Carbolicum acidum

Volume I — Special Symptomatology

(Acidum Caroolicum.)

Pharmacology. — This is an acid obtained from coal-tar, by fractional distillation and subsequent purification.

Carbolic acid, in its pure state, is a solid, at ordinary temperatures crystalizing in minute plates of long rhomboidal needles, white or colorless, of a peculiar odor, similar to creosote, and an acrid burning taste. Its specific gravity is 1.065. If colored brown under the influence of light and air, it is impure. It deliquesces on exposure, and ultimately becomes liquid. It is soluble in 20 parts water, its solution, if pure, colorless and remaining so ; but if impure, colored brownish by exposure. It is very soluble in alcohol, ether, acetic acid, glycerine, and the volatile and fixed oils.

It is neutral to test paper.

Officinal Preparation. — (1) Tincture (one grain to ten drops pure alcohol) ; (2) Triturations of the crystals with coarse sugar of milk.

Analogues. — Arsenicum, Baptisia, Bromide of Potassium, Bromide of Ammonia, Cimicifuga, Creosote, Lachesis, Mercurius corrosivus, et lod., Phosphorus, Nitric acid, Muriatic acid, Rhus tox., Sulphur, etc.

[The symptoms here given are mainly taken from Dr. Hoyne's pathogenesis, given in the Journal of Homeopathic Materia Medica for May, 1872, to which I have added Dr. Mitchell's symptoms and my own observations. (Hale.)]

Mental Sphere.

Entire disinclination to study/ what he had accomplished

seemed trilling. Disinclined to work; even correcting proof is fatiguing. Cross, loses control of temper readily. Affection bestowed seemed distasteful.

Reading increased all the head symptoms, especially the pressing in the occiput, while the intellect was unusually quiet. Dullness of intellect, which passed away after breakfast.

Head.

Forehead — Aching pain in the forehead (transient).

Feels as if a band was around the forehead. Headache in the forehead of a neuralgic character. Burning pain in the forehead.

Dull (or heavy) pain running from the forehead to the occiput.

Feels as if a band was around the forehead.

Felt a dull feeling in the frontal lobe of cerebrum, which

increased to a severe headache. Awoke with a dull, hot, constricted feeling in the head, more

especially in the forehead; followed before rising, by an

acute piercing pain in the left supra-orbital ridge. This

was circumscribed and might have been covered with a

silver ten cent piece. The acute piercing pain lasted only five or ten minutes, and

ceased on my rising, leaving the spot where it had been

sore to the touch for more than one day. Vertex — burning pain in the top of the head. Hard headache in the morning confined to the upper half of

the head.

Sensation as of fine electric sparks in vertex, changing to a pricking itching, with desire to rub the part and relief from it.

In the vertex a feeling as if the brain was swashing about. Temples — Burning pain in the right temple and top of the head. Dull aching pain in both temples and back of the head, when

leaning forward. Occiput — Dull aching pain in back of head, and right side and

temple. Back of head feels sore.

Constant dull, pressure and pain in the occiput and the muscles of the back of the neck, especially just behind the ears. {Mitchell.)

A very great sense of weight on my neck, with a tenderness, even to the touch, on the seventh cervical vertebrw. (A persistent symptom. Dr. F. N. Mitchell?)

Constant vertigo, not relieved by shutting the eyes ; better when walking fast in the open air; much worse when sitting down. {Fb.)

Constant humming, buzzing sound in the ears, with the headache, without dullness of hearing. (Ib.) Sides — Beating pain in right side of head. The pains are the most severe on the right side. Neuralgic pain in left side of head.

Scalp — Itching of scalp, first on right side, then on left. Head feels sore when moving it; sore feeling after the headache.

The dull, hot, constricted feeling which was severe enough to become an ache at times, (relieved by pressing the head with the hands,) lasted all day long and late in the night.

Confused feeling in the head.

Feel as if I had a cold in the head.

Head seemed to swell and felt hot, even as though it radiated

heat as from a hot stove. Hard headache most of the night.

The headache did not locate anywhere in particular, but was as

bad in the forehead as anywhere else. Headache worse when bending the head forwards. The headache continued until I went to sleep at night (all day.) ° Periodical sick-headache, generally just before or after the

menses.

