GUAIACOL IN THE TREATMENT OF PNEUMONIA.

While the use of guaiacol in tuberculosis of the lungs is fairly well known, but little attention has been paid to it as a remedy in the treatment of other infectious diseases, for instance, in pneumonia. Guaiacol is produced by the fractional distillation of beechwood creasote, of which it constitutes from sixty to ninety per cent. The purest form of guaiacol, however, is that made synthetically from the dry distillation of guaiac resin. Its properties, as a diaphoretic and antithermic, are demonstrable in all febrile conditions. As an agent in the treatment of tuberculosis pulmonalis, guaiacol has been lauded to the skies. It certainly acts well in that condition, improving the appetite, lowering the temperature, and, so some competent observers maintain, lessens the extension of the local destructive processes.

A most interesting communication from Dr. M. G. Cain, of Epping, N. H., appeared in the January 15, 1908, issue of The Therapeutic Gazette, in which this writer reports, altogether, a series of fifty cases of pneumonia treated with guaiacol, with a successful issue in every case, and that, too, without selection of the cases. His method was the slow dropping of twenty drops of guaiacol anywhere upon the skin of the patient, after washing the area with soap and water, or ether. The dropping was not repeated in less than twelve hours. The agent acted promptly, producing free perspiration within an hour, improvement in the pulse, temperature, and color of the skin. Within six hours the temperature dropped from two to four degrees, and the general symptoms are much improved. In some mild cases, it was not necessary to repeat the treatment, the temperature not rising again above normal. The average number of treatments was between three and four.

We are able to confirm these observations, in a measure, as representing true and definite results obtainable by the use of this agent in the treatment of croupous pneumonia. There certainly seems to be something rational in this treatment, and it deserves more attention than it has received at the hands of the profession. We urge the profession to give it a trial, and not be content to remain practically nihilistic, as regards medicaments in the treatment of pneumonia. Most physicians are content to employ heart stimulants and hydrotherapy in coping with this disease. The average mortality, under this nihilistic method, is high. The report of Cainfifty cases without a death-does not appear to be a therapeutic accident. It means a definite result; and, undoubtedly, the success which has attended the use of guaiacol in the treatment of pulmonary tuberculosis warrants its employment as a therapeutic agent in other infectious diseases, particularly in croupous pneumonia. We will wait with interest reports of other clinicians, giving an account of their experiences with guaiacol in pneumonia.

COMMERCIALIZING SCIENTIFIC INSTITUTIONS.

A circular and personal letter has recently been issued by the Memorial Institute for Infectious Diseases, of Chicago, Ill., addressed to the medical profession, calling attention to the fact that the scale of prices for diphtheria antitoxin has been too high, and that this institute is able to furnish reliable serum at a much lower rate than is charged by the commercial houses engaged in the manufacture of these products. It, therefore, requests the profession to purchase serum made by the institute which is furnished at a lower rate, in fact, at a rate "designed to cover the actual expense of production and distribution, together with provision for the progressive scientific work essential to maintaining the uniformity and potency of the product." Further, the circular states, "it is not the intention of the institute in any way to utilize its endowment for entering into competition with the commercial manufacturers of diphtheria antitoxin, but rather to determine the actual cost of production under carefully-controlled conditions, and to dispose of its limited output on this basis."

With all due respect to the institute and its staff, we are rather averse to the idea of this specifically-endowed institution entering the field of antitoxin manufacture and sale. If there were the slightest doubt in the minds of any one that the commercial houses of the United States which are engaged in the manufacture of this article, were not conducting this production under the most competent direction, and with every known appliance and facility, we would unqualifiedly put our stamp of disapproval on the products issued by these houses, refuse to use them, and suggest that this serum manufacture be conducted by governmental- or privately-endowed institutions for scientific research. Knowing, as we do, however, the high character of the experts who direct the manufacture of antitoxic sera in these commercial houses, knowing the fact that no expense has been spared by these houses in really developing the science of serum production and therapeusis, knowing the remarkably successful clinical experiences of the practitioners of America with these products, and, finally, knowing that every step of the process has for some time been under the eagle eyes of the official inspectors of the United States Public Health and Marine Hospital Service, who, in turn, examine and test all the products made by serum houses, we feel that the manufacture of these delicate goods is in safe and sane hands, that but a reasonable profit is made by these houses on these goods; that, in fact, they deserve even more than this profit by reason of their pioneer work in developing scientific research along most practical lines in short, we regard this gratuitous attempt to enter this field in this manner on the part of the Memorial Institute of Chicago as

presumptuous and uncalled for, and that a very poor argument has been advanced before the profession by the institute to secure their support.

Again, it might be added that governmental, State, municipal or institutional paternalism, if this expression may be pardoned, in regard to the manufacture of antitoxic sera, should be vigorously opposed, for the reason that the process of manufacture and preparation of these goods requires the most exact technique and care; that the commercial houses engaged in the manufacture of diphtheria antitoxin have already proved that they can make these products right, and that they are willing to stand the moral and financial responsibility for the mistakes of their employes. Who can say that the Government, State, city, or privately-endowed institute is either willing to stand this responsibility or can be legally punished for carelessness or ignorance. In proof of which, we need only allude to the example of the ignorant, incompetent or careless methods which characterized the mode of manufacture of diphtheria antitoxin by the municipality of St. Louis, Mo., a few years ago, when, after months of much carelessness in manufacture of this sensitive product, the inevitable finally happened the serum became contaminated with tetanus toxin, resulting in the death of some dozen or so children upon whom this supposedly carefully-made product had been used for the treatment of diphtheria. This accident gave a black eye to serum medication for some time, until the commercial houses successfully demonstrated that such accidents are due to carelessness, and are absolutely avoidable. Yet was there any redress against the municipality of St. Louis, Mo., or its erring servants, either upon criminal or civil grounds? Ask the bereaved parents, who have tried in vain to enter criminal and civil action against the Mayor and Board of Health of the city of St. Louis. For the protection of the public, therefore, this business should remain in the hands of those who are responsible, and who have already demonstrated their earnestness and sincerity of purpose in manufacturing scientific products.

We do not wish to be understood as holding a brief for the commercial houses, but we present this case on its merits, believing that this business should continue to be conducted as it has been in the past, both in the interest of the public and the profession of medicine. This circularizing of the profession by the Memorial Institute for Infectious Diseases, of Chicago, is, we repeat, misguided, presumptuous and uncalled for. Notwithstanding their distinct statement to the contrary, this institute is also commercializing itself in this movement, and deserves censure on this point. As we understand its avowed purpose, the institute was specifically endowed for scientific research. Let its staff devote themselves to this end, to the glory and honor of medicine.