Original Articles with Nothing Which Approximated to a Toxic Effect

duoers which have, perhaps, been thoughtlessly That creolin is non-toxic is immensely in its favor adopted and retained. as an antiseptic ; from this fact, other things being It is not overlooked that many other external equal, its advantage over corrosive sublimate, car- conditions have a groat influence upon the mortality bolic acid, and iodoform is great, and the range of of infants. I have only attempted to deal with one its use greatly enlarged, as, for example, it can be influence, which can, without great difficulty, be used with safety in washing out the pleural and controlled. abdominal cavities, as a gargle, and in nasal, uterine, (To be concluded.) vaginal, and bladder douches. In my experience which has not been inconsiderable, I have met Original Articles with nothing which approximated to a toxic effect. In the experiments and experience of others the CREOLIN.1 conclusion has been reached, with one or two ex- to make BY EDWARD O. OTIS, M.D. ceptions, that, used of sufficient strength it either or exter- .At a of I thoroughly antiseptic, internally previous meeting'*' this society it is innocuous to Rosin4 made a short statement which I nally, higher organisms. regarding creolin, and Baunini6 a case or two of had then been for some weeks in the report possible poison- using Surgical where was as a and uterine Department of the Boston Since that ing creolin used vaginal Dispensary. douche in the state. Against these cases time I have continued its use, both and puerperal ° surgically we have the one hundred and of with satisfaction a forty Minopoulos medically, increasing and firmer Munich in which he used conviction of its The of in the Lying-in Hospital, great utility. experience douches of creolin of and two per cent, others as to its use is also and I have one-half, one, accumulating, with no record of also the one therefore it be of interest and ser- solutions, poisoning ; thought might hundred and cases of Born7 with the vice to the society to give a rather more systematic twenty-four and extended account of the and its same results. compound 8 that in about cases of varied with the results which a trial Spaeth says thirty gen- uses, longer eral in which the used was creo- of its virtues has us. surgery antiseptic given lin he met with no toxic results nor does other which first came to be known ; any Creolin, through observer from its use. its use in veterinary medicine, is an organic com- report poisoning of That creolin is a reliable germicide the investiga- pound rather complex composition. Pearson of & of who offer it in tions Esmarch, Eisenberg, Parks, and Sedgwick Co., Hamburg,* the market, Esmarch9 made the of it : 6(5 cent, of abundantly prove. comparative give following analysis per tests of the power of creolin and car neutral hydrocarbonates ; 27.4 cent, germicidal per phenols bolic acid, and found that a solution of the former, (without carbolic acid) ; 2.2 per cent, organic bases ; 4.4 cent. ash. even weaker than one per cent., destroyed tho per of and Prof: H. B. of Harvard Univer- bacilli cholera, typhus, Staphylococcus pyo- My friend, Hill, aureus and surer than a like has made an examination of a genes quicker percent- sity, kindly speci- age of carbolic acid the anthrax men of Pearson's and finds it is a mixture ; bacillus, however, creolin, was rendered inert more the carbolic acid of the sodium salts of some resinous surely by acids, with than creolin. the part of oil of tar known as " irod oil." Al- by he is not he thinks the sodium salts Eisenberg,10 in the Vienna Hygienic Institute, in- though positive, stituted tests also of the of are what is known as " a resin germicidal properties probably Harzseife," this new He tried it with bouillon cul- soap. The oil contains a small amount of carbolic antiseptic. tures of various or cresylic acid. It is obtained from English pit bacteria, Streptococcus pyogenes, coals and in is abrownish- Streptococcus erysipelatus,Staphylococeus pyogenes by distillation, appearance and and the result was in favor of blaek fluid ; soluble in and aureus, others, oily easily alcohol, ether, creolin over carbolic even in the case of an- chloroform ; with water it forms a homogeneous, acid, alkaline white and thrax