Preparation

Creasote is one of the products of the destructive distillation of wood. it exists, therefore, in smoke, which owes its preservative property to this ingredient, and it enters into the constitution of tar. it probably results from the decomposition of resinous matter. I have before stated my belief that, if ready formed in tar, it must exist so combined as to neutralize its most extraordinary properties. it is procured by distilling tar, treating the empyreumatic oil thus obtained with carbonate of potassa, decanting an oily liquid which separates, and submitting this to a complex process, in order to purify the creasote. (See U. S. Dispensatory.)

Properties

When pure, creasote is a colourless liquid, of an oily appearance and feel, leaving a greasy stain upon paper, which, however, is not permanent. As found in the shops, it is often brownish from impurity. it has a very peculiar, strong, diffusive, permanent, disagreeable, empyreumatic odour, and a hot, unpleasant, acrid, almost corrosive taste. it is somewhat heavier than water, volatilizes on exposure, boils at 397°, burns with flame, and is soluble in alcohol, ether, the volatile and fixed oils, naphtha, acetic acid, and alkaline solutions. it dissolves iodine, phosphorus, sulphur, and the resins. With water it forms two combinations; one containing 1 part of creasote in 80 of water, the other 1 part of water in 10 of creasote. it is a neuter substance, and consists of carbon, hydrogen, and oxygen. When quite pure, it may be kept long without change.

Effects on the System

Two important properties possessed by creasote, which may be mentioned here, as they are the source of much of its usefulness as a medicine, are, first, its extraordinary power of preventing and correcting animal decomposition, and secondly, its property of coagulating albumen. in its physiological operation, it is a powerful local irritant, and, applied undiluted to the skin, produces heat and redness, and corrugates and corrodes the cuticle, which separates in furfuraceous scales. Applied in the same way to the mucous membranes, it whitens them, causes a separation of the epithelium, and inflames the tissue beneath. in reference, however, to these local properties, and to the therapeutic applications based upon them, it will be considered with the rubefacients. At present, it is only as an internal remedy that it will occupy our attention

When swallowed in moderate doses, as of one or two drops, it produces at first no other obvious phenomena than a sense of heat in the throat and stomach; but if continued, it frequently increases the secretion of urine, which sometimes becomes of a dark colour, and has the odour of the medicine. The breath also has the same smell. By a longer continuance, symptoms of strangury may come on, similar to those produced by the oil of turpentine, which creasote resembles closely in its operation on the urinary organs, though less energetic. if the dose is larger, gastro-intestinal irritation is produced, with nausea, vomiting, and abdominal pains, and occasionally, when the quantity taken has been very large, symptoms of diarrhoea or dysentery. in excessive doses, it becomes poisonous; and with the symptoms of gastro-intestinal irritation or inflammation, there are now mingled signs of cerebral disturbance, as flushed face, giddiness, headache, dimness or disturbance of vision, quick and laboured respiration, foaming at the mouth, and even coma or convulsions. Death from two drachms of it is said to have occurred (Pereira, Mat. Med., 3d ed., p. 2014); but I have seen no details of a fatal case. The treatment would be to empty the stomach and bowels, and then allay irritation by opiates, and support the system if necessary; inflammation, should it occur, being combated by the usual remedies.

That creasote enters the circulation, is proved by its smell in the breath and the urine. its effects upon the kidneys are no doubt the result of its direct contact with their secreting structure. The cerebral phenomena may proceed from its immediate action on the brain, or may be secondary to the gastro-intestinal affection. in small doses, it shows no narcotic powers. The effects on the stomach and bowels are probably the pure result of local irritation.

Therapeutic Application

Creasote may be used in all the urinary affections for which the oil of turpentine is administered, though probably less efficient. it has been strongly recommended in diabetes; but experience has not confirmed the first favourable anticipations. it may sometimes have palliated the gastric symptoms, and diminished the urinary discharge; but it has produced no material influence on the disease. I gave it a very full trial in one case, without benefit. in copious diuresis, however, proceeding from debility or nervous disorder, it may be expected, like the oil of turpentine, to produce good by stimulating the renal tissue.

