10 materia medica 1 Pulse 2 Congestion 4 Diathesis Congestion a 8 Type 10 Acute chronic etc. 11 Classification 13 Porx. principle 16 Narcotica 18 Narcotica simplicia Narcotics Astringents 1 Deobstruents 4 Diuretics 12 Diaphoretics 15 Errhines 17 Sialagogues 18 Emetics 19 Cathartics 22 Epispastics 30 Antidotes 32 Antacids 35 Mich. rem viz Irrit. & Dem. 36 Antilithics 38 Bloodletting 40 Cantharis 56 Capsicum 61 Monard. punct. 65 Hydric ether 66 Wine 67 Alcohol 71 Nitrate pot. 72 Carb. pot.. 78 Bicarb pot. 80 Veg. ac. 87 Acetic acid 87 Hydroc. ac. 82 Gelsem. nitid. 83 Helon. erythos. 85 Con. mac. 89 Cicuta mac. 90 Digitalis purp. 90 Lobelia iunfl. 94 Actaea rac. 96 Languin. can. 49 Aralia spin. 51 Baptisia tinct 52 Veratrum vir. 53 Andeira [iner???] 55 Opium 99 Astringents They produce a moderate vital contraction & condensation of the living fibre while at the same time they moderately decrease absorption & diminish morbid secretion Prof. Ives thinks they likewise diminish irritability The contraction is not [illegible] but vital As a class they are intermediate between the tonics & deobstruents partaking somewhat of the properties of each The vegetable astringents owe their astringency to tannin Properties of tannin etc. Because tannin forms leather with animal albumen it is incompatible with animal jellies as an article of diet Vegetable astringents inefficient in diarrhoea & dysentery not because of phlogistic diathesis but because of the morbid condition of the mucous membrane of the intestines they are useful after that has ceased and this discharge continues as a sort of habit. These remarks however apply only to the vegetable astringent for acetate of lead is as useful as calomel even in the early stages The mineral astringents do not depend upon any one proximate principle & hence they differ from each other in their operation. Vegetable astringents chesnut, the raspings of the wild [illegible] [illegible] [illegible] extract Quercus alba & tinctoria the inner bark Cocoluba vivifera of the sea side of Florida & [illegible] [terantosa] the leaves Geranium maculation the root [Heirchera] americana [italica] Carolina Geum uvale this more tonic than the others saxifraga pennsylvanica parnassis [ameril] Polygalam virginicum caenothus americanum tubus vellosus & vivialis napthar advena & [hymplicea] dorata these have a [nauseous] principle & a good deal of mucilage epiphagus virgiana this not nauseous as [Bart??] says All of these the root These native astringents are abundantly sufficient of our own wants. Foreign astringents found in the shops Green tea valuable when a narcotic power also wanted Mineral astringents acetate of lead etc. Sulph cop. alum Diseases Chronic coryza cough consumption (secondary stages etc. etc. Useful also externally atonic paristhmitis is inflammation of the fauces Spongy ulcers polypus [piles] of some sorts etc. Toothache is relieved by an intense astringent This remedy has been patented by a Hartford man Deobstruents produce a change of condition & action in the whole or part of absorbent & secernant system relieving affections of the liver increasing the secretion of this organ relieving various affections of the skin & produces [asolutions] of inflammations of muscles When they are given for some time in health they generally increase the secretions In disease they change as well as increase They produce less effect upon the brain than upon any other viscus The old definition is that they remove visceral obstructions the term obstruction is applied to indolent inflammations parabismata etc. of the viscera Tully revives this class. To what properties does mercury owe its anti syphilitic power? not in cathartic sialagogue etc. It is not stimulant or tonic, for it does not increase strength of arterial action or digestion & muscular strength. Mercury is a stimulant if we apply this term to any remedy which produces a powerful impression upon the system but this is too loose an application of the term A deobstruent effect may be indicated at the same time with a stimulant or other effect, as with a refrigerant effect but stimulant & refrigerant effects cannot both be indicated at the same time why then use the term stimulant with respect to the deobstruent effect. It is of no use to call mercury anti syphilitic antipsoraic etc. The United States abound in deobstruents & many of the properties of some of them are not generally known E.g. The salivation of mercury has been considered very strange It is however a part of its deobstruent effects which is more obvious & which exists also in a higher degree in tis than in some others of this class Expectorant emmenagogue sialogogue effects etc. may be either direct or indirect direct when not the [illegible] of a deobstruent agent in direct when a part of a general deobstruent effect upon the whole or nearly the whole secerunt & absorbent system For they do not all act upon every part of these systems A deobstruent effect may also be indirect e.g. the act of purging is a deobstruent operation while it lasts The deobstruent effect is frequently the only useful one e.g. colchicum Iris etc. which cannot be usefully employed as emetics & cathartics. This seems to be a sort of experimentum crusis with reference to the propriety of retaining this class Further in the modern systems there is no place for the pure deobstruents e.g. leontodon taraxacum which is put down among the diuretics & cathartics for neither of which effects will it answer And this has probably contributed to bring it into disease. So of other articles The deobstruents although not weakening still reduce the strength of the system in general if continued for a great length of time, especially if the deobstruent effect is combined with one of evacuation None of them however have direct refrigerant powers & none have sufficient stimulant powers to supersede the necessity of combining a stimulant in cases of great atony The system is frequently to be prepared for a deobstruent operation by being previously stimulated or reduced. Rheumatism generally requires one or other of these preparations, but still neither reduction or stimulation will ever cure these diseases. Dysentery is cured as effectually by Iris versicolor & other vegetable deobstruents as by calomel though requiring to be accompanied by opium. Still calomel applies to a greater variety of cases No deobstruents produce stimulation precisely but rather a tonic effect & none directly produce a refrigerant effect, they do this rather through their evacuating powers That a remedy be referred to the class of deobstruent, the only quality which it is indispensable that it should possess is a resolvent one Probably all the deobstruent cathartics are hydragogue. A resolvent power is that of dispersing & curing a topical inflammation without a necessary evacuation. an antipsoraic operation is that of curing a cutaneous disease by an internal remedy Discutient applies to curing an inflammation by a topical application Cholagogue applies to the increased & secretion & evacuation of bile These operations are the foundations of no classes The most common & best known deobstruents are the species of smilax including the rotundifolia & another if our species Comptonia asfil. & myrica galea Compt. destroys fish. Aralia racemosa & [rudicaulis] the root asclepias tuberosa & incarnata. Arctium lappa & another diervilla danadensis celastrus secundus Perhaps also the Collinsonia canadensis solanum nigrum & dulcamara but these too are narcotic Diseases rheumatism [strum??] dyspepsia syphilis yaws various cutaneous diseases Other plants doebstruents are myrica cerifera 3 species of anemone A. virg. etc. ranunculus acris bulbosa & scleratus All the species of trillium alisma plantago dirca palustris conium maculatum is a deobstruent narcotic cicuta maculatum & bulbifera also as well as argemoni mexicana In this vicinity have been used the different species of lettuce (not the exuded & inspissated sap but the inspissated juice & decoction) aconitum napellus strychnos nux vomica angostura bark etc. are acrid narcotics deobstruents rhododendron maximum (Litchfield county) kalmia latifolia Another set is astringent & moderately tonic viz uva ursi chimaphila as syrola 2 species ledum 2 sp. aletus farinose & aurea andromeda calygulata helmias droica The uses e.g. guaiacum oil of juniper several species oil & resin of copaifera off. ol. pinus australis sylvestris strobas etc. abies canadensis & [illegible] mifera These if pushed evacuate Aralia hispida (dwarf elder) diuretic & emetic Erythmium americanum & album these vomit Another set may be diuretic emmenagogue cathartic emetic etc. [Polygala] senega Hellebore Gratiola off. iris versicolas scilla mautima polygala pubescens eryngium aquaticum (properly yuccifolium) lebelia syphilitica These are said to be cathartic Sanguinaria belongs here but is not Colchicum autmnalis aralia spinosa (southern states) [Phyto???] candacendria delphinum consolidum etc. baptisia tinctoria (perhaps) styllingine sylvatica apocynum cannabinum & pubescens anderria inernis (cabbage bark) These are similar to the last class possessing a still greater assemblage of properties? Diuretics increase the urinary discharge Paris’s classification visionary in which he supposes some of them to act in substance upon the urinary organs Nitrate of potassa Tully denies to be a diuretic Diuretics are direct or (as being also general deobstruents) indirect They are also pure. The pure are not always the most powerful e.g. chrysanthemum leucanthemum Roots of opium petroselinum eupatorium purpureum & verticillatum collinsonia canadensis Refrigerant diuretics e.g. nitric ether bitartrate of potassa & acetate of potassa narcotic diuretics e.g. expressed juice of various species of lactuea. The [illegible] if taken very strong Stimulant diuretics e.g. several species of cantharis [illegible] mellifica several of the essential oils as those of the gaulthena [procumb???] & engeron canad. The most important are the deobstruent diuretics gratiola off. scylla maritima polygala senega & pubescens iris versic. & prismatica the several species of elder eryuquim mucifolium sambucus pubescens (red berried or mountain elder) The most efficient & certain single article is asclepias syriaca aralia hispida called dwarf elder. This unlike the rest never proves cathartic erythronium lanceola commonly macerated in ciders Seeds & roots of aretum lappa All these are expectorant emm. [illegible] & antipsoraic & if pushed are emetic & cathartic Next group are the resins & terebinthinate oils these are expectorant resolvent etc. Abies balsamifera the most elegant cpoaifera juniperus pinus australis etc. sang. europaea etc. abies canadend the oil Another set are astringent & perhaps tonic arbutus uva ursi another set is also narcotic e.g. nicotiana tabacum & digitalis purpura Another set are not emetic & cathartic Actaea racemosa cimicifuga this last said to more active rubra & pachypoda inferior Demulcent diuretics mucilages Three conditions of the system in which the diuretics are to be employed viz morbid irritability with atony without atony & In case of great distention diuretics will not operate until the water has been diminished by elaterium a hydrogogue cathartic & some such manner The diuretics however will not cure the disease Tully and his friends have not found diuretics more uncertain than other classes of remedies always succeeding by management combination of several articles or some such way Not always however curing this disease Case of officinal alcohol curing Diaphoretics restore or increase the perspiration It is commonly said that they are all stimulants the argument is that increased secretion implies increased action this fallacious e.g. the sweats of the dying because the weakened vessels may not be able to resist the vis a tergo In high entony refrigerants produce diaphoresis & in great atony stimulants 52 Alcohol continued. The fact that it has not always been used proves no more than that of cinchonas having been formerly unknown Alcohol continued from p. 52 Alcohol is best adapted to the nervous & wine to the putrid type of fevers The old practice of giving bark in wine, in intermittents was a good one now superseded by sol sulph of quinine All the cases of typhus All cases where there is great and extensive suppuration Collections of matter the liver thorax, & even in the female breast though opium possesses the greatest power Hectic, in one of the diseases Anthrax, where the system is considered affected Erythema oedematum gangrenosum anatomicum etc. Parismitis Malignant small pox measles scarlet fever (rosalia) Various cases of inflammation of the viscera Membranific inflammation (croup for instance in many cases N.B. in many of these diseases the wine or alcohol do not supersede the deobstruents etc. Genuine acute febrile dysentery according the nature of the constitutional febrile affection which may be synochus or putrid typhus etc. Marasmus tabes, sand scurvy # The different sorts of gangrene Certain sorts and stages of mental derangement, more especially wine Tetanus some consider them as specific falsely however. In Mass. this disease has been cured by alcohol & liquor of the arsenate of potassa, the latter in large quantities Lyssa canina a similar dispute Chorea according to the condition of the system # this is as much severer disease than sea scurvy which only require the milder astringent & tonics Bites and stings The practice is old and perfectly well established. Galen & Celsus quoted. The maderia medica of Hindoostan makes wine perfectly efficacious Case in the American medical Recorder in which at least 2 quarts of spirit & capsicum were retained in the stomach in the course of one night. The efficacy of spirit in the case of the most venemous serpents is perfectly well known in the tropical reg Instances are many of persons in a state of intoxication being bitten with impunity The excision is generally performed in cases which would not have been dangerous in any case, from the fact of the surgeon in the country being generally at a distance. Confined snake do not [illegible] a mortal bite. The next article to alcohol is opium the next is ammonia. The moderate cases may be relieved by any strong impression hence the reputation of various popular remedies External application of alcohol Dr Ives employs a mixture of alcohol & oil of origanum in burns and scales The vapours of burning alcohol is very usefully employed, by raising the bedclothes, supporting them [illegible] & introducing the vapour through a tin tube Useful in cholica etc. etc. & in that form of dyspepsia which is attended with gastrodynia Errhines excite sneezing by direct application the discharge is sometimes serous when secretion is promoted sometimes more purulent. Useful mainly as counter irritants sometimes the act of sneezing seems to be useful Disease Ophthalmia Cephalitis Deafness neuralgia auris & facies apoplexy etc. Some cases only of the above Snuff taking very injurious producing finally limosis syncoptica also thirst etc. Tobacco is the worst because narcotic Errhines are powdered white sugar the powdered root of the species of iris spirit of [?esculus] dried & pulverized flowers of helenum antimonali Veratrum album and viride Case of an apothecary who sneezed 30 times Euphorbia off. sanguinaria turpeth mineral calomel sialagogues promote salivation by topical application hence mercury is excluded for its salivation is not useful of itself Disease aphonia when idiopathic & symptomatic rheumatic pains of teeth gums Chewing tobacco wastes saliva exhum the strength producing anorexia limosis Drunkards begin with tobacco. Prevents costiveness however sial. antemis pyrethrum myrica cerifera asarum europeum & canadense horseradish zingiber cardamon seed Emetics produce vomiting independent of taste odour or quantity Effects of vomiting & nausea The act of vomiting is probably more or less deobstruent in all cases All emetics given in less than nauseating doses except tartrate of ant. are tonic? 4 purposes 1st to give a shock & break up 2nd to increase susceptibility & prepare 3d to excite the absorbents & create a resolution of inflammations etc. 4 to remove poisonous or offending matter from stomach 5 groups of emetic 1st simple vegetable emetics which produce no other effect e.g. ipecacuanha dorstenia braziliensis A species of asclepias viola [parsiflora] & another The two species of gillenia the best indigenous substitutes for ipecac. Two species of euphorbia These are indicated to remove poison to relieve the stomach of offending matter [illegible] vegetable deobstruent emetics useful where both emesis & deobstruent are both wanted Sanguinaria apocynum cannabinum aralia spinosa polygala senega not best however to use this as an emetic. It leaves the stomach & bowels in a deranged state syclla [matutima] or ornithogalum squilla Lobelia inflata styllingia sylvatica Perhaps also ranunculus flammula the distilled water no taste no nausea acting instantaneously after 5 or 10 min. Sinapis alba & nigra Deobstruent vegetable emetics are proper where strong counteraction at the commencement of diseases as croup etc. 3d Refrigerant mineral emetics tartrate of antimony & potassa James powd consisting of protox. of ant. & lime These emetics given at the commencement of typhous fever bring it on 4th Tonic mineral emetics sulphate of zinc bipersulphate of copper or blue vitriol ammoniuret of copper per acetate of copper or verdigri Limosis dispepsia etc. 5 Deobstruent mineral emetics The best is dipersulphate of mercury or turpeth mineral Cathartics increase or create evacuation from the intestines Murrays arguments about the stimulant operation upon the intestines too loose The peristaltic motion of the intestines essential to life kept up by the bile perhaps also the pancreatic juice & the mucous fluid of the intestines Evacuations promoted by checking perspiration application of cold water to the legs friction etc. Dr. Ives thinks the stimulus of distention of the bowels is very important Cathartics of more universal use than any other class 5 purposes 1st reducing 3nd sudden shock for breaking up diseases neither entonic nor atonic 3d increase susceptibility & equalize excitement in diseases neither at. nor entonic 4 remove fluids as in dropsy 5 to remove poisonous or offending 5 things to be had in view in selecting a cathartic 1st degree 2nd quality of evacuation 3d what other operation 4 the part of the alvine canal operate 5 1st as to degree 1st eccoprotic e.g. syrup of sugar manna subacid fruits 2nd laxative merely increase peristal act sufficient to evacuate the canal carbonate of magnesia ol. juniperus communis 3d purgative which also occasion an increase & discharge of not secretion septandra virginica triostium perf jalapa podophyllum petalum 4 drastica gamboge elaterium croton tiglium These produce copious & continued discharges & invert the action The stronger may be so managed as to operate like the weaker As to quality of discharge cathartics are 1st kopragoga producing fecal discharges e.g. castor oil rhubarb 2 cholagoga or bilious e.g. calomel 3d hydragogue or watery discharges the most perfect is elaterium Others are croton tiglium the refrigerant salts As to other influences 1st nervina allay morbid irritability etc. Cocculus & spec. though cathartic [these] exhilirate Carthagena bean (foederea) None have these two powers simply 2nd narcotica producing prostration etc. Cocculus comes here also Tobacco etc. refrigerantia diminish strength of act Sulphates of potassa magnesia soda & ammonia also the bisulphates the sulphates the hyposulphates Sulphates of lime Phosphates of all these Phosphites hypophosphite etc. Tartrates bitartratis etc. Also the compounds with two bases These act on the exhalents of the intestines These salts are apt to produce flatulency which the other hydragogue cathartics do not bring on These cathartics are commonly supposed to be mild cathartics yet they are bad in old dyspeptic subjects etc. 4th tonic cathartics federaea carthagena carthagena bean nicker nut? polygala [polyga???] aloes 5. astringent. E. g. rheumatism Indigenous species of rumex Ven alum purges & sometimes [illegible] useful in this way 6 deobstruentia Preparations of mercury the most common baptisia iris phytolacca etc. 7 emetica gamboge [triosteum] perfoliatum etc. 8th diuretic when given moderately elaterium tobacco asclepias syriaca 9th diaphoretic eupatorium perfoliatum & rotundifolia asclepias syriaca & tuberosa 10 Emmenagogue aloes convallaria majalis polygala polygama etc. As to part of canal on which they operate 1st stomach & intestines mercurials gamboge triosteum perfoliatum 2nd Colon lepandra jalapa senna etc. 3d Rectum aloes polygala polygama convallaria majalis Another point is the tonic Some are slow as mercurials aloes convallaria & polygama Others are intermediate as jalapa convolvulus juglans cinerca senna most speedy is croton frequently ½ hour Oil of seeds of euphorbia lanthyris & other of about the same qualities Castor oil is quick gamboge also elaterium The refrigerant salts especially when combined with tartrate of antimony as is done in Philadelphia Cathartics frequently break up diseases but generally are more auxiliaries The refrigerant & drastic cathartics however do not break up always Cathartics continued Never proper in dysentery. In low typhous patients may go 5 to 14 days without an evacuation & when it took place it will be of a natural appearance Much abused in this country in cutaneous diseases under the absurd notion of purifying the blood. Not abused on the continent of Europe as in G Brit. & this country The universal tampering with salts & calomel an exceeding evil. So also Flocking to Cheltenham & Saratoga So says MacCulloch. The same of the family medicine chest. The beneficial effects of travelling & the evils of nervous diseases referrable to the same source (McCulloch) Case of a lady of strong constitution who had taken salts & calomel every day since 8 years of age was nervous etc. McCull. Sir W. Scott understands the subject alludes to it in the legend of [Montrose] Physicians are remarkable for not associating with & enquiring after the practice of these different opinions All science properly so called depends upon the detection and classification of differences Epispastics by topical application produce either local inflammation or vesication or destruction of vitality Purposes 1st (acc. to Duncan) to increase the activity of the system in general by initiation then to be kept on some time applied to the extremities 2nd to increase the activity of a particular organ as the liver in jaundice one large plaster over the liver 3d to diminish the activity of a particular organ by counterirritation as in pneumonitis Contraindic in high entony or low atony Dispute whether they should be applied in local affections in the vicinity of or remote from the place Some say idyosyncrasy prevents or obstructs their employment. Tully thinks this is merely greater susceptibility & therefore requires smaller plasters. It is frequently advisable to convert the serous discharge into a purulent one by an irritating plaster or by the constant presence of a [illegible] body as orange peel Question whether issues or successions of blisters are best. This depends upon the disease e.g. hip disease diseases of the spine etc. require issues. The spine is the best situation for most cases of nervous diseases paraplegia various chronic affections of the bladder chronic cephalia [or] headache etc. Children must have them much smaller on account of their greater irritability Alexipharmics antidota etc. counteracting the operations of poisons With respect to toxicology Poisoning is the noxious effect of an ill timed or excessive quantity of an agent or otherwise improper use The Greeks had but one word [illegible] for both medicines and poisons. Pliny says every virus has a virtue. Every poison is a medicine It is not however true that in the present state of the science every poison has actually been made use of or is thoroughly understood Poisoning consists of irritation disorganization stupefaction exhaustion or some combination of these. The deleterious effects of poisons are the same with certain specific diseases. Inflammation of every kind colic paralysis coma apoplexy ptyalism (as of mercury) simple exhaustion marasmus in all 12 No one agent can always have the same effect hence there can be no specific remedy for any one poison If not too late the first indication is to remove the poison from the stomach Tully thinks experiments upon animals by injection into the blood are good for nothing Absurd also is the tying the duodenum and oesophagus Tully thinks toxicology as pursued by Orfila and his imitators as merely a mass of empiricism founded upon the doctrine of specific poisons and remedies Absurd notion of Orfila American editor that savages understand poisoning better than scientific physicians. Poisoning has always been confined to times of ignorance & has fled before the march of science which divests them of their obscure dreadfulness Orfila’s experiments unjustifiable Pure narcotic effects are the first and most simple poisonous effects 2nd acrid narcotics 3d irritating poisons 4 compound poisons Acrid narcotic poisons produce convulsions of a peculiar character tetanic spasms & neuralgic pain mineral vegetable & animal poisons 1st hydrocyanic acid laurel water gelseminum helonias erythrosperma & mist of the 2nd Strychnos nux vomica 3 Oil of tansy [illegible] camphor ol. nutmeg Cicuta maculata & the fungi produce colic Arsenous acid ranunculus phosphorus menchinal capsicum produce irritation Antacids combine with acid and neutralize free acids in the al. can. Ammonia calcia magnesia soda & their carbonates are the only ones Potassa soda and ammonia form lactates with the natural lactic acid of the stomach which are refrigerant Various other acids are found in the morbid states of the stomach as the phosphoric in inveterate and protracted cases of dyspepsia not formed by fermentation which Tully thinks never goes on in the stomach Antacids if ever necessary are merely palliatives because they will not remove the causes of the affection. Dyspepsia appears to be the only disease in which they are employed Mechanical remedies 1st irritants 2nd demulcents Irritants maybe vital or epispastics, or they may be of 3 classes 1st exercise of all sorts which are remedial processes 2nd dermatic as [?uction] percussion acupunctura or shampooing 3d alvine cow itch metallic [tin] filings of iron powdered glass & powdered porcelain charcoal partly Travelling diminishes morbid corporeal sensibility on account of exposure to air etc. increases the assimilation diminishes fecal discharges. Hence the constipation of travellers things inedible in health are harmless great activity of the absorbent system hence reduces obesity & hardens the muscles active exercise quickens the pulse & passive renders it slower hence the latter in some diseases of the heart combining it after a while with active change of air improves the blood changes even to a bad air are frequently useful just as the stomach thrives best on a variety of food Hence also as well as from exercise the ruddy complexion of stage coach drivers Shampooing almost peculiar to the Chinese description of it from Clark Abel Most of the alvine irritants are of doubtful utility Employed from the notion that digestion was caused by trituration & that worms were to be levigated A quack of Connecticut has employed powdered glass gentian & ginger which was certainly more useful in dyspepsia than the same remedy without the glass [illegible] opium aloes spices testicles of a boar & powdered porcelain in colic by a Connecticut family of quacks Good evidence for the utility of powdered glass as an anthelmintic. Anthlithics or lithontriptics A long dissertation upon urine uric acid. Lithis of the different kinds & the [illegible] different kinds of calculus Lithis urinalis has two varieties one with calculi in the kidneys & the other with gravel in them. The former impossible to discriminate by certain diagnosis. Hence a great part of the cases of gravel are fallacious & the experience upon this subject frequently false Antilithica prophylactica & lithontriptica It is the received opinion that the avoidance of animal food & perhaps also of fermented liquors prevents the uric acid diathesis which is the cause of the greatest number of calculi Another circumstance according to Paris’s theory will be the keeping up a natural and healthy action of the skin For the uric acid calculus lime water magnesia (given in soap are upon chemical principles the appropriate lithontriptics for the uric acid calculus No solvent is known for the mulberry calculus The acids which decompose it would form insoluble compounds in the bladder N.B. oxide of magnesia & soap are useful in many gouty cases where there are no calculi. Hence their chemical operation is doubtful The antilithic and lithontriptic modes of treating lithia are obvious [illegible] except in lithia renalis where however it is merely a palliative not reaching the cause of the disease. Better employ tonics opium (in the paroxysm Deobstruents however are the remedies Bloodletting (I was absent) The spring lancet on several accounts is preferable to the thumb lancet 6 distinct purposes of bloodletting 1st as a mere antiphlogistic measure 2nd to make a sudden & strong impression in non phlogistic diseases to produce a resolution 3d to equalize excitement increase susceptibility & prepare for other remedies 4th to divert a haemorrhage from some parts as a substitute for a habitual [illegible] 5th to produce faintness [illegible] in surgical operations 6th to promote absorption in paribismata & emphysemata Bloodletting is always indicated in phlogistic cases no matter what the age sex climate The quantity of blood abstracted should always depend upon the vital energies Strength (not hardness) indicates venesection Strength resists pressure. Hardness is wiry both in the systole & diastole & may be conjoined with weakness. Authors when they speak of hardness alone commonly mean strength The coriaceous or buffy coat upon the blood may depend upon phlogistic diathesis or may depend upon the slowness with which the blood is drawn or the depth of the vessel into which it is received or the particular disease Abundance of medical testimony on this subject Firmness of coagulum & concavity of surface better indicating especially when joined with a buffy coat. We must not mistake the rigidity of the coat of the arteries of elderly people & those who labour much in the open air for genuine strength of action. All diseases are not either phlogistic or antiphlogistic but if the former bloodletting is the remedy known If carried too far it causes a subsequent dropsy etc. General depletion does not benefit a merely local topical inflammation There are cases also of atonic inflammation The essence of inflammation a John Hunter says consists not in the quantity but the quality of action No one has ever opposed bleeding in phlogistic diathesis. Though it has been often asserted; as of Dr Danforth of Boston & Dr Tully falsely however. The diathesis of New England changed about 1805 Many believe and teach that in entonic cases we should aim at the production of faintness or syncope by the manner of abstracting blood Not so however except in surgical cases Sincope should be avoided by placing the patient in a recumbent posture A pint or pint & a half as was directed by Cullen will generally be sufficient if properly supported by refrigerants, subacid fruits cool air etc. With regard to bleeding after casualties. A New England physician of very extensive practice says he has seen more cases of death after a casualty produced by bleeding than by the casualty itself Latham quoted to the same extent Alcohol continued It has been and is now denied that this article ever increases vital energies, or gives new strength, but it [was] affirmed that it merely acts like the spur upon the horse. If this were true it would never be proper to use it in atonic disease, and ought to be banished from the druggist’s shops The ill effects of alcohol are very different from those of wine In chronic cases alcohol is seldom proper and then only to a limited degree. Good French brandy is the best form of alcohol. Morbid exhiliration & delirium & narcosis constitute intoxication Stimulation has nothing to do with intoxication. The ill effects of tippling are probably the result of the narcotic power, one thing is certain viz. that the ill effects of wine & alcohol are not the result of the stimulant operation [illegible] for no more stimulant produces similar effects v. page 48 On Bleeding in Typhus Been advocated at different times for 3 centuries See Good for a summary on this subject. This author advocates it in cases of what he calls congestion Yet from his manner of speaking we might conclude that he had not seen the practice very successful & it is opposed to his own opinion with respect to bleeding in atonic inflammation. There are several sorts of congestion. Superficial [concretion] caused by the action of the heart over powering the pressure of the atmosphere Visceral congestion caused by the atmospheric pressure overpowering the enfeebled action of the heart hence in this kind bleeding will increase it Good supposes that typhus is liable to run into a phlogistic diathesis False as is also the notion that cauma becomes atonic. These two states of the system are entirely incompatible Diseases are broken up in their forming stage by strong measures of the most opposite kind. This accounts for the success of large bleedings in many cases of typhus Free depletions will produce congestion Hence the greatest bleeders always have many cases of congestion & visceral inflammation 3d purpose of bloodletting to breakup diseases etc. The classes of remedies whose effects it increases are emmenagogue sialagogues diaphoretics diuretics cathartics etc. It does not increase the action of all the deobstruents as has been supposed In cases of atony it diminishes their action Most of the deobstruents act more powerfully as the vital energies are higher 4th as a substitute for habitual 7 moderate bloodletting & to remedy a too rapid sanguificatious disease passive haemorrhage paremenia Wounds of the lungs brain etc. It is not the best remedy for a paroxysm of haemorrhage especially if passive In some parts of the country it is the fashion to bleed every gravid woman. A very injurious practice Tully has known 5 or 6 successive cases of abortion in one family, caused by this practice This practice employed in aneurism to keep the vessels partially empty. These cases frequently supposed to exist in many cases when the palpitation was caused by dyspepsia It seems to be the best practice in cases of wounds of the brain & lungs, to avoid haemorrhage 5 to produce sudden faintness. Diseases the passage of gall stones of calculi from the kidneys some cases of hernia obstruction of parturition from rigidity. To facilitate luxations etc. In order to facilitate the production of this effect, place the patient in a sitting posture make a large orifice, pleno vivo. Great abuse in cases of pregnancy many fine women have had their constitutions ruined A Connecticut practitioner has done much mischief 6 purpose to promote absorption & reduce parabismata etc. It should be done in the early stages & should by followed by powerful emetics cathartics etc. The situation in which a person resides affects the necessity for bleeding Those in warm & moist situations require least. [Scrumous] persons bear it very ill. No attention is to be paid to the season of the year. In the Bethlehem hospital for the insane. It was the custom to bleed all the patients in the spring * purge them in the autumn, untill an investigation by parliament was had of all the insane hospital Infants & the aged bear bleeding less Excessive bloodletting is followed by dropsy hectic of inanition, corpulency & laxity with debility: nervous affections etc. Repeated bloodlettings Ill effects of alcohol the chronic effects are a peculiar sort of dyspepsia followed in the case of wine by gout etc. & in the case of alcohol by phthisis paruria mellita impotency delirium tremens, dropsy palsy ophthalmitis the objection that the use of alcohol in malignant cases produces intoxication is entirely unfounded. So also is that of it being liable to cause a habit of intemperance As to its benefit I health case of a students being supposed to labor excessively Alcohol will prevent his nervous tremors [exhaustion] may be prevented from disabling him for the remainder of the day by alcohol N.B. food will not answer Case of two brothers of schirrous diathesis and [in] health over exerting themselves at a fire The one who did not recruit himself by alcohol, lingered two or three years & died of consumption [illegible] of over work in harvesting & shad fishing After a shower rheumatism & pulmonary complaints may be prevented Tully’s own case of these vid. [16] Sanguinaria Canadensis Alkali called sanguinaria Several of its salts are of a beautiful red crimson or scarlet colour a circumstance almost peculiar to these The change produced by mixing the white acid and white alkali is very remarkable All the salts have the same medicinal properties Removes torpor of the liver exerting an action upon the whole secernant and absorbent system. Acts upon the stomach and promotes digestion. Promotes expectoration & the [illegible] secretion. In large doses it is emetic and narcotic It is liable to leave the stomach and intestines in a weak and irritable condition & hence sometimes proves fatal It irritates promotes absorption and action and frequently cures when applied externally to ulcers. It will probably be useful in inflamma It excites sneezing & increase of secretion in the sneiderian membrane Tartrate of sanguinaria experimented upon in Tully’s office & found to possess all the valuable medicinal powers of the root of the plant. It is less emetic It will sometimes answer when the preparation of the root cannot be tolerated The active principle of the plant is the colouring matter which pervades all parts of the 1st deobstruent 2nd acrid narcotic 3 emetic (1st cholagogue 2nd expectorant 3d emmenagogue (not diaphoretic) scarcely diuretic nor sialagogue not cathartic except by promoting the secretion of bile) 4th escharotic & anti-psoraic & discutient Begin with 30 gtts of tinct. & increase to 1 or 2 fl z First employed in Middlefield by Dr [?cjiah] Hoadly, as a sort of specific in some cases and as emetic in croup 1775 (about) First published account is in Foster’s Bossert 1772 says it is emetic. Employed Dr Bolton of Wallingford. First introduced into general practice by Dr Tully 1813 Apocynum cannabinum lectured on Aralia spinosa a large shrub or small tree in middle western & southern states cultivated here. Called angelica tree prickly ash toothache tree etc. etc. This is the most active species All of them have the same properties in different degrees The recent bark of the trunk root and branches & the fruit have an acrid taste in the fauces a common character of the vegetable deobstruents The immediate effects of the bark & fruit are languor lassitude sense of weakness prickly or burning sensation more especially on the face & hands diaphoresis & drowsiness. If continued long enough it promotes the secretions of the liver resolves inflammations finally hydragogue catharsis & sometimes like some other deobstruents produces a genuine articaria It may also be conveniently used as an emetic if sufficiently large doses are employed It has been employed in the bites of snake In such cases the sensation is caused by the bit of the rattlesnake & not by the aralia. It has long been popular in rheumatism Notice taken of A. racemosa (spikenard) A. hispida & A. medicaulis which are weaker and have not been so much experimented on Baptisia tinctoria podalyria tinct. The root is the only part used in medicine Not very thoroughly investigated. First said (of course almost) to be good for the bites of rattlesnakes by Dr Cutler. Dr [Stearn] of New Hampshire notices it in his American Herbal & his account has been (of course) regularly copied. High encomiums are bestowed on it by Dr Thatcher. Dr Joseph Comstock of Lebanon gives an account of its employment successfully as a powerful antiseptic W. B. C. Barton notices it. So others. Tully found that large doses operated as an emetic and cathartic and in smaller doses as a nauseating cathartic It allayed irritative heat and dryness of the skin, promoted the biliary secretions & resolved topical inflammations produced narcosis and always proved cathartic was useful in various cutaneous eruptions Very useful as an external application to ulcers in preventing gangrene Resembles colchicum most, though less dangerous Veratrium vide gum hellebore Treated of by Bigelow & this article upon it is the best in this “Medical Botany” Bigelow calls it highly stimulant. It has no stimulant Bigelow probably formed his conclusion from the fact of its being acrid Acidity will not necessarily produce stimulation That of this article produces irritation, not stimulation No more is every bitter necessarily a tonic Bigelow calls it sedative. But sedative powers may result from a narcotic a nervine or operation Bigelow goes on in the detailed account to deny its stimulant powers This article exactly resembles the veratrum album of Europe Like phytolacca [decandra] & most of the deobstruents it cannot advantageously be used as a mere caustic Too large a quantity in the 24 hours produces vertigo convulsions etc. An excessive single dose produces hyperemesis & hyper catharsis in addition. This last property however is no proof of its being a cathartic, for in poisonous doses one half of the articles in the materia medica will produce this effect. Case related of a physician’s prescribing skunk cabbage beer hyper emesis & catharsis tormina & even alvine haemorrhage etc. of the family & of a physician Relief was afforded by opium This article is an acrid narcotic deobstruent Not diaphoretic diuretic or cathartic It loses much of its power by drying It will produce vomiting when externally applied to a wound Andeira Andeira inernis ([Geffrona] inernis) cabbage tree of the warmer parts of N. America e.g. Jamaica Nat ord leguminasae yet the fruit is a drupe Not used in this country. Nearly resembles coilchicum in its operation. The bark is used The tests of an over dose are nausea & vomiting of to frequent doses, narcosis of too long continuance hydragogue catharsis It is employed in the West Indies and in Spanish America mostly as an anthelmintic Dr Wright of Jamaica considers it the best anthelmintic known Cantharis vesicatoria Stimulant, diuretic, epispastic Of the application of it in typhus Prof Ives has made more use of it than perhaps any other practitioner in the United States. He has given to the amount of a fluid ounce in 24 hours in cases so low as that the patients were insensible to all external objects, and unconsciously voided their urine and faeces Of considerable importance in delirium tremens As an epispastic useful in aposthema communis common boil may be dispensed, anthrax may sometimes, inflammation of the parotid gland Erythema oedematisum (internally in conjoin) with other stimulants and tonics As an epispastic in bubo & in chillblain also in all the varieties of cephalitis Parismitis caumatodes var. phlegmoneae is benefitted by blistering Parismatis typhodes (typhoid inflammation of the fauces) internally Most of the varieties of pneumonitis typhodes internally and externally Erythema of the lungs? Case of Dr Brown’s in Hartford taken suddenly, in 15 minutes [illegible], died in 12 hours partially roused by brandy opium & tinct. canth. The constitutional affection was t. syncopalis Sparganosis puerperarum benefitted by blistering unless it will bring on irritation in consequence of the previous exhaustion of the system Blisters in dysentery in inflammations of the eyes, in phthisis It is a common practice to blister in rheumatism, very injurious & frequently fata, from chasing the topical affection from joint to joint until it attacks a vital part. If however the rheumatism becomes fixed, then blistering may be useful So in chronic rheumatism Sciatica a neuralgia as much as a rheumatic affection, blisters are very useful though when physicians have injudiciously reduced the system by bleeding the blisters may produce a bad irritation Rickets marasmus [illegible] & scruma in these it is used internally. Said to be worth more than every thing else in scruma In gangrene where there is not great atony the topical application is valuable In vitiated ulcers, internally with tonics Ecphronia mania & melancholia, etc. amaurosis applied over the forehead In the early stages of deafness, applied about the ear In tetanus, in enormous quantities internally, just as opium is given to the amt of 100 gr. in 24 hours also blisters on the spine are beneficial Doubtful as to its benefit in neuralgia It has been proposed in lyssa canina Beneficial in idiopathic headache Leucophlegmosia palsy int. & ext. one of the most powerful remedies Blenorrhea leucorrhea [spermorea] [impotency] in these internally Dropsy in all its varieties Remarkable case mentioned by Dr Ives In internal use in one night carried off all the water flooding the floor of the room The patient was reduced to a skeleton & in a state of asphyxia from which he was roused by friction with ammonia etc. pledgets of ling dipped in amm. thrust into the nostrils & the internal administration of spicy & spiritous cordials. He recovered Internally in the species of paruria In paruria mellita or diabetes, give as much opium as will be borne without soporific effect for it will diminish the secretion of murine & increase that of the skin. Give the tinct. canth. Sponge the surface with caustic potash confined the patient to animal prod and debar the use of drink Keep the extremities warm cloth the body in flannel sometimes wearing stockings filled with capsicum to keep upon irritation. Various combinations of canth. with phosphorus etc. are necessary afterwards Exhaustion from haemorrhage has been relieved when other stimulants seemed to fail In the United States we have the cahntharis villata which is more powerful than the C. vesicatoria & might be furnished at a cheaper So the C. cinerea C. [illegible] lytta nuttallii of the N.W. territory is exceedingly powerful and might be collected in great quantities So other species of cantha Lytta gigas of India is about twice as large much more powerful and more speedy in its operation So other insects The larva of phalaena neustria is a good blistering insect. It is the common apple worm Apis mellifica is a blistering insect Various other insects are mentioned by the European writers Capsicum [Roem???] & Sch. [illegible] [illegible] sp. London gives 3 more Our species is the C. opossum or squash pepper. Pericarp oblong globose or conic [or] tetragonous etc. etc. Other species are cultivated but rare The imported cayenne is an indiscriminate mixture adulterated with salt & even with flour, frequently with peroxide of lead. Indian pods are stronger; but ours are strong enough Aleth species have the same properties in kind. By digesting the pods in ether for some days the oil is obtained & crops of crystals of capsicum are found on the sides of the vessel in acicular crystals This is destitute of sensible or medicinal properties So also of piperin. Each of these owe their small amt of virtue to their contamination. The active principle of each is the oil. The oil of capsicum is a perfect substitute Capsicum is a powerful stimulant. The first sensation is that of warmth As in condiment it prevents flatulence from vegetable food and is not liable to the injurious effects of the oriental spices upon the head. Instead of causing visceral obstructions particularly of the liver it is most probably that they prevent them The effects of too large a topical application are an excessive irritative inflammation which is relieved by olive oil & cerate of datura. Tully does not believe that the stomach will retain a sufficient quantity of the power to poison The habitual use of as an article of food in excessive quantities weakens the stomach & produces a troublesome kind of dyspepsia. As a rubefacient it possess peculiar powers One fourth or one eight of a minim of the oil is a dose, given in a pill made with some extract. Of the substance 2 to 12 grains is a dose. The doses are to be larger in tropical climates Lecture omitted Capsicum continued diseases continued Disguised gout various cases of gout misplaced gout Secondary stages of atonic acute rheumatism & in all cases of erythematoid rheumatism All the low atonic exanthematica e.g. rosalia maligna rubeola maligna, malignant small pox All positively passive hemorrhage Marasmus tabes. Sertosis rachea (rickets) All the srumous phlogotica i.e. strumous visceral inflammation. Porphyra hemorrhagica or land scurvy this the remedy second in importance Acetate of lead is first The several species of gangrene Tully considers it as a settled point that tonics deobstruents & acrids are frequently the best remedies for insanity e.g. Connecticut [illegible] which had been more successful than any other known Melancholia hypochondria N.B. this seems to be a compound of melancholia & dyspepsia. Chorea carus lethargus paramenia [illegible] atonic acrids then assist the operation of the deobstruents & tonics Blenorrhea simplex & chronica have as often been suspended by an internal use of capsicum So B. senodes emphysema abdominis (typanitis) Paruria mellita mostly externally sometimes internally as an adjuvant. Par. [incontin??] epidrosis profusa (sweating) The effects of the bits of serpents though not so effectual by itself as alcohol This last with opium is first, next are ammonia capsicum etc. Monarda punctata N S. to Car 14 sp. in R & S. This the most active species Com. name horse mint. Though this name is applied to sp. of mentha & pyenanthem Ess. oil is volatile and exceedingly pungent and acrid resembling the ess. oil of thymus vulgaris One of the most elegant aromatic stimulants and externally rubefacient & even vesicatory. Spt. 1 fl. oz. of oil to 7 of alcohol is the most convenient form for its internal administration First introduced into regular practice by Dr. Attley of Phil. Diseases (Attley & Eberle) 1st typhus in the cold state externally applied Cholera infantum externally Chronic rheumatism cephalea hemicrania obtuseness of hearing from atony dropped into the ear. Externally applied to the limbs in some forms of palsy Rheumatic odontalgia dropped into the tooth if it is carious if not applied to the face combined opium with it Our most common sp. is m. oblongata & this sp. would probably answer as well M. dydima (bee balm or Oswego tea) M. fistulosa common All have the same oil Ether sulphuric or hydric or vitriolic the most volatile of all known liquids. Extremely inflammatory sometimes producing serious accidents when poured out by candlelight. The best test of its purity will be its sp. gr. [illegible] a pure diffusibly stimulant and nervine N.B. Part of two lectures lost Disease (many lost) Typhus Dr Rush never suffered a patient to die without having first tried a very efficient use of this article Syncope of various species, in these it is the best remedy. Neuralgia auris (ear aches) dropped into the ear especially mixed with sulphate of morphine the ear being stopped with lint to prevent evaporation Cephalis hemicrania & nauseosa N.B. when externally applied and suffering to evaporate it is a refrigerant Chorea, common convulsion Hysteria asphyxia, after breathing has been restored. Tully has frequently seen a patient roused from a paroxysm of catalepsy by ether letharty, parodynia Burns & scalds mixed with spt of ammonia, employed by Dr Ives N.B. if vesication has already taken place, it must be so managed as to produce its refrigerant effects? In that state of the system which has been called concussion in consequence of a sudden and violent shock. Wine produce of the vitis vivifera which was originally from the south of Asia it is found however growing wild in Armenia Tauria etc. The varieties are almost innumerable Different sorts of wine 1st white & red again [illegible], adiculia aspera, & mitia acidulous e.g. shock dulcia frontenae malaga tokay, [illegible] aspera port, mitia or soft sherry claret burgundy champaign madeira Paris’ account if its being firs employed by Asclepiades a little before the time of Pompey It is mentioned by Hippocrates It increases the frequency of the morbidly slow pulse & diminishes the heat or increases it diminishes or increases sweating improves the appetite digestion, exhilirates, & strengthens etc. etc. # Habitual and free drinkers of wine are not subject at all to intermittents & but little to typhus Indeed it diminishes the liability to many inflammations etc. See MacCulloch on malaria Excessive quantities produce nausea vertigo etc. in short intoxication # These are the effects in atonic cases & when given in suitable and regular doses and for some time Habitual and excessive use a general weakness of the nervous system a peculiar sort of dyspepsia & gout These are all Wine is 1st stimulant 2nd nervine 3d narcotic The last operation consists of the vertigo nausea etc. Its sedative effects in case of irritability pain etc. are probably the joint result of all its operations Its effects are not slow and permanent enough to entitle it to be called a tonic Wine and opium are the most valuable articles of their kind Various eminent British authorities quoted Good is inconsistent and contradictory It is more especially adapted to the putrid type of typhus Chemical composition of the intoxicating principle One fourth part of the best wine is officinal alcohol or at least will furnish that amount So that a pint of wine will yield a half pint of brandy Now the effects of factitious wines do not differ from those of diluted alcohol The same is true when alcohol is added to wine. It is commonly supposed at the present day that the difference is owing to the chemical composition in which the alcohol [exists] in the wine, chemical comp more especially with the water But we have no evidence that alcohol will unite with water in any other manner than by solution Others supposed that only a portion of the alcohol exists in the wine previous to distillation. But Mr. Grande by adding [illegible] acetate of lead, separates the alcohol without distillation Pure alcohol is composed of the ponderable part of olefiant gas & water 2 to 1 ether is [illegible] to 1 In wine probably [illegible] will have it 1 to 1 Perhaps another compound of 1 ol. gas to 2 of water may be the princ. of [alc.] etc. which differ as much from [illegible] as this does from alcohol Alcohol Arabic named & discovery The name is figurative, meaning originally a fine powder of antimony used as a paint It retains its fluidity at 91 degrees below zero of Fahrenheit# The bluer the flame the purer the alcohol, and in this way its purity may be judged of The pure state has a sp. gr. of .792 Off alc. is .835 Arrack & spiritus oryzae (rice) The difference in the several sorts of spirit is owing to oily matter and acetic ether. The effects of wine and alcohol which are called by the same name yet differ Alcohol & tobacco have more effect upon the [illegible] Intoxication takes place sooner upon an empty stomach & when the body is immersed in water, but if the head is wet and the body dry, the reverse is true vid p 50 # Frozen by Mr Bussy Bulbs filled & surrounded with cotton dipped in anhydrous sulphurum acid, and placed under the receiver of an air pump vid. p. 43 Nitrate of potassa The most powerful refrigerant known next to blood letting most powerfully reducing [illegible] of action Tully thinks it not diaphoretic as has been said neither diuretic. It proves diuretic and diaphoretic in cases of obstructed perspiration & urine from phlogistic diathesis Sometimes however it has these effects in other circumstances though they cannot be calculated upon It is not sedative except as it relieves the morbid restlessness heat & dryness of skin etc. of phlogistic diathesis It may not febrifuge except in [?thenic] fevers, that is in a small portion of fevers Not laxative except as it relieves the torpor of phlogistic diathesis producing the natural discharges. Very doubtful if it is ever antispasmodic. Not antiseptic except upon dead animal matter. Sometimes there is a tendency to gangrene in high phlogistic diathesis which of course is relieved by any refrigerant Cinchona is the most powerful antiseptic, using the term in its most appropriate senses, but these two articles are entirely incompatible one will not counteract efficiently the improper use of the other as seems to be sometimes supposed. The injurious effects of efficient quantities of this article in atonic cases are crust on the teeth coldness of extremities etc. etc. It should always be given in uniform and small quantities from 5 gr. to 1 scr. The test of too large a quantity is pain in the stomach. Sometimes present in the urine, but not in proportion to its effects. The operation of the external application are similar to those of its internal hence it is used as a lotion on phlegmonous inflammation. it is also used as an irritant like tartrate of antimony not therefore a stimulant Deleterious effects, coldness of stomach, discharge of considerable [illegible] of blood weak pulse etc. etc. pallor of countenance etc. A very large quantity vomits and is thrown off. ½ an ounce to an ounce is a poisonous dose Orfila conjoined it refrigerating with its narcotic effects an egregious blunder In a medico jurisprudential point of view nothing short of find the article will answer. Show a distinguished anatomist says that the appearance of the stomach and intestines is not to be relied on as a proof of poison because all the appearances may be at times found in an unpoisoned stomach This very important in this country where medical jurisprudence is much abused. Remedies 1st vomit, not with the mineral, but the vegetable emetics the best is a dose of a table spoonful of black mustard which is more speedy and effectual in clearing the stomach and is useful as an acrid. Opium & alcohol with nutrition demulcent After the poisonous effects have taken place do not vomit and in any case prefer emesis to catharsis. Finally prescribe to the symptoms. The refrigerants & especially nitrate of potassa have been undervalued of late Partly from change of diseases, partly from the chemical theory of the production of animal heat by the solidification of oxygen The French writers call it stimulant because it produces irritation & inflammation Diseases Acute mercurial ptyalism as a topical application doubtful because it is an atonic agent. A dipsosis avens or morbid thirst, especially of intemperance doubtful for the above reason Opium etc. are also undoubtedly known to be useful. This also makes the above doubtful. Dyspepsia by Wilson Philip, upon his theory that the secondary stages of dyspepsia are phlogistic There is much more reason for considering it exceedingly injurious in this disease producing a bad sort of dyspepsia when freely given for affections of the urinary organs. Jaundice by the French writers melaena also by the same very improbable. Simple idiopathic cough very doubtful. Remittent But the opposite class of remedies is always wanted in the varieties of this disease. Idiopathic hectic because it is cooling & sedative Very little probability Synochous in this it does neither hurt nor good Typhus gravior very injurious. Cauma or actively inflammatory fever the most efficient remedy after bloodletting & perhaps after nauseating doses of tartrate of antimony A composition of nitrate of potassa tartrate of antimony & calomel used in Philadelphia under the appellation of Rush’s febrifuge it contains too little of the two first articles. As a general rule avoid being confined to set formulas. Some inflammations of the skin boils [illegible] etc. Blenorrhea lenodes (clap) it has been recommended. In inflammations of the female breasts & of the testicle, it is not so good as acetate of lead. Useful in phlogistic rheumatism still not so good as some other modes of treatment. Useful & important in all the entonic phlogotica. Active phlegmonous cephalitis & in quinsy Membranific inflammation of the bladder doubtful because copaiva oil of pine etc. are very useful. In hemorrhage haemoptysis but the restriction to active shd be made haemorhage It has been recommended in haemorrhage attended with plethora. Tully however does not believe in the existence of a disease consisting of too great a quantity of blood. Sea scurvy recommended very doubtful Tully is inclined to think sea scurvy not a different disease from land scurvy. The latter requires the system to be raised, the former will generally be cured by a change of food Obesity which however is better cured by the old rule mouth always shut eyes always open feet always in motion. Cellular dropsy doubtful Parunia various species, including diabetes. Neither this nor any other remedy has done much good Gravel improbable. Lepidosis psoriaca var. inveterata. Impetogo laminosa (salt rheum) I. herpetica (herpes) Tully has not known it do good & very different articles serviceable. Nitrate of soda possesses the same medicinal properties So also nitrate of ammonia although ammonia itself is stimulating. Various other nitrates also. Carbonate of potassa called sal tartari sal absynthii (salt of wormwood) The deliquation by exposure to air was called oleum tartari. Obtained from the [L??viation] of the ashes of plants not [illegible] when imperfectly purified called pearl ashes. It must be pure for most pharmaceutical preparations. The theory of its combination with oils forming soup it was formerly not understood has been lately investigated. Incompatibles, all the salt will decompose it It is refrigerant but this property is not so predominant as to prevent its use in atonic case Also diuretic, especially when aided by plentiful dilution, still it cannot be depended on in dropsy. In diuretic power greater than it refrigerating. Parunia inops most useful as a diuretic in this Sometimes antilithic viz. in cases of calculi of the xanthic acid & 2 others Antacid as in dyspepsia still not so good as oxide of potassium which is also tonic not so good also as lime. Not stimulating unless this term be applied to every remedial agent. Neither increased frequency of pulse, nor increased heat is an evidence of [stimulation] Not specifically anti-emetic unless retching is produced by a free acid. Not antispasmodic, as in bex convulsiva (whooping cough) Of no use in visceral enlargement. Dyspepsia remittents recommended in the form of effervescing mixtures which however operate by their carbonia acid & the salt formed. Saccharine matters supposed to impair its power. Water the only proper menstruum for its solution. Its solution commonly mixed with a little rhubarb & peppermint This much mused by physicians when at a loss what else to do. Case of A seamstress who had a horrid dyspepsia from costiveness relieved habitually by Lee’s pills relieved by this brought from the south Oftenest used as an effervescing mixture If sugar is added it should be dissolved not in the solution but in the lime juice or else the effervescence will be prevented But the bi carbonate of potassa is best for effervescing mixtures. Large doses are poisonous from irritation inflammation etc. Antidote at first vinegar afterwards demulcents particularly those of an [illegible] oily nature, with narcotics Bicarbonate of potassa called carbonata & super carbonate also sub tartari essentialis sal aeratus (this name is given to other salts of [illegible]) Does not deliquesce from exposure to the air possesses considerable activity as a refrigerant more than the last article. Much use of it as an antacid injurious from the distention. Tully does not believe with Edward and Varasseum that it possesses all the advantages of the carbonate & ought to be used for it although mor pleasant to the taste Carbonate of soda called sal sodae called in commerce when in its most impure state barilla Effloresces upon exposure to the air deliquesces by heat Obtained from marine plants especially the salsola soda Similar in powers to the above Tully thinks it not deobstruent. It can be given in pills carb of potassa cannot from its deliquating the carbonate of soda however must be [efflorescent] Tully can perceive no effect in jaundice from this or the carb. pot. Bicarb. soda (more commonly called sub-[illegible]) found native & called hard enough to build the walls of a fort Ingredient in some specimens of soda water This article originally was made of oxide of sodium Now, except in N. Haven, it is merely carbonated water. The prevailing custom very injurious Case of a brine spring in Albany. Saratoga very injurious ½ dr. to [illegible] gr. tart makes soda powders with pure concrete tartaric acid The tartrate of soda produced is cathartic proportions 25 gr tart. acid ½ dr. soda Seidlitz pow Hydrocyanic acid (I was absent) [Illegible] cerasus the essential oil Equally powerful as a narcotic with hydrocyanic acid 6 ol. oz. of distilled water to 1 pound of the recent leaves Less powerful upon man than upon the brute animals upon which the operation of a little laurel water to the eye or the inside of the mouth causes immediate death. Two or three minims of the (so called or supposed) essential oil kills small animals Tincture the most convenient form Cataplasms of the leaves are useful as a narcotic. The leaves are used for their flavour in cookery among the English & has sometimes in moderate quantities have produced death. Probably the cerasus virginiana has the same properties. probably in a less degree Gelseminum nitis (apocyneae) The effluvia of the flowers are said (in Elliott) sometimes to produce stupor) Tully considers it as a perfect substitute for hydrocyanic acid & free from its inconveniences. The root, most powerful part. In phlogostic cases it would probably like the other simple narcotics do neither good nor hurt. Never produces the calm placid pleasurable sensation exhiliration and wakefulness of the nervines. Tully has always used the tincture 4 oz. bruised root to 1 pint of alcohol macerate for a week. 10 to 20 minims from 3 to 6 hours beginning with small doses & more until narcosis begins to be powdered & then continue the same dose. It is well frequently to conjoin opium [illegible] will counteract its liability to to produce narcosis, Probable all the stimulants have this power. Perhaps the failures so frequently complained of are owing to want of skill in conjoining them Evil effects narcosis merely which may always be relieved by the diffusible stimulants. The best are alcohol [monarda] punctata capsicum spt. ammonia Make use of of napkins wet in cold water applied to the head & of friction, & rubefaction by the monarda punctata Case of a patient who book several doses in rapid succession. The very distressing symptoms were immediately relieved by brand & in 12 hours the patient was as well as before. Case of a girl at the south died in an hour Diseases bex (various species) phthisis where there is much irritation Dyspnea exacerbans acute & subacute rheum Helomas erythrosperma A pure narcotic yet differing materially in its effects from the Prussic acid & Gelsemenum Letter from Dr Brand of S. Carolina Affect the eyes making them sensible to light in an extraordinary degree blindness finally N.B. All narcotics appear to affect the sight Some produce dimness Some dilate the pupil Commencing dose of the tincture 10 minim. Tully has commonly found from 20 to 30 minims necessary at intervals of from 4 to 6 hours. With respect to most such articles, physicians are apt to give inefficient doses & then condemn the article Few of the narcotics, except opium directly produce sleep Chlorite of Potassa (oxymuriate) Prof. Ives is right in saying that it diminishes the heat of the kin & of the stomach. It diminished or at least does not increase entonic diathesis Said to relieve chronic hepatitis which however does not exist, for in dyspepsia accompanied with tenderness over the liver post mortem examination shows no inflammation. Said to be capable of during lues syphilis very doubtful Said to be good for cacherine, a loos term which may include one third of human diseases. Tully believes it a weak refrigerant of no great value without further experiment Vegetable acids. 3 groups 1st those which exist in a free state 2nd which do not & 3d those which are the products of decomposition The last are the benzoic & [illegible] & perhaps [illegible] all nervines Acetic acid 4 states one of which is acidum aceticum pyrumatica or syroligneous acid. Common vinegar is acidum acegum impurum The impurities are various according to the liquor from which it is made Frequently found in the sap of plants as [illegible] typhina vitis vinifera It is a pure refrigerant proper only in cauma. To be given diluted or in combination with mucilage Improperly used in putrid [illegible] to relieve heat [illegible] about the mouth & thirst which do not require [illegible] but if we need acids we must use the [illegible] acids a sulphuric & nitric. Though it is often given to humor nurses bystanders etc. Said to be antiscorbutic but this is loose and doubtful for the vegetable acids pure do not relieve scurvy, without vegetable matter. In obesity if insufficiently employed it does nothing if efficient, it is mischievous. Useful as a condiment, as [illegible] also Conium maculatum a deobstruent [diuretic] confounded with [??uta] maculata both in Europe and in this country. The ancient hemlock is unknown. We know of no plant which will produce the effects ascribed to hemlock in the account of the death of Socrates Perhaps the liquor was a compd of several narcotics The most common form & the best for administering it is extract. The term extract has four applications 2st expressed inspissated juice 2nd inspissated exuded juice 3d inspissated decoction 4th alcoholic extracts Tully places great reliance upon conium and iron in dyspepsia It is useful in paronina salax lagnesis [fluor] etc. etc. Tully used conium & iron with various aromatics in dyspepsia for 4 or 5 years without being able to get any physician to try it. Of more value than mercurials in jaundice Cicuta maculata frequently confounded with the latter more powerful very poisonous the poison cured by stimulants etc. as in other narcotics Digitalis purpurea purple foxglove cultivated in our gardens It is a narcotic deobstruent Medical testimony upon this article exceedingly contradictory. Tully denies that it is either stimulant or refrigerant thinks that the supposed phlogistic cases in which digitalis has been though a substitute for bloodletting were in reality synochous cases which are not phlogistic according to Tully nor are they phlogistic at the outset and typhoid at the last & though they will bear bleeding yet are cured much better without In large quantities it vomits and purges 1st narcotic 2nd deobstruent &^ as parts of this last it is resolvent diuretic and discutient Most commonly used for its diuretic operation [Black???] says that digitalis is not proper except when the urine is coagulable this was tried in this country by boiling the urine! Unfounded If the system is very low it must be raised by excitants in order to allow digitalis to operate So if it is very high it must be reduced Yet there is a considerable range within which neither is necessary Paris’s account of diuretics which are incompatible with it is unfounded The narcotic powers of this article are frequently useful to allay morbid irritability. The best form is tincture It has been supposed that the infusion is best as a diuretic and the tincture as antirritant. Not very probable Therapeutic application Dyspepsia accompanied with tenderness in the epigaastric regions & febrific symptoms digitalis has been used to alleviate these symptoms not so good however as actaea & [other] Recommended in many cases of chronic cough accompanied with dropsical swelling of face, leucophlegmasia Also is it useful in many cases of simple idiopathic cough best however as an auxiliary to opium etc. Whooping cough especially conjoined with arsenic Some forms of phthisis Rheumatism is of various kinds in some of them this article may be used though in most of them actaea & some similar articles are better It has been recommended in mania and probably may be very serviceable in breaking up the paroxysms N.B. the practice of attempting to do this by profuse bleeding is generally bad because the bloodvessels are affected by the mind and not the mind by they bloodvessels & the continuance of the practice may produce fatuity Digitalis long a popular remedy taken in ale among the Italian much used as a [vulnergry]. Withering about 50 years ago first used it in dropsy as a diuretic Frequently the excessive distention of dropsy will prevent the operation of diuretics until it has been reduced by paracentesis or hydragogue cathartics especially elaterium Few diuretics can be depended upon when used alone but required to be combined with others Asclepias syriaca seems to be the most sure which Tully has used. Lobelia inflata 1st narcotic 2n deobstruent 3d emetic as parts of its deobstruent effects it is cholagogue diaphoretic? diuretic? sialagogue & perhaps emmenagogue. No published account exists of its deleterious effects. The first account was published by Ref. Dr. Cutler 1785 It has been employed in form of powder of the leaves powder of the leaves infusion tincture of seeds & tincture of the leaves 2 oz. of recently dried leaves to 1 pint of proof spirit macerate 8 or 10 days Diseases Limosis dyspepsia especially where there is great insusceptibility Simple idiopathic cough considerable [evidence] for its utility. Often very efficacious in that sort of cough to which public speakers and singers are subject it is sometimes the sequel of acute diseases, and is always accompanied with more or less dyspnoea which will be manifested by a fit of coughing following upon the [illegible] to light a candle & blow off dust from every thing Frequently accompanied in these cases with s opium Bex convulsiva or whooping cough in the secondary stages, very useful Tully has not always succeeded with it Dyspnea exacerbans (commonly called asthma, though differing from it) give it in doses of a teaspoonful once in 5 or 10 minutes until the exacerbation disappears either with or without narcosis and vomiting. Highly effectual in asthma though not so certain because the disease is more obstinate The British physicians are just beginning to learn that this article has remedial powers. Tully has no doubt that in Britain diseases yield to smaller doses and less efficient practice than with us This article has been recommended in croup, though it has been rejected upon theoretic principles. Cases mentioned in which its emetic & deobstruent powers have been very serviceable. Actaea racemosa. Black [cohosh] frequently confounded with leontice [thaltroides] called blue [cohosh] No complete analysis has been made Tully thinks it probably has no alkaline principle being in this respect similar to digitalis and conium A narcotic deobstruent in large quantities an emetic Tully thinks he has seen in children moderate exhilirating effects produced by this article It may be pushed so far as to produce neuralgic pains This effect may be prevented by giving liquid food; or it may be remedied after it has taken place by giving opium etc. There is much evidence for its being a [part??] accelerator similar to [sclerotium] clavus With respect to its diuretic and diaphoretic operation it is not strictly correct to ascribe them because they follow the exhiliration of the article only when diaphoresis and diuresis are prevented by the diseased state of the system. The deobstruent effect may be prevented and in the hands of injudicious practitioners frequently is prevented [illegible] too great previous bleeding Actaea resembles digitalis most but differs from it 1st in not accumulating upon the system and suddenly breaking out Through these effects may be prevented in digitalis yet they are not liable to occur from actaea 2nd Actaea is not liable to reduce the patient to a low and dangerous state The narcosis is more easily remedied 3d Actaea produces neuralgic & perhaps spasmodic pains. And this effect is valuable as a test of the limits of the dose 4 Actaea possesses considerable power as a [partus] accelerator 5 It possesses more deobstruent power Actura differs from conium in being [illegible] a deobstruent more speedy & powerful Actaea is most powerful in acute & conium in chronic case The resolvent power of actaea is greater than its cholagogue vice versa with Conium No article has so great a resolvent power as actaea & none so [illegible] a cholagogue as conium Actaea may made indirectly diaph. diur. & expect. conium not Actaea seems to be a more effectual deobstruent than sanguinaria and causing less nausea than colchicum & less liable than either of them to leave the stomach and intestines in a deranged condition The watery preparations not to be relied on Tully used them in a vague way in some years without discovering its narcotic powers Tincture two [ounces] to 1 pint alcohol sp. gr. .835 Medium dose of alc. tinct. f z ss once in 2 or 3 hours Materia Medica 1831 & 2 Pure mineral deobstruents are iodine nitric muriatic nitromuriatic acids chloride of gold barium calcium etc. Perchloride & peroxide of mercury also proto chloride & diproto nitrate of mercury Vegetable deobstruent 1st pure, are leontodon, rubra tinctoria fumaria offic. cinchorium intybus sapomaria offic. Of all these, a large quantity must be used 2nd Aperient they restore, or augment the fluid secretions viz. halitus from the lungs diaphoresis & diuresis (formerly called [illegible] also sweetness of the blood) now often called diet drinks, from their being given in form of decoction & in large quantities. Some of them are spoiled by decoction however. e.g. sarsaparilla is injured even by the best of the sun Smilax off. syph. rotundif. and glauca. Officinal sarsaparilla is from S. off. & S. sulph. (S. sarsaparilla produces none it should be called by Micheaux’s name glauca) Comptonia asplen. (leaves) aralia [medicaulis] & racemosa (root) Asclepias tuberosa & incarn Arctium lappa & dardana? (roots & seeds) Diervilla lutea, celastorus scandens Collisonia canadense, solarum dulcamara (has slight & easily lost narcotic properties) These are used in hectic, lues, bucnemia elephantiasis, lithis arenalis, lepidosis several species. Ecpyresis. Sequels of rheumatism in dyspepsia 3d Acrid cheledonium majus, daphne Mezeocon etc. Dirca palustris ranunculi anemones clematides myrica cerifera 4th mild narcotics, destitute of acrimony solanum nigrum & tuberosum [ethusa] sinapium conium, cicuta & probably the lacturas 5th acrid narcotics they do not incline to produce somnolency or coma, but stupor the term acrid is used to denote this quality of a narcotic operation Kalmia 2 or 3 sp. rhododendron 2 or 3 aconitum napellus, strychnos nux vomica 6th Astringent chemaph. uva ursi [illegible] calyculata ledum [palustra] 7th tonic Canalyrium carolin. (unicorn root) Helonias dioica is the old name for this aletris farinosa (unicorn root also) 8th Evacuating Ol. & resin of pinus & abies & copaifera off. & juniperus [illegible] & guaiacum off. Iris vessic. & prism. Polygala senega & pubescens squills (conithagala squilla) Gratiole off. lobelia syphilitica nearly allied to senega & better because this latter deranges the al. can. Helleborus [2] sp. Eryngium yuccifolium sanguin. veratrum apocynim. aralia spinosa phytolacca colchicum, seeds of Daphinium cocculus [indicus], stillingia sylv. anderia inernis veratrum album Mercurial Ptyalism. Symptoms are ptyalism, soreness of the mouth, ulceration of mouth & fauces a vesicular erythema upon the skin etc. Different persons differ in susceptibility. The same person will be much more susceptible after a previous salivation especially if recent. Teeth set on edge is an incipient symptom Ordinarily there are no fatal consequences. When they occur they consist of caries of the jaw, sloughy ulcers of the mouth, total loss of the teeth, stiffness & incurvation of the limbs, extreme emaciation etc. etc. The treatment is in a good degree empirical. The question as to treatment seems to be, what will do the most good No foundation exists for the opinion that the mercury is deposited throughout the system. Sulphur flowers have been thought a specific nonsense! the only two compounds of mercury & sulphur or one a brilliant red & one black & both insoluble!! Purging, as such. Prof. T. is confident, does no good Dr Finlay of Ohio thinks it may be cured by antimony. Others have not succeeded by it. Sarsaparilla is much used a quart of decoction a day is much used in G.B. undoubtedly with benefit. Not of much use in our country Astringent lotions & gargles are much used They are useful in the latter stages In the first stages resolvent remedies seem to be most needed iced water has cured mild cases. Baptisia tinct. has been much used. The testimony is so strong that Prof T. credits it It is used topically. A strong solution (1 scr. to 1 oz of water of nit. sil. has been the best article used by Tully. Liquor of the arsenite of potassa is an excellent topical application is also taken internally Spts turpentine in gum arabic is employed by Prof. I Lycopus vulgaris decoct is recommended Watery solution of opium is strongly recommended The mineral acids are recommended Mucilages are very grateful acacia typho lab. viole pedata laura sassafras ([illegible]) decoct. of rice & barley strained through a cloth) tragacanth hibiscus althea Prof T. would try quinine Milk porridge is the most grateful diet air [illegible] & [free] Erythismus hydrargyratus Irregular action of heart & arteries, pale countenance exhaustion of strength anxiety in epigastrium, sighing, quick small & sometimes intermittent pulse tongue not furred. In this state, sudden exertion may destroy the patient Treatment A steady and regular use of moderate quantities of opium alcohol & quinine with strict rest Erythema hydragyratum vide Good A vesicular eruption (though like a case of sun burn, a magnifier may be needed to discriminate) Prof. T. does not believe in the spreading from the corrosion of the discharge (criticisms upon Bateman’s confounding erythema with exaena or rash erythema being vesicular) Bateman probably incorrect in saying that it may be caused by cold merely Bateman gives a very full & perfect account of the rise & progress of the disease Diseases teething cathartics too much used blue pill preferred Prof. T. objects to protoxide (blue pill) as being extremely uncertain (imperfectly oxydized) & when perfectly oxydized is in no way preferable to calomel It is milder only in consequence of the diminution of the dose in consequence of the imperfect oxydation. Prof T distributed some of that perfectly oxydized to his friend e.g. Drs Reed Cogswell Todd etc. They all declared they could perceive no difference It will combine with the lactic acid of the stomach & produce a troublesome compound Dyspepsia Prof. T. utterly protests against the fashionable practice of using mercury in dyspepsia Even when the liver sustains the burden of disease it is injurious. The use of mercury occasions tendency of abdomen etc. etc. Even as a deobstruent it is inferior to other articles Occasionally useful as a slow purge Colica Ileus (comm. col.) Of the utmost importance not as a cathartic for this is of no consequence the disease consisting of a suspension of the peristaltic motion. Commence with opium & continue the use of opium but the cal. cures the disease It will never produce ptyalism. It has been given to the amount of i dram once in 6 hours without this effect. Colica rachialgia the same with respect both to opium & mercury Coprostasis not the best article Diarrhoea purging will cure the disease by strong impression but the practice is foolish utterly inapplicable to sev severe cases Cholera Generally the phys. is called too late to allow of the exhibition of calomel In the commencement of the disease it is useful as a deobstruent Helminthia ascar. lumbri probably the best cathartic. The spigelia ought to have been given for the last 12 hours until narcosis is produced. Then give the cathartic Senna is an extremely poor vermifuge its purgative operation is not of the right kind. In the other species of invermination cal. is not the article Even in this species turpentine oil is a better article, but not so manageable as spigelia & cal. Jaundice Purging with cal. in the early stages & the use of [illegible] deobstruant is of great importance cal. is inferior only to conium in this disease. Give it alone cal. is better as a first measure than vomiting Vomiting is apt to produce soreness in the liver & irritative fever. This calomel treatment of jaundice is not the best. The yellow colour will remain and this may be removed if we treat with conium Cal. is apt to produce ptyalism Parabisma coactum There is but one article better than cal. There is an impression that these must be cured before attacking the intermittent. The interm. may be cured without disturbing the parabisma. Conium will cure the disease in half the time of cal. Corysa acuta (improperly entonica by Good) Calomel 7 opium will cure a paroxysm Fevers 1st Intermittent It is a great mistake to suppose that we must always being with purging & vomiting If cathartics are indicated, calomel is much the best notion a drastic dose nor combined with other cathartics Remittent a disease intermediate between intermittent & continued fever. Some cases approach more to an intermittent & others more to a continued form & the nearer it approaches to the latter the more is calomel indicated. It is slow purging that we need not small doses at considerable intervals not quick & drastic for them we increase irritability & irritation Typhus infantum absurdly called infantile remittent & worm fever. Purging with pure calomel & cal. in small doses & at regular & short intervals. It is well to conjoin it with antirritant & with ipecac Non malignant nervous typhus. The best article for producing a resolution, provided you have been called in very early & also before the patient has purged himself even 3 or 4 times with castor oil. Give it either in a single & full dose or in small quantities, so as to get a full dose in the course of 12 or 15 hours or conjoined with opium. Cal. & ipecac is an excellent article for the resolution of fever. Other modes e.g. vomiting, purging, sweating etc. are more liable to fail than to succeed. This mode has succeeded in 8 out of 10 cases in Tully’s practice. Sporadic cases are resolved more easily than epidemic. Purge no more than to remove the contents of the al. can. Dis-oxide of mercury (sub oxide black oxide) (protoxide aethiops per se) pulvis hydr. [illegible] oxidum cinereum is a different compound Mode of preparation vide U.S. Pharmacopoeia This process is very exceptionable An apoth. would require near a barrel of lime water in order to make such a quantity as he would wish to make at once. It is besides uncertain from the uncertain composition of the lime water. You will have an excess of carbonate of lime or of calomel The [illegible] of the Phil. phar. is the best for a chemist viz. cal. & caust. pot. with 1 pt. water Take cal. & carb. pot. equal parts triturate in a mortar to every troy oz. add alcoh. 