Jodium

[iodine.]

This agent was discovered in 1811 by Courtoir, a saltpetre manu- facturer of Paris. It is so named from iodes (violet-colored), on account of the color of its vapor. It exists in the mineral and vege- table kingdoms — iodide of silver and iodide of mercury are found in nature ; it is found in sea-water ; in salt or brine-springs (in England, Germany, etc.) ; in the algse (sea-weeds, kelp).

Iodine is a crystallizable solid, usually met with in micacious, soft, friable scales, having a grayish -black color, a metallic lustre, an acrid, hot taste, and a disagreeable odor, somewhat similar to that of chlorine. Iodine vapor has a beautiful violet-color and a specific gravity of 8.716. It dissolves readily in alcohol and ether. With starch it forms a blue compound, iodide of starch.

Orfila took two grains of iodine, which caused a horrible taste and loathing; next day, after taking four grains, he experienced, immediately after taking the drug, a constriction and heat in the fauces for a quarter of an hour, followed by vomiting of a yellowish liquid containing iodine, and by a slight tightness about the chest. Six grains caused immediate heat, contraction of the fauces, nausea and loathing, eructations, ptyalism, pain in the stomach and, ten minutes after, a bilious vomiting and slight colic; the pulse rose to eighty-five and even ninety beats; at times the

218 JODUM.

breathing felt oppressed, the temperature of the skin was somewhat increased and the urine a little darker.

After the excessive use of iodine, Zink observed restlessness, excessive heat, palpi- tation of the heart, frequent pulse, violent and continual erections, excessive diarrhoea, unquenchable thirst, trembling, emaciation, fainting fits and death. In another case he found the bowels distended, portions of them very much inflamed, almost as if sphacelated, the internal walls of the stomach were red, excoriated over a space of two inches, the serous coat was thickened and of a looser consistence, the liver was enlarged and paler than usual.

A woman took the tincture of iodine to remove her obesity, six drops three times a day, and afterward thirty drops daily for eight weeks, in all two ounces of the tincture. First she was attacked with a large furuncle between the scapulas and considerable inflammation of the surrounding parts (with loss of appetite and sleeplessness) ; the furuncle detatched itself from the skin after the application of warm poultices, in the shape of hard, knotty bodies, leaving deep and painless ulcers which refused to heal; afterward, she suddenly experienced a violent pain in the big toe of the right foot, increasing in violence and passing, on the day following, to the other toes; the toe which had been first affected became less sensitive, then cold, lastly black, with sudden supervention of a typhoid fever, the gangrene rising up to the thigh with horrid pains, the leg becoming black as pitch and icy-cold, until finally the tibia and fibula broke while the woman attempted to turn herself in bed, the whole limb drop- ping off; every spot which had been scratched became dark-brown, and the ulcerated places, remaining after the furuncles, became likewise gangrenous.

In the Horn. Klinih of December, 1870, the following interesting case of fatal poisoning with iodine is given :

A drunkard, thirty-eight years old, took on January 21, at 7:30 p. m., two ounces of the tincture of iodine, making ninety-six grains of iodine, whereas sixty grains are considered a fatal dose. Soon after, he experienced burning and pains in the fauces and abdomen, especially in the stomach, and vomiting and diarrhoea set in. Con- dition of the patient two hours and a half later : The patient re- clines in the bed in a half-sitting posture ; the face is very pale, sunk in, with glaring, dry, protruding eyes, with moderately dilated pupils, which react; the temperature is cool, especially in the upper ex- tremities ; the nose is icy-cold, the skin 'covered with light, cool perspiration, the abdomen soft, not bloated ; the bladder empty, no priapism.

Pressing docs not increase the pains in the stomach and around the umbilicus, nor is there any hyperesthesia or anaesthesia of the parts; no convulsions or contractions. The cavity of the mouth is pale and dry; the lips and tongue are uninjured, but at the root of the uvula is a small red arch, convex toward the hard palate. The wall of the pharynx is dry, slightly red ; velum and tonsils normal ; the expired air smells strongly of the iodine, especially during vomiting. The patient is conscious and his mind is clear; but the special senses are somewhat disturbed, and there is heaviness of the head.

He complains mainly of precordial anguish, which obliges him to change position constantly ; there is extreme prostra-

JODUM. 219

tion, but not to fainting, and when vomiting, he is able to raise him- self in bed. Respiration is somewhat quickened, normal in the lower lobes; in the upper lobes it is rather sharp, bnt without rales; the voice is weak, but otherwise natural ; the radial pulse is hard and thin; on the carotid it is one hundred and twenty, small and weak, in strong contradiction to the wild, irregular, sometimes inter- mitting motions of the heart, lie vomits every ten to fifteen minutes, and at first without much effort ; later, it takes place at longer intervals, coming on suddenly, but is not very copious; the vomited matter is at first dark, but after taking amyl and burnt magnesia, it became a whitish, thick fluid. Drinking or moving increases the vomiting, which gives him momentary relief ; nausea continues during the intervals, but the precordial anguish remains the most prominent symptom. Liquid stools, like red-brown jelly, smelling strongly of iodine, witli colic and tenesmus.

January, 22 Has had a sleepless night. Morning: The great nerve-centres are free ; increase of the precordial anguish and of the respiration. Temperature cool; pulse 132 and small; great collapse and hippocratic face ; speech stammering, voice hoarse, deglutition difficult.

Severe pain in the epigastrium, in the tymphanitic abdo- men, in the back and oesophagus. Vomiting is less frequent, but discharges of blood take place from the mouth and anus. He has voided about three table-spoonfuls of urine in twenty-four hours, of a dark, reddish-brown color and smelling strongly of the iodine. He is sitting up in bed, is very restless and perfectly clear in his mind.

He died, without agony, thirty-three hours after taking the poison.

Examination after death : There is little blood in the cerebral sinus, but the great veins and the capillaries of the membrane are very full ; the convolutions of the brain are very prominent ; the gray substance very pale and anemic ; the inner substance tough, elastic. The palate is strongly injected ; on the uvula and velum are orange-colored spots, formed by a thin but firm membrane, which can readily be removed ; these spots become confluent on the poste- rior wall of the pharynx, and pass, increasing in size, over into the oesophagus and trachea ; the mucus membrane underlying this formation is hyperemia The surfaces of the epiglottis are covered with strong pseudo-membrane ; here the mucous membrane is eroded, dark red, and full of congested blood-vessels, the sub-mucous mem- brane is oedematous, but tense ; the ventriculi morgagni are closed by swelling, and are covered by a similar pseudo-membrane, injected, and of a deep-red color; there are similar, only discrete, membranes on the vocal chords and the adjacent larynx ; the trachea is clear. The bronchial tubes, even to their most minute ramifications, are inflamed and filled with tough mucus; the lining mucous membrane is not oedematous, but highly swollen and injected. At every in- cision numerous small specks of mucus appear, looking like pus.

220 JODUH.

Well-defined, acute emphysema exists all through the lungs ; the parenchyma and the veins are deficient in blood. The heart is large ; the pericardial space small, without serum ; the left ventricle hypertrophied ; small cavities with partly coagulated blood. * * The mucous membrane of the cheeks and tongue is free ; but the whole oesophagus down to the stomach is covered by a false mem- brane, tough, of orange-color, which can be removed. The stomach contains a quantity of orange-colored mucous fluid ; the swollen mucous, membrane is of the same color ; the glands have a capillary extravasation at the center of every acinus ; all around, the mucous membrane is spotted, as if infiltrated by exudation ; other- wise it is normal; the color is normal; the mesenteric glands are anaemic; the peritoneum pale, moist, without a vestige of inflam- mation ; the liver that of a drunkard ; the ureters normal ; the bladder strongly contracted, empty, without the smell of iodine.

Chemical analysis showed iodine all through the intestines, especially in the stomach and colon, also in the blood of the hepatic veins and in the urine, but none in the bile. We have then, first, an exquisite picture of a croupous diphtheritic process in the larynx, pharynx and oesophagus : second, during life, a strong cardial reaction ; third, a remarkable diminution of urinary secretion, without any- thing in the kidneys; showing therefore a deep alteration of the nervous and other tissues.

Oowperthwaite gives the following clear and concise analysis of the action of jodum : It acts especially upon the ganglionic nervous system and through it upon the glandular and mucous tissues, having a depressing influence, impairing their reproductive energies and producing functional embarrassment, atrophy and even total destruction of the part. So, also, in some instances of glandular action, notably upon the thyroid, do we find the loss of reproductive and functional power resulting in cellular hypertrophy, the gland assuming the proportions of a morbid growth due to the same causes that will at other times produce atrophy.

The action of iodine upon the glands is more especially centered upon the thyroid, the mesen- teric, the mammae, ovaries and testicles. Of the mucous membranes its action is most prominent upon that of the respiratory tract. The leading expression of the drug is emaciation, both local and general, which accompanies nearly all iodine conditions.

CEREBRAL GROUP.

Jodum has caused : a painful pressure in the forehead and occiput, terminating in confusion of the head, followed by gnawing hunger and a discharge of loose feces. Throbbing in the head at every motion. Pain in the forehead and top of the head, increasing at

JODUM. 221

every noise. Vertigo, with congestion toward the head, violent headache, heaviness of the head. Frontal headache with stitches in the eyes and ears. Iodine is a valuable remedy in

NERVOUS HEADACHES, especially chronic ; headaches of old people and of scrofulous persons. The headaches are often accom- panied by falling off of the hair, worse from motion, conversation, in the warm room, relieved from the application of cold and eating. Concomitant symptoms are: sadness, emaciation, glandular indura- tions, constipation.

NERVOUS GROUP.

The action of iodine upon the nervous energy of the reproductive system is exceedingly depressing ; if the iodine is continued in suffi- cient quantity and for a length of time, an universal emaciation seems to be a very common result. The breast, testicles, the cellu- lar tissue and the parenchyma of organs have been known to dwindle away under the action of iodine. We may avail ourselves of this indication in the treatment of

MARASMUS OR ATROPHY, especially when the emaciation is attended with another characteristic effect of iodine ; we mean

TREMBLING OR TREMOR of the limbs. Gardiner observes that iodine causes : trembling of the limbs, resembling chorea and sometimes lasting a long time.

MARASMUS OF CHILDREN".— In the marasmus of children, of hysteric women, of drunkards even, iodine may render us eminent service if the patient trembles from attempting the least muscular effort, with hectic fever, slight chills followed by heat and dryness of the skin, loss of appetite, dizziness, headache.

HYDRARGYROSIS Marasmus as a form of hydrargyrosis, if the previously described symptoms are present, will find in iodine one of its powerful antidotes. We read that the abuse of iodine has caused a general trembling of the extremities and muscles of the back. The trembling commences with slight tremor of the hands, gradually invading the larger muscles of the arms and back ; the gait is unsteady ; the hand trembles to and fro when carried to the mouth ; the movements of the body are painful ; the patient is able to hold the trembling limb quiet if he does not attempt to move it.

These symptoms point to the use of iodine in

MERCURIAL TREMOR, which very much resembles the iodine- trembling in many essential features.

222 jodum.

We see it stated that a man who used iodine for impotence, was attacked with paralysis of the lower extremities.

Wallace informs us that iodine, after first causing headache and indigestion, then affected the muscular equilibrium, causing tremb- ling and afterward paraplegia.

PARALYSIS OF THE EXTREMITIES.— Effects like these may lead us to employ iodine in paralysis of the extremities, one or more, if the affection is the natural consequence of deficient innerva- tion, a gradual sinking of the reproductive energies in consequence of care, poverty, exposure.

In Htif eland? s yonmal several cases of paralysis are described which were cured with iodine. One is the case of a poor woman who had lost the use of her lower limbs in consequence of care, hard work and exposure. The lower extremities had become atrophied and contracted to such an extent that the soles of the feet almost touched the glutei muscles. She suffered great pains in the limbs which seemed to proceed from a belt-shaped region in the abdomen, whence the pain spread to the legs and feet.

Under the use of iodine, three times a day, a t.easpoonful of a solution of five grains in two ounces of water, the patient gradually recovered the perfect use of her limbs.

INFLAMMATOKT GEOUP.

Poisonous doses of iodine produce inflammation, ulceration and even gangrene of the intestinal mucous membrane.

A lady of twenty-six years undertook to kill herself with two drachms of the tincture of iodine. She experienced a burning and dryness from the throat to the stomach, with tearing pains in the epigastrium and fruitless attempts to vomit. Her face was flushed, her eyes weeping ; pulse contracted, small ; she complained of violent pains in the stomach that were made much worse by pressure. After haviug obtained relief by antidotal treatment, the pain shifted to the bowels along the tract of the colon.

GASTRO-ENTERITIS— These symptoms denote inflammation of the mucous lining of the digestive tube. It is only in a few cases that iodine may be available in gastro-enteritis ; in rheumatic inflam- mation of scrofulous children, for instance, it would be perfectly justifiable to use aconite or iodine ; this treatment might likewise be pursued in a case of inflammation induced by abuse of alcoholic stimulants.

SCROFULOUS INFLAMMATION OF JOINTS, knee, hip, elbow and other joints, may require iodine for their cure. The joint is swollen, looks red, more particularly of a dark-red color; effusion ma}7 have taken place. The patient complains of great pain, an aching, throbbing, sore pain. The inflammation is of a torpid character, the fever moderate.

jodum. 223

orbital group.

Iodine affects the sense of vision with considerable power.

Wallace has observed : trembling and oscillatory vibrations in the eyes.

In Frank's Magazine we read of a lady of thirty-two years who took iodine for goitre. She was attacked with excessive sensitive- ness of the retina, photophobia; objects appeared in a flaming, fiery aud dazzling light ; the candle-light was painful to the eyes.

Another observation by Wallace is that of a captain who, while under the effects of iodine, saw nothing but the white paper while reading print ; after he had got to the end of a phrase, the com- mencement of it would become visible.

AMAUROSIS.— Here we have delineations of peculiar forms of amaurosis which may occur as symptoms of scrofulosis, or as the development of some other constitutional, perhaps arthritic diathesis, and which may yield to iodine as their typical representative.

NASAL GROUP.

According to Jahr, the vapors of iodine exercise an inflammatory action upon the Schneiderian membrane and upon the lining mem- brane of the mouth and larynx, with violent coryza and cough, stupefaction, vertigo, ringing in the ears, sparks, headache.

CATARRH. — This group of symptoms may represent a sort of acute catarrh of the Schneiderian membrane for which iodine may prove a curative.

OZiENA. — Iodine is useful in ozasna whether of scrofulous or syphilitic nature. In

FETOR OF THE NOSE, arising from putrid ulceration of the Schneiderian membrane, in scrofulous subjects, iodine is eminently curative. In the case of a girl of eleven years, who had been afflicted with a most abominable odor from the nose for about two years, and loss of smell, small doses of the tincture of iodine effected a perfect cure.

BUCCAL GROUP.

Iodine causes ptyalism which differs from mercurial ptyalism in this, that it neither causes stomatitis, nor the fetor which is charac- teristic of mercurial salivation. It is a remarkable fact that, in spite of its acknowledged faculty to excite ptyalism, iodine is recom- mended and used by alloeopathic practitioners as one of their most efficient antidotes to

224 jODUir.

MERCURIAL PTYALISM AND STOMACACE. In Rufe- land's Journal and in other publications a number of cases are reported, where the internal use of the tincture of iodine in various doses, from two to five and more drops three or four times a day, effected a perfect cure.

In one case, the gums were entirely disorganized, transformed into a whitish pulta- ceous mass, covered with ulcers, teeth loose, copious ptyalism and very offensive fetor; the patient looked sickly, emaciated, with a quick and small pulse. Six grains of the pure iodine were made into pills by working them with a little gum, three of which the patient took, four times a day. He was completely restored after having taken twenty-four grains of iodine in all.

SEA-SCURVY — In Huf eland's Journal, a Berlin physician recom- mends iodine for sea-scurvy and likewise for

PURPURA HEMORRHAGICA which is regarded as a devel- opment of the scorbutic diathesis by many pathologists. The most celebrated anti-scorbutic agents contain iodine. The flesh of the turtle, for instance, which is recommended as excellent anti-scorbutic nourishment, is rich in iodine. The Greenlanders use for scurvy sea-algese which they prefer to scurvy-grass or cochlearia.

PHARYNGEAL GROUP.

CHRONIC SORE THROAT — Joerg and his pro vers found that iodine causes a scraping and burning sensation in the fauces, extending even down the oesophagus. Orfila experienced con- striction of the fauces. We may avail ourselves of this indication in certain forms of chronic sore throat, with incipient chronic bronchitis. ¥7e shall afterward see that in inflammatory irritations of the lining membrane of the air-passages iodine is a valuable agent.

CHTLO-POIETIC GROUP.

Orfila, when experimenting with four-grain doses of iodine, ex- perienced a horrid taste in the mouth, and vomiting of a yellowish fluid containing iodine.

Jcerg and his disciples have furnished some valuable hints regard- ing the use of iodine in gastric affections.

BULIMY.- — One of the permanent effects of small doses of iodine in the case of every prover was a sort of unnatural canine hunger. Guided by this symptom we may prescribe iodine in bulimy, especially when accompanied by emaciation. This condition is a peculiar species of marasmus which may find its remedy in iodiue.

Other prominent symptoms in the case of Joerg and his provers were : saltish taste in the mouth, musty eructations and a remark- able sympathetic relation between the head and stomach and bowels.

jodum. 225

Aching pain in the forehead ; after it had disappeared, the canine hanger set, in followed by discharge of thin feces. Tension in the stomach and bowels, slight oppression on the chest ; large and full pulse and lastly, cerebral congestions. Frequent attacks of headache after dinner ; he also experienced cutting pains hi the umbilical region, with papescent stools and succeeded by a feeling of embar- rassment in the back, ascending along the nape of the neck to the head.

INDIGESTION. — These groups of symptoms present indications for the use of iodine in various forms of chronic indigestion or dys- pepsia characterized by similar paroxysms. The nature of these paroxysms seems to be venous congestion, aud a peculiar irritability of the absorbeut or lymphatic system resulting in a sensation of morbid hunger and diarrhoeic stools.

Most of Jcerg's prove rs experienced diarrhoeic discharges from the use of small doses of iodine. One of the provers records this symp- tom : rumbling in the bowels, hunger and discharge of thin stool. Another : frequent pressing and liquid stool. Jcerg records : fetid flatulence, and papescent stools, with burning at the anus. In the

DIARRHCEA OF SCROFULOUS CHILDREN, with thin fetid discharges, distention of the bowels, pinching and cutting pains, iodine has been used with advantage.

Let me recall to your attention the fact that the provers of iodine have established the dependence of certain abnormal conditions of the digestive tube upon certain abnormal conditions of the brain. Frontal headache, equivalent 'to venous engorgement, was succeeded by pains in the bowels and liquid stools, equivalent to abdominal venous congestion. We have availed ourselves of this sympathetic action as a valuable indication for iodine in that form of

CHOLERA INFANTUM which speedily leads to marasmus and death from cerebral exhaustion. The discharges may be thin, fetid, or even bloody and purulent, accompanied with pains and pressing and symptoms of cerebral derangement, boring of the head into the pillow, rolling of the head, comatose drowsiness interrupted by sudden screams. In

CHRONIC DIARRHCEA depending upon a diseased condition of the mesenteric ganglia, iodine may render us important service.

JAUNDICE. — Iodine has been found a valuable remedy in cer- tain diseased states of the liver ; it is used more particularly in the treatment of jaundice with "dirty-yellowish skin; great emaciation;

VOL. II. — 14.

226 JODUM.

downcast, irritable mood ; yellow, almost brown color of the face ; thick coating of the tongue; much thirst; nausea; white, diarrhoeic stools alternating with constipation ; dark, yellowish-green, corroding urine ; after mercurial poisoning ; organic lesions of the liver ; dys- cratic states of the system with hectic fever." (Raue.)

Mrs. B., aged thirty-five, of nervous temperament, of medium height, weighing 165 pounds when in good health, came to me after having been an invalid for nearly three years and now weighing about ninety pounds. She had been completely jaundiced for a year and a half. There was nausea and vomiting after eating, with intense, canine hunger all the time.

Every third day she had a violent attack of gastrodynia, which she thought could only be relieved by an emetic. Frequent, empty eructations, heart-burn after eating solid food, distention of the stomach, pain when pressing upon the epigastrium, pain in the right hypochondria, extending through to the lower margin of the right shoulder-blade ; constipation, urine scanty, dark and turbid ; menses had been absent for the last six months. Iodine, first dec- imal dilution every four hours, and at a later date the same remedy in the 30th attenuation, acted so promptly, that the patient was discharged cured in three months, nor has there been a relapse of the disease during the fourteen years elapsed since then.

(Dr. J. O. Moore, in New Eng.

Med. Gazette, October, 1875.)

According to Joerg, small doses of iodine cause an increased secre- tion of thin, watery urine, or frequent discharges of small quantities of urine. From larger doses the urine assumed a dark, greenish- yellow color.

CHRONIC STRICTURE OF THE URETHRA, iodine has been employed with excellent effect.

SEXUAL GROUP.

IMPOTENCE WITH ATROPHY OF THE TESTES— Iodine has caused impotence with atrophy of the testes. Hence in this affection iodine may prove of great use.

Small doses of iodine cause violent and continued erections. We may therefore find this agent useful in cliordee-like erections when caused by mercurial poisoning.

INDURATION OF THE TESTICLE, as a symptom of a general scrofulous habit, may yield to the use of iodine.

A man of sixty years, asthmatic, was attacked with swelling of the parotids and other glands, mesenteric, inguinal, etc., whenever he took cold. After perspiring

jodum. 227

DYSMENORRHEA attended with colicky pains and violent headache, iodine has been found useful. It had a tendency to remove the pain and to increase the discharge to a normal quantity.

In one case of dysmenorrhoea, the menses were preceded by rising of heat to the head, palpitation of the heart, tension and bloating of the neck.

AMENORRHEA, as a sign of general scrofulosis, may be reme- died by iodine. It is particularly in the case of lymphatic women, afflicted with bad digestion, costiveness, distention of the bowels, oppression of breathing, palpitation of the heart, dizziness and head- ache, that iodine will prove useful.

The remarkable action of iodine upon the female organs of gene- ration has led to its use in several important disorders, particularly in metritis, chronic vaginitis and leucorrhoea.

CHRONIC VAGINITIS, especially in the case of scrofulous women. The mucous lining feels hot and sore, occasionally with stinging pains, a sense of fulness in the vagina, and yellowish, thick and perhaps fetid leucorrhoeal discharge.

LEUCORRH02A in thin, delicate, scrofulous women who suffer from indurations of glands and of the uterus and from chronic

228 jodum.

inflammations of the uterus and ovaries. The discharge is corrosive and is particularly profuse between the menses.

CATARRHAL GROUP.

CROUP. — "We may infer from these symptoms, that iodine has a striking effect upon the laryngeal mucous membrane, and that it may prove useful in affections of this tissue characterized by con- gestion and inflammation. Hence we use iodine with great advan- tage in croup, especially in that stage of croup, where the exuded lymph begins to become consolidated as an organized artificial mem- brane, with suffocative wheezing and a fully developed croupy sound during the inspirations. In

CHRONIC LARYNGITIS, with hoarseness, aching and sore pains in the larynx, and even occasional paroxysms of spasmodic cough emanating from the larynx, with discharge of lumps of hardened mucus, iodine may prove useful. Even in

LARYNGEAL PHTHISIS, if the previously described symptoms exist, accompanied with burning distress and expectoration of bloody and purulent mucus, iodine may still prove useful, especially in the case of scrofulous and syphilitic individuals. In

CHRONIC BRONCHITIS, with paroxysms of tearing, suffo- cating cough, violent tickling in the throat-pit, spasmodic con- striction, burning sensation in the air-passages, wheezing breathing, expectoration of frothy, blood-streaked, or even purulent mucus, iodine may do much good as long as no decided hectic fever appears.

THORACIC GROUP.

According to Joerg and his provers, iodine causes tightness, pres- sure and burning in the middle of the thorax, also in one side of the thorax, with dry cough and rheumatic pains in the arms, in the region of the neck and trunk.

It also causes hoarseness, stitching pains in the chest, with frequent paroxysms of deep and dry cough.

In the case of Orfila, two-, four- and six-grain doses of iodine caused asthmatic oppression, a more violent and rapid beating of the heart, increased frequency of the pulse.

JODUM. 229

In the case of other persons, iodine has caused a violent beating of the heart, with fainting ; relief being obtained by resorting to an horizontal position.

Another effect of iodine is recorded as a sensation as if the heart were squeezed.

The action of iodine upon the heart is simply indicative of con- gestion either of the ventricles or of the coronary arteries ; the squeezing sensation may be ascribed to congestion of these vessels. Palpitation of the heart may be an accompaniment of pulmonary phthisis.

We know that the development of tubercular phthisis sometimes

goes hand in hand with the disappearance of goitre, whence we infer

that iodine may develop, and, therefore, in certain conditions, act as

a curative agent in tubercular phthisis.

A girl of twenty-four years had been afflicted with glandular swellings for some years, without manifesting a trace of phthisis ; she took iodine internally for some months, and the swelling disappeared ; but in their places a dry cough set in which increased gradually and was accompanied with a feeling of heaviness and tightness in the chest and a sometimes blood-streaked expectoration ; the pulse was rapid, feverish, and the patient speedily died of pulmonary phthisis. This case is reported in Frank's Magazine, where the phthisis is alluded to as an effect of iodine.

TUBERCULOSIS OF THE LIVER.— In another case, the disappearance of goitre under the action of iodine seems to have developed tuberculosis of the liver.

A girl of twenty years was cured of goitre ; but stitching and aching pains in the liver supervened in its place ; her appetite became less, she grew thin, the menses became irregular, and she died with the symptoms of hepatitis, the character of which, it seems to me, must have been tubercular.

FEVER GROUP.

Iodine is not properly speaking a remedy for fever. The fever to which iodine is homoeopathic, is of a symptomatic character; it is a fever incident to other pathological conditions such as phthisis,

230 JODUM.

marasmus, rheumatism, etc. It may subserve its purpose as a symptomatic indication, but in iodine-affections it holds a secondary rank.

A lady of thirty-four years, after the moderate use of iodine, was attacked with a fever, dryness of the skin which was cold rather than warm; soft and hurried pulse, delirium, subsultus tendinum, grasping at flocks. The iodine being discontinued, the fever gradually ceased; in a few weeks the iodine was resumed, and the fever returned.

BXAKTHBMATOUS GKOUP.

GLANDULAR TUMORS, indurated, may yield to the continued internal and external use of iodine, especially if other medicines, such as belladonna, conium, aconite, etc., prove insufficient.

ENLARGEMENT OF THE LIVER, with stitching and aching pains in the region of this gland, in scrofulous subjects, and more particularly if this enlargement is a symptom of a generally de~ veloped scrofulous diathesis, may be advantageously treated with iodine.

RANULA may be treated with iodine. Apply the tincture of iodine externally several times a day.

JODTJM. 231

HYGROMA of the knee has been treated in a similar manner.

You recollect that iodine causes gangrene. We may derive ad- vantage from the use of iodine in

GANGRENE of the extremities, especially in rickety subjects, in the case of injuries, if the gangrene arises from want of care, or in persons tainted with a gangrenous dyscrasia. In the gangrene of old people, technically termed

GANGRENA SENILIS, we may be able to use iodine with good effect.

Lastly I may mention the good effect which iodine has produced in the treatment of certain affections of the scalp, more particularly

PHTHEIRIASIS, or the lice-malady, with which scrofulous chil- dren, who are not kept perfectly clean, are sometimes attacked. The internal use of the tincture of iodine, in conjunction with cleanliness, will cure this loathsome affection.

MENTAL GEOUP.

Doctor Gardiner says that he has seen iodine cause great and lasting auxiety of a peculiar character, referring to the present rather than to the future. Hence we may find iodine useful in certain forms of

HYPOCHONDRIA, where these forebodings prevail.

S32 KALI BICHKOMICUM.