ON THE ACTION OF ABSORBENT MEDICINES IN GENERAL.

WHEN a mixture of animal and vegetable food has remained a ſhort time in the ſtomach, a fermentation enſues, which is neceſſary to carry on the work of digeſtion, but which, when it becomes exceſ⯑ſive, degenerates into diſeaſe. During this fermentati⯑on a conſiderable quantity of air is produced, and the alimentary mixture gradually tends to acidity.

To reſtrain the inordinate ferment in the ſtomach, na⯑ture has wiſely given us the ſaliva or ſpittle, which ha [...] the property of preventing it from riſing to a degree injurious to health. But where the ſaliva is either cor⯑rupted [11]or inſufficient in quantity, where the tone of the ſtomach is ſo weak, as to detain the aliment too long before it be puſhed forward through the pylorus into the ſmall inteſtines, or where the nature of the aliment it⯑ſelf is too much diſpoſed to ferment; in all theſe caſes the air, which is of the ſame nature as that diſcharg⯑ed in the fermentation of vinous liquors, diſtends the ſtomach, and an obnoxious, and ſometimes moſt au⯑ſtere acid is produced, which irritates the coats of that bowel, particularly that plexus of nerves which is dif⯑fuſed about its upper orifice, and occaſions pain, four belchings, vomiting and heart-burn.

As this was the moſt obvious kind of acrimony, it became the faſhion, among the chemiſts of the ſeven⯑teenth century, to aſcribe the origin of almoſt all diſ⯑eaſes to a redundant acid; and their practice conſiſted in giving to their patients alkaline ſalts and abſorbent earths, ſuch as chalk, calcined oyſter ſhells, crab's claws, &c. and theſe were frequently adminiſtered in caſes where, perhaps, remedies of a very oppoſite kind were requiſite.

But when ſcience became more founded on rational principles than on imaginary hypotheſes, this practice loſt ground, and the uſe of abſorbents was confined to its proper bounds, to the correction of acidities when obviouſly prevailing in the firſt paſſages. And here in⯑deed was a large field for the employment of theſe me⯑dicines, a field which, perhaps, daily became more ſpa⯑cious, as luxury more prevailed, and as the increaſe of arts and manufactures tended to enervate the people by inducing them to lead more ſedentary lives.

Even in this ſtate of things, inconveniences aroſe from the property which all the common abſorbents poſſeſſed of being aſtringent. For though they, for a time, cor⯑rected acidity, yet they produced ſuch a degree of coſ⯑tiveneſs, as in effect rather added to the diſeaſe they were intended to cure, and an abſorbent earth of a dif⯑ferent nature was a deſideratum in practice.

Dr. Cadogan appears to have been the firſt phyſician who introduced the uſe of Magneſia Alba into theſe kingdoms. In his excellent treatiſe on the management of children, he recommended this powder as being more eaſily ſoluble in acids than the common abſorbents, and as a moſt ſafe and efficacious purgative. The opinion of phyſicians was, for ſome time, ſuſpended by the dif⯑ficulty of obtaining it in a ſtate of ſufficient purity. I have uſed my utmoſt endeavours to remove that difficulty; and by the great improvement of calcining it, which was firſt ſuggeſted by Dr. Saunders, the medicine is rendered much more extenſively uſeful.^*

It may be neceſſary to premiſe, for the information of thoſe readers who may not be acquainted with medi⯑cal ſubjects, that alkaline ſalts and abſorbent earths, when united with acids, have their nature entirely chang⯑ed, and form ſalts of a different kind, neither acid not alkaline, which ſalts differ according to the different acid [13]or alkaline employed. It has been too cuſtomary to con⯑ſider the action of theſe medicines as ſolely confined to the abſorption and neutralization of acids in the ſtomach and bowels; whereas, when thus united, they form a combination capable of being admitted into the lacteals, and from thence into the circulation, and thus acquire the property of acting by urine and by increaſing the perſpiration.

ON THE DISEASES IN WHICH MAGNESIA ALBA IS USEFUL.

