Complete Text (Part 34)

of 1 gramme of camphorated oil for four days, with ten-day intervals. His results were extremely satis- factory, but the injection method has its drawbacks, so he gives the camphor now in inunctions. He makes a salve with about 0.4 gramme of camphor in the amount rubbed in at one time. He uses percutilan as a vehicle, a new substance which he says "actually slips through the skin.'^ A little balsam of Peru is added and eucalyptus and rosemary- oil. These inunctions are made by the patient on five successive days and then a ten-day pause. The amount of sputum increases remarkably by the sec- ond day and then expectoration almost ceases, while the other symptoms are correspondingly improved. Equally favorable re- sults were observed in emphysema and bronchitis. The following combination is recommended as a very eifi- cient one in controlling the diarrhoea, which is due primarily to the general toxic condition: — IJ Bismuthi subnitratis, 3vj. Fluidextracti coto, 3j. Pulv. cretse comp., 3iij. Tinct. opii deod., 3iss-3iij. Pulv. pepsini, 3j. Syrupi zingiberis, q. o. ad Siij. Misce. Sig.: Shake and take one teaspoonful after each bowel movement. B Agaricin, gr. Vs. Zinci oxidi, gr. iij. Misce et fiat capsula no. j. Sig.: One such at bedtime. Indication: Used for night sweats. Hand-Book of Modern Treatment, 443 IJ Creosoti (beechwood), gtt. xxxij or 3j. Tinct. gentianse, f3j. Alcohol is, f5j. Vini albi, q. s. ad 3iv. Misce. Sig. : A teaspoonful in water or wine three times a day. IJ Spiritus chloroformi, f^ss. Morphinse sulphatis, gr. j or ij. Syrupi pruni virginianae, q. s. ad Siij* Misce. Sig.: A teaspoonful every four hours. Indication: Used when cough is excessive. IJ Acidi hydrocyanici diluti, gtt. xxiv. Potassii bromidi, 3ij. Sol. morph. magendie, 3iss. Chloralis hydratis, 3ij. Spiritus frumenti, Sj- Syrupi aurant., q. s. ad 5xij. Misce. Sig.: A tablespoonful when necessary to check cough. Indication: Used when cough is harassing. Cough-syrups are usually combinations of different opium ingredients: i.e,, if they allay the cough promptly. Codeine is the least objectionable of this group. Combined with the follow- ing remedies it affords great relief: — IJ Codeinffi, gr. iv. Tinct. belladonnffi, 3ij. Syrupi scill., Sij- Misce. Sig. : Teasponful two to four hours apart, if coughing. TYMFAinTES. IJ Glycerini, Sj- Terebinthinse, 3iv. Magnesii sulphatis, 3iv. Aquae, Svij. Misce. Indication: Tympanites after child-birth. r 444 Hand-Book of Modem Treatment. In conjunction with the above he gives ^o grain of calomel every two hours until 4 grains have been given. If this fails to act, 14 grain of elaterium is given in two hours. H Sodii bromidi, 3j. Aqiue dentil la t», 3j- Aqu£e flor. aur., 3ij. Sig. : A tablespoonful every two hours, and ordering an enema of 1 ounce of glycerine to 2 to 3 ounces of hot water to be thrown into the rectum. Indication: Used in tympanites of typhoid fever. H Tinct. asafoBtidsB, ^h9. Tinct. cardamom! comp., Sss. 8pirituB ammon. aromat., mxxxij. Aquse menthse pip., 5j- Aiisce. Sig. : One or two teaspoonfuls in water every two or three hours. Indication: Used in tympanites of typhoid fever. I^ Guaiacoli carbonatis, 3j. Fiant chartulae no. xxx. Sig. : One powder every four hours. Indication: l^sed in tympany of typhoid fover or in any case with intestinal fermen- tation. IJ Olei terebinth inae, 5j. Olei olivae, ^ins. Camphorae, gr. xx. Decocti avenop, f^viij. Misco et fiat enema. SSg. : Inject into the bowel. Indication: Used in hysterical tympanites. IJ Olei terebinthina;, 3j. Pone in capsulns no. xij. Siff. : One every two or three hours Indication: Used in tympany of typhoid fever. " ' Hand-Book of Modem Treatment. 