Part 8

His Essay on Fevers was much more important and has been highly esteemed by competent critics. He also wrote a valuable note on scurvy in seamen, recommending a more abundant supply of vegetables on voyages, and was the first to describe the malignant ulcerous sore throat now called diphtheria.

Huxham’s formula for Tinct. Cinchonæ Co. as given by himself was as follows:

Cort. Peruv. opt. pulv. ℥ ii, Flav. Aurant. Hispan. ℥ iss, Rad. serpent. Virgin. ℥ iii, Croci Anglic. ℈ iv, Coccinel. ℈ ii, Sp. Vini Gallici, (Brandy), ℥ xx. F. Infusio clausa per dies aliquot (tres saltern quatuerve) deinde coletur. The dose was ʒ i to ℥ ss every 4, 6, or 8 hours with 10, 15, or 20 drops of elixir of vitriol in diluted wine. Huxham says of this tincture “it tends to strengthen the Solids, to prevent the further Dissolution and Corruption of the blood and in the event to restore its Crassis.” He has previously stated that it is a very useful remedy “not only in slow, nervous fevers, but also in the putrid, pestilential, and petechial, especially in the Decline.” But he adds, “if the patient is costive or hath a tense and humid abdomen, I always premise a dose of rhubarb, manna, or the like.”

According to Dr. Paris, Huxham believed in complicated prescribing. “There are several prescriptions of Huxham extant,” we read in “Pharmacologia,” “which contain more than four hundred ingredients.”

CINCHONA OR CHINCHONA.

Sir Clements Markham, whose services in introducing cinchona culture into India and Ceylon are well known, has earnestly insisted on the adoption of the name chinchona instead of cinchona in justice to the lady after whom the generic title was chosen. In a Memoir of the Lady Ana de Osorio, Countess of Chinchon, Sir Clements Markham somewhat extravagantly exalts that “illustrious and beautiful lady,” whom he describes as “one of the most noble benefactors of the human race.” She may have been an excellent woman, but her advocate does not furnish sufficient evidence of her virtues to justify such lavish praise. The Countess was cured of a fever by the bark, and on her return to Spain she distributed the remedy to such of her vassals as needed it. Perhaps her physician, who brought a quantity of the bark home with him and sold it, did more to make it generally known than she did by her gifts.

Still there is no doubt that Linnæus intended by the name he gave to the genus to perpetuate her memory; and it is likewise true that her name was Chinchon and not Cinchon. The latter term, Sir Clements says, means a broad girdle or a policeman’s belt, and makes the intended honour ridiculous. His opinion was that Linnæus had erred in ignorance, having been misled by several French writers. Daniel Hanbury, however, who contested some of Markham’s assertions, gave good reasons for believing that Linnæus had adopted the term cinchona deliberately for the sake of euphony. Anyway he shows that Mutis, the disciple of Linnæus, who sent him the plant from which he wrote his description, while at first writing of chinchona soon followed the spelling of the master and continued to do so.

The name cinchona and derivatives from it are too well established to be dislodged now for a sentimental reason, even if it were not that the adopted name is undoubtedly easier to pronounce than the more strictly correct one would be.

CULTIVATION OF CINCHONA IN THE EAST.

Many botanists and travellers remarked upon the reckless manner in which the natives of Peru collected the bark. They felled the trees and stripped them of bark without planting new ones to take the place of those destroyed. Humboldt says that 25,000 trees were thus destroyed in a single year.

The first attempt to transport any plants to Europe was made by La Condamine in 1743. He had obtained some young plants and was conveying them down the Amazon River to Cayenne, intending to transport them to the Jardin des Plantes at Paris. At the mouth of the river a wave swept over his little vessel and washed away his whole collection. Joseph de Jussieu, who had accompanied La Condamine on his expedition, and remained in the country after him for fifteen years, was robbed of his collection at Buenos Ayres, and lost his reason as a consequence of his misfortune.