bacillus. slightly emulsion, milky opaque. Parks u found in the of 1:200 It is of odor and of an creolin, strength tarry aromatic, burning and an efficient friend Prof. taste. The I use is from the firm of 1:1000, germicide. My preparation of the Massachusetts Institute of Tech- William Pearson & who so far Sedgwick, Co., Hamburg, are, has made some with as I the manufacturers of and nology, kindly experiments know, only creolin, me of who the of all creolin for in the biological laboratory that guarantee uniformity composition of institution. To dilute 1400 that bears their In creolin is sewage containing stamp. Germany bacteria to the cubic creolin to two than carbolic, or iodoform centimetre, per cheaper acid, sublimate, ; cent, was and there was no here I think it is about the same price as carbolic added, growth. Again acid. a one-half per cent, creolin in a solution of pepsin bacteria to the cubic centimetre Creolin is claimed to be — and the evidence seems containing 6,435 all Lormuscan 12 makes the to the claim — a and stopped growth. gen- verify non-poisonous germicide eral statement that the of creolin ; one of the most deodorants tc germicidal power antiseptic perfect ; is ten times that of carbolic and its action on a certain extent a haunostatic ; and possessing qual- acid, ities which diminish secretion and 4 Therapeutische Monntähefto, Octobor, 1888. promote granula- 5 Ccnlralblatt tur üvnäkologio, 1888, 21. tions. Moreover, it exercises a most effeel 8 Mitiicluuiei' Mod. 1888, 45. happy i Wochenschrift, and mucous mem CeiitralblnttfUr ('yniikologio, 1888, No. 20. upon unhealthy pus-secreting 0 Milncucner Mod. wclinscfir., 1888, No. 4. branes. Finally, it is a non-irritant. 9 Ccntralblatt für lîactcriologie und l'araaitenkunde, IUl. II., 1887, 10,11. 1 Head boforo tho lloston Sooioty for Medical Observation ° Wien. Mcd. Wclmchr., 1388, xxxvili. 17-19. February 4. 1830. 11 of the 2 Study of Some l'yogcnic Uuctcria and of the Ucrmicldal Boston Med. and August 1888. 3 Surg. Jour., 9, Activity of Certain Antiseptics. Medical News, Dec. 1,1888. Contralblatt f\l=u"\r Chirurgie, 1888, No. 21. ' Moniteur du l'racticlen, March 25,1888.

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org at UNIVERSITY OF WESTERN AUSTRALIA on July 24, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. the spores is even more pronounced than that of burns of the second and third degree, varicose the sublimate. ulcers, wounds where there was not union by first The marvellous deodorant power of creolin is an- intention, says he was not only satisfied with the other of its excellent attributes. Rausche *" refers results but indeed surprised to see how rapidly the to the remarkable deodorizing effect a one per cent, sloughs disappeared and healthy granulations ap- creolin solution produced in the case of an enor- peared. The change was more rapid I hau when mous, filthy, stinking carcinoma when other means sublimate, iodoform, or carbolic acid was used, lie bad failed. The odor was not only destroyed, also narrates a case of amputation of the thigh I'm' he says, but there was an evident and continued pyaemia, where the pysemic fever continued and diminution of pus. We all know, in such eases sloughing went on in the stump in spite of appli- as this, how very difficult it is to prevent odor. cations of iodoform, sublimate, and the like, Minopoulos,14 in his obstetric clinic, found creolin finally, when the patient was nearly in extremis, a most excellent deodorant in cases of abortion with he applied gauze soaked in a two per cent, creolin evil-smelling discharge; be used for this purpose emulsion. Two days thereafter the condition of tampons soaked in a one per cent, solution of the patient and wound was entirely changed. The creolin) and allowed them to remain twenty-four granulations were healthy, under which the bone hours. In o/.tena Pleskoff w found that the odor Stump quickly disappeared. Tho sloughs were quickly disappeared, together with the cessation of quickly thrown off; the fever soon subsided; and the formation of crusts, by the use of creolin. In- the pulse grow stronger. Twenty days later heal- halations of creolin vapor in cases of phthisis with ex- ing was nearly accomplished. pectoration and odor are reported by Klamann10 to Altered and unhealthy