DURING the firſt months after the birth of a child, the ſtate of the ſolids is lax, and the juices thin and dilute. Theſe circumſtances contribute to the more eaſy growth of the body; yet to prevent the tone of the parts from becoming too much relaxed, nature, with that providential care which pervades her whole crea⯑tion, has given an acid to the ſtomach of young animals to ſtrengthen their fibres and prevent too great a ten⯑dency to alkaline acrimony. But this, like her other proviſions, ſometimes exceeds the bounds which were intended, and degenerates into a diſeaſe of an oppoſite tendency to thoſe it was deſigned to prevent. From the exceſs of acidity in the bowels of infants, the milk is coagulated, and, by oppreſſing the ſtomach, becomes the ſource of many diſeaſes. The bowels are irritated, [14]and ſpaſmodic contractions of the guts occaſion ſevere gripings to the tender infant, and as the nerves are, at that period, exceedingly irritable, convulſions of ſome particular part or of the whole ſyſtem are frequently the conſequence. Green ſtools and ſour vomitings diſcover this acidity in the bowels of young children ſo frequent⯑ly, that one of the beſt writers on the ſubject of their diſeaſes, attributes the origin of all infantile diſorders to this cauſe.^*

Children thus affected always loſe their florid com⯑plexion and become pale and wan. Sometimes they de⯑clare the ſevere gripings which torment them, by the moſt piercing cries; and ſometimes, when their ſtomachs are oppreſſed with coagulated milk or viſcid phlegm, they lie in a ſtate of ſtupidity, refuſing all nutriment. Their ſtools and what they vomit ſhew evident ſigns of acidity, not only in the colour but the ſmell.

Under theſe circumſtances it is too common a practice among nurſes, neglecting the primary cauſe of the diſeaſe, to pour in hot cordials, and often to quiet the complain⯑ings of the infant by adminiſtering opiates, inſtead of attempting to correct and carry off the acidity which occaſions the diſorder. Remove the cauſe and the effect will ceaſe. To this end, where the child vomits up phlegm or coagulated milk, or appears oppreſſed with them, it it may be proper to clear the ſtomach by giving a grain or two of ipecacuanha, or a tea-ſpoonfull of a dilute ſolution of emetic tartar; either of which may be adminiſtered with great ſafety; and after the operation [15]of the vomit, a ſmall doſe of Magneſia may be given and repeated occaſionally ſo as to keep the body of the child gently open. It is a great recommendation of Magneſia, that its inſipidity renders it more agreeable to infants than any other purgative; and it has this advan⯑tage over all the other abſorbents, that it acts as an eaſy purgative, whereas they tend to bind and render the body coſtive; a ſtate which ſhould be ſtudiouſly avoided during infancy, for a plentiful diſcharge by ſtool is al⯑ways ſo favourable to the health of children, that we ought to be very cautious how we haſtily check even the exceſſes which may ſometimes happen in that evacuation. As the looſeneſſes of infants are generally occaſioned by ſome acrid ſtimulus in the bowels, they are beſt cured by changing the nature of the offending matter and diſ⯑lodging it from its ſeat. The method, therefore, which has been propoſed above ſhould firſt be uſed, before any aſtringents are called in to our aid.

The raſh, commonly known by the name of the red gum, and the diſorder called the thruſh or frog, which ſo often affect children during the firſt months, may in general be cured by the ſame treatment. In the former, ſhould the body be too looſe, oyſter-ſhell powder, or ſhalk may ſupply the place of Magneſia. In the latter, ſome topical application may be neceſſary; the following [...]ormula is very efficacious.

Take of egg-ſhells, cleared from the internal ſkin or [...]embrane, dried before the fire, and reduced to a fine powder, and of ſugar, each a quarter of an ounce, of borax [...]n grains, mix them together. Let a ſmall quantity of his be placed now and then on the child's tongue, that [...]e may roll it about in his mouth.

It has been a common practice to give Magneſia to children as a preventive, and to mix it for this pur⯑poſe with their food, in order to correct that diſpoſition which milk and the farinaceous aliments have to turn four. This however ſhould be done with caution, for it is only the exceſs of acidity which is prejudicial to infants: ſome degree of it is neceſſary; and ſhould we too officiouſly and entirely deſtroy, what we ought only to reſtrain within due bounds, we may create diſorders of an oppoſite nature to thoſe we have endeavoured to prevent, and inſtead of an acid, produce an alkaleſcent diſpoſition in the firſt paſſages. Indeed, I fear that diſ⯑eaſes have been more frequently created than obviated by the uſe of preventive medicines, and they ſhould only be allowed in caſes where the approach to diſeaſe is ma⯑nifeſt. But when a child is in a healthy ſtate, the beſt means to preſerve him from a ſuperabundant acidity, is to pay due attention to the regulation of his diet, to give him proper exerciſe, not to confine him too much in the foul air of hot unventilated rooms, to waſh his whole body every day in cold water, and to rub him very well night and morning with a dry flannel, taking care that his ſtomach be not too full at the time when this friction is performed.

