A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases ... with numerous prescriptions ... a classification of diseases ... a copious bibliography, with references; and an appendix of approved formulae / ... By James Copland.

James Copland

Date:: 1844-58

Credit: A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases ... with numerous prescriptions ... a classification of diseases ... a copious bibliography, with references; and an appendix of approved formulae / ... By James Copland. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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$came before me in a lady, whom all the prac- titioners who had acquired a reputation in the treatment of cutaneous afi'ections had attended, strict attention to the state of the digestive and uterine functions removed the eruption. The fol- lowing electuary has sometimes been used by me in this and other obstinate cases. No. 7. B Potassse Bitart. in pulv. .1 j. ; Bi-boratis Sodae 3 ijss. ; Sulphuris Pra?cip. J ss. ; Contectioiiis Sennae et S) lup. Ziiigiberis aa 3 jss. M. Fial Electuarium, cujus capiat Coch. umim minimum omni nocte. At the same time a solution of two grains of the bi-chloride of mercury in four ounces of the com- pound tincture of cinchona was prescribed, and a teaspoonful of it directed to be taken twice daily, in half a glass of infusion of chamomile flowers. The lotion already recommended (§ 22.) was also employed. In cases similar to this, and, indeed, in all those accompanied with disorder of the digestive functions, cold or drastic purgatives ought to be avoided ; and the bowels should be regulated with the pilula aloes cum myrrha, com- bined with a little blue pill, or with the pill pre- scribed above (§ 18.) ; or theext. aides purif con- joined with the e.vtr. gentianse ; or the electuary now directed. Advantage will also be obtained from a draught of infusion of cascarilla, or of ca- lumba. with carbonate of soda or potass, or the liquor potassae, taken twice a day. 24. As to eiternal applications in this form of acne, little need be added to what has been already stated. The lotions with the bi-chlorile of mercury, or with the borax, are most to be de- pended upon, particularly when dissolved in an emulsion of bitter almonds, or in camphor mix- ture, with the addition of about twelve minims of the hydrocyanic acid to each ounce of the vehicle. In cases where the tubercles have at ail suppurated, it will be advisable to open them with the point of a lancet befoie the lotion is used. 25. At the commencement of the eruption, mild emollient poultices and fomentations are useful ; and afterwards, particularly i i the more obstinate cases, M. Biett, and ailer him 1\II\I. Cazexave and SciiEDEL, recommend the following ointments to be used, in order to promote the resolution of the tubercles : — No. 8. R Protochloridi Hydrarg. et Ammonias* (Sub- niur. Hydrarg.et Amnion.) 3 j—3j.; Axungiae 3 j•Mi^ce. Of this ointment I have had no experience ; but the following I have employed with advantage in several chronic eruptions, and in two cases of this species of acne : — No. 9. R Siilphureti lodinEE gr. xli — xxiv.: Axungije 3j. M. Ambrose Pahe and Darwin considered that blistering successively small portions of the face was the most successful means of removing this very obstinate eruption. This practice has been employed at the hospital St. Louis, by IM. Biett, with great benefit. When the disease has disap- peared, he has derived great advantage from a douche of cold sulphureous water in preventing a return of it. 26. 3^, Tn treating the punctated species of acne, it will be frequently necessary to press out the accumulated and hardened matter from tiie follicles. 'J'he vapour bath, the warm sulphur bath, followed by fiictions either with a coarse * Prepared by subliming equal qnantilifs of the bi- chloride of mercury and hydrochlorate of ammonia. towel or a flesh brush ; and lotions such as have been already recominended, or a weiik solution of pui-e potash, or of ox-gall, or of sulphuret of po- tassium, also followed by frictions, are particularly indicated in this species of acne. 27. liiternatlu, the solution of the bi-carbonate of potash, or of chlorine, advised by Under- wood and WiLLAN, may likewise be employed. Sulphur, magnesia, soda, rhubarb, and the borate of soda, are also of much benefit. Dr. Thomson slates, that he has seen the skin completely cleared by the use of the following alkaline tonic for six weeks ; at the same time regulating the bowels:— No. 10. R Zinci Sulphalis gr. xxiv. ; Liqiioris Potassse 3 xij. Solve. Suniantur guttae xxx. ex cyatho aquiE, bis quotidie. It ought always to be observed, as a general prin- ciple, in this as well as in the other forms of acne, that attention to the secretions of the abdominal viscera, and to the general health, by promoting the dige-tive functions, will of itself, independently of external means, go far in promoting a cure ; and that, without such intention, no cure will be permanent. 28. 4th, The treatment of acne rosacea is gene- rally unpromising. It should always have a strict reference to the particular nature of the affection of the liver, or digestive canal, or both, with which this eruption is associated, and in many respects symptomatic. A. rosacea often precedes serious di-ease of the liver, more frequently co-exists with it, and most commonly indicates a congested and obstructed state of the viscus. To this organ, therefore, ought our remedies to be particularly directed. A modeiate blood-letting ; the applica- tion of leeches on the region of the liver; and, if the eruption occurs in females, and is attended with obstructed or scanty menstruation, leeches also to tiie upper part of the insides of the thighs, or bleeding from the feet, and stimulating pe- diluvia, or the hip-bath ; the use of mild mer- curials, or alterative and deobstruent medicines, such as the pills previously described (§18.); the blue pill, or the hydrargyrum cum creta with soda and taraxacum ; Harrogate, Barege, and other sulpiiureous mineral waters; the decoction of dulcamara, lii|Uor potassaa, and chlorine or sul- phureous fumigatmg baths, are severally of advan- tage in some cases. But from none of these will any permanent benefit be derived, unless the regi- men presently to be noticed is rigidly observed, and the pathological relations of the eruption ap- pi'opriately treated. 29. Blood-letting in this, as well as the fore- going species of the eruption, was stronjjly insisted on by Ambrose Pare ; and certainly in the cases pointed out as requiring this practice should never be omitted ; more particularly when accustomed discharges have disappeared, as the ha'morrhoidal flux and the menstruiil evacuation. In this form of the disease, much advantage will sometimes be procured from tlie nitro-liydrociiloric acid foot-bath ; and from a lotion with these acids ap])licd to the affected parts twice or thrice a day (see F. 4, 5.). This practice has received the sanction of JMftJ. Biett, Cazenave, and Sciiedel. 1 he advantages to be derived from the use of these acids as a lotion will be more ceitainly secured by applying a few leeches to the vicinity of the eruption, and after- wards a fomentation, which may be followed either by a spirit and alum or zinc lotion, or by$