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SANTONIN.-SOME OF ITS USES.

BY BEN, H. BRODNAX, M. D.

O common a drug, and so long in use, and yet, as I view it, not as well known to the profession as it should be. When I first hung out my shingle, I had a talk with one of our doctors as to santonin. He remarked: "You had better be careful as to dosage, as it has the name of being, in some cases, a dangerous poison." Another remarked: "I have been afraid of it as I have seen some very severe symptoms follow its use-" A third said he had seen poisonous effects from two-thirds of a grain. "heeled," I was rather particular, giving one-fourth and one-eighth grain doses to the youngsters.

Thus

I was called to see a child with fever, and gave, as I thought, from one of my square saddle bag vials, four doses of about one and a half grains each of calomel to be taken a half hour apart, and took my leave, putting the vial in my vest pocket, and not back into the saddle bags. On my way home I stopped to see another patient, and taking my vial from the pocket to leave some calomel, I noted it was my santonin vial. It was hours since I had prescribed from it before so there was no help for patient No. 1. But I believe if I were going to be hung I could not have passed a more unpleasant night. Next morning I was up by day-break and enroute for the house, went in, "patient all right, but, doctor, look at this gown." It was bright yellow where he had urinated on it. "That's all right," I remarked, "there was some santonin in the powder." "Yes, there must have been, he has passed over a dozen worms," she said. Then I began to doubt. Some time afterward, a

complained, "I eat a plenty, but it don't do me any good; I am hungry all the time." Almost out of pure devilment I gave him three five-grain santonin powders, and told him to take them a half hour apart, and if they did not "move his bowels" by morning, to take a dose of castor oil and turpentine.

I did not see him for several months, and had forgotten all about it, when at a house several miles away, a big fleshy negro asked ¡me how I came to give him "the three powders." He then told me they caused him to pass "a hat full of worms." And right here, let me say, it is not an uncommon thing to find, on giving santonin to grown people, it causes evacuation of considerable numbers of lumbricoidia. I am of the opinion that these same are at the bottom of some trouble, some wasting diseases in old people.

A woman sixty-five years old died recently, and after death, I am told, over a hundred large worms came away from her. Now, were they not partly the cause of non-action of medicines and nourishment, and had they been removed prior to death, would not her chances for recovery have been better?

I have noticed that those who took these doses commenced to fatten up almost immediately—that the urine was more plenty, though high in color. Now, I thought, how would three to five grains three times a day do in cystitis? I tried it, and in this it was a success, supplanting to some extent, my old mode of nitrate of silver in the same trouble. That is, where the case was not acute.

This effect on the urine led me to use it in a case of gonorrhea that had run its first stage, and become somewhat chronic. Three grains three or four times a day, reduced to twice daily at the end of a week, resulted in a cure in less than two weeks. I have since then used it alternately with carbolic acid, two grains of santonin, two drops of acid, alternate every four hours, in acute gonorrhea, with result of disappearance of all symptoms in from fourteen to eighteen days.

Somewhere I got a hint that it might be useful in dysmenorrhea. I gave five

grains three times a day on the first day, six grains on the second, and seven grains on the third day, to a well built woman, who looked the picture of health, but who for four or five days every month was almost crazy with pain. The menses ap

INTERNAL AND LOCAL MEDICATION WITH INDUCTION-GALVANO-FAradism vs. THE X RAYS IN CANCER.

BY WM. A. ARMSTRONG, M. D.

INDER the caption "The Effects of

while she was at my house on a visit.

Why is this, and why does santonin act so on the urine, as well as on the bowels to expel worms? Does it separate, so that part of it acts on the intestines, and the other acts so freely on the genitourinary organs? It is a sulphate. Do these sulphates always split up this way? Quinine does not, that I know of, act otherwise than through the blood on the nervous system. We hear of the coal tar derivatives, like salve, becoming disengaged into pure phenol and salicylic acid. What is there in the drug, which is little else than the old fashioned "worm seedoil," deodorized, that should cause it to split up in that style? Also being a white powder and supposed to act on the intestinal canal, what causes the intense yellow? Is it the flow of blood-the urea or uric acid? I would like very much to know the maximum dose of santonin-i. e., one that would kill a backwoods doctor's patient. As it now stands, a boy of four years took in proportion to age what would be to an adult twenty grains, in three hours. Were the really good doctors who advised me thirty five years ago, mistaken in the matter, or was the santonin they used impure, and if impure, what was the material that rendered it so?

