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theatre of this Institution. The followingis said to be the inscription :-

THIS URN IS PRESENTED TO

B. B. COOPER, ESQ.

IN COMMEMORATION OF*

HIS OPERATION OF LITHOTOMY,PERFORMED ON THE BODY OF ONE

STEPHEN POLLARD,

WHOSE ASHES IT CONTAINS ;BY HIS AFFECTIONATE AND DISCERNING

PUPILS.

WESTMINSTER MEDICAL SOCIETY

April 25, 1829.

[The last Meeting of the present Session.]

Dr. A. T. THOMSON in the Chair.

EXPERIMENTS ON THE ACETATE OF LEAD

AS A SEDATIVE MEDICINE—COLICA PIC

TONUM - EAST INDIA AND ENGLISH

OPIUM—CHAIRMAN’S ADDRFSS.

ON the confirmation of the minutes,Dr. GORDON SMITH made some remarks

on the reports of the last evening. An im-

pression had gone forth on the subject of thedisease for which the corrosive sublimate inMr. IVard’s cases had been employed, forwhich, as he had been in some measure con-nected with it, he said he should be sorry ifthere were any just grounds. This error hewas desirous of correcting, and now ex-

plained that it was psora which had beenmentioned, and not syphilis.*Mr. LAIDLAW then rose, and proceeded

to read a paper on the internal exhibition ofthe acetate of lead, with a view of determin- iing to what extent it might be safely ex-hibited in the cure of disease, especially incases of haemorrhage. Very opposite opi-nions, he observed, had been entertained asto the propriety of the internal administra-tion of this medicine, some persons regard-ing it as dangerous in the highest degree,others considering it a justifiable and valu-able remedy. There could be no doubt that

’ The impression to which Dr. Smithalluded could not have aiiseu from the re-port in ttiK LANCET, as it did not connectDr. Smith’s name with the disease in ques-tion. A reference to the report will showthis, and that the disease itself was onlyconjecturally stated. The name was not

distinctly heard, and the cases were givenfrom memory.

its incautious use was injurious; and the in-vestigations of Sir George Baker had put itbeyond doubt, that the noted colica picto-num was the effect of the gradual intro-duction of this salt into the system. It wasthis, perhaps, which had created so muchprejudice against it as a medicine, thoughit was no proof that its judicious use mightnot effect salutary results. Agreeing thenwith those who considered the acetate oflead as a valuable remedy when exhibitedwith care and caution, Mr. Laidlaw pro-ceeded to examine in what the judicious useof it consisted. He considered, first, thatsmall doses were neither safe nor judicious ;their action was not sufficiently speedy. Itwas the gradual and insidious introductionthat produced paralysis and convulsions, andmore usually colica pictonum. In animals,the exhibition of small quantities producedno sensible effects. Orfila injected fromone to three grains of the acetate of leadinto the jugular veins of middle-sized dogswithout injury; he gave them internally adrachm and a half in the solid form, and awhole ounce

in solution. The only effectwas one which, from the known effects ofthe salt, could not have been anticipated,that of vomiting. This result, perhaps, pre-vented the true effects from being developed;he looked, therefore, farther for evidence onthe subject. He had often seen it adminis-tered at the Western Dispensary by Dr.Davies, in cases of uterine haemorrhage, indoses of two grains, combined with opium,every third or fourth hour, to be continueduntil refiet or injury resulted. He had him-

self administered it to the extent of fortygrains in four davs without deleterious

symptoms ; though, in these cases, if restand quiet could have been obtained, half thequantity might have sufficed. But therewere cases in which it must either be push-ed beyond forty grains, or abandoned in

despair. The question then became, is it

justifiable to proceed farther, without a

knowledge of what the ultimate conse-

quences might be 1 Influenced by a strongdesire to arrive at the truth, and hesitatingto use it upon others, be determined upontrying an experiment upon himself, and

prepared the following prescription: one

drachm of acetate of lead, eight grains ofopium, one drachm of extract of gentian,and a sufficient quantity of dilute acetic

’ acid, to make into eighteen pills, of whichthree, containing ten grains, were to betaken daily, until the occurrence of restrain-ing circumstances. He commenced Sept.12, 1827. The health was then perfect.No deviation occurred until the 14th. The

pulse became, then, somewhat slower; a

metallic taste in the mouth ; gripes, whichwere ultimately referrible to the transverseportion of the colon, insupportably intense

148

The last two pills (seven grains) were takenon the 16th, within two hours of each other.No unpleasant effects from that circum-stance. The pulse in bed 60, and indis-tinct ; after exercise 6-*-, but more distinct ;metallic .taste stronger; gums tender;bowels constipated. A larger dose wasnow tried, ten grains at once ; immediatelyafter, slight pain of the stomach and nausea ;pulse 58, and weak ; disturbing dreams ;pulse in bed 50, and hardly perceptible;weakness at the knees; urine high-colouredand diminished; bowels not moved since ’’

commencing. Early on the 18th awoke withsevere pain of stomach ; vomiting hardlysuppressed ; three drachms of sulphate ofmagnesia, in solution were taken ; the paininstantly relieved. Slept again. At seventhe pain had wholly left. To decomposethe salt entirely, he took three drachmsmore of the sulphate; the pulse rose tendegrees ; weakness gone ; urine more free,dark, and sweet. In a few days lie per-fectly recovered. On the subject of thisexperiment, he had to observe that the sen..sations upon which he was induced to stopit, were not the characteristic effects of thesalt, were not colica pictonum, but were un-equivocally gastrodynia, the result of theexcess of the last dose; not its specific effect,but its styptic quality. Its operation wasmuch like that of sour fruit. The decom-

position of the salt proved this. Colica pic-tonum required weeks sometimes to removeit, but the removal of the pain in this casewas instantaneous. Not satisfied with theresults, he ultimately resolved to makeanother experiment, but with more care tobring out the results. A like prescription,without opium, was made up, and com-menced on the l0th of October. Similareffects up to the 12th, when the result ofopening the bowels was tried. Rhubarb andjalap ; action moderate, the symptoms di-minished. 15th. Unpleasant tightness inthe breast increased by exercise ; metallictaste strong and bitter; gums tender; con-striction of the throat ; gripes; pulse 52 ;after exercise 85; urine high ; constipa-tion ; much debility; no nausea. The pillsbeing gone, a like quantity was made upagain. (The speaker was here interruptedby Mr. North, who stated that he believedthere was a law which limited the durationof papers, and of this lie begged to remindthe Chairman. The Chairman consideredthat a farther indulgence might be granted ;and Mr. Laidiaw stated he was near theclose of the experiment. The paper wast::en continued, but the whole of it was notread. Mr. Laidlaw, however, having con-cluded his views on the subject ia the courseof the debate which ensued, we subjoin anoutline of the whole in connexion. Theaccount of the experiment continued.)

On the 17th, all the symptoms became so

severe, that the experiment was stopped.18th. Ptyalism ensued; numbness of theextremities increased by usage ; the sul.

phate of magnesia dispelled all the symptoms,except the ptyalism, by the nfth day ; thelatter continued for weeks. Seventy-eightgrains had now been taken in eight days,without indications of colica pictonum,which he (Mr. Laidlaw) consequently be.lieved was not so frequently or readilypro.duced by the acetate of lead, as was oftensupposed. The occurrence of gripes did notmilitate against this. They occurred on toosmall a quantity. The sensations producedwere rather the result of irritation producedby the passing of the salt along the intesti.nal canal. The gripes were, so to speak,a local rather than a constitutional affection.Colica pictonum seemed to be produced bythe general diffusion of the metal throughthe system.The results most worthy of observation

in these experiments were, he thought,first, the effect of the salt on the circulation;the pulse was exceedingly depressed. Thesame result was observed in four of the sircases of colica pictonum quoted by Orfilafrom Merat’s Dissertation ; and he was in.duced to think, that when death from thatcomplaint resulted, it was owing to ex.

haustion, produced by the sedative quali.ties of the acetate. it was on a due kuow.

ledge of its powers in this respect, that ajudicious use of it might render it of greatvalue in haemorrhages. For this reason

rest and quiet were of importance, for gen.tle exercise would raise the pulse five andten degrees ; the salt then should accumu.late in the system ; the effect of aperientswas to prevent it. The experiments proved,that they ought not to be employed till themalady is checked. As the depression ofthe circulation was gradual, he thought itwas produced by absorption. With theseremarks on the sedative effects of the salt,and on some experiments of Orfila by iu.jection, Mr. Laidlaw observed upon its localeffects ; one of these was upon the lungs.He attributed this to its astringent qualitiesupon the substance of that organ, for a fullinspiration and exercise increased the un.easiness. The post-mortem examiiiatioas

by Orfila also, in some measure, corroborat-ed this conclusion, as did the fact, that

hæmorrhage of the lungs, stomach, and ute-rus could be succe3sfuliy suppressed by traacetate. A third effect which lie wished tJnotice was, the influence of the acetate canthe salivary glands; the gums and sa:lf3,

especially in the second experiment, weremuch affected. His patients, however, lialnot been affected to the same extent; it illai

greatest in those who had taken most; vrt.when the bowels were not confined, no M-

