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thing. Read,-read the admirable Essay ofM. Louis on this snbject. It will teach youhow to observe. It will teach you then, to

analyze, to compare, and to number the factsobserved, and to deduce inferences and lawsfrom them, which must henceforth constitutethe whole science of medicine. Then, andnot till then, will medicine be stable; itsbase being broad, like that of the pyramids,it will, like them, endure for ever. But, to accomplish all this, wc must be

careful not to allow ourselves to be beguiledby the imagined reliefs obtained by oneclass of patients, and the imagined painsexperienced bv another. Read the accountof cures by means of painted tobacco-pipes,hy the late Dr. Haygarth. Hysteric patientsare sad deceivers ; they will make some be-lieve that they can see with their lingers.Gentlemen, all this is not observation, is

not medicine. Learn, then, to observe;take M. Louis for your guide ; visit, ifpossible, his hospital, and see how carefully,how cautiously, he interrogates, and ob-serves, and notes. You will see how hisfacts and his deductions deserve your confi-dence. How beautiful is medicine in hishands, compared with the thing of the samename in the hands of those who, in the pre-sent day, are either making us smile at theinfinite tittleness, or wonder at the very enor-mity, of the doses of medicine which theyare giving to their credulous patients.But I have been led from my proper sub-

ject in making these remarks ; in my nextlecture I propose to bring before you thecases of 2r’r’ttrIGlOrt and congestion, as distin-guished from inflammation, and to pass onto consider the treatment of inflammation,and the use of inflammation as a crcrs forother diseases.

LECTURESON

MATERIA MEDICA AND

THERAPEUTICS;NOW IN COURSE OF DELIVERY

AT THE

WINDMILL-STREET SCHOOL OF MEDICINEBY

GEORGE G. SIGMOND, M.D.

TONICS :—Early defiraitiozt of this term. Theyrefer chiefly to effects oa2 the razusctelursystem. The theory of their action not wellunderstood. Effects which they produce onthe animal economy described ; these sotne-times differ with the serzson. Antiperiodi-city of some tonics considered. The theoryof periodicity discussed. Necessity of know-ing the precise iulue of each tonic ; over-

doses injudicious. Tnaics divided into orga-2?ie and inorganic ; examples of the 1((ttei-.7)’OM; ils utility and properties examined;first -ttsed in the form of rust ; preparationsoj; iii the New Pharmacopœia.GENTLEMEN :-The arrangement of medf-

cinal agents must always be a matter of veryconsiderable difIicnlty ; the substances whichwe employ do not bear such striking affini-ties as to make any classification perfect.It is sufficient for our purpose if we embrace,under particular divisions, those drugs whichexert nearly a similar influence upon thehuman economy. I shall, therefore, asso-ciate together the two classes which Murrayhas formed of agents which exercise a gene-ral stimulant operation on the system, andwhich, whilst they are less diffusible thannarcotics, are slower and more durable intheir operation. I shall consider, under thegeneral head of tonics, the most importantof those therapeutic agents which he hasranked in that class, or in that of astringent.I shall only dwell, however, upon those sub.stances which give strength to the wholesystem, reserving our inquiry into the actionof astringents upon particular organs, or

upon the various tissues, until a futureperiod.

It was a received opinion of some of theancient physicians, that muscular strength,and the general vigour of the human body,were entirely dependent upon the tensionof certain fibres, and that their relaxationproduced debility ; and hence the terms toneand atony were employed; the former to

express the due capability of the organs ofthe body to perform healthily their functions ;and the latter, the absence of the necessarystrength. The human frame was often com-pared to one of the stringed musical instru-ments of antiquity ; and many expressions,borrowed from the uses of these causes ofharmony, were introduced into common, andeven into medical language. The solids ofthe human body were said to be composedof the finest threads, or fibres, and that afluid, to which the name of animal spirits,or nervous fluid, was given, was preparedand conveyed to them. Boerhaave speaksof the diseases " fibrœ laxœ et debilis ;"Baglivi, Bellini, Sanctorius, and a large pro-portion of those physicians who believedthat the general laws which are observed togovern inanimate matter, were applicable tothe human body, and who introduced mecha-nics as explanatory of physiolory, believedthat relaxation, and a want of elasticity,were the cause of debility; and one of theaphorisms of Boerhaave was to show,-" What methods must be taken to remedytoo great elasticity, or weakness, in thesmallest fibres; what must bedone when thefibres are too fragile, or easily broken ; andwhat, when they are too much contracted, orelse distracted, by elongation." Our English

