Volume 1
A text-book of medicine for students and practitioners / by Adolf v. Strümpell.
- Adolph Strümpell
- Date:
- 1911
Licence: Public Domain Mark
Credit: A text-book of medicine for students and practitioners / by Adolf v. Strümpell. Source: Wellcome Collection.
61/874 page 33
![subcutaneously (gr. -J to £) accomplishes the same purpose and more promptly. It should be repeated every half hour till beginning narcotism. If neither food nor drugs be given by the mouth for some hours, there will be more chance for the intestinal coils to keep quiet.] In severe cases we may try injections of ergotin, or fluid extract of hydrastis, 20 drops three or four times, or a subcutaneous infusion of about 7 ounces (200 c.c.) of a one- to two-per-cent sterilized solution of gelatin in seven-per-cent salt solution. For the threat¬ ening anaemia following severe hemorrhages, subcutaneous infusions of nor¬ mal salt solution are to be employed. The baths cannot be resumed till there has been no bleeding for at least four or five daj^s—and then only cautiously. If peritonitis occurs, the treatment is much the same. Above all, opium must be used in still larger doses, but, unfortunately, as a rule, in vain. The surgical treatment of peritonitis has rather more of a future and more success, but experience of this is still scanty. If there is considerable diarrhea, we can give mistura gummosa [P. G., gum arabic and sugar, each 15 parts; water, 170 parts] or small doses of opium, the latter sometimes combined with tannin, tannigen, etc. In general it is cer¬ tainly proper not to check the ordinary moderate diarrhea of typhoid. Per¬ sistent constipation is always to be avoided. Constipation at the beginning of the disease is overcome by calomel (vide supra). In later stages we always try enemata first, to produce an operation. If this does not succeed, then we must employ rhubarb or castor oil. Great tympanites may be diminished by laying cold wet cloths or ice bags upon the belly. Considerable amounts of gas may often be removed by introducing a long rectal tube. As to punctur¬ ing the greatly inflated intestines, a method practiced by some physicians, we have no personal experience. If there are severe pulmonary symptoms, baths or wet packs are, as we have said, the best remedies. Internally we may try liquor ammonii anisatus [P. G., olei anisi, 1 part; aquae destillatae, 24 parts; aquae ammoniac, 5 parts] and, especially with weak heart, benzoic acid (gr. ij to iij, gm. 0.1 to 0.2, in powder) and gr. iij, gm. 0.2 of camphor. If the pulse be very rapid, we may try an ice bag over the heart. If at the same time the pulse is small and weak, we give stimulants (camphor, strophanthus, caffein, and strong wine). We only rarely use digitalis in typhoid. If symptoms of severe cardiac weakness—so-called collapse—suddenly occur, a rapid and energetic interfer¬ ence is urgently demanded. Hypodermic stimulation should be employed and, above all other drugs, camphor in oil. Besides camphor, caffein injec¬ tions (caffein nitrobenz., 2.0 in 10.0 = gr. xv in oijss. aquse destillatse, two to three syringefuls) may be employed, and wine, strophanthus, etc., internally. If the respiration stops it can sometimes be started up again by douches of cold water on the back of the neck. We may sometimes restore it by artificial respiration. For nervous symptoms the baths and douching are the most effective reme¬ dies. The head is meanwhile covered by an ice bag. Antipyrin sometimes acts favorably. If there be great excitement, as shown by excessive restlessness or delirium, small doses of morphin internally, or, better, subcutaneously, are often very useful. For insomnia, veronal in doses of 7.5 to 12 gr. (gm. 0.5 to 0.75), perhaps](https://iiif.wellcomecollection.org/image/b3136276x_0001_0061.jp2/full/800%2C/0/default.jpg)
