Part 9

was sent to Linnæus from Surinam in 1763 by C. D. Dallberg, one of his pupils, with the statement that it formed the basis of a secret remedy employed there by a negro slave in endemic malignant fevers. The negro’s name was reported as Quassi, and from this Linnæus invented the name of quassia. This bitter wood was obtained from a shrub growing in Dutch Guiana, but for the English market it was subsequently superseded by the wood of a large tree growing in Jamaica, belonging to the same genus. The earlier product is, however, still used in France and Germany. Ritman, who was in Surinam in 1756, said he had met with the old negro, Quassi, there, and reported that he was almost worshipped by some, while others suspected him of magic. Ritman, however, found him a simple old man skilled in old women’s medicines.

SARSAPARILLA.

Sarsaparilla was introduced to Europe early in the sixteenth century, and soon leaped into fame. The great Emperor Charles V, was cured of gout by it, or fancied he was, and this gave it an enormous advertisement. It appeared afterwards that it was really China root, another smilax, that was given to the Emperor, but it was called sarsaparilla, and the western medicine got the glory. Sarsaparilla was vaunted as a cure for syphilis, but physicians were not long in discovering that it was much more effectual whenever it was combined with mercurials. Its advocates insisted that it was a wonderful sudorific, and for many years a “sweating cure” was practised in Denmark and Sweden with apparent success. As a matter of fact sarsaparilla has no sudorific properties whatever; but it was given in long draughts, other more effective medicines were associated with it, and vigorous exercise and heavy blankets were adjuncts of the cure. It is not surprising that a sudorific result ensued.

Other confusions have distinguished the history of this so-called remedy. The species which Linnæus selected as the medicinal sarsaparilla and which he named _Smilax sarsaparilla_, happens to be about the only one of some two hundred species which has never been employed in medicine at all. It is only found in North America and not further south than Virginia. Jamaica sarsaparilla has the reputation of being the best, and that comes from Central America. The sarsaparilla which actually grows in Jamaica is not valued in European markets. The origin of the name of sarsaparilla is not agreed upon. Some authorities attribute it to sarsa--red, and parilla--a little vine. Littré derives it from zarza--a bramble, and Parilla--a hypothetical Spaniard who helped to introduce it. The native Indians call it salsa, and the French follow this origin and call it salsepareille.

STRAMONIUM

may have been known to the ancients as a poison. Dioscorides included it among the henbanes, and Avicenna is supposed to have described it under the name of the Methel nut. Some species of Datura were frequently used in Eastern countries by thieves and sorcerers to induce delirium and subsequent coma, and the herb had the worst of reputations when Störck, of Vienna, experimented with it first on himself about 1765. In consequence of its action on the brain he gave it in cases of mania and epilepsy, and he and some practitioners who followed him claimed to have administered it in such diseases with much success. Its action as an asthma remedy was, however, a popular Indian tradition which was made known to Europeans through a General Gent about 1802. It had been recommended to him by a native, and he found so much relief from it that he introduced it to Dr. Anderson who was practising at Madras. It was stated that General Gent used it so freely and so frequently that it caused his death.

XX

FAMILIAR MEDICINES AND SOME NOTES OF THEIR HISTORIES.

Morbi, non eloquentia sed remediis, curantur. CELSUS: _De Re Medica_.

BLACK DRAUGHT.

Laxative or cathartic potions have been prescribed in all modern pharmacopœias, most of them being preparations of senna. The original one was devised by Mannagetta, an Italian physician at the court of the Emperor Rudolph II, about 1600. His prescription became popular under the title of Aqua, or Potio Laxativa Viennensis, and was popularly known all over Germany as “Wiener Trank.” The formula was 1 oz. of senna, 6 drachms of currants, 2 drachms of coriander seeds, and 2½ drachms of cream of tartar. These ingredients were packed in a bag and suspended in hot water for a night. In the morning the liquor was strained after the bag had been pressed, and 5 oz. of manna and 3 drachms of cream of tartar added. The dose was 3 to 4 oz. In the London Pharmacopœia the alkaline salt of tartar was at first prescribed with the senna, but later the acid tartrate of potash was preferred. In the Edinburgh Pharmacopœias of the eighteenth century a formula for “Infusi Sennæ Unciæ Quatuor” was included, while the London Pharmacopœias of the same period provided an alkaline infusion, and an “Infusum Sennæ Limoniatum,” containing lemon peel and lemon juice with the object of making the draught less nauseous.

