Individual experience in 500 cases treated by intubation: there was not a single death from pushing down mem brane before the tube. When this acci dent, which was uncommon, did occur, the obstructing membrane was usually expelled after the withdrawal of the tube. The string is always left attached, and, if passed through a piece of fine rubber tubing, which stands a good deal of chewing, it will avoid being cut by the teeth. Bokal (Jahrbuch fiir Kinderh. und physische Erziehung, June 5, '94).
The results obtained by the use of anti toxin, followed, when necessary, by in tubation, have robbed one of the most deadly diseases of many of its terrors. (See DIPHTHERIA.) Tracheotomy for croup from December, 1886, to February, 1S92, 115 times; re coveries, 39.93 per cent.; 5 cases died during the operation. Bajardi (Archivio Ital. di Bed., July, '92).
Five hundred and seventy-two trache otomies performed in six years for croup; of these cases, 316, or 551/4 per cent., died. Hagedorn (Dent. Zeit. f. Chin, B. 33, 6, '93).
Among the other measures recom mended, turpentine and hydrochlorate of ammonia hold a prominent place, but the measures already outlined are to be pre ferred.
Turpentine in membranous croup is of extreme value. The drug should be administered in drachm-doses, repeated every hour for from four to six doses, then suspended for six or eight hours. The membrane becomes of a muddy yellow color, and is thrown off. If tbis change does not take place, recourse should be had again to the turpentine for three or four doses. S. 1, McCurdy (Columbus Mcd. Jour., Apr., 'DO).
Turpentine internally in large doses recommended. In 13 cases of croup treat ed with drachm-doses of turpentine, there were 8 recoveries. In only one case was any disagreeable effect of the remedy observed, and that was a stran gury of temporary character, after 15 drachms had been given in twenty-four hours, to a boy 4 years of age. Kellogg (Med. and Surg. Reporter, July 9, '92).
Hydrochlorate of ammonia is valuable (1) as a heart-stimulant, (2) in relieving the spasm and cedema of the glottis, and (3) in softening the membrane. Hub bard (Med. Rec., Apr. 11, '91).
The following formula, suggested by Joseph Holt, of NeW Orleans, has been tried many times with the happiest re sults:— Chloralis, 7 grains.
Potassii bromidi, 45 grains. Ammonii bromidi, 30 grains.
Aqum cinnamomi, 2 ounces.
AI. Sig.: Teaspoonful, and repeat in twenty minutes if not relieved.
This is intended for a child about 5 years old. For younger children the dose is slightly diminished. This prescription is of no benefit in true, or membranous, croup, wlien diphtheria antitoxin must be promptly used. II. R. Slack (Jour. Amer. lied. Assoc., May 6, '99).
CUBEB.—Cubeba officinalis is a climb ing perennial found generally through out the East Indies, and abundant in Java, Batavia, Saranak, New Guinea, Nepane, and the Isle of France. The fruit is the part employed medicinally, and appears as partly shriveled or wrinkled berries, owing to the fact they are gathered prior to ripening, bearing considerable resemblance in point of size, and also in color, to black pepper and piments, but less globose and furnished with a stout stalk that is continuous with raised veins that run over the surface of the fruit and embrace it like net-work.
The shell is hard, and contains a single loose seed covered with a blackish coat, but internally white and oleaginous with pungent aromatic taste and a peculiar aromatic odor that, once experienced, will never be forgotten. When reduced to powder the general tint is chocolate brown, becoming darker with age, and an oily look and feeling. A good quality freshly ground yields about 14 per cent. of volatile oil, which, however, is readily dissipated with age; little powdered cu bebs as found in shops will yield more than 4 per cent. of oil, and much of it is worthless.
Oil of cubebs is a greenish-yellow fluid possessed of a warm, camphoraceous taste and aromatic cubeb odor, soluble in al cohol, ether, and chloroform; it yields cubebic acid; cubeb-camphor, or stere opten; and cubebin.
Cubebic acid is a white, wax-like mass that, by exposure, acquires a brown hue and resin-like consistency; soluble in al cohol, ether, chloroform, and alkaline so lutions.
Oleoresin cubeb is identical with the preparation formerly known as ethereal extract.
Cubeb-resin is an amorphous body sol uble in alcohol and alkalies. Cubebin, at one time supposed to be identical with piperine, is a precipitate most easily ob tained from the oleo-resin (ethereal ex tract); it is white, crystalline, inodorous, and highly bitter, especially if dissolved in alcohol. Like cubeb-camphor, it is therapeutically inert.
Preparations and Doses.—Cubeb ex tract, ethereal (oleoresin),5 to 30 minims. Cubeb extract, fluid, 10 to 60 minims. Cubeb extract, solid, 2 to 8 grains. Cubeb infusion (4 to 16), 1 to 2 ounces Cubeb-oil, 10 to 30 minims.
Cubeb, powdered, 10 to 60 grains. Cubeb tincture, 15 to 120 minims.
Cubeb troches, 1 to 5; each should contain 3 grains of powdered cubebs with fruit-paste.
Cubebic acid, 5 to 10 grains.
Physiological Action and Therapeu ties.—Cubeb is stimulant, aromatic, sto machic, diuretic, expectorant, antiseptic, and mild diaphoretic; cubebic acid is markedly antiblennorrhagic. Appetite and digestion are generally increased and improved by- cubeb preparations; but too large doses or too prolonged use are apt to induce gastro-intestinal irritation, and, while exerting a laxative action, oc casions a sensation of heat and discom fort in the rectum; there appears to be also a selective action for mucous mem brane, more particularly that of the blad der and urethra. In very large doses (150 to 500 grains of powder) consider able febrile action is observed, along with griping, drastic purging, headache, net tle-like eruption, and, rarely, paralysis.
Cubeb, like other peppers, readily en ters into the circulation and increases the force and frequency of the heart's action. It is absorbed and eliminated with con siderable rapidity, chiefly by the kidneys, blit also through the skin and bronchial mucous membrane.