As in theory, so in practice, I believe that M. Broussais considers that rheumatism is to be viewed in the same light as the gout.
M. Laennec employs general bleeding in acute rheumatism; leeches in the chronic; and tartar emetic in both forms of the disorder.
An analytical examination of the points of doctrine and practice, which I have here briefly discussed, would lead me far beyond the limits which I have intended to observe in this Essay; but I could not overlook the most interesting novelty which has, for the last five years, engaged the French school of medicine.
It is still a custom amongst the French physicians to employ tisanes, which are decoctions or infusions of roots, herbs, flowers, or grains, as medicinal remedies on which they seem to place considerable reliance. The “formulaire pratique des Hôpitaux civils de Paris” contains nearly ninety prescriptions of different kinds of tisane. With us, the Lisbon diet drink, or the simple decoction of sarsaparilla, is the only medicine which we direct to be taken in quantity as a drink. But even sarsaparilla is given with more advantage, in a state of concentration, by using the cortical part of the root, exclusively, in which the whole virtue seems to reside.
I object to the general principle of using medicine in a state of large dilution. It is true that the French do not prescribe active substances in this form; but their fondness for these feeble agents, tends to establish inefficient and almost insignificant practice.
Diluent drinks are useful adjuncts to medicine; but I should think that a very limited number of tisanes would comprise all that can be considered either as useful or agreeable.
The nurse may safely act the part of the pharmacien in this department, but, at the same time, should be directed by the physician as to the preparation of suitable drinks. With this qualification, the attention of the French physician in nicely regulating the regimen of the sick chamber, is worthy of our imitation. The effect of the most useful and appropriate medicines will often be frustrated, unless a corresponding care in the plan of diet be strictly observed.
To this mode of practical medicine peculiar to the French, which I have here criticised as not worthy of the skilful physician, there are some striking exceptions.
At the excellent Hospital St. Louis, chiefly appropriated to the treatment of the various diseases of the skin, and principally under the direction of Alibert and Biett, arsenical and other active preparations are administered without apprehension. They prefer small doses of arsenical solution, twice a-day for a continuance, to the use of large doses for a short time. Tincture of cantharides, in the dose of twenty drops twice a-day, is one of their favourite remedies, alternately with arsenic, in the treatment of the order Squamæ. Before employing such medicines, however, they are careful to remove all inflammatory action from the system.
Subcarbonate of ammonia, dissolved in water, in the proportion of two drams to a pint and a half, and given in this quantity daily, is found useful in certain states of cutaneous irritation, apparently caused by a free employment of mercury for syphilis.