149

livation could be produced. He had metwith no other instances of similar ptyalism.In 11,Jerat’s cases there was a bitter taste inthe mouth, but these were not sufficiently

’’

explicit on this head to allow him to drawa positive conclusion. The same causes

which retarded that symptom in mercury,possibly prevented it in these cases. Gra-dual exhibitions of the salt did not seem to

produce salivation, but rapid and regularones did. i

The result of his experience on the qua-lities of this medicine led him finally tobelieve, that it was an invaluable remedy inall diseases requiring sedative remedies, inhemorrhages of every kind, and in all casesof increased secretions, which required me-dical interference ; with proper care in otherrespects, he could say, that it would proveto have the most powerful command overthem. Some attention was necessary as tothe form in which it was given, for therewere certain diseases in which the prac-titioner would readily see that the solidform would be the most plausible ; in others,that might be readily distinguished, thefluid form, in which also smaller quantitieswould be the most proper. As he did not,however, wish to intrude too long on theSociety, he should leave the subject of thequalities of the salt in the hands of themembers, and should be glad of their opi-nions upon it.

Dr. GORDON SMITH said, he had been onthe alert some little time, to discharge thedebt of gratitude which he and the membersowed to Mr. Laidlaw, for his valuable com- munication ; and he believed that most im-portant changes would ensue in the toxico-logy of poisons, upon experiments pursuedwith such distinguishing marks as these.When he considered the originality and theboldness with which they were pursued, hehad to congratulate Mr. Laidlaw that hewas now standing on his legs, and in a con-dition to answer a question which he wishedto put to him. Did Mr. Laidlaw say, thatwhea he found the effects of the medicinetoo pe;ve rful, he took sulphate of magnesia.2s a chemical antidote? 1 If so, lie must con-fess that it was a piece of news to him,that the sulphate ofmagnesia will act on anysalt to decompose it. Perhaps from the

paper having been cut short, he had lost thebenefit of subsequent experiments, whichwould have made this matter clearer.

Dr. WEBSTER mentioned a case in corro-torstiQn of the effects which Mr. Laidlawkid ascribed to the sulphate of magnesia.A man came to a pnhlic Dispensary with anulcerated )eg : two drachms of the acetate oflead were ordered in a quart of water, as aiutmu, and two ounces of the sulphate ofanagnesia to be taken, half that night, there: 0:1 the following day. The man left, and

when too late,- it was discovered that thedirections were such, as would most proba-bly lead him to swallow the whole. Somealarm was excited, but to their great asto-. nisbment, the man, a few days after, madehis appearance. He was questioned closely;he had drunk acetate, sulphate, and quart ofwater, got cured of his ulcers, and declaredthat he never was better in his life. It hadpurged him well, and nothing more.Mr. LAIDLAW replied to Dr. Smith, that

the most unequivocal decomposition hadtaken place. He supposed that every bodywas aware of this effect, and the sulphateand carbonate of soda would have the sameeffect. Orfila fully recognised this power inthe sulphate of magnesia.

Dr. SMITH said, he believed Orfila was agreat authority, but that he was often ledaway by a vivacious imagination. He hadhis doubts upon this subject ; he thoughtsuch an effect would not be produced uponthe acetate in the body. The stomach was

not a Wedgewood mortar, into which anychemical agents might be put with the sameimpunity within it as without. The vital

principle of the stomach would affect theprocess.The CHAIRMAN thought Dr. Smith was

not borne out in supposing this, because, inmost instances, the only antidotes to poisonwere those which would decompose them.The reason why the acetate of lead was notpoisonous was, that it was insoluble in thebowels, and was not talsen into the circula.tion.Mr. LAIDLAW wished to draw the atten-

tion of the members to the effect of theacetate of lead on the salivary glands, witha view to the question, whether its action,

that of mercury, and, as reported, that ofarsenic, in producing ptyalism, did not lead

to the conclusion, that all metals, taken toa certain extent, would produce the sameeffect. He had known a peculiar taste anda tenderness of the gums follow the takingfour drachms of carbonate of iron ; he thoughthe bad also noticed these effects after theuse of the nitrate of silver as a wash forulcers. In speaking of the metals, he meanttheir combinations as oxides, &c.

