Lectures on the theory and practice of physic (Volume 1).

  • William Stokes
Date:
1845
Catalogue details

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.)

    204/776
    After the use of the liydrarg. c. cretd and Dover's powder, this has a decided value in the treatment of ileitis.* In this way by leeching, mild laxatives, prescribing mercury with chalk, and compound powder of ipecacuanha with gum water, your patient begins to improve. The tenderness of the epigastrium disap- pears, the tongue begins to clean, the fever diminishes, the thirst goes oft; and appetite returns. This is the favourable termination. When the patient is of a weak and delicate habit, it is of great importance lo pay particular attention to supporting the strength, even Jrom an early period of the disease. In such a case, after the first week, the physician who neglects the proper means of supporting his patient's strength does wrong, and it has justly been remarked, that a practi- tioner will be right in supporting the general strength, at the same time that he is employing local antiphlogistics. It is in steering clear between these two opposite dangers that the judicious practitioner is seen; he does not allow his patient to die of inanition, while at the same time he takes care to remove local inflammation. I have seen several experienced physicians prescribe leeches to the abdomen on the same day that they ordered the patient to have chicken-broth, and even a little wine. There is nothing improper in this; an inex- perienced practitioner, who has his eye merely on the local inflam- mation, is apt to fall into the error of overlooking the constitutional debility, and allowing it to steal upon him. He finds very little dif- ference between the appearance of his patient this day and the next, and thinks the slight increase of debility undeserving of any attention. At last his patient begins to sink visibly, he gets alarmed and has re- course Jo stimulants, but it is now too late. Besides, there are several articles of diet which support strength, without increasing inflamma- tion; as, for instance, chicken-broth, sago, arrow-root, strained rice. &c. These do no harm, and they prevent the patient from falling into a dangerous typhoid condition. Let us look at this in another point of view. Suppose you are called to a child who is said lo have had an attack of worms, or bilious derangement, or that his bowels were costive, and purgatives were given, that the discharges were found to be bad and more purgatives were administered ; or suppose you are called to a child of a weak, scrofulous habit, who had been taking largequantities of purgative medicine, for what has been termed derangement of the bowels, and you find the little sufferer with pale, shrunken face, a black circle round his eyes, cold extremities, rapid faltering pulse, great thirst, and evident symptoms of increased cere- bral excitement; the little arms and hands are cold as death, but the belly burning, tympanitic, and very sensible to pressure, and when you compare the'radial artery with the femoral, as it turns over the pubis, you will have some conception of the excited condition of the abdo- minal vessels ; and in addition to this train of morbid phenomena, you find there is suppression of urine. Are you to attack these symptom> * [I have given with advantage, in ileitis, the blue mass in small doses, say three grains three times a day ; and have found warm fomentations by stupes and cataplasms on the iliac region service- able.—B.]