Royle in 1839 strongly advocated the introduction of cinchona into India, and suggested the Nilgiri Hills as a suitable position for the experiment. His suggestions were taken into consideration by the Government, but no immediate steps were taken. The Dutch Government first moved in the matter, sending a botanist named Hasskarl to South America in 1852. Their object was to establish cinchona gardens in Java. All through the fifties they were carrying on their experiments, but with very slow success. The English Government were meanwhile instructing their Consuls in South America to obtain seeds, but it was not until 1859 that the collection was seriously undertaken for India. In that year Mr. (now Sir) Clements Markham was commissioned to go to South America to collect seeds of the best species. Markham has told the full story of his mission in his work on “Peruvian Bark,” and has incidentally in that narrative exposed the parsimony of the authorities in their treatment of those associated in the important and profitable enterprise successfully carried through after some years of hard and often perilous labour. His principal coadjutor, Dr. Spruce, whose health was utterly ruined by his efforts, was paid a salary of £30 a month while the work lasted, and a special grant of £27 for an exhaustive report which he prepared. A pension of £50 a year was given him by the British Government for his botanical services, and after thirteen years of persistent importunity, the Indian Government granted him another £50 a year. Mr. Pritchett, who collected plants and seeds in the forests of Huanuco, was paid his salary and nothing more. To Mr. Cross, who assisted Dr. Spruce in the collection of the red bark, two grants of £300 each were made. Mr. Weir, “a most conscientious, active, and skilful worker, and, so far as his own labours were concerned, completely successful,” crippled and disabled for life, got nothing from the Government, though the Horticultural Society collected some funds which yielded £27 a year.

The monumental instance of official ingratitude was, however, manifested in the case of Charles Ledger, to whom, more than to any other man, the world is indebted for cheap quinine, and out of whose adventurous services the Dutch nation have made millions in their Java dependency. Between the years 1841 and 1858 Ledger was travelling in South America in the employment of the New South Wales Government buying alpacas. He had a faithful servant, Manuel Manami, who had often told him how jealously the natives, especially those of Bolivia, guarded the knowledge of their best seeds. Manami had himself been a cascarillero or bark cutter. On Ledger’s return to Australia in 1858 he found that Holland and England were eagerly seeking to plant cinchona in their Eastern possessions. The mission of Hasskarl had been practically a failure. He had not been able to enter Bolivia, and the species he brought to Java were comparatively valueless. Ledger was in South America when Markham went there on his official journey. He endeavoured to open communication with the British Government’s envoy but failed. He, however, pressed his faithful Manami to secure some of the precious “rojo” (_Cinchona Calisaya_, var. _Ledgeriana_) seeds from Bolivia. Manami fulfilled this service, somewhat reluctantly, sent the seeds to his master, but was himself thrown into prison, beaten, and died soon after in consequence of the cruel treatment he underwent.

Ledger sent the seeds to his brother in England authorising him to dispose of them as he best could. They were at first offered to the British Government, but as Markham was then in India superintending the planting of the seeds he had brought from Peru, the offer was not entertained. Half of them were sold to a Ceylon planter, and the rest were taken, after some discussion, by the Dutch Government for about £33, with a promise of a further payment if the plants flourished. A year later on a report that 20,000 plants had been raised from these seeds the Dutch Government paid Ledger a further £100 and got from him a letter expressing his satisfaction. That was in 1866.

For many years Ledger was lost sight of, and it was stated in several books that he was dead. In 1895, however, a letter from him was published in _The Chemist and Druggist_, of London, dated from Goulburne, N.S.W. He wrote simply in reference to a paper which had been printed in that journal referring to the admixture of some white flowers with coca as imported. The addition of the “inga flowers,” Mr. Ledger explained, was made by the natives in the belief that they kept the coca leaves fresh and green. Later it was found that Mr. Ledger was living in comparative poverty in consequence of the failure of Australian banks and the slump in land values. Efforts were made to induce the Dutch Government to make some compensation to the man who had done them such grand service, but at first a blank refusal was returned. In May, 1807, however, on his seventy-ninth birthday, Mr. Ledger received the announcement from Amsterdam that an annuity of £100 would be conferred upon him. He lived nine years after this.

