f Extracted.from the TranjJtetions of the Amejfran Medical AssociatioK,,Vol. xxv., 1S74 ] 
A NEW ANTIPRURITIC REMEDY. 
By L. DUNCAN BULKLEY, A.M., 4WS 
OF NEW YORK. 
Eighteen months ago we presented to the profession the 
“ liquor picis alkalinus,m which had proved itself valuable in cer- 
tain cutaneous affections in relieving itching in many instances, 
and whose value in this and other directions is daily becoming 
more evident. The failure of this as an antipruritic in some cases, 
as might be expected, has led us to the adoption of the compound 
here presented, which has thus far rendered inestimable service, 
but which has not, to my knowledge, been heretofore commonly 
known. 
More than a year ago I noticed in a medical journal the item 
that equal parts of hydrate of chloral and gum camphor when 
rubbed well together are converted into a fluid substance—which 
observation was repeated in the Boston Medical and Surgical 
Journal of Feb. 19, 1874, with the variation that the substances 
were to be mixed together, and the conversion would take place in 
a few days; no therapeutical suggestion was made in either in- 
stance. Stepping into a drug store, I immediately tested the truth 
of this, and found, after a few minutes’ trituration in a mortar of 
powdered camphor and Schering’s chloral, that in place of two 
crystalline substances a transparent colorless fluid existed, of the 
consistency of glycerin—no solvent having been added. It at 
once occurred to me that this would be of value in allaying itching, 
inasmuch as camphor acts ofttimes very gratefully when locally 
applied for this purpose, while I have long employed the chloral 
internally to the same end. 
I therefore had some ointment prepared after the formula:— 
1 ty.—Picis liquids, f£ij ; potass, caustics, 3j ; aqus destill. f3v ; ft. liq. picis. 
alk.; use diluted. Afckives of Scientific and Practical Medicine (Brown-Sequard),. 
February, 1873. 2 
R.—Pulv. gummi camph., 
Chloral liydrat., aa gj. 
Ung. aquae rosae, — M. 
Rub the chloral and camphor carefully together till fluid results, 
then add slowly to the ointment, mixing well. 
This when applied to the healthy skin produces no effect, but 
possesses great power in arresting itching without overstimulating 
the parts. It does not answer when the skin is at all broken ; it is 
then necessary to employ other less irritating agents, but the burning 
sensation caused on its first application lasts but a few moments, 
while the relief occasioned I have known to last for hours or even 
a whole day. 
This compound is soluble also in almond oil, alcohol, and ether 
to a considerable strength, as also in collodion. I have never em- 
ployed it other than in the formula above given, except that I 
have ordered it of a less strength, half a drachm of each to the 
ounce, also increased to a drachm and a half of each to the same 
quantity. I should expect a solution of moderate strength in collo- 
dion would prove useful in localized itching. I will give two or 
three illustrative cases:— 
Mrs. J. C. L., aged 34, seven months pregnant, was distressed 
with a most intense itching which commenced six weeks previous 
to her being referred to me by Dr. H. B. Sands, on Dec. 4, 1873. 
The itching was first noticed on the left arm near the shoulder, then 
on the right and on both shoulders behind, and soon the outer 
surfaces of the legs and the region of the waist became affected. 
When first seen her condition was indeed pitiable, the more so as 
she had become convinced that the distress would last until con- 
finement. Her general condition was poor, she looked worn and 
nervous; pulse 104, and weak ; tongue coated ; appetite very poor, 
and bowels irregular in action. She gave the history of being 
subject to neuralgia, and of having had a similar attack of pruritus 
when not pregnant nine months previous, which disappeared on 
the use of six sulphur baths. The skin when presented only 
the appearances due to scratching, namely, excoriated points and 
lines, resembling those seen in phthiriasis, but no traces of pediculi 
could be found nor indeed could any suspicion of this exist. 
Diuretic and tonic treatment seemed to effect very little, but 
some relief was afforded by the alkaline tar-wash before referred 
to, diluted about one part to sixteen of water. This was only tem- 
porary, and chloral and bromide of potassium internally failed to 
procure even a quiet night. The chloral and camphor in ointment, 3 
a drachm each to the ounce was then prescribed and the relief 
obtained was immediate and permanent, that is, with the applica- 
tion repeated every few hours at first, for she never really suffered 
from the itching after its first use, and in six days she had no 
further need of it. It is but right to state that she continued the 
same internal treatment as before, but she did not require any 
medicine to induce sleep. On the disappearance of the cutaneous 
symptoms a hoarseness occurred, evidently nervous in origin, which 
lasted until delivery, as it had accompanied also a previous preg- 
nancy to the end. 
