ON THE EMPLOYMENT OF THALLIN 
IN FEBBILE AFFECT TONS. 
BY 
J ' 
.T. P. CROZER GRIFFITH, M.D., 
ASSISTANT TO THE PROFESSOR OF CLINICAL MEDICINE IN THE UNIVERSITY OF 
PENNSYLVANIA. 
FROM 
THE MEDICAL NEWS. 
April 3, 1886. ON HE EMPLOYMENT OF THALLIN IS FEBRILE AFFECTIONS. 
By J. P. CROZER GRIFFITH, M.D., 
ASSISTANT TO THE PBOFESSOR OF CLINICAL MEDICINE IN THE UNIVERSITY OF 
PENNSYLVANIA. 
Tetrahydroparachinanisol, or tetrahydroparamethyloxyquinolin, 
a hydrate of parachinanisol, was first synthetically prepared by Prof. 
Skraup, of Vienna, in 1884, and named by him “ thallin,” on account 
of tho green color which its salts produce with the perchloride of iron 
([OaXXoq, a green shoot). 
It is a light powder'of a pale yellow or almost white color, with 
a pleasant aromatic odor, resembling greatly that of the trailing arbu- 
tus. Its taste, however, is bitter, pungent, and disagreeable. 
It is easily soluble in water, with difficulty in alcohol, and not at 
all in ether. The reaction of its solution is strongly acid. It is usually 
employed in the form of the sulphate or the tartrate of thallin, although 
other salts exist, Its chemical formula is C10H16NO. The reference 
to the paper containing a detailed description of the method of its 
manufacture will be cited below. 
Von Jaksch was the first to experiment with it upon animals, 
and to apply it subsequently in medicine. Following him, various 
other clinicians made researches with the new drug, and reported their 
results, but up to the present time there has appeared, I believe, no 
published account of any clinical experiments with it, made either in 
this country or in Great Britain. 
It was while watching its effect on fever, when given by v. Jaksch 
in the clinic of Nothnagel, before he had made his discovery public, 
that I first came to believe in the value of the drug as an antipyretic. 
And it is with the desire of bringing it more prominently and moro 
favorably before the profession, that the investigations herein detailed 
have been made, and this communication written. 
The first announcement from v. Jaksch was made to the Wiener 
k. k. G-esellschaft fur Aerzte, in the fall of 1884, and published by him 
later. He followed this by several other papers on the same subject. 
He shows that thallin is very similar in its effects to antipyrin, 
although in very much smaller doses; but claims that it is more rapid 
in its action, although the fall of temperature produced lasts for a 
shorter time. It is also less dangerous, inasmuch as it never causes 
collapse, as does the latter drug. Both agents may produce profuse 
sweating; and chilliness or rigors often occur with the subsequent rise 
of the temperature after the action of the medicines has ceased. 
These conclusions he reached by giving thirty cases of various 
diseases, accompanied by fever, alternating doses of antipyrin and 
thallin. His investigations, throughout, were most careful and thor- 
ough. The usual dose of of thallin as administered by him is four to fifteen grains, given at one time, and repeated in one or two hours if 
no effect is produced. Tne degree of reduction of temperature obtained 
varies somewhat, and the duration of the lowered temperature lasts 
usually but a few hours. 
He states that it can be detected in the urine by the dark red 
color which is produced on testing with the percholride of iron. 
Before testing, too, a peculiar greenish shimmer may be seen at the 
edge of the receptacle. 
Alexander, after experimenting on fourteen cases, confirms the 
favorable report of v. Jaksch. He gives the medicine in the same 
doses whenever the fever exceeds 102° F. This usually reduces the 
temperature to 101° or 101.5°, where it remains for two or three 
hours. On its again reaching 102° the dose is repeated, the patient 
receiving the drug four or five times in the course of the day. Very 
profuse perspiration is often produced, especially in cases of phthisis. 
