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Mr. Whately, on Strictures of the Urethra. 55$ of it, the bougie, upon which it is applied, should be increased in size, in proportion as the aperture of the stricture dilates, the better to effect the dilatation. Every succeeding bougie should pass with some degree of tightness through the stricture, and be moved backwards and forwards several times, either slowly or more quickly, as the patient best can bear, till the caustic is dissolved, Thp operation should be repeated in this manner till the contracted part of the urethra is dilated, if possible, to the natural size, which is generally practicable in recent strictures, In those of longer standing, we should make the attempt, and carry the dilatation as far as it can be done with safety. We are, however, on no account lo increase the quantity of caustic, as we increase the size of the bougie.
" On account of the extreme activity of this remedy, and tho certainty with which it destroys the organization of the part it touches, it is necessary to fix upon a maximum or determinate quantity, which we should not venture in any case to exceed. "Without this precaution, great mischief may result from its application; as some patients have so little irritability, as to be able to bear much larger quantities of it, without any sensible inconvenience, than it would be prudent to use. On this account, as well as from a wish that the remedy should act only on the surface of the stricture, without destroying its substance, 1 do not in any ease apply more of the kali purum at a time than a piece about the siz? of a common pin's head; and even this quantity cannot be borne where the habit is very irritable. It would be difficult to weigh such small portions of the article. In order, therefore, to convey a clear idea of the different quantities to be used, I shall here represent them by three dots of different sizes, thus, ? . . and to give further assistance on this important point, I find that twelve bits of the largest size weigh one grain." The succeeding chapter contains Mr. W's method of applying Il/nar caustic to strictures, as recommended in his former work ; for lie by no means wishes this remedy to be superseded by the new one, as different cases require different treatment.
" There are, (says Mr. YV.) as has beep before stated, some cases in which the contraction is so irregular, and its aperture so lintovvardly situate, that a bougie cannot readily, if at all, be passed into it; other cases have likewise been described, in which it js impossible to pass a bougie through the strictures. If, in the former of these cases, a bougie, furnished with the kali, cannot be passed into the stricture, or if it get through the stricture, and yet do pot destroy the irregularity, and it becomes necessary for this purpose to apply a caustic at the extremity of a bougie to the anterior part of the contraction, I should certainly prefer the lunar caustic to jhe kali purum. In cases of the latter description, the lunar caustic, for the reasons already assigned, ought always to be fairly tried in the same way, previous to the use of the kali purum.
The lunar caustic should be used in every case, in a determine to nate quantity, upon the extremity, and partly upon the shoulder*; of a common bougie, which has previously had the curvature of the urethra given to it. Theffollowing is an improved method of arming a bougie with this cafastic. Take a given quantity of powdered lunar caustic, e. g. the twelfth part of a grain, put it upon a bit of flat glass, then take a very small quantity of thick mucilage of gum arabic upon the point of a pen knife, (about the quantity of a large pin's head to a quarter of a grain of caustic is sufficient) mix the caustic and mucilage together. If the quantity of mucilage be nicely adapted to that of the caustic, it will almost immediately form a paste, which may be taken up from the glass on the point of a knife. In about half a minute this will become so stiff, that it may be rolled into a pill, without adhering'to the fingers. In this state it should be put immediately upon the end and shoulders of the bougie, and without delay so moulded upon it, as to become perfectly smooth, like the extremity of the bougie. The operator's finger and thumb will mould the paste, and his thumb nail will smooth its surface, or it may be polished by gently rubbing it on the glass. Rut this must be done expeditiously, otherwise the paste will become so hard as to be incapable of being thus moulded.''". " The bougie may likewise be prepared in the following manner : The liquid paste of caustic and mucilage, when first mixed, may be immediately put upon the extremity of the bougie from the point of the knife, and, as it hardens, may be coated upon it, partly by one of the fore fingers, and partly by the knife. This paste hardens so quickly, that by the following day it will be too firmly fixed 011 the bougie to be easily separated from it. u When a bougie, thus armed, is applied to either of the kinds of stricture I have just mentioned, it should be of as large a size as the urethra will admit. When it arrives at the strictured part, it should be pressed against it with a moderate degree of force, till the caustic is dissolved, which it will be in a minute or two.
