Much improved and extended. The Medical Formulary, being
a collection of prescriptions derived from the writings and practice
of many of the most eminent physicians in America and Europe ;
to which is added an Appendix, containing the usual dietetic pre-
parations and antidotes for poisons: the whole accompanied with
a few brief pharmaceutical and medical observations. By Ben-
jamin Ellis, M. D., Late Professor of Materia Medica and Phar-
macy in the Philadelphia College of Pharmacy. Morbos autem
non eloquentia sed remediis curari.—Cels, de med. lib. i. Ninth
edition, corrected and extended by Samuel George Morton,
M. D. 8vo. pp. 267. Philadelphia, 1849.
Were we to form a judgment of the relative extent of the two
works before us by the length of the titles, we should be led into
a grievous error; for there is no topic treated of in the latter,
which is not contained in the former; whilst in the selection that
has been made of the materials, more judgment has been displayed
by Dr. Griffith; and there is a copiousness in his work, which
we may look for in vain in his more showy companion and prede-
cessor. In his motto “ selecta sunt quce medicum nobilitant,”
from Linnaeus, there is contained a truth too much overlooked,
especially by those who are perpetually straining after originality,
and are never satisfied unless novel assertions, and startling pro-
positions, are brought forward. How much of our most instructive
medical literature consists of the “ selecta” judiciously made, and
attractively presented I In a combination of art and science,
which has existed from primeval periods; which is founded on an
accumulation of observations and deductions—many carefully,
others carelessly made by observers and reasoners in all ages—
it is as arrogant as it would be impossible for any writer
to attempt to form the science de novo; and to discard all
that had been done by distinguished predecessors and con-
temporaries. To attempt, for example, to compose an origi-
nal practice of medicine or an original treatise on the materia
medica would be an absurdity. If it were new, it could not
be a true exponent of the existing condition of a progressive
science ; whilst it would be a monument of the folly and presump-
tion of its author. Hence it is, that the most valuable works of
science, at the present day, are such as have brought together the
“ seZecZa” from the recorded observations and reflections of all
periods. The mass requires to be sifted ; the valuable ore to be
separated, and the dross to be rejected ;' and no little skill and
judgment is required on the part of him who undertakes the task.
The composer of a formulary belongs to the class of industrious
laborers who are esteemed to be engaged in facilitating the on-
ward progess of the science or rather of the art of medicine ; and
much of their success must depend upon the mode in which their
“ selecta” are made. We have had strong doubts, however,
whether as much benefit has resulted from such works as their
zealous authors may have imagined. The fact of one of those
before us having passed through eight editions is sufficient evidence
that they are popular—not on the principle, doubtless, embraced in
the motto prefixed to it—“ Morbos autem non eloquentid sed
remediis curari”—for by most persons this would be considered a
truism ; but because they spare the prescriber the trouble of think-
ing. He sees a formula composed for a special malady, and em-
ployed by some eminent practitioner—if not eminent in reality,
eminent by courtesy—adopts it unhesitatingly; learns to swear in
verba magistri, and becomes gradually, if not at once, a mere
routinist.
We apprehend, that this evil result from formularies is more
common than it may seem to be at first sight. There is, in the
young practitioner more especially, too great a degree of confi-
dence in the power of medicine,—in the special adaptation of
drugs to special morbid conditions : he fancies that he can cure
diseases in many cases where his endeavors are impotent, and
his interference meddlesome, and perhaps injurious; and he is apt
to become the creature of combinations ; and to be a drag on the
onward course of his profession: for if there be any thing that more
than another weighs on the progress of the science and art of
medicine—is fatal indeed to its advancement—it is undue confi-
dence in remedial agents ; and defective acquaintance with thera-
peutical principles. We did not, indeed, require the pages of the
works before us to demonstrate how few physicians there are who
belong to the viri prudentes of Gaubius. “ Medicus vir prudens
nihil prescribat nisi cujus suficientem queat reddere rationem
quum requiritur: hinc nunquam tumultuario, sed semper ex
indications prius rite deduct® agat”
The “Formulary of Ellis” has been so long before the public,
that we need not - attract attention to it much farther than by
stating, that the editor in preparing the present edition “has been
at great pains to render the work in all respects deserving of
continued professional confidence. The utmost care has been
bestowed in correcting and extending its several parts, omitting
some formulae and inserting others, and bringing the whole up to
the present state of pharmaceutical knowledge.” Yet we think
the pruning knife might have been employed more extensively,
and without detriment to the work. It would be difficult, indeed, to
comprehend the“ principles” of combination which have prevailed
in the throwing together—we know no better expression—of the
heterogeneous assemblage of ingredients in some of the formulae.
