Colonial North America: Countway Library of Medicine

170

Materia Medica

Tonics

or by its tonic power increase the symptom of fever. I have bled a patient eight times before I thought it proper to administer the bark and in billious fevers weeks have passed before the barks could be used, after it was the only remidy of efficacy. I think we should do well to precede the bark with some evacuant, but there is no need to excite the stomach actively by the use of Emetics, it is the activity of the stomach that prevents the use of many medicines. Emetics are improper when there is any disposition to vomit or where there is a determination of blood to the head, they often increase the irritability which is a verry difficult to manage. Since the fever of 1793 of this City Emetics have been given less frequently than before. Should any evacuants be thought necessary I should use cathartics, the following I have found most useful, Calomel either alone or combined with rhubarb, the root of May Apple the Padophyllum peltatum of Linneus is a verry gentle cathartic and may be advantageously combined with calomel, the dose of both is about ℈i [1 scruple]. Jallap is generally preferred, I seldom employ it as it is verry apt to excite nausea. I do not wish to exclude emetics entirely as a remedy in fevers they are sometimes verry serviceable. Evacuants have not only been of service in the commencement and

536

Materia Medica

Cathartics

I shall speak more of it when treating of Diuretics.

Jalap. This belongs to the same family with the Potatoe, and derives its name from a Town "Jalappa". It is a native of the southern part of the continent of America, and is said to be found in the United States, the resinous parts contain the virtues of the plant, the gummy have less of them. Jalap is certainly a verry valuable cathartic and is more employ’d in Britain than in this country. Dr Hofman thought it unsafe for children. Cullen triturated it with crystals of crem Tartar and liked it verry well. I do not observe (says he) that it is heating except in large doses, I do not however approve of it for children. It often gripes and pukes and I do not think it improved by the addition of crem Tart. I always combine with it calomel, the common dose for an adult in Pennsylvania ℈i [1 scruple] but it is given in doses from 15 grs [grains] to Ʒfs. [½ dram] children at the breast may take 2, 3, or 4 grs [grains]. Jalap in substance is far preferable to any of the preparations of it which are the extract and the tincture, of this the dose is from Ʒfs [½ dram] to Ʒi [1 dram] alone or with syrup.

Podophyllum Peltatum. Or May Apple. This grows in Pennsylvania, New York, and Delaware where it is called Mandrake, it grows also in some of the other States, in order to obtain the purgative effect of this common root, it should

538

Materia Medica

Cathartics

be combined with calomel,

Rx Podaph. Pelt. X or Xij grs [10 or 12 grains] Calomel iv or vi grs. [4 or 6 grains]

M. this is a dose for an adult. I have sometimes combined it with Crem Tart, but this combination induces griping, it is an article much adapted to the intermittant and remittants of our country to prepare the system for the exhibition of the bark. I have been informed by Physicians that they have cured intermittant fevers by it alone. I have recommended it to some who did not succeed with it because it was taken up in the spring when it should have been taken up in the autumn when the fruit is esculent and ripe and the leaves yellow and perfectly withered, the flowers of this plant is of a cream white, the fruit when ripe is yellow and the root grows horizontally, the whole of the root is used.

Hellebore. The helleborus Niger spontaneously grows on the mountains in Germany, but not in the United States the root of it is cathartic in the dose of from grs X to Ʒfs [10 grains to ½ dram] for an adult the purgative quality seems to reside in the resinous parts, this is a more powerfull cathartic than many I have yet mentioned, but still it is not verry violent the antients [ancients] thought it well adapted to cases of Melancholy from Atrabites and other diseases of the mind, and this practice is still pursued by some Physicians of our time, it is the article so much spoken of by Hypocrates and Galen.