'i^.-&*.'<'[*$?- i "J f■ V ^ ':- ■ UNITED STATES OF AMERICA WASHINGTON, DC. GPO 16—67244-1 re r\* \ V*7 -J-**"" Pft "■y & % v*fv7 % ,.^'"A > ' Jig: 7. ^ 7 ] IV. Its Effects on the Living Body, With afhort account of the Opinions ofthofe Au- thors who have written upon it. GOVERNOR Colden, who was bred to the profeflion of medicine, in a communication which he made to Linnreus, fays, " that the expreffed " juice of any part of this plant, when infpifllited " in the fun, is of great fervice in ulcers, and that " it has cured genuine cancers." I. Of the Root, " The roots are emetic and cathartic *. An " ounce of the dried root, infufed in a pint of * Dr. Griffitts informed me of a family, near Reading, who accidentally ufed the root inftead of the horfe-radilh. The confequence was immediate vomiting and purging, which continued violently for feveral hours. The mafter of the family was thrown into convulfions; all their countenances were very pale, and their whole frame greatly debilitated. However the fucceeding day they were all reftored again, and not the leaft of its effects were perceptible. C I was [ i3 ] "wine, r.nd given to the quantity of two fpoon- " fuls, frequently operates very kindly as an eme- " tic. In fome cafes it is preferable to moft other " emetics, as it hardly alters the tafte of the wine. " The roots are applied to the hands and feet in " ardent fevers. Farriers give a decoction of " them to drench cattle, and apply them in form " of poultice, for difcuffing * tumors f.". Parkinfon fays, " that the inhabitants of North " America make ufe of the juice of the root as I was alfo informed, by two foreigners, that after their arrival in fhi* country, they happened to eat fome of the root of this plant, not knowing what it was, becaufe it had a remarkable fweet t ifte. They immediately puked vio- lently; this continued for fome time, and debilitated them exceedingly, fo much fo, that they were not able to walk about. They neverthelefs, after taking milk and common fait, foon recovered, and the next day were both well again. The root, from the fweetifh tafte which it communicates to the palate, is a favourite food with fome animals. Thus hogs are exceedingly fond of it. It is, however, found to purge them when eating it. * Mr. J. Bartram informed me, that his father frequently cured the fiftulous ulcers of horfes with the extract of the root, where other powerful remedies would make no imprcflion. *f See the Rev. Mr. Cutler's paper in the Memoirs of the American Academy of Arts and Sciences, vol. i. p. 447. " a fami- [ 19 ] " a familiar purge. Two fpoonful9 of the juice " will work ftrongly *." In the difeafe called the "yellow water," which, for feveral years paft, has proved fo very mortal to horfes in Pennfylvania, New-Jerfey, and fome other parts of the' United States, the Phytolacca is thought to have been ufeful. The food of the horfes affected with this difeafe f, was fprinkled with a decoction of the roots of the plant. The Cherokee-Indians made ufe of the poke- root in cafes of venereal chancres. The chancres are dreffed with the powder of the root, well dried. It is certain, however, that this mode of treating chancres is not always, if ever, efficaci- ous ; fince many of the Indians fall victims to the * Mr. Macon, a refpectable member of Congrefs, inform- ed me, that he knew a man in South-Carolina, who made a very ftrong decotfion of the root, and drank nearly a quart of this liquor. It purged him violendy, but no other ef- fects (as he fa7s) were in any degree perceptible. f This difeafe appeared to be a true Synochus ; begin- ning with fynocha, and ending in typhus. It was called Yellow Water, from the yellow appearance which the ferum had after bleeding. » C 2 ravages [ *° n ravages of the difeafe juft mentioned *. Dr. Schoepf, in his Materia medica Americana potif- fimum regni vegetabilis f, fays, that the extract of the root of the poke is ufed both externally and internally, in ulcers of a bad kind (refembling cancerous ulcers) of the lips and mammce {. II. Of the Leaves. In many parts of the United States, the inhabi- tants boil the young (hoots, and eat them in the manner of fpinach ; the Items when boiled in this ftate are hardly to be diftinguifhed from it; they are nutritious and wholefome, and in tafte equal to afparagus §. Some caution, however, is neceffary in this cafe, as the leaves and (talks, when gathered in * From the information of Dr. Barton. f See page 71. % In Pennfylvania the inhabitants frequently fubftitute an ointment made of the root boiled with hogs lard, inftead of the extract. This they fay is alfo of great fervice in dif- ferent eruptions of the (kin. § Indeed in fome cafes it may be faid to be preferable, as it is a well known fact, that it does not affect the urine with that fcetid odour, which fo commonly occurs after the eating of afparagus* a more C « ] a more advanced ftate, fometimes have a violent cathartic effect. Profeffor Kalm, in his Travels, mentions this fact, and it is now familiar to moft of the people of the United States *. The powdered leaves are ufed by fome as an emetic f. But the root is generally preferred for this purpofe, as it appears to be much more pow- erful, and confequently fmaller dofes of it are re- quifite. * See vol. i. p. 197. f My ingenious friend Mr. Cooper (the prefent apothe- cary of the Pennfylvania Hofpital), in order to afcertain the effects of the leaves, made feveral experiments upon himfelf. In a letter with which he favoured me, he fays, " I took two " fcruples of finely powdered leaves of the Phytolacca. A *' flight naufea enfued, which foon went off; it returned, and " about an hour after I took the medicine, vomiting was pro- " duced. I vomited three times; the intervals were ihort, " with lefs ftraining and difagreeable fenfation than I " ever experienced from taking tartar emetic or ipecacu- " anha. I felt fomewhat drowfy afterwards." For the purpofe of trying their effects in decoction, he adds, " I took " two ounces of the green leaves of the fame plant, and " boiled them in a quart of water down to a pint; of this I " took about eight ounces, and felt little or no naufea after- " wards. It operated gently by ftool." He alfo adds, that after applying fome of the powdered leaves on an ulcer for a fhort time, it produced flight efchars. , c3 Profeffor [ 22 ] Profeffor Allioni, in his Flora Pedemontana *, fays, that in Piedmont, the leaves of the poke arc ufed in cancerous ulcers; but he adds, that they produced no other benefit than that of mitigating the pains arifing from thefe ulcers f, III. Of the Berries, Thefe, when perfectly ripe, are extremely fmooth, and of a dark reddifh colour. They of courfe are very tempting to eat, but this gratifi- cation can feldom be enjoyed to any degree, with- out great inconvenience +. Man is not the only * Vol. ii. p. 132. f They fometimes, however, have more efficacy, as ap» pears from the following cafe communicated to me by Dr, Wiftar. A negro (in the ftate of New-York) had a cancerT oas fore in his upper lip and nofe, which was confidered as incurable. He one day covered it with a poke-leaf, merely to keep off the flies, w*uch were exceedingly troublefome at that time of the year. On finding himfclf eafier in confe- quence of this new application, he continued it for fome time, which produced a fenfible amendment of the ulcer, and finally a cure ; but during the winter, when the leaves could iiot be procured, he applied the bruifed root. \ Profeffor Kalm, however, mentions (fee his Travels, vol. i. p. 197-) that "the berries are eaten in. autumn by »* children, without any ill confequence." Mr. Macon alfo iiifoi med me, that he had feen feveral French gentlemen eat thems C *3 3 animal to whom thefe berries are unfriendly ; many birds are obferved to be purged by them. The flefli of thofe who eat them acquires a high red colour, a difagreeable flavour, and is deftkute of adipofe fubftance *. Dogs alfo appear to be much affected by it. Thus Sprogel found that fome drops of the ex- preffed juice of the berries, when put into the mouth of a dog, excited a violent cough, alfo a tremor, and fome convulfive motions; and that two drachms of the fame juice excited in a dog much more violent effects ; the animal, however, recovered in a (hort time. Sprogel experimenta circa venena, p. 24. them, without any inconvenience, as if they were cherries, grapes, or any other innocent fruit. Inftances of a finiilai nature may fometimes ecccur; but this is not generally the cafe. Whole families are often exceffively purged merely by eating the flefh of birds, which have fed upon the berriea; although their eff^as muft have been rendered much milder by the dilution, and perhaps decompofition, of their juice in the bodies of thefe animals. * There are a number of b'rds which arc obferved to feed on thefe berries, fuch as the robin, the thruih, the mocking- bird, pigeons, and many others. Poultry are alfo very fond of them j likewife infects, fuch as grafs-lioppers, &c. C 4 Th~ [ *4 ] The extract of the berries, when applied to cancerous ulcers, has frequently proved an effec- tual remedy ; particularly in thofe of a long (land- ing #. The expreffed juice of the Poke-berries, exter- nally applied, is faid to cure corns : fcabies and herpes have been often removed by it. In thefe cafes, a folution of the extract in water is generally fubftituted, where the expreffed juice cannot be had. In rheumatifm the whole fubftance of this plant has at different times been of effential fervice ; although the berries have generally been pre- ferred f. In thofe rheumatic affections which * Dr. Rufh informed me, that his preceptor, Dr. Red- man, ufed the extract of the berries to a number of old ulcers with fuccefs. He particularly noticed a cafe of a Mrs. C. in this city, who had been afflicted with a cancerous ulcer in her breaft for feveral years. Every thing almoft had been at- tempted, but in vain. The extract of the berries was at length tried ; and by repeated applicatii ns fupp.trting the fyftem at the fame time with tonics, a cure was finally obtained. f Mr. William Madock of this city, is faid to have been recovered, by this treatment, from a very diftreffing cafe of chronic rhcumatifm. Dr. Barton informed me, that a feverc cafe of rheumatifm, which had baffled the fkill of feveral [ *5 ] fometimes occur to fyphilitic patients, its virtue far exceeds that of opium *. Being defirons of enquiring more particularly into the nature of this plant, as well as of afcer- taining which of its different parts was moft pow- erful, I tried the following experiments upon ani- ma!s. Experiment I. I gave an ounce of the expreffed juice of the leaves to a middle fized dog, of about three or four years old, on the feventh of October. The confequence was, that about five minutes after the exhibition, he began to puke moft violently, and continued doing fo near an hour; during which time it operated no lefs than fourteen or fifteen times, and appeared to excite extreme nau- feveral phyficians about Albany, was at length cured by the expreffed juice of the root of the Poke-plant. The berries would have been preferred, but they were not to be had at the time. * Dr. Griffitts, who has lately been particularly atten- tive to the Phytolacca decandra, related in his Lectures, that in cafes of fyphilitic rheumatifm, where he tried this remedy, he was always remarkably fuccefsful. fea. [ 26 ] fea. He, at the fame time, appeared to be very drowfy, particularly in the intervals of puking. The abdomen was alfo much diftended. It like- wife operated in fome degree as a cathartic and diuretic, befides occafioning a very troublefome cough, which tormented the animal in fuch a manner, that it had but little reft during the ope- ration. I alfo obferved, thav in the flighteft fit of coughing, an enormous quantity of vapour was always thrown from the lungs; more fo than ever I obferved in thefe animals, even during the fe- vered exercife they