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dispensatories, at the earliest period, rankedsuch agents under the head of corroborant;for instance, it is said, 11 Whatsoever actsas a stimulus, and crisps and corrugatesthe fibres into a more compacted tone, willremove such weakness and increase strength;and as, also, too much moisture may contri-bute to such relaxation, what has no otherquality but absorbing and drying up suchsuperflous humidity, may deserve, thoughaccidentally, to come under such denomi-nation."

I shall point out to your notice those sub-stances, which produce gradual, yet perma-nent, changes upon the system, without at-tempting to enter upon any consideration ofthe theory of their action ; for I believe it isnot yet sufficiently matured ; they seem, uni-formly, to act primarily upon the stomach,and hence to be conveyed to the varioustissues and organs. How they influence theliving principle, I am not prepared to say ;but they quickly seem to produce an in-creased action in the circulation, marked bya firmer state of the pulse, which is occa-sionally rendered more frequent. The mus-cular system, then, seems to derive freshpower; the excretions become more uni-

formly natural, and there is firmness givento the nervous system. From their action

upon the digestive organs, it would appearthat the more nearly tonic medicines approx-imate to the aliment which would be mosteasily digested, and be more decidedly nu-tritious, the greater the influence they pos-sess. They should never be of a nature toproduce any inordinate excitement, for thereaction, or exhaustion, that would followupon the stimulus, would be more hurtfulthan any beneficial influence they couldexert. It is a slow, steady, and uniformoperation that is required ; and the greater the delicacy of constitution for which you liare called on to prescribe, the more carefulmust you be in the quality, quantity, andmode of preparation, of your tonic. The

stage of the disease, the state of the func-tions, and even the season of the year, mustbe considered before you select your remedy.Iron, of such value in some cases, is produce-tive of mischief if the pulse be full, if anytendency to inflammatory action is present ;cinchona, or its alkali, quinine, will prove adangerous remedy if the vessels of thebrain are more than usually full, and, parti-cularly, if venous retardation be present;arsenic, to which we look with such con-fidence in the intermittent fevers of the

Autumn, and in periodic affections duringthe Winter months, is inferior in value to

cinchona, or to carbonate of iron, in the

Spring of the year. As Foderé has justlyobserved, arsenic is an autumnal medicine;but it may prove deleterious in the Spring.That the barks of trees should have moreefficacy in tha Autumn, when the changeshave taken plae in vegetable circulation and

secretion, is not, to us, a matter of much sur-prise ; but that these substances should, inthe Spring, act upon the system in so markeda manner, is somewhat unaccountable ; butthat such is the case has been very generallyobserved. Some of these remedies enterinto the circulation, and are capable of beingdetected by their usual tests; others, again,have not been discovered. Iron is soon re-ceived into the blood, and may easily berecognised; but the Yeruvian bark, thoughit has been continued for some length of

time, has not been found. Sometimes dimi.nished susceptibility of the excretory organsfollows quickly upon the use of tonics.At others, again, there is found an increasedaction, almost amounting to violent diar-rhoea ; and this is oftentimes evident uponthe administration of cinchona, and seemsto contra-indicate its use ; but this more

generally occurs where proper steps havenot been previously taken to remove, bygentle laxatives, any sordes that may haveaccumulated during the disordered action inthe alimentary canal; and sometimes it is asalutary effort of nature, which, if checked,may afterwards prove an abundant sourceof distress and harassment to the patient,and of difficulty and doubt to the practi-tioner.One of the striking characteristics of this

class of medicines is the power that someof them possess of preventing the recurrence,at fixed intervals, of particular states of thebody ; and from which circumstance theyhave acquired the quaint, but expressive,name of antiperiodics. Amongst the unex-plained phenomena attendant upon the mor-bid conditions of the living being, is thatpeculiar tendency to the return of certainmarked symptoms, for several days, at thesame hour in the day at which they at firstdeveloped themselves; thus, an aguish fevercoming on daily, will almost always com-mence its attack very early in the morning;whilst the tertian, which recurs at an inter-val of about forty-eight hours, for the mostpart, begins at noon; and the quartan whichexhibits itself after an interval of about 72hours, is generally present much later inthe day.

