GEN. II. Anetus. Medical hope left but in a long course of deobstruent bitters, and tinctura sacra, aided by the approaching summer."* IntermitMorton's medicine, of one scruple of chamomile tent fever. flowers, ten grains of salt of wormwood, and the same Ague. quantity of calx of antimony, given every sixth hour, is treatment. said to have subdued, in the metropolis, an obstinate Morton's tertian in two instances. And Dr. Heberden found that remedy. two drachms of the powder of myrrh, taken just before Heberden's. the time of the expected fit, relieved a patient from an ague which for a long time had resisted the power of the bark, though taken in very large quantities. favourite first intro oppressive: The red-bark was now also tried for the first time: it Red-bark was proved to be of unquestionably superior virtue to duced, that in common use; but even a moderate dose of it so often oppressed the stomach and excited nausea and but found vomiting, probably produced by its containing a larger proportion of resin, that, writing at this very period, Sir George Baker tells us, "I have for some time avoided the use of it." It contains, however, by far the largest but contains proportion of quinine, and is now usually selected for nine. this purpose. most qui I may here observe that in the East a variety of other Other barks employed in astringent and bitter barks are also employed both by India. native and European practitioners, and apparently in those regions with considerable advantage; as that called in honour of Van Swieten, Swietenia febrifuga, so warmly Swietenia. recommended by Dr. Roxburgh: that of the bead-tea (Melia Azedarach) and the Tellicherry bark. It does Azedarach. not appear that these were made trial of in the practice Tellicherry. just adverted to, but they have been employed since, yet with a far less success in this part of the world than they seem to produce in India. Arsenic was also tried in combination with opium. Arsenic geIt is admitted that it often effected a cure; but was fre- nerally injurious as quently productive of violent vomitings, colic, and dysen- at first emtery. It seems however to have been given at this period in a somewhat rude and unscientific form. "Arsenic", * Med. Transact. Vol. 1. p. 165. ployed. Anetus. tent fever. GEN. II. says the distinguished writer whom I have just cited, "is mentioned in books as a febrifuge, but it is one of those substances of which we are not as yet so far masters, as to be able, by any art, to render it transferable from the list of poisons to our Materia Medica; and it cannot be deemed to be a proper remedy for an intermittent fever whilst an intermittent fever is less formidable than arsenic." But to this substance we shall have to return treatment. Failure of medicines in an earlier period not for want of skill. Bitters em- Generally unite an astringent principle. And hence chiefly useful. presently. We may not, indeed, be disposed to encourage the farther trial of such operose preparations as milk boiled just seventy-seven times over *, which was one of the most popular charms of the above period; but I have heard of several remedies in high favour and in common use among ourselves, which have as little claim to distinction. The chief BITTERS and ASTRINGENTS that have been called into requisition, independently of those already noticed, are, gentian, cascarilla, willow-bark, nux vomica, and the leaves of the cherry-bay, or prunus Lauro-cerasus; the chief ASTRINGENTS, tormentil, galls, and oakbark; the bark of both species of the swietenia or mahogany tree; avens or caryophyllata (the geum urbanum Linn.), the Lycopus Europaus of the same naturalist, called in Piedmont, where it is supposed to rival the bark, Herb China, alum, and several of the metallic oxydes. To all these a common remark may be applied, that, where they have been of real service, it has generally, though not in every instance, seemed to arise from their Ephem. Nat. Cur. Dec. III. Ann. vII, VIII. Obs. 48. GEN. II. Anetus. uniting the two qualities of a bitter and an astringent, and that they have rarely answered where there has been only one of these qualities to depend upon. Thus tor- tent fever. mentil, one of the most powerful vegetable astringents Medical Ague. we possess, and gentian one of our most powerful vege- treatment. table bitters, succeed so rarely alone, that no dependence is to be placed upon them; but when given in combination, they almost rival the virtue of cinchona; and have occasionally succeeded where the latter has failed. "Joined," says Dr. Cullen, "with galls or tormentil, in equal parts, and given in sufficient quantity, gentian has not failed in any intermittents of this country in which I have tried it."* But the most useful ther un There is, however, a principle, independently of bitterness and astringency, that seems absolutely necessary to enter into conjunction with these, in order to give full efficacy to any medicine employed as a febrifuge in intermittents; and a principle that has hitherto eluded all ciple. research. For if the cure depended upon the intensity of a bitter and an astringent quality alone, galls, oakbark, and mahogany-bark ought to succeed better, not only that an union of tormentil and gentian, or chamomile and alum, which have also been found very serviceable, but than cinchona itself; which every one knows they do not, although, when Peruvian bark cannot be obtained, they become desirable substitutes. The nux vomica and Ignatius's bean (strychnos Nux Nux vomica. vomica, and ignatia amara, Linn.) combine, with an intense bitter, a most active narcotic virtue; and how far the last may be peculiarly opposed to a recurrence of that spasm on the extreme vessels which constitutes the cold fit, it is difficult to determine. M. Bourieu + from his own practice strongly recommends the latter, and Paullini and Aaskow § the former. If Dr. Fouquier's remark be well founded, which we shall have occasion to notice more at large when treating of paralysis, that Mat. Med. Part 11. Ch. II. p. 72. + Hist. de la Societé R. de Med. 1776. p. 340. Cent. II. Obs. 45. § Act. Societ. Med. Hafn. Tom. II. Anetus. tent fever. treatment. GEN. II. these poisons have a power of augmenting energy in debilitated muscular fibres, while they leave those in health unaffected, we can account for some part of the success which has been so vauntingly ascribed to them in the case of intermittents. But, notwithstanding that they have been for this purpose before the public for upwards of a century, the infrequency of their use is a strong argument that they are not much entitled to commendation. "In a very small dose," says Dr. Cullen, "the faba Sancti Ignatii has the effect of curing intermittent fevers." But whether he reports this from his own practice, or from that of others, we cannot exactly determine: nor does he tell us what is the small dose he refers to. I have tried the nux vomica to the extent of eight grains in powder every six hours for an adult under palsy, without any mischievous effects except a slight stupor in the head. And much beyond this we cannot proceed with prudence. Hoffman gives the case of a from its use. girl of ten years of age, who was killed by taking fifteen grains of it, divided into two doses, for an obstinate quartan +. Fatal case Lauro-ce rasus. Bitter almonds. The lauro-cerasus was at one time, as we are told by Dr. Brown Langrish, a common medicine in his neighbourhood for the cure of agues : but he takes no notice of the dose or mode of administering it. Its properties are nearly the same as those of bitter almonds; and Dr. Bergius informs us that he has frequently prescribed an emulsion of bitter almonds with success in intermittents, in the quantity of a pint or two daily during the intermission; and that it has sometimes cured where the bark had failed §. This is an authority worth attending to; and as the same medicines are said to have a peculiar power of resolving visceral obstructions, they have an additional claim to a cautious series of experiments. It son supposed is generally supposed, in the present day, that their Their poi to depend on their prussic acid. • Mat. Med. Part. II. Chap. II. p. 76. + Philos. Corp. Hum. Morb. P. 11. Čap. vn. Experiments on Brutes. See also Phil. Trans. No. 418, 420. $ Mat. Med. p. 412. Anetus. poisonous property depends upon their containing a por- GEN. II. tion of native prussic acid: the taste of prussic acid, Intermithowever, is not bitter, but sweetish and acrid. Yet it is tent fever. chiefly the bitter we seem to want in the present instance; Ague. and if prussic acid really exist in other, and could be treatment. separated from the bitter principle from which it appears to be distinct, we might be put into possession of a medicine of considerable importance. Medical sirable to this from their bitter principle. The only metallic oxyde really worthy of notice is that Hence deof arsenic; for although various oxydes of iron, mercury, separate zinc, and copper, have been tried, and occasionally extolled, none of them have proved so decidedly beneficial as to render it worth while to try them over again. Metallic Mercury, as we learn from Sir James Johnson, was oxydes. tried extensively some years ago at the Bocca Tigris in Mercury. the East, on the crews of two ships of war, the Grampus and Caroline, in consequence of the stock of bark being exhausted. The paroxysms, he tells us, were invariably put a stop to as soon as the system was saturated; but he adds that three fourths of the patients thus treated relapsed as soon as the effects of the mercury had worn off; and this after three, and, in a few instances, four successive administrations, so as to excite ptyalism*. And hence mercury, even where it is successful, does not appear in this case to produce any permanent impression upon the system. Iron, though of little value in most of its forms, has Iron. been said of late to have succeeded completely in that of its prussiate. Dr. Zollickoffer has given various instances of this in a foreign journal, and places its powers above those of arsenic or bark. It must be tried however upon a much larger scale before it is entitled to an established reputation. The ordinary adult dose is about four grains two or three times a-day in a little sugar and water. Arsenic, under various forms, has also been employed Arsenic. from a very early period +. It is, strictly speaking, an Its use imoriental medicine, and has been in vogue immemorially India. • American Medical Repository, July, 1822. ported from |