>frseiS;.*1^isavlixwft--or.:?■•.-• v-' :.v-.^-sffng ^VJ5 Sf>/> r-^S^vvr o^.;; v ■,."• Vw .-':«■..".';,-; > v : •; -';>,' '. •> ' ■ 'i ,: . e-,-' ■-',V-.'f^--,.. ., ■ -v :. ■ i - , '■■■.■■■■.■/.wfyy -vj* ;-■/-, . ■■■>:■[■. :*vflB. T* * . .•:.-■ ■■: ««Vi- w: i; ■-■ 5«-"-* f1*!,;" p ":'r--\ 'o»i.«, ' ''.'V o:. o- •• . : 'lillli;'e ■ ^V'i: llSllaee W% rtf-y■;;.■:■■,. ■■ • 'Jfi^.'-Tv': . ," ;e^'> ' e^Sk \;>' NATIONAL LIBRARY OF MEDICINE Washington Founded 1836 U. S. Department of Health, Education, and Welfare Public Health Service '..<& „ ,*■/. REMARKS > ^ ^ __ >i V----"^ •MTklftCAIi Y&OPEUYIES BEING A SERIES OP FACTS AND OBSERVATIONS, MADE FOR THE PURPOSE OF ASCERTAINING THE QUALITIES AND EFFECTS OF THAT VALUABLE PLANT. BY W. M. IRELAND, MEMBER OF THE ROYAL COLLEGE OF SURGEO 1 fUt*'L4M|DON J CORRE- SPONDING MEMBER OF THE ROVll INSTI1 TI'»V, &C &C. AND LATE SENIOR SURGEON TO H. B. MAJESTV S »>0TH OR ROYAL AMERICAN REGIMENT OF FOOT. " Prmcipus obsta, eero Medecina Paratur W ■ Cum mala per longas convaluere Moras."—Ovid V' / iY.J NEW-YORK: PUBLISHED BY JAMES EASTBURN AND CO. AT THE LITERARY ROOMS. —->♦<..... A. PAUL, PRINTER. 1817. TO €jje Eearneti 23otip Composing the Taculty of Pliysie /eV THE CITY OF NEW-YORK; THESE OBSERVATIONS ON THE MEDICAIL PROPERTIES OF THE STRAMONIUM, ARE MOST RESPECTFULLY DEDICATED, BY THEIR OBEDIENT, HUMBLE SERVANT, THE AUTHOR. *io o&2'2< '!<: ■ h .. British soldiers, who ate of it, by mistaking it for the Chenopodium Album, of Linnaeus: one be- came furious, and ran about like a madman; and the other died, with the symptoms of genuine tetanus. Dr. Woodville relates the case of a man, " aged sixty-nine, labouring under a calculous complaint, who, by mistake, boiled the capsules in milk, and in consequence of drink- ing this decoction, was affected with vertigo, dryness of the fauces, anxiety, followed with the loss of voice and sense; the pulse became small and quick, the extremi- ties became cold, and the limbs paralytic; the features distorted, accompanied with violent delirium, continual watchfulness, and a total suppression of all the evacua- tions : but althpugh all these symptoms took place, he was, in a few hours, restored to his former health." 11 The following advertisement appeared some time ago in the Bath paper, with the respectable signature of Dr. Haygarth; " Gardeners are particularly desired to take care, ne- ver to throw poisonous plants out of gardens into the streets, lanes, or even fields, to which people can have access. Poor children, for diversion, curiosity, or hun- ger, are prompted to eat all kinds of vegetables, which come in their way, especially seeds, fruits, or roots. This caution does not proceed from fanciful speculation, but from actual mischief, produced by the cause here speci- fied. A physician has lately seen several children poi- soned with the roots of Aconite, or Monkshood, thrown into a field, near the city of Chester; and with the seeds of the Stramonium, or Thorn-apple, thfown into the street. The former were seized with very violent con- vulsions and vomiting; an alarming pain in the head, stomach, and bowels: the latter with blindness, and a kind of madness; biting, scratching, shrieking, laugh- ing, and crying, in a frightful manner. Many of them dangerously affected, and escaped very narrowly with life. These, and all other poisonous plants, taken out of gardens, should be carefully buried or burned." This plant has long been known as a powerful narco- tic poison. It was known even among the Greeks; and hence it seems to have been received by Linnaeus into the Materia Medica. The Stramonium, in its recent state, has a bitterish taste, and a smell somewhat resem- bling that of poppies, or what is called by Bergius, Narcotic; especially if the leaves be rubbed in the hand. By holding the plant to the nose for some time, or sleep- IS ing on a bed made of the leaves, giddiness in the head, with stupor, &c. are said to be produced: but this I never have witnessed. It is rather surprising, after so much has been said of the virtues of this plant, by so many learned men of the profession, that it should be so much neglected among the practitioners of the present day. Adhelius tells us, " that of fourteen patients suffering under epileptic, and convulsive affections, to whom he gave the Stramonium, in the hospital at Stockholm, eight were completely cured, five were relieved, and only one received no be- nefit." Bergius also relates three cases of its success: one of mania, and two of convulsions. Reef, a Swedish physician, mentions its beneficial effects in two cases of mania. Doctor Aikin, in speaking of the extract, says, " This preparation is given in doses of from one to five grains, twice or thrice a day, and is said to be a very powerful remedy in various convulsive and spasmodic disorders^ epilepsy, and mania. The accounts of other practitioners have confirmed that of the first introducer." Wedenberg cured four girls, affected with convulsive complaints, by the internal use of the Stramonium. Ba- ron Storck, of Vienna, who had considerable experience