G. J. PALMER, PRINTER, SAVOY-STREET, STRAND.
ON
COD-LIVER OIL.
The introduction of a new therapeutical agent into general practice cannot fail to interest the medical profession and the public, and, profiting by the experience attained in a consideration of the manner in which former remedies have been brought into notice, extolled for their efficacy, persevered in for a time, and then gradually permitted to fall into disuse, and finally sink into oblivion, it will doubtless be useful to review the circumstances attendant upon the proposal now so generally entertained of the administration of the cod-liver oil for a variety of diseases and disorders.
Although it is only of late that the attention of the public has been particularly drawn to this subject, principally by the zealous endeavours of the Medical Practitioners of Germany, it will be found upon inquiry that the remedy is by no means a novel proposal; nor are we even indebted to our foreign savans for its introduction. It is to be traced back to the latter part of the 18th century, at which time it was extensively used in the Manchester infirmary, and its effects, as there exhibited, have been reported by the late Dr. Samuel Argent Bardsley, in his “Medical Reports,” 1807, 8vo. This able physician, who was for many years attached to the Manchester infirmary, in which institution chronic rheumatism formed a very large proportion of the medical cases under treatment, states, that for this afflicting malady, the Oleum Jecoris Aselli, or cod-liver oil, enjoyed a high reputation in Lancashire, and that thirty years previously to the time at which he published his useful and truly practical work, it was introduced by one of the physicians to the infirmary, and that its success was such as to induce the celebrated Dr. Percival to recommend it to his notice and attention as deserving of a fair and extensive trial.
Dr. Percival remarks, (Works, vol. iv. p. 355,) that it was so largely dispensed at the Manchester infirmary, that “near a hogshead of it was disposed of annually;” yet its employment was almost solely confined to the relief of cases of chronic rheumatism, sciatica, and those contractions and rigidities so frequently the consequences of exposure to damp and cold. In these cases it was considered as superior to all other remedial means that had been used, and its beneficial effects were strikingly apparent. The operation of the oil in the first instance was mostly to increase the pain sustained by the afflicted, but this was soon succeeded by a gradual subsidence of the severity of the symptoms. It occasioned, particularly in irritable habits, an acceleration of the pulse, and diffused a glow of warmth over the whole frame of a very agreeable description. It promoted the secretions of the skin, and occasionally acted on the bowels. It was observed, that when its use had been persisted in for a few weeks the tongue became foul and the appetite impaired, so that an emetic was found to be necessary. It was, however, given in large doses, varying from one to three table-spoonfuls twice, thrice, or four times daily. It was also employed extensively as a liniment to the stiffened joints or limbs; but if soreness existed its use was forbidden; it was also never exhibited internally when fever was present.
The oil employed at the Manchester Infirmary was obtained from Newfoundland, and brought thence in barrels containing from 400 to 520 pounds in weight; it was obtained by the putrefaction of the livers of the fish, which were heaped together for the purpose. The oil so procured was, however, found to be exceedingly nauseous and offensive, both as regards smell and taste, so that but few stomachs could bear it, although a variety of means were resorted to to disguise its unpleasant character.
Notwithstanding this, Dr. Bardsley remarks, that where it could be persisted in, such was the power of habit, that a relish for its flavour succeeded to its use, and what before was taken with such extreme disgust became pleasurably received. Dr. Percival says, the oil left upon the palate a savour like that of putrid fish, and that the perspiration of those taking it was strongly tainted with it. The oil, however, was not solely obtained from the livers of the cod-fish, but also from the ling (the Gadus Molva). So offensive was it found to be, that it was, in many instances, rendered necessary to combine it into the form of a liquid soap, and it is not too much to assert, that the efficiency of it as a remedy must have been, in no inconsiderable degree, impaired by the formulæ to which it was reduced.
Mr. Darbey, the house surgeon of the infirmary, in a letter to Dr. Percival, states the discovery of the effects of cod-liver oil to have been accidental, and to have occurred in a patient who, using it externally, was induced also to take some of it internally. She recovered the use of her limbs, and in a few weeks was dismissed. No particular attention was directed to the circumstance until her return to the infirmary, in the course of 12 months, on account of a renewal of her complaint with considerable violence, which, however, soon subsided by the employment of the same means of relief. Dr. Kay, one of the physicians of the infirmary, remarked upon the case, and wished to test the character of the remedies in similar cases, and found the practice to succeed beyond his most sanguine expectations. It is worthy of remark, that the instances in which it was found to be most serviceable were those in which the perspiration was gradually promoted. Those who had been cripples for many years were found, after persisting in its use for a few weeks, not only to be able to quit their seats, to which they had been confined, but also to walk even without the aid of crutches or a stick. The effects were so remarkable, that application was made to the infirmary for the oil in all kinds of lameness, and an expenditure of not less than 50 or 60 gallons annually was the result. This practice was commenced about the year 1772, and continued for many years afterwards.