Lect.xxiv
Purgatives.
Writers on the Materia Medica have applied
different names to Purgatives, expressive
of the degree & nature of their action. We
thus meet with Purgatives. Drastic purgatives.
Cathartics - Hydrogogues - chologogues
Laxatives &c. -
Barbier makes two classes only Purgatives
& Laxatives. He considers that these 
2 classes include Medicines which are 
different not only in composition
but also in their mode of action & effects
He defines a Purgative to be a Med 
which excites a temporary & special
irritation on the mucous membrane of 
the Intestines, & of those organs which open
upon their internal surface - that they 
are not converted into chyme - & that their 
effect is to evacuate the bowels downwards,
thro' the Irritation they excite.
while Laxatives have a relaxing effect
upon the bowels, produce no irritation
& are often converted into Chyme.

 

He includes among the Purgatives. Jalap
Scammony. Colocynth. Elaterium. Black
Hellebore. Senna. Rhubarb. Aloes. Gamboge.
Sulphate of Soda - of Potash-of
Magnesia-Tarter of Potash-Tartrate
of Potash & Soda. Phosphate of Soda
& the purgative mineral waters.
He includes among the Laxatives - Manna
Cassia pulp. Prunes. Tamarinds. Supertartrate
of Potash. - Almond - olive &
Castor oils. Honey - Fat broths - & Milk
in large doses. -
He considers that the chemical composition
of the vegetable purgatives differs from
that of the veg. laxatives - the former
being composed of Resins - Gum Resins
& Bitter extracts - having a nauseous
odour & a bitter taste - while the Laxatives
are mucilaginous, oily - saccharine
or acid, for the most part in odorous
& of a faint sweetish or acid taste. -
Observation has sufficiently established
the difference of effect produced by the 
different Medicines in use for the 
evacuation of the Intestines, but 

 

we cannot always speak positively of their 
mode of action. - We employ different ones for
different purposes, distinguishing in our 
practice those which are mild from those 
which are more powerful in their action,
but I do not think that this difference
is so marked as to require a separate
arrangement of these remedies. Barbier
first treats of Purgatives - then of Emetics,
& afterwards of Laxatives, as if Purgatives
& Laxatives had not a common virtue.
This faced distinction of Purgatives &
Laxatives does not hold good in practice
for Rhubarb, is one of the mildest
aperients in use, & cannot justly be
ranked, so far as its effects go with Scammoney
or Elaterium. Castor oil differs
in its effects in different people, tho'
generally laxative, it occasions considerable
irritation & purging in some persons, which
several of Barbiers purgatives operate
as the mildest laxatives, giving rise to 
no sensible irritation. - as Colocynth &
Aloes. -
Nor can we insist upon the 
difference of chemical composition 

 

for the Croton oil is of all purgatives the most 
acrid, tho' according to Barbier's definition
it ought to be ranked among the Laxatives.
He places the Tartrate of Potash under
Purgatives - & the Supertartrate under Laxatives
tho' the difference of effect is attributable
to the comparative insolubility of the 
latter, while there is no difference in composition,
except the atom of acid in excess
in the Supertartrate. - 
The effects of Medicines do not depend upon 
their peculiar properties, for age, habits,
idiosyncrasies, modify their influence, &
what would be purgative in one case
would be laxative in [cross out] another. The 
only guide for our use is experience, & we 
should avoid generalizing too far. If the 
principles of Barbier were pushed to 
an extreme in practice we should perhaps
hesitate to avail ourselves of some of the 
mildest aperients from fear of the irritation
he ascribes to purgatives, & if we
were to exhibit large or repeated doses
of his Laxatives, especially to delicate 

 

females & Children we should induce an irritation
of a serious nature, which he does not
admit as a possible consequence of Laxatives.
Experience has shewn that some Aperients,
administered in a certain dose
merely unload the Intestines of their contents
without any appreciable irritation,
& such, at least as far as the mildness
of their operation goes, are practically
laxatives - others produce a free flow 
of bile or occasion an increased secretion
from the mucous membrane, giving
rise to watery stools.
It is difficult to lay down any precise
general rules for the application of these
medicines, for the particular circumstances
of each case must regulate
our practice. - When we consider the 
importance of the organs on which they 
operate - their extent - & the delicacy of 
their structure, especially in Children
& in females, all unnessary irritation, it 
will be evident, should be avoided,
unless our object in their administration
is to afford relief to a distant
part by making a powerful impression
on the mucous membranes 

 

of the Alimentary canal. As a general rule
we may say that the mildest are by far 
the best. In this Country the use of them
is more indiscriminate & general than on 
the Continent where much attention
has been paid of late Years to the condition
of the mucous membranes, & to 
the influence of this structure on 
various parts of the body. But with 
every acknowledgment of the advantages
that are likely to result from a 
particular regard to the state of these
membranes in various diseases, I think
the French in in apprehending evil
consequences from the use of Purgatives
in many affections to which we 
apply them successfully. -
In the chronic affections of the head
which often depend in their early stage
at least to a congestion of blood
in the Brain, they apprehend a reaction
on that organ from the irritation of 
purgatives, tho' a daily drain from the 
Bowels is the best aid we can resort
to after V.S. & a regulated diet.
In Fevers they abstain from purging 

 

from a fear of exciting the circulating
system, tho' of all remedies, especially in 
that stage of Fever where bleeding is inadmissible,
there is none we can trust
to so confidently, as a moderate use of
Aperients, continued till the excretions
are of a natural colour.
Before speaking of the therapeutical
application of Purgatives, it will
be proper to direct Your attention to 
the parts to which they are applied
& on which they act. viz to the mucous
membrane of the stomach of the small
& large intestines. You are all aware 
that the Intestinal canal is lined thro'
its whole extent by a soft villous
membrane, which we denominate
mucous, - that this membrane in 
some parts has many circular folds
Called valvulæ conniventes, which
increase its surface - that mucous
follicles are copiously scattered throughout
its whole extent, larger & more numerous 
in some parts than in 
others. - that the excretory ducts
of the Liver & Pancreas open upon the 

 

Duodenum - that a net work of Capillary
vessels is spread over every part of its 
surface - that it receives its nerves
from the ganglia of the Grt Sympathetic
& its blood of the Sup. & Inf. Mesenteric
& same branches of the Cœliac. -
Besides this extensive membrane there 
is a muscular coat of circular & longitudinal
fibres, which give origin to
the vermicular or peristaltic motion
by which the contents of the bowels
are propelled downwards - & own this a 
serous coat - the 3 layers or coats being 
united by a dense cellular tissue.
The secretions on the internal surface
or mucous membrane of the 
Intestines are, mucus for the mucous
follicles - the gastric juice for the vessels
of the stomach, which Dr Prout
considers analogous to the Muriatic
Acid, besides the Bile & Pancreatic
fluid poured for the Liver & Pancreas
into the Duodenum. - A serous
exhalation probably takes place
from the Capillary vessels in every
part of the mucous membrane,

 

& in disorder a disease blood is effused
sometimes suddenly to a great amount
without apparent rupture or erosion
of the vessels - or from ulcerated spots. -
Myriads of Lymphatic vessels open
on the internal surface of this membrane
those which convey the Chyle are denominated
Lacteals, tho' in their nature
they do not differ from the Lymphatic
vessels in other parts of the body.
The immediate effect of purgatives
upon the intestines is an excitement of the 
mucous follicles & of the Capillary
vessels, by which the amount of mucous
& serous exhalation is increased, & this 
excitement is propagated to the muscular
coat, by which its natural action is 
accelerated & increased in power. -
If the stimulus arising for the purgative
be in excess more or less irritation is the 
consequence - The secretions are more copious
& the muscular fibres are strongly Called
into action giving rise to frequent stools
& to colicky pains, proceeding for the 
powerful contractions. If it be still
greater the afflux of blood to the mucous 

 

membrane is so great as to occasion a discharge
of the red particles from the great vis a tergo
or lymph is effused - & an inflammation
more or less extensive & of greater or less intensity
is the consequence. -
The different purgatives appear to act 
more immediately upon certain parts
of the Intestinal canal & to produce different
results from this locality of action
Those which produce bilious motions
act on the mucous membrane of the Duodenum -
& the excitement is propagated
for the extremity of the common Duct of 
the Liver & pancreas to those organs, & an
increased secretion from them is the consequence.
Calomel & the Blue pill act in 
this way. Others simply unload the large
Intestines of their Contents, without watery
discharge, as Aloes & Colocynth - others occasion
a profuse discharge of watery
fluid by acting on the small intestines
without stimulating the muscular
coat of the large Intestines so as to remove 
the excrementitious matters less is there
as the Neutral salts - Gamboage & Scammony.
There is a very important 

 

subject of consideration with regard to the 
mucous membranes which you cannot 
too frequently bear in mind, & that is the 
connection which exists between them
& the skin. Separately & abstractedly considered
they appear sufficiently distinct
but when closely examined this apparent
difference is last & we find an identity
of structure & of function.
They both stand in the same relation
to external objects - they are the seat of 
external absorption & secretion - every thing,
which is to form an integrant part 
of the body, passing thro' them, into the 
veins, from without - & every thing, which 
having formed a part, is to be thrown
off passing from the arteries thro' them
from within. They pass & repass into 
each other, when exposed to certain
causes which impede their natural
functions - skin assuming the form 
& function - of mucous membrane - &
the last [cross out] the structure & function
of skin. In contractions of the Limbs 
where the calf of the Leg is forcibly
applied to the thigh - or in the deep folds
of skin in fat children - the skin
loses its cuticle & secretes mucus,

 

& in prolapsus of the vagina & anus the 
mucous membrane of these parts loses its 
soft moist character - becomes comparatively
dry & hard - assuming in fact the 
appearance & nature of skin.
In the best work on General Anatomy
the Anatomic Generals of Beclard,
which you should read repeated by, the 
mucous membranes & the skin are considered
together, under the denomination
of the Integumental membranes. They
are described as those membranes which 
externally & internally furnish a covering
to those parts naturally exposed to the 
contact of foreign substances. - Next to 
the cellular tissue they are the most extensive
organ of the body - the first distinctly
visible in the embryo - the organs
of the most important functions - thro'
which all external absorption & excretion
takes place - on which all foreign
bodies exert their primary influence
& therefore those to which all therapeutical
agents are applied. -
These integumental membranes, viz
the mucous membranes & the skin 

 

have many characters in common, tho' they 
differ in situation, texture & function - &
may be regarded as the external & internal
covering of the body.
Considered generally they may be said to be 
one & the same, having an uninterrupted
continuity from the external skin to the 
internal investing membrane of the 
smallest ramification of the excretory duct
of the deepest seated gland. Its situation
therefore with regard to the rest of the 
body is external, tho' only one portion
of it appears so, viz the skin - the other 
portion being conceated living the Alimentary 
Canal, from the mouth to 
the Anus. Beclard compares the figure
of them to a Muff, which has 2 surfaces
continous at the 2 apertures - & between
which surfaces there is an intermediate
space or substance forming the body
of the Muff - So between the 2 portions
of the general integumental membrane
- the skin & mucous membrane - is a 
corresponding space or substance which 
includes all the rest of the Body.

 

These 2 portions, viz the skin & the mucous
membrane of the Alimentary canal, are the 
principal parts of the general membrane
continuous with each other at the two
orifices of this Canal, & between which there 
is the most marked sympathy in health
& disease. But there are other parts dependent 
upon & connected with them, more 
or less extensive ramified thro' the substance
of the body - such as the mucous membrane
of the genital & urinary organs -
of the one passages - of the nasal cavities
& sinuses - the auditory ducts  - the surface
of the eye - & the excretory ducts of glands - as 
of the Liver - Pancreas - Kidney. salivary
glands &c. -
Besides these larger appendages
there are many simple ones as those depressions
or pouch - like bodies which we call
follicles, lacunae &c, - They exist in every part
on the surface of the skin & mucous membrane,
& are formed by a fold of these 
membranes dipping inwards constituting
small sacs which open on their surface.
The pores on the skin & the little granulations
or the mucous membranes are 
occasioned by these simple bodies. They 

 

are surrounded by a vascular net work, &
differ with respect to the nature of their 
secretions - those of the skin being called Sebaceous 
follicles, those of the mucous membrane
mucous follicles. from the character of the 
secreted fluid. - Those of the mucous membrane
near the skin partake of a mixed
character.
These dependences are all of mucous
membranes, except the external ear, which
is cutaneous, & most of these open upon the
mucous membranes, tho' we have a remarkable 
example of the contrary in the
Mammæ which upon externally on the 
skin.
In animals of a more simple organization,
the difference between the skin &
mucous membrane, which in man is
so apparent at first sight, is gradually
last, & in those of a much higher organization, 
who inhabit the water, the distinction
is much less visible.
In man these parts, as I have before 
remarked pass into each other when certain
causes operate to impede their own peculiar
functions, & tho' in some parts the 
distinction is wide, as between the 
mucous membrane of the small 

 

intestines & the skin of the back yet in others
they approximate closely to each other - as at 
the lips of the vulva - the prepuce - anus -
mammæ & nostrils. At the eye lids & lips
the difference is more apparent.
They both have a foliated structure, being 
composed for a great part at least of their 
extent of 2 layers - the dermis & Epidermis.
The dermis is the deepest seated - & thickest,
in the substance of which the sanguineous
& lymphatic vessels & the nerves are distributed,
which form papillae - & that villous
appearance so peculiar to the mucous
membranes. - on the surface of the dermis
is the corpu mucosum - the seat of colour
in the skin, less apparent in the mucous
membranes, composed of a soft & scarcely
organized cellular tissue, in which on the 
terminating & origins of the white Capillary
vessels, & from which are supposed to 
arise those hard & horny appendages, peculiar
to certain parts of this structure.
The Epidermis forms a covering to the 
other layers, & is composed of albumen, secreted
from the vessels of the corpus mucosum.
This layers is supposed to be last
insensibly in some parts of the mucous
membrane, tho' it exists evidently in 

 

others, having been satisfactorily demonstrated
as far as the Cardiac orifice of the stomach
& for some distance from the Anus. In those
parts where it is supposed not to exist its 
place & functions are supplied by mucus,
between which & the Epidermis there is a 
close analogy with regard to their chemical
character. -
Both these membranes are furnished
with prominent appendages, as the nails
by the skin - & the teeth by the mucous membranes. 
They are both almost entirely converted
into Gelatin by decoction - they have a 
similar degree of elasticity - are the essential
organs of sensibility - of all external sensations
of the feeling of want or appetite - a defense
against foreign bodies & by their 
appendages became an offensive or defensive
power, especially in the lower Animals.
The functions of these membranes vary
according to their structure & situation. The 
mucous membrane is more adapted for 
absorption than the skin - the skin for sensation
& protection against the ordinary
external agents while the amount of 
secretion or excretion by bath is very great. 

 

The great extent of these Membranes - the importance 
of their functions - the influence
they exert own the rest of the body in health
& especially in disease, makes them of the 
first importance in practice, & therefore I 
have dwelt thus long upon their natural
affinity. This relation between them was 
perceived by the earliest absences, who were 
well aware that the amount of the secretions
of the one was in an inverse ratio
to that of the other. But their identity
was not clearly pointed out till Bichot
wrote his elaborate treatise on the different
tissues of the Body.
By close observation of their condition
& the influence which the disorder of 
either or both has own the rest of the Body
we are enabled to bring a precision to 
our practice, which without this study
we could not acquire. We now know
that a healthy condition of the skin
implies a healthy condition of the mucous
membranes - that a faded hue of the 
former is an unnerving index of the disorder
or disease of the latter or parts internally
connected with it. Individuals of a 

 

pale complexion, whose skins is delicate are 
liable to disorders of the mucous membranes
& by restoring vigour to the cutaneous circulation 
we invigorate the body & restore
it to health.
Any irritation long existing upon them is 
propagated to all its parts. Thus cold 
long applied to the body of delicate Children
gives them a blanched faded aspect
while the mucous membranes are surcharged
with blood - & the irritation upon
them which results from this congestion
gives rise to Scrofula. 
In delicate females the same cause developes
tubercles & leads to consumption.
Drastic purgatives - & such irritating medicines
as the preparations of Antimony
& Mercury long continued give rise to an 
extensive irritation upon the mucous membranes
& diminishes the tone & action
of the skin. Debility results from their
operation - the skin is rendered more sensitive
to the effects of cold on exposure,
from the tone of the body being lessened,
& it thus reacts on these membranes,
& chronic affections to which the body
maybe more or less predisposed are 
developed. -

 

The influence of a low temperature upon 
affections of the pulmonary organs is well
known to all of you. - Colds which arise
from inflammation of some portion of 
the m.m. of the air passages, are occasioned generally
by the shock communicated by a low 
temperature. The skin is deprived of blood
the mucous membrane is surcharged with 
it - & if the longs or air passages are the part predisposed
Catarrh - Cynanche Bronchitis - Pneumonia - Pleuritis
ensue - or if the mucous membrane of 
the alimentary canal be the predisposed
part, diarrhea ensues, warmth applied
to the surface till the blood is equally
distributed will suffice for the cure 
of the simpler of these Disorders-by if
a vital part is attacked we have to 
resort to V.S. & other measures.
old persons in winter have an habitual
cough from the constant impression
of a low temperature. If this cough is 
not very troublesome, they do nothing for 
it & it is cured spontaneously in summer, 
from the absence of the depressing influence
of cold. It may be removed in winter
by keeping them in a regulated temperature.
Consumption may be kept in 

 

check at its commencement by the surface
being kept warm in bed, whence the influence
of warm climates formerly so much relied
upon in this disease.
Those troublesome affections arising from 
increased action or the mucous membrane
of the female genital organs are no doubt
often kept up & aggravated from an inattention
to the skin - & to irritation in the 
adjacent mucous membranes. -
Those individuals who have no predispositions
to disorders of the mucous membranes,
or only slight ones, but the tone 
of whose had is diminished by any cause
as sedentary habits - late hours, are never
comfortable in their feelings under the 
impression of a low & variable temperature,
& when you consider the amount
of blood that circulates in the skin in 
a healthy condition of that membrane,
& the amount of the cutaneous transpiration,
which must vary in proportion 
to the activity of the cuticular
circulation, you will be at no loss 
to explain the cause of their uneasy
sensations. - These individuals always 

 

enjoy a better state of health in Summer
than in winter, for the warmth of summer
equalizes the distribution of blood, & takes
off the oppression of those internal ingestions
which always exist under the depressing
influence of cold in delicate subjects,
& it also restores the functions of the skin.
From these observations you will
perceive how much may be done
in practice by attending to the condition
of the skin & mucous membrane, &
have little can be expected from medicines,
where no attention is paid to 
them -. You will also be better enables
to appreciate the uses & effects of purgatives
by constantly hearing in mind
the extent of these membranes - their
great influence on each other & the 
rest of the body - & the intricate connection
existing between them - & some 
of the most important parts of the 
body - as the Lungs - Liver - the Kidnies
[cross out] the Bladder & uterus. -
I have said that the immediate effects
of Purgatives is an excitement or irritation
before the mucous membrane
which is propagated to the muscular

 

coat. This irritation may pass into inflammation
if the dose be too large or if the 
purgative be of the drastic kind or if the mucous
membrane be previously in a state of 
irritation. In this irritated condition of the 
mucous membrane the mildest laxatives shd
be administered, especially in persons of a pale
complexion, for a flux or flow of Blood may 
be the consequence of a drastic, purgative.
In fevers such individuals are often sunk
to a deplorable state of debility by a copious
discharge of Blood elicited from the already
morbidly sensitive mucous membrane.
You cannot therefore pay too close attention
to the condition of this membrane
which is indicated by the state of the skin
& the tongue. If the papillae of the tongue
be raised & of a bright red, & the whole
organ be redden than natural it is an 
indication of irritation on the mucous
surfaces, except in Scarlet fever. Give a 
strong purgative to a child or a sensitive
& delicate female whose tongue presents
this appearance &c you will see by its effects
the mischief it will occasion. It excites
the Capillaries & promotes an excessive
discharge from them, frequently mixed
with flakes of coagulable lymph, sometimes
these are large & cylindrical & passed with 

 

tormina & tenesmus.
The same process of reasoning which induces
us to stimulate the Bowels by the more powerful
purgatives when the Intestines are 
from any cause insensible to the effects
of [cross out] an ordinary stimulus, as in affections
of the head which impede the general 
diffusion of the nervous energy of the Brain
should lead us either to forgo the administration
of purgatives altogether in the over 
sensitive condition of the Intestines - or to 
use the mildest & in such doses as will
not increase the existing irritation, or to 
substitute simple injections. 
An acute observe of the nature of Diseases
& the effects of Remedies remarks
that there is no efficacy in Physic but 
in the precise application of it, & therefore
that when in prescribe-a remedy are
must have a definite pathological
object in view & endeavour to fit the 
means to the end. - how we can only reach 
this precision of practice by closely observing
the nature of disease - familiarity
ourselves with its symptoms - & knowing 
the effects of remedies -
Many of the articles in use as purgatives
from the violence of their operation & the 

 

inflammation they excite on the mucous membranes
are really poisonous, & in our use
of these powerful remedies we should
always hear in mind the nature of their 
effects.
In general the excitement or irritation
producely purgatives is transitory. The 
different parts of the Intestinal canal
are stimulated to an increased action, which 
ceases on the removal of the stimulus.
A determination of blood takes place to 
the parts acted upon, & the secreting or 
exhaling organs are excited to a freer discharge -
or the natural vermicular
motion of the intestines is quickened
& their contents merely evacuated.
In the condition of general or local
plethora or of inflammation something
more than the mere discharge of the 
fæculent matter is required, on the 
principle of revulsion or caustic irritation,
& we employ such medicines or 
promote a discharge of the fluids naturally
poured into the Intestines. In 
Dropsy we chiefly aim at this evacuation
of fluid when we employ that class
of purgatives denominated Hydrogogues,
from their power of increasing secretion
& exhalation. - In deficient secretion

 

of Bile we use those which act on the Duodenum
& the dustus choledochus - & in torpor
of the Colon & rectum those which stimulate
them to increased muscular energy.
Purgatives may act by the irritation
they occasion on coming in contact with 
the different portions of the Intestines - or 
the active principles of which they are 
composed may be absorbed into the veins
& act on the Intestines thro' the medium
of the blood. We have proofs that both 
of these modes of action occur. - Castor oil
posses thro' the Intestinal Canal unchanged,
& appears in the stools - The seeds
of Mustard pass unacted upon - Resinous
purgatives are supposed to pass thro' the 
Intestines unabsorbed till they reach the 
Rectum. - Rhubarb is absorbed &
frequently Colours the urine. The Croton
oil rubbed on the Abdomen purges freely.
& if injected into the veins in large quantity
acts upon the mucous membrane
as if it had been taken into the
stomach & excites a high degree of 
Inflammation. - Senna taken by the 
Nurse purges the Infant to whom she
is giving suck. The Sulphate of Potash
has been detected in the blood of the 
vena Porta & right ventricle of Drugs. 

 

Same Medicines which possess a purgative
property, when absorb exert their influence
on other parts than the Intestines - They may 
act on the Brain - Kidnies - Liver - absorbents
or salivary glands. Colchicum generally
purges, but it is not ranked among the 
purgatives, because its influence in the 
Brain primarily - & on the heart & circulating
system secondarily induces us to 
class it rather as a sedative. It is an 
example of a medicine that might be 
classed under various heads, for it emetic
diaphoretic - purgative & sedative - & affords
a striking illustration of the insufficiency
of any classification of medicines founded
on their ultimate effects. Hyoscyamus
is another instance - it generally acts by 
stool & is narcotic - Ipecacuanha &
Tartar Emetic, are most valuable
emetics, act also by stool - & on the skin.
The Neutral salts purge & act on the
Kidnies - Calomel & Blue Pele & the 
Hyd.e creta by their specific action on 
the Liver purge, thro' the influence of 
the flow of Bile - but they act on the 
absorbents, whence their use in Dropsy
Combined with Squill - on the Salivary
glands - on the skin - on the bones - the 
Brain & circulating systems -

 

This variety of effect produced by different
purgatives should be remembered, as we may 
advantageously employ different ones in different
cases - or avoid some of them as existing
circumstances may require. -
Purgatives are employed in two different
conditions of the body, viz in disorder & disease.
In disorder when there is merely
some functional derangement of the body
attended with torpor of the Intestines or 
Liver, & when a stimulus is requisite
to promote the discharge of feces or of 
bile. - In disease their application 
varies according to the affection & to 
the indications for their use. Sometimes
nothing more is required than discharging
the contents of the colon & rectum - at 
others the system requires depletion, &
this is obtained by diminishing the 
amount of circulating fluid by operating 
on the exhalant & secreting vessels
of the mucous membrane. The force &
frequency of the beat of the heart is at 
first increased by the exciting effect 
of purgatives - then diminished by 
the discharge which follows & the tone 
of the muscular system is diminished.
In the one case they are special stimulants

 

stimulants to make up for a deficiency in the 
natural energy of the bowels. In the other 
they are depressants by the abstraction of 
the thinner parts of the blood. They act 
beneficially also by revulsion - occasioning
an increase of action on the mucous
membranes to the relief of remote 
parts where ingestion or inflammation
exists, & in this respect they are analogous
in their effects to rubefacients applied 
to the skin, which excite a local action
to the relief of an internal part in 
the state of inflammation or congestion.
With regard to the use of these as 
well as of all other remedies it is most 
essential for you to bear constantly in 
mind the nature of the different diseases
in which they are applied. They are 
not to be indiscriminately & continuously
employed because they have the power
of depleting the system, for by such an inconsiderate 
use of them the disease
would be aggravated & the strength of 
the patient exhausted. The symptoms
of the disease & the strength, age, sex, &
general condition of the Individual 
are constantly to be regarded, & if the 

 

former are mild, if they do not indicate
danger - if the disease is progressing to its 
end naturally & safely, no vital organ attacked,
why induce irritation by medicines of 
any Kind, & this increase the uncomfortableness
of the patient & exhaust [cross out] his 
parvers?
In acute diseases when the attack is 
met by prompt recourse to energetic
measures - & the time for active practice
is past we may find advisable agents
for the reduction of the force & frequency
of the pulse & the lessening of the febrile
action by the use of purgatives, but 
when this has been obtained & nothing
is apprehended from the symptoms, even
tho' these are indicative still of febrile
action of disease we should not harshly
use purgatives. These acute diseases
have a determinate course & cannot 
unless in the onset be cut short. If 
they are established they must proceed
to their termination, & when they 
are progressing favourably do not 
impede their course by irritating &
nauseous medicines. - Watch over the 
symptoms & avert unfavourable
ones - put all the negative resources 

 

of our act into play, such as exclusion
of noise, light, undue heat - excitement
from any cause - stimulating food &
drinks, & then, if requisite apply your
remedies when you have a precise
object for their use. When this object
is obtained, stap - & do not fondly expect
that a virtue exists in draughts
& potions, when Nature herself is equally
her arm advisable resources to 
effect silently & secretly, all that you 
or the friends of the patient way anxiously
Cerise. -
It is an old proverb that 
Life is short & Art is long. Our Art
has been in a thousand & a thousand
cases too long applied for the brevity 
of human existence. It has prematurely
exhausted the oil of life, & millions
have sunk the victims of the charitable
means used for the restoration
of health, who would have resisted
successfully the ravages of Disease 
if left fairly to struggle with it, supported
by the innate energies of nature.
But when irritated & exhausted
by hourly doses of nauseous drugs, 

 

no rest by night or day can we be surprised
[cross out] that the body sinks under the combined
effects of the slow poison of disease
& the active poisons of Art? If you are 
graded by the solicitations of Friends
who suppose a healing virtue resides
in drugs, & that without their frequent
exhibition the objects of their affectionate
solicitude is left to perish without 
the interposing aid of Art, apply your 
remedies to the mind, & let them be of 
such a negative character that while
they do good to the mind they do no 
mischief to the body. Your own
resources will supply harmless materials
of this Kind, which while they 
leave the disease to Nature will
induce a belief in the mind of the 
patient & his attendants that it is 
in what they consider the more powerful
bands of Art. You are to recollect
that your judgement & conduct
is frequently to decide on the 
date of the former -, that You alone
are competent to judge what will 
be most conducive to his welfare,
& that Your convictions are not to 

 

Yield to the opinions of those who can
have but vague ideas of the real nature
of diseases & their remedies. Be careful
in forming Your opinion, but when 
on mature deliberation You have 
formed it, & it is confirmed by later
observation & reflection, adhere to it 
thro' good & evil report, & let the worst
happen You will feel free of reproach. 

 

Honey x
Raisins x
Prunes x
Figs x
Tamarinds-
Oleum Olivæ
Linapis serruria x
manna
Cassia x
Ol. Ricnic
Rhubarb x
Sulphur x
Hyd. c. creta
Pil. Hydrargyri
Hyd. Submurias
Senna x
Colocynth x
Jalap. x
Scammony
Gambaoge
Elaterium x
Croton oil.
Ipecacuanha 
Ant. Tartarizatum.
Hyoscyanus.
Colchicum
Squill
ol. Terebinthinæ
Magnesia
" Subcarbonas
Potassa Subcarbonas
" Carbonas
Sodæ Subcarbonas
" - " exsiccata
" Carbonas
Saline draughts
Sodæ Phosphas
Purg. Mineral waters.
Magnesiæ Sulphas
Potassæ Acetas
" Sulphas 
" Supersulphas
" Supertartras
" Tartras
Soda Tartarizatas
Sodæ Sulphas.
Leontadon Taraxacum
Polygala Senega
Pharmius Catharticus
Serium Catharticum
Asarum Europeaeum
Marrubium vulgare
Helleborus niger
" fœtidus
(Delphericium Staphisagria
Euphorbia officinarium
Daphne Mezereon
veratrum album
Guaiacum officiniale.
+ To be described after 2nd Lecture on Purgatives.
- plants & their preparations. - 

 

Mel
Mel despumatum 
Unae Possae. (vitis vinifera) Raisins.
Prema. (Prunes domestica) Prunes.
Caricae Fructus. (Ficus Carica) Figs.
Tamarindi Pulpa (Tamarind). T. Indica
Cassiæ pulpa. Pulp of the Pods. (C. Fistula)ʒi - ℥j
Confectio Cassiæ. ʒi - ℥j. -
Manna. Fraxinus ornus. - ʒi - ℥ij. -
Oliva oleum. Olive oil. O. Europaea. ℥j -℥ij
Surapis Semina. Mustard seeds. (S. alba).
Ricini oleum. Castor oil. R. commonunis. ʒj. ℥j
Rhei radix. Rhubarb root. R. palmatum.
Pulvis Rhei - gr v - XXX
Infusion - " - ℥j - ℥ij
Tinctura " - ʒss - ʒiv
Tinct. comp" - ʒss - ʒTV
Extractum " - gr X - XXX.
Sulphur Sublimatum. ʒss - ʒij. -
Hyd. c. creta - gr. ij - ℈j
Pel. Hydrargyri - gr iij - ℈j -
Hyd. Submuriatis - gr i - ℈j -
Sennae Folia. Senna leaves. C. Senna. ℈j - ʒi
Pulvis Sennae comp. - gr. X - XX.
Infusum - " - comp. - ℥ss - ℥iv.
Confectio - " - ʒi - ʒiv.
Tinctura - " - ʒi - ʒiv.
Syrupus - " - ʒi - ʒiv.

 

Aloes spicatæ Extractum. Socotrine Aloes. -
Ext. Aloes purificatum - gr iij XV.
Pulvis Aloes - gr iij - XV
" - " - compositus - gr X - XX 
Pilulæ Aloes c Myrrha - gr X - XX
" - " - compositæ - gr X - XX
" - " c Assafœtida gr X - XX
Decoctum Aloes compositum ℥ss - ℥ij
Tinctura - " - ʒss - ℥ss 
" - " composita - ʒss - ʒij
vinum Aloes. - ʒj - ℥j -
Colocynthidis pulpa. - Colocynth pulpa. (C.C.
Extractum Colocynthidis - gr ij - X
" - " - comp. - gr V - XV.
Jalapæ Radix. Jalap roots C. Jalapa.
Pulvis Jalapæ. gr. V - XXX
Extractum - " - gr X - XX
Tinctura - " - ʒi - ʒiv.
Scammoneæ gummi resins. (C Scammonea
Pulvis Scammonæ - gr ij - X
" - " compositae - gr v - XX
Confectio " - ℈j - ʒss -
Cambogia - Gamboge - S. Cambogioides.
Pulvis Cambogiæ - gr ij - vj
Pilulæ - " compositae - gr V - XX.

