Complete Text (Part 11)

when the urine becomes sugar-free, only to reappear again, however, when more liberal carbohydrate feeding is instituted and the hyperglycsemia increases. The best remedy for internal use, and almost a specific, is sodium salicylate, in doses of 30 grains, several times a day. Local applications are of very little value in general pruritis. In pruritus around the genitals, due in many cases to the development of fungi (mycosis vulva?), treatment directed towards the reduction of the glycosuria, sodium salicylate in- ternally and anodyne powders applied locally, usually relieves. A 5-per-cent. cocaine ointment or -/^-per-cent. eucaine ointment or a dusting powder containing 10 per cent, of orthoform, com- bined with frequent washing of the parts without rubbing or scratching, usually produces prompt relief. I^ Saccharin, gr. x. Pone in cachetas no. xx. Sig.: Place one or two in a cup of coffee. Indication: I'scful when vou can't use sugar. T^ Codeinse sulphatia, gr. x. Misce fiant pilulte no. xx. Sig.: One three times daily after meals. IJ Pulveris opii, 3ss. Misce fiant chartulae no. xxx. Sig.: One three times daily one hour after meals. Hand-Boole of Modem Treatment, 127 I^ Sodii salicylatis, 3vj. Aquse, q. s. ad ^w, Misce. Sig. : One teaspoonf ul t.i.d. after meals. 3 liquor potassii arsenitis, Siv^ Sig.: One drop three times daily after meals and increase one drop daily until physiological effect is produced. Indication: Used in anaemic patients. I^ Strontii salicylatis, Siv. liq. potassii arsenitis, mxx, Potassii iodidi; 31 j. Aquae, q. s. ad 5^j- Misce. Sig.: One teaspoonf ul in water after meals. Indication:. Used in anaemic and rheumatic patients. DIARRH(EA. B Tinct. opii camphoratae, fSij. Fluidextracti hamamelis, 5j- Acidi carbolici, 3j. Fluidextracti kino, f3ij. Tinct. zingiberis, i3ij. Calcis praecipitatae, 5j. Syrupi, q. s. ad 5viij. Misce. Sig.: Shake before using and take I tea- spoonful every three hours. Q Bismuth i subnitratis, 3ij. lodoformi, gr. xxiv. Saloli, gr. xxiv. Acidi tannici, 3ij. Pone in cachetas no. xij. Sig.: One cachet every six hours. Indication: An intestinal tuberculosis. 128 Hand-Book of Modem Treatment. 3 Bismuthi subnitratis, gr. xxx. Salolis, gr. v. • Misce. Sig. : One such powder every six hours until relieved. To prevent recurrence continue the remedy for some time, giving it, however, less frequently. Restrict the diet principally to eggs and malted milk. Indication: Chronic fermentation diarrhoea. B Acidi carbolici, m xxiv. Tinct. opii deodorate, 3j. Bismuthi subnitratis, Siv. Acacise pulv., q. s. Syrupus, q. s. ad 5viij. Misce et fiat emulsum. Sig.: Dessertspoonful every three hours. I^ Morphinee sulphatis, gr. j. Quininse sulphatis, 3j. Magnesii sulphatis, ^ij. Acidi sulph. aromat., q. s. sol. Aquse menthae pip., q. s. ad ^\y. Misce. Sig.: One to two teaspoonfuls in a glass of water after meals. Indication: Chronic diarrhoea. I^ Bismuthi subnitratis, gr. x. Sodii sulphocarbolatis, gr. iij. Cinnaniomi, gr. ij. Opii, gr. ss. Misce. Sig.: One dose to be repeated every two or three hours as long as needed. IJ Hydra rgjTi chloridi mitis. Pulveris opii. Bismuthi subnitratis. Misce et fiant chart ulse no. vj. Sig. : Give one every hour until al^ are taken or the diarrhoea is controlled. Hand-Book of Modern Treatment, 129 3 Capsici, gr. viij. Cinnamomi, gr. xvj. Greranii, gr. xxxij. Misce et fiant chartulae no. viij. Sig.: One in hot water every one, two, or three hours until relieved. Indication: Diarrhoea in which there is much blood. In persistent diarrhoea of the tuberculous, according to the International Clinics, the following