one distinct advantage over plain heroin, in that it can be given. for a long time without ill effects, and in the class of patients. in question this is, indeed, a most important feature. During the past year and a half I have treated a number of cases and recurrent winter coughs with Glyco-Heroin (Smith), and have obtained uniformly good results.

Example.-A. L., salesman, aged 28. I saw this patient early in the spring of 1903. He is robust and of good habits. He consulted me concerning a constant cough which had troubled him for over a year. It was usually worse in the morning and after meals, and accompanied by expectoration of thick mucopurulent matter, sometimes blood-stained, and especially so after a severe paroxysm. This circumstance preyed upon his mind considerably he thought he had consumption. I learned that he had had a severe attack of acute bronchitis during the spring of 1902, and had been coughing ever since. Physical examination excluded tuberculosis. The diagnosis was chronic bronchitis, sequential to acute. The patient was immediately put on Glyco-Heroin (Smith), and the same hygienic measures ordered as in Case 1. Here again the financial condition of the patient precluded change of climate. In addition to the GlycoHeroin (Smith) the patient was given syrup of hypophosphites as a tonic. I did not see him again until last October. then reported himself absolutely free from cough. He continued taking the Glyco-Heroin (Smith), and during the present winter has not experienced any return of the trouble. In this case a complete cure was effected by means of quieting the cough and stopping the irritation of the mucous membrane, in this manner allowing the restorative powers of the body, aided by the tonics and good hygiene, to accomplish a cure.

He

Example.- Miss R. M., aged 24, teacher. This lady had been coughing ever since she was nineteen years of age. At that time she had had an attack of rheumatism with a complicating bronchitis. After the acute condition had moderated, she continued to cough, the cough being very annoying in character, spasmodic and prolonged. After each paroxysm she was left in a state of exhaustion. During the attacks she urinated invol

untarily. On examination she was found to have chronic bronchitis, aggravated by an exceedingly irritable condition of the respiratory tract. The mere odor of cigar smoke was sufficient to induce a paroxysm of coughing. In treating this patient it was necessary to devote attention to the neurasthenia as well as the chronic bronchitis. She was placed on a diet and her mode of living regulated. Arsenic, strychnine, and iron in pill form were given. For the cough, I ordered Glyco-Heroin (Smith). The improvement was marked and rapid. The general nervous condition lost its spasmodic character. At the present time it amounts to but little more than a “clearing of the throat." This case, more than any other, demonstrated the excellent properties of Glyco-Heroin (Smith). The quick relief afforded was surprising, and no more gratifying to the patient than to me.

PYRENOL A CHEMICAL COMPOUND OF SALICYLIC ACID, BENZOIC ACID, AND THYMOL.*

BY DR. FRITZ LOEB, OF PROF. EWALD'S MEDICAL DIVISION OF THE AUGUSTA HOSPITAL AT BERLIN.

THE favorable results from pyrenol obtained in our division induced Prof. Ewald to ask me to continue and report on its employment. A white, crystalline powder of aromatic odor and sweetish taste, it is the finally successful attempt to combine salicylic acid, benzoic acid, and thymol with a sodium salt.

Its constituents give the clue to its pharmacodynamic effects. Schlesinger, who introduced it, first used it in neuralgia, but soon recognized its efficacy in asthma and pertussis. Shortly thereafter Sternberg found that it promptly stops the asthma attacks of chronic bronchitis and acts well in cardiac asthma. Then followed in rapid succession the works of Frey, Isenburg, Burchard, Gruenfeld, Komor, Manasse, Frieser, and others, whose experience furnishes the following indications:

Affections of the respiratory organs, asthma, pertussis, pneumonia, and acute, chronic, and putrid bronchitis.

*Abstracted from the Berliner klin. Wochenschrift, Oct. 10, 1904.

Rheumatic affections and infectious diseases, acute or chronic articular or muscular rheumatism, pleurisy, angina, and gout.

Since Schlesinger has thoroughly tested pyrenol as an antifebrile, antirheumatic and antineuralgic agent in 150 cases, we shall consider only its effects in respiratory diseases. Here it acts as a solvent and expectorant, limits secretion and soothes cough. In acute bronchitis and pneumonia it is antipyretic, but far less diaphoretic than salicylic acid. Helfer and Gruenfeld found that it prevents heart complications and is valuable in catarrhal and croupous pneumonia and simple pleurisy. Gruenfeld also says that it is specific in pertussis; and we certainly found it as effective as any of the so-called specifics.

