OBSERVATIONS
                                  ON
                          THE COD-LIVER OIL.




                             OBSERVATIONS
                                ON THE
                         OLEUM JECORIS ASELLI,
                                  OR
                            COD-LIVER OIL;

           ITS NATURE, PROPERTIES, MODE OF PREPARATION, &c.


                                  BY
                             JOHN SAVORY,

     MEMBER OF THE SOCIETY OF APOTHECARIES, LATE PRESIDENT OF THE
        ROYAL PHARMACEUTICAL SOCIETY OF GREAT BRITAIN, &c. &c.


                                LONDON:
                 JOHN CHURCHILL, PRINCES STREET, SOHO.
                                 1849.




                                LONDON:
             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.

One of the great evils attendant upon the introduction of a new
remedy is the universality of its application to cases, often of very
dissimilar nature. Its inefficiency to such a variety of purposes
thereby speedily becomes apparent, and those disorders to which it may
be beneficially applicable cease to be subjected to its operation:
the novelty is gone; a prejudice against its use is created, and some
new proposition speedily serves to banish it from a position it might
probably, with advantage, have held in the Materia Medica.

Dr. Bardsley, writing in 1807, however, gives his testimony to the
efficiency of cod-liver oil in cases of chronic rheumatism, and says,
“In some instances, where every other means have proved unsuccessful,
it has operated in a manner so decidedly beneficial as to excite
astonishment.” In many cases, however, of a mild description, it has
not been of any advantage. In the chronic rheumatism of aged persons,
in whom the muscles and their tendons have acquired great rigidity, so
that the joints have become almost inflexible, it was found to be most
serviceable. In females, also, whose powers had been much depressed
by frequent parturition, and in whom debility towards the decline of
life prevailed to a great degree, it has served to produce the happiest
effects. And, in all the cases, in which it has been attended with
benefit, it has uniformly been remarked that the consequences produced
by the exhibition of the oil have been to occasion an increase of
power, size, and general fatness. Its operation was far from being
uniform, for whilst in some instances it produced increased action
of the bowels and promoted the alvine discharges, in others it had
a tendency to induce constipation. In some it occasioned increased
perspiration, and in others an addition to the secretion of the urine.
In some it produced an eruption of the skin, attended with a sense of
prickling heat. In some few cases, none of these sensible effects were
to be observed. When it proved serviceable, its beneficial effects
were found to be apparent in the course of a fortnight, and if at the
expiration of that time no good resulted, little was to be expected
from a continuance of its use; it was, however, remarked, that when
it began to be useful its progress was observed to be gradual, and it
became necessary, in order to insure a cure of the patient and to guard
against a renewal of the attack, to continue its daily exhibition for a
period extending to not less than six or eight months.

The observations of these enlightened physicians have been confirmed
by more modern practitioners. Corroborative evidence has been adduced
against its employment in acute cases, or those attended by active
inflammatory action, and for its employment in chronic cases attended
by a low inflammatory condition, or in those cases where want of power
and diminished strength are most apparent.

It is not a little remarkable, that after the able and valued testimony
just alluded to, an agent of such therapeutical properties should have
been allowed to fall into utter neglect in this country. Much praise
is due to the physicians of Germany for investigating the subject, and
practically testing its efficiency. It would be out of place here,
and foreign to my purpose, to call attention to the various trials to
which the remedy has been submitted and its efficient powers confirmed;
these are to be found in the medical periodical literature of Germany
and France, and have been translated and transferred to the pages of
our own journals. (See “Medical Gazette,” “Lancet,” “Pharmaceutical
Journal,” “Medico-Chirurgical Review,” “British and Foreign Medical
Review,” “Continental and British Medical Review,” “London Journal of
Medicine,” &c.)

The cod-liver oil has been found principally efficacious in rheumatic,
gouty, and scrophulous cases, with their accompanying manifestations of
cutaneous eruptions and neuralgic pains. Whenever a deficiency of tone
is apparent in the system, its employment has been found of benefit.
Where, as in pulmonary cases, it cannot be looked upon as curative,
it nevertheless tends to the general support of the frame, and may
probably serve to give time for the employment of other remedies more
especially directed to the existing disease.