 

Elaterii Pepones. Elaterium. M. Elaterium
Extractum Elaterii. grs 1/8 - gr j
Teglii oleum - Croton oil. C. Tiglium
gtts. 1/2 - gtts j. -
Magnesiæ Subcarbonas - ℈j - ℥j
Magnesia - gr X - XXX
Potassae Subcarbonas - gr X - XXX
" Carbonas - gr X - XXX
Sodæ Subcarbonas - gr X - XXX
" - " exsiccata - gr V - XV
" Carbonas. - gr X - XXX 
Sodæ Phosphas - ℥ss - ℥ij
Magnesiæ Sulphas - gr X - ℥j
Potassæ Acetas - ʒij - ʒijv
" Sulphas - ʒj - ℥ss
" Supersulphas - gr X - ʒij
" Supertartras - ℥ss - ℥j
" Tartras - ʒj - ℥j
Soda Tartarizata - ʒi - ℥j.
Sodæ Sulphas. - ʒi - ℥ss.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25. Lecture
Purgatives 
are given either to promote simply an evacuation
of the fæcal contents of the large
intestines - or to occasion a drain from
the mucous follicles & serous exhalants
of the mucous membrane of the 
intestines generally. -
When they are given for the first intention,
viz to evacuate the fecal contents
of the bowels, they operate either by stimulating
the muscular fibres of the 
large intestines, & thus call forth
their peristaltic action, without exciting
increase of secretion or exhalation;
or this local excitement is attended 
with some increase of secretion & exhalation,
which lubricates the mucous
membranes, & diminishes the resistance
of Scybalous matter by softening it.
or they act by promoting a discharge
of bile, which proves of itself
a stimulus to the bowels. -
Those purgatives which generally act 

 

by unloading the bowels without occasioning 
any increase of Secretion or 
exhalation, are Ol. Ricini. Rhubarb
Aloes - the simple extract of Colocynth
& Jalap in small doses. -
Some of these given in excess will occasion
irritation & a discharge of serum
& mucus, with Scybala, especially
Colocynth & Aloes, but if the dose 
is proportionate to the habit of the 
patient & to the susceptibility of 
the mucous membrane to the impressions 
of purgatives, they will generally act
without producing what is called
watery Stools. -
Senna, given in Infusion generally does 
produce scybalous & watery stools,
& it is more apt to occasion griping
pains, but these are transitory &
may generally be relieved by some
Aromatic water, or warmth applied
over the Abdomen. -
Castor oil generally passes off unchanged
& it probably operates 

 

by the stimulus or irritation it occasion
in its transit thro' the bowels. Sometimes
it undergoes a peculiar change
in the body & passes off in the form 
of round fatty nodules - This is perhaps
[cross out] occasioned by its being acted upon
by an acid, for it is converted into 
a Substance like butter when boiled
[cross out] in Nitric Acid.
Aloes. Rhubarb & Colocynth appear
to act only on the lower part of the 
large intestines & to empty them of their 
contents. They are peculiarly adapted
to habitual constipation. Colocynth
generally produces yellow motions
& probably therefore acts upon the 
liver. In small doses, about 4 grs with
2 of Rhubarb it is one of the best
medicines for habitual Costiveness
that I know of, for it does not produce
irritation, or lose its effect upon
the bowels. -
Senna is more speedy in its operation
& should be given always in Infusion
In elderly people & in delicate 

 

habits these purgatives should be warmed
with ginger - or some aromatic. When 
given in the form of pills, a drop or two 
of the essential oils may be added to 
each pill - as the oil of Cloves &c, but 
in these cases the pills should be 
recently prepared. -
The best time for the exhibition of 
Aloes, Colocynth is at bed time. Rhubarb
is often given at dinner time
combined with Magnesia & Ginger - or 
with Ginger alone. - Senna is best 
given early in the morning - or day time 
as it will disturb sleep, if given in 
the evening. - Castor oil also in the day. -
Calomel. Hyd. c crete & Pil. Hydrargyri
act by the special excitement
of the Liver, & their usefulness is especially
indicated in those cases in which 
the secretion of bile from the Liver
is deficient or depraved. In small doses
they are admirable remedies in torpor
of the Liver of Children, & in the same 
condition of that viscus in Adults.
There is no organ in the body more 

 

liable to disorder function than the
Liver, & the colour of the skin, eye, &
of the stools indicate its disorder- The mind
also is an indication of its condition, for 
in all ages there has appeared to be a connection
between the fretfulness & morbid
depression of spirits, which individuals
are occasionally subject to, & derangements
of the Liver. These derangements
are obscure, but we may readily
congestive two kinds - are impeded
from a venous blood & a deficient
or suspended secretion of [cross out] bile.
In both conditions a stimulus to the 
liver will be productive of relief
& purgatives by exciting the Intestines, &
increasing their peristaltic action will
give a quicker motion to the blood
which circulates in their parieties,
& thus tend to remove, by a greater
vis - a tergo, any disposition to congestion
in the Liver, thro' which all the 
blood for the Intestines passes in its way
to the right side of the heart, which 
those medicines which act especially
on the liver, as the preparations 

 

of [cross out] or Mercury, will produce
a flow of bile, & emulge the excretory
ducts of the Liver & its gale bladder. -
When in any case You perceive a sallow
or saffron colour of the conjunction
or skin, & a clay or earthy colour in the 
evacuations, You may safely administer
mercurial medicines, but you must 
remember that they are given for a 
specific object, & when that object
is attained omit them & if any further
evacuation is requisite, choose such
remedies as are suited to the occasion
Mercury in all its forms is injurious
when long or in cautiously administered,
but timely applied & duly
regulated it is an admirable resource
As an expedient to overcame certain
obstacles to health it is preferable
to all other remedies, but its action
is too extensive & its influence over 
the secretions is too general to be empirically
administered. In chronic
cases it is excessively & perniciously
employed in this Country, being 

 

administered in too large & too frequent
& too long continued doses. These complaints
do not admit of a speedy cure
& most of them require cautious management
as to medicines. They have
insidiously undermined the health
& the functions of certain organs implicated
in them have become habitually
disordered. It is out of the power
of art to restore them suddenly to a 
healthy condition, & the object of 
practice is to study the symptoms,
to discover the nature of the disorder
& to work the existence of any action
differing from the natural action,
to apply means of relief with precision,
to remove all obstacles that 
lie on the way to a return to healthy
function, & to place the body & the 
mind under circumstance most favourable 
for the gradual development
of the curative process of 
nature. In fact in most chronic
complaints nature is the only Physician
to be relied upon, but 

 

art may do much to assist in operations,
& the judgement of the sound
pathologist is requisite, if not to cure
by the exhibition of drugs, at least to 
council the Individual as to the 
necessity of observing habits of diet
exercise, temperature, what to avoid
& what to seek. -
when purgatives are given with a mileu
to occasion a drain from the serous exhalants 
& mucous follicles of the 
lining membrane of the bowels, they 
are exhibited in two different disorders
or diseases, viz in febrile & inflammatory affections -
& in dropsies. -
In febrile & inflammatory affections
they are useful by depleting the system
as well as removing the irritating contents
of the intestines. Their action upon the 
open mouths of the capillary vessels
is to produce a more copious discharge
of the serum of the blood, & thus to diminish 
the amount of circulating fluid
& the action of the heart & arteries.

 

Their operation differs from blood letting
by their abstracting only the serous part
of the blood, while in venæsection we
take away a greater or less amount
of the blood itself. Blood letting is the 
most immediate & powerful of all 
depressants, & we resort to it in those 
cases where an impression is to be 
made upon the hearts action to the 
relief of any vital organ attacked
with a dangerous inflammation,
but we cannot resort to it continually.
Purgatives afford a milder
expedient for continuing the depletion
& by their use we control the later
stages of fever. -
These medicines act also as derivitives
like Blisters, & occasion a flow of 
blood to the intestines, to the relief
of remote parts, either in a state of 
congestion or inflammation. If a high 
degree of inflammation exists, other 
means must be resorted to - as V.S.
before purgatives are given, not only
because the latter are inefficient
to controul a dangerous inflammation,
but because their action

 

is impeded by the existing Diathesis. If 
bloodletting is practised the action of 
purgatives will be often immediate,
& indeed the relaxation following VS
will often of itself produce an evacuation
by stool. It is probable that
the purgative does not act from the 
vessels being indisposed to absorption,
for the existence of plethora is incompatible 
with free absorption. When 
the circulation fluid is diminished
absorption takes place readily, &
perhaps the relaxation arising from 
the sudden loss of blood takes way
the resistance which before existed
in the sphincter muscle of the 
anus, as occurs in parturition.
In specific fevers as Typhus purgatives 
purify the blood, at the same
time that they diminish its bulk,
& they prevent the absorption of morbid 
secretions, by removing all offensive
matter for the bowels. They 
thus prevent the irritation that would 
arise from the retention of excrementitious

 

matter. The feelings of comfort which 
ensure from an evacuation of the bowels,
& the uncomfortable sensations which
arise from constipation in ordinary
health, are evidences of the influence
which the absence or presence of 
fecal matter has over the system. -
In dropsies there is an accumulation
of serum in some of the cavities, arising
from inflammation & a consequent 
increase of exhalation - or from 
some impediment to the return
of venous blood, whence the thinner
parts are forced thro' the open mouths
of the exhalants, by the continued
vis a tergo of the arteries. In these
diseases we exhibit diuretics - &
hydrogogue cathartics - or those medicines
which increase the flow of 
urine- & occasion watery stools. -
Gamboage, - Supertartrate of Potash &
Jalap - Elaterium. Scammony
& the neutral salts various by combined are the purgatives
in common use in Dropsies. 

 

These medicines probate absorption of 
the fluid effused into cavities by 
depriving the blood of part of its serum
whence the vessels absorb the effused
serum to supply the waste occasioned
by the drain of the purgatives. There
is a constant effort to preserve the 
proportion of serum in the blood. If
the blood is in excess, as in plethora,
or if water be injected into the vessels
no absorption takes place, but if 
the blood be diminished, or its serum
be drained away, then absorption is 
rapid. - There is daily amount
of secretion & exhalation from the 
body, & in health a balance is 
preserved between them. In Summer
the cutaneous transpiration is copious
& the amount of urine lessened. The 
reverse takes place in winter. Now 
in Dropsy both cutaneous transpiration
& urine are diminished in consequence
of the error loci. with 
regard to the serum effused into 
the cavities. If in this condition
we deprive the blood of part of 

 

its serum, the effect is probably a 
diminution of effusion in the first place
& in the second absorption takes place
to supply the waste that has occurred
in the vessels. - In this way the effused
serum is taken up into the blood
vessels, & it is elicited from strumly
the action of irritating purgatives, 
& this action being continued the dropsy
for the time is cured. But this disease
so often depends on organic
disease that the relief is only temporary,
& the patient ultimately sinks
under it. -
In Dropsy for inflammation, especially
that form of it which occurs after
Scarlet fever. V.S. is the appropriate
remedy. It generally subsides after
free bloodletting, & gentle purging. It 
is a very dangerous & insidious form
of Dropsy & requires prompt bleeding.
The symptoms are peculiar, for the 
face & hands first swell, & the dropsical
effusion increases downwards. The 
respiration is embarrassed & effusion

 

takes place in the cellular tissue of the 
Lungs, rapidly destroying life. This disease
is in every case the effect of improper
exposure to cold - or to errors of diet in 
convalescence. -
All inflammation upon serous membranes
is attended with effusion - &
the reason is that the natural exhalation
which lubricates their surface is 
preternaturally increased - & the balance
between the exhalants & absorbents
is last. The former pour out more 
than the latter can take up. As the 
inflammation subsides the absorbents
gain upon the exhalants & the 
fluid is ultimately removed. - In chronic
inflammations, the same thing
occurs, but the relief is not so 
immediate, from the difficulty of 
controuling these obscure inflammations. -
From these observations You will
perceive that purgatives are given
in different disorders & diseases
to produce, either a simple discharge

 

of the fœcal contents of the bowels in 
cases of ordinary constipation - or to 
produce a drain from the intestines
for the purpose of moderating excitement -
or to remove dropsical effusions. -
Their application is so general
that there is scarcely a disorder
or disease during which they are not
in same stage or other administered.
This universality of application renders
it difficult to lay down precise
rules for their exhibition. -
As the primary action of purgatives
is an excitement of the mucous membrane
of the stomach & intestines
it is obvious that in cases of inflammation
of these membranes
their employment is hazardous, if
[cross out] the condition of the membranes
does not depend upon the presence
of some irritating substance. V.S.
Leeches over the abdomen - the blandest
food & mild enemata - with 
ol. Ricini are the appropriate remedies

 

It is in this inflammatory state of the 
mucous membranes, & in acute rheumatism
that purgatives are contain dilated
In the latter affection, where motion is 
painful & when exposure to cold is 
to be avoided their use should be 
preceded by V.S. by Colchicum by
Diaphoretics. -
In affections of the Liver they often produce
the happiest results. - If the bile is deficient
or vitiated - or obstructed, as 
in Jaundice the preparations of Mercury
alone or combined with Colocynth
are to be preferred - & the use of these 
remedies should be persevered in 
till the stools have a healthy colour.
In way of the affections of children
purgatives are of great use, but the 
mildest should be preferred, for the 
sensibility of the body is naturally
great at this period of life, & if drastic
medicines are given the strength is 
broken up, & a high degree of irritation
is the consequence. - In children especially
the sympathies which exist 
between the Liver & intestinal canal 

 

& the Brain are peculiarly active, & any irritation
long existing from any cause in 
the abdomen is insidious propagated 
to the head & endangers life. In this 
way Hydr. cephalus supervenes to a 
disordered digestion & torpor of the liver
& the irritated condition of the mucous 
membranes; - & Chorea is dependant 
upon a similar condition, Mesenteric
disease results from the same disorder
& all glands in the vicinity of an irritated
mucous membrane became 
diseased, - if the irritation is long continued. -
Gentle purging with occasional 
doses of Hyd. c creta. continued
till the stools are natural - simple
diet, the tepid bath, friction over the 
abdomen & fresh air & exercise should
be resorted to. If the irritating purgatives
are used - as [cross out] nauseants, the 
strength will be broken up, & it any
lurking predisposition to disease existing
at will be developed. You must 
always fear this result from general
debility however induced.
In inflammation of the Peritonæum 

 

after V.S. purgatives are admissible
but while the fever is high their operation
will be obstructed. The usual means for 
reducing the inflammation must be 
resorted to previously. -
In worms there are certain medicines
which are supposed to act by destroying 
these animals, & after their exhibition 
purgatives are administered to 
remove the dead animals for the intestines.
In these cases there is a morbid
accumulation of mucus in the bowels
& drastic cathartic are often requisite
to make an impression upon the 
mucous membrane. Gambaoge &
Calomel are the basis of most specifics
for worms. Oil of Turpentine
in large doses not only kills the lumbrici,
but acts as an aperient -
In diseases of the heart the mildest
laxatives alone are admissible, for 
all irritation & excitement is to be avoided.
One object is to alleviate distressing
symptoms. -
The affections of the pulmonary
organs purgatives by exciting a discharge

 

Remote from the seat of the disease will
operate generally with benefit, but they 
are only secondary resources in acute 
cases, & caution is sometimes requisite
that they do not check a salutary
evacuation from the parts affected.
In Pleurisy & Peripneumony they are 
only admissible after free depletion,
& in these affections you must take 
care that irritation from any source
does not kindle up the inflammation
which has been subdued by V.S.
You cannot too often or too strong by 
impress upon your mind the necessity
of avoiding excitement where diseased
action is going [cross out] in any part of the 
body. Nothing counteracts the beneficial 
effects of appropriate remedies,
applied to lessen excitement
or inflammation, as irritation from 
any source, as from improper food,
the use of drastic purgatives, mental
emotion. Purgatives in all cases
should be administered with a 
special regard to the effects they produce

 

In Chronic Coughs - in Bronchitis - in 
the peripneumonia notha occasional
laxatives are allowable, if the bowels
are torpid, but drastic purgatives are 
injurious. When the expectoration is 
free & copious, in peripneumony, in 
the specific Bronchitis of Small
pox a drain from the intestines may
worse the suppression of the natural
excretion for the mucous membrane
of the Bronchia. A regulated temperature
& an occasional laxative is all 
that is requisite, for the expectoration
is the natural termination of the 
disease. -
In the different forms of Asthma
which are [illegible] Known to depend
generally upon chronic affections
of the heart & lungs, giving rise to 
Dyspnœa a gentle action on the 
bowels is often salutary, but in these
& similar cases where cure is impassible,
You should do nothing
to waste the strength unnecessarily.
In Phthisis where the disease

 

is confirmed & the colliguative Diarrhœa 
is present, a mild laxative
as ol Ricini, disguised so as not to 
have the appearance of a purge, is 
often beneficial. It cleans the bowels
from the offensive discharge arising
from the ulcerated surface of the 
mucous membranes, & frequently
allays the irritation it occasions
when retained, but all harsh
purgatives are carefully to be awarded.
In head aches, & purgative is the 
only remedy required in many cases,
for these troublesome affections
often depend upon an overloaded
state of the Colour, & when this 
is emptied by a free evacuation the 
pain & heaviness of the head ceases.
But every head aches, arise from 
mental anxiety for the loss of sleep
from too much study, & we cannot
remove the effect without removing
the cause. Hemicrania generally 
arises from distress or anxiety, & 
if Bark be ordered without any 

* In the stage of Torpor however when effusion
is supposed to have taken place, the more 
powerful purgatives are beneficial, for 
the diminished sensibility - in conjunction
with Calomel & Blisters - & warm applications
or Sinapisms to the feet. The sinapism
should not remain on larger than 3/4 of an 
hour or an hour, left infln & stamping should
ensue. -

regard to the previous condition of the patient
the symptoms will be aggravated, &
vertigo will ensure. -
In chronic inflammation of the Brain
& its membranes purgatives are decidedly
useful, but in children where there 
is a tendancy to effusion a long continued
irritation on the bowels is injurious
from a reaction on the Brain
Cold steadily applied to the shaved head
& a proper diet, with laxatives is 
the best plan of treatment.
* In Apoplexy, especially in the threatened
attack of that formidable disease
they are essential often V.S. & a 
low diet, with absence of all stimulating
liquids. In paralysis the 
strongest purgatives are sometimes
required from the diminished Sensibility
of the System.
In the internal, of Epilepsy they are 
the best remedies. This disease often
depend upon a congestion of the Brain
arising from intemperance in meat
& drinks, either in regard to quantity 

 

or quality, & a strict regulation of diet 
& an open state of the Bowels will
often alleviate or avert the attacks.
I have remarked that many Epileptick 
persons continue free of fits
while under the treatment of fever
& it can only arise from the starvation
& mild diet observed in convalescence.
When there is reason
to suppose the fits are occasioned
by an organic affection of the head
we can only employ purgatives as 
palliatives. - 
In the different forms of mania
they have been used from the earliest
ages, but they can only be serviceable
in cases where no change
of structure exists in the Brain. -
In Idiotcy they can be of no use 
with regard to the cure of the 
disease, unless it has supervened
to some acute attack, & may be referred 
to a pressure on the Brain.
When this pressure is suspected 

 

in any forms of mania purgatives are 
decidedly indicated. -
It sometimes happens in elderly people
who are threatened with Apoplexy
that Mania differing in degree supervenes
insidiously, & in such cases
a course of purgatives continued
for several weeks restores the Individual 
to a sound state of mind
& averts the attack of Apoplexy.
In these cases there is often a diminished
Sensibility, & strong purgatives
are required. -
In cases of violent mania, with 
occasional increase of excitement
they are highly beneficial in restraining 
the violence of the Individual,
& it cannot be doubted
that a long perseverance in their 
use has proved successful in 
curing the disease, when diet has 
been attended to, & a gentle plan
of treatment adapted. 
End of Lecture 25. (too short.)

 

Honey. - Mel. source. Bees. separated of comb by dripping
& expression. Amber colour. saccharine
aromatic odour. sweet acidulous taste. Contains
sugar. wax. & an acid. & essential oil.
Best Honey of wet Hymattus & wet Ida & Cuba. white 
British. inferiour.. Laxative. In gargles.
Mel despermatum. Clarified Honey. melt by 
a water Bath & take off the scum.
In Pharmacy it is used combined with Borax
Red rose petals. Acetic Acid & vinegar of Squill.
forming mel Boracis
mel Rosæ - } in gargles
oxymel simplex}
" Scilla - expectorant -
Uvæ passæ. Raisins. vitis venifera
B'lk Raisins grape. Prepared by drying the grape, either
by cutting the stalk half through - or entirely off 
dipping them in potash by & drying either air.
In Pharmacy - laxative.
Pruna. Prunes. Prunus domestica. Asia. Greece. naturalized.
dried plum. Best from France. - laxative. Contain
sugar. mucilage & malic Acid. - Boiled for children
In Confectio Sennæ.
Caricæ fructus. Figs. Ficus Carica. Asia. naturalized.
dried in ovens. Laxative. contain mucilage & sugar. -
roasted or Boiled applied hot as a cataplasm to Gum
boils. recommended by the Prophet Isaiah. in the Book
of things. - 

 

Tamarindi Pulpa. Tamarinds. T. India. Egypt. & Indies. -
Pulp of the pods preserved in syrup. The Pulp consists
of a large proportion of Citric Acid. - Tartaric & 
malic Acids. Tartar. jelly & gum.
Laxative. refrigerant. Tamarind tea. q. S. in hot 
water - or a whey ℥i - oj milk & straining. in fevers.
Cassiæ pulpa. Cassia pulp. C. Fistula. Egypt. Indies.
Pulp consists of sugar - gelatin - gluten & resin.
laxative Confectio Cassiæ - Confectio Sennæ. -
not used. -
Sinapis semina. seeds of S. alba. native -
Radix Rhei. Rhubarb root. R. palmatum.
R. undulatum & R. compactum. China & Tartary
lutmun 35° & 40° North Lat.
1. Turkey & Russian. best. the same in all respects. perfd
2. East Indian & Chinese. del. derm perforated more
compact. with yellow pin & white streaks.-
The Russian & Turkey with bright red streaks - & more 
friable -
3. English. growth of this Country. R. undulatum & palmatum
peculiar aromatic odour. & bitter - nauseous taste.
It contains Gum. 31 Resin. 10. Extractive. Gallic Acid. 26 Tannin
Phosphate 2 - Molatr 6 (& oxalate of Lime) & woody fibre. 16.
mild Purgative with some astringency.. gr v: xxx
with Calomel in Fevers. To an Adult fr. xv - xxx.
Ginger & magnesia. or with Treacle an Electuary.
Colours urine. -
Powder best form. -

x
Ung. Sulphuris. Sublimed Sulphur ℥iij. Lard 1/2 tt. mix.
Ung. Sulphuris compositum. Sulphur 1/2 tt. white Hellebore root)
Nitrate of Potash ʒj. soft soap 1 tt. Lard 1 1/2 tt. - mix.
Both used in Itch - but the latter is unsafe.

Infusum Rhei. ʒi. macd.. 2 hours in oss hot water. tonic ℥i
Tinctura Rhei. Rhubarb. Card. & Saffron in Pr. sp. ʒss - iv
Tinctura Rhei Composita. Rh. Liq. root. Ginger & saffron
in proof spirit & water. ʒss - iv. both Tonic -
Extract. Rhei. in pr. sp. & water. not good. for the 
vol. fragrance is dissipated, as a vehicle for other
Cathartics. gr x - xxx. -
Sulphur. - native near volcanoes. Solfatara Naples
mixed with earth. sublimed. melted. cast in moulds
In this Country by roasting Pyrites - as the Copper
Pyrites of moles - the sulphur sublimes &
is collected in chambers. - & moulded -
Sulphur sublimatum is roll sulphur sublimed
by the heat of a sand Bath in an 
earthern cucurbit. - 
S. totum. is prepared by pouring boiling
water on precipitated Sulphur - that 
it may wash any Sulp. Acid. from it. -
S. præcipitatum. is Prepared by boiling Sublimd
sulphur & Lime in water - & dropping in 
muriatic acid, to precipitate the Sulphur.
It is whiter than sublimed Sulphur.
Sulphur is laxative & diaphoretic, & a specific
in Itch. Dose ʒss - ʒij in the form of Electuary
with Supertartrate of Potash. Piles. Rheumatism
asthma. - 


 

Sennæ Folia. Senna leaves. Cassia Senna. Egypt.
adulterated at Boulac with other species of cassia
& with cynanchum oleafolium or Arguel. -
The last is an adulteration. It may be known by 
its greater length. 1 1/8 Inch. having no prominent
lateral nerves at the under surface. being regular
at the base, & with an accumuiated point.
The true Senna leaf is about 7/8 of an Inch in 
length. irregular at the base - with prominent
nerves at the under margin - & more obtuse
at the apex. -
Senna exported for Alexandria.
Senna has a faint sickly odour - & a nauseous
sweetish - bitter taste. Water at 212° dissolves
1.3rd weight of leaves. & acquires a dark brown
colour. It deposits a yellowish matter on 
exposure to the air, which is extractive
combined with oxygen - This change takes
place within 48 hours. -
Senna contains extractive. resin & a volatile
matter. Cathartine obt.d by the French -
a saline substance purgative in small doses
uncrystallizable - reddish yellow - nauseous
bitter taste. sal. in Al. & water, not in Ether.
Senna most common of Cathartics & one 
of the most prompt - operating in 3-4 hours
& generally producing scybalous watery
stools. It is apt to gripe ash be combined
with an aromatic - as Ginger -
It is best given in Infusion. ℥j of leaves saturate
oj hot water.
Infusium - Confectio Sennæ best formulæ. 

 

Infusum Sennæ compositum ℥iss. Senna. ʒi ginger
macd. 1 hour. in oj. Boiling water in cond vessel
Given generally with ʒi Tartrate of Potash or 
Sulp. Magnesia. - Cold Infusion said not to 
gripe. Dose ℥ ij - iv. - good with Gentian root &
no salt. -
Confectio Sennæ. = Senna. Figr. Tamarinds. Cassia pulp. -
Prunes. Coriander Seed. Liquorice. sugar. ʒi ℥ gr
Commonly made of Green husks of walnut
Jalap. Sulp. & Tart. Acids
Pulvis Sennæ compositus. Senna. Supertartrate of 
Potash. Scammony. Ginger. gr X-XX.
Tinctura Sennæ. Senna. Carui Scm. Cardamom
Raisins ma E in pr. sp. ʒi - iv.
Syrupus Sennæ - with fennel seeds & manna. ʒi - iv.
Colocynthidis pulpa. Cucumis. Colocynthis. Turkey.
& Nubia.
Fruit a yellow gourd size of a small orange
peeled & dried in a stone. The white spongy cellular
matter is the officinal part. the seeds are 
nutritious & used as food in Northern Africa
according to Capt. Lyon. -
The pulp has a bitter nauseous flavour - &
a mucilaginous quality. The hot infusion is 
a bright yellow & gelatini ʒi as it cools - It 
consists of mucus resin-a bitter principle-
a Gallic Acid. The Tincture yield on evaporation
a yellow substance, only partially soluble
in water - the insoluble part is a white 

 

filamentous mass - turning yellow - this has been 
regarded by Vanquelin as the active principle
of the medicine & he calls it Colocyntine.
The pulp is too drastic for use - & is not employed, 
but in the form of Extract.
Extractum Colocynthidis. 1 tt. 1 gallon water. boiled
to 4 pints. strained & evaporated, gr II - X.
with Rhubarb ℈ij Col. ext. to ℈j. Rh. made
into 24 pills - i - iv. best of all purgatives for 
habitual use. -
Ext. Col. compositum. Colocynth. Aloes. Scamy.
Cardamon. Hard soap. in pr. sp. - gr v. xv
Jalāpæ Radix. C. Jalāpa. S. America.
named for Xolappa. a city of Mexico.
Root is large, with a wrinkled dark cuticle.
It comes in transverse slices - or in small
ovate roots - the best from vera cruz. -
Jalap has a faint sickly odour & a sweetish
unpleasant flavour - with some pungency.
It contains resin - extractive & starch & salts
to 10 p~ct & was obtained formerly in a separate
state.
Jalap is an active purgative. occasioning
after griping & nausea. It is cheaper than 
Rhubarb. & used more among the poor
but it is not so good or mild. It is better
adapted for worm cases combined with 
Calomel - or in dropsy with Supertartrate
of Potash. Dose of the Powder the best 
form of exhibition is v - xxx gr. - 

 

Extractum Jalapæ. Jalap. 1 tt. Rect. sp. o. iv. water 1 gallo
mac. the root in the Sp. 4 days. & pour off the Tincture.
Boil the drugs in the water to oij. strain both the 
Tincture & decoction separately. distill the Tincture
& evaporate the decoction till they grow thick
mix them & evaporate to proper consistence.
gr. X. XX. Apt to gripe - may be given with 
mucilage - or Mist. Amy gd. -
Tinctura Jalāpæ. ℥viij. mac. 14 days in oij pr. sp.
ʒj. iv. added to purgative Infus. Decoct. -
Scammony & Gamboage I spoke of among the 
Gum Resins. -
Elaterii pepones. - Fruit of Momordica Elaterium
South of Europe. cultivated here. Squirting
Cucumber - the gourd opens elastically. disengaging
itself when ripe for the peduncle
& squirting the seeds & juice thro' the hole
left in the base where the peduncle
was inserted.
Extractum Elaterii - only officinal. - the Ph. directs
the fruit to be sliced - the juice gently
expressed - strained - & left to deposit the thicker
part - the thinner part is poured off - &
the former is dried with a gentle heat.
It is in the form of small thin greyish
cakes - & is given in 1/8th - 1/2 gr doses as a hydrogogue
Cathartic.
Elaterium should be obtained without 

 

pressure - the juice round the seeds should be 
collected & permitted to deposit the thicker
part - This is more active - & given for 1/12 - 1/8 gr
Dr Clutterbuck got but 6 grs for the juice of 40
Cucumbers. - Elatin. Dr Paris.
It is given in ascites - Apoplexy. C. laryngea -
but should be cautiously administered.
as it excites inflammation.
Helleborus niger. root, Austria Italy.
Tinctura Hellebori.
drastic purgative. Amenorrhœa. dropsy. mania
H. orientalis. net olympus. Island Anticyra
ελλεβοροsμελαs of the Ancients.
Helleborus fœtidus. native. Leaves.
Leaves acrid. worms. - 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[cross out] 
Lect. 26.th. -
Anthelmintics.
use those medicines which expel worms
from the Intestinal canal.
Different Substances have been employed
for this purpose, same to 
act mechanically on them - as Iron &
Tin filings - & the spicula of the Dolichus
pruriceus - others to act as a 
prison upon the worms as bitters - &
oil of Turpentine - & others to effect
their expulsion by inducing purging
as Calomel - Gamboage - scammony,
& Jalap. -
There are 5 species of worms that are 
found in the Human Intestines. -
Ascaris lumbricaides. large round worm
Bremser. Plate 2. Fig. 3. & 4.
Tania solium. Tape worm.
Bremser. plate 6. & 7.
3. oxyuris vermicularis - Ascarides.
Bremser. plate 1. Fig. 3. - pate 2. Fig. 1. & 2.
Bothrio cephalus latus. broad tape worm.
Bremser. Plate. 4. & 5. -
Tricho cephalus dispar. Long thread worm. 
Bremser. plate 1. fig. 1. & 2. 

 

Besides these Intestinal worms. there are 
3 others classed among worms which are 
found in man. -
1. Filaria Dracunculus. or Guinea worm
Bremser. Plate 3. Fig. 1. (8 vo. vol. p. 198)
which infests the subcutaneous cellular
tissue of individuals native or resident
of the Torrid Zone. - It is principally found
in Arabia Petræa - on the borders of the 
Persian Gulf of the Caspian Sea,
of the Ganges - in upper Egypt - Abyssinia
& Africa - 
2. Cysticercus cellulasæ - (Hydatid)
Bremser. Plate 8. Fig. 1. - (8 vo. vol. page. 280)
which is found in the cellular tissue
of the muscles & of the brain, principally
in the Hog & monkey - but more rarely
in man.
3. Echinococcus hominis. (common Hydatid)
Bremser. Plate 8. Fig. 2. - (8 vo vol. page 293.)
(the Acephalocyste of Laennec)
It is found in all the organs of man
except the Intestinal Canal. 

 

The fine first worms are found in the 
Intestinal canal, & are those to which
that class of remedies termed Anthelmintics
apply.
The most common of these worms in this 
Country are 
the Ascaris lumbricardes - long round worm
Tænia Solium - a Tape worm.
oxyguris vermicularis. Ascarides. -
The 2 former are found in the small intestines
& are those worms which are the 
principal object of practice, So far as 
interval remedies are concerned -
The last is found in the rectum, giving rise
to peculiar symptoms, & is often expelled
by injections without the aid of interval
remedies -
The Bothrio cephalus latus - or broad tape
worm is not common in England - if 
at all found here - but is common
in the small intestines of the inhabitant
of Poland. Russia - Switzerland &
some parts of France. -
The Tricho cephalus dispar - or long thread worm
in the cæcum. It has only been known
about half a century.

 

The distinction between the 3 common
worms is evident to the eye. -
The Ascaris lumbricoides or long round
worm resembles the common earth
worm in appearance. 
The Tania solium - a tape worm, is so 
called from its general resemblance to a piece
of Tape, being flat but jointed -
The oxyuris vermicularis or Ascarides
is minute, like a peice of thread about 
1/4 of an inch long. -
Descriptions 
Ascaris lumbricoides. corpore utringue sulcato
canda. obstusiuscula
Tænia solium. copite sub hemispherics discrete
rostello obstuso - callo antrosum increscente,
articulis anticis benipenics -
insequentibus subquadratis, religuis
oblongis. omnibus obtusiusculis.
foraminibus marguialibus vage altervis. -
oxyuris vermicularis. Capitis obtusi membrana
laterali utringue vesiculari, candamaris
spirali obstusa, fæminæ subulata
recta. -
Bothrio cephalus latus. Capite foveisque marguialibus
oblongis. collv subseullo, articulis
anterioribus rugae formilbus, insequentiubis
plurimis brevibus subquadratis, latioribus
ultimis longiusculis.

 

Trichocephalus dispar. parte capillari langissima 
capite acuto indistinato, corpore
maris spiraliter involuto, fæminæ suberecto. -
The Ascaris lumbricoides or long round
worm was supposed to be the same 
as the Lumbricus terrestris or earth
worm, but they are totally distinct
animals. It is found in the small intestines,
but is discharged when it gets into 
the stomach or large intestines. Bremser
figures a small one which was discharged
in the act of sneezing by a woman
He supposes it got into the nasal fossæ
during vomiting, with which the Individual 
had been previously trouble
(Dr Thompson met preparation of the Liver
of a young person sent for west Indies.)
He supposed they crept up the Hepatic
ducts tho' one had perforated the edge
of the Liver. 

 

The Tænia Solium or tape worm which is 
common in England is flat & articulated
with marginal openings, The Bothriocephalus
latus - the Tænia or tape worm
of Poland. Russia & Switzerland differs
for the English Tape worm by having a 
depression in the head, & in living plaited
or waned like some of the fuci, & in 
having no lateral openings. - 
The tape worm inhabits the small intestines 
of the English & those nations of 
Europe not infested with the Bothriocephalus
It is perhaps more common in adults
& the long round worm in Children.
It is sometimes of an immense length
one at Pania 23 ft long! the Ascaris or 
round worm is for 3 - 4 - to 15 Inches only.
Sometimes the joints of the tape worm 
are discharged simply resembling gourd
seeds, forming what Heberden Called 
Lumbricus Cucurbitinus - or Gourd Worm.
You will easily recognise them as 
parts of the tape worm, by observing the
lateral pore. It was supposed formerly
that the entire worm waned from 
for these disjointed articulations, but 
it is not true. 