mucous surfaces, as in reduce the expectoration and destroy the odor. So of chronic naso-pharyngeal catarrh, cystitis, chronic the bad odor of cystitic urine. »Tessner17 narrates a gonorrhoea, tracoma, and the like, both in the quan- ease of chronic cystitis, in which after sublimate in- tity and quality of the secretion, change under the jections and other means had failed, he used a one- use of creolin, and the character of tho mucous half per cent, solution of creolin, which at first pro- membrane tends towards a more normal condition. duced a strong burning which later disappeared. I shall later give results and opinions as to its use In the afternoon of the same day on which the in the special mucous"membranes. A creolin solu- creolin was used he found a very different picture, tion may, and generally does, produce at first a he says: the patient presented an appearance of burning sensation, which, however, soon disappears well-being ; and when the urine was drawn if was in most cases if the solution is not too strong. I light and clear, instead of being thick and o I' bad have noticed this effect in washing out the bladder, odor; the sediment was also diminished. How and in nasal douches especially. perfectly two per cent, of creolin will destroy the Baimim 1!l says that in his experience a solution penetrating odor of iodoform is perhaps the best stronger than two per cent., applied to mucous test of its power as a deodorant. In brief, in all membranes and portions of the body where the eases of foul discharge and odor, chronic suppura- shin is delicate, produces a severe and continuous tion) sloughing, gangrene, and the like, creolin burning, even to erythema. In moist surgical dress- appears to be tho best and quickest deodorant yet ings I have had this burning complained of, and discovered. Creolin, in a solution of two or three K lamaiin-0 speaks of it in a like use of creolin, per cent., has been found to possess hœinostatic where a lotion of more than two per cent, is used. properties also. In the paronchymatous bleeding I n the nose, Dr. Leland says, atwo per cent, solution of fresh wounds, the bleeding from mucous mem- and five per cent, powder causes some smarting. I branes, ulcers, cavities which can be plugged with have never, however, seen any true irritant cifect Creolin tampons, and in the many smaller haemor- from its use, and all who, have written of it from rhages, often annoying and persistent, creolin acts their experience agree with Hillèr sl in ascribing to as a hiBinostatic of no mean value. In the removal it the virtue of being a, non-irritant antiseptic. of sloughs caused by chromic or glacial acetic acids, Spaeth *•' * says he has never met with local eczema from the nose, there is often more or less haemor- from its use, such as one.sometimes sees from subli- rhage, which, Dr. Lbland writes me, is controlled by mate or carbolic, or with general eczema, as from a two per cent, solution of creolin. iodoform. In order to obtain to any great extent the lueino- Prom tlie foregoing it will be seen that creolin has static power of creolin I believe the solution should a large range of usefulness; and my account will be as strong as two per cent. not be complete without giving some of its specific The peculiar and happy effect creolin exerts upon uses and the results. unhealthy surfaces, mucous or other, has been noted Pi ist, its use in general surgery, in all who have used it. I have observed this in by Fresh wounds : or in different of the in (operative accidental) Suppurations parts body, Hums. wounds. abscesses, and carbuncles. In a case of suppurating sinuses, bed sores. this latter malady I applied the pure creolin deep into the suppurating mass. One notices that the Suppuration, suchas) sloughing, pus secretion is diminished, unhealthy wounds and abscesses, ulcers become and indolent carbuncles. clean, granulations sinuses. fresh and firm. Spaeth,18 in referring to its use in Einpyieina. •3 Contralblatt fitr Chirurgie, 1888, 21. Gangrene. u hoc. cit. 's Thorniioutlscho Monatshefte, Oct. 1888. '9 XiOO. eil. •<• Allg. Mod. Ccntr. Ztg., 'Berlin, 1887, xxv. 07(1. ™ All. Mod. Centr, Ztg. Berlin, 1887, xxv. 070. '** Deutsche Mediiinal-Zcltung, 1887, No. 102. 21 Deutsche Mcd. Woclienschr., July 5, 1888. 18 J.oc, cit. " Loc. clt.

