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       (X

          A  TREATISE

            ON THE USE OP

9*u*0f «tc 0f grow,

    (Or, PRUSSIAN BLUE,)
                            i
                IN

  INTERMITTING AND REMITTING FEVERS
      BV WILLIAM ZOLMCXOFFBR, M. D,
               ' ' '
Licentiate in Medicine and Surgery; Member of the Med.
 cal and Chirurgical Faculty of Maryland ; Honorary-
 Member of the Society of Natural Sciences of St. Gall,
 Switzerland; and of the Medical Society of Maryland,
 and of the Baltimore Medical Society; and formerly one
 of the Attending Physicians to the Baltimore Genera*
 Dispensary, fkc.
&&^£c^>~
" Experience, whithis constantly contradicting Theorv, is f i
   surest test of Truth."             ^

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PRINTED BY SAMUEL BARNES
1822. 
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TO
    Baron Caspar Tobias \on ZoWickoi-

        fer not* A\teiik\mgeu, 3VL D.

                PRESIDENT

                   OF THE

       ^ocietg oC mtttval Sciences

                    OF

          St*<£all, SUM* tvim*;

     This Treatise upon the use of Prus*
     siate of Iron, is most  sincerely and
     respectfully dedicated, by  his friend
     and relation,
              WILLIAM ZOLLICKOFFER, M. D.

      HO L 3 /£


[1715! 
I  , 
pwdlce*
     THE object thr.t I have in view, in presenting the i*Ie
 Jical public with the virtues of the article which is the sub-
ject of this  treatise, I  trust  arises from the influence of
motives of the greatest interest toward humanity.

     That this remedy will at first meet with many oppo-
nents to its general introduction, I am well aware of, know-
ing that all new discoveries  have, with considerable diffi-
culty at first, overcome the. unfavourable opinions respect-
ing their utility, as applicable to disease ; but with these,
I am confident, it  will eventually shine more biilliantly in
the  list of valuable remedies in the Materia Medica  than
the justly esteemed, and very celebrated Cinchona officin.

     All I have to ask respecting this subject is, that such
as have an opportunity of perusing  the following pages,
will, without prejudice or partiality, enter into a rigid in-
 vestigation of the  virtues that have been ascribed to it, that
they may be fully  satisfied of the correctness of the state-
ments  that have been made.
i. 2 
 
A TREATISE
                 ON THE USE OF

       jslvuftsfate  oC  Kton5
             (Or, PRUSSIAN BLUE,)
                     IN
    INTERMITTING AND REMITTING FEVERS.

    COEVAL with the discovery of manufac-
turing the Prussiate of Iron for the purposes of
art, it has been to the present period, considered
as possessing certain deleterious properties, that
rendered its use as a medicine internally exhi-
bited, altogether inadmissible,  and productive of
the most fatal consequences.

    It  has, and is at present considered by lim-
ners, to be a paint of much value,  by combining
it in certain proportions with other substances:
but as  an article worthy of regard and attention,
on account of its application as a medicine, calcu-
lated to alleviate the sufferings of fallen  huma-
nity, induced by disease, it has never been known.

    The cause  which gave rise to the present
existing prejudices unfavourable to the U6e of this 
8
 dubstanee, I cannot in any way satisfactorily ac-
 count for: though  I am led to  conclude,  that
 they have originated from the circumstance of the
 Prussic acid being an article that enters into the
 preparation  of this compound,  possessing such
 activity, as when inhaled in a gaseous form, and
 the gas thu? inspired coming into contact with the
 lungs of small animals extinguishing life almost
 instantaneously,  together with its aqueous solu-
 tions when  taken into  the stomach proving an
 immediate poison, and in the generality of cases
 attended with fatality.

