Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    886/976 (page 866)
    concentrated solutions, will act as purgatives, whereas if very freely diluted they produce diuresis; and it must he at once evident to any one who considers the subject, that the introduction of a large amount of fluid into the system has the effect of rendering the blood more capable of holding sparingly soluble matters in solution, and of augmenting the various secretions from the body, especially the urine, and hence of facilitating the expulsion of any sucli matters from the system. It is necessary also to select proper times for the exhibition of these remedies; as the object is to have them rapidly absorbed, they should be given on an empty stomach, at least an hour before food; if taken at or soon after a meal, they are apt to cause distension and discomfort, and at the same time they are very slowly absorbed: any amount of free alkali, when taken at the time that digestion is going on, impedes the process very seriously by neutralizing the free acid of the gastric fluid. This is a fact too frequently overlooked in practice. Small doses of salines, if their use is long persevered in, are pre- ferable to large ones, as they produce no disturbance of the digestive process, act more freely on the kidneys and skin, and are not likely to cause debility. Magnesia and its carbonates have been long used in the treatment of chronic gout, and there can be no doubt that these salts are of value in many cases. Magnesia forms a moderately soluble salt with uric acid; it is also an alkali, and acts both as a direct and remote antacid ; it is useful as an adjunct, and especially in instances in which there is great acidity in the intestinal canal, and at the same time a sluggish state of the bowels. The salt formed in the stomach by its union with the acid produces a purgative effect, which tends to relieve the portal circulation, and often aids indirectly the function of kidneys. Carbonate of magnesia dissolved in excess of carbonic acid is an elegant form of administering the remedy. The lime salts offer no special advantage. Lime water may be employed as an antacid if there is much tendency to diarrhoea, as the salts of lime have a constipating effect. There are some other salts, not yet alluded to, whose virtue depends partly on the acid contained in them; for example, the phosphates of soda and ammonia. Both these salts increase the ^solubility of the urate of soda, and may be used with advantage in certain instances. The phosphate of ammonia has been employed in many cases of chronic gout, and clinical observation appears to show that it is useful in preventing paroxysms, probably by keeping the blood in a purer state. The result of my own experience of the use of the phosphate oi ammonia is favourable: it is especially indicated in cases in nine the circulation is feeble, and the function of the skin impaired, 3 remark applies equally to other ammoniacal salts. Treatment of Errors of the Digestive Function.—As the stomach an other parts of the digestive apparatus are generally affected in chi owe