Complete Text (Part 18)

according to the strength of the ointment used, immediately after an irrigation. IJ Zinci sulphatis, gr. xij. Aquae rosse, ^iij- Aquae dest., Svj- Misce. Sig.: Inject in terminal stage when few shreds are passed in morning or there is pres- ent a little irritation in the fossa navicularis. IJ Copaibae para, 3ij. Olei santali, 3ij. Olei cinnamomi, m xxiv. Saloli, 3ij. Misce et fiant capsulae no. xxiv. 8ig.: One after each meal. Hand-Book of Modern Treatment. 221 Q Sodii bromidi, 3iv. Tinct. belladonnse, gtt. xx. Liq. potassii hydroxidi, fSij. Tinct. opii camphoratse, 3iv. Syrupi zingiberis^ Jij. Aqu£e dest., q. s. ad 5vj. Misce. Sig.: Teaspoonful three times daily one hour after meals. Indication: Useful in nervous genito-uri- nary cases. IJ Argyrol, 3vj. Aquse dest., f^v. Misce. Sig.: Inject once or twice daily and retain for ten to fifteen minutes. Allow to escape and inject again and retain for some time. Use this for one week and follow with milder injec- tions. GOUT. I( Potassii iodidi, 5ij. Potassii bicarb., Svj. Vini colchici, Sij. Aquse camphorse, 5xij. Misce et fiat mistura. Sig.: One tablespoonful three times a day, after meals, in a wineglassful of water. IJ Tinct. seminis colchici, 5ss. Tinct. aconiti rad., 5ss. Tinct. guaiaci, ^ss. Elix. simplicis, 5ss. Misce. Sig.: One-half a teaspoonful in water after meals. The following combination is recommended, administered in the form of pills : — IJ Ext. colchici acetici, gr. xv. Ext. colocynth. comp. (6. P.)., gr. xviij. Pulv. ipecac, comp., gr. xviij. Misce et fiant pilulse no. xij. Sig.: One pill night and morning. 222 Hand-Book of Modern Treatment. IJ Ext. colchici acetici, gr. vj. Ext. rhei, gr. v. Ext. aloes soc, gr. v. Ext. belladonnae, gr. j. Misce et iiant pilulse no. vj. Sig. : One pill twice a week at bed time. IJ Tinct. stramonii, fSj. Tinct. colchici, fSiss. Tinct. guaiaci, fjij. Misce. Sig.: A teaspoonful three times a day in milk. IJ Vini colchici, f^ss. Magnesii carbon., Sij. Potassii bicarb., Sij. Aquae menthae pip., f^vj. Misce. Sig.: A tablespoonful every four hours. IJ Potassii bicarb., Six. Potassii nitritis, 3vj. Sodii nitritis, gr. j. Misce et fiant chartulae no. xx. Sig.: One in the morning in a large glass of water. Indication: Good when arterial tension is high. IJ Tinct. aconiti rad., 3j. Morphinae sulph., gr. ij. Antimonii tartarati, gr. j, Syr. zingiberis, Jss. Aquae, q. s. ad ^Jj- Misce et fiat mistura. Sig.: One teaspoonful every three hours in water. 5 Lithii bromidi, 5j. Vini colchici radicis, 5j. Syr. tolutani, 5j. Sol. potassii citratis, ^iv. Misce. Sig.: One teaspoonful well diluted in water after each meal. Indication: Useful in chronic £:out. Hand-BooJc of Modern Treatment, 223 I^ Lithii benzoatis, 3ss. Sodii brom., 3ij. Potassii carb., 3ij. Potassii acetatis, ^iss. Sodii phos., ^ss. Syr. zingiberis, 5vj. Aquae menth. pip., ^vj. Misce. Sig. : One teaspoonful to a tablespoonful in half a glass of water every four or six hours after eating. Indication: Useful in gout and rheumatism. IJ Colchicinae salicylatis, gr. ss. Phenacetini, 3ij. Misce et pone in capsulas no. xlvilj. Sig.: One capsule every four hours. Indication: Used to relieve pain in acute and subacute gout. ' IJ Morphinse hydrochlor., gr. x. Linimenti belladonnse, ^iij. Misce et fiat linimentum. Sig.: A teaspoonful mixed with a table- spoonful of hot water and applied on lint under oil silk every four hours. IJ Atropinae, gr. iij. Morphinse hydrochlor., gr. xv. Acidi oleici, ^}. Misce et fiat linimentum. Sig.: To be painted over the painful part and the joint wrapped in cotton wool. For external application : — R 01. gaultheriae, f3ij. 01. olivse, f3ij. Lini. saponis, f3ij. Tinct. aconiti, f3ij Tinct. opii, f3ij. Misce. Sig.: Apply freely and cover with cotton batting. 