Complete Text (Part 8)

3iij. Glycerini, 5j. Aqiue chloroformi, q. s. ad ^iv. Misee. Sig. : One small teaspoonful in water after food three times a dav. I^ Ferri redueti, gr. i-iij. Quininte sulphatis, gr. ii-v. Acidi arsenoHi, gr. Vw-Vjo- Misce. Sig. : To lie taken in pill or capsule three times a dav. J^ Sodii arsenatis, gr. iss. Acidi carboliei, m iij. Aquae destillatse, Siiss. Misce et fiat solutio. Sig.: Five minims as an initial dose and repeat, according to age. T^ Asaf(etida, gr. xx. Ext. Valeria nie, gr. xx. Zinci oxidi, gr. xx. Castori pulv., gr. xx. Ext. belladonnae, gr. ij. Misce et fiant pil. no. xx. Sig. : One or two night and morning. J^ Liquoris potassii arsenitis. Sig.: One drop in water three times daily, and increase 1 drop each day until puffiness of eyelids or pain in bowels ensues. Then de- crease half the dose and continue till disease disappears. COLIC, HEPATIC. B Extrac'ti helladonnce, gr. Vs. Kxtracti opii, gr. V3. Olei theobromatis, gr. xxx. Mince. Sifj. : Make into one suppository, one such to bo inserted everv half-hour for two hours. Hand-Booh of Modern Treatment. 91 Olive-oil has always been considered empirically as a specific remedy in hepatic colic, and even in gall-stones. But it has usually been administered during the attack, and more as a seda- tive than for preventive purposes. Dr. S. Artault de Vevet attempts to show that in oleic acid, the active principle of olive- oil, we possess a powerful preventive of biliary lithiasis. Ac- cording to the author, it is highly probable that to oleic acid the remedial effect of olive-oil in biliary colic is to be ascribed, and this conclusion has been completely borne out by observations covering a period of about six years. The effect of oleic acid in hepatic colic has always been uniform and remarkably good. The acid may be given in capsules of 8 minims each, one to be taken morning and evening, for a period of one to two weeks. If necessary 16 minims may be prescribed at a dose, and the acid taken for a prolonged time, with regular intermissions. In this manner the attacks of biliary colic may be prevented, and relieved when once established. This double efficiency is another valuable property of oleic acid. The author insists on the prime importance of obtaining the pure product, as often fraudulent substances are dispensed. The following conclusions seem to be warranted : 1. Oleic acid is a specific remedy for biliary lithiasis. 2. The remedy relieves promptly the pain of an attack of biliary colic, but its chief effi- ciency is shown in preventing the return of the paroxysm, by interfering with the further formation of stones. It is thus curative and preventive at the same time. 3. The single dose is 8 to 16 minims in capsules, one in the morning for ten days of the month, if the attacks recur monthly, or for fifteen days preceding the expected paroxysm. B Morphinse sulpha tis, gr. 14. Atropinse siilphatis, gr. Vioo- Misce. Sig. : Use hypodermically to decrease pain and relax spasm of muscular coat of ducts. B Hydrarg. chloridi mitis, gr. x. Sacchari, 3iv. Pone in capsulas no. Ix. Sig.: One capsule or tablet every four hours. Indication: Torpid liver. 92 Hatid-Book of Modern Treatment. J^ 01. tercbinthinse, mv. Syrupi acacie, f^s. Sodii phenolsulphonat., gr. xx. Spiritus etheris composit., mzv. Aquffi menthe pip., q. s. ad Qj. Misce. 8ig. : To be taken once or twice a day. COLIC, INFANTILE. B Potassii bromidi, gr. viij. Cliloralia hydratis, gr. iv. Aquae camphorse, q. s. ad fBj. Misce. Sig. : One teaspoonf ul every four hours. Indication: Severe colic and insomnia of children over one year old. J^ Emulsi asafoetidse, f^ij. Sig.: One-half teaspoonful as required. Indication: Used for flatulence and pain. B Spiritus setheris compositus, fjj. Sig.: Five or 10 minims in cold water every two hours. Five drops of tincture of lobelia in 2 ounces of water, half a teaspoonful every few minutes, given warm, will cure many cases of infantile colic from whatever cause, will soothe ner- vous irritation, and induce sleep. In severe cases among children. Dr. Louis Starr says that bromide of potassium and chloral are most useful ; they may be combined as follows: — B Potassii bromidi, gr. xvj. Chloralis hydratis, gr. viij. Syrupi, 5ss. Aquae raenth. pip., q. s. ad ^\j, Misce. Sig.: One teaspoonful for a dose. Of this preparation it is rarely necessary to give more than two or three doses, at intervals of an hour. Hand-Book of Modem Treatment. 