Complete Text (Part 14)

tincture of lycopodium. He had first given it to check the nocturnal enuresis of children ; but find- ing it so surprisingly successful, he next employed it for adults, with the result that micturition was quickly reduced from six or eight times an hour to once in two hours. Dose — 15 minims to 1 drachm. EPIDIDYMITIS AND ORCHITIS. IJ Ung. hydrarg., 3ij. Adipis lanse hydros!, 3vj. Ichthyoli, 3j. Ext. belladonnse, gr. x. Misce. Sig. : Apply externally twice daily, preceded with rest in bed, hot fomentations and ano- dynes for the relief of pain. I^ Tinct. opii, 5v. Liq. plumbi subacetatis, Jv. Misce. Sig.: Add to warm poultice a tablespoonful of this and apply. Support testicles by means of a suspensory bandage. Indication: Useful during acute stage with pain and swelling. I^ Olei santali, 3iss. Fiant capsulse no. xx. Sig.: One capsule after meals. 168 Hand-Book of Modem Treatment. IJ Ichthyoli, 3v. Ung. belladonnse, 3iv. Ung. hydrargyri, 3iv. Petrol ati, q. s. ad Jij. Misce. Sig. : Apply daily to scrotum and support with a suspensory bandage. Indication: Used in subacute and chronic cases. I^ Potassii iodidi, 3ij. Tinct. gentianse comp., 3iij. Aquae, q. s. ad ^iij* Misce. Sig.: One teaspoonful after meals. Indication: Used in acute and chronic cases. IJ Sodii bromidi, 3iv. Tinct. belladonnae, m xx. Liq. potassii hydroxidi, f3ij. Tinct. opii camphoratse, 3ij. Syrupi zingiberis, 3ij. Aquse, q. s. ad 5vj. Misce. Sig.: One teaspoonful after meals. EPILEPSY. IJ Sodii arsenatis, gr. ^/^. Zinci phosphidi, gr. Vm* Calcii phos., gr. j. Sodii benzoatis, gr. iij. Pancreatini, gr. iij. Misce. Sig.: At one dose three times a daj" before each meal. The arsenic and zinc preparations are nerve-tonics, the lat- ter being also a nerve-sedative, the former aiding the exhala- tion of nitrogen. The calcium phospliate reduces cerebral ex- citability. The pancreatin and sodium benzoate aid digestion arid overcome intestinal fermentation. In an article upon epilepsy Dr. William F. Waugh says: — "Here is one remedy whose action in some cases of epilepsy seems too well proved to permit it to be neglected, and yet its Hand-Book of Modern Treatment, 169 - — ■ i ■ mode of action is not at all explained. This is verbenin. It was introduced to my notice some years ago by Dr. H. D. Fair. After this, Dr. French took it up, and reported some un- doubted cures in which verbenin figured largely. He at- tributed the epilepsy to intestinal parasites of the maggot fam- ily, and believed verbenin acted upon these. A number of other cases have been reported in which verbenin proved useful, in which the parasites were not noticed, though I am not sure they were searched for in all cases. While some failures have been reported, this is not to be wondered at in dealing with a newly-introduced remedy whose action, physiological and thera- peutic, is as yet undetermined. That it has sometimes suc- ceeded is the interesting point. "I have been unable to find anything to show what effect verbenin exerts on the vital functions. The directions I have given in advising this remedy are to administer ^/g grain four times a day, and add Vg grain a day whenever a fit occurs. Some persons report having reached doses of 19 grains a day without notable effects; but usually before 3 grains a day have been reached the good effects of the drug are manifested in the gradual lightening and final cessation of the convulsions. "In this connection it may be well to call attention to a remedy which has been termed ^anti-epilepsy.^ It is composed of atropine and glonoin, ^/ogo grain each. This remedy has proved quite effective, the patient carrying it about and taking 1 or more granules whenever the fit threatens. The glonoin flushes the face almost instantaneously, and this effect is sustained and prolonged by the atropine. By this means the convulsion is jugulated at the start. After the patient has learned to rely on this powerful and effective remedy ho finds it acts even better than at first, so that in time the knowlodtre that he has an un- failing means of preventing the development of the convulsion will suffice to allay the irritability, without his needing to have recourse to its administration." We liave in chloretone a drug which, in selected cases, is an excellent substitute for the bromides. It is a driifj which in my experience gives good results with increasing dosa<re after the primary effect