Huchard finds the temperature always reduced by four to twelve 
grains of thallin, with but slight accompanying perspiration, although 
shivering occurs frequently. He believes that it probably lessens the 
fever by acting on the thermogenetic centre. 
Dujardin-Beaumetz, while admitting that thallin is the most 
powerful of antipyretics, considers it a poor member of the materia 
medica. He adopts the opinion of Brouardel and P. Loye that it re- 
duces the temperature by diminishing the respiratory power of the 
blood, and destroying the red blood corpuscles; and believes that anti- 
pyrin acts in an entirely different manner—i. e., on the thermogenetic 
centre—and is much to be preferred. 
This is the only really condemnatory criticism of the new antipy- 
retic of which I am cognizant. 
Guttmann's experience agrees with that of v. Jaksch, but he con- 
siders thallin to have many unpleasant secondary effects. Its action, 
too, he considers of too short duration, and he therefore gives the 
preference to antipyrin. 
Ewald, on the other hand, says that the drug is safe, sure, and 
has no disagreeable secondary effects. He administers it in doses of 
four grains. 
Landenberger reports seventy cases of various febrile affections 
to which he has administered the medicament. He gives it in from 
four to fifteen, usually eight grain doses, and in this way obtains a fall 
of temperature of even 5° or 7° F., accompanied by profuse sweating, 
but never by collapse or cjmnosis. The effects continue five or six 
hours, before the mercury rises again. He usually administers it in 
wafers, to avoid the unpleasant taste, and has the temperature recorded 
hourly during the day, and every two hours at night. 
He finds it much superior to antipyrin, kairin, and quinine, especi- 
ally in reducing the temperature of erysipelas. It is also very effica- 
cious in phthisis, but is apt to produce too profuse perspiration. 
Stintzing, in employing thallin in Ziemssen’s clinic, finds four 
grains sufficient to cause a fall of temperature of 1.5° to 3° F., lasting' 
for three or four hours. The mercury then rises until it reaches the 
former or even a greater elevation. There is always more or less 
sweating after its use. 
Mingazzini obtained better effects from a dose of eight grains than 
from smaller amounts. He never observed vomiting, collapse, or 
cyanosis, but sweating seldom fails to appear. He prescribes it either 
2 3 
by the mouth, hypodermatically, or in clyster, and produces a fall of 
temperature equalling 1.5° to 4.5° F.. and lasting tour to eight hours. 
Jaccoud has made a very careful series of investigations on seven- 
teen eases. His average dose is six to eight grains, and his maximum 
fifteen grains, administered in wafers. The drug was always given at 
11 A.M., and the temperature recorded hourly until 6 P.M. He be- 
lieves that the initial dose should always be small, of three or four 
grains or less, since the effect appears to depend more upon the indi- 
viduality of the patient, than upon the actual amount of the drug 
employed. The same observation is true of antipyrin. He finds that 
the temperature falls 3° to 9° F., and, having once reached its lowest 
point in one and a half to three hours, at once begins to rise again, 
there being no persistence of a minimum temperature. In two to 
four hours from the time the mercury begins its reascent, it attains its 
original elevation. Copious perspiration attends the reduction of the 
fever, and with the subsequent increase of the latter there is a sensa- 
tion of chilliness and sometimes a rigor. His conclusions are that the 
salts of thallin are much to be preferred to antipyrin. With the latter 
drug the dose is much larger, the reduction of temperature not so 
great, and of no longer duration, the sweating more profuse, and chil- 
liness and rigors more frequent. Then, too, there exists the disposi- 
tion to the occurrence of the antipyrin-exanthem. He considers that 
liability to the development of collapse is equally great with both anti- 
pyrin and thallin. But the danger is much greater and more insidious 
from the former drug. Having once established the amount of thallin 
which can be given to a particular case, this dose can be employed 
without fear for as long a time as may be desired. But in the case of 
antipyrin the danger is renewed with every administration of the 
remedy. He has found by actual experience that a dose of antipyrin 
borne well on one day, may on another cause symptoms of collapse. 
