REPORTS OF THE - .-***«»• OF THE CITY OF NEW-YORK, ON NOSTRUMS, OR SECRET n$BDI6IBf£S: PART I. ■' • ubjcct, as it would be humiliating to confess our utter ig- norance ; thus much however may be very safely asserted on this point; that when we can discover an article of the materia medica, which will furnish to the circulation a stimulus analogous to that presented by ardent spirits, which shall not produce inebriation, we may congratulate ourselves on having found an antidote. A remedy of this kind is still a desideratum, and it is very certain that un- less our enquiries are conducted on principles derived from the pathology of the immediate effects of drunkenness, it will so continue. As it respects the medicine of Cham- bers, there can be no doubt, that with the exception of its extravagant pretensions, and the confidence with which they are urged, there is in it nothing new. Not more than two years ago, a nostrum of a similar character, promising similar success, was offered on sale at New-Orleans, by a French gentleman called L'Oiseau; the benefits for a short time, which attended its use, were such as to induce the proprietors of several plantations to purchase the re- cipe that they might improve the intemperate habits of their negroes: the effects however were soon found to be ha- zardous, and its remedial virtues temporary. If it be not abandoned, it has already lost the confidence of the pub- lic* The basis of this nostrum was also tartar emetic. * On the authority of information from New-Orleans, it is stated that this remedy, in the hands of some of the planters was so disastrous in its effects, that many persons to whom it was given, sunk under its operation, and that prudential calculations induced Mons. L'Oiseau to change his residence. [ 17 ] though ipccacuana and several violent vegetable cathar- tics entered in its composition. The prescription found its way to this city and was publicly advertised and sold at a store in the Bowrery, but it soon lost its popularity, and gave place to this of Chambers'. It is not the intention of your Committee, to represent all nostrums of this description as utterly worthless, for there can be no doubt that they occasionally are found very serviceable in arresting the habit of intemperate drinking; but it is only in cases where the habit is recent, and moral restraints come in aid of their exhibition; where the morbid need which frequent intoxication induces, is so strong as to break through those restraints, and to destroy that self-respect w ithout which a man, however intelligent, is but little removed above the brute, they are not only of no use, but their frequent administration, is positively ha- zardous. Such is the active nature of the medicines of which they are composed, (and so far as your Committee are informed, they all possess the same general character— they are all violently emetic or drastic, or both,*) that phy- sicians, in all cases, should direct and superintend their exhibition ; for as nostrums, they cannot fail frequently to produce effects more disastrous, if possible, than the dis- ease which they are intended to remedy. Your Committee remark, that although the opportuni- ties for acquiring information on the subject of this medi- cine were ample, and they took great interest in the re- * Within a month or six weeks, a Dr. Preston, No. 29 Grand-street, in this city, has advertised a cure for intemperance, on different principles, he says, from any heretofore suggested. It is not nauseous, nor is it required to be mixed with intoxicating liquor, and one or two doses will generally be found sufficient. Drunkards who have become lost to all sense of shame, he will not treat, by which he impliedly admits, that moral restraints are essential in operating the cure. He also promises no cure, no pay, though the term of probation necessary to settle this question is not mentioned. [ 18 ] suits to which their inquiries might lead, they have found no reason to exempt it from the general censure to which all quack prescriptions are justly liable: its effects, so far forth as they have been able to ascertain them, are just such as might have been anticipated from its composition, as shown by the analysis, and such as have followed the exhibition of analogous remedies, from the time that expe- dients of this kind were first adopted for the treatment of the destructive habit for which it is now proposed; with this difference, however, that in the hands of skilful physr- cians, who possessed a thorough knowledge of the medi- cine they administered, whilst the same measure of benefit was derived, little or no harm was occasioned by its use; they have no hesitancy, therefore, in recording their con- viction, that as a nostrum, (though it may be productive of much advantage in certain cases,) the general terms in which it is recommended, the general directions with which it is accompanied, and the indiscriminate manner in which it is liable to be used, far more than countervail its benefits. That certificates in its favour should be numerous, is very natural; and indeed if they were not, this fact would stamp it with the mark of reprobation, as it is highly pro- bable that more intemperate persons have been the sub- jects of its operation within six months, in the city of New- York, simply in consequence of its being a nostrum, or secret remedy, than would have become the patients of physicians, for the cure of the same habit, in the space of half a century. Your Committee in closing this report, have only to observe that it has been drawn up under a distinct recog- nition of the responsibility which may attach to its publi- cation, in case the society should think proper so to direct. Drunkenness, as a vice, is so destructive of all morals, and as a disease, so remediless in its results; the evils [ 19 ] which it entails are so calamitous, and the misery which it inflicts so poignant and mortifying, that it may be em- phatically styled " the comprehensive curse," involving the ruin of every faculty, whether moral, intellectual or physical, which distinguishes man from all the irrational creation. It is no wonder, then, if all our sympathies should be enlisted in repressing its ravages and limiting its baneful influence; and it is no wonder, if in our eagerness to accomplish an object so desirable, we should lose sight of all consequences except the redemption of the drunk- ard : but sincerity is not truth, neither is purity of intention a justification, where ignorance is voluntary, or what is in effect the same thing, where prejudice precludes a rigid examination of that which humanity itself may even call duty. It is not our business to read a moral lecture for the direction of persons who are the guides of our youth and the exemplars of society, although we feel bound to sug- gest a salutary caution to all those who so far mistake, as to lend their characters and their influence to circulate a nostrum, which for all they know to the contrary, though there is abundant room for suspicion, and the information is easily acquired, may produce death. All which is respectfully submitted, William Hamersley, M. D. Ch'n."^ n Charles Drake, M. D. j o James R. Manley, M. D. 1 | John Watts, Jun. M. D. f § • Ansel W. Ives, M. D. | g Francis U. Johnson, M. D. J • Neio-York, August 20, 1827. Resolved, That the Report of the Committee on Cham- bers' Medicine, just read, be referred to the Committee on Quack Medicines, to be published under their direction. Extract from the Minutes, John J. Graves, M. D. Secretary. REPORT ON LEROY's MLSDECINE CURATIVE, READ BEFORE THE MEDICAL SOCIETY OF THE CITY OF NEW-YORK, AUGUST 20, 1827. ■■ ceffitter — The Mcdecine Curative of Leroy, has not as yet obtained much notoriety in this community. It is chiefly confined to the French population, who extol its powers with their accustomed enthusiasm. The Committee have heard of only two instances where the remedy was attended with unpleasant consequences. In the one case, the hy- per-catharsis and exhaustion became so alarming as to require medical aid ; and in the other, the patient seemed to labour under the effects of a violent acrid poison, and came very near perishing in the struggle. In France at one time it was in great repute, but of late it is much on the decline, for the people have had many opportunities of verifying the opinion of the faculty, that such violent means would often be attended with dangerous and fatal effects, if trusted to the discretion of unskilful and incom- petent persons. In the French colonies, and in some of the southern cities of thit country, it continues