93 In infantile colic the result of indigestion, overfeeding, con- stipation, or improper food, Illoway advises the following prepa- ration : — I^ MistuTse rhei et sodse^ 3ss. Spiritus setheris compositus, mxl. Syrupi rhei aromatici, q. s. ad 5j* Misce. Sig.: A half-teaspoonful of this may be given every half-hour or hour to an infant a month old or so. Under and over that age, the dose to be graduated accordingly. Two or three doses are usually sufficient. While paregoric has long been popular in the lay mind for painful troubles of this character in infants, it nevertheless is an unwise remedy to employ, and should always be reserved until after simpler measures have failed. McAlister gives as exciting causes of infantile colic, indul- gence of the mother in rest, in insuflBcient exercise, irregularity of diet, and the mental state. In bottle-fed babies the want of strict cleanliness in their care, overfeeding, and too rapid feed- ing, the last being a very prolific cause. Too long use of nip- ples causes them to become patulous and the flow is too free. Diagnosis of colic is important. All crying of babies is not from colic. Colic presents hardness of abdomen, palpation shows coils in intestine, drawing up of legs is present, and there is expulsion of flatus with vigorous crying. Great circumspec- tion should be exercised in the use of drugs. Opiates are con- demned. Encourage expulsion of flatus by manipulation of the abdomen, massage, and warmth to bowels. High acidity of bot- tle-fed infants has suggested the combination of alkaline prepar- ations with carminatives, as in the following: — ^ Sodii bicarb., gr. xl. Spts. ammon. aromat., m xl. Glycerini, mxxx. Aquse menth. pip., q. s. ad Sij* Misce. Sig.: Teaspoonful between feedings. A towel dipped in boiling water, wrung out rapidly, folded to proper size, and applied to the abdomen with a dry flannel over the hot towel, acts like magic in infantile colic. 94 Hand-Book of Modern Treatmmt. OOLIO, INTESTINAL, ADULTS. I( Chloroformi, Siss. Tinct. opii deodorat., 3j. Camphorae, gr. iv. 01. cajuputi, 3j. Aquae, Jij. Misce. Sig. : Teaspoonful every hour or two. Indication: Acute colic. IJ Spir. chloroformi, Jij- Tinct. belladonnse, m cl. Dionin, gr. v. Comp. tinct. cardamomi, q. s. ad Jiv. Sig.: Teaspoonful in water every half-hour for adults. B Codeinae, gr. iij. Bismuthi subnit., 3j. Chloroformi (Squibb's), 3ij. Tinct. lavand. comp., Jj* Syr. pruni Virg., 5j. Spts. vini gal., 5j. Misce. Sig.: One teaspoonful every fifteen minutes until relieved. Indication : Acute colic with cramps. Two to 5 ounces of butter stirred into 1 or 2 cups of black coffee, and taken at a draught. Follow with carbonated waters freely. Do not use opium or its preparations at the same time. This simple expedient is often of great and immediate value. COLIC, LEAD. Delearde treated five patients who were sick with lead colic by injecting 1 pint of physiological salt solution under the skin of the abdomen ; in all the cases muscular pain soon disap- peared; after twenty-four hours, instead of the constipation, a beneficial diarrhoea set in, lasting two or three days, when it ceased. Hand-Book of Modern Treatment. 96 Q Aluminis, gr. xx. Opii, gr. XX. Misce et fiant chartulse no. xij. Sig. : One every two hours. Indication: Used to relieve pain and consti- pation. COLIC; RENAL.— See Calculi, Renal and Vesical. CONDYLOMATA, COMMON. B Acidi salicylici — saturated sol, 5ss. Sig.: Moisten the growth once or twice daily, and remove the softened coating from time to time. I( Acidi lactici, f^ss. Sig.: Paint the growth once or twice daily. CONJUNCTIVITIS. IJ Hydrarg. oxidi flavi, gr. ij. Vaselini, Sij. Misce. Sig. : Apply at night. Indication: Simple conjunctivitis or acute contagious. B Zinci sulphatis, gr. i or ij. Aquse destillatse, 5j- Msce. Sig.: One drop in eye three times daily. Indication: Simple conjunctivitis or acute contagious. I( Zinci sulphatis, gr. j. Morphinse sulphatis, gr. ss. Atropine sulphatis, gr. ss. Aquffi destillatse, f^j. Misce. Sig.: Few drops in eye two or three times daily. 