APOLYSIN: A NEW ANTIPYRET

IC AND ANALGESIC.

BY DRS. L. V. NENCKI AND J. V. JAWORSKI.

As a study of the relation between pharmaco-dynamic action and chemical constitution amongst several aromatic compounds, the new remedy, Apolysin, has lately been the object of much attention in the Warsaw and St. Petersburg hospitals.

Apolysin is nearly related to phenacetin, with this difference, that instead of being an acetic acid derivative of para-phenetidin, citric acid takes the place of acetic acid. Apolysin is a yellowish white crystalline powder of acid taste, though not so distinctly acid as citric acid itself, which dissolves in cold water in the proportion of 1 to 55, and in hot in any proportion. It melts at 72 degrees Centegrade. In other respects Apolysin closely corresponds in chemical behavior to phenacetin.

Present knowledge of pharmacodynamic relations indicated that Apolysin from its constitution would be nonpoisonous, split up into paraphenetidin, ethyl and citric acid in the organism, producing a reduction of temperature and analgesia, and the phenetidin eliminated in the urine in the form of a glycuronic or sulpho compound.

The absence of toxic properties in Apolysin was proved by experiments on frogs and rabbits, one, four and 8 per cent aqueous solutions being gradually injected in the proportions of 1⁄2 to 4 parts Apolysin to 1,000 parts animal body-weight. The frogs as well as the rabbits bore the injections well and without any disturbance to the health or general condition. The products of the decomposition of Apolysin were found in the urine of the rabbits combined with sulphuric acid. The urine possessed the same behavior towards reagents as after the administration of phenacetin. Compounds of glycuronic acid could not be discovered.

Before administration of Apolysin to fever patients its antiseptic action was first tried on animals. For this pur

pose two rabbits were taken, in one of which diphtheritic toxine, in the other a pure cultivation of pyogenous streptococci was injected. The temperature of the animal inoculated with toxine rose after three hours to 39.6 degrees C., and on the afternoon of the second day to 39.9 degrees C., 1 c.c. of a 10 per cent aqueous Apolysin solution was injected. The temperature rose in the evening to 40.5 degrees C., but on the next day the morning, afternoon and evening temperatures were 40.1 degrees, 39.5 degrees, and 39.2 degrees C., respectively, and on the fourth day at the same haurs, 39.5 degrees, 30.1 degrees, and 39.0 degrees C. The second animal inoculated with pyogenous culture exhibited a temperature of 40.3 degrees C. in the evening, and the next morning at 40.1 degrees C., 1 c.c. of a 10 per cent aqueous Apolysin solution was injected at 11; at 12 o'clock the temperature fell to 39.4 degrees C., at 3 o'clock at 39.3 degrees C., at 7 o'clock 40.2 degrees C., and at 9 o'clock 40.1 degrees C.

Progressing to clinical observation, Apolysin has been employed for the purpose of testing its antipyretic and analgesic properties in the following cases: Four cases of croupous pneumonia, one case of scarlatina, one case of abdominal typhus, thirteen cases of influenza, two cases of puerperal fever, one case of pyaemia, five cases of angina follicularis, one case of facial erysipelas, three cases of hemicrania, two cases of sciatica, seven cases díagnosed generally as cephalalgia, three cases of neuralgia nervi trigemini, one case of neuralgia cervico-occipitalis, and two cases of neuralgia plexus lumbalio. The Apolysin was generally administered alone in powder form, in doses of fifteen grains three times daily at intervals of an hour, and only in a few cases was it combined with bromides, and twice with caffiene salts.

From these investigations and clinical observations the following conclusions have been determined: Administered internally Apolysin has an antithermic action on fever patients, and, simultaneously with the fall of temper

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I have used peroxide of hydrogen quite extensively for cleansing charging ears, the nasal and accessory cavities, and have tried all the brands of the preparation in the market, and once thought one manufacturer's make as good as another, and bought the cheapest as a matter of economy, but recent experience has taught me the difference in quality is greater than the difference in price. After an unpleasant experience with a solution of peroxide of hydrogen which severely injured the mucous membrane, I bought and examined, chemically, a bottle of each preparation of H2O2 in the market, and was surprised to find so much difference. Some are useless, and others worse than useless, because they contain too little available oxygen and too much free acids (phosphoric, sulphuric, hydrochloric). I now order Marchand's (medicinal) exclusively, because I find it contains the desired

quantity of available oxygen and not enough free acid to be objectionable, and its keeping properties are all that could be desired.

