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LECTURESON

MATERIA MEDICA AND

THERAPEUTICS;NOW IN COURSE OF DELIVERY

AT THE

WINDMILL-STREET SCHOOL OF MEDICINEBY

GEORGE G. SIGMOND, M.D.

CALUMBA, COCCULUS PALMATUS.COCCULUS PALMATUS.—Description of the

plaut; characters and properties of the rootfalsifications practised by the importers;mode of detecting the spurious calumba; pre-parations of the drug; its mediczuul iirtues.ANGUSTURA BARK.—Botanical description;the trlte plant first pointed out by Dr. Han-cuck; efficacy of the Angustura in somefe-vers; ealreritnentsofDr. Hancock ; spuriousAngustura ; dangerous effects and accidentsthereby produced ; mode of detecting the

false bark. DoRSTENIA CONTRA YERV A.-Description of the plant; preparutions used;their medicinal valite.GENTLEMEN :—The roots of several of the

menispermaceæ, or the cocculus tribe, arejjossfssed of tonic and febrifuge powers,and have considerable bitterness. The coc-culus platyphylla, the cocculus cinerascens,peltatus, crispus, fibraurea, baleis ovalr-folia, and the species of which I am about to speak to you, the palmatus, are all of them es-teemed for the medicinal virtues they possess,and are used in the cure of fever in those coun-tries in which they are indigenous. The rootsof some of this tribe seem to have still furthert’ta.ms to our notice ; for some of them arediuretic and aperient, and one has lately beenintroduced into our Pharmacopoeia, as veryvaluable in diseased states of the organs des-tined for the urinary secretion: the cissam-pe!os pare ira,orpareira brava. This medicinehas been lately revived amongst us, and is

brought to this country sometimes mixedwith roots of different species which are in-ferior to it in activity, such as the cissam-petos niauritania, and abuta, candicans, andrufescens. which have more or less of thesame power of acting upon the urinaryorgans. I have had occasion to mention to

you the effEct of the seeds of one of thespecies,—the menispermum cocculus,-asbeing most remarkable for the possession ofnarcutic properties, which seem to reside ina principle called piecrotoxia.The cucculus palmatus, or calumba plant,

grows in the thick forests that cover theshores about Oibo and Mozambique, on theeast coast of Africa, and was, for a longtime, a chief article of export of the Portu-guese from Mozambique ; but it was for a

long time supposed to be a native of theisland of Ceylon, and to take its name fromthe principal town, but it is now ascertain-ed that it is called amongst the Africanskalumb. M. Fortin, when trading on thecoast of Africa, obtained an entire off-set ofa larger size than usual ; on his proceedingto India he presented it to Dr. Anderson, ofMadras, who immediately planted it, andhad the satisfaction of rearing the plant; itproved to be a male. We should, however,have been without a proper knowledge ofthe female, had not Dr. Hooper, of Glas-gow, obtained from Professor Boyer a fulldescription of it, which he published toge-ther With a delineation of it coloured hy alady in the Mauritius. It is in the " Bota-nical Magazine " for the year 1830. Fromthis it appears that the root is pereniiial,composed of a number of fascicnlated, fusi-form, somewhat branched, fleshy, curved,and descending tubers, of the thickness ofan infant’s arm, clothed with a thin brownepidermis, marked towards the upper part,especially, with transverse warts; inter-nally they consist of a deep yellow, scent-less, very bitter flesh, filled with numerousparallel longitudinal fibres, or vessels ; thestems are annual, herbaceous, about thethickness of a little finger, twining, simpleiuthe male plant, branched in the female,rounded, green ; in the full green plant be-low, thickly ctothed with succulent longi-tudieal hairs, which are tipped with a

gland. The leaves are alternate, theyounger ones thin, pellucid, bright green,generally three-lobed ; older ones remote, aspan in breadth, nearly orbicular in theircircumscriptiou, deeply cordate, five to

seven-lobed, generally three-lobed, the lobt-sentire, often deflexed, waxy on the surfaceand margin, dark green above, paler under-neath, hairy on both sides, with prominentnerves and supported on round hairy foot-

