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ment of neuralgia. Nevertheless, on account of the freedom from disagreeable odor and taste, betol appears to be well worth further

and slightly curved, containing seeds and a viscid juice.

The spines are very tough and highly polstudy to establish the conditions in which it is ❘ished, and the wood is extremely tough. It of value and to determine the correct method of its administration.

Kobert, who describes this preparation under the name of naphthalol, found it very useful, and at least as valuable as other medicaments, in various forms of catarrh of the bladder, especially in gonorrheal cystitis, with alkaline decomposition of the urine. The urine soon became clear and acid, the formed elements in it were diminished in number, and the pains of the patients became easy.

A NEW LOCAL ANÆSTHETIC.

O physician nowadays can claim to eminence in the medical profession unless he has discovered a local anesthetic. There is no doubt in our mind that this fact is universally recognized. Witness the innumerable claims to the dignity of a new anæsthetic continually before us. The last candidate for these honors appears to be a joint discovery by a veterinary physician, Mr. Goodman, Dr. A. M. Seward, of Bergen Point, N. J., and Dr. J. Herbert Claiborne, Jr., of New York. Mr. Goodman was first on the scent by noticing the apparent anesthetic properties of a poultice made from a pile of leaves raked haphazard from the ground. Dr. Seward, according to Mr. Claiborne, discovered an alkaloid in some leaves submitted to him by Mr. Goodman, and he terms the alkaloid, of which the process of extraction is not given, stenocarpine. It appears, however, that the botanical name of the tree from which this substance is derived is unknown. According to Mr. Goodman, the source of the leaves employed by him is known in Louisiana, the locality where this substance was first employed, as the tear-blanket-tree.

grows in clumps and singly, and is abundant in Louisiana.

From the likeness of the tree to the Acacia stenocarpa Dr. Seward dubbed the new alkaloid stenocarpine. It would have been better, however, to withhold the naming of the alkaloid until the botanical name of the tree had been known.

Dr. Claiborne's share consisted in clinical experiments with the substance supplied him by Dr. Seward. According to Dr. Claiborne (Medical Record, July 30, 1887), two drops of an aqueous solution produced in a few minutes complete insensibility of the cornea and conjunctiva, with dilatation of the pupils, the anæsthesia lasting for about half an hour, the dilatation of the pupils for thirty-six hours. This substance would even appear to be more efficacious than cocaine as an anesthetic, for Dr. Claiborne reports instances in which the application of a few drops of a two per cent. solution on the skin produced almost absolute anesthesia, so as to permit the painless removal of tumors, warts, etc. In the nose also applications produce complete anæsthesia, and in the case of the ear, the instillation of a few drops permitted the touching of the drum-membrane without pain.

As to whether we are to have another disappointment in this case or not the future alone can tell.

A

SOLANIN.

S the readers of the GAZETTE may remember, though discovered in 1821 in potato shoots and in the parings of young potatoes, solanin has been only recently introduced into medicine by Dr. Geneuil, who employed it in subcutaneous injections in sciatica and other forms of neuralgia. Continued experience has, however, proved that so employed solanin injections are extremely irritating, and Geneuil therefore came to the conclusion that solanin possesses caustic action, and he recommended it to be employed only hypodermically in cases where a tolerably severe revulsive was desired.

It grows to the height of thirty-five to forty feet, with a diameter to the bole of about eighteen inches and a spread of foliage of about thirty to thirty-five feet. The leaves resemble those of an acacia. The bark is smooth. From the ground up the tree is furnished with clumps of forked spines or The subject has again been investigated by thorns, the parent spine springing at right M. Adrian, who presented his results to a angles from the bough or trunk. Though recent meeting of the Societé de Médecine Mr. Goodman is a native of the region, he Pratique (Les Nouveaux Remèdes, June, 1887). has never seen the tree blossom. As fruit it He has found solanin is not an alkaloid but a bears pods eight or ten inches in length, flat | glucoside, and if solanin is dissolved in an acid, the entire amount of acid may be recovered in its free state, while the solanin splits up into glucose, and a new base, still imperfectly known, which he terms solanidinė. It follows from this that it is incorrect to speak of solanin salts, and injections made of acid solutions of solanin owe their escharotic properties to the free acid. Nevertheless, it appears that solanin possesses decided analgesic properties.