is said to give satisfactory results where other means have failed: — I^ Ichthyoform, 3ss. Tannalbin, 5j. Bismuthi subgalL, 3j. Codeinse, gr. iss. 01. menthse pip., m iss. Misce et divid. in chart, no. vj. Sig.: One powder every three or four hours according to indications. Q Bismuthi subsalicylatis, Siiss. Zinci .phenolsulphonatis, gr. iij. Liquoris calcis, f^iss. Tinct. opii camphorata), f3iv. Aquae dest., f^iss. Misce. Sig.: A teaspoonful every two hours and after each passage until the diarrhoea ceases. B Pulveris ipecacuanhse, gr. x. Pulveris papain, 3j. Pulveris capsici, 3iss. Pulv. nucis vomicae, gr. x. Misce et fiant no. xl. Sig.: One three times daily. Indication: Fermentation diarrhoea. B Benzonaphtholis, gr. ij. Bismuthi subsalicylatis, gr. v. Resorcinolis, gr. ij. Misce et fiat pulver. Sig.: Some every three hours. 9 J 30 Hand-Booh of Modem Treatment, ^ 01. ricini, 3iv-5j. Tinct. opii deodorati, wxv-xx. Misce. Sig.: Take at one dose. ^ Indication: Used in acute diarrhoea with ab- dominal pain, due to eating decomposed or in- digestible food. In all diarrhoeas irritating toods and products of decomposition should be swept trom the alimentary tracts before giving sedative or astringent remedies. I^ Tannigeni, 3ij. Bismuthi subnitratis, 3iv. Resorcini, gr. vj. Misce et pone in cachetas no. xij. Sig.: One cachet every two. hours. Indication: Used in serous or mucous diar- rhoeas after ridding bowels of irritants and products of decomposition. For the diarrhoea that follows exposure to cold after a hearty meal, or that comes on from throwing off the bed clothes at night, the following is recommended: — I^ Tinct. capsici, Siiss. Tinco. opii, Siiss. Sp^^.. camphorae, Siiss. Chloroformi, 3j. Alcohol is, q. s. ad Jij* Misce. Sig.: One teaspoonful every hour until re- lieved of pain; then one teaspoonful every two hours until the diarrhoea is effectually checked. I^ Tinct. kino, Svj. Tinct. opii, Sj. Tinct. krameriae, Svj. Tinct. chiratse, Svj. Tinct. cardamomi comp., q. s. ad 5vj. Misce. Sig.: One ounce every three hours in water. Indication: Used in serous or mucous diar- rhoea with abdominal pain after bowel is rid of irritating material. Hand-Book of Modem Treatmeta, 131 9 Spiritos camphorae, Siij- SpiritUB chloroformi, ^iij* Misoe. Sig.: One temspoonfiil in water every hoar. Indication: Abdominal pain and diarrhoea. 3 Acidi (phenolis) carboliei, m x. Bismuthi sobnitratis, gr. c. Misoe et fiant cfaartulae no. x. Sig.: Take <Mie everr foor boors. DIAKRHSA, CHILDREH. Q Tannalbin. Siss. Hydrarg. ehloridi mitis,. gr. j. Ipeeacoanhje et opii. gr. xv. Saocharini, gr. ^4- Misce et fiant chartalc no. xx. Sig.: One ererr two hours for first three doses; then ereiy four to six hours for a child of one year. Two powders per dose for child three years old. 9 Magnesii sulphatis, Bij- TincL opii camphoratc, 3ij. Aquae, q. s. ad Bi^- JAiooe. Sig.: One teaspoonful until you get watery action and then as needed until complete re- eoverv. Indication: Green mucous diarrhcsa of chil- dren. 9 Tannalbin, 3ij. Spt. cinnamomi, m iij. PulTcris aromaticse, gr. xv, Sacehari, gr. xv. Misoe et fiant chartuls no. xa\ Sig.: One every three hours. 9 Tinct. iodi. gtt. isy. Syrupi. Siss- Aquc destil.,. q. s. ad ^x. Misoe. Sig.: One teaspoonful every two hours. Indication: Infantile diarrhoea. 132 Hand-Book of Modem Treatment. 