As one of the unnecessary preparations we may cite the following:
Enema with Tartrate of Antimony.
J&. Antimonii et potassae tartratis, 9j to gij,
Solutionis acaciae tepidae, Oj.	Misce.
This preparation is stated to be “ one admirably calculated to
overcome constipation which resists the ordinary remedies.” We
have sundry objections, however, to it. In the first place, the
title is defective. It should be “ Enema with tartrate of anti-
mony and potassa ;” in the second, in a Latin formula gj. to 9ij.
ought to be9j. ad B ij-; and in the third, Solutionis acacia tepida
conveys no definite idea to the young prescriber or to any one. We
presume it means “ tepid solution of acacia or gum arabic :” but,
as to the strength, we are left wholly in the dark; admitting,
however, the formula to be accurate in language, and intelligible
in enunciation, it surely cannot be regarded as worthy of a dis-
tinct place in a formulary;—yet it is in that of Dr. Griffith also.
As an instance of heterogeneous combination—-farrago would
be too harsh a term for it—we may give the following ‘expectorant’
mixture:—
“ Tincturse tolutani,	f.giss.
Acidi sulphurici aromatici. f.3ss.
Tincturae digitalis,	f.3j.
Vini antimonii,	f.3ij.
Meilis despumati,	f.giss.
Pulveris glycyrrhizae,	3ss.
Aquae distillatm,	f. syj.
Fiat mistura.”
In this formula we have one excitant expectorant—tincture of
tolu; two demulcent expectorants, honey and powdered liquorice;
—[why powdered liquorice when wre have the extract?]—cme pure
sedative—tincture of digitalis ; a grateful acid, but why introduced
we know not; the aromatic sulphuric acid; and a sedative dia-
phoretic, the vinum antimonii ;—but the merest tyro in chemistry
is aware, that sulphuric acid and tartrate of antimony and potassa
are incompatible in the same prescription; and that the author of
the combination, who manifestly supposed he would have the
effects of both, could not possibly have those of either; but of a
compound of whose very existence he was in unquestioned igno-
rance. The formula is little or not at all more philosophical than
the administration of sulphuric acid and acetate of lead at the
same time, but in separate vehicles, in a case of hemorrhage—used,
as we have known it, under the idea that each agent, singly, being
astringent, when united they must necessarily be more efficacious I
Not an idea was entertained by the blissful ignoramus, that an
insoluble and inert sulphate of lead was formed, which could not
possibly have any therapeutical agency.
But we have said as much as our space will permit of the
‘ Formulary ’ of Ellis ; and will only add, that the nomenclature
has been improved ; and made to approximate more to that of the
Pharmacopoeia of the United States. There is still room, however,
for farther improvement in this respect. For example : Infusum
is now appropriately used for the product of infusio or the act of
infusing; and hence we say infusum senna, not infusio senna,
(p. 50;) as praparatum is employed for the thing prepared; prapa-
ratio for the act of preparing. We would suggest likewise, that
if we apply the term at all to the pubes of dolichos (mucuna)
it must be spiculum, not spicula (p. 108.) We know of no such
word as spicula for a small spike or dart :—that vitellis unius ovi
(p. 144,) should be vitellum ; and in like manner vitellum ov. ij.
should be vitella. The school master is now abroad in the profes-
sion, and these linguistic matters ought to be attended to, espe-
cially as books, like those before us, are more referred to by the
younger than by the older practitioners.
The sphere embraced by the Formulary of Dr. Griffith—as the
epithet‘universal’ imports—is more extended. The design—as
announced by the author—is “to present a compendious collection
of formulae and pharmaceutic processes, with such additional infor-
mation as may render it useful to the physician and apothecary ;
and the principal aim has been to select materials most generally
applicable, and of practical utility. The sources from which they
have been derived are very numerous, as will be seen by a refer-
ence to the various authorities cited.” We wish that Dr. Griffith
had given us the titles of the works from which his formulae have
been selected, rather than a mere allusion to their authors. The
bibliography of formularies is rich and copious; and our French
and German brethren have been exceedingly prolific. Whether
this be an evidence of their greater advancement in professional
knowledge may admit of question. Our own mind has been long
made up on this matter; but others may not agree with us. We
think, that where numerous formularies prevail, it is rather an
evidence of a want of self-reliance, and that, perhaps, dependent
upon imperfect knowledge, and an undue deference to the “ words
of the master.”
