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.

    202/976 (page 182)
    and uneasiness, a warm water enema—say a quart of water with a little assafcetida, or sal volatile, or rether—will be the safest remedy. Vomiting is often continued in the reaction stage, and may have been caused by the irritation left by frequent previous retching, or by excess of stimulating remedies. In these cases a single dose of opium or morphia—say a grain of opium—will often act admirably. It may be repeated every four or six hours if the vomiting continues. The food requires careful management. Sometimes a table-spoonful of milk with one of lime-water may be given every half-hour or hour for the first day or two, or a small quantity of ice-water only. It is desirable to give the stomach as much rest as possible. In some cases the irritation is due to subacute gastritis, and requires a few leeches to the epigastrium—a blister is useful in all forms of the vomiting in the earlier stages of reaction, and sometimes one-lialf or two-thirds of a grain of morphia may be applied to the raw surface with excellent effect. Food should not be pressed upon the patient. For days he may not be able to take more than tea-spoonfuls or desert-spoonfuls of milk and lime-water, arrowroot, barley-water, &c. In some instances it will be necessary to trust entirely to nutritive enemata. Effervescing draughts with excess of soda are sometimes useful, and hydrocyanic acid may be tried. Diarrhoea, if slight, should not be interfered with at first, especially if the evacuations are at all offensive or bilious. Where decided enough to be weakening, gallic acid, or tannin, or mild opiates,” or chalk mixture with carbonate of soda, should be given. If there be tenesmus, a warm water enema with a drachm of carbonate of soda should be used, and followed after operation by one of laudanum and a little water. Turpentine stupes should be applied to the abdomen in all the states of intestinal irritation. Hiccup is frequently accompanied with much eructation of gas, and is difficult to stop ; it is not dangerous. It may be treated by sina- pisms to the spine, in the cervical and dorsal regions, and by ten minims of chloroform in mucilage every half-hour, or by chloroform inhalation, by morphia, or small doses of belladonna, and, if there be acidity, by alkalies. The common anti-spasmodics seem to have little effect. Want of sleep, without pyrexia or heat of head, may be relieved by a dose of calomel and opium, and perfect quiet,_ hot pediluvia, and, if very obstinate, chloroform inhalation. Sometimes a mild dose of alterative aperient medicine is beneficial. Imperfect reaction is very troublesome. Unless the discharges are arrested, the patient will sink in three or four days. A small dose of