Several of the affections of the nervoussystem have a strong tendency to becomeperiodic. The painful disorders calledneuralgia, epilepsy, St. Vitus’ dance, or cho-rea, and lunacy, have their precise inter-missions and their paroxysms so evident, asto have engaged, at a very early period, theattention of medical observers ; but thecauses that produce this singular habit of theconstitution have been very uselessly soughtfor. That in many of the functions of theorgans periodicity may be acquired, dailyexperience teaches us. There is no diffi-culty in so regulating the excretions both ofthe intestines and of the bladder, that theaction shall only recur at expected moments;

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but that the whole system should be calledinto morbid states, as in intermittent fever,must remain a subject for inquiry and in-vestigation. But over this striking habitthe tonics, both metallic and vegetable, ex-ercise a peculiar influence, restraining, iftaken during the intervals, the worst symp-toms of the paroxysms, and gradually pre-venting their recurrence. It is probablethat all the febrile diseases have their statedmoments of aggravatiou; and there are fewof them that do not, towards evening, exhi-bit a degree of exacerbation, during whichtonics do mischief, even if, in the remission,they have been found serviceable ; the pro-per time, therefore, of employing them, isof greater consequence to us than the in-qtiirylinto the causes of the periodic return;contenting ourselves for this silence by theremarks on this subject of Sydenham :—"Ido not desire to be called a philosopher;and for such as conceive they have a rightto this title, and upon this account may pos-sibly censure me for not having attemptedto dive into these mysteries, I advise themto try their faculties in accounting for thevarious works of Nature that everywheresurround us, before they go about to teachothers. I would fain know why a horsecomes to his full growth iri seven years, aman in twenty-one ; why some plants usuallyllowei- in May, others in June ; not to men-tion other innumerable effects whose causesare as hard to be discovered : now, if thelearned ingenuously confess their ignorance Ion these points, I see no reason why I should ’,be censured for being silent in a matter notless obscure, aud, perhaps, wholly inscrut-able ; especially as I am persuaded thatNature proceeds in this case, as in all others,with a certain regularity and uniformity,the matter of tertiaus and quartans beingnot less subject to, and governed by, thelaws of Nature than all other kinds of bodiesare."

In thus confessing our ignorance, I stillmust think that this subject is most worthyof our deepest investigation ; the periodicalreturns of certain actions are of infinite im-

portance in the regulation of our therapeuticagents. As I shall have occasion hereafterto point out that, even in the action of thosedrugs which induce the intestinal canal toevacuate its contents, a knowledge is req uir-ed of the habitual tendency in each indivi-dual, either by constant attention or by cus-tom, to have a periodic discharge of thefaecal coutents; and that, in the case of manydiseases, a neglect of obtaining this informa-tion will produce uncertainty and failurein the expected operation of Nature, assistedby art.A knowledge of the precise value of each

tonic medicine is of the deepest importance;and you will often feel, in the long and lin-gering illness which is consequent uponacute disease, the necessity of being fami-

liar with the powers of each therapeuticagent which may have the power of renovat-ing and restoring health. There are pre-cise stages in many diseases in which youmust suspend the administration of a re-

medy which becomes stimulant, where ithad previously been merely giving strength ;for, if you do not watch with caution, youwill have a state of collapse infinitely moremischievous than the disease ; and, in manyfebrile conditions, a relapse is much more tobe dreaded than the stages which at firstexcited the greatest apprehension. It is, Ifear, the fashion of the day to give too largedoses of tonic medicines, notwithstandingsome very admirable cautions of the mostpractical physicians, amongst whom I mustrank Dr. Graves, who, in a very excellent

