86 
THE PHARMACEUTICAL JOURNAL AND TRANSACTIONS. 
[July 29, 1871. 
3 > 
Codeia. 
f l TT -VT- /~k ( 0 II 
''1' 0 ( O.CH; 
Deoxycodeia. 
C H N O I ^ 
M7 ±1 i7 JNU (O.CH, 
Bromoeodide. 
C J7 H lf N0{^ CH 
Deoxymorpliia. 
c w h„ko{“ h 
3 » 
so that deoxycodeia probably bears to codeia the same 
relation as free hydrogen, H 2 , to water, H. OH; or as 
Ch “ CH OH 
acetic acid, q q 3 q pj, to glycollic, ^ q 2 q jj 5 bromoco- 
dicle corresponding similarly to hydrobromic acid, H Br, 
or to bromacetic acid, ^ q ~0 H 
Experiments are in progress to gain further insight 
into the structure of the group Cj-Hj-NO. By "the 
action of hydriodic acid on codeia methyl is eliminated 
as iodide, and the elements of free hydrogen and those 
of PI I are added on to this group ; from which, as well 
as from the easy polymerization to form tetracodeia 
bases, it appears probable that some at least of the 17 
carbon atoms are connected together somewhat after the 
fashion of ethylene or acrylic acid, which unite readilv 
with HI, HBr,H 2 , etc. Again, the oxidizing action of 
AgN0 3 on chlorotetramorphia is accompanied by the 
production of C 0 2 , which renders it not improbable that 
the third oxygen atom exists either as the group 
[C H (0 H) ]" or as C 0". 
On carefully examining, side by side, the qualitative 
reactions of the hydrochlorate B and those of a specimen 
of pure deoxycodeia-salt from codeia (without evolution 
of methyl bromide), not the slightest difference was dis¬ 
cernible between the two; in their physiological ac¬ 
tions, too, as observed by Dr. Michael Poster, the two 
bodies seemed perfectly alike, both being utterly dissi¬ 
milar from apomorphia, from which in all other respects 
(qualitative reactions, percentage, composition, etc.) they 
differ either not at all, or extremely little. 
{To be continued.) 
THE MODERN ASPECTS OF THERAPEUTICS. * 
BY WALTER G. SMITH, M.D. 
It must be allowed that the reproaches which have 
been so often levelled against the practice of medicine 
have had much foundation in the past history of thera¬ 
peutics, and all will re-echo Sir T. Watson’s opinion, 
that “ certainly, the greatest gap in the science of medi¬ 
cine is to be found in its final and supreme stage—the 
stage of therapeutics.” Some of its keenest satirists 
have been physicians of the highest eminence and most 
varied acquirements, and, on the whole, it must be ad¬ 
mitted, that the improvement of therapeutics, contrary 
to the other arts and sciences, “bears no proportion to 
its antiquity.” It is the consciousness of this dispropor¬ 
tion which damps the spirits of so many in the profes¬ 
sion, and which has led to so much distrust and doubt. 
Dr. Radcliffe used to say that “the whole art of physic, 
for which he had a profound contempt, might be written 
on one sheet of paper,” and it is not so long since the 
late Sir W. Hamilton, of Edinburgh, asked the ques¬ 
tion :—“ Has the practice of medicine made a single step 
since Hippocrates?” a revival of the older query, an 
datur ars medicince ? 
There are many evidences that the need for a more 
careful study of therapeutics is urgently felt by the body 
of the profession at large. In 1865, the physiological 
sub-section of the British Medical Association drew up a 
memorial to the General Medical Council praying the 
Council “ by pecuniary grants, and the appointment of 
* Thesis for the degree of M.D., 1870. Read before the 
Medical Society of the College of Physicians, March, 1871. 
suitable persons, to undertake investigations into the 
physiological action of medicines.” This memorial was 
supported in the council by the Regius Professors of 
Physic in the Universities of Dublin and Oxford, but was 
negatived on the ground of want of powers in the council 
to comply with the petition. 
A sub-committee was then appointed by the British 
Medical Association, and the results of its labours are 
seen in the elaborate report brought out by Dr. Hughes 
Bennett, on the action of mercury, podophyllin, and 
taraxacum on the biliary secretion. About the same 
time the Royal Medical' and Chirurgical Society in¬ 
trusted the examination of the method of subcutaneous 
injection to a committee, and the valuable observations 
embodied in their report furnish the most satisfactory 
data which we possess respecting this method. Quite 
recently the Medical and Psychological Association of 
Edinburgh have appointed a committee for the purpose 
of taking into consideration, among other things, the 
medical treatment of insanity, and they suggest propo¬ 
sitions for combined therapeutical investigation, and ask 
for special information on the action of chloral. The 
Clinical Society of London owes its establishment in 
1868, to the expressed want of more real knowledge on 
the various remedies in daily use, and the appearance of 
numerous detached papers, and of some works of merit 
on the doctrines and requirements of therapeutics testify 
to the deep-seated interest which now attaches to the 
prosecution of this subject. 
I propose, now, briefly to inquire what aro the re¬ 
sources at our command, and how far it may be said that 
therapeutics has advanced within the last quarter of a 
century, what are the hindrances to its progress, and, 
more particularly, in what directions we may hope for 
still further and more solid advances than have yet been 
gained.* 
To avoid entering upon too wide a field my observa¬ 
tions will be chiefly confined to the domain of what may 
be called medicinal therapeutics, i. e., of remedial agents 
as directly applied to the treatment of disease, and 
accordingly the steady progress and increased know¬ 
ledge of sanitary science and preventive medicine, the 
splendid results of operative surgery, and the develop¬ 
ment of state medicine, will be passed over without com¬ 
ment. 
The retrospect of the history of therapeutics for cen¬ 
turies past, is, in many respects, not encouraging, and 
one can scarcely help wishing that much, if not most, of 
what is called the accumulated experience of ages were 
swept clean out of remembrance, so overladen is it with 
confusion, misstatements, and unproven theories. In 
fact since the prevailing ideas as to the action of drugs 
became in some degree fixed at a time when pathology 
was less exact than it is now, when there were no such 
accurate means of testing the real effects of remedies, 
and when physics and chemistry were in their infancy, 
we cannot avoid insisting on the necessity for renewed 
observations, carried out under better auspices, and with 
a better directed aim. 
Yet it will be conceded that the materia medica 
abounds in agents by means of which very remarkable 
effects can be produced on the human frame, and a specu¬ 
lative mind might engage itself in showing that the 
possession of such powers by various medicines is an 
argument in favour of our being intended to exercise a 
due control over the progress of disease. Even as it is 
we can, at will, exalt or depress the action of the heart, 
the great fountain of life, and can, to some extent, con¬ 
trol the capillary circulation; we can compel the stomach 
to eject its contents, and the intestines to discharge their 
excreta. We have agents that act on special functions 
* For many suggestions I am especially indebted to, and 
have largely made use of Sir W. Jenner’s admirable address 
on medicine, delivered last year in Leeds, and Dr. Rogers* 
recent able work on therapeutics. 
