lODOFORM (Ter lodide of Formyle, C 2 H h.) ITS THERAPEUTICAL EFFECTS By Stiles Kennedy, M. D NEWARK, DELAWARE. NOTE. This paper is intended for private distribution to members of the medical profession, and the auxiliary and collateral arts, with a view of eliciting further investigation and practical inquiry into the Physiological and Therapeutical effects of what appears to he a really wonderful medicine. The writer has attempted to do nothing more than present, in as compact a form as clearness of the subject would admit, some cases actually treated by himself and others, since he called the attention of his professional brethren to lodoform, as a constitu- tional remedy, three years ago. He requests those who may give the medicine a trial to com- municate the result to him. S. K. lODOFORM. lodoform Therapeutically is alterative, nervine, sorbefacient, anti-periodic, and anesthetic. As an alterative it acts with more rapidity than other medicines of that class, in doses of one, two or three grains repeated thrice daily. As a nervine it is prompt and efficient, while it gives nervous strength, it calms speedily and beautifully the most severe pains. Its sorbefacient prop- erties are manifested with some degree of slowness. Five to seven grains, given in broken doses in rapid succession, produce a powerful anti-periodic effect. Its anesthetic properties are of local significance. It is rapidly absorbed into the blood. Accumulative effects have not been observed, lodofornj. is destitute of any local irritant action, and has that advantage over all other iodic remedies. It may be administered, with reasonable expectation of suc- cess, in the following diseases : Neuralgia of every description, chronic rheumatism, consump- tion, scrofula, opthalmia, chronic ulcerations and skin diseases, syphilis, and certain affections of the neck of the bladder and prostate gland, and whenever a powerful alterative agent is needed. This quality of lodoform is greatly enhanced, in the majority of cases, by the addition of pure iron, Fe. pr. hydrog. lODOFOEM AS A EEMEBY IN NBUEALCIA. Case I.—fm, 8., get. 6, Ees. Millville, Md., gastric neuralgia. Sept. Ist. This boy has suffered for ten weeks the most intense agony with pain in his stomach. When the paroxysms are on he is drawn into a knot, and his screams may be heard hundreds of yards. Sometimes the paroxysms follow each other in rapid succession for hours ; at other times they would appear at inter- vals of two, three or four hours during the day or night. Appe- tite good, bowels regular, no tympanites, no enlargement of in- ternal viscera, nor any other derangement of organs that could be detected, no tenderness along the spine. 4 Fever occasionally in the evening; the child was pale, weak, and despondent; severe purgation on one or two occasions had relieved the symptom for awhile. I was called to this case by the attending physician, and found that the treatment had been very thorough and extended; that there was little room left for any new effort; I advised heroic doses of quinine, iron and morphia, and promised to see the case in forty-eight hours. 3rd. Found the patient much easier, but not free from pain, and his parents said he had frequently been as much relieved for a day or two at a time. I directed 2 gr. of lodoform every six hours, and to shorten the interval one-half' if necessary to subdue the pain. 4th. After taking the first pill the child went to sleep ; awak- ened at the end of four hours screaming terribly with pain, as he always did after the largest doses of morphia. Another pill was administered at once, and then continued every six hours as directed. He has been comparatively easy, having had no severe paroxysms but the one mentioned. 6th. The patient had only a little pain during the night of the 4th, and since then none at all. Medicine continued for a week in 1 gr. doses, combined with same quantity of iron. This boy has not had any return of the disease to this time. Case 2.—Mrs. H., jet. 34. (Reported by Dr. Boyer, of Clear- field, Pa.) Neuralgia of ten years duration ; system much re- duced ; I suggested the remedies usually employed, and she ap- peared to be perfectly familiar with them all, and stated that her general health had suffered from their long use, which was attested by her appearance. I then suggested lodoform and iron pills, and, this being some- thing new, she readily agreed to give them a trial. I ordered her 100 pills from W. E. Warner & Co., 2 to be taken three times a day. The neuralgia rapidly disappeared, her blood-making powers were excited to action, and her health is fast returning. She has just finished the pills, and her husband writes, that “ we are both delighted and astonished that she has had no neuralgia amount- o o ing to anything since she began the pills.” Treatment continued. Under date of Jan. 17, 1870, Dr. N. 11. Chesbrough, of Hobo- ken, N. J., asked my advice in the following case; Case 3.