Part 17

There has been much discussion concerning the best method of making these pills so as to keep them from oxidation. Honey was for a long time generally used as the excipient, but glycerin and sugar are generally preferred with gum acacia or tragacanth. Pilula Ferri, B.P., is a substitute for Blaud’s pills.

THE CHELSEA PENSIONER.

An electuary for rheumatism bearing this title was evidently popular under the above name in the early part of the nineteenth century, but I have not been able to discover where or when or with whom it originated. The compilers of books of formulas naturally copy from each other, and consequently a legend once started is likely to become crystallised.

In The Chemist and Druggist, of June 13th, 20th, and 27th, 1896, an attempt was made to track this medicine to its origin, and a number of old formulas were sent in by correspondents. The statement is made in many books that the compound acquired its name from the circumstance that the recipe for it was given by a Chelsea Pensioner to Lord Amherst for gout and proved so successful that Lord Amherst gave him £300 and an annuity of £20. Sometimes this story associated Lord Anson with the pensioner and the amounts given in gratitude varied from £300 to 500 guineas, with an annuity sometimes of £20, sometimes of £30, and occasionally of £100. The then living descendants of Lords Amherst and Anson were written to by The Chemist and Druggist, but neither could give any information. It rather looks as if the fiction were concocted as an advertisement in the days when the electuary was a proprietary medicine, if it ever was.

The earliest formula traced in the correspondence referred to was given in Gray’s Supplement, 1821. This ran:--Pulv. gum. guaiaci, ʒi; pulv. rhei, ʒij; pulv. pot. bitart., 1 oz.; flor. sulph., 2 oz.; one nutmeg, and 1 lb. of honey. Of this, the dose was two tablespoonfuls night and morning. Sometimes pulv. pot. nit. is substituted for pulv. pot. bit.; probably a mistake of a copyist. In other formulas mustard appears instead of nutmeg; perhaps a similar slip for myristica. Treacle occasionally takes the place of honey, and the proportions of the ingredients vary considerably.

The Secretary of the Chelsea Hospital was good enough to take some trouble in reply to my inquiry to endeavour to trace this compound, but only negative results were attained. Dr. Thomas Ligertwood, the oldest living medical officer of the Royal Hospital, was appealed to, but he only knew of the remedy as “a very useful combination,” and had never heard the story of Lord Amherst’s purchase of the secret. He thought some information might be found in a work on the “Diseases and Infirmities of Old Age” by Dr. Daniel Maclachlan, a former Principal Medical Officer of Chelsea Hospital. That work (dated 1863) contains two allusions to the Chelsea Pensioner, but nothing about its history. Writing of Chronic Rheumatism the author says:--“ ... The more stimulating diaphoretics and diuretics prove serviceable. Among these the preparations of guaiacum deserve the confidence they have long enjoyed. The virtue of the powder (sic) known as the Chelsea Pensioner is chiefly due to the guaiacum and sulphur it contains.” In the section on gout he writes:--“The once famous Portland Powder has for long been abandoned, as has also the almost equally noted Chelsea Pensioner gout powder. One formula for the latter consisted of rhubarb, sulphur, nitre, and gum guaiacum, in equal parts. Fifteen or twenty grains of the powder were taken morning and evening in treacle. Another was powdered bark, ginger, guaiacum, aa ʒi, cream of tartar 1 oz., flowers of sulphur ½ oz., to be made into an electuary with simple syrup. One teaspoonful to be taken three times a day. This is certainly not a bad combination though a nauseous one.”

The following formula is given in the “Pharmacopœia Batava recusa cum notis et additamentis Medico-Pharmaceuticis,” published by J. F. Niemann, in 1824:--Resin of guaiacum, rhubarb, aa ʒij; supertartrate of potash, 1 oz.; sublimed sulphur, 2 oz.; one nutmeg; despumated honey, 1 lb. It is evident that this “Anti-Rheumatismal Electuary,” as Niemann calls it, and the Chelsea Pensioner had a common origin, and as the formula is not to be found in Niemann’s previous edition, 1811, it would appear to have come into popularity between that date and 1824. So far it remains doubtful whether its composition is due to an English or a Dutch author.

CITRINE OINTMENT.