     The Prussic acid, though perhaps ranking
 among the most powerful poisons, has,  within a
 very  few years past, attracted the attention of
 the Medical profession :  and it is  at present, by
 many who are in the constant habit cf employing
 it, considered  a medicine of much value  in  »he
 treatment of affections  of the  Thorax, particu-
 larly Phthisis Pulmonalis.  This  as well as ma
 ny other extremely poisonous articles belonging
 to the class of narcotics, is administered in verj
 small doses, so  that  it  cannot be  considered as
being more productive of serious  consequences,
when judiciously exhibited, under circumstances
favourable to  its  use, in  quantities  sufficiently
small,  to  prevent the unpleasant  effects that
 would arise  from an over dose,  than the  Mur
 Hyd. Cor. the Arsen. Alb. Opium, Datura Stra- 
y
moniuni, Rhus Toxicodendron, Cicuta, and very
many remedies now in use in practice, and em-
ployed with perfect safety.  But was the Prussic
acid of such a nature as to render it impracticable
to give it in  the  smallest quantity imaginable,
under circumstances of the most unfavourable
nature ; it certainly would be unphilosophic in the
extreme, to conceive that the Prussiate of Iron
should partake in any degree of the properties of
the acid  in its uncombined and freed state from
its metalic basis.

     Our knowledge of Chemistry, and the vari-
ous changes which bodies undergo, in consequence
of the laws of chemical affinity, to which all bodies
are  subject, when brought  within the sphere of
this action, forming an  entirely  new compound,
differing from either of the constituents in their
simple and uncombined state, and of assuming
new properties peculiar tr» itself, ought to disco-
ver to every dispassionate and reflecting mind,
the  absurdity of drawing conclusions, either fa-
vourable or unfavourable respecting the powers
of any remedy, though the articles that enter into
its composition, may, in their uncombined state,
possess the most destructful qualities, that would
render their use highly improper.  It may not be
unnecessary by way of establishing  this position,
merely  to adduce  the  few following  cases, by
which the reader, if unacquainted with the prin- 
10
ciples of the delightful science of Chemistry, will
become convinced of the propriety of the position
which has been taken.  Muriatic acid and Quick-
silver  are very simple substances ; the  former
may, in a sufficiently diluted state with water, and
rendered agreeable with the addition of loaf sugar,
be taken  as a  cooling drink; the latter can be
taken into the stomach without  occasioning any
inconvenience;  but bring them into contact, under
circumstances favourable  to  their union, and a
compound body will be obtained, that will be
found upon examination, to differ very materially
from  either  of the articles prior to their being
affected by this  change: a muriate of mercury will
be discovered to be the result of this combination j
an article that  cannot  be  too cautiously used in
medicine on  account of its very great activity.
Similar results will be obtained with the Nitric
acid and Quicksilver, Acetic acid and Lead,  Sul-
phuric acid  and Zinc,  Nitric acid and Potash.
In each of these cases, a very considerable change
is brought about in consequence of the virtue of
chemical affinity.

    But upon the other hand, it may be supposed
by many, that the Prussiate of Iron is altogether
harmless ; though when taken into the stomach,
it may there undergo a decomposition, and conse-
quently be productive of the most alarming and
distressing consequences, as the Prussic acid will 
11
then become freed from the body to which it is
united, and again assume all the noxious qualities
peculiar to it in an uncombined state: this opinion
will soon be laid aside by giving the article a trial
in two or three instances, by way of experiment.
However the number of cases in which it has been
repeatedly given without any unpleasant symp-
tom succeeding its use, will in their proper places
be  hereafter noticed, which will be sufficient to
establish its mildness.

    The circumstance that first led me to the dis-
covery of the invaluable virtues of the Prussiate
of Iron, as a remedy of very  great importance,
and worthy of the particular regard and attention
of practising physicians generally, was such as
might be supposed scarcely entitled to notice, but
not unfrequently occurrences  apparently unwor-
thy of the slightest observer, become of the most
interesting and important nature to mankind.