96 Hand-Book of Modern Treatment, Q Acidi borici, 3sb. Sodii biboratis, Sss. Aquae mentlise pip., 3iij. Fluidextracti hamamelis, 3iv. Aquffi camphorffi, ^ij* Aquae destillatae, 3U> Misce. Sig.: Bathe the eyes freely. B Argent i nitratis, gr. ij. Aquae destillatae, 3j* Misce. Sig.: Paint eyelids once daily. Indication: Simple and purulent conjunc- tivitis. ^ Argenti nitratis, gr. x. . Aquae destillatae, 3j* Misce. Sig.: Touch eyelids night and morning and wash off excess with salt solution. • IJ Protargolis, gr. xx. Aquae destillatae, fjj. Misce. Sig.: Wash eye and apply to the lids twice daily. Indication: Purulent conjunctivitis. IJ Iodoform!, gr. iss. >^ Cocainae hydrochlor., gr. j. i Petrolati, Siss. Misce. Sig.: Apply locally. Indication: Clcer of cornea. . ^ IJ Acidi borici, gr. xx. Sodii chloridi, gr. ij. Aquae destillatae, f^j. Misce. Sig.: Wash out the eye frequently. IJ Glyceriti acidi tannic! HO per cent.), fjj. Sig.: Apply to everted lids. Hand-Book of Modem Treatment. 97 IJ Boroglycerini (40 per cent.), fSj. Sig. : Apply to eTerted lids. ^ Acidi tannid, gr. xl. Tincturse iodi, m x. Glycerini, 5j- Misce. Sig.: Apply to everted eyelids. Indication: Last three prescriptions used in granular conjunctivitis. CONSTIPATION. I( Aloes eztracti; gr. iss. Ipecacuanhse pulveris, gr. ss. Nucis vomicffi extract!, gr. ss. Quinine sulphatis, gr. j. Saponis, gr. ss. Misce et fiant pilulse. Sig.: One pill to be taken immediately be- fore dinner. The following formula has been found to be an effective one: — I^ Aloinse, gr. 14 • Strychninse sulpha tis, gr. V«» Extracti belladonnse, gr. Vs* Pulveris ipecacuanhse, gr. Va* Misce et fiant pilulse. Sig.: One pill to be takeu daily. Employed alone, belladonna seems to be more efficacious in the case of women than of men, and appears especially applicable in those cases of constipation in which a painful condition of some of the pelvic viscera; (uterus or ovaries) tends to constipa- tion by inhibition of intestinal peristalsis. B Sulphuris loti, Jj- Potass, bitartratis, 5j. Pulv. sennse, Jss. Syr. rhei, 3j. Ext. cascarae sagradse, 3ij. Misce et fiat confectio. Sig.: Tablespoonful at night. 7 98 Hand-Book of Modem Treatment. A ven' successful remedy for constipation in infants is podophyliin, in small doses; iridin may be combined with it with good effect. Make a tincture of the following: — I^ Resinse podophyllini, gr. viij. Iridini, gr. v. Spiritus ammouiie aromatici, 5j* Misee. Digest for several days and filter. Sig. : One or two drops of this may be given at bed time on a small piece of loaf sugar, or the dose may be combined in mixture along with syrup of orange. This is the dome for a child of one year and under. In cases of chlorosis or anaemia, it is well to prescribe con- fectio sulphuris 5j to be taken everj- morning, followed by this mixture : — IJ Ferri sulphatis, gr. xij. Magnesii sulphatis, Bj. Quininse sulphatis, gr. x. Liquoris str^'chninse, fSss. Acidi sulphurici diluti, m xl. Aquffi dest., q. s. ad f^viij. Misce et fiat mistura. Sig.: Two tablespoonfuls to be taken once daily about one hour before dinner. IJ Extract! colocynthi, gr. Vs« Terebinthinse (Venice), gr. Vw Pulv. socotrinse aloes, gr. IVs. Ext. nucis vomicae, gr. V«. Ext. hyosciami, gr. Vw Misce for one pill. Sig.: One such pill to be taken twice daily. Indication: Constipation with flatulence. IJ Sulphuris loti, f^j. Potassii bitartratis, 5j- Pulv. sennse, 3iv. Syrupi rhei, fSij. Fluidextracti cascarae sagradse, fSij. ^riHce et fiat confectio. Sig.: One teaspoonful at night to move the bowels. Indication: Habitual constipation. Band-Book of Modem Treatment. 99 CONSTIPATION IN CHILDHOOD. Dr. E. S. McKee advises the following treatment in a child two or three years old, suffering from chronic constipation: — Massage 8 to 10 minutes morning and evening over the course of the colon. Give juice of half an orange and a glass of water or Vichy on rising. For breakfast I would advise oat- meal with cream, dried bread and butter, one Qgg, half a glass of milk, with cream and water added; for dinner, soup, one starchy vegetable (for example, potato with cream) and one green vegetable, beefsteak, baked apple, prunes, dried bread and butter, and water; for supper, cream toast, one ^gg, dried bread and butter or graham crackers, half a glass of milk with cream and water added; and suppositories of aloin, etc., at bed-hour. The well-known aloin, strychnia, and belladonna comp. pill divided into pills of one-fifth the ordinary strength, are very valuable in the treatment of constipation in children, repeating the pill one, two, or three times a day as necessary. In the constipation of sucklings a change in the diet of the mother may be tried, or from one to three teaspoonfuls of cream may be given before each nursing. In