That cod-liver oil should produce fatness, will not occur as
remarkable to any one who looks at its composition, the principal
ingredient of which consists of carbon; this is present in all oils
to a great degree, and it therefore offers a very valuable aid in
cachectic cases, and others of diminished power and general weakness;
hence it has been remarkably efficacious in cases of mesenteric
disease: its powers also in exciting the lymphatic system to activity,
in promoting also the capillary circulation, and in effecting
absorption of scrophulous deposits, have been very striking, and
demand the attention of every practitioner. Its effect is not merely
increasing the deposition of fatty matter in the system, but, as Dr.
J. C. B. Williams has asserted, increasing the muscular strength and
action, and improving the colour of the cheeks and lips, and thereby
affording evidence of improving the nature and condition of the blood.
Dr. Copland, in his valuable Dictionary of Medicine, has given his
approbation to its employment in cases of rheumatism and sciatica,
and also in several cases of neuralgia. It would form a volume to
give, even in abstract, the cases which, within the last three years,
have been recorded of the efficacy of the cod-liver oil in a variety
of affections; and my object in at all addressing the public on this
occasion, is to point out the necessity of obtaining this remedy in its
purest and most effective form, in order to insure its operation, and
prevent it from falling into that desuetude which has characterized so
many preceding remedies proposed by the profession.

One of the greatest objections to its use was, as already stated, the
exceedingly unpleasant savour it possessed, and the consequent disgust
to its exhibition produced in persons of delicate stomach. This has in
some measure originated from the introduction of a spurious article,
or from the manner in which the original has been introduced. What
could be expected otherwise than a most loathsome material, from
livers heaped together by thousands sent over from Newfoundland, to
deposit their oil by a course of putrefaction? The livers of other
fish have also been found to have accompanied those of the cod, hence,
probably, deteriorating the effect of that of the cod, or introducing
an article calculated to produce no good result. At Berlin it is
known that a spurious oil was introduced into the hospital, and the
failure in its operation had well nigh superseded its use altogether. A
genuine oil was however happily obtained, and the value of the remedy
established. Various modes of adulteration have been detected. It has
been found to be mixed with whale oil, the oil of the seal, &c.; and
its offensive character may easily be estimated. The price at which
the oil is to be obtained may probably, in some measure, serve as a
clue to the discovery of these attempts, than which nothing can be
more reprehensible. It is melancholy to reflect that in nothing more,
or perhaps equally so, is adulteration practised than in medicinal
articles. The public have little means of detecting these fraudulent
proceedings, which ought, however, when brought to light, to be
subjected to the severest censure and punishment.

It is questionable how far these adulterations may be detected by the
operation of the oil, since the principles of its immediate action in
various diseases is far from having been satisfactorily ascertained.
Its nutrient properties are known, and must be admitted in common with
all adipose substances, and a knowledge of their constituents and
action upon the human frame; but beyond this, namely, the specific
qualities as adapted to counteract scrophula, rickets, rheumatic or
gouty inflammation, neuralgia, pulmonary disorders, &c. is unknown.
The well-ascertained effects of iodine in the relief of scrophulous
diseases point out that substance as the immediate agent affording
relief in those cases, but it has been ascertained that the quantity
of iodine in the cod-liver oil is exceedingly small, being much
beneath that which is ordinarily given in the treatment of scrophulous
disorders, and without effect in those cases; still this small quantity
may perhaps by nature be so incorporated in the composition of the
oil, that although of diminished proportions, it may yet possess an
increased power of action, as in the case of natural mineral waters.
It may probably be truly averred, that no fictitious mineral waters,
however admirably prepared, and however accurately constituted,
according to the proportions of the several ingredients as ascertained
by chemical analysis, are capable of producing the same effects as
those by the water derived from the original spring. This may perhaps
be the result of some electric or galvanic agency operating in its
constitution, the place of which cannot be supplied by any substitute
to be found in the laboratory of the chemist. Nature here manifests
her decided superiority to the efforts of art, though ably directed
by the hand of science. Dr. Pereira has suggested bromine to be the
active principle in the oil, and others have attributed its efficiency
to various phosphoric compounds. Dr. Williams refers its agency to some
biliary principle; in short, nothing certain is known upon the subject:
the cause may here be said to be occult, but the effect is apparent.
Mons. Bretonneau asserts that he has obtained effects just as markedly
beneficial to result from the use of the common whale oil, as from the
cod-liver oil, although we know the power to be but very partially
obtained from the liver of the cetaceous tribe.