have undergone. However, as foon as the operation was over, which conti- nued about an hour and an half, the dog appeared to be as well as ever, except that the cough and dullnefs did not abate immediately, though they were much lefs violent. Experiment II. On the feventeenth of October, a week after the firft experiment, I gave an ounce and two drachms of the juice of the berries to the fame dog : he puked foon after ; and though a larger quantity had been given, yet he vomited nine or ten times only : the other fymptoms were nearly fimilar to thofe before-mentioned, but lefs violent. Its diuretic and cathartic effects, however, were more evident. Expe- [ V 1 Experiment III. On the twenty-firft of the fame month, I exhi- bited ten drachms of the expreffed juice of the root to the fame dog. This part of the plant ap- peared to be much more fevere in its effects than either of the others. It not only operated more violently as an emetic and cathartic, but alfo oc- cafioned much more (tupidity *. Wifhing to know the comparative (trength of the gum and refin of this plant, I tried the fol- lowing experiments. Experiment IV. I diffolved four fcruples of the gummy part of the leaves in about four ounces of water. One half of which I gave to a dog, with the afliftance of Dr. Lacoudre. Some naufea and drowfinefs were produced, but no vomiting. The other ef- fects were almoft the fame as above defcribed f. * It is very remarkable, that when I procured this dog, he was very fcabby, and affefled feveral perfons who touched him ; but after thefe experiments were concluded, he was fo perfectly cured, that not a fingle fcab was per- ceptible on his whole body. t Viz. Cough, diaphorefis, &c. : Expe- [ *i ] Experiment V. With the refinous product I proceeded in the fame manner as I did with the gummy, and exhi- bited an equal quantify of it to the fame dog. The confequence, however, was in fome refpects different, as the animal not only vomitted feveral times; but the foporific effects were alfo much more evident. Experiment VI. In order to try the effects of the fpirit, which I had diftilled from the berries, I gave about two ounces of it to a middle fized dog. Some nau- fea and drowfinefs came on, followed by flight convulfive motions, but no vomitting fucceeded. The other effects were nearly fimilar to thofe above-mentioned *. * I repeated thefe experiments upon young dogs, and was furprifed to find that they were not affected by any preparation of this plant, even when given in three or four times the quantity ufed in the above experiments. The fame circumftance was obferved with refpect to dogs of twelve or fourteen years of age. V. C *9 ] v. Remarks on the preceding FaSfs and Ex- periments. I. On the Chemical Analyfis. THE juice of this plant appears to contain a true gum-refin, as may be inferred from the ana- lyfis which I have made. The proportions of the gum and refin are, however, very different: thus we fee the quantity of refin from the root, is very fmall in comparifon to that of the leaves, or berries, and the gum alfo lefs than that of the berries. A queftion therefore, may naturally occur in this place, Why is the root more power- ful than the other parts, as we find it to be in the preceding experiments ? Of this however, I (hall fpeak prefently in its more proper place. The refinous part of the leaves, we may obferve, is greater in proportion to the gum, than that of tfce root or the berries. It is therefore very probable, as authors have not unfrequently conjectured, that the green colour of vegetables is in a great mea- fure owing to this product; and I have particu- larly obferved that the odour, which is fo pecu- liar to the green parts of vegetables, efpecially 1 when C 3° ] when drying, appeared to me much ftronger in the refinous than in the gummy part. Whether the Phytolacca contains any thing befides gum and refin, I have not had fufficient time to afcertain; though it feems evidently to contain a large proportion of faccharine matter, as appears from the remarkable fweet tafte, efpe- cially of the berries. Should the fpirit which may be procured from the berries, be found to retain fome of their pecu- liar qualities, it may probably ferve as an excel- lent menftruum for the other preparations of this plant. II. On Dying. With refpect to the Phytolacca as a dye, it may, perhaps, become an article of a very inter- efting nature, particularly as it grows in fuch great abundance in our own country. Several attempts h#ve lately been made to fix its colouring matter upon linen and cotton; but thefe attempts have as yet proved unfuccefsful. In the preceding experiments on dying, I have fucceeded in two articles only, viz. quills and paper. Of the quills the clarified only were pro- perly [ 3i ] perly affected. Hence it appears in fome meafurc evident, that, thofe fubftances, which are perfectly purified from foreign matters, particularly of the unctuous kind, are the moft proper fubjects for dying. Inftead of alum we may probably fubfti- tute many other aftringents, particularly thofe of the vegetable kind, which perhaps, are far fupe- rior ; and who knows but that by repeated trials we may difcover thefe to be the fubftances bed fuited for this purpofe, as has already been hinted at concerning the Indian dye ? Lime-water feems to be a mordant for fixing the colouring matter of the juice of the berries on paper ; though on cloth this has very little effect. The juice when thus impregnated and applied funk in it, fimilar to our black ink when prepared without gum arabic. It is therefore, not impro- bable, that by adding a proper quantity of gum arabic to this folution, and evaporating it to the confiftence of an extract, we may obtain an excel- lent and durable painting colour, ufeful for many valuable purpofes*. * * Gum Arabic itfelf, when added to the juice, was thought by one of my friends (who tried the experiment) to have this property. III. On [ 3^ J III. On its Operation on the Animal Body* The principal effect of this vegetable, when applied locally, feems to be that of a mild efcha- rotic. This I infer, i. From its producing efchars when applied to ulcers. 