* Bremser remarks that he is ignorant of any diagnosis
symptoms of the presence of this worm, tho' it is found
in most dead bodies. He met with one Solitary
instance of its being voided, in the case of a girl
6 years of age. who passed some long round worms &
Ascarides & 1 Trichocephalus. after having take
vermifuge medicines - He says no other Physician
has recorded a case of this worm being
voided. It is not therefore the object of practice.

The oxyuric vermicularis or Ascarides are 
found in the rectum & generally in great
number, & give rise to intolerable
irritation about the anus, especially
when the Individual is heated. This 
worm has been known of time immemorial.
The Trichocephalus dispar - or long thread
worm is found in the large intestines
& generally in the caecum. Rudolphi
says few men are without this worm,
& Bremser that it is found in almost
every dead body, may often only one, tho'
Rudolphi has found more than a 
thousand together.
If these observations are collect it certainly
must excite but little irritation,
for it was only discovered about 60
Years ago, or at least it was only generally
known about that time. Morgagni 
seems to have been aware of 
it, tho' his discovery fell into oblivion.
A student disputing, at Gottingen
in 1760, the value of the colour of 
a girl 5 years of age, accidentally 

 

Cut into the cæcum & several of these worms
came out. They were supposed be large
Ascarides, till Rœderer shewed they were 
a distinct species for any before known.
At the time an epidemic was raging
in a crops of the French army stationed
at Gottingen, which Rœderer & Wagler
described under the name of the morbus
muscosus - they found these worms often
in the body of those who died of the 
disease, & Rœderer supposed that 
the worms were a production of the 
disease. Wrisberg however thought
that the animals would have been
found sooner had they been sought
often, or the cæcum examined, of which
there Can be no doubt, for the frequent
occurrence of the animal in bodies
examined since. -  
The symptoms which waivers give rise
to, or which attend them differ, according
to the kind, or to the state of health
of the Individual. -
The Ascarides excite are intolerable
itching in the Anus. & are the most 
troublesome both for the symptoms 

 

they give rise to, especially towards the eveg.
& for their being the most difficult to remove,
Their size is so diminutive that they be
in the folds of the mucous membrane
& tho' large quantities of them are
discharged a few remain, & they multiply
with astonishing rapidity. -
Their situation is commonly in the rectum
but they have been found in the 
Cæcum (Bremser). - They sometimes
are found in the vagina & give rise
to irritation - & to nymphomania,
a circumstance You should bear
in mind when consulted on any 
case of extraordinary irritation in that 
part. - From their situation in the
rectum, enveloped with fecal matter
it is best to administer a purgative
& then to use injections, generally bitter
ones - Sulphur has been recommended
as a laxative - & soot of wood internally
relieves the irritation they excite
An injection of cold water acidulate
with vinegar is useful for the 
vagina.

 

They symptoms attending the presence 
of the long round worm & the tape
worm are a pale leaden hue of the
face, attended with flushings, a dulness
of the eye, enlarged pupil - a blue zone 
round the inferior palpebra - the 
nose is swollen & affected with an
intolerable itching to such a degree
that Children frequently pick pieces
from it, - often hemorrhage for the nostrils -
headache, ringing of the ears,
coated tongue, excess of saliva. fetid 
breath - variable appetite, sometimes
deficient - at others craving, - often
nausea - & vomiting of a limpio
fluid - colic pains about the umbilicus -
glairy - & often bloody stools.
hardness & smelling of the abdomen, with 
general emaciation of the rest of the 
body - troubled sleep with grinding
of the Teeth - & fretfulness. - 
These symptoms as well as those of 
the Ascarides are sometimes entirely
absent, & the presence of worms
is only indicated by their being 
passed at stool. All of them are 

 

not always present.
The Anthelmintics are 
Iron} act mechanically.
Tin}
Dolichos prurieus.}
Olum Terebinthinae} act as poisons
Artemesia Sontonica} to the worms.
Tarra " cetrum vulgaic}
Spigetior marilorudica}
vallriana officinalis}
Chenossodium Anthelminticum}
Polypodum Filix mos}
Camphor. -
Calomel} act as purgatives. - 
Scammony}
Gamboage}
Jalap.}
Senna}
Wood soot/ (Fuligo Ligni)
Eupyreumatri oil of Bremser.
Geoffaeoinumis. 

x Rush gave the Subcarbonate of Iron in ʒiij - iv.

Iron & Tin filings were formerly used as 
Anthelmintics - in dose of ʒi - ʒij - given
with syrup, followed by cathartics -
They were supposed to operate by mechanical
irritation. - They might do to 
especially Tin by causing the development
of Hydrogen gas, & in this view
Sulphur might be joined to them
& thus favour the formation of Sulphurate
Hydrogen gas. - They are neglected
* at the present day.
Dolichos pruriens 
native of the East & West Indies. The 
pods are covered with sharp bristles
or spiculæ, which excite an intolerable
itching when applied to the skin.
Enveloped in treacle or honey they are 
easily swallowed. & they were used on 
the supposition that they would act
on the worms as they did on the skin.
It is singular that the circumstance
of them being easily swallowed did not 
excite a doubt of their action on 
the worms, for if they did not irritate 

 

The mucous membrane of the fauces - Asophagus 
stomach - why should they the worms 
enveloped in mucus? The fact is 
that macerated in water the lose the 
power of irritating the skin. Dr Bigelow
enclosed a potion in muslin & gave them
to animals, & found that after removing
half an hour in the stomach they were
perfectly inert - now worms are generally
below the stomach, & if the medicine
loses its virtue in that viscus, it cannot
regain it in the Intestines. - Dose gr V-X 
Oleum Terebinthinæ
Dr Fenwick of Durham recommended
the oil of Turpentine in worm cases.
Given in large doses. It may be given
for ℥ss - ℥ij fasting in the morning. If it 
does not purge - castor oil - or Inf. of 
Senna should be given after it.
This oil should be given with some aromatic
water -.

* Artemisia Absinthium (herb. native
intensely bitten. Consists of bitter extract &
essential oil. Powder of herb ℈j - ʒj 
Extract made by boiling the tops (1 part in
8 parts of water by weight to one half)
dose gr x-xxx. It is a simple bitter.

Artemisia Santonica. Persin
The seeds, are small. Yellowish & mixed with 
the flower stalks - of a bitter taste & strong
smell. They are one of the best of the bitter
Anthelmintics given in powder for 10 - grs ʒss
for several days in honey or Treacle - &
followed by a cathartic.
*
Spigelia maylandica. N America
The root is officinal, but the whole plant
is bitter, if the powder of the root 10 grs may 
be given to a child to 4 years old - & ʒi to 
an adult - An Infusion is made by 
infusing ʒij of the root - or dried plant 
for 4 hours in oss of Boiling water. ℥ss
may be given to a child 2 years old
& oss to an adult, slightly narcotic in 
large doses.
Tanacetum vulgare. Tansy, Native,
The leaves & flowers, are warm & bitter.
The powder ℈j - ʒi, or Infusion, known
as Tansy tea.
valeriana officinalis. root. Native
Powder ℈j - ʒj.
Chenopodium Anthelminticum. N Am.
Powder of seeds 10 gr -ʒss.- 

* Powder of Fern root Dr Armstrong tells
me is given at Bishop Wearmouth with 
Complete Success in ℥i - ℥iss Doses - & is as 
effectual as Ol. Terebinthinæ. He thinks
it is given in too small doses generally. -  

Aspidium Filix mas. radix Filicis of 
the Phara. Polypods root.
The root when chewed has a mucilaguious
sweet, & afterward an astringent &
bitter taste. It has been in use as an Anthelmintic
since the time of Dioscorides,
It was revived by Mad. Neuffer, who
obtained a premiere for her secret remedy.
She gave ʒiij to an Adult & 2 hours
after a status - contg 12 grs of Calomel
* & resin of Scammony & 5 gr. of Gamboage
Camphor. has been extolled by Brera
as a valuable Anthalmintic - 2 - 3 grs
rubbed to powder with a drop or two of 
Alcohol - & suspended in mucilage
or syrup may be given to children -
& 15 - xx to an Adult. -
Calomel. Scammony. Gamboage - Jalap
& Senna - are the purgatives, in use 
after the bitter Anthelmintics. In 
general the dose is large - so as to 
obtain full purging. Calomel
is the basis of quack remedies. -
Jalap & Inf. of senna are generally efficient.

 

The soot of wood 10 grs - ℈j made into 
an Electuary with honey - or in pills
allays the irritation of Ascarides -
Bremser recommends the following preparations 
in Tænia & the wound worm
Rg. Seminum Art. Sontonica
Pulv Tanaceti - ana ℥ss
Pulv Valenianæ - ʒij
Pulv Jalapæ - ʒij
Potassa Sulphatis ʒij
Oxymel Scillæ - q ~
ut ft Electuarium. sumat cach.
iij vinienia guotidic.
or it may be made into pills. -
Eupyreumatic oil (Bremser)
Rj. ol. empyreum. Corneum ℥j
ol. Terebinthina ℥iij
the . et past dies guatnor distilla e balneo
arenæ ℥iij. - (Dose ʒi - ʒij? -)
End of Lecture 28th. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lecture 27.
Emetics
An Emetic is a medicine which excites
vomiting,or which expels by the mouth
matters contained in the stomach.
This operation of certain Substances classed
as emetics is being peculiar, & differs
from the effect of all other evacuant remedies
by producing an unnatural discharge
attended with peculiar violence
of action. Diaphoretics - Diuretics
& Purgatives increase the natural
secretion or excretions from the skin
Kidnies & bowels, but Emetics
invert as it were the natural action
of the stomach, & by exciting a 
spasmodic contraction of the stomach
diaphragm & abdominal muscles
forcibly expels thro' the esophagus
the substances that have been swallowed. -
Emetics differ also from 
other evacuant remedies in the 
peculiar sensations they excite, &
the remarkable impression they 

 

ake upon the body generally. This impression 
is indicated by the general languor
relaxation which precedes the action
vomiting. A peculiar Sensation, which 
[illegible] denominate nausea attends this 
sudden prostration of strength. It consists
a general & most distressing uneasiness
at the epigastrium - the face is 
[?ale] & often bathed with a cold sweat, the lower lip trembles
[illegible] [cross out] saliva pours from 
the mouth in profusion, the pulse
small, & irregular, & a general chilliness
creeps over the body. Suddenly
convulsive contraction of the abdominal
muscles & diaphragm take place
followed by other repeated involuntary
contractions of greater intensity, - & a 
copious discharge of the contents
of the stomach thro, the mouth,
This is attended with great straining
the face [cross out] becomes turgid with blood, the 
eyes suffused with involuntary
tears - the mucus of the nose & bronchi
is copious by discharged - the head 
is distressed with a sense of tightness
& rending pain. The symptoms  

 

gradually abate, tho' they generally are 
renewed two or three times before 
they completely subside, the last efforts
at vomiting generally bringing away
nothing but a copious secretion of 
bile or mucus. - A degree of nausea
something remains for a languor
shorter period, attended with a general
languor - a profuse perspiration
& a disposition to sleep. -
It was formerly supposed that the stomach
was principally active in the 
Phenomena of vomiting, but later
Physiologists have considered that 
it is occasioned principally if not 
entirely by the contraction of the diaphragm 
& abdominal muscles.
Magendic especially contends that the 
stomach is passive. He substituted
for the stomach in a dog the bladder
of a pig filled with a Coloured fluid
& succeeded in discharging the fluid 
upwards. He never saw the stomach 
contract in the act of vomiting, &
he supposes that the Diaphragm or 

 

or the abdominal muscles alone are capable
of producing vomiting. - Haller however
observed the contraction of the pylorus
in some cases - & it is probable that 
it is active in many, since the contents
of the duodenum are often discharged
with those of the stomach. This however
is a subject more of curiosity than of 
any practical utility
The efficacy of emetics in disorder & disease
not only depend upon the evacuation
of the stomach, but upon
the sudden relaxation [cross out] they produce
& the general excitement which accompanies
the act of vomiting. -
They are the only remedies indicated in 
over distention of the stomach - &
where acrid or indigestible substances
have been swallowed. They are useful
in cases of indigestion from any cause 
& [cross out] of intoxication, if early administered,
& in poisoning pump!, - In jaundice
& torpor of the liver they are useful
from the free evacuation of bile which 
accompanies their action. 


x cold stage of intermittents.

In all febrile diseases, especially in the 
commencement they are highly serviceable,
& will frequently cut the fever
short. - Their utility probably depends
death upon the relaxation they occasion
& the general excitement which follows
their actions. In all these febrile affections
there is a dryness of the skin & generally
an unequal distribution of 
the blood, & a loss of balance in the 
functions of secretion. The shock of 
an emetic, first reduces the hearts
action, & relaxes the whole tissue of 
the body, - & secondarily it promotes
a copious discharge from the mucous
membranes of the stomach - duodenum
lungs - & from the liver & the skin,
besides removing any source of irritation
in the stomach. -
In common simple fever an emetic
given early, & followed up by a purgative
will produce an almost immediate 
cure. -
They are singularly serviceable in 
croup, & in all inflammatory

* In Cynonche Laryngia. as well as in croup now 
should be frequently excited. if any symptom
of stricture in the larynx exist, after the first 
ration of an emetic. In hooping cough if the
expectoration is difficult- but if it is 
you must not disturb the stomach by repeated
nauseants & emetics. -

affections of the throat. viz in Cynanche * In many cases
of impeded expectoration they are the 
best expectorants from the relaxation
then produce - but in feeble subjects,
especially in old people, they should
not be given too often - or to nauseate
much, for if the strength is suddenly
reduced in such people, especially
by emetics given as nauseants, the power
to cough up is last & suffocation was 
ensue, without the exhibition of 
some diffusible stimulant. - 
Emetics generally promote absorption
& probably by their relaxing effect
diminishing the hearts action & the 
activity of the circulation - & thus 
checking effusion. The absorbents consequently 
gain upon the exhalants.
In hernia humoralis - & even in enlargements
of the Testicles vomiting has 
produced a cure. In the latter case
a sea voyage, if sickness is induced
has been of great service.
In erysipelas, with bilious symptoms,
in dysentery - in many cases of diarrhœa 

 

in acute rheumatism opstralmia hypochandriasis. in 
asthma. - in difficulty of expectoration in 
Phthisis emetics are occasionally serviceable.
They are contraindicated in general or local
plethora, especially in predisposition
of blood to the head - in hæmorrhagies -
in Apoplexy inflam. of brain In these cases V.S. must 
first be ordered. In delicate females
& in all chronic diseases they should
be used cautiously, They are dangerous
in pregnancy, especially in the advanced
stages - & in cases where miscarriage
has occurred. - 
In general dropsy they are not much used
but in local dropsies they are occasionally
exhibited. In Anasarca &
Ascites they are recommended by some 
practitioners - but by no one in hydrothorax. -
They are of use in promoting the absorption
of the matter of tumours, which 
we are anxious should not suppurate
sometimes promoting the absorption
with great rapidity.

Cephaelis Ipecacuanha. 5.1. Rubiaciæ.
Lui. Soc. Travs. 6. p. 137. - Martius. Spec. Mat. Med. Brasil.
Fasc. 1. Tab 1. & 8.
Brasil. between 8th & 20th Deg. s. Lat. Flowers Jany & Feby
fruit ripe in May. From Pernambuco to Rio Janerio. - woods.
other Brasilian Emetics noticed by martius
Richardsonia Scabra
" emetica.
Polygala Poaya. Tab 2.
Iruidium Ipecacuanha. Humb. t. 496
" brevicanle. Tab 3.
" urticæfolium. " 4.

The emetics in common use are 
Antimonium Tartarizatum
Zinc Sulphas
Cupri Sulphas
Cephaclis Ipecacuanha
Scilla maritima 
Besides these there are several other 
medicines which rank away the Emetics -
Ammonia Subcarbonas. Sinapis
alba. Anthemis nobilis. Polygala.
senega. veratum album. Calchicim
antum vale. Daphne Mezereon. - Asarum
europam - & Delphinium Staphisagia. -
It is needless to speak of these medicine
as emetics, for one have 3 substances
which possess eminently the emetic
quality, & which are preferable
to all other medicines of this class
these are Antm..- Tartarizatum
Zinci Sulphas.
Cephælis Ipecacuanha.
The operation of these emetics is distinct.
Ipecacuanha is the mildest
in its effects, but generally the 

 

most tardy - Tartar Emetic is the most 
powerful & most pervading, in small 
doses - & the Sulphate Zinc the most 
immediate. - 
Ipecacuanha of itself doses not produce
any dangerous effects, & is therefore 
especially applicable for delicate
persons - & for children. -
Tartar Emetic & the Sulphate of Zinc
excite considerable irritation, & rank
among the mineral poisons - The former
is preferable in these cases
where a decided & long continued
impression from vomiting is desired
& the latter, from its immediate
action, is useful in cases of poisoning
in intoxication - in arresting the cold
fit of ague - & in cases where we 
wish to avoid nausea. - 
Ipecacuanha is generally best given in 
a full dose - for an Adult about 
30 grs - or 20 grs with 1 gr of Ant. Tartarizatum. -
For an infant of the first 
year about 2 grs - & increasing by 
about 2 grs of the end of second year 
to the 10th. It is no moment to be 

 

very precise in the quantity for any excess
over the amount that could produce
vomiting is removed by the effect produced.
I have given 15 grs to a child
5 years of age - & vomiting did not come 
on for 3/4 of an hour. In general
any warm diluent as milk & water
will accelerate its effect. -
The virium Ipecacuanhæ may be 
given from ♏︎ x to an infant of a year
to ℥IV - V to a child 12 - 14 years old.
For an adult the powder is the best
form. -
Iron in all cases where there is irritation
on the stomach & intestines, & exhaustion
Ipecacuanha is the best emetic
we can use. It often acts as a laxative
after vomiting is over, & frequently on
the skin. - For its sudorific effect
it is generally given with opium in 
small doses. as in Pulv Ipecca. compos.
As a nauseant Ipecac. is given for 1/8 to 
gr 1 - 1/2 to an infant of 1 month - up to 
12 or 14 years of age - or ♏︎ iij - to 35 ♏︎. -
For an adult about 3 or 4 gr repeated

 

every third or fourth hour. - The effects of 
nauseants are very distressing to the patient,
& where there is debility by 
keeping the stomach in a constant
state of irritation they do often much 
harm. In cases of febrile excitement they restrain
the action of the heart. Where expectoration
is free they may check it, or 
deprive the patient of the power to 
expectorate, & in elderly people the 
effect is often fatal. The best application 
in effects of this kind is 
Ether as a diffusible stimulant
to restore vigour & enable the Individual 
to expectorate.
Tartar emetic is the only certain preparation
of Antimony, & allowing virtues
to the other preparations such as Pulv.
is Antimonialis & James Powder,
it is the only one extensively used as 
an emetic. The others are chiefly exhibited
for their diaphoretic effects,
but they are uncertain & generally
inert preparations. -
Tartar Emetic operates in much 

 

smaller doses than the other emetics.
From 1 to 2 grains is the amount given
to an adult. - & form 1/12 - to 1 gr of an infant
to a child 14 years old. of the virium
Ant. Tart. for ♏︎ x - ʒij - to children.
It is best given in solution in distilled
water, for it has no taste. -
This medicine is the most powerful
emetic we possess. It stimulates the 
stomach into long continued & powerful
contractions, acting also on the 
Duodenum & promoting a free discharge 
of bile, after the stomach has 
been emptied of its contents. By the 
face of its operation it seems to draw
remote parts of the body into a 
sympathetic action, & to break up
diseased actions which are unconnected
with the state of the stomach.
It is therefore preferable to all other 
emetics where the object desired is not 
simply to relieve the stomach of 
offensive ingesta, but to afford relief
by exciting vomiting for the cure 
disease, as in fevers at their commencement -
in Phlegmasiæ - especially in  

 

croup. Cynoncha Laryngea. - The danger
to be apprehended from its use is the 
irritation it excites on the mucous
membranes. It generally purges more
often vomiting than Ipecacuaha,
& if given in too large quantity induces
inflammation of the stomach &
intestines - diarrhœa, mucous - purulent
& blood stools & death. - It is 
this effect of Tartar emetic that 
remedies its use hazardous in delicate 
people & children, & fatal too frequently
if long continued, even in small
doses. -
The Sulphate of Zinc or white vitriol
is given of 15 - 30 grs to an adult - &
pain gr ss - vij of an infant to a 
child 14 years old. - Its advantage
is that it does not harass the patient
with its operation - it is instantaneous
in its effect which is soon finished.
The objection to its use in general is 
its very disagreeable taste. It is given
in Solution. 

 

Besides these important emetics there
are 2 others occasionally used. - the 
Sulphate of Copper & Squill. The 
former like all the preparations of Copper
is an acrid mineral poison - & has nothing
to recommend it. It has been given for 1/2
gr to 2 gr in Phthisis to excite vomiting
to the relief of the Lungs. -
Squill is generally employed as a diuretic
& expectorant. - but the oxymel
Scillae is sometimes given to children
as an emetic for ʒss - ℥j. Squill is generally
irritating, & sometimes violent in its 
effects, & Ipecacuanha is to be preferred
to it. - 
I need not say anything respecting
the other medicines classed as 
emetics, for they are not used - nor can 
we desire other remedies of this class
than those I have particularly 
noticed. - 

 

Diuretics
are Medicines which increase the discharge 
of urine - or its more copious
secretion from the Kidnies.
much is written upon the made of 
action of these remedies, but nothing
is so little understood as the positive
effect of remedies. Putting aside
all theoretical reasoning - & assumed
facts, what does experience teach 
us respecting the amount of urine 
passed under different circumstances
in ordinary health? - We find that 
at common temperatures more
copious draughts of any liquid will
occasion a more copious discharge
of urine - but if the temperature of the air
be high perspiration is increased,
especially if we use exercise, & the 
greater amount of the fluid drunk
passes off by the skin. - This is 
easily accounted for. The Kidnies
& skin are the great drains of the body 

 

& both of them discharge a large quantity    
of watery fluid. Under ordinary
circumstances there is a balance between
the amount of watery fluid excreted
by the Kidnies & skin - or in other words between the urine & the perspirable matter but this balance
may be last by a low temperature
which acts directly on the skin 
& impedes its functions - or the influence
of disease may extend to 
the one or the other & produce a 
similar effect. - Thus in urinate we
make more urine - & less in summer
because the blood is drain by the 
impression of cold for the surface
to the centra of the system - [cross out] It 
is on the contrary so rarefied by heat that under
its influence it spreads universally 
over the skin, & transudes freely thro'
the myriads of pores opened by the 
relaxing effect of the combined
heat & moisture. 
It is difficult to say anything positive
as to the amount of urine passed,
for it must depend upon the amount
of fluid taken in, & the 

drinks
heat & cold

greater or less action of the vessels of the 
skin. The more we drink, the more
urine or perspiration or both must
be excreted, Water there is a diuretic
& a diaphoretic. - It is absorbed into the 
veins - goes to the heart, & thence to 
all parts of the body, & passes off 
by urine & perspiration. -
Cold is also diuretic, but herb is 
a diaphoretic. -
So much for experience with regard
to copious draughts of watery fluid
& the influence of heat & cold on the Kidnies & skin. - The 
one occasions a larger flow of urine
because it increases the amount of
the watery particles of the Blood,
& the other affects the distribution 
of the blood, & influences the amount
of urine or perspiration, as it impels 
the blood to flow more copious by
either to the kidnies - or to the skin. -
Now what takes place with regard
to the more copious flow of urine
by the influence of cold occurs also 
by the influence of disease. 

Stimulants to Kidneys & Absorbent
&
Depressants to the Heart 

& in both cases the excretion by the skin
is diminished or entirely suspended. We
have a remarkable instance of this 
in diabetes, in which disease the skin
is dry, & harsh, & the perspiration apparently
stopped. It is a disease principally
characterised by an enormous
excretion of urine - But in dropsy
both the perspiration & urine are 
deficient or suspended, & the watery
particles of the blood instead of 
being excreted, are deposited either in 
the cellular tissue of the body - or in 
the cavities of the Abdomen - Chest
& head - or in sacs, formed for it
or by it. - It is in this last condition
of the Body that diuretics are principally 
used, - & they are given with a 
view of removing the unnatural collection
of water in the body.
They may do this by communicating
a direct stimulus to the Kidnies, or absorbents
or by influencing the circulation
directly, & consequently the secretions, &
indirectly absorption. - If they stimulate 

Stimulants to Kidnies 
Depressants to Heart
Squill a Stimulant to Kidney
Supertartrate Potash also -
Digitalis depressant to heart 

the Kidnies to increased action & occasion
a large drain of serum from the blood
it is supposed that the blood vessels
absorb a sufficiency of watery particles 
from the dropsical collections to 
supply the waste occasioned by the diuretic,
& in this way the medicine by 
repeated impressions on the kidneys
occasions the absorption of the whole 
fluid effused. - 
If the diuretic acts on the circulation
it is by diminishing its frequency
whence the secretion is diminished,
The Absorbents continue thin activity
& ultimately take up the fluid effused
They carry it to the veins, & the blood
they surcharged with serum is purified 
in its passage thro' the Kidnies
by these organs separating the serum
in the form of urine. -
Now Squill is supposed to be a direct
excitant of the Kidney, & so is Supertartrate 
of Potash. Digitalis is 
supposed to act on the circulation, 

Calomel stimulants to absorbents -
Diuretics not in dropsies only.
In affections of urinary organs.
Demulcents are diuretics. 

& Calomel to excite the absorbents.
I see no objections to receive these theoretical
views, but the truth is we 
do not know anything positively
upon the subject. -
[cross out]
Dropsy however is not the only diseases
in which Diuretics are administered
They are given in several affections
of the urinary organs. The urine
is a very complicated fluid & contains
many salts in solution. If the 
watery particles of the blood are 
deficient, the urine may from the 
stimulus of these salts prove highly
irritating to the mucous membranes
of the Kidnies - bladder & urethra,
& therefore demulcent fluids
which operate as diuretics from
the water they principally consist
of, are exhibited to increase the 
bulk of the watery particles of 

 

urine & render it less acrid. These medicines
also are supposed to sheath the 
mucous membranes with the mucilaginous 
matter dissolved in them
It is difficult to conceive of this 
for we suppose all mucilaginous
substances are decomposed in the 
act of digestion, but the fact is 
no less certain that great relief
is experienced in the condition of 
an irritable state of the mucous
membrane of the Kidnies - bladder
& urethra by drinking copious by 
of mucilaginous fluids. They probably
act by attenuating the urine. -
This irritable state of the mucous
membrane is excited also by gravel
or calculi, & the pain they excite in 
transitn is relieved in a similar
way. We administer acids or alkalies
as the gravel is either of 
the white or red Kind, but this 

Diuretics in fever & Infln,,

is with a view of acting chemically
on the urine. Demulcent remedies
in these cases may not only sheath
the mucous membranes, but favour
the passage of the gravel to 
the bladder & from bladder thro'
the urethra. -
It is in dropsy [cross out]
& affections of the urinary
organs that Diuretics are chiefly
used, but they are sometimes
employed in cases of fever &
inflammation - especially in 
gout & rheumatism & in pulmonary affections. In these cases
it is with the view of diminishing
the amount of circulating fluid,
& thus influencing the hearts action,
as in the case of purgatives. - Colchicum
for instance is exhibited
in gout & rheumatism - & the Acetate 
of Ammonia in fevers. If
the surface is kept hot the latter
acts by diaphoresis, but if the 

Diuretics in loss of urine.

patient is out of bed - or only covered
with a sheet & cool air circulates
round him, it acts by diuresis.
There is besides a peculiar disease in 
which diuretics are the only medicines
of any avail, & that is when 
the secretion of urine is suspended
& the head is suddenly affected
with coma. If the kidnies can be 
excited to action the patient recovers
but otherwise he dies under the 
symptoms of coma or Apoplexy.
You will find a history, of a case
of this Kind in the 6th col of the Med.
Trans. by Sir Henry Halford. The patient
died in 30 hours in a state of 
stupefaction. There is generally a 
urinous small in the perspirable matter
& the exhibition of Diaphoretic &
Diuretics are therefore indicated. - V.S.
is proper if the ureters are clogged up
with calculi. -


 

You will recollect that Diuretics are 
principally used in Dropsies - in affections
of the urinous organs attended with irritation
or deficient action of the Kidnies - & in pulmonary
affections - in gout & rheumatism.
We know very little upon the subject
of Dropsies, as to have the serum is poured
out whether this the open months
of the exhalant arteries taking on a vital action or thro' lateral 
pores. - Idiopathic Dropsy is defendant
upon the loss of balm in between
the exhalant & absorbents, without there 
being any apparent derangement of 
structure - Symptomatic Dropsy 
arises from organic disease of structure
& in some cases to a mechanical
obstruction to the circulation. or to 
inflammation. -
Idiopathic dropsy & that form of Symptomatic
which depends on inflammation
is cured by medicines & V.S.
but when the disease arises from 
organic derangement of structure
it can only be alleviated by medicines -
The other form arising from 
an impediment to the circulation
is the premier of the Surgeon.

 

The principal diuretics are 
Supertartrate of Potash
Calomel or Blue pill. -
Digitalis
Squill.
The Supertartrate of Potash & Squill are
supposed to excite the Kidnies directly
Calomel or Blue pill to stimulate
the absorbents - & Digitalis to act thro'
the medicine of the circulation.
Supertartrate of Potash be given
in solution - & drunk freely.
Squill is given combined with Calomel
or Blue pill p~ 1-3 grs of the dried root
with 1-2 grs of Calomel - or 3-VI grs of 
Blue pill. -
Digitalis is preferred in Hydrothorax
It is a dangerous remedy & must 
be given with great Caution & its 
effects wretched. - gr 1/2 - increased
cautiously. The Infus ℥ gr - ℥ i or Tincture
♏︎ X - XI is best. Brandy is the best 
antidote to its effects - unless inflammation
is excited. -
Besides these diuretics we have many 
others of more or less efficacy - viz 

Potassæ Subcarbonas - gr X - XXX. The ashes of 
Broom & worm wood formely use 
depended on this salt.
Potassæ Acetas ℈j - ʒj, largely diluted -
" Nitras gr v - xij. In large doses it is poisonous -
& the other salts of potash
are preferable to it.
Liquor Ammoniæ Acetatis ʒij - ℥j. It acts 
as a diaphoretic if the surface is coarse
Spiritus Ætheris nitrici ♏︎ x- 40 - combine
with other diuretics.
Cantharides
Colchicum
Nicotiana Tobacum
Copaiba
oil of Turpentine
oil of Juniper. Spiritus J. camp. Infus. Br
Allium porrum} juice 
satium.}
Ulmus camperuis - Decoct. N. Ulmi.
Spartium scaparium. Decoction.
Decoctum Taraxaci. ℥ij rec. root Aq. oj. boiled tb
Menyanthes trifoliata
Geraiaum officinale
Cardamine pratensis
Manubium vulgare
Rumex Acetasa.
Dancus Carata - agrestis - semina
Apium Petro sedinum. Decoct ad libitum.
Cissampalos Pareira. 
End of Lecture 26.

Digitalis purpureæ. Foxglove. Did. Angios. Personatæ. Indig.
Leaned July. Powder. Inf. & Tinct. water & Alcohol extract
the virtues. Foxglove contains Ammonia. extract. peagreen
resinous matter. & Digitalia. Pour ether on leaves. & macerate
filter & evaporate. dissolve the residuum in water. filter
add oxide of Lead in solution - evaporate & digest the residuum
in ether - & on evaporation it yields Digitalia - a brown deliquescent
uncrystallizable substance - of a bitter taste.
Direct Sedative. diminishing the action of Heart to 30 or 40.
erect posture quickens the heart & death sometimes occurs.
The pulse is often intermittent. vertigo. nausea. vomiting. purging
delirium. Syncope & death.-Large doses inflammation 
& death. In Phethisis. Dropsy - & irritability after V.S. &
long fevers. Anasarca - & Hydrothorax -
Powder 1 gr cautiously increasing to 3-4.
Inf. ʒi. boiling water oss. mac. 4 hours. strain. add Sp. Ceri. ℥ss
Dose ℥ss - ℥i. twice a day.
Tinct. ℥4. mac. 14 days in oij pr. sp. - Dose ♏︎ x - increas to XL.
(Brandy. & opium. v.s. Leeches. & opium.) -
Scilla maritima. 6.1. Liliaceæ. Spain. Levant. Africa. Bulb.
Bulb large. white or reddish. from the Levant. contains a 
white viscid juice of a bitter acrid taste. vesicating.
acrimony is last by drying at too great a heat - Contains
Scillitina 35} Scillitina is a white deliquescent
Tannin 24} uncrystallizable substance -
Gum Sugar 12} very bitter -
woody fibre 30}
Squill is used in small doses as an expectorant & diuretic.
If given in too large doses it occasions vomiting & purging -
exciting inflammation. Its use is inadmissible
in inflammatory diathesis. - but in chronic Bronchitis &
Asthma it is of use combined with Hyoscyamus - In
dropsy it is generally given with Calomel - 1gr of Squill
with 2 - IV grs of Calomel & ʒss of Ext Hyoscyamus or Op.
Acetum Scillæ. 1 tt dried bulb mace 24 hours in o.vi Dil. Acet.
Acid. add after straining o.ss proof of Spirit. dose ʒss - ʒij -
oxymel Scillæ. oij Acet. Scillæ boiled with 3 tt Cl. Honey to 
a due consistence. ʒss - ʒij. - Expectorant.
Pil. Scillæ compos. Squill. Ginger. Soap & Ammoniaum.
10 gr contain 1 of Squill. Dose x-xx gr.
Tinct. Scillæ ℥4 mac. 14 days in oij pr. sp. Dose x-xxx ♏︎ 

 

Lecture 28th,,
Diaphoretics 
are those medicines which increase
the exhalation for the skin when their 
operation is so divided as to occasion
sweating they are termed Sudorifics.
These medicines act by directly
stimulation the cutaneous exhalants
or with the air of warmth to the surface by increasing the determination
of blood to the skin - or by relaxing 
the vessels, & thus rendering
them less disposed to resist the 
impetus of the blood. -
Sulphur may be regarded as a direct 
stimulant to the cutaneous
exhalants - opium Guaiac Campher as operating
on the circulation - & Ipecacuanha & Antimony
as relaxing the vessels. -
Heat acts by bringing a flow of 
blood to the part to which it 
is applied, & as a stimulus to
the vessels themselves - & if it is 
applied by fomentations the part 
is also relaxed by the moisture. -
Ipecacuanha like Antimony is 


 

a relaxant, & when combined with 
opium, as in Pulv. Ipecac - compos -
acts by the combined effect of relaxing
the vessels - & increasing the 
incubation.
Diaphoretics diminish the amount
of the watery particles of the blood
determine the blood to the circumference 
for the internal parts - & 
thus equalize its distribution.
increase indirectly absorption, &
relax the cutaneous exhalants. -
Their efficacy is most marked
in cases of inflammation, where 
the skin is hot & dry, & especially
in the different forms of Cynanche
in Bronchitis & affections of the 
Lungs - & in Rheumatism. They 
operate most beneficially by equalizing
the circulation, & removing
the impediment to the natural
exhalation, whether caused by a 
deficiency of blood circulating in the skin
or by a constricted state of the 
vessels. The principle contain 

 

to be observed in exhibiting Diaphoretics 
is with regard to those which 
stimulate the system generally in 
cases of excitement & inflammation
such as Guaiac - opium. Camphor.
These are inadmissible in such 
cases, as they will aggravate the symptoms
they are intended to lessen.
The Body must be kept moderately
warm, & covered with flannel,
& exposure to cold avoided. Tepid
drinks must be administered.
The simplest & least infusions of diaphoretics
are exercise - & heat - especially
in the form of tepid bath -
or the air bath - or fomentations,
& next to these tepid drinks. -
There is a remarkable difference
between diaphoretics & diuretics,
viz that the former are generally
sure to operate - which the latter
are often unsuccessful for a great 
length of time. The reason is the easy
controul we have over the skin
& the facility of acting upon it. 