3 fl. oz. & wat 1 pt. Boil in a flask until there is a copious black precip wash & dry Blue pill will be more strong in proportion to the quantity of metallic mercury contained which is entirely inactive. If it is made with conserve of roses or with rhubarb, we shall have more or less of malate or gallate of mercury Light decomposes it. When made into pills with any articles which contain combustible matter a greater or less degree of decomposition takes place The mercurial ointment Prof Tully would retain although there is more or less uncertainty about it. But the blue pill mass he would utterly reject. Still this black oxide does not differ in its operation from cal. vide above upon cal. The physicians to whom Prof. T. distributed this article reported that where the stomach contained acid probably from the formation of a salt tormina followed its administra Prof T. would use the black oxide for those who have a prejudice against calomel & for this purpose only Cal. & op. is better in most cases for producing a mercurial action than the ointment still not always Black oxide macerated in nitric acid ([diluted] for 24 hours Wash the white powder. It is between 2/3 & ½ as active as calomel & ought to be substituted for the blue mass This is the di-proto-nitrate of mercury or the disnitrated disoxide Please sew these together Iodine characters Origin is from ocean salt springs zosteramarina Trigl. chin salsola atriplex chenopoidium dipsacis [fallorum] [sedium] teliphium The cryptogamous plants are much more numerous [f?cus] vesiculsus etc. It is found in zoophytes as sponge in the genera venus (clam) ostrea (oysters) etc. several mollusca. Probably iodine & potassium exists in its metallic state in combination with the other elements of the plants Potassa or oxide of potassium probably is produced by the incineration Operative effects Moderate augmentation of the appetite & digestive & of arterial vigor & muscular strength perhaps this is merely the effects of its alleviation of diseases It is of no utility as a [narcotic] 2nd resolves glandular enlargement as of the thyroid the ovaries the testicles & breast & lepidotic (especially) cutaneous aff & acute subacute & chronic inflammations (of an arthritic character especially) increases the catamenia & is said to diminish corpulency & fatten the lean An overdose will either be thrown off by vomiting or produces an atonic erythematic inflammation of the mucous men. of the fauces & al. canal. Dr Tully gives a teaspoonful of the saturated tinct. without injury It is said to have removed the heatlhy female breasts & male testicles. There is no good evidence of this Magendie & others who have much used it have seen no such effects Elliotson of England has employed it very much & even for 18 months without any injury, when disagreeable effects were produced he merely suspended it & afterwards diminished the dose Dr Wood has had it produce a vesicular infl. All the injurious effects are said to have happened in Switzerland, where there was a sort of mania for its use. Prof. T. has used it very much & has not known it produce injurious effects He has known it frequently relieve a diseased & not injure a healthy testicle It is said not to be so at Wether. st. pr. But then the prisoners there are dysthetic or cachectic One case was that of a fungus haematodes The other test. remained unimpaired Iodine is not a stimulant i.e not producing a quickly diffused & transient strength of action. It is a vital irritant capable of producing vesication upon the skin. When properly managed it is neither sialagogue expectorant, diaph nor diuretic. It acts upon the skin, but not in the way of producing diaphoresis. It has cathartic properties according to the experience of Dr Todd It is not known to be cholagogue s Iodine is then 1st deob. 2 tonic 3 rubefacient or even vesicatory Its deobstruent operations are 1st resolve 2nd atnipsoraic 3d emmenag 4th discutient Opium should always be conjoined to counteract its tendency to produce irritation. Opium will enable the patient to bear more iodine & will not injure its operation. Hyoscyam conium & other narcotics will answer [illegible] entony or atony contraindicate it. When used to freely or too long it is said to produce pytalism pain of teeth & gums. absorption of glands pain in internal ears vertigo, sense of burning in the stomach etc. etc. thirst vomiting NO doubt that glands are absorbed by an excessive use. Sufficient warming is given. If persevered in a dry cough sleplessness emaciation vomiting fiarrhoea paralysis priapism convulsions death from excessive irritation. Case of a young lady in Paris whose goitre was reduced to a hard knot. The knot was not cut out as it should have been. The iodine was not discontinued it produced excessive vomiting & purging with an emaciation such that the thighs were not larger than the wrists in health Eventually recovered or nearly so on opium. Authors recommend depletion of blood cathartics of neutral salts etc. a strict antiphlogistic [illegible] [illegible] can be scarcely be deduced from the symptoms On the contrary they indicate antirritants & moderate stimulants ([illegible] powerful stimulants) for the extreme exhaustion & irritation. Opium should be the main article. There is a prejudice among the people, derived undoubtedly from physicians that opium commonly palliate, & never cure disease. It is capable, if properly managed, of curing as many diseases as any other article A British author says that for gastrodynia medicine is of no use with the exception of opium given in efficient quantities. It is idiopathic gastrodynia which is here spoken of. No injurious effects follows Injurious effects follow only the use of opium where there is no disease ^ where of course it produces diseases. Many in the Senate at the Bar etc. are now free from gastrodynia enjoying health & comfort This author however, says Prof. T. seems to know of no mode of using it but to meet paroxysm but the disease may be radically cured even if it requires as it has in Prof. T.’s practice a year & a half. This is a disease not [ever] of inflammation but of irritation though after a long continuance infl. may come on Pharmaceutic prep. Pure [illegible] in pill tinct. ether ointment * plaster of iodine. Magendie’s formula is to be utterly disregarded, on account of the different weights & the different strength of their alcohol which is absolute alcohol a substance which cannot be obtained among us. The translators have sometimes translated the weights without reduction or reduced some & not others. The truth is the French pharmacy is loos & in the midst of their vast among of science there is a great deal of empiricism One grain is supposed to be a medium dose made, say with ext. glycirrh. Divide one gr into 2 pills & give perhaps 1 if necessary Tinct. made of sp. gr. .835. (Take a vial of a known weight put into it 1000 gr, of distilled water mark the heights alcohol up to this mark should weight 835 gr.) 24 gr. of iodine will sat. 1 fl. oz. 20 min. will contain a grain & this is a medium dose [2] or 3 times in a day we may need to give 15 min. or 30 min. or even a fl. dr. Elliotson has increased it from 5 min. to 2 fl. dr. It is said this tinct. will become weakened by crystallization, if it is kept long. Very probably this is the result of carelessly stopping the bottle & suffering the alcoh. to evap. Ether of iodine is used in France Ether contributes nothing. The only possible advantage must be that of having it a little more highly concentrated Ointment of iodine must vary in strength to suit the patient To 1 oz of simple cerate add from ½ a dram to 2 dr of iodine Put the scales of iodine into a wedgewoods mortar & rub it up with a piece of cerate as big as a nutmeg, in order to be sure of pulverizing the iodine. For parts, as the neck, exposed to view, we should use an ointment of iodide of potassium or sodium, which will have no stain upon the skin. These iodides have the same properties with the isolated iodine The plaster may be made of the same strength as the ointment & the best basis is pure white pine resin. If made with adhesive plaster containing lead, we have iodide of lead, which differs in properties perhaps [illegible] better one A hydriodic acid little know of its properties Iodide of potassium called also hydriodate of potassa. It seems to have no advantage over pure iodine, but in taste, & in greater solubility in water. We may use Elliotsons dose of from 1 gr to 1 ½ of the iodide of potas The iodide of sodium would be better from their not deliquescing etc. Phthisis 1st membranosa a thickening of the bronchial membrane caused by dust by dyspepsia neglected cold etc. 2d scrumous or tuberculous phthisis 3d apostematous phthisis Begins imperceptibly & at last an abscess is formed 4th another variety not mentioned in the books is the hemorrhagic phth. found in persons of hemorrhagic habit, begins with hem. this becomes more frequent etc. etc. finally hectic & phthisis 5th laryngeal phthisis an affection of the membrane of the larynx the lung perhaps not affected. The voice finally lost. Always (almost) fatal. It is connected with a strumous habit. It may begin in the fauces. Within a few years several cases have been cured by Brera & by Dr Woodw. of Verm. hydrid. & conium The difficulty is in curing by constitutional remedies. There would be little difficulty, if we could come at the parts & touch with nitrate sil. and corr. sub. Membranific hysteritis has been cured by iodine & conium Mesenteritis strumosa (enlargement) has been cured by it & conium Dysenteria chronica (so called) The cases were probably strumous ulcerations & thickening of the mucus memb. of the intestines very improperly called dysentery, which is never probably apyrectic Arthritis podagra in France externally (improperly?) & internally & with great success. Prof. T. would give it in ‘ teasp. doses of tinct. 5 or 6 times a day during’ the paroxysm but not continuing it long. No danger when the system is occupied with a powerful disease White swellings of various joints one of them is strumous infl. of the body of the bone another is a phlegmonoid inflam. of the cartilages & ligaments. Both have been cured by iodine, especially when applied externally It is surprising how soon the disease may be removed let it e administered in conjunction with conium internally & externally so as to be rubefacient & even vesicatory. Buchmenia indica or Barbadoes swelled [by] would probably be cured by iodine. Prof. T. has cured this repeatedly by arsenic internally & ointment of protoxide of mercury externally Careina vulgaris not sarcoma schirrhosum There are several distinct diseases called cancer which resemble each other in nothing but in terminating in aphagedenic ulcer. Dr Cogswell has cured several cases of unequivocal cancer in its earliest stages by ointment of iodine externally & conium & iron internally. There is no doubt that cancer may be absorbed without sloughing in the earliest stages In the first stages iodine cures the disease by resolution; in the advanced stages when it is too late for the knife, iodine cures by sloughing. Probably the disease is much less liable to return, after iodine Prof. Smith read 50 cases to Prof. T. & all returned in some part of the body Sarcoma medullare ([fungous] haematodes) The origin & progress of this disease is very curious. At first many small encysted tumors, filled with matter of the colour & consistence of honey finally becoming vascular afterwards resembling brain afterwards bursting out being obviously fungous haematodes, & destroying life by hemorrhage Case related of fungous of the testicle cured by iodine Sarcoma schirrhosum this is a much less formidable disease than carcinus vulgaris More easily cured by extirpation also, as well as by iodine. Carcinus vul. commences commonly about the areola the nipple will be draw in there will be a purckered appearance a livid colour etc. Sarcoma schirrhosum commences with a large ugly looking tumor, of the size perhaps of an orange Parapsis acris var. [pruritis] is called [illegible] (nothing visible to the eyes) Exomia pruritis has been cured by iodide of potassium The whole genus lepidosis (scaly) is benefitted by iodine 1st species [pytiocasis] dandruff & var. [illegible] capitis & versicolor one of them dandruff Topical applications are alone of consequence. Lepidosis lepriasis leprosy mild cases have been cured It seems to be considered incurable by authors, but their practice is milk & water treatment Lepidosis psoriasis a very formidable disease iodine with conium should be tried L. ichthyiasis iodine promises more than any other article Ecpyesis impetigo var. laminosa called salt rheum (other diseases also are called salt rheum) Various containers eruptions, when in an ulcerated & highly irritable state must first be brought to a bitter state before you can attempt the cure Ecpy impetigo var. herpetica lasts for years arsenic almost a specific it may be assisted by ointment of iodine Ecpyesis porrigo scald head & var. p. galatea is the worst. Prof. T. has used various articles he has applied tinct iod. by a camels hair pencil also ointment iod. instead of oint. iod. pot., for its greater strength Exostasis ostea & periostea In osteo-sarcoma for instance one of the var. we had better try iodine at the commencement of the disease. It is said to have been cured by it & by conium Case of a young physician The N.Y. & Phil. physicians despaired of him. Dr Todd put him upon conium enough to keep him under a very troublesome narcosis. Prof. T. considers it to have been probably a case of rheumatism Iodine is applicable to as great a range of diseases as mercury. It has been tried in hepatic mesenteric & uterine affections, with some benefit, & should be experimented upon farther It should be tried in lues more than it has. It has been tried with some benefit in epilepsy, chorea etc. [Bromine] resembles iodine but is weaker Chlorine a deobstruent also, not very strong Labarraque’s disinfecting liquid which should be called chloroxide of calcium useful occasionally for ill conditioned ulcers As to its disinfecting power there never has been brought up a shadow of proof. The story of a sewer being opened, & the work men being knocked down & after a quantity of disinfecting liquid. the atmosphere’s [being] pure, is easily explained by [irrespirable] gases, having time to disperse. A stinking sick room is rendered free from smell; in some cases. But stench does not produce disease It will not sweeten the air of a dissecting room There is no evidence that it will destroy the specific contagion of small pox, measles etc. Disinfecting can be effected only by soap & water & ventilations Whitewashers is but a poor substitute Painting is always better than whitewashing Vide [Caldwell] Fumigation & whitewashing on board of of [illegible] are [???pyrical] practices Vide Caldwell’s [illegible] of hospitals, injurious to eyes & lungs are empirical practices Vide Caldwell. Fumigation of hospitals is injurious to the eyes & lungs of the patients Nitric muriatic, nitro-cloric acids mild & weak deobstruents adapted to ill conditioned ulcers, secondary stages of syphilis etc. They have, like chlorine & iodine, weak tonic properties, just about enough to contraindicate them in entonic diseases They are useful in various dysthetic affections Chlorides of barium calcium & gold. Chloride of calcium is a valuable article in scrofula. All of these are weak deobstruents Chl. of barium is supposed to be stronger. No more poisonous than the former except that less is required at a dose. An excessive quantity will produce pain in stomach, tormina, & peculiar discharges. They are slightly diuretic Chloride of gold is stronger still Chloro-[aurate] of chloride of sodium is better than this Rubia tinctoria A pure deobstruent a valuable emmenagogue. Valuable in jaundice (Vide jaundice of Prof. F.) Dr I. gives 1 oz root to 2 pints of water dose 1 oz 2 or 3 times a day Better give as much as the stomach will bear without inconvenience Limosis dyspepsia where there is no great exhaustion. Icterus vulgaris The opponents of madder think it was prescribed merely to colour the feces. Prof. I. places it next after mercury in value Conium is preferable to either Chronic catarrh pneumonitis notha acute dysentery Marasmus atrophea var. infantum recommended. Others say that it has a tendency to produce atrophy Sertosis rachea, recommended by Haller. Ecphronia melancholia (monomania) Halusia hypochondrea by Boerhaave. Patamenia obstructionis & [illegible] & [suppr???] or obstruction and retention of menses Contradictory testimony upon this subject also. The madder of the dyers is not to be depended on. It should be gathered at a suitable time & kept fresh (not old & mouldy) for medical use Nat. order. Fumiariaceae 1st Fumaria officinalis the expressed juice. No doubt that it is adequate to the care of moderate cases oif jaundice & may be useful in dyspepsia 2nd Adlumia cerrhosus (Corydalis fungosa) Possesses considerable pungency i.e. the root in powder. If it is biennial the proper time to collect the root, is in the autumn of the first year. If perennial, wait til it is older Probably much superior to fum. off. 3d Corydalis bulbosa 4th Corydalis glauca is supposed to have the same properties in the top as the annual fum. off. The root is better 5th Dicytra cucullaria (Corydalis) Dutchman’s breeches. The root consists of tubers of the size & shape of an orange seed inclosed in a sheath. It is said to be quite active being narcotic anodyne soporific etc. It is well worthy of investigation & is a good subject for an experimental dissertation The [papa?? accal] [har??] active narcotic deobstruent powers & probably this article resembles them. The active narcotic power of such articles differ materially from that of opium & hyoscyamus. Saponaria officinalis A pure deobstruent perhaps not quite so powerful as madder. Often a useful auxiliary to mercury It has acquired considerable reputation in lues syphilis & syphilodes A good substitute for sarsaparilla Decoction [illegible] medium strength is 2 oz root in 4 pints water to be boiled to 2 pints the whole to be taken in 24 hours. It is prepared on the continent of Europe to leontodon The bruised roots with water make a lather, & are a substitute for soap Various other plants possess this property. Probably a union takes place of mucilage of alkali Scrophularia marilandica leaves & roots considerable popular reputation as an ointment & a cataplasm for piles 2 oz root or leaves in 2 pts water boiled to 1 pint the whole in 24 hours Scaly eruptions chronic pustular eruptions lues syphilodes jaundice scrofula dyspepsia protica marisce are the diseases for which it has a reputation. S. [modora] of Europe is used in scaly eruptions etc. Agrimonia eupatoria (naturalized) Inferior to the two last. A pure deobstruent It has the greatest analogy with leontodon taraxacum Dose 1 or 2 drams 3 or 4 times a day of extract Agr. odora is supposed to be more elegant. A. [suaveolens] is found among us [Aganthremen] crematum ([Diosma] crematum of Linneus) Bariosma crematum & [illegible] of [illegible] Adirandra of another. Diosma crematum & serratum ([Bookae, Buka, Buch??]) From Cape G, Hope Shrubs of moderate size are all the [diosmaceae]. The whole plant abounds with pellucid dots which yield a strong scented essential oil which is supposed to be the active principle. It seems to be a pure deobstruent distinguished only by its resolvent power It is a new article, now mentioned with [illegible] It is spoken of as valuable in [dyspep??] cystitis [arthritis] etc. Employed in infusion and tincture. Strength of decoction not mentioned We might try 2 oz. to 1 pt. boiling water Mr McDowel says this appears to be a very valuable article in dyspepsia, improving the appetite & colour of the skin proving slightly diuretic. It has been most celebrated in dystitis irritatis of infl. of the bladder. There is a very troublesome & irritable infl. of the bladder. There is a membranific infl. which is called by the same name. Physicians are apt to confound all diseases of the bladder under one loose term just as the common people are satisfied with the expression disease of the liver. Chronic rheumatism is a disease for which it has been recommended. But precisely what is meant by this is uncertain whether chronic rheumatism or chronic state of chronic rheumatism Lithia renalis cured by it, by affecting the stomach primarily Collinsonia Canadensis Ox-weed horse-weed archangel [illegible] [illegible]-weed, stone weed [illegible] [horseba???] Medicinal powers reside in the recent rhizoma. But it may be transplanted at any time of the year. Great discrepancy of opinion. The precise nature of its operative effects does not seem to be settled among those who employed But this is true of sarsaparilla leontodon etc. A moderate # deobstruent, particularly affecting the kidneys. It seems to belong to the class of aperients deobstruents. i.e. # moderate [urbites] are at present too much neglected those which promote the fluid secretions Dr I. thinks it resembles the tuberous species of [liatris] Dr Hooker thinks it resembles uva ursi & chemaphile corymbosa. Dose about an even tablespoonful of the rasped root. Used in veterinary medicine [illegible] is used. Decoction injures its properties. Infusion should be preferred The root is one of the hardest substances in the materia medica Limosis neuralgia very beneficial according to Dr Hooker Colica ileus but Dr Ives uses Indian meal & thinks this powdered root, likewise acts merely in a mechanical manner. David Miller of the Shakers thinks it useful in chronic rheumatism or rheumatalgia. Misplaced arthritic affection of the kidnies. It has a popular reputation in dropsy The best diuretic alone in dropsy according to Drs Beers & [illegible] Prof I thinks otherwise Paruria stillitia (strangury) all the varieties & the paruria of typhus [nervo??] A palliative in lithia renalis Aralia racemosa aperient deobstruent Aralia hispida dwarf elder etc. in a large dose it is emetic. It is said to be a Hydragogue cathartic probably it is not. It is the custom to ascribe purgative properties to every emetic, when given in doses short of the vomiting point. It is an efficient diuretic. Give as much as you can without vomiting & continue it until diuresis is produced. No doubt it is a deobstruent. It has not been experimented on sufficient to ascertain whether it is expectorant cholagogue etc. Not narcotic at all. Not known whether it leaves the stomach & bowels in a weak & irritable [continual] condition, like squills & senega, is not known. This is a very serious objection to these two last mentioned articles Contused root 2 oz. boiling water 1 pint & dose from 2 to 4 fl. oz. four to 8 times a day in 24 hours 4 oz to 1 pint alcohol tinct. ½ oz dose Proof spirit cincture seems to be better than alcoholic diseases 1st hydrops cellularis. Dr Reed of E. Windsor cured a case after failure with every other article Not stimulant not tonic Aralia odophylla of Cochin China is said to be highly effectual in dropsy A. scandens is said to have the same prop. Aralia spinosa (though it has no thorns but prickles) Formerly called angelica arborescens hence called angelica at present very improperly called prickly ash ([illegible]) Not indigenous in N. Engl. Languor lassitude, diminution of nat. frequency of pulse drowsiness prickly sensation even sleep. It is said sometimes to have produced genuine articaria It is emetic said to resemble ipecac It increases the biliar secretion undoubtedly cholagogue Dr McBride thought it the best of our native emetics Aralia racemosa is said to be useful in sequel of catarrh, in (pneumonitis ?) Simple idiopathic cough chronic dyspnoea lepidosis psoriasis & impetigo Veratrum album the root (the root is remarkable for being tunicated above & a solid bulb below) That found in our shops is always in powder & is worthless Carbonate of potassa & oxide of potassium which are mentioned among the proximate principles, are the products of combustion, for in this and in other cases, if the vegetable be rasped up & treated with suplhuric acid, no sulphate of potassa is produced It is called in the books merely emetic cathartic & local stimulant i.e. irritant. Veratrum album & strychnous nux vomica are acrid narcotics, not of that sort of narcotics which produce somnolency; they increase nervous strength of action. 1st deobstruent, independently of any evacuation 2nd acrid narcotic (it is a peculiar root of narcotic operation the articles are not necessarily acrids) 3 emetic 4 hydragogue cath. 5 epispastic 6 strumalatory (probably in consequence of its irritation 1st resolvent 2nd cholagogue 3 expectorant 4 diuretic 5 emmenagogue 6 sialagogue occasionally especially when applied to the mouth It does not appear to be diaphoretic except by resolving disease, or in poisonous doses by great exhaustion. Neither tonic or stimulant yet contraindicated in phlogistic diathesis, if for no other reason for this and it would do no good The dry root should not be used Formulae ½ oz to 2 oz. to 1 pt. of water infusion Decoction is thought to injure it. Most of the vegetable alkalies are decomposed at a boiling heat. The famous eau medicinale of [Husson] was probably a wine of the root of [illegible] 8 oz. recently dried root 2 ½ pts Spanish wine macerate for 8 or 10 days add 1 part of Sydenham’s vinum opii composition to 3 parts of this wine of veratrum From 1 to 3 fl. [illegible] about 4 times a day was the dose famous in gout & rheumatism Lobelia inflata therapeutic applications pneumonitis typhode Applicable to all the cases where squills are indicated not applicable where the stomach is very irritable. Arthritis acuta (sub acute rheumatism being without rheumatism, and is attended only occasionally with fever there is swelling and in the commencement the infl. is more or less metastastic Acute rheumatism is metastastic & has an acute fever accompanying it) Case of sub acute rheumatism cured in one night by tinct. lobelia & opium Arthritis rheumatalgia vide p. 37 not febrile no topical redness and swelling but with topical pain allied to neuralgia This disease has been cured by lobelia when other articles had failed Leucorrhoea communis has been sometimes cured and sometimes palliated by this article. N.B. This disease when of long standing cannot be cured all at once Recommended in hernia as a substitute for tobacco as an enema IT has not been tried very extensively in this way & should be further attended to [illegible] other species of lobelia appear to possess a similar assemblage of powers L. tapa of Peru is said to cause vomiting by its odour alone. L. syphilitica (S. flexa) has been praised & condemned by different persons Prof. Tully considers it as undoubtedly deobstruent emetic & hydragogue cathartic. It is expectorant (probably diaphoretic) (probably emmenagogue) diuretic? It has been considered a specific for syphilis much discussion has been excited Probably it will cure blenorrhea [illegible] Various deobstruents are now known to be capable of curing syphilis and probably this will. Prof. T. has tried it in pneumonitis typhodes & thought it equal (fully equal) to polygala senega L. cardenales has been reputed to have considerable medicinal powers it is doubtful whether it is worth retaining in the materia medica it has [sends] qualities of no great strength Actaea racemosa The general actaea and [cimicifuga] and also the macrotys of Rafinesque are now united by Decandolle under one genus actaea The worthy professor here treated us to a synopsis of the whole genus, because it is probable that all of them are [medicinal] Synonymas Actaea monagyna Cimicifuga serpentaria macrotrys serpentaria cin. racemosa macrotrys actaeidis Vulgar names black cohash the best. Various articles are called cohosh. Cornuticis herb crystoph. [darweed] rich weed etc. etc. Ninety plants have the name of snake root. Leontice thalectroides is called blue cohosh & is quite commonly sold for this article. The root of sanicula marylandica is often mistaken for it both being called black snake root. Actaea rubra and pachypode are likewise often mistaken for A. racemosa. No satisfactory analysis has been made. Decidedly and prowerfully narcotic. It is not worthy of reliance as anodyne or soporific though it is decidedly antirritant with respect to heat dryness of skin At least 4 oz. are necessary to saturate 1 pt alcohol sp. gr. .835. It is moderately nervine (probably) as Prof T. thinks he has seen it produce exhiliration and subdelirium in children It does undoubtedly possess the remarkable property of producing [fugitive] neuralgic pains in the extremities & in the sciatic nerve. Conium maculatum Contrary to the general rule, the plant is most active (not when the flowers a just opening) when the flowers are withering. Water is an improper menstruum Alcohol and ether only should be used The etherial tincture evaporated upon water, leaves as a rich green pellicle upon the surface of the water, which has the smell and medicinal virtues of conium Drying injures the plant Age destroys the virtues of this plant. Conium is a deobstruent & especially valuable as being also narcotic Dr March took in 5 hours 18 gr. 2 at first 4 at second 4 at third & 8 at 4th It was a recent extract. First sensations were pleasurable Secondly increased action of the stomach and duodenum pleasurable also Next vertigo unsteadiness in walking with a sensation of greater unsteadiness than really existed The pupil was natural in size but not affected by light nor darkness. Appetite good slept well at night. The next day in the afternoon he was affected with languor & headache which prevented his sleep that night. Next day he was perfectly well. 1831 & 2 Scleratum clavus, ergot parodynia as a substitute for the forceps and [vectis] which may be nearly or quite superseded by ergot. Dr Reed thinks that the forceps should always have the preference in the hand of a skilful hand on account of the danger to the life of the child Parodynia secundaria hourglass contraction of the uterus (which Dr Tully has seen in consultation though its existence is denied by some) The clavus will restore the natural contraction Parodynia secundaria var. retentiva retention of the placenta a perfect substitute for the introduction of the hand of the accouchment. In both cases the use of clavus is condemned upon theoretical views by writers in the procedures. Parodynia secundaria variety haemorrhagea Int his variety the clavus should be given as a preventive. Dr Reed however cautions against its use before the delivery of the head of the child on account of the danger to the life of the child Parodynia [secundi] dolorosa after pains Par. secu. ar. lochialis whenever there is atony of the uterus. Some suppose that it will not act after the delivery of the child but Tully has never known it to fail of expelling it into the vagina & further expulsion cannot be accomplished by the efforts of the uterus. Very little more is given in the books than was first promulgated by Dr Stearns. this article is applicable to a far greater variety of cases. Where hemorrhage at full time endangering abortion occurs we need not wait for pains to come on but give clavus without delay Dr Stearns does not generally give it without [previous] depletion this is not correct. Dr Stearns does not give it when nature is likely to succeed It had better be given in many cases to save pain and suffering Always using belladonna if necessary to produce relaxation He gives it as a rule not to used it except when the os tunica is dilated to the size of a dollar pay no regard to such a rule No regard should be paid to the opinion of epidemics being caused by this This article is supposed to have been used in Holland in 1747 it was used before Dr Stearns’ publication in Pennsylvania by a practitioner in N. London County Conn Dr Stearns heard of its success in the hands of some Scotch women. It is said to have been used in France & to have been prohibited about 1770. Schlerotium maydis is said to produce baldness in men and in swine, and in the latter as well as in mules producing a [paraple] gin. Hens are said to lay eggs without shells owing to premature delivery So too dogs, monkeys etc. are intoxicated by its narcotic properties These things are in L.A. various other species of sclerotium have probably the same powers And various purge; among others [lycoperda] bovista 1831 & 2 Opium is the descending sap of the Papaver somniferum, [illegible] in the sun Hippocrates apparently knew nothing of it. It was known in Homer’s time under the name of nepenth & was used then and afterwards at Thebes & was used as it is now in the east, as a kind of luxury. Extracted either by incision or by cutting off successively the top of the plant. The proximate principle is in [bicodati] of morphin (or by an absurd change of names, bi-mezorati of morphin) Meconic acid was first discovered and the proximate principle was then called bi-meconyti of morphin Afterwards codii acid was discovered to be the acid & afterwards it was called meconia & the meconia was called [codic]!! Just as Samarch [illegible] interchanged the names conium & cicuta The next proximate principle is narcotina or narcotin Some analysts describe a bitter extractive principle its existence is now doubtful This article is one of those capable of producing its effects in health and in disease. single pill doses produce costiveness, yet it acts upon the liver in creasing its secretion probably from this cause it is that the habitual use of opium does not produce constipation Opium undoubtedly counteracts the intoxicating effect of alcohol. So also alcohol counteracts the ultimate narcosis of opium Indeed both these articles are counteracted as to their ultimate narcosis by prussic acid Gelseminum and other pure narcotics Opium morphine The acetate of morphine & the most active The codate or meconate (N.B. This is the acid with which it is combined in the papaver ammonia is incompatible Nitric acid decomposes it so far as to produce an article of a different composition and if this is the case [illegible] [illegible] is incompatible with it. Tully says he has seen no great difference between the acetate and sulphate. One reason given for the super irrit of the acetate is its greater solubility. This by no good reason The next principle in opium & narcotine Bimaconate of sodium is another principle Extractive matter is another (i.e. something soluble in water and alcohol) A resinous principle (i.e. something soluble in alcohol & not in water Limine fecula essential oil etc. etc. Vegeto-animal matter (modified glutine) cautchouk etc. These are of no medicinal activity but may decompose other articles a grain or two on a healthy person produces a calm placid or pleasurable sensation wakefulness increase of force or fullness of pulse last from 8 to [illegible] hours in the latter part of the time some [illegible] next day languor want of appetite etc. etc. IN fuller doses nausea epigastricum easiness etc. It diminishes the biliary secretion hence producing costiveness [illegible] lecture upon morphine the French theory of its producing the pleasant without the unpleasant effects is entirely false Narcotine. Tully has never employed it morphine he is familiar with & has been so for years Great confusion and contradiction upon the subject of narcotic Magendie calls it stimulant Orfila narcotine & Bally says it has no powers whatever Most probably its effects are similar to those of morphine. But the subject wants investigation 2nd stimulant 1st nervine 3 narcotic 4 diaphoretic 5 cholagogue These are the effects of opium & of morphine It is a direct anodyne & a [illegible] & the most powerful soporific The other narcotics do not appear to be very directly soporific Sedative is a term applied to a group of effects If we desire the sedative without the stimulating effects we must give a single full dose So also of wine and alcohol One of the most powerful and useful effects is that of being a mere counteragent of disease Narcotica Diminish irritability & irritation sensibility & sensation in a non phlogistic diathesis also frequently somnolency In large doses stiff [illegible] cloud before the sight coma convulsions & death Epigastric uneasiness nausea Many suppose that they are all stimulant and nervine at their first operation this not true the notion prevails that sedative & stimulant affects are in competition very false Pure narcotics [cyan????] hydrocyanic acid lauro cerasus gelseminum nitidium daturae spigelia etc. helonia [erythro??] [illegible] doses produce what Brown called indirect debility which however 17 the long continued use of a narcotic diminish the susceptibility to itself but not to other agents Opium does not injure the health Tobacco & tea have been too much abused Alcohol the only one [which] produces visceral diseases E. [D.] North 18 1 Narcotica samplicia as hydrocyanic acid datura heloni hyoscyamus belladonna gelseminium poisonous mushrooms seem to be pure narcotics 2nd Stimulatia alcohol wine [opium] lactuca of several species These are the most important of the class narcotics To obtain their stimulant & antirritant effects in conjunction they must be given in regular & small doses etc. In large doses they are used to obviate a particular spasm etc. The former use was well understood by Cullen & his companions but not well understood at present The state of the mind affects very powerfully the operation case of a young man at dinner parties & of an auctioneer who had taken a dangerous dose of laudanum [Opium] more important than any other [article] of the materia medica Purging has done the most mischief Bleeding next the refrigerants next antimony & mercury next Deobstruent narcotics lobelia actaea digitalis nux vomica perhaps [aethusa] & cicuta etc. “Evacuating or generally cathartic sometimes emetic tobacco cocculus The long continued & habitual use of the nervine & stimulant diuretics (perhaps all) produces a certain uneasiness consequent upon their abstraction this peculiar to narcotics limosis syncoptica of Good Limosis syncoptica or epigastric sinking (when idiopathic) generally the sinking comes on about 9 o clock It attends hypochondriasis. Typhus syncopalis syncope The dying Seems to be found in a slight degree in intermittents when they first come on It being difficult to describe it is frequently considered as imaginary Resembles the sense of inanition which comes on when the sense of hunger has subsided after a meal missed at the customary hour Entirely different from the burning sensation of yellow fever Par vagum & the great sympathetic to which belongs the great semilunar ganglion’ In dyspepsia the par vagum seems to be affected In limosis syncoptica & T. sync. it is in the semilunar ganglion & is called sinking So it seems to be [illegible] cases of poisoning [from] mushrooms & snakes In L. sync. & even in limosis the digestion may be good Treatment first to relieve the paroxysm & second to obviate the censes Employ one narcotic to counteract another just as one disease (e.g. measles & small pox) is incompatible with another Give opium & camphor supporting them with stimulants & tonics. Concealing the fact of his giving opium gradually abstracting the opium continuing it for at least a year The tonics are utterly inadequate That produced by opium of less consequence & best cured by gradually obstructing the opium Tobacco conquerable by the will chambers medicine futile even when capsicum was mixed with 10 materia medica 1 Pulse 2 Congestion 4 Diathesis Congestion a 8 Type 10 Acute chronic etc. 11 Classification 13 Porx. principle 16 Narcotica 18 Narcotica simplicia Narcotics Astringents 1 Deobstruents 4 Diuretics 12 Diaphoretics 15 Errhines 17 Sialagogues 18 Emetics 19 Cathartics 22 Epispastics 30 Antidotes 32 Antacids 35 Mich. rem viz Irrit. & Dem. 36 Antilithics 38 Bloodletting 40 Cantharis 56 Capsicum 61 Monard. punct. 65 Hydric ether 66 Wine 67 Alcohol 71 Nitrate pot. 72 Carb. pot.. 78 Bicarb pot. 80 Veg. ac. 87 Acetic acid 87 Hydroc. ac. 82 Gelsem. nitid. 83 Helon. erythos. 85 Con. mac. 89 Cicuta mac. 90 Digitalis purp. 90 Lobelia iunfl. 94 Actaea rac. 96 Languin. can. 49 Aralia spin. 51 Baptisia tinct 52 Veratrum vir. 53 Andeira [iner???] 55 Opium 99 Astringents They produce a moderate vital contraction & condensation of the living fibre while at the same time they moderately decrease absorption & diminish morbid secretion Prof. Ives thinks they likewise diminish irritability The contraction is not [illegible] but vital As a class they are intermediate between the tonics & deobstruents partaking somewhat of the properties of each The vegetable astringents owe their astringency to tannin Properties of tannin etc. Because tannin forms leather with animal albumen it is incompatible with animal jellies as an article of diet Vegetable astringents inefficient in diarrhoea & dysentery not because of phlogistic diathesis but because of the morbid condition of the mucous membrane of the intestines they are useful after that has ceased and this discharge continues as a sort of habit. These remarks however apply only to the vegetable astringent for acetate of lead is as useful as calomel even in the early stages The mineral astringents do not depend upon any one proximate principle & hence they differ from each other in their operation. Vegetable astringents chesnut, the raspings of the wild [illegible] [illegible] [illegible] extract Quercus alba & tinctoria the inner bark Cocoluba vivifera of the sea side of Florida & [illegible] [terantosa] the leaves Geranium maculation the root [Heirchera] americana [italica] Carolina Geum uvale this more tonic than the others saxifraga pennsylvanica parnassis [ameril] Polygalam virginicum caenothus americanum tubus vellosus & vivialis napthar advena & [hymplicea] dorata these have a [nauseous] principle & a good deal of mucilage epiphagus virgiana this not nauseous as [Bart??] says All of these the root These native astringents are abundantly sufficient of our own wants. Foreign astringents found in the shops Green tea valuable when a narcotic power also wanted Mineral astringents acetate of lead etc. Sulph cop. alum Diseases Chronic coryza cough consumption (secondary stages etc. etc. Useful also externally atonic paristhmitis is inflammation of the fauces Spongy ulcers polypus [piles] of some sorts etc. Toothache is relieved by an intense astringent This remedy has been patented by a Hartford man Deobstruents produce a change of condition & action in the whole or part of absorbent & secernant system relieving affections of the liver increasing the secretion of this organ relieving various affections of the skin & produces [asolutions] of inflammations of muscles When they are given for some time in health they generally increase the secretions In disease they change as well as increase They produce less effect upon the brain than upon any other viscus The old definition is that they remove visceral obstructions the term obstruction is applied to indolent inflammations parabismata etc. of the viscera Tully revives this class. To what properties does mercury owe its anti syphilitic power? not in cathartic sialagogue etc. It is not stimulant or tonic, for it does not increase strength of arterial action or digestion & muscular strength. Mercury is a stimulant if we apply this term to any remedy which produces a powerful impression upon the system but this is too loose an application of the term A deobstruent effect may be indicated at the same time with a stimulant or other effect, as with a refrigerant effect but stimulant & refrigerant effects cannot both be indicated at the same time why then use the term stimulant with respect to the deobstruent effect. It is of no use to call mercury anti syphilitic antipsoraic etc. The United States abound in deobstruents & many of the properties of some of them are not generally known E.g. The salivation of mercury has been considered very strange It is however a part of its deobstruent effects which is more obvious & which exists also in a higher degree in tis than in some others of this class Expectorant emmenagogue sialogogue effects etc. may be either direct or indirect direct when not the [illegible] of a deobstruent agent in direct when a part of a general deobstruent effect upon the whole or nearly the whole secerunt & absorbent system For they do not all act upon every part of these systems A deobstruent effect may also be indirect e.g. the act of purging is a deobstruent operation while it lasts The deobstruent effect is frequently the only useful one e.g. colchicum Iris etc. which cannot be usefully employed as emetics & cathartics. This seems to be a sort of experimentum crusis with reference to the propriety of retaining this class Further in the modern systems there is no place for the pure deobstruents e.g. leontodon taraxacum which is put down among the diuretics & cathartics for neither of which effects will it answer And this has probably contributed to bring it into disease. So of other articles The deobstruents although not weakening still reduce the strength of the system in general if continued for a great length of time, especially if the deobstruent effect is combined with one of evacuation None of them however have direct refrigerant powers & none have sufficient stimulant powers to supersede the necessity of combining a stimulant in cases of great atony The system is frequently to be prepared for a deobstruent operation by being previously stimulated or reduced. Rheumatism generally requires one or other of these preparations, but still neither reduction or stimulation will ever cure these diseases. Dysentery is cured as effectually by Iris versicolor & other vegetable deobstruents as by calomel though requiring to be accompanied by opium. Still calomel applies to a greater variety of cases No deobstruents produce stimulation precisely but rather a tonic effect & none directly produce a refrigerant effect, they do this rather through their evacuating powers That a remedy be referred to the class of deobstruent, the only quality which it is indispensable that it should possess is a resolvent one Probably all the deobstruent cathartics are hydragogue. A resolvent power is that of dispersing & curing a topical inflammation without a necessary evacuation. an antipsoraic operation is that of curing a cutaneous disease by an internal remedy Discutient applies to curing an inflammation by a topical application Cholagogue applies to the increased & secretion & evacuation of bile These operations are the foundations of no classes The most common & best known deobstruents are the species of smilax including the rotundifolia & another if our species Comptonia asfil. & myrica galea Compt. destroys fish. Aralia racemosa & [rudicaulis] the root asclepias tuberosa & incarnata. Arctium lappa & another diervilla danadensis celastrus secundus Perhaps also the Collinsonia canadensis solanum nigrum & dulcamara but these too are narcotic Diseases rheumatism [strum??] dyspepsia syphilis yaws various cutaneous diseases Other plants doebstruents are myrica cerifera 3 species of anemone A. virg. etc. ranunculus acris bulbosa & scleratus All the species of trillium alisma plantago dirca palustris conium maculatum is a deobstruent narcotic cicuta maculatum & bulbifera also as well as argemoni mexicana In this vicinity have been used the different species of lettuce (not the exuded & inspissated sap but the inspissated juice & decoction) aconitum napellus strychnos nux vomica angostura bark etc. are acrid narcotics deobstruents rhododendron maximum (Litchfield county) kalmia latifolia Another set is astringent & moderately tonic viz uva ursi chimaphila as syrola 2 species ledum 2 sp. aletus farinose & aurea andromeda calygulata helmias droica The uses e.g. guaiacum oil of juniper several species oil & resin of copaifera off. ol. pinus australis sylvestris strobas etc. abies canadensis & [illegible] mifera These if pushed evacuate Aralia hispida (dwarf elder) diuretic & emetic Erythmium americanum & album these vomit Another set may be diuretic emmenagogue cathartic emetic etc. [Polygala] senega Hellebore Gratiola off. iris versicolas scilla mautima polygala pubescens eryngium aquaticum (properly yuccifolium) lebelia syphilitica These are said to be cathartic Sanguinaria belongs here but is not Colchicum autmnalis aralia spinosa (southern states) [Phyto???] candacendria delphinum consolidum etc. baptisia tinctoria (perhaps) styllingine sylvatica apocynum cannabinum & pubescens anderria inernis (cabbage bark) These are similar to the last class possessing a still greater assemblage of properties? Diuretics increase the urinary discharge Paris’s classification visionary in which he supposes some of them to act in substance upon the urinary organs Nitrate of potassa Tully denies to be a diuretic Diuretics are direct or (as being also general deobstruents) indirect They are also pure. The pure are not always the most powerful e.g. chrysanthemum leucanthemum Roots of opium petroselinum eupatorium purpureum & verticillatum collinsonia canadensis Refrigerant diuretics e.g. nitric ether bitartrate of potassa & acetate of potassa narcotic diuretics e.g. expressed juice of various species of lactuea. The [illegible] if taken very strong Stimulant diuretics e.g. several species of cantharis [illegible] mellifica several of the essential oils as those of the gaulthena [procumb???] & engeron canad. The most important are the deobstruent diuretics gratiola off. scylla maritima polygala senega & pubescens iris versic. & prismatica the several species of elder eryuquim mucifolium sambucus pubescens (red berried or mountain elder) The most efficient & certain single article is asclepias syriaca aralia hispida called dwarf elder. This unlike the rest never proves cathartic erythronium lanceola commonly macerated in ciders Seeds & roots of aretum lappa All these are expectorant emm. [illegible] & antipsoraic & if pushed are emetic & cathartic Next group are the resins & terebinthinate oils these are expectorant resolvent etc. Abies balsamifera the most elegant cpoaifera juniperus pinus australis etc. sang. europaea etc. abies canadend the oil Another set are astringent & perhaps tonic arbutus uva ursi another set is also narcotic e.g. nicotiana tabacum & digitalis purpura Another set are not emetic & cathartic Actaea racemosa cimicifuga this last said to more active rubra & pachypoda inferior Demulcent diuretics mucilages Three conditions of the system in which the diuretics are to be employed viz morbid irritability with atony without atony & In case of great distention diuretics will not operate until the water has been diminished by elaterium a hydrogogue cathartic & some such manner The diuretics however will not cure the disease Tully and his friends have not found diuretics more uncertain than other classes of remedies always succeeding by management combination of several articles or some such way Not always however curing this disease Case of officinal alcohol curing Diaphoretics restore or increase the perspiration It is commonly said that they are all stimulants the argument is that increased secretion implies increased action this fallacious e.g. the sweats of the dying because the weakened vessels may not be able to resist the vis a tergo In high entony refrigerants produce diaphoresis & in great atony stimulants 52 Alcohol continued. The fact that it has not always been used proves no more than that of cinchonas having been formerly unknown Alcohol continued from p. 52 Alcohol is best adapted to the nervous & wine to the putrid type of fevers The old practice of giving bark in wine, in intermittents was a good one now superseded by sol sulph of quinine All the cases of typhus All cases where there is great and extensive suppuration Collections of matter the liver thorax, & even in the female breast though opium possesses the greatest power Hectic, in one of the diseases Anthrax, where the system is considered affected Erythema oedematum gangrenosum anatomicum etc. Parismitis Malignant small pox measles scarlet fever (rosalia) Various cases of inflammation of the viscera Membranific inflammation (croup for instance in many cases N.B. in many of these diseases the wine or alcohol do not supersede the deobstruents etc. Genuine acute febrile dysentery according the nature of the constitutional febrile affection which may be synochus or putrid typhus etc. Marasmus tabes, sand scurvy # The different sorts of gangrene Certain sorts and stages of mental derangement, more especially wine Tetanus some consider them as specific falsely however. In Mass. this disease has been cured by alcohol & liquor of the arsenate of potassa, the latter in large quantities Lyssa canina a similar dispute Chorea according to the condition of the system # this is as much severer disease than sea scurvy which only require the milder astringent & tonics Bites and stings The practice is old and perfectly well established. Galen & Celsus quoted. The maderia medica of Hindoostan makes wine perfectly efficacious Case in the American medical Recorder in which at least 2 quarts of spirit & capsicum were retained in the stomach in the course of one night. The efficacy of spirit in the case of the most venemous serpents is perfectly well known in the tropical reg Instances are many of persons in a state of intoxication being bitten with impunity The excision is generally performed in cases which would not have been dangerous in any case, from the fact of the surgeon in the country being generally at a distance. Confined snake do not [illegible] a mortal bite. The next article to alcohol is opium the next is ammonia. The moderate cases may be relieved by any strong impression hence the reputation of various popular remedies External application of alcohol Dr Ives employs a mixture of alcohol & oil of origanum in burns and scales The vapours of burning alcohol is very usefully employed, by raising the bedclothes, supporting them [illegible] & introducing the vapour through a tin tube Useful in cholica etc. etc. & in that form of dyspepsia which is attended with gastrodynia Errhines excite sneezing by direct application the discharge is sometimes serous when secretion is promoted sometimes more purulent. Useful mainly as counter irritants sometimes the act of sneezing seems to be useful Disease Ophthalmia Cephalitis Deafness neuralgia auris & facies apoplexy etc. Some cases only of the above Snuff taking very injurious producing finally limosis syncoptica also thirst etc. Tobacco is the worst because narcotic Errhines are powdered white sugar the powdered root of the species of iris spirit of [?esculus] dried & pulverized flowers of helenum antimonali Veratrum album and viride Case of an apothecary who sneezed 30 times Euphorbia off. sanguinaria turpeth mineral calomel sialagogues promote salivation by topical application hence mercury is excluded for its salivation is not useful of itself Disease aphonia when idiopathic & symptomatic rheumatic pains of teeth gums Chewing tobacco wastes saliva exhum the strength producing anorexia limosis Drunkards begin with tobacco. Prevents costiveness however sial. antemis pyrethrum myrica cerifera asarum europeum & canadense horseradish zingiber cardamon seed Emetics produce vomiting independent of taste odour or quantity Effects of vomiting & nausea The act of vomiting is probably more or less deobstruent in all cases All emetics given in less than nauseating doses except tartrate of ant. are tonic? 4 purposes 1st to give a shock & break up 2nd to increase susceptibility & prepare 3d to excite the absorbents & create a resolution of inflammations etc. 4 to remove poisonous or offending matter from stomach 5 groups of emetic 1st simple vegetable emetics which produce no other effect e.g. ipecacuanha dorstenia braziliensis A species of asclepias viola [parsiflora] & another The two species of gillenia the best indigenous substitutes for ipecac. Two species of euphorbia These are indicated to remove poison to relieve the stomach of offending matter [illegible] vegetable deobstruent emetics useful where both emesis & deobstruent are both wanted Sanguinaria apocynum cannabinum aralia spinosa polygala senega not best however to use this as an emetic. It leaves the stomach & bowels in a deranged state syclla [matutima] or ornithogalum squilla Lobelia inflata styllingia sylvatica Perhaps also ranunculus flammula the distilled water no taste no nausea acting instantaneously after 5 or 10 min. Sinapis alba & nigra Deobstruent vegetable emetics are proper where strong counteraction at the commencement of diseases as croup etc. 3d Refrigerant mineral emetics tartrate of antimony & potassa James powd consisting of protox. of ant. & lime These emetics given at the commencement of typhous fever bring it on 4th Tonic mineral emetics sulphate of zinc bipersulphate of copper or blue vitriol ammoniuret of copper per acetate of copper or verdigri Limosis dispepsia etc. 5 Deobstruent mineral emetics The best is dipersulphate of mercury or turpeth mineral Cathartics increase or create evacuation from the intestines Murrays arguments about the stimulant operation upon the intestines too loose The peristaltic motion of the intestines essential to life kept up by the bile perhaps also the pancreatic juice & the mucous fluid of the intestines Evacuations promoted by checking perspiration application of cold water to the legs friction etc. Dr. Ives thinks the stimulus of distention of the bowels is very important Cathartics of more universal use than any other class 5 purposes 1st reducing 3nd sudden shock for breaking up diseases neither entonic nor atonic 3d increase susceptibility & equalize excitement in diseases neither at. nor entonic 4 remove fluids as in dropsy 5 to remove poisonous or offending 5 things to be had in view in selecting a cathartic 1st degree 2nd quality of evacuation 3d what other operation 4 the part of the alvine canal operate 5 1st as to degree 1st eccoprotic e.g. syrup of sugar manna subacid fruits 2nd laxative merely increase peristal act sufficient to evacuate the canal carbonate of magnesia ol. juniperus communis 3d purgative which also occasion an increase & discharge of not secretion septandra virginica triostium perf jalapa podophyllum petalum 4 drastica gamboge elaterium croton tiglium These produce copious & continued discharges & invert the action The stronger may be so managed as to operate like the weaker As to quality of discharge cathartics are 1st kopragoga producing fecal discharges e.g. castor oil rhubarb 2 cholagoga or bilious e.g. calomel 3d hydragogue or watery discharges the most perfect is elaterium Others are croton tiglium the refrigerant salts As to other influences 1st nervina allay morbid irritability etc. Cocculus & spec. though cathartic [these] exhilirate Carthagena bean (foederea) None have these two powers simply 2nd narcotica producing prostration etc. Cocculus comes here also Tobacco etc. refrigerantia diminish strength of act Sulphates of potassa magnesia soda & ammonia also the bisulphates the sulphates the hyposulphates Sulphates of lime Phosphates of all these Phosphites hypophosphite etc. Tartrates bitartratis etc. Also the compounds with two bases These act on the exhalents of the intestines These salts are apt to produce flatulency which the other hydragogue cathartics do not bring on These cathartics are commonly supposed to be mild cathartics yet they are bad in old dyspeptic subjects etc. 4th tonic cathartics federaea carthagena carthagena bean nicker nut? polygala [polyga???] aloes 5. astringent. E. g. rheumatism Indigenous species of rumex Ven alum purges & sometimes [illegible] useful in this way 6 deobstruentia Preparations of mercury the most common baptisia iris phytolacca etc. 7 emetica gamboge [triosteum] perfoliatum etc. 8th diuretic when given moderately elaterium tobacco asclepias syriaca 9th diaphoretic eupatorium perfoliatum & rotundifolia asclepias syriaca & tuberosa 10 Emmenagogue aloes convallaria majalis polygala polygama etc. As to part of canal on which they operate 1st stomach & intestines mercurials gamboge triosteum perfoliatum 2nd Colon lepandra jalapa senna etc. 3d Rectum aloes polygala polygama convallaria majalis Another point is the tonic Some are slow as mercurials aloes convallaria & polygama Others are intermediate as jalapa convolvulus juglans cinerca senna most speedy is croton frequently ½ hour Oil of seeds of euphorbia lanthyris & other of about the same qualities Castor oil is quick gamboge also elaterium The refrigerant salts especially when combined with tartrate of antimony as is done in Philadelphia Cathartics frequently break up diseases but generally are more auxiliaries The refrigerant & drastic cathartics however do not break up always Cathartics continued Never proper in dysentery. In low typhous patients may go 5 to 14 days without an evacuation & when it took place it will be of a natural appearance Much abused in this country in cutaneous diseases under the absurd notion of purifying the blood. Not abused on the continent of Europe as in G Brit. & this country The universal tampering with salts & calomel an exceeding evil. So also Flocking to Cheltenham & Saratoga So says MacCulloch. The same of the family medicine chest. The beneficial effects of travelling & the evils of nervous diseases referrable to the same source (McCulloch) Case of a lady of strong constitution who had taken salts & calomel every day since 8 years of age was nervous etc. McCull. Sir W. Scott understands the subject alludes to it in the legend of [Montrose] Physicians are remarkable for not associating with & enquiring after the practice of these different opinions All science properly so called depends upon the detection and classification of differences Epispastics by topical application produce either local inflammation or vesication or destruction of vitality Purposes 1st (acc. to Duncan) to increase the activity of the system in general by initiation then to be kept on some time applied to the extremities 2nd to increase the activity of a particular organ as the liver in jaundice one large plaster over the liver 3d to diminish the activity of a particular organ by counterirritation as in pneumonitis Contraindic in high entony or low atony Dispute whether they should be applied in local affections in the vicinity of or remote from the place Some say idyosyncrasy prevents or obstructs their employment. Tully thinks this is merely greater susceptibility & therefore requires smaller plasters. It is frequently advisable to convert the serous discharge into a purulent one by an irritating plaster or by the constant presence of a [illegible] body as orange peel Question whether issues or successions of blisters are best. This depends upon the disease e.g. hip disease diseases of the spine etc. require issues. The spine is the best situation for most cases of nervous diseases paraplegia various chronic affections of the bladder chronic cephalia [or] headache etc. Children must have them much smaller on account of their greater irritability Alexipharmics antidota etc. counteracting the operations of poisons With respect to toxicology Poisoning is the noxious effect of an ill timed or excessive quantity of an agent or otherwise improper use The Greeks had but one word [illegible] for both medicines and poisons. Pliny says every virus has a virtue. Every poison is a medicine It is not however true that in the present state of the science every poison has actually been made use of or is thoroughly understood Poisoning consists of irritation disorganization stupefaction exhaustion or some combination of these. The deleterious effects of poisons are the same with certain specific diseases. Inflammation of every kind colic paralysis coma apoplexy ptyalism (as of mercury) simple exhaustion marasmus in all 12 No one agent can always have the same effect hence there can be no specific remedy for any one poison If not too late the first indication is to remove the poison from the stomach Tully thinks experiments upon animals by injection into the blood are good for nothing Absurd also is the tying the duodenum and oesophagus Tully thinks toxicology as pursued by Orfila and his imitators as merely a mass of empiricism founded upon the doctrine of specific poisons and remedies Absurd notion of Orfila American editor that savages understand poisoning better than scientific physicians. Poisoning has always been confined to times of ignorance & has fled before the march of science which divests them of their obscure dreadfulness Orfila’s experiments unjustifiable Pure narcotic effects are the first and most simple poisonous effects 2nd acrid narcotics 3d irritating poisons 4 compound poisons Acrid narcotic poisons produce convulsions of a peculiar character tetanic spasms & neuralgic pain mineral vegetable & animal poisons 1st hydrocyanic acid laurel water gelseminum helonias erythrosperma & mist of the 2nd Strychnos nux vomica 3 Oil of tansy [illegible] camphor ol. nutmeg Cicuta maculata & the fungi produce colic Arsenous acid ranunculus phosphorus menchinal capsicum produce irritation Antacids combine with acid and neutralize free acids in the al. can. Ammonia calcia magnesia soda & their carbonates are the only ones Potassa soda and ammonia form lactates with the natural lactic acid of the stomach which are refrigerant Various other acids are found in the morbid states of the stomach as the phosphoric in inveterate and protracted cases of dyspepsia not formed by fermentation which Tully thinks never goes on in the stomach Antacids if ever necessary are merely palliatives because they will not remove the causes of the affection. Dyspepsia appears to be the only disease in which they are employed Mechanical remedies 1st irritants 2nd demulcents Irritants maybe vital or epispastics, or they may be of 3 classes 1st exercise of all sorts which are remedial processes 2nd dermatic as [?uction] percussion acupunctura or shampooing 3d alvine cow itch metallic [tin] filings of iron powdered glass & powdered porcelain charcoal partly Travelling diminishes morbid corporeal sensibility on account of exposure to air etc. increases the assimilation diminishes fecal discharges. Hence the constipation of travellers things inedible in health are harmless great activity of the absorbent system hence reduces obesity & hardens the muscles active exercise quickens the pulse & passive renders it slower hence the latter in some diseases of the heart combining it after a while with active change of air improves the blood changes even to a bad air are frequently useful just as the stomach thrives best on a variety of food Hence also as well as from exercise the ruddy complexion of stage coach drivers Shampooing almost peculiar to the Chinese description of it from Clark Abel Most of the alvine irritants are of doubtful utility Employed from the notion that digestion was caused by trituration & that worms were to be levigated A quack of Connecticut has employed powdered glass gentian & ginger which was certainly more useful in dyspepsia than the same remedy without the glass [illegible] opium aloes spices testicles of a boar & powdered porcelain in colic by a Connecticut family of quacks Good evidence for the utility of powdered glass as an anthelmintic. Anthlithics or lithontriptics A long dissertation upon urine uric acid. Lithis of the different kinds & the [illegible] different kinds of calculus Lithis urinalis has two varieties one with calculi in the kidneys & the other with gravel in them. The former impossible to discriminate by certain diagnosis. Hence a great part of the cases of gravel are fallacious & the experience upon this subject frequently false Antilithica prophylactica & lithontriptica It is the received opinion that the avoidance of animal food & perhaps also of fermented liquors prevents the uric acid diathesis which is the cause of the greatest number of calculi Another circumstance according to Paris’s theory will be the keeping up a natural and healthy action of the skin For the uric acid calculus lime water magnesia (given in soap are upon chemical principles the appropriate lithontriptics for the uric acid calculus No solvent is known for the mulberry calculus The acids which decompose it would form insoluble compounds in the bladder N.B. oxide of magnesia & soap are useful in many gouty cases where there are no calculi. Hence their chemical operation is doubtful The antilithic and lithontriptic modes of treating lithia are obvious [illegible] except in lithia renalis where however it is merely a palliative not reaching the cause of the disease. Better employ tonics opium (in the paroxysm Deobstruents however are the remedies Bloodletting (I was absent) The spring lancet on several accounts is preferable to the thumb lancet 6 distinct purposes of bloodletting 1st as a mere antiphlogistic measure 2nd to make a sudden & strong impression in non phlogistic diseases to produce a resolution 3d to equalize excitement increase susceptibility & prepare for other remedies 4th to divert a haemorrhage from some parts as a substitute for a habitual [illegible] 5th to produce faintness [illegible] in surgical operations 6th to promote absorption in paribismata & emphysemata Bloodletting is always indicated in phlogistic cases no matter what the age sex climate The quantity of blood abstracted should always depend upon the vital energies Strength (not hardness) indicates venesection Strength resists pressure. Hardness is wiry both in the systole & diastole & may be conjoined with weakness. Authors when they speak of hardness alone commonly mean strength The coriaceous or buffy coat upon the blood may depend upon phlogistic diathesis or may depend upon the slowness with which the blood is drawn or the depth of the vessel into which it is received or the particular disease Abundance of medical testimony on this subject Firmness of coagulum & concavity of surface better indicating especially when joined with a buffy coat. We must not mistake the rigidity of the coat of the arteries of elderly people & those who labour much in the open air for genuine strength of action. All diseases are not either phlogistic or antiphlogistic but if the former bloodletting is the remedy known If carried too far it causes a subsequent dropsy etc. General depletion does not benefit a merely local topical inflammation There are cases also of atonic inflammation The essence of inflammation a John Hunter says consists not in the quantity but the quality of action No one has ever opposed bleeding in phlogistic diathesis. Though it has been often asserted; as of Dr Danforth of Boston & Dr Tully falsely however. The diathesis of New England changed about 1805 Many believe and teach that in entonic cases we should aim at the production of faintness or syncope by the manner of abstracting blood Not so however except in surgical cases Sincope should be avoided by placing the patient in a recumbent posture A pint or pint & a half as was directed by Cullen will generally be sufficient if properly supported by refrigerants, subacid fruits cool air etc. With regard to bleeding after casualties. A New England physician of very extensive practice says he has seen more cases of death after a casualty produced by bleeding than by the casualty