No. 81.]· Suicide and Hypochondriacism. 253 afflicted. For the constitutional attack, he had been long convinced there is nothing like the carbonate of ammonia; and, for the purpose of giving the malady the death-blow, the topical application of lead would certainly prove successful, by paralysing the diseased nerve: more to the point he could not say if he preached a whole year. Dr. L. begged to be allowed to observe, that if lead really possessed the power of paralysing nerves, such a disease as tic doloureux, in which the affected nerve was evidently in a state of increased excitement, would never have come into action in the learned doctor's head. Mr. Ts warmly recommended lunar caustic, which he had administered in cases very similar, with the most encouraging results. He recommended him to take it, dissolved in water, with a few drops of the nitric acid, to prevent precipitation. Mr. B. said, he had attentively listened to all the suggestions of the learned gentlemen, but that nothing had "dropped from their lips" to shake his confidence in the belladonna; if he were ever to get well, it was by taking the extract, and applying it externally. The doctor observed that, in his juvenile days, he had taken rather too freely of the bella donna, and that he should be afraid to venture on it in the present state of his general health, which he attributed much to quacking himself. Mr. H. recommended the carbonate of iron, which he was certain would fortify his constitution, and restore the affected nerve to health. The doctor gave all the modes of treatment recommended by his medical counsellors a trial; but the only one which afforded much relief was the carbonate of iron: it, however, succeeded only in abating the anguish of the disease. At length apoplexy supervened, and suddenly proved fatal. By the death of the doctor, the College of Physicians have lost a member, who would have lent his aid to carry into effect any law they might make to monopolize the practice of medicine. Although he published a work on Diseases of the Viscera, evidently for popu lar perusal, he violently condemned popular medicine, and all. attempts in others to communicate medical information. Such works he censured as the most dangerous quackery. To enable the public to form an opinion of the professional abilities of a medical man was, in his opinion, a crime of the greatest magnitude-it was no less than treason against that venerable antient institution, the Royal College of Physicians. To the Sketch we have given of this physician in our twentyfourth Number, we have nothing further to add, than peace to his manes! SUICIDE.-Dr. J. P. Falret, an eminent French physician, has published an interesting work on Hypochondriacism and Suicide. He notices the instances of Barthez, Chatterton, and others, to prove that a tendency to commit suicide is often hereditary. Suicide is generally an act of insanity; and that insanity is often hereditary, no medical man will deny. The doctor gives the case of suicide in a child of seven years of age, and one in a girl of twelve, because she stood only second in her class. He is of opinion that climate has nothing to do with suicide; but he attributes much to the effects of the refinements of civilization and political reverses which will sometimes make suicide appear as an epidemic; much to violent passions, such as disappointed ambition, love, &c.; and he thinks the agency of physical causes, as the abuse of spirituous liquors, mercury, &c., and of visceral affections, have been greatly exaggerated. "In all these latter cases," observes the doctor, "it will be found that moral causes have produced or preceded the visceral disorder. Other circumstances have also convinced him that moral pains are more powerful and more destructive than physical pains." In discussing the general causes, or such as arise directly from political and religious institutions, philosophical sects, &c., Dr. Falret gives the first rank to absurd fanaticism in religion. "The stoical philosophy, which tolerates suicide," he says, has been too severely criticised." "It has," says M. Bricheteau, in his review of Dr. Falret's work, " produced great men and great virtues." Dr. F. denies that more suicides occur in France than in England, notwithstanding the great difference in the population of the two countries. A predisposition to suicide is often attended with profound sadness, invincible dread, or desire for solitude, and a susceptibility of the impressions of moral and physical causes. "The act, however," says Dr. F. " is always accomplished under a state of increased excitement;" it is, indeed, in his opinion, always an act of delirium. Dr. Bricheteau denies this, and evidently with reason; for insane subjects have accomplished it, not only with great coolness and precision, but with a degree of ingenuity, of which a delirious subject cannot be capable. The maniac is perhaps always aware that, by the act, he will terminate his worldly existence; but the man in a fit of delirium has no such idea, and, in the execution of the deed, shews nothing like ingenuity or precision. We lately had conversation with a gentleman who had thrown himself out of the window of a second floor during a fit of delirium. A lampiron fortunately broke his fall. He perfectly