Complete Text (Part 31)

In ten minims x>f water hypodermic- ally. I^ Camphorae, gr. xxx. Olei olivse, fBss. Misce. Sig.: Give fifteen minims every fifteen min- utes until reaction began. SLEEPLESSNESS.— See Insomnia. SMALLPOX. 9 Linimenti calcis, Bviiss. Olei eucalypti, 3iv. Calaminse prep., 3j. Misce. Sig.: Direct application to face by means of a large camel's hair brush every two to three hours. Indication: To prevent pitting. Q Tinct. aconiti, mxij. Spiritus aether is nitrosi, fSiv. Liq. potassii citratis, q. s. ad fjiij. Misce. Sig. : One or two teaspoonful s in water every two hours. Indication : Used in early stage as a circula- tory sedative. B Ichthyoli, 3ij. Guaiacoli, Sij. Glycerini, Jss. Misce. Rig.: Apply locally with a feather three times a day. 26 402 Hand-Book of Modem Treatment, The earlier it is commenced, the better. The face should be bathed before each application with luke-warm water and soap. As a stimulant in profound prostration, Stokes^s cognac mixture : — I^ Cognac optimi, fSxv. Aquffi destillatee, f3xv. Vitelli ovi, no. j. Synipi, fSvj. Misce. Sig. : A tablespoonful every two hours. To soften the scab nothing is better than a salve of the following composition : — B Sodii bicarbonatis, 3ij. Petrolati q. s. ad 5j» Misce. When extensive impetigo exists employ a bichloride bath and then dust the patient with a weak aristol or iodoform talcum powder. An ointment which is useful in treating impetigo pus- tules is : — B Hydrarg. ammoniati, gr. x. Pulv. amyli, 3ij. Pulv. zinci oxidi, 3ij. Petrolati, Jss. Misce et fiat unguentum. B Ichthyoli, 3iss. Vaselini, 5ij. Misce. Sig.: Apply to pustules to prevent pitting. I^ Saloli, Sss. Fiant chartulse no. xij. Sig. : One powder every eight hours. Indication: Used to abort pustulation and prevent irritation and desire to scratch. Ingalls reports thirty-six cases of variola, of which one was hsemorrhagic and thirteen confluent, treated by the bichlor- Hand-Book of Modei-n Treatment. 403 ide baths without mortality. The treatment was given as fol- lows: A six-foot bath-tub was placed beside the patient's cot and filled with a fairly warm — 103^-105° — solution of bi- chloride, 1 to 10,000, and the patient placed therein, head and shoulders above the solution; the nurse then went over the entire body, using a soft cloth, being careful of force applied so as not to cause much pain. After remaining in the bath about ten or twelve minutes, the patient was removed, thoroughly dried, dressed in freshly laundered clothing, and placed in a clean bed. These baths were given night and morning. After removal from the bath the patient expressed much relief, but shortly after, owing to the drying effect, complained of a burning sen- sation "just beneath the skin.'' He found that all were like- wise affected, so, to obviate this, began a routine practice of anointing patients immediately after the bath with a mixture of carbolic acid, bismuth subnitrate, and olive-oil, with a very happy result. He makes the following deductions concerning the method : There is practically no mortality. The suppurative fever can be shortened four to six days if patient is treated from the onset; a minimum of pitting is secured and an almost entire absence of the characteristic, disagreeable odor; the period of desqua- mation is materially lessened, owing to the thinness of the scab- formation; pain is much reduced, morphine being rarely indi- cated; the great distortion of features, which gives us such repulsive looking patients, is eliminated to a great extent. B Liq. potassii acetatis, fjiiiss. Spiritus setheris nitrosi, f^ss. Misce. Sig. : A tablespooiiful every two or three hours in a wineglassful of water. IJ Argenti nitratift, gr. xl. Aquse destillatse, fjij. Misce. Sig.: Paint the skin that is exposed to the light. Indication: To prevent pitting. 