J.N. Bredin
1887 The Lancet  
367 10,000 cases of these diseases with this agent, with the happiest results. So uniformly successful has it been that ' I I have in our very extensive practice here, given up the use of quinine and the cinchona alkaloids for the treatment of intermittent fever, and have substituted picrate of ammonia for them. A record was kept of 5000 cases of intermittent fever treated with this agent. Of this number, in nine cases only did it fail to cure, and in these quinine succeeded at once. 1 usually
more » ... ive it in doses of from one-eighth of a grain to a grain and a half four or five times a day in pill. Half a grain is a fair average dose. Thus given the result is soon visible. In the great majority of the cases treated, half-grain doses in the interval prevented the recurrence of the next attack of the fever, while in about 20 per cent. of the patients two or three attacks followed before the fever ceased. In one case of quartan ague, despite large doses of the salt, the fever recurred for six periods, gradually diminishing in intensity, and then yielded to it. It is equally successful in all the forms of ague, but it is a curious fact that the cases in which it failed to cure were all of the tertian variety. I have also employed this agent in the treatment of twenty-five cases of malarial neuralgia of various nerves, six cases of malarial headache, and one of malarial colic. In all these instances it cured completely and speedily. In remittent fever it does not appear to be of use; six cases of a severe type were treated with it without any effect. Neither is the enlarged spleen of ague benefited by it. I have given it in numbers of such cases in conjunction with ergotine with good results, but such results are secured equally by the use of the ergotine alone. ' My experience leads me to the conclusion that in all varieties of intermittent fever, and in malarial neuralgias, picrate of ammonia is a valuable antiperiodic, and it is an efficient and perfect substitute for quinia. It has the following advantages over quinine :-1. It is much less expensive. This is an important consideration where, as in Indian practice, hundreds of cases of malarial diseases have to be treated annually. 2. The dose given is very much smaller. 3. It does not produce the unpleasant effects that quinine does-headache, deafness, tinnitus, &c. nor does it disorder the digestion or cause nausea, as quinine is apt to do, in the doses in which it has to be given in India. IN THE LANCET for 1886 two cases of recovery from tetanus (traumatic) are referred to. I had myself a short time ago a successful case. On Sunday evening, Nov. 7th, I was called to B. B-, a a tall powerful man about the age of thirty, and found him suffering from pronounced tetanus, with eyes fixed and staring, hands clasped behind the neck and quite rigid, and opisthotonus so strong that four people could with difficulty keep him down when the spasms were violent, those of the diaphragm being agonising. I placed him under the influence of chloroform, and administered within a short time two drachms of bromide of potassium, together with one drachm of chloral hydrate. I remained with him nearly three hours, when he became quieter and had no more spasms. He was quite well in two or three days. His friend s did not know of any wound, but the man explained that in cutting a corn under the right great toe he had cut painfully into the quick three or four days ago. He was a night watchihan at that time and much exposed to the weather. Ravensthorpe, Yorks.
doi:10.1016/s0140-6736(02)23574-6 fatcat:dxnok3enize35pj2o7jmfflovu