Complete Text (Part 10)

Acidi benzoici, Siiss. Sodii biborat., 3v. 01. gaultherise, mxv. Aqus, ad ^ij. Misce. Sig: One drachm after meals. IJ Tinct. opii camphoratfle, ^i], Vini ip(?cacuanhae, 5ij- Spiritus aitheris nitrosi, SU* Si^. : Tcaspoonful three times a day. p]latoriinri is one of our best remedies in inflammatory (lifrK!uIlios like cystitis, when used in small, oft-repeated doses — wlien til ore is an uneasy burning after urinating, as if all had not been voided. Give: — R Tr. clatcrii, 31 j. Tr. belladonna; spec, gtt. xvj. \fueilupinis acaciaj, 5j. Aqua) dest., q. s. ad ^iv. AliHoo. Sig.: A teaH|)Oonfiil every one or two hours. Tliis is specific for this condition. Hand-Book of Modern Treatment. 115 I^ Morphinse acetatis, gr. iv. Tinct. veratri viridis, 3j. Tinct. hyoscyami, 3ij. Syrupi zingiberis, 5j- Aquae, q. s. ad Suj* Misce. Sig. : Teaspoonful in water every four hours. Indication: Acute cystitis with hsemorrhage and pain. 3 Potassii acetat., 3j- Fluidextracti buchu, ^j. Sp. eetheris nitrosi, 5j« Codeinae sulph., gr. iv. Infus. tritici repent., q. s. ad Oj. Misce. Sig.: One-half ounce every three hours. 3 Fluidextracti pichi, 3iv. Potassii citratis, 3iij. Tinct. hyoscyami, 3ij. Spt. setheris nitrosi, 3iij. Elixiri aurantii, q. s. ad 3ij* Misce. Sig. : One teaspoonful in water one hour and a half after meals. Indication: Acute cystitis and urethritis. DANDRUFF. B Potassii carbonatis, Sss. Ammon. carbonatis, 3ss. Glycerini, 3iv. Aquse, Sviij. Spiritus vini, Sviij. Olei lavandulse, gtt. vj. Misce. Sig.: Hair-wash as indicated. Q Resorcinolis, 3ij. Glycerini, fjss. Alcohol, q. s. ad fjvj. Misce. Sig.: Clean scalp with soap and water and apply this lotion. 116 Hand-Bool' of Modem Treatment. B Campliora, 3j. Alcoholis, fSvij. Aquae rosae, f3ij. Misce. iSjg.: Apply directly to scalp by mean? of atomizer. B Ung. sulphuris, 3iv. Petrolati, 5ij« Misce. Sig.: Apply freely night and morning. DEBILITY.— See Asthenia. 3 Acidi phosphorici diluti, 3j. Fluidextracti cocae, 3s8. Fluidextracti damianae, Jss. Tinct. nucis vomicae, ?n x. Syrupi zingiberis, 3j. Aquae, q. s. ad 5j- Misce et fiat dosis. Sig.: To be taken in water at 11 A.M. and 6 P.M. IJ Ferri et ammon. citratis, gr. v. Tinct. nucis vomicae, mv. Tinct. cinchonae comp., q. s. ad 3j. ^fisce. Sig.: One teaspoonful three times daily after meals. IJ Tinct. nucis vomicae, gr. v. Acidi phosphorici diluti, m viij. Syrupi hypophosphitis, q. s. ad 3j. Misce. Sig.: One teaspoonful three times daily. I^ Tinct. ferri chloridi, 3j. Elixiris gentianae comp., ^i}. Misce. Sig.: One-half to 1 teaspoonful three times daily. Hand-Book of Modern Treatment, \Y] DELIRIUM TREMENS.— See Alcoholism. In delirium tremens with insomnia, great excitability and inability to retain food, the following active cathartic is recom- mended : — B Pulv. jalapse co., gr. x. Hydrargyri chloridi mitis, gr. v. Sodii bicarb., gr. v. Misce et fiat chartula no. j. Sig. : To be taken at one dose. Should the heart show any signs of weakness the following is recommended: — 3 Tinct. capsici, 3iv. Tinct. digitalis, 3iv. Tinct. nucis vomicae, 3ij. Spts. ammon. arom., q. s. ad Siij* Misce. Sig.: One teaspoonful in water every four hours. In cases of extreme nervousness accompanied by insomnia, sedatives will be required, and in extreme cases a hypodermic of morphine. Chirata has been used in India for many years as a cure for drunkenness. The plant is held in high esteem among the natives, and the missionaries employ it extensively for the cure of drunkenness. A correspondent, who was chaplain to an army post and in charge of a mission in India for many years, informs us that he has seen very good results from the use of chirata in habitual drunkenness. He adds that the • drug seems to be more intensely bitter than gentian, quassia, etc., and attributes the effect of chirata upon alcoholics to this property. The disgust for drink which it creates is only tem- porary, however, and the patient must take the drug from time to time when the craving for alcohol returns. The best way to administer it is in the form of an infusion (V2 ounce of 118 Hand-Book of Modem Treatment, chirata to 1 pint of boiling water), the dose of which is from 1 to 2 ounces three times daily. Some recommend the use of hyoscin hydrobromate in av- erage doses of V200 of a grain combined with V^oo grain of atropine sulphate and V150 grain of strychnine sulphate in the treatment of morphine and cocaine habitues and habitual drinkers. The treatment necessitates