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org at UNIVERSITY OF WESTERN AUSTRALIA on July 24, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. For the ordinary purposes of an antiseptic in i i'i'itant properties of creolin together with the favor- operative surgery two solutions are required,— the able influence it exerts upon pyogenous membranes, one of two per cent., for cleansing and disinfecting render it an ideal antiseptic for washing out the the hands ; the portion of the body to be operated pleural cavity in empyanna. Upon- and for tho instruments; the other of one- Owing, however, to the delicate structure of the hal f per cent, for irrigal ingtho wound, and in which pleura, a mild solution should, at least at first, bo- to wet the gauze dressings, if used. Where a pow- used. Hiller " uses a solution of from one-tenth to der is desired to dust over the line of sutures, or for one-half per cent, for this purpose. other uses, creolin with boracic. acid can be used Creolin has been applied to the mucous mem- (creolin 3, boracic acid 100). To complete the branes in almost every part of the body, from the dressing there is creolin gauze of different per eye to the urethra. It bas been used in the cents, strength, which one can use either moist or Eye. dry, and absorbent cotton impregnated with creolin. Ear. Rausche211 recommends moist dressings, and says Nose (douche and tampon). that fresh wounds, either open or closed, do excel- Throat (douche and gargle). lently well under them. Bronchi and lungs (inhalations). Urethra and On open wounds creolin appears to have a pecul- (injection irrigation). iarly calming and curative effect, says LormUs- Bladder (washings). ean.-'' Unfortunate!\ a creolin solution is Vagina and uterus (douche). Opaque, In the and Am on82 have which is an objection to its use as tin antiseptic eye Purtscher,80 Mergl,"1 fluid for instruments. I have used diatomaceous used it in a one per cent, solution for conjunctiv- earth impregnated with creolin, at the suggestion of itis, acute and chronic, simple and phlyctenular ; Mi. Bassett, of J. T. Brown & Co., for a powder tracoma; blennorrhoea of the tear passage; and dressing, but am not altogether pleased with it: it keratitis. As there is severe burning when first is inclined to form an impenetrable crust and shut applied, Purtscher first uses cocaine. The best re- in whatever discharge there may be. The creolin- sults were obtained in tracoma and corneal ulcers, boracic powder is better. particularly in tho latter. Mergl says that in or in ulcers of the cornea combined with — paniius For burns, I think creolin oil can be used, one found that it tracoma be found creolin a most excellent applica- percent, suggested by Klamann,*"who tion. The ulcers cleaned and the acted exceedingly well, or creolin ointment of one quickly up — was in its course and or two per cent., with vaseline, lanolin, pannus stayed improved. 20 oragnineas less favorable results. a base. • In burns Kortiim found a perma- Grünhut,*8 however, reports large a solution of creolin — nent bath of creolin water useful. If a Eitelberg84 recommends very dry warm — for dressing is preferred, creolin absorbent cotton of ten drops to half a litre of water syr- the ears and as an to the two per cent, strength can be used. inging application auditory in active middle ear Pain in Where there is suppuration, either with or without passages inflammation. creolin is most the the neighborhood of the mastoid process disappears sloughing, effective, diminishing he under this treatment. amount of secretion and a con- very quickly, says, Being producing healthy is ho further dition of the as 1 have before mentioned. non-poisonous it admirably adapted, tissues, for the In bed sores Kortiim27 the affected says, syringing eustacbian tube, especially susjiended part in children. in a pan a one-half per cent, solution. containing a series of eases of rhinitis Sinuses can be out, with a solution of it Pleskoff"- reports syringed ; eh and sieca and in abscesses or wounds I have used roñica, ozœna, pharyngitis treated with suppurating He used a of one and what I call a creolin creolin. solution per cent., largely poultice, wringing