itself Latham quoted to the same extent Alcohol continued It has been and is now denied that this article ever increases vital energies, or gives new strength, but it [was] affirmed that it merely acts like the spur upon the horse. If this were true it would never be proper to use it in atonic disease, and ought to be banished from the druggist’s shops The ill effects of alcohol are very different from those of wine In chronic cases alcohol is seldom proper and then only to a limited degree. Good French brandy is the best form of alcohol. Morbid exhiliration & delirium & narcosis constitute intoxication Stimulation has nothing to do with intoxication. The ill effects of tippling are probably the result of the narcotic power, one thing is certain viz. that the ill effects of wine & alcohol are not the result of the stimulant operation [illegible] for no more stimulant produces similar effects v. page 48 On Bleeding in Typhus Been advocated at different times for 3 centuries See Good for a summary on this subject. This author advocates it in cases of what he calls congestion Yet from his manner of speaking we might conclude that he had not seen the practice very successful & it is opposed to his own opinion with respect to bleeding in atonic inflammation. There are several sorts of congestion. Superficial [concretion] caused by the action of the heart over powering the pressure of the atmosphere Visceral congestion caused by the atmospheric pressure overpowering the enfeebled action of the heart hence in this kind bleeding will increase it Good supposes that typhus is liable to run into a phlogistic diathesis False as is also the notion that cauma becomes atonic. These two states of the system are entirely incompatible Diseases are broken up in their forming stage by strong measures of the most opposite kind. This accounts for the success of large bleedings in many cases of typhus Free depletions will produce congestion Hence the greatest bleeders always have many cases of congestion & visceral inflammation 3d purpose of bloodletting to breakup diseases etc. The classes of remedies whose effects it increases are emmenagogue sialagogues diaphoretics diuretics cathartics etc. It does not increase the action of all the deobstruents as has been supposed In cases of atony it diminishes their action Most of the deobstruents act more powerfully as the vital energies are higher 4th as a substitute for habitual 7 moderate bloodletting & to remedy a too rapid sanguificatious disease passive haemorrhage paremenia Wounds of the lungs brain etc. It is not the best remedy for a paroxysm of haemorrhage especially if passive In some parts of the country it is the fashion to bleed every gravid woman. A very injurious practice Tully has known 5 or 6 successive cases of abortion in one family, caused by this practice This practice employed in aneurism to keep the vessels partially empty. These cases frequently supposed to exist in many cases when the palpitation was caused by dyspepsia It seems to be the best practice in cases of wounds of the brain & lungs, to avoid haemorrhage 5 to produce sudden faintness. Diseases the passage of gall stones of calculi from the kidneys some cases of hernia obstruction of parturition from rigidity. To facilitate luxations etc. In order to facilitate the production of this effect, place the patient in a sitting posture make a large orifice, pleno vivo. Great abuse in cases of pregnancy many fine women have had their constitutions ruined A Connecticut practitioner has done much mischief 6 purpose to promote absorption & reduce parabismata etc. It should be done in the early stages & should by followed by powerful emetics cathartics etc. The situation in which a person resides affects the necessity for bleeding Those in warm & moist situations require least. [Scrumous] persons bear it very ill. No attention is to be paid to the season of the year. In the Bethlehem hospital for the insane. It was the custom to bleed all the patients in the spring * purge them in the autumn, untill an investigation by parliament was had of all the insane hospital Infants & the aged bear bleeding less Excessive bloodletting is followed by dropsy hectic of inanition, corpulency & laxity with debility: nervous affections etc. Repeated bloodlettings Ill effects of alcohol the chronic effects are a peculiar sort of dyspepsia followed in the case of wine by gout etc. & in the case of alcohol by phthisis paruria mellita impotency delirium tremens, dropsy palsy ophthalmitis the objection that the use of alcohol in malignant cases produces intoxication is entirely unfounded. So also is that of it being liable to cause a habit of intemperance As to its benefit I health case of a students being supposed to labor excessively Alcohol will prevent his nervous tremors [exhaustion] may be prevented from disabling him for the remainder of the day by alcohol N.B. food will not answer Case of two brothers of schirrous diathesis and [in] health over exerting themselves at a fire The one who did not recruit himself by alcohol, lingered two or three years & died of consumption [illegible] of over work in harvesting & shad fishing After a shower rheumatism & pulmonary complaints may be prevented Tully’s own case of these vid. [16] Sanguinaria Canadensis Alkali called sanguinaria Several of its salts are of a beautiful red crimson or scarlet colour a circumstance almost peculiar to these The change produced by mixing the white acid and white alkali is very remarkable All the salts have the same medicinal properties Removes torpor of the liver exerting an action upon the whole secernant and absorbent system. Acts upon the stomach and promotes digestion. Promotes expectoration & the [illegible] secretion. In large doses it is emetic and narcotic It is liable to leave the stomach and intestines in a weak and irritable condition & hence sometimes proves fatal It irritates promotes absorption and action and frequently cures when applied externally to ulcers. It will probably be useful in inflamma It excites sneezing & increase of secretion in the sneiderian membrane Tartrate of sanguinaria experimented upon in Tully’s office & found to possess all the valuable medicinal powers of the root of the plant. It is less emetic It will sometimes answer when the preparation of the root cannot be tolerated The active principle of the plant is the colouring matter which pervades all parts of the 1st deobstruent 2nd acrid narcotic 3 emetic (1st cholagogue 2nd expectorant 3d emmenagogue (not diaphoretic) scarcely diuretic nor sialagogue not cathartic except by promoting the secretion of bile) 4th escharotic & anti-psoraic & discutient Begin with 30 gtts of tinct. & increase to 1 or 2 fl z First employed in Middlefield by Dr [?cjiah] Hoadly, as a sort of specific in some cases and as emetic in croup 1775 (about) First published account is in Foster’s Bossert 1772 says it is emetic. Employed Dr Bolton of Wallingford. First introduced into general practice by Dr Tully 1813 Apocynum cannabinum lectured on Aralia spinosa a large shrub or small tree in middle western & southern states cultivated here. Called angelica tree prickly ash toothache tree etc. etc. This is the most active species All of them have the same properties in different degrees The recent bark of the trunk root and branches & the fruit have an acrid taste in the fauces a common character of the vegetable deobstruents The immediate effects of the bark & fruit are languor lassitude sense of weakness prickly or burning sensation more especially on the face & hands diaphoresis & drowsiness. If continued long enough it promotes the secretions of the liver resolves inflammations finally hydragogue catharsis & sometimes like some other deobstruents produces a genuine articaria It may also be conveniently used as an emetic if sufficiently large doses are employed It has been employed in the bites of snake In such cases the sensation is caused by the bit of the rattlesnake & not by the aralia. It has long been popular in rheumatism Notice taken of A. racemosa (spikenard) A. hispida & A. medicaulis which are weaker and have not been so much experimented on Baptisia tinctoria podalyria tinct. The root is the only part used in medicine Not very thoroughly investigated. First said (of course almost) to be good for the bites of rattlesnakes by Dr Cutler. Dr [Stearn] of New Hampshire notices it in his American Herbal & his account has been (of course) regularly copied. High encomiums are bestowed on it by Dr Thatcher. Dr Joseph Comstock of Lebanon gives an account of its employment successfully as a powerful antiseptic W. B. C. Barton notices it. So others. Tully found that large doses operated as an emetic and cathartic and in smaller doses as a nauseating cathartic It allayed irritative heat and dryness of the skin, promoted the biliary secretions & resolved topical inflammations produced narcosis and always proved cathartic was useful in various cutaneous eruptions Very useful as an external application to ulcers in preventing gangrene Resembles colchicum most, though less dangerous Veratrium vide gum hellebore Treated of by Bigelow & this article upon it is the best in this “Medical Botany” Bigelow calls it highly stimulant. It has no stimulant Bigelow probably formed his conclusion from the fact of its being acrid Acidity will not necessarily produce stimulation That of this article produces irritation, not stimulation No more is every bitter necessarily a tonic Bigelow calls it sedative. But sedative powers may result from a narcotic a nervine or operation Bigelow goes on in the detailed account to deny its stimulant powers This article exactly resembles the veratrum album of Europe Like phytolacca [decandra] & most of the deobstruents it cannot advantageously be used as a mere caustic Too large a quantity in the 24 hours produces vertigo convulsions etc. An excessive single dose produces hyperemesis & hyper catharsis in addition. This last property however is no proof of its being a cathartic, for in poisonous doses one half of the articles in the materia medica will produce this effect. Case related of a physician’s prescribing skunk cabbage beer hyper emesis & catharsis tormina & even alvine haemorrhage etc. of the family & of a physician Relief was afforded by opium This article is an acrid narcotic deobstruent Not diaphoretic diuretic or cathartic It loses much of its power by drying It will produce vomiting when externally applied to a wound Andeira Andeira inernis ([Geffrona] inernis) cabbage tree of the warmer parts of N. America e.g. Jamaica Nat ord leguminasae yet the fruit is a drupe Not used in this country. Nearly resembles coilchicum in its operation. The bark is used The tests of an over dose are nausea & vomiting of to frequent doses, narcosis of too long continuance hydragogue catharsis It is employed in the West Indies and in Spanish America mostly as an anthelmintic Dr Wright of Jamaica considers it the best anthelmintic known Cantharis vesicatoria Stimulant, diuretic, epispastic Of the application of it in typhus Prof Ives has made more use of it than perhaps any other practitioner in the United States. He has given to the amount of a fluid ounce in 24 hours in cases so low as that the patients were insensible to all external objects, and unconsciously voided their urine and faeces Of considerable importance in delirium tremens As an epispastic useful in aposthema communis common boil may be dispensed, anthrax may sometimes, inflammation of the parotid gland Erythema oedematisum (internally in conjoin) with other stimulants and tonics As an epispastic in bubo & in chillblain also in all the varieties of cephalitis Parismitis caumatodes var. phlegmoneae is benefitted by blistering Parismatis typhodes (typhoid inflammation of the fauces) internally Most of the varieties of pneumonitis typhodes internally and externally Erythema of the lungs? Case of Dr Brown’s in Hartford taken suddenly, in 15 minutes [illegible], died in 12 hours partially roused by brandy opium & tinct. canth. The constitutional affection was t. syncopalis Sparganosis puerperarum benefitted by blistering unless it will bring on irritation in consequence of the previous exhaustion of the system Blisters in dysentery in inflammations of the eyes, in phthisis It is a common practice to blister in rheumatism, very injurious & frequently fata, from chasing the topical affection from joint to joint until it attacks a vital part. If however the rheumatism becomes fixed, then blistering may be useful So in chronic rheumatism Sciatica a neuralgia as much as a rheumatic affection, blisters are very useful though when physicians have injudiciously reduced the system by bleeding the blisters may produce a bad irritation Rickets marasmus [illegible] & scruma in these it is used internally. Said to be worth more than every thing else in scruma In gangrene where there is not great atony the topical application is valuable In vitiated ulcers, internally with tonics Ecphronia mania & melancholia, etc. amaurosis applied over the forehead In the early stages of deafness, applied about the ear In tetanus, in enormous quantities internally, just as opium is given to the amt of 100 gr. in 24 hours also blisters on the spine are beneficial Doubtful as to its benefit in neuralgia It has been proposed in lyssa canina Beneficial in idiopathic headache Leucophlegmosia palsy int. & ext. one of the most powerful remedies Blenorrhea leucorrhea [spermorea] [impotency] in these internally Dropsy in all its varieties Remarkable case mentioned by Dr Ives In internal use in one night carried off all the water flooding the floor of the room The patient was reduced to a skeleton & in a state of asphyxia from which he was roused by friction with ammonia etc. pledgets of ling dipped in amm. thrust into the nostrils & the internal administration of spicy & spiritous cordials. He recovered Internally in the species of paruria In paruria mellita or diabetes, give as much opium as will be borne without soporific effect for it will diminish the secretion of murine & increase that of the skin. Give the tinct. canth. Sponge the surface with caustic potash confined the patient to animal prod and debar the use of drink Keep the extremities warm cloth the body in flannel sometimes wearing stockings filled with capsicum to keep upon irritation. Various combinations of canth. with phosphorus etc. are necessary afterwards Exhaustion from haemorrhage has been relieved when other stimulants seemed to fail In the United States we have the cahntharis villata which is more powerful than the C. vesicatoria & might be furnished at a cheaper So the C. cinerea C. [illegible] lytta nuttallii of the N.W. territory is exceedingly powerful and might be collected in great quantities So other species of cantha Lytta gigas of India is about twice as large much more powerful and more speedy in its operation So other insects The larva of phalaena neustria is a good blistering insect. It is the common apple worm Apis mellifica is a blistering insect Various other insects are mentioned by the European writers Capsicum [Roem???] & Sch. [illegible] [illegible] sp. London gives 3 more Our species is the C. opossum or squash pepper. Pericarp oblong globose or conic [or] tetragonous etc. etc. Other species are cultivated but rare The imported cayenne is an indiscriminate mixture adulterated with salt & even with flour, frequently with peroxide of lead. Indian pods are stronger; but ours are strong enough Aleth species have the same properties in kind. By digesting the pods in ether for some days the oil is obtained & crops of crystals of capsicum are found on the sides of the vessel in acicular crystals This is destitute of sensible or medicinal properties So also of piperin. Each of these owe their small amt of virtue to their contamination. The active principle of each is the oil. The oil of capsicum is a perfect substitute Capsicum is a powerful stimulant. The first sensation is that of warmth As in condiment it prevents flatulence from vegetable food and is not liable to the injurious effects of the oriental spices upon the head. Instead of causing visceral obstructions particularly of the liver it is most probably that they prevent them The effects of too large a topical application are an excessive irritative inflammation which is relieved by olive oil & cerate of datura. Tully does not believe that the stomach will retain a sufficient quantity of the power to poison The habitual use of as an article of food in excessive quantities weakens the stomach & produces a troublesome kind of dyspepsia. As a rubefacient it possess peculiar powers One fourth or one eight of a minim of the oil is a dose, given in a pill made with some extract. Of the substance 2 to 12 grains is a dose. The doses are to be larger in tropical climates Lecture omitted Capsicum continued diseases continued Disguised gout various cases of gout misplaced gout Secondary stages of atonic acute rheumatism & in all cases of erythematoid rheumatism All the low atonic exanthematica e.g. rosalia maligna rubeola maligna, malignant small pox All positively passive hemorrhage Marasmus tabes. Sertosis rachea (rickets) All the srumous phlogotica i.e. strumous visceral inflammation. Porphyra hemorrhagica or land scurvy this the remedy second in importance Acetate of lead is first The several species of gangrene Tully considers it as a settled point that tonics deobstruents & acrids are frequently the best remedies for insanity e.g. Connecticut [illegible] which had been more successful than any other known Melancholia hypochondria N.B. this seems to be a compound of melancholia & dyspepsia. Chorea carus lethargus paramenia [illegible] atonic acrids then assist the operation of the deobstruents & tonics Blenorrhea simplex & chronica have as often been suspended by an internal use of capsicum So B. senodes emphysema abdominis (typanitis) Paruria mellita mostly externally sometimes internally as an adjuvant. Par. [incontin??] epidrosis profusa (sweating) The effects of the bits of serpents though not so effectual by itself as alcohol This last with opium is first, next are ammonia capsicum etc. Monarda punctata N S. to Car 14 sp. in R & S. This the most active species Com. name horse mint. Though this name is applied to sp. of mentha & pyenanthem Ess. oil is volatile and exceedingly pungent and acrid resembling the ess. oil of thymus vulgaris One of the most elegant aromatic stimulants and externally rubefacient & even vesicatory. Spt. 1 fl. oz. of oil to 7 of alcohol is the most convenient form for its internal administration First introduced into regular practice by Dr. Attley of Phil. Diseases (Attley & Eberle) 1st typhus in the cold state externally applied Cholera infantum externally Chronic rheumatism cephalea hemicrania obtuseness of hearing from atony dropped into the ear. Externally applied to the limbs in some forms of palsy Rheumatic odontalgia dropped into the tooth if it is carious if not applied to the face combined opium with it Our most common sp. is m. oblongata & this sp. would probably answer as well M. dydima (bee balm or Oswego tea) M. fistulosa common All have the same oil Ether sulphuric or hydric or vitriolic the most volatile of all known liquids. Extremely inflammatory sometimes producing serious accidents when poured out by candlelight. The best test of its purity will be its sp. gr. [illegible] a pure diffusibly stimulant and nervine N.B. Part of two lectures lost Disease (many lost) Typhus Dr Rush never suffered a patient to die without having first tried a very efficient use of this article Syncope of various species, in these it is the best remedy. Neuralgia auris (ear aches) dropped into the ear especially mixed with sulphate of morphine the ear being stopped with lint to prevent evaporation Cephalis hemicrania & nauseosa N.B. when externally applied and suffering to evaporate it is a refrigerant Chorea, common convulsion Hysteria asphyxia, after breathing has been restored. Tully has frequently seen a patient roused from a paroxysm of catalepsy by ether letharty, parodynia Burns & scalds mixed with spt of ammonia, employed by Dr Ives N.B. if vesication has already taken place, it must be so managed as to produce its refrigerant effects? In that state of the system which has been called concussion in consequence of a sudden and violent shock. Wine produce of the vitis vivifera which was originally from the south of Asia it is found however growing wild in Armenia Tauria etc. The varieties are almost innumerable Different sorts of wine 1st white & red again [illegible], adiculia aspera, & mitia acidulous e.g. shock dulcia frontenae malaga tokay, [illegible] aspera port, mitia or soft sherry claret burgundy champaign madeira Paris’ account if its being firs employed by Asclepiades a little before the time of Pompey It is mentioned by Hippocrates It increases the frequency of the morbidly slow pulse & diminishes the heat or increases it diminishes or increases sweating improves the appetite digestion, exhilirates, & strengthens etc. etc. # Habitual and free drinkers of wine are not subject at all to intermittents & but little to typhus Indeed it diminishes the liability to many inflammations etc. See MacCulloch on malaria Excessive quantities produce nausea vertigo etc. in short intoxication # These are the effects in atonic cases & when given in suitable and regular doses and for some time Habitual and excessive use a general weakness of the nervous system a peculiar sort of dyspepsia & gout These are all Wine is 1st stimulant 2nd nervine 3d narcotic The last operation consists of the vertigo nausea etc. Its sedative effects in case of irritability pain etc. are probably the joint result of all its operations Its effects are not slow and permanent enough to entitle it to be called a tonic Wine and opium are the most valuable articles of their kind Various eminent British authorities quoted Good is inconsistent and contradictory It is more especially adapted to the putrid type of typhus Chemical composition of the intoxicating principle One fourth part of the best wine is officinal alcohol or at least will furnish that amount So that a pint of wine will yield a half pint of brandy Now the effects of factitious wines do not differ from those of diluted alcohol The same is true when alcohol is added to wine. It is commonly supposed at the present day that the difference is owing to the chemical composition in which the alcohol [exists] in the wine, chemical comp more especially with the water But we have no evidence that alcohol will unite with water in any other manner than by solution Others supposed that only a portion of the alcohol exists in the wine previous to distillation. But Mr. Grande by adding [illegible] acetate of lead, separates the alcohol without distillation Pure alcohol is composed of the ponderable part of olefiant gas & water 2 to 1 ether is [illegible] to 1 In wine probably [illegible] will have it 1 to 1 Perhaps another compound of 1 ol. gas to 2 of water may be the princ. of [alc.] etc. which differ as much from [illegible] as this does from alcohol Alcohol Arabic named & discovery The name is figurative, meaning originally a fine powder of antimony used as a paint It retains its fluidity at 91 degrees below zero of Fahrenheit# The bluer the flame the purer the alcohol, and in this way its purity may be judged of The pure state has a sp. gr. of .792 Off alc. is .835 Arrack & spiritus oryzae (rice) The difference in the several sorts of spirit is owing to oily matter and acetic ether. The effects of wine and alcohol which are called by the same name yet differ Alcohol & tobacco have more effect upon the [illegible] Intoxication takes place sooner upon an empty stomach & when the body is immersed in water, but if the head is wet and the body dry, the reverse is true vid p 50 # Frozen by Mr Bussy Bulbs filled & surrounded with cotton dipped in anhydrous sulphurum acid, and placed under the receiver of an air pump vid. p. 43 Nitrate of potassa The most powerful refrigerant known next to blood letting most powerfully reducing [illegible] of action Tully thinks it not diaphoretic as has been said neither diuretic. It proves diuretic and diaphoretic in cases of obstructed perspiration & urine from phlogistic diathesis Sometimes however it has these effects in other circumstances though they cannot be calculated upon It is not sedative except as it relieves the morbid restlessness heat & dryness of skin etc. of phlogistic diathesis It may not febrifuge except in [?thenic] fevers, that is in a small portion of fevers Not laxative except as it relieves the torpor of phlogistic diathesis producing the natural discharges. Very doubtful if it is ever antispasmodic. Not antiseptic except upon dead animal matter. Sometimes there is a tendency to gangrene in high phlogistic diathesis which of course is relieved by any refrigerant Cinchona is the most powerful antiseptic, using the term in its most appropriate senses, but these two articles are entirely incompatible one will not counteract efficiently the improper use of the other as seems to be sometimes supposed. The injurious effects of efficient quantities of this article in atonic cases are crust on the teeth coldness of extremities etc. etc. It should always be given in uniform and small quantities from 5 gr. to 1 scr. The test of too large a quantity is pain in the stomach. Sometimes present in the urine, but not in proportion to its effects. The operation of the external application are similar to those of its internal hence it is used as a lotion on phlegmonous inflammation. it is also used as an irritant like tartrate of antimony not therefore a stimulant Deleterious effects, coldness of stomach, discharge of considerable [illegible] of blood weak pulse etc. etc. pallor of countenance etc. A very large quantity vomits and is thrown off. ½ an ounce to an ounce is a poisonous dose Orfila conjoined it refrigerating with its narcotic effects an egregious blunder In a medico jurisprudential point of view nothing short of find the article will answer. Show a distinguished anatomist says that the appearance of the stomach and intestines is not to be relied on as a proof of poison because all the appearances may be at times found in an unpoisoned stomach This very important in this country where medical jurisprudence is much abused. Remedies 1st vomit, not with the mineral, but the vegetable emetics the best is a dose of a table spoonful of black mustard which is more speedy and effectual in clearing the stomach and is useful as an acrid. Opium & alcohol with nutrition demulcent After the poisonous effects have taken place do not vomit and in any case prefer emesis to catharsis. Finally prescribe to the symptoms. The refrigerants & especially nitrate of potassa have been undervalued of late Partly from change of diseases, partly from the chemical theory of the production of animal heat by the solidification of oxygen The French writers call it stimulant because it produces irritation & inflammation Diseases Acute mercurial ptyalism as a topical application doubtful because it is an atonic agent. A dipsosis avens or morbid thirst, especially of intemperance doubtful for the above reason Opium etc. are also undoubtedly known to be useful. This also makes the above doubtful. Dyspepsia by Wilson Philip, upon his theory that the secondary stages of dyspepsia are phlogistic There is much more reason for considering it exceedingly injurious in this disease producing a bad sort of dyspepsia when freely given for affections of the urinary organs. Jaundice by the French writers melaena also by the same very improbable. Simple idiopathic cough very doubtful. Remittent But the opposite class of remedies is always wanted in the varieties of this disease. Idiopathic hectic because it is cooling & sedative Very little probability Synochous in this it does neither hurt nor good Typhus gravior very injurious. Cauma or actively inflammatory fever the most efficient remedy after bloodletting & perhaps after nauseating doses of tartrate of antimony A composition of nitrate of potassa tartrate of antimony & calomel used in Philadelphia under the appellation of Rush’s febrifuge it contains too little of the two first articles. As a general rule avoid being confined to set formulas. Some inflammations of the skin boils [illegible] etc. Blenorrhea lenodes (clap) it has been recommended. In inflammations of the female breasts & of the testicle, it is not so good as acetate of lead. Useful in phlogistic rheumatism still not so good as some other modes of treatment. Useful & important in all the entonic phlogotica. Active phlegmonous cephalitis & in quinsy Membranific inflammation of the bladder doubtful because copaiva oil of pine etc. are very useful. In hemorrhage haemoptysis but the restriction to active shd be made haemorhage It has been recommended in haemorrhage attended with plethora. Tully however does not believe in the existence of a disease consisting of too great a quantity of blood. Sea scurvy recommended very doubtful Tully is inclined to think sea scurvy not a different disease from land scurvy. The latter requires the system to be raised, the former will generally be cured by a change of food Obesity which however is better cured by the old rule mouth always shut eyes always open feet always in motion. Cellular dropsy doubtful Parunia various species, including diabetes. Neither this nor any other remedy has done much good Gravel improbable. Lepidosis psoriaca var. inveterata. Impetogo laminosa (salt rheum) I. herpetica (herpes) Tully has not known it do good & very different articles serviceable. Nitrate of soda possesses the same medicinal properties So also nitrate of ammonia although ammonia itself is stimulating. Various other nitrates also. Carbonate of potassa called sal tartari sal absynthii (salt of wormwood) The deliquation by exposure to air was called oleum tartari. Obtained from the [L??viation] of the ashes of plants not [illegible] when imperfectly purified called pearl ashes. It must be pure for most pharmaceutical preparations. The theory of its combination with oils forming soup it was formerly not understood has been lately investigated. Incompatibles, all the salt will decompose it It is refrigerant but this property is not so predominant as to prevent its use in atonic case Also diuretic, especially when aided by plentiful dilution, still it cannot be depended on in dropsy. In diuretic power greater than it refrigerating. Parunia inops most useful as a diuretic in this Sometimes antilithic viz. in cases of calculi of the xanthic acid & 2 others Antacid as in dyspepsia still not so good as oxide of potassium which is also tonic not so good also as lime. Not stimulating unless this term be applied to every remedial agent. Neither increased frequency of pulse, nor increased heat is an evidence of [stimulation] Not specifically anti-emetic unless retching is produced by a free acid. Not antispasmodic, as in bex convulsiva (whooping cough) Of no use in visceral enlargement. Dyspepsia remittents recommended in the form of effervescing mixtures which however operate by their carbonia acid & the salt formed. Saccharine matters supposed to impair its power. Water the only proper menstruum for its solution. Its solution commonly mixed with a little rhubarb & peppermint This much mused by physicians when at a loss what else to do. Case of A seamstress who had a horrid dyspepsia from costiveness relieved habitually by Lee’s pills relieved by this brought from the south Oftenest used as an effervescing mixture If sugar is added it should be dissolved not in the solution but in the lime juice or else the effervescence will be prevented But the bi carbonate of potassa is best for effervescing mixtures. Large doses are poisonous from irritation inflammation etc. Antidote at first vinegar afterwards demulcents particularly those of an [illegible] oily nature, with narcotics Bicarbonate of potassa called carbonata & super carbonate also sub tartari essentialis sal aeratus (this name is given to other salts of [illegible]) Does not deliquesce from exposure to the air possesses considerable activity as a refrigerant more than the last article. Much use of it as an antacid injurious from the distention. Tully does not believe with Edward and Varasseum that it possesses all the advantages of the carbonate & ought to be used for it although mor pleasant to the taste Carbonate of soda called sal sodae called in commerce when in its most impure state barilla Effloresces upon exposure to the air deliquesces by heat Obtained from marine plants especially the salsola soda Similar in powers to the above Tully thinks it not deobstruent. It can be given in pills carb of potassa cannot from its deliquating the carbonate of soda however must be [efflorescent] Tully can perceive no effect in jaundice from this or the carb. pot. Bicarb. soda (more commonly called sub-[illegible]) found native & called hard enough to build the walls of a fort Ingredient in some specimens of soda water This article originally was made of oxide of sodium Now, except in N. Haven, it is merely carbonated water. The prevailing custom very injurious Case of a brine spring in Albany. Saratoga very injurious ½ dr. to [illegible] gr. tart makes soda powders with pure concrete tartaric acid The tartrate of soda produced is cathartic proportions 25 gr tart. acid ½ dr. soda Seidlitz pow Hydrocyanic acid (I was absent) [Illegible] cerasus the essential oil Equally powerful as a narcotic with hydrocyanic acid 6 ol. oz. of distilled water to 1 pound of the recent leaves Less powerful upon man than upon the brute animals upon which the operation of a little laurel water to the eye or the inside of the mouth causes immediate death. Two or three minims of the (so called or supposed) essential oil kills small animals Tincture the most convenient form Cataplasms of the leaves are useful as a narcotic. The leaves are used for their flavour in cookery among the English & has sometimes in moderate quantities have produced death. Probably the cerasus virginiana has the same properties. probably in a less degree Gelseminum nitis (apocyneae) The effluvia of the flowers are said (in Elliott) sometimes to produce stupor) Tully considers it as a perfect substitute for hydrocyanic acid & free from its inconveniences. The root, most powerful part. In phlogostic cases it would probably like the other simple narcotics do neither good nor hurt. Never produces the calm placid pleasurable sensation exhiliration and wakefulness of the nervines. Tully has always used the tincture 4 oz. bruised root to 1 pint of alcohol macerate for a week. 10 to 20 minims from 3 to 6 hours beginning with small doses & more until narcosis begins to be powdered & then continue the same dose. It is well frequently to conjoin opium [illegible] will counteract its liability to to produce narcosis, Probable all the stimulants have this power. Perhaps the failures so frequently complained of are owing to want of skill in conjoining them Evil effects narcosis merely which may always be relieved by the diffusible stimulants. The best are alcohol [monarda] punctata capsicum spt. ammonia Make use of of napkins wet in cold water applied to the head & of friction, & rubefaction by the monarda punctata Case of a patient who book several doses in rapid succession. The very distressing symptoms were immediately relieved by brand & in 12 hours the patient was as well as before. Case of a girl at the south died in an hour Diseases bex (various species) phthisis where there is much irritation Dyspnea exacerbans acute & subacute rheum Helomas erythrosperma A pure narcotic yet differing materially in its effects from the Prussic acid & Gelsemenum Letter from Dr Brand of S. Carolina Affect the eyes making them sensible to light in an extraordinary degree blindness finally N.B. All narcotics appear to affect the sight Some produce dimness Some dilate the pupil Commencing dose of the tincture 10 minim. Tully has commonly found from 20 to 30 minims necessary at intervals of from 4 to 6 hours. With respect to most such articles, physicians are apt to give inefficient doses & then condemn the article Few of the narcotics, except opium directly produce sleep Chlorite of Potassa (oxymuriate) Prof. Ives is right in saying that it diminishes the heat of the kin & of the stomach. It diminished or at least does not increase entonic diathesis Said to relieve chronic hepatitis which however does not exist, for in dyspepsia accompanied with tenderness over the liver post mortem examination shows no inflammation. Said to be capable of during lues syphilis very doubtful Said to be good for cacherine, a loos term which may include one third of human diseases. Tully believes it a weak refrigerant of no great value without further experiment Vegetable acids. 3 groups 1st those which exist in a free state 2nd which do not & 3d those which are the products of decomposition The last are the benzoic & [illegible] & perhaps [illegible] all nervines Acetic acid 4 states one of which is acidum aceticum pyrumatica or syroligneous acid. Common vinegar is acidum acegum impurum The impurities are various according to the liquor from which it is made Frequently found in the sap of plants as [illegible] typhina vitis vinifera It is a pure refrigerant proper only in cauma. To be given diluted or in combination with mucilage Improperly used in putrid [illegible] to relieve heat [illegible] about the mouth & thirst which do not require [illegible] but if we need acids we must use the [illegible] acids a sulphuric & nitric. Though it is often given to humor nurses bystanders etc. Said to be antiscorbutic but this is loose and doubtful for the vegetable acids pure do not relieve scurvy, without vegetable matter. In obesity if insufficiently employed it does nothing if efficient, it is mischievous. Useful as a condiment, as [illegible] also Conium maculatum a deobstruent [diuretic] confounded with [??uta] maculata both in Europe and in this country. The ancient hemlock is unknown. We know of no plant which will produce the effects ascribed to hemlock in the account of the death of Socrates Perhaps the liquor was a compd of several narcotics The most common form & the best for administering it is extract. The term extract has four applications 2st expressed inspissated juice 2nd inspissated exuded juice 3d inspissated decoction 4th alcoholic extracts Tully places great reliance upon conium and iron in dyspepsia It is useful in paronina salax lagnesis [fluor] etc. etc. Tully used conium & iron with various aromatics in dyspepsia for 4 or 5 years without being able to get any physician to try it. Of more value than mercurials in jaundice Cicuta maculata frequently confounded with the latter more powerful very poisonous the poison cured by stimulants etc. as in other narcotics Digitalis purpurea purple foxglove cultivated in our gardens It is a narcotic deobstruent Medical testimony upon this article exceedingly contradictory. Tully denies that it is either stimulant or refrigerant thinks that the supposed phlogistic cases in which digitalis has been though a substitute for bloodletting were in reality synochous cases which are not phlogistic according to Tully nor are they phlogistic at the outset and typhoid at the last & though they will bear bleeding yet are cured much better without In large quantities it vomits and purges 1st narcotic 2nd deobstruent &^ as parts of this last it is resolvent diuretic and discutient Most commonly used for its diuretic operation [Black???] says that digitalis is not proper except when the urine is coagulable this was tried in this country by boiling the urine! Unfounded If the system is very low it must be raised by excitants in order to allow digitalis to operate So if it is very high it must be reduced Yet there is a considerable range within which neither is necessary Paris’s account of diuretics which are incompatible with it is unfounded The narcotic powers of this article are frequently useful to allay morbid irritability. The best form is tincture It has been supposed that the infusion is best as a diuretic and the tincture as antirritant. Not very probable Therapeutic application Dyspepsia accompanied with tenderness in the epigaastric regions & febrific symptoms digitalis has been used to alleviate these symptoms not so good however as actaea & [other] Recommended in many cases of chronic cough accompanied with dropsical swelling of face, leucophlegmasia Also is it useful in many cases of simple idiopathic cough best however as an auxiliary to opium etc. Whooping cough especially conjoined with arsenic Some forms of phthisis Rheumatism is of various kinds in some of them this article may be used though in most of them actaea & some similar articles are better It has been recommended in mania and probably may be very serviceable in breaking up the paroxysms N.B. the practice of attempting to do this by profuse bleeding is generally bad because the bloodvessels are affected by the mind and not the mind by they bloodvessels & the continuance of the practice may produce fatuity Digitalis long a popular remedy taken in ale among the Italian much used as a [vulnergry]. Withering about 50 years ago first used it in dropsy as a diuretic Frequently the excessive distention of dropsy will prevent the operation of diuretics until it has been reduced by paracentesis or hydragogue cathartics especially elaterium Few diuretics can be depended upon when used alone but required to be combined with others Asclepias syriaca seems to be the most sure which Tully has used. Lobelia inflata 1st narcotic 2n deobstruent 3d emetic as parts of its deobstruent effects it is cholagogue diaphoretic? diuretic? sialagogue & perhaps emmenagogue. No published account exists of its deleterious effects. The first account was published by Ref. Dr. Cutler 1785 It has been employed in form of powder of the leaves powder of the leaves infusion tincture of seeds & tincture of the leaves 2 oz. of recently dried leaves to 1 pint of proof spirit macerate 8 or 10 days Diseases Limosis dyspepsia especially where there is great insusceptibility Simple idiopathic cough considerable [evidence] for its utility. Often very efficacious in that sort of cough to which public speakers and singers are subject it is sometimes the sequel of acute diseases, and is always accompanied with more or less dyspnoea which will be manifested by a fit of coughing following upon the [illegible] to light a candle & blow off dust from every thing Frequently accompanied in these cases with s opium Bex convulsiva or whooping cough in the secondary stages, very useful Tully has not always succeeded with it Dyspnea exacerbans (commonly called asthma, though differing from it) give it in doses of a teaspoonful once in 5 or 10 minutes until the exacerbation disappears either with or without narcosis and vomiting. Highly effectual in asthma though not so certain because the disease is more obstinate The British physicians are just beginning to learn that this article has remedial powers. Tully has no doubt that in Britain diseases yield to smaller doses and less efficient practice than with us This article has been recommended in croup, though it has been rejected upon theoretic principles. Cases mentioned in which its emetic & deobstruent powers have been very serviceable. Actaea racemosa. Black [cohosh] frequently confounded with leontice [thaltroides] called blue [cohosh] No complete analysis has been made Tully thinks it probably has no alkaline principle being in this respect similar to digitalis and conium A narcotic deobstruent in large quantities an emetic Tully thinks he has seen in children moderate exhilirating effects produced by this article It may be pushed so far as to produce neuralgic pains This effect may be prevented by giving liquid food; or it may be remedied after it has taken place by giving opium etc. There is much evidence for its being a [part??] accelerator similar to [sclerotium] clavus With respect to its diuretic and diaphoretic operation it is not strictly correct to ascribe them because they follow the exhiliration of the article only when diaphoresis and diuresis are prevented by the diseased state of the system. The deobstruent effect may be prevented and in the hands of injudicious practitioners frequently is prevented [illegible] too great previous bleeding Actaea resembles digitalis most but differs from it 1st in not accumulating upon the system and suddenly breaking out Through these effects may be prevented in digitalis yet they are not liable to occur from actaea 2nd Actaea is not liable to reduce the patient to a low and dangerous state The narcosis is more easily remedied 3d Actaea produces neuralgic & perhaps spasmodic pains. And this effect is valuable as a test of the limits of the dose 4 Actaea possesses considerable power as a [partus] accelerator 5 It possesses more deobstruent power Actura differs from conium in being [illegible] a deobstruent more speedy & powerful Actaea is most powerful in acute & conium in chronic case The resolvent power of actaea is greater than its cholagogue vice versa with Conium No article has so great a resolvent power as actaea & none so [illegible] a cholagogue as conium Actaea may made indirectly diaph. diur. & expect. conium not Actaea seems to be a more effectual deobstruent than sanguinaria and causing less nausea than colchicum & less liable than either of them to leave the stomach and intestines in a deranged condition The watery preparations not to be relied on Tully used them in a vague way in some years without discovering its narcotic powers Tincture two [ounces] to 1 pint alcohol sp. gr. .835 Medium dose of alc. tinct. f z ss once in 2 or 3 hours Materia Medica 1831 & 2 Pure mineral deobstruents are iodine nitric muriatic nitromuriatic acids chloride of gold barium calcium etc. Perchloride & peroxide of mercury also proto chloride & diproto nitrate of mercury Vegetable deobstruent 1st pure, are leontodon, rubra tinctoria fumaria offic. cinchorium intybus sapomaria offic. Of all these, a large quantity must be used 2nd Aperient they restore, or augment the fluid secretions viz. halitus from the lungs diaphoresis & diuresis (formerly called [illegible] also sweetness of the blood) now often called diet drinks, from their being given in form of decoction & in large quantities. Some of them are spoiled by decoction however. e.g. sarsaparilla is injured even by the best of the sun Smilax off. syph. rotundif. and glauca. Officinal sarsaparilla is from S. off. & S. sulph. (S. sarsaparilla produces none it should be called by Micheaux’s name glauca) Comptonia asplen. (leaves) aralia [medicaulis] & racemosa (root) Asclepias tuberosa & incarn Arctium lappa & dardana? (roots & seeds) Diervilla lutea, celastorus scandens Collisonia canadense, solarum dulcamara (has slight & easily lost narcotic properties) These are used in hectic, lues, bucnemia elephantiasis, lithis arenalis, lepidosis several species. Ecpyresis. Sequels of rheumatism in dyspepsia 3d Acrid cheledonium majus, daphne Mezeocon etc. Dirca palustris ranunculi anemones clematides myrica cerifera 4th mild narcotics, destitute of acrimony solanum nigrum & tuberosum [ethusa] sinapium conium, cicuta & probably the lacturas 5th acrid narcotics they do not incline to produce somnolency or coma, but stupor the term acrid is used to denote this quality of a narcotic operation Kalmia 2 or 3 sp. rhododendron 2 or 3 aconitum napellus, strychnos nux vomica 6th Astringent chemaph. uva ursi [illegible] calyculata ledum [palustra] 7th tonic Canalyrium carolin. (unicorn root) Helonias dioica is the old name for this aletris farinosa (unicorn root also) 8th Evacuating Ol. & resin of pinus & abies & copaifera off. & juniperus [illegible] & guaiacum off. Iris vessic. & prism. Polygala senega & pubescens squills (conithagala squilla) Gratiole off. lobelia syphilitica nearly allied to senega & better because this latter deranges the al. can. Helleborus [2] sp. Eryngium yuccifolium sanguin. veratrum apocynim. aralia spinosa phytolacca colchicum, seeds of Daphinium cocculus [indicus], stillingia sylv. anderia inernis veratrum album Mercurial Ptyalism. Symptoms are ptyalism, soreness of the mouth, ulceration of mouth & fauces a vesicular erythema upon the skin etc. Different persons differ in susceptibility. The same person will be much more susceptible after a previous salivation especially if recent. Teeth set on edge is an incipient symptom Ordinarily there are no fatal consequences. When they occur they consist of caries of the jaw, sloughy ulcers of the mouth, total loss of the teeth, stiffness & incurvation of the limbs, extreme emaciation etc. etc. The treatment is in a good degree empirical. The question as to treatment seems to be, what will do the most good No foundation exists for the opinion that the mercury is deposited throughout the system. Sulphur flowers have been thought a specific nonsense! the only two compounds of mercury & sulphur or one a brilliant red & one black & both insoluble!! Purging, as such. Prof. T. is confident, does no good Dr Finlay of Ohio thinks it may be cured by antimony. Others have not succeeded by it. Sarsaparilla is much used a quart of decoction a day is much used in G.B. undoubtedly with benefit. Not of much use in our country Astringent lotions & gargles are much used They are useful in the latter stages In the first stages resolvent remedies seem to be most needed iced water has cured mild cases. Baptisia tinct. has been much used. The testimony is so strong that Prof T. credits it It is used topically. A strong solution (1 scr. to 1 oz of water of nit. sil. has been the best article used by Tully. Liquor of the arsenite of potassa is an excellent topical application is also taken internally Spts turpentine in gum arabic is employed by Prof. I Lycopus vulgaris decoct is recommended Watery solution of opium is strongly recommended The mineral acids are recommended Mucilages are very grateful acacia typho lab. viole pedata laura sassafras ([illegible]) decoct. of rice & barley strained through a cloth) tragacanth hibiscus althea Prof T. would try quinine Milk porridge is the most grateful diet air [illegible] & [free] Erythismus hydrargyratus Irregular action of heart & arteries, pale countenance exhaustion of strength anxiety in epigastrium, sighing, quick small & sometimes intermittent pulse tongue not furred. In this state, sudden exertion may destroy the patient Treatment A steady and regular use of moderate quantities of opium alcohol & quinine with strict rest Erythema hydragyratum vide Good A vesicular eruption (though like a case of sun burn, a magnifier may be needed to discriminate) Prof. T. does not believe in the spreading from the corrosion of the discharge (criticisms upon Bateman’s confounding erythema with exaena or rash erythema being vesicular) Bateman probably incorrect in saying that it may be caused by cold merely Bateman gives a very full & perfect account of the rise & progress of the disease Diseases teething cathartics too much used blue pill preferred Prof. T. objects to protoxide (blue pill) as being extremely uncertain (imperfectly oxydized) & when perfectly oxydized is in no way preferable to calomel It is milder only in consequence of the diminution of the dose in consequence of the imperfect oxydation. Prof T distributed some of that perfectly oxydized to his friend e.g. Drs Reed Cogswell Todd etc. They all declared they could perceive no difference It will combine with the lactic acid of the stomach & produce a troublesome compound Dyspepsia Prof. T. utterly protests against the fashionable practice of using mercury in dyspepsia Even when the liver sustains the burden of disease it is injurious. The use of mercury occasions tendency of abdomen etc. etc. Even as a deobstruent it is inferior to other articles Occasionally useful as a slow purge Colica Ileus (comm. col.) Of the utmost importance not as a cathartic for this is of no consequence the disease consisting of a suspension of the peristaltic motion. Commence with opium & continue the use of opium but the cal. cures the disease It will never produce ptyalism. It has been given to the amount of i dram once in 6 hours without this effect. Colica rachialgia the same with respect both to opium & mercury Coprostasis not the best article Diarrhoea purging will cure the disease by strong impression but the practice is foolish utterly inapplicable to sev severe cases Cholera Generally the phys. is called too late to allow of the exhibition of calomel In the commencement of the disease it is useful as a deobstruent Helminthia ascar. lumbri probably the best cathartic. The spigelia ought to have been given for the last 12 hours until narcosis is produced. Then give the cathartic Senna is an extremely poor vermifuge its purgative operation is not of the right kind. In the other species of invermination cal. is not the article Even in this species turpentine oil is a better article, but not so manageable as spigelia & cal. Jaundice Purging with cal. in the early stages & the use of [illegible] deobstruant is of great importance cal. is inferior only to conium in this disease. Give it alone cal. is better as a first measure than vomiting Vomiting is apt to produce soreness in the liver & irritative fever. This calomel treatment of jaundice is not the best. The yellow colour will remain and this may be removed if we treat with conium Cal. is apt to produce ptyalism Parabisma coactum There is but one article better than cal. There is an impression that these must be cured before attacking the intermittent. The interm. may be cured without disturbing the parabisma. Conium will cure the disease in half the time of cal. Corysa acuta (improperly entonica by Good) Calomel 7 opium will cure a paroxysm Fevers 1st Intermittent It is a great mistake to suppose that we must always being with purging & vomiting If cathartics are indicated, calomel is much the best notion a drastic dose nor combined with other cathartics Remittent a disease intermediate between intermittent & continued fever. Some cases approach more to an intermittent & others more to a continued form & the nearer it approaches to the latter the more is calomel indicated. It is slow purging that we need not small doses at considerable intervals not quick & drastic for them we increase irritability & irritation Typhus infantum absurdly called infantile remittent & worm fever. Purging with pure calomel & cal. in small doses & at regular & short intervals. It is well to conjoin it with antirritant & with ipecac Non malignant nervous typhus. The best article for producing a resolution, provided you have been called in very early & also before the patient has purged himself even 3 or 4 times with castor oil. Give it either in a single & full dose or in small quantities, so as to get a full dose in the course of 12 or 15 hours or conjoined with opium. Cal. & ipecac is an excellent article for the resolution of fever. Other modes e.g. vomiting, purging, sweating etc. are more liable to fail than to succeed. This mode has succeeded in 8 out of 10 cases in Tully’s practice. Sporadic cases are resolved more easily than epidemic. Purge no more than to remove the contents of the al. can. Dis-oxide of mercury (sub oxide black oxide) (protoxide aethiops per se) pulvis hydr. [illegible] oxidum cinereum is a different compound Mode of preparation vide U.S. Pharmacopoeia This process is very exceptionable An apoth. would require near a barrel of lime water in order to make such a quantity as he would wish to make at once. It is besides uncertain from the uncertain composition of the lime water. You will have an excess of carbonate of lime or of calomel The [illegible] of the Phil. phar. is the best for a chemist viz. cal. & caust. pot. with 1 pt. water Take cal. & carb. pot. equal parts triturate in a mortar to every troy oz. add alcoh. 3 fl. oz. & wat 1 pt. Boil in a flask until there is a copious black precip wash & dry Blue pill will be more strong in proportion to the quantity of metallic mercury contained which is entirely inactive. If it is made with conserve of roses or with rhubarb, we shall have more or less of malate or gallate of mercury Light decomposes it. When made into pills with any articles which contain combustible matter a greater or less degree of decomposition takes place The mercurial ointment Prof Tully would retain although there is more or less uncertainty about it. But the blue pill mass he would utterly reject. Still this black oxide does not differ in its operation from cal. vide above upon cal. The physicians to whom Prof. T. distributed this article reported that where the stomach contained acid probably from the formation of a salt tormina followed its administra Prof T. would use the black oxide for those who have a prejudice against calomel & for this purpose only Cal. & op. is better in most cases for producing a mercurial action than the ointment still not always Black oxide macerated in nitric acid ([diluted] for 24 hours Wash the white powder. It is between 2/3 & ½ as active as calomel & ought to be substituted for the blue mass This is the di-proto-nitrate of mercury or the disnitrated disoxide Please sew these together Iodine characters Origin is from ocean salt springs zosteramarina Trigl. chin salsola atriplex chenopoidium dipsacis [fallorum] [sedium] teliphium The cryptogamous plants are much more numerous [f?cus] vesiculsus etc. It is found in zoophytes as sponge in the genera venus (clam) ostrea (oysters) etc. several mollusca. Probably iodine & potassium exists in its metallic state in combination with the other elements of the plants Potassa or oxide of potassium probably is produced by the incineration Operative effects Moderate augmentation of the appetite & digestive & of arterial vigor & muscular strength perhaps this is merely the effects of its alleviation of diseases It is of no utility as a [narcotic] 2nd resolves glandular enlargement as of the thyroid the ovaries the testicles & breast & lepidotic (especially) cutaneous aff & acute subacute & chronic inflammations (of an arthritic character especially) increases the catamenia & is said to diminish corpulency & fatten the lean An overdose will either be thrown off by vomiting or produces an atonic erythematic inflammation of the mucous men. of the fauces & al. canal. Dr Tully gives a teaspoonful of the saturated tinct. without injury It is said to have removed the heatlhy female breasts & male testicles. There is no good evidence of this Magendie & others who have much used it have seen no such effects Elliotson of England has employed it very much & even for 18 months without any injury, when disagreeable effects were produced he merely suspended it & afterwards diminished the dose Dr Wood has had it produce a vesicular infl. All the injurious effects are said to have happened in Switzerland, where there was a sort of mania for its use. Prof. T. has used it very much & has not known it produce injurious effects He has known it frequently relieve a diseased & not injure a healthy testicle It is said not to be so at Wether. st. pr. But then the prisoners there are dysthetic or cachectic One case was that of a fungus haematodes The other test. remained unimpaired Iodine is not a stimulant i.e not producing a quickly diffused & transient strength of action. It is a vital irritant capable of producing vesication upon the skin. When properly managed it is neither sialagogue expectorant, diaph nor diuretic. It acts upon the skin, but not in the way of producing diaphoresis. It has cathartic properties according to the experience of Dr Todd It is not known to be cholagogue s Iodine is then 1st deob. 2 tonic 3 rubefacient or even vesicatory Its deobstruent operations are 1st resolve 2nd atnipsoraic 3d emmenag 4th discutient Opium should always be conjoined to counteract its tendency to produce irritation. Opium will enable the patient to bear more iodine & will not injure its operation. Hyoscyam conium & other narcotics will answer [illegible] entony or atony contraindicate it. When used to freely or too long it is said to produce pytalism pain of teeth & gums. absorption of glands pain in internal ears vertigo, sense of burning in the stomach etc. etc. thirst vomiting NO doubt that glands are absorbed by an excessive use. Sufficient warming is given. If persevered in a dry cough sleplessness emaciation vomiting fiarrhoea paralysis priapism convulsions death from excessive irritation. Case of a young lady in Paris whose goitre was reduced to a hard knot. The knot was not cut out as it should have been. The iodine was not discontinued it produced excessive vomiting & purging with an emaciation such that the thighs were not larger than the wrists in health Eventually recovered or nearly so on opium. Authors recommend depletion of blood cathartics of neutral salts etc. a strict antiphlogistic [illegible] [illegible] can be scarcely be deduced from the symptoms On the contrary they indicate antirritants & moderate stimulants ([illegible] powerful stimulants) for the extreme exhaustion & irritation. Opium should be the main article. There is a prejudice among the people, derived undoubtedly from physicians that opium commonly palliate, & never cure disease. It is capable, if properly managed, of curing as many diseases as any other article A British author says that for gastrodynia medicine is of no use with the exception of opium given in efficient quantities. It is idiopathic gastrodynia which is here spoken of. No injurious effects follows Injurious effects follow only the use of opium where there is no disease ^ where of course it produces diseases. Many in the Senate at the Bar etc. are now free from gastrodynia enjoying health & comfort This author however, says Prof. T. seems to know of no mode of using it but to meet paroxysm but the disease may be radically cured even if it requires as it has in Prof. T.’s practice a year & a half. This is a disease not [ever] of inflammation but of irritation though after a long continuance infl. may come on Pharmaceutic prep. Pure [illegible] in pill tinct. ether ointment * plaster of iodine. Magendie’s formula is to be utterly disregarded, on account of the different weights & the different strength of their alcohol which is absolute alcohol a substance which cannot be obtained among us. The translators have sometimes translated the weights without reduction or reduced some & not others. The truth is the French pharmacy is loos & in the midst of their vast among of science there is a great deal of empiricism One grain is supposed to be a medium dose made, say with ext. glycirrh. Divide one gr into 2 pills & give perhaps 1 if necessary Tinct. made of sp. gr. .835. (Take a vial of a known weight put into it 1000 gr, of distilled water mark the heights alcohol up to this mark should weight 835 gr.) 24 gr. of iodine will sat. 1 fl. oz. 20 min. will contain a grain & this is a medium dose [2] or 3 times in a day we may need to give 15 min. or 30 min. or even a fl. dr. Elliotson has increased it from 5 min. to 2 fl. dr. It is said this tinct. will become weakened by crystallization, if it is kept long. Very probably this is the result of carelessly stopping the bottle & suffering the alcoh. to evap. Ether of iodine is used in France Ether contributes nothing. The only possible advantage must be that of having it a little more highly concentrated Ointment of iodine must vary in strength to suit the patient To 1 oz of simple cerate add from ½ a dram to 2 dr of iodine Put the scales of iodine into a wedgewoods mortar & rub it up with a piece of cerate as big as a nutmeg, in order to be sure of pulverizing the iodine. For parts, as the neck, exposed to view, we should use an ointment of iodide of potassium or sodium, which will have no stain upon the skin. These iodides have the same properties with the isolated iodine The plaster may be made of the same strength as the ointment & the best basis is pure white pine resin. If made with adhesive plaster containing lead, we have iodide of lead, which differs in properties perhaps [illegible] better one A hydriodic acid little know of its properties Iodide of potassium called also hydriodate of potassa. It seems to have no advantage over pure iodine, but in taste, & in greater solubility in water. We may use Elliotsons dose of from 1 gr to 1 ½ of the iodide of potas The iodide of sodium would be better from their not deliquescing etc. Phthisis 1st membranosa a thickening of the bronchial membrane caused by dust by dyspepsia neglected cold etc. 2d scrumous or tuberculous phthisis 3d apostematous phthisis Begins imperceptibly & at last an abscess is formed 4th another variety not mentioned in the books is the hemorrhagic phth. found in persons of hemorrhagic habit, begins with hem. this becomes more frequent etc. etc. finally hectic & phthisis 5th laryngeal phthisis an affection of the membrane of the larynx the lung perhaps not affected. The voice finally lost. Always (almost) fatal. It is connected with a strumous habit. It may begin in the fauces. Within a few years several cases have been cured by Brera & by Dr Woodw. of Verm. hydrid. & conium The difficulty is in curing by constitutional remedies. There would be little difficulty, if we could come at the parts & touch with nitrate sil. and corr. sub. Membranific hysteritis has been cured by iodine & conium Mesenteritis strumosa (enlargement) has been cured by it & conium Dysenteria chronica (so called) The cases were probably strumous ulcerations & thickening of the mucus memb. of the intestines very improperly called dysentery, which is never probably apyrectic Arthritis podagra in France externally (improperly?) & internally & with great success. Prof. T. would give it in ‘ teasp. doses of tinct. 5 or 6 times a day during’ the paroxysm but not continuing it long. No danger when the system is occupied with a powerful disease White swellings of various joints one of them is strumous infl. of the body of the bone another is a phlegmonoid inflam. of the cartilages & ligaments. Both have been cured by iodine, especially when applied externally It is surprising how soon the disease may be removed let it e administered in conjunction with conium internally & externally so as to be rubefacient & even vesicatory. Buchmenia indica or Barbadoes swelled [by] would probably be cured by iodine. Prof. T. has cured this repeatedly by arsenic internally & ointment of protoxide of mercury externally Careina vulgaris not sarcoma schirrhosum There are several distinct diseases called cancer which resemble each other in nothing but in terminating in aphagedenic ulcer. Dr Cogswell has cured several cases of unequivocal cancer in its earliest stages by ointment of iodine externally & conium & iron internally. There is no doubt that cancer may be absorbed without sloughing in the earliest stages In the first stages iodine cures the disease by resolution; in the advanced stages when it is too late for the knife, iodine cures by sloughing. Probably the disease is much less liable to return, after iodine Prof. Smith read 50 cases to Prof. T. & all returned in some part of the body Sarcoma medullare ([fungous] haematodes) The origin & progress of this disease is very curious. At first many small encysted tumors, filled with matter of the colour & consistence of honey finally becoming vascular afterwards resembling brain afterwards bursting out being obviously fungous haematodes, & destroying life by hemorrhage Case related of fungous of the testicle cured by iodine Sarcoma schirrhosum this is a much less formidable disease than carcinus vulgaris More easily cured by extirpation also, as well as by iodine. Carcinus vul. commences commonly about the areola the nipple will be draw in there will be a purckered appearance a livid colour etc. Sarcoma schirrhosum commences with a large ugly looking tumor, of the size perhaps of an orange Parapsis acris var. [pruritis] is called [illegible] (nothing visible to the eyes) Exomia pruritis has been cured by iodide of potassium The whole genus lepidosis (scaly) is benefitted by iodine 1st species [pytiocasis] dandruff & var. [illegible] capitis & versicolor one of them dandruff Topical applications are alone of consequence. Lepidosis lepriasis leprosy mild cases have been cured It seems to be considered incurable by authors, but their practice is milk & water treatment Lepidosis psoriasis a very formidable disease iodine with conium should be tried L. ichthyiasis iodine promises more than any other article Ecpyesis impetigo var. laminosa called salt rheum (other diseases also are called salt rheum) Various containers eruptions, when in an ulcerated & highly irritable state must first be brought to a bitter state before you can attempt the cure Ecpy impetigo var. herpetica lasts for years arsenic almost a specific it may be assisted by ointment of iodine Ecpyesis porrigo scald head & var. p. galatea is the worst. Prof. T. has used various articles he has applied tinct iod. by a camels hair pencil also ointment iod. instead of oint. iod. pot., for its greater strength Exostasis ostea & periostea In osteo-sarcoma for instance one of the var. we had better try iodine at the commencement of the disease. It is said to have been cured by it & by conium Case of a young physician The N.Y. & Phil. physicians despaired of him. Dr Todd put him upon conium enough to keep him under a very troublesome narcosis. Prof. T. considers it to have been probably a case of rheumatism Iodine is applicable to as great a range of diseases as mercury. It has been tried in hepatic mesenteric & uterine affections, with some benefit, & should be experimented upon farther It should be tried in lues more than it has. It has been tried with some benefit in epilepsy, chorea etc. [Bromine] resembles iodine but is weaker Chlorine a deobstruent also, not very strong Labarraque’s disinfecting liquid which should be called chloroxide of calcium useful occasionally for ill conditioned ulcers As to its disinfecting power there never has been brought up a shadow of proof. The story of a sewer being opened, & the work men being knocked down & after a quantity of disinfecting liquid. the atmosphere’s [being] pure, is easily explained by [irrespirable] gases, having time to disperse. A stinking sick room is rendered free from smell; in some cases. But stench does not produce disease It will not sweeten the air of a dissecting room There is no evidence that it will destroy the specific contagion of small pox, measles etc. Disinfecting can be effected only by soap & water & ventilations Whitewashers is but a poor substitute Painting is always better than whitewashing Vide [Caldwell] Fumigation & whitewashing on board of of [illegible] are [???pyrical] practices Vide Caldwell’s [illegible] of hospitals, injurious to eyes & lungs are empirical practices Vide Caldwell. Fumigation of hospitals is injurious to the eyes & lungs of the patients Nitric muriatic, nitro-cloric acids mild & weak deobstruents adapted to ill conditioned ulcers, secondary stages of syphilis etc. They have, like chlorine & iodine, weak tonic properties, just about enough to contraindicate them in entonic diseases They are useful in various dysthetic affections Chlorides of barium calcium & gold. Chloride of calcium is a valuable article in scrofula. All of these are weak deobstruents Chl. of barium is supposed to be stronger. No more poisonous than the former except that less is required at a dose. An excessive quantity will produce pain in stomach, tormina, & peculiar discharges. They are slightly diuretic Chloride of gold is stronger still Chloro-[aurate] of chloride of sodium is better than this Rubia tinctoria A pure deobstruent a valuable emmenagogue. Valuable in jaundice (Vide jaundice of Prof. F.) Dr I. gives 1 oz root to 2 pints of water dose 1 oz 2 or 3 times a day Better give as much as the stomach will bear without inconvenience Limosis dyspepsia where there is no great exhaustion. Icterus vulgaris The opponents of madder think it was prescribed merely to colour the feces. Prof. I. places it next after mercury in value Conium is preferable to either Chronic catarrh pneumonitis notha acute dysentery Marasmus atrophea var. infantum recommended. Others say that it has a tendency to produce atrophy Sertosis rachea, recommended by Haller. Ecphronia melancholia (monomania) Halusia hypochondrea by Boerhaave. Patamenia obstructionis & [illegible] & [suppr???] or obstruction and retention of menses Contradictory testimony upon this subject also. The madder of the dyers is not to be depended on. It should be gathered at a suitable time & kept fresh (not old & mouldy) for medical use Nat. order. Fumiariaceae 1st Fumaria officinalis the expressed juice. No doubt that it is adequate to the care of moderate cases oif jaundice & may be useful in dyspepsia 2nd Adlumia cerrhosus (Corydalis fungosa) Possesses considerable pungency i.e. the root in powder. If it is biennial the proper time to collect the root, is in the autumn of the first year. If perennial, wait til it is older Probably much superior to fum. off. 3d Corydalis bulbosa 4th Corydalis glauca is supposed to have the same properties in the top as the annual fum. off. The root is better 5th Dicytra cucullaria (Corydalis) Dutchman’s breeches. The root consists of tubers of the size & shape of an orange seed inclosed in a sheath. It is said to be quite active being narcotic anodyne soporific etc. It is well worthy of investigation & is a good subject for an experimental dissertation The [papa?? accal] [har??] active narcotic deobstruent powers & probably this article resembles them. The active narcotic power of such articles differ materially from that of opium & hyoscyamus. Saponaria officinalis A pure deobstruent perhaps not quite so powerful as madder. Often a useful auxiliary to mercury It has acquired considerable reputation in lues syphilis & syphilodes A good substitute for sarsaparilla Decoction [illegible] medium strength is 2 oz root in 4 pints water to be boiled to 2 pints the whole to be taken in 24 hours. It is prepared on the continent of Europe to leontodon The bruised roots with water make a lather, & are a substitute for soap Various other plants possess this property. Probably a union takes place of mucilage of alkali Scrophularia marilandica leaves & roots considerable popular reputation as an ointment & a cataplasm for piles 2 oz root or leaves in 2 pts water boiled to 1 pint the whole in 24 hours Scaly eruptions chronic pustular eruptions lues syphilodes jaundice scrofula dyspepsia protica marisce are the diseases for which it has a reputation. S. [modora] of Europe is used in scaly eruptions etc. Agrimonia eupatoria (naturalized) Inferior to the two last. A pure deobstruent It has the greatest analogy with leontodon taraxacum Dose 1 or 2 drams 3 or 4 times a day of extract Agr. odora is supposed to be more elegant. A. [suaveolens] is found among us [Aganthremen] crematum ([Diosma] crematum of Linneus) Bariosma crematum & [illegible] of [illegible] Adirandra of another. Diosma crematum & serratum ([Bookae, Buka, Buch??]) From Cape G, Hope Shrubs of moderate size are all the [diosmaceae]. The whole plant abounds with pellucid dots which yield a strong scented essential oil which is supposed to be the active principle. It seems to be a pure deobstruent distinguished only by its resolvent power It is a new article, now mentioned with [illegible] It is spoken of as valuable in [dyspep??] cystitis [arthritis] etc. Employed in infusion and tincture. Strength of decoction not mentioned We might try 2 oz. to 1 pt. boiling water Mr McDowel says this appears to be a very valuable article in dyspepsia, improving the appetite & colour of the skin proving slightly diuretic. It has been most celebrated in dystitis irritatis of infl. of the bladder. There is a very troublesome & irritable infl. of the bladder. There is a membranific infl. which is called by the same name. Physicians are apt to confound all diseases of the bladder under one loose term just as the common people are satisfied with the expression disease of the liver. Chronic rheumatism is a disease for which it has been recommended. But precisely what is meant by this is uncertain whether chronic rheumatism or chronic state of chronic rheumatism Lithia renalis cured by it, by affecting the stomach primarily Collinsonia Canadensis Ox-weed horse-weed archangel [illegible] [illegible]-weed, stone weed [illegible] [horseba???] Medicinal powers reside in the recent rhizoma. But it may be transplanted at any time of the year. Great discrepancy of opinion. The precise nature of its operative effects does not seem to be settled among those who employed But this is true of sarsaparilla leontodon etc. A moderate # deobstruent, particularly affecting the kidneys. It seems to belong to the class of aperients deobstruents. i.e. # moderate [urbites] are at present too much neglected those which promote the fluid secretions Dr I. thinks it resembles the tuberous species of [liatris] Dr Hooker thinks it resembles uva ursi & chemaphile corymbosa. Dose about an even tablespoonful of the rasped root. Used in veterinary medicine [illegible] is used. Decoction injures its properties. Infusion should be preferred The root is one of the hardest substances in the materia medica Limosis neuralgia very beneficial according to Dr Hooker Colica ileus but Dr Ives uses Indian meal & thinks this powdered root, likewise acts merely in a mechanical manner. David Miller of the Shakers thinks it useful in chronic rheumatism or rheumatalgia. Misplaced arthritic affection of the kidnies. It has a popular reputation in dropsy The best diuretic alone in dropsy according to Drs Beers & [illegible] Prof I thinks otherwise Paruria stillitia (strangury) all the varieties & the paruria of typhus [nervo??] A palliative in lithia renalis Aralia racemosa aperient deobstruent Aralia hispida dwarf elder etc. in a large dose it is emetic. It is said to be a Hydragogue cathartic probably it is not. It is the custom to ascribe purgative properties to every emetic, when given in doses short of the vomiting point. It is an efficient diuretic. Give as much as you can without vomiting & continue it until diuresis is produced. No doubt it is a deobstruent. It has not been experimented on sufficient to ascertain whether it is expectorant cholagogue etc. Not narcotic at all. Not known whether it leaves the stomach & bowels in a weak & irritable [continual] condition, like squills & senega, is not known. This is a very serious objection to these two last mentioned articles Contused root 2 oz. boiling water 1 pint & dose from 2 to 4 fl. oz. four to 8 times a day in 24 hours 4 oz to 1 pint alcohol tinct. ½ oz dose Proof spirit cincture seems to be better than alcoholic diseases 1st hydrops cellularis. Dr Reed of E. Windsor cured a case after failure with every other article Not stimulant not tonic Aralia odophylla of Cochin China is said to be highly effectual in dropsy A. scandens is said to have the same prop. Aralia spinosa (though it has no thorns but prickles) Formerly called angelica arborescens hence called angelica at present very improperly called prickly ash ([illegible]) Not indigenous in N. Engl. Languor lassitude, diminution of nat. frequency of pulse drowsiness prickly sensation even sleep. It is said sometimes to have produced genuine articaria It is emetic said to resemble ipecac It increases the biliar secretion undoubtedly cholagogue Dr McBride thought it the best of our native emetics Aralia racemosa is said to be useful in sequel of catarrh, in (pneumonitis ?) Simple idiopathic cough chronic dyspnoea lepidosis psoriasis & impetigo Veratrum album the root (the root is remarkable for being tunicated above & a solid bulb below) That found in our shops is always in powder & is worthless Carbonate of potassa & oxide of potassium which are mentioned among the proximate principles, are the products of combustion, for in this and in other cases, if the vegetable be rasped up & treated with suplhuric acid, no sulphate of potassa is produced It is called in the books merely emetic cathartic & local stimulant i.e. irritant. Veratrum album & strychnous nux vomica are acrid narcotics, not of that sort of narcotics which produce somnolency; they increase nervous strength of action. 