to be re- ceived on the word of its author, as a panacea for the removal of all diseases, and as the ultimatum of medi- cal skill for restoring the healthy functions of the system. Undoubtedly, such extravagant notions lead to their own overthrow, but in the mean time, the penalty to the victim of the infatuation is not the less disastrous, by serving as a [ 21 ] warning to others ; and it were better to anticipate the re- currence of these evils, by putting the public in possession of the facts in relation to the remedy, where it has been most extensively employed. Unless something of this kind be done, we may expect, at no very distant day, to see it command a very general use amongst us; for of all empirical remedies, this one is set forth in the most spe- cious way to catch the popular favour. The French law not allowing of secret remedies, Leroy takes higher ground than the exclusive possession of a medicinal article. He pretends to lay open to the common gaze, the whole ar- cana of medicine; to show how diseases are produced, in what they consist, and to point out the only way in which they can be removed. In order to accomplish this labour without impediment, the few facts in medicine he may chance to know, he is obliged to forget, as subversive of his Medecine Curative, which is as new as it is simple— one disease and one remedy—a principle of corruptibility predominating in the fluids, the sole cause of disease—its evacuation through the primse viae, the only cure. A doc- trine so simple, so easily understood, and so easily applied to practise, could not fail of meeting with many advocates, delighted with becoming their own physicians, and even surgeons; for no matter what may be the ailment or acci- dent, whether a pleurisy, a luxation, or an injury of the head, the disease is still the same, a predominance of the mauvaise humeur, and its evacuation, par haul ou par has, according as the ailment is situated, above or below the py- loric portion of the stomach, constitutes the whole mystery of the curative medicine. His therapeutical agents con- sist of an emetico-cathartic of the vinous tincture of senna, and tartarised antimony, and of a purgative composed of concentrated preparations of several of the most acrid hydragogue purgatives. These medicines, especially the purgative, are given, not once, twice, or any limited number t 22 ] of times, but are to be followed up day after day, with as short intervals of rest as the. vigour of the constitution will possibly allow, till the entire, extinction of the disease; which, in some obstinate cases, has required from 60 to 100 repetitions of the drastic. The author's remedy, in short, is infallible, and his motto the same as that of the celebrated Sangrado, although his medicine may not be as mild in its operation as that of this worthy personage : If the patient ever dies under its administration, it is only because he has not taken sufficient of the remedy; on rfa pas assez purser. With such principles and such a practice, which are not in any degree exaggerated, but are set forth just as the author himself would record them, this Society need not be told what must be their frequent and inevitable conse- quences ; nor of the propriety of guarding this community against the introduction of so gross and dangerous an im- posture. Dr. Arnout, late of Metz, has favoured the Committee with some excellent observations on the medicine in ques- tion, and also with an historical account of its progress in France, which has essentially aided them in pursuing their investigations. In the course of 1823, this gentleman witnessed the fatal effects of the remedy, in a case to which he was called. The man perished with symptoms indicating the presence of an active and acrid poison. lie reported the occurrence to the constituted authorities, and analogous cases coming to their knowledge soon after, induced the French govern- ment to call the attention of the Royal Academy of Medi- cine of Paris to this subject: whereupon that learned body submitted the medicine to repeated and careful examina- tions. On analyzing portions that had been prepared by Leroy liimself, they found that a given quantity of the vomi-purgative, which he asserted to containonly 1 {- grains. [ 23 ] contained 3£ of tartarised antimony: and also that a given portion of the purgative contained 2^ drachms of a resin- ous material, which he asserted to contain only 38 grains. They also introduced portions of the medicine into the stomachs and intestinal canals of dogs, and on examining the internal surfaces of these organs after a given time, they invariably found them affected with a high degree of inflammation approaching to sphacelation. They conclude their report by observing; 1st. That the medicine, in the hands of a wise and discreet physician, may in some few cases be used with advantage, but em- ployed indiscriminately as the author enjoins, it becomes a most violent and dangerous poison. 2d. That French physicians have witnessed many fatal accidents from its use: And they close their report, by strongly urging upon the government, the necessity of rigidly enforcing the law against its sale and distribution. On the publication of this report, Leroy's medication became justly suspected, and his remedy lost much of its reputation. But it seems still destined to do its work of mischief in other countries, until there also, sad experience shall reveal its pernicious effects, and prove the futility of this bold empiric's theories. The following is Leroy's recipe for the preparation of his vomi-purgative: R Fol: Sennae Opt. 3 iv. Via. Hispan: ifeiv\ Infuse for three days, frequently shaking the mixture. and obtain the tincture from the senna leaves by strong expression. To each pound of the wine add one drachm of tartarised antimony, and filter for use. The dose for an ordinary adult is a table-spoonful; to a child of seven years, half the quantity, to be repeated in an hour and three quarters, and then every hour and a half till the proper effect be produced. His rule is, to produce seven or eight full emetic and cathartic operations, but [ 24 j he has no objection to its going much beyond this point. His usual plan is to commence the treatment of all diseases situated in the upper parts of the body (such as are locat- ed above the pyloric orifice of the stomach) by giving one, two or three doses of the vomi-purgative, at short intervals, until a certain degree of amelioration of the disease be ob- tained, and then to follow up the treatment with active and violent purging, till the disease is completely subdued, al- lowing of no other intervals to this daily purgation, than what the exhausted state of the patient may require. All diseases situated below the part indicated, he trusts solely to his purgative, repeated daily or as nearly so as possible, to the final extinction of the disease. Some obstinate cases of disease, he says, will require from 60 to 100 doses of his medicine, before they will be entirely overcome. He makes his purgative of four degrees, which differ from one another only in the relative quantity of its ingredients. The first degree, he gives to children and very debilitated subjects, and is one-fourth weaker than the second degree; with which he commences the treatment of ordinary adults. The third degree is one-third stronger than the second degree, and is given where this last fails in a given quantity to produce the desired effect. The fourth degree is twice the strength of the second degree, and is in like manner resorted to, where the third degree fails. The following is his recipe for the second degree, the ordinary preparation for adults. R Pulv: Res: Scammon : 3 ii. Pulv.Rad: Convol: Turpelh : 3 i. Pulv :---- ------ Jalap : 3 viii. Alcohol dilut. Ifexii. M. Infuse for twelve hours in a heat of 76°, strain, and add to the tincture the following syrup [ 25 ] R Senna? opt: 3viii. Aq: bullient: feii. Infuse for five hours, express and add to the liquor, sac- char, alb. lb iiss. and boil to a syrup. The commencing dose of this purgative is two table spoonfuls fasting, which should produce from twelve to twenty full alvine evacuations. The dose to be gradually increased, if necessary, till it produces its proper purgative effect. If four table-spoonfuls of the second degree does not answer the purpose, then that of the third degree must be re- sorted to in the same commencing dose as the other, and, in like manner, increased to the same quantity; when if it does not produce the desired effect, it must give place to the fourth degree, in doses of four table-spoonfuls, and in- creased, if