a special nurse day and night, inasmuch as the patient is purposely kept in a state of mild delirium for a period varying from thirty to ninety-six hours. The dosage varies with the patient, but it is repeated every two to six hours as indicated by dryness of mouth, dilatation of pupils, and delirium. Sleep is not usually produced. When the patient is allowed to emerge- from the influence of the hyoscin he soon develops a vigorous appetite, sleeps soundly after the first two or three nights, regaining his normal vigor and weight in the course of a month. Too few cases are reported to make this article of more than passing interest, but as a large number of observ- ers have recently tried the same method, we shall, no doubt, soon have reliable data at our command. I^ Potas. bromidi, gr. v. Sodii bromidi, gr. v. Chloral is hy drat is, gr. x. Tinct. zingiberis. m v. Tinct. capsici, m v. Spts. ammon. aromat., m x. Aquae, q. s. ad 3j. Mi SCO. 8ig. : One dose such as this three times daily. DENTITION. The argiiment that dentition is a purely physiological function and therefore cannot cause pathological phenomena is regarded as untenable. When the gums are hot and tense, then frequent rubbing with the following combination will give proper relief: — Eand-Bobk of Modei'n Treatment. 119 I^ Potassii bromidi, gr. xx. Chloralis hydratis, gr. x. Tinct. aconiti rad., m v-xv. Spts. chloroformi, 3j. Mucilaginis, q. s. ad 5j« Misce. Sig.: Apply to the gums frequently by rub- bing. At the same time he recommends that the following be given internally :— T^ Potassii bromidi, gr. iii-v. Chloralis hydratis, gr. i-ij. Aquffi destil., q. s. ad 3ij. Misce. Sig. : To be given at one dose by the mouth. The foregoing mixture may be given in double the size dose, per rectimi, using starch-water as a vehicle. T^ Tinct. iodi, m Ixxx. Tinct. opii, m Ixxx. Tinct. gallse, m Ixxx. Acidi carbolici, mviij. Misce. Sig.: For painting on the gums twice daily. Indication: Useful in dental periostitis. B Phenolis, 3j. Essentise limonis, 3j. Alcohol, 3v. Misce. Sig.: Wash and dry the cavity, soak a small piece of cotton with the solution, insert,, and then cover it with another small piece of cotton soaked in tincture of benzoin. Indication: Useful in dental caries. DERMATITIS. IJ Ichthyolis, 3ij. Ung. zinci oxid!, q. s. ad Jij. Misce. Sig.: Apply freely once daily and wrap well In gauze. Indication: Useful in burns. 120 Hand-Book of Modem Treatmmt, I^ Ung. zinci oxidi, 5j- Ung. aqiue ro4ie, 3j* Misce. Sig.: Apply freely. Indication: Useful in bums. I( Acidi picrici, gr. Ixxv. Alcoholis, l^iiss. Aqus destillatey Oij. Misce. Sig. : Soak gauze in this and apply and leave several days. Remove this and reapply and leave a week. I( Balsami peruviani, 3j. Resorcini, gr. x. Ung. aqu£e rose, 5j* Misce. Sig.: Treat antiseptically and apply. Indication: Useful in frost-bite. B Liq* plumbi subacetatis, Siv. Tincturse opii, 5j- Aquse, 5xvj. Misce. Sig.: Soak gauze and apply. Indication: Useful in ivy poisoning. I^ Fluidextracti grindeliae robusta, 3iv. Aquae, Oij. Sig.: Apply continuously in ivy poisoning. IJ Tinct. lobelifle, 5ij« Aquae, Oij. Misce. Sig.: Apply gauze soaked in this in ivy poi- soning. DIABETES INSIProUS. A man of 49, previously healthy, developed a typical dia- betes insipidus after a severe concussion of the nervous system. Strychnine was administered — fifteen injections during twenty Hand-Book of Modern Treatment, 121 days — a total of 0.0905 gram of strychnine nitrate. The urine subsided from a daily 8000 cubic centimeters to 3400 cubic centimeters. The strychnine was discontinued on account of symptoms of intoxication, but the urine continued its down- ward course to 2400 and 17>00 cubic centimeters and the patient is apparently cured. The density of the urine remained un- influenced by the strychnine. It ranged from 1.007 to 1.002. The persistence of this figure for the specific gravity forbids the assumption of a complete cure, but the subsidence of all the symptoms certainly justifies further trials of strychnine in such cases. I( Acidi gallici, $ss. Pone in capsulas no. xxiv. Sig.: One after each meal. IJ Fluidextracti ergotse, 5iv. Sig.: Thirty minims after each meal. DIABETES MELLITUS. The following combination containing boric acid, it is claimed, has been of curative benefit in treatment of diabetes. The cases in which it was used were young persons : — I( Acidi borici, gr. xx. Glycerini, 3j. Liq. arseni chloridi, wv. Liq. strych. hydrochlor., mx. Aquae destil., q. s. ad 5j* Misce. Sig.: To be taken at one dose and repeated three times a day. The arsenic and strychnine preparations are of 1-per-cent. strength as contained in the British Pharmacopoeia, and conse- quently the above dose of strychnine is on the border-line of danger and probably should never be prescribed in such size doses. It should be prescribed in doses of 3 to 5 minims. Phosphoric acid diminishes thirst and lessens the quantity of urine. Pilocarpine nitrate, ^/^^ grain in diluted spirit, may be placed on the tongue four times a day. Duchenne recom- 122 Hand-Book of Modem Treatment. mends potassium phosphate, 2 parts in 75 of water — a drachm of the solution twice or tlirice daily in wine or hop tea. Faulds has employed with success an infusion of eucalyptus in the treatment of diahetes as follows: — R Eucalyptus flores (dried), 3iv. Aquae, 5vj. Misce et fiat infusum. Sig. : One such draught to be taken twice daily. He states that he has obtained good results in 15 out of 16 cases. In one case, a girl of 18, in which there were 60 grains of sugar to the ounce of urine passed, after four days^ treat- ment only 1 grain to the ounce was passed, and on the sixth day none. He, however, thinks it of service only in those cases due to gout, overindulgence in food, or cold. It does not seem to be of service in those cases dependent on vasomotor disturbance affecting the blood-supply to the hepatic cells, as no improve- ment was shown in those cases. Eucalyptus-oil or eucalyptol will not produce the same results as the infusion. Some recommend the use of aspirin in the treatment of glycosuria and diabetes mellitus. . This preparation seems to have the most influence in the less severe forms and is less ser- viceal)le in the acute forms in young individuals. In order to produce any reduction in the milder forms it should be given in doses of 15 grains each four or five times a day. The pa- tient should be watched for the appearance of toxic symptoms. It is best to begin with a small dose, 10 grains two or three times a dav, and <?raduallv increase the dose. There is no disorder of the system in which empiricism has assumed a more important place in therapeutics than in the treatment of diabetes mellitus. W. R. Jones states that he derived splendid results from the use of uranium nitrate in the treatment of this disorder of metabolism. In every case in which this preparation has been used by the author great im- provemont has resulted. It should be given in doses of from Vo to V^, grain four times a day, administered in water, alcohol, or glycerine. The salts of uranium, while not luminous, are strongly fluoroscerit, which, according to the writer, lends inters Hand-Book of Modem Treatment. 123 est because of the discussion of radium at the present time. But whether the fluorescent property in any way affects metab- olism cannot be stated. He refers to the action of uranium on the skin producing a fine desquamation of the superficial layers of the epidermis somewhat similar to the effect of the x-ray. The degree, however, is very moderate and gradual. The general nutrition and activity of the skin are increased as well as the diaphoretic action, so that it is recommended for its beneficial effects on metabolism. It is a yellowish-green, crystalline solid, soluble in water, alcohol, ether, and glycerine. Some authors give it in 1- to 2-grain doses. I( Benzosol, gr. xlviij. Sodii benzoatis, 3iv. Acidi arsenosi, gr. j. Sodii salicylatis, 5iij. Misce et fiant capsulse no. xlviij. Sig. : Two capsules one hour after meals and at bed time. Indication: Useful in subacute cases. I^ Sodii sulphocarbol., 3ij. Salicini, 3j. Phenacetini, 3ij. Ammon. benzoatis, 3iv. Misce et fiant capsulse no. xlviij. Sig.: Two capsules one-half hour after meals. Diabetes mellitus can affect one of normal development as well as can the diabetes produced by brain or pancreas disease. That the primary disease is of little importance in the treat- ment is his belief. The greater number of cases of diabetes mellitus is met in persons who are predisposed, the disease being brought out by some deleterious influence. Adipose per- sons, and especially adipose children, are prone to develop the disease. In this class of individuals excessive eating of carbohy- drates, sweets, and beer is to be avoided, while mental and physical exercise is to be encouraged. Milk, green vegetables, and unsweetened fruits are to be allowed. In this disease the 124 Band-Book of Jfodem