Materia Medica and Therapeutics. By Thomas D. Mitchell,
A. M., M. D., Professor of the Theory and Practice of Medicine
in the Philadelphia College of Medicine, &c. &c. &c. Phila-
delphia: Lippincott & Grambo, 1850.
This book is evidently the work of a man of considerable expe-
rience, and professes to contain the substance of the author’s lec-
tures on Materia Medica and Therapeutics, as delivered in the
Medical Department of Transylvania University, in eleven succes-
sive winters. As an enlarged and philosophical treatise on Thera-
peutics, we must say, that it does not come up to our ideas on the
subject. The alphabetical arrangement which the author has
chosen in preference to a classification of remedies having an
analogous Therapeutic application, necessarily breaks the subject
too much into fragments, and gives us merely a dry detail of the
remedial effects of individual medicinal agents, which, though ex-
cellent in themselves, showing great research on the part of the
author, and highly useful to the student, does not in fact teach any
thing more than would a well arranged Dispensatory.
As a work on Therapeutics, in the extended and scientific sense
of the word, we therefore do not approve of Dr. Mitchell’s book;
as an abridged Dispensatory, with practical Therapeutic sugges-
tions, we do approve of it highly, and think that the research and
labor which must have been devoted to the compilation and ar-
rangement of such a mass of material, as honorable to the author
as it is creditable to the profession of which he is a worthy member.
The great fault of the book, in our estimation, is, a certain want
of dignity and good taste in the general tone of the details; a dis-
position on the part of the author to raise a monument to his own
merits at the expense of the profession; an assumption of superior
sagacity and intelligence, the existence of which Dr. M. may in
the course of his professional career have often felt, but the ex-
pression of which, we think, might have been alloyed with advan-
tage by “ some few cold drops of modesty.” These remarks we
make in no ill-natured spirit, but merely to express regret that a
man of talent should mar a good work by vanity. For, though
the foible is displeasing, we can say of the author as Dr. Johnson
said of David Garrick, whom some of his cotemporaries were ridi-
culing for his conceit: “yes, gentlemen, David is vain, but he has
the advantage of most of us in having a great deal to be vain of.”
The book contains 730 pages, of as varied material as can well
be imagined ; therefore we must of necessity content ourselves
and our readers with a few quotations illustrative of the author’s
manner of treating his subject. The Toxicological part of the
work is excellent; the methods recommended for the detection of
poisons; the preparation and application of antidotes, and the ge-
neral treatment of patients suffering under their influence, are all
good; so much so, that we think that this part of the book alone,
whatever its other merits may be, entitle it to high praise, and to
a space on the shelf of every medical library.
The alphabetical arrangement, though in our opinion disadvan-
tageous to a strictly Therapeutical work, in which, as we before
observed, the massing together of analogous remedies, saves the
necessity of frequent and tedious repetition, and gives, we think,
a wider and bolder view of the subject, is well adapted to the
Materia Medica and Toxicological part of the work, and has en-
abled the author to give the minute detail of an amount of mate-
rial which otherwise would have been impossible, without making
it too voluminous; which, as we presume the author intended it
as a text book for the students of his class, would not have an-
swered his purpose.
The details of Dr. Mitchell’s personal experience in the use
of remedies are generally good, practical, sensible and reliable,
but we object to his constant quotations from Braithwaite’s Retro-
spect, Ranking, and the like not that we do not esteem these
works as they deserve; on the contrary we think that they some-
times contain much useful information ; but they likewise abound
in much mere rubbish ; new remedies old as the eternal hills, that
have been resurrectionized; again buried, and again called into
life, to astonish doctors with large organs of wonder and credulity,
and to torment their patients.
The fact is, the majority of the contributors to such publica-
tions are men of some talent, struggling for a practice; they can-
not advertise in the newspapers, because that would be infra dig.,
and they would by such a proceeding lose caste, therefore the me-
dical journals are the only orthodox means by which they can
make themselves known to the public; thus they are constantly
on the alert to drag their “ soi disant” new modes of treatment
before the public, “ with twenty mortal murders on their heads
to push us from our stools,” and which, like Shakespeare’s caul-
dron, manufactured phantoms—
11 Show his eyes and grieve his heart,
Come like shadows, so depart.”
And all this is good and useful in its way; but an over and credu-
lous estimation of such reports is worse than useless, and we con-
tend that it is an over estimation to quote them in standard works,
unless proved by the touchstone of experience, as high and relia-
ble authority.
