Santonin or Santonine. Santonina. C30H18O6. A crystalline neutral principle obtained from Santonica. When pure, it occurs in brilliant, colourless, rhombic, flat prisms, inodorous, of a feeble bitterish taste, scarcely soluble in cold water, sparingly in boiling water, but abundantly in chloroform, boiling rectified spirit, and volatile and fixed oils. The crystals become yellow on exposure to light. On account of the difficulty of procuring it pure, M. Gaffard suggests its use in an impure state, designated Brown Santonin, which is almost equally efficacious and much cheaper than the pure article. It was first obtained by Kohler, of Dusseldorf, in 1830, but was not known in England as a vermifuge till 1844.* Four years subsequently, Mr. Spencer Wells published a paper on its use, and since that time its reputation has gone on steadily increasing, until, by the general consent of most of those who have recorded their experience, it may be pronounced to be one of the most certain, and probably one of the safest anthelmintics we possess.

Med. Prop. and Action. Unless given in large doses, Santonin induces no marked physiological effects; but one which occasionally attends its use is very remarkable, viz , a yellow discoloration of the vision. M. Guepin found that of one hundred persons three only exhibited no modification of vision; about fifty perceived objects yellow for a short time only, about an hour after taking the medicine; whilst in the remainder the vision was more decidedly yellow, which continued for a longer period. In one case this continued for twelve days after leaving off the Santonin. Where very large doses are taken, the yellow discoloration deepens to a red hue. The urine also assumes a peculiar yellow colour. m effects have occasionally, though rarely, resulted from its use. No case of death from its employment is recorded. One case indeed is mentioned,§ in which a child, in Belgium, died after taking Santonin, but it was proved that five-sixths of the fatal powders consisted of Strychnine.

The dose for children under four years is gr. ij. - iv., above twelve years gr. vj. - viij., with an equal quantity of white sugar or in syrup. The Brown Santonin is best given in M. Gaffard's lozenges, each of which contains gr. 1/3 of Santonin. One of these is the dose for an infant of six months old; for older children, the dose is proportionately larger. ||

* Lancet, May 11, 1844, p. 226. Med. Gaz., July 16, 184S, p. 1035. X Bull. de Therap., lviii. p. 500.

§ Med. Times and Gaz., Nov. 26, 1859, p. 553. || Ann. de Therap., 1850, p. 82.

2417. Therapeutic Uses

In cases of Ascarides Lumbricoides, Santonin is invaluable. Its efficacy has been attested by all who have recorded their experience in its use. My own experience with it, which has been very extensive, has been most satisfactory. Kuchenmeister* states that the worm perishes more rapidly and certainly in an oleaginous solution of Santonin than in any other vehicle; hence he directs it to be given in Castor Oil. Dr. Brisbane employed this formula with the best effects, but Dr. Chipperfield did not find it, when thus exhibited, more effectual than when given rubbed up with about thrice its weight of sugar. In many cases no aperient is needed, one or two stools succeeding its exhibition containing the worms, if any were present; still it is the safer plan to administer an aperient a few hours after the last dose of Santonin. Dr. Chip-perfield advises an interval of six or eight hours between any two doses of the medicine, and not to administer more than three doses in succession, allowing a space of three or four days to elapse before employing the medicine again. In this opinion I perfectly coincide. In cases of Ascarides Vermiculares (Thread Worm) its effects are often very striking, though it does not exercise a curative power without the aid of constitutional treatment by Salts of Iron, &c.

2418. In Chorea, Epilepsy, Hysteria, and in many Nervous and Convulsive Affections in Women and Children, Santonin has very frequently, in my practice, disclosed the unsuspected cause of the affection, viz., worms; and the cause being removed by the medicine, the effect has ceased. As an aid to diagnosis in doubtful and anomalous cases, it is of great value. Bouchardat§ considers that it possesses incontestable efficacy as an anti-periodic in Intermittent Fevers, when given in doses of gr. iv. - v. daily. No other testimony in its favour in this character is recorded

2419. In Diseases of the Eye, the peculiar effect which Santonin exerts on the coloration of vision (termed Chromatopsy) led M. Martini|| to employ it in Amaurosis, and the results obtained were so satisfactory that M. Guepin¶ was induced to extend its use to other eye diseases; and he concludes that Santonin given to the extent of gr. xxx. divided into ten doses, taken in a period of five days, produces good effects in the latter stages of Iritis, Irido-Choroiditis, and Choroiditis with plastic exudation, when the inflammatory condition no longer persists. In other diseases of the eye, the results were either negative, trifling, or mischievous. Its use may often be advantageously

* Archiv. Gun. de Med., 4th series, xxix. p. 206.

Med. Times, June 9, 1860, p. 589.

J Madras Quart. Med. Journ., Jan. 1861, p. 78.

§ Ann. de Therap., 1851, p. 147. || Comptes Rendus, March 1860. ¶ Op. cit. and Med. Times and Gaz., Supt. 1, 1860, p. 219.

combined with Atropine and other medicines, as may be required.