stdtks, about as long as the leaves. In themale plant the racemes are axilhu’y, solitary,or two together, drooping, about as long asthe petiole, compound, clothed with glandu-lar hairs, and having at the base small de.ciduous bracteas. The calyx is smoothconsisting of six ovate, acute, nearly equalleaves arranged in a double series ; the co-rolla is pale green, consisting of six petalsarranged round a central orbicular disk or

gland, in a single series; the filaments are

six, with fonr-celled anthers, the cells open-ing internally, and filled with oblong grainsof yellow pollen. In the female plant theracemes are also axillary, solitary, simple.shorter than those of the male ; the pecliciesare furnished with minute caducous bracteasThe petals are six, rarely eight, green, gla-brous, shorter than the germens. and re-

curred at the extremity. The pistils ’arethree, tree, of which two are generally abor-tive, and contain one ovule. The f-tyte is

very short, and the stigma has several

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spreading points; the fruit is drupaceol1s, matter that the peculiar properties of theor berried, about the size of a hazel-nut, drug reside.densely clothed with long spreading hairs, Our preparations are a tincture and anwhich at their extremity are tipped with a infusion, which have all the useful qualitiesblack gland; the seed is subreniform, cloth- that are inherent in the root, and both ofed with a thin black shell, transversely them form useful medicines. The infusionstriated. is made thus :-Take of calumba, sliced,

It is about the month of March that the five drachms, of boiling distilled water aroots are clug up ; it is only the off-set from pint ; macerate for two hours in a vessel,the main root that is cut away, the prin- lightly covered, and strain ; of this an ouncecipal stock being left; great care is taken or two may be given. Mr. Phillips ob-as to the selection of those that are not too serves, that it contains no astringent matter.fibrous ; as soon as it is somewhat dry, it It must not be long kept, as it is soon ren-is cut into the slices in which you see it, and dered untit for use. The tincture is madehung upon ropes in the shade until all the by macerating, for fourteen days, threemoisture contained is perfectly evaporated; ounces of sliced calumba in two pints ofthat which breaks short is considered very proof spirit, and then straining; a drachmgood ; that which becomes at all black is or two is the usual dose. The powderedrejected as unfit for exportation. You will root, too, is occasionally given in substance,observe thatthe specimens which are placed and about a scruple, two or three times, is

before you are in round pieces ; these are the taken either alone, or in combination withresults of the slicing the roots transversely. some other of the tonics, or febrifuges.There is an external bark of a brown The knowledge we have of the value of thewrinkled appearance. The interior part is calumba root is principally to be ascribed toof a light yellow colour : it is much shrunk Dr. Percival; his essays, medical and exup from the way in which the exsiccation perititeiital, contain some very valuable dis-takes place; the texture is spongy, there sertatiolls on many subjects, and amongstare rays converging which are of somewhat them is one entitled, " Observations anda darker colour. Those sections which Experiments on the Calumba. Root." It has

weigh most, which are not- worm-eaten, been found that modern practice has verifiedwhich are heavy, and of a bright yellow the inductions of Dr. Percival, and the dis-colour, are evidently the best. It is liable eases in which he recommended it are fre-to many adulterations, both in this country, queutly controlled by its use. It is inaud in the places from which it is exported. diarrhoea, and more especially that whichThe root of the red-berried bryony, bryonia proceeds from an inordinate secretion anddaoica, tinged yellow, with a little of the discharge of bile, where astringents wouldtincture of calumba, is occasionally made be hurtful, it seems to correct the irregularlip to resemble it ; and the root of an Ame- action, and to diminish gradually the in-rican plant, the Fraseri Walteri of Michaux, creased action of the liver. III bilious colic,ih imported, and sometimes sold as the true where there is sevete sickness and vomiting,calumba; from which, however, it is to be it has been, also, much prized. It was pre-distinguished by its great sponginess, its scribed with very considerable advantagelighter texture, its whiter appearance, the by Mr. Johnson, in the East Indies, whoabsence of the wrinkles, and the rays, but, had the care of a hospital ship, during theabove all, by its taste, for it has by no means prevalence of the cholera, and it sooner