    In the latter part of the summer and fall of
1821,  more cases of intermitting and  remitting
fevers claimed my attention, particularly among
children under two years of age, than I recollect
seeing, during an extensive practice,  since I first
entered into the  laborious and arduous duties of
the profession.  And these kind of patients claim-
ed my peculiar sympathy, regard and attention, in
consequence of my being fully aware of the exist- 
13
ing difficulty of treating them successfully; should
the disease not yield to the free and discretionary
use of emetics and cathartics, inasmuch as I was
confident that Barks could not, in the generality
of cases, be given in doses suitably large, to pro-
duce its revolutionizing effects upon the system,
from the circumstance of the exceedingly unplea-
sant and peculiar taste  accompanying its internal
exhibition, which I knew to be a very frequent
cause of their being refused by the little sufferers,
and if taken into their extremely  delicate sto-
machs, of their producing irritation and causing
them to be rejeeted.  And being thus situated for
want  of  remedy equally prompt and effectual,
with the  Cort. Peruvi. by  which  I might, with
perfect ease, controul the unruly and  distressing
paroxysms of intermitting and remitting  fevers;
and supposing that nature  was not so limited in
her gifts as to have provided but one remedy, and
that from the vegetable kingdom, for the removal
of a disease so general as the one under present
consideration, I concluded, r.fter reflecting upon a
number of articles that might be supposed, though
they had never been recommended, to be produc-
tive of some practical utility, to give the Prussiate
of Iron a fair trial.  I had at this time seven cases,
in which I exhibited this remedy, and the result of
which exceeded  my most sanguine  expectations ■
for five out of the number were relieved, without
being subject to an attack of the disease for some
 rime. 
18
    The sulphate and carbonate of Iron  have
long since been  noticed by most writers on the
Materia Medica.  These articles certainly pos-
sess virtues, as medical remedies, that render them
worthy of attention, and  deserving of a place
which they have obtained in the  list  0/ tonics 2
though from experience, I can boldly assert, that
neither of them can be considered of the least im-
portance, in a practical point of view, when com-
pared to the Prussiate of Iron.  The two former
articles, as tonics, are slow in producing the effects
peculiar to this class of remedies, upon the human
system, and from this  circumstance, the result
arising from their administration, is seldom visible
under two or three days: neither  have I found
either of them competent to the cure of intermit-
ting and remitting fevers.  The Prussiate of Iron
in this respect, differs very materially from  these
preparations, in  being more certain, prompt and
effectual, in fortifying the subject of this distress-
ing malady against  the return of  future parox-
ysms.

    The oxide of arsenic exhibited  in the form of
the Sol. Arsen. Fol. Min.is an article that is high-
)y prized by many practitioners, on the account of
its supposed superiority  as  a  remedy,  over all
others, in the treatment  of intermittents.  The
utility of this compound cannot be doubted; al-
though the consequences resulting from its inter-
           B 
14
nal exhibition are not unfrequently of such a na-
ture as to  render the further use of medical aid
essontially necessary, in order to relieve the pati-
ent from a partially diseased state, that has been
brought on by giving it in doses rather large, as
likewise  by continuing its use for too  great  a
length of time, without occasionally  suspending
it.  Another inconvenience occurs, which would
appear to be an objection to its use under all cir-
cumstances, and that is, of administering it to the
more illiterate class of society, many of whom are
of the opinion, that if a small quantity of a medi-
cine is calculated to be beneficial, that an increas-
ed proportion must be productive of the most cer-
tain and happy effects: and by this mode of false
reasoning, they are induced to give as  much more
(out of the phial that may be left them) as their
judgment may, on the occasion, influence them to
conceive necessary, without having any reference
to the rule prescribed by the physician for their
observation.  Every practising physician of expe-
rience in the profession must certainly be well
acquainted with this circumstance, inasmuch as
they have, from time to time, in paying their visits
to the class of people alluded to, discovered this
disposition.

     The Prussiate  of  Iron, which is  recom-
mended  in this disease, cannot be objected to on
'his account, inconsequence  of its mildness, and 
15
 indeed, it is perhaps more so than any other reme-
 dy of equal power, with  which the present im-
 proved and considerably enlarged state of the Ma-
 teria Medica acquaints us. It is far more certain,
 and better adapted  to the treatment of intermit-
 tents, than arsenic under any form : and  it pos-
 sesses an advantage with this article,  in any pe-
 riod of the disease, being a suitable time for  its
 administration; though it has never been produc-
 tive of nausea even in one solitary instance, where
 the stomach would not receive, without becoming
 irritated, every other remedy.  I have merely to
 observe in closing this part of the subject, that it
 is hoped, that those who are in the constant habit
 of using of arsenic will, at least, if not continue
 to use the Prussiate of Iron, give it a few trials,
 in order to test the  superior and decided  advan-
 tages that it has been stated  to possess over this
 article.