3 Bismuthi subnitratis, 3j. Hydrarg. cum crete, Sss. Pulveris hydrastis, Sss. Misce et fiant chartulse no. xxx. Sig. : One every two or three hours for a two-year-old child. Indication: Cholera infantum and summer complaint. •WHEN TO GIVE OPIUM IN DIARRHCEA OF YOUNG CHILDREN. It is contraindicated (1) in the first stage of acute diar- rhoea, before the intestinal canal has been freed from decom- posing matter; (2) where the passages are infrequent and of bad odor; (3) when there is a high temperature or cerebral symptoms are present; (4) when its use is followed by an ele- vation of temperature or the passages become more offensive. It is indicated (1) when the passages are frequent with pain; (2) when the passages are large and watery; (3) in dysenteric diarrhoea, together with castor-oil or a saline; (4) in later stages with small, frequent, and nagging passages; (5) when the passages consist largely of undigested food, and the bowels act as soon as food is taken into them. Most excellent results are secured from the use of gelatine in the diarrhoea of infants. Chemically pure gelatine is taken and dissolved in ten times its weight of boiled water. The so- lution is then sterilized in an autoclave at 120° C. for half an hour. The solution is then tubed, putting 10 cubic centimeters (representing 1 gram of gelatine) in each tube. The contents of one tube are then added to each bottle of milk given to the infant. In this way 8 grams of gelatine may be given a day, although 12 or even 14 grams have been used. The good effects of the treatment are seen verv soon. The number of stools diminishes, they become more solid, and lose their green color and offensive odor. The general symptoms improve rapidly — often after four or five tubes. The medication finds its clearest indication in cases of dyspeptic diarrhoea without organic lesion. In true cholera infantum good effects are not obtained. The gelatine appears to have a direct effect upon the coagulation of the milk and upon the intestinal secretions. The fermentative and putrefactive Hand-Book of Modem Treatment. 133 processes are stopped, perhaps by a purely physical process, as some experiments outside the body would seem to indicate. n Bismuthi subnitratis, gr. x. Syrupi acacise, wxx. Mist, cretse, q. s. ad f5j. Misce. Sig.: One such every two hours for a child one year old. Indication: Simple diarrhoea. I^ Magnesii sulphatis, gr. y-x. Tinct. rhei dulcis, m x. Syrupi zingiberis, m x. Aquse, q. s. ad fSj. Misce. Sig.: This may be given every half -hour for several doses until free watery movement en- sues. B Bismuthi subcarb., 3j. Aquse cinnamomi, ^ij* Tinct. opii, gtt. ij. Misce. Sig.: Teaspoonful every one or two hours. I^ Phenolis, gtt. ii or vj. Mucilaginis, ^i]. Misce. Sig.: Teaspoonful every two hours. I^ Argenti nitratis, gr. ij. Aqu£e dest., ^ij. Misce. Sig.: Teaspoonful every two hours. 9 Resorcini, gr. ij. AqusB cinnamomi, ^ij* Tinct. opii, gtt. ij. Misee. Sig.: Teaspoonful every two hours. Indication: Each of the above four preserip tions useful in cholera infantum. 134 Hand-Book of Modem Treatment. I( Ammonii chloridi, gr. xxiv. Fluidextracti glycyrrhizse, Jss. Aquse, q. s. ad 5iij. Misce. Sig. : One teaspoon ful three times daily. Indication: Useful when much mucus is in stools. DIURETIC AND DIAPHORETIC. IJ Potassii acetatis, gr. xv. Potassii nitratis, gr. xv. Oxymelis scillse, 3iss. Syrupi sarsaparillse comp., Siss. Infusi juniperus, Jiiiss. Misce. Sig. : To be taken during the day. ^ Ext. stigmat. maidis, gr. xlv. Ext. convallarise majalis, gr. xlv. Sodii benzoat., gr. xlv. Lithii carbonat., gr. xlv. Misce et fiant pilulse no. Ix. Sig.: Give from four to ten daily. The following is recommended by the Practitioner to pro- duce diaphoresis in combating colds: — IJ Pulv. camphorse, gr. v. Pulv. opii, gr. Vs. Potass, acetatis, gr. iij. Sacchari, 3iiss. Misce et fiat chartula no. j. Sig. : One such powder to be taken