445 I^ Olei terebinth inse, f3j. Olei olivffi, f3iv. Emulsi asafcetidsBj q. s. ad f^viij. Misce et fiat emulsum. Sig.: Used by rectal injection. Indication: Used in tympany of typhoid fever and peritonitis. Also apply turpentine stupes to the abdomen. I^ Spiritus setheris compositi, fSj. Tinct. cardamomi comp., f^j. Misce. Sig.: Teaspoonful every hour or two. Indication: Used in tympany of acute in- digestion. ULCER. DUODENAL ULCER. GASTRIC ULCER. Usually in women 25 to 35 Most frequent m men. years of age. Pain comes on soon after Pain two to four hours after eating. Pain lessened by vomiting. Vomitus contains food-rem- Vomiting more rare than in nants, mucus, and often gastric ulcer, and does not eating, and located in the right hypochondrium. Vomiting does not relieve pain. blood. often contain blood. Severe dyspeptic symptoms Dyspeptic symptoms slight, usually present. Melaena rare. Melsena comparatively fre- quent. IJ lodoformi, 3iv. Petrolati, ^ij- Misce. Sig.: Apply twice freely each day on sur- geon's lint. Indication: Of great value in syphilitic and tubercular ulcers. In a case of extensive ulcers of the legs of a somewhat rachitic child 2 years old, with ulcers over the back, treated in many ways unsuccessfully: — 446 Hand-Book of Modern Treatment. ^^a^i^M^i^— ^— ^— ^^M .. . _ . I , ■ I ■ ■ MM M. . ^^^^i^^— ^i^M^^— ^^^i»^M^— — M^l^^— M^^il^^— ^^^^^^— ^ IJ Pulv. amyli, 3ij. Zinci oxidi, 3ij. Mercurolis, gr. xv. Chloretoni, Sss. Petrolati, 5j. Misce et fiat unguentum. Sig. : To be applied on pieces of lint, con- stantly recovering the affected areas. IJ Argenti nitratis, gr. v. Balsami Peruviani, 3iss. Ung. simplicis, 3iij. Misce. Sig.: • Apply locally to the affected areas after thoroughly cleansing the parts. Indication: Used in treatment of varicose ulcers. By the above method the ulcers become clean, the secretion and odor are diminished, and healing takes place rapidly. IJ Picrotoxini, gr. j. Morphinse hydrochloridi, gr. j. Atropinffi sulphatis, gr. Vs. Ergotini, mxx. Aquse laurocerasi, 3iij. Misce. Sig.: Four to six drops five to ten minutes before each meal. Indication: Used in gastric ulcer. B Camphorse triturationse, 3ss. Zinci oxidi, 3viiiss. Lani, q. s. ad Svj. Misce. Sig.: Apply locally. Indication: Used on ulcers of the leg. IJ Camphorse triturationse, 3ss. Zinci oxidi, Jiij. Olei olivffi, Siij. Misce. Sig.: Apply locally. Indication: Used on ulcers of leg. "•• • :- Hand-Book of Modem Treatment. 447 9 OhloffOformi, mxviij. BiMBnthi subnitratis, gr. xlv. Aqmm, q. a. ad S^ss. Big.: One-half tablespoonful every hour or IndieaAioii: Used in chronic ulcer of the 9 U«g. ainei oxidi, 5ij. fiHlg;: Spread on lint and apply. Indleatimi: Used in irritable painful ulcers. 9^ Pnhr. iodoformi, 3ij. . Pulv. saloli, 3ij. Biamuthi subnitratis, 3ij. Pnhr. cinchonfe, 3ij. Pair, benzoini, 3ij. Polv. carbonis, 3ij. Sig;: Uae as dusting powder locally. Indieatioii: Used on varicose ulcers. 9 Caleii chloridi, gr. Ixxx. l^jrrupi acacife, ^iv. Aqam menthie pip., 5iv. lOaee. 8lg»: Tablespoonful every hour. Indication: Useful in gastric ulcer when iMKnorrhage occurs, to aid in coagulation of tiM blood. In order to insure success in cases of chronic ulceration of the legs it is absolutely necessary: (1) previously to bring the uloer into an aseptic condition; (2) to remove the edge of the nloer before applying the grafts; (3) to treat varicose veins or ofher causes of the ulceration ; (4) to insist upon the patient's Xtesting the leg for a considerable period afterward until the acDieBion of the grafts has become firm. Indication: Used