is obtained. In administering the drug it is usually put up in capsules, and sufficient is given in the begin- 170 Hand-Book of Modern Treatment. ning to produce an hypnotic effect. In a large class of epileptic cases the fits occur most frequently at night, and one dose of 15 or 20 grains a day is given at night until a drowsy effect on the following day is produced ; if the desired results in reducing the number of fits are obtained, the dose is reduced one-half and the patient kept on this indefinitely. The dietetic, hygienic, and constitutional treatment is rigidly enforced in conjunction with the administration of the chloretone. IJ Potassii bromidi, 3x. Sodii bromidi, 3iij. Ammonii bromidi, 3iij. Sodii benzoati, 3iij. Aquae destil., Oij. Misce. Sig. : As a beginning dose take one table- spoonful after breakfast and at bed time. The dose should be increased so as to control the seizures. If the epileptic attack recurs at a regular hour each day, two- thirds of the daily amount should be given an hour before the time of the expected attack. IJ Acidi hydrobromici diluti, mx. Ferri bromidi, gr. j. Potassii bromidi, gr. x. Sodii salicylatis, gr. ij. Spiritus rectificati, m x. Glyceroli pepsini, m x. Olei gaultherise, in ss. Liq. ammonii citrati (B. P.), 3ss. Misce, Sig. : At one dose. Double it if necessary. IJ Sodii bromidi, 3x, Fluidextracti solani Carol inense, ^ij. Aquae camphorae, q. s. ad Jiv. Misce. Sig.: One teaspoonful three times a day in water. IJ Bromidi strontii, 3j. Elix. curacoae, 5iij- Misce. Sig. : Teaspoonful in water four times a day. Uand-Book of Modern Treatment, 171 I^ Lactatis stanni, gr. xl. Elix. curacoffi, Biij. Misce. Sig. : Alternate these formulse weekly. Ap- ply a current of galvanism descending from the forehead to the sacrum daily^ of from 10 to 50 milliamp^res, for a half -hour. I^ Potassii hromidi, 3iij. Infus. adonis vernalis, fjiv. Aquse dest., q. s. ad fjvj. Misce. Sig.: Dessertspoonful three times daily. IJ Ammon. bromidi, 5j. Antipyrinse, 3ij. Misce et fiant chartulse no. xxiv. Sig.: One powder twice daily. I^ Liq. potassii arsenitis, 3iv. Sig.: Give three drops twice daily with the above description. IJ Potassii bromidi, 3iv. Tinct. belladonnse foliorum, 3ij. Syrupi simplicis, f3iij. Aquse, q. s. ad f^iij. Misce. Sig.: Teaspoonful in water after meals. EPISTAXIS. The best remedy for bleeding at the nose is the vigorous motion of the jaws as if in the act of cliewing. In the ease of a child, a wad of paper should be inserted and chewed hard. It is the motion of the jaws that stops the flow of blood. The remedy is very simple, ])iit has never been known to fail in a single instance, even in the severest cases. For epistaxis Hutchinson recommends that the i)ationt soak his hands and feet in water as hot as can be borne: a method which he savs never fails, even in obstinate cases. « The treatment of nose-bleed is local and the most reliable means available is plugging the nostrils with cotton which is 172 Hand-Book of Modern Treatment. saturated with adrenalin chloride 1 to 2000. Compression of the artery on the upper lip near the nose by pressure against the jawbone will often control the haemorrhage. IJ Antipyrini, gr. viiss. Tannini, gr. xv. Pulv. saccharini, gr. cl. Sig. : To be used locally. IJ Gelatini, gr. cv. Acidi salicylic!, gr. iv. Aquse bullientis, Jiij. Misce. Sig.: Inject a teaspoonful into the nostril. In habitual epistaxis without regard to the cause, the fre- quency of the attacks, or their severity, Woodward says ammo- niimi carbonate is an absolute specific. Two grains every ten minutes will stop the flow quickly during the attack. To cor- rect the tendency and overcome the habit, 2 grains should be given from three to six times each day. In a case of severe epistaxis Professor J. Chalmers Da Costa used Carnot's formula of: — IJ Normal salt solution^ 16 parts. Gelatine, 1 part. Misce. Saturating the cotton with this solution, he plugged the nose in the usual way. The advantage of this solution is that it forms an aseptic coagulum. Dr. Gillette recommends the use of a peroxide of hydrogen, a teaspoonful or more in full strength, injected by means of an ordinary syringe, as a remedy for epistaxis, claiming the relief to be immediate. In operations in the nasal cavity when bleed- ing obscures the vision, injection of peroxide of hydrogen will check the haemorrhage, and if the patient be asked to blow the nose the field will be found to be clear again. I^ Liq. adrenalini chloridi (1 to 1000). Sig.: Place on pledget of cotton and insert in the nose. Hand-Book of Modern Treatment. 