As, however, cod-liver oil is admitted to be an important medical
agent, and as so many eminent medical practitioners have given
their decided approbation to its employment, it is of the greatest
consequence to have the article in the most perfect state of purity.
Under this impression I have for a considerable time been engaged
in various methods to accomplish this end, and without occasioning
any change in its constituent properties, or altering the relative
proportion of the several substances which enter into its formation,
I have at length been enabled to obtain the oil from the fresh livers
in a state of purity and comparative sapidity which I flatter myself
will be universally approved. Its clearness and transparency is equal
to that of any other oil even of a vegetable nature; its taste is
such that it needs no admixture to disguise it, and it is therefore
freed from the suspicion of being, by any combination, deprived of its
essential and curative properties. It may be taken, not in the large
doses previously administered in the Manchester Infirmary, of one, two,
or three table-spoonfuls, two, three, or four times daily, but in that
of one, two, or three tea-spoonfuls twice a day, and may, without
fear of counteracting its medicinal quality, be agreeably taken in a
small quantity of milk, or coffee, or beer. Infusion of orange-peel
is a convenient and agreeable vehicle for its administration.
Peppermint-water is also a convenient and proper means. If it be
employed in the form of an emulsion, care must be taken that no syrup
be employed into the constitution of which acid enters, as it would be
incompatible with the alkali necessarily used to form the mixture.

If the oil be pure and freed from all extraneous matters, and the
livers from which it is procured be in a recent and not in a putrid
state, there is little apprehension as to any disagreeable effects
following its exhibition; in some cases, however, it has been found to
disorder the bowels in a slight degree upon commencing its use, but
that speedily subsides, and has rarely required the aid of remedies to
counteract such effects.

Externally it may be used by itself, or in combination with ammonia, or
camphor, spermaceti, wax, &c., according to the intention with which
it is employed, and which it is hardly necessary to say should be under
the direction of a professional adviser.

  _143, New Bond Street,
      Feb. 21, 1849._


                                LONDON:
             G. J. PALMER, PRINTER, SAVOY STREET, STRAND.




                         _By the same Author._


                  Third Edition, 12mo., cloth, 5_s._

A COMPENDIUM of DOMESTIC MEDICINE, and COMPANION to the MEDICINE CHEST.
Comprising Plain Directions for the Employment of Medicines――their
Properties and Doses――Brief Descriptions of the Symptoms and Treatment
of Diseases――Disorders incidental to Infants and Children――Directions
for restoring Suspended Animation――Counteracting the Effects of
Poison――A Selection of the most Efficacious Prescriptions and various
Mechanical Auxiliaries to Medicine.

By JOHN SAVORY, Member of the Society of Apothecaries, and late
President of the Royal Pharmaceutical Society of Great Britain.


“This is decidedly the completest work of its kind that has fallen
under our notice.”――_Mirror._

“This very useful little manual is entirely divested of scientific
phraseology, and may be safely consulted, in cases of emergency,
by persons residing at a distance from their medical adviser, more
particularly where delay may be productive of fatal results.”――_Analyst._

“A work which merits the attention of our parochial clergy, who
are often called upon to act the part of the good Samaritan. In
cases of trying emergency, when medical assistance is not at hand,
it will be found a safe guide, the symptoms of diseases being
clearly defined, and their appropriate remedies plainly pointed
out.”――_Essex Standard._


       *       *       *       *       *


 Transcriber’s Notes:

 ――Text in italics is enclosed by underscores (_italics_).

 ――Obvious punctuation and spelling inaccuracies were silently corrected.

 ――Archaic and variable spelling has been preserved.