Headache with nausea; better from drinking a cup of green tea.

Pressure at first 2'elieves the pain for a moment, but if continued increases the headache. However, if the pressure was removed, if only for an instant, and then re-applied, it would bring relief for a moment.

The head pains are the most severe and worse on the right side.

Feels very dizzy from the slightest motion.

A sensation, when stooping, of a coldness in one spot, followed by a clammy sweat on the head.

Eyes.

Very severe orbital neuralgia, worse over right eye. Burning pain in the eyes, worse in the left. ° Pupils contracted.

Things look as if they were moving backwards and forwards. Cannot see across the room.

While writing, the letters seem to run together, so that it is

with difficulty I can read what is written. Eyes sensitive to light. A constant dark spot in front of left eye.

Ears.

Beating pain, with a humming sound in both ears. Constant humming, buzzing sound in the ears.

Nose.

Both nostrils plugged up. Dryness of posterior nares.

When blowing the nose the mucus was bloody — bright red blood.

Feeling of expansion in the nasal passages. Smell decidedly more acute.

Watery discharge from both nostrils while in the open air; ceasing when in doors — returning when entering a cold room.

Sensation at left wing of nose as of fine electric sparks; wants

to rub the part repeatedly. ° (Ezena, even malignant, with great foetor, and ulceration.

{Hale.)

Face.

Sharp pain about the centre of the cheek, as if bitten by a

mosquito. Face flushed and burns.

Slight heat of face and forehead, especially the left side. c Face blanched and bathed in perspiration. Drawing pain in the jaw, right side.

Mouth.

Nasty taste in the mouth.

Swelling and soreness, internal side of left cheek, opposite the molars; the cheek is in the way of the teeth when biting. ° Interior of the mouth very white. 0 Slight lividity of the lips and tips of the fingers. ° Tongue dry and chippy.

Aching of teeth of right upper jaw; grinding of the teeth.

0 Toothache from caries, or from a cold.

3 Thrush in children and consumptives (a weak wash).

Throat.

Throat sore; felt slightly hoarse, as if taking cold.

Throat sore only when swallowing, and pressing upon the

upper part of the larynx; worse on the right side. Soreness worse on the right side. Soreness of the throat on empty deglutition. Sharp stitches in the throat.

The pain in the throat comes on every few moments; the pain

is sharp and pricking. Pricking burning in the throat, as if she had eaten something

strong. Much mucus in pharynx. Dryness of pharynx and posterior nares. Hawking of clear white mucus while in the open air. Hawking from pharynx and posterior nares of much white

mucus.

0 Spasmodic contraction of the oesophagus. Slight nausea in the throat.

Mucous membrane of the oesophagus dry and shrunken and

of a brownish color. 0 Ulceration of the throat, tonsils, palate, etc.

Gastric Symptoms. Constant belching up of large quantities of wind. Sensation as if the stomach was filled with wind, which ought

to come up.

"Wind in the stomach very troublesome; better after raising a

sort of sweetish-sour liquid. Nausea in the stomach. Slight nausea in the throat.

• Nausea nearly all the morning.

After tea the nausea was better, but she was very drowsy. After tea the nausea returned, and was increased by taking a

little sherry wine. Regurgitation from the stomach which tastes like buttermilk

and cabbage.

In the afternoon, after dinner long continued hiccough Dull aching, uneasy feeling in the stomach. Burning pain in the stomach.

° Chronic vomiting of sarcinae.

0 Chronic vomiting of every meal.

0 Yomiting in pregnancy.

0 Inflammation of the stomach and duodenum.

Abdomen. Aching pain in lower part of abdomen. Burning pain in lower part of abdomen and top of the head. Rumbling and rolling in the abdomen, with a sense of distension.

Rumbling in the bowels; a feeling as if diarrhoea would come

on, after walking about. "While sitting, a crampy stitch in left inguinal region. Abdominal muscles feel sore. Constant sensation of distension in the abdomen.

Anus and Stool. The anus itches and feels as if the skin was rubbed off. Bowels seem torpid but not costive.

Desire for a stool all day, although I had had a natural movement in the morning.

Two natural stools per day, which is unusual, having generally but one passage in two days.

