Page images
EPUB iv.
·gr. xv.
.gr. ss.
.gr. iv,

. q. s.

OUTLINES FOR THE TREATMENT 103 F., then extend time to every six hours,

discontinuing capsules when temperature OR ABORTION OF TYPHOID

falls as low as 102 F. FEVER.

If tenderness with tympany of the bowels

exist to a considerable extent, use the folBY J. A. WARD, M. D.

lowing as an external application to the

bowels :If called within the first three to five R Oil turpentine

.3ij. days after an attack of typhoid fever, and Oil eucalyptol, being sure as to my diagnosis, I give the Tinct. opii (stupe for bowfollowing


āā. 3j. (No. 1.)

Castor oil (cold pres.).q. s. 3vj. R Hydrarg chlor, mit.

M. Sig.–Shake well together, then put Guaiacol (carb.)

the mixture in a pan or some other vessel Podophyllin

to heat. Saturate a piece of flannel, three Menthol

to four double or folds, and apply over the Oil eucalyptol

gtts. v.

tender part of the abdomen as warm as the Sacch. lactis

patient can bear it. It should be re-saturM. Divide capsules No. 64.

ated and warmed every three to four hours. Sig.--Give two capsules every half-hour, washed down with half a glass of water.

This will remove the soreness and facili

tate the action of the bowels. Will also If the patient be of adult age, continue act as a general alterative. treatment day and night (not stopping to

If the above fails to remove soreness and let the patient sleep) until the bowels act tympanic condition, paint over the abdofreely, reaching as high as five to seven men with tincture iodine, evening and actions in twenty-four hours. The object morning, until the skin becomes too sore is to get the bowels thoroughly cleaned from the effect of the iodine to permit its out.

continuance, when the castor oil, stupe, or On the third or fourth day discontinue a poultice may be used instead of the tinccapsule No. 1, and give No. 2 every two ture of iodine. After the skin has recovhours.

ered from the effect of the iodine, it may (No. 2.)

be used again if necessary. We believe the R Guaiacol (carb.)

.gr. xv.

tincture of iodine to be one of the best, if Menthol

.gr. viij.

not the very best, local application that can Podophyllin

.gr. ss.

be made to the tender abdomen in cases Hyd. chlor. mit.

.gr. iij.

of typhoid fever. Oil eucalyptol

.gtts. x.

On the sixth or seventh day drop off Sacch. lactis

capsule No. 2, and give the following :M. Divide capsules No. 64.

R Oil turpentine

.3iij. Sig.-Give a capsule every two hours, Oil eucalyptol

.3j. night and day, with water.

Guaiacol (carb.)

.gr. XX. In the meantime, that is from the com

Tinct. opii

...3j. mencing of treatment, should temperature

Powd. acacia

.3iv. run up to a dangerous point, give the fol- Aqua minth. pip.

· Zij. lowing, in conjunction with other remedies, Syrup tolu .

.q. s. Zvj. to regulate temperature:

M. Sig.-Shake the bottle before giving R Acetanilid


each dose, and give a teaspoonful every Caffeine citrate

four hours, night and day. Give in a little Tinct. capsicum (pres. to regu

water. late temperature),

We only wish to give the main points Tinct. minth. pip...ãā. gtts. xij. in the treatment of typhoid fever, allow

Camph. monobrom. v. ing the physician in charge to use his own M. Divide capsules No. 30.

judgment as regards the working of his Sig.–Give a capsule every two to four remedies, and to increase, decrease, disconhours until the temperature comes below tine, or introduce other remedies, accord

.q. s.

.gr. xxiv.

ing to his judgment, in relation to the spe- expectoration attended recovery. She had cial case on hand. And as we rarely, if dropsy when 18 years old, from which she ever, find two cases of any disease exactly recovered, but it left a torpid liver, and alike, therefore the treatment of all cases

she had occasional attacks of severe cramps of disease is, to a greater or less extent, (probably hepatic colic), which continued experimental.

till about fifteen years ago, and her heart's. In a vast majority of cases, however, of action has never been quite normal since typhoid fever, if the treatment herein out- she had dropsy, as before stated. lined is commenced within the first three Some months previous to this attack her to five days from the attack, and persist lower limbs were swollen, and continued to ently followed, the disease will be aborted, swell during and after her recovery from or will not run more than twelve to fifteen pneumonia. Then, along in March, her days before convalescence will be thor- abdomen began to bloat in spite of the use oughly established.