artificially-fed children, the top milk with cream should be fed. Water, barley- water, or oatmeal will sometimes obviate the difficulty. As laxatives, simple syrup, manna, olive-oil, castor-oil, or fluid magnesia may be sufficient. A conical piece of soap inserted into the rectum is somletimes sufficient, as is even a ther- mometer if inserted at regular intervals. In infants after the fifth or sixth month costiveness is an indication for the intro- duction of starchy matter into the diet. The daily injection in infants of warm soapsuds by means of a soft-bulbed ear-syringe, or of glycerine gtt. xv-xx in a tea- spoonful of water, is very successful. The following may be given : — B Magnes. oxidi, gr. viiss. Sacch. lactis, gr. viiss. Put a piece of flaked manna in each bottle of artificially- fed infants* food. Ten drops of syrup of figs, 2 to 4 drops of fluid extract of cascara sagrada, a pinch of salt in the bottle, the addition of Mellin^s food to the diet, the twice-daily massage, XOO Hand-Book of Modem Treatment. the addition to each bottle of milk of 2 to 4 gr. phos- phate of soda, an increase in the proportion of cream, Tarrants' seltzer aperient, 10 grains in the milk, a little milk of magnesia added to the milk or water — these are usually suc- cessful, one or all, used in consecutive order. I^ Magnesii sulphatis, ^ss. Sodii sulphatis, ^bq. Potassii sulphatis, gr. ij. Sodii bicarbonatis, gr. viij. Sodii chloridi, gr. xx. Aquae, q. s. ad 5 viij. Misce. Sig. : Wineglass before breakfast. Indication: Artificial Hunyadi Janos for constipation. Spoeth has employed the following formula in the treat- ment of intestinal fermentation in the course of the infectious diseases, such as typhoid fever: — IJ Creolini, Siss. Alcoholis diluti, wxv. Pulveris glycyrrhizse, Siss. Extracti glycyrrhizse, Siss. Mucilaginis tragacanthi, gr. xv. Misce. Sig. : Make into 100 pills and give one three times a day. For constipation in infants and small children cathartics ought not to be given. Instead, let a small quantity of glycerine — a half teaspoonfiil — to which has been added a few drops of water to make it flow, be injected into the rectum by means of a small hard-rubber syringe. This may be repeated every day when the act of evacuation does not take place naturally. The effect of the glycerine is that of a mild stimulant to the rectum, the result of which is expulsion of its contents. No harm can come of this treatment, while much damage does come from the use of cathartics. The first step must be to regulate the habits and life of the mother. She must be placed on a diet of fresh meat, fresh Hand-Book of Modern Treatment, 101 vegetables, and freshly-cooked fruit, with due provision for regular exercise, and restriction in the matter of tea-drinking and other dietetic irregularities. This regime will diminish the proteid, and increase the fatty constituents of the milk, and will go far to rid the infant of the tendency to constipation. Should it fail, the best treatment for the child is the admin- istration of cream in doses of from 1 to 2 teaspoonfuls in warm water from time to time just before the periodical meal. Although there are exceptions to the rule, I find most cases of constipation are caused from a lack of attending to the call of Nature. Having some unfinished work to perform when Nature calls, it is put off until the work is finished, then the call is forgotten and the subject becomes habitually consti- pated. I first give the patient a severe lecture on his neglect to answer the call of Nature promptly. Then I instruct him to finish each meal with a good, ripe apple (and, if small, to eat , two). And, as I consider the most appropriate time for the bowels to move is immediately after breakfast, I instruct the patient to fill an ordinary P; P. syringe with pure glycerine and inject, per rectum, immediately after that meal, which will usually cause a free passage within five or ten minutes, and to continue these injections until Nature calls at that time with- out its use. I have found the glycerine to be needed but a short time. The following combinations are serviceable remedies in correcting constipation in adults: — B Fluidex tract i frangulae, 3vj. Fluidextracti cascarse, Svj. Glycerini, Siij. Misce. Sig. : One or 2 teaspoonfuls at bed time. I^ Ext. cascarse, gr. "A. Podophyllin, gr. V?. Ext. hyoscyami, gr. Vt. Euonymin, gr. V?. Pulv. saponis, q. s. Misce et fiat pilula no. j.