PRELIMINARY CONSIDERATIONS

Being fully conviuced that ‘‘No medical proposition should be condemned solely on the grounds of its appearing visionary and improbable wben first enunciated ” and without giving it a fair and unprejudiced trial, I determined to submit a certain number of cases of tubercular pbthisis to the influence of the naphtha recommended by Dr. Hastings, and note with the most rigid impartiality every fact as far as it related to the effects of the remedy (if any) on the general symptoms, but especially on the physical signs. I was stimulated to the investigation of the value of naphtha, also, by the fact that every case of the disease, sufficiently advanced to admit of a positive diagnosis being formed, which I had previously witnessed, had invariably progressed from bad to worse, and from this to death ; no matter what plan of treatment had been employed. Believing, with the Reviewer in the Provincial Medical Journal, of Dr. Hasting’s work, that “ the high importance of the question involved demands at least an unprejudiced trial and an impartial judgment, and moreover they are due to the author who has franldy and openly stated his views, without any attempt at concealment or mystification,’^ I determined to lay before the profession rather ^efacts tJiemselves which I had gleaned by my enquiries, and

allow tliem to judgc for themsclvcs, tlian any gcneralizations or conclusions of my own formed by the considération of the same facts.

Notwitbstanding that I was determincd to investigate the subject in the aniinus I hâve mentioned, stül 1 must candidly confess that I commenced the use of naphtha with a complété disbclief of its possessing any spécifie power over the general syraptoms, much less over the pathological essence of the disease — belie\ing this to be in its nature incurable. The results of my présent expérience, however, compel me to sa y that many chronic forms, especially when the disease is not extensively disseminated, and most cases in their early stages yield favoiu’ably to naphtha when exhibited in suitable doses, either given düuted with water alone, or combined with such other treatment as the featurcs of the individual case may indicate. Hence it will be seen that I hâve corne to the conclusion that the proper or médicinal naphtha is by far the most valuable remedy hitherto proposed for the relief and in some instances cure of this distressing malady.

As regards the curability of some stages and forms of genuine tubercular phthisis I do not now entertain the shadow of a doubt. Cicatrized tubercular cavities bave been observed and recorded by competent authorities, proving that the disease is in its nature curable, although the powers of the patient never effect a cure, except in those rare instances where very limited tubercular dépositions, are not followed by a subséquent augmentation of the disease. Many cases in their earliest stages hâve doubtless been cured by change of climate, and by judicious treatment, wHch would hâve gone on to the patients destruction, under less favourable circum stances; although, perhaps, these hâve been considered merely as threatened cases of phthisis, from a want of minuteness and accuracy in diagnosis.

Dr. Marshall Hall states that he has known the constant application of a lotion consistiug of one part pure alcohol and three parts water to the upper régions of the thorax, just below the clavicles, effect a cure of tubercular dépositions. The lotion is to be applied through the medium of a piece of soft linen, folded six times — the linen being moistencd every five minutes.

and free évaporation being allowed. If Dr. Hall’s assertions meet witli assent and belief, bis testimony would prove that sucli cases are not always incurable.

The testimony of Drs. Stokes and Graves would also tend to prove that there are cases of genuine phthisis which aie not incurable. “ Several remarkable cases of phthisis,” says Dr. Graves, “hâve occurred in owîi practice, and in the practice of Dr. Stokes, in which the patients recovered either temporarily or permanently, in a manner quite unforseen and unexpected. In some recovery took place after the occurrence of abundant tubercular déposition and crepitus, and in otliers after the formation of tubercular cavities. Facts such as these ought to prevent the practitioner from placing too great reliance upon stethoscopic examinations as a positive means of proÿnosis ; for it may be looked upon as established that phthisis, like most other diseases, does not always necessarily progress to a fatal termination.^

* The following case has been recently published in an American journal. — Spontaneous Cure of Phthisis by C. T. Collins, M.D.

“ It is my belief that there are many more cases of phthisis pulmonal's cured by nature alone than medical men are generally aware of. I do not mean to say that we should always trust to nature alone, by any means, but that we should be very cautious lest we do too much.” The case came under Dr. Collins’ care the 29th of March last.