° Diarrhoea from bad drainage.

° Cholera infantum, with putrid, rice-water discharges, like foul eggs.

Urinary Organs.

Passed an unusual quantity of saccharine urine. Urine increased, and had a strong smell. Passed urine oftener than usual during the night. Unusually free flow of urine — normal in color, odor and quantity.

The urine was voided about once in two hours, and was large

in quantity — quality normal. c Greenish urine, after scarlet fever.

Genital Organs. Lascivious dreams, with emissions, followed by weakness and

dejection.

Male — Sexual appetite very much decreased. Awakened by unusual strong sexual excitement.

15?

Itching of scrotum and inside of thighs, relieved by scratching, but it soon returns. Intense burning itching of the genitals.

Female — Menses came on two days later than usual, and were more profuse.

Menses much more profuse, and darker color than usual, followed by headache and great nervous irritability for twelve hours.

• Mucous tubercles on the labia and inside of the thighs, with

discharge from the vagina. ° Puerperal fever, with putrid symptoms. ° Ulceration of the cervix uteri; obstinate. {Hale.)

Larynx.

• Short hacking cough, with tickling in the throat. Constant inclination to cough.

Left side of larynx very sore when pressed upon — not true of

the right side, Irritation of the throat, causing a short, dry cough. Expectoration of a large quantity of thick whitish mucus. ° Catarrhal laryngitis. 0 Large granulations in the throat. Coughed to clear the bronchi ; expectorated a little. ° Catarrhal croup.

c Chronic laryngitis, threatening phthisis laryngea. (Hale.)

Chest.

Stitches in region of the heart. Slight uneasy pains in right lung.

Dull aching pain whole left side of chest and abdomen, running around to the shoulder-blades.

While walking out of doors, feeling of expansion (of lightness) in the lungs; also in the nasal passages.

Sensation as of fine electric sparks on the sternal end of right clavicle; later on middle finger of left hand; later on vertex, changing slowly to a pricking itching, with desire to rub the part, and relief from it.

Respiration free and deep; inclination to take a deep breath.

Respiration stertorous, and smelling strongly of the fluid.

Back.

Aching pain across the small of the back and in the lower limbs. General soreness; worse in back, abdomen, chest and muscles of neck.

Neck feels lame and stiff, when moving the head. Drawing in muscles of neck (right side) — think in splenitis capitis.

Soreness of the seventh cervical vertebrse.

While walking rapidly, after dinner, had spasm of the left

common carotid artery. Spasm of the left external carotid artery.

Upper Extremities. Drawing pain in the left arm, from the shoulder to the elbow. Constant tired, heavy feeling in left arm. Lameness and soreness of right shoulder while walking. Aching pain in right shoulder when bending forward. Numbness of the skin of the hands.

Peculiar feeling of stiffness and discomfort (puckering) of the

entire hand, which remained until night. Sensation as of fine electric sparks on middle finger of left

hand.

Appearance of a small pimple on middle finger of left hand, which increased in size until it became a sore resembling a carbuncle. The flesh suppurated until a probe could be passed nearly through the finger. (From the direct application of the acid.)

° Lividity of the tips of the fingers.

Lower Extremities.

Occasional pains in hips and shoulders.

Dull pain in right hip, ankle and left knee, most of the morning. ^

The pain in the hip has gone to the left shoulder.

Very severe aching pain in right hip joint, felt only while

walking, not when sitting still. Tingling in the left great toe, followed by a feeling as if

pressed on.

Sensation, just below the knee on the shin, as if it was touched with a piece of ice.

Fever.

0 Miasmatic fever.

° Typhoid or enteric fever, in the stage of ulceration ° Scarlatina maligna, with putrid sore throat, etc. ° Pulse quick, feeble, intermittent, small, slow (60 to 100). Chilly sensations; pulse 78.

Sleep.

Incessant yawning; feel languid and sleepy.

Slept heavy; awoke sore all over, especially legs (gluteal

muscles), back, chest and arms. Wakes often during the night.

Woke up in the middle of the night and found that he was bathed in perspiration.

Wakes frightened; paralyzed with fear.

Awakened by unusual strong sexual excitement.

Awoke with a dull, hot, constricted feeling in the head.