out about absorbent cotton in a one-half cent, solution tampons ten to fifteen centimetres long and per the of little after and with a of cotton. thickness the finger, which, being applying it, covering dry out in the creolin he inserted This makes a clean, antiseptic, moist dressing readily wrung solution, deep < and renewed. I the into the anterior nares and allowed to remain for quickly generally give patient minutes for rhinitis sicca. In a a small bottle of the pure and tell him to twenty comparatively creolin, short time he found tho of the secretion was put a few in a, of warm water and satu- quantity drops glass and the character of the mucous membrane rate his cotton with the solution. This answers lessened to a moro normal condition. In ozama the all the purposes of an ordinary poultice and adds changed the derived from the odor quickly disappeared and the formation of crusts advantages peculiar properties In sicca the were of creolin. (¡auze. either plain or with one. or two stopped. pharyngitis tampons inserted the so that lier cent, of creolin, can be used in the same way. into posterior nares they pro- In the incision of jected into the posterior nasal space. Creolin was abscesses, felons, suppurating also to the In conclusion buboes, and the a bath of warm creolin solu- applied locally pharynx. like, he that we in a rem- tion for some to the says have creolin remarkable minutes, preparatory dressing, an in not only renders the cavity antiseptic, but tends to edy which promises to play important part check undue In extensive diseases of the throat and nose. In ordinary cases any htemorrhage. sup- of catarrh I have been in the habit of the a permanent naso-pharyngeal puration, especially extremities, of the a small amount of creolin Bath of creolin as suggested Kortiim28 for giving patient water, liy and him to with one or two to burns, can be used. The non-poisonous and non- tolling begin drops =9 Deutsche 1888. *"* Mod. Woehensehr., .Inly 5, Ccntralblatl für Chirurgie, 1888, 21. 3° Ccntralblalt für Augenheilkunde, March, 1888. =4 Moniteur du l'raclicicii, March 25, 1888. 3' 1888. Ibid., August-September, ' « Alle. Mod. (entr. Ztg. Berlin, xxv. B76. 3= Loe. oil. r -" Berlin, klln. Wchnschr.,1887, 40. 33 l'rugor Medicinischo Wochenschrift, 1888, 39. " toc. cit. U Wiener (led. Presse, 1888, No. lit. a8 Loe. cit. 35 Therapeutische Monatshefte, Oct., 1888.

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org at UNIVERSITY OF WESTERN AUSTRALIA on July 24, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. a tumbler of warm water and use the solution with used either as an injection or as an irrigation ; in a nasal syringe. The mucous membrane of the some cases both methods were employed. It was nose, like that of the eye, is very sensitive, and used in six cases as an injection with an ordinary sometimes only a drop or two to a glass of water urethral syringe three or four times a day ; these can at first be borne. were the more acute eases. The strength of the Dr. Leland writes me that he has used creolin in solution was one-half per cent., to be diluted if the nose for several months with satisfactory re- necessary. In nearly all these cases tho injection sults. was painful, even when considerably diluted, and In sotting up deflected septa, he says he uses either seemed to increase or failed to diminish the pervious hard rubber plugs wound with absorbent discbarge. In one case it seemed to work quite cotton and saturated with some antiseptic fluid. well. In ten cases irrigation was used once or twice Previous to the uso of creolin it was necessary to a week. A quart of warm one-fourth per cent, so- change these plugs every day, or every other day, lution was used through a soft catheter passed down on account of tho extremely disagreeable taste and to the bulbus urethrae. This method was more odor, notwithstanding frequent washings with satisfactory, he says. In several cases it was more Dobell's solution. By saturating the cotton-wound or less successful in reducing the discharge to a plug with a two per cent, solution of creolin, and minimum, although in a few there was no noticeable washing thoroughly once daily with the same solu- improvement. In