1st deobstruent, independently of any evacuation 2nd acrid narcotic (it is a peculiar root of narcotic operation the articles are not necessarily acrids) 3 emetic 4 hydragogue cath. 5 epispastic 6 strumalatory (probably in consequence of its irritation 1st resolvent 2nd cholagogue 3 expectorant 4 diuretic 5 emmenagogue 6 sialagogue occasionally especially when applied to the mouth It does not appear to be diaphoretic except by resolving disease, or in poisonous doses by great exhaustion. Neither tonic or stimulant yet contraindicated in phlogistic diathesis, if for no other reason for this and it would do no good The dry root should not be used Formulae ½ oz to 2 oz. to 1 pt. of water infusion Decoction is thought to injure it. Most of the vegetable alkalies are decomposed at a boiling heat. The famous eau medicinale of [Husson] was probably a wine of the root of [illegible] 8 oz. recently dried root 2 ½ pts Spanish wine macerate for 8 or 10 days add 1 part of Sydenham’s vinum opii composition to 3 parts of this wine of veratrum From 1 to 3 fl. [illegible] about 4 times a day was the dose famous in gout & rheumatism Lobelia inflata therapeutic applications pneumonitis typhode Applicable to all the cases where squills are indicated not applicable where the stomach is very irritable. Arthritis acuta (sub acute rheumatism being without rheumatism, and is attended only occasionally with fever there is swelling and in the commencement the infl. is more or less metastastic Acute rheumatism is metastastic & has an acute fever accompanying it) Case of sub acute rheumatism cured in one night by tinct. lobelia & opium Arthritis rheumatalgia vide p. 37 not febrile no topical redness and swelling but with topical pain allied to neuralgia This disease has been cured by lobelia when other articles had failed Leucorrhoea communis has been sometimes cured and sometimes palliated by this article. N.B. This disease when of long standing cannot be cured all at once Recommended in hernia as a substitute for tobacco as an enema IT has not been tried very extensively in this way & should be further attended to [illegible] other species of lobelia appear to possess a similar assemblage of powers L. tapa of Peru is said to cause vomiting by its odour alone. L. syphilitica (S. flexa) has been praised & condemned by different persons Prof. Tully considers it as undoubtedly deobstruent emetic & hydragogue cathartic. It is expectorant (probably diaphoretic) (probably emmenagogue) diuretic? It has been considered a specific for syphilis much discussion has been excited Probably it will cure blenorrhea [illegible] Various deobstruents are now known to be capable of curing syphilis and probably this will. Prof. T. has tried it in pneumonitis typhodes & thought it equal (fully equal) to polygala senega L. cardenales has been reputed to have considerable medicinal powers it is doubtful whether it is worth retaining in the materia medica it has [sends] qualities of no great strength Actaea racemosa The general actaea and [cimicifuga] and also the macrotys of Rafinesque are now united by Decandolle under one genus actaea The worthy professor here treated us to a synopsis of the whole genus, because it is probable that all of them are [medicinal] Synonymas Actaea monagyna Cimicifuga serpentaria macrotrys serpentaria cin. racemosa macrotrys actaeidis Vulgar names black cohash the best. Various articles are called cohosh. Cornuticis herb crystoph. [darweed] rich weed etc. etc. Ninety plants have the name of snake root. Leontice thalectroides is called blue cohosh & is quite commonly sold for this article. The root of sanicula marylandica is often mistaken for it both being called black snake root. Actaea rubra and pachypode are likewise often mistaken for A. racemosa. No satisfactory analysis has been made. Decidedly and prowerfully narcotic. It is not worthy of reliance as anodyne or soporific though it is decidedly antirritant with respect to heat dryness of skin At least 4 oz. are necessary to saturate 1 pt alcohol sp. gr. .835. It is moderately nervine (probably) as Prof T. thinks he has seen it produce exhiliration and subdelirium in children It does undoubtedly possess the remarkable property of producing [fugitive] neuralgic pains in the extremities & in the sciatic nerve. Conium maculatum Contrary to the general rule, the plant is most active (not when the flowers a just opening) when the flowers are withering. Water is an improper menstruum Alcohol and ether only should be used The etherial tincture evaporated upon water, leaves as a rich green pellicle upon the surface of the water, which has the smell and medicinal virtues of conium Drying injures the plant Age destroys the virtues of this plant. Conium is a deobstruent & especially valuable as being also narcotic Dr March took in 5 hours 18 gr. 2 at first 4 at second 4 at third & 8 at 4th It was a recent extract. First sensations were pleasurable Secondly increased action of the stomach and duodenum pleasurable also Next vertigo unsteadiness in walking with a sensation of greater unsteadiness than really existed The pupil was natural in size but not affected by light nor darkness. Appetite good slept well at night. The next day in the afternoon he was affected with languor & headache which prevented his sleep that night. Next day he was perfectly well. 1831 & 2 Scleratum clavus, ergot parodynia as a substitute for the forceps and [vectis] which may be nearly or quite superseded by ergot. Dr Reed thinks that the forceps should always have the preference in the hand of a skilful hand on account of the danger to the life of the child Parodynia secundaria hourglass contraction of the uterus (which Dr Tully has seen in consultation though its existence is denied by some) The clavus will restore the natural contraction Parodynia secundaria var. retentiva retention of the placenta a perfect substitute for the introduction of the hand of the accouchment. In both cases the use of clavus is condemned upon theoretical views by writers in the procedures. Parodynia secundaria variety haemorrhagea Int his variety the clavus should be given as a preventive. Dr Reed however cautions against its use before the delivery of the head of the child on account of the danger to the life of the child Parodynia [secundi] dolorosa after pains Par. secu. ar. lochialis whenever there is atony of the uterus. Some suppose that it will not act after the delivery of the child but Tully has never known it to fail of expelling it into the vagina & further expulsion cannot be accomplished by the efforts of the uterus. Very little more is given in the books than was first promulgated by Dr Stearns. this article is applicable to a far greater variety of cases. Where hemorrhage at full time endangering abortion occurs we need not wait for pains to come on but give clavus without delay Dr Stearns does not generally give it without [previous] depletion this is not correct. Dr Stearns does not give it when nature is likely to succeed It had better be given in many cases to save pain and suffering Always using belladonna if necessary to produce relaxation He gives it as a rule not to used it except when the os tunica is dilated to the size of a dollar pay no regard to such a rule No regard should be paid to the opinion of epidemics being caused by this This article is supposed to have been used in Holland in 1747 it was used before Dr Stearns’ publication in Pennsylvania by a practitioner in N. London County Conn Dr Stearns heard of its success in the hands of some Scotch women. It is said to have been used in France & to have been prohibited about 1770. Schlerotium maydis is said to produce baldness in men and in swine, and in the latter as well as in mules producing a [paraple] gin. Hens are said to lay eggs without shells owing to premature delivery So too dogs, monkeys etc. are intoxicated by its narcotic properties These things are in L.A. various other species of sclerotium have probably the same powers And various purge; among others [lycoperda] bovista 1831 & 2 Opium is the descending sap of the Papaver somniferum, [illegible] in the sun Hippocrates apparently knew nothing of it. It was known in Homer’s time under the name of nepenth & was used then and afterwards at Thebes & was used as it is now in the east, as a kind of luxury. Extracted either by incision or by cutting off successively the top of the plant. The proximate principle is in [bicodati] of morphin (or by an absurd change of names, bi-mezorati of morphin) Meconic acid was first discovered and the proximate principle was then called bi-meconyti of morphin Afterwards codii acid was discovered to be the acid & afterwards it was called meconia & the meconia was called [codic]!! Just as Samarch [illegible] interchanged the names conium & cicuta The next proximate principle is narcotina or narcotin Some analysts describe a bitter extractive principle its existence is now doubtful This article is one of those capable of producing its effects in health and in disease. single pill doses produce costiveness, yet it acts upon the liver in creasing its secretion probably from this cause it is that the habitual use of opium does not produce constipation Opium undoubtedly counteracts the intoxicating effect of alcohol. So also alcohol counteracts the ultimate narcosis of opium Indeed both these articles are counteracted as to their ultimate narcosis by prussic acid Gelseminum and other pure narcotics Opium morphine The acetate of morphine & the most active The codate or meconate (N.B. This is the acid with which it is combined in the papaver ammonia is incompatible Nitric acid decomposes it so far as to produce an article of a different composition and if this is the case [illegible] [illegible] is incompatible with it. Tully says he has seen no great difference between the acetate and sulphate. One reason given for the super irrit of the acetate is its greater solubility. This by no good reason The next principle in opium & narcotine Bimaconate of sodium is another principle Extractive matter is another (i.e. something soluble in water and alcohol) A resinous principle (i.e. something soluble in alcohol & not in water Limine fecula essential oil etc. etc. Vegeto-animal matter (modified glutine) cautchouk etc. These are of no medicinal activity but may decompose other articles a grain or two on a healthy person produces a calm placid or pleasurable sensation wakefulness increase of force or fullness of pulse last from 8 to [illegible] hours in the latter part of the time some [illegible] next day languor want of appetite etc. etc. IN fuller doses nausea epigastricum easiness etc. It diminishes the biliary secretion hence producing costiveness [illegible] lecture upon morphine the French theory of its producing the pleasant without the unpleasant effects is entirely false Narcotine. Tully has never employed it morphine he is familiar with & has been so for years Great confusion and contradiction upon the subject of narcotic Magendie calls it stimulant Orfila narcotine & Bally says it has no powers whatever Most probably its effects are similar to those of morphine. But the subject wants investigation 2nd stimulant 1st nervine 3 narcotic 4 diaphoretic 5 cholagogue These are the effects of opium & of morphine It is a direct anodyne & a [illegible] & the most powerful soporific The other narcotics do not appear to be very directly soporific Sedative is a term applied to a group of effects If we desire the sedative without the stimulating effects we must give a single full dose So also of wine and alcohol One of the most powerful and useful effects is that of being a mere counteragent of disease Narcotica Diminish irritability & irritation sensibility & sensation in a non phlogistic diathesis also frequently somnolency In large doses stiff [illegible] cloud before the sight coma convulsions & death Epigastric uneasiness nausea Many suppose that they are all stimulant and nervine at their first operation this not true the notion prevails that sedative & stimulant affects are in competition very false Pure narcotics [cyan????] hydrocyanic acid lauro cerasus gelseminum nitidium daturae spigelia etc. helonia [erythro??] [illegible] doses produce what Brown called indirect debility which however 17 the long continued use of a narcotic diminish the susceptibility to itself but not to other agents Opium does not injure the health Tobacco & tea have been too much abused Alcohol the only one [which] produces visceral diseases E. [D.] North 18 1 Narcotica samplicia as hydrocyanic acid datura heloni hyoscyamus belladonna gelseminium poisonous mushrooms seem to be pure narcotics 2nd Stimulatia alcohol wine [opium] lactuca of several species These are the most important of the class narcotics To obtain their stimulant & antirritant effects in conjunction they must be given in regular & small doses etc. In large doses they are used to obviate a particular spasm etc. The former use was well understood by Cullen & his companions but not well understood at present The state of the mind affects very powerfully the operation case of a young man at dinner parties & of an auctioneer who had taken a dangerous dose of laudanum [Opium] more important than any other [article] of the materia medica Purging has done the most mischief Bleeding next the refrigerants next antimony & mercury next Deobstruent narcotics lobelia actaea digitalis nux vomica perhaps [aethusa] & cicuta etc. “Evacuating or generally cathartic sometimes emetic tobacco cocculus The long continued & habitual use of the nervine & stimulant diuretics (perhaps all) produces a certain uneasiness consequent upon their abstraction this peculiar to narcotics limosis syncoptica of Good Limosis syncoptica or epigastric sinking (when idiopathic) generally the sinking comes on about 9 o clock It attends hypochondriasis. Typhus syncopalis syncope The dying Seems to be found in a slight degree in intermittents when they first come on It being difficult to describe it is frequently considered as imaginary Resembles the sense of inanition which comes on when the sense of hunger has subsided after a meal missed at the customary hour Entirely different from the burning sensation of yellow fever Par vagum & the great sympathetic to which belongs the great semilunar ganglion’ In dyspepsia the par vagum seems to be affected In limosis syncoptica & T. sync. it is in the semilunar ganglion & is called sinking So it seems to be [illegible] cases of poisoning [from] mushrooms & snakes In L. sync. & even in limosis the digestion may be good Treatment first to relieve the paroxysm & second to obviate the censes Employ one narcotic to counteract another just as one disease (e.g. measles & small pox) is incompatible with another Give opium & camphor supporting them with stimulants & tonics. Concealing the fact of his giving opium gradually abstracting the opium continuing it for at least a year The tonics are utterly inadequate That produced by opium of less consequence & best cured by gradually obstructing the opium Tobacco conquerable by the will chambers medicine futile even when capsicum was mixed with 10 materia medica 1 Pulse 2 Congestion 4 Diathesis Congestion a 8 Type 10 Acute chronic etc. 11 Classification 13 Porx. principle 16 Narcotica 18 Narcotica simplicia Narcotics Astringents 1 Deobstruents 4 Diuretics 12 Diaphoretics 15 Errhines 17 Sialagogues 18 Emetics 19 Cathartics 22 Epispastics 30 Antidotes 32 Antacids 35 Mich. rem viz Irrit. & Dem. 36 Antilithics 38 Bloodletting 40 Cantharis 56 Capsicum 61 Monard. punct. 65 Hydric ether 66 Wine 67 Alcohol 71 Nitrate pot. 72 Carb. pot.. 78 Bicarb pot. 80 Veg. ac. 87 Acetic acid 87 Hydroc. ac. 82 Gelsem. nitid. 83 Helon. erythos. 85 Con. mac. 89 Cicuta mac. 90 Digitalis purp. 90 Lobelia iunfl. 94 Actaea rac. 96 Languin. can. 49 Aralia spin. 51 Baptisia tinct 52 Veratrum vir. 53 Andeira [iner???] 55 Opium 99 Astringents They produce a moderate vital contraction & condensation of the living fibre while at the same time they moderately decrease absorption & diminish morbid secretion Prof. Ives thinks they likewise diminish irritability The contraction is not [illegible] but vital As a class they are intermediate between the tonics & deobstruents partaking somewhat of the properties of each The vegetable astringents owe their astringency to tannin Properties of tannin etc. Because tannin forms leather with animal albumen it is incompatible with animal jellies as an article of diet Vegetable astringents inefficient in diarrhoea & dysentery not because of phlogistic diathesis but because of the morbid condition of the mucous membrane of the intestines they are useful after that has ceased and this discharge continues as a sort of habit. These remarks however apply only to the vegetable astringent for acetate of lead is as useful as calomel even in the early stages The mineral astringents do not depend upon any one proximate principle & hence they differ from each other in their operation. Vegetable astringents chesnut, the raspings of the wild [illegible] [illegible] [illegible] extract Quercus alba & tinctoria the inner bark Cocoluba vivifera of the sea side of Florida & [illegible] [terantosa] the leaves Geranium maculation the root [Heirchera] americana [italica] Carolina Geum uvale this more tonic than the others saxifraga pennsylvanica parnassis [ameril] Polygalam virginicum caenothus americanum tubus vellosus & vivialis napthar advena & [hymplicea] dorata these have a [nauseous] principle & a good deal of mucilage epiphagus virgiana this not nauseous as [Bart??] says All of these the root These native astringents are abundantly sufficient of our own wants. Foreign astringents found in the shops Green tea valuable when a narcotic power also wanted Mineral astringents acetate of lead etc. Sulph cop. alum Diseases Chronic coryza cough consumption (secondary stages etc. etc. Useful also externally atonic paristhmitis is inflammation of the fauces Spongy ulcers polypus [piles] of some sorts etc. Toothache is relieved by an intense astringent This remedy has been patented by a Hartford man Deobstruents produce a change of condition & action in the whole or part of absorbent & secernant system relieving affections of the liver increasing the secretion of this organ relieving various affections of the skin & produces [asolutions] of inflammations of muscles When they are given for some time in health they generally increase the secretions In disease they change as well as increase They produce less effect upon the brain than upon any other viscus The old definition is that they remove visceral obstructions the term obstruction is applied to indolent inflammations parabismata etc. of the viscera Tully revives this class. To what properties does mercury owe its anti syphilitic power? not in cathartic sialagogue etc. It is not stimulant or tonic, for it does not increase strength of arterial action or digestion & muscular strength. Mercury is a stimulant if we apply this term to any remedy which produces a powerful impression upon the system but this is too loose an application of the term A deobstruent effect may be indicated at the same time with a stimulant or other effect, as with a refrigerant effect but stimulant & refrigerant effects cannot both be indicated at the same time why then use the term stimulant with respect to the deobstruent effect. It is of no use to call mercury anti syphilitic antipsoraic etc. The United States abound in deobstruents & many of the properties of some of them are not generally known E.g. The salivation of mercury has been considered very strange It is however a part of its deobstruent effects which is more obvious & which exists also in a higher degree in tis than in some others of this class Expectorant emmenagogue sialogogue effects etc. may be either direct or indirect direct when not the [illegible] of a deobstruent agent in direct when a part of a general deobstruent effect upon the whole or nearly the whole secerunt & absorbent system For they do not all act upon every part of these systems A deobstruent effect may also be indirect e.g. the act of purging is a deobstruent operation while it lasts The deobstruent effect is frequently the only useful one e.g. colchicum Iris etc. which cannot be usefully employed as emetics & cathartics. This seems to be a sort of experimentum crusis with reference to the propriety of retaining this class Further in the modern systems there is no place for the pure deobstruents e.g. leontodon taraxacum which is put down among the diuretics & cathartics for neither of which effects will it answer And this has probably contributed to bring it into disease. So of other articles The deobstruents although not weakening still reduce the strength of the system in general if continued for a great length of time, especially if the deobstruent effect is combined with one of evacuation None of them however have direct refrigerant powers & none have sufficient stimulant powers to supersede the necessity of combining a stimulant in cases of great atony The system is frequently to be prepared for a deobstruent operation by being previously stimulated or reduced. Rheumatism generally requires one or other of these preparations, but still neither reduction or stimulation will ever cure these diseases. Dysentery is cured as effectually by Iris versicolor & other vegetable deobstruents as by calomel though requiring to be accompanied by opium. Still calomel applies to a greater variety of cases No deobstruents produce stimulation precisely but rather a tonic effect & none directly produce a refrigerant effect, they do this rather through their evacuating powers That a remedy be referred to the class of deobstruent, the only quality which it is indispensable that it should possess is a resolvent one Probably all the deobstruent cathartics are hydragogue. A resolvent power is that of dispersing & curing a topical inflammation without a necessary evacuation. an antipsoraic operation is that of curing a cutaneous disease by an internal remedy Discutient applies to curing an inflammation by a topical application Cholagogue applies to the increased & secretion & evacuation of bile These operations are the foundations of no classes The most common & best known deobstruents are the species of smilax including the rotundifolia & another if our species Comptonia asfil. & myrica galea Compt. destroys fish. Aralia racemosa & [rudicaulis] the root asclepias tuberosa & incarnata. Arctium lappa & another diervilla danadensis celastrus secundus Perhaps also the Collinsonia canadensis solanum nigrum & dulcamara but these too are narcotic Diseases rheumatism [strum??] dyspepsia syphilis yaws various cutaneous diseases Other plants doebstruents are myrica cerifera 3 species of anemone A. virg. etc. ranunculus acris bulbosa & scleratus All the species of trillium alisma plantago dirca palustris conium maculatum is a deobstruent narcotic cicuta maculatum & bulbifera also as well as argemoni mexicana In this vicinity have been used the different species of lettuce (not the exuded & inspissated sap but the inspissated juice & decoction) aconitum napellus strychnos nux vomica angostura bark etc. are acrid narcotics deobstruents rhododendron maximum (Litchfield county) kalmia latifolia Another set is astringent & moderately tonic viz uva ursi chimaphila as syrola 2 species ledum 2 sp. aletus farinose & aurea andromeda calygulata helmias droica The uses e.g. guaiacum oil of juniper several species oil & resin of copaifera off. ol. pinus australis sylvestris strobas etc. abies canadensis & [illegible] mifera These if pushed evacuate Aralia hispida (dwarf elder) diuretic & emetic Erythmium americanum & album these vomit Another set may be diuretic emmenagogue cathartic emetic etc. [Polygala] senega Hellebore Gratiola off. iris versicolas scilla mautima polygala pubescens eryngium aquaticum (properly yuccifolium) lebelia syphilitica These are said to be cathartic Sanguinaria belongs here but is not Colchicum autmnalis aralia spinosa (southern states) [Phyto???] candacendria delphinum consolidum etc. baptisia tinctoria (perhaps) styllingine sylvatica apocynum cannabinum & pubescens anderria inernis (cabbage bark) These are similar to the last class possessing a still greater assemblage of properties? Diuretics increase the urinary discharge Paris’s classification visionary in which he supposes some of them to act in substance upon the urinary organs Nitrate of potassa Tully denies to be a diuretic Diuretics are direct or (as being also general deobstruents) indirect They are also pure. The pure are not always the most powerful e.g. chrysanthemum leucanthemum Roots of opium petroselinum eupatorium purpureum & verticillatum collinsonia canadensis Refrigerant diuretics e.g. nitric ether bitartrate of potassa & acetate of potassa narcotic diuretics e.g. expressed juice of various species of lactuea. The [illegible] if taken very strong Stimulant diuretics e.g. several species of cantharis [illegible] mellifica several of the essential oils as those of the gaulthena [procumb???] & engeron canad. The most important are the deobstruent diuretics gratiola off. scylla maritima polygala senega & pubescens iris versic. & prismatica the several species of elder eryuquim mucifolium sambucus pubescens (red berried or mountain elder) The most efficient & certain single article is asclepias syriaca aralia hispida called dwarf elder. This unlike the rest never proves cathartic erythronium lanceola commonly macerated in ciders Seeds & roots of aretum lappa All these are expectorant emm. [illegible] & antipsoraic & if pushed are emetic & cathartic Next group are the resins & terebinthinate oils these are expectorant resolvent etc. Abies balsamifera the most elegant cpoaifera juniperus pinus australis etc. sang. europaea etc. abies canadend the oil Another set are astringent & perhaps tonic arbutus uva ursi another set is also narcotic e.g. nicotiana tabacum & digitalis purpura Another set are not emetic & cathartic Actaea racemosa cimicifuga this last said to more active rubra & pachypoda inferior Demulcent diuretics mucilages Three conditions of the system in which the diuretics are to be employed viz morbid irritability with atony without atony & In case of great distention diuretics will not operate until the water has been diminished by elaterium a hydrogogue cathartic & some such manner The diuretics however will not cure the disease Tully and his friends have not found diuretics more uncertain than other classes of remedies always succeeding by management combination of several articles or some such way Not always however curing this disease Case of officinal alcohol curing Diaphoretics restore or increase the perspiration It is commonly said that they are all stimulants the argument is that increased secretion implies increased action this fallacious e.g. the sweats of the dying because the weakened vessels may not be able to resist the vis a tergo In high entony refrigerants produce diaphoresis & in great atony stimulants 52 Alcohol continued. The fact that it has not always been used proves no more than that of cinchonas having been formerly unknown Alcohol continued from p. 52 Alcohol is best adapted to the nervous & wine to the putrid type of fevers The old practice of giving bark in wine, in intermittents was a good one now superseded by sol sulph of quinine All the cases of typhus All cases where there is great and extensive suppuration Collections of matter the liver thorax, & even in the female breast though opium possesses the greatest power Hectic, in one of the diseases Anthrax, where the system is considered affected Erythema oedematum gangrenosum anatomicum etc. Parismitis Malignant small pox measles scarlet fever (rosalia) Various cases of inflammation of the viscera Membranific inflammation (croup for instance in many cases N.B. in many of these diseases the wine or alcohol do not supersede the deobstruents etc. Genuine acute febrile dysentery according the nature of the constitutional febrile affection which may be synochus or putrid typhus etc. Marasmus tabes, sand scurvy # The different sorts of gangrene Certain sorts and stages of mental derangement, more especially wine Tetanus some consider them as specific falsely however. In Mass. this disease has been cured by alcohol & liquor of the arsenate of potassa, the latter in large quantities Lyssa canina a similar dispute Chorea according to the condition of the system # this is as much severer disease than sea scurvy which only require the milder astringent & tonics Bites and stings The practice is old and perfectly well established. Galen & Celsus quoted. The maderia medica of Hindoostan makes wine perfectly efficacious Case in the American medical Recorder in which at least 2 quarts of spirit & capsicum were retained in the stomach in the course of one night. The efficacy of spirit in the case of the most venemous serpents is perfectly well known in the tropical reg Instances are many of persons in a state of intoxication being bitten with impunity The excision is generally performed in cases which would not have been dangerous in any case, from the fact of the surgeon in the country being generally at a distance. Confined snake do not [illegible] a mortal bite. The next article to alcohol is opium the next is ammonia. The moderate cases may be relieved by any strong impression hence the reputation of various popular remedies External application of alcohol Dr Ives employs a mixture of alcohol & oil of origanum in burns and scales The vapours of burning alcohol is very usefully employed, by raising the bedclothes, supporting them [illegible] & introducing the vapour through a tin tube Useful in cholica etc. etc. & in that form of dyspepsia which is attended with gastrodynia Errhines excite sneezing by direct application the discharge is sometimes serous when secretion is promoted sometimes more purulent. Useful mainly as counter irritants sometimes the act of sneezing seems to be useful Disease Ophthalmia Cephalitis Deafness neuralgia auris & facies apoplexy etc. Some cases only of the above Snuff taking very injurious producing finally limosis syncoptica also thirst etc. Tobacco is the worst because narcotic Errhines are powdered white sugar the powdered root of the species of iris spirit of [?esculus] dried & pulverized flowers of helenum antimonali Veratrum album and viride Case of an apothecary who sneezed 30 times Euphorbia off. sanguinaria turpeth mineral calomel sialagogues promote salivation by topical application hence mercury is excluded for its salivation is not useful of itself Disease aphonia when idiopathic & symptomatic rheumatic pains of teeth gums Chewing tobacco wastes saliva exhum the strength producing anorexia limosis Drunkards begin with tobacco. Prevents costiveness however sial. antemis pyrethrum myrica cerifera asarum europeum & canadense horseradish zingiber cardamon seed Emetics produce vomiting independent of taste odour or quantity Effects of vomiting & nausea The act of vomiting is probably more or less deobstruent in all cases All emetics given in less than nauseating doses except tartrate of ant. are tonic? 4 purposes 1st to give a shock & break up 2nd to increase susceptibility & prepare 3d to excite the absorbents & create a resolution of inflammations etc. 4 to remove poisonous or offending matter from stomach 5 groups of emetic 1st simple vegetable emetics which produce no other effect e.g. ipecacuanha dorstenia braziliensis A species of asclepias viola [parsiflora] & another The two species of gillenia the best indigenous substitutes for ipecac. Two species of euphorbia These are indicated to remove poison to relieve the stomach of offending matter [illegible] vegetable deobstruent emetics useful where both emesis & deobstruent are both wanted Sanguinaria apocynum cannabinum aralia spinosa polygala senega not best however to use this as an emetic. It leaves the stomach & bowels in a deranged state syclla [matutima] or ornithogalum squilla Lobelia inflata styllingia sylvatica Perhaps also ranunculus flammula the distilled water no taste no nausea acting instantaneously after 5 or 10 min. Sinapis alba & nigra Deobstruent vegetable emetics are proper where strong counteraction at the commencement of diseases as croup etc. 3d Refrigerant mineral emetics tartrate of antimony & potassa James powd consisting of protox. of ant. & lime These emetics given at the commencement of typhous fever bring it on 4th Tonic mineral emetics sulphate of zinc bipersulphate of copper or blue vitriol ammoniuret of copper per acetate of copper or verdigri Limosis dispepsia etc. 5 Deobstruent mineral emetics The best is dipersulphate of mercury or turpeth mineral Cathartics increase or create evacuation from the intestines Murrays arguments about the stimulant operation upon the intestines too loose The peristaltic motion of the intestines essential to life kept up by the bile perhaps also the pancreatic juice & the mucous fluid of the intestines Evacuations promoted by checking perspiration application of cold water to the legs friction etc. Dr. Ives thinks the stimulus of distention of the bowels is very important Cathartics of more universal use than any other class 5 purposes 1st reducing 3nd sudden shock for breaking up diseases neither entonic nor atonic 3d increase susceptibility & equalize excitement in diseases neither at. nor entonic 4 remove fluids as in dropsy 5 to remove poisonous or offending 5 things to be had in view in selecting a cathartic 1st degree 2nd quality of evacuation 3d what other operation 4 the part of the alvine canal operate 5 1st as to degree 1st eccoprotic e.g. syrup of sugar manna subacid fruits 2nd laxative merely increase peristal act sufficient to evacuate the canal carbonate of magnesia ol. juniperus communis 3d purgative which also occasion an increase & discharge of not secretion septandra virginica triostium perf jalapa podophyllum petalum 4 drastica gamboge elaterium croton tiglium These produce copious & continued discharges & invert the action The stronger may be so managed as to operate like the weaker As to quality of discharge cathartics are 1st kopragoga producing fecal discharges e.g. castor oil rhubarb 2 cholagoga or bilious e.g. calomel 3d hydragogue or watery discharges the most perfect is elaterium Others are croton tiglium the refrigerant salts As to other influences 1st nervina allay morbid irritability etc. Cocculus & spec. though cathartic [these] exhilirate Carthagena bean (foederea) None have these two powers simply 2nd narcotica producing prostration etc. Cocculus comes here also Tobacco etc. refrigerantia diminish strength of act Sulphates of potassa magnesia soda & ammonia also the bisulphates the sulphates the hyposulphates Sulphates of lime Phosphates of all these Phosphites hypophosphite etc. Tartrates bitartratis etc. Also the compounds with two bases These act on the exhalents of the intestines These salts are apt to produce flatulency which the other hydragogue cathartics do not bring on These cathartics are commonly supposed to be mild cathartics yet they are bad in old dyspeptic subjects etc. 4th tonic cathartics federaea carthagena carthagena bean nicker nut? polygala [polyga???] aloes 5. astringent. E. g. rheumatism Indigenous species of rumex Ven alum purges & sometimes [illegible] useful in this way 6 deobstruentia Preparations of mercury the most common baptisia iris phytolacca etc. 7 emetica gamboge [triosteum] perfoliatum etc. 8th diuretic when given moderately elaterium tobacco asclepias syriaca 9th diaphoretic eupatorium perfoliatum & rotundifolia asclepias syriaca & tuberosa 10 Emmenagogue aloes convallaria majalis polygala polygama etc. As to part of canal on which they operate 1st stomach & intestines mercurials gamboge triosteum perfoliatum 2nd Colon lepandra jalapa senna etc. 3d Rectum aloes polygala polygama convallaria majalis Another point is the tonic Some are slow as mercurials aloes convallaria & polygama Others are intermediate as jalapa convolvulus juglans cinerca senna most speedy is croton frequently ½ hour Oil of seeds of euphorbia lanthyris & other of about the same qualities Castor oil is quick gamboge also elaterium The refrigerant salts especially when combined with tartrate of antimony as is done in Philadelphia Cathartics frequently break up diseases but generally are more auxiliaries The refrigerant & drastic cathartics however do not break up always Cathartics continued Never proper in dysentery. In low typhous patients may go 5 to 14 days without an evacuation & when it took place it will be of a natural appearance Much abused in this country in cutaneous diseases under the absurd notion of purifying the blood. Not abused on the continent of Europe as in G Brit. & this country The universal tampering with salts & calomel an exceeding evil. So also Flocking to Cheltenham & Saratoga So says MacCulloch. The same of the family medicine chest. The beneficial effects of travelling & the evils of nervous diseases referrable to the same source (McCulloch) Case of a lady of strong constitution who had taken salts & calomel every day since 8 years of age was nervous etc. McCull. Sir W. Scott understands the subject alludes to it in the legend of [Montrose] Physicians are remarkable for not associating with & enquiring after the practice of these different opinions All science properly so called depends upon the detection and classification of differences Epispastics by topical application produce either local inflammation or vesication or destruction of vitality Purposes 1st (acc. to Duncan) to increase the activity of the system in general by initiation then to be kept on some time applied to the extremities 2nd to increase the activity of a particular organ as the liver in jaundice one large plaster over the liver 3d to diminish the activity of a particular organ by counterirritation as in pneumonitis Contraindic in high entony or low atony Dispute whether they should be applied in local affections in the vicinity of or remote from the place Some say idyosyncrasy prevents or obstructs their employment. Tully thinks this is merely greater susceptibility & therefore requires smaller plasters. It is frequently advisable to convert the serous discharge into a purulent one by an irritating plaster or by the constant presence of a [illegible] body as orange peel Question whether issues or successions of blisters are best. This depends upon the disease e.g. hip disease diseases of the spine etc. require issues. The spine is the best situation for most cases of nervous diseases paraplegia various chronic affections of the bladder chronic cephalia [or] headache etc. Children must have them much smaller on account of their greater irritability Alexipharmics antidota etc. counteracting the operations of poisons With respect to toxicology Poisoning is the noxious effect of an ill timed or excessive quantity of an agent or otherwise improper use The Greeks had but one word [illegible] for both medicines and poisons. Pliny says every virus has a virtue. Every poison is a medicine It is not however true that in the present state of the science every poison has actually been made use of or is thoroughly understood Poisoning consists of irritation disorganization stupefaction exhaustion or some combination of these. The deleterious effects of poisons are the same with certain specific diseases. Inflammation of every kind colic paralysis coma apoplexy ptyalism (as of mercury) simple exhaustion marasmus in all 12 No one agent can always have the same effect hence there can be no specific remedy for any one poison If not too late the first indication is to remove the poison from the stomach Tully thinks experiments upon animals by injection into the blood are good for nothing Absurd also is the tying the duodenum and oesophagus Tully thinks toxicology as pursued by Orfila and his imitators as merely a mass of empiricism founded upon the doctrine of specific poisons and remedies Absurd notion of Orfila American editor that savages understand poisoning better than scientific physicians. Poisoning has always been confined to times of ignorance & has fled before the march of science which divests them of their obscure dreadfulness Orfila’s experiments unjustifiable Pure narcotic effects are the first and most simple poisonous effects 2nd acrid narcotics 3d irritating poisons 4 compound poisons Acrid narcotic poisons produce convulsions of a peculiar character tetanic spasms & neuralgic pain mineral vegetable & animal poisons 1st hydrocyanic acid laurel water gelseminum helonias erythrosperma & mist of the 2nd Strychnos nux vomica 3 Oil of tansy [illegible] camphor ol. nutmeg Cicuta maculata & the fungi produce colic Arsenous acid ranunculus phosphorus menchinal capsicum produce irritation Antacids combine with acid and neutralize free acids in the al. can. Ammonia calcia magnesia soda & their carbonates are the only ones Potassa soda and ammonia form lactates with the natural lactic acid of the stomach which are refrigerant Various other acids are found in the morbid states of the stomach as the phosphoric in inveterate and protracted cases of dyspepsia not formed by fermentation which Tully thinks never goes on in the stomach Antacids if ever necessary are merely palliatives because they will not remove the causes of the affection. Dyspepsia appears to be the only disease in which they are employed Mechanical remedies 1st irritants 2nd demulcents Irritants maybe vital or epispastics, or they may be of 3 classes 1st exercise of all sorts which are remedial processes 2nd dermatic as [?uction] percussion acupunctura or shampooing 3d alvine cow itch metallic [tin] filings of iron powdered glass & powdered porcelain charcoal partly Travelling diminishes morbid corporeal sensibility on account of exposure to air etc. increases the assimilation diminishes fecal discharges. Hence the constipation of travellers things inedible in health are harmless great activity of the absorbent system hence reduces obesity & hardens the muscles active exercise quickens the pulse & passive renders it slower hence the latter in some diseases of the heart combining it after a while with active change of air improves the blood changes even to a bad air are frequently useful just as the stomach thrives best on a variety of food Hence also as well as from exercise the ruddy complexion of stage coach drivers Shampooing almost peculiar to the Chinese description of it from Clark Abel Most of the alvine irritants are of doubtful utility Employed from the notion that digestion was caused by trituration & that worms were to be levigated A quack of Connecticut has employed powdered glass gentian & ginger which was certainly more useful in dyspepsia than the same remedy without the glass [illegible] opium aloes spices testicles of a boar & powdered porcelain in colic by a Connecticut family of quacks Good evidence for the utility of powdered glass as an anthelmintic. Anthlithics or lithontriptics A long dissertation upon urine uric acid. Lithis of the different kinds & the [illegible] different kinds of calculus Lithis urinalis has two varieties one with calculi in the kidneys & the other with gravel in them. The former impossible to discriminate by certain diagnosis. Hence a great part of the cases of gravel are fallacious & the experience upon this subject frequently false Antilithica prophylactica & lithontriptica It is the received opinion that the avoidance of animal food & perhaps also of fermented liquors prevents the uric acid diathesis which is the cause of the greatest number of calculi Another circumstance according to Paris’s theory will be the keeping up a natural and healthy action of the skin For the uric acid calculus lime water magnesia (given in soap are upon chemical principles the appropriate lithontriptics for the uric acid calculus No solvent is known for the mulberry calculus The acids which decompose it would form insoluble compounds in the bladder N.B. oxide of magnesia & soap are useful in many gouty cases where there are no calculi. Hence their chemical operation is doubtful The antilithic and lithontriptic modes of treating lithia are obvious [illegible] except in lithia renalis where however it is merely a palliative not reaching the cause of the disease. Better employ tonics opium (in the paroxysm Deobstruents however are the remedies Bloodletting (I was absent) The spring lancet on several accounts is preferable to the thumb lancet 6 distinct purposes of bloodletting 1st as a mere antiphlogistic measure 2nd to make a sudden & strong impression in non phlogistic diseases to produce a resolution 3d to equalize excitement increase susceptibility & prepare for other remedies 4th to divert a haemorrhage from some parts as a substitute for a habitual [illegible] 5th to produce faintness [illegible] in surgical operations 6th to promote absorption in paribismata & emphysemata Bloodletting is always indicated in phlogistic cases no matter what the age sex climate The quantity of blood abstracted should always depend upon the vital energies Strength (not hardness) indicates venesection Strength resists pressure. Hardness is wiry both in the systole & diastole & may be conjoined with weakness. Authors when they speak of hardness alone commonly mean strength The coriaceous or buffy coat upon the blood may depend upon phlogistic diathesis or may depend upon the slowness with which the blood is drawn or the depth of the vessel into which it is received or the particular disease Abundance of medical testimony on this subject Firmness of coagulum & concavity of surface better indicating especially when joined with a buffy coat. We must not mistake the rigidity of the coat of the arteries of elderly people & those who labour much in the open air for genuine strength of action. All diseases are not either phlogistic or antiphlogistic but if the former bloodletting is the remedy known If carried too far it causes a subsequent dropsy etc. General depletion does not benefit a merely local topical inflammation There are cases also of atonic inflammation The essence of inflammation a John Hunter says consists not in the quantity but the quality of action No one has ever opposed bleeding in phlogistic diathesis. Though it has been often asserted; as of Dr Danforth of Boston & Dr Tully falsely however. The diathesis of New England changed about 1805 Many believe and teach that in entonic cases we should aim at the production of faintness or syncope by the manner of abstracting blood Not so however except in surgical cases Sincope should be avoided by placing the patient in a recumbent posture A pint or pint & a half as was directed by Cullen will generally be sufficient if properly supported by refrigerants, subacid fruits cool air etc. With regard to bleeding after casualties. A New England physician of very extensive practice says he has seen more cases of death after a casualty produced by bleeding than by the casualty itself Latham quoted to the same extent Alcohol continued It has been and is now denied that this article ever increases vital energies, or gives new strength, but it [was] affirmed that it merely acts like the spur upon the horse. If this were true it would never be proper to use it in atonic disease, and ought to be banished from the druggist’s shops The ill effects of alcohol are very different from those of wine In chronic cases alcohol is seldom proper and then only to a limited degree. Good French brandy is the best form of alcohol. Morbid exhiliration & delirium & narcosis constitute intoxication Stimulation has nothing to do with intoxication. The ill effects of tippling are probably the result of the narcotic power, one thing is certain viz. that the ill effects of wine & alcohol are not the result of the stimulant operation [illegible] for no more stimulant produces similar effects v. page 48 On Bleeding in Typhus Been advocated at different times for 3 centuries See Good for a summary on this subject. This author advocates it in cases of what he calls congestion Yet from his manner of speaking we might conclude that he had not seen the practice very successful & it is opposed to his own opinion with respect to bleeding in atonic inflammation. There are several sorts of congestion. Superficial [concretion] caused by the action of the heart over powering the pressure of the atmosphere Visceral congestion caused by the atmospheric pressure overpowering the enfeebled action of the heart hence in this kind bleeding will increase it Good supposes that typhus is liable to run into a phlogistic diathesis False as is also the notion that cauma becomes atonic. These two states of the system are entirely incompatible Diseases are broken up in their forming stage by strong measures of the most opposite kind. This accounts for the success of large bleedings in many cases of typhus Free depletions will produce congestion Hence the greatest bleeders always have many cases of congestion & visceral inflammation 3d purpose of bloodletting to breakup diseases etc. The classes of remedies whose effects it increases are emmenagogue sialagogues diaphoretics diuretics cathartics etc. It does not increase the action of all the deobstruents as has been supposed In cases of atony it diminishes their action Most of the deobstruents act more powerfully as the vital energies are higher 4th as a substitute for habitual 7 moderate bloodletting & to remedy a too rapid sanguificatious disease passive haemorrhage paremenia Wounds of the lungs brain etc. It is not the best remedy for a paroxysm of haemorrhage especially if passive In some parts of the country it is the fashion to bleed every gravid woman. A very injurious practice Tully has known 5 or 6 successive cases of abortion in one family, caused by this practice This practice employed in aneurism to keep the vessels partially empty. These cases frequently supposed to exist in many cases when the palpitation was caused by dyspepsia It seems to be the best practice in cases of wounds of the brain & lungs, to avoid haemorrhage 5 to produce sudden faintness. Diseases the passage of gall stones of calculi from the kidneys some cases of hernia obstruction of parturition from rigidity. To facilitate luxations etc. In order to facilitate the production of this effect, place the patient in a sitting posture make a large orifice, pleno vivo. Great abuse in cases of pregnancy many fine women have had their constitutions ruined A Connecticut practitioner has done much mischief 6 purpose to promote absorption & reduce parabismata etc. It should be done in the early stages & should by followed by powerful emetics cathartics etc. The situation in which a person resides affects the necessity for bleeding Those in warm & moist situations require least. [Scrumous] persons bear it very ill. No attention is to be paid to the season of the year. In the Bethlehem hospital for the insane. It was the custom to bleed all the patients in the spring * purge them in the autumn, untill an investigation by parliament was had of all the insane hospital Infants & the aged bear bleeding less Excessive bloodletting is followed by dropsy hectic of inanition, corpulency & laxity with debility: nervous affections etc. Repeated bloodlettings Ill effects of alcohol the chronic effects are a peculiar sort of dyspepsia followed in the case of wine by gout etc. & in the case of alcohol by phthisis paruria mellita impotency delirium tremens, dropsy palsy ophthalmitis the objection that the use of alcohol in malignant cases produces intoxication is entirely unfounded. So also is that of it being liable to cause a habit of intemperance As to its benefit I health case of a students being supposed to labor excessively Alcohol will prevent his nervous tremors [exhaustion] may be prevented from disabling him for the remainder of the day by alcohol N.B. food will not answer Case of two brothers of schirrous diathesis and [in] health over exerting themselves at a fire The one who did not recruit himself by alcohol, lingered two or three years & died of consumption [illegible] of over work in harvesting & shad fishing After a shower rheumatism & pulmonary complaints may be prevented Tully’s own case of these vid. [16] Sanguinaria Canadensis Alkali called sanguinaria Several of its salts are of a beautiful red crimson or scarlet colour a circumstance almost peculiar to these The change produced by mixing the white acid and white alkali is very remarkable All the salts have the same medicinal properties Removes torpor of the liver exerting an action upon the whole secernant and absorbent system. Acts upon the stomach and promotes digestion. Promotes expectoration & the [illegible] secretion. In large doses it is emetic and narcotic It is liable to leave the stomach and intestines in a weak and irritable condition & hence sometimes proves fatal It irritates promotes absorption and action and frequently cures when applied externally to ulcers. It will probably be useful in inflamma It excites sneezing & increase of secretion in the sneiderian membrane Tartrate of sanguinaria experimented upon in Tully’s office & found to possess all the valuable medicinal powers of the root of the plant. It is less emetic It will sometimes answer when the preparation of the root cannot be tolerated The active principle of the plant is the colouring matter which pervades all parts of the 1st deobstruent 2nd acrid narcotic 3 emetic (1st cholagogue 2nd expectorant 3d emmenagogue (not diaphoretic) scarcely diuretic nor sialagogue not cathartic except by promoting the secretion of bile) 4th escharotic & anti-psoraic & discutient Begin with 30 gtts of tinct. & increase to 1 or 2 fl z First employed in Middlefield by Dr [?cjiah] Hoadly, as a sort of specific in some cases and as emetic in croup 1775 (about) First published account is in Foster’s Bossert 1772 says it is emetic. Employed Dr Bolton of Wallingford. First introduced into general practice by Dr Tully 1813 Apocynum cannabinum lectured on Aralia spinosa a large shrub or small tree in middle western & southern states cultivated here. Called angelica tree prickly ash toothache tree etc. etc. This is the most active species All of them have the same properties in different degrees The recent bark of the trunk root and branches & the fruit have an acrid taste in the fauces a common character of the vegetable deobstruents The immediate effects of the bark & fruit are languor lassitude sense of weakness prickly or burning sensation more especially on the face & hands diaphoresis & drowsiness. If continued long enough it promotes the secretions of the liver resolves inflammations finally hydragogue catharsis & sometimes like some other deobstruents produces a genuine articaria It may also be conveniently used as an emetic if sufficiently large doses are employed It has been employed in the bites of snake In such cases the sensation is caused by the bit of the rattlesnake & not by the aralia. It has long been popular in rheumatism Notice taken of A. racemosa (spikenard) A. hispida & A. medicaulis which are weaker and have not been so much experimented on Baptisia tinctoria podalyria tinct. The root is the only part used in medicine Not very thoroughly investigated. First said (of course almost) to be good for the bites of rattlesnakes by Dr Cutler. Dr [Stearn] of New Hampshire notices it in his American Herbal & his account has been (of course) regularly copied. High encomiums are bestowed on it by Dr Thatcher. Dr Joseph Comstock of Lebanon gives an account of its employment successfully as a powerful antiseptic W. B. C. Barton notices it. So others. Tully found that large doses operated as an emetic and cathartic and in smaller doses as a nauseating cathartic It allayed irritative heat and dryness of the skin, promoted the biliary secretions & resolved topical inflammations produced narcosis and always proved cathartic was useful in various cutaneous eruptions Very useful as an external application to ulcers in preventing gangrene Resembles colchicum most, though less dangerous Veratrium vide gum hellebore Treated of by Bigelow & this article upon it is the best in this “Medical Botany” Bigelow calls it highly stimulant. It has no stimulant Bigelow probably formed his conclusion from the fact of its being acrid Acidity will not necessarily produce stimulation That of this article produces irritation, not stimulation No more is every bitter necessarily a tonic Bigelow calls it sedative. But sedative powers may result from a narcotic a nervine or operation Bigelow goes on in the detailed account to deny its stimulant powers This article exactly resembles the veratrum album of Europe Like phytolacca [decandra] & most of the deobstruents it cannot advantageously be used as a mere caustic Too large a quantity in the 24 hours produces vertigo convulsions etc. An excessive single dose produces hyperemesis & hyper catharsis in addition. This last property however is no proof of its being a cathartic, for in poisonous doses one half of the articles in the materia medica will produce this effect. Case related of a physician’s prescribing skunk cabbage beer hyper emesis & catharsis tormina & even alvine haemorrhage etc. of the family & of a physician Relief was afforded by opium This article is an acrid narcotic deobstruent Not diaphoretic diuretic or cathartic It loses much of its power by drying It will produce vomiting when externally applied to a wound Andeira Andeira inernis ([Geffrona] inernis) cabbage tree of the warmer parts of N. America e.g. Jamaica Nat ord leguminasae yet the fruit is a drupe Not used in this country. Nearly resembles coilchicum in its operation. The bark is used The tests of an over dose are nausea & vomiting of to frequent doses, narcosis of too long continuance hydragogue catharsis It is employed in the West Indies and in Spanish America mostly as an anthelmintic Dr Wright of Jamaica considers it the best anthelmintic known Cantharis vesicatoria Stimulant, diuretic, epispastic Of the application of it in typhus Prof Ives has made more use of it than perhaps any other practitioner in the United States. He has given to the amount of a fluid ounce in 24 hours in cases so low as that the patients were insensible to all external objects, and unconsciously voided their urine and faeces Of considerable importance in delirium tremens As an epispastic useful in aposthema communis common boil may be dispensed, anthrax may sometimes, inflammation of the parotid gland Erythema oedematisum (internally in conjoin) with other stimulants and tonics As an epispastic in bubo & in chillblain also in all the varieties of cephalitis Parismitis caumatodes var. phlegmoneae is benefitted by blistering Parismatis typhodes (typhoid inflammation of the fauces) internally Most of the varieties of pneumonitis typhodes internally and externally Erythema of the lungs? Case of Dr Brown’s in Hartford taken suddenly, in 15 minutes [illegible], died in 12 hours partially roused by brandy opium & tinct. canth. The constitutional affection was t. syncopalis Sparganosis puerperarum benefitted by blistering unless it will bring on irritation in consequence of the previous exhaustion of the system Blisters in dysentery in inflammations of the eyes, in phthisis It is a common practice to blister in rheumatism, very injurious & frequently fata, from chasing the topical affection from joint to joint until it attacks a vital part. If however the rheumatism becomes fixed, then blistering may be useful So in chronic rheumatism Sciatica a neuralgia as much as a rheumatic affection, blisters are very useful though when physicians have injudiciously reduced the system by bleeding the blisters may produce a bad irritation Rickets marasmus [illegible] & scruma in these it is used internally. Said to be worth more than every thing else in scruma In gangrene where there is not great atony the topical application is valuable In vitiated ulcers, internally with tonics Ecphronia mania & melancholia, etc. amaurosis applied over the forehead In the early stages of deafness, applied about the ear In tetanus, in enormous quantities internally, just as opium is given to the amt of 100 gr. in 24 hours also blisters on the spine are beneficial Doubtful as to its benefit in neuralgia It has been proposed in lyssa canina Beneficial in idiopathic headache Leucophlegmosia palsy int. & ext. one of the most powerful remedies Blenorrhea leucorrhea [spermorea] [impotency] in these internally Dropsy in all its varieties Remarkable case mentioned by Dr Ives In internal use in one night carried off all the water flooding the floor of the room The patient was reduced to a skeleton & in a state of asphyxia from which he was roused by friction with ammonia etc. pledgets of ling dipped in amm. thrust into the nostrils & the internal administration of spicy & spiritous cordials. He recovered Internally in the species of paruria In paruria mellita or diabetes, give as much opium as will be borne without soporific effect for it will diminish the secretion of murine & increase that of the skin. Give the tinct. canth. Sponge the surface with caustic potash confined the patient to animal prod and debar the use of drink Keep the extremities warm cloth the body in flannel sometimes wearing stockings filled with capsicum to keep upon irritation. Various combinations of canth. with phosphorus etc. are necessary afterwards Exhaustion from haemorrhage has been relieved when other stimulants seemed to fail In the United States we have the cahntharis villata which is more powerful than the C. vesicatoria & might be furnished at a cheaper So the C. cinerea C. [illegible] lytta nuttallii of the N.W. territory is exceedingly powerful and might be collected in great quantities So other species of cantha Lytta gigas of India is about twice as large much more powerful and more speedy in its operation So other insects The larva of phalaena neustria is a good blistering insect. It is the common apple worm Apis mellifica is a blistering insect Various other insects are mentioned by the European writers Capsicum [Roem???] & Sch. [illegible] [illegible] sp. London gives 3 more Our species is the C. opossum or squash pepper. Pericarp oblong globose or conic [or] tetragonous etc. etc. Other species are cultivated but rare The imported cayenne is an indiscriminate mixture adulterated with salt & even with flour, frequently with peroxide of lead. Indian pods are stronger; but ours are strong enough Aleth species have the same properties in kind. By digesting the pods in ether for some days the oil is obtained & crops of crystals of capsicum are found on the sides of the vessel in acicular crystals This is destitute of sensible or medicinal properties So also of piperin. Each of these owe their small amt of virtue to their contamination. The active principle of each is the oil. The oil of capsicum is a perfect substitute Capsicum is a powerful stimulant. The first sensation is that of warmth As in condiment it prevents flatulence from vegetable food and is not liable to the injurious effects of the oriental spices upon the head. Instead of causing visceral obstructions particularly of the liver it is most probably that they prevent them The effects of too large a topical application are an excessive irritative inflammation which is relieved by olive oil & cerate of datura. Tully does not believe that the stomach will retain a sufficient quantity of the power to poison The habitual use of as an article of food in excessive quantities weakens the stomach & produces a troublesome kind of dyspepsia. As a rubefacient it possess peculiar powers One fourth or one eight of a minim of the oil is a dose, given in a pill made with some extract. Of the substance 2 to 12 grains is a dose. The doses are to be larger in tropical climates Lecture omitted Capsicum continued diseases continued Disguised gout various cases of gout misplaced gout Secondary stages of atonic acute rheumatism & in all cases of erythematoid rheumatism All the low atonic exanthematica e.g. rosalia maligna rubeola maligna, malignant small pox All positively passive hemorrhage Marasmus tabes. Sertosis rachea (rickets) All the srumous phlogotica i.e. strumous visceral inflammation. Porphyra hemorrhagica or land scurvy this the remedy second in importance Acetate of lead is first The several species of gangrene Tully considers it as a settled point that tonics deobstruents & acrids are frequently the best remedies for insanity e.g. Connecticut [illegible] which had been more successful than any other known Melancholia hypochondria N.B. this seems to be a compound of melancholia & dyspepsia. Chorea carus lethargus paramenia [illegible] atonic acrids then assist the operation of the deobstruents & tonics Blenorrhea simplex & chronica have as often been suspended by an internal use of capsicum So B. senodes emphysema abdominis (typanitis) Paruria mellita mostly externally sometimes internally as an adjuvant. Par. [incontin??] epidrosis profusa (sweating) The effects of the bits of serpents though not so effectual by itself as alcohol This last with opium is first, next are ammonia capsicum etc. Monarda punctata N S. to Car 14 sp. in R & S. This the most active species Com. name horse mint. Though this name is applied to sp. of mentha & pyenanthem Ess. oil is volatile and exceedingly pungent and acrid resembling the ess. oil of thymus vulgaris One of the most elegant aromatic stimulants and externally rubefacient & even vesicatory. Spt. 1 fl. oz. of oil to 7 of alcohol is the most convenient form for its internal administration First introduced into regular practice by Dr. Attley of Phil. Diseases (Attley & Eberle) 1st typhus in the cold state externally applied Cholera infantum externally Chronic rheumatism cephalea hemicrania obtuseness of hearing from atony dropped into the ear. Externally applied to the limbs in some forms of palsy Rheumatic odontalgia dropped into the tooth if it is carious if not applied to the face combined opium with it Our most common sp. is m. oblongata & this sp. would probably answer as well M. dydima (bee balm or Oswego tea) M. fistulosa common All have the same oil Ether sulphuric or hydric or vitriolic the most volatile of all known liquids. Extremely inflammatory sometimes producing serious accidents when poured out by candlelight. The best test of its purity will be its sp. gr. [illegible] a pure diffusibly stimulant and nervine N.B. Part of two lectures lost Disease (many lost) Typhus Dr Rush never suffered a patient to die without having first tried a very efficient use of this article Syncope of various species, in these it is the best remedy. Neuralgia auris (ear aches) dropped into the ear especially mixed with sulphate of morphine the ear being stopped with lint to prevent evaporation Cephalis hemicrania & nauseosa N.B. when externally applied and suffering to evaporate it is a refrigerant Chorea, common convulsion Hysteria asphyxia, after breathing has been restored. Tully has frequently seen a patient roused from a paroxysm of catalepsy by ether letharty, parodynia Burns & scalds mixed with spt of ammonia, employed by Dr Ives N.B. if vesication has already taken place, it must be so managed as to produce its refrigerant effects? In that state of the system which has been called concussion in consequence of a sudden and violent shock. Wine produce of the vitis vivifera which was originally from the south of Asia it is found however growing wild in Armenia Tauria etc. The varieties are almost innumerable Different sorts of wine 1st white & red again [illegible], adiculia aspera, & mitia acidulous e.g. shock dulcia frontenae malaga tokay, [illegible] aspera port, mitia or soft sherry claret burgundy champaign madeira Paris’ account if its being firs employed by Asclepiades a little before the time of Pompey It is mentioned by Hippocrates It increases the frequency of the morbidly slow pulse & diminishes the heat or increases it diminishes or increases sweating improves the appetite digestion, exhilirates, & strengthens etc. etc. # Habitual and free drinkers of wine are not subject at all to intermittents & but little to typhus Indeed it diminishes the liability to many inflammations etc. See MacCulloch on malaria Excessive quantities produce nausea vertigo etc. in short intoxication # These are the effects in atonic cases & when given in suitable and regular doses and for some time Habitual and excessive use a general weakness of the nervous system a peculiar sort of dyspepsia & gout These are all Wine is 1st stimulant 2nd nervine 3d narcotic The last operation consists of the vertigo nausea etc. Its sedative effects in case of irritability pain etc. are probably the joint result of all its operations Its effects are not slow and permanent enough to entitle it to be called a tonic Wine and opium are the most valuable articles of their kind Various eminent British authorities quoted Good is inconsistent and contradictory It is more especially adapted to the putrid type of typhus Chemical composition of the intoxicating principle One fourth part of the best wine is officinal alcohol or at least will furnish that amount So that a pint of wine will yield a half pint of brandy Now the effects of factitious wines do not differ from those of diluted alcohol The same is true when alcohol is added to wine. It is commonly supposed at the present day that the difference is owing to the chemical composition in which the alcohol [exists] in the wine, chemical comp more especially with the water But we have no evidence that alcohol will unite with water in any other manner than by solution Others supposed that only a portion of the alcohol exists in the wine previous to distillation. But Mr. Grande by adding [illegible] acetate of lead, separates the alcohol without distillation Pure alcohol is composed of the ponderable part of olefiant gas & water 2 to 1 ether is [illegible] to 1 In wine probably [illegible] will have it 1 to 1 Perhaps another compound of 1 ol. gas to 2 of water may be the princ. of [alc.] etc. which differ as much from [illegible] as this does from alcohol Alcohol Arabic named & discovery The name is figurative, meaning originally a fine powder of antimony used as a paint It retains its fluidity at 91 degrees below zero of Fahrenheit# The bluer the flame the purer the alcohol, and in this way its purity may be judged of The pure state has a sp. gr. of .792 Off alc. is .835 Arrack & spiritus oryzae (rice) The difference in the several sorts of spirit is owing to oily matter and acetic ether. The effects of wine and alcohol which are called by the same name yet differ Alcohol & tobacco have more effect upon the [illegible] Intoxication takes place sooner upon an empty stomach & when the body is immersed in water, but if the head is wet and the body dry, the reverse is true vid p 50 # Frozen by Mr Bussy Bulbs filled & surrounded with cotton dipped in anhydrous sulphurum acid, and placed under the receiver of an air pump vid. p. 43 Nitrate of potassa The most powerful refrigerant known next to blood letting most powerfully reducing [illegible] of action Tully thinks it not diaphoretic as has been said neither diuretic. It proves diuretic and diaphoretic in cases of obstructed perspiration & urine from phlogistic diathesis Sometimes however it has these effects in other circumstances though they cannot be calculated upon It is not sedative except as it relieves the morbid restlessness heat & dryness of skin etc. of phlogistic diathesis It may not febrifuge except in [?thenic] fevers, that is in a small portion of fevers Not laxative except as it relieves the torpor of phlogistic diathesis producing the natural discharges. Very doubtful if it is ever antispasmodic. Not antiseptic except upon dead animal matter. Sometimes there is a tendency to gangrene in high phlogistic diathesis which of course is relieved by any refrigerant Cinchona is the most powerful antiseptic, using the term in its most appropriate senses, but these two articles are entirely incompatible one will not counteract efficiently the improper use of the other as seems to be sometimes supposed. The injurious effects of efficient quantities of this article in atonic cases are crust on the teeth coldness of extremities etc. etc. It should always be given in uniform and small quantities from 5 gr. to 1 scr. The test of too large a quantity is pain in the stomach. Sometimes present in the urine, but not in proportion to its effects. The operation of the external application are similar to those of its internal hence it is used as a lotion on phlegmonous inflammation. it is also used as an irritant like tartrate of antimony not therefore a stimulant Deleterious effects, coldness of stomach, discharge of considerable [illegible] of blood weak pulse etc. etc. pallor of countenance etc. A very large quantity vomits and is thrown off. ½ an ounce to an ounce is a poisonous dose Orfila conjoined it refrigerating with its narcotic effects an egregious blunder In a medico jurisprudential point of view nothing short of find the article will answer. Show a distinguished anatomist says that the appearance of the stomach and intestines is not to be relied on as a proof of poison because all the appearances may be at times found in an unpoisoned stomach This very important in this country where medical jurisprudence is much abused. Remedies 1st vomit, not with the mineral, but the vegetable emetics the best is a dose of a table spoonful of black mustard which is more speedy and effectual in clearing the stomach and is useful as an acrid. Opium & alcohol with nutrition demulcent After the poisonous effects have taken place do not vomit and in any case prefer emesis to catharsis. Finally prescribe to the symptoms. The refrigerants & especially nitrate of potassa have been undervalued of late Partly from change of diseases, partly from the chemical theory of the production of animal heat by the solidification of oxygen The French writers call it stimulant because it produces irritation & inflammation Diseases Acute mercurial ptyalism as a topical application doubtful because it is an atonic agent. A dipsosis avens or morbid thirst, especially of intemperance doubtful for the above reason Opium etc. are also undoubtedly known to be useful. This also makes the above doubtful. Dyspepsia by Wilson Philip, upon his theory that the secondary stages of dyspepsia are phlogistic There is much more reason for considering it exceedingly injurious in this disease producing a bad sort of dyspepsia when freely given for affections of the urinary organs. Jaundice by the French writers melaena also by the same very improbable. Simple idiopathic cough very doubtful. Remittent But the opposite class of remedies is always wanted in the varieties of this disease. Idiopathic hectic because it is cooling & sedative Very little probability Synochous in this it does neither hurt nor good Typhus gravior very injurious. Cauma or actively inflammatory fever the most efficient remedy after bloodletting & perhaps after nauseating doses of tartrate of antimony A composition of nitrate of potassa tartrate of antimony & calomel used in Philadelphia under the appellation of Rush’s febrifuge it contains too little of the two first articles. As a general rule avoid being confined to set formulas. Some inflammations of the skin boils [illegible] etc. Blenorrhea lenodes (clap) it has been recommended. In inflammations of the female breasts & of the testicle, it is not so good as acetate of lead. Useful in phlogistic rheumatism still not so good as some other modes of treatment. Useful & important in all the entonic phlogotica. Active phlegmonous cephalitis & in quinsy Membranific inflammation of the bladder doubtful because copaiva oil of pine etc. are very useful. In hemorrhage haemoptysis but the restriction to active shd be made haemorhage It has been recommended in haemorrhage attended with plethora. Tully however does not believe in the existence of a disease consisting of too great a quantity of blood. Sea scurvy recommended very doubtful Tully is inclined to think sea scurvy not a different disease from land scurvy. The latter requires the system to be raised, the former will generally be cured by a change of food Obesity which however is better cured by the old rule mouth always shut eyes always open feet always in motion. Cellular dropsy doubtful Parunia various species, including diabetes. Neither this nor any other remedy has done much good Gravel improbable. Lepidosis psoriaca var. inveterata. Impetogo laminosa (salt rheum) I. herpetica (herpes) Tully has not known it do good & very different articles serviceable. Nitrate of soda possesses the same medicinal properties So also nitrate of ammonia although ammonia itself is stimulating. Various other nitrates also. Carbonate of potassa called sal tartari sal absynthii (salt of wormwood) The deliquation by exposure to air was called oleum tartari. Obtained from the [L??viation] of the ashes of plants not [illegible] when imperfectly purified called pearl ashes. It must be pure for most pharmaceutical preparations. The theory of its combination with oils forming soup it was formerly not understood has been lately investigated. Incompatibles, all the salt will decompose it It is refrigerant but this property is not so predominant as to prevent its use in atonic case Also diuretic, especially when aided by plentiful dilution, still it cannot be depended on in dropsy. In diuretic power greater than it refrigerating. Parunia inops most useful as a diuretic in this Sometimes antilithic viz. in cases of calculi of the xanthic acid & 2 others Antacid as in dyspepsia still not so good as oxide of potassium which is also tonic not so good also as lime. Not stimulating unless this term be applied to every remedial agent. Neither increased frequency of pulse, nor increased heat is an evidence of [stimulation] Not specifically anti-emetic unless retching is produced by a free acid. Not antispasmodic, as in bex convulsiva (whooping cough) Of no use in visceral enlargement. Dyspepsia remittents recommended in the form of effervescing mixtures which however operate by their carbonia acid & the salt formed. Saccharine matters supposed to impair its power. Water the only proper menstruum for its solution. Its solution commonly mixed with a little rhubarb & peppermint This much mused by physicians when at a loss what else to do. Case of A seamstress who had a horrid dyspepsia from costiveness relieved habitually by Lee’s pills relieved by this brought from the south Oftenest used as an effervescing mixture If sugar is added it should be dissolved not in the solution but in the lime juice or else the effervescence will be prevented But the bi carbonate of potassa is best for effervescing mixtures. Large doses are poisonous from irritation inflammation etc. Antidote at first vinegar afterwards demulcents particularly those of an [illegible] oily nature, with narcotics Bicarbonate of potassa called carbonata & super carbonate also sub tartari essentialis sal aeratus (this name is given to other salts of [illegible]) Does not deliquesce from exposure to the air possesses considerable activity as a refrigerant more than the last article. Much use of it as an antacid injurious from the distention. Tully does not believe with Edward and Varasseum that it possesses all the advantages of the carbonate & ought to be used for it although mor pleasant to the taste Carbonate of soda called sal sodae called in commerce when in its most impure state barilla Effloresces upon exposure to the air deliquesces by heat Obtained from marine plants especially the salsola soda Similar in powers to the above Tully thinks it not deobstruent. It can be given in pills carb of potassa cannot from its deliquating the carbonate of soda however must be [efflorescent] Tully can perceive no effect in jaundice from this or the carb. pot. Bicarb. soda (more commonly called sub-[illegible]) found native & called hard enough to build the walls of a fort Ingredient in some specimens of soda water This article originally was made of oxide of sodium Now, except in N. Haven, it is merely carbonated water. The prevailing custom very injurious Case of a brine spring in Albany. Saratoga very injurious ½ dr. to [illegible] gr. tart makes soda powders with pure concrete tartaric acid The tartrate of soda produced is cathartic proportions 25 gr tart. acid ½ dr. soda Seidlitz pow Hydrocyanic acid (I was absent) [Illegible] cerasus the essential oil Equally powerful as a narcotic with hydrocyanic acid 6 ol. oz. of distilled water to 1 pound of the recent leaves Less powerful upon man than upon the brute animals upon which the operation of a little laurel water to the eye or the inside of the mouth causes immediate death. Two or three minims of the (so called or supposed) essential oil kills small animals Tincture the most convenient form Cataplasms of the leaves are useful as a narcotic. The leaves are used for their flavour in cookery among the English & has sometimes in moderate quantities have produced death. Probably the cerasus virginiana has the same properties. probably in a less degree Gelseminum nitis (apocyneae) The effluvia of the flowers are said (in Elliott) sometimes to produce stupor) Tully considers it as a perfect substitute for hydrocyanic acid & free from its inconveniences. The root, most powerful part. In phlogostic cases it would probably like the other simple narcotics do neither good nor hurt. Never produces the calm placid pleasurable sensation exhiliration and wakefulness of the nervines. Tully has always used the tincture 4 oz. bruised root to 1 pint of alcohol macerate for a week. 10 to 20 minims from 3 to 6 hours beginning with small doses & more until narcosis begins to be powdered & then continue the same dose. It is well frequently to conjoin opium [illegible] will counteract its liability to to produce narcosis, Probable all the stimulants have this power. Perhaps the failures so frequently complained of are owing to want of skill in conjoining them Evil effects narcosis merely which may always be relieved by the diffusible stimulants. The best are alcohol [monarda] punctata capsicum spt. ammonia Make use of of napkins wet in cold water applied to the head & of friction, & rubefaction by the monarda punctata Case of a patient who book several doses in rapid succession. The very distressing symptoms were immediately relieved by brand & in 12 hours the patient was as well as before. Case of a girl at the south died in an hour Diseases bex (various species) phthisis where there is much irritation Dyspnea exacerbans acute & subacute rheum Helomas erythrosperma A pure narcotic yet differing materially in its effects from the Prussic acid & Gelsemenum Letter from Dr Brand of S. Carolina Affect the eyes making them sensible to light in an extraordinary degree blindness finally N.B. All narcotics appear to affect the sight Some produce dimness Some dilate the pupil Commencing dose of the tincture 10 minim. Tully has commonly found from 20 to 30 minims necessary at intervals of from 4 to 6 hours. With respect to most such articles, physicians are apt to give inefficient doses & then condemn the article Few of the narcotics, except opium directly produce sleep Chlorite of Potassa (oxymuriate) Prof. Ives is right in saying that it diminishes the heat of the kin & of the stomach. It diminished or at least does not increase entonic diathesis Said to relieve chronic hepatitis which however does not exist, for in dyspepsia accompanied with tenderness over the liver post mortem examination shows no inflammation. Said to be capable of during lues syphilis very doubtful Said to be good for cacherine, a loos term which may include one third of human diseases. Tully believes it a weak refrigerant of no great value without further experiment Vegetable acids. 