means known, that it is labour implying a very considerable exertion of intellect. The construction of an index like the present requires not only infinite labour, but much attention to method and arrangement, to scientific distinction and classification, and, in short, the exertion of mental faculties of an elevated order. All this Dr Hennen has accomplished with great ability. If it were true that the construction of such an index could be accomplished by a person of less extensive knowledge, less accurate and philosophical mind, and inferior attainments, the present work only proves that greater merit is due to Dr Hennen for the performance of a task so serviceable to others, and one which renders the treasures of a voluminous publication so accessible to the reading portion of the profession.

ART. III.-1. The Elements of Materia Medica and Therapeutics. By JONATHAN PEREIRA, M.D., F.R.S. et L.S., Fellow of the R. College of Physicians, London; V. P. of the R. Medico-Chirurgical Society, &c.; Examiner in Materia Medica and Pharmacy to the University of London; and Assistant Physician to, and Lecturer on Materia Medica at the London Hospital. Third edition, enlarged and improved, including Notices of most of the Medicinal Substances in use in the Civilized World, and forming an Encyclopædia of Materia Medica. Vol. i. London, 1849. 8vo. Pp. 978; and Vol. ii. Part i. London, 1850. 8vo. Pp. 899-1538. 2. Medicines, their Uses and Modes of Administration; including a Complete Conspectus of the three British Pharmacopœias, an Account of all the New Remedies, and an Appendix of Formula. By J. MOORE NELIGAN, M.D., Edin., M.R.I.A., Licentiate of the College of Physicians of Ireland, Physician to Jervis Street Hospital, Lecturer on the Practice of Medicine, formerly Lecturer on Materia Medica and Therapeutics in the Dublin School of Medicine, &c. Third Edition. 1851. 8vo. Pp. 555.

3. The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, M.D.CCC.L. Dublin, 1850. 8vo. Pp. 191. 4. Pharmacopæia Nosocomii in curam Morborum Cutaneorum Fundati, A. D. M.D. CCC. XLI. Londini, 1850. 32mo. Pp. 48.

5. Pharmacopaia ad usum Nosocomii Phthisicorum et Pectoris

Morbis Agrotantium Accommodati. Editio Secunda. Londini, M.D.CCC.LI. 12mo. Pp. 42.

IN the fifty-first and fifty-fifth volumes of this Journal was given an account of the Elements of Materia Medica, by Dr Jonathan Pereira, as the work appeared in the first edition, published in 1839 and 1840.*

In the two articles then devoted to the work, we entered into some detail as to the nature of the work, and the manner in which Dr Pereira had treated his subject. Our limited space permits us not to go over the same ground again; and it must be acknowledged, that while such an account is less necessary, it becomes, in the present instance, more difficult. We propose merely to advert, in a general manner, to the leading characteristics of the present edition, which is the third.

The work is very much enlarged, as may be understood from the fact, that the first volume, and the first part of the second, extend to 1538 pages. The second and concluding part of the

second volume has not hitherto made its appearance.

It is impossible also to doubt that the work is improved, so far as the amplitude and accuracy of the information go. In condensation it can scarcely be said to be rendered more acceptable to readers and consultants. Any change, indeed, in this respect, cannot be expected, considering the object and intention of Dr Pereira, which is to provide physicians and surgeons with a complete digest of all the therapeutic and remedial agents employed in the cure of disease, and the alleviation of its symptoms and effects. This purpose has induced him to extend and enlarge a plan, not by any means limited; and the result is, that the work, in its present shape, and so far as can be judged from the portion before the public, forms the most comprehensive and complete treatise on Materia Medica extant in th English language.

Dr Pereira has been at great pains to introduce into his work, not only all the information on the natural, chemical, and commercial history of medicines, which might be serviceable to the physician and surgeon, but whatever might enable his readers to understand thoroughly the mode of preparing and manufacturing various articles employed either for preparing medicines, or for certain purposes in the arts connected with Materia Medica and the practice of Medicine.