two or three cases the benefit tion, he is enabled to keep the plugs in place for was very decided, and in one the discharge was ab- six days without removal. Also in dilating narrow solutely stopped in a month after three months of nostrils or in keeping wounded or cauterized sur- unsuccessful treatment by other means. The more faces apart, he uses smooth splinters of wood chronic the cases the slighter the discharge, and wound with cotton and soaked in a two per cent, the less inflamed and sensitive the urethra the solution of creolin ; with the use of a wash of one- better was the result. Where there is much active half to one per cent, solution by the patient the inflammation, he says, it is irritating. Probably nostrils are kept clean and sweet, so that these still better results would have been obtained by plugs can be worn with comfort. the irrigation method if it, had been used more fre- The two per cent, solution, he says, and tho five quently than once or twjee a week. I have used per cent, powder (with infusorial earth) cause some creolin solutions for washing out the bladder in the smarting in the nose, but this is insignificant when chronic cystitis from enlarged prostate. A one the surfaces aro well under cocaine, and' lasts but to five hundred solution was about as strong as a, short time otherwise. He also notes the liicino- could be borne without causing severe pain. In one statio effect of the two per cent, solution, which I rather extreme case creolin has served me as well as, have before referred to. if not better, than permanganate of potash or any Amon00 speaks of the excellent results ho obtained other antiseptic used, although I have not obtained from the use of creolin in diphtheria; by tho use such brilliant results as Jessner did in his case of no other remedy had ho seen the symptoms so before narrated. If I had been able to use a quickly disappear. He uses from one-fourth to one stronger solution than one-fifth per cent. I probably per cent, solution locally applied and as a gargle.87 should have seen more marked effects. In puru- Schnitzler88 uses the following formula) for lent cystitis of long standing, accompanied with gargle, mouth wash, and insufflation in the stubborn pain and an offensive odor to the urine, the creolin forms of angina follicularis : washings seem to have produced the most favorable — I that a It. Creolin, one or two parts. results. would advise solution not much A(|iuo dcBtill. vol. than one to five hundred should be Month. Pip., one hundred to live hundred stronger used, Aqua) pnrtB. - M. Sig. As a gargle. at least to begin with. ti. (ireolin, one to live parts. In obstetric and gynecological practice creolin Aqtue destill., tlfty to one hundred parts. has been used. at Prof. M. Sig. Apply with a briiBli. extensively Minopoulos,41- Winkcl's clinic in made a test It. Creolin, one to live parts. Munich, comparative Acid boric, ten parts. of it with sublimate. In two hundred and Month. s. eighty 01. Pip., Q. cases he used the bichloride and M. Sig. For Insufflation. lying-in with half creolin with half. The solutions of creolin wore Anión80 also used inhalations of creolin in vapor one-half, one, and two per cent.. Irrigations were phthisis, which, he says, reduced the expectoration made before and after the odor He immediately birth, and in and stopped when present. used from the when the tem- one half to two cent, solution. I am also subsequent lying-in period only per using rose to fever Before each exami- for a of with perature point. the same case apex catarrh, together nation the hands and instruments were the administration of the but thoroughly internal compound, disinfected with creolin. Of the one hundred and the not been case has under observation long enough cases treated with two were to results. In forty creolin, severely obtain any definite urothritis, espe- one and nineteen were less when creolin has been used with infected, crying, severely cially chronic, infected. The two septic cases were treated with more or less success. Dr. Allen has kindly given one-half cent, solution and its uso in thirteen cases which he per only during labor, me the results of and not before or after Of treated in the of the immediately delivery. Genito-Urinary Department the nineteen, two were examined in their Boston in the summer of 1888. It Avas remaining Dispensary own dwellings and probably were already infected 36 Miinchener Med. Wochenschrift, 1888, 20. when came to the There then re- 37 Vide also Kochlcr: Creolin m the Local I'rcvenlativeund Cura- they hospital. tive Treatment of Infectious Thront Diseases. Médirai Kecord, mained seventeen slightly infected cases. Of the January 11), 18811. one 38 Deutsche Mcdicln Wochenschrift, August 10,1888. hundred and forty cases treated with the sub- 39 ¿oc, cit. *" Loe. cit. i

