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.)
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![emollient stupes containing some narcotic, after the manner first introduced by my colleague, Dr. Graves. One of the best of this kind is the tobacco stupe; if you cannot get this, you may employ poppyheads for the same purpose. The tobacco stupe is much better than the tobacco injection, because its effect can be more easily regulated, but in violent cases I am in the habit of combining both, employing the stupe during the paroxysms of pain, and throw- ing up a tobacco enema every four or six hours, until a decided impression has been made on the symptoms. In the success which has attended my distinguished friend Dr. O'Beirne's treatment of tetanus by the use of tobacco we have seen an analogous effect. In this way you will succeed in giving relief; you should also prescribe a brisk cathartic; and this you may do without any fear of injuring the patient, or exciting intestinal inflammation. The insensibility of the intestines to the stimulus of even powerful purgatives is a curi- ous feature in this disease, and bears strongly against the idea of its being connected with any inflammatory condition of the tube. . the Hospital La Charitt the treatment is routine ; it consists of an cmeto-purgative [and narcotic] plan, which is continued day after day until the symptoms yield. The purgatives we employ in the Meath Hospital are croton oil, combined with castor oil and mucilage, or given in the form of pill. When the bowels have been freely acted on, the case generally goes on well. After the bowels have been opened, we continue the employment of the hip bath, the narcotic stupes, and anodyne injections, taking care at the same time to persevere in the use of purgatives. Andral makes a good remark on this point: — Here (says he) are cases in which, from some peculiar alteration in the state of innervation, the mucous surface of the bowels is rendered less sen- sible than in its ordinary condition, and can bear freely the stimulus of powerful purgatives. May not this condition also occur in other states of the ecomony ? We are, therefore, led to conclude that pur- gatives are not, in all cases, direct stimulants. Painters' colic has been treated in Paris by bleeding and leech- ing ; but this has not been found so successful as the ordinary pur- gative plan. I have never seen a case in which general bleeding seemed to be called for except one, and this was a most violent case, which had resisted the ordinary means of treatment forty-eight hours. I recommended bleeding from its well known anti-spas- modic power ; a quantity of blood was taken, and soon after the pur- gatives began to act, and the patient got relief. With respect to leeches, I have employed them only in those cases which are ac- companied with symptoms of fever and gastric irritation; where there is quick pulse, hot skin, foul tongne, thirst, vomiting, and epi- gastric tenderness. In such cases I have applied leeches, but my experience of them is, that the relief afforded is by no means so great, or so decided, as in cases of intestinal inflammation, and it is a mode of treatment which I do not by any means rely upon for removing the disease.* * [In the cases of painters' colic which have fallen under my notice and care, I have found but little benefit from other means,](https://iiif.wellcomecollection.org/image/b21156955_0357.jp2/full/800%2C/0/default.jpg)