In the thesis recently published by M. Gainard, he there states as the result of the experiments which he has carried out under Professor Dujardin-Beaumetz, and with Dr. Bardet, that solanin, obtained from the germs of the potato, is possessed of incontestable anesthetic properties, and is almost free from toxic effects, as much as 15 grains of solanin being required to kill a small rabbit. It is, of course, possible that solanin obtained from different species of Solanaceæ may contain atropine or other allied alkaloid, which will, perhaps, explain the character of the results produced by it. The subject is well worthy further study.

QUILLAJA ACID—A conTRIBUTION TO
OUR KNOWLEDGE OF THE

K

SAPONIN GROUP.

OBERT, of Dorpat, Russia, contributes an elaborate article under the above title to the Archiv für Experimentelle Pathologie und Pharmakologie, 23 Band, 3 u. 4 Heft, of which the following is a concise abstract:

In 1782 Molina described a Chilian tree whose bark gave to water a biting taste, and which he called Quillaja saponaria. It is generally counted among the Rosaceæ, although Brown has pointed out marks of difference. The bark of the tree was soon known as "washwood," or "panamarinde." Sections made through the bark show masses of crystals of calcium oxalate and a net work of fibrous tissue. The active principle is contained in formless masses of dark-colored substance, contained in the cells of the parenchyma of the bark. Concentrated sulphuric acid turns this substance first yellow, then bright red, and finally a violet-blue. Early analyses of the plant, after the method of Schroder and others, seemed to demonstrate the identity of saponin with the so-called Egyptian soap-root, the quillajarinde of Henry and Boutron-Charlard, and also the common senega-root, together with other common plants with which we had long been familiar. The importation and use of the Egyptian plant were lessened by the cultivation of the native sources of saponin.

Kobert's analyses of various sources of saponin, from different sources, convinced him that the saponin of various authors is not a simple body, but a combination of at least two substances not easily separated. He found that the separation of saponin by precipitating it with barium was wholly worthless, as the efficiency of the drug was thus more or less impaired. He was led to conclude, however, that the process of obtaining the active principle by its combination with acetyl gave a substance whose poisonous adjuvants were thus destroyed; it was more reliable than the barium process. Pure saponin he found to be a tasteless substance, of unirritating odor, and free from poisonous properties; the symptoms of poisoning following the use of the drug were caused by its mixture with other substances. By a method whose most important steps were concentration of a solution from the boiled bark, precipitation by acetate of lead, the removal of coloring-matter by chloroform, and finally drying the precipitate from a clear solution over sulphuric acid in a vacuum, Kobert obtained a powder, of acid reaction, which he called quillaja acid. With its alkaline salts it is in water, carbonates, and caustics readily soluble. By treating it with alcohol and chloroform crystals may sometimes be obtained, but this happened too infrequently to admit of analysis of the crystals. Only the free acid is soluble in alcohol; this solution will take five times its bulk of chloroform before precipitating the solid. A test between pure saponin and sapotoxin and common commercial saponin lies in the fact that the latter are very little soluble in absolute alcohol. In methyl alcohol quillaja acid is easily soluble; in ether insoluble; in chloroform sparingly soluble by warming. This acid and its alkaline salts hold insoluble powders so well in suspension that their filtration is difficult. It may be best combined in emulsions, as the French have found. Copper sulphate, ferric and mercuric chlorides, ferro- and ferricyanides of potassium, and other allied salts do not precipitate it. Solutions are readily decomposed by bacteria, and germs grow read❘ily in them. Concentrated sulphuric acid colors quillaja acid a beautiful dark red. Further experiments show it to be a glucoside, turning polarized light towards the right; it is found to be a glucoside acid, resembling ergotin acid. Pepsin, pancreatin, ptyalin, and diastase do not decompose it. It was found that quillaja acid and saponin differ in that the latter is an impractical modification of the former. The formula C19H30O10 corresponds to the results of analyses, and it is composed of about one-third of sapogenin and twothirds glucoside; its acidity is exceeded thirty-five and one-third times by sulphuric acid. Although many have written regard ing this substance, yet few have used it therapeutically, and it has as yet no therapeutic literature proper.