The modern combination of sulphate of magnesia with an infusion or tincture of senna, and sometimes with manna, sometimes with ammonia, and always with some aromatic ingredient, began to be used about the beginning of the nineteenth century. The earliest mention of the term “black draught” that I have met with is in Paris’s “Pharmacologia,” 1824. It was dropped out from later editions. The mixture was called “black dose” in Brande’s “Materia Medica and Pharmacy,” 1839. The phrases “black draught” and “blue pills” were not given as synonyms in the Pharmacopœia until 1885. They are essentially English. Dorvault gives a formula (practically the Mist. Sennæ Co.) entitled “Potion Noire Anglaise,” and Hager has “Pilulæ Hydrargyrosæ seu pilulæ ceruleæ Anglorum.”

BLAUD’S PILLS.

These pills are probably taken in larger numbers than any other pills sold in Great Britain. If in proper condition they present iron in the form of the protocarbonate, either formed in the pills, or perhaps partially or entirely in the stomach. They are similar to Griffiths’ pills, which were the popular Mist. Ferri Co. in pilular form. Dr. J. Blaud, a French provincial practitioner, in an article published in the _Revue Medicale_, in 1831, entitled “Memoires sur les Maladies Chlorotiques,” gave the following formula:--

“Gummi Arabici, 5 grammes; solve calore baln. vapor in aquæ distillatæ, 30·5; syrupi simplicis 15 grammes; ferri sulfuric. sicci, 30; quibus caute mixtis adde kalii carbonici, 30; et inter agitatione ope spatula ferreæ in balneo vaporis evaporando ad massam pilularum redige; e qua forma pilulas 120; obducantur argento foliato.”

There has been much discussion concerning the best method of making these pills so as to keep them from oxidation. Honey was for a long time generally used as the excipient, but glycerin and sugar are generally preferred with gum acacia or tragacanth. Pilula Ferri, B.P., is a substitute for Blaud’s pills.

THE CHELSEA PENSIONER.

An electuary for rheumatism bearing this title was evidently popular under the above name in the early part of the nineteenth century, but I have not been able to discover where or when or with whom it originated. The compilers of books of formulas naturally copy from each other, and consequently a legend once started is likely to become crystallised.

In _The Chemist and Druggist_, of June 13th, 20th, and 27th, 1896, an attempt was made to track this medicine to its origin, and a number of old formulas were sent in by correspondents. The statement is made in many books that the compound acquired its name from the circumstance that the recipe for it was given by a Chelsea Pensioner to Lord Amherst for gout and proved so successful that Lord Amherst gave him £300 and an annuity of £20. Sometimes this story associated Lord Anson with the pensioner and the amounts given in gratitude varied from £300 to 500 guineas, with an annuity sometimes of £20, sometimes of £30, and occasionally of £100. The then living descendants of Lords Amherst and Anson were written to by _The Chemist and Druggist_, but neither could give any information. It rather looks as if the fiction were concocted as an advertisement in the days when the electuary was a proprietary medicine, if it ever was.

The earliest formula traced in the correspondence referred to was given in Gray’s Supplement, 1821. This ran:--Pulv. gum. guaiaci, ʒi; pulv. rhei, ʒij; pulv. pot. bitart., 1 oz.; flor. sulph., 2 oz.; one nutmeg, and 1 lb. of honey. Of this, the dose was two tablespoonfuls night and morning. Sometimes pulv. pot. nit. is substituted for pulv. pot. bit.; probably a mistake of a copyist. In other formulas mustard appears instead of nutmeg; perhaps a similar slip for myristica. Treacle occasionally takes the place of honey, and the proportions of the ingredients vary considerably.