The Boston Medical and Surgical Journal as published by The New England Journal of Medicine. Downloaded from nejm.org at UNIVERSITY OF WESTERN AUSTRALIA on July 24, 2016. For personal use only. No other uses without permission. From the NEJM Archive. Copyright © 2010 Massachusetts Medical Society. limato, three were severely infected, with one death, Creolin powder with boracic acid, three to one and thirteen lessseverely. His conclusions are that hundred. the results obtained with creolin are as favorable, if Creolin oil, two per cent. not more so, than those obtained with corrosive sub- Creolin soap, five and ten per cent. limate. Born41 obtained equally satisfactory re- Creolin ointments, of from two and a half to ten sults in his one hundred and twenty-four cases. per cent., with vaseline, lanolin, agnine, cerate, Baumm42 concludes from his experience that etc., as a base ; and creolin as a prophylactic and as a means of fighting Creolin mixed with iodoform (one or two per puerperal fever shows itself as good as any of the cent, of the Connor"), which renders it disin- previous antiseptics. Injuries of the parturient fectant and deodorant. This combination tract heal under creolin, he says, strikingly well. applied to wounds, ulcers, abscesses, etc., gives Kortiim used tampons saturated with a two per results, it is said,40 at least not less favorable cent, solution in severe atony of the uterus, with than from pure iodoform. favorable results. For lubricating the lingers of I have to thank Mr. Bassett, of the firm of J, T. the operator he used a two per cent, creolin oil. Brown & Co., and Messrs Grosvenor and Richards, In fetid lochia, cases of abortion with evil-smell- for kindly preparing for me much of this creolin ing discharge, leucorrhœa, cancer of the uterus with material. and foul creolin would ready bleeding discharge, This is the of creolin, and although we be a most both as a story appear to excellent application, may not exclaim with the enthusiastic Lormuscan, vaginal and uterine douche. "l'iodoform est vivo lo from the will be noticed that in all these uses of creolin morte, creolin," still, It favorable results thus far obtained, 1 think we are in treating mucous membranos the more chronic the warranted in it as a valuable addition to the the results obtained. accepting condition better our list of antiseptics, and prompted to investi- It only remains for me to speak of the internal gate its virtues still farther. use creolin and to enumerate the different cre- of Since the above was written further residís and observation! upon olin j (reparations. I have used creolin internally in tho uso of creolin have beon published, and it slill appears to bo re- due to but garded as a valuabio antiseptic. My continued uso of it, also, con- phthisis and in dyspepsia fermentation, tinus my belief in its cftlcacy. 10. O. ()., June 18, 1881). not to obtain definite re- extensively enough any BIBLIOGRAPHY. a sults, excopt that it is very unpleasant compound E. v. Elmaren, Centralblattftlr Bactériologie und Paras!tenknhde, to unless enclosed in as Bd. 11.. 1SS7, 10, il. take, gelatine capsules, J. Ncudürfor. Das Creolin und sciiio therapeutische Verwenden;;'. niller48 recommends. Internationale uiln. Kundschnu, 18S8, Nos. 1, 4, 13. 