Pavay has employed thallin in seventeen cases and with a result 
almost diametrically opposed to that obtained by Jaccoud; much pre- 
ferring antipyrin. Like v. Jaksch, he gave antipyrin and thallin 
alternately in a series of cases, and finds that of the two thallin pro- 
duces much the greater sweating when eight grains of it are given. 
But it requires forty-five to sixty grains of antipyrin to lower the tem- 
perature to the same degree. The reduction of temperature after 
antipyrin lasts much longer, and rigors and collapse are not so likely 
to occur. 
He disputes the statement of Dujardin-Beaumetz, and has re- 
peatedly examined the blood without finding any alteration of the red 
blood-corpuscles after the use of thallin. 
He gives four grains every quarter to half hour if the temperature 
exceeds 102° F. In one to two hours a fall of 3° to 5° F. is almost 
always obtained. He has endeavored in vain to check the profuse 
perspiration by administering one-sixty-fifth grain of atropia simul- 
taneously with the antipyretic. After a dose of twelve grains of 
thallin he has observed collapse and more or less cyanosis. He agrees 
with Jaccoud that the drug is not to be invariably recognized in the 
urine by means of the perchloride of iron—a proof that it is largely 
consumed in the system. 
Sara Welt, on the other hand, has never seen true collapse follow 
its use. The patient, although perhaps appearing somewhat cyanosed, 
feels well, and there is do diminution of strength. She has made in the medical clinic of Eichhorst, in Zurich, careful observations on the 
effects on the system of both thallin and antipyrin, administered to a 
large number of cases. Four grains of thallin are given hourly until 
apyrexiais produced. There is less profuse sweating and less frequent 
vomiting after the use of thallin than follow antipyrin, but chilliness 
or rigors occur more frequently. 
Ehrlich and Laquer, in a recent paper on the employment of 
thallin in typhoid fever, advocate an entirely new method of adminis- 
tering it. They admit that thallin has two disadvantages: 1st. Its 
action, though rapid, is too transient. 2d. Hyporprexia with rigors 
is apt to follow the cessation of its effect on the system. 
Antipyrin, on the other hand, has a more gradual fall of tempera- 
ture, and a more lasting effect with a slower reascension of the tem- 
perature curve. This is because thallin is absorbed with great 
rapidity, often affecting the system in ten or fifteen minutes, and its 
elimination begins in one-half to one hour. Antipyrin, on the con- 
trary, is absorbed more gradually and does not appear in the urine 
until three hours after its administration (Maragliano). 
Thus are explained the disadvantages of thallin, and also the 
much greater danger accompanying the exhibition of antipyrin claimed 
by Jaecoud, and fully agreed to by Ehrlich and Laquer. 
They have limited their article to their experience with nineteen 
cases of typhoid fever, to which they gave thallin in small doses fre- 
quently and persistently repeated. There method is as follows: Thal- 
lin tartrate is given in solution every hour during the day, and every 
two hours at night, and the temperature recorded every two hours. 
Six-tenths to one grain hourly is the initial dose, which, after two or 
three hours, is increased by one-tenth to one-eighth grain, and again 
by the same amount in two or three hours more. 
In this manner the dose is gradually increased until a reduction 
of temperature of 1.5° to 2.5° F. is obtained, without, however, 
attempting to procure complete apyrexia, and carefully avoiding any 
unpleasant secondary symptoms. In this way they are enabled to 
escape entirely all rigors and excessive perspiration. They claim also 
that the subjective symptoms of the disease, especially those affecting 
the sensorium, are improved. 
They have never observed collapse, and but rarely chilliness, 
which was caused by too large a dose. Vomiting occasionally occurs, 
due to the very unpleasant taste. As soon, therefore, as they have 
once determined the proper dose for a certain patient, they order the 
medicine in pill form. The digestive organs and the kidneys were 
never affected, and the exanthem of antipyrin never observed. Occa- 
sionally slight sweating takes place, but without being annoying to 
the patient. 