2. From its property of difcufling tumors. 3. From its being of an emetic and cathartic nature. For we (hall generally find fuch fub- ftances when applied, poffeffed of a cauftic or efcharotic power. It alfo appears evidently to poffefs an anodyne quality, which may be inferred from the drowfi- nefs it occafions, and perhaps from the eafe in its operation as an emetic. Its anodyne effects feem, however, lefs evident and powerful than the evacuant*. * I believe the Phytolacca will never prove fatal as a narcotic, becaufe when given in large dofes, it will always procure its own rejection by its emetic power. The emetic power feems fo counteracted by the narcotic, that it will not act violently unlefs taken in an immenfe quantity. It [ 33 ] It is diaphoretic, cathartic, and diuretic. Thefe effects probably proceed from the narcotic and anodyne qualities above mentioned ; for when an emetic is exhibited in fmall dofes, diaphorefis generally is the refult, efpecially if combined with an opiate ; and frequently emetics when they pafs unchanged from the (tomach into the inteftines, prove cathartic: fuch fubftances often (timulate the kidneys, and thereby (hew diuretic effects. This vegetable as an emetic, combined with an anodyne, far exceeds any other yet difcovered. It is owing to this admirable property, that it is not fo liable to occafion naufea and ficknefs when ex- hibited in fmall dofes, as is the cafe with other diaphoretics, and for this reafon alfo we do not perceive that excruciating pain when applied to ulcers, particularly of the atonic kind, which arifes from other efcharotics. The different effects of the different parts of this plant are remarkable. Why the root is more powerful than the other parts, fince it contains a fmaller proportion both of gum and refin, I can- not well afcertain. But it feems highly probable that it contains, in a greater quantity than the other parts, fomething of a volatile and corrofive property (which exifts throughout the whole plant) as when tafted, it is evidently ftronger and more acrid, than either the leaves or the berries. D This L 34 ] This corrofive and volatile property, appears alfo to be much more evident in the green than in the dry date of this vegetable, and is leaft fen- fible when it is boiled. Hence perfons who ufed decoctions of this plant were not only frequently difappointed, although the decoctions were ftrong; but had to fwallow immenfe dofes, before any cathartic effect could be produced. Phyficians therefore, in my opinion, ought to be extremely cautious of exhibiting fubftances prepared in this way. Indeed were they in general to make lefs ufe of decoctions, than they hitherto have done, I believe they would be much more fuccefsful in their management of difeafes*. Whether the Phytolacca decandra is a fedative or a ftimulant, is a queftion of too much impor- tance to be neglected in this place. But I wifh to ftate a few propofitions refpecting ftimulants and fedatives in general, before I proceed to fay any thing on this fubject. * Decoctions are faid to be particularly ufeful in cafes of debility, where the ftomach is fcarcely able to retain aay thing offered: In fuch cafes I fhould prefer cold infufions, when given in fmall and repeated dofes, as the irritability of that organ is frequently fo great as to reject fubftances which are only in a fmall degree ftimulant. For want of this precaution, phyficians have in my opinion rejected fub- ftances from the Materia Medica as inert, which perhaps, aie really valuable. i. There C 35 ] 1. There is no fubftance in the Materia Me- dica, which may not be claffed under one or other of thefe two heads, viz. Stimulants and Seda- tives. 2. Each of thefe fubftances in producing its effects upon the living body, acts particularly upon fome fyftem or part of the body*. 3. That many ftimulant fubftances thus acting upon the different fy(terns of the body, produce fedative effects f. 4. That fedatives when applied in certain fitu- ations, prove ftimulant and tonic J. * As an example of fuch fubftances as act upon different fyftems it will be fufficient for me to mention, that ipecacu- anha acts primarily on the ftomach; jalap more particularly on the inteftines; mercury on the lymphatic and glandular fyftems; bark on the arterial; affafcetida on the nervous -? oil of amber on the nervous and mufcular; hemlock on the brain and nerves, and opium on them all. f For inltance, ipecacuanha, jalap, mercury, &c. Sti- mulants which produce fedative effects are only fuited for a mixed ftate of fever, for if given in a ftate of exceffive aclion they frequently fail, and aggravate the difeafe by adding more ftimulus; and vice verfa in an atonic ftate. X For inftance, cold, bleeding, &c. Cold in producing tonic effects under different circumftances when applied to JD 2 the r 3« ] Stimulants, I define to be fuch fubftances as increafe action, and the force of action, whether of the arterial, the nervous, the lymphatic, or any other fyftem of the animal body. Sedatives are fuch fubftances as leffen it. Before I proceed any further, I wi(h to make a few obfervations on emetics and narcotics. 1. Emetics, I believe may all be confidered as (timulants. In producing fedative effects they ftimulate the ftomach into action, and thereby to throw out its contents. Their fedative effects by this operation, are however, lefs confiderable and evident than their ftimulating. Hence, they are the living body, has been very improperly ftyled a tonic itfelf. That it produces tonic effects by its fedative quality may be eafily explained. Thus we know, that a tempera- ture of fixty two degrees of Fahrenheit's Thermometer is the natural ftandard of health. Now if a perfon be fur rounded by a temperature of ninety or ninety fix degrees, it will naturally ftimulate his fyftem to excefs, and thereby bring on indirect debility. But if the fame perfon be re- moved into a temperature of fifty or fixty degree?, which is confiderably lower than that he was in before, a great load of ftimulus will be removed, his mufcular fibres which were before expanded beyond natural bounds, will now contract, and he will perform his different motions with ten times the alacrity he did before. fo [ 37 I fo very ufeful in difeafes of a typhoid nature, or fuch as are compofed of acute and chronic (tates of fever*. Subftances which aft in this way, generally act on moft other fyftems at the fame time; for in- ftance, on the lungs, (kin, kidneys, liver, &c. 2. Narcotics j-, in my opinion, may fafely be laid to be ftimulants. They feldom produce even fedative effects, unlefs combined with an evacu- ating, or fome other fimilar, power. They are ftimulants becaufe they increafe action, either in the arterial, the nervous, or other fyftems. In the arterial, they (how their effects by increafing the fullnefs and force of the pulfe j in the ner- vous, by indirectly ftimulating them, and thereby bringing on firft ebriety, and then drowfinefs. The almoft only objection of any importance that has * Dr. Grant,makes ufe of the term femi-acute-ailment in this ftate of fever. f Narcotic and anodyne medicines have generally been thought to be different. For inftance, an anodyne is fup- pofed to be fuch a fubftance, which will eafe pain and pro- cure fleep; while a narcotic eafes the patient by ftupifying him. This d'ftinction in my opinion is tolerably juft, info far that a narcotic acls more effentially on the brain and nerves ; while an anodyne acts almoft equally on all the other fyftems, thereby throwing tnem'into indirect debility and fufpending pain for a certain time. D 3 ever t 38 ] ever been offered againft the doctrine that ano- dynes are ftimulants, is, that they diminifti the frequency of the pulfe. This feeble argument however, I think may eafily be confuted, by a fingle experiment; for inftance, if, after the exhi- bition of opium (that is, as foon as it begins to operate) we take off about ten or twelve ounces of blood ; we (hall generally find, that the pulfe will inftantly rife about ten or fifteen (trokes in a minute. Now this we will find, is never the cafe, when proper fedatives are adminiftered. A comparifon will, I think, ftrengthen this opinion ; for inftance, when we give wine to a patLnt in a typhus fever,, where the pulfe is fluttering and the {trokes fo frequent as fcarcely to be counted $ wc (hall find that the wine (allowed to be a ftimulus by almoft all phyficians) will always lower the pulfe confiderably. Thus far, I have given a few preliminary obfer- vations on ftimulants and fedatives in general; if our ideas upon this fubject are any ways juft ; our conclufions refpetting the Phytolacca, will in my opinion be fair and eafy, to wit, that it is in its own nature a direct ftimulant; proving in fome meafure indirectly fedative, by acting principally on fyftems deftined for fecretion. VI, [ 39 3 VI. Pharmaceutical Treatment, THE leaves (hould be gathered about July, (when the foot-ftalks begin to affume a reddifti colour), dried in the (hade and powdered for ufe. An extract may eafily be obtained from the leaves when gathered at this period, by gently evapo- rating their expreffed juice to a proper confif- - tence*. A tincture may be made by diffolving either the extract, or the leaves, in their green or dry ftate in common brandy; or in the fpirit diftilled from the berries. An ointment is alfo made by powdering the dried leaves, and mixing them well with hogs- lard, or fimple cerate; or by boiling fome hogs- lard and bees-wax with frefli leaves, and draining the mafs. The proper time for gathering the berries in this climate, will be in October, when * When the leaves are gathered for the purpofe of an extract, care (hould be taken to ufe them immediately; otherwife they will foon be fpoiled, as they are very fubject to fermentation. D 4 they C 4* ] they become foft and ripe, and are of a blackifh colour. They are generally ufed in tincture, made by infufing them in Brandy. An extract may eafily be made by evaporating their expreffed juice. The root is to be gathered about November or December, when the (talks of the plant are per- fectly dead. It may be prepared in the fame manner as the leaves are ; but to facilitate drying,. it (hould be perfectly divided into final! pieces. With refpect to the dofes of the different pre- parations of the Phytolacca that have been given internally, I may recapitulate firft, (upon the authority of Mr. Cutler), that when an ounce of the dried root is infufed in a pint of wine^ and given to the quantity of two fpoonfulb, it fre- quently operates very kindly as an emetic. Par- kinfon alfo fays, that if two fpoonfnlls of rhe expreffed juice be given, it will operate ftrongly*. In a note under the fame article, I took notice of the cafe of a gentleman (related to me by * Whether dogs can bear a greater quantity than men, I have not afcertained. However, fhould this be the cafe, the difference in my opinion, does not feem very great, efpe- cialjy if we compare the account of Mr. Parkinfbn, with the- experiments which I have made with the expreffed juice o£ the root on thefe animals, widi nearly a fimilar refult. the C 4» ] the honourable Mr. Macon) who was violently purged, by drinking nearly a quart of a ftrong decoction which he made from the root. 2. Of the leaves. Very Bate is known reflect- ing their dofes, fince the other parts are generally preferred for internal purpofes. Two fcruples of the powder of the leaves taken by Mr. Cooper,, vomited him only three time*, and from eight ounces of a ftrong decoction of them he fek very little inconvenience. 