Edinburgh Medical and Surgical Jorunal, 10(37): 15-16 (1814)
On the Use of Charcoal-Powder, as a substitute for Cinchona
R. C
ALVERT
Physician to the Forces, Palermo.

A PHYSICIAN to the Sicilian Hospital at Palermo, having hinted to me, that he had prescribed the powder of charcoal in a case of intermittent fever, with success, and recollecting myself that burnt rags, soot, and similar substances, have sometimes succeeded in curing agues in England, I determined to try the effects of charcoal in an obstinate case of ague in my hospital. Finding it succeed in that instance. I have continued to employ it in a variety of other cases. And, was [permitted to form a judgment of its virtues after the short but active period in which I have used it, I should declare it equal, if not superior to Peruvian hark. I subjoin the original case of Dr Calcagno, the Sicilian physician, wherein sulphuric acid was given, with an idea of liberating carbonic acid, or some antiseptic principle which he thought the charcoal contained. As I was not aware of any such principle to be liberated by the combination, I omitted the acid entirely, and without disadvantage, as will be seen in the second case, which was also the next in order of the cases in which charcoal was employed at this place.

*Might it not have a good effect, during the remissions in the plague?

The general effects of this substance seem to be, to take away bitter and disagreeable tastes in the mouth; to allay sickness, wherever is a tendency to vomit, and sometimes to stop the vomiting, when it has occurred; to promote appetite, and assist digestion. It has some tendency, however, to constipate the bowels; but it neither produces griping nor any other unpleasant symptom. In one instance, indeed, where I prescribed it, immediately after the bloody evacuations had ceased in a dysentery of a week's standing, it appeared to prevent the recurrence of that disorder. In any species of fever, after the natural evacuations by the skin and kidneys have been restored, it appears to preserve them in that state, and prevent the fresh accession of fever*. Whether or not the carbon finds its way into the mass of blood, I will not attempt to decide, but certain it is, that the lips soon lose that milky opake appearance, so common in intermittents, and gain a deep redness, while the skin is very soon tinged with the colouring matter, if it may be so called, of the carbon. These two last effects, however, soon go off when the remedy is discontinued.

Should further experience confirm the efficacy of this plentiful, cheap, and well known substance, so as to render it a common substitute for Peruvian bark, it will cause a considerable saving to government. But the greatest advantage will be felt amongst the poor.

I have paid no attention to the particular wood from which the charcoal is obtained; the only selection I have made being of the best charred pieces.

The most convenient mode of administering it is in the form of bolus, folded in a wafer made of flour, after dipping it in water, as is commonly practised in Roman Catholic countries. I am Sir, your most obedient servant,

R. CALVERT, Physician to the Forces.

CASE I. (Translation from the original Italian.)

*A situation in Sicily, peculiarly subject to intermittent fevers.

On the 5th July, a young man named GIACHINO COLOMBA, from Cessalu, aged 20, was admitted into this great hospital; by profession a seaman, of a sanguineous temperament, and tolerably well fed. He had been affected three days with a fever, that as.. sailed him every day towards two o'clock P. M. with a sensation of cold, and that afterwards terminated towards morning with a little perspiration, leaving him free from all those troublesome symptoms, such as thirst, headache, and excessive heat, which tormented him during the course of the paroxysm. He assigned no other cause for his complaint than his employment; but said, that, a few days before, be lived on the shore of Caronia, near a rivulet*. A vomit was immediately prepared of two grains of tartar-emetic, with a drachm of acetito-ammoniacale, (acetite of ammonia.) He vomited a quantity of mucous yellow matter. When visited after dinner, the fever was upon him, the cold stage of which, he said, came on at two o'clock, as usual. Decoction of elder flowers; broth, but no food.

(Signed) FRANCISCO CALCAGNO.

CASE II.

JOHN GRAHAM, private 20th Light Dragoons, aet. 45, melancholic temperament, was first attacked with a tertian fever about twelve months ago, when quartered near the Mole at Palermo, but not a great while after leaving the Stradone, a place notorious for producing remittent and intermittent fevers. He states, that he remained about three months in the hospital of the 3d Battalion King's German Legion, during which time he took a considerable quantity of bark; that in a few days after his discharge, the fever returned, though in a slighter degree, and has hung about him ever since; that he was admitted into the detachment hospital about three months ago, labouring under an inflammation of the intestines, which caused him to lose a considerable quantity of blood (about 90 ounces) ; that he recovered and was discharged.

On the 14th June last he was readmitted with a gonorrhoea and swelled testicle. These complaints had nearly disappeared, when, on the 16th July, during the morning visit, he was seized with a very strong paroxysm of the ague. Its violence was somewhat interrupted by a dose of opium and the pediluvium. The paroxysm being over, he began to take a drachm of the powder of bark every three hours; low diet, four ounces maccaroni,

Palermo, 1st August 1813.