ARMY MEDICAL LIBRARY FOUNDED 1836 WASHINGTON, D.C . MEDICAL THESES SELECTED FROM AMONG THE INAUGURAL DISSERTATIONS, Ajblished and defended BY THE GRADUATES IN MEDICINE, OF THE UNIVERSITY OF PENNSYLVANIA, AND OF OTHER MEDICAL SCHOOLS IN THE UNITED STATES: WITH AN INTRODUCTION, APPENDIX, AND OCCASIONAL NOTES. BY CHARLES CALDWELL, M. D. EDITOR OF THE WORK. TO BE CONTINUED ANNUALLY. \ _2Z>^ PHILADELPHIA: PUBLISHED BY THOMAS AND WILLIAM BRADFORD, PRINTERS AND BOOK- SELLERS, NO. 8, SOUTH FRONT-STREET. FRY AND KAMMERER, PRINTERS, LAETITIA COURT. 1805. District of Pennsylvania, to ivit: ^ ^w» • BE IT REMEMBERED, That on the tenth day of January, seal i in the twenty-ninth year of the Independence of the United ^^ States of America, a. d. one thousand eight hundred and five, Thomas and William Bradford, of the said district, have depo- sited in this office, the title of a book, the right whereof they claim as ' proprietors, in the words following, to wit: \N " Medical Theses, selected from among the Inaugural Dissertations* " published and defended by the Graduates in Medicine, of the Univer- " sity of Pennsylvania, and of other Medical Schools in the United " States: with an Introduction, Appendix, and occasional Notes. By " Charles Caldwell, M. D. Editor of the Work. To be continued " annually." In c^rJcnr.ltv- to the act of the Congress of the United States, in'.lmlec1., "An act for the encouragement of learning, by securing the copies of ';,aps, charts, and books, to the authors and proprietors of cuch < o:.-ies during the times therein mentioned:" And also to the act, entitled, " An act supplementary to an act, entitled, " An act for the encouragement of learning, by securing the copies of maps, charts, and books, to the authors and proprietors of such copies during the times therein mentioned," and extending the benefits thereof to the arts of designing, engraving, and etching historical and other prints." D. CALDWELL, Clerk of the District of Pennsylvania. CONTENTS. PRELIMINARY DISCOURSE,...........................PA°v I. Seybert's Attempt to Disprove the Putrefaction of the Blood, in Living Animals, 1 II. Potter on the Medicinal Properties and Deleterious Qualities of Arsenic, 45 III. Prioleau on the use of the Nitric and Oxygenated Muriatic Acids, in certain Diseases,.................................... 81 IV. Horsfield on the Rhus Vernix, Rhus Radicans, and Rhus Glabrum, vulgarly called, Poison-ash, Poison-vine, and common Sumach, .... 113 V. Cooper on the Properties, Effects, and Medical uses, of the Datura Stramonium, or common Thorn-apple,...................... 165 VI. Mo ore on the use of Digitalis Purpurea, or Fox-glove, in certain Diseases, 195 VII. May on the Unity of Disease, as opposed to Nosology,..............215 VIII. Smith's Attempt to Prove, that certain Substances are conveyed, un- changed, into the. Circulation,............................229 IX. Roebuck's Experiments and Observations on the Bile,..............255 X. Young on the Principles of Nutrition, and the Digestive Process,......275 XI- j Walker's Experimental Inquiry into the similarity in virtue between the ■, Cornus Florida and Sericea, and the Cinchona Officinalis; together with an inquiry into the modus operandi of astringent vegetables, .".......299 XII. Miller on the Means of Lessening the Pains of Parturition,.........337 XIII. i Caldwell's Experimental Iwi.iin, ixs^ecting the Vitality of the Blood, 353 6, M*~ PRELIMINARY DISCOURSE. WHEN an Editor, about to engage in a new periodical publication, makes known his intention to the lovers of science, and solicits them to encourage the performance by their patronage, he may be considered as acting his part in the negociation of an important compact. Under such circumstances, justice requires, and custom bestows hersanction on the measure, that his proposals to the public should be accompanied, if not by a complete analytical prospectus, at least by some account, of the work. That such an account may prove useful, and afford the degree of satis- faction required, it ought to contain an exposition of the ground on which the work is undertaken, a statement of the matter it is to embrace, and the manner in which it is to be conducted, and some information, as to the resources and prospects of the editor, in relation to a faithful compliance with his engagements. It is only by being duly and correctly informed on these points, that the public can be enabled to judge, respecting the probable merit and utility of the work, and the claim, it is likely to present to their patronage. Impressed as he is, with the truth of these sentiments, and subscribing to the principles which they inculcate, and the conduct which they pre- ^ scribe, the Editor of the work herein announced to the public, is desirous to manifest his regard for them, in his intercourse with his fellow-citizens on the present occasion. This it shall be his object to do, by endeavour- ing, in this address, to communicate the necessary degree of information on the three foregoing heads. He will proceed therefore to state, as briefly as may be consistent with the nature of his subject, the reasons why the present work has been instituted, of what materials . it is to be composed, and from what sources those materials are to be • drawn. The Editor would first, however, beg leave to observe, that he is aware of the impracticability of exhibiting, within the limits to which he must here confine himself, a complete epitome, or view in miniature, of the work in which he is about to engage. A performance so condensed, and yet complete in all its parts, never has been, and perhaps never can be, A vi • PRELIMINARY maouuixo^. executed. The utmost he can promise is, to give a faint outline of the leading features of the work, leaving to its future progress the finishing of the picture. Whoever will consider, with attention, the present condition of the United States, in relation to the causes and nature of diseases, and com- pare it with that of other places, will discover ample ground for the institution of publications, calculated to perpetuate and diffuse the know- ledge of all such discoveries and improvements in medicine, as relate particularly to the diseases of our own country. When we recollect that we differ very materially from all the countries of the old world, in the nature and general character of our climates, in the condition of our atmosphere with regard to humidity, in the state of our agriculture, arts, manufactures and occupations, in our diet, customs, habits, and amuse- ments, and in many of our civil and political institutions: when we reflect, I say, that we differ widely from other countries in these objects, which are known to exercise a powerful influence over the constitutions and characters of men, we must expect to differ from them no less strikingly, in -he frequency, nature, and character of our diseases. But the position that there exists a difference between the diseases of the United States, and those of other places, is not to be regarded as a mere inference, drawn by analogy from general principles. Conclusions of this kind, however 4air in appearance, may still be fallacious. That such a difference does actually prevail, is a fact, resting for its authenticity on the observation of ages. One of the first remarks of the original adventurers to the western world was, that they were attacked by new and unknown maladies. Nor cIols the observation of intelligent foreigners, on their first arrival among us, differ from this at the present day. The novelty in the form, character, and, I am sorry to add, the frequency and violence of our diseases, particularly during the summer and autumn, is too often one of the earliest, as well as one of the most melancholy objects, that attracts their attention. But the evidence in favour of our position does not terminate here. Ask a native of the United States, who has visited foreign places, and he will tell you, that the diseases of his own and of other countries differ from each other no less strikingly, than the manners and appearance of their inhabitants and animals. We may still advance a step further in proof of the assertion, that the diseases of the eastern and western hemispheres are different from each other. It is a truth which must be familiar to every physician of the United States, who has joined reading to observation, that we cannot find, in the medical writings of the old world, accurate descriptions of the diseases of the new. Nor is this declaration intended to impeach, in the smallest degree, either the accuracy or fidelity of trans-atlantic writers. These authors, no doubt, describe most faithfully t!:e complaints which they witness in their respective countries. PRELIMINARY DISCOURSE. vii But this is not sufficient for the purposes of America. In vain do we look into the mirro^ of a foreign page, for faithful images of our native maladies. As well might the description of an Englishman, or a French- man, be applied to one of our western savages, as the descriptions of the diseases of Great-Britain or France, be applied to the diseases of the United States. Though in each case the general outlines of the picture would be nearly the same, the finishing of it would c:dl for very different shades. It is, indeed, true, that during the seventeenth, and about the begin- ning of the eighteenth century, the condition of certain parts of Europe bore a nearer resemblance to dial of the United States, than it does at present. The inhabitants of those countries were surrounded, then, as we arc now, with marshes undrained, lands cleared but not cultivated, and vast tracts of territory overshadowed by deep aid impenetrable forests. Added to this, their habits, manners, and general modes of life, do not appear to have been greatly dissimilar to those, which now prevail in some parts of the United States. We might hence be led to believe, that their diseases at that time exhibited no inconsiderable resemblance to ours at present. Nor am I inclined to think that such an inference would be very distant from the truth. Whoever will look into the foreign publications of that period, will find in pome of them abler accounts, and more accurate descriptions of certain diseases that now prevail in the United Stater, than are contained in the writings of our own medical contemporaries o" Europe. Tiut as those old works are written, for the most part, in the Latin I.aiguage, and greatly interspersed with visionary theories, fabulous rtc ie.i, absurd practice, and obsolete philosophy, they will not, in Jrs country, be generally read, nor can they be recom- mended rs fountains ol" knowledge, free from exception. It is from that immaculate so.irce of information alore, the book,of nature, that the physicians of .America ~an acquire, in the first instance, an adequate knowledge of the maladies that surround them. But if it be'true, that the diseases of the United States are different, in their nature and character, from those of other countries, they neces- sarily call for a corresponding difference in their modes of treatment. •Hence, in foreign publications, we search in vain for able lessons of practical instruction,* relative to the diseases of our cvrn country. And hence European physicians, on their frsc emigration across the Atlantic, are incompetent ?o the successful, treatment of the complaints they have to encounter. They are obliged to abandon many of the piacUcal doc- trines taught in the schools of their native country, and either embark on the hazardous sea of cq-jrinent, with nothing but trmr own obser- vation for their guide, or avail themselves of the experience of the physicians of America. The modes of mv.cLice incu.ieai.ed in iheucl.uois, viii PRELIMINARY DISCOURSE. and detailed in the medical writings, of Europe, are too feeble to arrest the course of the gigantic forms of disease, which frequently appear in the United States. They are suited only to the complaints of a climate free from extremes, or of a people enervated by luxury and an excess of labour. It is American practice alone, that appears to be accommodated to the character and strength of American diseases. But it is not only by a difference in the character, form, and violence of her diseases, that the United States is distinguished from the countries of Europe. She is, perhaps, no less distinguished by the peculiarities of her native remedies. Though we do not mean to assert, that such is the ba- lance between physical good and evil, that diseases and their antidotes uni- formly spring from the same soil, yet perhaps the sentiment ought not to be too hastily rejected. It is unquestionably true, that certain countries remarkable for their diseases, have enriched the materia medica with some of its choicest articles. But be this as it may, we have seen enough to convince us, that, in a medical point of view, the bosom of our country- has not been so bounteously peopled with vegetables to no purpose. The plants of the new world possess balsamic and healing virtues no less active, and in no less abundance, than those of the old. But, as yet, these virtues have not been so completely developed, nor their form and mode of exhibition in medicine, so accurately ascertained. It is still in the fields and forests of the western hemisphere, that the lines of the poet are most emphatically realized. " Full many a flower is born to blush unseen, " And waste its virtues on the desert air." Nothing but time and attention are necessary to draw many of these plants from their native obscurity, and render them alike subservient to the purposes of ornament and health. Such are a few of the principal considerations that have led to the projection of the work, which is herein offered to the patronage of the public. If it be true, that we are subject to forms of disease different from those that prevail in other countries, and requiring modes of treat- ment not to be learnt from foreign publications; and if it be further true, that we possess many domestic remedies exclusively our own, it is in the medical productions of our own country that such peculiarities should be faithfully recorded. As it is in British works that we must search for accurate accounts of British diseases, British remedies, and British prac- tice, so it is in American publications alone, that a system of medicine truly American must be ultimately found. To continue in a state of medical pupilage to our parent country, long after the expiration of our national minority, is unmanly and humiliating. It is on our own talents and exertions, and not on those of foreigners, we must rely for the final PRELIMINARY DISCOURSE. ix accommodation of the healing art to the diseases of our country. As well might we look to the acts of the British parliament for laws suited to the political condition and exigencies of the United States, as to the writings of British, or any other foreign physicians, for authorities to govern us in the practice of medicine. The same motives of self-pre- servation, interest, and national pride, which urged us, as a people, to the attainment of political independence, at an incalculable expense of wealth and blood, call on us to assert, with equal firmness, our independence in relation to the healing art. As it is to the former, that we are principally indebted for the eloquence and lustre of our present statesmen, so it is the latter alone, that can ever raise the physicians of the United States to a corresponding grade of eminence in their profession. Inferiority is the natural concomitant of a state of dependence. But I would not be here supposed to insinuate, that we ought to live and write exclusively for ourselves. The medical publications of the United States should be calculated for other purposes than merely to shed light on the peculiarities in the diseases, remedies, and modes of practice of our own country. To restrict them within such narrow bounds, would be equally selfish and degrading. The authors or editors of them ought to aspire to loftier pretensions, and aim at nobler and more liberal ends. The healing art is still in a state of minority, and the physi- cians of the United States would subject themselves not only to censure, but contempt, were they ever to resign their part in the honourable work of rearing it to manhood. On the score of medical knowledge, we have long been borrowers from the schools and presses of Europe. As the terms granted us have been liberal and advantageous, it is time for us to think of reimbursing the loan. Nor are we altogether unprepared to cancel, in part, our weighty obligations. Already have certain new lights in medicine broken forth in the United States, and extended their lustre across the Atlantic. Already have the writings and teachings of some of our countrymen obtained the approbation, and even commanded the respect and admiration, of the physicians of Europe. Nor is this all: on various points of medical science, they have conveyed to them new and important instruction. This appears to be particularly the case with respect to the philosophy and treatment of febrile diseases, more espe- cially those of a malignant and pestilential nature. If I am not greatly misled by that partiality which every man feels, and perhaps ought to feel, for his native country, these subjects are better understood in the United States, than in any other quarter of the globe. To embody, there- fore, the collective knowledge and experience of our country, on these and other points intimately connected with the health and welfare of mankind, and communicate them to distant nations, should constitute x PRELIMINARY DISCOURSE. part of the intention of all our periodical publications in medicine. To this we are urged no less by a sense of duty and humanity, than by our pride and love of fame, as a people. The second division of our subject, namely, to give a statement of the matter which the proposed publication is intended to embrace, and of the manner in which it is to be conducted, comes now to be considered. Under this head it will be impossible to speak odierwise than in very general terms. It will be sufficient, briefly to mention, that all the sub- jects treated of, snail belong either strictly to the science of medicine, or to some one of its collateral and subservient branches. I need not mention that the most distinguished of these branches are, Chemistry, Botany, and Natural History. Whatever may appear calculated to throw useful light en the Materia Memcu of our country, shall receive parti- cular attention, i'roni the extensi/e range of objects which this division of medical science ^-nr!races, it is reasonable to suppose, that in the cultivation of it, discoveries "w ill be made, applicable to some of the subordinate art1;. Though our primary aim, therefore, will be the improvement of medicine, we may v.dth much certainty calculate on the accomplishment of certain secondary purposes of general utility, by con- tributing to the improvement of the arts arid manufactures of the United States. Should biographical sketches of distinguished physicians be occasionally admitted, it is hoped that they will not be deemed altogether foreign from the design of the work. In selecting matter for the proposed publication, though plausible hypotheses and ingenious speculations will not be unconditionally rejec- ted, yet a preference will be always given to inquiries and dissertations of practical utility. It would be as unreasonable and unnatural to renounce entirely the pleasures cf theory, as to endeavour in the spring, to bar the senses against the beauty and fragrance of reviving nature. On subjects, however, where experiment and observation can be had recourse to, as tests of truth, mere hypothesis will be admitted with caution. As the Editor will probably annex to each volume, in the form of an appen- dix, one or more memoirs written by himself, he thinks it necessary to remark, that these arc the only papers for the truth of which he will hold himself responsible. The authenticity of ail others must rest entirely on their own internal evidence, and the reputation of their authors. It remains for the Editor to give some account of the resources, by the aid of which he expects to be able to render a periodical publication interesting and useful. From the title of the work it must have been already perceived, that his principal reliance will be placed on the Inaugural Dissertations, published under the auspices of the University of Pennsylvania, and other medical schools in the United States. Of * xvi^i«*mr,.RY DISCOURSE. XI those productions, the annual number issuing from the first of these insti- tutions alone, ranges from fifteen to twenty, each one consisting of from thirty to sixty or eighty pages octavo. Out of this number it rarely occurs, that less than six or eight, and sometimes more, are well worthy of being preserved from that fate, which awaits most works that fall from the press, in the form of pamphlets. These, with a short appendix, con- sisting of original papers, which can be subjoined without any difficulty, will afford matter sufficient for an annual volume. The Editor flatters himself, that it is unnecessary for him to observe, that, as far as his judgment may be relied on, the merit of each Thesis, in whatever part of the United States it may have been published, shall be the only ground of its admission into the work. In making »i selection, no personal or local considerations, shall have any part in determining his choice. To such persons as may be strangers to the University of Pennsyl- vania, and therefore, not qualified to judge what anticipations are to be indulged respecting a work consisting in part of Theses, published undev its auspices, the following observations may not be unacceptable. That celebrated School of Medicine, emphatically the Leyden of the We3t, is annually resorted to by pupils from all parts of the United States, as well as occasionally from the West-India islands. As these gentlemen have all studied the rudiments of their profession, under the direction of private preceptors, each one of them brings along with him some share of medical knowledge. Many of them have even treasured up original and useful facts, collected by personal observation, respecting the soil, climate, vegetables, minerals, states of society, and diseases, of their respective places of abode. So constant, liberal, and familiar is the intercourse between them, during their continuance in the University, by means of private conversation, and public debates in societies, to which they attach themselves, that their medical acquirements are converted into what may be regarded as a common stock. The knowledge of each individual is surrendered up as the property of the whole, while the knowledge of the whole becomes in return the property of the indi- vidual. In this way, may each student acquire important information respecting the diseases, remedies, and modes of practice, that prevail in every part of the United States, from the province of Maine to the island * of New Orleans, and from the shores of the Atlantic to the banks of the Mississippi. On this common stock, which includes also the knowledge and experience of the different professors, as detailed in their public lec- tures, the candidates for medical honours are privileged to draw for materials to compose their Inaugural Dissertations. The doctrines and opinions, therefore, contained in these dissertations, are not, as might be supposed, the crude offspring of juvenile minds. They are to be regarded, xii PRELIMINAR\ uiav.uunoc. for the most part, as the opinions and doctrines of the University, or some of its professors, illustrated and amplified by the graduates them- selves. Such is the general outline of the work, to which the attention of the public is solicited. Composed of materials derived from a source so ex- tensive, distinguished, and respectable, the editor cannot, for a moment, doubt of his fellow-citizens concurring with him in opinion, that, if judiciously conducted, it will prove both useful and honourable to our countiy. As medical characters from all parts of the United States, will occasionally contribute to enrich its pages, it may be viewed in the light of a national production. Though it is not to issue from the press under the immediate sanction of the University of Pennsylvania, yet it will constitute a " Thesaurus Medicus" of that institution. It is the present determination of those concerned in the work, to continue it annually, as long as the public may deem it worthy of patronage. The Editor will only add, that although he has promised to annex to each volume, an appendix written by himself, yet this engagement shall not operate to the exclusion of any valuable papers, with which he majr be favoured by his correspondents, either at home or abroad. Philadelphia, January 1st, 1805. AN INAUGURAL DISSERTATION: BEING AN ATTEMPT TO DISPROVE THE DOCTRINE OF THE PUTREFACTION OF THE BLOOD OF LIVING ANIMALS. SUBMITTED TO THE EXAMINATION OF THE REVEREND JOHN EWING, S. T. p. PROVOST; THE TRUSTEES, AND MEDICAL PROFESSORS OF THE UNIVERSITY OF PENNSYLVANIA, FOR THE DEGREE OF DOCTOR OF MEDICINE; ON THE EIGHTH DAY OF MAY, A. D. ONE THOUSAND SEVEN HUNDRED AND NINETY-THREE. BY ADAM SEYBERT, OF PHILADELPHIA; HONORARY MEMBER OF THE PHILADELPHIA, AND MEMBER OF THE AMERICAN, MEDICAL SOCIETIES. " FOR THE LIFE OF THE FLESH IS IX THE BLOOD."----LEVITICLf INTRODUCTION. THE opinion, that the blood became putrid in many diseases, is of ancient date. It has been embraced, with various modifications by most of the sects in Medicine. It particularly engaged the attention and belief of the learned Boerhaave, who publicly taught it in the celebrated school of Ley den. Under the imposing authority of his name, and by means of his industry, it was diffused throughout almost the whole globe. It be- came the theme of the vulgar; and at this day has many great and illus- trious names to support it. There have been, however, at different times, a few medical philoso- phers, who, although they adopted it in some instances, seem to have had doubts respecting the truth of the doctrine, and to have rejected it in their explanations of many diseases. In this class may be reckoned the cele- brated Hoffmann, who explained the phenomena of many disorders without any regard to the state of the blood. He was followed in this by the great Cullen, who, in his system, attends less to the state of the fluids in diseases than any of his predecessors. The doctrine has of late been wholly denied by the very ingenious Dr. Milman, in his Treatise on the Scurvy; and entirely rejected by the late sagacious Dr. Brown, of Edinburgh, from his System of Medicine. Many physicians appear to have adopted the sentiments of these gentlemen; so that at present there is a diversity of opinion among medical philosophers respecting the putrefaction of the blood of Living Animals. * On examining the subject, I found that it had never been put to the test of fair experiment; but, that speculative reasoning (too often delusive at best) and a few indecisive facts, were the chief supports of the argument on both sides. With these data, the result was neither satisfactory nor convincing. I then determined to contribute my mite towards investigat- ing the matter by experiment. In the prosecution of this attempt, my attention has been directed to the advancement of science; and, in the detailing of the experiments which I have made with this view, truth shall be my polar star. 4 INTRODUCTION. I have been induced, from reflection and experiment, to adopt a positive belief on this subject, and to deny the truth of the doctrine which I have just noticed. I am, therefore, necessarily led into an opposition to the opinions of many celebrated men. But, I trust, I have observed a decent regard and veneration for those from whom I dissent, without being at all depressed by the weight of their authority. Having viewed nature atten- 1 tively, I shall endeavour to communicate accurately what I have observed. I will not sacrifice truth to the lustre of great names, but, with confidence adopt the sentiment of Cicero—" Mea fuit semper h»c in hac re voluntas et sententia, quemvis ut hoc mallem de iis, qui essent idonei, suscipere quam me: me, ut mallem quam neminem." INAUGURAL DISSERTATION. IT will be proper, before I enter upon the consideration of the Putre- faction of the Blood of Living Animals, to take a brief view of Putrefaction in general; for, this is, indeed, the.only method by which we can be pre- pared for an examination of the circumstances necessary to induce that state of the blood in living animals. Though chemistry is much improved, and numerous discoveries are made almost every day by different philosophers, Putrefaction is, at this moment considered as the same difficult subject, that it was in the days of the celebrated Lord Bacon. This last stage of fermentation, in the days of Stahl, was supposed to be a mere consequence of the vinous and acetous stages; but, modern discoveries teach us the contrary; for we find, that while some substances undergo only the last stage, others suffer the three successive changes in a regular manner: thus mucilages, Sec. become acid without undergoing the vinous fermentation, and the glutinous matter of vegetables will putrefy before it undergoes either of the other changes. Observation, the grand parent of discovery, has taught us, that no substance is capable of undergoing a change by the putrefactive fermen- tation, except it be animal or vegetable; and that the numerous classes of the productions of nature, comprehended under the title of the Mineral Kingdom, are excluded. It is also an opinion, generally established, and proved by experiment, that the fluid and softer parts of those bodies, pu- trefy much sooner than the harder and more solid parts. It has likewise been observed, " That the flesh of younger animals is somewhat more prone to putridity, than that of older animals."* Animal and vegetable matters cannot putrefy in every situation or condition in which they may exist; for it is necessary that a living animal or vegetable should undergo a considerable change, before it can be ren- dered capable thereof: it must even be deprived of life, or the vital prin- ciple. No one has ever seen an entire animal or vegetable putrefy whilst * Medical Commentaries, vol. ii. p. 142. 8 SEYBERT'S DISPROOF OF THE alive; and Beccher, on this subject, beautifully observes: " Causa putre- factionis primaria defectus spiritus vitalis balsamini est." And, indeed, in all researches into those kingdoms which are the subjects of fermentation, it is of so great consequence to keep this universal actuating principle in view, that by neglecting it, we may commit great mistakes, and look to other causes than the true ones for its palpable effects; insomuch that the learned Chaptal, when regretting the imperfect success which che- mistry has met with, in the analysis of animal matters, cannot help observ- ing it. " All (says he) have mistaken or overlooked that principle of life which incessantly acts upon the solids and fluids, modifies, without ceasing, the impression of external objects; impedes the degenerations which depend on the constitution itself; and presents to us phenomena which chemistry never could have known or predicted by attending to the inva- riable laws observed in inanimate bodies."* The presence of that invisible elastic fluid, which we term vital air, is so necessary to putrefaction, that a body cannot putrefy without being in contact with it; and may be preserved sound and pure for years, if the communication between them be destroyed. It is a well known fact that a body will not putrefy in vacuo. This has been noticed by an ingenious author, in the following words: " How much the air contributes to putre- faction, is evident hence, that bodies buried deep under the earth, or in water, out of the reach of air, shall remain for ages entire; which yet, being exposed to the open air, shall soon rot and moulder away."t It appears that too great a degree of moisture, or a total want of it, retards the process of putrefaction. In order, therefore, that a body may putrefy, it is necessary that it be only duly moistened. Thus it happens, that after an animal or vegetable substance has been made perfectly dry, it may be preserved, in that state, for many years after. It has been ob- served by the immortal Beccher, that too great a degree of moisture pre- vents putrefaction: These are his words: " Nimia quoque humiditas a putrefactione impedit, prout nimius calor; nam corpora in aqua potius gradatim consumi quam putrescere, si nova semper affluens sit, experi- entia docet: unde longo tempore integra interdum submersa prorsus a putrefactione immunia vidimus; adeo ut nobis aliquando speculatio occur- reret, tractando tali modo cadavera anatomix subjicienda, quo diutius a fcetore et putrefactione immunia forent."| That all enlivening principle, heat, which, in a certain degree, is neces- sary to life, is no less necessary to the bringing on of the dissolution of a body. Temperature has been found to have great influence in promoting and retarding putrefaction. * Chaptal's Chemistry, vol. iii. p. 280. f Frew-en's Physiologia, p. 128. \ Phys. Sub. lib. 1. s. 5. cr.p. 1. p 277- PU 1 REFACTION OF THE BLOOD. 7 I have now mentioned the most essential circumstances necessary to promote the inception of putrefaction; to which we may subjoin Rest; for bodies do not putrefy while in continual motion. In proportion as these circumstances take place the process will advance with greater or lesser rapidity. Certain substances, as well known to the vulgar as to the philosopher, by the name of Ferments, when added to a fermentable mass, are found to hasten the process in a manner truly astonishing; though both the peasant and the philosopher stand on an equal footing with regard to a knowledge of the principle by which their application produces a specific operation. " We are told indeed (says the ingenious Mr. Henry) that a vinous ferment induces the vinous, that a ferment of an acetous kind brings on the acetous fermentation, and a putrid one, that fermentation which ends in putrefaction. But we receive no more information, relative to the manner in which they produce those effects, than we do with regard to fermentation itself."* I will now proceed to examine, whether in becoming putrid, a body undergoes any considerable change; and, whether it be possible to remove putrescency after it has taken place. The very meaning of the word putrefaction conveys the idea that an essential change must have taken place in any substance which has acquired a putrid state. Putrefaction reduces both animals and vegetables to the same princi- ples, for, it causes an entire and complete decomposition of them, inso- much, that it is difficult, and indeed impossible, to distinguish between a putrefied mass of animal and one of vegetable matter. The former cha- racteristics of each are at an end. Colour, texture, and every sensible quality of the body, are thereby destroyed. It reduces the animate part of the creation to an indiscriminate level with inanimate matter. There is abundance of truth in the observation, that bodies, in this process, undergo a new combination, as well as separation of their constituent parts. Pu- trefaction causes the sweetest substances to become the most offensive and disagreeable to the smell; and, instead of a vegetable acid, at length produces a volatile alkali—bodies possessing very opposite principles. Many philosophers have gone so far as to say, that, by certain chemi- cal processes, they were able not only to render putrid substances sweet again, but restore them to the condition they were in, previously to then- undergoing this peculiar change. This, according to them, is to be effected by surrounding the putrefied body with an atmosphere of fixed air; to the loss of which principle, an enlightened philosopher wholly attributed the changes produced in a body by putrefaction; though the opinion has been * Manchester Memoirs, vol. ii. p. 259. 8 SEYBERT'S Dwrnuur ur i nu ingeniously refuted, and therefore needs not much consideration in this place.* It is true, that by surrounding a putrefied body with fixed air, we shall prevent the advancement of the process; yet the fixed air has no specific operation in this respect, for other substances possess a similar property. After I had suffered several pieces of highly putrid beef to remain com- pletely covered with fresh pump water for several hours, and then washed them frequently in water several times renewed, I found, that by this operation the water gained a highly offensive and putrid smell, and that the meat had lost a great degree of its own; but its solidity was not in the least restored. It is a common and well-known fact in domestic economy, that meat, which has become tainted, is very frequently washed in fresh water before it is cooked; and the reason assigned for this process is, that the meat is thereby rendered sweeter. Thus do house-keepers reason from a knowledge of the fact without any theory to bias them. Hence it appears very clear, that to explain this fact no specific opera- tion is necessary to be recurred to, since water, free from the combination of fixed air, had effects similar to those produced by fixed air itself. Mr. Chaptal, in my opinion, explains the operation of this, and of the other substances which are said to have the like effect, upon very simple and phi- losophical principles. When speaking of the necessity of the presence of vital air to putrefaction, he says, " We shall observe, on this subjectj that the effects observed in flesh exposed to the Carbonic acid, Nitrogene gas, &c. are referable to a similar cause; and it appears to me that it is without sufficient proof that a conclusion has been drawn, that these same gases, internally taken, ought to be considered as antiseptic; because, in the cases we have mentioned, they act only by defending the bodies they surround from the contact of vital air, which is the principle of putre- faction."! To me it appears plain, that, so great is the chemical change and de- composition which a putrid body has undergone, that no means can re- medy it. On this point Fontana truly observes, " We do not know any power, nature herself does not disclose any, that can recompose an organ that is destroyed, and entirely decomposed by putrefaction, or by the con- cussions of external bodies. This is what has never yet either been ac- complished or seen. We have, therefore, every possible reason not only to believe an animal that is reduced to this state dead, but likewise to be- lieve it dead for ever."{ From the above consideration of putrefaction, as going on out of the body, it appears, that a certain degree of heat, the presence of vital air, a * Medical Commentaries, vol. ii. p. 150. f Chaptal's Chemistry, vol. iii. p. 398. | Fontana on Poisons, vol. i. p. 406. PUTREFACTION OF THE BLOOD. 9 certain degree of moisture, together with rest, are indispensably necessary to, putrefaction; and that without their presence no body can putrefy. We also know, that by adding certain substances to bodies which are to undergo the change, the process is hastened in a manner surprising to every one who has ever had occasion to notice it. Having considered the circumstances in which fermentation, in gene- ral, takes place, as it is conceivable that if the above circumstances be pre- sent in the livingfanimal, the process might readily go on in it—let us examine if these necessary requisites be present, so as to act in a due and proper manner -upon that vital fluid, the blood. Several questions occur here.—Is there any difference between dead and living matter?—Is there not in living animals a positive power of re- sisting putrefaction?—Whether the nice and inexplicable operation which is employed in converting the dull mass of the motionless creation into the peculiar condition of organic sensibility, acts to no purpose ?—In fact, whether the principal characteristic of death, has not been determined by physiologists to be the beginning of putrefaction in the body ? The principle we denominate vital, with whose effects we begin to be acquainted, though its nature and origin will perhaps ever be hidden from us, is found to be the chief impediment to the putrefaction of a living animal. As soon as the animal is deprived of it, putrefaction is the inevi- table consequence, except the above precautions be well observed. This may be fairly demonstrated. All the circumstances necessary to putre- faction take place with respect to the external surface of our bodies, yet they do not putrefy while alive; but if life be by any means destroyed, they will as readily undergo the process as other inanimate matter. It is to be observed, that by the living principle is understood that power which in an animal actuates its whole system, or from which is derived sensation, motion, and the other qualities of life. It is the cause of the preservation of the body from dissolution, and is capable of existing, for sometime, under a suspension of all its actions.* We will now proceed to consider the presence of heat, pure air, mois- ture, and rest, with regard to the blood; in order to determine whether we might expect a putrefaction of that fluid, if the principle of life were not alone sufficient to obviate it. 1st. Of Heat. Though different degrees of heat are found sufficient to maintain life, in different animals, yet no animal while alive has ever been found devoid of a considerable quantity of it; indeed, so careful was Nature in this respect, that she has endowed man, and the inferior animals, with a power, whereby they are capable of generating heat;—a process, die investigation of which has of late much engaged the attention of phi- losophers, and upon which considerable light has been thrown. It is prc- * Gardiner'; Animal Economy, p. 3. c 10 SEYBERT'S DISPROOF OF THE bable that the blood of every living animal contains a degree of heat suf- ficient to support the process of putrefaction. 2dly. Pure Air. That element so necessary to our existence, and which we receive into our bodies, by means of those vital viscera, the lungs, is no less necessary to the maintaining of animal life, than to the process of putrefaction. A man will no more live, than a dead body will putrefy, in vacuo.* It was for a long time supposed that elastic air existed in the blood- vessels of living animals; but, the experiments of the ingenious Darwin clearly prove the contrary; the following is one of them. " Part of the jugular vein of a sheep, full of blood, was included between two tight liga- tures, and cut out while the animal was yet alive. It was immediately put into a glass of warm water, and placed in the receiver of an air pump. It sunk at first to the bottom of the water, and did not rise again, although the air was carefully exhausted. After this, it was wiped dry, and laid on the brass floor of the receiver. The air was again exhausted, but there was not the least visible expansion of the vein or its contents."! By the experiments above referred to it is reduced to a certainty, that no air exists, formally in the blood, while enclosed in the blood-vessels. And it is evident, that it was without sufficient grounds, that philosophers inferred, that air existed in the blood, while enclosed in the blood-vessels-; because they perceived it in blood drawn from a vein, and placed in the receiver of an air pump; for during its exposure it must have had time to absorb air from the atmosphere. The celebrated Huxham was of opinion, that " elastic air is probably generated in the arterial and venous systems, in putrid fevers,"! though he has no experiments to prove it. Let us then examine, whether air can exist in the blood-vessels of living animals. With this view the ingenious Luzuriaga tried many experiments on living dogs. He injected several different kinds of air into the blood-vessels, and in every instance the animals were killed, in a very short time. I will only mention that he twice injected inflammable air; once phlogisticated air; once fixed air; once nitrous air. I will state the particular circum- stances that happened in the instance, when dephlogisticated or pure air, which is the chief agent of putrefaction, was injected.—It was forced into the jugular vein of a dog, and in three minutes he died. On dissection, * That air is a very active and powerful agent in putrefaction, is evident from the following fact, viz. Whilst pus remains shut up in a perfectly close cavity it will keep sweet and inodorous, but on exposure to the atmosphere, it contracts in a very short time a putrid smell; the same circumstance takes place with re- gard to extravasated blood. t Medical Commentaries, vol. vi. p. 35. i Medical Observations, vol. iii. p. 36. PUTREFACTION OF THE BLOOD. 11 the blood appeared of a lively red colour, and frothy, but not grumous nor coagulated.* Thus it appears, that air does not, and cannot exist, formally, in the blood-vessels of a living animal; a circumstance which refutes the opi- nion, that the blood is capable of undergoing the process of putrefaction, during the life of the animal. 3dly. Moisture. No person in his senses dares to deny the presence of this third circumstance, as essential to putrefaction, and therefore it needs no further consideration. 4thjy. We have mentioned that it was necessary for a body, which is to undergo the putrefactive process, to be at rest. The continual motion of the blood of living animals, must certainly be a great impediment to the process; and indeed motion has been found to be a very effectual means of preventing it; even a brisk wind has been known to retard it.f We have found that the life of the animal, the want of air in the blood- vessels, and its circulatory motion, were great impediments to the putre- faction of the blood; we shall now proceed to consider, whether the prin- ciple of animal life is contained in the blood. The situation of that principle, to which we owe our existence as living beings, is at present much disputed. While some physiologists will have it to exist wholly in the nervous system, in the form of a subtle fluid, whose presence the best microscopes have not been able to discover; there are others, whose authority is by no means inferior, who strenuously op- pose the doctrine, and persist that blood partakes of it also. In this latter class we may rank the celebrated Hunter and Fontana. That the life of the animal exists in the blood, is an opinion of as an- cient a date as Holy Writ itself: it was the favourite sentiment of many ancient philosophers; and the great Harvey, to whom we are so much indebted, says, " the blood is the primum vivens, and the ultimum mori- ens, of the animal." This hypothesis was for sometime sunk into oblivion, but was again revived and placed on a firm basis by the able Mr. John Hunter, of London; who supports the doctrine by reasoning truly philosophical, and by expe- riments, in my opinion, incontrovertibly convincing. It would be needless for me to repeat all the ingenious arguments which are made use of by him on this occasion, as they may be easily seen, by referring to the En- cyclopaedia, vol. iii. p. 313. His 5th argument alone would almost suffice to convince me of the truth of his opinion. " The blood (says he) preserves life in the different parts of the body. When the nerves going to a part are tied or cut, the part becomes paralytic, and looses all power of motion; but it does not * Luzuriaga's Inaug. Dissertat. Eden. 1786. p. 2C f Medical Commentaries, vol. ii. p. 146. 12 SEYBERT'S DISPROOF OF THE mortify; if the artery be cut, the part dies, and mortification ensues." What keeps it alive in the first place ? Mr. Hunter believes it is the living principle which alone can keep it alive; and he thinks that this pheno- menon is inexplicable on any other supposition, than that life is supported by the blood.* This doctrine is every day gaining ground; and appears to be further supported by the opinions and experiments, of the celebrated Fontana; who observes, " What may lead one to suspect, that a very active and volatile principle does really exist in the blood, is, that the viper's venom prevents its coagulation when it is drawn from the vessels, and on the contrary, produces it in the vessels themselves. One would suppose (says he) in the first case, that something had flown off from the blood, which exists in it when it is enclosed by the vessels."t " My experiments on animals (continues this last mentioned enlight- ened philosopher) in which the nerves were bit by vipers, shew that the venom is a substance perfectly innocent to these organs, that it does not occasion in them any sensible change, and that they are not even a means or vehicle of conveying it to the animal. In a word, it appears that the nervous system does not concur more to the production of the diseases of the venom, than does the tendon, or any other insensible part of the ani- mal : on tiie other hand, all the experiments on the blood, the injection of venom into the vessels, and so on, constantly evince that the action of the venom of the viper is on the blood itself. This fluid is alone changed by the venom, and this fluid conveys the vjnom to the animal, and distributes it to its whole body. The action of the venom, and its effects on the blood, are almost instantaneous.'*! His experiments, in my opinion, allow this inference, that since life was not destroyed by the immediate application of the poison to the bare nerves, and that the loss of it wa3 almost instantaneous when the poison was applied to the blood; there exists some quality in the blood, that does not exist in the nerves; and as death can only be produced by de- stroying the vital principle, this principle must consequently exist in the blood, and in a state different from that in which it exists in the nervous system. I will now proceed to give a connected view of the reasons, which, to- gether with the experiments hereafter to be mentioned, induce me to deny the putrefaction of the blood to have ever taken place, and which confirm me in believing, that no such change can happen in the blood of living animals. * Ercyclopoedia Loc. citu*. t Fontana on Poisons, vol. ii. p. l.v, t Ibid. vol. i. p. 306. PUTREFACTION OF THE BLOOD. 13 1st. We have seen that the process of putrefaction cannot take place in the animal or vegetable kingdoms, until after the animal or plant be deprived of life. I think we have given some proof of the blood's contain- ing the principle of animal life, of which (whether it be convincing or not) the candid will judge. When life is once perfectly destroyed, there are no means, at our command, by which it can be again restored: therefore, we must infer, that all putrid cases are necessarily mortal, or a putrefac- tion of the blood cannot take place. 2dly. From viewing the process of mortification, as going on in the solid parts of animals—for the death of the part invariably precedes the symptoms of putrescency, as is evidenced by the want of sensibility in the part. 3dly. There is no vital air in the blood-vessels, and we know putrefac- tion cannot go on without it. 4thly. The blood in the living animal is in continual motion—a small degree of motion has been known to impede the process. 5thly. The doctrine of ferments. For as long as a drop of this putrid blood remained in the vessels, no particle could exist in them, without be- ing changed by it; therefore it is a necessary consequence, that in every case, where putrefaction is supposed to have taken place in the blood, every drop of that fluid should be drawn from the vessels, and the vessels should undergo a perfect cleansing before healthy blood could exist in them; consequently, if the vessels are not cleansed, the process must necessarily continue for ever, and in attempting to cleanse them, would not death be the inevitable consequence?* 6thly. We are as yet unacquainted with any means by which we are able to recover a body, when once putrid; for, according to a chemical axiom, it has undergone a perfect decomposition in the process; and, cer- tainly, without obviating the effects of putrefaction on the blood, and re- ducing it to its fonner state, the animal cannot exist for any length of time. 7thly. In every case of putrefaction a great quantity of elastic air is evolved, and no author (as far as I know) has made mention of the pre- sence of air in the blood-vessels of those who have died of diseases, which were supposed to belong to the putrid class, and whose bodies were dis- * The difficulty of restraining putrefaction after it has taken place, and of de- stroying the putrid ferment in vessels that have contained putrid substances, is well known to the brewers. When their liquor becomes putrid, or as they term it, " foxed," the vessels which contained it become so contaminated, that they will excite the same fermentation in any fresh liquor that may be put into them, even after they are washed. It is only by white-washing or scouring them with lime that they can be thoroughly cleansed. I have heard of a brewer, who waa so much embarrassed by a putrid ferment in his vessels, that he was about giving up his business, when he fortunately learned the use of lime. U SEYBERT'S DISPROOF OF THE sected immediately after death. It has been fairly proved that air, on being injected into the vessels, kills in a very short time.* 8thly. According to the ideas of the supporters of the putrefaction of the blood in diseases, the process must be different in typhus, &c. from what it is in scurvy; since, in the former case, bark and wine, together with other stimuli, are the only true remedies; whereas, according to thera, these remedies are found to be of little or no service in the latter, and fresh vegetables are its only remedies. For the blood, they say, is putrid in both instances; and since putrefaction going on in the same substance would appear to be always the same, we might, with propriety, suppose, that what retards and corrects it in the one instance, would do it in the other. Who has thought of exhibiting such vegetables, in typhus, yellow fever, &c. and neglecting those powerful remedies, bark and wine? 9thly. It is incompatible with sound reasoning to suppose that putre- faction of the blood takes place in the plague, 8cc. since we find that persons sometimes fall down dead, immediately on being exposed to the effluvia, that have been said to give origin to this and other diseases of the same class; as the porters, who opened bales of goods in the lazarettos of Mar- seilles. Mead relates, that, " Upon opening one of the bales of wool in a field, two Turks employed in the work were immediately killed, and • some birds which happened to fly over the place, dropped down dead."t How is it possible that the mass of blood, or any part of it, could become in the least degree putrid in those instances ? For the space of time, before death was produced, was too short to allow of it. Since the poison kills so quickly, can we with reason suppose that an animal can live while the fountain of life is impregnated with it ? If a small portion of such effluvia produces disease, when its action may, exclusively, be supposed to be merely on the external surface of the body, is there not strong ground for believing that instant death would follow if the blood were in the least tainted by it ? lOthly. Experiments seem to prove, that the blood is peculiarly quali- fied to excite motion in the heart and arteries, and that no other fluid will answer the same purpose—That even milk, and other bland liquors, when injected into the vessels of living animals, kill. We know it is an established truth, that by putrefaction bodies undergo a complete decom- position and dissolution of their constituent parts, and are rendered totally different from what they were before. How then can we imagine that life can be kept up whilst the blood is in a putrid state in the vessels? For these reasons I concluded that a putrefaction of the blood could not take place in the living body; but the importance of the subject in- duced me to engage in a series of experiments which might enable me, " Vide ante, page 10. t Mead's Works, p. 198. PUTREFACTION OF THE BLOOD. 15 with more indisputable certainty, to decide the question, Whether the blood of living animals can be rendered putrid ? And this I supposed, if possible, would be ascertained by the following circumstances, viz. I. By Starvation. II. By a putrid Diet. And, III. By injecting putrid and other substances into blood-vessels. 1st. Of Starvation. When we consider the many and various actions performed by man and other animals, we plainly see why a certain quan- tity of aliment is necessary to be taken by them. Physiology teaches, that by every action man suffers a loss of the solids, and that by every secretion the blood becomes less in quantity. The blood being the fountain from whence all the solid parts derive their support, and the fluids their origin, it must naturally have been sup- posed to be affected by starvation, as it is immediately prepared from the aliment we take in. If the case be as above stated, is it not surprising that man can live for a length of time without taking any nourishment at all ? There are in- stances related where men have lived for six, twelve, and even fourteen days, or longer, without receiving any aliment.* Drink is found to be no less necessary to the maintaining of animal lift- man the solid matters of our food. The necessity of this article was sup- posed to be merely in recruiting, blunting, and correcting the acrimony of the blood which would take place if we did not use them. And it has been found by experiment, that life may be supported a much longer time by water than it could without it. Rhedi, who made experiments to ascer- tain how much longer life might be supported by the use of drink, without the use of any Other article of diet, than when the animal was totally deprived of all food, found, that fowls to whom he gave no drink lived until the ninth day; whereas one who was allowed water, lived more than twenty days.f Though man may live for a considerable length of time without taking in any nourishment, yet his situation is not agreeable; for, he not only suffers pain, but all the functions, as well bodily as mental, are in conse- quence affected; his sensations are strange, his ideas confused, his sight deceptive and deranged, his countenance becomes pale and sallow, his weight decreases considerably, though the excretions are sparing or none at all, the respiration suffers, the action of the heart decreases in propor- tion, till at last no pulsation can be felt, debilit} by degrees overpowering life, death approaches and puts an end to his sufferings. * Manchester Memoirs, vol. ii. p. 467. and r.eq. t Ibid, vol. ii. p. 575. 16 SEYBERT'S DISPROOF OF THE If after having fasted a length of time, the person recover, he becomes melancholy, hysterical, effeminate, stupid, &c* The functions performed by the fluids and solids of an animal, being so nearly connected the one with the other, have occasioned this question, Does starvation operate by inducing disease in the solids or fluids ? Most physiologists are in favour of an opinion, that the fluids are particularly affected, and that by starvation the animal suffers from the quality, rather than from the deficient quantity of the blood. They suppose it to become acrid and even putrid. To determine whether it was the blood that suffered, I performed the 2d and 3d following experiments, and also examined the phenomena presented by the blood of a healthy dog, the better to judge of the state of that fluid in all the succeeding experiments. And let me here observe, that the experiments I shall have occasion to relate, were made in the presence, and with the assistance of my worthy friends, Messrs. Jesse Thompson, John Andrews, my fellow graduate, and Jacob Wagner, jun. They were witnesses to all the phenomena; and I take this public method of acknowledging my obligations to them for their kind assistance. EXPERIMENT I. September 6th, 1792. An ounce of blood was drawn from one of the crural veins of a healthy dog, at 15 minutes after 2 o'clock, p. m. It was coagulated at 20 minutes after 2 ; separation into serum and crassamentum was evident at 34 minutes after 2. Serum did not change the colour of a piece of paper stained with a vegetable blue.f EXPERIMENT II. A young dog was kept for the purpose of starvation, and the phxno- mena were as I shall now relate. I thought it not unnecessary to weigh him, at different times. I shall therefore mention the weight, as observed at those several periods. July the 28th. He weighed 5 3-4lb. July 29th. 7 l-21b. Food was given him the last time, in the afternoon of the 29th of July. August 3d. He weighed 6 1-21b. August 12th. He weighed 5lb. At 2 minutes before 12 o'clock an ounce of blood was drawn from one of the crural vessels. The blood flowed * Halleri Elementa Physiology. t The vegetable blue was made use of as a tost, with the view of ascertaining whether the serum of a healthy animal contained any alkaline salt in a formal state, as it is a well established fact, that the volatile alkali is produced by putre- faction ; and the production of it i9 one of the characteristic circumstances of that process: the same test was made use of in the subsequent experiments, to ascer- tain whether serum gained any alkaline properties by the different treatment which the several animals sufieroo* PUTREFACTION OF THE BLOOD. 17 freely, but by misfortune an artery was opened instead of a vein. The colour and smell of the blood were quite natural, being highly florid like arterial blood. It was coagulated at 3 minutes after 12—separation into serum and crassamentum was evident at 13 minutes after 12. The se- rum and crassamentum appeared perfectly natural. A piece of the blue stained paper was dipped into the serum, and no change of colour was produced. To prevent a further hemorrhage, as he was much weakened by the bleeding, the wound was well closed, and a piece of spunge bound tightly over it. The leg became paralytic. August 13th. The leg was much swollen below the ligature, and when handled did not appear to give him any pain. The ligature was somewhat loosened. August 14th. Weighed 4 l-2lb. August 15th. This morning at 8 o'clock I found him dead. During the above management the dog had very few evacuations by stool or urine, till the two last days of his life, when the urine dropped continually from the urethra. His eyes were several times examined, and no alteration in them was evident. He did not appear to suffer pain till the 3d of August, at which time he cried very much, gaped frequently, and appeared very weak; weakness continuing daily to increase till his death. I did not perceive that respiration was much affected; but the action of the heart became so feeble, that I could scarcely perceive its beating for some days previous to his death, though I applied my hand to the part where its stroke is generally felt. The abdomen was much contracted, and the fore-part of it was drawn up to the spine. The body was examined immediately on finding him dead, when ap- pearances were as follow: The stomach contained a considerable quantity of a whitish fluid, its texture was perfectly natural. The intestines were of a greenish cast. The other viscera appeared in a sound and natural state. At 39 minutes after 8 o'clock, blood was caught in a tumbler from an opening made into the heart; colour and smell natural. It was coagu- lated at 45 minutes after 8. It began to separate into serum and crassa- mentum at 51 minutes after 8. Coagulum and serum perfectly natural. Serum did not change the paper stained blue. EXPERIMENT III. April 10th, 1793, a dog was kept for the purpose of starvation. April 20th. Blood was drawn from him at 15 minutes past 3 o'clock; the colour and smell were natural—it coagulated at 20 minutes after 3, 18 SEYBERT'S DISPROOF OF THE and separated into serum and crassamentum at 35 minutes after 3. The serum was not in the least acrid to the taste. April 26th. Blood was drawn at 33 minutes past 3 o'clock. The co- lour and smell were natural—it coagulated at 38 minutes past 3, and separated into serum and crassamentum at 53 minutes past 3. The coagulum and serum were natural. The serum was not in the least acrid to the taste. 2dly. Of Putrid Diet. The necessity of our taking aliment being fully established, Nature, with her usual wisdom, has given man and the other animals an appetite for it. She has also provided different kinds of aliment in the different climates, in a proper quantity, so that each might have what was most suitable and agreeable to his particular condition. To this purpose the appetites of the inhabitants of the different regions vary; while some prefer a vegetable, others according to the situation, with more pleasure and benefit to their health, derive their chief support from the same class of beings to which they themselves belong, though of different genera and species. Animals are styled herbivorous, carnivorous, and omniverous, from the particular kind of aliment they make use of: thus sheep live wholly on a vegetable diet, while the wolf and other animals of the same species are found to support themselves best by a diet which is entirely animal; and man, from the peculiar structure of his teeth, appears to be destined to take in all kinds of alimentary matter, and thus he is found to live best on a diet, composed of animal and vegetable substances. Experiment* would seem to prove that an animal, who is naturally herbivorous, may be made to live entirely on flesh, although not so conveniently. A mixed diet, as already mentioned, best suits the appetite and peculiar state of man, but there are instances where he entirely lives on vegetables; and on the contrary, he has, in other situations, been found to live wholly on the inferior animals. While the mixed diet renders him placid and fit for every purpose, for which nature formed him, one entirely animal renders him ferocious as the brute, and that altogether vegetable renders him weak and feeble. Among civilized nations, aliment, before it is eaten, always undergoes -some kind of preparation, whereby it is rendered more or less fit to be the subject of digestion. Aliment, after being received into the stomach, remains there for some time, and undergoes a considerable change, before it quits that viscus; for it thereby becomes fitted for the forming of the chyle, from which the blood itself is immediately prepared. The state of the chyle, and consequently that of the blood, is by many supposed to be much influenced by the aliment we take; thus a putrid and bad diet is supposed to produce vitiated and putrescent chyle, and const- PUTREFACTION OF THE BLOOD. 19 quently, in their opinion, the blood is tainted in the same manner. This opinion probably took its rise from the flesh of certain animals tasting similar to the food they eat; thus sea-fowls, we know, have a fishy taste j pidgeons who have fed on poke-berries for sometime have their flesh tinged with the colouring matter of that vegetable; and the flesh of the pheasant who has lived upon laurel-berries is capable of communicating the deadly effects of that active poison to the human system. These, and perhaps other like circumstances, were the means of giving rise to the opinion, that the blood of animals must be affected differently by different articles of diet, and that corrupted or putrid food would be the means of producing a putrefaction of the blood. As long since as the days of Hip- pocrates, physicians have been of opinion that water and corrupted meat were the true causes of putrid diseases. In this manner was the plague, Scurvy, &c. thought to have been produced; but the sentiment of many moderns is, " That scurvy arises from the want of a due quantity of ali- mentary matter in the food of those who are afflicted with the disease." This opinion is supported by the two cases of scurvy related in the Medical Transactions by Dr. Milman, and also by Dr. Stark's Dietetic Experiments.* To convince myself whether, the state of the blood was affected by a putrid diet, the following experiments were performed. EXPERIMENT IV. July 29th, 1792. A dog was put upon a diet of putrid meat and putrid water, and continued to feed thereon till the 27th day of August following. The meat was beef, and never given to him till it was highly putrid: the drink was clear pump water, rendered putrid by suspending a piece of putrid beef in it, and exposing it to the action of the sun. August the 12th his eyes were examined, and the pupils of both ap- peared much contracted. They were watery. At 20 minutes past 12 o'clock an ounce of blood was drawn from one of the crural veins Its colour and smell were perfectly natural—-it was coagulated at 25 minutes after 12— separation into serum and crassamentum was evident at 30 minutes after 12; the coagulum and serum were perfectly natural—the serum did not change the colour of a piece of paper, stained with a vegetable blue. August 19th. He appears weak and very sick. For these few days past he has had a disrelish for the putrid meat. His eyes appear sore and in- flamed. I washed them with cool pump water. The action of the heart was regular though feeble. Blood was drawn at 4 minutes before 11 o'clock; the colour and smell were perfectly natural—it was coagulated at 11— • Vide Blane on Seamen's Diseases—Medical Transactions—and Stark's Works. 20 SEYBERT'S DISPROOF OF THE separation into serum and crassamentum was evident at 6 minutes after 11. The serum and coagulum were perfectly natural—the serum did not change the colour of the paper stained blue. August 20th. His eyes appear much better—washing them with cold water continued. He appears weak. August 22d. His eyes appear quite well. Strength somewhat recover- ed. Appetite appears also to be increased. August 24th. Blood was drawn at 20 minutes after 5 o'clock. Its colour and smell were perfectly natural. It was coagulated at 24 minutes after 5; separation into serum and crassamentum was evident at 31 minutes after 5. The coagulum and serum were natural. The serum did not change the colour of the paper stained with the vegetable blue. He in general ate and drank a sufficient quantity; but ate more in the beginning than towards the latter end of the experiment. He was reduced by the diet. The excretions were not evidently affeGted. The action of the heart was regular as has been mentioned, and respiration appeared to be performed in a natural and easy manner. EXPERIMENT V. A dog was kept fasting from September the 10th, 1792, till the 14th of the same month. During his fasting he did not appear uneasy till the evening of the 13th, when he cried. He continued in this state till the morning of the 14th, when at 15 minutes after 9 o'clock highly putrid broth was given him: he swallowed it greedily, belched several times afterwards, but did not vomit. The action of the heart, which before was frequent and feeble, now became slower and fuller; he appeared very lively and full of play. At 3 o'clock, p. m. he was fed again with putrid broth. September 15th. At 2 o'clock he received some more of the putrid broth. The action of the heart in every respect natural, except that it was a little feeble. September 16th. At 3 o'clock he was fed again with putrid broth, which he took in heartily. September 17th. At 33 minutes after 9 o'clock blood was drawn from one of the crural vessels. Its colour and smell were natural. It was coagu- lated at 39 minutes after 9. It began to separate into serum and crassa- mentum at 50 minutes after 9. The serum and coagulum were perfectly natural. The serum had no effect in changing the colour of the paper stained blue. EXPERIMENT VI. A bitch was kept under the same circumstances as the dog last men- tioned, and the phenomena were alike in both instances. PUTREFACTION OF THE BLOOD. 21 September 17th. At 12 minutes before 10 o'clock, blood was drawn. Its colour and smell were natural. It was coagulated at 6 minutes before 10. It began to separate into serum and crassamentum at 3 minutes af- ter 10. The serum and coagulum were perfectly natural. The serum did not change the colour of the paper stained blue. From these experiments, it is evident, that the sensible qualities of the blood are not, in the least, affected by a putrid diet. The question then ' must certainly be, How does a putrid diet operate upon the system? I an- swer, by inducing debility from the little nourishment it contains; and that from hence the solids suffer. This I hope to prove by an experiment performed on the dog, the subject of the 19th experiment, which will be related under the head of injections of putrid matters into the blood-vessels. The process of digestion is one of the most curious operations of na- ture. It acts wonderfully and powerfully upon our aliment, changes the properties of animal and vegetable matters, reduces them both to a sub- stance possessing like properties, and operates upon the hardest as well as the most fluid substances—All this is said to be performed by a fluid we call the gastric juice. If such are the effects of digestion on our aliment, is it not reasonable to suppose, that the properties of putrid matters taken into the stomach may be also changed? Let us examine whether putrid food undergoes a change of properties in the stomach. That great Italian philosopher, Spallanzani, was I believe, the first who made experiments to this purpose. He performed them on birds, cats, dogs, and even went so far as to swallow putrid meat himself. He found that the meat, in every instance, lost its putrid smell.* I repeated his experiments on dogs, with the like success, and shall now relate them. EXPERIMENT VII. September 17th, 1792. Three ounces of highly putrid beef were given to a bitch. She retained it. Three hours and a half after, the contents of the stomach were examined. The meat was found surrounded by the gastric-fluid; its putrid smell was entirely destroyed, and its colour ap- peared more natural than it was before the animal had swallowed it. EXPERIMENT VIII. September 17th, 1792. Highly putrid broth was given to a dog. The stomach retained it; and three hours after, its contents were examined, some of the broth was remaining together with some of the solid matters that were mixed with it. The putrid smell was found to be abundantly diminished. * Spallanzani's Dissertations, vol. 1. p. 284, and seq. 32 SEVBERT'S DISPROOF OF THE I shall now proceed to the consideration of my 3d head, which has for its object of inquiry, Whether the blood be materially changed and ren- dered putrid, by the injection of putrid and other substances into the blood- vessels ? Many centuries have elapsed since physicians first began to be afraid of the access of the least particle of contagious matter into the blood- vessels, for, that it excited a fermentation therein, contaminated the whole mass of blood, and caused it to partake of its contagious properties. If (say they) by adding a small quantity of a ferment to a mass of flour, or other fermentable matter, we are able to bring on a fermentation in it, and convert it into tlrj nature of the ferment, why should not the blood, in like manner, be affected, if by chance or otherwise a putrid or othetf ferment should get into the vessels and mix with it ? Thus they supposed the small-pox, measles, and other eruptive diseases to be produced. These men always overlooked the vital principle, which exists in the one substance, and not in the other; and here in my opinion the material difference lies; for we know that if the other requisite circumstances be duly observed, it is only necessary to destroy life, in order to bring on a putrefaction in the animal. I think, from what I have stated, there is ground for believing that the blood cannot putrefy in the living animal; but the deductions of reason, however just and true, the inferences are not to be solely relied upon, when the better evidence of substantial facts—and of facts more immediately in point than the preceding ones, can be had. To ascertain beyond a doubt whether the blood could be excited to a putrid fermentation, by injecting putrid matters into the blood-vessels, became an important and essential desideratum. With this view I made the following experiments, which were performed on healthy dogs. The operation of injection was always executed on one or the other of the extremities of the animal, An incision was made, and the vein was laid bare, which was for some distance dissected free from connection with the adjacent parts. An opening was then made into its cavity, sufficiently large to admit a curved tube, which was retained in it by means of a liga- ture passed round the vessel. The tube was made so as to screw on4he mouth of a common pewter syringe. EXPERIMENT IX. Was performed July 29th, 1792, on a bitch, two months old, in good health. About 5 drachms of putrid serum were injected into one of her femo- ral veins. The serum was obtained from the blood of a healthy dog; and exposed in an open phial, for one week; and had a smell similar to that of rotten eggs. « Some difficulty attended the introduction of the pipe, by which the matter was injected, owing to its large size, and the smallness of the vein__ PUTREFACTION OF THE BLOOD. 23 the vein, when laid bare and touched with any instrument, contracted considerably, its diameter being thereby much diminished. During the operation, she lost but a very inconsiderable quantity of blood, yet she seemed very weak and languid, probably owing to the pain she endured. Whilst I was injecting the serum into the vein, she had two convulsive paroxysms, and appeared to be in great pain, which she expressed by several loud cries. The muscles of her whole body seemed affected with these convulsive motions; that they were not owing to the irritation pro- duced by introducing the pipe into the vein is certain, because no such symptoms appeared befoi-e the injection of the serum, though it was intro- duced twice or thrice. After the injection was finished, she was placed on the floor, and attempted to walk, but was so weak that she fell down. The action of the heart was very frequent, though weak and feeble; respi- ration was anxious and difficult. She seemed not at all inclined to move; and was quiet, except that at different intervals, she groaned and sighed, and afterwards vomited some of the food she ate at noon, in an indigested state, together with about two ounces of a yellowish green coloured fluid. Continuing in this situation, she was frequently affected with convulsive motions of the abdominal muscles and lower jaw, she became weaker and weaker. At 15 minutes past 7 o'clock, about an hour and an half after the experiment was performed, all her muscles were in a relaxed state, and she appeared motionless. At half past 7 she was dead. Dissection. I did not examine the body till the 30th, at half past 8 ©'clock; so that she was 13 hours dead, when the examination took place. The abdomen was much distended; upon cutting into its cavity, a quantity of putrid air, of a smell like that of rotten eggs, rushed out. There was an effusion of a lympid fluid. The intestines were distended with air, and contained but a small quantity of liquid feces. The stomach contained little else, but a large quantity of the before mentioned flatus, and a fluid of a yellowish colour. At its lower orifice it appeared rather pretematurally red. All the other viscera were in a sound and natural state. The veins appeared much distended; and air, intermixed with blood, of a dark venous colour, appeared through their coats. When I cut into the vessels, air came out in bubbles, together with the blood. The blood did not appear to be very firmly coagulated. The heart was much distended with blood, particularly the right auricle, which contained some air also. In the heart the coagulation was more perfect than it was in the veins. The blood did not smell in the least putrid. EXPERIMENT X. Was also performed July 29th, 1792, on a bitch in good health. About a drachm of pus, diluted with a small quantity of clear pump water, was injected into one of her femoral veins. The pus was obtained 24 SEYBERT'S DISPROOF OF THE on the 27th inst. from an abscess of the intercostal muscles. This day it possesses a putrid smell. During the injection of the matter, she had two very violent fits of convulsion, the last of which continued for some time, and she appeared to be in great pain; respiration was quick and irregular; the heart beat frequently though with some force. The pulsations were small and irre- gular, accompanied with frequent intermissions, and to all appearance she was dying. When she was placed in a cool situation, the respiration be- came less difficult, and the action of the heart more regular. She continued in this state and lay quiet for some time, when a mercurial thermometer was applied to the axilla, and the mercury rose to 100°, as it did when it was applied before she underwent the experiment. After lying about twenty minutes in a cool place, she got up and attempted to walk, but was very weak, and did not go far before she fell down; after which she seemed again to recover. At 30 minutes past 7 o'clock she was seized with twitchings of the muscles of her abdomen and lower jaw; the weak- ness increased; at length she became motionless; and at fifteen minutes before 8 o'clock, about an hour and an half after the injection, she was dead. Dissection.^—"The body was not examined till Monday morning the 30th, about 14 hours and an half after she died. The abdomen was consi- derably distended; I made an incision into it, but found that no air escaped; about 2 oz. of a lympid fluid was found effused in the cavity. The intes- tines were much distended, and when an incision was made into them, air and fxces came out. The stomach was likewise much distended with air and half digested food. The same preternatural redness about the lower orifice, which occured in the former case, appeared also in this. The other abdominal viscera appeared perfectly natural and sound. The heart was much distended with blood, but no air was found in it or the blood-vessels. The blood was more firmly coagulated than that mentioned in the last experiment, and it had no unnatural smell. EXPERIMENT XI. Auguust 6th, 1792. A drachm of fluid matter, produced by highly putrid beef, was diluted with four drachms of putrid pump water, and injected into one of the femoral veins of a healthy dog. The matter was injected at half an hour after 11 o'clock. During the injection he was much convulsed, and appeared to be in great pain. The pupils of the eyes were somewhat dilated. The beating of the heart was now very frequent, though feeble, as it was during the injection of the matter At fifteen minutes before 12 o'clock the breathing became very frequent, accompanied with great difficulty and sighing. At this time he vomited a quantity of half digested food, and appeared to be greatly PUTREFACTION OF THE BLOOD. 25 relieved by it; at 12 o'clock he vomited again, which relieved him so that he rose, but in one or two minutes laid down again. At 4 minutes past 12 he had an evacuation of fxces—at 7 minutes after 12 he attempted to lay down, but fell, and laid in an unnatural posture—he appeared to be very weak—his breathing became more difficult and laborious—his eyes appeared watery and sunk in the orbits. At 10 minutes past 12 he had another evacuation of fxces. At 15 minutes after 12 he was raised upon his feet—he stood, though with difficulty, and his left hind leg became paralytic* In a short time all his hind parts appeared to be more or less affected in this manner. At 40 minutes after 12 he became very restless, turning and twisting his body every way. At 45 minutes after 12 he was again raised upon his feet, but could not stand, for all his muscles appeared greatly relaxed. At 10 o'clock the pupils of the eyes were much dilated, and his sight seemed to be greatly diminished—he had an evacuation of urine. He began to groan, and the abdominal muscles were convulsed. The convulsions, after continuing some time in those parts, extended to the muscles of his head and neck. Respiration, and the action of the heart ceasing, he died at 12 minutes past 10 o'clock. Dissection. The body was examined immediately after death, and no- thing unusual was observed. The blood was quite natural in every respect. EXPERIMENT XII. August 10th, 1792. Twelve grains of putrid blood, diluted with a drachm of clear pump water, were injected into the femoral veins of a healthy bitch, at thirty-five minutes past 10 o'clock. During the injection she seemed uneasy, and had an evacuation of urine. The action of the heart became much slower, and very feeble. Respiration was somewhat difficult. She was then placed on the floor, and continued standing—12 minutes after she had a natural motion from the rectum, and then laid down. At 11 o'clock her eyes were examined, and they did not appear any way preternatural. She seemed dull, heavy, and much inclined to sleep. At 12 o'clock I perceived that she had had another evacua- tion of urine. The eyes were now examined again, and no alteration appeared to have taken place in them. She laid quiet till half past one 6'clock, when violent efforts to vomit came on, and she brought up a quantity of the food she had eaten previously to the performing of the experiment. The heart beat very frequent and feeble—respiration was not greatly affected, but she continued dull and heavy. At 2 o'clock meat and drink were offered her—she would not even bear the smell of meat, but rose and drank some water. She laid down. At half past 2 o'clock she got up again, walked about, and evacuated urine; then laid down again, and * The incision in thi9 experiment was made on the right thigh. E 26 SEYBERT'S DISPROOF OF THE was dull and heavy as before. At 5 minutes before 5 o'clock she had ano- ther evacuation of urine. At 3. minutes before 5 she had a very copious evacuation of extremely fluid feces, of the colour of coffee-grounds, and of a very putrid smell. She now appeared weaker than she was before the evacuation, though not quite so dull. At 6 o'clock she evacuated urine again. I left her at 25 minutes after 6, when circumstances did not ap- pear much altered. At 8 o'clock I saw her again, meat and drink were offered—she drank, but would not eat. The heart beat very frequent and feeble—in other respects as before. August 11th. This morning, at 8 o'clock, I found her dead. A disa- greeable odour arose from her body. The abdomen appeared somewhat distended. I perceived she had had another loose evacuation of the de- scription above mentioned, though not so copious as the former one.. There was a great deal of saliva about the mouth, and the tongue pro- truded through the teeth. On Dissection, the following appearances were observed. Upon cutting into the cavity of the abdomen, no air escaped, but I experienced a very disagreeable foetid smell. The superior parts of the intestines appeared in several places of a dark green colour, spotted with small white specks, while the lower portions appeared natural. When an incision was made into the intestines, a quantity of putrid air rushed out, together with liquid dark green coloured feces. The stomach appeared to be rather small—I made an incision into it, when some of the like liquor flowed out. The liver was in many places of a preternatural colour, and adhered to almost, all the other abdominal viscera, particularly to the stomach and right kid- ney. The gall-bladder was much distended with a light green coloured bile; the lungs were collapsed; the right lobes were of a blackish colour, intermixed with red; the left lobes appeared natural. The red appearance of the lower orifice of the stomach, mentioned in the other cases, was not apparent in this. The veins and heart were much distended with blood, %vhich was not very firmly coagulated, but its smell was perfectly natural. EXPERIMENT XIII. August 14th, 1792. At 4$ minutes after 10 o'clock six grains of putrid blood, mixed with a drachm and a half of clear pump water, were in- jected into one of the femoral veins of a bitch. During the injection she appeared very uneasy—the action of the heart was slow and feeble__re- spiration slow, and performed with difficulty. She was placed on the floor, appeared dull, and laid down. At 10 minutes before 11 o'clock her abdo- minal muscles were violently convulsed. At 7 minutes before 11 she was seized with violent retchings and efforts to vomit, but did not evacuate. At 15 minutes before 3 o'clock meat and drink were offered her__she ate but would not drink. At 23 minutes before 7 she had a copious evacuation PUTREFACTION OF THE BLOOD. 27 of urine. At 20 minutes before 7 she ate and drank. I left her at 15 mi- nutes before 7, when she seemed easy. I saw her again at 8 o'clock and no alteration was evident. August 15. This morning at 8 o'clock, I saw her—she appeared per- fectly easy—action of the heart nearly natural, though rather frequent. She was now fed, and ate as before. I perceived that she had had a natural evacuation of feces. At 21 minutes after 5 blood was drawn—its colour and smell were natural—it was coagulated at 24 minutes after 5—the se- paration into serum and crassamentum was evident at 30 minutes after 5; a piece of the paper stained blue was dipped into the serum, and no change of colour took place—the serum and coagulum were quite natural. I saw her again at 8 o'clock. She appeared as she did when in health. August 16th. She was perfectly well. EXPERIMENT XIV. August 17th, 1792. At 15 minutes after 12 o'clock twelve grains of putrid blood, mixed with a drachm and a half of clear pump water, were injected into one of the humeral veins of the bitch last mentioned. During the injection, she cried violently, and appeared to be in great pain. Re- spiration became very frequent—action of the heart frequent and feeble. The eyes were examined, and the pupils were found to be much con- tracted. She was placed on the floor, walked a few steps, leaned against the wall, in a standing posture, and appeared very sick. At 26 minutes after 12 she had an evacuation of feces, which was rather loose. At half past 12 she laid down, appeared dull, and much inclined to sleep. At half past 2 the abdominal muscles were affected with convulsive contractions; they did not continue long. The eyes were again examined, and the pupils appeared natural. At 3 minutes before 5 she had a copious evacuation of urine. At 10 minutes after 6 I left her eating, and to appearance easy, though dull and languid. I saw her again at 8 o'clock, when I perceived she had had another loose evacuation of feces, which was copious. Pul- sation of the heart frequent and feeble—she appeared easy. August 18th. Blood was drawn at 5 minutes before 6 o'clock p. m. its colour and smell were natural—it was coagulated at 6—at 5 minutes after 6 it separated into serum and crassamentum—coagulum and serum were quite natural—Serum did not change the paper stained hlue. At 8 she appeared perfectly well. August 19th. She was perfectly well. The blood, which was drawn yesterday, had a natural odour, when it was examined this morning at 11 o'clock. EXPERIMENT XV. August 20th, 1792. At 4 minutes before 11 o'clock, half a drachm of putrid blood and a drachm of clear pump water, were injected into one 28 SEYBERT'S DISPROOF OF THE of the humeral veins of the last mentioned bitch. During the injection she was very uneasy, and gave several loud shrieks. The heart beat fre- quent and feeble. Respiration became very difficult. She was placed on the floor, and immediately after had a copious evacuation from the sto- mach. She appeared very weak, and leaned against the wall. At 7 minutes after 11, she had retchings and violent efforts to vomit, but no evacuation ensued. At 32 minutes after 11, she began to groan and sigh. At 5 minutes after 12, she had efforts to vomit, but nothing was thrown up. I left her at 15 minutes before 1; she drank, and appeared easy, though she was very weak. I saw her again at 2 o'clock, the heart beat very frequent and feeble. I perceived she had had an evacuation of feces while I was absent—it was rather loose. Meat and drink were offered her; she drank, but did not eat. She appeared very sick. I saw her again at 8 o'clock, when she appeared just as she was at 2 o'clock. August 21st. Blood was drawn at 2 minutes before 5 o'clock p. m. its colour and smell were natural—it was coagulated at 3 minutes after 5—s.paration into serum and crassamentum was evident at 9 minutes after 5—the coagulum and serum were perfectly natural—the serum did not change the colour of the paper stained blue. At 8 o'clock she ap- peared very well. August 22d. Serum of the blood drawn yesterday, did not change the colour of the paper stained blue. EXPERIMENT XVI. August 22d, 1792. At 11 o'clock, a drachm of putrid blood, mixed with half a drachm of clear pump water, was injected into one of the crural veins of the bitch last mentioned. During the injection, the action of the heart became very frequent and feeble. Respiration very laborious. She vomited. After this she was placed on the floor, and appeared very weak, yet stood for some minutes, and then fell down gently. At 8 minutes after 11, she had an evacuation of urine and of feces. At 14 minutes after 1 l,the eyes were examined; the pupils were found to be very much con- tracted. At 16 minutes after 11, she had another evacuation of urine. At 19 minutes after 11, she began to cry violently, and appeared to be in very great pain. The respiration became very laborious, and the action of the heart increased in frequency and feebleness. At 23 minutes after 11, she became convulsed. At 25 minutes after 11, a finger was drawn over the eye, and no contraction of the eye-lids took place. At 28 minutes after 11, she was dead. Dissection. The examination of the body took place at 8 minutes after 12 o'clock. All the viscera were found in a sound and natural state except the lungs—there a bloody effusion was discovered, particularly in the inferior parts of the left lobes. At 20 minutes after 12, blood was PUTREFACTION OF THE BLOOD. 29 obtained by opening one of the large veins; the colour and smell were natural. When I left the blood, it was not so perfectly coagulated, as in the other instances, owing to its having been by accident much agitated. I returned in the afternoon, and found the coagulation complete—the co- agulum and serum were natural—the serum did not change a piece of paper stained blue. EXPERIMENT XVII. August 14th, 1792. At 16 minutes after 3 o'clock, six grains of putrid blood, diluted with a drachm of clear pump water, were injected into one of the femoral veins of a healthy dog. During the injection, he was very uneasy and gave several loud shrieks. The action of the heart became so feeble, that it could scarcely be felt, and was also frequent. He was placed on the floor, when he lay down. In a short time he rose up, stood sometime, and appeared very weak. Respiration became laborious, and he lay down again. At 15 minutes before 4 o'clock, he was seized with twitchings about the bottom of, and across the thorax, in a great degree resembling a hiccup. At 4 minutes after 4, meat and drink were offered him; he would not drink, and seemed as if desirous to eat; but when he approached near the meat, he drew his head from it, as if the smell of it were offensive to him, though the meat was fresh killed this morning. At 2 minutes before 5, he had an evacuation of urine, and rather a loose eva- cuation from the rectum. At 4 minutes after 5, he had a copious evacua- tion from the stomach, when the action of the heart became perceptible to the touch. At 20 minutes after 5, he had violent efforts to vomit, and brought up a quantity of greenish coloured fluid. At 34 minutes after 5, they recurred again, with the like effect. They attacked him a third time at 3 minutes before 6; the consequence was the same as in both the for- mer instances. I left him at 15 minutes before 7 o'clock, when he was eating and drinking. He seemed easy. I saw him again at 8 o'clock, when he appeared heavy. I perceived that since I had left him, he had had a sparing evacuation of feces, rather loose. August 15th. This morning at 8 o'clock, he appeared dull, heavy and weak. The action of the heart was frequent and feeble. He was now fed. At 2 o'clock, I saw him again; he was as described in the morning. At 5 o'clock, blood was drawn—the colour and smell were natural—it coagulated at 4 minutes after 5—separation into serum and crassamen- tum took place at 12 minutes after 5—the colour of the paper stained blue was not changed by the serum—The coagulum and serum were per- fectly natural—I saw him again at 8 o'clock, and he appeared perfectly well. August 16th. He was perfectly well to-day. 30 SEYBERT'S DISPROOF OF THE EXPERIMENT XVIII. August 17th, 1792. At 15 minutes after 4 o'clock, ten grains of pu- trid blood, mixed with a drachm of clear pump water, were injected into one of the femoral veins of the dog last mentioned. During the injection he appeared to be in much pain, and had an evacuation of urine ; the ac- tion of the heart became frequent and feeble, but respiration was not much altered. At half past 4, the abdominal muscles were convulsed; the convulsions did not last any length of time. At 20 minutes before 5, he was seized with tremors over his whole body; they lasted about two minutes, and then went off. At 16 minutes before 5, he had an evacua- tion of urine. At 15 minutes after 6, I left him eating, when he appeared pretty easy. I saw him again at 8 o'clock, and perceived he had had a motion since I left him. The action of the heart was frequent and feeble. While I was with him he had an evacuation of urine, and appeared easy. August 18th. Blood was drawn at 10 minutes after 6 o'clock this morning—its colour and smell were natural—it was coagulated at 14 mi- nutes after 6—separation into serum and crassamentum began to take place at 23 minutes after 6. The coagulum and serum were natural. The serum did not change the colour of the paper stained blue. At 8 he appeared to be perfectly well. August 19th. He was perfectly well to-day. The blood that was drawn yesterday was examined this morning, and possessed no unnatural smell. EXPERIMENT XIX. August 27th, 1792. At 40 minutes before 10 o'clock, a drachm of putrid blood, mixed with half a drachm of clear pump water, was injected into one of the femoral veins of the dog, the subject of the 4th experi- ment. During the injection, he was very uneasy, and evacuated urine. The action of the heart became very frequent and feeble. He was placed on the floor, and immediately after vomited. At 3 minutes before 10, he had an evacuation of natural feces. At 2 minutes before 10, he vomited again. At 10 his breathing became very laborious, and he had a loose and small evacuation of natural coloured feces. At 3 minutes after 10, he lay down. The heart beat so feeble, that it could scarcely be felt. At 10 mi- nutes after 10, he rose, vomited again, and then lay down. At 15 minutes -after 10, the eyes were examined and no alteration in them was apparent. At 21 minutes after 10, he rose again, walked about the room, stood for sometime, and then again lay down. The action of the heart became more evident. At 11 o'clock, he groaned very much. At 6 minutes after 11 the action of the heart became more frequent and feeble. The eyes were now again examined, but presented no unnatural appearance. At 20 mi- nutes after 11, he rose and walked a few steps, had a sparing evacuation PUTREFACTION OF THE BLOOD. 31 of chocolate-coloured, liquid feces, then fell down, and appeared as'if sti- mulated to evacuate again; he rose and had an evacuation of urine, and again fell down. At 18 minutes before 12, his abdominal muscles became convulsed. At 4 minutes before 12, he vomited again. At 28 minutes after 12, he rose, walked a few steps, had an evacuation of very thin cho- colate-coloured feces, and appeared to be very weak; after this he walked a few steps again, and then lay down. I left him at 10 minutes before one o'clock, when he appeared easy, though very weak and sick. When I re- turned, at 12 minutes before 3, I perceived, that during my absence, he had had two or three evacuations of urine. The heart beat frequently and feebly. At 10 minutes before three, he had an evacuation of urine, and afterwards vomited. At 8 minutes before 3, he had an evacuation of very liquid feces, intermixed with mucus. At 5 minutes before 3, he had retch- ings and efforts to vomit, but did not evacuate. At 16 minutes before 3, he rose, and had another evacuation of feces similar to the one last men- tioned. At ten minutes after 4, he had an evacuation from the rectum, of mucus intermixed with blood. At 25 minutes after 4, putrid meat and putrid water were offered him, he drank plentifully, but did not eat. I left himat half past 4, and saw him again at half past 7, when I perceived he had had a very copious evacuation of urine, but had not eaten. The heart beat frequently, though not so feebly as before. Respiration was pretty free. He seemed easy, and appeared much better than when I left him the last time. August 28th. When I saw him this morning at 8 o'clock, marks of an evacuation of feces and urine were evident. I perceived he had eaten nothing. Putrid water was given him and he drank of it. The heart beat frequently and feebly. He appeared very weak; and the wound put on a bad appearance. At 2 o'clock I saw him again, when I perceived that he had had two or three evacuations of urine, but that he had not eaten. I now offered him some fresh meat; he held it in his mouth, but did not swallow any of it, and let it drop. Putrid water was again offered to him and he drank it. Respiration did not appear to be much affected. The action of the heart was frequent, and so feeble as scarcely to be felt. In my presence he had an evacuation of urine; I caught some of it in an earthen vessel, dipped a piece of the blue coloured paper in it, but no change of the colour was evident. The wound appeared in a gangrenous state. He seemed very weak, and it was with difficulty that he stood. At 8 minutes before 5, blood was drawn; the colour and smell were natural. It coagulated at 4 minutes before 5 ; separation into serum and crassamentum was evident at 7 mi- nutes after 5; the serum and crassamentum were perfectly natural; the serum did not change the colour of the paper stained blue. The wound appeared much worse. In every other case, yet mentioned, it invariably put on a good appear.ince and healed readily. After bleeding he appeared 32 SEYBERT'S DISPROOF OF THE exceedingly weak. At 35 minutes after 5 I left him very uneasy. I saw him again at 8 o'clock, and he appeared nearly in the same condition as when I left him last. August 29th. This morning at 8 o'clock, I found him dead. The blood drawn yesterday, was now examined. No unnatural smell was evi» dent. The serum did not change the colour of the paper stained blue. The coagulum was so firm, that when thrown out of the tumbler on the floor, it did not break. A very disagreeable and foetid odour arose from the body. Dissection. The body was examined at half past 9 o'clock, when I cut through the skin covering the lower ribs, the flesh below appeared gangrenous. The liver in some places was of rather a lighter colour than natural. The inferior part of the small intestines appeared inflamed. The stomach was perfectly natural, both internally and externally; it contained mucus and a whitish fluid. A bloody effusion was found in the lungs, particularly in the right lobes. The bladder was quite natural. The heart and veins were much distended with blood, which was firmly co« agulated in both; the colour and smell of it were perfectly natural. As yeast is well known to be a powerful ferment, and the volatile al- kali a great chemical agent, and a dissolver of the blood when out of the body, the following experiments were made, to ascertain what effect they would have on the blood, when injected into the blood-vessels. EXPERIMENT XX. August 14th, 1792. At 20 minutes after 11 o'clock, three drachms of stock-yeast were injected into one of the femoral veins of a dog. During the injection he appeared somewhat uneasy. Respiration became very difficult and laborious; the action of the heart irregular, intermitting, and somewhat increased in force. He was placed on the floor but was not able to stand. At 30 minutes after 11, he had an evacuation of urine; at 33 minutes after 11, he had an evacuation of natural feces. The eyes being examined, did not appear evidently altered. The muscles of his whole body now seemed to be in a relaxed state. At 40 minutes after' 11, his eye-sight appeared to be much diminished; at 5 minutes before 12, he was dead. Dissection. The body was examined immediately after death. No- thing preternatural was observed, except a bloody effusion in the lungs. The blood was in every respect natural. EXPERIMENT XXI. August 7th, 1792. At 20 minutes before 11 o'clock, 15 grains of mild volatile alkali, dissolved in 2 drachms of clear pump water, were injected into one of the femoral veins of a healthy bitch. During the injection, PUTREFACTION OF THE BLOOD. 