went much further than this, and extensive degeneration of the glandular structures of the intestine resulted. A noteworthy phenomenon was the formation of hyaline material about the villi, and the decomposition of the blood. The large intestine showed similar effects in less degree. Endocarditis, especially about the valves, was often present. There was ædema of the hepatic duct and gall-bladder. The urinary bladder and pelvis of the kidney were occasionally the seat of the same changes as the intestine. The urine was full of blood and cystic débris. Hæmoglobinuria and albuminuria were often present. Quillaja acid itself was not found in the urine. Changes in the kidney-structure itself were rarely found, although there was good reason to expect them. The liver was generally slightly enlarged, but not greatly affected. The mesenteric glands were also swollen. The muscles of the general muscular system, and also the heart-muscle, were not affected. As has been stated, the heart-valves were roughened, and at their bases there was swelling and ædema. At the early stages of the poisonous effect no diminution in blood-pressure was observed, but in the later stage of coma a complete vaso-motor paralysis was observed. When the fatal dose was so small that no intestinal lesions were observed, nothing else pathological could be observed, and the fatal result was ascribed to paralysis of the cerebral ganglia by an agent which by repeated circulation in the ganglion-cells successively paralyzed them. In the slowness of its action the drug resembled the heavier metals which are poisonous. The largest fatal dose given was 1 part of the weight of the animal experimented upon; the smallest dose was T030000 of the body weight; and when the dose was reduced to 1166667 part of the animal's weight, recovery was the result. After the injection of large doses of the poison into the blood it could not be certainly identified in the urine. It has been shown that quillaja, when compounded with sodium, in solution of 이익, dissolves bloodcorpuscles. Hæmoglobinuria was not observed frequently, irregularly only, and it was found that the liver was somewhat distended by decomposed blood-corpuscles after the poison had been injected into the blood. In cases where no changes were observed in the intestines it was found that the number of red corpuscles was diminished, and the intestinal changes were thought to be due more to decomposition of the blood than to any change

A case of poisoning from the drug has been reported by Lessellier. The symptoms were rigors; epigastric cramp: cold sweats; tremors; syncope, which soon disappeared; a small pulse; skin moist; excessive vomiting; anxiety and distress referred to the præcardium; vesical tenesmus, and increased secretion of urine. These symptoms disappeared under expectant treatment in three days. The sodium salts of quillaja acid have a strongly acrid taste. A five per cent. solution applied to the throat promotes salivary flow, and produces great irritation; profuse nasal and lachrymal secretion are caused when the same solution is applied to the nasal passages. In the larynx convulsive cough is produced. A minute particle of the substance, or a drop of two or five per cent. solution, brought in contact with the conjunctiva, produces burning, intense pain, followed by ædema and pus-formation. The pupil is contracted, from irritation; the cornea does not generally become involved, and in five hours after the application the swell ing has disappeared. Strong solutions, when painted on the external skin, are inert, but application by ointment with friction produces erythema, with itching and burning, and, if the application be continued, a pustular eruption. The tissues of the frog, when brought in contact with the substance in solution, lose their vitality much more rapidly than commonly, Blood-corpuscles are dissolved or disintegrated by the substance in solution; it is a poison to protoplasm, and injures the vitality of the tissues when brought into direct contact in solutions of even one-half per cent. For injection into the blood a solution of onetenth per cent. was taken. In fatal cases it was often impossible to find post-mortem changes; death resulted evidently from cerebral paralysis, and paralysis of the respiratory centre. Post-mortem changes were most generally found in the upper and lower portions of the small intestine, and consisted of excessive hyperæmia, profuse secretion, and thickening of the mucosa. Extravasation of blood did not occur, but the capillaries were enormously distended. The toxic effects often | originating in the intestine. Although' this In distinction from quillaja acid saponin was found almost non-toxic, having but feebly the effects of the acid, although decomposing to some extent blood-corpuscles. It was thought to be at least thirty per cent. weaker | chest, and said that he had known cases of than quillaja acid.