3. Of the berries. The extract and tincture are generally made ufe of. Mr. William Matlock,. who tried the effects of the tincture for a confider- able time, infufed about a pint meafure full of die berries in a pint of brandy. Of this he took a common wine glafs full every night and morning ; he fays it purged him considerably. Others for the purpofe of a diaphoretic, take a table fpoon- full of a tincture, fomewhat weaker than that made ufe of by Mr. Matlock. Dr. Griffitts in- formed me, that in cafes of rheumatic pains, he ufed to exhibit to adults from two to four grains of the extract of the berriei, with great advan- tage. VII. [ 4* J VII. Of the Ufe of the Phytolacca Decandra in Medicine, i PREVIOUS to any conjectures as to the ufe of this plant in difeafes, I beg leave to offer a few fentiments. i. I believe all the variety of univerfal difeafes which we meet with at different times, are origi- nally but on« and the fame difeafe, viz. a fever. 2. That this fever by affuming different types at different periods, may be divided into three diftinct dates, viz.; the tonic ; typhoid ; and ato- nic ; or in other words, into the acute, mixed, and chronic dates of fever. The Phytolacca therefore, reafoning a priori* appears to be principally adapted to the fecond or typhoid ftate; and may be exhibited with confi- derable advantage, in the tonic or inflammatory date, after fufEcient evacuations have been pre- mifed, fuch as blood-letting, purging, &c. But it promifes the greated fuccefs if applied in the typhoid ftate, when inclining towards the atonic. In C 43 3 In proceeding to fpeak of difeafes in which it feems to be indicated, I (hall begin with the cob. fideration of the INTERMITTENT FEVER. This fever appears to be the original form of the whole tribe of febrile difeafes we are at pre- fent acquainted with; as they all, more or lefs, and at different periods, affume this type. It is, when in the form of a fimple tertian, a perfect ty- phoid ; and from this circumftance I (hould expect the Poke to be of peculiar fervice. It will fur- ther appear particularly indicated, when we re- flect, that other medicines of nearly fimilar pro- perties, have at different times been applied with Angular fuccefs, fuch as arfenic, tartar emetic, ipe- cacuanha, and a number of others. To thefe re- medies, however, I (hould believe it to be fupe- rior, as it is endued with an anodyne power. Now when we give an anodyne, fuch as opium, immediately before a paroxyfm, it will fometimes prevent it entirely, and by repeating it, will in many inftances effectually cure the difeafe. Thefe two principal qualities of emetic and narcotic being combined in the Phytolacca, render it, I think, a medicine fuperior to any yet difcovered for curing this ftate of fever ; for we may give it at all times with perfect fafety. This we know is by r 44 ] by no mean* the cafe with cither opium «r tartar emetic; for opium, when given uncombined hi the commencement of this ftate, which is gtBCu rally attended with a degree of inflammatory dia- thefis, will do more harm than good. The fame will be the cafe with tartar emetic, if given at a time when there is a deficiency of action. To the Peruvian bark (which is fo uuiverfally applied in intermittent fevers) I alfo prefer thU medicine, and on this account; the bark, when given without any previous evacuations, often fails; and if we wifti to perform a cure, we muft continue it a great while, and exhibit it in large quantities; fo that our patients often become tired before we can obtain a complete cure. II. OF CANCERS. Many inftances of this difeafe have occurred^ in which the ufe of this plant has been attended with extraordinary fuccefs, when applied in a ftagc and period fuited to the application of a fub- ftance of this nature. As this fubftance, as well as innumerable others, has often proved unfuc- cefsful in the hands of empirics, and of many eminent phyficians, I am induced to make a few observations on cancers in general; and here, as ?n other parts of my fubject, I (hall take the liberty of Z 45 3 of thinking for myferf j and though the ideas which I offer may appear ftrange, they may, I think, excite reflections which may lead us to a more fuccefsful inveftigation of this hidden and obfeure part of pathology. Cancers have certainly too often been confi- dered as incurable ; and this idea alone is enough to render them fo. I believe this idea of cancers has arifen, not (o much from our want of proper remedies, as our ignorance of the real nature of the diforder. My belief will be rendered pro- bable by the hiftory of the improvements which have taken place in the cure of difeafes. It is not long fince even the dyfentery was confidered as a mortal difeafe. We cure this, as well as many other difeafes, with more eafe now than formerly, becaufe we are acquainted with their nature and caufes. The ancients defined every tumor which they could not diffolve to be a (chir- ms, and every ulcer cancerous which they could not cure ; and at prefent our writers confine this name to only one fingle genus. But the name is unfortunate, as it conveys an idea, as if fomething foreign had been introduced into one affected part of the body, where it is fuppofed to effect thofe fatal confequences that fometimes occur ; and there have been authors who referred its proximate caufe to poifonous infects. One of the principal caufes which has fo long retarded the cure of this difeafe [ 46 1 difeafe is, that it has frequently been confidered as a local complaint. The only argument of any importance that has ever been advanced in favour of this affertion is, that this diforder may be radi- cally cured by the mere removal of the part, with- out exhibiting, at the fame time, any medicines internally. I however imagine there arc but few cafes that are radically cured by this treatment. The late Dr. Monro, whofe authority I believe no one will doubt, has given us a mod dreadful and difcouraging account of near fixty cancers, almod all of which, after extirpation, returned again. Indeed he has been accufed of making ufe of mercury after the operation, and thereby of taking the mod efficacious deps to excite and reproduce the complaint, while his defign was to