A large amount of useful and selected matters, well arranged,
with the original observations of the author interlarded, is made
to precede and follow the Formulary proper: among these are
the subject of weights and measures, domestic and foreign ; specific
gravity; temperatures; vocabulary of words employed in pre-
scriptions,—the less needed by the way, in the work before us,
owing to Dr. Griffith’s having adopted a course, which will be
lauded by some and condemned by others, of giving all the ingredi-
ents of the formula in the vernacular ; observations on the manage-
ment of the sick room ; doses of medicines ; rules for the adminis-
tration of medicines ; management of convalescence and relapses;
dietetic preparations ; list of incompatibles ; posological table ;
officinal preparations and directions; bloodletting; poisons ;
index of diseases and their remedies, &c. &c.
Dr. Griffith’s formulary—unlike that of Dr. Ellis—is arranged
alphabetically, “ according to the pharmaceutic names adopted in
the United States Pharmacopoeia ; but in each formula the English
appellations for the articles composing it are used, and the quan-
tities of these ingredients are expressed in words, and not in the
usual pharmaceutic signs.”
To a certain extent the objection already made to the formulary
of Dr. Ellis, applies, however, to it. Numerous unnecessary and
badly compounded formula? are inserted; and a dangerous poly-
pharmacy is encouraged, which the good sense of intelligent
observers is now every where discarding. Imagine, for a moment,
the rationale of such a preparation as the “ Compound Tincture of
Opoponax,” (p. 304,) recommended by Brera, an Italian physician,
as an application to foul venereal ulcers ;—opoponax itself not being
admitted into the Pharmacopoeia of the United States; and not
an allusion made to it in our dispensatories as an external remedy.
Round birthwort,
* If Dr. Griffith discards the technical Latin names in his formulae, why
does he retain the cloven foot of Jupiter, which now means Itecipe ?
Long birthwort,
Orris root, each half an ounce,
Opoponax,
Sagapenum, each two drachms,
Guaiacum, four scruples,
Cloves, two drachms,
Camphor, three drachms,
Alcohol, ten ounces.
Macerate for twenty-four hours, and filter.
We plead guilty to consummate ignorance in regard to the prin-
ciples of combination, if any such there be, that suggested this
formula; and it is only one example of the endless permutations
that might load the books, provided the crude notions of every
prescriber were recorded. This, we doubt not, has received the
name of ‘ Brera’s Compound Tincture of Opoponax,’ in the same
way as the names of different respectable physicians have been
attached to other formulae for venal purposes. Aloes has been a
god-send to the pill-inventors. A larger or a smaller proportion
of the basis, with this or that adjuvant; and a variety of corri-
gents and excipients, has given occasion to the admission into the
‘Formulary’ under notice, of Anderson’s, Barthez’s, Becker’s,
Chapman’s, Duchesne’s, Frank’s, Fuller’s, Griffith’s, Hooper’s,
James’s, Lady Webster’s, Mitchell’s, Morrison’s, Peter’s, Pitt-
schaft’s, Speediman’s, and Whytt’s pills,—a motley assemblage of
the names of eminent physicians, a titled lady, and numerous
arrant empirics.
It is unfortunate that the names of respectable members of the
profession should ever be permitted to be attached to such for-
mulae. How are the unprofessional to discriminate between the
pills of Morrison the empiric, and of Hooper the respectable physi-
cian ; and then the transition is so easy to the elixir of McMunn,
the panacea of Swaim, and the drops of Lignum—for so an arch
empiric of the name of Wood disguised his patronymic—that the
landmarks between science and empiricism are destroyed, or over-
looked ; and a tendency is given to the latter even by those who
would hesitate to prescribe a secret remedy, and be startled at the
idea that they could be esteemed encouragers of quackery.
On the whole, it will be inferred, that we are not over-favorable
to formularies ; but if they are to exist—and we do not suppose
that any prepossessions of ours will diminish their number—we
think the one of Dr. Griffith is worthy of recommendation, not
only on account of the care that has been bestowed upon it by its
estimable author; but its general accuracy, and the richness of its
details, ■which to him, however, who relies wholly upon it, can
scarcely fail to prove un embarras des richesses.