The Ledger cinchona had also been introduced into India, and as it was found to be yielding such rich bark Mr. Markham appealed in 1880 to the Indian Government to grant Mr. Ledger at least the sum of £200 to compensate him for the expenses he had been put to, which far exceeded what he was paid for the seeds. “The reply, after four months’ delay, was a curt refusal,” wrote Mr. Markham to _The Chemist and Druggist_, in April, 1895.

Mr. Ledger, who was born in Bucklersbury, London, on May 4, 1818, wrote a very pleasant and modest autobiographical sketch of his varied experiences for _The Chemist and Druggist_, which was published in that journal of July 27, 1895.

CUBEBS

have had a rather chequered medical history. The Arab physicians used them apparently for the same medicinal purposes, that is, for checking urethral discharges, as they are generally prescribed for by our own physicians; but in the middle ages we hear of them as a popular but costly condiment. Curious particulars of this use of cubebs are given in “Pharmacographia.” They were an ingredient in the P.L. formulas for Mithridate and Theriaca, probably as a stimulant. Then they seem to have dropped out of use. They were omitted from the P.L. 1809. Their re-introduction into medical practice is due to an article by Dr. Crawfurd in the _Edinburgh Medical and Surgical Journal_, 1818, but it appears that the knowledge of the anti-blennorrhagic properties of cubebs came from an English officer in Java, whose Hindoo servant had recommended to him the use of them as a medicine. The employment of cubebs in hoarseness and bronchial complaints was popularised by some American Troches, a proprietary medicine, but this use of the medicine was familiar a hundred and fifty years ago. In James’s Dispensatory it is stated that cubebs are “recommended in hoarseness and loss of voice, especially when the tonsils are stuffed and obstructed.”

DIGITALIS.

Foxglove, the common and ancient name of this handsome plant, is believed to be a corruption of a still older name, Foxes’ glew, or Foxes’ music, in allusion to an instrument consisting of a series of bells hanging from one support. The Norwegian name of the plant is Rev-bjelda, fox-bells. A pretty fancy, but one which is not supported by evidence, is that the original name was folks’ glew, or fairy bells. In Scotland the flower is called bloody fingers, and sometimes dead men’s bells; in France, gants de notre Dame, and doigts de la Vierge. The German popular name is finger-hut, finger hood or thimble, and the Latin term, digitalis, coined by Fuchs of Tubingen about 1550, was intended to be the equivalent of that designation.

The medical history of the foxglove is somewhat varied. It appears to have been used as an ingredient in external applications by old herbalists, principally for scrofulous complaints. Gerard, Parkinson, and Salmon, who wrote in the sixteenth and seventeenth centuries, extol its virtues and mention also its employment internally for the falling sickness or epilepsy. Parkinson quotes an Italian saying concerning it that it is a salve for all sores. It found a place in the London Pharmacopœia of 1650 and in several subsequent issues.

But foxglove was always a medicine with a popular rather than a professional reputation until Dr. William Withering, of Birmingham, published “An Account of the Foxglove, and some of its Medical Uses,” in 1785. Withering was a scientific pioneer of European fame, an intimate associate of Priestley, Watt, and Boulton, a painstaking botanist in whose honour a genus of the Solanaceæ was named Witheringia, and a mineralogist whose name is similarly commemorated by the name Witherite, given to barium carbonate.

In Dr. Withering’s “Account of the Fox-glove,” he narrated that ten years previously his opinion had been asked about a family recipe for the cure of dropsy which had long been the secret of an old woman in Shropshire, and which he was told had cured cases after regular treatment had failed. The medicine was composed of some twenty different herbs, but it was not difficult, he says, for one conversant with such matters to perceive that foxglove was the active ingredient.

