Naphthalinum

Volume IV — Appendix

NAPHTHALINUM.

A ciyrtalline sutxtance prepared fivm tar, Cjo Hg.

II. Pohmings.-—!, a. The peculiar effect of N., even of the purest specimen, upon the urinary secretion has been noted repeatedly by various physicians. Dr. Pick, of Coblentz, calls special attention to this objectionable feature in the Dtutseht Med. Wech.^ No. 10, 1885, as expressed by a frequent and inordinate desire to urinate, and violent burning sensations in the urethra after micturition. In a 2^ years' child, suffering from chronic intestinal catarrh, five daily doses of 0*25 erm. were administered. After the twelfth dose the catarrh itself was improved, but the following untoward symptoms appeared all at once : Violent desire to urinate, reddening and tumefaction of the external urethral orifice, and oedema of the prepuce. As soon as the N. was discontinued these unpleasant after-efiects of the drugceased instantly.

b. Dr. Pauli, of Liibeck, reports in the Berl. Kl. IVochtnschrifiy No. 10, 1885, similar evidences of untoward symptoms caused by this drug. He treated five children, all affected with chronic intestinal catarrh, with N. (o.i to 0*3 grm. every 3 h.), and found the drug, though very elective if persisted in against the disease, still to produce what he regarded as a constitutional intoxication. The face assumes a pale-yellowish hue ; the children either grow restless or lie quietly as if stupefied by a narcotic. {Thtrap. Gaztttty Oct. 15th, 1885.)

III. Experiments on animals.— i. Experiments with N. on rabbits showed that, when fed with it, the fundus of the eye was either thickly studded with numerous small brilliant points — compared to the appearance of the sky at night— -or there appeared a large white spot usually at lower part of pupi^ which increased in size and concealed the vessels cS the choroid. Similar spots appeared later in other parts of the fundus.

On the optic papilla there appeared brilliant points which increased in size, so that at length the whole papillary depression appeared to be filled with them. In the vitreous humour only occasionally some small floating crystals could be seen, The crystalline lens became dim, beginning at its posterior aspect and from the border. Shining and shady spots are alternately seen with the ophthalmoscope, The dimness grows apace, so that alter 2 d, the whole posterior surface of the lens is diffusely ‘opaque. Besides this there radiate from the border opaquestri. The author supposes this dimness to be caused by exudation between the lens and its capsule, and between the fibres of the peripheric parts of the ens, All the animals died of parenchymatous nephritis. If the Naphthalin was given. in large doses of 2 to 3 grms., the symptoms occurred in a violent manner, and sometimes detachment of retina ensued, but in smaller doses the process might goon for several months. (Macnus, Berlin, KL, Wochensch 1887, 834.)

1. Dor experimented on rabbits and guinea-pigs. After 3 to 5 d. there appeared in the retina of the rabbits small white spots the size of a pin’s head, and in one perceptible dimming in the periphery of the lens of both eyes. (A similar dimness appeared in the lens of one of the guinea pigs—but it went no further.) ‘The round chalk-white retinal spots increased in number and size, and so did the opacity of the lens, so that on the 11th d, it was impossible to see into the ocular fundus, After 33 d. a rabbit died. There was found uid in pericardium and pleura, Heart and lungs were studded with spots similar to those observed in the retina for x to 3 mm, in diameter. Similar appearances were found in pleura, liver, kidneys, and convex surface of brain, These little lumps consisted entirely of agglomerated Teucocytes mixed with small crystals. (K/. Monatsbl. f. dugenheilh., 1887, 246.)

2. Panas experimented on rabbits. Crystallised Naphthalin was powdered and made into a paste with glycerine, and of this a 3 grm. dose was given daily by the mouth, Signs of malnutrition of the whole body rapidly appeared together with excretion by urine of crystals of carb. or sulph. oflime, A little later, and before the appearance of cataract, sparkling points appeared in the vitreous, and soon afterwards a number of strongly reflecting spots and plaques in retina, ‘These were shown by microscope to be octahedric and acicular crystals of oxalate or sulphate of lime and spheroidal masses of carb. of ‘The papilla became cedematous and swollen. Then, later, opacities appeared in lens, at first fine radiating strize between nucleus and cortex, more marked in posterior layer, and passing rapidly on to opacity of entire lens which remained soft and enlarged, pushing forward the iris, and of a yellowish or brownish tint. Dissection was made at different stages. ‘The retina showed first localised points or patches of cedema, associated with a slight detachment of the hyaloid and an exudation between the two; then serous infiltration of the retina and separa~ tion from the hexagonal epithelium, and sulph. of lime in its layers. Later the hyaloid became completely detached from the retina, the two being separated by an albuminous uid. Later still the completely detached. retina, freely infiltrated with calcareous granules, became

niscd, and the choroid atrophied as in dislocatice choroidoletinitis. The papilla showed oedema, then inflammatory proliferation

Ra free passage of leucocytes into vitreous. The lens showed an accumulation of transparent fluid at the posterior pole, and the alion of vacuoles separating the fibres of the peri. nuclear zone ; later stage the fluid appeared to penetrate into the nucleus Itself, the fibres being disorganised, the capsular epithelium disturbed, the entire lens swollen, its anterior portion stained with irispigment, finally, crystals of sulph. of lime were to be found in its substance, and in some cases the posterior capsule was ruptured. The vitreous becomes detached from the retina first at its posterior pole.

t^stals of sulph. of lime surrounded by leucocytes weie found in the ernal layers, these increase in quantityand the whole vitreous becomes re fluid, especially at its centre. The aqueous humour contains albumen from the first appearance of the cataract, and the albumen increases in quantity with the increasing opacity of the lens. Precipitated albumen was found in aqueous chambers. Iris and ciliary processes remain normal. {Archives cTOphtaimalogii, 1887, 113.*)