The Secretary of the Chelsea Hospital was good enough to take some trouble in reply to my inquiry to endeavour to trace this compound, but only negative results were attained. Dr. Thomas Ligertwood, the oldest living medical officer of the Royal Hospital, was appealed to, but he only knew of the remedy as “a very useful combination,” and had never heard the story of Lord Amherst’s purchase of the secret. He thought some information might be found in a work on the “Diseases and Infirmities of Old Age” by Dr. Daniel Maclachlan, a former Principal Medical Officer of Chelsea Hospital. That work (dated 1863) contains two allusions to the Chelsea Pensioner, but nothing about its history. Writing of Chronic Rheumatism the author says:--“ ... The more stimulating diaphoretics and diuretics prove serviceable. Among these the preparations of guaiacum deserve the confidence they have long enjoyed. The virtue of the powder (_sic_) known as the Chelsea Pensioner is chiefly due to the guaiacum and sulphur it contains.” In the section on gout he writes:--“The once famous Portland Powder has for long been abandoned, as has also the almost equally noted Chelsea Pensioner gout powder. One formula for the latter consisted of rhubarb, sulphur, nitre, and gum guaiacum, in equal parts. Fifteen or twenty grains of the powder were taken morning and evening in treacle. Another was powdered bark, ginger, guaiacum, aa ʒi, cream of tartar 1 oz., flowers of sulphur ½ oz., to be made into an electuary with simple syrup. One teaspoonful to be taken three times a day. This is certainly not a bad combination though a nauseous one.”

The following formula is given in the “Pharmacopœia Batava recusa cum notis et additamentis Medico-Pharmaceuticis,” published by J. F. Niemann, in 1824:--Resin of guaiacum, rhubarb, aa ʒij; supertartrate of potash, 1 oz.; sublimed sulphur, 2 oz.; one nutmeg; despumated honey, 1 lb. It is evident that this “Anti-Rheumatismal Electuary,” as Niemann calls it, and the Chelsea Pensioner had a common origin, and as the formula is not to be found in Niemann’s previous edition, 1811, it would appear to have come into popularity between that date and 1824. So far it remains doubtful whether its composition is due to an English or a Dutch author.

CITRINE OINTMENT.

An ointment thus named appeared first in the P. L. 1650. It was a compound of coral, limpet shells, quartz, white marble, white lead, and tragacanth incorporated into a basis of hogs’ lard, suet, and hens’ grease. It was reputed useful for certain skin complaints, freckles, etc. In the P.L. 1678 some of the old ingredients were omitted, sugar of lead was substituted for the white lead and rose water, and frankincense and citron bark were added.

Nitrate of mercury ointment appeared first in the Edinburgh Pharmacopœia of 1722. It was made by dissolving mercury in a sufficient quantity of nitric acid, and adding the solution to melted lard gradually. This was not a satisfactory formula, and it was not until 1787 that anything similar was introduced into the P.L., when 1 oz. of mercury, 2 oz. of nitrous acid, and 1 lb. of lard were combined. This was intended, according to Christison, as an imitation of the well-known golden eye salve, which, however, was, as we know it, an ointment of the red oxide of mercury. Other authorities, Paris Dorvault, Gray, etc., have stated that Singleton’s golden eye ointment was an ointment of sulphuret of arsenic, orpiment some say, realgar others. Pliny refers to the use of sandrach (probably realgar) as an application in ophthalmic affections.

Apparently the originator of the P.L. nitrate of mercury ointment was a Dr. Thomas Nettleton of Halifax, Yorkshire. In a pamphlet entitled “On a Safe and Efficacious Medicine in Sore Eyes and Eyelids,” by Thomas Dawson, M.D., of Hackney, printed in 1782, the writer relates that he had heard of a yellow ointment specially good for sore eyes, which fifty years previously had been in the possession of Dr. Thomas Nettleton of Halifax, “whose merit as a man and a physician exceeds all encomium.” One day one of Dr. Dawson’s patients told him of a yellow ointment she had had from a Dr. Key, of Manchester, who had been a pupil of Dr. Nettleton’s. Dr. Dawson wrote to Dr. Key, who at once sent him the recipe, which was as follows:--

Take 1 oz. each of aqua fortis and mercury; dissolve and add the solution to 8 oz. of butter melted. To this add 2 drachms of camphor dissolved in 2 oz. of olive oil.

About the end of the eighteenth century, a citrine ointment, made with an ounce of mercury dissolved in nitric acid and incorporated with a pound of lard, was introduced into the Hotel Dieu Hospital of Paris, and used to cure itch. The formula was adopted in the Dublin Pharmacopœia, 1807.