Passed urine oftener than usual during the night.

Dreams of fire; so vivid was the dream that he was awakened.

Had a great many dreams, some amorous, others I was unable to recall.

Dreamed that she could not get to sleep on account of thinking about the body I had enbalmed; thought she tossed about and then tried to wake me, to give her some medicine to stop thinking; she thought she could not wake me, and pulled me out of bed ; and that I was bathed in perspiration, pale face; thought I was dead. She could not at first be persuaded that she had been asleep. Gave her a dose of Nux and she dropped to sleep at once, and slept soundly.

Skin.

Itching of the skin of various parts of the body; scalp, back of neck, left shoulder, left elbow, arms, right forefinger, buttocks, right thigh, outside of thigh, inner side of left knee, shin, calf of leg, ankles, face, nose, right cheek, abdomen, scrotum, genital organs.

Slight eruption of a vesicular character all over the body.

Vesicular eruption on the hands and all over the body, which 1 itches excessively; better after rubbing, but leaves a burn

ing pain. Neither Arsenicum, Rhus, or Sulphur had any influence over it. Disappeared after eighteen days without treatment. * Pustular eruption.

*Acne; eczema; impetigo; scabies; psoriasis inveterata.

c Confluent variola, the pocks began to dry up on the eighth day, tongue clears off, no secondary fever / the pocks were dry all over the body on the twelfth day. {Dr. Middleton, Hahnemannian Monthly, April, 1872.)

° Indolent or irritable ulcers, with unhealthy granulations, and foetid pus, (externally).

° Leprosy; prurigo; pityriasis; lupus; carbuncles.

° Pediculi, and vermin of all kinds on the body.

General Symptoms.

Complains of being very tired.

Cannot walk straight.

The pains seem to affect the right side first, and afterwards

the same parts of the left. Itching of various parts of the body. Feels as if he had taken a violent cold. General soreness, worse in back, abdomen and chest Soreness as if I had taken much cold — think I have not. ° Body much swollen a short time before death. All the muscles prominently used are sore and stiff. ° Cancerous affections.

Volume II — Special Therapeutics

This powerful agent, introduced into medicine as a disinfectant is worthy a high rank as an internal remedy. The provings instituted by Drs. Hoyne and Mitchell develop the fact that its true analogues are Arsenicum, Baptisia, the Bromides, Cimicifuga, Creasote, Lachesis, Belladonna, Solanum, Sulphur, etc. Many of its symptoms remind us of the acro-narcotics ; others of the corrosive poisons.

It is feared that it will meet the fate that Arnica meets at the

hands of the majority of our school. Hahnemann had a high opinion of Arnica as an internal remedy, and he gave us an excellent pathogenesis, but somehow the idea takes possession of the average homoeopath ist, that it is to be used solely as an external application, or if given internally at all, only in case of injuries. The fact is that Arnica is nearly as valuable as Bryonia or Nux vomica in a variety of internal diseases.

So with Carbolic acid. It will prove far more useful as an internal remedy than it ever has as a topical application. As a disinfectant even it has lately been deposed from the high rank once assigned to it.

My present estimate of Carbolic acid is, that its sphere of action is the cerebrospinal centres, and that the disorders of the mucous surfaces, of the blood and secretions, of digestion, etc., are but the consequences of this primary action on the central nervous system. Its pathological action, when applied locally to any tissue, is that of a caustic, disorganizing the surfaces when it is applied in a peculiar manner. It causes an ulceration and sloughing, with tendency to putrescence. It is in this class of local lesions that its use, in very dilute solutions, will cure by its homoeopathic relations.

It has been supposed by some that this acid cures diseases, external and internal, by its power of destroying certain germs which permeate the blood and secretions.

It is true that this substance destroys the life of animal and vegetable growths, such as infusoria, bacteria, vibriones, microscopic fungi, etc., quicker than any known substance, unless it be the Sulphite of soda. But this does not prove that it cures or can cure all diseases where these organisms abound in the fluids and solids.

In a majority of diseases these organisms are a result and not a cause of disease.

Just in proportion as the nervous life of the body becomes weakened, comes the tendency to deterioration of the solids and fluids, and finally the presence in them of animal and vegetable organisms.