The most beneficial therapeutic influence of creasote, internally administered, is probably the relief of nausea and vomiting. it is certainly very effectual in cases of this kind, of a purely functional or nervous character, as the vomiting of hysteria and pregnancy, and that sympathetic of Bright's disease of the kidneys; and it is asserted to be useful also in sea-sickness, though, in this affection, I have little confidence in its powers; but it scarcely merits all the commendation it has received as an anti-emetic, for it not unfrequently fails in the cases apparently most favourable for its influence, and is incomparably inferior to opiates. To cases of vascular irritation, or acute inflammation of the stomach, it is altogether inappropriate. I believe that its action as an anti-emetic depends on no peculiar sedative or anodyne influence, as some have supposed, but simply on the stimulant effect it undoubtedly has upon the organ, and which very much resembles that of the aromatic oils, which are also admirable anti-emetics.

In cases of chronic gastritis with vomiting, especially when there is reason to suspect ulceration, it would probably occasionally prove useful by its stimulant action upon the ulcerated surface, exactly as it operates favourably upon similar ulcers of the skin.

Upon the same principle, I am prepared to admit that it may be useful, like oil of turpentine, in intestinal ulceration, and consequently may have produced good results in obstinate cases of diarrhoea, and even chronic dysentery, in the former of which it has been strongly recommended. Dr. G. E. Elmer, of Louisiana, found highly favourable effects from it, given in the dose of two drops every two hours, in a malignant epidemic dysentery, which prevailed in his neighbourhood;* and Dr.

* New Orleans Med. News and Hosp. Gaz., Jan. 1858.

Wilmert has employed it advantageously in acute dysentery by enema, a fluidrachm of it being injected with twelve fluidounces of thin starch.* it is said to have proved efficient in neuralgia, but I have little faith in its power over this disorder; and though, like everything else capable of producing a decided impression upon the system, it may have afforded relief in some cases, experience has proved that it is inadequate to the successful treatment of that complaint, and cannot be relied on even as a palliative.

That it will occasionally relieve gastrodynia and cardialgic uneasiness, is very probable; but so will any other stimulant or carminative volatile oil, and oil of turpentine often acts energetically in this way. it is by no special anodyne power that creasote acts in these cases.

Creasote has also been used with a view to its stimulant or alterative influence over the bronchial mucous membrane, in chronic or pituitous catarrh, asthma, and phthisis; and here also the same advantages may be expected from it as from the terebinthinate remedies.

In hysteria, in which also it has been recommended, though it may have afforded relief sometimes as a gastric stimulant, it has no special curative powers.

The inhalation of the vapour has been used with advantage in chronic bronchial diseases, and is especially applicable when there is an excess of secretion, from a relaxed state of the bronchial mucous membrane.

The reader will have inferred, from what has been said above, that I have no belief in the possession by creasote of any extraordinary or mysterious powers as a general remedy, considering it simply as a local stimulant to any part with which it may come into contact, with a somewhat greater disposition to act on the kidneys than upon other organs which it reaches through the circulation.

Administration

The dose of creasote, to begin with, is one or two drops, three times a day in chronic cases, every hour or two in the more acute, to be increased gradually if required, and, if tolerated by the stomach, up to five or six drops or more. As much as ninety drops have been given, within twelve hours, without ill effects. The dose of the oil may be most conveniently administered shaken up with a wineglassful of some sweetened aromatic water, or in the same quantity of diluted syrup or mucilage duly flavoured. The U. S. Pharmacopoeia directs Creasote Water (Aqua Creasoti, U. S.), which is prepared by shaking a fluidrachm of creasote with a pint of distilled water till dissolved. The dose is from one to four fluidrachms. it is also used locally to correct fetor, and to stimulate indolent surfaces. The British Pharmacopoeia prepares a Creasote Mixture (Mistura Creasoti, Br.), by mixing sixteen minims of creasote with the same quantity of glacial acetic acid, then gradually adding fifteen fluidounces of water, and finally a fluidounce of syrup, and half a fluidrachm of spirit of juniper. The acid aids the solution of the oil. The dose of the mixture, containing a minim of creasote, is one fluidounce.

* North-west. Med. and Surg. Journ., quoted in the Bost. Med. and Surg. Journ., liii. p. 236.