Volume 3

St. Andrews Medical Graduates' Association : transactions, [1869-1871] / edited by W. Sedgwick.

Date:
1870-1872
Catalogue details

Licence: Public Domain Mark

Credit: St. Andrews Medical Graduates' Association : transactions, [1869-1871] / edited by W. Sedgwick. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    174/286 (page 144)
    ON CROUP. that the advocates for the last named plan are comparatively fW. In the treatment of diphtheria, there is little diversity of opinion upon this point. Among the external remedies for croup may be named bleeding, (general and local,) blisters, hot and cold applications to the throat, warm baths, medieated vapours and sprays, solutions of nitrate of silver, tannin, and sulphate of copper. The internal medicines are calomel, tartarized antimony as an emetic and sudorific, ipecacuanha, purgatives, the alkaline salts, chlorate of potash, quinine, alum, sulphate of copper, sulphate of zinc, diaphoretics of various kinds, and more recently lactic acid, lacto-phosphate of lime, lime water, bromide of potassium, and others. I am incompetent to give an opinion from practical experience as to the utility of most of these medicines. My own mode of treatment, which I believe has been tolerably successful, is generally the following: lancing the gums if necessary, an emetic of tartarized antimony or of ipecacuanha, leeches to the throat, warm bath, stupes to the throat in the form of a flannel bag filled with bran and dipped in boiling water, and sometimes sprinkled with spirits of turpentine ; from one and a half to three grains of calomel, with sugar, placed upon the tongue every two or three hours, with small doses of ipecacuanha, or tartarized antimony; sometimes mustard poultices or blisters to the throat. The treatment varies according to circumstances, the time at which the patient is seen, and the stage of the disease. It has been said that calomel can have no rapid effect upon the inflamed tracheal membrane; but I believe that calomel acts bene- ficially in this disease, and in some other diseases of children, by its revulsive action upon the intestinal mucous membrane, and not by any direct action upon the part affected. As is well known, some American physicians—Rush, Bard, and Anderson—believed that it arrested the secretion of lymph, and favoured its detachment when formed. If croup were a disease of longer duration, this explanation would be a feasible one, but it is difficult to accept it as applied to acute croup. Some practitioners trust exclusively to antimony or ipecacuanha, or both combined ; and others, who have fallen into the modern practice of stimulation, would avoid anything approaching to the antiphlogistic treatment. I could quote abundant evidence, or rather opinions, as to the efficacy of certain modes of treatment, but I fail to find any evidence satisfactory enough to lead me to abandon a practice that I believe I have found successful. One