Complete Text (Part 3)

Sig.: Two pills with each meal. 3 Hydrargyri chloridi corrosivi, gr. j. Sodii arsenatis, gr. j. StrychninsB sulphatis, gr. j. Potassii carbonatis, gr. xxx. Ferri sulph., gr. xxx. Misce et fiant pilulse no. Ix. Sig. : One after each meal. Indication: Amenorrhoea in debilitated and aniemic states. I^ Pulv. damianse, gr. iii%. Pulv. sabinse, gr. iss. Pulv. rutae, gr. iss. Pulv. croci, gr. iss. Pulv. zingiberis, gr. %. Misce. Sig.: For one capsule; one, morning and evening. IJ Ferri pepton, gr. xxx. Manganesii lactatis, gr. ixx. Scaramonii, gr. xxx. Strych. sulphatis, gr. ^/^. Misce et fiant pilulae no. xl. Sig.: Give two to four each evening on re- tiring. L Hand-Book of Modem Treatment, 21 Citrate of manganese has given fairly good results in amenorrhoea (especially uncomplicated oligochromaemia). It is administered in 5-grain doses thrice daily, increased, if neces- sary, to as much as 15 grains. It may with advantage be given at meal-time; 5 grains of sulphate of iron to be taken one hour afterward if anaemia be produced. « JJ Hydrargyri chloridi corrosivi, gr. j. Liquoris arsenici chloridi, gtt. xlviij. , Tincturi ferri chloridi, 3iv. Acidi hydrochlorici diluti, 3iv. Syrupi zingiberis, q. s. ad 5vj. Misce. Sig. : Dessertspoonful in water after meals. Indication: Amenorrhoea due to depressing hygienic surroundings. 3 Tinct. ferri chloridi, fSiij. Tinct. cantharidis, f3j. Tinct. guaiaci ammon., f5ss. Tinct. aloes, 5ss. Syrupi, q. s. ad fjvj. Misce. Sig. : Tablespoonf ul three times a day. 3 Acidi arsenosi, gr. j. Ferri sulph. exsiccat., 3ss. Pulv. piperis nigri, 3j. Pilulae aloe et myrrhse, 3j. Misce et fiant pilulse no. xl. Sig.: One three times daily after meals. Indication: Useful in chlorosis and amenor- rhoea. I^ Ergotini (Bonjean), gr. ij. Quininse sulph., gr. ij. Misce et fiat capsulse no. j. Sig.: One capsulse three times a day. I^ Apiolini, f3j. Pone in capsulas no. xx. Sig.: One capsule three times a day for one week before time for menstruation. 22 Hand-Book of Modem Treatment, I( Maiigani dioxidi, 3j. Pone in capsulas no. xvj. Sig. : One three times daily for few days before time for menstruation. lit Pilulse ferri carbonatis no. 1. Sig.: One pill after meals and increase. Indication: Useful when chlorosis and anae- mia are present. IJ Olei rutsB, ^ss. Pone in capsulas no. xlij. Sig.: One capsule three times daily. I^ Olei sabinse, 3iv. Pone in capsulas no. xlij. Sig.: One three times daily. I^ Olei tanaceti, 3iv. Pone in capsulas no. xlij. Sig.: One three times daily. ANiEIQA. I^ Liq. potassii arsenitis, fSiiss. Acidi phosphorici diluti, fjiij. Extract! osis marrow, q. s. ad 5viij. Misce. Sig.: Dessertspoonful after each meal. Indication: Pernicious anaemia. Ift Acidi arsenosi, gr. ss. Ext. nucis vomicae, gr. v. Ferri reducti, gr. ij. Misce et fiant pilulae no. xx. Sig. : One after each meal. R Codeinae phosphatis, gr. x. Elixiri pepsini, 5iss. Aquae foeniculi, q. s. ad Jiv. Misce. Sig.: One teaspoonful three times daily. Indication: Useful in chronic anaemia marked by mental depression. Hand-Book of Modern Treatment. 23 IJ Ferratini, 3ij. Pulv. rhei radicis, 3iv. Sodii bicarbonatis, 3ij. Olei foeniculi, m xxx. Misce. Sig. : One teaspoonful at night in water. Indication: Useful in anaemia with consti- pation and painful menstruation. 