404 Hand-Book of Modern Treatment, B Tinct. ferri chloridi, fjj. Sig. : Five to ten minims in water every four to six hours. Indication : To affect specifically the pyemic fever. ^ Caffeine citrate, gr. vj. Antipyrini, 3j. Misce. Sig.: One powder as required. Indication : Used to relieve pain in back and head. I^ Potassii chloratis, f^ss. Tinct. myrrhffi, fjss. Aquffi, q. s. ad S^rvj. Misce. Sig.: Shake well and use as mouth wash as necessary. Indication: Used for sore mouth. SNAKE-BITES.— See Bites and Stings. SPEBMATOBBHCEA. I^ Tinct. cantharidis, 3ij. Tinct. ferri chloridi, 3vj. Misce. Sig.: Twenty drops in water three times daily. Indication: Used in impotence with sperma- torrhoea. IJ Tinct. gelsemii, 3j. Tinct. belladonnffi, 3ij. Misce. Sig.: Fifteen drops at bedtime. B Antipyrini, 3ij. Syrupi acaciae, 5ss. Aquae cinnamomi, q. s. ad fjiv. Misce. Sig.: A dessertspoonful on retiring. Indication: Used when due to neurasthenia. Hand-Book of Modern Treatment. 405 B Potassii bromidi, 5j- Aquas destillatse, q. 8. ad fjij. Misce. Sig.: A teaspoonful three times daily. Indication: Used in the strong and ple- thoric. B Potassii bromidi, 3iv. Fluidextracti ergot®, fSiv. Tinct. belladonnae, fSij. Aquse camphorse, q. s. ad fjviij. Misce. Sig.: Tablespoonful at bedtime. Indication: Used in cases with spinal hyper- sesthesia and nocturnal pollutions. SPLENIC ENLARGEBIENT.— See Fever, Intermittent. SPRAINS.— See Braises. STINGS.— See Bites and Stings. STOMATITIS. A. J. Perkins says that this complaint, "nursing sore mouth/' is usually mild and easily palliated, but in many cases it is very severe and makes the nursing period one of great suffer- ing. It usually commences soon after the nursing commences, and continues until the child is weaned. He does not attempt to explain its etiology. For many years he has been looking for a remedy, and now thinks he has one which will make short work of the disease. This is sodium sulphite. ITe gives it in solution, a drachm to a cup of water, a teaspoonful every hour until bed-time each day. For those who dislike the taste of the sulphite a syrup is used : — IJ Sodii sulphitis, 3j. Pulv. rhei, gr. x-xx. Glycerin!, fjii-iv. Aquae bullientis, q. s. ad Oj. Misce. Sig.: Teaspoonful every one, two, or three Iiours as urgency of symptoms indicates. 406 Hamd'Book of Modern Treatment. li Potassii chloratis. 3v. Saponis medic, 3iiss. Calcii carbonatis, 3t. Olei men the pip., ^ xv. Olei can-ophylli, m iv. Misce. Sig. : Use as dentifrice. Indication: Mercurial stomatitis. ^ Potassii chloratis, Tinct. myrrha, gr. xlv. Aquae destillatae, 5^j. Misce. Sig.: Use externally as mouth wash or to wash oral cavity. Indication : Used in aphthous stonuititis. B Saloli, gr. xv. Catechu, gr. xxx. Spiritus menthse pip., Jiss. Misce. Sig.: A teaspoonful in a tumbler of hot water. Indication: Used in smokers' stonuititis. STRANGURY. I^ Extracti belladonnse, gr. i-iv. Olei theobromae, 3ss. Facit suppositorium no. j. Sig. : Introduce into the bowel and repeat in four hours if necessarj'. ]ft Tinct. veratri viridis, fSss. • Morphinse acetatis, gr. ij. Spiritus setheris nitrosi, fjj. Liq. potassii citratis, q. s. ad fBviij. Misce. Sig.: Shake. Tablespoonful in water every two hours. Indication: Used in acute inflammation of the bladder and prostate. Hand-Book of Modem Treatment. 