224 Hand-Book of Modein Treatment. I^ Potassii iodidi, fSss. Linimenti saponis, fSss. 01. cajuputi, fSss. 01. carui, f5ss. Spirit, vini rectif., q. s. fjvij. Misce. Sig. : Apply on lint and cover with pro- tective. I^ Guaiacoli, ^as. Olei gaultherise, ^ss. Olei olivae, Sij. Misce. Guaiacol is readily absorbed by the skin and is said to reduce the temperature. A more ele- gant mixture, however is: — IJ Mentholis, 5j- Alcoholis, 5iv. Glycerini, 8j. Aquae laurocerasi, 5j. Misce. Indication: Useful as local application. HiEMATEMESIS. 5 Ergotae, gr. xlv. Fluidextracti hydrastis, gr. xlv. Kramer ise syrupi, Svj. Aquae dest., ^iv. Misce. Sig.: A dessertspoonful everj^ quarter of an hour and later every ha If -hour or hour. IJ Liquor is ferri subsulphatis, Sij. Sig.: Ten to twenty drops in two table- spoonfuls of water three times daily. IJ Olei terebinthinae, 5ss. Sig. : Five to ten minims three or four times dnilv. J^ Morphinae sulpha tis. Sig. : One quarter of a grain hypodermically when needed. Indication: To allay mental distress. Hand-Book of Modem Treatment. 225 ADRENALIN IN GASTRIC H-SIMORRHAGB. Dr. S. S. Halderman describes the satisfactory treatment of a case. The patient was a man 65 years of age. The condition of the patient was most serious. He was in a cold, clammy perspiration, radial pulse imperceptible, and with every appear- ance of impending dissolution. He was given 10-drop doses of solution adrenalin chloride every half hour to one hour until he had taken 1 drachm of the solution. The vomiting and haemorrhage soon stopped, and for three weeks rectal alimenta- tion was depended upon; also every day he was given, per rec- tum, 1 pint of normal salt solution, with instructions to retain it if possible, which was usually done. After three weeks he was allowed milk and bread, and has now resumed his usual diet and appears in better health than for a year. IJ Tinct. hydrastis, Siij. Tinct. viburni, Siij. Tinct. hamamelidis, 3vj. Tinct. castanese (chestnut), 3vj. Misce. Sig. : Take fifteen to twenty drops each meal in sweetened water. Indication: To control haemorrhage from any cause. I( Fluidextracti ergotse. Sig.: Twenty minims hypodermically and repeat several times if necessary. Chloride of calcium, in doses of 8 to 16 grains, every two to four hours, should be tried in all forms of persistent haemor- rhage, especially haemoptysis, haematuria, and intestinal haemor- rhage of typhoid fever, for this salt increases the coagulability of the blood. It should be remembered, however, that this drug should not be used more than three days continuously, for its prolonged use decreases the coagulability of the blood. Dr. Arendt calls attention to a new method of controlling post-partum haemorrhage. He seizes the cervix with a bullet or volsella forceps and draws it down to the vulva. This kinks the afferent vessels, and so stops or lessens the flow of blood through them. Uterine action is excited by alternate traction 16 226 Hand-Book of Modem Treatment. and relaxation. He believes that tamponing of the uterus is effective mainly because of the incidental pulling down of the uterus. W. Coleman treated five cases of intestinal haemorrhage with adrenal substance. Four patients recovered, although in two of them the haBmorrhage was very severe. The fifth patient died of toxaemia and exhaustion several days later, and not of haemorrhage. He advises the free use of adrenal substance, and gives 15 grains every two