173 I^ Pulv. aluminiSj Bss. Pulv. amyli, Jss. Misce. Sig.: Snuff up the nostrils. I^ Alumnol, 25 per cent, sol., |[ss. Sig.: Place on pledget of cotton and place on bleeding point. B Argenti nitratis (40 per cent, solution), 3ij. 8ig. : Touch the bleeding points with this. XJ Acidi tannici, 3ij. Pulveris amyli, 3ss; Misce. Sig.: Use by insufflation. ERYSIPELAS. Mortimer recommends as prophylactic measures in the treatment of erysipelas that the patient should be isolated and that all dressings should be burned when removed. Proper ven- tilation should be established and thorough cleanliness observed. In the general management of the patient, small doses of calo- ^^1> ^/s graiii? every two hours for eight doses, followed by a saline, should be given, as well as for the first twenty-four hours y^ minim of the tincture of aconite every two hours. When stimulation is required, alcohol should be adminis- tered freely, and if necessary, strychnine and nitroglycerine. An ice-bag or cold compresses applied to the head to relieve the pain are of service ; in addition the following may be given : — I^ Caffeinse, gr. ss. Camphor, monobrom., gr. ss. Acetanilidi, gr. ij. Misce et flat capsula no. j. Sig.: One such capsule every two hours. Applied locally to the affected areas the author recommends compresses saturated with the following: — B Tinct. opii, fjj. Liq. plumbi subacet., f^ij. AquflB destil., Oj. Misce. Sig.: To be applied locally on compresses. 174 Hand-Book of Modem Treatment. Liquid nourishment should be given liberally and system- atically about every three hours. It should consist chiefly of milk, broths, and beef juice. Ice cream may be given, also cold water acidulated; lemonade may be substituted for the water. During convalescence a general tonic treatment is indicated with some form of iron : — B Strychninse sulph., gr. Vw Acidi arsenosi, gr. Voo* Ext. gentianse, gr. ss. Quininse sulph., gr. ij. Misce et fiat capsula no. j. Sig..: One such capsule after meals. I^ Strychninse sulph., gr. ^. Liq. ferri et ammon. acet., f^vj. Misce. Sig.: One tablespoon ful in water after meals. B Tinct. opii, 3iv. Fluidextracti aconiti, 3ij. Ext. belladonnae, 3iv. Fluidextracti veratri, 3iij. Ichthyoli, q. s. ad ^iv. Misce. Sig. : Apply every three hours. Indication: Erj^sipelas and traumatic in- flammation. IJ Phenolis, gr. xv. Tinct. iodi, gr. xv. Mucil. acaciae, 3j. Alcoholis (pure), 3v. Misce. Sig. : Shake and paint over the affected area every two hours until the swelling and shiny redness have disappeared. IJ Ichthyolis, 3j. Ung. zinci oxidi, 5j« Misce. Sig.: Apply locally and cover with gauze. Hand-Book of Modern Treatment, J 75 9 Tincturse ferri chloridi, fjss. Sig.: Ten to twenty drops through a glass tube every four hours. IJ Ichthyolis, 5ij. Adipis lanse hydrosi^ Sij* Sig.: Apply freely and cover with gauze or cloth. 3 Tinct. iodi, 3vj. Olei camphorse, 3iij. Ichthyoli, 3iij. Misce. Sig.: Shake and apply locally two or three times a day. W. F. Waugh recommends in the treatment of erysipelas the use of pilocarpine in stheuic cases, and iron in asthenic cases. During a period of twenty-five years he has had good results with this line of treatment, and no deaths. No local treatment is recommended. In sthenic cases the pilocarpine is given every hour until sweating occurs. When this takes place the edges of the involved area begin to recede. This remedy is then sus- pended for a day, and if the eruption continues the treatment is resumed until it is evident that the remedy has perfect control of the disease. In asthenic cases the tincture of the chloride of iron, 30 drops every four hours, and nourishment crowded, when improvement sets in at once. Dr. M. J. Bliem writes that as an external application he paints the affected area once or twice a day with Norwood's tincture of veratrum viride. "It has produced quicker allevia- tion than any other treatment I have ever used. I will say nothing of the internal treatment, as that will, of course, depend.^ 99 PAVUS. 9 Resoreini, 3ij. Adipis lanse hydros!, Bij- Vaselini, 5ij. Misce. Sig.: Massage scalp thoroughly with this twice daily. 