 

In general these two excretions are opposed 
to each other, & the one diminishes as 
the other is increased. That of the urine
is less liable to become deficient, but 
that [cross out] of the skin is exposed to constant
impediments from cold - &
from an irritable state of the mucous
membrane of the alimentary canal.
Its deficiency is not attended with such 
dangerous consequences as that of the 
urine, but the health is sensibly
impaired by its disorder - & many 
chronic ailments are [cross out] to be attributed
to it. In this Country we are 
exposed to a cold & variable Camp climate
& the functions of the skin are impeded
by the effects of this variation
of temperatures. We therefore pass
more urine than people who reside
in tropical climates do - & one more
commonly have diseases of the urinary
organs - & they of the skin. - 
It is of the first importance to attend
to the condition of the skin, not only
as its condition indicates the state 
of the cutaneous transpiration, but 

 

as it guides us to a knowledge of the state 
of the mucous membranes. Proper of a 
blanched faded aspect are never comfortable
in their feelings & are liable 
to dyspeptic disorders. - They do not freely
perspire - & they are liable to irritation
on the mucous membranes. There is more
blood circulating in them & less in the 
skin. When it is equalized by the heat 
of summer they are sensible if a lightness
& cheerfulness that they do not 
feel in winter - Exercise in the open 
air - proper clothing - flannel next 
the skin - tepid & at last cold ablutions,
if a glow follows them - or the 
frequent use of the tepid bath at 90
are the appropriate remedies. Friction
also is beneficial. - & a proper diet.
A minute attention to these membranes
is of the greatest importance in the 
practice of medicine, & sufficient
consideration is not paid to them.
They mutually effect each other.
Thus the mucous membranes primarily
affected will act on the 
skin - & the skin disordered by habitual 

 

exposure to cold & moisture - & by sedentary
occupations will affect the mucous
membranes. - My clothing warmly & proper
exercise we guard against the immediate
impression of a low temperature
& habituate ourselves to it. The skin 
becomes less sensible to the variation
of temperature, cold acts upon it as 
a stimulus not as a depressant - the 
blood is freely distributed to it, &
the internal parts are not liable
to congestion & to a state of irritation
We avoided colds - & children avoid
scrofula & mesenteric diseases - &
those who are predisposed to consumption
pass thro' life without that 
fatal disease being called into action.
The diseases in which diaphoretics
are employed are those of inflammation
especially of the air passages - & mucous
membranes of the alimentary Canal,
especially Dysentery. - in Diabetes - in 
rheumatism & in some chronic 
affections of the skin. When there 
is much excitement & a full hard 
pulse V.S. & purgatives are generally 

 

premised. -
The simplest Diaphoretics are exercise
tepid drinks - heat either natural, as 
that of Summer or artificially
applied in the form of fomentations
or the tepid - & warm bath - or air 
or vapour Bath.
Exercise promotes the general health
by bringing all the parts of the body
into play, & we are especially sensible
of its effects on the skin from
the glow of heat which ensues from 
it when we have been chilled
by sedentary occupations in winter.
The beneficial effects of it partly
result from the invigorating qualities
of fresh air, & the impressions
made upon the mind by external
objects. Sedentary persons are generally
pallid from a deficient
distribution of the blood on the 
surface of the body, & from the 
want of fresh air. The blood does 
not [cross out] became duly decarbonized -
& all the secretions are eventually
impaired - & the excretions 
are either impeded - or the balance
between them is last. In those 

 

secretions on the healthy condition of 
which the vigour of the body depends
it is reasonable to suppose there is 
something deficient if the blood
which affords them is deteriorated in 
quality. That this is the case in the 
gastric juice, & perhaps in the bile
on which the important functions
of digestion - & alnine excretions depend
I think is apparent from 
the difference which is so marked
in the health of the peasant & the 
manufacturer. Yet we do not 
attend to these considerations, or 
at least we hope to effect cures
by drugs, when the remedy lies
in the return to natural habits.
Tepid drinks prove diaphoretic
by affording watery particles to 
the blood, by increasing its momentum,
& by relaxing the skin, if the 
surface is kept warm. If it be 
kept cool they prove diuretic. In 
summer we are sensible of their
immediate action on the skin, when 
we take copious draughts of warm
tea - & in winter we are equally
sensible of the glow they diffuse 

 

own the body.
Baths afford a Sort of artificial
atmosphere, & operate by the heat they 
impart & by the relaxation they occasion
on the skin. The temperature should
never exceed the natural heat of the 
body at first, for a high temperature
will constrict the skin as cold does.
The heat may be raised gradually 
till a free perspiration is induced.
In this Country Baths are most 
strangely regluted, tho the climate
is such as requires their use more 
than any other. The habitual use of 
Bathing is essential at least to 
comfort -for it promotes cleanliness -
equalizes the circulation - keeps
the skin soft & perspirable, & operates
by sympathy on the mind. -
In congestion fevers - in Diabetes
in chronic affections of the intestinal
canal, especially in Dyspepsia
Hypochondriais hot Baths [cross out] an admirable
remedies. They are not so serviceable
in acute rheumatism as is generally
supposed - flannel - & friction
with a regulated temperature - after
V.S. Colchicum - & a regulated diet
are the appropriate remedies. 

 

The hot air bath - or the vapour bath 
are serviceable in many cases, where
the patient cannot be moved, & 
they are more easily applied.
In the hot dry skin of fevers cold ablutions
have been used since the time 
of Dr Currie - & they operate directly
as depressants & remotely as excitants
They remove the heat of surface & the 
constriction of the skin, & generally
promote diaphoresis by the excitement
which follows: the skin being in 
a favourable state, by the removal
of the constriction, for the passage of 
the perspirable matter.
Cold drinks also operate as diaphoretics 
in fever - & Hippocrates & Celsus
speak frequently of their efficacy.
They act probably by diminishing
the morbid heat of the body, by determining
the blood to the skin, (as in 
the reverse application of cold to
the skin the blood is determined
to the internal parts) & by furnishing
a supply of watery particles
to the blood. -
Nauseating remedies perhaps operate
in one respect in a similar

 

way, viz by their debilitating effects
primarily on the mucous membranes
& subsequently by the general relaxation of the 
whole body. There operation is aided
by tepid drinks - & warmth to the skin.
The most powerful Diaphoretics
are opium & colchicum. or opium
combined with Ipecacuanha - or with 
Calomel.
Tartar emetic as a nauseants
Pulvis Antimonialis 
Liq. Ammoniæ acetatis
Sub Carbonate of Ammonia. with Citric
Acid as an effervescing Dght.
Guaiacum} as stimulants
Camphor} 
Sulphur
Pitch. -
Decoctum Sarsaparillæ
Dorstenia Contrajervæ
Daphne Mezereon 
Laurus Sassafras
Aristolochia Serpentaria 

 

Opium. in powder - 1 - iij grs
Tinct. Opii - vy XX - 60 -
Opium 1 gr with 1 - 2 grs of Calomel
Pulv Ipecac. compos. gr x-xx.
Colchici pulvis - gr iij - vij -
Verium Colchici - ʒss - ʒj
Liq. Ammoniæ Acetatis ℥ss - ℥j
Subcarbonatis Ammoniæ gr VI - X 
with Ac. Citrici gr XV - XX. -
Ant. Tartarizatum. gr 1/10 - 1/4. - with 
Opii gr 1. -
Camphorae gr iij - x - 
Mist. Camphorae ℥i: ℥ij: with 
Pulv. Ipecac. Camphor. or Ant Tart.
Guaiaci resinia gr V - XV.
Mist. Guaiaci. ℥ss - ℥ij. & diluents
Tinct. Guaiaci ʒi - ʒij
" - " Ammoniati ʒi - ʒij
Sulphuris sublimate ʒss - ʒiss.
Picis liquidæ gr XV - ℥ss. with flour.
Decocti Sarsaparallæ ℥iij - oss} thrice
' - " compositi ℥iij -oss} a day
Pulv. Contrageivæ gr X - XXX
" - " compos. gr X. XXX. 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lect xx- viij
Narcotics
have been defined these medicines
which diminish the actions &
powers of the body without occasioning
any sensible evacuation.
This definition does not apply
to all the remedies usually remake
under the head of Narcotics. nor 
is it strictly true of any of them
for they generally act on the skin 
At least opium & Alcohol do,
while Hyoscyamus frequently acts
as a laxative - & the Acrid Narcotics
from the irritation they 
excite on the mucous membranes
after occasion vomiting & purging.
Narcotics vary in their actions
& effects. - Opium & Hyoscyamus
in full doses induce sleep
& relieve pain.
Alcohol & Ether are diffusible
stimulants & induce the symptoms

 

of intoxication, with a comatose
state resembling in some respects
the cause of Apoplexa. -
Digitalis remarkably diminishes
the hearts action - & in dropsy operates
as a diuretic.
Colchicum allays pain. operates by 
the skin & [cross out] bowels. & like
Digitalis often produces sickness.
without inducing sleep.
Prussic Acid & Tobacco are most 
powerful sedatives, & produce
languor - & universal relaxation.
Nux vomica acts specifically on 
the spinal cord, & produces the 
convulsions of Tetanus. -
Belladonna. Stramonium & Coraium
occasion Delirium convulsions
of the muscles of the face 
& limbs, pains of the Epigastrium
vomiting & purging.
In practice we do not rely upon 
definitions, but upon the effects
of remedies, & experience has 

 

led to the distinction of those Narcotics
which induce the alleviation
of pain & promote a state of quietude
or sleep - & of those which 
operate by allaying irritation - or 
lessening pain without inducing
sleep. -
For the former effects we use Opium
& Hyoscyamus. - & for the latter we 
employ the Prussic Acid - & Colchicum.
The former may be regarded as Narcotics
& the last as sedatives. -
Undo not use Digitalis to lessening
pain - but it is a powerful
means of reducing the Hearts action
& may therefore be considered as 
a sedative. The Stramonium allays
irritation in spasmodic asthma
when applied directly to the mucous 
membranes of the air passages
by smoking it - & may also be 
regarded as a sedative. The Conicum
is also used to lessen pain as well
as diminish irritation, but its
action is not so decided as some 
of the sedatives, especially as 

 

Colchicum in gout & rheumatism.
The Belladonna is only applied to 
the eye to dilate the pupil. It is not 
given internally. -
The Nux vomica is not used in this 
Country, at least as a Narcotic.
on the continent it has been given 
in paralysis, because it increases
powerful convulsions, & was supposed 
therefore to act as a stimulus 
to the palsied limb. But 
paralysis generally depend on an 
organic disease of the Brain &
spinal cord, & cannot be deputed
to be removed by an occasional 
stimulus, so long as the source
of nervous energy is destroyed. -
It has been recommended in Dysentery,
& is said to act specifically
on the large bowels & produce
healthy motions & a rapid recovery. -
We do not employ Alcohol
& Ether for their intoxicating effects
in medicine. Ether is used as a 
diffusible stimulant, & urine 

as a Tonic-
Narcotics & Sedatives
Papaver Somniferum} Narcotics
Hydoscyamus niger}
Lactuca Sativa}
Humulus Lupulus}
Andum Prussium} Sedatives
Nicotiana Tobacum}
Digitalis purpurea}
Colchicum Autumnale}
Datura stramonium}
Conium maculatum}
Atropa Belladonna}
Solanum Dulcamara} not used as 
Laures Camphora} narcotics or Sedatives
Strychus Nux Vomica
Aconitum Napellus}
veratrum album}
Rhus Toxicadendron}
Alcohol. intoxication & Coma. not used as Narcotic. - 

I shall confine myself principally to 
the consideration of the application
& effects of the Narcotics & sedatives,
which we employ in practice for 
the alleviate of pain & the production
of sleep, & leave the Acrid Narcotics
till I treat of prisons.
There have been 2 theories in vague
for the explanation of the effects of 
Narcotics. Now Opium of all remedies
of this class is entitled to the first 
rank as a Narcotic - & I shall speak 
of these theories with reference to its.
action. -
Cullen supposed that opium was a 
direct sedative, that is that its natural
tendency was to depress the powers of 
life. He explained its stimulant effect
when given in small doses, by supposing
that the viz medicatrix - or in other
words the powers of the System were 
excited to throw off the noxious medicine -
but when the dose was large
& the sedative effects were marked
he supposed it conquered the resisting
powers, which were thrown 

 

prostrate by its stupefying effects, whence
the quiescence & sleep & relief from pain.
Brown advanced an opposite theory.
He supposed that opium was a diffusible
stimulant - but that its stimulating
effects were transiting, & that diminished
action resulted from its stimulation,
just as fatigue follows great
muscular exertion. - He therefore regarded
opium as a direct stimulant,
& an indirect sedative - while Cullen
supposed it was a direct sedative
& an indirect stimulant -
These opinions are the romances of physic,
like the frictions of the poet
based upon the bodiless fabric of a 
mild imagination. - Brown however
is generally supposed to have come
nearer the truth, for opium is regarded
as a stimulant. It probably
acts in a small dose by determining
blood to the brain, the functions of 
which it exalts indirectly thro' the 
medicine of the blood, (the natural
stimulus of the body) while in 
a large dose it impels the blood 

 

in such quantity as to occasion a diminution
of its functions, & thus produce
stupor - & sleep & consequent relief
from pain. The functions of the brain
once disturbed those vital actions
dependent upon it are impeded,
especially respiration, & any impediment
to the dilatation of the lungs
acts on the Brain, so long as the 
Hearts action is not stopped, by 
impeding the return of nervous blood.
whence the Brain is durably
compressed, viz by the action of the 
Heart which sends its supply
of arterial blood, & by the impeded
action of the lungs which prevents
the return of nervous blood. -
Bleeding therefore is the main remedy
in an overdose of opium - for
you diminish the pressure on the brain
by diminishing the blood which 
compresses it, & it is remarkable 
that the converse also is true, that 
a full dose of opium is the appropriate
application after profuse



 

hæmorrhage or bleeding, which leaves
behind a state of extreme irritability,
that is lessened by the quiescent
effects of opium. This is of the most 
important consequences in those 
cases where large Bleedings are required
to subdue a dangerous
inflammation, for the irritation
subsequent to a copious detraction
of blood would kindle up the 
inflammatory action, unless
it was allayed by opium.
This view of the action of opium is 
rendered probable by observing its 
visible effects. - tho' these differ
in different conditions of the body.
Thus after long acute pain a full
dose will merely produce quiescence
& ease. In spasms & convulsions very
large doses are required to produce
any effect, probably because the 
cause is to be found in some disorder
of the Brain, which is rendered 
insensible to the action
of opium. - In small doses under 

 

the ordinary condition of the body it 
excites hilarity - & a species of intoxication,
similar to that from Alcohol.
& a correspondent languor & lassitude
ensues. Some times the excitement
amounts to delirium & is followed
by stupor. - At others somnolency
a coma suddenly came on, yet the 
patient was be roused by shaking
him. The eyes are motionless & dull,
the pupil dilated - sometimes contracted.
the iris is insensible to light,
the muscles & limbs are relaxed, &
mobility & sensibility destroyed.
The respiration is imperceptible or 
painful, stertorous & interrupted,
the pulse varies - convulsions sometimes
come on - & death ensues. - Now these
last symptoms are analogous to those
of Apoplexy, & the difference
between them is attributable to 
the difference of the exciting cause.
In the case of an overdose of Opium
we suppose the congestion of the 
Brain to the universal - In Apo-

 

it is sometimes so congested - or a partial
disorganization of its structure
has taken place. -
There is another view of the made of 
action of opium, & that is that it 
is absorbed, that it acts specifically
on the Brain, as it were
stupefing it, impeding the transmission
fits nervous energy, whence
the respiration, being deprived
of its natural stimulus for the nerves
becomes impeded, while the heart,
apparently less immediately depandant
on the Brain, continues 
its functions, & the Brain becomes
congested between them.
In either view the morbid appearances
after death on the Same
viz the Brain & Lungs are found
gorged with blood - as well as the 
right side of the heart. - the blood
generally, as in cases of Asphyxia
remaining fluid after death.

 

Opium & Hyoscyamus are the only narcotics
in use for procuring sleep.
The former is the more powerful, but 
where from any peculiar idiosyncrasy
it occasions disagreeable
effects Hyoscyamus is used as its 
substitute. Its action differs from
opium by exciting a peculiar mental
alienation, to which a state
of stupor supervenes, & it frequently
operates as a laxative. It differs from 
the acrid narcotics in inducing sleep
& in not inflaming the mucous
membranes. - It is not to be compared
to opium as an Anodyne
in procuring remission from pain
nor does it as surely produce refreshing
sleep.
The Extract of Hyoscyamus for gr 5-20
is principally employed - tho' besides
this we have the Tincture from 
♏︎ xx - ʒiss. -
Crude Opium or the Tincture of 
opium are used in this Country


 

the crude when we wish to keep up 
the effect of the drug, & the Tincture
when we are desirous of its operating
speedily.
Opium is [cross out] used often comb Canth Calomel [cross out],
as a stimulant, [cross out] but its effects
in this respect are transitory, & 
always followed with opposite
symptoms. - It is more often employed to 
allay pain - to lessen irritation
to remove spasm - to produce
sleep, to check profuse evacuations, evacuations,
& to promote perspiration. 
If given to a person in health,
in a short time it exalts the 
animal spirits, & produces a 
tranquil confidence & serenity
of mind, with a subsequent
tendancy to sleep. The sensibility
of the system is diminished, &
the body becomes less susceptible
of pain or disturbance for external
causes. The irritability in the 

 

various organs & textures is diminished
& their functions checked or 
impeded. The secretions & excretions
except that of the skin, are lessened,
the digestive organs are rendered slower
in the performance of their functions
whence appetite is [cross out] impaired
& a state of costiveness induced.
The urine is less copious, & the 
secretion of mucus for the throat
& fauces rendered more sparing
& tenacious. - 
These efforts of opium generally
pass off in for 12 to 24 hours,
leaving a sense of dullness, heat
thirst, costiveness, headache &
frequently an itching on the skin.
If the dose has been large
a train of alarming symptoms
rapidly come on, as vertigo, confusion
of mind, gradual loss 
of vision, paleness, great muscular 

 

relaxation, difficulty of speech &
deglutition, somnolency, & sometimes 
delirium  & convulsions.
These pass into a profound
apoplectic stupor, with stertorous
laborious respiration, a full 
hard slow pulse, which state
continues till death. -
Opium loses its effects by the continued
use of it, & it must therefore
in Chronic diseases be
exhibited in increasing doses.
Bodily pain also counteracts
its usual effects, so that a person
suffering for cramp or colic will
take a large dose, which under
ordinary circumstances would
have been dangerous, & yet
he will experience no ill 
effects for it.
Opium is used to allay irritation
in the advanced stage of 

 

fevers when watchfulness & restlessness
are present. It is sometimes
given before the paroxysm
of an intermittent to stop the 
cold stage, & where the case is 
urgent, & there is not time to 
wait the effect of Bark it is 
useful in a full dose. -
In the Phlegmasiæ or inflammations
after free depletion it is  
an admirable recourse to stop 
the irritation, which the sudden
debility occasions, especially in 
those cases where V.S. has been 
carried to deliquium. It should 
always be given in a full dose 
for 2 to 4 grs - & half the amount
repeated for 2 or 3 times at the 
interval of 3 or 4 hours. Cases
of Peritonitis - especially puerperal
peritonitis - Pleuritis are often
immediately stopped by this bold 

 

& judicious practice, which we 
owe to Dr Armstrong.
In Dysentery after V.S. it is essential
to lessen the distressing pain,
2-4 grs as a suppository.
In Rheumatism, when the active
stage is post as a Diaphoretic.
In all cases of increased susceptibility
to impressions arising from 
debility, giving rise to restlessness
watchfulness, tumours, delirium
it is essential. You have an instance
in Delirium tremens.
where large doses, if the watchfulness
has been long continued
must be exhibited.
In the exanthematæ, at least in 
Small pox, it is useful to lessen
the irritation for the eruption, after
the violence of the fever is past.
In all passive Hæmorrhagies - &
Chronic discharges not accompanied
by fever. - In Catarrh 

 

when the Cough is kept up by irritation
after the inflammation is past.
In Epilepsy, as a palliative, when
the fit comes on at night, & there 
is no symptoms of plethora or cause
of irritation giving rise to the fit.
In Gangrene to check the progress
of the disease & under the body
less susceptible of the pain which 
attends it 
In spasmodic Asthma where 
the distress is urgent. -
In colic - & Cholera - in obstinate
vomiting. in all acute & agonizing
pains, where no danger is apprehended
for the presence of active
inflammation. -
Its use is contraindicated in general 
plethora, in determinations of blood
to the head - in the state of fever
with a hot dry skin & a hard 
full & rapid pulse. -
For internal use crude Opium 

 

for 1-4 gr, & the Tinct. for 20 ♏︎ to ʒj
are the best preparations. In chronic
cases the Blk drop. where 
constant resort to its narcotic
effect is requisite - & the dose must 
be proportionate to the previous use & the 
occasion.
The Tincture is applied externally
in pains & cramps for 2 - 4 ʒ rubbed
on the part.
Enemata & suppositories are highly
useful in tenesmus - & in pains
of the urinary organs - & uterus.
In ophthalmia, often the inflammation
is past it is used by Surgeons. 
There are some cases that require
the freest use of Opium, as those
spasmodic affections of the alimentary
canal, Known under
the names of cramp of the stomach
& colic. These affections counteracted
narcotic effect of Opium
untill relief is obtained, 

 

when the system becomes as susceptible 
to its influence as in ordinary
cases. The Tincture is 
usually given, & often in the dose
of 100 drops or more - repeating the 
quantity it intervals of 20 minutes
till relief is obtained. I have known
600 drops given in this way in a 
short time, & in Tetanus the dose
has amounted to 2000. In these
Cases you must be cautious not 
to continue the large doses after relief
is apparent - & the bowels must
subsequently moved by Inf. Sennæ
& injections. -
In mild cases of colic whether 
pain is endurable V.S. & cathartics
are more appropriate remedies,
but in extreme cases do 
not fear to use Opium liberally.
You are more likely to err
by giving too small doses,
a common fault where the 
full narcotic effect is desired, 

 

Prussic Acid
is employed as a sedative, with the view 
of controuling the circulation, & diminishing
the irritability of the body.
In some cases its effects are marked
by a profound prostration of strength,
depression of the spirits, & unwillingness
to move, speak or take food, the patient
expressing himself as only "half alive."
The mind remains clear, pain is suspended,
the heat is natural, & the 
pulse steady & tranquil. This state
lasts 12 or 24 hours, & is not followed
by heaviness, head ache, & the symptoms
which succeed to the use of opium.
It is employed in Phthisis, especially
in its commencement, when the pulse
is rapid, & the cough irritating, in
Asthma - chronic Catarrh - hooping
cough. It is said to afford relief in 
painful & difficult menstruation
in menorrhagia - hæmoptysis - been given
in derangements of the stomach, from 
the idea of its local sedative effect
on the irritated mucous membrane,
but it surely is not to be so employed.

 

It is difficult to form a correct opinion
of the value of a new remedy, & to decide
upon its application, much that has 
been said upon this Acid is to be taken
with caution, & its use is to be cautiously
recommended. - It is of all known
substances, in a concentrated state, the 
most instantaneous & powerful
poison known & even when reduced
in strength for medical purposes
the most trivial increase of dose
has suddenly brought on the most 
alarming symptoms. - Such as convulsions
& suspended animation.
It has unquestionably been of use in 
incipient consumption - & Digitalis
has acted in a similar beneficial
manner, by controuling the hearts
action. Rest in bed - & the blandest
diet must be followed at the same 
time, - with either. In a case of Hooping
cough Prussic Acid was taken 
for a week in gradually increasing
doses untill convulsions followed the 
last dose. Yet the disease was neither
checked or shortened in its duration.
Dose ♏︎ ij - vj of the Apothecaries Hall Acid. 

 

Tobacco
as a sedative is applied in the form of 
Enema, either of the smoke - or infusion
of the leaves in cases of ileus - strangulated
Hernia - trismus - dislocations
It operates in all these affections by
the profound relaxation it occasions
The safest made of exhibiting it is 
in the form of an Enema of the Infusion -
about ʒss of the dried leaves infused
in o.ss of hot water.
It was formerly used as a diuretic 
in Dropsy & it action was analogous
to that of Digitalis. -
Infus. Tobaci. ʒi leaves. Boil quarter o.j
macerated an hour & strained. - 

 

Stramonium
in small quantities act as an Anodyne
& antispasmodic, & as a poison in large
doses. Even in small doses it produces
nausea & giddiness, but if the dose is 
large it brings on great prostration
of strength, loss of muscular power
insensibility of the retina, dilated
pupil tremors, delirium, & sometimes
convulsions, coma & death.
Dr Marcet was favorable to its 
internal use as an anodyne in 
painful chronic diseases, as sciatica
Tic Douloureux - Cancer &c. The effect
in these cases were to lessen sensibility
& pain - to occasion a sort of 
nervous shock, frequently attended
with a momentary affection of 
the head & eyes - to excite nausea,
& symptoms like those of intoxication
sometimes a sense of suffocation
in the throat - a relaxation rather 
than constipation of the bowels, &
to occasion little soporific effect
excepting the produced by the succession
of case after pain. It was 

 

most effectual in sciaticas combined
with Syphilis. 
The powdered leaves are sometimes given 
in the dose of 1 gr. but the Extract is 
preferred, in 1 gr doses 3 times a day contains
by increasing the quantity, till
nausea or vertigo are felt by the patient 
or relief is obtained. -
The leaves are used by smoking, in 
the same way as those of Tobacco, &
have produced relief in the paroxysms
of spasmodic Asthma. It is 
only used during the paroxysm, &
is less effectual in the asthma of 
plethoric or in temperate people, or 
where the affection is Symptomatic
depending on causes of irritation in 
the stomach & bowels. -
The fresh leaves bruised form an 
anodyne application to painful
tremours. - 
An ointment made of the fresh
leaves with lard & wax is officinal 
in the Arm. Phra. - as an anodyne
application to painful tumours
ulcers & hæmorrhoids. - 

 

Conium
Hemlock is another palliative used in 
painful chronic affections, giving
rise to those symptoms which have 
occasioned it & similar remedies to be 
classed among the Narcotics. These are 
dizziness - nausea - a sense of fullness
about the eyes - diminished vision,
faintness & general relaxation, delirium -
coma, convulsions & death. -
It was introduced as an internal
remedy by Baron Storck of Vienna
in scirrhus, cancer &c. It is said to 
relieve the pain, & to improve the 
character of the discharge - to lessen
it, & to cause the ulcer to contract
& assume a disposition to heal. Its 
effects are however only temporary,
& its use is confined as a palliative
for the pain attending these diseases.
It has also been given in Syphilitic
ulcerations - in Scrofula - & in glandular
indurations. - in pulmonary irritation.
In Ameria Hemlock is 
considered as a remedy of great power
in Jaundice, when that disease
is not dependant on organic alteration

 

of structure. The yellowness of the skin 
& other symptoms generally disappear
when the dose is carried high enough 
to occasion giddiness. - It is also employed
in Tic douloureux & hemicrania 
when the last is not intermittent. 
The powder of the leaves, which should
be of a lively green. is given in doses of 
1-3 grains, cautiously increasing. - or the 
Extract which is preferred for ij - 5 grs
3 times a day, increasing it gradually
till increase a weakness & vertigo appear.
(Read for Dr Thompsons Lectures on Inflamn,,
the passage respecting Storcks introduction of 
Conium. p. 197- to 199.)

 

Colchicum
is like the proceeding remedies a deleterious
acrid narcotic, operating in 
small doses as a Cathartic, & sudorific
& possessed of every marked sedative powders
especially in controuling the circulation
whence it has of late Years been extensively
used in all febrile & inflammatory 
Affections - & regarded almost
as a specific in gout & rheumatism
It cannot be doubted that it has 
the power of diminishing the pulse
both with regard to its force & frequency,
of allaying pain, & the other 
symptoms of inflammation, &
thus to fulfill the object of depletion
by the Lancet.
Mr Haden has extensively used it for 
10 or 12 Years in inflammatory affections,
giving it every 4 hours till it 
produces an action on the bowels,
& has found that under its operation
the pulse becomes nearly natural
from being either quick & hard or 
slow & full. He has used it in preference 
to V.S. when the inflammation
has not attacked a vital part
& been so active as to endanger life, 

 

& has found that the patient is left in 
a state more favourable to rapid recovery
from its use than when depletion
has been practised. -
In Gout & rheumatism it has been most 
useful - & it operates in many cases
like a charm, abating the pain & tension
of gout - & the pain & distress of 
rheumatism, tho' no other effect has 
been perceptible from its action than 
sickness - or a distressing or slight nausea
sweating & purging. -
of all the acrid Narcotics it is the one 
have most employed - & in which 
I place the most confidence - but 
its effects must be watched - & the 
medicine suspended, if sickness 
or purging came on. -
For an adult the powder of the 
root is given in vii gr doses 4 times
a day - generally combined with some 
purgative - or the Tinct. of the Seeds
of which a ʒ may be given - in 3 
Cases - or the first dose may be 
ʒj with ʒij of Sulp. maga- & repeated
every 4 or 6th hours to the extent of 
20 ♏︎ till its effects are perceived. 

 

In rheumatism the doses are similar
to those in gout, but some practitioners
combine it with opium. Giving 1 gr
of opium with v. of the powder of the 
bulb of Colchicum. -
In chronic Rheumatism Mr Haden
has found it successful, if its use 
is persevered in . - 

 

Digitalis
is principally employed as a Diuretic 
in dropsy, but its action on the 
circulating system, on which its diuretic
powers are supposed to defend,
is availed of in other diseases, especially
in incipient consumption. -
The symptoms of this disease on 
its first appearance, are a quick 
pulse, flushings of heat, & a dry small
hacking Cough, scarcely noticed by 
the patient, & heat of the palm
of the hands - & feet. -
Digitalis is employed with rest &
a milk diet to reduce the morbid
frequency of the pulse, & under its use 
the symptoms have disappeared.
In a large dose it brings on giddiness
imperfect vision - nausea - a most 
profound relaxation - & vomiting -
& occasionally profuse evacuations.
The pulse is reduced to 40 - or 35 beats in 
the minute - but it is remarkably
influenced by position - for it rises 
to 70 in the sitting posture - & to 100
if the person is erect. It does not 

 

act on the Kidnies in health. -
Digitalis from its sedative effects
was formerly used, as Colchicum is now,
in many inflammatory disorders, as a 
substitute for V S. - & in Hæmorrhagics
Its use now is principally as a diuretic
in dropsy - & as a sedative in 
incipient consumption - & in some 
diseases of irritation - as chronic Catarrh. -
The Tincture is best given in small 
doses - about ♏︎ x - xv - increasing Cautiously
till the pulse is affected. The 
patient must be in bed - & take 
light meals of farinaceous food,
or milk - & great caution must 
be observed in regard to future
expose to cold & damp - & all 
sources of irritation. -
End of Lecture 27.

