Guaiacol, topically, as a prophylactic against diphtheria / by Solomon Solis-Cohen.

  • Solomon Solis-Cohen
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Guaiacol, topically, as a prophylactic against diphtheria / by Solomon Solis-Cohen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    visits to the ward and on their return there- from. The attendants of the manse did not come in contact with the outer world in any sense. When the first case developed, the building was isolated ; the people of the third floor where the disease originated were not allowed to communicate with the people of the second floor. In other respects, the building was used as it had always been, but, it may be re- peated, was isolated from any communica- tion with the other buildings.^ As stated, cases of diphtheria continued to occur in the Manse at intervals of a few days. At the request of Dr. Barr, conveyed through Dr. .DeForest Willard, chairman of the Hospital Committee, I visited the insti- tution on the evening of November 8, 1894. Every recognized method of precaution and prophylaxis was found in force, and the treat- ment of the sick children, concerning which my colleagues on the medical staff, Dr. J. Madison Taylor and Dr. D. T. Laine, had likewise been consulted, was such as to com- mand entire approval. Being pressed by Dr. Barr for a possible improvement in prophylactic routine, it oc- curred to me that perhaps guaiacol, the most active therapeutic constituent of creosote, which I had repeatedly tested upon mucous membranes and found to be devoid of caustic properties and decidedly beneficial in the treatment of septic and ulcerative processes, might prove useful, either in destroying the germs of diphtheria or in rendering the throat an unfruitful soil for their propagation. At all events we agreed that it was worth the trial. Merck's guaiacol was obtained, as some of the other preparations found in the shops contain caustic impurities. It was to be used in full strength, or diluted one-half with glycerin or olive oil, according to the 1 The quarantine of this building was not removed until January i, 1895, ^'^'er very thorough cleansing, disinfection and fumigaiion. susceptibility or tractability of the children. From the time that the applications of guaia- col were begun, but two additional cases occurred, both exceedingly mild. I append a brief but sufificiently detailed report from Dr. White, and Dr. Barr's reply to my query of: Post hoc or propter hoc ? REPORT OF DR. FRANK WHITE. During our recent epidemic in the Manse the prophylaxis was as follows : Careful atten- tion to cleanliness, maintenance of even tem- perature and freely changing the air of day rooms. The dormitories and bedding were always carefully aired daily, and the strictest watch kept over bedding. The children on the third floor (where the trouble originated) were carefully examined twice daily (morning and evening), and throats were all painted with a solution of hydrogen dioxid. This treatment was being carried on, with a case developing now and then, when, at the sug- gestion of our Dr. Cohen, guaiacol was sub- stituted. The first application of guaiacol was made to 64 children on November 9, 18^4. A small wad of cotton was wrapped on a probe, then dipped in a 50 per cent, solution of guai- acol and the drug painted on thoroughly over the sLU-face of tonsils and posterior wall of pharynx. The closest attention was given to small cup-shaped cavities and sinuosities of tonsils, as it was noticed that all cases that developed were in children that had had, at some previous time, inflammatory trouble in this locality. The cases, the next day, on going over the throats, presented an appear- ance of general hyperemia—and brighter children complained of an astringent sensa- tion and a feeling of soreness of the upper pharyngeal tract. The throats were painted twice a week, and no suspicious case was noticed until No- vember 27, 1894, when a boy on the second
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