in the internal use of the Stramonium, and who seems to be the first that tried its effects in mania, convulsive, epileptic, and melancholic diseases, with the most bene- ficial and happy effects. Hufeland gave it in the form of tincture, prepared with two ounces of the seed, in four ounces of wine, and one of diluted alcohol, in dis- eases of the mind. Doctor Barton, professor of bo- tany in this country, mentions it with the highest respect, and considers it to be a medicine of great efficacy. Doc- 13 tor Barton gave it in powder, beginning with doses of a few grains, and increasing them in a few days, to fifteen or twenty. In one case, in which it was given to the extent of thirty grains, it dilated the pupil of one eye, and produced paralysis of the eyelids, which was remo- ved by the application of a blister. Plenk seems to be the only practitioner who has taken much notice of its external effects: he says, " that if the bruised leaves be applied to hard, indurated, and inflamed tumours, they will soon disappear. It also," says he, " softens and dis- perses tumours in the breasts of nurses, from indurated milk," &c. An abridged account, with some of the me- dical properties, and several instances of its efficacy, taken from a treatise, printed at Upsal, by Doctor We- denberg, is to be seen in the Medical Commentary, vol. iii. p. 18. Many well-informed Swedish and German physicians have mentioned the beneficial effects of this valuable plant; but I should be taking up the read- er's time to no purpose, were I to trace the subject any further. Had the practitioners of America followed the example of Doctor Barton, the virtues of this valuable plant would not have remained so long unknown to the medical world in general. In England, indeed, where physicians observe the rule, " Soltem non nocere," more strictly than in any other country, the Stramonium has been very little em- ployed as a medicine: in every other country, however, they have been guided more by the axiom, " that which is incapable of doing much harm, is equally unable to do much good:" this remark was very fully exemplified by the practice of Baron Storck. We see that from the time of Gesner to that of a modern date, that even the Nux Vomica, Avas recommended by a succession of 14 authors of different countries, as an antidote to the plague, as a febrifuge, as a vermifuge, as a remedy in mania, hypochondriacis, hysteria, rheumatismus, gout, and canine madness. Nor was that valuable plant, the Conium Maculatum, of Linnaeus, or Hemlock, much used as a medicine, till noticed by that able physician Baron Storck. The great philosopher, Lord Bacon, used to say, that whenever the Medical Science had arrived to that state in which it could administer poisonous sub- stances wkh impunity, the art would then be at its zenith of perfection. The Stramonium possesses all the soothing antalgic qualities of the opium, without its hypnotic and astringent effects; hence its superior efficacy as an application to all inflammations, and painful local affections. There was a small treatise published a few years ago in England, by a Mr. Fisher, on the efficacy of the Stramo- nium, when smoked as tobacco, in all asthmatic and pul- monary affections, which was attended with considerable success; and many are the instances where this practice has been attended with the most beneficial and happy effects. So great was the demand for the herb in a dried state, prepared for the purpose of smoking, that it was sold by almost every druggist in London at three shillings sterling per pound, and the seed sold for six shillings per ounce. Nor has its character at all dimi- nished in the-dpinion of those who have tried its effects; for I am personally acquainted with several very respect- able people, who declare that there is nothing affords them so much relief, as the constant smoking of the dried herb. I shall now relate the facts that have come under my own observation, without entering into any theoretical 15 speculations, or advancing any exaggerated accounts. I have given the Stramonium internally, with consider- able beneficial effects, in several convulsive and melan- cholic diseases; but the result of my practice in that way, shall be communicated to the public at some future pe- riod ; as a medicine possessing such signal and potent qualities should be given with caution and great exact- ness, so that its effects should be perfectly ascertained, previous to its being recommended to general use. As a topical application, no substance that 1 am acquainted with, or perhaps, that the whole Materia Medica affords, possesses such soothing, anodyne, and antalgic effects, particularly in the form of a tepid ablution. It relieves pain, abates inflammation, and promotes rest. Painful, indolent, glandular, carcinomic tumours, are much relieved, and frequently dispersed altogether, by a frequent fomentation composed of a strong tepid de- coction of the leaves and herb of the Stramonium. Gangrenous, phagedenic, and sloughing ulcers* are re- lieved from pain, and brought into a healthy state, if the part be so situated, as to admit of its being steeped or soaked for fifteen or twenty minutes, twice a day, in a strong decoction of the Stramonium: if the parts be so situated as not to admit of the above method, the part must be fomented with a flannel rag, squeezed out of a Avarm decoction of the leaves and herb. A plaster, composed of three parts of the " Emplastrum Robo- rans," two of the " Extractum Stramonium," and one of the "Emplastrum Lythse;" will relieve almost any pain, in any part of the body. Several cases of chronic rheumatic affections, and other chronic pains in the small of the back and loins, have been relieved by the application of this plaster. Pains in the chest and sides, 16 are almost always relieved by the application of a large plaster of the above ingredients, applied to the part affected. Pains in the small of the back, head, and limbs, with hot and dry skin, bitter taste in the mouth, and a sore- ness all over the body, as if they had been beaten, (to use the patients' own words,) are most certainly relieved by a tepid bath of the decoction of Stramonium; the bath should be taken at bed-time, and if the body be stimulated all over by the friction of a flannel rag, the patient will take repose, a gentle diaphoresis will be produced over the whole body, and the patient awake, relieved from all complaint. The symptoms just re- lated, are frequently the messengers and forerunners of that frightful and alarming disease, called fever! If, how- ever, people were to attend to the symptoms so manifest in the incipient state of this scourge to human nature, and would keep their bowels open with gentle cathar- tics, and take a tepid bath at bed-time, as before directed, and this plan continued for a few days, that formidable and dreadful disease would be nipped in the bud, and thereby prevented from arriving to maturity; by Avhich means the lives of thousands would be saved, who othenvise fall victims for the want of timely care. This language may be considered rather bold by some of our great physicians, who have pretended to measure the specific laavs of pyrexial diseases, with mathematical ex- actness, and given geometrical rules, with respect to the range of its proximate and remote causes; yet, all these elaborate and vague reasonings have not advanced us one single step further, than we were two thousand years ago. The reader will, I hope, pardon this short digression froifl our subject. 17 The beneficial effects of the external application of the Stramonium, are agreeably satisfactory, in opthalmic and inflammatory complaints, when used in the form of a te- pid ablution to the eyes: a small poultice composed of oat- meal, mixed with the warm decoction, applied at bed- time, and the bowels kept open with gentle cathartics. Many are the instances which I have seen, of its happy effects, produced by immersing children in a tepid bath of the decoction, in cases of severe griping pains in the bowels, and purging with green stools; often produced by colds, wet feet, dentition, &c. and sometimes attended with an evening exacerbation of fever. Children la- bouring under those complaints should have a tepid bath, composed of the decoction of the leaves and herb of the Stramonimn, twice a day; and the body should be stimulated all over with a flannel rag, particularly about the bowels and stomach; the bowels kept open with small doses of Pulv. Rhaei. et Pulv. Ipecac, comp. this done, there are very feAV cases indeedj but would recover by a few days' continuance of this plan of treat- ment. There is one circumstance which must be most particularly attended to, and that is, not to let the bath be too hot. This is the reason why the warm bath (as it is called) has too often added to the complaint which it was intended to relieve. For, almost all nurses (and some medical men) use the bath too hot. It is a Avell- known fact, and a fact that must have J^egn observed, by every one acquainted with a sick chamber, that if a patient remain long in what they call a " warm bath," the patient faints; and were he not taken out in time, he would as certainly die. Now, if a patient in the lowest state of debility, be placed in a tepid or subtepid bath, and while in it, allow- 3 18 ed to take a glass of wine, the pulse will rise, and the patient will feel refreshed and strengthened; his coun-^ tenance will become more cheerful, and a glow of warmth will be felt all over the body; and when wiped dry, and put to bed, he will fall into a gentle sleep, and awake much refreshed. These are not fanciful specu- lative arguments, but facts, that will be found to take place, whenever they are managed with caution and judgment. Cutaneous affections of all descriptions, are mitigated, and frequently cured altogether, by a constant ablution with the tepid decoction twice a day, and keeping the bowels open with gentle cathartics. The manner of pre- paring the decoction for this purpose, is as follows, fake a handful of the leaves and herb together, and simmer them over a slow fire, for about half an hour, then pour the whole