I have for several years used a syrup made of the fresh leaves, seeds and seedpods of the "Jerusalem oak," and instructed the negroes how to make their own "worm physic" out of the fresh plant, and they are not particular about the strength of the medicine, so it does the work. What principle in it acts as an anthelmentic, after it has expended its force on the alimentary canal? Is it absorbed and then acts on the urinary organs with as much or more force? Brodnax, La.

DR. E. C. Jenigor, of Newfield, Maine, writes: " Continue to send the Summary, Could not do without it."

U

Growth," an editorial in the Medical Review of Reviews, (Jan. 25, 1903, page 44), the author states: "We have had the opportunity of inspecting many cases, and up to the present time have seen only two where satisfactory results have been secured, but have had and seen a large number of failures."

The fact is that some cases of epithelioma of the skin have been apparently cured, and some mammary growths have been reduced in size. These are not cures, however. We must patiently await the time test, which will doubtless eliminate many cases from the cures now being reported. The report of Dr. S. G. Shattock's case, presented to the London Pathological Society, at the meeting held Dec. 2, 1892, (Lancet, Dec. 6, 1902), he said that he had had the opportunity of studying an example of scirrhous tumor of the mammary gland, which was excised by Dr. W. F. Brook. The specimen came from a case shown by Dr. Brook at the last meeting of the British Medical Association. (Brit. Med. Jour, Oct. 25. 1902, page 1305). The tumor was subjected for about three months to the rays, and clinically underwent diminution in size, in addition to becoming more movable on the subjacent parts. Examination after removal showed, however, that no changes could be associated with the treatment, either macroscopic or microscopic. The stroma presented a variable amount of lymphocytic infiltration, and contained mast cells and a few groups of Unna's plasma cells. The epithelium, which was of the spheroidal celled kind, presented nowhere any necrosis, and the only fatty degeneration of any note concerned the cells of the few mammary lobules still remaining about the edge of the growth. At no part of the margin was the growth ceasing to extend. The "cancer body" occurred in groups or singly in certain of the epithelial cells, and the arterioles around

and in the stroma were normal. The results of the examination were highly disappointing, for no degeneration of any kind, or cell lysis, had been induced by the treatment. No phagocytic invasion of the epithelium was in progress, and on every side the growth was in an extending condition. There was nothing which might not be met with in cases where no treatment had been carried out.

Can such failures with the X rays be ascribed to an absence of certain electrolytic disintegrating chemical properties, such as are obtained with InductionGalvano-Faradism? (Then, too, with the institution of no appropriate internal or local medication, which, although sneered at by eminent authorities, necessarily must, and does, produce certain amounts of constitutional effects). While escharotic effects are obtained in both methods, may there not exist certain principles in one which are wanting in the other? Be this as it may, the number of bona fide cures with Induction Galvano Faradism, dating back to 1888, has been great, the most remarkable one being that of an old lady, then in her sixty-eighth year, with an enormous rectal cancer, now (1903) still living and free from recurrence, at the age of eighty-three. This cure was effected fifteen years ago. Certainly, the "time test," which will doubtless eliminate many cases from the X-ray cures now being reported, (as mentioned in above editorial) is met by this cure, as well as the others reported in the SUMMARY, November and December, 1896, and January, 1897, and later, in September, October, November and December, 1901, and April and September, 1902, numbers of this most excellent publication.

Since by electrolysis, (a term applied to the process of decomposing compound substances by the galvanic current) it is possible to decompose water into its constituent gases. Why should diseased human tissues be excempt from similar electrolytic action? Applying two wetted sponges, attached to the poles of a powerful galvanic battery, and keeping them in position for a certain length of time, produces vesication. What causes this phenomenon? Is it not the liberation of the acids and alkalies, metals, etc., made

Or

electrically active by the current? ascribe it to any other cause you wish, the effect is unmistakable there. Now, reasoning from analogy, this tremendous force, which can destroy the skin, must produce some effect on a malignant growth; if so, what is it? Who can answer?

Further, the human nerve has been proved to possess the three elements of a galvanic battery-the nerve, one element, the sheath the other, and the white substance of Schwann, the exciting fluid. Says Dr. St. Clair: "Every man, woman and child is a galvanic battery—a storage battery, if you like-and each will, and does, retain a certain amount of electricity." R. C. Shettle, M. D., physician to the Royal Berkshire Hospital, England, in 1871, (Brit. and For. Medico Chirurgical Review) fully demonstrated and proved that analogy, if not perfect identity, existed between the electro-magnetic and vital forces. (See MEDICAL SUMMARY, February, 1902, pages 360-61.

Just why the X rays should have been experimentally used, instead of the Induction Galvano-Faradism, in the treatment of cancer and tuberculosis, is a question. Possibly their remarkable photo-penetrating power may have led investigators to think that on this account curative effects must necessarily be superior to galvanism, in the form of I. G. F. Results, however, have not borne out the high hopes entertained.

INTERNAL AND LOCAL MEDICATION IN
CANCER, ETC.

The remedies which have given the best results in cancer, are: First, arbor vitæ, Lin., (thuja occidentalis), fluid extract and saturated tincture. This tree is also known as white cedar, (not, however, the white cedar of the Southern States). It is an indigenous evergreen tree, growing wild from Canada to the Carolinas, and cultivated for ornament in gardens. The leaves, or small twigs invested with leaves, are the parts used. The tincture and fluid extract have been employed for many years in various diseases. Among its many virtues may be mentioned: Allments resulting from insufficient peripheral energy; it prevents and checks degeneration of tissue substance; it is asep

tic; it energizes capillary vessels, causing their contraction; it is hemostatic, controlling exhuberant granulations; it destroys the odor of gangrene, at the same time overcoming the discharge. Warts are eradicated by both local and internal use. Eczema, balanitis, abrasions and chancres yield to its curative effects. Granular conjunctivitis, umbilical hemorrhage, hemorrhoids, tonsillitis, elongated uvula, and in the early stages of diphtheria. For goitre; by injection in the scrotum for hydrocele. For hernia, by injecting thuja in and around the rings. In prolapsus ani, chronic proctitis, intermittent and remittent fevers, coughs, rheumatism, scurvy, dropsy, amenorrhea, etc. It has been used quite extensively, both locally and internally, in malignant and non-malignant tumors and ulcerations. It is analgesic and arrests the progress of the malady, and when used in conjunction with Induction Galvano-Faradism, effects a permanent cure.

As long ago as 1856, Dr. Benedict recommended the strong tincture as an emmenagogue, (N. Y. Jour. of Med.) Dr. James R. Leaming, of New York, published in New Remedies, (New Preparations, 1878, page 6), his experience with thuja, which are virtually those above mentioned. Thus far thuja appears to have been employed empirically only, but it would seem that its action may be explained by a property somewhat similar to that possessed by ergot, namely, of contraction of unstriped muscular fibres. This would explain, in some degree, its alleged power of controlling hemorrhage, and the growth of vascular tissue, like cancer and condylomata.

An interesting case is that of an old gentleman, aged seventy-two, who had a small ulcer in front of the two middle lower incisors. When first seen, there was an excavation about the size of a grain of corn. Solid nitrate of silver was carefully applied and repeated, with no perceptible benefit. Iodoform was then resorted to, and a mouth wash of potassium chlorate and carbolic acid was used occasionally. In spite of these measures the sore still enlarged, and at the end of four months it measured fully an inch in length by three-fourths in width. An

eminent surgeon was consulted, who advised an operation as the only probable resource, but, owing to the age and cachectic state of the patient, and the uncertainty of being able to remove the affected tissues entirely, he did not urge such a procedure. Several other experienced men entertained similar opinions. The case went on from bad to worse, until the gums and alveolar process, from the left canine to the last molar, and the corresponding inner buccal tissues, were all involved. The bone was crumbling; the sublingual and submaxillary glands were greatly enlarged, and of scirrhous hardness. The tongue was crowded upward to such an extent that it was with extreme difficulty that the patient was able to take sufficient nourishment to sustain life.

