population very subject to this complaint, he had an immodiate opportunity of putting his conjecture to the test of experiment, and was speedily gratified by obtaining the most decisive proofs of the efficacy of the new remedy. The result of his first trials were published by Dr. Coindet in July 1820, in a memoir printed in the Bibliotheque Universelle; and this was afterwards followed by two others. These memoirs were translated into English by Dr. J. R. Johnson, and published in the form of a small pamphlet, in the winter of 1821. In his first memoir Dr. C. informs us that under the use of iodine a vast number of cases of bronchocele have been cured in a space of from six to ten weeks, and in such a way as to leave no trace of their existence; but that some of the tumours that appear goitrous resist the action of this remedy under every form of prescription; and that others are only dissipated partially, but so as to leave neither inconvenience nor deformity. He states iodine to be a most active emenagogue; and concludes by expressing his conviction "of its becoming, under skilful hands, one of the most powerful remedies with which modern chemistry has enriched the materia medica." In his second memoir, the author protests against the unjust clamour that appears to have been raised against the new remedy by the public in Geneva on the score of its dangerous effects on the living system; attributing such ill effects as may have been witnessed by others, to the incautious, indiscriminate, and popular use of it, and repeating his former opinions, strengthened by additional experience, of its great efficacy and (when properly administered) perfect safety. He here states that the neutral salt formed by the hydriodic acid and potass to which some pure iodine has been added (ioduretted hydriodate of potass) is the preparation most easy to manage, and is the one almost exclusively used by him. In this memoir the author enters somewhat more fully upon the effect of iodine on the animal economy, and gives some account of the symptoms developed by its continued use, or the saturation of the body with it, in which respect (as we shall see hereafter) it resembles mercury and arsenic. He repeats his belief that the new remedy will be found useful in amenorrhoea and other chronic diseases of the uterus; and states his having found it very successful in the cure of indolent scrophulous tumours of the glands in the neck. In his third memoir Dr. Coindet gives an account of his trials with the iodine rubbed in externally with lard, and states his having treated twenty-two cases of goitre in this manner, and cured more than half of these in from four to six weeks. He was led to employ the remedy externally in hopes that it would not be found to occasion the disagreeuble

effects occasionally resulting from its internal use, and which he seems to think owing to its local action on the mucous membrane of the stomach and bowels; and he considers that experience justified his hopes, as he says that this method "presents a sure and easy mode of employing this powerful remedy, exempt from those objections made to its internal exhibition." In this memoir he states his further experience of the iodine in enlarged scrophulous glands, and that his scccess has exceeded his most sanguine expectations. He suggests the probable benefit of a combination of this medicine with mercury in syphilitic complaints complicated with scrophula; and of the simple remedy in ovarian affections, from the analogy some of these bear to the disease of the thyroid gland.

Since the publication of Dr. Coindet's memoirs, iodine has been employed by many practitioners of eminence, as for instance, by Dr. Decarro of Vienna, Formey of Berlin, Majendie and Gimelle of Paris, Sacco and Omodei of Milan, Fenolio of Turin, and lastly, by the distinguished author of the Clinical Essay whose title is placed at the head of this article. In the hands of all of these it has been most suc cessful in the cure of bronchocele, and has been considered by some of them as a valuable medicine in other diseases. In this country, we believe it has not had a very ample trial. We mentioned in a former number of this Journal that it had been used in one case by Dr. Kennedy of Glasgow, without success; but we learn from some communications in the Medical and Physical Journal for August and October 1822, that it has been used with great success in the case of goitrous affections common in the elevated parts of Sussex and Surry. In one instance a comparative trial of the sponge lozenges and tincture of iodine was made by a very judicious and well informed practitioner, Mr. Austin of Haslemere, and the result was in favour of the superior efficacy of the latter. In the part of the country just mentioned (Haslemere) we have the means of knowing that bronchocele prevails to a surprizing extent, affecting almost every female (and scarcely any males) among the labouring classes. In these cases the burnt sponge lozenges (prepared by Shepherd of Fleet Street) are considered by the resident medical gentlemen as of almost specific efficacy, if persevered in for a sufficient length of time, and are not found to be productive of any ill effects.

Mr. Austin, we are informed, is now engaged in giving a full trial to the iodine; and we have every reason to expect from him a judicious administration of the remedy, and a faithful history of its effects.

It was with the knowledge of the results obtained from the

employment of this remedy in France, Switzerland, and Germany, that Brera determined to give it a full trial in the Clinical School of Padua in the year 1821; and in the small volume before us he has submitted to the profession the fruits of his experience. Although the author entitles this a Clinical Essay, and commences with a detail of cases, yet he takes occasion, in the course of his memoir, to give a more connected and comprehensive view of the general medical relations of iodine than is to be found in any other work; and as we think these details will prove much more interesting than the cases, we shall reverse the order of his Essay, and give an account of these general matters first. In doing this, as our object will be to submit to our readers an epitome of what is known respecting the new remedy, we shall neither restrict ourselves to the order nor to the substance of our author's treatise, but cull our materials from whatever other sources are accessible to us.