By inquiry I learn that Marchand's is the preparation that is used by almost all surgeons, and it is considered by them the standard.

(My personal experience with peroxide of hydrogen confirms entirely the statement of Dr. J. P. Parker. I have used exclusively Marchand's brand until lately, when I experimented with hydrozone. Then I gave up entirely the use of peroxide of hydrogen and use hydrozone on account of its strength, which cannot be compared with any other brand, even Marchand's. I must say that the results which I obtained with hydrozone are most gratifying.-Ed. Times and Register.)

DOVER'S POWDER MODIFIED.

By WILLIAM F. WAUGH, A. M., M. D., Professor of Practice, etc., Illinois Medical College.

Dover's powder is one of the few relics of mediaeval polypharmacy that have retained their popularity, even in this age of scientific medication. The formula was one of those happy combinations where each ingredient favorably influences the other. While opium constipates and checks the secretion of digestive ferments, the tissue metabolism and the excretion of toxines by the liver and the kidneys, ipecacuanha antagonizes each and every one of these actions. Opium prevents the nauseant action of ipecacuanha and its tendency to cause griping. Both drugs increase the secretion from the skin and the bronchial mucous membrane, relax the vaso-motors and allay fever, especially when due to inflammation of the respiratory apparatus. The potassium sulphate acts as a laxative, even in the small quantity present in an ordinary dose of Dover's powder.

In arranging this compound for use in a granule, the alkaloids were employed instead of the crude drugs, while the potassium sulphate was replaced by camphor monobromide.

Many physicians have recommended the use of potassium bromide, instead of the sulphate in the ordinary Dover's powder; while for many of the uses of this powder camphor is a valuable adjuvant. To break up colds, cure coryza, prevent the attacks of local inflammation that so often follow exposure to cold or wet, to relieve coughs, diarrhoeas or mild attacks of dysentery, camphor harmonizes well with the ipecacuanha and opium.

The granule is one of the best remedies for coughs I have ever employed. Time and again I have received letters from

strangers living at a distance from Chicago, asking me to send them the prescription for these granules, some of which had been given them by patients they had met. The efficacy of the combination in many cases of intestinal flux is no less marked. In children and adults, when peristalsis exaggerated, there is no better sedative to the irritated bowel. When given to prevent or break up a cold, a full dose should be taken, with a glass of hot ginger tea and a hot bath as adjuvants. If the depression be great twenty drops of spirits of camphor will prove a better addition than any alcoholic stimulant. In many cases, also, where opium must be employed, this is a less objectionable and dangerous preparation than any other. It may be that there is a "Dover's powder habit," but I have never seen a case.

(We asked for the above by Dr. Waugh, being much interested in and much pleased with this preparation, and believing that at this season of the year we could not do better for our friends than to bring it to their attention. The formula is scientifically arranged, and if the granule is accurately and carefully compounded, the results of its proper application will be all that can be desired. We heartily indorse it and recommend it to our friends, believing that it will fill a niche in daily practice heretofore more or less vacant. Samples can be obtained of the granule manufacturers. — Ed.) — Alkaloidal Clinic.

A post-graduate medical school has been established in Washington, D. C.

ANALGESIA AND SEDATION AN ESSENTIAL ADJUNCT TO

TREATMENT.

BY JNO. J. SULLIVAN, M. D,
University of the City of New York.

On account of the frequency with which pneumonia in late years is accompanied with grippal symptoms, the treatment, to a great extent, has been modified or changed. The essential features in the result desired are a diminution of the pain and a lowering of the temperature. Opinions differ as to whether a reduction of the temperature influences the course of the disease, but a concensus of opinion is that antipyretic treatment is distinctly called for in the beginning, and an analgesic at all times, if needed to assuage suffering. The antipyretic should be antikamnia, and the analgesic is supplied by codeine and antikamnia together. This is given every three or four hours in tablets containing 43⁄4 grains antikamnia and 4 grain codeine throughout the period of congestion and consolidation. Where there is great restlessness, this will have a delightful effect.

