulty, because most of the  narcotics,  are inci-
tants: not recollecting that several agents in the class
of Cullen's sedative narcotics,  are characterised by
effects quite as anomalous  and difficult to  recon-
cile with our present received notions of the effects
of narcotics,  as many of his class were with the
principles of his own  disposition.   The class of
sedatives which! propose to restore; will embrace
medicines and  agents equivalent to the  • ■ contra-
stimulants" of the  Italian school.   And if  in the
restoration of a long disused,  and a much abused
name, I may be unsustained by the prevailing tenets
of theday—I am, certainly in my ownopinion, and
I  venture to believe by the confession of all who
have  devoted any thought upon the  subject of these
lectures, most strenuously supported; and intrench-
ed by the known difficulty of getting on  without it.
If there be no sedatives, or agents which act  ac-
cording to an operation on the system designated
by the usual  acceptation of that term,  then sure-
ly we have some medicines without a name, which
cannot be arranged in any of the classes  of the
present received systems of arrangement.   I  ad-
mit  the acknowledged difficulty  of disciplining
 narcotics—I believe them in the anarchy and con-
 fusion of raw  recruits  sent into the forces of re-
 mediate agents—but I believe a  detailed  guard 
189                 [NAR.
might receive,  and control the refractory, which
may refuse to  fall in  the ranks and obey  the
movements prescribed  to each company—that of-
fice I shall assign to sedatives.
  It has been  discovered by  the researches  of
Saturnier Derones and Majendie, that the narcot-
ic principle of opium is separable from the other
principles  of that substance; and they have gi-
ven to this principle the name of narcotine.  De-
prived of this principle, opium becomes a different
remedy, and much of the inconvenience and distress
occasioned  by  its use by some  persons,  is pre-
vented.
  For further details  on this subject I refer you
to the outlines of the lecture on opium.
  The practical application of the subjects of the
preceding remarks,  to the treatment and cure of
diseases,  it is impossible to set forth in the abstract
general view of the whole  aggregation, for rea-
sons already given—their various effects.   The
medical use will be more properly and efficiently
shewn, in  the discussion of the peculiar proper-
ties and effects of the  individuals constituting this
group.   This point will be attended to in the lec-
tures. 
RKF.J                 t90
REFRIGERANTS.
  These are remedies which have been supposed
to diminish the heat of the body without occasion-
ing diminution of sensibility or  nervous energy.
It has been assumed that they do this whether  in-
ternally taken  or externally  applied, by  acting
with an immediate reducing force on the sanguif-
erous system.   They constitute the second section
of Cullen's  class of sedantia.    After an  atten-
tive review of the grounds on which this class  has
been established and  continued—after duly weigh-
ing the facts and phsenomena, chemical and physi-
ological, which have been brought in support of it
—after surveying the wide field of hypothesis and
conjecture, on which  these facts  and phsenomena
have been martialled into an arrayed force to com-
pel an accrediting consent to  the  real existence of
remedies which generate  cold in  the body—after
pondering on Dr. Crawford's doctrine of the chemi-
cal origin of animal heat: and that more generally
recived  theory  supported by Brodie, of the inhe-
rent principles of animal heat  co-existent with
and dependant on the living principle which ani-
mates the frame;  both of which theories  are inti-
mately  involved in the course and bearings estab-
lished  for the  operation of  refrigerants—after
reflecting on Brockley's  observations, predicated
on the phsenomena of the chemical solution of the
neutral  salts—after attaching as much importance
to Turberville Needhams theory  of an expansive 
191
[REF.
force and resisting power every where in nature:
and Cullen's intrenchment of the modus operandi of
refrigerants behind the application of this antizy-
mic power as he terms it, to the exhibition of neu-
tral salts to the stomach ;—after devoting in a word
as much reflection to  this intricate subject  as  its
complexities required: and bringing to my aid what
practical  experience my opportunities have  in
near twenty years  afforded me,  of the operative
phsenomena of medicines on the  body—I am not
able to perceive the slightest shadow of reason for
allowing the existence of any such remedies as  in-
ternal refrigerants.   Consequently I enjoin  an ob-
literation from your minds, of the misleading prac-
tice to which the admission that there aresuch, tends,
when you pass in review the multitudinous subjects
of Materia  Medica.  I shall  enter more into  de-
tail  on this  point,  in the lectures ;  in  the mean
while I wish to be understood, that I not only ad-
mit  of such a set  of remedies and agents of thera-
peutic  power, as  may  be grouped under the title
of topical external refrigerants,  but I believe such
remedies could find no  suitable place under any
other name.    And hence though unfriendly to
classification,  purely  as such, yet I believe that
method of the mind which groups by a catch-word,
(if I may resort to the stage for a figure) an  assem-
blage of articles  producing a singleness of effect,
and an undeviating fidelity in its production when
applied under  the same circumstances—may be
useful in a practical point of view.  Such a group
I believe topical  refrigerants to be,  and they  are
the  more constant in their operation and consistent
in their effects,  because they  are  influenced by
chemical and physical principles.  It will  be per-
ceived that in the second volume of these outlines 1
 sometimes speak under " medical property and uses
        Q2 
REF.]                 192
of the articles, of the virtues being ••refrigerant,"
by which I would be understood simply to use the
common parle of practitioners, without admit-
ting its  propriety: and I would, in such and other
instances when I employ the terms  of classes in
the legitimacy of which I cannot believe,  be also
understood merely to designate that  effect, prima-
ry, secondary, or remote,  which has been noticed
by authors, without conceding the propriety of the
terms, or the  veritable existence of such remedies
as those terms  designate.  I proceed now to the class
1 propose to stand in lieu of refrigerants.
           TOPICAL REFRIGERANTS.