article, entitled, " Observations on theTreatment of various Diseases," which isto be read in the "Dublin Journal" forMay, 1832, speaking of the large doses ofcarbonate of iron which have been had re-course to by some of our most eminent me-dical men, says,« I have examined this

subject, in a practical point of view, withgreat attention, and think that what is trueconcerning carbonate of iron, applies to mosttonic medicines. In fact, we may considerit as a general rule, that tonics are rarelyindicated where moderate doses do noteffect the desired purposes; this appliesmore particularly to the stronger doses,such as the salts of iron, of arsenic, andof quinine. I can scarcely conceive a casepossible in which a judicious physicianwill ever find it necessary, for instance,to give more than ten grains of sulphate ofquinine in a day; and yet much larger dosesare not unusual here and elsewhere." I ammuch pleased to find such an authority formy own opinion and practice ; and, when Iread, as I have done, of one-ounce dosesof carbonate of iron, and of a case of achild nine years of age, in which four

pounds and six ounces were given in five

weeks, for chorea, I am not surprised thatviolent cephalgia and intermittent fever,exasperating the original disease, shouldsupervene; and the great source of consola-tion is, that the child should survive. For-tunately a large portion of the medicinemust pass away completely unchanged; andthis, I believe, is often the case where enor-mous doses are administered.

I shall subdivide this class of medicinesinto those which are obtained from inor-ganic matter, and those which are producedby organic matter ; under the first divisionmay be ranged many of the metals very con-veniently, such as iron, arsenic, copper,lead, silver, bismuth ; nor do I see whymercury may not be placed amongst tonicsubstances, and thus enable me to take, atan early period, a view of one of the mostextraordinary agents we possess. Amongstthe otganised bodies, I shall consider the

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product of the fermentation of vegetables,the various alcoholic and vinous fluids, andthen proceed to the barks and woods of

plants. Under the vegetable tonics will befound a variety of very important objects,which possess bitterness, astringency, andaroma, and a peculiar principle upon whichtheir action seems to depend ; cinchona,cascarilla, calumbo, cusparia, quassia, gen-tiana, canella among the bitters, amomum,piper, anthemis, capsicum, and several ofthe aromatics, will be associated together ;and such substances will be brought beforeyou as may be employed in cases of debi-lity, or diminished power of the system.

IRON.

The tonic to which I shall now inviteyour consideration, is that metal so impor-tant in the sciences and in arts, so indispen-sable to the happiness of man,-so neces-sary to him, that society scarcely exists in astate of civilization without it, and whichwas one of’ the earliest medicines of whichwe have a tradition,—I mean iron. I mustrefer you for a brief narrative of its value tomankind to the work of that great and dis-tinguished chemist Fourcroy. He has, inone of those eloquent and beautiful dis-courses which adorn the learned works ofour scientific neighbours, and which rendertheir volumes so attractive and easy of com-prehension, and so much more inviting tothe reader, than the dry and monotonousdetails of our own countrymen, pointedout, in forcible language, the uses of themetal ; the necessity there is that the philo-sopher, the geometer, the navigator, theastronomer, and the physician, should eachinquire into the history of this substance ;and, combining the varied information eachpossesses, contribute his assistance to im-prove still further our knowledge. He hashimself drawn up a monographic history ofthis metal, with a precision and methodwhich are as clear and concise as they areinstructive, and worthy of imitation. Itforms the most complete narrative of the in-formation we possess relating to that mine-ral, upon which the fortune and station ofthe different nations established on the faceof the earth depend, and from which everyindividual in society derives both the imme-diate and the distant sources of his happi-ness, his comfort, and his heallh. We re-

quire an acquaintance with the physicalproperties of the metal aud its ores ; the

phenomena and results of its combinationswith the principal element of the atmos-pheric air, by which its oxidation occurs ;its union with hydrogen, with carbon, withphosphorus, with sulphur, and with theother metallic bodies; its power uponwater ; its multiplied effects upon theacids, upon saline combinations; the unionsIt enters into; the compounds which itforms; the ,colourrs winch it communicates

and assumes; the power it gives to theearths, the alkalies, and the salts; and itsvaried action upon the organs and tissues ofthe animal frame.

Iron is universally diffused over the stir-face of the globe ; the forms of its ores, theircolour, their texture, and their composition,are very singularly varied ; five llrincipalstates have been acknowledged,—that ofnative metal ; that of its alloys ; its comLina-tion with combustible bodies ; its salts.Native iron was, foralong period, supposedto be masses left by the inhabitants of for-mer ages, who had been working at thismetal ; and its existence was a sort of ull-

resolved problem amongst naturalists. Onan analysis of various specimens, made byMr. Howard, it was found that they all con-tainerl an alloy of nickel, and this led to theidea that these masses are meteoric ; since itis found that those bodies which have appa-rently fallen from some œthereal system, allcontain nickel; some imagine these to bedetached from the moon ; others, that theyhave formed in the atmosphere, from somecauses yet unknown.You will find, in the magnificent collection

of mineralogy and secondary fossils in theBritish Museum, deposited, in the first case,in the Long Gallery, some singular speci-mens of native iron, found in insulatedmasses, and disseminated in meteoric

stones ; amongst these a large piece, detach-ed from the celebrated mass of iron-stonewhich was discovered by Pallas, in Siberia,on the summit of a hill, between Ababanskand Belskor Ostrog, where it was consider-ed by the Tartars as a sacred relic ; themass which I saw in the mineralogical col-lection at St. Petersburg, originally weighedabout 1680 pounds. Amongst the meteoricstones which you will also observe, there isa fragment of the stone which was seen tofall November 7th, 1492, at Alsace, in the

presence of the Emperor Maximilian, thenKing of the Romans, and of his whole army,then on the point of engaging in battle withthe French army ; this mass weighed 270

pounds. It was preserved in the cathedralof Ensisheim, till the beginning of theFrench Revolution, when it was conveyedto the public library at Colmar. There islikewise a fragment of a mass, weighing 6fipounds, which fell near Wold Cottage, inYorkshire, and I believe is the one alludeclto by Mr. Brande, in his lecture on iron, inTilE LANCET, in 1827. There is likewise aspecimen in the collection of the Royal In-stitution, brought from India, weighingabout 25 pounds. The varieties of the oresof this metal may be referred to fifteen dif-ferent species,-native iron, arseniated car-buret, sulphuret, arseniated sulphuret, fouroxides of ii-oii, sulphate, phosphate, tung-state, carbonate, prussiate, and quartzoseiron.

I must refer you, for the different speci-

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mens of these ores of iron, to the BritishMuseum ; you will find the collection so ad-mirably arranged, as to form a complete il-lustration of that portion of the science ofmineralogy which it is necessary for you tobecome acquainted with. The system adopt-ed is that of Berzelius, founded upon theelectro-chemical theory, and the doctrine ofdefinite proportions, as developed by him,in a memoir read before the Royal Academyof Sciences. This splendid collection iswell adapted to assist you in the pursuit ofyour studies, and is, in every respect, wor-thy the highest commendations, as a scien-tific exhibition, and as an ornament of thecountry. In the sixth case you will find the

sulphurets of iron, or common pyrites, fromseveral localities. In the fourteenth andfifteenth cases are the oxides of iron ;amongst these the specular oxide of iron,the specimens from Elba, displaying theirbeautiful iridescence and play of colours ;those from the volcanoes of Vesuvius andStrombole, in large laminar crystals, ap-pearing like polished steel. In the sixteenthcase are the hydrous oxides of iron, or

brown iron-stone ; amongst which are someremarkable varieties, such as the micace-ous, of a blood-red colour; the shining,brownish-black variety, used as hair-powderby the natives of the neighbourhood of theGreat River, in South Africa. In the fifty-eighth case are some beautiful specimens ofsulphate of iron, in fine large rhomboidalcrystals, from Bodenmais, in Bavaria, andin stalactic, ’fibrous forms, such as thosewhich come from the Rammelsberg, in theHartz Mountains. There are likewise car-bonates, phosphates, arseniates, titonafes ofiron, and most of the volcanic and speculariron with glassy fracture. Amongst the