Though not prepared to make a positive claim to that effect, yet 
they are led to conclude from their observations that thallin probably 
has a specific action on typhoid fever, often ameliorating the symp- 
toms and appearing to hasten recovery. 
There are several other articles on the subject to which I could 
not obtain access. 
There will be found below a list of references to the literature, 
which I have tried to make complete. 
The abstracts of the views of the various investigators quoted 
above, exhibit a considerable difference of opinion. Dujardin-Beau- 
4 metz is the only one who really condemns the new antipyretic. Pavay 
thinks that it can never take a place equal to that of antipyrin ; and 
Guttmann also prefers the latter drug. But, with these exceptions, 
the general verdict is that thallin is a most valuable, prompt and safe 
antipyretic. The majority also claim that there is less profuse sweat- 
ing following the use of thallin, and that the medicine is much safer 
and more rapid in its action than antipyrin. The weight of opinion, 
however, goes to prove its only disadvantage to be that the reduction 
of temperature after its employment does not last so long as that pro- 
duced by antipyrin; but even this is contested by many of the writers 
mentioned. 
I report below a series of cases illustrative of the value of thallin 
as an antipyretic. In most of these the drug was administered in a 
single dose, usually of four grains. The variety of diseases is unfortu- 
nately, but unavoidably, not so great as could be desired. The tem- 
perature was, when possible, recorded every hour ; often this was not 
possible. It is not, as a rule, quoted here for those days upon which 
no antipyretic was given. 
5 
Case. I.—Phthisis with hectic and night sweats. 
Nov. 19, 1885.—7 P.M., 103.4°; 8, 103.2 (4 grains of thallin sulph.); 9, 99.8; 
10, 100.6; 11, 100.8; 12, 101; 1 A.M., Nov. 20th, 100.6. 
27th.—8.30 P.M., 102° (4 grains of thallin sulph.); 9, 100.2; 10, 99.8; 11, 
99.4; 12 99. 
28th—1 A.M., 98.4°; 2, 98.2; 3, 98.6; 4, 99; 5, 99.2; 6, 99. 
Dec. 9.—7 P.M., 102.4°; 9, 101 (4 grains of thallin sulph.); 11, 100.6. 
10th.—1 A.M., 100°; 3, 99.4; 5, 99.8. 
11th.—7 P.M., 102°; 9, 101.8 (4 grains of thallin sulpli.); 11, 100.2. 
12th.—1 A.M., 99.4°; 3, 99; 5, 98.8. 
l^th.—9 P.M., 101.4° (4 grains of thallin sulph.); 10, 100.8; 11, 100; 12, 99. 
15th.—2 A.M., 99.4°; 3, 98.8; 5, 99.6; 6, 99.4. 
27th.—2.30 P.M., 104.2° (4 grains of thallin sulph.); 3.30, 101.4; 4.30, 99.8; 
5.30, 99; 6.30, 99.2; 7.30, 99.8; 8.30, 100.2; 10.30, 101.4. 
Profuse sweating, usually followed the administration of thallin to this 
patient. For several days, however, she was very positive that she slept better 
and felt better after the use of the medicine. Later in the disease, the subjective 
symptoms were not so favorable. 
Case II.—Phthisis with hectic and profuse night sweats. Man, aged twenty. 
Nov. 20, 1885.—8.30 P.M., 103° (4 grains of thallin sulph.; at 8.40, copious 
perspiration, but not so great as usual); 9, 102; 9.30, 100.6; 9.50, 100. 
For three nights this patient took four grains of thallin with excellent results. 
Slept better, felt better, and perspired less than usual. 
Subsequent trial of the medicine seemed to increase the sweating. A short 
time after taking the drug he was always conscious of a tingling, burning feel- 
ing throughout his whole body. 