The accounts of the physiological and therapeutic effects of remedies are given with great clearness and accuracy, and in a manner calculated to interest as well as instruct the reader. Dr Pereira, while he is desirous to give due weight to the testi

* Edinburgh Medical and Surgical Journal, Vol li. p. 487. Edinburgh, 1839; and Vol. Iv. p. 219. Edinburgh, 1841.

mony of different authorities in determining the therapeutic merits of different agents, exercises great judgment in pronouncing his final conclusions. This part of Materia Medica and Therapeutics is one of the inost difficult to deal with properly; for, while one order of practitioners commend certain agents in strong and decided language, and represent them to be remedies which never fail, others are not less decided in rejecting all testimony, and exercising a degree of doubt bordering upon skepticism and total disbelief. It would be unjust to say, that in such circumstances truth lies in the medium, as has been often done. Truth often does not lie in the medium, in the case of statements regarding medicinal remedies and therapeutic agents. The only mode of finding what is truth, and where truth lies, under such circumstances, is, after comparing the testimony of the most trustworthy witnesses, to determine what evidence is furnished by correct experiments and observations. This Dr Pereira has in general attempted to accomplish; and, if he have not in all cases succeeded, he has made at least as near an approach to the object as under the circumstances can be expected.

Many examples of this careful and delicate mode of balancing conflicting evidence the reader will find in the present volumes.

The limits within which these observations must be confined permit us not to adduce examples of this; but we may refer in general to the descriptions which Dr Pereira has given of the physiological and therapeutic effects of such agents as lead, mercury, arsenic, opium, colchicum, strychnia, and similar articles.

The description of the method of employing the sulphuretted bath as an antidote against the poison of lead is given in the following manner.

"This bath is prepared by dissolving four drachms of sulphuret of potassium in thirty gallons of water (Rayer.) For some purposes a small proportion of sulphuret (as two drachms) will be sufficient. It should be prepared in a wooden bathing vessel.-Used in obstinate skin diseases, as lepra and scabies. If an acid be added to this bath, sulphur is precipitated and sulphuretted hydrogen evolved. Care must be taken lest asphyxia be produced by the inhalation of the latter. This bath is an important and valuable agent in the treatment of saturnine poisoning, especially lead colic, saturnine arthralgia, and paralysis from lead. It renders brown or black and destroys the poisonous qualities of any portions of lead contained on the skin, and thereby prevents the further absorption of the poison. The hands, arms, buttocks, and other parts of the body of painters and workmen in white lead manufactories are sometimes completely blackened by it: but the blackness is readily removed by a brush. The hair follicles frequently contain plumbeous particles, and are in consequence blackened by the bath. The benefit obtained by the use of the sulphuretted bath does not appear to me merely of a pre

ventive nature; but the great relief from already existing symptoms which patients usually obtain by the use of this bath induces me to believe that the sulphuret becomes absorbed and acts in the system as a counterpoison, rendering inert the lead which has already been taken up."-Pp. 482, 483.

"The brown or black incrustation of sulphuret of lead is to be removed, while the patient is in the bath, by the use of a good stiff flesh brush and soap and water. The patient should be then redipped in the sulphuretted bath, and the scrubbing process again resorted to. These proceedings should be continued until the skin no longer becomes discoloured by the sulphuretted bath. In this way the lead deposited on the skin is rendered insoluble and inert, and its absorption prevented. In a few days it will be found that the sulphuretted bath will again give rise to the dark incrustation,— a fact which proves that either the lead is excreted by the skin, or that a portion of the lead had before escaped the action of the sulphuretted solution. These baths, therefore, should be repeated every few days for several weeks,-until, in fact, their use is unattended with discoloration of skin. By these means, relapses of the malady, arising from the absorption of this metal from the cutaneous surface, are prevented.