In the nocturnal pains of syphilis, in the grinding pains which precede labor, and the uterine contractions which often lead to abortion, in tic-douleureux, brachialgia, cardialgia, gastralgia, hepatalgia, nephralgia and dysmenorrhoea, immediate relief is afforded by the use of this combination, and the relief is not merely temporary and palliative, but in very many cases curative.

In the neuroses of the respiratory organs, great relief is afforded by the use of this combination. A paroxysm of asthma is often cut short by a full dose; hay-fever or autumnal catarrh is benefited by its use.

In the harassing cough of phthisis, or in the pain of pleuritis, in the painful sensations accompanying bronchitis when the tubes are dry and irritable as they usually are-the blending of codeine and antikamnia will not be found wanting in its action, but will give results that are both gratifying to the patient and the medical attendant. As a producer of sleep it will be found efficacious. This is doubly true when there is great nervous excitement.

In pulmonary diseases this combination is worthy of trial. It is a sedative to the respiratory centers in both acute and chronic disorders of the lungs. Cough in the vast majority of cases is promptly and lastingly decreased and often entirely suppressed. In diseases of the respiratory organs pain and cough are the symptoms which especially call for something to relieve; this tablet does it, and in addition controls the violent movements accompanying the cough, and which are so distressing.

This combination is the remedy for diabetes and is superior to any other in diminishing the quantity of sugar in the urine, and also in diminishing the quantity of urine itself in diabetes mellitus. The bulimia and polydipsia are lessened by its use, and probably the changes in the nervous system which accompany or are causative of the disease are arrested or prevented. It also prevents waste. It controls restlessness; it relieves insomnia; it relieves distressing nervous symptoms. It relieves the craving of the stomach, and lessens the frequency of the calls to urinate.

It is not claimed that the combination will cure diabetes mellitus, but there will be, in many cases, arrest of the disease, with prolonged periods of good health, and cure in some cases.

266 West 38th Street, New York City.

THE THERAPEUTIC RANGE OF MELACHOL.

In these days of physiologic therapy when the whole medical profession is running wild over the remedial agency of even germ-life itself, there is danger of neglecting those agents of the inorganic world, which not only themselves form a large part of the constituency of the human organism, but also, when chemically adjusted, are capable of almost infinite applications in the restoration of physiologic functions. Among these agents, there is nothing which produces such a profound effect, or has a wider range of therapeutic function than phosphorus and its compounds, especially the salts, which from their crystalline character are ready for osmosis at once, without waiting for any preparatory work of

assimilation. If there is any one principle of the human organism which more than any other lays claim to physiologic significance in the higher animal organisms, it is phosphorus. Being the center of crystallization, as it were, for the chemic forces of the whole nerve system, are of the physic, and indeed the psychic autonomy of the body, it is thus absolutely necessary for all building of tissue, as well as performance of function in the metabolism of tissue. Working to this end the physiologic chemist has reached a triumphant issue in the preparation of these principles in such a form as to accomplish:

1. A direct supply of ultimate tissue principles to the organism without the necessity of digestive aid.

2. A direct stimulus of function within the digestive tract.

3. A direct antagonism to all forms of retrograde metamorphosis.

4. A direct antidote not only to the special effect of physiologic narcotism, but also direct destroyer of that strange and awful livery which the habit of narcosis throws over the nerve centres of the organism.

This last effect alone would forever record it a priceless boon to mankind. especially in this age of over-heated thought and action.

A system of clinical reports is now in preparation setting forth the therapeutic ranges and effects of Melachol and the technique of its administration to the various pathologic conditions in which has been proved to be specific and adjuvant in its effect.Nat. Board of Health Mag.

Dr. Ben. H. Brodnax, of Louisiana, says in the Charlotte Medical Journal, (March, 1895,) "I am satisfied that Sanmetto is the safest, pleasantest and most effective genito-urinary alterative and tonic I have ever tried."

Where seminal vesiculitis exists, there is generally a previous history of urethral or bladder inflammation, sexual abuse and the like, all of which are agents tending to produce localized inflammation in the seminal vesicles.