In bronchial asthma, pleurisy, bronchitis and influenza, our results were very good indeed. It acted surprisingly well in bedridden phthisis cases, promoting expectoration so markedly that many patients demanded it when it had been withdrawn. Pyrenol is indicated in phthisis when there is a dry, troublesome cough.

It has no depressant effect on blood pressure or pulse. The stomach stands it very well. To children or sensitives it may be given in raspberry syrup, peppermint water, cold milk, or similar corrigents.

We conclude that pyrenol is entirely free from noxious byeffects and is to be warmly recommended in all cases of acute febrile and chronic bronchitis, asthma, especially bronchial asthma, influenza, angina, simple pleurisy, croupous pneumonia, and acute broncho-pneumonia.

Our maximum adult dose was 671⁄2 grains daily. As pvrenol contains about 40% salicylic acid, this equals about 27 grains of the latter, which is far below the limit of toleration determined by Brugsch for salicylic acid. We obtained the full therapeutic effect without any renal irritation.

IF THE CAUSE OF PAIN in the feet is not otherwise clear, examine them in the dependent position. This may develop the presence of erythromelalgia.- American Journal of Surgery.

ARHOVIN, A NEW INTERNAL ANTIGONORRHEIC.*

PY DRS. F. BURCHARD AND A. SCHLOCKOW, BERLIN, GERMANY.

ARHOVIN, an addition-product of diphenylamine and esterified thymolbenzoic acid, was subjected by us to extensive physiological and therapeutic experimentation. It is a fluid of aromatic odor and cool, slightly burning taste, with a boiling point of 218°C., almost insoluble in water, but readily soluble in alcohol, ether, and chloroform. Its gastric absorption is exceedingly rapid (15 minutes). The exact form in which it is excreted is as yet undetermined; but the dark green reaction of the urine with 1% ferric chloride solution points to phenyl-hippuric acid, the thymol being changed into thymol-glycuronic acid.

In our entire series of experiments on healthy persons and patients there was never the slightest indication of any undesirable effect on the organism. On the contrary, the condition of the subjects invariably improved, even when the remedy was given continuously for weeks. The dose was 4 grains five times daily in capsules. By mouth it is best given in capsule form.

In some persons the urine became clear and absolutely odorless at the beginning; in others it retained normal color and bouillon-like smell. Cloudy urine was quickly cleared; but arhovin had no influence on phosphaturia. The urine was rendered powerfully bactericide and entirely inhibited growth in pure cultures of gonococci, streptococci, etc.

Urinary reaction in some cases became strongly acid; in others it remained unchanged. Usually, however, acidity was permanently increased, preventing or arresting ammoniacal decomposition. It seems that the acid and bactericide urine renders the vesical and urethral mucosa unsuitable for bacterial growth.

Arhovin is a prophylactic of gonorrheal joint inflammation and of endocarditis. Most if not all of these affections are metastatic; the direct cause of the disease is brought to the joint by the blood current, and finds a nidus in the synovial membrane. Injuries and exposures to cold are but predisposing agents, if

*Abstracted from Die Medicinische Woche.

causative at all. We believe the gonococci do not circulate free in the blood, but appear there in or on pus cells and also on particles of solid uric acid. The advent of the latter alone in the synovial sacs may cause swelling and inflammation of the joints. Since arhovin changes the fairly insoluble uric acid into the very soluble hippuric acid, it may well prevent the deposition of the crystals in the joints.

Diphenylamine, thymol, and benzoic acid have long been recognized as antiseptics; but their toxicity have stood in the way of their internal use. We regard arhovin, whose absolute nonpoisonousness we have proved by months of experimentation, as a most fortunate combination.

With regard to the simultaneous use of the customary injections, individualization is desirable, though we do not believe that a drug capable of destroying the gonococci and of sterilizing the nutrient media within three weeks needs any such support. Arhovin is especially advantageous in female gonorrhea, where there are practical difficulties in the way of local treatment.

Arhovin has no notable effect on the amount of urine excreted. Kidney disease is no contraindication to its use.

Microscopic examination for gonococci was made in every case and always gave negative results.

THERAPEUTICS OF ARTIFICIAL SERUM.*

BY HUBERT RICHARDSON, M. D., BALTIMORE.

THE blood plasma contains inorganic salts in certain definite proportions, forming a fluid of definite specific gravity adapted for holding in solution the cellular elements as well as the effete matters of metabolism which are eliminated by the kidneys. A change in the proportion of these salts produces pathologic conditions and interferes with nutrition and elimination, causing starvation or autointoxication.

Arteriosclerosis is due to deposits of calcium and cholesterine in the arterial walls. Trunecek, reasoning that the normal conAbstracted from Dietetic and Hygienic Gazette, February, 1906.