 

 

 

Lect. XXIX.
The works as Materia Medica which
have had the greatest influence
over the opinions of Medical men,
were written at a time when the operation
of medicines was supposed to 
be more extensive than is generally admitted as the present day [cross out]
The actions of these [cross out] agents on the 
living body were supposed to resemble 
the actions of particles of in animate matter
upon each other, & are consequently
find attempts in medical writings to 
refer the causes of diseases to changes
merely mechanical or chemical the explain actions issued in the same principles. - Hence
we have diluents Attenuants Inspissants. Astringents
Tonics. Emollients. Antispasmodics,
Demulcents - Antacids - Anlathalics &
Antiseptics, as So many distinct classes
of medicines, which from the names
applied to them we might suppose
had a specific mode of action.
It is necessary that you should be 
made acquainted with the vague 

* Diluents were to increase the watery patches 
of the blood - & a natural & sure 
expedient was resorted to, viz drinking one 
copiously; but another class of remedy
were supposed to increase the fluidity
of the blood - viz 

theories on which some of these classes were 
founded, that you may understand the 
conjectural nature of this department
of physic, & place confidence in what
is known by experience, rather than 
what is imagined from theory. We have 
rejected Some of these fanciful opinions,
but we retain others, not because
we understand them, but because
a cram of medical substances
are to be found steer in our Pharæ 
which we cannot treat of, unless 
we arrange them in the order, in 
which they have descended to us. -
* Attenuants were medicines which 
were supposed to increase the fluidity
of the Blood, not by increasing
its watery particles, but by operating
on the other constituents of the 
fluid. Parts of the blood were supposed
to unite together, & form preternaturally
grass & impervious masses.
& it was the effect of Attenuants
to break down these agglutinations
either mechanically or chemically, 

 

from Alholics. Soaps. Sugar, Honey & sweet
fruits were supposed to be the Hammer
& Anvil - & the Chemists on these occasions.
Inpissants were those substances which 
increased the general consistence of the 
mass of the blood, & Acids & Alcohol 
had this power given to them. - 
Emollients were medicines which diminish
the force of cohesion in the particles
of the solid matter of the body, &
thereby render them more lax & flexible
water insinuated in the Substance of 
[cross out] solids, diminishes [cross out] their density, &
[cross out] force of cohesion - Oil insinuated
into the intestines of dry particles diminishes
friction, & makes them flexible
This is true applied to the external particles
of the body, as in simple or medicated poultices - cataplasms & fomentations -
Demulcents are medicines which prevent
the action of acrid substances
by involving them in a mild viscid
matter, thus rendering them inert upon
the sensible part of our bodies - as 
oils & mucilage - & mucilaginous fluids.

x
whence the use of the perm or carbonated alkalies in the lethic [diath??]
or in acidity of the stomach - & of the acid in the Alkaline [condi??]
of the urine - a practice only established of late years - & our [sal??]
resonance in the treatment of calculous diseases - except where
local injury or irritation may lead to a change in the vital
action of the Kidney - 

Antiseptics where those medicines which 
corrected the putrescency of the body. It was 
supposed that there was a constant
tendency in the system to putrescency
& putrefaction, & when it rose to a great
height various disease were the consequence
as fevers of all kind - & scurry.
The lists of Antiseptics were taken 
from those substances which corrected
putrescency out of the body, & they were 
supposed to act in a similar way
within, as salts - vegetable Acids,
bitters - fermenting liquors. sugar. -
Antispasmodics were those medicines
which controuled the increased energy
of the Brain, either by correcting this
excitement on which it depended, or 
the collapse which succeeded to the 
excitement, or by obviating the too
sudden alternation of these States.
such as Narcotics & fetid medicines.
Antacids were substances used to 
neutralize the acidity of the fluids in the stomach
& of the blood. & Ant alkalies to neutralize
* their Alkalinity. 

 

Astringents were substances which produced
a contraction & condensation of the 
soft solids, & thereby increased their density
& force of cohesion, are effect referred
to an attraction taking place
between these astringents & the particles
of the animal solid, just as takes place
between the skin of animals & astringent 
substances in the tanning of 
leather. -
Tonics are those substances which give
firmness & strength to the whole system
& thereby to particular parts, operating
not as astringents upon the solid part
of the fibres of the body, but on the 
nervous power existing in them. -
Now tho' therey is natural & agreeable 
to the mind, & its resort in call cases where
effects cannot be logically traced to 
causes, it cannot have any influence
over physical evils - & either
alleviate pain - or cure disease. -
Our object as medical men is 
to correct the disorders - & cure the 
diseases of the body - to apply palliatives

 

palliatives in pain - to calm restlessness
& watchfulness - & by the judicious
& correct applications of remedies to restore
health to the body & mind. We
can only do this by understanding the 
nature of disorders & diseases - & the 
mode of action & effects of medicines.
Happily in many acute & dangerous
diseases the symptoms are so decidedly
marked that any one learned in the 
rudiments of Physic counterpart
from them the nature of the malady;
& the indications of relief are so 
simple & so effectual (if properly
administered) that in many cases
health ensues from our interference
But in chronic disorders & diseases
giving rise to a long series of morbid
effects, & feelings, it is exceedingly
difficult to trace symptoms to 
their Sonic - or to deduce a correct
history of the origin - progress - &
extent of the malady. Hence we 
practice in the dark, & the multitude
of expedients that are resorted
to in our embarrassments, drawn 

 

from conjecture, & sanctioned by use &
authority. - Hence too the general ill success
of our practice - the dissatisfaction that 
ensues from our vague opinions [cross out]
& the want of confidence in our 
skill.
If you compare the remedies
in use for acute diseases with those 
employed in Chronic you will feel
satisfied that where the nature of 
the disorder is known, the materials
available are few in number &
simple in kind -. Little or no diversity
of opinion exists respecting them - except
perhaps in the degree of their application. 
The reason is that all minds
are satisfied of the nature of the 
disease, & the effects of the remedy.
But in chronic disease nothing is 
comparatively known in the certainty,
& every practitioner has his conjecture
or the theoretical views of same 
mastermind have dominion over all - & no 
recourse is bad to observation &
reason. Hence we either have new 
theories - & new remedies - or blindly 

 

adhere to hypothesis sanctioned by 
time & the respect paid to the authority
of intellect. - or imagination.-
In this state of comparative ignorance upon so large
a number of human maladies, it is 
not to be wondered at that we have
a lost of uncertain remedies, the uses
of which are empirical - & the effects
of which are vague & unsatisfactory.
Not having arrived at truth ourselves
with regard to the nature of many 
observe diseases, nor proposed theories
more evidently allied to truth we 
are naturally compelled to listen to 
the conjectures of those who proceeded
us - to adapt their views - & prescribe
their remedies. - In some respect we
have decidedly advanced, & our practice differs
from theirs - as in chorea, scurry & perhaps
hysteria - diabetes - hypochondriasis
&c. - Chorea was supposed to be 
purely dependant upon the state of 
the brain - & antispasmodic remedies
were exclusively applied to it.
[cross out] but Dr Hamilton has shewn
that it frequently if not always 

 

depends upon irritation arising from 
are overloaded state of the colon & that 
it [cross out] is curable by purgatives. Luis
proved that Scurry was often benefitted
by V.S. & Castre by attention
to the clothing, mind & diet - & cleanliness
of the sailor prevented its 
occurrence. Hysteria is not non 
treated by nervous medicines but 
by operating on the mind & general
attention to the health & habits
of the individual. And in Hypochondriasis 
& Diabetes we meet
present symptoms, & not vaguely
prescribe for theoretical notions
of the nature of these disorders.
We no longer here of Attenuants
Inspissants - & Antiseptic remedies,
for we knew nothing that 
can attenuate the blood but by
dilution - & nothing whatever
that than thicken it, at least
as far as external remedies are
concerned, nor do we believe 

 

in the Antiseptic power of specific
medicines. That [cross out] poisons [cross out] are intire
bad under peculiar circumstances
as the miasmata which give use
to fevers - the infection of small 
pox - measles - scarlatina - & the 
putrid matter received from puncture
in dissection, there can be no 
doubt, but we obviate the effects
of these poisons not by acids - sugar 
- or salts, but by depleting the 
system, & purifying the blood
by draining it, till its secretions
are healthy. So far from regarding
fevers that arise from these source
as [cross out] diseases of position debility,
& treating by stimulants 
tonics & antiseptics, are considered
them as diseases of excitement 
& to be treated accordingly - regarding
the debility as relative to certain
specific effects of the poison 

 

upon the mucous membrane of the 
lungs - & not as arising from any 
putrescency in the blood itself. -
With regard to Diluents Emollients -
& Demulcents we still adhere 
to the old theories & not without
reason. perhaps not from all the 
theoretical views in which they 
were first grounded, but from 
a reasonable faith in their efficacy
& made of action. - Thus diluents
relieve the pain arising from 
the acrimony of the urine, when 
this has become highly concentrated
[cross out] from the inability to swollen liquids,
as in certain cases of Cynanche - or 
spasmodic affections or obstructions 
in the Esophagus -. Emollients
are beneficial not only for the 
relaxing effects of moisture, but
from the heat that accompanies
fomentations & cataplasms & sometimes we 
use medicated fomentations

 

with advantage, as where we combine
narcotic or sedative infusions with 
them. - Demulcents operate not by 
involving acrid substances in a mild
viscid matter & thus render them
inert on the sensible part of our 
bodies, but by sheathing the mucous
membranes against the acrid
excretions which pass along them
in their passage from the body. Thus 
mucilaginous fluids relieve the 
pain of strangury, either by protecting 
the mucous membranes - or by 
diluting the blood & consequently the 
excretions. In Cough they appear 
alone to sheathe the mucous membrane
of the glottis & pharynx, for 
the irritation is allayed before the 
substance can be absorbed to 
act upon the blood.
Antacids & Alkalies I have already
spoken of. The former is 

 

used not only to correct acidity of 
the stomach, & by the neutral compound
formed to act as a laxative 
upon the bowels, but to influence
the nature of the urine, & diminish
its acid properties - so favourable
under certain conditions of the 
system to the formation of the 
lithic Acid Calculi or Gravel. -
Ant alkalies are employed to 
affect the alkaline condition
of the urine alone - & prevent
the formation of the Phosphatous 
Calculi or Gravel - serving for 
no other indication. - 
Now besides these classes of Remedies
that we retain, there are others 
still in use, under which many 
of the articles of the materia medica
rank, & which therefore require
a more detailed consideration.
These are Astringents - Tonics

 

Stimulants & Antispasmodics.
Astringents
were formerly used to fulfill two indications -
to act as tonics - & to restrain
inordinate evacuations. They are only
used for the last at the present day.
It was supposed that many disorders
might arise from relaxation, or from 
that condition of the fibres of the body
in which their density & contraction
were lessened, & astringent substances
were used to corrugate & can dense the 
lax matter of which the fibres were 
composed. Thin action was supposed
to be analogous to that of Astringent
infusions on [cross out] skin, which becomes
more dense tough & indestructible
from its union to the astringent
principle than it was before. But 
this mechanical view of the action
astringents on the body is wholly
inadmissible, in as much as there 
is no evidence that the affections
in which astringents are given 

 

depend upon a mechanical laxity
of the solids, or if there was that a 
process like tanning could go on 
in the living subject. - Debility
was formerly ascribed to this general
relaxation, but we now refer it 
& the relaxation as effects of some 
general cause or causes, & not that 	
the [cross out] relaxation is the cause of the [cross out] debility.
From this view it is probable that 
Astringents can have no action
like that attributed to them, tho'
they are returned as a seperate class 
of medicines, from their power of 
restraining excessive evacuations.-
It is difficult to point out the 
[cross out] nature of their operation. It
is supposed that they operate as slow 
& permanent stimulants, which 
without increasing the force of the 
circulation, give a tone or power of
contraction to the vessels, which 
enables them to resist the impetus
of the blood, whence the evacuation

 

of the Serous or red particles ceases,
or it is supposed that they are capable 
of producing a local corrugating effect
when taken internally, & that this 
is propagated by sympathy to other 
parts. - Their action is more decided
when they can be applied to the part 
on which their corrugating effect
is desired, as in external wounds - in 
Epistaxis - in Hemorrhoids - & in 
chronic inflammations of those 
mucous surfaces which admit 
of astringent injections being applied
to them. -
It is of importance not to 
apply these medicines in cases where 
the discharge is Salutary, or where 
its sudden suppression would 
be attended with injurious effects.
The nature of the diseases in which 
they are applied must therefore be understood,
or if the discharge, which 
is best [cross out] a symptom or effect
of some morbid condition, he
alone treated, dangerous & even 

 

fatal consequences may ensure. In this 
way astringents have been productive
of gout mischief in Diarrhœa,
the discharge of which is 
the principal object of consideration
to the ignorant practitioner,
tho' this is of minor consideration
to the primary cause or its proximate 
effect, which may be either 
offending scybala - or inflammation,
or ulceration, or the sudden shock
of cold upon the surface. In the one
case purgatives, in the others V.S. &
the application of heat would remove
the [cross out] disorder. -
We have astringents medicines both
from the mineral & vegetable kingdoms -
& the most powerful are 
Alum - Kino - * Catechu & Galls. In the 
vegetable astringents we find Tannin
& Gallic Acid - & in the mineral
[cross out] Lead & Sulphuric Acid, in 
Combination with [cross out] oxides, as in 
Alum. Sulphate of Zinc & of Cooper. 

 

The Astringents are 
Sulphuric Acid 
Alum
Sulphate of Zinc 
- of Copper
Acetate of Lead
Catechu
Kino
Galls
Hæmatoxylin 
Quercus pedunculata
Salix Caprea
Krameria triandria 
Tormentilla officinalis
Polyganum Bistorta
Punica Granatum
Rubia Tinctorum
Arbutus unvae ursi 
Rosa Gallica
Swietenia febrifuga.

Astringents 
Ac. Sulp. delut. ♏︎ II-XXX
Alumen - gr X-XX 
Zinci Sulphas - gr I-ij
Cupri Sulphas - gr 1/32 - 1/16
Plumbi Acetas - gr ij - vj.
Acacia Catechu - gr X-XXX
Inf. Cat. compos. - ℥i - ij 
Tinctura Catechu - ʒi - ʒij 
Ptiocarpus Erinacea-gr x-xxx
Tinctura Kino-℥i-℥ij
Querus pedunculata - gr X-XV
Duartom Inerus ℥i - ij
2. Infutoria 
Pulvis Eallarum } externally.
Hæmaloxylin Campechianum
Extract. Hæmatoxyli - gr X-XXX
Arbutus uva ursi - gr X - ʒij
Rosa Gallic
Inf. Ros. Compositum - ℥i - IV
Salix Capraea
Krameria triandria 
Tormentalis officinalis 
Polyganum Bistorta
Rubia Tinctorum
Swietenia febrifuga
Punica Granatum 

Sulphuric Acid is used as an Astringent
in Hemoptysis - after V.S. & blisters - in 
menorrhagia - but especially in the night 
sweats of Phthisis as a palliative, to 
check the inordinate perspiration.
The dose of the dilute acid is X-XI ♏︎ made 
pleasantly acid with water - It should 
be sucked thro' a quill. 
It may be exhibited in the form Inf.
Rosa compositum. to which a few
♏︎ of the dilute Acid may be added, if 
necessary. Dose ℥i - ij.
Alum may be given in doses of X grs
or in the form of whey under by coagulating
a pint of milk with ʒij of 
Alum - of which a wine glass may be 
taken in propose chronic diarrhœa
A saturated solution is used as a 
styptic lotion in hemorrhage - as a 
gargle in Cynanhe - Apthæ - & in relaxation
of the Uvulae. The curd separated
for the whey is used as an astringent
poultice to old ulcers.
Liq. Aluminis Compositus. Alum. S of Zinc āā ℥ gr, B genetin 2 pints is used a lotion
to ulcers - chilblains - &c -

 

Sulphate of Zinc used externally as a callyrium -
& in infections, in the proportion
of about 1 or 2 grs to 1 ℥ of water. Internally
1-11 grs as an Astringent.
Sulphate of Copper is esteemed in America
as highly useful in uterine Hemorrhage
1 1/2 gr dissolved in ℥ of distilled water - &
30 ♏︎ given every 10 or 15 minutes - It probably
operates by its nauseating effect.
It enters into the composition of the 
Aqua Stiptica of Sengeous, made by
dissolving ℥iij of Sulphate of Copper &
Alum in o.ij of water & adding 1 1/2 ℥ of 
Sulp. Acid. It is used externally in 
Epistaxis & hæmorrhagis for wounds.
Acetate of head is used in hæmorrhage 
for the Lungs - bowels & uterus. either
alone or combined with opium - after
V.S. The dose usually recommended
is gr j. but it has been given in much
larger doses, even to the extent of ʒi,
& in dangerous hæmorrhage small doses
will be of little avail. ij - vi grs may
be given & repeated for iij - 6 hours - with
5 gr of Dovers powder. - The antidote
is Sulphate of Magnesia - or of Soda.

*
Quercus pedunculata. The inner bark of the small 
branches of this oak afford a large portion of 
Tannin. 1 ℥ by hixerniation affording 77 grs. - 
Decoction Quercus. 1 ℥ boiled in oij water to oji-
this used as a lotion in hard ulcers & offensive discharges.- 
in injections. The powder of the Bark
has been given on Intermittents for 15 - 20 grs. 

Nauclea Gambir (E2.
Kino & Catechu. for the Pterocarpus erinacea 
&c Acacia Catechu - are two of the most powerful
of the vegetable astringents, consisting
of Tannin & extractive matter. Kino may be 
given in Substance for x - xxx grs - or for ʒi - ij of the 
Tinctures Catechu is preferred, for it contains
half its weight of Tannin. Dose grs X-XX. or 
of the comp. Infusion ℥ss - ℥ij - or of the Tincture
ʒi. ʒij. - The Infus. is used as a wash in spongy
bleeding gums - & a tooth powder is made 
by mixing 1 part of powdered Myrrh - with 
3 parts of Catechu & Cinchona Bark.
Galls
are the vests of a species Cynips - an insect
that infest several of the oaks, & which 
perforates the bark for the purpose of depositing
its egg. A spherical excressence 
ensues from the puncture, which grows 
to the size of a nutmeg & contains the 
larva of the fly. These excressence are galls
The Quercus ceiris - & the 2. infections are 
the oaks which afford them. They contain
Tannin & Gallic Acid. These use 
is principally in the form of Infusion
as gargles - or styptic lotions - or in the form 
of ointment applied to piles. either 1
part of powder of galls to 8 of lard - forming
a simple ointment - or adding to this 
* 1/2 part of powdered opium - ʒi - ij Liq. Pl. Subac. di

 

Hæmatoxylm Campechianum or Logwood.
The extici officinal. & gr x - ʒss, in chronic discharges.
[cross out] Salix Capræa. the bark is astringent & bitter
& the powder may be given for ℈i - ʒj or 
ʒi of the Decoction - made by boiling ℥ij
of the Bark in oij of water to oj -
Krameria triandria - Bark of the root. Rotary
root. Peru. It contains tannin.
Tormentilla officinal. root. gr X-XXX -
of the powder. or ℥i - ℥ij of the Decoction
(℥i rod. water oj. boil to ℥xij & strain)
Polygonum Bristorta. root. - ℈j - ʒi of powder
not used.
Punica Eranatum, Bark of the Fruit of 
the Pomegranate. native of Barbary &
South of Europe. The rind of the fruit
is astringent & has been given in Tania.
Powder ʒss - ℈j -
Rubia Tinctorum. Madden root. slightly
astringent
Rosa Gallica - the petals have a slight 
astringency - & are used in the Inf. Ros. Comp
with Sulphuric Acid. -

 

Arbutus uva ursi, Leaves, a strong astringent
lately used in Nephritic complaints
for ℈j - ℈iij of the powder. It operate probably
by its tonic power - conecting the 
dyspeptic symptoms which accompany
these attacks. 

 

Tonics
are defined to be those substances which 
give firmness & strength to the whole
system & there by to particular parts,
operating not as astringents upon the 
solid fibres, but on the nervous power
existing in them. -
In speaking of astringents I mentioned
that it was difficult to say anything
precisely as to their mode of action
but the difficultly in regard to tonics,
is greater. That they operate beneficially
in some cases there can be no 
doubt, but to say that they operate
on the nervous power existing in the 
fibres is absurd, for there is no thing 
to prove it, & no ingenuity can comprehend,
their effects. - It is merely disguising
are ignorance under a specious
cloak of words, which actually mean
nothing. - 
If we regard Tonics as mild stimulants
their effects may be to excite a more 
vigorous action of the secreting vessels
of the stomach, & produce a more 
copious flow of the gastric juice,

 

& the increased secretion of this important
fluid may give rise to a healthier 
digestion, & consequently to an increase
of strength & vigour. Their stimulus 
may extend to the neighboring parts
& the liver & bowels may be thus 
invigorated. - The morbid condition
of the stomach with regard to acidity
in this view would be corrected by the 
purifying influence of a healthy &
copious flow of gastric juice, &
the uneasy sensations arising from 
acidity would be removed. These 
effects actually appear for the use of 
Tonics in dyspeptic persons, but taken
with all their efficacy they must 
be regarded only as palliatives or 
as aids to other measures on which 
the restoration to health must depend. 
Tonics are given in many cases of 
convalescence from acute diseases
when Nature herself by the gradual
return to healthy functions is restoring
the vigour a substance of the body,
& virtues have been ascribed
to them which properly belong
to the curative powers of nature. 

 

In these cases there is the cessation of pain
& all the concomitants of disease - the 
return of appetite & of sleep - of cheerfulness
of mind - of exercise - of hope
& of happiness, & they are quite sufficient
with a simple diet - & the 
absence of too powerful stimulants
& of the depressing effects of cold
to restore health. That these medicines
do not passes any specific
power is evident from own not 
trusting to them alone - from the 
multitude of similar tonics in use
& form the indifference that is felt
in regard to the employment of any
particular one. It is idle to consider
the febrifuge power of Bark & of 
Arsenic as a tonic power, for we 
might call it by any other name.
We may rank these medicines
among Tonics but we are no wiser
for doing so, forever know nothing
of their mode of action - or of 
the condition of the body on which 
Intermittents depend. No reasoning
would have led us to apply these 

 

remedies is in Ague, & experience alone 
could teach us their specific virtues.
There is no analogy, between Bark &
Arsenic but in the effects they produce, 
& no relation between these solvable
remedies & the other tonics, with 
regard to their power over Intermittent
The common language with respect
to the disease & the remedy is that the 
one is a disease of a debility - & the 
other remedy of tonic power. Now
debility is an abstract word that 
is most vaguely applied, & the condition
if refers to attends all diseases
more or less, but in more is there
the peculiar characteristicks which 
belong to Intermittent fever. Debility
is an effect - & the cause on 
which it depends is as various as 
the diseases it accompanies. We 
remove the effect in removing the 
cause when we discover it, &
where it is hid from us as in Intermittents
we prescribe in the 
dark, tho' experience may track 
us that we prescribe safety & 

x Tonics perceptibly do not increase the 
secretions, but Stimulants by their warm
diffused action often do, as by diaphorese
diuresis - &c -

& surely. Debility attends Dysentery &
Diarrhœa & Consumption & is an effect
of visible causes, the removal of 
which in the former diseases is not 
by tonics - & in the latter is hopeless.
Considering tonics therefore as mild
stimulants, their operation is to be 
referred to the power of exciting the
system locally or generally. They seem
to have a local action, for generally
speaking they do not occasion any marked
excitement. It is probable that 
they act upon the stomach, & by invigorating 
it produce the beneficial
effects usually ascribed to them.
They differ from stimulants in this 
locality of action, at least from the 
most marked stimulants, as Ammonia
& Alcohol - & the spices;
They generally [cross out] possess a remarkable
bitterness, tho' there is a few of 
them that seem to possess this bitterness
combined with an aromatic
quality, holding a middle rank 
between the purely bitter tonics &
the aromatic stimulants - as Ginger, capsicum

 

capsicum- cloves &c.
The diseases in which Tonics are prescribed 
are those of impaired digestion
& of chronic debility - In many cases of nervous
symptoms, dependant upon debility
they are of use, but proper diet
exercise & clothing, & cheerfulness of 
mind are the most essential parts
of the treatment. In convalescence
their use is general, but in the susceptibility
of the body to stimulus
in the exhausted state in which it is 
left after acute diseases, great contain 
is requisite that inflammation
is not rekindled by the injudicious
use of tonics. more deaths occur 
from too full a diet & from improper
stimulation in the state of convalescence
than from the savages of disease. nor 
can the mind be too cautiously
managed in this state, for the Brain
is as susceptible of impressions from 
without - as the body is to stimulants
within. -
Tonics are found in the vegetable &
mineral kingdoms - & the former
maybe classed as Aromatic &c Bitter tonics 

 

Mineral Tonics 
Iron
Liquor Arsenicalis
Subnitras Bismuthi
Oxidum Zinci.
vegetable bitter Tonics
Cinchona
Gentiana Winter
Menispermum palmatum
Quassia excelsa:
" Serriarouha:
Anthenis nabilis
Chironia curtannium:
Meryanthis trifoliata.
[cross out]
vegetable aromatic Tonics
Croton Eleutheria:
Bonplandia Trefoliata:
Inula Helenium:
orange peel.
Lemon peel.
Myrrah.

 

I have already spoken of the mineral
Tonics & most of the vegetable ones, tho'
there are some of the latter which I have 
to notice. I do not consider that Arsenic
& Cinchona have any right to be 
classed with Tonics - but I insert them
here in a Medicine to the general sense 
of the writers on Materia Medica.
In their specific effects in Intermittents
& periodical pains they differ from 
all other remedies & stand alone. -
The Bitter tonics are characterized
by their pure bitterness - & Gentian -
Calumbo - Quassia are the best examples. -
The Aromatic Bitters possess a degree
of stimulating power derived from 
the presence of a volatile oil
Quassia excelsa wood Jamaica
It is of a pale yellowish Colour. Contains
a peculiar bitter principle Quassia
It is one of the best bitters & does not 
excite nausea & oppression as Bark
often does. Inf. Quassia ʒss. macd 2 hours
in o.ss of B'genatin. ℥i - ℥iv twice a day. 

 

Quassia Siniaranba. Bark. S. Am
& Jamaica. - This is the species first employed
by a negro in Guian named Quassia
whence the name of the genus. Stedman
in his ap of Suriman gives his portrait 
It is a mild & not disagreeable bitter
Inf. Siniaranbæ. Bark ℥ss. water o.ss. mac
2 hours & strained ℥i - ℥iv 
Chirsnia centanrium. flowering head
native. Bitter
ulmus Compestrio: the inner Bark.
native. mucilaginous & Bitter
Decoctum Ulmi. ℥iv. Aq. o. iv. boiled to oij
℥ij -o.ss. It is rather demulcent than 
tonic. 
Croton Eleutheria. xv - ʒss of powder
Infusion. ℥i - ℥ij.} It is the Cascarilla.
Tincture. ʒi. ʒij}
Bonplandia Trifoliata
or the Cusparia febrifuga. Angustura
Bark. - South America.
It is bitter & aromatic.
Powder gr 5 - 20
Infus. Cuspariæ. ℥j. ℥iv.
Imla Helenum. root.
not used. - 
End of Lecture 29th.

 

Stimulants
The general operation of all medicines
is that of exciting, either the whole
system, or particular organs, & therefore 
all medicines might be ranked
as stimulants. This excitement have
in many is the primary effect, &
we class medicines generally not 
by their primary but their second-on
effects, The primary effects are 
the impressions or changes made upon
our organs by the direct action of medicines -
& the Secondary effects are the 
phenomena which result from &
are the consequences of these impressions
or changes. Thus vomiting, purging
diaphoresis &c are the consequences
of the impressions made by emetic
Cathartic & diaphoretic medicines,
the primary effects of which was 
to excite the abdominal muscles -
the bowels & skin;.-
In many medicines therefore we do 
not regard their primary effects, but 

 

look solely to their ultimate effects, unless
the former are remarkable & require
consideration from the consequences
that might ensue from them in some
conditions of the body. For instance
in diaphoretic medicines we are cautious 
not to administer those which are 
powerfully stimulant in the condition
of local or general inflammation,
& in diuretic medicines we always 
have regard to the sedative qualities
of some of them lest danger should
ensue from their use - tho' this sedative
effect is not the aim of their 
exhibition, [cross out] so much as the consequences
resulting from it. - In purgatives
likewise we have regard to the degree
of excitement they produce,
tho' we principally look to their 
ultimate effects on the bowels, for 
if the former, especially in the use of 
drastic purgatives, is great, more mischief
may result from it, than advantage
from the latter. -
In this view of the effects of medicines
You will perceive that all of them 
are strictly speaking stimulants  

 

but that we do not regard them so, in 
our common mode of classification
because we overlook this primary
effects, & rank them according to their
secondary effects. For practical
purposes it is convenient to do so,
for no advantage would arise from 
our considering their power of excitement
when this in many cases is 
transitory & unimportant compared
with their peculiar effects. -
But there are some medicines that 
we principally use for their primary 
effects, which one those of excitement, 
& these are denominate stimulants,
for we do not look to their
ultimate effect, partly because we 
exhibit these medicines in such 
doses as are scarcely sufficient
to render these last effects perceptible,
or if they are apparent they are
unimportant in consequences, [cross out]
since the advantage are arrived at 
was obtained [cross out] before they were 
manifested. - Now Alcohol as a 

 

diffusible stimulant is an example
of this kind. A tea spoon full of brandy
in certain conditions of the body will
restore vigour & some life, solely from 
its stimulation, & the quantity necessary
for this effect is too trifling to 
act upon the Brain & produce
intoxication, the ultimate effect of 
this medicine, There are other medicines
which act in this beneficial
manner of producing a general excitement,
& which scarcely produce
any other effects or if they do it is
only by increasing the temperature
of the body - & perhaps augmenting
the cutaneous transpiration - as 
ginger & the spices volatile oils. Now these medicines
we set apart for these specific
medicines which act by giving
rise to the peculiar phenomena
of vomiting - purging - of diminishing
sensibility as Narcotics - & we call 
them from their primary effects
Stimulants. - Tonics & Astringents may 
be regarded as stimulants but 
their action is more local & more 

 

continued than Alcohol - Ether - Ammonia
&c. for these last produce a 
rapid & diffused effect, soon manifested
& in its nature transitory. Their
operation is to increase the force & frequency 
of the hearts action & to augment
the animal temperature. They are 
often called diffusible stimulants
as contra distinguished from the slowly
developed & local & more permanent
effects of Tonics & astringents. They 
produce a remarkable primary
impression, but a trifling secondary
one - The first is the object
to be obtained from their use, &
the second, which often is increase
of temperature & diaphoresis is of 
secondary importance. -
You have examples of the beneficial
effects of this primary effect of 
stimulants in cases of syncope, of 
sudden debility, in congestion of the remarkable
impression made upon the system
by some offending ingesta, & their 
occasional use in chronic debility

 

is attended with happy results. -
Syncope whether produced for affections
of the mind - from impressions made 
upon the organs of sense, as by offensive
odours, or from sudden acute
pain - or from hemorrhage - or V.S.
or as an effect of disease, is relieved
by Stimulants - which rouse the 
quiescent state of the heart - & restore
animation. 
Sudden debility may arise from 
affections of the mind - from a change
of posture in the weak state of 
convalescence from acute diseases, 
& unless a stimulus is given to 
raise the failing power of life
Syncope may come on, & in the 
last case terminate in death.
You have a similar state of debility
from the use of certain
medicines, as digitalis, which reduces
the action of the heart in a remarkable
manner, & gives rise to an alarming
prostration of strength. Nauseate
sometimes in elderly people have 
a similar effect, especially when 

* Congestion. -
offending ingesta.

given as expectorants. From the debility they 
occasion the power of expectorating is last 
& death may ensure for suffocation from 
the making up of the Bronchia. 
*
Stimulants therefore are those substances
which increase the energy of the vital
functions, producing the most marked
effects upon the circulation & thereby
augmenting the animal temperature.
They differ from tonics & astringents
in the rapidity of their action & the 
transition nature of their effects. -
They excite a sense of warmth in the 
stomach - the action of the heart is increased
in frequency & force - the respiration
is accelerated - the animal heat 
rises - the capillary circulation becomes
active - a glow of heat succeeds - the 
colour of the face deepens - the eyes are 
more brilliant - & the mind is excited,
& the general strength augmented. Besides
this general action the skin &
kidnies are excited to an increased
excreting The vegetable stimulants
are their properties to a volatile
oil or resin. 

 

The Stimulants are 
Ammonia. Ether. Alcohol.
Copsicum annuum
Piper nigrum. longum. cubeba
Coves. ginger. Cardamon.
Cinnamon. Nutmeg. Myrtus peniacta
Camphor. volatile oils. Guaiaum. [cross out]
mustard. Horseradish.
L. Sassafras. L. vobilis. Camilla alba.
Acorus Calamus
[cross out] 
Crocus sativum
[cross out] 
Anthemis pyrethrum
[cross out]
Coriandrum sativum

 

Antispasmodics
have been defined to be those medicines
which equalize the nervous energy or 
which controul the increased energy of 
the Brain, either by correcting the excitement
on which it depended or the collapse
which succeeded to the excitement - or 
by obviating the too sudden alternation 
of these states.
Spasm consists in irregular muscular
contraction - alternating with relaxation
& the cause is generally to be found
either from plethora especially of the 
brain - from irritation - & from the 
increase of sensibility & irritability
in cases of extreme debility, & from 
affections of the mind. -
In the one case V.S. is the appropriate
remedy - In the other removing the irritating
cause - as lancing the Gums of Children
expelling worms. In the third stimulants
& in the last in inducing a change
of habit - & of feeling. -
Now these are no medicines forming
a class of Antispasmodics, a giving
together by any natural affinities 

 

capable of fulfilling these indications.
If the energy of the Brain is increased
we must search for the cause & apply
our remedy accordingly. Sometimes a 
state of extreme irritability will occasion
tremors & spasm - as in Delirium tremors -
& either V.S. an Emetic - if seen 
early - or Narcotics if seen late will
effect a cure. Sometimes the irritation
from the pain of nothing - for a spicula if 
bone pressing on the Brain - from 
a foreign substance remaining in a 
[cross out] wound - from the local injury
of a nerve - from the presence of 
worms - from a pressure on the 
brain - will give rise to spasm &
to convulsions - & the remedy must 
depend on the cause.
In some cases the cause is obscure
as in Hysteria & Epilepsy - & it is these 
cases of which specific Antispasmodics
are employed - & for which 
this seperate class of medicines were
instituted. Hysteria was supposed
to depend upon some obscure condition
of the uterine system - & 
the fetid medicines were supposed 

 

to have a specific action upon this 
system - They were supposed to stimulate
the uterus - on the morbid condition
of which the anomalous symptoms
of Hysteria depended. But this 
vague idea - & empirical practice
is exploded - for a powerful impression
on the mind is the most certain
means of correcting the disorder. It
is a subject of extreme difficulty
but it is evident that medicines
have little or no controul over this 
obscure affection. The habits of the 
individual - the diet, exercise - the 
[cross out] functions of the stomach
& bowels must be waked to, & all 
profuse sympathy in the morbid
feelings of the individual must be 
avoided - It is not by the use of what 
are called nervous medicines that 
Hysteria is curable - & therefore the use 
fœtid gums [cross out] is nearly exploded in 
modern practice - They are highly 
stimulant & in many cases do harm 
& alone seldom do good. The best 
Combination is with purgatives - as 
Aloes - especially in deficient action 

 

of the uterus - and bowels - giving rise
to a menorrhœa - to constipation - &
flatus. may frequently the irritation
is to be found in the color - as in Chorea
& in many cases of Hysteria.
The classes of Antispasmodics therefore
should be abolished - & the fetid
medicines ranked under stimulants
for in practice we find that under
this head of Antispasmodics - if the 
Class is to be retained would rank
V.S. - Narcotics - purgatives - Stimulants.
& surgical operations. -
Ether. 
Camphor } stimulants
Opium - Narcotics
Assafœtida 
Galbanum 
Sagapenum 
Ammoniac 
Opaponax 
valerian 
Rue 
Musk 
Castor 
Oil of Amber } fœtids.

 

Lect. XXX.
Having in my previous Lectures finished
the history of the Articles of the Materia
Medica, I have now to call your attention
to one of the most difficult
subjects connected with Medicine. viz
that of Poisons.
There is no part of Physic which requires
such precise knowledge of the nature &
the [cross out] impressions of diseases - of the nature &
effects of those substances which have 
a deleterious action on the body - & of 
the application of the laws of Chemistry
to the investigation of the character
of these substances, as that which 
relates to Poisons. -
The chief difficulty lies in discriminating
between the symptoms & effects
of diseases that arise spontaneously
in the body, & the symptoms & effects
which arise from poisons - & in the 
detection of Poisonous substances in 
the solids or fluids rejected from or 

 

contained in the body. -
If a person in the enjoyment of his ordinary
health is suddenly seized with violent
pain - vomiting - copious evacuations - convulsions -
or with vertigo - delirium - coma
& he dies in a short time, a suspicion
naturally arises that he has been poisoned,
Yet all these symptoms may be the 
[cross out] result of a sudden supervention of 
a spontaneous disease. - The appearances
on dissection may be sufficient fully
to amount for the symptoms & the death;
or they may be equivocal - & if they are 
so marked as to amount for the fatal
termination - the question arises whether
they are the results of disease or poison.
You examine every thing found in the 
body, & detect nothing of a poisonous
nature - The history of the case leads to 
no suspicion of poison [cross out] having been taken by the 
individual - or having been administered
by design by another - & the decision is that 
the death was natural. And yet notwithstanding
all this scrutiny perhaps
Poison was the cause. - 

 

Before therefore entering into the detail
of the history of Poisons it will be necessary
to call your attention to some of those diseases
which give rise to symptoms, resembling 
those produced by poisons - or which might 
be confounded with them. 
The subject therefore is naturally divisible
into
1. Certain disorders or diseases - the symptoms
& effects of which may be confounded
with those of Poisons.
2. The History of Poisons - arranged in 4 classes
1 Irritating Poisons
2 Narcotic - "
3 Acrid Narcotic "
4. Septic - "
The effects of [cross out] Poisons generally may be 
said to be either inflammation of the 
parts they came in contact with producing
death by the local injury & the sympathetic
effect resulting from it on 
the nervous system - or no inflammation
occurring, an effect being directly
produced on the nervous system by the 
absorption of the Poison into the 

 

blood, destroying life either by its effect on the 
Brain or Spinal cord, or thro' the Brain on the Lungs & Heart.
The Irritating poisons excite inflammation
& the Narcotic operate on the Nervous
system. The Acrid Narcotic operate in 
both ways at once - & the Septic give rise 
to a specific fever - operating like other
depressants on peculiar structures - at least 
this is the case with putrid animal 
matter, absorbed into the blood in dissection -
or from the puncture of a foul
lancet. - or from the accidental contact 
of morbid matter.
With regard to the disorders which produce 
symptoms that may be mistaken for 
those arising from poison may be first 
enumerated those which proceed from 
thy peculiar idiocyncrasies of same
persons. It is remarkable that from 
some individual peculiarity, not 
easily to be explained, substances in
themselves harmless to most persons,
will in others produce sudden & alarming
effects - as pain. Sickness - 
loss of power & syncope. - These apparently 

 

natural aversions are generally known to the 
Individual & to his friends - & the substances
exciting these Symptoms are avoided. -
Some cannot bear cheese - eggs. milk - &
certain odours - You should always
therefore inquire in to the feelings, habits
& idiosyncrasies of individuals. -
Indigestion arising either from mental
or physical causes, frequently gives rise 
to the most alarming symptoms. -
A sudden acute pain with nausea &
vomiting, or a complete sinking of the 
vital powers sometimes ensues from 
eating the simplest articles of food.
From some inexplicable condition
of the system these generally inert substances
prove the source of a peculiar 
irritation - operating either on the nerves
of the stomach as an irritant - the effect
being propagated to the brain - or occasioning 
some sudden change in the 
blood, by imparting to it thro' absorption
a subtle poison. A piece of pork
of Sausage - cold pudding high seasoned food - taken
especially at night. have given rise to 

 

these alarming Symptoms - & unless prompt
relief is afforded the patient may die in 
a short time from the shock communicated
to the nervous System. In these cases
You find the pulse slow - & the skin cool
& a diffusible stimulant - as brandy - or 
an emetic will rapidly restore the person 
to health. - These attacks came on 
soon after taking food, & generally
when the body is exhausted by fatigue
watching or anxiety. - You have not 
the usual concomitant symptoms of 
poisoning, & the sudden restoration to 
health is inconsistent with the idea 
of any poisonous substance having been 
taken. violent exercise after a full
meal - strong mental emotions before
or after a meal will cause indigestion.
The food remains unacted upon in the 
stomach - proves an irritant - excites 
pain - nausea, retching & a sense of faintness.
All these symptoms disappear
often the operation of an emetic - & the 
history of the case & its sudden termination
explains its nature. - 
 

 

In a weakened condition of the body, as in 
the state of convalescence from fever, a 
full meal after long continued abstinence
often gives rise to these alarming 
symptoms, & death is frequently the consequence.
In these cases patients are 
perhaps taking medicines, & some doubts
may arise as to the cause. You must 
remember that in this condition nothing 
is more common than sudden death
from too full a diet - or from indigestible
food even in small quantities - but 
you should make inquiries as to the 
kind of medicine the patient was taking 
& the history of the case will generally
explain its nature, especially if You 
cannot detect any thing of a poisonous 
nature in the contents of the stomach
& bowels - or any morbid alterations in 
those parts.- 
Death in these cases more sudden than from 
poisons, except Prussic Acid. odour shews it.
or Digitalis. -
In this state of debility in the stage of 
convalescence persons frequently die from 
resuming too soon the erect posture -
or the same thing occurs when a person 
gets up who is debilitated by disease.
A sudden demand is made upon the 

 

heart - its action becomes hurried & irregular
syncope comes on - & unless the patient is 
immediately lain prostrate Le dies. -
Drinking cold water in very hot weather
after fatigue, often causes irritant death.
A cold bath after long continued fatigue
& profuse perspiration, operates as a powerful
depressant, & the individual
may sink either under the form of the 
extreme variety of congestive fever in a 
that time - or die after a longer or shorter
period from the inflammatory fever
supervening to the congestion. In all these 
cases You must trace the history of 
the case, & this history taken in conjunction
with the absence of all evidence
of poison will explain their true nature
The Symptoms which are produced by 
the irritating poisons, viz inflammation
purging - vomiting - convulsions - cramps
&c resemble in some respects those 
proceeding from cholera morbus - colic 
diarrhœa - & the sudden supervention
of inflammation of the intestines & peritoneum
in cases of perforations of the 

 

Stomach - bowels - of hernia - intussusceptio -
ileus - alvine concretions -
Cholera is generally prevalent in Summer
towards August & September - but does 
occur tho' more rarely at other seasons. It 
may arise from a sudden gush of acrid
bile which proving an irritant to the 
stomach & bowels causes a vomiting & 
purging of bilious matter - great pain -
cramps & a sudden sinking of the 
vital powers. Copious diluents to sheath
the mucous membranes from the acrimony
of the bile - injections of mucilaginous
fluids into the rectum - will generally
relieve this form of the complaint, &
diffusible stimulants as opium under the sudden 
collapse which sometimes rapidly follows
the copious evacuations will restore the 
sinking powers of life. 
In the extreme form of Cholera arising
from a sudden congestion of the Liver &
its associate veins the vomiting & purging
is of a thin fluid like rice water. The skin 
is cold - the pulse small & feeble - & cramps 
invade different parts of the body.

 

This variety is sometimes fatal in a few 
hours, but life may be saved by restoring
the animal heat by the use of the hot air 
bath - & the free administration of opium
& brandy. -
Colic arises from different causes. from 
acrid matter contained in the intestinal 
canal, from inflammation, & from -
the long continued exposure to the fumes
of substances impregnated with lead or to 
the handling that metal - as occurs in those 
who gave their livelihood by the working 
that metal. - This last form of Colic
is familiar to you under the warm of 
Colica pictorum [cross out]
The other forms of Colic
are generally easily distinguished by the 
history of the case, by the absence of 
the concomitant symptoms of poisoning
& of the evidence of the actual detection
of any poisonous ingredient
Diarrhœa may arise from inflammation
of the mucous membranes, especially
of the large intestines - from 
acrid matter contained in the bowels, 

 

especially from retention of fœces in the colour 
or from indigestible food, or from a sudden
chill, arising from wet feet, or exposure to 
cold & damp after free exercise -
When Diarrhœa arises from inflammation
it generally begins gradually - the stools are at 
first mucous, (if the small intestines are 
inflamed) a dark coloured & offensive if 
the inflammation is at the commencement
of the Colour. Now in the case of 
the irritating poisons, especially if they are 
in large quantity, the symptoms are at 
once severe & a purging of blood takes place.
In the spontaneous disease the inflammation 
has generally succeeded to a chronic 
disorder & is limited in extent, but in 
cases of poisoning the attack is sudden,
is referable to something taken - & the 
inflammation frequently extend through 
out the alimentary canal. -
A fatal form of Diarrhœa however often 
arises from the injudicious use of medicines -
& amounts to actuals poisoning.
You see this in the empirical use of 
Tartar emetic - given in nauseating doses,
in that of Colchicum, & the acrid purgatives. -
Dysentery is a form of Diarrhœa,
indicated by shiny bloody stools 

 

tormina & tenesmus, & arises from inflammation
of the mucous membrane of the 
middle & lower portion of the colour. This 
disease prevails sometimes epidemically
& would seem to arise from some atmospherical
distemperature - for in certain
situations many individuals are seized
with it at the same time. It is often
accompanied with the symptoms of ague 
& often the two diseases prevail at the 
same time - some being seized with ague
or intermittent fever - & others with Dysentery. -
One of the characteristic marks
of Dysentery is besides the tormina & tenesmus,
the appearance of Scybala with scanty
evacuations - & the relief experienced by 
the passage of the stools. It is relieved
by opium - bleeding - the warm baths,
Ipecacuanha - & the history of the case
explains its nature. -
violent symptoms arise from those 
diseases turned intussusceptio - ileus, 
& from alvine concretions - from stricture
of the rectum - but I need not enter
into particulars respecting them as 
the examination after death will
generally explain their true nature.
There is generally the absence of 

 

purging in these cases, unlike the effects of 
the irritating poisons. In Ileus there is vomiting
of fecal matter - & in alvine concretion
there is the evidence of a local tumour.
while in all there is the absence of all 
evidence of a poisonous substance, either
in the matter vomited - or in the contents of 
the Bowels after death.
Perforations of the stomach or Bowels also
give rise to sudden & fatal symptoms.
These perforations sometimes appear to take 
place suddenly from some obscure condition
of the Solids or fluids - at others they are the 
result of ulceration, proceeding from a 
chronic inflammation of the mucous
membrane of the stomach & bowels,
They occur not use frequently in young
children who have been weaned suddenly.
& in these cases there is found one
or more perforations in the stomach, the 
contents of which have escaped into
the abdomen & given rise to inflammation
of the peritoneum & death - In 
all cases of perforation whether of the 
stomach & bowels the symptoms of 
abdominal inflammation are 
sudden & acute & death takes place 

 

in 24 or 48 hours - On examination of the body
You find the traces of extensive inflammation
in the peritoneum - & no evidence of 
any poisonous substance in the Solids or 
fluids. In the stomach of young children
there appears a peculiar pulpiness & softening
of the edges of the peroration. In other 
cases, where ulceration has been the cause
You find generally one or more ulcers
in the vicinity of the perforation - & 
no traces of extensive inflammation 
along the mucous membrane, as would 
be the case if the perforation was referable 
to the action of a corrosive
poison.
Certain organic diseases as cancer of the 
pylorus - stricture of the rectum - ulceration
proceeding from the sticking of a gall
stone or an alvine concretion - or the 
presence of a foreign body may give
rise to inflammation - ulceration &
erosion & in these cases You have the 
evidences of the Cause distinct on 
dissection. -
Apoplexy - sudden coma - Hydrocephalus
in its most acute form may give 
rise from the sudden & alarming 

 

symptoms to the idea of their being excited
by some narcotic poison - You may generally
detect opium when given in large
quantities & Prussic Acid by the smell,
but in children opium in my small
quantities will produce coma & convulsions
In these Hydrocephalus in its acute form
generally supervenes to a chronic disorder
of the stomach & bowels - & coma may 
arise for the presence of offending ingesta - to 
the shock of cold acting as a depressant
& inducing a state of congestion of the 
Brain. Sometimes the acute symptoms 
of inflammation of the Brain - or coma
or convulsions - or delirium suddenly supervene
to an insidious chronic inflammation
of the Brain or its membranes arising
from a blow. The accident may have 
occurred months or even years previous to 
these acute symptoms - & in all such cases
You must trace the history with great 
care - for the detection of vegetable poisons
is more difficult than that of mineral
poisons. -
I have briefly called Your 
attention to the consideration of these 

 

disorders & diseases because the symptoms
they are characterized by are like those produced 
by the irritating - corrosive or narcotic
poisons. In all cases therefore of sudden
& alarming indisposition you are to bear 
in mind these different affections - & if 
nothing can be learned from the history
of the case to justify the suspicion of 
poison, & especially if nothing of a poisonous 
nature can be detected in the food or 
medicine of the sick person - or in the matter
vomited or passed by stool, however equivocal
the case may be you will be justified 
in referring the sickness or death 
to natural causes.
In all of these cases you must inquire into
the strength - previous condition of the patient
as to health - circumstances - feelings & pursuits,
& all offending ingesta must be accurately
examined. - Sometimes death takes place
by poison accidentally administered as from 
a mistake in giving a medicine internally,
that was meant for external application
or form a misconception as to the amount 
of medicine to be taken
Archbishop of Dublin. Sulphate of Quinine. 

 

Sometimes the most harmless substances will
give rise to the most alarming symptoms &
at others the most corrosive poisons will
produce fatal effects with no previous
suffering. - Morgagni mentions the case of a 
female who had eaten a paste made of Arsenic
& milk that had been made for rats,
& she died in 12 hours without having suffered
any severe pains - & yet the stomach was 
found eroded. The mineral [cross out] Acid have 
been swallowed to the amount of 1-2 ℥ &
death has occurred without any of the 
previous suffering usually resulting from
them.
It is the duty of a medical man 
to attend to every particular connected
with a case of poisoning, or where a suspicion
of poison arises. Every thing associated
with the patient should be secured for 
future accurate examination. The Kitchen
utensils - phials. Boxes - papers balding
powders - the matter vomited or passed
by stools - or that is found in the stomach
bowels - or cavity of the Abdomen - & even
the whole Alimentary Canal itself
should be secured for examination,
& the analysis of these substances should 
be entrusted to some are perfectly 

 

Competent to the task. Truth alone at whatever
cost, should influence the decision of a medical
man, as these cases because matters
of public notoriety, - & are liable to be 
investigated by a jury. - 
A Poison may be defined to be a Substance 
which impairs the health or destroys
life, taken internally or applied to the 
surface of the body.
The 3 Kingdoms of nature furnish poisons,
You have examples of mineral poisons
in Arsenic. corrosive sublimate & lead &c
- of vegetable poisons in opium. Digitalis
Colchicum & Hemlock - & - of animal
poisons in the putrid animal [cross out] matter
derived from dead bodies in dissection -
& the poisons of serpents. -
It is necessary to make an artificial
classification of poisons, for the greater
facility of understanding their symptoms
& effects - but I know of no arrangement
that is not objectionable. -
They formerly were classed under the 
heads of Animal - mineral & vegetable
poisons - but many of the mineral 

 

poisons act like some of the vegetable -  therefore
the best arrangement is that founded
on their effects. It is an approximation
to truth, tho' the exceptions are numerous 
under some of the heads. -
Vicat first suggested the idea of class in 
them in this way - & Orfila who has paid 
the most attention to the effects of poisons
adapts his arrangement. - He makes 4 
classes. -
1. Irritating or corrosive poisons. including
mineral substances & the acrid vegetables
the principal effects of which are an 
inflammation of the parts they Come 
in contact with, & more or less of disorganization 
of these parts; producing
death by the local injury they occasion.
2. Narcotic poisons including those vegetable
substances which do not act on 
the parts to which they are applied 
but which are absorbed & act on the 
Brain & nervous system. -
3. Acrid narcotics - including those vegetable
substances the action of which is partly
that of exciting inflammation of the 
parts to which they are applied, & 

 

of acting on the Brain & nervous system.
4. Septic poisons - including putrid animal 
matter which gives rise to a specific
fever - & those poisonous fluids furnished
by certain animals, - which taint the mass
of the blood & produce specific effects
on different strictures. -
Poisons act with greater rapidity in the state
of minute division - thus fluids act with 
greater intensity than solid substances. &
those solids which vary in solubility, vary 
in the intensity of their effect. All are more 
active when the intestinal canal is empty.
When we wish to obtain the effects of 
opium immediately are prefer the Tincture
to the powder, because it is more readily
absorbed, being in a state of minute division. - 
The proximate principles of opium
being, when obtained pure, insoluble
produces no effects in large doses - but 
when we combine these principle with 
An acid we obtain a soluble Compound
& one that must be administered in Small 
doses - We give the Liq. Arsenicalis after
a slight meal, that the action of this powerful
medicine may be moderated by the 
presence of food in the stomach. 

 

The Irritating poisons act immediately on the 
parts to which they are applied. This is most 
evident in those corrosive substances which 
destroy the organization of the external parts to 
which we apply them as the strong Acids &
the pure Alcolics. - This Acrid Narcotics also 
act in this way immediately - but they also
act, thro' absorption, like the Narcotic &
Septic poisons on the Nervous System &
peculiar structures. -
The evidence of the absorption of poisons is 
derived from the observation of their effects.
If you apply a poisonous substance to 
the subcutaneous tissue. & it produces a
local effect, & the animal dies - & you find 
peculiar traces of diseased action in the heart - lung
or alimentary canal You infer that the 
poison was absorbed into the blood - &
that it occasioned the morbid appearances
You discovered. You will be confirmed
in this conclusion if you apply the same 
substance to other structures - & find the 
same effects, only the more rapidly
induced, the greater power of absorption there 
is in the part to which the poison
was applied. - on the contrary if the 
poison so applied produces local & immediate
& not general & remote effects you 

 

would infer that absorption had not taken place.
I shall first notice the particular poisons under
each of the heads I have enumerated, pointing
out thru physical character - the symptoms
& effects to which they give rise - the Antidotes
& treatment proper for each & the 
tests for their detection - [cross out]
[cross out] 
I shall begin with the Irritating poisons
under this head are classed substances
which generally agree in the effects they 
produce, but some of them produce peculiar
effects, & these I shall notice when I 
speak of the particular poisons. -
Irritating, acrid, or corrosive Poisons, are 
those substances which excite an irritation
or inflammation of the parts to 
which they are applied, which may 
terminate in ulceration, erosion - gangrene
& death, arising from the local injury
& the Sympathetic effects produced by 
this on the Brain & nervous system. -
Under this head are included the 
mineral & the vegetable Acids 
Alkalies.
Lime.
Nitre.

 

Mineral Acids.
The Sulphuric. Nitric. & Muriatric Acids have
all occasioned death, either having been taken
by design or this mistake. 
The symptoms they give rise to are an acid
burning taste - intense heat in the throat &
stomach - violent pains in the same parts
vomiting of a bloody matter, which effervesces
on lime stone or marble, & reddens
litmus - bloody stools - violent colic - quick
irregular pulse - thirst - cold shivering
coldness of the [cross out] surface & extremities
difficulty of passing urine, jactitation
convulsions - prostration of strength - a 
sunk countenance - but the intellectual
faculties remain entire till death. -
Generally the inside of the mouth & lips
are thickened & as it mere burnt with black 
or white spots, which seperate & give rise 
to great irritation - a painful cough
the voice is changed, & sometimes a painful
eruption takes place on the skin.
The effects of these acids are inflammation
of the mucous membrane more or 
less intense for the mouth to the rectum
sometimes slight where the poison has 
passed rapidly as in the pharynx & esophagus

 

& small intestines. In the stomach the inflammation
is intense - with dark spots of blood extravasated
in the submucous tissue - eschars - ulceration
& erosion - The membranes are either  
thickened in some places or reduced to pulp
in others, so as easily to be detached. -
Death in these cases is the result of the inflammation -
& the sympathetic effect
produced on the Brain & nervous system.
If the acids are applied externally they act
as caustics, producing effects similar
to burns, destroying the parts they are in 
contact with - & not end on giving life
unless the local injury is so extensive as 
to prove fatal by the shock communicated
to the system - as in extensive burns.
The nitric Acid in addition to the symptoms 
above mentioned stains the parts
it comes in contact with of a yellow or lemon
colour, especially the lips & chin - & the 
hands of the patient, if the matter vomited
has touched these parts - Orfila remarks
that this lemon tinge does not always take 
place on the mucous membranes from this 
Acid - that it sometimes is observable 
in the duodenum for the other acids - & that 
then it arises from a decomposition of 
the bile, the yellow matter of which fluid 

* Sulp. Acid charrs veg. matter for its great affinity for 
water. It attracts to itself the Hyd. & oxy. of the vegetable
& leaves the Carbon naked. 

is deposited on the mucous membrane.
now the evidence of the poison in all cases is 
to be derived from the history of the Case
the symptoms manifested - during life,
the morbid alterations which are discovered
after death - & the detection of the 
poisonous substance either in the vessel
from which it was taken - in the food 
or in the matter vomited or passed by stool
or in the fluids found in the stomach 
the intestines - or the cavity of the Abdomen. -
Suppose the Sulphuric Acid had been 
the cause of death. - If any portion
of remained in a cup or Phial You 
would recognise it by its oils consistency,
its great sp. gr. By its charring vegetable. [cross out]
x-[cross out] matter, its strong acid taste
its effects on veg. colours - & by its affording 
Sulphurous Acid when boiled with 
charcoal [cross out] or mercury, which decompose
the Acid by uniting with a portion of 
its oxygen - whence the evolution of  
the remainder in the form of Sulphurous
Acid. - If the Acid swallowed
was a weak acid you have only to 

* Sulp. Acid poured in a solution of Acetate of Lead [illegible]
an abundant precipitate of insoluble Sulphate of [illegible]

concentrate it by boiling to produce these
effects. - or you may pour a portion of 
it into a solution of a salt of Barytes
& You have an insoluble Sulphate of Barytes
found - which will not dissolve in 
* water or Nitric Acid. -
If the Acid cannot be detected in its pure
state in any vessel - & is suspected to exist 
in the matter vomited - or passed by stool
or in the contents of the Intestinal canal 
or abdomen. - You must saturate one part of 
the fluid obtained with Carbonate
of Lime, Sulphate of Lime will fall.
Collect this on a filter - on one part
of it pour boiling distilled water which 
will dissolve it - & add to the solution
muriate of Barytes dissolved in distilled 
water - You will obtain a white 
precipitate of Sulphate of Barytes
insoluble in water & nitric Acid.
Take the other portion of Sulphate
of Lime, & mix it with 1/4th its weight
of Powdered Charcoal, & calcine the 
mixture for 2 hours in an earthern
crucible. The Sulphate will be decomposed,
& a Sulphuret of Lime formed -
If you add this to water acidulated 

 

with nitric or muriatic Acids You get 
an evaluation of Sulphuretted Hydrogen, apparent
by the peculiar odour of this Gas like 
that of rotten eggs. -
The treatment in cases of poisoning
by Sulp. Acid consists in administering 
Calcined Magnesia in large quantity.
If this is not at hand soap & water
or cold water in large quantities &
mucilaginous drinks. The inflammation
must be treated on the 
Common Principles - by V.S. leeches.
Nitric Acid may be Known by its peculiar
odour & by its staining the cuticle
yellow - & by its giving off nitrous oxide
gas (which uniting with the oxygen of 
the air is connected into Nitrous Acid
Known by its red fumes) when Copper
Zinc - iron - or powdered Charcoal is added
to it.
If the Acid is weak saturate it with 
Subcarbonate of Potash - evaporate
& you obtain Nitre
Pour a Portion of the Nitric Acid on

 

Copper filings - a brisk effervescence takes 
place of the orange coloured fumes - arising
from the decomposition of a portion of the 
Acid. Nitric oxide gas is given off which 
unites with the oxygen of the air & is converted
into Nitrous Acid. Known by the 
deep orange fumes. You have remaining 
a nitrate of Copper in solution of 
a green colour, which passes eventually
to a blue. The Copper having been 
oxidated at the expense of a portion
of the nitric Acid, unites with form 
of oxide with the undecomposed portion
of the Acid - & forms a Nitrate of Copper.
The green colour of this solution depends
on the presence of a portion of the 
nitric oxide in it, & the green disappears
as the nitric oxide gas is disengaged.
& the blue is manifested. -
(The nitric oxide in union with 
the nitric Acid or with the Acid Nitrates
of Metals, under certain circumstances
gives them a greenish Colour, by converting 
a part of the Nitric Acid
into a greenish nitrous Acid.)

 

Nitric Acid is Known by the peculiar salts
it forms with Potash. Soda. Barytes
& Strontium. - When the Nitrates of these 
oxides are thrown on live coals, a rapid
increase of combustion takes place with 
an evaluation of heat & light, & a sudden
expansion attended with raise & explosion
mixed with sulphur & thrown on a 
hot amicable, an intense ignition is 
the consequence. These effects depend
upon the instantaneous decomposition
of the salts, which in part their 
oxygen to the Charcoal & sulphur,
quicken their combustion, while 
a great quantity of gaseous matter
is liberated. -
If no Pure nitric Acid can be 
obtained from the vessel out of which 
it was taken by the patient You
must search for it in the matter
vomited - or in the contents of the stomach
& bowels or Abdomen. - Collect
these fluids & strain them - & test
them with Litmus - with Copper filings
& with Potash. If Nitric Acid be 

 

Present the Litmus will be reddened - the
Copper filings with cause an evolution 
of Nitric oxide, which will pass of in 
the form of the red fumes of Nitrous Acid,
& the Potash will on evaporation afford
Nitre. -
If the Acid in these fluids is so weak
from the large portion of water combined 
with it You must boil them
with the Copper filings - & in this 
way the Acid will be concentrated -
& thus decomposed. -
If these fluids afford no traces of the
Nitric Acid, take the solid matter
found in the stomach or intestines -
& the detached peices of mucous membrane 
- put them into a phial
& boil them for 3/4 of an hour in a 
solution of pure potash. The liquid
will be of a red Colour - filter - &
evaporate. Boil the residuum in 
rectified spirit. The spirit will
take up the excess of potash & the Animal
matter - & You will have remaining 

 

reaming Nitrate of Potash - which will 
be a proof of the presence of Nitric
Acid.
You will recollect as an additional
Proof of the poisoning of Nitric Acid
is the Yellow lemon stain it leaves
on the Cuticle - especially about 
the lips chin & hand of the patient.
The mucous membrane
is often converted into a fatty matter
& stained of a Yellow colour.
The treatment in cases of Poisoning by 
Nitric Acid is the exhibition of Calcined
Magnesia. - Where this cannot
be had soap & water - chalk. -
Demulcents must be given - such
as mucilage of gum arabic. milk
Linseed tea in great quantity. -
Inflammation treated on common 
Principles. -
This Acid is the one most commonly
employed for the purposes of seed destructive. - 

 

Muriatric Acid may be Known by its 
transparency, & by the white vapour it gives
off on exposure to the air. If exposed to 
heat it gives off muriatric Acid Gas, of a 
peculiar pungent odour, which is rapidly
absorbed by water, & which on exposure
to the air forms white vapour, arising
from this Acid having a strong affinity
for water, whether in a gaseous or liquid
state: & the white fumes depend upon
its attraction the aqueous vapour always
existing in the air. -
Heated with the Black oxide of Manganese
it is decomposed - & chlorine is 
given off, Known by its Yellow Colour.
With Potash, Soda & Barytes this Acid
favors Salts, which when added in 
Solution to a Solution of nitrate of 
silver cause a white curd by precipitate
of Chloride of Silver - soluble in liquid
Ammonia but not in Nitric Acid.
The Supernatural liquor contains Nitrates 
of Potash - Soda or Barytes in 
solution. -
The symptoms & morbid alterations produced
by this Acid are like those of the 
Sulphuric & Nitric Acids, excepting that 

 

the lemon tint peculiar to the Nitric Acid
is absent. -
If the muriatic Acid is suspected in the 
fluid vomited or in that found in the 
stomach or Bowels, the liquid must 
be subjected to distillation. Muriatic
Acid gas will rise & be received in the 
receiver - Test the product of the distillation
with Litmus & Nitrate of Silver, 
& if muriatic Acid be present the 
Litmus will be reddened - & chloride 
of Silver formed. This chloride is soluble
in liquid Ammonia - but not 
in Nitric Acid. -
If the Muriatic Acid is suspected in 
the Solid matter vomited or formed
in this [cross out] Stomach or Bowels, its 
presence may be detected by boiling 
these solid substances with pure
potash & distilled water for 3/4 of an 
hour. Strain - & add to the liquor 
a Solution of Nitrate of Silver - & if 
muriatic Acid was present an insoluble
Chloride of Silver will fall.
The best antidotes for this Acid are 
calcined Magnesia & soap & water - administ-

* You will recollect that the best application
in all cases in Calcined Magnesia
Suspended in water - or large draughts of 
soap & water - or if these cannot be 
procured chalk & water. Carbonate of 
Magnesia may be used - but the evaluation
of Carbonic Acid distends the stomach
& therefore pure magnesia is best.
Opium may be given freely to ally excessive
vomiting, after the poison has 
been neutralized & vomited up. Heat
fomentations to the Abdomen - &
the hot Bath are useful. 

freely copious mucilaginous liquid - or 
tepid water. -
The symptoms & effects produced by 
these Mineral Acids are sufficiently
distinct, & the mode of their detection
easy. The inflammation they excite
is intense. If the patient obtains
relief before the corrosive poison 
has destroyed the texture of the parts
to which it has been applied,
the inflammation excited is to 
be treated upon the ordinary principles -
by V.S. if the fever is high 
or by Leeches to the throat & Epigastrium
as occasion may require.
* In these cases where life has been 
saved the individual has been 
unable to Swallow for a longer
or shorter period from the injury
done to the fauces & Pharynx. In 
these cases life has been Sustained
by infections of nutritious fluids.
In many cases the voice has never 

 

recovered its usual tone, & difficulty
of breathing, speaking & deglutition
remain thro' life. - In these cases the 
Epiglottis is found indurated, & contracted
so as not to shut the glottis.
Marasmus - followed by dropsy eventually
destroy the life of the sufferer. -
Some remarkable anomalous Cases 
are on record, of death from these Acids,
taking place without pain - & yet
the stomach has been found eroded.
A woman confessed that she had 
swallowed Nitric Acid, but she appeared
so little affected by it that 
she was not credited. Nothing was
apparent in her symptoms but 
a small weak pulse & prostration
of strength, & she was supposed to 
labour under Typhus. She died 
the next day - & the stomach was 
found eroded - & stained of a Yellow
Colour. -
The Nitric Acid has been
most commonly resorted to by suicides.
Tartra gives an account of 56 Cases 

 

of Poisoning by this Acid, 19 of which 
were fatal from the immediate effects.
When it is much diluted so as not
directly to dissolve the mucous membrane
that pains are excessive - a dreadful
colic Supervenes with Costiveness. The 
Abdomen is tense - there is a copious
flow of saliva for the mouth - & the 
mucous membrane is eventually detached
& vomited up in a sphacelated
state. Excessive emaciation ensues
& death occurs from a few weeks
to some months or even Years.
The Stomach in these cases is found
contracted, & the Intestines are sometimes
not larger in diameter
than a quill. The pylorus will
only admit a small probe. The 
mucous membrane in some 
places seems newly formed, but 
less villous than natural. Adhesions
between the stomach & the adjacent
viscera are sometimes found & on 
detaching it small perforations
on its coats are discovered. 