Case III.—Phthisis with night sweats. Woman, aged twenty. 
Nov. 28, 1885.—8 P.M., 102° (4 grains of thallin sulph.); 10, 100.4; 11, 99.6; 
12, 99. 
29th.—1 A.M., 99°; 2, 98.4; 3, 98.2; 4, 98.4; 5. 98.4; 6, 100; 7, 100. 
30th.—3 P.M., 102.4° (4 grains of thallin sulph.); 9, 101.2; 10, 101; 11, 99.6; 
12 98 2 
Dec l.—l A.M., 98°; 2, 98; 3, 99.2; 4, 99.4; 5, 99.8; 6, 99.2. 
2d.—7 P.M., 102° (4 grains of thallin sulph.); 9, 100.4; 10, 100,6; 11, 100; 
12, 99.2. 
3d.—1 A.M., 98 8°; 2, 98.4; 4, 99; 6, 99.2. 
l^th.—9 P.M., 102.6° (4 grains of thallin sulph.); 10, 101.4; 11,100; 12, 99.8. 
15th.—2 A.M., 99.2°; 3, 99.8; 4, 99.4, 5, 99; 6, 100; 7, 102. 
■26th.—9 P.M., 102.2° (4 grains of thallin sulph.); 10, 101.8; 11, 100; 12, 99.6. 
27th.—1 A.M„ 99.2°; 2, 98.8; 3, 100; 4, 100.4; 5, 100.3; 6, 100.8. Jan. 2, 1886.—9 P.M., 102.6° (4 grains of thallin sulph.) 10, 100.4; 11, 99.4; 
12, 99. 
3d.—1 A.M., 99.2°; 2, 99.6; 3, 100.8; 4, 100.4; 6, 100.8. 
6 
Case IV.—Pyopneumothorax; septic. Man, aged twenty-five. 
Dec. 2,' 1885.—9 P.M., 103.4° (4 grains of thallin sulph.); 11.30, 98.4 (pro- 
fuse sweating and some chilliness and depression of strength). 
3d,—3.30 A.M., 101°; 6,101; 9, 103.6 (4 grains of thallin sulph.) ; 12.15 P.M., 
100.2 (not much perspiration, but subjective symptoms not improved); 2.30, 
101; 4.3Q, 101.8: 5.30, 102. 
5th.—8 P.M., 104.6° (4 grains of thallin sulph.); 10, 100.8. 
6th.—12.30 A.M., 100°; 2, 101.6; 6, 101.6; 7, 103. 
23d.—9 P.M., 104.4°; (4 grains of thallin sulph.); 10, 101.2 (free perspira- 
tion); 11, 100.4; 12, 100. 
24th.—1 A.M., 100°; 2, 99.6; 5, 101.2; 6, 102. 
Jan. 14, 1886.—9 P.M., 102.6° (4 grains of thallin sulph.); 12, 100. 
15th.— 2 A.M., 99.2°; 3, 99.2; 6, 101.6. 
Case V.—Typhoid fever in a girl aged fifteen; eighth day of the disease. 
Dec. 4, 1885.—9.30 A.M.. 105° (4 grains of thallin sulph.); 10.30, 102.4 (pro- 
fuse sweat, pulse softer); 11.30, 102.6; 1.30 P.M., 105.6 (sponging with water and 
vinegar every hour); 6.30, 104.4. 
5th.—9.50 A.M., 104.6° (4 grains of thallin sulph.); 10.30, 101 (perspiring; 
pulse soft); 11.30, 102; 1.30 P.M., 105 (2 grains of thallin sulph.; at 12.45 there 
was a slight chill, lasting half an hour, evidently ushering in the rise of tempera- 
ture); 3, 102.6; 5, 105.7 (2 grains of thallin sulph.); 6.30, 103.8. 
Case VI.—Phthisis, advanced. Woman. 