recollected opening the window, for the purpose of making his escape from two men, whom he fancied he saw on the opposite side of the bed, with large knives in their hands, one of whom appeared to be ready to plunge a carving-knife into his body. It is probable that all who have committed suicide in this manner during delirium have been influenced by such imageries. Dr. F. states, that dissection has not illustrated the causes of suicide, but he thinks, and no doubt correctly, that the brain is always primarily affected. In those cases which Dr. F. terms delirious suicide, the substance of the brain has always been found to be inflamed; and even in cases of cool and deliberate suicide, that organ has been frequently found in a morbid condition. We are therefore at a loss to conjecture what the Doctor means, by saying that dissection has thrown no light on the cause of suicide. In the late unfortunate case of suicide, which has deprived our country of a very able statesman, and in private life a real good man, there are many points worthy of observation. We are told, his physician, Dr. Bankhead, has attributed it to insanity, arising from debility of brain, which followed over exertion of the mind, particularly in the House of Commons. For three or four days previous to the fatal catastrophe, his coun No. 81.] Suicide and Hypochondriacism. 255 tenance and his manners strongly evinced a disordered state of his brain. About two or three days before he inflicted the fatal wound, he was seen, in a state of confusion, purchasing the knife of a Jew boy, in the open street, with which he perpetrated the deed. Is it not most extraordinary, that no active means were adopted by his physician, to quiet his brain, or by his friends about him, to prevent the commission of an act of violence? His Lordship complained of great confusion of head, attended with pain. Dr. Bankhead ordered seven ounces of blood to be abstracted by cupping, and a saline purgative to be administered. The abstraction of blood afforded much relief, for his Lordship became more collected, and obtained some refreshing sleep. Now, on such a subject as the late Marquis of Londonderry, with such an affection of the brain, what effect 'could the learned Doctor expect from the loss of seven ounces of blood? If the Doctor had any doubts as to the condition of the brain of his patient, which, from the appearance of his eyes, and the presence of acute pain in the head, was clearly inflammatory, why did he not order the operation of cupping to be repeated, and a qnantity to be abstracted, proportioned to his Lordship's habit, and the importance of the organ which was effected, after the effects of bleeding had removed all mystery from the case? As there was evidently great nervous excitement of the brain, why not apply blisters to the nape of the neck and to the legs, and a cold lotion to the head? Had such active treatment been employed at the time. the Doctor ordered him to be cupped, might not His Lordship have been at this time in the enjoyment of health? When Dr. Bankhead saw the Marquis, immediately after he had inflicted the wound, he did not observe any hæmorrhage; but when he was prostrate on the ground, he discovered it. This to us is most unaccountable:-although his Lordship desired him to catch him in his arms, he did not see the blood which must have been thrown out with considerable force from the wounded side of his neck, until he was on the floor!! When he did discover the wound, instead of taking up the artery, or attempting to stop the hæmorrhage, by pressure, he shewed his gallantry by running to the Marchioness to acquaint her with the calamity that had befallen her Lord and Master. In all the cases of division of the trunk of the carotid artery we have heard of, the first hæmorrhage did not terminate life: the bleeding in each was suspended by syncope, and had the doctor applied ligatures to the divided ends of the artery, instead of leaving his patient, the result might have been more creditable to him. Similar cases have done well; but the Doctor, although he held the appointment of surgeon in the army, perhaps thought, as many Members of the College of Physicians do, that by performing a surgical operation he would derogate from his dignity as a physician. The Doctor slept at the Marquis's house, to be ready in case of emergency, and if he was not competent to bleeding, or taking up an artery, his attendance could not be of much advantage to his patient. The circumstances of his Lordship having purchased the knife a few days before he committed suicide, and the nicety with which he divided the artery, have induced some to suppose that he could not have been deranged. But, as we have already observed, insane people often display much ingenuity in planning their destruction; and his Lordship betrayed symptoms of a disturbed imagination for some days prior to the act; indeed, the act of suicide is in itself a host of evidence of insanity; for no person would commit it, who was capable of exercising his reason on the subject, or sensible of the enormity of the crime. ACETATE OF MORPHINE. - Dr. Alloneau, of Thouars, haş published eight cases, in which he has given this remedy to adults, in doses of a quarter of a grain to one grain, daily, beginning sometimes with a quarter, sometimes with half a grain. Of these eight patients, five were consumptive: the remedy was given to allay the cough, and to procure sleep. In two of these cases it succeeded, in the three others it failed. The other three patients had chronic diseases of the ovary, the heart, and the stomach. This last patient was entirely cured. The affection of the heart was relieved by it; but the effect was only temporary. In the case of diseased ovary, it cured all the numerous sympathetic irritations that existed; but the complaint remained unchanged. Dr. Magendie had before employed this medicine to relieve the pain of a schirrous breast. The author confirms the observation of Mr. Lens, that morphine in these doses does not cause the excitement, head-ache, constipation, nor stupor, as opium and laudanum do. GANGLION.-Mr. Selwyn, a scientific surgeon of Ledbury, informs us, that, in a case of unusually large ganglion, situated on the back of the wrist of a female, he employed a large seton, with complete success. The silk was introduced through the centre of the tumour, and a discharge was kept up for some weeks. Very little irritation came on, the tumour gradually decreased in size. When it appeared to be reduced, so that nothing remained but its cyst, he withdrew the silk, and applied pressure, to produce ad hesion. WEN, GREEN SICKNESS, &c. A medical gentleman of Horsham, in Sussex, has found the tincture of iodine, taken internally, very beneficial in dispersing wen. He states that, in his practice, ten drops of the saturated tincture, taken three times a day, succeeded in removing the complaint, in the course of five or six weeks. The subjects were all females, about the age of puberty. A physician of Liverpool informs us, that he has administered the saturated tincture of iodine, with wonderfully good effect, in many cases of green sickness, attended with symptoms of approaching consumption, and also in incipient phthisis. RHEUMATISM.-In America, an ointment of stramonium, made by gently boiling six ounces of the recent leaves (bruised) in a pound and a half of fresh hog's lard, till they become crisp, is in high repute as a remedy for this disease. The size of a nutmeg, Dr. Turner, of Philadelphia, has found to remove rheumatic pains, after electricity and other powerful liniments, with internal remedies, had totally failed; and Dr. Zollickoffer says, that he has known the stramonium ointment to succeed in cases of rheumatism, after No. 81.] Purgative Medicines. 257 the internal exhibition of the tincture of stramonium had no effect. For internal use, the Doctor prefers a tincture of the leaves (made in the proportion of an ounce and a half of the dried leaves to a pint of proof spirit) to the extract. ON THE PECULIAR PROPERTIES OF PURGATIVE MEDICINES.-By MR. SCOTT. (Continued from page 156.) SCAMMONY.-The plant that produces this article of medicine grows spontaneously in Cochin China, Syria, Mysia, and Cappadocia ; particularly on the chain of mountains which extends from Antioch to Mount Lebanon; it flourishes also on Mount Taurus, and in the plains between Latachia and Tripoli Syria: in fact, on most of the Syrian hills, which are productive of vegetation, the Scammony plant may be found. Aleppo is the principal market for it; to which place it is brought (principally by Jews) from the various villages, near to which it is collected; as Antioch, Maraash, Shogre, Edlib, &c. Scammony, (or Mahmoody, as the natives call it,) is the milky juice of the root of the plant, dried in the sun. It is a resin; generally of a grey colour; is very light and brittle, breaking easily with the mere pressure of the fingers; and is shining in its fracture. The merchants try it, by touching it with the point of the tongue, or the extremity of a wet finger; when, if it be genuine, it immediately turns milky; but this test is not to be relied on, for, as it is often adulterated with flour, the same effect will be produced by the bad as the good. GENUINE Scammony, if broken and thrown into water, is QUICKLY DISSOLVED; forming a MILKY liquid of a GREENISH HUE; which, after a short time, deposits a VERY SMALL sediment; the fluid remaining PERMANENTLY milky. This experiment is the best test of the purity of the drug. The colour of Scammony is exceedingly variable, and is by no means descriptive of its real quality; various specimens of the best samples of the article being found of almost every degree of colour, from deep black to a yellowish white; which those who collect it attribute to the different methods of drying it: but, yet all good and unadulterated scammony, whatever may be its external character, agrees in one general appearance, when powdered; that is, a brownish white colour. It is adulterated with a great variety of substances; as flour, fine sand, ashes, earth, &c. It is also mixed with the expressed juice of the root, stalks, and leaves; which renders it very hard and insoluble, and considerably lessens its purgative qualities; for it has been ascertained, by experiment, that neither the flowers, leaves, stalks, nor seeds, possess cathartic properties.* * Dr. Alexander Russel, who resided at Aleppo, made some experiments to ascertain the properties of different parts of the scammony plant. He says, "to a person with whom a scruple of very |