into a small tub, or wash-hand basin, and add as much cold water as will make the whole milk-warm; then with a jlannel rag, squeezed out of the decoction, rub the body all over, from head to foot, so as to cause a general stimulating effect in every part of the body: this continued twice a day, for several days, (at the same time attending to the state of the bowels,) there are very few cases indeed, but will be relieved by this plan of treat- ment. An ointment made of the Stramonium, is equally efficacious, Avhen applied to painful sloughing ulcers, and painful biles, &c. A poultice made with oatmeal, or any other substance of the kind, mixed into a consistence, with a strong warm decoction of the Stramonium, instead of water, and applied warm to any bile, or painful sore of any kind, or any other local painful tumour, will in- variably afford relief, if repeated a few times. 19 I shall now relate a few cases, with every fact and par- ticular that is necessary for our purpose. On the 11 th of September, 1816,1 was called to visit a child belonging to Mr. Fowler, No. 139 Hester-street, aged about tAVo years; had been visited by another physician, and was then thought to be past recovery. I found the child labouring under a severe oppression of the chest; tongue furred, skin hot, pulse quick and rather small, bowels open, stools brownish and offensive; an exacerbation of fever every evening about five o'clock. I ordered the child to be washed all over the body with a tepid decoction of the Stramonium; to friction the body with a flannel rag, so as to excite a general stimu- lation, but more particularly about the parts affected, this to be repeated every night and morning; an injec- tion was given, and the bowels kept open with small doses of castor oil. This practice was most strictly at- tended to, for four or five days, when the child became perfectly free from complaint, and the father called on me " to thank me for saving his child's life," (for these Avere his words) and pay my account. On the 2d of October, 1816, I was called up in the night to visit a child belonging to Mrs. Romaine, No. 302 Bowery, in strong convulsions. I ordered a decoc- tion of the Stramonium to be got ready immediately, and the child to be washed and rubbed all over the body with a flannel rag squeezed out of the warm decoction. The child to have an injection, and to take some cathar- tic medicine; the bathing and friction to be repeated, should the convulsions return. On my visiting the child the next morning, it Avas playing about the house, apparently as well as ever, save the debility occasioned by the pre- 20 vious night's exertions. The child continued to recover, and has not had a return of its disorder. On the 10th September, Mrs. Long, of Spring-street, brought a child to me, about 18 months old: it had been purged and severely griped for several days; stools dark- coloured, and fetid; tongue white; skin cold and clammy; pulse so low and quick as not to be counted; body much emaciated and reduced. I ordered her to go home, and get ready a decoction of the Stramonium immediately; and bathfe ifhe child all over the body with the tepid de- coction ; to stimulate the skin by friction with a flannel rag, particularly about the bowels and stomach; ordered Pulv. Rhaei. c Ipecac, comp. every three or four hours. The bathing and friction were continued twice a day, and the medicine -given according to the state of the bowels, and in a few days the child was free from all complaint. It gradually recovered its strength, and has not been ill since. September 21, Mr. White, of Rivington-street, came to me, and requested I would visit his child imme- diately, as they thought it was dying in fits. I found the child in strong convulsions; ordered an injection im- mediately, and a tepid bath of the decoction of the Stramonium as soon as it could be got ready, Avhich was to be repeated twice a day, with friction, and the bow- els to be kept open with small doses of cathartic medi^ cine. Thcchild got perfectly well, and I have not heard of it since. November 2, 1816, I was called to see a child at No. 6 Prince-street, named M'Guire, aged about two years and a half. On visiting it, I found the body consi- derably emaciated and reduced. Great debility, and 21 what Dr. Butler calls, " Infantile remittant fever," was present. Tongue furred, skin shrivelled and dry, pulse small and quick, boAvels costive, urine scanty and high- coloured, and that whining and crying (whenever it Avas touched, or moved) observable in marasmus. There was an exacerbation of fever every evening, with clam- my perspiration in the morning. I ordered the child to be washed all over the body with a tepid decoction of the Stramonium; the body to be stimulated with the fric- tion of a flannel rag, for five or ten minutes*j^f? a day; to have an injection, and take small doses of castor oil, to keep the body open, and to take its drink cold; such as beef-tea, nourishing soups, &c. in which a large spoonful of some mild stomachic cordial should be put; and this to be taken as often as the child^ould drink it, in the absence of fever. The child passed a very comfortable night, and had several hours rest towards the morning: this treatment was persisted in for several days; whenthe*,fev$r.left it, and never returned. The child began to eat, and gain strength; it continued to do well, and perfectly recover- ed its strength, flesh, and good health. Mrs. Hart, of Rivington-street, came to me, and said, she had a son who had a very sore toe, which she was afraid would mortify. On visiting the boy, I found the toe and foot in a state of considerable inflammation, with severe pain. The top of the toe was :ii|-a sloughing phagedenic state. There was restlessness with febrile excitement; tongue white, bowels costive. I ordered some cathartic medicine to be given immediately, a de- coction of the Stramonium to be prepared, and the whole foot to be soaked in it for fifteen or twenty mi- nutes : after which, a poultice of oatmeal mixed with the %% strong decoction, to be applied. This relieved the pain, abated the inflammation, and promoted rest. The bow- els were kept open by cathartic medicine, and the fo- mentation and poultice repeated twice a day; and in about six or eight days the boy was walking about. I was called to visit a child belonging to Mrs. Post, in Spring-street, said to be ill with worms. I was informed by the mother, that" several medical men had seen the child, and that nothing which had been ordered had done any £ood." This was another of what is called by Dr. Butler " Infantile remittant fever." Paroxysm every evening about five or six o'clock. Tongue furred, pulse quick and rather small, bowels costive, skin hot, and urine high-coloured. I ordered a little castor oil to be taken eyerjk two hours, till several evacuations were produced. The child to be bathed in a tepid decoction of the Stramonium every twelve hours, and the bowels to be kept moderately open. This practice was con- tinued for a few days, when the child began to take its food as usual, and gradually to recover: the fever did not return, and the child got perfectly well. I wish particularly to observe, that whenever the bow- els are in a constipated state, and cathartic medicines seem to produce no effect, evacuations will invariably be produced, after the stimulating action, produced by the friction and warmth of the bath, has been continued for any length;of time. On reflecting on the soothing and narcotic, as well as analeptic effects, produced by the external application of the Stramonium; it will be found to be analogous with all the phenomena of the absorb- ent system, with Avhich we are acquainted. The cinchona^ opium, emetic-torpor, mercury! &c. &c. are absorbed when applied to the surface, and produce 23 similar effects, (though in a milder degree,) as when taken internally. Since the doctrine of the lymphatic system has been more generally understood, we see that their unob- structed state is so compatible with health, that when- ever this circumstance is not particularly attended to, diseases of all descriptions commence their ravages. This is the grand reason, why tepid ablution, with stimulating friction, should never be omitted as an aid, in the cure of all diseases attended with obstruction of the Vasa Absorbentia. The few hints and observations, which I now give on the subject, will, I trust, call the attention of the more able and liberal-minded part of the profession; possess- ing more ability and influence than myself^ to make fur- ther trials of the medicinal effects of this valuable plant. For as Cicero said, JYec mepudet ut istos, fateri nescire quod nee nesciam. Since writing the preceding pages, I have received the fol- bwing Letter from a friend of mine, who has witnessed the happy effects produced by smoking the herb of the Stramonium, in Asthmatic complaints, botKm this city, and in many parts of England. MY DEAR DOCTOR, I shall have great pleasure in finding that your endeaA'ours to introduce the use of the Stramonium have the success they merit. 24 Although not a medical man, I can bear witness to its beneficial effects on several friends of mine in London, who used it as a remedy for asthmatic complaints; and in one case, in particular, where it was recommended by Dr. R. Bree, one of the physicians to His Royal High- ness the Duke of Sussex, who, it is well known, is a martyr to asthma. In that case, as well as many others, that have fallen within my knowledge, it was productive of great relief to the patient, and it is very generally used by sufferers in that very painful disorder, in England. I shall be most happy if any thing I can say in the limited circle of my acquaintance here, can in any way forward your praiseworthy exertions, and with much regard remain, My dear Doctor, Your's sincerely, W. ROBERTS. Dr. W. M. IRELAND, M. R. C. S. London. Now in New-York. NEW-YORK, Jan. 12, 1817. Med. Hist. WZ rib Ik5V MiV . -^ ■■'■•■ v- ->•?•.•:■<■'• :••*■ v-r ;JeJ'-ei, >e0§§Plf} - X-'." ■ >o 0*ri^"P '?V ..A .V f y ..••; o : ;*■& ^.?# •$> ff&stt* ,';■•• e^o «r,- e'^-.:,v->r''■}*•'-,^ »^> ev 'V* • " "v^v