Mrs. F. C. M., aged 32; a lady of highly nervous organization 
who was in the habit of greatly overworking in a literary line; 
has had several attacks during the last two and a half years of a 
very peculiar pruritus extending down the right arm and on the 
right shoulder behind to the median line. The itching and burn- 
ing she describes as horrible, and the skin was found to be hard 
and scratched. On former occasions she had obtained very great 
relief from the liquor picis alkalinus diluted, with internal medica- 
tion, but nevous exhaustion had been repeated so often by ex- 
cessive literary work that all the old measures failed to give relief 
at the last attack I witnessed. The nerve distress is further shown 
by a partial writer’s cramp. 
She was directed to abstain from using the right hand as much 
as possible, substituting the left, and was given the chloral and 
camphor ointment, a drachm each to the ounce. The relief follow- 
ing the first application was prompt and perfect, and a few days 
sufficed to remove the itching entirely, she using the same internal 
treatment which before proved ineffectual; no return of the 
pruritus has yet occurred after the expiration of several months. 
Whether on a recurrence of the skin trouble the remedy will still 
exercise as beneficial an influence it is impossible to say, but the 
relief afforded in this instance was as striking as it was gratifying. 
I will give one more case :— 
Mrs. B , aged 56, a large, fleshy lady, was kindly referred 
to me by Dr. A. L. Loomis, for a pruritus vulvae which had lasted 
six months. During the previous summer she began to have more 
or less irritation about the vulva, and had scratched herself to 
relieve it, continuing to do so till seen by me in Dec. 1873. A 
very large number of remedies had been most judiciously applied, 
with but very little relief to the distressing itching, and on inspec- 
tion the parts were found to be greatly thickened and discolored 4 
with more or less excoriation reaching down on the thighs and 
toward the anus. The clitoris was enlarged and elongated, but no 
follicular condition of the mucous membrane, no cervical erosions, 
nor any apparent cause of the trouble could be discovered. The 
urine was examined and gave no indications of glycosuria. The 
irritation and itching of the whole region she said were beyond 
description, and her troubled expression of face told the same story. 
She was then keeping the bed and using hot hip-baths night and 
morning with some comfort. These latter were directed to be ex- 
changed for fomentations with very hot water frequently repeated, 
and iron, quinine, and Fowler’s solution were given, also a diuretic 
mixture later. 
Some considerable amelioration was obtained subsequently by 
the alkaline tar used in the other cases, but soon this seemed to 
have lost its effect, and various other applications failed to cause 
improvement. After about two weeks’ treatment, the camphor and 
chloral ointment was prescribed with the happiest results, the itch- 
ing disappearing entirely sometimes for seven or more hours after 
its application, while in the mean time the patient gained in 
physical condition, and the thickened state of the parts which had 
been caused and kept, up by scratching subsided, and she was able 
to be up and around with a great degree of comfort. There still 
remains some itching at times, and the patient has just left for 
Europe for change of scene, etc., though for the last two months or 
so the irritation has been very slight. The relief afforded by the 
ointment'in this case far exceeded that obtained from any other 
measure attempted. 
In using this remedy the only caution I know of is to see that 
the parts to which it is to be applied are not greatly if at all ex- 
coriated by scratching, as the application is then pretty painful, 
and the unprotected derma is irritated and possibly inflamed thereby. 
From its success in these three forms of itching here exemplified, 
namely, that of pregnancy, that of the vulva, and that due to a 
pure neurosis as in the second case, I would suggest the employ- 
ment of the camphor and chloral compound in the general pruritus 
attending the senile alterations in the skin, also in anomalous cases 
and in those of chronic papular eczema or lichen, where itching is 
a prominent feature. Likewise in the 'pruritus lriemalis lately 
described by Dr. Duhring, of Philadelphia, in the Philadelphia 
Medical Times, of which I have seen some instances. 
The ointment loses strength on standing exposed, and should be 
made fresh very frequently.