necessary; which degree will always be found quite sufficient for any case. A free use of diluent drinks is allowed during the operation of the purgative, and an infusion of tea may be given, to moderate the effects of the emetic in some cases. All other remedial agents are de- clared to be absolutely injurious, except, perhaps, blisters occasionally; as he has obtained good effects from their ap- plication to parts remote from the seat of the disease. Thus have we, in as few words as possible, given the pe- culiar notions, and leading directions of this famous Char- latan, that the Society might be enabled to judge at once of the man and his remedy. This Society are already familiar with the medicinal properties of all the articles that enter into the com- position of his medicines, except, perhaps, the turbith root. This is a species of jalap; the root of the convolvolus turpethum: an old and rejected article of the materia me- dica, which has been so entirely superseded by the ordi- nary jalap, that it has completely lost its rank as a medi- cine. Authors are not agreed on its medicinal activity. D [ 26 ] Virey, in his Elements of Pharmacy, says, that it is more acrid and drastic than jalap, and this seems to be the opi- nion ol many; but others consider it as possessing less ac- tivity, and less to be depended upon as a purgative than jalap, and this accords with our own limited experience. From repeated trials made with such parcels of the arti- cle as we were enabled to obtain, it could not be depended upon as a cathartic, in less than drachm doses, and even then did not produce any thing like the same cathartic effect, that ordinarily follows the same quantity of jalap. As the root emitted a very peculiar penetrating flavour, it was judged to be of good quality. The Committee procured some of the purgative prepa- ration prepared by the proprietor, and also had it prepared according to the recipe given in the book. They made comparative trials of them in a considerable number of cases, for the purpose of ascertaining their medicinal pro- perties, and what,if any differences, existed between them. The preparations were exhibited in cases of ascites, scro- fula, and other apyrexial diseases, where there was no ap- prehension of the existence of a state of preternatural ex- citability of the intestinal canal; but, on the contrary, the functions of this organ were rather slow and torpid. From many trials, it appeared that the proprietor's preparation is much more acrid and violent in its operation, than that prepared after his recipe. The patient complained of much more tormina and exhaustion, than from even larger doses of the recipe preparation, and could not bear its repe- tition near as well. I n doses of two ounces of the fourth de- gree,-even in robust subjects, it kept up a violent catharsis for eight or ten hours, and left forsome hours after, pain and tenderness of the abdominal region, with inappetency for food. The recipe preparation of the fourth degree, in (loses of from one to two and a half ounces, is an active hydra- gogue purge, operating very quickly, and producing from r 27 ] three to eight full alvine evacuations, but not possessing any decided advantage over the hydragogue purges in com- mon use. On the whole, the Committee are of opinion, that both Leroy's preparation, and that prepared according to his formula, may be advantageously employed where drastic purgatives are required, as in dropsies, torpor of the intes- tinal function, cerebral derangements, and, in short, in all cases where a speedy and violent revulsive effect by ca- tharsis is called for. They are both calculated to do seri- ous mischief, if employed where there exists a morbid excitation of the primae vise, or where there is a tendency to that condition. Consequently, their introduction into families as a domestic remedy, to be resorted to whenever a purgative is thought to be required, is to be dreaded by the intelligent physician, and he should use his best en- deavours to prevent its employment. As for the vomi-purgative, the same observations ap- ply to it as to the purgative—it is harsh and violent in its operation, and not at all suited for ordinary use. The cases are indeed rare, where the physician would think of employing it; consequently, it can never with safety be administered by the unskilful and unprofessional. All which is respectfully submitted, William Hamersley, M. D. Ch'n.^ — Charles Drake, M. D. j o James R. Manley, M. D. John Watts, Jun. M. D. Ansel W. Ives, M. D. Francis U. Johnson, M. D. i REPORT ON SWAIM's PANACEA, AND THE OTHER DEPURATIVE SYRUPS. read before the medical society of the city of new-york, june 25, 1827. ■ tetttttee m The Committee charged with the examination of such Nostrums as are in general use in this city, have turned their attention, in the first instance, to the consideration of the different depurative syrups, which have within these few years, excited a good deal of attention, and seem of late to be getting into very general use. Although the ar- ticle on which their essential qualities depend, is not un- known to many of the profession, who have prepared the remedy, and employed it in a considerable number of cases, still the nostrum-venders contrive to throw an air of mystery and concealment around it, which the interests of the profession, and the public good, require should be re- moved. At any rate, if the remedy be really valuable, which we are far from denying, it becomes the duty of physicians to endeavour to ascertain its remedial powers, that it may be made one of the regular resources of the art, in place of being committed to the disposal of a set of persons who are neither qualified to discriminate the cases in which it may be beneficially employed, nor interested in appreciating it at its just value. It is with regret that the Committee find themselves called upon to state, that several very respectable physicians have given the sane- [ 29 ] tion of their professional reputation to the advertising cer- tificates of these persons, thereby implying that they pos- sess a secret remedy, which may be beneficially employed in cases that professional skill cannot, control. It is not the wish of the Committee to impute blame to these gen- tlemen, their motives were at least disinterested; but the consequences have been injurious to the character of the profession, by inspiring the public with increased confi- dence in nostrum-mongers, and thereby multiplying the number of these speculators on vulgar credulity. At first, the principal syrup of this kind in this country, was Swaim's Panacea, but of late, the Columbian Syrup, Par- ker's Vegetable Panacea, Potter's Catholicon, Shinn's Panacea, Scott's Panacea, Wilson's Panacea, besides others of less note, all of them essentially the same, have come into the market, claiming equal merit with their pre- decessor. Indeed, many years before the appearance of the Panacea, we had the Syrup of Salza of De Angelis, but as it never was favoured with the recommendation of any of the faculty, it has been limited to the private prac- tice of its promulgator.* They are all of them set forth as possessing most extraordinary efficacy in the treatment of syphilis in all its forms, mercurial disease, scrofula, scurvy, rheuma- tism, hepatic derangements, and in all chronic eruptions and old ulcers. The Committee deem it important, that the profession should be put in possession of the principal facts in relation to these syrups, and they have accordingly been at considerable pains to investigate * The celebrated Cirillo is supposed to have first introduced into Naples, whence De Angelis came, the Sirop de Cuisinier, or Rob of Laffecteur, which he was much in the habit of using, and highly recommended, under the name of Syrup of Salza. [ 30 ] them, under the three-fold relation of their composition, their remedial powers, and their mode of operation. 