  These are chemical compounds or products, or
natural agents externally applied to such parts of
the body  as may be marked by superficial inflam-
mation: and which tend to reduce directly the in-
creased activity of the vessels of the part inflamed.
I will not say, that a reduction of general temper.
ature may not  be the consequence of these reme-
dies, thus externally, but more generally applied
to the surface  when  no superficial  inflammation
exists.  But I would say,  that it is chiefly in ca-
ses of  actual inflammation,  as in burns, scalds,
erysipelatous and phlegmonous heat, that they are
to be resorted to as remedies.
   The substances I would dispose under this class,
are
   1st. Chemical compounds, as ether, or etherial
spirits, w hich generate coldness by their evapora-
tion ;  and
   2nd. Natural fluids and products, as cold water,
ice.   Articles  operating in the manner either of 
193
[ref.
them do, will also properly fall in here.  The sub-
ject  will be more extensively discussed in the lec-
tures, and the practical application of these rem-
edies pointed out by facts and illustrations.   1 hese
substances and agents thus collected under the title
above,  should more properly be considered among
the, " adventitious remedies" which I have noticed
at the end of the discussion of therapeutic medica-
ments.  I shall accordingly mention the title there,
 and let the foregoing hints of the subjects pertain-
 ing to it, be considered as all  I have room to ad-
 vance in these outlines. 
RUB.]
194
RUBIFACIENTS.
  These are irritating substances applied  to the
skin,  which excite its vessels to a slight degree, I
will not say of inflammation, but "something ap-
proaching to it, designated by the redness which
follows  their  application:  and hence the  term.
They are certain acrid substances chiefly from the
vegetable kingdom ;  as Arum.  Mezereon. Ranun-
culus  bulbosusand R. acris, mustard, horseradish,
horse-mint,  skunk-cabbage,  capsicum, (different
species.) garlic and some other alliacea**. and bulb-
iferse  ; the essential distilled principle of resins, as
oil of turpentine,  oil of horse-mint, oil of tansy,
pennyroyal, and several of the verticillatse ;  some
peculiar substances,  as camphor and its  tincture,
aqua ammonia, &c.   In  short every thing which
blisters, applied with that effect,  may be so man-
aged as to procure a  moderation of that vesicating
effect, so as simply to  redden  the skin,  thus be-
coming rubifacients.   Dr. Paris has  refered ru-
bifacients,  to  a collection of  agents called  Lini-
ments, from the operation and mode of application
of which, I think they differ in so many material cir-
cumstances, that  I cannot accord with  him in this
disposition.   I preserve therefore the name  at the
head  of these hints, to designate articles which
operate in the manner those already mentioned do:
and  refer  to  liniments,  such  substances as are
characterized  by the  discrepancy of  application
and effect just hinted. 
195
[rck
  Dry-cupping is placed with this assemblage, not
because I have no  other place to consider it as a
therapeutic agent, but because it produces the same
local excitement  of the blood vessels ,n the  skin
and its  vicinal parts,  which is  effected  by other
rubifacients, and which that name so faithfully
identifies.   I consider that  Burgundy pitch, and
similar substances usually placed here, produce a
very different effect and in  a different manner-
pustular eruption being generally the consequence
of their continued  application, as is usual  with
this and similar substances, and by which contin-
ued action  ii is deemed justly,  they produce all
their good  effects as  counter-stimulants.  1 have
also  placed tartar-emetic ointment, or this medi-
cine applied externally in some other of the now
common ways, among what I have called pustulat-
ing irritants. Where else should I place it? Surely
not with epispastics! it does noly?roduce *?y .e^t
analogous  to those  agents.   With  rubifacients?
 Clearly not.   These  excite heat with rednesss of
 the skin only-this is far from being the effect of
  artar^emetic externally applied.   With liniments
 Impossible.  It appears  to me that  the  peculiar
 SToc looking eruption which  follows tartar-
 emetic externa^ applied, has been overlooked
  »™he history of therapeutic agents  by autliors
 trpatises  on materia medica.  Ihey ai range ic
 erroneously too, with epispastics and rubifacients
 IUs however so much employed  and is really so
  mportant a remedy, that I have thought proper
 to refer it to some assemblage of remedies,  of the
 effect  of which  its peculiar operation may be con-
 sidered the type. 
SED.]                196-
SEDATIVES.
   These are agents which  directly,  and without
evacuation, diminish the  muscular actions, cere-
bral functions,  and visceral operations of  the hu-
man system.  I have already,  under the outlines
of the class of  narcotics,  stated my belief of the
existence of such agents.  I am sustained by facts,
by physiology*  by the known effect of certain med-
icaments and therapeutic agents,  in restoring this
old class.   I do not hesitate to aver, that, without
it, those who advocate classification will be sorely
puzzled,  to know  where to  refer hydrocyanic
acid and the medicines  which operate by this prin-
ciple, arsenic,  corrosive sublimate and other poi-
sons of a similar character ; digitalis, hyocyamus,
belladonna, &c.  These I place here, as also nitre,
borax, some of the mineral and  vegetable acids,
and  other  articles  usually  termed  (general re-
frigerants.)  The leading articles of the assem-
blage I refer to this title, are capable,  in undue
quantities, surpassing in  any  considerable degree
their proper dose, of producing such a  depression
'of the vital powers,  as may be incompatible with
the continuance of their action, and consequently
producing death.  Without this  class, those who
advocate  systematic arrangement, would in vain
strive to dispose of the agents already enumerated,
and others of a similar character.  At all events
the term will afford a word to eke out the language
of materia  medica,  which,  without it,  would be
imperfect.
   Further details and  illustrative examples  will
be given in the lectures. 
197
[set.
SETONS.
  These are artificial drains similar to issues, and
differing chiefly in their being inserted  between a
considerable nether surface of the skin and par-
tially of the teguments beneath it, and the muscle.
The skin is pinched up into a fold with the fingers
of one hand, while the seton needle mounted with
a skein of silk, a piece of broad  tape, or  several
strands  of  narrow tape,  is  pierced  through the
duplicature by the other hand,  and the  silk  or
tape carried along  with  it.  A loose tie is then
made of the ends, and an emollient poultice  applied
for six or eight or ten hours, or, until suppuration
has  commenced.  It  is kept up by  drawing the
inserted material daily so far out of the  wound,
as to expose the part covered  by it:  it is then
washed clean  with soap and water, a mild  dress-
ing  applied,- and the succeeding day  is dra^vn
through the other side to its first place: and this
treatment is necessary to be pursued as long as
the seton is supposed  useful, or until its discharge
spontaneously ceases,  or at least is so  inconsidera-
ble as to be inefficacious.   It has been supposed
that setons are preferable  to issues,  because we
can  gradually lessen the discharge by removing
strands of  the silk or small tape, until the whole
be taken out;  thus avoiding the inconvenience and
even danger which  it is asserted has sometimes
occured, by suddenly stopping the discharge of the
common issue  by removal  of  the irritant body. 
set.]
198
 There may be some reason in this, though I confess
 I have never seen such results.   Allowing it to be
 so,'the caustic issue can be managed pretty nearly
 as well as the seton, so as to lessen gradually its pur-
 ulent evacuation.by a cautious attention to the na-
 ture of the dressings applied with a view to heal it.
 The mere introduction of the seton is not more pain-
 ful than venesection, if adroitly done with a sharp
 needle properlv furnished with as much silk or tape,
 as will readily pass through the wound it makes: but
 the subsequent inflammation is often considerably
 distressing, and after some time the irritation con-
 veyed, in peculiar habits, to the general  nervous
 system,  is intolerable.    Besides this, they are
 more troublesome  in  the  dressing,  frequently re-
 quiring in  warm weather, two or three ablutions
 in twenty-four hours.   Applied to the nape of the
 neck, they produce more stiffness  than  caustic
 issues, which is  particularly inconvenient from its
 impeding the free rotation of the head.  Notwith-
 standing all  these inconveniences however,  they
 possess  some advantages  over issues, common or
 caustic; and according to my observation,  they
 induce a greater drain.   They may be introduced
 even without the consciousness of the patient, who
 alarmed at the slightest incision by a knife in the
teguments  or muscles,  would resist the further
progress of the operation.  They are used for the
same purposes as issues. 
199
[si A.
SIALOGOGUES.
  These are  usually  defined by authors to be
general and local stimulants which increase  the
salivary discharge. I divide them into two groups,
the 1st, I leave as I found them under  the above
title,  Sialogogues—by which I mean such medi-
cines, as, internally administered, produce among
numerous other stimulant effects,  a peculiar stim-
ulant impulse on the salivary glands, by which an
increased flow of their secretion is established, and
for some time  continued.  The 2d, I shall desig-
nate  by the term salivant-masticatories.  It is
with the first  class  I have any  thing to do here.
Mercury, by which  I  mean  all  the salts of that
body, is the only true sialogogue which  has as yet
come to our knowledge.  It is  true nitric acid,
and other medicines have been said often to induce
this effect: yet it appears doubtful if such substances
do this,  by being taken into the course of the circula-
tion,  as mercury  decidedly  is.  and through this
course stimulating the salivary glands to pour out
considerable quantities of saliva.  At all events,
admitting  that such  substances  do  often  induce
ptyalisin—no one would  hazard the assertion that
they always, or  for the most part do so; indeed
sucli effect is of exceedingly rare occurrence, com-
paratively  with  the  innumerable exhibitions  in
various forms, for various affections, of the anoma-
lous salivant  substances in question.   An acci-
dental or an unusual effect of a medicine can never
        R 
SIA.j
200
entitle it to be ranked with others which always,
or with rare exceptions,  induce that effect.  Mer-
cury  therefore stands  insulated  in  the  materia
medica; first,  because  it is a universal stimulant
which no other medicine is; and secondly, because
internally  taken  or  externally applied  by  fric-
tions  of ointments  made of  it.  it establishes  a
powerful excitement in the secreting  and excret-
ing functions of the salivary glands.   The lecture
on  this subject therefore, will embrace all that is
peculiar to the effect of sialogogues ;  and to that I
shall for the present, refer you. for the theoretical
views and practical application  of this master-
medicine.
           SALIVANT MASTICATORIES.

