A text-book of medicine : for students and practitioners / by Adolf Strümpell.
- Date:
- 1893
Licence: Public Domain Mark
Credit: A text-book of medicine : for students and practitioners / by Adolf Strümpell. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![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. Considei'able amounts of gas may often be removed by introducing a long rectal tube. As to puncturing the greatly mflated intestines, a method practiced by some physicians, we have no personal experience. If there are severe pulmonary symptoms, baths and pouring on cool water ai'e, as we have said, the best remedies. Internally we may try liquor ammonii anisatus [P. G., olei anisi, 1 part; aqase destillatoe, 24 parts; aqua3 ammonias, 5 parts] and benzoic acid (grains ij to iij, gramme 0-1 to 0-2, in powder). If the pulse be very rai)id, we can put an ice-bag over the heart. If at the same time the pulse is small and weak, we give stimulants, of which the best is camphor (vide infra). Digitalis (one-half grain of the leaves, gramme 0'03, two or three times daily) may also be employed if the pulse be rapid; but it should be used with great caution. For nervous symptoms the baths and douching are the most effective reme- dies. The head is meanwhile covered by an ice-bag. If there be great excite- ment, as shown by excessive restlessness or delirium, small doses of morphine are often very useful. The conditions of collapse and cardiac failure, which sometimes appear rather suddenly, demand prompt and energetic treatment. Stimulants to be given in- ternally are some stronger kind of wine, camphor (two to five grains, gramme 0-10 to 0-30, in the form of a powder), musk (one half grain to one grain, gramme 0-03 to 0-05 at each dose), or spiritus setheris [P. G., sether, one part; alcohol, three parts]. Subcutaneous injections act quicker and are much more conven- ient. We may use either ether or camphor (one part camphor to four parts oUve- oil, seven to fifteen minims, c. c. 0-5 to 1-0, every one to two hours). To start up respiration, the best means is to pour cold water on the back of the neck. Artifi- cial respiration also succeeds, in many cases, in reviving the breathing when it is about to stop. The numerous other complications and sequelae which may occur, but which can not all be mentioned here, should be treated on general principles. The lorophylactic measures to avoid the spreading of the disease can be only briefly referred to. Of chief importance is careful disinfection of the excreta, which can be accomplished by pouring upon the stools a not too small amount of five-per-cent. carbolic solution. We should also take care that bed-pans, bed- clothes, linen, etc., are handled by other persons as little as possible. If there seems reason to suspect that the disease arose from bad water, of course the source of such suspected water must be cut off. [Recent experiments tend to show that the above solution of carbolic acid does not kill spores except after prolonged contact. The following are the measures of disinfection recommended by the American Public Health Association. It will be observed that they apply to all infectious diseases, and it seems well to give them here nearly in extenso, as the directions for disinfection in most text-books are far too vague. Disinfectio7i of Excreta, etc.—The infectious character of the dejections of patients suffering from cholera and from typhoid fever is well established; and this is true of mild cases and of the earlier stages of these diseases as well as of severe and fatal cases. It is probable that epidemic dysentery, tuberculosis, and perhaps diphtheria, yellow fever, scarlet fever, and typhus fever, may also be transmitted by means of the alvine discharges of the sick. In cholera, diphtheria, yellow fever, and scarlet fever, all vomited material should also be looked upon as infectious; and in tuberculosis, diphtheria, scarlet fever, and infectious pneu- monia, the sputa of the sick should be disinfected or destroyed by fii-e. It seems](https://iiif.wellcomecollection.org/image/b21981553_0054.jp2/full/800%2C/0/default.jpg)