40" I^ Tinct. cannabis Indies, fSj. Sig.: A half-teaspoonful every four hours. Indication: Used when urine is bloody and when due to spinal disease. B Pulveris opii, gr. ii-iv. Olei theobromsB, 3j. Misce et fiant suppositoria no. ij. Sig.: Introduce one into the bowels and re- peat in four hours if necessary. STRUMA.— See Rickets and Scrofulosis. STYE. B Hydrarg. oxidi rubri, gr. xij. Petrolati, 3iv. Ung. aquffi rosse, 3iv. Misce. Sig. : Apply night and morning after a thor- ough cleansing with hot boric solution. If very distressing and involving much of the lid the stye should be incised, with full antiseptic precautions. I^ Hydrarg. chloridi corrosivi, gr. •/»• Vaselini, gr. 3vii-xlij. Misce et fiat unguentum. Sig.: Ointment for eyelids. I^ Sulphur, sublimati, gr. xlvj. Ammonii chloridi, gr. xv. Aquffi rosse, fSj. Spiritus camphorae, f3i8S. Misce et fiat collyrium. Sig. : For local use on eyelids. B Hydrargyri oxidi flavi, gr. iss. Adipis lanse hydrosi, SiVs- Glycerini, q. s. Misce et fiat unguentum. Sig.: Eye ointment. 408 Hand-Book of Modern Treatment, According to an abstract in the Medical Eecord, the lash should be removed from the center of the inflammatory area. The swelling should be carefully touched with tincture of iodine or pure carbolic acid. When pus is present it should be released by a small incision. The pain will be relieved by wann fomenta- tions. A weak mercurial ointment will generally cause the dis- appearance of the remaining thickening of tissue. The diet should be regulated when there is any constitutional disturb- ance. I^ Hydrarg. oxidi rubri, gr. iss. Vaselini; 3v. Misce et fiat unguentum. Sig. : For external use. B Acidi borici, 3j. Aquffi rosae, q. s. ad f^iv. Facit lotio. Sig.: Apply freely lukewarm. SUPPURATION.— See Abscess. SWEATING. In the night-sweats of phthisis camphoric acid in the dose of ^/g drachm taken one hour before bed-time is a valuable remedy. This dose is best given on the tongue and washed down with a swallow of water. Other drugs of use are atropine, picro- toxin, agaricin, acetate of thallium, and guaiacolate of piperi- dine. Of late the opinion has been expressed by several observers that, since the perspiration of night-sweats has been found on analysis to contain tuberculin, no attempt should be made to lessen the sweating, but that, on the other hand, it should be encouraged. B Balsami Peruvian®, m xv. Acidi formici, gr. Ixxx. Chloralis hydratis, gr. Ixxx. Aleoholis (pure), Jiiiss. Misce. Sig.: Sponge the body witli the foregoing combination at bedtime. Hand-Book of Modem Treatment. 409 The following combination is frequently used locally in the treatment of night-sweats: — B Aluminis, 3iv. Alcoholis, 3ij. Aquae, Oj. Misce. Sig. : Apply locally night and morning with a sponge. Indication: Night sweats due to tubercu- losis. B Plumbi acetatis, gr. x. Extracti gentianse, q. s. Misce et fiant chartulse no. xij. Sig.: Three to four powders daily. I^ Aluminis, 3iv. Acidi acetici diluti, fjiv. Aquse, q. s. ad S^cvj. Misce. Sig.: Sponge the body several times daily. Indication: Used to prevent night sweats. ]ft Acidi borici, gr. xv. Sodii boratis, 3vj. Acidi salicylici, 3vj. Glycerini, 5iss. Alcoholis, q. s. ad Jiij. Misce et fiat lotio. Sig.: For local application. Indication: Sweating feet. ]^ Sodii salicylici, gr. xxx. Kali permanganatis, 3j. Bismuthi subnitratis, Sxij. Pulv. talci, q. s. ad Jiij^ Misce et fiat pulv. Sig.: Dust on feet and into stockings and shoes every morning. B Acidi borici, Jij* Acidi salicylici, 3j. Misce. Sig.: Used as a dusting powder upon feet and also in the stockings. 