generally operates as a cathartic; but that effect cannot be depended upon, it may produce an opposite one; and in that case it will be absorbed in excess, and may produce noxious effects. Having experienced its influence under such cireumstances, I have since either given it along with another cathar tic, or exhibited one soon afterwards, whenever it has been slow of producing a purgative influence. The advantages arising from employing the oleum terebinthine with this intention, are chiefly from its concentrating the vital energies towards the organs of digestion and chylifaction, and by those means effecting a more complete and permanent revulsion of the impetus of the circulation from the great nervous centres. Its effects upon the internal membrane of those organs, and the vessels opening upon its surface, are more efficient; and it tends to remove the viscid mucus and disordered secretions often obstructing their functions.

When exhibited in this quantity, experience has now proved its certain and almost specific influence as a vermifuge.

II. Respecting the method of exhibiting and combining this remedy, so as to render it more agreeable, and at the same time to assist its effects in the different diseases in which it may be prescribed. This is a subject of importance as connected with the exhibition of this remedy, and indeed not of this alone, for it is an important consideration in the internal use of most of our active medicines. Dr. Cullen* found the unpleasant sensations consequent to the ingestion of the terebinthinous remedies in any large dose, a considerable bar against their employment among delicate females, in several diseases in which he considered them of important service. Had he, however, prescribed them, even in the manner recommended by Aretæus,+-that is, combining them with some other aromatic stimulant, and making honey the vehicle,-his objection would have been in a great measure removed.

1st. It may be prescribed in either of the already-mentioned proportions, floating upon the surface of a draught composed of some agreeable distilled water, with the addition of a drop or two of some fragrant oil and a little warm aromatic tincture. The addition of two or more aromatics to this remedy will prevent it from producing any degree of nausea, or pain in the stomach, which its uncombined exhibition sometimes occasions. The propriety of employing hot aromatics in this manner has been judiciously noticed by Dr. Paris; and I can fully confirm his observations, not only in this particular remedy, but also in

Materia Medica, art, Terebinthine,

+ Aret, in loc, unt, cit.

+ Pharmacologia, p. 104 et passim.

many others which I have found it requisite to prescribe in irritable states of the stomach, surpassing what is usually met with in temperate climates.

Thus, in the intermittents which prevail during the rainy seasons in hot climates, the state of the stomach is usually so irritable that it is with difficulty the smallest doses of the bark of cinchona are retained, when exhibited uncombined. If given, however, combined with aromatics to a degree proportioned to the habits of the individual regarding the use of those condiments, the dose of this admirable remedy may be carried to a surprising length, without producing effects in the least degree unpleasant. In this manner I have frequently exhibited half-an-ounce of cinchona at one dose, with the unvarying effect of putting a stop to the disease. The corrigents which I have thus been in the habit of prescribing most frequently, are the carb. of ammon. camphor, some of the hot aromatic spices, tinctures, and essential oils. The capsicum annuum I have found, both from personal feeling and from experience, with others, to possess the most pleasant and most permanent effects in correcting and in preventing the disagree able sensations arising from other remedies.

2d. Another mode of administering this remedy, indepen dently of the quantity, is by suspending it in the vehicle by means of some mucilage. When given in this form, the neces sity of conjoining it with another essential oil, in order to subdue its odour and correct its effects upon the stomach, is still required: the compound spirit of ether may be also employed with that intention; the tincture of capsici, or any other warm aromatic spirit or tincture, may be also added. This mode of exhibition I have never found to produce nausea; but, even when given in a large dose, its absorption is, in my opi nion, thereby promoted.

3d. A third form under which it may be taken internally, and one in which it was generally exhibited by the ancients, is that of a linctus made with honey, or with any rich aromatic syrup. This mode may be chosen when it is desirable to give it in small doses: the necessity, however, of prescribing in the same recipe some fragrant and aromatic preparation must be sufficiently obvious when we direct the remedy in this form.

I have been of late frequently in the habit of prescribing this medicine for children of almost all ages, and in different proportions, but generally in the maximum dose; and I do not recollect an instance wherein it has not been taken by the child, or wherein it was afterwards rejected.

The lively author of the article upon Cookery, in the 69th Number of the Edinburgh Review, (p. 45,) ingeniously considers that the flavour of any substance arises from the odoriferous

4

particles escaping during the process of mastication, and while it is held in the mouth, through the posterior nares, and there, at the same time, affecting the organs of smell. In pursuance of this doctrine, and for the benefit of those who are doomed to copious draughts of nauseous remedies, I would recommend that the olfactory nerves, whether anterior or posterior, should be secured as far as possible against the invasion of the disagreeable odour; both while it is external to those watchful sentinels, or even after it has entered the portals which they so faithfully guard. The manner in which this may be effected requires not my formal prescription.

PART II.

Observations respecting the particular diseases in which it may be employed.

Chronic Rheumatism.-The terebinthinous remedies haye been long in use in several varieties of this disease, as in lumbago, sciatica, &c. and experience has long demonstrated their essential service. Drs. Pitcairn and Cheyne were the first to recommend the essential oil in this affection; afterwards Dr.. Home and Dr. Cullen* employed it frequently. Homet gave it in the form of a linctus, consisting of two drachms of the oil and one ounce of honey; and of this a tea-spoonful was taken, twice or thrice in the twenty-four hours. This was the same.. formula as that recommended by Cheyne; and, from the cases related by Home, it appeared to have generally cured the disease.

In more modern times, it was highly recommended in combination with the preparations of cinchona in this disease; but, as cases were of every-day occurrence in which cinchona alone. produced unpleasant effects in the stomach, the addition of the oil only did not remove that objection, and it appears never to have come into very general use. When this remedy is employed in chronic rheumatism, it may be taken either in the small or medium dose, and may be combined with any of the preparations of cinchona, or with the senega, &c. triturated with mucilage into the form of a draught; to which tinct. capsici, or tinct. cardam., or spirit. armorac. comp., : with a drop of some essential oil, ought to be added, in conformity with the observations already offered. The capsicum annuum is, in my opinion, preferable to every other, both as an adjuvant and as a corrigent to other remedies in this disease;

*Mat. Med. loc. ant. cit.

+ Clinical Experiments, p. 246 et seq.

I shall give, in a following Number of this Journal, some observations on the medicinal qualities of this substance.

for I have ascertained that, if given in considerable quantities, in the form of pills, it will of itself remove this disease as soon as any other remedy.

In Sciatica, I have found the following linctus always effica cious:-R. Mellis optimi, uncias duas; olei terebinthinæ, tincturæ guaiaci ammoniatæ ãā, drachmas duas; olei caryophil. et olei limonis, ää Miij. Misce ut fiat linctus: cochleare unum minimum bis terve de die sumendum.-The operation of the turpentines should be watched, lest they affect the urinary organs. I am much inclined to suppose that the use of diluents, if resorted to at the same time, will tend to determine their action towards the kidneys and urinary passages.

In Lumbago, I have never employed this medicine. Dr. Darwin* found it of service in this variety of rheumatism, and gave it in the dose of one drachm twice a-day.

Respecting its mode of operation in removing this complaint, I consider it to act like most stimulants possessing a permanent character. Its action in this disease cannot, however, be readily explained, while the pathology of the disorder remains unestablished. The prevailing opinion is, that this affection consists in a slow inflammatory action, or inflammation of some sort, existing in the fibrous textures of the body, or even sometimes in serous membranes; but it is now considered doubtful whether it actually does arise in muscular fibres. To this pathology has been urged the objection, whence comes it that rheumatic inflammation, if it be actually such, never terminates like inflammation in other textures? Because it is seated in unyielding and thin textures, can be the reply: the former quality preventing that relaxed state of the capillaries necessary to suppuration; the latter, as it allows its immediate connexion to sound parts, along one of its surfaces at least; and from no part, in consequence of this character, being removed to a sufficient distance from the healthy interior and exterior tissues to permit of its sphacelation, before the neighbouring textures participate in the disease,

But it may be again inquired, if it be granted to be an inflammatory or any analogous state of the capillaries, existing in a peculiar species of texture, whence arises its sudden inva sion, and rapid termination, from causes which operate directly upon the nervous sensibility? To this I would answer, that impressions made primarily upon the nerves of a part may influence, for longer or shorter periods, the state of the lymphatic and capillary arteries.+ That such influence may be equally exerted, whether it takes place through the medium of the

Zoonomia, vol. ii. sect. iii. chap. 2, sect. 6.

+ By lymphatic arteries, I mean the colourless vessels, not admitting red blood. No. 270. 2 c

system, or from the local influence of the causes. The mode of either being brought about, I must reserve to another opportunity to show: let it suffice at present to say, that rheumatism, and even gout, most probably arises from constitutional or local and fortuitous causes operating changes upon the nervous constitution of a part; and that the primary affection in the nerves cannot long exist, without inducing changes in the state of the capillary circulation of a proportionate degree of intensity.

Such, then, being the view I entertain of this disease, I consider that the substance now under consideration operates in removing it, primarily, from the stimulant effects it produces upon the digestive organs, and by nervous communication upon the heart and other textures; and afterwards, when it becomes absorbed into the current of the circulation, it produces those effects in a more signal manner, by being conveyed to the very seat of ailment, and by stimulating the nervous fibrilla distributed upon the affected capillary vessels, restores them to their natural tone and energy.

In the hemorrhagia, I consider it a remedy of almost immediate efficacy in many of the affections belonging to this class. It requires, however, great discrimination on the part of the physician to determine the precise circumstances of the patient, under which it shall prove of decided advantage; the quantity of the remedy requisite to produce the desired effect; and when to stop in its exhibition; for, if given in very small doses, so as to become absorbed into the circulation, without producing much previous increase in the action of the heart, it will, generally prove of essential service: whereas, if the dose ex-. ceed even a few drops, if it be repeated too frequently, or if its use be too long continued, an increase of the disease may be the consequence. The effects, however, depend entirely upon the state of the habit and diathesis of the individual. A phlogistic temperament, even although the debility may be considerable, ought to forbid its exhibition. The best general indications for the internal employment of this remedy in hemorrhagic diseases, and those by which I have been guided, are the absence of plethora and the phlogistic diathesis; when there has been a previous great loss of blood; when the pulse is soft, weak, and easily compressed, indicating a want of tone in the arterial system. In a word, it can be confidently resorted to in all hemorrhages possessed of a truly passive cha

racter.

In many cases of hemorrhage displaying what has been commonly called the hemorrhagic effort, as preceded and marked by a sense of titulation, heat, &c. this medicine, if properly watched, is not contra-indicated; for, if it be given in such a