—Mrs. , set 48. “Menstruating, sterile ; has been gradually declining in health since the fall of 1868, when she had a severe illness from bilious diarrhoea and dysentery. About 5 this time an abscess of the labium presented, which was duly opened, but after a time it opened itself into the rectum, causing a recto-labial fistula. She suffered greatly from mere debility, and was constantly growing weaker, when in August last she was operated on for the fistula by incision, and the cut surfaces allowed to heal by granulation. Ten days subsequently symp- toms of irritable bladder appeared, which has continued to the present time in spite of an almost endless variety of treatment. Meanwhile neuralgia has invaded nearly every part of her system, stomach, bowels, chest, arms, face, head, so that you can readily imagine her to be an extreme sufferer. “ Her present sufferings are mainly from gastralgia, uteralgia, and cystalgia; the paroxysms usually setting in at 9A. M., and continuing more or less all day, only so far as controlled or mod- ified by the use of morphia; it requiring 1 gr. to grs. to keep down the pain. Sometimes, in addition, I have to employ opiate enema per rectum and per urethram before the paroxysms can he subdued. “All her organs are believed to be free from disease; bowels in- clined to be loose ; womb pronounced to be all right; complains that most medicines hum her stomach; has never borne iron well, and the smallest quantity of stimulants affects her bladder; has no appetite ; pulse ranges from 60 to 80; the patient has taken a great deal of medicine; at present I am making a trial of the faridaic current, morphia for pain and acid hydrocyan, gtt. 3 before each meal,” This was certainly a perplexing case of terrible suffering. Many physicians have passed through a life-long practice without meeting a case half so troublesome, besides experience has taught me that it is exceeding unsatisfactory to treat patients by de- scriptions of symptoms and person. We are often better able to judge by the mere appearance of a patient than by a long account in writing. Nevertheless, I ventured by return mail on the 20th of January, to advise a plan of treatment, of which lodoform was the basis ; J gr., lor even 2 grains three times a day. I thought she was needing iron, so I recommended the Fe. pr. hydrog. in the same quantity, and, supposing the burning in stomach and distress in bowels to come from acidity, I advised sub. nit. bis. gr. 5 ter in die.; mucilagenous drinks and fomentations of hops to bowels and external genitals. As a convenient and efficient mode of administering the lodoform et Ferrum, I suggested the sugar-coated pills made by Wm. R. Warner & Co., of Philadelphia. Dr. C’s next letter is dated January 24th. Prom it I learn he 6 began the treatment suggested. He says; “ Grave one pill I. and F., 1 gr. each, after supper on 20th; 21st gave two pills after breakfast; 1 after two remaining meals ; 22d none were given, she experienced so much inconvenience and discomfort, causing burning, &c.; 23rd gave J pill three times ; the symptoms in bladder and urethra have increased; she has nearly constant distress in those parts, burning, aching and darting, occasionally darting off in violent paroxysms, continually worse about 9 P. M.; nothing will alleviate these but the injections, per urethram, of grain doses of morphine; last night two such were required, besides 2 pills containing Altogether s. morph, gr. i, ext. bellad. gr. £ ext. hyos. gr. ij. I have used a great deal of bismuth, quinine, strychnine, arsenic, iron in every form, opiates of every kind, in every method, valerian, zinc, assafoedita, mercury, dry cupping from occiput to sacrum. The patient has become pre- judiced against the use of lodoform.” There was certainly nothing very cheering in this letter of the doctor’s for either the patient, Dr. C., or myself; but I answered it at once, urging the importance of continuing the lodoform. Fearing the iron caused some trouble, I requested that it be dropped, and that pure lodoform be made into 2 gr. pills, and that one be given after each meal; also advised 5 gr. American pepsin before each meal to aid digestion, &c., with a few other general directions. The doctor’s next letter is dated January 31st. He says: “Up to the 27th (when he received my last letter) I had only advanced at snails pace in the use of the I. and F. pills, having- given in all but 11 in one week’s time. I had your last prescrip- tions prepared at once, and have given the new pills regularly since, so that 12 of them have been taken. lam unable as yet to discover