of cholagogues and hydragogue cathartics, The idea of the treatment that we have until she was as large as though in the herein formulated was suggested by Dr. last stage of pregnancy. About the first Woodbridge, formerly of Youngstown, of June I called Dr. G-, who had seen Ohio, now of Chicago, Ills., and while our her several times during the pneumonia. formulæ differ to some extent, the prin- He prescribed elaterium tablets, but they ciple and results are the same.

made her so sick that, after two days, they Our prescriptions can be put up by any

were discontinued. Nephroson (Merrell) good druggist, hence are always fresh and was then given, with no result, which was free from deterioration.

followed by apocynum, sparteine, strophanWe have been using the treatment above thus, digitalis, etc., with no result that I outlined for fifteen years, during which could see, the bloating, dyspnea, and heart time we have lost only a single patient from trouble increasing. The case looked destyphoid fever, and he died from failing to perate. The patient had heard of a case obey orders; while the longest period that that Dr. W- was credited with curing, the fever continued in any one case was

and he was called in consultation. He preseventeen days. Since we adopted the scribed nux and digitalis combined, and treatment herein suggested, we have had diuretic tablets; but these had no perat least two epidemics of typhoid fever ceptible effect except to regulate the acthat we got through without the loss of a tion of the heart. single case.

Both physicians and myself had about

concluded that it was a case of ascites, and Troy, Mo.

that tapping would have to be done as a dernier resort. I said to the doctors that

I had derived benefit from a decoction of DROPSY: AN INTERESTING CASE.

the green bark of boretree (sambucus

niger) in hard cider, with an infusion of By J. R. BORLAND, M. D.

horseradish root, in dropsy. Dr. W—

said he had often used a decoction of Miss E. K., age 49 years, was taken with squills, and added to it potass. nit., with congestion of the right lung on January 17, marked benefit. I had often given the jalap 190%, and in forty-eight hours the left lung comp. with potass. bitart., with excellent became congested, resulting in double pneu- results. This was about the middle of Aumonia. Blisters were applied over the con- gust. I put on my studying cap and degested area of both lungs, which had a cided upon the preparation, which folvery decided influence in arresting the lows: congestion. Veratrum and aconite were I got a boy to go along, and we gathered used to control temperature, and mild ex- a lot of boretree stalks of that summer's pectorants for the cough. She also had growth, stripped off the bark, until I had cardiac trouble from mitral insufficiency, three or four double handfuls. Could not for which strychnine and other heart get cider, so took cider vinegar, one part tonics were employed. She passed through to four of water, and made a strong decocthe pneumonia fairly well, and but little tion of the bark; then made a decoction of

two ounces of squills, in a similar men- I am now having the remedy used on struum, put them together and simmered the third dropsical case, and look for favortiem down to a quart; then filtered it and able results. added two ounces of potass. nit. and two If one will read up on the therapeutics ounces of Ald. ext. jalap.

of these drugs, he need not be surprised at I had the patient take two tablespoonfuls their action. every two hours, until the bowels were I should have stated, in regard to the freely moved and plenty of water in the first case, that for several weeks before and evacuations; then smaller doses or enough during the administration of the dropsy to keep them going. It nauseated some- remedy, until the water was completely what, but not enough to induce vomiting, evacuated, .she could get no rest without a matter which had concerned me all a hypodermic of morphine and atropine; through her sickness. The result of the but fearing she would become addicted to action of this remedy was most remark- it, I changed to the H. M. C. No. 2 (Abable. Thirty-six hours after the remedy bott's) tablets, which contain the eighth of was commenced, the bloating began to go a grain of morphine. She said she could down, and continued to go down at the quit them, and she did. rate of an inch a day, until the water was Franklin, Pa. completely evacuated. This by actual and careful measurement. The medicine acted on the kidneys as well as the bowels; the THE DISPENSING DOCTOR AND heart's action and respiration were improved as the water was evacuated.

