The principles of treatment and their applications in practical medicine / by J. Mitchell Bruce.

  • John Mitchell Bruce
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: The principles of treatment and their applications in practical medicine / by J. Mitchell Bruce. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    must provide in planning the management of the case. Thirdly, at any moment unfavourable symptoms may develop, a circumstance which demands watchful attention, judgment, resource and promptness of action. Lastly, the majority of cases of perityphlitis recover without surgical treatment, and this fact, if it be properly regarded by the practitioner, will teach him to avoid precipitate and unnecessary interference. In dealing with appendicitis he must know not only when and how to act, but—which is more difficult—how to respect the natural disposition to recovery, avoid meddlesome interfer- ence and hold his hand. All this he cannot be expected to do, however large his experience, unless he be acquainted with the principles on which, according to present knowledge, he ought to proceed. Outline of Practice. I. Commencement of Case.—A. If evidence of acute necrosis of appendix or general peritonitis : immediate surgical interference (page 528). B. If disetise be local: (1) At in- vasion and for three days after.—General management.—Rest in bed—immediate, complete and continued; arrangements for illness of at least a fortnight, possibly tw(^ months. A nurse with special surgical training. Diet.—None for a few hours (p. 532). Stiimdants.—None, unless brandy be demanded by collapse (p. 532). For thirst, an enema con- sisting of one pint of tepid water with a teaspoonful of table salt. Local applications.—Hot fomentations of saturated solution of boric acid to lower half of abdomen (p. 526). Medicines. —No purgatives (p. 527). For pain and collapse if present (p. 531): (1) 1^ Injectionis Morphina' Hypodermic£e l\v-x, Liquoris Atropine^ Sulphatis ii\i. [U.S.P. 1^^ Morphin?e Tartratis gr. Atropine^ Sulphatis gr. j-^, Aquae Destillatae ii]^v-x.] At once hypodermically; repeated in half an hour if pain and collapse continue. Or (2) 1^;: Extracti Opii gr. -J, Extracti Bella- donn.T Viridis gr. J. [U.S.P. ^ Extracti Opii gr. |, Extracti I'.elladonna^. Foliorum Alcoholici gr. J ] Every three or four hours whilst pain continues. Or (3) 1^ Opii gr. i, Hydrargyri