Dr. Withering details his experience as well as that of others with the drug in some hundreds of cases. He noted its action on the heart and as a diuretic. He had also ascertained that it was prescribed in family recipes in Yorkshire. An article in Parkinson’s “Herbal,” written he believed by Mr. Saunders, “an apothecary of great reputation at Worcester,” declared it to be of great value in consumptive cases. It had been admitted into the Edinburgh Pharmacopœia 1783, but many practitioners were giving it in such dangerous doses that he feared its reputation would not last long.

Dr. Withering died in 1799 at the age of fifty-eight. A foxglove is carved on his monument in Edgbaston Old Church.

GUAIACUM

Came into fame in Europe in the early years of syphilis. The story told about it (perhaps it was only a clever advertisement, though it is related without any question by Leclerc) was that a certain Spaniard named Gonsalvo Ferrand having taken the disease and finding no cure for it resolved to go into the countries from which the infection had come, confident that he would there find the remedy which the natives themselves employed. He went to St. Domingo, discovered that the wood there called Huaiacon was regarded as a specific, took it himself, and was cured. This was in 1508. Whatever may be the truth of this history it seems that Ferrand was subsequently a seller of guaiacum wood (according to Freind), at seven gold crowns per pound (say 35s.), and accumulated a great fortune. Enormous popularity accrued to guaiacum by the book which Ulrich von Hutten, the German poet and reformer, wrote on the “Morbus Gallicus” in 1519. Therein he narrated his own experience; what he had suffered from this disease; how he had undergone salivation with mercury eleven times to no purpose; and how at last he had been cured completely in thirty days by a course of treatment by guaiacum. This early treatment as it was developed in the sixteenth and the seventeenth centuries deserves to be recorded. First a decoction was made by boiling 1 lb. of the wood raspings in 8 or 10 pints of water down to 5 or 6 pints. After straining this off another weaker decoction was made from the same wood. The syphilitic patient was prepared for his course of treatment by a few days’ spare diet, and by a few aperient doses. Then he went to bed in a well-warmed room, and early every morning took half a pint of the first decoction warm. He was then covered with blankets and allowed to sweat for two or three hours. After being dried he was given a few biscuits with some almonds and raisins. The process was repeated in the latter part of the day, and so on for fifteen days, only enough food being given to prevent the patient from fainting. In the middle of the month a day or two’s interval was granted, and during that time the bowels were evacuated by an enema. Then the treatment was renewed as before, but a rather more liberal diet was permitted. All the time the second decoction was taken for drink as freely as the patient could be induced to swallow it. Gradually the usual habits of eating and drinking were resumed.

It is not surprising to learn that the treatment just described was soon accused of so reducing the strength of many patients that they never recovered from it, and it was being abandoned when Boerhaave revived it for a time as a remedy in syphilitic cases.

IPECACUANHA.

Although several earlier allusions to ipecacuanha have been found, the first being in an account of Brazil by a Portuguese friar given in Purchas’s “Pilgrimes” (1625), where the medicine is named Igpecaya and is described as a remedy for the bloody flux, its effective introduction to European medicine was in the year 1686, when Louis XIV bought from Jean Adrien Helvetius the secret of a medicine with which he had performed a number of remarkable cures of diarrhœa and dysentery.

Helvetius, whose original name was Schweitzer, was the son of a Dutch quack, and had gone to Paris to try to sell his father’s compounds there. Apparently he had also enrolled himself as a student of medicine, for he is reported to have accompanied a physician of note at the period, named Afforty, in his attendance on a merchant variously called Grenier and Garnier. The merchant, having recovered from his illness, wished to present to Afforty a parcel of a new drug which he had received from Brazil. Afforty was not tempted by the offer, but his companion was more open to be influenced by something new. He experimented with the medicine and found it of remarkable efficacy in dysentery. Thereupon he placarded the corners of the streets with his announcements of a new remedy but without stating what the drug was. Colbert, having heard of the success of Helvetius, mentioned the remedy to Louis XIV when the dauphin was ill with dysentery, and the young Dutch quack was sent for. With the consent of the court physician, D’Aquin, Helvetius treated the Dauphin and cured him. As a result the king authorised D’Aquin and his confessor, the Père de la Chaise, to negotiate with Helvetius for the publication of his secret, which he sold for a thousand louis d’or, for a share in which the merchant Garnier unsuccessfully sued. This was the beginning of a successful career which was continued by his son and his grandson. The last became France’s fashionable poet and philosopher in the generation before the Revolution. The discoverer of ipecacuanha was appointed Inspector General of the Hospitals of Flanders, and became physician to the Duke of Orleans.

