Copy 1, Volume 1

A treatise on the practice of medicine / By George B. Wood.

  • George Bacon Wood
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the practice of medicine / By George B. Wood. Source: Wellcome Collection.

    787/824 (page 761)
    bleeding is required than in the serous inflammations, and the great majority of cases do very well without it. Occasionally, but not often, the bleeding may be repeated. In relation to the loss of blood, it is highly important to have reference to the constitution of the patient ; and the dis- charge should always be stopped, however little may have been lost, when. the pulse begins to fail. In feeble patients, it is of the utmost import- ance to reserve sufficient strength for the expectoration of the pulmonary secretion. When bleeding is of doubtful propriety, should the local in- flammation seem to call for depletion, leeches or cups should be applied to the breast-or between the shoulders, or wherever the sibilant rale may be most heard ; and, in all cases, these are admirable adjuvants to the lancet. Sometimes, when there is considerable debility, dry cups may be applied with benefit. In severe cases, a full purgative dose of calomel should be given at first, and followed by depletion and diaphoretics as above. Some advise, as an adjuvant to the lancet, or as a substitute for it in cases in which it may be of doubtful propriety, tartar emetic in doses as large as can well be tolerated by the stomach without emesis, as one-quarter, one-third, or one-half of a grain, every hour or two. W hen the first violence of the inflammation is over, remedies should be given calculated to favour the expectoration. Squill or seneka in con- nexion with tartar emetic, ipecacuanha, or sanguinaria, are now suitable remedies. Some strongly recommend also the alkaline carbonates, as hav- ing the property of thinning and rendering of easier expectoration the viscid bronchial secretion. I have little. confidence, however, in the latter remedies. It is more desirable to associate with the expectorants, sub- stances calculated to allay the cough and quiet restlessness. Opium, how- ever, which, under favourable circumstances, is best adapted to these ends, cannot be used with propriety in this stage of bronchitis, at least as a general rule, in consequence of its ordinary effect of restraining mucous secretion, and therefore of shutting up the inflammation in the membrane. Recourse, then, may sometimes be had, where the cough is peculiarly violent, to the preparations of hyoscyamus, conium, or hydrocyanic acid. All these medicines may be advantageously given in liquid mixtures, along with some demulcent substance, as liquorice, gum arabic, or sugar. Every practitioner can make a cough mixture out of these materials to suit his own views, and the circumstances of thecase. It is generally preferable to employ the liquid preparations of the medicines recommended, as the syrup of squill or seneka, the wine or syrup of ipecacuanha, and the tincture of sanguinaria. Tartar emetic may be used in aqueous or vinous solution ; and the narcotics in the form of tincture or extract.- The proportions should be so arranged that a dose may be given’ every two, four, or six hours, according to the urgency and acuteness of the symptoms.* After expectoration has been fairly established, opiates come in with * A mixture may contain, in each dose, for an adult, from m,x to fZss of Antimonial or Ipecacuanha wine or Tincture of Sanguinaria, or from f%ss to 3] of Syrup of Ipe- cacuanha; combined with from Mxx to MLxl of Syrup of Squill, or Nx to NL xx of Vinegar or Tincture of Squill, or from f3ss to £3] of Syrup of Seneka; and with from f%ss to £3] of Tinct. of Hyoscyamus or Conium, or NLij to MLiv of Officinal Hydrocyanic Acid. In cases suitable for opiates, for the above narcotic tinctures, may be substituted, in each dose, from Nij to NLiv of laudanum, Mxv to fZss of Solution of Sulphate of Morphia, or f3ss to £3} of Camphorated Tincture of Opium. It will be convenient to prescribe these medicines in a mixture of f3vj, with 3ij of Gum Arabic, and ij of Sugar or Liquorice, in such quantities, that a tablespoonful of the mixture shall contain the doses above men- tioned.