Licence: Public Domain Mark
Credit: Lectures on the theory and practice of physic (Volume 1). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
169/776
![For permanent effect various mineral preparations are prescribed in gastralgia. Of these, subnitrate or trisnitrate of bismuth, oxide of zinc, subcarbonate of iron, nitrate of silver, and arsenical solution, have been the most extensively employed. If the former be pre- scribed, it should be at first in a dose of four or five grains, gradually increased to twenty grains. Some French writers speak of prescrib- ing it familiarly in quantities of eighteen, thirty, and even seventy grains in the course of a day. (Trousseau and Pidoux, Traill de. Therapeufique et de Matihre Medicale, t. ii., p. 776.) The obser- vations of Odier of Geneva, on the subnitrate of bismuth in pains and cramps of the stomach, recorded in 17S6 (Journal de Medecinc), seem to have been quite forgotten, if we may form an opinion from theemphatic reference to writers of our own time on this subject. Our obligations are, however, due to M. Bretouneau for a more precise and definite description of the circumstances under which this remedy can be used with the greatest advantage. The subni- trate of bismuth is more particularly adapted, as we learn from the French writers, to laborious digestion, accompanied with nidorous eructations and tendency to diarrhoea. When the eructations are acid or the flatus inodorous, the medicine almost always fails. It is indicated in chronic vomiting, without fever, which follows acute gastritis, indigestion, or the effect of an irritating medicine, and in the gastralgia complicated with this state. But, on the other hand, if gastralgia be accompanied by habitual constipation, and there is no vomiting, or only of a glairy, insipid, or acid mucus, and complica- tion of chlorosis, or facial neuralgia, or rheumatism, or of leucorrhoea and hemorrhoids, or any other flux, except diarrhoea, the subnitrate is of small service. In the vomiting to which children are subject, during dentition, and which so often precedes softening of the mucous membrane of the stomach, and, also, to that which is caused by overfeeding and accompanies the rauguet (stomatitis with altered secretion), this medicine displays its curative agency in a very satisfactory manner. Chalybeates are beet, if not exclusively, adapted to gastralgia in persons of an anemic habit, and especially in females of a lax and de- licate frame, and who suffer from ainenorrlicea and leucorrhcea. The amuioniated iron and the vinuin ferri have been recommended on (li.se occasions. Preferable to both is the subcarbonate (precipi. tated carbonate), in conjunction with aromatic powder, or a little ginger alone, h has been found that the carbonated chalybeate waters are often successful when no officinal preparation of iron can be borne . and hence a visit to Ballston,or Bedford Springs, and drink- ing the chalybeate waters there, will give the patient a double chance ol restoration ; first, by the journey and its concomitants, change of air and scene, and change of thoughts and feelings; and, secondly, by the medicinal effects of the waters themselves. Nitrate of silver has of late years been tried, in cases of morbid sensibility of the stomach, by Dr. James Johnson -(Morbid Sensibi- lity of the Stomach and J]oiecla), and is well spoken of by Auten- rieth, Rueff, and others, in this disease. For Rueff's practice, see Amer. Joum. of Med. Science, May, J837. By the latter it' has-](https://iiif.wellcomecollection.org/image/b21156955_0169.jp2/full/800%2C/0/default.jpg)