An ointment thus named appeared first in the P. L. 1650. It was a compound of coral, limpet shells, quartz, white marble, white lead, and tragacanth incorporated into a basis of hogs’ lard, suet, and hens’ grease. It was reputed useful for certain skin complaints, freckles, etc. In the P.L. 1678 some of the old ingredients were omitted, sugar of lead was substituted for the white lead and rose water, and frankincense and citron bark were added.

Nitrate of mercury ointment appeared first in the Edinburgh Pharmacopœia of 1722. It was made by dissolving mercury in a sufficient quantity of nitric acid, and adding the solution to melted lard gradually. This was not a satisfactory formula, and it was not until 1787 that anything similar was introduced into the P.L., when 1 oz. of mercury, 2 oz. of nitrous acid, and 1 lb. of lard were combined. This was intended, according to Christison, as an imitation of the well-known golden eye salve, which, however, was, as we know it, an ointment of the red oxide of mercury. Other authorities, Paris Dorvault, Gray, etc., have stated that Singleton’s golden eye ointment was an ointment of sulphuret of arsenic, orpiment some say, realgar others. Pliny refers to the use of sandrach (probably realgar) as an application in ophthalmic affections.

Apparently the originator of the P.L. nitrate of mercury ointment was a Dr. Thomas Nettleton of Halifax, Yorkshire. In a pamphlet entitled “On a Safe and Efficacious Medicine in Sore Eyes and Eyelids,” by Thomas Dawson, M.D., of Hackney, printed in 1782, the writer relates that he had heard of a yellow ointment specially good for sore eyes, which fifty years previously had been in the possession of Dr. Thomas Nettleton of Halifax, “whose merit as a man and a physician exceeds all encomium.” One day one of Dr. Dawson’s patients told him of a yellow ointment she had had from a Dr. Key, of Manchester, who had been a pupil of Dr. Nettleton’s. Dr. Dawson wrote to Dr. Key, who at once sent him the recipe, which was as follows:--

Take 1 oz. each of aqua fortis and mercury; dissolve and add the solution to 8 oz. of butter melted. To this add 2 drachms of camphor dissolved in 2 oz. of olive oil.

About the end of the eighteenth century, a citrine ointment, made with an ounce of mercury dissolved in nitric acid and incorporated with a pound of lard, was introduced into the Hotel Dieu Hospital of Paris, and used to cure itch. The formula was adopted in the Dublin Pharmacopœia, 1807.

COLD CREAM.

The Unguentum Refrigerans, also called “Ceratum,” appeared in the first P.L., the formula being attributed to Galen. Four ounces of white wax were melted in 1 lb. of rose oil (ol. rosarum omphacinum, that is, olive oil in which rose buds 4 oz. to the lb. had been macerated, the maceration being carried out three times, each time with a fresh lot of roses). The melted oil and wax were to be poured frequently from one vessel to another, stirring in a little cold water meanwhile, until the mixture became white. Lastly, it was to be washed with rose water, and a little rose water and rose vinegar were to be added.

DIACHYLON PLASTER.

The original formula for this plaster was compiled by Tiberius Claudius Menecrates, who lived in the reign of the Emperor Tiberius, and was probably his physician. In a Greek inscription discovered at Rome he is described as Physician of the Cæsars, probably Tiberius, Caligula, and Claudius, for he died in the reign of the last named. He wrote a great work on remedies entitled “Autocrator Hologrammatos,” literally, “The Emperor, whose words are written in full.” Probably the book was dedicated to one of the Emperors, and thus got its first title. The second intimates that the recipes are written out in full so that any reader could understand them; suggesting that the other physicians who wrote such books were in the habit of employing abbreviations.

The formula for diachylon and the directions for compounding it were put into iambic verses by Servilius Damocrates, who lived a little later than Menecrates, and it is in this form that they have been preserved by Galen. Briefly the composition was to incorporate 1 lb. each of the mucilages of fœnugreek, of linseed, and of marshmallow root with 3 lb. of old oil, and 1½ lb. of golden litharge. The mucilages were made by boiling the seeds and root in water. Damocrates concludes his poem with the line (I quote from the Latin translation): “Vocabat ipsum non absurde Dia Chylon.”

Mesué wrote at length about this plaster, and devised a much more complicated formula which was named Diachylum Magnum. It contained, besides the mucilages already named, others made from raisins and figs, juices of orris, squill, and dill, œsypus (sheep wool fat), turpentine, rosin, and wax. Subsequent authors also devoted their talents to the further improvement of this famous preparation.

Diachylon meant a preparation of juices, and this plaster received the name of plaster of the mucilages in many pharmacopœias. In 1746 the London College, having dismissed the adjuncts, altered the name of the simple plaster to Emplastrum Commune, but the old term has refused to die. An Emplastrum Commune cum Gummi was also prescribed. This contained galbanum, thus, and turpentine combined with the Emplastrum Commune.

The Menecrates to whom we owe Diachylon is alleged to have written 155 works, and Galen gives a number of his formulas, but no other than Diachylon has survived. He must not be confounded with the perhaps more celebrated Menecrates who was physician to Philip of Macedon. This one was particularly noted for his vanity, which amused the king. Once he wrote a letter to Philip commencing “Menecrates-Jupiter to King Philip, greeting.” The king replied, heading his letter, “Philip to Menecrates, Health and Common Sense.” Menecrates got himself up to look like Jupiter, and had attendants who were made to figure as Apollo, Æsculapius, and Mercury. Philip gave a banquet in his honour. A separate table was reserved for him, and instead of viands only incense was served to him, while the other guests were gloriously feasted. Menecrates was offended at the joke and left the table in anger. He is credited with having written a Book of Remedies, but it has been lost.

DOVER’S POWDER.

Thomas Dover, to whom we owe “Dover’s Powder,” practised as a doctor in London in the first half of the eighteenth century. He was born and buried at Barton on the Heath in Warwickshire in 1660. How he got his medical training is not on record, but some time in his youth he lived in the house of Thomas Sydenham, the famous physician, from whom probably he acquired his independent ideas of medical treatment, and possibly the germ of his lack of reverence for the College of Physicians. While living with Sydenham he had small-pox, and forty or fifty years later he described how the doctor treated him. First he was bled to the extent of 22 oz.; then he took an emetic. He only took to his bed when he became blind with the disease. In his bedroom he had no fire, the windows were always kept open, and the bedclothes were only allowed up to his waist. This was in the middle of January. For medicine, Dover says, “he made me take twelve bottles of small beer acidulated with spirit of vitriol every twenty-four hours,” and he concludes, “I never lost my senses one moment.”

Having resisted both the disease and the treatment, Dover is first heard of in practice in Bristol in 1684. He plodded along there until 1708, when at the age of forty-eight he set out with a privateering party on a voyage round the world. The expedition consisted of two ships, the Duke and the Duchess. Captain Woodes-Rogers, who has left an account of the voyage, was in chief command, and Dover on the Duke was his lieutenant. He must have had previous experience of seafaring life or he would never have been entrusted with the command of a vessel.

The buccaneers were away from England three years, and when they returned they brought with them a Spanish frigate of twenty-one guns, and a quantity of loot. One event of their voyage proved to be of world-famous importance. On February 2, 1709, Dover, on the Duke, touched at the island of Juan Fernandez and took on board Alexander Selkirk who had lived alone on the island four years and four months, and whose story was to develop in the skilful hands of Defoe into that of the immortal Robinson Crusoe.

A few months after leaving Juan Fernandez the expedition arrived at Guayaquil in Peru. Having duly sacked the city and stored their plunder in the ships, the sailors slept in the churches, and Dover quaintly relates how annoyed they were by the smell of the Spanish corpses; for plague was raging in the place at the time, and the victims were buried just under the floors with only a plank or two over them. Two days later, at sea, the disease broke out among the crews. They had 180 cases all at the same time, and Dover had four surgeons with him. He ordered them to go round and start bleeding all the patients, and to stop the bleeding when the round had been completely made. About 100 oz. of blood, he says, was taken from each man. Then he gave them spirit of vitriol, and only seven or eight died.

The next we know of Dover is that from 1721 to 1728 he was in practice in Cecil Street, Strand; he returned to Gloucestershire for a few years, then came back to London and practised in Lombard Street, removing in 1736 to Arundel Street, Strand.

He is supposed to have died about 1742. It was in these latter years that he wrote his “Ancient Physician’s Legacy to his Country.” He describes himself on the title-page as Thomas Dover, M.B., and his book as “Being what he has collected in forty-nine years’ Practice, or an account of the several diseases incident to mankind, described in so plain a manner that any person may know the nature of his own disease. Together with the several remedies for each distemper faithfully set down.”