any appreciable good effects from the drug; her suf- ferings still continue in about equal severity, recurring at present for the most part in paroxysms pretty regularly from about 3 to 10 P. M. daily. lam obliged to give about the same amount of morphia; tastes the medicine (Iodoform) when she belches. I think that leaving off the iron has been of some benefit; she requires something to remove constipation; had her menses last week, free, rather painful, a week sooner than usual; she sits up none, and every day talks of passing away ; her debility certainly increases.” So far no one will accuse me, of having a flattering prospect ahead. Still I was not as despondent as Dr. C. I thought I could discern a faint ray of hope, and I was willing to trust that 7 small ray. I observed that the 35 grains, in all of lodoform that she had taken, in irregular doses and times during 11 days, had forced these pains to mass themselves in the afternoon, as if for their protection, so I advised the doctor to shorten his lines and make another attack; to give one 2 gr. pill of lodoform at 10 A. M., 12 M., and 2 P. M. for a few days; to use the efferv. cit. mag. to move the bowels. Dr. C’s next letter is dated February 14th. He says : “Your prescriptions were faithfully carried out till the Ist inst., (the day after his last letter), the stomach at this time so affected that I was obliged to suspend its use, (fifteen 2 gr. pills had been taken.) It was not resumed till after the receipt of yours in reply to mine of 31st ult. On 4th inst. patient took 3 pills as directed at 10, 12, 2; same on sth inst., and her old enemy has been routed, horse, foot and dragoon. The poor and battered frame still suffers from the consequences of the prolonged malady, and the effects of the struggle in its final grapplings with its antagonist, but the neuralgia as it was is here no longer.” The lodoform was then discontinued, but she continued to suffer greatly from burning distress in bowels, bladder and urethra. Another physician was called in and he decided that these symptoms resulted from the large doses of opiates she had taken and was then taking, so they were discontinued on the Bth inst., and he concludes his letter: “ Her general condition begins to improve every way, and I have no doubt of her steady and gradual amendment and certain recovery.” The necessity of perseverance as taught by this extraordinary case is too obvious to need comment. Case 4.—Miss 0., set. 19, Delaware. I was called to see this case June ’6B. The young lady was suffering from painful men- struation, which had been gradually increasing for 18 months in spite of the best advice she could secure. I have never seen dysmenorrhcea more painful than in this case; for two to four days the patient would be almost frantic. I was called after this attack had a good start, and I done little more than watch the case; directed hop fomentations, 1 gr. ext. hyos., every 4 hours, if necessary. After a careful examination I came to the conclu- sion that this young lady had neuralgia of the womb, which was developed only at the menstrual flow, so I directed her to take in the interval one I. and F. pill twice a day, and ordered fifty pills. July.—The menstrual period of the j>atient has passed without the slightest pain ; menses free at regular time. 8 She was directed to repeat the prescription and take three pills a day for three days preceding her usual menstrual period; she did so, and has had no return of her disease since. In the Medical and Surgical Reporter, January 15th, current year, the reader will find detailed several cases of the severest forms of neuralgia known, treated successfully with lodoform et Ferri. Pil., by Hr. Knotts, of Maryland; Hr. Hamilton, of Ten- nessee, and myself. IN CONSUMPTION. Any medicine that will assuage the sufferings of the phthisical patient, is indeed a boon, hut lodoform offers more; there is every reason to believe that it exerts a most potent influence in discus- sing and removing the disease in its early stages. Certainly it will apply to all those cases where iodine has been heretofore thought especially adapted, with much greater hope of success than has attended that celebrated remedy. And in another class of cases where Dr. Churchill has made considerable reputation for the hypophosphites, it is presumed the average number of cures will be greatly increased by the simultaneous use of lodo- form, if not by its independent exhibition. Case 5. Miss L. LeC.