WHAT SHALL HE DISPENSE. The urine was frequently examined, which contained a considerable amount of

By E. S. McKee, M. D. urates, but no albumin. The liver and heart were, no doubt, the

Environment-city, town, village, or main factors in causing the dropsy. She

country practice makes a difference. The is now quite well, but takes the dropsy

country practitioner, far removed from a mixture and heart tonics occasionally.

reliable, up-to-date drug store, should have

a liberal supply of drugs, all necessary Shortly after putting this lady on the

proved pharmaceuticals pruning his supply, dropsy mixture, I was called to see a man,

as all doctors should limit their use of age 44 years, who for several years had

drugs to those which will stand the test, been troubled with asthma, and, in addition, had mitral insufficiency and anasarca.

eliminating the worthless unreliable fads

of to-day. We obtain our best results in After relieving him of the asthma he was

the practice of our art, not through the put on the dropsy mixture, which removed

careless indiscriminating use of numerous the water in less than a week.

drugs, but by the proper selection and apNeither of these patients will probably propriate application of a few with which be entirely relieved of the heart trouble;

we are well acquainted, and in the use and but by taking this remedy occasionally with

abuse of which we are well informed. proper heart tonics, they may have their

Prestige, as well as valuable time and lives indefinitely prolonged.

possibly a still more valuable life, is lost Now, dear reader, if you have a case in urgent cases by not having some few of dropsy which baffles your best efforts, picked remedies at hand. For the relief try this remedy. Give it in large enough of pain, the prompt evacuation of the stomdoses to cause free watery evacuations and ach and bowels, one should always be preyou will not be disappointed.

pared; also for the checking of hemorThe inner (green bark) of the mature rhage and the relief of syncope and cardiac shrub is the part used. Cut the stalks in affections. proper lengths to go in the stove oven, heat The doctor who enters the chamber of them until the outer bark can be rubbed suffering, "when the iron tongue of midoff by the hand, then cut off the inner night hath told twelve,” armed only with a bark. If in the latter part of the summer, pencil and a piece of paper, is as unwise this is not necessary.

as the soldier who rushes to repel the attack of the enemy at “night's mid-most rhea should be treated, in the majority of stillest hour,” leaving his arms and ammu- cases, without the aid of the druggist. The nition in his tent. The dumb doctor, like latter treats numbers of these cases withthe silly soldier, is often doomed to defeat. out the aid of the physician. They should Forewarned, well armed.

be kept in close confidence, and a drug The self-administration of drugs at the store is, in the great majority of cases, hands of the physician to a patient in dire not a secret service bureau. Aside from distress, outside of the question of time this there is the danger of the patient saving, has a psychical effect, for who has repeating the prescription indefinitely, thus not seen the anxious expression on the face injuring both himself and his medical atof the sufferer who, with good reason, tendant. The various remedies for the fears that all may be over before the mes- treatment of these confidential cases and senger returns from the pharmacy. In their sequela should be kept on hand by case both the physician and his prescrip- the general practitioner. tion leave, it seems to the sufferer that all A hypodermic syringe, a good one, of hope has departed. Self-administered, the simple construction, which will not get out physician is assured that the patient has of order, should, like the doctor's nerve, the remedy properly given and has time to be always with him even in his dress suit. wait and observe its mode of action. It should be omitted only in his bathing

Non repetatur has little effect on the suit, and then should be on the beach. His ordinary druggist, and all habit-forming hypodermic case should contain soluble drugs, narcotics, and such were better dis- hypodermic tablets of morphine, morphine pensed than prescribed, as they are then and atropine, codeine, apomorphine, atrounder the control of the physician. He pine, strychnine, nitroglycerin, morphine would be able to follow the patient and and hyoscine, pilocarpine, cocaine. These know how often he was repeating the pre

remedies may, of course, when necessary, scription and, in his judgment, allow or be used by the mouth as well as hypoderrestrict its continued use.

mically. Pecuniarily speaking, there are remedies We have long been in need of a remedy which should be kept on hand. Those which, given hypodermically, would cause drugs and combinations which are in every- a prompt evacuation of the bowels. This day use and which keep well.

we seem to have in apomorphine hydroPills, tablets, or ready-made mixtures chloride. Diphtheria and croup demand are not the only remedies which can be quick action and a package of at least kept on hand by the busy practitioner. 3000 units of antitoxin should be at hand While these are most convenient, yet many

and changed as necessary. It is wasted useful combinations may be readily made time to telegraph and take the train for with the aid of a few active principles,

antitoxin after a case of diphtheria is tinctures, and fluid extracts.

discovered. Calx iodata and other remeThe confidant and friend of him who,

dies for croup should be ready when in distress, confides to us not only his suf

needed. ferings, his sorrows, but also his shame, The obstetric bag should contain chlorowe should administer ourselves, where

form, ether, phenol, boracic acid, ergot, practicable, the remedies which become bichloride of mercury tablets, sealed tubes necessary in these cases. If they went to

of aseptic ergot, quinine sulphate, petroa drug store they would divulge to the latum, adhesive plaster, absorbent cotton, drug clerk and his many chums the nature

and sterilized gauze. of the malady for which your patient was, Urinalysis.-Nitric, sulphuric, tartaric, in all confidence, consulting you alone, citric and hydrochloric acids, Fehling's soEmmenagogues are sometimes properly ad- lution, liquor potassi, hydroxide, and bisvisable, yet what drug clerk and the nu- muth. merous young men loafers who are in his Poison Antidotes.-Lime water, carbonconfidence will not surmise the worst, with ate of magnesia, vinum ipecac, olive oil, reference to both patient and physician, zinc sulphate, peroxide of iron, charcoal, when a lady patient hands him a prescrip- ammonia, alcohol, vinegar, atropine. tion for these drugs. Syphilis and gonor- A medicine case, which constantly ac


There are,

companies the writer, contains: Tablets come. The physician should be cool, well or pills of calomel and soda, acetanilid informed, and more or less decided in his and codea compound, migraine, mercury

The general condition and sympprotiodide, mentholic throat lozenges, toms of his patient should suffice to sugchlorate of potash and borax, cocaine tab- gest an appropriate modification of any lets for solutions, caricans comp., calcidin, preconceived and favored plan of treatmethylene-blue comp., coryza, iron, arsenic ment. Thomas Macaulay, in his brilliant and strychnine, orthoform lozenges, nitrate essay upon Sir James McIntosh, calls the of amyl in pearls, Seiler's tablets, aloin, readers' attention to the fact that it was strychnine and belladonna comp., soda seldom possible to get an opinion from Sir mint, Dover's powder, heart stimulant, James in its formatative state. The opinvaginal astringent, quinine, triple arsenites ion was almost invariably ready, based with nuclein, bichloride antiseptic tablets, upon carefully selected evidence, and morphine, glonoin, while in screw-capped formed in the most accurate, elegant lanbottles in my bag are phenol liquefactum, guage. In other words, he had his knowlspiritus frumentum, hydrogen peroxide, edge and opinions at his command. It is aromatic spirits of ammonia, chloroform, not requiring too much to expect at least chloral, solution of protargol, vaccine an approximate degree of such proficiency points, slides, sputum bottles and swabs for from the physician. specimens for microscopical examination,

Many theories have been advanced about tube of ethyl chloride. This, of course, the etiology of puerperal eclampsia, some varies somewhat as to the time of the year of which have often confused, rather than and the diseases then in mode.

enlightened, the general practitioner. Here of course, a number of other solutions and

we find the old rule observed, namely, that drugs and appurtenances which one should the less we know of a subject the more have about the office, but are too bulky to eloquently we can write, for then, you carry about and too numerous to mention.

know, there is no end to speculation. They will accumulate if you practice long Among the theories advanced as to the enough.

cause or factors in the etiology of puerSome of these remedies, if at hand at peral eclampsia we have, in a nutshell, as the right time under urgent circumstances, follows: Mechanical pressure from the are worth their weight in gold, and the

gravid uterus; fetal products of excrepractitioner who has them not when sorely mentitious matter;

mentitious matter; toxic products and needed, feels correspondingly cheap. biliary salts of fetal origin; increased

The general practitioner should neither metabolism; uremia; toxemia; leucodispense nor prescribe exclusively, but ad- maines in the blood; ptomaines in the cirhere to the happy medium, doing a part culation; impaired functions of the glandof each as best for himself and his pa- ular organs; hepatic cellular degeneration; tient.

faulty action of the hepatic functions in 19 West 7th St., Cincinnati, Ohio. the processes of metabolism; renal insuffi

ciency; renal congestion; nephritis; more

or less sensitive condition of the motor SOME EXPERIENCES WITH PUER. areas of the cerebrum, etc. At present the PERAL ECLAMPSIA.

consensus of opinion is, however, that the

most constant and predominating factor in By J. H. HIDEN, M. D.

the etiology of puerperal eclampsia is renal

insufficiency. The primary cause in most In discussing puerperal eclampsia, I am cases, then, may be considered a toxemia. well aware that nothing really new is pre- This thought, accepted and digested, will sented in this article. It is simply my pur- doubtless point out to the physician a pose to review and to emphasize the value rational course of treatment. And though of certain medical facts as they appear to in some cases this toxemia may be more me in the management of such cases. or less of hepatic origin, as has been often When called to a case of puerperal convul- shown upon autopsies in which fatty, cellusions we then have little or no time for lar degeneration, capillary hemorrhages, meditative work. The time for action has infarcts, etc., have been observed, yet the

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