3 groups 1st those which exist in a free state 2nd which do not & 3d those which are the products of decomposition The last are the benzoic & [illegible] & perhaps [illegible] all nervines Acetic acid 4 states one of which is acidum aceticum pyrumatica or syroligneous acid. Common vinegar is acidum acegum impurum The impurities are various according to the liquor from which it is made Frequently found in the sap of plants as [illegible] typhina vitis vinifera It is a pure refrigerant proper only in cauma. To be given diluted or in combination with mucilage Improperly used in putrid [illegible] to relieve heat [illegible] about the mouth & thirst which do not require [illegible] but if we need acids we must use the [illegible] acids a sulphuric & nitric. Though it is often given to humor nurses bystanders etc. Said to be antiscorbutic but this is loose and doubtful for the vegetable acids pure do not relieve scurvy, without vegetable matter. In obesity if insufficiently employed it does nothing if efficient, it is mischievous. Useful as a condiment, as [illegible] also Conium maculatum a deobstruent [diuretic] confounded with [??uta] maculata both in Europe and in this country. The ancient hemlock is unknown. We know of no plant which will produce the effects ascribed to hemlock in the account of the death of Socrates Perhaps the liquor was a compd of several narcotics The most common form & the best for administering it is extract. The term extract has four applications 2st expressed inspissated juice 2nd inspissated exuded juice 3d inspissated decoction 4th alcoholic extracts Tully places great reliance upon conium and iron in dyspepsia It is useful in paronina salax lagnesis [fluor] etc. etc. Tully used conium & iron with various aromatics in dyspepsia for 4 or 5 years without being able to get any physician to try it. Of more value than mercurials in jaundice Cicuta maculata frequently confounded with the latter more powerful very poisonous the poison cured by stimulants etc. as in other narcotics Digitalis purpurea purple foxglove cultivated in our gardens It is a narcotic deobstruent Medical testimony upon this article exceedingly contradictory. Tully denies that it is either stimulant or refrigerant thinks that the supposed phlogistic cases in which digitalis has been though a substitute for bloodletting were in reality synochous cases which are not phlogistic according to Tully nor are they phlogistic at the outset and typhoid at the last & though they will bear bleeding yet are cured much better without In large quantities it vomits and purges 1st narcotic 2nd deobstruent &^ as parts of this last it is resolvent diuretic and discutient Most commonly used for its diuretic operation [Black???] says that digitalis is not proper except when the urine is coagulable this was tried in this country by boiling the urine! Unfounded If the system is very low it must be raised by excitants in order to allow digitalis to operate So if it is very high it must be reduced Yet there is a considerable range within which neither is necessary Paris’s account of diuretics which are incompatible with it is unfounded The narcotic powers of this article are frequently useful to allay morbid irritability. The best form is tincture It has been supposed that the infusion is best as a diuretic and the tincture as antirritant. Not very probable Therapeutic application Dyspepsia accompanied with tenderness in the epigaastric regions & febrific symptoms digitalis has been used to alleviate these symptoms not so good however as actaea & [other] Recommended in many cases of chronic cough accompanied with dropsical swelling of face, leucophlegmasia Also is it useful in many cases of simple idiopathic cough best however as an auxiliary to opium etc. Whooping cough especially conjoined with arsenic Some forms of phthisis Rheumatism is of various kinds in some of them this article may be used though in most of them actaea & some similar articles are better It has been recommended in mania and probably may be very serviceable in breaking up the paroxysms N.B. the practice of attempting to do this by profuse bleeding is generally bad because the bloodvessels are affected by the mind and not the mind by they bloodvessels & the continuance of the practice may produce fatuity Digitalis long a popular remedy taken in ale among the Italian much used as a [vulnergry]. Withering about 50 years ago first used it in dropsy as a diuretic Frequently the excessive distention of dropsy will prevent the operation of diuretics until it has been reduced by paracentesis or hydragogue cathartics especially elaterium Few diuretics can be depended upon when used alone but required to be combined with others Asclepias syriaca seems to be the most sure which Tully has used. Lobelia inflata 1st narcotic 2n deobstruent 3d emetic as parts of its deobstruent effects it is cholagogue diaphoretic? diuretic? sialagogue & perhaps emmenagogue. No published account exists of its deleterious effects. The first account was published by Ref. Dr. Cutler 1785 It has been employed in form of powder of the leaves powder of the leaves infusion tincture of seeds & tincture of the leaves 2 oz. of recently dried leaves to 1 pint of proof spirit macerate 8 or 10 days Diseases Limosis dyspepsia especially where there is great insusceptibility Simple idiopathic cough considerable [evidence] for its utility. Often very efficacious in that sort of cough to which public speakers and singers are subject it is sometimes the sequel of acute diseases, and is always accompanied with more or less dyspnoea which will be manifested by a fit of coughing following upon the [illegible] to light a candle & blow off dust from every thing Frequently accompanied in these cases with s opium Bex convulsiva or whooping cough in the secondary stages, very useful Tully has not always succeeded with it Dyspnea exacerbans (commonly called asthma, though differing from it) give it in doses of a teaspoonful once in 5 or 10 minutes until the exacerbation disappears either with or without narcosis and vomiting. Highly effectual in asthma though not so certain because the disease is more obstinate The British physicians are just beginning to learn that this article has remedial powers. Tully has no doubt that in Britain diseases yield to smaller doses and less efficient practice than with us This article has been recommended in croup, though it has been rejected upon theoretic principles. Cases mentioned in which its emetic & deobstruent powers have been very serviceable. Actaea racemosa. Black [cohosh] frequently confounded with leontice [thaltroides] called blue [cohosh] No complete analysis has been made Tully thinks it probably has no alkaline principle being in this respect similar to digitalis and conium A narcotic deobstruent in large quantities an emetic Tully thinks he has seen in children moderate exhilirating effects produced by this article It may be pushed so far as to produce neuralgic pains This effect may be prevented by giving liquid food; or it may be remedied after it has taken place by giving opium etc. There is much evidence for its being a [part??] accelerator similar to [sclerotium] clavus With respect to its diuretic and diaphoretic operation it is not strictly correct to ascribe them because they follow the exhiliration of the article only when diaphoresis and diuresis are prevented by the diseased state of the system. The deobstruent effect may be prevented and in the hands of injudicious practitioners frequently is prevented [illegible] too great previous bleeding Actaea resembles digitalis most but differs from it 1st in not accumulating upon the system and suddenly breaking out Through these effects may be prevented in digitalis yet they are not liable to occur from actaea 2nd Actaea is not liable to reduce the patient to a low and dangerous state The narcosis is more easily remedied 3d Actaea produces neuralgic & perhaps spasmodic pains. And this effect is valuable as a test of the limits of the dose 4 Actaea possesses considerable power as a [partus] accelerator 5 It possesses more deobstruent power Actura differs from conium in being [illegible] a deobstruent more speedy & powerful Actaea is most powerful in acute & conium in chronic case The resolvent power of actaea is greater than its cholagogue vice versa with Conium No article has so great a resolvent power as actaea & none so [illegible] a cholagogue as conium Actaea may made indirectly diaph. diur. & expect. conium not Actaea seems to be a more effectual deobstruent than sanguinaria and causing less nausea than colchicum & less liable than either of them to leave the stomach and intestines in a deranged condition The watery preparations not to be relied on Tully used them in a vague way in some years without discovering its narcotic powers Tincture two [ounces] to 1 pint alcohol sp. gr. .835 Medium dose of alc. tinct. f z ss once in 2 or 3 hours Materia Medica 1831 & 2 Pure mineral deobstruents are iodine nitric muriatic nitromuriatic acids chloride of gold barium calcium etc. Perchloride & peroxide of mercury also proto chloride & diproto nitrate of mercury Vegetable deobstruent 1st pure, are leontodon, rubra tinctoria fumaria offic. cinchorium intybus sapomaria offic. Of all these, a large quantity must be used 2nd Aperient they restore, or augment the fluid secretions viz. halitus from the lungs diaphoresis & diuresis (formerly called [illegible] also sweetness of the blood) now often called diet drinks, from their being given in form of decoction & in large quantities. Some of them are spoiled by decoction however. e.g. sarsaparilla is injured even by the best of the sun Smilax off. syph. rotundif. and glauca. Officinal sarsaparilla is from S. off. & S. sulph. (S. sarsaparilla produces none it should be called by Micheaux’s name glauca) Comptonia asplen. (leaves) aralia [medicaulis] & racemosa (root) Asclepias tuberosa & incarn Arctium lappa & dardana? (roots & seeds) Diervilla lutea, celastorus scandens Collisonia canadense, solarum dulcamara (has slight & easily lost narcotic properties) These are used in hectic, lues, bucnemia elephantiasis, lithis arenalis, lepidosis several species. Ecpyresis. Sequels of rheumatism in dyspepsia 3d Acrid cheledonium majus, daphne Mezeocon etc. Dirca palustris ranunculi anemones clematides myrica cerifera 4th mild narcotics, destitute of acrimony solanum nigrum & tuberosum [ethusa] sinapium conium, cicuta & probably the lacturas 5th acrid narcotics they do not incline to produce somnolency or coma, but stupor the term acrid is used to denote this quality of a narcotic operation Kalmia 2 or 3 sp. rhododendron 2 or 3 aconitum napellus, strychnos nux vomica 6th Astringent chemaph. uva ursi [illegible] calyculata ledum [palustra] 7th tonic Canalyrium carolin. (unicorn root) Helonias dioica is the old name for this aletris farinosa (unicorn root also) 8th Evacuating Ol. & resin of pinus & abies & copaifera off. & juniperus [illegible] & guaiacum off. Iris vessic. & prism. Polygala senega & pubescens squills (conithagala squilla) Gratiole off. lobelia syphilitica nearly allied to senega & better because this latter deranges the al. can. Helleborus [2] sp. Eryngium yuccifolium sanguin. veratrum apocynim. aralia spinosa phytolacca colchicum, seeds of Daphinium cocculus [indicus], stillingia sylv. anderia inernis veratrum album Mercurial Ptyalism. Symptoms are ptyalism, soreness of the mouth, ulceration of mouth & fauces a vesicular erythema upon the skin etc. Different persons differ in susceptibility. The same person will be much more susceptible after a previous salivation especially if recent. Teeth set on edge is an incipient symptom Ordinarily there are no fatal consequences. When they occur they consist of caries of the jaw, sloughy ulcers of the mouth, total loss of the teeth, stiffness & incurvation of the limbs, extreme emaciation etc. etc. The treatment is in a good degree empirical. The question as to treatment seems to be, what will do the most good No foundation exists for the opinion that the mercury is deposited throughout the system. Sulphur flowers have been thought a specific nonsense! the only two compounds of mercury & sulphur or one a brilliant red & one black & both insoluble!! Purging, as such. Prof. T. is confident, does no good Dr Finlay of Ohio thinks it may be cured by antimony. Others have not succeeded by it. Sarsaparilla is much used a quart of decoction a day is much used in G.B. undoubtedly with benefit. Not of much use in our country Astringent lotions & gargles are much used They are useful in the latter stages In the first stages resolvent remedies seem to be most needed iced water has cured mild cases. Baptisia tinct. has been much used. The testimony is so strong that Prof T. credits it It is used topically. A strong solution (1 scr. to 1 oz of water of nit. sil. has been the best article used by Tully. Liquor of the arsenite of potassa is an excellent topical application is also taken internally Spts turpentine in gum arabic is employed by Prof. I Lycopus vulgaris decoct is recommended Watery solution of opium is strongly recommended The mineral acids are recommended Mucilages are very grateful acacia typho lab. viole pedata laura sassafras ([illegible]) decoct. of rice & barley strained through a cloth) tragacanth hibiscus althea Prof T. would try quinine Milk porridge is the most grateful diet air [illegible] & [free] Erythismus hydrargyratus Irregular action of heart & arteries, pale countenance exhaustion of strength anxiety in epigastrium, sighing, quick small & sometimes intermittent pulse tongue not furred. In this state, sudden exertion may destroy the patient Treatment A steady and regular use of moderate quantities of opium alcohol & quinine with strict rest Erythema hydragyratum vide Good A vesicular eruption (though like a case of sun burn, a magnifier may be needed to discriminate) Prof. T. does not believe in the spreading from the corrosion of the discharge (criticisms upon Bateman’s confounding erythema with exaena or rash erythema being vesicular) Bateman probably incorrect in saying that it may be caused by cold merely Bateman gives a very full & perfect account of the rise & progress of the disease Diseases teething cathartics too much used blue pill preferred Prof. T. objects to protoxide (blue pill) as being extremely uncertain (imperfectly oxydized) & when perfectly oxydized is in no way preferable to calomel It is milder only in consequence of the diminution of the dose in consequence of the imperfect oxydation. Prof T distributed some of that perfectly oxydized to his friend e.g. Drs Reed Cogswell Todd etc. They all declared they could perceive no difference It will combine with the lactic acid of the stomach & produce a troublesome compound Dyspepsia Prof. T. utterly protests against the fashionable practice of using mercury in dyspepsia Even when the liver sustains the burden of disease it is injurious. The use of mercury occasions tendency of abdomen etc. etc. Even as a deobstruent it is inferior to other articles Occasionally useful as a slow purge Colica Ileus (comm. col.) Of the utmost importance not as a cathartic for this is of no consequence the disease consisting of a suspension of the peristaltic motion. Commence with opium & continue the use of opium but the cal. cures the disease It will never produce ptyalism. It has been given to the amount of i dram once in 6 hours without this effect. Colica rachialgia the same with respect both to opium & mercury Coprostasis not the best article Diarrhoea purging will cure the disease by strong impression but the practice is foolish utterly inapplicable to sev severe cases Cholera Generally the phys. is called too late to allow of the exhibition of calomel In the commencement of the disease it is useful as a deobstruent Helminthia ascar. lumbri probably the best cathartic. The spigelia ought to have been given for the last 12 hours until narcosis is produced. Then give the cathartic Senna is an extremely poor vermifuge its purgative operation is not of the right kind. In the other species of invermination cal. is not the article Even in this species turpentine oil is a better article, but not so manageable as spigelia & cal. Jaundice Purging with cal. in the early stages & the use of [illegible] deobstruant is of great importance cal. is inferior only to conium in this disease. Give it alone cal. is better as a first measure than vomiting Vomiting is apt to produce soreness in the liver & irritative fever. This calomel treatment of jaundice is not the best. The yellow colour will remain and this may be removed if we treat with conium Cal. is apt to produce ptyalism Parabisma coactum There is but one article better than cal. There is an impression that these must be cured before attacking the intermittent. The interm. may be cured without disturbing the parabisma. Conium will cure the disease in half the time of cal. Corysa acuta (improperly entonica by Good) Calomel 7 opium will cure a paroxysm Fevers 1st Intermittent It is a great mistake to suppose that we must always being with purging & vomiting If cathartics are indicated, calomel is much the best notion a drastic dose nor combined with other cathartics Remittent a disease intermediate between intermittent & continued fever. Some cases approach more to an intermittent & others more to a continued form & the nearer it approaches to the latter the more is calomel indicated. It is slow purging that we need not small doses at considerable intervals not quick & drastic for them we increase irritability & irritation Typhus infantum absurdly called infantile remittent & worm fever. Purging with pure calomel & cal. in small doses & at regular & short intervals. It is well to conjoin it with antirritant & with ipecac Non malignant nervous typhus. The best article for producing a resolution, provided you have been called in very early & also before the patient has purged himself even 3 or 4 times with castor oil. Give it either in a single & full dose or in small quantities, so as to get a full dose in the course of 12 or 15 hours or conjoined with opium. Cal. & ipecac is an excellent article for the resolution of fever. Other modes e.g. vomiting, purging, sweating etc. are more liable to fail than to succeed. This mode has succeeded in 8 out of 10 cases in Tully’s practice. Sporadic cases are resolved more easily than epidemic. Purge no more than to remove the contents of the al. can. Dis-oxide of mercury (sub oxide black oxide) (protoxide aethiops per se) pulvis hydr. [illegible] oxidum cinereum is a different compound Mode of preparation vide U.S. Pharmacopoeia This process is very exceptionable An apoth. would require near a barrel of lime water in order to make such a quantity as he would wish to make at once. It is besides uncertain from the uncertain composition of the lime water. You will have an excess of carbonate of lime or of calomel The [illegible] of the Phil. phar. is the best for a chemist viz. cal. & caust. pot. with 1 pt. water Take cal. & carb. pot. equal parts triturate in a mortar to every troy oz. add alcoh. 3 fl. oz. & wat 1 pt. Boil in a flask until there is a copious black precip wash & dry Blue pill will be more strong in proportion to the quantity of metallic mercury contained which is entirely inactive. If it is made with conserve of roses or with rhubarb, we shall have more or less of malate or gallate of mercury Light decomposes it. When made into pills with any articles which contain combustible matter a greater or less degree of decomposition takes place The mercurial ointment Prof Tully would retain although there is more or less uncertainty about it. But the blue pill mass he would utterly reject. Still this black oxide does not differ in its operation from cal. vide above upon cal. The physicians to whom Prof. T. distributed this article reported that where the stomach contained acid probably from the formation of a salt tormina followed its administra Prof T. would use the black oxide for those who have a prejudice against calomel & for this purpose only Cal. & op. is better in most cases for producing a mercurial action than the ointment still not always Black oxide macerated in nitric acid ([diluted] for 24 hours Wash the white powder. It is between 2/3 & ½ as active as calomel & ought to be substituted for the blue mass This is the di-proto-nitrate of mercury or the disnitrated disoxide Please sew these together Iodine characters Origin is from ocean salt springs zosteramarina Trigl. chin salsola atriplex chenopoidium dipsacis [fallorum] [sedium] teliphium The cryptogamous plants are much more numerous [f?cus] vesiculsus etc. It is found in zoophytes as sponge in the genera venus (clam) ostrea (oysters) etc. several mollusca. Probably iodine & potassium exists in its metallic state in combination with the other elements of the plants Potassa or oxide of potassium probably is produced by the incineration Operative effects Moderate augmentation of the appetite & digestive & of arterial vigor & muscular strength perhaps this is merely the effects of its alleviation of diseases It is of no utility as a [narcotic] 2nd resolves glandular enlargement as of the thyroid the ovaries the testicles & breast & lepidotic (especially) cutaneous aff & acute subacute & chronic inflammations (of an arthritic character especially) increases the catamenia & is said to diminish corpulency & fatten the lean An overdose will either be thrown off by vomiting or produces an atonic erythematic inflammation of the mucous men. of the fauces & al. canal. Dr Tully gives a teaspoonful of the saturated tinct. without injury It is said to have removed the heatlhy female breasts & male testicles. There is no good evidence of this Magendie & others who have much used it have seen no such effects Elliotson of England has employed it very much & even for 18 months without any injury, when disagreeable effects were produced he merely suspended it & afterwards diminished the dose Dr Wood has had it produce a vesicular infl. All the injurious effects are said to have happened in Switzerland, where there was a sort of mania for its use. Prof. T. has used it very much & has not known it produce injurious effects He has known it frequently relieve a diseased & not injure a healthy testicle It is said not to be so at Wether. st. pr. But then the prisoners there are dysthetic or cachectic One case was that of a fungus haematodes The other test. remained unimpaired Iodine is not a stimulant i.e not producing a quickly diffused & transient strength of action. It is a vital irritant capable of producing vesication upon the skin. When properly managed it is neither sialagogue expectorant, diaph nor diuretic. It acts upon the skin, but not in the way of producing diaphoresis. It has cathartic properties according to the experience of Dr Todd It is not known to be cholagogue s Iodine is then 1st deob. 2 tonic 3 rubefacient or even vesicatory Its deobstruent operations are 1st resolve 2nd atnipsoraic 3d emmenag 4th discutient Opium should always be conjoined to counteract its tendency to produce irritation. Opium will enable the patient to bear more iodine & will not injure its operation. Hyoscyam conium & other narcotics will answer [illegible] entony or atony contraindicate it. When used to freely or too long it is said to produce pytalism pain of teeth & gums. absorption of glands pain in internal ears vertigo, sense of burning in the stomach etc. etc. thirst vomiting NO doubt that glands are absorbed by an excessive use. Sufficient warming is given. If persevered in a dry cough sleplessness emaciation vomiting fiarrhoea paralysis priapism convulsions death from excessive irritation. Case of a young lady in Paris whose goitre was reduced to a hard knot. The knot was not cut out as it should have been. The iodine was not discontinued it produced excessive vomiting & purging with an emaciation such that the thighs were not larger than the wrists in health Eventually recovered or nearly so on opium. Authors recommend depletion of blood cathartics of neutral salts etc. a strict antiphlogistic [illegible] [illegible] can be scarcely be deduced from the symptoms On the contrary they indicate antirritants & moderate stimulants ([illegible] powerful stimulants) for the extreme exhaustion & irritation. Opium should be the main article. There is a prejudice among the people, derived undoubtedly from physicians that opium commonly palliate, & never cure disease. It is capable, if properly managed, of curing as many diseases as any other article A British author says that for gastrodynia medicine is of no use with the exception of opium given in efficient quantities. It is idiopathic gastrodynia which is here spoken of. No injurious effects follows Injurious effects follow only the use of opium where there is no disease ^ where of course it produces diseases. Many in the Senate at the Bar etc. are now free from gastrodynia enjoying health & comfort This author however, says Prof. T. seems to know of no mode of using it but to meet paroxysm but the disease may be radically cured even if it requires as it has in Prof. T.’s practice a year & a half. This is a disease not [ever] of inflammation but of irritation though after a long continuance infl. may come on Pharmaceutic prep. Pure [illegible] in pill tinct. ether ointment * plaster of iodine. Magendie’s formula is to be utterly disregarded, on account of the different weights & the different strength of their alcohol which is absolute alcohol a substance which cannot be obtained among us. The translators have sometimes translated the weights without reduction or reduced some & not others. The truth is the French pharmacy is loos & in the midst of their vast among of science there is a great deal of empiricism One grain is supposed to be a medium dose made, say with ext. glycirrh. Divide one gr into 2 pills & give perhaps 1 if necessary Tinct. made of sp. gr. .835. (Take a vial of a known weight put into it 1000 gr, of distilled water mark the heights alcohol up to this mark should weight 835 gr.) 24 gr. of iodine will sat. 1 fl. oz. 20 min. will contain a grain & this is a medium dose [2] or 3 times in a day we may need to give 15 min. or 30 min. or even a fl. dr. Elliotson has increased it from 5 min. to 2 fl. dr. It is said this tinct. will become weakened by crystallization, if it is kept long. Very probably this is the result of carelessly stopping the bottle & suffering the alcoh. to evap. Ether of iodine is used in France Ether contributes nothing. The only possible advantage must be that of having it a little more highly concentrated Ointment of iodine must vary in strength to suit the patient To 1 oz of simple cerate add from ½ a dram to 2 dr of iodine Put the scales of iodine into a wedgewoods mortar & rub it up with a piece of cerate as big as a nutmeg, in order to be sure of pulverizing the iodine. For parts, as the neck, exposed to view, we should use an ointment of iodide of potassium or sodium, which will have no stain upon the skin. These iodides have the same properties with the isolated iodine The plaster may be made of the same strength as the ointment & the best basis is pure white pine resin. If made with adhesive plaster containing lead, we have iodide of lead, which differs in properties perhaps [illegible] better one A hydriodic acid little know of its properties Iodide of potassium called also hydriodate of potassa. It seems to have no advantage over pure iodine, but in taste, & in greater solubility in water. We may use Elliotsons dose of from 1 gr to 1 ½ of the iodide of potas The iodide of sodium would be better from their not deliquescing etc. Phthisis 1st membranosa a thickening of the bronchial membrane caused by dust by dyspepsia neglected cold etc. 2d scrumous or tuberculous phthisis 3d apostematous phthisis Begins imperceptibly & at last an abscess is formed 4th another variety not mentioned in the books is the hemorrhagic phth. found in persons of hemorrhagic habit, begins with hem. this becomes more frequent etc. etc. finally hectic & phthisis 5th laryngeal phthisis an affection of the membrane of the larynx the lung perhaps not affected. The voice finally lost. Always (almost) fatal. It is connected with a strumous habit. It may begin in the fauces. Within a few years several cases have been cured by Brera & by Dr Woodw. of Verm. hydrid. & conium The difficulty is in curing by constitutional remedies. There would be little difficulty, if we could come at the parts & touch with nitrate sil. and corr. sub. Membranific hysteritis has been cured by iodine & conium Mesenteritis strumosa (enlargement) has been cured by it & conium Dysenteria chronica (so called) The cases were probably strumous ulcerations & thickening of the mucus memb. of the intestines very improperly called dysentery, which is never probably apyrectic Arthritis podagra in France externally (improperly?) & internally & with great success. Prof. T. would give it in ‘ teasp. doses of tinct. 5 or 6 times a day during’ the paroxysm but not continuing it long. No danger when the system is occupied with a powerful disease White swellings of various joints one of them is strumous infl. of the body of the bone another is a phlegmonoid inflam. of the cartilages & ligaments. Both have been cured by iodine, especially when applied externally It is surprising how soon the disease may be removed let it e administered in conjunction with conium internally & externally so as to be rubefacient & even vesicatory. Buchmenia indica or Barbadoes swelled [by] would probably be cured by iodine. Prof. T. has cured this repeatedly by arsenic internally & ointment of protoxide of mercury externally Careina vulgaris not sarcoma schirrhosum There are several distinct diseases called cancer which resemble each other in nothing but in terminating in aphagedenic ulcer. Dr Cogswell has cured several cases of unequivocal cancer in its earliest stages by ointment of iodine externally & conium & iron internally. There is no doubt that cancer may be absorbed without sloughing in the earliest stages In the first stages iodine cures the disease by resolution; in the advanced stages when it is too late for the knife, iodine cures by sloughing. Probably the disease is much less liable to return, after iodine Prof. Smith read 50 cases to Prof. T. & all returned in some part of the body Sarcoma medullare ([fungous] haematodes) The origin & progress of this disease is very curious. At first many small encysted tumors, filled with matter of the colour & consistence of honey finally becoming vascular afterwards resembling brain afterwards bursting out being obviously fungous haematodes, & destroying life by hemorrhage Case related of fungous of the testicle cured by iodine Sarcoma schirrhosum this is a much less formidable disease than carcinus vulgaris More easily cured by extirpation also, as well as by iodine. Carcinus vul. commences commonly about the areola the nipple will be draw in there will be a purckered appearance a livid colour etc. Sarcoma schirrhosum commences with a large ugly looking tumor, of the size perhaps of an orange Parapsis acris var. [pruritis] is called [illegible] (nothing visible to the eyes) Exomia pruritis has been cured by iodide of potassium The whole genus lepidosis (scaly) is benefitted by iodine 1st species [pytiocasis] dandruff & var. [illegible] capitis & versicolor one of them dandruff Topical applications are alone of consequence. Lepidosis lepriasis leprosy mild cases have been cured It seems to be considered incurable by authors, but their practice is milk & water treatment Lepidosis psoriasis a very formidable disease iodine with conium should be tried L. ichthyiasis iodine promises more than any other article Ecpyesis impetigo var. laminosa called salt rheum (other diseases also are called salt rheum) Various containers eruptions, when in an ulcerated & highly irritable state must first be brought to a bitter state before you can attempt the cure Ecpy impetigo var. herpetica lasts for years arsenic almost a specific it may be assisted by ointment of iodine Ecpyesis porrigo scald head & var. p. galatea is the worst. Prof. T. has used various articles he has applied tinct iod. by a camels hair pencil also ointment iod. instead of oint. iod. pot., for its greater strength Exostasis ostea & periostea In osteo-sarcoma for instance one of the var. we had better try iodine at the commencement of the disease. It is said to have been cured by it & by conium Case of a young physician The N.Y. & Phil. physicians despaired of him. Dr Todd put him upon conium enough to keep him under a very troublesome narcosis. Prof. T. considers it to have been probably a case of rheumatism Iodine is applicable to as great a range of diseases as mercury. It has been tried in hepatic mesenteric & uterine affections, with some benefit, & should be experimented upon farther It should be tried in lues more than it has. It has been tried with some benefit in epilepsy, chorea etc. [Bromine] resembles iodine but is weaker Chlorine a deobstruent also, not very strong Labarraque’s disinfecting liquid which should be called chloroxide of calcium useful occasionally for ill conditioned ulcers As to its disinfecting power there never has been brought up a shadow of proof. The story of a sewer being opened, & the work men being knocked down & after a quantity of disinfecting liquid. the atmosphere’s [being] pure, is easily explained by [irrespirable] gases, having time to disperse. A stinking sick room is rendered free from smell; in some cases. But stench does not produce disease It will not sweeten the air of a dissecting room There is no evidence that it will destroy the specific contagion of small pox, measles etc. Disinfecting can be effected only by soap & water & ventilations Whitewashers is but a poor substitute Painting is always better than whitewashing Vide [Caldwell] Fumigation & whitewashing on board of of [illegible] are [???pyrical] practices Vide Caldwell’s [illegible] of hospitals, injurious to eyes & lungs are empirical practices Vide Caldwell. Fumigation of hospitals is injurious to the eyes & lungs of the patients Nitric muriatic, nitro-cloric acids mild & weak deobstruents adapted to ill conditioned ulcers, secondary stages of syphilis etc. They have, like chlorine & iodine, weak tonic properties, just about enough to contraindicate them in entonic diseases They are useful in various dysthetic affections Chlorides of barium calcium & gold. Chloride of calcium is a valuable article in scrofula. All of these are weak deobstruents Chl. of barium is supposed to be stronger. No more poisonous than the former except that less is required at a dose. An excessive quantity will produce pain in stomach, tormina, & peculiar discharges. They are slightly diuretic Chloride of gold is stronger still Chloro-[aurate] of chloride of sodium is better than this Rubia tinctoria A pure deobstruent a valuable emmenagogue. Valuable in jaundice (Vide jaundice of Prof. F.) Dr I. gives 1 oz root to 2 pints of water dose 1 oz 2 or 3 times a day Better give as much as the stomach will bear without inconvenience Limosis dyspepsia where there is no great exhaustion. Icterus vulgaris The opponents of madder think it was prescribed merely to colour the feces. Prof. I. places it next after mercury in value Conium is preferable to either Chronic catarrh pneumonitis notha acute dysentery Marasmus atrophea var. infantum recommended. Others say that it has a tendency to produce atrophy Sertosis rachea, recommended by Haller. Ecphronia melancholia (monomania) Halusia hypochondrea by Boerhaave. Patamenia obstructionis & [illegible] & [suppr???] or obstruction and retention of menses Contradictory testimony upon this subject also. The madder of the dyers is not to be depended on. It should be gathered at a suitable time & kept fresh (not old & mouldy) for medical use Nat. order. Fumiariaceae 1st Fumaria officinalis the expressed juice. No doubt that it is adequate to the care of moderate cases oif jaundice & may be useful in dyspepsia 2nd Adlumia cerrhosus (Corydalis fungosa) Possesses considerable pungency i.e. the root in powder. If it is biennial the proper time to collect the root, is in the autumn of the first year. If perennial, wait til it is older Probably much superior to fum. off. 3d Corydalis bulbosa 4th Corydalis glauca is supposed to have the same properties in the top as the annual fum. off. The root is better 5th Dicytra cucullaria (Corydalis) Dutchman’s breeches. The root consists of tubers of the size & shape of an orange seed inclosed in a sheath. It is said to be quite active being narcotic anodyne soporific etc. It is well worthy of investigation & is a good subject for an experimental dissertation The [papa?? accal] [har??] active narcotic deobstruent powers & probably this article resembles them. The active narcotic power of such articles differ materially from that of opium & hyoscyamus. Saponaria officinalis A pure deobstruent perhaps not quite so powerful as madder. Often a useful auxiliary to mercury It has acquired considerable reputation in lues syphilis & syphilodes A good substitute for sarsaparilla Decoction [illegible] medium strength is 2 oz root in 4 pints water to be boiled to 2 pints the whole to be taken in 24 hours. It is prepared on the continent of Europe to leontodon The bruised roots with water make a lather, & are a substitute for soap Various other plants possess this property. Probably a union takes place of mucilage of alkali Scrophularia marilandica leaves & roots considerable popular reputation as an ointment & a cataplasm for piles 2 oz root or leaves in 2 pts water boiled to 1 pint the whole in 24 hours Scaly eruptions chronic pustular eruptions lues syphilodes jaundice scrofula dyspepsia protica marisce are the diseases for which it has a reputation. S. [modora] of Europe is used in scaly eruptions etc. Agrimonia eupatoria (naturalized) Inferior to the two last. A pure deobstruent It has the greatest analogy with leontodon taraxacum Dose 1 or 2 drams 3 or 4 times a day of extract Agr. odora is supposed to be more elegant. A. [suaveolens] is found among us [Aganthremen] crematum ([Diosma] crematum of Linneus) Bariosma crematum & [illegible] of [illegible] Adirandra of another. Diosma crematum & serratum ([Bookae, Buka, Buch??]) From Cape G, Hope Shrubs of moderate size are all the [diosmaceae]. The whole plant abounds with pellucid dots which yield a strong scented essential oil which is supposed to be the active principle. It seems to be a pure deobstruent distinguished only by its resolvent power It is a new article, now mentioned with [illegible] It is spoken of as valuable in [dyspep??] cystitis [arthritis] etc. Employed in infusion and tincture. Strength of decoction not mentioned We might try 2 oz. to 1 pt. boiling water Mr McDowel says this appears to be a very valuable article in dyspepsia, improving the appetite & colour of the skin proving slightly diuretic. It has been most celebrated in dystitis irritatis of infl. of the bladder. There is a very troublesome & irritable infl. of the bladder. There is a membranific infl. which is called by the same name. Physicians are apt to confound all diseases of the bladder under one loose term just as the common people are satisfied with the expression disease of the liver. Chronic rheumatism is a disease for which it has been recommended. But precisely what is meant by this is uncertain whether chronic rheumatism or chronic state of chronic rheumatism Lithia renalis cured by it, by affecting the stomach primarily Collinsonia Canadensis Ox-weed horse-weed archangel [illegible] [illegible]-weed, stone weed [illegible] [horseba???] Medicinal powers reside in the recent rhizoma. But it may be transplanted at any time of the year. Great discrepancy of opinion. The precise nature of its operative effects does not seem to be settled among those who employed But this is true of sarsaparilla leontodon etc. A moderate # deobstruent, particularly affecting the kidneys. It seems to belong to the class of aperients deobstruents. i.e. # moderate [urbites] are at present too much neglected those which promote the fluid secretions Dr I. thinks it resembles the tuberous species of [liatris] Dr Hooker thinks it resembles uva ursi & chemaphile corymbosa. Dose about an even tablespoonful of the rasped root. Used in veterinary medicine [illegible] is used. Decoction injures its properties. Infusion should be preferred The root is one of the hardest substances in the materia medica Limosis neuralgia very beneficial according to Dr Hooker Colica ileus but Dr Ives uses Indian meal & thinks this powdered root, likewise acts merely in a mechanical manner. David Miller of the Shakers thinks it useful in chronic rheumatism or rheumatalgia. Misplaced arthritic affection of the kidnies. It has a popular reputation in dropsy The best diuretic alone in dropsy according to Drs Beers & [illegible] Prof I thinks otherwise Paruria stillitia (strangury) all the varieties & the paruria of typhus [nervo??] A palliative in lithia renalis Aralia racemosa aperient deobstruent Aralia hispida dwarf elder etc. in a large dose it is emetic. It is said to be a Hydragogue cathartic probably it is not. It is the custom to ascribe purgative properties to every emetic, when given in doses short of the vomiting point. It is an efficient diuretic. Give as much as you can without vomiting & continue it until diuresis is produced. No doubt it is a deobstruent. It has not been experimented on sufficient to ascertain whether it is expectorant cholagogue etc. Not narcotic at all. Not known whether it leaves the stomach & bowels in a weak & irritable [continual] condition, like squills & senega, is not known. This is a very serious objection to these two last mentioned articles Contused root 2 oz. boiling water 1 pint & dose from 2 to 4 fl. oz. four to 8 times a day in 24 hours 4 oz to 1 pint alcohol tinct. ½ oz dose Proof spirit cincture seems to be better than alcoholic diseases 1st hydrops cellularis. Dr Reed of E. Windsor cured a case after failure with every other article Not stimulant not tonic Aralia odophylla of Cochin China is said to be highly effectual in dropsy A. scandens is said to have the same prop. Aralia spinosa (though it has no thorns but prickles) Formerly called angelica arborescens hence called angelica at present very improperly called prickly ash ([illegible]) Not indigenous in N. Engl. Languor lassitude, diminution of nat. frequency of pulse drowsiness prickly sensation even sleep. It is said sometimes to have produced genuine articaria It is emetic said to resemble ipecac It increases the biliar secretion undoubtedly cholagogue Dr McBride thought it the best of our native emetics Aralia racemosa is said to be useful in sequel of catarrh, in (pneumonitis ?) Simple idiopathic cough chronic dyspnoea lepidosis psoriasis & impetigo Veratrum album the root (the root is remarkable for being tunicated above & a solid bulb below) That found in our shops is always in powder & is worthless Carbonate of potassa & oxide of potassium which are mentioned among the proximate principles, are the products of combustion, for in this and in other cases, if the vegetable be rasped up & treated with suplhuric acid, no sulphate of potassa is produced It is called in the books merely emetic cathartic & local stimulant i.e. irritant. Veratrum album & strychnous nux vomica are acrid narcotics, not of that sort of narcotics which produce somnolency; they increase nervous strength of action. 1st deobstruent, independently of any evacuation 2nd acrid narcotic (it is a peculiar root of narcotic operation the articles are not necessarily acrids) 3 emetic 4 hydragogue cath. 5 epispastic 6 strumalatory (probably in consequence of its irritation 1st resolvent 2nd cholagogue 3 expectorant 4 diuretic 5 emmenagogue 6 sialagogue occasionally especially when applied to the mouth It does not appear to be diaphoretic except by resolving disease, or in poisonous doses by great exhaustion. Neither tonic or stimulant yet contraindicated in phlogistic diathesis, if for no other reason for this and it would do no good The dry root should not be used Formulae ½ oz to 2 oz. to 1 pt. of water infusion Decoction is thought to injure it. Most of the vegetable alkalies are decomposed at a boiling heat. The famous eau medicinale of [Husson] was probably a wine of the root of [illegible] 8 oz. recently dried root 2 ½ pts Spanish wine macerate for 8 or 10 days add 1 part of Sydenham’s vinum opii composition to 3 parts of this wine of veratrum From 1 to 3 fl. [illegible] about 4 times a day was the dose famous in gout & rheumatism Lobelia inflata therapeutic applications pneumonitis typhode Applicable to all the cases where squills are indicated not applicable where the stomach is very irritable. Arthritis acuta (sub acute rheumatism being without rheumatism, and is attended only occasionally with fever there is swelling and in the commencement the infl. is more or less metastastic Acute rheumatism is metastastic & has an acute fever accompanying it) Case of sub acute rheumatism cured in one night by tinct. lobelia & opium Arthritis rheumatalgia vide p. 37 not febrile no topical redness and swelling but with topical pain allied to neuralgia This disease has been cured by lobelia when other articles had failed Leucorrhoea communis has been sometimes cured and sometimes palliated by this article. N.B. This disease when of long standing cannot be cured all at once Recommended in hernia as a substitute for tobacco as an enema IT has not been tried very extensively in this way & should be further attended to [illegible] other species of lobelia appear to possess a similar assemblage of powers L. tapa of Peru is said to cause vomiting by its odour alone. L. syphilitica (S. flexa) has been praised & condemned by different persons Prof. Tully considers it as undoubtedly deobstruent emetic & hydragogue cathartic. It is expectorant (probably diaphoretic) (probably emmenagogue) diuretic? It has been considered a specific for syphilis much discussion has been excited Probably it will cure blenorrhea [illegible] Various deobstruents are now known to be capable of curing syphilis and probably this will. Prof. T. has tried it in pneumonitis typhodes & thought it equal (fully equal) to polygala senega L. cardenales has been reputed to have considerable medicinal powers it is doubtful whether it is worth retaining in the materia medica it has [sends] qualities of no great strength Actaea racemosa The general actaea and [cimicifuga] and also the macrotys of Rafinesque are now united by Decandolle under one genus actaea The worthy professor here treated us to a synopsis of the whole genus, because it is probable that all of them are [medicinal] Synonymas Actaea monagyna Cimicifuga serpentaria macrotrys serpentaria cin. racemosa macrotrys actaeidis Vulgar names black cohash the best. Various articles are called cohosh. Cornuticis herb crystoph. [darweed] rich weed etc. etc. Ninety plants have the name of snake root. Leontice thalectroides is called blue cohosh & is quite commonly sold for this article. The root of sanicula marylandica is often mistaken for it both being called black snake root. Actaea rubra and pachypode are likewise often mistaken for A. racemosa. No satisfactory analysis has been made. Decidedly and prowerfully narcotic. It is not worthy of reliance as anodyne or soporific though it is decidedly antirritant with respect to heat dryness of skin At least 4 oz. are necessary to saturate 1 pt alcohol sp. gr. .835. It is moderately nervine (probably) as Prof T. thinks he has seen it produce exhiliration and subdelirium in children It does undoubtedly possess the remarkable property of producing [fugitive] neuralgic pains in the extremities & in the sciatic nerve. Conium maculatum Contrary to the general rule, the plant is most active (not when the flowers a just opening) when the flowers are withering. Water is an improper menstruum Alcohol and ether only should be used The etherial tincture evaporated upon water, leaves as a rich green pellicle upon the surface of the water, which has the smell and medicinal virtues of conium Drying injures the plant Age destroys the virtues of this plant. Conium is a deobstruent & especially valuable as being also narcotic Dr March took in 5 hours 18 gr. 2 at first 4 at second 4 at third & 8 at 4th It was a recent extract. First sensations were pleasurable Secondly increased action of the stomach and duodenum pleasurable also Next vertigo unsteadiness in walking with a sensation of greater unsteadiness than really existed The pupil was natural in size but not affected by light nor darkness. Appetite good slept well at night. The next day in the afternoon he was affected with languor & headache which prevented his sleep that night. Next day he was perfectly well. 1831 & 2 Scleratum clavus, ergot parodynia as a substitute for the forceps and [vectis] which may be nearly or quite superseded by ergot. Dr Reed thinks that the forceps should always have the preference in the hand of a skilful hand on account of the danger to the life of the child Parodynia secundaria hourglass contraction of the uterus (which Dr Tully has seen in consultation though its existence is denied by some) The clavus will restore the natural contraction Parodynia secundaria var. retentiva retention of the placenta a perfect substitute for the introduction of the hand of the accouchment. In both cases the use of clavus is condemned upon theoretical views by writers in the procedures. Parodynia secundaria variety haemorrhagea Int his variety the clavus should be given as a preventive. Dr Reed however cautions against its use before the delivery of the head of the child on account of the danger to the life of the child Parodynia [secundi] dolorosa after pains Par. secu. ar. lochialis whenever there is atony of the uterus. Some suppose that it will not act after the delivery of the child but Tully has never known it to fail of expelling it into the vagina & further expulsion cannot be accomplished by the efforts of the uterus. Very little more is given in the books than was first promulgated by Dr Stearns. this article is applicable to a far greater variety of cases. Where hemorrhage at full time endangering abortion occurs we need not wait for pains to come on but give clavus without delay Dr Stearns does not generally give it without [previous] depletion this is not correct. Dr Stearns does not give it when nature is likely to succeed It had better be given in many cases to save pain and suffering Always using belladonna if necessary to produce relaxation He gives it as a rule not to used it except when the os tunica is dilated to the size of a dollar pay no regard to such a rule No regard should be paid to the opinion of epidemics being caused by this This article is supposed to have been used in Holland in 1747 it was used before Dr Stearns’ publication in Pennsylvania by a practitioner in N. London County Conn Dr Stearns heard of its success in the hands of some Scotch women. It is said to have been used in France & to have been prohibited about 1770. Schlerotium maydis is said to produce baldness in men and in swine, and in the latter as well as in mules producing a [paraple] gin. Hens are said to lay eggs without shells owing to premature delivery So too dogs, monkeys etc. are intoxicated by its narcotic properties These things are in L.A. various other species of sclerotium have probably the same powers And various purge; among others [lycoperda] bovista 1831 & 2 Opium is the descending sap of the Papaver somniferum, [illegible] in the sun Hippocrates apparently knew nothing of it. It was known in Homer’s time under the name of nepenth & was used then and afterwards at Thebes & was used as it is now in the east, as a kind of luxury. Extracted either by incision or by cutting off successively the top of the plant. The proximate principle is in [bicodati] of morphin (or by an absurd change of names, bi-mezorati of morphin) Meconic acid was first discovered and the proximate principle was then called bi-meconyti of morphin Afterwards codii acid was discovered to be the acid & afterwards it was called meconia & the meconia was called [codic]!! Just as Samarch [illegible] interchanged the names conium & cicuta The next proximate principle is narcotina or narcotin Some analysts describe a bitter extractive principle its existence is now doubtful This article is one of those capable of producing its effects in health and in disease. single pill doses produce costiveness, yet it acts upon the liver in creasing its secretion probably from this cause it is that the habitual use of opium does not produce constipation Opium undoubtedly counteracts the intoxicating effect of alcohol. So also alcohol counteracts the ultimate narcosis of opium Indeed both these articles are counteracted as to their ultimate narcosis by prussic acid Gelseminum and other pure narcotics Opium morphine The acetate of morphine & the most active The codate or meconate (N.B. This is the acid with which it is combined in the papaver ammonia is incompatible Nitric acid decomposes it so far as to produce an article of a different composition and if this is the case [illegible] [illegible] is incompatible with it. Tully says he has seen no great difference between the acetate and sulphate. One reason given for the super irrit of the acetate is its greater solubility. This by no good reason The next principle in opium & narcotine Bimaconate of sodium is another principle Extractive matter is another (i.e. something soluble in water and alcohol) A resinous principle (i.e. something soluble in alcohol & not in water Limine fecula essential oil etc. etc. Vegeto-animal matter (modified glutine) cautchouk etc. These are of no medicinal activity but may decompose other articles a grain or two on a healthy person produces a calm placid or pleasurable sensation wakefulness increase of force or fullness of pulse last from 8 to [illegible] hours in the latter part of the time some [illegible] next day languor want of appetite etc. etc. IN fuller doses nausea epigastricum easiness etc. It diminishes the biliary secretion hence producing costiveness [illegible] lecture upon morphine the French theory of its producing the pleasant without the unpleasant effects is entirely false Narcotine. Tully has never employed it morphine he is familiar with & has been so for years Great confusion and contradiction upon the subject of narcotic Magendie calls it stimulant Orfila narcotine & Bally says it has no powers whatever Most probably its effects are similar to those of morphine. But the subject wants investigation 2nd stimulant 1st nervine 3 narcotic 4 diaphoretic 5 cholagogue These are the effects of opium & of morphine It is a direct anodyne & a [illegible] & the most powerful soporific The other narcotics do not appear to be very directly soporific Sedative is a term applied to a group of effects If we desire the sedative without the stimulating effects we must give a single full dose So also of wine and alcohol One of the most powerful and useful effects is that of being a mere counteragent of disease Narcotica Diminish irritability & irritation sensibility & sensation in a non phlogistic diathesis also frequently somnolency In large doses stiff [illegible] cloud before the sight coma convulsions & death Epigastric uneasiness nausea Many suppose that they are all stimulant and nervine at their first operation this not true the notion prevails that sedative & stimulant affects are in competition very false Pure narcotics [cyan????] hydrocyanic acid lauro cerasus gelseminum nitidium daturae spigelia etc. helonia [erythro??] [illegible] doses produce what Brown called indirect debility which however 17 the long continued use of a narcotic diminish the susceptibility to itself but not to other agents Opium does not injure the health Tobacco & tea have been too much abused Alcohol the only one [which] produces visceral diseases E. [D.] North 18 1 Narcotica samplicia as hydrocyanic acid datura heloni hyoscyamus belladonna gelseminium poisonous mushrooms seem to be pure narcotics 2nd Stimulatia alcohol wine [opium] lactuca of several species These are the most important of the class narcotics To obtain their stimulant & antirritant effects in conjunction they must be given in regular & small doses etc. In large doses they are used to obviate a particular spasm etc. The former use was well understood by Cullen & his companions but not well understood at present The state of the mind affects very powerfully the operation case of a young man at dinner parties & of an auctioneer who had taken a dangerous dose of laudanum [Opium] more important than any other [article] of the materia medica Purging has done the most mischief Bleeding next the refrigerants next antimony & mercury next Deobstruent narcotics lobelia actaea digitalis nux vomica perhaps [aethusa] & cicuta etc. “Evacuating or generally cathartic sometimes emetic tobacco cocculus The long continued & habitual use of the nervine & stimulant diuretics (perhaps all) produces a certain uneasiness consequent upon their abstraction this peculiar to narcotics limosis syncoptica of Good Limosis syncoptica or epigastric sinking (when idiopathic) generally the sinking comes on about 9 o clock It attends hypochondriasis. Typhus syncopalis syncope The dying Seems to be found in a slight degree in intermittents when they first come on It being difficult to describe it is frequently considered as imaginary Resembles the sense of inanition which comes on when the sense of hunger has subsided after a meal missed at the customary hour Entirely different from the burning sensation of yellow fever Par vagum & the great sympathetic to which belongs the great semilunar ganglion’ In dyspepsia the par vagum seems to be affected In limosis syncoptica & T. sync. it is in the semilunar ganglion & is called sinking So it seems to be [illegible] cases of poisoning [from] mushrooms & snakes In L. sync. & even in limosis the digestion may be good Treatment first to relieve the paroxysm & second to obviate the censes Employ one narcotic to counteract another just as one disease (e.g. measles & small pox) is incompatible with another Give opium & camphor supporting them with stimulants & tonics. Concealing the fact of his giving opium gradually abstracting the opium continuing it for at least a year The tonics are utterly inadequate That produced by opium of less consequence & best cured by gradually obstructing the opium Tobacco conquerable by the will chambers medicine futile even when capsicum was mixed with 10 materia medica 1 Pulse 2 Congestion 4 Diathesis Congestion a 8 Type 10 Acute chronic etc. 11 Classification 13 Porx. principle 16 Narcotica 18 Narcotica simplicia Narcotics Astringents 1 Deobstruents 4 Diuretics 12 Diaphoretics 15 Errhines 17 Sialagogues 18 Emetics 19 Cathartics 22 Epispastics 30 Antidotes 32 Antacids 35 Mich. rem viz Irrit. & Dem. 36 Antilithics 38 Bloodletting 40 Cantharis 56 Capsicum 61 Monard. punct. 65 Hydric ether 66 Wine 67 Alcohol 71 Nitrate pot. 72 Carb. pot.. 78 Bicarb pot. 80 Veg. ac. 87 Acetic acid 87 Hydroc. ac. 82 Gelsem. nitid. 83 Helon. erythos. 85 Con. mac. 89 Cicuta mac. 90 Digitalis purp. 90 Lobelia iunfl. 94 Actaea rac. 96 Languin. can. 49 Aralia spin. 51 Baptisia tinct 52 Veratrum vir. 53 Andeira [iner???] 55 Opium 99 Astringents They produce a moderate vital contraction & condensation of the living fibre while at the same time they moderately decrease absorption & diminish morbid secretion Prof. Ives thinks they likewise diminish irritability The contraction is not [illegible] but vital As a class they are intermediate between the tonics & deobstruents partaking somewhat of the properties of each The vegetable astringents owe their astringency to tannin Properties of tannin etc. Because tannin forms leather with animal albumen it is incompatible with animal jellies as an article of diet Vegetable astringents inefficient in diarrhoea & dysentery not because of phlogistic diathesis but because of the morbid condition of the mucous membrane of the intestines they are useful after that has ceased and this discharge continues as a sort of habit. These remarks however apply only to the vegetable astringent for acetate of lead is as useful as calomel even in the early stages The mineral astringents do not depend upon any one proximate principle & hence they differ from each other in their operation. Vegetable astringents chesnut, the raspings of the wild [illegible] [illegible] [illegible] extract Quercus alba & tinctoria the inner bark Cocoluba vivifera of the sea side of Florida & [illegible] [terantosa] the leaves Geranium maculation the root [Heirchera] americana [italica] Carolina Geum uvale this more tonic than the others saxifraga pennsylvanica parnassis [ameril] Polygalam virginicum caenothus americanum tubus vellosus & vivialis napthar advena & [hymplicea] dorata these have a [nauseous] principle & a good deal of mucilage epiphagus virgiana this not nauseous as [Bart??] says All of these the root These native astringents are abundantly sufficient of our own wants. Foreign astringents found in the shops Green tea valuable when a narcotic power also wanted Mineral astringents acetate of lead etc. Sulph cop. alum Diseases Chronic coryza cough consumption (secondary stages etc. etc. Useful also externally atonic paristhmitis is inflammation of the fauces Spongy ulcers polypus [piles] of some sorts etc. Toothache is relieved by an intense astringent This remedy has been patented by a Hartford man Deobstruents produce a change of condition & action in the whole or part of absorbent & secernant system relieving affections of the liver increasing the secretion of this organ relieving various affections of the skin & produces [asolutions] of inflammations of muscles When they are given for some time in health they generally increase the secretions In disease they change as well as increase They produce less effect upon the brain than upon any other viscus The old definition is that they remove visceral obstructions the term obstruction is applied to indolent inflammations parabismata etc. of the viscera Tully revives this class. To what properties does mercury owe its anti syphilitic power? not in cathartic sialagogue etc. It is not stimulant or tonic, for it does not increase strength of arterial action or digestion & muscular strength. Mercury is a stimulant if we apply this term to any remedy which produces a powerful impression upon the system but this is too loose an application of the term A deobstruent effect may be indicated at the same time with a stimulant or other effect, as with a refrigerant effect but stimulant & refrigerant effects cannot both be indicated at the same time why then use the term stimulant with respect to the deobstruent effect. It is of no use to call mercury anti syphilitic antipsoraic etc. The United States abound in deobstruents & many of the properties of some of them are not generally known E.g. The salivation of mercury has been considered very strange It is however a part of its deobstruent effects which is more obvious & which exists also in a higher degree in tis than in some others of this class Expectorant emmenagogue sialogogue effects etc. may be either direct or indirect direct when not the [illegible] of a deobstruent agent in direct when a part of a general deobstruent effect upon the whole or nearly the whole secerunt & absorbent system For they do not all act upon every part of these systems A deobstruent effect may also be indirect e.g. the act of purging is a deobstruent operation while it lasts The deobstruent effect is frequently the only useful one e.g. colchicum Iris etc. which cannot be usefully employed as emetics & cathartics. This seems to be a sort of experimentum crusis with reference to the propriety of retaining this class Further in the modern systems there is no place for the pure deobstruents e.g. leontodon taraxacum which is put down among the diuretics & cathartics for neither of which effects will it answer And this has probably contributed to bring it into disease. So of other articles The deobstruents although not weakening still reduce the strength of the system in general if continued for a great length of time, especially if the deobstruent effect is combined with one of evacuation None of them however have direct refrigerant powers & none have sufficient stimulant powers to supersede the necessity of combining a stimulant in cases of great atony The system is frequently to be prepared for a deobstruent operation by being previously stimulated or reduced. Rheumatism generally requires one or other of these preparations, but still neither reduction or stimulation will ever cure these diseases. Dysentery is cured as effectually by Iris versicolor & other vegetable deobstruents as by calomel though requiring to be accompanied by opium. Still calomel applies to a greater variety of cases No deobstruents produce stimulation precisely but rather a tonic effect & none directly produce a refrigerant effect, they do this rather through their evacuating powers That a remedy be referred to the class of deobstruent, the only quality which it is indispensable that it should possess is a resolvent one Probably all the deobstruent cathartics are hydragogue. A resolvent power is that of dispersing & curing a topical inflammation without a necessary evacuation. an antipsoraic operation is that of curing a cutaneous disease by an internal remedy Discutient applies to curing an inflammation by a topical application Cholagogue applies to the increased & secretion & evacuation of bile These operations are the foundations of no classes The most common & best known deobstruents are the species of smilax including the rotundifolia & another if our species Comptonia asfil. & myrica galea Compt. destroys fish. Aralia racemosa & [rudicaulis] the root asclepias tuberosa & incarnata. Arctium lappa & another diervilla danadensis celastrus secundus Perhaps also the Collinsonia canadensis solanum nigrum & dulcamara but these too are narcotic Diseases rheumatism [strum??] dyspepsia syphilis yaws various cutaneous diseases Other plants doebstruents are myrica cerifera 3 species of anemone A. virg. etc. ranunculus acris bulbosa & scleratus All the species of trillium alisma plantago dirca palustris conium maculatum is a deobstruent narcotic cicuta maculatum & bulbifera also as well as argemoni mexicana In this vicinity have been used the different species of lettuce (not the exuded & inspissated sap but the inspissated juice & decoction) aconitum napellus strychnos nux vomica angostura bark etc. are acrid narcotics deobstruents rhododendron maximum (Litchfield county) kalmia latifolia Another set is astringent & moderately tonic viz uva ursi chimaphila as syrola 2 species ledum 2 sp. aletus farinose & aurea andromeda calygulata helmias droica The uses e.g. guaiacum oil of juniper several species oil & resin of copaifera off. ol. pinus australis sylvestris strobas etc. abies canadensis & [illegible] mifera These if pushed evacuate Aralia hispida (dwarf elder) diuretic & emetic Erythmium americanum & album these vomit Another set may be diuretic emmenagogue cathartic emetic etc. [Polygala] senega Hellebore Gratiola off. iris versicolas scilla mautima polygala pubescens eryngium aquaticum (properly yuccifolium) lebelia syphilitica These are said to be cathartic Sanguinaria belongs here but is not Colchicum autmnalis aralia spinosa (southern states) [Phyto???] candacendria delphinum consolidum etc. baptisia tinctoria (perhaps) styllingine sylvatica apocynum cannabinum & pubescens anderria inernis (cabbage bark) These are similar to the last class possessing a still greater assemblage of properties? Diuretics increase the urinary discharge Paris’s classification visionary in which he supposes some of them to act in substance upon the urinary organs Nitrate of potassa Tully denies to be a diuretic Diuretics are direct or (as being also general deobstruents) indirect They are also pure. The pure are not always the most powerful e.g. chrysanthemum leucanthemum Roots of opium petroselinum eupatorium purpureum & verticillatum collinsonia canadensis Refrigerant diuretics e.g. nitric ether bitartrate of potassa & acetate of potassa narcotic diuretics e.g. expressed juice of various species of lactuea. The [illegible] if taken very strong Stimulant diuretics e.g. several species of cantharis [illegible] mellifica several of the essential oils as those of the gaulthena [procumb???] & engeron canad. The most important are the deobstruent diuretics gratiola off. scylla maritima polygala senega & pubescens iris versic. & prismatica the several species of elder eryuquim mucifolium sambucus pubescens (red berried or mountain elder) The most efficient & certain single article is asclepias syriaca aralia hispida called dwarf elder. This unlike the rest never proves cathartic erythronium lanceola commonly macerated in ciders Seeds & roots of aretum lappa All these are expectorant emm. [illegible] & antipsoraic & if pushed are emetic & cathartic Next group are the resins & terebinthinate oils these are expectorant resolvent etc. Abies balsamifera the most elegant cpoaifera juniperus pinus australis etc. sang. europaea etc. abies canadend the oil Another set are astringent & perhaps tonic arbutus uva ursi another set is also narcotic e.g. nicotiana tabacum & digitalis purpura Another set are not emetic & cathartic Actaea racemosa cimicifuga this last said to more active rubra & pachypoda inferior Demulcent diuretics mucilages Three conditions of the system in which the diuretics are to be employed viz morbid irritability with atony without atony & In case of great distention diuretics will not operate until the water has been diminished by elaterium a hydrogogue cathartic & some such manner The diuretics however will not cure the disease Tully and his friends have not found diuretics more uncertain than other classes of remedies always succeeding by management combination of several articles or some such way Not always however curing this disease Case of officinal alcohol curing Diaphoretics restore or increase the perspiration It is commonly said that they are all stimulants the argument is that increased secretion implies increased action this fallacious e.g. the sweats of the dying because the weakened vessels may not be able to resist the vis a tergo In high entony refrigerants produce diaphoresis & in great atony stimulants 52 Alcohol continued. The fact that it has not always been used proves no more than that of cinchonas having been formerly unknown Alcohol continued from p. 52 Alcohol is best adapted to the nervous & wine to the putrid type of fevers The old practice of giving bark in wine, in intermittents was a good one now superseded by sol sulph of quinine All the cases of typhus All cases where there is great and extensive suppuration Collections of matter the liver thorax, & even in the female breast though opium possesses the greatest power Hectic, in one of the diseases Anthrax, where the system is considered affected Erythema oedematum gangrenosum anatomicum etc. Parismitis Malignant small pox measles scarlet fever (rosalia) Various cases of inflammation of the viscera Membranific inflammation (croup for instance in many cases N.B. in many of these diseases the wine or alcohol do not supersede the deobstruents etc. Genuine acute febrile dysentery according the nature of the constitutional febrile affection which may be synochus or putrid typhus etc. Marasmus tabes, sand scurvy # The different sorts of gangrene Certain sorts and stages of mental derangement, more especially wine Tetanus some consider them as specific falsely however. In Mass. this disease has been cured by alcohol & liquor of the arsenate of potassa, the latter in large quantities Lyssa canina a similar dispute Chorea according to the condition of the system # this is as much severer disease than sea scurvy which only require the milder astringent & tonics Bites and stings The practice is old and perfectly well established. Galen & Celsus quoted. The maderia medica of Hindoostan makes wine perfectly efficacious Case in the American medical Recorder in which at least 2 quarts of spirit & capsicum were retained in the stomach in the course of one night. The efficacy of spirit in the case of the most venemous serpents is perfectly well known in the tropical reg Instances are many of persons in a state of intoxication being bitten with impunity The excision is generally performed in cases which would not have been dangerous in any case, from the fact of the surgeon in the country being generally at a distance. Confined snake do not [illegible] a mortal bite. The next article to alcohol is opium the next is ammonia. The moderate cases may be relieved by any strong impression hence the reputation of various popular remedies External application of alcohol Dr Ives employs a mixture of alcohol & oil of origanum in burns and scales The vapours of burning alcohol is very usefully employed, by raising the bedclothes, supporting them [illegible] & introducing the vapour through a tin tube Useful in cholica etc. etc. & in that form of dyspepsia which is attended with gastrodynia Errhines excite sneezing by direct application the discharge is sometimes serous when secretion is promoted sometimes more purulent. Useful mainly as counter irritants sometimes the act of sneezing seems to be useful Disease Ophthalmia Cephalitis Deafness neuralgia auris & facies apoplexy etc. Some cases only of the above Snuff taking very injurious producing finally limosis syncoptica also thirst etc. Tobacco is the worst because narcotic Errhines are powdered white sugar the powdered root of the species of iris spirit of [?esculus] dried & pulverized flowers of helenum antimonali Veratrum album and viride Case of an apothecary who sneezed 30 times Euphorbia off. sanguinaria turpeth mineral calomel sialagogues promote salivation by topical application hence mercury is excluded for its salivation is not useful of itself Disease aphonia when idiopathic & symptomatic rheumatic pains of teeth gums Chewing tobacco wastes saliva exhum the strength producing anorexia limosis Drunkards begin with tobacco. Prevents costiveness however sial. antemis pyrethrum myrica cerifera asarum europeum & canadense horseradish zingiber cardamon seed Emetics produce vomiting independent of taste odour or quantity Effects of vomiting & nausea The act of vomiting is probably more or less deobstruent in all cases All emetics given in less than nauseating doses except tartrate of ant. are tonic? 