Dec. 5, 1885.—6 P.M., 101.5° (headache, gave 4 grains of thallin sulph.); 
8, 97 (slight perspiration, feels better, and head aches less). 
Case VII.—Phthisis with nephritis and pyopneumothorax. Man, aged 
twenty-one. 
Dec. 7, 1885.—5.15 P.M., 103,5° (4 grains of thallin sulph.); 5.45, 102.1 (at 
5.40 a sensation of warmth over the whole body, and perspiration commencing; 
now profuse); 6.20, 100.4 (sweating entirely ceased); 7, 101, 
Case VIII.—Typhoid fever (seventh day) with pneumonia, Man, aged 
forty. 
Dec, 8, 1885.—9.30 A.M., 103.4° (4 grains of thallin sulph.); 10.30, lfiO.8 
(profuse perspiration); 11.30, 101; 1.30 P.M., 104.4; 2.30, 104.6 (4 grains of thal- 
lin sulph.); 3.30, 101.8 (profuse perspiration); 4.30, 102.1; 6.30, 104.4. 
Case IX.—Typhoid fever, second week. Man. 
Dec. 18, 1885.—9.30 A.M., 102.4° (4 grains of thallin sulph.); 11, 98.4 (copi- 
ous perspiration); 2 P.M., 102.5. 
Case X.—Phthisis. Woman, aged twenty-four. 
Jan. 2, 1886.—9 P.M., 103.4° (4 grains of thallin sulph.); 10, 101.8; 11, 
100.2; 12, 99. 
3d.— 1 A.M., 99.8°; 2, 99.6 ; 3, 101.8; 4, 101; 5, 101; 6, 103.2. 
5th.—8 P.M., 103.4° (4 grams of thallin sulph,); 9, 101.8 ; 10, 99.5 ; 11, 98.4; 
12, 100. 
Case XI.—Phthisis. Woman, aged twenty-eight. 
Jan. 5, 1886.—1 P.M., 100°; 2, 100.8; 3, 100.6; 4, 101; 5, 101.4; 6, 102; 7, 
102.4; 8, 103.2 (4 grains of thallin sulph.); 9, 101.2; 10, 99; 11, 98.2; 12, 99.2. 
Feb. 1.—8 A.M., 100°; 8 P.M., 103. 
2d.—8 A.M., 99.80; 8 P M., 102.6. 
3d.—8 A.M , 99°; 8 P.M., 102.4 (administration of thallin tartrate, 6-10 grain 
every two hours, commenced). 
4th.—8 A.M., 98.4° (6-10 grain of thallin tartrate hourly); 8 P.M., 100. 
5th.—8 A.M., 98°; 8 P.M., 103 (thallin stopped at 10 A.M., Feb. 5th, on 
account of vomiting). 7 
The temperature during the administration of the drug was recorded hourly, 
and showed a very marked reduction of the febrile temperature. Through an 
oversight, these records were destroyed. 
Case XII.—Phthisis. Man, aged twenty-two. 
Jan. 14, 1886.—7 P.M., 104.2°; 9, 104.8 (4 grains of thallin sulph.); 10, 
102.2; 11, 101 (considerable sweating); 12, 100,2. 
15th.—1 A.M., 99.2° (chilliness); 2, 99; 3, 98.8; 4, 99.8; 5, 101.8; 6, 99.8; 
7, 104. 
19th.—7 P.M., 104°; 9.30, 106.6 (4 grains of thallin sulph.); 11.30, 99.6. 
20th.—12.30 A.M., 99°; 1.30, 99; 2.30, 99; 5.30, 100.2. 
Case XIII.—Typhoid fever, fifth day. Man, aged twenty-one. 
