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ELEMENTS OF MATERIA MEDICA.

power, emetic tartar is frequently of considerable serv ice. Thus in dis-locations of the larger joints (the hip and shoulder, for example), blood-letting, and nauseating doses of emetic tartar, are employed to diminishthe resistance of the muscles opposing the reduction.

Emetic tartar, in large doses, is a most powerful and valuable remedyin the treatment of inflammation, especially peripneumonia. As an eme-tic, nauseant, or diaphoretic, it has long been in use in this disease ;having been employed by Riverius in the 17th century, and snbsequentlyby Stoll, Brendel, Schroeder, and Richter, in Germany ; by Pringle,Cullen, and Marryat, in England. But as a remedy for inflammation,independent of its evacuant effects, we are indebted for it to Rasori (seethe French translation of his Memoir, in Bayle’s Biblioth. de Therap.i. 198), vv r ho first used it in the years 1799 and 1800, in an epidemicfever which raged at Genoa. Subsequently he exhibited it much moreextensively, and in larger doses, in peripneumonia. This mode of treat-ment was tried and adopted in France , first by Laennec {Treat, on Dis.of the Chest, translated by Dr. Forbes); in this country by Dr. Bal-four ( Illust. of the Power of Emet. Tart. 2d edit. 1819). Its value asan antiphlogistic is now almost universally admitted. Practitioners,however, are not quite agreed as to the best method of using it. Rasori{op. cit.), Laennec {op cit.), Recamier ( Gaz. Med. 1832, p. 503), Broussais (Cours de Path, et de Therap. gen. ii. 521), Bouillaud {Diet, de Med. et deChir. pratiq. xiii. 395), Dr. Mackintosh ( Tract. of Phys. i. 426), Drs.Graves and Stokes {Dubl. Hosp. Rep. v. p. 48),Dr. Davis (Lect. on Dis. ofthe Lungs and Heart , 188), and most practitioners of this country, employblood-letting in peripneumonia, in conjunction with the use of emetictartar. But by several continental physicians the abstraction of blood isconsidered both unnecessary and hurtful. Thus Peschier (Bayle, Bibl.Ther. i. 246) advises us on no account to draw blood : and Trousseau{Diet, de Med. 2d edit. iii. 220) observes, that blood-letting, far fromaiding the action of emetic tartar, as Rasori, Laennec, and most practi-tioners, imagine, is, on the contrary, singularly injurious to the anti-phlogistic influence of this medicine. On these statements I wouldobserve, that few practitioners in this country have ventured to trust toemetic tartar alone in the treatment of violent pulmonary inflammation.Of its efficacy when used alone, in several slight cases of pneumonia, Ican bear testimony; bnt in severe cases I have invariably conjoinedblood-letting, and I believe most British practitioners have done thesame. Louis {Rech. de la Saignee) has published some numerical resultsof the treatment of inflammation of the lungs by blood-letting and byemetic tartar ; from which it appears that this substance, given in largedoses, where blood-letting appeared to have no effect, had a favourableaction, and appeared to diminish the mortality {op. cit. p. 62). But heparticularly states that blood-letting must not be omitted (p. 32).

Laennec’s mode of using this salt, and which, with some slight modi-fication, I believe to be the best, is the following:—Immediately after-bleeding give one grain of emetic tartar, dissolved in two ounces and ahalf of some mild fluid [cold weak infusion of orange flowers], sweetenedwith half an ounce of syrup of marshmallows: this is to be repeatedevery two hours for six times, and then suspended for seven or eighthours, if the symptoms are not urgent, or if there be any inclination tosleep. But if the disease has already made progress, or if the oppression