tion, leads me to infer that in carbolic acid properly used and prepared we have an antiseptic whose use will lead up to some remarkable results in infected conditions. My habit in the main has been to use it in 1 to 300 solutions in nearly all of my infected cases where a moist dressing was demanded, and in many infected wounds that have been sent to the hospital for cure and treatment, even where the infection was deep seated, and the tissues badly torn and lacerated, I have found, after a proper cleansing and scrubbing of the parts, very satisfactory results to follow carbolized dressing. Many have condemned the use of this drug on account of its so-called toxic properties when applied in sufficient strength to destroy the microorganisms found in the infected area, but since Seneca D. Powell, of New York City, has given to the medical fraternity his discovery of the antidote for carbolic acid, it seems that we must have the antiseptic par excellence. In 1894 Powell wrote that he was convinced that he could control the action of carbolic acid under all circumstances, and that he was then using it in its full strength of 95 per cent., and under the influence of alcohol as an antidote he was able to control or modify its action according to the exigencies of the case.

Dr. A. N. Phelps of New York seems to have taken up the suggestion as given by Powell and given this drug and its antidote wide range in his practice, extolling its virtue most highly. For those who care to farther inform themselves regarding cases treated by Dr. Powell through the use of carbolic acid in its different strengths and for its varied uses, I would refer them to an article by Powell in the American Journal of Surgery and Gynecology, April, 1902, No. 9. One point in that article which I wish to emphasize and bring before the society, is, that alcohol is an antidote for carbolic acid when taken internally. Powell quotes a number of cases where the acid was taken in fatal doses and its effect overcome through the use of alcohol in practically the same amount as the carbolic acid taken. I have had experience in but one case of this kind. A woman took probably one or two ounces of 95 per cent. carbolic acid, with suicidal intent. Through the use of the telephone I was notified to see her and advised the immediate use of three ounces of alcohol. Upon arriving at the house, probably 20 to 25 minutes later, I found the woman in a fairly comfortable condition, yet the lips, mouth and fauces were whitened from contact with the acid. I immediately applied the

stomach tube, washed out the stomach thoroughly, after which she was advised to drink at short intervals strong albumen water. The woman made an uninterrupted recovery, barring a very mild attack of gastritis. In view of the fact that carbolic acid is being taken so frequently for suicidal purposes it seems that much honor should be given Dr. Powell for this discovery.

I wish to cite a few examples of its results in my practice. In so-called palmar abscesses I have obtained of late some most excellent results. Those of us who have had to deal with infection in this locality must recognize how unsatisfactory the treatment, and in many cases the conspicuous sequelae that follows. In the early stage of this trouble, I have of late made fairly free openings, washed out the infected area with sterile salt solution, after which I injected the parts with 95 per cent. carbolic, following almost immediately with an injection of 95 per cent. alcohol, and since using this method of treatment my results have been more satisfactory. I find that the patient suffers less, the abscess is usually limited and the time of recovery shortened, very little deformity remaining. In the cases of joint abscesses where this mode of treatment has been employed, I have been very much satisfied with the results. In late appendix cases where the parts are in a necrotic condition and sloughing, I have found after the removal of the appendix, and cleansing the parts with dry sterile sponges, that the application of 95 per cent. carbolic acid applied by the use of a cotton swab and followed up immediately with the application of 95 per cent. alcohol has given me very satisfactory results. In cases of pelvic abscesses which are opened through the vagina and where discharging sinuses remain, I inject a 50 per cent. carbolic solution followed immediately by an injection of 95 per cent. alcohol, and here again the results are most marked and remarkable, the sinus practically closing up in a week and no indication of infection remaining.

Since the action of 95 per cent. carbolic acid can be so thoroughly controlled by 95 per cent. alcohol I find in its use a very great advance made in the treatment of deep infection where the mechanical treatment cannot be applied.

DISCUSSION.

DR. ROGERS-I think we all endorse what Dr. McNaught has said. There is one question I should like to ask him, and that is the strength at which he uses the carbolic acid.

DR. MCNAUGHT-I to 300.

DR. ROGERS-A very weak solution. I endorse all Dr. McNaught has said.

DR. STOVER-I would like to ask if Dr. McNaught has noticed the action of continuously appplied weak solutions of carbolic acid in producing necrosis, of which I have seen some reports.

The

DR. MCNAUGHT-The weaker solution I have not. stronger solution I have seen some necrosis of the skin following it. But the continuous use of the 1 to 300 solution I have found very satisfactory, and very rarely any necrosis of the skin or of the parts.

SOME OBSERVATIONS ON SALOQUININE.

By EDWARD C. HILL, M.S., M.D.,

Professor of Chemistry in the Denver-Gross Medical College and in the Colorado College of Dental Surgery, University of Denver.

The conjoint administration of quinine and salicylic acid is very often indicated in disorders characterized by vasomotor ataxia and rheumatic manifestations. As ordinarily administered, both quinine and salicylic acid commonly induce disagreeable cerebral symptoms (headache, vertigo, tinnitus aurium), and the acid is an irritant to the stomach. Both drugs have a decidedly disagreeable taste, which can hardly be concealed in liquid. media, and which persists in the mouth even when they have been taken in capsules.