410 Hand-Book of Modein Treatment. IJ Tinct. belladonnse, Jss. Sig. : One or two drops three times daily, gradually increased to five or six. Indication: Used to control sweating. (1) Boot socks may be used made of filter paper, linen or cork, soaked in a mixture of potassium permanganate, 1 gram (15 grains) ; water, 100 cubic centimeters (3^ ounces) ; thy- mol, 0.5 gram (8 grains) ; and then dried. They should be changed daily. (2) A lotion of naphthol, 5 parts; glycerine, 10 parts; alcohol, 100 parts; this to be followed by a powder of naphthol and starch, 1:90. (3) Socks may be powdered with talc, 40 parts; bismuth subnitrate, 45 parts; potassium per- manganate, 3 parts; sodium salicylate, 2 parts; rice powder, 60 parts. (4) Perchloride of iron, 30 parts; glycerine, 10 parts. (5) A lotion of quinine sulphate, 5 parts; tannin, 2 parts; alco- hol, 100 parts; water, 250 parts; to be followed by a powder of salicylic acid, 3 parts; starch, 10 parts; talc, 87 parts; alum, 45 parts. (6) Tincture of belladonna, 25 parts; eau de Cologne, 120 parts. SYCOSIS. B Sulphuris prsecipitati, Sss-iss. Ichthyoli, 3i-isa. Petrolati, q. s. ad 5j. Misce. B Resorcini, 3j. Glycerini, fSij. Ung. aquse rosse, q. s. ad 5ij- Misce. Sig.: Apply several times daily. Indication: To be used after crusts have been softened with oil. ^ Liq. arsenici et hydrarg. iodidi, fSij. Syrupi zingiber is, fjj. Aquse destillatse, q. s. ad f^iij. Misce. Sig.: Teaspoonful after each meal. Hand-Book of Modem Treatment. 41 J I^ Hydrarg. oleatis (5 to 15 per cent.), 3ij. Sig. : Paint over the affected part. ]^ Ung. hydrarg. nitratis, 3iv. Sulphur is, 3ij. Creosoti, gtt. x. Adipis lanse hydrosi, 3i-ij* Misce et fiat unguentum. Sig. : Rub in well. SYNOVITIS. B Chloralis hydratis, 3iv. Phenolis, Sss. Aquas, q. s. ad Oj. Misce. Sig.: Apply as hot as possible upon layers of lint, changed every hour, and covered with oil silk. ]ft Ichthyoli, 5ij. Adipis lanse hydrosi, Jij- Misce. Sig.: Apply freely upon cloth and place joint at rest. Indication: Used in acute cases. B Liq. plumbi subacetatis, Jij. Tinct. opii, Jij- Aquffi bullientis, q. s. ad ^xxxij. Misce. Sig. : Apply upon soft cloths and place joint at rest. Indication: Used in acute synovitis. B Tinct. iodi, fjj. Sig.: Apply with a brush every second or third day. B Potassii iodidi, 3iv. Sodii salicylatis, f3iv. Aquffi menthse pip., q. s. ad Jiij. Misce. Sig.: A teaspoonful in water after meals. 412 Hand-Book of Modern Treatment. R Emplastri cantharidis. Sig. : Apply every night until the skin is well reddened. If this does not avail, leave on until a bleb is formed, which may be cut, poul- ticed, and dressed with simply cerate. Indication: In the chronic form. SYPHILIS. Otto Lerch, in American Medicine, advocates the adminis- tration of mercury by inunctions in syphilis. He concludes that the virus spreads from the seat of infection along the lymph channels, and that the glands remain swollen when no other symptoms of the disease can be discovered. Secondary infec- tion of the vessels, viscera, and nervous system takes place, and late infection can be easily explained by such deposits of virus. In support of his views he states if the drug is used by mouth it has to travel a circuitous route to reach the original deposits, and part of it is lost by way of the intestines, kidneys, and liver. If given by injections of soluble salts, it meets a similar fate, as it is largely taken up by blood-capillaries, and this is also true if administered by injection of insoluble salts, though better results seem to have been obtained by this method, which gives the lymphatics a better chance. It is true that the employment of mercury by inunction is inconvenient, dirty, and