     Of all  remedies recommended in intermit-
 tents, none has been so generally employed as the
 different species of  the interesting genus,  Cin-
 chona: particularly the Cortex (or  bark) of  the
 Cinchona Lancifolia, the  Cinchona  Cordifolia
and the Cinchona Oblongifolia.   These different
species of bark* are supposed by many practition-
   * This medicine is noticed by different authors under
various common and local appellations, such  as Kinkina,
Kipa Kina, Chinchina, Quina Quina, Chinachina, Gentiana
Indies., Jesuiticus Pulvis, Jlntiquartium Peruvianum, (Jc. 
16
ers to contain specific properties, which give them
a decided superiority over the generality of tonics
in this disease ; and as such has, for a very consi-
derable length of time, claimed the  particular
regard and attention of nearly all, who have gone
through an academic course of  studies, and have
afterwards arri fed to a  state of pre-eminence in
the medical profession ;  but although it has justly
claimed the notice of the wisest and most distin-
guished of physicians, both in Europe, as well as
throughout  the  vast extensive territory  of  the
United States, it cannot but be considered as pos-
sessing three very great disadvantages. The first
consists in its taste being exceedingly unpleasant
and nauseating, combine it with other articleB as
we may, in order to cover its unpleasant and pecu-
liar gustation, and thereby endeavour to render it
more palatable.  The second, and a much more im-
portant objection to giving it, particularly in sub-
stance, is, that some stomachs will not bear it, from
the oppression, and even vomiting which in these
cases it excites.  The third, and last inconvenience
arising from its internal administration is. that of
the impossibility of giving it in  any stage of inter-
mittents, t"he apyrexise only excepted.  The disad
vantages may not be very sensibly experienced, in
consequence  of the long accustomed use of it in
practice, which so frequently occurs either in one
instance o* the other, as on every occasion to pre-
pare the mind for thereception of such information
as may be unfavourable to its administration. 
17
     It may by many be supposed that I am taking
 rather an unwarrantable  position,  when  I bring
 before the public these objections at this remote
 period, from the introduction of the use of Barks.
 as an inestimable remedy, calculated to subdue the
 most distressing attacks  of intermitting  and re-
 mitting fevers j but the principal object I have in
 view at present is,  to contrast the advantages of
 the Prussiate of Iron to this celebrated and much
 esteemed remedy.   That  Barks,  as an article de-
 serving of the regard and attention of every phy-
 sician,  is a valuable medicine in a number of dis-
 eases to which mankind are subject,  I am bound to
 acknowledge; though  I cannot for a moment sup-
 pose, that it possesses one advantage, but on the
 contrary, several disadvantages, to the use of the
 Prassiate of Iron in the diseases under considera-
 tion. The Prussiate of Iron is a remedy of very
 great importance, and which has, in  my  hands,
 been productive of the  most salutary effects in the
 diseases upon which I have treated.   With this
 article I have been enabled to subdue the most
 contumacious  and wearisome intermittents; cases
 that had for a very considerable time, resisted the
 use of the Barks ;  and  which yielded to the inter-
 nal administration of this remedy in a very few
 days ; though  I have, in one or two instances, em-
ployed the Barks advantageously when the Prus-
 siate of Iron  had failed:  but more  frequently
found it necessary to resort to the use of this arti-
            b 2 
18
 cle, and that with the most decided success after
 the exhibition of the celebrated Cort. Peruv. had
 proved unsuccessful.

     The Prussiate of Iron possesses the follow
 ■ ng advantages over the Cinchona ojficin. as a re-
 medy in intermitting and remitting fevers:
   First.  It is void of taste, and may therefore be
 much  more  readily exhibited, than the  Pulv.
 Cinch, qffin.  which, to some, is extremely unplea-
 sant.
   Secondly. It may be given in every stage of the
 urease ; while the administration of Bark is con-
 fined to the apyrexiw.
   Thirdly.   The dose is much smaller, being from
 four to six grains twice or thrice in twenty-four
 hours ; or at morning, noon and at night:  while
 Bark, to  be effectual,  must  be  given  in  much
 larger doses.
   Fourthly.  It never disagrees with the stomach,
 or creates nausea, even in the most irritable state
 of this viscus: while Bark is not unfrequently
 rejected.
   Fifthly  In its effects as H remedy calculated
 to prevent the recurrence of future paroxysms, it
 is  more certain,  prompt end  effectual than  the
justly celebrated  cort. peruvian.
   Sixthly, and lastly. A patit nt treated with this
 article will recover from the influence of intermit-
 ting and  remitting  fevers, in the generality of 
19
oases, in .much less time than is usual in those
cases in which Bark is employed.  In making use
of the Prussiate of Iron as a remedy in disease,
care must be taken to select that which is of a very
dark blue, approaching to a black, having a shin-
ing coppery  fracture, and adhering firmly to the
tongue.

