and constant pain also in the head. His bed had the odour of a strong bed of violets. Mild emulsions, diluents, and purgatives were now employed. On Thursday the urine became clear, and no distress remained except the pain in the head. On the ensuing Monday a seton was made in the nape of the neck, slight aperients were administered, and the warm bath directed to be used at a low degree of temperature. With this treatment, slightly varied, he was shortly discharged, cured.

Case 5. A boy, nine years old, had, when at the age of . five years, a strong epileptic fit. He had another less severe in three weeks; this was followed, after short intervals, by others, differing in their degree of violence. For the last two years he has been in a state of idiotism, and has not passed one night during the last thirteen months without a fit, and he has frequently had them in the day. One night he had twelve. His urine is passed involuntarily; but he has the power of retaining his stools, which are very irregu lar, and his bowels are generally costive.

This boy commenced the use of the ol. terebinth. rectif. on the 15th of February, and left it off on the 7th of April; and during the period here indicated, he took of it two pints and ten ounces. It was administered at first in the doses of half a dram four times in the day, and the dose was at length increased to three drams, which was not at any time exceeded, whilst it was continued for nine successive days.

From the 15th of February to the 1st of March he had nineteen fits, which occurred after longer intervals, were less severe, and of shorter duration than heretofore. From the 1st of March to the 28th of the same month, he had no fit. On the 29th he had a very weak fit, which lasted about five minutes. From the 29th to the 16th April he had not a recurrence of the paroxysm. On the 16th of April he left the hospital at the request of his parents.

The changes that resulted from this treatment was as follows:

1st. The pulse at the commencement was irregular, small, and quick. On the ninth day of the treatment it became regular, but continued small and quick. This regularity was disturbed for a few days; but ultimately the pulse was free, soft, and regular.

2dly. The bowels were slightly purged, and regular. No worms were voided.

3dly. The incontinence of urine was entirely obviated. 4thly. The fits, when they occurred, were less severe, and took place only after longer intervals, and the patient had Vol. III. No. 10.

3 M

but one fit during the subsequent six weeks, and that lasted only four or five minutes. And,

5thly. At first his intellects were so dull, that he was perfectly idiotic; when he had taken the medicine about three weeks, he became noisy, mischievous, and very troublesome, and occasionally would point to his head as if in pain there. In this state of cerebral excitement, he continued for a week. He then improved, and the amendment continued progressive, showing itself by a remarkable docility of disposition, and by a desire to read and to write.

The length of time during which this boy had laboured under his malady having been so considerable, the permanency of his improvement may be very doubtful, and I cannot, by any means, consider him as cured. But, so obvious and striking was the amendment in this case, it excited in me sensations so gratifying, peculiar, and inexpressible, that although the cure may be imperfect, I am still desirous of relating it in this paper, in order that other practitioners may give it a trial in similar, hopeless, and melancholy disorders.

In continuing to relate additional cases, I should only offer a tedious repetition of such as have been favourable; for 1 have nothing to record of a contrary kind, beyond those I have noticed in a former part of this memoir. In making this selection, I have had principally in view such cases as have reference to the administration of the oil in large and frequent doses; because in small doses it has, for many years, received the sanction and recommendation of estimable authorities.

This recommendation, however, was accompanied with a caution to limit with accuracy the dose to a few drops; and in order to enforce this caution, cases have been detailed, in which the most violent, and, in some instances, fatal effects, were the consequences of exceeding the prescribed dose. Where death or severe disease has been the consequence, I consider that we are either to attribute it to some idiosyncrasy of the patient; or to the dose having been so intermediate between the small and the large quantity as not to have been sufficient to excite that energetic action on the stomach and alimentary canal, which appears from recent experience to be its more immediate operation. If we should suffer the first of these causes, namely, some idiosyncrasy, to deter us from the use of this or any other active medicine it seems probable that, at no very remote period, we should relinquish some of the most important remedies that are now relied upon in the treatment of diseases; the use of which, have been founded, for the most part, on

physiological reasonings and observed facts. Cases corroborative of this opinion are numerous and frequent; but I will nevertheless mention two, which regard the use of that powerful medicine, mercury.

A man, aged thirty-five, labouring under certain complaints for which mercury was considered necessary, commenced by direction to rub on his legs and thighs one dram of the unguentum hydrargyri fortius on a Tuesday night. This was repeated on the Wednesday, Thursday, and Friday nights, when a severe ptyalismus supervened, his face swelling much, accompanied with a copious discharge of saliva. Upon this the friction was omitted. He was debilitated, and his bowels severely affected with diarrhoea; this was at first slightly encouraged, and then moderately checked. Early in the morning of the following Tuesday, great prostration of strength suddenly occurred, his pupils were insensible and contracted, his extremities cold and livid, he passed into a comatose state, and died on the Wednesday night. It appears that the quantity of ointment used was only four drams; and this quantity produced consequences rapidly fatal.