3 Ferri sulph. exsiccat., 3ij. Potassii carbonatis, 3ij. Syrupi, q. s. Misce et iiant pilulae no. xlviij. Sig.; One to three pills three times daily. I^ Liq. potassii arsenitis, f3iv. Sig.: One minim three times daily and in- crease one drop each day till puffiness under eyes. Then reduce by half. I^ Cupri arsenitis, gr. ij. Sig.: One-fiftieth of a grain three times daily. IJ Syrupi ferri iodidi, fSij. Sig.: Ten minims in milk three times daily. IJ Hydrarg. chloridi corrosivi, gr. ij. Aquae f^iss. Sig.: Ten minims three times daily. Byrom Bramwell, in a case of splenic anaemia, of an unknown causation, occurring in a young man, 25 years of age, found the blood to contain 48 per cent, of haemoglobin, although the red cells were not much reduced (4,030,000 per cubic millimeter). The white cells were 3800. There was some, but not marked, poikilocytosis. No nucleated red corpuscles were seen. The white corpuscles were in about normal proportions; no myelocytes were found. The patient did not use alcohol, and malaria and syphilis were excluded. He had had good health until about three years preceding, when he was suddenly seized with acute pain in the left side of the abdomen, and, almost immediately afterward, vomited 24 Hand-Book of Modem Treatment. a large quantity of bright red blood. Since this attack he had never felt strong and his skin had been always sallow. Sub- sequently, he had vomiting of blood on two occasions. He was suffering with marked anaemia and debility when he com- menced treatment with Blaud^s pills (gr. v. thrice daily) and a daily exposure to the X-rays. Almost immediate improvement resulted; in one month the red blood-cells increased from 2,440,000 to 4,260,000, and the haemoglobin from 20 to 46 per cent. The yellow coloration of the skin had almost entirely disappeared. The patient was discharged at his own request, looking and feeling well. The spleen was only slightly reduced in volume. ANAL FISSURE. IJ Hydrarg. chloridi mitis, gr. xxx. Extract! opii, gr. x. Extract! belladonnse, gr. x. Vaselini, ^j. Misce. Sig. : Give a laxative at night and apply the above ointment. 3 Bismuthi emulsionis, 3j. lodoformi, gr. x. Olei olivse, ^iv. Misce. Sig. : Inject and retain on alternate days. 3 Sol. potassii broraidi, Siss. Glycerini, q. s. ad 5j- Misce. Sig. : Apply to fissure with a brush. The fissure is first anaesthetized with cocaine, and pure ichthyol is applied with a bit of cotton on a glass rod. For sub- sequent applications, which are made every other day, anaBsthesia is generally unnecessary. Cicatrization is usually very rapid, and stretching of the sphincter is not necessary. The bowels must be kept free. Hand-Book of Modern Treatment. 25 I^ Ext. conii, gr. xv. Olei ricini, gt. xv. Lanolini, gr. xxx. Misce. Sig. : To be applied to parts after each action of the bowels. In cases of anal fissure in which severer measures are de- clined by the patient it may be well to try a method of treat- ment recommended by Katzenstein, who seeks to soothe the nerve-endings and do away with the spasm of the sphincter with the aid of the following mixture : — R Ext. belladonnse, gr. viiss. Cocainse hydrochlor., gr. Vao- Ammonium sulphichthyolate, q. s. ad 3iss. Misce. Sig. : This is warmed and applied by means of an applicator wrapped with cotton once or twice a day for a week or two; then sitz baths are used and the bowels carefully regulated. Indication: A non-operative treatment of fissure of the anus. IJ Cocainae hydrochlor., gr. j. Extract, belladonnse, gr. j. Ichthyoli, 3iss. Misce et fiat unguentum. Sig.: Apply twice daily. R lodoformi, gr. xxx. Phenolis, gr. xv. Olei olivse, Jvj. Misce. Sig.: Inject one ounce into rectum after evacuation. Indication: To relieve pain and promote healing. ANiESTHESIA. LOCAL ANESTHESIA. A valuable local anaesthetic for inflamed tissues can be had by adding a few drops of 1 to 1000 solution of adrenalin 26 Hand-Book of Mftdem Treatment. to V2- to 1- per cent, solution