Arthur George Hill.

Annual of the universal medical sciences and analytical index. A yearly report of the progress of the general sanitary sciences throughout the world. [1888-1896.] ... online

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AbIS

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ANNUAIv



OF THE



Universal Medical Sciences



A YEAELY REPORT OF THE PROGRESS OF THE GENERAL
SANITARY SaENCES THROUGHOUT THE WORLD.



EDITiU) BT



CHARLES E. SAJOUS, M.D.,

AND

SEVENTY ASSOCIATE EDITORS,

AflSIBTSD BY

OVER TWO HUNDRED CORRESPONDING EDITORS, COLLABORATORS,
AND CORRESPONDENTS.

I[llii»traited with 4rbr0m0.cttb0Qra^Ii»t Ctigramtigs mA M^ff^^



VOLXJIXEE V.




1890.

F. A. DAVIS, Publisher.

PHTLADELPHU, NEW YORK, CHICAGO. ATLANTA, AND LONDON.
AGENCIES : SYDNEY. N. a W. ; CAPE TOWN. SO. AFRICA.



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EDtortd Moordinf to Act of CongreM, in the jear 189U, bj

F. A. DAVIS,

In th« Ofioe of tho LibrarUn of ConcreM, at Washinstoa, D. C, U. 8. A.



Philadelphia, Pa.. U. S. A.:
Tba Madieal BalUUa Printing Hoom,

ISSl FilbOTt StTMi.



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TABLE OF CONTENTS OF VOLUME FIFTH.



General Therapeutics,

By J. p. CROZER GRIFFITH. M.D.,

PHILADELPHIA,

iDBtmctor in Clinicftl Medicine in the University of Pennsyl-

yania,

AND

H. W. CATTELL, M.D..

PHILADELPHIA,

Assistant Demonstrator of Chemistry in the University of
Pennsylvania.

Experimental Therapeutics,

By HOBART a. HARE, M.D., B.Sc,

PHILADELPHIA.

Demonstrator of Therapeutics, Clinical Professor of Diseases

of Children, in the University of Pennsylvania, etc.

Electro-Therapeutics,

By a. L. RANNEY, M.D.,

NEW YORK,
Ihrofessor of the Anatomy and Physiology of the Nervous
System in the New York Post-Oraduate Medical School
and HospitaL

Climatology and Balneology, ....

By GEORGE H. ROHE, M.D.,

BALTIMORE,

Professor of Hyf^iene and Dermatology in the College of Phy-
sicians and Surgeons, etc.

Medical Demography,

By albert L. GIHON, A.M., M.D.,

BROOKLYN,
Medical Director United States Navy, etc.

By JOHN B. HAMILTON, M.D.,

WASHINGTON,

Supervising Surgeon-General U. S. Marine Hospital Service,

ASSISTED BY

C. H. A. KLEINSCHMIDT, M.D.,

AND

G. M. GUITERAS, M.D.,

WASHINGTON.



Section A



Hygiene,



Section B



Section C



Section D



Section E



Section F



(iii)

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IV TABLE OF CONTENTS OF VOLUME FIFTH.

Embryology, Section G

By W. XAVIER SUDDUTH, M.D., F.R.M.S.,

PHILADELPHIA,

Professor of Pathology and OraJ Surgery in tbe Philadelphia

Polyclinic and College for Graduates, etc.,

ASSISTED BT

E. B. SANQREE, M.D.,

PHILADELPHIA,
Demonstrator of Histology in tbe Medico-Chirurgical College.

Histology and Microscopical Technology, . . Section H

By frank W. brown, M.D.,

DETROIT,

Professor of Histology and Microscopy in the Detroit College

of Medicine.

Physiology, Section I

By W. H. HOWELL, Ph.D., B.A.,

ANN ARBOR,

Lecturer in Physiology and Histology in the University of

Michigan.

Anatomy, Section J

By WILLIAM S. FORBES, M.D..

PHILADELPHIA,

Professor of Anatomy in the Jefferson Medical College, Phila-
delphia, etc.

Reference List of Journals, Section K

General Index, Section L



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GENERAL THERAPEUTICS.

By J. P. CROZER GRIFFITH, M.D.,

AND

H. W. CATTELL, M.D.,

PHILADELPHIA.