The following quotation is from the author’s introduction :
“ Possibly some of ray readers may be disposed to say that this
book should have been called a dispensatory. But having the chris-
tening in my own hands, it has seemed good to me to give it the title
it bears, and as I think most appropriately. If a dispensatory be not
a work on materia medica, why is it made a text book by profes-
sors, who teach this department of medical science ? The fact is too
palpable to be misunderstood by men of sound common sense, that
a good dispensatory cannot be a bad exhibit of materia medica ; and
it is equally manifest that a well digested work on materia medica
and therapeutics, even though alphabetically arranged, cannot
be a serious hinderance to the study of the teachings of a dispensa-
tory. Vastly fond am I of judicious and real distinctions, but I con-
fess that I have no special regard for a distinction that hardly im-
plies a difference.”
We have already given our reasons for considering the alpha-
betical arrangement as disadvantageous to an enlarged view of
the science of therapeutics, and therefore shall make no further
comment.
The subjoined remarks upon the subject of the antagonism of
poison and disease, are well and philosophically written, Every
medical man of experience must be aware of their truth.
“ The point to which I desire to call attention specifically, is one
that has entered into my public teachings for many years, and I am
free to confess that I do not yet comprehend it fully. I refer to
the fact about which there can be no difference of opinion (I mean
as to its existence) that decidedly poisonous doses, so far as bulk or
weight are concerned, have been frequently swallowed without
material injury, and that, too, independently of any condition of the
stomach sufficient to account for the result. The doctrine that has
appeared to me as the true solution of the problem, is that in the
most striking cases on record, the otherwise ^poisonous dose has
spent its force on the morbid action present in the system, what-
ever that may have been, and in this way its legitimate character
has not been developed. I have not met with a single direct refer-
ence to this view of the case anywhere, excepting in a short article
lately published by Dr. Beck, in which there was an incidental allu-
sion to it. I am aware of the effects of habit in controlling the mis-
chievous action of poisons so as to render them quite harmless; but
I have no reference to this agency on the present occasion, for that
could not meet the difficulty.”
“ The case most familiar to the profession, illustrative of this doc-
trine, is the administration of large doses of tartar emetic in the
treatment of pneumonic inflammation. Here the dose is often so
great as to be exceedingly hazardous if its operation were restricted
to the stomach. The idea of tolerance is associated necessarily
with the fact that some other organ besides the stomach is to parti-
cipate in the agency of the remedy; that other organ is the hinge
which feels the influence of the medicine in its restoration to the
condition of health. Now although we cannot demonstrate all this
just as if it were a problem in Euclid, we are compelled to believe
that the salutary influence of great doses of tartar emetic in this dis-
ease involves the principles which it is our purpose to illustrate.
We do not desire to be understood here as advocating this plan
of curing pneumonia, but simply as attempting to account for the
result by the obvious antagonism of disease and poison.”
The mammoth doses of nitrate of potassa administered latterly
in cases of acute rheumatism, are given by Dr. Mitchell as another
illustration of this point; and he might have added the enormous
doses of calomel which have been administered in fevers, and in
Asiatic cholera, without producing salivation.
In speaking of tobacco as an antidote, or a remedy in poisoning
by arsenic, he writes as follows :
“ A portion of arsenic fully sufficient to kill under ordinary
circumstances, was counteracted by the use of tobacco and without
any emetic action. What were the facts with regard to the patho-
logical condition of the stomach ? The arsenic had commmenced
its'appropriate action beyond doubt, as the symptoms evinced:
there was very probably set up true inflammation, such as arsenic is
competent to establish. How then were the patients saved ? The
tobacco was given in strong infusion, expressly with the design of
vomiting, and so dislodging the poison. But the emetic action
failed entirely, and yet the patients were restored after comparative-
ly little suffering.
I know that it has been said that the arsenic and tobacco formed
a neutral mixture, in which the poisonous property of both articles
was lost or nullified. But it is more probable that the intrinsic
character of tobacco failed to display itself, because its power was
spent on the existing morbid condition of the stomach and bowels.”
The author, in treating of counter irritation with tartar emetic,
recommends the following combination :
JL	Emet. tart.	9i.
Oil Olivar.	§ss.
Oil Croton.	3ss.	Mix.
