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.

  • West, Samuel (Samuel Hatch), 1848-1920.
Date:
1902
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.

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    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.—So far as drugs go, all that is necessary in these cases of slight haemoptysis 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 drugs 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 haemoptysis.—In the severe cases of haemoptysis the general principles of treatment are the same, but they must be most rigidly enforced, and supplemented by other methods, the aim of which is specially directed towards controlling the bleeding. Haemostatics.—Of these tannic acid, gallic acid, the mineral acids, and acetate of lead are the favourite remedies. Gallic and tannic acid. —Tannic acid is probably not absorbed as such but is first converted into gallic acid in 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 in water every hour or so, according to the urgency of the case. The mineral acids are also frequently given, the favourite being sulphuric acid. Their effect upon hemoptysis is absolutely nil, but they are grateful to the palate, and in combination with gallic acid and opium, enter into most of the stock prescriptions for hemoptysis. Acidi Gallici, gr. x ; [or Glycer. Acid Gall., 3 ss to 5 i]; Acidi Sulphur, dil., lip xv ; Aquam. ad l i. This dose to be taken every hour or every two hours. To this may be added Tt. Opii, m. ii or nq iii; or Tt. Camphor Co., ill 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 rliatany and catechu. Common salt is a popular remedy, given in doses of a teaspoonful every half houror so. Its real effect is nil, and it, of course, considerably increases the thirst. The perchloride and other astringent preparations of iron are usually regarded as mischievous in haemoptysis. If administered in full doses they are very likely to upset the stomach and to confine 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,1 and at the same time to increase the clotting properties of the blood. It is given in full doses, not less than 2 mains every hour, and almost invariably in combination with opium. Whatever effect lead and opium may have upon intestinal haemorrhage, the effect upon hemoptysis is probably due rather to the opium than to the lead. The drugs are given either in solution or as a pill. The solution is the best form, for pills take some time to dissolve, and are less certain in action. Pill. Plumbi acetat., gr. ii; Opii, gr. j- or I ; Extr. Hyoscyami, gr. ii. ^ il/irtitrc.—Humbi acetat., gr. ii ; Acidi acetic dil., lip xxx ; aqua;, * i; to which may be added It. Opii, Tit n or iii, according to requirements. ,. Ttigitali8. The use of this drug is opposed to theory, and is not supported by experience, so ttiat it is no longer included in the list of remedies for haemoptysis. Ergot and ergoline.—These are the stock remedies of the present day. The greatest difference exists as to their physiological action, so that their usefulness must be determined by 1 Stilld and Maisch, Dispensatory, p. 1189.