"The internal antidotal treatment consists in the use of water acidulated with sulphuric acid (sulphuric lemonade), or of solutions of the soluble alkaline and earthy sulphates (sulphates of soda or magnesia, or alum). Mr Benson used with great benefit, as a preventive for the workers in lead, treacle beer acidulated with sulphuric acid; the formula for which is as follows:

66

Treacle, fifteen pounds; bruised ginger, half a pound; water, twelve gallons; yeast, one quart; bicarbonate of soda, an ounce and a half; oil of vitriol, an ounce and a half by weight. Boil the ginger in two gallons of water, add the treacle and the remainder of the water (hot), put the whole in a barrel, and add the yeast. When the fermentation is nearly over, add the oil of vitriol, previously mixed with eight times its weight of water: lastly, the soda dissolved in one quart of water. It is fit for use in three or four days. The soda gives briskness, and, saturating one half of the acid, forms sulphate of soda."-P. 732.

The following example of gangrenous inflammation of the mouth and cheek, bore, in its symptoms and phenomena, so close a resemblance to the irritant and phagedenic effects of mercurial poisoning, that it was at first regarded as proceeding from that cause.

"A man affected with rheumatism sent to a surgeon for advice, who, without seeing him, prescribed some pills, one of which was to be taken thrice daily. At the end of the week, his rheumatism not being relieved, he sent his wife again to the surgeon, who ordered the pills to be repeated. Another week elapsed, when the patient requested Mr W. H. Coward, surgeon, of the New North Road, Hoxton, to see him; to whom I am indebted for part of the parti

culars of this case. Mr Coward found his patient with the following symptoms: fever, great prostration of strength, sore throat, rheumatic pains in the wrists, profuse ptyalism, more than a pint of saliva being discharged per hour, with the breath having the 'mercurial' odour; and on the inner surface of the right cheek a foul ulcer. He ascribed his present condition to the pills, as he had no sore mouth until after taking them. On cutting one of the pills, it was observed to have a light-brown colour, and the odour of opium: hence it was supposed that they were composed of calomel and opium. Purgatives, tonics, and gargles of chloride of soda, were used without avail; and, after some days, Mr Coward requested me to see the patient. I found him in the following condition: right side of the face swollen and slightly red; gums swollen, red, and ulcerated; breath horribly offensive, its odour not distinguishable from that called mercurial. On the inner side of the cheek, near the orifice of the parotid duct, there was a slough about the size of a sixpenny piece; salivation most profuse,-in fact the saliva flowed in a continued stream from his mouth; over the body were observed a few petechia. Notwithstanding the means employed, the man became worse, the sloughing gradually increased until the whole of the right cheek became involved, and in about a week from my first visiting him he died.

"A day or two before his death, I ascertained from the surgeon who had prescribed the pills that they contained Dover's powder, and not an atom of any mercurial preparation."-Pp. 816, 817.

A better season for any details of this deseription will arrive when the concluding part of the work is published.

In the sixty-third volume of this Journal, April 1845, was given an account of the first edition of the work of Dr J. Moore Neligan, which was published in 1844.* A sufficiently full account of the arrangement and method employed by the author was at the same time given. A second edition of the work was published in Jannary 1847; and the present is the third.

In the course of these transitions the author has evidently improved his work, and makes it a most serviceable Treatise on the present state of Materia Medica, Pharmacy, and Therapeutics.

In speaking of some remedial agents, Dr Neligan shows his judgment by modifying the commendations with which he introduced some remedies. For instance, he expresses himself in terms greatly less confident of the remedial properties of Monesia, an article which was manifestly praised much beyond its real merits.

The account given of the therapeutic powers and curative properties of pyroxylic spirit, an agent which has been introduced into the last edition of the Dublin Pharmacopoeia, is moderate, judicious, and, according to our own observation, correct.

Edinburgh Medical and Surgical Journal, Vol. Ixiii. p. 454.