amounts to the same thing, of the nux vomica, we cannot refrain from alluding to one which, in view of the strength and unmanageable nature of the agent, should be represented to the too credulous public in the way of a caution. There are those who by the neces sity of their position and avocations, cannot have that knowledge of it, and familiarity with this and other giants of the Materia Medica, which fit them for advising or regulating their use. Still very many, in every community, are willing to take from such unskilled persons, compounds. containing unknown amounts of strychnia, &c., &c. Thus we have soidisant or retired clergymen advertising that they will furnish a prescription for a preparation containing the active principle of St. Ignatius's bean, and the direction for using the same. All such tamperers with human strength and life are accountable to a higher tribunal than any earthly one, and those who aid and abet them must bear them company thither. It being quite sure that the adoption of these quack remedies by the people, only brings the honest physician more patients, we shall not be accused of covetousness in protesting against them. We do not aspire to coerce people, even by argument and the exposition of the bold and unwarrantable assumption that seeks to medicate-or rather to poison them-they are free agents, but certainly in no other affairs do they act so inadvisedly or expose precious interest so recklessly as in the care (as they understand it) of their health.

"The proper uses of strychnia, as of all medicinal agents, are only thoroughly known by the educated physician. Why does any one desire or dare-having the manifest peril in view which its improper employment implies-to intrust its administration to the unfamiliar the adventurer-or still worse, if possible, to their own judgment?

"And we commend to legislative consideration the dangers constantly attendant upon the unrestricted sale of medicinal articles, a fractional part of a grain of which sometimes takes life more quickly than the knife or the bullet. The facility of procuring such materials, arms the unprofessional murderer quite as surely, if less covertly, than it does a PALMER."-[Boston Med. and Surg. Jour.

On Secondary Eruption following Vaccination.

Mr. Ross lately read a paper on this subject before the Medical Society of London, in which he contends that the secondary eruption is a legitimate result of the true vaccine disease, and that a marked peculiarity of this as a constitutional disease is a tendency to periodicity.

After some general observations on the obscurity of the subject, the author said: "The propositions which I shall endeavor to establish are 1st. That there are various forms of eruptive disease consecutive to and caused by vaccination; 2d. That these eruptions appear at different periods, and are subordinate to the specific laws

of the vaccinous disease; 3d. That these eruptions are not prejudicial to the person vaccinated, but are rather evidences of the complete impregnation of the system, and of the protective efficacy of the act of vaccination. Notwithstanding the assertions by some authors that vaccination does not cause consecutive disease, the occurrence of such disease has been frequently noticed by medical practitioners; and even its varieties have been designated. Most works on diseases of the skin have some reference to such affections. There is not, however, any methodical analysis on record of such maladies, and they have been regarded rather as unimportant casualties than as legitimate sequences of vacination. The desire, probably, thoroughly to establish vaccination in the confidence of the public has insensibly led to a depreciation of the after-symptoms, whereas it would have been more philosophical to examine the facts themselves, and to trace their actual connection, if any, with the original disease. There need be no fear that the great value of Jenner's immortal discovery will be impaired by an accurate acquaintance with all its phenomena. The whole number of secondary eruptions noticed by me during the period whilst I was conducting these inquiries was nineteen, and of these the specific character was recorded in eleven; the others were adverted to in general terms as 'secondary eruption;' but I believe that the greater number, or the whole of them, were of the vesicular type. Of these eleven, one was a transient exanthem, three were papular, and seven vesicular. In three other cases an eruption appeared at the end of about three weeks, but whether these cases were attributable to vaccination or not, the evidence is not decisive. The vesicular eruptions varied much in character, sometimes being as small as millet-seeds, and few in number; at other times as large as a crownpiece, and looking as if one vesicle was comprised within the circle of another. The size of the eruption was frequently that of the cow-pox at the eighth day, which, indeed it very much resembled. being a vesicle with a small central depression and circumferential redness. These eruptions were always preceded by fever, which was proportioned in degree to the number of vesicles thrown out. This fact proves the constitutional character of the affection. this point I may remark that I have several times seen patients suffering from pyrexia and general malaise on the day when in other cases an eruption has usually appeared; but of these I have taken no account. The pyrexia, however, has convinced my mind, that the activity of the virus does not always cease with the drying-up of the pock. Even after the local action has disappeared, there are periodical changes going on in the constitution, which are, according to circumstances, of greater or less energy, and which are manifested by fever and secondary eruptions. The most important point connected with these secondary affections is their periodicity. In some of the cases the eruption appeared on the tenth day from the day of vaccination; in others on the fifteenth day; whilst, in