1. Composition. The American syrups, like their pre- decessors in Europe, are very concentrated decoctions of sarsaparilla, formed into syrups, with other articles of lit- tle or no efficacy, to give them flavour, and to disguise their true character. British physicians, as far as the Committee have been enabled to learn, have never been much in the habit of exhibiting sarsaparilla in this form. This article of the materia medica very soon lost its repu- tation among them, although Mr. Fordyce, in 1755, published an excellent paper in the first volume of the Medical Observations and Inquiries, showing, that when given in a very strong decoction, it was a medicine of very considerable power in all the secondary forms of syphilis and their sequela?. It still continued to maintain a doubt- ful reputation with practitioners generally, until of late, it has become more highly esteemed. Cullen thought it absolutely inert, and Mr. J. Hunter, whose authority, par- ticularly on this subject, stood deservedly high, seems to have placed it below guaiacum as a remedy in syphilitic diseases, and in fact, to have placed little dependance on its powers. Other respectable authorities might be quoted as coinciding with Cullen and Hunter, in their opinion of sarsaparilla, which no doubt aided in depressing its repu- putation; but, on the other hand, Pearson, Abernethy and Alathias, consider it to be a valuable remedy in some of the secondary forms of syphilis and the mercurial diseases, although they do not bestow upon it the high commenda- tions of Fordyce and Dr. Hunter. In France, it appears, from its introduction, to have enjoyed a more uniform and general reputation, and to have been long employed, both in the form of decoction and syrup. The Committee have not been able to discover when it was first given in the form of a syrup. It appears, however, to have been a [ 31 ] preparation of very ancient date, probably nearly coeval with the introduction of the article in 1530. At any rate, a compound syrup of sarsaparilla, under the name of sirop de cuisinier, with or without the addition of a small quan- tity of corrosive sublimate, has been a long time very ex- tensively employed in France, in the forms of disease for which the syrups under consideration are so much extol- led, and the recipe for its preparation, with immaterial variations, is to be found in the old French works on phar- macy. The following is the recipe for this syrup, as given in the French Codex. It does not differ from those given by Virey, in his Traite de Pharmacie, and by Alibert. in his Elemens de Therapeutique, except in its mode of prepa- ration ; they omitting the macerations. R Rad: Sarsap: Jfeii. Aq: tepid : O xii. Infuse for 24 hours, afterwards boil for 15 minutes, express, and to the residuum add Aq: Ox. boil to O vi. repeat 2ce or 3ce, then mix all the liquors, and boil gently with Flor: Borag: off. Flor: Rosar: Fol: Sennae Sem: Anis: dd 3ii. Reduce to one half, strain, and add, Mel: com : Sac-char: dd Ifeii, and boil to the consistence of a syrup. The Codex observes, that it differs little or nothing from the anti-syphilitic syrups, either in the nature or propor- tions of the substances of its composition, or the means of preparing it. The ordinary dose is one or two ounces twice a day, with or without a grain of corrosive subli- mate added to each pound. The patient at the same time taking freely throughout the day of sarsaparilla ptisan. [ 32 ] This recipe was adopted by the compilers of the United States Pharmacopoeia, which was formed in 1820, by merely substituting liquorice root for the borage flowers. They also adopted a syrup of sarsaparilla and guaiacum, using equal quantities of these articles, with other ingre- dients analogous to those in the above recipe. Besides the above, there are other syrups of the same kind, which have been much in vogue in France, bearing the names of their inventors ; as the sirop de Feltz, sirop de Mittie, sirop de Svelnos. and the rob de Laffecteur; each of which have had more or less of the same reputa- tion that the American syrups now claim. The rob de Laffecteur has far surpassed all the others in the high cha- racter it has long enjoyed, and it still continues to be greatly employed throughout France and her colonies. Even in this country, it would probably wholly supersede those that have sprung from it, were it not for the exorbitant price that is demanded for it.* This preparation was first offered to the public in 17G4, and is known to have been invented by Boiveau, a well instructed French apothecary, who induced Laffecteur to attach his name to it as the in- ventor and proprietor ; doubtless, that he might be the bet- ter enabled to exert his influence and character in bring- ing it into notice. After it had been considerably employ- * The price of Laffecteur's rob in this country, is seven or eight dollars a bottle, and as many cases require from eight to sixteen bottles to re-esta- blish the health, the expense of the article often becomes a hindrance to its general introduction into practice. The price of Swaim's preparation is three dollars, and some of the other syrups are sold at still less price. The actual cost of the medicine, as we have ascertained from frequent trial, pre- pared from the best materials, is about five shillings for the same quantity ; which fact ought to induce every practitioner, to encourage the apothecary to prepare it, by giving his article the preference. By this means the medi- cine would be brought within tlte ability of a considerable class of patients, who require its use, and arc unable to advance forty or fifty dollars for its purchase. [ 33 ] ed, and its inventor felt himself assured of its efficacy, he contrived to obtain an order from the French Minister, to make use of it in some aggravated forms of disease, under the immediate scrutiny of several distinguished members of the faculty, who reported favourably of its remedial effects. He also submitted his preparation to be analysed by Darcet and Bucquet, who were unable to discover any mercury or other mineral in the composition. Still, the acknowledged difficulty of detecting minute portions of mercurial salts in a preparation like this, inclined many to consider it as containing corrosive sublimate, which opi- nion injured its reputation, and prevented it from being more extensively employed; although the chymists asserted that the syrup would decompose this preparation of mercury, and cause it to be thrown down in the form of calomel.* To obviate this objection, Boiveau furnished De Lassone, the first physician to the king, with the recipe for its pre- paration, who prepared it for himself, and administered it in several cases with the best effects. He reported the result of his trials to the Society of Medicine, upon which the Society appointed a Committee of their body, who * Notwithstanding this opinion of the chymists, the French Codex and the French works on Pharmacy, permit corrosive sublimate to be added to these svrups. Many of their eminent practitioners, as Larrey, Boyer and Alibert, arc constantly in the habit of making this addition, in the proportion of one grain to a pound of the syrup, for such cases as seem to demand an altera- tive mercurial course. We have ourselves, in some instances, added the mer- curial salt, and in one case, thought we obtained decided mercurial effects from its use, although there was only one grain to the pound of the syrup. We are not aware that any other mineral salt has been added to the remedy, though we think it probable that antimonial preparations have, in some in- stances, been employed; for the compound decoctions of sarsaparilla, as the tisane de Vinache, tisane royale, tisane de Feltz, &c. formerly much em- ployed by the French in cases where these syrups are now used, all contain an antimonial preparation: and besides, antimony once had a reputation as an anti-syphilitic. E t 34 ] submitted the remedy, prepared under their inspection, to further trial, and also reported favourably of it in several of the most hopeless and aggravated forms of disease. From all which the Society conclude, that the rob of Laf- fecteur does not contain any mercurial preparation, and that it is a most excellent remedy in secondary and com- plicated cases of syphilis, especially in those cases where the mercurial treatment is either insufficient for the remo- val of the disease, or may render it more malignant. After this the reputation and employment of the rob of Laffecteur progressively increased, with little or no oppo- sition from the faculty, so that in 1781, we find the French government ordering the marine establishments to be kept constantly supplied with it; and this order, it is believed, is still continued. Many of the faculty have long been in the habit of employing it to the exclusion of the sirop de cuisinier. The elder Berger seems to have been the first who employed it in this city. About the year 1811, he was joined in consultation with several other respectable phy- sicians of this city, in the case of a gentleman labouring under a loathsome complication of disease, the sequelae of syphilis, and the repeated and irregular use of mercury, which had resisted all Ihe ordinary modes of treatment; and, on his suggestion, the rob was given, and