Chinese physicians credit so many remedial agents that a work of forty volumes is devoted to their description and an outline of their uses. Dr. George Cheever Shattuck, in his work "A Synopsis of Medical Treatment," gives what might be called the Pharmacopeia of the Massachusetts General Hospital; and it comprises twenty-five pages, including therein mention of but twenty-four agents derived from botanic sources. There are nineteen countries with well-based pharmacopeias, and they recognize five hundred and fifty botanic drugs. There are seventy-eight botanic drugs recognized in sixteen of these national standards, which covers the important list in world-wide commerce. Two hundred and thirty botanic drugs are recognized in but one or two pharmacopeias, twenty-nine of these being found only in the United States Pharmacopeia. Among these latter are: Bloodroot, cottonseed oil, oil of pimento, oil of chenopodium, sabal, stillingia, yerba santa, crampbark, leptandra, calendula, berberis, pereira, sassafras, and sumach. We attach importance to most of these; but so does Mexico to her native drugs, Japan to many that are esteemed there, and India to certain tropical species.

Each country has its own plant remedies; they are, often, especially adapted to the uses of the people, are readily procured at moderate cost, and sometimes suddenly assume importance, as is instanced in our own oil of chenopodium as an anthelmintic.

The great European war has stimulated the study of our own resources for the production of botanic remedies and the fabrication of chemical ones. Various American universities and large drug houses are undertaking the experimental cultivation of medicinal plants, some three hundred species having been tried out. Many have failed under our conditions of soil and climate, but an increasing number of successes are being noted; so that, ultimately, we shall develop a new and promising drug industry.

And other countries are doing the same thing, in some degree at least. Indeed, as regards botanic remedies, it will be hard to internationalize medicine, much as this might be desired.

Definite chemical substances are often made under patented processes, or are marketed under copyrighted trade names; thereby, a stable profit is derived from their exploitation and sale. But preparations derived from botanic drugs are neither patented nor copyrighted, and the profits derived from their sale, not being sufficient to pay for exploitation except in the form of mixed-ingredient proprietary specialties, these botanic remedies are not pushed to the fore. Physicians are not urged to use them, seldom hear of them, and rarely employ them. In fact, many botanic remedies are not available in retail trade, and physicians cease to prescribe them.

War conditions are changing these relationships of supply and demand; and it is more than probable that each country will, hereafter, develop its indigenous botanic drugs and work up into finished products its crude chemical resources.

Each country has problems of its own as relates to the collection, cultivation, and pharmaceutical manipulation of its botanic crudes. In the United States the high labor costs militate against competition with countries producing crude botanic remedies on a basis of cheap labor. The logical solution of this difficulty is that of skilled propagation, in which strains of medicinal plants will be developed of high proximate principle content and easy extraction. These will crowd out of the better markets the rather indifferent quality of crude medicinal plants commonly imported. When this much-to-be-desired consummation is realized, botanic drugs will come into their own again.

The growing use of alkaloids and other proxi-mates calls for an increased production, and it is probable that chemical houses will be able to use, in alkaloid production, and profitably therein, the ordinary grades of plant crudes, leaving the better grades for the making of tinctures and extracts. This will make a stable market and encourage production on a large scale.

As between the empiricism of much which passes muster as "clinical experience," and the dogmatism of the more militant school of laboratory pharmacologists, much untilled ground lies in the field of botanic remedial agents. This book will make an effort to till that ground, so far as one book may.

Avoiding the encyclopedic generalizations illustrated in the multi-remedy plan of China on one hand, and the paucity of resource of the Massachusetts General Hospital on the other hand, the effort will be made to present herein a careful record of data upon such botanic drugs as seem to hold a respected and warranted place in medical literature. The large number of botanic drugs recognized in the pharmacopeias of the leading nations testifies to the importance of this class of remedial agencies in medical practice. Therefore, the list of such plant remedies discussed herein will not be pedantically limited.

Frankly favoring the development of our own American drug industries, indigenous American plant remedies will be quite generally noticed, even though it must be conceded that many of them are of but minor importance, so far as we know at present. Some gentlemen may consider it as detracting from the scientific value of a medical work to enter into a discussion of minor drugs, and from a certain point of view such a criticism is justified; but, and the author realizes the fact most acutely, it is quite impossible, in our present state of knowledge, to prepare a truly scientific text upon the subject matter here undertaken. Hence, this book pretends to nothing more than what it actually is, and does not pose in the light of the scientific exactitude illumining a modern text book upon bacteriology or operating-room technic, nor can it do so.

Nevertheless it is not markedly to our credit that the botanic remedies, the ones longest known, some of them for thirty centuries, are the class least understood in the whole range of curative resource. So, then, a book upon this subject must, of necessity, be marked by numerous inconclusive passages and but semi-scientific divisions.

As a medical practitioner of nearly thirty years' experience, it is but natural that the author should stress the evidence derived from the clinical side. Yet notwithstanding this bent of the clinician, one in active practice meets with so many disappointments from drugs in his management of cases of illness, that he comes to welcome - and hope for -something definite in drug action - something empiric experience fails in giving and that laboratory research alone can supply.

Yet it must be admitted that, as regards the botanic drugs, there is no considerable volume of laboratory research recorded. Only a few botanic remedies have had adequate pharmacologic study, and even some of this research remains inconclusive or but partially worked out. So far as may be, the discussion of remedies in this volume will be upon a scientific basis. Wherein such data is not available, the author will call upon clinical literature and his own experience and observation, frankly conceding the errancy liable to mar such methods of conclusion.

Believing that the proponents of a drug usually overstate the case, and that a multitude of claims regarding its efficacy gradually grow like barnacles upon its literature, this book will present only sifted conclusions. There has been a wonderful accumulation of therapeutic junk carried from one book upon materia medica into another one, and so on from book to book. With the best of intention to avoid this irrational method of literary composition, this book will still pass along some of that sort of thing; but, let us hope, a minimum of it.

No theories, systems or preconceived schemes of therapy or dosage will find place herein; but the effort to be fair to all and to preserve a judicial balance will be consistently maintained.

Having previously written two works upon materia medica and therapeutics, the author does not exploit herein either a newborn or a shop-worn enthusiasm. Having very largely used the botanic remedies as discriminatingly as the exigencies of practice permitted, and noted some successes and many failures, he believes himself to be in position to record somewhat of the things the careful and modern practitioner wishes to know regarding the botanic drugs. If the reader but partially agrees with this "preliminary egotism," as a preface is well said to be, as well as with the main text of the work itself, the author will feel abundantly repaid.

Harrisburg, Pa., 1917.