 

Alkalies
The effects of the Alkalies in large doses, pure
or combined with Carbonic Acid are similar
to those of the mineral Acids
Potash applied externally is caustic - & its 
effects are similar if taken internally.
The Subcarbonate taken to the extent of ℥ss
was fatal to 2 girls - aged 16 - & 12. - violent
vomiting with pain at the Epigastrium
were the prominent symptoms. These were 
subdued, but death occurred in one case 
in 2 months & in the other in 3 from the 
injury done to the stomach - which in 
both instances was found thickened &
mucous Coat almost wholly destroyed.
The Pylous was ulcerated - & the intestines
glued together from lymph effused on their 
peritoneal coat
Soda has similar effects to Potash.
Liquid Ammonia is highly pungent & caustic.
When too freely inspired in Cases of syncope
it has caused inflammation of the air 
passages & lungs. -
Orfila relates a fatal case where it was 

 

applied by a servant to his master who was 
suddenly seized with the usual symptoms
of Epilepsy. The servant observing a battle
on the chimney piece & supposing it was 
what his master usually applied, dipped
the corner of a Hke in the fluid & applied
it to the nostrils & mouth of his master.
Death took place in about 24 hours with 
appearances on dissection of a most acute
inflammation of the mucous membrane
of the Larynx & bronchia - similar to that 
of an acute attack of cramp. - Traces of inflammation
were found also in the 
esophagus - stomach & jejunum -
Huxham & Haller report cases where 
death took place in a few minutes - hemorrhage
from the nose & intestines taking
place & the parts to which the Ammonia
was applied being as it were cauterized.
The Alkalies are distinguishable by their
styptic & urinous taste - by the matter
vomited affecting vegetable blue colours, changing
them to green - [cross out] & restoring the blue
when reddened previously by an acid.
Potash is distinguishable from Soda  

 

by being precipitated of a light Yellow by 
the Nitro muriate of Platinum.
Ammonia is recognized by its pungent
volatile odour -
The treatment Consists in administering
vinegar or lemon juice - & treating the inflammation
on common principles. -

 

 

 

 

 

 

 

 

 

 

 

Lect. XXXI.
Irritating Poisons contd
The Irritating poisons I have already called
your attention to operate by their direct
effect on the parts to which they [cross out] are
applied, & occasion death by the local
injury to the alimentary canal &
[cross out] by the sympathetic effect produced
by this injury on the nervous system.
These poisons, viz the mineral Acids, the 
Sulphuric - the Nitric & the muriatic 
operate in proportion to their concentration -
they are not absorbed, but act 
as caustics on the stomach especially,
& destroy more or less the texture of that 
viscus, & the mucous membrane of 
the whole alimentary canal.
I mentioned that there were objections
to the classification of Poisons adapted
by Orfila, & that under lack head exceptions
might be found in certain poisonous
substances, the action of which did
not entirely agree with the definition
he gives of each class. A remarkable
example of this occurs in the oxalic Acid

 

which is ranked under the irritating poisons,
but which differs in its mode of action &
affects from the mineral poisons I have 
spoken of. - Like them in a concentrated
form it is an irritant producing inflammation 
& erosion, but its fatal effects are more 
rapidly developed when the poison is diluted.
In the concentrated form it destroys life
by the local injury & by the sympathetic effect
produced on the nervous system - but 
when diluted, its local effects are trifling,
& it acts by absorption, & destroys life
with great rapidly, operating thro' the 
blood immediately on the spinal cord
& Brain, & thro' them on the heart &
lungs. -
The oxalic acid is used in domestic
œconomy for cleaning boat - tops, & for 
removing Iron moulds, & before its 
poisonous qualities were discovered was 
in common use as a refrigerant. It 
was employed in effervescing Draughts
& as an acid beverage, as the Citric &
Tartaric Acids are at the present
time. No notice of its poisonous
qualities occurred before the year 1814.
Mr Rayston in that you mentioned 

 

the case of a woman who swallowed ℥ss
of oxalic Acid by mistake for Epsom salts
& she died in 40 minutes after great agony.
This case excited general attention. Mr Hume
of Longaore was satisfied the substance
swallowed was oxalic Acid, & he endeavoured
to account for the death by supposing
that the Acid decomposed the Phosphate
of Lime in the coats of the stomach. This 
suggestion is of no farther importance
at the present moment than as a proof
of the astonishment excited in the minds
of professional men at the unexpected
effects of this Acid in large doses. Mr 
Humes theory was disproved by the appearances
found on dissection, for there were 
no traces of decomposition of the coats of 
the stomach, & the Phosphate of Lime
existing in the coats of that viscus is 
scarcely appreciable. It was subsequently
denied that the poison of which the 
woman died was oxalic Acid, but the 
occurrence of a similar mistake in the 
year following, sufficiently established
the tenth of Mr Humes analysis,
& the poisonous quality of this Acid,
many similar cases, arising from 

 

the mistaken substitution of this Acid for 
Epsom salts, were met with from time 
to time - & now [cross out] its fatal effects [cross out]
are so generally Known that it is frequently
used for criminal purposes -
The circumstance of its general resemblance
to Epsom salts - its use in domestic
œconomy the rapidity of its action - &
its generally fatal effects, make this 
Acid of the first importance to the 
Physician. Perhaps no poison has 
been so common in this Country during 
the last 6 or 8 years. -
Oxalic acid is in the form of 4 sided prisms
transparent - of a very acrid taste - soluble
in 2 parts of water at 60- - & in their own
weight at 212. - Exposed to heat the crystals
melt - & by the loss of skin water of crystallization,
fall to powder - boiling last more 
than 1/3 of their weight. A portion of 
the acid sublimes unchanged - no passing 
the acid thro' a red hot tube it is 
decomposed, & there is no deposition
of carbon, arising from the great quantity 
of oxygen it contains. - [cross out]
[cross out] 

 

This Acid contains more oxygen than any other 
veg. acid. It consists of [cross out]
Carbon 33.34}
Oxygen 66.66/100. -}
The crystals have 48 p~ct of water of crystallization
The acid is less soluble in Alcohol than Water
At the moment when the crystals came 
in contact with Alcohol - they appear to 
burst & a slight noise is heard. -
One of its most distinguishing characteristics
is its strong affinity for Lime - taking
it from all the calcareous salts - even
for the Sulphate of Lime. - Oxalate of Lime
is formed, which is insoluble in water
& in excess of oxalic Acid, but soluble
in nitric & Muriatic Acid.
Oxalic Acid forms neutral salts with 
Potash [cross out] Soda & Alumina - which are Soluble in 
water - but when the Acid is in excess
the super salts are less soluble & are precipitated. - The 
other neutral metallic oxalates are much 
less soluble - but these in the state 
of super salts are generally more easily soluble.
The oxalic Acid is classed among the 
Irritating Poisons, because in a concentrated 

 

concentrated state it acts as an irritant upon
the stomach - giving rise to a local injury
& death ensues from the sympathetic
effect produced by this injury on the 
nervous system - as occurs in the mineral
poisons. -
But most commonly it is administered
in a diluted state, giving rise to no 
local injury, but occasioning death
thro' absorption, acting thro' the medium
of the blood on the spinal cord & Brain
immediately - & thro' them on the heart
& lungs.
From experiments made upon
Animals whose esophagus has been tied
after the introduction of a concentrated dose
of oxalic Acid, it appears that inflammation
& abrasion of the mucous membrane of the Stomach & an 
extravasation of blood into that viscus is found after death.
Sometimes there is soften in of the mucous
tissue. - If the body be examined immediately
after death, the chemical action
of the poison is not great on the coats of 
the stomach, but if the examination
be delayed, the coasts are found more or 
less dissolved by the action of the Acid 

 

after death. This action is a solution of the 
albumen & gelatin of the coats in the Acid,
& you may produce a similar effect
by immersing the coats of the stomach
in the strong acid - or Albumen & gelatin
seperately. - That it is a mere solution
of the coats in the acid is proved by the 
mixture having a tendency to gelatinize
& by its forming a precipitate with 
Tannin - & also by the mixture reddening 
litmus.
The above effects are produced
on Dogs by ℥ doses of this Acid, & death
occurred for half an hour to 3 or 4 hours.
The death is soonest in these cases where 
the local injury is least, & it then results from 
the absorption of the prison. The symptoms
are vomiting, (when the esophagus is tied
efforts to vomit) accelerated respiration
then the breathing becomes short & interrupted -
the animal droops - falls suddenly
on his side - is convulsed & dies. -
The stomach is found more or less 
filled with extravasated blood - the mucous
membrane is inflamed - sometimes
softened, but not dissolved or eroded
unless the examination has been 
delayed sometime after death. 

 

But if instead of this concentrated dose You 
give 30-35 grs dissolved in 6 ℥ of water to 
a dog, the symptoms are different. He
tries to vomit - has [cross out] stiffness of the 
hind legs - hurried breathing - the hind leg,
became more rigid - he is seized with general
opisthotonus. the body then becomes 
relaxed & the animal dies. You find
the mucous membrane of the stomach
somewhat corrugated, of a light ash 
grey colour, but quite entire & with
no traces of inflammation generally.
The lungs are found studded on their 
surface with scarlet spots & sometimes
their whole substance of a uniform
scarlet colour. The right side of the 
heart is filled with dark blood - &
it will not contract or the application
of a stimulus no [illegible] appearance
of water is found in the brain. -
From the circumstance of the rapidity
of action of a diluted portion of this 
Acid - & its not acting on the coats of 
the stomach - & from its producing 
effects on remote parts which are 
not referable to a sympathetic
effect, we infer that in this 

 

diluted state it acts by absorption.
That this is the fact is proved by experiment.
Death takes place in a short time when 
the par vagum & sympathetic nerves
are divided on each side of the neck,
all communication by nerves, being thus 
cut off between the stomach & brain.
The fatal effect therefore cannot be 
ascribed to any sympathy thro' nervous
communication. between the stomach
& brain.
[cross out] 1 ʒ of the acid in XI parts of water was injected
into the stomach of 2 rabbits - one of 
which had the par vagum & sympathetic
nerves divided on each side the neck. - The 
rabbit whose nerves were entire in 8 1/2
began to breath hurriedly - in 10' was seized
with opisthotonus - & he died in 13' from the 
commencement of the injection. The rabbit
whose nerves were divided died in 14'
under similar symptoms. - In neither
was there any derangement of the coats of 
the stomach, except a slight diminution
of the toughness of the epidemics. -
2. The symptoms & fatal effect of this 
poison are nearly similar whenever 
it is applied - whether introduced into the 
stomach or intestines - or injected into the 
sac of the pleura - peritoneum - cellular 

 

cellular tissue or into the veins. Its activity is 
proportional to the absorbing power of 
the part to which it is applied - being
more rapid on the pleura & in veins. -
A small quantity introduced into the sac of the 
pleura or into a vein will rapidly destroy
life, while the same amount
introduced into the stomach would 
be insufficient to produce the same 
effect. The more immediately therefore 
it is introduced into the blood 
the more intense & rapid is its action.
It follows therefore that its power in 
the system is exerted thro' the medicine
of the blood.
3. Another proof [cross out] that it acts thro' absorption
is that its effects are produced
by its application to a part, which 
is made to have no other connection
with the body than that of blood vessels.
The symptoms arising for this poison
are seen more distinctly, when it has 
been given in such quantity as not to 
produce death for an hour or two.
If a small quantity be introduced into 
the stomach, intestines or peritoneum of a dog,

 

he is soon seized with violent efforts to vomit.
But the first characteristic sign of the action 
of the poison is a slight permanent stiffness
of the hind legs, drooping of the head, weakness, increased
frequency of the pulse & a dull sorrowful
look. A slight sudden check to the inspiration 
takes place from the respiratory
muscles contracting before the chest is fully
expanded. The stiffness of the hind legs increases,
they often became paralysed - the head is drawn backwards,
the animal walks with a stiff gait.
the muscles of the chest are more frequently affected
with spasms, so as even to suspend
respiration for a time - The head, tail & extremities
are more or less extended. Sometimes amounting
to violent opisthotonus. The insensibility
which first appeared in the hind legs extends
to the trunk, forelegs & lastly the head. The 
breathing diminishes in frequency - the spasms
are less & less & finally cease - & at last coma
comes on with complete relaxation - The 
most action can scarcely be felt - the breathing
is slow & short & becomes more obscure till
life is extinguished without a struggle.
The symptoms vary with the dose. Thus if
it be augmented the spasms came on early & with 
great violence - & the animal dies in one of the 
paroxysms before the stage of insensibility
begins. - Unless the death has been very 

 

rapid the lungs are almost always studded on their 
surface with scarlet spots & sometimes their 
whole substance is found of a scarlet colour.
And in those cases where death occurs before 
the stage of insensibility comes on the heart is 
found 2 or 3 minutes after death neither
contracting or contractile on the application
of a stimulus. -
From these facts it appears that the spinal
cord - brain - heart & lungs are the parts acted
on by the poison. The affection of the spinal
cord is first indicated by the stiffness & paralysis
of the hind legs - by the spasm of the muscles
of the trunk impeding inspiration - & the 
stage of insensibility marks the affection
of the brain. - The functions of the heart &
lungs are impeded by the injury done to the 
nervous system - & the animal dies either 
slowly of asphyxia from the impeded respiration
or more rapidly by an effect produced
on the heart - by which its action is destroyed
at once - & its contractility annihilated.
Tho' this Acid has proved the cause
of death in many cases where it has 
been mistaken for Epsom salts - or taken
by design, we have no accurate account
of the symptoms it occasions - or of the 
appearances after death. - & therefore

 

the effects produced upon Animals by it are 
the more interesting. -
From the cases recorded it appears that death
frequently takes place before medical assistance
is obtained.. a person swallowed 6ʒ
& survived scarcely 15 minutes. others have
died within 1 - or 3 or 4 hours. - The quantity
taken is generally from 3 or 4 ʒ to 2 ℥ - The 
rapidity of the poisoning has depended chiefly
on the quantity taken & the length of time 
it remained in the stomach. - In one case
where ℥ss was taken for Cheltenham salts
vomiting was spontaneously induced - but 
the patient survived 3 weeks, sinking under
the local injury done to the stomach &
œsophagus.
The first Symptoms are a hurried
pain in the stomach & œsophagus & - violent vomiting,
(sometimes the vomiting is slight or 
absent, & in these cases the patient - sinks
within half an hour). In those cases where 
vomiting is present death frequently takes 
place sooner or later. A woman who swallowed
2 ℥, died 20 minutes afterwards, tho'
she vomited fully immediately after the 
drought. The matter vomited is dark & bloody
as occurs in Animals. - The Bowels are 
seldom much affected, tho' occasionally
griping & purging are met with.
In most cases the pulse is scarcely

 

perceptible, & a deadly coldness with clammy
sweats, & lividity of the fingers & nails were apparent. -
That the nervous system is affected
is evident from the numbness & tingling of the 
extremities complained of in 2 cases long after
the violent symptoms had gone off - & the 
patients were progressing towards recovery.
Insensibility existed before death in 2 cases,
& in 4 others convulsions are recorded at 
the time of death, or a short while before 
it. -
The appearances on Dissection are as 
unsatisfactory as the history of the symptoms
for in most cases the Brain - Lung & Heart
are not alluded to. The stomach is reported
to contain a dark fluid like Coffee Grounds,
Probably extravasated blood, like that
found in [cross out] animals who have been
killed by a concentrated dose. In one case
of a girl who died about 30 minutes
after swallowing ℥j of the Acid no morbid
appearance was found in any part of the 
alimentary canal, yet she scarcely vomited.
In this case the poison was probably largely
diluted & the examination made soon after
death. In another case of a girl who died
15 minutes after swallowing 63 the inner
coat of the œsophagus peeled off easily, 

* The oxalates of Ammonia & Potash are poisonous.

the rugæ of the stomach were pultaceous - & the 
other membranes were tender & in some parts
perforated, so that the contents had escaped into 
the abdomen. In this case there was no vomiting
& the examination was put off for 3 days - the 
disorganisation therefore was owing to the 
affect of the acid on the body after death.
From the known effects - of this poison on 
dogs, we may infer that its effects are similar
on man - at least the rapidity of its 
action & the important histories of the cases
on record warrant this conclusion, for in 
most cases the death is too immediate
to be referred to the local injury. It is probably
to be referred in some cases to the 
combination of the local injury - & the 
absorption of the poison. 
With respect to the treatment, it unfortunately
happens that the case is beyond the control
of art before medical and can be procured.
The best antidotes are Magnesia & Chalk.
In one case Magnesia instantly relieved the 
burning pain - & the patient expressed great
gratitude for the relief it afforded. - Where the 
acid has been saturated with Magnesia or Chalk 
& removed by vomiting or the pump, if the symptoms
indicate inflammation of the stomach
Leeches may be applied - & hot fomentations. 

 

fomentations. Where the pulse is small or scarcely perceptible
opium & brandy should be exhibited,
the extremities should be kept warm. - 
The evidences of poisoning by oxalic Acid are to be 
drawn partly for the symptoms - the morbid appearances -
& the chemical analysis of the contents
of the stomach & intestines - of the matter vomited.
The symptoms I have already described when 
a person dies in the short space of from 15 minutes
to an hour, with a burning pain in the region
of the stomach, after taking medicine, violent
vomiting, followed by loss of pulse convulsions
& insensibility, the suspicion may be naturally
exited of poisoning by oxalic Acid, But one 
or more of these symptoms may be absent.
The morbid appearances in the stomach may 
vary for the concentration of the dose - or from 
the length of time intervening between the 
death of the patient & the period of examination.
If the examination is long deferred
the stomach may be perforated - but if the 
body is opened immediately & the dose was 
large & strong there may be only signs of inflammation
& softening. If the dose was 
diluted these appearances maybe slight.
It maybe said generally, that there maybe 

 

general or partial abrasion of the mucous epidemics
with a gelatinization & translucency of the 
corion, & charring of the blood in the vessels. or 
patches when the mucous membrane is only 
thickened, brittle, diminished in adhesion, of 
a yellowish brown colour, or simply elevated
defined patches of a bright red or scarlet
colour, referable to the vessels - or the stomach
may be quite unchanged, with a mere reddish
blush upon its surface.
Little or no evidence, if we judge for the effects
of the poison on animals, can be drawn for 
the rest of the alimentary canal, tho' the poison
may be found in the duodenum, & its effects
perceptible there. The Lungs & heart should
be examined, & a bright scarlet colour of 
the lungs, either uniform or in patches - &
the presence of bright scarlet blood in 
the left cavities of the heart may be considered
circumstantial evidence, especially when 
the stomach is little injured. -
The strongest evidence will be the chemical 
analysis of the contents of the stomach & the 
matter vomited - & the suspected medicine,
when the stomach is much disorganized the 
acid will be found in the tissues of it, probably
in the contents of the stomach & certainly in 
the matter vomited.
If the epidermis is alone disorganized the acid will
not always be found in the coats, or in the 

 

contents of the stomach, but it would exist in the 
first matter vomited
when the stomach is not disorganized, but merely
discoloured, no acid will be found in the coats,
& probably little in the contents of the stomach,
but would be found in the first matter vomited.
And lastly when there is no discoloration of the 
stomach, (as when the acid was much diluted
a neutralized) no acid will be found in the 
coats & possibly none in the contents of the stomach
even tho' no vomiting has occurred - but if the 
patient vomited early it would be found in 
the matter vomited. -
It is evident therefore that by chemical analysis
it may always be found in the first matters
vomited, but sometimes neither in the coats or 
contents of the stomach - & that there may be 
cases in which, tho' no vomiting occurred, no 
acid is found in the coats or contents of the stomach,
because it has been entirely absorbed.
To analyse the suspected matters, let the stomach
be washed with pure water - & if it is disorganized
preserve it for examination. - Let the contents of 
the stomach - the vomited matter - the disorganised
tissues - & the suspected medicine or food be boiled
separately in a little distilled water. Filter - & test
the filtered fluid with litmus paper - with 
muriate of Lime - the sulphate of Copper &
the Nitrate of Silver. -
If the liquid contains oxalic Acid, the muriate

 

of Lime dropped into it will cause a precipitate 
of oxalate of Lime, soluble in Nitric acid - but 
not in the muriate Acid.
Remove the colour from another portion of the
liquid by chlorine, & drop in Sulphate of Copper
if oxalic acid be present a blueish white precipitate
will fall.
The nitrate of Silver produces a heavy white 
precipitate with oxalic Acid - or with the oxalates.
& this precipitate when dried & heated
were a candle becomes brown on the edge - then 
of a sudden fulminates faintly & is all dispersed
in white fumes - If the precipitate is impure
it deflagrates like gum powder, & where in too
small quantity to be collected, the filtering
paper burns as if it had been striped in Nitrate
of Potash.
If magnesia or chalk has been given as an antidote
during the patients life, the oxalate
of magnesia or lime may be weighed with 
the contents of the stomach - or with the vomited
matter - This will be collected on the filter,
& is to be separated from other matters by 
elutriation. If the powder be oxalate of magnesia,
boil it for a few minutes in a 
little distilled water - & test it by the muriate
of Lime - Sulphate of Copper - & Nitrate of Silver,
The oxalate of magnesia is sufficiently soluble
to furnish a solution capable of being 
acted on by these Tests. 

 

If the powder be oxalate of Lime boil it for 15 
minutes with half its weight of pure subcarbonate
of Potash dissolved in 20 parts of water. A 
neutral exchange takes place & the solution
will contain oxalate & Carbonate of Potash -
[cross out] neutralize the Carbonate of Potash with muriatic
Acid - & then test the solution with muriate
of Lime or Sulphate of Copper. - or neutralize the 
Carbonate of Potash with Nitric Acid - & test 
the solution with Nitrate of Silver. In this 
last case there must be a little excess of Acid
as possible, because the oxalate of Silver is soluble
in Nitric Acid. - - 

 

Arsenious Acid. -
Arsenic is a metal of a blueish white 
colour, resembling steel, emitting when 
heated a smell like garlick. It is the 
safest & most volatile of the metals
subliming without melting, when 
exposed in close vessels to 356° -
When exposed to heat in contact with 
the air it sublimes in the form of a white
powder, or if the heat be increased it 
burns with a pale blue flame - The 
product of the sublimation & combustion
is the white oxide of Arsenic or Arsenious
Acid, used in the arts, especially to make 
the green pigment, known by the name 
of Scheeles green (Arsenite of Copper) - & by 
glass-makers. -
It is this preparation of Arsenic which is 
known familiarly as the poisonous
Arsenic. & it is used for the purposes
of crime - & to destroy rats. -
The white oxide of Arsenic is in the form 
of white masses of a glassy appearance,
or in the form of powder, resembling
powered sugar; of a very acrid & corrosive
taste, leaving an impression of sweetness. 

 

Exposed on live coals it volatilizes in the 
form of thick white vapours, of an oleiaceous 
odour. A clean plate of copper held over these
vapours is covered with a beautiful white 
coat of the Arsenious acid, which may
be rubbed off with the finger, leaving the 
copper of its natural colour.
1000 parts of cold water dissolve 2 1/2 parts of the 
acid - & 1000 parts of boiling water dissolve
77 3/4 parts - as the water coals the acid in 
excess is precipitated in regular tetrahedrons.
The aqueous solution reddens vegetable blues.
Water impregnated with Sulphuretted Hydrogen
precipitates a metallic sulphuret
of Arsenic of a golden colour when dropped into the aqueous
solution of the Arsenious Acid. - (The Hydrogen
writers with the oxygen of the Acid to form 
water, & the Sulphur writers with the metallic
Arsenic to form the Sulphuret) This is a 
very delicate test, & will detect the Arsenious
Acid in a solution that contains only 1/100.000th
part of it; This Sulphuret dried on a filter
& heated with caustic potash in a glass tube
is decomposed in a few minutes - Sulphuret
of Potash is formed, & metallic arsenic 
sublimes, attaching itself to the sides of 
the tube.
A solution of Sulphate of Copper dropped

 

in to the Solution of Arsenious Acid, gives in 
a few moments a green flocculent precipitate
of Arsenite of Copper. - (a drop of liquid
Potash added will immediately produce the 
precipitate, by the Potash favouring the separation
of the oxide of Copper, thro' its 
affinity for the Sulphuric Acid.
Cuprum Ammoniatum also precipitates
a green Arsenite of Copper. This is a most 
delicate test, for it will detect the Arsenious
Acid in a solution that contains only 1/120.000th
part in weight.
Arsenious acid in fine powder &c vexed with 
its weight of carbon & potash - or of black flex
(a mixture of finely powdered carbon & subcarbonate
of Potash, made by putting 2 parts
of Tartar & 1 of nitre in a red hot crucible)
is decomposed by heat, when put in a glass 
tube - & metallic arsenic sublimes on the side,
of the tube. - (Arsenite of Potash is formed. The 
Carbon decomposes this Arsenite - takes its oxygen
& flies off as Carbonic acid - while the Arsenic
having last its oxygen sublimes in a metallic
state. The Potash is of use to hold the Arsenious
acid, as it would sublime (without its union
to the Potash) before the heat could be raised
high enough to enable the carbon to take its oxygen. 

 

Lime water added to a solution of Arsenious
acid, occasions a precipitate of Arsenite of Lime
of a white colour - The precipitate is soluble
in excess of Arsenious Acid.
Nitrate of Silver added to the solution causes
a precipitate of Arsenite of silver, of a yellow
colour, which becomes black on being exposed
to the light.
Arsenious acid is poisonous taken internally
or applied externally, & its effects are the 
more immediate in proportion to the absorbing
power of the part to which it is applied.
It was formerly supposed that it occasioned
death by the inflammation it produces
in the stomach, but later observations
have proved that it acts also by absorption
on the [cross out] heart & nervous system. -
It is remarkable that its effects are 
similar whether taken internally or applied
to the surface of the body.. These effects
are indeed equally produced, whether it be 
applied to the mucous membrane of the 
alimentary canal - to that of the vagina
to the cellular or serous tissue - or injected into 
the veins. It destroys the contractility
of the heart - often inflames its substance
& the mucous membrane of the alimentary  

 

canal. This local effect of the Alimentary
Canal is however too trifling in some cases,
& death occurs too rapidly, to refer the fatal
issue to the local irritation, & in these cases
it is referrible to the affection of the heart,
tho' in some instances this has apparently
been recovered from, & death has taken place
from the destructive inflammation of the 
stomach & intestines
The symptoms arising from swallowing this
Acid are, pain & a sense of burning heat
in the stomach - vomiting of a brownish or 
bloody matter - stools of a blackish colour 
& intolerably offensive - intense thirst - great anxiety a 
small frequent - or slow & irregular pulse,
difficult respiration - sometimes an icy 
coldness is complained of great prostration
of strength - bloody urine - delirium - convulsions
& death. In many cases the surface
of the body is covered with livid spots or 
a miliary eruption - the hands & feet are 
cold & last to feeling - the face is changed
a livid circle surrounds the eye lids - & sometimes
the hair falls off - & the cuticle desquamates
The symptoms vary from several 
circumstances - in proportion to the amount
swallowed - to the spontaneous vomiting
that may occur - or to the effects used to 

 

counteract the effects of the poison - In a 
few cases it is most remarkable that all
the usually distressing symptoms have been
absent, & death has been preceded only 
by debility & occasional syncope.
Chanssier relates a case that was fatal
& in which syncope only occurred. The 
poison was found in the stomach. yet no
inflammation or erosion was visible
in the alimentary canal. - Other cases are 
recorded where the poison was detected &
yet no trace of inflammation was perceived
in the stomach or intestines.
In general however the mouth - stomach
& intestines are inflamed. & often perforated
the villous appearance of the stomach destroyed -
& the mucous membrane reduced
to a brownish red pulp. -
Mr Brodie applied 7 grains to a wound made 
on the Back of a rabbit. In a few minutes 
the animal drooped - the respiration became
short & quick - the pulse feeble & almost 
imperceptible - & the posteriour extremities
paralysed - He became senseless & motionless
except at times having convulsive movements
& he died in 53 minutes. On examining 

 

examining the Body the heart was found feebly
& slowly contracting, but its action could
not be prolonged by inflating the Lungs
The mucous membrane of the Stomach
was slight inflamed. -
He injected 2 ʒ of the acid dissolved in 6 ℥
of water into the stomach of a dog. In 3 
minutes the animal vomited mucus - &
the vomiting occurred several times - the 
pulse was less frequent & intermitting.
In 32 minutes the posteriour extremities
were paralysed - & the sensibility gradually diminished.
In 45 minutes the pupils were 
dilated, & the pulse had follow from 140
to 66, & was intermitting. The animal 
there became insensible, convulsed &
died in 5 minutes after. Or opening the 
thorax the heart was observed in a 
tremulous motion, not sufficient to 
keep up the circulation - the stomach 
& intestines were highly inflamed & filled
with mucus.
Mr Brodie infers that the poison acts on 
1st,, the nervous system, indicated by the paralysis
first of the posteriour extremities, & afterwards
of the rest of the body - by the convulsions, 

 

the dilatation of the pupils & the general
insensibility. - 2nd,, On the heart - indicated by 
the slow feeble intermitting pulse - the 
feebleness of the hearts contractions after death
& the inefficacy of artificial respiration
to maintain its action - & 3rd. on the Alimentary
Canal, indicated by the pains in the 
Abdomen - nausea - vomiting - & the inflammation
found on the mucous membrane
of the stomach & intestines. -
In some cases the nervous System is more 
particularly affected - in others the sanguiferous.
& Mr Brodie thinks therefore that 
the local inflammation is not to be 
considered as the cause of death in most of 
the cases of poisoning by this Acid. But 
of the animal does not sink under the 
first impressions of the poison. & time 
is allowed from the full development of 
the inflammation, there is no doubt then 
that it may destroy life. - In proof of this 
Mr Carle reports the case of a woman who 
recovered from the first alarming symptoms
but died on the 4th day - & ulcerations were 
found throughout a great extent of the 
stomach & intestines. - 

 

Mr Brodie found in many cases that the inflammation
of the stomach was very slight.
In general it commences immediately after
the poison has been swallowed, & is more intense
in proportion to the length of time the 
animal lives. Its intensity & the rapidity
of its development is greater when the poison
is applied to an ulcerated surface than 
when it is introduced into the stomach.
The inflamed parts are generally uniformly
red - or only in patches - & the inflammation
is commonly confined to the mucous
membrane, which is softened - pulpy &
easily separated from the muscular Coat.
Sometimes blood is extravasated on the surface
of the mucous membrane, or between
it & the muscular coat. If the animal
dies in a short time neither ulceration or 
escars are found, but if he survives a 
long time both these are found in the 
stomach & intestines. - Mr Brodie remarks
that the extravasation of blood is often mistaken
for escars -  & he refers to a stomach,
in Mr Hunter's museum, of a man who 
died by Arsenic, where a coagulum of blood
was found & mistaken for an escar. - 

 

The first object in the treatment of a case 
of poisoning by Arsenious Acid is to expel
the poison, & this is best effected by large
& repeated draughts of tepid water - of sugar
& water - or honey & water milk - or any mucilaginous
infusion or decoction. If the pump
is at hand these should be copiously 
injected - & withdrawn till the stomach
is completely emptied. - Injections of 
the same nature should be thrown up 
repeatedly, & opium administered in 
full doses - After the first symptoms
have disappeared the local inflammation
of the throat - stomach & intestines
is to be removed by V.S. Leeches.
hot bath - fomentations -  opium -
as in ordinary cases.
The copious draughts of mucilaginous 
fluids, giving rise to free vomiting have
proved efficacious in man - & have put 
a stop to all urgent symptoms in animals.
The Sulphate of Zinc & of Copper only add to 
the irritating effects of the poison - & as 
these emetics have generally to be sent 
for, it is as easy to procure the pump 

 

as them, for this valuable instrument is or 
should be found in every druggists shop.
Orfila reports oils - fat - butter to be 
injurious - & Fourcroy asserts the same 
thing. Tepid water & sugar are always
at hand - & while these are administered,
a mucilaginous decoction can be 
prepared for use, both to drink & to 
administer by injection. - 
milk with lime water will serviceable
where the poison has been administered
in solution - Arsenite of Lime will be 
formed, which acts feebly as a poison -
vomiting may afterwards be induced. -
This poison however is commonly administered
in a solid state, & in that case 
the lime water will not easily unite
with it.
A milk diet should be used in convalescence -
& all irritation of the stomach by 
diet & drinks avoided. -
In the detection of the poison particular
regard must be paid to any solid or fluid
remaining in the cup or phial, from which 
the suspected matter was taken - & also 

 

to the matter vomited - or found in the stomach
& intestines - & to the inflamed portions of 
those viscera. -
If any portion of the suspected fluid or solid
remain in any vessel used by the patient
or by a person who administered the poison
to him, its analysis is simple; but if 
none of the suspected matter is found
it may be detected in the matter vomited,
or the contents of the Abdomen.
Where this Acid has been previously dissolved &
free vomiting has occurred none will generally
be found in the stomach or intestines
after death - but it must be sought
for in the matter vomited. - But if it 
has been taken as is generally the case 
in a solid state, it may be discovered
both in the matters vomited & the stomach.
If the matter found in a cup or vessel that 
has been used by the patient or by a person administering
the poison to him, be fluid - or 
if it be solid, as found in the cup or in the 
matter vomited or in the contents of the stomach,
1/2 a grain may be dissolved in ℥ss of distilled
water. You then test the fluid so obtained
by the syrup of violets - Lime water. Nitrate of 

 

Silver - Sulphate of Copper Cuprum ammoniatum - & water impregnated
with Sulphuretted Hydrogen. -
If the fluid contains Arsenious Acid it will redden
vegetable blues. -
with Lime water it cause a white precipitate of Arsenite 
of Lime - soluble in excess of Arsenious acid.
with nitrate of Silver it causes a yellow precipitate
of Arsenite of Silver, which turns black on exposure
to light.
with Sulphate of Copper it produces a green precipitate
of Arsenite of Copper.
with Cuprum ammoniatum a green precipitate
with water impregnated with Sulphuretted Hydrogen
it produces a golden precipitate of Sulphuret 
of Arsenic. This Sulphuret dried on a filter
& heated with Caustic potash in a glass tube
is decomposed, Sulphuret of Potash is formed,
& metallic Arsenic sublimes on the sides of the 
tube.
If the matter found in the vessel - in the stomach
or in the matter vomited be solid mix it with 
its volume of black flux or Carbon & Subcarbonate of Potash
put it in a glass tube, & expose it to a red heat
& metallic Arsenic will sublime on the sides 
of the glass tube. This Arsenic thrown on hot 
coals will give an Alliaceous smell - & cause 
a green precipitate with Cuprum Ammoniatum.
If the Arsenic has been applied externally
in the form of a paste or plaister, the paste 

 

or plaister must be divided in different portions.
Add one of the parts to 6 or 7 parts by weight
of boiling distilled water - filter - & test the solution with 
the tests already enumerated. - Take another 
part & mix it with the black flux - & expose
the mixture in a glass tube to a red heat - &
metallic Arsenic will sublime. This last in 
all cases is the most satisfactory, & indeed
essential test. -
If nothing can be found in any vessel used by 
the patient, collect the matter vomited, filter
a portion of it & test it with the substances
already mentioned. - Evaporate another portion
to dryness & mix it with the black flux. -
After the death of the patient the contents of 
the Stomach & intestines are to be collected
& heated as the matter vomited. -
The stomach & duodenum should be removed
& cut in small peices & preserved in Alcohol
for deliberate examination. - 

 

 

 

Lect. XXXII. -
Mercury -
Calomel. -
Corrosive Sublimate
Calomel seldom fatal from its immediate
affects. - In chronic diseases
it is often fatal from abuse.
It excites fever - & acts on the secretory &
excretory organs generally -
The symptoms are pain in the abdomen
purging, tenesmus - ptyalism - swelling 
of the salivary glands & tongue - fever, marasmus -
debility - & the consequent development
of that diseases to which the 
constitution may be liable, especially
tubercles. -
The action of calomel is sometimes peculiar 
exciting a lively delirium - Sometimes
the smallest dose excites ptyalism, accompanied 
with great depression of mind &
general debility - an irregular small pulse
& syncope. These symptoms often assume
the type of an inflammatory remittent
fever, & death has not infrequently occurred
suddenly. -
In syphilis its abuse has aggravated

