Colonial North America: Countway Library of Medicine

60

Materia Medica

Astringents

stimulant are improper in that stage, there are some cases in which they prove serviceable in curing dropsey, as when they check the paroxysms of fever on which the dropsy may depend, a patient under my care with typhus fever became dropsical, I became alarmed gave bark, wine &c, to remove the fever which they did and with it the dropsical swellings, many cases of a similar nature have occurred in my practice. Dr Lind used to say he who used bark plentifully during aprexy of Intermittant fevers seldom had dropsy to follow, astringents have been universally employed to stop hemorrhages, but as these are allowed to depend on the verry different state of the arterial system, we must at once perceive the impropriety of employing this remidy indiscriminately in every case. Dr Cullen has I think verry properly divided hemorrhages into active and passive, or such as are owing to increased arterial action, or such as ensue from debility, it is only in the latter kind that we expect any advantage from astringents. I believe its owing to Dr Cullens failure in the indiscriminate use of this remidy that he was led to make this just distinction in this disease,

62

Materia Medica

Astringents

which is a verry valuable one in Diarrhea as depending on a relaxed or torpid state of the bowells they may be used with advantage in the diarrhea of old people accompanied with great pain, they are improper in Dysentary they are frequently injurious. Dr Cullen supposed to this to depend on a spasm of a part of the colon, produced verry often by increased arterial action. I do not believe this idea of the disease to be correct but rather suppose it to depend on a febrile action in the internal or mucous membranes of the intestines, hence it is obvious that these membranes that diminish the action of the arterial action system ought first to be employed, astringents are serviceable in some cases of Dysentary, but such only as depend on a relaxed state of the system, or are of a cronic nature there are some of the vegitable astringents that may be used in its first stage. Leucorrhaea. Astringents are serviceable according to Dr Cullen, but some authors have found them injurious, there are evidently two species of this disease, one commencing with fever and more or less of a febrile nature through all its stages, the other the effect of debility, they are serviceable in the latter kind, but I have cured some cases of

64

Materia Medica

Astringents

Leucorrhea by the most oposite treatment such as bloodletting, milk diet &c. In others I have found the most powerfull astringents usefull. Diabetes. Astringents have been employ'd with evident advantage. Iron has been recommended in the cronic state of this disease. Allum is also usefull when it depends on relaxation of the urinary organs; but the same caution is necessary in their employment in this disease as in all others that I have spoken of, as it certainly does not always depend on debility of the kidneys, the disease is sometimes a translation of the gout, and the most decided cure I have ever seen was cured by bloodletting and the depleting plan. Gonorrhea. In which they were long employed by Dr Cullen who seems to not have a correct idea of this disease and especially of this remidy, in many instances they are highly serviceable, they have been employed in calculous affections by Dr Ham and others. They cannot be supposed to act by any power they possess of dissolving the stone. Dr Cullen supposed they acted by absorbing an acid in the stomach, in such cases, and further fixed air is a verry valuable remidy and we cannot suppose it to act in this manner, as it is its self an acid their operation here is verry difficult

90

Materia Medica

Astringents

a lax state of the system and uterus, in such cases astringents may be proper, it is directed to be given immediately after consumption, its dose is from ℈i [1 scruple] to Ʒi [1 dram] in Intily [Italy] it is used in the process of tanning having finished the vegitable astringents. I shall proceed to treat of some not belonging to that kingdom.

Allum. This salt is formed by the union of sulphuric acid with the argellarous earth, it is well known to be a powerful astringent. Dr Home proved by several experiments that it acted on the pulse. It therefore exerts with its astringency some degree of stimulant power, it is used internally and externally. Allum is employed in almost every case of hemorrhage which must certainly be improper. Dr Cullen being aware of two species of hemorrhage very happily observes that it can do service in hymoptesis, and is only serviceable in hemorrhages from relaxation or debility. I have given it with galls in the following proportions

Sulp. Allum Ʒi [1 dram] Galls Ʒfs [½ dram] Mice fit doi XII* [footnote back 1 page]

I have seen it succeed when the sugar of lead failed. If it purges which is not uncommon Opium may be mixed with it. Cullen says it must be given in small doses as it is apt to irritate the stomach and in several instances I have seen it rejected by vomiting in urgent cases the dose must be frequently

92

Materia Medica

Astringents

repeated and increased, we may begin with five grs [grains] and increase it to ℈i [1 scruple] several times in the day, before we administer this remidy in morbid evacuations or hemorrhages we should attend to the cause whether it be an increased arterial action or debility. I shall now mention the different diseases in which it has been employed. Leucorrhea. It has been recommended in this disease, which is frequently connected with the Phytisis, I have used it with colombo with advantage it is of much importance to the pulse. Gonorrhea. Many authors have recommended it in this disease. I have used a simple solution, but prefer it mixed with a decoction of the oak bark. Dr Foroler has found it verry usefull in scorbutic hemorrhages. I have used it with success with galls. Diabetes. On the authority of Dr Mead it has been used in this disease, but it would be natural to doubt its efficacy in diabetes, there are however some facts which seem to show it may be usefull in some cases. Dr Wistar informed me he was successfull in a case that appeared to be desperate. Dr Dover had a verry high opinion of it other physicians have used it with success. Dr Darwin supposed it acted by exciting the absorbents of the urinary organs into their natural action, but I