Now, it is my belief that Carbolic acid has the same effect on

the human as on the lowest organisms, namely, the destruction of the vitality of the nerve-centres.

We will now take up the most characteristic symptoms of the drug, and compare them with the cures made with it, and see if the above speculations are borne out :

The head symptoms are quite prominent, thus :

“ Feels as if a band was around the forehead.” (Bell.)

“ Dull pain, running from forehead to .occiput.”

“ Burning in top of the head.” (Sulph.)

“ Constant dull pressure and pain in the occiput and muscles of the back of the neck, especially just behind the ears.”

“ A very great sense of weight on the neck, with a tenderness, even to the touch, on the seventh cervical vertebrae.”

“Constant vertigo, not relieved by shutting the eyes; better when walking fast in the open air; much worse when sitting down.”

“ Constant humming, buzzing noise in the ears, with the headache, but without dulness of hearing.”

“ A full, dull, but constricted feeling in the head.”"

All the symptoms closely resemble the headache and abnormal sensations from cerebro-spinal irritation , and resemble the symptoms of Silica, Gelseminum, Calabar, Cannabis indica, and other irritants of the cerebro-spinal centres.

It has been used successfully, by myself and a few others, in the headaches following meningitis, and “ spotted fever ;” or the head symptoms occurring after sunstroke ; for sick-headache, periodical, generally just before or after the menses.

The eye-symptoms are notable — they point to failing vitality of the optic nerve. I would call the attention of our oculists to these symptoms.

In fetid, purulent discharges from the nose, from any cause, its topical application, not too strong, will be attended by the best results (10 grains of the crystals to a pint of water). It may be injected with a sponge, or thrown up by an atomizer, or simply snuffed up. If it is done thoroughly, two or three times a day, the unhealthy nature of the discharge will soon disappear. In cases of ulceration it may have to be aided by Aurum, Silica, or Mercurius.

If the infusorial origin of hay fever, “ catarrhus cestivus,” is

proven, or even if it is caused by the pollen of plants, the injection of a dilute solution ought to cure that disorder. Helmholtz says Quinine cures it, and Carbolic acid has the same action, only more rapid, on such organisms.

In aphthous conditions of the mouth and fauces, if the odor is very offensive or cadaverous Carbolic acid washes are useful; if not , the Sulphite of soda or Borax are better.

In diphtheria, with fetor, the same observation will apply, but if fetor is not decided, I prefer Phytolacca or Guaiacum. In ulceration of the throat, syphilitic or not, the acid may be used as a gargle.

It is said to have cured “ spasmodic stricture of the oesophagus,” but the authority is not known to me.

In caries of the teeth, a plug of cotton, moistened with the officinal solution, and crowded into the cavity, destroys the sensitiveness of the dentine and abolishes the fetor.

As might be expected it has cured vomiting of sarcince, but Sodae sulphite is just as effectual and much more safe; for, in order to be effectual, enough must be given to destroy the fungi, and prevent their propagation.

One of the most persistent of the symptoms in all the provings, was morning nausea and vomiting, and it has been very successful in the practice of both schools, in the treatment of the morning nausea of pregnancy. It cures vomiting of ingesta during pregnancy, and in children.

You may find it very useful in some of the many forms of dyspepsia, and flatulence.

Dr. Hoyne considers it indicated in attacks of “ diarrhoea from bad drainage.” It may be useful in diarrhoea from drinking impure water. I have found it very efficacious in cholera infantum, attended with great prostration, hot head, fetor of the breath and all the excretions; the discharges from the bowels were putrid and like rice-water, or like the odor of spoiled eggs. In true cholera infantum, when the head is implicated, and the disease runs a rapid, malignant course, I have had the best success with Camphor, Bromide of soda, and Carbolic acid. I now rarely use Arsenicum, Veratrum, or other of the routine remedies usually recommended.

All the provers had increased urine. It is known to be diuretic, as is Creasote. I predict it will be useful in some of the varieties of Bright’s diseases, and possibly in diabetes.

