The Caledonian medical journal : new series, vol. VI, no. 2, October, 1904 / edited by W.A. Macnaughton and Andrew Little.

  • Caledonian Medical Society.
Date:
1904
Catalogue details

Licence: In copyright

Credit: The Caledonian medical journal : new series, vol. VI, no. 2, October, 1904 / edited by W.A. Macnaughton and Andrew Little. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    French practitioners seem to secure excellent results from intravenous saline injections. Saline enemata are often followed by, at least, temporary improvement, just as they often are in profuse haemorrhage. Some practitioners, again, use bicarbonate of sodium in large doses, both by the mouth and per rectum, as a matter of routine. It is difficult to perceive on what principle. Liberal doses of boracic acid in hot water were very fashionable for a time in some parts of West Africa; but one hears little of this treatment now. Calomel enjoys a considerable reputation, especially in West Africa. There, it is not infrequently given in heroic doses; but there are very few diseases in that part of the world in which calomel is not exhibited more or less as a matter of routine. When we leave specific drugs and come to general principles,, we arrive on less uncertain ground. Whatever the original cause of the disease may be, there can be little doubt that a chill is, in the great) majority of cases, the determining cause of an attack of blackwater fever. The patient should at once be put to bed, lie on blankets, and have a liberal allowance of blankets over him. A hot-water bottle should be applied to the feet, and hot fomentations or, still better, mild turpentine stupes should be put round the loins. A five grain dose of calomel or saline cathartic should be administered, and, if the patient cannot retain the dose, the bowel should be emptied by an enema of warm water and soap, or of glycerine. If the dose of calomel be retained, it should be followed in three or four hours by a saline. From the first, copious draughts of bland fiuid, prefei’ably warm, should be given and continued throughout. If the patient reject these, they should be persisted in nevertheless, even though they should resolve themselves into a mere succession of washings out of the stomach. The choice of drinks is a liberal one. As examples may be mentioned—weak whisky and soda, barley water, soda water, warm home-made lemon or lime juice neutralised by bi- carbonate of potassium, warm water and milk, weak tea, coffee, lager beer, &c. Personally, I have never administered lager beer; but a friend—an excellent observer—in the Northern Transvaal, assures me that he not uncommonly finds his patients retain it when they can keep down nothing else, and that it adds to their comfort and seems to have a markedly favourable effect on the character of the urine. Ihe diet should consist exclusively of milk until at least wo days after the urine has cleared up. Diuretics must not