in cup of tea at bed time. EFFERVESCING DIAPHORETIC DRAUGHT. This well-known combination is useful: — I^ Potassae carbonatis, 3ij. Aquae destillatse, 5iv. Solve. Hand-Book of Modern Treatment, 135 IJ Succi limonis recentis, fjij. Aquse destillatse, f^ij. Misce. Sig. : Mix two tablespoonfuls of the lemon- ade with one of the alkaline solution, and let the mixture be drunk while effervescing. To be repeated every two hours. This preparation is practically the well-known "neutral mixture," but is frequently better borne and its efferves- cence makes it more agreeable. IJ Digitalini crystal., gr. Yqq. Pilocarpinae hydrochlor., gr. 14« Sparteinse sulph., gr. ss. Aquae destill., mxv. Misce. Sig.: For hypodermic use. Repeat if neces- sary. I^ Pulv. ipecacuanhse et opii, 3j. Camphorse, gr. v. Pulveris chocolatae, 3ij. Misce et fiant chartulse no. x. Sig.: One at bed time with a warm drink. Indication : Diaphoretic. I^ Hydrarg. chloridi mitis, gr. j. Pulveris ipecacuanhse, gr. j. Sacchari lactis, gr. xx. Misce et fiant chartulae no. x. Sig.: One powder three times daily. Indication: Infants with green stools. IJ Tincturse digitalis, fSiv. Sig.: Six minims four or five times daily. Indication : Diuretic. B Tinct. strophanthi, fSiv. Sig.: Five minims four times daily. B Theobrominae sodii salicylatis (diuretin), 3ij. Sig.: Four grains six times daily. 136 Hand-Book of Modem Treatment. DIPHTHERIA. If on account of poverty people cannot afford antitoxic serum, Curtius uses local treatment alone and has had excel- lent results with it. (Of 28 patients treated during one sum- mer with it alone, only 1 died.) He employs Loeffler^s solution, the formula of which is as follows : — IJ Mentholis, gr. xxxviij. Solve in toluene, m cxl. Alcoholis absol., Siv. Liq. ferri chloridi, wxv. This he believes to be the most efficient antiseptic solution on the market. He applies this until all the membrane particles have disappeared ; at first every three hours and later three times daily. He first removes the membrane as well as he can with a cotton swab, then applies the solution with an applicator against the surface for ten seconds. Bascoul practices in Algiers, where it is not always possible to obtain fresh antidiphtheria serum. In the lack of it, he uses bromine, and states that seven years of experience with it have demonstrated its great efficiency. He administers from 5 to 10 drops of bromine in 200 grams of sweetened water, with 3 grams of potassium iodide. He uses for a gargle the same with from 20 to 30 drops of the bromine. He applies this treatment to all kinds of sore throats, including those of the eruptive fevers, and has found it both certain and effectual. If antitoxin cannot be obtained early, Dr. Leonard Wil- liams recommends that isolation be carried out in the usual way and a mixture containing the biniodide of mercury be given. The preparation is insoluble in water alone, but is freely solu- ble in an excess of potassium iodide. The following combina- tion is recommended: — IJ Hydrargyri perchloridi, gr. j. Potassii iodidi, gr. xx. Glycerini, 3ij. Aquae, q. s. ad Jviij. Mi see. Sig. : One teaspoonful to a tablespoonful three or four times daily. Hand-Book of Modem Treatment, 137 In the foregoing mixture a double decomposition occurs, forming the biniodide of mercury, about Vg grain to the ounce. The glycerine is added in order to increase the tendency to adhere to the fauces and thus increase its local effects. As a bactericide the biniodide is said to be four times as powerful as the perchloride, and it does not have the tendency to throw down an inert albuminate when coming in contact with the