Nervous System. - Large doses are apt to produce headache, restlessness, delirium, or stupor. The reflexes may be depressed, or in some cases choreic movements may appear. Muscular contractility and the excitability of the nerve-centers to external stimulation are lessened.

Respiratory System. - Very large doses produce convulsive respiratory movements.

Absorption and Elimination. - Iodoform is absorbed from the stomach, or from mucous membranes or wounds to which it is applied. It is slowly absorbed from the alimentary canal, but readily absorbed from wounds. In the tissues it combines with the proteid molecules, and is retained in the system in part as potassium iodide and other iodides. Free iodoform is, however, found in the body, else poisoning would probably not develop. It is eliminated in all the secretions, and has been detected in the urine and saliva within one hour after its administration, traces of it being perceptible in the secretions for three days. Iodine is liberated at the points of elimination, either as an iodate or as some organic compound of iodine, or both. The drug is also detected in the breath, though it is chiefly eliminated in the urine as alkaline sodium iodate, coloring the urine yellow. It should be remembered that iodoform is absorbed much more rapidly than it is eliminated.

Temperature. - Large doses cause a rise of temperature, while poisonous doses may, at the last, produce a decided reduction of animal heat.

Untoward Action. - Sometimes iodoform excites an eczematous eruption, which may be papular or erythematous, and symptoms of vertigo. Muscular weakness and double vision have also been observed; sleepiness, alternating with excitement; incoherence of speech; headache; mental confusion; and amblyopia.

Poisoning. - Three forms of poisoning by iodoform are described by Duret - the eruptive, the cerebral, and the syncopal. The relation of iodoform to the methane group is to be borne in mind.

No two cases of poisoning present the same symptoms, hence every case should be considered a law unto itself and be treated accordingly. With reference to fatal doses, 75 grains (5 Gm.), administered over a period of one week, have caused death.

In the first of these there may be a severe and extensive erythema or eczematous eruption. The cerebral variety is characterized by an increase of temperature and accelerated pulse - as high as 150 or 175 per minute; great irritation of the gastro-intestinal tract; widely dilated, or motionless and contracted, pupils; intense headache over the entire circumference of the head; insomnia, restlessness, melancholia; great depression of spirits or hallucinations and active delirium or suicidal mania.

In the syncopal variety the patient complains of dizziness and mental confusion; is languid and weak; he suffers from insomnia, is restless, and unable to keep quiet. He may develop hallucinations either of an exciting or depressing nature, and may develop violent delirium; the heart's action becomes very rapid and feeble, the patient passing at length into a lethargic or comatose condition, with paralysis of the sphincters, and finally dying, perhaps quite suddenly.

The symptoms of poisoning may appear soon after the application of the drug, or they may be deferred for days and even weeks. In the latter case, which may properly be termed chronic poisoning, the patient is more apt to be depressed, weak, and apathetic with slight fever and accelerated pulse. Old people are the more susceptible to its toxic influence.

Treatment of Poisoning. - Every particle of the drug should be immediately removed from the body and its internal administration be discontinued at once. Stimulants, diaphoretics, and diuretics should be given, with frequent bathing of the body in warm water, to hasten elimination. Opium and large doses of potassium bicarbonate have been recommended.

Therapeutics. - Externally and Locally. - Iodoform acts as an alterative, analgesic, protectant, antiseptic, and germicide to at least some forms of bacilli. Its extremely disagreeable odor does not commend it for anything. Odorless compounds with similar actions are much to be preferred. It is a valuable application to wounds, ulcers, etc. It is especially valuable in the treatment of tuberculous affections, such as tuberculous joints, when it is used in the form of an injection - 10 to 20 per cent. - in sterilized olive oil. In tuberculous parenchymatous synovitis the mixture is injected directly into the joint-cavity.

Iodoform is an exceedingly valuable application to syphilitic ulcers, chancres, chancroids, suppurating buboes, ulcerations of the uterus, uterine cancer, and indolent and irritable ulcerations of the leg.

Incorporated in a suppository, it is very efficacious in painful hemorrhoids, fistula, and fissure of the anus.

It is a valuable application in many diseases of the ear, nose, throat, eye, and skin, where a drug of this character is indicated.

Internally. - Iodoform is used but very little internally, and has no particular indications.

The allied compounds here mentioned are used locally as substitutes for iodoform. Most of them possess the great advantage of being odorless, and some of them seem to be in all respects quite as efficient as iodoform. Aristol is undoubtedly superior to it in the treatment of indolent ulcers and in many diseases of the skin, ear, nose, and throat. Europhen and iodol should certainly replace iodoform in many cases.

Administration. - Internally, iodoform should be given in pills or capsules. Externally, it may be used in the form of a powder, alone or mixed with powdered borax or boric acid. It is also used in the form of an ointment or collodion. It is given hypodermi-cally, mixed with olive oil and glycerin, or dissolved in ether, in strengths varying from 10 to 30 per cent.

Its disagreeable odor may be modified or disguised by mixing it with tar, liquid styrax, balsam of Peru, thymol, coumarin, menthol, ground coffee, oil of lavender, bergamot, bitter almond, coriander, musk, vanilla, or some similar aromatic and pleasantly odorous substance. At best, however, it is almost impossible to eradicate the disagreeable odor.