drug was so poisonous when injected into the blood, when given by the mouth it was much less active. A rabbit took 여인이에 part of its body weight of the drug without any symptoms of poisoning; another took 1 part of its body weight with no worse result than diarrhea for two days. The intestinal symptoms following death from the drug, when given by the mouth, were wanting, a notable difference from its effect when injected into the blood. Kobert reckons that five hundred times as great a dose can be taken by the mouth without injury as can be given by injection into the blood; this depends upon the very slow rate of absorption of the poison by the intestine. It is not decomposed by the ferments of the pancreas, stomach, and saliva, for it was found in the fæces. The subcutaneous injection of the drug was practised upon frogs, on whom between 12 and 11⁄2 of a grain produced fatal effects. A notable effect of poisonous doses subcutaneously was ideomuscular contractions, which persisted in the skeletal muscles for twenty-four hours after life had apparently ceased; rigor mortis subsequently ensued. In warm-blooded animals injections subcutaneously caused great pain, with local hemorrhagic inflammations, with a tendency to abscess-formation and ædema. The injected fluid could be found after several days in the fluid of ædematous tissues. Fatal effects followed such injections very tardily, showing the slow absorption of the poison. Intestinal changes were not often observed. Several hemorrhages were seen beneath the pleura in one case. The dose was in one case of poisoning by subcutaneous use 여이이이 of the body weight. In cases where the poisonous symptoms were slow in development, minute hemorrhages were found in the subserosa of the intestines.

DR. F. HUBER read a paper based on a study of forty-seven cases, the results of which had convinced him, he said, that at the present time tracheotomy should only be resorted to in cases in which intubation had failed to afford the needed relief; and he was of the opinion that a case of this kind would seldom be met with. Having stated that the dyspnea was as effectively relieved by intubation as by tracheotomy, he spoke of the advantages of the former, and also referred to the origin of the procedure as proposed and practised by Bouchut in 1858. Then, after referring to some practical points derived from his personal experience, he said that intubation had now passed through the experimental stage, and that its utility had been fully established by numerous operators in different parts of the country. Notwithstanding the gratifying results obtained, however, it had as yet received very little favor, or even attention, in Europe.

Of his forty-seven cases, Dr. Huber said that twenty-nine, with eleven recoveries, were in children under three years of age, and eighteen cases, with nine recoveries, in children of three years or over. Of the children under three years, one was nine and one-half months; one, ten and one-half months; two, eleven months; one, one year; two, two years; two, two and one-half years; and two, two years and eight months old. Of all the children that he had been called upon to treat, who were suffering from laryngeal stenosis, he had found it necessary to resort to intubation in only one out of every three or four cases, and he thought that it should not be practised until dangerous symptoms had supervened. He used it, in fact, in exactly the same class of cases in which one year ago he would have performed tracheotomy. Having spoken of the diagnosis of croup and the indications for surgical interference, he referred to the importance of making a careful examination of the neck and

Reports on Therapeutic Progress.

INTUBATION OF THE LARYNX.

Intubation of the larynx was recently made the subject of debate before the New York Academy of Medicine, and we lay before our readers a full abstract of the papers read, as published in the Boston Medical and Surgical Journal for July 28, 1887.

retro-pharyngeal abscess and empyema to be mistaken for laryngeal stenosis. As confirmatory of the diagnosis of the latter, relative absence of fever, in uncomplicated cases, was of much value; and aphonia, with difficulty of both inspiration and expiration, was positively indicative of croup.