  These T shall assume  are  external stimulants,
which by immediate contact with the excretory ducts
of the salivary glands, excite the glands themseh es
to an increased action.  They are taken  into the
mouth  and masticated, but no part of their  juices
is swallowed:  or at least  it is not  necessary  to
their salivant effect that this should happen.  They
are consequently,  local remedies, of specific  de-
termination  to parts within  reach  of a limited
sphere,  of local impulses.  There is no  theory
required to account for a self-evident fact, arising
from an evident cause:  and \> hirh can arise,  in the
present instance,  from no other.   There  are two
advantages  arising from the  introduction of this
class: the removing from the company of mercury,
the imbecile mimics  of their power,  which have
no claim to real consanguinity—and  the provision 
201
[SIA.
of a suitable place for the reception of those out-
casts of the sialogogue family.   They are entitled
to this attention,  even in a practical point of view,
because they are, without doubt, useful palliatives
if not remedies.  I shall enter more fully into this
subject, in the proper stage of the course of lectures,
and with  these outlines dismiss the subject, first
enumerating some of the pungent acrimonious sub-
stances which  I believe are properly located in this
class,  as  examples, viz. Pyrethrum ; Mezereum;
Tobacco ; Horse-Radish ; Senega snake root; In-
dian turnip, &c. &c. 
TON.}
202
TONICS.
   Substances which give  strength to the system.
They do this chiefly by their continued exhibition.
I  confine  this  definition to absolute tonics—or
those endued with the tonic power inherent in them,
and evinced under  any proper  circumstances for
their use.  I shall not consider here, such reme-
dies and  means, as, in themselves, are any thing
else than  tonics, but which by their operation on
the system under certain circumstances, produce
indirectly an invigorating effect—in  other words
give tone to the system. They, relatively to the con-
dition of the body for which they have been applied,
act eventually as absolute tonics do—but it would
create confusion  of terms and ideas,  and be  sub-
versive of the unity of the subject to notice  any
such as tonics.   It  is far from settled  into  any
thing like a uniform belief, in what  ways tonics
do act.   It is in truth, after all which  has  been
advanced on the subject by Gregory, Cullen, Dar-
win, Barton, Blanc, Paris and a host more—pure-
ly speculative,  whether they operate by  the bitter
principle, the astringent  principle, a  specific de-
termination on  the muscular fibres, &c.  &c.  I
shall enter fully into a  consideration  of the differ-
ent theories which  have been proposed on this sub-
ject, in the lectures—in the mean while I may simp-
ly state in these outlines,  that, there is no  class
of remedies or means,  the effect of  which is so
palpable, so generally understood and appreciated, 
                      203                 [TOff.

•while the rationale of that effect is so hypothetical.
It is enough to  distract the tyro, to attempt  to
propound the contradictory opinions on this point:
and it is more than enough to divert his attention
from the main feature of the class—the therapeutic
application of  these remedies.   I shall endeavour
by familiar  illustration to fix your  attention  on
this point, when  treating of the various medica-
ments which belong to  the head of these remarks.
For the present I  have only to observe that tonics
are forbidden in all states of the system involving
undue  arterial action—and  the  instances are so
few, in which  a deviation  from this  rule may be
proper,  that they may profitably be passed  bye,
until your experience at the  bed side, shall give
you those lights to direct a safe aberration, which
mere abstract reasoning or discourse can never  af-
ford.                                 .
   This may be a proper place to recapitulate  the
 sectional division of positive tonics, which I have
 already proposed page 39 of these outlines, viz.
   ].  Simple tonics.
   2.  Bitter  tonics.
   3. Astringent tonics.
   4. Aromatic tonics yielding essential oil.
   5. Warm tonics, or those possessing aroma, but
    ' yielding no essential oil; or if any,  not com-
      municating the whole of its effects to the sys-
      tem, as when exhibited in the native state of
      existence in the substance itself.
   I shall fill up these outlines, by a full exposition
  of all the substances pertaining properly, in  my
  estimation, to each  of those sections-ami I shal
  do this the more carefully, because I believe  and
  shall endeavour to shew, that important practical
  inferences are deducible  from this  disposition—
  The extent of the class; the variety in the promi-
        R 2 
TON.]                204
nent principles of its subjects, and the diverse mode9
of their primary effect on the system, though  all
leading to the same ulterior issue, are facts which
impress the necessity of this course,  strongly  on
my reflection.
  Having thus  sketched the outlines of the thera-
peutic part of our course, so far as actual medica-
ments are  in question, I proceed to review what
has been said in the foregoing pages, by recapitula-
tion—and finishing the subject by outlines of ther-
aputic agents not medicaments.
            RECAPITULATION

Of the classes proposed in these outlines to be re-
  tained ; and a scheme of those additional thera-
  peutic agents, not  properly  medicaments,  but
  which form a very  necessary part of curative
  means, and should never be lost sight of by the
  reflecting and philosophic physician.

      1. Antacids.
      2. Antispasmodics.
      3. Anthelmintics? (of doubtful claims.)
      4. Aromatics.
      5. Astringents.
      6. Cathartics.
      7. Diaphoretics.
      8. Diluents.
      9. Diuretics.
     10. Emetics.
     11. Emollients.
     12. Epispastics.
     13. Errhines, or Sternutatories.
     14. Escarotics* 
205
     15.  Antilithics.
     16.  Narcotics.
     17.  Pastulating irritants.
     18.  Rubifacients.
     19.  Sedatives.
     20.  Sialagogues (internal.)
     21.  Salivant Masticatories.
     22.  Tonics.
     23.  Toipcal refrigerants.

  It will be perceived I have lessened the number
of classes in Murray's arrangement by four as-
semblages.   His is the simplest arrangement, and
contains fewer classes than any systematic classifi-
cation,  except Darwin's,  with the principles  of
which I cannot accord.  I have added five classes:
Aromatics—Sedatives,—Salivant Masticatories,—
Topical  refrigerants—and  Pustulating  irritants.
I have  expunged,  Expectorants—Refrigerants.—
Emmenagogues and Demulcents; and 1 have  assu-
med the  class of Antilithics in  lieu  of Lithontrip-
tics. With this modification of twenty-three instead
of twenty-two classes. I leave  the  subject of clas-
sification of medicaments to  proceed  to  notice
what 1  shall denominate " Adventitious therapeu-
tic agents, not medicaments;"  in the proper sense
of the word,  and to  this assemblage I deem pro-
per to refer Emollients, Epispastics, Escarotics
and  Demulcents, of Murray's scheme—modifying
this latter class,  into Local Demulcents.  This
will reduce the twenty-three classes  retained and
proposed—to fifteen of true medicaments.   The
following scheme  will exhibit the points of the
recapitulation,  and the anticipatory view  of the
adventitious remedies. 
206
  CLASSIFICATION OF MEDICAMENTS.
{Proposed by W. P. C. B. in lieu of Murray's scheme.)


      A—GENERAL  STIMULANTS.
      Sialogogues (Mercury and its salts only.)
a. Diffusible, j Narcotics.
              (_ Antispasmodics.
              f Aromatics.
b. Permanent. < Tonics.
              L Astringents.
        B—LOCAL STIMULANTS.
                Emetics.
                Cathartics.
                Diuretics.
                Diaphoretics.
                Anthelmintics?

       C—GENERAL  SEDATIVES.
(Hydrocyanic acid, as the type; including therefore
  every thing acting like it on the system.)

      D—CHEMICAL REMEDIES.
                Antacids.
                Antilithics.

     E — MECHANICAL  REMEDIES.

                Diluents. 
207
t
             CLASSIFICATION

       ALPHABETICALLY ARRANGED, OF

  ADVENTITIOUS REMEDIES NOT MEDICAMENT^.

          (Proposed by W.  P. C. B.J

                 Section 1st,

Belonging to division (A.) of Synopsis beginning these outlines*.

1. Acupuncturation or Acupuncture,
              Topical resolvent stimulant agents*

               f Topical stimulants involving gen-
2. Affusions. |   e*ral action bv sympathy.

              a.  By velocity  with ordinary tem-
                  perature of water.
              b.  By velocity with ordinary tem-
                  perature and paucity of fluid in
                  a partial  stream.
              c. By velocity with reduced temper-
                  perature and quantity of fluid.
              d.  By either of the above with the
                  addition of nitro-muriatic acid ;
                  vinegar;  ether;  &c. &c.  in
                  which case they are medicated.

3. Baths:              f External stimulants of
                       •{    secondary general
   Simple and Medicated. L    effect.
                         a. Cold.
                         6. Tepid.
                         c. Hot. 
208
4.  Cataplasms,         1
    (called also Poultices. J
                        Topical stimulants or
                         emollients,  according
                         to the natureof the sub-
                         stances of which they
                         are composed.  Their
                         secondary effect is to-
                         nic,  revulsive,  relax-
                         ing,  or promotive  of
                         suppurative action ac-
                         cording to their nature.

5.  Cols,                               .
           In form of ice or currents of air.

        a. Topically or partially applied.
        6. Generally applied.
               Internally and externally, applied;
                 when  externally are  refriger-
                 ant impulses, of secondary  gen-
                 eral tonic effect ; when inter-
                 nally,  as  by   swallowing ice,
                 iced waters, or by introducing
                 ice into the uterus for  hemorr-
                 hage—topical astringents.

ti.  Douche.
           a. By fluids.
           b. By vapour.
               Topical  stimulants  of secondary
                 general relaxing effects—may  be
                 so managed  as to  induce a se-
                 condary roborant effect. 
                    209

7. Electricity.
                Vivid general stimulant locally
                 applied to the uninsulated bo-
                 dy, or generally, by insulation
                 on a non-conducting substance.