    The following cases are adduced in evidenee
of its efficacy in the diseases mentioned :
                   Case 1.
    On  the 4th of August, I was called to visit
Mr. P---->s lady, who, upon examination, I found
to belabouring under the tertian  form of inter-
mittent  fever.  This lady had, a-few days previous
to my visit, taken an emetic, which was succeeded
by a dose of the sub  mur.  hyd> and shortly after
followed by a small dose of ol. ricini.  Under these
circumstances, 1 thought it advisable, inasmuch as .
the stomach and bowels had been freely evacuated,
to prescribe the use of the prussiate of iron, which
1 directed to be taken morning and evening in a
little sugar and water.  I left sixteen grains, di-
vided into four doses*f she  commenced taking the
first^owder on the morning intervening the dis-
ease, and had taken three powders before the time
in which she expected the return of the paroxysm:
but no symptoms of the disease occurred.
                  Case  2.
    August the ith:  I'pon this day the case of a 
20
 ehild came under my care. The disease was of the
 quotidian type, under which it had been labouring
 for eight days.  I left a small  dose  of mur. hyd.
 mit. which operated sursum et  deorsum freely ;
 after which I ordered one powder of the prussiate
 of iron to  be given every three hours during the
 apyrexise.  The child had taken but four powders
 when the affection disappeared;  and it remained
 hearty for four weeks.
                   Case  S.
     August the Sth.  I was called upon to visit
 Miss H----n, who I found affected with the inter-
 mittent fever.  I left her a dose of sub. mur. hyd.
 cum. jallapa, which I directed to be taken in a
 small quantum of syrup, "simp, and  its operation
 to be facilitated by drinking any simple tea.  After
 which  I ordered one powder of the prussiate of
 iron, containing four grains each, to be taken twice
 a day, in a little sugar and water.  By the time she
 had taken five powders the disease left her.
                   Case 4.
     August the \Qth.  Mr. P—«-'s son had been
 affected with the disease of the quotidian form for
 several  days.   I gave him a dose of the sub. mur.
hyd. and after its operation had  ceased,  directed
 one powder of the prussiate of iron, to be  given in
 a small quantity of milk every three hours during
 the apyrexiae.  He had taken but four of the pow-
 ders when he became  perfectly relieved, and re-
mained in the enjoyment of health for sometime 
2i
                    Case  5.
    . August 17th.  I left Mr. P----'s child (who
 was labouring under feb. interm. and whose bow-    /
k els had been freely evacuated, and had been taking
 the barks  in considerable quantities, but to no
 effect) several  powders of  tie prussiate  of iro»j
 and directed one to be taken morning and evening,
 in sugar and water.  It took them all without any
 benefit resulting from their administration.  From
 this case, it will be peiceived, that neither, the
 bark nor the prussiate of iron had any effect upon
 the disease.
                    Case 6.
      Augtist 19th.   Visited Mr. J----n's  child,
 which I found affected with feb. intermittens, and
 to which I ordered a small dose  of the pulv. rad.
 rhoci to be taken in a small quantumof syrup, simp.
 and which was  succeeded  by the internal use of
 six powders of the  article that  is the subject of
 this paper, but without any visible effects.
                    Case  7.
     September 10th. This day saw Mr. P----e's
 ;hild; I gave it a  dose of sub.  mur. hyd. which
 operated freely ; after which I directed one pow-
 der of prussiate of iron, to be given morning and
 evening. The child had taken but four  powders
 when it  obtained relief.
                    Case  8.
     September \§th. Mr. II----y had two chil-
 dren who Mere for some consider'' 1<V time labour- 
23
ing under the influence of this distressing malady
I left both of them cathartic medicines, which ope-
rated satisfactorily.  I  afterwards  left each of
them eight powders of the prussiate of iron. One
of them became perfectly relieved, and the disease
in the other case merely assumed the postponing
form.
                   Case 9.
     Miss D----e I was called upon to visit about
the middle of September.  Upon paying my first
visit she appeared to be but triflingly indisposed;
being apprehensive of her suffering from an at-
tack of the then prevailing epidemic, I prescribed
an emetic, which was succeeded by a dose of calo-
mel.  Upon nay second visit, 1 found her unfortu-
nately  much worse, for  by this time she was la-
