A dictionary of treatment, or, Therapeutic index : including medical and surgical therapeutics / by William Whitla.

  • Whitla, William, 1851-1933.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A dictionary of treatment, or, Therapeutic index : including medical and surgical therapeutics / by William Whitla. Source: Wellcome Collection.

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    such circumstances is worse than useless. One larr/e dose of an alkali gives immediate relief. The amount should be sufficient to neutralize the large and often enormous quantity of highly irritating, acrid acid present. Fermentation is at once arrested. 2 drachms of bicarbonate of soda or potash may be required, and the writer has given more than double this amount. If this should fail to give relief, an emetic must be administered. These remedies, it is to be understood, are not to be often or habitually employed, or serious troubles may result; but when used they may be given unsparingly. Often at the beginning of what would become a painful attack, one large dose of lactopeptine, 30 to 45 grains, will dispel all uneasy sensation, and there is no objection to such treatment being frequently employed. Papain is more valuable, as it may be given with full doses of alkalies, whilst pepsin will only digest with acids. In very chronic cases, and especially where the fermentation is de- pendent upon some organic lesion, such as obstruction at the pylorus, all treatment fails, because the stomach still retains some ferment when the fresh food is swallowed, and thus the process is kept incessantly going on. In such cases, very satisfactory results will be obtained by washing out the stomach thoroughly with a weak solution of boric acid or Condy's fluid. The writer has seen pain and acid vomiting disap- pear, never to return, after having withstood everything prior to this treatment. Having relieved urgent symptoms, remedies may be com- menced which retard or prevent fermentation changes, and forraost amongst these is creasote, which is now easily procured in soft gelatin capsules, each containing one minim. Six may be given in the day; 2, one or two hours after each meal. Carbolic acid, 1 to 3 minims, may be likewise used. Sulphurous acid, in doses of 1 drachm, freely diluted ; sulphocarbolates of soda and potash, sulphites of the same bases, or salicylates, in 10 to 20 grain doses, may be given, or oxide or nitrate of silver in doses of i grain in pill. Often the writer has obtained benefit from 5 minim doses of oils of cloves and peppermint, which are powerful and harmless anti- septics. Charcoal freshly dried and given in the dry state, wrapped up in wafer paper, is a powerful absorbent of the gas which accumulates during the acid fermentation, and which adds to the distress of the patient. Having relieved the more acute stages, the physician should direct attention to the condition of the gastric mucous membrane, which is the source of the trouble. Subcarbonate of bismuth, 10 grains ; heavy magnesia, 10 grains; and morphia, gi'^^iii. powder, will alFord the best routine treatment. An excellent combination is : K .—Bismuth subnit gi'- Lactopeptin Pulv. ipecac, et opii g^'- S.—Make twenty such powdei-s. One to be taken three times a day.