with its usual good effects in such cases. The remarkable reco- very of this gentleman, and the difficulty of obtaining an adequate supply of the rob for extensive use, owing to the restrictions that at that time existed on our commercial intercourse with Europe, led Dr. McNeven, who was one of the physicians in the consultation, to give publicity to its composition and its worth. He accordingly published in the third volume of the Medical and Philosophical Jour- nal and Review, the recipe of M. Allion, a French chy- mist, for its preparation. The remedy prepared accord- ing to this recipe, with the exception of substituting the bark [ 35 ] of sassafras, or the shavings of guaiacum, for the marsh reed-grass, was soon after employed by several of our city practitioners, with the usual happy results. Among many patients, Mr. S waim, then a book-binder living in this city, experienced its beneficial effects in his own person, and soon after succeeded in obtaining from Dr. N. J. Quackinboss, the practitioner who had administered it to him, the recipe for its formation, and the directions for its employment: whereupon he removed to Philadelphia, and set forth his vegetable syrup, which he denominates Swaim's Panacea, for the treatment of those diseases for which the rob has been so long celebrated. In the first instance, Mr. Swaim's directions for using his panacea, for preparing the sarsaparilla ptisan, and the quantity and times of taking it, in conjunction with the syrup, were the same, nearly verbatim, as those given by Dr. McNeven, in the publication above referred to, for the use of the rob; but of late he has altered his directions considerably, and has ceased to insist on the conjoined use of the sarsaparilla ptisan, even in small quantities. The flavour of the sas- safras in the syrup first prepared by Swaim was very per- ceptible, but it is now the opinion of* many, that he has substituted the leaves of the sipsisewa, (chimaphila co- rymbosa of Pursh,) for the marsh reed-grass, sassafras or guaiacum, which we think very probable. However this may be, the syrup also contains the oil of winter-green (ol: gaultheriae); for its flavour is evident, both to the smell and taste. Swaim's object in this addition is, doubtless, to dis- guise the other materials, and to render the medicine agreeable to the taste; but it may also be a useful addition as a stimulant and carminative, obviating that loathing and disgust of the medicine, which sometimes occurs from its long continued use. The very profitable trade which Swaim has carried on with this article, (for it has been most extensively used, even with the approbation of many [ 36 ] of the faculty, as we have already observed, and with ef- fects equally beneficial with those to be obtained from its French predecessor,) has induced others to enter into com- petition with him, and some of them not unsuccessfully. There is every reason to believe that they are all of them virtually the same article. From the testimony of a medi- cal man who lived for some time in France, in the same house with Laffecteur, where he prepared his rob, it ap- pears, that the sarsaparilla was the only constant ingredi- ent, and that he was in the habit of varying the other arti- cles as it suited his convenience; in order to render it more difficult for the public to ascertain with precision, its exact composition. However this may be, there is reason to believe that the marsh reed-grass is not entirely desti- tute of medicinal properties; for it has from the earliest times, possessed some reputation as an anti-scorbutic and diuretic. The sipsisewa, which it is supposed Swaim and his imitators now substitute for the sassafras or guaiacum, is probably a remedy of still more efficacy than the marsh reed-grass of Laffecteur. Many physicians think it a va- luable addition, and have been long in the habit of employ- ing it in these syrups. They were probably first led to make this alteration, from a vague tradition existing among the Aborigines of this country, that it possesses anti-syphi- litic powers. However improbable this notion may be, it is very certain, that it is endowed with active medicinal properties, which are essentially adapted to co-operate with the sarsaparilla, in the removal of those diseases for which these syrups are so much praised. It is admitted to be a powerful diuretic, an excellent tonic, especially in debilities of the digestive organs, and to possess a decided tendency to increase the transpiratory functions : effects, if we mistake not, to which these syrups owe much of their celebrity. For some interesting observations on this [ 37 ] article by Dr. Somerville, see Medico-Chirurgical Trans- actions, volume V. p. 340. The following is M. Allion's recipe for the preparation of Laffecteur's rob, which is generally believed in France to be the correct formula. R Rad: Sarsap: Arund: phragmit: a a 3 xxx. Flor: Borag: off: 3viii. Fol Sennas Flor: Rosar: d d 3 ii. Sacchar: Mel: opt: dd ftvi. Boil the sarsaparilla and marsh reed-grass in nine pints of water for one hour, strain off the decoction, and pour the same quantity of water on the residuum, which is to be boiled for two hours: towards the end of the boiling, add the borage flowers, senna and rose leaves, then strain off, and to both decoctions add the sugar and honey, and boil the whole to the consistence of a syrup. Laffecteur gives very minute and detailed directions to be observed during the course of the rob. The patient to precede its use by four days of preparation. On the first day to take two quarts of a diluent ptisan, made either of wild succory or pearl barley; to abstain from coffee, spi- rituous drinks, &,c. and to eat but little. On the second day, to undergo the same regimen as on the first, and to be bled if there be any inflammatory irritation in the sys- tem, or tendency to hemorrhages. On the third day, to take an emetic, if there be any indication of derangement of the stomach, and to be still more abstemious than on the preceding days. On the fourth day, he is to take some moderate purgative, to be worked off by some light vege- table decoction, and on the next day to commence the use of the rob. L 38 ] The dose for men is six table-spoonfuls, and for women four, taken without addition, at six in the morning; and two hours after, to commence drinking the sarsaparilla ptisan, prepared as directed below, and to take a tumbler of it, at half hour intervals, so as to take seven before din- ner. To dine at twelve o'clock on a small quantity of some light animal food, taking the ptisan for sole drink, and four hours after dinner, to take a second dose of the rob, as before directed. Two hours after dinner, the patient is to re-commence drinking the ptisan, and to take five tumblers of it successively, at half hour intervals. At nine o'clock he is permitted to sup as he dined. -This course is directed to be daily pursued until the patient has consumed four bottles of the rob, when it is to be discontinued for four or five days, during which time the ptisan is to be continued as before, and the diet to be light and diluent. After this the rob is to be continued, with the same observances as before, without further interruption, until the disease be wholly removed, which in ordinary cases requires about eight bottles, but in old and inveterate cases, from twelve even to twenty-five bottles are sometimes required to re- establish the constitution. The use of the ptisan is to be persevered in for fifteen days after the rob has been discon- tinued, at the same time gradually rendering the diet more nutritious. Laffecteur directs the occasional use of emol- lient enemata during the course, should the patient be con- stipated ; but if on the contrary, the medicine should prove too laxative, and produce more than three evacuations in twenty-four hours, the dose of the rob must be diminished to the quantity that the patient, is able to bear without producing this effect. In cases attended with much de- bility, marasmus, or hectic irritation, he advises the rob to be taken in less quantity than is directed for ordinary cases. The sarsaparilla ptisan, to be taken in conjunc- tion with the rob, is made by boiling two ounces of the [ 39 ] root in three quarts of water, to two quarts, letting it infuse during the night, and straining it off in the morning. In summer, and for women, an ounce and a half of sarsapa- rilla will be sufficient. The ptisan is to be drunk warm in winter and cool in summer, and to constitute the pa- tient's sole drink. Milk and all spirituous drinks are to be rigidly abstained from, during the