A manual of practical therapeutics : considered with reference to articles of the materia medica / by Edward John Waring ; edited by Dudley W. Buxton.

Edward John Waring

Date:: 1886

Credit: A manual of practical therapeutics : considered with reference to articles of the materia medica / by Edward John Waring ; edited by Dudley W. Buxton. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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$eral cases illustrative of its efficacy. The following formula is advised: R. Argent. Nit., gr. i^, Opii, gr. }(, Pulv. Rhei, Ext. Hyoscyam., aa gr. j. M. Ft. pil. in die sumend. 322. In Gonorrhcea, the abortive treatment by the early use of strong injections of the nitrate (gr. xv-xx, ad Aq. Dest., %]), and by the administration of copaiba or cubebs in large doses, was, atone time, much in vogue; but *'the success which attends either of these methods (observe Hill and Cowper, p. 507) is so small, while the dangers which attend them are so great, that we have abandoned them. The reason why abortive treatment is now generally discarded, they add, is that dangerous reaction is often induced by it. Gangrenous inflammation of the urethra, inflammation of the neck of the bladder, prostatitis, orchitis, bubo, and stricture have all been known to follow the use of caustic injections; whilst large doses of copaiba or cubebs in the first stage of the disease are apt to excite congestion of the kid- neys, or to cause violent vomiting and purging. (See also Zinci Sulphas.) In the advanced stages, when inflammation has sub- sided, a weak solution of the nitrate (gr. ij, Aq. Dest., ^j) forms a useful injection, especially when the discharge is white and moderately copious. Like all injections, it should be weak at first, and never sufficiently strong to excite more than a few minutes' smarting. 323. In Chronic Urethritis in the Female, Dr. Braxton Hicks states that the solid nitrate is a very efficient though painful appli- cation. It should be held in a small caustic holder on the end of a stilette, and sliding easily within a small silver tube, from which the caustic can only be made to project a short distance. The nitrate should be sheathed in the tube when passed into the urethra, and then, being projected beyond the tube, should be slowly withdrawn. By this means the mucous membrane is lightly touched throughout its whole extent. It is more painful than tannin {q.v.), but the pain soon passes off, and in a day or two much relief is obtained. It should be repeated in a week, and a third time at the same interval, if required. 324. In Ulceration of the Os and Cervix Uteri, the solid nitrate was, till quite a recent period, held in high repute, but has now fallen into comparative disuse. According to Dr. West (p. 122), it is not, in general, suitable to these cases, as its application is often followed by pain and also by bleeding. He prefers the Acid Nitrate of Mercury {q.v.^. Dr. AtthilP goes further, remarking that he can with confidence say that, as an application in disease of the body of the uterus or of the cervix, the nitrate is perfectly useless. In cases of Vaginitis, however, he adds, it it may be applied with advantage. It must be applied through a speculum, and the surface of the vagina well brushed over with a * Med. Press, Dec. 31, 1873.$