COLD CREAM.

The Unguentum Refrigerans, also called “Ceratum,” appeared in the first P.L., the formula being attributed to Galen. Four ounces of white wax were melted in 1 lb. of rose oil (ol. rosarum omphacinum, that is, olive oil in which rose buds 4 oz. to the lb. had been macerated, the maceration being carried out three times, each time with a fresh lot of roses). The melted oil and wax were to be poured frequently from one vessel to another, stirring in a little cold water meanwhile, until the mixture became white. Lastly, it was to be washed with rose water, and a little rose water and rose vinegar were to be added.

DIACHYLON PLASTER.

The original formula for this plaster was compiled by Tiberius Claudius Menecrates, who lived in the reign of the Emperor Tiberius, and was probably his physician. In a Greek inscription discovered at Rome he is described as Physician of the Cæsars, probably Tiberius, Caligula, and Claudius, for he died in the reign of the last named. He wrote a great work on remedies entitled “Autocrator Hologrammatos,” literally, “The Emperor, whose words are written in full.” Probably the book was dedicated to one of the Emperors, and thus got its first title. The second intimates that the recipes are written out in full so that any reader could understand them; suggesting that the other physicians who wrote such books were in the habit of employing abbreviations.

The formula for diachylon and the directions for compounding it were put into iambic verses by Servilius Damocrates, who lived a little later than Menecrates, and it is in this form that they have been preserved by Galen. Briefly the composition was to incorporate 1 lb. each of the mucilages of fœnugreek, of linseed, and of marshmallow root with 3 lb. of old oil, and 1½ lb. of golden litharge. The mucilages were made by boiling the seeds and root in water. Damocrates concludes his poem with the line (I quote from the Latin translation): “Vocabat ipsum non absurde Dia Chylon.”

Mesué wrote at length about this plaster, and devised a much more complicated formula which was named Diachylum Magnum. It contained, besides the mucilages already named, others made from raisins and figs, juices of orris, squill, and dill, œsypus (sheep wool fat), turpentine, rosin, and wax. Subsequent authors also devoted their talents to the further improvement of this famous preparation.

Diachylon meant a preparation of juices, and this plaster received the name of plaster of the mucilages in many pharmacopœias. In 1746 the London College, having dismissed the adjuncts, altered the name of the simple plaster to Emplastrum Commune, but the old term has refused to die. An Emplastrum Commune cum Gummi was also prescribed. This contained galbanum, thus, and turpentine combined with the Emplastrum Commune.

The Menecrates to whom we owe Diachylon is alleged to have written 155 works, and Galen gives a number of his formulas, but no other than Diachylon has survived. He must not be confounded with the perhaps more celebrated Menecrates who was physician to Philip of Macedon. This one was particularly noted for his vanity, which amused the king. Once he wrote a letter to Philip commencing “Menecrates-Jupiter to King Philip, greeting.” The king replied, heading his letter, “Philip to Menecrates, Health and Common Sense.” Menecrates got himself up to look like Jupiter, and had attendants who were made to figure as Apollo, Æsculapius, and Mercury. Philip gave a banquet in his honour. A separate table was reserved for him, and instead of viands only incense was served to him, while the other guests were gloriously feasted. Menecrates was offended at the joke and left the table in anger. He is credited with having written a Book of Remedies, but it has been lost.

DOVER’S POWDER.

Thomas Dover, to whom we owe “Dover’s Powder,” practised as a doctor in London in the first half of the eighteenth century. He was born and buried at Barton on the Heath in Warwickshire in 1660. How he got his medical training is not on record, but some time in his youth he lived in the house of Thomas Sydenham, the famous physician, from whom probably he acquired his independent ideas of medical treatment, and possibly the germ of his lack of reverence for the College of Physicians. While living with Sydenham he had small-pox, and forty or fifty years later he described how the doctor treated him. First he was bled to the extent of 22 oz.; then he took an emetic. He only took to his bed when he became blind with the disease. In his bedroom he had no fire, the windows were always kept open, and the bedclothes were only allowed up to his waist. This was in the middle of January. For medicine, Dover says, “he made me take twelve bottles of small beer acidulated with spirit of vitriol every twenty-four hours,” and he concludes, “I never lost my senses one moment.”