A preparation that combines the generally admitted therapeutic effects of quinine and salicylic acid, and is at the same time devoid of their unpleasant by-effects, is a desideratum of quite recent fulfillment, namely, the synthetic product salo-quinine, which is, chemically speaking, the salicylic acid ester of quinine, having the formula CH..OH.CO.O.CHNO. It appears in

white crystals, that are quite insoluble in water, difficultly soluble in ether or cold alcohol, but readily dissolved by chloroform or warm alcohol. Because of its insolubility in the saliva, the drug is quite tasteless, and, for a like reason, it is only gradually ab

sorbed, which accounts probably for the absence of unpleasant and toxic effects after its administration. Thirty grains of the powder, taken at one dose by the writer, in a state of health, had no appreciable physiologic action other than a slight rise in blood pressure; the special senses were in no wise affected; the ferric chlorid reaction for salicyluric acid, and the thalleioquin test for quinine, could not be obtained with the urine for several hours. The combination of salicyl with quinine in saloquinine renders the latter naturally more strongly germicidal than quinine alone. As a febrifuge it contrasts favorably with the great majority of coal-tar antipyretics in being tonic rather than depressant in its action on innervation, circulation and hematopoiesis. The relative euphoria manifested by febrile subjects to whom saloquinine has been given, is attested by M. Overlach, Franz Tauszk and others, and is probably due as much to increased vasomotor tonicity as to the antiseptic-antipyretic action of the remedy.

The average dose of saloquinine is two to four grams (30-60 grains) daily for an adult; children in proportion. It can be administered in powders, cachets or capsules. The last mentioned mode is most agreeable to the patient.

The therapeutic indications for saloquinine embrace all the well known uses of its two components, quinine and salicylic acid, of the former of which it is the legitimate succedaneum. It should be of particular service in malaria, neuralgias, influenza and other specific infectious diseases, acute catarrhal conditions and para-rheumatic affections.

Tauszk has employed saloquinine successfully against the lancinating pains of locomotor ataxia. He states that during its use the course of tonsillitis seemed to be shortened, and claims that in his experience it always allayed the pains of chronic rheumatism. The same writer remarks that, if administered two hours before the onset of the fever in pulmonary tuberculosis, saloquinine had some slight beneficial effect. When utilized for the cure of periodic malarial neuralgia, it should be given three or four hours before the expected attack.

Overlach has employed saloquinine largely as an antipyretic, especially in typhoid fever, giving a dose of 30 grains in the evening shortly before the bath, so that the action of the drug will be "manifested at a time when the effect of the bath, which is not of long duration, is already vanishing." Under the admin

istration of saloquinine, he observed a striking alleviation of the apathy, or "typhoid state."

J. Sternberg has found saloquinine promptly curative in the malarial headaches of anemic women, and for splenic tumors in which quinine alone had been administered without success.

The present writer has had the opportunity of testing saloquinine clinically in a considerable number of cases in which it appeared to be indicated, and has been much pleased with the actual results. Fortunately or unfortunately, malarial affections are rare in the Rocky Mountain region, and therefore the observer was prevented from applying the remedy to this large class of cases in which it would seem particularly applicable. Our changeful climate predisposes to coryza and other forms of "colds," which are well treated in the ordinary manner by a calomel purge, a hot general bath or hot mustard foot bath, hot drinks and quinine. The writer has prescribed for some years capsules containing equal weights of quinine, salicylic acid, phenacetin and sodium bicarbonate. Of late he has employed saloquinine in about a dozen cases of acute catarrhal conditions, and has found it more pleasant and equally as efficient as the former combination. It is well, of course, to institute simple sudorific measures in addition to this remedy, of which a 5-grain capsule may be given every two hours.

Two cases of primary supraorbital neuralgia of sufficient intensity to prevent sleep yielded within a few hours to saloquinine in the dose of 15 grains every two hours. A third case of neuralgia, attended by catarrhal antral disease, was speedily relieved by saloquinine in large doses, and by cleansing the nostrils with a saline-alkaline solution. An attack of double sciatica in a pregnant lithemic subject, quickly subsided after a single dose of 30 grains of saloquinine taken at bed time. Another case of sciatica due to cold was relieved by three 15-grain powders.

As an antipyretic saloquinine should be of special service in the treatment of influenza, because of the happy combination it presents of analgesic and tonic properties. The writer has thus far had only one opportunity of proving the value of this drug in genuine la grippe. The patient, a strong, robust young man, complained of marked general soreness, headache, pharyngitis and great prostration. Though his temperature was a little less than 102 degrees, the pulse while lying was 128. He was put upon saloquinine, 15 grains four times a day, with frequent feedings with oyster broth and other nourishing and easily digested foods. The next day all the pains had vanished and he felt much stronger, with a pulse of 86 and a temperature of 99 3-5 degrees. The following day he was able to attend to some business, and so made. a rapid and easy recovery.

The question of the value of saloquinine in typhoid fever is