Licence: Public Domain Mark
Credit: The study of medicine / by S. Cooper. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
779/788 (page 721)
![CL. m.] SANGUINEOUS FUNCTION. [OHD. I. the fever is continued, instead of being remissive; and that tlie local irritation is seated in the peritonaeum, (or, as Dr. Good should have said, in the uterus and its appendages,) instead of in the liver * Synochu* or any other organ. This inHammation must be subdued, and that speetfily, or tiie patient will perish ; and hence abstraction of blood and calomel purgatives are the arms on which we have chiefly, if not solely, to dejiend ; and both should be employed decidedly, and to as great an extent as we dare. Eighteen or twenty ounces of blood should be drawn from the Venesection, arm, as soon as possible after the commencement of the disease, and re}H?ated within twelve hours, if necessary, and the strength will allow : but if venesection have not taken place byfore the third day, the debility will have gained so high an ascendency, and the general symptoms put on so putrescent a complexion, that little benetit is to be gained from it. 'I’he bowels should, at the same CstI>Artic«, time, be moved by six or eight grains of calomel, given in the form of a pill; and the same preparation, to the amount of three or four grains—Dr. Douglas advances the dose to not less than ten grains— should be continued every six hours till the tension and soreness of the abduineu have abated. And it will often be useful to accompany ithe calomel with one or more doses of castor oil, or the essentid < oil of turpentine, or both combined. Dr. Vandenzande dejiends ujxm a free exhibition of calomel with- Calomel, out venesection, which, after the manner of Dr. Hamilton of llpswich, he unites with opium; luid he boasts of the certainty of 'Success which this treatment has developed ; though, in conjunc- :tion with omum and calomel, he sometimes employs mercurial ■friction. • There can be no (question of the benefit of a liberal use of calomel in an early stage ot the disease ; but, to let it supersede ithe use of the lancet, is to abandon our first chance of success, and to encounter an unnecessary peril. It happens not unfrequently, however, that the patient’s frame is Neitlu-r advii.a> ■«o weak and delicate, that we should risk more by drawing blood ble in some 4Cenerally, tlian even by leaving the case to nature; as it does also :that the stomach and bowels are, from the first, in a very high ilegree of irritation, with violent purging and vomiting, and will not ibear any additional stimulant. Our wisdom is here to yield to cir- icumstunces, and let the general rule admit of particular exceptions. Instead of the lancet, we should have recourse to leeches, and, in lAxal ihis manner, remove twelve ounces of blood at the least; and unite ''on. jpium with smaller doses of calomel. It does not follow that calo- t)pium. ncl in such a combination will increase the irritation of the stomach »r bowels; I have often seen the contrary ; and tliat by the exhibi- lon of two or three grains with one grain of opium, repeated every ive or six hours, the irritation has yielded to the commencement if a new action. It is also in such cases of extreme debility that the essential oil oil of •if tur|H?ntine has often been found highly beneficial when employed noiKniia*;. iiternally by itself; for, while it operates as a mild aperient, it acts •A a counter-irritant, and hence directly influences the morbid state if the |>eritona'um, while the pulse is supported by its stimulant • Olisi'rvitiums [iruli<|ue<i sur la Muludie coiiimv sur Ic Noin de IViritouitt, ou o Fiifvr* putriwndi.-, Hvo. ISiil. VOL. l. f} A 721 Ges. IV.](https://iiif.wellcomecollection.org/image/b28268878_0001_0779.jp2/full/800%2C/0/default.jpg)