“ Sarah Hamor, ætat 55, born in England, had always been rather délicate. She W'as attacked last fall with erysipelas of the left hand and arm, and after recoveting from that she caught a severe cold which was followed by a troublesome cough, and shooting pains through the chest, but more especially on the right side — from the right mamma to the shoulder blade of the same side. She now began to lose flesh, and when I first saw lier (which was as above stated) she was so much emaciated — to use a commun phrase — that she was a mere skeleton. She was so weak that she was unable to help herself; she had profuse night sweats, severe cough, and expeetorated about half a pint or more of light greyish yellow pus of a frothy nature (same as is usually seen in the last stages of consumption) in the course of twenty-four hours. Her shoulders were raised and brought forwards, the chest flat, and the clavicles very prominent — leaving a hollow. On auscultation there was that peculiar hollow gurgling Sound at times heard over the right lung, and at others there was no Sound to be heard of respiration at some points. The dyspnæa sometimes became so urgent that the friends several times thought her dying. Almost as soon as she fell asleep, she would break out into a profuse perspiration, and the little sleep she did get was not refreshing. There was an abscess on the right side of the spine, extending from about the second rib to the nintb or tenth, and about four inches wide, involving ail the muscles of the back contained within that space. There was anopening about an inch and a half from the spine, over the région between the fifth and sixth libs,

Although naphtlia (médicinal) is not to be regarded as a spcedy and certain cure in ail forms and stages of phthisis, yet it almost invariably effects tlie raost prompt and marked relief of the general symptoms, not only in the early, but in the most advanced stages of the complaint. This eflfect of the remedy alone would give it a title to rank very high as an article of the materia medica.

In conducting my enquiries into the value of naphtha in tubercular phthisis, I determined to exhibit it indiscriminately in ail cases of the disease, whether they appeared to be favourable or unfavourable, and to collect a sufficient number of facts ta settle the following questions, as weU as my opportunities of observation would enable me to do.

Ist. What substance, under the name of naphtha, was recommended by Dr. Hastings, and by what tests can it be recognized ?

2nd. Whether this naphtha could be considered as a valuable remedy in any genuine cases of tubercular phthisis ?

3rd. What were the particular forms and stages of phtliisis especially benefitted, as indicated by the symptoms, and especially by the physical signs ?

4th. What eflfect the naphtha exerted on the general symptoms ? and also more particularly what eflfect on the physical signs (if any)?

5th. What is the modus operandi, and appréciable eflfects ?

6th. What cii’cumstances contra-indicate the use of naphtha ?

which I enl irged by means of a bistoury, and kept open by the use of poultîces The abscess discharged constantly, and at one tirne nearly a pint of well marked pus.

“ My great object in lier case was to palliate her sutferings and merely make lier as comfortable as possible during the time she might live. I told her friends to let her eat as mucli as she wanted, and anything in the way of ordinary food, also to let her hâve a small quantity of wine. Ordered the following mixture to be given at night, and at any time during the daywhen the cough was most troublesome. — g, Guni Acac. Ext. Glycyrrh, ââ Syr. Altheæ, Træ Opii. ââ ^ss. Vin Antim. gtx. Aquæ §iij. — Dose coch. amp.

“ The patient gradually recovered, and in about four weeks from the time I first saw her, the cough had entirely left her, and she was gaining strength fast. The right side became much smaller than the left, owing to the ohest’s shaping itself to the new condition of the lung. In about six weeks from the time I first saw her she left town for Pough Keepsie, in better heallh, she said, than she had enjoyed for years. I gave her nothing of any importance besides cough mixtures similar to the one first ordered.”— New York Jourtml of Medicine, Sept. 1844.

CHAPTEE II.

PHYSICAL AND CHEMICAL CHAKACTER OP NAPHTHA MEDICINALIS.

EPFECTS ON TUBERCLE.

