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GUAIACOL AND CREOSOTE IN PULMONARY PHTHISIS.
1717 the the poor form has to pass to return to its elements in thenot only obtains instant immobilisation, but agglutination so :’ any that the masses of agglomerated bacilli are often-process of earth burial. We know that it is safe from anymarked
chance of those horrible disturbances which take place in llarge enough to occupy nearly an entire oil-immersion field. I am, Sirs, yours faithfully, cemeteries from time to time, which are too dreadful to dwell EDMOND J. MCWEENEY, M.D. R.U.I., upon, but which are no less horrible realities. To speak of churchyards and cemeteries as being "God’s acresis merely I Pathologist to thp. ivater MisP.l"ioròiae TORDital. Duhlin. Nov. 30th, 1896. covering over a horrible reality with a beautiful sentiment. To speak of earth burial asI I essentially a Christian method of dealing with the dead" is misleading, as our Lord’s body was not committed to the earth, but laid in a tomb hewn in GUAIACOL AND CREOSOTE IN PULMONARY the rock, and such a form of burial was freely practised at -
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PHTHISIS. that time. The bodies were wrapped in linen cloths and much as the were accustomed to deal with Egyptians spices, To the Editors of THE LANCET. their dead. In our son’s case, his form having returned to SiRS,-It was with great pleasure that I read Dr. Seifert’sits elements, the thoughts of his mother and myself no longer dwell upon it, but dwell with his memory as withadmirably clear article on this subject in THE LANCET of’ To us the thought is full of peace. Nov. 14th, 189õ. as it will help to draw attention to the value a spiritual presence. I have no wish, however, to force others to be of4of this group of remedies in the treatment of phthisis, which the same way of thinking, but write to let others know 1many in England are disposed to doubt. I am well the procedure, and how it is regarded by those who haveacquainted with the advantageous properties of the carbo-had experience of this method of parting with the bodilynates of creosote and guaiacol and have myself prescribed 1 former with apparent benefit. But at present the priceform of one beloved whose spirit has passed into its futurethe state. Everything about the procedure is peaceful andIof these drugs is prohibitive excepting for wealthy patients. soothing, very different to what passes at the graveside in A lady under my care who had been taking creosotal for a churchyards and cemeteries, than which there are few thingsfew weeks plaintively asked me one day whether it was more trying to one’s feelings, even when the body beingabsolutely necessary to continue paying a guinea a bottle for I committed to the earth is not that of a relative or even aI .her medicine; and on inquiry I found that none of mynear friend. There is one other aspect not lightly to patients could get it for much less, while one gentleman passed over in contrasting the two methods of dealing withiI had obtained it from a well-known firm, through a cousin our dead. How many a useful life has been cut short who was a trained nurse, at the "reduced price " of 22s. for through standing at the graveside in all sorts of inclement an 8-oz. bottle. In some recent wholesale price-lists creosoteweather. There is a real and substantial foundation for the and guaiacol are priced respectively at 6d. and ls. 6d. per old saying, " One funeral makes many." This cannot be the ounce, whereas the carbonates are 2s. 4d. and 4s. 6d. per These higher prices are prohibitory for hospital ounce. case in cremation ; the parting takes place under cover, free from the risk of damp and chills. patients, and are strongly objected to buy ordinary middleclass patients when the course of treatment is (as it must beI remain. Sirs. faithfnllv vours. in phthisis) a long one. Under these circumstances one is JOHN W. MARTIN. M.D. R.U.I. driven to use the cheaper remedies in most cases and to Clare mont-place, Sheffield, Nov. 16th, 1896. The causticity overcome their drawbacks in other ways. of creosote and guaiacol has in my opinion been somewhat overrated, as I find them clinically well borne if suitably "MALIGNANT DISEASE OF THE BREAST OF prescribed-in most cases in doses up to forty-five minims per diem by the mouth, and occasionally in much larger doses. TWENTY YEARS’ DURATION." Every medical man is in the habit of prescribing without -. To the Editors of THE LANCET. any ill effects such caustic drugs as phenol, liquor potassse, and SIRS,-It is right to mention that the portion of tissue nitric and sulphuric acids, merely by suitably diluting them,. Dr. Campbell Black was kind enough to send me and which and the same can be done with creosote and guaiacol. The latter should always be given on a full stomach, and their was examined by Dr. Rolleston was scanty and much dissolution in alcohol or glycerine further diluted by mixing were unable maceration in We to spirit. integrated by some bland fluid such as milk. Possibly in this way an clearly make out its structure, and our negative tendency in with the face of the clinical evidence adduced by Dr. Black albuminate is formed; but, at all events, this is effective amounts to nothing. Personally, I am not able to recognise and in most patients causes no disturbance. Pills and " cancer a pathognomonic cell," and only the general capsules I regard with suspicion, as they might liberate their structure and arrangement of cells are in such cases to be un iluted contents on the surface of the stomach and are less readily