prevent it. But, in my opinion, this could not have been the cafe, had the cancer been a local difeafe ; for I believe wc could never produce a cancer merely by giving mercury, if there were not fomething of a cancerous diathefis at the fame time, Mr. John Hunter is of opinion, that cancer is a topical complaint, fimilar to a chancre on the glans penis, or to the inflammation and ulceration of the arm from inoculation. This idea I think cannot be admitted, unlefs we admit alfo, that cancers may be produced by mere external appli- cation, as in the cafe of chancre and fmall-pox ; whereas C 47 ] whereas, there are few or no inflances of their being produced in this manner. From thefe confiderations, befides others which might be adduced, I am inclined to believe, that cancer is a difeafe of the fydem in general, termi- nating in tumors of different kinds, fomewhat analogous to the date of general inflammation which produces local inflammatory affection. I I believe alfo, that this general diathefis, upon which the local cancerous affections depend, is of an inflammatory nature, becaufe it occurs particu- larly when we would expect plethora and inflam- mation, (as about the ceffation of the catamenia in women) ; and becaufe cancers are bed treated by means which are calculated to remove inflam- mation *. This idea of the origin of thefe tu- mors is rendered probable by confidering that they are often the obvious effects of inflammation in glandular parts f. The inflammation fome- * Dr. Rufh informed me, that Dr. Tate (an eminent phyfician for curing cancer) affured him, that he could not do any thing with the tedious ulcers or tumors, unlefs he had recourfe to remedies that would previoufly change the fyftem. f I confider fcrpphula as a difeafe fomewhat analogous to cancer; it may affume a different appearance, and may be lefs violent on account of a difference in the ftructure of its fubjects, who are more delicate than perfons fiibject to cancer. times r. 48 ] times ceases, and leaves them indolent; bnt when they are irritated, the difeafe refurnes its progrefi. Considering cancer as a general difeafe pro- ducing a local affection, the remedies to be ap- plied (hould be general and local. In all cafes where the arterial fydem is affected With too much tone, the general remedies fliould be, 1. Blood-letting. This remedy when ufed (hould be fmall and frequently repeated *. c. Purges. For this purpofe the neutral faks (hould be preferred, fuch as Sal Glauberi, fal fod. phofpherat. &c. f * Mr. Henry Fearon fays, « I am inclined to think, that " were we to treat cancerous complaints at an early period, " as proceeding from inflammation, we fhould be much " more fuccefsful in practice." His mode of cure confifts in bleeding, either topical or general, according to the feat of the complaint, which muft be perfevered in for a fufficient length of time ; to which mull be joined, a milk and vegeta- ble diet, an open belly, and faturnine applications, avoiding wine, fpirits, and fermented liquors. Memoirs of the Medical Society, London, 1789. f Crawford ufes his muriatic of barites with aftonifhing fuccefs in cafes of this kind. It purges, acts as a diaphoretic 1 and r 49 ] 3. Diaphoretics. As medicines of this clafs are in general principally fuited to this date, the Phytolacca defeives particularly to be mentioned. Although it has in no cafe (to my recollection) been given internally, yet from analogy I (hould fuppofe it would be of Angular fervice *. 4. Low diet. This Mr. Fearon recommends ftrongly, and it has not unfrequently had the de- fired effect in cafes where it was rigidly obferved f. and diuretic. In cafes of debility he always joins fome pre- paration of iron to it. * Diaphoretics appear to be the only medicines fuited to cure this diforder, particularly in this ftate, confidering oc- cafional bleeding and purging only as auxiliaries. For this purpofe I have no doubt, but that if we could point out fuch medicines, which would aft principally on the fkin and other glandular parts, in which this diforder terminates, we could remove it as certainly as we could a gangrene from a wound by bark and wine. Whether the Phytolacca has this pro- perty, I have not as yet fufticiently afcertained ; but in fuch cafes I would not neglect its ufe, unlefs I could difcover a remedy of fuperior efficacy. Arfenic, though recommended by fome, I fhould'Vvoid as much as poffible, and for this reafon; thefe complaints al- ways require a long time to be perfectly cured ; and arfenic is too great a ftimulus to be continued for any confiderable period, without (howing fome deleterious effects. f The following cafe feems in fome meafure to confirm the ufe of low diet in the cure of cancers, viz. A lad in this E v\tyt [ 5° ] 5. Red. The advantage of red in this and fimilar complaints is fo obvious, that I need not dwell upon the fubject. The local applications in this date are fimple and familiar. They ought to be of a cooling and mild nature. The faturnine applications feem to be chiefly indicated for this purpofe. The general remedies in the atonic date arc tonics. For this purpofe the preparations of (teel ought to be chiefly depended upon : among thefe the Ferrum ammoniacale of Juftamond is a very excellent preparation, as having been of great fer- vice, not only when exhibited by himfelf, but alfo by feveral others. city, of about fourteen years of age, had a cancerous fore in his upper lip, being at the fame time affected with a ftone in the bladder, for which he took very large dofes of opium. Dr. Tate, who attended him for the cancerous com- plaint, defifted fiom the ufe of his medicine a few weeks be- fore the operation of lythotomy was performed ; in confe- quence of which the fore increafed rapidly. However, after the operation, the patient being put upon a low diet, and the dofes of opium gradually leffened, the cancerous fore icon (hewed evident figns of amendment, and lvhich, with a vt- application of the aforefaid medicine, has almoft completed a cure. 4 The C 51 ] The local applications for this ftate fliould be ftimulants, particularly fuch as are in fome degree of a cauftic nature, yet mild in their operation. For this purpofe fome of the vegetable candies ought to be preferred, as the Phytolacca, and others. The Phytolacca I would always try fully, efpecially as it has been of effential fervice in other fimilar inftances. III. OF SCROPHULA. From the analogy between fcrophula and can- cer, I fuppofe the Phytolacca might be ufeful here, provided it be applied in its proper ftate and time. IV. OF RHEUMATISM AND GOUT. Rheumatifm is a difeafe, in many inftances of which, this plant may be employed with great propriety. It has lately drawn the attention of many inhabitants of the United States, by its ef- fects* in fimilar complaints; and they fpeak with aftonifliment of the fucefs which they obtain *. * The cafe of Mr. William Matlock, who was cured by the ufe of this valuable remedy, deferves to be men- tioned. He informed me, that he was afflicted with this diforder for about eight or nine years; during which time he had been attended by a number of phyficians, but in vain : they tried every thing they could think of (though E z never, [ 5* ] Gout has alfo, in a number of cafes, been fup- pofed to be equally relieved by it ; and I do not know what objection we can have to ufe this me- dicine in thefe affections; particularly when the mixed ftate is prefent, and the vital organs are not in any ways affected. V. OF DYSENTERY. Here afrer previous evacuations, fuch as purg- ing or bleeding, the Phytolacca would be one of the principal remedies to which I would truft a cure ; efpecially as this difeafe is fo often the re- fult of an intermittent fever ; or, in other words, a febris introverfa, as mentioned by Dr. Syden- ham. never, to his recollection, had they recourfe to phlebotomy.) Some remedies gave relief for a fhort time, but their ef- fects w^ere foon over. In this condition his cafe really became defperate: he was for a confiderable time unable to move, his jaw became locked, (which once continued above ten days), and his appetite failed. He at laft had recourfe to the tinfture of the berries, prepared as above defcribed. In about a week after the ufe of this remedy, h'u appetite began to return, and his pains to fubfide : when the medicine purged him too much, he difconti- nued its ufe for a few days. Ey perfifting in this remedy f( r about three months, he was perfectly reftored, and is now able to follow his bufinefs (being a watch maker by trade), with as much eafe as ever he was befoie. VI. C 53 ] VI. OF PHTHISIS PULMONALIS. In this difeafe, although the mixed ftate may frequently prevail, I would feldom, if ever, make ufe of this remedy. My reafon for this precau- tion is, id, That I believe very few fuch cafes have ever been cured by diaphoretics. 2dly, That this mode of treatment, provided cafes are favourable, generally requires a very long time for this purpofe. 3dly, That medicines of this nature are endued with a power of acting in a great degree on the lungs, thereby producing expectoration, which in many indances may aggravate the difeafe. VII. OF SYPHILIS. If it has been found that opium, when fimply exhibited, has ever cured the venereal difeafe, or even a fymptom of it, the poke ought certainly be ufed in preference to it; and this has, of late, fortunately been the cafe with feveral patients. In difcufling buboes, I have no doubt of its effi- cacy, provided we properly regulate the fyftem at the fame time; but I (hould more generally prefer it [ 54 ] it in venereal ulcers of a long duration, and de- (titute of inflammatory appearances. vnr. OF ERUPTIONS. There are a number of cafes of this nature which have been perfectly cured by different pre- parations of this plant, when applied both exter- nally and internally ; and, as Dr. Rufli very juftly remarks (in his Clinical Lectures) that they are fevers turned infide out, or febres" retroverfas (as much fo as dyfentery is in moft cafes a febris in- troverfa), and the whole tribe of a typhoid na-*" ture, I think we may eafily account for its modus operandi, IX. OF MANIA. In mania, epilepfy, and a number of other ner- vous diforders, I would as much omit the ufe of this remedy, as in all febrile difeafes, where the vital parts are principally affected. Medicines of this kind are calculated to redouble the violence of fuch diforders (efpecially when poffeffed of a large (hare of narcotic or anodyne power, fuch aft hem- lock, camphor, opium, &c. *) * Could we point out fuch remedies to cure nervous d;f- eafes as would produce the effect hy an impreffion upon fome other part of the body, without acting direftly upon the i ss 1 the nerves, we mould, in my opinion, be much more fuccefs- ful than we hitherto have been. For this purpofe I have no doubt, but that mercury, when ufed a confiderable time as a fialogogue, (efpecially after previous evacuations, where the cafes are febrile) would prove a very ferviceable remedy. This has lately been, in fome meafure, the cafe with epilepfy, where patients have aftually been cured. Dr. Hugh Smith of London, who ftarted the the ufe of mercury in this difeafe, was followed by Dr. Rufh of this city; both of thefe gentle- men point out cafes which feem to confirm its ufe. Other reme- dies, I have no doubt, will be of equal fervice, provided they have a tendency to bring on inflammation in the mufcles or the arterial fyftem, fuch as' friction with ftimulating fub- ftances, particularly after the ufe of the cold bath, or any other remedy of this property. The effefts of the intermittent fever, when it cures melan- choly and madnefs, may be explained upon thefe principles. P. S. Since I wrote the foregoing DifTertation, I have learned that the induflrious Mr. L'Heritier has figured and defcribed, in his Stirpes Nova, &c. a fifth fpecies of Phytolacca, under the name of Phytolacca dodecandra. 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