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.

    440/450 (page 406)
    Ergot and ergotine.—These are the stock remedies of the present day They vary much in quality and some samples are worthless, so that it is most important to avoid the use of ergot of unknown origin. The greatest difference of opinion exists as to the physiological action of ergot, so that its usefulness must be determined by clinical observation and not by theory, and the \yidespread belief in its efficacy, which has stood the test of time, should not be lightly disregarded. Ergot produces general vaso-constriction of central and not peripheral ori<^rin and has a powerful tonic action on the heart. It thus produces a general rise of blood pressure, and that pulmonary as well as systemic. The increase in pulmonary pressure might be considered a theoretical objection to its use in hc-emoptysis. Yet ergot produces not contraction but dilatation of the pulmonary vessels. Anyway, experience seems to prove its utility in h£emoptysis Ergot and opium are the two remedies upon which greatest reliance is placed but neither must be expected to do impossibilities in bleeding from the lung anv more than m bleeding from any other part. Ergot may be given in the form of the liquid extract by the mouth, but if more immediate action IS required subcutaneous injections of ergotin are pieferable immeaiate rf ^'''J'-'^,^oi''''°^^.'^i'^°'' ^^^^^ 8^'''^ i-epeated in half an hour or an hour, after which 20 or 30 drops may be given as thought necessary. Jirgotine is given in doses of 3 to 10 minims of the oUicinal hypodermic solution, and rep ated as required. The solution does not keep well and should be Ireshly prepared, or the tabloids or lamels used, and dissolved when wanted. , i Astrmgent inhalations and sprays.—The only remedy used as a vapour for luhalation is tur-peniine. A teaspoonful of the oil is sprinkled upon lint or a handkerchief, which is placed over the mouth. It is dilhcult to see what action is expected from it, but it is frequently employed I have used it myself and seen it used frequently by others, but I have never obtained any convincing ])roof of its efficacy. In the form of spray various astringent substances have been advocated. Tamvicacid{g-c. h to 20 in the ounce); alum (gr. 30 to 60 in the ounce or a saturated solution); ■perchlor%de of irmi in varying strengths. The spray may be produced either by hand, i.e., by compressed air, or by steam. It is diffi- cult to see what use a spray can be. The greater part of the spray is deposited in the mouth and tliroat, and unless the patient has learnt how to inhale properly none of it reaches even the larynx. If any did make its way to the distant parts of the lung, it is clear that it would pass more easily into any other part of the lungs than into the bleeding parts, where the tubes are more or less filled with blood ; and even if it did gain access to these parts it could not be in sufiicient amount or strength to have any effect. When to these objections are added the inconyeinence and discomfort of the inhalation and the irritation and coughing it often excites It IS obvious that such inhalations are likely to do harm and cannot do good. In my opinion tney are all useless. ^ Sedatives.—Opium and Morphia.—Bow far these drugs have any effect upon the large vessels whence the bleeding comes in hemoptysis may be fairly ques- tioned, but they certainly allay nervous excitement, and thus quiet both the respiration and the circulation. In this respect they are of the greatest use, and m most cases of severe ha;moptysis their administration constitutes an important part in the routine treatment of the disease. In urgent cases morj.hia is best administered sub cuicm, but in less severe oases small doses of laudanum may be given at short intervals by the mouth. Remedies directed to diminish blood pressure.—Cardiac depressants.—Oi these the chief are tartar emetic, aconite, and ipecacuanha, but they must be given in full doses sufficient to produce the effect intended.