the .aroma and not disagreeble bitterness of checked the vomiting than any other remedythe calumba ; besides which the first im- which was used. It has been employedpression that it makes is somewhat sweet- with success in bilious fever ; and Dr.ish. Bigelow, in his 11 Treitise on the Ma- Haygarth, in a fever of that kind, whichteria Dleclica," has pointed out these dis- had been epidemic at Nantwich, and othertinctions; and Stoltze, in the 11 Pliarniaceiitic parts of Cheshire, found it to snpply theAnnual of Berlin," has given us a test, the place of cinchona bark, correcting the bile,infusion of galls, which, he observes, gives restoring the proper tone of the stomach,’10 precipitate with the infusion of the fra- and of the whole habit; it also preventedseria. There is also a spurious calumba relapses, to which, in that fever, the patientssent from the coast of Africa to France, were very liable.which contains no starch, and is, therefore, During dentition children are very apt toeasily detected by iodine, which does not be subject to severe vomiting and diarrhoea.alfect its colour; it likewise turns black and very often instant relief is procured bywith sulphate of iron, and disengages all1- the calumba root, when other efficaciousruonia by the action of caustic potash. remedies have been tried in vain. In en-Planche, whose labours are to be found in fpcbled states of the stomach, brought onthe "Bulletin de Pharmacie," has shown by dissipation, by hard drinking, where thethat calumba contains starch, a. yellow bitter appetite fails, where nausea and flatulencematter, an animal substance, a quantity of distress.the individual, this may be adini-volatile oil, silta of lime and potass, oxide, nistered, combined with the common gen-of iron nud silex, and it is iu the -yellow- tian, or with chirayita, infused in a lit. Ie

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Madeira wine; and, during its use, the an agreeable tonic, free from the objectionstincture of rhubarb may occasionally be which are raised to the stronger bitters, andprescribed as a warm and strengthening sufficiently powerful to strengthen the sys-purgative. Vomiting, arising from dis- tem where no very acutf disease, nor anyordered function, from depraved secretions very materially altered state of organs hasof the gastric and pancreatic juices, when occurred.it is totally independent of any diseasedaction of the kidneys, which is more gene- CUSPARIA, OR ANGUSTURA BARK.-GALlr(rArally the cause of habitual vomiting " than CUSPAttIA.

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anything else, is essentially relieved by the There are among the rutaceac, or rueoccasional use of the calumba root, and tribe,several species, characterised by greatthen it is very necessary to combine it with bitterness, and by their febrifuge powers.warm cordials, with the dilfusible stimuli, Amongst these there is a bark possessed ofor any of the aromatic bitters. In that these good qualities, which grows abun-highly distressing state of stomach which dantly on the river Carony, in South Ame-occurs in the earlier stages of pregnancy, rica, and has been prized by the Capuchinwhere nausea and sickness are the constant Friars, who form the different missions ofattendants of the early morning, where the Upata, of Capassui, and Magna Græcia.sight of almost any food is very apt to pro- It is called the quina de la Guayna, or deduce vomiting, and where the want of ap- la Angustura, as it came from Nueva

petite, or a depraved desire for food occurs, Guayna, or Angustura. This bark has beenI have very constancy recommended the in- said to be the produce of different trees. Itfusion of calumba, with very great relief to has been ascribed to hrucea ferruginea to

the patient, more particularly where the two species of magnolia, to the bonptimd-tbowels are kept in a gently relaxed state by trifoliata of Willdenow, the cusparia febri-magnesia, which, by its absorbing power, fuga of Humboldt.and its neutralisation of the acid which is In the splendid work upon equinocfialat this period generated, becomes a mild plants, by Humboldt and Bonpland, is de-and gentle aperient, and at the same time scribed the bonplanda trifoliata, as an ele-alleviates the disordered sensations that are gant evergreen, which rises to fifty or sixtyso usually complained of. feet in height, its trunk covered with a groyCalumba root has the power of retarding bark; its wood is bright yellow, and sus-

