A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 2).

  • Copland, James, 1791-1870.
Date:
1834-59
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of practical medicine: comprising general pathology, the nature and treatment of diseases, morbid structures, and the disorders especially incidental to climates, to the sex, and to the different forms of life : with numerous prescriptions for the medicines recommended, a classification of diseases according to pathological principles, a copious bibliography, with references, and an appendix of approved formulae : the whole forming a library of pathology and practical medicine and a digest of medical literature (Volume 2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    CROUP—Prophylactic Treatment. employed, after depletions, by Kendrick and HuGGANs. It may be used both externally and internally (as may the preparations of morphine,) with aromatics, camphor, or assafetida, musk, &c., in the states of the disease now mentioned. Henbane, and extract of poppy, may also be em- ployed under similar circumstances and forms of combination. Tobacco has been prescribed in croup, in various modes. Dr. Vandkrburgh and Dr. Godman recommended a plaster covered with Scotch snutf to be applied across the top of the sternum ; and myself and^thers have employ- ed this substance, with the vrew of detaching the false membrane by exciting sneezing and an in- creased secretion of mucus. The smoke of tobacco has also been directed to be inhaled, in order to remove spasm, and promote expectoration, by its direct operation in the air-passages ; and others have advised the patient to smoke a cigar, with the intention of producing nausea, as well as the other effects last enumerated. After depletion, and when the disease is about its acme, the powers of life not being materially exhausted, a cautious use of this means may be serviceable. In the case of children who cannot use a cigar, the smoke of one may be blown around them, and in this way it will have a sufficient effect. Cloth moistened with an infusion of tobacco may, under some circumstances, be applied over the throat, and its efl'ects carefully watched ; but this measure is not without hazard, particularly after lowering remedies have been used, or in an ad- vanced stage of the malady. 72. (/. The preparations of ammonia have been much employed in all the states of croup. Caus- tic ammonia, in doses of three or four drops, given every hour ; ammoniacal liniments being at the same time applied about the throat ; has been ad- vised by some writers, in order to promote the excretion of the concrete exudations in the third stage of the disease. The carbonate of ammonia has been more generally employed. M. Rechou prescribed it both internally, and externally in ointments to the throat. In the latter stages, as a useful antispasmodic stimulant, it may be some- times of service ; it is very advantageously com- bined with camphor, or even with calomel, in the complications of croup with angina maligna, or with any of the eruptive fevers. M. Chamerlat has recommended the muriate of ammonia to be taken internally, and applied to the fauces, when the disease is associated with inflammation of the. throat. The cuprum ammoniatum, and the hydro- sulphur et of ammonia, have also been prescribed in doses suitable to the age of the patient. They may be sometimes of service in the more spas- modic states ; but I have had no experience of their effects in this complaint. 73. r. M. Valentin has recommended the ap- plication of the actual cautery upon each side of the throat, in the most severe forms of the disease, when it is at its acme. Moxas seem to be pre- ferable to the actual cautery ; and, if this practice should be adopted, it might, perhaps, be advan- tageous to follow it by fomentations placed over the trachea. M. Dupuytren employed in one case, referred to by Guersent, a small rod of whalebone covered by pieces of sponge, which was introduced into the pharynx in order to remove the partially separated portions of false membrane lodged in that situation, or partly thrown out from the larynx. In the adviinccd stage of croup complicated with angina pliaryn- gea, this contrivance is calculated to succeed. 74. ;. Tracheotomy.—There does not seem to be a chance of success from this operation in any case wherein the treatment developed above has failed. The practitioner, however, may be called to a case so late in the disease, and where the suffocation is so imminent, that the propriety of having recourse to it may be admitted : but, even in these, the chances are infinitely greater against than in favour of its success ; and if benefit can be obtained from any measure, it is as likely to accrue from the energetic exhibition of suitable emetics as from tracheotomy. Cases have doubt- less been recorded of the success of the operation in croup; but these are so very few, compared to the number in which it has failed, that I per- fectly agree with Goelis, Cheyne, Royer- CoLLARD, Porter, Wood, and many others, in concluding that it should seldom or never be attempted in this disease. Of the propriety of having recourse to it in certain sitates of laryngi- tis, &c. there can be no doubt; and it niay, with some slight grounds of hope, be resorted to when croup is chiefly confined to the larynx and upper portion of the trachea ; also, perhaps, in some cases of its consecutive occurrence upon inflam- mation of the throat with membranous exudation; and when we infer, from the general symptoms and the signs furnished by the stethoscope, that the bronchi and lungs are unaffected ; but in that period of the simple as well as of most of the complicated forms of the disease, in which only it should be attempted, and when internal treatment has failed, I believe that the superin- duced lesions in the bronchi, lungs, circulating fluid, and nervous system, are such as to pre- clude hopes of its success. Moreover, the feel- ings of the parents regarding it, and the reputation of the physician and operator, are not to be kept out of view. Ad tracheotomiam, says Goe- lis, omnium remediorum incertissimum con- fugere res ardua est ; parentes abhorrent, aver- santur agnati et periclitatur medici fama, quem, infausta si fuerit operatio ac votis illudens, lacry- mis multis velut homicidam prolis amatas detes- tantur parentes. 75. ii. Prophylactic Treatment, &c.— A. GoELis states, that he never saw a child with porrigo and other chronic cutaneous affections at- tacked by croup whilst they remained fully devel- oped, even when this disease was most prevalent. He therefore advises the having recourse to any form of issue, when an attack is dreaded. To re- sort, however, to emetics, to antimonial medicines, to counter-irritants, to depletions, to confinement in-doors one half of the year, and other measures which have been advised, is attended with greater mischief than to allow the child to run the slight risk there is of his having the disease. The case, however, is different in respect of a child who has once suffered an attack. Tiie liability of croup to recur, even several times, after intervals of various duration, renders precautions, under such circumstances, very requisite. The chief of such measures are — removal from the predispos- ing and exciting causes (§ 24 — 31.) ; change of air and locality ; the use of the shower or cold bath every morning, the skin being well rubbed with a hard or coarse cloth afterwards ; the wear- ing of flannel ne.xt the skin, and of a neckcloth in winter and spring ; light nourisliing diet, with