The quantity of caustic employed in the first operation, should not in any case exceed the sixteenth part of a grain. At the second and third operation, the twelfth part of a grain may be used, if the quantity first employed gave but little pain. If, after this, no progress is made in opening the stricture, the quantity of caustic may be gradually increased to the eighth, the sixth, or ii the patient bear the preceding quantity very well, even to the fourth of ;i grain at each application. I5ut the increase should be made with a very cautious hand, and in no case ought we to exceed the quantity last mentioned. In those who are young and healthy, it may sometimes in these cases be repeated to advantage every live days ; in other cases, however, a week, or even less frequent! v, will be sufficient. In making an addition to the quantity be lore used, we should attentively regard the effect produced by preceding applications; should these have produced pain and irritation, with a Irequent desire to make water; or haemorrhage, eyeft <A the slightest kind ;? we must not even repeat the caustic, much Dr, Ford's Three Letters on Medical Sufyects, ? 561 Jess increase its quantity, till these effects have entirely ceased, As a proof of the necessity of keeping an attentive eye on the effect of former applications, I may inform the reader, that J have seen an instance, where only the twenty-fourth part of a grain of this caustic produced great irritation/' The remaining part of the volume contains observations on the danger, suffering, and consequent inconvenience of Mr. Home's method of applying caustic to strictures; to which succeed a competent number of cases to illustrate the use of both remedies* There is also an Appendix, on a peculiar affection of the bladder in elderly people.
In our opinion, all sufferers from strictures in the urethra, as well as surgeons in general, are much indebted to Mr. Whately for thg important improvements he has made in this branch of the profession, Tiie first and principal part of this little publication is no more a subject for medical criticism than the advertisements of the fashionable empirics of the day. It will only excite some surprize, that a regular physician should depart from the line of professional respectability, in thus advertising a secret medicine prepared under his own inspection, and taking pains to satisfy the world that the secret will remain in the family, unimpaired, after the death of the inventor.
The next subject is, remarks on the use of granulated tin as a vermifuge, and as a medicine of general activity in relieving the intestines from indurated faeces long retained, Besides this wellknown power of tin tilings, the author attributes to it, when used ift large doses, a peculiar sedative operation in checking haemoptysis, and in quieting various powerful nervous impressions on the mind, without being attended with the same inconveniencies that follow the use of opiates. With this view Dr. F. particularly advises the tin to be employed in the latter stages of pregnancy, when the mind is often peculiarly anxious and irritable, and when at the same time, a state of costiveness ought to be carefully avoided. A sedative power has, we believe, never been before attributed to this remedy ; if well founded, possibly it may be owin * to the load with which the tin in common use is generally alloye.l in a small proportion, and which may have a sensible operation in the large doses employed by the author, In an appendix is added the following process for preparing the hydtargyrus cum magnesia or mercurius alkalizatus.
" Take of purified quicksilver, the finest and cleanest manna, of each one ounce. Rub them well together in a stone mortar, until the mercurial globules entirely disappear, which will be in a few minutes, adding a few drops of water if necessary, and afterwards as much more as will reduce the mixture to the consistence of a thick syrup or treacle. With this, incorporate, by trituration, one drachm of magnesia, and add a pint of tepid water,?After the mercury has subsided, pour off the ciear liquor, and add another pint of tepid water as before; and decant it off alter the subsidence of the powder: To this powder add three drachms of magnesia, and as much water as will reduce it to the consistence of an electuary.?After a little trituration, put the mass upon filtering paper, and dry it with a gentle heat, breaking it now and then to expedite the drying. When it is thoroughly dried, add two drachms of gum arabic in powder, and mix them well in a stone mortar." This method of using manna for the extinction of the mercury, and afterwards washing it out, leaving the metal combined with the earth, appears to us a real improvement, and worthy of attention.
