Add to each bottle: bicarbonate of soda, ❘ unnecessary to continue or repeat the inha 5 grammes, cork, seal and apply the capsule very quickly. These are the motives which have led me to employ this method. In the first place, I make all my solutions cold, because citrate of magnesia remains longer soluble and unalterable when prepared at a low temperature. Moreover, I avoid using the common simple syrup, because, being cla- | rified with white of egg, it always retains some albumen, which by its natural viscidness assists the tendency which the salt of magnesia has of becoming gelatinous. Finally, to render the lemonade effervescing, I use bicarbonate of soda, because citrate of soda crystallises more clearly than citrate of magnesia, and not having, as the latter salt lation; but if protracted, this state of complete or almost entire insensibility to pain may easily be maintained by even an unpractised assistant. The obvious advantage of this plan (which doubtless has been acted upon by others beside myself) is that of affording a sure and very simple criterion by which to judge of what is a sufficient dose of the anesthetic. The effect is attained without risk, though I admit that patients are sometimes less docile than where the nervous system is more entirely under the influence of the free and prolonged exhibition of chloroform. I have never known it to produce sickness during its inhalation in this moderate quantity, and but rarely even nausea or headache after has, the inconvenience of undergoing mo-wards-a point of no trifling importance, lecular changes, its presence prevents the metamorphosis. I shall conclude with one remark: some practitioners sweeten their lemonade with sugar of gum for the purpose of softening and concealing the excess of acid; but this modification is more injurious than useful, for gum arabic acts on the magnesian salt in the same manner as albumen, and hastens | its decomposition. By following the method which I have just indicated, lemonade of 40 or 50 grainmes may be kept ten or fifteen days without alteration, and those which contain 20 to 40 grammes of citrate of magnesia may be kept for nearly a month. --Journal de Pharmacie. CHLOROFORM IN OPERATIONS. To the Editor of The Lancet. SIR,-As the value of a practical hint depends on the simplicity of its application, I may perhaps be excused for requesting your insertion of a communication which might, except on this ground, appear too trifling and deficient in interest to trouble you with. where the operation is serious. The effect of chloroform on the system appears to be very analogous to, if not absolutely identical with, that of alcoholic drinks taken into the stomach, the intoxication being more transient when produced by the inhalation of the vapor. I believe that we may thus account for the occasional shrinking of patients, and their expressions of suffering under operations, when they afterwards declare that they have experienced no pain. They do feel, probably but slightly, yet forget all about it, as the drunken subject of a severe accident wonders where he is, and what has happened, when he finds himself, on recovering his consciousness, within the walls of an hospital. As an overdose of alcohol is not a desirable introduction to the treatment of a grave accident, so I think we should be specially cautious in the administration of chloroform when about to perform a serious operation. I do not regard the shock which the physical frame sustains from the infliction of pain as, per se, of very material importance; I do not mean to undervalue the boon on this account; but I more highly estimate the moral relief which the antici I have been in the habit of using chloro-pation of undergoing a painless operation form freely, but not indiscriminately, in operations; and have for a long time adopted the following precaution in its exhibition:-Assuming as a general principle that sensation and a conscious exercise of volition are simultaneously suspended, I direct my patient to make some voluntary effort, such as raising his hand, or squeezing that of an assistant-giving him to understand, that directly he ceases to do so at command, the operation will be commenced. The patient readily enters into this arrangement, and never fails of efficiently executing his part. If the operation be brief, it is affords. Patients who have not felt the knife certainly complain more afterwards of the wound inflicted. Probably this is explained by the relative intensity of the suffering, as experienced during and after an operation, by those who have not had chloroform. Mr. Carpenter, house-surgeon to St. Thomas's Hospital, who has been in the habit of superintending the administration of chloroform in our operating theatre, informs me that the indications afforded by the pulse, respiration, and state of the pupil, entirely coincide with the simpler test which I have referred to. Mr. Carpenter adds fect fruits, or that there exist other plants that he considers there is no risk, so long as the pulse and respiration retain their natural relation to each other in point of frequency, even though both be accelerated; but he regards an increasing rapidity of pulse, accompanied by diminished frequency of respiration, as an unequivocal indication that the administration of the chloroform should be immediately suspended. An instrument such as that manufactured by Mr. Bigg, is simple and efficient. It is provided with two India--rubber discs, which act as valves in an opposite direction. The inspired air is thus freely admitted over the moistened sponge by one aperture, and the expired air is expelled by the other. From one to two drachms I have usually found sufficient to effect the required purpose; but this, it is well known, varies extremely in different individuals. In one case under my care, complete insensibility was produced almost instantaneously. The patient was partially under the influence of a very moderate opiate, which perhaps rendered him more susceptible of the agency of the chloroform. If this be so, might not the combination be desirable under some circumstances? I am, Sir, Your obedient servant, F. LE GROS CLARK. Spring-gardens, May, 1852. ON THE GALBANUM PLANT. THE author states, that in his travels in Persia he discovered the plant which yields galbanum. In June, 1848, he found it on the declivities of the Demawend. It is a ferrula, from the stalks of which a liquid issues abundantly, by the odor and nature of which he immediately recognised galbanum, and his guides assured him, moreover, that galbanum is gathered from this plant. The author has not yet distinctly determined the plant. It appears to differ from Ferula erubescens (Annales des Sciences, iii., Sér. 1844, p. 316) only by the absence of commissural vitæ ; but as neither Aucher-Eloy nor Kotschy, who have both collected the Ferula erubescens, make any mention of its yielding galbanum, the author is in doubt whether his plant be the same, or a variety of it. Don's genus Galbanum (Trib. Sibrine) and Lindley's Opaïdia (Trib. Smyrneæ) do not agree with the plant seen by Buhse, unless that both of these authors have made their descriptions from imper which yield galbanum. The plant which Buhse describes is called, in some parts of Persia, Khassuch (not Kasneh, which means Cichor intybus, nor Gäshnis, which is Coriand. sativum), and appears to be confined to certain districts of Persia. In the whole large district of the Elburs-chain, from the south-east angle to the south-west angle of the Caspian Sea, it is only found in the neighbourhood of the Demawend; but here at an elevation of from 4000 to 8000 feet, and even on the declivity of the top of the Demawend. It exists neither on the mountains of Talysch, nor in the districts of Karadagh and Tabris. It is said to re-appear on the Mount Alwend, near Hamadan, and in the neighbourhood of the great salt-desert. Near Hamadan AuchorEloy has gathered his Ferula erubescene, and this supports the supposition that the author's plant is the same. In the saltdesert itself Buhse did not meet with it again. The inhabitants of the Demawend collect the gum-resin, which issues spontaneously from the lower part of the stalk; they do not make incisions in the plant; but it is not at this place that the galbanum is collected for commercial purposes. When fresh, the gum-resin is white like milk, liquid, and somewhat glutinous. In the air, it soon becomes yellow, elastic, and finally solid. The odor is rather strong, unpleasant, and similar to that of our commercial galbanum.-Central Blatt, für 1852, No. xiii., and Pharmaceutical Journal. : PASTE OF PUMPKIN SEEDS IN MORE than thirty years ago, Dr. Mongeney called the attention of physicians to the paste of pumpkin as having uniformly succeeded in expelling tænia in 7 or 8 hours. He mentioned, among others, cases in which all previously-known remedies had failed, and in which the success of this medicament was complete: the paste which he ordered was composed of 90 grammes of fresh pumpkin and 180 grammes of honey. Since then, many physicians have obtained good results from the same means. Dr. Brunet, of Bordeaux, among others, has employed it with success more than thirty times; Dr. Sarramea has likewise succeeded in expelling tænia a great many times by the same process; these physicians employed a paste composed of 45 grammes of the seeds of the large pumpkin (cucurbita maxima) combined with 45 grammes of sugar. another case, a physician attacked with a worm which gave him great inconvenience In took over-night 30 grammes of pumpkin (ON THE PREPARATION OF STRA seeds, pounded with 10 grammes of sugar, and which, having used a simple lavement twelve hours after, caused him to pass 7 metres of tænia. Such facts are of a nature to encourage practitioners to prescribe in all cases of tænia, a medicine which, even if it were not quite so certain in its action as pomegranate root, oil of fern and kousso, should always be tried in the first place on account of its cheapness and certain innocuity.-Journal de Medicine de Bordeaux. ON GAMBIR. BY BERTHOLD SEEMANN. BLACK pepper (Piper nigrum, Linn.) and Gambir (Uncaria Gambir, Roxb.) are grown in great quantities (in Singapore), and exclusively by the Chinese, these articles are so exceedingly cheap that Europeans have not deemed it worth their while to engage in the speculation. Pepper and gambir plantations are always combined, because the refuse of the gambir leaves serve as an excellent manure for the pepper; and moreover, what is of equal, if not of still greater importance, kills the lalang (Andropogon caricosus, Linn.), a plant which, like the couch-grass (Triticum repens, Linn.), spreads with astonishing rapidity over the fields, growing so close together and so high, that within a short space of time valuable plantations are rendered useless, and many have to be given up from the utter impossibility of freeing the ground from this weed. The process by which gambir is extracted and prepared is simple. The leaves are boiled in water