putrescency, and has been observed to mo- ceptible of a high polish. It has numerousderate alimentary fermentation without sus- branches ; the younger ones covered withpending the process of digestion. As its smooth bark, of a bright green colour, andtaste very much resembles mustard, Dr. studded with small greyish tubercles. ThePercival was led to make some compara- leaves are ranged alternately on the branches;tive experiments, with infusions of calumba, they are about two feet lolig, and composedof mustard, and of chamomile, and they were of three oblong leaflets,attached to a commonin favour of tlzr calumba root. He was, petiole, which is from ten to twelve inchestherefore, led t@ the conclusion, that it had in length. The flowers are produced in athe advantage over other bitters in disor- terminal raceme, composed of alternateders of the stomach attended with a vio- peduncles, bearing from three to six flowerslent fermentation of the food." Certainly, each; the calyx is inferior, persistent. five-where there is an extrication of a gaseous toothed, and tomentose ; the corolla funnel-flatus, and much acidity, it has very con- shaped, and composed of five petals, whichsiderable powers, and may t e safely taken appear as one tube. The nectary consistsby the dyspeptic a few minutes before a of five oblong glalldular bodies, coveringmeal. It appears neither to increase the the base of the germen. The stamens arefulness nor to affect the regularity or velo- shorter than the petals, and are furnishedcity of the pulse. It is particularly service- with oblong yellow anthers. The germenable where a milk diet has been found neces- is superior, and composed of five ovate hairysary for the nutrition of the body, for it pre- ovaries, with a single style, and five oblongvents the acidity which is so generally the blunt fleshy, green stigmas ; the capsulesconsequence, and likewise diminishes the consist of five oval bivalve capsules, eachtendency to flatulence. inclosing a single seed. This description,

Dr. Denman has found it preferable to together with a figure which represents abark in the low stage of puerperal fever. raceme, or spike of flowers, of the bouplan-As for any benefit in phthisis pulmonalis dia, with a leaf, in outline, considerablyand in hectic fever, I believe little to be de- reduced, you will find in Stephenson’s 11 Me-rived from it further than that the organs of dical Botany." taken from the work to whichdigestion are better capable of bearing it as 1 have alluded.a.tonic than they would the Peruvian bark, Dr. Hancock, however, had actual op-which, in some instances, produces diar- portunities of seeing the true Angusturarhoea. The chewing the root has been bark. In a paper read before the Medico-recommended in dyspepsia, in pyrosis, and Botartical Society, in 1828, he gave his obser.in gastrodynia; altogether it may rank as vations on the external appearance of the

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plant, and the prominent differences between missions of Tumeremo, Uri, Alta Græciathe plant he had seen and the one described and Cnpapui (as correctly mentioned byby Humboldt and Bonpland. The gold Humboldt), which are the southern and backmedal of the Society was awarded to him missions of the Orinoko, at a distance offor his discovery, and that he is fully en- upwards of 200 miles from the sea. It linestitled to the merit of pointing out the real the roadside, in many places, between thetree from which the bark is obtained, there missions of St. Antoni and Villa Upatu. Itcan be no doubt. Humboldt himself, who delights in a rich soil, and flourishes at thehas spoken in honourable terms of Dr. Han- height of between 600 and 1000 feet abovecock’s labours, has not controverted the the level of the sea. It seldom or never ex-statements advanced by our learned and in- ceeds the altitude of 20 feet, the usual me-

defatigable countryman, who having tra- dium being about 12 or 15 feet. The dia-velled repeatedly, and resided during seve- meter of the trunk, which is tolerably erect,ral months (particularly during August and is from three to five inches. Branches scat-September, 1816), in the missions of Carony, tered over the whole tree without muchand sketched a map of the district, had had order. Bark, smooth and externally gray.an opportunity of seeing many thousands of Leaves, placed, for the most part, alternatelythe bark trees, and of examining numerous on the branches, composed of three folioles.specimens on the spot. In the course of his Flowers, numerous, borne towards the ex-observations he remarked that it would have treme part of long spikes or racemes, whichbeen impossible for any botanist, however are both terminal and axillary. Bracteae,expert, to recognise the Angustura bark tree lanceolate, acute, in pairs. The flowers alsowith the assistance of any one of those have a peculiar, not the most pleasant,odour.works, into which its descriptions have all Calyx, Tllonopetalous, bell-shaped, five cleft,been transcribed from that of Baron Alexan- hairy, rough, inferior, and persistent; green,der df Humboldt, and his scientific coadju- about one-fourth of the length of the corolla.tor, M. Aim6 Boupland. He was informed Corolla, somewhat curved prior to expan-by MM. Ravigo and Jose Terreas, with sion, tubular, bursting from the centre.whom the travellers lodged at Angustura, Stamina, two. Filaments flat, inserted intothat they did not visit the missions of Ca- the two longer petals at the mouth of therony, but sent an Indian, who returned with tube, considerably shorter than the nectaria.a sample (muestra) of the leaves, but, much Anthers large, linear, erect, longer than theto their disappointment, without flowers. It filaments, four-channelled, two-celled. Pis-