 

all the secondary symptoms, especially the 
ulcerations of the throat - & soft parts. - &
the excessive ptyalism - & the action on the 
bowels have often exhausted the constitution 
18th vol. P.hed & Surg. Journal. -
Mr Cruikshanks 1797. Rollas work on Diabetes.
In all cases of the excessive action of Calomel
to use must be omitted. Ptyalism, if 
attended with much fever, must be met
[illegible] V.S. Leeches - cool air. - Decot. Sarsaparilla
& bland diet. - Action on the Kidneys & Bowels
must be established before ptyalism, if 
long [cross out] existing, be suddenly removed
as dangerous consequences have resulted
from its sudden suppression.
Corrosive Sublimate is one of the most virulent
poisons Known. externally or internally
applied. In small doses its effects resemble
those produced by Calomel, but in large ones
death often occurs in 12 or 24 hours. -
A mother gave ℥ij in Treacle to herself & 4
children. - one at. 3. died in 12 hours. - 1 at 12 in 
24 hours. one at 8 - in 70 hours - & the mother 
in 31. hours - one at 14 recovered.
The symptoms are acrid metallic taste 

 

heat in the throat - acute pain in the Abdomen
vomiting of bilious & bloody matter - purging
the stools tinged with blood & often containing
coagulable lymph - sometimes in the 
form of membrane - small frequent pulse 
faintness - debility - difficulty of breathing 
cramps - convulsions & death - Frequently
paralysis of the extremities occurs before 
death.
when externally applied to an ulcer or abrade
surface pain is felt at the part - & nausea
vomiting - convulsions & death ensue. -
Orfila thinks it impossible to point out 
with precision the seat & character of 
the morbid effects of this poison.  
Mr Brodie thinks it acts on the mucous
membrane - occasioning death by the sympathetic 
effect arising for the local injury. -
(He denies that it is even absorbed).
The mucous membrane is found inflamed
& eroded, & the inflammation often spreads
to the peritoneum. The bladder is found
empty & contracted. - This local action on 
the stomach & intestines may be considered
as the common effect of the poison, varying
in degree in proportion to the dose. -
The treatment consists in exhibiting 

 

Albumen in large quantities - (white of eggs)
It decomposes the salt, & a triple compound
of Albumen. muriatic acid & Calomel is 
formed. - vomiting must be excited by dilutes
& the pump used. -
wheat flour - gluten - starch - have been 
given - but Albumen is the most efficacious
Inflammation to be treated on the Campion
Principles. -
In consequence of the easy decomposition
of this salt, there is no satisfactory test
of its presence, for generally it has passed 
into the state of Calomel before it is 
subsisted to our analysis. In this case 
the only satisfactory evidence his in collecting
any dry residuum from the matter
vomited or for the contents of the stomach 
& reducing it by means of the Blk flux.
or charcoal in a close vessel. By this 
means You have the proof of the presence
of metallic mercury, but the evidence 
of its presence does not prove what 
preparation of Mercury was used.
If any powder can be collected, it may be 
throw on hot coals - & it will volatilize
in the form a dense white smoke 

 

of a pungent odour - exciting cough - & irritation
if inhaled. - It has no smell of garlic, like 
Arsenic - & will tarnish a plate of Copper
which by friction will assume the white 
glistering appearance of Mercury. -
If any of the salt is detected in any vessel
used by the patient - dissolve a part of it 
in distilled water - & add 2 drops of a solution
of Muriate of Tin - If corrosive sublimate
be present there will be a white precipitate
This is a delicate test recommended by 
Dr Bostock. -
Mr Sylvester has proposed an ingenious application
of galvanism. - A piece of Zinc 
or Iron wire about 3 inches long, is to be 
twice bent at right angles 17. The 2 ends
are to be tied to a gold ring. Let a plate 
of glass be placed horizontally - & on one 
side drop some dilute Sulphuric Acid
spreading it to the size of a half penny -
or the other side drop some of the suspected
fluid - & let the edges of the 2 liquids touch.
Place the wine on the acid & the ring on the 
suspected fluid. If corrosive sublimate be 
present the ring will be coated with 
Mercury, where it touches the liquid. - 

 

Antimony
Tartar Emetic in large doses is a virulent
poison, acting as a local irritant on the 
stomach & intestines, & producing palsy,
convulsions - coma & death thro' absorptions
A man at 50 took ℈ij to commit suicide
vomiting - purging - convulsions - pain of Abdomen -
difficulty of moving his Tongue,
he had the appearance of a drunken man 
the pulse was imperceptible - & he died on 
the 5th day.
In some cases vomiting does not occur - there 
is difficulty of deglutition - hiccup. pain 
of Abdomen - frequent stools - vertigo - insensibility - 
convulsions & death. -
In small doses as a nauseant, frequently
repeated, it acts as an irritant on the mucous 
membrane of the intestines - giving rise 
to inflammation - ulceration - & death -
The stools are at first mucous - shiny,
bloody, purulent - highly offensive - &
the head especially in children is affected
before death. -
In the form of ointment it is injurious if 
long persevered in. Dr Francis mentions a 
case where coma - great debility - enlargement
of the smaller joints occurred for its long use. 

 

The morbid appearances after death are inflammation
of the mucous membranes - & sometimes
of the Brain & Lungs.
Majendic generally found the Lungs of Animals
inflamed that he experimented on. - 
Mr Brodie applied it externally & internally
on rabbits & found the symptoms were the 
same. He thinks it acts always thro' absorption,
inflaming the mucous membrane
of the stomach, (not of the intestines) &
occasioning paralysis. drowsiness & at 
last complete insensibility & death. -
He found that it usually acted as an Emetic
but not always. - The purging is a 
sufficient proof of its irritating effect
on the mucous membrane of the Intestines
& the bloody & at last purulent stools 
are indications of inflammation &
ulceration of that structure. - 
The treatment of poisoning by Tartar Emetic
consists in exhibiting copious draughts of 
Decoct. Cinchonæ - & afterwards promoting
vomiting by warm water - Infusion
of Chamomile & warm wood. - or by the Pump.
Strong tea. Decoction of Galls - of Astringent
roots & Barks may be substituted for Cinchona.

 

The Inflammation must be treated by V.S.
Leeches - opium to allay excessive vomiting
The best test of this poison is reducing the 
powder by the Blk flux. By a red heat
You obtain Metallic Antimony & carbonate 
of Potash. -
An Infusion of Nut Galls in Alcohol is the 
most delicate test of a solution of Tartar
Emetic, producing on abundant precipitate
of a dirty white, inclining to yellow.
The juices of plants - decoctions of roots & 
Barks also precipitate the solutions of 
Tartar Emetic - The precipitates one of a 
reddish yellow colour, consisting of oxide of 
Antimony & vegetable matter. -
All these precipitates shd be dried - & reduced
by the Blk flux. - 

 

Copper 
is more frequently injurious from the incautious
use of domestic utensils made of this metal,
& not kept in a clean state, than from the 
exhibition of the salts of Copper used in 
Medicine or the arts. - Accidents also happen
from swallowing copper coins. -
In its pure state Copper like the other metals
is inert, but when oxidated - & combined
with Carbonic or Acetic Acids it is a virulent
poisons. 
Copper coins have been swallowed & produced
no other ill effects than those arising from 
mechanical obstruction.
Paris mentions a case where 5 penny peices
were swallowed with a view to self destruction,
& no ill consequences resulted but from 
obstruction. They were voided after a lapse 
of 5 Years. -
In some instances however these coins have 
undergone a chemical change in the stomach
& operated as poison. A child swallowed 2 
farthing at an interval of 6 months. After 
the first he complained of great pain in the 
stomach & drivelled as if he had been 
salivated. - He last his flesh after the second
& washed considerably, but ultimately
recovered. - Portal mentions a case of 

 

dropsy, in which Copper filings were administered
& the effects were cholic, tenesmus & vomiting.
The danger to be apprehended from the use 
of Copper utensils, is that they may become oxidated
unless kept in the cleanest condition.
Copper when exposed to a moist air becomes
tarnished - a coat of oxide forms & combines
with the Carbonic Acid of the Atmosphere, forming
a greenish compound
Fat, salts, & acids rapidly act on the metal - & 
many cases are on record of fatal effects
resulting from the use of food, cooked in unclear
copper pans, whence the custom
of Tinning these vessels for common use.
The symptoms from poisoning by the 
Acetate of Copper or verdigris of commerce
are an acrid Styptic taste - sense of strangulation,
coppery eructations - vomiting - pains in 
the abdomen - frequent purging with tenesmus
syncope, great debility, cramps & convulsions.
The morbid appearances are inflammation
of the mucous membrane of the Stomach
& Intestines, extending to the rectum, which is 
sometimes perforated by ulceration. The fluids
in the Intestines are found of a green colour. -
The Sulphate of Copper produces similar
symptoms & effects - & when applied externally
to a wound in Animals it 

 

inflames the stomach. -
Albumen is the best antidote for Copper salts
preferable to sugar which was formerly
used - The Inflammation must be met
by the ordinary measures.
The salts shd be reduced by the black flux
Sulphuretted Hydrogen is a debilitate test
of Acetate of Copper - throwing down a blk 
Sulphuret of the metal. -
where no vestige of the poison remains in 
the fluids, remove the mucous membrane
of the stomach & intestines - submit them 
to a strong heat in a crucible - & you may 
detect metallic Copper in them. - 

 

Lead.
From the extensive application of Lead to 
the oils, & its poisonous qualities, the most 
disastrous consequences have resulted
from its action on the human body.
In its metallic state it is inert, but 
in the form of oxide - Acetate - Carbonate
or vapour it is poisonous. -
The protoxide of Lead is the basis of the 
salts. It is that grey pellicle which 
forms on the surface of melted lead. In 
this state it is the massicot of Commerce
when vitrified, as by colouring lead upon
a large scale it is the Litharge of Commerce.
Litharge or the vitrified protoxide of 
Lead is one of the most pernicious of 
the compounds of this metal. It is used
by wine dealers, as well as the Acetate
to sweeter Acid wines. -
The Carbonate of Lead - the ceruse or white 
Lead, familiar to you as the basis of 
white paint is another fatal compound.
The compounds of lead have been 

 

classed among the astringent poisons, from 
the peculiar contraction of the Colon found 
after their exhibition - But as they cause 
inflammation of the stomach & intestines
& act also on the nervous System
they may be ranked among the irritating
poisons.
There are not many cases on recorded
poisoning by the Acetate of lead.
You will find one however in the Trans
Lond. Col. Phys. - vol 6th.
A Soldier drank a solution of the Acetate
He was seized with violent symptoms
of gastric inflammation - with a sense 
of suffocation, retraction of the belly
costivness, trismus, & he died in great
agony on the 3rd day. The mucous
membrane of the stomach was abraded
in several places - & the esophagus, stomach -
duodenum - Mesentery Liver & 
spleen were in a high state of inflammation.
Orfila tried its effects upon dogs, & found
in large doses that it destroyed Life in 
a few hours, even when vomiting occurred 

 

inflaming the mucous membranes, but 
not contracting the large intestines. In 
a solid state it corroded the stomach. -
when given in a liquid state, & it remained
long enough on the stomach to be absorbed
its fatal effects were attributable to its 
action on the nervous system. - producing convulsions.
Orfila found that it did not produce 
serious consequences unless taken in large 
doses, & remaining some time on the 
stomach. In small doses it excited vomiting
& purging.
In the 1st vol of Trans. of med. Socty. of London
there is a most distressing history of the 
poisoning of a family by Ceruse. (the Carbonate)
4 persons out of 9 died. An Infant of 15 months
died in 24 hours. A child 6 Years lived 14 days.
The mother at 40 lingered 3 months - & the 
mother in law at 67. 4 months for the attack.
The symptoms were similar in all, vomiting,
pains in the stomach, costiveness - with 
a pale Sickly countenance - a slow pulse
but no paralysis. nothing was observed
in the body of the mother & the others were 
not examined.
This fatality, so inexplicable, excited the 

 

attention of the med. Socy. - Some members
examined into the circumstances of the family
but could find nothing to explain the 
cause of the mortality. - At last a white 
powder was discovered adhering to the inside
of a cash, in which Sugar was kept for use 
& this proved to be Ceruse.
The most lingering & distressing effects of 
Lead occur in those who one from their 
occupation exposed continually to its 
influence - as Painters - plumbers, patters
printers, essayers - colourmen, miners, who 
are often attacked with Colic arising from 
handling Lead or being exposed to its emanations. -
This is the well Known Colica
Pictonum, which begins with colic
pains, at first of that duration, but 
which recur & eventually continually harass
the patient. The stools are passed with 
difficulty, nausea, & vomiting occur when 
the pains are very acute - the umbilicus
is drawn inwards - there is anorexia - great
anxiety, with absence of all fever. - The 
pain of the Abdomen is relieved by 
strong pressure. Some of the limbs, 

 

especially the arm, are eventually pulsed.
The only morbid Appearance found often death
is a contraction of the large intestines, especially
the colour, no trace of inflammation
being visible in the Intestines. -
The antidotes for the salts of Lead are 
Sulphate of Magnesia or of Soda. These
from insoluble & inert Sulphate of Lead.
℥i - ij may be given - & Inflammation
treated on common principles. -
The tests of the Acetate of lead are Sulphuric 
Acid, which precipitatLs a white 
Sulphate of Lead. - the Subcarbonate
of Soda, which precipitates a white 
Carbonate. - Sulphuretted Hydrogen
which precipitates a Blk Sulphuret
of Lead. - A plate of Zinc put in the 
Solution of Acetate of Lead is covered with 
a blk coal - on which small scales
of Lead very brilliant in appearance are 
perceived. - Gallic Acid throws down 
a yellowish white precipitate.
Let all the Precipitates be mixed with Blk
flux, & reduced in a crucible. - 

 

Nitrate of Silver
acts with great intensity on the parts it 
is applied to, destroying their texture - or 
if diluted, giving rise to intense inflammation. -
The escars it forms are of 
a greyish white or deep black colour. -
The treatment consists in exhibiting
large draughts of water [cross out] holding 
in solution muriate of Soda - or common
salt. - muriate or Chloride of Silver
is found which is insoluble & inert. -
Diluents. V.S. Leeches - Opium - &c -
If any of the solid salt can be detected
put a portion of it upon live coals. It gives 
off red fumes of nitrous acid - & metallic
silver remains of a brilliant lustre 
on the coals. -
Dissolve on other portion of the salt
in distilled water, & add muriatic Acid
or solution of muriate of Soda, & muriate
or chloride of Silver of a greyish white 
colour falls, insoluble in water or nitric
Acid, but Solube in Ammonia - & 
blackens on exposure to light. -
If no poison can be detected, separate
the mucous membrane of the stomach
that has been disorganized - dry it - & 

 

colonic it in a crucible & you obtain metallic
silver. - 
Sulphate of Zinc
is generally expelled by vomiting Soon after
its exhibition. If it remains long in 
the stomach it inflames it - The best 
treatment is to give large dfts of tepid
milk & water - to distend the stomach
& excite vomiting. - 
Subnitrate of Bismuth
inflames & corrodes the stomach in large
doses, operating by sympathy on the nervous 
System, - & Orfila thinks or the heart.
Tepid milk & water - diluents to promote
vomiting - & V.S. - 

 

Cantharides
largely applied to the surface of the body or 
taken internally acts as an irritating poison
giving rise to some peculiar symptoms
from its action on the urinary & genital
organs. -
When taken in large doses it causes vomiting -
purging - pain in the abdomen referable 
to the stomach - Kidnies & bladder
sense of heat in the bladder - bloody
urine - priapism - convulsions - tetanus
& delirium. 
It inflames the mucous membrane of the 
stomach & intestines - & unless the death
is too immediate for the development 
of its ultimate effects, also the mucous
membrane of the bladder & genital organs.
If externally applied its action is on the 
urinary & genital organs, & not on the 
Alimentary Canal.
The death is referable to the local inflammation
& the sympathetic effects
on the nervous System.
The Powder of Cantharides is recoginsed by 
its brilliant shining green colour - &
this, with the peculiar Symptoms &
morbid effects explain the nature of the poison 

 

The treatment consists in expelling the poison
by vomiting - demulcents - opium - & meeting
the inflammatory symptoms.
Under the head of Irritating Poisons are 
included Helleborus niger
Elaterium
Colocynth
Gambooge
Euphorbium
Aconitum napelles
Squill
Nitrate of Potash 
Excite inflammation. -
vomiting. Pump. demulcents. opium.
V.S. Leeches. - 

 

Narcotic Poisons. -
Opium. Hyoscyamus. Prussic Acid.
Narcotics are those Substances which 
act primarily on the nervous system - not 
exciting inflammation, & which give
rise to the following symptoms.
Numbness - stupor - somnolency - vertigo - 
insensibility - coma - & apoplectic condition.
Sometimes there is a lively or furious delirium,
with pains at first slight afterwards
insupportable - plaintive cries - convulsions
palsy - dilatation of the Pupil - strong
Hard pulse, with accelerated respiration 
After death Brain & membranes
are gorged with blood - Lungs violet &
congested - no trace of inflammation in 
the alimentary canal, unless it has been 
caused by some irritating substance, given
for relief.
Act thro' absorption, for their effects are 
produced when applied to any part of 
the body.
Opium in small doses excites probably
by determining blood to the Brain,

 

the functions of which it exalts. In large
doses it probably acts by impelling it in 
such quantity as to cause a diminution
of its functions - & induce stupor - sleep -
coma. & death. The patient was be roused
by shaking him. eyes motionless - pupil
generally dilated - sometimes contracted. iris
insensible to the stimulus of light - the 
muscles & limbs relaxed - & mobility &
sensibility destroyed - There is frequently
nausea & vomiting - difficult deglutition
the respiration imperceptible - painful
stertorous & interrupted - distortion of mouth
It acts even if the par vagum is cut on 
both sides
Pump. V.S. cold application. shaking
acids.
Hyoscyamus. excites a peculiar mental
alienation followed by stupor - trismus
palsy. convulsion & death. It does not 
excite inflammation & acts by absorption
Treatment as in opium. 

 

Prussic Acid.
concentrated - the most instantaneous poison
Known. Applied to the tongue of an Animal
Bird held over the phial!
Scharinger. professor at Vienna. applied to 
his arm & died in a very short time.
The symptoms are immediate embarrassment
of the respiration - general or partial
Palsy - insensibility. Pain at the Epigastrium.
& the tongue shews the red papillæ
from mucous gastric irritation.
It destroys the contractility of the voluntary
muscles & of the heart - & the Brain &
Lungs are found congested. generally there 
is the peculiar odour of the Acid in the 
blood - stomach & Brain.
Similar effects are produced by the distilled
water - oil & watery extract of 
Prunus Laurocerasus 
Brandy. Ammonia. as diffusible stimulants
& if the Brain be affected V.S. - Leeches
to the Epigastrium, if pain there. - 

Camphor. acts on the mucous system, especially the 
Brain - & causes convulsions & death. Infln of 
mucous membranes. 

The Acid Narcotics
operate not only on the nervous System but 
excite inflammation of the mucous membrane
of the stomach & Intestines
The action of some of them [cross out] is peculiar
& it is impossible to give any general
definition which will apply to them 
all, but you will understand that 
their Power is exerted on the nervous
System - as well as on the mucous membranes.
The Colchicum & Digitalis act as Sedatives
diminishing the force & frequency of the 
heart - & give rise to extensive irritation
& inflammation of the Stomach &c -
Tobacco - causes a universal relaxation,
tremors & obstinate vomiting
The Belladonna. aconitum napallus Stramonium - Corium Cicuta virosa
give rise to delirium - convulsions - pain
in the Abdomen - vomiting - & purging.
The Nux vomica excites the spinal cord
& produces tetanus. chest motionless. asphyxia.
The morbid appearances are similar
in the Lungs & Brain to those produced by 
narcotics - besides traces of inflammation
on the mucous membranes. -

 

Colchicum. Digitalis. Tobacco. -
Brandy. opium. - If necessary V.S. Leeches.

 

In closing these Lectures, Gentlemen, I have
only to thank You for the patience with 
which You have heard me; & to recommend
to you the most undivided attention to the 
essential Parts of your Professional studies
viz to Anatomy & Physiology. - the nature
of diseases - the effects of remedies - & their
Precise application in the various conditions
of the body, arising from the various
disorders & diseases to which it is liable.
Tho' my duty has led me to 
detail the particulars of the many remedies
which are included in our Phara,
that You might have at least a general
idea of their Physical & Chemical Characters,
& their therapeutical virtue, You
will not consider that they all come 
equally recommended to you, or that all
the Medicines included in it are stamped
with the Authority of the recommendation
of the more enlightened members of the 
Profession of the present time.
A Pharmaco Pain is in Some respects
like an old neglected garden, planted 

 

originally by many hands, & producing a few 
useful fruits, but more rank poisons &
useless weeds. It is a vague collection of many 
Prescriptions sanctioned by the brief authority
of names that were Prevalent for an hour,
but which have passed into oblivion, &
of a few that have stood & will ever stand
the test of experience. 
It comes to us under the imposing sanction
of a public body, but without any 
directions for the use of its arbitrary
formulæ, & if rigidly examined, the great 
mass of its scientific detail will be 
found to be worse than useless, for the 
few admirable remedies it contains are 
so last in the heap of inert or pernicious
compounds, that a mind ignorant of the 
real simplicity of Practical medicine
is at a loss where to choose amid such 
a display of empirical wisdom. - The 
worse effect of this display of compounded
is the fostering a confidence in the 
mind of the Student of the value of 
particular compounds, & of exciting a 
faith in remedies that has no foundation
in reason or experience. -

 

The implements of Physic in the hands 
of a master workman are few & simple,
& a Pharmacopœia which would include
the materials used by a modern Pathologist
would not be extended beyond a few brief
passes.
Time however has sanctioned the 
materials of Symptomatic medicine, &
time alone must erase them from our
works of Authority, but you must at 
once endeavour to dismiss them from 
your minds, & justly appreciating the 
extent of human efforts over the ranges 
of disease, & the far more Powerful
resources of Nature You must apply
simple remedies, the effects of which 
you understand & trust nothing to the 
chance of incongruous compounds.
The Knowledge of a few simple
remedies - their precise application & 
effects should be the first object of 
your attention, after you have acquired
clear conceptions of the nature of diseases,
the combination of these remedies will
easily be acquired afterwards, & how 

 

few the materials are that are available
in disease You may judge from the small
number recommended to You by Your 
Teachers of Medicine & Surgery.
You may unquestionably find advantages
in the occasional use of analogous
medicines, where any particular one 
does not answer Your expectation, but 
in all cases let Your prescriptions
be simple, & the use of them precise.
Employ active remedies for a precise
object, & persevere in their use so long
as Your judgement deems them essential
to the welfare of your patient,
but when that object is obtained,
& Your active interference is no longer
necessary, give placebos of the simplest
Kind to Satisfy the mind, & be as 
precise in their application as if the 
Life of the Individual depended on 
their regular administration, for 
that Confidence which it is your 
object to inspire.
You will Soon learn by experience
the heavy responsibilities of the 

 

Profession You have chosen, & under the 
embarrassments arising from the many 
difficulties attending it, & from the entire
confidence reposed in You, at having the 
lives & happiness of others placed at Your 
disposal, You will find no Solace, but 
in the honest assurance of your own mind
that You have endeavoured to the best 
of your ability to acquire the Knowledge
requisite for the discharge of your Professional
duties.
In my case You are called to You will
find some thing to learn, & you must 
not disregard the suggestions of your 
own mind, impressed as it will often 
be with different ideas of the nature 
& treatment of Diseases from those 
derived from the observations of others.
Place a firm but modest confidence
in Your own opinions, if they are 
the respect of reputation & observation,
denote Your thoughts & time to your 
professional avocations - be lavish
of your sympathy in the bodily & 
mental sufferings of those who are 
the objects of your care, & tho' Your 

In the early pursuit of your profession &c

may heavily feel the weight arising from 
the load of human misery imposed upon
You, you will even find the best consolation
in the conviction that relief is 
often derived from Your skill - or felt
& acknowledge from [cross out] your tenderness. -
If any of you should travel to foreign
countries bear in mind the imperfection
of our Knowledge of several of 
the Articles of our Materia Medica,
& endeavour to throw light upon these
obscure subjects. Your aid will be 
gratefully acknowledged by your professional
Brethren at home, & Your trouble
will be repaid by the services you
do to mankind.
That You may deserve Prosperity in 
Your Profession & most abundantly meet
with it - & with every happiness & honour
is my service wish - & I bid You all
affectly farewell. - 

24 Gower St. Bedford Square. May 10. 1831.
My first Lecture at the Webb St. School was delivered
June 3. 1826 - & my last lecture on May 
7. 1831. when I delivered the following Farewell
Address
Gentlemen! I have now arrived at the 
limit of my labours, as a Teacher at this 
School, & it only remains for me to discharge
a painful duty in bidding you Farewell.
I thank you for the attention with 
which You have honoured me, & especially
for the courtesy which has uniformly 
marked your intercourse with me. I 
trust you are all conscious of its having 
been reciprocal - & I hope that the regret
which I feel at this moment at our 
approaching separation is in some degree
participated in by you. I would not 
hazard the expression of such a hope, if 
I could recollect a single circumstance
that has occurred since I entered upon 

my duties here, which calls for a case has 
called for even a transient regret from 
any one. 
It has been my good fortune to 
wake many friends here. Indeed from
the spot I now occupy my friendship
has radiated in many directions, & I 
stand connected with many persons in 
places for distant & remote - & I cannot 
finally turn from a scene associated
with so many gratifying feelings, with a 
chill indifference either to the fate of 
those who remain to preside over it,
or of those who have resorted here for 
instruction.
My retirement, which has arisen from 
circumstances in some respects beyond
my power of controul, can operate to 
my prejudice only, for the void it occasions
will be filled more honourably
to the School & more advantageously to 
you. I have never aimed at any other 
merit than that of diligence & of an 

anxious desire to promote the welfare of those 
who honoured are with their confidence,
for I have Known of us distinction between
myself & them, but that which a few
Years seniority on my part might fairly
entitle me to, a difference which a 
little time, with its opportunities for 
study & observation, will entirely remove 
from between us. -
I shall always recur with pleasure
to the time I have passed here, & my 
best wishes will ever be bestowed for 
the success of this Institution, which 
was originally founded by the enterprize
& ably supported by the talents of Mr 
Edward Grainqer - by the genius & the 
fame of any lamented Friend Dr Armstrong.
The former has a worthy representative
of his name & abilities in 
Mr Richard Grainqer, but the latter
has left no semblance of himself
behind, for it would be difficult to 
find any one endowed with that [cross out]

sagacity & simplicity of mind - that originality
of view with respect to the nature & treatment
of disease - that powerful & fascinating
eloquence - that guilelessness of heart
which were found united in Dr Armstrong. -
For Mr Pilcher I shall ever
entertain the feelings & the affections
of a Friend & Brother. I love his unaffected
goodness of heart - I admire his 
candour - & his modesty which seems
to me often to shroud his natural talents
& his extensive practical information.
I can conceive of no higher gratification
than to be associated in the discharge
of a public duty with a man of such 
inflexable integrity & independence of 
mind & such unallayed sweetness of 
disposition. 
Of Mr Millards worth I can 
speak confidently from a long experience
of his character - his diligence & zeal as 
a pupil, & it is one of the additional 

sources of regret to me in retiring from my labours
that that connection which existed so much 
to my satisfaction should now be interrupted
when an honourable competition in equal
labours was just established between us.
I have had no opportunity of cultivating 
an acquaintance with Mr Cooper or 
Dr Lee, & I regret it, but they need no 
eulogy from me, for the well-established 
reputation of the one as an active & expert
Chymist, & the published proofs of the 
research & ability of the other are sufficient
evidences of their just claims to your 
respect.
To them, & to all I leave the expression
of my good will - the proffer of 
my best wishes - the humble but the 
Sincere homage of my respect.
To you, Gentlemen I have but a 
few words to offer, in taken of my parting
benediction - I have done what my 
limited capacity has permitted me to 
do for your welfare, & I would fain 

hope that amid the recollections of past time,
my name may hereafter be occasionally remembered,
as that of one who was connected
with you for a season in the bonds of personal
friendship - who contributed tho' in some 
trifling degree perhaps to the stock of your 
Knowledge, & who endeavoured steadily to 
point to a proper standard of professional
as well as moral worth as indispensable
to your success & happiness.
Let me beg of you to pursue Knowledge
in & beyond the limits of your Profession.
The advantages to be derived from the 
pursuit of Science have been so well 
pointed out by Mr Hershell in his "Preliminary
discourse on the Study of Natural
Philosophy" that I cannot do better than
strongly recommend that Essay to your 
notice. In the wisdom & the truth of 
the views you will there find developed
I fully concur, & it is my parting recommendation
to you that you turn 
to them & to the study of Science for inward
peace of mind & for outward power & usefulness. 

If I should ever hereafter be considered
capable of contributing to your Knowledge
You must recollect that you have just
claims upon me, & you cannot do any 
thing more effectually to soften the regret
I feel at our parting than determining
to maintain on intercourse with me 
tho' at a distance of time & place founded
on the basis of old friendship & the mutual
desire of usefulness. -
In a moment like the present
when old connexions are about to be 
severed forever - in which friends have 
met to part - & friends who, when 
parted, are to be borne devious down
the stream of Life, it is allowable to 
extend our thoughts beyond the present
moment - to indulge in wishes for 
the future - to hope that the blessings
of Life may be liberally stewed along 
the paths we are to take.
Let us then recollect that if our professional 
duties compel us to live for others, 

there are high duties of a personal nature
which demand of us occasionally to live 
for ourselves, for to acquire happiness - to 
obtain Knowledge is the simple but elaborate 
object of Life. 
Let us frequently call to mind the Persian 
maxim of making it "a habit to 
be happy" that we may not be borne
down by the weight of ill our Professional
labours impose upon us - & by 
turning to those enabling pursuits
of Philosophy, which are so well calculated
to wean us from the too sensible
perception of our own personal 
trials, let us learn to blend our destinies
with the harmonious order
& the magnificent designs of all 
outward nature. 
In the early pursuit of your Profession 
you must be sensible that much 
time will be at your disposal, for as 
there is a gradation in every natural
development, so must there be in your 

success in Life. The seed passes from an 
inert state to that of incipient germination,
& the infant plant draws feeble
but adequate nourishment at first 
from [cross out] its own resources, then slowly
protrudes its roots - unfolds its leaves,
& completes its structure, untill it 
has acquired strength to put forth
its blossoms & mature its fruits.
You must not expect that this the 
invariable order of nature will be 
reversed in your case, & that you will
exhibit the blooming honours of your 
reputation & the rich display of your 
fruitful harvest before you have
manifested those qualities upon which 
these advantages must depend.
You must also be sensible that 
every stage & condition of life hath
its enjoyments as well as its duties, &
you must not suffer your expectations
to run beyond their just limits, but 
by habits of industry - of prudence & 

economy you must live & enjoy according to 
your means that when the full abundance
of your husbandry comes you may use 
the blessings bestowed upon you with discretion.
The leisure that will succeed
to the active pursuits of your present
situation will be eminently favourable
to the Systematic review of the information
you have lately largely acquired.
But while paying in the temple of 
Knowledge the first fruits of your devotion,
do not suffer yourselves to be 
misled - or your minds to be contaminated
by the short sighted policy of 
exclusive worldly aggrandizement, for 
there are members from Profession-
who strive to make their attainments
subservient to the purposes of mere 
gain & not always by a course of 
conduct that can be reconciled to the 
principles of integrity & fair dealing, but 
do you abandon yourselves to the enthusiasm
of your faith in the protecting power of 

of Knowledge & shew it by the sincerity of 
Your zeal - & by the constancy of your appeals
at the altar of her spiritual influence.
Tho' You may gain no outward signs
of distinction to point you out to the 
crowd as her followers, Your minds
& hearts will be invested with the 
livery of her faith, which not only the 
best of Your fellow beings will recognise
in your thoughts & actions, but which 
we are taught to believe will be 
marked by an eye that seeth in secret
& rewardeth openly.
In the eventful & apparently uncertain
scenes of this world, tho' we seem to be 
the sport of fate & in no respect the 
arbiters of our own destroy, yet there 
is a sure anchor of hold & a quiet haven
of retreat from the most appalling tempests
of Life, to those who have learned
truly to interpret the chart of their way 
& to trust to the compass of their course, 

& as in the threatened wreck of the vessel of the 
deep it is not the rich freight nor the outward
gilding that can give support & consolation
in the hour of trial, but the 
still small voice of competent - Knowledge
in the mind of the Mariner, so 
must we amid the tempestuous waves
of Fate, trust to the guidance of intellect,
to a vital principle of faith in 
the truths of Religion - to the consolations
of a conscience void of offense -
& if we can Summon these resources 
to our aid, we may meet the worst that 
can happen with composure from the 
satisfaction of Knowing that we have 
performed our parts well - & that the 
issue rests with him from whom nothing 
but final good can proceed. -
I speak to You Gentlemen for the
last time of the pervading & healing 
influence of intellectual cultivation &
mental integrity, as the best temporal
resources of our nature in the varying

emergencies of life - & those who have acquired
them, however they may suffer
from the storms of fate will have an 
interval sunshine which no clouds
of adverse destiny can long on shadow,
& the reflection of which will cast a 
light along their path in the deepest
midnight - gloom of feeling that must 
over us, when we are called upon to 
mourn over the wreck of the fondest
hopes & the dearest ties of our nature.
I wish You Gentlemen deserts equal
to the good will & the Kindly remembrances
I shall ever bear toward 
all of you - & a prosperity & a happiness 
in every relation of life that may 
leave You nothing to desire but the 
possession of the same enjoyments in 
others.
I must affectionately bid you 
Farewell! - 
F. Boott

 

 

 

 

 

 

 

 

 

 

 

Trenton