33. she gave three or four loud cries, and seemed to be in great pain. She was placed on the floor, walked three or four steps, and then lay down. The action of the heart was increased in frequency, and respiration was performed with difficulty. In other respects she seemed easy and quiet. At 11 o'clock, meat and drink were offered to her; she would not take of either. Respiration now seemed to be performed with no great difficulty. The action of the heart was as before mentioned. At 35 minutes past 4, the eyes were examined, and they appeared no ways altered. At 42 mi- nutes past 11, she began to be restless. The action of the heart seemed to have recovered some degree of quickness; the frequency of it still con- tinued. Respiration appeared pretty easy, though short. At 40 minutes past 12, her whole body was seized with a tremulous motion, when a thermometer was applied to the axilla, and the temperature was as when in health. These tremors came on in paroxysms, each of which lasted but a little time, and they recurred frequently. The heart, during a pa- roxysm of trembling, beat frequently and feebly. The tremors increased in violence, and in frequency of recurrence. At 14 minutes past 1, she was affected with several violent convulsive contractions across her abdo- men. At half past 1, the eyes were again examined, and the pupils were observed alternately to dilate and contract frequently and considerably,. At 40 minutes after 1, she rose, looked about; meat and drink were again offered her, but she refused both, and lay down again. At 10 minutes before 2, the tremors attacked her again, her breathing became more dif- ficult and laborious, the tremors continued more or less violent for 5 minutes, then went off, and she appeared easy. At 15 minutes after 2, the tremors and laborious breathing came on again; they were of short dura- tion ; when they went off she appeared easy, and continued so till 5 minutes after 4, when they occurred again. At 10 minutes after 4, she gave three or four loud cries, as if affected with much pain, then was easy again, and remained so till 40 minutes after 5, when I left her. At 8 o'clock, I saw her again; she seemed perfectly easy, the action of the heart was frequent and feeble. August 8th. At 8 o'clock this morning she appeared easy, but was very weak; and her heart beat frequently and feebly. She now ate and drank; at 2 o'clock she appeared as in the morning: I also perceived that she had had a natural evacuation from the rectum since I saw her in the morning, which was the first that occurred since the operation was performed. At 7 o'clock I saw her again; no alteration was evident. I found that she had had a natural evacuation of feces this afternoon; but I did not perceive any marks of a discharge of urine. August 9th. She seemed quite well, but drank more than dogs usually do in health. «4 SEYBERT'S DISPROOF OF THE EXPERIMENT XXII. August 10th, 1792. At 40 minutes after 11 o'clock, 25 grains of mild volatile alkali, dissolved in two1 drachms of clear pump water, were inject- ed into the bitch last mentioned During the injection, she was violently convulsed, and gave several loud cries; she also had an evacuation of urine and vomited. The heart beat very frequently, and breathing was laborious. She was placed on the floor, ran about the room, and then lay down. Her aspect was very wild. She did not lay long before she got up again; but in a few minutes lay down. At half past one she rose, and immediately afterwards lay down again. The breathing was very frequent. At 2, meat and drink were offered her, but she did not take of either. I left her at 25 minutes after 6, she continuing to be in the same condition. At 8 o'clock I saw her again; meat and drink were then offered her, she drank, but would not eat. Her heart beat very frequently, though weak; she seemed in other respects as she was before. August 11th. This morning at 8 o'clock she appeared to be easy, was quiet, and ate and drank. Her heart beat frequently and feebly. I saw her again at 8 in the evening; she was in the same condition as in the morning. At 26 minutes after 8 blood was drawn—its colour and smell were quite natural—it coagulated at 32 minutes after 8 o'clock—separa- tion into serum and crassamentum was evident at 38 minutes after 8 o'clock—the coagulum and serum were every way natural—the serum did not change the colour of the paper stained blue. August 12th. To-day she appeared perfectly well. EXPERIMENT XXIII. August 13th, 1792. At 15 minutes before 11 o'clock 45 grains of mild volatile alkali, dissolved in two drachms and a half of clear pump water, were injected into the same bitch. During the injection she appeared to be in great pain, and gave several loud cries. She was placed on the floor, ran about the room, then lay down, and was very restless. The ac- tion of the heart was extremely frequent, and her aspect was wild. After lying a few minutes she became easy. At 35 minutes after 2, meat and drink were offered her; she ate, but would not drink. At 30 minutes after 4 o'clock, blood was drawn—its colour and smell were natural—it coagulated at 35 minutes after 4—separation into serum and crassamen- tum was evident at 39 minutes after 4—the crassamentum and serum were perfectly natural—the serum did not change the colour of the paper Stained blue. At 39 minutes after 4 more blood was drawn from the same vein—its colour and smell were natural: as soon as it was drawn, I added 45 grains of mild volatile alkali, dissolved in 3ij of clear pump water» to it, when the colour became a very deep brown, nearly black. At 8 PUTREFACTION OF THE BLOOD. 35 minutes before 5 o'clock it appeared to have a tendency to coagulate. At 10 minutes before 6 it was of the consistence of mucus. At 10 minutes after 6 she seemed perfectly easy, and was eating meat. At 8 o'clock she appeared in the same easy situation. August 14th. At 8 o'clock this morning she appeared perfectly easy. The blood last mentioned was examined, and its consistence was much us before. From the above experiments the following inferences result: 1st. That, contrary to the generally received opinion, the blood is nei- ther rendered alkaline, acrid nor putrid by starvation. This I think is evinced by these circumstances—that the blood went through its sponta- neous changes in the regular and usual manner—that the serum had no effect in changing the colour of my test—and that no sense of acrimony was perceptible to the taste. 2dly. That a putrid diet does not operate upon the blocd so as to change its sensible properties. This is a material part of the inquiry, since physicians, from Hippocrates down to the present clay, have sup- posed various and wonderful changes to be produced in the animal econo- my by such food. From the above experiments, it appears very clear, that a putrid diet had no effect whatever in changing the qualities of the blood, although the animals were strictly confined to it. We are also led to con- clude from them, that a putrid diet does not change the sensible qualities of the excretions; since, as I have related, the urine did not alter the co- lour of the vegetable blue. Here it may be objected to me, that I ought merely to infer from these experiments, that the blood of dogs only is not affected by this treatment. I answer, that the inference may, probably, be extended to the whole animal creation; for, we cannot but suppose that nature is, in this respect, as beneficent to the one species as she is to the other; and to substantiate this opinion, I avail myself of the result of the experiments of the celebrated Spallanzani, as above mentioned, who not only operated upon the brute creation, but went so far as to risk his own life for the benefit of science; and found, contrary to the received opinion, that vitiated food, previous to its leaving the stomach, is converted into a matter capable of furnishing good blood. " Men, such as the inha- bitants about the mouth of the Orange river, in Africa, live always on ani- mal food, such as whales, seals, limpets, and what fish they can catch; that many times their food has entered into a great degree of putrefaction, and there is no vegetable food whatever employed at the same time; probably most of them never tasted any vegetable substance in their lives, except^ ing aromatics for seasoning; yet they are perfectly healthy and free from all putrefaction in their fluids or solids, though they are not very careful of avoiding it'in the exterior parts of the body. We see likewise maggots, live in and upon putrid masses, while they themselves, and all their fluida, 36 SEYBERT'S DISPROOF OF THE are perfectly sweet and free from all appearance of putrefaction."* There appears to be an intimate connexion between the fluid and solid parts of our bodies; but how far this connexion between them subsists, 1 will not undertake to assert. Perhaps I might, in truth, have said that a putrid diet acts upon the solids of our machine, by its not containing alimentary matter in a proper quantity, and therefore not affording a sufficiency of blood to support the animal. We know that the solids derive their nou- rishment from the blood; and, in my opinion, it is sufficiently evidenced, from the mortification of the muscular parts which ensued upon making an incision into the thigh, as has been already stated, that a putrid diet does operate upon the solids. 3dly. That although the blood, or other animal matter, may be ex- cited into a putrid fermentation out of the body, by the addition of a pu- trid ferment, yet that such a process cannot be excited in the living body. We have found that many grains of putrid matter existed in the blood- vessels for some days without changing the blood. Is it probable that a fermentation can be induced in the blood when the ferment enters the system by absorption, and no such process take place by introducing a putrid ferment immediately into the blood-vessels ? 4thly. That by the introduction of putrid matter into the blood-vessels, very violent symptoms were produced, although the quantity of the mat- ter was small, and of the same nature as the blood, except that it had become putrid.f Is it probable, then, that the animal could exist with the whole mass of blood in a state of putrefaction, when such violent symptoms were the consequence of the introduction of so small a quan- tity of putrid matter as was injected in the foregoing experiments? And, 5thly. That though the volatile alkali may operate upon the blood in a wonderful manner out of the body, it does not evidently affect the blood when injected into the blood-vessels. From these experiments, it is also evident, that cathartic and emetic medicines, when injected into the blood-vessels, cannot operate in a spe- cific manner; for in almost every instance evacuations were the conse- quence of the experiments, when neither cathartics nor emetics were in- jected. Probably any matter capable of producing a suffioient irritation, will produce those effects, when thus thrown into the animal. I attribute the presence of air in the vessels and heart, which oc- curred in one of the experiments, to the imperfect state of the syringe; * Fcrdyce on Digestion, p. 155. ... f My reason for making use of putrid serum and putrid blood, is, that they are the same substance, only altered by putrefaction. We know, from experi- ments of transfusion, that blood may be passed from the vessels of one animal, into those of another, without any evident injury. From this circumstance we are led to infer, that it, in these instances, acted as putrid matter. PUTREFACTION OF THE BLOOD. 37 for it consisted of one whole piece, when the two first experiments were performed. Before I leave this part of the inquiry, I beg leave to state the follow- ing questions, viz. Is there a power in the blood-vessels, or in the blood, capable of as- similating to the blood matters which are injected into the vessels? Do not the following circumstances make it probable ? I could not by a mi- nute examination distinguish between the blood and the matter injected. The serum of the blood, where the volatile alkali was injected, did not possess the odour of that salt, neither did it change the colour of the paper stained with a vegetable blue. Does not the doctrine of secretion, which is now gaining ground, favour such an idea? I own that there are certain exceptions to this opinion. Do not the loss of vision, the dilated and contracted pupil, together with the convulsions which happened, denote the nervous system to be affected by the contents of the blood-vessels ? I shall now proceed to inquire, whether there is any reason to believe that blood becomes putrid in any disease ? This is a question of considerable importance. Extensive experience is necessary to decide it; and as my own has been very limited with re- gard to diseases supposed to be putrid, I must beg leave to refer the un- prejudiced reader to books, which treat at large of them. Perhaps upon thorough consideration, he will believe the matter to be at least doubtful. All I can do, will be to state some objections to the inferences that have been drawn from the symptoms and circumstances attending these diseases. A symptom on which great stress has been laid, is, the appearance of petechia, vibices, or effusions of blood, which takes place in the last stage of typhus, yellow fever, scurvy, &c. These appearances are generally sup- posed to be indicative of a dissolved state of the blood in those diseases, though in my opinion without a sufficient reason. It is conceded by all that the system in those diseases is very much debilitated, and of consequence the system of blood-vessels, and these particularly at their ultimate ter- minations. The effect of this debility is a relaxation of the solids; the fibres of the blood-vessels will not now be in as close contact as they ware in health, and the mouths of the exhalents will not be as narrowly con- tracted. This particular state of the vessels at their terminations, will allow the blood to transude, and be effused in the cellular membrane; or the exhalents, which in health pour out a lympid fluid, may now be ca- pable of forwarding the red blood itself. Analogy supports the opinion. Do not the vessels of the eye in ophthalmia, through which a colourless lymph is circulated in health, receive in this diseased state, red globules? Do we not find in dropsy, that the vessels allow of a greater exhalation 38 SEYBERT'S DISPROOF OF THE than when in health ? If in proportion as we become debilitated, we ap- proach nearer to a state of death, does not the transudation of bile through the coats of the gall-bladder, in dead subjects, give additional strength to ■the idea? Again, is it not confirmed by the circumstance, that these ap- pearances take place in the last stage of those diseases when the debility is greatest? If petechia; were true symptoms of a dissolved and putrid state of the blood, we should certainly find that the bodies of those who die, marked ■with such symptoms, would certainly putrefy much sooner than the bo- dies of others who die without any such marks. The contrary of this is said to happen; and anatomists assort, " that the bodies of those who die, of what are called putrid fevers, are longer before they undergo real pu- trefaction than of those who die of other diseases, or who die in perfect health by violence."* The dissections of the celebrated Lind and Rouppe, seem to pro\'e that the blood in those diseases is not putrid. The former found it in the yellow fever to be grumous and viscid, and covered with a yellow gluten, impenetrable to the finger unless cut by the nail.t The same gentleman relates, " that in scurvy, red coagulated blood is found extravasated in almost all parts of the body; not only into the tela cellulosa, but into the bellies of the muscles, particularly of the legs and thighs, which often become quite stuffed, and even distorted, with large grumous masses.| After stating that, " Some authors from a supposition of the great dissolution of the blood in petechial fevers, and from another supposition, that blisters increased the dissolution of that fluid still more, have forbid their application in such fever." He adds, " But the experience of the most eminent practitioners does not support those theoretical opinions."|| Rouppe, a physician who had great experience in the scurvy, found that the blood was always more or less coagulated in those instances, in which he had an opportunity of viewing it. He observes, " If we consi- der, we shall find that the blood of those who have a continual fever, or an inflammation, after they have lost a good deal by bleeding, is so dissolved, that no one can find blood of a thinner consistency even in the last stage of the scurvy. Who (he justly interrogates) has even pretended to say' these diseases were owing to a dissolved or putrid state of the blood ?"§ We may further observe, that a dissolved state of the blood is by no means a proof of its having become putrid; it merely indicates a lessened * Moore's Medical Sketches. f Lind's first paper on Fevers and Infection, p. 13. et seq. \ Lind'o second paper, p. 100. U Ibid, p. 87. § Rouppe on the Diseases incidental to Seamen, p. 200. PUTREFACTION OF THE BLOOD. 3* disposition to coagulate; and do we not find the blood in several other diseases besides the scurvy, &c. to be in a more fluid state than it is in health ? Certainly we do. We are informed by Dr. Lind, that the blood of scorbutic persons did not impart the least sense of acrimony to the tongue, any more than the white of an egg; and that the blood of scorbutics does not become putrid sooner than other blood, which it certainly ought, cseteris paribus, if it had already begun to putrefy in the body. Nay, we are moreover in- formed by this celebrated writer, that the serum of the blood of such patients, is not septic but antiseptic; and would it not be absurd and inconsistent with the facts of chemistry to say, that a portion of matter which had already began to putrefy on being added to an unputrefied mass should retard the process ? The benefit derived from the use of fresh vegetables and their acids in curing scurvy, is, in my opinion, by no means to be admitted as proof of the bloods being in a putrid state. We must in this place notice, that it is a well established opinion, that the powers of digestion are such, as to be capable of converting all matters into one and the same kind of chyle, whether animal or vegetable, though the one may not afford it in as great proportion as the other. The above circumstance being admitted, and it cannot be denied, we at the same time must allow, that those matters undergo a considerable change in the stomach before they go on to the formation of the blood. Consequently, if they suffer a change, they possess no longer the proper- ties of a vegetable, or a vegetable acid, and therefore a tertium quid must be formed. What its nature and properties are, I will not pretend to say, but leave the candid to judge for themselves; though we might equally well suppose it to be septic or antiseptic* There are many physicians, who supposed fixed air to be chiefly useful when injected into the intestines in those diseases suspected to be putrid, by acting as an antiseptic on the putrid blood; but, when thus applied, does it not rather act on the contents of the intestines, and destroy the bad effects produced by their offensive smell, &c. since it has been well observed, " that, any thing putrid is totally incompatible with the perfect well being of the animal?" It is generally allowed, that putrid effluvia act as debilitating powers on the system. Indeed putrid matters, lying for a time in the intestines, * I think that the following circumstance justifies my assertion, that vegetable aliment after it has suffered the changes produced on food in the stomach, &c. when it is sent on to form the chyle, has more of a septic than antiseptic quality. Fordyce on Digestion, p. 164, mentions, that by distillation in a retort we obtain an empyreumatic oil, volatile alkali and water, and charcoal remains in the retort, whether the substance distilled be chyle, a piece of flesh, or other animal sub- stance. 40 SEYBERT'S DISPROOF OF THE would seem to be debilitating, as in the instance of the dysentery. It ap- pears also that fixed air acts as a stimulant: Mr. Henry found that it in- flamed an ulcer.* And Dr. Dobson says, that when received by the mouth into the stomach, in ten minutes it raised the pulse from 71 to 77 strokes.t It was objected to me, that the urine, breath, and other excretions of persons labouring under diseases of the putrid class, were highly foetid and obnoxious. We grant this may be the case; though a question will then arise, whether these excretions contract this fcetor from the blood, or be- come foetid after they are separated from the general mass ? I am of the latter opinion, and think it highly probable that they become foetid in their respective reservoirs, or in some other manner not yet explained. We know that the excretions do not by any means possess the properties be- longing to the blood, and we also know that they may be very different in disease, though the blood remain the same as when in perfect health. To this purpose, I will quote Dr. Home's observation: he mentions that the blood of diabetic persons appeared perfectly natural; that the serum of the same possesses no more sweetness than that of other blood; though the urine of the same patients tasted very sweet, and upon evaporation afforded a large quantity of saccharine matter.J The case of a patient, who was lately under the care of my worthy preceptor, Dr. Wistar, may also be mentioned in confirmation of these sentiments. He was affected with pneumonia, and had all the usual symptoms; but in addition to them, an odour proceeded from him so pu- trid and offensive that no one could remain long in his room without great inconvenience; it even extended its offensive smell into the rooms a story below him. His urine had also an intolerable fcetor. The symp- toms of pneumonia required bleeding, and this remedy was used with great caution; but notwithstanding the above circumstances, the blood coagulated very firmly, and had some inflammatory appearances on its surface. 1 he arguments taken from Dedier's, Couzier's, and Homes's experi- ments, employed by Dr. Ferris to prove, that the bile and blood undergo a change in the plague and measles, are by no means conclusive. We know the plague and measles to be highly contagious diseases, and easily communicated to those who are in a state of predisposition to receive the infection. Dr. Ferris supposes, that as the blood or bile of one who died of the plague, when injected into the veins of a dog, produced symptoms of that disease; and as the measles ensue after inoculating with the blood of those who labour under it, the blood and bile must have under- gone changes in those diseases. In my opmion these facts prove nothing * Henry's Exper. p. 127. f Dobson's Commentary on Fixed Air. £ Homes'* Clinical Experiments, p. ]J2. PUTREFACTION OF THE BLOOD. 41 that favours such a conclusion; and all that we can infer from them is, that the contagious or infectious matter was diffused through the blood, or adhered to it in those instances, as it does to old buildings, cloathing, &c. Facts prove that it does so with respect to these subjects, for months, nay even years, and then is as effectual as ever in its deadly operation. We are uninformed of the appearance or state of the blood in those in- stances. In the measles, the blood appears to be no more changed or altered than in other inflammatory diseases. How it is in the plague, I know not. Dedier and Couzier have taken no notice of any evident change—gentlemen whose accuracy would not have allowed them to have neglected such a circumstance if it had occurred. What confirms me in the opinion, that the contagious matter was only diffused through the blood, or adhered to it in the same manner as to old buildings, 8cc. is, that in the one instance the plague, in the other the measles, was produced. If the contagious matter had mixed with the blood so as to produce a chemical change therein, neither the plague nor the measles would have been the result of the experiments; as by this mixture, they would both have lost their former properties, and a new compound would have been produced by their union, not possessing the properties of the contagious matter or of the blood. The sixth law of the affinity of composition, reads thus: " Two or more bodies, united by the affinity of composition, form a substance, whose properties are very dif- ferent from those of any one of the bodies before their combination."* Consequently a disease very different from the plague or measles must be produced, if a chemical union had been formed.t With respect to Dr. Home's Experiment, I beg leave to make one or two observations. He says, " I thought that I should get the blood more fully saturated with what I wanted, if it Avas taken from the cutaneous veins amongst the measles, than if I took it from a large vein, where there was a much greater proportion of blood from the more internal parts than from the skin. I therefore ordered a very superficial incision to be made amongst the thickest of the measles, and the blood, which came slowly away, was received upon some cotton."^ The doctor appears to be of the opinion that a fermentation of the blood, produced by the introduction of contagious matter into the system, was not the cause of the disease; for, he says, the blood taken from the * Fourcroy's Chemistry, vol. i. p. 64. f We have already proved that the blood in the vessels of living animals was not subject to the laws of fermentation, and that no fermentation could be ex- cited in it by the introduction of ferments; therefore, if a change had been pro- duced in the blood in the above instances, it must have been by aeliemicalunion, and consequently must be subject to the laws of chemical affinity. f Home's Medical Facts, &.c. p. 268. G 42 SEYBERT'S DISPROOF OF THE more internal parts was not as plentifully saturated with the morl,Ulrcs intevraittentes s\ib forma larvaW of Dr. Ser.ac. 60 POTTER ON ARSENIC sons with other intermittents, and yielding to the same remedies. The Peruvian bark often succeeds in the cure of this disease, but do far as I have been able to ascertain, is far inferior to the solution; nor need this surprise us, for this affection generally exhibits a more chronic appear- ance, is not attended by much inflammatory diathesis, and is consequently admirably adapted to the operation of arsenic. There is no reason why this medicine should cure a periodical head-ach more certainly than others, provided they are constituted by the same degree of action; and from the general operation of Arsenic we should be induced to expect the happiest effects from its use, in all cases not the consequence of considerable inflam- matory diathesis. The head-ach is often a chronic disease; the effect of a feeble morbid action in the vessels of the brain, while the other parts of the system possess their usual powers. In all such cases as cannot be, traced to some offending matter in the stomach, or to some local cause, arsenic may be recommended with the most flattering prospect of success. Although the action in this disease is so inconsiderable as to be easily overcome by arsenic, it is nevertheless indisputably the effect of excessive morbid ex- citement, and the pain is incontrovertibly the effect of inflammation,* without which there can be no pain. The proximate cause of all fever consists in an irregular action of the arterial system, and the most abject state of typhus is as essentially a fever, and as certainly the effect of some degree of inflammation, however insignificant, as a phrenitis or a pneu- mony. As the proximate cause of all fever is the same, there cannot possibly exist any other just distinction between them, than what arises from their different degrees of inflammation. The cure, with this view of fever, divides itself into two parts; such as require depletion to sub- due them, and such as are capable of being overcome by the action of stimuli. Arsenic may be used advantageously in all such cases as require a new action to be suddenly excited, unless so great a degree of debility exists as to render other tonics, more certainly invigorating, indispensable. IN DISEASES OF THE ALIMENTARY CANAL. Amoxg the variety of cases in which I had occasion to prescribe this medicine in the diseases of children, I sometimes observed, that such as were affected with symptoms usually judged to be most characteristic of worms, recovered under its use. The worms were in some cases dis- charged, but this occurred in a very small proportion of cases, in which the most prominent symptoms were effectually removed. In many of these cases the symptoms were so ambiguous, that I found it difficult to * See Dr. Alexander's ingenious dissertation on the effect of one disease curing another, p. 20. POTTER ON ARSENIC. 6! determine whether the arsenic acted by obviating a state of debility, with which worms were accidentally connected, or by destroying the worms acting as the cause of an idiopathic disease. In two cases, where the most unexpected cures were obtained, the symptoms rather indicated the phe- nomena of an atrophy from lymphatic obstructions, than of any other disease; and whoever reflects on the insinuating properties of arsenic, will not think it irrational to conjecture that it might have operated as a deobstruent upon the mesenteric glands. The pulvis stanni has formerly been a remedy much celebrated as a vermifuge, and has by some been supposed to act mechanically: although it is possible that it may produce some effect in this way, it would appear to me more philosophical to ascribe its virtues to the arsenic it contains. As this remedy, which suggested itself fortuitously, is yet problematical, with respect to its ope- ration as an anthelmintic, we shall not presume to recommend it in pre- ference to the more ordinary remedies; nevertheless, as they are all occasionally fallible, it will be laudable in such cases, to experiment with judicious caution on this new remedy. IN DISEASES OF THE SKIN. Were we to speak strictly anatomical, we might have classed these diseases with those of the arterial system, and indeed some of those under this head invade likewise the glandular and lymphatic system; but as they appear more conspicuously on the superficies, and affect more particularly this part, we have judged it most convenient to arrange them with the cutaneous affections. Whoever observes the force which this medicine exerts upon the skin, will find the transition to its use in cutaneous dis- eases natural, and the prospect of its advantages plausible. I received the first information of its success internally in cutaneous diseases, from the judicious Dr. Martin, of Maryland, who had witnessed its victory over an obstinate case of leprosy. Soon after I received this useful instruction, I was appealed to, to decide on the nature of a case which had run the ordinary routine of remedies generally resorted to in such cases, and which so strongly resembled the description the doctor had given of the case which he had cured, that I did not hesitate to denominate it the lepra Grwcortmi of medical writers. As this case had already become one of the opprobria of medicine, I undertook it with much diffidence, rather to gratify the solicitations of the patient's friends, than because I expected to perform a cure. I directed ten drops of the mineral solution to be taken morning, noon, and night: distance prevented my seeing the,patient for the space of two weeks, but the medicine was assiduously persevered in. I now had the pleasure to observe, the hard white surfaces of the ulcers which had usurped almost the whok superficies of the body, beginning to moulder 6- POTTER ON ARSENIC away in white pulverulent sloughs, and the bottoms of many of the sores, before of a phagedenic appearance, assuming a more salutary complexion. At the end of six weeks the disease was completely eradicated, and had not returned two years after. On my return to Philadelphia in the sum- mer of 1792, I informed my preceptor, Dr. Rush, of what I had heard and seen concerning the internal use of arsenic; he soon had an opportu- nity of trying its efficacy in an obstinate herpetic eruption which had resisted the usual remedies; it succeeded, but as it had been a tedious chronic case, and the predisposition not completely removed, some symptoms of the disease have since returned. I have repeatedly seen this remedy tried in various anomalous cuta- neous affections, and find it a powerful medicine where neither fulness nor inflammatory diathesis exist; in which cases we shall soon see; previous depiction is necessary. In cutaneous diseases we may observe two states of the excitement diametrically opposite to each other: some cases depend upon a loss of tone in the extreme vessels, by which means the excitement is divided. The cure of this state consists in restoring the excitement, either by raising it by external applications, or by such internal powers as exert their influence principally upon that system of vessels. To pre- vent the vessels upon the surface from relapsing into their former atony, it will be found requisite in this state of the skin, to raise a higher tone than that which is the state of the same vessels in a state of health; an- indication which may often be effectually fulfilled by arsenic. But, one stimulus will not always answer the desired indication, although it may- be sufficiently strong; it will therefore often be prudent to use them in succession. The want of a certain knowledge of the particular system, which a stimulus specifically affects, often renders its exhibition pro- blematical. The remaining state of cutaneous disease, is in every respect the re* verse of that already delineated. In both the excitement is divided and unequal; but in the latter its morbid force is concentrated in the skin, and may be denominated nfbris extrovena with a propriety as strict!v phy- siological, as the dysentepy has been a febris introversa by Dr. Sydenham. This state is truly a local fever, and the indication of cure is to diminish •' t:.e excitement in the extreme vessels, until it shall be reduced to an equality with the other parts of the system. It wouhi be superfluous, and perhaps hazardous, in this state of the system, to prescribe astringent topics, or to administer stimuli internally, unless some can be found suf- ficiently powerful to raise a superior action in the vessels, a thing not easily accomplished. As there is no medicine more stimulating t!"-.n arsenic, there can consequently be none more improper in this state of the system. Agreeably to this ide^ of the inflammatory nature of some POTTER ON ARSENIC *'•* cutaneous diseases, we find a fact recorded by Sir William Jones,* who observes, « The natives (of Indostan) cure the elephantiasis by one part of white arsenic united to six parts of black pepper; but the remedy is more certain when gentle cathartics and bleeding are previously used." By this practice two advantages are gained; first, the tone which pre- vented a more healthy action from being excited is removed; secondly, the excitability of the whole system is accumulated, by which means sti- muli act with more force and certainty. The same author relates the case of a gentleman « so affected with the confirmed lues, (called in Asia, the Persian fire) with his hands and feet entirely ulcerated and almost corroded, that he became an object of disgust and abhorrence. Some- blood was taken from his arm, and a cathartic administered on the next d.iv; in a fortnight his recovery was complete." He farther adds, " But the power of this medicine has been chiefly tried in the cure of what has ^ been called the Juzam, a disease affecting the whole mass of blood, at- tended in the last stage with an erosion of the fingers: it is also hereditary, and in that respect has been classed by medical writers with the gout, consumption, and white leprosy." This learned author assures us, that this preparation of arsenic and black pepper was successful in every ca:;c in which it was used, and relates a great variety of cases; but from his having placed the cause of the disease in a contamination of the fuid-, he has not developed the disease so clearly as to enable us to follow him in its investigation. The pathology of the fluids is so obscure a comer in the field of science, that I would not presume to determine what share they may have in the- causes of diseases. Whatever might have been the precise meaning of physicians by that class of medicines called alteratives, I am persuaded, that arsenic merits that character to a very eminent de- gree; perhaps not by a direct operation upon the blood, but by changing the state of the excitement, by its sudden and energetic action on the several systems it affects. I should have suspected the accuracy of the author's observation on this solitary case of syphylis, had it not been cor- roborated by a case which lately came within my own notice. A medical gentleman from the West-Indies, having been baffled in his efforts t? cure a cutaneous affection of a syphilitic origin, consulted Dr. Rush, who advised the internal use cf arsenic with the most propitious result. Arsenic in such inveterate chronic cases, seems to act by its power in exciting tl..' system insensible to other stimuli, for in this case, even'mercury had been used in vain. In buboes, that after ulceration have become callous, arid not disposed to heal, but put on a cancerous appearance, I can say, both from my own observation and that of ethers, that no remedy with v.'ue^ we are acquainted, is so powerful as the internal use of arsenic. * Jones's Asia, p. ■170—80. Published 1793. .64 POTTER ON ARSENIC. IN DISEASES OF THE GLANDULAR AND LYMPHATIC SYSTEM. Much has been said concerning the use of arsenic in cancers, but from having seen it fairly tried in only two cases of ulcerated cancer, I cannot say much of its virtues.* It has been dogmatically asserted that arsenic is competent to the cure of every condition of cancer; an opinion which, so far as I can inform myself, is extremely presumptuous. Cancer, like all other diseases, is attended with different states of action, no one remedy can therefore cure every case. There is no disease whose patho- logy is involved in more obscurity than that of cancer, and every internal remedy that can be prescribed for it must be in some measure empyrical, until its causes are better understood. If there should ever be a radical cure for cancer found, and no doubt there will, it will probably be one that acts specifically powerful upon that system principally occupied by the disease, or by altering the condition of the whole system. The chi- meras of fancy have often constituted a part of the theory of diseases, but none which I have ever read, are more visionary than the phantoms of Mr. Justamond'st imagination. This gentleman has by his boldness contributed in some measure to lessen the prejudice of physicians against the internal use of arsenic; but from his ludicrous hypothesis, of the dis- ease depending upon insects in the cancer, he has detracted from the weight his observations might have carried with them; for his animalcules, like those of Liewenhoech, have either never been demonstrated, nor ever seen by any but their authors. In both those cases in which I have seen this medicine tried in cancer, the disease had so totally contaminated the whole system, that little hope could be reasonably entertained from any remedy ; for if even in such cases the ulcer should be healed, unless the predisposition could be eradicated, a return of the disease would still await the unfortunate patient. It must be acknowledged, that in those cases wherein I attempted the use of arsenic in this disease, it was not altoge- ther an inert medicine; the excruciating pains were mitigated, and the intolerable fcetor of the ulcers entirely corrected. These temporary alle- viations, were of a very transitory duration, for those symptoms returned with their usual virulence as soon as the remedy was withheld. This me- dicine v/as persevered in six months in one case, and four in the other, yet n'> advantage was gained as to the healing or diminution of the ulcer. What might have been the issue of these cases under the use of arsenic at a more early period of the disease, I cannot venture to conjecture, but * Fee Medical Commentaries, vol. ii. p. 301, Sec. + Just amend":; Tracts. POTTER ON ARSENIC. 65 esteem it some consolation to possess a medicine that can, when death is inevitable, strew flowers on the borders of the tomb. From the penetrating nature of arsenic, it would seem to promise the most beneficial effects in all cases of schirrous and obstruction in the glandular system; and from this property it has obtained the reputation of having cured the more inveterate states of cancer. It is often a desirable indication to rouse the torpid vessels of a part into vigorous action; under such circumstances, arsenic may be advised with more plausibility than any other remedy with which we are acquainted, provided it affect that system of vessels occupied by the disease. As this mineral operates forcibly upon the lymphatic system, what would be its effects in scrophula? Although I have not seen it experimented upon in this disease, I should, a priori, be induced to think favourably of its powers, more especially where the system had been sufficiently re- duced to admit of its most extensive influence. Wherever the same indications of cure are to be fulfilled, in the cancerous, callous, or fungous state of ulcers, the internal use of arsenic in moderate doses, affords the fairest prospect of success. In many cases where its external application is proper, it may be found advantageous to conjoin its internal use. There is no fact in the science of medicine, of which I am more decidedly con- vinced, than that arsenic is an improper medicine in all cases where ulcers are accompanied with an inflammatory diathesis. The following letter from Dr. Martin may tend to corroborate some of the preceding observations, especially as it was written by a gentleman whose authority in medicine is inferior to none. EASTON, FEBRUARY 1st, 1796. DEAR SIR, I have long promised you some observations on the use of arsenic, which I shall confine within the bounds of my own experience. I have been in the practice of prescribing arsenic, about five years, in cutaneous diseases and intermittents only. My friend Dr. Birchhead first recom- mended the use of arsenic, and referred me to the Dispensatory lately published, for some hints under the head of mineral solution. Here I found that arsenic was recommended in cutaneous diseases. As I had been baffled in a case, which I had called lepra Gnecorum, after using every remedy which could be thought of by myself or others, I re- solved to try the mineral solution of arsenic on my old patient, Thomas M'Namara, who had wearied out every physician and others, who wotdd administer any thing for his relief. As he had retired to some unknown part of the country, I mentioned my intention to Dr. Johnson, who had witnessed his deplorable situation in the poor-house, while a student with me, and desired that he would administer the solution whenever he should K 66 POTTER ON ARSENIC. find him, engaging th?t I would do the same if I should see him first. The Doctor shortly after this fell in with him, and told him what we had agreed on. Poor Thomas was always eager to catch at any thing for relief. He was desired to take twelve or fifteen drops three times a day, but in a week or two the poor fellow had increased the dose to thirty drops, because he found his sores healing in a manner he had never before expe- rienced, for at least five years, and I think, in less than four weeks, every sore or part affected, was healed up. Thus relieved, contrary to all ex- pectation, Thomas began to make free with ardent spirits, when some appearance of the disease was again discovered, which was a second time relieved; but his intemperance soon brought on the disease with worse appearances, when he was once more admitted into the poor-house. I was astonished to observe how soon his sores began to heal, and to vanish entirely, except one up his nostrils,. and even this to appearance was cured, when Thomas begged to be discharged. This winter he is a third time admitted, and it yet remains to be tried, whether he can be again relieved by arsenic. Quere: If arsenic had been used earlier, and this patient had been a temperate one, whether the predisposition to this disease might not have been entirely eradicated? A mulatto man in this county, (Talbot) aged about forty years, had symptoms of the lepra Gra- corum before he was twenty-one; and I am well satisfied, when I saw him fifteen months ago, he had this disease with every characteristic symptom. The mineral solution of arsenic had a most astonishing effect in this case, for every symptom vanished in the course of a few weeks, except one sore on his leg or foot, and I have not seen him since last March. I once thought the mineral solution had a wonderful effect in a schirroua breast, but the predisposition still remained: the woman was of a bad habit of body, and some hardness continued to her death. In agues and fevers I am sometimes induced to think this a valuable remedy, but like every other it is fallible, and I am frequently disappointed in its effects, yet I have known it to succeed, when the bark has failed. In some children in the ague and fever, it has an immediate effect. That it is a safe and useful remedy I am well convinced, and therefore give it to my own children without scruple. In my son it seemed to have no effect, good or bad, but has greatly relieved my little daughter in the ague and fever. In the periodical head-ach, I have sometimes thought arsenic better entitled to infallibility than any other remedy in the materia medica. Thus, my dear sir, I have summed up all that I can say about this safe, agreeable, and valuable acquisition to the materia medica. You are at liberty to make any use you may think proper, of the above observa- vations. With my best wishes for your success in life, I am your friend, ENNALLS MARTIN. POTTER ON ARSENIC. 67 OF THE EXTERNAL USE OF ARSENIC. However much timidity and scepticism may have influenced the minds of practitioners, respectihg the internal use of arsenic, both empy- rics and theorists have been less scrupulous in its external application. Two opinions have divided practitioners concerning its application to can- cerous and other ulcers. Dr. Mosely* condemns its use unequivocally, and observes, " that it will not produce the salutary effects obtained by corrosive sublimate. It rots indiscriminately the sound and unsound flesh wherever it comes in contact. Corrosive sublimate is bounded in its corrosive action by healthy flesh, or acts but slightly as a destroyer. Arsenic has a tendency to destroy or deaden the functions of organized parts; corrosive sublimate to inflame those parts." In the introduction to this essay, I adverted to the disastrous consequences of not attending particularly to the doses of medicine, and the state of the part to which they may be applied; here we see it exemplified in a peculiar manner: we see prejudice co-operating with sophistry, producing a conclusion from false premises equally ridiculous and absurd. Every practitioner who has seen arsenic applied externally in different degrees of strength, must testify against the injustice of Dr. Mosely's criticisms. The princi- ple upon which the operation of arsenic essentially depends, is the same that actuates corrosive sublimate, of which he has spoken so extravagantly. Arsenic, in the state it is used externally, is a true metallic oxyde, or the semi-metal united to vital air. Corrosive sublimate is composed of the oxygenated muriatic acid and mercury, and owes its activity to the oxy- gene it contains, otherwise calomel, which is composed of the same metal, united to the common muriatic acid, would prove equally corrosive. Red precipitate, which is a calx of mercury, or that metal united to vital air, is likewise a caustic of considerable power, but if it be subjected to a strong heat, the oxygene will be dissipated, the metal will resume its native state, and is as innocent in actual contact with the most irritable surface as so much water. It would therefore appear that the operation t of these medicines depend upon the oxygene they contain, and that their powers are accurately apportioned to their relative degrees of fixity and concentration, Nothing can illustrate this idea more clearly than what we must have often observed; that caustics and escharotics in a state of dilution or division act as the most certain astringents. In this state arsenic and corrosive sublimate, produce the most salutary effects, and are nearly entitled to infallibility, in all cases of tenia, herpes, and other states of the skin, not supported by fulness or inflammation. The particular condition * See Treatise on Tropical Diseases, by Benjamin Mosely, M. D. p. 5?1. ?,. Z. 68 POTTER ON ARSENIC. of the part to which arsenic is to be applied, should be carefully observed; if much inflammation attend, it should be used in a very diluted state, and may then be advantageously applied to any part. At the request of Dr. Rush, I applied a solution of arsenic to a cancerous inflammation in the internal canthus of the eye, where the rapid progress of the disease me- naced the erosion of the lachrymal sack, and probably the patient's life: we had the satisfaction of seeing the disease completely extirpated, and the man soon restored to health. In the year 1784 Dr. Rush* detected the presence of arsenic in the celebrated cancer powder, so successfully administered by Dr. Hugh Martin; and has favoured us with observations on the use of this caustic. He remarks, " I should suppose from the examination of the powder I mr.de with the eye, that the proportion of arsenic to the vegetable powder could not be more than -t- part of the whole compound. The great art of applying arsenic successfully is, to dilute and mix it in such a manner as to mitigate the violence of its action. Dr. Martin's preparation was happily calculated for this purpose. It excited a moderate inflammation, which separated the morbid from the sound parts, and promoted a plen- tiful afflux of humours to the sore during its application. It seldom pro- duced ail eschar; hence it insinuated itself into the deepest recesses of the cancers, and frequently separated those fibres in an unbroken state, which are generally called the roots of the cancer." Thus we see, that however useful it may be to attend minutely to the state of the system in the inter- nal use of arsenic, that it is equally indispensable in its external appl'ca- . tion. Its operation depends upon the same principles of excitability and ex- citement, and it must be obvious to all who are the least conversant in the practice, that so acrimonious a substance must require the most cautious attention. Upon a review of all the cases of the external use of arsenic that have been recorded, we find no discrimination of the different states of the parts to which it has been applied; but from all that we can learn en this subject, we are authorised to say, that its beneficial effects arc principally confined to such as have been already enumerated. In the year 1783, an itinerant practitioner, who called himself Lafierti, travelled through the state of Maryland: he astonished the practitioners of that country by curing ulcers long deemed beyond the reach of the sur- gical art, and it is not to be controverted that his success was unparalleled. It was observable, that he refused to undertake the cure of recent ulcers, and, unlike most of Lis empyrical brethren, candidly acknowledged that he had no skill in such cases as others considered most curable. The author's deceased father who at that time practiced physic and surgery in * See Rushv Medical I:"piiries :.r.d Observations, vcl. i. p. 2.35, or, Philosophi- cal Transactors. POTTER ON ARSENIC. 69 that country, left the following account of this practitioner, in a letter which he intended to have sent to a medical friend. " We have in this county (Caroline) a man who does wonders in the cure of obstinate old sores; but he uses so much mystery, and applies his powder with so much secrecy, that he does not seem to intend to let us into the secret. However, I have just procured a small parcel of his medicine; at first I thought it looked like corrosive sublimate, but upon trial found myself mistaken: I put some of it on the fire, which soon perfumed the room with the smell of garlic, from which it must be arsenic." Mr. Justamond, who has re- commended arsenic so strenuously in cancer, mentions the authority of Sir Hans Sloanc for its good effects in scrophulous ulcers, and thinks it a valuable medicine in such cases. I have no doubt but that arsenic will re- move the state of atony often attending such sores, or that cancerous state of callosity into which they sometimes degenerate; JDUt to cure them radi- cally, the diathesis on which they depend should be removed. The mu- riate of barytes* is said to have proved useful in schrophula, as it often contains a small portion of arsenic, it is not improbable that it may owe its virtues to this active mineral. What might be the effect of the arseni- cal acid, as a medicine, I leave future researcb.es to instruct us. PHARMACEUTIC TREATMENT OF ARSENIC. It may perhaps be thought necessary to investigate the chemical properties of arsenic, but as all I could say on that head would be no more than plagiarism from authors already in general circulation, I shall con- tent myself v\ ith as laconic an explanation as possible of the pharmaceutic treatment of that preparation, which appears to me to possess sor.i;.* advan- tages over all others, and which mi far as I am capable of judging, admits of no improvement. The following receipt for making the mineral solution is translated from the Latin of Dr. ! owler, and the table of doses which we shall have- occasion to mention, is taken from the same author; both cf which it may not be improper to insert, as arsenic is a medicine so little hr.oan. " Take of the powder of white arsenic, and of the purest veget.ibl.: alkali, each sixty-four grains, of distilled water half a pound, apothecaries' weight: put them into a vessel and submit them to a sand heat; let them boil moderately until the arsenic shall be perfectly dissolved; then add to the cold solution Iu.lf a pound of the- compound spirit of lavender, aiul so much distilled spring water us will make the whole accuiv.tely fifteen ounces." * See Cell on the Venereal, and Med. Com. vi.l. J- 70 POTTER ON ARSENIC. The simplicity of this chemical preparation renders it preferable to more complex forms. The vegetable alkali has not the smallest effect in diminishing its virtues, for that proportion of the solution which we know to contain any given quantity of arsenic, will act as forcibly upon the sys- t?m, as the same quantity in pills, or even in a state of pulverization. The almost infinite divisibility of this form renders its doses variable to the exigencies of all possible cases. The small proportion of compound spirit of lavender is added to give it a more medicinal appearance; not with a view of captivating the eye, by drawing the veil of mystery over the composition, but lest from its being colourless and insipid, those who May be intrusted with its exhibition should be tempted to use it with too much liberality, the consequences of which might prove troublesome, if not dangerous. To a pound of the solution, sixty-four grains are added for the purpose of a more accurate calculation, by which means the pre- cise quantity of arsenic contained in any given number of drops may be ascertained. If the alkali should not be perfectly pure, it will be found in- adequate to the production of a perfect solution; a circumstance which might occasion great confusion and uncertainty in the doses of the medi- cine. If therefore, the alkali cannot be obtained pure, a double proportion of purified nitre may be substituted, for there is a stronger attraction be- tween the arsenic and the vegetable alkali, than between the same alkali and the nitric acid, which last is therefore disengaged. The two solutions do not differ in point of efficacy, and by attending to the preceding direc- tions, they will be found to possess a uniform degeee of strength; a cir- cumstance of importance in the use of such a heroic medicine. Although we cannot altogether approve Dr. Fowler's mode of ad- ministering the solution, and must therefore observe, that his doses are rather larger than we prefer, (at least in this country) his table may be useful in graduating the doses for different ages. Patients are to take, according to their ages, the following doses of the solution: YEARS. DROPS. From 2 to 4........from 2 or 3 to 5 ---- 5 — 7........---- 5—7 ---- 8 — 12........---- 7—10 ---- 13 — 18........---- 10 __ 12 ----- 18 and upwards ... 1 '2 Thus from five to seven years the dose may be apportioned by allow- ing a drop for each year, but a drop for each year under that period will be insufficient, and soon becomes too much beyond it, as twelve drops are a medium dose for an adult. T.'.is medicine may be administered with considerable latitude to aduita, but a very general rule may be established which will often pre- POTTER ON ARSENIC. 71 vent most of those unwelcome consequences which follow the use of large doses. It will generally be found most advantageous in the end, to begin. with an under dose, and to increase it until it shall affect the stomach slightly, unless a cure be obtained. If the system should be much disor- dered by the solution, it will be proper to discontinue it a day or two, and instead of ten drops three times a day, five drops six times a day may be administered, which will often agree with the stomach, and perform a cure as certainly, though not as expeditiously, as a larger dose. It will often be necessary to continue the medicine for some time after the cure is apparently complete; by this practice a relapse may often be effectually prevented. Where nausea, vomiting, or pains in the bowels arise from the solution, they may not only be mitigated, but often prevented, by combining a few drops of laudanum with the solution, and this will sel- dom interfere with the virtues of the medicine, as the former is generally admissible where the latter is proper. A combination of their stimulant effects will sometimes be found more powerful than either of them alone, especially in curing intermittents. In some cases instead of diluting the dose by a tea-cup full of cold water (die usual vehicle) in case of turbulent symptoms supervening, a larger proportion of water will be a successful method of obviating them. This observation applies more particularly to the use of the solution among children,* whose tender organs are often molested by a very small dose of the solution; instead therefore of giving the medicine in a tea-spoon or table-spoon full of water, double the quan- tity may be used to advantage. The disease for which the medicine is prescribed, will likewise require to be noticed, both with respect to the quantity of the dose, and the time of administering it. In intermittent fevers and periodical head-achs most advantage will result from the ad- ministration of as large a dose as the system can conveniently bear^ as nearly preceding the paroxysm as possible. In the treatment of cancers and many diseases of chronic debility, it may be necessary to continue the use of the solution for weeks, and even months, to obtain all its advantages. Under such circumstances, the solution must be frequently gradually increased, for the system becomes so habituated to its stimulus, that an ordinary dose will be altogether inert. I have gone as high a^s thirty drops three times a day, in a case of cancer, without producing one dis- agreeable sensation. In the exhibition of this medicine, little is to be learned from an apparent delicacy of constitution, for women whose ap- pearance would lead us most to expect irritable frames, often bear the medium dose of an adult with the greatest composure; whereas the most robust men frequently feel very sensibly the commotions excited * It is nevertheless worthy of observation, that children often bear larger doses, in proportion to age and other circuinnunro?, than adult*. POTTER ON ARSENIC by a smaller dose. I have given this medicine to pregnant women labour- ing under intermittents, with safety, in very considerable doses, but can- not avoid observing, that although these cases were such as in every respect (their gravid state excepted) might from common experience be supposed most easily cured, I was less fortunate than in any equal num- ber of cases that came within the sphere of my notice. The tension imparted to the arterial system by the stimulus of distension, or that artificial inflammatory diathesis which accompanies a state of pregnancy, must have prevented the medicine from exciting an action sufficient to cure the disease. It has been alleged against the internal use of arsenic, that it de- stroys the tone of the stomach, thereby laying a foundation of dyspepsia and general debility. If this objection should be founded on truth, it will alone be sufficient to exclude arsenic from the materia medica, and to banish from the mind of every reasonable physician all thoughts of advo- cating its character. To determine this important question beyond the possibility of a controversy, I examined all those cases wherein I was under the necessity of persisting long in the use of arsenic. Out of forty persons whom I interrogated touching this point, I found but two who discovered dyspeptic symptoms, both of whom were notorious for their attachment to ardent spirits, by which the disease had been produced years before they had taken arsenic. Even dogs that had been poisoned by it and recovered, exhibited no marks of indigestion. It has moreover been objected to arsenic, that both from its internal and external use, it has sometimes produced paralytic symptoms and a vertiginous disposition in the brain; but in all the cases where I have seen it used, even where, from a long protracted external application, an absorption might have been thought probable, no such consequence fol- lowed. Such effects have doubtless followed the poisonous influence of arsenic, but those who cannot draw the line of distinction between its medicinal and poisonous degrees, would do well not to interfere with the feelings of mankind. Mr. William Gaskill,* an ingenious surgeon, at Rotherhythe, instituted a series of experiments upon the external absorp- tion of arsenic, from which he proved decisively that no symptoms of a disordered economy were even perceptible. He has not taken notice of its diuretic qualities, although they are dwelt upon with so much em- phasis by Mr. John Sherwin,f surgeon, who performed the same expe- riments with tartarized arsenic, and attributes the diuretic effects it pro- duced upon himself and four otliers, exclusively to the operation of arsenic. But the conclusion he has drawn is by no means just, and a * See a pamphlet entitled, Experiments on the external ;■'■ s >rpti<>n of arsenic and emetic tartar. ■j Medical Commentaries, vol. xv. p. 220, <-i e ;. POTTER ON ARSENIC. 73 very superficial knowledge of chemistry will be required to detect its fal- lacy. By the union of the chrystals of tartar and arsenic, the tartarized arsenic is formed; a substance which,although it partakes in some measure of an arsenical nature, is yet widely different from the pure semi-metallic oxyde, and possesses properties peculiar to itself. Dr. Fowler has recorded many unpleasant effects of the solution; such as nausea, vomiting, swellings of the face, and sometimes of the abdomen, all which, he says, vanish from the use of gentle aperients, and most of them by a temporary omission of the medicine. Doctors Arnold and Withering, although much in the habit of using the solution, have not mentioned such effects; and even Dr. Clark, who inveighs with so much acrimony against arsenic, has been silent on this particular. I first began the use of the solution in the doses prescribed by Dr. Fowler, and expe- rienced many of the painful sensations which he has ascribed to it. I afterwards found it easy to prevent them in most cases, by diminishing the dose, and observing the precautions already mentioned. One of the most characteristic properties which we have attributed to arsenic, is, its power of accumulating the stimulability of the system; a circumstance of much importance to be attended to in practice, especially in a state of convalescence; inasmuch as both medicine and diet are to be regulated accordingly, either of which, in over doses, night be productive of the most alarming consequences. This caution cannot be better en- forced than in the emphatical words of the elegant Dr. Armstrong. ..............When the vital fire Burns feebly, heap not the green fuel on; But prudently foment the wand'ring spark With what the soonest feels its kindred touch: Be frugal even of that; a little give At first; that kindled, add a little more, 'Till by deliberate nourishing, the flame Rcviv'd, with all its woatcd vigour glows. OF THE DELETERIOUS QUALITIES OF ARSENIC. Hitherto we have viewed arsenic as a remedy, capable of abstracting from that portion of pain and disease to which the frailty of human na- ture is subjected. But as this mineral, like all other things destined for the use of man, is liable to abuse, and subject to a deviation from that order which was originally imposed upon it; we are constrained to the melancholy necessity of reversing the picture, and of contemplating human nature in the most deplorable state that the imagination can pos- sibly conceive. Happily for mankind, such catastrophes as this poison is capable of producing do not often occur; but as physicians are sometimes L 74 POTTER ON ARSENIC. summoned to arrest the progress of death from this cause, the most ef- fectual antidote becomes a desideratum of the highest importance. It would far exceed the limits of this essay to detail all the expen- ments from which we have deduced the following conclusions; we shall therefore give the result of the most important, in as concentrated a form as the nature of the subject will admit. We have already hinted at some of the formidable consequences of this poison; and where its medical effects end, we may date the com- mencement of its deleterious qualities. This stygian draught when taken into the stomach in quantities disproportioned to the excitability of the system is productive of nausea, vomiting, purging, hiccough, gastrodynia, convulsions, subsultus tendinum, increased flow of saliva, hematuria, thirst, gnashing of the teeth, syncope, asphyxia, and death, unless a speedv remedy is administered. As some peculiarities attend the operation of this poison, it may be useful to trace them to their remotest consequences. A gentleman whom I saw, and with whom I conversed, soon after he had been nearly deprived of his life by this poison, exhibited the following phenomena. From having been remarkable for his althletic powers, he became sallow, emaciated, and enervated. Previous to this accident he had enjoyed an uninterrupted series of good health for ten years. In the autumn after this misfortune, he was attacked by an obstruction of his liver; which left him in a state of paralysis, from which he with difficulty recovered during the winter. He has been subject to jaundice three or four times every year since that memorable event, and his teeth, before remarkable for their whiteness, became incrusted with a black scale, and some of them have decayed without pain. It has sometimes been observa- ble that arsenic, even in small quantities, like the vegetable and other acids, has set the teeth on edge; and some of the dogs who recovered from the poisonous effects of arsenic lost their teeth, an occurrence I ap- prehend to be very unusual in these animals. Whether arsenic produces this effect by a general operation, inducing a general debility in conse- quence of which the teeth decay, or whether its peculiar acid acts speci- fically upon the calcarious earth of the teeth, I shall not presume to determine. Mr. William Lempriere,* an intelligent English surgeon, has drawn the picture of a case from the poisonous effects of arsenic, which is suffi- cient to demonstrate, that even in some cases where a recovery is obtained, ■life is under such circumstances the most intolerable of human burdens. He observes, " I was desired to visit the emperor's favourite wife, vho had been poisoned by arsenic, conveyed into her food by the machination! «f her rivals. Afte;' a tedious conflict between life and death, the effect* * Tour to-Morocco. POTTER ON ARSENIC. 75 of the poison in part abated, but the unhappy lady was left in a dreadful state of debility and irritation. Her beauty, the fatal cause of her misfor- tune, was completely destroyed, and her enemies, though disappointed in their aim at destroying her life, yet enjoyed the malignant triumph of seeing those charms which had excited their jealousy, reduced below the standard of other women. Her digestion was so weak, that every species of food, after remaining a few hours on her stomach, was returned per- fectly crude and undigested. Her body was reduced to a shadow, and her strength so far exhausted that she could not walk without assistance. Her skin, from being naturally clear and fair, was changed to a sickly brown, which joined to a ruined set of teeth and ghastly countenance, effaced every trace of that beauty which she might once have possest." Various antidotes have been proposed to counteract the poisonous effects of arsenic. Oils and such other substances as seemed best calcu- lated to obtund the acrimony of the metallic particles, have been supposed adequate to the relief of the pernicious effects of all saline poisons. Scep- tical on this subject, I instituted a series of experiments upon dogs, the result of which clearly demonstrated, that no oleaginous substance is equal to the prevention of evil from such causes. In cases where the portion of poison was inconsiderable, mucilaginous and oily matters seemed in some measure to protract and mitigate the symptoms, but never af- forded entire relief; for such as recovered had taken so small a quantity as scarely to be capable of doing mischief if no remedy had been at- tempted. I used for these experiments the oil of almonds, train oil, lin- seed and castor oils, all of which proved insufficient. The castor oil, where it was given in quantities so large as to operate speedily, seemed to procrastinate life, by translating the seat of the disease from the sto- mach to a less vital part, the lower intestines. When the arsenic was given mixt with the oils, its virulent effects were not obviated, unless the quantity of the poison was so small as to remain suspended, and not to come in contact with the stomach and intestines. Conformable to this idea of the insufficiency of oils to prevent the effects of arsenic on the stomach, we may regard a custom authorised by the superstition of the Hindoos. One of the nine modes of trial by the ordeal consists in com- pelling the accused to eat from the hand of a Brachman a preparation composed of sixty-four parts of clarified butter, mixt with two parts and a half of pure arsenic; if the poison produce no visible effect, he is ab- solved, otherwise condemned.* Milk has been proposed as an antidote agaimt arsenic and other poisons, but proved inert in every instance, although I gave it the fairest trials, and never produced the smallest benefit, only in proportion as it * ilistcrvof Ir.doitan. 76 POTTER ON ARSENIC. diluted or washed off the poison concentrated in the stomach. Whoever will observe the specific gravity of arsenic, must readily conceive the difficulty of defending the stomach against its corrosive qualities. The impracticability of such a hypothesis is farther augmented by reflecting, that the arsenic is always in actual contact with the stomach before the antidote can possibly be administered, and that all attempts for relief must be superfluous, unless the poison be instantaneously removed. The prema- ture exhibition of viscid substances may moreover interfere with the opera- tion of that remedy which we shall see hereafter affords the only rational prospect of relief. Where the poison has been evacuated, and a slight inflammation still remains, oils may prove useful by their lubricating quality. I attempted the relief of those devoted victims by a variety of diluents, given copiously immediately after the poison; but they all proved futile, and their synchronous exhibition was attended with the same fate. Chemistry has furnished a variety of substances which have been thought equal to the neutralization of arsenic. Vinegar has been extolled by Mr. Sage; but whatever appearances the combination of these agents may exhibit to the eye, I can assert, from repeated experiments, that Avhen they meet in the stomach they do not rescue the body from de- struction. Mr. Navier, an ingenious French physician and chemist, has proposed to decompose arsenic by a direct combination of the liver of sulphur. We know that orpiment, although it contains a large proportion of arsenic united to sulphur, may be taken into the stomach in a considerable quan- tity with impunity. This would at first sight seem to favour the idea that sulphur alone might neutralize arsenic, but from a variety of expe- riments we can assert the contrary. The hepar sulphuris is a most ra- pacious solvent of some metals, and might therefore aptly obtrude itself upon the prolific imagination of a speculative chemist. Whoever will be at the trouble of mixing arsenic and the liver of sulphur, will be amply satisfied of their slow and feeble influence upon each other. Their action is so slow, even out of the body, that a man might die a thousand deaths before a single particle of arsenic could be neutralized. Every experi- ment tended to confirm me in the opinion, that chemistry has yet invented no power capable of neutralizing arsenic. The animals upon which the experiments were made individually died, although in many cases a few grains only had been t'ken, and the proportion of hepar, mentioned by the fanciful Mr. Navier, immediately administered. The proportions of each were varied, and the experiments repeated, with a result equally unpropitious. Whatever effect the alkali may have in the formation of the hepar, I am satisfied that sulphur alone will do as much towards effecting a cure as in their combined state; for death will ever be the POTTER ON ARSENIC. 77 inevitable consequence of the arsenic, although they may both be used with ever so much liberality and expedition. No remedy can ever alleviate these melancholy preludes of death, unless it operate with the velocity of light as a solvent, or evacuate the poison from its contact with the sto- mach. I defy the imagination to conceive of a poison more irresistible in its operation than a large dose of arsenic; it will therefore be irrational to indulge a hope of averting its instantaneous effects, unless a remedy can be invented that shall equal it in the rapidity of its operation. I will not dogmatically affirm that chemistry does not possess a substance ade- quate to the instantaneous neutralization of arsenic, but can safely say, that none of the great variety upon which I have so repeatedly experi- mented, is equal to this important indication. History has recorded an antidote for this herculean poison, which we are seriously informed is infallible. " The best antidote against the poisonous effects of arsenic are the scrapings of leather reduced to ashes: if the quantity taken be accu- rately known, four times as much of these ashes mixt with water, and drunk by the patient, will sheathe and counteract the poison."* Baffled in every attempt to prevent the fatal effects of arsenic taken into the body, I attempted it by the use of the most powerful emetics that could be obtained. In every case where the quantity was not so great as to destroy life suddenly, or to render the stomach altogether insensible, an effectual relief was obtained. If the length of time between the taking the poison and the exhibition of the emetic shall be considerable, all at- tempts for relief will be in vain. The strongest emetics that can be ob- tained should be administered as soon as the accident shall be discovered, and however copious their effects may be, large quantities of warm water should be immediately taken, and persisted in, until it may be supposed that the whole is evacuated. The warm water not only washes off the acrimonious particles of the poison, but accelerates the operation of the emetic. Amongst the variety of emetics of which I made trial, I found the vitriol of zinc the most certain: indeed I can say with certainty that it afforded complete relief in all rases where the excitability was not nearly extinguished. After a naitiul evacuation of the stomach, I endea- voured to finish the cure by such substances as might be judged most powerful on account of their inviscnting qualities; the uniform conse- quence of which was, to retain the poisonous particles in closer contact with the stomach, and to expedite the approach of death. * History of Iiulostan, p. 4S1. 78 POTTER ON ARSENIC. TESTS FOR DISCOVERING THE PRESENCE OF ARSENIC. It may often be a desirable thing to determine satisfactorily what poison has been the cause of such distressing symptoms. The presence of arsenic may be detected in tw o ways. 1. If the least particle can be per- ceived and burnt, it will emit white fumes, and an evident smell of garlic. 2. Confine a small quantity of arsenic between two plates of copper, and subject them to a strong heat, a white appearance will be communicated to the copper. These methods are sufficient to detect the presence of arsenic, even where it may be diffused among the contents of the stomach, or present in a very minute proportion; but whoever shall feel himself dissatisfied on this point, may use a method communicated by Mr. Berg- man. Infuse a small portion of the powder in a solution of vegetable alkali in water; after standing an hour or two, pour upon it a solution of the sulphate of copper in water; the colour of the vitriol will be immei diately converted into an elegant green, and will soon be precipitated. The same experiment may be used to detect its presence in water. Arsenic is a substance which is copiously diffused through the bowels of the earth: it is a component part of many metallic products, and may, by its latent distribution among them, become the unsuspected cause of the most serious calamities. Tin, as we have already observed, contains a considerable portion of arsenic; we ought therefore to be cautious in admitting it into the composition of culinary utensils, especially such as may be intended to contain acids, or to be much exposed to great heat. Pewter likewise sometimes contains a small portion of arsenic, but the quantity is so insignificant as not to be justly an object of terror: it is nevertheless, a duty incumbent on the manufacturers of these metals, to ascertain with precision what proportion of arsenic their materials contain. If we dissolve tin which contains this substance, in the muriatic acid, the solution will exhibit a black powder, which consists of the arsenic sepa- rated from the tin. This experiment renders the smallest particle con- spicuous. The property which arsenic possesses of being soluble in water, mul- tiplies and facilitates its destructive powers; springs and rivulets are some- times impregnated by flowing over this noxious mineral, and those who inhabit their vicinity may fall victims to their insidious influence before a suspicion of the fatal cause shall arise. Besides the method we have already described, for discovering the presence of arsenic in water, it may be accomplished with more simplicity am! equal certainty, by evaporating the water in a clean iron vessel: a portion of the arsenic will be deposited o:i the sides and bottom of the vtssel, and when thrown upon burning POTTER ON ARSENIC. 7J coals, will emit the well known garlic-like odour. If a copper vessel be used, the inside of the vessel will become white. The same end may be attained more expeditiously by evaporating the water rapidly from an ignited iron; but this method is liable to a decep- tion, for no odour will be emitted unless the water be strongly impreg- nated by the semi-metal. These methods may, however, prove less accu- rate than others devised by the ingenuity of chemists. The most infallible with which we are acquainted, are the following: 1. If a solution of the hepar sulphur is be poured into water adulterated with arsenic, a colour more or less yellow will be produced, and if the sul- phur superabound orpiment will be deposited. 2. If boiling lime water be poured upon water holding arsenic in solution, a white precipitate of difficult solubility in water, will fall down. This precipitate is soluble in the acetous acid, and in a solution of arsenic; when mixt with oil and laid upon the fire, it yields the garlic-like smell peculiar to arsenic* 3. Cuprum ammoniacum affords an excellent means of detecting the presence of arsenic in any liquid; it produces with it a yellowish green precipitate, which, if separated from the superincumbent liquor, dried and put upon ignited coals, manifests the same garlic-like odour. Other tests might be devised to ascertain the presence of arsenic by different re-agents, but it would be a work of supererogation, as those already described are deemed amply sufficient to detect it in its almost infinite variety of combinations. It has been the object of the preceding essay to collect such informa- tion as could in any wise tend to illustrate a subject as yet in its infancy. As an impartial investigator, the author has, unbiassed by prepossession or prejudice, extolled or condemned it agreeably to the suggestions of his own judgment. It may perhaps be observed, by those who have experi- enced the difficulties of adapting medicines to particular exigencies and to the various conditions of disease, that more minuteness and precision are necessary in the use of so active a medicine: but whoever will attend to the principles that govern the operations of this medicine, as they are laid down in the progress of the subject, will find its management both practicable and easy. It would have been easy to have decorated every page with the tinsel phantoms of the imagination, but as the theory which has been contemplated, is the inevitable consequence of the phxnomena of diseases, or the obvious operation of the medicine, the author ought in justice to be rescued from the implication of vanity or presumption. Should any thing have escaped him which shall be hereafter found erro- * Chemical tests, invented by J. F. A. Gotling, Professor of Chemistry at Jena,in Saxony. 80 POTTER ON ARSENIC. neous, it shall be retracted with unspeakable pleasure; for, whether his efforts should lead to truth directly or indirectly, through the medium of error, they will afford a gratification not to be conceived by any but those who have felt the pleasure of doing good. If we take a retrospective view of the agency of this mineral as a me- dicine, we shall see that nature hath made nothing in vain, or, to speak more philosophically, that the Author of Nature has acted most benevo- lently in its formation; for if we view impartially even its most destructive attributes,, we shall see, that they are no more than deviations from that order, which was imposed upon the universe from the beginning, afford- ing us additional reason to exult with the poet, " All discord's harmony misunderstood, " All partial evil universal good." AN INAUGURAL DISSERTATION ON THE USE OF THE NITRIC AND OXYGENATED MURIATIC ACIDS, IN SOME DISEASES. SUBMITTED TO THE EXAMINATION OF THE REVEREND JOHN EWING, S. T. P. PROVOST; THE TRUSTEES, AND MEDICAL FACULTY OF THE UNIVERSITY OF PENNSYLVANIA, ' ON THE TWENTY-SECOND DAY OF MAY, OX'E THOUSAND SEVEN HUNDRED AND NINETY-EIGHT. FOR THE DEGREE OF DOCTOR OF MEDICINE. BY PHILIP GENDRON PRIOLEAU, A. B. OF CHARLESTON, SOUTH-CAROLINA; HONORARY MEMBER OF THE PHILADELPHIA MEDICAL AND CHEMICAL SOCIETIES. EX PRINCIPIIS NASCIl VR PROBABILITAS; EX FACTIS VERO VERITAS. PREFACE. IN treating of the Nitric and Oxygenated Muriatic Acids, it may be necessary to premise, that it is not my intention to speak of their chemical affinities to the substances which surround us. As this is very accurately and minutely taken notice of, in every system of che- mistry, I mean to confine myself to their medical properties, and their effects on the human body, as this part is that with which physicians are, as yet, least acquainted. In pursuing this subject then, I shall first, in as concise a manner as I am able, give the history of the discovery of the use of the Nitric Acid in diseases: next relate some cases in which it was exhibited, and draw such conclusions from them as they justly warrant: I shall then treat of the Oxygenated Muriatic Acid in the same manner, and endeavour to prove that these acids act on the same principle with mercury in the cure of the venereal disease. ON THE NITRIC ACID. THE history of the important discovery of the use of the Nitric Acid in some diseases, is as follows: Mr. William Scott, surgeon in the service of the East India Company, (in August, 1793) imagined that the obstructions of the liver were occa- sioned by the bile depositing its resin; and desirous of becoming acquainted with the modus operandi of the calces of mercury, which seem so pe- culiarly qualified for removing those obstructions, h e instituted a series of experiments on the bile. By mixing a quantity of the resin of the bile, (carefully separated from its soda and lymphatic matter with which it is united) and half its weight of the red calx of mercury with ten or twelve ounces of water, and exposing them to heat, he found, that part of the oxygen of the mer- curial calx, had combined with the resin, an dmade it surprisingly more soluble in water. By his experiments on the base of the bile, having thus found that oxygen made it more soluble in water, and being at that time afflicted with chronic hepatitis, he resolved to take a quantity of oxygen united to some substance, for which it has no great attraction. After some reflection oh the subject, nothing appeared to him so well calculated for the purpose as the nitric acid, which is knowTi to consist of about four parts of oxgyen, united to one part of nitrogene, with a certain portion of water. In September, 1793, says Mr. Scott, I began to take the nitric acid. I mixed about a drachm of the strongest I could procure, with a sufficient quantity of water; and was happy to find that I could finish that quantity, in the course of a few hours without any disagreeable effects from it: the following \a the journal I kept of myself at that time. September 11th, 1793, 1st day. Took at different times about a drachm of the strong nitric acid, diluted with water. Soon after drinking it, I felt a sense of warmth in my stomach and chest; but no disagreeable sensation from it, nor any other material effect. 2d. I have taken to-day a considerable quantity of acid, diluted v. ith water, as much ai I could easily drink during the fort noon. 86 PRIOLEAU ON THE NITRIC AND 3d. I have continued the acid. I feel my gums affected from it, and they are somewhat red, and enlarged between the teeth; I slept ill, but could lie for a length of time on my left side, which from some disease in my liver, had not been the case for many months before. I perceive a pain in the back of my head, resembling what I have commonly felt when taking mercury. 4th. My gums are a little tender: I continue the acid as before, I still find a pain in my head, and about my jaws, like what arises from mercury. I perceive no symptoms of my liver complaint. 5th. I have taken the acid, and always feel an agreeable sense of heat after drinking it. I spit more than usual. 6th. I continue the acid. I observe my mouth sorer to-day, and spit more. 7th. I think I am now sufficiently oxygenated. I feel my mouth so troublesome, that I shall take no more acid. From this time my mouth got gradually well, and I found my health considerably improved. Mr. Scott administered the nitric acid in several cases of tedious inter- mittents, in two cases of diabetes, in each of which the subjects were in the decline of life, and in a number of syphilitic cases with the happiest effects. This short account of the discovery of the use of the nitric acid in diseases, I have thought it my duty to give, in honour of the discoverer: and it is done with more pleasure, as it was the result of reflexion and well directed experiments; and not, as is frequently the case, stumbled upon by accident. Mr. Scott's account of the nitrous acid, was first published in the Bom- bay Courier, of April 30th, 1796. It has since been republished in the first volume of Dr. Duncan's Medical Annals, and also in the first volume of the New-York Medical Repository. In the latter end of August, 1797, I met with Mr. Scott's account of the nitric acid, in Duncan's Medical Annals: and have since that time given it in a number of syphilitic cases, with the happiest effects. As the subject is new, and nothing is wanting to bring this invaluable medicine into general use, but facts in its support, I will relate some of the cases which came under my ow n observation. CASE I. September 1st, 1797. F. e.K:——r, came into the alms-house as a pauper. She had four chancres on her labia pudenda and nymphx, which she had contracted three weeks before. I directed her to take five drops of the nitric acid every hour in a little sweetened water, which she con- tinued for a fortnight; her mouth was slightly affected, three of her THE OXYGENATED MURIATIC ACID. 87 chancres had entirely healed and the other greatly diminished. She was at this time attacked with pleurisy, so violent as to make me neglect the syphilitic complaint. Her pleurisy was cured by four bleedings and ca- thartics of glauber's salts and emetic tartar. I thought no more of her syphilis for six weeks after this, when she informed me that her old com- plaint had returned. Upon examination I found that two of the chancres had reappeared and were nearly of the size of a small button. She recommenced taking the nitric acid, and continued its use three weeks longer, at which time she left the alms-house. But previous to her depar- ture she informed me, that her sores were entirely well, except (to use her own expression) " a small spot about the size of a pin's head." December 27th. After being out of this institution three weeks, she this day called on me to request more acid; telling me at the same time, that the sore which had not been entirely healed, had enlarged to a size that would admit the end of her little finger. I gave her the nitric acid as before, and desired her to call on me every three or four days. She faithfully took the acid for four weeks more, when the chancre appeared to be perfectly Well. But by way of insurance I desired her to take the acid two weeks longer, wiiich she did. I saw her the other day ; it is upwards of a month since she has omit- ted the acid, and she informed me, that she has been perfectly well ever since. CASE II. October 8th, 1797. T. D. aged twenty-three years, was received a pauper in the alms-house: he was afflicted with pains and ulcers in his limbs. The history of his case is as follows: In January last he was in- fected with the venereal disease, he had a gonorrhoea, chancres, and an enlargement of the glands in his groins, which had been discussed by mercury, and he considered himself as c^ired. Fourteen weeks ago, he took the small pox (and had the disease mildly) the natural way; shortly after the small pox had run its usual course and disappeared, small pus- tules arose on his legs which degenerated into ulcers, in their appearance resembling those of a venereal nature; from which time to the present they have continued to increase, and he now has on bis lower extremities six and twenty ulcers \J he also complains of pains in his limbs. I gave him the following mixture: R Gum: Arab: iv drach: iv. '"\ Aqux menth: vi unc: vi. Acid: nit: ii drach: ii F. M. With directions to take a table spoonful every hour, mixed with sweet- ened water. 88 PRIOLEAU ON THE NITRIC AND October 11th. The third day after he began with the acid, and when he had taken but four drachms of it, I found him lying on his bed, with his hand supporting his head, and the saliva driveling from his mouth into a cup. His mouth was very sore; his gums had a similar appearance with those of persons slightly affected with mercury. The salivary glands were much enlarged. His breath, at present, has no offensive odour, though he says that when he first began to spit, it was very disagreeable. The ulcers on his legs look cleaner. His mouth is so sore that the acid is omitted. October 16th. His mouth is much better: his ulcers are in a healing state, but the pains in his bones still continue. He was desired to take the acid again. November 1st. Has continued to take the acid so as to keep his mouth slightly affected. His ulcers have entirely healed, but the pains in his limbs still continue. November 16th. He has continued the acid and is well in every re- spect, except the pains in his limbs, which remain the same. Finding the acid after so fair a trial incompetent to the removal of the pain, and believing the rheumatism to be syphilitic, I thought it my duty to give him mercury. He took, from the 16th of November to the 18th of December, calomel, so as to keep up the affection of his mouth, and a pretty considerable ptyalism, without producing the least alteration of the pain. He then left off the use of mercury and used friction with the flesh brush, and in the course of three weeks found himself almost free from pain. He continued the friction, and in a short time after was perfectly well. CASE III. W. L. aged thirty-nine, was admitted in the alms-house for a venereal ccmpiaint. He has several times before had syphilis, has at present noc- turnal pains in his bones, nodes on his shins, and an ill-conditioned ulcer on the calf of his right leg. October 16th, 1797. He was ordered the following mixture: R Gum: Arab: drach: iv. Aqux menth: unc: viii.j Acid: nitros: drach: ii. F. M. With directions to take a table spoonful every hour, mixed with sweet- ened water, and the ulcer to be dressed with the ung: mere: precip: rub: October 21st. He has taken four drachms of the acid; he complains of soreness of his gums: the medicine he thinks has caused a griping and looseness in his bowels: his ulcer looks cleaner and his nocturnal pains are less violent. M THE OXYGENATED MURIATIC ACID. 89 October 25th. He has continued the acid; the ulcer is clean and in a healing state; the nodes are less painful and begin to decrease. October 30th. Has continued to take from one to two drachms of the nitric acid daily. His mouth is but slightly affected; he has no fcetor of the breath, and continues to mend in every respect. November 4th. Has continued the acid; his teeth are loose, and he has a moderate ptyalism. November 20th. He has continued to take the acid. His ulcers have entirely healed, his nodes have disappeared, and he appears in every respect to be perfectly well. It is now four months since he left off the use of nitric acid, and he has never had the return of a single symptom of his old complaint. N. B. He has taken no mercury for upwards of twelve months. CASE IV. February 7th, 1798. M- M'G----n, aged thirty-four, was admitted into the alms-house for a venereal complaint. She had a deep ill-condi- tioned syphilitic ulcer on the calf of her right leg; together with a sy- philitic discolouration of the skin on the face, neck, breast, and arms. The following mixture was prescribed for her. R Gum: Arabic: drach: iv. Aqux menthas unc: iv. Acid: nitros: drach: iii. F. M. With directions to take a table spoonful every hour, mixed with some sweetened water. She was directed to dress the ulcer with the ung: ex :erugine. February 9th. She has taken the acid. No alteration in her disease. She complains of a little griping in her bowels. February 10th. She has continued to take three drachms of the acid daily. She complains of a swelling in the submaxillary glands; and her gums begin to swrell. The ulcer is less painful, and looks cleaner. The discolouration of the skin remains the same. February 13th. Has continued the acid. She complains of her mouth being sore and her teeth loose. No foetor of the breath is observable. Her ulcer is contracting, and the discolouration of the skin she thinks is lessening. February 16th. Has continued the acid. Her mouth is very sore and she spits near a quart a day. The ulcer is healing and the discolouration of the skin diminishing. On account of the soreness of her mouth the acid was omitted. February 24th. Her mouth is much better, and the ptyalism has ceased. The ulcer is nearly healed and the skin resuming its natural ap- pearance. She was directed to recommence the use of the acid. 90 PRIOLEAU ON THE NITRIC AND February 27th. Has taken the acid. Her mouth is slightly affected, and she continues to mend. March 2d. Has continued the acid. The ulcer has healed, and the discolouration of the skin is fast disappearing. March 6th. lias taken the acid. Her mouth is slightly affected. She continues to mend. March 12th, Has continued the acid. She is in a profuse ptyalism. Her skin is of its natural colour, and she appears perfectly free from her complaint. The acid was omitted. Her mouth in a week after the omission of the acid got well, and she was discharged as cured. N. B. Not a single grain of mercury had been given in this case. As my present object is to shew the efficacy of the nitric acid in the ve- nereal disease; and as nothing will have a greater tendency to its establish- ment, than its utility having been experienced by medical gentlemen of unblemished reputation, in different quarters of the globe; and especially as the result of their experience is in the hands of but a few, I think it my duty to avail myself of some of their cases. And in order to make this paper less prolix, I will omit the recitation of several other cases, which came under my immediate inspection. Within these few days I have had the good fortune to meet with part of a small pamphlet, entitled, " Reports of the effects of the Nitrous Acid in the Venereal Disease." It contains twelve cases by Mr. I Iammick, jun. one of the surgeons of the royal hospital, at Plymouth (England) which were selected from upwards of fifty cases in which the nitric medicine had been found efficacious, and sent to Dr. Beddoes for publication. As the one now in my possession is the only copy in Philadelphia, and I have some reason to believe it is the only copy as yet in America, and as it contains some very decided cases, which corroborate my experience on this subject, I will take the liberty of relating some of them. CASE V. George Hall, a marine, thirty-nine years of age, was received into the royal hospital, at Plymouth, on the 17th clay of April, 1797, for a vene- real complaint which he had contracted about three weeks before. At this time he had a large, irregular, foul chancre on the lower part of the penis near the scrotum, with an enlargement in the right groin; had never taken any medicine, or applied any thing to the chancre itself: the next day, the 18th of April, he was ordered the following drink: Be Acidi nitrosi diluti drachmas j j. Succi limonis uncias j. Aqux fontanx libras jj. M. bibat quotidie. THE OXYGENATED MURIATIC ACID. 9"! The ulcer was dressed with the simple white ointment: he continued this drink daily to the 3d of May, when the diluted nitric acid was changed for the same quantity undiluted, which he took, with the addition of syrup till the I lth day of May, when the chancre was healed, the en- largement in the groin could not be felt, and in every respect he became well. He was discharged to quarters on that day to go on duty. N. B. This man never took a grain of mercury. CASE VI. Thomas Plangett, marine, twenty years of age, was received into the royal hospital on the 17th day of April, 1797, for a venereal complaint, which he had contracted about sixteen days before; had not used any medicine for it: he had now two large indurated glands in the right, and a large one still in the left groin, and a venereal eruption on the pubis. The following day he was ordered; R Acidi nitrosi drachmas 1 ss. Syrupi simplicis uncias vj. Aqux fontanx libras jj. M. Bibat quotidie. He took it that day, and continued it in the same proportion daily to 15th day of June, when the swellings in his groins being gone, and the erdption having entirely disappeared, he was discharged on that day, in order to go to quarters. N. B. This man had not used any mercurial preparation. CASE VII. John Burr, seaman, twenty-seven years of age, was received into this hospital, on the 5th day of June, 1797, for a venereal complaint, contract- ed about a month before: this man had not taken any thing for it. Its appearance at this time was a large bubo in the right groin, which had suppurated two days before ; two chancres appeared on the lower part of the penis; he had a phymosis with great inflammation, and an appear- ance tending to gangrene; and an ulcer on the scrotum: the same day- he was ordered the following drink: R Acidi nitrosi drachmas ii. Syrupi simplicis uncias viii. Decoct: lignorum libras ii. M. capiat quotidie. The penis and bubo were poulticed, and the chancres dressed with the ** simple white ointment. He took his drink that night, and before he had 1 taken it six days, there was an rpparent alteration for the better. He , o/iuinued it to the 10th day of July, when his bubo, chancres, &c. being healed, the phymosis entirely removed, and the man in perfect heath, he 92 PRIOLFAU ON THE NITRIC AND was ordered from the venereal ward to another surgical waid, as he had a hernia. N. B. This man had never used mercury. CASE VIII. Samuel Pope, seaman, twenty years of age, was received into the hos- pital on the 4th day of June, 1797, for a venereal complaint, which he had contracted about ten days before. The account he gave me was, that about six days before his arrival here, he found great pain and difficulty in pass- ing his urine, attended with a phymosis, and a discharge of matter from the urethra; that three days after that, he perceived a black spot on the prepuce, which continued spreading till the day of his arrival here, when a profuse hxmorrhage taking place from the dorsum penis, it alarmed him and he then applied t© the surgeon for the first time, who immedi- ately sent him here. I found the whole prepuce entirely mortified, and the mortification had seized the upper part of the glans penis, from whence the prepuce had, from its weight in hanging down, been de- tached; he had also much symptomatic fever: he was ordered to be well fomented twice a day, and the yeast poultice to be applied, and to take the following drink: R Acidi nitrosi drachmas ii. Syrupi simplicis uncia.; viii. Decocti lignorum libras ii. M. capiat quotidie. Capiat hora somni opii grana ii. > June 5th. Has bled somewhat during the night, and the sphacelus on the glands seemed to have spread; the nitric drink, Sec. continued as yesterday. June 6th. Nearly the same as yesterday, only appears to have less fever; drink, &c continued. June 7th. The whole of the prepuce sloughed off this morning; the mortification on the glans had not spread: nitric medicine, 8cc. continued. June 8th. There was a detachment of the sloughs: drink, See. ordered as usual. June 9th. The sloughs came entirely off this morning from the glans, so deep as to occasion some alarm that the urine would find its way out through the side of the urethra. June 10th. Appeared to be better, and the nitric drink, &c. were con- tinued without any alteration, (except the ulcer being dressed with oint- ment on the 13th, in lieu of poultice) to the 17th of July, when the wounds «tf round the glans from whence the prepuce had sloughed off and elsewhere, • were healed; and he being in all respects perfectly cured of the venereal '- disease, he was sent from the venereal ward to another surgical ward, as * THE OXYGENATED MURIATIC ACID. 93 he had a lame arm from a hurt he had received on board some time before. N. B. This man had never used either mercury or bark. The preceding cases in my opinion justly warrant us in saying not only that the nitric acid is useful in the venereal disease, but that it is at least equal to mercury. But there is hardly a practitioner, who has not met with some cases of syphilis, in which he has had too just cause to lament the inefficacy of mercury, where either owing to idiosyncracy, or to the constitution not having sufficient stamina to contend both with the disease and remedy, or rather to the constitution being so irritable, as to be unable to bear the action of mercury, for a sufficient length of time, to eradicate the disease; in which cases the physician is reduced to the extreme mortification of being a spectator to the sinking of his unfortunate patient out of his miserable existence, with a disease, which besides being the most painful, is, by the world, esteemed the most loathsome and detestable. / With what honours then, should not science crown the man, who discovered a remedy capable of snatching a fellow creature in so deplora- ble a situation, from the jaws of death. The nitric acid, as will appear by the following cases, is sufficient to accomplish so desirable an end. And the gratitude of mankind in general, should pay the tribute justly due to the ingenious Mr. Scott, whom reason, reflection, and experiment, has conducted with so much honour to the discovery. In the pamphlet from which some of the preceding cases were taken, we find also the following, which are much to our present purpose. CASE IX.. Thomas Homewood, seaman, twenty-six years of age, was received into this hospital on the 29th day of March, 1797, for a venereal complaint, which he contracted about a month before. He had taken different medi- cines without effect, for it, on board; the appearance of the disease, was, a very large and deep chancre, extending ail the length of the penis on the back part; a large and extremely inflamed bubo in each groin, with a profuse discharge of matter from the urethra, accompanied with great heat in passing his urine. His buboes were ordered to be fomented and poulticed twice a day, and two drachms of the strong mercurial ointment to he well rubbed in on the thighs at night; which applications were continued to the 2d of April, when his buboes (now ready to suppurate) were touched with the lapis infernalis, ami the eschars were thrown off on the 5th. The next night he used the friction again, and continued it to the 10th, when I found him very weak and low, with a violent cough and much expectoration of thick phlegm streaked with blood, profuse sweats, 94 PRIOLEAU ON THE NITRIC ANT) and such extreme debility, as not to be able to raise himself from his pil- low, attended with diarrhoea. The chancre and buboes continuing very foul, the friction was discontinued, and he was the next day ordered the following drink: R Acidi nitrosi drachmas ii. Syrupi simplicis uncias viii. Aqnx fontanx libras ii. ?.!. capiat quotidie. The day after, finding himself somewhat better, the drink was conti- nued, and from the above alarming symptoms yielding, and an entire alteration taking place both in his health and appearance of the ulcers, he took it to the 10th of May; when he complained the drink vomited him. The nitric acid was then reduced to one drachm daily, which he drank without any uneasy sensation in his stomach, and continued it in that pro- portion to the .>0ih day of May; when his buboes and chancre being healed, and all the venereal complaints entirely gone, the drink was no longer used, and he was discharged from the royal hospital on the 5th day of June, in order to join his ship. CASE X. Thomas Edmcd, seaman, aged twenty-four, was received into this hospital on the 9th day of February, 1797, for a venereal complaint, con- tracted about three weeks before, and had taken mercury on board for it. At this time he had a very bad phymosis; the prepuce being very thick and hard, with a profuse discharge appearing to come from chancres situated behind the glans penis: he had also great difficulty in passing his urine, accompanied with a chordee. This man was very delicate, with fair complexion: he was ordered the next day to rub well into his tivighs at night, two drachms of the strong mercurial ointment, and to rpply twice a day, a poultice of linseed meal, &c. to the penis: he rub- bed, between the 10th cf February and 12th of March, twenty-three times, and fumig-ted the part night and morning with the cinnab: factit: on this day, viz. 12th of March, he was ordered to forbear the friction, as he was low and weak, and his mouth very sore and swollen: he spat in the four and twenty hours nearly three pints; diarrhoea, cough, pain of breast, and his venereal complaint appeared much aggravated. He was put on a nutiitlve diet, wirh wine and cordials; he was ordered an infusion of bark in lime water; two grains of opium every six hours, and a quart of the decoction of woods, to be taken daily, lie was kept on that course with- ' out gaining ground in any respect, to the 12th day of April: he was then " Thunberg's travels. RHUS RADICANS, AND RHUS GLABRUM. 121 The roots of the rMis vernix are large, irregular and knotty; they generally run some distance near the surface of the ground. To determine the question whether the tree which has been described in the preceding pages, be the same with that from which the famous varnish of several oriental countries is obtained, has at different times, been an object of attention among botanists of the first reputation. The oriental varnish-tree has been described with great accuracy by Kxmpfer, in his Amcenitates Exoticx. Of this description an extract is given in the appendix. From a very accurate comparison of Kxmpfer's description of the varnish-tree of the Japanese, with the rhus vernix of our country, and ♦ifrom frequent comparisons of the leaves of our rhus vernix, which I pro- cured from different parts of Pennsylvania, with Kxmpfer's figure of the Vernix of Japan, I am fully convinced that they are identically the same. This opinion was also entertained by Linnxus, Miller, Dillenius, Clay- ton and Thunberg. To trace the similarity of our varnish-tree, with that described by Kxmpfer, in all their different parts, would lead to a tedious prolixity.* A long and acrimonious controversy, concerning this subject, was carried on about forty years ago, between Mr. Philip Miller and Mr. John Ellis.f The former contended for the sameness of the American varnish- tree with that of Japan; which the latter positively denied. To relate, in this place, the different opinions and arguments, which were adduced on both sides of the question, would be neither interesting nor instructive. I have perused their different papers with much attention, but I find nothing in them to induce me to change the opinion above advanced. The dispute certainly was carried on under very unfavourable circumstances: the difficulty of procuring specimens from foreign countries; the imper- fection or fallacy of specimens when procured; and the variations, to which vegetables naturally are subject, when removed from their native soil to distant and unaccommodated climates, has led them, on both sides, into many inaccuracies and mistakes. Every person, acquainted with botany, who has seen the trees in their native countries, will readily dis- cover the sources of their deception. It is to be regretted, that while the plants concerning which they differed in opinion, were natives of Japan * Dillenius, in his description of the rhus vernix, remarks: "It should not seem strange, that the varnish-tree should be found in America near the same latitude with Japan; since the ginseng, the bignonia, commonly called catalpa, with many other plants, are found to be natives of these countries. And I ques- tion, if the toa-trce might not be discovered in America, if persons of Bkiil were to search for it." t See London Philosophical Transactions, vols,, xlix and 1. K 122 HORSIIELD ON THE RHUS VERNIX, and North-America, their controversy was unfortunately canned on in Great-Britain. One of my chief objects, in investigating the properties of our rhus vemix, was to determine whether it contained the same singular varnish- like juice, which is obtained from this tree in Japan; and whether this juice might be employed with advantage, by our artists, in the preparation ' of varnishes. My first trials were instituted at that season of the year, when in trees of a similar growth, the sap or juice is found in greatest abundance. Dur- ing the first week of May, on a warm clay, I made a number of circular incisions into the bark of a tree of moderate size; these incisions were immediately followed by a very copious flow of a viscid fluid, which at first was of a white or light yellow colour, but which upon a short expo- *? sure to the air, became brown, and in some instances nearly black.* I was able in the course of about half an hour, to collect from this tree half an ounce of its juice. I made similar incisions into several other trees, in the neighbourhood of the first; and by repeated collections on different days, I obtained several ounces of this varnish. If the vessel in which this juice has been collected, is immediately closed, it retains its original white or yellowish colour, and becomes brown only on that surface, which is in contact with the air. The juice has a sweet, but somewhat disagreeable odour; it is viscid,t glistering and pellucid; its taste is acrid; it imparts, when fresh, a slight sensation of heat to the tongue, and when swallowed irritates the fauces and excites ■coughing. It appears to agree in every particular with that described by Kxmpfer, as flowing from the varnish-tree of Japan. About the middle of May, when the leaves are fully expanded, I per- ceived that the juice flowed less copiously out of incisions into the bark; its quantity gradually diminished, and during the first week of June, the decrease was very evident. I found, however, by frequent trials, that at every period of the year, from May till September, some juice always followed an incision into the bark.J My next object should have been to determine the application of this juice, to the art of varnishing: this I have not been able to accomplish. The investigation of some of the properties of several other species of rhus, engaged all the time I could devote to these pursuits. Perhaps I * The juice which accidentally exsudes from the tree and dries on its bark, always assumes a jet black colour. f " From the toxicodendron, when wounded, issues a great quantity of juice, which when exposed to the heat of the sun, turns so very clammy, that it proves a good birdlime, and is with great success made use of for that purpose." Hughes'* Natural History of Barbadoes. \ The juice flows more copiously after wet weather. RHUS RADICANS, AND RHUS GLABRUM. 123 would have been more usefully employed in determining the properties of this varnish. Prom its very great analogy to the oriental varnish described by Kxmpfer, it is evident that it promises considerable utility in the art of varnishing: it is a matter of importance, and will be the object of some of my future researches. II. THE RHUS RADICANS. This plant is generally known in the United States, by the name of poison-vine; in some parts of Pennsylvania it is called poison-creeper.* It gro.vs only in a fertile soil; but is capable of existing in different situ- ations ; sometimes it is found near rivulets, at others in dry and elevated places. The rhus radicans has a slender ascending stem, which supports itself on the bodies in its vicinity. Like various species of ivy, it frequently climbs up to the top of our tallest trees, arriving at the height of forty or fifty feet. It appears to delight in ascending the lofty oak trees, which surround the fields of our farmers. Very often it is met with along the sides of fences, which serve it as a very convenient support. Its stem rarely exceeds two or three inches in thickness; in a few plants which were growing in a very fertile soil, I have seen it nearly five inches in diameter. The stem in many cases is compressed on the sides; some- times it is interrupted by small tubercles. It is covered with a gray barki which in young plants is of a lighter colour. If the rhus radicans happens to grow in situations where it meets not with a support, it never exceeds four or five feet in height; in these , instances its growth is always windmg or oblique; its branches frequently return and creep along the ground. In some cases it is forced to pursue this procumbent course for a considerable distance, without exceeding two or three feet in height. In order to attach itself in its ascent, to trees and other substances, the stem and branches of the rhus radicans are furnished with a great num- ber of long, thin, thread-form radicles or tendrils, which proceed in abun- dance from almost every part of the stem and branches. It is from these numerous radicles, that it has obtained its specific name of radicans or rooting.t By means of these radicles it sometimes adheres with so much * This is the toxicodendron triphyllon glabrum. Tournefort. Institut. Hcdera trifolia canadensis. Cornuti. Dillenius's toxicodendron rectum, foliis minoribus glabris, is a variety of our- rhus glabrum. The Delaware Indian name is Pu-tschis-ktey. D. Zeisberger's spelling book. I have observed several varieties of this species of rhus. f In very young plants these radicles frequently arc of a beautiful crunsr -i colour. 124 HORSFIELD ON THE RHUS VERNIX, force to the neighbouring bodies, that it is difficult, and not unfrequently impossible to detach, without breaking it. I have frequently seen large plants, so completely enveloped with a thick coat of these tendrils, that no part of their bark was visible. From the bark of the rhus radicans, when it is wounded, exsudes plentifully a milky juice: in proportion to the size of the plants, it appears to flow as copiously from the rhus radicans as it does from the vernix. After a few hours exposure to the air, it takes on an intensely black co- lour ; in its other properties it resembles the juice obtained from the rhus vernix. Its taste is acrid and somewhat aromatic. A similar juice ex- sudes from the leaves, immediately after being detached from the plant: this juice has been employed in a few experiments, which will be related in a subsequent part of this dissertation.* The trunk of the rhus radicans, almost during its whole course sends off lateral branches in an oblique or rectangular direction; which fre- quently proceed to the distance of two or three feet, and in their course again send off a number of lesser branches. The smaller branches are very slender and frequently pendulous. This arrangement of the branches gives the plant, where it stands exposed to view, an irregular and bushy appearance. If it grows in situations, where it is supported for a small distance only, it sends off, near the top, numerous branches, which spread irregu- larly in various directions. The rhus radicans frequently pursues a spiral course around its neigh- bauring trees; it is frequently in twined in a beautiful manner with our hedera quinquefoila. Its wood is brittle, but more firm than the wood of the vernix. The leaves of the rhus radicans are trifoliate, (three'd) the coramoi petiole, on the larger plants, is several inches in length. The two lateral leaflets are supported by very short petioles; while that of the terminating leaflet is somewhat longer. The leaves generally are intire, egg'd, smooth, and terminated by an acute point; they are divided in the middle by a prominent nerve. But I knew few plants, the form of whose leaves is so various: sometimes they are pretty regularly saw'd, at others irregularly sinuous; in some instances they are nearly oval, in others they are lance- shaped. According to Linnxus's specific character the leaves are: " three'd: leaflets petioled, egg'd, naked, most intire." When they first appear in the spring,! they are of shining red or of a copper colour; after having arrived at perfection, their superior surface is of a light green * V>'hcnthe bark of the rhus radicans is burned, it emits a smell resembling that of burning chestnuts or cashew-nuts. t In the vicinity of Philadelphia about the latter end of April; in the back parts of Penr.sjlvaria, later. RHUS RADICANS, AND RHUS GLABRUM. 125 colour, which is paler beneath. They are thin and of a weak texture. When dried, and preserved in a box, they have a very agreeable odour, very much resembling that of bohea tea. I have been informed by Dr. Barton, that the leaves are eaten by horses with impunity ; they are also eaten by cows; and sheep (according to professor Thunberg, in his travels) eat the leaves of a similar species, the rhus lucidum. Horses, Mr. William Bartram informs me, are very fond of the leaves of the rhus toxicodendron. The flowers are produced along the whole course of the lesser branches; they mostly originate at the basis, and just within the common petiole of a leaf, though many of their peduncles are sent off seaprately. Their peduncles are very short, and their panicles are less complex than those of the rhus vernix; about fifteen or twenty flowers are gene- rally supported by one common peduncle. The flowers are small, and their petals of a light yellow colour.* They have a most delightful odour, which resembles, but far exceeds in suavity, the odour of the reseda odorata. The male and female flowers are generally produced, on different plants. Irregularly round, striated berries, of a green colour, succeed the female flowers; they contain a small hard seed which is laterally compressed. They ripen about the beginning of October. The seeds are very perma- nent, and frequently adhere to the branches, in a dry state, during the course of a whole year. The roots of the rhus radicans are slender; they run near the surface of the ground, and in their course, send forth a number of young plants. III. THE RHUS GLABRUM, COMMON SUMACH OR SMOOTH PENNSYLVANIAN SUMACH. This plant is found abundantly in almost every part of Pennsylvania. It grows in a loose, fertile soil; frequently upon vacant or uncultivated fields, and along the sides of roads and fences. It sometimes rises to the height of eight or ten feet; in many instances it does not exceed four or five feet. The trunk of the rhus glabrum is seldom erect; after rising in an in- curvated or oblique direction, to the height of two or three feet, it divides into several large branches. The small branches which they send off, are disposed in such a man- ner as to form numerous irregular, oblique angles. They are covered with a smooth light gray or reddish bark, containing a viscid, glossy, yellow * They appear about the beginning of June. 126 H0RS1TELD ON THE RHUS VERNIX, juice, which is not changed upon exposure to the air. The wood is very light. The leaves, like those of the vernix, are compound; each leaf con- sists of nine or ten pair of leaflets or wings, which are placed opposite, and are terminated by an odd one. The leaflets are smooth, lanced, sawed and acute; the Linnxan specific character is " leaves feather'd, saw'd, lanced, naked on both sides." It is said, the leaves when dried, are mixed by the Indians with the tobacco they use in smokihg. The leaves which in summer are of a deep green colour, change to a beautiful red, in autumn; hence, what Kxmpfer elegantly remarks of the spurious varnish-tree of Japan, may with, strict propriety be applied to the rhus glabrum: " Rubore suo autumnali, quo viridantcs sylvas suaviter interpolat, intuentium oculos elonginquo in se convertit." The flowers are produced in large, erect, compound thyrses, at the termination of the superior branches. They are of a herbaceous colour. They appear about the beginning of July. The seeds are arranged, like the flowers, in large conical thyrses. They are of a dark red colour; and after their arrival to maturity, early in autumn, covered with a white tenacious powder, of an agreeable acid taste. The berries with their saline covering, have been subjected to seve- ral experiments, which will be related in a subsequent part of this disser- tation. From this white, saline powder, which is found on the berries, the rhas glabrum has been called, in various parts of Pennsylvania, Indian salt.* OF THE POISONOUS QUALITIES OF SEVERAL SPECIES OF RHUS. My observations under this head, apply chiefly to the rhus radicans and the rhus vernix. These two plants in consequence of the deleterious effect they produce on the skin, and by means of it on other parts of the human body, have been called poisons; the former, as if it claimed that name in preference to all other substances, is called in some parts of Pennsylvania, the poison; and both formerly belonged to a genus denomi- nated in systems of botany, Toxicodendron. As I shall have frequent occasion, in the course of the following ob- servations, to use the term poison, it may be proper to remark, that with * " Iidigenx hac substantia ad cames condiendas utuntur." Schapf. " The seed of a certain species of rhus, was formerly used, according to VViny, for seasoning meat, instead of salt; and was thought to render all flesh- meat mo-c savoury and grateful to the palate." James's Med. Diet. " The be-rvs are used as a mordent, or fixer, for the red colour with which the Indiuns Cye their porcupine quills." Dr. Barton's Collect, towards a M. M. of the U. S. RHUS RADICANS, AND RHUS GLABRUM. 127 physicians and naturalists this term ought to be considered as entirely of a relative nature. The most innocent and salubrious substances, may at certain times and in improper doses, produce effects similar to those gene- rally ascribed to poisons; while the most active or injurious substances, such as opium or arsenic, administered at a proper time and in proper doses, produce the most beneficial effects. Poisons according to their different nature, affect different parts of the human body: some, as stramonium and several other narcotic vegetables, appear to act chiefly on the brain; others act specifically on the blood, for instance the poison of the viper; some act primarily on the lymphatics; while others, as opium, hyoscyamus and the contagions* of the plague and yellow fever, may be considered as universal poisons, which exert their influence on every part of the human body. A large proportion of poisons belong to that class of the materia me- dica, which has been happily called by Dr. Darwin, Incitantia. The arti- cles of this class incite the motions of the different parts of the human system; they produce an increase of the action of the heart and arteries, increased secretions of the glands and viscera, and excess or irregularity^ in the action of the organs of sensation and thought; effects which are analogous to the operation of the following well known articles of the materia medica, opium, electricity, alcohol. This inciting effect is pro- duced in a peculiar manner, on the cutaneous system, by the rhus radicans and the rhus vernix, which have been ranked with propriety among the topical incitantsf. In treating of the poisonous property of these two plants, I shall first enumerate the various methods in which their effects are communicated to the human body; I shall then describe the morbid symptoms which are produced by them; and lastly, I shall mention the remedies by which these symptoms are obviated or cured. Ever since these plants have attracted the notice of naturalists and of other persons, it has been observed, that the susceptibility of receiving their poisonous influence, exists in different constitutions in very different degrees. While some are affected with a cutaneous eruption by their exhalation, at the distance of twenty feet, others are not affected by freely handling them, or by applying their juice to the tongue and fauces. The cause of the different predisposition to this eruption, has never been satisfactorily explained. Irritable habits, it has been observed, are more liable to be poisoned than others; yet, even among persons whose irritability is nearly alike, the tendency to be acted upon by this poison, is very various. The following circumstances have considerable influence, in varying in the same person, the aptitude to the reception of the poison. * Dr. Rush's Lectures. f Dr. l^iten. 128 HORSFIELD ON THE RHUS VERNIX, 1. A warm or cold climate. « In the southern climates these plants are more active than in the northern."* 2. Different seasons of the year: this I have very strikingly experi- enced in my own case. The rhus vernix never affects me in the smallest degree, except on very hot days in summer.t 3. Infancy or manhood. Dr. Barton has remarked, that children are more readily poisoned than adults: several instances in proof of this, have fallen under my own observation .\ 4. Exposure before or after a meal. " These plants more readily poison immediately after than before a full meal."|| 5. The presence of moisture. It is very generally believed, by inha- bitants of the country, that the effluvia of the plants, when combined with moisture, are most apt to produce the eruption. According to several facts which I have collected, this opinion deserves credit. It requires to be further investigated.§ 6. A state of increased perspiration, at the time of exposure to the poison, has a most powerful influence, in rendering persons more sus- ceptible of the eruption. Of this I had several unequivocal proofs during the course of last summer: in collecting the juice of the rhus vemix, if I was in a state of high perspiration at the time, I never failed to be af- fected, more or less with the eruption; if my skin was perfectly dry, the poison produced not the least effect upon me. Professor Kalm remarked the same during his travels; speaking of the rhus vernix, he says: u I found, however, that it could not exert its power upon me, when I was not perspiring." females, Dr. Barton has observed, are more easily affected than male* Of the different species of rhus, which are natives of the United States, three are considered poisonous. They vary in their degree of * Dr. Barton. f " They are more active in spring and summer, than in autumn and winter." Wangenheim, von den Nord Amerikanischen Holzarten. Gccttingc^, 1787. \ This I believe is the case with most other cutaneous diseases. An intelli- gent person informed me, that during his infancy he was very easily infected by the itch; but, that since his arrival to manhood, he is, upon exposure, much less readily affected by that disease. I also met with a person, who in early life was readily poisoned by the common rue of our gardens, in whom this plant produced no effect, after having advanced in age. I) Dr. Barton. § That moisture does not destroy their poisonous quality, appears by the fol- lowing quotation from Fontana on Poisons, vol. ii. Fontana, in order to examine the air of the leaves of the toxicodendron, as he knew that he was easily poisoned, observes: " I caused them to be got ready by another person, but I touched a few of the leaves when under tcater. In four days my face and eyes swelled, 8ic." RHUS RADICANS, AND RHUS GLABRUM. 129 activity. The rhus vemix is the most violent, and the most universal in its effects: the toxicodendron and radicans, though they resemble it, pos- sess the poisonous property in an inferior degree; many persons who are never poisoned by the radicans, are easily affected by the vernix. From a number of observations and facts, I am inclined to believe, that with the existence of certain circumstances, such as warm weather, and a state of high perspiration, no person would be found entirely unsusceptible of the poisonous influence of the rhus vernix. The manner in which the eruption is excited, like its degrees of vio- lence, is subject to many variations. It is mostly produced by one of the following circumstances: 1. By the exhalation or effluvium of the plants. Although this may be questioned by persons, who have not had an opportunity of observing their effects, yet, the facts in proof of it are so numerous, and many of them so decided and unequivocal, that not the least doubt is to be enter- tained on the subject. Dr. Barton and Dr. Woodhouse both informed me, that they had been poisoned in this manner. In these cases the first symptoms frequently shew themselves on the face and hands; but, though the poison appears to be applied principally to these, yet its effects in most instances soon become general. To what distance the exhalation, is capable of extending its influence, I have not been able accurately to de- termine. My observations lead me to believe, that in very excitable habits, it extends at least to fifteen or twenty feet.* A second method is, the smoke of the burning wood. This circum- stance is pretty generally known, and I believe generally admitted. Se- veral facts in proof of it, were communicated to the royal society of Lon- don, by Dr. Sherard and Mr. Dudley, before the year 1720.f It is also noticed by Kalm in his travels, and by Wangenheim. From several observations, I am induced to believe, that the effect in these instances, does not depend simply upon the smoke of these plants, but, that the particular part, in which the poisonous quality consists, is volatilized by the application of heat, and spreads its influence in every direction. Persons frequently are poisoned by sitting near a fire, in which some of the wood of either species is burning, without the least particle of smoke coming in contact with any part of their body. Dr. Cooper was poisoned by the steam arising from a decoction of the rhus radicans. * Some authors ascribe the poisonous effect to the scent of the plants; this ap- pears to be a mistake; the odour, espec'adh i>f the radicans, is by no means strong; it is scarcely perceptible when a person is in contact with the plant, nor is any specific effect produced on the schneiderian membrane t Philos. Trans. Abr. vol. vi. p. 307 and 308. s 130 HORSFIELD ON THE RHUS VERNIX, 3. By the actual contact of the leaves, stem, or branches of the plants. In this manner, I believe, the eruption is most generally excited.* 4. By the immediate application of the juice of the plants, to the ex- ternal surface of the skin, or by introducing it by inoculation, within the cuticle. In some persons, who can handle the leaves and branches without injury, the eruption is excited by the application of the juice to any part of the skin.f That the poison can be communicated by inoculation, was first demonstrated by an experiment made by Dr. Barton, during the last spring. I was since led by accident, to observe the production of the disease, by the insertion of a very small quantity, of the juice, between the cuticle and cutis. In two or three instances I observed a slight erup- tion, after phlebotomy, with a lancet, the quantity of juice communicated by which must have been so very minute, as to render it scarcely con- ceivable how the eruption was excited. The peculiar symptoms, pro- duced by inoculation, will be detailed hereafter. In illustration of the foregoing positions, many facts might be related, but this would lead to a prolixity, perfectly inconsistent with the design of this dissertation. The particular part of these plants, in which this deleterious property resides, appears to be their juice, which as was observed in the history of their growth, exsudes plentifully out of incisions made into the bark. This juice is highly acrid and corrosive; which is evident from its appli- cation to the skin of persons, who are not liable to be affected by the plants; in these cases it uniformly produces, like nitrous acid, or lunar caustic, a destruction and desquamation of the cuticle. It is capable of being volatilized by heat; and during the life and vigour of the plant, it appears to be exhaled, in forml of a peculiar gaseous fluid possessing its specific qualities, surrounding and defending the plant by an atmos- phere of poison. The manner in which those different symptoms are produced, which will soon be described, I have not had an opportunity of examining with sufficient accuracy. It will appear evident from a review of these symp- toms, that the poison induces in the vessels of the skin a peculiar morbid action; an inflammation sui generis. This inflammatory action exists in different degrees: in some instances the poison produces merely an ery- sipelatous eruption, which in others advances to effusion, to suppuration, and to ulceration. * Mr. N. Jones informed me, that he knew a numerous company of boys to be poisoned by their us'mg a stick, cut from the rhus vernix, in playing at ball. t Its application to the cuticle in the palms of the hands, is in some cases, an exception to this rule; in one instance, the juice being applied to these parts did not produce any effect, till it was communicated by contact to other parts of the body. RHUS RADICANS, AND RHUS GLABRUM. 131 This I acknowledge is speaking only in very general terms; it is re- peating what must be obvious to every person who examines the disease with attention. At present, however, I have neither time nor inclination to speculate on the pathology of this singular cutaneous affection. The subject is open for further investigation. I proceed now to the description of the symptoms which occur, upon exposure to the poison, in any of the methods above enumerated; and, in the first place, I shall describe them, as they appear in persons but moderately disposed to the disease. The interval of time, between the exposure and the appearance of the poisonous eruption, is various. It depends in a great measure upon the disposition of the person to be acted upon by the poison. In certain habits the effects appear in a few hours, in others not till in as many days. A slight degree of itching, or a sensation of heat, is the first harbinger of the approach of the eruption; this itching gradually increases, and is followed by redness and inflammation of the skin, which in some instances is very extensive, and in otliers is confined to round circumscribed spots, or to longitudinal streaks. The inflamed parts now become somewhat elevated and tumefied; small vesicles appear on their surface, containing a pellucid fluid, which gradually increases in size. The fluid soon becomes yellow, and after some time, takes on the colour and consistence of pus. The vesications in some cases are found separate, but where the inflam- mation has been violent, their number is mostly so considerable, that they come into contact, run into one another, and cover a considerable space. After the vesications are completely distended, they break, and some of their pus being discharged, by drying on their surface, forms a yellow incrustation.* In this state, if the vesicle is single, it somewhat resembles a pustule of the small pox; but where the vesications have been numer- ous, their purulent surface is proportionably extensive; so that towards the end of tiie disease, large surfaces are covered with a yellow incrusta- tion, which in a short time becomes brown. The disease generally ter- minates by a desquamation of this crust, which leaves the skin very tender and of a florid red colour.f A very troublesome itching accompanies the whole course of the eruption. It is very seldom that scars remain after its disappearance. Four or five clays are generally required for the eruption to pass through these different stages. Somewhat like this is the common course of the disease when left to itself; but, like all other diseases, it is in its progress subject to innumer- * If the vesications be irritated by scratching or by fiction, large quantities of serum or pus are discharged from them; the incrustations in these cases are formed sooner, but arc less regular on their surface. f If the eruption has been very slight, or if it has been stopt in its progress by the early application of proper remedies, still the cuticle of the affected parts is universally thrown off. 132 HORSFIELD ON THE RHUS VERNIX, able variations. These depend, in a very great degree, on the habit of the person affected. By the application of the remedies which are to be mentioned hereafter, its progress in moderate cases, can be prevented; and in violent cases the symptoms may be much relieved and their period shortened. I now proceed in tracing the history and symptoms of this disease; and in the first place, I shall mention several deviations from its usual course. 1. In many cases, although the disease does not exist in a violent degree, yet it is not terminated by passing through the several stages above enumerated. The eruption being excited in one part, is often pro- pagated to the part lying contiguous to it, from whence by slow degrees, it passes in some instances through the whole cutaneous system. Thus there exists in different parts of the body, a constant succession of sepa- rate eruptions passing through their several stages. 2. The itching and the vesications which take place in the incipient stage of the eruption, frequently disappear and return several times suc- cessively. In some instances pustules of considerable size, are entirely reabsorbed. 3. The poison appears to have a peculiar capricious disposition, to attack particular parts; in most persons the eyes are specifically affected; in some the body, the legs or thighs. A peculiar and distressing itching of the scrotum and of the prxputium penis, is one of the most general and characteristic symptoms of the disease, which in males, I have found to take place in every instance that has fallen under my notice, with but one exception. In quibusdam occurrit erectio penis. An fceminis labia pudend* similiter affectantur? Its peculiar tendency to affect the eyes, is most strik- ingly observed in persons that are readily susceptible of the eruption; in most of these, if its progress is not opposed by proper remedies, blindness of a longer or shorter continuance, is the certain consequence.* It has been observed that the eruption, when it is re-excietd, has a particular disposition to affect again the same parts, that were formerly affected. In habits which are very susceptible of the poison, the same symptoms occur which were above enumerated; but they make their appearance * Although I am but little disposed to the eruption, yet whenever the smallest degree of it is excited in me, my eyes are primarily affected: a slight tumefaction of the eye-lids and of the skin immediately below the eyes, takes place; this is accompanied by a sensation of fulness, by heat and itching, and followed by a scarlet eruption, extending circularly several inches around the eyes. Not only in this, but in several other cutaneous diseases, the eyes are specifi- cally affected: bbndness of a short continuance, frequently occurs in violent cases of the small-pox. RHUS RADICANS, AND RHUS GLABRUM. 133 earlier, continue longer, and exist with much more violence. The symp- toms peculiarly distressing in these cases are, excessive tumefaction, vesications cdvering very extensive surfaces, sometimes almost the whole body, and extreme pain, heat and itching. The tumefaction is in some instances confined to the parts first affected, in others it is general; the extremities sometimes swell to twice their natural size. " I was acquainted (says Kalm) with a person, who merely by the noxious exhalation of the rhus vernix, was swelled to such a degree, that he was as stiff as a log of wood, and could only be turned about in sheets." I know a person, whose face in the latter stage of the disease, was covered with incrustations in such a manner, that he resembled a person having the confluent small pox, in the highest degree of violence. And the vesi- cations and subsequent ulcerations, are sometimes so extensive, and their consequences so terrible, that not unfrequently four or five weeks elapse before the person recovers. In this situation, as we may easily conceive, the patient suffers immense torture; the whole course of the disease is accompanied by incessant burning and itching, and in every position in which he can possibly be placed, he irritates a part in a state of disease and high sensibility. One of the most singular, and at the same time, one of the most universal concomitants of the eruption, when it exists in a violent degree, is a sympathetic fever of the arterial system. From much inquiry con- cerning this subject, among persons of every description; from several cases which have fallen under my own observation, and from a number of facts, which have been communicated to me by several very intelligent medical friends, I am induced to believe, that this sympathetic affection of the arterial system, occurs in a greater or less degree, in every case, in which the symptoms of the disease are violent. When we consider how frequently local diseases excite the sympathy of the arterial system, it must appear singular, that this should not have been generally noticed, by authors who describe this eruption, which in some instances, for a short period, is as violent in its symptoms as any other cutaneous disease whatsoever. If it be demanded, by what symptoms and circumstances the existence of this fever is proved? I answer: 1. By the quick, frequent, full or tens-^ pulse, which in violent cases universally prevails.* 2. By blood drawn during the course of the disease, having been found sizyt and cup-formed4 3. By loss of appetite and sickness at stomach. 4. By a white tongue. ' Fontana, in his description of the effects produced by the rhus toxicoden- dron on himself, seriously tells us: I had no fever, but my pulse was very quick. t By Dr. Barton. J Dr. Cooper. 131 HORSIIELD ON THE RHUS VERNIX, 5. By a burning of the palms of the hands and soles of the feet. 6. By head-ach. 7. By a throbbing of the temporal arteries; and 8. By delirium.' Most of these symptoms I have observed in several cases that have come under my notice. The time of the appearance of the fever, after the exposure to the cause of the disease, is various; in cases of a less degree of violence, it is not excited till the eruption has made considerable progress, till the second, third or fourth day; in violent cases it takes place very early in the disease. After the detail of all these symptoms, it might properly be asked, whether or not, in some instances, death is produced by these injurious plants. Several car.es were communicated to me, in which the symptoms were so violent, that it was more probable that the disease would termi- nate in death, than in a recovery; and it ii very reasonable to suppose, thr.t the extensive ulcerations might in some instances terminate in gan- grene, or that the sympathetic fever might proceed so far, as to prove destructive to the life of the person affected. Although I never met wit'i a case, in which this disease proved mortal, yet its possibility is rendered very evident by the violence of the symptoms in some cases; and that it is capable of producing death, appears likewise to be proved by the fol- lowing quotation from a writer of credit. " In Pennsylvania I was assured by a number of reputable persons, that there were instances of persons having died in consequence of the bad effects of the rhus vernix; and probably by neglecting the use of proper remedies." Wangenheim. There are several other symptoms of this disease, which on account of their singularity deserve to be described, though they appear less fre- quently, than most of those which have already been enumerated; they might be called with propriety anomalous symptoms. 1. A periodical return of most, sometimes of all-the symptoms of the disease, about a year after its first appearance, without fresh exposure to ti-e cause in an/ manner. This periodical return occurs annually in some instances, for the course of four, five, or even ten years. A number of cases of this periodical return have been communicated to me. Several I have observed myself. But no case establishes this sin- gular occurrence in so unequivocal a manner, as the case of Dr. Barton. He was poisoned in the year 1785,. near the Ohio; about a year after this, he went to Europe. In the year 1786, nearly at the same time of the year when he was first affected, most of the symptoms of the eruption return- ed : here there could not be the most distant suspicion of the poison being communicated to him by means of the atmosphere, or in any other * Several other symptoms of fever occurred in a case communicated to me by Dr. C. Caldwell. Seethe appendix. RHUS RADICANS, AND RHU'-i GLABRUM. JJi manner. The eruption returned annually till the year 1790; at every successive attack it was less violent in degree.* To account for this periodical return of the eruption, might furnish a subject for interesting speculation. But to speculate is at present not my intention. The poison generally is excited during the hot summer months. It is only during these months that the eruption re-appears spontane- ously. I have never heard of its recurrence at any other period. During these months, from various causes, the irritability of the skin is consider- ably increased; and I believe, on inquiry of persons thus affect..d, we should find, that before the re-appearance of the eruption, they have by means of exercise, or by other causes, produced a certain degree of in- creased action in the vessels of the surface of the body. May not then, with this increase of irritability, or of action, in the cutaneous vessels, a morbid action, similar to that which existed about an annual period be- fore, (under analogous circumstances of every kind) be associated; and by this association, an inflammation of the skin, resembling the poisonous eruption, be re-excited? Dr. Rush ascribes, with much ingenuity, the re- currence of the paroxysms of the intermitting fever to a certain association of ideas and motions. This eruption appearing periodically, might be called an annual fever of the cutaneous system. * There exists in many respects, a striking analogy between the rhus vernix and the anacardium occidentale. The juice of the anacardium, like that of the rhus vernix, produces an indelible black stain on linen. From its stem exsudes a, black liquor, which may be used for the purposes of varnish. Like the rhus ver- nix it produces an eruption on the skin, which to complete our analogy, in some cases returns every year periodically. A remarkable instance of this was com- municated to me by Mr. Josiah Coates, of Philadelphia, where the eruption returned for four or five years successively. The physician who had the care of it employed with success in its cure, a salivation. A similar case came under the notice of Dr. Physick, in which the eruption returned periodically, for several years. In another case of eruption, excited by the oil of cashew-nuts, in a young woman, who was lately attended by Dr. Physick, violent febrile symptoms super- vened, which were relieved by bleeding: the blood drawn was sizy. The Iiippomane mancinella, a celebrated poison tree of tropical comiiries, is also in many respects similar to the rhus vernix. The milky juice contained hi its bark, upon touching the skin, immediately raises watery vesicles. (B?.nkr:)h"t's History of Guiana.) And dew drops falling from it are so caustic, as to blister the skin and produce dangerous ulcers. Darwin's Botanic Garden. Several vegetables which are familiar to most persons, prodaco effects analo- gous to the rhus radicans and the vernix; though in an inferior degree. The effluvia of the neriuni oleander, produced in a case which, came under.Dr. Bur- ton's notice, an extensive erysipelatous affection of the skin; the same has also followed the contact of the flowers of our broad leafed laurel (kalmia b.tlfol.) That an eruption of the skin is produced by the common rue of our gardens, is almost generally known; and one case was communicated to me, iu v bi'.h a imi- \ersal eruption wus produced, by the, berries of the rhus gk.brum 136 HORSFIELD ON THE RHUS VERNIX, 2. In habits which are easily acted upon by the poison, if proper reme- dies are not applied early in the disease, or at least soon after the appear- ance of the vesications, they sometimes terminate in troublesome, lingering ulcers, resembling such ulcers, as are denominated phagedenic. These frequently are the source of immense pain and distress to the person af- fected, and if they finally heal, they are remembered by permanent scars. 3. The eruption is not unfrequently succeeded by a great number of small phlegmons or boils; I have often observed this symptom. Dr. G. Wilson informed me, that while one of his arms was affected by the common poisonous eruption, the other was covered with a number of small boils. 4. A swelling of the tongue, and an ulceration of the mouth, are in some instances very painful symptoms. 5. A swelling of the lymphatic glands. This symptom occurred sev- eral times in Dr. Barton's case, during the existence of the eruption; he also noticed it in the case of a person, who after being poisoned by the rhus radicans, applied to him for medical assistance. 6. After the disappearance of every other symptom of the disease, the patient is sometimes harrassed, for many days, by a very disagreeable itching, which extends over the whole surface of the body. In this place I shall relate the following two cases, the symptoms of which likewise differ from those that usually occur. 7. I had an opportunity of seeing a person at the alms-house of Phila- delphia, in whom the poisonous eruption had been originally excited, by the smoke of the rhus radicans. It did not make its appearance till two months after he was exposed to the smoke, when small vesications were seen on his shoulder, which were easily cured by very simple remedies. Twelve months after this, the disease returned upon the same part. The succeeding year it first appeared on his legs; it travelled up his thighs to his arms and shoulders, and finally affected his back and face. This was in May, 1797. The disease now was in a state of ulceration; the ulcers, however, were superficial, and did not appear to extend beyond the skin; they very much resembled a certain cutaneous affection, which some- times occurs in consequence of the venereal disease. His eyes were also affected at this time, by a serous discharge, which was followed by a de- fective vision, in one of his eyes, and almost total loss of sight in the other. The blindness was relieved, by a slight salivation and by several other remedies. 8. A man labouring under a highly inflammatory fever, was bled by a person who had handled the rhus vernix, but who had used the pre- caution, after detaching the resinous juice adhering to his hands by spirit of wine, to wash them repeatedly with soap and water. About forty-eight hours after the venesection, a red eruption and several serous vesicles. RHUS RADICANS, AND RHUS GLABRUM. 137 appeared above the place where the vein had been opened by the lancet; these upon examination were found to be the poisonous eruption. This eruption rapidly extended over the whole arm, and some of it appeared on the arm of the opposite side. The scrotum was also covered by the erup- tion and by vesications. The most remarkable phenomenon of this case was, that during the exacerbation of the fever, the eruption and vesications very sensibly increased, and the scrotum was perceptibly tumefied, while they almost entirely subsided during the intervals between the paroxysms.* The different methods in which the poison is generally communicated, were formerly mentioned; there remains, to enumerate a few symptoms, which are produced by several of the different methods of communication. 1. When the smoke of the rhus vernix is the exciting cause, its effects generally resemble those produced by other causes; but when it has been very powerfully applied, symptoms of a different nature have been pro- duced : this appears from the following fact, communicated to the philo- sophical society of London, by Dr. Sherard. " Some people had cut some of the rhus vernix for fuel, which they were burning; in a short time they lost the use of their limbs, and became stupid; so that if a neigh- bour had not accidentally opened the door, and saw them in that condition, it is generally believed, they would soon have perished." 2. Desirous of knowing the effects of the juice of the rhus vernix on myself, I applied a considerable quantity of it to the back of my left hand. This was done while I was standing near a tree, from which the juice flowed after making an incision through the bark. A slight pungent pain was felt immediately after the application, rosembling that produced by the emplastrum cantharidum. The spot soon assumed a black colour, and became somewhat elevated; this elevation gradually increased; it was accompanied by a constant sensation of fulness and heat. In twenty- four hours, the whole spot was covered by a large vesicle, which on being punctured discharged a viscid, serous fluid: a scar is yet to be seen where the juice was applied. 3. It was mentioned, in a preceding part of this dissertation, that Dr. Barton had excited the eruption by inoculation: a very small quantity of the juice of the rhus vernix was introduced by a slight puncture, between the cuticle and skin of his left hand. In thirty-six hours, an itching and tumor were perceived in that spot, and soon afterwards symptoms of the eruption and slight vesications appeared on different parts of the body ; * This case would serve to prove, if any proof were required, that the poison »cts in the first place locally on the cutaneous system; the patient at the time of its application laboured under a violent affection of the arterial system: that two general affections of one system (for instance, the arterial, nervous, &c.) cannot exist at the same time, is I beUeve, at present almost universally admitted. T 133 HORSHELD ON THE RHUS Vis UNIX, it produced likewise, a slight sv< lling of the axillary gland of the left arm, the usual affection of the scrotum, and a universal itching. Its progress was checked by a remedy, which will be mentioned in its proper place.' The following case was communicated to me by my very ingenious friend Dr. S. Cooper. " On Monday, about twelve o'clock, 1 was inocu- lated on my wrist, with some of the juice of the poison-vine. The next morning when I awoke, my eye-lids itched and were redder than natural. In the afternoon this symptom became worse, my face began to itch, swell and look red, and my scrotum and prepuce were affected in a similar manner. The part where 1 was inoculated, now began to inflame. Dur- ing the existence cf the preceding symptoms, I experienced frequent flushings of heat through my whole body; and my pulse was unusually quick and frequent. Vesicles were hindered from forming about my eyes and face, by often applying ice to these parts. Vesicles arose on the scrotum, on each wrist and hand, and on my feet and legs. In about eight days time the whole affection disappeared. Much cuticle came away from my face." CONCERNING THE CURE OF THE DISEASE, PRODUCED ■ BY THE RHUS RADICANS AND VERNIX. From a review of the causes and symptoms of this disease, we shall easily be led to a proper method of cure. It is produced by a highly inciting cause; in every instance an inflammatory affection of the skin exists, and in many cases it is attended by an inflammatory fever of the whole system. Reasoning therefore from its causes and symptoms, I shall not hesitate to recommend such remedies, as are generally known to relieve inflammatory affections. These are chiefly evacuants. But another class of remedies, which act locally on the part affected, is neces- sary ; these remove the existing morbid action, by exciting a stronger action in the diseased part. The application of these remedies to this disease, and to many others, has been rendered very obvious, by the clear and comprehensive therapeutical rules, which are taught in this univer- sity, by the excellent professor of the institutes and clinical medicine. The remedies are naturally divided into such as act generally in the whole system, and such as are applied locally to the parts affected. Of the former I shall recommend blood-letting, purging, cold in the form of ice, cold water or cold air, and mercury given with the view of exciting a salivation. * I have in several instances, and in habits which were very susceptible of the poison, attempted to propagate it, by inoculation with the serous fluid con- tained in the vesicles; but in no instance wuj I able to excite the infection. RHUS RADICANS, AND RHUS GLABRUM. 139 1. Blood-letting. This remedy has lately been used, with singular vuccess, by Dr. Barton and Dr. Cooper, of this city, and by Dr. Stocket, of Maryland.* The appearance of the blood drawn, was mentioned in a fonner part of this essay. In violent cases it should never be omitted, and in moderate cases it will shorten the course of the disease, and render the symptoms less distressing. 2. Purging. Ibis remedy, especially in cases accompanied by much inflammation, should always be used in conjunction with the last remedy: It may be particularly useful in such cases, where from the extent of the tumefaction or ulceration, blood-letting is rendered impracticable. In these cases this remedy will be one of our chief resources. Under this head is to be ranked, copious drinking of sea-water. This was used in a case communicated to me by Mr. Samuel Coates, in which the disease returned several years periodically, and resisted all the reme- dies that were applied until the patient was sent to the sea-shore, where it soon yielded to sea-bathing and plentiful potations of sea-water, which produced very copious and continued evacuations from his bowels. Wherever this is convenient it may be an excellent remedy. The analogy between these poisons and the mancinella, was mentioned in a former part of this essay. It is confirmed by the following circumstance: Bancrofft, in his History of Guiana, tells us, that in the bad effects produced by the mancinella, sea-water, and the juice of limes, e:c. are effectual remedies. A remedy which is used in the cure of the eruption, occasioned by the rhus vernix of Japan and China, produces violent purging.! 3. Cold, whether applied in the form of ice, of cold water or cold air, is an excellent palliative of all the symptoms, in the early stage of this disease. It particularly relieves the itching, which in some cases is very distressing, and it often retards or entirely prevents the tumefaction. A person who is very susceptible of the poison, informed me, that a very cold bath relieved all the symptoms and entirely checked the progress of the disorder. Dr. Cooper derived great benefit from the application of ice to his face; and in my own case every symptom was soon relieved, by the use of this excellent remedy. Kalm, likewise used this remedy with advantage. It was remarked formerly, that the eruption is less easily ' excited in cold than in warm weather. 4. In violent cases, where the symptoms of the disease run high, and where the patient's life may be in danger, I recommend with great con- fidence, the internal use of mercury, with the view of exciting a salivation. From its almost specific effect in all cutaneous diseases, we may also in • It was also employed, with good effect, in a case communicated to me by Dr. C. Caldwell. f Duhalic'^ History of China. 140 HORSFIELD ON THE RHUS VERNIX, this instance, expect much from this powerful remedy. I formerly men- tioned a case of erysipelas produced by the anacardium occidentale, in the cure of which it was used with success. 2. Topical remedies. The first and most powerful of these, is a solution of corrosive subli- mate in water. This remedy was first employed by Dr. Barton in his own case, and by him it has been recommended to several other persons: from the success which has uniformly attended this remedy, in every case in which it was used, he is led to believe, that it may be employed in the cure of this eruption, with as much certainty and probability of success, as it is in many other diseases. The application of the solution, very soon excites a specific inflammation of the skin in the parts affected, which at this time are in a state of great excitability; this inflammation is of greater force than that produced by the rhus, which it counteracts or destroys.* It soon allays the itching, accelerates the suppuration of the vesicles, if any have formed, and brings on a desquamation of the purulent crust, or in moderate cases, of the cuticle. But, its effects are not topical alone; in all persons that are easily acted upon by mercury, it produces a salivation; this happened in Dr. Barton's case.t 2. In moderate cases I have applied with very considerable advantage, an ointment prepared by mixing one drachm of saccharum saturni with one ounce of unguentum simplex. My friend and fellow graduate, Mr. P. G. Prioleau, informed me, that upon being poisoned by the rhus radi- cans, partic ularly on his hands and arms, after using several remedies with little effect, he was cured by the application of a solution of saccha- rum saturni. It was also used in conjunction with the ungt. mercur. precip. rubr. in the case related p. 136, with considerable advantage. 3. The unguentum simplex of the Dispensatories, sweet oil, and emollient cataplasms, should be applied in all cases, where in consequence of neglect in the beginning, tedious and ill-conditioned ulcers remain. Whenever their cure is much protracted, mercury should be exhibited internally. With these remedies, general and topical, regulated according to thfe existing stage of the disease, and accommodated to the constitution of the * Dr. J. Otto informed me, that a friend of his had in several instances, re- moved the eruption in a short time, by the application of the spiritus sal. amnion. diluted with water: this acts in a manner similar to the solution of corrosive subbmate. f The ungt. mercur. precip. rubr. is used in some parts of Pennsylvania in the cure ofthis eruption; it is called by the inhabitants of the country, poison-salve. In the case which occurred in the alms-house of Philadelphia (see p. 136) it assist- ed in the cure of a number of chronic ulcers produced, by the rhus radicans. It is an exceL'est remedy in these cases. RHUS RADICANS, AND RHUS GLABRUM. 141 patient, and the condition of his system, I believe it will never be difficult to bring the disease to a fortunate termination. I shall now enumerate a few of the remedies, which are most gene- rally used by the inhabitants of the country; among whom, from evident reasons, this disease is most frequently met with. The leaves of the datura stramonium, houseleek (a species of semper- vivum,) the expressed juice or a decoction of the roots of the sanguinaria canadensis,* cream and water, and a solution of common salt or of cop- peras in water. All these are applied externally, and may be very proper in moderate cases; but they are superseded by the more effectual reme- dies above enumerated. More violent, but less commendable are, salt dissolved in hot soap- suds, brandy, and spirit of urine; which have all been used externally. Soot dissolved in milk is taken by some persons; perhaps it acts as « cathartic. Under this head are to be mentioned several other remedies, which .formerly were very celebrated. Of these I can say nothing from my own experience. 1. The leaves and wood of both species of rhus, burnt to ashes and rubbed on the parts affected. This has been said to be very effectual in curing the disease. 2. Kalm, in his travels, observes: " Some people assured me, that a person suffering from the noisome exhalations of these plants, would easily recover, by spreading a mixture of the wood burnt to charcoal, and hogslard upon the swelled parts."t Wangenheim says: " If the poison exists in its highest degree of violence, the ashes of the wood, prepared in a close vessel, is used in its cure; an ointment is made of it with lard, with which the affected parts are anointed." EXPERIMENTS ON THE RHUS GLABRUM. Experiment I. About two pounds of the fresh berries of the rhus glabrum, were infused twenty-four hours in a gallon of hot water; the infusion had an agreeable acid taste; it was evaporated almost to the con- sistence of a syrup, and exposed in a cool place to crystallize. Nearly twelve drachms of impure crystals of a reddish brown colour were ob- tained : their form was oblong or cuboidal, and by repeated solution and evaporation, they were rendered perfectly clear and pellucid. Th?y * This is used by the country people, in all chronic ulcers. f Dr. Barton has been informed, that an empiric near Lancaster, uses an oint- ment prepared with the charcoal of the rhus radicans and hogslard, with great success in the cure of the itch. 112 HORSFIELD ON THE RHUS VERNIX, appeared very analogous to crystals of tartar; and the following circum- stances, tend to prove their complete identity with that saline substance. 1. Their taste very much resembled the taste of cream of tartar; it it was however more truly acid, devoid of the earthy taste which always accompanies that salt, and which may be owing to the aluminous earth by which it is clarified, or to calcareous earth with which it appears sometimes to be adulterated. Perhaps the crystals obtained from the rhus contain a greater proportion of acid. 2. The superabundance of tartareous acid was rendered very evident by a violent effervescence, which took place on adding a small quantity of potash to a solution of these crystals. Their analogy to chrystals of tartar is further proved: 3. By their diffi- cult solubility in water: 4. By being rendered much more soluble by the addition of a little borax ; and 5. By a slight red colour, which they pro- duce on blue vegetables.* The gallic acid has been found to exist in every species of rhus, which has hitherto been examined by the chemist. I have met with it in dif- ferent proportions, in several of our native species of this genus, in the rhus vernix, rhus radicans, rhus typhinum, rhus copallinum, and especially in tlie rhus glabrum. And we may very probably suppose from analogy, that it will be found in a greater or less degree, in every species of this genus.f It appears from the following experiments, that this acid casts in different proportions in different parts of the same species: no part of the plant, however, is entirely destitute of it; I have found it in the flow- ers, the leaves, the bark, the seeds, and even the root. The relative quantity contained in the different species, is very various: from the few trials I have made, the result of which requires much further confirmation, I suppose they may be ranked in the following order: the rhus glabrum contains most, next the typhinum, copallinum, vernix, and radicans. As the rhus glabrum appeared to contain the gallic acid in the largest proportion, and as it was procured with more facility than any of the other species, I subjected it to the following experiments. Experiment II. The infusion of the leaves, after a short exposure to the air, is of a light brown colour; the infusion of the berries is of a beautiful crimson colour. Experiment III. To a pint of pure water, in which one grain of sulphate of iron had been dissolved, one drop of an infusion of one ounce of the leaves in a pint of water was added: a slight grayish blue dis«- colouration soon took place, which in twenty-four hours became more perceptible; if to the same solution three drops were added, the water soon assumed a purple colour. * \ solution of these crystals, produced in lime-water and in a s-jlu'ion of the a^ctite of lead, a white precipitation. 7 It exists plentifully in the rhus corlar.':: and coiinus of Europe. RHUS RADICANS, AND RHUS GLABRUM. 143 Experiment IV. If to half an ounce of the infusion of one ounce of the fresh berries in a pint of water, one drop of a solution of sulphate of iron is added, a black precipitation takes place, which is immediately re- dissolved ; if even three or four drops are added, still the liquor remains transparent; but if now a few drops of a solution of potash are added, a deep black colour is instantly produced. Experiment V. If to half an ounce of the infusion of the leaves, of equal strength of that of experiment the third, one drop of a solution of sulphate of iron is added, the liquor immediately assumes a black colour: but, if to the same quantity, previously one drop of diluted sulphuric acid is added, the black precipitation, as in the last experiment, is again re-dissolved, until the acid is neutralized by the addition of a few drops* of a solution of potash. This experiment was repeated with the same result, with an infusion of galls. Experiment VI. To determine the relative quantity of gallic acid contained in the leaves and berries of this species of rhus, I infused one ounce of each, in half a pint of water, and to equal quantities of both in- fusions, I added a scruple of sulphate of iron. Characters written with the infusion of the leaves were nearly black, while such as were written with the infusion of the berries were only brown. With a view to neu- tralize the tartareous acid of the berries, I added a few drops of a solution of potash; an effervescence took place, but the blackness of the infusion was not increased.* Experiment VII. To determine the relative quantity of gallic acid contained in the rhus glabrum, and in galls, I infused an ounce of the leaves, berries, and galls, each separately in a pint of water; to-equal quantities of these infusions, I added a scruple of the sulphate of iron. Characters written with the infusion of the berries, were as in the last experiment, considerably paler than those written with an infusion of the leaves; while between such, as were written with the infusion of the leaves and of galls, I could not discover the least difference in point of blackness ; nor could several of my friends to whom they were shewn. Observing the blackness produced in the last experiment by the sul- phate of iron in an infusion of the leaves, I was induced to believe, that by a due proportion of the relative quantity of the leaves of the rhus glabrum and of sulphate of iron, they might be used advantageously in the preparation of ink; to determine this, the following experiments were instituted. Experiment VIII. My first trials were made with the berries; six drachms of these, two of sulphate of iron, and one of gum arabic, were * Small quantities were first added, and these were gradually increased; but though by a very small quantity the colour of the infusion was not impaired, yet, when it vvaa increased, a duty brown colour was always produced. 144 HORSFIELD ON THE RHUS VERNIX, infused in half a pint of water. The ink obtained in this manner, as might readily be expected from the result of the sixth experiment, was of a brown colour. It was not improved by the addition of potash. By tak- ing a larger proportion of berries the blackness was somewhat increased. Experiment IX. I infused six drachms of the leaves, two drachms of sulphate of iron, and one of gum arabic in half a pint of water;* by this infusion I obtained very good ink, equal in point of blackness to our common writing ink. Experiment X. To determine more accurately the degree of black- ness of this ink, I made a relative trial with exactly the same quantity of galls. The blackness of characters written with both, after having been kept for four months, was so nearly alike, that by the nicest examination I could scarcely perceive any difference: they were shewn to, and examin- ed by several persons, who were of opinion, that no difference existed between them.f If a greater proportion of leaves to the other ingredients was used, the intensity of the blackness of the ink was considerably increased. The preceding experiments indicate the presence of a considerable quantity of gallic acid; to establish more fully the identity of the rhus glabrum, with those vegetables, which are commonly called astringent vegetables, I made the experiments which immediately follow. Experiment XI. To a very strong filtered infusion of the leaves, a small quantity of a solution of potash was added; a very copious yellowish precipitation soon took place; the addition of potash was continued till no more precipitation ensued: after some time the supernatant liquor was poured off, and a few drachms of sulphuric acid were added to the precipitation, by which it was instantaneously dissolved.} Experiment XII. If to an infusion of the berries, the solution of potash was added, a violent effervescence took place, which was owing to the tartareous acid of the berries (exper. 1.); by increasing the quantity of potash, a precipitation ensued, as in the last experiment, which was very soluble in sulphuric acid. Experiment XIII. After saturating about two pints of the infusion of the berries with potash, half an ounce of diluted sulphuric acid was added to it; the liquor then was suffered to evaporate spontaneously. In about two months a number of crystals were formed, resembling those of sulphate of potash. * These are the proportions recommended by Mr. Lewis. Phil. Com. of Aits. f When this ink was first prepared (with the rhus glabrum) and a few days •afterwards, it had a slightly brownish hue; this disappeared in my specimens, after being kept a few weeks; the ink prepared with galls, as is well known, has whei recent, a bluish cast. J The precipitation was insoluble in water and in alcohol. RHUS RADICANS, AND RHUS GLABRUM. 145 Experiment XIV. To the clear supernatant liquor, remaining in the tv.elfth experiment, small quantities of sulphuric acid were added; a precipitation took place, which being dried, by forming a dark brown tincture with alcohol, exhibited evident signs of the presence of a resin, which however exists only in small quantity. Experiment XV. In the supernatant liquor of the twelfth experi- ment, a solution of sulphate of iron produced a black precipation; the oxygenated muriate of mercury, and the muriate of barytes, produced a precipitation' of a brown colour. Experiment XVI. The precipitation produced by potash in the infusion of the leaves, is readily soluble in the sulphuric acid, as appears from the eleventh experiment; but, by the addition of potash, ammoniac, or a solution of borax, it is again precipitated. By spontaneous evapora- tion of this solution, a highly astringent, gummy substance is obtained, which being dissolved in water, is readily decomposed by potash or by muriate of barytes. Experiment XVII. The infusion of the berries concentrated by evaporation, produced in a solution of silver in the nitrous acid, a white, and in a solution of mercury, a yellow precipitation; in a solution of the acetite of lead it produced a white precipitate; in lime-water and the oxygenated muriate of mercury a gray precipitate; and in a solution of sulphate of potash a brown precipitate. Experiment XVIII. About two pounds of the berries, recently col- lected, were digested several days in a gallon cf water; the liquor was then filtered, evaporated to a pint, and one ounce of quick-lime gradually added to it; having digested twenty-four hours, the calcareous sediment was collected, and frequently washed with warm water; one ounce of diluted sulphuric acid was now poured upon it, and after some time the liquor was poured off, evaporated to a pellicle, and exposed to crystallize. About two drachms of long, slender, four-sided crystals were obtained.* These crystal-, did not effloresce in the air; dissolved in water they pro- duced a copious milky precipitation in lime-water and in a solution of the acetite of lead. Experiment XIX. On half an ounce of the berries of the rhus glab- rum, I poured five ounces of strong nitrous acid; a large quantity of nitrous gas was disengaged; a moderate degree cf heat was applied for several hours; the remaining fluid was then poured into a plate, and in a short time a large number of delicate, needle-form crystals were pro- duced. A solution of these crystals caused an instantaneous milky preci- pitation in lime-water and in a solution of the acetite of lead; in a solution * I obtained at the same time, a few very minute crystals of the »ul; 1 -a'.e a potash- u 146 HORSFIELD ON THE RHUS VERNIX, of sulphate of zinc or copper, a white precipitate was produced. These crystals effloresced when they were exposed to an air of a moderate tem- perature. On a repetition of this experiment, I obtained some crystals of the same form with those just described, and others, of a quadrilateral form, terminated by dihedral summits; the former of which effloresced in the air. Experiment XX. By treating half an ounce of the extract of rhus glabrum, with five ounces of nitrous acid, I obtained lamellated and ob- long crystals, which possessed all the properties of those described in the last experiment. When these crystals are thrown into water, an evident crackling noise is heard; this is peculiar to this salt, and is ascribed by Fourcroy to a sud- den breaking of its particles. Experiment XXI. About three pounds of the leaves of the rhus radicans were infused in brandy; after being boiled a few minutes, they were exposed in a moderate temperature. At the end of several months, this infusion was found converted into very strong vinegar; it resembled that which is obtained from cyder, exceeding it however in strength. Its taste was very pungent, and it retained some of the peculiar odour of the plant. On adding a little potash to it, a violent effervescence took place. Experiment XXII. To two pints of a strong infusion of the berries of the rhus glabrum, some chalk, and a small quantity of weak spirit of wine was added; the mixture was then exposed in a vessel slightly stop- ped, in a moderate temperature. In the course of three or four months, vinegar was produced, which resembled that generally used for culinary purposes; some of it being added to a little potash, produced considerable effervescence. OBSERVATIONS ON THE PRECEDING EXPERIMENTS. By the first experiment a considerable quantity of semisaturated tar- tarite of potash was obtained. In order to succeed with this experiment, it is necessary to collect the berries while they are in a state of entire per- fection, and covered with the white saline substance, which was described in the history of the growth of the plant; if this is not attended to, the salt is dissolved by the rain or moisture, to which the plant is frequently exposed. I have endeavoured to establish the identity of this salt with crystals of tartar, by a few simple but apparently conclusive experiments and analogies. Mr. Hermbst Chemical Dictionary, we find an extract from a series of ex- periments, on the subject*of ink, by a French gentleman of the name of Ribau- court. Although his experiments are iiwyerou., and ingenious, they do not discov- er that simplicity and pertinence, winch characterize the experiments to v. hich I above alluded. He considers the precipitate, produced by alkali in an infusiou of gul'.«, as a calcareous earth; and finally infers from his experiments, that in the formation of ink, the calcareous earth of the galls unites with the vitriolic iiid of the vitriol, and forms selcnite, most of which falls down with the first precipitate, on account of its insolubility in water; while the calx of iron com- bines with the colouring matter of the galls, and forms the black fecula which subsides more slowly. f The ink produced by the rhus glabrum resembles that made with galls, not only in its degree of blackness, but, the precipitate of the iron, likewise remains easily suspended in the menstruum, by the addition of gum arabic, and docs not, like that prepared with astringent vegetables containing much resin, concrete into large particles. \ If it should be found in trials in the large way, that the quantity of gallic acid contained ii: the rhus glabrum, is not quite equal to that of galls, this defect may very e*siK be remedied, by employing it in greater pro; ji-iion. RHUS RADICANS, AND RHUS GLABRUM. U9 rhus coriaria in Turkey, Germany, Spain and France; the rhus cotinus in Italy.* Our own forests are sensibly consumed; our oak-trees will soon be exhausted. To what vegetable then, for a substitute, can we so readily resort, as the rhus glabrum ? It grows plentifully in most parts of the United States, and where it is deficient, it may easily be cultivated; its growth is rapid, and while in a very young state,f it answers all the purposes of this art. I have thus endeavoured to point out the probable utility of the rhus glabrum in-several of the most useful of our arts. The further investi- gation of this subject, especially on a larger scale, is requisite. I wish it to be considered, not merely as a matter of philosophical curiosity. It deserves attention not only in a local or individual point of view, but its application may become of a more extensive nature. I have no doubt, that at a future period, the cultivation or preservation of this plant, will lie considered an object of general, of national policy. The analysis of astringent vegetables has of late been effected with great accuracy: in the eleventh and several of the succeeding experi- ments, (12, It, 15 and 16) it was my design to shew the similarity of the rhus glabrum to several of the most powerful of this class. The reader will perceive, that most of them were suggested by the experiments of Dr. Woodhouse;{ whose accunate analysis of the persimon has added much to our knowledge of the subject of vegetable astringency. In the eleventh experiment, the alumine, one of the constituent parts ef astringent vegetables, was precipitated from a strong infusion of the leaves, by a solution of potash: one of the chief characteristics of this precipitate, is its ready solubility in sulphuric acid. The result of the twelfth experiment concurred with that of the last, after the tartareous acid of the berries was saturated. The quantity of resin contained in the rhus glabrum, appears to be very minute, (exp. 14.) In the sixteenth experiment, by the re-union of the alumine, precipitated from an infusion of the leaves, and sulphuric acid, a liquor was produced, which possessed all the properties of a solution of the common sulphate of alumine. In reviewing these and the preceding experiments, we find in the rhus gla- brum all the component parts of astringent vegetables; a small propor- tion of resin, and a considerable quantity of gallic acid and of alumine. In the thirteenth experiment, the sulphuric acid, in consequence of its greater affinity, appeared to unite with the potash of the mixture, while the tartareous acid was separated. The precipitations produced in * Smith's Tour. f The shoots of the rhus coriaria, are cut down every year, q*:;te to the root; and after being dried, they are reduced to powder by a. mill, and thus ;s 'j^a-d for the purposes of tanning. Nichol. Chciii. Diet. J Inaugural Dissertation, 1792. 150 HORSFIELD ON THE RHUS VERNIX, the seventeenth experiment, resemble those that are produced in the same solutions, by the crystallized acid obtained from the nut-gall. The design of the eighteenth and several of the succeeding experi- ments, was different from those we have already discussed. In the eighteenth, by the process invented by Scheele for obtaining the pure tartareous acid from crystals of tartar, I obtained an acid, which appeared to possess all the properties of the tartareous acid. I found it of import- ance to employ quick-lime in this process; with common chalk the ex- periment did not succeed. This experiment affords additional proof, to what was said in considering the first experiment, of the nature of the salt obtained by lixiviation from the berries. By subjecting the berries and extract of the rhus glabrum to the action of the nitrous acid, according to the process generally employed for procur- ing the oxalic acid, I obtained crystals of different kinds: some upon exami- nation appeared to possess the properties and form of the oxalic, while others more exactly resembled the tartareous acid. The affinities of these two acids to earthy and to other substances are so nearly alike, that I have found it somewhat difficult to distinguish between them. One of the most evident marks of distinction appeared to be the circumstance, that the oxalic acid generally effloresced in a warm temperature, while the tartareous did not. It is not difficult to conceive, that by the same pro- cess these two acids should be procured. Hermbstscdt obtained from sugar by weak nitrous acid, tartareous; by strong, oxalic acid. The ox- alic differs from the tartareous, merely in being more highly oxygenated^ it is in fact the most oxygenated of all vegetable acids. This is one instance among innumerable others, of the ready convertibility of one vegetable acid into another; the analogy between many of these acids is so great, that they are considered by several chemists as fundamentally the same. Among the most respectable characters who entertain this opinion, are Westrumb* and Hermbstasdt,f two German chemists; the former con- tends that the acetous is the only elementary vegetable acid, while the latter considers as such exclusively the tartareous. On reviewing their labours, every person will admire their perseverance and ingenuity; but neither of them has yet been able so far to extend or generalize his expe- riments, as to establish his hypothesis. In the twenty-first experiment, by the infusion of the leaves of the rhus radicans in brandy, after exposure for several months, an excellent vinegar was produced. Different species of rhus have long been em- ployed in the preparation of vinegar. I have been informed by the gar- dener of the Pennsylvania hospital, who has several years resided in * Keir's Chemical Dictionary. t Physikalisch-chcmische Beobachtungen RHUS RADICANS, AND RHUS GLABRUM. 151 Canada, that the French inhabitants of that country about Montreal, pre- pare a very good vinegar from the berries of the rhus glabrum. The berries are boiled in water, and afterwards exposed in a cask to the heat of the sun, in order to ferment. " The young gennen of the fruit of the rhus typhinum, when fermented, produces vinegar; hence it is called vine- gar-tree. (Encyclopxdia.) Boththese species grow abundantly in many parts of Pennsylvania, where they might be collected, fermented, and afford cheap and excellent vinegar. By the twenty-second experiment, vinegar was likewise produced; in this instance was not the tartareous acid of the berries gradually converted into the acetous? CONCERNING THE USE OF SEVERAL SPECIES OF RHUS, IN THE ART OF DYEING. Experiment I. The fresh leaves of the rhus radicans, broken off from the plant, exsutle a liquor of a white milky appearance; this liquor applied to flannel, to muslin or linen, imparts to them, after being a short time exposed to the light, and especially to sunshine, an intensely black colour. Applied to paper it stains it black in the same manner. The liquor when first applied, is scarcely visible; it resembles a spot of oil, but gradually becomes yellow, red, brown, and finally black. This black stain cannot be washed out by means of alkali or soap. It docs not fade on exposure to the air. Alcohol appears to have no action upon it. If leaves or branches are broken off and exposed to the air, the juice exsuding from their ends, likewise becomes black; in this case the colour has a more glossy appearance. Experiment II. In order to obtain this elegant black juice, for the purpose of fixing it on flannel or linen, I pounded some of the stalks which appeared to abound with it, and expressed their juice; but I obtained merely a greenish liquor; the black colouring matter appeared to be ab- sorbed by the pith of the stalks. I have tried a variety of methods, to extract or separate this black colouring matter, which exsudes from every part of the plant, but with none have I, as yet, been able to succeed. Experiment III. In a strong filtered decoction of the fresh leaves of the rhus radicans, I boiled for the space of an hour, small pieces of flannel, muslin, linen, and silk. It imparted to the flannel and silk a dark fawn colour, which after the stuffs were once washed in soap and watery was permanently fixed. The linen and muslin had scarcely takai up any of the colouring matter. Experiment IV. In a decoction prepared in the same manner as the last experiment, I boiled small pieces of flannel, muslin, and linen, after having steeped them in a strong solution of sulphate of alumine. 152 HORSFIELD ON THE RHUS VERNIX, The flannel was dyed of a dark yellow colour, which was permanently fixed. V\'ith the linen and muslin the success was better than in the last experiment. Experiment V. In a decoction similar to that used in the third ex- periment, after adding a little vinegar, I boiled small pieces of flannel, muslin, and linen; they acquired a dirty brown colour: with small quan- tities of the nitrous or sulphuric acid, the result was nearly the same. Experiment VI. To separate portions of the decoction of the third experiment, I added small quantities of nitrate of potash, muriate of soda, potash and urine: the stuff's were impregnated with a brown or grayish colour; but neither of these promises the least utility in dyeing. Experiment VII. In a decoction of the leaves of the rhus radicans, prepared with the addition of one fourth part of spirit of wine, I boiled a piece of flannel which had been soaked in a solution of alum; it acquired an elegant pale yellow colour. Experiment VIII. In the simple decoctiQn of the leaves and bark of the rhus vernix, a piece of flannel acquired a pale dawn colour; and Experiment IX. A piece of flannel, having been steeped in the so- lution of alum, acquired a very brilliant yellow colour. Experiment X. With the fresh bark of the rhus glabrum, a strong decoction was prepared, in which small pieces of silk and flannel were dyed of a yellowish fawn colour, which on the silk appeared more ele- gant than that of any of the former simple decoctions. Experiment XI. In the same decoction, a piece of flannel and silk, after being impregnated with a solution of alum, acquired a very handsome permanent yellow colour. Experiment XII. In a decoction of the leaves and stalks of the rhus glabrum, a piece of flannel and silk having been steeped in a solution of altim, acquired a yellow colour, resembling that of the last experiment. Experiment XIII. In a strong decoction of the rhus radicans, in which a certain quantity of sulphate of iron was dissolved, I boiled re- peatedly a piece of blue woollen cloth; it acquired a deep black colour. REMARKS ON THE PRECEDING EXPERIMENTS. The blackijjuice which flows from several species of rhus, on wound- ing their stem or detaching their leaves, (exp. 1.) has long attracted the notice of naturalists. Ksmpfer appears to be the first who described the juice distilling from incisions into the rhus vernix.* Lawson, in his na- tural history of Carolina, published in the year 1709, has the following * Amcenitatcs Exotic?:. RHUS RADICANS, AND RHUS GLABRUM. 153 passage: "The juice of the poison-vine will stain linen, never to wash out. It marks a blackish blue colour, which is done only by breaking a bit of the vine off, and writing what you please therewith."* In 1755 the Abbe Mazeas communicated to the philosophical society of London seve- ral experiments, which he made on suggestion of the Abbe Sauvages, with three different species of rhus.f He mentions having produced a brown stain on linen with the juice of the rhus vernix, while with the juice of another species, which he calls hedera trifolia canadensis, he produced a deep and permanent black. The latter of these plants, from his descrip- tion, evidently appears to be the rhus radicans4 This supposed discovery of the Abbe Mazeas, was the cause of the controversy between Mr. Miller and Mr. Ellis, which was mentioned in the description of the rhus vernix. Since the time of the Abbe Mazeas, this subject has been attended to by several persons, and among others, by the ingenious Mr. Lewis: hitherto their labours have not been successful in extracting or separating the black juice, for the purpose of fixing it on linen. The subject de- serves to be further investigated. ' It is supposed by some persons, that the Indians of North America make use of the rhus radicans, in staining different substances cf a per- manent black colour. The circumstance, of the immediate change of the colour of the juice from white to black, upon exposure to atmospheric air is very singular. What would be the effect of an atmosphere of pure azote, or oxygen? By the simple decoction of the rhu3 radicans, vernix and glabrum, a fawn colour of a darker or paler hue, is produced on flannel and silk, which appears to best advantage on the latter. By none of my experi- ments, was I able to impart to linen or muslin, the same colour that was easily imparted to flannel and silk: it appears necessary that they should previously undergo some process, to fit them for the reception of the colouring matter. If the flannel or silk, was steeped in a solution of alum, before being boiled in the decoction of the different species, it acquired a very good yellow colour. Every one of these colours was permanently fixed.\\ * Ho adds7: " I have thought, that the East-India natives set dieir colours, by some such means, into their finest calicoes." I London Philosophical Transactions, v. xlix. % \. The stain produced by the rhus vernix, I have always observed, to be less hlaek than t'.iat produced with the rhus radicans. |j The residt of these experiments agrees with those of Eerthollet on the rhus coriaria. "The rhus coriaria alone (he says) gives a fawn colour inclining to green; but stuffs that have been impregnated with acetous alum, take a very good and durable yellow." x 154 HORSriELD ON THE RHUS VERNIX, It appears to me, from a review of my specimens, that several species of rhus, and especially the glabrum, might be employed with consider- able advantage, in imparting a yellow colour to flannels. Its cheapness, and the facility with which it is procured, ought cer- tainly to recommend it to our dyers. To the decoction of the seventh experiment, a small portion of alcohol was added; this appeared to increase the brilliancy of the colour: it is probable that the colouring matter of these plants is contained chiefly in their resinous part, which is rendered soluble by the extractive matter they possess in considerable proportion.* CHEMICAL ANALYSIS OF THE RHUS VERNIX AND RHUS RADICANS. Experiment I. I distilled about two pounds of the flowers and leaves of the rhus vernix, after adding to them a few quarts of water, in a small copper still; a moderate degree of heat was applied; the fluid which came over, was slightly impregnated with the odour of the plant, but did not appear to possess any active properties. From the liquor re- maining after distillation, I obtained by evaporation one ounce of extract, of a dark brown colour. Experiment II. About two pounds of the leaves and flowers of the rhus radicans, were distilled, like those of the vernix in the last experi- ment; and with a similar result. I obtained no essential oil, either by this or by the last experiment; although the odour of the flowers of both species was highly aromatic, and appeared to indicate its presence. It is probable, that by employing very large quantities of the flowers, a small portion of essential oil might be obtained. I had not an opportunity of determining with accuracy, the properties of the distilled water; I have no doubt, but that in persons who are easily affected by the poison of these plants, it would produce a cutaneous eruption. Du Fresnoyf ob- serves, " the leaves inflamed and swelled the hands and arms of those that took them out of the still, and brought on an itching, which remained for several days." No effect was produced on my hands by handling the leaves, remaining after distillation; the cause of which was mentioned in a former part rithis essay. * A young man, a native of the United States, is said to have prepared a kind of ink.resemblingChina ink,from the rhus radicans; forthe exclusive privilegeof mak- ing which, he procured about thirty years ago a patent from the British parliament. It appears probable to me, that it was prepared with the charcoal of the bark of the rhus radicans, finely levigated and conglutinated by means of gum or glue. j Des propriety de la plante appellee rhus radicans, p. 46. RHUS RADICANS, AND RHUS GLABRUM. 155 The liquor remaining after distillation, and a solution of the extracts, of both species, produced a copious black precipitation in a solution of sulphate of iron.* Might not an extract of the rhus glabrum, be advan- tageously employed for the purpose of dyeing black? It would contain the gallic acid in a very concentrated state, a small quantity only would be requisite, and it might be very conveniently preserved for use. Experiment III. Several ounces of the berries of the rhus vernix, radicans and glabrum, were separately exposed in a retort, to an intense degree of heat. A pellucid fluid, of an empyreumatic smell, first passed into the receiver; the degree of heat being increased, a black empyreu- matic oil was obtained, resembling that which by this process is procured from most vegetables. The result was the same with the three different species. In the pellucid fluid which first came over, a slight precipita- tion was produced by petash, sulphuric acid and oxygenated muriate of mercury. This distillation, with a violent degree of heat, is at present generally omitted in the analysis of vegetables; from plants which pos- sess the most opposite properties, from " cabbage and hemlock," the same products are obtained. I was convinced of its fallacy, by the result of these experiments: the presence of the gallic acid, one of the chief com- ponent parts of these vegetables, was scarcely discoverable in the products of this distillation. Experiment IV. From one ounce of the dried bark of the rhus radi- cans, I obtained by frequent infusions with rain water, thirty-five grains of pure extract. Experiment V. One ounce of the powdered bark of the rhus radi- cans, was repeatedly infused in highly rectified alcohol; by spontaneous evaporation, after carefully filtering this infusion, I obtained fifty-five grains of an elegant shining, deep brown resin. Experiment VI. Four drachms of the powdered bark of the rhus vernix, afforded two scruples of resin, resembling that obtained from the rhus radicans. A solution of the resin of both species in alcohol, produced in a solution of the sulphate of iron, a copious black precipitation. This resin very much resembles the juice exsuding from the bark of these plants. It is probable that it might be collected in this manner, for the purposes of varnish. Experiment VII. By infusing the bark of both species, in common spirit, a considerable quantity of gum-resinous substance, of a brown glossy appearance, was obtained. Experiment VIII. A quantity of the leaves of the rhus radicans and glabrum, being infused in boiling water, and exposed to a warm tempera- • The quantity of extract which I obtained after the distillation of the ilu;* radicans, amounted to six drachms. 156 HORSFIELD ON THE RHUS VERNIX, ture, (in the month of July) soon passed into a state of fermentation, and emitted a smell resembling that of small-beer. Whether upon distillation spirit of wine might be obtained from them, I have not yet determined. OF THE MEDICAL PROPERTIES OF THE RHUS RADICANS. Little is at present known, concerning the internal effects of the rhus radicans on the human body, or concerning its qualities as an article of the materia medica. To determine its probable utility or ineffi- cacy in the cure of diseases, was one of the objects, which at the com- mencement of the examination of the properties of this vegetable, I had particularly in view. A defect of proper cases for its exhibition, and the in- terference of a variety of other pursuits, have prevented me from collecting the necessary materials for this purpose. A concise statement of what has been written on this subject by others, and a few facts and observations, which I have had an opportunity of collecting, will be related in this section: in how far future experiments will confirm or refute these ob- servations, I am not able even to conjecture. To a man, who had laboured under pulmonary consumption nearly two years, and who was in a very debilitated state, I gave two ounces of a strong infusion of the leaves of the rhus radicans; it excited some fever, increased the frequency and hardness of his pulse, produced pain in his bowels, and an increased flow of urine; after the disappearance of these symptoms, his pulmonary complaint was considerably relieved. His wife, invited by the agreeable odour of the infusion, drank a tea-cup full; it pro- duced an unusual degree of cheerfulness, and a copius discharge of urine. A person who had been afflicted above a year, with a very obstinate head-ach, took four ounces of a strong infusion of the leaves of the rhus radicans. In consequence of this, he discharged, by his own account, in one night nearly as much urine, as he was accustomed to do in a week. He had been in the habit of discharging very small quantities. In the case of a woman, who had universal anasarca, the infusion pro- duced a copius perspiration, by which she was considerably relieved. In two cases of pulmonary consumption, in which the infusion of the leaves, and small quantities of the extract were exhibited, they appeared to produce an increase of the symptoms of the disease and were soon omitted. The subject of the first of these cases was a man in the early stage of the disease; the other, a woman about twenty-five years of age, originally of a plethoric habit: the extract produced a pain in her sto- mach. In another case of the same disease, small quantities of the extract evidently relieved the symptoms; the person was aged; the medicine, in her opinion, relieved her by keeping the bowels open. RHUS RADICANS, AND RHUS GLABRUM. 157 , From the foregoing cases it appears, that the rhus radicans acts slightly as an incitant and diuretic. It is a very general opinion, among the inhabitants of the western parts of Pennsylvania, especially about Carlisle, that the rhus radicans is an effectual remedy in the cure of phthisis pulmonalis. Dr. Woodhouse, in his inquiries concerning this subject, met with a young man, who lived in the vicinity of that place, and who had been relieved of a pulmonic affection, by an extract prepared from the bark of this vegetable. The young man informed him, that it relieved the pain in the breast, produced an eruption on the skin, and a slight salivation; and that it opened the bowels. He remarked likewise, that in order to derive benefit from it, it is necessary to take large quantities. Schcepf, in his mat. med. Ameri- cana, has the following observation: " Radices (rhus radicant.) a nonnullis in asthmate chronico bono cum successu adhibebantur in Lancaster." If it should be found, by further trials, that the rhus radicans inter- nally exhibited, is not an active medicine; the effects which it produces on the external surface of the body, may still render it highly valuable, in the cure of many diseases. Its application for evident reasons, will be confined to particular habits and constitutions. A determination to the skin produces relief in many acute diseases; and the production of violent cutaneous affections, has cured or relieved many diseases of a chronic nature. Eruptive diseases have in several instances removed mania. Melancholia and epilepsy have been cured by inoculation for the itch.