is, therefore, probable that their descriptions tillum, consists of a five-lobed depressedrefer chiefly to specimens which they ob- germ, immersed within a coriaceous recep-served in the province of Cumana, where a tacle ; a simple, filiform style, hairy at thespecies of the genus to which the Angustura middle, longer than the tube, and a capitatebark tree appertains may grow to the size entire stigma. Pericarp, consists of five bi-mentioned. valve capsules, of which two or three are

He was never enabled to learn from what commonly abortive, resembling short legu-source the illustrious travellers above men- mes, gibbous. Seeds, two to a capsule;tioned derived the name cuspare for the Ca- one of them often abortive, round, black,rony bark tree. He resided for three years the size of a small pea, fastened near toge-and a half at St. Thomas de Angustura, in ther by minute pedicles within a chaffy en-Spanish Guiana, whence he made several velope, which is again surrounded by aexcursions amongst the missions of Carony, strong elastic perisperm or arillus, which iaand the tracts inhabited by Indian tribes be- horny, bivalve, bursting with violence, andtween them and the mountains of Parime, dispersing the seeds it contains to a con-but never ollce heard the term used; the siderable distance.vernacular name among the aborigines of The Angustura bark tree flowers in vastthis part of Guiana being O1’ayur!; and profusion during the months of August andamong the Spaniards and Creoles, it was

September, when its elegant white blossomsknown by the name of cascarilla, or quina de acld greatly to the beauty of the scenery. ItsCarony. The cuspa, however, which is seeds ripen in October and November.known as a tree of Cumana, has a bark that ., ’

is bitter, and of a yellow tint ; and although Decandolle, in arranging the species ofit is much lighter, nauseous to the taste, galipoea, has adopted the cuspari as the spe-and altogether different from the orayuri, it cific name, and the London College has fol-is fancied by the inhabitants of Cumana to lowed his example; the pharmacopoeias ofbe allied to the Carony bark tree; at the the United States have, however, adoptedsame time they acknowledge its virtues to the authority of Dr. Hancock. -

be much inferior. In the years 1816 and 1817 there prevailedThe Angustura bark tree grows in abun- in the district of Orinoko, and particularly

dance on the mountains in the neighbour- at St. Thomas de Angustura, a malignanthood of St. Joaquin de Carony, situated be- bilious intermittent fever, which proved fataltween the 7th and 8th degrees of northern to great numbers of the inhabitants as welllatitude. It is also well known in the as to foreigners. In the latter, it assumed

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the form, in many cases, of true yellow bottom, who have given us the result of

ever, with vomitu paieto. their experience; and more recently Dr.Dr. Hancock had tae appointment ot Hancock has spoken of it, and pronounced

Medico de Sanidad in the harbour, which is that, " from ample experience of the virtuesabout 260 miles up the river, and had an of the bark, it is one of the most valu-

opportunity of observing this disease in all able febrifuges we possess, being adaptedits various shapes. He had also the care to the worst and most malignant biliousof the Alilitary Hospital in 1811, and had fevers, while the fevers in which cinchouaseldom less than 60 or 70 patients with is chiefly administered, are simple intermit-fever, dropsy, and dysentery. The number tents, for the most part unattended withof hydropic patients was almost incredible. danger.It was distressing to see them dying along Sometime since there was introduced intothe streets of Augustura from the effects of Europe a spurious Angnstura, or cusparia,fever and want of food, the town being which was asourceof considerable mischief;besieged by the patriot forces under General it was said to be the produce of the brilceaBolivar. ferruginea, a native of Abyssinia; it ap.