——set. 13. Jan. 10, 67. Ees. Hear Chester- town, Md. High fever, quick pulse, severe pain in right side, bad cough, expectorates thick yellow mucus; on auscullation a cavity is clearly discernible in upper lobe of right lung. The mother says her child has had a cough for a long time. Two or three doctors had said they coidd do nothing for her, that she had consumption and “ liver disease.” The child could not be touched without greatly increasing her cough and sharp pleuritic pains. She had wasted to a mere skeleton, and was one of the most pitiable objects of human suffering I have ever been called to attend. I advised a Turpentine stupe to side, a hot semicupium, and the following prescription ; Syrp. Prun. Yirg. Spts. Yin. Gal. aa |ij. S. Morph, gr. iij. M. Sig. Two teaspoonsful occasionally. Jan. 12. I found the patient much better so far as relief from pain and exhaustion were concerned. I now directed one hun- dred pills of lodoform and iron each one grain, to be given one three times a day, also a cough syrup of sanguinaria, scillte and senega. 9 Feb. 15. The patient has been gradually and rapidly improv- ing; she has gained flesh so that she no longer resembles herself, has no night sweats, no pain and very little cough, is playing cheerfully with her companions. On auscultation I find at upper lobe of right lung an intensely rough wet rale. Eespiration quite good elsewhere. Medicine continued. May 12. I saw this patient a day or two since, and she is to all appearances well. Fat, hearty, active and cheerful; has not complained of pain or cough for nearly two months. There is a little dullness on percussion on upper right breast, and beneath this the respiration is a little rasping; but the abscess has healed. Whatever obstructed breathing may be discerni- ble comes from cicatrix and the remains of inflammatory pro- ducts. Three years have passed since this case was treated and she is yet well and strong. In December of ’6B she caught a severe cold, and her father wished me to see her, as he feared a return of the consumption. I saw her once, and with very little medication she was relieved. I directed fifty of the pills of I. and F. to be taken as before; merely as a safeguard. Case 6. W. K. Merchant. a)t. 32. Wrights X Eoads, Del. I was called to see this man Nov. 30. ’6B, and found him with all the evidences of consumption. He had been able to go about and attend to his business; but now he was quite debilitated, thin in flesh, with diarrhoea, severe cough, pain, etc., and confined to his room. I employed the usual remedies for a few days in allaying some local irritation which was temporarily aggravated; then placed him upon two grains each of lodoform and iron, three times a day with Syrp. Scillfe, Tr. Op. C. and Cupri Sul. for his cough. This patient gradually recovered his strength, appetite and flesh to some extent, so that he was able to attend to his usual business duties, and he remained so during the summer and fall. I do not know how he is doing this winter, though I doubt whether the good impression made on his system will last very long, for he only took the lodoform about one month. Case 7.—J. E. set. 30 Ees. Henderson, Md., called Dec. 30, ’6B. This man was in the last stage of consumption, had been in bed most of the time from first of October. He suffered intense pain in his chest, and after his severe paroxysms of coughing would lie so exhausted that he could not move arm nor limb, and bathed in profuse sensible perspiration. He had been attended by a 10 skilful physician and had received the usual attention and treat- ment: I therefore told him and his family that I could hold out no hope of recovery, that at most I might relieve his pain and possibly palliate to some extent his cough, and with this under- standing I prescribed; lodoform and iron aa griij ter in die, to meet the first indication. 01. Terebin, externally as a coun- ter irritant, with the ordinary syrups internally met the second. This man began to improve at once. At the end of two weeks he could sit up most of the day in a chair. On the first of Feb- ruary he could move about the lower rooms of his house, and at my last visit, Feb. 25, he met me in the yard. In the spring I heard he could give a sort of superintendance to his farming. In the summer I met him taking his fruit to market. He had not taken any medicine for more than three months, and did not up to the time of his death. He died the December fol- lowing. Case. B.—B. S. Male set 28. This case was in the same neigh- borhood as above, and the two cases were as much alike in every particular as any two patients ever were, except that this one had an idiosyncrasy that forbid the use of Iodoform; the smallest quantity could not be tolerated. It is the only instance I have ever known where the use of iodoform had to be abandoned on this account. This patient died in less than a month. Dr. Boyer of Clearfield, Pa., writes “ I have on several occasions in scrofulous cases with hereditary lung taints, prescribed this remedy, and am satisfied that it has, for the time being at least, arrested the disease.” IN SCROFULA. I do not know that lodoform has been used in any case of open scrofula, i. e, ulceration of the lymphatic glands; but sev- eral cases bearing that diathesis, and springing from that cause alone, so far as could be judged by the senses, has been treated successfully. Case 9.—Mrs. M., residence Maryland, ast. 40. Very thin in flesh ; sallow and quite debilitated; for more than a year has been suffering with severe pain in left leg from hip to ankle ; the pain is much worse at night, and she is often unable to sleep until morning, when the pain seems to wear itself out; there are several sores on the leg, which follow in successive crops; they appear as small boils, very hard around the base, and they are very slow in forming; run for several weeks, and heal by a suc- 11 cession of scabs. There is an eruption on the scalp of many months standing; it is dry, scabby and smooth beneath the latter. She has been treated by arsenic, iodide of mercury, tonics, quinine, morphia, etc.; locally by innumerable lotions. Her health was fast failing, and her friends showed much solici- tude. Pill lodoform et Ferri No. c. sig., two to be taken three times a day. 17th—Patient is entirely relieved of pain; sleeps well at night; appetite is improving; medicine continued ; several weeks later the patient made a visit some forty miles from her home, the medicine having been discontinued; while absent the pain in her leg returned, which was immediately removed by the exhibition of the same prescription; the scrofulous sores and skin disease were entirely healed, and did not return during that year at least. Case 10.—Mr. R, near Camden, Delaware, set. 30, carpenter, of strumous habit, had an eruption on his scalp of ten years’ duration ; had taken medicine of several eminent physicians, all of whom had said it was scrofulous. His general appearance and antecedent history fully bore out this testimony. I pre- scribed, on August Ist, pill lodoform et Ferri, No. c. sig., two, three times a day, without any further directions regarding local treatment or general health. Aug. 18th—The patient pre- sented himself this morning looking remarkably well; I said to him : “ Mr. R, your head is not much better, or you would not be back so promptly.” “ Sir, my head is better outside and in than it has been for years,” was the reply, and on examination I found that the disease was at least one half abated. The medi- cine was continued for three months, when no traces of the disease could be seen. I have met the patient frequently during the last two years, and there has been no return of the disease. I am treating now a little girl of 12 years of age, who has a scrofulous eruption of the nasal floor of two years’ standing; for several months she has complained of pain, almost every day, in her right lung; there is rough respiration in that lung; there is also an eruption of the derma. This child looks remarkably well, and on the street would not be selected as an unhealthy or diseased person. She has been treated heretofore, but the only impression made on her system was a partial relief of the cutaneous disorder. I prescribed for this case July 10th. 12 She has been under my care twenty days, taking one lodoform et Ferri pill, ter in die. The nasal trouble has made a marked improvement; the blotched cutis has cleared up, and she says her “side hurts her yet some, but not as bad as it did.” There is still rough respiration, but I think the expiratory sound is not as long as at first. The medicine will be con- tinued, and I have no doubt the patient will be restored to per- fect health. lODOFORM m OPTHALMIA. Case 12.—Miss L. G-., near Bridgton, Maryland, set. 19. April 7. This young lady is of strumous diathesis, light hair, blue eyes and quite pale. She has been suffering from sore eyes for nearly two years ; has a great deal of pain, and as her mother forbade her the use of laudanum, she came to ask me for something else to give her rest. The lower lids are tumid, knotty, about half the hairs are out, and the conjunctival edges are red and slightly everted; the conjunctiva of the eye balls are congested, and on the right one is the shadowing of a pterygium. Most of the pain is in the eyeballs, though probably, as she says, “ if the pain was not there it would be in the lids.” An acrid fluid escapes from the enlarged sebaceous crypts; her temples show the marks of the scarificator, and the mastoid processes bear the scars of repeated blisters. The general functions of the economy are not much disturbed. I directed an ointment of lodoform gr. xxx, Simp. Cerat, Adeps. aa JssM. Ft. Ungt. Sig.—Bathe the lids in warm water fifteen minutes at bed time, and apply the ointment, keeping the lids closed. I also directed 100 pills of lodoform and iron, 2 of the former to 1 gr. iron, two to he taken three times a day; gave full general directions about avoiding everything irritating, as cold winds, dust, lights, work, reading, etc. 23rd—The patient looks better generally, hut her eyes are not much improved in appearance; says that she has suffered no pain for two weeks, and that her eyes have improved a great deal within the last three or four days; treatment; ointment con- tinued, the pills to be 1 gr. each of lodoform and iron, taken as before. May 10—Patient returned much improved; the secretion from 13 the lids has lost its acridity; they are not tumid, nor is the con- junctiva as much congested; treatment, pills continued, one three times a day. Tune Ist—So far as can be noticed the patient’s eyes are well; she says her eyes pain her if she reads; treatment continued for one month. I met this young lady in August, and she was entirely recovered. IN CHRONIC ULCERS. Dr. S. Henry Dessau, resident physician, Philadelphia Hos- pital, in a late essay on this subject; Med. and Surg. Hep. xxn.7, speaking from a large experience, and magnificent opportunity to study and note the results of every plan of treatment, makes use of the following language: “ There is no ailment nor affec- tion in the domain of surgery more trying to the skill of the surgeon than a chronic ulcer. It might almost be called the opprobium of surgery, but fortunately for the reputation of the surgeon and the comfort of the patient, it sometimes gets well.” Case 13.—Mrs. H., jet. 30. Reported by Dr. P. L, Reichard, Chairman of the Sanitary Commission of Lehigh county Medical Society, to the Pennsylvania State Medical Society, 1868. “ The ulceration was of six years duration, and the patient has been under treatment before and since she came to this city, but to no effect. I was called to see her in May, 1867; found her in a helpless condition ; cpiite debilitated, and obliged to be carried about the house like an infant; one ulcer involved nearly the entire ankle; the knee was also much diseased; here the veins were quite exposed, in fact the entire left leg, from the knee to the ankle was affected with ulceration. The patient requested me to amputate the leg that she might find some relief; the sores were undermined; the edges inverted and callous. Notwith- standing the disputed question of the propriety of healing ulcer- ations of this character, I ventured upon making an effort. All that was irreclaimable was removed. My first object then was to bring the ulcer to a simple granulating condition so as to give nature an opportunity to give the healing process locally. I applied the nitric acid lotion once in 48 hours, during the interval I used the cold water dressing (warm disagreed.) In a short time the ulcer presented a granulating surface. I then substituted ungt. hydrarg. nit., diluted, internally; I gave quinine and iron, and a good nourishing diet. Still I found great trouble in keep- ing healthy granulations, they would become sluggish. I tried a number of alteratives such as iodide of potassium, &c. Still 14 the case progressed very slowly, until my attention was attracted to an article in the Medical and Surgical Eeporter on Modoform. lat once concluded to give this remedy a fair trial, I discon- tinued all other constitutional treatment and gave 3 pills three times a day, manufactured by W. E. Warner & Co., and contain- ing lodoform and Ferrum pr. hydrogen aa gr. j. I soon had the satisfaction of seeing my patient engaging in all her household duties. Mot a vestige of the disease is to be seen. The patient is enjoying perfect health, active and lively. I have treated two other cases, one of them of four years standing, with the same good result. In the last case that came under my notice, I saw the same marked effects, but could not push the remedy as far, nor as fast as I should like to have done, as the patient could not afford it. I feel convinced of the efficacy of the remedy.” For other cases see Med. and Surg. Eep., Feb. sth, ’7O, vol. xxii., Mo. 6. I have now under treatment two cases of chronic eczema of the leg, tending towards ulceration. The soreness and pain has been so great as to prevent the patients from walking, except with difficulty, and they could not sleep at night from the same cause. The first application of an ointment, composed of lodoform gr. xxx, adepis. §i. at bed time, produced in each case a good night’s rest, and both cases are rapidly healing by the use of the oint- ment, twice a day, and the internal use of Donovan’s solution. AS A LOCAL APPLICATION. By careful manipulation a solution of lodoform in alcohol and glycerine can be obtained, which will be found an excellent remedy in the painful skin diseases of infancy, particularly those of syphilitic origin. To hot alcohol giij. add lodoform gr. v, stir rapidly till dis- solved, then add at once glycerine £vi., stir and cork. The solu- tion should be compounded in the vial intended to be used, as the lodoform is exceedingly volatile. The solution should be applied with aC. TI. pencil twice or thrice a day. After a few days the lodoform will sometimes be deposited on the bottom of the vial, but it can readily be dissolved by heating. I have had the above solution, however, to stand several weeks without de- positing the iodoform, which I think was due entirely to using care in its preparation. In those fearful syphilitic pains of the *“ lodoform as a Constitutional Remedy.” By Stiles Kennedy, M. D., Med. and Surg. Reporter, Philadelphia, vol. xvi., No. 20. 15 tibia, which occasionally seem to defy all treatment, I have seen most excellent resnlts follow the incorporation of 30 grains lodoform to the ounce of the ordinary plaster and ointments used for syphlitic periostitis, etc. In two cases of chancre I applied the lodoform as a dry powder with magical results; the pain ceased at once,' and the sores healed rapidly. Dr. Besnier, of Paris, in the Bulletin de Therapeutic, ’6B, testifies to the power of this remedy in healing slow cicatrizing wounds, soft chancre, syphilitic ulcerations, and open cancer. The Am. Jour. Phar., ’6B, gives the following as a good lotion, gargle or injection in sore-throat, ozoena, abscess of ear, &c. : Corap. tr. iod. m xlv., cryst. carbol. ac. fu. gtt vi. glycerine gviij. aqua dist gv. M. Put the bottle, well corked, in a water bath 100° P. until it becomes colorless. The efficacy of the above preparation is doubtless due to the chemical change it undergoes. The transformation of the iodine into iodide of formyle (Iodoform) at the expense of the carbon of the acid. An ointment of 30 to 60 grains lodoform to the ounce of lard forms one of the most delightful remedies for the relief and heal- ing of painful burns, sores, skin diseases, chancres, boils, &c. A correspondent of the Medical and Surgical Reporter, Yol. xviii, Mo. 6, writing from Paris, says : At the municipal Maison de Sante, in the service of M. Dem- arquay, some remarkable cases have been recently observed of the beneficial influence of lodoform upon cancer of the uterus. Without in any way hindering the march of the disease, this agent seems able to diminish the suffering to an extraordinary degree. The first case related is that of a patient who entered the Maison perfectly exhausted with hemorrhage and pain. A. basselated tumor occupied the uterine orifice. After a day or two of expectation, the physician introduced into the vagina a suppository composed of ten grammes of butter of cacao, and fifty centigrammes of lodoform. During four or five days no benefit was derived from this treatment, but on the sixth, the suppository was pushed into a cavity of the tumor, and from that day the pains ceased as if by enchantment. Certain digestive troubles disappeared, the patient’s appetite and sleep returned, and very soon she found herself so completely comfortable, that she had no doubt of her rapid recovery. The suppository was introduced every two days during three months, and the comfort of the patient was undisturbed to the last moment. After sev- eral days of extreme feebleness, in which the dying woman never 16 ■ceased to bless the remedy which she believed had saved her life, death supervened, but disguised by the most complete -euthanasia. In another patient, of whom the observation is not yet com- plete, a similar remission of suffering was also obtained. In another letter from the same correspondent, which I have misplaced, he states that Dr. Besnier by the application of the lodoform to a large cancerous ulcer of the breast, actually set up cicatrization when the patient was lost sight of. Dr. Besnier uses the powder by insufflation when treating the womb or the various affections of the mucus membranes. When used in the nasal or pharyngeal passages the dose should be smaller, and mixed with some other powder, as bismuth. It will have been observed that the several gentlemen who have used lodoform, in combination with iron, as well as myself, have used the “Pil: lodoform et Ferri,” made by Wm. R. Warner & Co., Philadelphia, manufacturers of officinal sugar-coated pills, and so far as I know they have been entirely satisfactory. This firm, I believe, is the only one in this country that manufactures lodoform at all. And aside from the experience of quite a num- ber of practitioners, the accurate composition of their pills is attested by one of the leading chemists of the country. lam much indebted to their spirit and enterprise for valuable infor- mation in regard to the chemical relations of lodoform, etc., etc.