4 purposes 1st to give a shock & break up 2nd to increase susceptibility & prepare 3d to excite the absorbents & create a resolution of inflammations etc. 4 to remove poisonous or offending matter from stomach 5 groups of emetic 1st simple vegetable emetics which produce no other effect e.g. ipecacuanha dorstenia braziliensis A species of asclepias viola [parsiflora] & another The two species of gillenia the best indigenous substitutes for ipecac. Two species of euphorbia These are indicated to remove poison to relieve the stomach of offending matter [illegible] vegetable deobstruent emetics useful where both emesis & deobstruent are both wanted Sanguinaria apocynum cannabinum aralia spinosa polygala senega not best however to use this as an emetic. It leaves the stomach & bowels in a deranged state syclla [matutima] or ornithogalum squilla Lobelia inflata styllingia sylvatica Perhaps also ranunculus flammula the distilled water no taste no nausea acting instantaneously after 5 or 10 min. Sinapis alba & nigra Deobstruent vegetable emetics are proper where strong counteraction at the commencement of diseases as croup etc. 3d Refrigerant mineral emetics tartrate of antimony & potassa James powd consisting of protox. of ant. & lime These emetics given at the commencement of typhous fever bring it on 4th Tonic mineral emetics sulphate of zinc bipersulphate of copper or blue vitriol ammoniuret of copper per acetate of copper or verdigri Limosis dispepsia etc. 5 Deobstruent mineral emetics The best is dipersulphate of mercury or turpeth mineral Cathartics increase or create evacuation from the intestines Murrays arguments about the stimulant operation upon the intestines too loose The peristaltic motion of the intestines essential to life kept up by the bile perhaps also the pancreatic juice & the mucous fluid of the intestines Evacuations promoted by checking perspiration application of cold water to the legs friction etc. Dr. Ives thinks the stimulus of distention of the bowels is very important Cathartics of more universal use than any other class 5 purposes 1st reducing 3nd sudden shock for breaking up diseases neither entonic nor atonic 3d increase susceptibility & equalize excitement in diseases neither at. nor entonic 4 remove fluids as in dropsy 5 to remove poisonous or offending 5 things to be had in view in selecting a cathartic 1st degree 2nd quality of evacuation 3d what other operation 4 the part of the alvine canal operate 5 1st as to degree 1st eccoprotic e.g. syrup of sugar manna subacid fruits 2nd laxative merely increase peristal act sufficient to evacuate the canal carbonate of magnesia ol. juniperus communis 3d purgative which also occasion an increase & discharge of not secretion septandra virginica triostium perf jalapa podophyllum petalum 4 drastica gamboge elaterium croton tiglium These produce copious & continued discharges & invert the action The stronger may be so managed as to operate like the weaker As to quality of discharge cathartics are 1st kopragoga producing fecal discharges e.g. castor oil rhubarb 2 cholagoga or bilious e.g. calomel 3d hydragogue or watery discharges the most perfect is elaterium Others are croton tiglium the refrigerant salts As to other influences 1st nervina allay morbid irritability etc. Cocculus & spec. though cathartic [these] exhilirate Carthagena bean (foederea) None have these two powers simply 2nd narcotica producing prostration etc. Cocculus comes here also Tobacco etc. refrigerantia diminish strength of act Sulphates of potassa magnesia soda & ammonia also the bisulphates the sulphates the hyposulphates Sulphates of lime Phosphates of all these Phosphites hypophosphite etc. Tartrates bitartratis etc. Also the compounds with two bases These act on the exhalents of the intestines These salts are apt to produce flatulency which the other hydragogue cathartics do not bring on These cathartics are commonly supposed to be mild cathartics yet they are bad in old dyspeptic subjects etc. 4th tonic cathartics federaea carthagena carthagena bean nicker nut? polygala [polyga???] aloes 5. astringent. E. g. rheumatism Indigenous species of rumex Ven alum purges & sometimes [illegible] useful in this way 6 deobstruentia Preparations of mercury the most common baptisia iris phytolacca etc. 7 emetica gamboge [triosteum] perfoliatum etc. 8th diuretic when given moderately elaterium tobacco asclepias syriaca 9th diaphoretic eupatorium perfoliatum & rotundifolia asclepias syriaca & tuberosa 10 Emmenagogue aloes convallaria majalis polygala polygama etc. As to part of canal on which they operate 1st stomach & intestines mercurials gamboge triosteum perfoliatum 2nd Colon lepandra jalapa senna etc. 3d Rectum aloes polygala polygama convallaria majalis Another point is the tonic Some are slow as mercurials aloes convallaria & polygama Others are intermediate as jalapa convolvulus juglans cinerca senna most speedy is croton frequently ½ hour Oil of seeds of euphorbia lanthyris & other of about the same qualities Castor oil is quick gamboge also elaterium The refrigerant salts especially when combined with tartrate of antimony as is done in Philadelphia Cathartics frequently break up diseases but generally are more auxiliaries The refrigerant & drastic cathartics however do not break up always Cathartics continued Never proper in dysentery. In low typhous patients may go 5 to 14 days without an evacuation & when it took place it will be of a natural appearance Much abused in this country in cutaneous diseases under the absurd notion of purifying the blood. Not abused on the continent of Europe as in G Brit. & this country The universal tampering with salts & calomel an exceeding evil. So also Flocking to Cheltenham & Saratoga So says MacCulloch. The same of the family medicine chest. The beneficial effects of travelling & the evils of nervous diseases referrable to the same source (McCulloch) Case of a lady of strong constitution who had taken salts & calomel every day since 8 years of age was nervous etc. McCull. Sir W. Scott understands the subject alludes to it in the legend of [Montrose] Physicians are remarkable for not associating with & enquiring after the practice of these different opinions All science properly so called depends upon the detection and classification of differences Epispastics by topical application produce either local inflammation or vesication or destruction of vitality Purposes 1st (acc. to Duncan) to increase the activity of the system in general by initiation then to be kept on some time applied to the extremities 2nd to increase the activity of a particular organ as the liver in jaundice one large plaster over the liver 3d to diminish the activity of a particular organ by counterirritation as in pneumonitis Contraindic in high entony or low atony Dispute whether they should be applied in local affections in the vicinity of or remote from the place Some say idyosyncrasy prevents or obstructs their employment. Tully thinks this is merely greater susceptibility & therefore requires smaller plasters. It is frequently advisable to convert the serous discharge into a purulent one by an irritating plaster or by the constant presence of a [illegible] body as orange peel Question whether issues or successions of blisters are best. This depends upon the disease e.g. hip disease diseases of the spine etc. require issues. The spine is the best situation for most cases of nervous diseases paraplegia various chronic affections of the bladder chronic cephalia [or] headache etc. Children must have them much smaller on account of their greater irritability Alexipharmics antidota etc. counteracting the operations of poisons With respect to toxicology Poisoning is the noxious effect of an ill timed or excessive quantity of an agent or otherwise improper use The Greeks had but one word [illegible] for both medicines and poisons. Pliny says every virus has a virtue. Every poison is a medicine It is not however true that in the present state of the science every poison has actually been made use of or is thoroughly understood Poisoning consists of irritation disorganization stupefaction exhaustion or some combination of these. The deleterious effects of poisons are the same with certain specific diseases. Inflammation of every kind colic paralysis coma apoplexy ptyalism (as of mercury) simple exhaustion marasmus in all 12 No one agent can always have the same effect hence there can be no specific remedy for any one poison If not too late the first indication is to remove the poison from the stomach Tully thinks experiments upon animals by injection into the blood are good for nothing Absurd also is the tying the duodenum and oesophagus Tully thinks toxicology as pursued by Orfila and his imitators as merely a mass of empiricism founded upon the doctrine of specific poisons and remedies Absurd notion of Orfila American editor that savages understand poisoning better than scientific physicians. Poisoning has always been confined to times of ignorance & has fled before the march of science which divests them of their obscure dreadfulness Orfila’s experiments unjustifiable Pure narcotic effects are the first and most simple poisonous effects 2nd acrid narcotics 3d irritating poisons 4 compound poisons Acrid narcotic poisons produce convulsions of a peculiar character tetanic spasms & neuralgic pain mineral vegetable & animal poisons 1st hydrocyanic acid laurel water gelseminum helonias erythrosperma & mist of the 2nd Strychnos nux vomica 3 Oil of tansy [illegible] camphor ol. nutmeg Cicuta maculata & the fungi produce colic Arsenous acid ranunculus phosphorus menchinal capsicum produce irritation Antacids combine with acid and neutralize free acids in the al. can. Ammonia calcia magnesia soda & their carbonates are the only ones Potassa soda and ammonia form lactates with the natural lactic acid of the stomach which are refrigerant Various other acids are found in the morbid states of the stomach as the phosphoric in inveterate and protracted cases of dyspepsia not formed by fermentation which Tully thinks never goes on in the stomach Antacids if ever necessary are merely palliatives because they will not remove the causes of the affection. Dyspepsia appears to be the only disease in which they are employed Mechanical remedies 1st irritants 2nd demulcents Irritants maybe vital or epispastics, or they may be of 3 classes 1st exercise of all sorts which are remedial processes 2nd dermatic as [?uction] percussion acupunctura or shampooing 3d alvine cow itch metallic [tin] filings of iron powdered glass & powdered porcelain charcoal partly Travelling diminishes morbid corporeal sensibility on account of exposure to air etc. increases the assimilation diminishes fecal discharges. Hence the constipation of travellers things inedible in health are harmless great activity of the absorbent system hence reduces obesity & hardens the muscles active exercise quickens the pulse & passive renders it slower hence the latter in some diseases of the heart combining it after a while with active change of air improves the blood changes even to a bad air are frequently useful just as the stomach thrives best on a variety of food Hence also as well as from exercise the ruddy complexion of stage coach drivers Shampooing almost peculiar to the Chinese description of it from Clark Abel Most of the alvine irritants are of doubtful utility Employed from the notion that digestion was caused by trituration & that worms were to be levigated A quack of Connecticut has employed powdered glass gentian & ginger which was certainly more useful in dyspepsia than the same remedy without the glass [illegible] opium aloes spices testicles of a boar & powdered porcelain in colic by a Connecticut family of quacks Good evidence for the utility of powdered glass as an anthelmintic. Anthlithics or lithontriptics A long dissertation upon urine uric acid. Lithis of the different kinds & the [illegible] different kinds of calculus Lithis urinalis has two varieties one with calculi in the kidneys & the other with gravel in them. The former impossible to discriminate by certain diagnosis. Hence a great part of the cases of gravel are fallacious & the experience upon this subject frequently false Antilithica prophylactica & lithontriptica It is the received opinion that the avoidance of animal food & perhaps also of fermented liquors prevents the uric acid diathesis which is the cause of the greatest number of calculi Another circumstance according to Paris’s theory will be the keeping up a natural and healthy action of the skin For the uric acid calculus lime water magnesia (given in soap are upon chemical principles the appropriate lithontriptics for the uric acid calculus No solvent is known for the mulberry calculus The acids which decompose it would form insoluble compounds in the bladder N.B. oxide of magnesia & soap are useful in many gouty cases where there are no calculi. Hence their chemical operation is doubtful The antilithic and lithontriptic modes of treating lithia are obvious [illegible] except in lithia renalis where however it is merely a palliative not reaching the cause of the disease. Better employ tonics opium (in the paroxysm Deobstruents however are the remedies Bloodletting (I was absent) The spring lancet on several accounts is preferable to the thumb lancet 6 distinct purposes of bloodletting 1st as a mere antiphlogistic measure 2nd to make a sudden & strong impression in non phlogistic diseases to produce a resolution 3d to equalize excitement increase susceptibility & prepare for other remedies 4th to divert a haemorrhage from some parts as a substitute for a habitual [illegible] 5th to produce faintness [illegible] in surgical operations 6th to promote absorption in paribismata & emphysemata Bloodletting is always indicated in phlogistic cases no matter what the age sex climate The quantity of blood abstracted should always depend upon the vital energies Strength (not hardness) indicates venesection Strength resists pressure. Hardness is wiry both in the systole & diastole & may be conjoined with weakness. Authors when they speak of hardness alone commonly mean strength The coriaceous or buffy coat upon the blood may depend upon phlogistic diathesis or may depend upon the slowness with which the blood is drawn or the depth of the vessel into which it is received or the particular disease Abundance of medical testimony on this subject Firmness of coagulum & concavity of surface better indicating especially when joined with a buffy coat. We must not mistake the rigidity of the coat of the arteries of elderly people & those who labour much in the open air for genuine strength of action. All diseases are not either phlogistic or antiphlogistic but if the former bloodletting is the remedy known If carried too far it causes a subsequent dropsy etc. General depletion does not benefit a merely local topical inflammation There are cases also of atonic inflammation The essence of inflammation a John Hunter says consists not in the quantity but the quality of action No one has ever opposed bleeding in phlogistic diathesis. Though it has been often asserted; as of Dr Danforth of Boston & Dr Tully falsely however. The diathesis of New England changed about 1805 Many believe and teach that in entonic cases we should aim at the production of faintness or syncope by the manner of abstracting blood Not so however except in surgical cases Sincope should be avoided by placing the patient in a recumbent posture A pint or pint & a half as was directed by Cullen will generally be sufficient if properly supported by refrigerants, subacid fruits cool air etc. With regard to bleeding after casualties. A New England physician of very extensive practice says he has seen more cases of death after a casualty produced by bleeding than by the casualty itself Latham quoted to the same extent Alcohol continued It has been and is now denied that this article ever increases vital energies, or gives new strength, but it [was] affirmed that it merely acts like the spur upon the horse. If this were true it would never be proper to use it in atonic disease, and ought to be banished from the druggist’s shops The ill effects of alcohol are very different from those of wine In chronic cases alcohol is seldom proper and then only to a limited degree. Good French brandy is the best form of alcohol. Morbid exhiliration & delirium & narcosis constitute intoxication Stimulation has nothing to do with intoxication. The ill effects of tippling are probably the result of the narcotic power, one thing is certain viz. that the ill effects of wine & alcohol are not the result of the stimulant operation [illegible] for no more stimulant produces similar effects v. page 48 On Bleeding in Typhus Been advocated at different times for 3 centuries See Good for a summary on this subject. This author advocates it in cases of what he calls congestion Yet from his manner of speaking we might conclude that he had not seen the practice very successful & it is opposed to his own opinion with respect to bleeding in atonic inflammation. There are several sorts of congestion. Superficial [concretion] caused by the action of the heart over powering the pressure of the atmosphere Visceral congestion caused by the atmospheric pressure overpowering the enfeebled action of the heart hence in this kind bleeding will increase it Good supposes that typhus is liable to run into a phlogistic diathesis False as is also the notion that cauma becomes atonic. These two states of the system are entirely incompatible Diseases are broken up in their forming stage by strong measures of the most opposite kind. This accounts for the success of large bleedings in many cases of typhus Free depletions will produce congestion Hence the greatest bleeders always have many cases of congestion & visceral inflammation 3d purpose of bloodletting to breakup diseases etc. The classes of remedies whose effects it increases are emmenagogue sialagogues diaphoretics diuretics cathartics etc. It does not increase the action of all the deobstruents as has been supposed In cases of atony it diminishes their action Most of the deobstruents act more powerfully as the vital energies are higher 4th as a substitute for habitual 7 moderate bloodletting & to remedy a too rapid sanguificatious disease passive haemorrhage paremenia Wounds of the lungs brain etc. It is not the best remedy for a paroxysm of haemorrhage especially if passive In some parts of the country it is the fashion to bleed every gravid woman. A very injurious practice Tully has known 5 or 6 successive cases of abortion in one family, caused by this practice This practice employed in aneurism to keep the vessels partially empty. These cases frequently supposed to exist in many cases when the palpitation was caused by dyspepsia It seems to be the best practice in cases of wounds of the brain & lungs, to avoid haemorrhage 5 to produce sudden faintness. Diseases the passage of gall stones of calculi from the kidneys some cases of hernia obstruction of parturition from rigidity. To facilitate luxations etc. In order to facilitate the production of this effect, place the patient in a sitting posture make a large orifice, pleno vivo. Great abuse in cases of pregnancy many fine women have had their constitutions ruined A Connecticut practitioner has done much mischief 6 purpose to promote absorption & reduce parabismata etc. It should be done in the early stages & should by followed by powerful emetics cathartics etc. The situation in which a person resides affects the necessity for bleeding Those in warm & moist situations require least. [Scrumous] persons bear it very ill. No attention is to be paid to the season of the year. In the Bethlehem hospital for the insane. It was the custom to bleed all the patients in the spring * purge them in the autumn, untill an investigation by parliament was had of all the insane hospital Infants & the aged bear bleeding less Excessive bloodletting is followed by dropsy hectic of inanition, corpulency & laxity with debility: nervous affections etc. Repeated bloodlettings Ill effects of alcohol the chronic effects are a peculiar sort of dyspepsia followed in the case of wine by gout etc. & in the case of alcohol by phthisis paruria mellita impotency delirium tremens, dropsy palsy ophthalmitis the objection that the use of alcohol in malignant cases produces intoxication is entirely unfounded. So also is that of it being liable to cause a habit of intemperance As to its benefit I health case of a students being supposed to labor excessively Alcohol will prevent his nervous tremors [exhaustion] may be prevented from disabling him for the remainder of the day by alcohol N.B. food will not answer Case of two brothers of schirrous diathesis and [in] health over exerting themselves at a fire The one who did not recruit himself by alcohol, lingered two or three years & died of consumption [illegible] of over work in harvesting & shad fishing After a shower rheumatism & pulmonary complaints may be prevented Tully’s own case of these vid. [16] Sanguinaria Canadensis Alkali called sanguinaria Several of its salts are of a beautiful red crimson or scarlet colour a circumstance almost peculiar to these The change produced by mixing the white acid and white alkali is very remarkable All the salts have the same medicinal properties Removes torpor of the liver exerting an action upon the whole secernant and absorbent system. Acts upon the stomach and promotes digestion. Promotes expectoration & the [illegible] secretion. In large doses it is emetic and narcotic It is liable to leave the stomach and intestines in a weak and irritable condition & hence sometimes proves fatal It irritates promotes absorption and action and frequently cures when applied externally to ulcers. It will probably be useful in inflamma It excites sneezing & increase of secretion in the sneiderian membrane Tartrate of sanguinaria experimented upon in Tully’s office & found to possess all the valuable medicinal powers of the root of the plant. It is less emetic It will sometimes answer when the preparation of the root cannot be tolerated The active principle of the plant is the colouring matter which pervades all parts of the 1st deobstruent 2nd acrid narcotic 3 emetic (1st cholagogue 2nd expectorant 3d emmenagogue (not diaphoretic) scarcely diuretic nor sialagogue not cathartic except by promoting the secretion of bile) 4th escharotic & anti-psoraic & discutient Begin with 30 gtts of tinct. & increase to 1 or 2 fl z First employed in Middlefield by Dr [?cjiah] Hoadly, as a sort of specific in some cases and as emetic in croup 1775 (about) First published account is in Foster’s Bossert 1772 says it is emetic. Employed Dr Bolton of Wallingford. First introduced into general practice by Dr Tully 1813 Apocynum cannabinum lectured on Aralia spinosa a large shrub or small tree in middle western & southern states cultivated here. Called angelica tree prickly ash toothache tree etc. etc. This is the most active species All of them have the same properties in different degrees The recent bark of the trunk root and branches & the fruit have an acrid taste in the fauces a common character of the vegetable deobstruents The immediate effects of the bark & fruit are languor lassitude sense of weakness prickly or burning sensation more especially on the face & hands diaphoresis & drowsiness. If continued long enough it promotes the secretions of the liver resolves inflammations finally hydragogue catharsis & sometimes like some other deobstruents produces a genuine articaria It may also be conveniently used as an emetic if sufficiently large doses are employed It has been employed in the bites of snake In such cases the sensation is caused by the bit of the rattlesnake & not by the aralia. It has long been popular in rheumatism Notice taken of A. racemosa (spikenard) A. hispida & A. medicaulis which are weaker and have not been so much experimented on Baptisia tinctoria podalyria tinct. The root is the only part used in medicine Not very thoroughly investigated. First said (of course almost) to be good for the bites of rattlesnakes by Dr Cutler. Dr [Stearn] of New Hampshire notices it in his American Herbal & his account has been (of course) regularly copied. High encomiums are bestowed on it by Dr Thatcher. Dr Joseph Comstock of Lebanon gives an account of its employment successfully as a powerful antiseptic W. B. C. Barton notices it. So others. Tully found that large doses operated as an emetic and cathartic and in smaller doses as a nauseating cathartic It allayed irritative heat and dryness of the skin, promoted the biliary secretions & resolved topical inflammations produced narcosis and always proved cathartic was useful in various cutaneous eruptions Very useful as an external application to ulcers in preventing gangrene Resembles colchicum most, though less dangerous Veratrium vide gum hellebore Treated of by Bigelow & this article upon it is the best in this “Medical Botany” Bigelow calls it highly stimulant. It has no stimulant Bigelow probably formed his conclusion from the fact of its being acrid Acidity will not necessarily produce stimulation That of this article produces irritation, not stimulation No more is every bitter necessarily a tonic Bigelow calls it sedative. But sedative powers may result from a narcotic a nervine or operation Bigelow goes on in the detailed account to deny its stimulant powers This article exactly resembles the veratrum album of Europe Like phytolacca [decandra] & most of the deobstruents it cannot advantageously be used as a mere caustic Too large a quantity in the 24 hours produces vertigo convulsions etc. An excessive single dose produces hyperemesis & hyper catharsis in addition. This last property however is no proof of its being a cathartic, for in poisonous doses one half of the articles in the materia medica will produce this effect. Case related of a physician’s prescribing skunk cabbage beer hyper emesis & catharsis tormina & even alvine haemorrhage etc. of the family & of a physician Relief was afforded by opium This article is an acrid narcotic deobstruent Not diaphoretic diuretic or cathartic It loses much of its power by drying It will produce vomiting when externally applied to a wound Andeira Andeira inernis ([Geffrona] inernis) cabbage tree of the warmer parts of N. America e.g. Jamaica Nat ord leguminasae yet the fruit is a drupe Not used in this country. Nearly resembles coilchicum in its operation. The bark is used The tests of an over dose are nausea & vomiting of to frequent doses, narcosis of too long continuance hydragogue catharsis It is employed in the West Indies and in Spanish America mostly as an anthelmintic Dr Wright of Jamaica considers it the best anthelmintic known Cantharis vesicatoria Stimulant, diuretic, epispastic Of the application of it in typhus Prof Ives has made more use of it than perhaps any other practitioner in the United States. He has given to the amount of a fluid ounce in 24 hours in cases so low as that the patients were insensible to all external objects, and unconsciously voided their urine and faeces Of considerable importance in delirium tremens As an epispastic useful in aposthema communis common boil may be dispensed, anthrax may sometimes, inflammation of the parotid gland Erythema oedematisum (internally in conjoin) with other stimulants and tonics As an epispastic in bubo & in chillblain also in all the varieties of cephalitis Parismitis caumatodes var. phlegmoneae is benefitted by blistering Parismatis typhodes (typhoid inflammation of the fauces) internally Most of the varieties of pneumonitis typhodes internally and externally Erythema of the lungs? Case of Dr Brown’s in Hartford taken suddenly, in 15 minutes [illegible], died in 12 hours partially roused by brandy opium & tinct. canth. The constitutional affection was t. syncopalis Sparganosis puerperarum benefitted by blistering unless it will bring on irritation in consequence of the previous exhaustion of the system Blisters in dysentery in inflammations of the eyes, in phthisis It is a common practice to blister in rheumatism, very injurious & frequently fata, from chasing the topical affection from joint to joint until it attacks a vital part. If however the rheumatism becomes fixed, then blistering may be useful So in chronic rheumatism Sciatica a neuralgia as much as a rheumatic affection, blisters are very useful though when physicians have injudiciously reduced the system by bleeding the blisters may produce a bad irritation Rickets marasmus [illegible] & scruma in these it is used internally. Said to be worth more than every thing else in scruma In gangrene where there is not great atony the topical application is valuable In vitiated ulcers, internally with tonics Ecphronia mania & melancholia, etc. amaurosis applied over the forehead In the early stages of deafness, applied about the ear In tetanus, in enormous quantities internally, just as opium is given to the amt of 100 gr. in 24 hours also blisters on the spine are beneficial Doubtful as to its benefit in neuralgia It has been proposed in lyssa canina Beneficial in idiopathic headache Leucophlegmosia palsy int. & ext. one of the most powerful remedies Blenorrhea leucorrhea [spermorea] [impotency] in these internally Dropsy in all its varieties Remarkable case mentioned by Dr Ives In internal use in one night carried off all the water flooding the floor of the room The patient was reduced to a skeleton & in a state of asphyxia from which he was roused by friction with ammonia etc. pledgets of ling dipped in amm. thrust into the nostrils & the internal administration of spicy & spiritous cordials. He recovered Internally in the species of paruria In paruria mellita or diabetes, give as much opium as will be borne without soporific effect for it will diminish the secretion of murine & increase that of the skin. Give the tinct. canth. Sponge the surface with caustic potash confined the patient to animal prod and debar the use of drink Keep the extremities warm cloth the body in flannel sometimes wearing stockings filled with capsicum to keep upon irritation. Various combinations of canth. with phosphorus etc. are necessary afterwards Exhaustion from haemorrhage has been relieved when other stimulants seemed to fail In the United States we have the cahntharis villata which is more powerful than the C. vesicatoria & might be furnished at a cheaper So the C. cinerea C. [illegible] lytta nuttallii of the N.W. territory is exceedingly powerful and might be collected in great quantities So other species of cantha Lytta gigas of India is about twice as large much more powerful and more speedy in its operation So other insects The larva of phalaena neustria is a good blistering insect. It is the common apple worm Apis mellifica is a blistering insect Various other insects are mentioned by the European writers Capsicum [Roem???] & Sch. [illegible] [illegible] sp. London gives 3 more Our species is the C. opossum or squash pepper. Pericarp oblong globose or conic [or] tetragonous etc. etc. Other species are cultivated but rare The imported cayenne is an indiscriminate mixture adulterated with salt & even with flour, frequently with peroxide of lead. Indian pods are stronger; but ours are strong enough Aleth species have the same properties in kind. By digesting the pods in ether for some days the oil is obtained & crops of crystals of capsicum are found on the sides of the vessel in acicular crystals This is destitute of sensible or medicinal properties So also of piperin. Each of these owe their small amt of virtue to their contamination. The active principle of each is the oil. The oil of capsicum is a perfect substitute Capsicum is a powerful stimulant. The first sensation is that of warmth As in condiment it prevents flatulence from vegetable food and is not liable to the injurious effects of the oriental spices upon the head. Instead of causing visceral obstructions particularly of the liver it is most probably that they prevent them The effects of too large a topical application are an excessive irritative inflammation which is relieved by olive oil & cerate of datura. Tully does not believe that the stomach will retain a sufficient quantity of the power to poison The habitual use of as an article of food in excessive quantities weakens the stomach & produces a troublesome kind of dyspepsia. As a rubefacient it possess peculiar powers One fourth or one eight of a minim of the oil is a dose, given in a pill made with some extract. Of the substance 2 to 12 grains is a dose. The doses are to be larger in tropical climates Lecture omitted Capsicum continued diseases continued Disguised gout various cases of gout misplaced gout Secondary stages of atonic acute rheumatism & in all cases of erythematoid rheumatism All the low atonic exanthematica e.g. rosalia maligna rubeola maligna, malignant small pox All positively passive hemorrhage Marasmus tabes. Sertosis rachea (rickets) All the srumous phlogotica i.e. strumous visceral inflammation. Porphyra hemorrhagica or land scurvy this the remedy second in importance Acetate of lead is first The several species of gangrene Tully considers it as a settled point that tonics deobstruents & acrids are frequently the best remedies for insanity e.g. Connecticut [illegible] which had been more successful than any other known Melancholia hypochondria N.B. this seems to be a compound of melancholia & dyspepsia. Chorea carus lethargus paramenia [illegible] atonic acrids then assist the operation of the deobstruents & tonics Blenorrhea simplex & chronica have as often been suspended by an internal use of capsicum So B. senodes emphysema abdominis (typanitis) Paruria mellita mostly externally sometimes internally as an adjuvant. Par. [incontin??] epidrosis profusa (sweating) The effects of the bits of serpents though not so effectual by itself as alcohol This last with opium is first, next are ammonia capsicum etc. Monarda punctata N S. to Car 14 sp. in R & S. This the most active species Com. name horse mint. Though this name is applied to sp. of mentha & pyenanthem Ess. oil is volatile and exceedingly pungent and acrid resembling the ess. oil of thymus vulgaris One of the most elegant aromatic stimulants and externally rubefacient & even vesicatory. Spt. 1 fl. oz. of oil to 7 of alcohol is the most convenient form for its internal administration First introduced into regular practice by Dr. Attley of Phil. Diseases (Attley & Eberle) 1st typhus in the cold state externally applied Cholera infantum externally Chronic rheumatism cephalea hemicrania obtuseness of hearing from atony dropped into the ear. Externally applied to the limbs in some forms of palsy Rheumatic odontalgia dropped into the tooth if it is carious if not applied to the face combined opium with it Our most common sp. is m. oblongata & this sp. would probably answer as well M. dydima (bee balm or Oswego tea) M. fistulosa common All have the same oil Ether sulphuric or hydric or vitriolic the most volatile of all known liquids. Extremely inflammatory sometimes producing serious accidents when poured out by candlelight. The best test of its purity will be its sp. gr. [illegible] a pure diffusibly stimulant and nervine N.B. Part of two lectures lost Disease (many lost) Typhus Dr Rush never suffered a patient to die without having first tried a very efficient use of this article Syncope of various species, in these it is the best remedy. Neuralgia auris (ear aches) dropped into the ear especially mixed with sulphate of morphine the ear being stopped with lint to prevent evaporation Cephalis hemicrania & nauseosa N.B. when externally applied and suffering to evaporate it is a refrigerant Chorea, common convulsion Hysteria asphyxia, after breathing has been restored. Tully has frequently seen a patient roused from a paroxysm of catalepsy by ether letharty, parodynia Burns & scalds mixed with spt of ammonia, employed by Dr Ives N.B. if vesication has already taken place, it must be so managed as to produce its refrigerant effects? In that state of the system which has been called concussion in consequence of a sudden and violent shock. Wine produce of the vitis vivifera which was originally from the south of Asia it is found however growing wild in Armenia Tauria etc. The varieties are almost innumerable Different sorts of wine 1st white & red again [illegible], adiculia aspera, & mitia acidulous e.g. shock dulcia frontenae malaga tokay, [illegible] aspera port, mitia or soft sherry claret burgundy champaign madeira Paris’ account if its being firs employed by Asclepiades a little before the time of Pompey It is mentioned by Hippocrates It increases the frequency of the morbidly slow pulse & diminishes the heat or increases it diminishes or increases sweating improves the appetite digestion, exhilirates, & strengthens etc. etc. # Habitual and free drinkers of wine are not subject at all to intermittents & but little to typhus Indeed it diminishes the liability to many inflammations etc. See MacCulloch on malaria Excessive quantities produce nausea vertigo etc. in short intoxication # These are the effects in atonic cases & when given in suitable and regular doses and for some time Habitual and excessive use a general weakness of the nervous system a peculiar sort of dyspepsia & gout These are all Wine is 1st stimulant 2nd nervine 3d narcotic The last operation consists of the vertigo nausea etc. Its sedative effects in case of irritability pain etc. are probably the joint result of all its operations Its effects are not slow and permanent enough to entitle it to be called a tonic Wine and opium are the most valuable articles of their kind Various eminent British authorities quoted Good is inconsistent and contradictory It is more especially adapted to the putrid type of typhus Chemical composition of the intoxicating principle One fourth part of the best wine is officinal alcohol or at least will furnish that amount So that a pint of wine will yield a half pint of brandy Now the effects of factitious wines do not differ from those of diluted alcohol The same is true when alcohol is added to wine. It is commonly supposed at the present day that the difference is owing to the chemical composition in which the alcohol [exists] in the wine, chemical comp more especially with the water But we have no evidence that alcohol will unite with water in any other manner than by solution Others supposed that only a portion of the alcohol exists in the wine previous to distillation. But Mr. Grande by adding [illegible] acetate of lead, separates the alcohol without distillation Pure alcohol is composed of the ponderable part of olefiant gas & water 2 to 1 ether is [illegible] to 1 In wine probably [illegible] will have it 1 to 1 Perhaps another compound of 1 ol. gas to 2 of water may be the princ. of [alc.] etc. which differ as much from [illegible] as this does from alcohol Alcohol Arabic named & discovery The name is figurative, meaning originally a fine powder of antimony used as a paint It retains its fluidity at 91 degrees below zero of Fahrenheit# The bluer the flame the purer the alcohol, and in this way its purity may be judged of The pure state has a sp. gr. of .792 Off alc. is .835 Arrack & spiritus oryzae (rice) The difference in the several sorts of spirit is owing to oily matter and acetic ether. The effects of wine and alcohol which are called by the same name yet differ Alcohol & tobacco have more effect upon the [illegible] Intoxication takes place sooner upon an empty stomach & when the body is immersed in water, but if the head is wet and the body dry, the reverse is true vid p 50 # Frozen by Mr Bussy Bulbs filled & surrounded with cotton dipped in anhydrous sulphurum acid, and placed under the receiver of an air pump vid. p. 43 Nitrate of potassa The most powerful refrigerant known next to blood letting most powerfully reducing [illegible] of action Tully thinks it not diaphoretic as has been said neither diuretic. It proves diuretic and diaphoretic in cases of obstructed perspiration & urine from phlogistic diathesis Sometimes however it has these effects in other circumstances though they cannot be calculated upon It is not sedative except as it relieves the morbid restlessness heat & dryness of skin etc. of phlogistic diathesis It may not febrifuge except in [?thenic] fevers, that is in a small portion of fevers Not laxative except as it relieves the torpor of phlogistic diathesis producing the natural discharges. Very doubtful if it is ever antispasmodic. Not antiseptic except upon dead animal matter. Sometimes there is a tendency to gangrene in high phlogistic diathesis which of course is relieved by any refrigerant Cinchona is the most powerful antiseptic, using the term in its most appropriate senses, but these two articles are entirely incompatible one will not counteract efficiently the improper use of the other as seems to be sometimes supposed. The injurious effects of efficient quantities of this article in atonic cases are crust on the teeth coldness of extremities etc. etc. It should always be given in uniform and small quantities from 5 gr. to 1 scr. The test of too large a quantity is pain in the stomach. Sometimes present in the urine, but not in proportion to its effects. The operation of the external application are similar to those of its internal hence it is used as a lotion on phlegmonous inflammation. it is also used as an irritant like tartrate of antimony not therefore a stimulant Deleterious effects, coldness of stomach, discharge of considerable [illegible] of blood weak pulse etc. etc. pallor of countenance etc. A very large quantity vomits and is thrown off. ½ an ounce to an ounce is a poisonous dose Orfila conjoined it refrigerating with its narcotic effects an egregious blunder In a medico jurisprudential point of view nothing short of find the article will answer. Show a distinguished anatomist says that the appearance of the stomach and intestines is not to be relied on as a proof of poison because all the appearances may be at times found in an unpoisoned stomach This very important in this country where medical jurisprudence is much abused. Remedies 1st vomit, not with the mineral, but the vegetable emetics the best is a dose of a table spoonful of black mustard which is more speedy and effectual in clearing the stomach and is useful as an acrid. Opium & alcohol with nutrition demulcent After the poisonous effects have taken place do not vomit and in any case prefer emesis to catharsis. Finally prescribe to the symptoms. The refrigerants & especially nitrate of potassa have been undervalued of late Partly from change of diseases, partly from the chemical theory of the production of animal heat by the solidification of oxygen The French writers call it stimulant because it produces irritation & inflammation Diseases Acute mercurial ptyalism as a topical application doubtful because it is an atonic agent. A dipsosis avens or morbid thirst, especially of intemperance doubtful for the above reason Opium etc. are also undoubtedly known to be useful. This also makes the above doubtful. Dyspepsia by Wilson Philip, upon his theory that the secondary stages of dyspepsia are phlogistic There is much more reason for considering it exceedingly injurious in this disease producing a bad sort of dyspepsia when freely given for affections of the urinary organs. Jaundice by the French writers melaena also by the same very improbable. Simple idiopathic cough very doubtful. Remittent But the opposite class of remedies is always wanted in the varieties of this disease. Idiopathic hectic because it is cooling & sedative Very little probability Synochous in this it does neither hurt nor good Typhus gravior very injurious. Cauma or actively inflammatory fever the most efficient remedy after bloodletting & perhaps after nauseating doses of tartrate of antimony A composition of nitrate of potassa tartrate of antimony & calomel used in Philadelphia under the appellation of Rush’s febrifuge it contains too little of the two first articles. As a general rule avoid being confined to set formulas. Some inflammations of the skin boils [illegible] etc. Blenorrhea lenodes (clap) it has been recommended. In inflammations of the female breasts & of the testicle, it is not so good as acetate of lead. Useful in phlogistic rheumatism still not so good as some other modes of treatment. Useful & important in all the entonic phlogotica. Active phlegmonous cephalitis & in quinsy Membranific inflammation of the bladder doubtful because copaiva oil of pine etc. are very useful. In hemorrhage haemoptysis but the restriction to active shd be made haemorhage It has been recommended in haemorrhage attended with plethora. Tully however does not believe in the existence of a disease consisting of too great a quantity of blood. Sea scurvy recommended very doubtful Tully is inclined to think sea scurvy not a different disease from land scurvy. The latter requires the system to be raised, the former will generally be cured by a change of food Obesity which however is better cured by the old rule mouth always shut eyes always open feet always in motion. Cellular dropsy doubtful Parunia various species, including diabetes. Neither this nor any other remedy has done much good Gravel improbable. Lepidosis psoriaca var. inveterata. Impetogo laminosa (salt rheum) I. herpetica (herpes) Tully has not known it do good & very different articles serviceable. Nitrate of soda possesses the same medicinal properties So also nitrate of ammonia although ammonia itself is stimulating. Various other nitrates also. Carbonate of potassa called sal tartari sal absynthii (salt of wormwood) The deliquation by exposure to air was called oleum tartari. Obtained from the [L??viation] of the ashes of plants not [illegible] when imperfectly purified called pearl ashes. It must be pure for most pharmaceutical preparations. The theory of its combination with oils forming soup it was formerly not understood has been lately investigated. Incompatibles, all the salt will decompose it It is refrigerant but this property is not so predominant as to prevent its use in atonic case Also diuretic, especially when aided by plentiful dilution, still it cannot be depended on in dropsy. In diuretic power greater than it refrigerating. Parunia inops most useful as a diuretic in this Sometimes antilithic viz. in cases of calculi of the xanthic acid & 2 others Antacid as in dyspepsia still not so good as oxide of potassium which is also tonic not so good also as lime. Not stimulating unless this term be applied to every remedial agent. Neither increased frequency of pulse, nor increased heat is an evidence of [stimulation] Not specifically anti-emetic unless retching is produced by a free acid. Not antispasmodic, as in bex convulsiva (whooping cough) Of no use in visceral enlargement. Dyspepsia remittents recommended in the form of effervescing mixtures which however operate by their carbonia acid & the salt formed. Saccharine matters supposed to impair its power. Water the only proper menstruum for its solution. Its solution commonly mixed with a little rhubarb & peppermint This much mused by physicians when at a loss what else to do. Case of A seamstress who had a horrid dyspepsia from costiveness relieved habitually by Lee’s pills relieved by this brought from the south Oftenest used as an effervescing mixture If sugar is added it should be dissolved not in the solution but in the lime juice or else the effervescence will be prevented But the bi carbonate of potassa is best for effervescing mixtures. Large doses are poisonous from irritation inflammation etc. Antidote at first vinegar afterwards demulcents particularly those of an [illegible] oily nature, with narcotics Bicarbonate of potassa called carbonata & super carbonate also sub tartari essentialis sal aeratus (this name is given to other salts of [illegible]) Does not deliquesce from exposure to the air possesses considerable activity as a refrigerant more than the last article. Much use of it as an antacid injurious from the distention. Tully does not believe with Edward and Varasseum that it possesses all the advantages of the carbonate & ought to be used for it although mor pleasant to the taste Carbonate of soda called sal sodae called in commerce when in its most impure state barilla Effloresces upon exposure to the air deliquesces by heat Obtained from marine plants especially the salsola soda Similar in powers to the above Tully thinks it not deobstruent. It can be given in pills carb of potassa cannot from its deliquating the carbonate of soda however must be [efflorescent] Tully can perceive no effect in jaundice from this or the carb. pot. Bicarb. soda (more commonly called sub-[illegible]) found native & called hard enough to build the walls of a fort Ingredient in some specimens of soda water This article originally was made of oxide of sodium Now, except in N. Haven, it is merely carbonated water. The prevailing custom very injurious Case of a brine spring in Albany. Saratoga very injurious ½ dr. to [illegible] gr. tart makes soda powders with pure concrete tartaric acid The tartrate of soda produced is cathartic proportions 25 gr tart. acid ½ dr. soda Seidlitz pow Hydrocyanic acid (I was absent) [Illegible] cerasus the essential oil Equally powerful as a narcotic with hydrocyanic acid 6 ol. oz. of distilled water to 1 pound of the recent leaves Less powerful upon man than upon the brute animals upon which the operation of a little laurel water to the eye or the inside of the mouth causes immediate death. Two or three minims of the (so called or supposed) essential oil kills small animals Tincture the most convenient form Cataplasms of the leaves are useful as a narcotic. The leaves are used for their flavour in cookery among the English & has sometimes in moderate quantities have produced death. Probably the cerasus virginiana has the same properties. probably in a less degree Gelseminum nitis (apocyneae) The effluvia of the flowers are said (in Elliott) sometimes to produce stupor) Tully considers it as a perfect substitute for hydrocyanic acid & free from its inconveniences. The root, most powerful part. In phlogostic cases it would probably like the other simple narcotics do neither good nor hurt. Never produces the calm placid pleasurable sensation exhiliration and wakefulness of the nervines. Tully has always used the tincture 4 oz. bruised root to 1 pint of alcohol macerate for a week. 10 to 20 minims from 3 to 6 hours beginning with small doses & more until narcosis begins to be powdered & then continue the same dose. It is well frequently to conjoin opium [illegible] will counteract its liability to to produce narcosis, Probable all the stimulants have this power. Perhaps the failures so frequently complained of are owing to want of skill in conjoining them Evil effects narcosis merely which may always be relieved by the diffusible stimulants. The best are alcohol [monarda] punctata capsicum spt. ammonia Make use of of napkins wet in cold water applied to the head & of friction, & rubefaction by the monarda punctata Case of a patient who book several doses in rapid succession. The very distressing symptoms were immediately relieved by brand & in 12 hours the patient was as well as before. Case of a girl at the south died in an hour Diseases bex (various species) phthisis where there is much irritation Dyspnea exacerbans acute & subacute rheum Helomas erythrosperma A pure narcotic yet differing materially in its effects from the Prussic acid & Gelsemenum Letter from Dr Brand of S. Carolina Affect the eyes making them sensible to light in an extraordinary degree blindness finally N.B. All narcotics appear to affect the sight Some produce dimness Some dilate the pupil Commencing dose of the tincture 10 minim. Tully has commonly found from 20 to 30 minims necessary at intervals of from 4 to 6 hours. With respect to most such articles, physicians are apt to give inefficient doses & then condemn the article Few of the narcotics, except opium directly produce sleep Chlorite of Potassa (oxymuriate) Prof. Ives is right in saying that it diminishes the heat of the kin & of the stomach. It diminished or at least does not increase entonic diathesis Said to relieve chronic hepatitis which however does not exist, for in dyspepsia accompanied with tenderness over the liver post mortem examination shows no inflammation. Said to be capable of during lues syphilis very doubtful Said to be good for cacherine, a loos term which may include one third of human diseases. Tully believes it a weak refrigerant of no great value without further experiment Vegetable acids. 3 groups 1st those which exist in a free state 2nd which do not & 3d those which are the products of decomposition The last are the benzoic & [illegible] & perhaps [illegible] all nervines Acetic acid 4 states one of which is acidum aceticum pyrumatica or syroligneous acid. Common vinegar is acidum acegum impurum The impurities are various according to the liquor from which it is made Frequently found in the sap of plants as [illegible] typhina vitis vinifera It is a pure refrigerant proper only in cauma. To be given diluted or in combination with mucilage Improperly used in putrid [illegible] to relieve heat [illegible] about the mouth & thirst which do not require [illegible] but if we need acids we must use the [illegible] acids a sulphuric & nitric. Though it is often given to humor nurses bystanders etc. Said to be antiscorbutic but this is loose and doubtful for the vegetable acids pure do not relieve scurvy, without vegetable matter. In obesity if insufficiently employed it does nothing if efficient, it is mischievous. Useful as a condiment, as [illegible] also Conium maculatum a deobstruent [diuretic] confounded with [??uta] maculata both in Europe and in this country. The ancient hemlock is unknown. We know of no plant which will produce the effects ascribed to hemlock in the account of the death of Socrates Perhaps the liquor was a compd of several narcotics The most common form & the best for administering it is extract. The term extract has four applications 2st expressed inspissated juice 2nd inspissated exuded juice 3d inspissated decoction 4th alcoholic extracts Tully places great reliance upon conium and iron in dyspepsia It is useful in paronina salax lagnesis [fluor] etc. etc. Tully used conium & iron with various aromatics in dyspepsia for 4 or 5 years without being able to get any physician to try it. Of more value than mercurials in jaundice Cicuta maculata frequently confounded with the latter more powerful very poisonous the poison cured by stimulants etc. as in other narcotics Digitalis purpurea purple foxglove cultivated in our gardens It is a narcotic deobstruent Medical testimony upon this article exceedingly contradictory. Tully denies that it is either stimulant or refrigerant thinks that the supposed phlogistic cases in which digitalis has been though a substitute for bloodletting were in reality synochous cases which are not phlogistic according to Tully nor are they phlogistic at the outset and typhoid at the last & though they will bear bleeding yet are cured much better without In large quantities it vomits and purges 1st narcotic 2nd deobstruent &^ as parts of this last it is resolvent diuretic and discutient Most commonly used for its diuretic operation [Black???] says that digitalis is not proper except when the urine is coagulable this was tried in this country by boiling the urine! Unfounded If the system is very low it must be raised by excitants in order to allow digitalis to operate So if it is very high it must be reduced Yet there is a considerable range within which neither is necessary Paris’s account of diuretics which are incompatible with it is unfounded The narcotic powers of this article are frequently useful to allay morbid irritability. The best form is tincture It has been supposed that the infusion is best as a diuretic and the tincture as antirritant. Not very probable Therapeutic application Dyspepsia accompanied with tenderness in the epigaastric regions & febrific symptoms digitalis has been used to alleviate these symptoms not so good however as actaea & [other] Recommended in many cases of chronic cough accompanied with dropsical swelling of face, leucophlegmasia Also is it useful in many cases of simple idiopathic cough best however as an auxiliary to opium etc. Whooping cough especially conjoined with arsenic Some forms of phthisis Rheumatism is of various kinds in some of them this article may be used though in most of them actaea & some similar articles are better It has been recommended in mania and probably may be very serviceable in breaking up the paroxysms N.B. the practice of attempting to do this by profuse bleeding is generally bad because the bloodvessels are affected by the mind and not the mind by they bloodvessels & the continuance of the practice may produce fatuity Digitalis long a popular remedy taken in ale among the Italian much used as a [vulnergry]. Withering about 50 years ago first used it in dropsy as a diuretic Frequently the excessive distention of dropsy will prevent the operation of diuretics until it has been reduced by paracentesis or hydragogue cathartics especially elaterium Few diuretics can be depended upon when used alone but required to be combined with others Asclepias syriaca seems to be the most sure which Tully has used. Lobelia inflata 1st narcotic 2n deobstruent 3d emetic as parts of its deobstruent effects it is cholagogue diaphoretic? diuretic? sialagogue & perhaps emmenagogue. No published account exists of its deleterious effects. The first account was published by Ref. Dr. Cutler 1785 It has been employed in form of powder of the leaves powder of the leaves infusion tincture of seeds & tincture of the leaves 2 oz. of recently dried leaves to 1 pint of proof spirit macerate 8 or 10 days Diseases Limosis dyspepsia especially where there is great insusceptibility Simple idiopathic cough considerable [evidence] for its utility. Often very efficacious in that sort of cough to which public speakers and singers are subject it is sometimes the sequel of acute diseases, and is always accompanied with more or less dyspnoea which will be manifested by a fit of coughing following upon the [illegible] to light a candle & blow off dust from every thing Frequently accompanied in these cases with s opium Bex convulsiva or whooping cough in the secondary stages, very useful Tully has not always succeeded with it Dyspnea exacerbans (commonly called asthma, though differing from it) give it in doses of a teaspoonful once in 5 or 10 minutes until the exacerbation disappears either with or without narcosis and vomiting. Highly effectual in asthma though not so certain because the disease is more obstinate The British physicians are just beginning to learn that this article has remedial powers. Tully has no doubt that in Britain diseases yield to smaller doses and less efficient practice than with us This article has been recommended in croup, though it has been rejected upon theoretic principles. Cases mentioned in which its emetic & deobstruent powers have been very serviceable. Actaea racemosa. Black [cohosh] frequently confounded with leontice [thaltroides] called blue [cohosh] No complete analysis has been made Tully thinks it probably has no alkaline principle being in this respect similar to digitalis and conium A narcotic deobstruent in large quantities an emetic Tully thinks he has seen in children moderate exhilirating effects produced by this article It may be pushed so far as to produce neuralgic pains This effect may be prevented by giving liquid food; or it may be remedied after it has taken place by giving opium etc. There is much evidence for its being a [part??] accelerator similar to [sclerotium] clavus With respect to its diuretic and diaphoretic operation it is not strictly correct to ascribe them because they follow the exhiliration of the article only when diaphoresis and diuresis are prevented by the diseased state of the system. The deobstruent effect may be prevented and in the hands of injudicious practitioners frequently is prevented [illegible] too great previous bleeding Actaea resembles digitalis most but differs from it 1st in not accumulating upon the system and suddenly breaking out Through these effects may be prevented in digitalis yet they are not liable to occur from actaea 2nd Actaea is not liable to reduce the patient to a low and dangerous state The narcosis is more easily remedied 3d Actaea produces neuralgic & perhaps spasmodic pains. And this effect is valuable as a test of the limits of the dose 4 Actaea possesses considerable power as a [partus] accelerator 5 It possesses more deobstruent power Actura differs from conium in being [illegible] a deobstruent more speedy & powerful Actaea is most powerful in acute & conium in chronic case The resolvent power of actaea is greater than its cholagogue vice versa with Conium No article has so great a resolvent power as actaea & none so [illegible] a cholagogue as conium Actaea may made indirectly diaph. diur. & expect. conium not Actaea seems to be a more effectual deobstruent than sanguinaria and causing less nausea than colchicum & less liable than either of them to leave the stomach and intestines in a deranged condition The watery preparations not to be relied on Tully used them in a vague way in some years without discovering its narcotic powers Tincture two [ounces] to 1 pint alcohol sp. gr. .835 Medium dose of alc. tinct. f z ss once in 2 or 3 hours Materia Medica 1831 & 2 Pure mineral deobstruents are iodine nitric muriatic nitromuriatic acids chloride of gold barium calcium etc. Perchloride & peroxide of mercury also proto chloride & diproto nitrate of mercury Vegetable deobstruent 1st pure, are leontodon, rubra tinctoria fumaria offic. cinchorium intybus sapomaria offic. Of all these, a large quantity must be used 2nd Aperient they restore, or augment the fluid secretions viz. halitus from the lungs diaphoresis & diuresis (formerly called [illegible] also sweetness of the blood) now often called diet drinks, from their being given in form of decoction & in large quantities. Some of them are spoiled by decoction however. e.g. sarsaparilla is injured even by the best of the sun Smilax off. syph. rotundif. and glauca. Officinal sarsaparilla is from S. off. & S. sulph. (S. sarsaparilla produces none it should be called by Micheaux’s name glauca) Comptonia asplen. (leaves) aralia [medicaulis] & racemosa (root) Asclepias tuberosa & incarn Arctium lappa & dardana? (roots & seeds) Diervilla lutea, celastorus scandens Collisonia canadense, solarum dulcamara (has slight & easily lost narcotic properties) These are used in hectic, lues, bucnemia elephantiasis, lithis arenalis, lepidosis several species. Ecpyresis. Sequels of rheumatism in dyspepsia 3d Acrid cheledonium majus, daphne Mezeocon etc. Dirca palustris ranunculi anemones clematides myrica cerifera 4th mild narcotics, destitute of acrimony solanum nigrum & tuberosum [ethusa] sinapium conium, cicuta & probably the lacturas 5th acrid narcotics they do not incline to produce somnolency or coma, but stupor the term acrid is used to denote this quality of a narcotic operation Kalmia 2 or 3 sp. rhododendron 2 or 3 aconitum napellus, strychnos nux vomica 6th Astringent chemaph. uva ursi [illegible] calyculata ledum [palustra] 7th tonic Canalyrium carolin. (unicorn root) Helonias dioica is the old name for this aletris farinosa (unicorn root also) 8th Evacuating Ol. & resin of pinus & abies & copaifera off. & juniperus [illegible] & guaiacum off. Iris vessic. & prism. Polygala senega & pubescens squills (conithagala squilla) Gratiole off. lobelia syphilitica nearly allied to senega & better because this latter deranges the al. can. Helleborus [2] sp. Eryngium yuccifolium sanguin. veratrum apocynim. aralia spinosa phytolacca colchicum, seeds of Daphinium cocculus [indicus], stillingia sylv. anderia inernis veratrum album Mercurial Ptyalism. Symptoms are ptyalism, soreness of the mouth, ulceration of mouth & fauces a vesicular erythema upon the skin etc. Different persons differ in susceptibility. The same person will be much more susceptible after a previous salivation especially if recent. Teeth set on edge is an incipient symptom Ordinarily there are no fatal consequences. When they occur they consist of caries of the jaw, sloughy ulcers of the mouth, total loss of the teeth, stiffness & incurvation of the limbs, extreme emaciation etc. etc. The treatment is in a good degree empirical. The question as to treatment seems to be, what will do the most good No foundation exists for the opinion that the mercury is deposited throughout the system. Sulphur flowers have been thought a specific nonsense! the only two compounds of mercury & sulphur or one a brilliant red & one black & both insoluble!! Purging, as such. Prof. T. is confident, does no good Dr Finlay of Ohio thinks it may be cured by antimony. Others have not succeeded by it. Sarsaparilla is much used a quart of decoction a day is much used in G.B. undoubtedly with benefit. Not of much use in our country Astringent lotions & gargles are much used They are useful in the latter stages In the first stages resolvent remedies seem to be most needed iced water has cured mild cases. Baptisia tinct. has been much used. The testimony is so strong that Prof T. credits it It is used topically. A strong solution (1 scr. to 1 oz of water of nit. sil. has been the best article used by Tully. Liquor of the arsenite of potassa is an excellent topical application is also taken internally Spts turpentine in gum arabic is employed by Prof. I Lycopus vulgaris decoct is recommended Watery solution of opium is strongly recommended The mineral acids are recommended Mucilages are very grateful acacia typho lab. viole pedata laura sassafras ([illegible]) decoct. of rice & barley strained through a cloth) tragacanth hibiscus althea Prof T. would try quinine Milk porridge is the most grateful diet air [illegible] & [free] Erythismus hydrargyratus Irregular action of heart & arteries, pale countenance exhaustion of strength anxiety in epigastrium, sighing, quick small & sometimes intermittent pulse tongue not furred. In this state, sudden exertion may destroy the patient Treatment A steady and regular use of moderate quantities of opium alcohol & quinine with strict rest Erythema hydragyratum vide Good A vesicular eruption (though like a case of sun burn, a magnifier may be needed to discriminate) Prof. T. does not believe in the spreading from the corrosion of the discharge (criticisms upon Bateman’s confounding erythema with exaena or rash erythema being vesicular) Bateman probably incorrect in saying that it may be caused by cold merely Bateman gives a very full & perfect account of the rise & progress of the disease Diseases teething cathartics too much used blue pill preferred Prof. T. objects to protoxide (blue pill) as being extremely uncertain (imperfectly oxydized) & when perfectly oxydized is in no way preferable to calomel It is milder only in consequence of the diminution of the dose in consequence of the imperfect oxydation. Prof T distributed some of that perfectly oxydized to his friend e.g. Drs Reed Cogswell Todd etc. They all declared they could perceive no difference It will combine with the lactic acid of the stomach & produce a troublesome compound Dyspepsia Prof. T. utterly protests against the fashionable practice of using mercury in dyspepsia Even when the liver sustains the burden of disease it is injurious. The use of mercury occasions tendency of abdomen etc. etc. Even as a deobstruent it is inferior to other articles Occasionally useful as a slow purge Colica Ileus (comm. col.) Of the utmost importance not as a cathartic for this is of no consequence the disease consisting of a suspension of the peristaltic motion. Commence with opium & continue the use of opium but the cal. cures the disease It will never produce ptyalism. It has been given to the amount of i dram once in 6 hours without this effect. Colica rachialgia the same with respect both to opium & mercury Coprostasis not the best article Diarrhoea purging will cure the disease by strong impression but the practice is foolish utterly inapplicable to sev severe cases Cholera Generally the phys. is called too late to allow of the exhibition of calomel In the commencement of the disease it is useful as a deobstruent Helminthia ascar. lumbri probably the best cathartic. The spigelia ought to have been given for the last 12 hours until narcosis is produced. Then give the cathartic Senna is an extremely poor vermifuge its purgative operation is not of the right kind. In the other species of invermination cal. is not the article Even in this species turpentine oil is a better article, but not so manageable as spigelia & cal. Jaundice Purging with cal. in the early stages & the use of [illegible] deobstruant is of great importance cal. is inferior only to conium in this disease. Give it alone cal. is better as a first measure than vomiting Vomiting is apt to produce soreness in the liver & irritative fever. This calomel treatment of jaundice is not the best. The yellow colour will remain and this may be removed if we treat with conium Cal. is apt to produce ptyalism Parabisma coactum There is but one article better than cal. There is an impression that these must be cured before attacking the intermittent. The interm. may be cured without disturbing the parabisma. Conium will cure the disease in half the time of cal. Corysa acuta (improperly entonica by Good) Calomel 7 opium will cure a paroxysm Fevers 1st Intermittent It is a great mistake to suppose that we must always being with purging & vomiting If cathartics are indicated, calomel is much the best notion a drastic dose nor combined with other cathartics Remittent a disease intermediate between intermittent & continued fever. Some cases approach more to an intermittent & others more to a continued form & the nearer it approaches to the latter the more is calomel indicated. It is slow purging that we need not small doses at considerable intervals not quick & drastic for them we increase irritability & irritation Typhus infantum absurdly called infantile remittent & worm fever. Purging with pure calomel & cal. in small doses & at regular & short intervals. It is well to conjoin it with antirritant & with ipecac Non malignant nervous typhus. The best article for producing a resolution, provided you have been called in very early & also before the patient has purged himself even 3 or 4 times with castor oil. Give it either in a single & full dose or in small quantities, so as to get a full dose in the course of 12 or 15 hours or conjoined with opium. Cal. & ipecac is an excellent article for the resolution of fever. Other modes e.g. vomiting, purging, sweating etc. are more liable to fail than to succeed. This mode has succeeded in 8 out of 10 cases in Tully’s practice. Sporadic cases are resolved more easily than epidemic. Purge no more than to remove the contents of the al. can. Dis-oxide of mercury (sub oxide black oxide) (protoxide aethiops per se) pulvis hydr. [illegible] oxidum cinereum is a different compound Mode of preparation vide U.S. Pharmacopoeia This process is very exceptionable An apoth. would require near a barrel of lime water in order to make such a quantity as he would wish to make at once. It is besides uncertain from the uncertain composition of the lime water. You will have an excess of carbonate of lime or of calomel The [illegible] of the Phil. phar. is the best for a chemist viz. cal. & caust. pot. with 1 pt. water Take cal. & carb. pot. equal parts triturate in a mortar to every troy oz. add alcoh. 3 fl. oz. & wat 1 pt. Boil in a flask until there is a copious black precip wash & dry Blue pill will be more strong in proportion to the quantity of metallic mercury contained which is entirely inactive. If it is made with conserve of roses or with rhubarb, we shall have more or less of malate or gallate of mercury Light decomposes it. When made into pills with any articles which contain combustible matter a greater or less degree of decomposition takes place The mercurial ointment Prof Tully would retain although there is more or less uncertainty about it. But the blue pill mass he would utterly reject. Still this black oxide does not differ in its operation from cal. vide above upon cal. The physicians to whom Prof. T. distributed this article reported that where the stomach contained acid probably from the formation of a salt tormina followed its administra Prof T. would use the black oxide for those who have a prejudice against calomel & for this purpose only Cal. & op. is better in most cases for producing a mercurial action than the ointment still not always Black oxide macerated in nitric acid ([diluted] for 24 hours Wash the white powder. It is between 2/3 & ½ as active as calomel & ought to be substituted for the blue mass This is the di-proto-nitrate of mercury or the disnitrated disoxide Please sew these together Iodine characters Origin is from ocean salt springs zosteramarina Trigl. chin salsola atriplex chenopoidium dipsacis [fallorum] [sedium] teliphium The cryptogamous plants are much more numerous [f?cus] vesiculsus etc. It is found in zoophytes as sponge in the genera venus (clam) ostrea (oysters) etc. several mollusca. Probably iodine & potassium exists in its metallic state in combination with the other elements of the plants Potassa or oxide of potassium probably is produced by the incineration Operative effects Moderate augmentation of the appetite & digestive & of arterial vigor & muscular strength perhaps this is merely the effects of its alleviation of diseases It is of no utility as a [narcotic] 2nd resolves glandular enlargement as of the thyroid the ovaries the testicles & breast & lepidotic (especially) cutaneous aff & acute subacute & chronic inflammations (of an arthritic character especially) increases the catamenia & is said to diminish corpulency & fatten the lean An overdose will either be thrown off by vomiting or produces an atonic erythematic inflammation of the mucous men. of the fauces & al. canal. Dr Tully gives a teaspoonful of the saturated tinct. without injury It is said to have removed the heatlhy female breasts & male testicles. There is no good evidence of this Magendie & others who have much used it have seen no such effects Elliotson of England has employed it very much & even for 18 months without any injury, when disagreeable effects were produced he merely suspended it & afterwards diminished the dose Dr Wood has had it produce a vesicular infl. All the injurious effects are said to have happened in Switzerland, where there was a sort of mania for its use. Prof. T. has used it very much & has not known it produce injurious effects He has known it frequently relieve a diseased & not injure a healthy testicle It is said not to be so at Wether. st. pr. But then the prisoners there are dysthetic or cachectic One case was that of a fungus haematodes The other test. remained unimpaired Iodine is not a stimulant i.e not producing a quickly diffused & transient strength of action. It is a vital irritant capable of producing vesication upon the skin. When properly managed it is neither sialagogue expectorant, diaph nor diuretic. It acts upon the skin, but not in the way of producing diaphoresis. It has cathartic properties according to the experience of Dr Todd It is not known to be cholagogue s Iodine is then 1st deob. 2 tonic 3 rubefacient or even vesicatory Its deobstruent operations are 1st resolve 2nd atnipsoraic 3d emmenag 4th discutient Opium should always be conjoined to counteract its tendency to produce irritation. Opium will enable the patient to bear more iodine & will not injure its operation. Hyoscyam conium & other narcotics will answer [illegible] entony or atony contraindicate it. When used to freely or too long it is said to produce pytalism pain of teeth & gums. absorption of glands pain in internal ears vertigo, sense of burning in the stomach etc. etc. thirst vomiting NO doubt that glands are absorbed by an excessive use. Sufficient warming is given. If persevered in a dry cough sleplessness emaciation vomiting fiarrhoea paralysis priapism convulsions death from excessive irritation. Case of a young lady in Paris whose goitre was reduced to a hard knot. The knot was not cut out as it should have been. The iodine was not discontinued it produced excessive vomiting & purging with an emaciation such that the thighs were not larger than the wrists in health Eventually recovered or nearly so on opium. Authors recommend depletion of blood cathartics of neutral salts etc. a strict antiphlogistic [illegible] [illegible] can be scarcely be deduced from the symptoms On the contrary they indicate antirritants & moderate stimulants ([illegible] powerful stimulants) for the extreme exhaustion & irritation. Opium should be the main article. There is a prejudice among the people, derived undoubtedly from physicians that opium commonly palliate, & never cure disease. It is capable, if properly managed, of curing as many diseases as any other article A British author says that for gastrodynia medicine is of no use with the exception of opium given in efficient quantities. It is idiopathic gastrodynia which is here spoken of. No injurious effects follows Injurious effects follow only the use of opium where there is no disease ^ where of course it produces diseases. Many in the Senate at the Bar etc. are now free from gastrodynia enjoying health & comfort This author however, says Prof. T. seems to know of no mode of using it but to meet paroxysm but the disease may be radically cured even if it requires as it has in Prof. T.’s practice a year & a half. This is a disease not [ever] of inflammation but of irritation though after a long continuance infl. may come on Pharmaceutic prep. Pure [illegible] in pill tinct. ether ointment * plaster of iodine. Magendie’s formula is to be utterly disregarded, on account of the different weights & the different strength of their alcohol which is absolute alcohol a substance which cannot be obtained among us. The translators have sometimes translated the weights without reduction or reduced some & not others. The truth is the French pharmacy is loos & in the midst of their vast among of science there is a great deal of empiricism One grain is supposed to be a medium dose made, say with ext. glycirrh. Divide one gr into 2 pills & give perhaps 1 if necessary Tinct. made of sp. gr. .835. (Take a vial of a known weight put into it 1000 gr, of distilled water mark the heights alcohol up to this mark should weight 835 gr.) 24 gr. of iodine will sat. 1 fl. oz. 20 min. will contain a grain & this is a medium dose [2] or 3 times in a day we may need to give 15 min. or 30 min. or even a fl. dr. Elliotson has increased it from 5 min. to 2 fl. dr. It is said this tinct. will become weakened by crystallization, if it is kept long. Very probably this is the result of carelessly stopping the bottle & suffering the alcoh. to evap. Ether of iodine is used in France Ether contributes nothing. The only possible advantage must be that of having it a little more highly concentrated Ointment of iodine must vary in strength to suit the patient To 1 oz of simple cerate add from ½ a dram to 2 dr of iodine Put the scales of iodine into a wedgewoods mortar & rub it up with a piece of cerate as big as a nutmeg, in order to be sure of pulverizing the iodine. For parts, as the neck, exposed to view, we should use an ointment of iodide of potassium or sodium, which will have no stain upon the skin. These iodides have the same properties with the isolated iodine The plaster may be made of the same strength as the ointment & the best basis is pure white pine resin. If made with adhesive plaster containing lead, we have iodide of lead, which differs in properties perhaps [illegible] better one A hydriodic acid little know of its properties Iodide of potassium called also hydriodate of potassa. It seems to have no advantage over pure iodine, but in taste, & in greater solubility in water. We may use Elliotsons dose of from 1 gr to 1 ½ of the iodide of potas The iodide of sodium would be better from their not deliquescing etc. Phthisis 1st membranosa a thickening of the bronchial membrane caused by dust by dyspepsia neglected cold etc. 2d scrumous or tuberculous phthisis 3d apostematous phthisis Begins imperceptibly & at last an abscess is formed 4th another variety not mentioned in the books is the hemorrhagic phth. found in persons of hemorrhagic habit, begins with hem. this becomes more frequent etc. etc. finally hectic & phthisis 5th laryngeal phthisis an affection of the membrane of the larynx the lung perhaps not affected. The voice finally lost. Always (almost) fatal. It is connected with a strumous habit. It may begin in the fauces. Within a few years several cases have been cured by Brera & by Dr Woodw. of Verm. hydrid. & conium The difficulty is in curing by constitutional remedies. There would be little difficulty, if we could come at the parts & touch with nitrate sil. and corr. sub. Membranific hysteritis has been cured by iodine & conium Mesenteritis strumosa (enlargement) has been cured by it & conium Dysenteria chronica (so called) The cases were probably strumous ulcerations & thickening of the mucus memb. of the intestines very improperly called dysentery, which is never probably apyrectic Arthritis podagra in France externally (improperly?) & internally & with great success. Prof. T. would give it in ‘ teasp. doses of tinct. 5 or 6 times a day during’ the paroxysm but not continuing it long. No danger when the system is occupied with a powerful disease White swellings of various joints one of them is strumous infl. of the body of the bone another is a phlegmonoid inflam. of the cartilages & ligaments. Both have been cured by iodine, especially when applied externally It is surprising how soon the disease may be removed let it e administered in conjunction with conium internally & externally so as to be rubefacient & even vesicatory. Buchmenia indica or Barbadoes swelled [by] would probably be cured by iodine. Prof. T. has cured this repeatedly by arsenic internally & ointment of protoxide of mercury externally Careina vulgaris not sarcoma schirrhosum There are several distinct diseases called cancer which resemble each other in nothing but in terminating in aphagedenic ulcer. Dr Cogswell has cured several cases of unequivocal cancer in its earliest stages by ointment of iodine externally & conium & iron internally. There is no doubt that cancer may be absorbed without sloughing in the earliest stages In the first stages iodine cures the disease by resolution; in the advanced stages when it is too late for the knife, iodine cures by sloughing. Probably the disease is much less liable to return, after iodine Prof. Smith read 50 cases to Prof. T. & all returned in some part of the body Sarcoma medullare ([fungous] haematodes) The origin & progress of this disease is very curious. At first many small encysted tumors, filled with matter of the colour & consistence of honey finally becoming vascular afterwards resembling brain afterwards bursting out being obviously fungous haematodes, & destroying life by hemorrhage Case related of fungous of the testicle cured by iodine Sarcoma schirrhosum this is a much less formidable disease than carcinus vulgaris More easily cured by extirpation also, as well as by iodine. Carcinus vul. commences commonly about the areola the nipple will be draw in there will be a purckered appearance a livid colour etc. Sarcoma schirrhosum commences with a large ugly looking tumor, of the size perhaps of an orange Parapsis acris var. [pruritis] is called [illegible] (nothing visible to the eyes) Exomia pruritis has been cured by iodide of potassium The whole genus lepidosis (scaly) is benefitted by iodine 1st species [pytiocasis] dandruff & var. [illegible] capitis & versicolor one of them dandruff Topical applications are alone of consequence. Lepidosis lepriasis leprosy mild cases have been cured It seems to be considered incurable by authors, but their practice is milk & water treatment Lepidosis psoriasis a very formidable disease iodine with conium should be tried L. ichthyiasis iodine promises more than any other article Ecpyesis impetigo var. laminosa called salt rheum (other diseases also are called salt rheum) Various containers eruptions, when in an ulcerated & highly irritable state must first be brought to a bitter state before you can attempt the cure Ecpy impetigo var. herpetica lasts for years arsenic almost a specific it may be assisted by ointment of iodine Ecpyesis porrigo scald head & var. p. galatea is the worst. Prof. T. has used various articles he has applied tinct iod. by a camels hair pencil also ointment iod. instead of oint. iod. pot., for its greater strength Exostasis ostea & periostea In osteo-sarcoma for instance one of the var. we had better try iodine at the commencement of the disease. It is said to have been cured by it & by conium Case of a young physician The N.Y. & Phil. physicians despaired of him. Dr Todd put him upon conium enough to keep him under a very troublesome narcosis. Prof. T. considers it to have been probably a case of rheumatism Iodine is applicable to as great a range of diseases as mercury. It has been tried in hepatic mesenteric & uterine affections, with some benefit, & should be experimented upon farther It should be tried in lues more than it has. It has been tried with some benefit in epilepsy, chorea etc. [Bromine] resembles iodine but is weaker Chlorine a deobstruent also, not very strong Labarraque’s disinfecting liquid which should be called chloroxide of calcium useful occasionally for ill conditioned ulcers As to its disinfecting power there never has been brought up a shadow of proof. The story of a sewer being opened, & the work men being knocked down & after a quantity of disinfecting liquid. the atmosphere’s [being] pure, is easily explained by [irrespirable] gases, having time to disperse. A stinking sick room is rendered free from smell; in some cases. But stench does not produce disease It will not sweeten the air of a dissecting room There is no evidence that it will destroy the specific contagion of small pox, measles etc. Disinfecting can be effected only by soap & water & ventilations Whitewashers is but a poor substitute Painting is always better than whitewashing Vide [Caldwell] Fumigation & whitewashing on board of of [illegible] are [???pyrical] practices Vide Caldwell’s [illegible] of hospitals, injurious to eyes & lungs are empirical practices Vide Caldwell. Fumigation of hospitals is injurious to the eyes & lungs of the patients Nitric muriatic, nitro-cloric acids mild & weak deobstruents adapted to ill conditioned ulcers, secondary stages of syphilis etc. They have, like chlorine & iodine, weak tonic properties, just about enough to contraindicate them in entonic diseases They are useful in various dysthetic affections Chlorides of barium calcium & gold. Chloride of calcium is a valuable article in scrofula. All of these are weak deobstruents Chl. of barium is supposed to be stronger. No more poisonous than the former except that less is required at a dose. An excessive quantity will produce pain in stomach, tormina, & peculiar discharges. They are slightly diuretic Chloride of gold is stronger still Chloro-[aurate] of chloride of sodium is better than this Rubia tinctoria A pure deobstruent a valuable emmenagogue. Valuable in jaundice (Vide jaundice of Prof. F.) Dr I. gives 1 oz root to 2 pints of water dose 1 oz 2 or 3 times a day Better give as much as the stomach will bear without inconvenience Limosis dyspepsia where there is no great exhaustion. Icterus vulgaris The opponents of madder think it was prescribed merely to colour the feces. Prof. I. places it next after mercury in value Conium is preferable to either Chronic catarrh pneumonitis notha acute dysentery Marasmus atrophea var. infantum recommended. Others say that it has a tendency to produce atrophy Sertosis rachea, recommended by Haller. Ecphronia melancholia (monomania) Halusia hypochondrea by Boerhaave. Patamenia obstructionis & [illegible] & [suppr???] or obstruction and retention of menses Contradictory testimony upon this subject also. The madder of the dyers is not to be depended on. It should be gathered at a suitable time & kept fresh (not old & mouldy) for medical use Nat. order. Fumiariaceae 1st Fumaria officinalis the expressed juice. No doubt that it is adequate to the care of moderate cases oif jaundice & may be useful in dyspepsia 2nd Adlumia cerrhosus (Corydalis fungosa) Possesses considerable pungency i.e. the root in powder. If it is biennial the proper time to collect the root, is in the autumn of the first year. If perennial, wait til it is older Probably much superior to fum. off. 3d Corydalis bulbosa 4th Corydalis glauca is supposed to have the same properties in the top as the annual fum. off. The root is better 5th Dicytra cucullaria (Corydalis) Dutchman’s breeches. The root consists of tubers of the size & shape of an orange seed inclosed in a sheath. It is said to be quite active being narcotic anodyne soporific etc. It is well worthy of investigation & is a good subject for an experimental dissertation The [papa?? accal] [har??] active narcotic deobstruent powers & probably this article resembles them. The active narcotic power of such articles differ materially from that of opium & hyoscyamus. Saponaria officinalis A pure deobstruent perhaps not quite so powerful as madder. Often a useful auxiliary to mercury It has acquired considerable reputation in lues syphilis & syphilodes A good substitute for sarsaparilla Decoction [illegible] medium strength is 2 oz root in 4 pints water to be boiled to 2 pints the whole to be taken in 24 hours. It is prepared on the continent of Europe to leontodon The bruised roots with water make a lather, & are a substitute for soap Various other plants possess this property. Probably a union takes place of mucilage of alkali Scrophularia marilandica leaves & roots considerable popular reputation as an ointment & a cataplasm for piles 2 oz root or leaves in 2 pts water boiled to 1 pint the whole in 24 hours Scaly eruptions chronic pustular eruptions lues syphilodes jaundice scrofula dyspepsia protica marisce are the diseases for which it has a reputation. S. [modora] of Europe is used in scaly eruptions etc. Agrimonia eupatoria (naturalized) Inferior to the two last. A pure deobstruent It has the greatest analogy with leontodon taraxacum Dose 1 or 2 drams 3 or 4 times a day of extract Agr. odora is supposed to be more elegant. A. [suaveolens] is found among us [Aganthremen] crematum ([Diosma] crematum of Linneus) Bariosma crematum & [illegible] of [illegible] Adirandra of another. Diosma crematum & serratum ([Bookae, Buka, Buch??]) From Cape G, Hope Shrubs of moderate size are all the [diosmaceae]. The whole plant abounds with pellucid dots which yield a strong scented essential oil which is supposed to be the active principle. It seems to be a pure deobstruent distinguished only by its resolvent power It is a new article, now mentioned with [illegible] It is spoken of as valuable in [dyspep??] cystitis [arthritis] etc. Employed in infusion and tincture. Strength of decoction not mentioned We might try 2 oz. to 1 pt. boiling water Mr McDowel says this appears to be a very valuable article in dyspepsia, improving the appetite & colour of the skin proving slightly diuretic. It has been most celebrated in dystitis irritatis of infl. of the bladder. There is a very troublesome & irritable infl. of the bladder. There is a membranific infl. which is called by the same name. Physicians are apt to confound all diseases of the bladder under one loose term just as the common people are satisfied with the expression disease of the liver. Chronic rheumatism is a disease for which it has been recommended. But precisely what is meant by this is uncertain whether chronic rheumatism or chronic state of chronic rheumatism Lithia renalis cured by it, by affecting the stomach primarily Collinsonia Canadensis Ox-weed horse-weed archangel [illegible] [illegible]-weed, stone weed [illegible] [horseba???] Medicinal powers reside in the recent rhizoma. But it may be transplanted at any time of the year. Great discrepancy of opinion. The precise nature of its operative effects does not seem to be settled among those who employed But this is true of sarsaparilla leontodon etc. A moderate # deobstruent, particularly affecting the kidneys. It seems to belong to the class of aperients deobstruents. i.e. # moderate [urbites] are at present too much neglected those which promote the fluid secretions Dr I. thinks it resembles the tuberous species of [liatris] Dr Hooker thinks it resembles uva ursi & chemaphile corymbosa. Dose about an even tablespoonful of the rasped root. Used in veterinary medicine [illegible] is used. Decoction injures its properties. Infusion should be preferred The root is one of the hardest substances in the materia medica Limosis neuralgia very beneficial according to Dr Hooker Colica ileus but Dr Ives uses Indian meal & thinks this powdered root, likewise acts merely in a mechanical manner. David Miller of the Shakers thinks it useful in chronic rheumatism or rheumatalgia. Misplaced arthritic affection of the kidnies. It has a popular reputation in dropsy The best diuretic alone in dropsy according to Drs Beers & [illegible] Prof I thinks otherwise Paruria stillitia (strangury) all the varieties & the paruria of typhus [nervo??] A palliative in lithia renalis Aralia racemosa aperient deobstruent Aralia hispida dwarf elder etc. in a large dose it is emetic. It is said to be a Hydragogue cathartic probably it is not. It is the custom to ascribe purgative properties to every emetic, when given in doses short of the vomiting point. It is an efficient diuretic. Give as much as you can without vomiting & continue it until diuresis is produced. No doubt it is a deobstruent. It has not been experimented on sufficient to ascertain whether it is expectorant cholagogue etc. Not narcotic at all. Not known whether it leaves the stomach & bowels in a weak & irritable [continual] condition, like squills & senega, is not known. This is a very serious objection to these two last mentioned articles Contused root 2 oz. boiling water 1 pint & dose from 2 to 4 fl. oz. four to 8 times a day in 24 hours 4 oz to 1 pint alcohol tinct. ½ oz dose Proof spirit cincture seems to be better than alcoholic diseases 1st hydrops cellularis. Dr Reed of E. Windsor cured a case after failure with every other article Not stimulant not tonic Aralia odophylla of Cochin China is said to be highly effectual in dropsy A. scandens is said to have the same prop. Aralia spinosa (though it has no thorns but prickles) Formerly called angelica arborescens hence called angelica at present very improperly called prickly ash ([illegible]) Not indigenous in N. Engl. Languor lassitude, diminution of nat. frequency of pulse drowsiness prickly sensation even sleep. It is said sometimes to have produced genuine articaria It is emetic said to resemble ipecac It increases the biliar secretion undoubtedly cholagogue Dr McBride thought it the best of our native emetics Aralia racemosa is said to be useful in sequel of catarrh, in (pneumonitis ?) Simple idiopathic cough chronic dyspnoea lepidosis psoriasis & impetigo Veratrum album the root (the root is remarkable for being tunicated above & a solid bulb below) That found in our shops is always in powder & is worthless Carbonate of potassa & oxide of potassium which are mentioned among the proximate principles, are the products of combustion, for in this and in other cases, if the vegetable be rasped up & treated with suplhuric acid, no sulphate of potassa is produced It is called in the books merely emetic cathartic & local stimulant i.e. irritant. Veratrum album & strychnous nux vomica are acrid narcotics, not of that sort of narcotics which produce somnolency; they increase nervous strength of action. 1st deobstruent, independently of any evacuation 2nd acrid narcotic (it is a peculiar root of narcotic operation the articles are not necessarily acrids) 3 emetic 4 hydragogue cath. 5 epispastic 6 strumalatory (probably in consequence of its irritation 1st resolvent 2nd cholagogue 3 expectorant 4 diuretic 5 emmenagogue 6 sialagogue occasionally especially when applied to the mouth It does not appear to be diaphoretic except by resolving disease, or in poisonous doses by great exhaustion. Neither tonic or stimulant yet contraindicated in phlogistic diathesis, if for no other reason for this and it would do no good The dry root should not be used Formulae ½ oz to 2 oz. to 1 pt. of water infusion Decoction is thought to injure it. Most of the vegetable alkalies are decomposed at a boiling heat. The famous eau medicinale of [Husson] was probably a wine of the root of [illegible] 8 oz. recently dried root 2 ½ pts Spanish wine macerate for 8 or 10 days add 1 part of Sydenham’s vinum opii composition to 3 parts of this wine of veratrum From 1 to 3 fl. [illegible] about 4 times a day was the dose famous in gout & rheumatism Lobelia inflata therapeutic applications pneumonitis typhode Applicable to all the cases where squills are indicated not applicable where the stomach is very irritable. Arthritis acuta (sub acute rheumatism being without rheumatism, and is attended only occasionally with fever there is swelling and in the commencement the infl. is more or less metastastic Acute rheumatism is metastastic & has an acute fever accompanying it) Case of sub acute rheumatism cured in one night by tinct. lobelia & opium Arthritis rheumatalgia vide p. 37 not febrile no topical redness and swelling but with topical pain allied to neuralgia This disease has been cured by lobelia when other articles had failed Leucorrhoea communis has been sometimes cured and sometimes palliated by this article. N.B. This disease when of long standing cannot be cured all at once Recommended in hernia as a substitute for tobacco as an enema IT has not been tried very extensively in this way & should be further attended to [illegible] other species of lobelia appear to possess a similar assemblage of powers L. tapa of Peru is said to cause vomiting by its odour alone. L. syphilitica (S. flexa) has been praised & condemned by different persons Prof. Tully considers it as undoubtedly deobstruent emetic & hydragogue cathartic. It is expectorant (probably diaphoretic) (probably emmenagogue) diuretic? It has been considered a specific for syphilis much discussion has been excited Probably it will cure blenorrhea [illegible] Various deobstruents are now known to be capable of curing syphilis and probably this will. Prof. T. has tried it in pneumonitis typhodes & thought it equal (fully equal) to polygala senega L. cardenales has been reputed to have considerable medicinal powers it is doubtful whether it is worth retaining in the materia medica it has [sends] qualities of no great strength Actaea racemosa The general actaea and [cimicifuga] and also the macrotys of Rafinesque are now united by Decandolle under one genus actaea The worthy professor here treated us to a synopsis of the whole genus, because it is probable that all of them are [medicinal] Synonymas Actaea monagyna Cimicifuga serpentaria macrotrys serpentaria cin. racemosa macrotrys actaeidis Vulgar names black cohash the best. Various articles are called cohosh. Cornuticis herb crystoph. [darweed] rich weed etc. etc. Ninety plants have the name of snake root. Leontice thalectroides is called blue cohosh & is quite commonly sold for this article. The root of sanicula marylandica is often mistaken for it both being called black snake root. Actaea rubra and pachypode are likewise often mistaken for A. racemosa. No satisfactory analysis has been made. Decidedly and prowerfully narcotic. It is not worthy of reliance as anodyne or soporific though it is decidedly antirritant with respect to heat dryness of skin At least 4 oz. are necessary to saturate 1 pt alcohol sp. gr. .835. It is moderately nervine (probably) as Prof T. thinks he has seen it produce exhiliration and subdelirium in children It does undoubtedly possess the remarkable property of producing [fugitive] neuralgic pains in the extremities & in the sciatic nerve. Conium maculatum Contrary to the general rule, the plant is most active (not when the flowers a just opening) when the flowers are withering. Water is an improper menstruum Alcohol and ether only should be used The etherial tincture evaporated upon water, leaves as a rich green pellicle upon the surface of the water, which has the smell and medicinal virtues of conium Drying injures the plant Age destroys the virtues of this plant. Conium is a deobstruent & especially valuable as being also narcotic Dr March took in 5 hours 18 gr. 2 at first 4 at second 4 at third & 8 at 4th It was a recent extract. First sensations were pleasurable Secondly increased action of the stomach and duodenum pleasurable also Next vertigo unsteadiness in walking with a sensation of greater unsteadiness than really existed The pupil was natural in size but not affected by light nor darkness. Appetite good slept well at night. The next day in the afternoon he was affected with languor & headache which prevented his sleep that night. Next day he was perfectly well. 1831 & 2 Scleratum clavus, ergot parodynia as a substitute for the forceps and [vectis] which may be nearly or quite superseded by ergot. Dr Reed thinks that the forceps should always have the preference in the hand of a skilful hand on account of the danger to the life of the child Parodynia secundaria hourglass contraction of the uterus (which Dr Tully has seen in consultation though its existence is denied by some) The clavus will restore the natural contraction Parodynia secundaria var. retentiva retention of the placenta a perfect substitute for the introduction of the hand of the accouchment. In both cases the use of clavus is condemned upon theoretical views by writers in the procedures. Parodynia secundaria variety haemorrhagea Int his variety the clavus should be given as a preventive. Dr Reed however cautions against its use before the delivery of the head of the child on account of the danger to the life of the child Parodynia [secundi] dolorosa after pains Par. secu. ar. lochialis whenever there is atony of the uterus. Some suppose that it will not act after the delivery of the child but Tully has never known it to fail of expelling it into the vagina & further expulsion cannot be accomplished by the efforts of the uterus. Very little more is given in the books than was first promulgated by Dr Stearns. this article is applicable to a far greater variety of cases. Where hemorrhage at full time endangering abortion occurs we need not wait for pains to come on but give clavus without delay Dr Stearns does not generally give it without [previous] depletion this is not correct. Dr Stearns does not give it when nature is likely to succeed It had better be given in many cases to save pain and suffering Always using belladonna if necessary to produce relaxation He gives it as a rule not to used it except when the os tunica is dilated to the size of a dollar pay no regard to such a rule No regard should be paid to the opinion of epidemics being caused by this This article is supposed to have been used in Holland in 1747 it was used before Dr Stearns’ publication in Pennsylvania by a practitioner in N. London County Conn Dr Stearns heard of its success in the hands of some Scotch women. It is said to have been used in France & to have been prohibited about 1770. Schlerotium maydis is said to produce baldness in men and in swine, and in the latter as well as in mules producing a [paraple] gin. Hens are said to lay eggs without shells owing to premature delivery So too dogs, monkeys etc. are intoxicated by its narcotic properties These things are in L.A. various other species of sclerotium have probably the same powers And various purge; among others [lycoperda] bovista 1831 & 2 Opium is the descending sap of the Papaver somniferum, [illegible] in the sun Hippocrates apparently knew nothing of it. It was known in Homer’s time under the name of nepenth & was used then and afterwards at Thebes & was used as it is now in the east, as a kind of luxury. Extracted either by incision or by cutting off successively the top of the plant. The proximate principle is in [bicodati] of morphin (or by an absurd change of names, bi-mezorati of morphin) Meconic acid was first discovered and the proximate principle was then called bi-meconyti of morphin Afterwards codii acid was discovered to be the acid & afterwards it was called meconia & the meconia was called [codic]!! Just as Samarch [illegible] interchanged the names conium & cicuta The next proximate principle is narcotina or narcotin Some analysts describe a bitter extractive principle its existence is now doubtful This article is one of those capable of producing its effects in health and in disease. single pill doses produce costiveness, yet it acts upon the liver in creasing its secretion probably from this cause it is that the habitual use of opium does not produce constipation Opium undoubtedly counteracts the intoxicating effect of alcohol. So also alcohol counteracts the ultimate narcosis of opium Indeed both these articles are counteracted as to their ultimate narcosis by prussic acid Gelseminum and other pure narcotics Opium morphine The acetate of morphine & the most active The codate or meconate (N.B. This is the acid with which it is combined in the papaver ammonia is incompatible Nitric acid decomposes it so far as to produce an article of a different composition and if this is the case [illegible] [illegible] is incompatible with it. Tully says he has seen no great difference between the acetate and sulphate. One reason given for the super irrit of the acetate is its greater solubility. This by no good reason The next principle in opium & narcotine Bimaconate of sodium is another principle Extractive matter is another (i.e. something soluble in water and alcohol) A resinous principle (i.e. something soluble in alcohol & not in water Limine fecula essential oil etc. etc. Vegeto-animal matter (modified glutine) cautchouk etc. These are of no medicinal activity but may decompose other articles a grain or two on a healthy person produces a calm placid or pleasurable sensation wakefulness increase of force or fullness of pulse last from 8 to [illegible] hours in the latter part of the time some [illegible] next day languor want of appetite etc. etc. IN fuller doses nausea epigastricum easiness etc. It diminishes the biliary secretion hence producing costiveness [illegible] lecture upon morphine the French theory of its producing the pleasant without the unpleasant effects is entirely false Narcotine. Tully has never employed it morphine he is familiar with & has been so for years Great confusion and contradiction upon the subject of narcotic Magendie calls it stimulant Orfila narcotine & Bally says it has no powers whatever Most probably its effects are similar to those of morphine. But the subject wants investigation 2nd stimulant 1st nervine 3 narcotic 4 diaphoretic 5 cholagogue These are the effects of opium & of morphine It is a direct anodyne & a [illegible] & the most powerful soporific The other narcotics do not appear to be very directly soporific Sedative is a term applied to a group of effects If we desire the sedative without the stimulating effects we must give a single full dose So also of wine and alcohol One of the most powerful and useful effects is that of being a mere counteragent of disease Narcotica Diminish irritability & irritation sensibility & sensation in a non phlogistic diathesis also frequently somnolency In large doses stiff [illegible] cloud before the sight coma convulsions & death Epigastric uneasiness nausea Many suppose that they are all stimulant and nervine at their first operation this not true the notion prevails that sedative & stimulant affects are in competition very false Pure narcotics [cyan????] hydrocyanic acid lauro cerasus gelseminum nitidium daturae spigelia etc. helonia [erythro??] [illegible] doses produce what Brown called indirect debility which however 17 the long continued use of a narcotic diminish the susceptibility to itself but not to other agents Opium does not injure the health Tobacco & tea have been too much abused Alcohol the only one [which] produces visceral diseases E. [D.] North 18 1 Narcotica samplicia as hydrocyanic acid datura heloni hyoscyamus belladonna gelseminium poisonous mushrooms seem to be pure narcotics 2nd Stimulatia alcohol wine [opium] lactuca of several species These are the most important of the class narcotics To obtain their stimulant & antirritant effects in conjunction they must be given in regular & small doses etc. In large doses they are used to obviate a particular spasm etc. The former use was well understood by Cullen & his companions but not well understood at present The state of the mind affects very powerfully the operation case of a young man at dinner parties & of an auctioneer who had taken a dangerous dose of laudanum [Opium] more important than any other [article] of the materia medica Purging has done the most mischief Bleeding next the refrigerants next antimony & mercury next Deobstruent narcotics lobelia actaea digitalis nux vomica perhaps [aethusa] & cicuta etc. “Evacuating or generally cathartic sometimes emetic tobacco cocculus The long continued & habitual use of the nervine & stimulant diuretics (perhaps all) produces a certain uneasiness consequent upon their abstraction this peculiar to narcotics limosis syncoptica of Good Limosis syncoptica or epigastric sinking (when idiopathic) generally the sinking comes on about 9 o clock It attends hypochondriasis. Typhus syncopalis syncope The dying Seems to be found in a slight degree in intermittents when they first come on It being difficult to describe it is frequently considered as imaginary Resembles the sense of inanition which comes on when the sense of hunger has subsided after a meal missed at the customary hour Entirely different from the burning sensation of yellow fever Par vagum & the great sympathetic to which belongs the great semilunar ganglion’ In dyspepsia the par vagum seems to be affected In limosis syncoptica & T. sync. it is in the semilunar ganglion & is called sinking So it seems to be [illegible] cases of poisoning [from] mushrooms & snakes In L. sync. & even in limosis the digestion may be good Treatment first to relieve the paroxysm & second to obviate the censes Employ one narcotic to counteract another just as one disease (e.g. measles & small pox) is incompatible with another Give opium & camphor supporting them with stimulants & tonics. Concealing the fact of his giving opium gradually abstracting the opium continuing it for at least a year The tonics are utterly inadequate That produced by opium of less consequence & best cured by gradually obstructing the opium Tobacco conquerable by the will chambers medicine futile even when capsicum was mixed with 10 materia medica 1 Pulse 2 Congestion 4 Diathesis Congestion a 8 Type 10 Acute chronic etc. 11 Classification 13 Porx. principle 16 Narcotica 18 Narcotica simplicia Narcotics Astringents 1 Deobstruents 4 Diuretics 12 Diaphoretics 15 Errhines 17 Sialagogues 18 Emetics 19 Cathartics 22 Epispastics 30 Antidotes 32 Antacids 35 Mich. rem viz Irrit. & Dem. 36 Antilithics 38 Bloodletting 40 Cantharis 56 Capsicum 61 Monard. punct. 65 Hydric ether 66 Wine 67 Alcohol 71 Nitrate pot. 72 Carb. pot.. 78 Bicarb pot. 80 Veg. ac. 87 Acetic acid 87 Hydroc. ac. 82 Gelsem. nitid. 83 Helon. erythos. 85 Con. mac. 89 Cicuta mac. 90 Digitalis purp. 90 Lobelia iunfl. 94 Actaea rac. 96 Languin. can. 49 Aralia spin. 51 Baptisia tinct 52 Veratrum vir. 53 Andeira [iner???] 55 Opium 99 Astringents They produce a moderate vital contraction & condensation of the living fibre while at the same time they moderately decrease absorption & diminish morbid secretion Prof. Ives thinks they likewise diminish irritability The contraction is not [illegible] but vital As a class they are intermediate between the tonics & deobstruents partaking somewhat of the properties of each The vegetable astringents owe their astringency to tannin Properties of tannin etc. Because tannin forms leather with animal albumen it is incompatible with animal jellies as an article of diet Vegetable astringents inefficient in diarrhoea & dysentery not because of phlogistic diathesis but because of the morbid condition of the mucous membrane of the intestines they are useful after that has ceased and this discharge continues as a sort of habit. These remarks however apply only to the vegetable astringent for acetate of lead is as useful as calomel even in the early stages The mineral astringents do not depend upon any one proximate principle & hence they differ from each other in their operation. Vegetable astringents chesnut, the raspings of the wild [illegible] [illegible] [illegible] extract Quercus alba & tinctoria the inner bark Cocoluba vivifera of the sea side of Florida & [illegible] [terantosa] the leaves Geranium maculation the root [Heirchera] americana [italica] Carolina Geum uvale this more tonic than the others saxifraga pennsylvanica parnassis [ameril] Polygalam virginicum caenothus americanum tubus vellosus & vivialis napthar advena & [hymplicea] dorata these have a [nauseous] principle & a good deal of mucilage epiphagus virgiana this not nauseous as [Bart??] says All of these the root These native astringents are abundantly sufficient of our own wants. Foreign astringents found in the shops Green tea valuable when a narcotic power also wanted Mineral astringents acetate of lead etc. Sulph cop. alum Diseases Chronic coryza cough consumption (secondary stages etc. etc. Useful also externally atonic paristhmitis is inflammation of the fauces Spongy ulcers polypus [piles] of some sorts etc. Toothache is relieved by an intense astringent This remedy has been patented by a Hartford man Deobstruents produce a change of condition & action in the whole or part of absorbent & secernant system relieving affections of the liver increasing the secretion of this organ relieving various affections of the skin & produces [asolutions] of inflammations of muscles When they are given for some time in health they generally increase the secretions In disease they change as well as increase They produce less effect upon the brain than upon any other viscus The old definition is that they remove visceral obstructions the term obstruction is applied to indolent inflammations parabismata etc. of the viscera Tully revives this class. To what properties does mercury owe its anti syphilitic power? not in cathartic sialagogue etc. It is not stimulant or tonic, for it does not increase strength of arterial action or digestion & muscular strength. Mercury is a stimulant if we apply this term to any remedy which produces a powerful impression upon the system but this is too loose an application of the term A deobstruent effect may be indicated at the same time with a stimulant or other effect, as with a refrigerant effect but stimulant & refrigerant effects cannot both be indicated at the same time why then use the term stimulant with respect to the deobstruent effect. It is of no use to call mercury anti syphilitic antipsoraic etc. The United States abound in deobstruents & many of the properties of some of them are not generally known E.g. The salivation of mercury has been considered very strange It is however a part of its deobstruent effects which is more obvious & which exists also in a higher degree in tis than in some others of this class Expectorant emmenagogue sialogogue effects etc. may be either direct or indirect direct when not the [illegible] of a deobstruent agent in direct when a part of a general deobstruent effect upon the whole or nearly the whole secerunt & absorbent system For they do not all act upon every part of these systems A deobstruent effect may also be indirect e.g. the act of purging is a deobstruent operation while it lasts The deobstruent effect is frequently the only useful one e.g. colchicum Iris etc. which cannot be usefully employed as emetics & cathartics. This seems to be a sort of experimentum crusis with reference to the propriety of retaining this class Further in the modern systems there is no place for the pure deobstruents e.g. leontodon taraxacum which is put down among the diuretics & cathartics for neither of which effects will it answer And this has probably contributed to bring it into disease. So of other articles The deobstruents although not weakening still reduce the strength of the system in general if continued for a great length of time, especially if the deobstruent effect is combined with one of evacuation None of them however have direct refrigerant powers & none have sufficient stimulant powers to supersede the necessity of combining a stimulant in cases of great atony The system is frequently to be prepared for a deobstruent operation by being previously stimulated or reduced. Rheumatism generally requires one or other of these preparations, but still neither reduction or stimulation will ever cure these diseases. Dysentery is cured as effectually by Iris versicolor & other vegetable deobstruents as by calomel though requiring to be accompanied by opium. Still calomel applies to a greater variety of cases No deobstruents produce stimulation precisely but rather a tonic effect & none directly produce a refrigerant effect, they do this rather through their evacuating powers That a remedy be referred to the class of deobstruent, the only quality which it is indispensable that it should possess is a resolvent one Probably all the deobstruent cathartics are hydragogue. A resolvent power is that of dispersing & curing a topical inflammation without a necessary evacuation. an antipsoraic operation is that of curing a cutaneous disease by an internal remedy Discutient applies to curing an inflammation by a topical application Cholagogue applies to the increased & secretion & evacuation of bile These operations are the foundations of no classes The most common & best known deobstruents are the species of smilax including the rotundifolia & another if our species Comptonia asfil. & myrica galea Compt. destroys fish. Aralia racemosa & [rudicaulis] the root asclepias tuberosa & incarnata. Arctium lappa & another diervilla danadensis celastrus secundus Perhaps also the Collinsonia canadensis solanum nigrum & dulcamara but these too are narcotic Diseases rheumatism [strum??] dyspepsia syphilis yaws various cutaneous diseases Other plants doebstruents are myrica cerifera 3 species of anemone A. virg. etc. ranunculus acris bulbosa & scleratus All the species of trillium alisma plantago dirca palustris conium maculatum is a deobstruent narcotic cicuta maculatum & bulbifera also as well as argemoni mexicana In this vicinity have been used the different species of lettuce (not the exuded & inspissated sap but the inspissated juice & decoction) aconitum napellus strychnos nux vomica angostura bark etc. are acrid narcotics deobstruents rhododendron maximum (Litchfield county) kalmia latifolia Another set is astringent & moderately tonic viz uva ursi chimaphila as syrola 2 species ledum 2 sp. aletus farinose & aurea andromeda calygulata helmias droica The uses e.g. guaiacum oil of juniper several species oil & resin of copaifera off. ol. pinus australis sylvestris strobas etc. abies canadensis & [illegible] mifera These if pushed evacuate Aralia hispida (dwarf elder) diuretic & emetic Erythmium americanum & album these vomit Another set may be diuretic emmenagogue cathartic emetic etc. [Polygala] senega Hellebore Gratiola off. iris versicolas scilla mautima polygala pubescens eryngium aquaticum (properly yuccifolium) lebelia syphilitica These are said to be cathartic Sanguinaria belongs here but is not Colchicum autmnalis aralia spinosa (southern states) [Phyto???] candacendria delphinum consolidum etc. baptisia tinctoria (perhaps) styllingine sylvatica apocynum cannabinum & pubescens anderria inernis (cabbage bark) These are similar to the last class possessing a still greater assemblage of properties? Diuretics increase the urinary discharge Paris’s classification visionary in which he supposes some of them to act in substance upon the urinary organs Nitrate of potassa Tully denies to be a diuretic Diuretics are direct or (as being also general deobstruents) indirect They are also pure. The pure are not always the most powerful e.g. chrysanthemum leucanthemum Roots of opium petroselinum eupatorium purpureum & verticillatum collinsonia canadensis Refrigerant diuretics e.g. nitric ether bitartrate of potassa & acetate of potassa narcotic diuretics e.g. expressed juice of various species of lactuea. The [illegible] if taken very strong Stimulant diuretics e.g. several species of cantharis [illegible] mellifica several of the essential oils as those of the gaulthena [procumb???] & engeron canad. The most important are the deobstruent diuretics gratiola off. scylla maritima polygala senega & pubescens iris versic. & prismatica the several species of elder eryuquim mucifolium sambucus pubescens (red berried or mountain elder) The most efficient & certain single article is asclepias syriaca aralia hispida called dwarf elder. This unlike the rest never proves cathartic erythronium lanceola commonly macerated in ciders Seeds & roots of aretum lappa All these are expectorant emm. [illegible] & antipsoraic & if pushed are emetic & cathartic Next group are the resins & terebinthinate oils these are expectorant resolvent etc. Abies balsamifera the most elegant cpoaifera juniperus pinus australis etc. sang. europaea etc. abies canadend the oil Another set are astringent & perhaps tonic arbutus uva ursi another set is also narcotic e.g. nicotiana tabacum & digitalis purpura Another set are not emetic & cathartic Actaea racemosa cimicifuga this last said to more active rubra & pachypoda inferior Demulcent diuretics mucilages Three conditions of the system in which the diuretics are to be employed viz morbid irritability with atony without atony & In case of great distention diuretics will not operate until the water has been diminished by elaterium a hydrogogue cathartic & some such manner The diuretics however will not cure the disease Tully and his friends have not found diuretics more uncertain than other classes of remedies always succeeding by management combination of several articles or some such way Not always however curing this disease Case of officinal alcohol curing Diaphoretics restore or increase the perspiration It is commonly said that they are all stimulants the argument is that increased secretion implies increased action this fallacious e.g. the sweats of the dying because the weakened vessels may not be able to resist the vis a tergo In high entony refrigerants produce diaphoresis & in great atony stimulants 52 Alcohol continued. The fact that it has not always been used proves no more than that of cinchonas having been formerly unknown Alcohol continued from p. 52 Alcohol is best adapted to the nervous & wine to the putrid type of fevers The old practice of giving bark in wine, in intermittents was a good one now superseded by sol sulph of quinine All the cases of typhus All cases where there is great and extensive suppuration Collections of matter the liver thorax, & even in the female breast though opium possesses the greatest power Hectic, in one of the diseases Anthrax, where the system is considered affected Erythema oedematum gangrenosum anatomicum etc. Parismitis Malignant small pox measles scarlet fever (rosalia) Various cases of inflammation of the viscera Membranific inflammation (croup for instance in many cases N.B. in many of these diseases the wine or alcohol do not supersede the deobstruents etc. Genuine acute febrile dysentery according the nature of the constitutional febrile affection which may be synochus or putrid typhus etc. Marasmus tabes, sand scurvy # The different sorts of gangrene Certain sorts and stages of mental derangement, more especially wine Tetanus some consider them as specific falsely however. In Mass. this disease has been cured by alcohol & liquor of the arsenate of potassa, the latter in large quantities Lyssa canina a similar dispute Chorea according to the condition of the system # this is as much severer disease than sea scurvy which only require the milder astringent & tonics Bites and stings The practice is old and perfectly well established. Galen & Celsus quoted. The maderia medica of Hindoostan makes wine perfectly efficacious Case in the American medical Recorder in which at least 2 quarts of spirit & capsicum were retained in the stomach in the course of one night. The efficacy of spirit in the case of the most venemous serpents is perfectly well known in the tropical reg Instances are many of persons in a state of intoxication being bitten with impunity The excision is generally performed in cases which would not have been dangerous in any case, from the fact of the surgeon in the country being generally at a distance. Confined snake do not [illegible] a mortal bite. The next article to alcohol is opium the next is ammonia. The moderate cases may be relieved by any strong impression hence the reputation of various popular remedies External application of alcohol Dr Ives employs a mixture of alcohol & oil of origanum in burns and scales The vapours of burning alcohol is very usefully employed, by raising the bedclothes, supporting them [illegible] & introducing the vapour through a tin tube Useful in cholica etc. etc. & in that form of dyspepsia which is attended with gastrodynia Errhines excite sneezing by direct application the discharge is sometimes serous when secretion is promoted sometimes more purulent. Useful mainly as counter irritants sometimes the act of sneezing seems to be useful Disease Ophthalmia Cephalitis Deafness neuralgia auris & facies apoplexy etc. Some cases only of the above Snuff taking very injurious producing finally limosis syncoptica also thirst etc. Tobacco is the worst because narcotic Errhines are powdered white sugar the powdered root of the species of iris spirit of [?esculus] dried & pulverized flowers of helenum antimonali Veratrum album and viride Case of an apothecary who sneezed 30 times Euphorbia off. sanguinaria turpeth mineral calomel sialagogues promote salivation by topical application hence mercury is excluded for its salivation is not useful of itself Disease aphonia when idiopathic & symptomatic rheumatic pains of teeth gums Chewing tobacco wastes saliva exhum the strength producing anorexia limosis Drunkards begin with tobacco. Prevents costiveness however sial. antemis pyrethrum myrica cerifera asarum europeum & canadense horseradish zingiber cardamon seed Emetics produce vomiting independent of taste odour or quantity Effects of vomiting & nausea The act of vomiting is probably more or less deobstruent in all cases All emetics given in less than nauseating doses except tartrate of ant. are tonic? 4 purposes 1st to give a shock & break up 2nd to increase susceptibility & prepare 3d to excite the absorbents & create a resolution of inflammations etc. 4 to remove poisonous or offending matter from stomach 5 groups of emetic 1st simple vegetable emetics which produce no other effect e.g. ipecacuanha dorstenia braziliensis A species of asclepias viola [parsiflora] & another The two species of gillenia the best indigenous substitutes for ipecac. Two species of euphorbia These are indicated to remove poison to relieve the stomach of offending matter [illegible] vegetable deobstruent emetics useful where both emesis & deobstruent are both wanted Sanguinaria apocynum cannabinum aralia spinosa polygala senega not best however to use this as an emetic. It leaves the stomach & bowels in a deranged state syclla [matutima] or ornithogalum squilla Lobelia inflata styllingia sylvatica Perhaps also ranunculus flammula the distilled water no taste no nausea acting instantaneously after 5 or 10 min. Sinapis alba & nigra Deobstruent vegetable emetics are proper where strong counteraction at the commencement of diseases as croup etc. 3d Refrigerant mineral emetics tartrate of antimony & potassa James powd consisting of protox. of ant. & lime These emetics given at the commencement of typhous fever bring it on 4th Tonic mineral emetics sulphate of zinc bipersulphate of copper or blue vitriol ammoniuret of copper per acetate of copper or verdigri Limosis dispepsia etc. 5 Deobstruent mineral emetics The best is dipersulphate of mercury or turpeth mineral Cathartics increase or create evacuation from the intestines Murrays arguments about the stimulant operation upon the intestines too loose The peristaltic motion of the intestines essential to life kept up by the bile perhaps also the pancreatic juice & the mucous fluid of the intestines Evacuations promoted by checking perspiration application of cold water to the legs friction etc. Dr. Ives thinks the stimulus of distention of the bowels is very important Cathartics of more universal use than any other class 5 purposes 1st reducing 3nd sudden shock for breaking up diseases neither entonic nor atonic 3d increase susceptibility & equalize excitement in diseases neither at. nor entonic 4 remove fluids as in dropsy 5 to remove poisonous or offending 5 things to be had in view in selecting a cathartic 1st degree 2nd quality of evacuation 3d what other operation 4 the part of the alvine canal operate 5 1st as to degree 1st eccoprotic e.g. syrup of sugar manna subacid fruits 2nd laxative merely increase peristal act sufficient to evacuate the canal carbonate of magnesia ol. juniperus communis 3d purgative which also occasion an increase & discharge of not secretion septandra virginica triostium perf jalapa podophyllum petalum 4 drastica gamboge elaterium croton tiglium These produce copious & continued discharges & invert the action The stronger may be so managed as to operate like the weaker As to quality of discharge cathartics are 1st kopragoga producing fecal discharges e.g. castor oil rhubarb 2 cholagoga or bilious e.g. calomel 3d hydragogue or watery discharges the most perfect is elaterium Others are croton tiglium the refrigerant salts As to other influences 1st nervina allay morbid irritability etc. Cocculus & spec. though cathartic [these] exhilirate Carthagena bean (foederea) None have these two powers simply 2nd narcotica producing prostration etc. Cocculus comes here also Tobacco etc. refrigerantia diminish strength of act Sulphates of potassa magnesia soda & ammonia also the bisulphates the sulphates the hyposulphates Sulphates of lime Phosphates of all these Phosphites hypophosphite etc. Tartrates bitartratis etc. Also the compounds with two bases These act on the exhalents of the intestines These salts are apt to produce flatulency which the other hydragogue cathartics do not bring on These cathartics are commonly supposed to be mild cathartics yet they are bad in old dyspeptic subjects etc. 4th tonic cathartics federaea carthagena carthagena bean nicker nut? polygala [polyga???] aloes 5. astringent. E. g. rheumatism Indigenous species of rumex Ven alum purges & sometimes [illegible] useful in this way 6 deobstruentia Preparations of mercury the most common baptisia iris phytolacca etc. 7 emetica gamboge [triosteum] perfoliatum etc. 8th diuretic when given moderately elaterium tobacco asclepias syriaca 9th diaphoretic eupatorium perfoliatum & rotundifolia asclepias syriaca & tuberosa 10 Emmenagogue aloes convallaria majalis polygala polygama etc. As to part of canal on which they operate 1st stomach & intestines mercurials gamboge triosteum perfoliatum 2nd Colon lepandra jalapa senna etc. 3d Rectum aloes polygala polygama convallaria majalis Another point is the tonic Some are slow as mercurials aloes convallaria & polygama Others are intermediate as jalapa convolvulus juglans cinerca senna most speedy is croton frequently ½ hour Oil of seeds of euphorbia lanthyris & other of about the same qualities Castor oil is quick gamboge also elaterium The refrigerant salts especially when combined with tartrate of antimony as is done in Philadelphia Cathartics frequently break up diseases but generally are more auxiliaries The refrigerant & drastic cathartics however do not break up always Cathartics continued Never proper in dysentery. In low typhous patients may go 5 to 14 days without an evacuation & when it took place it will be of a natural appearance Much abused in this country in cutaneous diseases under the absurd notion of purifying the blood. Not abused on the continent of Europe as in G Brit. & this country The universal tampering with salts & calomel an exceeding evil. So also Flocking to Cheltenham & Saratoga So says MacCulloch. The same of the family medicine chest. The beneficial effects of travelling & the evils of nervous diseases referrable to the same source (McCulloch) Case of a lady of strong constitution who had taken salts & calomel every day since 8 years of age was nervous etc. McCull. Sir W. Scott understands the subject alludes to it in the legend of [Montrose] Physicians are remarkable for not associating with & enquiring after the practice of these different opinions All science properly so called depends upon the detection and classification of differences Epispastics by topical application produce either local inflammation or vesication or destruction of vitality Purposes 1st (acc. to Duncan) to increase the activity of the system in general by initiation then to be kept on some time applied to the extremities 2nd to increase the activity of a particular organ as the liver in jaundice one large plaster over the liver 3d to diminish the activity of a particular organ by counterirritation as in pneumonitis Contraindic in high entony or low atony Dispute whether they should be applied in local affections in the vicinity of or remote from the place Some say idyosyncrasy prevents or obstructs their employment. Tully thinks this is merely greater susceptibility & therefore requires smaller plasters. It is frequently advisable to convert the serous discharge into a purulent one by an irritating plaster or by the constant presence of a [illegible] body as orange peel Question whether issues or successions of blisters are best. This depends upon the disease e.g. hip disease diseases of the spine etc. require issues. The spine is the best situation for most cases of nervous diseases paraplegia various chronic affections of the bladder chronic cephalia [or] headache etc. Children must have them much smaller on account of their greater irritability Alexipharmics antidota etc. counteracting the operations of poisons With respect to toxicology Poisoning is the noxious effect of an ill timed or excessive quantity of an agent or otherwise improper use The Greeks had but one word [illegible] for both medicines and poisons. Pliny says every virus has a virtue. Every poison is a medicine It is not however true that in the present state of the science every poison has actually been made use of or is thoroughly understood Poisoning consists of irritation disorganization stupefaction exhaustion or some combination of these. The deleterious effects of poisons are the same with certain specific diseases. Inflammation of every kind colic paralysis coma apoplexy ptyalism (as of mercury) simple exhaustion marasmus in all 12 No one agent can always have the same effect hence there can be no specific remedy for any one poison If not too late the first indication is to remove the poison from the stomach Tully thinks experiments upon animals by injection into the blood are good for nothing Absurd also is the tying the duodenum and oesophagus Tully thinks toxicology as pursued by Orfila and his imitators as merely a mass of empiricism founded upon the doctrine of specific poisons and remedies Absurd notion of Orfila American editor that savages understand poisoning better than scientific physicians. Poisoning has always been confined to times of ignorance & has fled before the march of science which divests them of their obscure dreadfulness Orfila’s experiments unjustifiable Pure narcotic effects are the first and most simple poisonous effects 2nd acrid narcotics 3d irritating poisons 4 compound poisons Acrid narcotic poisons produce convulsions of a peculiar character tetanic spasms & neuralgic pain mineral vegetable & animal poisons 1st hydrocyanic acid laurel water gelseminum helonias erythrosperma & mist of the 2nd Strychnos nux vomica 3 Oil of tansy [illegible] camphor ol. nutmeg Cicuta maculata & the fungi produce colic Arsenous acid ranunculus phosphorus menchinal capsicum produce irritation Antacids combine with acid and neutralize free acids in the al. can. Ammonia calcia magnesia soda & their carbonates are the only ones Potassa soda and ammonia form lactates with the natural lactic acid of the stomach which are refrigerant Various other acids are found in the morbid states of the stomach as the phosphoric in inveterate and protracted cases of dyspepsia not formed by fermentation which Tully thinks never goes on in the stomach Antacids if ever necessary are merely palliatives because they will not remove the causes of the affection. Dyspepsia appears to be the only disease in which they are employed Mechanical remedies 1st irritants 2nd demulcents Irritants maybe vital or epispastics, or they may be of 3 classes 1st exercise of all sorts which are remedial processes 2nd dermatic as [?uction] percussion acupunctura or shampooing 3d alvine cow itch metallic [tin] filings of iron powdered glass & powdered porcelain charcoal partly Travelling diminishes morbid corporeal sensibility on account of exposure to air etc. increases the assimilation diminishes fecal discharges. Hence the constipation of travellers things inedible in health are harmless great activity of the absorbent system hence reduces obesity & hardens the muscles active exercise quickens the pulse & passive renders it slower hence the latter in some diseases of the heart combining it after a while with active change of air improves the blood changes even to a bad air are frequently useful just as the stomach thrives best on a variety of food Hence also as well as from exercise the ruddy complexion of stage coach drivers Shampooing almost peculiar to the Chinese description of it from Clark Abel Most of the alvine irritants are of doubtful utility Employed from the notion that digestion was caused by trituration & that worms were to be levigated A quack of Connecticut has employed powdered glass gentian & ginger which was certainly more useful in dyspepsia than the same remedy without the glass [illegible] opium aloes spices testicles of a boar & powdered porcelain in colic by a Connecticut family of quacks Good evidence for the utility of powdered glass as an anthelmintic. Anthlithics or lithontriptics A long dissertation upon urine uric acid. Lithis of the different kinds & the [illegible] different kinds of calculus Lithis urinalis has two varieties one with calculi in the kidneys & the other with gravel in them. The former impossible to discriminate by certain diagnosis. Hence a great part of the cases of gravel are fallacious & the experience upon this subject frequently false Antilithica prophylactica & lithontriptica It is the received opinion that the avoidance of animal food & perhaps also of fermented liquors prevents the uric acid diathesis which is the cause of the greatest number of calculi Another circumstance according to Paris’s theory will be the keeping up a natural and healthy action of the skin For the uric acid calculus lime water magnesia (given in soap are upon chemical principles the appropriate lithontriptics for the uric acid calculus No solvent is known for the mulberry calculus The acids which decompose it would form insoluble compounds in the bladder N.B. oxide of magnesia & soap are useful in many gouty cases where there are no calculi. Hence their chemical operation is doubtful The antilithic and lithontriptic modes of treating lithia are obvious [illegible] except in lithia renalis where however it is merely a palliative not reaching the cause of the disease. Better employ tonics opium (in the paroxysm Deobstruents however are the remedies Bloodletting (I was absent) The spring lancet on several accounts is preferable to the thumb lancet 6 distinct purposes of bloodletting 1st as a mere antiphlogistic measure 2nd to make a sudden & strong impression in non phlogistic diseases to produce a resolution 3d to equalize excitement increase susceptibility & prepare for other remedies 4th to divert a haemorrhage from some parts as a substitute for a habitual [illegible] 5th to produce faintness [illegible] in surgical operations 6th to promote absorption in paribismata & emphysemata Bloodletting is always indicated in phlogistic cases no matter what the age sex climate The quantity of blood abstracted should always depend upon the vital energies Strength (not hardness) indicates venesection Strength resists pressure. Hardness is wiry both in the systole & diastole & may be conjoined with weakness. Authors when they speak of hardness alone commonly mean strength The coriaceous or buffy coat upon the blood may depend upon phlogistic diathesis or may depend upon the slowness with which the blood is drawn or the depth of the vessel into which it is received or the particular disease Abundance of medical testimony on this subject Firmness of coagulum & concavity of surface better indicating especially when joined with a buffy coat. We must not mistake the rigidity of the coat of the arteries of elderly people & those who labour much in the open air for genuine strength of action. All diseases are not either phlogistic or antiphlogistic but if the former bloodletting is the remedy known If carried too far it causes a subsequent dropsy etc. General depletion does not benefit a merely local topical inflammation There are cases also of atonic inflammation The essence of inflammation a John Hunter says consists not in the quantity but the quality of action No one has ever opposed bleeding in phlogistic diathesis. Though it has been often asserted; as of Dr Danforth of Boston & Dr Tully falsely however. The diathesis of New England changed about 1805 Many believe and teach that in entonic cases we should aim at the production of faintness or syncope by the manner of abstracting blood Not so however except in surgical cases Sincope should be avoided by placing the patient in a recumbent posture A pint or pint & a half as was directed by Cullen will generally be sufficient if properly supported by refrigerants, subacid fruits cool air etc. With regard to bleeding after casualties. A New England physician of very extensive practice says he has seen more cases of death after a casualty produced by bleeding than by the casualty itself Latham quoted to the same extent Alcohol continued It has been and is now denied that this article ever increases vital energies, or gives new strength, but it [was] affirmed that it merely acts like the spur upon the horse. If this were true it would never be proper to use it in atonic disease, and ought to be banished from the druggist’s shops The ill effects of alcohol are very different from those of wine In chronic cases alcohol is seldom proper and then only to a limited degree. Good French brandy is the best form of alcohol. Morbid exhiliration & delirium & narcosis constitute intoxication Stimulation has nothing to do with intoxication. The ill effects of tippling are probably the result of the narcotic power, one thing is certain viz. that the ill effects of wine & alcohol are not the result of the stimulant operation [illegible] for no more stimulant produces similar effects v. page 48 On Bleeding in Typhus Been advocated at different times for 3 centuries See Good for a summary on this subject. This author advocates it in cases of what he calls congestion Yet from his manner of speaking we might conclude that he had not seen the practice very successful & it is opposed to his own opinion with respect to bleeding in atonic inflammation. There are several sorts of congestion. Superficial [concretion] caused by the action of the heart over powering the pressure of the atmosphere Visceral congestion caused by the atmospheric pressure overpowering the enfeebled action of the heart hence in this kind bleeding will increase it Good supposes that typhus is liable to run into a phlogistic diathesis False as is also the notion that cauma becomes atonic. These two states of the system are entirely incompatible Diseases are broken up in their forming stage by strong measures of the most opposite kind. This accounts for the success of large bleedings in many cases of typhus Free depletions will produce congestion Hence the greatest bleeders always have many cases of congestion & visceral inflammation 3d purpose of bloodletting to breakup diseases etc. The classes of remedies whose effects it increases are emmenagogue sialagogues diaphoretics diuretics cathartics etc. It does not increase the action of all the deobstruents as has been supposed In cases of atony it diminishes their action Most of the deobstruents act more powerfully as the vital energies are higher 4th as a substitute for habitual 7 moderate bloodletting & to remedy a too rapid sanguificatious disease passive haemorrhage paremenia Wounds of the lungs brain etc. It is not the best remedy for a paroxysm of haemorrhage especially if passive In some parts of the country it is the fashion to bleed every gravid woman. A very injurious practice Tully has known 5 or 6 successive cases of abortion in one family, caused by this practice This practice employed in aneurism to keep the vessels partially empty. These cases frequently supposed to exist in many cases when the palpitation was caused by dyspepsia It seems to be the best practice in cases of wounds of the brain & lungs, to avoid haemorrhage 5 to produce sudden faintness. Diseases the passage of gall stones of calculi from the kidneys some cases of hernia obstruction of parturition from rigidity. To facilitate luxations etc. In order to facilitate the production of this effect, place the patient in a sitting posture make a large orifice, pleno vivo. Great abuse in cases of pregnancy many fine women have had their constitutions ruined A Connecticut practitioner has done much mischief 6 purpose to promote absorption & reduce parabismata etc. It should be done in the early stages & should by followed by powerful emetics cathartics etc. The situation in which a person resides affects the necessity for bleeding Those in warm & moist situations require least. [Scrumous] persons bear it very ill. No attention is to be paid to the season of the year. In the Bethlehem hospital for the insane. It was the custom to bleed all the patients in the spring * purge them in the autumn, untill an investigation by parliament was had of all the insane hospital Infants & the aged bear bleeding less Excessive bloodletting is followed by dropsy hectic of inanition, corpulency & laxity with debility: nervous affections etc. Repeated bloodlettings Ill effects of alcohol the chronic effects are a peculiar sort of dyspepsia followed in the case of wine by gout etc. & in the case of alcohol by phthisis paruria mellita impotency delirium tremens, dropsy palsy ophthalmitis the objection that the use of alcohol in malignant cases produces intoxication is entirely unfounded. So also is that of it being liable to cause a habit of intemperance As to its benefit I health case of a students being supposed to labor excessively Alcohol will prevent his nervous tremors [exhaustion] may be prevented from disabling him for the remainder of the day by alcohol N.B. food will not answer Case of two brothers of schirrous diathesis and [in] health over exerting themselves at a fire The one who did not recruit himself by alcohol, lingered two or three years & died of consumption [illegible] of over work in harvesting & shad fishing After a shower rheumatism & pulmonary complaints may be prevented Tully’s own case of these vid. [16] Sanguinaria Canadensis Alkali called sanguinaria Several of its salts are of a beautiful red crimson or scarlet colour a circumstance almost peculiar to these The change produced by mixing the white acid and white alkali is very remarkable All the salts have the same medicinal properties Removes torpor of the liver exerting an action upon the whole secernant and absorbent system. Acts upon the stomach and promotes digestion. Promotes expectoration & the [illegible] secretion. In large doses it is emetic and narcotic It is liable to leave the stomach and intestines in a weak and irritable condition & hence sometimes proves fatal It irritates promotes absorption and action and frequently cures when applied externally to ulcers. It will probably be useful in inflamma It excites sneezing & increase of secretion in the sneiderian membrane Tartrate of sanguinaria experimented upon in Tully’s office & found to possess all the valuable medicinal powers of the root of the plant. It is less emetic It will sometimes answer when the preparation of the root cannot be tolerated The active principle of the plant is the colouring matter which pervades all parts of the 1st deobstruent 2nd acrid narcotic 3 emetic (1st cholagogue 2nd expectorant 3d emmenagogue (not diaphoretic) scarcely diuretic nor sialagogue not cathartic except by promoting the secretion of bile) 4th escharotic & anti-psoraic & discutient Begin with 30 gtts of tinct. & increase to 1 or 2 fl z First employed in Middlefield by Dr [?cjiah] Hoadly, as a sort of specific in some cases and as emetic in croup 1775 (about) First published account is in Foster’s Bossert 1772 says it is emetic. Employed Dr Bolton of Wallingford. First introduced into general practice by Dr Tully 1813 Apocynum cannabinum lectured on Aralia spinosa a large shrub or small tree in middle western & southern states cultivated here. Called angelica tree prickly ash toothache tree etc. etc. This is the most active species All of them have the same properties in different degrees The recent bark of the trunk root and branches & the fruit have an acrid taste in the fauces a common character of the vegetable deobstruents The immediate effects of the bark & fruit are languor lassitude sense of weakness prickly or burning sensation more especially on the face & hands diaphoresis & drowsiness. If continued long enough it promotes the secretions of the liver resolves inflammations finally hydragogue catharsis & sometimes like some other deobstruents produces a genuine articaria It may also be conveniently used as an emetic if sufficiently large doses are employed It has been employed in the bites of snake In such cases the sensation is caused by the bit of the rattlesnake & not by the aralia. It has long been popular in rheumatism Notice taken of A. racemosa (spikenard) A. hispida & A. medicaulis which are weaker and have not been so much experimented on Baptisia tinctoria podalyria tinct. The root is the only part used in medicine Not very thoroughly investigated. First said (of course almost) to be good for the bites of rattlesnakes by Dr Cutler. Dr [Stearn] of New Hampshire notices it in his American Herbal & his account has been (of course) regularly copied. High encomiums are bestowed on it by Dr Thatcher. Dr Joseph Comstock of Lebanon gives an account of its employment successfully as a powerful antiseptic W. B. C. Barton notices it. So others. Tully found that large doses operated as an emetic and cathartic and in smaller doses as a nauseating cathartic It allayed irritative heat and dryness of the skin, promoted the biliary secretions & resolved topical inflammations produced narcosis and always proved cathartic was useful in various cutaneous eruptions Very useful as an external application to ulcers in preventing gangrene Resembles colchicum most, though less dangerous Veratrium vide gum hellebore Treated of by Bigelow & this article upon it is the best in this “Medical Botany” Bigelow calls it highly stimulant. It has no stimulant Bigelow probably formed his conclusion from the fact of its being acrid Acidity will not necessarily produce stimulation That of this article produces irritation, not stimulation No more is every bitter necessarily a tonic Bigelow calls it sedative. But sedative powers may result from a narcotic a nervine or operation Bigelow goes on in the detailed account to deny its stimulant powers This article exactly resembles the veratrum album of Europe Like phytolacca [decandra] & most of the deobstruents it cannot advantageously be used as a mere caustic Too large a quantity in the 24 hours produces vertigo convulsions etc. An excessive single dose produces hyperemesis & hyper catharsis in addition. This last property however is no proof of its being a cathartic, for in poisonous doses one half of the articles in the materia medica will produce this effect. Case related of a physician’s prescribing skunk cabbage beer hyper emesis & catharsis tormina & even alvine haemorrhage etc. of the family & of a physician Relief was afforded by opium This article is an acrid narcotic deobstruent Not diaphoretic diuretic or cathartic It loses much of its power by drying It will produce vomiting when externally applied to a wound Andeira Andeira inernis ([Geffrona] inernis) cabbage tree of the warmer parts of N. America e.g. Jamaica Nat ord leguminasae yet the fruit is a drupe Not used in this country. Nearly resembles coilchicum in its operation. The bark is used The tests of an over dose are nausea & vomiting of to frequent doses, narcosis of too long continuance hydragogue catharsis It is employed in the West Indies and in Spanish America mostly as an anthelmintic Dr Wright of Jamaica considers it the best anthelmintic known Cantharis vesicatoria Stimulant, diuretic, epispastic Of the application of it in typhus Prof Ives has made more use of it than perhaps any other practitioner in the United States. He has given to the amount of a fluid ounce in 24 hours in cases so low as that the patients were insensible to all external objects, and unconsciously voided their urine and faeces Of considerable importance in delirium tremens As an epispastic useful in aposthema communis common boil may be dispensed, anthrax may sometimes, inflammation of the parotid gland Erythema oedematisum (internally in conjoin) with other stimulants and tonics As an epispastic in bubo & in chillblain also in all the varieties of cephalitis Parismitis caumatodes var. phlegmoneae is benefitted by blistering Parismatis typhodes (typhoid inflammation of the fauces) internally Most of the varieties of pneumonitis typhodes internally and externally Erythema of the lungs? Case of Dr Brown’s in Hartford taken suddenly, in 15 minutes [illegible], died in 12 hours partially roused by brandy opium & tinct. canth. The constitutional affection was t. syncopalis Sparganosis puerperarum benefitted by blistering unless it will bring on irritation in consequence of the previous exhaustion of the system Blisters in dysentery in inflammations of the eyes, in phthisis It is a common practice to blister in rheumatism, very injurious & frequently fata, from chasing the topical affection from joint to joint until it attacks a vital part. If however the rheumatism becomes fixed, then blistering may be useful So in chronic rheumatism Sciatica a neuralgia as much as a rheumatic affection, blisters are very useful though when physicians have injudiciously reduced the system by bleeding the blisters may produce a bad irritation Rickets marasmus [illegible] & scruma in these it is used internally. Said to be worth more than every thing else in scruma In gangrene where there is not great atony the topical application is valuable In vitiated ulcers, internally with tonics Ecphronia mania & melancholia, etc. amaurosis applied over the forehead In the early stages of deafness, applied about the ear In tetanus, in enormous quantities internally, just as opium is given to the amt of 100 gr. in 24 hours also blisters on the spine are beneficial Doubtful as to its benefit in neuralgia It has been proposed in lyssa canina Beneficial in idiopathic headache Leucophlegmosia palsy int. & ext. one of the most powerful remedies Blenorrhea leucorrhea [spermorea] [impotency] in these internally Dropsy in all its varieties Remarkable case mentioned by Dr Ives In internal use in one night carried off all the water flooding the floor of the room The patient was reduced to a skeleton & in a state of asphyxia from which he was roused by friction with ammonia etc. pledgets of ling dipped in amm. thrust into the nostrils & the internal administration of spicy & spiritous cordials. He recovered Internally in the species of paruria In paruria mellita or diabetes, give as much opium as will be borne without soporific effect for it will diminish the secretion of murine & increase that of the skin. Give the tinct. canth. Sponge the surface with caustic potash confined the patient to animal prod and debar the use of drink Keep the extremities warm cloth the body in flannel sometimes wearing stockings filled with capsicum to keep upon irritation. Various combinations of canth. with phosphorus etc. are necessary afterwards Exhaustion from haemorrhage has been relieved when other stimulants seemed to fail In the United States we have the cahntharis villata which is more powerful than the C. vesicatoria & might be furnished at a cheaper So the C. cinerea C. [illegible] lytta nuttallii of the N.W. territory is exceedingly powerful and might be collected in great quantities So other species of cantha Lytta gigas of India is about twice as large much more powerful and more speedy in its operation So other insects The larva of phalaena neustria is a good blistering insect. It is the common apple worm Apis mellifica is a blistering insect Various other insects are mentioned by the European writers Capsicum [Roem???] & Sch. [illegible] [illegible] sp. London gives 3 more Our species is the C. opossum or squash pepper. Pericarp oblong globose or conic [or] tetragonous etc. etc. Other species are cultivated but rare The imported cayenne is an indiscriminate mixture adulterated with salt & even with flour, frequently with peroxide of lead. Indian pods are stronger; but ours are strong enough Aleth species have the same properties in kind. By digesting the pods in ether for some days the oil is obtained & crops of crystals of capsicum are found on the sides of the vessel in acicular crystals This is destitute of sensible or medicinal properties So also of piperin. Each of these owe their small amt of virtue to their contamination. The active principle of each is the oil. The oil of capsicum is a perfect substitute Capsicum is a powerful stimulant. The first sensation is that of warmth As in condiment it prevents flatulence from vegetable food and is not liable to the injurious effects of the oriental spices upon the head. Instead of causing visceral obstructions particularly of the liver it is most probably that they prevent them The effects of too large a topical application are an excessive irritative inflammation which is relieved by olive oil & cerate of datura. Tully does not believe that the stomach will retain a sufficient quantity of the power to poison The habitual use of as an article of food in excessive quantities weakens the stomach & produces a troublesome kind of dyspepsia. As a rubefacient it possess peculiar powers One fourth or one eight of a minim of the oil is a dose, given in a pill made with some extract. Of the substance 2 to 12 grains is a dose. The doses are to be larger in tropical climates Lecture omitted Capsicum continued diseases continued Disguised gout various cases of gout misplaced gout Secondary stages of atonic acute rheumatism & in all cases of erythematoid rheumatism All the low atonic exanthematica e.g. rosalia maligna rubeola maligna, malignant small pox All positively passive hemorrhage Marasmus tabes. Sertosis rachea (rickets) All the srumous phlogotica i.e. strumous visceral inflammation. Porphyra hemorrhagica or land scurvy this the remedy second in importance Acetate of lead is first The several species of gangrene Tully considers it as a settled point that tonics deobstruents & acrids are frequently the best remedies for insanity e.g. Connecticut [illegible] which had been more successful than any other known Melancholia hypochondria N.B. this seems to be a compound of melancholia & dyspepsia. Chorea carus lethargus paramenia [illegible] atonic acrids then assist the operation of the deobstruents & tonics Blenorrhea simplex & chronica have as often been suspended by an internal use of capsicum So B. senodes emphysema abdominis (typanitis) Paruria mellita mostly externally sometimes internally as an adjuvant. Par. [incontin??] epidrosis profusa (sweating) The effects of the bits of serpents though not so effectual by itself as alcohol This last with opium is first, next are ammonia capsicum etc. Monarda punctata N S. to Car 14 sp. in R & S. This the most active species Com. name horse mint. Though this name is applied to sp. of mentha & pyenanthem Ess. oil is volatile and exceedingly pungent and acrid resembling the ess. oil of thymus vulgaris One of the most elegant aromatic stimulants and externally rubefacient & even vesicatory. Spt. 1 fl. oz. of oil to 7 of alcohol is the most convenient form for its internal administration First introduced into regular practice by Dr. Attley of Phil. Diseases (Attley & Eberle) 1st typhus in the cold state externally applied Cholera infantum externally Chronic rheumatism cephalea hemicrania obtuseness of hearing from atony dropped into the ear. Externally applied to the limbs in some forms of palsy Rheumatic odontalgia dropped into the tooth if it is carious if not applied to the face combined opium with it Our most common sp. is m. oblongata & this sp. would probably answer as well M. dydima (bee balm or Oswego tea) M. fistulosa common All have the same oil Ether sulphuric or hydric or vitriolic the most volatile of all known liquids. Extremely inflammatory sometimes producing serious accidents when poured out by candlelight. The best test of its purity will be its sp. gr. [illegible] a pure diffusibly stimulant and nervine N.B. Part of two lectures lost Disease (many lost) Typhus Dr Rush never suffered a patient to die without having first tried a very efficient use of this article Syncope of various species, in these it is the best remedy. Neuralgia auris (ear aches) dropped into the ear especially mixed with sulphate of morphine the ear being stopped with lint to prevent evaporation Cephalis hemicrania & nauseosa N.B. when externally applied and suffering to evaporate it is a refrigerant Chorea, common convulsion Hysteria asphyxia, after breathing has been restored. Tully has frequently seen a patient roused from a paroxysm of catalepsy by ether letharty, parodynia Burns & scalds mixed with spt of ammonia, employed by Dr Ives N.B. if vesication has already taken place, it must be so managed as to produce its refrigerant effects? In that state of the system which has been called concussion in consequence of a sudden and violent shock. Wine produce of the vitis vivifera which was originally from the south of Asia it is found however growing wild in Armenia Tauria etc. The varieties are almost innumerable Different sorts of wine 1st white & red again [illegible], adiculia aspera, & mitia acidulous e.g. shock dulcia frontenae malaga tokay, [illegible] aspera port, mitia or soft sherry claret burgundy champaign madeira Paris’ account if its being firs employed by Asclepiades a little before the time of Pompey It is mentioned by Hippocrates It increases the frequency of the morbidly slow pulse & diminishes the heat or increases it diminishes or increases sweating improves the appetite digestion, exhilirates, & strengthens etc. etc. # Habitual and free drinkers of wine are not subject at all to intermittents & but little to typhus Indeed it diminishes the liability to many inflammations etc. See MacCulloch on malaria Excessive quantities produce nausea vertigo etc. in short intoxication # These are the effects in atonic cases & when given in suitable and regular doses and for some time Habitual and excessive use a general weakness of the nervous system a peculiar sort of dyspepsia & gout These are all Wine is 1st stimulant 2nd nervine 3d narcotic The last operation consists of the vertigo nausea etc. Its sedative effects in case of irritability pain etc. are probably the joint result of all its operations Its effects are not slow and permanent enough to entitle it to be called a tonic Wine and opium are the most valuable articles of their kind Various eminent British authorities quoted Good is inconsistent and contradictory It is more especially adapted to the putrid type of typhus Chemical composition of the intoxicating principle One fourth part of the best wine is officinal alcohol or at least will furnish that amount So that a pint of wine will yield a half pint of brandy Now the effects of factitious wines do not differ from those of diluted alcohol The same is true when alcohol is added to wine. It is commonly supposed at the present day that the difference is owing to the chemical composition in which the alcohol [exists] in the wine, chemical comp more especially with the water But we have no evidence that alcohol will unite with water in any other manner than by solution Others supposed that only a portion of the alcohol exists in the wine previous to distillation. But Mr. Grande by adding [illegible] acetate of lead, separates the alcohol without distillation Pure alcohol is composed of the ponderable part of olefiant gas & water 2 to 1 ether is [illegible] to 1 In wine probably [illegible] will have it 1 to 1 Perhaps another compound of 1 ol. gas to 2 of water may be the princ. of [alc.] etc. which differ as much from [illegible] as this does from alcohol Alcohol Arabic named & discovery The name is figurative, meaning originally a fine powder of antimony used as a paint It retains its fluidity at 91 degrees below zero of Fahrenheit# The bluer the flame the purer the alcohol, and in this way its purity may be judged of The pure state has a sp. gr. of .792 Off alc. is .835 Arrack & spiritus oryzae (rice) The difference in the several sorts of spirit is owing to oily matter and acetic ether. The effects of wine and alcohol which are called by the same name yet differ Alcohol & tobacco have more effect upon the [illegible] Intoxication takes place sooner upon an empty stomach & when the body is immersed in water, but if the head is wet and the body dry, the reverse is true vid p 50 # Frozen by Mr Bussy Bulbs filled & surrounded with cotton dipped in anhydrous sulphurum acid, and placed under the receiver of an air pump vid. p. 43 Nitrate of potassa The most powerful refrigerant known next to blood letting most powerfully reducing [illegible] of action Tully thinks it not diaphoretic as has been said neither diuretic. It proves diuretic and diaphoretic in cases of obstructed perspiration & urine from phlogistic diathesis Sometimes however it has these effects in other circumstances though they cannot be calculated upon It is not sedative except as it relieves the morbid restlessness heat & dryness of skin etc. of phlogistic diathesis It may not febrifuge except in [?thenic] fevers, that is in a small portion of fevers Not laxative except as it relieves the torpor of phlogistic diathesis producing the natural discharges. Very doubtful if it is ever antispasmodic. Not antiseptic except upon dead animal matter. Sometimes there is a tendency to gangrene in high phlogistic diathesis which of course is relieved by any refrigerant Cinchona is the most powerful antiseptic, using the term in its most appropriate senses, but these two articles are entirely incompatible one will not counteract efficiently the improper use of the other as seems to be sometimes supposed. The injurious effects of efficient quantities of this article in atonic cases are crust on the teeth coldness of extremities etc. etc. It should always be given in uniform and small quantities from 5 gr. to 1 scr. The test of too large a quantity is pain in the stomach. Sometimes present in the urine, but not in proportion to its effects. The operation of the external application are similar to those of its internal hence it is used as a lotion on phlegmonous inflammation. it is also used as an irritant like tartrate of antimony not therefore a stimulant Deleterious effects, coldness of stomach, discharge of considerable [illegible] of blood weak pulse etc. etc. pallor of countenance etc. A very large quantity vomits and is thrown off. ½ an ounce to an ounce is a poisonous dose Orfila conjoined it refrigerating with its narcotic effects an egregious blunder In a medico jurisprudential point of view nothing short of find the article will answer. Show a distinguished anatomist says that the appearance of the stomach and intestines is not to be relied on as a proof of poison because all the appearances may be at times found in an unpoisoned stomach This very important in this country where medical jurisprudence is much abused. Remedies 1st vomit, not with the mineral, but the vegetable emetics the best is a dose of a table spoonful of black mustard which is more speedy and effectual in clearing the stomach and is useful as an acrid. Opium & alcohol with nutrition demulcent After the poisonous effects have taken place do not vomit and in any case prefer emesis to catharsis. Finally prescribe to the symptoms. The refrigerants & especially nitrate of potassa have been undervalued of late Partly from change of diseases, partly from the chemical theory of the production of animal heat by the solidification of oxygen The French writers call it stimulant because it produces irritation & inflammation Diseases Acute mercurial ptyalism as a topical application doubtful because it is an atonic agent. A dipsosis avens or morbid thirst, especially of intemperance doubtful for the above reason Opium etc. are also undoubtedly known to be useful. This also makes the above doubtful. Dyspepsia by Wilson Philip, upon his theory that the secondary stages of dyspepsia are phlogistic There is much more reason for considering it exceedingly injurious in this disease producing a bad sort of dyspepsia when freely given for affections of the urinary organs. Jaundice by the French writers melaena also by the same very improbable. Simple idiopathic cough very doubtful. Remittent But the opposite class of remedies is always wanted in the varieties of this disease. Idiopathic hectic because it is cooling & sedative Very little probability Synochous in this it does neither hurt nor good Typhus gravior very injurious. Cauma or actively inflammatory fever the most efficient remedy after bloodletting & perhaps after nauseating doses of tartrate of antimony A composition of nitrate of potassa tartrate of antimony & calomel used in Philadelphia under the appellation of Rush’s febrifuge it contains too little of the two first articles. As a general rule avoid being confined to set formulas. Some inflammations of the skin boils [illegible] etc. Blenorrhea lenodes (clap) it has been recommended. In inflammations of the female breasts & of the testicle, it is not so good as acetate of lead. Useful in phlogistic rheumatism still not so good as some other modes of treatment. Useful & important in all the entonic phlogotica. Active phlegmonous cephalitis & in quinsy Membranific inflammation of the bladder doubtful because copaiva oil of pine etc. are very useful. In hemorrhage haemoptysis but the restriction to active shd be made haemorhage It has been recommended in haemorrhage attended with plethora. Tully however does not believe in the existence of a disease consisting of too great a quantity of blood. Sea scurvy recommended very doubtful Tully is inclined to think sea scurvy not a different disease from land scurvy. The latter requires the system to be raised, the former will generally be cured by a change of food Obesity which however is better cured by the old rule mouth always shut eyes always open feet always in motion. Cellular dropsy doubtful Parunia various species, including diabetes. Neither this nor any other remedy has done much good Gravel improbable. Lepidosis psoriaca var. inveterata. Impetogo laminosa (salt rheum) I. herpetica (herpes) Tully has not known it do good & very different articles serviceable. Nitrate of soda possesses the same medicinal properties So also nitrate of ammonia although ammonia itself is stimulating. Various other nitrates also. Carbonate of potassa called sal tartari sal absynthii (salt of wormwood) The deliquation by exposure to air was called oleum tartari. Obtained from the [L??viation] of the ashes of plants not [illegible] when imperfectly purified called pearl ashes. It must be pure for most pharmaceutical preparations. The theory of its combination with oils forming soup it was formerly not understood has been lately investigated. Incompatibles, all the salt will decompose it It is refrigerant but this property is not so predominant as to prevent its use in atonic case Also diuretic, especially when aided by plentiful dilution, still it cannot be depended on in dropsy. In diuretic power greater than it refrigerating. Parunia inops most useful as a diuretic in this Sometimes antilithic viz. in cases of calculi of the xanthic acid & 2 others Antacid as in dyspepsia still not so good as oxide of potassium which is also tonic not so good also as lime. Not stimulating unless this term be applied to every remedial agent. Neither increased frequency of pulse, nor increased heat is an evidence of [stimulation] Not specifically anti-emetic unless retching is produced by a free acid. Not antispasmodic, as in bex convulsiva (whooping cough) Of no use in visceral enlargement. Dyspepsia remittents recommended in the form of effervescing mixtures which however operate by their carbonia acid & the salt formed. Saccharine matters supposed to impair its power. Water the only proper menstruum for its solution. Its solution commonly mixed with a little rhubarb & peppermint This much mused by physicians when at a loss what else to do. Case of A seamstress who had a horrid dyspepsia from costiveness relieved habitually by Lee’s pills relieved by this brought from the south Oftenest used as an effervescing mixture If sugar is added it should be dissolved not in the solution but in the lime juice or else the effervescence will be prevented But the bi carbonate of potassa is best for effervescing mixtures. Large doses are poisonous from irritation inflammation etc. Antidote at first vinegar afterwards demulcents particularly those of an [illegible] oily nature, with narcotics Bicarbonate of potassa called carbonata & super carbonate also sub tartari essentialis sal aeratus (this name is given to other salts of [illegible]) Does not deliquesce from exposure to the air possesses considerable activity as a refrigerant more than the last article. Much use of it as an antacid injurious from the distention. Tully does not believe with Edward and Varasseum that it possesses all the advantages of the carbonate & ought to be used for it although mor pleasant to the taste Carbonate of soda called sal sodae called in commerce when in its most impure state barilla Effloresces upon exposure to the air deliquesces by heat Obtained from marine plants especially the salsola soda Similar in powers to the above Tully thinks it not deobstruent. It can be given in pills carb of potassa cannot from its deliquating the carbonate of soda however must be [efflorescent] Tully can perceive no effect in jaundice from this or the carb. pot. Bicarb. soda (more commonly called sub-[illegible]) found native & called hard enough to build the walls of a fort Ingredient in some specimens of soda water This article originally was made of oxide of sodium Now, except in N. Haven, it is merely carbonated water. The prevailing custom very injurious Case of a brine spring in Albany. Saratoga very injurious ½ dr. to [illegible] gr. tart makes soda powders with pure concrete tartaric acid The tartrate of soda produced is cathartic proportions 25 gr tart. acid ½ dr. soda Seidlitz pow Hydrocyanic acid (I was absent) [Illegible] cerasus the essential oil Equally powerful as a narcotic with hydrocyanic acid 6 ol. oz. of distilled water to 1 pound of the recent leaves Less powerful upon man than upon the brute animals upon which the operation of a little laurel water to the eye or the inside of the mouth causes immediate death. Two or three minims of the (so called or supposed) essential oil kills small animals Tincture the most convenient form Cataplasms of the leaves are useful as a narcotic. The leaves are used for their flavour in cookery among the English & has sometimes in moderate quantities have produced death. Probably the cerasus virginiana has the same properties. probably in a less degree Gelseminum nitis (apocyneae) The effluvia of the flowers are said (in Elliott) sometimes to produce stupor) Tully considers it as a perfect substitute for hydrocyanic acid & free from its inconveniences. The root, most powerful part. In phlogostic cases it would probably like the other simple narcotics do neither good nor hurt. Never produces the calm placid pleasurable sensation exhiliration and wakefulness of the nervines. Tully has always used the tincture 4 oz. bruised root to 1 pint of alcohol macerate for a week. 10 to 20 minims from 3 to 6 hours beginning with small doses & more until narcosis begins to be powdered & then continue the same dose. It is well frequently to conjoin opium [illegible] will counteract its liability to to produce narcosis, Probable all the stimulants have this power. Perhaps the failures so frequently complained of are owing to want of skill in conjoining them Evil effects narcosis merely which may always be relieved by the diffusible stimulants. The best are alcohol [monarda] punctata capsicum spt. ammonia Make use of of napkins wet in cold water applied to the head & of friction, & rubefaction by the monarda punctata Case of a patient who book several doses in rapid succession. The very distressing symptoms were immediately relieved by brand & in 12 hours the patient was as well as before. Case of a girl at the south died in an hour Diseases bex (various species) phthisis where there is much irritation Dyspnea exacerbans acute & subacute rheum Helomas erythrosperma A pure narcotic yet differing materially in its effects from the Prussic acid & Gelsemenum Letter from Dr Brand of S. Carolina Affect the eyes making them sensible to light in an extraordinary degree blindness finally N.B. All narcotics appear to affect the sight Some produce dimness Some dilate the pupil Commencing dose of the tincture 10 minim. Tully has commonly found from 20 to 30 minims necessary at intervals of from 4 to 6 hours. With respect to most such articles, physicians are apt to give inefficient doses & then condemn the article Few of the narcotics, except opium directly produce sleep Chlorite of Potassa (oxymuriate) Prof. Ives is right in saying that it diminishes the heat of the kin & of the stomach. It diminished or at least does not increase entonic diathesis Said to relieve chronic hepatitis which however does not exist, for in dyspepsia accompanied with tenderness over the liver post mortem examination shows no inflammation. Said to be capable of during lues syphilis very doubtful Said to be good for cacherine, a loos term which may include one third of human diseases. Tully believes it a weak refrigerant of no great value without further experiment Vegetable acids. 3 groups 1st those which exist in a free state 2nd which do not & 3d those which are the products of decomposition The last are the benzoic & [illegible] & perhaps [illegible] all nervines Acetic acid 4 states one of which is acidum aceticum pyrumatica or syroligneous acid. Common vinegar is acidum acegum impurum The impurities are various according to the liquor from which it is made Frequently found in the sap of plants as [illegible] typhina vitis vinifera It is a pure refrigerant proper only in cauma. To be given diluted or in combination with mucilage Improperly used in putrid [illegible] to relieve heat [illegible] about the mouth & thirst which do not require [illegible] but if we need acids we must use the [illegible] acids a sulphuric & nitric. Though it is often given to humor nurses bystanders etc. Said to be antiscorbutic but this is loose and doubtful for the vegetable acids pure do not relieve scurvy, without vegetable matter. In obesity if insufficiently employed it does nothing if efficient, it is mischievous. Useful as a condiment, as [illegible] also Conium maculatum a deobstruent [diuretic] confounded with [??uta] maculata both in Europe and in this country. The ancient hemlock is unknown. We know of no plant which will produce the effects ascribed to hemlock in the account of the death of Socrates Perhaps the liquor was a compd of several narcotics The most common form & the best for administering it is extract. The term extract has four applications 2st expressed inspissated juice 2nd inspissated exuded juice 3d inspissated decoction 4th alcoholic extracts Tully places great reliance upon conium and iron in dyspepsia It is useful in paronina salax lagnesis [fluor] etc. etc. Tully used conium & iron with various aromatics in dyspepsia for 4 or 5 years without being able to get any physician to try it. Of more value than mercurials in jaundice Cicuta maculata frequently confounded with the latter more powerful very poisonous the poison cured by stimulants etc. as in other narcotics Digitalis purpurea purple foxglove cultivated in our gardens It is a narcotic deobstruent Medical testimony upon this article exceedingly contradictory. Tully denies that it is either stimulant or refrigerant thinks that the supposed phlogistic cases in which digitalis has been though a substitute for bloodletting were in reality synochous cases which are not phlogistic according to Tully nor are they phlogistic at the outset and typhoid at the last & though they will bear bleeding yet are cured much better without In large quantities it vomits and purges 1st narcotic 2nd deobstruent &^ as parts of this last it is resolvent diuretic and discutient Most commonly used for its diuretic operation [Black???] says that digitalis is not proper except when the urine is coagulable this was tried in this country by boiling the urine! Unfounded If the system is very low it must be raised by excitants in order to allow digitalis to operate So if it is very high it must be reduced Yet there is a considerable range within which neither is necessary Paris’s account of diuretics which are incompatible with it is unfounded The narcotic powers of this article are frequently useful to allay morbid irritability. The best form is tincture It has been supposed that the infusion is best as a diuretic and the tincture as antirritant. Not very probable Therapeutic application Dyspepsia accompanied with tenderness in the epigaastric regions & febrific symptoms digitalis has been used to alleviate these symptoms not so good however as actaea & [other] Recommended in many cases of chronic cough accompanied with dropsical swelling of face, leucophlegmasia Also is it useful in many cases of simple idiopathic cough best however as an auxiliary to opium etc. Whooping cough especially conjoined with arsenic Some forms of phthisis Rheumatism is of various kinds in some of them this article may be used though in most of them actaea & some similar articles are better It has been recommended in mania and probably may be very serviceable in breaking up the paroxysms N.B. the practice of attempting to do this by profuse bleeding is generally bad because the bloodvessels are affected by the mind and not the mind by they bloodvessels & the continuance of the practice may produce fatuity Digitalis long a popular remedy taken in ale among the Italian much used as a [vulnergry]. Withering about 50 years ago first used it in dropsy as a diuretic Frequently the excessive distention of dropsy will prevent the operation of diuretics until it has been reduced by paracentesis or hydragogue cathartics especially elaterium Few diuretics can be depended upon when used alone but required to be combined with others Asclepias syriaca seems to be the most sure which Tully has used. Lobelia inflata 1st narcotic 2n deobstruent 3d emetic as parts of its deobstruent effects it is cholagogue diaphoretic? diuretic? sialagogue & perhaps emmenagogue. No published account exists of its deleterious effects. The first account was published by Ref. Dr. Cutler 1785 It has been employed in form of powder of the leaves powder of the leaves infusion tincture of seeds & tincture of the leaves 2 oz. of recently dried leaves to 1 pint of proof spirit macerate 8 or 10 days Diseases Limosis dyspepsia especially where there is great insusceptibility Simple idiopathic cough considerable [evidence] for its utility. Often very efficacious in that sort of cough to which public speakers and singers are subject it is sometimes the sequel of acute diseases, and is always accompanied with more or less dyspnoea which will be manifested by a fit of coughing following upon the [illegible] to light a candle & blow off dust from every thing Frequently accompanied in these cases with s opium Bex convulsiva or whooping cough in the secondary stages, very useful Tully has not always succeeded with it Dyspnea exacerbans (commonly called asthma, though differing from it) give it in doses of a teaspoonful once in 5 or 10 minutes until the exacerbation disappears either with or without narcosis and vomiting. Highly effectual in asthma though not so certain because the disease is more obstinate The British physicians are just beginning to learn that this article has remedial powers. Tully has no doubt that in Britain diseases yield to smaller doses and less efficient practice than with us This article has been recommended in croup, though it has been rejected upon theoretic principles. Cases mentioned in which its emetic & deobstruent powers have been very serviceable. Actaea racemosa. Black [cohosh] frequently confounded with leontice [thaltroides] called blue [cohosh] No complete analysis has been made Tully thinks it probably has no alkaline principle being in this respect similar to digitalis and conium A narcotic deobstruent in large quantities an emetic Tully thinks he has seen in children moderate exhilirating effects produced by this article It may be pushed so far as to produce neuralgic pains This effect may be prevented by giving liquid food; or it may be remedied after it has taken place by giving opium etc. There is much evidence for its being a [part??] accelerator similar to [sclerotium] clavus With respect to its diuretic and diaphoretic operation it is not strictly correct to ascribe them because they follow the exhiliration of the article only when diaphoresis and diuresis are prevented by the diseased state of the system. The deobstruent effect may be prevented and in the hands of injudicious practitioners frequently is prevented [illegible] too great previous bleeding Actaea resembles digitalis most but differs from it 1st in not accumulating upon the system and suddenly breaking out Through these effects may be prevented in digitalis yet they are not liable to occur from actaea 2nd Actaea is not liable to reduce the patient to a low and dangerous state The narcosis is more easily remedied 3d Actaea produces neuralgic & perhaps spasmodic pains. And this effect is valuable as a test of the limits of the dose 4 Actaea possesses considerable power as a [partus] accelerator 5 It possesses more deobstruent power Actura differs from conium in being [illegible] a deobstruent more speedy & powerful Actaea is most powerful in acute & conium in chronic case The resolvent power of actaea is greater than its cholagogue vice versa with Conium No article has so great a resolvent power as actaea & none so [illegible] a cholagogue as conium Actaea may made indirectly diaph. diur. & expect. conium not Actaea seems to be a more effectual deobstruent than sanguinaria and causing less nausea than colchicum & less liable than either of them to leave the stomach and intestines in a deranged condition The watery preparations not to be relied on Tully used them in a vague way in some years without discovering its narcotic powers Tincture two [ounces] to 1 pint alcohol sp. gr. .835 Medium dose of alc. tinct. f z ss once in 2 or 3 hours Materia Medica 1831 & 2 Pure mineral deobstruents are iodine nitric muriatic nitromuriatic acids chloride of gold barium calcium etc. Perchloride & peroxide of mercury also proto chloride & diproto nitrate of mercury Vegetable deobstruent 1st pure, are leontodon, rubra tinctoria fumaria offic. cinchorium intybus sapomaria offic. Of all these, a large quantity must be used 2nd Aperient they restore, or augment the fluid secretions viz. halitus from the lungs diaphoresis & diuresis (formerly called [illegible] also sweetness of the blood) now often called diet drinks, from their being given in form of decoction & in large quantities. Some of them are spoiled by decoction however. e.g. sarsaparilla is injured even by the best of the sun Smilax off. syph. rotundif. and glauca. Officinal sarsaparilla is from S. off. & S. sulph. (S. sarsaparilla produces none it should be called by Micheaux’s name glauca) Comptonia asplen. (leaves) aralia [medicaulis] & racemosa (root) Asclepias tuberosa & incarn Arctium lappa & dardana? (roots & seeds) Diervilla lutea, celastorus scandens Collisonia canadense, solarum dulcamara (has slight & easily lost narcotic properties) These are used in hectic, lues, bucnemia elephantiasis, lithis arenalis, lepidosis several species. Ecpyresis. Sequels of rheumatism in dyspepsia 3d Acrid cheledonium majus, daphne Mezeocon etc. Dirca palustris ranunculi anemones clematides myrica cerifera 4th mild narcotics, destitute of acrimony solanum nigrum & tuberosum [ethusa] sinapium conium, cicuta & probably the lacturas 5th acrid narcotics they do not incline to produce somnolency or coma, but stupor the term acrid is used to denote this quality of a narcotic operation Kalmia 2 or 3 sp. rhododendron 2 or 3 aconitum napellus, strychnos nux vomica 6th Astringent chemaph. uva ursi [illegible] calyculata ledum [palustra] 7th tonic Canalyrium carolin. (unicorn root) Helonias dioica is the old name for this aletris farinosa (unicorn root also) 8th Evacuating Ol. & resin of pinus & abies & copaifera off. & juniperus [illegible] & guaiacum off. Iris vessic. & prism. Polygala senega & pubescens squills (conithagala squilla) Gratiole off. lobelia syphilitica nearly allied to senega & better because this latter deranges the al. can. Helleborus [2] sp. Eryngium yuccifolium sanguin. veratrum apocynim. aralia spinosa phytolacca colchicum, seeds of Daphinium cocculus [indicus], stillingia sylv. anderia inernis veratrum album Mercurial Ptyalism. Symptoms are ptyalism, soreness of the mouth, ulceration of mouth & fauces a vesicular erythema upon the skin etc. Different persons differ in susceptibility. The same person will be much more susceptible after a previous salivation especially if recent. Teeth set on edge is an incipient symptom Ordinarily there are no fatal consequences. When they occur they consist of caries of the jaw, sloughy ulcers of the mouth, total loss of the teeth, stiffness & incurvation of the limbs, extreme emaciation etc. etc. The treatment is in a good degree empirical. The question as to treatment seems to be, what will do the most good No foundation exists for the opinion that the mercury is deposited throughout the system. Sulphur flowers have been thought a specific nonsense! the only two compounds of mercury & sulphur or one a brilliant red & one black & both insoluble!! Purging, as such. Prof. T. is confident, does no good Dr Finlay of Ohio thinks it may be cured by antimony. Others have not succeeded by it. Sarsaparilla is much used a quart of decoction a day is much used in G.B. undoubtedly with benefit. Not of much use in our country Astringent lotions & gargles are much used They are useful in the latter stages In the first stages resolvent remedies seem to be most needed iced water has cured mild cases. Baptisia tinct. has been much used. The testimony is so strong that Prof T. credits it It is used topically. A strong solution (1 scr. to 1 oz of water of nit. sil. has been the best article used by Tully. Liquor of the arsenite of potassa is an excellent topical application is also taken internally Spts turpentine in gum arabic is employed by Prof. I Lycopus vulgaris decoct is recommended Watery solution of opium is strongly recommended The mineral acids are recommended Mucilages are very grateful acacia typho lab. viole pedata laura sassafras ([illegible]) decoct. of rice & barley strained through a cloth) tragacanth hibiscus althea Prof T. would try quinine Milk porridge is the most grateful diet air [illegible] & [free] Erythismus hydrargyratus Irregular action of heart & arteries, pale countenance exhaustion of strength anxiety in epigastrium, sighing, quick small & sometimes intermittent pulse tongue not furred. In this state, sudden exertion may destroy the patient Treatment A steady and regular use of moderate quantities of opium alcohol & quinine with strict rest Erythema hydragyratum vide Good A vesicular eruption (though like a case of sun burn, a magnifier may be needed to discriminate) Prof. T. does not believe in the spreading from the corrosion of the discharge (criticisms upon Bateman’s confounding erythema with exaena or rash erythema being vesicular) Bateman probably incorrect in saying that it may be caused by cold merely Bateman gives a very full & perfect account of the rise & progress of the disease Diseases teething cathartics too much used blue pill preferred Prof. T. objects to protoxide (blue pill) as being extremely uncertain (imperfectly oxydized) & when perfectly oxydized is in no way preferable to calomel It is milder only in consequence of the diminution of the dose in consequence of the imperfect oxydation. Prof T distributed some of that perfectly oxydized to his friend e.g. Drs Reed Cogswell Todd etc. They all declared they could perceive no difference It will combine with the lactic acid of the stomach & produce a troublesome compound Dyspepsia Prof. T. utterly protests against the fashionable practice of using mercury in dyspepsia Even when the liver sustains the burden of disease it is injurious. The use of mercury occasions tendency of abdomen etc. etc. Even as a deobstruent it is inferior to other articles Occasionally useful as a slow purge Colica Ileus (comm. col.) Of the utmost importance not as a cathartic for this is of no consequence the disease consisting of a suspension of the peristaltic motion. Commence with opium & continue the use of opium but the cal. cures the disease It will never produce ptyalism. It has been given to the amount of i dram once in 6 hours without this effect. Colica rachialgia the same with respect both to opium & mercury Coprostasis not the best article Diarrhoea purging will cure the disease by strong impression but the practice is foolish utterly inapplicable to sev severe cases Cholera Generally the phys. is called too late to allow of the exhibition of calomel In the commencement of the disease it is useful as a deobstruent Helminthia ascar. lumbri probably the best cathartic. The spigelia ought to have been given for the last 12 hours until narcosis is produced. Then give the cathartic Senna is an extremely poor vermifuge its purgative operation is not of the right kind. In the other species of invermination cal. is not the article Even in this species turpentine oil is a better article, but not so manageable as spigelia & cal. Jaundice Purging with cal. in the early stages & the use of [illegible] deobstruant is of great importance cal. is inferior only to conium in this disease. Give it alone cal. is better as a first measure than vomiting Vomiting is apt to produce soreness in the liver & irritative fever. This calomel treatment of jaundice is not the best. The yellow colour will remain and this may be removed if we treat with conium Cal. is apt to produce ptyalism Parabisma coactum There is but one article better than cal. There is an impression that these must be cured before attacking the intermittent. The interm. may be cured without disturbing the parabisma. Conium will cure the disease in half the time of cal. Corysa acuta (improperly entonica by Good) Calomel 7 opium will cure a paroxysm Fevers 1st Intermittent It is a great mistake to suppose that we must always being with purging & vomiting If cathartics are indicated, calomel is much the best notion a drastic dose nor combined with other cathartics Remittent a disease intermediate between intermittent & continued fever. Some cases approach more to an intermittent & others more to a continued form & the nearer it approaches to the latter the more is calomel indicated. It is slow purging that we need not small doses at considerable intervals not quick & drastic for them we increase irritability & irritation Typhus infantum absurdly called infantile remittent & worm fever. Purging with pure calomel & cal. in small doses & at regular & short intervals. It is well to conjoin it with antirritant & with ipecac Non malignant nervous typhus. The best article for producing a resolution, provided you have been called in very early & also before the patient has purged himself even 3 or 4 times with castor oil. Give it either in a single & full dose or in small quantities, so as to get a full dose in the course of 12 or 15 hours or conjoined with opium. Cal. & ipecac is an excellent article for the resolution of fever. Other modes e.g. vomiting, purging, sweating etc. are more liable to fail than to succeed. This mode has succeeded in 8 out of 10 cases in Tully’s practice. Sporadic cases are resolved more easily than epidemic. Purge no more than to remove the contents of the al. can. Dis-oxide of mercury (sub oxide black oxide) (protoxide aethiops per se) pulvis hydr. [illegible] oxidum cinereum is a different compound Mode of preparation vide U.S. Pharmacopoeia This process is very exceptionable An apoth. would require near a barrel of lime water in order to make such a quantity as he would wish to make at once. It is besides uncertain from the uncertain composition of the lime water. You will have an excess of carbonate of lime or of calomel The [illegible] of the Phil. phar. is the best for a chemist viz. cal. & caust. pot. with 1 pt. water Take cal. & carb. pot. equal parts triturate in a mortar to every troy oz. add alcoh. 3 fl. oz. & wat 1 pt. Boil in a flask until there is a copious black precip wash & dry Blue pill will be more strong in proportion to the quantity of metallic mercury contained which is entirely inactive. If it is made with conserve of roses or with rhubarb, we shall have more or less of malate or gallate of mercury Light decomposes it. When made into pills with any articles which contain combustible matter a greater or less degree of decomposition takes place The mercurial ointment Prof Tully would retain although there is more or less uncertainty about it. But the blue pill mass he would utterly reject. Still this black oxide does not differ in its operation from cal. vide above upon cal. The physicians to whom Prof. T. distributed this article reported that where the stomach contained acid probably from the formation of a salt tormina followed its administra Prof T. would use the black oxide for those who have a prejudice against calomel & for this purpose only Cal. & op. is better in most cases for producing a mercurial action than the ointment still not always Black oxide macerated in nitric acid ([diluted] for 24 hours Wash the white powder. It is between 2/3 & ½ as active as calomel & ought to be substituted for the blue mass This is the di-proto-nitrate of mercury or the disnitrated disoxide Please sew these together Iodine characters Origin is from ocean salt springs zosteramarina Trigl. chin salsola atriplex chenopoidium dipsacis [fallorum] [sedium] teliphium The cryptogamous plants are much more numerous [f?cus] vesiculsus etc. It is found in zoophytes as sponge in the genera venus (clam) ostrea (oysters) etc. several mollusca. Probably iodine & potassium exists in its metallic state in combination with the other elements of the plants Potassa or oxide of potassium probably is produced by the incineration Operative effects Moderate augmentation of the appetite & digestive & of arterial vigor & muscular strength perhaps this is merely the effects of its alleviation of diseases It is of no utility as a [narcotic] 2nd resolves glandular enlargement as of the thyroid the ovaries the testicles & breast & lepidotic (especially) cutaneous aff & acute subacute & chronic inflammations (of an arthritic character especially) increases the catamenia & is said to diminish corpulency & fatten the lean An overdose will either be thrown off by vomiting or produces an atonic erythematic inflammation of the mucous men. of the fauces & al. canal. Dr Tully gives a teaspoonful of the saturated tinct. without injury It is said to have removed the heatlhy female breasts & male testicles. There is no good evidence of this Magendie & others who have much used it have seen no such effects Elliotson of England has employed it very much & even for 18 months without any injury, when disagreeable effects were produced he merely suspended it & afterwards diminished the dose Dr Wood has had it produce a vesicular infl. All the injurious effects are said to have happened in Switzerland, where there was a sort of mania for its use. Prof. T. has used it very much & has not known it produce injurious effects He has known it frequently relieve a diseased & not injure a healthy testicle It is said not to be so at Wether. st. pr. But then the prisoners there are dysthetic or cachectic One case was that of a fungus haematodes The other test. remained unimpaired Iodine is not a stimulant i.e not producing a quickly diffused & transient strength of action. It is a vital irritant capable of producing vesication upon the skin. When properly managed it is neither sialagogue expectorant, diaph nor diuretic. It acts upon the skin, but not in the way of producing diaphoresis. It has cathartic properties according to the experience of Dr Todd It is not known to be cholagogue s Iodine is then 1st deob. 2 tonic 3 rubefacient or even vesicatory Its deobstruent operations are 1st resolve 2nd atnipsoraic 3d emmenag 4th discutient Opium should always be conjoined to counteract its tendency to produce irritation. Opium will enable the patient to bear more iodine & will not injure its operation. Hyoscyam conium & other narcotics will answer [illegible] entony or atony contraindicate it. When used to freely or too long it is said to produce pytalism pain of teeth & gums. absorption of glands pain in internal ears vertigo, sense of burning in the stomach etc. etc. thirst vomiting NO doubt that glands are absorbed by an excessive use. Sufficient warming is given. If persevered in a dry cough sleplessness emaciation vomiting fiarrhoea paralysis priapism convulsions death from excessive irritation. Case of a young lady in Paris whose goitre was reduced to a hard knot. The knot was not cut out as it should have been. The iodine was not discontinued it produced excessive vomiting & purging with an emaciation such that the thighs were not larger than the wrists in health Eventually recovered or nearly so on opium. Authors recommend depletion of blood cathartics of neutral salts etc. a strict antiphlogistic [illegible] [illegible] can be scarcely be deduced from the symptoms On the contrary they indicate antirritants & moderate stimulants ([illegible] powerful stimulants) for the extreme exhaustion & irritation. Opium should be the main article. There is a prejudice among the people, derived undoubtedly from physicians that opium commonly palliate, & never cure disease. It is capable, if properly managed, of curing as many diseases as any other article A British author says that for gastrodynia medicine is of no use with the exception of opium given in efficient quantities. It is idiopathic gastrodynia which is here spoken of. No injurious effects follows Injurious effects follow only the use of opium where there is no disease ^ where of course it produces diseases. Many in the Senate at the Bar etc. are now free from gastrodynia enjoying health & comfort This author however, says Prof. T. seems to know of no mode of using it but to meet paroxysm but the disease may be radically cured even if it requires as it has in Prof. T.’s practice a year & a half. This is a disease not [ever] of inflammation but of irritation though after a long continuance infl. may come on Pharmaceutic prep. Pure [illegible] in pill tinct. ether ointment * plaster of iodine. Magendie’s formula is to be utterly disregarded, on account of the different weights & the different strength of their alcohol which is absolute alcohol a substance which cannot be obtained among us. The translators have sometimes translated the weights without reduction or reduced some & not others. The truth is the French pharmacy is loos & in the midst of their vast among of science there is a great deal of empiricism One grain is supposed to be a medium dose made, say with ext. glycirrh. Divide one gr into 2 pills & give perhaps 1 if necessary Tinct. made of sp. gr. .835. (Take a vial of a known weight put into it 1000 gr, of distilled water mark the heights alcohol up to this mark should weight 835 gr.) 24 gr. of iodine will sat. 1 fl. oz. 20 min. will contain a grain & this is a medium dose [2] or 3 times in a day we may need to give 15 min. or 30 min. or even a fl. dr. Elliotson has increased it from 5 min. to 2 fl. dr. It is said this tinct. will become weakened by crystallization, if it is kept long. Very probably this is the result of carelessly stopping the bottle & suffering the alcoh. to evap. Ether of iodine is used in France Ether contributes nothing. The only possible advantage must be that of having it a little more highly concentrated Ointment of iodine must vary in strength to suit the patient To 1 oz of simple cerate add from ½ a dram to 2 dr of iodine Put the scales of iodine into a wedgewoods mortar & rub it up with a piece of cerate as big as a nutmeg, in order to be sure of pulverizing the iodine. For parts, as the neck, exposed to view, we should use an ointment of iodide of potassium or sodium, which will have no stain upon the skin. These iodides have the same properties with the isolated iodine The plaster may be made of the same strength as the ointment & the best basis is pure white pine resin. If made with adhesive plaster containing lead, we have iodide of lead, which differs in properties perhaps [illegible] better one A hydriodic acid little know of its properties Iodide of potassium called also hydriodate of potassa. It seems to have no advantage over pure iodine, but in taste, & in greater solubility in water. We may use Elliotsons dose of from 1 gr to 1 ½ of the iodide of potas The iodide of sodium would be better from their not deliquescing etc. Phthisis 1st membranosa a thickening of the bronchial membrane caused by dust by dyspepsia neglected cold etc. 2d scrumous or tuberculous phthisis 3d apostematous phthisis Begins imperceptibly & at last an abscess is formed 4th another variety not mentioned in the books is the hemorrhagic phth. found in persons of hemorrhagic habit, begins with hem. this becomes more frequent etc. etc. finally hectic & phthisis 5th laryngeal phthisis an affection of the membrane of the larynx the lung perhaps not affected. The voice finally lost. Always (almost) fatal. It is connected with a strumous habit. It may begin in the fauces. Within a few years several cases have been cured by Brera & by Dr Woodw. of Verm. hydrid. & conium The difficulty is in curing by constitutional remedies. There would be little difficulty, if we could come at the parts & touch with nitrate sil. and corr. sub. Membranific hysteritis has been cured by iodine & conium Mesenteritis strumosa (enlargement) has been cured by it & conium Dysenteria chronica (so called) The cases were probably strumous ulcerations & thickening of the mucus memb. of the intestines very improperly called dysentery, which is never probably apyrectic Arthritis podagra in France externally (improperly?) & internally & with great success. Prof. T. would give it in ‘ teasp. doses of tinct. 5 or 6 times a day during’ the paroxysm but not continuing it long. No danger when the system is occupied with a powerful disease White swellings of various joints one of them is strumous infl. of the body of the bone another is a phlegmonoid inflam. of the cartilages & ligaments. Both have been cured by iodine, especially when applied externally It is surprising how soon the disease may be removed let it e administered in conjunction with conium internally & externally so as to be rubefacient & even vesicatory. Buchmenia indica or Barbadoes swelled [by] would probably be cured by iodine. Prof. T. has cured this repeatedly by arsenic internally & ointment of protoxide of mercury externally Careina vulgaris not sarcoma schirrhosum There are several distinct diseases called cancer which resemble each other in nothing but in terminating in aphagedenic ulcer. Dr Cogswell has cured several cases of unequivocal cancer in its earliest stages by ointment of iodine externally & conium & iron internally. There is no doubt that cancer may be absorbed without sloughing in the earliest stages In the first stages iodine cures the disease by resolution; in the advanced stages when it is too late for the knife, iodine cures by sloughing. Probably the disease is much less liable to return, after iodine Prof. Smith read 50 cases to Prof. T. & all returned in some part of the body Sarcoma medullare ([fungous] haematodes) The origin & progress of this disease is very curious. At first many small encysted tumors, filled with matter of the colour & consistence of honey finally becoming vascular afterwards resembling brain afterwards bursting out being obviously fungous haematodes, & destroying life by hemorrhage Case related of fungous of the testicle cured by iodine Sarcoma schirrhosum this is a much less formidable disease than carcinus vulgaris More easily cured by extirpation also, as well as by iodine. Carcinus vul. commences commonly about the areola the nipple will be draw in there will be a purckered appearance a livid colour etc. Sarcoma schirrhosum commences with a large ugly looking tumor, of the size perhaps of an orange Parapsis acris var. [pruritis] is called [illegible] (nothing visible to the eyes) Exomia pruritis has been cured by iodide of potassium The whole genus lepidosis (scaly) is benefitted by iodine 1st species [pytiocasis] dandruff & var. [illegible] capitis & versicolor one of them dandruff Topical applications are alone of consequence. Lepidosis lepriasis leprosy mild cases have been cured It seems to be considered incurable by authors, but their practice is milk & water treatment Lepidosis psoriasis a very formidable disease iodine with conium should be tried L. ichthyiasis iodine promises more than any other article Ecpyesis impetigo var. laminosa called salt rheum (other diseases also are called salt rheum) Various containers eruptions, when in an ulcerated & highly irritable state must first be brought to a bitter state before you can attempt the cure Ecpy impetigo var. herpetica lasts for years arsenic almost a specific it may be assisted by ointment of iodine Ecpyesis porrigo scald head & var. p. galatea is the worst. Prof. T. has used various articles he has applied tinct iod. by a camels hair pencil also ointment iod. instead of oint. iod. pot., for its greater strength Exostasis ostea & periostea In osteo-sarcoma for instance one of the var. we had better try iodine at the commencement of the disease. It is said to have been cured by it & by conium Case of a young physician The N.Y. & Phil. physicians despaired of him. Dr Todd put him upon conium enough to keep him under a very troublesome narcosis. Prof. T. considers it to have been probably a case of rheumatism Iodine is applicable to as great a range of diseases as mercury. It has been tried in hepatic mesenteric & uterine affections, with some benefit, & should be experimented upon farther It should be tried in lues more than it has. It has been tried with some benefit in epilepsy, chorea etc. [Bromine] resembles iodine but is weaker Chlorine a deobstruent also, not very strong Labarraque’s disinfecting liquid which should be called chloroxide of calcium useful occasionally for ill conditioned ulcers As to its disinfecting power there never has been brought up a shadow of proof. The story of a sewer being opened, & the work men being knocked down & after a quantity of disinfecting liquid. the atmosphere’s [being] pure, is easily explained by [irrespirable] gases, having time to disperse. A stinking sick room is rendered free from smell; in some cases. But stench does not produce disease It will not sweeten the air of a dissecting room There is no evidence that it will destroy the specific contagion of small pox, measles etc. Disinfecting can be effected only by soap & water & ventilations Whitewashers is but a poor substitute Painting is always better than whitewashing Vide [Caldwell] Fumigation & whitewashing on board of of [illegible] are [???pyrical] practices Vide Caldwell’s [illegible] of hospitals, injurious to eyes & lungs are empirical practices Vide Caldwell. Fumigation of hospitals is injurious to the eyes & lungs of the patients Nitric muriatic, nitro-cloric acids mild & weak deobstruents adapted to ill conditioned ulcers, secondary stages of syphilis etc. They have, like chlorine & iodine, weak tonic properties, just about enough to contraindicate them in entonic diseases They are useful in various dysthetic affections Chlorides of barium calcium & gold. Chloride of calcium is a valuable article in scrofula. All of these are weak deobstruents Chl. of barium is supposed to be stronger. No more poisonous than the former except that less is required at a dose. An excessive quantity will produce pain in stomach, tormina, & peculiar discharges. They are slightly diuretic Chloride of gold is stronger still Chloro-[aurate] of chloride of sodium is better than this Rubia tinctoria A pure deobstruent a valuable emmenagogue. Valuable in jaundice (Vide jaundice of Prof. F.) Dr I. gives 1 oz root to 2 pints of water dose 1 oz 2 or 3 times a day Better give as much as the stomach will bear without inconvenience Limosis dyspepsia where there is no great exhaustion. Icterus vulgaris The opponents of madder think it was prescribed merely to colour the feces. Prof. I. places it next after mercury in value Conium is preferable to either Chronic catarrh pneumonitis notha acute dysentery Marasmus atrophea var. infantum recommended. Others say that it has a tendency to produce atrophy Sertosis rachea, recommended by Haller. Ecphronia melancholia (monomania) Halusia hypochondrea by Boerhaave. Patamenia obstructionis & [illegible] & [suppr???] or obstruction and retention of menses Contradictory testimony upon this subject also. The madder of the dyers is not to be depended on. It should be gathered at a suitable time & kept fresh (not old & mouldy) for medical use Nat. order. Fumiariaceae 1st Fumaria officinalis the expressed juice. No doubt that it is adequate to the care of moderate cases oif jaundice & may be useful in dyspepsia 2nd Adlumia cerrhosus (Corydalis fungosa) Possesses considerable pungency i.e. the root in powder. If it is biennial the proper time to collect the root, is in the autumn of the first year. If perennial, wait til it is older Probably much superior to fum. off. 3d Corydalis bulbosa 4th Corydalis glauca is supposed to have the same properties in the top as the annual fum. off. The root is better 5th Dicytra cucullaria (Corydalis) Dutchman’s breeches. The root consists of tubers of the size & shape of an orange seed inclosed in a sheath. It is said to be quite active being narcotic anodyne soporific etc. It is well worthy of investigation & is a good subject for an experimental dissertation The [papa?? accal] [har??] active narcotic deobstruent powers & probably this article resembles them. The active narcotic power of such articles differ materially from that of opium & hyoscyamus. Saponaria officinalis A pure deobstruent perhaps not quite so powerful as madder. Often a useful auxiliary to mercury It has acquired considerable reputation in lues syphilis & syphilodes A good substitute for sarsaparilla Decoction [illegible] medium strength is 2 oz root in 4 pints water to be boiled to 2 pints the whole to be taken in 24 hours. It is prepared on the continent of Europe to leontodon The bruised roots with water make a lather, & are a substitute for soap Various other plants possess this property. Probably a union takes place of mucilage of alkali Scrophularia marilandica leaves & roots considerable popular reputation as an ointment & a cataplasm for piles 2 oz root or leaves in 2 pts water boiled to 1 pint the whole in 24 hours Scaly eruptions chronic pustular eruptions lues syphilodes jaundice scrofula dyspepsia protica marisce are the diseases for which it has a reputation. S. [modora] of Europe is used in scaly eruptions etc. Agrimonia eupatoria (naturalized) Inferior to the two last. A pure deobstruent It has the greatest analogy with leontodon taraxacum Dose 1 or 2 drams 3 or 4 times a day of extract Agr. odora is supposed to be more elegant. A. [suaveolens] is found among us [Aganthremen] crematum ([Diosma] crematum of Linneus) Bariosma crematum & [illegible] of [illegible] Adirandra of another. Diosma crematum & serratum ([Bookae, Buka, Buch??]) From Cape G, Hope Shrubs of moderate size are all the [diosmaceae]. The whole plant abounds with pellucid dots which yield a strong scented essential oil which is supposed to be the active principle. It seems to be a pure deobstruent distinguished only by its resolvent power It is a new article, now mentioned with [illegible] It is spoken of as valuable in [dyspep??] cystitis [arthritis] etc. Employed in infusion and tincture. Strength of decoction not mentioned We might try 2 oz. to 1 pt. boiling water Mr McDowel says this appears to be a very valuable article in dyspepsia, improving the appetite & colour of the skin proving slightly diuretic. It has been most celebrated in dystitis irritatis of infl. of the bladder. There is a very troublesome & irritable infl. of the bladder. There is a membranific infl. which is called by the same name. Physicians are apt to confound all diseases of the bladder under one loose term just as the common people are satisfied with the expression disease of the liver. Chronic rheumatism is a disease for which it has been recommended. But precisely what is meant by this is uncertain whether chronic rheumatism or chronic state of chronic rheumatism Lithia renalis cured by it, by affecting the stomach primarily Collinsonia Canadensis Ox-weed horse-weed archangel [illegible] [illegible]-weed, stone weed [illegible] [horseba???] Medicinal powers reside in the recent rhizoma. But it may be transplanted at any time of the year. Great discrepancy of opinion. The precise nature of its operative effects does not seem to be settled among those who employed But this is true of sarsaparilla leontodon etc. A moderate # deobstruent, particularly affecting the kidneys. It seems to belong to the class of aperients deobstruents. i.e. # moderate [urbites] are at present too much neglected those which promote the fluid secretions Dr I. thinks it resembles the tuberous species of [liatris] Dr Hooker thinks it resembles uva ursi & chemaphile corymbosa. Dose about an even tablespoonful of the rasped root. Used in veterinary medicine [illegible] is used. Decoction injures its properties. Infusion should be preferred The root is one of the hardest substances in the materia medica Limosis neuralgia very beneficial according to Dr Hooker Colica ileus but Dr Ives uses Indian meal & thinks this powdered root, likewise acts merely in a mechanical manner. David Miller of the Shakers thinks it useful in chronic rheumatism or rheumatalgia. Misplaced arthritic affection of the kidnies. It has a popular reputation in dropsy The best diuretic alone in dropsy according to Drs Beers & [illegible] Prof I thinks otherwise Paruria stillitia (strangury) all the varieties & the paruria of typhus [nervo??] A palliative in lithia renalis Aralia racemosa aperient deobstruent Aralia hispida dwarf elder etc. in a large dose it is emetic. It is said to be a Hydragogue cathartic probably it is not. It is the custom to ascribe purgative properties to every emetic, when given in doses short of the vomiting point. It is an efficient diuretic. Give as much as you can without vomiting & continue it until diuresis is produced. No doubt it is a deobstruent. It has not been experimented on sufficient to ascertain whether it is expectorant cholagogue etc. Not narcotic at all. Not known whether it leaves the stomach & bowels in a weak & irritable [continual] condition, like squills & senega, is not known. This is a very serious objection to these two last mentioned articles Contused root 2 oz. boiling water 1 pint & dose from 2 to 4 fl. oz. four to 8 times a day in 24 hours 4 oz to 1 pint alcohol tinct. ½ oz dose Proof spirit cincture seems to be better than alcoholic diseases 1st hydrops cellularis. Dr Reed of E. Windsor cured a case after failure with every other article Not stimulant not tonic Aralia odophylla of Cochin China is said to be highly effectual in dropsy A. scandens is said to have the same prop. Aralia spinosa (though it has no thorns but prickles) Formerly called angelica arborescens hence called angelica at present very improperly called prickly ash ([illegible]) Not indigenous in N. Engl. Languor lassitude, diminution of nat. frequency of pulse drowsiness prickly sensation even sleep. It is said sometimes to have produced genuine articaria It is emetic said to resemble ipecac It increases the biliar secretion undoubtedly cholagogue Dr McBride thought it the best of our native emetics Aralia racemosa is said to be useful in sequel of catarrh, in (pneumonitis ?) Simple idiopathic cough chronic dyspnoea lepidosis psoriasis & impetigo Veratrum album the root (the root is remarkable for being tunicated above & a solid bulb below) That found in our shops is always in powder & is worthless Carbonate of potassa & oxide of potassium which are mentioned among the proximate principles, are the products of combustion, for in this and in other cases, if the vegetable be rasped up & treated with suplhuric acid, no sulphate of potassa is produced It is called in the books merely emetic cathartic & local stimulant i.e. irritant. Veratrum album & strychnous nux vomica are acrid narcotics, not of that sort of narcotics which produce somnolency; they increase nervous strength of action. 1st deobstruent, independently of any evacuation 2nd acrid narcotic (it is a peculiar root of narcotic operation the articles are not necessarily acrids) 3 emetic 4 hydragogue cath. 5 epispastic 6 strumalatory (probably in consequence of its irritation 1st resolvent 2nd cholagogue 3 expectorant 4 diuretic 5 emmenagogue 6 sialagogue occasionally especially when applied to the mouth It does not appear to be diaphoretic except by resolving disease, or in poisonous doses by great exhaustion. Neither tonic or stimulant yet contraindicated in phlogistic diathesis, if for no other reason for this and it would do no good The dry root should not be used Formulae ½ oz to 2 oz. to 1 pt. of water infusion Decoction is thought to injure it. Most of the vegetable alkalies are decomposed at a boiling heat. The famous eau medicinale of [Husson] was probably a wine of the root of [illegible] 8 oz. recently dried root 2 ½ pts Spanish wine macerate for 8 or 10 days add 1 part of Sydenham’s vinum opii composition to 3 parts of this wine of veratrum From 1 to 3 fl. [illegible] about 4 times a day was the dose famous in gout & rheumatism Lobelia inflata therapeutic applications pneumonitis typhode Applicable to all the cases where squills are indicated not applicable where the stomach is very irritable. Arthritis acuta (sub acute rheumatism being without rheumatism, and is attended only occasionally with fever there is swelling and in the commencement the infl. is more or less metastastic Acute rheumatism is metastastic & has an acute fever accompanying it) Case of sub acute rheumatism cured in one night by tinct. lobelia & opium Arthritis rheumatalgia vide p. 37 not febrile no topical redness and swelling but with topical pain allied to neuralgia This disease has been cured by lobelia when other articles had failed Leucorrhoea communis has been sometimes cured and sometimes palliated by this article. N.B. This disease when of long standing cannot be cured all at once Recommended in hernia as a substitute for tobacco as an enema IT has not been tried very extensively in this way & should be further attended to [illegible] other species of lobelia appear to possess a similar assemblage of powers L. tapa of Peru is said to cause vomiting by its odour alone. L. syphilitica (S. flexa) has been praised & condemned by different persons Prof. Tully considers it as undoubtedly deobstruent emetic & hydragogue cathartic. It is expectorant (probably diaphoretic) (probably emmenagogue) diuretic? It has been considered a specific for syphilis much discussion has been excited Probably it will cure blenorrhea [illegible] Various deobstruents are now known to be capable of curing syphilis and probably this will. Prof. T. has tried it in pneumonitis typhodes & thought it equal (fully equal) to polygala senega L. cardenales has been reputed to have considerable medicinal powers it is doubtful whether it is worth retaining in the materia medica it has [sends] qualities of no great strength Actaea racemosa The general actaea and [cimicifuga] and also the macrotys of Rafinesque are now united by Decandolle under one genus actaea The worthy professor here treated us to a synopsis of the whole genus, because it is probable that all of them are [medicinal] Synonymas Actaea monagyna Cimicifuga serpentaria macrotrys serpentaria cin. racemosa macrotrys actaeidis Vulgar names black cohash the best. Various articles are called cohosh. Cornuticis herb crystoph. [darweed] rich weed etc. etc. Ninety plants have the name of snake root. Leontice thalectroides is called blue cohosh & is quite commonly sold for this article. The root of sanicula marylandica is often mistaken for it both being called black snake root. Actaea rubra and pachypode are likewise often mistaken for A. racemosa. No satisfactory analysis has been made. Decidedly and prowerfully narcotic. It is not worthy of reliance as anodyne or soporific though it is decidedly antirritant with respect to heat dryness of skin At least 4 oz. are necessary to saturate 1 pt alcohol sp. gr. .835. It is moderately nervine (probably) as Prof T. thinks he has seen it produce exhiliration and subdelirium in children It does undoubtedly possess the remarkable property of producing [fugitive] neuralgic pains in the extremities & in the sciatic nerve. Conium maculatum Contrary to the general rule, the plant is most active (not when the flowers a just opening) when the flowers are withering. Water is an improper menstruum Alcohol and ether only should be used The etherial tincture evaporated upon water, leaves as a rich green pellicle upon the surface of the water, which has the smell and medicinal virtues of conium Drying injures the plant Age destroys the virtues of this plant. Conium is a deobstruent & especially valuable as being also narcotic Dr March took in 5 hours 18 gr. 2 at first 4 at second 4 at third & 8 at 4th It was a recent extract. First sensations were pleasurable Secondly increased action of the stomach and duodenum pleasurable also Next vertigo unsteadiness in walking with a sensation of greater unsteadiness than really existed The pupil was natural in size but not affected by light nor darkness. Appetite good slept well at night. The next day in the afternoon he was affected with languor & headache which prevented his sleep that night. Next day he was perfectly well. 1831 & 2 Scleratum clavus, ergot parodynia as a substitute for the forceps and [vectis] which may be nearly or quite superseded by ergot. Dr Reed thinks that the forceps should always have the preference in the hand of a skilful hand on account of the danger to the life of the child Parodynia secundaria hourglass contraction of the uterus (which Dr Tully has seen in consultation though its existence is denied by some) The clavus will restore the natural contraction Parodynia secundaria var. retentiva retention of the placenta a perfect substitute for the introduction of the hand of the accouchment. In both cases the use of clavus is condemned upon theoretical views by writers in the procedures. Parodynia secundaria variety haemorrhagea Int his variety the clavus should be given as a preventive. Dr Reed however cautions against its use before the delivery of the head of the child on account of the danger to the life of the child Parodynia [secundi] dolorosa after pains Par. secu. ar. lochialis whenever there is atony of the uterus. Some suppose that it will not act after the delivery of the child but Tully has never known it to fail of expelling it into the vagina & further expulsion cannot be accomplished by the efforts of the uterus. Very little more is given in the books than was first promulgated by Dr Stearns. this article is applicable to a far greater variety of cases. Where hemorrhage at full time endangering abortion occurs we need not wait for pains to come on but give clavus without delay Dr Stearns does not generally give it without [previous] depletion this is not correct. Dr Stearns does not give it when nature is likely to succeed It had better be given in many cases to save pain and suffering Always using belladonna if necessary to produce relaxation He gives it as a rule not to used it except when the os tunica is dilated to the size of a dollar pay no regard to such a rule No regard should be paid to the opinion of epidemics being caused by this This article is supposed to have been used in Holland in 1747 it was used before Dr Stearns’ publication in Pennsylvania by a practitioner in N. London County Conn Dr Stearns heard of its success in the hands of some Scotch women. It is said to have been used in France & to have been prohibited about 1770. Schlerotium maydis is said to produce baldness in men and in swine, and in the latter as well as in mules producing a [paraple] gin. Hens are said to lay eggs without shells owing to premature delivery So too dogs, monkeys etc. are intoxicated by its narcotic properties These things are in L.A. various other species of sclerotium have probably the same powers And various purge; among others [lycoperda] bovista 1831 & 2 Opium is the descending sap of the Papaver somniferum, [illegible] in the sun Hippocrates apparently knew nothing of it. It was known in Homer’s time under the name of nepenth & was used then and afterwards at Thebes & was used as it is now in the east, as a kind of luxury. Extracted either by incision or by cutting off successively the top of the plant. The proximate principle is in [bicodati] of morphin (or by an absurd change of names, bi-mezorati of morphin) Meconic acid was first discovered and the proximate principle was then called bi-meconyti of morphin Afterwards codii acid was discovered to be the acid & afterwards it was called meconia & the meconia was called [codic]!! Just as Samarch [illegible] interchanged the names conium & cicuta The next proximate principle is narcotina or narcotin Some analysts describe a bitter extractive principle its existence is now doubtful This article is one of those capable of producing its effects in health and in disease. single pill doses produce costiveness, yet it acts upon the liver in creasing its secretion probably from this cause it is that the habitual use of opium does not produce constipation Opium undoubtedly counteracts the intoxicating effect of alcohol. So also alcohol counteracts the ultimate narcosis of opium Indeed both these articles are counteracted as to their ultimate narcosis by prussic acid Gelseminum and other pure narcotics Opium morphine The acetate of morphine & the most active The codate or meconate (N.B. This is the acid with which it is combined in the papaver ammonia is incompatible Nitric acid decomposes it so far as to produce an article of a different composition and if this is the case [illegible] [illegible] is incompatible with it. Tully says he has seen no great difference between the acetate and sulphate. One reason given for the super irrit of the acetate is its greater solubility. This by no good reason The next principle in opium & narcotine Bimaconate of sodium is another principle Extractive matter is another (i.e. something soluble in water and alcohol) A resinous principle (i.e. something soluble in alcohol & not in water Limine fecula essential oil etc. etc. Vegeto-animal matter (modified glutine) cautchouk etc. These are of no medicinal activity but may decompose other articles a grain or two on a healthy person produces a calm placid or pleasurable sensation wakefulness increase of force or fullness of pulse last from 8 to [illegible] hours in the latter part of the time some [illegible] next day languor want of appetite etc. etc. IN fuller doses nausea epigastricum easiness etc. It diminishes the biliary secretion hence producing costiveness [illegible] lecture upon morphine the French theory of its producing the pleasant without the unpleasant effects is entirely false Narcotine. Tully has never employed it morphine he is familiar with & has been so for years Great confusion and contradiction upon the subject of narcotic Magendie calls it stimulant Orfila narcotine & Bally says it has no powers whatever Most probably its effects are similar to those of morphine. But the subject wants investigation 2nd stimulant 1st nervine 3 narcotic 4 diaphoretic 5 cholagogue These are the effects of opium & of morphine It is a direct anodyne & a [illegible] & the most powerful soporific The other narcotics do not appear to be very directly soporific Sedative is a term applied to a group of effects If we desire the sedative without the stimulating effects we must give a single full dose So also of wine and alcohol One of the most powerful and useful effects is that of being a mere counteragent of disease Narcotica Diminish irritability & irritation sensibility & sensation in a non phlogistic diathesis also frequently somnolency In large doses stiff [illegible] cloud before the sight coma convulsions & death Epigastric uneasiness nausea Many suppose that they are all stimulant and nervine at their first operation this not true the notion prevails that sedative & stimulant affects are in competition very false Pure narcotics [cyan????] hydrocyanic acid lauro cerasus gelseminum nitidium daturae spigelia etc. helonia [erythro??] [illegible] doses produce what Brown called indirect debility which however 17 the long continued use of a narcotic diminish the susceptibility to itself but not to other agents Opium does not injure the health Tobacco & tea have been too much abused Alcohol the only one [which] produces visceral diseases E. [D.] North 18 1 Narcotica samplicia as hydrocyanic acid datura heloni hyoscyamus belladonna gelseminium poisonous mushrooms seem to be pure narcotics 2nd Stimulatia alcohol wine [opium] lactuca of several species These are the most important of the class narcotics To obtain their stimulant & antirritant effects in conjunction they must be given in regular & small doses etc. In large doses they are used to obviate a particular spasm etc. The former use was well understood by Cullen & his companions but not well understood at present The state of the mind affects very powerfully the operation case of a young man at dinner parties & of an auctioneer who had taken a dangerous dose of laudanum [Opium] more important than any other [article] of the materia medica Purging has done the most mischief Bleeding next the refrigerants next antimony & mercury next Deobstruent narcotics lobelia actaea digitalis nux vomica perhaps [aethusa] & cicuta etc. “Evacuating or generally cathartic sometimes emetic tobacco cocculus The long continued & habitual use of the nervine & stimulant diuretics (perhaps all) produces a certain uneasiness consequent upon their abstraction this peculiar to narcotics limosis syncoptica of Good Limosis syncoptica or epigastric sinking (when idiopathic) generally the sinking comes on about 9 o clock It attends hypochondriasis. Typhus syncopalis syncope The dying Seems to be found in a slight degree in intermittents when they first come on It being difficult to describe it is frequently considered as imaginary Resembles the sense of inanition which comes on when the sense of hunger has subsided after a meal missed at the customary hour Entirely different from the burning sensation of yellow fever Par vagum & the great sympathetic to which belongs the great semilunar ganglion’ In dyspepsia the par vagum seems to be affected In limosis syncoptica & T. sync. it is in the semilunar ganglion & is called sinking So it seems to be [illegible] cases of poisoning [from] mushrooms & snakes In L. sync. & even in limosis the digestion may be good Treatment first to relieve the paroxysm & second to obviate the censes Employ one narcotic to counteract another just as one disease (e.g. measles & small pox) is incompatible with another Give opium & camphor supporting them with stimulants & tonics. Concealing the fact of his giving opium gradually abstracting the opium continuing it for at least a year The tonics are utterly inadequate That produced by opium of less consequence & best cured by gradually obstructing the opium Tobacco conquerable by the will chambers medicine futile even when capsicum was mixed with