bouring under a high grade of bilious intermittent
fever.  I  kept her bowels  free,  and during the
apyrexiae ordered a teaspoonful of the best barks
to be given every three hours, which she continued
to use for  four  days, without experiencing any
benefit. After  this I concluded to  give my new
remedy a trial.  She commenced its  use, and was,
after this,  saved from suffering the recurrence of
another paroxysm.
                  Case 10.
     Mr. B----h had been  sick during the course
of the summer, of feb. intermittens.  This gentle-
man had taken  emetics repeatedly, succeeded by
the use of cathartics of various kinds; he had 
S3
likewise been in the constant habit of using barks
in large quantities : and as he observed, " he had
taken almost every thing he had heard of, and that
had been recommended to him," without his expe-
riencing any alleviation.  I left him four powders
of the prussiate of iron, each containing six grains,
and ordered one to be taken morning and evening:
when he became perfectly relieved, and has never
since had a return of the disease.
                  Case 11.
    Mr. J----'g son, aged  fifteen years, was sick
0/ intermitting fever four weeks. I gave him an
emetic  of  Euphorbia  corollata,  (or  coralloid
spurge,) which was followed by a dose of sub. mur.
hyd. cum. pulv. jallap ; afterward I ordered one
powder of the prussiate of iron  to be given, morn-
ing, noon, and at night.  This case recovered after
having taken but six doses.
                  Case 13.
     September 20th.  I was requested to visit Mr.
S----h's child, whom, upon examination, I found
to be labouring under feb.  intermit, of the  quoti-
dian form.  I ordered a cathartic of sub. mur. hyd.
and afterwards directed one powder of the prus-
siate of iron, containing two  grains each, to be
given every four hours.  The child had taken but
eight, when it became relieved of the disease.
                  Case 13.
     Upon this day I was also called to visit the
case of a Mr. S----s, who was affected  with n 
24
double tertian.   I gave him an emetic of Euphor-
bia corollata, which operated freely, and directed
a cathartic of sub. mur. hyd. cum. pulv. rad. podo-
phyllum peltatum, to be taken in two hours after
the operation of the emetic had ceased; after which
I ordered one powder of the prussiate of iron to be
taken morning, noon, and at night, in sugar and
water.  But nine powders were taken when the
disease disappeared.
                    Case 14.
     September 21 st.  This morning  a messenger
came, requesting me to  visit Mr. D----n.   This
gentleman was  affected with a bilious intermitting
fever of considerable violence.  I gave him three
pills, composed of mur, hyd. mit. gum. aloes and
pulv. rad. conv. jallap: these operated  to my satis-
faction.*   I then directed one powder of the prus.
ferri to be taken every four hours.  This case was
relieved after six powders had been taken.
                    Case 15.
     A labouring man applied  to  me, who stated
that he had been affected for some time with the
ague, and that  he had taken several purgatives, as
    * Venesection, sohighly recommended by some writers,
[ have occasionally, when the inflammatory symptoms ran
very high, had recourse to ; but I must acknowledge, from
ieveral years experience in the treatment of intermittents,
♦hat I have rarely found any advantage to be derived from
 t; but to the contrary, I have been led  to conclude, that
. l every case, with the exception of two or three, venesec-
tion was calculated to cause the disease to assume rather a
•retracted form. 
25
well as barks, but to no effect.  I gave hi a* eight
powders, and requested him to take one morning
and evening. He became relieved by the time he
had taken them all.
                  Case 16.
    Jacob B---y expressed a wish to have some
thing that would relieve him from this disease   I
gave him a large dose of sub. mur. hyd. cum. pulv
rad. podophyllum peltatum, which  operated sur-
sum et deorsum. This case was relieved after hav
ing taken ten powders.
                  Case 17.
     September 2\th.  I find in my note book, the
case of a person who had laboured under the dis-
tressing malady under consideration, for upwards
of six months, without any intermission.  Purga-
tive medicines, he stated, he had taken not unfre-
quently, and barks, and many other preparations
of the kind, in considerable quantities.  He had
laboured under its effects until he became reduced
to a mere skeleton.  I concluded that the admini-
stration of  a cathartic in this case was altogether