We beg leave to call the attentioa of our readers to the fact,
which may at once become apparent to them, that there are in the
following pages certain omissions of papers which have appeared
in the journals during the last year, and also to the same explana-
tion of this which we gave in last year's Annual, and which still
holds good. This is, that those articles bearing on the use of
certain drugs in certain diseases have probably been assigned to
the editors having charge of the other departments. Reference to
such articles as have been omitted here will therefore be found in
the different volumes of the Annual by reference to the index.
It must also be remembered that the doses given in the following
pages are, for the most part, from the writers* articles, but owing to
the fact that so much diversity exists in preparations of the same
drug, as in pyrodin, creolin, etc., and that we have as yet no inter-
national pharmacopoeia, the doses given sometimes represent the
strength of the preparation in the pharmacopoeia of the country in
which the article was originally written. For the sake of uni-
formity we have adopted the plan of giving the final " e " to alka-
loids, and removing it from the drugs of a purely chemical nature.

What we shall call the long, increasing array of new medicines
which are daily added to our list is of the greatest importance. A
commission was appointed by the French Academy to consider this
question, and a rSsumS of the report, by Dujardin-Beaumetz as
chairman, is of interest. It is as follows : The chemical names of
such drugs as antipyrin, sulphonal, etc., are too difficult for general
use, and any therapeutic value which the drug possesses was estab-
lished by reports and experiments made with the name given to
the drug by its discoverer or introducers. Several important legal

(A-l)

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A-2 GRIFFITH AND CATTELL. [Fr^Sri



LPreoatorius.



facts at once arise and are answered by the jurist Pouillet, who
says : (1) " The chemical name cannot be used as a trade name,
but any appellation derived from any of its properties, real or
fancied, is the property of the person so using it, and can be pro-
tected by law ; (2) if the physician prescribes a drug by its trade
name, without adding the name of the inventor or commercial
house making it, the druggist is able to put up the drug by its
chemical name. Thus, if antipyrin (Knorr) be prescribed, the
druggist must dispense dimethyloxyquinizine prepared by, or under
the permission of, Knorr; but if antipyrin be written for, the
druggist has a perfect right by law to dispense dimethyloxyquinizine,
whether prepared by Knorr or any other manufacturing chemist."

As too much confusion would be caused by the Academy giving
a new name to each drug (tried by Bourgoin, who attempted to call
antipyrin, analgesin), it was recommended that the popular name
be employed in writing the prescription, but that the druggist be
permitted to use the chemical name of the compound in filUng it.

This decision of the French Academy cannot attract too great
attention. We are as ever firmly opposed to the use in medicine
of patent and proprietary medicines. Yet the value of antipyrin
is so great that its employment is almost a necessity. In the
absence of any term shorter and more appropriate than the chemical
one, we have designated it by its usual title, but with the hope
that physicians will insist on druggists furnishing an article with
the proprietary name unaltered, should such a substance be pro-
curable. The term "acetananilid " they have invariably substituted
for " antifebrin," the proprietary title.

Ahrus Precatorius, — In a communication to the Royal Society,
Martin and Wolfenden^,2?.j^„have proved the existence of a
globulin in abrus precatorius (jequirity). Martin has also found
an albumose. Both of these compounds possess toxic properties,
which, however, are destroyed by moist heat. When these pro-
teids enter into the circulation, a form of poisoning is produced,
which, according to Martin, strikingly resembles that produced by
the venom of the snake. The chemical composition of these two
poisons is similar, local lesions of the same character being pro.
duced, the body temperature being lowered, and the blood
remaining fluid after death.

Absinthium. — Cadeac and Albin Meunier,S«have performed



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^Sl^d!'] GENERAL THERAPEUTICS. A-3

on animals some interesting physiological experiments with small
and large doses of the oil of wormwood, and find that it possesses
antiseptic properties in a marked degree.

