PYOKTANIN IN DISEASES OF 
THE EYE, EAR AND 
THROAT. 
W. CHEATHAM, M.D., 
Lecturer on Diseases of the Eye, Ear, Throat 
and Nose, University of Louisville 
Since Prof. Stilling’s article, in 
Merck's Bulletin, of June, 1890, on 
pyoktanin was published, much has 
been written for and against it as a 
remedy. I think the best way to satisfy 
oneself of the virtues of a medicine 
is by self-trial, and this I have been 
doing for some weeks with pyoktanin. 
Pyoktanin is a combination, by sub- 
stitution, of some of the coal tar ex- 
tracts, and is either blue or yellow. I 
have used both of them in the stick, 
and in solutions from 1 to 500, to 1 to 
2,000. 
Prof. Stilling tells us: 
“ A paste made of wheaten flour and 
a 2 per i ,000 solution ofjT*5s w. CHEATHAM, M.D., 
not sour, no matter how long kept. 
Mold fungus, mucor stolonifcr, was put 
on bread-rolls, some moistened with 
water and others with solution of pyok- 
tanin, of from i to to i to 1,000; 
on the former the mold grew lux- 
uriently, but on the latter, which were 
kept moist for a fortnight, not a trace 
of mycelium could be detected. This 
same mold, with others, was put in a 
mixture of sugar, extract of meat and 
gelatin, which had been painted in 
stripes with a solution of pyoktanin, 
one-half per cent, in strength. The mold 
grew rapidly where there was no pyok- 
tanin, but was checked abruptly when 
it reached the line. 
“ Small vials were filled with solu- 
tions of pyoktanin of from i to i ,000 to 
1 to 64,000, and placed by the side of a 
bottle containing pure water, and in 
each vial was placed a piece of raw 
meat; the vials were then stoppered with 
cotton and placed in a thermostat kept 
at 250 C. Each one was examined once 
a day, twenty-four hours from the time 
of its last removal. That in the vial 
of water exhibited stinking putrefaction 
at the end of twenty-four hours. It 
was found that a solution as weak 
as 1 to 30,000 acts as an obstacle ON PYOKTANIN. 
3 
to the development of putrefactive 
bacteria.” 
Prof. Stilling says: 
“ On the basis of all these experi- 
ments, the conclusion is reached that 
from a mere botanical point of view in 
the first place, pyoktanin is an agent 
which, even in rather weak solutions, 
exercises a very marked restraint on the 
development and growth of bacteria; 
whereas, in somewhat stronger solutions, 
say i to 2,000 to i to 1,000, it acts as an 
absolute preventive and surely destroys 
whatever bacteria are already present.” 
He also says: 
“The best agents discovered in the 
experiments besides the blue pyoktanin 
were some compounds pertaining to the 
auramine group, the most eligible of 
which I shall, for distinction from the 
blue variety of pyoktanin hitherto de- 
scribed, denote yellow pyoktanin.” 
Prof. Stilling has written much more 
of this remedy. I have used it a good 
many times and can verify many of his 
statements: 
“ If used in the eye of a white rabbit, 
it will color the pink iris, and not the 
cornea if the latter is intact. If there 4 
W. CHEATHAM, M.D., 
be an abrasion or broken surface on the 
cornea, the latter will become colored. 
It dilates the pupil, and does not affect 
the accommodation. Injected subcu- 
taneously, the rabbit and the guinea- 
pig bear very large doses. If injected 
into the peritoneal cavity, very large 
doses will kill the animal. Death 
occurs from coloration, and thereby 
paralyzation of important nerve-centers; 
the blood is not affected. The abdomi- 
nal cavity is remarkably dry. Rabbits 
ingest pyoktanin administered in their 
food in great quantities, without ex- 
periencing any disturbance.” 
As I stated before, my personal 
experience has been rather extensive. 
Pyoktanin solution, i to i ,000, dropped 
into the eye, causes but little pain. 
Numbers of cases of the milder affec- 
tions of the conjunctiva, in which I 
had for some time used the usual reme- 
dies and not relieved, yielded readily 
to solutions of pyoktanin. I have on 
hand some new cases of trachoma which 
I have been treating for months with all 
the well known remedies, and which 
have shown remarkable changes for the ON PYOKTANIN. 
5 
better under the use of pyoktanin, 
in pencil, applied daily. I have never 
seen cases of suppuration, or muco- 
purulent inflammations of the tear sac, 
yield as readily as they do under the 
use of i to 1,000 solutions of pyok- 
tanin. In suppuration of the antrum, 
it alone, I think, is not so good as 
hydrogen peroxide, alone or followed 
by the pyoktanin solution. 
I have been treating for some time a 
case of interstitial keratitis in which the 
anterior chamber was very deep, the iris 
umbilicated, and the pupil undilatable 
with any of the mydriatics with or with- 
out cocaine. I prescribed pyoktanin, 
blue, i to 1,000 solution, two drops in 
the eye three times a day, before meals, 
and atropia after meals. The next day 
the pupil was well dilated, and re- 
mained so as long as the pyoktanin 
was used. When left oft', the pupil 
would return to its former condition. 
The corneal trouble also improved 
rapidly under its use. Two other cases 
on hand are doing equally well by the 6 
W. CHEATHAM, M.D., 
use of pyoktanin. I have had some 
very favorable results from the use of 
pyoktanin in suppurative inflammations 
of the middle ear. 
The main, and the only objection I 
know of to its use, is that it stains. The 
skin can be protected where pyoktanin 
is used in the eye by putting a little 
vaseline on the lids. 
I direct my patients, when drop- 
ing pyoktanin solutions into the eyes, 
to lie flat on their back, drop in one 
or two drops and lift the lids so 
it can get into the cul-de-sacs, and 
wipe ofl' what remains with a bit of 
cloth before getting up. 
The blue solution rendered me quite 
a service the other day in a case of 
trauma, in which the cornea was rup- 
tured and the iris and vitreous hung 
from the wound. I trimmed up all the 
shreds 1 could see hanging from the 
wound, and washed the eye out well 
with a solution of pyoktanin i to i ,000. 
It immediately colored some transparent 
shreds 1 had missed, thus enabling me ON PYOKTANIN. 
7 
to clean the wound much better. The 
wound healed readily, although made 
with a dirty blunt instrument, there 
being consequently much contusion. 
I believe if pyoktanin is used prop- 
erly, it will be of much help to us in the 
management of many affections of the 
eye, ear, nose and throat. It is not a cure- 
all; let no one condemn it until he tries 
it thoroughly. The blue pyoktanin is 
not the well known methylene blue, 
but is a combination, by substitution, of 
some of the coal tar groups. “ Pyok- 
tanin” means “ pus killer.” 
FROM 
THE LANCET-CLINIC, 
November 15, 1890.