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.

    285/976 (page 265)
    and handkerchiefs, or by small bags containing heated bran, which can be accommodated to the child’s changes of position. Care should be take'n that no part of the surface is chilled, and dry, warm flannels should be from time to time applied to the body, legs and feet.. Counter-irritation is of doubtful efficacy; the application of tincture of iodine to the sides of the neck is of some service, and acts more beneficially when it is covered with water-dressing. Linseed poultices, not too moist, with which a little mustard is mingled, may be usefully applied to the back of the neck and shoulders, or even to the legs : where signs of bronchial irritation are found at any part of the chest, or there is less expansion at one part than another, the advantage de- rived from having that part covered with a large simple linseed poultice is very great; if the other symptoms are favourable, it may be suffi- cient to use stimulating friction over these parts three times a day when the poultice is changed. A blister may be required for more serious pulmonary implication, but should be so dressed with cotton- wool as to give rise to no ulterior pain or discomfort. Opiates are to be avoided ; sleep is needful, and will naturally happen while the disease is within safe limits, then the easy respiratory movement and increasing roundness of the chest present a strong contrast to the flattening and retraction observable during restlessness and excitement; sleep will continue while that normal condition of the chest is maintained, if not, it is soon interrupted, and there would he danger in its being artificially prolonged. The strength is to be carefully guarded during the necessary contest with disease, and requires early support; milk and farinaceous food, as well as whey and barley-water, are soon necessary ; if the attacks of dyspnoea have been severe, beef tea or chicken broth may be given early; if distasteful, or tending to excite spasm in deglutition, they are to be given in small quantities by the rectum. The various meat essences, prepared by Hogarth, McCall, and others, after Liebig’s formula, are very serviceable, as they contain the restorative salts of the flesh without any of the protein compounds requiring gastric digestion. Alcoholic stimulants are injurious, until the primary obstruction to respiration is overcome, and some pulmonary complication is the source of danger. The stimulant expectorants are often required, and when repeated emetics are indicated in the decline of the disease a stimulant should be combined ; ammonia, or the ammoniated tincture of valerian, may be added to the wine of ipecacuanha given for this purpose; the tincture of lobelia may also be cautiously used as an adjunct, but not if there be much obstructing secretions; senega is here of the greatest value, either in large, repeated doses as an emetic, or in combination with ammonia and squills as an expectorant; for this purpose, when the occasion arises, a grain of carbonate of ammonia with two or three minims of tincture of squills and a dessert-spoonful of infusion of senega may be given every two or three 2 as prescribed by Dr. West, mixed with a very little milk and sweetened with treacle or coarse sugar; the infusion of senega should