Acetanilid, — As in the history of every drug, so in that of
acetanilid— on its introduction the uses to which it was put were
almost innumerable ; reports of favorable results poured into the
journals from all sides, and it seemed as though the typical anal-
gesic and antipyretic had been discovered at last. Soon, however,
unfavorable reports began to be made, attributing to it either
inefficacy or positive harmfulness. That too large doses were at
first used cannot be gainsaid, and, until experience taught the
proper sphere of its action, the drug was expected to perform
marvels of healing. The probability is that, in acetanilid, we have
added to our armamentarium a drug powerful for good or for evil,
according to the occasion and the manner of its use. The reports
of both its good and bad results are still being published, but will
undoubtedly steadily diminish in number as we become more able
to strictly define the field of its therapeutic application. As an
analgesic, especially in cases of neuralgic or neuritic nature, or in
pain from reflex causes, acetanilid has been of marked benefit.
In sciatica, lumbago, trifacial and other neuralgias, girdle-pain of
locomotor ataxia, ovarian or other visceral pain, it has been freely
used throughout the past year, and still maintains a well-deserved
reputation. As an antipyretic it has also been much employed,
some writers ceding it first place among the newer drugs of this
class. It is certainly of value where medicinal measures are
allowable or advisable in combating hyperpyrexia. Its insolubility
in water is a disadvantage, from the fact that its use by enema or
hypodermic syringe is prevented. It is, however, easily adminis-
tered in capsule or in a dry powder on the tongue. Its power to
abbreviate disease is probably simply one of the many merits that
were at first unwarrantably claimed for it.

A. Crombie,Jliin reviewing the comparative values of anti-
pyrin, acetanilid, and phenacetin, places acetanilid second as regards

rapidity and certainty of action.

Opinions differ as to the value of the drug in typhoid fever.

C. Z. Wroczynski^ believes it is decidedly harmful in that it

lengthens the course and intensifies the symptoms of the disease.

Other authorities, however, while not claiming any abbreviating



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A-4 GRIFFITH AND CATTELL. [AoetwiUld.

action for the drug, highly recommend it for combating the symp-
toms of hyperpyrexia. It would seem that in acetanilid we have
a drug that can relieve one of the most serious symptoms of
typhoid fever, and that, if used in small doses and with due regard
to the condition of the patient's cardiac and respiratory functions,
it is not dangerous. Wroczynski thinks the drug has a specific
action in croupous pneumonia, not only lowering the temperature, ^
but also diminishing the extent of the pathological changes.

In both of these diseases acetanilid may prove inefficacious,
as is shown by W. S. Greene, ]if who reports 3 cases of typhoid
fever and 1 of pneumonia, in which, after acetanilid failed to re-
duce the h)^rpyrexia, antipyrin succeeded. The drug would
seem to be of especial service against the hyperpyrexia accompany-
ing the febrile diseases of childhood, and also as an almost specific
antispasmodic for the paroxysms of whooping-cough. Several in-
stances of alarming toxic symptoms following the administration
of acetanilid to children have been reported during the past year ;
but, as a rule, they have been the result of either too long
continued administration after the fall of temperature began or of
a dose out of proportion to the age of the child. Most authors
agree in considering the drug a good and safe antipyretic for use in
childhood. The number of cases reported during the past year of
the occurrence of uncomfortable or alarming symptoms, out of all
proportion to the dose employed, shows that there exists in some
people an idiosyncrasy to the action of the drug. As yet we can
have no means of foreseeing sucli ill effects ; but it is possible that
in the near future some of the factors causing these peculiarities
may be recognized. W. R. Gushing d^ aw sports the case of a
nursing woman suffering from mild typhoid fever, in whom the
repeated administration of 5 grains (0.32 gmmme) of acetanilid,
two or three times in twenty-four hours, produced, with the fall
of temperature, sweating and a free accumulation of milk in the
breasts. The author cited believes, and probably correctly, that
the increased production of milk was due not only to the lowering :.
of temperature, but also to the stimulation of the mammary as well
as the other less highly developed sudoriparous glands of the skin.
SembritzkiJiJlhas apparently discovered one of the classes of
patients who exhibit marked susceptibility to the influence of
acetanilid. In a number of cases of pregnant and nursing women