Feb. 10, 1886.—8 A.M., 102.4° (6-10 grain of thallin tartrate every hour); 
10, 102; 12, 103.6; 2 P.M., 104 (dose increased to 8-10 grain hourly, and at night 
every two hours); 4, 104.4 (5 grains of thallin tartrate in one dose without effect); 
6, 104.6 (the continuous use of 8-10 grain continued); 8, 104.4; 10, 103.4; 12, 103.6, 
11th.— 2 A.M., 102.4°; 6, 103.2; 8, 102; 10, 101; 12, 102 (dose of 1 grain of 
thallin tartrate substituted for 8-10 grain); 2 P.M., 103.8; 4, 103.2 (8 grains of 
thallin tart, in single dose, with but little sweating;; 6, 102.2; 8, 101.4; 10, 102; 
12, 102.2. 
12th.—2 A.M., 102.6°; 4, 101.8; 6, 102; 8, 103; 10, 102 (dose increased to 1£ 
grains); 12, 103; 2 P.M., 103.4; 4, 102; 6, 103; 8, 103.4; 10, 103.2 ; 12, 103.2. 
13th,—2 A.M., 103.2°; 4, 103.2; 6, 103.4; 8, 101.2; 10, 102; 12, 102.2; 2 P.M., 
103 ; 4, 102; 8. 103; 10, 100.2; 12, 102.8. 
14th.—2 A.M., 102.6°; 6, 103.4; 10, 101.4 (dose increased to 2 grains); 12, 
103.5; 2 P.M., 102; 4, 102.6; 8, 103 ; 10, 103.4; 12, 102. 
15th.—2 A.M., 104.6°; 4, 102.4; 6, 104,4; 10, 103.2 (thallin commenced 8 
A.M., Feb. 10th, in continuous doses, now stopped); 12, 102.6; 2 P.M., 103 (20 
grains of quinine); 3, 103; 3.30, 103.6; 4, 104; 4.30, 104; 5, 103.4; 5.30, 103; 6, 103; 
6.30, 103; 7, 103; 7.30, 102.8; 8, 102; 8.30, 102,2; 9, 102.4; 9.30, 101.8; 10, 101.8; 
12, 102. 
16th.— 2 A.M., 102°; 4, 102,2; 6, 102.2; 10, 101; 12, 103.4; 2 P.M., 103.4; 4, 
104: (15 grains of antipyrin); 6, 101.2 (profuse sweat, more so than with thallin 
on Feb. 11th, q. «.); 8, 101.2; 9, 101.4; 11, 101.4. 
17th.—10 A.M., 102°; 12, 103.2; 2 P.M., 103; 4, 103.4; 4.30, 104 (cold pack, 
with a slight temporary reduction of temperature); 8, 102.4; 10, 103.4; 12, 102. 
18th.—2 A.M.. 104.6° (15 grains of antipyrin); 4, 102.4 (profuse sweating); 
6, 104.4; 8, 102.6; 10.30, 103,4; 11.30, 103.4 (cold pack, lasting 25 minutes with a 
fall of temperature at 11.55 in axilla, but a rise in the rectum); 11.55, 102.6; 2 
P,M., 103.4; 3.30, 104.4 (8 grains of thallin sulpli.); 4.45, 100 (profuse sweating 
and considerable depression); 8, 103.3; 10, 103.6; 12, 102.6. 
19th.—2 A.M., 103°; 4, 103.4; 6, 103.6; 7, 104. 
This case is particularly interesting as being an example of the greater effi- 
ciency of both thallin and antipyrin, as compared with quinine and the cold pack. 
Case XIV.—Pneumonia. Boy, aged twenty-two months. 
Feb. 13, 1886.—1 P.M., 102.1° (f grain of thallin tartrate); 2,15, 101,4; 4, 
103,9. 
14th.—12,30 P.M.. 103,2° (§ grain of thallin tartrate); 2, 102.5; 3.15, 103.9 (1 
grain of thallin tartrate); 4, 100.8, 
Case XV.—Pneumonia. Boy, aged twelve. 