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one case, the eruption was thrown out on the tenth day, it continued for a few days, then disappeared, and was observed again on the fifteenth day. In other instances the eruption appeared both on the fifteenth and twentieth days, or thereabouts. These cases further show the periodicity of the affection, and seem to reconcile the discrepancies between the cases that occurred on the tenth and fifteenth days respectively."

A discussion of some length took place, in which several fellows of the Society joined. The chief point discussed referred to the question whether the secondary eruption was the direct result of the vaccination or merely the consequence of the irritaton produced in the system by the introduction of a foreign matter. It was general. ly considered that the secondary eruption was the result of simple irritation produced in the system by the vaccine virus, and that any other source of irritation might have been followed by the same results; that, in fact, the eruption was due to the developement of the same latent disposition in the system to the eruptive disease which manifested itself. None of the speakers had been enabled from observation to connect the eruption with any periodicity in its appear

ance.

Mr. Ross, in reply, stated that the whole gist of his paper depended on this periodicity, of which he was certain, and without which his paper advanced nothing new. He thought the subject open to investigation, and upon that point was worthy of the serious consideration of the Society.-[Lancet.

Arsenic as a Caustic.

In our preceding No. (p. 97.) we had occasion to comment on the danger of the external application of arsenic. The following remarks from a recent paper (Med. Times and Gaz., Jan. 17th 1857) by Prof. SIMPSON, strongly confirm the correctness of our caution.

"Arsenic.-The escharotic effects of arsenical preparations, when locally applied, were known to the ancients, and are alluded to by Dioscorides, Pliny, Celsus, and others. Arsenic is recommended in the form of sulphuret, as a topical remedy in the cure of malignant and recurrent ulcers by various old Greek and Roman physicians, as Galen, Ætius, Scribonius, Largus, etc. In the 15th and 16th centuries it was employed by Fuchs, Valescus, Fernel, and others in the elimination of cancerous parts. They applied it in the form of white arsenic or arsenious acid, diluted and mixed with soot and various vegetable and other powders. In later times it has been used under the same form by many distinguished surgeons in the extirpation of cancerous ulcers and structures. It has formed the basis, also, of most of the secret topical remedies or caustics for the cure of cancers that have at different times been in vogue; as for example, those of Müller, Martin, Von Campen, Chonet, Katzenber

gen, Plunkett, Guy, etc. The form in which arsenic has chiefly been employed in later times as an escharotic is an arsenious acid; and the caustic powder or paste employed has usually consisted of a small percentage of this preparation, compounded and diluted with various other materials. The celebrated anti-cancerous caustics of Frè Côme, Rousselot, Justamond, Hellmund, Heyfelder, Anthony Dubois, etc., severally consists of white arsenic, mixed up with cinnabar, dragon's blood, or the resin of the Pterocarpus draco, charcoal, etc., and made, before their application, into a paste or pomade with water, saliva, mucilage, or white of egg. Dupuytren's arsenical powder consisted of from one to five or six parts of arsenious acid, mixed with a hundred parts of calomel. The caustic of M. Manec, which is extensively employed in France at the present day, is formed of one part of arsenious acid, seven or eight parts of cinna bar, and four parts of burnt sponge, formed into a paste with a few drops of water.