hours during the day and every four hours during the night, gradually diminishing the dose as re- quired. HiBHATUBIA. I( Acidi gallici, 3j. Acidi sulphuric! diluti, fSij. Aquae dest., q. s. ad f^iij- Misco. Sig.: Teaspoonful in water every four hours. IJ Fluidextracti ergotse, ^ij. Sig.: One teaspoonful three times daily when bleeding is from prostate or urethra. U Adrenalin! chlorid! (MOGG), 5j. Aquae, q. s. ad ^v. Sig.: Inject in urethra one teaspoonful three times daily. IJ Sodii thiosulphatis, 5ij- Sig.: One teaspoonful every two hours until free purgation takes place. IJ Calcii chloridi, 3j. Aquae, 5iss. Misce. Sig.: One teaspoonful four times daily for three days. IJ Aluminis, gr. xxxij. Aquae, Oj. Misoe. Sig.: Inject four ounces into the bladder twice daily. Hand-Book of Modern TreaUnent. 227 HiEMOPTYSIS. IJ Extract! ergotse, gr. xxx. Pulv. digitalis foliorum, gr. xx. Extract! hyoscyami, gr. xx. Quininse sulphatis, gr. xxx. Misce et fiant pilulae no. xx. Sig. : Three to five pills may be taken daily, 3 Liquoris ferri subsulphatis, gtt. xx. Aquae dest., f^iv. Misce. Sig.: Use in an atomizer every few minutes as a spray. IJ Potassii bromidi, 3ij. Chloralis, 3j. Syrupi acacise, 3iv. Aquae, q. s. ad ^ij. Misce. Sig.: Two teaspoonfuls in water at once, and then one teaspoonful every hour until the patient becomes quiet. Indication: To be used if heart is rapid, strong, and patient is excited. Ice-bag or coil on chest. • IJ Tinct. aconiti, m iv. Aquae, 8j. Misce. Sig.: Teaspoonful every hour until pulse becomes quiet and compressible. Indication: Used to quiet excited, overact- ing heart. I^ Acidi tannici, gr. xx. Glycerini, 3ij. Aquae dest., ad Jiij. I^ Aluminis, gr. vj. Aquae dest., ^JJj* Indication: Useful as a spray if haemor- rhage is just beginning. 228 Hand-Book of Modern Treatment. 3 Fluidextracti hydrastis^ 3iv. Tinct. hydrastis canadensis, 3iv. Misce. Sig. : From twenty to fifty drops to be taken three times daily. When the haemoptysis is arrested the treatment should be continued for two or three days, and the dose then rapidly reduced to cessation. Should obstinate cough prevent the haemo- static effect, morphine or codeine should be added, in the following proportions: To the foregoing prescription add from 4% to 7% grains of codeine, or from 2^ to 4% grains of morphine. The same dose should be given as before. IJ Plumbi acetatis, gr. viij. Pulveris opii, gr. j. Misce et fiant chartulse no. iv. Sig.: One powder every two hours to quiet nervous and excited patient. IJ Calcii chloridi, gr. lx-3j. Syr. menthse pip., 5j. Aquae dest., 5iij. Misce. Sig.: To be taken in twenty-four hours, a tablespoonful every two hours, and this may be renewed on the following day; and if the kid- neys act properly may be continued for a con- siderable time. HAIR TONIO. Shampoo with tar soap ten minutes; then wash and dry the scalp and apply: — IJ Hydrarg. chloridi corrosivi, gr. vij. Glycerini, 3j. Aquae, ^v. Misce. Sig.: Apply after adding a ^-per-cent. so- lution of naphthol in absolute alcohol; then apply Hand-Book of Modem Treatment, 929 Q Acidi salcylatis, gr. xxx. Tinct. benzoini, 3j. Olei oliv®, 5iij. Indication : Useful in parasitic alopecia. I^ Sulphuris prsecipitatis, 3ij. Pulv. camphorse, gr. x. Tinct. cantharidis, 3ij. Resorcini, gr. xx. Olei myrciae, gtt. x. Alcoholis, q. s. ad 3ij> Misce. Sig. : Use once daily — ^well rubbed on. Indication: Useful in alopecia, secondary sind non-parasitic. Q Tinct. cantharidis, 3ij. Tinct. capsici, 3iv. Olei ricini, 3ss. AlcoholiSj q. s. ad Siv. Misce. Sig.: Apply once daily as a stimulant. HAY FEVER. ADRENALIN IN HAY FEVER. There is