A text-book of medicine : for students and practitioners / by Adolf Strümpell ; translated by permission from the 2nd and 3rd German editions by Herman F. Vickery and Philip Coombs Knapp ; with editorial notes by Frederick C. Shattuck.
- Date:
- 1887
Licence: Public Domain Mark
Credit: A text-book of medicine : for students and practitioners / by Adolf Strümpell ; translated by permission from the 2nd and 3rd German editions by Herman F. Vickery and Philip Coombs Knapp ; with editorial notes by Frederick C. Shattuck. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
100/1022 page 68
![dexterity. The child is to be brought to a sitting posture for this purpose, with its head bent sharply forward. A common surgical syringe is employed, with a short piece of rubber tubing on the end, and a weak solution of salicylic acid is injected (1-400), or a one-per-cent, solution of carbolic acid. It has also been recommended to pour a few teaspoonfuls of cold water at short intervals into the nose, giving what is called a “ cold nasal douche. ” And, finally, we may try to contribute to the disinfection of the mouth by dusting the diphtheritic ulcers with iodoform. We shall mention only a few of the numerous other remedies which have been recommended. There is another local remedy, papayotin, which is obtained from the milky juice of a certain plant, and has the property of digesting albumen. If a diphtheritic exudation be frequently touched with a five-per-cent, solution of this, it will sometimes disappear rapidly ; but the drug can not be shown to have an active influence upon the disease itself. Of internal remedies, we should mention potassic chlorate, which has been much vaunted as a specific, when given inter- nally in rather large doses. We recommend it, but it should be used as follows : a half-teaspoonful of a two- or three-per-cent, solution should be slowly swallowed about every half-hour. The aim is to obtain, not a constitutional, but a local antiseptic action. It should not be given in larger amounts than drachm j-jss. (grm. 5-6) in twenty-four hours, lest it cause hsemoglobinuria or other toxic symp- toms. Several physicians have lately recommended spirits of turpentine very highly, one half to one teaspoonful being given several times a day. It has not become popular. Injections of pilocarpine have also been praised. They are said to promote the detachment of the false membrane ; but their efficacy is doubtful. [The tincture of the chloride of ii’on is much used in this country in the treat- ment of diphtheria, and appeal’s to be of real service ; but it must be given in large doses. The following prescription is recommended by Jacobi, whose experience has been very large, for a child of two years : R Tinct. ferri chloridi 3 ij ; Potas. chlorat gr. xx ; Glycerin, pur § j ; Aquce § v. M. S. : Teaspoonful every fifteen, twenty, or thirty minutes. Turpentine is better as an inhalation than by the stomach ; a teaspoonful or two of the oil can be poured in water kept at the boiling point by an alcohol-lamp. The whole air of the room is thus charged with the remedy. No drug should be used which disorders the stomach.] If the larynx is attacked, and the consequent laryngeal stenosis threatens to cause suffocation, tracheotomy is our only resort. It is never indicated by the dis- ease itself nor by the severity of the case, but only by persistent obstruction of the larynx. It is therefore not invariably easy to decide whether tracheotomy is called for in any particular case. If the general condition be bad and respiration already impaired, it may be very difficult to determine whether laryngeal stenosis exists. Tracheotomy will be of no avail if the croup has already extended to the bronchi, or if the dangerous condition of the patient is due to the severity of the constitutional infection or to incipient paralysis of the heart. This explains why the results of tracheotomy are not remarkably brilliant. On an average, only about one third or one fourth of the cases operated upon get well ; but even this number is enough to make us prize the operation very highly. How it is per- formed, and in what the after-treatment consists, must be learned in the text-books on surgery. The attempt to expel the false membi’ane from the larynx by inducing vomit-](https://iiif.wellcomecollection.org/image/b21981565_0100.jp2/full/800%2C/0/default.jpg)