It appears from a treatise which Helvetius wrote that at first ipecacuanha was given in doses of two drachms, sometimes in decoctions and sometimes in enemas. Hans Sloane in England and Leibnitz in Germany wrote warmly in favour of the new remedy, but it was not till thirty years after it had been introduced that the dose was popularly reduced to some four to ten grains. Dover’s lucky combination of ipecacuanha with opium had a great effect in ensuring its permanent adoption.

KOUSSO.

Although Bruce, the African traveller and others had described the tree which bears the kousso flowers in Abyssinia (Hagena Abyssinica) and had noted that the natives used these as worm medicine, the first knowledge of them actually made use of came through a French physician named Brayer residing in Constantinople about the year 1820. Brayer was one day in a café where was a waiter extremely emaciated and who suffered cruel pains from tapeworm. An old Armenian came into the café and told this waiter that he possessed a remedy which his son had brought from Abyssinia, and which he was sure would cure him. Brayer ascertained the successful result of the experiment and subsequently tested the remedy himself on other patients with similar results. He sent some of the flowers to the German botanist Kunth, to whom they were new, and who named the tree _Brayera anthelmintica_. Still it does not appear that much notice was taken of the reports until about the year 1850, when a Frenchman offered the flowers in London for 35s. per ounce. The fancy price attracted attention to the remedy, which proved effectual.

OPIUM.

The ancients recognised two kinds of opium. The superior kind was called opion, and was the juice which exuded from the poppy head while it was growing; and the second quality, which was named meconion, was an extract made from the crushed heads and leaves of the poppy.

It is doubtful whether Hippocrates was acquainted with the juice of the poppy at all. He refers to mecon but he attributes to it a purgative as well as a narcotic power; it is therefore probable that he alludes to some other plant. In any case, he made but very little use of poppy or opium if he used either. Theophrastus certainly knew opium, and Dioscorides distinguishes opion and meconion as explained above. Dioscorides also gives the receipt for the famous Dia-kodion (made from the poppy head), the original of our syrup of poppies. His process was to macerate 120 poppy heads for two days in three sextarii (a sextarius was nearly equal to our Imperial pint) of rain-water. This was boiled, strained, mixed with honey, and boiled down to a suitable consistence.

Probably the shopkeepers and travelling quacks made more use of opium in Rome than the regular physicians. Galen expressly says that he never used the drug except in very urgent cases; but he enthusiastically commends several confections such as theriaca which owed their efficiency to opium more than to any other ingredient. Indeed it may be said that the fame of those compounds was due to opium, and that by them the medicinal employment of the drug was maintained during many centuries.

We know that Paracelsus owed much of his success to the bold way in which he administered opium to his patients; evidence that his contemporaries did not use it to any great extent. His followers were as enthusiastic as himself over the virtues of opium, and before long the most serious practitioners were advocating it, and devising formulas for its suitable administration. Platerus of Basle about 1600 strongly recommended it, and Sylvius (de la Boe) a Dutch physician said that without opium he would not practise. Van Helmont about 1640 used opium so frequently that he was called the Doctor Opiatus. Sydenham about 1680 says, “Among the remedies which it has pleased Almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium.” Many other eminent physicians might be cited to the same effect, and some who took an opposite view. Stahl, for instance, wrote a treatise entitled De Imposturis Opii. Hoffmann considered that the use of opium was greatly abused, and he believed his ether would fulfil its purpose in almost all cases.

QUASSIA