It will be obvions that it is of the highest importance to ascertain ivhat substance, out of tbe many sold under tlie name of naphtha, proves médicinal. My own observations would lead me to tbe conclusion tliat two-thirds of those who bave tried naptba in consumption, including ail tbose wbo bave found tbe substance tbey bave employed eitber useless or injurions, (and bave tbus apparently failed), hâve not used tbe médicinal napbtba wbicb I bave exbibited witb constant relief, and in many cases witb a curative effect, to my patients — being tbe same wbicb Dr. Hastings recommends and employs. I corne to tbis conclusion aiso from tbe difificulty wbicb exists of obtaining witb any certainty tbe proper remedy, and from tbe strâking différences wbicb exist in tbe publisbed accounts of tbe pbysical properties of tbe substance and its effects, by most ob servers, and my own examinations and trials. A great variety of substances are sold under tbe name of napbtba, and it is difficult to obtain two spécimens, even from tbe same sbop, at different times, wbicb do not présent some sbades of différence. Wbite’s, cbemist, Piccadilly, and generally BeU’s, Oxford-street, are tbe only two sbops I bave tried wbere médicinal napbtba can be obtainedwitb any certain ty. Witb tbe exception of tbe remedy I sball presently describe, I bave found ail otber substances of tbe napbtba class eitber inert or (as is generally tbe case) positively injurions : bence I divide tbese substances into two classes — tbe médicinal and tbe nonmedicinal.

Tbe pbysical cbaracters of tbe médicinal napbtba are as follows; — Wben pure it is a colourless, limpid liquid, readily miscible in aU proportions witb water and alcobol, baving a spécifie gravity at 60° F. of about ‘800.

Tbe smell is alcobolic and peculiar — being a compound smelî

of silcoliol and acctic æthcr, with soracthing rather uauseous and bitter, but by no means very unpleasant or disyusting.

The taste is warm, alcoholic, and rather nauseous — far, however, from being either very unpleasant or disgusting. Patients hâve invariably told me, that although they could not consider the naphtha pleasant, still it was not at ail worse to take than anything else bearing the name of medicine.

Hence if a liquid be offered for sale of a dark colour, oily appearance, or which becomes milky on the addition of water, it is obviously a non-medicinal specimen ; so also if it possess a very nauseous, sickly smell or taste.

Specimens, however, may be found which agréé in ail these particulars, and yet belong to the non-medicinal class. I hâve several times tried a specimen which is more purely alcoholic in its taste and smell, and without the slight nauseous flavour and smell of the médicinal, which invariably disagreed with the patients, aggravated ail the symptoms, and produced headache and sickness. These very patients had been previously much benefitted by the médicinal naphtha, and were again speedily relieved from ail the distressing symptoms by returning to it, and by leaving olf the liquid which disagreed.

The médicinal naphtha occasions a sense of warmth on being swallowed, usually foUowed by expulsion of flatus, soon succeeded by a comfortable sense of freedom of respiration, with relief of the distressing shortness of breath so constantly experienced by the phthisical. The peculiar odour of the medicine is imparted to the breath and sputa, and sometimes to the urine passed shortly after its use. In no case bave I found the médicinal naphtha dérangé the stomach or bowels, or produce any unpleasant symptom. Hence if nausea, vomiting or purging, faintness, giddiness or headache follow the exhibition of any liquid used as naphtha, it should be rejected as a non-medicinal article.

The Chemical characters of médicinal naphtha are essentially those of pyroxylic spirit (hydrate of the oxide of methule, C2 Hs O, aq., Liebig.) Itis highly volatile, very inflammable, burning with a very pale blue flame ; and the production of much beat, and boils at about 150” F. It is perfectly neutral to test paper, and is a ready solvent of iodine, essential oils, and resins.

dissolves sulphur and pliosphorus witli the aid of beat, in smali qiiantitieSj but exerts no action on tbe fixed oils.

I snbmitted equal qnantities of médicinal napbtba^ and tbe non-inedicinal (wbicb I bave mentioiied as very closely approximating to tbe médicinal) to tbe following tests, in order to discover, if possible, some ready mode of distinguisbing tbem.

Tincture of litmus and litmus paper suffer no change of colour on the addition of the médicinal naphtha, but are reddened in a marked manner by the non-medicinal.

Neitber turmeric paper nor reddened litmus suffer any change on the addition of eitber tbe médicinal or the nonmedicinal (tbis specimen *) naphtha.

ADDITION OF STRONG NITRIC ACID.

The médicinal (vi^hich I shall distingnish by a) is rendered of a pale reddish, slightly brown tinted, colour, when vievi^ed by reflected light, more approaching to a pale salmon colour when viewed by transmuted light. The non-medicinal (whicli I shall distingnish by b,) is also rendered of the same colour.

ADDITION OF lODINE.

a and b both readily dissolve iodine without beat, and acquire the deep reddish-brown tint of the tincture of iodine ; b, however, dissolves it much more readily, and in greater abundance ; — in my experiments a dissolved x grs., b. xv. grs.