Nor would I adviſe parents to rely with too much ſe⯑curity on the virtues of this medicine, where the diſor⯑ders of their children are complicated or obſtinate. The advice of the ſagacious and diſtinguiſhing practitioner will then be neceſſary, to direct what method of treat⯑ment is to be purſued. Nor can I here avoid lamenting that the management of children, when diſeaſed, is ſo [17]often in the hands of nurſes and ignorant women, from an abſurd notion that their diſeaſes are not proper ſub⯑jects of medical inveſtigation; when, in truth, there are none which require a clearer judgment, a quicker pene⯑tration, or a greater ſhare of medical knowledge in the preſcriber.

During the period between dentition and puberty, the diſeaſes attendant on a lax fibre ſtill continue, though not ſo predominantly as in the former ſtage; yet aceſ⯑cency is the manifeſt cauſe, or at leaſt the concomitant of many of the complaints to which children are at this time liable. To this they are diſpoſed, notwithſtanding the change in their diet to a more alkaleſcent kind, by the great quantities of fruit, frequently crude and un⯑ripe, cakes, and other ſweet and greaſy food with which they are too often indulged. By theſe errors, their bowels are overcharged; their digeſtion impaired, and the aliment remaining too long in the ſtomach becomes ſour, and occaſions vomitings, head-achs, and other com⯑plaints which are thought to proceed from worms, and indeed are frequently attended with that diſorder; as the crudities thus generated in the bowels ſerve as a nidus for theſe deſtructive vermin. Here likewiſe Magneſia may be of conſiderable advantage, as an alkaline purga⯑tive, neutralizing the offending acid, and at the ſame time promoting its diſcharge by ſtool. But if the ſto⯑mach be overloaded with mucus, or undigeſted aliment, a gentle vomit ought to precede the exhibition of the Magneſia.

And even in a more advanced ſtage of life, perſons of weak habits, and who lead ſedentary lives, are often af⯑flicted [18]with indigeſtion, four eructations, heartburn, vo⯑mitings, and coſtiveneſs. Theſe diſorders very frequent⯑ly attend women during their ſtate of pregnancy, and are ſometimes almoſt inſtantly removed by the uſe of Mag⯑neſia. Doctor Watſon^* has publiſhed the caſe of a pregnant woman, who was afflicted with ſuch ſevere vo⯑mitings as to bring on convulſions, hiccoughing, and violent pain at her ſtomach. What ſhe brought up was acid, and ſo very acrimonious, as to inflame and exco⯑riate her mouth and throat; and the great uneaſineſs ſhe felt at her ſtomach, upon ſwallowing any liquor that had the leaſt degree of acrimony, or was more than luke⯑warm, made it probable that the internal ſurface of the ſtomach was affected in the ſame manner. In this deſpe⯑rate ſituation, after variety of remedies had been tried in vain, the ſtomach was waſhed with unſalted mutton broth, till the liquor was diſcharged without any acid taſte. Her pain was by this means abated, but in about two hours was apparently returning with the ſame vio⯑lence as before. This ingenious phyſician then directed a drachm of Magneſia to be given in mutton broth, and to be repeated as often as her pain returned, without any regard to the quantity the whole might amount to, ſup⯑poſing her pain to continue ſevere. The firſt doſe reliev⯑ed her, and in three days ſhe took three ounces of Mag⯑neſia; and in the next three days, two ounces more, by which time all her ſymptoms were removed. It is re⯑markable in this caſe, that an exceſſive purging was not [19]the conſequence of taking ſo large a quantity of Magne⯑ſia, where there was ſo much acid to neutralize it.

In bilious habits, where there is generally a diſpoſition in the ſtomach contrary to acidity, Magneſia is uſually eſteemed to be improper, taken alone: but I am dubious whether this opinion is well founded, and many reaſons for theſe doubts may be deduced from ſome experiments which have been recited in a former work.^* However, where putrid bile is to be corrected and diſcharged by ſtool, very good purpoſes may, perhaps, be anſwered by taking the Magneſia, joined with a ſufficient quantity of acid to neutralize it, while in a ſtate of efferveſcence; or by ſwallowing the Magneſia and the acid, one imme⯑diately after the other, ſo as to produce the fermentation in the ſtomach: for thus the fixed air, with which the Magneſia abounds, being let looſe, may powerfully cor⯑rect the tendency to putridity in the contents of the pri⯑mae [20]viae, and at the ſame time evacuate them down⯑wards.

