The antidotal property of potassium bromide explained by stating that it ex cells all other salts in regard to its sol vent property for iodoform. Samter and Retzlaff (Wiener med. Blatter, July 11, '89).
Therapeutics.—The use of iodoform in the treatment of wounds and ulcer ative processes has become so general that a list of its indications would serve no useful purpose. The manner in which iodoform produces its effects, however, will prove of practical interest.
In the powdered state, iodoform has been shown by de Ruyter, Kronacher, Baumgarten, Heyn, Drovsing, and others to possess but little, if any, value as an antiseptic in laboratory experiments, notwithstanding its undoubted value in practice. It was found, when mixed with rapidly infective bacteria, in no way to reduce the development of disease in animals. Even the bacillus tuberculosis, though previously mixed with powdered iodoform, when introduced into guinea pigs produced tuberculosis precisely as if no antiseptic had been employed. Again, it was found to have no direct effect in preventing the development of staphy lococcus pyogenes, the coccus pneu monia!, or other well-known organisms.
Far different were the results, however, when the solutions in which decomposi tion of the iodoform has already begun were utilized. Organic fluids, blood, serum, in which micro-organisms are undergoing the process of development possessing the property of decomposing iodoform, its antiseptic powers, though unexplained, are nevertheless accounted for. In other words, the properties of iodoform are due to its decomposition, and the activity displayed is proportion ate to the energy of the chemico-physical process involved. Whether the decom position is due, as is believed by many, to ptomaines, local stimulation, or other effects is not fully established.
If wounds inflicted on dogs or guinea pigs are infected with staphylococci or streptococci and are treated with iodo form, they heal more quickly and secrete less than those which are not thus treated. Iodoform lessens the virulence of these micro-organisms; neutralizes or destroys the microbe toxins, but not completely; it does not lessen the amce boid motion or the phagocytosis of the u hite blood-corpuscles. Lomry (Archiv f. kiln. Chir., B. 53, II. 4, '96).
Iodoform is not used in surgery as it was a few years ago, although it may safely be said that, all advantages con sidered, no drug has shown itself entitled to its place. Its unpleasant odor has alienated the majority of those who have abandoned it. Its present status among surgeons at large is well represented by the varying views expressed at a recent meeting of a surgical society:— Use of iodoform is not increasing, but, on the contrary, it is decreasing. Ace
tanilid gauze has largely superseded it. T. G. Morton.
The writer uses iodoform very little. Thymol-diiodide is cheaper and better for fresh wounds. Thymol and acetanilid are sufficient for nearly all cases. De Forest Willard.
Not used by writer as much as for merly, but it is a very good remedy in certain cases, as in bone-cavities and es pecially in cases of abscess about the rectum, where no packing can take its place. Used in the same way in opera tions about the mouth iodoform packing remains sweet longer than any other packing. H. R. Wharton.
The employment of iodoform in per sonal practice limited to its use as a gauze for packing and drainage, espe cially where dryness and antisepsis are required for prolonged periods; as an injection in emulsion with glycerin for tubercular joints or abscesses; and, oc casionally, in the shape of a 5-grain sup pository in tubercular affections of the rectum. Thomas S. K. Morton.
There are two classes of cases in which powders are used antiseptically, one in which the drying element is desired and the other in which antisepsis is to be ob tained. In the latter case there is not anything to be compared to iodoform. Iodoform is the most reliable agent to stop suppuration when actual contact can be secured. G. G. Davis.
The writer has not been able to find anything which would take the place of iodoform in securing cleanliness in a moist cavity. George Erety Shoemaker.
Routine use of iodoform to the exclu sion of other dressings equally as good and free from the many objections pro tested against. W. G. Porter.
Iodoform is still a valuable drug. It is used nearly as much to-day as ten years ago. R. H. Harte.
The rational use of iodoform is as much indicated to-day as it ever was. It is useful in chancroids, and nothing can take its place. W. Joseph Hearn. (Annals of Surgery, May, '98.) Summary of 84 replies from prominent surgeons to the question: "Would sur gery suffer if iodoform were abolished?" The effect, according to 37, would prob ably be negative; 47 considered that surgery would suffer. Of the latter, 27 thought the detriment would be general, 12 limited its use to surgical tuberculosis, and 8 to its use in gauze and specific cases. Personal belief that in five years the general answer will be: "Not in the least." E. C. Brush (Jour. of Amer. Med. Assoc., Dec. 16, '99).