We must confess that we look upon this prescription as rather
heroic. Croton oil, even well diluted, has frequently in our expe-
rience, produced very severe effects ; emetic tartar, as every body
knows, will often produce most painful ulcerations, therefore we
do not understand why they should be combined. Dr. Mitchell is
evidently a good chemist, and may have discovered, or fancy that
he has discovered (which is the same thing now a days,) that cro-
ton oil and tartar emetic exert a modifying influence on each other
when in combination: but as he has not favored us with any such
developement, we ourselves shall continue to use them sepa-
rately. We must also object, by the way, to the exceedingly un-
scientific jumble of languages in this formula, for which we know
no authority. We are charitable enough to attribute it to over-
sight on the part of the author, but it is a dangerous example to
set before a beginner.
One author has given us a very good article upon the uses and
abuses of alcohol, in the course of which he says, and every mem-
ber of the profession will agree with him, that it is the duty of
doctors to discourage drunkenness: but we protest against the
bad taste of the following remarks :
“ On account of its active solvent power, (alcohol,) the books
abound with tinctures, and there has been too great a willingness
to exhibit them. But, inasmuch as a large majority of the sots
have been made so by the doctors through the agency of alcoho-
lic medicines, it is the duty of the profession to correct the evil as
speedily as the nature of the case will allow.”
We have heard this charge made in the lecture-room, and al-
ways regarded it as puerile and ridiculous: such excuses may
have been made by sots, who think that by accusing the doctors,
they excuse their own brutal vices. But what man of common
sense will ever believe that a few teaspoonfuls of a medicinal
tincture, taken occasionally, ever truly made a drunkard 7 No;
the fellow who could have the impudence to make such a charge,
would have been a sot under any circumstances. The thief might
just as rationally excuse his career of crime, by stating that hav-
ing been once, by his wicked father or employer, left alone with a
cent, he took it, and could never again refrain. A tendency so
strong is the disease itself, not developed, perhaps, but it is there.
As Lord Byron says of friendship between the two sexes,
“ It is love full fledged, waiting for a fine day to fly.”
Cod liver oil seems to be a favorite subject with Dr. Mitchell; for
though he does not give us much of his own experience in its use,
which we regret, we should have more faith in it than in Dr.
Williams’ flourish of trumpets, quoted at length by our author,
which reads to us very much like the rhapsody of a very well
meaning and learned gentleman on the back of a favorite hobby-
horse, which he has previously determined to ride nobody
knows where.
Cod liver oil, it would appear, is the fashion, and, as was for
some time the case with the iodide of potassium, is now prescribed
for every thing. # Upon the credit of various high authorities it
will cure the following diseases:—Consumption, Bronchitis, Pleu-
risy, Neuralgia, Liver Complaint, Rheumatism, Tertiary Syphilis,
Scrofula, and all its incidental ailments, Gout, Dyspepsia, Lepra,
Impetigo, Porrigo, &c., &c., &c. So that, in short, the fabulous
Elixir of the alchymist is at last realized, and in the hands of the
speculating apothecaries, who swept the market of all the stinking
oil they could find, has doubtless produced a golden harvest.
We have tried the remedial powers of this oil, and found it of
service in some scrofulous affections, but we are sorry to say that
we have never yet found it of use in any undoubted case
of tubercular phthisis. Still, we are willing to continue the
trial, and never let pass a favorable opportunity of doing so; for
it is our wish to see this remedy, if it be one for genuine phthisis,
take its proper place.
But such a system of puff and exaggeration as has been lately
carried on in most of the journals upon this subject, is really as
pernicious to the interests of humanity, and the true dignity of
medical science, as the worst quackery that ever imposed on the
credulity of mankind.
When on the subject of calomel, the author makes the following
remarks, which are perhaps judicious, but which we fear might
be construed into an apology for ignorance on the part of some
blundering or uneducated shop boy.
“ As a thing of mere expediency, not to say safety, I hold the
word calomel to be preferable, in our written prescriptions, to any
other term ; and the same remark is of equal force touching cor-
rosive sublimate. By these common names all persons, boys or
men, engaged in dispensing medicines, know the one and the
other. But all do not comprehend the more correct technicals,
which are oftener employed to display the imaginary knowledge
of the doctor, than because they are really to be preferred. Fewer
blunders would occur, if we invariably used the old terms.”
We regret that want of space prevents our quoting more
extensively from Dr. Mitchell’s book. Notwithstanding the
fault which we have presumed to find with certain portions of it,
we cannot conclude without repeating our good opinion of it as a
whole—recommending it heartily to the perusal of all persons in-
terested in such subjects. To the young practitioner and the me-
dical student we think it will prove a valuable assistant.