in varicose ulceration of 'Uleg. 448 Eand-Book of Modern Treatment. IJ Tinct. conii, f3ij. Morphinse sulphatis, gr. j. Phenolis, m iv. Syrupi acacise, fSiij. Misce. Sig.: A teaspoonful when in pain. IJ Hydrarg. ammoniat.j gr. xv. Olei eucaplypti, m viij. Betanaphtholis, gr. x. Pulv. marantse, 3ij. Ung. zinci oxidi, 3j. Misce. Sig.: Apply locally. Indication: Used in chronic eczematous or weeping ulcers. IJ Argenti nitratis, gr. v. Pulv. opii, gr. iiss. Misce et fiant pilule no. xx. Sig.: One pill thrice daily. Indication: Used in gastric ul««v. IJ Formaldehydi (40 per cent, sol.), mviij. Aquse hydrogenii dioxidi, fSxvj. Misce. Sig.: Use locally as a wash. Indication: Used as cleansing and antisep- tic wash. IJ Acidi tannici, gr. Ixxv. Hydrarg. nitratis acidi, gtt. xij. Adipis lansB hydrosi, Sviiss. Fiat imguentum. Sig.: Apply as a dressing. Indication: Used in chronic syphilitic ulcers. IJ» Emplastri plumbi, 5ij. Ung. hydrargyri, 5ss» Olei cadini, 3ij. Fiat unguentum. Sig.: Spread on linen and apply. Indication Used in inflamed syphilitic ulcers. Hand-Book of Modern Treatment. 449 I^ Tinct. iodi, f^j. Acidi tannici, q. s. ad saturandum. Misce. Sig.: Apply locally to ulcers of rectum and anus. I^ Balsami peruviani^ fSiv. Tinct. benzoin! comp., f3ij. Petrolati, q. s. ad 3ij. Misce. Sig. : Spread on surgeon's lint and apply. Indication: Used in irritable painful ulcers. I^ Ghloralis bydratis^ 3ss-ij. Aquae, f^vj. Fiat lotio. Sig.: Use as a wash. Indication: Used in sluggish ulcers. IJ Argenti nitratis, gr. v. Ext. hyoscyami, gr. x. Misce et fiant pilulse no. xx. Sig.: One before each meal. Indication: Used in gastric ulcer. I^ Bismuthi subnitratis, 5vj. Pulv. opii, gr. vj. Misce et fiant chartulse no. xij. Sig.: One powder three times daily. Indication: Used for relief of pain in gas- tric ulcer. 3 Eserin sulphatis, gr. V4« Hydrarg. oxidi flavi, gr. Vg-j. Petrolati, 3j. Misce. Sig.: Apply to eye. Indication: Used in ulceration of the cornea. UB^MIA. IJ» Acidi benzoici, gr. c. Fiant chartulse no. v. Sig.: One powder every three hours well diluted. 29 450 Hand-Book of Modern Treatment, IJ Caffeinse citrata, gr. xxiv. Fiant chartulae no. xij. Sig. : One powder every two hours until three powders have been taken each day. Indication: Used as a diuretic if arterial tension is high. B Pulveris jalapse comp., 3iv. Sig.: Teaspoonful once daily. Indication: Used as a brisk purge. B Spiritus glyceryl is nitratis, gtt. xxiv. Aquse camphorae, ^iij* Misce. Sig. : Teaspoonful every three or four hours. Indication: Used as a diuretic if arterial tension is high. Hot pack and hot bath are valuable adjuncts. IJ Pilocarpinae hydrochloratis, gr. ij. Aquse destillatse, 3ij. Misce. Sig.: Inject five minims for a child of five: ten minims for an adult. Indication: Used in conjunction with a hot pack. In the presence of a weak heart the pilo- carpine is dangerous. IJ Spiritus setheris nitrosi, f^j. Liq. ammon. acetatis, f^ij. Aquse, q. s. ad 3viij. Misce. Sig.: Tablespoonful in water every two hours. Indication: Used as a diuretic if the symp- toms are not urgent. IJ Chloralis hydratis, gr. xx. Sodii bromidi, 3j. Misce. Sig.; Place in three ounces of boiled starch and administer by the rectum. Indication: Used to relax spasm of ursemic convulsions. Hand-Book of Modem Treatment. 451 URIC ACm DIATHESIS.