Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    140/976 (page 120)
    of that mild form of disease which follows chills without much charging of the system with malaria, provided it be had recourse to sufficiently early. Morehead speaks slightingly of the hot bath in the treatment of any form of dysentery, but I have found it to be a most useful remedy, used with the precautions and in the manner advised above. Acute Dysentery.—In this form it is even of more importance than before that the patient should be early seen and treated. He should at once be ordered to bed, and as quickly as possible brought under the influence of ipecacuanha in large doses. Some insist on the propriety of first giving a full dose of Battley’s sedative, tincture of opium, or a few drops of chloroform, with the intention of making the stomach tolerant of the remedy, and restraining nausea and vomiting. I believe that the sedative in some cases is useful, and acts in the manner just described. On the other hand, I have often seen ipeca- cuanha do its work well, and with little disturbance of the stomach, without opium. Should it be determined to premise opium, thirty drops of the tincture should be given, and in half an hour followed by from twenty-five to thirty grains of ipecacuanha, which should be given in as small a quantity of fluid as possible; a little syrup of orange-peel covers the taste as well as anything else. As already advised, the patient should keep perfectly still, and abstain from fluid for at least three hours. If thirsty, he may suck a little ice, or a teaspoonful of cold water at a time may be allowed. It is seldom that under this management nausea is excessive, and vomiting is rarely troublesome, seldom setting in for at least two hours after the medicine has been taken. The abdomen should be covered with a large sinapism, or a sheet of spongio-piline sprinkled with a little turpentine after being wrung out of hot water. In from eight to ten hours, according to the urgency of the symp- toms, and the effect produced by the first dose, ipecacuanha in a reduced dose should be repeated, with the same precautions as before. All who have had opportunities of trying this mode of treating dysentery can bear testimony to the surprising effects that often follow the administration of one or two doses of ipecacuanha given in this manner. The tormina and tenesmus subside, the motions quickly become feculent, blood and slime disappear, and often, after profuse action of the skin, the patient falls into a tranquil sleep and awakens refreshed. The treatment may require to be continued for some days, the medicine being given in diminished doses, care being taken to allow a sufficient interval to admit of the patient taking some mild nourishment suited to the stage of the disease. This, in a few words, is the system of treating acute Dysentery now almost invariably followed in India. It has been long enough in use on a sufficiently large scale to enable us to appeal to statistics and bring it to the test of figures. It has almost entirely superseded the old plan of general and local bleeding, with mercurialization, either by calomel in scruple doses, or in smaller quantities at short intervals,