until all their astingent pro perty is extracted. The decoction is then poured into another vessel, in which it becomes inspissated, and, when nearly dry, is cut in small square pieces, and thus brought into the market. M'Cullock states that sago is used in thickening it. This, however, at least in Singapore, is not the case; but, instead of sago, a piece of wood is dipped into the vessel, by which the desired effect is produced. It must, indeed, be an extraordinary substance, the mere dipping of which into the fluid can cause it to become a thickened mass. I was very eager to obtain a piece of this wood: unluckily, the Chinaman, whose laboratory I visited, could not be persuaded to part with his, and a friend of mine, who was exerting himself to procure a sample, had not succeeded at the time of the Herald's departure: he promised, however, to send it to England, ac MONIUM OINTMENT. THE powerful narcotic and sedative properties of the Datura stramonium, added to the fact of its luxuriant growth in the vacant grounds of the inhabited districts of the United States, has made its use popular with most of our practising physicians. Besides its use smoked as tobacco in asthmatic cases, its properties, analogous to those of hyosciamus and belladonna, have enabled practitioners to use with success for producing dilatation of the pupil and in anodyne fomentations. In fact, the consequence of its demonstrated efficient activity as a remedial agent, has prompted its adop tion in the United States Pharmacopeia, where the leaves and seeds are recognised, and the tincture, extract, and ointment are officinal. According to our Pharmacopœia, last edition, to prepare the ointment, one drachm of the extract of stramo nium is mixed to the proportion of one ounce of lard. Such a mixture, though possibly as effectual as need be, lacks the green color and homogeneity to which both patients and physicians have been accustomed. To remedy these objections, I have found the following process to give a good preparation both in quality and appearance. I am inclined to think that the objections which have been made to the former offi cinal ointment are chiefly ascribable to the difficulty of obtaining readily an ointment which would keep one year, that is free from water of vegetation or not impaired by a too protracted ebullition, and consequent de composition, which deprives it of its properties, spoiling its appearance, and giving it an unpleasant pyrogenous odor, which shows the extent of the alteration it has un dergone, making of it an irritating rather than a soothing unguent. In the process I now submit to the opinion of the profession, I had in view, 1st. To obtain at all seasons an ointment fulfilling the reasonable expectations of practitioners; 2nd. Which could be easily prepared by competent pharmaceutists throughout the United States. It is as follows: Stramonium leaves.. half a pound. Alcohol at 95°......a sufficient quantity. Prepared lard......fourteen ounces. Moisten the leaves, previously reduced to a coarse powder, with sufficient alcohol, in a tight vessel having a suitable cover; melt the lard in a pan three times in capacity to companied by the Malayan name, and spe- the bulk of the lard, and stir in it gradually cimens of the tree.-Hooker's Journal of Botany. the prepared stramonium; keep the mix- / more loosely packed, do not yield so fully ture in a warm place for five hours, stirring or so readily. The addition of torrefied occasionally, till the alcohol has disappeared | dandelion root is intended to give to this from the ointment, which may be ascer- fluid extract some greater value on account demics was furnished, by which it appeared that the disease literally decimated the black troops, while not a single death occurred among the European soldiers serving in the same garrisons. The author observed, that tained by placing a lighted match on the surface of the warm ointment just stirred. Filter the mixture through flannel, in an appropriate vessel. The stramonium ointment thus prepared is a reliable preparation, possessed of a handsome green color, a rather pleasant herbaceous odor, and forms a homogeneous mass containing all the valuable constituents of the Datura stramonium, if the leaves have been gathered while the plant is in bud, and properly preserved. For the warm days of summer the substitution of two ounces of beeswax for the same quantity of lard gives it the consistence which it has at the low temperature of the remaining seasons.--New York Journalof Pharmacy, January, 1852. Mix the dry plants, previously reduced to a coarse powder, with the water holding the alkaline carbonate in solution: let the mixture stand twelve hours; introduce it in a percolator, and gradually pour in water until a gallon of liquid shall have passed; evaporate it to twenty ounces by means of a water bath, then add the sugar, filter, and make the addition of the alcoholic solution of gaultheria when cold. By following this process, I believe that a kind of saponification takes place, which allows of the more ready solution of the active principle of the senna in the aqueous vehicle, probably because chlorophylle being united to a dried essential oil, participating in the properties of resins, is rendered soluble, and the extractive portion being denuded of its resinoid covering, is more readily extracted by the percolating liquid. I make use of a percolator possessed of a convenient hydraulic power, it has rendered readily, within thirty hours, a highly saturated