of cocaine. In injecting this the first result is an ananiia of the skin, due to its action on the vasoconstrictors, followed by a deep anaesthesia. Incisions can be made into iuHanied tissues with the loss of very little bloody and the method is well athipted for furuncles, anthrax, etc. It is wise never. to anaesthetize a patient in the presence of many people. It renders him more a«:itated and nervous. It is preferable to amrsthetize in an adjoining room, or to cause all but the anaesthetist and one assistant to leave the room until the patient is thoroughly under the influence of the anaesthetic. In giving etlier it is a mistake, after anaesthesia is complete, to continue it until it becomes very profound, and then to leave off until the patient shows signs of returning consciousness, Allowing the patient one breath of pure air to every four or five of ether will commonly keep him in excellent condition, while the anaesthesia is effective and safe. Lasting anaesthesia can be produced by spraying ethyl- chloride over a surface previously moistened with a concen- trated watery solution of cocaine. Cocainized ethyl-chloride has been employed for opening abscesses, etc. SPINAL ANAESTHESIA. I would limit the indications for its application at the present moment: 1. To adults, and to reasonable persons who have good self-control, thereby excluding children, hysterical patients, and the insane. 2. To patients in whom the methods of local or regional anaesthesia are inaj)plicable. 3. To pa- tients suffering from emphysema, advanced asthma, chronic bronchitis, and other respiratory affections in whom a general inhalation aUcTsthetic is absolutely contra indicated ; in advanced cardiac cases with degenerative lesions, I would fear the possible depressing effects of the injection and excitement on the circula- tion. 4. In the majority of cases in which the painful p:irt of the operation is not likely to be prolonged beyond one hour and a half, as T would ])e averse, in the present state of our know- ledge, to repeat a second cocainization or to increase the total dose of the cocaine to more than 2 cubic centimeters, especially in exhausted subjects. Dr. Gartner has recently patented an instrument which Uand-Book of Modern Treatment, 27 records the pulse of a patient who is under the influence of an anaesthetic. The instrument is fastened to the forearm, and a graduated disc records the increase or retardation of the pulse. The experiments in the hospital of Vienna succeed marvelously. It is hoped by means of it to prevent death during operations. The following formulae for the use of camphor as anaes- thetics for local use in itching affections: — I^ Camphorae, gr. xv. Olei amygdalae dulcis, 5%. Misce. Q Lanolini, ^iij- Camphorated oil, 5V3. Choraiis hydratis, gr. xv. Misce. 3 Zinci oxidi, 3vi%. Cretffi, 3vi^. Camphorated oil, 3vi^. Liquoris calcis, 3vi^. Misce. A SIMPLE METHOD FOR PRODUCING LOCAL ANESTHESIA. A very simple method for producing local anaesthesia, and one that will commend itself in the performance of minor op- erations, has recently been described by a writer in the Lancet. The method outlined is as follows: A solution consisting of adrenalin chloride, 2 drachms; cocaine, 5 grains; and water, ^/a ounce, is prepared. Lint is folded into a pad of four layers, soaked in the solution and placed under a positive electrode. A large negative electrode is applied elsewhere, and a current of from 15 to 30 milliamperes is slowly induced and run for the space of from 5 to 15 minutes. The surface may then be washed with ether, and superficial operations performed pain- lessly and without