— See Gout. I^ Lithii benzoatis, 3ij. Tinct. belladonnse foliorum, m Ixxij. Fluidextracti tritici, f^iij. Misce. Sig. : A teaspoonful every two or three hours in irritable bladder, depending on an excess of acid, and in uric acid calculi. IJ Piperazini, 3iij. Pone in capsulas no. xxx. Sig.: Dissolve a capsule in water and take after each meal. Indication: Used to relieve irritability of the bladder due to the uric acid diathesis. B Liq. potassii arsenitis, wv. Potassii bicarbonatis, gr. v. Ferri et potassii tartratis, gr. v. Infusi quassiffi, f^j. Misce. Sig.: To be taken in teaspoonful doses three times daily after meals. Indication: Used in asthenic cases. IJ Lycetali, 3j. Pone in phialas no. xlviij. Sig.: Dissolve the contents of a vial in water and take after each meal. Indication: Used in subacute and chronic cases. B Lithii cTarbonatis, Siiss. Sodii iodidi, 3iiss. Ext. gentians, gr. xxiij. Pulv. acaciae, gr. xxiij. Ext. glycyrrhizae, gr. c. Misce et fiant pilulse no. c. Rig. : Preserve in a well-stopped bottle. One pill after meals. Indication : Used in chronic cases with tophi in the joints. 452 Hand-Book of Modern Treatment. 1^ Sodii bicarbonatis, 3j. Tinct. calnmbse, f^j. Infusi quassise, q. s. ad f^iij. Misce. Sig. : A tablespoonful four times daily. I)» Aquse bullientis, Sxiiss. Sodii chloridi, gr. xv. Sodii phosphatis, gr. xxx. Sodii sulphatis, 3j. Misce. Sig.: Inject seventy-five minims morning and evening in the skin of the buttock. Indication: Used in cases of gastric intol- erance where diuretic medication is requisite. URINE, INCONTINENCE, RETENTION, ETC. In the physician's office laboratory two of the petty annoy- ances that he has to contend with in testing for albumin are dirty test-tubes and specimens that need filtration. I have found the following plan a simple method of obtain- ing a clean test-tube and a clear specimen: Take an ordinary cotton tampon on a string, such as is used in gynaecological work, push it to the bottom of a test-tube with a stick or glass rod, and pack it firmly. Then pour the urine into the test- tube and pull out the tampon very slowly by the string. This, on account of the atmospheric pressure, causes the urine to pass through the tampon and remain in the tube. The tampon car- ries out with it any particles that can be removed by filtration, and at the same time cleans the inside of the test-tube. If there are several specimens to be filtered, the tampon can be rinsed under the faucet, and used again. I find by this method my test-tubes are always bright and clean inside, and there is none of the delay occasioned in using filter-paper. The process can be repeated quickly two or three times if the first filtration is not satisfactory. In detecting very small traces of albumin, a per- fectly clean test-tube is of great importance. TESTING FOR TOTAL SOLIDS. Multiply the last two figures of the specific gravity of the urine by the number of ounces voided in twenty-four hours, and Hand-Book of Modem Treatment. 453 add 10 per cent, to the product. Thus, if the amount passed in twenty-four hours was thirty-six ounces, and the specific grav- ity 1.021, it would be 36 X 21 = 756 + 10 per cent. = 831, the number of grains of solids in the whole amount. By comparing this with the table it can readily be ascertained if the amount is above or below the normal standard for the body-weight of any patient. This method is Haines's modification of Basser^s. IJ Atropinffi sulphatis, gr. Vw Morphinse sulphatis, gr. iss. Aquse destillatse, f3j. Misce. Sig. : Ten minims hypodermically and re- peat once if required. Indication: Used in retention from spas- modic stricture. Patient should be immersed in hot bath for half an hour. IJ» Ext. rhus. arora., 5j. Syrupi arom., Sij- Aquae destillatse, Jvj. Misce. Sig.: Teaspoonful three times a day. Indication: Used in incontinence. IJ Sodii benzoatis, gr. xx. Sodii salicylatis, gr. xx. Fluidextracti belladonnse, gtt. ij. Aquae cinnamomi, ^iv. Misce. Sig. : A teaspoonful four or five times daily. Indication: Used in incontinence. The following has proven beneficial in a number of obstinate cases in older children and adults, whether due to lack of mus- cular tone of the bladder or paralysis : — IJ» Fluidextracti ergot®, Sj- Fluidextracti hydrangese, Sj- Fluidextracti triticum repens, Sj* Fluidextracti belladonnse, m xv. Tinct. cantharidis, 3j. Olei gaultherise, 3ss. Glycerini, q. s. ad 5iv. Misce. Sig.: A teaspoonful three times a day. Indication: Used in incontinence. 