Human health, or, The influence of atmosphere and locality, change of air and climate, seasons, food, clothing, bathing and mineral springs, exercise, sleep, corporeal and intellectual pursuits, etc. on healthy man, constituting elements of hygiene / By Robley Dunglison.
- Dunglison, Robley, 1798-1869.
- Date:
- 1844
Licence: Public Domain Mark
Credit: Human health, or, The influence of atmosphere and locality, change of air and climate, seasons, food, clothing, bathing and mineral springs, exercise, sleep, corporeal and intellectual pursuits, etc. on healthy man, constituting elements of hygiene / By Robley Dunglison. Source: Wellcome Collection.
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![232 ASTRINGENTS. effects of astringents by acting chemically on the contents of the stomach and intestines, very few remarks will suffice. Both lime and its carbonate, or chalk, operate in checking diarrhoea by neutral* izing the ascescent matters which augment the irritability of the intestines, and keep up their morbidly increased peristaltic movement. Owing to the little solubility of pure lime, chalk, rubbed up with mucilage of gum so as to suspend it in any fluid, is preferred in cases of diarrhoea. It is incompatible with vegetable infusion containing much tannin, and with preparations of ipecacu- anha. When it is necessary to continue the use of the chalk mixture for some time, the bowels should be cleared wdth a purgative, as accumula- tions in the form of hard balls are apt to take place in them, and, lodging in the folds of the intestines, to cause much inconvenience and, occa- sionally, hazard. [The agents, considered thus far, may be re- garded as direct astringents ; but profuse evacua- tions may be connected with different states of the living system, so that agents, possessed of no astringent properties, may check them or produce an astringent operation indirectly. Hence, there may be direct and indirect astringents, as there are direct and indirect tonics. Opium, for exam- ple, by allaying the augmented peristole in diar- rhoea, may exert an action of astringency, and diminish the number of discharges : accordingly, it is often had recourse to in such cases. Again, the increased discharges of dysentery ai'e induced by an inflammatory condition of the mucous coat of the intestines : bleeding, therefore, by allaying this inflammation, and castor-oil,—given occasion- ally, so as to remove gently the morbid secretions, —by taking away the cause, may check the effects. A pjredominancc of acidity in early infancy lays the foundation for many of the bowel complaints, which are so common at that age, and keeps them up when once established. A proper antacid, as before observed, b}'^ neutralizing the acid, takes away the cause, and thus becomes an indirect astringent. (The writer’s General Therapeutics and Mat. Med. ii. 96, Philad. 1843.)] In a therapeutical and practical point of view, astringents, when administered on proper princi- ples, are a valuable class of remedies. In inter- mittent fevers, the vegetable astringents have been successfully employed in the same manner as simple tonics. We can form no other idea of the manner in which they prove beneficial than by supposing, that they obviate the relaxation wdrich favours the influence of the exciting causes of agues. On this account it has been asserted that tonics and astringents operate in every respect in a similar manner ; but many tonics, such, for in- stance, as sulphate of quinia, possess no astrin- gency, and nevertheless arc useful in intermittents; a)Kl it must be admitted that, as pure astringents are seldom or never given alone in intermittents, it is difficult to ascertain how much of the benefit is due to their influence. They are employed in •» continued fevers only to moderate incidental diar- rhoea and internal hemorrhages. In the phlegmasise, astringents are contra-indi- cated as general remedies ; but in that state of inflammatory action which assumes a chronic character, and is kept up by debility and increased nervous excitability, such as occurs in the eye and in the tonsils, they are local remedies of conside- rable value. Solutions of the metallic salts, and infusians of astringent vegetables, with the addi- tion of diluted sulphuric acid, are well adapted for these cases. Indeed, after inflammatory action has been subdued by the use of the lancet and other antiphlogistic measures, the application of cold and astringent solutions tends greatly to restore the healthy action of the part. [In diphtheritic affections of the throat, a solu- tion of nitrate of silver has been found of great benefit; and in cases of diphtheritic laryngitis, the inhalation of finely powdered alum has been mark- edly advantageous. Not only—according to Laen- nec—has it afforded great and speedy relief in tra- cheitis, but in laryngitis isthmitis, and pharyngitis.] No remedies are so important in the hemorrha- giaB as astringents ; but they are not to be indis- criminately prescribed, or at all times employed: it is, therefore, necessary, to inquire what are the circumstances indicating their use in these cases ? Hemorrhages are properly divided into active and passive. In the first or active kind, the flow of blood generally arises from a plethoric condition of the vascular system; and it may, in some respects, be regarded as an effort of nature to relieve the morbid fulness of the vessels. In this form of hemorrhage, tonic astringents are improper; and even those exerting a sedative influence should not be resorted to until the vessels be either emp- tied spontaneously or by the use of the lancet. In passive hemorrhages the animal fibre is relaxed, the red particles of the blood are diminished, and diffused in a superabundance of serum, so that the blood assumes a pale watery aspect; while the system suffers from general debility. In this state, astringents are decidedly indicated, and may be liberally employed. Although these opposite states appear very obvious in description, yet much judgment and attentive observation are requi- site to distinguish them on man}'^ occasions. If we take, for example, epistaxis, let us enquire, what are the peculiar symptoms which clearly indicate the employment of astringents ? When bleeding takes place from the nostrils of young persons of a plethoric habit, it may be critical, or connected with congestions, or a determination of blood to the head. In this state the hemorrhage should not be checked by astringents, unless it is so profuse and long continued as greatly to lower the pulse, to produce pallor of the countenance, and exhaust the general strength. On the con- trary, when epistaxis happens in weak boys or youths, or in old persons; or when it is sympto- matic of diseased liver, or some other internal organ ; then astringents may be at once adminis- tered to check the direct loss of blood, whilst other means are resorted to for removing the exciting causes of the hemorrhage. The best astringents in these cases are solutions of metallic salts and of alum : they may be either injected into the nostrils, or dossils of lint soaked in an astringent solution may be inserted ; while at the same time cold water is applied to the face and nape of the neck. In haemoptysis, if the excitement be considerable, the lancet must be employed, after which the application of cool air, cold water, or ice to the](https://iiif.wellcomecollection.org/image/b29331663_0470.jp2/full/800%2C/0/default.jpg)