increasing evidence that adrenalin fully meets the indications as a remedial agent in hay fever. It controls the nasal discharge, allays congestion of the mucous membranes, and in that manner reduces the swelling of the turbinal tissues. As the nasal obstruction disappears, natural breathing is materially aided and the ungovernable desire to sneeze is mitigated. In short, a season of comparative comfort takes the place of the former condition of distress and unrest. Adrenalin blanches the mucous membrane by vigorously contracting the capillaries, and thus reduces local turgescence. It strengthens the heart and overcomes the sense of malaise so frequently a prominent feat- ure in cases of long standing. In the treatment of hay fever the solution of adrenalin chloride should be used. This preparation is supplied in the strength of 1 part adrenalin chloride to 1000 parts normal saline solution, and is preserved by the addition of 0.5 per cent, chlore- 230 Hand-Book of Modem Treatment. tone. The 1 to 1000 solution should be diluted by the addition of 4 parts normal salt solution and sprayed into the nares with a "cocaine'' atomizer. In the office the 1 to 1000 solution may be applied in full strength. A small pledget of cotton is wrapped about the end of an applicator and moistened with a few drops of the solution (1 to 1000). The speculum is then introduced, the patient's head is tilted backward in a position most favorable for thorough illumination by the head-mirror, and the visible portions of the lower and middle turbinate bodies and the septum are carefully and thoroughly brushed. The same application is made to the other nostril, when usually re- lief follows in a few moments. Should the benefit prove only partial, then the 1 to 5000 solution may now be sprayed into both nares, and a few drops instilled into both eyes. The effect of this treatment may be expected to last for several hours. Indeed, some physicians report that it is necessary to make but one thorough application daily to afford complete relief. It is also recommended that the solution of adrenalin chlor- ide be administered internally in 5- to 10-drop doses, beginning ten days to two weeks prior to the expected attack. In explana- tion of the beneficial effect of the drug when used in this man- ner, the suggestion has been made that hay fever is essentially a neurosis, characterized by a local vasomotor paralysis, affect- ing the blood-supply of the eyes, nose, face, and pharynx, and occasionally of the laryngeal and bronchial mucous membranes. Adrenalin overcomes this condition, restores the normal balance in the local blood-pressure, and thus aids in bringing about a cure. The profession is to be congratulated that it has at last an agent that, if not a specific, fulfills the therapeutic indica- tions more completely and with greater satisfaction than any other remedial measure recorded in the history of medicine. This combination is of value as a prophylactic measure and during the attack in rheumatic patients: — 5 BrucineB phosphatis. gr. iij. Ext. hyoseyami, gr. xv. QuininaB valerianatis, 3j. Camphors^, gr. xxx. Misce et fiant capsiilse no. xxx. Big.: One capsule four times a day. Hand-Book of Modem Treatment 231 I^ Adrenalin chlor., gr. ss. Norm, saline sol., Sj. Phenolis, m j. Glycerini, 3ij. Aquae rosse, q. s. ad ^ij- Sig. ; Spray nose every two to three hours, and follow up with: — IJ Mentholis, gr. x. Cocainse, gr. x. Thymolis, gr. ij. Vaselini liq., q. s. ad 5ij« Misce. Sig.: Use in an oil atomizer. IJ Resorcini, gr. v. Adrenalin chloridi, gr. ss. Acidi borici, gr. xv. Aquae camphorae (hot), f^ss. Glycerini, f3ss. Aquae destillatae, q. s. ad f^ij. Misce. Sig.: Use as a spray to eyes and nose four or five times a day. Use the following sprays in order indicated, one to three times daily: — No. 1. IJ Sodii bicarbonatis, gr. xx. Sodii boratis, gr. xx. -• Glycerini, f^ss. Phenolis (chemically pure), gr. iv. Aquae rosae dest., q. s. ad ^iv, Misce. Sig.: Cleanse the nasal passages thoroughly. No. 2. IJ Adrenalin chloridi (1-1000), gtt. xv. Sodii chloridi (0.9 per cent.), gtt. xv. Misce. Sig.: Use in two applications. 