A practical treatise on the diseases of children / by Alfred Vogel ; translated and edited by H. Raphael.

Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children / by Alfred Vogel ; translated and edited by H. Raphael. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    patient, as a rule, soon becomes accustomed to the direction given to the limb, although it is just the contrary to the one he had him- self selected. Uninterrupted rest is to be maintained so long as , there is any sign of inflammation, and only after it has entirely ter- minated can any movements of the limb, even with the utmost pos- sible care and protection, be allowed. The pains are best allayed by the internal use of narcotics, as also the local application of oint- I ments containing morphine, etc.; but, if they have become very in- I tense, then we should not hesitate to use cold, or even to apply ice. I [The best remedy for the relief of the pain is the separation of ' the inflamed surfaces of the joints, by means of an extension and f counter-extension apparatus.] Many remedies have been recommended as resolvents, to facilitate I the absorption of the exudation. Those most frequently used are the preparations of iodine—iodide of potassium ointment; Richter’s solu- tion of iodine for pencilling the part—iod. pur., kali hydroiod., aa 3 j, glycerine 3 ij. The use of mercurial preparation requires much caution. Jobert has lately recommended nitrate of silver as an excellent remedy in chronic inflammations of the joints. At first an ointment containing argent, nitr. 3 j to adipis 3 j, of which from 3 ss to 3 j is rubbed in twice daily; it is gradually made stronger, until it contains 3 iij of nitrate of silver to | j of fat. Setons, issues, moxas, and the actual cautery, have been used as derivatives; the latter, especially, has acquired a great reputation in Rust’s hands. Nevertheless, the result falls far short of the expectations that have been entertained. Numerous baths are also employed for the treatment of the cachexia as well as for the local affection; but these are only permissible with the understanding that the change of posture and movements will not cause the patient more harm than good. Iodine and bromine baths have acquired a certain amount of reputation; baths, with common cooking salt, deserve especial recommendation on account of their simplicity and cheapness. Priesnitz’s method of treating joint-aflfeo- tions may be added here, which, in its entire extent over the whole body, should be discarded on account of the small amount of strength the child has to spare in the exhausting cure; but, locally to the affected joint, it deserves full consideration. Where suppuration exists, care should be taken to allow the pus to escape freely; the sinuses are,to be dressed with simple, unirritating applications. Abscesses develoj> ing themselves in the vicinity of a joint, and bulging up under tlie integument, are to be opened as early as possible ; on the other hand, the opening of abscesses which are in connection witli the joints, or, after having perforated the capsule of the. joint, subsequently reach beneath the sldn, shouH be delayed as long as possible, if the strength I