8. Embrocations.                        .
                 Topical, resolvent and relaxing
                 stimulants.

 9. Emollients.                    „c     .
                 Topical stimulants, of seconda-
                 ry  relaxing effects.

10. Enemata.
           a.  Aqueous.       "1
           b.  Oily.             I
           c.  Mucilaginous.    !  civstcrs.
           d.  Mixed.           [
           e.  Medicated.
           f.  triform.       J     .
                 Topical evacuant stimulants.

11. Epispastics.                       .
                 Topical vesicating stimulants.

l«  Errhines or Sternutatato.ies.
I,., .ckkhi*     Topira|  sero-mucus  evacuant
                  stimulants.

 ,S. Escarotics.     .fal  dc8tr|ictive stimulants,
                   including actual,  cautery and
                   moxa.
,4. F»ME"TATI<,^0.)ical resolve„t stimulants 
eio
 15. Frictions.
          a. Dry.
          6. Wet.
                 Topical, diaphoretic or  sudo-
                  rific stimulants.
             When dry, by hand-rubbing, with or
              without a woollen glove, by flannel,
              by the flesh-brush, and the  like.
             When wet, by the same means, uni-
              ting astimulant or lubricating fluid,
              with the mechanical effect of rub-
              bing.

46. Galvanism.
                 Vivid general stimulant topi-
                  cally applied.

17. Inhalations.
                 Topical expectorant stimulants.
18. Issues.

19. Liniments.

20. Lotions.
Topical draining stimulants.

Topical lubricating stimulants.
                 Topical refrigerant stimulants*
21. Local Demulcents.
                 Topical obtunding remedies.
22. Pediluvium. *)
    Cor foot-bath.) J
           a. Warm simple.
           b. Warm medicated.
           c. Cold simple.
           d. Cold medicated.
           Also other partial baths.
                 Topical, diaphoretic and revul-
                  sive stimulants. 
211
24. Percussion.
          Including shamooing, thumbing, knead-
            ing, &c.
25. Pressure.
           By bandages and ligatures.
                 Topical revulsive stimulants.
26. Pustulating irritants.
                 Topical stimulants, acting like
                  epispastics,  but more vehem-
                  ently.
27. Rubifacients.
           a. By medicamental irritants, exter-
               nally applied.
           b. By dry-cupping.
                 Topical  cutaneous  stimulants,
                  acting by exciting slight super-
                  ficial inflammation in the ves-
                  sels of the skin and contiguous
                  parts.

■»8. Semicupium.
                 External diaphoretic and  re-
                  vulsive  agents.
29. Setons.


30. Sinapisms.
Topical  draining stimulants,
 like issues.

Topical  irritating stimulants,
 acting secondarily  as revul-
 sives.
31. Sponging.
           a. .With cold fluids.
           6.  With hot fluids.
           c.  With alcoholic fluids.
           d.  With medicated fluids.
                 Topical, relaxing and diaphor-
   s              etic agents,  acting by a stimu- 
212
                  lant effect; and uniting the ef-
                  fect of No. 11 with the peculiar
                  effect of the fluid employed.
32. Sanguineous Evacuants.
                  General  Depletives,  operating
                  by a primary  and  secondary
                  effect towards the same issue.
  The abstraction of blood  from  the  body is  a
therapeutic mean of the  highest importance.  It
is accomplished by different operations of an arti-
ficial or natural kind ; and according as these are
so conducted as to affect the general system prima-
rily, by immediately  evacuating the blood  from
vessels directly in the course  of  circulation ; or
secondarily  by liberating it  from superficial ves-
sels  remotely  connected  with the  circulation:
blood-letting is called general or topical.
  Sanguineous evacuants may be thus classed:
  1. Blood-letting by venesection.
   2.  .       ----hy arteriotomy.

                  by slackening the ligature
                    of the  umbilical chord, or
                    by severing  it by  scis-
                    sors  or scalpel,  before
                    the ligature has been ap-
                    plied.

           ------by cupping and the scarifi-
                      cator.
           ------by  scarification with the
                      lancet.
                                 {Natural opera-
                                 tion  artificially
                                 used.
  The first and fourth and sixth means are  those
ordinarily resorted  to.  The second is sometimes
>
4.
5.
6. 
213
necessary.  The fifth is employed by surgeons for
liberating the  inflamed and torpid vessels of the
adnata, and other  purposes;  and the third  may
save life, in the new born, in  certain  engorged
conditions of the fetal circulation,  arising  from
causes involved in parturition.
  The efficacy of  blood-letting  generally, in the
cure  of  diseases,  will be the  subject  of a par-
ticular discussion in the  lectures; and  the  pecu-
liar cases requiring the different means of produ-
cing this evacuation, will be stated.
32. Suppositories.
           a.  Simple.
           b.  Medicated.
                  Topical evacuant  stimulants,
                   acting when medicated, by the
                   united effect of local irritation
                   of  the sphincter ani and the
                   specific determination of the
                   cathartic employed in the med-
                   ication,  to  the  rectum, and
                   through it on the bowels ;  when
                   simple, acting as local  irri-
                   tants on the sphincter ani.

33. Swimming.
                  Uniting exercise with bathing.

34. Topical Retrigerants.
                  Chemical  remedies   inducing
                   coldness by evaporation.

35. Vapour Baths.
           a.  Simple.
           b.  Medicated.
                  External stimulant Dirphoret-
                   ics acting by  a secondary  effect
                   on the general system. 
214
  ADVENTITIOUS REMEDIES NOT MEDICAMENTS.

                 Section 2d,

Belonging to division (C.) of Synopsis at the beginning oi
                  these outlines.

1. EXERCISE.
                a. Rocking in a  rocking-chair,
                     walking in a room, under or
                     without  exposure to fresh
                     air.
                b. Walking abroad.
                c.  Swinging.
                d. Sailing in  rivers  or  small
                  waters.                            *»
                e.  Sailing at  sea.
                /.  Gestation for a few miles in an
                     easy close  carriage, open
                     carriage, in a stage or rough
                     vehicle, by journies in the
                     same.
                g. Equitation, journies by  this
                     conveyance.
                h. Gyration.
                i.  Dancing the rope, dancing un-
                     der the exhiliration of music.
                k. battle-dorc.

2. Manly Sports.
                a. Hunting, shooting.
                b. Playing   at  cricket,  tennis,
                     nine-pins, quoits, ball  and
                     the like. 
215
3. Athletic Exercices.
                   a.  Fencing.
                   b.  Personal defence  by  stuffed
                       gloves.
                   c.  Dum-bells.
                   d.  Labour, as exercise.

4. Gymnastics.*
             Gymnastic Dress; prophylactic agents
                in their exercises,  as the truss.
                   a.  Running.
                   b.  Leaping.
                   c.  Leaping by the pole.
                   d.  Climbing the ladder.
                                 the rope-ladder.
                                 the pole.
                                 the rope.

  * The gymnastic exercises are now more important as thera-
peutic agents, since establishments are in operation in Europe
and this country, for performing them  There is one in Boston;
and one in this city  under the supenntendance of Mr. Wdhiun
Fuller, a gentleman every way qualified to conduct it with ad-
vantage and propriety.  The gymnastic exercises are not only
manly and invigorating, but they can be practised in bad weath-
er under shelter—and  when exercise by riding,  walking, &c.
would be impracticable.  Another advantage  they  afford, is
variety ; each exercise calling into action a different set ot
muscles. There is a regular gradation of the exertion required
—and the least active and violent feats should first be tried, and
in succession, those calling for greater activity and energ).  I do
not know that the truss has ever constituted a part of the pre-
cautionary preparations  for their  violent exercises—I  think
however, that a gymnasium should be furnished with several
double trusses, to be worn by those of lax habit, during the ex-
ercise of leaping and  vaulting, at least; and perhaps  during
those, of running and climbing. The invigoration induced by
practice, will 8-ifficiently protect the  body from rupture, and
{hen the precautionary truss may be laid aside.   Bel.evmg as I
do that many chronic diseases originate from a want ot sutti-
cient exercise, I  can recommend the gymnasium, as affording
the best prophylactic exercises, particularly in the winter sea-
son, which can be had.  There are cases in which its therapeu-
tic effect, would be beneficial.
        S  2 
216
e.  Vaulting.
/  Darting the javelin.
g.  Exercise on the bars.
    1. Horizontal bar.
    2. Parallel bar.
h.  Hauling the rope.
  ADVENTITIOUS "REMEDIES NOT MEDICAMENTS.

