Volume 1
A dictionary of practical medicine, comprising general pathology, the nature and treatment of diseases, morbid structures and the disorders especially incidental to climates, to the sex, and to the different epochs of life. With ... prescriptions, ... bibliography ... formulae / [James Copland].
- James Copland
- Date:
- 1832-1858
Licence: Public Domain Mark
Credit: A dictionary of practical medicine, comprising general pathology, the nature and treatment of diseases, morbid structures and the disorders especially incidental to climates, to the sex, and to the different epochs of life. With ... prescriptions, ... bibliography ... formulae / [James Copland]. Source: Wellcome Collection.
357/378 page 335
![81. An accurate idea of the remote causes of the disease, as well as of their probable operation and continued effect, should lead not only to their removal as far as possible, but also to atreatment modified accordingly. The mental impressions and moral emotions are often more or less affected, - particularly in those irregular forms of disorder, which have very generally been confounded with chorea. This circumstance should not escape the attention of the physician, as it points to the em- ployment of moral management in aid of medical measures. As the mental affection, when it ex- ists, has generally an intimate relation to the remote causes of the disease, the importance of ascertaining the existence of the former, as well as the nature of the latter, as a basisof an appro- priate treatment, must be manifest. 32. c. Having removed accumulations of mor- bid matters, and subdued irritation existing about the origin of the voluntary nerves, or in parts of the cerebro-spinal axis, or enveloping membranes, and having excited the actions of the secreting and assimilating organs by the means stated above, the third intention of cure is to be now entered upon ina more decided manner, by the exhibition of tonics combined with antispasmodics, and by due attention to the state of the bowels, and functions of the secreting viscera and sur- faces. The combination or alternation of bitter tonics with aperientsand antispasmodics wil! often be necessary during this stage of the treatment; or an occasional dose of a brisk purgative, or of calomel, will be exhibited with advantage during the employment of tonics. Even when the bowels are so active as apparently to render this interference unnecessary, a dose of the pilula hydrargyri, given once or twice a week, either with or without the pilula aloes cum myrrha, will be found serviceable. As to the choice of tonics, no immutable rule can be laid down. The state of the pulse, and of the secreting organs, should be the chief guide in the selection of them. At- tention to the mode of combining them is also of much importance. Bark, in any form, will be beneficial when judiciously prescribed. The fol- lowing powder will be found serviceable, and may be taken in some aromatic water; the doses of the ingredients being varied according to the age of the patient, and the state of the bowels : — No. 126. RB Pulv. Cinchone gr. xij.; Pulv. Rhei gr. viij.; Sodze Sub-carb. gr. x.; Pulv. Capsici Annui gr. ij. Misce. If the decoction be preferred, it will be found most beneficial when given with liquor ammoniz acetatis, and a little of the spiritus ammoniz aro- maticus, The sulphate of quinine is an excellent medicine, especially when the patient is old enough to take it in the form of pill, when it may be most advantageously combined with aloés, as in F, 572—577., or with camphor and aloés as follows. In this state of combination a decided action will be exerted on the bowels : — No. 127. BR Camphore rase, Quinine Sulphatis, aa 9j.; Extr. Aloés Purif. 3ss.; Extr. Gentiane (vel Pilul. Galban. Comp.) 3j.; Syrup. Simp. q.s. M. Fiant Pilule xxxvj., quarum capiat binas bis quotidié. ° 33. In this stage of treatment much advantage will often be obtained from valerian, combined with other antispasmodics and tonics, or with the alkalies (F. 269. 368.) ; from the preparations of iron, as recommended in the article on Cutorosis, (§ 13.),or in F, 521, 523.; and from the sulphate 335 of zinc (F. 582—587), or the arsenical solution (F. 364.). As chorea is sometimes compli- cated with disease about the heart, or the roots of the voluntary nerves, or the membranes of the brain or spinal chord, of an inflammatory nature, care should be taken not to exhibit this last ac- tive substance, or even the preparations of iron, or of bark, until the symptoms of these complica- tions have been removed by local depletions, cold affusions, or the shower bath, and counter-irrita- tion. A similar precaution is still more requisite in respect of the employment of strychnine, or the nux vomica (see F. 443. 541, 542. 565. S07), which I have found of much service in the ad- vanced course of treatment of the simple form of chorea, or when it has been associated with rheu- matism of the joints of extremities, with chlorosis, hysteria, or amenorrhoea; in which complicated states of the disease I have likewise found the tincture of iodine, and hydriodate, or ioduretted hydriodate of potash of great service (I', 234, 722.). The formule for the above medicines given in the Appendix, or the following, may be adopted : — No. 128. R Olei Valeriane 1M xij.; tere cum Sacch. Purificati 3 iijss.; tum adde Infus, Valerianz 3 vijss. ; Lig. Arsenicalis 11] xv. ad. xxx. Misce. Capiat cochlearia duo larga ter quotidié. No. 129. RK Pulv. Calumbe gr, x.; Pulv. Valeriane gr. xij.—9 j.; Carbon Ferri Prep. gr. x.; Pulv. Cinnam. gr. vj. M. Fiat Pulvis, vel Electuarium molle cum Syrup. Zingib. q. s., bis terve quotidié sumatur. No. 130. KR Carbon Ferri Prep. 3ss. ; Pulv. Supertart. Potasse 3 vj.; Confection. Senne, Syrup Zingiberis, 2a 3% jss. Misce. Fiat Electuarum, cujus capiat Cochleare unum minimum mane nocteque. No. 131. B Carbon. Ferri; Sulph. Precip. aa 3 ij. ; Po- tasse Supertart. Pulver. 3 v.; Confectionis Senne et Syrup. Zingiberis 4a 3 jss.. Misce. Fiat Electuarium, Su- No. 132. R Sub-boratis Sode, Supertart. Potasse, aa in Pulv. 3iij.; Carbon. Ferri 3ij.; Confectionis Senne 3ij.; Syrup. Zingiberis q. s ut fiat Electuarium molle, cujus Cochleare unum minimum mane nocteque sumatur, 34. During the use of these medicines, the tar- tarized antimonial ointment or plaster may be applied to the spine; and when the tonics are not combined with aperients, the former may be ex- hibited in the course of the day, and the latter at bed-time, as they may be required. The nitrate of silver may also be tried in doses of half a grain, or a grain, combined with aloes, or the aloes and myrrh pill. 35. C. The treatment of the complicated and irregular states of this disease must necessarily be modified according to the diversified form it as- sumes. The association of the disease with rheumatism has been observed by me on several occasions, and, in nearly all, there has been a marked disposition of the rheumatic affection to recede from the joints or extremities, and attack the internal fibro-serous membranes, as those of the cerebro-spinal axis and the pericardium. This unfavourable result has generally been pro- moted by a too lowering treatment; but pre- vented by tonic and stimulating medicines, with due attention to the alvine evacuations. In cases, therefore, complicated with rheumatism, chlorosis, aneemia, or retention of the menses, the purgatives selected should be of a warm and stomachic kind, or combined with cordial and stimulating substances; the ammoniated tincture of guaiacum, camphor, serpentaria, and similar medicines, being also employed. In these states of disease, the internal use of the cod or tusk-liver oil will he found most beneficial, Having observed instances](https://iiif.wellcomecollection.org/image/b33285330_0001_0357.jp2/full/800%2C/0/default.jpg)
