[Footnote: From a paper published in the British Medical Journal.]

By F.J.B. QUINLAN, M.D., M.R.I.A., F.K.Q.C P., Physician to St. Vincent's Hospital, Dublin.

From time immemorial, the Verbascum thapsus, or great mullein, has been a trusted popular remedy, in Ireland, for the treatment of the above formidable malady. It is a wild plant--most persons would call it a weed--found in many parts of the United Kingdom; and, according to Sowerby's British Botany, vol. vi., page 110, is "rather sparingly distributed over England and the south of Scotland." In most parts of Ireland, however, in addition to growing wild it is carefully cultivated in gardens, and occasionally on a rather extensive scale; and this is done wholly and solely in obedience to a steady popular call for the herb by phthisical sufferers. Constantly, in Irish newspapers, there are advertisements offering it for sale; and there are, in this city, pharmaceutical establishments of the first rank in which it can be bought. Still it does not appear in the Pharmacopoeia; nor, as far as I know, has its use received the official sanction of the medical profession. Some friends with whom I talked over the matter at the Pharmaceutical Conference at Southampton last August, suggested that it would be desirable to make a therapeutical research into the powers of this drug, and ascertain by actual experiment its efficacy or otherwise.

Having partially accomplished this, I am anxious to very briefly set forth what has been done, in order that others may be induced to co-operate in the work.

"There are five mulleins, all belonging to the parent order of the Scrophulariaceae; but the old Irish remedy is the great mullein, or Verbascum thapsus, a faithful delineation of which will be found in Plate 1, 437, vol. vi., of Sowerby. It is a hardy biennial, with a thick stalk, from eighteen inches to four feet high, and with very peculiar large woolly and mucilaginous leaves, and a long flower spike with ugly yellow and nearly sessile flowers. The leaves are best gathered in late summer or autumn, shortly before the plant flowers. In former times it appears to have been rather highly thought of, particularly as a remedy for diarrhoea; and Dioscorides, Culpepper, and Gerarde favorably allude to it.

"Having been furnished with a good supply of fresh mullein from a garden near this city, where it is extensively grown, I commenced operations. As it proved useful, subsequent supplies were procured from our drug-contractor.

"The old Irish method of administering the mullein is to place an ounce of dried leaves, or a corresponding quantity of the fresh ones, in a pint of milk; to boil for ten minutes, and then to strain. This strained fluid is given warm to the patient, with or without a little sugar. It is administered twice a day; and the taste of the mixture is bland, mucilaginous, comforting to the praecordia, and not disagreeable. I resolved to try this method, and also the watery infusion; and, moreover, the natural expressed juice fortified with glycerin. This latter preparation was carefully made for me, from fresh mullein leaves, by Dr. John Evans, chemist to the Queen and the Prince of Wales.

"Some phthisical sufferers, of whom there are here, alas! too many, were now admitted from time to time into St. Vincent's Hospital. They were admitted in all stages, from an early one to the most advanced. On each admission the case was carefully examined; the history, symptoms, and physical signs were exactly noted; and the patient was weighed on a stage balance with great accuracy. The patient was put as much as possible on the mullein treatment only. For obvious reasons, no cod-liver oil, koumiss, or other weight producer was given; the patients got the diet suitable to such sufferers; and, if the special symptoms became troublesome, received appropriate treatment. As much as possible, however, they were left to the mullein--a proceeding which was entirely satisfactory to themselves. In addition to the admission weighing, they were carefully weighed every week, and care was taken that this should be done as nearly as possible on the same day and hour, with the same clothes, and, in fact, as much as could be under the same conditions. In securing this the patients anxiously co-operated; and it was frequently amusing, but sometimes painful, to watch the satisfaction or chagrin with which the weekly result was received.

I must here tender my acknowledgments to our zealous, attentive, and accurate house surgeon, Mr. Denis P. Kenna, by whom this important, but tedious, duty was discharged."

Dr. Quinlan then refers to several cases, in which the mullein plant has been tried as a remedy for consumption, and remarks that these cases, although too few to justify any general conclusion, appear to establish some useful facts. The mullein plant boiled in milk is liked by the patients; in watery infusion it is disagreeable, and the succus is still more so. The hot milk decoction causes a comfortable (what our Gallic neighbors call pectorale) sensation, and when once patients take it they experience a physiological want, and when the supply was once or twice interrupted, complained much in consequence. That it eases phthisical cough there can be no doubt; in fact, some of the patients scarcely took their cough mixtures at all--an unmixed boon to phthisical sufferers with delicate stomachs. Its power of checking phthisical looseness of the bowels was very marked, and experiment proved that this was not merely due to the well known astringent properties of boiled milk. It also gave great relief to the dyspnoea.

For phthisical night sweats it is utterly useless; but these can be completely checked by the hypodermic use of from one-eighteenth to one-fiftieth of a grain of the atropia sulphate; the smaller dose, if it will answer, being preferable, as the larger causes dryness of the pharynx, and interferes with ocular accommodation. In advanced cases, it does not prevent loss of weight, nor am I aware of anything that will, except koumiss. Dr. Carrick, in his interesting work on the koumiss treatment of Southern Russia (page 213), says: "I have seen a consumption invalid gain largely in weight, while the disease was making rapid progress in her lungs, and the evening temperature rarely fell below 101° Fahr. Until then I considered that an increase of weight in phthisis pulmonalis was a proof of the arrest of the malady." If koumiss possesses this power, mullein does not; but unfortunately, as real koumiss can be made from the milk of the mare only, and as it does not bear traveling, the consumptive invalid must go at least to Samara or Southern Russia. In pretubercular and early cases of pulmonary consumption, mullein appears to have a distinct weight-increasing power; and I have observed this in several private cases also.

Having no weighings of these latter, however, makes this statement merely an expression of opinion. In early cases, mullein milk appears to act very much in the same manner as cod-liver oil; and when we consider that it is at once cheap and palatable it is certainly worth a trial. I will continue the research by careful weighings of early cases; and will further endeavor to ascertain whether the addition of mullein to the cultivating solution prevents the propagation of the phthisical bacillus.