                 Section 3d,

Belonging to division (B) of Synopsis beginning these outlines.

  They are exciting agents, operating therapeuti-
cally on the mind and body—through moral agency.

1. Public Amusements.
                  Social intercourse with friends;
                     the theatre; equestrianism;
                     miscellaneous  sights,  or as
                     the French term them  * spec-
                     tacles*—The peculiar  moral
                     effect of tragedies, comedies,
                     operas,farces and pantomim-
                     ic exhibitions enquired into.

'>.. EXERCISE OF THE LuNOS.
                a. Reading Aloud.
                b. Declaiming.
                c. Singing.
                d. Practice  on  musical instru-
                    ments—all  uniting  a  moral
                    influence with a physical ex-
                    ercise. 
ai7
                  Section 4th,
Prophylactic agents belonging to division (D) of the Synopsis
              beginning these outlines.
                  a. Natural agents.
                  b. B-.dily evacuations.
                  c. Natural rest,
                  d. Celibacy.
                  c. Marriage.

                  Section 5th,
           Belonging to the same division (D).
                     Moral agents unaccompanied
                      by bodily exercise.
                  a. The exhilarating emotions and
                      enlivening  passions.
                    (The  details, and illustrations
                       in the lectures.)
                  b.  Rarely,   but sometimes,  the
                       depressing passions.
                      (Details  and illustrations in
                         the lectures.)
            RESTORATIVE DIETETICS.

Belonging to division (E) of the Synopsis preceding these
     °                outlines.

   This division I substitute in place of tlie materia
alimentaria which Cullen,  Darwin, Barton and
o^r  writers  have considered  a part of  Materia
Medica;  under the head  E  in the synopsis, the
outlini of this subject are given ; I therefore have
only to enumerate the  individual subs ances in the
lecture, and endeavour to point out their peculiar
properties and effects in relation to each other; and 
218
then proceed to notice briefly those of the remedies
belonging  to  Materia  Medica proper, not medi-
caments—which  have  not been  already sketched
in the preceding outlines.

  Detail of the relative portions of the articles of
Materia Medica  from the vegetable,  mineral and
ari'ual  kingdoms.
  The Pharmacopia of the United States contains
in its two  lists 292 simple medicinal articles—of
these
  236 are Vegetable.—Botany.
   44 — Mineral.—Mineralogy.
    5 — Animal.                 1
    2 — From the sea.            > Zoology.
    5— Insect tribe.—Entomology.}

  The Materia Medica of Cullen  (a  standard work)
contains  under different heads or classes, 480 articles
and compounds—of these
  510 are Vegetable.—Botany.
   29 — Mineral.—Mineralogy.
   89 — Animal                    ~) r* i
    2 — Insect tribe.—Entomology.  $ *00l°gy-

  Dyckman's edition of the  Edinburg Dispensatory
contains under its various heads, 2088 articles and com-
pounds—of these
 1372 are Vegetable.—Botany.
  619— Mineral.—Mineralogy.
   41 — Animal.                 ~)
   17 — From the sea.            y Zoology.
   39— Insect tribe.—Entomology.}

  Thatcher's Dispensatory contains 1037 articles  and
compounds under its various heads—of these
  668 are Vegetable.—Botany.
  332 — Mineral.—Mineralogy.
   15 — Animal.
 8 — From the sea.             I Zoology.
14 t- Insect tribe—Entomology. J 
£19
  Eberle's Elements  of Materia  Medica, and Thera-
peutics, contains under its various heads, 342 articles
and compounds—of these
  211 are Vegetable.—-Botany.
  120 — Mineral.—Mineralogy.
    6 —. Animal.                 •> „ ,
    5 — Insect tribe—Entomology. 5 *^00i0^*

  Chapman's Elements of Materia Medica, and Ther-
apeutics contains under its different heads, 198 articles
and compounds—of these
  108 are. Vegetable.—Botany.
   81 — Mineral.—Mineralogy.
    3 — Animal.                 •■> „ ,
    6 — Insect tribe— Entomology. 5 AooloSy'
   Having sketched the outlines of the divisions
A. B.  C. D. E. I have yet to notice the next di-
vision, viz:
                   TOXICOLOGY.
Belonging to division  (F) of the Synopsis preceding these
                     outlines.

   This is the history of the substances and agents,
effects, and curative, neutralizing, resisting, or ex-
pelling means of poisons—I shall divide the subject
into:
   a. Natural and chemical  history of poison.
   b. Incompatible  substances,  with poisons.
   c. Effects.
   d. Symtomatology, by  which those effects  are
       known.
   e. Antidotes, 
220
             INCOMPATIBLES.

   As pertaining to Toxicology  which  cannot  he
studied without a knowledge of the  incompatible
substances of the Materia Medica,  I  subjoin  an
alphabetical exposition of these,  according to their
English names.  The  following pages of incom-
patibles  are  the bases  of  toxicological practice:
besides which they contain what it is essential the
student should know, to enable him  to write con-
sistent, prescriptions, the ingredients of which may,
by avoiding incompatible substances,  be co-opera-
tive, and not antagonizing, neutralizing or decom-
posing.  It will be expected that candidates for a
degree will be well.prepared  on the subject of in-
compatibles.

Acetate of Lead, (sugar of lead) Plumbi Acetas, ii
       incompatible with
    Sulphuric Acid.
    Muriatic Acid.
    Carbonic Acid.
    Citric Acid.
    Tartaric Acid.
    Potass.
    Soda.
    Ammonia.
    Muriate of Soda.
    Liquor Ammoniae Acetatis.
    Lime Water.
    Carbonate of Lime.
    Sulphate of Lime.
    Solution of Sulphuretted Hydrogen.
    Hard Water, usually. 
221
Acetated Liquor of Ammonia, 'Ammonias Acetatis
       Liquor, is incompatible with

    Acids.
    Potass.
    Soda.
    Subcarbonate of potass.
    Subcarbonate of Soda.
    Lime  Water.
    Magnesia.
    Sulphate of Magnesia.
    Oxymuriate of Mercury.
    Sulphate of Iron.
    ---------Copper, and
    ---------Zinc.
    ■Nitrate of silver.
    Acetate of Lead.
    Subacetate of Lead.
    Super-acetate of Lead.

 Acetate of Potash,  Potasae Acetas, is incompatible
        with
     Sulphuric,
    Muriatic, and
    Nitric Acids.          ,
     Sulphate of Soda, and
     ----------Magnesia.
     Most  Metallic Salts.
     Most  Earthy Salts.
     Most  Acids.
     Most  Acidulous Salts-
     Lime  Water.
     Muriate of Lime.
     Salts  of Lead.
     Salts  of Silver. 
222
Ammoniated Copper, Cuprum Ammoniatum, is in-
       compatible with
    Acids.
    Pofass.
    Soda.
    Lime Water.

Angustura Bark,  Cuspariae Cortex, is incompati-
       ble with
    Tartar Emetic.
    Muriate of Mercury.
    Nitrate of Silver.
    Sulphate of  Iron.
    _______.---Copper.
    Acetate and super-acetate of Lead.
    Pure Potass.
    Infusion of Galls.
    ----------Yellow Cinchona.

Aromatic  Confection,  Confectio Aromatica is in-
       compatible with
    Acids of all kinds.

Aromatic Spirit of Ammonia,  Spiritus Ammonite
       Aromaticus, is incompatible with

    Acids.
    Acidulous Salts.
    Earthy Salts.
    Lime Water.
    Metallic Salts.

Ammoniated Iron, Ferrum Ammoniatum, is incom-
       patible with

     Alkalies.
     Alkaline Carbonates.
    Lime Water.
     Astringent Vegetable bodies. 
223
 %/Erugo,

     Vinegar converts it into a  soluble acetate, and
       ought not therefore to be employed  as an anti-
       dote to its  poison—Sugar  exercises a chemical
       action on it by which its solubility in the human
       stomach is  diminished, and is  therefore a speci-
       fic against its deleterious consequences.

 Balsam Copseiva, is incompatible with
     Sulphuric Acid.
     Nitric Acid.


Berries of Capsicum, Capsici flacca?,are incompat-
       ible with

     Corrosive Sublimate.
     Acetate of Lead.
     Nitrate of Silver.
     Sulphate of Iron.
     ■----------Zinc.
     ---------—Copper.
     The Carbonates of Alkalies.

Calomel, Hydrargyri  Submurias, is incompatible
       with

    Potass.
     Soda.
    Ammonia.
    Alkaline Carbonates
    Hydrosulphurets
    Lime Water.
    Iron.
    Lead.
    Copper.
T 
224
Calumba  Root, Calumbz  Radix, is>compatibU

       with

    Acetate of Lead.
    Super-acetate of Lead.
    Infusion of Galls.

Camphor Mixture, Mistura Camphorae, is incom-
       patible with

    Camphor.
    Sulphate of Magnesia.
    Several Saline Bodies.
    All which separate the camphor from the water.

 Carbonate of Magnesia,  Magnesise Carbonas, is
       incompatible with

     Acids.
     Acidulous Salts.
     Alkalies.
     Neutral Salts.
     Cream  of Tartar.
     Nitrate of Silver.
     ----- —-- Mercury.
     Corrosive Sublimate.
     Super-acetate of Lead.
     Fixed Alkalies and their Carbonates.
     Lime Water.

  Carbonate of Soda,  Sodae Carbonas, is incompati-
        ble with

     The same as those of Sodee Subcarbonas.

  Carbonate  of  Potash, Potassae Carbonas,  is  in-
        compatible with

      The same substances as Potassee Subearb.  except
      Sulphate of Magnesia.
      Calomel, unless heated. 
£25
 Chammomile Tea, Infusum Anthemidis, is incom-
        patible with
     Salts of Iron.
     ------Mercury.
     ------Silver.
     ------ Lead.
     Isinglass.
     Infusion of Cinchona

 Citric Acid, Acidum Cilricum, incompatible  with
     Nitric and Sulphuric Acids.
     Alkaline Solutions.
     ■-------Sulphates.
     --------Carbonates.
     ------— Tartrates.
     Soaps.
     Earthy Carbonates.
     Acetates, particularly of Mercury and Lead.
     Metallic Carbonates.

 Golds Muriatis Liquor.
     Same as with Calcis Murias.

 Cinchona,  is incompatible with
     Sulphate of Zinc.
     Nitrate of  Silver.
     Tartar Emetic.
     Common Sublimate.
     Salts of Iron.
     Solution of Arsenic.

Clove Tea, Infusum Caryophyllorum, is incompatr
       ible  with
     Lime Water.
     Solutions of the Preparations of Iron.
                          Ditto of Zinc.
                          Ditto of Lead,
                          Ditto of Silver.
                          Ditto of Antimony. 
226
Cochineal, Coccus,  is incompatible with

    Acetate of Lead.
    Sulphates of Zinc and Iron.

Colchicum,
    Acids and oxygenating substances render the vi-
    nous  infusion drastic—alkalies  render it mild
    by increasing its solubility in the stomach.

Colocynth, is incompatible with

    Acetate and Super-acetate of  Lead.
    Sulphate of Iron.
    Nitrate of Silver.
    Fixed  Alkalies.

Compound mixture of Iron, Mistura Ferri Com-
      positum, is incompatible with

    Acids and acidulous Salts  which dissolve the  Pro-
      to-carbonate of Iron.
    Vegetable Astringents.

Compound Decoction  of  Aloes,  Decoctum Aloes
       Compositum, is incompatible with

    Acids.
    Acidulous  Salts.
    Earthy Salts.
    Metallic Salts.
    All substances which are decomposed by, or which
      decompose Subcarbonate of Potass.

Compound Infusion   of Senna,  Infusum Sennas
       Compositum, is incompatible  with

    Strong Acids.
    Lime  Water.
    Most metallic Salts. 
227
 Compound  Infusion of Roses, Infusum Rosas Com-
       positum. is incompatible  with
    Alkalies.

    Earths and all substances which combine with Sul-
      phuric Acid, or are acted upon by small quanti-
      ties of it.
    Acetate of Lead.
    Sulphate of Iron.

Compound  Infusion of Gentian. Infum Gentianas
       Comp. is incompatible with

    Solution of Acetate of Lead.
    ---------Sulphate of Iron.

Compound  Infusion of Flaxseed,  Infusum Lini
       Compositum is incompatible with.

    Alcohol.
    Preparations of  Lead.
    -------------  Iron.
    Most metallic Salts.
    Muriated tincture  of Iron.

Compound  camphorated  liniment,   Linimentum
      camphorae comp. is incompatible with

    Acids.
    Water.

Compound Infusion of Catechu,  Infusum Catechu
       Compositum, is  incompatible with

    Sulphate of Iron.
    Tartar Emetic.
    White Vitriol.
    Corrosive Sublimate.
    Strong Acids.
    Solution of Isinglass.
    Infusion of Cinchona.
      T 2 
228
Compound Infusion of Horse Radish, Infusum Ar*
       moraciae Comp. is incompatible with

    Alkaline Carbonates.
    Salts of Silver.
    ------Mercury.
    Infusion of Galls.
            i- Cinchona.

Corrosive  Sublimate, Hydrargyri  Oxymurias, is
       incompatible with

    Potass.
    Soda.
    Ammonia.
    Carbonate of Potass.
    ----------Soda.
    ----------Ammonia.
    Sulphuret of Potass.
    All Hydrosulphurets.
    Soap.
    Lime  Water.
    Many Metals.
    Tartarized Antimony.
     Nitrate of Silver.
     Acetates  of Lead.
     Infusion of Bitter Vegetables.
     ------—- Astringent Vegetables.
     Mortass of glass,  as earthen ware, should be used
       for dispersing medicines containing this salt.

 Dandelion root,  Radix Taraxaci, is  incompatible
        with

     Corrosive Sublimate,
     Sulphate of  Iron.
     Human  Caustic.
      Super-acetate of Lead
      Inlu&ion of  Galls. 
229
Decoction of Qince Seed,  Decoctum Cydonise, is
       incompatible with

    Acids.
    Alcohol.
    Most metallic Salts.

Decoction of Oak Bark, Decoctum Quercus, is in-
       compatible with

    Alkaline Solutions.
    Mo!«t metallic Salts.
    Solutions of Isinglass.
    Decoction of Yellow Bark.

Decoction of Sarsaparilla, Decoctum Sarsaparillae,
       is incompatible with

    Lime Water.
    Acetate of  Lead.

Decoction  of Slippery  Elm, Decoctum Ulmi, is
       incompatible  with

    Alcohol.
    Tinctures in any considerable quantities.

Dried Alum, Alumen Exsiccatum, is incompatible
       with

    Alkalies.
    Carbonates of Alkalies
    Tartrate of Potass.
    Lime.
    Lime Water.
    Magnesia.
    Carbonate of Magnesia.
    Acetate of  Lead. 
                      250

Epsom Salt. Magnesise Sulphas,  is  inqprnpatible
       witn

    Potass.
    Soda.
    Ammonia.
    Subcarbonate of Potass.
    --------------Isoda.
    Lime Water.
    Muriate of Lime.
    Acetate of Lead.

Extract of Opium, Extractum  Opii.

    Carbonate of Potass.
    Muriate of Mercury.
    Sulphate of Zinc.
    ----------Copper.
    Acetate of Lead.
    Nitrate of Silver.
    Solution of Astringent Vegetables.

Extract  of Poppies,  Extractum Papaveris, is in
       compatible with

    The same as Extract of  Opium.

Flowers  of  Zinc,  Zinci Oxydum, is incompatible
       with.
    Acids.
    Acidulous Salts,
    Alkalies.

Foetid Spirit of Ammonia, Spiritus Ammonise Foz-
       tidus, is incompatible with

    The same as in Spirit. Ammonise. Arom, 
231
Fowlers Solution, Liquor Arsenicalis, is incompati-
       ble with

     Acids.
     Acidulous Salts.
     Lime Water.
     Muriate of Lime.
     Sulphate of Magnesia.
     Alum.
     Sulphate of Iron.
     Muriate of Lime.
     Nitrate of Silver.
     Sulphate of Copper.
     Sulphuretted Hydrogen and its compounds.
     Decoction of Cinchona.

 Henbane  leaves, Hyosyamus  Foliae, is incompati-
        ble with

     Super-acetate of Lead.
     Nitrate of Silver.
     Sulphate of Iron.

 Hemlock Leaves, Conii Folia,
     Its vower is greatly diminished by vegetable acidsj
     hence vinegar is the best antidote for its poison.


 Infusion of Quassia, is incompatible with

     Lunar Caustic.
     Super-acetate of Lead.

 Infusion  of Orange Peal,  Infusum Aurantu, is
        incompatible with

      Super-acetate of Lead.
      Sulphate of Iron.
      Lime Water
      Infusion of Cinchona. 
232
Infusion of Calumba, Infusum Calumbae, is incom-
       patible with
    Lime Water.
    Acetates of Lead.
    Oxymuriate of Mercury.

Infusion of Cascarilla Bark,  Infusum Cascarillas,
       is incompatible with
    The same as with Infusum Caryophyllorum and
      Infusion of Galls.

Infusion of Angustura Bark,  Infusum Cusparify
       is incompatible with
    Infusion of Catechu  and Galls.
    Solutions of the Salts of most Metals.

Infusion of Simaruba  Bark, Infusum Sj/marubaey
       is incompatible  with
    Decoction  of Galls.
    Infusion of Catechu.
    Alkaline Carbonates.
    Lime  Water.
    Salts of Lead.
    ------  Silver.
    ------  Mercury.

Ififusion of  Digitalis, Infusum Digitalis, is incom-
       patible with
    Solutions of  the Salts of Iron.
    Probably those of most other Metals.

Ipecacuhanha root and  powder of it, are incompat-
       ible with
    AH vegetable astringents as Infusion of Galls, &c.
    Vegetable  acids, particularly the acetic, weaken
      its powers. By exposure to air and light it is
      deteriorated, and long exposed, becomes inert 
23S
Kino, is incompatible with

    The Mineral Acids.
    Alkalies and their Carbonates-
    Isinglass.
    Acetate of Lead.
    Nitrate of Silver.
    Tartar Emetic.
    Super-acetate of Lead.
    Sulphate of Iron.
    Muriate of Mercury.
    Decoction of Galls.
    In fact all  those  substances  which  decompose
       tannin.

-Laudanum, Tinctura Opii, is incompatible with

     Potass, and its Subcarbonate.
     Soda, and its Subcarbonate.
     Ammonia and  its Subcarbonate.
     Most metallic  Salts.
     Infusion of Galls.
     The solution of opium in water is precipitated by
       pure ammonia ;  fixed alkaline carbonates; solu-
       tions of corrosive sublimate, lunar caustic? ace-
       tate and super-acetate of lead ; sulphate of cop-
       per zinc and iron, infusion of galls and cinchona.

 Lime Water, Liquor Calds, is incompatible with

     All Alkaline and Metallic Salts.
      Borates.
      Tartrates.
      Citrates.
      Acids.
      Sulphur.
     Spirituous Preparations.
     Infusion of Orarige Peal.
     -------—-Calumba.
      ______. Cinchona.
      ------—Rhubarb.
      i-----------Senna. 
234
     And all other astringent vegetables, carbonic acid
        throws down a carbonate of lime.

 Lime, Calx, is incompatible with

     Acids.
     Acidulous Salts.
     Alkaline Carbonates.
     Ammoniacal Salts.
     Borates.
     Metallic Salts.
     Astringent Vegetable Infusions.

 Liquor ferri  Alkalina, is incompatible with

     Water.
     Vegetable Infusions and Decoctions.
     Pure Acids.
     Alcohol.
     Alkalies.

 Liquor of Subacetate of Lead, Plumbi  Subacetatis
        Liquor, is incompatible with

     Same as Plumbi Acetas.

Liquor of Ammonia,  Ammoniae Liquor, is incom-
       patible with

     All Acids Alum, Metallic Salts, in fact with
     Saline Solutions of most Earths and  Metals,  ex-
      cept Barytes  or Lime.

Liquor of Potash, Potassae Liquor, is incompatible
       with
    Acids.
    Acidulous Salts.
    Subcarbonate of Ammonia
    Acetate of Ammonia.
    Muriate of Ammonia. 
                      2S5

    Preparations of Earths and  Metals  held in Solu-
       tion by Acids.
    Calomel.
    Corrosive Sublimate.

Liquor of Subcarbonate of Potass, Potassae Sub-
       carbonatis Liquor,  is incompatible with

    The same as with Potassae subcarb.

Logwood, Hasmatoxyli lignum, is incompatible with

    Mineral Acids.
    Acetic Acid.
    Solutions of Alum.
    Sulphate of Iron.
    ----------Copper,
    Tartar Emetic.
    Acetate of Lead.

Magnesia, is incompatible with

    The same substances as Magnesia? Subcarb. except
       Lime Water.

Mallows, Malva, is  incompatible with

    Liquor Plumbi acetatis and the other salts of lead.

Mercury with Chalk,  Hydrargyrum cum Creta, is
       incompatible  with

    Acids.
    Acidulous Salts.

Mucilage of Gum Tragacanth, is incompatible
       with

    Sulphate of Iron and Copper.
    Super-acetate of Lead ; they precipitate the muci^
      lage. 
236
Mucilage  of Gum Arabic,  (Acadae Gummi,J is
       incompatible with

    Strong acids and Alcohol.
    Sulphuric Ether.
    Compound spirit of Sulphuric Ether.
    Tincture of Muriated Iron.
    Sub-acetate of Lead.
    (Super-acetate of Lead if an alkaline salt be pre-
      sent.)
    Volatile Alkali.
    Lunar Caustic.
    And some Metallic Salts.

Muriatic Acid, Acidum Muriaticum,  is incompati-
       ble with

    Alkalies.
    Tartrate  of Potass.
    Sulphuret of Potass.
    Most Earths.
    —— Oxides.
    ----Carbonates of  the incompatible oxides.
    Tartarized Antimony.
    Tartrate of Iron.
    Nitrate of Silver.
    Solution of Subacetate of Lead.

Muriated Tincture of Iron, Ferri Muriatis  Tinc-
       tura, is incompatible with
    Alkalies.
    Carbonates of Alkalies
    Lime Water.
    Carbonate of Lime.
    Magnesia.
    Carbonate of Magnesia.
    Astringent Vegetable bodies..
    Solution of Gum Arabic, 
237
 Muriate of Ammonia, Ammoniae Murias, is incom-
        patible with

     Nitric Acid,
     Sulphuric Acid.
     Lime.
     Potass and its Carbonate.
     Carbonate of Soda.

 Muriate of  Lime,  Calcis Murias, is incompatible
        with

     Sulphuric Acid.
     Sulphates.
     Potass.
     Soda.
     Carbonate of Potass.
     -----------Soda.
         —----- Ammonia.

 Musk Mixture,  Mistura  Moschi, is  incompatible
       with

     Mineral Acids.
     Corrosive Sublimate.
     Sulphate of Iron.
     Lunar Caustic.
     Infusion of Yellow Cinchona.

Nitric Acid, Acidum Nitricum, is incompatible with
     Alkalies.
     Carbonates of Alkalies.
    Acetates of Alkalies.
    Earths.
    Essential  Oils,
    Compound  Spt. of Lavender, if there be  much
        added.
    Metals, except Platina and Gold.
    Oxides.
    Sulphate of Iron. 
238
    Solution of Acetate of Lead.
    Sulphurets.
    Charcoal.
    Phosphorus.
    Sugar.
    Alcohol and  spirits.

Nitrate of Silver, Argenti Mtras, is incompatible
       with

    Almost all Spring and River Water.
    Potass.
    Soda.
    Carbonate of Potass.
    Carbonate of Soda.
    Soaps.
    Lime Water.
    Sulphuric Acid,"!
    Muriatic Acid, Vand salts containing these Acids:
    Tartaric Acid, J
    Carbonate of Ammonia.
    Liquor Arsenicalis.
    Sulphuretted Hydrogen.
    Hydrosulphurets.
    Astringent Vegetable Infusions.

 Pomegranate Root,  Granati  Cortex, is incompat-
       ible with

    Sulphate of Iron.

 Potassae Sulphuretum, is incompatible with
     Acids which combine with Potass and expel  Sul-
       phuretted  Hydrogen Gas.
     Solution of  most of the Metals.

 Prepared Chalk, Creta Preparata, is incompatible
        with
Acids.
Acidulous Salts. 
                      239

Precipitated Sulphuret of Antimony, Antimonii Sul-
       phuretum   praedpitation,  is  incompatible
       with

    All acids and acidulous salts they increase its em-
      etics properties.

Red Oxide of Mercury, Hydrargyri Oxydum Rti-
       brum, is incompatible with
    Acids.
    Acidulous Salts.
    Sulphuretted Hydrogen.

Red Precipitate,  Hydragyri  Nitrice* Oxydum,  is
       incompatible with

    The same as with Hydrargyri Oxydum Rubrum.

Resin  and  Wood of  Guaiacum,  is incompatible
       with

    The Mineral Acids.

Rhubarb Tea, Infusum Rhei is incompatible with
    The stronger Acids.
    Metallic  Solutions.
    Some  astringent Infusions,
    As cusparia, catechu, cinchona, Galls, &c

Salix,  is incompatible with

    Solution of  Isinglass.
    Alkaline  Carbonates.
    Lime  Water.
    Sulphate  of Iron.
U 2 
240
Soap is incompatible with

    Acids.
    Acidulous Salts.
    Alum.
    Muriate of Lime.
    Sulphate of Magnesia.
    Metallic Salt*.
    Astringent Vegetables.
    Hard Water.

Spiritus Camphorse,  Tinctura Camphorae, is in-
       compatible with
    W'ater which precipitates it.

Spiritus Ammoniae Sucdnatvs, with

    Acid-..
    Acidulous Salts.
    Earthy  Salts.
    Metallic Salts.

Spirit of Ammoniated Camphor,  Spiritus Ammo-
        niae Camphorae is incompatible with

     Water.

 Spirit of Nitrous Ether, Spiritus JEtheris Nitrid,
        is incompatible with

     Sulphate of Iron.
     Tincture of Guaiacum.
     Tincture of Camphor.

 Squill Root, is incompatible with

     Lime Water.
     Alkaline Carbonates.
     Lunar Caustics.
     Acetate of Lead. 
241
Subcarbonate  of Soda, Sodae  Subcarbonas, is in-
       compatible with
    Acids
    Acidulous Salts.
    Muriate of Ammonia.
    Earthy arid Metallic Salts.
    Lime Water.


Subcarbonate of  Potash,  Potassse  Subcarbonas is
       incompatible with
    Acids.
    Acidulous Salts.
    Muriate of Ammonia.
    Acetate of Ammonia.
    Lime Water.
    Muriate of Lime.
    Sulphate of Magnesia.
    Alum.
    Tartarized Antimony.
    Nitrate of Silver.
    Ammoniated  Copper.
    Ammoniated Iron.
    Tincture of Ammoniated Iron.
    Tincture <>f Muriated Iron.
    Sulphate of Zinc.
    Calomel.
    Corrosive Sublimate.
    Acetate of Lead.
    Subacetate of Lead.


Subcarbonate of  Magnesia,  Magnesia*  SubcarbQ'
       nas,  is incompatible with

    Acids.
    Acidulous Salts.
    Muriate of Ammonia-
    Lime Water.
    Metallic Salts. 
242
Subcarbonate of Iron,  Ferri  Subcarbonas, is in-
       compatible with
    Ands.
    Acidulous Salts.

Subcarbonate of Ammonia, Ammonias Subcarbonas,
       is  incompatible  with
    All Acidulous Salts.
    Acids.
    Potass.
    Soda.
    Subcarbonate of Soda.
    ______________Potass.
    Supersulphate of Potass.
    Supertartrate of Potass.
    Lime.
       . - Water.
    Solution of  Muriate of Lime.
    Magnesia.
    Sulphate of Magnesia.
    Alum.
    Solutions of Iron, except of Tartarized Iron.
    Sulphate  of Iron.
    .---------Zinc.
    Acetate,  Sub-muriate  and Oxymuriate of Mer-
       cury.
    Acetate of  Lead.
     Subacetate  of Lead.
     Superacetate of Lead.


 Sulphate of Potash, Potassas Sulphas, is incompat-
        ible with

     Tartaric Acid.
     Barytes Water.
     Muriate  of Barytes.
     Muriate  of Lime.
     Acetate of Lead.
     Subacetate of  Lead. 
243
Sulphate  of Soda, Sodae Sulphas, is incompatible
       with
    Subcarbonate of Potass.
    Solution of Barytes.
    Barytic Salts.
    Muriate of Lime.
    Nitrate of Silver.
    Acetate of Lead.
    Subacetate of  Lead.

Sulphate  of Magnesia, Magnesise Sulphas, is  in-
     compatible with

    Muriate of Ammonia.
    Barytes.
    Lime.
    Nitrate of Silver.
             - Lime.
     Sub-acetate of Lead.
     Super-acetate of Lead.
     Fixed alkalies and their carbonates, lime-water;
       these precipitate from it magnesia and  the car-
       bonate of magnesia.  The  volatile alkali forms
       with it a  triple  compound precipitating at the
       same time,  a portion of magnesia.

Sulphuric Acid, Acidum Sulphuricum is incompati-
       ble with

     Alkalies.
     Alkaline Carbonates.
     Some Earths.
     Some Earthy  Carbonates;
     Solution of Muriate of Lime.
     Barytic Salts.
     Most Metals.
     ---- Oxides of Metals.
     Solution of Acetate of Lead. 
244
 Sulphate of Copper, Cupri sulphas, is incompatible
       with

    Alkalies and their Carbonates.
    Earths and their Carbonates.
    Acetate of Ammonia.
    Muriate  of  Lime.
    Acetate and Super-acetate of Lead.
    Sub-borate of Soda. (Borax.)
    Tartrate of  Potass.
    Nitrate of Silver.
    Corrosive  Sublimate.
    Acetate of Iron,
    All astringent vegetable tinctures and infusions.

Sulphate  of Iron, Ferri Sulphas,  is incompatible
       with

    Potass.
    Soda.
    Ammonia.
    Carbonate of Potass.
    Carbonate of Soda.
    Barytes.
    Salts of Barytes, and
    ------Strootia.
    Strontia.
    Lime  Water.
    Muriate of Lime.
    Soaps.
    Nitrate of Silver.
    Acetates of  Lead.
    Astringent Vegetable bodies.

Super-sulphate of Potash,  Potassas Supersulphas,
       is incompatible with
    Alka'ies.
    Ea.ths.
    Cat Donates of Earths.
    Most  Metals.
    ----  Oxides. 
245
Tamarinds, Tamarinda Pulpa. is incompatible with

    Tartrites and Acetates of Potass and Soda.
    The resinous Cathartics.
    Infusion of Senna.


Tartar Emetic, Antimonium Tartarizatum, its so-
       lution  is incompatible with
    Alkalies.
    Alkaline Carbonates.
    Some Earths.
    Lime Water.
    Muriat:; of Lime.
    Some Metals.
    -     Oxides of Metals.
    Acetates of Lead.
    Infusions  of Cinch jna.
    ——------ Rhubarb.
    ■----------Catechu.

Tartarized Soda, Soda  Tartari%ata, is incompati-
       ble with
    Most Acids.
    Most Acidulous Salts, except Supertartrate  of
       Potass.
    Barytic Salts.
    Salts of Lime.
    Acetate of Lead.
    Subacetate of Lead.


Tartaric Acid, Acidum Tartaricum,  is incompati
       ble with
    Alkalies.
    Carbonates of Alkalies.
    Salts of Potass.
    Most Earths.
    ----Carbonates of Earths
    Salts of Lime.
    -— -— Lead. 
S46
 Tincture  of Guaiacum,  Tinctura  Guaiaci, and
        Volatile T incture of Guaiacum,  Tinctura
        Guaiad Ammon: are incompatible with

     Oxvmuiiatic Acid.
     Nitrous Acid.
     Spirit of Nitious Ether.


 Tincture  of Ammoniated Iron, Ferri Ammoniati
        Tinctura, is  incompatible with

     The same as with Ferrum Ammoniatum.


 Tormentil Root, Radix Tormentillae, is incompati-
       ble with

     Solution of Isinglass.
     Salts of Iron.
     Alkalies.
     Alkaline Earths.


 Valerian Root, is incompatible with

     The Salts of Iron.


Wine of Iron, Vinum Ferri, is incompatible with

     The same as Ferri Muriatis Tinctura.


White Vitriol,  Zind Sulphas, is incompatible with
     Alkalies.
    Alkaline Carbonates.
    Lime Water.
    Hydrosulphurets.
     Astringent vegetable Infusions.
END OF VOL. I.