He next spoke of the various accidents and mishaps which had been met with in connection with intubation, and the objections raised against the procedure. He referred first to the gag, and said that O'Dwyer's gag was liable to be displaced by the struggles of the patient, but that this was not the case with the one devised by Dr. Denhart, which he exhibited. The thread attached to the tube should be eighteen or twenty inches in length, and, if not withdrawn at once, should be passed over the ear and secured. In order to avoid accidents in introducing the tube the efforts to place it in position should be short and repeated, rather than kept up uninterruptedly for any length of time. One of the most serious accidents that could occur was the pushing of dislodged membranes before the tube, and in a case of this kind Dr. E. D. Fergusen, of Troy, was obliged to resort to tracheotomy.

Several deaths had been reported from this accident, and Dr. Waxham had recently devised a long tracheal forceps for the purpose of removing the membranes when it occurred. In a case of his own in which it happened he gave the child brandy, with the effect of exciting a fit of coughing which expelled both the tube and the membranes. If, at any time after the tube had been introduced, noisy breathing should set in, it was an indication for the temporary removal of the tube. The tube had been known to be coughed up and then swallowed. Instances had also been reported in which the tube had slipped through the larynx into the trachea; but this was when the earlier pattern of tube, with small head, was employed. The tube did not act as a foreign body when in the larynx, giving rise to choking sensations and coughing; but if it remained in position for a considerable length of time it might possibly produce slight ulceration. This, however, did no harm.

No positive prognosis should ever be made, however, until forty-eight hours had elapsed from the time of insertion of the tube.

As regards medicinal treatment, Dr. Huber said that it was his practice to keep up the use of bichloride of mercury throughout the course of the disease, whether intubation were resorted to or not. He employed it, in accordance with the views of Dr. Jacobi, in larger doses than those usually recommended, giving from to a grain, and in severe cases as much as 1 grain, in divided doses, during the twentyfour hours. When there was much difficulty in swallowing, he gave it in the form of tablet triturates, off of a grain each, mixed with sugar and placed dry upon the tongue. If there were extensive diphtheritic membranes in the fauces he also employed tincture of iron and chlorate of potassium. In threatened heart-failure he resorted to brandy, caffeine, etc. If the temperature was very high, antipyretics were employed either by the mouth or rectum. Finally, he used the steam atomizer for producing a moist vapor.

Intubation, he went on to say, possessed every advantage possessed by tracheotomy. It could also save many cases in which tracheotomy would not be permitted, as well as many which would die if the latter were performed, especially in children under three years of age. Out of twelve cases in which Dr. Huber had resorted to tracheotomy, ten had proved fatal. He had also seen many cases in the hands of others in which the results were no more favorable, so that he felt warranted in assigning to intubation a much higher position.

DR. J. O'DWYER read a paper on "Feeding after Intubation of the Larynx," in connection with which he exhibited various tubes modified to overcome difficulty in feeding. He also showed specimens with the tube in position, and a section of the cricoid cartilage filled up with membranes, except where the tube had left an opening, the form of which was just the shape of the latter.

As to the time for removing the tube, in some cases this might be done as early as the fourth or fifth day, although it was often desirable to allow it to remain longer. As a rule, how ever, it could be dispensed with at a much earlier date than the tracheotomy tube. If the respiration continued free, the tube should generally be allowed to remain until the fifth or sixth day; but if the respiration became noisy it should be promptly removed, and The difficulty of swallowing, he said, was afterwards reintroduced, if this should prove | recognized by all as the most important objecnecessary. When there were diphtheritic ❘tion to intubation, and he had long been try

patches discernible in the nose or pharynx it was advisable, as a rule, to leave the tube in position until they had disappeared.

ing various modifications in the shape of the tube in order to diminish this as far as possible. At first he tried making the heads of the tubes quite small; but, while this rendered it possible for them to slip down into the trachea, it did not make deglutition any easier. The next modification that he made was to increase the size of the head to some extent,

In intubation, as in tracheotomy, the prognosis was more favorable when there was simply local obstruction in the larynx than in cases where there was marked constitutional infection from the diphtheritic poison. No age offered a contraindication to intubation. ❘ and also give the tube a greater curve, in

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