No. 683.

[1836-37.

EXPERIMENTS WITH NEWREMEDIES.

THE brief interval which will occur beforwe can begin to devote the first pages of theNumbers of our present Volume to the publi- Ication of new courses of lectures, we occupy ’,by making the following interesting extracts ; from the last numbers of Rust’s Magazinewhich have reached us,—Numbers 1, 2, and 3 of Volumes 46 and 47. The first article in IVol. 46 consists of the Annual Report of theHospital of La Chrerit6 at Berlin, drawn up by Dr. H. KoHLER, which contains, amongstother information, an account of certain ex- periments conducted in that hospital with ’,some comparatively new remedies, of which ’,the following are the principal :-Creosote,chlorate of potash, croton oil, nitrate of

strychnine, tartar emetic, and indigo. After

describing these, we shall subjoin such other analyses of the contents of these num- ibers as space will allow us to give.

CREOSOTE.—This was employed in severalcases of pulmonary and laryngeal consump-tion ; against carcinoma of the uterus, chro-nic exanthemata, particularly the itch, andtoothach arising from carious teeth. It wasgenerally administered in the form of pills,with the root of the marsh-mallow, and liquo-rice juice, commencing with half a grainMorning and e vening, which dose was gra-dually increased to eight grains, so that thepatient had sometimes taken more than 120grains in three weeks. Externally this re-medy was administered in a solution of adrachm to six, eight, or ten ounces of water.The general effects of creosote on consump-tive patients were far from being favour-able. Given in the various stages of thecomplaint, it increased the fever and num-ber of pulsations, aggravated the coughand dyspnoea, without easing the expectora-tion, or changing the quantity and quality ofthe sputa; it moreover encreased the ten-

dency to haemoptysis, and diminished thesecretion of the urine. The digesthe func-tions were seldom deranged during its use ;in one case only, the occurrence of severevomiting on the eleventh day rendered itnecessary to suspend the medicine alto-gether. From its stimulating actiun on thecirculating system, and the increase of feverwhich it produced, the creosote frequentlybrought on rapid sinking of the generalstrength, and the patient died in a very un-expected manner at an early period. In onecase it evidently promoted the developmentof a dropsical affection, by diminishing theurinary secretion. This remedy never seem-ed to act as a palliative, much less as a radi-cal means of cure, in the treatment of phthisis,for of twelve patients submitted to its usesome died within the space of three weeks,and the rest immediately after its suspen-sion. In one patient, affected with a com-plication of universal syphilis and laryngealphthisis, the former complaint was muchaggravated during the treatment. The sameunfavourable results were obtained by theexperiments made with the creosote lotionin cases of carcicoma uteri. The diseasecontinued to march without any modifica-tion, while no change took place in the dis-charge, the pains were remarkably inereas-ed, and the haemorrhage continued withoutany abatement. It was also employed as alotion, (one draclim to ten ounces of water,)in cases of chronic exanthema, and gav e riseto acute burning sensation and injection ofthe integuments, until the skin became, asit were, accustomed to its use. One caseof impetigo spaansu of the lower extremitie&,which had existed for several year, wascured within eight weeks ; but it producedno effect in a case of impetigo scabida of theface and arms. In several cases the creosotecured scabies within eight days. It actedin the most remarkable manner or. the pain.arising from carious teeth; the applicationof a small quantity with a bit of wool to thecarious cavity invariably produced cessa-tion of the pain within a few minutes.

CIII.ORATE OF POTASS.—This, (the kali chlo-rinicum), was also employ ed in 25 cases oftubercular phthisis, in the following form;-

D

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Kati chlnrinici, j. Dissolve in distilledwater, four ounces, and add of the syrup ofmarsh-mallow, one ounce. M. D. S. A table-spoonful to be taken four times a day.Whenever the medicine was well sup-

ported by the stomach, itwas carried to oneand a half or two drachms. Four of thepatents submitted to this remedy wereof the climacteric age; the rest, thoughyounger, had all passed the period of pu-berty. All the patients had arrived at thesecond stage of the complaint; in only onecase the disease was at its commencement,and in another it had reached the colliqua-tive stage. The effects were very similarto those of creosote. It encreased the pulseand cough, and produced pain in the chestand bloody sputa, without improving theexpectoration. In addition to this it actedin an unfavourable manner on the digestion,diminishing the appetite, producing pain inthe abdomen, and watery diarrhoea, and, inmany cases, it became necessary at once to