In March, 1817, the mortality increasing, proached very nearly to strychnia in its in-the stock of cinchona was soon expended, tensity of action ; so many were the disastersand there was no other resort but to the to which it gave rise, that, in some parts ofquina de Carony, of which there was a large the Continent, all the bark that had been im-supply in the town. It was prepared nearly ported was ordered to be burnt. Thesytnp-as prescribed by those who were there termed toms that presented themselves, where acuriosos, or the native doctors. portion had been taken, bore a very strong

Into a large jug, containing about six gal- resemblance to those I have detailed to onIons, was put one pound of coarsely-powder- as following upon the injuclioions emptoy-ed bark, with an equal quantity of brown meut uf nux vomica. In Hufeland’s Jour-sugar, the jug was nearly tilled with boiling nal is ttt he found a paper upon this subject,water, and about four onnces of wheaten bread by Professor Emmert, and he has minutelyadded to hasten fermentation. It was then described the effects. Professor Mare, ofstopped close, placed in the sun, and shaken Paris, owing to a mistake, took a smallfrequently. As soon as fermentation was quantity of the spurious Angustura, for thewell begun, it was considered fit for use, cure of intermittent fever. An infusion ofand administered in the quantity of from it had been made, of which he only drankfour to six ounces to the dose, three or four three-quarters of a hqueur-gtass full, andtimes a day. for two hours he suffered from a train ofThe success of this seemingly odd prepa- very alarming symptoms, which fortunately

ration was very remarkable. The irregular were alleviated by the administration of

paroxysms of fever were suspended on the ether and of the tincture of opium. Hesecond or third day after commencing its was, at first, seized with nausea and painuse. The number of deaths of patients from in the stomach, there then followed a deter-fever was soon diminished to one-fourth of mination of blood to the head, giddiness,that which before fell victims to this dread- singing in the ears ; his vision became ob-ful scourge; though prior to this time it scure, his limbs stiff; every attempt atwas gradually on the increase. movement produced pam; locked jaw super-

Dr. Hancock, at first, cORceived that fer- vened, and his articulation was incoherent,mentation might injure the remedy, but had and he was almost incapable of uttering anysubsequently every reason to suppose, that souuds. The sensibility, it would appear,the evolution of the carbonic acid rendered is materially affected even during the ab-the remedy more energetic, and more grate- sence of those paroxysm?, which bear soful to the palate and the stomach. strong a resemblance to those. that occur

It was not long before he perceived the where strychnia has been taken ; for, in oneefficacy of the fermented infusion in dropsy. instance, a lad who had died in consequenceThis naturally induced him to give the same of having taken it, implored the physicianremedy as a tonic to those patients who not to touch him, as it threw him into thewere simply dropsical or without fever. Its most violent fits. Christison mentions thepower in those proved more striking and experiments made by Emmert to show thatdecided than anything he ever witnessed the poison acts on the spine directly, andbefore in medicine. not on that organ through the medium of theHe had thus no reason to regret the ex- brain, for if an animal be poisoned by in-

change he had from necessity made, for the serting the extract of the false AngusturaAngustura bark was found to be greatly bark into its hind leg, after the spinal chordsuperior to the Peruvian bark. had been severed at the loins, the hind lega

It was in the year 1788 that the bark of as well as the fore legs are thrown into athe tree was first imported from Dominica, state of spasm; or if the medulla oblongataand our acquaintance with the medical be cut across, and respiration maintainedpowers by which it is distinguished is de- artificially, the usual symptoms are prodrre--rived from Brande, Lettsom, and Winter-jed over the whole body by the administra-

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tion internally, or the employment exter- comes in to our aid. She detects oxide ofnally, the only material difference being that iron in the false and not in the true, for thethey commence more slowly, and that a fe) rocyanate of potash causes, in a muriaticlarger dose is required to produce them than infusion of the false bark, a precipitate,’where the medulla is not injured ; on the which is first green, and then becomes blue;other hand, when the spinal chord is de- and the same reagent converts into blue thestroyed suddenly after the symptoms have reddish powder which lines the bark; nobegun, they cease instantaneously, although such effect is vi3ible where the true Angus-the ch’culat on goes on for some minutes. tura bark is thus acted upon.The symptoms that are produced certainly It appears that the active matter of thelead one to believe, that it is to the princi- bark is taken up by cold and hot water inple called brucia that these effects were infusion,and thatit is not injured by boiling;owing; this principle is twenty-four times for the infusion we are directed to take ofless powerful than strychnia, according to cusparia, bruised, five drachms, of boilingAndral ; but the Angustura, or, at least, the distilled water, a pint, macerate for twofalse bark, is very powerful, for we learn hours in a vessel lightly covered,and strain;from the" Toxicologie Generale," that Orfila of this the dose usually prescribed is fromdestroyed a dog in less than two hours with one to two ounces. Dr. Anthony Toddeight grains. Some botanists have thought Thomson found that the watery infusionthat this fearful drug is obtained from the precipitated the infusion of galls and ofsolanum pseudo quina, or the quina da yellow cinchona, that it precipitates suiphatecampo of the Brazilians. Of course it be- of iron, tartrate of antimony, sulphate ofcomes a matter of the deepest importance to copper, acetate and superacetate of lead,us, to distinguish the medicinal cusparia from muriate of mercury,and pure potash, yellow ;the poisonous; and in the twelfth volume he confirms the analysis of Vauquelin, whichof the "Edinburgh Medical and Surgical shows that cuspariabark contains cinchonia,Journal" will be found an accurate detail resin, a peculiar variety of extractive, car-of these differences. It is brought to this bonate of ammouia, and essential oil. Fromcountry in casks. It is in pieces of different personal knowledge I can say nothing of thelengths, some are almost flat, others are Angustura bark. Brande, who wrote in