It is a favorite remedy in 'pruritus of the organs of generation, and of the perinteum and anus. Pruritus is often caused by ulceration of the os uteri, chronic vaginitis, aphthous conditions of the vagina and vulva. When these conditions are present, a weak solution should be used as an enema, and the same wash applied topically. One of its pathogenetic symptoms is, “ itching of the scrotum and inside of the thighs ; intense burning itching of the genitals.”

As an application in ulceration, or granulation, of the os uteri, it is equal to Chromic acid.

Carbolic acid is, par excellence, the remedy for the unhealthy discharges from the uterus and vagina following miscarriage and natural labor. In the best-managed cases some small portions of membrane or scraps of placenta will remain and give rise to fetid discharges. I am in the habit of ordering the nurse to use enemas of Carbolic acid, of the strength of ten grains to a quart of water, twice a day, so soon as fetor shows itself. I believe by its use we may prevent the occurrence of pyeemic poisoning, or phlebitis, in the majority of cases. It may be alternated with Sulphite of soda.

In uterine cancer, its use is indispensable, either alone or alternated with the Sulphite of soda, or Bromo-chloralum. I may as well state in this place, as in any other, that the pretensions claimed for Carbolic acid, as a curative agent (when internally administered, in the attenuations), in the treatment of cancer, are without foundation. These claims were trumpeted forth by a once notorious surgeon belonging to our school of practice. The idea that infinitesimal quantities of this acid will exert any destructive action on the cancer-cells or germs in the blood or tissues of the body, is absurd in the extreme. I have carefully watched the progress and termination of the cases of alleged cures, and assert that in no single instance can I learn that the disease has been eradicated.

The cough and laryngeal symptoms are important. It causes “short hacking cough, with tickling in the throat. The cough is constant, irritating, and generally dry, or may end in expectoration of thick white mucus.” This resembles the cough of Rumex, but without the excoriation in the chest. It is an excellent palliative in this kind of cough, when occurring in chronic laryngitis , bronchitis and consumption. It may also act as a curative agent in these diseases in the early stages, if it is administered in a proper manner.

It should be prescribed internally, in the 3X or 6X, and used in a spray or steam atomizer, in about the same strength. It has one symptom similar to Lachesis, Hepar, and Stillingia, namely :

“ Left side of larynx very sore when pressed upon — not the right side.”

It is a favorite remedy with many of our school in whoopingcough. Some prefer it in the middle attenuations, others in the lowest, and a few claim brilliant results for its use when inhaled from an atomizer. If the infusorial cause of this disorder be true it ought to be the specific.

It is said to be of great value in malignant scarlatina, even when coma is present.

Dr. Middleton* reports several cases of confluent variola treated with Carbolic acid. He says: “The pocks began to dry up on the eighth day, tongue cleaned off, no secondary fever ; the pocks were dry all over the body on the twelfth day.” Dose: a few drops of the 2X ever two hours.

It is an excellent plan to put a small quantity of the acid into the water with which patients sick with malignant fevers, etc., are bathed. It is enough if the water has a faint odor of the acid.

In diseases of the shin it has been found curative, when given internally and applied externally in the form of a lotion or unguent.

It caused, in the provers, “ itching of the skin all over the body ; vesicular eruptions, itching excessively, better after rubbing, but leaving a burning pain.”

It is said to have cured leprosy, prurigo, pityriasis, lupus, carbuncles, indolent and irritable ulcers, acne, impetigo, scabies, and psoriasis. I have italicized those in which I have used it successfully.

• Hahnemannian Monthly, April, 1872.

Since the pathogenesis in the first volume of this work was printed I have found the following case of poisoning by Carbolic acid. The symptoms of the heart are so important that I quote the case :

“ A man of thirty years, suffering from stricture of the urethra, took by mistake a teaspoonful of a solution of Carbolic acid,” containing, perhaps, twenty-five to thirty centigrams of the acid (two and one-half grains).

He felt a burning in the throat and oesophagus, and took some milk and water and a dose of Castor oil. After ten or fifteen minutes a slight tremor set in over the whole body, steadily increasing, followed by delirium, irritability and rage, with copious perspiration. Ilis breath smelled slightly of the acid. At the attempt to examine his throat he closed his teeth tightly. The beat of the heart as well as the pulse could not be felt. Pupils were normal and reacted to light. The abdomen was bloated, especially in the epigastric region, but neither hard, nor tense, nor sensitive to pressure. He could not take medicine.