Elements of Materia Medica and Pharmacy. By J. Murray, Lecturer on Chemistry, and on Materia Medica and Pharmacy. 2 vol. 8vo. pp. 746. Edinburgh, 1804; This work is divided into three parts: the first treats of pharmaceutic chemistry, or of those parts of general chemistry that relate to pharmacy; the second contains a classification of all the subjects of the materia medica, with a summary view of these properties and the chief modes of combination in which they are employed ; the third part is the pharmacopoeia, or rules for the preparation of the different medicines, chiefly from the last edition given by the Edinburgh College, collated with the London Pharmacopoeia, together with remarks 011 the rationale of each prescription where any thing occurs worthy of notice.
We shall give a short view of each section. The part devoted to pharmaceutical chemistry begins with a slight sketch of the chemical elements, some of which can only be introduced for the sake of uniformity, as they have 110 connection with pharmacy. The author, with propriety, enlarges on the analysis of vegetable matter as moje peculiarly relating to the preparation of medicines. lie very justly enforces the important distinction between the proximate and the elementary principles of vegetables, and shews that the business of the pharmaceutical chemist altogether relates to the former, not the latter. The proximate principles being described, the methods of separating and preparing them for use, and the re-agents necessary for this purpose, .are thus enumerated. " From this enumeration of the proximate principles of vegetables, we may perceive the reasons for those pharmaceutic processes to which plants are usually subjected. " By infusion in water, we impregnate the fluid with the gum, sugar, extract, tannin, Valine substances, part of the essential oil, and part also of the resinous principle. The aroma of the plant is 2 generally generally first taken up: by longer infusion the water is loaded with the colouring astringent and gummy parts : these are alio most abundantly dissolved when the temperature is high. Hence an infusion differs according as the water has stood, longer or shorter*; 011 the materials, and according as it has been promoted or not by heat. An infusion made in the cold is in general more grateful, while one made with hea':, or by keeping the fluid long upon tin* materials, is more strongly impregnated with active matter. " By decoction or boiling, the solvent power of the water is still farther increased ; and hence the liquor always appears darker coloured, and is, in fact, more loaded with the principles of the vegetable which it can hold dissolved. The volatile parts, however, particularly the essential oil, are entirely dissipated; and therefore it is an improper process tor those vegetables whose virtues depend; wholly or partially, on these parts. Even the fixed principles of vegetables, at least some of them, are injured by long decoction.
The extractive matter, for instance, gradually absorbs oxygen from the atmosphere, and is converted into a substance nearly insipid and inert. Opium, Peruvian bark, and many other vegetables, arc injured in this manner by decoction, especially if the atmospheric air is freely admitted; and these two circumstances, the dissipation of the volatile matter, and the oxygenation of the extractive, considerably limit tlxe application of this process. It is still used, however, with advantage, to extract the mucilaginous parts of vegetables, their bitterness, and several other of their peculiar qualities. " Alkohol may be applied to vegetables to extract those principles which are not soluble in water. It dissolves entirely their essential oil, camphor, and resin; and as these are often the parts 011 which the virtues of vegetables depend, these solutions, or tinctures, as they are termed, are often active preparations. " Equal parts of alkohol and water, in general, extract still more completely the active matter of plants, as we thus obiain a solution of all those substances which are separately soluble in cither of these fluids.
" When by the action of one or both of these fluids, we obtain a solution of the active principles of a vegetable, the solution may be evaporated to the consistence of a thick tenacious mass. This forms what is termed an extract: it is termed an aqueous extract when obtained from the aqueous intusion or decoction ot a plant, and spirituous when alkohol has been the solvent. The design of this preparation is to obtain the active matter of the vegetable in a small bulk, and in such a state that it may be preserved a long time without suffering any alteration. It is evident, that it is a process which can be properly applied to such plants only as have their virtues dependant on some of their fixed principles, and oven these arc often injured by the heat employed, and the free access of the atmospheric air. " Distillation is another process applied to vegetable substances, O o2 by by which we obtain some of their active principles, particularly their essential oil.
If the vegetable matter be heated along with the water, the oil is volatilized, alongst with the aqueous vapour: it separates from the water on being allowed to remain at rest; a part of it, however, is also dissolved, and communicates to the water a 'considerable degree of flavour, and often also of pungency. This forms what are termed distilled waters. If alkohol be used instead of water, the essential oil is completely dissolved in it, and we thus obtain what are termed distilled spirits." The oxygenation of the solutions of those substances which liquid menstrua arc able to extract from vegetables, has been supposed by several chemists to impair their medicinal virtues. Mr. M. is of tile same opinion, and lie gives the example of the decoction of cinchona in illustration.
" From an accurate analysis,of it, (the cinchona) it has been proved that seven parts out^of eight cf it consist of woody fibre, or of a matter inert and insoluble, which cannot act on the system, and which affects the stomach only by its weight and insolubility. The remaining eighth part is that in which the activity of the medicine resides: it is therefore evident that if this be extracted, without injuring its activity, the medicine could be exhibited with much more advantage. This is in part accomplished by the preparations of it that have been mentioned ; but even these do not convey it in all its force. If one ounce of the bark be infused or boiled in a certain quantity of water, the infusion or decoction is not nearly equal in efficacy to the whole quantity of bark operated on.
It is therefore evident that during either of these operations, the active matter of the bark has not been entirely extracted, or has suffered some change. And here chemistry lends her assistance, and still farther elucidates the peculiar nature of this substance, and the changes produced in it by these processes. It has been proved by experiments, that the matter on which the power of the bark depends, has a strong attraction for oxygen at a temperature moderately increased; that during the infusion, and particularly during the decoction of that drug, this active matter absorbs oxygen from the atmosphere, and is converted into a substance insipid, and inert. This leads to the improvement of the preparations of this medicine; and experiments instituted for the purpose have accordingly proved, that, while by long boiling the virtues of the bark are nearly totally destroyed, they are fully extracted by a few minutes decoction in covered vessels. The same investigations have pointed out the nature of the action of some other substances on bark, formerly not well understood. Thus, it has been found by experience, that the alkalies, and more particularly magnesia, enable water to extract the virtues of bark, more completely by infusion?a circumstance elucidated by the fact since discovered, that the extractive matter of the bark, to which its activity is owing, combines with facility with these substances, and forms soluble 'Compounds/' W The Mr. Murray'? Materia Medica and Pharmacy. ? 5<p5 The author's classification of medicines is in some degree different from his predecessors, principally indeed by following the simplifying system of Brown with very scrupulous accuracy. The author's -

Emollients."
All that has been said or can be said on the subject of stimulant and sedative, in the present state of human knowledge, has long been exhausted; M e shall therefore abstain from entering into this controversy, but we must make a single remark on the mode in which the author introduces this arrangement to his readers. lie observes, that " the systems of classification of the articles of the materia medica, which are founded on their sensible qualities, their chemical compositions and properties, or their characters as objects of natural histoiy, are extremely defective. They associate substances, which, as medicines, have little resemblance, and separate others which are intimately connected.
" As the study of the materia medica is merely the study of the medicinal properties of certain substances, it is evident that the method of arranging them, as they agree in producing effects on the living system, is the one best calculated to fulfil all its objects. " The foundation of the classes being similarity of operation, those substances are arranged together which have the closest resemblance in medicinal power, and although, when the extremes of the classes are considered, substances may sometimes be foi\nd associated which appear to be little connected, yet this can never be go much so as in the other systems of classification, and the con- Classification is so good a thing in itself that an indifferent one is pernaps. better than none at all, for experience will sooner or later correct the errors of defective system ; but if similarity of operation is to be the basis of a classification of materia medica, we know not where in any of this other systems will be found a more palpable violation of this principle than in the present, which includes, under the same head, alcohol, tobacco, and digitalis.
The description of each individual article of materia medica is brief, accurate, and as comprehensive as is compatible with the limits the author has allowed hims<elf. The following will serve as a specimen : " Angustura is a bark imported within these few years from the Spanish West Indies, the botanical characters of the tree producing it b. ing unknown. It is in fiat pieces, external'} grey and winkled ; internally, of a yellowish brown, and smooth ; has little flavour ; taslc, bitter and slightly aromatic. Water, assisted by heat, takes up the greater part of its active matter, which does not seem to be injured even by decoction. Alkohol dissolves its bitter and aromatic parts, but precipitates the extractive matter dissolved by water.
Proof spirit is its most proper menstruum. By distillation, it affords a *>mall quantity ot essential oil. The powdered bark, triturated with lime or pot-ash, and water, gives a smell of ammonia. ture, while a diminution in the consumption of oxygen must have an opposite effect. If, therefore, when the temperature of the body is morbidly increased, substances be introduced into the stomach, containing a large proportion of oxygen, especially in a state of loose combination, and capable of being assimilated by the digestive powers, the nutritious matter received into the blood must contain a iarger proportion of oxygen than usual; less of that principle will be consumed in the lungs, by which means less caloric being evolved, the temperature of the body must be reduced; and this operating as a reduction of stimulus, will diminish the number and force of the contractions of the heart. " It might be supposed that any effect of this kind must be trivial, and it actually is so. It is, as Cullen has remarked, not very evident to our senses, nor easily subjected to experiment, and is found only in consequence of frequent repetitions." The contents of the third part of this work have been mentioned to be a translation of the new Edinburgh Pharmacopoeia, with an addition of those preparations of the London College that are peculiar, or differ essentially from the former. To some of the metallic and saline preparations, suitable remarks are added on the rationale of the operation. Under the pubis antimonialis, Mr. C'henevix's new method is given; but the author adds, (what we believe to be perfectly well founded) that neither this nor the antimonial powder of the College is precisely the same as the celebrated empiric preparation which they profess to imitate.
The dangerous nomenclature now adopted by the Edinburgh College for calomel and corrosive sublimate, is here noticed.-? Mr. M. prefers the old distinctions of corrosivus <!)-mil is.
The first appendix to these volumes contains a very short view of the medical history of the gasses, of electricity, and Galvanism. In the second appendix a few remarks are given on the method of composing medical prescriptions, with a table of doses. " The following are the principal circumstances to be attended to in forming a prescription. " 1st, Simplicity should be attained, as far as is consistent with the objects of the prescription: Nothing ought to enter into the composition which does not add to its virtue, render it less ungrateful, give it a convenient form, or which is n>t necessary to conceal any particular ingredient ; and, in general, the practice of accumulating a number of articles in one prescription is to be avoided. " 2dly, Substances, it is evident, ought not to be mixed togegether, which are capable of entering into chemical combination, or of decomposing each other, unless it be with a view of obtaining the product of the combination, or decomposition, as a remedy. " Those mixtures are also to be avoided, in which one medicine, by its peculiar action on the stomach or general system, O o 4 modijies 56S Dr. Trotter's Essay on Drunkenness modifies and changes the action usually exerted by another, unleSwhere the object is to obtain the effects of that modified opera tion. " 4tk!y.i The error of contra-indication is to be guarded against, or those .medicines ought not to be combined, the virtues of which are not merely different, but arc, iri some measure, opposed to each other. " 5tJ*y, The ingredients which arc to be mixed, must be such as will mix properly together, so that the form in which the remedy is designed to be exhibited, may be easily obtained and preserved. " Lastly, The form under which a medicine is prescribed, must be adapted to certain circumstances; principally to the nature of the disease, the nature of the remedy itself, and, as far as may be possible, to the taste of the patient.