A treatise on the practice of medicine, for the use of students and practioners / By Roberts Bartholow.

  • Bartholow, Roberts, 1831-1904.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the practice of medicine, for the use of students and practioners / By Roberts Bartholow. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    this combination. Infusion of rhubarb, tincture of cinnamon, with some bicarbonate of potassium, makes a disagreeable but extremely- serviceable prescription in these cases. Oxide of zinc, oxide of silver, nitrate of silver, are useful in those cases characterized by severe watery purging rather than vomiting. When the vomiting is excessive, and other medicines are rejected, calomel is extremely beneficial, and, in- deed, in ordinary cases, it has the first position almost as a sedative to the gastro-intestinal mucous membrane. It must be given in very small doses—one twentieth to one tenth of a grain, every half hour or hour. It may be rubbed up with some sugar of milk and dropped on the tongue. When there is much straining, and especially if there be much mucus, and mucus streaked with blood, passed from the bowels, minute doses of arsenic (from one eighth to one fourth drop of Fow- ler's solution) with a little opium (half to one drop), every three hours, are very serviceable. If the discharges are very profuse, watery, and not restrained by the remedies prescribed by the stomach, enemata of starch and laudanum may be used. Counter-irritation by mustard (the skin very little reddened or irritated), or by means of a spice-bag, or, better, a turpentine-stupe, is beneficial, if not carried too far. DUODENITIS—CATARRH OP THE DUODENUM. Definition.—Catarrh of the mucous membrane of the duodenum, which may be acute or chronic. As the ductus communis choledochua opens into that part of the canal, the catarrhal process extends up by contiguity of tissue, and hence catarrhal jaundice may coexist with duodenitis. Etiology.—Climatic changes are very influential in setting up a catarrh of the duodenum. External irritation, if severe and prolonged, will cause hypersemia and structural changes, just as a severe burn will excite ulceration. Probably the most common cause is indigestible aliment, which passes the stomach unchanged, and the excessive use of starchy, saccharine, and fatty foods, which require for their diges- tion and absorption the action of the intestinal juices, of the bile, and of the pancreatic fluid. Pathological Anatomjo—The general description already given ap- plies here. Hyperaemia and oedema occur to a more pronounced extent about the orifice of the common bile-duct, which is so swollen as to encroach materially on the lumen. More or less injection and swelling of the mucous lining of the duct exist to a variable extent. Symptoms.—The anatomical seat of the inflammation influences, to a great extent, the symptoms. In other cases of intestinal catarrh, diarrhoea is a prominent symptom ; in duodenitis, diarrhoea is excep- tional, and more or less constipation is the rule. Pain and disorders of digestion are usually present, and jaundice is a prominent symptom.