Such were the conditions when Dr. A. C. Miller, of Cleveland, was met, and the case incidentally mentioned to him. In the course of a conversation, Dr. Miller mentioned thnja occidentalis as having been employed by him with encouraging results in the treatment of malignant disease, his attention having been first called to the virtue of the drug in this class of affections by Dr. J. R. Leaming, of New York. As soon as the saturated tincture of the thuja could be prepared, its administration was begun. The patient usually took fourteen fluid drams daily of this tincture. It was taken as frequently and in such quantities as he was able to swallow. A pretty strong infusion of the thuja was placed within reach, and frequently used as a mouth wash. He occasionally resorted to the solution of potassium chlorate, 1 grain of quinine and one-fortleth grain of arsenious acid thrice daily. His chief nourishment was mush and milk. The improvement was gradual. The tumefied glands grew softer and diminished in size. The ulcer assumed a more benign appearance, as also did the parts thickened by infiltration. Strength increased, and there was remarkable relief from pain. He persevered with the treatment most heroically, under many discouraging circumstances, but after the lapse of four months was happily rewarded by perfect recovery, which continued with no relapse.

Another very interesting case is the following: An old malignant scirrhous cancer, embracing the entire mammary gland of a large fleshy lady, sixty-four years old. The cancer extended from breast bone to arm pit, and measured 11% by 6 inches. The cancerous mass had been removed from over the breast bone and three ribs, for a space of five inches, but there were found masses of hair like fibers imbedded in the bone that all endeavors failed to remove. Thuja was then applied, which loosened the periosteum so it could be raised and clipped off. And that in twenty-four hours from first application. The applications were continued, and she received the drug twice daily per orem. Result: second day the ribs, for three inches, and nearly across the width of the breast bone, were bare and clean. Fourth day, the third rib was black, and its thin edge and connection with the breast bone completely broken from the lower portion, and sunk one-fourth inch. At each inspiration the serum within the chest sprayed out, and

as well as an alterative of great power. Instead of arsenious acid, Arsenauro or Mercauro are to be preferred, affording much better results than any other preparations of arsenic I know of. The latter can be given in increasing doses to saturation, then omit for a day or two, then recommence with a smaller dose. Needless to add that Bovinine should be administered from start to finish, in doses of one teaspoonful to two tablespoonfuls, in milk, grape juice, etc., every two or three hours.

NOTE.-For a full account of the two last cases, send to Parke, Davis & Co., Detroit, Mich., for their Working Bulletins No. 5, Arbor Vitæ Lin., and No. 26, Echinacea Angustifolia, D. C., which will be sent free of charge to physicians enclosing their card.

1808 North Park Ave., Philadelphia.

WHEN TO GIVE IRON.

BY A. TOPFER, M. D.

7HE administration of iron as a rem

rendering it impossible to use the silver plates, fearing that this incessant working might slide them through the large opening into the cavity of the chest. The use of thuja was continued, and electric currents were sent along the ribs, and for three days applied the negative sponge, an inch in diameter, to the naked investment of the lung. Eighth and tenth day new osseous formation appearing along the ribs. Twelfth to fifteenth day, rib and breast bone fully united. From this time healthy granulations crept over the sternum and between the ribs, the osteal membrane forming over the repaired bones. Twenty-eight days from first using thuja, the entire opening is closed with clean healthy fiesh. The patient is comfortable and not confined to the house.

These cases are certainly remarkable, and worthy of considerable attention, especially since we know that surgical interference or X-rays are not successful, at least in very many cases, especially those of truc cancer.

I have found it of benefit, in certain cases, to combine with thuja, echinacea angustifolia, which is an excellent tonic

are so remarkable for anemia and neuralgia, an almost daily duty of the practitioner. But it is by no means indifferent in which form iron is introduced into the organism, in order to realize the intention of the physician. True enough, it is a recognized fact that metallic iron, as well as its oxides and acid preparaitons produce excellent results, if adapted to the conditions in which the digestive organs happen to be, and if given in correct doses. It is, however, equally true and well known that iron, combined with albumen or peptone, so-called organic iron, produces a curative effect fully as favorable, without requiring special regard to the digestive organs, if only the stomach will retain its power of absorption. One condition, nevertheless, must be performed by the physician if he wishes to avoid disappointment. He must ascertain whether or not the blood is in need of iron, no matter what kind of iron, organic or inorganic, he intends to employ. Where the economy has no need for a supply of iron, the administration even of iron is useless.