* Eruptions and burns have frequently suspended epilepsy, and relieved fetuity.t A case of herpes, cured by the eruption excited by the rhus radicans, is related by Du Fresnoy. (See the appendix.) In certain stages of mania, melancholia, and pulmonary consumption; in epilepsy, palsy, and other chronic disease, which for a long time had resisted the effects of powerful remedies; in habits that are acted upon by the rhus radicans or vernix, I should not hesitate to excite a universal cutaneous eruption, by means of the poison of these plants, • There appears to be considerable ground, for a reasonable supposition, that at least in some instances, this treatment would remove a disease or palliate its symptoms. A dissertation has lately been published by Dr. I. Alderson, of Eng- land, on the rhus toxicodendron, which he particularly recommends in paralytic affections; as appears from Darwin's Zoonomia. From one to four grains of the powder of the dried leaves, are to be taken three or four times a day. I have not had an opportunity of seeing this dissertation. * Instances of this are related by Drs. Muntzell and Zimmermann. t A case of epilepsy, cured by the small-pox, is related by Dr. S. Cooper, ip his Inaugural Dissertation on Stramonium. 158 HORSFIELD ON THE RHUS VERNIX, One treatise only has hitherto been published on the medical proper- ties of the rhus radicans. It is entitled: " Des proprietes de la plante appellee Rhus Radicans. De son utilite et des succes, qu'on en a obtenu pour la guerison des Dartres, des affections Dartreuses, et de la Paralysie des parties, inferieures. Par M. Du Fresnoy, M. D. 1788. Dr. Du Fresnoy was led by accident to the employment of this vegetable in her- petic eruptions. The case which first suggested to him its use, is curious: it is related in the appendix. Before he exhibited the rhus radicans to other persons, Du Fresnoy ascertained its dose by experiments made upon himself. Perceiving no effect from taking an infusion of one of the leaves of the plant, he gradually increased the number of leaves for each infusion, to twelve. " At this dose, (he says) I observed a slight pain in my stomach, and my perspiration and urine were increased in quantity." He relates seven cases of obstinate herpetic eruptions, which had re- sisted several powerful remedies, but which were cured by the infusion or the distilled water of the rhus radicans. After ascertaining the good effects of this vegetable, in the cure of herpes, he met with a case of palsy, which was ascribed to the suppression of a herpetic eruption;* he exhibited the extract of the rhus radicans, and by this remedy, continued about two months, succeeded in curing his patient. The successful issue of this case, suggested the employment of the extract of the rhus radicans in several other cases of palsy, four of which were cured, by this remedy. These cases are related in his treatise, with great accuracy and minuteness. Du Fresnoy, from the fortunate event of the cases just mentioned, is led to consider the rhus radicans as a specific for those paralytic affec- tions of the inferior extremities, which succeed convulsions. " Je ne crois pas devoir hesiter a presenter le rhus radicans, comme un specifique pour la paraplexic, ou paralysie, des extremites inferieures, lorsqu'elle est la suitte des mouvements convulsifs." He mentions in his treatise three species of this disease: palsies of the upper extremities; palsies in consequence of apoplexy, and palsies which follow convulsions. In the two former species he did not succed with this remedy.f It is somewhat difficult to conceive, according to our present ideas of this disease, that in palsies which affect different parts of the body, the * Soupconnant done que l'humeur Dartreuse pouvoit bicn etre la cause de sa paralysie, je crus devoir saisir cette occasion d'es;.;a\ or l'extrait de rhus radicans. t II y a des paralytiques qui ont eu le coinage de prendre de l'extrait de rhus radi- eans, jusq'a la dose d'une once, trois fois le jour, sans en resscntir le plus leger effet. The usual dose of the extract, will appear from a case related in the appendix. It is generally requisite, in order to derive benefit from it, to exhibit it in large. doses. From two grains to several drachms, tin ee or four 'dmes a day, have fre- quently been given by Du Fresnoy. RHUS RADICANS, AND RHUS GLABRUM. 159 same remedy should produce such different effects. It would have beeft deeirable, if Du Fresnoy had related more definitely the symptoms and habits of those patients in whom the remedy failed. Does he consider paralytic affections of different parts of the body as essentially different, and depending on different causes? Many trials are yet necessary, be- fore we can draw a certain conclusion concerning the use of his remedy in palsies. Much credit, however, is due to Dr. Du Fresnoy for this dis- sertation ; he appears to be candid in the relation of his cases, his remarks are made with caution, and indicate great accuracy of observation. A more effectual remedy than either of those recommended by the ingenious author of the preceding dissertation, for the eruptive disease produced by the rhus vernix, rhus radicans, &c. will be found in the use of bbsters. While the cu- taneous affection resulting from these poisons is yet circumscribed, its further progress may be effectually arrested by the application of one or more blistering plasters, of such dimensions as not only to cover the whole diseased surface, but to extend about an inch beyond its circumference. Those persons acquainted with the principles incideated in the writings of the late celebrated John Hunter, will readily comprehend the modus operandi of the remedy here recommended. It in- duces in the skin a new disposition and state of action, which destroy the existing diseased ones, continue for a few days, and then terminate in health. EIII TOE.. APPENDIX. A. DESCRIPTION QE THE RHUS VERNIX OF JAPAN: EXTRACTED FROM KjEMPFER's AMOENITATES EXOTICjE, P. 791. Sii'z, vel Sitzdsju, i. e. Sitz planta, vulgo Urus seu Urus no ki. Arbor vernicifera legitima, folio pinnato Juglandis, fructu racemose ciceris facie. Arbor paucis ramis brachiata, salicis ad akidudinem luxuriose exsurgit. Cortice donatur incano, ex verruculis scabro, facile abscedente; Hgno sa- lignio fragillimo; medulla copiosa, ligno adnata; Surculis longis crassis in extremitate inordinate foliosis. Folium est impariter pennatum, spitha- male vel longius, Juglandis folio smulum, costa tereti, leviter lanuginosa; quam a semipalmari nuditate stipant lobi sive folia simplicia, pediculo perbrevi nixa, tenuia, plana, ovata, trium vel quatuor unciarum longitu- dinis, basi inaequaliter rotunda, mucrone brevi angusto, margine integro, suprema facie obscure viridi, lsevi, et ex nervis lacunosa, dorso incano et molliter lanuginoso. Nervus medius in mucronem terminans subinde multos a latere demittit nervos minores, citra marginem deficientes. Sapor folio sylvestris inest, cum sensibili calore; humor affrictus extem- plo chartam ferrugineo colore imbuit. In surculis quibusdam ex foliorum axillis singuli surgunt Racemi laxe ramosi, palmares, tenues, qui, petiolis in calyculos rotundos desinentibus, Flosculos continent pumilos, et citra Coriandri seminis magnitudinem radiantes, in luteum herbaceos, penta- petalos, petalis carnosis nonnihil oblongis et repandis; staminibus ad pe- talorum interstitia singulis, apicatis, brevissimis, stylo perbrevi tricipite, floris turbini insidente. Odorem spirant dulcem, Aurantio flori affinem et pergratum. Fructus flosculum excipit gibbosus, utcumque in rhom- boidis figuram compressus, bifidus, facie ac magnitudine ciceris, mem- branula tenui micante vestitus, per maturitatem durissimus et obsoleti coloris. Cortex arboris cultro crenatus lacteum fundit lentorem, humore crys- tallino (ex aliis ductibus stillante) permixtum, qui ad aeris contactum nigrescit. Eundem surculi divulsi, foliorum pediculi, et nervi produnt, nullius gustabilis qualitatis participem, nisi calefackntis sine acredine. APPENDIX. 161 Venenatos tamenspiritus hxc a:bor exhalare dicitur, vehementesadeo,ut pueris circa eandem commorantibus exanthemata in corpore pariant: qua- lia etiam lignum tractantes alii (non omnes) experiuntur. Collectio L ruy, sive Vernicis, ut instituatur, caudices praecipue triennes, paucis crenis vulnerandse sunt, ex quibus stillans liquor subinde excipitur, iterata in recente loco sectione, donee exsucci marcescant. Emulsi atque omni succo orbati, illico amputandi sunt; sic nova e radice provenit soboles, quae triennis facta, collectioni denuo subjicitur. B. THE FOLLOWING INTERESTING CASE WAS OBLIGINGLY COMMUNICATED TO ME, BY DR. CHARLES CALDWELL. PHILADELPHIA, APRIL 16, 1798. DEAR SIR, In the summer of ninety-seven, T. L. a boy of about twelve years old, and possessing a very high degree of what is denominated a melancholic temperament, was exposed to the action of the rhus radicans. I am un- able to say whether or not he handled the leaves of the plant, or was only subject to the action of the effluvia which it emits. As circumstances render it probable that our patient was exposed, for several days in succession to the influence of this poison, it is impossible to tell what length of time elapsed after he had actually received the in- fection, (for so I shall term it) previously to the commencement of the disease which it produced. The following is a brief sketch of the first appearance and subsequent progress of the symptoms of his illness. The disease was ushered in by an attack on his hands and face, which were affected with an eruption accompanied by some degree of redness and swelling. A fever succeeded, attended by unusual drowsiness, some thirst, and considerable constipation of the bowels. The fever continued for several days, during which time the eruption spread gradually over his whole body, in a manner as well as I recollect, much resembling the progress of the inoculated small-pox. A swelling and very troublesome itchiness accompanied the eruption through the whole of its cours-j. The exact term during which our patient's febrile symptoms conti- nued, I do not now recollect. In about ten or twelve days from the com- mencement of his attack, the eruption had, in a great measure, disap- peared from his hands and face, and continued to die away on the other parts of his body in the same gratlual manner in which it lirst made its appearance. So severe and painful was the affection on his low v-r extre- mities, that for several days he was unable either to sit, wall., or stand, without experiencing much distress. Y 162 APPENDIX. During the course of his illness he was bled twice, kept cool and quiet, and took two or three doses of purgative medicines. Of the exact appearance of his blood I am not able to inform you, having had no op- portunity of seeing it after it was drawn. By those who examined it, it was said to be very bad, from which I think it probable that it was marked with an appearance of size. This, however, I advance only as a matter of supposition. What, or whether any external applications were used, I do not now with certainty remember; for I was not the attending phy- sician, but only an occasional visitant in the family. From the foregoing statement it would appear, that the poison of the rhus radicans acts in a manner somewhat similar to the contagion of the small-pox when communicated to the system through the medium of inoculation. In the case of T. L. the hands and face having been exposed naked to the poisonous effluvia, may be considered as the immediate seat of inoculation. These accordingly became first disordered, by a topical eruption. In a short time a fever supervened, and the eruption extended to the other parts of the body, in a manner analogous to the inoculated small-pox. If the foregoing communication can avail you any thing in your pre- sent interesting investigation, I beg you to consider it entirely at your command, and to give me credit for the sincerity with which I have the pleasure to be, Your friend and very humble servant, CHARLES CALDWELL. C. AX VCCOUST OF THE CASE WHICH SUGGESTED TO DR. DU FRESNOY THE EXHIBITION OF THE RHUS RADICAXS IN HERPETIC AFFECTIONS. A young man, he first informs us, had voluntarily rubbed his hands with tire leaves of the rhus radicans: the succeeding day he perceived an eruption on his hands, which he mistook for the itch. He then proceeds: " Le lendemain les mains et les poignets, dont le gonflement avoit aug- ments la nuit, etoient couverts d'une grande quantite de petites vesicules, qui se remplirent en grossissant de plus en plus pendant sept ou huit jours, d'une ferosite jaunatre, qui annoncoit un eresipele f .cheux. Mal- gre les saignees, les bains, les fomentations emollientes et les boissons de- layantes, la tOte s'enfla si fort, qu'il fut aveugle, par le gonflement prodi- gieux des paupieres, pendant plus de vingt-quatre heures. Les deman- geaisons se porterent ensuite sur toutes les parties du corps, principale- ment les chevelues et celles de la generation qui'l se mit en pieces a force de se grutter. Au bout de dix jours, les accidens cessJrvnt, les poignets, APPENDIX. 163 qui avoient jete une grand quantite' de serosites, se depouillerent de leur epiderme. II fut fort etonne de se voir gueri d'une Dartre qu'il portoit au poignet depuis plus de six ans, et qui avoit elude les frictions, le sub- lime corrosif a la plus haute dose, et les remedes prescrits par les per- sonnes de l'Art les plus eclairces de la Province Depuis, cette Dartre n'a plus reparu. M. Du Fresnoy's Dissertation on the Rhus Radicans. D. ACCOUNT OF A CASE OF PALSY WHICH SUPERVENED IN CONSEQUENCE OF A HERPETIC ERUPTION, AND WHICH WAS CURED BY THE EXTRACT OF THE RHUS RADICANS. FROM DU FRESNOY's DISSERTATION. L'objet de la premiere observation etoit un jeune homme, age de 14 a 15 ans, Perruquier de son metier. Le 7 Janvier je fis prendre au ma- lade, deux grains d'extrait en bol, quatre fois le jour, a sept heures et a dix du matin, a quatre et a neuf heures du soir. Le 8,. six grains quatre fois le jour, Le 9, dix grains. Le 10, seize grains. Le 20, vers le soir, le malade a commence a remuer treslegerement les doigts du pied. J'ai successivement augmente les prises d'extrait, de 6*ix grains par jour, jusqu'a ce que je fusse parvenu a la dose d'un gros par prise; dose a. laquelle je me suis tenu pour ce malade, jusqu'a pax- faite guerison. Le 14, il a leve la jambe. Le 16, il a remue les doigts de la main, et s'est tenu sur les jambes, e'tant soutenu par les bras. Le 24, il a marche, soutenu par la main. Le 27, il otoit son bonnet, de la main malade. Le 2 FeVrier, il marchoit a l'aide d'une canne. II a toujours continue d'aller de mieux en mieux, Quand il est sorti de l'Hotel-Dieu, (le 14 Mars) il mettoit des papillotes, accommodit les cheveux et rasoit, a peu-pres aussi aisement qu'avant son accident. II paroissoit ne lui rester d'une maladie aussi grave, qu'une le'gere difficulte dans les mouvemens du bras malade, qu'il n'avoit point avant son He'miple'gie. A DISSERTATION ON THE PROPERTIES AND EFFECTS OF THE DATURA STRAMONIUM, OR COMMON THORN-APPLE; AND ON ITS USE IN MEDICINE. SUBMITTED TO THE EXAMINATION OF THE REVEREND JOHN EWING, S. T. P. PROVOST; THE TRUSTEES, AND MEDICAL FACULTY OF THE UNIVERSITY OF PENNSYLVANIA, ON THE TWELFTH DAY OF MAY, A. D. ONE THOUSAND SEVEN HUNDRED AND NINETY-SEVEN. FOR THE DEGREE OF DOCTOR OF MEDICINE. BY SAMUEL COOPER; MEMBER OF THE CHEMICAL AND MEDICAL SOCIETIES OF PHILADELPHIA. n j * PREFACE. IN the following pages we have ventured to bring into view some experiments and observations, relative to the properties and effects of the Datura Stramonium, or common Thorn-apple. It was thought that, as this active plant has not received much attention from the medical expe- rimenter, it was worthy of further investigation. It furnishes a subject extensive and important. He, who would do justice to such a subject, should possess talents, leisure, and industry. To a deficiency in the two former points, many of the imperfections of the present work may be justly ascribed. Instead of some months, or rather weeks, could a few years have been devoted to its execution, it might have been less imper- fect, and consequently less unworthy of the acceptance of the reader. With great diffidence it is submitted to bis inspection, INAUGURAL DISSERTATION. THE vegetable world is highly tributary to the existence and hap- piness of man. From hence he derives many articles of food, and many remedies for disease; and it is probable that his happiness will increase in proportion, as ingenuity or accident shall give rise to useful discoveries in this department of nature. Many unknown plants doubtless inhabit our globe, some of which may possess valuable alimentary properties; and others again, may be imbued with energies capable of obviating some of the present incurable diseases, which invade the animal system. These plants and their uses, will, sooner or later, be discovered. In the mean while, any effort to extend our knowledge of such, as are imperfectly known, may be attended with advantage. Influenced by this belief, we have been led to devote some time to the consideration of the Datura Stramonium. We shall premise some remarks on its- natural history, and afterwards attempt an experimental investigation of its component parts, of its effects on the animal body, and of its use in medicine. The genus Datura is arranged by the celebrated Linnaeus, in the class Pentandria,. and order Monogynia; and is thus described: " Datura. Cor. funnel-form. Cal. tubular; angled,deciduous. Caps. 4—valved."* This genus includes seven species; that of which we are about to treat, is the second, with " pericarps thorny erect egged, leaves egged smooth."* In respect to the leaves this description is erroneous, if Ave may be guided by observation, and by the authority of Dr. Haller and Dr. Woodville. The leaves are not egged; but the plant when it is very young, has for the most part egged, or ovate leaves; and Linnaeus might have drawn its specific character from an imperfect specimen. According to Dr. Haller they arc angled; and according to Dr. Woodville, they are pointed at the extremity, indented, and formed into several obtuse angles. This species of thorn-apple very generally grows throughout the United States. Whether it be a native of these states, or an exotic, is a * System of Vegetables of Linnaeus, translated by a botanical society at Ljtck- ticl that he had experienced during the night much heat in his hands and feet. Experiment XXIII. To P. M. healthy, thirty-two years old, his pulse soft and full, and beating seventy-four strokes in a minute, I gave two grains of the leaves diffused in water. In 5 10 15 20 25 30 35 40 45 50 55 60 65 minutes, The pulse beat 80 76 78 78 79 82 83 82 84 79 80 84 71 strokes. When ten minutes had elapsed he found his head somewhat giddy: in twenty he was drowsy, and his pulse was quick. In thirty minutes his hands sweated: in forty his tongue acquired some whiteness, and the pupil of the eye was somewhat dilated. In forty-five minutes his pulse beat fuller and quicker strokes; his hands were warm, and had become more sweaty; his cheeks were redder, and his drowsiness had increased. In fifty minutes he complained of pain in his head, and his whole body was unusually warm: in sixty his eyes became misty; his stomach sick. Desirous of sleeping he laid his body in a horizontal position. In sixty- five minutes his pulse evidenced great tension and was still fuller. I was now obliged to leave him, but returned to him, about the eightieth minute, and found him asleep; his eye-lids were not completely closed; his face was red, and moist; he resembled a person labouring under the effects of too much spirituous potation. Experiment XXIV. M. F. aged forty, healthy, but having an ulcer on the leg, and his pulse beating seventy-eight strokes in a minute, took in the evening two grains of the powdered leaves suspended in about an ounce of temperate water. In 5 10 15 20 25 30 40 45 50 55 60 65 70 80 minutes, Pulse beat 81 83 83 81 79 78 78 76 74 73 72 70 72 68 strokes. In five minutes his pulse was quicker, and between the tenth and fifteenth minute, he was affected with a slight pain of the head. In sixteen minutes he experienced a heaviness in his eyes; in twenty his hands and feet were warm and sweaty, and his pulse was full and tense. In seventy, his face was flushed; and in eighty, nausea supervened. He now drank some cold water, which relieved the nausea and the other symptoms. On the succeeding morning he informed me, that he felt unusually cheer- ful, and that his appetite was increased. Expehiment XXV. P. M. on whom experiment twenty-third was instituted, his pulse beating eighty times in a minute, took four grains of the powdered leaves. 176 COOPER OX ST11AMOXIUM. In 2 5 10 15 20 25 35 45 50 60 75 minutes. Puke btat El 76 80 78 76 74 74 68 66 66 66 stroke*. In twelve minutes the pulse was more full and tense, and the heat of his face and hands was increased. In twenty-eight minutes his head became giddy, and his stomach sick. This sickness at stomach was of short duration. In about forty-eight minutes the fulness and tension of his pulse had rather increased. In about se^ enty minutes evident intoxication v>as induced, resembling that which arises from drinking alcohol. His cheeks and his eyes were reddened; his pupils were dilated; his voice faultered, and he was hardly capable of sitting erect. About the eightieth minute he took some tea, which obviated in some measure the preceding symptoms. In a short time his pulse was felt, and it beat eighty-four strokes in a minute. This experiment was made in the evening. During the night he experienced much head-ach and thirst. On the succeeding morning his tongue was covered with a white pellicle. He was troubled with head-ach and with pain in his limbs for many subsequent days. These latter symptoms regularly supervened upon the approach of even- ing, and continued till morning. Experiment XXVI. I gave to I. C. about fifty years old, and labour- ing under mania, of diminished violence, five grains of the powdered leaves. Previously to exhibiting the medicine, his pulse beat eighty-three times in a minute. In 5 10 15*20 26 30 40 45 50 55 70 80 minute*, Pulse beat 75 73 74 63 61 60 64 66 70 77 75 80 strokes. In about tight minutes some nausea occurred: his pulse was more tense. In twenty minutes he had a urinary discharge; in thirty his pulse had become full. The Peruvian bark, he said, that he had taken, had made l.im thirsty. He drank some water. In forty-two minutes the heat of his body was manifestly increased; and in fifty his cheeks were reddened. About the fifty-eighth minute lie had an alvine, and a urinary discharge. In seventy minutes he was thirsty again, and drank; in ninety he had another evacuation of urine. Experiment XXVII. I gave to M. F. on whom experiment twenty- four was made, six grains of the powdered leaves diffused in water. Pre- viously to taking the medicine, his pulse was somewhat full and tense, and beat eighty strokes in a minute. In 3 6 10 15 20 25 3Q 35 40 45 50 60. 65 70 75 80 88 90 95 100 m. p.b. 80 84 78 77 75 74 74 74 77 79 80 80 86 87 87 87 100 99 102 105 st. In five minutes his pulse had undergone some increase in tension, and he thought that his eyes had become slightly dim. Before ten minutes had elapsed his hands were warmer, and he had experienced a slight pain COOPER ON STRAMONIUM. 177 in the back part of his head, which was succeeded by dulness of mind. In thirty minutes this dulness was diminished. About die thirty-sixth minute he took four grains more of the powder. On the forty-second minute his pulse had increased in tension, and in sixty, in quickness. In seventy minutes he was thirsty, dull and sleepy; in seventy-five he expe- rienced some head-ach. About the eightieth minute he was bled to ten ounces. His pulse immediately afterwards was less tense and quick, and his head-ach and disposition to sleepiness, though not bis thirst, were removed. In ninety-five minutes his body was warmer, and his thirst greater. I was now obliged to leave him. In three hours I saw him again. During my absence he had taken some drink, slept, and dis- charged a considerable quantity of urine. He had continued free from any pain in his head; the heat of his body had greatly diminished and his pulse was full and soft, and only beat seventy-two strokes in a minute. It may be proper to observe, that in the beginning of this experiment my patient was sitting, and that when his pulse was last felt he was in a recumbent posture. The blood which was drawn evidenced a degree of siziness. Experiment XXVIII. After bringing the heart of a frog into view, a few drops of the expressed juice of the leaves were applied to it. It ceased to move in a few minutes; and it could not be roused into fresh motion by pricking it with the point of a scalpel. The scalpel was applied afterwards to some of its muscles, and they contracted. Experiment XXIX. Upon bringing into view the heart of a young dog, and the ventricles ceasing to beat, I injected into the vena cava some of the expressed juice. The motion of the heart was renewed; and the heart pulsated many times. Experiment XXX. Upon bringing into view the heart of a frog, about three drachms of the expressed juice were injected into the intestines. Previously to the injection, the heart beat nineteen strong strokes in a minute. In five minutes it beat nineteen quick and stronger strokes. In ten minutes it beat eighteen strokes; in fifteen, seventeen; in twenty, sixteen; in twenty-five, twelve; and in thirty, eight. After the twentieth minute its motions gradually lessened in strength till they entirely ceased. This frog lived about an hour and a half. Another one treated in the same manner, but without the injection, lived for several hours. Experiment XXXI. After removing a portion of the cranium in such a manner as to bring the brain into view, some of the expressed juice was applied to the part. Convulsions were the immediate consequence, the frog dying in three minutes. Experiment XXXII. About two drachms of the juice were injected into the cavity of the abdomen of a dog. Upon killing the animal about two hum's afterward and inspecting the abdomen, a portion of tie surface 2 x 178 COOPER ON STRAMONIUM. of the intestines, and a part of the omentum and peritoneum were preter- naturally reddened. Experiment XXXIII. About half an ounce of the expressed juice of the leaves, was injected into the jugular vein of a bitch. She made one violent struggle and died. She lived about half a minute after injecting the juice. Upon dissection, her blood was found fluid; and a white coagulum had extensively formed in the right auricle and ventricle of the heart. The brain was more watery than natural. Experiment XXXIV. More than an ounce of the expressed juice was injected into the rectum of a small dog. In a few minutes the pulse became more frequent and quick. In about ten minutes he endeavoured to vomit, but his endeavours were ineffectual. His stomach was oppressed, and something regurgitated into his mouth which was swallowed as often as it regurgitated. In fifteen minutes he had several stools, which con- sisted of fxces and of the expressed juice. After these discharges, fresh efforts to vomit ensued, but they were as vain as the former. He tottered as he walked. In half an hour he became dull and slept. During his sleep his whole frame was affected with frequent tremulous motions or startings. He did not sleep long, made again efforts to vomit, attempted to walk, but was unable, and laid down. He now fell into a sleep of greater composure and of longer continuance. On.the ensuing day he was lan- guid, but able to w:.H:; took some nourishment, and gradually recovered. Experiment XXXV. To a bitch whose pulse was at one hun- dred and eleven in a minute, I gave about an ounce and a half of a spiritu- ous tincture of the leaves. The pulse gradually increased in quickness and frequency; and in thirty minutes it beat one hundred and forty strokes. In twenty-three minutes derangement of mind came on; the animal running in circles into the fire, against the furniture of the room, tumbling on her side, rolling on her back, and agitating her feet in the air. She was now bled from one of the jugular veins. Her blood, as it flowed, was florid; upon standing some time the crassamentum floated in the serum, was somewhat loose in its texture, and numerous red par- ticles were deposited at the bottom of the bowl. Upon killing and dissecting the animal, neither her flesh, nor her secretions appeared to be imbued with the odour of the tincture cf the leaves. In this experiment I was induced to pay attention to the odour of the flesh and secretions, as I had once made a similar experiment with the tincure of opium, and found that the whole animal upon dissection seemed to be impregnated with its smell. The portion of the tincture of opium used, was about three ounces. Experiment XXXVI. I poured an ounce and a half of the expressed juice down t^e throat of the dog, used in the last ex]>erinicnt except one. His heart a&cnvard beat slow and strong strokes. His respiration COOPER ON STRAMONIUM. 179 became more and more laborious, and at length the thorax moved with such force and irregularity, that the pulsations of the heart could not be felt. His sleep, when he slept, was restless and imperfect. During the two following days he drank, but eat little, slept much, and was found dead on the morning of the fourth day. Upon removing a portion of the cranium the brain was found to be watery. About two drachms of limpid fluid were found in the ventricles of the brain. The lungs appeared to be surcharged with blood. The blood in the vena cava and in the right auricle and ventricle of the heart, was in a dissolved state. The valve of the pylorus was greatly contracted. The contents of the stomach were yellowish, and consisted partly of the medicine which had been taken. The gall-bladder was highly distended with a dark coloured bile; and much bile of the same colour was found in the intestines. Experiment XXXVII. I obtained a dog that laboured under peri- odical twitehings or convulsions, which occurred every three or four minutes. He appeared to be old, his frame was emaciated, his countenance dull, and when he walked, his steps were slow and irregular. To this clog I gave a scruple of the extract of the leaves, which was repeated several times. The effects of the medicine were frequent black stools, a frequent flow of darkish urine, thirst, languor, and emaciation of the body. But this treatment did not diminish his convulsions. I now remitted the medicine for several weeks. During this period he became fatter, and more lively than I had hitherto seen him. Upon repeating the medicine in larger doses, similar effects as before, but of a more violent nature, were produced. His respiration became laborious and slow; and his death soon occurred. Upon opening his abdomen a large worm lay naked to the view, except its extreme parts, which were concealed by the intestines. I was much astonished, and much delighted, at a discovery so unexpected; and at once concluded, that the worm had been the cause of convulsion in the dog. It was of a vermilion colour, above a yard in length, and nearly an inch in circumference. Professor Barton, so justly celebrated for his profound knowledge of the objects of nature, is of opinion, that this worm is a new species of ascaris. He probably will be induced to describe and arrange it among the vermes. No perforation through the intestines was obvious: they were full of a yellowish fluid; but not any fluid was found in the cavity of the abdomen. May we not conjecture, that the worm perforated the intestines upon the first exhibition of the stramonium, which according to Dr. Rush and Dr. Fowler, is offensive to worms. The external surface of the intestines and stomach were redder than natural. Some parts of the intestines, and much of the mesentery appeared to be in a gangrenous state. A small quantity of water was found in the ventricles of the brain. These last effects, I think, may in a great measure be attributed to the violent opera* tion of the medicine. 180 COOPER ON STRAMONIUM. OBSERVATIONS ON THE PRECEDING EXPERIMENTS. It appears that the leaves of stramonium possess no essential oil, as they afford none when distilled with water. The distilled water, taken into the stomach, produces little or no effect. (Exper. 1, 2.) The oily matter, -which rises to the surface of the expressed juice, cannot with strict propriety be called an essential oil, as it does not rise till a degree of fermentation occurs in the juice. This oily matter pro- bably originates from a decomposition of the resin of the fluid. The dry leaves, when exposed in a retort to a violent heat, yield empyreumatic oil, and when burnt yield potash; products which are ufforded by numerous vegetable substances. (Exper. 3, 5.) From four drachms of the powdered leaves, which had been exposed to repeated quantities of alcohol, twelve grains of resin were obtained. The same leaves subjected to a pure water yielded one scruple of gummy matter, among which many very minute crystals existed. Had these crystals been separated from the gum, they would perhaps have amounted to three or four grains. (Exper. 6, 7.) Three grains of the resin, given to a healthy person, produced much exhilaration of mind, fever, and head- ach, and several alvine discharges. Three grains of the gummy matter gtven to a healthy person, produced a slight exhiliration of mind, fever and head-ach, and a copious flow of urine. Might not this gummy matter tie exhibited with effect in some dropsies? The gray, earthy, insipid substance, which neither the alcohol, nor the water dissolved, weighed two drachms and eighteen grains. Hence it seems that the constituent parts of the powdered leaves of stramonium are a resin, a gum, an essential salt, and an earthy matter. The resin appeal's to be the most active part. The gum possesses a bitter, the resin, an astringent principle. (Exper. 9.) With regard to the other parts of the plant, the honey of the flowers, the seed, and the root, my experiments are extremely deficient. How- ever, I may observe that the honey is bitter, the seed and the root sweet, and that they all in a greater or less degree possess the properties of the leaves. An ingenious botanist, William Bartram, informs me, that he cats this honey with pleasure and avidity, and without experiencing any thing morbid from its-use. But my fellow student, Joseph Johnson, assures me, that he once was attacked with head-ach, and with sickness at stomach, after sucking many of the flowers; and professor Barton supposes that this is one of the plants from which'the bee, in this country, sometimes extracts a pernicious honey. The sweet taste of the seed has betrayed many a child into great danger. The seed and the root are pulverized with much difficulty. When it is necessary to report to them, it will per- haps be best to roast, grind, and make the former into coffee; and best to COOPER ON STRAMONIUM. 131 pov fr*. a sc ^sop: slice, and boil the latter for a decoction. In the following experiments, and cases, I have used the leaves in preference to the other parts of the plant. They may be gathered, dried, and powdered with ease. They may be plucked during the flowering state of the branches, put in an airy and shaded apartment, and pulverized as soon as they become diy. The use of a fine seive will be proper to obtain the powder free from the fibres of the leaves. It may now be kept in glose vessels; and if good, it will possess a beautiful green colour. When this powder is applied to the tender membrane of the nose it produces sneezing, and an increased flow of mucus. When taken into the mouth, it stimulates the salivary glands into great action. (Exper. 12, 13.) It disagreeably affects the senses of taste and smelling; and if the leaves be chewed for some time they induce a degree of intoxication. In these circumstances stramonium resembles nicotiana, or tobacco. And they are similar in other respects; for the same insect, in the caterpillar, and in the fly state, and the same animals feed alike on both plants. Should man not alter the current of £is present propensities; should he continue to indulge a relish for unnatural luxuries, and delight in being the inge- nious tormentor of himself, it may be predicted that stramonium, like tobacco and alcohol, will become the bane of society. But a hope is en- tertained that future generations, taught by the experience and misfor- tunes of their ancestors, will relinquish the general use, and prevent the introduction of such injurious articles. A drop of an infusion of the powder applied to the eye, dilates the pupil. (Exper. 15, 16.) It is difficult to account for this curious effect produced on the eye. Upon the application of the infusion does an un- usual action occur in the external coat of that organ, which is communi- cated by sympathy to the retina; an action or affection, which to a certain degree deprives the retina of the power of receiving the impres- sions of objects? Or does the diffusive vapour of stramonium, like heat or electricity, penetrate to the retina, and excite in it a peculiar disease I That fluids or vapours are capable of thus acting, is rendered somewhat probable by the following experiment. About three drachms of the powdered leaves were mixed with a pint of tepid water, and poured into a sound bladder; the neck of the bladder was then tightly tied; and as so/m as the bladder became well moist, the odour of the stramonium was perceptible on its surface. And the great Dr. Darwin, in the second volume of his work.entitled, Zoonomia, says, " There appear to be three different modes by which extraneous bodies may be introduced into die system, besides that of absorption. 1st. By etherial transition, as heat and electricity: 2d. By chemical attraction, as oxygen; and 3d. By ex- pansive vapour, as ether, and essential oils." That the infusion applied to the eye is ab..oi,ocd, and produces its effect through the medium of the 182 COOPER ON STRAMONIUM. circulating fluids, is an opinion, which is highly improbable. If the in- ifusion acted through this medium, both eyes would be alike affected. The following instance of the action of stramonium on the eye is a curious one, and it favours what we said in a former experiment. " The late Dr. Bond had under his care a patient, a young girl, who had put the seeds of this plant into her eye, which dilated the pupil to such a degree, that she could see in the dark, but in the light was almost blind."* Since this vegetable is capable of acting with such energy on the eye, we may expect, that it will sooner or later be applied with success, in some dis- eases of that exquisite organ. If the leaves be pounded into a soft poultice, and applied to a pail from which the cuticle is removed, they excite heat and pain; if applied to a part, which is shielded by the cuticle, no effect seems to be produced. (Exper. 18.) But if a decoction of the leaves be rubbed for some time on the surface of the body, febrile symptoms will be excited. (Exper. 19,) The decoction externally applied to a very young rat, seemed to induce convulsions. (Exper. 20.) The exhalation of stramonium excites head-ach and fever in the human system. (Exper. 21.) This exhalation, I endeavoured to collect, by putting many branches of the plant under a large glass vessel full of water, and afterwards exposing it to the sun. But in this I did not suc- ceed ; the water imbibed the exhalation. That the vapour emanating from this plant is capable of producing febrile action, is an opinion, which is supported by many facts. The following particulars countenance this opinion. " Below the falls of Ohio, (says a very intelligent gentlemanf) I lay some days in camp, with general Putnam, and several others. Here the earth was extensively covered with stramonium in full blossom, whose strong odour produced a pain in my head, which continued after leaving that place and till we arrived in the AVabash river. I was now seized with a fever, which had nearly proved fatal, and which was succeeded by a giddiness of the head of many weeks continuance. General Putnam wa9 also attacked with this fever; he recovered, though his recovery was not expected. Although my illness and general Putnam's might have arisen from breathing the fogs of the river, yet as I had been accustomed to these fogs before, without being affected by them, I have ever been of opinion, that my fever originated from the scent of these plants." And professor Barton has been informed, that jt st before the peace of 1783, it was sup- posed by the physicians of New-York, that the great abundance of stramo- nium* in the vicinity of that city had produced fevers; and that on this account the plant was cut down. For a similar reason, according to the * Appendix to Notes on Virginia, written by Thomas Jefferson. t John Hec.ke-.vclder, of Bethlehem, Pci»nR>lvania, in a letter. COOPER ON STRAMONIUM. 183 &ame excellent professor, a law has been lately passed at St. Vincennes, bn the river Wabash, for destroying this plant. The inhabitants of the place assert, that previously to its introduction* among them, they knew not what a remitting fever was. It may be said, that the preceding opinions relative to the production of fever by its exhalation, are founded on deception; and that fever in these instances might have arisen from the common cause, vegetable and animal putrefaction. It cannot perhaps be declared, that no putrid animals and vegetables existed at Fort Vin- cennes, and the other places, where the vapour of the thom-apple seemed to produce such morbid effects. Vegetable and animal putrefaction might have existed in these places, and have co-operated with the scent of the plant in producing disease. As alcohol gives origin to a febrile disposi- tion in the system, in like manner, the scent of these plants might have disposed to the production of fever. But their vapour or scent, I should imagine, would be highly equivalent, without the aid of any other cause, to give rise to fevers of a remitting type; especially when we recollect that the leaf can excite head-ach, convulsion, and mania. Alcohol and opium alone have excited the most violent diseases. I saw, I think, towards the close of last autumn, a case of true yellow fever which was induced in a person somewhat depressed in his mind, who for several days had taken nothing except repeated quantities of wine and brandy. And it is well known, that a kind of apoplexy originates from an excessive dose of opium. Thus we see that many morbid stimuli act with equal violence, * Colonel Winthrop Sargent informed Dr. Barton, that the datura stramonium has been known to exist on the grounds near the river Wabash, above twelve or fourteen years. To these parts it was probably conveyed by accident or curiosity. Some persons much admire its flowers. In a letter already quoted, that I received from J. Heckcwelder, of Bethlehem, there is the following information worthy of note. He says, " I met with this plant about the year 1769, for the first time, on the road from this place (Bethlehem) to Philadelphia. Its flower pleased me so well', that after its seeds were ripe, I took some of them home with me, and planted them on a farm near Nazareth. I found the plant at some places on the river Ohio, particularly at Fort Washington. This plant does not grow about Bethle- hem, and does not appeal- in several parts of Pennsylvania." Professor Kalm, who travelled about fifty years ago through this country, from Wilmington, in Dela- ware state, to Quebec, in Canada, only speaks of the datura stramonium, as growing between Wilmington and Philadelphia. From these and other circum- stances it is doubtful, whether the thorn-apple is a native of all of the United States. Perhaps it is not a native of any one of them. In a former part of this work I might have observed, that the plant is fre- quently called James-Town, or Jameson weed, because a number of soldiers were once violently diseased by ignorantly eating the boiled plant at James-Tovin, in Virginia. In like manner I might have observed, that it is called French chest- nut in New-Jersey. 184 COOPER ON STRAMONIUM. and in a way somewhat similar on the human system; hence may we not be led to conjecture that their constituent principles may be the same, at least in some degree, though differently combined ? Might not this active vegetable exhalation* be breathed with advan- tage in some weak habits, and in some cases in which the intestines and stomach are not able to retain medicine ? Would it not make a good addition to the pneumatic materia medica, a science which has been cultivated with considerable success by Dr. Beddoes ? Thus, former phy- sicians were in the habit of placing the poppy in the chambers of persons labouring under certain diseases; a practice which might perhaps be revived, and extended with advantage to many plants. One grain of the powdered leaves taken in a small quantity of tempe- Tate water, in the space of fifteen minutes, increased the frequency and force of the pulse; and finally produced thirst and sleepiness. (Exper. 22.) In five minutes two grains of the same medicine increased the fre- quency of the pulse. In a longer space of time, they rendered it full and quick, as well as more frequent; and produced the following symptoms: giddiness, warm skin, moist hands and face, intoxication, sleepiness. (Exper. 23.) The same quantity of medicine, given to an older person than either of the two former, rendered the pidse full and tense; produced cheerful- ness, and increased the appetite for food. (Exper. 24.) The medicine given in larger doses produced fulness, quickness, and tension, rather than frequency in the pulse; produced intoxication, diffi- culty of speech, and great thirst; dilated the pupils of the eyes; rendered the blood sizy and the stomach sick; opened the bowels; increased the floW of urine, and gave origin to febrile symptoms of some days continu- ance. (Exper. 25,26, 27.) From the preceding symptoms produced by stramonium, we may infer that this substance is a stimulant. The experiments on frogs and dogs tend to confirm this opinion. They moreover serve to point out its higher degrees of action. Like other stimulants, stramonium exhausts the irritability of the animal body. The expressed juice of the leaves applied to the heart of a dog destroyed its motion in a few minutes. (Exper. 28.) But the same fluid injected into the vena cava of a dog, after the heart had ceased to beat, stimulated it into fresh motion. (Exper. 29.) * The other species of datura probably exhale a strong odour. In a garden, which Dr. Smith visited on the continent, he says, that the datura arborea, covered with its magnificent and fragrant flowers, was at this time the finest thing, ard had crowds of visitors every evening. Few people could support its perfume nry length of time. Sketch of a Tour-on the Continent, in the years 1786 and 1787, vol i. p. Hi. COOPER ON STRAMONIUM. 185 The juice when injected into the rectum of a frog, a part of whose thorax hud been previously removed that the heart might be viewed, seemed to accelerate its death. And death is accelerated in frogs that are treated in this way, with opium, spirit of hartshorn, and spirit of wine, if we may trust the experiments of the ingenious Dr. Crumpe. The juice applied to the brain produced convulsions; injected into the abdomen, redness or inflammation of some of its contents; injected into the blood, immediate death. Instead of the juice, if water had been in- jected into the blood, a less sudden death I suspect would have been the consequence. (Exper. 31, 32, 33.) The juice injected into the rectum of a dog induced sickness at the stomach, and seemed to disorder the whole alimentary canal; induced in- toxication, sleep and convulsive motions. (Exper. 34.) The juice injected into the rectum of a cat produced a violent cough of many days continuance; and in another, it produced a partial loss of hair, and a slight scurfiness of the skin. The blood drawn from an animal labouring under the effects of a spirituous tincture of the leaves, was found to be loose in its texture; red particles were deposited at the bottom of the\ bowl; signs, according to Dr. Rush, of high inflammatory action in the system. In an animal destroyed by stramonium, two drachms of water were found in the ventricles of the brain; and dissolved blood appeared in the blood-vessels, and dark coloured bile in the intestines and gall-bladder. In another, the same cause gave origin to a gangrenous state of the mesen- tery and intestines. (Exper. 37.) Drs. Whytt and Woodhouse have found, that the fluid occasionally effused in the ventricles of the brain resembles water rather than serum, as it does not coagulate upon being exposed to the action of heat. This fluid perhaps consists of water, and a very small portion of marine salt. It is doubtless effused by vessels of very fine organization. I have found that it neither coagulates with heat, with spirit of wine, nor with vitriolic acid; but a slight precipitation seemed to take place upon mixing it with a solution of caustic vegetable alkali. The effused fluid that I employed was taken from a person who died of mania. Hence, stramonium inflames the eye, dilates the pupil of that organ, increases the action of the arteries, and the heat of the body. It gives origin to intoxication, or mania; to convulsion in the muscles, and to in- flammation in the bowels, and disposes the liver to secrete an altered bile. It gives origin to gangrene in the intestines and mesentery, to effusion in the brain, renders the blood siz\, loosens and dissolves its texture. Neither opium, hyoscyamus, nor cicuta, I believe, affect the eyes so much as stramonium. The fever, the intoxication, and the convulsions, which thhi last article excites, are probably sympathetic affections depend- 2b 186 COOPER ON STRAMONIUM. ing 6n its local application to the stomach or intestines. We cannot with • propriety attribute such affections to its absorption, and consequent diffu- sion through the body. Some absorption may take place; yet that they are produced in this way, is opposed by their sudden existence upon the application of the article, and their sudden disappearance upon its removal. Stramonium taken into the stomach, in a very few minutes affects the head and the arteries. In the first volume of the American Philosophical Transactions, Dr. Rush has related the case of a child who was much affected in consequence of swallowing the seeds. In this case the symp- toms were fever, tremors, blindness, and an eruption on the skin, which immediately disappeared upon the final evacuation of the seeds from the stomach and intestines, by the repeated use of vomits and purges. The intoxication or mania, which stramonium induces, scinis to be analogous to that which arises from the action of opium, alcohol and some other stimulants. Like alcohol it sometimes induces mania of many days continuance. In Beverley's History of Virginia, a remarkable account is related of its effects on several persons, who gathered, boiled, and ate it for greens. In each of these persons it seems, that a mania came on, which lasted about eleven days.* According to some it has induced mania which has continued during life. Do not such facts throw a blaze of light on the nature of the mind ? Should we not be induced to attempt the dis- covery of other articles which affect the mind? May not articles exist which are capable of affecting all its different faculties? May not poste- rity gain a dominion over it, near!} as complete as that, which we possess over the soil of our gardens ? In two persons! who used the boiled leaves for vegetable food in New- Jersey, violent diseases supervened; mania in ono, and tetanus in the other. Two children who had eaten of the seeds, seemed to labour under hydrophobia, according to Dr. Lobstein4 They rejected every kind of * The James-Town weed being an early plant was gathered very young for a boiled salad, by some of the soldiers sent thither; and some of them ate plentifully of it, the effect of which w as a very pleasant comedy; for they turned natural fools upon it for several days: one would blow up a feather in the air; another would dart straws at it with much fury; and another stark naked was sitting up in a cor- ner, like a monkey, grinning and making mouths at them; a fourth would fondly kiss and paw his companions, and sneer in their faces, with a countenance more antic than any in a Dutch droll. In this frantic condition they were confined, lest they shoidd in their folly destroy tliemselves; though it was obseved, that all their actions were full of innocence and good nature. Indeed they were not very cleanly; for they v.ould have wallowed in their own excrements, if they had not been prevented. A thousand such simple tricks they played, and after eleven days returned to themselves again, not rembering any thing that had passed. Beverley's History of the present'state of Virginia. Book ii. p. 24. London, 1705. f Dr. Barton's Lect. on the Materia Medica. \ Med. Trans, v. 5. p. 83. COOPER ON STRAMONIUM. 187 i • liquid, and on offering a cup full of drink to them, the moment it touched their lips violent spasms invaded the throat. Thus it seems, that one cause acting on different constitutions may be capable of giving origin to three seemingly different diseases, or morbid states of the system; mania, tetanus, and hydrophobia. May we not hence conjecture, that whenever these diseases exist, they are owing to causes which are the same, or which act in a similar manner. These causes must be of a stimu- lating nature, and excite excessive and irregular action in the system. If we would obviate this action, we must have recourse to remedies which eradicate the original causes of it, or which by their sedative operation diminish the commotion, or oppression of the system. Dr. Rush, who may be justly styled the father of medicine in this country, has attributed diseases in general, to stimulus, as their remote, and to excessive and ir- regular action, as their proximate cause. Do not the facts just mention- ed in some measure confirm the justness of his theory of disease ? But the justness of his theory is better confirmed by the success which attends its application to medicine. Stramonium disposes the liver to morbid secretion. In thus acting it resembles opium, alcohol, and the miasma, which produces intermitting and yellow fevers. But it does not constipate the bowels like opium. On this account it may prove more useful than opium in certain diseases. In not constipating the bowels it resembles hyoscyamus niger, or hen-bane, which keeps the intestines lax, according to Dr. Barton's ingenious expe- riments on this plant. The inflammation and gangrene in the intestines; the effusion of water in the brain; the sizy, loose, and dissolved blood, produced by the action of stramonium on animals, possess a great simili- tude to the effects of malignant fevers on man. There are many instances of death being the consequence of taking stramonium. Some years ago, in the county of Burlington, in New-Jersey, two children of Treadwell Warren, were destroyed by eating its seeds.* In cases in which our plant is taken into the stomach, the seeds, the leaves, or the root, the best remedies will be vomits and purges often re- peated to evacuate the offending substance; and copious bleedings to diminish or obviate the violence of its action. Dr. Rush has evinced the utility of vomits and purges, for obviating the effects of this plant; and that bleeding will also be proper, I infer from its successful use, in casesw herein the hyoscyamus niger, or common hen-bane and opium have been taken into the stomach. Sir Hans Sloane cured four children, by bleeding, blisters, and purges, who were seized with great thirst, ver- tigo, dimness of sight and profound sleep, upon eating the seeds of the * This information I received from my respectable and intelligent friend, Samuel Coates, one of the managers of the Pennsylvania hospital. 188 COOPER ON STRAMONIUM. hyoscyamus niger: and Dr. Rush has lately applied copious bleedings with success in the disease which arises from swallowing opium. But the following case in the best manner answers my purpose. In a child that had taken into her stomach some of the seeds of stramonium last fall, blood-letting and purges were used with the best effects. The blood which was drawn was cupped. This patient I saw. She was attended by my ingenious friend, Dr. Caldwell. In slight cases, or after the use of more powerful remedies the vegetable acid may prove serviceable. In affections produced by the plant, it has been used with advantage by the late Dr. Bond and others. But a plant diffusing such a poisonous exhalation should not be suffer- ed to grow upon farms, near roads and houses, or upon vacant grounds in cities. The rich soil, which it infests and impoverishes, should be sur- rendered to more salutary vegetables. Its abode should be confined to the remotest corners of private medical or botanical gardens. Few or no accidents would then arise to children from swallowing its seeds; foreigners or ignorant persons would not be tempted to use it for food; its morbid ex- halation would seldom or never be breathed; and when recourse was had to its aid, as a remedy, it would more readily affect the human system. From what has been advanced relative to the effects of stramonium on the animal body, we may fairly conclude that it is a stimulant. In this opinion we are not alone. It is held and taught by two of the pro- fessors in the university of Pennsylvania; and in the second volume of the Zoonomia, stramonium is enumerated among the inciting articles of the materia medica. ON THE USE OF STRAMONIUM IN MEDICINE. To that acute physician Dr. Storck, are we indebted for introducing the datura stramonium in the cure of diseases. He exhibited an extract of the leaves of this plant with advantage, in some cases of mania, in epilepsy, and some other convulsive affections. In similar cases this re- medy was afterwards used by Drs. Wedenberg and Odhelius with con- siderable success. Dr. Greding was then induced to try the stramonium. He gave it in a great number of epileptic cases, and in cases of epilepsy joined with mania, and only found the remedy to be effectual in a single- instance. And the late very respectable Dr. Cullen thinks, that it is seldom suited to the cure of such diseases. Yet, as if unwilling to decide on a subject concerning which such different opinions were entertained, he says, " Nevertheless, I have no doubt, that narcotics may be a remedy in cei'tain cases of mania and epilepsy; but I have not, and I doubt if any other person has leanied to distinguish the cases to which such remedies are propel ly adapted." COOPER ON STRAMONIUM. 189 Thus it seems that Drs. Storck, Wedenbcrg, and Odhelius, gave the medicine with success, while Dr. Greding found it to be nearly useless. The former physicians might have given it in proper cases and doses, while the latter one in these respects might have erred. On the occasion Dr. Cullen deduces nothing from his own experience. He considers stra- monium as a narcotic, and therefore a sedative. But the preceding experi- ments and observations I hope will evince, that it produces stimulating effects on the animal body. The following cases may in some measure point out the conditions of the system in which it may prove useful. The preparation of the plant which has been chiefly given in these cases is the powder of the leaves. The dose is from half a grain to four grains, mixed with conserve of roses or water, twice or thrice in the day. IN EPILEPSY. Dr. Rush has greatly simplified and elucidated the subject of noso- logy, by considering pleurisy, phrenitis, mania, apoplexy, and numerous other diseases, as febrile states of the system. To the number of these febrile states of the system, I think epilepsy might be added; for it is induced by the same causes which induce other fevers. These causes are alcohol, terror, obstinate costiveness, a cessation of certain discharges, as in the cases of piles, ulcers, &c. It appears to be a fever, because during the existence of a paroxysm the pulse is uncommonly tense and full, the face red, and the pupils of the eyes dilated; symptoms which frequently occur in fevers, Moreover in the intervals between the fits the patient is subject to vertigo, and his tongue is for the most part white. Like other fevers, epilepsy generally attacks the young, and the plethoric, and occurs in the night, and sometimes changes into mania. In a woman, who, during the existence of a paroxysm died of epilepsy in the Pennsylvania hospital, in the spring of 1796, the arteries of the brain seemed to be enlarged to twice their usual size. Other dissections have discovered water, and hydatides inthe brain; effects which probably resulted from morbid action in the arteries of that viscus.* Dr. Rush has effectually cured it once or twice by mercury; but, has not, I believe, succeeded always upon using * This disease has been cured or suspended by the small-pox, by pulmonic and by intermitting fever. I was informed by a black man, whom I could believe, that he had been once very subject to fits, w Inch according to his description must have been of the epileptic kind, and that bis fits had never returned upon his violently having the natural small-pox. There is at this time a patient in the Pennsylvania hospital, who has been long subject to epileptic fits, yet upon his being lately attacked with pulmonic fever, they have entirely ceased to occur. A boy who was much harrasscd by fits remained free from them for several months; but during this time he laboured under an intermitting fever, as will hereafter appear Hence, is it not probable that epilepsy is a fever, as it seeins at least sometimes to change into other fevers. lo0 COOPER ON STRAMONIUM' / I this remedy. In epilepsy, Dr. Darwin has exhibited opium with great « . success. I suspect that stramonium is a remedy which is equal, if not superior to either of these, in the present disease. It is a less disagreeable remedy to the patient than mercury, as it does not confine him to his bed, by inducing a painful affection; and it seems to answer all the purposes of opium, without constipating the bowels. It was used with considerable success in the case of a boy about twelve years old, in the Pennsylvania hospital, in part of the autumn and winter of 1796. I will briefly relate his case. If the contagion of the yellow fever did not occasion his epi- lepsy, the cause of it is unknown. I am informed by his friends, that he had the first epileptic fit during the prevalence of the yellow fever in Philadelphia in 1793; that he had another in about two months after- wards; and that the fits in 179 1, and in the beginning of 1795 occurred somewhat more frequently, till he at length had one about every two weeks. But I am told that in the summer of 1795 he was sent into the country, where he was attacked by an intermitting fever, under which he laboured for four or five months. During this period, it seems that his fits entirely left him; but that they returned upon the disappearance of the fever. In the winter of 1795, and in the spring and summer of 1796, he took the cuprum ammoniacum and some other remedies, which seemed in some measure to lengthen the intervals between the fits. But not being durably relieved by these remedies, they were discontinued; and he was admitted a patient into the Pennsylvania hospital in the autumn of last year. He now had three or four fits every week. Dr. Shippen who was at that time the attending physician, prescribed for him Fowler's mineral solution, to be given in small quantities. As the fits became more fre- quent upon using the solution, it was discontinued. Half a grain of the powdered leaves of stramonium was now prescribed; it was to be taken in the morning and evening, and the dose was gradually increased to three grains twice in the day. Upon taking this last medicine, his fits soon began to diminish in force and frequency; and at length he appear- ed to be cured of them. It is proper to observe that he was bled and purged before taking the stramonium, and was bled again a week or two afterwards; and that at a time when he seemed to be threatened with a paroxysm, Dr. Rush, who succeeded Dr. Shippen in the hospital, had him bled with obvious ad vantages. Would not the application of pressure to the carotid artery just before its commencement, prevent the fit? This boy was discharged from the hospital as cured, but I am sorry to add that after remaining about five months free from the fits, he has had a return of them About the beginning of this spring after getting his feet wet by long exposure on a rainy day, and coming in the evening into a close warm room, and having to do some work which required stooping, he was seized with a fit. He has had several of them within the COOPER ON STRAMONIUM. 191 two last months; but he has lately been bled and purged, and resumed the pills with much advantage. The last fit and the preceding one have been less violent, and more protracted in their access. By bleeding and stramonium a perfect cure may yet be effected. If they should fail, the age of puberty may make a favourable change in his system. I gave two grains of the powdered leaves every evening to a woman about thirty years old, having imperfect speech, and a kind of catalepsy, which returned every night, and lasted about an hour. These affections, I believe, arose from frequent spirituous intoxication. Upon taking the medicine about three weeks, she appeared to be cured of the catalepsy, and relieved of the imperfect speech. Might not stramonium be taken as a substitute for alcohol, in persons who wish to relinquish the use, or who suffer great inconvenience from the want of this noxious article ? Two grains of the powdered leaves taken evening and morning, seemed to be of much service to a woman, who. had long been subject to tremors of the limbs, and occasional epileptic fits; affections which seemed chiefly to arise from a contortion and ulcer in the foot. Our remedy was given in some cases of epilepsy in the alms-house of this city with a success not to be regretted. Dr. Hart, who attended to its effects, informed me, that it performed a cure in one of them; and that it relieved the others. The following valuable observations on the effects of stramonium in epilepsy, I lately received in an obliging letter from Dr. John Archer, of Harford county, Maryland. This letter contains other observations respecting the use of stramonium, which I shall detail in their proper places. " I have administered the stramonium to several, with various effects; to some with great advantage, and to others without any other advantage than prolonging the time of the return of the fit, or only lessen- ing its duration. I observed that those who had regular returns of the fits, or had them at short intervals, received the greatest benefit; because they could take a sufficient quantity of the medicine before the time of a return: by this means the return of the fit was prevented: then attending to the time another fit should return, the medicine was again given, and in general a cure obtained; but those who had irregular returns of the fits, unless of short duration, could not take the stramonium so as to act at the time of the fit, as it came on unexpectedly; these were not much benefited. " In the epilepsy with regular periods of return, I order two grains of the powdered seeds made into a pill, to be given every four hours, until some sensible effects are produced; and then lengthen the time to six or eight hours, so as to keep up some sensible operation of the medicine, until the time of the fit. The medicine is now to be omitted till three or four days before the next return. It is then to be exhibited as before. To use the stramonium with effect in these cases, and with any benefit in the preceding ones, low diet and occasional blood-letting should be enjoined. 192 COOPER ON STRAMONIUM. " I need scarcely remark to you that those patients, who have irregu- lar returns of the fits with long intervals, must take the stramonium constantly, else they will miss the proper time of taking it. In such cases, though it may not prevent the return of the fits, it may mitigate their violence. I have also remarked, that it is administered with little or no advantage to those patients who are become simple or foolish by the violence or long continuance of the disease. " The seeds should be gathered when fully ripe, before the frost and the rains injure them. The best seeds for use are of a blackish colour. Take a scruple of the powdered seeds, half a scruple of flour, and a sufficient quantity of water; mix them well, and divide them into ten pills. These are to be given as already directed. u I do believe the seeds of stramonium to be a valuable medicine in many diseases; I have tried them in several others with great advantage, as mania, retention of urine, &c. but they must be given with regularity and attention. In my opinion in a regular epilepsy, it is as powerful as the Peruvian bark in intermittents." In the cure of epilepsy how does stramonium act? Does it act by giving origin to a new disease, or by wasting that general or partial accumulation of excitability or sensorial power, which favours the pro- duction of a paroxysm ? IN MANIA. This disease, which Dr. Rush has proven to be a fever, may in some of its forms be obviated or relieved by stramonium. In J. B. this remedy appeared to effect a cure. Being deranged in his mind, and somewhat outrageous, he was admitted into the hospital during Dr. Parke's attend- ance last summer. He was bled and purged several times; in consequence of this treatment he became somewhat more rational. After these reme- dies two grains of the powdered leaves of stramonium were prescribed; these were to be taken every evening and morning. The medicine occa- sioned whiteness of the tongue, fever, and a slight head-ach. He took the stramonium about two weeks, rapidly grew better in his reason, and was discharged from the hospital as cured. Dr. Rush considers the occurrence of head-ach in maniacal cases as a favourable symptom, and I have seen it frequently occur in his patients at the hospital as soon as their derangement had much diminished or ceased. Alight not this salutary symptom in mania be accelerated, or induced in many cases of this dis- ease by the use of stramonium ? M. R. wild and melancholic, having been deranged for some months, took one grain of the powdered leaves of stramonium morning and evening. Previously to taking the medicine he was bled and purged several times. The medicine seemed to'make little or no impression on him, but upon increasing it gradually to four grains, he became affected COOPER ON STRAMONIUM. 193 with fever and pains in his limbs. He now became rational; but succes- sive suppurations occurred in the parts where the pains existed. Open- ings were occasionally made into the collections of pus; and at this time he appears to be on the recovery, and continues to be rational. To M. F. melancholic, a female patient, one grain of an extract of the leaves was given night and morning, which quantity was gradually increased to three grains. She was delighted with the medicine, seemed to get better, and would anxiously call for the pills when they were out. By some means she at length discovered that they were made of what she called Jameson weed, and refused to take any more of them. Upon taking the medicine in increased doses, she informed me that she fre- quently saw small dark spots in the air; and that sparkles of light some- times seemed to proceed from her eyes. Dr. Archer within these few days informed Dr. Rush, that in a certain case in which he gave stramo- nium double vision was produced. For J. B. labouring under melancholy madness, Dr. Wistar last summer prescribed stramonium in doses of half a grain, to be taken twice in the day; but the medicine affected her stomach with so much sickness that it was discontinued. It was given to several persons in the cells of the hospital who had been deranged for many years; some of these it seemed to relieve by exciting violent diarrhoea; others again it seemed to injure. In these latter instances some advantages might perhaps have been derived from it, if its use had been premised by bleeding and purging. IN TETANIC FEVER. Dr. Archer's letter informs me that he once moderated the symptoms of tetanus by giving stramonium; and that Dr. Simmes, formerly his student, now living in Georgia, had succeeded in the cure of a tetanus by using this medicine. Dr. Archer adds, that he attributes his own late ill success in some cases of tetanus, wherein lie administered stramonium, to his not having preceded the remedy by evacuants. IN HYDROPIC AND PARALYTIC FEVERS. In one hydropic, and two paralytic cases, in which our remedy was tried, it seemed to prove injurious. IN SEVER WITH SWEATS. To a person having nocturnal fever, attended with sweats, two grains of the powder were given several hours before going to bed, for about a week; but it was necessary to discontinue the remedy, as the fever and sweats were increased. He was afterwards cured by purges and elixir of vitriol. 2 c 194 COOPER ON STRAMONIUM IN INTERMITTING FKVER. In a case of intermitting fever, in which two grains of the powdered leaves were given about two hours before its expected attack, the pa- roxysm was prevented. IN AFFECTIONS OF THE EVES. In a patient labouring under gutta serena, where the pupil had not lost the whole of its irritabiliiv, the seeds taken twice in a day, first half a grain of them, and afterwards three grains, seemed to produce some increase of vision; but on account of the medicine disagreeing with his stomach he relinquished its use. In this case the local application of an infusion of stramonium, might perhaps have answered a good purpose. Two old women with weak eyes seemed to derive some benefit from applying to the eye the juice of. the leaves diluted with water. The strength of the preparation was a drop of the juice to an ounce of water. A weak infusion of the dry leaves would perhaps be equally serviceable as a preparation of the diluted juice. IN I.IIEUMATIC FEVER. Dr. Rush prescribed last winter, a spirituous tincture of the leaves for a pain in the knee, in the hospital. It seemed to relieve the affection by causing eruptions on the skin. An ointment made by boiling the green leaves of the plant in hog's lard, I once saw prove very serviceable in violent rheumatic pains. Dr. Bache informed me that an old lady in the country, near the city, applies this ointment with great success, incases of club-feet. I lately saw it of great service in one of these cases. It is said that this ointment is very useful in burns and in piles. I must now conclude these pages. Time will not permit me to dwell any longer on this interesting subject. The preceding experiments and observations have been accomplished at t'le expense of some ease, and some health. But if they should in any way extend our knov.iedire of a powerful vegetable substance; if they should collect into a point some of its different effects on the animal system; and, if they should have t!se least tendency to obviate any portion of human misery, mv ends will be answereJ, and I shad conce.se that my labours have been rewarded \>ith an ample reconipence. AN INAUGURAL DISSERTATION DIGITALIS PURPUREA, OR FOX-GLOVE; AND ITS USE IN SOME DISEASES. SUBMITTED TO THE EXAMINATION OF THE REVEREND JOHN EWING, S. T. P. PROVOST; THE TRUSTEES, AND MEDICAL FACULTY OF THE UNIVERSITY OF PENNSYLVANIA, ON THE THIRTY-FIRST OF MAY, ONE THOUSAND EIGHT HUNDRED. FOR THE DEGREE OF DOCTOR OF MEDICINE. BY JOHN MOORE, OF PENNSYLVANIA, MEMBER OF THE PHILADELPHIA MEDICAL AND CHEMICAL SOCIETIES. / INTRODUCTION. AS Digitalis has excited a great deal of attention within a few years, and as it has been used in two very different diseases, viz. dropsy and pulmonary consumption, with remarkable success, I have made it the subject of my Inaugural Dissertation. I am, however, fully sensible of the truth of the following observation made by Dr. Withering: " I wish it was easy to write on Digitalis. I despair of pleasing myself or instructing others, on a subject so difficult. It is much easier to write upon a disease than upon a remedy. The former is in the hands of nature, and a faithful observer, with an ej't of tolerable judgment, cannot fail to delineate a likeness. The laiter will ever be subject to the whims, the Inaccuracies, and the blunders of mankind." As there is very little pretension to originality in any part of the following essay; as the parts which are extracted from authors, can be easily distinguished by every medical reader, and as I here make particular acknowledgments, to those authors, I hope to be excused for omitting minute references to them. Most of the experiments which are related, were repeated several times, but as their results were similar, or nearly so, to those mentioned, and as I wished to be as concise as possible, I have not detailed them. « ) « A DISSERTATION ON DIGITALIS. CHAPTER I. A SHORT DESCRIPTION OF THE PLANT. THIS plant is the Digitalis Purpurea* of Linnaeus. It is very com- mon in England, and is found also on different parts of the continent of Europe. It may be cultivated to advantage in the United States. It be- longs to the second order of the fourteenth class, or the Didynamia Angiospermia of Linnaeus. The essential characters of the genus are, Cup with five divisions. Blossom bell-shaped, bulging. Capsule egg- shaped, two celled. Chives. Threads crooked, white. Tips yellow. Pointal. Seed-bud greenish. Honey-cup at its base more yellow. Sum- mit cloven. S. Vess. Capsule not quite so long as the cup. Root. Knotty and fibrous. Leaves. Slightly but irregularly serrated, wrinkled; dark green above, paler underneath. They resemble in some degree, the leaves of mullein,! and it has been gathered for digitalis. Lower leaves egg-shaped; upper leaves spear-shaped. Leaf-stalks fleshy, bordered. Flowers. Numerous, mostly growing from one side of the stem, and hanging down one over another. Floral leaves. Sitting taper pointed. The numerous purple blossoms hanging down, mottled within; as wide and nearly half as long as the finger of a common sized glove, are sufficient marks whereby the most ignorant may distinguish this from every other plant. It grows in dry, gravelly or sandy soils, particularly on sloping ground- It is a biennial, and flowers from the middle of June to the end of July. No cattle are observed to eat it. The root, the stem, the leaves, and the flowers have a bitter herbaceous taste. * The trivial name, purpurea, is ru>t a very happy oYio, for the blossoms though generally pu.ple are *unietimes of a pure white; I shall therefore, hereafter call it simply digitalis. t YYibascuin ul Linnaeus. 200 MOORE ON DIGITALIS. This plant ranks among the Luridx, one of the Linnxan orders in a natural system. It has for congenera, nicotiana, hyoscyamus, datura, solarium, &c. Fuchsius, who wrote in the year 1542, is the first author who notices it. From him it received its name of Digitalis, in allusion to the German name of Finger-hut, which signifies a finger-stall, from the blossoms re- sembling the finger of a glove. Sensible qualities. Leaves bitter and nauseous. Sensible effects. In large doses it produces sickness, nausea, vomiting, vertigo, confused vision, increased secretion of urine, with a desire to discharge it, and a tendency to salivation. Every part of the digitalis possesses similar properties, but the leaves, according to Dr. Withering, are much the most efficacious part; and I believe that inattention to his directions, is a principal source of failure among physicians. As Dr. Withering's treatise may not be in the hands of every one who may read this dissertation I shall give his method of preparing it, in his own words. " The leaves should be gathered when the plant is flowering. The leaf-stalk and mid-rib of the leaves should be rejected, and the remaining part should be dried, either in the sun-shine, or on a tin pan or pewter dish before the fire. " If well dried, they readily rub down to a beautiful green powder, which weighs something less than one-fifth of the original weight of the leaves. Care must be taken that the leaves be not scorched in drying, and they should not be dried more than what is requisite to allow of their being readily reduced to powder." As he mentions a heat barely sufficient to make them suitable for powdering, and as it is, certain that its active quality may be greatly dissi- pated by being long dried before the fire, we have great reason to believe that the method of curing it, may be very often a cause of its failure, since we see how much care is necessary. CHAPTER II. OF THE PRIMARY EFFECTS OF DIGITALIS ON THE HUMAN RODT. Many of the authors who have written on this subject, have taken notice of its remarkable effect on the arterial system; but their obsenu- tions have been principally confined to its power of diminishing the frequency of the pulse.. In order to ascertain if possible the principles by which its effects were to be explained> I instituted the follov»ing MOORE ON DIGITALIS. 201 experiments with the dried leaves, picked in the manner recommended by Dr. Withering. As its effects can be more clearly ascertained in a state of health, than when complicated with the symptoms of disease; and as its opera- tion in morbid affections will be more properly considered after its mode of action has undergone examination, I shall here confine myself to an enumeration of its effects on the body in a state of health, and particu- larly of its primary effects on the arterial system. Experiment I. Having for two days previously had some pain in my head, at two o'clock, p. :i. half an hour after eating a light dinner, I took one grain and a half of digitalis made into pills with the mucilage of gum. Arab, my pulse beat seventy-two strokes in a minute, and the following changes were observed in it; it was reckoned immediately be- fore, at, and after the periods mentioned in the first line of the following table: In 5 10 15 20 25 30 35 40 45 50 55 60 70 75 80 85 90 105 120 minutes, Pulse beat 72 76 76 78 7 8 76 78 74 72 72 70 68 66 64 60 60 58 60 60 strokes. Twenty minutes after taking the medicine, I felt an increase of the pain of my head, accompanied with pain in my eyes; in forty-five mi- nutes, some increase of fulness in my pulse was very perceptible. Sixty minutes having elapsed, rr y pulse lost the increase of fulness, and my stomach was slightly affect L-d with nausea. In one hundred minutes I felt but very little pain in my head. During the remainder of the after- noon, I had several time■■> a little nausea, which however soon went off, and in the evening the pain of my head returned as before. Experiment II. At ten minutes before twelve o'clock, a. m. I took three grains of digitalis; *" my pulse beat sixty strokes in the minute, its natural standard. In twenty minutes it was increased six strokes; in thirty-five minutes it v/as smaller, and it continued between sixty-six and sixty, for seventy-five minutes, when it remained at sixty-two. I had during the experiment several times a slight nausea. Experiment III. At ten o'clock, p. m. three hours after drinking a little coffee, and eating some bread and butter, I took three grains of digitalis; my pulf>e beat sixty strokes in a minute. In 5 10 15 20 25 30 35 40 45 50 55 60 65 80 minutes, Pulse beat 60 60 60 56 55 54 53 58 56 56 58 60 60 50 strokes. In twenty-five minutes had considerable nausea, and my pulse was diminished in force; in sixty minutes nausea continued, and my pulse was a little fuller; in two hours the nausea was so great that it was with * I max rom 'k here, that in all my experiments, I took and pave the medicine i» the for.u of pills, made with the mucilape of gum. Aral). 2d 4* 202 MOORE ON DIGITALIS. difficulty I could avoid vomiting, and my pulse did not appear (for it was not counted) to be more than forty strokes in a minute. Experiment IV. At twenty minutes before seven o'clock, a. m. my worthy friend and colleague, Dr.t Enoch Wilson, took (fasting) three grains of digitalis; he had some pain in his head, and his pulse beat sixty-four strokes in a minute. In 5 10 15 20 30 35 40 45 50 55 64 75 85 90 95 100 105 110 115 120 125 135 m. p.b. 66 66 68 70 72 72 72 70 70 68 68 68 66 62 62- 62 6? 62 60 60 58 58 -,t. In fifteen minutes he had a sense of heat at his stomach; in twenty- five minutes his pulse was evidently fuller, and the pain of his he\d some- what increased; in sixty minutes had some uneasiness at his stomach, with an increased flow of saliva, which continued as long as the disorder of the stomach; in sixty-five minutes his pulse was diminished in force; • in eighty-four minutes had some nausea which continued for one hundred and thirty minutes, when his pulse was much smaller. I le had some nausea several times during the remainder of the di.y, and three copious evacuations from his bowels, but had some doubt about ascribing this effect to the medicine, because he had caught a cold. Experiment V. To George Tavener, a^ed forty, a robust healthy man, who hud been accustomed to drink freely of ardent spirits, I gave four grains of digitalis, ten minutes before seven o'clock, A. m. and before he had eaten any breakfast or drank any liquor: his pulse beat sixty-eight strokes in a minute. In 5 10 15 20 25 30 35 40 45 50 60 7V 80 90 100 minutes, Pulse beat 68 68 72 72 72 72 70 70 72 72 72 70 68 68 68 strokes. In twenty minutes he complained of vertigo; in forty minutes had some nausea; in sixty minutes his pulse was weaker than before the experiment; in eighty minutes he was very sleepy, which might in part have been owing to his sitting still, as he is general!y very active. Dur- ing the remainder of the day he had three copious d scharges from his bowels. He observed to me, that his sensations during the day were very similar to those he experienced after drinking freely of ardent spirits. I am induced to believe that these sensations were produced by the digitalis, from his making the observation without being interrogate!; nor was any idea of such effect hinted to him previously: they were not occasioned by spirits, because I cautioned him against drinking any during that day, and I could depend upon his veracity. Experiment VI. Twenty minutes after six o'clock, a. v. I gave to Thomas Maborough, a black man aged forty-eight, six grains of digitalis; his pulse beat ninety strokes in a minute, its natural standard. MOORE ON DIGITALIS. 203 In 5 10 12 20 25 30 35 50 55 60 70 75 80 85 95 105 110 120 130 lid minutes, P.b. 90 90 90 t>4. 86 84 84 82 84 80 80 79 79 78 78 80 79 70 70 70 strokes. In fifty-five minutes after taking the medicine, he was so sleepy that it was widi difficulty he could keep awake; in sixty minutes he had some nausea; in eighty minutes the ltuisea was increased, accompanied with pain in his stomach; in one hundred and twenty minutes the sickness abated and the pain descended from his stomach to the intestines; in two hours and a half he was perfectly well, and the digitalis did not increase any of the excretions. I £ave digitalis to the same man several times, in smaller doses, with exactly the same effects, only in a more moderate degree; it did not in any instance raise his pulse above the natural standard. Experim ent VII. Fifteen minutes before six o'clock, a. m. Dr. Enoch WTilson took three grains of digitalis, before he breakfasted. His pulse "beat sixty strokes in a minute, its natural standard. In 5 10 15 20 25 30 35 40 45 50 55 60 66 76 90 100 112 120 130 minutes, P. beat 60 60 62 64 66 68 70 70 71 72 68 68 68 68 68 64 62 60 60 strokes. In twenty minutes he felt some uneasiness at his stomach; in twenty- eight minutes his pulse was increased in force, and he had a sense of heat at his stomach, and vertigo, with a confusion of mind; in thirty-five minutes he had a sense of fulness in his head, and the vertigo continued; in seventy minutes his pulse was considerably weaker. Between sixty and one hundred minutes, he had an unusual degree of languor, with ver- tigo ; also, great thirst, which was very uncommon for him at that time in the morning. During all the experiments, and particularly those made on Dr. Wilson, great care was taken to avoid every circumstance that could have any influence on the circulation, and therefore motion was especially avoided. Experiment VIII. I took three grains and a half of digitalis, early in the morning, which raised my pulse eight strokes in fifteen minutes; and in fifty-eight minutes it was reduced ten strokes: its effects on my stomach were similar to the other experiments ; my pulse in fifty mi- nutes was fuller and stronger, and I had some pain in my head, which, however, soon went, off, I took several doses of digitalis and gave a considerable quantity to other persons, who were in good health, with results so similar to those above related, that I do not think it necessary to repeat them. I might here insert four experiments, which were communicated to me by my friend, Mr. Joseph Trent,* of Virginia, and which were con- * Mr. Trent bad chosen digitalis for the subject of bis Inau(rural Disserta- tion, but when be heard that I had also chosen it, he Very politely favoured me with his experiments, for which I wish him to accept of my acknowledgments. 204 MOORE ON DIGITALIS. ducted with gnat accuracy; but as their' events are very analogous to those I have made, it will not, I imagine,be considered as essential to detail them minutely; I shall therefore, refer to them presently, as if related. The opinions of physicians, relative to the operation of digitalis, were unanimous in favour of its sedative power, without regard to it;; primary effect; and it was considered as ^edative medicine, from the time of its first introduction into the materitrrnedica, until the winter 1798-9, when Dr. Barton taught, in his lectures, that notwithstanding all that had been said in proof of its lowering or diminishing the frequency of the pulse, he was induced to believe that it was a stimulant. My experiments, or at least, the first, second, fourth, fifth, seventh and eighth, lead to a very similar conclusion, and seem sufficient to establish the opinion a!x>ve stated. If we mean by a stimulant, a medicine which will always increase the force and frequency of the pulse, digitalis may not be entitled to that appellation; but, if I mistake not, there are mcdicines^Jenominatcd stimu- lants, or incitants, which will not, on every constitution and habit produce the same effect of accelerating the pulse. I am inclined to believe, that opium is one of these medicines, whose primary effect in particular con- stitutions, will be to depress instead of raising the pulse; and this opinion is very much strengthened by recollecting the notion which was so long maintained of its sedative properly. From attending particularly to the experiments of Dr. Crumpe, I do not iind the stimulating property of opium (as to the heart and arteries) so great, as some authors assert it to be; we find, for example, from his sixth experiment, that his pulse was only increased six strokes; in the seventh, the young man's pulse was increased six strokes'; in the eighth, his own pulse was increased eight strokes, and in the seventeenth, ten strokes; which was the greatest height it arrived at. If we attend to the fourth and seventh#experiments which I made with digitalis, we may observe, that in the former, my colleague's pulse was raised eight strokes in half an hour, and in the latter, twelve strokes in fifty minutes, from the time of taking the medicine. In the first and second experiments, my pulse was increased six strokes, and in the eighth, eight strokes. In the fifth experiment, George Tavener's pulse w.j> raised four strokes. The experiments of Mr. Trent, tend likewise to corroborate the idea of its stimulating power, for in the three first, his pulse was increased in frequency, and in the fourth, it was diminished in frequency, but in- creased in force. In the other experiments, it is true, that it did not raise the pulse, but in most of them an evident fulness was perceptible, during its primary operation on the sanguiferous system; and a very eminent author does not ascribe to opium any other effect on the arterial system, than that of MOORE ON DIGITALIS. 205 lessening the frequency, and increasing the fulness of the pulse; and yet this same author classes it among the stimulating medicines. There is little doubt, that a very considerable similitude exists between the operation of opium and digitalis; perhaps, as much as there is be- tween conium maculatum, nicotiana, ^hyoscyamus, datura, solanum and opium. Let us take a short view of their similar effects oh the living system. Opium increases the frequency and fulness of the pulse; digi- talis very frequently does the same. Opium produces sometimes an increased flow of saliva; so will digitalis. Opium produces profuse per- spiration; one of the patients in the alms-house, who took digitalis, had for the first three or four days, more copious perspiration than before. Opium is sometimes a diuretic; this is one of the most prominent effects of digitalis. Who has not seen opium in some instances prove laxative? Digitalis purged in several of the experiments,- when I gave it to the healthy subject Opium in a large dose, produces vertigo, confused vision,* thirst and stertorous respiration; the same effects follow large •doses of digitalis. Analogical reasoning is, perhaps, on no subject less tenable than on medicine; when the suppossed certainty or doubt of any one point, may prove destructive to many patients. If however, we were permitted to make use of it, we should derive great support from comparing our medicine with those which are allied to it by botanical affinity, and which are acknowledged to be stimulants: they were mentioned in the descrip- tion of the plant. From saying that in many respects the operations of opium and digi- talis are similar, let no person suppose, that I mean to attempt to ex- plain their operations on the nervous system. The former of these has employed the ingenuity of the most learned physicians for generations long since past; and notwithstanding all that has been done on this very interesting subject, much yet remains to do. Perhaps we may look for- ward for a satisfactory explanation of all'the peculiarities in the operation of opium, to generations or probably ages yet to come. With regard to the operation of digitalis, I am alike unqualified to offer any explanation. Some of the preceding experiments, and subse- quent cases, show very clearly, the wonderful power k possesses in cer- tain circumstances, of lessening the frequency of the pulse: the manner in which it does this must remain a secret, until physiologists acquire more certain ideas of the laws, functions, connexions and dependencies of the nervous system, and its influence over the arterial. i . • n * Jesse Scott, in tlie alms-house, complained very much of his sight being ijn- * $ peded during part of the time that he took digitalis. , '"'' 206 MOORE ON DIGITALIS. CHAPTER III. ON THE USE OF DIGITALIS IN DISEASES. If we attend to the history of digitalis, since it has been considered as a medicine, we shall find that from the sixteenth century to nearly the present period, it furnished a subject for applause to one practitioner, and for unqualified condemnation to another. It is somewhat extraordinary, that its diuretic property should have been so long overlooked; for no writer has noticed it, I believe, previous to the year 1770. Anterior to that time, they confined themselves principally to its use in epilepsy and scrophula; and in the latter of these it has been particularly famous. Haller mentions several hereditary instances of this disease, said to have been cured by it: six or seven spoonfuls of the decoction produce nausea, vomiting, and purging; not without some marks of a deleterious quality. The same author likewise mentions its use in gout and rickets,- in the form of ointment and in powder.* Ray and Boerhaave, mention its operation as generally deleterious. Dr. Withering, I believe, was the first physician who treated dropsies successfuljy with digitalis; and his practice is sufficiently confirmed by every practitioner who has used the medicine in the manner he directs; particularly in that species of dropsy called anasarca. Among other diseases, digitalis has been recommended in phthisis pulmonalis, or consumption of the lungs. Dr. Salmon, who wrote at the commencement of the present century, speaks of it as a specific in phthisis; and Dr. Withering has given us a manuscript note of a Mr. Saunders, found in Parkinson's Herbal, which mentions consumptions as infallibly cured by a decoction of fox-glove leaves in water, or wine and water, taken for constant drink. The doctor's opinion of it, notwithstand- ing his expressed wish that it may be farther tried in this disease, was cot, it is true, very encouraging; but it should be recollected, that even with him it succeeded in one case, (No. cxx.) that it relieved another, (No. xlO very far advanced, and that the remaining cases in which it was given by-.him were lost before recourse was had to digitalis. Dr. Darw|)i^nd Sir George Baker directed their attention particu- larly to its use in pulmonary consumption, but they were somewhat dis- appointed in their expectations. Within a few years our medicine has excited the notice of Dr. Beddoes, who tried it without much benefit; but two of his correspondents, Drs. Fowler and Drake have been much more successful with it. The. latter * Haller's Hist. Stirp;J|jfcen. Helvet. MOORE ON DIGITALIS. 207 of these gentlemen, (Dr. Drake) has communicated two cases to Dr. Beddoes, which the doctor has published in a work entitled, " Contri- butions to physical and medical knowledge." As these cases are accu- rately described, and appear to have been genuine phthisis, and as the books which contain them are very scarce, I shall take the liberty of giving as brief a detail of them as possible. The first case which Dr. Drake relates was of a Mr. James Marris, aged sixteen, who complained of considerable difficulty of breathing upon motion, and of pain in the right side: he had a frequent short cough, attended*vith a copious expectoration of what appeared, and upon trial, with the vitriolic acid and caustic alkali, proved to be in great proportion pus; it was dense, foetid, and occasionally mixed with blood: pulse one hundred and twenty, and the morning and evening exacerbations, especially the latter, strongly marked; great emaciation and prostration of strength; tongue clean; thirst not considerable; appetite not impaired; belly regu- lar ; sleep interrupted, and he could not lie with ease on his left side: slight perspirations towards morning; skin hot and dry; shivering fits every two or three days; urine high coloured. Had a hereditary pre- disposition to phthisis from his relations. He was evidently likewise of the form and habit which physiologists consider as predisposing to tuber- cular consumption. June 26th. Pulse still one hundred and twenty, with great debility, and the symptoms increased. He took the following prescription. ft Foliorum digitalis purpurea in pulverem crassum trit: unc: I. spi- ritus vini rectificati et aquss punc a a unc. ii. Digere leni calore, s:cpe agitans per horas xxiv, et cola. ft Kali p. p. scrup: i. Succi limonis unc: ss. Aqux purx drachm: vi. Tinct: digitalis purpurea: gtt. xv. Fiat haustus primo mane et horis duabus ante prandiuiu sumendus. Ordered a little wine and animal food. He continued this medicine gradually increasing the tincture of digitalis until the 5th of July, when his pulse was reduced to seventy-six; and all his symptoms mitigated. ft Infusi cinchonee unc: 1. ss. Acidi vitriolici diluti gtt. x. Tinct: digitalis purpur: gtt. xxxv. ,. Fiat haustus mane et meridie sumendus. July }7fi- He took fifty drops of the tincture twice a day, with more wine and animal food: his pulse was reduced to forty-four; expectoration was very much diminished, and lie was in every respect much better. 208 MOORE ON DIGITALIS. Julv 22d. Pulse forty, intermitted after every third stroke; doses of the tincture diminished to forty drops twice a day. His pulse continued at fortv and from that to fifty until the 15th of August, when it had not been beyond fifty for better than four weeks. From that time he took the infusion of Peruvian bark with quassia, elix. vitriol, and the tinct. of digitalis: his pulse gradually returned to its natural standard, every symp- tom disappeared, and he was on the 29 th of August in all respects perfectly well. The second case. September 10tli, 1797. Mr. George Grimes, aged nineteen, complained of very acute pain in his right side, vdiich was increased by expectoration; he had incessant cough, and great difficulty of breathing, accompanied with frequent expectoration, which was evi- dently purulent, and very fetid. Pulse one hundred and twenty, and hard; complexion very florid; tongue foul; thirst great; appetite mucli impaired; body regular; urine high coloured and depositing a copious sediment; little or no rest; frequent shivering fits, and his heulth was rapidly declining. He had been liable for many months to slight pul- monary complaints, as cough, hectic flushings, and occasional expecto- ration. His father, mother and sister all died of phthisis pulmonalis. R Kali p. p. scrup: i. ' Succi limonis q. s. Lactis amygdui: unc : i. Tinct: digitalis purpur: gtt. xx. Fiat haustus mane et meridie sumendus. R Mucilaginis sem. cydanii mali et aqux cinnam: unc: iii m. et sumat cochleare largum urgente tussi. On the 18th of September, his pulse was reduced to fifty, and he was in every respect much better. Ordered a decoction of Peruvian bark and diluted vitriolic acid, with the tincture of digitalis. On the 19th, pulse forty-eight; 29th, pulse forty-four. He relapsed on the 9th of October, and his pulse rose to one hundred and eight; but by the 19th, he was "again restored to health, and his pulse fifty: he was flowed animal food, wine and porter, and continued in good health. In the first of the above cases, not any sickness was induced during the whole course of the cure. In the second cr.se, a sickness and vomit- ing came on when the tincture was increased to forty-right drops twice a day; but these symptoms readily disappeared when the medicine was omitted for a short time. In Mr. Marris's case, one day when his pulse v/as below fifty, from a wish to ascertain the result, the two doses of the tincture were omitted, and his pulse next morning beat one hundred and twelve; whereas in Mr. Grimes's case, though the digitalis was entirely omitted on the 2-ith of September, in consequence of the nausea, and on the 2 of October, the pulse had not risen beyond forty-right. MOORE ON DIGITALIS. 209 DoctoV Fowler has also related several cases of phthisis, in which he gave digitalis with great benefit i he declares that he had better success than a priori he had reason to expect. The following case was communicated to me by my very worthy preceptor, Dr. Wistar; I will relate it in his own words. " A young gentleman about twenty-one years of age, who had lost a brother and several relations with phthisis pulmonalis, was attacked with a severe catarrh.in the West-Indies, in consequence of exposure to cool air, during sleep. About two weeks after the commencement of the disease, he arrived at Philadelphia, affected with fever, great dyspnoea, and freguent cough, his pulse full and much irritated. " In consequence of the usual antiphlogistic treatment, the cough was removed, and the dyspnoea, diminished in a small degree, but the pulse remained in a state of extreme irritation. Evacuations and diaphor- etic remedies, had no effect but that of reducing the strength of the pulse, for the frequency and quickness continued Undiminished during several weeks, in which- time his muscular strength declined, so th^t he was unable to sit up more than half an hour in the day, and he became ex- tremely emaciated; his skin being very dry, the cuticle peeled off from the palms of his hands and the soles of his feet. It is however to be • remarked, that he had neither chills nor sweats, and that although he was not fiee from uneasiness about the thorax, the sensations were so obscure that he could not describe them. In this situation, I began the use of digitalis, and exhibited the powder of the leaves, made into pills with conserv. rosarum. In doses of two grains, it affected the stomach and bowels; but he took four or five doses of one grain each, during twenty- fqur hours, without inconvenience. After taking about forty grainsjn this manner, his pulse became much less frequent, and the irritation and quickness went off entirely; in a few days it became unusually slow and irregular, and by the steady use of digitalis, varying it from three to eight doses in twenty-four hours, it was kept in this state. In the course of two weeks, he perceived 'himself much stronger, and the'uneasy sensations about the breast were' gone; his flesh had also increased: being greatly encouraged by these circumstances, he persisted steadily in the use of the medicine, and by the end of three or four weeks more, walked at his ease about house, rode out, and appeared like a convalescent, labouring only under the debility induced by previous disease. Soon after this he 'went into the country, and, in consequence of nausea, from redundance of bile, discontinued the medicine suddenly; this alteration produced no change in his health, and I have been informecl that he is now perfectly well, having omitted the medicine for two months. His diet consisted of milk and vegetables: the pulse continued irregular, during the whole time of the exhibition of the digitalis, varving from thirty-five to seventy 2 K 210 MOORE ON DIGITALIS1. in the minute, and never appearing to beat at the same rate during one minute." In the Philadelphia alms-house,.where a number of patients are admit- ted annually, with phthisis pulmonalis, and consequently a considerable number fall victims to that unconquerable disease, a medicine which has been used successfully even in a few instances, demands particular atten- tion ; accordingly, the digitalis was exhibited in several cases of phthisis, since last February. I shall relate a few of these cases, but do not think it necessary to detail all the symptoms of each .case: 1st, because they would occupy more space than the limits of this dissertalftn would admit of; and 2dly, because the physicians of the bouse saw them, and had no hesitation in pronouncing them confirmed phthisis. CASE I. Eleanor Wells, aged forty, was#admitted hito the alms-house, as a patient, on the 15th of February, 1800. The history which she gave of her case *vas the following: at the commencement of (he winter season She was attacked with pleurisy, for which she was bled twice, and took some medicine which relieved her' considerably, but not entirely; owin^ • as she supposed, to her being obliged to spend a great part of her time in a damp cellar. She, however, so far recovered as to be able to attend to the duties of a small family, but was harrassed constantly by a cough and pain in her breast. In this state she remained, till about eight weeks previous to her. admission, When all the symptoms were greatly increased. When Dr. Wilson saw her, she complained of a fixed pain immediately under the sternum; had a very troublesome cough, accompanied with a copious expectoration, of a substance which appeared to the eye to con- sist of pus; great heat of the palms of the hands and soles of the feet, together with profuse night sweats; flushed cheeks in the afternoon; chills and fever, which however, did not observe the stated periods, that a true hectic commonly does. When Dr. Church visited her, which was soon after her admission, from the above and other circumstances relative to her case, he believed that she laboured under genuine phthisis, and ordered her to take a grain of the powdered leaves of digitalis three times a day, and a blister to be applied to the breast. After the use of these remedies for a few days, she was much relieved; the medicine was therefore persisted in, and the dose gradually augmented to two grains three times a day, beyond which it was never carried, for the sickness induced by it was so distressing as to forbid more. The medicine was continued till the latter end of March, when she no longer complained of the pain of the breast; her cough and night sweats were gone, and in short, every unfavourable symptom had disappeared, and she only remained debilitated, for which she took a decoction of Peruvian bark; MOORE ON DIGITALIS. 311 was allowed a-little Mine and animal food, which completely restored her to health, and she was discharged cured, on the 14th of April following.* # It must be remarked, that the above mentioned woman lost about twenty ounces of blood at three bleedings, during the time of her taking digitalis, and took occasional laxatives ;• these remedies, no doubt, aided the digitalis in effecting a cure. A constant effect of the medicine was to produce sickness at stomach, which she complained much of; but the relief she experienced was so great, that she was very willing to continue it; it also produced languor and a great degree of debility. * CASE II. John Potter, aged twenty-five, was affected in the summer of 1799, with a pain in his spine, and a derangement of one of the dorsal-vertebrs, which was succeeded by a paralysis of his lower extremities. July 25th, 1799, he was admitted into the alms-house, and treated for a diseased spine. In October following, he was seized with a violent pain in his breast, burning in the palms of his hands and soles of his feet, flushing! of his face, night swe*ats, &c. He was bled several times and blistered, and used some other remedies, Which relieved him for some time. February 17th, 1800. All his symptoms having very much increased, so as to become a genuine phthisis far advanced, he was ordered to take one grain of digitalis three times a day. February 24th. The medicine was increased to one grain and a hal£ three times a day. He continued this until the 24th of March, with some benefit, but it was then omitted on account of a diarrhoea, which super- vened at that time; and he was ordered to take a cretac. mist. April 2d. His diarrhoea was relieved, but all his pulmonary symp- toms increased; pulse eighty and quick, with some hardness; he was. ordered to take four grains of digitalis daily. The medicine not being very good, it was increased gradually without any very material change, excepting a diminution of the cough, until he took twenty-three grains, in a day; this quantity produced very distressing sickness during.the succeeding night; and his urine, which was before slightly increased, was then diminished in quantity; his pulse as before; cough better. April 8th. Pulse eighty, very full and strong; complained of vertigo, and drowsiness. He continued to take from four to six and eight grains of stronger digitalis daily, as his stomach would bear it, till the 15th, when his pulse was seventy-four, softer and less quick; perspiration at night diminished; cough not troublesome; expectoration diminished * This woman sahl that Irer parents antl^roral of her ralatLiis died of con- sumption. 212 MOORE ON DIGITALIS. from n quart of fluid, evidently purulent, down to half a pint in twenty- four hours. April 16th. Pulse seventy-eight,* soft and regular; he rested well last night; less perspiration; cough better. Ordered an infusion of Peruvian bark with the elixir of vitriol, and one grain of digitalis, three times a day. He continued the medicine with an abatement of all his pulmonary com- plaints, till the 21st, when his pulse was but fifty-four, full and irregular; continues the infusion of bark, &c. April 22d. Pulse forty-eight, irregular with an intermission after every third stroke; continues the medicine. Ordered a glass of sherry wine three times a day; in the evening of the sa»ie day, his pulse rose'to one hundred;* has taken two doses of the infusion, says he is better. April 24th. Pulse fifty-two; had a violent pain in his face and jaAv, which was induced by taking cokl. April 25th. Pulse forty-eight, irregular; continues the wine and digitalis; in every respect much better; appetite good; no cough; ex- pectoration diminished to a gill in twenty-four hours. April 26th, Pulse seventy-two, small; the -pajtiin his face and jaw has returned. Ordered a blister, which very much relieved him; con- tinues the digitalis. May 3d. Pulse sixty-six, soft and regular; has not had any pain in his breast for more than three weeks; no burning in the palms of his hands; »cough entirely gone; expectoration amounts to three table-spoon- fuls in twenty-four hours. He v/as this day discharged from the alms- house to go into the country: he took a quantity of digitalis in order that he might omit it gradually. I have not heard from hum since he was discharged, but think it very probable, if he can use muderute exer- cise, his pulmonary disease will be entirely cured. CASE III. Jesse S«ott, aged forty-three, was admitted into the alms-house on the 7th of April, 1800. About two months before, he was attacked with pneumonia, for which he had no medical assistance, and took nothing but two small phials of medicine; he did not know what they contained. Since that time he has had a very distressing cough, which is now ac- companied with a very copious expectoration, amounting to three pints of fluid, mixed with pus, in iwenty-ibur hours; occasional flushings and chills; burning in his hands and feet; nifjl'.t sweats; pain under the right scapula; very much emaciated; his belly regular; tolerable appetite. April 9th- His pulse ninety-two; ordered the following medicine: * I examined the pulse morning ar.J evening, of die cases w herein I n»ci:tir>n itc effects on the pulse, but cannot be so minute as to detail them all. MOORE ON DIGITALIS. 213 R Sal sod: scrup: i. Tinct: digitalis saturat: 'gtt. xv. Aqux cinnam! unc: ss. Fiat haustus mane et meridie sumendas. April 13th. Pulse eighty, hard and quick; very profuse perspirations at night; expectoration still very copious; body regular; he is able to walk across the ward, but with great difficulty. Ordered to continue the draught, increasing the tincture of digitalis five drops* every dose. April 16th. Took one hundred drops of the tincture yesterday, at two doses, pulse eighty; passed a restless night; complains of griping-; ex- pectoration and cough better. Ordered to take fifty drop* of tincture twice a day, -without any of the soda. April 17th. Pulse eighty; griping more severe accompanied with some diarrhoea; cough better; expectoration greatly lessened. He took a dose of the oleum ricini, which relieved the griping, and he took like- wise a dose of the tincture at noon. April 18th. Pulse eighty; complains of great pain in his belly, with nausea and diarrhoea. Ordered to take one grain of opium immediately, which relieved him. April 19th. Ordered to take forty drops of the tincture twice a day, and increase it as before. April 20th. Pulse eighty; has taken fifty-five drops of the tincture at a dose; pain under the scapula better; very profuse perspirations at night; cough still better; appetite good. ' April 21 st. Pulse fifty-one, full and irregular with a pause after every sixth stroke. Other symptoms as yesterday. April 22d. Morning, pulse eighty; rested well last night; perspira- tions very much diminished; takes sixty drops twice a day; complains of vertigo and drowsiness after taking the medicine. Allowed a little animal food. April 23d. Pulse fifty-four; has considerable nausea; complains of his vision being obstructed, and says he has had more or less of it for three days past; it comes on at ten o'clock in the morning, and goes oft" between three and four in the afternoon. April 30th. Pulse sixty; takes fifty drops of the tincture twice a. day. May 11th. Pulse varies from forty-six to seventy-eight; has no ob- struction in vision; expectoration diminished to about a gill in twenty- four hours; no night sweats; very little cough; in short, he is so much bettef, and his strength has so much increased, that there is good reason to expect he will be perfectly restored to health. The above cases shew very decidedly the wonderful dominion which digitalis possesses over the heart and arteries; and also that phthisis 314 . MOORE ON DIGITALIS. pulmonalis, even when confirmed, is not as it has been generally consi- dered, necessarily an incurable disease. Digitalis was exhibited in several other cases of phthisis with mani- fest advantage; its good effects were especially remarkable in relieving the cough, and diminishing the expectoration; these cases, however, have all relapsed, and will probably fall victims to the disease, except one, who was lately discharged very much relieved; but as he used other remedies, we could not ascribe the whole of the benefit he experienced to digitalis alone. I am very far from being of opinion that digitalis ought to be con- f idered as infallible, in cases of pulmonary consumption; but that it may be regarded as a very proper remedy in some cases, and is worthy of attention in every one, few I think will deny. AN INAUGURAL DISSERTATION ON THE UNITY OF DISEASE, AS OPPOSED TO NOSOLOGY. SUBMITTED to the examination-of the REVEREND JOHN EWING, S. T. P. PROVOST; THE TRUSTEES, AND MEDICAL FACULTY OF THE UNIVERSITY OF PENNSYLVANIA. OX THE THIRTY-FIRST OF MAY, ONE THOUSAND EIGHT HUNDRED. FOR THE DEGREE OF DOCTOR OF MEDICINE. ry Alexander may, of Pennsylvania. " E PLURIBUS UNUM." INAUGURAL DISSERTATION. THE unity and simplicity of nature, in all her operations, is obvious to every judicious observer. The nearer we approach to truth in exploring the phenomena of the universe, the greater identity and uniformity we discover; and the more complex our notions, the more the mind becomes enveloped in error. The frugality ef nature is conspicuous in all her operations; where one agent is sufficient to affect her purpose, she never uses more. The motions ofthe heavenly bodies, the change of seasons, the suc- cession of day and night, the tides, winds, and the different phenomena of motion, were most absurdly explained, till one single power was discovered to be the sole governing principle of them all. The science of chemistry affords many proofs of this law of unity and simplicity existing throughout the works of nature. A few elementary substances are found to be the basis of all the various forms of matter which compose the universe. All life, animal and vegetable, however variously modified, is the effect of one agent, viz. stimulus. Health and disease, are effects of the same - agent, differing in degree. The simplicity of nature's operations often prevents their being seen. Men in their investigations extend their views beyond the simplicity of truth, and consequently become lost in error. The circulation of the biood was long a mystery; but its simplicity appears to have been the only cause of its obscurity: and the physiology of the nervous system, the arcanum of the present day, probably lies concealed under the same simplicity. Some have become infidels in religion, from no other cause, than that truth was too simple to be believed. The same cause makes men infidels in the science of medicine, by leading them beyond the simplicity of nature for the cause of disease." I. Disease is simply% morbid excitement, or wrong action; or, in other words, it consists in a morbid state of the system, in which some of its functions are carried on in an uneasy and irregular manner. This morbid excitement, whether it exist in the form of convulsive action, suffocated action, &pas?n, itching, or heat, is the same thing, and all 2 k 218 MAY ON THE UNITY OF DISEASE. these are effects of different degrees of force in the remote, or exciting causes, or of the difference of organization in the affected parts; they all, moreover, occur at different times, under different circumstances of treat- ment, in the same form of disease; as in gout and yellow fever. From an ignorance of the unity of disease, physicians have fabricated a nosology, dividing disease into as many different diseases as the various forms in which it appears; and arranging them into different classes, orders, genera and species, according to their various causes, seats, or symptoms. Nosology, or a history of diseases, has long engaged the labours of physicians. The ancient Greek and Roman physicians began the attempt. Since them, Platerus, Sagar, Sauvages, Sydenham, Baglivi, Linnxus, Vogel, Cullen, and others, have laboured to bring it to perfection; but all to very little purpose. " All of the attempts," say the learned and ingenious editors of the Medical Repository, " to arrange morbid affections, have been exceedingly imperfect, and it is likely they will always remain so. We suspect there is a radical difficulty in all these nosological attempts, which it is impos- sible to remedy; and that is, that nature has not distinguished symptom from symptom, in diseases, with the same exactness, by which plant differs from plant; or one animal, or mineral, varies from another; but, on the contrary, has interwoven the tissue of diseases by threads which are inextricable, but by a more correct and scientific acquaintance with their causes." It is impossible to divide diseases, or give them names which can delineate with any accuracy their different natures, from the different forms of morbid action. i Cullen's pyrexia, would lead us to believe, from the definition of the word, that this class of diseases* is always attended with a preternatural degree of heat, which is not the case, as all the different orders of this class frequently appear with a temperature of the body, that is natural, or preternaturally cool. Yellow fever is a name given to specify a particular form of disease; but the symptom from which it derives its name does not occur oftener, perhaps, than once in twenty cases: here we are liable to be deceived nineteen times in twenty by the name. Fevers have been called intermittent, remittent, &c. by way of dis- tinction ; but these names are not characteristic of any particular form of fever; as the symptoms by which these are designated, occur more or less in all forms. Thus the impropriety and uncertainty of naming. * The plural number is used in conformity to custom. MAY ON THE UNITY OF DISEASE. 219 disease, from any form whatever, might be shewn, did it not seem like an attempt to illustrate what must already appear self-evident. We might as well expect to comprehend the nature of a storm, by attending to its various forms, and distinguishing them by hard names, as to divide fevers by their remissions or intermissions. II. Diseases have been divided from their remote causes; but this is improper, as they all act more or less in one way, viz. by stimulus. Dr. Brown says: " All stimulant hurtful powers, are participant, but of one effect." Poisons, intemperance, opium, external violence, mias- mata, contagions, vicissitude of heat and cold, and passions of the mind, all produce diseases so similar, that the most discriminating nosologist could not distinguish them. The poison of the viper produced a disease so much like a pleurisy, that Dr. Tennant was induced to administer the same remedies in the cure of both. Intoxication, in the fall of 1799, produced a fever with violent con- vulsions, delirium, and inability to stand or speak. The cure was the same as if marsh miasmata had been the remote cause. The loss of a pint of blood, restored the patient to the use of his feet, speech and reason. A case of fever from opium, occurred in 1798; the remote cause not being known, it was suspected to be yellow fever: the face was flushed, the eyes inflamed, the pulse high; by copious bleeding, purging and blistering, the patient recovered, and acknowledged the remote cause to be a draught of laudanum. Heat and cold, in the extreme, produce similar effects; inflammation, vesication, and pain, are the common effects of both.* Bilious fever and pleurisy, have different remote causes; but they have symptoms exactly similar, and are both cured by depletion, which proves that they are the same disease, for even Dr. Cullen admits that " disorders, which are cured altogether by the same remedies, are of the same nature." The fever succeeding a broken bone, surgical operations, as lithotomy, amputation and trepanning, has the same symptoms as pleurisy and bilious fever, and is cured by the same remedies The remote cause of small-pox, though different from any other, produces the same symptoms that occur from other remote causes. * The similar sensation produced by the f/igorifc mixture, to that of heat, was experienced by a number of the chemical class, as \\\*M as myself, last winter, when the brilliant experiment of freezing mercury, was performed by the indefatigable and accurate chemist, Dr. Woodhouse. The cold produced, caused the mercury in the thermometer to fall sixty degrees below o; and the mixture felt like coals of fire. This experiment was never performed before in Ameriea. 220 MAY ON THE UNITY OF DISEASE. " The small-pox and measles, are cured by the same means as peripneu- mony, or any other sthenic disease," says Brown. And " disorders which are cured altogether by the same remedies, are of the same nature," says Cullen. In the present month, a middle aged man, of a robust habit, was taken ill, with every symptom of a highly malignant fever, at Chester in this state; he had drunken spirits freely through the day; was bled a quart in the evening; purged; bled next morning, purged again. The remote cause was unknown, till the small-pox made their appearance. Three days afterwards, he walked out, and complained only of pain from the eruption. In the same way, physicians often prevent death, from the small-pox, by mistake, without a knowledge of the remote cause, or the name of the disease. That the cure of small-pox, is the same as of other diseases, is proved by the success of the present mode of inoculation. By the abstraction of stimulus, Ave as certainly lessen the malignity of small-pox, as if marsh miasmata had been the remote cause; and by the addition of any stimulus, we as certainly aggravate its symptoms. Even the eruption, which is its specific characteristic, may be prevented by copious depletion. The pustules are the mere effects of the disease. Erysipelas, miliaria, shin- gles, nettle-rash, phlegmon, abscesses, cancers, buboes, scrophulous and scorbutic ulcers, are all local affections, induced by fever. They are not diseases, but disorders, the effects of disease, and mere accidental circum- stances. " Eruptions, are fevers translated to the skin; the prickly-heat, the rash, and the essere of authors, are all states of misplaced fever."* Sydenham calls dysentery, febris introversa; we may with the same propriety, call eruptive fever, febris extraversa. This variety in the effects of disease, is nothing more than pervades all nature; but cannot affect the unity of disease, which depends on unity of cause, and unity of cure. As many different remote causes, produce similar effects at one time, so at another time, one produces the different effects of all. The same stimulant power supports life and health; and, in a different degree, causes disease. The same remote cause produces effects directly dissimilar: what is more so, than the cold and hot fits of ague? The various symptoms of bilious fever, caused by marsh miasmata, afford a proof of the same tiling; these are apoplexy, coma, convulsions, rigor, sore throat, hoarseness, giddiness, faintness, delirium, pain in the head, eye-balls, back, hips, limbs, neck and ears, nausea, vomiting, burning in the hands and feet, hxmorrhage from the nose, mouth and * Dr. Rush's Inquiries and Observations, vol. iv. MAY ON THE UNITY OF DISEASE 221 bowels.* These are all symptoms of but one disease, and Cullen says, " that some similarity of the cause, argues a similarity of disorder pro- duced by it." A physician of a neighbouring village informed me, that the cold of last January, produced, in the course of his practice, pleurisy, rheumatism, gout, apoplexy, palsy, nephritis, haemoptysis, quinsy, pneumony, ophthal- mia, hemiplegia, catarrh, stricture in the urethra, and cynanche trachealis, and that depletion cured them all. These could not be different diseases, for they arose from one cause, and were cured by one remedy. A noso- logist would have attempted to find names for all these different symptoms; which would have been as useless in leading to a proper mode of treat- ment, as a knowledge of the names of the different persons affected. The venereal virus seldom affects different persons in the same way. One is affected with gonorrhoea, another with chancres, some with buboes, others with phymosis, and chordee; whilst many receive no injury, who have all been equally exposed to the same infection. All these different effects also occur in the same person, at different times, from the same cause. Inflammation appears in different forms, as phlegmon, gangrene, and scirrhus. The two latter are only effects of the former; and the differ- ence in form is caused by different modes of treatment, the susceptibility of the parts, and the different degrees of the cause producing them. Pleasure and pain are both the effects of one cause, differing in de- gree. Thus, friction when gentle gives pleasure; when violent, pain. So heat, in cold weather, produces both, according to the quantity applied; and cold in hot weather has the same effect. So uniform is the power that produces disease in its operations, that could we ascertain the force of the acting power, and the strength or susceptibility of the system acted on, we might almost with certainty predict the final issue of disease. When we see effects so similar, from causes so different, and when we see these effects removed by the same mode of treatment, we con- clude with Dr. Cullen, " that disorders which are cured altogether by the same remedies are of the same nature." When we see effects so different, produced by the same cause, we also conclude with Cullen, " that some similarity of the cause argues a similarity of the disorder produced by it." And our final conclusion must be, that all the remote causes, however various, unite in their operations, and produce but one disease, viz. morbid action. III. Diseases cannot be divided from the predisposing cause; it is a unit, viz. debility; or a derangement of the equilibrium of excitement * See Dr. Rush's account of bibous fever, vol. i. 222 MAY ON THE UNITY OF DISEASE. and excitability, which is the standard of health. This derangement is induced by the power of the remote cause. When it operates feebly on the system it only induces debility, and the power of the exciting cause is necessary to produce disease; hence debility is not disease, but its pre- disposing cause. IV". Diseases have been divided from the exciting cause; but these have on!y one mode of action, and are reinforcements to the remote causes acting by the same stimulant power on the accumulated excitability, and producing the /iroxinmte cause of disease. V. Diseases have been divided from their proximate cause; but this is improper, for the proximate cause is a unit, viz. morbid excitement or the disease itself; and as disease which is caused and cured in the same manner, is a unit, so must the proximate cause be a unit; but out of (his one disease, Cullen has fabricated one thousand three hundred and eighty-seven different diseases, for many of which he gives a different proximate cause; his-success in this attempt may readily be imagined, from his unfortunate choice of spasm for the proximate cause of fever. Says Cullen again: " But as medicines are only applied to diseases for the purpose of removing the proximate cause, it must necessarily be, that disorders which are cured altogether by the same remedies are of the same nature." Here the proximate cause and nature of the disease depend' on the success of the medicine. If bark and wine do not cure the remittent and intermittent fevers they are necessarily diseases of different natures, with different proximate causes; but when depletion cures them both, they become one, and when bleeding cures yellow fever, bilious fever, gout, and small-pox, of necessity they become diseases of one nature, with but one proximate cause. Since the mode of cure has been found to be a unit, the number of drugs is reduced in our shops, prescriptions are less complex, and the whole science is rendered more simple and intelligible. A student now may acquire more useful knowledge in a few years, where simplicity and unity are taught, than in an age in the schools of the nosologists. Here we have theory founded on the firm basis of reason and experience, and facts to prove the truth of our theory. VI. Nosologists have even given different names to diseases from their different seats. Pain in the head is called cephalalgia; in the ears, otalgia; in the teeth, odontalgia; in the limbs, rheumatism ; in the feet, gout, and in the side, pleurisy. We might with the same propriety give different specific names to clouds, from the different parts of the hemis- phere they occupy. Spasm in the glottis is named croup; in the bowels, colic; in the lower jaw, tetanus; in the limbs, cramp; in the extreme vessels, Cullen's proximate cause of fever. MAY ON THE UNITY OF DISEASE. 223 Eruption on the face is erysipelas; on every part but the face, mili- aria ; on part of the body, shingles; on all the body, rash, prickly-heat, and hives. These are all symptoms or effects of disease, determined to a weak part. To divide these different forms into different genera and species, or to call them by different names every time they change their »eat, is as absurd, as to say a man changes his species whenever he changes his situation, or to call him by a different name every time we meet him in a different place. Inflammation in the brain is named phrenitis; in the liver, hepatitis; in the kidneys, nephritis; in the stomach, gastritis; in the intestines, enteritis; in the lungs, pneumony; in the eyes, ophthalmia; in the schnciderian membrane, coryza; in the trachea, cynanche trachealis, and in the tonsils, cynanche tonsillaris. All these would be treated differ- ently by a nosologist, according to their names and situation; as if fire which breaks out in the kitchen were specifically different from that in the parlour, and required different applications to extinguish it; but fire is still the same thing, and the simple article water, extinguishes it with equal success in every part. The form of nervous fever, which is called typhus gravior, is repre- sented as being a specific disease; but it is found to be peculiar in nothing but in degree; which instead of being of the lowest, as has been sup- posed, is of the highest inflammatory type. It occurs in confluent small-pox, which is the highest grade of this form of fever. We often find the pulse raised by blood-letting in this fever, from a low typhus to a violent synocha. When the system is stimulated to the extent of its power, it succumbs under the load of greater stimulus and is prostrated; the pulse is depressed; but depletion relieves it, and permits it to act again with violence. A patient in this form of fever could not sit up for weakness; his physician desired his pupil to bleed him; he lost thirty ounces of blood, and large bleedings frequently repeated restored him to perfect health. Dr. Brown mentions a desperate case of typhus gravior cured by bleeding, which he says puzzled him; and similar cases often occur, which are cured by bleeding, to the utter astonishment of all Bruncnians and nosologists who have never experienced the happy effects of it in this form of fever. Those who distinguish diseases from their effects or symptoms, are under the necessity of changing their names as often as the symptoms vary; but, says Cullen, " characters in nosology ought pot to be usurped by any means, till after a long continuance of the disorder; perhaps not till it is finished! To name a disease after it is finished! Are these the words of the illustrious Dr. Cullen? How great the absurdity 224 MAY ON THE UNITY OF DISEASE. of nosological arrangement, to produce such a declaration from so great a man! Delenda est nosologia! To specify the genera and species of disease from the effects or symp- toms, is impossible; because many which are said to be of different genera and species, have symptoms exactly similar. Hysterical and hypochondriacal symptoms frequently occur in gout and malignant states of fever. Small-pox and stcne are both attended with symptoms of nephritis; and the same disease often affects all parts of the body, as the gout; yet none call it by different names; it is still gout, whether seated in the head, stomach, or extremities. All the different symptoms of disease are but varieties of the same thing. The same cause seldom produces similar effects in different constitutions, nor in the same con- stitution at different times; and the same disease appears with different symptoms in different countries, among different nations, and in different climates and seasons, affecting all variously. As when a hurricane in- vades the oaks of the forest, all feel the shock, and each one stands, or falls, or breaks, or bends, according to its strength: would a nosologist divide the cause of this storm into genera and species, from its different effects ? To prescribe for the symptoms of disease leads to a most absurd mode of practice. If a patient, after amputation, complained of an itching or a burning sensation in the foot, would a nosologist call it gout, and recommend warm flannels to be applied to the part affected ? If it is improper to specify the nature, genera, and species of disease, from the effects or symptoms, nosology is entirely hypothetical; because, on these is founded the whole nomenclature of diseases. It is contrary to the nature of things, that effects, essentially different, can arise, ctsteris paribus, from one cause. Effects from the same cause may vary in form, but can never change the nature of the cause. Animals and vegetables may change their appearance; but their nature, genera, and species, remain unchangeable. Animals have never imparted their specific characters to others of a different class; but one disease runs through the different classes, orders, genera and species of all, and all again unite in one. Hysteria, the Proteus of disease, appears in almost every possible form; and all the different forms of disease, appear in gout. Consumption is often transformed into head-ach, rheumatism, diarrhoea, and mania; and phrenitis, nephritis, gastritis, and enteritis, are frequent symptoms of yellow fever. Were we thus to examine all the diseases of Cullen's nosology, we should not find a single symptom, in any one disease, which had not occurred in diseases of a different name. The changeable forms of disease render them incapable of division into genera and species, or of being designated by any unchangeable character. All MAY ON THE UNITY OF DISEASE. 225 the different forms must be taken for a- whole; as soon as a division is attempted, the whole is thrown into confusion. « These forms," says my preceptor in medicine, " should no more be multiplied into different diseases, than the numerous and different effects of heat and light upon our globe, should be multiplied into a plurality of suns."* If the classification of animals and vegetables; substances possessing uniformly the same properties, is still imperfect and uncertain; if the line of distinction between animate and inanimate matter, is yet undeter- mined, how absurd is it in nosologists to attempt a classification of dis- eases, which are ever varying their seats and forms ! Nosological arrangements of diseases have rendered the science of medicine incomprehensible, by unmeaning names, which are never understood, nor exemplified in practice; they have seduced the attention of the physician from an exclusive attention to the state of the system; they have crowded the science of medicine with mysterious diseases, such as opprobria medicorum, diseases sui generis, and a long class of incurables, all of which have originated from nosology, and are only to be removed by adopting the unity of disease. " To pronounce a disease incurable, is often to render it so. The intermittent fever, if left to itself, would probably prove more frequently, and perhaps more speedily fatal, than cancers."f " The want of success in the treatment of those diseases which are thought to be incurable, is occcasioned in most cases, by an attachment to such theories as are imperfect, or erroneous."! Consumption, dropsy, gout, rheumatism, and cancers, were long con- sidered as incurable; but since these have been found to be only different effects of one primary disease, they have all yielded to the same mode of treatment. The unity of disease, abolishes the whole class of incurables, and gives the greatest encouragement to believe, that what is practicable in one form of disease, may be accomplished in every other. A conviction of the truth of this principle, encourages the physician to persevere in the use of remedies; and renders him capable of administering to his patient, hope, at once animating and salutary. Many patients have been abandoned by their physicians, from the iiotion of the disease being incurable; some of whom were afterwards cured by nature, accident, or quacks: and others suffered to fall victims to a disease, which probably might have been cured in a few days, had it never been distinguished by a place in nosology. * Dr. Rush's Medical Inquiries and Observations, vol. ir. + 11/id. vol. L I Ibid. vol. ii. preface. 3 G 226 MAY ON THE UNITY OF DISEASE. The names of diseases have often been the cause of their proving fatal, by leading the nosologist to treatment contrary to the state of the system. A case of what is called yellow fever, with depressed pulse, by a nosologist, is named typhus gravior; bark and wine are administered, which generally hasten the termination of the disease in death. Another case of the same form of fever, appears with the symptoms of what has been called worm fever: pink-root tea is prescribed for it, which is as effectual in checking the progress of the disease, as it would be in calming the ocean. If the yellow fever were to receive different names from the different seats and forms in which it appears, it would nearly monopolize all the names in Cullen's nosology. To treat all these forms differently, accord- ing to their names, would cause such diversity, perplexity and uncertainty in practice, as to render it also an incurable disease. Nosology is the nurse of empiricism. Were physicians obliged to prescribe for the state of the system, without naming the disease, or if the Chinese custom of prescribing, from feeling the pulse only, without seeing or conversing with the patient, were imposed on physicians, exclu- sive empiricism could no longer exist. Persons inattentive to the state of the system, would not attempt to cure what they were ignorant of, and men of science only would be consulted by all ranks of people. The notion of a specific difference in the nature of disease, probably gave rise to the ridiculous practice of specific remedies. Black cat's blood for the cure of shingles; mare's milk for the hooping-cough; sheep's saffron for the small-pox; flower-water for the dropsy, have all been prescribed by the most learned physicians of the last century ; they were the offspring of nosology; they have all perished; may nosology speedily perish with them, never to revive again! Nosology is the ignis fatuus of medicine ; it is only seen in darkness; and whilst we pursue the fleeting phantom, it flies with equal speed, or finally leaves us plunged deeper in obscurity. " To describe diseases by any fixed or specific characters, is as impracticable as to measure the dimensions of a cloud in a windy day. Much mischief has been done by nosological arrangements of diseases. They erect imaginary boundaries between things which are of a homogeneous nature. They degrade the human understanding, by substituting simple perceptions, to its more dignified operations of judgment and reasoning. Thev gratify indolence in a physician, by fixing his attention upon the name of a disease, and thereby leading him to neglect the varying state of the system." " The whole materia medica is infected with the baneful consequences of the nomenclature of diseases; for every article in it is pointed only against their names, and hence the origin of the numerous contradictions MAY ON THE UNITY OF DISEASE. 22T among authors who describe the virtues and doses of the same medi- cines."* A belief in the unity of disease, will always lead a physician to prescribe for its varying forms and stages. It will lead him likewise to attend to the effects of the medicines prescribed, and to continue or withhold them as circumstances may require. This mode of practice, it is true, will not be relished by the idle practitioner, for it requires fre- quent visits, and a close examination of symptoms in every form of disease ; but medicine can never be perfected in any other way. The benefits of adopting the unity of disease will appear farther, in its prostrating what is called the diagnosis of disease. A physician, instead of drawing on his memory for a hoard of definitions, attends only to the state of the system. A knowledge of this is soon acquired, and just prescriptions as soon follow. "By knowing the cause of gout, pleurisy and malignant fevers to be the same, it would lead to depletion for each, under equal circumstances; it would terminate disputes about disease and medicine among physicians, by directing their attention to a single object, and thus remove those controversies, in the medical science, which nosology is calculated to create. By admitting but one disease, we likewise prostrate the too frequent use of the term, " complication of diseases." This idea has often led to , a belief, that patients have had as many diseases, as they have had pains. Thus yellow fever has been called phrenitis in the morning; gastritis at noon; colic at night; next nephritis; then rheumatism; and last of all convulsions. This supposed complication of diseases, vanishes on the fifth day in a black vomit; it is then known for the first time to be a yellow fever. By admitting the unity of disease, we render it less necessary to investigate their remote causes. The business of a physician is to remove their effects only, except when the causes continue to act, and are sub- ject to his controul. Thus the mariner lets go the haliards in a squall, without regarding the quarter from whence the wind comes.. He knows full well that the wind is a unit, and that its mode of destruction is the same, whether it blows from the east, the west, the north, or the south. Many have seen and lamented the uncertainty, complexity, and obscurity of medicine; but few have seen its simplicity and unity. Dr. Balfour reduced ^our diseases, viz. cholera morbus, diarrhoea, dysentery, and colic, to the intestinal state of fever. These constitute the febris introversa of the discerning Sydenham, who likewise had a glimpse of the unity of disease, when he saw that all its different forms, in any season, assumed the type of the reigning enidemic. This distant view of • Dr. Rush's Medical Inquiries and Observations, vol. iv. 228 MAY ON THE UNITY OF DISEASE. unity affords a more useful hint to physicians, than all the names in nosology; it gives us warning when a malignant epidemic is prevalent, never to consider any disease as trifling, and it leads us by the sameness of its cause, to the same mode of cure. It is said of Dr. Brown, that between the fifteenth and twentieth years of his medical studies, « A very obscure gleam of light, like that of the first break of day, dawned upon him." Had this gleam been so bright as to have discovered to him, that his two forms of disease, sthenic and asthenic, were but one, it would have prevented many of the errors of his system. Mr. John Hunter's " incompatibility of action," was a near approach to the unity of disease, and did honour to his extraordinary genius; but truth on the simplicity and unity of disease, never appeared in its full lustre till it was unfolded in the lectures and publications of my respected preceptor,* from whom the principles contained in this disser- tation have been imbibed; for whose friendly instruction, both public and private, I shall ever feel the warmest gratitude; to whom the medical world will always be indebted; and whose name and memory will be dear to thousands, long.....long after he has bidden adieu to all sublunary things. * Dr. Rush. AN INAUGURAL DISSERTATION: BEING AN ATTEMPT TO PROVE THAT CERTAIN SUBSTANCES ARE^CONVEYED y' ' UNCHANGED INTO THE CIRCULATION: OR, IF CHANGED, THAT THEY ARE RECOMPOSED AND REGAIN THEIR ACTIVE PROPERTIES. SUBMITTED TO THE EXAMINATION OF THE • REVEREND JOHN EWING, S. T. P. PROVOST; THE TRUSTEES, AND MEDICAL FACULTY OF THE UNIVERSITY OF PENNSYLVANIA, ON THE THIRTY-FIRST OF MAY, ONE THOUSAND EIGHT HUNDRED. FOR THE DEGREE OF DOCTOR OF MEDICINE. BY EDWARD DARRELL SMITH, A. M. OF CHARLESTON, S. C, MEMBER OF THE PHILADELPHIA MEDICAL SOCIETY- INTRODUCTION. DURING the reign of the Humoral Pathology, the opinion, that substances were conveyed unchanged into the circulation, was necessarily adopted by the supporters of that doctrine. It was supposed that disease was seated in the fluids of the human body, and that medicines were f valuable in proportion to their power of correcting or altering the vitiated fluids. Succeeding and more accurate observations having induced the be- lief that the doctrine of the Humoral Pathology was not founded upon suf- ficient grounds; the opinion respecting the operation of medicines was like- wise called in question: from remarking that certain powerful substances exerted their effects so speedily, that it could not possibly be supposed they were carried into the circulation, many philosophers were led to search for some other mode in which medicines operated. They founded their rejection of the old opinion principally upon two circumstances, viz. that they were not able to discover, in any part of the course of the cir- culation, active substances which had been taken into the stomach; and . that any fluid, even milk, which is the most assimilated to the blood, when ^injected into the veins of a living animal, produced sudden death. They asserted that the mutative power of the chylopoetic viscera was such, that every thing noxious was rejected, and only the nutritious parts of substances were permitted to pass into the sanguiferous system. Finally, they referred all the phenomena, which were inexplicable to them, to a cer- tain vague term called sympathy; which perhaps involves as many or more • difficulties than the former opinion. It is not pretended to be denied, that 4 in the operation of certain medicines a sympathy does appear to exist between certain parts of the body; but it also seems probable, that this sympathy has had too great a latitude; and that certain circumstances are referred to it, which are more easily explained on other principles. Many respectable inquirers continue to entertain the idea that some substances are found in their active state after having entered into the circulation; and of consequence that they must have passed unchanged, or if changed, have regained their original properties, by some process unknown to us. 2S2 INTRODUCTION. They grounded their opinion upon experiments and observations made with accuracy and fidelity; the accounts of these are to be found in va- rious writings from ancient down to modern date; but, so far as is known to the author, there has been no compilation or collection of them into one mass. As the only way to arrive at the knowledge of the truth, is to possess a clear view of the evidence; and as this question is deemed of some importance, it is contemplated in the following essay to exhibit to the reader a brief sketch of the arguments in favour of the opinion, that substances are found in their active state after having entered the circulation. The subject is divided into three sections. In the first I shall endeavour to shew that the question is not of a trivial nature, or interesting only as a matter of curiosity; but that it is of much importance and practical utility. In the second section will be given in support of the opinion adopted, the proofs as they appear in the fluid parts of the body. In the third, the proofs as they appear in the solid parts. INAUGURAL DISSERTATION. SECTION I. OF THE IMPORTANCE OF THE QUESTION. THE present question is not merely of a speculative nature, inte- resting only to the curious observer, and not to the practical physician. It embraces a wider scope, and the determination of it will be of essential importance in many cases that fall under our notice. A superficial view of the subject may induce us to suppose, that it cannot be of any real utility; but by the reflecting inquirer, a different opinion will be formed. In endeavouring to investigate a question of this nature, we ought to discard the ingenious subtilties of metaphysical reasoning, which often confuse, while they do not convict. Our data should be facts well authen- ticated, from which we are to draw fair and just conclusions. Taking truth for our guide, and not suffering ourselves to be warped by a preju- dice for any particular opinion or theory, however plausible, we shall most probably accomplish the object of our pursuit. It is to be observed, ^ that the ancients were strongly impressed with the idea, that certain substances were conveyed, with little or no change of their properties, into the circulation. Hence they prescribed in certain diseases, the milk of animals, which had fed upon peculiar vegetables proper for those dis- eases. We know that milk constitutes a considerable portion of the aliment of man, in almost every part of the globe. Some nations, as the Laplanders, have scarcely any other subsistence,'during one season of the year. If certain active substances are conveyed into it unchanged, it must surely be of importance to ascertain these; as their introduction into the body, at some periods of life, and in certain states of the system, may be productive of pernicious consequences. In like manner, much advantage may result from introducing into the diseased system, in this way, medi- cines which could not be administered in any other. Subsequent facts will tend to prove, that very destructive habits may be thus acquired. An inattention to diet in a nurse, is often the unsuspected cause of distressing complaints in the sucking child. Active medicines, taken into the circur v 2h 234 SMITH OX ABSORPTION. lating fluids of a nurse, will affect the child in an alarming manner. Instances of this kind are not rare. If by the collection of facts on this subject, any hints may be given, which may lead to the discovery of a solvent of urinary or biliary calculi, it would be of essential service to mankind. That this idea is not visionary or impracticable, will be allowed by those who have investigated this subject with attention. Although disappointment may be frequently the reward of our exertions, yet by persevering industry, we often accomplish our undertakings. It has generally been supposed, that the preparations of lead, exter- nally applied, are innocent, and under some circumstances salutary. But if cases occur, in which it is absorbed into the system, producing mis- chievous effects, it is surely of importance to keep these in view in using lead. We may thus account for anomalous symptoms, which cannot be satisfactorily explained in any other manner. By knowing the cause of an evil, we may often remove the effect. On the contrary, the physician who rejects entirely this opinion, will be perplexed about the situation of his patient; and by not removing the source, will aggravate the disease. If it is discovered that certain medicines, by being externally applied, will be conveyed through the medium of the circulation, to different parts of the system, and produce the same effects as when taken internally, will not this discovery be of considerable importance in peculiar habits, and in diseases which will not admit of the internal use of medicines J Facts, to be related hereafter, will at least render this supposition probable. If it be ascertained, that while most substances are animalized by the chyliform process, and rendered subservient to the nutrition of man, others are conveyed into the circulation unchanged; it is surely of importance to inquire what are these substances, and in what circumstances they are peculiarly injurious. These remarks, it is hoped, are sufficient to excite the attention of the medical philosopher, and to convince him, that the question proposed for consideration, is not one of mere curiosity, but of real practical utility. SECTION II. t>F THE PROOFS, THAT SUBSTANCES ARE FOUND IX THEIR ACTIVE STATE AFTER HAVING ENTERED THE CIRCULATION, AS THEY APPEAR IN THE FLUIDS. Notwithstanding what has been asserted respecting the wonderful mutative power of the chyliform process, there are numerous instances of substances, after baring entered the circulation through the lacteuls, being found in their original state in the different fluids of the body. We SMITH ON ABSORPTION. 535 are likewise possessed of cases where substances, conveyed by external absorption through the lymphatics into the circulation, manifested their obvious properties. To place the facts in the clearest point of view, it is thought proper to arrange them as they respect the chyle, blood, milk, saliva, urine, perspiration, &c. I. Chyle. The opinion that substances suffered a change of their properties before they entered the lacteals, was principally founded upon the celebrated experiment of Dr. Wright. It was made with the view of ascertaining whether chalybeates entered the blood. The experiment was this: having kept a dog fasting sixty-six hours, he forced him to swallow a quantity of bread and milk, with which a portion of sulphate of iron was mixed: he opened him in an hour afterwards and collected some chyle ,* .from the thoracic duct, the colour of which was not changed by dropping the tincture of galls into It; although this tincture changed the colour to a deep purple when one quarter of a grain of sulphate of iron was dissolved in it.* From this the conclusion was drawn, that the lacteals had the power of rejecting chalybeates. On this experiment Dr. Percival ob- serves, " that it only evinces that the iron did not subsist in the chyle as a vitriol, qualified to strike a black colour with galls; neither does the calx of iron, nor the glass of iron possess this power; yet, though changed, they are both capable of being restored to it: perhaps with equal reason it might be presumed by one, ignorant of chemistry, that sal martis con- tains no iron, because it is not acted upon by the load-stone." But there are experiments which directly oppose that of Dr. Wright, and from which very different conclusions must be drawn. Dr. Musgrave injected solutions of indigo and of stone-bluet into the small intestines of clogs, which he had kept fasting for a considerable time. On opening the dogs some hours after, he discovered that the lacteals and also the thoracic duct were coloured with the injections4 " A great many substances m^y enter the lacteals along with the chyle, even solids reduced to fine powder. When indigo has been thrown into the intestines of a sheep, I have seen the chyle rendered quite blue: now indigo is not soluble in water, but is a solid reduced into a very fine powder. So musk gets into the chyle, giving it a strong smell, and a great variety of other substances of various colours, various tastes, and various smells, each of them giving colour, or taste, or smell to the chyle."|| II. Blood. It is asserted that foreign matters cannot be conveyed into • the blood in their active state, for that such a mild fluid as milk, infused * Philosophical Transactions, vol. i. part 2. p. 295. f " Stone-blue is a preparation of cobalt, pot-ash, and white lead; whiclj, being converted into f^las^, is ground into a fine powder.:' Percival. \ Philosophical Transactions, abridged, chap. 4. part 2. p. 76. || Fordyce ou Digestion. 236 SMITH ON ABSORPTION. into it, produces death; granting for a moment that this is the fact, we may however observe that the case is different where substances are immediately introduced into the blood vessels, and when they pass through the common routine of the circulation: we may observe further, " that what passes by the lacteals or lymphatics is carried into the thoracic duct, and there mixed with a large portion of the chyle and lymph, by which its acrimony is sheathed and diluted, or its chemical properties changed before it enters the mass of blood."* We are in- formed of cases, where foreign matters were actually seen floating in the blood. An instance is recorded of a milky discharge from the groin of a boy, which recurred several times and continued several days each timet The chyle does not immediately become assimilated with the mass of blood, but floats in it for some time in its original state: the following instance is in point. " A maid, after eating a good breakfast about seven in the morning, was let blood about eleven the same day in her foot. The first blood was received in a porringer, and within a little while it turned very white. The last blood was received in a saucer, which turned white immediately, like the white of a custard. Within five or six hours after, I chanced to see both; and that in the porringer was half blood and half chyle, swimming upon it like a serum as white as milk; and that in the saucer all chyle, without the least appearance of a drop of blood. And when we heated them distinctly over a gentle fire, they both hardened as the white of an egg when it is heated, or just as the serum of the blood doth with heating, but far more white. This maid was then in good health, and only let blood because she never had her courses, yet of a very florid clear complexion."\ Experiments prove moreover, that the injection of medicines into the veins, is not necessarily fatal; but that administered in this way, they often produce their effects as certainly as when given in the or- dinary manner. Thus we are informed by Iialler,|| that a poison or medicine injected into a vein, will produce certain determinate effects, as vomiting in the stomach, purging in the intestines, and drunkenness in the brain. Wahrendorf, in a village of Lusatia, injected wine into the vc-ins of dogs, and remarked that it made them drunk. A solution of opium, injected into the veins, exerts its narcotic power even for two days. Vinous medicines, similar to opium in their intoxicating power, produced similar effects on living animals. Poisons, infused into the veins, exert a specific effect upon the different viscera. Certain emetics administered in this way, excite vomiting in the same manner as if * Percival. Essay on the Operation of Medicines. t Edinburgh Medical Essays, vol. v. $ Lower. Tractatus de Corde, &c. || Elem. Physiolog. vol. i. SMITH ON ABSORPTION. 2S7 taken by the mouth. Borrichius asserts, that the same dose of medicine, which taken by the mouth, purges, will produce a similar effect if in- fused into the veins. Many others relate similar cases. Diuretic medi- cines, infused into the veins, are carried to the urinary organs, and pro- duce the same effects as when swallowed. Two drachms of the tincture of cantharides, injected into the veins of a dog, excited a most copious flow of urine, eroded his bladder and destroyed him in the second expe- riment. Nitre, introduced in this manner, excited a copious flow of urine, without any ill consequences. Eight or nine drops of spirit of tobacco, injected into a vein, produced vomiting and great distress. There are instances of the salutary effects of medicines, exhibited in this manner, in diseases affecting the constitution. Purmann, a celebrated surgeon, cured himself of a cutaneous eruption, by injecting into his veins an infusion of cochlearia with spirits of theriacalis. We have instances related of syphilis, cured by medicines introduced into the veins. And we read of a man, labouring under the most dangerous symptoms from the bite of a viper, being cured by spirits of hartshorn injected into his veins. " We have injected by a siphon about two drachms of a laxative medi- cine into the median vein of the right arm of three patients, in the hospital at Dantzick. One of the patients was a lusty, robust soldier. " He, when the purgative liquor was infused into him, complained of great pains in his elbow; and the little valves of his arm did swell so visibly, that it was necessary by a gentle compression of one's finger to stroke up that swell- ing towards the patient's shoulder. Some four hours after it began to work, not very troublesome, and so it did the next day, insomuch that the man had five good stools after it. " The two other trials were made upon the other sex. A married woman, of thirty-five, and a serving maid, of twenty years of age, had been both of them from their birth very grievously afflicted with epileptic fits, so that there were little hopes left to cure them. They both under- went this operation, and there was injected into their veins a laxative resin dissolved in anti-epileptical spirit. The first of these had gentle stools some hours after the injection, and the next day; the fits, recurring now and then, but much milder, are since altogether vanished. As for the other, viz. the maid, she went the same day to stool four times, and several times the next; but by going into the air and taking cold, and not observing any diet, she cast herself away. " Mr. Smith hath adventured to open a vein and infuse some medi- cines into the blood of two persons, in the hospital of Dantzick, despe- rately infected with the pox, whereof the one recovered and the other died."* * Philosophical Transactions, abridged, vol. iii. p. 234. 233 SMITH ON ABSORPTION. If credit be due to these facts, we cannot hesitate r.v believing that active substances may mix with the blood in their original state. We must also grant, that so far from being productive of any ill consequences, they maybe subservient to beneficial views. It is not probable, however, that this mode of exhibiting medicines will ever be brought into general practice, as there is some inconvenience attending it, and as it is seldom or ever necessary. The examples are cited only to confirm the justness of tiie general principle, that active substances may enter the circulation with impunity. Several additional arguments may be adduced in support of what has been already advanced. Thus, it is asserted by Mr. Bell and others, that mercury cures lues venerea by mixing with, in the blood, and neutra- lizing it. " Mercury will pass into the system in various forms from the surface of the body. Lues venerea has been cured by frequent immersions of the feet and legs in a solution of corrosive sublimate. The application of a mercurial plaster to the surface of the body, if of any considerable extent, will also cure the disease.'-* If the poison of contagious diseases can circulate in the sanguiferous system without injury, why may not medicines, which are not more active, also pass into the system with impunity ? It is well known that the lues venerea is communicated from the mother to the foetus in utero. Some cases of the small-pox being communicated in like manner have occurred. Mr. Turnbull relates the case of a lady, who was inoculated in the seventh month of her pregnancy. Nine days after the eruption she received a fall, and in a few days after that was delivered of a dead child, which was covered with variolous pustules in a state of suppuration. The matter was proved to be variolous from its communicating the disease to several persons who were inoculated with it.t It has been denied by some that variolous matter could enter the blood in its active state; but this and other instances convince us that it can. We should therefore be cautious in inoculating pregnant women, as we may sometimes unintentionally destroy their embryo offspring. Some cases are mentioned where the small-pox was communicated by variolous matter introduced into the stomach.} In these there can be no doubt that the matter was taken into the circulation in its active state in order to produce the eruption. In a pregnant woman, who had used a considerable quantity of saffron, the liquor amnii is said to have been tinged of a saffron colour.U * Bell on Lues Venerea, chap. 4. sect. 4. t Memoirs of London Medical Society, vol. iv. p. 364. \ Medical Repository, vol. i. p. 258. [J Haller. Elements of Physiology, vol. viii. de Fetu. SMITH ON ABSORPTION. 239 The fact being ascertained, that active substances can enter the cir- culation and produce their specific operation on different parts of the body, according to the different qualities which they possess, we have a clue afforded to extricate us from the labyrinth, in which we have been wandering. Certain phenomena, which have been hitherto shrouded under the dark veil of sympathy, are more easily explicable, it is con- ceived, by the opinion we advocate. Tobacco beaten up into a poultice with vinegar or brandy, and applied to the stomach, produces violent vomiting, and is very effectual in remov- ing hard tumours of the hypochondria. Groundsel beaten down to a pulp, and applied to the stomach, produces vomiting and cures agues** Oil of tobacco, dropped upon the tongue of a cat, impregnated the whole of the animal with its odour. The decoction of this plant, when the head was washed with it, caused vomiting, fainting, and convulsions; applied to the belly, it produced vomiting and intoxication; the oil in the form of ointment produced purging; the roots of white hellebore applied to the stomach, occasion vomiting. Bitter medicines applied externally to the abdomen, destroy worms. Crocus metallorum, applied externally to cure a herpetic eruption, produced vomiting-t The experiments of Mr. Sherwen would lead us to conclude that tart. emet. exteijpajly applied, is taken up by the absorbents and conveyed through the medium of the circulation to the stomach. Five grains of tart. emet. rubbed into the palms of the hands, in six hours produced a slight nausea, burning of the skin and increased perspiration. A larger quantity, rubbed into the hands and wrists, produced, in a few hours after, a sickness, brisk evacuation by stool, and an increased flow of urine for several days. In one case, the medicine, after producing slight nausea and gentle catharsis, was succeeded, in two or three days, by a rash with a considerable itching all over the skin, which continued some days. In acase, where disagreeable symptoms had succeeded the drying up of an old ulcer in the leg, tart. emet. administered in this way produced nausea, profuse perspiration, and a discharge from the ulcer, by which all the symptoms were relieved. Experiments with arsenic, made in the same manner as with tart. emet. prove, that it occasions slight nausea and increased flow of urine.} The dangerous properties of arsenic have hitherto intimidated practitioners from an extensive use of it internally. If therefore experiments of this kind should lead us to discover that arsenic, externally applied, is conveyed into the system, and is a safe and efficacious diuretic, we shall add a new weapon to our store for combating the dreadful disease of dropsy. * Edinburgh Medical Essays, vol. ii. f Haller. Elements of Phyisology, vol. t. • I Medical Memoirs, vol. ii. 240 SMITH ON ABSORPTION Certain Italian physicians have instituted experiments on this subject, the result of which would appear to favour our doctrine. A woman having violent pains, and refusing to take opium by the mouth, was a fit subjeot ^ for experiment. Dr. Chiarenti dissolved three grains of pure opium in two scruples of the gastric juice of a crow; and after suffering it to remain at rest some hours, he mixed it with simple ointment and nibbed it on the backs of her feet. In an hour the pains were wholly removed, and did not again return. Squills and fox-glove were used in the same manner with equal success. It appears, from experiment, that the appli- cation of these substances was most successful, when they were dissolved in gastric juice or saliva. " Dr. Ballerini, of Mantua, cured one dropsy with frictions of six grains of squills, dissolved in gastric juice, made every second evening; and another with one scruple of squills, dissolved in one drachm of saliva, rubbed in at three times during the course of the day. The assistants, who made the frictions, had likewise an increased flow of urine." Professor Breraused opium, in this manner, with success in chlorosis; also squills, digitalis purpurea, corros. sublim. aconite, and tart. emet. in other diseases. From his observations he concludes, " that every animalized fluid is fitted by nature to render remedies capable of being absorbed."* . • We have numerous instances of the unhappy consequences attending the introduction of lead into the system, which are perhaps more ration- ally explained on this principle than on any other. Litharge carried under the arm-pits caused dyspnoea, fainting, nausea, vomiting, Sec. Ceruse applied to a part that had been chafed produced similar .effects.! The immoderate use of the saturnine lotion for six days to a leg and foot, from which the cuticle had been stripped, produced colic, trembling of the limbs, continual nausea, and frequent vomitings-! The application of Goulard's poultice to the knee, continued for some time, produced a violent pain in the bowels, which did not cease until the removal of the poultice. Instances have occurred of convulsions being produced in children by ceruse sprinkled on excoriated parts. It is not improbable that litharge, the common basis of plasters, when employed in dressing issues, produces some of the common effects of the prepara- tions of lead taken internally.(| Dr. Baker observes " that he met with a most violent and obstinate colic, which seemed to have been occasioned by some litharge mixed in a cataplasm, and applied to the vagina with a view to allay a troublesome itching." * Annals of Medicine, vol. iii. f Haller. Elem. Physiolog. vol. v. t Percival's £ >say on the Poison of Lead. jj Medical Transact, vol. i. SMITH ON ABSORPTION. 241 The vapour of lead, which exhales when it is melted, will excite colica pictonum, as in the case of plumbers and potters, and those who make shot. This vapour, when the metal is heated by mere friction, will pro- duce this colic, with all its terrible consequences.* " We want no authorities to testify, that the too fashionable applica- tion of ceruse to the skin, has been followed by obstinate colics, pains, tremors and resolution of the limbs, slow wasting fevers and pulmonary consumption. For such frequently has been the fate of those who have thus endeavoured to supply the defects of their persons, by a vain and temporary imitation of beauty.t " The vinegar of lead, diluted and rubbed upon the skin, cures break- ings out, redness, inflammations, and the erysipelas; it gives a whiteness and beauty to the skin, but proves pernicious to the body; at length occasioning a consumption, as appears by many melancholy examples."} The ung. saturnin. applied for ten days to parts, from which the* cuticle had been removed, occasioned a severe colic,-resemblinginmany of its symptoms, the colica pictonum. A gentleman, having strained the tendo achillis of each leg, was advised to use a bath of vegeto-mineral water. The bath was so constructed, that he could immerse his'legs to the height of the calves. He used it for five or six minutes every morn- ing and evening for a week, when he was obliged to delist, from the violent spasmodic and paralytic affections it occasioned; nor did he reco- ver from them for some time.|j There is an instance upon record, of a palsy of both legs and arms, being induced by the application of sacch. saturni. to venereal warts, for the purpose of destroying them.§ " A gentleman, who had for many years had a fontanel, finding that the pea was not sufficiently depressed for two or three years past, applied occasionally, a piece of the thinnest lead over the oil-skin which covered the pea. This apparently answering the purpose, the oil-skin was by degrees omitted; so that the lead was generally in immediate contact with the pea and the orifice of the fontanel. " This was the case about the end of June, 1771, when an uneasiness and oppression were felt at the prxcordia and diaphragm, with anxiety and difficulty on making a deep inspiration. The disorder daily increas- ing,, became, towards the end of July, so grievous as to require the serious attention of the person afflicted. On recollection, he began to suspect that his complaints might be owing to the noxious quality of the lead, which covered the fontanel. He therefore immediately threw it off, and from that time, without the use of any medicines, the disorder very * Med. Transact, vol. i. t Baker. } Boerhaave. Elem. Chem. vol. ii. process 172- || Med. Transact, vol. iii. § Ibid. vol. ii. 242 SMITH ON ABSORPTION. soon abated, and in about one month was entirely removed; nor has it in any degree returned."* The inferences to be drawn from the above mentioned facts, must be sufficiently obvious to the candid observer. If we take into consideration the various circumstances attending the external application of lead in these cases, some light may be thrown upon the subject. It was neces- sary for a certain portion of time to elapse before the poison manifested its effects. If it operated by sympathy, the effect should be instantaneous, as we know it to be in other cases where the phenomena are referred to an unknown sympathy. But as we find that a space of time, sufficient for the introduction and diffusion of the poison in the circulation, must inter- vene before its effects are perceived, we have a right to suppose that it does enter the circulation, and thus produces its mischievous conse- quences. The symptoms attending, coincide so exactly with those which succeed the internal use of lead, that they afford strong reason to believe the poison actsrimmediately upon the parts affected. This can only be effected by its entering into the circulation in its active state. The dangerous consequences which sometimes result from the exter- nal use of the preparations of lead, under certain circumstances, should teach us caution in the management of this metal. This appears to be more especially necessary in cases where the parts have been excoriated, as in those situations the absorbents seem to be peculiarly active. The pernicious practice of applying to the skin pigments, of which lead is a constituent part, cannot be too strongly reprobated. By diminishing the sense of the danger, we encourage the growth of the evil. It is only by inculcating the opinion, that the poison of lead may be absorbed into the circulation, and thus be productive of the most dreadful consequences, that we can hope to arrest this destructive fashion. Mercury is often adulte- rated with lead, and its use is sometimes attended with the peculiar -effects which succeed the use of the preparations of lead. It is therefore of some consequence to keep this circumstance in our remembrance, when we are exhibiting mercury.} Observation would lead U6 to suppose, that lead internally used, passes into the circulation in its active state. Is not this supposition rendered probable from the palsies of the limbs, which succeed colica pictonum? Here is an affection of parts distant from those to which the poison is directly applied. Colics, which arise from other causes, are not attended with similar consequences. Is not the supposition further strengthened by the fact, ascertained from Mr. Hunter's experiments, that the applica- tion of sacch. saturni. to the muscles of dogs, produced in them the same appearance which is exhibited by the muscles of painters labouring under * Baker on the Poison of Lead. } Ibid. SMITH ON ABSORPTION. 243 paralysis? Sour wines sweetened with lead have produced many unhappy consequences of this kind. It is known that sacch. saturni. will render gin, which has a yellow tinge, of a beautiful transparent whiteness. This iniquitous process has been too frequently the unsuspected cause of many distressing symptoms. The honey extracted by bees from the kalmia latifolia, (bastard laurel) and some other poisonous plants, has the remark- able property of proving errhine, after it has been taken into the stomach some time. It produces sneezing occasionally for two or three days afterwards.* The powder of the different parts of the kalmia latifolia is considerably errhine.t How can we account for this strange effect, but by supposing that the honey is taken into the mass of blood and that it continues to circulate in its active state for some days? From what has been said concerning the proofs of the opinion, which is maintained in this essay, as they appear in the blood, we learn in the first place, that active substances, directly mixed with the blood, are not necessarily fatal, but sometimes salutary. Secondly, knowing this fact, we can more easily explain, on this principle than on any other, certain phenomena resulting from the external application of medicines. Thirdly, • circumstances attending the internal exhibition of some medicines, are most easily accounted for by this opinion. III. Milk. Certain substances manifest their presence in the milk by their colour, taste, smell or peculiar effects. Milk is faintly tinged of a red colour from eating the Indian fig, and also from madder: it assumes a blue colour from the use of indigo.} Saffron imparts its colour to the milk of women using it.|| The sugar of milk depends upon the quantity of sugar contained in the aliment which is used. Its acescency is supposed to proceed from the use of vegetable aliment. Cows, fed upon certain vegetables, give milk of a colour and taste similar to those vegetables, as the horse- chestnut, madder, &c. All the siliquosa communicate a peculiar taste and odour to the milk of animals feeding on them.§ It is a fact very generally known, that where animals feed upon garlic, pepper-grass, salt-marsh, &c. their milk, and the butter obtained from it, partake of the taste and smell of the substance used. Animals, feeding on a certain species of gentian, have their milk, and the cheese made from it, of, a bitter taste. We may discover in milk both the smell and taste of the strong treacle-mustard, and also of saffron. The bitterness of wormwood and the smell of thyme are often perceptible in milk.** * Barton's Lectures on Materia Medica. } Essay towards a Materia Medica of the United Strtes. i Haller. Elcm. Physiolog. vol. vii. de lacte. |J Ferris on Milk. § Barton's Lecturer on Materia Medica. ** Haller. Elem. Phys. vol. vii. 244 SMITH ON ABSORPTION. The peculiar effects produced by the milk of animals, which have feet upon particular plants, evince that the active matter is carried into the circulation, and retains its properties even in the secreted fluids. A case is related by Dr. Cooper, of a woman who was salivated, pro- ducing the same affection in a child sucking her, Gmelin asserts, that the milk of salivated animals will salivate a child. Dr. Hamilton detected globules of mercury in the milk of a salivated woman, by slow evapora- tion.* The properties of spurge have manifested themselves even in cheese; the eating of such cheese having occasioned dangerous vomiting and purging. The milk of cows, whicli feed on the hedge hyssop, is purga- tive. A nurse having taken a purgative medicine and afterwards suck- ling a child, a hypercatharsis was induced on the child; but the nurse felt no ill effects from the medicine. A boy, who was sucking a nurse that had drunk spirituous liquor, was thrown into violent convulsions.} Infants, from being suckled by drunken nurses, have contracted a pro- pensity for strong drink.} A child was intoxicated by the milk of a nurse who had taken a considerable quantity of opium.|| The ancients were so strongly persuaded that substances were taken * into the circulation in their active state, that in certain diseases they pre- scribed the milk of animals which had fed on vegetables proper for the cure of those disease».§ The milk of goats, which have fed on astringent and balsamic herbs, is recommended as an excellent remedy in certain species of diarrhoea. Thus also the properties of pellitory, madder, the lesser nettle, lettuce, purslain, on which cows have fed, are carried into the milk so unchanged, that they produce their usual effect in the sick who use this milk.** Some modern writers also entertain the opinion, that the active pro- perties of substances are found in the milk. The celebrity of these writers cannot fail to give additional support to the opinion. A nurse, by eating of cabbage, or of other flatulent vegetables, always gave her sucking child the windy gripes.}} To prevent the belly-ach, which is so frequent among sucking children, their nurses should be careful to avoid eating vegeta- ble food.}} In cholera infantum, when the child is reduced so low in the latter stage of the disease that it cannot swallow cordial medicines; if it be sucking, the medicines are to be administered to the nurse, and they will in this way enter the system of the child.|||| These observations teach us a new mode of exhibiting medicines, from the proper management * Barton's Lectures on Materia Medica. t Haller. Elem. Physiol, vol. vii. } Ferris on Milk. |! Ba:ton'> Lectures on Materia Medica. § Ferns on Milk. v • H::f er. Elcm. PIr.siol. vol. vii. }} Perch al's Essays, vol. i.p. 168. l\ Rush's Lectures. ]'] It'll. SMITH ON ABSORPTION. 245 of which much advantage may be derived. In constitutions, where pecu- liar circumstances render the direct application of remedies improper, we may perhaps administer medicated milk with essential benefit. In cases where it is*"hecessary that medicines should be exhibited for a long time, gradually, and in small quantity, no more agreeable mode could be disco- vered. The facts that have been related clearly prove, that the active properties of some substances are found in milk; and it is at least worth the trial, to endeavour to apply this principle to some useful purpose. IV. Saliva. Some proofs may be adduced, which appear in the saliva. The property of exciting an increased flow from the salivary glands, which is manifested by certain substances, some time after they have been taken internally or applied to the external surface, is only to be explained by supposing that these substances are conveyed in their active state, through the medium of the circulation to the parts affected. A partial and temporary salivation may be produced by topical stimu- lants applied to the glands. This ceases shortly after the irritant, which excited it, is removed from the mouth, and may be referred wholly to the direct external application of stimulus. But the salivation, occasioned by mercury, and some other articles, remains long after their use has be?n relinquished, and can only be accounted for on the principle we have adopted. Mercury is taken into the circulation in many cases, especially where it excites salivation. It reaches and acts upon the organs of perspiration. The long continued use of it, produces an inflammatory crust upon the blood. Certain preparations of antimony, also salivate; and the same effect is produced by oxygen gas, nitric acid, citric acid and polygala seneka, Sec* Lead, used internally, has been known to salivate. In the case of professor Thumberg, related by himself, it is observed, that in eight days after the salivation commenced, lead was perceived in the saliva.} The oil of the melaleuca leucadendron, rubbed upon the soles of the feet, manifested its taste in the 'mouth. Petroleum, dropped upon the head, discovered its taste in the mouth.} V. Urine. The facts, which are related respecting the presence of substances in their original state, in the urine, are so numerous and well authenticated, that none will hesitate in giving his assent to them. Cer- tain articles impart to the urine, their colour, taste, and smell, or imbue •it with their'peculiar properties. « Extract of logwood, taken internally, sometimes gives a bloody oue to the urine." Its astringent property, often accompanies its colouring * Barton's Lectures on Materia Medica. } Voyage to the Cape of Good-Hope, vol. i. } Haller. Elem. Physiolog. vol. v. 246 SMITH ON ABSORPTION. matter.* Persons eating the Indian fig, have their urine of a blood colour; the same takes place from eating red beets, or madder. It becomes blue from inciigo. Asparagus and olives, communicate a strong smell to it. Turpentine gives it a violet smell. It is also scented by nutmegs, mace, cloves, juniper, parsley-roots, fennel, carrot, parsneps. It is made bitter by balsam copaiba:. Vinous spirits are sometimes found in the urine; also oil shortly after it has been taken in. A certain species of mushroom, possessing an intoxicating property, is found to retain this property, after passing into the urine.} Rhubarb, taken into the stomach, colours the urine for many hours after. It is said to possess a diuretic property. The oil of savin sometimes exerts diuretic effects upon the kidneys, and in these cases the urine is impregnated with its smell.} Nitre, taken internally, is found in the urine in its native state. When applied to the external surface of the body, it is taken up by the absorbents and conveyed through the medium of the circulation into the hbuUL-r, unchanged. A solution of nitre, applied in a pediluvium, is said to have been absorbed into the circulation; for a piece of paper, dipped in the urine and dried, burnt in the same manner as touch-paper.|j Turpentine acts as a diuretic; when taken in large doses it produces strangury, diabetes, Sec and hence we infer that it has a peculiar action on the kidneys. Whether applied externally or internally it discovers its smell in the urine. We have a proof that it is taken into the circulation and carried to the bladder, from its correcting the peculiar smell which is observed in the urine of persons who have eaten of asparagus.§ Kaauw Boerhaave relates, that a man, holding turpentine.in his hands for some time, perceived in his urine the same violet smell, which is observed when turpentine has been taken into the stomach.** This fact is familiar to anatomists, who are in the habit of injecting dead bodies and washing- their hands with spirits of turpentine. The different species of garlic appear to pass into the circulation, par- ticularly affecting the urinary system, and sometimes discovering their smell in the urine and perspiration. From their supposed property of passing into the urine unchanged, they have been recommended as lithon- tnpJcs. Some of the siliqucsa are used in dropsies, with advantage. Their active matter is probably carried into the circulation and thus to the kidneys, occasioning heat of urine, kc/~\ * Percival's Essays. } Haller. Elem. Physiolog. vol. vii. de Urlnae. } Barton's Lectures en Materia Mc dica. (j Zoonomia, vol. iii. p. 361. $ Barton's Lectures on Materia Medica. * * De Perspi: atior.c. No. 430. }'; Barton's LcAv/cci. on Materia Medica. SMITH ON ABSORPTION. 24/ It is supposed that the strangury, which sometimes succeeds the external application of cantharides, is occasioned by the absorption and internal stimulus of them. This opinion is supported by the following observations: 1. " Nerdicr mustard, the actual or potential cautery, nor any other vesicating stimulus, but cantharides, excite this complaint. 2. " Drinking plentifully prevents the strangury, by diluting in the kidneys and bladder the acrimonious particles of the cantharides. 3. " A blister, laid upon the head immediately after shaving, is almost always succeeded by the strangury; wkereas no such effect takes place, if the application be delayed twenty-four hours."* The effects produced by certain medicines, which have been used as lithontriptics, render it probable that they are conveyed into the urine, unchanged. From the remarkable effects produced by uva ursi in nephri- tis, have we not a right to suppose that it is conveyed info the circulation' unchanged ? The acid liquor, which is obtained from uva ursi, attacks human calculi, diminishes them and softens the parts which it cannot dissolve. Nor was there one, among one hundred and fifty calculi, which it could not dissolve. It is not probable that its powers are lost, when it is given internally ; for when mixed with blood and bile it still retained its solvent property. It appears to abstract the mucus from the calculus, to loosen the connecting medium of the earth which composesTt, and to diminish the whole stone by dissolving a part and softening the remainder which was insoluble.} The carbonate of soda is equally efficacious in alleviating the distres- sing symptoms of nephritis, and in causing large quantities of gravel to pass off by urine. " The stones voided appeared half dissolved, which before had been hard and rough, and when dry seemed to be covered with a fine soft powder. The use of this medicine produced a large mucus and very ropy sediment in the urine and a great abatement of pain." This medicine has also given great relief in biliary calculi of long standing.} Fixed air is asserted to be lithontriptic. Doctor Perch'al informs us, that an eminent physician in London has been successful in the use of it, " having brought away in small fragments, and in a whitish chalk-like substance, a stone from the urinary bladder, by administering fixed air to his patient during the space of a few weeks."l| Several re- spectable authorities have adopted the opinion, that fixed air may be conveyed unchanged into the bladder. Although it may be doubted whether fixed air can be conveyed through, the circulation into the blad- * Pcrcival's Essay on Blisters. } Haller. Histor. Stirp. ludigcn. Helvct. vol. i- } Beddoes. ] Percival. 218 SMITH ON ABSORPTION. der; yet it appears from experiment that from a certain quantity of fresh made urine, one fifth of its bulk of pure fixed air was obtained. Drink- ing water containing this air may impregnate the urine with it, and make it more efficacious in dissolving calcareous matters than it would other- wise be.* The drinking of waters impregnated with fixed air is recommended and extolled by Hoffman and others, as very efficacious in preventing and dissolving calculi. Human calculi, by being macerated in these waters, were considerably diminished. They are also diminished by immersion in the urine of those persons, who had drunk water impregnated with fixed air; while the urine of a person in health, not using such water, had no effect in lessening their bulk.} From this fact the inference must certainly be drawn, that fixed air is conveyed unchanged into the urine. Doctor Sydenham entertained the idea that malt liquors alleviated the pain and irritation arising from gravel. In his own case, he observes, that whenever he was obliged to ride over stones, it was his custom to take one or two large draughts of small beer, which prevented bloody urine. Doctor Dobson observes, " that upon the whole, the sedative and solvent powers of fixed air, in cases of the stone, are so far ascertained, as to give it^t claim to the particular attention of the faculty. Further expe- rience can alone determine whether, by the steady and long continued use of this medicine, a cure may not in some instances be happily effected." It appears that the urine of persons, using alkaline remedies becomes alkaline, and that it exerts some degree of a solvent power upon urinary calculi immersed in it.} Doctor Falconer speaks very highly of the use of the aqua mephitica alkalina, or solution of fixed alkaline salt, saturated with fixible air in calculous complaints. In the case of Mr. Colbourne, who had occa- sionally passed small stones and was much troubled with nephritic symp- toms, he observes, " that during the use of the mephitic alkaline solution, he parted with no gravel, his urine deposited no sediment whatever, nor discoloured the vessel; though, if it was omitted even for a few days, these appearances took place and small bits of gravel were perceivable in his water." The use of this solution is observed to correct the fcetor and disposition in the urine to putrefy, which manifested themselves previously to its use.|| It is well known that fixed air will retard the * Priestley on Air, vol. ii. p. 216,17. } Dobson on Fixed Air. } Home's Clinical Experiments and Histories. R_ Falconer on Aqua Mephit. AlLal. SMITH ON ABSORPTION. 249 putrefactive fermentation out of the body, and hence the foregoing fact furnishes us with an analogical argument that this air is conveyed into the bladder. Human calculi, immersed in this solution, were found to lose a con- siderable part of their weight. A daily portion of the urine of a person, who used the solution, was poured upon a fragment of a calculus for six months, at the end of which time it had lost two-thirds of its original weight. Upon another fragment of the same calculus, a daily portion of the urine of a person in health, not using the solution, was poured for two months, but did not exert any solvent effect.* Does not this prove that the solution is conveyed unchanged into the bladder? The prepara- tions of some of the metals are found in the urine in their original state, as is discovered by the usual tests. " Iron appears to possess the property of passing into the circulation under the form of jethiops. The valuable experiments of Menghini, published in the memoirs of the institutes of Bologna, have proved that the blood of persons, who take martial remedies, is thicker and contains more iron. Mr. Lorry observed that the urine of a sick person, to whom he administered iron in a state of extreme division, was manifestly coloured with the nut-gall."} From what has been related, respecting the presence of substances in the urine, it must be granted by all, that certain matters are found in this fluid in their original state. It is, however, denied, by a celebrated and ingenious writer,} that active substances are conveyed through the course of the circulation into the bladder. He asserts, that the lymphatic vessels of the bladder, communicating Avith the absorbents of the intestines, take on a retrograde action, and thus an easy and direct passage is made into the bladder. One of the principal arguments for this opinion rests upon the phxnomena observed in diabetes. It is supposed that the immense quantity of urine, which is sometimes discharged in this disease, cannot be secreted by the kidneys, but must pass by some direct communication between fhe alimentary canal and the bladder. This opinion is said to be supported by the circumstances attending the drinking of mineral waters. It has been supposed that the short time, in which the flow of urine takes place after receiving these waters into the stomach, demonstrates the existence of some more direct route than through the ureters. « But in this case the stimulus of cold water received into the stomach, like external cold applied to the skin, causes a concussion of the bladder and urinary parts, by which they are solicited to repeated discharges of the old urine which was before in the body, and not immediately of that * Falconer. f.Chaptal's Elements of Chemistry, partiii. chap. x. i Darwin. * 2 k 250 SMITH ON ABSORPTION. Which was last drunk. Again, one thousand ounces of blood are con- veyed through the kidneys in an hour, and this is surely sufficient to furnish twenty or even fifty ounces of urine. Finally, it is certain that both men and brute animals perish if the ureters are obstructed by a ligature or otherwise. We then observe also that no urine can be found in tiie bladder."* The limits of this essay will not allow a fuller investigation of the doctrine of the retrograde motion of the absorbent vessels; and the more especially as it is not strictly connected with the present subject of inquiry. VI. Perspiration. Marks, that substances have entered the cir- culation in their active state, are sometimes found in the fluid excreted fron i the surface of the body. Opium is absorbed into the blood-vessels. Haller asserts, that the smell of op\uin is sometimes observed in the perspiration, particularly in his own case.} The active property of camphor appears to reside in a volatile vapour; it is sometimes absorbed into the mass of blood, is known to salivate, and discovers its smell in the perspiration and sweat.} The common garlic and the red onion, when taken into the stomach, pass off by perspiration, occasioning considerable thirst, 8cc. The smell of garlic is said to be perceived in issues, fistulx, &c.|| It is probable that elixir vitriol is conveyed into the vascular system and excreted by the pores of the skin. It is said to perform a cure in nurses, who are affected with the itch, and also in children sucking them.§ Dr. Russel remarks, that the people of Aleppo, who take large quantities of oil internally, are found to have oil transuding through the pores of their skin. Oil obtained from the livers of cod-fish, adminis- tered internally, in the Manchester hospital,, manifested its nauseous taste and smell in the* perspiration of those who used it. " An oil of the same kind forms no inconsiderable part of the food of many northern nations; and it is said to penetrate and imbue the deepest recesses of the body."** We have thus endeavoured to exhibit a comprehensive view of the proofs of the opinion, maintained in this essay, as they appear in the fluids. Considered individually they may not perhaps amount to a demonstration; but taken collectively, it is presumed, they will make some impression upon the mind of the candid inquirer. * System of Anatomy, vol. ii. p. 411. } Barton's Lectures on Materia Medica. } Ibid. || Ibid. § Percival's Essays. ** Ibid. SMITH ON ABSORPTION. 251 That medicines should be conveyed into the circulation unchanged, or, if decomposed, that they should be recomposed, is not more strange or unaccountable than that urine, semen, Sec. should be secreted from the blood. Chemistry presents us with an analogy. We see, that by the union of two different substances, a third is produced differing in qiuiity from either. By the Edition of another substance we procure one of the first constituents in its original form and properties. May not a process similar to this be carried on in the circulation ? Much yet remains to be explored. • SECTION III. OF THE PROOFS, AS THEY APPEAR IN THE SOLIDS. The proofs that have been already adduced in support of the opinion, that certain substances enter the circulation in their active state, afford at least a high degree of probable evidence. We now come to consider the proofs, with which we meet in the solids. These, although few in number, are decisive, and must carry conviction to the lover of truth. They are arranged as they appear in the skin, flesh, and bones. I. Skin. Sulphur, after passing through the circulation and being conveyed to the skin, evidently recovers its original properties. It com- municates its particular odour to the perspiration, and blackens silver, Sec. A gentleman, who was in the habit of taking sulphur daily, per- ceived, after some time, that his silver knee-buckles were made black and also his watch. It is observed by bishop Watson, that persons, using cosmetic lotions containing lead, and at the same time drinking sulphurated waters, will have the parts, to which the lotions are applied, changed black. « Dr. Swediaur relates the case of a protestant minister, near Ham- burgh, who took, by the direction of an emfric, some nitrate of silver- for an obstruction of the liver. After continuing this medicine for several months, his skin began to change gradually, till at last it became almost perfectly black. This colour lasted during several years, but is now wearing off."* The active part of the diet of some animals, seems to enter into the course of the circulation, and to manifest itself perceptibly in their inte- guments. The turkey-buzzard (vultur aura of Linnceus) is a carni- vorous bird, and feeds upon the putrid carcases of animals. The quills of * La medicine cdaiiee par les scicnees physiques, S;e. Fourcroy. 252 SMITH ON ABSORPTION. these birds have generally such a stinking odour that we are obliged to keep them a long time, before they become fit for use.* II. Flesh. The. active properties of certain substances, which are eaten by animals, are conveyed into the circulation in such an unchanged state, that the flesh of these animals will produce the same effect, as is produced by those substances. It is a fact, well known, that the flesh of wild pigeons, which have eaten the berries of the Phytolacca, or poke root, will purge, if a considerable quantity of it is taken into the stomach. The flesh of pheasants, which have fed upon kalmia latifolia, or wild lau- rel, one of the most fatal poisons, has been known in several well authenticated instances, to exert deleterious effects, in a few hours after it has been taken into the stomach.} Dr. Barton informs me, that he has been considerably purged by eating the flesh of deer, which had fed upon the leaves of the kalmia lati- folia. Dogs, who had eaten the flesh, were affected with convulsions and paralysis of the hinder legs. Kxmpfer, in his history of Japan, mentions a fish,} which being fed with a certain poisonous plant, is infected with its peculiar deleterious properties, and destroys the persons who eat of it. The red sea-bream when found in the South sea, salivates. This fish taken in the Pacific and Atlantic oceans, does not produce this effect. The peculiar property of salivating, is occasioned by its eating the medusa or sea-blubber, which is known to possess this property.|| The balsam of the populus balsamifera, called balsam or tacamahaca tree, is so very penetrating, that it communicates its peculiar smell and taste to the flesh of-certain birds, which feed upon the buds.§ The onion has such a durable strong taste and smell, that it is perceived in the flesh of peacocks who are fond of eating it.** It is generally known, that the flesh of some animals, killed at a particular season of the year, is strongly tainted with garlic. This is particularly the case with sucking calves, who receive it through the medium of the milk. " Tne London mutton is known to taste strong of turnips, with which the sheep prepared for market are chiefly fed." The following fact is transcribed from an ancient book, in its original style and language. * Barton's Lectures on Natural History, } Medical Repository, vol. i. p. 161. } Tetraodon ocellatus. |j Cook's Vovages. § Barton's Essay towards a Materia Medica of the United States. - »* HaJJer. Kistor. Stirp. Indl^en. Helvet. vol. ii. SMITH ON ABSORPTION. 253 " Here a multitude of the inhabitantes, as well women as men, H resorted to hym (Columbus) with cheerefull countenaunce and without " feare: bringynge with them popinjayes, breade, water and cunnyes. " But especially stoke-doves muche bygger then owres: which, he " affirmeth, in savoure and taste to be muche more pleasaunt then oure " partryches. Wherefore, as in eatinge of them he perceaved a certyne " savoure of spyce to proceade from them, he commaunded the croppe to « bee opened of such as were newely kylled, and fownde the sa/ne full of « sweete spyces, whiche he argued to bee the cause of theyr strange "|aste. For it standeth with good reason, that the fleshe of beastes " shulde drawe the nature and qualitie of theyr accumstomed nuryshe- " mente."* Wormwood affects not only the milk, but also the flesh of animals, with its intense bitterness.} " Our table was always plentifully and even luxuriously furnished with truffles, red-legged partridges, and a great variety of small birds; the latter Were not indeed very palatable to us at first, on account of the high flavour of the juniper berries on. which they fed."} Birds, which live wholly on fish, have their flesh to taste of fish. Mr. Hunter observes, " this fact was so well known, that it was hardly necessary to put it to the test of an experiment. Yet he took two ducks, and fed one with barley, the other with sprats for about a month, and killed both at the same time; when they were dressed, the one fed wholly with sprats was hardly eatable, it tasted so strongly of fish."[j Let the candid reader weigh, with mature consideration, what has been said under this head, and then decide whether any doubt remains with him on this subject. III. Bones. We meet with but few proofs, in the bones, of substances being conveyed into the circulation in their active state. Perhaps this is owing to want of attention. One solitary fact, however, would be more in point, than a thousand which are negative. Mercury is received into the blood unchanged; for it has been found fluid and in its native state, in the cells of the bones.§ It would appear that some substances, which lose their properties on entering the circulation, again acquire them after having passed through it. Thus madder does not tinge the skin, muscles, ligaments or fat, but when carried to the bones, it colours them."* • Translation of the Decades of Peter Martyr, decad. i. p. 16, 17. London edition, 1555. } Barton's Lectures on Materia Medica. } Smith's Tour, vol. i. p. 146. || Animal Economy, p. 177- § Holler. Elemen. Ph\ siolog. vol. vi • * Percival'ii Eisay» 554 SMITH ON ABSORPTION. " The bones of the Canada porcupine, during winter, arc of a greenish yellow, owing, as is supposed, to the bark of the pine on which the animal feeds in that season of the year."* In the disease of rickets, which is supposed to be occasioned by a deficiency of bony matter, the exhibition of lime-water, both internally and in the form of bath, has been found exceedingly advantageous. May we not reasonably suppose that the lime is carried into the circulation, and there, rmeeting with the phosphoric acid, supplies the bony matter where it is Wanting?} Circumstances, unavoidable, do not permit the further investigation of the present interesting inquiry. I regret that the same circumstances' prevented me from bestowing a longer and more minute attention upon this subject than I have done. The field is truly extensive, and patient, persevering labour may glean much valuable fruit from it. No other merit is claimed in this dissertation, than the having collected together into one body the scattered remarks and opinions of various writers. If this essay should direct the attention of some future enterprising genius to this too much neglected subject, and if it should meet with the appro- bation of those, whose esteem the writer is most anxious to deserve,~he will be amply repaid for his exertions in the field of science. To depart from this university, without expressing a strong sense of the advantages it offers, in the prosecution of the study of medicine, would be highly unjust and ungrateful. To the numerous testimonies of the zeal, diligence, and abilities of the different medical professors, mine is now cheerfully added. To some of them I am indebted, not only for public instruction, but for numerous private acts of friendship and politeness. To these I now offer publicly my sincere thanks. * Pennant's Arctic Zoology, vol. i. p. 126. } Me-Jical Repository, vol. i. ^. 427- EXPERIMENTS AND OBSERVATIONS ON THE BILE. SUBMITTED TO THE EXAMINATION 01 THE REVEREND JOHN EWING, S. T. P. PROVOST; THE TRUSTEES, AND MEDICAL FACULTY OF THE UNIVERSITY OF PENNSYLVANIA. ON THE EIGHTH OF JUNE, ONE THOUSAND EIGHT HUNDRED AND ONE7 FOR THE DEGREE OF DOCTOR OF MEDICINE. BY JARVIS ROEBUCK, OF THE ISLAND OF ST. CROIX, HONORART MEMBER OE THE PHILADELPHIA MEDICAL AND CHEMICAL SOCIETIES. CONAMUR TUVUES, OBAXDIA.—— HOB EXPERIMENTS ON THE BILE. IN the investigation of a subject like this, to which much time, and great talents, have often been devoted, little else can be effected by the hand of inexperience, than to retrace the road, which towering and suc- cessful genius has pointed out. Little advantage, however, has resulted from the inquiries of our pre- decessors, who, unaided by the rapid improvements which have recently been made in the science of chemistry, deduced inferences from those results alone, Which they were capable of obtaining by the assistance of heat; the fallacy of which must be evident in a minute analysis, and from which many prejudices, at present existing, have originated. To the mere speculation of Boerhaave, are we indebted for an opinion, which modern chemistry has combated in vain: the saponaceous nature of the bile, founded on analogy alone, has been received by successive generations as a well established point in physiology; and the reputation of that great man has sanctioned the error. The support which the opinion of Boerhaave has received, from the experiments of Cadet, are insufficient, however, to establish it on the firm basis of truth. Resting the result on the action of heat, he obtained by his experiment a quantity of oil, soda, &c. he, therefore, immediately concluded the bile to be a true animal soap. This was contested in a publication at Stratsburg, by a Mr. Roederer, who advanced the coagulation of milk by bile, as a sufficient refutation of its alkaline nature. Without entering into the consideration of this refutation, we may easily convince ourselves of the fallacy of Cadet's inductions, by reflecting on the tendency of heat to produce dif- ferent results, according to the mode of its application; but a sole reli- ance on heat was improper: the salts existing in the bile, must inevitably be decomposed, their earthy or alkaline bases will remain, and as there certainly does exist an oil in the bile, are we on such slight foundation to infer the saponaceous nature of it? The experiments which I have insti- tuted, clearly evince the existence of a considerable proportion of phos- phoric acid, and that combined with an earth and alkali; the union therefore of the oil and alkali will be prevented; the presence of an acid, and the formation of soap being incompatible. 2l 258 ROEBUCK ON THE BILE. Of the various fluids of the human body, none has engaged the atten- i\ tion of the physiologist more than the subject of the present essay. Its presence, in almost all the classes of animals, must have indicated some salutary effect; and the defect of its introduction, in the chylopoetic viscera, by disease, was sufficient to establish the efficacy of its operation. But, although all were willing to allow the advantages of an uninterrupted excretion, yet many regarded the bile as a necessary agent in the forma- tion of chyle; while others adopted the opinion of its being merely excre- mentitious, and separated from the blood as a mass, unfit for the purposes of the animal economy. Numerous are the arguments which might be advanced in favour of either opinion. On the one hand, a deficiency of chyle has been attributed to the obstruction of the biliary ducts; for if the bile is a requisite ingre- dient in the composition of chyle, the want of it will present a substance improper to repair the constant waste incident to the human system; and its action on the alimentary canal, in assisting the protrusion of its con- tents, has long been considered as indispensable. On the other hand, may not its agency, in the formation of chyle, be justly called in question, when we reflect on the support which the system receives, independently of the bile, during the disease of jaundice; if chyle is not formed, the disease must necessarily be fatal; if it is formed, (which for the patient to survive it certainly must be) it is effected without the assistance of the bile, and as this takes place in one instance, why not at all times? But does not the retention of the faeces strongly exhibit the necessity of its operation ? Having at one time exerted its influence on the viscera, the cessation of that stimulus must certainly be prejudicial; does this, how- ever, evince any more than that parts accustomed to the operation of any stimulus will be incapable of performing their accustomed functions when deprived of it? Does it amount to a positive demonstration of an original incapacity in the intestines, to be excited to a regular action, but by means of the bile ? Had this fluid some other outlet from the body, would not the contents of the stomach prove sufficiently stimulant? For as the irri- tability of the parts would be less impaired, an inconsiderable stimulus must be capable of exciting a sufficient degree of action. The stomach, unaided by the bile, drives onward its contents, for its occasional presence there must be considered an error loci, the constant effect of disease; and the stimulus of distention appears sufficient to excite the muscular fibres of the oesophagus to their accustomed duty. The important operation attributed to the bile, in the process of chylification, as the medium of combination, between the oily and aqueous portions of the chyme, thereby forming that most important fluid, the chyle, and the precipitation of the fcecal part, for the purpose of its elimination, wears the garb of deceptive hypothesis, rathe? than of conclusive experiment. The saponaceous ROEBUCK ON THE BILE. 259 nature of the bile, we have already attempted to disprove; but, admitting this property, and that nature had kindly afforded us this medium for the proper union of the repulsive parts of the unassimilated chyme, to what must this union be attributed, when by disease the usual supply has been prevented? To an improper stimulus in the arterial system, must the uneasy sensations of the patient be ascribed, and not to a defect of nou- rishment. Are not the faeces separated in the disease of jaundice? The torpor, indeed, of the intestines, owing to the privation of an accustomed stimulus, prevents their speedy expulsion, and the activity of the absorb- ents deprives them of their usual moisture; but " Non nostrum, inter hos, tantas componere lites." I must therefore wave the further consideration of these opinions; much learning and ingenuity has, without doubt, been displayed on both sides. To experiment, the sole and never failing source of truth, must the deci- sion be referred; reasoning, without its aid, is the mere mantle of fallacy, and plausibility alone has enslaved whole ages in the bonds of error! Although a considerable diversity of sentiment existed,, respecting the nature of the operation of the bile, more unanimity prevailed as to the source of its supply. The peculiarity of the structure of the liver, in the unusual number and size of its vessels, when compared with any other viscus, and the necessity of the returning blood of the intestinal canal taking that route, previous to its being reconducted to the general circu- lation, were too striking to escape observation, and too important to be neglected by our speculative predecessors. They supposed that this blood possessed some principle, which the parts where it had been distri- buted were in a particular manner calculated to afford; and which was not to be detected in any other portion of the vascular system: to this the ambiguous term phlogiston Avas appended, a term of singular service, in expressing whatever is little understood; and that this phlogiston ulti- mately separated from the blood in the liver, appeared under the form of bile. This idea is, I believe, or ought to be, entirely discarded. When we consider the great length of the intestinal tube, how numerous and minute must be the ramifications of the mesenteric arteries for the pur- pose of their supply, we may readily conceive, that in this tedious route, the oxygenous principle which it had received in the lungs must be dissi- pated; but, in no respect, does it differ from the refluent blood of the extremities. But is the presence of oxygen unfavourable to the secretion of bile? By no means: accidental dissections have satisfactorily established this point; and the case of Mr. Abernythy alone, wherein the vena portarum communicated immediately with the ascending cava, and the hepatic artery was found adequate to the nourishment of the liver and the pur- 260 ROEBUCK ON THE BILE. poses of the bilious secretion, proves to a demonstration, that the process is carried on, though the parts be supplied solely with arterial blood. The opinion which Maclurg maintained, in his celebrated treatise on the bile, namely, that its secretion was calculated to separate that portion from the blood, which in the tedious course of the circulation, had ac- quired the putrefactive taint, has been sufficiently refuted; not alone by opposing argumentvto argument, but by an appeal to the most decisive .tribunal, that of experiment. In the frequent analyses of the bile, which have been given to the world, the results have been very different. Thus, for instance* the bile has been considered a true soap, formed by the combination of an animal oil and soda, to which a small proportion of mucilage and resin has been added. At another, we find the soda united with an acid, either the mu- riatic or phosphoric, and sometimes both. Some more fortunate than the rest, have detected the presence of iron; while others, with the same views have experimented in vain. Nor must lime and ammoniac be omitted in this brief review; to which, if the saccharine substance, simi- lar to the sugar of milk, mentioned by Cadet, be added, we shall have nearly ascertained the sum total of opinions on this subject. But are we to conclude from this, that the bile of the same species of animal, uninfluenced by disease, can, at different periods, afford such varying results ? May we not with greater propriety, attribute them to ignorance, prejudice, or mistake? A preconceived opinion too often in- fluences the'inductions from the best experiment; by ignorance, phan- tasms are taken for realities; and mistake has been a frequent clog to the wheel of science. Although much remains to be done on this subject, little satisfaction can the reader derive from the perusal of the following pages. Owing to the limited period in which I was to make an election, and conclude the consideration of a subject, (the period of a few weeks) I was obliged to confine myself to one view of the subject, viz, to the difference, if any, which exists between the bile of different animals. The number has un- avoidably been small. My experiments were first made with the bile of the ox. To obtain the results more satisfactorily, I took advantage of the assistance of heat, and the requisite chemical agents, Experiment. I exposed ten ounces of recent ox bile in a retort, to which was appended a tubulated receiver, over Argand's lamp, to a low degree of heat; at the end of some hours, I obtained eight ounces of trans- parent colourless water, which was strongly impregnated with the odor submoschatus, or aroma of the bile, but entirely free of bitterness: imme- diately after this, the retort was filled with a white dense vapour, of such gravity, that it fell to the bottom of the receiver, and was there condensed. I ROEBUCK ON THE BILE. 261 A small quantity of water which fell from the neck of the retort with this vapour was immediately mixed with it, and presented a colour as white as milk: half an ounce of it was obtained; it was slightly empy- reumatic, and being placed aside for an hour, a thick white substance was precipitated; the supernatant liquor, however, remained still somewhat coloured by it. This I consider an oil; the colour must be owing to the low degree of heat used. After which I obtained half an ounce of a brown oil strongly empyreumatic: a hard bitter mass remained in the retort. ANALYSIS OF THE BILE OF THE OX, BY CHEMICAL TESTS. Nine ounces of ox bile being taken, a quantity of alcohol was added; it was then laid by for forty-eight hours, at the end of which time by means of filtering paper, a gluten was separated, which after desication weighed twelve grains. The brown, transparent saccharine and intensely bitter liquor which passed the paper, was evaporated to the consistence of a dense extract; on this extract distilled water was poured, for the purpose of separating that portion which has been called resinous; this being again filtered, left nothing behind that could be denominated a resin. Evaporation was a second time performed, and carried so far that the residuum underwent an imperfect crystallization, when taken from the lamp; this was divided into several portions and treated with the following tests: To one, the oxalic acid was added; the precipitate which ensued demonstrated the presence of lime. To a second, the muriated barytes; the phosphate of barytes was precipitated. To a third, a few drops of the alcohol of galls; no change of colour ensued. To a fourth, the prussiate of pot-ash; the presence of iron, however was not detected by it. To a fifth, the nitrate of silver; a copious precipitate ensued; but are we from this experiment to conclude that the muriatic acid exists in combination in the bile? Many, I am aware, have inferred the existence of it, by this experi- ment .alone; without considering, that, as the phosphoric acid exists with the soda or lime, the addition of nitrated silver must cause a precipitation; owing to the stronger affinity which exists betweeen the nitric acid of the silver, and the soda of the phosphoric salt, whereby the phosphoric acid seizes on the silver, and forms an insoluble compound. Does there exist any difference between the component ingredients of the ox's bile and that of the calf; are any of them wanting in the 262 ROEBUCK ON THE BILE. latter which age may be supposed to supply ? or may they not all exist, and the only difference be in the proportions? To satisfy myself on this point, the bile of a calf, two weeks old, was subjected to examination. Two ounces of this bile, with the addition of a sufficient quantity of alcohol, after remaining the usual time, for the proper separation of the glutinous part, were subjected to the filter; the gluten which remained on the filter was in very small quantity, adhering to "the paper, extremely yellow, and very slightly bitter.* The filtered liquor was brown, f diaphanous, and possessed of an aromatic bitterness not to be met with in the more pungent bile of the ox; distilled water was added to this, to separate the resin; no precipitate however was obtained; the liquor was evaporated: a portion of the extract dissolved in distilled water, with the addition of the oxalic acid, produced a cloud barely to be distinguished. To a second portion, the addition of the muriated barytes, caused a phosphate of barytes to be precipitated. Neither the prussiate of pot-ash, nor alcohol of galls, produced a change in point of colour. A drop of the nitric acid by chance fell in the glass where a small portion of the extract was dissolved, and a slight purple tint was produced; this was greatly increased by the addition of two or three drops more. By this we perceive that what is found in the bile of the ox, is also to be detected in that of the calf, the proportions however being much smaller in that of the hitter. ANALYSIS OF THE BILE OF THE DOG. Having obtained some dog's bile, to an ounce and a half of it were added two ounces of alcohol; it was laid by for two days, then committed to filtering paper; a dark green liquor was separated, and left alight green substance on the paper, which had been precipitated by the alcohol. This substance carefully taken from the paper, was weighed when moist, and amounted to twenty-two gruins; the external surface assumed a dark green appearance, by the action of the air: the surface which rested on the paper, was of a light grass-green colour: applied to the tongue it was perfectly inripid: when perfectly dry, it weighed but three grains: although the specific gravity of this substance was so small yet the bulk was considerable; so much so, indeed, that previous to my weighing it the second time, 1 judged it could not be less than fifteen or twenty grains: when broken, the edges were shining; the central parts of a dusky green, and very compact: one fourth of it was put in a * This gluten coidJ not have exceeded a grain in weight. ROEBUCK ON THE BILE. 56S small quantity of water; the water was rendered'turbid; and on resting a few minutes the whole fell to the bottom in the form of a floccous precipitate. Another portion was tried with the nitric acid, it was entirely dissolved; the colour of the solution was of a reddish yellow. A third in the muriatic acid; it was also dissolved completely, and was of a beautiful bottle-green colour; when water was added to this, the whole assumed a beautiful blue colour; and a floccous substance fell to the bottom: some of the phosphate of lime, was added to a portion of that solution; the colour was still preserved. To a fourth portion some concentrated alcohol was added: it had no action on it. The liquor which had passed the filter was next tried. It was exposed in an open vessel to a gentle heat, and the alcohol driven off. To the residue, about an ounce of distilled water was added, for the purpose of obtaining the resinous part which the alcohol had dissolved: the lkmor after filtration was clear, somewhat sweet, intensely bitter, and of a dark green colour; the resinous part which remained on the paper was very small in quantity, brown and slightly bitter. The liquor was again evaporated, the extract Avas of a sweet taste, still extremely bitter, although the resinous part, in which the bitterness is said to reside, was separated, and. very tenacious or viscid. After further solutions and evaporations, the extract was analysed to ascertain the nature of the salts. To five grains of this extract, dissolved in distilled water, two or three drops of the oxalic acid were added: a precipitate was obtained, which evinced the presence of lime in no inconsiderable quantity. The proportion was much greater in this bile than in that of the ox ; it was impossible for me to ascertain the exact quantity, as it readily passed the filter, and by rest was converted into a pretty strong pellicle, adhering to the sides of the glass. To a solution of the above quantity of the extract in distilled water, a few drops of the nitrate of silver were added; a copious precipitate was the consequence, a dusky red substance adhered to the sides of the glass: this precipitate was principally, if not entirely, a phosphate of silver. The phosphoric acid was clearly indicated to be present by two other experiments, wherein precipitates were obtained by the addition of muriated barytes and the acetate of lead, or saccharum saturni. To a solution of the extract, a small quantity of the alcohol of galls was added; no black colour was produced; neither was a change of colour observed when the prussiate of pot-ash was made use of. 264 ROEBUCK ON THE BILE. ANALYSIS OF THE BILE OF THE ACEPENSER STURIO, OR STURGEON. The bile of fishes being known to be much more acrid, in general, that of terrestrial animals, it was a matter of curiosity to ascertain whether this analysis, would present me with the same results as those I had obtained in the preceding investigations. The colour of this bile when taken from the gall bladder of the fish, was of a strong and as elegant a green as I had ever observed, and to the taste, it was intensely bitter. To an ounce measure of it, Avas added the same quantity of highly concentrated alcohol; it remained unmolested for tAvo days, at the end of which time a considerable precipitate, occupied the bottom of the glass: the Avhole Avas throAvn on filtering paper. The glutinous part which remained on the paper, did not amount to more than half a grain. The liquor which had passed the filter was evaporated: to the extract some distilled water was added; the whole was taken up by the water ; on filtering it no resinous substance remained on the paper; the liquor was again evaporated, and the extract was treated in the following manner, after being re-dissolved in distilled water. To a portion of it, a drop or tAvo of muriated barytes were added; a precipitate was obtained; this was without doubt the phosphate of barytes. To a second, the addition of the oxalic acid, evinced the presence of lime in a very small proportion. To a third, I added the alcohol of galls, no change of colour Avas produced ; nor did the prussiate of pot-ash evince the presence of iron. EXAMINATION OF THE HUMAN BILE. Having obtained the bile of a person, who, afflicted with chronic mania for a number of years, ultimately fell a victim to pulmonary consumption, I Avished to ascertain whether any particular change is effected in this fluid by disease; consequently kept it separate from the bile of another person Avho had been differently affected. The quantity I obtained rather exceeded an ounce; the colour was of a dark brown, edged Avith a shining yelloAv; the taste moderately bitter: a couple of ounces of alcohol being added, it remained undisturbed for several hours, at the end of which a very copious precipitate fell to the bottom. It Avas now committed to the filter; the gluten which was separated, Avas of a yelloAvish green colour, in the course of a feAV hours it became dry; I found it weighed ten grains. Externally it Avas of a deep green, frequently ROEBUCK ON THE BILE. 265 interrupted by a yelloAV spot or streak.and interspersed with a number of thin scales of a micacious brilliancy ; the internal surface when exposed by fracture, evinced a greater portion of the yellow than the external" j the scales were distributed, but not very thickly, through the entire substance. This substance was soluble in the saliva, but of no perceptible bitterness when applied to the tongue. The paper through which fie mixture of the bile with alcohol had passed, and on which the glutinous part remained, presented an interesting appearance, which was, that on the evaporation of the alcohol, Avhite brilliant plates, similar to those in the glutinous portion, but infinitely more abundant, Avere spread upon it. Was this a portion of the resin held in solution by the alcohol, which the paper had absorbed, and which, after an exposure to the atmosphere cad the consequent dissipation of the spirituous part, remained on the paper in a crystallized form ? Or Avas it the size, with which the paper Avas impregnated? No such appearance, it must be confessed, Avas observed, . in any experiments with the bile of other animals: if it proceeded from , the paper, it should have taken place in every experiment. Some of these plates Avhen taken up by the point of a knife, and applied to the tongue, were perfectly insipid or wjthout taste. The proportion of tins substance Avas very small, probably not more than one and a half or two grains. • After repeated additions of distilled water* and evaporations of the liquor which passed the filter, the salts Avhich remained were coloured Avith a small portion of a broAvn extractive matter, very similar in consistence to a dense syrup, which made them adhere to every thing that came in contact Avith them, which extractive matter I could not separate from them, as it Avas equally soluble in alcohol or water: the salts, together Avith this broAvn substance, Avhich was in very small quantity, Aveighed only two grains. The Avhole was dissolved in distilled water, and divided into several portions. As I Avished to ascertain the presence of the muriatic acid, Avhich has been mentioned by some writers as existing in the bile, and -knowing that the ordinary method Avas inaccurate, I ventured to try the following: To a portion of the saline substance, dissolved in distilled water, a quantity of the sulphate of iron Avas added, sufficient to decompose all the salts; by it I expected to have formed a phosphate of iron; and, if the muriatic acid existed in combination in any of the salts, a muriate of iron. The phosphate of iron, I knew, Avas insoluble; it Avould conse- quently be detained in the filter. The muriate of iron is soluble, that necessarily would exist in the filtering liquor; and the sulphate of lime or gypsum could be separated; by this means I expected, Avith the nitrate l «f silver, to detect the muriatic acid, if it existed. 266 ROEBUCK OX THE BILE. After the addition of the green vitriol, the liquor was turbid; on resting, a broAvn substance Avas precipitated, Avhich Avas the phosphate of iron: the Avhole Avas thrown on filtering paper; the broAvn, extractive substance, mentioned above, adhered to the precipitate, and the filtered liquor Avas not in the least discoloured: a thin pellicle on the surface of the liquor, gave me reason to suppose that the sulphate of lime had passed through the paper; this I Avas more inclined to believe Avas the case, a(s in some former experiments I found the oxalate readily passed * through: I therefore doubled my paper, and refiltered it: the nitrate of silver Avas now added, and a turbidness in the liquor was the consequence: from this, therefore, I think the conclusion ought to be, that the muriatic acid exists in combination in the bile. A second portion of the saline matter being dissolved, as above, a drop or tAvo of the muriated barytes were added: the phosphate of barytes was precipitated. To a third, the addition of the oxalic acid produced an oxalate of lime. No change of colour Avas produced on the addition of the alcohol of galls, or prussiate of pot-ash. From these experiments it is necessary to draw some inference. I am sorry that it is not in my power to add an analysis of the bile of an animal purely carniAorous; it might have given strength to the opinion Avhich those I have performed enable me to advance, on the nature of bile in general. An opinion deduced from experiments, has, I hope, more than plausibility, to recommend it. I shall here attempt a separate consideration of some of the most important parts of the bile. The colour of the bile as immediately at- tracting observation, I shall first speak of. This in different animals varies considerably; it is observed in animals of the same class. The bile of the ox differs from that of the sheep: the one is of a deep broAvn, the other of a greener hue. Human bile ap- proaches nearer to that of the ox; and that of the dog is a deep bottle- green; how different also is the black bile of the cuttle-fish, from the lively green of the sturgeon, and many others. To what is this owing? Some there are Avho attribute the colour to the presence of iron; and Cadet thought it probable, that a ferruginous calcareous earth, together with a peculiar animal oil, were the causes of bitterness and colour.* To the first (the opinion of M. Durade of Geneva) 1 must answer, that as I have been constantly unsuccessful in my attempts to detect the presence of iron, and as the evasive manner in Avhich it has been men- tioned by this \rery author, induced Maclurg to suspect that some pre- possession was necessary to detect it; from these considerations, I am • ?/Iedical Commentaries vol. i. p. 69. ROEBUCK ON THE BILE. 267 unwilling to ascribe an effect so material, to a cause, the existence of Avhich is far from being undisputed. If the presence of iron should be proved, could analogy favour us Avith one argument in support of the opinion ? Experiment I have reason to suppose could not. The hypo- thesis of Cadet has something more to recommend it; the ferruginous earth, to which he attributes so important an operation in the economy of this secretion, taken in this view, does not deserve the least attention. * Calcareous earth certainly does exist in the bile,' and admitting it to be ferruginous, no advantage can be derived from it Awhen an acid is present. Neutral salts, Avheh they exist, are incapable of effecting a change; they are not necessary to the formation of bile; their presence must be consi- dered fortuitous, but constant. Is there a person Avho considers carbonic acid a constituent part of atmospheric air? Yet who has ever failed in detecting it? Neutral salts have their definite characters, and as long as these characters are preserved, no change can be produced; this must only be effected by decomposition, Avhich argues a non-existence; and when causes cease to exist, are effects to be looked for? This reasoning is not applicable to the experiments of Cadet'; he does not suspect the existence of a neutral salt. As far as he went his analysis is just; to be satisfactory, it should have been more minute. His inductions were erro- neous, because his Ariew of the subject was incomplete. Although my acquaintance Avith the subject is but partial, it yet affords me sufficient grounds for these arguments; the presence of neu- tral salts cannot be denied: the experiments are easy, and any.person may satisfy himself on this score; this being the case, the opinion of Cadet must fall! He has mentioned an oil; this, I have reason to belieA^e, must materially influence the colour of the bile; but not as he supposed, when united with an earth. I have hinted above, that the presence of salts is not required in the formation of bile; they exist in every animal fluid, and characterize none. ' What are the more prominent features of this secretion? I ansAver colour, taste, consistence, and smell; the principles which, when united, produce these, are its component ingredients, and these consist in a gluten, a volatile and fixed oil, and an acid. I shall endeavour to account for the colour, by a union of some of these; although supported by the experi- , ment, I may be mistaken. After the gluten had been separated from the bile of a dog, it Avas divided into several portions, and an acid added to two of these, the nitric to one, the' muriatic to the other; in both cases it Avas dissolved; the first was of a reddish yelloAv colour, the last a beautiful bottle-green ; when Avater Avas added to the last, the colour Avas changed to a blue. From this, I conceive that an acid, acting on an animal sub- stance, produces a colour which is considerably modified by the presence of an oil, and that the difference of colour is ov>;ug to the proportion of 268 ROEBUCK ON THE BILE. each;.this is rendered probable by the folloAvingexperiment: the gluten of sheep's \n\e is very yellow; I took a few grains of it,^md added a tea spoonful of spermaceti oil; they were intimately mixed; it was of a deep chocolate colour. This Avas increased by the addition of the muriatic acid; but on the addition of Avater, the whole put on a light green appearance. I h;,d an Idea that this acid might be supplied by the decomposition of sea sali., and u;:^ t'ose animals which make the greatest use of it, are possessed of a brighter coloured bile; but there may be many unanswer- al 2 objections to this; and as the phosphoric exists in greater quantity than the nnmatic. and the same phenomena occur when it is used, it is imma- terial Avhici. of the two be present;' but probability seems more in favour of u.'; fonner. The ai ■ .ui, I am apt to belieA'e, depends on a volatile oil, which comes over Avith the Avater in distillation; but on the addition of alcohol, acids, £cc. is destroyed; to the presence of this oil, and even One of a more fixed nature, I ascribe the formation of the resin mentioned by all writers; I know no proof of its formal existence. Do Ave detect it when fire alone is used? Some have called the residuum after the distillation of bile has been carried to a certain length, " a brittle resinous or pitchy mass;" atmospheric air aided by heat, may have inspissated the remaining oil; but by increasing the heat, it comes over in a highly empyreumatic state. Hoav do chemists explain the formation of vegetable resins; is it not by the oxygenation of the volatile oils ? " By exposure to the air," says Fourcroy, " they become thick, and in process of time assumerthe charac- ter of resin." . On the addition, therefore, of alcohol or an acid, with the intention of separating the gluten, a partial decomposition ensues, and a sufficient quantity of oxygen is afforded to thicken the volatile oil;'this change we have reason to suppose, takes place as the aroma is destroyed. Noav, as this aroma forms an essential part of such an oil, and as we know that this principle can only be lost (when it is so by long keeping) by a change being effected in the nature of the oil, is it irrational to conclude, that when a greater quantity of oxygen is afforded, the samething should take place in a short space of time? In recent bile, therefore, I have no idea of the existence of a resin; but in what manner are we to account for the strongest characteristic of the bile, I mean its bitterness ? Authors have laid great stress on its residing in the resin; but Avhen the resinons part is separated, by the addition of water to the alcohol Avhich holds it in solu- tion, and the liquor which passes the filter is evaporated, the extract when formed, is A^ery bitter. How are Ave to account for this ? Ought bitterness to remain Avhen the principle in Avhich it consists is taken aAvay ? I have •bserved. in sJl the extracts I made, a dark coloured viscid substance, ROEBUCK ON THE BILE. , 269 tenaciously adhering to the saline portion; this was equally soluble in water or alcohol, and Avhile it remained the residuum was intensely bitter. Was this a resin? a resin is insoluble in Water: a mucilage? to haA-e answered this character it could not be dissolved in alcohol: was ita.sac: charine matter? a pungent bitter, and strongly saline taste alone was perceptible. I conceived it to be an oil, somewhat changed hoAvever, by the treatment it had undergone; and principally to this fixed oil, I think the bitterness of the bile is to be ascribed. The consistence of the bile is much increased by remaining in the gall-bladder; this has properly enough been ascribed to an absorption of the aqueous parts. This viscidity may be referred to the gluten, in a great measure, but the quantity of oil present must have a considerable influence. I have deviated from the general opinion of those who have Avritten on this subject, in considering the substance separated from the bile by alcohol, a gluten. They have denominated it a mucilage; the characters of these substances are sufficiently marked to prevent one being taken for the other; and as chemists have written on the subject, want of consideration may probably be imputed to me in deviating from receiA'ed opinions. Although I may be mistaken, as to the nature of the substance, still I must confess, that I never have detected any thing Avhich answers my idea of a mucilage. I formed my opinion of the nature of this substance, by some experiments on the precipitate, afforded by the mrxture of dog's bile and alcohol: they are related in the analysis of the bile of that animal. By them I found that acids dissolved it completely after some time; that water rendered it soft, but did not dissolve it, and that it AA'as insoluble in alcohol. I Avas dissatisfied with the name of mucilage, when applied to a substance insoluble in Avater. The appearance of that of the dog, when perfectly dry, Avas dense and uniform; that of the sheep was granulated. I could not detect the saccharine matter, mentioned by Cadet, similar to the sugar of milk. The taste of recent bile, is however considerably saccharine; that of the ox more particularly. To the presence of ammoniac, I have paid little attention; it is very frequently a creature of our oavii formation, and a variation in some circumstances, is adequate to its production. Thus, to conclude the imrestigation which was the object of these experiments, I am of opinion, that the bile of all animals is alike, in those parts which are most material or requisite for its formation; the principles Avhich I have mentioned aboA-e are the same in all; the differ- ence I coneeiA^e, is to be found only in the proportions ; this I grant may be very great in point of colour, taste, Sec. In the elaborate com- pilation of Haller on this subject, can there be found any tAvo persons Avho exactly correspond in opinion. In line, this performance has been executed in haste: to do justice to the subject, time and indefatigable perseverance are required. 270 ROEBUCK ON THE BILE. While I was engaged in the foregoing experiments, a most inveterate case of jaundice occurring under the care of my preceptor, presented me Avith an opportunity of instituting sundry experiments, in order to detect the presence of the bile in the blood, as characterizing the disease of jaundice. Many there are, Avho do not consider the bile as capable of existing in the blood-A esscls Avithout occasioning death; and others, on the con- trary, are too apt to ascribe a yellowness of skin, &c. so frequently in many diseases, to the absorption of it. On this disease it is not my intention to say any thing; all I shall endeavour to prove will be, Avhether the bile can exist in the blood-vessels Avith impunity; for this purpose I obtained a quantity of jaundiced blood. After it had separated, the scrum Avas remarkably yellow, of a saline taste, perfectly void of bitterness. Experiment I. A table spoonful of the serum Avas exposed to the heat of a candle; the albuminous part after the evaporation of the serous portion avcis a cry yellow; this on being tasted, betrayed not the least sensible bitterness. Experiment II. Some of the crassamentum Avas next taken; it was freed from the coagulable lymph by Avashing; the lymph was somewhat yelloAv; no taste of the bile, hoAvevcr, Avas perceptible in it. Thatjiart of the coagulum Avhich remained after the separation of the lymph, Avas exposed to heat, the aqueous part being dissipated, the residuum was somewhat salt, not bitter. Experiment III. A portion of the crassamentum, freed from the coagulable lymph, Avas put in a Avine-glass; to this some alcohol was added; a partial coagulation was effected, which was soon after dissolved; a little water Avas next added, Avhich occasioned the precipitation of a coagulated substance; a part of the supernatant liquor, holding the red globules in solution, Avas carefully poured off and exposed to a gentle heat; after the evaporation, a scum of a brown colour remained, of a saline taste, but not in the least bitter. Finding that it would in this way be impossible to detect its presence, I resolved to avail myself of the aid of chemical tests. Experiment IV. A table spoonful of the jaundiced serum Avas poured in a glass; three or four drops of the muriatic acid were added; an immediate green colour was produced. To ascertain whether the marine acid is a good test for bile, tAvelve drops of that of the ox, were mixed in a little water; to this a few drops of the acid Ave re added ; the green colour was produced. I found that the nitric acid, also produced a green with the jaundiced serum ; and when added to bile mixed Avith water, the same thing took place. ROEBUCK ON THE BILE. 271 The muriatic acid hoAvever, is much the better test, as the green is more rapidly evolved by its use. The sulphuric, caused a.yellow colour. • To establish the residt of the above experiments, it was requisite to ascertain the action of the acids, on healthy serum. Having obtained some blood from a friend a^io was in perfect health, on the separation of the serum, a portion of ft was taken, to which I added a few drops of the muriatic acid ; a Avhite coagulum alone was the result. . The same took place on the addition of the nitric acid. A patient labouring under pneumonia, whose serum Avas remarkably yelloAv, afforded me an opportunity of ascertaining how far a mere colouring matter might tend towards the production of the green, with the nitric or muriatic acid. For this purpose, a quantity of it Avas obtained ; to an ounce of this serum, a few drops of strong nitric acid Avere added ; an entire coagulation ensued ; the coagulum was at first Avhite; standing for some minutes it assumed a yellow tinge. The serum,- on the contrary, of the jaundiced person, instantaneously on the contact of the acid, formed a deep green coagulum. With the muriatic, a slightly yelloAv firm coagulum ensued. This is sufficient to establish the absence of bile in the inflammatory serum; and also, that the presence of it Avas absolutely necessary to the production of the green colour, exemplified in the foregoing experi- ments, on the ser.um of the jaundiced patient. I found a very small quantity of bile, sufficient to produce the colour; for on adding four drops of ox bile to a table spoonful, or half ounce of the inflammatory serum on the immediate contact of the marine acid, the green Avas strong, but on being shaken it was faintly discernible in the yellow coagulated mass. When I used tAvelve drops of the bile, with the above quantum of serum, the muriatic acid produced a permanent green. Having procured some of the urine of the same person, I was desirous of seeing how far that secretion Avas affected by the disease.. The contrast betAveen this and healthy urine Avas very remarkable: the one was viscid, and of a dark yelloAV, the other free from viscidity, and of a straw colour. Experiment V. To half a wine-glass of urine, Avere added about t^;i drops of concentrated nitric acid: a very deep green colour was imme- diately produced; on agitating the glass a slight effervescence took place, attended Avith the sudden destruction of the green colour. ^Experiment VI. To a portion of the same urine Avere added a few #drops of the muriatic acid; the green colour Avas immediately produced: Ho effervescence ensued: the colour Avas permanent. 272 ROEBUCK ON THE BILE. When the sulphuric acid Avas used, a black colour was the conse- quence, attended Avith the disengagement of caloric. The following experiments were required, to ascertain the action of the acids on healthy urine. Experiment VII. To half an ounce of healthy urine, ten drops of the nitric acid Avere added*; a considerable effervescence followed; the liquor Avas of its pristine tolour. Experiment VIII. To the above quantity of the same urine, ten drops of muriatic acid were added; a slight purplish tint was observable; ten more of the acid being added, the whole was changed to a slightly purple hue; no effervescence Jook place. The effect of a little ox bile mixt Avith the healthy urine, exposed to the action of the acids, was next tried to ascertain the affinity of the result betwen this and the jaundiced urine. Experiment IX. To half a wine-glass of healthy urine, twelve drops of the ox bile, with the same proportion of nitric acid Avere added; the green colour Avas produced; an effervescence then took place, which immediately destroyed the above colour. Experiment X. The same proportions of urine and bile being mixt, twelve drops of the* muriatic acid were added; the green colour Avas produced, and Avas permanent; no effervescence took place. From these experiments, I think Ave may safely conclude, that a considerable quantity of bile must be present in the urine of the person the subject ofthem. By the experiments also, Ave find that the muriatic is the best test. The reason why' the nitric is not so good, must proceed from the stronger affinity which that acid has for the bases of the urinary salts, Avhereby, although the green colour is at first produced, yet the affinity it has for these bases being greater than that with the bile, it soon quits the bile for them; effervescence is produced, and the green colour lost. With the muriatic this does not take place; no effervescence ensues, owing to this acid being a component part of some of the urinary salts, or other acids in combination Avith an alkaline, or earthy base, having a stronger affinity for them than the muriatic has. The event of the above experiments, being sufficiently satisfactory to establish the presence of something more than the colouring matter of the bile in the blood, I yet determined on performing an experiment which has been mentioned by several authors, namely the tying up of the hepatic and cystic ducts, in order to produce the.disease of jaundice, and to ascertain the presence of the bile not by the mere colour as they have done, but in a more unequivocal manner, by the aid of chemical tests Two experiments were performed on dogs, but as my intention was to preserve them several days after the operation, in order to effect more ROEBUCK ON THE BILE. 273 completely Avhat I had in vieAv; some accident or other generally occurred Avhich entirely defeated my designs. The folloAving experiment, however, may not be entirely unworthy of notice. The great hardiness of hogs was an inducement for me to try the above mentioned experiment on one of .this kind. For this purpose, a pig being obtained, ligatures were made on the cystic and common ducts, on the 5th of April; the gall bladder was well distended with bile; the Aoav of it into the ductus choledochus Avas prevented by the ligature nearly at the mouth of the cyst. He continued very well until the 22d of April, when, by an unfortuYiate accident, he was killed. On examination, the wound in his abdomen had entirely healed. On opening, the intestines were firmly agglutinated to the peritoneum; the parts being carefully separated, the liver appeared of a colour nearly natural, and the gall-bladder, Avhich, Avhen tied up, contained a considerable quantity of bile, appeared now to be filled Avith a transparent liquor; and that portion of the duct included between the two ligatures, where the hepatic joined the cystic, to form the common duct, Avas distended almost to the size of the gall-bladder, and contained a quantity of genuine bile. Here then was the formation of a neAV cyst; and by some means or other, the bile opened a passage into the duodenum. Both the ligatures Avere found on the ducts, covered with coagulable lymph: no jaundice was produced in this case; the urine when tried by- the nitric and muriatic acids, evinced no change of colour. Although I Avas disappointed in the object of the experiment, yet the appearance of this Avhite transparent fluid in the old cyst, and the formation of a new one, Avere phenomena in some degree calculated to lessen my regret: I shall hoAvever forbear any comments. When the liquor of the old cyst was received in a glass, a quantity of a mucous substance, immediately fell to the bottom, which left the supernatant liquor clear; the liquor was very viscid, for on the ('application of the finger it was draAvn out into small threads, and Avhen tasted, perfectly void of bitterness, and inconsiderably saline. A part of this liquor was taken and mixed Avith distilled Avater, and on the addition of the muriated barytes, a precipitate was the consequence, which indicated the presence of the phosphoric acid. Another portion was tried with the oxalic acid, and lime Avas detected; indeed the salts, in this fluid, appeared to be exactly the same.as those Avhich exist in the bile. To the mucous substance, Avhich we meotioned above to be precipi- tated from the transparent liquor, was added a little muriatic acid; it Avas turned green by the action of it: Avhen water* was added, the colour wa$ lost. '* Although a want of success attended my experiments on the dogs and pig? there still remained one, which, if successful, would incon- 2 N ■*' 574 ROEBUCK ON THE BILE. testibly establish the possibility of the bile existing in the blood-vessels without a fatal consequence, and that was, by injecting it into them. For this purpose a dog Avas obtained. An incision being made through the integuments of the neck, and the external jugular exposed, two drachms of dog's bile, previously diluted with the same quantity of water, were injected. This was conducted in such a manner that not a drop of the bile was lost. The vein and integuments being properly secured, the dog was let loose. A few hours after he appeared very dull, Avould not quit the place in which he lay, and refused the meat that was offered him. This continued for two or three days: he then gradually recovered his appetite, and is noAV perfectly well. TJius Ave have proved the stimulus of the bile in the blood-vessels, r.o" to be necessarily attended with fatality; and as the comparative experiments between the inflammatory and jaundiced serum, indicate something in the latter, Avhich, in the result Avith the acids, does not in the least differ from that of healthy serum with the addition of bile, I will venture, unfashionable as it may appear, to ascribe to absorption, what modern theorists might attribute to sympathy. In embracing an ' antiquated doctrine, I am sanctioned by experiment. This surely ought not to be deserted for the deceptive flushings of a diseased1 imagination. AN EXPERIMENTAL INQUIRY INTO THE PRINCIPLES OF NUTRITION, AND THE DIGESTIVE PROCESS. SUBMITTED TO THE EXAMINATION OF THE REVEREND JOHN ANDREWS, D.D. PROVOST PRO TEM. THE* TRUSTEES, AND MEDICAL PROFESSORS OF THE UNIVERSITY OF PENNSYLVANIA, FOR THE DEGREE OF DOCTOR OF MEDICINE. OX THE EIGHTH OF JUNE, ONE THOUSAND EIGHT HUNDRED AND THREE. BY JOHN R. YOUNG, OF MARYLAND, MEMBER OF THE AMERICAN UNNjEAN AND PHILADELPHIA MEDICAL SOCIETIES. * 4 " We ought in every instance to submit our reasoning to the test of Experi- ment, and never to search for truth, but by the natural road of Experiment and Observation."——L a v o s is r. 9 AN EXPERIMENTAL INQUIRY. MAN is endowed Avith motion, sensation, and thought. These are dependent on some internal or inherent principle, and also on various external agents; when they are all regularly performed, they are slid to constitute perfect animal life. When we contemplate this life, we are struck Avith motion, as its principal characteristic; and when we take a farther view, Ave must perceive that this motion and its laws must neces- sarily tend to waste the machine in Avhich they reside. It' becomes essential therefore to the existence of the living body of man, that he be provided Avith means to counteract his tendency to decay. To effect this", he is furnished with an apparatus Avhich prepares new materials, to supply the waste of the old; and these the beneficent hand of nature has plenti- fully diffused, over every part of the globe. Lest he should neglect them, he is furnished with faithful centinels, which seldom fail to admonish him of the exigencies of the system; and as life would be endangered Avere those admonitions but feeble and temporary, Hunger and Thirst are among the strongest, and most impatient of all sensations, and the grati- fication of them is accompanied by the most exquisite pleasure. In the present Essay it is proposed to consider the substances Avhich supply this waste and growth of the system, and the changes they under- go previous to their entering the circulating mass; or the Nutrientia and their Digestion. NUTRIENTIA. II y the Nutrientia are meant, such substances, as taken into the system, are suited to supply its groAVth, and the Avaste of its solid and fluid parts. The articles taken as aliment by man, comprehend an. immense variety of substances, in the animal and vegetable kingdoms; and, as we pre- sently shall attempt to shew, some from the mineral. It has been, how- ever, a disputed question, whether his natural food be confined to animals or vegetables, or aa hether he be carnivorous or phytivorous; Ave shall take it for granted he is both, or an animal " ad omnia," which seems clearly evinced by his instinctiA-e appetites, Avhich urge him to use, them promiscuously, in Avh|itever clime he may be situated. 278 YOUNG ON DIGESTION AND NUTRITION. We' shall not pretend to enumerate the variety of articles taken by man as food, but only attempt to point out the principles on Avhich their alimentary or nutritious property depends. Dr. Cullen supposes that all animal matter is derived from a vegetable origin, because all animals feed directly, or entirely on vegetables, or upon other animals that do so; hence he refers the principle of nutrientia to vegetables; and that they derive this property from their acid, sugar and oil. These, Avith some others, Ave will examine in order. Acid. This we are disposed to reject as one of the nutrientia. The doctor appears to have founded his opinion on the idea, that all vegetable substances, Avhen taken into the stomach, undergo a fermentation, Avhereby an acid is evolved; and " as this entirely disappears Avith the progress of th% aliment, without being again evident in the mass of blood," so he sup- posed it undoubtedly entered into the composition of the animal fluid. That an acetous fermentation takes place in the human stomach in a healthy state, Ave entirely reject, as will appear in what folloAvs; and if this opinion be well founded, Ave obviate the principal argument favour- ing the idea, of an acid being nutritious. Acescent vegetables we cannot doubt as affording nourishment, but this is not to be referred to their acid, but to their sugar and oil. That the acid of A-egetables is nutritious, seems most probable, from the circumstance of vegetables curing scurvy, a disease supposed to arise from a Avant of this kind of food; and the more so as the pure citric acid is found to expedite their operation. The pa- thology of this disease, however, is not as yet fully established. Its cure seems pretty Avell understood, but its proximate cause, and the modus operandi of medicines found useful in it, is still enveloped in darkness. Some have ascribed its proximate cause to a putrescency of the fluids, and acids as nutrients, were supposed well adapted to correct this vitiated state of the system. Modern physiologists, with much propriety, reject this supposed state of the fluids, as quite incompatible with the laAVs of the animal economy. What farther proves that the acid of vegetables does not cure this disease by affording nourishment, is, that the mineral acids have also been found to cure the scurvy, and that their hitherto inefficacy arose from not diluting them sufficiently, so that a large enough quantity Avas not taken. Whatever be the principle on which the mineral acids operate in this disease, the same no doubt is to be ascribed to the vegetable; uoav the very advocates for this last being nutritious, reject the former as never entering into the composition of the animal fluid; on their OAvn ground therefore A\'e reject both. The most probable opinion appears to be, that acescent vegetables cure this disease, by the stimulus of the acid being accommodated to the excitability of the system, and that the sugar and oil of the vegetables afford the proper proportion of nourish- ment. YOUNG ON DIGESTION AND NUTRITION. 2/9 Oil. This enters into almost all our aliments, and composes part of the daily food of all nations. Its universal use clearly evinces its nutritive property. Dr. Stark lived fourteen days on a diet of olive oil and flour, ahd ftund in that length of time he gained in Aveight, four pounds eleven ounces and six drachms. On a diet of suet and flour for the same length of time, he gained four pounds eleven ounces and tAvo drachms. Sugar. Many proofs might be adduced to prove this one of the nu- trientia ; even our instinctive appetites when children, urge us to relish this, in preference to every other article of food. It is Avell known the negroes in the West-Indies, when preparing this article from the cane, live almost entirely on it, and become quite fat at this season. Many are the instances of the creAvs of ships subsisting on their cargoes of sugar, when their provisions have become expended. Dr. Cullen supposes sugar ' is not alimentary in its pure saline state, but only Avhen combined with an oleaginous matter, but the above sheAvs to the contrary. As these two last articles, oil, and sugar, compose the principle of nourishment, in most of the articles we use as food, plethora and serious consequences would resultfrom taking them in any considerable quantity, Avhen in their pure state: but these are obviated, by the stomach kindly becoming satiated Avhen they are taken in but a small quantity, and almost uniformly rejecting them when taken in excess. A remark made by the late Dr. Stark, Avas appropriate to the present point: " Does not an ex- cess in sAveets give a greater shock to the system than an excess in fats? Is there any article of food so hurtful as either, Avhen taken immode- rately?"* Gum. Dr. Cullen supposes this alimentary, and that it derives thi» property from the sugar, oil and acid, Avhich he imagined entered into its composition. Modern chemistry, however, rejects this analysis of gum, and teaches us it contains neither of these principles; it has however an acidifiable base, but requires another agent, oxygen, to form an acid. Independent- of these principles, hoAvevcr, it is a nutritious substance. Haselquist relates in his travels, of a caravan having expended their pro- visions, in passing the deserts of Africa, who had recourse to their cargoes of gum Arabic, and subsisted on them alone for fourteen weeks. Profes- sor Bartonf informs us, that having a child labouring under great debility * This Avas the last remark made by this indefatigable physician, when expe- rimenting on himself, on the effects of different kinds of diet. He was using honey and flour as his constant food, which considerably affected his alimentary canal, and system generally. His diseased state advanced, and as usual he marked down every effect.' His symptoms at length became alarming, and the last remarks he was able to note down, were the above judicious questions. Alas! his own fate soon answered them; in a few days he Avas cut off in the midst of his experiments, and in the blossom of life. f MSS. Lectures. 280 YOUNG ON DIGESTION AND NUTRITION and emaciation, he prescribed large quantities of sugar, but to little pur- pose; a solution of gum Arabic was then had recourse to, and Avith the desired effect; the child thrived Avell, and subsisted on this alone for six weeks. • • In order to ascertain whether other animals could be supported by gum alone, the following experiment was made. A rabbit Avas confined in a cage, and supplied with gum Arabic, but it refused to eat it for twelve hours. By the following artifice, hoAvever, it Avas brought to relish it very Avell: a roasted apple was put in some boiling Avater, in which it remained some time, until the water Avas impregnated with the flavour of the fruit. Upcn dipping pieces of gum in this, it Avas eaten greedily; it Avas indulged in this manner for two days, after Avhich becoming accustomed to its neAV * diet, it eat it alone. It was kept upon this for fourteen days, Avhich was thought a sufficient time to prove its nutritious property. The animal, hoAvever, lost flesh on this diet, but appeared Avell, and was as active at the expiration of this period, us when it began to eat the gum. Calcareous earth. This has hitherto been found not to be decom- posed, and of course looked upon as a simple, or elementary body. Ana- lysis, teaches us the composition of the bones to be calcareous earth, united to the phosphoric acid. We are forced then to suppose this earth is one of the nutrientia, as it in a great measure supplies the growth of the bones. But lime is not only present in the bones, it is found in small quantity in all the solids and fluids of the body. We are led to belieA'e it is taken up as regularly as any of the nutrientia, since the bones, like other parts, are liable to a constant waste. That they are liable to waste, appears: First, From their vessels transmitting an osseous matter, Avhich no doubt must supply them Avith an increase: if additions Avere regularly made, and no Avaste occurred, they Avould be liable to increase in size, even in the adult. Secondly, It is Avell knoAvn that madder colours the bones of animals, when they are fed with it; here a supply must take place, and consequently a loss. That bony matter can be absorbed Ave knoAv well, from what occurs to bones pressed upon by enlarged arteries; and to the alveolar processes when the teeth are extracted. In the vegetable kingdom we have abundant proof of its nutritious property. It is found in every part of vegetables even in their seed. Its use in agriculture is well known. Water. This in a great measure supplies the Avaste of the fluids, which constantlv takes place in tb.e system; but it does not alone supply the Avaste of the fluids; experiments prove it also goes to form the solids. Seeds, it is Avell knoAvn, A'egetate, and arrive to their full growth in pure Avater. Dr. Fordyce informs us he put a gold-fish in a glass vessel, and supplied it with spring Avater; the fish lived in this manner for fifteen months, greAv to more than double the size it was when first YOUNG ON DIGESTION AND NUTRITION. 281 confined, and threw out much feculent matter. Lest it should be supposed the fish lived on substances held in the water by solution, he used distilled water and impregnated it Avith the air of the atmosphere, and put other gold-fish in the Avater thus treated, and kept them six months, during which time they threw out feculent matter, and thrived aa before mentioned. The common spring frog (rana pipiens) I have kept for two months on pure water alone, during all which time they were as plump, and active as when first confined. Indeed water appears to be their principal nourishment; for though they be brought from springs in good health, and their stomachs distended with food, and be kept out of water, they generally die in less than thirty-six hours, as I have observed from very frequent trials. When I exposed them in a dry jar but one night, they frequently became quite unable to leap, and by keeping them thus con- fined for tAventy, or twenty-four hours, their extremities became quite dry, and withered; these consequences were ahvays hoAvever prevented, or obviated when they did occur, by putting them in water. It may not be improper to enter more minutely into this subject, which will be of use to us Avhen we come to speak particularly of digestion. To sheAv Iioav dependent frogs are upon Avater, the following experi- ment will serve, as the result of many performed on tins subject. A frog, six hours after being brought from a spring, in good health, Aveighed four drachms and tAAo grains. It Avas put in a jar containing Avater, where it remained for tAvelve hours, in order that it might regain any vigour it had lost; at this time it weighed four drachms fifty grains: it was then put in a dry jar, and in twenty-eight hours Avas found dead, and Aveighed only three drachms and tAventy-five grains. Many thus exposed died sooner, and others again survived longer, but one or tAvo, however, lived to the third day. That Avater Avas taken into the systems of these animals, Avas evident from their great increase of weight, when put into it after being previously exhausted: but upon opening several of them after this increase, I never could find any water either in the stomach or bowels; it Avas conjectured therefore, that the Ai-e'ght they gained arose from an external absorption; to ascertain this the foil- wing experiment was performed. A frog weighing fn-e drachms and forty-six grains, Avas confined in a dry jar for twelve hours. At this time it had Jcit.a great deal of its plump appearance, and was scarce aide to leap, and weighed, but four drachms and thirty-six grains. It was now extended upon a thin piece of board, and laced firmly; in this situation it was immersed in water as high up as its fore legs, and let remain so for fi\ e hours: not a particle of water could be taken in by the frog's muutis, as its head avus 2 o YOUNG ON DIGESTION AND NUTRITION. aboA-e Avater, and firmly fixed to the board. At the expiration of this time it was dryed, and found to have gained fifty-tAvo grains, so that it had externally absorbed this weight of Avater. Many experiments of a similar kind Avere performed and all with the same result. Their external absorption Avas ascertained in another manner; by exposing them in damp grass during the night, after being previously exhausted by keeping them from water, they always regained their original weight, or the loss they sustained by being kept dry. Having thus ascertained that frogs are nourished by an external absorption of Avater, it occurred that on this principle Ave might explain Iioav snaikes are supported many months, Avithout eating the least particle of food. Dv. Barton has kept a rattle-snake for eighteen months during all which time it never eat any thing: and I myself kept a copper-snake during the last summer, for more than three months, all which time it refused to eat, though its natural food was frequently presented to it. This occurrence appeared quite inexplicable to me; how action and excretion could go on such a length of time when no food was taken: I was led therefore to suppose it could not have abstained from food all this time, but must occasionally have caught insects, that might have craAvled or fallen into its cage; but I had no reason to have recourse to these conjectures, when I heard of the above fact occurring under so careful an observer as Dr. Barton. With a view of ascertaining Avhether snakes derive nourishment from an external absorption, the following experiment was performed. A snake was kept confined in a dry jar for five days; at this time it was lean and quite inactive, and weighed one ounce four drachms and fifty-eight grains. It was now extended upon a narrow board, on Avhich it Avas laced firmly; in this situation its whole body, except about three inches of its upper part, was immersed in water, where it remained for three hours. Upon being taken out and dried, it was found to weigh, one ounce seven drachms and twehe grains, so that it absorbed tAvo drachms and fourteen grains, in the short space of three hours. Hence it Avould appear, that frogs and snakes, like plants, derive a considerable portion of their nourishment from water alone; and that snakes, when kept confined, are nourished by absorption from a moist atmosphere, as from moisture condensed on their surfaces. Hoav simple Avater can go to form an animal substance, we shall not pretend to offer a conjecture; we only state the fact, and shall leave the hydrogen and oxygen of the water, together Avith the different gasses, taken in by the lungs, to the chemist, who by A'ariously combining them, may explain the phenomenon. Oxvgex. As this enters into the system and becomes fixed, thereby supplying a waste that constantly takes place, it properly comes under YOUNG ON DIGESTION AND NUTRITION. 283 our definition of nutrientia. The intimate connexion of life, Avith a con- stant supply of oxygen gas, is now fully established: it is the least to be dispensed with, of any of the nutrientia. The experiment of Dr. Priestley, who exposed a bladder containing venous blood, to an atmosphere of oxy- gen gas, Avhich passed through the coats of the bladder, and turned the external surface of the blood to the arterial red, sheAvs in a beautiful manner, how the vital air of the atmosphere penetrates the tender mem- branes of the lungs, and oxides the blood. Light. Animal as well as vegetable life, exists but in an inferior de- gree, when deprived of light; that life may continue however without it, the unhappy subjects of tyrants have too often witnessed; but as animals do not arrive to their full growth and vigour when deprived of light, it deserves a place here. Professor Barton mentions, his having found a hoard of young mice, in a cellar, where they had been deprived of light; they were all white and sickly. The experiments of NeAvton prove light to be material and divisible; but whether as a matter it enters into the system, we cannot say; we are therefore doubtful whether to consider it strictly as one of the nutrientia, or whether it might not with more propriety be looked upon in the light of a condiment. Having thus considered the nutrientia, we now proceed to examine the processes these undergo, previous to their entering the circulating mass. The food is first masticated, and during this process is well mixed with saliva. This fluid is poured into the mouth from*the parotid, sub- maxillary, and sublingual glands. These are excited into action by pressure, or the action of the lower jaw, by stimulating substances applied to their ducts, and by the action of the mind*, all these causes operate * Is not the secretion of the saliva and gastric fluid synchronous? It is highly probable from long habit, the actions of these two sets of vessels become associ- ated; hence, when the stomach and its vessels are irritated, as in nausea, there is always a flow of saliva, though nothing stimulating has been applied to the mouth. The excitement of the vessels of the one, seems to keep pace with that of the other; when the nausea is so great that vomiting is just at hand, the flow of the saliva is proportionally increased; and when we make an unsuccessful effort to vomit, we generally throw out a mouthful of saUva. If this association of ves- sels be admitted, will it not explain the modus operandi of salivating medicines? All the preparations of mercury affect the stomach and its vessels, and as we suppose, by association, the salivary glands. When one dose of turpeth mineral is taken, it produces a temporary flow of salhH, as soon as it acts on the stomach: when, therefore, this or other preparations of mercury, operate permanently 0:1 this viscus, a permanent flow of saliva takes place. But how does it operate when externally applied? We answer by its action being always determined to the stomach; being in this respect on a footing with many other substances. Thus, ipecacuanha affect* the stomach, even when injected into tlie blood-vessels; and 284 YOUNG ON DIGESTION AND NUTRITION. " when Ave are eating, and the fluid thus flows in greatest abundance, when most required. By deglutition it is then conveyed into the stomach, where it meets Avith a second fluid, the gastric, Avhich constantly flows from the coats of this atscus. It bears a great resemblance to saliva, but differs from it and all other animal fluids, in being apoAverful menstruum for animal and vegetable matter. The food after being retained in this reservoir from three to six hours, is expelled into the duodenum, in a dissolved or pultaceous mass; here it meets Avith two other fluids, bile ard pancreatic liquor, and being mixed Avith these, a mass is formed, op.p^ole of affording chyle. We noAv proceed to examine this process, in a more particular manner. Digestion is performed in a similar manner, in all animals Avith membranous stomachs; they all have a general receptacle into Avhich the food is received, and exposed to the action of a dissohdng men- struum; and all have bile and pancreatic liquor Avith which it is after- Avards mixed. As food is then exposed in all, uuder the same circumstan- ces, similar effects must be produced upon them, or the process, generally speaking, is the same. We shall avail ourselves, therefore, of this similarity, and throughout, Ave shall not confine our observations to man alone, but also attend to that of other animals, by which we may draw plausible, if not. conclusive, inferences concerning our oAvn digestion. We go on to speak generally of SOLUTION. It avouW be unnecessary to recite particular experiments, to prove the solvent property of the gastric fluid, this being admitted on all hands. Under this head Ave shall, therefore, only make general observations concerning the solution of various substances by different animals. The effects of solution are most remarkable in such animals as swallow their food Avithout mastication; we will therefore relate a few experiments made on some of these. Our common large bull-frog (rana ocellata) Avas chosen in order to observe the effects of the gastric fluid, as they swalloAV all their prey Avhole. They have a large membranous stomach, which Avhen distended, occupies the whole anterior part of the abdomen: the oesophagus is very wide, so that their food can be examined at pleasure. Two of a very tobacco nauseates when externally appUed, and in the form of enema. Many otlier substances sabvate, as digitalis, seneka, tart. emet. squills, &c. and all in small quantities will puke. This theory will also explain, why children, under a certain age cannot be salivated, because these two sets of vessels have not acted long enough together for their motions to become associated. YOUNG ON DIGESTION AND NUTRITION. 285 large size Avere procured, and their stomachs were found to be greatly dis- tended Avithfood: being desirous of seeing what was their natural aliment, and the effects of their digestive power upon it, by means of a pair of forceps, one of their stomachs was easily emptied of its contents ; and to my surprise, and that of others who witnessed the fact, it was found to contain a common sized spring frog, and afforded a fine oppor- tunity to see the effects of their gastric liquor. The Avhole external surface of the frog Avas acted upon, the muscles having, superficially, quite lost their texture; some parts of the back bone were bare, the spinous processes of Avhich were quite soft. Upon introducing a forceps, a second time, the hinder parts of a second frog were found, which sheAved the effects of their fluids in a still greater degree: the muscles of the thigh were reduced to a complete jelly, though still retaining their form; some parts of the bones that were covered Avith flesh, were quite soft and flexible. Upon extracting the contents of the stomach of the second frog, it was found to contain a field mouse, about a third larger than our common mojjse: Its- whole surface was quite soft, having entirely lost its textur^flteTore^Vegs were nearly disconnected from its body, the bones of which were soft; the bones of other parts of the body were also examined; they were all soft. But what was most sur- prising, the teeth of this animal did not escape; the incisores were, as Dr. Jacobs witnessed, soft and flexible, having the appearance of a pieca of half dried tendon.v Neither the frog nor the mouse had any acid or putrid smell. It appeared very evident from the preceding experiment, that the fluids of these animals acted upon bones; but in order to ascertain Avhether they could dissolve them completely doAvn, the following experiment was performed. The head and all the bones of the mouse Avere cleared of their flesh, and forced into the empty stomach of one of the frogs; he Avas then put into a jar of water. In tAvo days, the bones were all dis- charged in the form of a mortar; by rubbing it between the fingers, small pieces of bone were distinguishable. This will serve to shew us, the poAverful action of an apparently inert fluid on an animal matter, sparing not bones, nor even the teeth of animals. Being desirous of knowing the length of time they would require to dissolve down a small frog, the following experiment Avas performed. A packthread Avas tied to the hind legs of a living spring frog; its head was then put into the mouth of one of the large frogs; as soon as he felt it move it was swallowed greedily. In five hours it Avas drawn up by means of the thread; the skin and external surface of the muscles Avere tender. It was again introduced; in the space of seven hours, it was draAvn up a second time; the abdominal muscles Avere now dissolved, and the intestines had protruded; the bones of the feet Avere soft, and 286 YOUNG ON DIGESTION AND NUTRITION. separable from the leg by the least force; in a word, the whole Avas a complete dissolved mass. It Avas swallowed a third time, and attempted to be drawn up in six hours afterwards; but it had so far lost its texture that the tAvo legs, to Avhich the thread Avas tied, could only be brought up; the bones of these were soft and flexible, as before mentioned. Many experiments of this kind were made to see the effects of their gastric menstruum: in many cases, after giving them small frogs, the trunk and head of these animals were drawn out of their stomachs complete ske- letons, but the bones Avere always soft, and felt like tender cartilage. In all the half digested substances which Avere at different times taken from their stomachs, as frogs, veal, beef, See an acid was constantly found present: they were seldom examined before two hours after being swal- loAved; at this short interval when their surfaces were touched with litmus paper, it Avas turned red. Snakes, like the large frogs, also swallow their food without mastica- tion : many experiments Avere therefore also made on them, by forcing frogs, lizards, &c. into their stomachs, to see the effects of solution: they agreed in every respect with what has been said of frogs, like them per- fectly dissolving down entire animals. The only difference between them was, that the solution of snakes went on only about half as fast as that of the large frogs. The gastric fluid of man, and that of frogs and snakes agree perfectly in their action on flesh, as the experiments of Spallanzani prove that the first of these powerfully dissolves meat out of the body. As the men- struum of the two latter animals acted so uniformly on bones, it appeared highly probable, the fluid of our own stomach would also. To ascertain this, the condyles of the thigh bone of a chicken, weighing eleven grains, were sAvallowed; the bohe remained a considerable time in the stomach, as was supposed from some uneasy sensations that were occasionally experienced for between two and three days; the fourth day it was dis- charged, reduced to a shell, Aveighing only three grains. Thus far the digestion of man and these animals perfectly agree in solution, being the first step toAvards the conversion of food into chyle; but they differ in some particulars, and probably by attending to these, they may be of use to us. First. They are cold blooded animals: heat is a poAverful agent in all solutions, and the experiments of Spallanzani prove it greatly assists the action of the gastric liquor out of the stomach. Secondly. They do not masticate their food. These two inconveniencies are obviated, by these animals never drinking Avhen their digestion is going on, so that their fluid acts in its undiluted state; Avhereas in man, it is ahvays diluted, as he seldom eats without drinking. That this Avas the case Avith these animals I had clear YOUNG ON DIGESTION AND NUTRITION. 28T proof; for although I examined the contents of their stomachs so often, in no one case could I find any fluid more than a jelly like substance, appearing to be made up of gastric juice and dissolved flesh. Supposing, however, that the pressure used in bringing up the food of the frogs might have forced the more fluid parts into the duodenum, I resolved to ascertain the fact in another way; this was easily done. A tea-spoon could readily be passed into their stomachs, and with this the dissolved food could all be brought up; it was always howeA-er of the consistence above mentioned.* During the time these experiments were made, they were constantly kept in large jars of water. The attention to this circumstance by these animals, which swalloAv their prey entire, is a necessary part in their digestion, as they require a very powerful menstruum, so as to dis- solve not only entire muscles, but also bones. The inference we would draw from it, would be, to attend occasionally, to what necessity urges them to observe constantly. Thus when our stomachs are Aveak, or Ave are troubled with dyspeptic symptoms, like them we ought to avoid much diluting our gastric juice; so that although it were secreted not perfectly healthy, yet having the advantage of acting in its uncombined state, solu- tion and digestion may go on, when it otherwise Avould not, with the common quantity of drink. Indeed our stomachs in this respect act a kind part to us; for when we make our first dish on broth ij seldom relishes much solid aliment after it; hence soups are the first dish at the table of the temperate, and the last at that of the epicure. While speaking of the solvent property of the gastric fluid, it may not be improper to observe, it has lately been ingeniously proposed as a solvent for the stone in the bladder. In this disorder we have hitherto only had recourse to the knife; but such a formidable and dangerous operation makes other means desirable. Dr. J. S. Dorsey has proved the gastric fluid may be introduced into the bladder with safety; no endeaAours therefore ought to be lost in ascertaining Avhat fluid may act on calculi, with most effect. From the facility with which bones and teeth were dissolved by frogs, it appeared highly probable, their fluid would also operate on calculi. On this subject the folloAving experiment was made. A calculus was obtained from Dr. Jacobs, of a very firm texture weighing exactly fifty grains. It Avas introduced into the stomach of one of the large frogs. In tAvo days it was taken out for examination: at first sight it was evident solution had taken place, for the gastric juice which * The eagle appears to observe the same rule respecting drink. Mr. Peale in- forms me bis eagle never drinks during the cold season; and that he only gives it water in the hot summer weather, when it is fond of washing itself in it, and will tben occasionally di'ink, but very sparingly. It is highly probably most carnivorous animals that sAvallow their prey Avhole, or piece-meal, observe the same rule. 288 YOUNG ON DIGESTION AND NUTRITION. adhered to it Avas coloured Avith some of the dissolved stone: it was found to Aveigh forty-five grains. It Avas forced into the stomach a second time, Avhere it remained for tAvo days; it now Aveighed thirty-eight grains: from this it appears, it is well worthy of more attention. When introduced into the bladder, Avith the heat of the human body, we have little doubt it would act upon calculi with much effect. Their fluid is easily procured, and without the necessity, as in other animals, of sacrificing a life every time we Avish to obtain it: by means of a tea-spoon it is readily brought up from their stomachs. Spallanzani and most modern naturalists take it for granted, that some carnivorous animals, particularly birds, cannot digest vegetable matter. This opinion if well founded is of importance, not only as it concerns the natural history of those animals, but also as it relates generally to the theory of digestion. There is a great analogy subsisting between man and such birds, in their digestive processes; they both have membranous stomachs, into which food is received, and exposed to heat and moisture; circumstances equally favourable in each to a fermentation; but if it shall appear such birds cannot digest vegetable food, which under equal circumstances ferment sooner than flesh, we are justified in concluding a fermentation has nothing to do Avith their digestion; and from the great analogy just mentioned, we raise a strong argument in opposition to fermentation being the efficient cause of our own digestion. Spallanzani and Reaumer have both attempted to support this opinion by experiments: I know Avell the distinguished rank both these authors hold in the philosophic Avorld, and the weight of their authority in any opinions they may have adAranced. Perhaps no man in the age in which he lived, considered subjects in a more philosophic point of view, or threAv more light on such as he undertook to examine, than the former of those naturalists: his works will remain as long as experimental philosophy holds its present footing among the learned. With due deference then to this high authority, I would beg leave to differ, or at least to raise a doubt to the opinion above stated: " Aliquando bonus dormitat Homerus." Experiments are the sure and unerring guides to truth; Avhen they light the path we ought with confidence to pursue it, though authority should oppose. Before attempting to point out the fallacy of their opinion, we shall premise the folloAving experiments and observations. The large frogs so often mentioned are purely carnivorous, as I never could find any vegetable matter in their stomachs. Into the stomachs of different ones, Avere introduced beans, peas, wheat, and bread, enclosed in linen bags. In thirty hours they were all taken out for examination: the peas, wheat, and beans Avere entire, and not the least acted upon; but the YOUNG ON DIGESTION AND NUTRITION. 289 bag that contained the bread Avas quite empty. This experiment confirmed to me a conjecture formed by looking over the experiments of those two naturalists mentioned above. Does not the living principle in seeds resist the digestive powers? But this Avill be answered better presently. Bags containing beans, peas, and wheat Avere again introduced into the stomachs of frogs, in Avhich they remained for three days: upon being examined at this interval they were all found SAvelled, but quite entire. Bags containing beans and peas Avell bruised, and bread, Avere then forced into the stomachs of these frogs, Avhere they remained two days: upon examination they were all found empty. Life or a suscepti- bility of life certainly exists in seeds, and is in some inexplicable manner connected with organization. Seeds as above stated Avhen their texture Avas not destroyed, uniformly resisted digestion; but on the contrary, when their organization was destroyed, they Avere as uniformly digested: hence Ave think ourselves justifiable in concluding the gastric fluid cannot act upon seeds as long as they remain entire, or that their living principle resists digestion. It occurred, if entire seeds resist digestion, would they not vegetate if retained a sufficient length of time in the stomach ? This was easily put to trial. Two beans were enclosed in a bag, and into a second, Avas put Avheat: these two bags were then forced into the stomachs of different frogs. In six days they Avere examined: the Avheat and beans Avere swelled and soft. They were again forced doAvn, enclosed as before. In six days more, they Avere drawn up for examination: the tender germs had now protruded in both the Avheat and beans, as Avas quite evident, and witnessed by Dr. Barton and many others. From the above experiments we will.be able to give credit to a case related by the great Italian anatomist Morgani. He informs us that a young lady living entirely on vegetables, (it being lent) was seized with a violent affection of her stomach, and great emaciation ensued. Different medicines were used, but Avithout the least alleviation of her symptoms. At length a violent vomiting commenced, and to the astonishment of all present, she threw up a small# plant, With perfect leaves and roots! This at first sight might be looked upon as approaching the marvellous; yet Avhy should Ave doubt it? the authority of our author is as respectable as any other of our profession; and we have just seen that seeds aa ill vegetate Avhen retained a sufficient length of time in the stomach. The probability here was, that the young lady had swallowed the seed of some small plant, Avithout destroying its texture by mastica- tion; which being retained in the stomach, and exposed to Heat and moisture, vegetation progressed. Having thus, Ave hope, established one point, that seeds resist the digestive powers unless their organization or vital prir.cipie-be previously 290 YOUNG ON DIGESTION AND NUTRITION. destroyed, Ave are now prepared to examine the experiments of those authors, before mentioned, Avhich seem to prove some animals cannot digest vegetables. The following are the experiments M. de Reaumer founded his opinion upon, that some carnivorous birds could not digest vegetables. To a kite he gaA'e beans enclosed in tubes, which Avere retained in the stomach of the bird for a considerable length of time; upon the tubes being thrown up, the beans contained in them, were not the least affected by the gastric fluid, though it had free access to them. Peas and Avheat were tried in the same manner, and with a similar result. These experiments appeared to our author, satisfactory; but his erroneous conclusions from them Avill be apparent, from what has already been said: had he bruised his seeds, we have little doubt he Avould constantly have found his tubes empty, Avhen thrown up by these birds. Spallanzani gave great weight to Reaumer's opinion, from the number of the experiments and variety of animals on which he performed them: Ave shall candidly examine all he advances in support of his principle. After making some remarks on the subject, he observes, " I had proof of this opinion being true, from what occurred to myoAvls: they would sAvalloAV a whole sparroAv, and thus receive into their stomachs, the feathers and undigested food those little birds contained in their crops. After the flesh had been digested, the feathers Ave re A'omited in the form of a hard ball, and along Avith the feathers the grain, Avhich though softened by maceration, yet continued whole : and when the small birds have eaten bread, if the matted feathers be disen- tangled, Ave may generally perceive traces of bread." The seeds here throAvn up are no proof of his doctrine; neither is the bread, if Ave attend particularly to what he himself tells us. " Traces of bread Avere" only " generally to be perceived." We have little doubt our naturalist, by attention, would just as generally perceived traces of flesh; for to me it is impossible to conceive how feathers contained in the stomach, could be matted into a ball, Avithout some of its contents being entangled and matted with them, and of course traces of bread and flesh to be perceived when the ball was opened. His second experiment is in all respects similar, and equally as ex- ceptionable as Reaumer's, consisting in forcing tubes containing entire beans and peas into the stomachs of different owls; the result our reader will anticipate; none were dissolved. His third experiment was on the falcon: he enclosed peas, portions of apples and pears in tubes, Avhich were forced into the stomach of his bird; though retained for a length of time they Avere all discharged, and none of their contents dissolved: the peas we pass over; but the apples and pears were not acted upon. Does not this prove the falcon could not YOUNG ON DIGESTION AND NUTRITION. 291 digest, at least, some vegetables? We believe not, and would explain this on the same ground we have all the rest. We do not understand the nature of life, but we may lay it doAvn that every substance of the vegetable and animal kingdoms, Avhich, under certain circumstances, resists a spon- taneous dissolution or fermentation, has life. Apples and pears are regu- larly organized, have vessels, juices, &c. and for a time resist dissolution, and therefore have life; and consequently cannot be dissolved by the gastric fluid until their texture be completely destroyed. Spallanzani anxious to extend this principle, next had recourse to the eagle; but unfortunately for his doctrine, he first tried it with bread: when he gave it to the amount of six ounces of this at a time, it was not throAvn up as indigestible substances were, nor did it appear in the excre- ments ; he Avas therefore " obliged to conclude this species of vegetable was digested." He next gave this bird seeds of cerealea and Avheat; but these were not altered! At this he expresses his astonishment (at the same time tacitly informing us our doctrine is true) by observing, " it is someAvhat surprising that this should be the case with wheat, Avhen Avheaten bread is so perfectly digested." We have only one more objection to obviate, which is, in one or two experiments, boiled seeds were tried with some of these carnivorous birds, yet were not digested. In answer to this, Ave state the folloAving quotation from Dr. Barton's Elements of Botany. When speaking of how ex- tremely tenacious seeds are of the vita! principle, our author observes: " Thus the late illustrious Spallanzani discovered there are certain kinds of seeds which do not refuse to vegetate, even after having undergone the operation of boiling in Avater, and Duhamel mentions an instance of seeds germinating, after they had experienced in a stove a heat of 235 degrees of Farenheit. Spallanzani even found that the seed of mould, which is a true vegetable, survive a heat infinitely greater than this." We have thus examined this subject at large, Avhich, from its import- ance, it seemed to demand. As yet we think there is no proof but that all animals can digest A^egetables, and by habit may be brought to live upon them: dint of hunger will learn, and habit will soon confirm these Avide transitions; so, that animals naturally carnivorous, Avill subsist on A'ege- tables; and graminivorous, on flesh. In proof of these assertions we» state the folloAving: Dr. Barton informs me, he has received information from a respectable gentleman, Mr. Watkins, stating that he has seen two polar bears (ursus arctos) that had subsisted on vegetable food alone, from the time they Ave re taken from their mothers' breasts; and that thev Avere more than half groAvn, and very fat. These animals in their natural state, are as purely carnivorous as the lion. Spallanzani acknow- ledges his eagle could digest bread; and Buffon informs us, "Avhen they ai-eunable^to procure tiesh they feed on bread." The large bull-frogs, 292 YOUNG ON DIGESTION AND NUTRITION. purely carniAorous, digested and were supported by bread; on the con- trary graminivorous animals Avill subsist on flesh. The Italian naturalist, so often mentioned, by dint of hunger learnt a pigeon to eat meat, of which it became so excessively fond, that it preferred it to every other kind of food, even to Avheat, which in their natural state, they eat before any thing else. With this Ave dismiss our observations under the head of solution, and shall now proceed to examine how aliment is converted into chyle. We have already seen the poAverful action of the gastric fluid, by which the food is completely dissohed. But a\ ill simple solution explain the conversion of aliment into chyle; a fluid differing from it in so many particulars, and yet always the same, whatever be the nature of the food ? The most natural explanation of this phenomenon, would be by a fer- mentation, by Avhich Ave know bodies are entirely altered in their nature. This opinion bears the face of probability, inasmuch as the food is de- tain., d in a warm reservoir, and exposed to moisture, circumstances highly favoring this process. On this account, and from the respectability of those Avho have stood in its defence, as Pringle, Macbride, Cullen, Dr. Rush, &c. it deserves our particular attention. We therefore proceed to examine the doctrine of FERMENTATION. Chemists divide fermentation into three kinds, the vinous, acetous, and putrefactive; the product of the first is vinous spirit, or alcohol; of the second acetous acid, or vinegar; of the third ammoniac or volatile alkali. Li order to ascertain whether a vinous fermentation could take place in the human stomach, the folloAving experiment was performed. My friend, Mr. Mitchell, avoided his usual breakfast, in the place of which he took, between the boars of eight and ten, twelve ounces of su::\>r. Nothing more Avas taken until one o'clock. Having the power to ruminate, it was at this hour thrown up; the mass was sweet: upon being put f> rest no intestine motion or disengagement of air was to be perceived. It was then subm"utcd to distillation: a limpid fluid passed over into the receiver, Av-hich was sweetish, but had none of the properties of a vinous spirit. Carbonic acid gas is constantly evolved during the vinous fermentation ; M.\ Mitchell therefore paid particular attention to this, as long as the su ;;.r was on h:s stomach; but there was not the least eructation of air during the whole period the experiment was going on. If ever a vinous fermentation took place in the stomach, we expected to have found it in this experiment; as this viscus was plentifully supplied with saccharine ratter, v.hich passes so readily to this state: but as nothing of the kind occurred, we conclude the v.ncus fermentation has nothing to do with the digestive process. « YOUNG ON DIGESTION AND NUTRITION. 293 We next speak of the acetous fermentation. The arguments advanced in support of the opinion are, 1 st. Heat and moisture of the stomach. 2dly. The disengagement of air from this viscus. 3dly. The fluids with Avhich the food is mixed quickly running to the acetous fermentation. 4thly. The presence of an acid in the sto- mach. These we will examine in order. To the first argument we give its full weight, being founded in truth; but to the second, the disengagement of air from the stomach, we object, as giving any support to this doctrine. This is constantly spoken of as a uniform occurrence, whereas every one Avho has attended to the state of their oavii stomachs, must confess they haA^e frequently digested meals Avithout the eructation of a particle of air: with much propriety there- fore, Ave might reverse this argument, and bring it as a strong objection to this doctrine. Sdly. The fluids with Avhich food is mixed quickly running into the acetous fermentation. The saliva is said quickly to pass into this process as the experiments of Macbride and Dr. Rush clearly prove. Those gentlemen mixed some vegetable and animal matter Avith saliva, and others AA-ith water. Upon placing these under equal circumstances, in a moderate heat, the vegetable and animal matter mixed Avith saliva fer- mented much the soonest. From this they draw a strong argument, apparently favouring the same taking place in the human stomach, the food there being plentifully supplied with this fermenting juice. Aliment is not however, in these experiments, exposed under all the circumstances it is Avhen in the stomach ; a fluid of much more importance than the one just mentioned is left out, and of course the inferences draAvn from them cannot be valid. The gastric juice, Spallanzani found poAverfully to resist fermentation; and even restored putrid substances to their original sweetness, as I have also witnessed Avith my frogs. In the following experiment hoAvever, food is exposed under all the circumstances it is Avhen in the stomach, but with a different result from those just men- tioned. On an empty stomach I made a light dinner, on chicken pye, and drank simple Avater: in half an hour, by irritating my fauces, it Avas throAvn up; at this time it Avas plentifully supplied with gastric fluid, as Avell as saliva, as the quantity of food was but small. It was then ex- posed in a tumbler, to a heat equal to the human temperature. For the space of nine hours, there Avas not the least intestine motion, nor any disengagement of air. As digestion is performed sooner than this period, it Avas not attended to any longer. From this experiment Ave are forced to draw conclusions directly in opposition to those above mentioned. 4thly. The basis of this doctrine is the presence of an acid in the sto- mach : that this is the case Ave are fully convinced; but from Avhat has already been said it appeared to us an acetous fermentation did not take 594 YOUNG ON DIGESTION AND NUTRITION. place in the human stomach. We were therefore led at first to suppose, the acid Avas only present Avhen this viscus was in a morbid state; but experiments proved to us the contrary: in all the different animals Ave ex- amined, an acid Avas almost constantly found present. Hunter observes, " that in all the animals, whether carnivorous or not, which he examined, he ahvays found an acid present in their stomachs, though not a strong one." It was before observed, that when small frogs were digested in the stomachs of larger ones, the dissoked mass was ahvays acid; here "■ nature was interrupted in her regular operations," nothing morbid could there- fore be said to be present. The following experiments satisfied us to Avhat tkis acid Avas to be referred. A piece of fresh veal Avas introduced into the empty stomach of one of the large frogs: in two hours it was examined; the surface was a little tender; upon being touched with litmus paper it Avas turned red. Here digestion was progressing quite regular, yet an acid was present. It appeared impossible at the same time to conceive, the meat could become sour in so very short a time, and in so very low a tempera- ture ; it Avas therefore conjectured, the acid was to be referred not to the meat, but to the gastric juice, which the folloAving experiments confirmed us in. A frog Avas kept starving for two days; a piece of litmus paper \ra.s then forced into its empty stomach, by means of a pair of forceps; upon being draAvn out, it Avas covered with gastric juice, and the litmus turned red. The naked gastric juice was aftenvards often examined, by bringing it out of their stomachs with a tea-spoon, and constantly found to be slightly acid. Being thus fully persuaded the acid, in the digested food of frogs, did not arise from a fermentation, but was to be referred to their gastric juice, Ave Avere led by analogy to suppose, the acid of our OAAn stomachs was to be attributed to the same origin: but this analo- gical reasoning might be called mere probability; the following experi- ment Avas therefore performed. Early in the morning my stomach being empty, I irritated my fauces Avith a view of throwing up some gastric juice: though many efforts were made, none could be vomited. The fol- loAving day, I took some meat on an empty stomach: in half an hour afterwards, by irritating my fauces, the meat Avas thrown up, and Avith it some gastric fluid: upon being tested, an acid was very evidently present. Here no one can suppose the acid Avas to be referred to the meat. We have little hesitation, therefore, in saying, that the acid so constantly found in the stomach cf man, and almost, probably, all animals, is to be referred to their gastric fit ad. Having thus, we hope, traced the acid of the stomach to its proper origin, Ave next attempted to ascertain its nature- by chemical tes:.s. Mr. Mitchell being in good health, and having the poAver to ruminate* frequently thre'.v up the contents of his stomach for me; .hichlfcing YOUNG ON DIGESTION AND NUTRITION. 295 filtered, a transparent and acid fluid was obtained: on this fluid the folloAving experiments Avere performed. I. To a portion of this fluid, acetate of lead was added, a white precipitation immediately took place: this being Avashed, muriatic acid Avas added, which decomposed it, a very white powder remaining at the bottom, and a fluid above. Comparative precipitations of urine and this fluid, by the above agents, were in every respect the same. The explanation* of urine t treated in this manner is, that the phosphoric acid of this fluid, decom- poses the acetate of lead, forming an insoluble phosphate of lead; this being washed, by the addition of muriatic acid it is decomposed, plumbum corneum or a muriate of lead formed, Avhile the phosphoric acid remains in a liquid state above, AAdrich by disoxygenation affords phosphorus. Though great accuracy, and many varied experiments are required to ascertain certainly the presence of an unknoAvn acid, yet Ave are disposed to belieAe any person who had witnessed the great similarity in the comparative precipitations just mentioned, avouM have pronounced the same explanation Avas to be applied to both, or that the acid in the filtered fluid Avas the phosphoric. II. To a solution of silver in the nitric acid, some of the acid fluid was added; a precipitation immediately ensued. III. Mercury Avas precipitated by it from its nitric solution. IV. Lime was precipitated from lime Arater. Authors inform us, the phosphoric acid precipitates all these com- pounds as above mentioned, forming phosphates. Experiment the first proves, the acid of our fluid is not the acetous, as it precipitated lead from the acetous acid. From the acid in the stomach being the phosphoric, Ave explain Avhy some metallic substances, are so uniformly acted upon, Avhen taken in the stomach. The Italian physicians recommend iron in its pure metallic state as a tonic; and experience has confirmed! its efficacy: here the iron is acted upon by the phosphoric acid.f Copper is also dissolved in the stomach and by the same agent. In the acidity of dyspeptics and pregnant Avomen, where the quantity of acid in the gastric fluid, is morbid in quantity, similar to what the lithic is sometimes in affection* »1 the kidneys; Ave learn the superiority of lime Avater as a corrector,. from its great affinity to phosphoric acid. We shall conclude on this subject Avith one more observation. We have already seen lime is one of the nutrientia: no one supposes this' * See Lavoisier. t Does not the uniform effects of iron in its metallic itate, prove that au acid is &l\v;\ t present in the stomach ? f Bh\ Barton's MS. Lectures. 296 YOUNG ON DIGESTION AND NUTRITION. can undergo a fermentation: Ave all agfee as to, the simplicity and uniformity of nature in all her operations; but, according to the above doctrine, it would be departing widely from this, to say, she does not ferment all the nutrientia, previously to their entering the circulating mass. 'Water we have also seen above, promotes the growth of animals; ' here she would be again forsaking her accustomed path; for none of her laAvs teach us pure water will ferment, in the short time necessary for digestion to be performed. Having thus rejected fermentation, Ave proceed to attempt the explanation of the digestive process on other principles. We have already seen the food is completely dissolved by the gastric fluid, and then mixed Avith two other fluids, bile and pancreatic liquor. But as was before observed, Avill simple solution and mixture explain the conversion of aliment, into a fluid having, none of the properties of either? Or will it explain how two different articles as bread and meat, are changed to the same substance?* I confess I cannot conceive it will. Thus, if " vitriolic acid be added to iron, ferrum vitriolatum is formed." But if " vitriolic acid be added to a different substance, as copper, it will not form the same ferrum vitriolatum, but a substance quite different, the cuprum vitriolatum." Solution and mixture will not then explain the true digestive process, or how food is converted into chyle. In attempting to account for this, we shall begin by observing, chyle does not exist ready formed ?.i the alimentary canal, any more than bile exists in the blood-vessels; for, by no process can we obtain either from them. The formation of these tAvo fluids therefore, Ave look upon in the same point of view. They are both formed by two secretory processes. The alimentary canal we look upon as a vena portarum, or a vena intestinalis, whieh circulates its dissolved and heterogeneous mass; like to the portarum, it has secreting ducts, or lacteals leading from it; and like to it a reservoir or thoracic duct, into Avhich it pours its secreted fluid. We would therefore explain this process in a few words. Aliment is dissohed by the gastric menstruum; it then passes into the duodenum and meets with bile and pancreatic liquor; after being united with these, a heterogeneous mass is formed called chyme, and from this the lacteals secrete chyle. We are led to believe this to be the true doctrine, because, as before observed, simple solution will not explain the phenomenon of digestion; nor will the mixture of this dissolved mass, with bile and pancreatic liquor, change it into chyle; for Ave know chyle is formed when both these fluids are Avanting: thus nutrition goes on when the biliary ducts are * Dr. Fordyce fed two dogs, the one on meat, the other on bread; upon killing tlicm, the clnle of both were found to ajrree in *ver\ rcsj'.cxt. , * YOUNG ON DIGESTION AND NUTRITION. 597 obstructed, and also Avhen theJpancreas is schirrous. That the absorbents haAre a secreting or digestive power, we learn from the following. Dr. Wistar informs us of a remarkable case, which occurred under his own observation, of a person who was supported for many weeks, by nourish- ing enemata, alone. Here it cannot be said there Avas bile, gastric and pancreatic liquors to assimilate the injected fluid into chyle; yet chyle was formed and the system nourished. If the lacteals acted the part of simple absorbing, or capillary tubes, their contained fluids ought to partake of the sensible properties of the mass from which they are absorbed. But the reverse of this is the case: chyle has always the same taste, however different the sensible properties of the contents of the intestines may be, Avhether they are acid, bitter, &c. We draw a strong argument in truth of this opinion, by turning to the vegetable kingdom, throughout the Avhole of which, the digestive process is seated in the absorbents. Water is to them, what the fluids of the primx vise are to the digestion of man: it dissolves their food, which being exposed to their vessels is taken up; but the fluid thus taken up, cannot be imitated by any mixture of earth and water, any more than we can imitate chyle, by combining aliments with the fluids of the alimentary canal. As we thus have proofs the one is a secretory process, why not admit that of the other to be so also, since the circumstances of each so perfectly agree. There is as yet one point remaining, which it is necessary for us to notice. The powerful action of the gastric fluid has been frequently mentioned in the preceding pages, as dissolving animal and vegetable matter: if animal substances are so readily dissolved by it, why does not this fluid also dissolve the stomach ? Hunter in the course of his dissections, frequently observed the large curvature of the stomach to be dissolved, particularly in such subjects as were carried off by sudden death: this dissolution he ascribes to the agency of the gastric fluid; but in the living body he supposed the vital principle of the stomach effectually resisted its action. This ingenious explanation has been objected to; the solution mentioned^ is said to arise from a putrefaction; that the same takes place in the intestines, where no such solvent fluid is to be found. Spallanzani though he appears to accede in a great measure to Hunter's idea, yet he observes, " too much is attributed to this principle." He supposes AvhateA'er possesses life is capable of resisting the action of the gastric fluid: his arguments by no means prove this. The folloAving considerations will render the general proposition doubtful. Fish dissolve and digest living crabs, lobsters, &c. ' The leech is concocted by the human stomach, though it has no pores, and can sustain a temperature equal to that of man." As the large frogs swallow animals alive, it Avas supposed they would ansAver very well to investigate*this principle. As it wa£ 2q 298 YOUNG ON DIGESTION AND NUTRITION. observed of the fish above, these large frggs without doubt swalloAved living animals, and very soon digested them. But does the gastric fluid act upon them before death ? The following experiment proved to us clearly it did not. A packthread was tied to the leg of a living frog; it was then given|. to one of the large frogs, who immediately sAvalloAved it. In fiver' minutes it Avas draAvn up, and as soon as it was extricated front** the mouth of the large frog, it leaped aAvay. It was sAvallowed a secon® time, and remained in the stomach for eight minutes, Avhen it was.;» draAvn out; it Avas still alive, though quite unable to leap. It being ^ SAvalloAved a third time, it was examined in fifteen minutes afterwards, when it Avas dead. Upon opening the mouth of the large frog when it contained the lesser one in its stomach, the manner in which their prey Avas destroyed Avas easily explained; the passage of the oesophagus, though it can be greatly enlarged, yet it is completely closed by doublings of its substance, and thus effectually prevents any accession of air into their stomachs: their prey is therefore soon destroyed ror want of air. The following experiments, we hoAvever hope, decisively prove that the living principle does effectually resist the action of the gastric fluid. Two threads Avere tied around the fore legs of a living common sized spring frog; its whole body, except the head and fore legs was introduced into the stomach of one of the large frogs: the fore legs of the lesser Avere made to clasp around the lower jaAV of the larger ' frog, and firmly tied in this situation; each of the threads were then tied to the fore legs of the larger frog also: thus situated it Avas impos- sible the small frog could be entirely SAvalloAved doAvn, or thrown out of the stomach of Lhe larger one. They were then put in a basin con- taining a linle water, where they remained undisturbed for one day and a half. The small frog upon being drawn out Avas perfectly alive, and its \-,hoIe l*ody coAered with gastric juice, and not the least dissolved in any part*. The same frog Avas then killed, and again introduced into the stomach of the large one in the very same situation as just described. In five hours it Avas drawn out, when its whole surface was completely dissolved. HaA'ing this clear proof of the living principle, resisting the action of the gastric fluid, it was next proposed to try ' whether the action cf this fluid Avould be resisted by a part in which the living principle was Aveakened. The great sciatic nerve of a living frog Avas therefore divided, and introduced into the stomach of a large one ss ?.bove; it was drawn out in tAvelve hours, when it was still alive, and the paralysed extremity was quite sound. i * AN EXPERIMENTAL INQUIRY • INTO THE SIMILARITY IN VIRTUE BETWEEN THE CORNUS FLORIDA AND SERICEA, AND THE CINCHONA OFFICINALIS OF LINNiEUS: TOGETHER WITH AN INQUIRY INTO THE MODUS OPERANDI OF ASTRINGENT VEGETABLES IN PREVENTING THE PUTREFACTIVE FERMENTATION. SUBMITTED TO THE EXAMINATION OF THE REVEREND JOHN ANDREWS, D. D. PROVOST PRO TEM. THE TRUSTEES, AND MEDICAL PROFESSORS OF THE UNIVERSITY OF PENNSYLVANIA, FOR THE DEGREE OF DOCTOR OF MEDICINE. ON THE EIGHTH OF JUNE, ONE THOUSAND EIGHT HUNDRED AND THREE. BY JOHN M. WALKER, OF VIRGINIA, MKMBER OF THE AMERICAN LINNiEAN SOCIETY AT PHILADELPHIA, AND MEMBER OF THE PHILADELPHIA MEDICAL SOCIETY. Every theory founded on experiment, and not assumed, is ahvays ^nod for as much a;", it will explain.---Burke. INTRODUCTION. IT was an opinion early held in Medicine, that every country pos- sessed an antidote to its diseases. The history of the Peruvian Bark tended greatly to confirm this, and if there be any justness in it this opinion may be again revived in America. For if Nature has given us, in our swamps and marshes, a Pandora's Box, she has in our forests given us a Cornu Copia: has she in our vallies soAved the seeds of disease, she has on our hills planted the Cornus Florida; or has she, more grievously to us, given wing to the volatile miasmata, that, under protean forms, attack us in a thousand ways, she has most providently scattered in our swamps the Cornus-Sericea. But I would not be understood to overvalue these provident gifts of nature, in implying specifics. Conscious of the short-lived reputation which exaggerated virtues beget for their medicines, I shall not deal in hyperbole; much less shall I detract from the Peruvian Bark, its justly accumulated praises, to heighten the blaze of contrast; nor shall I even introduce from obscurity into notice, inert undeserving vegetables:— Already have their virtues been perceived by the penetrating eye of professor Barton.* I have only then to shew, upon analytical principles, what foundation there is for a similarity in virtue betAveen the Cornus Florida and Sericea, and the red Peruvian Bark. The most satisfactory mode of doing which, appeared to be that of subjecting the Corni to every experiment, to which the Peruvian Bark has been subjected. The desire of utility, and not the love of novelty, nor the merit which is generally annexed to it, could have prompted to such an analysis; for so many valuable experiments and observations have already been made on the Peruvian Bark, that little noAv remains to be added. My claim to indulgence must, therefore, rest upon the intention alone, and not the performance. * Vide his Collections for an Essay towards a Materia Medica of the United States, p. 12. 302 INTRODUCTION. Too long has America paid tribute to foreign countries; too often have her physicians been baffled in their practice from the adulteration. of the bark. Every attempt, therefore, to liberate us from importation and obviate imposition is praiseworthy in itself; but how much more so must it be, when it is directed to our own too long neglected treasures. Flattering myself that your zeal to encourage such an attempt, will draw the mantle of forgetfulness over its imperfections, I shall proceed to the investigation of the subject, in prosecuting Avhich I cannot follow a bet- ter method than the canon of Linnxus," Systemate, Qualitate," Experi- menta, " et experientia, eruitur omnis usus plantarum." EXPERIMENTAL INQUIRY. SYSTEMATE. THE genus Cornus, to which the English have given the name of Cornel, or Dogwood, is arranged by Linnaeus in the class and order Tetrandria Monogynia of his sexual system. In this artificial system it is associated Avith a number of genera, the species of which are often endued with properties very essentially different from those of the tAvo species of Cornus, which form the principal objects of this dissertation. In his work on the natural orders of vegetables the great Swedish naturalist has arranged the genus Cornus, in his forty-seventh order, to which he has given the name Stellatx, or Stellate plants, a name ori- ginally applied by the illustrious Mr. Ray. In this order, the Cornus is associated Avith a number of genera, some of which are endoAved Avith highly useful medical, or other properties. I shall here mention the names of some of them: they are galium, rubia, spigelia, coffea, and psychotria. In the system of Mr. De Jussieu, the Cornus is arranged in the third order of his eleventh class, to which he has given the name of Caprifolia. Some of the principal genera with which it is here associated, are loni- cera, triosteum, caprifolium, viscum, viburnum, and sambucus; and the medical properties of these, as far as Ave are yet acquainted Avith them, are not very similar to those of the species of Cornus which are about to claim our attention. The viscum, or misletoe, has, indeed, been re- commended by some practitioners, as a remedy in intermittent feArers, and as a tonic in other diseases. The following is Linnxus's abridged definition of the genus Cornus: Involucrum 4—phyllum sspius. Petala supera, 4—Drupa Nucleo 2— loculari. Of this genus, many species are now knoAvn to the botanists, and of these, several, especially of the North-American species, were unknown to Linnxus; with the Cornus Florida, and Cornus Sericea, hoAvever, he was acquainted. 304 WALKER ON THE The Cornus Florida, which is well known in many parts of the United States by the name of Dogwood, and less generally by that of BoxAvood, is a very common vegetable in many parts of North-America. The following account of the DogAvood, is taken from an interesting manuscript copy of the Geographical History of the Plants of North- America, read to the American Linnxan Society, by Dr. Barton, president of said society. « The Cornus Florida grows as far north as latitude 45° and it extends as far south as latitude 28°. It is a tree of moderate stature. It does not in general attain the height of more than from eighteen to tAventy-five feet. Sometimes, hoAvever, it makes a nearer approach to the more lofty trees of the forests, attaining to the height of at least forty feet, and near one foot in diameter." The trunk is strong and covered with a rough bark, Avhich is much disposed to separate into longitudinal and transverse fissures or cracks. The Avood is extremely hard and durable; hence it has received one of its names, that of New- England Boxwood. The branches are numerous and spreading, and sometimes placed opposite, but frequently by fours, arising from oppo- site points, and pretty regularly disposed. The leaves are oval, pointed, entire, and very veined. The flowers are produced at the extremity of the small branches in clusters, the individuals of which are more or less numerous. They consist of an involucre, which is composed of four \ery large obcordate folioles, of a fleshy texture, and of a fine white colour. The extremity of each foliole, is marked by a notch, which sometimes exhibits the appearance of having been bitten. These parts of the involucre are generally of a dusky rose colour. The flowers, Mhich are situated in the centre of the large im'olucre (involucrum max- imum of Linnxus) are very small and of a yellowish colour. The calyx or empalement is monophylous, or one leafed, very small and four toothed aboA-e. It is deciduous or falls off before the ripening of the fruit. The corolla consists of four petals. The stamens are four, and of the same length. There is one pistil consisting of a roundish germ, Avhich is infe- rius or beneath. The style is filiform and nearly the length of the corolla. The stigma obtuse. The floAvers generally make their appearance, in Pennsylvania and oilier middle parts of the United States, about the beginning of May. They exhibit a most beautiful appearance; the large and white involucre forming a fine contrast with the green of the forest. They are succeeded by oblong drupes, commonly called berries, which are of a rich crimson colour. The berries ripen in September, and are the food of various species of birds, such as the robin, (turdus migratorius,) thrush, (turdus rufus,) he. They have a very bitter taste, r.-.d a spirituous impregnation of them is much used as a morning bitter, and sometimes as a remedy in intermittents, in many parts of the United States. CORNUS FLORIDA AND SERICEA. EXPLANATION OF THE PLATE. (A) A view of the four folioles of the involucre. (B) An expanded flower, exhibiting the involucre, in the centre of which are placed the flowers. (C) A single blossom exhibiting the calyx, petals, and four stamens. (D) The four-toothed calyx, and the pistil. (E) The ripe drupes, or berries. The Cornus Sericea, or American Red-rod Cornel, agrees in its generic character, with the Cornus Florida. It grows in a moist soil, by the sides of creeks and rivers and seldom attains the lieight of more than ten or twelve feet. In general, a considerable number of stems arise from the same root and are very straight. The bark or rather epidermidal covering of the young shoots is very smooth, shining, and of a rich dark red colour. This cir- cumstance added to the manner of growth of the stems, has procured to this species, the improper name of the Red Willow, by which name it is knoAvn in many parts of the United States. In Virginia it is called the Swamp Dogwood, and Rose Willow. The branches are placed opposite as are also the leaves, which a good deal resemble those of the Cornus Florida. Their under surface has a somewhat silken appearance, on which account Linnxus gave to this species the name of Cornus Sericea. The flowers are produced in clusters or cymes, of a whitish colour, and commonly make their appearance in June or July; they are succeeded. by succulent drupes or berries, which are of a blue colour, inclining to Sreen when ripe. They are eaten by different species of birds. I am informed by professor Barton, that the Indians of North-Carolina used to scrape the inner bark of this tree and smoke it in their pipes, when their tobacco was scarce; and they would frequently mix the bark of it along with their tobacco to smoke. This habit would seem to imply something narcotic. For an excellent figure of the Cornus Sericea, I may refer the reader to the late Mr. L'Heritier's valuable Monographia on the genus Cornus. On the uses of the Corni in the arts, much might be said; but I .hall merely enumerate a few of the most important purposes to Avhich thev may be applied. The fine texture, hardness, whiteness, and durability of the wood of the Cornus Florida, renders it an important article to the cabinet-makers and ioiners, in inlaying and ornamenting their various Avorks. To the mechanics in general, in making the most durable handles to their instru- ments, their guages, squares, and plane stocks, **•****"h]?h purposes, it is but little inferior to the English Boxwood. To the dentist it is no little acquisition, being the only kind of wood which will answer the purpose of plugging in transplanted teeth. 306 WALKER ON THE The straight slender red sprouts of the Cornus Sericea, are often employed for making baskets. The bark of these two species of Cornus are very similar in those , properties Avhich interest the mechanic. The more abundant bark of the Cornus Florida will, therefore, recommend itself in making ink, tanning, dyeing, galling, &c. For the quantity of gallic acid in the bark of the Dogwood, intitles the latter to rival the oak and the galls in the above processes. For the purpose of encouraging the use of our own indigenous vegetables, as well as lessening the necessity of importing the galls, I have here given the result of several experiments on the subject of making ink. By mixing, | oz. Pulv. Cort. Cor. Flor. 2 dr. Sulph. Iron. 2 sc. Gum. Arab. 16 oz. Aqux Font. an excellent black thin ink was made, fit for immediate use; and with which the Avhole MS. of this dissertation has been written. I must here observe that it is not necessary to be particular in choosing the particular parts or size of the part of the tree, in procuring the bark for this or medical purposes. I attended to this in the early part of my experi- ments, but I found the difference in virtue between the bark of the root, body, or branches of a moderate size, not to be worthy of notice. QUALITATE. The majority of practitioners of the present time, pay so little attention to this mode of investigating the medical qualities of plants, that I shall not be very minute on this part of my subject, which, according to the design and order above given, first presents together the Cornus Florida and Sericea, and the Cinchona* Officinalis for similar investigation. Plants, like animals, have a considerable analogy in their structure; hence what is said on the bark of the one will apply, with but little exception, to the other two. A horizontal section of a branch of the Cornus Florida, exhibits an external thick covering or bark, which is perceptibly divided into three distinct rings or layers, the outermost of which is called epidermis,! the middlemost parenchyma, and the inner- • For I deemed it unnecessary to say anything on the botanical history of the Cinchona. It has been too long a favourite article in the materia medica, to require, now, an historical account. f Grew and Malpighi, were the first who minutely examined the structure of vegetables, and gave names to the different parts. The latter was a celebrated anatomist and pli; sit* gist. Hence the above anatomical names. CORNUS FLORIDA AND SERICEA. 307 most is called cortical; this latter is the part which is to occupy our attention in the present and subsequent divisions of this dissertation. The colour of this cortical part is, in the Florida, yellowish, in the Sericea, grayish, and in the Cinchona, red. Its taste is in all three of these vegetables nearly similar, though someAVhat more bitter and astringent in the Corni than the Bark: the former when retained in the mouth sometime, only impart to the tongue these two tastes, along with a pleasant warmth; Avhereas when the latter is retained the same length of time, along with this bitterness and astringency, it imparts an indescribable taste, which will be easily recognized by every one who has taken the bark. EXPERIMENTA, INCLUDING THEIR CHEMICAL ANALYSIS. So important is analysis to chemistry, that many, learned in that science, have honoured it by calling chemistry the science of analysis: and certainly no researches, in which man has been engaged, 'have unfolded the powers of his mind, in a more ample manner, than this part of chemistry. In its history Ave perceive the gradual developement of his intellect, in shaking off the trammels of Egyptian priests, and emerging from the veil of alchymical hieroglyphics. But in no view do .we behold him more nobly engaged, than in tracing, link after link, that elective attraction, which binds together the particles of matter, and which, it would seem, were intended by nature to conceal them under eternal darkness. But the destructive flame, while it conceals its OAvn simplicity, developes the composition of those bodies on which it operates. By our acquaintance with this promethean torch, we approximate our works to those of nature, since we do not the less imitate her, by commencing Avhere she terminates; and though we cannot equal her in composition, we certainly rival her in resolving bodies into their primordial simplicity. When has a natural analysis taken place, without destroying itself in obedience to synthetic laws ? But the chemist, when he has broken the vinculum of union in bodies, collects the separated particles, and reserves them for future investigation. This is the business of analysis. In the progress of this operation, two stages may be marked ; first, that Avhich resolves compounds into their proximate or secondary principles,* such as gums, resins, &c. and secondly, that Avhich decomposes these again into their ultimate particles, as carbon, hydrogen, &c Since my object is tot treat the Corni as articles of the materia medici, I shall only prosecute their analysis to the first stage; this being the only * Fourcroy 308 WALKER ON THE one which enlightens the subject in such a vieAV: for though plants by their diversity in size, colour, texture, and form, display to our observation characters apparently the most dissimilar, yet they afford, by their ultimate analysis, results so simple and similar to each other, as not to be the objects of the materia medica. In prosecuting this analysis, I have laboured to be concise. To have detailed separately the various experiments, to which each individual t article was subjected, Avould have extended this dissertation far beyond the ordinary limits of an inaugural thesis. I have, therefore, arranged such experiments, as admitted, into a condensed tabulated form. I have likewise laboured to be accurate. Many experiments were performed in such manner, that the succeeding either confirmed or disapproved the accuracy of the preceding: thus, in ascertaining the solvent power of different menstrua, by Aveighing the menstruum before and after maceration on the article, the difference in w«ight shewed its solvent power; this Avas again confirmed by the residue, after evaporation, agreeing with the above difference. The first experiment which I made, was distillation. Equal quan- tities, that is one ounce of the pulverised bark of the root of the Cornus Florida and Sericea, and of the red Peruvian Bark, were macerated in six ounces of water, in retorts, during six hours. Receivers were then luted to the retorts, and heat gradually applied, and continued until near half of the fluids had come over; the receivers Avere then changed, and empty ones adapted as before; the heat was then increased to the intensity which Argand's lamp would afford, and continued until the poAvders appeared, in the retorts, like dried cakes. The products of the first distillation, of the Corni were transparent whitish fluids, possessing a slight aromatic odour, resembling new whisky, Avithout any perceptible taste. They did not produce any change Avith the following re-agents, employed with the products of the second distillation. Knowing the etherial oil, which is the base of vegetable aroma, appears under different forms, I did not conclude against its presence in the Corni, because it did not swim on the surface of the distilled liquor. The Avhiteness of the fluid indicated the presence of something Avhich I concluded to be essential oil, having its specific gravity, equal to that of the fluid,"and might, therefore, remain in any part of the fluid, without rising or sinking. The fluid, distilled from the Peruvian Bark, differed from the above in no respect, but in possessing a flavour not aromatic, but peculiar to the Bark. The fluid Avas clear and transparent. The fluids, furnished by the last distillation, were more disagreeable in smell, Avith a taste someAvhat acerb. Those from the Corni acquired a lemon colour; that from the Peruvian Bark was tinged with red. CORNUS FLORIDA AND SERICEA. 309 The following is a synopsis of the changes which took place upon mixing the fluid, distilled from With litmus paper* Oxy-sulphate. Ace. Lead. Garb. Alumen. CCorn. Flor. Red. Black. Precipitate. Effervescence. the -i Corn. Seri. Red. Black. Precipitate. Effervescence. CCort. Peru. Red. Brown. Precipitate. Slight Effervescence. This experiment sufficiently proves that the virtues of the Corni and Peruvian Bark are for the most part fixed, and that each contains the gallic acid, though it is in greater quantity in the Corni than in the Bark, as is manifest from the difference in the colour, produced by their mixture Avith the oxy-sulphate. The gallic acid likewise comes over in distillation in an uncombined state, as appeared evident upon applying a piece of litmus paper, which had been dipped into the distilled fluid, Avith a similar piece taken out of a saturated solution of the carbonate of potash, a perceptible effervescence took place. This experiment likeAvise adds some Aveight to those of Dr. Skeete, who with a boldness paramount to his ingenuity, has denied to the Peruvian Bark an aromatic quality, which has been conferred upon it for near a century, and which had been the foundation for many of its praises. Attentive to this circumstance, I conducted the distillation with a gradually increasing heat, furnished by Argand's lamp, Avhich enabled me to regulate it in the manner I judged most favourable for the production of essential oil, but, upon examination, I could not detect the least quantity. Discouraged at the result of this experiment, and recollecting the success of the ancient chemists, many of whom laboured thirty years in the distillation of dried vegetables, without obtaining a different result, I did not choose to prosecute the distillation farther, but preferred folloAving the moderns in the employment of menstrua. For the improvement of this kind of analysis, the materia medica is greatly indebted to the labours of Bouldoc and Fourcroy, since it is this kind which has enriched it with some of its most important articles, as gums, resins, extracts, &c. The following table exhibits, in a synoptical view, the solvent power of water, under different modes of treatment. There is but little requisite to be said in explanation of it, since the slightest attention will render it intelligible. But it may here be observed, that the chalybeate solution, mentioned in the last column, was the oxy-sulphate of iron, dissolved in water, in the proportion of one drachm of the former to four ounces of the latter, which is the propor- tion to be recollected, whenever this solution is mentioned, and the proportions of the preparations tested, and the test is half an ounce of the former to half a drachm of the latter. * Of the shops. TABLE I. SHEWING THE SOLVENT POWER OF THE SAME MENSTRUUM UNDER DIFFERENT MODES OF PREPARATION. Propoition of Time ot Weight of Quantity Solvend and prepara- SENSIBLE QUALITIES. Menstruum per oz. ta- Colour with Al'.TICl.ES EXPERIMENTED WITH. Solvent in tion in per ounce in ken up iii Chalybeate. dr. oz. Hours. Colour. Taste. dr. sc. grs. grains. Water employed in all the Experi-ments. 7 "2 11 Cm o Pulv. Cort. Rad. Corn. Flor. 4 6 light red bitter acerb 8 0 7 16 dark black 2 c .2 a Pulv. Cort. Arb. Corn. Flor. 4 6 light red bitter acerb 8 0 GV lH black Pulv. Cort. Rad. Corn. Seri. 4 6 dark red bitter 8 0 5 14 dark black X g Pulv. Cort. Arb. Corn. Seri. 4 6 dark red and acerb 8 0 5 14 black « _Pulv. Cort. Peru. Rub. 4 6 red bitter do. 8 0 Oi 9f dark l-i o 'Pulv. Cort. Rad. Corn. Flor. 3 5 24 red bitter 8 0 2| nl dark black Pulv. Cort. Arb. Corn. Flor. 3 5 24 red and acerb 8 0 1 10 ditto Pulv. Cort. Rad. Corn. Seri. 3 5 24 dark red bitter 8 0 2 11 ditto Pulv. Cort. Arbo. Corn. Seri. 3 5 24 I£ Pulv. Cort. Arbo. Corn. Flor. 3 5 1 2 light red and acerb 8 0 5 14 ditto Pulv. Cort. Rad. Corn. Seri. 3 5 1 2 dark red bitter 8 0 3 12 dark black Pulv. Cort. Arb. Corn. Seri. 3 5 1 •5 dark red and acerb 8 0 3 12 ditto _Pulv. Cort. Peru. Rub. 3 5 1 2 light red ditto 7 2 18* 71 ' 2 black CORNUS FLORIDA AND SERICEA. 311 Though few comments upon this table are required, it will not be improper to point out some of the peculiarities Avhich prevailed in these experiments, and which could not be noticed in the table. The difference in all these preparations is not so great as to require describing them in separate classes. I may therefore, add, that though the taste of the Comi is a more simple and agreeable bitter than the Peruvian Bark, it has nevertheless considerable austerity combined with it; the decoctions possess most of the latter, and the hot triturated infusions the next. I may likewise add that the decoctions and hot infusions Avere less elegant preparations; the hot menstruum held in suspension some of the fine powder, which was not entirely deposited by cooling, nor in passing through the filter. This circumstance accounts for the generally received opinion, that heat increases the solvent power of .water on vegetables in general, and in so considerable a degree, upon the Peruvian Bark in particular, that Dr. Skeete estimated the specific gravity of the decoction to be, to that of the infusion as five to two. In this part of the doctor's valuable obser- vations on the Bark, his usual correctness must have deserted him. .The result of the experiment in table 1st. article the last, in experiments the second and third, shew their specific gravity to be as, 1.900 to 1.000. Nor is this superior gravity of the decoction over the infusion owing, as the doctor supposed, to the superior solvent power of the hot over the cold menstruum, but to the mere suspension of the fine powder of the Bark in the menstruum, which becomes so incorporated with the gum and mu- cilage, by the heat increasing their liquidity, and by the agitation of boiling, that it is difficult to separate it afterwards. This is rendered probable by the after analysis of the gum. What could the superior dark- ness of the solution of the gum obtained from the decoction, be oAving to, unless to something which was insolsuble in Avater and alcohol ? Nor did the decoction manifest stronger virtues by its sensible qualities, or from the change it produced Avith a solution of the oxy-sulphate; nor did the effects produced on the pulse, hereafter to be mentioned, manifest its superior power. I shall not dwell longer on this part of the table, in pointing out the peculiar advantages which each mode of preparation has, but shall only add, that experiment the fifth shews the cold triturated in- fusion to be equal to any, and it has the advantage of expedition. As the ascertaining the exact quantity of gum, resin, or extract, in any given quantity of the articles in substance, Avould be more curious than useful, and more difficult than either, from the tenacity of these substances to the vegetable fibre, I have* omitted such inquiry, Avhile I * For which omission, I may expect pardon, when I add, that Dr. Percival, whose patience was equal to his zeul for science, acknowledged that twenty-five coctions, .and thirty miterations Avere insufficient to exhaust the virtues of the 312 WALKER ON THE have directed my experiments to the more useful investigation of what part of the vegetable their virtue resides, and the proportion Avhich these parts bear to each other, in the more common preparations of infusions, tinctures, &c The utility of such an inquiry must be palpable to every one who is acquainted with the powers which chemistry furnishes us, by which we may imitate, or modify these proportions when they shall be knoAvn. Already much has been done by the artificial combination of bitter- ness and astringency; and though I have not the vanity to suppose I shall add any thing new, to the long sought for constitution of the Bark, yet my object will be ansAvered in tracing its analysis with that of the Corni. Experiment VI. The object ot this experiment was, to ascertain •the constituent parts of the gum-like mass, furnished by the evaporation of the decoction of the bark of the root of the Cornus Florida. Two drachms of this gum, which were furnished by seven and a half ounces of the decoction, were macerated in successive quantities of the best alcohol, until the last portion ceased to be changed in colour and taste; this, like the former portions, was separated from the gum by the filter; after the gum had dried upon the filter, it was collected, and weighed only half a drachm. The dried gum was then dissolved in a small quan- tity of water. Its solution was imperfect, not transparent, nor bright coloured; it possessed no particular taste, which might not be ascribed to its viscid consistence; and it produced no change of colour with a solution of the oxy-sulphate of iron. The want of transparency led me to suppose there might be some mucilage in the solution; to determine which I added, in small portions, diluted sulphuric acid to the solution: a precipitate slowly fell to the bottom in a coagulated form. When the precipitation had ceased, it was separated from the solution by the filter, and evaporated to dryness, at the same time with the solution. By weigh- ing each residuum, I found the mucilage to be in the proportion of three to five, that is eighteen grains of gum, and twelve of mucilage. I should here observe, that upon the addition of the acid, the solution turned dark, and that I do not ascribe the want of transparency in the gummy solution to the presence of mucilage entirely; but to the fine poAvder of the medicine, which the viscidity of the fluid suspended and concealed; and probably the change of colour, just mentioned was owing to the carbonation of these particles by the acid. The alcohol which had been employed in the early part of this experi- ment was next examined, and found to possess an intense bitter taste along with considerable astringency: it produced an intense black colour with the oxy-sulphate of iron. Its colour Avas a beautiful dark red, not inferior to the tincture of kermes. By evaporating the alcohol I obtained a drachm CORNUS FLORIDA AND SERICEA. S13 and a half of what ancient chemists called saponaceous matter, but what I shall, after the example of Mr. Hermstadt,* to whom I am indebted for the suggestion of many of the re-agents employed in these experiments, call extractive matter; which he says may be distinguished from all other vegetable matter, by being soluble in water and alcohol, and not in sul- phuric ether. But I must here observe, that this character is mere exten- sive than Mr. Hermstadt appears to be apprized of, for it equally applies to the Tannin principle. May not Tannin be the extract of vegetables altered by the gallic acid? The above character of extractive matter suggested the maceration of it in ether, to ascertain whether the water, by boiling the medicines in substance, had taken any of their resin. Accordingly two ounces of sulphuric ether were poured on the ninety grains of extract, which, at the end of thirty-six hours, Avas separated by the filter; and this Avas repeated as often as the last portion of ether was changed in taste or colour; whichchanges indicated the presence of resin. After the last filtration the extract was suffered to dry upon the filter; when collected and weighed, it had lost only six grains of its former weight. The ether had acquired a bitter taste, without astringency. It did not produce a black colour Avith a solution of the oxy-sulphate of iron. The evaporation of the ether left a broAvn resinous mass in the vessel, Avhich weighed nearly six grains. From the difficulty, if not the impossibility, of accurately separating the tannin and the gallic acid from the extractive matter, at this stage of the analysis, I omitted the attempt, and preferred considering the extractive matter as a ternary compound, possessing a very bitter taste, along with considerable astringency; it produced a black colour Avith the oxy-sulphate. The gum from the decoction of the bark of the root of the Cornus Sericea, and of the Peruvian Bark, were treated in a similar manner. Their ingredients, along with thj|r proportions, may be seen in the following synopsis. The sensible and chemical qualities of the decoction of the bark of the trees Cornus Florida and Sericea, differed so little from those of the roots of their respective trees, that I thought it unnecessary to analyse their gums in the above manner. • Gum. Muc. Res. C7\ oz. of decoc. of Cor. Flor. j there is in grs. 18 12 6 I 8^-oz. of decoc. of Cor. Ser. In O C7> CO t— £ £ ao ■* Ol » VO (O N ^ ^ co 0 O co Ol O M 0> » N •p s £ N«(N «N O O — — — — — — tN —' — — — ^S ^ lO (O IC lO (O N t^ h- 1^ b- b- b- h- h- b- b- »- b- erg O.S "7S 0 1° 0 en 4) & Time in Days. Ol Gi Qt O) Cl CO CO 00 CO CO CO CO CO CO CO Proportion of Solved & Solvent. dr. oz. (O ^D lO tO (O K CO CI M C) •O (O \o 0 0 IO to *-> -4-» 4J £ t-, t, S-, t. f_, O O O O O O f-UUUUU ARTICLES E j> j> _> ^> J> 3 3 3 3 3 Ph Ph Cl, Ph CU e: ^ > X .-£ CJ is j> j> ^> s* > 3 3 3 3 3 Ph Ph Ph Ph Ph *-----v------' HH C<+1 >-l . 0 0 > S &•£ X -rcn cd ji Ji ji ji j£; 3 3 3 3 3 Ph Ph Ph Ph Ph I i V •^ 3 -it, W This table, as Avell as the former, proves Hie superior solubility of the Comi in aqueous and diluted spirituous liquors, while the Peruvian Bark is equal to it in alcohol. The inferior solubility of the Bark in aqueous fluids can only be oAving to its possessing resin in the greatest quantity which is sparingly soluble in such fluids; while the Corni possessing more gum and extract, are nearly soluble alike in water and alcohol. They are likewise more miscible in Avater than the Bark, as might be in- ferred from the latter possessing the greatest quantity of resin. And I CORNUS FLORIDA AND SERICEA may observe that the Cornus Sericea approaches nearest to the Bark, in the proportion of its constituent parts, as may be seen by an attentive examination of their analyses. To add more on their sensible qualities, would only be a repetition of the sensible qualities of the Bark, which, it is presumed, are sufficiently knoAvn; for, as far as I can perceive, they are exceedingly alike, their colours being different shades of red, and their tastes bitter and astringent. The tenth experiment had for its object the separating the extractive matter taken up by the alcohol, from the resin. With this intention I macerated one drachm of the resinous mass of the Cornus Florida with repeated small quantities of sulphuric ether: the solution Avas very "imperfect. The first and second portions of ether acquired a dark colour, the third was so little altered in colour, that I judged it had taken up all the resin. This portion of ether, like the other two, was separated from the insoluble mass by the filter, and mixed with them. The ether was now of a bitter taste, without much astringency; it did not strike a black colour with the oxy-sulphate: upon evaporation it afforded forty- five grains of resin, of a yellowish colour. The extract now collected from the filter was of a dark colour, with considerable bitterness and astringency; produced an intense black colour with the oxy-sulphate, and weighed fifteen grains. It is to be recollected that the small quantity of the medicine, employed in this experiment, to be tested, was equal in all these articles, and for which allowance has been made. The following synopsis exhibits that ' r Resin. Extract. (~4 oz. of alcoholic tine, of Cor. Flor. j there is in grains . 45 15 J 41 oz. of alcoholic tine, of Cor. Seri. In ] 2 there is in grains 47| 12l 4 oz. of alcoholic tine, of red Pern- io vian Bark, there is in grains 51 9 I am here to observe that the extract is to be considered as a compound of extract, tannin, gum, perhaps a little mucilage, and the gallic acid; for alcohol has the property of taking up all these, in a small quantity, from vegetable matter. A summary recapitulation of these experiments shew that the Cornus Florida and Sericea, and the Peruvian Bark possess the same ingredients, that is gum, mucilage, and extract, which last contains the tannin and gallic acid, though in different proportions. The Florida possesses most of the eum, mucilage, and extract; the Sericea the next, which appears to be an intermediate between the Florida and Peruvian Bark; while the latter possesses most of the resin. Their virtues appear equally similar in their residence. The extract and resin possess all their active virtues. The extract appears to possess all their tonio power. The resin ii fgrs. 60 ** - 60 60 316 WALKER ON THE when perfectly separated from the extract, appears to be purely stimu- lant ; and probably the tonic poAver of the extract is increased, when combined Avith a portion of the resin, as in the spiritous tincture. THEIR RELATIVE POWER OF RESISTING THE PUTRE- FACTIVE FERMENTATION- By this term, Avhich was first introduced into chemistry in the six- teenth century, by Van Helmont, is understood "that spontaneous decomposition Avhich takes place in vegetable and animal substances, after death." Although the surprising phenomena Avhich attend this natural analysis of bodies, Avere not unnoticed by the ancients, yet they remained for miry years in the greatest obscurity. Nog Avas it until the close of the eighteenth century, that this cloud began to be dispelled, by the illustrious but unfortunate chemist, Avhose discoA'eries haAre immortalized H;m name by giAdng a neAV £cra to chemistry. LaA'oisier, the ornament of philosophy, and the boast of chemistry, taught us the nature of those grimes Avhich have a principal share in this process. It Avas Lavoisier, for whose untimely f?te philosophy mourned and chemistry acknoAV- ledgcd her loss, that gave origin to the present theory of chemistry, Avhich now adorns the nineteenth century. But unfortunately for this subject, the rapid impiwements Avhich distingu'sh this age have not been equally extended to it. For notAvithstanding the labours of a Macbride, a Percival and a Priestley, the complicated changes Avhich take place in putrefaction aiv still enveloped in darkness and uncertainty. Equally uncertain is the modus operandi of certain medicines in pre- venting or checking these changes, Avhen they have commenced. I feel the less diuidence in declaring their manner of action to be the obiect- of my present in-juiry, since I shall not wander in the in:>.ze of theory, nor go a step beyond the "broad basis of experiment. And as " every theory founded on experiment, and not assumed, is always good for as much as it will explain," I shall confine my observations to astringent vegetable substances. Since the time of Anaximenes, with Avhom nature's great law* Avas uniformity, philosophers and chemists have united in acknowledging the homogeneousness of nature's works: from this universal principle*sprung the co-extensive law of chemistry, that every body has either an efficient or predisposing affinity for every other. These affinities are changeable into each other, .and upon their mutual conversion, which, hoAvever, is modified or prevented by every poi-slblc variety ofcircuinMances, depends * Ilr.Pfcld's History of Philosophy. CORNUS FLORIDA AND SERICEA. 317 those secret and wonderful operations of nature. Thus the sugar in the matured grapes, possesses, Avithin their integuments, a predisposing affinity for oxygen, and no sooner do the circumstances of its deA-elope- ment into a fluid, the access of air, and increase of heat, take place, than this predisposition is changed into efficiency, which constitutes the vinous fermentation, whose degree and continuance is modified by the paucity of sugar, or deficiency of heat. Hence the vast variety of alcoholic products. Or it is changed by the too long continuance of these circum- stances, or their existing in too favourable a degree, which facilitates the too speedy union of the oxygen Avith the carbon of the sugar, and thereby reduces it to mucilage, by the decarbonation of the sugar in the form of carbonic acid. Hence the acetous fermentation. Or this conversion of affinities may be again changed by the too great heat, too free access of air, or too great fluidity, which, while it evolves the gluten of the vege- table, conducts to the putrefactiAre fermentation, which lends in the volatilization of the ingredients. Or, lastly, this change may be prevented by destroying the efficient affinity of the sugar, mucilage, or gluten, for oxygen. Thus has nature, in stamping similarity on her productions, planted Avithin them the germ of their destruction; thus does she make affinity the principle of synthesis and the cause too of analysis; and thus does she accomplish the perpetual circle of compositions and decomposi- tions, Avhich demonstrates her fecundity, while it anounces equal grandeur and simplicity in her operations., Hence the difference between nature and art.' Nature is rich in poverty ; art is poor in riches. Nature has few materials,* her Avorks are innumerable; art has many, her Avorks are few. Such are the principles of pneumatic chemistry, which teach us, we have only to substitute gelatin for gluten, to make the above illustration apply to animal putrefaction. The illustration already given shews us too, the foundation for two kinds of antiseptics, which may be called mechanical and chemical. The enveloping the gelatin in a 'body impermeable to air, as resin, or the condensing the particles of the gelatin within the sphere of a too strong attraction, by boiling and drying, as in making portable soup, belong to the first, Avhile those bodies, Avhich present to the gelatin an affinity superior to that for oxygen, belong to the latter; such are astringent vegetable substances. The first experiment which Avas made on this class of vegetables, Avas Avith a vieAV to ascertain the comparative antiseptic poAver of the Corni and Peruvian Bark. Accordingly four drachms by Aveight of fresh veal, Avere immersed in equal quantities, that is tAvo ounces of the filtered infusion of the Cornus Florida and Sericea, and the Peruvian Bark, in separate * Or elements. S18 WALKER ON THE CORNUS FLORIDA, &c. tumbler glasses. The immersion of the veal soon occasioned a precipi- tate, of a grayish colour, in the infusion from the Corni, and reddish in that from the Peruvian Bark, and also of unequal quantities, being greater in the Florida and next in the Sericea. The result of this experiment (see tables, exp. 11.) shewing considerable proportion between the antiseptic poAver of the articles, and the precipitates, induced me to ascribe the antiseptic poAver, to the precipitate; which, upon examination, was found to be the tannin principle; a substance to Avhich our attention was first called by Sequin, and afterwards investigated by Proust. The changes Avhich the muscular fibre underwent, greatly confirmed this opinion; its juices Avere soon decomposed, the red blood lost its colour, and the fibres appeared corrugated and condensed, though these changes Avere less in the infusion from the Peruvian Bark. These changes rendered it very probable that the gelatin of the fibre, and of the blood unitedrfo the tannin, and formed a compound capable of resisting putrefaction in proportion to the quantity of the tannin present: for on the sixth day, at which time the veal in the infusion from the Peruvian Bark was offensive, a portion of veal was taken out of the infusions from the Cornus Florida and Sericea, which was perfectly SAveet; when dry I found it pulverable between the fingers, but could not trace the fibrous texture: so intimate Avas the union with the tannin. For though there was a difference in this respect, between the muscle and tanned leather, I nevertheless ascribed the change to the tanning process, judging the difference in appearance and qualities, to be owing to the difference in texture. To prove this more decisively, I precipitated the tannin from fresh infusions of the medicines, by a saturated solution of glue. The liquor was then separated from the precipitate, formed in this manner, by the filter, and four drachms of fresh A'eal were added, as in the former experi- ment, but Avith a very different result. Its antiseptic power was destroyed. See table 3. exp. 12. It is unnecessary to dwell longeron this*part of the experiment, since the following table sheAvs the experiments which were made, and the changes which took place. For the better understanding the table, it-is to be recollected that all the infusions of the different medicines were made under similar circum- stances, and in similar proportions. Thus the simple infusion employed in experiments 11, 12, 13, 14, Avere made with tAvo drachms of the powder, and four ounces of water, macerated twenty-four hours, and then filtered. The compound infusions were made by triturating tAvo drachms of the powder, and one drachm of the calcareous earth with six ounces of water; Avhich, after standing the same length of time Avere filtered. TABLE III. SHEWING THE ANTISEPTIC POWER OF THE INFUSIONS OF DIFFERENT MEDICINES, IN THE TEMPERATURE OF ABOUT 72° OF FARENHEIT'S THERMOMETER. Z3 W.S 5-2 X S «U3 Changes which took place (the figures stand for days.) MEDICINES. Proportion of Iijf'iis. Veal. oz. dr. The relative Time it re- quantity of Change with mained 'Simp. aqua. 2 Cort. Rad. Corn. Flor. 2 Cort. Arb. Corn. Flor. 2 Cort. Rad. Corn. Ser. 2 Cort. Arb. Corn. Ser. 2 Cort. Peru. Rub. 2 Cort. Querci. Rub. 2 Rad. Columb. 2 Pulv. Gallae. 2 Cort. Rad. Corn. Flor. 2 Cort. Rad. Corn. Ser. 2 .Cort. Peru. Rub. 2 4 1 Pale, 2 texture diminished and greenish, 4 putrid. 4 Tannin. A C1 Copious precipitate, 6 sweet, fibre condensed, 15 inf. acid,") C. 16 mouldy on the surface, taken out and dried, sweet. 5 10 F Copious precipitate, 6 sweet, fibre condensed, gray colour," 14 acid and mould infusion, and nearly evaporated, taken ( out, on 15. trating smen. j . Cl Copious precipitate, 10 sweet, 15 solid and firm, 18 infusion^ ^ £ mouldy. 4 1 No precipitate, 2 pale and soft, 4 offensive. ") 1 Copious precipitate, 4 condensed, 8 sweet, 10 mould infu 4 C1 Small precipitate, 4 fibre lax and pale, 6 greenish, 8 pene-7 £ trating smell. 5 sion, 18 acid. 3 Changes which took place when the tannin was precipitated. . C1 No precipitate, nor corrugation of fibre, pale, 8 green, C 5 putrid. . C1 Ditto pale and relaxed, 3 greenish, 4 unpleasant smell, 4t 5 putrid. 4 1 Ditto, 3 greenish colour, soft, 4 unpleasant, 5 putrid. 15 0 12 Gallic acid. B sweet. C. pale brown. > 26 ditto . ditto ditto ditto broAvn. I 26 14 30 7 3a TABLE III. See—CONTINUED. MEDICINES. 8 -S *o J" Cort. Rad. Corn. Flor. X 6-1 1 Cort. Rad. Corn. Ser. W u3 «S *- Cort. Rub. Peru. 2.5 b, • gi c C Cort. Rad. Corn. Flor. £ g.2 precipi- blacks out astrin- 10 j tate. black j gency. 20 7 18 1-2 y ditto 11 S idit 19 18 S> ditto 10 3 ditto C ditto C ^ ditto ditto WALKER ON THE CORNUS FLORIDA, &c 321 COMMENTS • N THE CLASSES OF EXPERIMENTS CONTAINED IN THE PRECEDING TABLE. Strongly impressed with the justness of the principle, which the great Newton laid down on experimental evidence, which is, that " though the arguing from experiments and observations, by induction, be no demonstration of general conclusions, yet it is the best mode of arguing Avhich the nature of things admit of,and may be looked upon as so much the stronger, by how much the induction is the more general;" I have, to profit by the authority of so great a philosopher, extended my experi- ments to several articles which were not the objects of my dissertation; the plain induction from all of which, is, that the tannin principle of astringent vegetables, which is thrown down by the gelatin of the flesh, is the antiseptic principle; and that it acts by chemically uniting with the gelatin, and thereby destroying the efficient affinity of the latter for oxygen, which is the septic principle. The changes which the muscle underwent in the infusions, as far as they could be expressed in the table, agree with the quantity of tannin present in those infusions, as expressed under A. experiment 11.. The relative quantity of tannin, expressed in this column, Avas ascertained by adding equal quantities of a saturated solution of gelatin to equal quantities of the different infusions concen- trated by partial evaporation, the quantity of precipitate shoAved the rela- tive quantity of tannin: letter B. of the same experiment, sheAvs that the gallic acid is precipitated along with the tannin, when gelatin is the pre- cipitant ; for upon the addition of the oxy-sulphate of iron, to the infusion out of the tumblers, a very slight change took place. C. This sheAvs the length of time the simple infusions ■will remain free from acidity, in the common stopped phials; the figures stand for days. Why those infusions Avhich have the greatest quantity of tannin, should remain unchanged the longest, is difficult to account for; unless it be that the tannin principle has a stronger affinity for oxygen than the 'jjnucilage of the infusion, upon the union of which with oxygen, acidity depends. This is someAvhat probable from the circumstance that tannin will reduce the oxy-sulphate of iron to the common sulphate. May not this be the cause of the change of colour of the blood and muscle, above mentioned ? The tannin uniting to the oxygen of the blood deprives it of that principle, to Avhich the present chemico-physiologists ascribe ita red colour. What farther can be required to prove the above manner of account- ing for the antiseptic poAver of astringent vegetables, is given in the 12th experiment, which proved, that the previous precipitation of the tannin destroys this poAver. 322 WALKER ON THE Experiment 13th sheAvs, that these medicines check putrefaction, after it has commenced, in the same manner and proportion. The 14th, sheAvs they prevent or check the acetous fermentation, probably by ab- sorbing oxygen from the mucilage of the fermenting mass. Experiments 15, 16, and 17. B. The precipitate which takes place upon adding the oxalate of ammoniac to these compound infusions, shews that the calcareous earth is dissolved in them, which, by forming a new compound with the tannin, destroys* its astringency and antiseptic property. C. D. The results in these two columns, agree with the expe- riments of professor Woodhouse.t For though the astringency of the com- pound infusion Avas destroyed by the mixture with the calcareous earth, it nevertheless struck a black colour Avith the oxy-sulphate, but did not possess the taste of astringency, nor corrugate the flesh immersed in»it. A. Soon after the introduction of the Peruvian Bark into practice, physicians not content with its solubility in aqueous menstrua, combined many different articles with it, to increase its solubility, and virtue in other respects; among which were magnesia, lime, &c. These experi- ments prove, that Avhatcver the combination with lime or magnesia, may do in other respects, its solubility cannot be said to be increased; for B proves the superior weight of the infusion to be oAving to the calcareous earth; D, that its astringency is destroyed; and the 15th, 16th, and 17th experiments at large, prove that its antiseptic poAver is also destroyed. Experiment XVIII. On the styptic power of the Corni, and Peru- vian Bark. With a view to ascertain this, I cut out three portions from the glut»i and vasti extend of a dog, with a dull scalpel to imitate com- mon incised Avounds, on Avhich I sprinkled the three powders; the Florida and Sericea soon stopped the haemorrhage; the Peruvian Bark was slow in stopping it; the blood and poAvder appeared to be chemically united, and formed a defence to the open tubes; the Cornus appeared not only to act upon the surface of the wound, in corrugating it, and thereby diminishing the orifice of the bleeding vessels, but the tannin likewise precipitated the gelatin of the blood, with which it formed an adhesive mass, that remained on the surface of the wound. EXPERIMENTS ON THE TANNIN PRINCIPLE. It is not my intention to give, in this place, a treatise on the art of tanning. But as the Corni promise to be profitably subservient to .this ,art, and as there has lately appeared on this subject some ingenious speculations, which, as Avell from the author, as their own merit, deserve attention, I hope the following digression will not be unacceptable. * Vide sixth Law of the Affinity of Composition. \ S»« hi* Qb>ti vation* uu the Combination of Acids, Bitters, uvd Astringents. CORNUS FLORIDA AND SERICEA. «3 Though the art of tanning is of ancient date, yet the tannin principle is of modern discovery, with the particular nature of Arhidh, we are not well acquainted; chemists, however, suppose it to be a distinct principle in vegetables. The ancients Avere content Avith ascribing this property to such vegetables as contained a gum-resinous matter, along Avith astrin- gency ; and their choice of tanning substances was chiefly confined to such vegetables. Though an established opinion and long practice in any art, only give sanction, without proving the correctness of such opinions; yet I am convinced the choice of the ancients was very judicious. The ingenious Mr. Biggins, supposes the tannin principle is all that is necessary for this process of tanning; and " as the gallic acid* corru- gates the surface, and does not seem to combine with the matter of skin," he thinks " it not only useless but detrimental."! Induced by the novelty and ingenuity of this opinion, I instituted the folloAving experiment, to see how far it Avould obtain in practice. I obtained some pure tannin, by partially evaporating a strong decoction of the Cornus Florida, and adding to it a'saturated'solution of the carbonate of potash; a copious precipitate fell down, which Avas collected upon the filter, afterwards washed in a small quantity of cold water, then dissolved in the like quan- tity of boiling Avater. This Avas tested with litmu3 paper to detect the excess of alkali; the paper being slightly changed green. Diluted sul- phuric acid was now added until the litmus paper indicated it to be neutralized. A grayish precipitate began again to appear, which increased by standing. When it had ceased subsiding, it AA'as again separated by the filter, and then dissohred in a small quantity of cold water, to Avhich Avas added a small piece of fresh calf-skin, previously deprived of the hair and small pieces of flesh, by the ordinary means for such pursoses. It was examined on the sixth day, but there Avas no appearance of the action of the tannin; and the skin appeared as unaltered as if it had lain the same length of time in pure Avater; it Avas soft, white, and slippery betAveen the fingers, and had undergone Avhat tanners call SAvelling. Con- vinced that the tannin thus separated, differed from the tannin in the fresh decoction in no other respect than the depriAration of the gallic acid, I determined to see Avhat effect another vegetable acid Avould have. Strong acetous acid was accordingly added to it, under the above circum- stances. The changes Avhich took place in the skin in ten days after- wards, Avere so similar to such as appeared in a similar piece of skin, which had been immersed in some of the decoction^: from which the tan- * It is here to be understood that Mr. Biggins means by the gallic acid, the astringent principle. f Philosophical Transactions. J I shall here give the reason, why the decoction was preferred as a standard. From the experiments of Messrs. Da\y, Proust, and Sequin, it appears tluu heat evolves the tannin principle: their experiments were made chiefly upon coffee; they 321 WALKER ON THE nin had not been precipitated, and which had been employed a* a standard by which to judge of the facility of the two processes, that I could not for- bear concluding, that astringency was essential, in the process of tanning. I should here observe that the gallate of tannin (for they unite together by a strong affinity) is very astringent. Noav as the gallic acid, though somewhat acerb in taste, cannot, from its Aveakness in this respect, be strictly called astringent, it is probable that the tannin contains some alumen, the union of the gallic acid Avith which, Dr. Woodhouse has satisfactorily proved to be astringent: this is somewhat confirmed by the increased astringency of the acetite of tannin; for the potash above em- ployed, by saturating the gallic acid, might have precipitated the alumine along Avith the tannin, and which, by uniting with a portion of the ace- tous acid, might have increased its astringency. In what manner astringents act in tanning is difficult to be explained; but it appears -probable that they serve the same purpose in tanning, Avhich mordents do in dyeing; they fix the tannin and gelatin to the cuticular fibre. The success of the acetate of tannin aboAre mentioned, giA'es consider- able countenance to the conjecture already made, that the tannin prin- ciple is the mere extract of vegetables altered by the gallic acid. Under this impression I endeavoured to imitate the tannin principle by uniting the extract of common flour* with Aveak alum-Avater, to which mixture a thin piece of skin, properly prepared, was added: the changes which took place, being perfectly similar to the tanning process, con- vinced me that this artificial combination of extract and acid possessed the true properties of the natural tannin. Hence I conclude, astringency is essential in tanning. The present subject involves the consideration of astringency in so palpable a manner, that I cannot, though I willingly Avould, have passed it over in silence; for astringency is a problem that has never been satisfactorily solved; nor do I pretend to such a solution, but only claim the privilege of opinion. found that a strong infusion of this article did not exhibit any marks of the tannin principle, nor of the gallic acid; but if it was first toasted, or a decoction made from it, the liquor thus prepared contained the tannin principle, and struck a black colour with the oxy-suljlhate of iron. Is it not probable that the heat produced this change, by increasing the affinity of the base of the gallic acid, for oxygen, which was furnished by the air. in toasting, or the water in boiling, and thus pro- duced the gallic acid, which united to the extractive matter, and formed the tannin principle. However this may bo, it is worthy the attention of tanners, fori am convinced from the experiments I have made, that thin skins maybe perfectly tanned, in the decoction of the Corni or oak bark, in ten days. * In many parts of our country, the country people tan thin leather, by first im- mersiri it in flour ?.r.d waf.r several days, and then placing the skin in alum-water. CORNUS FLORIDA AND SERICEA. 325 From the experiments of authors, as Avell as those which I have made upon this subject,* I am convinced we cannot limit astringency to the com- bination of a single acid, the gallic, with a calcareous base. Astringency, like bitterness, is the result of many binary combinations. Its production depends upon those secret changes Avhich take place upon the union of bodies, in conformity to the sixth law of the affinity of composition.! Limited would be the expression, that the sulphate of magnesia Avas alone the bitter principle; equally limited must it be, if it affirms the gal- late of alumine to be alone the astringent principle. Are not the sulphate, the muriate, the nitrate, and acetate of alumine, astringent? And what experiments have detected the presence of the gallic acid in theso»salts ? or, how many detections Avould convince us of its existenceyAvhen we knoAV that the sulphuric, muriatic, and nitric acids, convert the gallk into citric, malic, or oxalic acids; as little do Ave know of the tests ror the astringent principle. Doctor Woodhouse, whose ingenious labours have greatly enriched chemistry, proved in a pamphlet, Avhich has already been quoted, that the property of producing a black colour with the chalybeate solution was fallacious. Taste has been supposed the most certain criterion of its presence. But so little do Ave knoAv of the modus operandi of astringents on the organ of taste, or on the solida viva, that even with this we are subject to fallacy. Thus, alcohol, by attracting the saliva from the surface of the mouth, produces a taste similar to that of astringency. The dry air, by favouring the evaporation of fhe saliva, produces a similar taste, and were it not for our senses correcting the deception of taste, we should taste astringency whenever we Avalked in dry air. Many other articles, by stimulating the absorbent system, the excre- tories of which being more simple and facile in motion than the secreting, evacuate their tubes as fast as they are filled, and consequently produce corrugation of the part, by the sides of the emptied tubes approaching each other, which disposition of parts constitutes the astringent taste. This opinion, that astringents act upon the solida viva, in consequence of their stimulus, is not a novel one. Percival and Darwin, long since, entertained it. What are we then to conclude respecting astringency; * I thought it unnecessary to introduce the experiments which I made on the astringent principle, because their results only agreed with the experiment? of Dr. Woodhouse, that the gallate of alumine was astringent. But they, in no manner, tended to shew that astringency was an undivided principle, confined to a. single neutral salt. But, on the contrary, every salt, of which alumine was the hase, was astringent to the taste, and many other articles are confess^y astringent. ■{• According to which, compounds possess properties different from their component parts. 326 WALKER ON THE shall we, with Dr. Moore,* deny their existence; or, shall we, with more probability, acknowledge it the property of many combinations. EXPERIMENTS ON THE HEALTHY SYSTEM. The following is a synopsis of the effects of the different medicines, and their different preparations, on the healthy human body. And I must here observe, that the greatest attention was paid to obviate those circumstances which affect the pulse, by myself, as well as by my friendly fellow graduates, who assisted me in these experiments; and Avhose names I with pleasure insert to be Messrs. Massie, Downey, Wilsori *nd Young, and my friend Mr. Gregg. To avora unnecessary prolixity, I have only expressed the quantity and kiwi of medicine taken, in each experiment, Avithout inserting the name, time of day, 8cc. since it is to be presumed that every circumstance Avas attended to, which could be favourable to the success of these experi- ments. And to render them as satisfactory as possible, I have noted down the state of the pulse, and the affection of the system in general, opposite to the time Avhen they took place. A SYNOPSIS OF THE EXPERIMENTS ON THE PULSE. EXPEKIMENT 20. EXPERIMENT 21- EXPERIMENT 22. 30 gr. Pu^y. Cort. Rad. Cor. Flor. 30 gr. Pulv. Cort. Rad. 1 gr . Pulv. Cort. Per. Cor. Seri. Rub. Min . Pulsed Min. Pulse. Min. Pulse. 0 62 soft, natural 0 70 naturally full 0 66 natural 5 10 62 slight change 63 full, heat at 5 10 72 quick, soft 73 do. 5 10 66 no change 67 quicker, ful- 15 63 stomachy 15 74 slight nausea 15 67 ler do. 20 65 quick and full 20 76 full 20 68 full and 25 66 full and strong 25 76 nausea ceased 25 69 tense 30 68 do. 30 78 full and tense 30 69 do. 35 69 quick tense 35 78 do. 35 70 do. 40 70 flushed face 40 79 do. red face 40 70 strong and 45 50 70 tense, heat in-70 creased 45 50 79 regu. hard 78 full 45 50 71 regular 71 do. 55 70 do. 55 78 do. 55 72 do. 60 70 do. 60 78 do. head-ach 60 72 do. 75 68 full, regular 85 68' do. 95 * 65 reduced in 105 63 fulness. 75 85 95 105 77 do. quick 75 do. 73 slight 70 decrease. 75 85 95 105 71 slight head-70 full [ach 68 do. 67 nearly natural * Vide his Materia Medica. CORNUS FLORIDA AND SERICEA. 327 EXPERIMENT 23. EXPERIMENT 24. EXPERIMENT 25. * 12 gr. of the Resin of * 12 gr. of the Resin of * .12 gr. of Resin of P. Cor. Flor. Cor. Seri. Bark. Min Pulse. Min. Pulse. Min. Pulse. 0 62 soft, natural 0 72 natural 0 64 natural 5 62 slight disgust 5 72 small 5 64 full 10 61 nausea 10 72 do. and 10 65 and IS 61 in a slight deg. 15 73 quick, consi- 15 66 regular 20 62 quick and 20 75 derablenaus. 20 68 do. 25 63 fuller 25 75 fuller 25 68 do. 30 63 quick and 30 76 full 30 68 full and 35 66 frequent 35 77 do. 35 69 tense 40 68 do. 40 77 do. 40 69 do. 45 70 do. 45 79 do. tense 45 70 do. * 50 72 do. 50 80 do. 50 71 regular 55 73 do. 55 82 tense, regular 55 72 do. 60 71 do. slight 60 82 & flushed face 60 72 do. 65 69 head-ach 65 80 heat of the skin 65 73 full, flushed 70 67 full 70 79 tense 70 73 face 75 68 irregular 75 79 do. 75 70 do. 80 65 80 77 full and softer 80 66 do. 85 63 85 75 85 65 diminished in 95 60 small 95 72 95 65 fulness. EXPERIMENT 26. EXPERIMENT 27. EXPERIMENT 28. t 12 grs. of Extract of 12 grs. of Extract of 12 grs. Extract of P. Cor. Flor. Cor. Ser. Bark. 0 68 natural and 0 76 natural 0 66 natural 5 68 soft, full 5 76 soft and full 5 60 full and 10 69 quick and 10 77 quicker 10 67 strong 15 70 full 15 78 anxiety 15 68 quick 20 70 do. 20 78 full and 20 69 do. 25 72 do. agreeable 25 79 regular 25 69 do. 30 73 heat, tense 30 80 tense, flushed 30 69 do. 35 73 and regular 35 81 face 35 70 full and 40 74 do. 40 81 do. 40 70 tense 45 76 do. 45 82 do. 45 72 do 50 77 fuller) tense 50 82 do. 50 72 do. 55 77 do. flushed 55 80 do. 55 72 do. * Obtained by the simple evaporation of th« alcoholic tincture : for its consti- tuent parts, vide p. 315. t See Chemical Analysis, p. 315. 328 WALKER ON THE Min. Pulse. 60 77 flushed face • 65 77 do. 75 76 hard and tense 95 69 stro. than nat. EXPERIMENT 29. t 12 grs. of Gum of Cor. Flor. 0 62 natural 5 10 62 slight change 63 in fulness 15 20 65 full and quick 66 do. 25 67 do. 30 70 fuller and 35 40 70 regular 70 do. 45 50 71 moderately 70 tense 55 70 do. 60 69 do. 65 70 69 4go. 68 soft but full 75 64 EXPERIMENT 32. 2 oz. of Decoction of Cor. Flor. R. 0 66 natural 5 67 increase in 10 68 strength and 15 68 fulness 20 70 do. 25 72 do. 30 72 do. 40 77 tense and 50 80 strong 60 80 bounding 70 78 slight pain in 75 77 the head Min. Pulse. 60 79 diminished in 65 79 hardness 75 78 95 77 soft and full EXPERIMENT 30. 12 grs. of Gum of Cor. Ser. 0 64 natural 5 65 full and 10 65 regular 15 67 quicker 20 67 and fuller 25 68 do. 30 71 tense and 35 71 strong / 40 72 do. 45 73 do. 5.0 71 slight change 55 70 full 60 69 do. 65 68 do. 70 68 quicker than 75 67 natural. EXPERIMENT 33. 2 oz. of Decoction of Cor. Ser. R. 0 68 natural and 5 68 quick 10 69 fuller 15 70 do. 20 71 do. quicker 25 71 do. 30 73 do. 40 74 do. 50 74 flushing of 60 76 the face 70 80 full and 75 79 strong Min. Pulse. 60 71 full and tense 65 70 do. 75 68 diminished in 95 67 strength EXPERIMENT 31. 12 grs. of Gum of P. Bark. 0 72 natural 5 72 no change 10 73 fuller 15 75 do. and 20 75 quicker 25 77 tense 30 78 do. 35 80 do. 40 81 fuller and 45 82 stronger 50 82 do. 55 82 do. 60 80 quick and full 65 79 do. 70 76 do. 75 75 above natural. EXPERIMENT 34. 2 oz. of Decoction of P. Bark. 0 62 natural 5 62 soft 10 63 do. 15 65 quicker 20 65 with fulness 25 67 do. 30 68 do. 40 69 considerable 50 71 tension 60 72 do. 70 73 do. 75 71 tense with f By evaporating th« aqueous solution: for its component parts, see p. 313. CORNUS FLORIDA AND SERICEA. 329 Min. Pulse. Min. Pulse. 80 74 and flushing of 80 76 slight affection 90 73 the face 90 73 of the head 100 67 quick and soft 100 70 quick pulse. EXPERIMENT 35. 2 oz. of Infusion of Cor. Flor. R. 0 72 natural 5 73 quicker 10 74 do. 15 74 do. 20 75 fuller 25 76 do. 30 78 full and 40 79 tense 50 81 do. 60 84 do. 70 84 strong 75 83 do. 80 81 do. 85 79 flushing of 90 78 the face 100 75 above natural. EXPERIMENT 36. 2 oz. of Infusion of Cor. Seri. 0 76 natural 5 76 slight change 10 79 in quickness 15 80 fuller 20 81 quick and full 25 82 do. 30 84 do. 40 84 tense 50 85 do. 60 87 do. 70 85 do. 75 84 do. 80 82 heat of the skin 85 79 90 79 quicker. 100 77 Min. Pulse. 80 77 flushing of the 90 69 face 100 66 full and quick. EXPERIMENT 37. 2 oz. of Infusion of P- Bark. 0 64 natural 5 64 no change 10 66 quicker 15 68 do. 20 69 fuller 25 70 do. 30 72 tension 40 73 increased 50 74 do. 60 76 full and 70 76 tense 75 76 do. 80 74 do. 85 74 full 90 73 do. 100 66 above natural. I have but little to add on these experiments. From the difficulty of performing them, from the long and constant attention they require, and the difficulty of avoiding every circumstance, Avhich though insignificant in itself, often affects the pulse in a considerable degree, it is not pretended but some slight inaccuracy may have been noted doAvn: but it is hoped they will shew the resemblance between the three medicines. They likeAvise will sheAV the greater solubility and quicker action of the Cornus Florida. The Sericea appears to be next. This agrees with their chemi- cal analysis. Their regularity, and durability of action is likewise apparent, for in no one of them did the pulse return exactly to its natural state, but was often fuller and stronger, and always quicker. EXPERIENTIA. The little opportunity of applying a new medicine to practice, by the student of medicine, must be known to every one. It will not, on that account, be expected that many experiments on the diseased subject, will be related. However, from the kindness of Dr. Church, to Avhose friendship and. attention I am greatly indebted, 1 shall relate the success 2y 330 WALKER ON THE of an experiment with the Cornus Sericea in the case of an intermittent feA-er which came under the doctor's direction. April 13th, 1803. W. F. aged thirty-four, was taken with a chill about ten o'clock, a. m. Avhich continued four hours, and Avas succeeded by a fever which lasted ten hours; it Avent off in the ordinary manner by a copious perspiration. 14th. Free from fever, but debilitated. 15th. A similar paroxysm as on the 13th. 16th. As on the 14th. He iioav commenced Avith the arsenical solu- tion of FoAvler, in the dose of ten drops three times a day. 17th. Had another severe paroxysm. The drops were noAv omitted and blisters applied to his Avrists. 18th. He had given him six papers of the Cornus Sericea, containing a half drachm each, to be taken three times in the day. 19th. Free from fever. His intermittent has not returned. May 10. The following is a case afforded me by my friend and fellow graduate Mr. Hutchison, in his own Avords. On the 25th of April, 1803, I avcis desired to visit Samuel Anderson, aged thirty, Avith an intermittent fever. I found his pulse active, tongue furred, and his skin warm, he complained of pain in his head and back, he informed me he had two paroxysms previous to my visit. Four grains of tartar emetic Avere given him, which produced a copi- ous A-omiting. On the morning of the 26th I found him free from fever, and ordered thirty grains of Cort. Peru, to be taken every two hours. This was continued until eleven o'clock a. m. of the 27th, when the paroxysm returned. 28th. Finding him free from fever, I gave him twenty grains of the Cornus Sericea in powder, every three hours, which was continued for several days; he has had no return of his fever, May 6, 1803. It may here be added, that this species of the Cornus was used by the physicians of the French army in America, during the revolution, as a substitute for the Peruvian Bark. On the subject of the Comus Florida, I have receiAred a communi- cation through the hands of my friend and fellow graduate, Mr. Warms- ley, from Dr. Amos Gregg, of Bristol, Pennsylvania, which will be found doubly interesting; first, because it comes from a practitioner, whose success and zeal for the promotion of medical science, endears him to his medical brethren; and, secondly, because his opinion of^the Comus Florida is founded on an experience of tAventy-three years practice with it. The folloAving is in extract of the communication: " About the year 1778, during the American revolution, the great scarcity and high price of the Peruvian Bark, and the embarrassment from the Avant of it, induced me to search for a substitute. With this CORNUS FLORIDA AND SERICEA. 331 intention I tried the yellow poplar, in Avhich I Avas disappointed. The common Dogwood (Cornus Florida) Avas the next which I selected; and having at that time the intermittent fever, I took several ounces of the decoction of it, which effectually cured me, though it produced some pain in my bowels, Avhich was relieved by a feAv drops of laudanum. This property of affecting the boAvels with pain, I found it to possess only in its recent state; and never after it was twelve months old, did I find it disagree, in exciting pain, cathartic or emetic effects. I have, therefore, at different times, had considerable quantities well dried and pounded, so as not to be without it in my shop for twenty-three years. During which practice, I have found its virtues such as to convince me that it was not inferior to the Peruvian Bark in curing intermittents, nor inferior as a corroborant in all cases of debility. I must observe, however, that I have generally given the DogAvood in doses of thirty-five grains, which I haAre always found equal to thirty of the Peruvian Bark. I have used the Dog- wood in seA'eral other cases, the most interesting of which are: first, in a dropsical patient, Avho, after a feAv days of violent pain in his legs, had them SAvelled to a very large size, and considerably inflamed: soon after, small blisters appeared upon them, which in eight and forty hours turned of a dark purple colour; at this time I gave him thirty grains of the Dogwood in powder, with six grains of Virginia snake-root every half hour for two days, and once an hour for the succeeding twenty-four hours. The man recovered. " The other Avas a patient, avIio, by accident, had a great portion of the muscular part of his leg torn off; the Aveather being excessive warm, the purulent discharge soon became very great and offensive. I gave him the DogAvood joined Avith the snake-root as above, the man soon recovered, and is hoav living. I have often used the Dogwood, joined with gentian, columbo, camomile, and with aromatics in bitters, and have found it equal to the Peruvian Bark, and therefore concluded it is a valu- able medicine." APPLICATION. A When we look back upon the similarity between the /Corni and the Cinchona, in their sensible qualities, in their chemical analysis, and their similarity of action on the incised, and dead fibre, and particularly Avhen wa vieAV their similar operation on the healthy and diseased subject, Ave cannot but receiA-e the most flattering inducements to estimate these provident gifts of Nature. And Avhen Ave reflect upon the causes of the various forms of disease, Avhich are the endemics of our country, Ave cannot but receive additional inducements to regard the Corni as the most valuable vegetable, Avhich Nature, in the prolificness of her bounty, has scattered through the Avide forests of North-America. For so long ai 332 WALKER ON THE the mouldering ruins of our sAvamps, and the uncultivated condition of our marshes shall afford materials for the peccant operation of an autumnal sun, Ave shall vieAV, Avith peculiar delight, the virtues of these two vege- tables, which inherit the tAvo essential characters of the most valuable division of the materia medica; I mean, bitterness and astringency; to the " happy union" of which the Corni have a claim, as respectable as that which has procured for the Peruvian Bark a celebrity as extensiA'e as the bounds of rational medicine. Indeed, so striking is the similitude, so exact the result, from comparative trials, that in this attempt to recom- mend the Cornus Florida and Sericea, to the attention of practising phy- sicians, I cannot even review the forms of disease, in the particular states of which the Corni are indicated, without encroaching upon the reputa- tion of the Cinchona: for, in truth, it may be said, that in whatever form of disease the Cinchona has been decidedly serviceable, the Corni will be found equally so. And if we make allowances for the chances and inducements to adulteration in the former, for our relationship to the latter, for its wide extent through the very soil in which are engendered the seeds of those maladies, their virtues are fitted to remove, we must acknoAvledge their superiority. Experiments, of a diversified nature, warrant this conclusion. They are, like the Bark, bitter and astringent in the mouth, tonic and febrifuge in the stomach, and their chemical analysis afford results perfectly analogous. But shall I, on this account, recommend, in intermittents, remittents, choleras, diarrhoeas, and dysen- teries, the corroborant virtue of the Corni, because the same virtue, in the Cinchona, has been said to be their specific remedy ? This Avould, indeed, be following the usual mode of introducing neAv medicines into notice. But would it not be adding a specific to nosological titles, and one more poAverful nostrum to the long catalogue of empyricism? Had the improvements in pathology and therapeutics kept pace with the rapid enlargement of the materia medica, an attempt at this day to haAre added one more article to the latter, Avould have been regarded as fruitless and unnecessary. But while the medical mind Avas busily employed in draAving noso- logical distinctions, and Avasting the efforts of genius in searching for- specifics, the embryon of rational science Avas rising in the western horizon. In its growth it vieAved, Avith grief and horror, the species of diseases multiplying* themseh-cs in numbers and augmenting their malignity. And no sooner had it arrived at its zenith, than its first act * In proof of which the following is given as an example. Sauvage has, in hi* Nosology, 10 classes, 44 ordors, 300 genera, with species. and varieties innumerable. Linnxus has, 11 classes, 37 orders, specie? proportionally numerous. CORNUS FLORIDA AND SERICEA. 333 was to liberate medicine from the trammels of nosological complexity, and restore to disease that unity and simplicity, which allied it with its proximate cause. Fully impressed with the inestimable value of this improvement in medicine, which does distinguished honour to its author, I shall neglect the nosological order; nor shall I say that the Comi are indicated in remittents or intermittents, merely because they consist of paroxysms, remissions or intermissions, but shall pay particular attention to that state of the system, which affords the only rational indication for tonic medicine. I assume it a truth, sufficiently established by the illustrious professor of clinical medicine, in this university, " that disease is the same, however variously it may be modified by age, constitution, climate, season, remote or exciting causes, or by its duration." But if none of these circumstances, are sufficient to establish a specific difference in the nature of disease, what criterion are we to adopt, by which Ave may regu- late the administration of the Corni, or any other article of the materia medica, all of Avhich, though differing greatly in their respective qualities have nevertheless an appropriate point in the scale of morbid excite- ment? The very circumstances carry along with them the answer; namely, the existing state of the system, Avhich is to be judged of by the season, age, and duration, &c. but more particularly by the state of the arterial excitement, as pointed out by the pulse. So important is the nosometrical power of the pulse in sheAving the force of arterial action in the system, that it may emphatically be called the alter oculus of physicians. In taking, therefore, this nosometer of the system for my guide, my labour, in the application of the curative powers of the Corni will be greatly abridged. Instead of tracing their application through the cata- logue of nosologists, I am guided to that particular state of the system, which may occur in every form of disease, and which Avhenever it does occur, calls for the Corni, or such medicines as possess similar virtues. In tracing the pulse, in disease, Ave find it in two very opposite states. In the one Ave find it full, strong, hard and frequent, accompanied with heat of body, thirst, restlessness, Sec. to Avhich state has been attached the term of inflammatory action. In the other it is AA'eak, small and Vogclius has, 11 classes, containing 560 genera, with their species and varieties proportionally numerous. Cullen, 4 classes, 59 orders, 350 genera, with their species and varieties. Sagarus, 13 classes, 54 orders, 350 genera, containing 2,500 species with their varieties " Hci mihi! Tot mortes homini quot membvana, malisque " Tot sumus infevti, mora ut medicina putetur." 334 WALKER ON THE quick, accompanied with debility and prostration of strength, heaviness and dejection of spirits, and various other circumstances, which has attached to this state, the various terms of nervous, jail, hospital, ship, petechial, putrid or typhus fever. Every form of disease in its various modifications, approaches more or less near to one of these two opposite states, betAveen which there are several gradations of morbid excitement, indicated by corresponding degrees of arterial action. I have only, then, to say that the Corni or other tonics, whose virtue consists in increasing and supporting the strength of arterial action, and thereby removing that debility which is the principal symptom of this latter state, are indicated here. And that their exhibition may be extended, with probable success, to every other form of disease, in proportion as it approaches to this latter described state. But I cannot here omit the golden rule, in the exhibition of this class of medicines, for the authority of which we have the exalted names of a Darwin, a Rush, and a Barton, that is, whenever in the exhibition of tonic* or stimulants, the pulse becomes sloAver, fuller, and stronger, their administration is judicious, and should be continued; but Avhen, on the contrary, it becomes quicker, more frequent Avith an increase of heat on the body, anxiety, and dryness in the mouth, they are improper, and Ave may say with Ovid, " parce stimulis, et utere loris." In attending to disease, as it occurs in our oavii country, Ave perceive that some forms of disease approach more uniformly to that particular state, just described as requiring tonics, than others, such are those which occur in the summer and autumnal months. I shall therefore briefly enumerate them, in attempting which, I feel sentiments of gratitude in adopting the division and doctrines of the illustrious professor of the practice of physic, who enumerates six original forms of autumnal disease; in all of which the Cornus Florida and Sericea, may be employed with the happiest effects, according to circumstances; they are, " 1. The malignant yellow fever. 2. The inflammatory bilious fever. 3. The remittent bilious fever. 4.The intermittent bilious fever. 5. Chronic fever, and 6.Febricula." These embrace all the affections of the alimentary canal, in the shapes of cholera, diarrhoea, and dysentery; of the skin, in various eruptions; of the pulmonary system, intiie form of peripneumony notha; of the spleen and pancreas, in inflammations and obstructions; of the brain, in the shape of hydrocephalus and coma; and of the arterial system, in all the grades of arterial excitement, from the malignant to the typhus action. My limited time will not admit my dwelling on these forms of disease; all that I shall say therefoi js, that the disease which generally occurs at this season cf the year, generally shapes itself in such a manner, as to enable us to derive the greatest advantage from the tonic poAver of these CORNUS FLORIDA AND SERICEA. 335 * vegetables; the remissions and intermissions which succeed to the paroxysms of morbid excitement, often presenting favourable opportunities of conquering, by the active poAvers of the Corni, the growing habitudes of morbid excitement. On the particular indications which may be answered by the small difference in the proportions of the constituent parts of the Corni and Cinchona, as pointed out in their chemical analysis, I have but little to say ; they are easily judged of. Thus the superior miscibility and solu- bility of the Corni, shew that they may be given in smaller doses, and oftener repeated; whereas the more difficult solubility of the Peruvian Bark, requires that it should be given in larger doses and at longer intervals. When in debilitated habits along with which there is a dyspeptic state of the stomach, the Peruvian Bark disagrees Avith the latter, probably from its insolubility, the corni should be given. In the remitting fever, where the remission is not so complete as to admit the stimulating resin of the Bark, the Cornus Florida, as possessing less of this, may be employed. When an indication is founded upon great debility and laxity of the muscular system, accompanied with morbid irritability, and probably sensibility, depending upon this debility, the superior astringency of the Corni promises its aid. In those persons, whom from a particular state of the bowels, the Bark purges, the astringency of the Corni recommends itself. The greater antiseptic power of the Corni, claims for them a supe- riority in external application, in the form of fomentations, &c. to sphacelus parts. In debility of the alimentary canal in general, and of the stomach in particular, which gives rise to acidity in the latter, as often occurs in dyspepsia, Avhich require tonics, the superior anti-fermentative poAver of the Corni, should be employed. For hoAvever satisfactorily physiologists may account for digestion by the powers of solution, in the healthy state of the stomach, there are too many evident marks of acidity in its diseased state, to deny the acid fermentation in the latter condition of this viscus. Conscious of the imperfect manner, in Avhich I have treated this truly important and interesting subject, I must do it the justice to conclude in the words of Mr. Pope: " If vain our toil, We ought to blame the culture, not the soil". But before I take a final adieu of you, illustrious professors, permit me in this humble manner to return you my most sincere thanks, for 336 WALKER OX THE CORNUS FLORIDA, &c. the inestimable principles Avhich I have received from each and of all you, in the science of medicine. For it is from the most impressive evidence I add, that it is in this university, that new avenues to medical knoAvledge have been unfolded, and the just importance of former ones established: in which university, the genuine principles of medicine have received a developement, and a kind of demonstration hitherto unknoAvn. And lastly, in which its students enjoy that profound liberality, and indulgence in sentiment Avhich banishes superstition, and its concomitants blind venera- tion and credulity. AN ESSAY ON THE MEANS OF LESSENING THE PAINS OF PARTURITION. SUBMITTED TO THE EXAMINATION OF THE REVEREND JOHN ANDREWS, D. D. PROVOST PRO TEM. THE TRUSTEES, AND MEDICAL PROFESSORS OF THE UNIVERSITY OF PENNSYLVANIA, FOR THE DEGREE OF DOCTOR OF MEDICINE. ON THE FIRST DAY OF JUNE, ONE THOUSAND EIGHT HUNDRED AND FOUR. BY PETER MILLER, OF PHILADELPHIA, LATE HOUSE SURGEON OF THE ALMS HOUSE AND HOUSE OF EMPLOYMENT. In our attempts, therefore, to improve and extend the means of lessening them, we do but develope the kind and benevolent disposition of the Creator of the world to the human race.----Rush. INAUGURAL ESSAY. THE diseases peculiar to the female sex, and more especially those connected with a state of pregnancy are highly interesting, and have at all times, excited the greatest attention of physicians. It appears to be peculiarly hard, that the fairest and loveliest part of the creation should suffer more than an equal share of the evils that afflict mankind. They not only participate in almost all the diseases to Avhich man is liable, but are also subject to a long train of suffering and distress in consequence of complying with a duty imposed upon them by the great Author of Nature, for the purpose of propagating the human race. They have therefore, a strong claim, not only to our sympathy, but also to every exertion that can be made to alleviate their pains. We accordingly find, that medical men very early began to investigate the nature of their complaints, and to propose suitable remedies for their removal; but although great progress has already been made, there yet remains a Avide field for improvement. Numerous treatises have been published on the art of midAvifery, in Avhich the greatest attention has been paid to the operative part; but an attempt to lessen the pains of parturition, appears to have been almost entirely neglected. We cannot account for this neglect in a more satis- factory manner than by supposing, that all those avIio have written on this subject Avere of opinion, that pain is necessarily connected Avith par- turition. That practitioners haA'e held such an idea is sufficiently obvious: hence we find an eminent accoucheur, Dr. Osborn, observes, that" Avoman if necessarily exposed to great pain, difficulty, and danger in parturition."* Again, " it is the intention of nature that labour should be a slow, delibe- rate, and painful operation"! And another, not less distinguished for his abilities,'Dr. Denman, says, that "it is natural for women to have sIoav and painful labours."\ This doctrine of the necessity of pain, appears to be founded, first upon that passage in the sacred Avritings Avhich declares, that " in soitoav * Essays on the Practice of Midwifery, p. 28. f Ibid. p. 49. \ Dcnman's Midwifery, vol. 2. p. -1S2. 340 MILLER ON THE MEANS OF LESSENING thou shalt bring forth children," and which Avas announced to the mother of the human race, as a punishment for her disobedience; and secondly, upon the erect position of the' human body.* It having been supposed necessary that nature should have formed such a structure of parts as Avould counteract the effects of gravity, and prevent premature labour; and though these ends are obtained, yet the means she has employed create those obstacles which impede delivery, and are unavoidably the cause of the excruciating pains Avhich the unhappy sufferer is compelled to endure. That labour is frequently a tedious and painful operation will not be denied; but that pain should be a necessary consequence of the form and structure of the human body, or that the Supreme Being should have enjoined it as a curse upon the female sex, appears so derogatory to the idea we have of his wisdom and goodness, that we cannot admit it. That a AAroman may bring forth in sorrow, and yet not be subjected to much bodily pain, may very readily be conceived. When she reflects upon the dangers attending the puerperal state, the slow and difficult recovery of some, the death of others; Avhen she considers that half of the human race do not attain the age of seven years; that hardly a half of the remainder arrive to years of maturity, and that even should the fruit of her womb be so fortunate as to escape death in its youth, yet that it will be exposed to dangers and temptations, in the world, to which it may fall a prey, and Avhich may render life a burden to itself, and a reproach to its parents: under circumstances like these, it may truly be said, that in sorroAV does she bring forth. But that it is not the intention of nature that labour should be a pain- ful operation is sufficiently evident from the ease and facility with Avhich many women are delivered. " We knoAv that many women are safely delivered of full sized children, so suddenly that they have scarce time to call for assistance: that, sometimes waking from their sleep Avith a slight pain, labour is hurried through in a feAv minutes, while the woman is almost unconscious of Avhat has happened. Some women, again, have been taken in labour while walking, and have not even had time'to be comreyed to any house, or convenient place, but have dropped their bur* dens Avhere they happened to be first seized. Others, while 'on a visit, at dinner, or in the midst of some amusement, have been surprised by labour, and have parted with their children with little pain or trouble."! If these facts be admitted, they will prove that pain does not occur in every case of parturition; and hence it will follow, that if all women are not necessarily and inevitably subjected to pain, none are; but, that pain, - Osborn's Essays, p. 10. Dcnman's Midwifery, vol. 2. p. 18. + Bland on Parturition, p. 24. THE PAINS OF PARTURITION. 