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AMteniUd.] GENERAL THERAPEUTICS. A-5

who were suffering from typhoid fever, he observed disagreeable
or alarming symptoms follow the exhibition of any but very mod-
erate doses of the drug. Larger, but still moderate, doses were
frequently followed by profuse diaphoresis, or even collapse,
whereas the temperature was easily reduced by a dose that in
other cases would seem to be entirely inadequate. Joseph Haigh JJf
reports 2 cases in which gradual loss of memory was produced
by long-continued administration (5 to 30 grains — 0.32 to 1.95
grammes) of acetanilid. Memory was regained upon stopping the
drug. James Wilding g^^ reports the case of a young man, 19 years
old, with acute pulmonary tuberculosis, in whom 10 grains (0.65
gramme) of acetanilid produced collapse. C. KlippelJL^saw
acetaniUd produce cyanosis and oppressed breathing, without
reduction of temperature, in a case of blood-poisoning. The cause
of the latter was not stated. Charon ^ii;^! reports a case of
neurasthenia in which eight doses were readily taken without
bad effect, but the ninth produced marked cyanosis and collapse,
which were successfully combated by free stimulation. The
amount administered with each dose was not stated.

E. FiirthAplJi reports a case of poisoning by a single dose of 4
grammes (62 grains) of acetanilid. The symptoms were exces-
sive vomiting, superficial and slow breathing, and a cyanotic face.
Later on, the pupils were dilated, there were gnashing of the teeth,
nervous twitching, delirium, and coma ; eight hours later the patient
became conscious, but complained of pain in the stomach. In two
days she was able to leave her bed. W. R. Allison's jJi^.^ patient
was equally fortunate. A man took, by mistake, 17 fluidrachms
(62.80 cubic centimetres) of a mixture containing 1 part of acetan-
iUd in 6 parts of compound elixir of taraxacum. Recovery ensued,
although the patient exhibited the most profound symptoms of
cardiac and respiratory depression. Pauschinger^„ reports a case
of violent diarrhoea following the administration of 1 gramme
(15^ grains) of acetaniUd every hour until 5 powders had been
taken. It took ten days to control the diarrhoea.

The average dose for an adult may be set down as from 4 to
7 grains (0.26 to 0.45 gramme), repeated, if necessary. For chil-
dren the dose should be smaUer, but need not be reduced to quite
the proportion necessary with most dnigs. The prolonged use of
acetaniUd is certainly not without danger, which may be of two



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A-6 GRUTITH AND CATTELL. [JtSSuS^l

kinds: 1. The production of marked and more or less transient
changes in blood composition has been frequently reported from
its long use. 2. There seems to be some cumulative power in the
drug, as is illustrated by a case reported by Robert Haley. „^.,

In this case a young married woman took 4-grain (0 26
gramme) doses of the drug at frequent intervals, until, at the end
of three days, 48 grains (3.11 grammes) had been taken. On the
third day of this course of self-medication, the patient suddenly fell
from her chair, unconscious and cyanosed.

The most common toxic symptoms presented are marked
cyanosis, labored respiration, palpitation of the heart, weak and
thready pulse, cold extremities, subnormal temperature, and other
symptoms of collapse. The drug would therefore seem to be a
depressant to the functions of respiration and circulation, with dis-
turbance of the vasomotor system and probably of the heat-
regulating centres. That the cyanosis is due to the respiratory
difficulty, and not to the reduction or alteration of haemoglobin, is
shown by its rapid disappearance under treatment.

The indications for treatment of the poisoning are plain.
Cardiac, respiratory, and vasomotor stimulation are imperatively
demanded. Ether, hypodermically, has been most frequently used,
but in belladonna we have probably the best drug to fulfill the in-
dications. This drug, with external warmth and some more direct
cardiac stimulant, would, ci priori^ seem to be the best remedy we
have for antagonizing the overaction of acetanihd. The bene-
ficial effects to be derived from the use of belladonna are seen in a
report by James E. Gibbons jl;J\ of a case of poisoning produced by
the injection of a drachm (3.90 grammes) of acetanilid. In this
case Gibbons administered tr. belladonnae, 4 drops every half-hour,
for four doses, after which the remedy was repeated every two
hours for about eight hours, the time required to entirely overcome
the toxic symptoms. A fatal case has been reported, m^i occurring
in a child, from the administration of 3.85 grains (0.25 gmmme)
of acetanilid, every two hours during the day. By evening the
child was cyanosed and in fatal collapse.

Acetic Acid. — E. and J. A. Cutter JJ^« make the remarkable
statement that vinegar should be used with great caution, as by
its use tuberculosis may be produced. They recommend that
vinegar be prepared from the wine of grapes. In the treatment of



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t^^^^A^^^LI GENERAL THERAPEUTICS. A-7

gonorrhoea, E. MaguireJSlhas used with good results a 1- to 4-
per-cent. solution of acetic acid.

Aconite^root. — P. W. Squire ^thinks that aconite-root should
be gathered in the fall, when it is at perfection, rather than in the
winter or early spring, as directed in the British Pharmacopoeia.
Frank Woodbury j2i reports a case of poisoning from the "normal
liquid aconite-root," of which the dose is given as .03 to 0.13
gramme (^ to 2 minims). Two doses of 1 minim (0.06 cubic centi-
metre) each, given one hour a part, produced tingling, mild
delirium, diplopia, and other indications of aconite poisoning.

Aconite. — Fred. C. Valentine d^Jj^^ relates a case of poisoning
in which a stout German took eighteen tablets of aconitine, each
containing ^^^ grain (0.000025 gramme). They were probably
taken within half an hour. He was found an hour and a half
afterward with symptoms of paraplegia, stertorous, irregular respira-
tions occurring from six to thirteen times a minute, strangling, and
tingling in the fauces. The pulse was irregular, the pupils slightly
dilated and sluggish. The man recovered under the use of morpliine
hypodermically, emetics, whisky, and ammonia.

AdhcUoda Justicia (syn., Adhatoda Vasica^ A. Oendarussa^ A.
Puhescens). — ^The natives of Ceylon use with asserted benefit adha-
toda in pulmonary and catarrhal aflfections. The leaves contain
an alkaloid (vasicine) and an acid (adhatodic acid). In experiments
made by Hooper, kU^i it was found that an infusion of the leaves
was poisonous to flies, fleas, spirogyra, and animalculae, but harm-
less to the larger animals. Jayesingha has used it with great
beneflt in asthma in doses of 10 grains (0.65 gramme) of the
powdered leaves, t. i. d., \ fluidrachm (1.85 grammes) of a tr. (2|
ounces — 77.76 grammes— of dried leaves to 1 pint — J Utre) t. i. d.,
the patient being also advised to smoke the leaves in a pipe. H,
H. Rusby^^. suggests its use in diphtheria.

Adonis Vernalis — Adonidin. — An editorial ,2?« states that the
glucoside, adonidin, is obtained from adonis vemalis. Thomas
Oliver H^l,^ used it in 6 cases with marked success. Where tliere
is mitral and aortic regurgitation it is of great value. The action
on the blood-vessels is hardly perceptible.

Agaricine — Agaric Add. — W. T. Thackeray ^quotes Pri-
bram, the discoverer of the alkaloid, agaricine, as summing up his
experience of the physiological action as follows : Sweat is always



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A-8 GRIFFITH AND CATTELL. f^lKl^i*'



L Aleohol.



decreased ; thirst and the excretion of the urine are diminished ; the
fiinctions of the lungs and skin are not interfered with, and there
are no bad eflfects. The administration of pure agaric acid greatly
lessens the danger of vomiting and purging. The subcutaneous
injection of the soluble sodium salts should not be used, as violent
inflammation may follow. Hofmeister'sv^,,^ physiological experi-
ments have shown that it checks pathological sweating not by a
central action, but by directly influencing the glands themselves.
In this only does it resemble atropine. Small doses, 0.02 to 0.03
gramme (^ to ^ grain) are preferred to a single large dose. The
action is slow, but lasts a long while.

Alcohol. — J. M. Farringtongij, denies the value of alcohol as
a therapeutic agent, adding, as proof, his own experience and the
articles of some writers who agree with him. Alexei M. Mohi-
lansky^^^'S.has studied the dietetic action of alcohol on 15 healthy
men. His researches were made in order to determine the nitrog-
enous metabolism and the assimilation of the proteids and fats
by means of the occasional use of alcohol. In those habituated to
its use the appetite, as well as assimilation of the nitrogenous con-
stituents of the food, is increased. In those who are total ab-



Online LibraryArthur George HillAnnual of the universal medical sciences and analytical index. A yearly report of the progress of the general sanitary sciences throughout the world. [1888-1896.] ... → online text (page 1 of 71)