quilled; externally it has a rough, gray 1791, was very sanguine as to its very greatappearance; internally it is of a brownish efficacy. Alibert gave it a fair trial at theyellow colour, powdered it is pale yellow ; Hospital of St. Louis, but does not seem toit is very easily reduced to powder. The have appreciated it very highly. It seems

following have been given as the characte- to check diarrhoea, and to be useful in someristics by which the true bark may be stages of dysentery, and may doubtless beknown, when compared with the false. The employed where tonics are indicated.true has a strong and disagreeable smell,some-

CONTRAYERVA3, DORSTENIA CONTRAYERVA.thing like chenopodium olidum; the false CONTRAYERVA, DORSTENIA CONTRA YER VA.

has scarcely any ; the taste is very striking The contrayerva has been, in its day, ain the false ; it is intensely bitter, and lasts fashionable medicine, but I believe that it

upon the palate a long time, whilst in the is rarely ever prescribed in modern days.real bark, although the taste is bitter, it is In the former Pharmacopoeia there was anot so insupportable, nor does it last. The compound powder of contrayerva, maole ofepidermis of the true is generally covered five ounces of the powdered root, and awith an immense number of lichens, which pound and a half of prepared shells, ofhave been described by Feé in 11 Essai sur which the dose was from ten to thirty grainsles Cryptogames des Ecorces Officinales ;" in water, or rubbed up with mucilage andwhilst the opegrapha pelletiere and pyrenula mint-water ; it was stated upon good autho-nitida are the only ones that have been ob- rity to be of advantage in typhoid fevers,aervrd on the false; besides these it is found in the malignant exanthematic, in chronicthat the real Angustura, when put into dysentery, and diarrhoea ; it wasa medicinewater, soon becomes dry, and imbibes it of the school of Huxham and of Pringle,readily ; it is easily broken when dry ; it is but Dr. Cullen seems to have driven it outvery light, and of a spongy texture ; it of repute, and the present Pharmacopoeiabteaks with a resinous and brilliant frac- has erased from its formulae the powderture; it is internally of a yellowish brown which it appears was often rubbed intocolour, and capable of being detached in balls, and administered under the name oflaminas, and it is easily cut by sharp-edged lapis contrayervae. The plant from whichtools. Now, in contradistinction to these it is obtained is perennial ; is a native ofcharacteristics, the false bark, put into South America and some of the West Indiawater, still remains hard ; it is difficult to Islands. Dr. Houston asserts, that thebreak; it is very heavy and compact in its roots of two species of this family are oftentexture ; when broken, it is unpolished and mixed and exported with that which is call-black ; internally it is nearly black, smooth, ed officinal, the dorstenia houstonia, andand not to be detached in laminae, and it is drakenia. It was placed by Jussieu amongstcut with difficulty. Chemistry, likewise, the urticeae or nettle tribe, and is of the

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Linnaean class and order, Monoecia Diandria.The roots are the parts which have beenmedicinally used ; they have a bitterishtaste, a remarkably overpowering odour,with some degree of purging ; where theyare indigenous they are considered to havemuch power as antidotes to the bites ofvenomous auimais; water and alcohol bothextract whatever power they possess ; thewatery decoction is highly mucilaginous,and was a favourite remedy as a gargle in

malignant angina and in scarlet fever, bothwith Fothergill and Withering. It has beenrecommended too in dropsies; amongst theherbatists it is often quoted ; Motherbyand Hill recommended a tincture, but theyobserve that the old prescribers put somewarm root into it, such as the galangal, andit then forms an excellent cordial and sudo-rific : 11 good in fevers and in nervous cases,and against indigestions, colics, and weak-nesses of the stomach."