I. Chemical History of Iodine. For a complete account of this we must refer to the sources formerly mentioned, and to the work before us. We shall only here observe that iodine is a simple substance, of characters analogous to those of oxygen, chlorine, &c. solid at the ordinary temperature of the atmosphere, but volatile at a moderate degree of heat, under the form of beautiful violet-coloured fumes, from which it has derived its name. It is very sparingly soluble in water, but much more so in alcohol and æther. It is not inflammable. It forms acids when combined with hydrogen, oxygen, and chlorine, which are respectively named-the hydriodic-the iodic, and the chloriodic acids; and it unites with many of the metals forming iodurets. Its acids form salts with the alkalies, earths, and metals; of which, and also of the pharmaceutical preparations derived from these, a very complete catalogue is given in Brera's memoir.

II. Pharmacology. We have already stated Dr. Coindet's opinion that the ill effects occasionally found to follow its internal use would be obviated by its external application. Brera, however, informs us that further experience has proved the fallacy of this notion, and assures us that it can be employed internally with equal safety, and with greater effect, except in such cases as require its topical agency. The fol lowing are the formulæ most recommended by Professor Brera.

1. Tincture of Iodine. Made by dissolving 48 grs. of pure iodine in an ounce of alcohol (at 35.) This is the preparation most frequently used at first by Dr. Coindet, who,

as well as Brera, recommends it being used fresh, as it is liable to decomposition in a few days. The dose is from five to twenty drops for adults, three times a day. Twenty drops contain about one grain of iodine.

2. Pills of Iodine, made by forming one grain of iodine into two pills, with elder-rob and liquorice powder-one to he taken morning and evening.

3. Iodine Ointment, made by rubbing up a dram of pure iodine with an ounce of lard, or half a dram of hydriodate of potass with an ounce and a half of lard; the former in the quantity of a scruple, the latter about the size of a filbert, rubbed on the part.

4. Solution of Hydriodate of Potass. This preparation is stated to be preferable to any of the foregoing, producing their good effects without their inconveniences. It is formed by dissolving 36 grains of the hydriodate in an ounce of distilled water, and is given in the same dose as the tincture.

5. Solution of the loduretted Hydriodate of Potass, formed by dissolving 36 grains of the hydriodate and ten grains of pure iodine in ten drams of water. This is said to be a still more efficacious preparation than the preceding, and requires to be given in small doses, viz. five or six drops, three times a day, to begin with.

The following precautions are to be attended to during the administration of iodine :-not to combine it with substances likely to decompose it, and not to give it when the stomach is loaded, but in the morning, a couple of hours before or after dinner, and in the evening. Our author farther recommends the occasional suspension of the medicine, on account of the sometimes sudden supervention of unpleasant effects from it, and to give a dose of magnesia on the day of its suspension, with the view of clearing the primæ viæ. The liquid preparations may be given in any vehicle. Coindet usually employed syrup and water.

III. Effects of Iodine on the Living Body..

A. On Animals. We have already observed that both Majendie and Orfila, on the first discovery of iodine, made experiment of its effects on animals. The following are the results derived from the trials of the latter on dogs.

1. Introduced into the stomach in small quantity, it acts

as a gentle stimulant, and excites vomiting.

2. In the dose of a dram it invariably destroys the dogs

to which it has been administered, (the oesophagus being tied,) producing ulceration of the mucous membrane.

3. In the dose of two or three drams it produces similar effects in the animals whose œsophagus has not been tied,

provided they have not vomited for some hours after its ingestion.

4. It is not fatal when applied externally.

5. It seems to act on the human body in the same manner as on animals.

6. It ought to be classed among the corrosive poisons.

B. On Man. When iodine is cautiously and gradually introduced into the system, it affects it in a general manner, analogous to that of mercury, but very different in the con sequences. The first, and what may be called the salutary effects of iodine, are an increase of appetite and of the strength of the pulse; whenever these are produced we must watch with the greatest care that these salutary limits are not ex. ceeded, and the pernicious consequences of an over saturation of the system induced. The complete impregnation of the system is indicated by the change of the above-mentioned in. creased action of the pulse into decided frequency and quickness-by a sense of heat and irritation of the fauces-pain of the orbits or eye-balls, with obscured vision-pain of the internal ears and gums, (with occasional salivation,) headache, restlessness, loss of sleep, with swelling and pain of the diseased organs, (e. g. thyroid and other glands,) and an increase of appetite sometimes to a degree of voracity. In some persons the submaxillary glands become painful and swollen, and a similar state of the mamma, with eventual diminution of their natural volume, takes place in some females. When given from the first in an over-dose, iodine produces a strong burning sensation in the fauces, which frequently extends 'down the oesophagus to the stomach and whole intestinal canal. In a still higher degree of saturation (or iodization, as the author calls it) of the system, to the above-mentioned symptoms succeed very considerable emaciation even in the space of a few days, excruciating pains in the orbits and eyes, with great defect of vision, and similar pains in the diseased parts; the strength vanishes; neuralgic pains are experienced in the stomach, chest, bowels, &c. the sleep entirely fails, and there is obstinate palpitation of the heart, with tremors, convulsions, or palsy of the extremities; to the excessive appetite succeeds complete anorexia, and the factitious disease finally terminates life, in a short time, by universal inflammation of the nervous and vascular systems, (profonde angioitidi e neuritidi.)

Upon the appearance of the milder class of symptoms above-mentioned, the immediate suspension of the medicine (which ought always to be done) sometimes is found sufficient to put a stop to them in a few days. For allaying