organo-chcmical, or such mineralized bodiesas are composed after the manner of organicbodies, you will observe the oxalate of iron,now called Humboldite, formerly resinousiron. All these present to the eye a richvariety, and they would afford an amplefield for inquiry by those who would wishto become intimately acquainted with thenatural history of one of the most importantobjects of creation, and which appears soliberally and so variously distributed inorganic and inorganic matter.These varieties require particular modes

and processes for their analysis, and theirtreatment forms aportion of chemistry whichis denominated melallurgy. The first objectfor medical consideration is the oxidation ofiron, as the mode of administration whichmust oriainally have suggested itself, was inthe form of rust. Common observation pointsout that of all the metals with which we areacquainted, that which is most immediatelyacted on by the atmospheric air is iron ; thatit breaks gradually into a yellow powder,which is well known to us under the fami-liar appellation of rust ; that the largest

masses are, by a gradual decomposition,entirely destroyed; that they waste away,as it were, in the centre ; that they minglewith the earth, whose appearance and colour the powder assumes. This insinuates itselfinto combination with the bodies with whichit comes in contact, and thus iron entersinto the constitution of so large a proportionof all the objects which belong to our globe.A small quantity of water most materiallyassists in promoting this decomposition.The spontaneous oxidation of iron in theatmospheric air was made use of by theearlier alchemists for the purpose of prepar-ing a medicine, to which they gave the nameof the aperitive saffron of Mars ; for this di-vinity was.chosen as the tutelary genius ofthis metal, at a time when the planetary in-ffnence over the objects of nature was con-sidered a subject of the deepest importance.The plan pursued by the earlier adepts, toobtain a strengthening medicine, was to ex-pose iron filings in new vessels of earth, orof glass, to the dew of May ; the water pre-cipitated from the air during the refrigera-tion of the night, and the action of the

atmospheric oxygen, produced an oxidewhich gradually absorbed the carbonic acidof the atmosphere, which became a yellowcarbonate, which was much employed.Melampus, the oldest Greek physician

whose name has been handed down to us,and whose fame has been celebrated in abook, now lost, by the poet Hesiod, has thereputation of having first administered therust of iron. Iphicles, one of the warriorsengaged in the Argonautic expedition, waschildless ; and, as this was ascribed to dis-ordered function, Melampus administeredthe rust of iron, infused in wine, for tendays, which appears to have remedied thecause of complaint. This is the first in-stance we have upon record of the employ-nient of a mineral medicine, and has, accordingly, been commented on by various au-thors. We find Dioscorides aad Galenrecoinntending the rust of iron, as restrainingfluor albus, and preventing conception.Wine, in which a red-hot iron has been im-mersed, is also spoken of as a cure for

dysentery, for affections of the spleen, forcholera. Its external application, mixedwith vinegar, is said likewise to be usefulin chilblains ; it is also ordered to give firm-ness to the gums, and likewise to be used asan ointment for the nout. Pliny, at a laterperiod, mentions only one mode of adminis-tering it internally; and that is, by quench-ing hot iron in water, for dysentery ; andCelsus prescribes it, in the same way, toprevent enlargement of the spleen. Iron is,perhaps, the only metal which possesses nodeleterious effect upon the human body ;for, although the sulphate of iron exerts adeleterious agency, this is owing rather tothe acid than to the metal. The tincture ofthe muriate or sesquichloridc has occa-

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sioned death. Of this Dr. Combe, of Lfith,furnished Dr. Christison with an instructiveexample: -A gardener swallowed, one morn-ing, about ano unce and a half of the tincture,instead of whisky. Violent pain in thethroat and stomach, tension, and contractionof the epigastrium, and nausea, immediatelyfollowed ; afterwards coldness of the skinand feebleness of the pulse were remarked ;and then vomiting of an inky fluid, with,subsequently, profuse vomiting of mucusand blood, and, also, bloody stools under theuse of laxatives. For some days he was ina very precarious state, but he then beganto rally, and in three weeks resumed hisoccupation. In two weeks more, however,Dr. Combe found him emaciated, cadaver-ous in appearance, and labouring under

pains of the stomach, costiveness, and thirst,in which state he lingered for five daysmore and died. In the dead body therewas found great thickening towards thepylorus, a cicatrized patch there threeinches long, and two inches bioad, and an-other large patch of inflammatory redness,surrounded by a white border. The pre-paration contains a third of its volume of Ihydrochloric acid, and a tenth of its weight

of oxide of iron.Among the new names introduced into

the New Pharmacopoeia, will be found thesesquioxide of iron ; it is the subcarbonateof former times, and was originally calledthe prepared rust of iron; it is formed offour pounds of sulphate of iron, fourpounds two ounces of carbonate of soda,and boiling water, six gallons. The sulphateof iron and the carbonate of soda are to bedissolved separately in three gallons of wa-ter, then the liquors, being mixed together,are set by, that the powder may subside;lastly, the supernatant liquor is poured off,and that precipitated in water is washedand dried. During this process the car-

bonic acid leaves the soda and unites it-self to the oxide of iron, forming a carbonateof iron, which, from its insolubility, is pre-cipitated in the fluid, whilst the soda nowdisengaged combines with the sulphuricacid set at liberty, and the resulting com-pound, sulphate of soda,remains in solution.During the washing; which is required to

disengage the sulphate of soda, the protoxideof iron acquires oxygen from the atmos-pheric air, and gets rid of carbonic acid,and thus becomes a sesquioxicle of iron ; it

still, however, retains a small portion ofcarbonic acid. The powder is of a reddish-brown colour, has little or no smell, is some-what styptic to the taste ; it is insoluble inwater, but is totally dissolved by hydro-clrloric acid ; it is decomposed by heat, andbecomes the black oxide of the metal. Thepilulae ferri eompositae are prepared nearlyin the same manner ; the sulphate of sodais not got rid of ; but as the quantity direct-ed to be-made is small, this is but of little

consequence ; myrrh, powdered, is added,and treacle. for the purpose of forming theingredients into pills ; these are favourifeswith many practitioners in cases in whichiron is to be administered, but they are veryoften so long kept in the shops as to beperfectly hard and dry; sometimes theyhave been found to pass through the in-testinal canal precisely in the same formand size in which they were administered;and, occasionally, they have been retainedso long as to have accumulated, and to beproductive of considerable mischief.

FATAL CASES OF LITHOTRITY.

W. JEAFFRESON, Surgeon.

To the Ecliton of THE LANCET.

SIR,—As I think it right that our profes-sion should be informed of the failures, aswell as the triumphs of litliotrity, I shouldfeel obliged if you would record the follow-ing cases in your valuable Journal, in addi-tion to the successful ones which you wereso kind as to insert some time back. I havethe honour to be, Sir, yours very faithfully,

W. JEAFFRESON, Surgeon.Framliuaham, —

CASE 1.—Iu December, 1833, Mr. Smith,miller, of Framlingham, aged 68, appliedfor relief, having suffered the symptoms ofstone in the bladder for several years, ac-companied by the most irritable urethra Iever witnessed. On the 24th, Mr. King, inmy presence, detected and grasped a calcu-lus of rather more than an inch in diameter,which was crushed without difficulty ; but,from the morbidly-sensible urethra, and en-laraed prostate, there was more and louderexpression of suffering than usual, whichwas repeated at every subsequent sitting,although the manipulations were conductedwith the greatest tenderness. This inducedus, after nine sittings, which gave us over adrachm of detritus, to prevail on him to

place himself under the care of Mr. Cos-tello, who, on the llth of November, ex-tended his ride from Ipswich, and in the

presence of several of my surgical friends,very dexterously seized and crushed severalportions of calculus ; this was attendedwith the same loud expression of pain.January, 1835, he went to town, and wasunder the care of Mr. Costello for two

months, during which time lie submitted totwenty-two sittings, and returned, bringingwith him an additional jv., viij. grs. ofdetritus, relieved of his urgent symptoms,and with an assurance from Mr. C. that hisbladder was free from calculus. He re-mained in tolerable comfort till about thesecond week in October, when he assuredme his sufferings were as severe as ever,and urged me to examine the bladder,which I did, but failed in detecting calculus.