QUININE. By Dr. A. B. Shipman, of Laporte, Ia.-It is curious to hear the opinions of medical men on the modus operandi of quinine, and also on its effects on the system, when laboring under other diseases aside from malarious. Some contend that it operates on the poison of malaria, by entering the circulation and neutralizing it by a chemical action; others, that it acts as a sedative; others, as a tonic, and so forth. There is a great difference of opinion when to give it, and in what doses. The most enthusiastic advocates for its use, and those who make it a hobby, give it at all times and in all stages, and in all manner of doses, from 10 grains to 60, or even larger ones in some cases. These men contend that when malaria enters the system in sufficient quantities to produce fever, a sufficient quantity of quinine will prevent its attacks, if given in season; and when the attack commences, in whatever stage, cold, hot, or sweating, if given in requisite quantities, it will stop the fever, whether it be of the intermittent or remittent type. They contend that no intermission or remission is necessary for its exhibition; that the hot stage of remittent fever is preferable, on the whole, to any other stage; and whether this reasoning is good and sound, or bad and untenable, as respects the modus operandi, one thing is very certain, that the patients treated in this way get well in a most incredibly short time. A man is seized to-day with a chill, and high febrile reaction comes on and continues for a few hours, or, as the case may be, a few days; he sends for a physician, and he prescribes 60 grains of quinine in six equal doses, and if he is very restless he adds one-quarter or one-eighth of a grain of morphine to one of the powders, perhaps the first one; he orders them taken once in four hours, and nothing else. In twenty-four hours the fever is gone. There has been neither emesis or catharsis, but a most profuse sweating has come on a few hours after the first dose; and all the sensible effect besides the subsidence of the fever and the sweating, is that the patient feels as if a swarm of bees had taken his head for a hive, or that it had become a tea kettle with boiling water in it. I have experienced the sound like wind in a distant forest, or like the distant noise of the surf breaking on the sea-shore. In some, a profuse secretion of urine will follow; but whether caused by the medicine or the subsidence of fever, may not be accurately determined. It is true, they get well; and it will appear odd to some, to be told that neither cathartic nor any other medicine is necessary to complete the treatment. Some begin the treatment by a short preparationa cathartic of calomel or an emetic-and wait for an intermission or a remission, and then give the quinin, and follow its use by a laxative. Others give small doses of 5 or 2 grains often repeated; while the bold, decided ones, give one large dose and let that suffice. Quinine is the remedy in every stage of the fever; but if organic changes have occurred from the continuance of the fever, as gastro

enteritis, hepatitis, splenitis, meningitis, bronchitis, pneumonitis, or other local disease of a serious character, then we are not to expect a cure by this remedy alone; but still they say give it, by all means, to destroy the primary cause; and treat the other affection as an independent disease. These local difficulties are so apt to come on when a fever is not arrested early, that it is quite a misfortune to neglect calling in aid early.

With regard to the mortality of fever in the West, it is quite inconsiderable, compared with the great numbers who are the subjects of it. Most of those who die with fever are neglected, either from poverty, negligence of nurse, eating some imprudent thing during convalescence, obstinacy in refusing proper diet, or using inert or improper treatment, and all the great number of causes acting on a large scale, over a great extent of country. I am convinced, however, that where one person dies at the West with fever, notwithstanding the poor accommodations that they have, fifty die of fever at the East-that is, out of an equal number of cases. This success is noticed by the people generally, and by the physicians in particular; and hence, many a man educated at the East, and thoroughly, too, in medicine, will apply the principles learned there to the treatment of fever, and fail, and that, too, at a time when he wished to make the most favorable impression in the community where he has settled, viz: the first year of his practice. But if they are not too self-sufficient, and will observe the disease closely, and deign to lay aside their dignified airs, and get down from their high horse, they will soon master what is really no very difficult matter.-Boston Med. and Surg. Journal.

NAPHTHA AS AN ANESTHETIC.-Prof. Simpson has been latterly experimenting upon the light coal tar naphtha as an anesthetic. It is as powerful as chloroform, but not so pleasant to inhale, and its only advantage is its cheapness. Prof. Simpson believes that the active anæsthetic constituent is benzole.

ANESTHESIA FROM THE LOCAL APPLICATION OF CHLOROFORM.— Mr. Higginson communicated to the Liverpool Medical and Pathological Society, the case of a lady, aged twenty-five years, in labor with her first child; the perineum had long been on the stretch by the head, which was tumefied by the pressure; the pain was great with each uterine contraction, but was referred entirely to the perineum, no pain being apparently felt from the uterine contraction itself.

About half a drachm of chloroform was poured upon a hand

kerchief in the ordinary manner, but instead of being applied to the mouth, it was held in almost immediate contact with the perineum. The pain immediately ceased, though the uterine contractions continued in full force; and the first intimation the patient had of the progress of the labor was hearing the child cry. Her mind was not at all affected, nor was intellectual consciousness in any degree diminished.

He had observed the same thing, though in a less degree, when the chloroform had been applied to the sacrum in another case.

He had also applied this agent to the os uteri of a patient suffering from very severe dysmenorrhoea, by means of a sponge placed in a curved glass speculum, which was introduced into the vagina. The pain almost immediately abated, and on its return, after some hours, the patient re-applied it herself with similar benefit.

Dr. Watson mentioned some cases confirmatory of its good effects when locally applied. He had painted it over a swelled testicle, with speedy relief to the pain, and had applied it along the course of the spine with a similar result in a case of acute spinal tenderness, which had not been relieved by other treatment. He had also applied it to the surface of a large mammary abscess, prior to opening it, which was afterwards done without suffering to the patient; and also to the vulva of a woman before cauterizing the orifice of the urethra. It had relieved the cramp and collapse in a case of English cholera when laid upon the epigastrium, and had abated the pain almost immediately when painted round the edge of a surface to which potassa fusa had been applied for the purpose of forming an issue.-Lond. Med. Gaz., Jan., 1849.

LOCAL ANESTHESIA IN NEURALGIA.-Dr. Hays stated, that he had employed the chloroform to produce local anesthesia with apparently the most happy effects, in a case of neuralgia, occurring in a gentleman fifty years of age, who had been for a long time a sufferer from neuralgia of the foot, in which all the remedies that had been previously employed failed to produce relief. Dr. H. was called to this patient about eight days since, and found him in intense pain, which had deprived him of sleep the whole of the preceding night. Dr. H. directed the affected parts to be enveloped with a pledget of lint, or a few folds of muslin, wet with chloroform, and the whole to be covered with a portion of oiled silk, to prevent evaporation; on the next morning he found him entirely free from pain, which has not since returned. Whether the relief experienced in this case is to be ascribed to the local anesthesia produced by the chloroform, or is to be considered as

a mere coincidence, Dr. H. does not pretend to decide.-Trans. Phila. College of Phys., Vol. ii., No. vi.

Since this communication was made to the College, the further history of this case has shown that an arrest of the paroxysm is always accomplished by the application of the chloroform; and by the use of the article, several other similar cases have been attended with like results.

BENEFICIAL EFFECTS OF COFFEE IN INFANTILE CHOLERA.Dr. Pickford states, that from the great importance which now attaches to the treatment of cholera, he feels it to be incumbent upon him to impart to others the experience which recent opportunities have afforded him of the effects of coffee in the cholera of infants.

In the case of an infant at the breast, to which he was called late, to whom the usual remedies had been administered unavailingly for four days, the exhibition of coffee was attended with complete success. The incessant vomiting and purging had produced extreme emaciation; the abdomen was distended; the pulse was frequent and small; there was great restlessness, and sleeping with the eyes half-opened; convulsive motions of the eyes when awake. Carbonate of ammonia, with nourishing diet, and external stimulants, having been fruitlessly exhibited, Dr. Pickford determined to have recourse to coffee, which he knew to have been recommended as a stimulating tonic by Dr. Dewees. He began with a small dose, a scruple infused in two ounces of water, with one ounce of syrup, giving a large spoonful every hour. The effect was surprising; the vomiting was arrested; the evacuations became more consistent, improved in color, and less frequent. The amendment progressed so rapidly, that by the tenth day the child was discharged as cured.

The effects were equally good in a little girl, fourteen weeks old, in whom the vomiting was not so severe, but the diarrhoea was quite as copious. In this case, also, the coffee was given, after other means had been tried, and the patient greatly reduced.

Dr. Pickford has since used this remedy in nine children of different ages, from four weeks to two years and a half. The doses have varied from half a scruple to two scruples daily. He has, also, administered it to children laboring under premonitory symptoms, especially where the evacuations have been very lightcolored. In some cases a single dose of calomel has preceded its employment. The effect was always favorable, except in one case to which he was called too late, when the child was already sinking. He has not had any occasion to try the value of coffee in the

diarrhoea of adults, having found calomel and opium of sufficient efficacy.

The benefit of coffee, especially in bilious diarrhoea, has been extolled by Lauzow and Chultze, (Richter's Arzneimittellehre, vol. 1.) West, in 1813, found a combination of coffee and opium very useful in the epidemic of that year. Coffee has long been employed by the common people as a remedy (in Germany, we suppose) after excessive indulgence in spirit drinking. It is known to have the property of promoting digestion, and the action of the bowels.

The purgative action of burnt coffee is attributed by Dr. Pickford to its tonic exciting properties. Like some other substances, in small doses it is capable of restraining diarrhoea, while in large doses it acts as a cathartic. The physiological explanation of this opposite effect of the same remedy is probably to be found in the condition of the motor nerves, which, being weakened, are by its moderate stimulus restored to their normal state of excitement, and thereby diarrhoea depending on their paralysis is cured. In this way, also, is explained its aperient action in larger doses on adults, by its over-stimulating these nerves, and so promoting increased movement of the intestines.-Lond. Med. Gaz., Nov. 1848, from Henle's Zeitschrift, Vol. v. 11, Part 1.

ON THE EXTERNAL USE OF IODINE IN CROUP.-Dr. Willige speaks of having had remarkable success in the treatment of urgent cases of croup by the external application of iodine to the larynx and trachea. He recommends that tincture of iodine should be smeared with a feather over the front part of the neck, corresponding to the larynx and trachea and their immediate neighborhood; and that this should be repeated several times, with intervals of about four hours, until redness and irritation of the skin is induced. In most cases this is followed by subsidence of the distress of breathing, of the spasms of the glottis, and of the other bad symptoms. He mentions the particulars of three cases, in which, by this means, he succeeded in averting impending death.-Lond. Med. Gaz., Jan., 1848, from Schmidt's Jahrbucher, No. 7, 1847.

THE ADVANTAGES OF CHLORIDE OF GOLD AS A CAUSTIC. By M. Chavannes.

MM. Récammier and Legrand signalized the advantages of the chloride of gold as a caustic many years ago and our author confirms their statements from observations made chiefly in the treat