[Reprinted from THE MEDICAL News, November 24, 1894.] 
G U AIA COL EXTERNALLY IN TUBERCULOSIS. 
PHYSICIAN TO THE HOME FOR CONSUMPTIVES, CHESTNUT HILL J HON- 
ORARY PROFESSOR OF LARYNGOLOGY, JEFFERSON MEDICAL 
COLLEGE ; EMERITUS PROFESSOR OF DISEASES OF THE 
THROAT, PHILADELPHIA POLYCLINIC, ETC. 
J. SOLIS-COHEN, M.D., 
In The Medical News of September 30, 1893, I 
published a “ Preliminary Note on the Pronounced 
Effect of the Endermatic Use of Guaiacol in Controll- 
ing High Temperature in Tuberculosis.” After more 
than a year of continuance of the treatment it is 
worth while to add my present satisfactory impres- 
sions of the remedy, the result of its use in some- 
thing under fifty cases, some thirty of them in the 
Home for Consumptives at Chestnut Hill, and 
therefore under peculiarly favorable surroundings. 
We began in that institution with a dose of np xlv, 
as had been recommended in the French journals. 
This dose was far too great in the climate at Chest- 
nut Hill, and sometimes produced positive collapse. 
So rapidly did the temperature fall that the lips and 
finger-tips of the patient soon became blanched, the 
cardiac impulse weak, and the perspiration profuse. 
We then diminished the dose. We found np xxv a 
good average. Some patients did equally well with 
doses of up xx, np xv, and even of but np x. 
Free perspiration is a good indication of satisfac- 
tory action of the remedy; the temperature fall- 2 
ing more rapidly the more free the perspiration. 
When perspiration is slow, hot milk or other hot 
drink given just before the remedy is applied, or hot 
water-bags placed along the surface of the body, will 
favor the perspiration. 
Temperature reduced with np xv of guaiacol does 
not remain reduced for so long a period as when re- 
duced with larger doses. It will generally rise again 
on the following day. If a dose of xx xxv is 
then rubbed into the same patient there will probably 
be a prompt reduction of three or more degrees, 
perhaps even a degree or so below the normal 
standard, with return to normal in a few hours, and 
continuous maintenance of the normal temperature 
for three or four days, a week, or longer. This 
normal temperature was maintained for six weeks in 
one of our hospital-patients. 
Should the temperature fall very rapidly from 
103.50 or 104° to below normal, with profuse per- 
spiration, the patient will feel cool and comfortable 
the cardiac impulse will remain unimpaired, and the 
lips and finger-tips will continue rosy until the tem- 
perature has dropped to about 990. Then, if the 
temperature continues to fall, as it sometimes does, 
to 970, or even to 96°, the sensations of comfort are 
replaced by sensations of chilliness, and the rose- 
tint of the lips and the finger-tips becomes empur- 
pled. A hot drink and a hot-water bag at the side 
will send the temperature back to normal in a few 
minutes, and the patient may fall into a refreshing 
sleep. 
The method of using guaiacol at the Home for 
Consumptives is as follows: The skin where the 3 
guaiacol is to be rubbed in is well washed with soap 
and water, and then thoroughly dried. The place 
selected is a matter of indifference, but we have usually 
chosen a spot over the seat of greatest lesion of the 
lung. Ten or more minims of guaiacol, as may be 
wanted, are poured into a dish, whence it is taken up 
upon a camel’s-hair pencil and brushed upon the 
parts, back and forth, until the whole dose has been 
absorbed. This will take ten, fifteen, or more 
minutes. Then the part is rubbed dry with the hand, 
after which it is covered with a layer of cotton 
protected by paraffin paper or oiled silk. In many 
cases the temperature drops a degree or more before 
the rubbing is completed, and two degrees within 
thirty minutes of commencing the application. 
When the patient is near death, and the temper- 
ature elevated in consequence of the approach of 
dissolution, guaiacol in the doses in which we have 
applied it had no effect in arresting continuous 
rising of the temperature. 
It may be concluded that the endermatic use of 
guaiacol, when carefully employed, often promotes 
the comfort of the patient in a manner which can- 
not be obtained from its use by ingestion, by subcu- 
taneous injection, or by direct injection through 
the air-passages.