Excerpt from The Medical Analectic, Vol. 6: A Monthly Epitome of Progress in All Divisions of Medico-Chirurgical Practice

Taste, however, is practically abolished in most cases of enteric fever, and the patients to whom I gave it in milk make no complaint on this score.

Out of seven cases, four, of whom two were boys of twelve, took the drug in doses of 31/2 grains every two hours during the whole course of the disease, until the temperature remained normal for five or six days: one boy aged ten took gr. iss instead of gr. iij doses. In two cases the naphthol had to be discontinued before the termination of the fever. In addition antifebrin or phenacetin was administered in the manner stated above.

The patients' ages varied from ten to thirty-two years. Taking first the five cases in which naphthol was given throughout the illness, the average duration of fever, reckoned from the first appearance of spots to defervescence, was thirteen days. Diarrhoea was in all slight, and the stools became at once very much less offensive than before naphthol was given, though still retaining the characteristic appearances and alkaline reaction of typhoid evacuations; there was never more than a moderate degree of abdominal distension, this symptom, when in marked degree on admission, showing diminution in a few days. The tongue cleaned early, and there was not the usual degree of dryness of the lips and mouth, nor of the dirty brown fur so often found on the tongue towards the end of the second week and succeeding the period of fever. Enlargement of the spleen was not detected in four of the cases, and only in slight degree in one. There was certainly less pain and tenderness in the abdomen than is generally found, and no albumen was present in the urine.

As to temperature, it followed the usual course, the highest range being from 103.5° - 104.8°F. There was a varying amount of bronchitis. One of the boys complainad in the third week of the disease of pain in the stomach after his milk, so the naphthol was stopped for two days, and was then continued wirhout further trouble.

It might certainly be anticipated that naphthol in checking the abnormal fermentations taking place in the alimentary canal, would also hinder the normal fermentative process of digestion, and give rise to dyspeptic disturbance. Although I believe that this does not occur in the majority of cases, in the two following instances the use of the drug was stopped on this account. The first patient, a girl of twenty-three, was admitted with irregular rises of temperature ranging from 101° - 103.40°, but with no spots or other symptoms of enteric fever. The stools, dark, liquid, and offensive, were rendered at once almost odorless by the administration of naphthol. After eight days she improved, and the temperature became normal during the two following days; it then began to rise, and the typical symptoms of an attack of typhoid developed themselves, the spots appearing on the seventh day from the commencement of the rise of temperature; on the fifth day of this period the naphthol, which had been steadily taken from the day of admission, was discontinued on account of its exciting pain and vomiting. The vomit consisted of a large amount of very firm hard curd, barely corroded by the gastric juice, indicating perhaps that the action of pepsin was interfered with.

In the second case a relapse occurred eleven days after defervescence from a mild first attack; the patient had been taking naphthol during the whole twentythree days occupied by the first attack and subsequent apyrexial period, and appeared to be convalescent, until a severe relapse occurred lasting four weeks and nearly proving fatal. On the sixth day of the relapse there was much pain in the lower part of the abdomen, considerable distention and vomiting: naphthol was therefore stopped, and the pain and distention became less, whilst the vomiting ceased on the foll..