whole course of treat- ment. II. Medicinal Properties. That the sarsaparilla sy- rups, aided by the liberal use of a decoction of the same, are efficient remedies in a great number of anomalous and puzzling cases of chronic disease, we have, not only the testimony of the French physicians, but the experience of a number of physicians of this city, who have used them very extensively for fifteen years past. One of the Com- mittee has employed them very extensively in two public institutions, where ample opportunities were continually afforded for testing the remedy, in cases of the most obsti- nate character. The results of his observations we shall endeavour to give in this place, in as condensed a form as the very diversified nature of the cases in which it was Used will admit, remarking at the same time, that we do not pretend to characterize with precision, all the forms of disease in which it may be advantageously resorted to. Often, patients labouring under incurable diseases in the same wards, seeing its remarkable effects under the most discouraging circumstances, would entreat to be allowed the remedy, or use stratagems to obtain it; and thus, as it became a favourite medicine, it was frequently given in cases that did not hold out a reasonable prospect of relief; and yet in some of these cases, it afforded more or less benefit. The properties of the remedy are of that peculiar character, that even after a considerable experience, its use in many cases may very properly be merely tentative* [ *> . ] The question whether or not sarsaparilla in any form or quantity, will remove the primary forms of syphilis, is now of little importance, since it seems to be very generally ad- mitted that these will often yield under rest and anti-phlo- gistic treatment, without being afterwards followed with secondary symptoms ; and also that mercury, judiciously employed, is both the safest and most expeditious mode of curing the disease. In the few cases of small and simple chancre, which were trusted to the use of the rob and de- coction, with simple dressings to the part, the disease wras finally overcome, without the aid of mercury, but the reco- very was so gradual and protracted, that it was not judged expedient to continue the practice. The progress of the cases, in short, did not indicate that the medicine possessed any specific or peculiar power over the disease. Considering the slow operation of the medicine, and the great importance of the parts of the throat liable to syphi- litic ulcerations, we have not thought ourselves justified in trusting to it in this form of the disease; but not ah uncom- mon sequela of ill-treated and protracted syphilis, is an ulceration in the back part of the posterior fauces, of a cha- racter altogether dissimilar to syphilitic sore-throat, in which the remedy may be employed with advantage. These ulcerations are of an indolent and languid charac- ter ; so much so, that they frequently make considerable progress, before the patient is aware of their existence. They seem to be rather a melting away of the soft parts, than the effects of inflammation. They present smooth, uneven, rounded edges, and an uneven, tuberculated sur- face, covered with a whitish slimy matter, which partakes more of a morbid secretion of the mucous membrane, than of ordinary pus. If the disease be not arrested, it finally extends downwards, and produces phthisis laryngitis. It is usually complicated with the other symptoms of the mercurial disease, as cutaneous affections, disease of the [ 41 ] joints, ligaments, &c. to be hereafter described, and is commonly the last to yield to the influence of the remedy: often rendering it necessary to continue it for six or eight months, and after all, requiring the application of some sti- mulant or caustic solution, to cause the parts to heal. A strong solution of the sulphate of copper answers this pur- pose very well, after the habit has been sufficiently changed and renovated by the internal remedy. A course of the syrup and decoction steadily persevered in for six or eight weeks, will in general remove syphilitic affections of the cutaneous and osseous system, especially if the patient, during the time, be not exposed to cold, and he remain in the house and at rest; but their removal will be much aided, by giving at the same time, small doses of the muriate of mercury. This course of treatment, al- though it may not be so expeditious as the mercurial plan, possesses this great advantage, that the patient comes out of it with a constitution unimpaired; nay, he is often in higher health than he enjoyed before the attack, and is not liable to those unpleasant sequelae, for which these syrups are almost the only antidote. Not only venereal ulcers, but others which arise from a vitiated state of the habit, and have long resisted all the various modes of treatment, and are aggravated by mer- cury, will often heal under this remedy, with little aid from external means. The removal of diseases, apparently so opposite in their character as many of these ulcers are, is truly surprising, and only to be accounted for by supposing, that the long use of the medicine, produces a very general and material change throughout the habit of body. The value of the remedy is best displayed in those com- plicated and anomalous forms of disease, occurring in con- stitutions fairly demolished and ruined by the long conti- nued irritation of the venereal poison, and the excessive or irregular exhibition of mercury; conjoined with exposure F [ « ] to cold, intemperate living, and perhaps with some origi- nal vice of habit. This constitutional vice or predisposi- tion, is generally thought to be a lymphatic temperament, and the morbid action to be nearly allied with scrofula. This was the opinion of John Hunter, who treated these cases with various success, with cicuta and tonics, as bark, iron, sea-bathing, &c. But that they differ materially from scrofula, may be inferred, from their yielding to means which exert little or no action over that disease. To give a clear description of these cases is exceedingly difficult; for each case usually exhibits much of individuality. The most prominent symptoms are ; inflammatory affection of one or more of the joints, most usually the knee, wrist, elbow or ankle joints; more rarely the metacarpal, finger, and sterno-clavicular articulations. The inflammation of the joints is in the first instance, of a sub-acute character, attended with soreness and tenderness to the touch, some stiffness on motion, a moderate degree of swelling, with pains darting through them, and little or no discolouration of the integuments; but as the disease goes on gradually aggravating, the swelling augments, becomes red and very tender to the touch, more or less painful, with the superven- tion of general pains throughout the system, which conti- nually harass the patient night and day, wearing him out with the hectic of irritation. Sometimes these swellings occur on the dorsum of the metacarpal or metatarsal bones, in the course of the fore arm and leg, more rarely on the other bones, and run the same course as the affec- tion of the joints. They are usually much larger and more prominent than the true syphilitic node. If submit- ted early to a proper course of treatment, they are usually dispersed, otherwise they only diminish in size, lose their inflammatory character, and leave the joint or part with a limited degree of motion and use. Besides the thicken- ings and inflarnmations of the articulations and bony en- r 43 ] velopes, there are frequently ill-conditioned and indolent ulcerations on different parts of the body, especially on the hairy scalp and face, and in the posterior fauces, as before described. Under this load of disease, the constitution, before impaired, suffers severely ; the pulse becomes small, irritated and frequent; the skin moist and clammy, alter- nating with a state of dryness and morbid heat, with foul tongue, inappetency for food, and an irregular state of the bowels, inclining to looseness. As the disease progresses, the rheumatic pains become more constant and severe, the febrile irritation more intense, with evening exacerba- tions, night sweats, colliquative diarrhoea, progressive ema- ciation, and a general failure of the vital powers. This form of the disease requires a regular course of the syrup and decoction, to be continued for six or eight months; sometimes even longer. The amendment is always very gradual, often not very perceptible after four or five months treatment. The first indication of amendment, is some improvement in the general