Animadversions on a late treatise on the kink-cough. To which is annexed, An essay on that disorder:
Kirkland, Thomas, 1722-1798.

CHAP. VI. Of the cure of the kinkcough, both when simple and com∣plicated, supported by your own reasons.

n this chapter it was reasonable to expect, that the different indications in all the varities arising from complication with other disorders would have been pointed out; but if we except the measles, in which you have never given this re∣medy, and lancing the gums in dentition, how∣ever complicated the disorder, there is but one in∣dication which is to give hemlock; and giving hem∣lock, we imagine, is no indication at all, but we guess what you mean. And this principle, I ob∣serve, you first lay down when you speak

Of the simple kinkcough.

And yet, two pages, after you forget yourself, and recommend a variety of purging medicines to be taken, if the patient has not two stools a day; so that the contents of the bowels being retained is another indication: and what is very curious, it seems very immaterial with you whether the pa∣tient takes hemlock in a mixture, or in powder, bolus, or pills; and yet, if what we have said about sugar, vegetable juice, and water ferment∣ing be true, the mixture and the powder, &c. may be as different medicines as nitre and salt of Page  34wormwood; and this will be looked upon as one instance, how well you consider what effect com∣bination may have upon the medicines you prescribe.

Of the cure of the kinkcough with worms.

The very same means is recommended in this complication as for the simple kinkcough; be∣cause a child who used to part with a great num∣ber of round worms, had some come away while it was taking this medicine (see case 11.) and, for this reason, we are to believe, that hemlock will, in such cases, often supersede the use not only of laxatives, but of any other medicines whatever in the cure of both disorders.

Of the cure of the kinkcough with a dysentery.

Hemlock is here the best remedy, because opium saved a child's life under these circum∣stances, when the stools had acquired a pretty na∣tural appearance from the use of gentle vomits, laxatives, blisters, the Peruvian bark, &c. But we will ask the advice of those skilled in medicine, whether, notwithstanding the idle theory about the hemlock removing clotty feculent accumulations lurking in the guts, either it or opium can be given with safety, without previous evacuations, or purging medicines joined along with them? Hem∣lock is allowed to act the part of an astringent in diarrhoeas; and will it not, if the advice here given is pursued, confine the fomes morbi in the Page  35intestines, and for the most part be the death of the patient?

The cure of the kinkcough with dentition.

In this variety too hemlock is to be depended upon, because, if both diseases are urgent, by lancing the gum you relieve the patient.

The cure of the kinkcough with an ague.

Again, hemlock is the fac totum, because

"it does not appear that the bark was more effica∣cious than hemlock in poor HELE's case"
(17); only that the bark shift intirely removed the ague, which was not cured while the hemlock was de∣pended on as a febrifuge. Indeed, on the ninth of March it appears from the case, that she had neither ague nor fever, but on the tenth it return∣ed; and on the twelfth, things were in such a state, that recourse was immediately had to the bark shift, and opium, with a good effect. But suppos∣ing the ague fit to be removed for a little time previous to the use of the bark, why is this to be attributed to hemlock? The child's belly was hard and full at the onset of the disease; magnesia and sal polychrest were joined with hemlock, and purged the patient: and have not agues thus cir∣cumstanced been cured by purging medicines? There is scarce a practitioner living who has not cured the ague, accompanied with a big belly in children, with a few doses of calomel and jalap; and so powerful a medicine is sal polychrest and rhubarb in this very case, that Dr. William Page  36Fordyce is of opinion, he might have made a for∣tune by using it as a nostrum; and I am astonish∣ed that any man should have his head so turned, as to draw a conclusion in favour of hemlock from such premises; and what is worse, poor HELE is dead, perhaps because earlier recourse was not had to the bark.

Of the kinkcough with the small-pox; which we have already taken notice of.

Of the cure of the kinkcough with the measles,

Which you have never treated, and therefore your recommendation of hemlock in this case does not require any comment. And we shall hereaf∣ter mention a plain fact, which may perhaps de∣termine whether it or other medicines ought to have the preference in cases of pregnancy*.

The corrollaries we shall hereafter have occasion to refer to; and as to the preparations of hem∣lock we think them unnecessary, because we have already much safer and better medicines of the same class. Indeed it may be much questioned, whether your stewing this medicine over the fire does not render it nea••y effete; for a surgeon Page  37gave some of the extract a considerable time with∣out the least alteration in the patient, but a few spoonfuls of the juice of hemlock, being taken had a most violent and dangerous effect; and, though you are willing to have it believed, that you have availed yourself of the rule given by CELSUS, yet you have not proved that hemlock cures the kinkcough safely, certainly, expeditious∣ly, and pleasantly, or even that it cures it at all. I shall, therefore, take the liberty of instructing you in the use and abuse of this medicine; and if a mind which cannot bear contradiction, should be∣come boisterous upon this occasion, we will, as time and opportunity permit, explain and amend any representations in these animadversions that may displease you; and, perhaps, we may be able to present you with a dialogue from the dead be∣twixt SOCRATES, HELE, and TOPLIS, who all had, while living, sufficient experience of the medicine you so earnestly recommend, and who went out of the world nearly in the same manner.

I am, Sir, Your most humble servant, The AUTHOR.

Dec. 31st, 1773.