"One disadvantage connected with the topical use of arsenic as a caustic is the great amount and duration of local pain and irritation which it often produces. M. Lebert, who has had repeated occasion, as he tells us, to witness and watch the successful employment of Manec's arsenical paste by M. Manec himself, and who believes this caustic to be the best yet suggested, nevertheless states, that when used as an escharotic the immediate action of arsenic is 'one of the most painful means in surgery. Already,' says he, at the end of some hours violent pains commenced in and all around the part, tumefaction at first, and subsequently an erysipelatous-like inflammation speedily succeeded the pains, and it is only towards the end of five, six, or eight days that this general and extensive inflammation begins to diminish. During all this time,' he adds, the sufferings are sufficiently great to deprive some patients of all rest and sleep, and ten or fifteen days may elapse before these complications disappear.'-Traité Pratique des Maladies Cancereuses, page 646.

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But a still graver objection exists to the use of arsenic as a, caustic, viz., the danger of its absorption into the system, and of its subsequent action as a poison upon the patient, particularly when, as an escharotic, it is applied either too frequently or too freely to a surface of any considerable extent. Besides, there is singular uncertainty in the effects of arsenic when thus locally applied. A patient of Professor Roux's was fatally poisoned by the application, for a single night, of an arsenical paste containing four per cent. only of arsenic, to a small mammary ulcer only one and a half inch in diameter. Numerous instances have been observed in which vomiting, diarrhea, colic, and other symptoms of arsenical poisoning have followed the external application of arsenical preparations. 'Its use,' says Dr. Pereira, 'is always attended with some danger.' Sometimes the patient has, like Roux's, died after its topical application as a caustic; and with all the symptoms that followed the internal administration of the poison. Medical literature has on record

a large number of such fatal cases. In speaking of the occasional danger attendant upon the local external use of arsenic as an escha rotic in cancer, Sir Benjamin Brodie observes, An old medical practitioner, whom I knew in the early part of my professional life, informed me, that it had fallen to his lot to see many of Miss Plunkett's patients, and that after the application of her caustics, many of them died, from what seemed to be inflammation of the bowels.' -[Lectures on Various Subjects in Pathology and Surgery, page 335." Amer. Jour. of Med. Science.

Tubercular Phthisis. By R. E. HAUGHTON, M. D., of Richmond, Indiana.

I now offer for your Journal the views which I have formed after a careful study and analysis of many cases of Tubercular Phthisis, under the following head: The primary pathological conditions of the system which finally terminate in scrofula and tuberculosis. These forms of disease are prevalent to a great and alarming extent in our country, and among our people, and the effort to obtain the primary and exact pathological conditions, and upon such a basis to erect a standard of treatment which will be successful in arresting their progress, and effecting a cure of those maladies, will be regarded as a benefaction to the race. Not that I hope to be able to do so, but to offer my mite to be cast into the great field of pathological inquiry, and to be rejected as error, or gathered up as important truths.

The first stage of phthisis is commonly said to be that in which the physical signs indicate a morbid deposite in the lung. But we must go back in our investigations to an earlier period, when there are undeniable evidences, and this long before the most experienced observer can detect the sounds which indicate an increasing solidity of structure in the lung. There is, prior to this, a peculiar antecedent state of the general system, which acts as a causative agent, originating the altered and pathological state of the blood, and which not only acts as a predisposing cause of tubercular deposits, but elaborates and prepares the material ere it enters and becomes part and parcel of the blood, from which tubercle is to be formed, and deposited in the lung. And here let me say to your readers, to this part of my subject I ask your careful attention, and your more careful and future study. When we go back and investigate the primary conditions of the system, we shall find not only the real and pathological causes of the disease, but in it a hopeful period of treatment, the very period in which we may arrest the most fatal of all the diseases which afflict fallen humanity. It has always been my belief that if we wait till a half organized cacoplastic deposit is made in the lung,