for the past twenty years has been such as to bring me in contact with numerous cases of prostatic disease. In most of these cases the patients did not suspect that they were laboring under any prostatic affection, but applied for treatment either on account of spermatorrhœa, loss of sexual power, or urinary trouble. I have in many cases found it difficult to convince them that the source of trouble was in the prostate gland. Some, indeed, could not be convinced, having formed a theory of their own, derived from pernicious quack publications, and they of course were lost. But whenever the patient has had the strength of will, and, above all, the confidence in advice, to adhere faithfully to the treatment which I have here indicated, the relief has been as gratifying as it was marked and unexpected. It is not by any means to be understood that these local applications are the only treatment required in such cases. They all require general treatment according to the indications present in each case, but the object of this paper is to emphasize the value and importance of local applications to the prostate, and it would extend it much beyond the original limits imposed upon it to enter into a discussion of the general management and medical treatment of these diseases, which I have considered at some length in a former monograph. There is the same necessity for alterative treatment, renal resolvents, general and special nerve tonics, and restorative medication, according to the individual peculiarities of each case, and the age and general physical condition of the patient. Local applications are not intended to supplant any of the usual means employed for anchoring frail humanity to earth awhile longer, but they supplement, aid, and assist them, and materially increase their efficacy and success, and render the results of our treatment more satisfactory and relief more certain and speedy. Finally, medical practitioners should impress the fact upon their patients that the first serious indication of prostatic disease is some imperfection in the act of micturition, and whenever any trouble is experienced in passing water for any considerable length of time, suspect disease of the prostate gland. THE ANTIPYRETIC ACTION OF ANTIFEB S RIN. By Dr. E. W EVANS, EASTON, PENNA. PART II. ON THE FEVERED ANIMAL. INCE the publication of Part I. in the April number of this journal, I have made the following experiments in order to observe the action of antifebrin in the presence of a pyrogenic agent, deutero-albumose being employed, it having been demonstrated by Ott and Collmar* that the albumoses and peptones were active heat-producing agents, the fever setting in at the end of the first half-hour and continuing for about three hours. The dose used by them being from .015 to .020 gramme. In all of my experiments I have not used. less than this, and in some cases more, getting a rise in all of from 5° to 1.4° in the first hour after injection into the jugular. And at the end of the hour, when the fever was still on the incline, the antifebrin was given in the same manner, and the animal replaced in the chamber of the calorimeter. These experiments are certainly significant in the uniformity of their results, as will be shown, there being not a single case in which there was not a reduction both in the production and the dissipation of heat, although the doses of the pyrogenic and the antipyretic agents varied greatly. Experiment 1.-Rabbit; weight, 1.88 pounds. Hourly heat after dissipation deutero-albumose..... 4 88 Hourly heat production after deutero-albumose..... 5.19 Hourly heat dissipation after antifebrin............... 2.79 Hourly heat production after antifebrin............... 3.41 189 WISCONSIN STREET. * "Albumose and Peptone Fever," Medical News, February 19, 1887. 2.79 Hourly heat dissipation after deutero-albumose..... 4.88 Hourly heat dissipation after deutero-albumose... 38.10 Hourly heat dissipation after antifebrin......... Loss in heat dissipation.......... 2.09 Loss in heat dissipation............. Hourly heat dissipation after antisebrin.............. 27.52 10.58 albumose. After deutero- After anti- Decrease. Increase. After deutero- After anti- Decrease. Increase. febrin. febrin. albumose. * two-thirds of them, was due to the great decrease of heat production in excess of the accompanying decrease in heat dissipation; since in the two experiments where the temperature continued to rise after the antifebrin had been injected, the reduction of heat production was small in comparison with the reduction in heat dissipation. In most of these experiments, particularly when large doses had been given, a peculiar cyanotic condition of the ears appeared shortly after the administration of the antifebrin. Upon analysis of the blood in these cases with the Sorby-Browning micro-spectroscope, the third band of methæmoglobin was distinctly seen. The drug evidently alters the coloring-matter of the blood, progressively changing and reducing the oxyhemoglobin to methæmoglobin. This cyanosis has also been frequently noticed by many observers in the clinical application of the drug. In conclusion, it is evident that acetanilide is a powerful, safe, and certain antithermic agent, and that its antipyretic effect in fever is due to the reduction it causes in the amount of heat produced; whether by direct stimulation of the inhibitory heat centre, paresis of the spinal heat centres, or by an action on the tissues themselves, remains to be demonstrated. THE INFLUENCE OF ANTIFEBRIN, SALICYLIC ACID, AND CARBOLIC ACID ON NORMAL AND ABNORMAL BODILY TEMPERATURE. S BY H. A. HARE, M.D. (UNIV. OF PA.).* OME months since there appeared in the GAZETTE quite a lengthy study on fever, and the agents which produced and combated it, by Dr. Wood, Dr. Reichert, and myself, and the following series of experiments may in a manner be considered as a continuation of the former ones.t * Demonstrator of Experimental Therapeutics and Instructor in Physical Diagnosis in the University of Pennsylvania. † For the manner in which fever was produced, and any other details concerning the methods of this research, the writer must refer to the paper just mentioned. The writer desires to call attention to the statement made in this joint paper that a thermogenic substance in the pepsin was a pepsin-peptone, as his researches make this somewhat doubtful. He has found that certain commercial pepsins charged with peptone fail absolutely to produce increase in bodily temperature, but, on the contrary, decrease it. This is of course in accord with At the time these experiments were begun no calorimetrical investigations as to the manner in which these agents act had been performed, and it is only within the last few weeks that a short but elaborate paper has appeared in this journal on the influence of antifebrin on bodily heat by Dr. Evans, of Easton, Pa. With the exception of this lastnamed investigation the profession possesses the results of no true calorimetrical observations on these three constantly used drugs, and it was this dearth of information which provoked these experiments. The objects of the research have been, therefore, as follows: First. To determine the effect of each drug on normal temperature in the animal, which was free to come and go as it chose. Second. To discover what changes came about in the circulation during the alterations in the normal bodily temperature. Third. To determine what changes in the circulation occurred when the drug was influencing bodily temperature above normal. Fourth. To study in what manner these changes in temperature were produced, both with and without fever, or, in other words, whether these agents reduced bodily heat by altering heat production or dissipation, or both. I. ANTIFEBRIN. I have made ten experiments on the influence of antifebrin on normal rectal temperature, which show that this drug possesses to a marked degree the power of reducing bodily heat when no fever is present. In every instance there followed after the injection of the drug a very considerable fall, in some cases amounting to more than a degree Fahrenheit. The following experiments, which agree in all respects with the others made on this point, will serve as examples: Experiment 1. - Rabbit; weight, 22 pounds. Time. 11.05 Drug. ...... 1⁄2 gr. Rec. temp. 30 102 ...... the well-known fact that the commercial peptone of Grübler decreases animal temperature. It is plain that if the fever-producing agent really is a peptone, there must be two peptones in the commercial article, one of which decreases and the other increases bodily temperature. The relations of peptones to albumoses is so exceedingly close that it is quite probable that the so-called pepsin-peptone may be an albumose. 2.55 102° ...... 3.15 ...... 10230 Death came without a tremor, a gasp, or any sign of an approaching cardiac failure. On making an autopsy a small clot was found in the left ventricle, and there was also a long, well-formed clot extending from the canula in the carotid to the innominate artery. The death was evidently due to this cause. When antifebrin is injected into the jugular vein in an animal suffering from the pepsin fever it apparently has little, if any, effect on Experiment 3.-Rabbit; weight, 2 pounds. the pyretic condition, and both temperature On studying the influence of antifebrin on bodily temperature and its relations to arterial pressure, we find that under normal conditions it generally produces a fall of temperature and a fall of pressure; but this is not by any means a constant action of the drug, since in Experiment 6 we see that though the temperature was decreased there was not a fall, but a rise of arterial pressure. This one exception would have but little weight against the others were it not that the fall of arterial pressure, when it did occur in the others, was not steady, but interrupted by temporary and unexplained rises; in other words, pressure and temperature did not fall side by side. Notwithstanding this fact, however, it is a just and proper conclusion that antifebrin in and pressure mount upwards as if free from any inhibiting influence. This is the more remarkable since we have already discovered that this drug depresses normal temperature, but it may be that it is not able to cope with systemic changes produced by the pepsin. A glance at the charts will show this statement to be a fact, and we will now pass on to a consideration of its action on the production and dissipation of heat, hoping thereby to discover some cause for this rather remarkable result, for, as is well known, most drugs which depress normal temperature possess still greater powers over abnormal temperature. From the experiments on heat production and dissipation in the normal animal we are able to draw the following conclusions, viz., that this drug reduces bodily temperature both by increasing dissipation and decreasing production. (See Experiments 12, 13, 14, and 15.) By the above the writer does not mean to insinuate that antifebrin decreases temperature by a double action necessarily in any one case, but rather that in one case the temperature is decreased by increased dissipation, and in another by decreased production. |