lay the remedy aside. The secretion ofurine was rather increased than diminished.It was, however, much better -supportedwhen united with some digitalis, or cherry-laurel water, or, in case of purging andcolic being produced, with laaadanum. Theduration of the treatment varied from eightdays to eight weeks, and more. Of the 25patients 19 died, and four were left unre-sieved ; of the two remaining, a woman,whose disease seemed rather to be ulceratedphthisis, (phyexulcerata), and a man, above30 years of age, the hectic fever and expec-toration gradually diminished, and then dis-appeared ; the appetite became improved,and with it the patient’s strength, and atlength the cure seemed perfect. The man’scase was entirely lost sight of; however,the woman was seen by Dr. KÖHLER a longtime afterwards in the best health. Althoughthe general result of the experiments madewith this latter remedy was unfavourable,yet the author thinks it should be admittedamongst the number of medicines useful inpulmonary phthisis, though its stimulatingaction on the circulating and pulmonarysystems cannot be denied. Its use is contra-indicated in cases where the fever runs high,where there is any sign of inflammation ofthe lungs, or any tendency to hæmoptysis.

CROTON OIL.-This was employed ex-

ternally in the numerous rheumatic cases

which presented themselves, and likewiseas a counter-irritant in cases of headach,nervous pains, pleurisy, &c. One part ofthe croton oil was mixed with five of someinactive oil (oil of poppies, bergamot), andfrom 10 to 20 or 30 drops of the mixturewere rubbed in twice or thrice a day, overthe integuments covering the affected parts.The immediate effect was to produce abright red colour of the skin, which gra-dually became stronger ; and, if the skin

was sensitive, passed, within twelve hours,into a pustular eruption. The oil was nowrubbed into another part of the integuments,or the use of the remedy suspended for ashort time, during which the pustules driedoff, and the natural colour of the skin wasrestored. In most cases the eruption pro-duced itching, and a slight sensation ofburning, but in a few individuals very acutepain. The author never observed any otherunpleasant consequence, or purging. Rheu-matic affections were in general much bene-fited by this mode of treatment; the painswere considerably relieved in a short time,and even chronic tumours, and deposits in thetendinous structure, were dissipated. In or-ganic diseases of other parts, and in nervouspains, it sometimes produced benefit, some-times none. Thus it appears that croton oilshould occupy a middle place between thetartar emetic ointment and sinapisms. It hasthis advantage over the former, that its ac-tion may be increased or diminished as cir-

cumstances may require, and over the latter,that the pustules dry off much quicker, with-

out leaving behind them any of the ulcerat-ing tumours, which so often attend the useL of the tartar emetic. It is a remedy particu-larly useful in the treatment of the diseasest of children.

NITRATE or STRYCHNINE. -This nitrate(strychninum nitricum) was employed in se-veral cases of paralysis, arising either fromcerebral hæmorrhage, poisoning with lead,rheumatism, or tabes. The eighth of a grainwas mixed with ten grains of sugar, and onepowder given daily, at the commencement.After a lapse of eight or ten days, or whenthe remedy seemed to produce little or noeffect, the same quantity was administeredtwice a day. The highest dose taken washalf a grain morning and evening ; but thisquantity soon brought on violent convul- sions. Neither the small nor the more con-siderable doses produced any remarkable in-fluence on the ganglionic nervous system. Itwas almost always well supported by the sto-mach, and, in a very few cases only, gaverise to vomiting. In a short time after itsadministration, the pulse became more fre-quent and full, the temperature of the skinmore elevated, the cheeks slightly red, andthe increased warmth was followed by agentle and universal perspiration, whichproduced a sensation of relief to the patient.The remedy did not seem to increase anyother secretion than that of perspiration. Incases where small doses only were adminis-tered, the patients experienced slight pains,and a sensation of stiffness and weakness inthe affected part, which rendered them un-willing and incapable of making any effortswith their limbs (where the latter were onlypartially paralyzed); however, after the lapseof a few hours, the same parts recoveredtheir former power of motion, with a feeling

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of increased activity and strength. Higherdoses of the strychnine produced flashingsof the eyes, convulsions of the limbs, and insome cases, especially in females, violentand general convulsions, accompanied withquick respiration, and a complete periodicsuspension of the breath. When the intel-lectual faculties became affected, the effectmanifested itself in prostration, depressionof the spirits, and a strong tendency to cry.Other patients were affected in an oppositemanner, and laughed excessively, even onthe slightest occasion. In some individualsof nervous temperament, the sensibility to-wards external impressions was so great,that they broke out into an uncontrollablefit of violent laughter as soon as they weretouched with the finger. In a few cases itwas impossible to continue the medicine inany dose ; in others, where a large quantitywas given, it produced severe symptoms ofcongestion towards the head and breast, withpain in the chest, and headach, hoemoptysis,symptoms of cerebral apoplexy, and generalfever. Hence its use is contraindicated inindividuals of a plethoric temperament,where the pulmonary system is easily ex-cited, or where there is any marked tendencytowards congestion of the chest or head.Strychnine seems to produce an excitation

of the whole nervous system, and particu-larly of the vertebral nerves, together witha secondary action on the vascular systemand organs of secretion; but it does notcommunicate any durable increase of forceor power. Hence it seems much better

adapted for cases where the excitability hasbeen simply exhausted by frequent actionof some powerful or specific stimulus, wherethe power of the nervous system seems toslumber, and to require nothing but a pro-per excitant to bring it into action. In casesof general feebleness, or true exhaustion ofthe vital force, it generally produces moreinjury than benefit. Hence we should al-ways begin with small doses, given at con-siderable intervals, and increase the qnan-tity very gradually, in order to keep pacewith the increased action of the nervoussystem, and avoid producing the exhaustionwhich accompanies this artificial excite-ment. As to the effects of the remedy incases of paralysis, there were some fortunate,-sometimes no result occurred, the latterwas much more frequent than the former.In a very few instances only was the curecomplete, that is to say, the members whichwere partially or completely paralyzed re-covered complete power of motion, and thisstate continued during the eight to twelveweeks’ employment of the remedy. It ge-nerally produced, for the first few days of itsemployment, a manifest amelioration; butin most cases it was impossible to obtain anyfurther relief, even by considerable increaseof the dose. On the contrary, where thedose was elevated, in the hope of keeping

up the improvement manifested in the earlystage, the strychnine produced more evilthan good, by bringing on convulsions, fol-lowed by an increase of the paralysis. Thepatients often supported well one-eighth ofof a grain once or twice a day, and then im-proved a good deal; but when the dose wasincreased to two-eighths once or twice daily,it very often occasioned some of the acci-dents above mentioned, and it became ne-cessary to suspend the remedy altogether.In cases of this kind, it was generally neces-sary to abandon this mode of treatment with-out reserve, as the patients could never againbear even the smallest dose. Authors re-commend the external use of strychnine incases of a desperate nature, where stimu-lants of every kind have already been em-ployed in vain, and say that from one-eighthto two-eighths of a grain, mixed with fromone to two grains of sugar, is well support-ed, and sometimes produces beneficial ef-fects. When this remedy was tried exter-nally at the Berlin Hospital, it very soonproduced pains and stiffness in the paralyzedlimbs, which, however, diminished after thelapse of a few hours. The healthy memberswere much less affected. The most bene-ficial results were obtained in cases of para-lysis from lead, and after them in rheumaticaffections. Its eflicacy against paralysis,resulting from cerebral haemorrhage, was-much more confined, and when given fortabes dorsalis, instead of doing good, it acce-lerated the march of the disease.

VENOCS INJECTION OF TARTAR EMETIC INTETANUS—An ore-smelter, 47 years of age,while engaged in melting some metal, poureda quantity of the fluid into his right shoe.The sole of the foot was burned in a severemanner, and the whole of the tendons, nerves,and blood-vessels of this region were exposed,’exactly as in an anatomical preparation.The patient was brought to the hospital ofLa Charité a few hours after the accident,with symptomsof severe general fever. Somealleviation was produced by blood-letting,with cold local applications, and an anti-phlogistic regimen. After the lapse of a fewdays, the patient, who had been accustomedto the free use of spirituous liquors, wasseized with delirium tremens, and the agita-tion of the injured limb, which he kept inconstant motion, finally excited an attack oftetanus. This new accident was combatedwith the potash bath, frictions along thespine with the mercurial ointment withopium, leeches to the neck, and the internaluse of opium and laurel-water. As theseremedies produced no effect whatever, it wasdetermined to throw a solution of tartaremetic into the veins. The operation wasperformed in the usual manner, and withthe utmost caution. The median vein of theleft arm being exposed, a small incision wasD2

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made into the vein, and a quill introducedthrough the orifice. The quill was now fixedin the vein, with a ligature, and an ounce ofdistilled water, containing three grains oftartar emetic, gradually thrown in with asmall syringe, whose nozzle exactly fittedthe quill-tube. The action of the medicinewas instantaneous. The pulse became smalland frequent ; the respiration accelerated ;the pupils sometimes contracted, sometimesdilated ; the patient began to cough, and ina very short time vomited once or twice ; the body was now covered with a profusegeneral sweat. The remedy, however, seem-ed to exercise no influence u.x the disease.The tetanic symptoms continued unabated,opisthotonos set in, and the patient soon

after died. On examining the body, ther.iembranes of the brain and spinal marrowwere found considerably congested. Thesubstance of the spinal marrow seemed softerthan natural, but otherwise normal. Thevein into which the solution of tartar emetichad been thrown showed evident traces ofinflammation, from the point of incision asfar as the vena cava. The right cavities ofthe heart were filled with dark coagulatedblood. The rest of the body presented no-thing worthy of notice.

INDIGO IN EPILLPSY.—In cases of epilepsy,where it was impossible to ascertain, withany certainty, the cause of the disease, orwhere the attacks persisted in spite cfrational treatment, recourse was had to spe-cific measures, especially indigo. This lat-ter remedy was frequently employed in thefollowing form :-R Indigo powder, ss ; uuotnatic powder,

3 ss ; sinaple syrup, ii. M. d. in olla. Takea tea-spoonful three times a day.

In this way the patient usually took abouta drachm of indigo per day, and the dosewas gradually increased until the wholehalf-ounce was administered in the courseof the day. The medicine was generallywell supported by the stomach ; sometimeslarge doses produced purging, and, in a fewcases, vomiting. The excrementitious mat-ter presented a dark-blue colour, but theurine only a bluish-grey tinge. In mostcases the accesses became more violent afterthe administration of indigo, but after a cer-tain interval they became more mild andshort, and, finally, in several cases, disap- I,peared altogether, after a period of treat- ment varying from three to four months. Inseveral other cases, however, this methodof treatment produced little or no benefit ;hence it remains for future experience todetermine how far and in what particularcases this medicine, united with proper dietand attention to the general health, may beuseful in the treatment of epilepsy.

CONIUM MACULATUM IN CARCINOMA OF THE UTERUS.

We extract the following case from thethird No. of the 46th Vol. It is not drawn

up in a very accurate or scientific manner,and the author seems over hasty in the con-clusions which he draws from a single ex-periment. However, any thing that pro-mises to throw light on the medical treat-ment of carcinoma uteri is worthy of atten-tion.

CASE.—Madame F., a woman 50 years ofage, mother of six children, generally en-joyed good health. The catamenia were re-

gular during the early part of her life, butat the critical period she was attacked withfrequent and violent uterine hæmorrhage,which at first was mistaken for a derange-ment of the menstrual discharge, so com-

mon at this period of life. The remedies

employed to combat this state were of littleor no benefit, and the patient, though arobust woman, soon became excessively

thin, and instead of her former healthycolour, presented a yellowish, cachetic ap-

pearance, very characteristic of some or-

ganic disease. The existence of the latter-

was, moreover, indicated by a pricking,burning sensation in the deep-seated partswithin the pelvis, and sympathetic pains inthe mammae. The author suspected the ex-istence of schirrous metritis, or occult can-cer of the uterus, more particulary as thedischarge of a yellowish fluid, mixed withcoagulated blood, emitted the specific odourof cancer. The loss of blood was now ex-cessively profuse, and the patient some-times reduced to the utmost extremity. An

examination, par vaginam, was made, to de-termine more exactly the nature of the dis-ease, and the os uteri found partly scirrhous,partly carcinomatous. The patient was im-mediately placed on a milk diet, and injec-tions composed of lime-water and milk, andfinally (as the discharge of blood and foetidmatter became more profuse), of a solutionof the extract of green walnut-shells in lime-water. These local means were, of course,only palliati e. The internal treatment con-sisted in the use of the conium maculatum,which the author determined to experimentwithout the aid of any other remedy. Two-

grain pills were made up, containing a moietyextract, a moiety powder, of the conium. Oneof these was administered morning andevening, and the dose gradually increased,until the patient was brought to take 56 pills,

containing 116 grains of this medicine, inthe day.. It now became necessary to sus-’ pend the use of the remedy, from the greatdepression it produced on the system in ge-neral, the sinking and slowness of the

pulse, the livid appearance of the patient’scountenance, the dyspepsia, with occasionalpurging, the constant sopor it occasioned,