Dr. JoHNSTONE thought, that greater ap-prehension existed as to the effects of theacetate of lead, than was necessary. Dr.Latham said it might be eaten like lumpsugar, and had mentioned a case of 70 grainsbeing taken in seven days. He had seenhimself 10 grains a-day given for four orfive days, in haemorrhage. Constipation ofthe bowels was the only bad effect. It

might be given largely with opium, withgreat safety.A long conversation ensued on the mode

in which colica pictonum is produced. Thelast speaker believed the lead of the paint

150

arose by evaporation of the turpentine, orother liquid, and was absorbed. The Chair-man saId, he knew of many instances ofthat complaint, where no turpentine hadbeen present. The Devonshire colic, heobserved, was colica pictonum, but it didnotarise fiom similar causes. Further ob-servations were made by other members tillnear the close of the evening, when theChairman craved leave, on the part of Dr.Webster, to exhibit a specimen of EastIndia opium.Dr. WEBSTER stated, it had been sent

to him by Dr. ADAM, the Secretary to theMedical and Physical Society of Calcutta,as a specimen of very pure opium, packedin a small box between plates of mica. Itwas considered as superior to any Turkeyopium. His own experience of it was, thatit was equal to the best. He was sorry tosay, Dr. Adam had not sent him the priceat which it could be sold, as it was a greatobject, if it could be obta;-ned from our

colony, we should have it thence, rather,as Dr. Smith observed, than that we shouldgo to the rascally Turks. The manufactureof English opium was adverted to, which,it was stated, yielded more morphium thanthe Turkey, but required a very great ex-pense to produce it.

At the close of the discussion, the Chair-man begged the attention of the membersfor a short time, and addressed them in thefollowing words:--

. As this is the last evening of the session,I will take the opportunity, before we sepa-rate, of addressing a few words to you onthe great utility of this Society, and I wish.it was in my power to express to their fullextent the feelings with which I regard it.It is impossible for any person to attendthese Meetings, and witness the freedom ofdiscussion which distinguishes them, with-out being aware of its great importance,and of the advantages its existence presentsto the profession. I reflect on this withthe greater pleasure from the fact of this

having been the first Medical Society in themetropolis, which permitted free communi-cation during its Meetings amongst itsMembers. Most of the Societies in Londonwere founded on the model of the RoyalSociety, in which papers were read, but nodiscussions permitted upon them. It wasthe Westminster Medical Society which seta better example, and there is now scarcelya society in London, in which free discussionis not allowed. There is another thing con-nected with this Society, to which it givesme sincere pleasure to be able to allude, thatof its having first conceived the bill,* now,

Y We advise Dr. A. T. Thomson to lookback into the pages of THE LANCET. TheWestminster Society, indeed, the cause of

however, withdrawn for a short time, whichhas been brought before Parliament for the

regulation of anatomical dissections. It wsshere the first impulse was given to that hi,1,and, I may not only say this, but I may add,that it is owing to this Society that it hasbeen carried forward to the point at which itnow rests ; the public, I think, is much in.debtedtoit for what has been done. As to theproceedings of the Society during the session,I have one thing to say, feeling my own de.linquencies at the same time most fully;I have to regret extremely, that so much dis.appointment has been occasioned in thereading of papers to the Society, (Heur,hear ;) and I do think I am bound to say,though I am one of their number, that theCommittee have not done their duty duringthe present session. Nothing can be mondistressing to the Chairman, than to presideover that which has more the appearance ofbeing a Quaker’s meeting, than of the

meeting of a learned and scientific body. Ido not think it is creditable to the Members.to draw gentlemen here as visitors, with aview to their obtaining information uponmedical subjects, information which theyknow fiom the character of the Society, theycan obtain if the Members choose, and thento suffer them to go away disappointed, asthey repeatedly have done. I am verysorryto be compelled to make remarks, but it isdue to truth that I should do so, and it isan objection which I cannot help making, to .the internal regulation of the Society. Ihave no doubt, however, impressed as I amsure we all are, with the great importanceof the Society, that we shall meet on thenext session, determined to do justice to itsobjects. For myself, I beg to offer you mysincere thanks for the kindness which has

invariably been extended to me in my duties,and the way my deficiencies in presiding ;have been met. If at anv time I have statedmy opinions in too strong a manner, or haveexpressed myself warmly and irritably,lbopeit will be regarded with indulgence, and al-together be forgotten. When we assembleagain, nothing shall prevent me from endea.vouring to do my duty to the Society, and Ipray to God I may be able to perform it, forI am sure that our exertions are likely to befollowed by the greatest possible benefit.

the Parliamentary proceedings on the question of Anatomy ! Why, the Society itselfowes its ]EXISTENCE to the notice it has re-ceived in the pages of this Journal. Takethis fact, Mr. Professor, it is in our powerto PROVE, that previously to the publicationof the reports of the discussions, the meet-ings frequently did not consist of six per..sons! Away, then, with the humbug cantand lies about hostility to the practice ofREPORTING.--ED. L.