After about two hours he became more quiet, the sweating decreased, pulse and beat of the heart could not yet be counted. Instead of the tremors a somnolent state set in, the sweating ceased, the pupils dilated, but showed reaction to light. He swallowed now the most part of a tablespoonful of Magnesia. The pulse was irregular and intermitting, the veins appeared swollen and raised. Three hours after taking the poison the pulse became more regular and stronger, but frequent (120 to the minute), the pupils began to contract, the patient more quiet, answered rationally, and only complained of feeling languid. The pupils were now normal, the pulse full, and 100 to the minute. The oil showed now its action, but the faeces showed no smell of Carbolic acid. Later, he vomited twice a watery, thin fluid, not smelling of the acid. Ho pains in the stomach. He slept good, and when awakened complained only of some burning in the throat; fauces were slightly red, and showed some small gray spots, which soon passed off. The urine showed at first large quantities of albumen, after awhile it was clear, but of a dirty brown color; it never smelled of Carbolic acid. The dark color passed off gradually, but it remained albuminous for four days. Chemical analysis showed the acid in the dark-colored urine.

The most pregnant symptom in this case is the relaxation of the activity of the heart; if death had occurred at the beginning of the stage of the depression, following the primary stage of excitation, the paralysis of the heart would have to be considered as the causa morbis. — Schmidt’s “ Jahrb.” 10, 1874.

Dr. Adams, Professor of Surgery, in Chicago Homoeopathic College, writes of its uses in Surgery :

“ Carbolic acid has been most extensively used, and so far has been rivalled in general utility only by Thymol. We can best illustrate the use of the method by describing, e.g., an amputation. The surface of the part to be operated upon is thoroughly cleaned by sponging or irrigation with an aqueous solution of the acid of the strength of 5 per cent. (1-20). All sponges, instruments, etc., are carefully cleansed in a solution of the same strength.

“ During the operation a weaker solution (1 per cent.), is used for washing sponges, and also in the form of spray, which by means of a suitable atomizer is thrown directly upon the field of operation so as to completely envelop the wound and its surroundings in an antiseptic mist. The amputation made, the vessels are secured by torsion, acupressure, or the carbolized catgut ligature* firmly tied in a square knot and both ends cut short. A drainage-tube is inserted, the edges of the wound brought into apposition by carbolized gut or silk sutures, f and the projecting end of the tube cut off flush with the level of the integument. The external dressing consists, first, of oiled silk, carbolized, known as “protective,”^: its object being to protect the wound from any stimulant effects of the acid in the next application, consisting of eight layers of carbolized gauze,* under the top layer of which a piece of thin rubber cloth is placed to prevent the too rapid washing away of the antiseptic material from the gauze, by the

• Catgut Ligature. — Soak catgut of required thickness in carbolized olive oil, one part acid to five of oil, with a small quantity of water diffused through it to keep the gut supple.

f Sutures. — Silk may he rendered thoroughly aseptic by steeping in a mixture of beeswax 1 0 parts, Carbolic acid one part, the superfluous wax being wiped off the silk as it is drawn from the mass.

J Protective. — Oiled silk, lightly brushed with copal varnish on both sides. After drying again brush with a solution of starch and dextrin, so that it may retain a watery solution of the acid when dipped in it before application.

serous discharge from the womb. The spray is kept up continually from the beginning of the operation until the dressing is completed, and is used at all changes of the dressing until the wound is healed. It will be seen that the method depends for its success upon the principle of allowing nothing to come near the wound except it be first rendered aseptic. The drainage-tube should be of pure rubber, and is essential whenever the wound is of any considerable extent, as a free flow of serum follows the use of the spray. In most cases not more than from two to five dressings will be required, and may be made, in the absence of complications, at intervals of one, two, and three days, respectively. If suppuration occurs in a case under treatment after this plan, carried out in detail, it will be such as is not due to putrefaction, and the pus will be perfectly innocuous. Frequent meddling with wounds is to be avoided. As long as they do well they are better let alone. All materials needed now can be obtained at the surgical instrument stores ready for use, or may be prepared according to the above-mentioned formulae.