It is probable Magneſia may be of ſervice in diſeaſes of the ſkin. Several authors have attributed cutaneous eruptions, and indeed the antient chemiſts, as has been before obſerved, aſcribed almoſt all diſorders to the pre⯑ſence of an acid in the blood; whilſt others abſolutely deny that an acid can be admitted into the lacteals, or if admitted, exiſt in the blood in a ſtate of acidity. In theſe caſes, however, if an acid acrimony abounds in the ſtomach and bowels, with a coſtive habit, and pale com⯑plexion, Magneſia will be a uſeful corrector, and enter⯑ing the circulation in the form of a mild neutral ſalt, may act as an excellent alterative; or, where there is no ſuſpicion of acidity in the ſtomach, an equal quantity of cream of tartar may be mixed with the Magneſia.

HAVING thus given a curſory detail of the medicinal properties of Magneſia in its natural ſtate, I ſhall now proceed to conſider it in a ſtate of calcination.

MAGNESIA ALBA, &c. ON THE MEDICINAL VIRTUES OF CALCINED MAGNESIA.

THOUGH, in the preceding chapter, notice has been taken of the good effects ariſing from the fixed air of the Magneſia being let looſe in the ſtomach, by drinking ſome acid beverage immediately after the powder, in diſeaſes of a putrid tendency; yet in diſor⯑ders of a different type, and in perſons of flatulent ha⯑bits, the diſcharge of this air by the acid of the ſtomach often occaſions uneaſy ſenſations in the bowels, inflating and diſtending them over-much, inducing griping pains, and above all, a ſenſe of debility or ſinking, which is not eaſily deſcribed. In order to obviate theſe inconve⯑niences, I was induced, by the reaſons mentioned in chapter firſt, to deprive the Magneſia of this part of its compoſition by calcination. By this proceſs it loſt ſeven twelfths of its weight, and though it produced no effer⯑veſcence with acids, yet it had not acquired any degree of acrimony to the taſte; and when thirty grains of it were diluted with a few ſpoonsful, and ſwallowed, it oc⯑caſioned no uneaſy ſenſation in my ſtomach, nor ſenſe of heat in my throat, proved nearly as aperient as a double [20] [...] [21] [...] [22]quantity of uncalcined Magneſia, and operated without the leaſt griping.

Thus Magneſia Alba is not only diveſted of the diſa⯑greeable qualities which have been alluded to, but ac⯑quires new properties which render it likely to anſwer ſome very important practical purpoſes.

Calcareous earths, alkaline ſalts, and Magneſia, be⯑ing deprived of their air, attract it from every ſubſtance with which it has a ſmaller degree of affinity. The two former becoming highly cauſtic by the loſs of their air, cannot be adminiſtered but in very ſmall doſes. But Calcined Magneſia, being abſolutely diveſted of air, though not rendered acrimonious, and being able to ab⯑ſorb a large quantity of this elaſtic vapour, may act more powerfully than the whole tribe of carminatives, yet eſſentially differs from them in many reſpects. They contain a large quantity of air; Magneſia in this ſtate is entirely free from it; Aromatics may be apt to ferment, and increaſe acidities; the Calcined Magneſia is incapable of efferveſcence, and corrects an aceſcent diſpoſition in the gaſtric juices; the former conſtipate the belly, the latter is laxative.

From this property of Magneſia, when calcined, of abſorbing air, it occurred to me that it would, of all others, be the moſt proper purgative for patients labour⯑ing under the ſtone who might be taking the lixivium ſaponarium, or ſoap ley, having the advantage over all the vegetable purgatives, which abound with air, and conſequently have a tendency to render the cauſtic alkali mild and inert: I even flattered myſelf that it might co⯑incide [23]in promoting the efficacy of that powerful ſolvent of the human calculus. Doctor Macbride's theory, that the lixivium acts by depriving the calculus of its fixed air, appears to be well founded; and Mr. Chittick, in the exhibition of his noſtrum, which, notwithſtanding all his arts to diſguiſe it, is now known to have been the ſoap ley, kept his patients from every kind of diet abounding with air. We may therefore venture to re⯑commend it, though not as a lithontriptic, being inſo⯑luble in water, yet as an aſſiſtant to the lixivium, by abſorbing a part of that air in the primae viae, which would otherwiſe be attracted by the cauſtic alkali, and thereby render it incapable of acting on the calculus.

In all the diſeaſes attended with an aceſcent diſpoſiti⯑on in the firſt paſſages, in which Magneſia has, in ano⯑ther place, been recommended, the calcined powder may be given with ſuperior advantages, as it will not produce any of thoſe inconveniences which have been attributed to that medicine when uncalcined. Beſides that it will act in a threefold capacity, viz. as an abſorbent of air, and of acidity, and alſo as an eaſy purgative. I know ſeveral who could never bear to take the common Mag⯑neſia, with whom the calcined perfectly agrees. This medicine has been very ſerviceable in flatulent cholics; and even in gouty habits, joined with ſome warm aro⯑matic, it has been found uſeful in correcting the very great flatulency which ſo much afflicts perſons of this conſtitution; and the Cayenne pepper appears to be the moſt proper addition to it, on account of the ſmall quan⯑tity of this ſpice that is neceſſary to make the Magneſia [24]gratefully warm to the ſtomach. Hypochondriacs, and thoſe perſons who, from leading ſtudious and ſedentary lives, labour under obſtinate coſtiveneſs, and obſtructions of the bowels, have generally recourſe, for the cure of theſe complaints, to warm aloetic purgatives, and with propriety, where their habits are not too full, and diſ⯑poſed to inflammation: but in theſe caſes, the uſe of ſuch medicines frequently induces piles, and inflamma⯑tory irritation; whereas the Calcined Magneſia ſucceeds much better, correcting the acidity which is ſo prevalent in ſuch patients, and removing conſtipation, without oc⯑caſioning the diſagreeable conſequences of more ſtimula⯑ting medicines.

The Calcined Magneſia appears, in general, to be a preferable medicine for children to the uncalcined. It is an agreeable circumſtance that ſo much ſmaller a doſe of the former is neceſſary, as it operates in half the quan⯑tity that is requiſite of the latter, and proves an effectual corrector of the flatulencies which give ſo much diſturb⯑ance to the tender bowels of infants. I have adminiſter⯑ed it to children of but few days old, with ſafety and ſucceſs, nor have I ever obſerved any diſagreeable con⯑ſequences from its uſe.

My ingenious friend Dr. Lettſom^* has related the caſe of a woman, aged 43, who was ſeized with convul⯑ſive twitchings in the left ſide, accompanied with a moſt acute pain under the ſhort ribs, ſhooting towards the re⯑gion of the ſtomach. She had laboured under this diſ⯑eaſe [25]for about two years before her admiſſion into the Diſpenſary in Alderſgate-ſtreet. The fits attacked her two or three times a day, and generally continued from half an hour to three hours. During the paroxyſms, ſhe ſuffered the moſt excruciating torture, till at length, na⯑ture being exhauſted, ſhe ſunk into a ſtate of ſtupefacti⯑on. In ſome of the fits, a ſpontaneous vomiting termi⯑nated them ſooner, but no particular matter was ejected.

Beſides bleeding, bliſtering, and laxative medicines, ſhe had tried a great variety of remedies in vain. Dr. Lettſom, from the frequent eructations of wind, joined with the other ſymptoms, judiciouſly concluded that fla⯑tulence in the ſtomach and bowels principally excited this direful diſeaſe; and that beſides opiates to quiet the convulſive motions, it was neceſſary to abſorb the ſuper⯑abundant air that ſeemed detached in theſe viſcera, and ſometimes diſtended them ſenſibly to the touch.

An emetic was preſcribed to be taken every week, and in order to abſorb the fixed air which might be ac⯑cumulated in the inteſtines, and to correct acidity, ſhe was directed to take four ounces of lime water, and alſo two drachms of Calcined Magneſia three times a day, and one drachm of the Paregoric elixir was exhibited once a day at leaſt.

By the uſe of theſe medicines, and due attention to her diet, ſhe experienced eaſe the firſt week; the fits gradually diminiſhed in violence and in frequency, and [...]n two months nearly ſubſided; at which time the elixir was omitted. She continued to take Calcined Magneſia and lime-water for a week afterwards, and ſince ſhe was [26]diſcharged from the hoſpital, the Doctor aſſures us that her health has remained uninterrupted, without the uſe of any medicine.

Calcined Magneſia is a medicine very well adapted to counteract the coſtiveneſs occaſioned by the uſe of the Bath, Tunbridge, and Briſtol waters; and may be a convenient ſubſtitute for the ſaline purging waters, be⯑ing taken in ſmall doſes, waſhed down with a large draught of pure water, or, in caſes where acidity does not prevail in the ſtomach, of lemonade or any acidu⯑lated liquor.

As a preparative for the ſmall-pox, few medicines can be given to infants preferable to Calcined Magne⯑ſia. And from its antiſeptic property, or power of re⯑ſiſting the putrefaction of fleſh and of bile, it ſeems well deſerving the attention of practitioners, as a purga⯑tive in putrid diſeaſes.