STATE OF MEDICAL SCIENCE INSPAIN.

To the Editor of THE LANCET.SIR:-The high estimation in which the

medical profession is held, both in Franceand England, induces me to contrast the de-plorable want of respect evinced towards itin Spain.When the British Auxiliary Legion went

out to Spain in 1835, it was notorious thatthe medical oflicers (generally speaking) hadthe worst billets, and, with but few excep-tions, received the most cavalier treatmentfrom the Spaniards. So well aware wasLieut. Colonel Sloane, who commanded the4th, or Queen’s own Fusileers, from expe-rience, that the Spaniards thought little ornothing of medical officers, that he orderedthe surgeons and assistant-surgeons of hisregiment to wear the sash, so that theyshould not be distinguished from otherofficers.The surprise which this want of respect

created in my mind, was completely eradi-cated on perusal of the following advertise-ment, which appeared in a Madrid paper :" Wanted a medical man, who will under-take to attend a parish four leagues fromMadrid ; the salary is 4000 reals (about 401.sterling) a year, out of which he is to pay375 reals for the maintenance of the poor.His keeping a barber’s shop, however, willprove no detriment to his capacity for theoffice, as it is understood that he will be atliberty to make what he can by shavin-He must, however, be a chartered memberof the Madrid Faculty,"

It may be necessary here to observe, andI have it upon the authority of two Spanishmedical practitioners of San Sabastian, thatone year’s attendance on the lectures at

Madrid, entitles them to practice in the pro-vinces.

For the edification of your readers, I willlay before them ttto cases, the one medical,and the other surgical, to show what know-ledge these gentlemen possess.

Annetta Y-, aet. 9, daughter of a wine-shop keeper in San Sebastian, was attackedwith typhus fever, and allowed to remainsome days before medical aid was sent for,the mother thinking the child had nothingbut a cold ; on the fifth day, however, shebecame alarmed, in consequence of the pa-tient’s pallid countenance, emaciated form,and her constant refusal of food, and imme-diately sent for a Spanish physician, whoordered some chocolate to be given to thechild immediately, the door of the bed-room to be closed, the head to be bound upwith a handkerchief as tightly as she couldbear it, and to have at night a little openingmedicine.The next day he called, the child was

considerably worse, and had, during the

night, pulled off the handkerchief repeat-edly, and complained of intolerable pain inthe head ; the handkerchief, however, wasdirected to be tied tighter to stop the pain !Food was ordered to be administered re-peatedly in small quantities; the child loath-ed it, but she was forced to take it accord-ing to orders!On the evening of the seventh day from

the attack, I was sent for hy mere accident,in consequence of my dealing witha French-man who lived on the flat above SignoraY.,and who came and requested me to see thechild; I accordingly accompanied him, and,on entering the apartment, I was horror-stricken : the Door child was Ivins in a re-cess, with a candle burning at the top andanother at the bottom of her bed; a cru-cifix in her hand, head bound up; twentyleeches on her chest; blisters on the calf ofeach leg, and on the soles of the feet. Themother and father were standing about thebed of their only child, together with theirrelatives, crying with the utmost bitterness.The room was lighted up with long waxcandles, a custom practised by the Catholicsabroad, when any one is lying dangerouslyill. The effluvia in the room was intolerablefrom want of ventilation, and the faeces beingpassed in bed, the sheets of which had notbeen removed for three days! On seeingthe dark-brown dry tongue, and the sordesabout the mouth and teeth, I at once recog-nised my familiar acquaintance, typhus fever.I at once ordered the head to be unboundand shaved, the leeches and blisters to beremoved, the child’s linen and bed-clotheschanged, and the room to be freely aired :-the relief which these simple means aloneafforded the poor little creature is not to bedescribed ; the room was abundantlysprinkled with chloride of lime water.Having exacted a promise from the parents