_Sir_:—On page 678 of the Cincinnati _Lancet-Clinic_, of Dec. 9, 1893,
appears a letter from J. M. Murkon, M.D., of New York, to the editor,
calling attention to the dose of santonin, used as an emmenagogue, which
I had reported in the AMERICAN THERAPIST, vol. I., no. 1, p. 8 (July,
1892). Dr. Murkon asks “whether the dose as given is not a misprint; if
not, it is certainly more than dangerous, as five grains has caused a
fatal result.”
I wish to say that in the year and a half since the article in question
was written, I have often made use of _ten-grain_ doses of santonin for
its emmenagogue effects, and in no instance have I learned of the
slightest discomfort from such a dose. I rarely administer more than a
single dose; but if more are required, I invariably wait twenty-four
hours before giving them. The dose is always administered at night on
retiring, and at the same time I order a mustard foot-bath, and
frequently hot drinks _ad libitum_. I would say again that I have never
seen this procedure lead to any untoward effects, or even any
discomfort, and usually the menstruation is comfortably and apparently
normally established by the next day.
I do not believe it is possible to produce miscarriage or abortion by
this treatment. I have never seen it follow, and so certain am I of this
fact that I have come to look upon it as being a safe and convenient
means in making a differential diagnosis as to the presence or absence
of conception in cases of suppressed menses. I am so confident of this
diagnostic value that I am in the habit of saying to the patient when
there is any doubt as to the cause of the suppression, “I shall give you
a dose of medicine which will bring matters around all right if you have
taken a cold, but if there is a natural cause for the arrest of the
menstruation you need look for no results.” Who has not occasion,
frequently, to decide for the anxious patient the _cause_ of delayed
menstruation? They come to you insisting that the suppression is not due
to conception, and are exceedingly importunate in their demands for
relief. Here, then, is a medium through which I have frequently solved
this perplexing question; and through which I have been enabled to
conscientiously _prescribe_ for such cases, while otherwise I should
have refused to use any means to afford relief, simply advising
patience, and awaiting the tedious restoration of function by Nature’s
own forces.