health, with return of appetite and quiet night?. If the disease has been of long standing, the joints usually remain somewhat swelled and anchylosed, but otherwise the patient will recover his health, with a renewed tone and vigour of constitution. Thickenings of the periosteum, attended with most ex- cruciating and deep-seated pain, which certainly did not arise, either from a venereal taint, or the use of mercury, have in several instances been treated with this remedy with entire success. Many chronic eruptions, usually supposed to be the se< quelae of syphilis, and many that certainly are not so, will frequently yield under the use of this remedy: and no mat- ter what may be their character or nature, from simple herpes to loathsome leprosy, even after they have resisted all other means, this remedy is well worthy of a trial. [ 44 ] There is no reason to believe that the remedy exerts any control over cancerous ulcerations; at least in the few cases in which we have seen it tried, it was of no benefit. Neither can it be said to be a remedy for scrofula. Nu- merous trials were made of it in all the forms and stages of the disease, both in adults and children, without deriv- ing any material benefit from it. Under its long conti- nued use, the general health seemed to improve, and as far as that went it was of service, but no further. From this general remark may perhaps be excepted the tabes mesenterica of children. Here it sometimes answered very well, but not better than mucilaginous decoctions, with occasional laxatives. We could not convince ourselves that it possessed much power over common rheumatism, even in its chronic state. It was tried in some cases of phthisis pulmonalis, which might be attributed to a venereal irritation, if this disease ever arises from such a cause, and without producing the least benefit: on the contrary, it appeared to hasten on the fatal event, by adding to the colliquative diarrhoea. Gtuarin speaks in praise of sarsaparilla in the treatment of gout. We have not made trial of the remedy in this disease, but should not judge it applicable, as its tendency is to produce high health, with a fulness and plumpness of habit. The rob has been greatly extolled as an anti-scorbutic, and it is doubtless in reference especially to this property, that the French government was induced to direct their marine establishment to be supplied with it; as it is gene- rally supposed that the subjects of these establishments, are liable to have their syphilitic affections aggravated and rendered inveterate, by the existence of the scorbutic dia- thesis. It must be confessed, that the complicated cases which we have described above, as the sequelae of syphi- lis and mercurial action, and in which the rob displays its [ 45 ] best powers, have always seemed to us, in the character of the ulcerations, and the indurations and swellings of the soft parts, to bear a greater analogy to scurvy than to scro- fula ; and so far the remedy may be considered an anti- scorbutic. How far it may be a remedy in simple, uncom- plicated scurvy, we have never satisfied ourselves; for the dietetic means that can always be commanded on shore, at a less expense than these syrups, render their employ- ment quite useless. In the impure air of prisons and in- firmaries, it might indeed be a useful adjuvant. Chronic hepatitis and other chronic hepatic derange- ments, are another class of ailments, for which these sy- rups are recommended by their venders, and we have know7n even physicians to have recourse to them in such cases. That some of the effects of the rob may be inci- dentally beneficial in some cases of these derangements, is very probable; but we should think that no physician, who is well grounded in the physiology and pathology of the human system, would, for that reason, submit these diseases to a course of the rob, any more than he would give squills as a laxative, because its ordinary tendency is to increase alvine evacuation. III. Modus Operandi. The way in which medicines act in overcoming chronic and apyrexial diseases, is, for the most part, involved in great obscurity ; and the diffi- culty is generally attempted to be obviated, by resorting to a specific action. The explanation, if indeed it be one, conveys no useful or definite idea to the mind, and is more- over, calculated to check inquiry, by resting on an impos- ing epithet. However difficult the task may be, of arriv- ing at any satisfactory result, from pursuing the opposite course, we shall, nevertheless, attempt to establish some general principles on the modus operandi of the remedy under consideration, by collating such evident effects as t 46 ] we have been enabled to collect from an extensive em- ployment of the remedy, under circumstances favourable for correct observation. The most constant and evident effect of these syrups is, to maintain the bowels in an open and relaxed state: so great is this tendency, that the greater number of patients labouring under mercurial disease, the sequelae of syphilis, or such as are much debilitated, are not enabled to take more than the half, or even the third of the quantity direct- ed by Laffecteur. In some instances, they will not bear more than a table-sjJbonful thrice a day, without produc- ing excessive alvine discharges. Laffecteur acknow- ledges the same effect himself, by directing, that should the rob produce more than three evacuations in the twenty-four hours, its quantity should be lessened. We have ourselves observed, that its effects were most de- cidedly beneficial, when it regularly produced one or two free alvine evacuations daily, and would therefore propose that this effect should regulate its exhibition. Two or three ounces daily will, in the majority of cases, accom- plish this end. We have no doubt that the syrup also in- creases the transpiration, and the urinary flow ; at least, this was found to be the case, from exhibiting the sarsapa- rilla in powder, though these effects were not nearly so evident as when the patient took conjointly, a quart of the strong decoction daily. Besides.these effects, the medi- cine exhibits tonic powers. Under its regular and conti- nued use, the appetite gradually improves; all the functions indicate the existence of a moderate state of excitation, more especially those of nutrition: and thepttient acquires a degree of vigour he had been long unaccustomed to, with plumpness, sometimes even a state of fulness approach- ing to plethora. That the sarsaparilla is a mild tonic, is now generally admitted, and has of late been much em- [ 47 j ployed with the best effects, in debilities of the digestive organs. A part, however, of the invigorating and nutri- tive effect of the remedy may be fairly assigned to its sac- charine and mucilaginous properties. Were this not the case, a decoction of the sarsaparilla, which extracts all the active properties of the root, should be equally bene- ficial with the syrup, which does not accord with our ob- servation. Neither, on the other hand, will the syrup, without the use of the decoction, produce the same good effects as when both are employed. In many obstinate cases it will even totally fail; the combined action of the two forms being necessary to bring about that change of system, which is indispensable for the restoration of health. On the whole then, we are of opinion, that the good effects of this medicine are to be attributed to its maintaining a very moderate and general excitement throughout the sys- tem, diluting its fluids, and accelerating the action of all the emunctories,* especially those of the skin, kidnies and digestive organs, and thereby eliminating the fluids that had become altered and vitiated, from the long irritation of morbid action ; at the same time, that it supplies a mild and healthy nutriment to repair the losses of these in- creased discharges. The low and abstemious diet enjoined by Laffecteur during the treatment, we have never insisted on. Debili- tated patients, who take two or three ounces of the syrup daily, with a quart of the strong decoction of sarsaparilla, which is as much as they can be induced to continue or they can bear, without oppressing the stomach, are not much inclined to o;.?r-eating, and we merely advise them to re- * The action of sarsaparilla, says Mr. Carmichael, particularly when assisted by antimonials. is to increase all the secretions. [ 48 ] frain from stimulating drinks, and to take lood that is nutritious and of easy digestion. The ptisan directed by Laffecteur, does not contain nearly as much sarsaparilla as the officinal decoction. His strongest