17, 18. Pilarm, Post., ISS, p. 229. Anion,44 from the results of several months' dial Frontier, Bemerkungüber die llngiftlgkcit fies Croolins. Ibid., of it in and No. 20; also Archiv für WisscnschiiI'll, und Tbieiboil., 1887, No. 14. pulmonary tuberculosis, simple inflam- Fisenl'crg, .1. lieber did dosinllzirende Wirkung und «lie praktische affections of tho lungs,—using it internally AnwondungswoiscdesCroolhiH. W'icn. Med. Wchnschr., 188S,xxxviiI. matory en. — it a net, co.",, and by inhalation, gives high place among Kortiim. Berlin clin. Wchnsclir, 1387, No. -111. Cofitralblatt für remedies for these diseases. He also declared his Chirurgio, 1KH8, !l(). (.'entnilbliitt liir (j.vniikologie, 1888, No. 0, of Kausche, II. libar das Creolin. Contrail), für Chirurgie, ISSS, 21. belief in the future importance creolin in the Anion. MUnohn. Mod. Wehnscbr., ISSS, 2Ü. and of infectious diseases. Spaoth, I'. Hbor innoie Darreichung des Creolins, Münchcncr prophylaxis therapeutics Med. Wehnselir., 1888, xxxv. 247; also 1SSS, No. I. Hiller45 is enthusiastic over creolin for diseases of Behring, Chorden untiaoptiBelicu Worth «los Creolins. Deutscho canal. He in mil. iirl'/.l. Ztsohr,, Berlin, 1888, xvil. 337, 848. the alimentary gives strong gelatine Klaniann. All«. Med. Centr. Ztg. Berlin, 1SS7, xxv. 67Ö. capsules, containing from three to fifteen grains, an ilaiuuiu. Creoiin in der (.¡oburtshüll'e. Contialblatt für ('yniikol., in 1SSS, xil. 20. hour after meals. Given this way it promptly liorn. Erfahrungen liber das Creolin. Ibid., No. 20.' and certainly relieves meteorism from whatever Deutsche Med. Wochenschrift, July 5 and August Hi, 1SS8. Further Observations on Creolin. Tboi'apeutie (¡azotte, ,luly 15, cause, he says. He found it also efficient in simple 1SS8. acute and chronic l.ormuscan. Moniteur du Pracliclon, March 2i*>, 1S8S. flatulence, gastric dilatation, gas- Medical News, September 1, December 1, and December 211, Isss. tric and Purtscher. liber die Anwendung dos Crcollns in dor Augonholl- catarrh, typhlitis, diarrhoea, especially isss. Its come out kundn. Oentralblatt für praktische Augenheilkunde, March, typhoid fever. antizymotio properties Mergl. 1'bcr Croolin in dei Augonlieilkundo. Ibid., August-Sop- most he concludes, when used the toinbor, ISSS. clearly, against Pleakotf, M. TborapcnUseho Versuche mltCreolin. Therapeutische numerous processes of fermentation and decompo- Monatshefte, October, ISSS. which if not such dis- Rosin H Min Fall von wahrscheinlicher Oreolinverglftung, sition accompany most, all, Thorapcutisclio Monatslieflo, October, ISSS. eases ; and used in such conditions ho considers it Breitung. Deutsche Medlclnal-Zoltung. Berlin, 1888, No. 2. creosote, Minopoulos. Munchencr Mcdiciniselie Wochenschrift, November, the best remedy, excelling naphthalin, ISSS, No. 15, Parks. of some of tho bacteria ano of the and all others. He also Study. pyógenio gormi- thymol, calomel, reports eldal certuin Medical News, Doc. ISSS. from its use in aetivitv of antiseptics. .1, prompt and complete results tœnia Jossucr. Beitrag zur Blnmerknns des Kreolin auf Schleimhäute. and Deutsche Medizinal Zeltung, 1887, No. 102. oxyuris. Cawiilowski, A. l'lmr. Post., ISSS, p, 2211. The preparations of creolin I have are : Rochier, F. W. Creolin in tho local piovcntatlvo and curativo treat- cent. — mont of infectious throat discases. Modical Kecord, January It), Creolin gauze, one and five per 1S81I. Creolin absorbent also one and five Lieblich, O. Dus Croolin. Therapeutische Monatshefte, November, cotton, per 1887. cent. (Irünbut. Hoher do Verwendung des Croolins in do Augenheil- Creolin per cent. kunde. Präger Mcdiciniselie Wochenschrift, 1888, 31). jute,,five Wiener Modieiniselio lïliittor, August 22, ISSS. Creolin lint, one and five per cent. C. Orecchia ami C. Francioni. Bull. d. Cult. Sc. Med. d. Siona, for sutures and fase. v. Creolin silk, ligatures. Sirena and Alessl, BU. Med., No. 258. Creolin with infusorial earth, two and Fenzold. Mlínchcncr Mod. Wochenschrift, 1888,32. powder, Hitolborg. lieber die therapeutische Verwendung des Creolins in five per cent, creolin. dor Otiatría. Wloncr Med. Presse, 188S, No. 13. Nussbaum, Internat, klinisclio Rundschau. Wien, 1MS8, No, I. ' Creolin. 3ter Pearson & • hoc. cit. istor, 2tcr, Thcil. William Co., Ham- «** für Contrnlblatt (¡ynäkologio, 1&S8,21. burg. do « Deutsche Mcd. Wochenschrift, July 0,1588. Chél'on, Dr. .Iules. Gazette Gynecologic, May 1, 1880. " Loo. cit. « Loe. cit. '<> Medical News, Doccmbcr 1,1889.