A List of Simples and of such Medicinal Preparations as ought to be kept in Readiness for private Practice.
The Method of preparing and compounding such Medicines as are recommended in the former Part of the Book, with the Addition of several others of a similar Nature.
Remarks on the Doses, Uses, and Manner of applying the different Preparations.
IGNORANCE and superstition have attributed extraordinary medical virtues to almost every production of nature. That such virtues were often imaginary, time and experience have sufficiently shewn. Physicians, however, from a veneration for antiquity, still retain in their lists of medicine many things which owe their reputation entirely to the superstition and credulity of our ancestors
THE instruments of medicine will always be multiplied, in proportion to men's ignorance of the nature and cause of diseases: when these are sufficiently understood, the method of cure will be simple and obvious.
IGNORANCE of the real nature and permanent properties of those substances employed in the cure of diseases, is another reason why they have been so greatly multiplied. Physicians thought they could effect by a number of ingredients, what could not be done by any one of them. Hence arose those amazing farragos which have so long disgraced the medical art, and which were esteemed powerful in proportion to the number of simples that entered their composition.
THE great variety of form into which almost every article of medicine has been manufactured, affords another proof of the imperfection of the medical art. A drug which is perhaps most efficacious in the simplest form in which it can be administered, has been nevertheless served up in to many different shapes, that one would be induced to think the whole art of physic lay in exhibiting medicine under as many various forms as possible.
DIFFERENT forms of medicine, no doubt, have their use; but they ought never to be wantonly increased. They are by no means so necessary as is generally imagined. A few grains of powdered rhubarb, jalap, or, ipecacuanha, will actually perform all that can be done by the different preparations of these roots, and may also be exhibited in as safe and agreeable a manner. The same observation holds with regard to the Peruvian bark, and many other simples of which the preparations are very numerous.
MULTIPLYING the ingredients of a medicine, not only renders it more expensive, but also less certain, both in its dose and operation. Nor is this all. The compound, when kept, is apt to spoil, or acquire qualities of a different nature. When a medicine is rendered more safe, efficacious, or ageeeable; by the addition of another, they ought, no doubt, to be joined; in all other cases, they are better kept asunder. The combination of medicines embarrasses the physician, and retards the progress of medical knowledge. It is impossible to ascertain the precise effect of any one medicine, as long as it is combined with others, either of a similar or dissimilar nature.
IN the exhibition of medicine, regard should not only be had to simplicity, but likewise to elegance. Patients seldom reap much benefit from things that are highly disagreeable to their senses. To taste or smell like a drug, is become a proverb; and to say truth, there is too much ground for it. Indeed no art can take away the disagreeable taste and flavour of some drugs, without entirely destroying their efficacy: it is possible, however, to render many medicines less disgustful, and others even agreeable; an object highly deserving the attention of all who administer medicine.
THE design of the following pages is to exhibit such a list of drugs and medicines as may be necessary for private practice. They are considerably more numerous indeed than those recommended in the former part of the Book, but are still greatly within the number contained in the most reformed dispensatories. The same medicine is seldom exhibited under different forms; and where different medicines answer nearly the same intention, there is commonly no more than one of them retained. Multiplying forms of medicine for the same intention tends rather to bewilder than assist the young practitioner, and the experienced physician can never be at a loss to vary his prescriptions as occasion requires.
THE chemical and other difficult preparations are for the most part omitted. All of them that are used by any private practitioner are not worth preparing. He will buy them much cheaper than he can make them. Great care however is necessary to obtain them genuine . They are often adulterated, and ought never to be purchased unless from persons of known veracity. Such of them as are in common use are inserted in the list of drugs and medicines. Their proper doses, and manner of application, are mentioned in the practical part of the Book, wherever they are prescribed.
SUCH articles of medicine as are to be found in the house or garden of almost every peasant, as barley, eggs, onions, &c. are likewise, for the most part, omitted. It is needless to swell a list of medicines with such things as can be obtained whenever they are wanted, and which spoil by being kept.
THE preparations made and sold by millers and confectioners are also generally left out. These people, by operating upon a larger plan, generally make things better, while it is in their power to afford them much cheaper than they can be prepared by any private hand.
THE quantity ordered of every medicine is as small as could well be prepared, both to prevent unnecessary expence, and that the medicine might not spoil by keeping. almost every medicine suffers by being kept, and should be used as soon after it has been prepared as possible. Even simple drugs are apt to spoil, and should therefore be laid in in small quantities; they either rot, are consumed by insects, or evaporate so as to lose their peculiar taste or flavour, and often become quite insignificant.
IN the preparation of medicines, I have generally followed the most improved dispensatories; but have taken the liberty to differ from them, wherever my own observations, or those of other practical writers, on whose judgment I could depend, suggested an improvement.
IN several compositions, the ingredient on which the efficacy of the medicine principally depends is increased, while the auxiliaries, which are generally ordered in such trifling quantities, as to be of no importance, are left out, or only such of them retained as are necessary to give the medicine a proper consistence, or the like.
THE colouring ingredients are likewise for the most part omitted. They increase the bulk and price of the medicine; without adding any thing to its value. It would be well if they were never used at all. Medicines are often adulterated for the sake of a colour. Acrid and even poisonous substances are, for this purpose, sometimes introduced into those medicines which ought to be most bland and emollient. Ointment of elder, for example, is often mixed with verdegrise to give it a fine green colour, which entirely frustrates the intention of that mild ointment. Those who wish to obtain genuine medicines should pay no regard to their colour.
SOME regard is likewise paid to expence. Such ingredients as greatly increase the price of any composition, without adding considerably to its virtue, are generally either omitted, or somewhat less expensive substituted in their place. Medicines are by no means powerful in proportion to their price. The cheapest are often the best; besides, they are the least apt to be adulterated, and are always most readily obtained.
WITH regard to the method of compounding medicines, I have generally followed that which seemed to be the most simple and natural, mentioning the different steps of the process in the same order in which they ought to be taken, without paying an implicit regard to the method of other dispensatories.
FOR many of the remarks concerning the preparation, &c. of medicines, I have been obliged to the author of the New Dispensatory. The other observations are either such as have occurred to myself in practice, or have been suggested in the course of reading, by authors whose names I am not able distinctly to recollect.
I HAVE followed the alphabetical order, both with regard to the simples and preparations. A more scientific method would have been agreeable to some persons, but less useful to the generality of readers. The different classes of medicine have no great dependance upon one another; and, where they have, it is hard to say which should stand first or last; no doubt the simple preparations ought to precede the more compound. But all the advantages arising from this method of arrangement do not appear equal to that single one, of being able, on the first opening of the book, to find out any article, which, by the alphabetical order, is rendered quite easy.
THE dose of every medicine is mentioned wherever it appeared necessary. When this is omitted, it is to be understood that the medicine may be used at discretion. The dose mentioned is always for an adult, unless when the contrary is expressed. It is not an easy matter to proportion the doses of medicine exactly to the different ages, constitutions, &c. of patients; but, happily for mankind, mathematical exactness here is by no means necessary.
SEVERAL attempts have been made to ascertain the proportional doses for the different ages and constitutions of patients; but, after all that can be said upon this subject, a great deal must be left to the judgement and skill of the person who administers the medicine. The following general proportions may be observed; but they are by no means intended for exact rules. A patient betwixt twenty and fourteen may take two thirds of the dose ordered for an adult; from fourteen to nine, one-half; from nine to six, one-third; from six to four, one-fourth; from four to two, one-sixth; from two to one, a tenth; and below one, a twelfth.
DISPENSATORIES are usually written in the Latin language. Even authors who write in English, generally give their prescriptions in Latin; and some of them shew so great an attachment to that language, as first to write their recipes in it, and afterwards translate them; while others, to compromise the matter, write the one half in Latin and the other in English. What peculiar charm a medical prescription, when written in Latin, may have, I shall not pretend to say; but have ventured to make use of the plainest English I could, and hope my prescriptions will succeed no worse for it.
N. B. THE Apothecary's weights, and the English wine measures, are used throughout the whole book, the different denominations of which will appear from the following Table:
A pound contains twelve ounces.
An ounce contains eight drachms.
A drachm contains three scruples.
A scruple contains twenty grains.
A gallon contains eight pints.
A pint contains sixteen ounces.
An ounce contains eight drachms.
A spoonful is the measure of half an ounce.