unnecessary, in consequence of his bowels having
been so frequently evacuated ; consequently, I  or-
dered one powder of prussian blue, to be taken
morning and evening.  This unfortunate sufferer
was relieved in four days after, and has since  in-
formed me, that he had enjoyed good health to the
 present time.
            C 
26
                  Case 18.
    September 26th.  Mr. S----y applied to me,
with a view of obtaining something  for his  little
girl: she had the tertian form of the disease.  I
gave her a cathartic, and afterwards ordered one
of the powders to be given three times during the
course of twenty-four hours.  This little girl had
taken ten, but to no purpose; for the disease, in-
stead of yielding, assumed the anticipating form.
I afterwards gave her barks without any visible
effects. The disease after this became a quotidian.
                   Case 19.
    This morning I visited Mr. A----m, who was
labouring under the disease under consideration.
I  ordered a cathartic of rad. pod. peltatum, and
requested him to take one powder of the prussiate
of iron three times a day.  He  continued their use
for three days, without receiving any benefit. This
case was afterward relieved by the use of the bark.
                   Case 20.
     October Mi. A gentleman called upon me
this morning. He rode fourteen miles (as he said)
with a view of obtaining  something that would
afford  him relief from an intermitting fever of
 some considerable standing.  I gave him a powder
 of calomel and jallap, which I  ordered him to take
 as soon as he arrived at home, and requested him
 to facilitate its operation by drinking freely of cof-
 fee, or any simple tea; and ordered the use of one
 powder of the prussiate of iron, containing six 
a*
grains, to be taken in a little milk, every four
hours. He became perfectly relieved without ever
suffering from another attack.
                  Case 21.
     October 6th.  My attention to-day, was called
towards the case of a child, two months of age.
It appeared from what I could  observe, from the
sufferings of this babe, that it was labouring under;
a remitting fever of considerable violence. In con-
sequence of  its having taken several times of the
ol. ricinii, I  thought it unnecessary to give it an;
other medicine to  evacuate the bowels,  but con-
cluded to prescribe the use of the prussiate of iron.
I commenced by giving a powder, containing one
grain each, every morning, noon,  and night.  The
child had taken but three of them  when the dis-
ease assumed a distinct  intermittent  form, of
which it was relieved in three days from the time
it first commenced the use of this remedy.
                  Case 22.
     October 7th.   Mr. ---- stated to me, that he
was affected with the ague, and  requested that  I
would give him such medicine as I supposed would
afford him some relief. I prescribed a dose of sub.
mur. hyd. and ordered it to be followed by the use
of an ounce  of ol. ricinii, and gave him ten pow-
ders, with  directions to take one twice a day,
morning and evening.  He had taken but eight.
•vhsn he experienced relief. 
ses
                  Case  S3
     October 10th.  A case of the quotidian form
of the disease under  consideration,  claimed my
attention.  I administered an emetic, and directed
it to be succeeded by the use of a dose of calomel;
and ordered one powder of theprussiate of iron, to
be taken twice a day, which afforded relief to the
subject of this distressing malady.
                  Case 21.
     October \2th.  A case of the quartan form of
the disease  came under my notice,  which took
eight powders during the apyrexiae, and was pre-
served from the attack of another paroxysm.
                  Case 25.
     October \3th.  To-day I called to visit a pati-
ent,  whom I directed a few days ago, to take  a
dose of calomel  and jallap, and use, according to
the directions left him, the  prussian blue ; from
which he received much benefit.
                  Case 26.
     October 20th.  The case of a gentleman, who
had been subject to an intermitting fever for some
time, this day claimed my attention.  He stated to
me, that the use of barks at first removed the dis-
ease, which generally returned in eight or ten days
after; and expressed a wish, that I should, if I had
it within my  power, give him something that
would not only afford him temporary relief, but
prevent him from suffering  from another attack
rr the disease, as he was apprehensive of its return- 
29
ing in a few days, provided he might experienee
relief.   1 gave him fifteen powders of the  prus-