March 12, 1886.—4 P.M., 104.4° (2 grains of thallin sulph); 5, 103.4; 5,15, 
103.8; 7, 105.2. 
Hth.—8 A.M., 104.4°; 4 P.M., 104.2 grains of thallin sulpli.); 6, 100.6. 
Case XVI.—Pneumonia. Boy, aged nine. 
March 21.—4.30 P.M., 106.5° (3 grains of thallin sulph.); 5.30, 104.2 ; 6.30, 
101; 9, 105 (3 grains of thallin sulph.); 12, ’00. 
22d.—6.30 A.M., 105°; 12.30 P.M., 104.8 (2 grains of thallin sulph.); 2, 102; 
4, 105 (2 grains of thallin sulph.); 5, 103.4; 8, 103. 
Thallin in both Cases XV". and XVI. not only reduced the tem- 
perature greatly while producing only moderate perspiration, but diminished markedly the nervousness and restlessness and the rapid 
and violent heart’s action. The condition of the sensorium was also 
decidedly improved, and the patients stated that they felt better. 
Sometimes natural sleep followed the use of the antipyretic. To both 
patients cold sponging was given hourly without any effect. 
An inspection of the records given will show that thallin has been, 
without exception, efficacious in reducing temperature in the oases 
reported, and that this has usually occurred within one hour after its 
exhibition, although at times from two to three hours have been re- 
quired before the full effect was obtained. Of course, no one claims 
that thallin or any other antipyretic is invariably successful. 
The number of cases observed is sixteen, and the number of times 
the drug was administered, and the temperature recorded, exclusive of 
the continuous frequent exhibition of it in Cases XI. and XII.; equals 
forty-four. The dose usually given was four grains, which I have 
generally found sufficient. The greatest reduction of temperature 
obtained equals 7° F., and the least, 0.4° F; the average being 2° to 4° 
F. The effect lasted a variable time, in the acute febrile affections not 
so long as in phthisis. In the latter disease, a dose of thallin adminis- 
tered in the evening sometimes occasioned a lowered temperature 
throughout the night. As a rule, it required two to five hours before 
the mercury reached its former elevation, if, indeed, it did ascend so 
high. I cannot agree with Jaccoud that the persistence of the mini- 
mum temperature equals nil. Profuse sweating was frequent, chilli- 
ness occurred but seldom, and a slight rigor was seen once. I have 
never observed collapse, but have seen depression of strength occur in 
two instances; due, I think, to excessive perspiration. Vomiting was 
produced in but one case, caused probably by the unpleasant taste of 
the medicine. 
As to the subjective symptoms, some of the phthisical patients 
especially complained greatly; principally on account of the copious 
sweating. Others, however, experienced no unpleasant effects, and 
some felt decidedly better, slept better, and had less profuse perspira- 
tion than usual. Two cases perceived a peculiar sensation of warmth 
throughout the whole body soon after the ingestion of the drug. 
My experience with the continuous administration of small doses, 
is limited to Cases XI. and XIII. Although unsuccessful in the later, 
I am inclined to believe that the remedy will often prove very effica- 
cious when given in this manner. 
Whether the simultaneous exhibition of atropia in sufficiently 
large doses will check the profuse perspiration forms not only an in- 
teresting clinical question, but bears upon the solution of the problem 
whether thallin simply causes a reduction of the surface temperature 
by evaporation, or acts upon the thermogenetic centre. 
Thallin is undoubtedly a most powerful antipyretic, and the fact 
that decided depression of strength occurred twice in forty-four 
exhibitions of this remedy, indicated that it must be given with care 
to greatly debilitated subjects. It appears to have no particular action 
on the heart or on the respiration. As a rule, the rapidity of the 
respiratory movements and of the pulse is reduced at the same time 
with the degree of the fever, although not necessarily in proportion. 
With the question concerning the indications for the use of antipy- 
retics in general, or the advisability of using them at all, these investi- 
gations have had nothing to do. 
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