tolerated by most patients. relied upon. May I take this opportunity of mentioning much Dr. Seifert does not state how the guaiacol was administered that I have long been collecting evidence upon cases where the young dog he referred to, but in any case a dose of long life has been observed after removal of the breast for to scirrhus and should be grateful to your readers for the brief a drachm and a half (corresponding to one of about sevenfluid drachms in a man) would be likely to act as an particulars of any of their most important and interesting teen Such an experiment is of little value, cases? Any such information shall receive fall acknowledge- irritant poison. except as showing the superior blandness of the carbonate, I am, Sirs, yours truly, ment. which is not now in dispute. Concentrated creosote and NmumL. ra. turicemnLVmL t.J.J..J..JJJ..L.J...UJ. guaiacol are undoubtedly caustic to epithelial structures, but, 1896. Cavendish-place, W., Nov. 29th, In some experiments are much less so to deeper structures. of mine with Dr. Hewlett on rabbits it was found that 2c.c. of pure guaiacol could be repeatedly injected under the skin without any obvious mischief, and oily solutions of from 20-"ON THE SERO-DIAGNOSIS OF TYPHOID to 50 per cent. volume may be injected in very large FEVER." quantities in the human subject without mischief if theTo the Editors of THE LANCET. skin is not rendered too tense and the injection is slowly SIRS, I desire to draw attention to the conclusive performed. As regards the relative toxicity of creosote and guaiacol and striking results to be obtained from using obliquely solidified blood serum as a culture medium for the typhoid and their carbonates one would not expect to find much bacilli in Widal’s diagnostic method. A loopful of the turbid difference after absorption, since the carbonic acid is liberatedcondensation fluid from an oblique ox-serum tube twenty- in the bowel. Poggi’s experiments refer, as Dr. Seifert four hours after inoculation with typhoid contains myriads surmises, to guaiacol and not its carbonate. I hope very of extremely short and most actively worked bacilli which shortly to test their correctness. In conclusion, I may say’ show the phenomena of immobilisation and agglutination in that Dr. Seifert will be a benefactor to the British public if a much more striking way than when grown on broth. Both he can induce the manufacturers of creosotal to send it occur almost instantaneously on the addition of the typhoid over at considerably reduced prices, whereby they will probserum, whereas I notice that with broth cultures complete ably obtain for it a much larger market. immobilisation is rare inside two minutes, and agglutination is I am, Sirs, yours truly, rendered less striking by the fact that the bacilli are in many F. R. WALTERS, M.D., M.R.C.P. Lond. fields few and far between. By the use of serum tubes one Welbeck-street, W.
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chance of those horrible disturbances which take place in llarge enough to occupy nearly an entire oil-immersion field. I am, Sirs, yours faithfully, cemeteries from time to time, which are too dreadful to dwell EDMOND J. MCWEENEY, M.D. R.U.I., upon, but which are no less horrible realities. To speak of churchyards and cemeteries as being "God’s acresis merely I Pathologist to thp. ivater MisP.l"ioròiae TORDital. Duhlin. Nov. 30th, 1896. covering over a horrible reality with a beautiful sentiment. To speak of earth burial asI I essentially a Christian method of dealing with the dead" is misleading, as our Lord’s body was not committed to the earth, but laid in a tomb hewn in GUAIACOL AND CREOSOTE IN PULMONARY the rock, and such a form of burial was freely practised at -
I
PHTHISIS. that time. The bodies were wrapped in linen cloths and much as the were accustomed to deal with Egyptians spices, To the Editors of THE LANCET. their dead. In our son’s case, his form having returned to SiRS,-It was with great pleasure that I read Dr. Seifert’sits elements, the thoughts of his mother and myself no longer dwell upon it, but dwell with his memory as withadmirably clear article on this subject in THE LANCET of’ To us the thought is full of peace. Nov. 14th, 189õ. as it will help to draw attention to the value a spiritual presence. I have no wish, however, to force others to be of4of this group of remedies in the treatment of phthisis, which the same way of thinking, but write to let others know 1many in England are disposed to doubt. I am well the procedure, and how it is regarded by those who haveacquainted with the advantageous properties of the carbo-had experience of this method of parting with the bodilynates of creosote and guaiacol and have myself prescribed 1 former with apparent benefit. But at present the priceform of one beloved whose spirit has passed into its futurethe state. Everything about the procedure is peaceful andIof these drugs is prohibitive excepting for wealthy patients. soothing, very different to what passes at the graveside in A lady under my care who had been taking creosotal for a churchyards and cemeteries, than which there are few thingsfew weeks plaintively asked me one day whether it was more trying to one’s feelings, even when the body beingabsolutely necessary to continue paying a guinea a bottle for I committed to the earth is not that of a relative or even aI .her medicine; and on inquiry I found that none of mynear friend. There is one other aspect not lightly to patients could get it for much less, while one gentleman passed over in contrasting the two methods of dealing withiI had obtained it from a well-known firm, through a cousin our dead. How many a useful life has been cut short who was a trained nurse, at the "reduced price " of 22s. for through standing at the graveside in all sorts of inclement an 8-oz. bottle. In some recent wholesale price-lists creosoteweather. There is a real and substantial foundation for the and guaiacol are priced respectively at 6d. and ls. 6d. per old saying, " One funeral makes many." This cannot be the ounce, whereas the carbonates are 2s. 4d. and 4s. 6d. per These higher prices are prohibitory for hospital ounce. case in cremation ; the parting takes place under cover, free from the risk of damp and chills. patients, and are strongly objected to buy ordinary middleclass patients when the course of treatment is (as it must beI remain. Sirs. faithfnllv vours. in phthisis) a long one. Under these circumstances one is JOHN W. MARTIN. M.D. R.U.I. driven to use the cheaper remedies in most cases and to Clare mont-place, Sheffield, Nov. 16th, 1896. The causticity overcome their drawbacks in other ways. of creosote and guaiacol has in my opinion been somewhat overrated, as I find them clinically well borne if suitably "MALIGNANT DISEASE OF THE BREAST OF prescribed-in most cases in doses up to forty-five minims per diem by the mouth, and occasionally in much larger doses. TWENTY YEARS’ DURATION." Every medical man is in the habit of prescribing without -. To the Editors of THE LANCET. any ill effects such caustic drugs as phenol, liquor potassse, and SIRS,-It is right to mention that the portion of tissue nitric and sulphuric acids, merely by suitably diluting them,. Dr. Campbell Black was kind enough to send me and which and the same can be done with creosote and guaiacol. The latter should always be given on a full stomach, and their was examined by Dr. Rolleston was scanty and much dissolution in alcohol or glycerine further diluted by mixing were unable maceration in We to spirit. integrated by some bland fluid such as milk. Possibly in this way an clearly make out its structure, and our negative tendency in with the face of the clinical evidence adduced by Dr. Black albuminate is formed; but, at all events, this is effective amounts to nothing. Personally, I am not able to recognise and in most patients causes no disturbance. Pills and " cancer a pathognomonic cell," and only the general capsules I regard with suspicion, as they might liberate their structure and arrangement of cells are in such cases to be un iluted contents on the surface of the stomach and are less readily tolerated by most patients. relied upon. May I take this opportunity of mentioning much Dr. Seifert does not state how the guaiacol was administered that I have long been collecting evidence upon cases where the young dog he referred to, but in any case a dose of long life has been observed after removal of the breast for to scirrhus and should be grateful to your readers for the brief a drachm and a half (corresponding to one of about sevenfluid drachms in a man) would be likely to act as an particulars of any of their most important and interesting teen Such an experiment is of little value, cases? Any such information shall receive fall acknowledge- irritant poison. except as showing the superior blandness of the carbonate, I am, Sirs, yours truly, ment. which is not now in dispute. Concentrated creosote and NmumL. ra. turicemnLVmL t.J.J..J..JJJ..L.J...UJ. guaiacol are undoubtedly caustic to epithelial structures, but, 1896. Cavendish-place, W., Nov. 29th, In some experiments are much less so to deeper structures. of mine with Dr. Hewlett on rabbits it was found that 2c.c. of pure guaiacol could be repeatedly injected under the skin without any obvious mischief, and oily solutions of from 20-"ON THE SERO-DIAGNOSIS OF TYPHOID to 50 per cent. volume may be injected in very large FEVER." quantities in the human subject without mischief if theTo the Editors of THE LANCET. skin is not rendered too tense and the injection is slowly SIRS, I desire to draw attention to the conclusive performed. As regards the relative toxicity of creosote and guaiacol and striking results to be obtained from using obliquely solidified blood serum as a culture medium for the typhoid and their carbonates one would not expect to find much bacilli in Widal’s diagnostic method. A loopful of the turbid difference after absorption, since the carbonic acid is liberatedcondensation fluid from an oblique ox-serum tube twenty- in the bowel. Poggi’s experiments refer, as Dr. Seifert four hours after inoculation with typhoid contains myriads surmises, to guaiacol and not its carbonate. I hope very of extremely short and most actively worked bacilli which shortly to test their correctness. In conclusion, I may say’ show the phenomena of immobilisation and agglutination in that Dr. Seifert will be a benefactor to the British public if a much more striking way than when grown on broth. Both he can induce the manufacturers of creosotal to send it occur almost instantaneously on the addition of the typhoid over at considerably reduced prices, whereby they will probserum, whereas I notice that with broth cultures complete ably obtain for it a much larger market. immobilisation is rare inside two minutes, and agglutination is I am, Sirs, yours truly, rendered less striking by the fact that the bacilli are in many F. R. WALTERS, M.D., M.R.C.P. Lond. fields few and far between. By the use of serum tubes one Welbeck-street, W.
be
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I
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°