tissues. The author is emphatic in his statement that this prepara- tion of mercury, excepting, of course, antitoxin, is a more ef- fective foe of the Klebs-Loeffler bacillus than any other drug or inhalation or local application which has ever been used. In all forms of sore throat the heart should be frequently examined as in rheumatism and chorea. IJ Seri antidiphtherici. Sig.: Inject 1500 to 2000 units into subcu- taneous tissues of the back and repeat in twelve hours. Dose should be repeated every six to twelve hours in severe cases. As a prophylactic should employ 500 units of the serum. ;B Hydrarg. chlor. corros., gr. 148' Tinct. ferri chlor., m x. Glycerini, mx. Tinct. bellad., m ij. Aquse destill., f3j. Mi see. Sig.: Take every hour or two, well diluted. IJ Tinct. ferri chloridi, fjss. Sig.: Two to ten drops every two or three hours. IJ Phenolis, fjj. Olei eucalypti, fjj. Olei terebinthinse, fjiij. Misce. Sig.: I'se as directed. Place two table- spoonfuls of this in a quart of water, and this is placed in an open vessel and allowed to boil constantly. 138 Hand-Book of Modem Treatment, 3 Potassii permanganatis, gr. xx. AqiUB, Oj. Misce. Sig. : Swab throat two or three times daily. DROPSY. I^ Pulveris digitalis, gr, xlviij. Camphorse, gr. xlviij. Flor. benzoes, 3ij. Misce et fiant chartulse no. xxiv. Sig.: Three to four such powders each day. I^ Tinct. digitalis, 3ij. Sol. nitroglycerini (1 per cent.), 3j. Tinct. strophanthi, 3j. Misce. Sig.: Fifteen drops four times daily. IJ Diuretini, Jiij. Sig. : Thirty grains four times daily. B Tinct. digitalis, f3ss. Liq. ammon. acetat., f^ss. Spt. seth. nitrosi, f3ij. Syrupi tolutani, f^ss. Aquae carni, q. s. ad fSiij. Misce. Sig.: Teaspoonful every two hours for a child 6 or 8 years old. I^ Tinct. digitalis, f3ss. Elixiris simp., 5ss. Liq. potassii citratis, q. s. ad ^iij. Misce. Sig.: One teaspoonful every two hours to a child 6 or 8 years old. B Pulv. digitalis foliorum, gr. xx. Hydrarg. chloridi mitis, gr. xx. Pulveris scillae, gr. xx. Miace et fiant chartulae no. xx. Sig. : One powder after each meal. Indication : Cardiac dropsy. Hand-Book of Modem Treatment. 139 3 Liq. potassii arsenitis, 3iy. Sig.: Two or three drops three times daily after meals. Indication: Useful in dropsy of old people. DYSENTERY. J. D. Hunter, who has resided in Peru for nearly forty years, where severe types of dysentery are endemic, usually gives ipecacuanha in a 45-grain dose as soon as the patient is seen, preceded, a half-hour before administering, by 15 to 30 min- ims of laudanum or a hypodermic of ^/^ grain of morphine and a sinapism to the pit of the stomach. In spite of the lauda- num and sinapism the patient is likely to experience severe nausea and vomiting. Peruvian practitioners usually give an infusion of the contused ipecac-root and sometimes enemata of this infusion. The clear decanted liquid, as used in these infu- sions, is rather less disgusting to most patients than the pow- dered ipecac. A second dose of the medicine is given within twenty-four hours, usually the next morning. When ipecac fails, or for any reason cannot be used, many Peruvian doctors use an emulsion of castor- and almond- oils in small, repeated doses, or other fats. Sulphur, grains xx, and Dover's powder, grains x, every four hours, is also good ; or the sulphates of magnesium or sodium may be profitably tried. Res. podophylli, grain Vs^ ^^^ powdered ipecac, grain ^/o, every hour until the stools become bilious was also found to be effective in some cases. Turpentine, much lauded in chronic dysentery, the author also likes in acute cases, and recommends the fol- lowing : — I^