232 Hand-Book of Modern Treatment. No. 3. I^ Mentholis, gr. xx. Petrolati liq. (purified), ^iv, Misce. Sig.: Use freely. IJ Terpin hydratis, gr. Ixxv. Spt. vini galliei, f^ij. Syrupi lactucarii, ^iij- Syrupi tolutani, 5iij. Misce. Sig.: One or two dessertspoonfuls three or four times daily. IJ Cocainse sulphatis, gr. xij. Morphinse sulphatis, gr. xij. Bismuthi subnitratis, 3j. Misce. Sig.: Use as a snuff. A method of using quinine locally in typical cases of hay fever has proved remarkably successful. The treatment con- sists of the employment of a saturated solution of the quinine sulphate, in sterilized water, as a nasal spray, and the appli- cation to the mucous membrane of the nares of an ointment consisting of quinine and vaseline in the proportion of 30 grains to the ounce, the applications being made every four or six hours. The use of the spray alone will not suffice, but should be used as an adjunct to the ointment. Spraying the nares will at once stop all symptoms of coryza, but the effect will soon disappear unless followed up by the thorough application of the ointment. Somewhat recently the attention of the profession, chiefly through the writings of Bishop, of Chicago, has been directed to the fact that the neurotic condition of the patient and the hypersensitiveness of the nasal passages were often due to an excess of uric acid in the blood, and that this excess could be eliminated by the ingestion of mineral acids. Probably any mineral acid would prove efficacious, but there are two which suggest themselves as peculiarly efficacious : Hy- drobromic acid, because of its sedative qualities, and nitromuri- atic acid, because it is thought to limit the production of uric acid. Hand-Book of Modem Treatment, 233 A writer^s experience has been limited to the effects of nitro- muriatic acid, which for the past three years he has prescribed in doses of 3 to 5 drops of the freshly-prepared concentrated acid, after meals, and sometimes also at night. The dose should be diluted with a half-tumberful of water, and the patient, after taking the medicine, should rinse out his mouth and swallow another half-tumblerful of water. The results of the remedy are apparent within forty-eight hours, and the relief of all hay fever symptoms is usually suffi- cient to enable the patient to remain at home and attend to his ordinary business engagements in comparative comfort. IJ Orthoformi, 311 j. Slg. : Insufflate a small quantity into each nostril twice daily. HEADACHE. I^ Caffelnse dtratee, gr. xv. Acetphenetldini, gr. xxx. Saccharin!, gr. xv. Mlsce et fiant chartul® no. xv. Sig.: One every two hours until relieved. I^ Sodll arsenatls, gr. ^. Ext. cannabis Indlcse, gr. Ij. Ext. belladonnse, gr. iij. Mlsce et fiant pllulae no. xlj. Sig.: One every three hours until relieved. Indication: Useful in headache from meno- pause. I( Sodll arsenatls, gr. ss. Atropinse sulphatis, gr. y^, Extractl aconlti, gr. iv. Pulveris canellse, 311 j. Mlsce et fiant pilulse no. xxx. Sig.: One to four daily. Dose should be diminished if it causes dryness of throat or heat or tingling. Indication: