146 On the Local Application of the Vapour of Chloro- form in Uterine and other Diseases; and Descrip- A SYNOPSIS CONTAINING A SHORT ABSTRACT OF THE MOST PRACTICAL ARTICLES IN THE FOLLOWING PAGES: SHOWING, AT A GLANCE, THE MOST IMPORTANT INDICATIONS OF TREATMENT PUBLISHED BY DIFFERENT WRITERS WITHIN THE LAST HALF-YEAR. (ARRANGED ALPHABETICALLY.) AFFECTIONS OF THE SYSTEM GENERALLY. AGUE.-In cases of the quotidian type, small doses of strychnia, one twenty-fifth to one-fiftieth of a grain, have proved very valuable in several cases of the poorer labourers at the Crystal Palace, who were much exposed at night. (Dr. F. E. Wilkinson, p. 59.) DROPSY.-Give eight grains of calomel and eight grains of jalap with with one of emetic tartar, in the morning; and if necessary give a little wine and water during its operation. Follow this by three grains of powdered squill with two of digitalis, every night for six successive nights. At the same time give a mixture with bitter infusion, and small doses of tincture of squills and spirit of nitre, twice a day. Then omit the digitalis and continue the other medicines for six nights more. Occasionally the drastic purge will have to be renewed. (Mr. J. Toogood, p. 48.) FEVER.-Fever in one sense is incurable, but, by proper management, it cures itself. "We cure the patient by preventing him from dying" during a certain period, and then the disease dies out; we keep him up by food, stimulants, and tonics. One of the most important doctrines of the day, is, that fever may produce local symptoms very like inflammation, but not really so; and if these local affections be treated on the antiphlogistic plan in cases of fever, it is probable that the results will be fatal. Therefore, in fever, although the patient be attacked apparently by inflammation of the brain, causing delirium, &c., dont deplete, but steadily support the patient by food and small and repeated doses of brandy or wine, say a teaspoonful or tablespoonful every hour or two. The same principle must be remembered in affections of the lungs, heart, and digestive organs. All or some one of them may be attacked by apparent inflammation, but dont deplete if you see typhus present. On the other hand, boldly give food and stimulants, till you see the brown tongue assuming a healthier aspect, notwithstanding the apparent inflammatory symptoms, as it is the rarest thing possible for real inflammation to co-exist with fever. (Dr. W. Stokes, p. 1-12.) Where the secreting surface is not easily disorganized, we may try, by stimulating it, to aid in the elimination of the poison. This we may fulfil by emetics. Ipecacuan is the emetic to be preferred in 3j. doses of the wine. It should be given during the early stages, while nausea already exists as a symptom. Fever terminates commonly in four ways; 1st. The patient may be struck down at once and die by the shock; 2nd. He may die from the first to the second week; in this case there is great febrile action, and the patient dies by phrenitis, or this perhaps conjoined to some other complication. 3rd. The cerebral symptoms may appear more gradually, as at the end of the second week, commencing with delirium, and if fatal, ending with coma. In the 4th class, he may die at the end of the third, fourth, or fifth week, the asthenia increasing, and accompanied, perhaps, by specific intestinal lesion. In the third class, where violent delirium is present, we must give opium and apply cold effusion to the shaven head. The opium may be guarded with ipecacuan. If coma comes on, large blisters must be applied. The strength must be sustained on the plan of Dr. Todd, by giving small quantities of brandy and water and beef-tea at frequent and short intervals, and it must be especially observed that severe febrile symptoms do not contra-indicate this method. In the fourth class we must relieve the pain and tympanitis in the bowels and peritoneal cavity by turpentine stupes. A turpentine enema may be also given in the following form: Spirit of turpentine, thirty minims; tincture of catechu, two drachms; tincture of opium, fifteen minims, to be added to Zij. of decoction of starch. (Dr. W. Brinton, p. 16-25.) Tropical Fever and Dysentery.-When the remissions are imperfect, and there is acute congestion of some important abdominal or other organ, give quinine (in j. doses) from 3j. to Zij. daily. The more acute the symptoms and the less the remissions, the larger and earlier should be the doses. These doses should be continued until complete cinchonism is produced, namely, singing in the ears and deafness. In robust cases, before the accession of the fever, one blood-letting often gives great temporary relief. (Mr. E. Hare, p. 25-31.) GOUT, Acute.-Apply pure spirits of wine to the part by means of a piece of lint, and cover it with oil-silk. (Dr. Goolden, p. 45.) Chronic Gout and Rheumatism.—Mix 3j. of carbonate of soda with a bread poultice and apply this hot every night. (Dr. J. R. Bennett, p. 45.) PURPURA HEMORRHAGICA.-Give turpentine in the following manner: Sp. terebinth 3ij; sacchari albi, pulv. acaciæ, ãã Zij; tinct. lavandcomp. 3j; aquæ menth. pip. ad Zviij. M. fiat mistura. 3j ter die(Dr. G. Willis, p. 51.) RHEUMATISM.-Almost all the salts which act on the kidney are useful. Lemon-juice seems to be useful chiefly by acting on the kidneys and from the supercitrate of soda or potass which it contain; for the same reason we may give citrate of ammonia, acetate of ammonia, and nitrate of potass. Dr. Golding Bird prefers acetate of potass. He gives half an ounce, largely diluted, in divided doses every twenty-four hours. (Dr. G. Bird, p. 41.) Dissolve Ziij. of nitrate of potash in a pint of water, let the whole be taken during the twenty-four hours. By this dose gastric and renal irritation is avoided, and the patient does not get disgusted with the drug as he is apt to do when the quantity taken is two or three ounces in the same period. (Dr. Rowland, p. 39.) Chronic Periosteal.-Dr. Basham has observed that in cases of chronic periosteal rheumatism, where the patient has been benefited by iodide of potassium, at some antecedent period he has been salivated by mercury; whereas if no salivation has previously occurred, he has found the iodide of potassium of little or no effect. This disease may depend upon the impregnation of the system by mercury, or from the syphilitic virus. If the former, iodide of potassium is the remedy; if the latter, alterative doses of some mild preparation of mercury. (Dr. R. W. Basham, p. 44.) SCARLATINA.-When coma exists after or during an attack of scarlatina, the electro-galvanic battery has been found successful, the same as in cases of poisoning by opium. At the same time a flexible tube may be passed into the stomach, and port wine and ether introduced. (Dr. P. J. Murphy, Lancet, April 1, 1854, p. 360.) AFFECTIONS OF THE NERVOUS SYSTEM. CEREBRITIS.When fever is present, of a typhus character, dont be afraid of the symptoms of inflammation in the exhibition of wine. When typhus is present there may seem to be local inflammation either in the brain, heart, or other organs, but this is not real inflammation, and will really be aggravated by depletion. (Dr. W. Stokes, Edin. Med. and Surg. Journ., April 1, 1854, p. 364.) CHOREA, Hysterical.-Give 3ss. doses of the syrup of the iodide of zinc, and calomel night and morning. (Dr. Barlow, p. 70.) EPILEPSY.-Let the patient live by rule, and take a proper degree of exercise. Act daily on the bowels twice by the following pills, mercurial pill one scruple, compound colocynth pill two scruples, make into twelve pills, and take one occasionally. Also take of the juice of the cotyledon umbilicus (Davenport's) one teaspoonful daily before breakfast. Avoid stimulants, suppers, balls, theatres, &c. Increase the juice by and by to two teaspoonfuls. (Dr. Joseph Williams, p. 57.) |