At the time the last-mentioned patient was under treatment, a female, aged fifteen, had used, by means of friction, in the course of four weeks, nearly four ounces of the ointment prepared in the same manner, and had taken, in small doses, during this period, as well as three weeks previously, several drams of the submuriate of mercury, without any apparent effects.

Are we then to abrogate the use of mercury in the treatment of diseases? Or, are we even to be more scrupulous than hitherto in the use of it, on account of such cases as those which I have related? Upon similar grounds I consider we are to decide upon the use of the oleum terebinthinæ rectificatum, when administered in large doses; although the results of the fourth case related in this paper, were unfavourable or deleterious.

In cases where any idiosyncrasy does not appear to exist, I should refer the deleterious consequences to the dose not having been large enough; for instance, forty or fifty drops given twice or three times a day, will often produce strangury and bloody urine, with the other ordinary concomitant symptoms, whilst in the same subject one, two, three, or four ounces, cause no such effect; but operate in the manner described in this memoir.

Experiments and observations, which I do not think it necessary to relate here, have led me to entertain an opinion that where the small doses have been given and followed

with the violent symptoms remarked by the older authors, the oil being retained too long in the stomach, exerts an undue action on the nerves of this organ; and by sympathy or other relations, on the functions of the brain; and hence the respiration becomes disturbed, and the secretions are changed and vitiated, but more particularly that of the urine; and according to the extent of this preternatural action or excitement, we are to expect more or less of severity in the consequent symptoms. This I will briefly illustrate by an experiment. A man took early in the morning one dram of the oil; in about ten minutes, he began to experience a sense of heat at the stomach, which was followed by pain in the head, his pulse and respiration became quickened. He shortly afterwards voided a small quantity of urine, denoting the effects of turpentine. In the course of three hours he became easier. In the afternoon he had a slight return of these complaints, and the urine presented more powerfully the odour of the oil. At five o'clock in the afternoon he had a gentle purging evacuation; the abovementioned symptoms then began to subside, and soon totally disappeared. Four days afterwards he took another dram of the oil;-in about forty minutes he suffered the sense of heat at the stomach, and the pain in his head, as described in the last experiment; immediately he took one ounce and a half more; the symptoms did not increase in severity, he was quickly purged, and by noon he experienced no effects of the medicine. For these reasons I am of opinion that it is better to give the oil in doses of an ounce and a half or two ounces, repeating it at the intervals of an hour, according to circumstances, than to give, at one dose, the same quantity as was taken in Case 3 of this paper. Because, if the immediate effects were of the most aggravated kind, then, I conceive, a repetition of the medicine would be rapidly fatal; on the other hand, if symptoms were to follow similar to those which appeared subsequent to the experiment, then I should rely upon a repetition; knowing, from a number of other experiments, where this medicine, in small doses, operated in the way mentioned, that the most efficient remedy is, the immediate administration of a large dose, by which the energetic action of this oil is demonstrated.

I could bring forward additional facts and experiments; but I trust that I have here presented such a series of observations, as will be deemed sufficient to direct the attention of other practitioners to this remedy in a manner commensurate with its merits.

The author cannot allow this opportunity to pass without

thanking the medical officers attached to the hospital during the period referred to in the course of this paper, for the kindness and indulgence he experienced from them collectively, but more particularly the superintendent, Dr. Kerr, whose attention was very much directed to the facts herein detailed. The author further begs to say that if the officers belonging to eleemosynary institutions will give the medicine a full trial, he is convinced that the funds of these charities will be thereby materially benefited.

Hanover Street, Hanover Square.

London, 1821.

II.

Annual Report of the General Committee of the Associated Apothecaries and Surgeon Apothecaries of England and Wales, received and adopted at the Annual General Meeting of the Association, held by Public Advertisement, at the Crown and Anchor Tavern, Strand, July 3d, 1822.-Joseph Hayes, Esq. President.

YOUR Committee, with all due respect, submits to the general meeting the following report of its proceedings during the past year, and of the present state of the Society.

From the formation of this Institution, the principal object which the association has had in view has been the advancement of the usefulness and respectability of the medical profession, by effectually restraining the uneducated and the ignorant from practising an art, which, above all others, requires patient study and close attention, investigation the most minute, knowledge the most varied, and ap plication the most intense.

It was soon perceived that this end was attainable only through the medium of legislative interference. The necessary interposition was therefore respectfully sought for, and principally through the exertions of this Society, and to a certain extent obtained.

Had the Act of Parliament alluded to been efficient to the purposes required, little had been wanting to the public security from the misconduct of rash pretenders to medical skill, or to the wellbeing of the general practitioner; but while it is acknowledged by all who are competent to judge, that in the law referred to, ("commonly called the Apothecaries' Act,") there are ambiguities and defects, which can be remedied only by a new enactment, your Committee regrets that no favourable opportunity has offered of applying to Parliament for relief.

From such an application the Committee has been deterred by different considerations; the fate of the Surgeons' Bill, and even of the Apothecaries' Act, "curtailed of its fair proportions," during its progress through the Upper House, tended greatly to discourage such a step; nor did the state of the funds warrant an attempt which would certainly be expensive, and probably unsuccessful; a still