Having resisted both the disease and the treatment, Dover is first heard of in practice in Bristol in 1684. He plodded along there until 1708, when at the age of forty-eight he set out with a privateering party on a voyage round the world. The expedition consisted of two ships, the _Duke_ and the _Duchess_. Captain Woodes-Rogers, who has left an account of the voyage, was in chief command, and Dover on the _Duke_ was his lieutenant. He must have had previous experience of seafaring life or he would never have been entrusted with the command of a vessel.

The buccaneers were away from England three years, and when they returned they brought with them a Spanish frigate of twenty-one guns, and a quantity of loot. One event of their voyage proved to be of world-famous importance. On February 2, 1709, Dover, on the _Duke_, touched at the island of Juan Fernandez and took on board Alexander Selkirk who had lived alone on the island four years and four months, and whose story was to develop in the skilful hands of Defoe into that of the immortal Robinson Crusoe.

A few months after leaving Juan Fernandez the expedition arrived at Guayaquil in Peru. Having duly sacked the city and stored their plunder in the ships, the sailors slept in the churches, and Dover quaintly relates how annoyed they were by the smell of the Spanish corpses; for plague was raging in the place at the time, and the victims were buried just under the floors with only a plank or two over them. Two days later, at sea, the disease broke out among the crews. They had 180 cases all at the same time, and Dover had four surgeons with him. He ordered them to go round and start bleeding all the patients, and to stop the bleeding when the round had been completely made. About 100 oz. of blood, he says, was taken from each man. Then he gave them spirit of vitriol, and only seven or eight died.

The next we know of Dover is that from 1721 to 1728 he was in practice in Cecil Street, Strand; he returned to Gloucestershire for a few years, then came back to London and practised in Lombard Street, removing in 1736 to Arundel Street, Strand.

He is supposed to have died about 1742. It was in these latter years that he wrote his “Ancient Physician’s Legacy to his Country.” He describes himself on the title-page as Thomas Dover, M.B., and his book as “Being what he has collected in forty-nine years’ Practice, or an account of the several diseases incident to mankind, described in so plain a manner that any person may know the nature of his own disease. Together with the several remedies for each distemper faithfully set down.”

In this work Dover relates a number of wonderful cures he had effected, gives names and addresses of many of his patients, often adding grateful letters from them. He had but limited confidence in the “clan of prejudiced gentlemen,” as he calls the College of Physicians, and he complains vigorously of the extortions of the Apothecaries. Metallic quicksilver was his panacea, and he prescribed it so lavishly that he acquired the title of “the quicksilver doctor.” It forms balsam with the blood, he says. That is why it cures venereal diseases. Other doctors gave it, but in disguise, in the form of Ethiops Mineral generally; which was like using the sword in the scabbard.

His formula for “Diaphoretic Powder” is given in a chapter on gout. It was as follows:--

“Take opium 1 oz.; saltpetre and tartar vitriolated, each 4 oz.; liquorish 1 oz.; ipecacuanha, 1 oz. Put the saltpetre and tartar into a red-hot mortar, stirring till they have done flaming. Then powder them very fine. After that slice in your opium; grind these to a powder, and then mix the other powders with them. Dose, from 40 to 60 or 70 grains in a glass of white wine posset going to bed, covering up warm, and drinking a quart or three pints of the posset while sweating. In two or three hours at furthest the patient will be free from pain, and though before not able to put his foot to the ground, ’tis very much if he cannot walk next day. The remedy may be taken once a week or once a month.”

The dose appears to us in these degenerate days a large one, and Dover states that “some apothecaries have desired their patients to make their wills before they venture upon so large a dose.” But he declares he has given up to 100 grains, and the patient has appeared abroad the next day. The notion of danger, he adds, proceeds entirely from their ignorance, and from the want of knowing those ingredients that are mixed up with it, for they naturally weaken the power of the opium.

Dover’s powder first appeared in the London Pharmacopœia for 1788. Probably it was adopted after the quack Ward had made it famous as a “sweating powder.” Ward died in 1761 and the formulæ for his remedies were published soon after his death.

UNGUENTUM ELEMI.