siate of iron, which relieved him ; and he has ne-
ver since been troubled with this distressing ma-
lady.
                   Case 27.
    Mr. J----n applied to me for such remedies
as I thought proper to give him.  I ordered a ca-
thartic of calomel and jallap, with the use of the
prussian blue, but without an effect resulting
from its administration. This individual was after-
wards relieved by the use of bark.
                  Case 28.
    A case of the disease under consideration, of
a Mrs. S----r, was relieved by the use of six
powders of prussian blue.
                   Case 29.
    October 25th. This day I 6aw a Miss P----tt,
who was labouring under a double tertian.  I or-
dered a dose  of sub. mur. hyd. which  was  to be
succeeded by the use of the ol. ricin. and left seve-
ral powders of the prus. ferri, with directions how
to use them.  This case was relieved after suffer-
ing from an attack of one paroxysm.
                   Case 30.
    October 30th.  A gentleman called upon me
this morning, and stated thaj his child  (six  years
old) was affected with the ague and fever, which
occurred every other day.  I gave him a cathar-
tic, with directions how to use it-,  I  likewise re-
            c 2 
30
commended the use of one powder of the prus-
siate of iron,  three times a day.  The  child com-
menced taking the medicine immediately after
the fever had passed off, and never had a return
of it-
                  Case 31.
    November 2d.  My attention was  this morn
Ing called to the case of a child, four years of age,
whom I found, upon making the necessary exami-
nation, to be labouring under a remitting fever.
To thi s child I prescribed a dose of the sub. mur.
hyd. which was ordered to be succeeded by the
use of the ol. ricin. I left ten powders of the prus-
siate  of iron,  with directions to take one, three,
times  during  the  course of twenty-four hours.
This  little sufferer became relieved by the time
eight  of the powders had been given it.
                  Case 32.
    Upon the same day, a case of intermitting fe
ver claimed my attention, which was  relieved by
the use of this remedy, after the  stomach and
bowels had been freely evacuated by the use of an
emetic (of Euphorbia  corollata*) and a cathartic
of sub. mur. hyd. cum. pulv. rad. podophyllum pel-
tatum.
    * For a knowledge of the virtues of this  article, I beg
leave to refer the reader to a work which I wrote, and pub-
lished in 1819, entitled " A Materia Medica of the United
States, &c."—toUo 39. 
3*
                  Case 33.
    November 3d.  I was called upon  to visit a.
j\lr# A——c, who was, and had been affected with
aremitting fever for eight days previous to my see-
ing him.  I gave him a cathartic of sub. mur. hyd.
cum. pulv. rad. pod. peltatum, which operated sur-
sum et dcorsum,  and left twelve powders of the
prussiate of iron, one of which I directed to be
taken three times a day; which relieved him effec-
tually.
                   Case 34.
    This day I saw Mr. C----r, and directed an
emetic of antim. tartari, and likewise ordered a ca-
thartic of sub. mur. hyd. et pulv.rad.conv. jal. and
I left ten powders, with  directions how to use
them ; which afforded this gentleman relief.
                   Case 35.
     November bth.  A case of intermitting fever
 claimed my attention, which was relieved by the
 use of the prussiate of iron, after barks  had been
 taken for some time without any effect.
                   Case 36.
     A gentleman who had been affected for some
 time with this disease, was relieved after having
 taken several powders of the prussiate of iron.
                   Case 37.
      November 5th. This morning I saw a case of
 the intermitting form.  I gave an emetic, which
 was followed with the use of a cathartic ; and or-
 dered  one  powder of prussian blue to  be taken 
32
every three hours, which had the effect of causing
the disease to assume the postponing form.
1822.
     July.  During this month ten cases of feb.
interm. claimed my attention; six of which assum-
ed the tertian type, and the remaining four that
of the quotidian.  Four of  this number were re-
lieved, after the bark had been exhibited unsuc-
cessfully, by the use of the prussiate of iron. Three
recovered by taking  it alone. Two the bark re-
lieved, when the prussiate of iron had  no effect:
and the remaining one neither the bark nor this
remedy appeared to do any good.
                 ERRATA.
Page 9—6 lines from the top, read "favourable," instead of
             " unfavourable."
    17—12 lines from the top, read " as," instead of «• is."