Electrolysis of each dilated sebaceous follicle with a negative platinum needle and a current of from 4 to 6 milliam peres is an effective, though tedious, measure. The needle should be moved around in the follicle in order to thor oughly destroy it. In the advanced hypertrophic form direct removal with the knife is the best procedure. (Brocq.) Hypodermic injections of alcohol have recently been recommended.
Local subcutaneous injections of 95 per-cent. alcohol.. The part is compressed with the fingers, and 20 or 30 drops of alcohol injected with a clean hypodermic syringe with a thin needle. The immedi ate effect of the injection is a local swell ing and anmmia, lasting but a few mo ments; then an increased redness lasting from half an hour to three or four hours; this gradually disappears, and the treated skin-area assumes normal color. The dilated blood-vessels and papules, after repeated injections, un dergo slow obliteration, until finally the whole lesion disappears and the affected integument appears normal. The treat ment, in some cases, lasts eight or ten weeks; in others, a great deal longer. 11. Abrahams (Amer. Med.-Surg. Bull., May 16, '96).
ACONITE.--The preparations of aco nite usually employed are obtained from the root of the Aconiturn napellus (monk's-hood): a conical tuber greatly resembling horse-radish. This resem blance has caused many deaths. When scraped, however, aconite-root does not emit the pungent odor peculiar to horse radish. Again, instead of irritating the palate, as does horse-radish, aconite-root, when masticated, soon produces in the mouth a sense of warmth and tingling, soon followed by local numbness varying in duration according to the length of time the mucous membrane is exposed to the effects of the drug.
The active principle of aconite, aconi tine, will be considered in the next article.
Preparations and Dose. — Aconite in substance is not employed, and the preparations made with the leaves are no longer official.
The tincture (tinctura aconiti rad., U. S. P.) is three times stronger than either the English or French tinctures. Dose, 1 to 3 minims, every three hours. Its effects should be closely watched, especially in anomie and corpulent indi viduals and in those addicted to alcohol.
Fleming's tincture is no longer offi cial and should not be employed.
The fluid extract (extractum aconiti fluidum, IT. S. P.), to 2 minims, every three hours.
The solid extract (extractum aconiti, U. S. P.), 7, to grain.
Physiological Action.—Within half an hour after its administration the drug commences to affect the general system, slowing and weakening the heart's ac tion, lowering arterial tension, increasing the action of the skin and kidneys, and producing more or less muscular weak ness in proportion to the amount taken. It causes a tingling sensation in the lips, extremities, and, perhaps, the whole body; it diminishes the rapidity and depth of the respiration, and causes dis orders of vision and loss of tactile sensi bility and sense of pain. According to Wood, aconite, when administered in sufficient dose, is a powerful depressant of the sensory nerve; and there is some reason for believing that the stage of nerve-paralysis is preceded by one of nerve-stimulation. Subsequently, how ever, its action on the spinal cord was further ascertained, and Bartholow states that aconite affects the sensory nerves before the motor. It paralyzes first the end-organs, next the nerve-trunks, and finally the centres of sensation in the cord. It also impairs the reflex function of the cord, but, doubtless, secondarily as regards the sensory paralysis. The power of voluntary movement, which continues after the cessation of the reflex functions, is finally lost, owing to the action on the motor centres of the cord, and subsequently on the nerve-trunks.
Pyraconitine. obtained from aconitine by heating to separate a molecule of acetic acid, causes no tingling of the lips or tongue. It causes slowing of the heart, partly from vagns irritation, partly from depression in function of intrinsic rhythmical and motor mechan isms. After its administration activity of respiration is reduced (by central de pression) to a degree incompatible with life. Neither muscular nor intramus cular nervous tissue is strongly influ enced by pyraconitine, but the spinal cord is impaired in its reflex function, and there is a curious condition of ex aggerated motility. Theodore Cash and W. K. Durstan (Brit. Med. Jour., Aug.