176 Hand-Book of Modern Treatment, IJ Phenolis, 3j. Ung. picis liq., 3ij. Ung. hydrargyri nitrat., 3ij. Ung. sulphuris, 5iv. Misce. Sig. : Wash scalp with soap and water every day and rub this in well^ and should be made up once weekly. IJ Acidi sulphurosi, 5v. Sig.: Dilute with water and apply twice daily after washing the head. I^ Unguenti hydrargyri, 5j. Unguenti sulphuris, Jij. Misce. Sig.: Apply twice daily. Indication: Used after scales removed. I^ Unguenti chrysarobini, 3ij. Ung. picis liquidse, 5ij. Misce. Sig. : Apply once daily after cleansing scalp. IJ Ung. sulphuris, Jss. Ung. picis liq., q. s. ad Sij. Misce. Sig.: Apply to areas affected. Indication: Useful in favus of non-hairy regions. FELON. In treating felons do not waste time with poultices, but incise at once, drain, use antiseptic dressings, and in some cases place the extremity in splints. Take a hypodermic syringe and find the sensitive point, or take a lead-pencil and press the point down over the felon until you thus localize the sensitive point. Go down into the peri- osteum with the hypodermic and inject cocaine at this point, and keep injecting it as you draw out the syringe. Then cut down to the periosteum with a bistoury, and with a syringe or probe go down into the pocket and inject carbolic acid. You Band-Book of Modem Treatment, 177 have then taken the necessary steps to kill the microbe. If you are afraid of carbolic acid poisoning, put in some alcohol. Put on a loose dressing. A commencing felon will always be aborted by the local ap- plication of alcohol under perfect air-exclusion. Cotton is sat- urated with alcohol and placed about the affected part, and a thin rubber finger-stall applied over all. Seventy-two hours usually suffices to give relief or even effect a cure. I^ Tr. opii, 5j. Liq. plumbi subacetatis, Sj. Aquae, Sxvj. Misce. Sig.: Keep affected part well bandaged and soaked in the above. FCETEB OF BREATH. 9 Potassii chloratis, gr. xxx. Tinct. myrrhse, mx. Elix. calisayse, f^iij. Misce. Sig.: Dilute one tablespoonful with two of water and use as a mouth wash. 9 Potassi chloratis, gr. xlviij. Acidi muriat. diluti, fSj. Syrupi, f^ss. Aquae, q. s. ad f^iij. Misce. Sig.: Teaspoonful every two hours for a child 3 years old. Indication: Foetor due to ulcerative stoma- titis. For such this is useful. IJ Pepsini (scale), 3iv. Acidi hydrochlorici diluti, fSiv. Strychninae sulphatis, gr. i/4. Aquae, q. s. ad f^viij. Misce. Sig.: A tablespoonful m water after meals. Indication: As a result of gastric fermen- tation due to an acidity. 12 ^«r-^ i; .1 170 ll-iifii:. ] il I'luMioii-. 7}\ Mi-.-. ui- ' I . f % « a V r tivo \k I- ••1 , ]i . -» no. x. .•\x[ t\»ll(>\v in ; » .111 auto- I !, ■ ii ■ji i -' t.'^iij. X •:'«. I'vorv two '.•!iu- tcvors. ^x'l'Ul rXJTV two ■ »'\ri •«. Hand-Book of Modern Treatment, 179 I^ Tincturse digitalis, fSiij. Tincturse ferri chloridi, f3v. Misce. Sig. : Fifteen drops three times daily. Indication: Used in hectic fever. FEVER, INTERMITTENT AND REMITTENT. B QuininsB hydrobromatis, gr. xxx. Hydrargyri chloridi mitis, gr. v. Pulveris capsici, gr. iss. Pulveris Doveri, gr. v. Aloini purificati, gr. V«. Misce et fiant capsulse no. vj. Sig.: One every four hours. Q Quininse sulphatis, 3ij. Acidi sulphurici aromatici, fSj. Olei menthae piperitae, mv. Fluidextracti glycyrrhizse, f^j. Glycerini, f^iv. Misce. Sig.: A teaspoonful or two every two or three hours. Q Quininae sulphatis, 3j. Sodii arsenatis, gr. ij. Ext. ignatise ale, gr. ij. Misce et fiant pilulse no. xx. Sig. : A pill three times a day. I^ Quininae sulphatis, 3j. Acidi sulphurici aromat., 3j. Liquoris potassii arsenitis, 3j. Syrupi aurantii corticis, 5j. Aquae, q. s. ad 5v. Misce. Sig.: A tablespoonful twice a day after eating. Indication: Used to prevent relapse after paroxysms have passed. - I( Quininae sulphatis, 3j. Elixir is taraxaci comp., Sij* Sig.! A teaspoonful twice a day after eai- ing. Indication: Used to prevent a relapse. 180 Hand-Book of Modern Treatment. The following formula, having the quinine in solution, is not very unpalatable, and cured many eases where the quinine alone failed : — B Quininse sulphatis, gr. 1 vel Ixxx. Acidi hydrochlor. dil., fSiss vel iiss. Tinct. zingiberis, fSiiss vel iv. Tinct. opii camph., fSii vel iv. Syr. limonis, f^ij. Aquae, q. s. ad f^viij. Misce. Sig. : Tablespoonful every four hours. Take through a straw. The following prescription is of much value in malaria where quick action is not necessary: — B Pulv. capsicum, gr. x. Euonymin, gr. xx. Quininse sulph., gr. xxx. Misce. Sig.: