Cantharidin

“ The external action of cantharides or cantharidin is extremely characteristic. When it is applied to the skin there are no obvious consequences for some hours. Thereafter the part becomes warm and painful, owing to marked local vascular dilatation. ”

“ The extraordinary tendency of cantharidin to crystallize, even under the most adverse circumstances, taken in connection with its insolubility, per se, has hardly received sufficient attention from phar­ma­ceu­tists as a cause of the deterioration of {368} cantharidal preparations, and the discovery of a menstruum, that will retain that principle in solution for an indefinite period, is a problem yet to be solved, and worthy the attention of phar­ma­ceu­ti­cal investigators. ”

“ If applied over an extensive surface, absorption and poisoning may occur.
Internally cantharides is an irritant, and produces its effects on any part which the free cantharidin is brought into contact. When swallowed it irritates the digestive mucous membrane; large doses produce gastro-enteritis. The active cantharidin is absorbed, and in the blood forms a non-irritant albuminoid, but in the kidneys is again liberated, developing its characteristic irritation, medical doses stimulating the urino-genital tract, causing diuresis, and in some animals increases [75] sexual appetite ”

“ In the Linimentum Cantharidis, United States Pharm., in which an ounce of flies is digested in eight fluid ounces of oil of turpentine, the cantharidin is to be the menstruum as 1 to 1500, a proportion probably quite sufficient to retain it in solution. The importance of the officinal direction to digest is evident. ”

“ There can be little doubt that the London preparation would be much improved by digesting the flies in the acid for an hour in a close glass vessel at the temperature of boiling water.
f. The cantharidal collodion of M. Ilisch has been considerably used as a vesicant in this country. Ether being a good solvent for cantharidin readily keeps that principle in solution. When applied to the skin, the escape of the ether leaves a coating of ethereal extract of cantharides, admixed with collodion. ”

“ It must also be admitted that the heat ordinarily employed in making the blistering cerate of the United States Pharmacopœia, does not injure the preparation by volatilizing the cantharidin, and that the recommendation to digest the flies in the melted vehicle on a water bath is not only not injurious, but decidedly advantageous, as it increases, many fold, the solvent power of the fatty matter. ”

“ The acetic alcoholic extract of cantharides of Ferrari is made by digesting four parts of cantharides in sixteen parts of alcohol 36° B. mixed with one part of acetic acid 10° B. In the opinion of the author, the acetic acid tends to prevent the cry­stal­li­za­tion of the cantharidin, a statement rendered doubtful by the above experiments, as that principle separates in crystals from an acetic solution of cantharides. The alcohol dissolves the green oil {367} which gives to the extract a butyraceous consistence. ”

“ Cantharidin is a white, neutral substance, of which the formula according to Regnault is C10 H O4. Gmelin considers it of the nature of a solid volatile oil. As usually seen it has the form of minute flatted four-sided prisms (c,) much broken up, so as to appear like scales. When deposited from an ethereal solution of cantharides by slow evaporation, or from its solution in hot acetic acid by cooling, it assumes the form of flattened oblique four-sided prisms with dihedral summits, derived from the rectangular prism by the bevelment of its edges (see fig. a and b from c.) ”

“ Since then various experimenters have been engaged in the chemical investigation of these flies, and in the more recent treatises they are stated to consist of cantharidin, yellow fixed oil, green fixed oil, a yellow viscous substance, a black matter, ozmazome, uric acid, acetic acid, phosphoric acid, and the phosphate of lime and magnesia. It is proverbial among apothecaries and physicians, that the phar­ma­ceu­ti­cal preparations designed to produce vesication, vary very much in their power as prepared by different individuals, and from different samples of cantharides by the same recipes. ”

“ There are not rarely cases of poisoning of cattle from feeding on herbage bearing a large number of the beetles and authentic cases are known of human beings who have been poisoned by eating the flesh of such cattle. Kobert states that the beetles are not poisonous to birds but that the flesh of birds which have fed on them is poisonous to man, and that if the flesh of chickens or frogs which have fed on the cantharidin be fed to cats it causes in them the same symptoms as does the cantharidin. ”

“ Treatment of cases of cantharidin poison is a matter for a skilled physician. Until he can be obtained, emetics should be administered and these should be followed by white of egg in water. Oils should be avoided, as they hasten the absorption of the poison.
Other Cryptotoxic Insects—Though the blister beetles are the best known of the insects with poisonous blood plasma, various others have been reported and we shall refer to a few of the best authenticated. ”

“ Preparations: Cerate (32 per cent.) ; Collodion (q.v.) ; Tr. (D., 3—10 min.) .—See also, Cantharidin.—Antidotes: Emetics, flaxseed tea; opium per rectum; morphine subcut.; hot bath. Avoid oils!
Cantharidin Merck.—C.P., Cryst.
Colorl., cryst. scales; blister the skin.—Sol. in alcohol, ether, chloroform.—Stimulant, Vesicant, Antitubercular.—Uses: In lupus and tuberculosis; also cystitis.—Dose: Teaspoonful of 1:100,000 solut. in 1% alcohol (with still more water added before taking) , 3 or 4 t. daily.—Injection is given in form of potassium cantharidate, which see. ”

“ There are met with in various parts of India other allied species, which differ more or less from the above description, but they all partake of the same irritant and vesicant properties, the active principle being the same with that of the officinal Cantharides, viz., Cantharidine. It is apparently a complete substitute for the European article as a vesicant, provided that due care is taken in its preparation, &c. The best season for collecting the insects is just previous to the setting in of the monsoon, in the early morning or evening ”

“ The greater effect observed in Orfila’s experiment was probably owing to obstruction of the pulmonary capillaries by the oil.
Orfila has examined with care not only the preparations of cantharides already mentioned, but likewise the various principles procured by M. Robiquet during his analysis; and it appears to result, that the active properties of the fly reside partly in the crystalline principle, and partly in a volatile oil, which is the source of its nauseous odour.
The symptoms produced by cantharides in man are more remarkable than those observed in animals. ”

“ It is certain that in Europe the preparation of these drugs renders them pernicious and mortal. For example, at Naples the mixture of opium and cantharides, in known doses, is a slow poison; the surest of all, and the more infallible as one cannot mistrust it. At first it is given in small doses, that its effects may be insensible. In Italy we call it aqua di Tufania, Tufania water. No one can avoid its attacks, because the liquor obtained from that composition is as limpid as rock water, and without taste. ”

“ If it should make the head tender, only use half the tincture of cantharides. The alcohol must be strictly 95 per cent.—you can add hartshorn if not strong enough, also bergamot for perfume [176] to suit. It is good for tetter on the head. Every ingredient can be had at almost any of the drug stores.
TO RESTORE THE HAIR IN BALDNESS.
Take of cold pressed castor oil 2 ounces, tincture of cantharides 1⁄2 ounce, acetic acid 1⁄2 ounce, strong water of amonia 11⁄2 ounces, oil of nutmegs 1⁄2 drachm, oil of lavender 1⁄2 drachm, put this in a bottle, make into a lotion, when it will be ready for use. ”

“ The part to which it was to be applied was quite denuded and tender; but I told the patient to stick a small piece of the plaster over it and wear it, and keep it as sore as he could for a month or more. He was, however, to call on me once a week,—or, perhaps, at first, twice,—that I might watch the effects. There was some danger of an absorption of the cantharides into the system, which might do more of general harm than would justify an attempt at local good.
No man ever followed the prescription of his physician with more pertinacity and faithfulness than young Theodore. ”

“ In any forensic case, the defence will not improbably be set up that some animal (e.g., a fowl poisoned by cantharides) has been eaten and caused the toxic symptoms, for cantharides is an interesting example of a substance which, as before stated, for certain animals (such as rabbits, dogs, cats, and ducks) , is a strong poison, whilst in others (e.g., hedgehogs, [476] fowls, turkeys, and frogs) , although absorbed and excreted, it appears inert. Experiment has shown that a cat may be readily poisoned by a fowl saturated with cantharides ”

“ The Arabians treat the disease exactly as the Greeks. Avenzoar recommends purging, a regulated diet, and friction with oil of nuts and cherva. Haly Abbas approves of general evacuants, friction, and stimulant applications containing cantharides, nitre, &c. Alsaharavius recommends emetics after food, purging with hiera picra, friction with compositions containing mustard, euphorbium, pellitory, nettle-seed, with oil of sesame, or with liquid pitch. Ophiasis, he says, is to be treated upon the same principles. Among the ingredients of Mesue’s compositions, we remark cantharides, musk, and amber. ”

“ The Preparation of this Antidote, (so he calls it) is by infusing the Cantharides in Soure Butter-milk Twenty Four Hours, then drying them, and with the Flower of Lentils and Wine making them up into Troches of a Scruple Weight, of which one is to be taken every Day, By which means he assures us, that tho’ the Patient make bloody Urine, yet that Milk largely drank will abate that Symptom, and that an Hydrophobia will be happily prevented. Boccone (98) tells Us, That in Upper Hungary They give Cantharides to Men bitten by a Mad Dog, Five to a Dose; and to Beasts in greater Quantity. ”

“ The drug often has a marked aphrodisiac action, producing priapism, or in the female sex the onset of the catamenia or abortion.
Cantharides is used externally for its counter-irritant action. There are certain definite contra-indications to its use. It must not be employed in cases of renal disease, owing to the risks attendant upon absorption. It must always be employed with caution in the case of elderly persons and children ”

“ If adulteration would not destroy, by its baneful influence, the advantageous form of complex extracts, we could obtain a desirable amelioration of our officinal cerate, by substituting for the powdered cantharides an equivalent proportion of the oleaginous liquid, with which they are saturated in the fresh state, and which is possessed of all the vesicating properties of the insect. ”

“ It is frequently used as a counter-irritant in sore throat, chronic cough and roaring. Mixed with cantharides the strength can be reduced as an irritant and less apt to permanently destroy the hair bulbs. It is used internally to arrest the growths of actinomycoses and scirrhous cord, but in those cases the benefits are derived from the potassium iodide which it contains, and I would recommend administering internally without the mercury. ”

“ Strangury may result from the external application of cantharides as a blister, &c. Priapism is often obstinate and painful, and the fatal termination is generally ushered in by violent convulsions and delirium. In pregnant women, abortion may take place as a result of the general irritation and disturbance of the system, there being no proof that the uterus is particularly affected by the drug. The vomited matters may contain shining green particles, the presence of which indicates the nature of the poison taken. The invasion of the symptoms may in some cases be retarded. ”

“ When that great shadow falls, it is not the fine, strange Cocks we trust to keep off the bird of prey!
Chantecler
[Suddenly grown great of size, his wounds forgotten, stands in the midst of them, and in an authoritative tone.] Yes, close around me, all of you, all! [All, huddled in their feathers, their heads drawn in between their wings, press against him.]
The Pheasant-hen
Dear, brave, and gentle heart!
Chantecler
[The shadow sweeps over the crowd a second time. The Game Cock makes himself small. Chantecler alone remains standing, in the midst of a heap of ruffled, trembling feathers.] ”

“ Chantecler
I am thrice stronger now than you. Black excites me, you see, as red excites the bull, and thrice I have stared at night in the form of a bird’s shadow!
The White Pile
[Driven to bay, against the hedge, prepares to use his razors.]
The Pheasant-hen
[Screaming.] Look out! He has two sharp razors at his heels, the beast!
Chantecler
I knew it!
The Cat
[From his tree, to the Game Cock.] Use your knives!
Patou
[Ready to spring from his wheelbarrow.] If he uses those, I ll strangle him, that’s all!
The Crowd
Oh!
Patou
I will! Howl you never so loud! ”

“ Knowing so little about it, Chantecler is convinced that the magic of his cock-a-doodle-doo! makes the sun rise every morning! The pearl of the poem is the scene in the second act, where Chantecler confides this marvellous secret to the gloriosa donna delta sua mente, the Hen-Pheasant, who has taken refuge in the poultry-yard. A pheasant sees more of the world than a cock, flies and rockets up in the sky, dwells in the forest, and therefore, half-sceptical, half-scandalised, she listens while Chantecler, manlike, expatiates on the necessity of his existence. ”