341 or absence of pain, must depend upon adventitious causes. We c,annot suppose that a Being who has established general laws for the govern- ment of the universe Avould be partial in this particular. In proof of this we find, that women who live in a certain state of society, in a certain climate, or who follow a particular mode of life, are entirely free from pain. Bruce,* speaking of the Avomen of Abyssinia, says, they do not confine themselves even a day after labour, but Avash and return to their Avork immediately. " A Morlack woman neither changes her food nor interrupts her daily fatigue on account of her pregnancy, and is frequently in the fields, or on the road by herself, and takes the infant, washes it in die first water she finds, carries it home, and returns the day af- ter to her usual labour, or to feed her fiock."t It is related by Hennepius,j: that " the Spaniards in Brazil, who perform the office of midAvives to their teeming consorts, receive the infant, tear the navel string, and wash and paint it. The lying-in Avoman does not meet Avith more indulgence than the infant: as soon as she is disburdened, she goes and AA'ashes herself, and immediately sets about her Avork, without suffering the least inconA'enience from it." He also says, " The wives of the LiAonian peasants use the same custom. The Avomen retire to some private place Avhen the time of delivery is at hand, and return immediately after to their work." " The Moorish women," says Sagnier and Brisson,|| " have no midAvives, but are usually alone at the moment of delivery, laid on the ground, under an indifferent tent. They have seen these Avomen depart even on the day of their delivery, to encamp at the distance of fifteen or twenty leagues." The labours of the Sicilian women are accompanied Avith so little pain and danger, that they appear perfectly well the day after delivery. " For in this happy climate," says Brydone,§ "child-bearing is divested of all its terrors, and is only considered as a party of pleasure." The Indian Avomen of our own country also possess this happy privilege to a great degree: " Avhen taken in labour while marching with their husbands, they will retire behind a bush, deliver themselves, and in an hour's time rejoin their companions." This testimony in favour of the ease and facility of parturition, suffi- ciently proves, that it is not the intention of the Supreme Being, that it should be a painful operation, and that it would at all times be performed with ease and safety, had not mankind, as they became more civilized, * Travels to discover the source of the Nile, vol. 2. p. 21. f Dobson's Encyclopedia, article Morlachia. \ Ceremonies and Religious Customs of various Nations, vol. 3. p. 20. || Voyage to the Coast of Africa, p. 494. § Tour through Sicily and Malta, vol. ii. letter 22- 342 MILLER OX THE MEANS OF LESSENING introduced customs and modes of living so very different from those of their ancestors. To this alteration, therefore, in their diet and habits of life, Ave may attribute the pain and difficulty that so frequently attends labour. All the soft parts concerned in parturition in a natural and healthy state, are prepared and disposed to dilate; they therefore make little resistance to the expulsion of the child, which is effected Avith very little exertion, and almost Avithout pain. But from " irregular and improper customs and habits of living" they acquire such a firm and rigid texture, that it requires considerable force and time to dilate them. Although all the soft parts concerned in labour, are susceptible of this rigidity, yet in general it is more particularly confined to the os uteri, and the strongest and most violent contractions of the uterus, are sometimes unable to overcome it. This firm and rigid texture of the os uteri, has been noticed by most writers on the obstetric art, as a cause of difficult labour; and we have frequently known parturition delayed for hours, and even clays, in some instances, from this cause, Avhen every other circumstance was in favour of a speedy and happy termination of the patient's sufferings. For the purpose of dilating the soft parts and expelling its contents, the uterus is possessed of a strong poAver of contraction, by which means the liquor amnii and the foetus is pressed against the os uteri, and thus gradually dilate it. This action of the uterus we shall consider as threefold. First. A permanent contraction, by which, like other hollow viscera, it adapts itself to its contents, as the biood-Aressels to the blood, and the bladder to the urine. Secondly. The occasional contraction. This it OAves to muscular structure. It is a temporary contraction, and cannot be continued long at a time. Thirdly. An irregular, spasmodic, or convulsive action. By the first of these actions, Avhen there is no resistance from the soft parts, the contents of the uterus is expelled. By the second, the os internum and externum is dilated. These two actions Ave consider as the natural, and healthy action of the uterus. The last is a disordered action, arising from great irritability of the uterus; from inflammation of the os uteri and p:.:ts adjacent, occasioned by violent pressure of the c- ild's head, or from irritation of the os uteri by frequent examination or ait. npts to dilate the parts Avith the hand. This irregular action is never of any service in dilating the parts, or in expelling the foetus, and is generally attended with the most excrucia- ting pain. It frequently occurs after tb.e delivery of the child, and by closing the os tincx or by the contraction taking place in the middle of THE PAINS OF PARTURITION. 343 uterus, it prevents the accoucheur from extracting the placenta.* It is always overcome Avith difficulty. In some cases it is impossible to introduce the hand, and even dangerous to attempt it. The resistance to the expulsion of the foetus, from the rigidity of the soft parts, and the irregular action of the uterus, Ave conceive to be the principal causes of pain. Hence the indications of lessening pain, are, to give to the soft parts a disposition to dilate, and to restore the uterus to its natural and healthy action. We do not find that any thing has been offered for the express purpose of lessening the pains of parturition until very lately.f Accoucheurs believing it impossible to give to the parts their disposition to relax,f contented themselves with confining their attempts to dilate the os tincse, to very lingering or preternatural cases only. Opium|| and the Avarm bath have been recommended for the purpose of relaxing the uterine parts. But to produce any such effect by opium, it Avould be necessary to give it in large doses; this might be attended with danger, as it has, when thus exhibited, " been known to produce convulsions."§ Some advantage might be derived from the relaxing power of the warm bath, but the application of it is attended with many inconveniences, and its good effects are not certain: we therefore do not consider either of them as proper remedies. The means usually employed were fomentations and mechanical dilatation, by moving the hand in a rotatory manner. From the inability of producing a sufficient degree of relaxation by these means, recourse AA'as too frequently had to instruments, by Avhich the life of the child Avas often destroyed, and considerable injury done to the mother. In consequence of the many inconveniences and dangers arising from this mode of practice, accoucheurs at length thought it most prudent not to interfere, but in all cases (preternatural presentations, or Avhere there was great deformity of the pelvis, excepted) to trust entirely to the efforts of nature. Dr. Hamilton** relates a case in which, though the contractions of the uterus were " strong and frequent," yet it required two days before the os tincje Avas sufficiently dilated; and in his remarks on that case observes, that it " sheAvs the advantages of waiting patiently for the efforts of nature." What I would ask, are those advantages ? The case * See the writings of Burton, GifFard, Mauriceau, La Motte, Exton, Johnson, Perfect, Dease, Denman, and Osborn. f See Dr. Rush's letter to Dr. Miller. Medical Repository, vol. 6. p. 26. \ Denman's Midwifery, vol. 2. p. 69. || Mead's works, vol. 3. p. 137. § Denman's Midwifery, vol. 2. p. 418. ** Cases in Midwifery, by J. Hamilton, jun. M. D. order 1st. case 4th. 344 MILLER ON THE MEANS OF LESSENING proves that nature, left to herself, had power sufficient to expel the child; but surely subjecting the patient to the most exquisite pain for forty-eight hours, cannot be considered an advantage. It is the more surprising that Dr. Hamilton should advocate this doctrine, as he appears to be Avell acquainted with the effects of blood-letting, in relaxing the os uteri, and recommends it in cases Avhere we might apprehend a rupture of the uterus.* That the poAvers of nature, in a simple state of society, and in those in whom a general relaxation of fibre is produced by climate, or particular habits of living, are sufficient for the expulsion of the foetus, has already been noticed. We also grant, that in general she is adequate to the task, in those who, from different modes of life, have produced the rigidity of the soft parts, Avhich we have considered as the principal cause of difficulty; but here she requires a considerable time to effect her purpose, and her patient is subjected to much unnecessary pain, and great anxiety of mind. To view the distress of a felloAV creature, from whatever cause it may arise, is to the mind of sensibility extremely painful; but there is no situation which excites greater solicitude, or in which our feelings are more interested, than that Avhich we are now considering. Certainly then we ought not to be inactive spectators, when we have it in our power to give almost instantaneous relief, but should make use of those means by which a mitigation of suffering may be obtained. And more especially Avhen the means to be employed would not only produce present relief, but also prevent future danger. But there are cases in which nature requires such a considerable time to accomplish the delivery, that by Avaiting for her efforts irreparable injury is frequently the consequence. From great rigidity of the os uteri, and strong and violent contractions of the uterus, there has occurred: 1. Rupture of the uterus.f 2. A laceration of the os uteri4 3. A protrusion of the os uteri before the head of the child, Avhich, in some cases has been divided before delivery could be effected.|| 4. From long continued pressure of the head upon the soft parts, has arisen inflammation and mortification, which has sometimes proved fatal; and in other cases, though the patient has survived, she has been subject to an involuntary discharge of feces or urine through the vagina.§ * Hamilton's Cases, p. 152. f Noticed by Foster, Dease, Denman, and J. Hamilton, jun. $ Perfect's Cases, case 142. Fofter's Midwifery, p. 246. || Annals of Medicine, for 1798, p. 331. $ Dease's Midwifery, p. 38 and 75. Clarke's Practical Es.says, p. «.}. THE PAINS OF PARTURITION. 345 5. From frequently repeated antt violent contractions, the uterus becomes exhausted, an atony succeeds," and even though the soft parts should then become relaxed, the powers of the uterus are insufficient to expel the foetus. In some such cases Ave must have recourse to instruments, nor does the injury end here; from an inability of the uterus to contract, an hxmorrhage supervenes, Avhich is generally fatal to the patient.* And Avhen we add to these, the risk of convulsions,! rupture of blood- vessels,:}: or laceration of the perinxum,|| all of which have happened, and may again happen under similar circumstances", we cannot suppose that any great advantage can be derived from " waiting patiently for the efforts of nature." Having pointed out the ill consequences arising from a rigid state of the soft parts, and an irregular action of the uterus, we proceed to the consideration of the means by which these evils may be remedied. We shall notice, first, Such as are necessary during gestation, and which will prevent a morbid irritability of the uterus, and enable the soft parts to retain their disposition to dilate. And, secondly, The means to be employed at the time of parturition, by which Ave may effect a dilatation qf the soft parts and restore the uterus to its natural and healthy action. From the stimulus of distension, the indulgence of the appetite, and a deficiency of exercise, during the period of uterine gestation, there is a constant tendency to a plethoric disposition; this, if not actual disease, is the cause of most of the irregularities of the system attendant on preg- nancy, and lays the foundation, for the causes of pain and difficulty in parturition, already mentioned. Hence it becomes necessary to pay particular attention to the state of the system, and when symptoms of disease occur, to be early in administering remedies for their removal. As most of the complaints of pregnancy "arise from this plethoric dispo- sition of the system, it will be proper in almost every instance to meet them Avith the lancet. The safety of blood-letting in pregnancy is already sufficiently established, and although it is not necessary to bleed when there is no symptom of disease present, yet if Ave Avish to conduct our patient in such a manner as to ensure her an easy labour, it would be highly improper to neglect blood-letting when these symptoms do occur. The remedies to obviate this plethoric disposition, are, first, A low diet. The appetite during pregnancy is frequently considerably increased, and much mischief has accrued from an inordinate indulgence of it. It * Hamilton's Cases, order 2. case 1st. f Denman, vol. 2. p. 403. | Ibid. vol. 2. p. 50. H Foster, p. 246. Deasc,p. 35. Denman, vol. 1. p. 67, and 383. 2 Y 316 MILLER ON THE MEANS OF LESSENING will not only be necessary to lessen the quantity of food, but also to attend to its quality. Animal food, strong drinks, spices, and all sub- ' stances of a stimulating nature, should, in a great measure, be avoided, and a diet of fruit, vegetables and milk, should be enjoined. The easy labours of the Indian women of America, have very properly been ascribed by Dr. Rush* to their scanty diet. In the following case its good effects are apparent. CASE I. D. W. aged tAventy-five years, Avas admitted pregnant into the alms- house, on the 14th of December, 1802. In consequence of an ulcer on her neck, she Avas ordered into the surgical ward, and was confined to a low diet, consisting entirely of vegetable substances, until the 12th of January, 1803, Avhen she Avas taken in labour: it came on so suddenly, that there Avas scarcely sufficient time to remove her to the lying-in room before she was delivered, and Avith so much ease, that it was observed by a medical student present, that it might be truly called a case of parturi- tion Avithout pain. Immediately after her delivery she arose, made up her bed and undressed herself, Avith as much unconcern as if nothing had happened to her. This patient was not confined an hour to her bed, either from debility or disease. Secondly, Exercise. It is observed by Aristotle, « that those Avomen Avho take most exercise endure uterine gestation and labour with greater ease and safety."! This observation has been confirmed by most of the succeeding writers on midwifery. Hence we account for the more easy labours of the women residing in the country, than of those in cities. And to the combination of exercise and scanty diet, may be attributed the little pain and difficulty attending parturition among the female slaves of the southern states. Thirdly, Laxative medicines. These should be administered tAvo or three times a week, for a month or six weeks previous to parturition. Their efficacy in disposing the parts to dilate is evident, from the advan- tages following the use of sAveet oil among the Avomen of Turkey, which is supposed by Dr. Rush} to'act merely as a purgative. For the purpose of ascertaining its effects the ol. ricini Avas prescribed in the following case. CASE II. December 1st, 1802,1 was requested by Mrs. M. C. to attend her at the time of parturition, which she supposed would take place in about six * Medical Repository, vo4. 6. p. 26. f Introduction to Smellie's Midwifery, p. 16. a \ Medical Repository, vol. 6. p. 26. THE PAINS OF PARTURITION. • 347 weeks. She was thus early, she^sa^d, in her application, because in all her previous labours she had suffered extremely from the duration of labour, and the intensity of pain with which it Avas attended; and if any thing could be done whereby she might obtain an allcA iation of pain, she would willingly comply with any directions that I might give for that purpose. I desired her to take half an ounce of the ol. ricini, every other day, and continue the use of it until the time of parturition. During the six Aveeks she made use of twelve ounces. On the 10th January, 1803, I was sent for, but before 1 arrived at the house, she had parted with her child. The information which I received, was, that she had sent for me on the approach of the first pain; that before that pain had left her the membranes Avere ruptured; that it Avas quickly succeeded by another which expelled the child, and that the pain she experienced was so trifling, that she could not say she.had suffered any. But as practitioners are seldom consulted respecting the regimen to be observed during gestation, and frequently are not called until the moment when their assistance becomes necessary, they are precluded from advising the measures recommended for the prevention of the causes of pain and difficulty. We therefore meet with these causes, and must attempt their removal at the commencement of labour. We now proceed to the consideration of the means mentioned under our second general head, viz. Such remedies as may be employed at the time of parturition, for the purpose of effecting a relaxation of the soft parts and restoring the uterus to its natural and healthy action. They are, first, Blood-letting. This of itself is fully adequate to the purpose, and is the best remedy we can enlploy; it not only produces present effects in lessening the pains of labour, but extends its beneficial influence to the prevention of subsequent dangers. In cases where blood-letting is objected to, perhaps some advantage might be derived from, secondly, Nauseating doses of emetics. Of this remedy we can say nothing from experience, but from observing the relaxation that has frequently followed nausea and vomiting in difficult cases, and from the common observation of the old Avomen, " that a sick labour is an easy one," we have been led to suppose, that much benefit might be obtained from adopting a mode of relief pointed out by nature. So great a degree of relaxation is pro- duced by nauseating medicines, that they have been recommended by Dr. Physick,* Avhen blood-letting is objected to, in cases of luxation, where the reduction of the bone is prevented by muscular contraction. Blood-letting for the express purpose of lessening the pains of partu- rition, was first recommended by Dr. Rush.t It was adopted by several practitioners of medicine with the happiest effects: of its efficacy we can * MS. Lect. on Surgery. f Medical Repository, vol. 6. p. 'ZJ. 348 • MILLER ON THE MEANS OF LESSENING speak from experience. The following cases which we have selected from a number of others, will shew in the most striking manner the great utility derived from the use of it. CASE III. In November, 1S01, I Avas desired by Dr. DeAvees to visit a Avoman who had been in labour nearly tAvo days; on arriving at my patient's, I received the folloAving account from the midwife in attendance. The woman, she said, Avas large and fat, in labour with her first child, and twenty-eight years of age; that she had been in labour thirty-six hours, at the commencement of Avhich every thing appeared to do Avell; that the labour, though slow, gradually progressed until the head of the child had passed the os tinc», after Avhich, notwithstanding the pains were strong and frequent, no further progress was made. In this situation she had passed the twenty-four hours previously to my arrival. On making an examination, I found the head firmly Avedged in the vagina, the external parts very firm and rigid, and it was Avith difficulty that I could introduce two fingers into the os externum. It Avas here evident, that the rigidity of the external parts was the sole cause that retarded the birth of the child. I therefore immediately deter- mined to bleed my patient, in order to effect a relaxation of the parts. My intention was to bleed ad deliquium animi; but after draAving off forty- eight ounces of blood and finding there was no tendency to syncope, I stopped the bleeding to examine the state of the parts. I now found that they were very much relaxed, and that the head was slowly advancing; yet so perfectly easy was the patient? that it could not be ascertained from external appearances that the uterus was contracting. I then requested the midAvife to take the seat that I might tie up the arm, and before this Avas effected my patient was delivered of a large healthy child, and declared that she did not experience the least degree of pain during its expulsion. This was at that time to me a very interesting case, and from it may be deduced the folloAving inferences. That a large quantity of blood may be draAvn, Avithout injury to the patient. * That it is r.nt necessary to bleed until fainting is induced, in order to effect a relaxation of the parts, or to restore the uterus to its natural or healthy action. That after the resistance from the rigidity of the soft .parts is removed the permanent contraction of the uterus is sufficient to expel the child. That Avhen a relaxation of the soft parts is effected, and the uterus restored to its healthy action, parturition Avill take place with very little pain. THE PAINS OF PARTURITION. 349 CASE IV. In December, 1802, I was requested by A. B. to visit his Avife, Avho was then, he said, in labour: on my arrival I was informed, that she had had several severe pains, but that they had left her, and she was now easy. On making an examination per vaginam, I found the os uteri very little dilated, and its edges extremely hard. I proposed bleeding, which was readily assented to. She had heard, she said, of its good effects, from several of her neighbours whom I had attended, and wished to try the experiment: I accordingly took from her twenty-four ounces of blood. Having a case at the same time to attend to in the alms-house, I was under the necessity of leaving her, but desired they would send for me immediately on the return of her pains. I heard no more of this patient until the next day, Avhen on meeting her husband, and inquiring after his wife, he informed me, that about one hour after I had left her, she had a return of her pains, that she requested him to go for me, but that before he could leave the room the child was born. On visiting this patient afterwards, I learnt that the pain she experienced during the expulsion of the child, was considerably less than that she had suffered previously to her being bled. CASEV. ' E. R. aged twenty-eight years, was admitted into the alms-house on the 3d of February, 1803. A few hours after her admission she com- plained of slight labour pains, which gradually became Aveaker, and at length entirely subsided. An injection was given, and at ten o'clock, p. m. I took from her tAventy ounces^of blood, and left her, with directions to have me called as soon as her pains should return. About two o'clock, a.m. of the 4th, I Avas called by the nurse, but before I could reach the room, although not more than ten minutes had elapsed, I Avas informed that the child was born. This patient declared, that she sent for me the moment she experienced tlje least degree of pain; that she had felt but two or three slight pains before the child Avas born; and also, that she had suffered much more in a former labour from one pain, than she had in this, during its AAdiole continuance. # CASEfVI. M. C. aged thirty years, became in labour on the morning of the 27th of January, 1803. During the Avhole of this day her pains Avere strong and frequent,-yet had so little effect in dilating the os uteri, that on the morning of the 28th, it was only sufficiently dilated to ascertain that the vertex presented. From this time to twelve o'clock, she suffered consi- derably, from the Aiolent contractions of the uterus; but notwithstanding 350 MILLER ON THE MEANS OF LESSENING this strong action, the os uteri remained inflexibly hard and tense, and was not dilated to more than the size of half a croAvn. She noAv lost twelve ounces of blood; this hoAveAer produced no e'ffect; at one o'clock the os uteri retained its pristine rigidity. I now dreAv off twenty ounces more of blood. So immediate Avas the dilatation, that in ten minutes she'was safely deliA'ered. From the foregoing cases Ave may infer, that blood-letting at the time of parturition is a safe, easy, and effectual means of lessening the pains of labour. This inference is confirmed by a number of other cases, in which Ave have employed that remedy for this purpose; in no instance did any ill consequence arise from the use of it, and in every case the patient had a speedy and happy recovery. Cases fourth and fifth, Avill shew the impropriety of leaving our patients after a large bleeding. Blood-letting to be effectual must be copious. We have'not observed, in any instance, £hat a less quantity than twenty ounces, has produced any great effect upon the os tincx; but in those cases where the patient lost from twenty to forty ounces, it frequently acted as a charm in producing an immediate dilatation of the soft parts. We should, therefore, repeat the operation, when we find that no effect is produced by the first bleeding. There are, howeAer, exceptions to this as a general rule: from those " who have been debilitated |?y previous disease, or by accidental evacu- ations of any kind," it would not be necessary to take so large a quantity ; the parts being disposed to dilate, easily yield to the slightest impulse. Hence, we find that labours in the last stage of chronic diseases, are generally attended with but little pain. • It may be objected to this practice, that copious blood-letting Avould occasion syncope, whereby the uterus mi^t lose its power of contraction, and consequently there would be an inability to expel the fcetus. Such an accident Ave believe would not occur, unless considerably mor6 blood than necessary Avas taken. We haA'e used blood-letting for the purpose of lessening pain, in a number of cases, and in no instance was afaintness induced. The system, during pregnancy, and at the time of parturition, will bear the loss of blood in larger quantities Avithout its producing faint- ness, than at any other time. From a mere disposition to faint we Avould apprehend no danger. " Blood-letting lessens sensibility but not irrita- bility."* And the uterus " acts, or makes its efforts to act, in sleep, during faintness, and sometimes eA-en after death."! In this state of the system, such a complete relaxation takes place, that the permanent con- traction of the uterus Avould be sufficient to expel the child. In those cases in Avhich blood-letting Avas employed at the commence- ment of labour, it generally suspended, the action of the uterus for some * Ru i.'& MS. Lectures. f Denman's Midwifery, vol. % p. 33?. THE PAINS OF PARTURITION. ' 351 time: during this suspension of action, the parts assumed their disposi- tion to dilate, and on the return of the uterine contractions, the delivery was accomplished in a short time, and attended with very little pain. But in cases where it was not employed until tAventy-four or thirty hours aftef the commencement of labour, its effects were immediate. Nor is the lessening the pains of parturition the only advantage, Ave derive from blood-letting. By the use of this remedy we prevent all those accidents which have been ^numerated as arising from the rigidity of the soft parts, and the irregular action of the uterus. By blood-letting we prevent the premature rupture of the mejnbranes, and thereby have the assistance of the Avaters in dilating the parts. It facilitates the delivery of the placenta by preventing spasmodic contractions of the uterus. It prevents after pains, puerperal fever and mania. In preternatural presentations, blood-letting, by removing the spas- modic action of the uterus, and relaxing the parts, very much facilitates the introduction of the hand, and delivery of the child. And in cases where there j§ a deformity of the pelvis, though Ave cannot by bleeding hasten parturition, yet by its relaxing effects, it will enable us to make use of the necessary means, Avith more ease to our patients as Avell as ourselves. To the medical professors of this university, for the instruction I have receiA'ed from their truly valuable lectures, I return my most grateful thanks. And that each of you, gentlemen, may long enjoy that honour and happiness, Avhich you so deservedly merit, from your indefatigable exertions in the promotion of useful knowledge, is my most fervent wish. AN EXPERIMENTAL INQUIRY, RESPECTING THE VITALITY OF THE BLOOD. BY CHARLES CALDWELL, M. D. PREFATORY NOTE. IT is nearly three years since most of the experiments and obser- vations detailed in the following sheets, Avere completed. If there be any thing new or valuable in them, the author ought, in justice to himself, to have published them sooner. If there be not, it is his misfortune, that he obtrudes them on the public, even at this late period. Be the matter, hoAvever, as it may, he is willing to own them, and to take his chance of meeting whatever public sentiment they may be calculated to awaken. Some of them haA'e been already spoken of, and attributed to, if not claimed by, other persons, who have certainly no knoAvledge of them, except what they have derived from verbal information. For, though never printed, they have been repeatedly mentioned in private conversation, and also on occasions of a more public nature. They were included in a course of medical instruction, delivered last winter, in the infirmary of the Philadelphia alms-house. It Avas at that time that they were moulded into Lectures, the form under which they now appear. They are submit- ted, with due deference, to the consideration of the medical class of the university of Pennsylvania, and of the physicians of the United States in general. Should they either serve to heighten zeal in physiological pursuits, or furnish faint glimmerings that may lead other more for- tunate inquirers to luminous and important truths, the ambition of the author will be fully gratified. Philadelphia, January 1st, 1805. { I AN EXPERIMENTAL INQUIRY. LECTURE I. GENTLEMEN, FROM the colour, warmth, and other striking properties of the blood, from the force with which it issues from wounds and lacerations in living animals, and from syncope and death proving oftentimes the consequence of an excessive loss of it, this fluid must, even in the earliest times, have become at least an object of attention, if not a subject of philosophical investigation. Nor has it ceased to attract the notice, awaken the curiosity, and exercise the intellects of men, from that period to the present day. There is scarcely an age or a nation, however bar- barous and uncultivated, from which we have not received some record, either written or traditional, bearing testimony to this universal regard bestowed on the blood. Before entering, therefore, on the experimental part of this inquiry, it is but justice to those who have gone before me, and may not prove either uninteresting or useless to you, to take a brief retrospect of the opinions entertained respecting the nature of this fluid, by certain enlightened and distinguished characters, both of ancient and modern times. We learn from sacred history, that as early as the death of Abel, an immediate descendant of the progenitor of mankind, the blood was regarded as a fluid of no common qualities. For evidence of the truth of this, we need only turn to the inspired page of the great laAV-giver and leader of Israel. When the Deity there addresses Cain in the language of reprimand and malediction for the murder of his brother, he says, " What hast thou done? the voice of thy brother's blood crieth unto me from the ground." What, I beg leave to ask, can be the foundation of this bold apostrophe ? and whence arises such a striking personification of the blood? It is not said that the flesh, the bones, the brain, the heart, or any other solid part of the body of the deceased, cry aloud for vengeance on his guilty brother; to the blood alone is declared to belong the prerogative of making this high and solemn appeal for justice. But it is by no means probable that this would have been the case, had that fluid been considered as a mass of 358 CALDWELL ON THE inanimate matter. It would seem that nothing short of a belief in its vitality could have procured for it, on so solemn an occasion, a rank and an office so distinguished and honourable. I know it Avill be said in reply, thaf the scriptural passage here quoted, is purely figurative, and will not, therefore, either admit of a literal con- struction, or Avarrant a philosophical inference. That the passage is figurative Avill not be denied; for figure is so interwoven with most of the oriental languages, that, if divested of it, they would be scarcely suffi- cient for the common purposes of life. But the use of figures is as much under the guidance of principles and rules, as that of any other mode of speech. In personification, particularly where, as in the present case, the figure is so bold and animated as to call forth language from any thing not really possessed of utterance, the skilful rhetorician never ventures to per- sonify an object of seco?ida?y consideration. Such an error would expose him to censure, if not to ridicule. It Avould be like transplanting an illiterate clown, from his humble dwelling, to the august floor of a senate cham- ber. In this lofty flight of personification, the object that speaks must correspond in its dignity to the office it performs. Hence, the very circumstance of representing the blood of Abel *s addressing itself to heaven for justice and vengeance, if it did not bestow on it a decided pre- eminence, affords at least sufficient evidence, that it was considered as no Avay inferior, in rank and importance, to any of the solid parts of his body. Being made, as it were, the advocate of the whole man, it could not have been viewed in any other light, than as one of his most respectable and dignified parts. But, without possessing the attribute of life, it could not have been entitled to such a standing. These considerations justify us in concluding, that, even among the first family of mankind, the blood was held to be a living-fluid. In confirmation of the justice of my remarks, on the proper use of personification, I Avould refer you to the Lectures of Dr. Blair, Avhose aut1 ority in rhetoric is universally admitted. That enlightened critic takes just exception at .a passage in Pope's " Eloisa to Abelard," in con- sequence of the personification of two subordinate objects. After repre- senting her as suffering all the agony that could arise from a tumultuous conflict betAveen loA'e and devotion, attachment to her Abelard and duty to her God, the poet makes his fair enthusiast give utterance to her feelings, in the folloAving tender and impassioned apostrophe. " Dear fatal name! rest ever unreveal'd, " Nor pass these lips, in holy silence seal'd. " Hide it, my heart, within that close disguise, " Where, mix'd with God's, his lov'd idea li ■* ■. " O! write it not, my hand.'—his nam-.- appears " Already written—Blot it out, my tears'" VITALITY OF THE BLOOD. J59 'i " Here," observes our author, Dr. Blair, " are several differed?objects And parts of the body personified; and each of them is addressed or spoken to; let us consider with what propriety. The first is the name of Abelard; « Dear fatal name! rest ever," &c. To this no reasonable objection can be made. For, as the name of a person ofu-n stands for the person himself, and suggests the same ideas, it can bear this perso- nification with sufficient dignity. Next Eloisa speaks to herself, and personifies her heart for this purpose: " Hide it, my heart, Avithin that close," &c. As the heart is a dignified part of the human frame, and is often put for the mind, or affections, this also may pass Avithout blame. But, when from her heart she passes to her hand, and tells her hand not to write his name, this is forced and unnatural; a personified hand is low, and not in the style of true passion; and the figure becomes still Avorse, Avhen, in the last place, she exhorts her tears to blot out what her hand had written: « 01 Avrite it not," &c. There is, in these two lines, an • air of epigrammatic conceit, which native passion never suggests, and which is altogether unsuitable to the tenderness Avhich breathes through the rest of that excellent poem." But to return from this digression. Passing from the time of Adam to that of Abraham, we still discover the prevalence of a similar sentiment, respecting the nature and qualities of the blood. We find that at the latter period, this fluid was used in sacrifices and oblations to the Most High, as well to appease his supposed indignation, as in grateful commemoration of favours he had bestoAved. It appears to have been selected for this high destination, in consideration of its possessing, or being supposed to possess, something precious, sacred, and altogether different from the properties of common matter. For, certainly, nothing inferior to the most choice and precious of produc- tions, would haA^e been deemed worthy to be offered on the altar of the Majesty of Heaven. If Abraham and his posterity were in the habit of offering, in sacrifice, the first-born of- their flocks, and the first fruits of their fields, it is not probable that they would, on any occasion, have mocked and insulted their God,, by pouring out in his presence, what they considered as nothing but an inanimate fluid. The inference, therefore, is "plain, that they must have believed the blood to be possessed of life. At a subsequent and more enlightened period, Avhen the descendants of Abraham were returning from Egypt, the nature and properties of the blood appear to have been further developed, and better understood. Moses, who, from having been bred up in the court of Pharaoh, was master of all the literature and science of the Egyptians, not only con- tinued the use of this fluid in sacrifices, from a belief in its peculiar and perhaps sacred qualities, but forbade its being eaten by his companions, / assigning as his reason for such prohibition, that it Avas the immediate ? seat of animal life. " I Avill eAren," says this inspired penman, addressing 360 CALDWELL ON THE his folloAvers in the person of the Deity, " set my face against that soul that eateth blood, and will cut him off from among his people: For the life °f the flesh is in the blood." * It has been frequently made a question, whether or not, on this occasion, the leader and prophet of Israel uttered his own private senti- ment, or officiated as the immediate oracle of heaven. In either case, hoAvever, his words are entitled to our attention and respect. If he spoke from the impulse of divine inspiration, no one will call in question the evidence of his Avord. For whoever believes in inspiration from above, must admit it to be a source of immaculate truth. But, supposing Moses to have addressed his followers in the character of a mere man, it is to be remembered that his opportunities for acquiring a knoAvledge of the subject under consideration, had been favourable and extensive. Egypt, from its first settlement, must have been no less famous for the diseases * of its climate, than for the fertility of its soil. The intemperate heat of its atmosphere, and the annual and extensive inundations of the Nile, taken in conjunction with the plagues which afflicted the subjects of Pharaoh, and still continue the endemic scourge of that country, afford sufficient evidence of the truth of this remark. It is reasonable and natu- ral, therefore, to suppose, that the healing art, in its various branches, was among the earliest and favourite pursuits of the learned Egyptians. For what will sooner excite the human intellect to action, or urge it to more expedients or greater exertions for the acquisition of knowledge, than a desire to relieve ourselves and others from the pains and dangers of accident and disease ? But we have reason to believe, that, as early as the days of Moses, the priests and other enlightened characters of Egypt, had made considerable progress in certain branches of liberal science, as well as in many of the arts of life. And we are further assured, as already remarked, that that enterprising and extraordinary character, contained within himself an epitome of the knowledge of his native country. These considerations, together with the many enlightened precepts which he delivered to his countrymen on the subjects of cleanliness, regimen, health, and disease, give us an assurance not easily shaken* that Moses possessed an acquaintance with medical science. Being, therefore, one of the most enlightened characters then living, his mere opinion, respecting the nature and properties of the blood, is enti- tled to notice and regard, even at the present day. From Persia, Avhich has been considered as the birth-place of man- kind, and Egypt, the acknoAvledged cradle of the arts and sciences, let us pass on Avith the progress of learning to the countries of Europe. Here, our attention is first attracted to the states of Greece, and some of the adjacent islands. In these places, famed as the nursery of human greatness, but subject, like the United States, to summer and autumnal 2z VITALITY OF THE BLOOD. 361 diseases, many distinguished characters, led by motives of interest or humanity, devoted their time to the cultivation of medicine. Of these, though Hippocrates attained the greatest celebrity as a physician, Aris- totle seems to have bestoAved most attention on the science of physiology in general, particularly on the nature and qualities of the blood. This was a necessary consequence of his attachment to the study of the natu- ral history of animals, which led him, no doubt, to numerous dissections. In his physiological writings, this great philosopher assigns to the blood a very distinguished place among the component parts of the human body, and speaks of it as a fluid characterized by striking and peculiar properties. On some occasions he very explicitly declares it to be pos- sessed of life. In the 19th chapter of the 3d book of his " History of Animals," we find the following sentence: " Et semper quamdiu vita ser- vatur, sanguis unus animatur et fervet." In the 2d chapter of the 1st book of the same Avork, our author says; " Sanguis nempe, instar laris fanuliaris, est anima ipsa in corpore." And, in another place, he obserAres; « In sanguine reperitur divinum quid, respondens elemento stellarum," From these, and many other passages which I forbear to quote, it is evident, that Aristotle considered the blood as one of the'vital parts of the body. Nor ought his authority on this subject to be treated Avith disre- spect. Those Avho will take the trouble to examine his Avritings AAdth the attention they merit, will find, that the knoAvledge he possessed of the blood, both in a healthy and a morbid state, would not disgrace even an enlightened physician of the nineteenth century. Though there is no reason to believe that he ever suspected it to be a circulating fluid, he was perfectly acquainted with the difference between venous and arterial blood. He had also a correct knoAvledge of the fibrina, or coagulating lymph, and declares that if this be removed, " Sanguis neque concrescit neque spissatur." I shall take leave of Aristotle and his writings, by adding, that the existence of cold and hot blooded animals, and their relation to each other in the scale of nature, appear to have been as fami- liar to him as they are to the naturalists of the present day. To the catalogue of ancient philosophers, Avho believed in the vitality of the blood, we may add the respectable names of Empedocles, Critias, and Lactantius. If, in matters of science, it Avere admissible to adduce authorities from works of imagination, I might further refer you to the Iliad of Homer, and the jEneid of Virgil, for the opinions entertained by the ancient Greeks and Romans, on the subject of the vitality of the blood. In the last and fatal intervieAV between Hector and Achilles, Homer, as trans- \ lated by Pope, puts into the mouth of the Trojan hero the following | >vords: } « I shall not fall a fugitive, at least, ' " My *<>«/ [or life] shall bravely issue fvvn my breast." ' 3 ,v 362 CALDWELL ON THE This is evidently a figurative expression, where a part is made to stand for the whole. By life issuing from the breast, Ave are unquestion- ably to understand the poet to have meant the blood, which he considered as a living fluid, or the repository of life. In describing the fall of Pallas by the sAvord of Turnus, Virgil says, " Ille [meaning Pallas] rapit calidum frustra de vulnere telum: " Una eademque via, sanguisq; animusq; seyuuntur." which may be thus rendered in English: In vain the youth withdrew the reeking dart, For life and blood gush'd mingled from bis heart. In this last line the bard and philosopher evidently meant to express his belief, that in the living animal body, life and the blood are insepa- rably connected; or, in other words, that healthy blood is at least itself a living fluid, if not the common fountain of life to the solid parts of the body. Passing over the long list of medical characters who flourished in Rome and other parts of the continent of Europe, as being little else than humble folloAvers of their predecessors in Greece, I come doAvn to the time of Dr. William Harvey, of England. That celebrated physician and anatomist, instead of tamely treading in the footsteps of those who had gone before him, exhibited, from his youth an originality and inde- pendence of mind, which prevented him from doing homage to any authority but that of nature. He lived and wrote about the beginning of the seventeenth century, and was decidedly the first medical philosopher of his age. Indeed when We consider the state in which he found his profession, and contrast it with that in which he left it, we are forced to acknowledge, that Avith regard to the importance of his contributions to the promotion of the healing art, he has not been surpassed by any of his successors. His discovery of the circulation of the blood, is an event familiar to every student in anatomy. But his opinion respecting the nature and properties of this fluid, can be learned only by such an exami- nation of his Avritirgs, as is but rarely made by the physicians of the United States. In pursuing his inquiries, relative to the generation of animals, Dr. Harvey was led to pay particular attention to the first appearance and progressive formation of the blood, as well as to its properties and uses in the living system. In the course of these pursuits he soon found rea- son to believe, not only that this fluid is itself possessed of life, but that it is the immediate fountain of both being and life to the other parts of the body. Hence he denominates it at one time uparticula genitalis prima," and at another " furs ptLJgtnia corporis," and, in support of the VITALITY OF THE BLOOD. 863 justness of these appellations, assigns the following reason, viz. " Sangtda emm est, qui primus in generatione conspicitur." He further declares it to be the true " primum vivens et ultimo moriens" of animals. This opinion he endeavours to substantiate by arguments, which I shall make no apology for detailing in his own words. " Nee sanguis," says he, " solum pars primigenia et principalis dicendus est quod in eo et ab eo motus pulsusque principium oriatur; sed etiam, quia in eo primum color animalis innascitur, spiritus vitalis ingeneratur, et anima ipsa consistat." " Vita igitur," continues our author, " in sanguine consistit, quia in ipso vita atque anima primum elucet, ultimoque deficit. Crebra enim, ut dixi, vivorum dissectione expertus sum, moriente jam animali nee amplius spirante, cor tamen aliquamdiu pulsare vitamque in se retinere. Quiescente autem corde, motum vicleas in auricults sufierstitem,ac postremoin auricula dextra; ibique tandem cessante omni pulsatione, in ipso sanguine undulationem quon- dam et obscuram trepidationem sive palpitationem (extremum vita indicium J repcrias." Again: " Quoniam itaque sanguis supra vires elementorum agit dictis- que istis virtutibus pollet, atque summi opiflcis instrumentum est; nemo facultates ejus admirabiles et divinas satis unquam depradicaverit. Habet profecto in se animam primo et principaliter, non vegetativam modo, sed sensitivam etiam et motivam." I shall close my quotations from Dr. Harvey's works, by the folloAv- ing sentence, which exhibits, in a few words, the general outlines and substance of his opinion respecting the nature, properties, and importance of the blood. " Clare constat," says this able writer," sanguinem esse partem genitalemy fontem vita, primum vivens et ultimo moriens, sedemque anima primariam; in quo, tanquam in fonte, calor primo et principue abundat, vigetque; et a quo reliqua omnes totius corporis partes, colore influente foventur et vitam obtinent." Considering the distinguished rank Avhich Dr. Harvey holds among the medical characters of modern times, the extent to Avhich he carried his inquiries respecting the blood, and the decided manner in Avhich he expresses his belief in its vitality, it is someAvhat singular, that his works should have been passed over, without notice, by subsequent Avriters, particularly by the late Mr. John Hunter, of London, whose Avritings on this- subject now claim our attention. With the foregoing opinions of Aristotle, Dr. Harvey, and several other Avriters, fresh in my recollection, I am at a loss to determine in what light to vieAV the folloAving passage in Mr. Hunter's " Treatise on the Blood, Inflammation, a?id Gun-shot Wounds." " That the blood has life," says our author, u is an opinion / have started for above thirty years, S64 CALDWELL ON THE and have taught it for near twenty years of that time in my lectures; it does not, therefore, come out at present as a new doctrine," &c. &c. If Mr. Hunter means by this to set up a claim to the mere opinion, that the blood is a living fluid, it is evident that his pretension is unfounded. So far from being a " new doctrine" in medical science, at the time he wrote, it had been believed and inculcated even for centuries. A moderate attention to the writings of his predecessors on this subject, A\rould have taught him, that it was not till the disciples of Hoffman and Cullen, had too far discarded the humoral pathology, that any one ventured pointedly to deny the vitality of the blood. With the writings of his countryman, Dr. Harvey, in particular, I am Avilling to believe that Mr. Hunter Avas unacquainted. For a want of . information, even where it might haA-e been easily obtained, is more excusable than a Avant of candour. Had Mr. Hunter, while actually possessing a knoAvledge of the sentiments of Dr. Harvey on the subject, endeavoured to establish a belief that he was himself the author of the doctrine of the vitality of the blood, he would be deservedly ranked Avith the Avorst of plagiarists. My regard for the memory of so great a man forbids me to admit that this Avas the case. But Avhile Ave deny the validity of Mr. Hunter's claim to the original doctrine of the vitality of the blood, it is but justice to acknowledge, that he Avas the first who brought this doctrine to the test of experiment. He possessed, unquestionably, much more enlightened, definite, and practical ideas on the subject, than any medical character Avho had gone before him. He had' the invention and address to subject to the evidence of sense, what others had barely believed and reasoned on, as a point of speculative doctrine. While we Avithhold from him, therefore, the title of a discoverer, justice compels us to bestoAv on him that of an original and an able experimenter. In pursuing his inquiries, relative to the nature and properties of the blood, Mr. Hunter's first object appears to have been, to fix on one or more phenomena or facts, that might serve as ultimate and incontrover- tible tests of the existence of life in animal matter. By making, in this respect, an enlightened and judicious choice, he laid the best possible foundation for conducting his experiments to a satisfactory issue. The phxnomena, or rather properties, Avhich he selected for this purpose, Avere, 1st. An inherent power of self-preservation. And 2dly. A suscepti- bility of the impressions of stimuli. This last property is denominated by most physiologists, irritability, excitability, or stimulability, and by Dr. Danvin, the sensorial power of irritatio?i. As there appears to be throughout all nature a constant warfare between life and death, or between organized being and the powers destii-^d to C.^.w-yy it, the i*.,st and met simple act or operation of the VITALITY OF THE BLOOD S65 vital principle is, to countervail the works and encroachments of dissolu- tion. Whatever body or substance manifests a power of self-preservation, beyond that of common matter, placed under circumstances precisely similar, may be regarded as a being possessed of life. Thus a fresh egg will resist the influence of both heat and cold much longer than one that is stale or putrid. The reason of this is obvious. The former is in possession of the principle of vitality, whereas the latter has lost that preservatiAre power. For a similar reason, a turnip or potato just ta*ken out of the earth, is more difficult to freeze, and will resist the encroach- ment of putrefaction longer than one that has undergone the process of boiling. But a mere resistance of the work of dissolution must be regarded as a passive property of life, or in other words, as life in a latent state. The first or lowest manifestation of active life, or life in a sensible state, is, motion resulting from the impression of stimuli. If we pass the electric spark or the galvanic influence through a piece of metal or charcoal, neither of these substances suffers any visible motion whatever. But if Ave pass them through a bit of muscle, just taken from the system of an animal not yet dead, the part is immediately throAvn into lively contrac- tions. Hence Ave are led to say, that the muscle is possessed of stimula- bility, or one of the lowest properties of life, while Ave regard the metal and charcoal as nothing but masses of dead matter. Influenced by these vieAvs of the subject, Mr. Hunter very justly inferred, that if he could discover in the blood, after its elimination from the vascular system, a poAver of self-preservation, accompanied by a capability of being excited into motion by the application of stimuli, he Avould thereby prove it to be possessed of life. Hoav far he succeeded in his attempt at this, appears from the result of his experiments detailed in his Treatise on the Blood, most of which I have myself repeated, and some of Avhich I shall here recite. In relation to a self-preserving poAver in the blood, we have to regret that our author has left his inquiry in a very imperfect state. He appears to have made but tAVo experiments on this head, and even these have only an indirect reference to the point to be determined. The first of them was intended to ascertain, whether the blood of a young or of an old person will putrefy soonest. I shall relate the experiment in the writer's oAvn words. " June 24th. Some blood," says he, " Aps taken from a Avoman of tAventy years of age, and its surface, after coagulation, AA-as covered with an inflammatory crust. " On the same day, some blood Avas taken from a Avoman, aged sixty, when the crassamentum Avas also coArered with an inflammatory crust. " These quantities of blood AA'ere set by. 366 CALDWELL ON THE " The blood from the old woman putrefied in tAvo days. That from the young Avoman kept quite SAveet till the fifth day, when it began to smell disagreeably ; in this state, it continued two days more, and then emitted the common odour of putrid blood. " Several experiments," he continues," were made in the course of the summer, of a similar nature with the last, in all Avhich it appeared that the blood from young people kept longer sweet than that which Avas taken from old." The folloAving was most probably the train of reasoning which induced Mr. Hunter to institute this experiment. Old age is an approach toAvards death. The principle of vitality, therefore, whatever it may be, is in a more feeble condition in the systems of old people than in those of young. But this principle will preserve from putrefaction, the parts of the system in which it resides, for a length of time directly proportioned to the degree of its strength. Now there exists, on chemical principles, no reason Avhy the blood of old persons should putrefy sooner than that of young. If, therefore, it be found-that it actually does putrefy sooner, the phenomenon can be explained in no other Avay, than by admitting, that the blood of both old and young possesses life, but that this principle exists in a much more feeble state in the blood of the former, than it does in that of the latter. But, it has been already remarked, that this experiment is by no means decis'iAe. The inference to be draAvn from it is necessarily indirect, because the ground on which it was instituted is only constructive. Nor can I speak much more favourably of our author's second experiment on this head, the immediate object of which, to use his oAvn words, is " To see if recent blood or coagulated blood lost their heat soonest. " Four ounces of blood," says he, " after coagulating, Avas heated till it raised the mercury of a thermometer, placed in the middle of the coagulum to the 98th degree. The thermometer was placed in a similar quantity of blood, immediately after it was taken from the vein, and the mercury stood at 90°. These Avere placed by each other, and the thermometer put alternately in each, to observe how they parted with their heat. " Coagulated blood.........98°. Recent blood.........90°. Do. after 2 minutes 97°. Do. after 2 minutes 89°. , Do. after 4 do. more $3°. Do. after 4 do. more 88°. Do. after 2 do. %nore*92°. Do. after 2 do. more coag dated 87°. Do. after 2 Mo. more 91°. Do. after 2 do. more 86°." To understand this experiment it must be remembered, that .Mr. Hunter had, by previous experiments, ascertained that living bodies*. VITALITY OF THE BLdOD. 567 "whether animal or Aegetable, when exposed to a medium colder than themselves, part from their heat more sloAvly than such as are dead. In the instance under consideration, he appears to have regarded the coagu- lated blood as little else than dead matter, and to have held the comparative facility with which the two portions of this fluid might let go their heat, to be a proper test to determine, what difference existed between them in point of vitality. As the blood recently drawn, proved most retentive of its heat, this circumstance can be accounted for only, by ascribing its superior power of retention, to the operation of the vital principle. Mr. Hunter was more fortunate in his attempt to detect in the blood the second property, viz, stimulability, or a poAver of active life. He conceived that from this property arose the coagulation of the blood, a process which he considered as perfectly analogous to muscular contraction. " To see," says this enlightened physiologist," whether a stimulus can be applied to the blood, so as to make it coagulate faster than it does naturally, I desired the following experiment to be made. " Three ounces of blood were taken from a boy about ten years of age, and immediately after the cup was put into Avater heated to 150°. A similar quantity was taken in another cup from the same boy, at the same time, Avhich Avas put into water heated only to 48°. The first coagulated completely in five minutes, but the latter remained perfectly fluid for tAventy minutes, and then began to coagulate, but Avas not com- pletely coagulated for five minutes more. " This experiment shows," continues he, " that heat above the natural standard acts as a stimulus upon the blood, and makes it coagulate consi- derably sooner than cold does." An experiment which Mr. Hunter made on the muscle of a sheep, compared with the foregoing, exhibits such a striking analogy betAveen the coagulation of blood and muscular contraction, as cannot fail to pro- duce at least a strong presumption, that these tAvo phenomena depend on the same causes. " As soon," says our author," as the skin could be removed from a sheep that was neAvly killed, a square piece of muscle was cut off, Avhich Avas afterwards divided into three pieces, in the direction of the fibres. Each piece Avas put into a basin of Avater; the Avater in each being of different temperatures, viz. one 125°, about twenty -seven degrees warmer than the blood; another 98°, the heat of the animal; and the third 55°, about forty-three degrees colder than the animal. The muscle in the water heated to 125°, contracted directly, so as to be half an inch shorter than the other tAvo, and Avas hard and stiff. The muscle in the water heated to 98°, after six minutes, began to contract and grow stiff; at the end of 368 CALDWELL ON THE twenty minutes it Avas nearly, though not quite, as short and hard as the above. The muscle in the Avater heated to 55°, after fifteen minutes began to shorten and grow hard; after twenty minutes it was nearly as short and hard as that in the water heated to 98°. At the end of tAventy- four hours they Avere all found to be of the same length and stiffness. " Here," continues the writer, " is also a similarity in the excitements of coagulation in the blood, and of contraction in muscles, both apparently depending on the same principle, namely, life." The following is another interesting experiment of our author, in his inquiry respecting the excitability of the blood. " Some blood," says he, " Avas taken from the arm into a basin, stirred, and then mixed Avith different infusions as follows: " Tavo ounces Avith the same quantity of the infusion of gentian; tAvo more with two ounces of the Avatering solution of opium; and two ounces were kept in a vessel by themselves. " The blood which had been mixed with the bitter infusions, and the simple blood all coagulated at the same time, viz. in six minutes; but the blood Avhich had been mixed with the solution of opium did not coagulate for twelve minutes, and then the coagulum was very loose. " This experiment Avith the opium Avas repeated, and the result Avas exactly the same." In this instance the solution of opium appears to have acted so sud- denly and powerfully on the excitability of the blood, with which it Avas mixed, as to produce in it a state of exhaustion bordering on death. Hence, that portion of the blood coagulated more sloAvly and feebly than either of the others. But Mr. Hunter appears to have draAvn his favourite argument in support of the vitality of the blood, rather from the uses and functions of this fluid in disease, particularly in inflammation, than from any experi- ments performed on it, after its emission from the vascular system. In cases of wounds he found coagulated blood to constitute the bond of union by the first intention. For, says he, this " union is not that of two divided parts to^each other, but the union of these parts to the intermediate extra- vasated blood; so that it is the blood and parts uniting, which constitutes union by the first intention." It may certainly be considered as a self-evident truth, (if any physical truth can be called self-evident) that no healthy and permanent union can take place between living and dead animal matter. Such an union, being necessarily the result of reciprocal affinity or appetency, calls for active life in both of the uniting parts. If, then, as our author asserts, and as I believe to be true, extravasated blood, and divided flesh, form a real and living union, the former must possess the principle of life, in common with the latter. VITALITY OF THE BLOOD. 369 But Mr. Hunter carries his ideas on this subject still further. He maintains, that blood extravasated and coagulated in v-r\y part of the living system, is not only to all intents and purposes a living substance, but even possesses within itself a kind of creative power. That it is capable, not only of uniting to the surrounding and contiguous parts^fcut of forming within itself, and by its own operation, both A'essels, nerves, and bone. " Blood thus extraATasated," says he, " forms either vessels in itself, or vessels shoot out from the original surface of contact into it, forming an elongation of themselves, as we have reason to suppose they do in granu- lations. I have reason, hoAvever, to believe that the coagulum has the poAver, under necessary circumstances, to form vessels in and of itself." In the next page he observes, " As the coagulum, whether wholly blood, or coagulating lymph alone, has the materia vitae in its composition, which is the cause of all its actions, it soon opens a communication Avith the mind, forming within itself nerves. Nerves have not the poAver of form- ing themselves into longer cords, as we conceiAre vessels to have; for we knoAv, that in the union of a cut nerve, where a piece has been taken out, it is by means of the blood forming a union of coagulum; and that the coagulum becomes gradually more and more of the texture, and has of course more and more the use of a nerve, somewhat similar to the gradual change of blood into a bone in fractures." As it Avould be difficult to deliver the Avhole of Mr. Hunter's argu- ments in favour of the vitality of the blood, without reciting too great a portion of his Avork on that subject, I must earnestly recommend the work itself to your close and serious attention. I cannot, hoAvever, close my account of that performance, without giving the following quotation from it, Avhich shoAVS, perhaps, in a more striking manner than any other passage it contains, the elevated rank Avhich our author assigned to the blood, as a component part of the animal system. " No part of the body," says he, "is to be considered as a complete living substance, producing and continuing life, Avithout the blood: so that blood makes one part of the compound, without Avhich life Avould neither begin nor be continued. Any living part, or whole, shall die in a little time, by simply preventing the blood from moAing through the vessels; under this idea it is not clear to me, whether the blood dies sooner without the body, or the body without the blood." 3 8 370 CALDWELL ON THE LECTURE II. GENTLEMEN, Having presented you Avith a summary view of the sentiments of others, respecffng the vitality of the blood, I proceed to detail to you my own experiments and opinions on that subject. In doing this I disclaim all pretension to original discovery. Actual discovery in physiological science, is an honour of ay hich feAv persons are privileged to boast. My only merit (if indeed I have a just claim to any) in the present instance, consists in having taken up the matter where Mr. Hunter left it, per- formed sundry experiments Avhich he had omitted, and delivered, in a form somewhat compact, a chain of reasoning on the subject, Avhich he had either totally neglected, or scattered through such a mass of irrele- vant matter, as to impair its perspicuity and weaken its force. As the success of this inquiry does not depend on a determination of the question, What life is? whether it be material or immaterial, a sub- stance or a quality? I shall decline entering on the discussion of that intricate point. It is proper, however, to remark, that whatever may be the nature or essence of life, we have facts sufficient to convince us, that it neither results from, nor has any necessary dependence on, the mere organization of matter. Organization is indeed essential to certain given modes, functions, or operations of life; but not to the simple existence of life. It modifies and gives effect to vital action, but cannot become its real source; in the same manner as the barrel of a musket determines the direction of the ball, but can never set it in motion, Avithout the explo- sion of the powder within. In entering on my course of experiments, I took, as standards or tests of vitality, the same properties which had been receiA'ed as such by Mr. Hunter, namely, stimuUxbility, and an inherent power of self-preservation. I considered the coagulation of blood, after its emission from the vessel that contained it, as arising from the former of these properties, and as being in all respects analogous to muscular contraction. My first object was, therefore, to try the effects of various stimuli, not before employed for that purpose, in quickening the commencement and progress of this phenomenon. The first stimulus applied wli.ii this intention was elec- tricity. EXPERIMENT I. Four ounces of blood avci-c drawn from the arm of a person in health into a small tin cup, and set aside as a standard of natural coagulation. From the same orifice were immediately drawn four ounces more, into a similar cup, ay hich Avas coi.nccted to the prime conductor of an electrical n...chine. Through this latter portion of blood repeated shocks were VITALITY OF THE BLOOD. 371 ■passed, alternated Avith sparks draAvn from various parts of it. It coagu- lated sooner by several minutes, than the blood to which no electricity Avas applied. The coagulum, when formed, was alike firm in' each portion. This experiment was repeated more than twenty times, under various modifications, and on the blood of different persons, both sick and well, old and young, without any material difference in the result. In cases of disease, where the blood taken from the patient and suf- fered to coagulate naturally was sizy, that subjected to the influence of electricity Avas free from size. The reason of this is obvious. That portion of blood to Avhich electricity was applied, coagulated, in consequence of- this artificial stimulus, too suddenly, to allow the red globules to sink to the bottom, and the fibrina or coagulating lymph to ascend, and form a stra- tum aboA-e them. For the size of blood is nothing but a stratum of the coagulating portion, formed.in that way. And it will be found on exami-' nation, that blood which coagulates suddenly, let the cause of this coagu- lation be what it may, never exhibits a sizy covering. I am induced, therefore, to believe, in opposition to the opinion of Mr. Hunter, that this covering arises from a degree of exhaustion, or in other words, an enfeebled state of life in the blood. Perhaps I might properly term it a partial paralysis of the blood. Yet on some occasions blood of this description, when stimulated to action, contracts with a preternatural, degree of force. This is to be regarded, probably, as a tonic spasm of the fibrina of the blood. In inflammatory fever, Avhere sizy blood constitutes, for the most part, one of the characteristic symptoms, this fluid may be considered, like other parts of the system, in a state of exhaustion, in consequence of the excess of stimulus to which it has been subjected. When draAvn from the vein, therefore, it requires a greater length of time, than if it were in a natural and healthy state, to coagulate, or contract itself, analogous to what happens to muscular fibres, Avhen partially exhausted of their excita- bility, by an excess of stimuli. This tardiness of coagulation allows the red globules, being the heaviest portion of the blood, time to descend, before they become entangled by the coagulating lymph, Avhich they leave, in the form of a white or yelloAv membrane, on the top of the cras- samentum. I have found by experiment, as will hereafter appear, that by draAving healthy blood into a tin cup reduced to^he temperature of about fifty degrees, and alloAving it to stand in a medium of the same temperature, it will generally, if not uniformly, in consequence of its sIoay coagulation, exhibit a sizy covering. 372 CALDWELL ON THE EXPERIMENT II. To ascertain whether or not the effect of electricity on muscular substance, be analogous to that which it produces on the blood, the fol- loAving experiment Avas performed. A bit of muscle, about four inches in length, was taken from the neck of a calf, immediately after the animal had been knocked doAvn, and Avhile it stiii manifested strong symptoms of life. This muscle being divided longitudinally into two equal parts, one half of it was placed on a table where it lay undisturbed, Avhile the other had frequent shocks of electricity passed through it. 1 he electrified portion of muscle was perceptibly convulsed, and soon became nearly half an inch shorter than the other. The experiment was repeated several times, without any sensible difference in the result. Here we see that the coagulation of blood, and the contraction of muscular fibres, are alike accelerated by the influence of electricity. Is it not reasonable, then, to infer, that these phxnomena, so pre- cisely analogous, result from the same cause, namely, the action of stimulus on excitability ? EXPERIMENT III. Mr next object Avas to Ascertain the effects of different gases on the coagulation of the blood. For this purpose I took five small glass jars, one of which I filled with oxygenous gas, another with carbonic acid gas, a third Avith nitrous gas, a fourth Avith hydrogenous gas, and the fifth Avith common atmospheric air. Into each of these I drew from the same orifice in the arm of a robust, healthy, young man, about three ounces of blood, agitating the jars as soon as the quantity of blood was received into them, in order that the gases might come in contact with every part of this fluid. Those portions of blood subjected to the action of the oxygenous and carbonic acid gases, coagulated at about the same space of time after their emission from the arm; those recieved into the jars containing hydrogenous gas, and common atmospheric air, were some minutes longer in coagulating; but that recieved into the jar of nitrous air could not be properly said to coagulate at all, as the gas acted chemi- cally on it, changinfftit in some measure into a ne\v compound. This portion, like the others, became solid, but it had not the solidity , of true coagulation, in the light in which Ave apply this term to the blood., The result of this experiment, under several repetitions, was in substance the same. Those portions of blood exposed to the action of the oxygenous and carbonic acid gases, ahvays coagulated first, because, as I conceive, these airs are more active stimulants than the others. All the portions (that in contact Avitli nitrous air excepted) after having stood VITALITY OF THE BLOOD. 373 twelve hours, were precisely alike, with regard to their separation into serum and crassamentum. EXPERIMENT IV. This experiment was made with a vieAv to determine the effect of temperature on the coagulation of the blood. Four small tin cups were taken, into each of which three ounces of blood wore drawn, from the arm of a person in health. One of these was exposed to a temperature of 125°, another to a temperature of 98°, a third to a temperature of 80°, (the temperature of the atmosphere at the time the experiment was made) and the fourth to a temperature of about 52°, being that of our pump water when first drawn. That portion of blood exposed to a heat of 125°, coagulated in a very short time; that exposed to a heat of 98°, was several minutes longer in coagulating; that exposed to a heat of 80°, coagulated at a still later period; while that exposed to a heat of 52°, remained fluid nearly three times as long as either of the other portions, and, when if did at length coagulate, exhibited a sizy covering. The explanation of this experiment is obvious and easy. The blood in the different cups coagulated with a celerity proportioned to the stimu- lus of heat, acting on its. excitability. The whole experiment is perfectly analogous to that made by Mr. John Hunter, on the muscle of a sheep's neck. The sizy covering of that portion of blood exposed to fifty-tAvo degrees of heat, is to be attributed entirely to the slowness of its coagulation. Its long fluidity, as mentioned on a former occasion, gave time for the red globules to fall to the bottom of the cup, leaving the lighter coagulating lymph at top. EXPERIMENT V. Believing that blood (other circumstances being alike) always coagulates Avith a celerity proportioned to the degree of vitality it pos- sesses, and concieving arterial blood to possess a higher degree of this principle than venous, I made, for my satisfaction on these points, the following experiment. Into two glass tumblers, of the same sizeand form, were draAvn, at the same time, six ounces a piece of blood from the carotid artery and jugular vein of a calf. These portions of blood were exposed only to the action of the atmosphere. That drawn from the artery coagulated first by nearly tAvo minutes. On repeating this experiment several times, I found no material difference in the result. The arterial blood ahvays coagulated from one to tAvo minutes sooner than the venous. If we attend the shambles of a butcher, Avhile he is slaughtering calves or sheep, we may observe, that a\ hen the large vessels of the neck are divided, the 374 CALDWELL ON THE florid blood issuing from the arteries never fails to coagulate sooner than that from the veins. EXPERIMENT VI. When animals (to use a common expression) are run to death, as sometimes happens in the chase of the fox and the stag, as Avell as in the savage pastime of bull-baiting, the muscles can neither be made to con- tract nor the blood to coagulate. Considering this circumstance as arising from the complete extinction of life in e\rery part of the system, in consequenee of the excessive stimulus of exercise, I concieved that a similar effect might be produced on the blood, by subjecting it to the action of an excess of stimulus, after its emission from the vessel that contained it. To determine this point the folloAving experiment was made. I took two eight-ounce phials and drew into each of them four ounces of blood, from the same orifice in the arm of a healthy person. The phials Avere carefully closed by stoppers, and one of them placed on a table, where it was suffered to remain at rest, while the other was briskly and someAvhat forcibly agitated in the hand for the space of an hour, and then placed on the same table and disturbed no further. The blood in the first phial coagulated in the usual time, Avhile that in the other, which had undergone agitation, remained perfectly fluid till it became putrid, which event occurred in it three days sooner, than it did in that which was alloAved to coagulate. There is no difficulty in explaining this experiment. The stimulus of agitation, like that of excessive exercise to the entire animal, totally destroyed the vital principle of the blood, and in that way disqualified this'fluid for either coagulating, or resisting, in any measure, the pro- cess of putrefaction. The same result Avas obtained in several repetitions of this experiment. EXPERIMENT VII. This experiment was made with a vieAv to determine the difference between the celerity in the coagulation of the blood of old and of young persons. Into a small glass jar was draAvn four ounces of blood, from a free orifice in the arm of a woman about eighty-four years of age. At the same time, in the same room, and into a similar jar, was drawn an equal quantity of blood, from a similar orifice in the arm of a female, aged twenty years and a feAv months. Both these persons were in good health. The tAvo portions of blood, Avithout undergoing any agitation, were set along side of each other on the floor of the room. That draAvn from the young woman coagulated first by several minutes. On repeating tl.s VITALITY OF THE BLOOD. 375 ) experiment with the blood of other similar subjects, the result Avas in substance the same. The youthful blood ahvays coagulated first. In explanation of this experiment, it is necessary only to remark, that the excitability of the blood, like that of the muscles, is less obedient to the action of stimuli in old people than in young. The blood, as well as the solids of persons far advanced in years, is in a state of exhaustion, or partial paralysis. EXPERIMENT VIII. If the limb of a living animal be first exposed to a degree of cold sufficiently intense to freeze it, and immediately afterwards to a medium of a high temperature, mortification and death of the part are knoAvn to ensue. To ascertain Avhat effect a similar treatment Avould produce on the blood, the following experiment Avas made. A tin tube, half an inch in diameter, being first reduced to the tempe- rature of Zero, Avas filled Avith blood as it flowed from the arm of a per- son in health. The tube Avith its contents was then immersed in a freezing mixture, composed of salt and pounded ice, having its open end closed by a cap made for the purpose. Long before it had time to coagu- late, it Avas converted into a column of ice. The tube, at the expiration of tA\ enty minutes, Avas Avithdrawn from the freezing mixture, and sud- denly plunged into water, raised to the temperature of 126° of Farenheit. The blood whenthaAved, Avhich event took place in a short time, was thin and dark coloured, precisely similar to dissolved blood, drawn from a person in the last stage of a malignant fever. It was hoav poured from the tube into a glass tumbler, in order that Avhatever phenomena should occur in it might be more accurately observed. It remained liquid nearly an hour, but at length coagulated so far as to acquire a consistence some- what similar to that of molasses. It continued, however, an uniform mass, without separating into serum and crassamentum, and putrefied sooner, by several days, than another portion of blood taken from the same person, at the same time, and allowed to coagulate in'the natural way. On repeating this experiment several times, the result was, in no instance, materially different from the foregoing. There appears to be no difficulty in explaining the phxnomena which here occurred. In consequence of the extremes it underwent, and the violent treatment to which it was exposed, the vital principle of the blood, though not entirely destroyed, Avas so far Aveakened, as to be unfit for the performance of its usual functions. The fibrous portion, therefore, was unable to contract so strongly as to press the serum from among the cruor; hence, the tenderness and uniform consistence of the -whole mass; and the vis cot.*rrz » « warts, polypi, and other preternatural excrescences, on this principle. By obliterating, by means of ligatures, the cavities of the vessels that supply those excrescences with blood, they soon perish, and fall off, in a gangrenous state. By an operation similar in its principle, opaque spots are oftentimes removed from the lucid part of the cornea. If the arteries conveying blood to these spots be divided by a lancet, and prevented from uniting again, the spots will perish for want of their vital fluid, and be removed, most probably, by the action of the absorbents. When the nerves, passing to any part of the body, are compressed, divided, or otherwise destroyed, though sensibility and mobility, are injured by the operation or accident, life itself still remains, provided the circulation of the blood be unobstructed. Hence we see, that blood is essential to the existence of life, in every member, organ, and even excrescence, of the body, though the nervous influence is not. The latter only contributes to the activity and perfection of life, while the former is necessary to its very existence. But if blood conveys life to, and preserves it in, the several organs and parts of the system, it must unquestionably be itself a living fluid. I know it may be said, that blood preserves life in parts to which it flows, by acting simply as a stimulus, and not by carrying the principle or matter of vitality along with it. But if this were the case, life might be presented in these parts, at least for a time, by some other stimulus, besides that of blood. This, however, cannot be done. If tire current of blood, to the leg or arm, be completely obstructed, Avarm poultices, fomentations, and other stimulants are applied to no purpose. Death 388 CALDWELL ON THE and mortification ensue, as certainly and perhaps as speedily, as if no applications Avhatever were employed. 2dly. If an extraordinary exertion of life be required to be made by any member or part of the animal body, the economy of nature is such, as to supply that part with a preternatural quantity of blood, to enable it to make and sustain, the exertion required. This is particularly illustrated in the healing of wounds, the erection of the penis, and the phxnomena exhibited by the gravid uterus, and the female mamma: during the secretion of milk. The healing of a Avound requires an unusual exertion and expenditure of vital energy. Soon, therefore, after a muscle or other part is cut, lacerated, or punctured, a sAvelling occurs, which is nothing else than an accumulation of blood, around the injured spot. Vessels which were before invisible, and which contained nothing but a colourless lymph, are now enlarged, and become the receptacles of red blood. Nor does the healing process ever go on favourably without more or less of this accumulation or SAvelling. If the lips or sides of a large Avound continue *C&tCt pale and p|pAi, the symptom is a bad one, and poultices, fomentations, and other means, are employed, to solicit a flow of blood into the part. In such a case, the nerves and absorbents appear to bear no part in producing an augmentation of the vital energy. They preserve very nearly their usual appearance, without sustaining either an increase or diminution of size, throughout the whole process of cure. It is the blood-vessels alone, that are altered very materially both in their state and appearance. Their diameters are expanded, their tone is increased, they become more vigorous in their action, and receive a preternatural influx of blood. There is, then, the most solid ground to believe, that this preternatural accumulation of blood is intended to strengthen, and does strengthen, the vital energy of the part, which it could not do without being itself possessed of life. As no other component part of the body, Avhether solid or fluid, is present in an unusual quantity, the blood must operate as the sole cause of the increase of vital energy and action. Hence, in pale, leucophlegmatic, and emaciated habits, where this fluid is in small proportion, and of Aveak qualities, wounds heal with much difficulty. And hence, in the latter stage of malignant fever, when the blood is in a state of exhaustion bordering on death, the smallest scratch proves some- times incurable. I belieA'e it may be laid doAvn as an axiom in surgery, that Avithout a sufficient accumulation of blood, to augment the vital energy in the wrunded part, no curative process can eA'er go forward. In the erectio perns, and its natural concomitants, there is a vast expenditure of vital energy. To prepare the part for this expenditure, a great accumulation of blood is effected. This accumulation appears to act in a twofold manner, viz. mechanicaliy and vitally. By its mechanical VITALITY OF THE BLOOD 38§ operation, it gives the necessary tension and firmness to the member, and by its vital, increases both its sensibility and appetency. It is an error to say, that the peculiar sensibility and appetency of the erect penis, are the natural and necessary consequences of its mechanical distension. Were the distension produced by any other fluid than blood, no such exquisite feeling, or strong propensity Avould ensue. Sensibility and animal appetency, are attributes or properties of life. An increase of them, therefore, m any part of the body, can arise only, from an increase in the powers or energies of life in that part. But no one Avill pretend to maintain, that mere mechanical distension can have any influence in strengthening these energies. Does the aqueous distension in anasarca add to the energies of life in the lower extremities? Does it not, on the other hand, produce in these parts the greatest debility ? How, then, can mere distension be productive of such opposite effects in the penis? To the vitality, and life-increasing poAver of the blood alone, must we attribute the difference between the sensibility and appetency of the penis, in an erect, and those which it possesses m a flaccid state. In the gravid uterus there must necessarily occur, perhaps the greatest possible accumulation and expenditure of vital energy. Besides maintaining the vitality of the organ itself, life is to be conferred on an entire, being contained Avithin its cavity, and that being afterwards expelled, by the most poAverful and painful efforts. Let us briefly examine the course which nature pursues, in bestowing on the uterine system, this accumulation, and preparing it for this expen- diture, of the energies of life. She does not attempt her purposes, by increasing the number or size of either nerves, absorbents, or solid fibres. These parts, though all-important in their proper stations and functions, are not calculated for the accomplishment of her ends. She turns her attention to the blood-vessels alone, as the only instruments, by which the vast work of gestation can be completed. These she greatly augments, both in number and size, and pours into them a preternatural volume of blood, conscious, that by no otlier means can the necessary quantity of life be concentred in the part. This appears to be a kind of conclusive testimony, borne by nature herself, in favour of the doctrine for which v, e are contending. If the blood be not alive, Avhy is it alone employed, to add to the vitality of a particular organ ? If the nerves and other solids only, be vital, Avhy can they not be rendered subservient to the purposes of nature, in this instance? Surely the mere accumulation of dead matter, cannot be supposed to strengthen in any measure the energies qflife. But it may be alleged by some, that the blood strengthens the ener- gies of life, in the uterine system, only by acting on it, as a suitable and powerful stimulus. This, however, cannot be admitted. If the blood 390 CALDWELL ON THE operated on the uterus only as a stimulus, increasing its action, without at the same time augmenting its power, it would produce indirect debility or exhaustion, which is the very reverse of an accumulation of vital strength. For Iioav can indirect debility be more certainly induced, than by the long continued impression of a preternatural stimulus ? Instead of blood, suppose the uterus were subject to the constant and long continued action of a preternatural degree of heat, which is nothing but a pure stimulus. Would this tend to strengthen its vital energies ? or would it not rather, either rouse it to active inflammation, or wear it down by degrees into indirect debility? One or the other of these latter results, would unquestionably take place. The same remarks which have been made relative to the uterine system, in a state of pregnancy, may be applied to the mamma, during the period of lactation. While secreting milk, these glands require a greater accumulation, and are subject to a greater expenditure, of life, than at any other time. Besides the increased action necessary in per- forming their secretory process, they acquire also a peculiar sensibility, and vital appetency, which they did not possess before. Indeed their whole appearance, and functions are expressive of a preternatural accu- mulation of life. To Avhat cause is this accumulation of both irritative, and sensith'e life to be attributed? Not to an enlargement in the size, an increase in the number, or any other alteration in the state, of the nerves, lymphatics, or solid fibres. No such changes, with respect to these parts, take place. The only perceptible alterations that occur in the mammae, are confined exclusively to the sanguiferous system. The blood-vessels are not only expanded in their dimensions, but I believe increased in number, to make room for a preternatural influx of blood, To this influx, then, are we compelled to look, for that accumulation of life, and that increase of action, which prevail in the mammae during the time of lactation. The objections Avhich were urged against the blood's acting as a simple stimulus, on the uterine system, during gestation, are equally applicable in the present instance. Exhaustion, or indirect debility, would be the natural issue in either case. Various other phenomena might be enumerated, in which, a tem- porary accumulation of life is produced, by means of a local accumulation of blood. The erection of the papilla of the tongue, occasioned by the sight, and taste of grateful food, the turgescence of the lips arising from voluptuous kisses, and the protrusion, or erection, as it may be termed, of the nipple of the female breast, resulting from gentle titillation, appear to be all of this description. The turgescence, or swelling, in these cases, bears a strong analogy to the erection of the penis. Its final cause is pleasurable sensation. It is itself produced by an accumulation of blood, VITALITY OF THE BLOOD. 391 and produces, in its turn, an accumulation of both irritative, and sensitive life, i rom what has been here advanced, the blood would seem to be nature's flying squadron, which she dispatches at pleasure, from part to part of the system, accordingly as the functions, or exigencies of one organ or another, demand a temporary reinforcement of their vital energy. For these purposes, the blood is peculiarly fitted, by its fluidity, and consequent aptitude for motion. Nor is its vitality less essential to the offices it performs in the economy of the body. If with Girtanner, Humbold, Davy, and otlier philosophers, we view life as a mere chemical phenomenon, resulting from the affinities and action of certain kinds of matter, Ave may thence derive even further evidence, in confirmation of the vitality of the blood. In considering this point, we must take analysis for our guide. As far as that has hitherto thrown light on the subject, the fibrina of the blood appears to consist of the same component parts, and those in nearly the same proportion, with the muscular, or irritable fibre. If, therefore, in the latter substance, life be the result of the mutual action of these parts on each other, or of the action of some extraneous matter, on the whole of them as a com- pound, must not, in the former, the same causes produce invariably the same effect? Unquestionably they must, else every principle of reason is fallacious, and all rules of induction are at an end. In examin- ing the doctrine on chemical principles, no shadow of objection against the vitality of the blood, can be drawn from the circumstance of its fluidity. Perhaps even the reverse of this is true. For, other circum- stances being alike, chemical agents are most powerful in their operation, Avhen reduced to a fluid, or an aeriform state. If, therefore, life be a phenomenon purely chemical, it is likely to exist in a state of even greater vigour in the blood, than in the solid parts of the body. This consideration not only justifies, but adds weight to, the declaration of Mr. John Hunter, that he was at a loss to determine, whether the body would die sooner without the blood, or the blood without the body. For my oaati part, I am at present inclined to believe, that, in whatever way the matter is to be explained, the blood, particularly in warm blooded animals, is more tenacious of life than the solids. I think it will appear, that the fibrina continues longer to contract, on the application of stimuli, than a bit of muscle, cut from an animal at the same time the blood Avas draAvn.* * I would not have it inferred, from any thing here advanced, that I am, as vet, an advocate for the hypothesis of chemical life. The doctrine of the vitality of ihe blood, stands in no need of aid from that speculative source. If it did, 1 wuirld certainly abandon it. For, notwithstanding the fashiouableness of the Jn putiiciis in Europe, and the ascendency it has gained over some mimls in this 392 CALDWELL ON THE It might, perhaps, be considered improper in me, to close these observations, Avithout taking some notice of the opinions of certain medi- cal philosophers, Avho have lately appeared in opposition to the doctrine of the vitality of the blood. The most distinguished of these, whose writings have fallen into my hands, are professor Blumenbach, and Dr. Crumpe of the Royal Irish Academy. As these authors have not attempted to bring their inquiries to the only genuine test of truth, I mean experiment, I cannot attach to their opinions, in this instance, the same respect Avhich I am bound to do in many others. Whoever will read, with attention, the short treatise " De vi vitali tanguim neganda" must I think, close it Avith a sentiment of regret, that it has nothing in it worthy of the professor of Gottingen. Strike from it the name of Blumenbach, and it will dwindle into a Atery feeble perfor- mance. Did it contain a single experiment, I would endeavour to answer it; but, being from beginning to end, a mere tissue of hypothesis, and Avritten in a style of Latin, not very intelligible to common medical readers, and therefore, not likely to mislead public opinion, I do not think it necessary to make it the subject of any further remarks. As Dr. Crump's Treatise on Opium, has acquired for its author considerable reputation, and is, no doubt, familiarly knoAvn to most of you, any errors it may contain on the subject of the Adtality of the blood, present a higher claim to our attention. Under these impressions, I cannot suffer the folloAving sentiment to pass unnoticed. " Separate," says the doctor, " a muscle from au animal, and it will contract on being irritated; draw a cup of blood, and no irritation can rouse it into action." This latter assertion is so directly opposed to the result of experiment, that I know not how to reconcile it with even a very country, it will require stubborn facts to convince me, that man with all his cor- poreal and intellectual attributes, is nothing but a hydro-phosphorated oxyde of azote. On all subjects, however, I hope and beheve, that I am open to the impression of facts and reasonings. But they must be such as I can understand. I am sorry to add, that every thing on the subject of chemical life, that has hither- to reached me, either through the press, or otherwise, is, to me, wholly incom- prehensible. I can readily assent to the beautiful extravagance of the poet, when he exclaims, w That very lav, which moulds a tear, " And bids it trickle from its source, " That laAv preserves the earth a sphere, " And guides the planets in their course." But, when the chemist declares, that the same laws which direct the crystal- lization of spars, nitre, and Glauber's salts, direct also the crystallization of man he must pardon me if I neither understand him, nor believe hiin. VITALITY OF THE BLOOD. 393 moderate share of knoAvledge on the subject. Had Dr. Crumpe ever seen a portion of fresh-drawn blood, exposed to the influence of electricity, to the action of air or water raised fifteen or twenty degrees aoove its own temperature, or even to the stimulus of simple agitation, he could never have declared that fluid to be unsusceptible of irritation. For a full refutation of the error, into which our author has here fallen, I need only refer you to the results of my first and fourth experiments. I trust it is there satisfactorily proven, that blood is no less susceptible of irritation, than muscular fibre. Dr. Crumpe again contends, that in cases of incised wounds, the blood Avhich is effused, and undergoes coagulation between the divided parts, does not connect them together, by becoming itself an organic and vas- cular substance, but by serving as a mere receptacle and mechanical support, for the elongated and inosculating vessels, that shoot out from the fresh surfaces on either s/ide. " It [the blood] appears to me," says he, " to be only the medium through which the divided, inflamed, and irritated vessels extend their extremities." He adds, " Can an instance be shewn, where effused or coagulated blood, so situated as not to be in reach of these vessels, ever became vascular?" To this interrogation, I think I can ansAver decidedly in the affirmative, and hope to convince you, by the following fact, that I do not risk my opinion on hypothetical grounds. In the summer of the year 1800, I was obliged to submit to the extraction of a tooth from my lower jaAV. The hemorrhage from the lacerated vessels, though not very copious, proved tedious and trouble- some. Various expedients were devised to suppress it, AA'ithout effect. It at length occurred to me, that if the blood were allowed to fill up the alveolus, and retained there by pressure, till coagulation should take place, the thrombus would effectually close the mouths of the divided vessels. The experiment was made, and succeeded to my wishes. The hasmorr- hagy, which had continued during nearly three days and nights, was now at an end; and as the coagulated blood proved neither inconvenient nor disagreeable, it Avas suffered to remain in the socket of the jaAv. The weather being Avarm, I examined it cai-.fully, seA-eral times a day, lest it might become putrid and offensive. But instead of this, I observed it on the fourth or fifth clay after coagulation, beginning- to assume the appear- ance of flesh. Nor did this incarnation commence at the circumference, but in the centre of the coagulum, at the greatest possible distance from any vessels that might, by elongation, haAe been protruded from the adjacent gums. From this central point, the process continued to extend, till what had been at first nothing but congealed blood, became a piece of perfect flesh, similar in texture and appearance, to that of the gums. It resembled; for a time, a piece of flesh ingrai.ju. or introduced, 394 CALDWELL ON THE in the form of a plug, into the jaw. In this case, the blood was not exchanged for, but actually com^erted into, an organic substance. Should this fact ever come to the knoAvledge of Dr. Crumpe, I hope he will have the candour to admit, that, at least, in one instance, effused and coagulated blood has become vascular, and that in a part to Avhich the surrounding vessels could not at first reach. As the incarnizing process began in the centre of the coagulum, the phenomenon can be explained only by admit- ting the blood to be possessed of a vital and self-organizing power. Another fact, analagous to the foregoing one, has taken place in my oavh person, Avithin the last five months. Blood lodged in the alveolus Avas certainly converted into flesh. I suspect this to be a very frequent occurrence after the extraction of teeth. The only further error of Dr. Crumpe, I shall here notice, is, one into which a physician of extensive reading (as I believe him to be) ought not to have fallen. Speaking of the order, in Avhich the different parts of an animal embryo are originally evolved, the doctor asserts, that " the heart is generally the first part observed, and always in motion." Respecting this assertion, I shall only briefly observe, that abundant evidence of its fallacy, may be collected from the writings of Dr. William Harvey, whose knoAvledge on the subject of the order or succession of animal evolution, will not be called in question. The following sentence expresses his opinion, on the point under consideration: " Quantum" says he, " ex accurata insjiectione discernere lieu?/, fit sanguis antequam punctum salien* efformatur." If, then, it be true, that the blood is the primogenial or first-born part of the animal embryo, and even, as Harvey alleges, the common parent or source of all the parts subsequently formed, it is not only an error, but a palpable absurdity, to deny it the possession of a principle of life. For how can that, which is in itself destitute of life, give origin to vital organs and membranes ? It does not appear to be an abstract principle of life, operating on the blood as a raw mat'rial, but the blood itself, acting as a living fluid, that gives being and life to the solid and organized parts of? the body. In the great work of generation, or what I have already termed animal evolution, the first, and most simple vital act, appears to be, the formation of blood, out of what may be denominated the rudiments, or raAv materials of animal nature. With this fluid, Avhen formed, the vital principle, whatever may be its essence or origin, seems to incorporate itself, confering on it the attributes of vitality, and, by its aid, goes on to prodirc, in proper order of succession, the various solid parts of the body. To these solids, thus originally formed and fashioned by '. .If, the blood continues afterwards to he the faithful dispenser of VITALITY OF THE BLOOD. 395 life and sustenance; while they, by their peculiar and appropriate modes of action, preserve it in a renovated and healthful state. Hence, the beauty and perfection of the animal circle! The blood gives original existence and life to the solids: the solids, by their energies and action, preserve the blood in health, and continue it in motion; while it, again, on each return to the several organs, which it visits in its round, comes fraught with Avhat is necessary to replace their expenditures, whether of substance, strength, or vitality. FINIS. .X'. ■::■:■. . :'• ^vi:::::v.-#^#