Volume 1

The elements of materia medica and therapeutics / by Jonathan Pereira.

  • Jonathan Pereira
Date:
1849-1853
Catalogue details

Licence: Public Domain Mark

Credit: The elements of materia medica and therapeutics / by Jonathan Pereira. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    heated with a conical piercer, and the caustic introduced while the composition is quite soft. The point of the bougie should then be rubbed quite smooth on a piece of polished marble till no inequality in the size of it appear.1 Notwithstanding that the application of nitrate of silver to stricture of the urethra has been advocated by Mr. Hunter, Sir E. Home, Mr. Wilson, Dr. Andrews, and others, it is now but little employed; yet of its efficacy and safety in many obstinate cases, where the simple bougie fails, I am assured by repeated observation. It is commonly supposed that it acts by burning or destroying the stricture: such is not the fact. It induces some change in the vital actions of the part, which is followed by a relaxation of the narrowed portion of the canal, but which change is as difficult to explain as the sub- duction of the internal inflammatory action by the application of this salt. Of the use of the caustic bougie in stricture of the oesophagus I have no experience. Administration.—Nitrate of silver may be exhibited in doses of one-sixth of a grain, gradually increased to three or four grains, three times a day. As before mentioned, Dr. Powell has increased the dose to fifteen grains. The usual mode of administering it is in the form of pills made of bread-crumb ; but the chloride of sodium which it contains renders it objectionable : some mild vegetable powder with mucilage is preferable. Common salt or salted foods should not be taken either immediately before or after swallowing these pills. Dr. Johnson2 asserts “ that there is no instance on record where the complexion has been affected by the medicine when restricted to tliree months7 administration.77 It is advisable, however, not to continue the use of it beyond a month or six weeks at a time. Eor external use, an aqueous solution is employed of strengths varying from a quarter of a grain to two scruples, in an ounce of distilled water. The formula for Mr. Guthrie’s ointment has already been given. Antidote.—The antidote for nitrate of silver is common salt (chloride of sodium), When this comes in contact with lunar caustic, nitrate of soda and chloride of silver are produced : the latter compound is, according to the experiments of Orfila,3 innocuous. The contents of the stomach should be removed, and the inflammatory symptoms combated by demulcents, blood- letting, and the usual antiphlogistic means. When the local use of nitrate of silver causes excessive pain, relief may be gained by washing the parts with a solution of common salt. Pieces of caustic have been left in the vagina and urethra without unpleasant conse- quences resulting. Injections of a solution of common salt are the best means of preventing bad effects. To diminish the slate-coloured tint of the skin arising from nitrate of silver, acids or the super-salts offer the most probable means of success. The exter- nal and internal use of dilute nitric acid, or the internal employment of bitartrate of potash, may be tried: the discoloration is said to have yielded to a steady course of the last-mentioned substance.4 L LIQUOR VRGENTI NITRATIS, L .; Solutio Argenti Nitratis, E.; Solution of Nitrate of Silver. (Nitrate of Silver, 5j. [grs. 40, A1.] ; Distilled 1 Dr. Andrews, Observations on the Application of Lunar Caustic to Strictures, p. 126, 1807. 2 Essay on Morbid Sensibility of the Stomach and Bowels, 2d edit. p. 90. 3 Toxicol. Gen. 4 United States Dispensatory.