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that, after taking an ounce of guarana daily for nearly a week, the bowels continued to act normally. In large doses, it does appear to dispel drowsiness, and is so far an aid to sustained work, by helping a man to begin and continue his work even after a late dinner. What its action on the chemical constitution of the urine may be, I cannot say. In my own case it did not at all influence the occurrence of several slight attacks of phosphatic gravel, to which I am rather subject when more than usually hard-worked.
The following are the details of the experiments on the attendants and myself:
J. D. G, aged 28, unmarried, was a soldier, and had been in India, but is in excellent bodily health.
March 10.-Took half a drachm of guarana at 10 P.M.: no effect.
March 11.-Took a drachm at 10 A.M.: had persistent twitching of the eyelids. Another drachm taken at 10 P.M. He awoke at midnight, and complained of a tightness across the forehead. He fell asleep shortly, and had no return of pain in the head when he awoke next morning.
March 12.-Took a drachm at 10 A.M., another at 3 P.M., and a third at 9 P.M. No result followed, except very slight constipation.
March 13.-Took three drachms during the day, but with no result.
March 14.-Powders repeated as before, and with a similar effect.
On March 15, and the day following, he took three drachms. each day; on the 17th he took four drachms. He might apparently have continued swallowing guarana at the same rate for an unlimited period, but he began to suffer from influenza. The attack was very severe, necessitating his confinement to bed. Some of his neighbours suggested the probability that the influenza was the result of the powders which he had been taking. Accordingly, when he got better of his attack of cold, he exhibited such a disinclination to be again sacrificed for the benefit of science, that I did not attempt to argue with him on the matter.
He bore decided testimony as to the power of guarana pre
venting or removing drowsiness after food. Having been a very abstemious man all his life, he found, on coming here as an attendant, that the very liberal diet, consisting largely of animal food, had a very soporific effect upon him. Indeed, if I mistake not, he got into trouble on one occasion for falling asleep after dinner when he was on duty. He found that a drachm of guarana entirely prevented this heaviness, and he did not experience that feeling of congestion of the head which occurs so often after a liberal meal.
J. G, the brother of the previous case, took an ounce of guarana in drachm doses. He, however, became suspicious, when he observed his brother suffer so severely from influenza, that it was not altogether so harmless a drug as it had been represented to him. He therefore gave it up. It produced no effects upon him, except slight constipation; and he thought he was more lively and readier for work than usual.
Concerning the observations made upon myself, I may say that they were conducted with great care, and were as follows:1. I took the drug for some time, but experiencing no effect, gave it up, that I might begin some observations as to its effect upon the temperature of the body. 2. By a series of observations I ascertained my average temperature for all periods of the day. 3. Having done so, I resumed the use of guarana, and continued the thermometric observations at the same time.
The following are the details of the first series of experiments:
March 3.-At 9.30 P.M. took 30 grs., with no effect; took 30 grs. at 11.30 P.M., and went to bed to read: still not the slightest effect.
March 4.-Took 30 grs. at 9.30 A.M.: no result beyond slight pulsation in head, which was probably not due to the drug. Took 45 grs. at 2.45 P.M.: no result; 60 grs. at 8 P.M.: no result, except that I appeared in unusual humour for continued hard work.
March 5.-11 A.M., 90 grs.: the same at 10.30 P.M. At 11.45 P.M., bowels operated for the first time for about seventytwo hours; a very unusual occurrence for me to be so long constipated.
March 6.-Took four doses of guarana, each containing 90 grs., during the day: no effect.
Omitted drug from 7th to 9th March.
March 10.-At 10.30 A.M., took a drachm; repeated the dose at 4.30, and again at 10.45 P.M. From 9 P.M. until bedtime my head felt rather confused; I was quite "out of sorts," and unable to settle to work.
March 11.-A drachm at 10.30 A.M. Bowels operated at noon; decidedly constipated. At 12.30, took a drachm in beer. During the remainder of the day I felt unsettled, restless, and unable to work with vigour. There was a really distressing fulness and throbbing in the head, chiefly in the temporal regions. March 12.-Took a drachm at 9.30 A.M., another at noon, and a third at 3.50 P.M.: all with no effect.
March 13.-Took a drachm at 9.30 A.M., another at 1 P.M., another at 8 P.M., and a fourth at 11 P.M. Bowels moved normally at 10.30 A.M., and a small motion occurred at 8 P.M.
March 14.-To-day the dose was doubled: two drachms at 9.30 A.M., two at noon, two at 3.30 P.M., and two at 11.30 P.M. Bowels operated normally twice during the day; in the morning at 11.45, and in the evening 10.15.
Being satisfied that but little could result from a continuation of such experiments, I stopped taking the drug, waited for nearly a week, and then began some observations on my normal temperature and pulse-rate. During this time I continued my ordinary duties and diet. For some minutes, on an average for a quarter of an hour, I rested on a couch before taking the rate of the pulse. As nearly as possible, the observations were made at the same hour on each day.
March 21.-9 A.M.: P. 80, T. 98° 6. 12.45 P.M.: P. 78, T. 98°. 4:30 P.M.: P. 73, T. 98°. 9 P.M.: P. 74, T. 97°.8. Midnight : P. 76, T. 98°.2.
March 22.-At 8 A.M.: P. 66, T. 98°4. 1 P.M.: P. 79, T. 98°4. 7 P.M. P. 87, T. 98°.7. 11.35 P.M. P. 74, T. 98°.2. March 23.-At 8:30 A.M.: P. 68, T. 98°4. 12.30 P.M.: P. 74, T. 97° 8. 4 P.M.; P. 78, T. 98°. 10 P.M.: P. 74, T. 98°.
March 24.-At 8 A.M.: P. 70, T. 98°.2. 12.15 P.M.: P. 71, T. 98°. 3.15 P.M.: P. 82, T. 98°4. T. 98°.2.
7.15 P.M.: P. 88,
March 25.-12.30 A.M. P. 80, T. 98°. 8.30 A.M.: P. 66., T. 98°. 3 P.M.: P. 73, T. 98°2. 10.30 P.M.: P. 76, T. 98°.
March 26.-8.30 A.M.: P. 72, T. 98°-2. 3 P.M.: P. 72, T. 98°. 11 P.M. P. 76, T. 97°.8.
March 27.-12.15 A.M.: P. 72, T. 98°2. 8.15 A.M.: P. 70, T. 98°4. 3 P.M.: P. 72, T. 98°-2. 10 P.M.: P. 72, T. 98°.2.
An average of these figures gives the following:
During the morning the pulse was 70, the temperature 98°3; at midday, P. 75, T. 98°; during the afternoon, P. 75, T. 98°1; at 9 P.M., P. 78, T. 98°1; and at midnight, P. 75, T. 98°.
The following are the details of the observations made whilst I took guarana in large doses :
March 28.-At 2.30 P.M., P. 72, T. 98°6. At that time I took a drachm, and at 4.15 P.M. found no change-P. 72, T. 98°·6. March 29.-At 7.45 A.M.: P. 72, T. 98°2; took one drachm. At 8.20 A.M. P. 66, T. 98°4. At 3.45 P.M.: P. 81, T. 98°2; took a drachm. At 5 P.M.: P. 74, T. 98°2. At 8 P.M.: P. 76, T. 98°; took another drachm. At 10.30 P.M.: P. 74, T. 98°. March 30.-At 8.30 A.M.: P. 72, T. 98°2; took a drachm. At 11 A.M.: P. 76, T. 98°. At 2 P.M.: P. 74, T. 98°2; took another drachm. At 4.15 P.M: P. 78, T. 98°. At 7.15 P.M.: P. 89, T. 98°-2; another drachm. At 10 P.M. P. 78, T. 98°.
March 31.-At 7.30 A.M.: P. 74, T. 98°4; took two drachms. At 9.15 A.M. P. 76, T. 98°4. At 12.30 P.M.: P. 71, T. 98°2; again took two drachms. At 1.30 P.M.: P. 70, T. 98°2. At 4 P.M. P. 76, T. 98°; again took two drachms. At 7.30 P.M.: P. 80, T. 98°. At 8.30 P.M.: P. 78, T. 98°; again took two drachms. At 10.30 P.M.: P. 80, T. 98°.
April 1.-The observations of yesterday were repeated, with similar results.
The average of these figures is as follows:-During the morning, P. 73, T. 98°-3; at midday, P. 70, T. 98°2; during the afternoon, P. 76, T. 98°1; at night, P. 78, T. 98°. A comparison of these results with those above shows an almost complete identity.
Although the results of the latter observations have been entirely negative, it is some satisfaction to know that they are trustworthy, the greatest care having been taken to secure accuracy. That guarana is a most efficient remedy for sick-headache is beyond all doubt; and that it may prove useful in asylum practice for other conditions of the nervous system is probable enough, and worthy of extended research.
ON THE TREATMENT OF ENTERIC FEVER BY THE USE OF INTERNAL DISINFECTION.
BY STEPHEN SKINNER, M.B..
IN the following short paper it is my wish to draw the attention of my readers to what I consider the real value of the sulphocarbolate of sodium as a mode of treatment for enteric fever; hoping that possibly some of my brother practitioners may give it a trial, and by their valuable testimony add to or diminish our confidence in the drug.
For it is only by extended use that the true value of a medicine can be properly appreciated. Any private collection of cases, no matter however numerous or favourable they may be, are always open to the objection that they were slight cases, and would in all human probability have got well if left to nature; or to the suspicion that the recorder has been too partial to his remedy, and has, either willingly or in error, aided and abetted in suppressing facts that might possibly put his "favourite " in an unfavourable light. I trust neither of these errors has been mine. I have taken the cases in the exact order in which they occurred-not omitting one-and I think they have all been of the usual type of enteric fever.
In the Practitioner for June 1872, I read Dr. Arthur Sansom's able article on "The Antiseptic Treatment of Smallpox," and I was then so much impressed with his views on the subject of internal disinfection that I resolved on giving it a fair trial in every case of smallpox or enteric fever I could meet with. Since then I have been able to treat twenty cases of the latter disease on this principle, and the result has been so satisfactory