A CASE of GANGRENE of BOTH FEET in an EARLY GENERAL PARALYTIC
Authors: J. R. Lord
Journal: BMJ (1898)

wnte the marked "keeping" properties of the urines of patients taking large doses of creosote.I have allowed some of these specimens to stand for nearly two months without auy change occurring in their reaction or production of fer- ineatative changes.I have, unfortunate)y, not had the opportunity reoently of treating a, case of cystitis, or other disease of the genito-urinary tract in which fermentative changes occur, and where a non-irritant disinfectant would be ot value, but it seems possible that creosote would be of use inemch a case, seeing that no symptoms, either subjective or obeetive, have been noticed in any of these cases to show t*at the drug produces the slightest irritation when the mucous membrane is normal, though, of course, it might pawve harmful to a diseased mucous membrane.Lastly, it is asserted by many that creosote cannot be given to children in more than minute doses.I regret I have not Ikad the opportunity of testing this objection, as few children suffering from phthisis are admitted into this hospital.I have, therefore, only been able to watch the effects of the drug in three cases.Two of the patients were 5 years of age and the other was 2 years older.The two former had marked pulmonary tuberculosis, the latter was suffering from fibrosis of the left lung with bronchiectasis and fcetid expectoration.Tlhey all took 30 minims of creosote three times daily, with decided improvement in each case, and certainly no signs of tozamia.ilaving compared the objections raised against the admini- stration of beechwood creosote in phthisis with the results obtained at this hospital by treating ioo cases with this drug, [ would suggest that the followlng points are worthy of con- sideration and further investigation.z.The best beechwood creosote can be given with benefit, in amounts varying from 120 to 240 minims daily, in cases of pulmonary tuberculosis.2..The drug is best administered in cod-liver oil or in a spirituous solution, and in some cases the " creosote cham- ber" or oro-nasal inhaler may be ordered in addition, with adrantage.3. The dose should be small at first, but it can be rapidly inreased to 4o minims three times daily for an adult.In 3 eases doses of 30 minims three times a day were well borne by children.4. Large doses rarely cause any gastric disturbance; on the ~awtrary, the appetite is frequently increased, symptoms of 4ydpepsia disappear, and cod-liver oil is more easily assimi- Wted.The cough, expectoration, and night sweats are diminished, and the physical signs improved.S. Owing to its disinfectant action in the alimentary canal the drug probably diminishes the risk of tuberculous enteritis by.atoinfection when patients swallow their sputa, but ownig to the increased peristalsis, which is created by creosote, it is usually contraindicated in cases where the uleeration is already advanced.6.The drng does not tend to cause hiemoptysis, but rather to prevent its recurrence. 7. Creosote does not irritate the normal mucous membrane of the genito-urinary tract.8. Owing to its extremely small cost pure creosote can be given to a much larger number of patients than the carbo- aates of creosote and guaiacol, which respectively cost four times and twelve times as much as the older drug.