Trcalment. capacity (tolerance) of each indiridual is to bo determmed. Medium and mild degree eases should receive treatment re- gardless of any complication, of which tuberculosis is the worst. The tolerance to sugars is to be increased, if possiljle, and the sooner a case is treated the greater is the chance of benefit, especially since the diabetes tends to grow worse in all cases with a percentage greater than one. Opium, quinine, arsenic, carbolic acid, etc., esert a beneficial influence on the sugar output, but it is not lasting. These remedies, however, are of value when used in conjunction with the dietetic regimen. The number of calories necessary for each individual is to be de- termined and his diet list arranged accordingly. The end to be obtained is a sugar-free uriue, and in any case the sugar should be kept below one-half per cent, if possible. Where the sugar has disappeared a very gradual return to regular diet may be cautiously tried after two weeks in which no sugar has been present in the urine. Jlild cases require about two months of treatment before the sugar-free period is obtained. Massage, baths, and g\Tnnastic8 are of value in selected cases. The urine should he examined during the first six months every two weeks, after this every month ; and every attack of indisposition should be investigated without delay. For secondary symptoms the following is recommended: — Stoma litis. — The stomatitis, gingivitis, and pyorrhcea, the loosening and caries of the teeth, may be due either to localized infections or to trophoneurotic influences. The niouth-manifes- tations are among the moat distressing symptoms of diabetes. It is important that every case of diabetes should, from the beginning, be instructed carefully in regard to the possibility of mouth-complications, and taught how to obtain month asepsis and to perform the proper toilet of the teeth and gums. After each meal a diabetic should rinse his mouth and cleanse hia teeth, preferably with a 3-per-cent. solution of sodium carbonate in warm water, to which may be added, as a flavor, a few drops of tincture of eucahTituB or a little menthol. Mechanical irregu- larities of the teeth should be corrected early, preferably during the aglycoBuric period. All articles of food that can mechanic- ally scratch or injure tlic gums, and very hot beverages, should be forbidden. A hard tooth-brush should never be used. Hand' Book of Modem Treatment 126 Excessive foetor may be corrected by using the following mouth-wash : — R Beta-naphtholis, gr. ij. Sodii biboratis, Siiiss. Aquee inenthse pip., $iv. Aquse dest., q. s. Oij. If the gums are painful and bleeding, the following mouth- wash is useful: — IJ Tinct. opii, gr. xx. Potassii chloratis, m x. Sodii biboratis, m x. Syrupi althsese ofl&cinalis, 5ij» Diarrhoea, — Fatty diarrhoea (steatorrhoea) is not uncom- mon. Here, possibly, the involvement of the pancreas and he- patic insufficiency can be made responsible. The fats in the diet should be reduced. Sodium carbonate, or calcium carbonate, in 10-grain doses, with pancreatin or ox-gall, of each, 5 grains, should be administered at frequent intervals during the day. Constipation, — Obstinate constipation is often a trouble- some and a daijgerous complication. It, too, not infrequently precipitates coma if allowed to persist. Here absorption of bowel-poisons from stagnation and putrefaction of bowel-con- tents must be accused of determining the attack of coma. Usu- ally abundant fat-feeding and the restriction of carbohydrates are enough to counteract the constipation. Saline waters or a lemonade made as follows: — B Glycerini, mvj. Acidi citrici, gr. x. Aquae, 5iv. the whole quantity to be administered during the day, are all useful measures. The best medicines to counteract the con- stipation in diabetes are rhubarb and soda mixtures, eitlier mistura rhei et sodae 2 drachms to 3 ounces, or the following powder : — 126 Hand-Book of Modem Treatment. 3 Radicis rhei, gr. v. Sodii bicarbonatis, gr. v. Sulphuris prsecipitati, gr. v. Misce. Sig. : To be taken at nighty preferably in milk. Pniritis. — Pruritis, either general or localized, especially about the genitals, is one of the earliest, most distressing, and most obstinate symptoms of diabetes. General pruritis is pre- sumably due to irritation of the cutaneous nerves by circulat- ing sugar. In most cases its intensity fluctuates with the degree of glycosuria, and the symptom frequently disappears without further interference