is made by boiling two ounces of the root in six pints of water to four pints ; whereas the Edinburgh College direct four ounces in four pints, boiled to two. Patients will take a strong decoction as readily as a weaker one. and as M. Alibert justly observes, large quan- tities of it fatigue the stomach, so that patients cannot con- tinue the quantity directed by Laffecteur. We have usu- ally employed the decoction, in the strength and quantity directed by Mr. Fordyce; that is, three ounces of the root in six pints of water, boiled to two pints. This quantity patients may be induced to drink in the course of the twenty four hours, and to continue for a considerable lime. Mr. Fordyce thinks that the complaint of authors, that the decoction hurts the tone of the stomach, arises from its being prepared by long maceration of the root, which ren- ders it very liable to spoil soon, and thus prove injurious. His plan is to prepare it by boiling it immediately in a given quantity, as above observed, and to make it fresh every two days; keeping what is to be used on the second day, in a cool cellar. As this intelligent surgeon did more with this decoction, than any other author with whom we are acquainted, and indeed, nearly as much as can be accomplished with the remedy under consideration, his opinion in every thing concerning its administration, is entitled to great weight; and for that reason, wre call in question the propriety of the directions of the Colleges which order these decoctions to be prepared by long previous macerations of the sarsa- parilla. Before closing this report, we shall take the liberty of subjoining an extract from Mr. Fordyce's excellent paper [ 49- ] above referred to, comprising the conclusions he has drawn from his employment of the sarsaparilla decoction. " It (the decoction) will commonly relieve, in a very short time, venereal head-achs, and nocturnal pains; and, if persisted in, I believe, will always cure. " In emaciated or consumptive habits, from a venereal cause, it is the greatest restorer of appetite, flesh, colour, strength and vigor, that I know of. " When the throat, nose, palate, or the spongy bones in general are affected with a slough or caries, it will com- monly complete the cure, if persevered in long enough, provided a mercurial course, I mean by unction, has pre- ceded the use of the sarsaparilla. " When the body is covered with dry blotches, or moist sores, (still supposing the cause venereal,) it will greatly promote the cure, nay often complete it: but, without the assistance of mercury, there will be danger of a relapse. " In simple chancres it will do little service ; but if it is given in cases where the chancres or buboes will not heal or dissolve, after the use of the mercurial unction, it will often cure, and always do manifest service. " It will oftentimes answer and that speedily, without sweating, confinement, or any very strict regimen, at all seasons of the year, where mercurial unctions, and long continued courses of strong decoctions of guaiacum, either by itself simply, or compounded with a small proportion of our sarsaparilla, have failed; of this I could produce seve- ral other proofs, besides the above histories. " It would seem probable, from any observations I have yet been able to make, that the sarsaparilla root is only to be depended on in venereal cases where mercury has failed ; at least has preceded the use of the decoction, or when it is combined with it, and therefore it is not to be trusted to alone, unless iu such circumstances. And this is agreeable to the well known effects of that medicine, the F [50 ] reputation of which, in inveterate venereal cases, first put me on making this inquiry. " Mercury alone will in general, cure most venereal complaints. The sarsaparilla will perhaps always cure what resists the power of mercury. It is therefore proba- ble, that we may find in mercury and sarsaparilla, properly combined, a certain cure for every case that can be called Venereal." The following extracts, appended to Mr. Fordyce's paper, show that both Fallopius and Petronius, formed nearly the same opinion of the sarsaparilla, as was enter- tained by Mr. Fordyce. " Recenseamus experimemtum cui nolunt credere per- tinaces. Dioscorides elicit habere vim antidoti in morbis contagiosis, &. connumerat grana & folia inter ea medi- camenta quae venenisexhibentur, ideo regium est auxilium & antidotum ad fugandum luem veneream, & hac ratione ego fido magis Salfae quam ligno guajaci; imbecillior est certe ligno; habet tamen ipsa nobiles vires, quibus superat guajacum, & est, quod si, post superatum Gallicum, restant ulcera rhagades circa sedem, duplo citius sanat ha?c quam lignum Indicum. Erat scholaris papiensis qui tophis osseis & lapideis laborabat circa pedes & tibias: Ego brevi dis- cussos vidi ope Sarsaeparillae, & prima vice usus sum hac in milite Lucensi qui dicebatur (E Capitan Capon) hie hebebat in capite tumores & gummata, quae per decem dies evanuerant omni: cum ergo in Gallico adsunt ulcera, ad hoc medicamentum confugio tanquam ad certissimum auxilium: si non facit prima dieta, faciet saltern secunda & tertia. Salsa est regina in hoc, quia disculit tophos quodam quasi miraculo. Decoctum salsse semper agit omnibus temporibus: decoctum guajaci non; agit tempes- tate hiemali. Fallop. tractat de morbo Gallico, cap. 63, & 95. c. 95." [ 51 ] " Prodest decoctum sarsae, quemadmodum guajaci de- coctum omnibus lue Gallica inquinatis, sed quanto quam illud tenuiorum partium est, tanto celerius auxiliatur, po- tissimum vero his, quibus caput insigniter dolet, postquam guajaci decoctum ante exhibitum aut parum aut nihil con- tulit; adde etiam, ut cuidam placet, ulcera, &, circa sedem rhagadia, multo celerius quam decoctum guajaci curare, & gummationes dissolvere, consuevit. Sarsaparilla pollet adversus euni qui sua natura mitis est, aut incipit, aut in- clinat, aut si quidem saevus fuerit, ahis tamen remediis, attritus atque subactus hominem adhuc infestat. Hinc certe vim magnam in morbum Gallicum habere Sarsapa- rilla creditur, utpote quern guajacum non sanarit, haec postea sanat: sanat enim immanem, quern guajacum, aut si quid hujusmodi antea mutavit, mitigavit atque dissolvit; non sanat vero si statim ab initio contra ilium sumatur; quo circa Sarsae decoctum luem quidem Gallicum evertit, sed quia debiles sunt ejus vires, non nisi mitem aut incipi- entem, aut declinantem, aut omnino si saeva fuerit post- quam aliis remediis ante demissa devictaque sit, evertit. Alex. Trajan. Petron. lib. v. cap. 2, & 4." The history of these syrups affords a striking instance of the predilection of the human mind, to resort to secret and mysterious agents for the removal of disease. Adminis- tered by the regular and intelligent practitioner, or as the officinal preparations of this country or of France, they have never excited much attention; none from the public at large, and not as much from physicians generally, as they really deserve; but in the hands of the pretending em- piric, they perform miracles, command the confidence of the public, and call forth the encomiastic approbation of respectable physicians. Neither the welfare of the public, nor a proper regard for the character of the profession, is consulted in maintaining this state of things, and a society constituted like ours, is called upon to use their best en- [ 3H } deavours to arrest the evil. If the untaught empiric be permitted to seize upon the approved remedies of the art, and, in order to speculate on suffering credulity, veil them under the specious garb of secrecy, their partial successes will confer upon their order, an importance and character that could not be otherwise attained, to the serious detri- ment of the healing art. I low, it may be asked, is this to be prevented ? To the Committee, the answer in the case before us is obvious. Let every practitioner deter- mine not to employ these nostrum syrups, nor recommend them to others; but, on the contrary, take every proper opportunity to inform the public of their true character and history, and use in their stead the officinal preparation; which will be found to be a remedy of more value and ex- tensive application, than physicians generally are yet aware of. In this way we shall finally succeed in wrest- ing from the hands of the empiric, a medicine that requires the discrimination of professional experience, to direct its proper application, and fix its true value. All vHiich is respectfully submitted, Felix Pascalis, M. D. "\ O William Hamersley, M. D. | | Charles Drake, M. D. )> 3 James R. Manley, M. D. | S" John Watts, Jun. M. D. J a