Druitt's surgeon's vade mecum : a manual of modern surgery.

  • Robert Druitt
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Druitt's surgeon's vade mecum : a manual of modern surgery. 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.

    109/1016 page 95
    effect, and such might be desirable, e.g. in iritis; but if this be not indicated, it is best given in smaller doses, say one grain three times a day. Calomel in dose of a grain night and morning, with half a grain of opium, takes eiiect very quickly. Hyd. c. cret., and pulv. ipecac, co., of each gr. j., made into pill and taken thrice daily, acts very well: the dose may be pushed to five or six pills daily. The green iodide is an uncertain remedy, being liable to decomi^osition. It should therefore be avoided. In most cases the author prefers the corrosive siMimate (P. 162, &c.) Mercurial ointment is not so likely to disorder the bowels as the blue pill, but it is a little more troublesome. The dose is gr. xx.-lx.: to be rubbed in daily upon the inside of the thighs or arms till it dis- appears. The morning is the best time for doing it, as the skin is then softei. It should be rubbed on different limbs successively, the patient wearing the same drawers both by day and night. If the skin becomes irritated, it should be well washed and bathed. If the patient caanot rub in the ointment himself, it may be done by an attendant, whose hands should be protected by a pig's bladder, well softened in oil and tied round his wrist. Subcutaneous Injection of mercurial solutions is used by some : the best are Sigmund's (hydrarg. perchlor. gr. iv., sodii chloridi gr. Ixxx., aq. x]., dose 10-20 ni), and Eagazzoni's (hyd. biniodid. gr. iv., sodii iodid. enough to dissolve the mercury, 4 grains or less, nt aq. 256, dose in x.) This method produces a rapid effect, but should rarely be used, as it is painful and causes abscesses and inflammation at the punctures. Rest after the injection, which is best made into the subcutaneous tissue of the flank (Hill), should be insisted on. The 111 effects of mercury.—1. Irritation of tlie Itowels, with dysenteric symptoms, straining and tenesmus. To be treated by opium with chalk mixture and opiate enema; omitting the mercury for a few days, and combining it afterwards with opium; and using double pre- caution against cold and damp. 2. Salivation.—It is common to meet with jpersons who are salivated by very small quantities, and every practitioner should make a point of ascertaining this before he prescribes large doses of mercury for a new patient. Mercury is imperfectly eliminated in Bright's disease, and salivation is consequently easy. The symptoms of severe salivation are, swelling and inflammation of the salivary glands, cheeks, tongue, and fauces, with a flow of peculiarly foetid saliva, foul breath, and sloughing of the surface of the gums and of the inside of the cheeks. The earliest symptoms are the most important: metallic taste in the mouth, tenderness of the teeth, a red line on the gums where they touch the teeth and some swelling of them, and increased flow of saliva. The occurrence of any of these symptoms should lead to diminution of the dose, unless the evidences of syphilis will not yield to smaller quantities of the drug. Salivation is treated by withholding mercury : by employing strong gargles of alum or chlorate of potash, or tincture of myrrh and tannin, Turkish baths thrice a week if the patient can bear them, and the cautious administration of pot. iodid. with bark. Keep the bowels open and give a liberal diet. Change of air and removal from hospital wards are indispensable. 4. General cachexia.—A condition of malnutrition marked by great anremia, emaciation, loss of strength, and disordered state of the secretions generally. The condition may resemble scurvy.
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