In one patient application of an oint ment (1 to 40) to the face induced great swelling and marked redness, lasting nearly three weeks. In another patient use of the powder on a fissure of the vulva caused intense tumefaction, and nodular swellings in various parts of the body. Brocq (La Presse Med., Apr., '99).
Orthoform may produce two separate varieties of eruption: erythema, alone or complicated with vesicles or pustules, and gangrenous eruptions, which are rare. The former may appear even when the orthoform is applied upon healthy skin, not necessarily upon an open wound. They are readily cured in a few days. The gangrenous eruptions occur when varicose ulcers are treated with orthoform. There is much pain. Two such cases reported, both of which recov ered after a long time. The fact that the physician would not stop using the ortho form increased the period of duration of the gangrenous eruption. W. Dubreuilh (Phila. Med. Jour., from La Presse bled., May 1S, 1901).
Therapeutics. — Orthoform is chiefly used in painful ulcerations of the upper air-passages. It occasionally produces a slight burning for a few minutes after its application. It may replace cocaine when prolonged anwsthesia of ulcerated surfaces is desired, cocaine being re served to produce temporary anesthesia of an intact mucous membrane.
Orthoform has been extensively em ployed by Neumeyer (1) in painful dis orders occurring in the upper air-pass ages, as in tuberculous ulceration of the larynx; (2) in operations as a local anes thetic; (3) in pain due to gastric ulcer ation, whether simple or malignant; (4) in urethral pain; (5) in painful disorders of the skin; and (6) in neuralgias, in tabes, etc. He also observed that ortho form exercises an excellent local, anaes thetic action. One application often sufficed to lull pain for hours or even days. The remedy must be applied di rectly to the nerve-endings. In painful angina of the throat the application of orthoform was without effect, as it does not act on an intact mucous membrane. In ncuralgias it was without action.
Orthoform has given good results in hay fever, the powder being insuffiated into the nasal cavities. Lichtwitz (Ar chives Inter. de Laryng., Jan., Feb., '9S).
Orthoform used in a large number of cases of rhino-laryngology, and complete local has always been ob tained when applied to exposed sensitive terminal nerve-endings. In all forms and varieties of ulcerations in the nose, mouth, pharynx, or larynx it gives abso lute freedom from pain, the effect last ing several hours to several days. It is so thoroughly antiseptic that ulcerations heal much more rapidly when orthoform is used than when it is not used. In troubles o= the fauces where there is no ulceration, but where the epithelial layer of mucous membrane has been denuded, the application of orthoform relieves the pain and reduces the inflammation. After removal of the faucial tonsils, if orthoform is applied to the cut surfaces the patients can eat solid food without pain, and the parts heal quickly. There is no pain after removal of an elongated uvula if orthoform is applied.
In case in which a necrosed tooth was removed the soft parts were badly lacer ated. The cavity was packed with or thoform and in a short time all pain was relieved and the patient could eat with no inconvenience. The relief of the pain lasted eight hours, when the cavity was again packed with orthoform. Twenty four hours after the operation the case was examined and no pain, soreness, or inflammation was found; the lacerated parts were pale and shrunken, and did not become inflamed in the least. John North (Amer. Med. Compend, Nov., '9S).
Emulsion of orthoform, 25 parts, and olive-oil, 100 parts, used for laryngeal application. The burning sensation lasts only about a quarter of an hour, and is then succeeded by anesthesia, which commonly lasts from 24 hours to days. The patient is able to eat all kinds of food, the appetite is greatly in creased, and it seldom causes dyspepsia.
The emulsion has been employed chiefly in cases of tuberculosis. A distinct diminution in the amount of secretion in cases of ulceration is noted, but other wise it does not appear to have any local therapeutic value. Patients do not dread the lactic-acid treatment if orthoform emulsion is used regularly. Kassel Monats., No. 10, '98).