Volume 1

Diseases of the organs of respiration : a treatise on the etiology, pathology, symptoms, diagnosis, prognosis, and treatment of diseases of the lungs and air-passages / by Samuel West.

  • Samuel West
Date:
1909
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Diseases of the organs of respiration : a treatise on the etiology, pathology, symptoms, diagnosis, prognosis, and treatment of diseases of the lungs and air-passages / by Samuel West. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    439/450 (page 405)
    School of Sec. 49.] H^4ol^:j:^^|s.: . .405 small lumps of ice, or to drink water acidulated with phosphoric acid or lemon juice. As soon as may he the diet should be concentrated, and small quantities of solid food given, such as pounded or finely mixed chicken or mutton. Medicinal Treatment—far as drugs go, all that is necessary in these cases of slight hfemoptysis is a little opium and a saline purge, with perhaps some ergot. It IS a common practice to administer small doses of mineral acid of which the dilute or the aromatic sulphuric acid are the favourite, or to give gallic acid tannic acid, alum, or lead acetate. Opinions as to the actual efficacy of these druag vary greatly, but all writers agree that the addition of opium greatly increases their efficacy, from which I think we may conclude that it is to the opium that their real activity is due. 2. Treatment of profuse Haemopcysis—In the severe cases of haemo- ptysis the general principles of treatment are the same, but they must be most ngidly enforced, and supplemented by other methods, the aim of which is specially directed towards controlling the bleeding. I will commence by giving a description of the remedies in common use, and then express my opinion as to their value. IJcemostatics.-Oi these, tannic acid, gallic acid, the mineral acids, and acetate of lead are the favourite remedies. Gallic and tannic aaVi.-Tannic acid is probably not absorbed as such but is first converted into galhc acid m the stomach and it is the latter drug that is most commonly prescribed. Gallic acid is most conveniently prescribed as the glycerinum, of which half a drachm to a drachm may be given m water every hour or so, according to the urgency of the case. The. mineral acids are also frequently given, the favourite being suli.huric acid. Their effect upon haemoptysis is absolutely ml, but they are grateful to the palate. Lid in combination with gallic acid and opium enter into most of the stock prescriptions for hfemoptysis Acidi Galhci, gr. x ; [or Glycer. Acid Gall., 3 ss to 3 i]; Acidi Sulphur, dil., 1T1_ xv ; Aquam. This dose to be taken every hour or every two hours. To this may be added Tt. Opii, TTl ii or TTl iii ; or Tt. Camphor Co. m. xxx When the preparation contains opium the frequency of its administration will be determined by the amount it contains. Alum has been also employed, but it is useless, and so are rhalany and catechu. Common salt is a popular remedy, given in doses of a teaspoonful every half-hour or so. Its real effect is nil, and it, of course, considerably increases the thirst. The percUoride and other astringent preparations of iron are usually regarded as mischievous in h£emoptysis. If administered in full doses they are very likely to upset the stomach and to conhne the bowels, results which it is desirable to avoid. Acetate of lead is a stock remedy. It is stated to act as a sedative to the heart,' and at the same time to increase the clotting properties of the blood. It is given in full doses, not less than 2 grains every hour, and almost invariably in combination with opium. Whatever effect lead and opium may have upon intestinal hmmorrhage, the effect upon hamioptysis is probably due rather to the opium than to the lead, j tr j The (li-ugs are given either in solution or as a pill. The solution is the best form, for pills take .some time to dissolve, and are le-ss certain in action. Pill. —Ylumhi acetat., gr. ii ; Opii, gr. J or \ ; Extr. Hyoscyami, gr. ii. JlfM;^Mrfi.—Plumbi acetat., gr. ii; Acidi acetic dil., lix xxx; aquce, « i: to which may be added It. Opii, m, ii or iii, according to requirements. Bi'jitfilis.—The use of this drug is opposed to theory, and is not supported by experience, so that it is no longer included in the list of remedies for htemoptysis. ' ^ Stili^ and Maisch, Dispensatory, p. 1189. 27