loss of blood. AN IMPROVED METHOD OF LOCAL ANALGESIA. Prof. Arthur E. J. Baker prepares his analgesic solu- tion as follows: 3 grains of betaeucaine and 12 grains of pure sodium chloride are added to 3^/2 ounces of boiling 28 Hand-Book of Modetji Treatment, distilled water, and IG drops of a 1 to 1000 solution of adrenalin chloride are poured into the fluid after it has cooled. This makes a normal saline solution containing 2 to 1000 eucaine and 1 to 100,000 adrenalin chloride. The whole quantity could, within the limits of safety, be injected into a patient at one sitting, but Professor Barker has found that an extensive operation can be done with about one-half of it. Barker never observed secondary luemorrhage following the use of the method. He used it in 34 cases, which include 10 operations for radical cure of liernia, 5 cases of strangulated hernia, 2 castrations for tuberculous testis, 5 cases of varicose veins, 6 cases of psoas abscess, 1 case of loose body in the knee, 1 case of tumor of the neck (actinomycosis), 1 colotomy, 1 of Thiersch skin-grafting, and 2 cystic adenomata of thyroid. The analgesia was always satisfactory and far exceeded in complete- ness and comfort all other procedures. A NEW LOCAL ANAESTHETIC. Dr. G. Frank Lydston describes his method of using antipyrine as a local anaesthetic. lie has used it in a number of cases of urethrotomy. He uses a 10-per-cent. solution, which appears to be quite as efficacious as co- caine. The solution should be fresh and should be allowed to remain in the urethra for ten minutes. lie suggests the anti- pyrine solution for nose and throat work in conjunction with cocaine. It is annesthotic and styy)tic, and, unlike cocaine, is not followed by vascular relaxation. He simis up the advantages of antipyrine as compared with cocaine as follows: (1) abso- lute safety, (2) freedom from constitutional effects, (3) distinct lessening of haemorrhage after operation, and (-1) less damage to nutrition of the wounded tissue. ANEURISM. I^ Potassii iodidi, ^iss. Syrupi sarsaparillse comp., 5vj. Misce. Sig.: One teaspoonful in water after meals. Hand-Book of Modem Treatment. 29 ' ^' »■■■! ■- ■■■_ ■ l_l ■■■■■„,■-■■■ I ■ ■■ ^^l^— p I( Gelatini, gr. xxx. Sodii chloridi, gr. cl. Aquee destillat., f^iv. Misce. Sig.: Inject two ounces of this every second day into loose tissues of back or thigh. I^ Tinct. veratri, fSij. Tinct. opii deodorati, fSij. Elixiris aromatici, q. s. ad f^iij Misce. Sig.: One or two teaspoonfuls every two or three hours. IJ TinctursB veratri, 3ij. Syrupi simplicis, q. s. ad Biss. Misce. Sig. : One teaspoonful three times a day. Indication: When heart is excitable and arterial tension high. I^ Morphinffi sulphatis, gr. iv. Chloralis hydratis, 3iij. Syrupi simplicis, 5j» Aquae, q. s. ad ^iv, Misce. Sig.: One teaspoonful in water at bedtime. ANGINA PECTORIS. IJ Spiritus setheris comp., 3ij. Sig.: Give twenty minims during attacks and repeat if necessary. IJ MorphinaB sulphatis, gr. V4- Atropinse sulphatis, gr. Vibo* Misce. Sig.: Inject during the attack. IJ Amylis nitritis, f3j. Sig. : Inhale two to five drops on a handker- chief. Indication: To relieve attack. 30 Hand-Book of Modern Treatment, U Tr. digitalis, fSj. Tr. strophanthi, wxxiv. Nitroglycerini ( 10 per cent. ) , m xxiv. Tr. cardamomi, q. s. ad fSiij. Misce. Sig. : One teaspoonf ul three times a day. Indication: Useful between attacks if heart is feeble and tension high. I^ Liq. potassii arsenitis, fSiv. Sig.: One drop in water after meals and increasing till puflfiness under eyes or intes- tinal pain appears. IJ Spiritus glonoini, f3j. Sig.: One drop in water every three to four hours. Indication: High arterial tension. IJ Erythrol-tetranitratis, gr. j. Alcoholis, fSj. Aquae dest., f3vij. Misce. Sig.: For one dose. Take four doses daily. I^ Spiritus ammonise aromatici, f3j. Sodii bicarbonatis, gr. x. Tincturse cardamonii compositae, f3j. Spiritus chloroformi, m xx. Solutionis nitroglycerini (1 per cent.), mj. Aquae, q. s. ad Jiss. Misce et fiat haust. Sig.: To be slowly sipped on the commence- ment of symptoms. Indication: For the anginal paroxysm. Tlie following capsule is said to be very effective in per- sistent forms of angina that recur after temporary relief has been obtained by the use of pearls of amyl nitrite. The cap- sicum favors rapid absorption; the castor-oil seems to have a like effect : — w %" Hand-Book of Modem Treatment, 31 I^ Nitroglycerini, gr. Viw Amyl. nitrit., gr. V*. Menthol., gr. Vbo- Oleoresin. capsici, gr. Vwo* 01. ricini, mx. Misce for one capsule. Sig. : Take when pain recurs. In the treatment of angina ordinary sweet spirit of niter has been overlooked. It is rapidly absorbed, as a rule, and in a very short time produces a marked fall in blood-pressure. To an adult a tablespoonful may be given at a dose. M. Houchard lays but little stress on the value of iodine preparations as reducers of arterial over-tension. Iodine medi- cation, however, is indicated when marked arteriosclerosis is present, in which case the resolvent action of the iodine prepara- tions is explained by phagocytosis. In the period preceding sclerosis iodine preparations, according to the author, are value- less, and in their stead the essential vasodilators should be em- ployed, such as amyl nitrite, trinitrite, or sodium nitrite. The following combination is recommended by him : — I^ Sodii nitritis, gr. iij. Potass, nitratis, gr. xv. Sodii bicarb., gr. xxx. AquflB destill., fSij. Misce. Sig. : The entire mixture to be taken at one dose and repeated once or twice daily. IJ Sodii nitritis, gr. xxx. Potass, nitratis, Siiss. Sodii bicarb., 3v. Aquae destill., fSx. Misce. Sig.: A dessertspoonful to a tablespoonful once or twice daily in half a glass of water. Indication: High arterial tension. The advantages in the foregoing combination are, that when the sodium nitrite is combined with the potassium nitrate and then rendered alkaline with the sodium bicarbonate, the so- 32 Hand-Book of Modem Treatment. dium nitrite becomes less noxious and is of great value in low- ering arterial tension, which remains low for some time after the preparation is discontinued. I^ Sodii chloridi, Siiss. Sodii sulphatis, gr. xv. Calcii phosphatis, gr. vj. Magnesii phosphatis, gr. vj. Sodii carbonatis, gr. vj. Sodii phosphatis, gr. ivss. Misce. Sig.: Above dose t.i.d. Indication : Arteriosclerosis. ANOREXIA. I^ Tinct. nucis vomicae, 3ij. Tinct. capsici, 3ij. Tinct. cinchonse, 5ij- Tinct. gentianse, 5ij- Misce. Sig.: One teaspoonful before each meal di- luted in water. I^ Pepsini, 3ij. Glycerini, 3ij. Acidi hydrochlorici diluti, 3iv. Aquae menthae piperitae, q. s.. ad ^iv. Misce. Sig.: One teaspoonful after meals. I^ Acidi hydrochlorici diluti, f^ss. Tinct. cinchonae comp., fjvj. Misce. Sig.: Dessertspoonful after meals well di- luted in water. IJ Pulveris capsici, gr. x. Extracti nucis vomicae, gr. v. Takadiastase, gr. xl. Pone in capsulas no. xx. Sig. : One after each meal. Hand-Book of Modern Treatment, 33 I^ Acidi nitro-muriatici diluti, mv. Tinct. nucis vomicae, m v. Tinct. columbse, m xxx. Syrupi limonis, q. s. 3j. Misce. Sig.: Take after meals. I^ Acidi nitrohydrochlorici (fresh), fSij. Aquae dest., f^iss. Strychnince sulph., gr. j. Misce et adde Tincturse cardamomi comp., 5vj.