tiring, and that a stomatitis, intestinal colics, erythema, and eczema cannot always be avoided and that the exact amount of the mercury absorbed cannot be determined. Most of these defects are shared by the other methods, and es- pecially this last point upon which so much stress has been laid offers no more certainty than we encounter when the drug is administered by mouth or hypodermic injection. However, the mercury used by inunction is taken up by the l}Tiiphatics and brought immediately and directly in contact with the virus, immunizing the glands and making them unfit for deposits of the poison. Inunctions are painless, do not disturb the digestive system, and, above all, clinical experience shows "they give superior results/' Hand-Book of Modem Treatment, 413 The following is the treatment used by Lerch : — If the ulcer can be extirpated without difficulty it ought to be done in every instance to insure healing by first intention, to modify favorably general infection, and perhaps prevent it altogether in a few cases. After positive diagnosis has been made, generally only after the appearance of constitutional symptoms, characteristic enlargement of glands, skin eruptions, etc., mercury ought to be administered. The mercury may be given by inunction in from 3-gram to 7.78-gram (45 to 120 grains) doses; in severe cases, blue ointment should be used each twenty-four hours. The patient is directed to divide the amount into two equal parts, and use one for each leg over the inside, with vigor- ous massage. It is necessary to continue the rubbing for fifteen minutes over each side to cause absorption, and it is best to control the time by the watch, as the process is tedious and too often the time of rubbing shortened by the patient. The second day the process is repeated over the inside of the thighs in the same manner, the third day the inside of the arms, fourth day, chest and abdomen ; the fifth day the back must be treated, and on the sixth day a full warm bath for cleaning purposes is ad- ministered. To prevent colds, especially during the winter, the patients are directed to use the inunction before retiring. The patient may use the inunction himself during the first four days, after full instructions, or all may be given by a professional masseur. Thirty inunctions generally constitute a full treat- ment. In other words, the process has to be repeated six times. E. G. Ballenger, after discussing the various mercurial and iodide treatments, says that cases are occasionally encountered where these drugs alone not only prove ineffectual, but actually aggravate the s3rmptoms and hasten the destruction of tissue. For these cases the author states that Cooper, in the Practi- tioner, of London, advises the Zittman treatment, which, after two weeks^ use, will arrest the disease and cause a rapid healing of the lesions. The principle of the treatment consists in eliminating the poison from the system by purgation and sweat- ing. The patient is kept in a room, the temperature of which is maintained at 80° F. The evening before the treatment is be- gun two of the following pills are administered :* — 414 Hand-Book of Modern Treatment. IJ Hydrarg. chloridi mitis, gr. ij. Ext. colocynthidis, gr. v. Ext. hyoscyami, gr. ij. Misce et fiant pilulse no. ij. The diet is regulated and for the first four days the patient drinks a half-pint of the following decoction, as hot as possible, at 9, 10, and 11 a.m., tad 12 m. : — IJ Jlad. sarcse contus., 3iv. Sem. anisi contus., ^iss. Sem. fceniculi contus., Jviiss. Fol. sennse, Sj* Rad. glycyrrh. contus., 3iv. Add in linen bag: