PART SECOND.

REVIEW S.

New Remedies: the Method of Preparing aud Administering them, their Effects on the Healthy and Diseased Economy, &c. By ROBLEY DUNGLISON, M.D., Professor of the Institutes of Medicine and Materia Medica in Jefferson Medical College of Philadelphia, &c. 8vo. pp. 503. Philadelphia, 1839.

THE title of this book led us to hope, not only that it would give an account of the more recent additions to the materia medica, and of their supposed physiological and therapeutical actions, but also that from it we might be able to profit somewhat by the experience of our transatlantic brethren, in the use of some of the many "new remedies" which have of late years been brought under the notice of the profession. In regard to the former point, we must admit, that Dr Dunglison has evinced a very considerable amount of diligence and zeal, in having collected a vast body of what are commonly called medical facts; but along with this diligence and zeal, there is a very great lack of judgment in the selection. In his preface, he tells us that he has thought proper to give, so far as he was able, the recorded experience of all who have employed the remedies in question, owing to the difficulty of sifting the results of true from those of false observation." In continuation, he remarks on the superiority of a rational and inductive cultivation of medicine, over a merely empirical method, admitting, however, that well-substantiated experience in practical medicine, must always be entitled to take precedence of reasoning as to the power of a remedy. "To treat disease methodically and effectively, the nature of the actions of the living tissues, in both the healthy and morbid conditions, must be correctly appreciated; the effects which the articles of the materia medica are capable of producing under both these conditions, must be known from accurate observation, and not till then can the practitioner prescribe, with any well-founded prospect of success." Preface, p. iv. "Every one will be compelled to admit, that it is the duty of the correct therapeutist, to doubt the existence of qualities in any article, until they have been adequately proved. When such is the case, no reasoning can set

aside facts; but unless the evidence be overpowering, it is equally his duty to remain in doubt, especially should reflection suggest to him strong grounds for believing that the number of observations has been insufficient,-that they have not been properly made, or are inconsequential." "To enable the profession

to form an accurate estimate of the value of remedies of more recent introduction, or of the older remedies, whose use has been revived under novel applications, the present volume was undertaken by the author." Preface, pp. vii. and viii. These remarks are in themselves good, and would be appropriate were they appended to any other work than the present. But the author seems to have forgotten these ideas when engaged in the work of compilation, or rather in writing his preface, which we presume, like most prefaces, was the last part written, has forgotten the character of much that his book contained. A great proportion of what he has collected, consists merely of isolated statements regarding uses, often prima facie inconsequential, to which various agents have been applied, unsupported by any "overwhelming evidence," and therefore totally inadequate to lead to any accurate estimate" of the powers of the remedies. It would be easy to make a book twice the size of Dr Dunglison's, out of the curiosities of medical literature, with which the periodical press teems, but we apprehend, that it would have been much better to have omitted one-half of what is here presented to us,—to have limited the inquiry to a few of the more important agents,-to have subjected these first to the inductive test, by a more ample reference to general physiological and pathological principles,– and then to have presented us, not with a few detached statements, but with good numerical results of cases where the remedy has succeeded entirely, succeeded partially, or totally failed. It is perfectly right that practitioners should communicate to the periodicals of the day new or remarkable applications of remedies, but it is not worth while collecting these, and making a book of them, until they have been tested by the experience of several

persons.

In our expectation of some account of the experience of new remedies in the hands of American physicians, we have been entirely disappointed. The quotations of American experience are few and far between, and are for the most part unimportant. In fact, the book seems chiefly calculated to let the Americans know what has been going on in the medical world on this side of the Atlantic. The quotations are chiefly from continental journals and books, and occasionally from English authors, and constant reference is made to the treatise of Dr Riecke of Stuttgart1 on

1

Die Neuern Arzneimittel, u. s. v. von V. A. Riecke. Stuttgart, 1837.

new remedies, and Magendie's Formulary, which works seem to have been the author's model in writing the present book. With respect to Dr Dunglison's general style, we have little to remark. The sententious writing, which of necessity characterises a compiled work like the present, leaves little to be done in the way of mere composition or elegant diction. We must decidedly protest, however, against certain of the strange phrases and words which Dr Dunglison substitutes for some of the ordinary technical terms. Thus, at page 312, and in other places, we find him talking of a medicine having been used in "three cases of gastrieism.' What this may mean, we cannot very well say. It cannot signify abdominal affections generally, for peritonitis is specified in a subsequent clause of the same sentence. It is a very bad substitute for "gastritis," if this is what is meant to be signified by it, for the Latin termination itis is universally known to indi cate an inflammatory affection. It may perhaps correspond to the absurd French word gastricité, which we are told in the Dictionnaire de Médecine, is expressive of "embarras gastrique;" it certainly is not an English word, at least we cannot find it in Good's Study of Medicine, in the Cyclopedia of Practical Medicine, or Johnson's English Dictionary; we rather suspect that it is one of those singular phraseological monsters, with which, by a kind of verbal superfotation, our transatlantic friends have impregnated the language of their forefathers.2

Such are the principal faults which we have to find with Dr Dunglison's book. We return with pleasure to our first statement, that the work evinces great zeal and diligent research on the part of the author, and though we assert that it contains much that is useless, and that there are many glaring omissions and imperfections, we have found in its pages a good deal that is valuable, and for collecting which, Dr Dunglison deserves well of the profession. We would exhaust the patience of our readers, by specifying all the subjects treated of by our author; we propose, therefore, to select a few of the more important and interesting of his topics, and to offer some remarks on them.

The first article in Dr Dunglison's list, which is arranged alphabetically, is hydrocyanic acid. For the preparation of this medicine, he gives three formulæ,-that of Scheele, now entirely abandoned for practical purposes,-that of Gay Lussac, for preparing the anhydrous acid,-and that of Vauquelin, for obtaining a diluted acid, by the action of sulphuretted hydrogen on bicy anide of mercury. It is not a little singular, that our author makes no allusion to the process of Geiger, by the action of sul

Formulaire pour la Préparation et l'Emploi de plusieurs Nouveaux Médicamens. 8me edit. Paris, 1835.

This word (gastricismus) is used by the Germans. It ought to be expelled from medical terminology.

phuric acid on prussiate of potassa. It is by far the best for preparing medicinal acid; it had been adopted by the London pharmacopoeia of 1836, and Dr Dunglison must have seen it mentioned in Pereira's Elements of Materia Medica,—a work which he quotes in the very pages now under consideration. Another remarkable omission is the want of any allusion to a method of accurately determining the strength of the medicinal acid, although he observes that "it is hardly necessary to say that the physician must be acquainted with the character of the acid he prescribes." There is in the following sentence evidence of confused notions respecting the chemical properties of prussic acid, which seem very strange in a professor of materia medica. In speaking of the mode of administration, he says, "It must also be recollected that the acid loses its strength by keeping. Magendie remarks, that when left to itself in a close vessel, it sometimes becomes decomposed in less than an hour, and that it rarely preserves its integrity for more than a fortnight." Now, all this is quite true with regard to the anhydrous acid, but surely Dr Dunglison does not suppose, that, though there is a formula for its preparation in the French codex, it is ever kept for medicinal purposes. If he means his remarks to apply to the medicinal acid, he is completely in error, for with a very moderate degree of attention, the medicinal acid may be preserved for more than a year.

With regard to the more important question, as to the therapeutical uses of the acid, and its action on the economy, Dr Dunglison gives us a very good abstract of the leading statements which have been made by practical men regarding it. After mentioning the employment of this remedy, by various practitioners, in inflammations, phthisis, hooping-cough, asthmatical affections, neuralgia, nervous disorders, and diseases of the skin, the evidence by the following observations, which we quote, both as being in accordance with our own opinions, and as being a good average specimen of Dr Dunglison's phraseology and style of writing.

he sums up

"Such are the principal affections in which the hydrocyanic acid has been used. We have often employed it internally, in many of the cases recommended, especially in painful affections, accompanied by great nervous impressibility, and in consumption, but have not had sufficient reason to place it high in rank amongst our medicinal agents. We have certainly had no evidence that it can cure consumption when not beyond its first stage, as remarked by Magendie. If the practitioner will bear in mind the effects which the acid is capable of producing upon healthy man, when carried to the requisite extent, he will have no difficulty of deciding upon the cases in which its agency may be appropriate. If not a true sedative, it is the nearest approach to one, and therefore its employment is clearly indicated in diseases where there is much erithism, administered alone, or along with other agents of the same class."

We pass over a host of subjects, including, amongst others,

lactic acid, hydrocyanic ether, preparations of silver, preparations of gold, and acupuncture. The chapter on the last-mentioned topic contains a fair summary of what has been observed of the action of acupuncture, since its comparatively recent revival in Europe. At page 115, we have an account of the remedial uses of animal charcoal, which we shall indulge the curiosity of our readers by quoting. In his introductory remarks on this substance, Dr Dunglison, after alluding to the former employment in Germany of burned hedgehogs, hares, moles, and shoe-soles, which he justly regards as relics of ancient ignorance and superstition, now properly fallen into oblivion with the profession, and after mentioning burned sponge, the virtues of which were most probably due to the iodine which it contains, says,"These were perhaps the only forms in which animal charcoal was used at the time when Weise, a German physician, revived its employment; and many physicians soon came forward to attest favourably in regard to it." Exactly so, and scarcely a year elapses without the same thing occurring with respect to a dozen different substances, especially if they are employed in the treatment of obscure and chronic complaints. Let a new remedy be but well puffed in one quarter, and testimonials in its favour are sure to pour in for a while in every direction. The effects of dietetic and general hygienic treatment, are left out of consideration altogether. The drug is the thing. It is a humiliating confession, but we believe it must be owned, that from want of a little reflection and sound induction on the part of medical men, it is just as common in our profession, to see physicians following each other in praise of a remedy of little or no real value, as it is in a Cheviot farm to see a string of sheep rush in at a gate, and make prodigious leaps over nothing, because one lanigerous leader has selected this particular route, or chosen to display similar saltatorial agility. Our readers, however, may be curious to know what these German physicians have to attest in favour of animal charcoal.

"In the case of a young man of scrofulous diathesis, Weize saw a tumour of the size of a hazel-nut, and very painful, situate under the nipple, disappear under the use of animal charcoal. According to him, its efficacy is strongly exerted on the uterus and mammæ. Rothamel and Hohnbaum extol it in dyspepsia and gastricism, as well as in cases of diarrhoea. In obstinate chronic glandular indurations, especially of the mammary glands, Weise affirms it to be a certain remedy; he, at the same time, however, considers a regulated diet to be indispensable. Scirrhus of the lips, he says, also disappears under its use, and even schirrhous goître when the charcoal is associated with burnt sponge. On cartilaginous polypi, it is said to have exerted a beneficial agency, and to have diminished the tendency of mucous polypi to return after operation. Even open cancer, it is asserted, has been healed by it. On these recommendations of Weise, animal charcoal has been used by several German physicians, especially by Wagner, Kopp, Pitschaft, Radius, Rothamel, Hesselbach, Gumpert, Hohnbaum, Fricke, Michaelsen, and Siebenhaar; and as a general result of their observations, it would seem not to