Morphine muriate, 1 grain. Beech-creasote, 6 minims.
Glycerin (neutral), 154 minims. Alcohol, 2,0 minims.
Water, enough to make 224 min ims.
Dose, 1G minims, five or six times daily, injected deep into the muscular substance. The morphine is often left out, its sole purpose being the obtunding of the pain that supervenes after the operation. On the whole, however, sote hypodermically possesses no advan tage over the oral administration. Physiological Action.—Topically, cre asote is caustic, antipruritic, analgesic, astringent, and markedly antiseptic and germicide. Taken internally, in small doses it is expectorant and a cardiac and nerve-stimulant; besides, it is cooling and sedative to the stomach, from which it is readily absorbed into the circulation and then diffused with great celerity; it is styptic, increasing the coagulability of the blood. Larger doses depress the heart and nervous system, but accelerate respiration and render it full, with haps a secondary result which entirely reverses the order; it stimulates the vagi both at the periphery and centre. It is eliminated chiefly by the kidneys and lungs. Its beneficial effects cannot be attributed to any antibacillary action, since it does not diminish the number of the bacilli of tuberculosis nor even di minish their virulence.
Creasote is eliminated by the kidneys no matter how administered, and the largest amount thrown out is during the first twelve hours after administration. The elimination by the lungs is com paratively insignificant. The guaiaeol elernent appears to be most rapidly elim inated. Imbert (Nouv. Montpellier Mild., '92; Then Gaz., Mar., '92).
The favorable action of creasote is due to (a) bactericidal action on the microbes which accompany the bacillus of Koch : (b) to its stimulating action on nutri tion, so that phagocytes which prey -upon the tubercle bacilli are increased in number; and (c) to its chemical ac tion on the toxins excreted by bacilli. Savine (Academy of Medicine, July, '9S).
Poisoning by Creasote.—When toxic quantities are ingested, the heart and cir culation are powerfully depressed, the temperature is lowered several degrees, the pupils are minutely contracted, and respiration. is paralyzed. This is also the case with the vasomotor centre of the medulla; there is first yertigo, later stupor. Owing to stimulation of the an terior cornu of the cord, muscular trem blings and even convulsions may super vene.
Some persons seem very sensitive to the action of ereasote, while others ap pear to tolerate it in enormous doses ; hence the problem of elimination should be taken into account on all occasions where the drug is prescribed.
Two eases of pulmonary tuberculosis treated by rectal injections of creasotc 30 minims daily. The urine soon became black, though clear when first passed, and resembled that excreted in carbolic acid poisoning. Even after the substitu tion of guaiaeol for ereasote, one ease con tinued to pass urine that became black. Nimier (L'Union Med., Aug. 31, '95).
Case of a man, aged 35, suffering from phthisis pulmonalig, who commenced to use creasote in doses of 1 minim thrice daily, and rapidly increased the same until he was ingesting exactly 340 minims every twenty-four hours. Dur ing. two and one-half months he con tinued to take 3 and 4 fluidrachins daily, and then he reduced to 140 minims, which he still continues. He has never experienced any' ill effects. Graham (Brit. Med. Jour., Jan. 15, '93).
Result of six experiments on dogs: 1. Creasote, 1 to 625 body-weight, caused death in twenty minutes. The necropsy showed acute gastro-enteritis (stomach strongly' corroded and small intestines markedly inflamed), and pulmonary cedema from cardiac paralysis. 2. Crea sote carbonate, 1 to 3165 body-weight, did not give rise to the slightest disturb ance. 3. The same dog on the following day received creasote carbonate, 1 to 600 body-weight, but presented no abnormal symptoms beyond hebetude. 4. A dose of the same, 1 to 500 body-weight, gave no results. 5. Guaiacol, about 1 to 1000 body-weight, gave rise to uncertainty in hind-legs, falling, vomiting, trembling, especially of the limbs, and sluggish pupils. The vomiting continued, with noisy respiration, watery discharge from the mouth, and later subnormal tempera ture, slow respiration, and slow pulse were observed. Death followed in about seven hours from the administration of the drug. The necropsy showed aente gastro-enteritis (marked inflammation of the gastric and upper portion of the small intestine and swelling of the re mainder) and pulmonary crdema from cardiac paralysis. 6. Guaiacol carbon ate, 1 to 500 body-weight, caused no results. 7. The same, 1 to 330 body weight, also produced no result. In con clusion it can be stated that both crea sote and guaiacol in large doses are poisonous, and cause death through their corrosive action, and, per contra, erea sote and guaiaeol carbonates, even in large doses, have no influence upon the system. W. Hesse (Deut. med. Woch., No. 5, '93).