liquid, containing in a gallon all the soluble principles of this extract. Ordinary percolators will answer also; but the ingredients needing to be of its peculiar action on the hepatic system. I employ in preference the German chamomile (Camomila vulgaris*), because of its pleasant aroma and its carminative properties, joined to a bitter principle, which seems to increase the purgative effect of the senna. This extract has become a favorite antibilious purgative with many of our practitioners, who, some of them at least, have used it with success with children, who can take it readily, as well as for adults, where an antibilious purgative is desirable, seldom producing pain or nausea, and not liable to induce constipation. -New York Journal of Pharmacy, January, 1852. ON THE PROTECTION AGAINST SMALL-POX AFFORDED BY VACCINATION, ILLUSTRATED BY THE RETURNS OF THE ARMY, NAVY, AND THE ROYAL MILITARY ASYLUM. BY T. GRAHAM BALFOUR, M.D., SURGEON TO THE ROYAL MILITARY ASYLUM. ONE of the principal difficulties in the investigation of this subject, the author thought, arose from the impossibility of ascertaining what proportion of the general population was unprotected by vaccination. Accurate deductions could, however, be founded on the returns of the army, navy, and Royal Military Asylum. Although the returns of the first department did not show the actual number of soldiers who had been vaccinated or had the small-pox, yet a tolerably accurate approximation might be obtained. From returns forwarded to the Army Medical Board, it appeared that out of 90,092 recruits medically inspected and found fit for service, 20,132 bore marks of small-pox, 64,096 had marks of vaccination, and 5,864 bore no distinct traces of either. By the rules of the service, the latter would be immediately vaccinated; added to the second class, a total of 69,960, or 78 per cent. of the whole, would be protected by vaccination; 22 per cent. representing the proportion of those protected by previous smallpox. The question next arising was, what number of admissions into hospitals and deaths by small-pox had occurred in this number. Abstract No. 1 in the Appendix furnished this information, and it showed the proportion of cases of small-pox to have been 66, and the deaths 8, in every 100,000 Matricaria. men serving throughout the army. But the prevalence and mortality varied in different portions of the force. Thus, the deaths had been four times as numerous among the troops in the United Kingdom as in temperate colonies, and eight times as numerous if the hypothesis be correct, that the pro as in tropical colonies; while a still greater tective power of vaccination became gradudisproportion was found to exist in the ad- ally weaker, and at length died out, the missions into hospital. A comparative mortality from small-pox should be greatstatement of the proportion of small-pox est among the old soldiers. The following among the black troops and Europeans ser- return illustrated this point: ving in tropical colonies during several epi Returns from the navy exhibited the same vaccination, he thought such a course most satisfactory evidence of the protective power | unjustifiable. Absolute immunity from small-pox was not to be expected, but the foregoing returns showed the great exemption obtained by vaccination. Vaccination should be made compulsory. It had been said that this would interfere too much with the liberty of the subject; but so to a certain extent did all measures relating to the public health. The prejudices of the few must be made to give way before the interests and safety of the many. In Factory Acts, parliament recognised the principle of protecting the young against an amount of labour calculated to be injurious, and this in spite, not of the prejudices, but of the socalled rights of parents; and it would be but an extension of this humane principle to make vaccination compulsory, and thus afford protection against a malady of so fatal a character as small-pox. of vaccination. The vaccination register of the Royal Military Asylum had been kept with great care, and reliable evidence could be obtained from it. During a period of 48 years, 31,705 represented the aggregate strength of the boys, and among these only 39 cases of small-pox occurred, of whom 1 died. It must be borne in inind that every child bore marks of cow-pox or sinall-pox or had been subsequently vaccinated so that, in a population completely protected, the average was but 123 cases, and the deaths but 12, in every 100,000, being a still lower ratio than in the army serving in the United Kingdom. Another return displayed the comparative amount of protection afforded by vaccination and previous small-pox. The ratio of cases per 1000 of the latter was 6.15, and the deaths 2.05 while of those previously vaccinated, the ratio of cases was 7.06, and the deaths 0. All the deaths were thus from secondary small-pox. The author thought the preceding facts afforded the most conclusive evidence of the protective value of vaccination, while the extensive numbers, and the period of time over which the observations extended, justified a very firm reliance on such evidence. He thought this evidence had an important bearing on the proposition recently made to legalize inoculation. While so large a proportion of chloride of sodium from the urine in of the community remained unprotected by pneumonia, and who, in 1850, had pub ON THE DIMINUTION OF THE CHLO RIDES IN THE URINE, OR THEIR AB- BY LIONEL SMITH BEALE, M.B. Lond. |