454 Hand-Book of Modern Treatment, IJ Tinct. belladonna, Sj. Sig. : Ten drops three times a day and in- crease one drop a day till the throat gets dry. With it give all the lemonade patient will drink (this makes the urine alkaline). Indication: Used in incontinence. HOW DRUGS AFFECT THE COLOR OF URINE. The urine is green after taking saffron or salicylic acid; orange from chrysophanic acid and santonin (alkaline carmine) ; brown from senna (alkaline blood red) ; smoky brown or black from tar, salol, gallic acid, resorcin, iiva ursi, and naphthalin; reddish from logwood (alkaline violet) or fuchsin; bright yel- low from picric acid; blue or greenish-blue from methylene- blue or methyl-violet. N. B. Gwyn has made a number of experiments to show the relative value of different disinfectants for urine. This is an important subject, since it is probable that urine, by reason of its apparent harmlessness, plays and has played the most im- portant part in the spread of typhoid fever. Bacilli are present in pure culture in 20 to 30 per cent, of the cases. Their num- ber is sometimes enormous; in one case there were 500,000,0*00 per cubic centimeter. Dr. Gwyn shows that for disinfection immediately or within five minutes a given volume of urine re- quires one-half its volume 1 to 20 carbolic-acid solution; one- fifth its volume 1 to 1000 bichloride solution; three-tenths its volume 10-per-cent. formalin solution; one-fortieth its volume chlorinated-lime solution ; two-fifths its volume liquid chlorides. If a longer time for disinfection is allowed the bichloride be- comes proportionately more active. This and the chlorinated lime seem the most valuable, all things considered. The forma- lin is good, but expensive. IJ Antipyrini, 3ij. Alcoholis, fSj. Aquffi, f5j. Misce. Sig. : One teaspoonful at bedtime in small amount of water. Indication: Used in treatment of inconti- nence of nrine in children. Hand-Book of Modern Treatment. 455 TEST FOR PUS IK URINE. The addition of a few drops of peroxide of hydrogen to urine containing pus will cause bubbles to rise and froth to ap- pear on the surface, similar to its action on pus in other localities. This test is characteristic and reliable. TO REDUCE THE ALKALINITY OF URINE. Attention has been called by E. Hutchinson to the value of acid sodium phosphate as an acidifier of urine. According to this author it has the greatest acidifying power of any prepar- ation employed. It is a valuable agent in the treatment of cys- titis, accompanied by the use of urotropin, which produces its best results in acid urine. The foregoirg preparation is readily soluble in water, and may be given in doses of from 30 to 60 grains every three or four hours if necessary. THE PROPHYLACTIC AND CURATIVE ACTION OF UROTROPIN. Under this caption Dr. Zaudy has published the report of a case of paraplegia in which urotropin was remarkably efficacious in relieving the bladder complication. It is rare that the oppor- tunity is presented of convincing one's self of the effect of urotropin by post-mortem examination. From the first day until the time of his death (May 11 to