Cass Win I Book * t/2 Copyright^?. COPYRIGHT DEPOSIT HAND-BOOK MODERN TREATMENT Medical Eormtjlary A CONDENSED AND. COMPREHENSIVE MANUAL OF PRACTICAL FORMULA AND GENERAL REMEDIAL MEASURES COMPILED BY W. B. CAMPBELL, M.D. CI AN AT THE JlETI of Philadelphia SECOND REVISED EDITION PHILADELPHIA: F. A. DAVIS COMPANY, Publishers 1910 \ <*° COPYRIGHT 1908 COPYRIGHT 1910 BY F. A. DAVIS COMPANY [Registered at Stationers' Hall, Loiidun, Eng. Philadelphia, -Pa., U. S. A.: Press of P. A. Davis Company 1914-16 Cherry Street ©GU259023 \h, PEEFACE TO SECOND EDITION. Since the issuance of this hook a little more than a year ago its use has become so extensive as to require two separate printings of several thousand copies each. It was inevitable that a number of errors should have appeared in the first edition, but upon the occasion of the third printing of the work the publishers have availed themselves of the opportunity to have these errors corrected and the book otherwise carefully revised throughout by Dr. John C. Rommel. A number of use- ful new formulae and prescriptions of proven value have been added, while a small number which have not met the require- ments have been canceled. As it now stands we believe the book a substantial improvement over the first edition, and we trust it will become increasingly useful to the general practitioner from whom it has received such a cordial welcome. The Publishers. (Hi) PEEFAOE TO FIBST EDITION, The subject matter of the "Hand-Book of Modern Treat- ment" has been gathered from the results obtained by medical men of wide and ripe experience. It is hoped that it will serve as a ready reference book to the busy physician. Diseases are arranged alphabetically, and the prescriptions, which have proved most gratifying in results secured, are ar- ranged under the diseases for which prescribed, and in this way the use of the Hand-Book is facilitated. A feature of the work, to which the attention of the pro- fession is directed particularly, is the clinical hints and sug- gestions scattered through its pages. This feature will, it is be ieved, add greatly to its value and usefulness to the busy physician. The prescriptions designated contain the drugs used in the forms favored by those who are in the front rank in the study of remedial measures for the cure of disease. Its use in busy moments and its careful perusal in leisure hours will add to the practitioner's efficiency and usefulness. W. B. C. 5107 Wayne Avenue, Germantown, Philadelphia, Pa. (iv) CONTENTS Diseases of Digestive System. Diseases of the Mouth, Tonsils and Larynx. ■„,.„„ ' ° PAGE Pharyngitis 336, 431 Quinsy 377 Stomatitis 405 Aphthous 34, 406 Foetor of Breath 177 Gingivitis 210 Mercurial 406 Mouth Wash 301 Ptyalism 371 Smoker's 406 Tonsillitis 427 Diseases of the Stomach. Acidity 4 Acute "Gastritis 203 Anorexia 32 Biliousness 54 Chronic Gastritis 205 Dyspepsia 144 Gastralgia 199 Gastric Catarrh , 77 Gastric Cancer 202 Gastric Ulcer 201, 207 Gastro-Enteritis 204, 205 Hsemateinesis 224 Hyperacidity 249 Pyrosis 375 Seasickness 400 Sub-acute Gastric Catarrh 206 Vomiting 46'5 Diseases of the Intestines. Anal Fissure 24. 191, 193 Appendicitis 38 Cholera Infantum 87 Cholera Morbus 88 Constipation 97 Diarrhoea 127, 131 Dysentery 139 Enteralgia 163 Enteritis 163 Flatulence 193 (v) vi CONTENTS. PAGE Haemorrhoids 240 Infantile Colic 92 Intestinal Colic 94 Intussusception 265 Lead Colic 94 Piles 344 Tape Worm 420 Trichinosis 438 Tympanites 443 Worms 39, 479 Diseases of the Liver. Gall Stone Colic 198 Hepatic Cirrhosis 245 Hepatic Colic 71 Hepatitis 246 Jaundice 267 Diseases of the Peritoneum . Dropsy and Ascites 138 Peritonitis 334 Tubercular Peritonitis 333, 336 Diseases of the Kidneys and Genitourinary Organs. Acute Nephritis 305 Chordee 89 Chronic Interstitial Nephritis 306 Diuretic and Diapnoretic 134 Enuresis 165 Epididymitis and Orchitis 167, 323 Hematuria 226 Impotence 251 Incontinence 257 Oxaluria : 327 Prostatitis -. 361 Pyelitis and Cystitis 112, 374 Renal and Vesical Calculi 72 Pvetention of Urine 380, 452 Satyriasis 394 Seminal Emissions 160 Spermatorrhoea 404 Strangury 406 Uraemia 449 Uric Acid Diathesis 451 Diseases of the Blood and Ductless Glands. Addison's Disease 8 Adenitis 8 Anaemia 22 Chlorosis 22 CONTENTS. vii PAGE Cretinism 110 Glands Enlarged and Inflamed 208 Goiter 210 Leukemia 277 Myxoedema 305 Purpura 373 Diseases of the Respiratory System. Diseases of the Nose and Throat. Coryza and Cough 105 Diphtheria 136 Epistaxis 171 Laryngitis 273 Nasal Catarrh 79 Ozama 328 Spasmodic Croup 110, 272 Diseases of the Lungs. Asthma 42 Bronchial Asthma 43 Bronchitis 62 Bronchorrhoea 65 Emphysema 65, 160 Hsematemesis 224 Haemoptysis 227 Hav Fever Asthma . . . . 29 Phthisis . 340 Pneumonia 348 Pulmonary Dyspnoea 147 Tuberculosis * 439 Diseases of the Pleura. " Emphysema 65, 160 Pleurisy 345 Diseases of Eye and Ear. Blepharitis 58 Conjunctivitis 95 Earache 1 49 Glaucoma 210 Interstitial Keratitis 269 Iritis 265 Otitis and Otorrhoera 324 Phlyctenular Keratitis -."." 269 Scleritis 398 Tinnitus Aurium ' 427 Ulcerative Keratitis 270 Acute Infectious Diseases. Anthrax 33 Bubo 67 viii CONTENTS. PAGE Bubonic Plague 67 Cholera 86 Dysentery 139 Erysipelas 173 Fever 178 Gonorrheal Infection 214 Hydrophobia 249 Influenza 259 Intermittent Fever 179 Malarial Fever 179 Measles 187, 291 Mumps 303 Pertussis 473 Pneumonia 348 Relapsing Fever 184 Remittent Fever 179 Rheumatic Fever 381 Scarlet Fever 187 Septicemia and Pyemia 373 Small Pox ' 401 Syphilis 412 Tetanus 422 Tuberculosis 439 Typhoid Fever 187 Typhus Fever ^ 190 Varicella 461 Yellow Fever 191 Diseases of Circulatory System. Aneurysm 28 Angina Pectoris 29 Cardiac Asthma 46 Cardiac Dyspnoea 147 Endocarditis 161 Palpitation 330 Pericarditis 333 Diseases of Nutrition. Arthritis 381 Asthenia 41 Chronic Rheumatism 390 Debility 116 Diabetes Insipidus 120 Diabetes Mellitus 121 Gout 221 Marasmus 289 Myalgia 304. 395 Obesity . ' 318 Rickets 378 Scrofula 298 Scurvy 399 CONTENTS. ix Diseases Due to Intoxications. PAGE Alcoholism 12 Bites and Stings . . 56, 379 Chronic Alcoholism 117 Lead Poisoning 275 Opium Habit . . 323 Poisoning 355 Diseases of Women. After Pains 10 Agalactia 11 Amenori hoea 20 Cancer of Uterus 72 Dysmenorrhcea 142 Fissure of Nipples 191 Labor 271 Leuchorrhoea 278 Mammary Inflammation 287 Menopause . 294 Menorrhagia and Metrorrhagia 295 Metritis 298 Morning Sickness 465 Nymphomania 318 Phlegmasia Albadolens v 339 Puerperal Convulsions 373 Sore Nipples 316 Vaginismus 458 Vaginitis '. 459 Varicose Veins . 462 Vulvitis 469 t Diseases of the Nervous System. Acute Mania 288 Anaesthesia : 25 Chorea 90 Coma or Apoplexy . 37 Convulsions 102 Epilepsy 168 Headache 231 Hysteria 254 Insomnia 262, 469 Locomotor Ataxia 282 Melancholia 292 Meningitis 293 Neuralgia 309 Neurasthenia 313 Neuritis 315 Paralysis 331 Paralysis Agitans 332 Sciatica . . 395 Shock 400 Tabes 419 Tetanus 422 CONTENTS. PAGE Toothache 436 Trismus 439 Vertigo . . . 462 Diseases of the Skin and Its Appendages. Abscess 2 Acne ' 4 Alopecia 14 Alopecia Areata 17 Bed Sores 53 Boils 59 Bromidrosis 61 Bunions 68 Burns and Scalds 68 Carbuncle 75 Caries 73 Chancre 81 Chancroids 82 Chapped Hands and Lips 83 Chilblains 84 Chloasma 85 Condylomata- 1 — Warts 71, 471 Corns 103 Dandruff 115 Dermatitis 119 Ecthyma .' 152 Eczema • 152 Favus 175 Felon 176 Frost Bite 195 Furuncle 196 Herpes ., ' 246 Ichthyosis 255 Impetigo 255 Intertrigo 264 Keloids 268 Lentigo 276 Lupus 286 Narvi 305 (Edema 320 Onychia 321 Pediculosis 281 Pemphigus 332 Phagedena 336 Prickly Heat .' 359 Prurigo 363 Pruritis 368 Psoriasis ..,..„ 369 King Worm 392 Eupia 393 Scabies — Itch . . 267, 394 Stye 407 Sweating . . 252, 408 Sycosis 410 Tinea Tonsurans 426 CONTENTS. x i PAGE Tinea Versicolor 426 Ulcer 445 •Wounds 480 Diseases Unclassified. Bladder Affections T .' 56 Dentition .' 118 Gangrene 199 Hiccoughs 241 Hydrocephalus 249 Ingrowing Toe Xail 261 Periostitis 333 Synovitis 411 Treatments. Alteratives 18 Baths , 51 Enemata 162 Hair Tonics 228 Hypnotics 251 Koumiss 270 Tonics 423 HAND-BOOK OF MODERN TREATMENT. ABDOMINAL OPERATIONS. High rectal injections of normal salt solution are the best means of combating excessive thirst after abdominal operations. Washing out the stomach just before the patient awakens from anaesthesia .has a happy effect in preventing, to a great extent, the nausea following ether. Continuous saline proctoclysis con- stitutes the leading part of the Murphy treatment for septic peritonitis, drainage being used to eliminate the toxins in the peritoneal cavity. ABORTION. POTASSIUM IODIDE IN THREATENED ABORTION. Montgomery urges the use of potassium iodide in the prophy- laxis of threatened abortion, even when the question of syphilis is in doubt. He believes that it is one of the most effective reme- dies in decreasing the irritability of the uterine mucous mem- brane. In this connection he says: "I have seen many pa- tients in whom it is impossible to elicit any indication of syph- ilis, who have done well and carried the foetus to full term upon the use of iodide of potash. So much good have I seen from the use of this drug that it is now my custom, in every case of irritable uterus where abortion is feared, to place the patient upon the use of iodide, 5 grains three times a day, given in water after meals. In cases in which sclerosis or areolar hyperplasia of the uterus has occurred, I know of no plan of treatment which will insure a woman the completion of her pregnancy." Morphine, gr. ss-% or j, as needed, will quiet a contracting uterus. Follow with bro- mide, gr. xv, every three hours, and fluidextract of viburnum prunifolium, 3j every three hours, for several days. The patient must rest in bed. Hand-Book of Modern Treatment. ABSCESS. M. Porosz, of Budapest, claims that if any one has once used a 2- to 5-per-cent. solution of nitric acid in treatment of abscesses and buboes he will never treat them in any other way, as the effects are so satisfactory. He first evacuates the pus and then injects the solution with a urethral syringe as forcibly as possible. The abscess-cavity becomes distended with the fluid, which penetrates into every crevice and seems to stimulate the tissues in their work of repair after the germs in the lesion are killed by the action of the acid. In very deep buboes it may be necessary to repeat the injection daily, but healing is usually complete after two injections. The severest cases all healed in a week in his experience. B Phenolis, 3j. Glycerini, f3iiss. Misee. Sig. : Inject a few drops into the painful and inflamed area. Indication : To abort abscess in early stage. I£ Aqua? hydrogenii dioxidi, fgiv. Sig. : Inject in cavity and syringe out. Indication: To be used after incisions and when pus collects. Peroxide is dangerous in deep cavities, as the effervescence forces the germs deeper into the tissues. Its best use is on the surface. J£ Liquoris plumbi subacetatis, f§j. Tincturae opii, fgj. Misce. Sig.: Add to water one quart and apply to parts on cloth compress. Indication : Used to decrease pain in the acute stages. I£ Calcis sulphuratae, gr. xij. Fiant pilulse no. xlviij. Sig. : One pill every three or four hours, followed by a draught of water. Indication: To abort in early stages of in- flammation. Hand-Book of Modern Treatment. AOETOZONE. Klinedinst reports a case of infected corneal traumatism in which this agent was used with marked success. He has been surprised by the rapid manner in which acetozone controls bac- terial infection and thinks that the ophthalmic surgeon has in this agent a germicide which is at once safe and more power- ful than any other known. The solution of 1 grain to 2 fluid- ounces is strong enough for the eye, though a stronger solution did not seem to do any permanent harm, and only caused greater temporary burning and pain. ACETOZONE IN MINOR SURGERY. Dr. James Burnett publishes some notes concerning his experience with acetozone in chancroid, abscess, and lacerated wound. The chancroid was dusted twice daily with acetozone, 2 parts, and powdered talc, 98 parts. The abscess was opened and its cavity washed out with aqueous solution of acetozone (2V 2 grains to 4 ounces). It was dressed with lint wrung out of the solution and covered with gutta-percha tissue. A severely crushed finger with fracture of the terminal phalanx was thoroughly washed with acetozone solution and occasionally poulticed for a few days, when the parts were powdered with acetozone and zinc oxide. The author concludes : "Though acetozone is perhaps mainly available in surgical conditions, there is no reason why it should not prove serviceable in medical diseases. Already it has been fcumd helpful in typhoid, and I fancy that in tuber- culous enteritis, in cholera, and in dysentery it may prove of some value. Again, in puerperal septicaemia I think its use would be preferable to that of perchloride. owing to its nontoxio nature. Its administration internally may be by means of cap- sules containing 3 grains. In this form I would suggest its trial in cases of chronic gastric catarrh with much fermentation." Hand-Book of Modern Treatment. ACIDITY. I£ Bismuthi subnit., 3iij. Aeidi carbolici, gtt. ij-v. Mueil. acaciae, 3j. Aquae menth. pip., §iij. Misce. Sig. : Tablespoonful three or four times a day. 1$, Sodii bicarbonatis, 3ij. Spts. amnion, aromat., 3ij. Tr. zingiberis, Sj- Infus. gentianae, q. s. ad £viij. Misce. Sig.: Tablespoonful two or three times daily. IJ Cerii oxalatis, 3j. Fiant pilulae, no. xxx. Sig. : One every four hours. 1$. Liq. potassii hydroxidi, 3iij. Sig. : Fifteen minims well diluted in water, three times daily. Ifc Aquae creosoti, f3vj. Sodii bicarbonatis, §j. Misturae cretae, q. s. ad 3iij. Misce. Sig. : Two teaspoonfuls three times a day. IJ Sodii bicarbonatis, 3ij. Tinct. gentianae comp., ^iss. Aquae, q. s. ad 3vj. Misce. Sig.: Two tablespoonful s three times daily. ACNE. ACNE ROSACEA. Dr. Gilchrist, in a recent paper, thus tersely sums up the treatment of acne rosacea. Strict attention to diet, good, plain food, avoidance of pork, pickles, salads, highly-seasoned foods, rich gravies, sauces, cheese, pastry, candy, cakes, strong Hand-Book of Modem Treatment. tea or coffee, and very hot liquids. Fresh fruits and green vegetables are beneficial. Correct the underlying constipation, dyspepsia or menstrual trouble, avoid all stimulants, wash the face in hot water every night, and then apply a sulphur oint- ment or lotion. Local treatment consists in rapid puncture of the skin of the nose with a sharp aseptic needle, and electrolysis to obliterate the blood-vessels, if thev are visible. ACNE OINTMENT. I£ Antipyrini, 3iss. Fluidextracti coca, §ij. Tinct. aurantii, 3j. Glycerini, §j. Misce. Sig. : Teaspoonful three times daily between meals. ACNE IN CHILDREN. The treatment of acne in children consists in the restric- tion of the diet. Coffee, pork, fish, pastry, cheese, and spices should be restricted. The following combination is recom- mended before meals : — IJ Sodii bicarb., gr. iij. Magnesia? calcinatse, gr. iss. Pulv. cascarse sagradse, gr. iss. Misce, fiant capsulse no. j. Sig.: One capsule to be taken before each meal. The face should be washed in very hot water in which have been boiled bran and sodium borate. In the evening, after washing the parts with naphtha soap, the following ointment should be applied: — I£ Betanaphthol, Tinct. saponis viridis, of each, gr. ivss. Cretae prep., Sulphuris lati, of each, gr. viiss. Petrolati, 3vj. Misce, fiat unguentum. Sig. : Apply locally. g Hand-Book of Modern Treatment. The following morning, after bathing the face, the follow- ing lotion is recommended : — 1$, Sodii boratis, 3j. Spt. aetheris sulph., f5v. Aquae rosae, fgiss. Aquae destil , f^iiss. Misce, fiat lotio. Sig. : Apply locally to the affected parts. Indication: Used in acne in children. SIMPLE ACNE. I£ Bismuthi subnitratis, 3ij. Ung. hydrarg. amnion., 3ij. Ichthyolis, 3ij. Vaselini, ^iiss. Misce. Sig.: Apply locally. R, Ichthyolis, Sj. Aquae dest., Sj. Misce. Sig.: Rub in before retiring; wash off with soap and warm water in the morning. During the day use a weak solution of mercuric chlo- ride. Indication: Simple acne. t£ Mucilaginis acaciae, m lxxij. Sulphuris sublimati, £ss. Alcoholis, Sss.. Aquae, 5ss. Misce. Sig.: Apply once daily. Indication: A paste for the acne of young persons. B Sulphuris praecipitati, gr. xc. Spt. camphorae, f3iv. Aquae dest., f§j. Sig. : Apply in the evening and let dry on the skin. Next morning wash off with warm water. Indication: Inflammatory acne. Hand-Book of Modern Treatment. ACNE LOTION B> Betanaphthol. gr. xl. Sulphuris sublimati, gr. cc. Petrolati, gr. c. Saponis viridis, gr. c. Misce. S.ig. : Apply externally each night. Indication: Simple acne. P* Sulphuris praecipitati, gr. xc. JEtheris, f3iy. Alcoholis, fgj. Misce. Sig. : Apply as a lotion. Wash parts fre- quently with hot water and green soap. Indication: Used when acne becomes pustu- lar. R> Ichthyolis, m xxx. Acidi salicylici, gr. xxx. Saponis yiridis, gr. xviij. Adipis lanae hydrosi, q. s. ad 3iv. Misce. Sig.: Apply at night and wash off in the morning with hot water. R> Potassii iodidi, gr. xl. Potassii bromidi, §j. Liq. acidi arsenosi, 3iss. Tinct. sumbul, 3ij. Aquae camphorae, £xij. Misce. Sig. : Tablespoonful in water after meals. Indication: Acne rosacese. P* Potassii sulphidi, 3j. Zinci sulphatis, 3j. Aquae rosae, f§iv. Misce. Sig. : Apply before retiring at night. Indication: Used as an acne lotion. P* Antipyrini, 3iss. Fluidextracti cocae, §ij. Tinct. auranti, £j- Glycerini, 3j. Misce. Sig. : Teaspoonful three times daily between meals. Hand-Book of Modern Treatment. IJ Potassii arsenitis (sol.), f Sj- Sig. : Three minims three times daily. Indication: Useful if debility or anaemia is present, and should be continued for a month or two. ADDISON'S DISEASE. H. A. Moody publishes an account of a well-marked case in which the use of 3 grains of suprarenal extract in capsules thrice daily was attended by rapid amelioration of the symptoms and lessening of the pigmentation. Finally the patient discontinued the remedy for nine months. Upon resuming it in the same dose, on the fifth day, after having taken twelve capsules, 36 grains, the patient was attacked by intense gastralgia, the sur- face being pale and cold, indicating intense vasoconstriction, the mucous membrane participating in the* bloodless condition. "Morphine and atropine soon relieved the paroxysm, and, after suspending all medicine for a few days, the capsules were resumed. After taking six more she had another attack of gastralgia and again the extract was suspended. At the end of a week she began taking one capsule at night and one in the morning. On the fifth day the gastralgia returned more violently than ever, the vasoconstriction being marked and per- sistent. The pulse was weak, slow, and labored, and the entire surface cold and pale. It required active and energetic treat- ment, including the administration of morphine, atropine, and nitroglycerine, to relieve her. It was with some difficulty that I persuaded the patient to resume the treatment, but in a few days she did so, taking only one capsule a day. This amount caused no trouble, and a very gratifying improvement of all the symptoms appeared." I£ Glandulse suprarenalis siccae, 3j. Pone in capsulas no. xx. Sig. : One capsule three times daily after meals. ADENITIS. IJ Ammonii hydrochloride 3iss. Camphorae, 3ss. Adipis, 5j. Misce. Sig. : To be applied morning and evening. Eand-Book of Modern Treatment. Ifc Potassii iodidi, gr. xvj. Extracti ciculse, gr. xxxij. Aquae dest., f3iss. Lanolini, 3j. Misce. Sig. : Apply twice daily. Indication: Useful in chronic adenitis. Ifc Syrapi ferri iodidi, fSiv. Sig.: 5 to 20 minims in water after meals. Indication: Good when accompanying anae- mia. I£ Unguenti iodi, §j. Adipis, Sj- Misce. Sig. : Apply locally night and morning. . Ifc Ichthyolis, 3iv. Adipis benzoinat., §ij. Misce. Sig. : Rub some into the swelling three times daily. B Tinct. iodi, 3ij. Sig. : Paint thoroughly over the gland. ADHERENT DRESSINGS. PAINLESS REMOVAL OF ADHERENT DRESSINGS. Dr. von Mikulicz suggests an easy means of obviating this drawback — viz., by wetting the dressings with oxygenized water. This provokes a copious evolution of bubbles of gas, the mechanical effect of which is to free the gauze and allow its removal without causing pain. The method is so simple as to deserve the notice of surgeons. REMOVAL OF ADHESIVE STRIPS. In removing adhesive strips which have been used as dress- ings, a little ether poured on the same will facilitate the removal by dissolving the glue. 10 Rand-Book of Modern Treatment. ADRENALIN. Dr. Winfield Ayers has found a mild solution of adrenalin extremely useful in certain kinds of genito-urinary work. In examining the urethra an irritable stricture is frequently dis- covered, the first evidence of the fact being generally a severe haemorrhage, which there is sometimes difficulty in stopping. It occurred to Dr. Ayres to use adrenalin, and he finds it answers the purpose well, a solution of 1 to 100,000 being suffi- cient for the purpose. THE USES OF ADRENALIN. Adrenalin, a stable substance of pure crystalline form, is the active principle of the suprarenal gland recently isolated. Dr. Emil Meyer writes that he has used solutions of adren- alin chloride, 1 to 1000, 1 to 5000, and 1 to 10,000. Blanch- ing of the tissues followed the application of the strongest of these solutions in a few seconds, and was very thorough. In no instance was there any constitutional disturbance. Thirty- five cases are reported. A few operative cases bled freely, but in every instance the haemorrhage was promptly checked by a Second application of adrenalin. The adrenalin was used not only as a haemostatic, but for the relief of nasal congestion, as a diagnostic aid, and for the continuous treatment of acute inflammatory affections of the accessory sinuses. Of the same preparation, Dr. E. Fletcher Ingals says that a case of daily epistaxis was relieved by sprays of a 1 to 10,- 000 solution. Another case, one of conjunctival congestion from overwork, was entirely relieved by the instillation of a similar solution. The author has had equally satisfactory results in cases of conjunctivitis ; laryngitis, acute and chronic ; acute laryngitis with oedema glottidis ; acute coryza ; chronic laryngo-tracheitis with acute exacerbation; and in preparation for operations upon the nose. AFTER-PAINS. In many cases a nice warm meal is better than any medicine ; "still, where the pains are exhaustingly severe, I turn to amyl nitrite. The potent drug is a very efficient controller of after- Hand-Book of Modern Treatment. H pains, and, used cautiously, I see no reason to apprehend harm from it. A neat way of using it is to saturate a small piece of tissue-paper with 5 or 6 drops, stuff this into a two-drachm vial, and request the patient to draw the cork and inhale the odor when she feels the pains coming on. It acts with magical celerity. SALOPHEN IN AFTER-PAINS. Dr. Audebert recommends salophen for the treatment of after-pains. The remedy has the property of abolishing the pain without interfering with the contractions of the uterus. He prescribes a dose of 15 grains, which he repeats in two hours if necessary. As a rule, the pains disappear in a half-hour after the first dose. It occasionally happens that the pains reappear on the next day, but then another dose drives them away completely and permanently. AGALACTIA. R Strych. sulph., Pilocarpine hydrochlor., of each,-gr. j. Sacch. lactis, Siiss. Misce et fiant tabellse triturationes no. lx. Sig.: One every four hours. R Ext. ergotae, Ext. nucis vomicae, of each, gr. vj. Quininse hydrochloratis, gr. xxiv. Misce, fiant pilulae no. xxiv. Sig. : One pill every six hours. Indication: Use in anaemic subjects. R Potassii arsenitis, 3iv. Sig. : One drop three times daily in milk and increasing one drop each day until five is reached, and return to one drop three times dailv. ALBUMINURIA.— See Nephritis. 12 Hand-Book of Modern Treatment. ALCOHOLISM. R Oleoresini capsici, m x. Olei caryophylli, m x. Hydrarg. chlor. mit., gr. xx. Aloe, gr. xl. Misce et fiant pilulse no. xx. Sig.: One three times a day after meals. Indication : Used in the atonic stomach of drunkards. R Tinct. capsici, f3iss. Tr. opii deodorat., f3ij. Spiritus setheris nitrosi, f3iv. Tr. lavandulse comp., q. s. ad f^iv. Misce. Sig. : Dessertspoonful every four or five hours. R Spiritus aromatici amnion., fSij. Sig.: Ten minims in water every half-hour. Indication: To relieve acute alcoholism. R Potassii bromidi, gr. v. Sodii bromidi, gr. v. Chloralis hydratis, gr. x. Tr. zingibeTis, m v. Tr. capsici, m v. Spts. amnion, aromatici, m xv. Aquae, q. s. ad 3j. Misce. Sig. : To be taken as one dose, and used as necessary. Indication : Useful in delirium tremens. R Paraldehyde f3vj. Elixiris aromatici, q. s. ad fSiv. ^ Misce. Sig. : Tablespoonful in every two or three hours. Indication: Useful in mild delirium and restlessness. Hand-Book of Modem Treatment. 13 IJ Acidi hydrochlor. diluti, f3j. Tr. nucis vomicae, f3ij. Tr. capsici, f3j. Tr. gentiarise comp., q. s. ad fSiij. Misce. Sig. : Two teaspoonfuls in water before meals. Indication: To improve appetite and diges- tion after an alcoholic debauch. The insomnia and intense nervousness which frequently accompany acute alcoholism should be corrected by promoting free elimination from the bowels, skin, and kidneys. A brisk laxative in the form of Hunyadi water, Seidlitz powder, or mag- nesium citrate should be given, also a Turkish bath, if not too depressing. Sodium bromide should be preferably used as a sedative and hypnotic. The author does not favor the indiscriminate use of bromides chiefly because of the danger of producing gastric disturbance. A mixture similar to the following is recommended : — IJ Chloralis hydratis, gr. xv. Sodii bromidi, gr. xv. Tinct. capsici, m x. Aquae menthae piperitis, £ss. Misce. Sig. : At one dose. The author, however, prefers paraldehyde as an hypnotic, combined as follows: — I£ Paraldehydi, 3ss to j. Olei olivae, gss. Misce. Sig. : At one dose, to produce sleep. Paraldehyde is said to produce sound, refreshing sleep, with no depressant after-effects. Food should be withheld until the bowels move freely. I£ Sodii bromidi, Sj. Tinct. capsici, 3j. Tinct. digitalis, 3ss. Elix. simplicis, ad 3ij. Misce. Sig. : A teaspoonf ul every two or three hours in water. Indication: Acute alcoholism. 14 Hand-Booh of Modern Treatment. quinquaud's sign of chronic alcoholism. This sign is thus described by Aubry: The patient holds up his hand with the fingers spread apart. The examiner then presses upon the patient's finger-tips with his own, using mod- erate firmness. If the patient is an alcoholic there will be observed in a few seconds a grating or crackling of the phalanges as though the bones were rubbing each other. It is more marked in men than women. In the extreme depressions, irritable system, and cerebral perversions following a debauch, I have frequently observed excellent results from the following: — IJ Sodii broniidi, 3ij. Fid. ext. hyosciami, 3j. Fid. ext. lobelise, 3j. Fid. ext. pulsatillae, gtt. xx. Fid. ext. lupulini, 3ij. Aquae menthae, q. s. Sij. Misce. Sig. : Teaspoonful occasionally. Indication: For alcoholic excess. If the heart is very weak give nitrate of strychnine, while as a tonic in convalescence prescribe nux vomica, calumba, gentian, and hydrastis. The primary feature is to afford the patient rest and comfort, the above usually being sufficient. ALOPECIA. I£ Resorcin, 3j. Olei ricini, m xxx. Olei tiglii, m iv. Alcohol, 5iv. Misce. Sig.: Rub in twice daily. Indication: Used in premature dropping out of the hair. B Acidi salicylici, gr. x. Betanaphtholis, gr. xx. Sulphuris praecip., 3j. Vaselini, q. s. ad 3j. Misce. Sig. : Apply night and morning. Hand-Book of Modern Treatment. 15 I£ Liq. carbonis deterg., 3j. Lanolini, 3iij. Vaselini, q. s. ad §j. Misce. Sig. : Apply night and morning. 1$ Acidi acetici, 3ij. Pulveris boracis, gr. xxx. Glycerini, 3iss. Spts. vini, 3ij. Aquae rosae, q. s. ad %\\. Misce. Sig.: Apply twice daily. I£ Liquoris amnion, acetati, 3j. Ammon. carbonatis, gr. xv. Glycerini, 3iss. Aquae sambuci, q. s. ad §iv. Misce. Sig. : Apply once daily. I£ Tr. cantharidis, 3iv. Tr. capsici, m xl. Olei ricini, §j. Alcoholis, q. s. ad %iv. Misce. Sig. : Apply once daily. Indication: Stimulating tonic and to be used with care. I£ Olei cadini, 3iss. Lanolini, 3iij. Vaselini, q. s. ad 3j. Misce. Sig. : Apply once daily. I£ Chrysarobini, gr. xxx. Vaselini, gj. Misce. Sig. : Paint over and rub in. Indication : Useful in alopecia areata. I£ Trikresolis. Sig. : Apply to scalp by inunction once weekly. 16 Hand-Book of Modern Treatment. I£ Olei ricini, fgss. Acidi carbolici, 3j. Tinct. cantharidis, fgss. Olei rosmarini, gtt. xv. Spts. vini rectif., q. s. ad f^iv. Misce. Sig. : Apply as indicated. IJ Pilocarpine hydrochlorati, gr. v. Olei rosae, m viij. Olei rosmarini, 3iv. Linimenti cantharidis, 3iv. Glycerini, %]. Olei amygdalse expressi, 3x. Spiritus camphorae, 3x. Misce. Sig.: To be rubbed well into the scalp night and morning. After cutting the hair close to the scalp and cleansing with soap and water, the following lotion : — I£ Hydrargyri chloridi corrosivi, gr. iij. Acidi acetici, gr. xv. Alcoholis, §iv. iEtheris, §ij. Sol. lavend. (alcoholic), 3ij- Misce. Sig.: Apply locally once a day. After drying, the head is rubbed with lactic acid, about 30 per cent. The following has been used with gratifying success in preventing that condition so annoying to humanity which is described by the patient as "My hair is falling out" : — fy Acidi salicylici, 3iij. Acidi carbolici, 3j. Olei ricini, f3ij. Alcoholis, q. s. ad fl$vj. Misce. Sig. : Apply freely to the scalp once or twice daily. Hand-Book of Modern Treatment. 17 ALOPECIA CIRCUMSCRIPTA. J. V. Shoemaker states that persons troubled with alopecia circumscripta generally require constitutional treatment by means of diet and proper medicine. The following combinations are advised by him: — I£ Syr. ferri lactati, 3ij. Ext. malti diastasic, 3vj. Misce. Sig. : One dessertspoonful three times a day after meals. Locally the following: — I£ Sulphuris sublim., 3j. Olei eucalypti, m x. Acidi salicylici, gr. x. Ungt. zinci oxidi, Sj. Misce et fiat unguentum. Sig. : Rub into the affected spots well twice a day. TRIKRESOL IN ALOPECIA AREATA. MacGowan states that he has cured eight cases of alopecia areata within a period averaging two and one-half months. After the part has been cleansed with benzin, the patch and surrounding zone are thoroughly rubbed with a cotton swab saturated with tri- cresol. The latter is applied pure to the scalp and in 50 per cent, dilution with alcohol on the face. The applications cause burn- ing, which disappears in the course of a few minutes. The applications are repeated in from four to ten days. Ifc Tr. cantharidis, 3j. "Quininse hydrochloratis, 3j. Aquse rosse, q. s. ad 5 v "j- Misce. Sig. : Apply morning and evening. Indication: For falling hair after severe ill- ness. ALOPECIA AREATA. A young woman who had rebellious alopecia for more than a year was practically cured by washing the head twice a day lg Eand-Book of Modem Treatment. with soap and then rubbing kerosene vigorously into the bald patches. They soon became covered with soft hairs which, by the end of eight months, had almost all been transformed into adult hairs. ALTERATIVES. For failure of appetite, weak digestion, and the general debility of warm weather, the following stomachic: — 1^ Acidi nitrohydrochlorici, 3ij. Aquae, §iss. Strychniae sulph., gr. j. Misce et adde: — Tincturse cardamomi comp., giij. Tincturae gentianae comp., q. s. %\}. Misce. Sig. : Dessertspoonful after meals in water. I£ Potassii iodidi, §j. Tincturse gentiange comp., q. s. £vj. Misce. Sig. : Five minims or more well diluted three times daily. 1$ Liq. potassii arsenitis, 3iss. Infus. gentianae comp., q. s. ad %iv. Misce. Sig.: One teaspoonful diluted three times daily after meals. I£ Hydrarg. chloridi corrosivi, gr. iss. Infus. gentiange comp., Sivss. Misce. Sig.: One teaspoonful diluted three times daily. Use with care. 1$ Hydrarg. iodidi rubri, gr. iss. Potassii iodidi, 3iv. Aquae cinnamomi, giij. Misce. Sig.: One teaspoonful well diluted three times daily. Hand-Book of Modern Treatment. 19 I£ Vini colchici seminis, 3iv. Potassii iodidi, 3ij. Aquae menthae piperit., q. s. ad §iij. Misce. Sig. : One teaspoonful three times daily. I£ Olei morrhuae, f^iij- Syrupi calcii lactophosphat., §iss. Liquoris calcis, 3iss. Mi see. Sig. : One or two teaspoonfuls three times daily. Indication: Useful for rachitis and ill-nour- ished child over two years. I£ Liq. potassii arsenitis, m xx. Syrupi, Sj. Tinct. cardamomi comp., 3iij. Aquse q. s. ad §v. Misce. Sig. : One teaspoonful three times daily. Indication: Useful for children. Ifc Potassii iodidi, gr. xlviij. Syrupi sarsap. comp., ^iij. Aquse, Siij- Misce. Sig. : One or two teaspoonfuls three times daily. Indication: Useful for children. AMAUROSIS AND AMBLYOPIA. I£ Potassii iodidi, 3ij. Pepsini (scale), 3ij. Aquae, q. s. ad fSiij- Misce. Sig. : Teaspoonful in water after meals and increased. Indication: Useful when due to syphilis or metallic poisons. 20 Hand-Book of Modern Treatment. AMENORRHEA. I£ Tinct. ferri chloridi, f3iij. Tinct. cantharidis, f3j. Tinct. guaiaci amnion., f3iss. Tinct. aloes, f&ss. Syrupi, q. s. ad f^vi. Misce. Sig. : One tablespoonful three times a day. I£ Ferri et potassii tartratis, 3iss. Ext. artemisise, 3ss. Ext. absinthii, 3ss. Pulveris aloes Socotrinse, 3ss. Essen, anisi, gtt. iij. Misce et fiant pilulae no. 1. Sig.: Two pills with each meal. IJ Hydrargyri chloridi corrosivi, gr. j. Sodii arsenit., gr. j. Strychninse sulphatis, gr. j. Potassii carbonatis, gr. xxx. Ferri sulph., gr. xxx. Misce et fiant pilulae no. lx. Sig. : One after each meaL Indication: Amenorrhea in debilitated and anaemic states. I£ Pulv. damianse, gr. iii%. Pulv. sabinse, gr. iss. Pulv. rutse, gr. iss. Pulv. croci, gr. iss. Pulv. zingiberis, gr. %. Misce. Sig.: For one capsule; one, morning and evening. I£ Ferri pepton, gr. xxx. Manganesii lactatis, gr. xxx. Scammonii, gr. xxx. Strych. sulphatis, gr. 1 / 7 . Misce et fiant pilulae no. xl. Sig. : Give two to four each evening on re- tiring. Eand-Book of Modern Treatment. 21 Citrate of manganese has given fairly good results in amenorrhea (especially uncomplicated oligochromaemia). It is administered in 5-grain doses thrice daily, increased, if neces- sary, to as much as 15 grains. It may with advantage be given at meal-time; 5 grains of sulphate of iron to be taken one hour afterward if anaemia be produced. IJ Hydra rgyri chloridi corrosivi, gr. j. Liquoris arsenici. chloridi, gtt. xlviij. Tincturi ferri chloridi, 3iv. Acidi hydrochloride diluti, 3iv. Syrupi zingiberis, q. s. ad 3 v j- Misce. Sig. : Dessertspoonful in water after meals. Indication: Amenorrhoea due to depressing hygienic surroundings. 1$. Tinct. ferri chloridi, f3iij. Tinct. cantharidis, f3j. Tinct. guaiaci ammon., f3ss. Tinct. aloes, ^ss. Syrupi, q. s. ad f^vj. Misce. Sig. : Tablespoonful three times a day. IJ Acidi arsenosi, gr. j. Ferri sulph. exsiccat., 3ss. Pulv. piperis nigri, 3j. Pilulse aloe et myrrhse, 3j. Misce et fiant pilulse no. xl. Sig.: One three times daily after meals. Indication: Useful in chlorosis and amenor- rhoea. IJ Ergotin (Bonjean), gr. ij. Quininee sulph., gr. ij. Misce et fiat capsulae no. j. Sig. : One capsulse three times a day. IJ Apiolini, f3j. Pone in capsulas no. xx. Sig. : One capsule three times a day for one week before time for menstruation. 22 Hand-Book of Modern Treatment. I£ Mangani dioxidi, 3j. Pone in capsulas no. xvj. Sig. : One three times daily for few days before time for menstruation. I£ Pilulae ferri carbonatis no. 1. Sig. : One pill after meals and increase. Indication: Useful when chlorosis and anae- mia are present. 1^ Olei rutae, £ss. Pone in capsulas no. xlij. Sig. : One capsule three times daily. 1$, Olei sabinae, 3iv. Pone in capsulas no. xlij. Sig. : One three times daily. I£ Olei tanaceti, 3iv. Pone in capsulas no. xlij. Sig.: One three times daily. ANAEMIA. 1$ Liq. potassii arsenitis, 3iiss. Acidi phosphatis, Siij- Extracti osis marrow, q. s. ad §viij. Misce. Sig. : Dessertspoonful after each meal. Indication: Pernicious anaemia. I£ Acidi arsenosi, gr. ss. Ext. nucis vomicae, gr. v. Ferri reducti, gr. ij. Misce et fiant pilulae no. xx. Sig. : One after each meal. t^ Codeinae phosphatis, gr. x. Elixiri pepsini, §iss. Aquae foeniculi, q. s. ad §iv. Misce. Sig. : One teaspoonful three times daily. Indication: Useful -in chronic anaemia marked by mental depression. Hand-Book of Modern Treatment. 23 IJ Ferratini, 3ij. Pulv. rhei radicis, 3iv. Sodii bicarbonatis, 3ij. Olei foenieuli, m xxx. Misce. Sig. : One teaspoonful at night in water. Indication: Useful in anaemia with consti- pation and painful menstruation. IJ Ferri sulph. exsiccat., 3ij. Potassii carbonatis, 3ij. Syrupi, q. s. Misce et fiant pilulse no. xlviij. Sig. : One to three pills three times daily. IJ Tiq. potassii arsenitis, f3iv. Sig. : One minim three times daily and in- crease one drop each day till puffiness under eyes. Then reduce by half. IJ Cupri arsenitis. gr. ij. Sig. : One-fiftieth of a grain three times daily. IJ Syrupi ferri iodidi, f^ij. Sig.: Ten minims in milk three times daily. IJ Hydrarg. ehloridi corrosivi, gr. ij. Aquse f^iss. Sig. : Ten minims three times daily. Byrom Bramwell, in a case of splenic anaemia, of an unknown causation, occurring in a young man, 25 years of age, found the blood to contain 48 per cent, of haemoglobin, although the red cells were not- much reduced (4,030,000 per cubic millimeter). The white cells were 3800. There was some, but not marked, poikilocytosis. Xo nucleated red corpuscles w r ere seen. The white corpuscles were in about normal proportions ; no myelocytes were found. The patient did not use alcohol, and malaria and syphilis w r ere excluded. He had had good health until about three years preceding, when he was suddenly seized with acute pain in the left side of the abdomen, and, almost immediately aftenvard, vomited 24 Hand-Book of Modern Treatment. a large quantity of bright red blood. Since this attack he had never felt strong and his skin had been always sallow. Sub- sequently, he had vomiting of blood on two occasions. He was suffering with marked anaemia and debility when he com- menced treatment with Blaud's pills (gr. v. thrice daily) and a daily exposure to the X-rays. Almost immediate improvement resulted; in one month the red blood-cells increased from 2,440,000 to 4,260,000, and the haemoglobin from 20 to 46 per cent. The yellow coloration of the skin had almost entirely disappeared. The patient was discharged at his own request, looking and feeling well. The spleen was only slightly reduced in volume. ANAL FISSURE. IJ Hydrarg. chloridi mitis, gr. xxx. Extracti opii, gr. x. Extracti belladonnas, gr. x. Vaselini, §j. Misce. Sig. : Give a laxative at night and apply the above ointment. I£ Bismuth i emulsionis, 3j. Iodoformi, gr. x. Olei olivse, %i\\ Misce. Sig. : Inject and retain on alternate days. I£ Sol. potassii bromidi, 3iss. Glycerini, q. s. ad 3j. Misce. Sig. : Apply to fissure with a brush. The fissure is first anaesthetized with cocaine, and pure ichthyol is applied with a bit of cotton on a glass rod. For sub- sequent applications, which are made every other day, anaesthesia is generally unnecessary. Cicatrization is usually very rapid, and stretching of the sphincter is not necessary. The bowels must be kept free. Eand-Book of Modem Treatment. 25 I£ Ext. conii, gr. xv. Olei ricini, gr. xv. Lanolini, gr. xxx. Misce. Sig. : To be applied to parts after each action of the bowels. In cases of anal fissure in which severer measures are de- clined by the patient it may be well to try a method of treat- ment recommended by Katzenstein, who seeks to soothe the nerve-endings and do away with the spasm of the sphincter with the aid of the following mixture : — IJ Ext. belladonnse, gr. viiss. Cocainae hydrochlor., gr. Vao- Ammonium sulphichthyolate, q. s. ad 3iss. Misce. Sig. : This is warmed and applied by means of an applicator wrapped with cotton once or twice a day for a week or two; then sitz baths are used and the bowels carefully regulated. Indication: A non-operative treatment of fissure of the anus. I£ Cocainae hydrochlor., gr. j. Extract, belladonnse, gr. j. Ichthyoli, 3iss. Misce et fiat unguentum. Sig. : Apply twice daily. Ifc Iodiformi, gr. xxx. Acidi carbolici, gr. xv. Olei olivae, §vj. Misce. Sig. : Inject one ounce into rectum after evacuation. Indication: To relieve pain and promote healing. ANAESTHESIA. LOCAL ANAESTHESIA. A valuable local anaesthetic for inflamed tissues can he had by adding a few drops of 1 to 1000 solution of adrenalin 26 Hand-Book of Modern Treatment. to V 2 - to 1- per cent, solution of cocaine. In injecting this the first result is an anaemia of the skin, clue to its action on the vasoconstrictors, followed by a deep anaesthesia. Incisions can be made into inflamed tissues with the loss of very little blood, and the method is well adapted for furuncles, anthrax, etc. It is wise never to anaesthetize a patient in the presence of many people. It renders him more agitated and nervous. It is preferable to anaesthetize in an adjoining room, or to cause all but the anaesthetist and one assistant to leave the room until the patient is thoroughly under the influence of the anaesthetic. In giving ether it is a mistake, after anaesthesia is complete, to continue it until it becomes very profound, and then to leave off until the patient shows signs of returning consciousness, Allowing the patient one breath of pure air to every four or five of ether will commonly keep him in excellent condition, while the anaesthesia is effective and safe. Lasting anaesthesia can be produced by spraying ethyl- chloride over a surface previously moistened with a concen- trated watery solution of cocaine. Cocainized ethyl-chloride has been employed for opening abscesses, etc. SPINAL ANESTHESIA. I would limit the indications for its application at the present moment: 1. To adults, and to reasonable persons who have good self-control, thereby excluding children, hysterical patients, and the insane. 2. To patients in whom the methods of local or regional anaesthesia are inapplicable. 3. To pa- tients suffering from emphysema, advanced asthma, chronic bronchitis, and other respiratory affections in whom a general inhalation anaesthetic is absolutely contraindicated ; in advanced cardiac cases with degenerative lesions, I would fear the possible depressing effects of the injection and excitement on the circula- tion. 4. In the majority of cases in which the painful part of the operation is not likely to be prolonged beyond one hour and a half, as I would be averse, in the present state of our know- ledge, to repeat a second cocainization or to increase the total dose of the cocaine to more than 2 cubic centimeters, especially in exhausted subjects. Dr. Gartner has recently patented an instrument which Hand-Book of Modern Treatment. 27 records the pulse of a patient who is under the influence of an anaesthetic. The instrument is fastened to the forearm, and a graduated disc records the increase or retardation of the pulse. The experiments in the hospital of Vienna succeed marvelously. It is hoped by means of it to prevent death during operations. The following formulae for the use of camphor as anaes- thetics for local use in itching affections: — 1$, Camphorae, gr. xv. Olei amygdalae dulcis, 5 % • Misce. IJ Lanolini, §iij. Camphorated oil, 3V 3 . Choraiis hydratis, gr. xv. Misce. I£ Zinci oxidi, ^vi 1 /^. Cretae, Svi 1 /^. Camphorated oil, Zvi 1 ,^. Liquoris calcis, 3vi^4. Misce. A SIMPLE METHOD FOR PRODUCING LOCAL ANAESTHESIA. A very simple method for producing local anaesthesia, and one that will commend itself in the performance of minor op- erations, has recently been described by a writer in the Lancet. The method outlined is as follows : A solution consisting of adrenalin chloride, 2 drachms; cocaine, 5 grains; and water, 1 / 2 ounce, is prepared. Lint is folded into a pad of four layers, soaked in the solution and placed under a positive electrode. A large negative electrode is applied elsewhere, and a current of from 15 to 30 milliamperes is slowly induced and run for the space of from 5 to 15 minutes. The surface may then be washed with ether, and superficial operations performed pain- lessly and without loss of blood. AN IMPROVED METHOD OF LOCAL ANALGESIA. Prof. Arthur E. J. Baker prepares his analgesic solu- tion as follows : 3 grains of betaeucaine and 12 grains - of pure sodium chloride are added to 3 1 / 2 ounces of boiling 2g Band-Book of Modern Treatment. distilled water, and 16 drops of a 1 to 1000 solution of adrenalin chloride are poured into the fluid after it has cooled. This makes a normal saline solution containing 2 to 1000 eucaine and 1 to 100 7 000 adrenalin chloride. The whole quantity could, within the limits of safety, be injected into a patient at one sitting, but Professor Barker has found that an extensive operation can be done with about one-ha'.f of it. Barker never observed secondary haemorrhage following the use of the method. He used it in 3-L cases, which include 10 operations for radical cure of hernia, 5 cases of strangulated hernia, 2 castrations for tuberculous testis, 5 cases' of varicose veins, 6 cases of psoas abscess, 1 case of loose body in the knee, 1 case of tumor of the neck (actinomycosis), 1 colotomy, 1 of Thiersch skin-grafting, and 2 cystic adenomata of thyroid. The analgesia was always satisfactory and far exceeded in complete- ness and comfort all other procedures. A NEW LOCAL ANESTHETIC. Dr. G. Frank Lydston describes his method of using antipyrine as a local anaesthetic. He -has used it in a number of cases of urethrotomy. He uses a 10-per-cent. solution, which appears to be quite as efficacious as co- caine. The solution should be fresh and should be al'owed to remain in the urethra for ten minutes. He suggests the anti- pyrine solution for nose and throat work in conjunction with cocaine. It is anaesthetic and styptic, and, unlike cocaine, is not followed by vascular relaxation. He sums up the advantages of antipyrine as compared with cocaine as follows: (1) abso- lute safety, (2) freedom from constitutional effects, (3) distinct lessening of haemorrhage after operation, and (4) less- damage to nutrition of the wounded tissue. ANEURISM. B Potassii iodidi, §iss. Syrupi sarsaparillse comp., Svj. Misce. Sig. : One teaspoonful in water after meals. Band-Book of Modem Treatment. 29 I£ Gelatini, gr. xxx. Sodii chloridi, gr. cl. Aquae destillat., fgiv. Misce. Sig. : Inject two ounces of this every second day into loose tissues of back or thigh. I£ Tinct. veratri, f3ij. Tinct. opii deodorati, f3ij. Elixiris aromatici, q. s. ad f^iij. Misce. Sig.: One or two teaspoonfuls every two or three hours. IJ Tinctures veratri, 3ij. Syrupi simplicis, q. s. ad ^iss. Misce. Sig. : One teaspoonful three times a day. Indication: When heart is excitable and arterial tension high. Ifc Morphines sulphatis, gr. iv. Chloralis hydratis, 3iij. Syrupi simplicis, Sj. Aques, q. s. ad %\\. Misce. Sig. : One teaspoonful in water at bedtime. ANGINA PECTORIS. Ifc Spiritus setheris comp., 3ij. Sig. : Give twenty minims during attacks and repeat if necessary. I£ Morphines sulphatis, gr. 1 / i . Atropines sulphatis, gr. V 150 . Misce. Sig. : Inject during the attack. I£ Amylis nitratis, f3j. Sig. : Inhale two to five drops on a handker- chief. Indication: To relieve attack. 30 Hand-Book of Modern Treatment. 1} Tr. digitalis, f3j. Tr. strophanthi, m xxiv. Nitroglycerin! (10 per cent.), m xxiv. Tr. cardamomi, q. s. ad f^iij. Misce. Sig. : One teaspoonful three times a day. Indication: Useful between attacks if heart is feeble and tension high. I£ Liq. potassii arsenitis, f3iv. Sig.: One drop in water after meals and increasing till puffiness under eves or intes- tinal pain appears. 1$. Spiritus glonoini, f3j. Sig.: One drop in water every three to four hours. Indication: High arterial tension. I£ Erythrol-tetranitratis, gr. j. Alcoholis, f3j. Aquae dest., f3vij. Misce. Sig. : For one dose. Take four doses daily. R Spiritus ammonise aromatici, f'3j. Sodii bicarbonatis, gr. x. Tincturse cardamomi composita?, f3j. Spiritus chloroformi, m xx. Solutionis nitroglyeerini (1 per cent.), m j. Aquse, q. s. ad Siss. Misce et fiat haust. Sig. : To be slowly sipped on the commence- ment of symptoms. Indication : For the anginal paroxysm. The following capsule is said to be very effective in per- sistent forms of angina that recur after temporary relief has been obtained by the use of pearls of amyl nitrite. The cap- sicum favors rapid absorption ; the castor-oil seems to have a like effect : — Hand-Book of Modern Treatment. It Nitroglycerin!; gr. 7 100 . Amyl. nitrit., gr. 1 / i . Menthol., gr. 1 / 50 . Oleoresin. capsici, gr. 1 / 100 . 01. ricini, m x. Misce for one capsule. Sig. : Take when pain recurs. In the treatment of angina ordinary sweet spirit of niter has been overlooked. It is rapidly absorbed, as a rule, and in a very short time produces a marked fall in blood-pressure. To an adult a tablespoonful may be given at a dose. M. Houchard lays but little stress on the value of iodine preparations as reducers of arterial over-tension. Iodine medi- cation, however, is indicated when marked arteriosclerosis is present, in which case the resolvent action of the iodine prepara- tions is explained by phagocytosis. In the period preceding sclerosis iodine preparations, according to the author, are value- less, and in their stead the essential vasodilators should be em- ployed, such as amyl nitrite, trinitrite, or sodium nitrite. The following combination is recommended by him: — I£ Sodii nitritis, gr. iij. Potass, nitratis, gr. xv. Sodii bicarb., gr. xxx. Aquae destill., f3ij. Misce. Sig. : The entire mixture to be taken at one dose and repeated once or twice daily. R Sodii nitritis, gr. xxx. Potass, nitratis, 3iiss. Sodii bicarb., 3v. Aquae destill., f3x. Misce. , Sig. : A dessertspoonful to a tablespoonful once or twice daily in half a glass of water. Indication: High arterial tension. The advantages in the foregoing combination are, that when the sodium nitrite is combined with the potassium nitrate and then rendered alkaline with the sodium bicarbonate, the so- 32 Hand-Booh of Modern Treatment. dium nitrite becomes less noxious and is of great value in low- ering arterial tension, which remains low for some time after the preparation is discontinued. IJ Sodii chloridi, 3iiss. Sodii sulphatis, gr. xv. Calcii phosphatis, gr. vj. Magnesii phosphatis, gr. vj. Sodii carbonatis, gr. vj. Sodii phosphatis, gr. ivss. Misce. Sig.: Above dose t.i.d. Indication : Arteriosclerosis. ANOREXIA. R Tinct. nucis vomicae, 3ij. Tinct. capsici, 3ij. Tinct. cinchona?, 3ij. Tinct. gentiana?, 3ij- Misce. Sig.: One teaspoonful before each meal di- luted in water. I£ Pepsini, 3ij. Glycerini, 3ij. Acidi hydrochlorici dilute 3iv. Aqua? menthae piperita?, q. s. ad %iv. Misce. Sig. : One teaspoonful after meals. P£ Acidi hydrochlorici diluti, f-$ss. Tinct. cinchona? comp., f^vj. Misce. Sig. : Dessertspoonful after meals well di- luted in water. R Pulveris capsici, gr. x. Extracti nucis vomicae, gr. v. Takadiastase, gr. xl. Pone in capsulas no. xx. Sig. : One after each meal. Hand-Bool; of Modem Treatment. 33 IJ Acidi nitro-muriatiei diluti, m v. Tinct. nucis vomicae, m v. Tinct. columbae, m xxx. Syrupi limonis, q. s. 3j. Misce. Sig. : Take after meals. I£ Acidi nitrohydrochlorici (fresh), f3ij. Aquas dest., fgiss. Strychninae sulph., gr. j. Misce et adde Tincturae cardamomi comp., gvj. Tincturae gentian, comp., fgvj. Misce. Sig. : Dessertspoonful after meals in water. Indication: For failure of appetite, weak digestion, and general debility. IJ Pulv. capsiei, gr. xx. Quininae sulph., 3ss. Sodii bicarb., 3j. Ext. nucis vomicae, gr. iss. Misce et fiat in capsulas no. xviij. Sig. : Give one immediately after each meal, three times per day. Indication: Anorexia in old and debilitated subjects. IJ Acidi nitrohydrochlorici, 3iv. Tincturae gentianae, q. s. ad Siij- Misce. Sig. : One teaspoonful after meals, well diluted. Indication : Taken after severe illness. ANTHRAX. B Acidi carbolici, 3j. Aquae destillatae, Siiss. Misce. Sig. : Soak gauze in this and apply to abort or inject into swelling. 34 Hand-Book of Modern Treatment. Ifc Acidi carbolici, 3j. Aquae destillatae, 3x. Misce. Sig.: Inject a few drops, wash out the cavi- ties with H 2 2 , and then cover with 25 per cent, ointment of ichthyol and equal parts of lanolin and zinc oxide used as a base. I£ Hydrarg. chloridi corrosivi, gr. j. Aquse destillat., gtt. c. Misce. Sig. : Inject into and around the border of the pustule. Indication: Used in early stage to abort in- fection. APHTHAE. 1$ Potassii chloratis, gr. x. Listerine, f3ij. Aquae, q. s. ad f£j. Misce. Sig.: Shake and use freely as mouth wash. I£ Potassii iodidi, gr. iij. Glycerini, f3ij. Aquae rosae, q. s. ad f£j. Misce. Sig.: Use locally. I£ Potassii chloratis, gr. xlviij. Acidi muriat. diluti, f3j. Syrupi, %ss. Aquae, q. s. ad f^iij. Misce. Sig.: Teaspoonful diluted for a child three years old every three hours. Indication: Used in obstinate cases. I£ Potassii chloratis, gr. lxxx. Phenolis, gr. ij. Glycerini, f§j. Aquae, q. s. ad fSviij. Misce. Sig. : Thoroughly apply to ulcers twice daily and use as mouth wash. Hand-Book of Modem Treatment. 35 I£ Grlycer. boracis, f§j. Sig. : Wash mouth with warm water and then apply this with clean piece of cloth or I£ Sodii salicylate gr. x. Sodii borat., gr. x. Acidi carbolici, gr. j. Glycerini, f3ij. Aquae rosae, q. s. ad f£j. Misce. Sig. : Use locally. B Tr. myrrhae, f3v. Tr. opii camph., m lxxv. Mel. rosae, fgj. Misce. Sig. : Add to 5 ounces of barley water and use as a gargle. I£ Potassii chloratis, gr. xxx. Tinct. myrrhae m x. Elix. calisayae, f^iij. Misce. Sig. : Dilute one tablespoonful with two of water and use as mouth wash. IJ Aquae hydrogen, dioxidi, f^ij. Sig.: One teaspoonful dissolved in five of water and mouth washed freely every two or three hours. IJ Sodii hyposulph., gr. xx. Aquae destil., f3v. Glycerini, f3iij. Misce. Sig.: One teaspoonful every two hours, to be taken internally. And it should be applied locally with a camel's hair brush. IJ Argenti nitratis fusi. Sig. : Apply to the ulcers. Indication: Used in the severe forms. 36 Hand-Book of Modern Treatment. The following combination is also recommended as of great value as an antiseptic and astringent: — IJ Zinci sulph., gr. ij to v. Aquae rosae, f§ij. Misee. Sig. : Apply locally. Baginsky recommends the application of potassium perman- ganate topically in a 1 to 25 solution, and resorcin internally. IJ Alumin. et potass, sulph., 3j. Tinct. catechu, f3j. Mel. rossp, 3j. Misce. Sig.: Apply locally. IJ Potass, chloratis, gr. xlviij. Acid, hydrochlor. dil., f3j. Syrupi, f^ss. Aquae, q. s. ad f^iij- Misce. Sig.: One ounce diluted every three hours for child three years old. IJ Potassii chloratis, gr. xlviij. Listerini, f^j. Aquae hydrogen, peroxidi, f£j. Misce. Sig.: Cleanse mouth by means of soft cloth dipped in this every two or three hours. R Potassii permanganatis, gr. iij. Aquae, q. s. ad f^iij. Misce. Sig.: Use as mouth wash twice daily. IJ Acidi borici, gr. xxiv. Acidi salicylici, gr. v. Aquae, q. s. ad f£v. Misce. Sig.: Wash mouth every four hours. Hand-Book of Modern Treatment. 37 APOPLEXY. R. Olei tiglii, f3ss. Sig. : One drop in five of olive oil on tongue. Indication: Rapidly acting purge. B Potassii iodidi, 3j. Aquae, q. s. ad f§j. Misce et fiat solutio. Sig.: Three drops in water or milk and in- creased each day until ten or fifteen are given. 3 Elaterini, gr. v. Alcoholis, fgiv. Dissolved by gentle heat. Misce. Sig. : One teaspoonful as dose and as indi- cated. I£ Strychninse sulphatis, gr. j. Sacchari lactis, q. s. Alcoholis, q. s. Misce. et fiant tabellse triturationes no. xxx. Sig. : One tablet three times a day and in- creased to four or five times daily. R. Tincturse aconiti, f3j. Sig. : Used as indicated to lower blood- pressure. IJ Triturationes elaterini, gr. lij. Hydrargyri chloridi mitis, gr. xij. Misce et fiant chartulae no. vj. Sig.: One powder every hour until four are taken. B Potassii iodidi, 3vj. Syr. sarsap. co., q. s. ad f^iij. Misce. Sig.: Forty drops every three hours. Indication: To absorb clot. B Liq. potassii arsenit., f'3j. Syr. calcii lactophos., q. s. ad f§iij. Misce. Sig. : Two teaspoonfuls three times a day. 38 Hand-Book of Modern Treatment. APPENDICITIS. I£ Magnesii sulphatis, §j. Sig.: Give at one dose and repeat after a time if no result. Indication: To unload the bowels if opera- tion is refused. Ieebag over painful area. Liquid diet. 1$ Olei ricini, f§j. Sig. : Take in one dose and repeat if neces- sary. Indication: Same as the preceding. IJ Acidi hydrochlor. diluti, f3iv. Aquse, q. s. ad f^iij- Misce. Sig. : One teaspoonful after each meal. Indication: To aid digestion. Rest in bed. Ieebag on abdomen, liquid diet, enema of soap water or oil, each day, in non-operative treat- ment. I£ Opii deodorata, gr. xx. Fiant pilulse no. xx. Sig.: One pill every four hours to relieve pains. Indication: Used in those refusing opera- tion and non-operative cases. I£ Magnesii sulphatis, Siij- Sig. : One tablespoonful in tepid water every three hours until bowels thoroughly moved. An ieebag may be applied over the appendix to reduce inflammation, similarly to the treat- ment of ovaritis. Care must be exercised that the cold is not too continuously prolonged, as necrosis and sloughing may occur. The medical treatment requires constant care and is not a very safe procedure. TURPENTINE-OIL IN" INFLAMMATION OF THE APPENDIX. Mayer, having used turpentine-oil with much success in a case of empyema, and believing that it possesses an antiphlo- gistic and absorbing quality, has employed it in cases of in- Hand-Book of Modern Treatment. 39 flarnmation of the appendix. He uses it in doses of several drops three or four times a day, given either in an emulsion with the yelk of eggs or in mixtures with brandy, sugar, tincture of cinnamon, or other substances. It has certain disadvantages, particularly the production of strangury, or, in cases of infiltra- tion of the lung, having a tendency to cause pulmonary haemor- rhage. Its advantages are that it diminishes the pain, causes the exudate to appear early, and probably stimulates tire organ- ism to remove the cause of irritation. The histories of twelve cases are appended. ARTHRITIS.— See Rheumatism. ASOARIDES (ROUND WORMS). IJ Olei chenop. anthel., 3j. Fluidextracti spigelian et sennse, 3ss. Santonini, gr. viij. Pulv. acacise, 3j. Syr. rhei arom., gj. Misce. Sig. : Shake and take one teaspoonful an hour before each meal. After the last dose the following should be taken: — B Olei terebinthinae, gtt. x. Olei ricini, §ss. Misce. Sig. : To be taken at one dose. To children four or five years of age the following combina- tions are of service in the removal of roundworms: — B Fluidextracti spigeliae, §ss. Fluidextracti sennse, Sss. Syr. simplicis, Sss. Misce. Sig. : One teaspoonful night and morning. I£ Fluidextracti spigeliae, §ss. Santonini, gr. v. Fluidextracti sennse, Sss- Misce. Sig. : One teaspoonful twice a day. 40 Hand-Book of Modern Treatment. The following combinations are sometimes recommended in the form of an enema in the treatment of ascarides: — IJ Olei cajuputi, roxx. Magnesise levis, gr. x. Mucilaginis, 3iv. Mi see. Sig. : At one dose in the form of enema. IJ Liquor calcis, %iv. Decoct, althseae, §j. Misce. Sig. : As an enema. The roundworm, or ascaris lubricoides, inhabiting as it does chiefly the small intestine, requires more especially internal treatment for its destruction and dislodgment. Santonin is regarded as the best preparation. It may be given in powder form as follows: — 1$ Santonin, gr. ij. Hydrarg. chloridi mitis, gr. j. Saccli. lactis, q. s. Misce. Sig. : At one dose at bedtime or in solution according to Yeo, as follows: — IJ Santonin, gr. vj. 01. ricini, 3iv. Syr. aurantii, 3iij. Mucil. acacise, 3vj. Aq. carui, q. s. ad gvj. Misce. Sig. : Take one-half of the amount in the morning while fasting. The oil of chenopodium was formerly used a great deal. It may be given in a mixture similar to the following: — IJ 01. chenopodii, m viij. 01. ricini, 3ss. Mucil. acacise, 3iij. Misce. Sig.: One teaspoonful three times a day be- fore meals. Hand-Boole of Modern Treatment. 41 ASCITES.— See Dropsy. ASTHENIA. I£ Tinct. nueis vomicae, 3v. Elixiris calisayas, q. s. ad 3vj. Misce. Sig. : One teaspoonful before meals. Indication: Useful in asthenia with loss of appetite. I£ Strychnines sulphatis, gr. j. Acidi hydrochlor. diluti, 3iv. Infus. gentianas comp., q. s. ad Sviij. Misce. Sig. : One teaspoonful diluted three times daily. I£ Liq. arsenici chloridi., 3iss. Tinct. ferri chloridi, gj- Hydrarg. chloridi corrosivi, gr. j» Acidi hydrochlor. diluti, 3ss. Aquae, q. s. ad §iv. Misce. Sig. : One teaspoonful diluted three times daily. B Strychninse sulphatis, gr. j. Acidi phosphorici diluti, §ij. Aquae, q. s. ad giv. Misce. Sig. : One teaspoonful diluted three times daily. B Elixiris ferri, quinines et strychnines phos- phorici, ^vj. Sig. : One teaspoonful diluted three times daily after meals. I£ Elixiris phosphori, fgv. Sig. : One teaspoonful in water after meals. 42 Hand-Book of Modem Treatment. I£ Quininae sulphatis, gr. xlviij. Acidi hydrochlorici diluti, 3ij. Aquae, q. s. ad 5iv. Misce. Sig. : One teaspoonful in water after meals. Indication: Used in anaemia. IJ Tinct. nucis vomicae, 3ij. Tinct. gentianae comp., q. s. ad %i\. Misce. Sig.: One teaspoonful three times a day. Ifc Strychninae sulphatis, gr. j. Acidi phosphorici diluti, Bij- Aquae, q. s. ad %\. Misce. Sig. : One teaspoonful in water three times a day. Use with care. ASTHMA. I£ Potassii iodidi, 3ij. Liq. ammon. anisati, 3j. Tinct. opii camphoratae, 3ij. Syrupi tolu, 3iv. Aquae, q. s. ad 5iij- Misce. Sig.: Teaspoonful in water every two or three hours. Indication: Useful in an acute attack. Ifc Potassi iodidi, 3ij. Morphinae sulphatis, gr. j. Tinct. belladonnas, 3iss. Liq. ammon. anisati, 3iss. Syrupi tolu, q. s. ad gij. Misce. Sig.: A teaspoonful in water every two or three hours. Indication: Useful in acute attacks. Hand-Book of Modern Treatment. 43 IJ Pulveris potassii nitratis, 3j. Pulveris stramonii, 3ij. Pulveris lobeliae, 3ij. Pulveris belladonnae, 3ij. Pulveris grindeliae, 3ij. Pulveris hydrastis canadensis, 3j. Misce. Sig. : A teaspoonful of this is to be burned under an improvised tent. Inhale for ten to twenty minutes or until relieved. I£ Chloroformi, 3j. Morphinae sulphatis, gr. j. Pulv. gummi arabici, 3j. Syrupi simplicis, 3iv. Aquae, q. s. ad £iv. Misce. Sig. : A teaspoonful every hour. Indication: When the dyspnoea is urgent this is very helpful. B Ammonii iodidi, 3iss. Ext. grindeliae robustae, f3vi. Tinct. lobeliae, 3iij. Tinct. belladonnae, 3iiss. Extracti glycyrrhizae, f^ij. Syrupi tolutani, q. s. ad %iv. Misce. Sig. : One teaspoonful in water three or four times daily. BRONCHIAL ASTHMA. In considering the treatment of bronchial asthma, the Practitioner calls attention to the importance of distinguish- ing it from the other forms of asthma, such as cardiac, renal asthma, hay asthma, thymic asthma, or laryngismus stridulus due to enlargement of the thymus gland. During the attack a little chloroform should be inhaled to produce rapid relaxation of the bronchial muscles. A powder consisting of pulverized belladonna, stramonium, and hyoscya- mus leaves with some potassium nitrate, burnt and the fumes inhaled, will often bring relief. An inhalation of from 3 to 5 44 Hand-Book of Modem Treatment. minims of the nitrite of amyl from a crushed capsule frequently relieves the paroxysm. Between the attacks the following com- binations, containing potassium iodide, are recommended: — f£ Potassii iodidi, gr. x. Tinct. lobeliae, f3ss. Vini ipecacuanha, m xij. Aquae chloroformi, q. s. ad f§j. Misce et fiat mistura. Sig. : Two tablespoonfuls three times a day- after food. R Potassii iodidi, gr. xij. Ext. stramonii, gr. W Spts. chloroformi, m xx. Spts. amnion, arom., m xx. Aquae, q. s. ad f^ss. Misce. Sig. : To be taken at one dose on retiring at night. Whiskey and a few minims of the spirits of chloroform often relax the bronchioles and check an oncoming attack. Combinations containing lobelia and also stramonium are recommended by some authors : — IJ Tinct. lobeliae, f3j. Tinct. belladonna, f3j. Tjnct. aconiti, m xx. Aquae cinnamomi, q. s. ad fSiij- Misce, Sig.: One tablespoonful every three or four hours until relieved. I£ Tinct. stramomi, f3iv. Tinct. aconiti, f3ij. Potassii bromidi, Sj. Aquae chloroformi, q. s. ad f^iij- Misce. Sig.: One teaspoonful in water at the be- ginning of the attack. Hand-Book of Modern Treatment. 45 SPASMODIC ASTHMA. I£ Potassii iodidi, 3iiss. Fid. ext. grindelise robustae, 3j. Syrupi asafcetidae, §j. Misce. Sig. : One teaspoonful every three hours. Syrup of lemon or orange peel with saccharin may be added to mask the taste. I£ Potassii nitratis, ^ss. Pulv. anisi fruct., 3ss. Pulv. stramonii fol., §j. Misce et fiat pulv. Sig.: Let patient inhale smoke of a thimble- ful of this powder, formed into a cone and lighted at the top. T}, Potassii nitratis, 3ss. Pulv. stramonii flor., gj. Pulv. anisi fruct., 3ij. Pulv. 1 obelise inflatse, 3j. Pulv. fol. these sinemsis nig., 3j. 01. eucalypti, m xv. Misce et fiat pulv. Sig. : To be burned as above, using a thim- bleful at a time. A good asthma powder for emergency use is one part by weight, of saltpetre and two parts of black tea, powdered. ASTHMA AND ADRENALIN. According to M. Aronsohn, the painting of the mucous membrane of the nose with a solution of adrenalin (1-1000) arrests an attack of asthma in a very few minutes. It does not cure asthma, but aifords rapid relief. If it were not possible to employ the solution, the following ointment might be sub- stituted : — R Sol. adrenalini, m xx-lx. Lanolini, 3j. Vaselini, oj. Misce. Sig.: About the size of a pea is introduced into the nostrils. • 46 Hand-Booh of Modem Treatment. IJ Potassi iodidi, 3j. Tr. phytolaccse, 3ij. Tr. belladonnas, 3ij. Tr. sanguinarise, 3j. Aquae, q. s. ad §ij. Mi see. Sig. : Half-teaspoonful every two hours until eased, then teaspoonful three times a day. In the humid variety, nitrate of sanguinaria, 1 / 50 grain, every two hours, will be found of benefit. In chorea, fluid extract of Scutellaria and cimicifuga, with bromide of soda, forms one of the best modes of treatment. CARDIAC ASTHMA. Osier advises comfortable bed rest; tapping for hydro- thorax; morphine for nocturnal dyspnoea with restlessness; nitroglycerine in increasing doses in mitral valvular disease without dropsy and with high pulse tension. A. H. Smith gives fluid extract of quebracho, wxx-xl t. i. d. In mitral insufficiency von Basch emphasizes the utility of light exercise adapted to the individual case; suitable diet; regular secretions and excre- tions ; digitalis and atropine. For the dyspnoea of mitral sten- osis Thomson recommends belladonna with compound spirit of ether. I£ Tinct. phytolaccse, §ss. Potass, iodidi, 3j. Syrupus simplici, §ij. Misce. * Sig. : One teaspoonful after meals and at bedtime. This will cure a large number of cases, but, as each is a law unto itself, it must be carefully studied, and, as the differ- ent symptoms come up, they must be treated. By so doing we can treat a large percentage of asthmatics with success. Exercise, gymnastics, walking, and bicycle. In the attack paint the nostrils at once with a 1 to 20 solution of cocaine hydrochlorate. Take a hot mustard foot-bath, with the hands 'Hand-Book of Modem Treatment. 47 placed in very hot water. Smoke cigarettes "Epsic" or nitre- paper in a pipe, or burn the following mixture in a saucer : — IJ Potass, nitrat., gr. xlv. Pulv. fol. daturae, Zi 1 /^. Pulv. fol. belladonna, Zi 1 /^. Pulv. gelsemini, 3i^4. IODINE AND ARSENIC IN THE ASTHMA OF CHILDREN. Lemonnyer, following Comby, recommends as a prophylac- tic treatment between the crises, potassium iodide and arsenic in alteration: — I£ Potassii iodidi, gr. lxxv. Aquae dest., ^iiiss. Misce. Sig. : A teaspoonful morning and evening in a little water. When this mixture is finished it is to be followed by : — I£ Sodii arsenatis, gr. V 3 . Aquas dest., Siiiss. Misce. Sig. : A teaspoonful morning and evening. After this a suspension for ten days is recom- mended, and then the treatment is to be re- newed. For treatment during the crises, besides the usual drugs, a careful use of morphine, fumigations of belladonna, hyoscya- mus, stramonium, internal use of lobelia inflata or grindelia robusta, the author finds inhalations of pyridine (a handkerchief, upon which a few drops have been poured, suspended from the child's throat) of great use. Powdered ipecac in a nauseating dose may abort the attack and arrest the spasm. I£ Codeini sulph., gr. iij. Fluidextracti grindelia^, 3iij. Syr. pruni serotinae, 3"j- Misce. Sig. : A teaspoonful four times a day, and during the night if awake more than an hour at a time. 48 Band-Book of Modern Treatment. PASSIFLORA INCARNATA IN ASTHMA. From the department "Treatment of the Sick" in American Medicine, edited by Dr. Solomon Solis-Cohen, we extract the fol- lowing : — "Passion-flower (Passiflora incarnata) is not official in the United States Pharmacopoeia, and does not appear to have been well studied experimentally. Clinically it possesses hypnotic and antispasmodic powers, and in sufficient dosage it would prob- ably act as a narcotic poison. Even in moderate doses it may in some cases provoke nausea and emesis. The emetic properties may depend upon a different principle from that to which its sedative action is due. At all events, the combination of relax- ant influences gives it a peculiar value in allaying asthmatic paroxysms and in preventing their full development. It may be given in tincture or fluid extract. The dose is from 10 to 30 minims well diluted and given from every ten minutes to every half -hour until relief is experienced, emesis caused, or drowsiness induced. We have never exceeded 1 / 2 fluidounce of the fluid extract in the course of two hours. Patients have fallen asleep after six doses of 10 to 20 drops each, given every ten or fifteen minutes, or after a single dose of 1 fluidrachm. In 2 out of 8 cases its use produced but slight mitigation of dis- tress and was abandoned. In 6 cases rebellious to other methods it gave prompt relief. Ifc Potassii iodidi, gr. xlviij. Sodii bromidi, gr. xlviij. Euphorbia piluliferae, gr. Ixxij. Spiritus glycerylis nitratis, gr. 6 / 25 . Tinct. lobeliae, m xlviij. Misce et fiant pilulse no. xxiv. Sig. : One pill every three hours. Ifc Sodii arsenatis, gr. iv. Pulv. eucalypti foliorum, %]. Pulv. stramonii foliorum, §j. Pulv. hyosciami foliorum, £j. Potassii nitratis, 3j. Misce. Sig. : Burn a half teaspoonful and inhale the fumes. Hand-Book of Modern Treatment. 49 $ Chloralis hydratis, 3iij. Sodii nitritis, 3ss. Tinct. s'tramonii, 3j. Syrupi glycyrrhizse, q. s. ad Bij- Misce. Sig. : One teaspoonful every four hours. I£ Hyoscinae hydrobromatis, gr. x / 8 . Morphinae sulphatis, gr. %. Sodii bromidi, 3vj. Liq. potassii arsenitis, 3ij. Tinct. digitalis, 3iv. Infus. gentianse comp., q. s. ad 3vj. Misce. Sig.: Dessertspoonful in water every three hours. I£ Pulv. stramonii, 3vj. Pulv. belladonnas fol., 3vj. Pulv. potassii nitrat., 3ss. Pulv. opii, gr. xv. Misce. Sig. : To be used in the form of a fumiga- tion. Internally the iodides are of great service in chronic asthma, given as follows, according to Fothergill's formula: — ffc Amnion, iodidi, 3iss. Ammon. bromidi 3ij. Syr. tolutani, 5ij. Tinct. lobelias, §iij. Misce. Sig. : One teaspoonful in water three or four times a day. IJ Acidi oxalici, gr. xxx. Sodii bicarb., gr. xlviij. Syr. aurantii, §ij. Misce. Sig. : One tablespoonful every hour. Indication: Used in treatment of asthma and capillary bronchitis. 4 50 Hand-Book of Modern Treatment. IJ Potassii iodidi, 3ij. Tr. belladonna? foliorurn, f3ij. Aquse, q. s. ad fgiij. Misce. Sig. : One teaspoonful with tablespoonful of essence of pepsin in water, every three hours, until permanent relief. Indication: Used in bronchial asthma. Ifc Tr. gelsemii, Bj- Tr. lobelise, gj. Potassii bromidi, $ss. Misce. Sig. : Twenty drops in water every three hours. I£ Potassii iodidi, gr. ij. Sodii bromidi, gr. ij. Euphorbise piluliferae, m iij. Spiritus glycerylis nitratis, gr. l / 200 . Tinet. lobeliae, m ij. Misce. Sig.: One such every three hours. I£ Tinct. digitalis, f3j. Tinct. strophanthi, m xxiv. Spiritus glycerylis nitratis, m xxv. Tinct. cardamomi, q. s. ad fSiij- Misce. Sig. : Teaspoonful three times daily. Indication: Very useful in period between attacks. BACKACHE. I£ Olei camphoratis chamomile, 3v. Olei hyosciami, 3v. Extracti belladonnas, gr. xv. Extracti A. cannabini, gr. xv. Extracti opii, gr. xv. Mentholis, gr. xxx. Chloroformi, gr. Ixxv. Misce. Sig. : This is to be lightly rubbed in and flannel impregnated with the liniment bound upon the part. Indication: Backache 01 neurasthenics. Hand-Book of Modern Treatment. 51 Writing of the differential diagnosis between muscular rheumatism and sprained back, Dr. J. Schneck states that in the former the pain is often one-sided, in the latter usually two- sided ; and in the latter fever is present, as a rule ; in the former rarely. BATHS. THE BRAND METHOD. This standard for treating typhoid fever consists essenti- ally in cold baths (65° to 70° F.), with friction through sheet, and stimulants, if necessary, whenever the temperature is 102 1 / 2 ° F. or higher. Water should be poured over the head to lessen shock on entering the bath. The patient is taken out in fifteen or twenty minutes, wrapped in a dry sheet, and cov- ered with a light blanket. These baths are contraindicated only in peritonitis or intestinal haemorrhage. It is not necessary to renew the water more than once in twenty-four hours. BATHS FOR INFANTS. Dr. A. Jacobi teaches that, while during the early days of an infant a cold or even cool bath should not be given, yet after a few months, and by carefully graduating down the tem- perature of the water, a cool or cold bath can, and should be used for infants, especially during the hot season. He believes that cold bathing promotes a very strong and healthy resistance to diseases, especially the enervating diseases of hot weather. RULES FOR BATHING. Cold baths should never be taken when the body is fatigued, even during the summer. A warm or hot bath will always re- lieve fatigue, or muscular or nervous irritability and restless- ness. Baths of any kind should not be taken within two hours after finishing a meal, and a meal should not be taken within one hour after a bath. In the latter case, it takes an hour at least for the complete reaction to take place and the circulation to become evenly distributed again. Bathing too soon after eat- ing interferes with the digestive processes. 52 Hand-Book of Modern Treatment. SCIENTIFIC BATHING. Bathing affects the nervous and circulatory systems of the skin. Hot baths cause vasomotor dilatation in the skin, with relative withdrawal of blood from internal organs. After the bath this process gradually becomes reversed. This assists the assimilation of food, causes the ingestion of more food, and in- creases the body-weight, when regularly repeated over a long period of time. Cold bathS) with active exercise, cause peri- pheral vasomotor constriction, followed by a gradual dilatation. Exercise has a similar but localized effect. Baths are of most benefit in the infectious diseases for reducing temperature and overcoming nervous symptoms. They are also indicated for chronic inflammatory changes, circulatory disturbances, venous stasis, etc. TEMPERATURE OF THE BATH. Friedrich Grosse believes that much confusion has arisen through a too loose use of terms. A warm bath, which is seda- tive in action, is a bath the temperature of which ranges between 98° and 100° F. A hot bath, which is stimulating in action, is a bath with a temperature ranging between 107° and 113° F. The full hot bath, he says, gives good results in a large class of diseases. As a rule, it should not be employed when pus is present or when there is a lesion of the central nervous system. The action of the hot bath is based upon : (1) a powerful stim- ulation of the entire nervous system for a brief period; (2) an intense revulsion of circulation, leading to hyperemia of the skin and anaemia of inner organs; (3) a perspiration more abundant than after any other form of bath; (4) a raising of metabolism; and (5) the creation of leucocytosis. CLASSIFICATION OF BATHS ACCORDING TO TEMPERATURE. While a classification of baths according to temperature must necessarily be more or less arbitrary, the following classi- fication is a very convenient and practical one: — Hand-Book of Modern Treatment. 53 Very cold 32° F. to 55° F. Cold 55° F. to 65° F. Cool 65° F. to 80° F. Tepid . 80° F. to 92° F. Warm (or neutral, 92° to 95°) 92° F. to 98° F. Hot 98° F. to 104° F. Very hot 104° F. and above. ARTIFICIAL SEA BATH. IJ Sea salis, 3viij. Sodii sulphatis, 3iiiss. Calcii chloridi, 3vij. Magnesii chloridi, 3iij. Aquae, q. s. ad Oviij. Misce. BED-SORES. TO PREVENT BED-SORES. B Alumin., 3ss. Sodii chloridi, §ss. Aquae, 1 pint. Alcoholis, 1 pint. Misce. Sig. : Use twice a day locally. Ijc Zinci sulphatis, gr. xlv. Plumbi acetatis, gr. xxx. Tinct. myrrh®, mxx. Petrolati, q. s. ad Sij- Misce. Sig. : Use twice a day locally. ]$ Argenti nitratis, 3j. Aquae destillatae, §iv. Misce. Sig. : Apply to red and tender spots. Indication: To be applied over red, sore spots. Ifc Tinct. ferri chloridi, 3ij- Sig. : Fifteen minims every four hours. Indication : Suppository if ulcers slough and are large. 54 Hand-Booh of Modern Treatment. NEW REMEDY FOR BED-SORES. Dr. Strater recommends the application to the injured area of a piece of felt, ten centimeters long and twelve centimeters broad, with an opening about four centimeters in diameter. The upper surface is supplied with some adhesive material so that it shall stick well to the skin, and not become loosened with the movements of the patient, while protecting the bed-sore from every pain and pressure. In from five to six days, without any other medication, the dried crust falls off, leaving normal skin beneath. The method has proved of excellent service in several cases that the author reports, without any disadvantages. BILE-PIGMENT. Presslich says that he has found a method which, for prac- tical purposes at least, presents many advantages over the test for bile in the urine usually employed. It consists simply in adding to the suspected urine a few drops of foaming nitric acid, and stirring. In the presence of bile-pigment a well marked green color is produced. Comparison with Gmelin's and Eosin's tests showed that the author's method yields more satisfactory results. It does not react to urobilin, nor to the substances oc- curring in the urine of patients who have been taking rhubarb, salol, aspirin, sodium salicylate, or antipyrine. The simplicity of the test, the ease of performance, and the fact that large quan- tities of urine may be turned green by the use of 15 to 20 drops of the acid, so that the color is easily recognizable, renders it a useful method for everyday use. BILIOUSNESS. IJ Tinct. euonymi (Lloyd's), 3j. Tinet. chionanthi, £ss. Tinct. dioscorese, 3ss. Misce. Sig. : Fifteen to sixty minims every three or four hours until bowels act well. Ifc Ammonii chloridi, 3ss. Fiant chartulse no. xlviij. Sig. : Give five grains three times a day. Indication: Biliousness associated with ca- tarrh of stomach, intestines, or bile-ducts. Hand-Book of Modern Treatment. 55 Ifc Resinse phodophylli, gr. j. Sacchari lactis, gr. x. Misce et fiant chartulae no. x. Sig. : One powder morning and evening. Indication: To relieve constipation. 1$. Hydrargyri chloridi mitis, gr. j. Sodii carbonatis, gr. xx. Misce et fiant chartulae no. vj. Sig. : One every fifteen minutes, followed in four hours with saline. Indication: When constipation, slight drow- siness or languor after meal is present. 1$, Podophyllin, gr. v. Euonymi, gr. ix. Leptandrini, gr. ix. Ext. chiratae, gr. xlv. Creosoti, gr. xj. Misce et fiant pilulae no. xxv. Sig. : One pill each night. BITES AND STINGS OF INSECTS. TO GUARD AGAINST THE BITE OF THE MOSQUITO. Mcintosh recommends an application which he has used for some years when out fishing or hunting in the swamps where mosquitoes are prevalent, and in the evenings when sitting out- of-doors, and which he has found to be most excellent and effi- cient; it is the oil of citronella (oil of verbena, Indian melissa- oil). It has a very pleasant odor, and is not expensive. The oil should be rubbed into the exposed parts and repeated occa- sionally, or the following is quite as efficient: — B Olei citronellae, 3ij. Alcoholis, 3ij. Misce. Sig. : Apply freely to face, neck, hands, and ankles to prevent mosquito biting. 56 Hand-Book of Modem Treatment. IJ Spiritus aetheris nitrosi, 3j. Infusi digitalis, 3j. Spiritus vini gallici, 3j. Misce. Sig. : One to two teaspoonf uls in water every two or three hours. Indication : Bites and stings of insects. IJ Aquae ammoniae, f3j. Aquae, q. s. ad f§v. Misce. Sig. : Inject into vein. Indication: To be employed in urgent cases of snake-bite. 1$. Potassii permanganatis, gr. xx. Aquae destillatae, f^iiss. Misce. Sig. : Inject into wound and around it freely. Indication: Snake-bite, and give whisky also to overcome depressing effect. BITING THE FINGER-NAILS. Generally, individuals who are addicted to this habit show symptoms of degeneracy. They present undergrowth, are slow, drowsy, unreliable, and have defective teeth. The treatment of onychophazia is indicated and requires careful observation on the part of parents and physicians ; in many individuals paint- ing the finger-nails and the tissues around them with tincture of quassia has brought good results. The extremely bitter taste of quassia prevents the child from putting the finger in the mouth, and in many instances we know a cure to have been effected. BLADDER AFFECTIONS.— See Cystitis. Ifc Acidi benzoici, 3iv. Boracis, 3iv. Alcoholis, 3iv. Tinct. hyosciami, 3ij. Syrupi pruni virginianae, %\]. Syrupi aurantii cortici, §iss. Aquae destillatae, q. s. ad 3vj. Misce. Sig. : A dessertspoonful every four hours, followed by a glass of water. Indication: Irritable bladder. Hand-Book of Modern Treatment. 57 B Salolis, 3ij. Tinct. hyosciami, 3ij. Infusi buchu, q. s. ad 3vj. Misce. Sig. : Tablespoonful three times a day. Indication: Irritable bladder after confine- ment. METHOD TO EMPTY THE BLADDER. To empty the bladder when partially paralyzed from par- turition or any other cause, throw a large amount of very warm water into the bowel, thereby doing away with the necessity of using a catheter; and the bowel and bladder will empty them- selves at the same time. BLADDER IN ALCOHOLIC COMA. In alcoholic coma always investigate the bladder. It is apt to be very full. If there is no stricture the urine would drain itself out after awhile, but if prostatic or other stricture should exist, a rupture of the bladder might take place. TO PREVENT RECURRENCE OF STONES IN THE BLADDER. Guyon writes that the task of the surgeon in case of stone in the bladder is far from being restricted to the mere removal of the stone. The accompanying cystitis must be cured and the recurrence of stones prevented. Experience has demonstrated that the presence of calculi is no obstacle to the attenuation, and even cure of a cystitis, if it is secondary ; also, that the removal of the stones does not necessarily cure it. Local treatment •is imperative both before and after the operation, especially when the cystitis is old and severe. Instillations are usually all that can be borne at first, followed by fractioned irrigations as soon as possible. Some cases allow the irrigations to be com- menced from the start, followed by instillations. Calculi do not contraindicate a permanent sound. If the bladder is painful or hemorrhagic, it may be necessary to evacuate the organ without leaving it empty, replacing each portion of urine withdrawn by the same amount of a tepid solution of boric acid. This topical treatment may relieve without anodynes, but sometimes 58 Hand-Book of Modern Treatment. a suppository or injection of an opium or antipyrine solution may be necessary. This treatment of the cystitis may require one or two weeks, the criteria being the number of micturitions, the capacity of. the bladder, and the acidity of the urine. The urine becomes less infectious, and it is possible to avoid febrile accidents. Silver nitrate is the best of all measures. It seems to have an elective action on pyogenic bacteria and on the urobacillus liquefaciens, and is especially active when the urine ceases to be acid. Silver nitrate restores normal acidity to the urine, and this is the most certain means to prevent the recurrence of sec- ondary calculi. Mineral substances become insoluble in an ab- normal urine. Patients operated on should be cautioned not to neglect to test the reaction of their urine frequently with litmus- paper, and resume the silver nitrate if the acidity is diminishing, and continue it until the urine turns the litmus-paper red. This opposes a chemical barrier to the causes of the precipitation of the phosphates. General hygienic measures are of great im- portance, avoiding alcohol and rich food, alkaline water, and the tartrates of lime and magnesia, and a diet too abundant in vege- tables. The patients should return once a week for repeated verification and successive evacuations. BLEPHARITIS. I£ Aeidi salicylici, gr. v. Unguenti hydrargyri oxidi flavi, 3j. Unguenti aquae rosse, 3iij. Mi see. Sig. : Apply locally. Indication: Blepharitis of children. FOR SQUAMOUS BLEPHARITIS. This occurs in connection with seborrhcea of the scalp, and gives rise to small crusts at the ciliary border of the eyelid. A sulphur ointment serves as the most effective means of cure, but is apt to cause a burning sensation and lacrymation by en- tering the conjunctival sac. Terrien advises, therefore, a weak preparation, such as the following: — Hand-Book of Modern Treatment. 59 R Sulphuris precip., gr. iij. Vaselini pur., 3v. Misce et fiat # unguentum. Sig. : External use. R Sodii boratis, gr. 'xv. Aquae destillatae, f5ij. Misce. Sig. : Apply freely to margin of lids. Indication: To remove crusts and scales. R Acidi borici, 3j. Aquas destillatae, %\]. Misce. Sig.: Wash out eye every three or four hours. BLEPHAROSPASM. R Hyosciami, gr. j. Aquae destillatae, 3iv. Misce. Sig.: Four drops three times daily. BOILS.— See Abscess. ABORTIVE TREATMENT OF BOILS. Gallois advises for this purpose that the boil be painted with a concentrated solution of iodine in acetone. This sol- vent takes up four times as much iodine as alcohol, and its use on a boil is followed by the formation of a brown scab, under which the inflammation subsides. The solution should be kept for some weeks before it is used. TO TREAT BOILS. Much relief from boils has been derived from an ointment containing 5 or 10 grains of carbolic acid, 1 or 2 drachms of fluid extract Of ergot, 2 drachms each of powdered starch and zinc oxide, and 8 drachms of rose-water ointment. The mixture is spread on a moderately thick layer of absorbent cotton, which is held in place by strips of plaster at the sides of the boil. 60 Hand-Book of Modern Treatment. NOVEL METHOD OF TREATING BOILS. W. K. Smith employs the following method in the treat- ment of boils and thinks it greatly superior to poultices, the ma- jority of local applications, and internal medication. He takes a piece of soft linen or borated gauze, rub's some vaseline upon one side of it, quickly pours on it some chloroform, applies it to the unopened boil or carbuncle, and places a bandage over all. It smarts a little at first, but this is soon succeeded by a pleasing, cool sensation. The patient is given a bottle of the remedy and directed to change the cloth often. In from two hours to one day the boil (no matter how indurated) softens and opens. The advantages claimed for this method are : ( 1 ) the pain is relieved from the first, (2) a painless opening, (3) it avoids shocking the patient, (4) it heals more rapidly than after any other method yet used, and (5) it makes a patient who fears a knife the doctor's everlasting friend. TO ABORT BOILS. Dr. Ochme covers the affected area freely with collodion, containing from a / 2 to 2 grains of salicylic acid to- the drachm. This application is repeated two or three times in twelve hours. Another abortive method which is used with almost mirac- ulous results is the application of electricity to the area, after painting freely with colorless tincture of iodine. This is par- ticularly desirable where abscess-formations are present on the face. Ifc Iodoformi, gr. v. Salol, gr. viij. Acidi carbol., gr. iss. Spt. setheris, 3ss. Spt. vini rect., 3iss. Misce. Sig. : Ten drops to be injected into the dis- eased tissue. Inject the following directly into the boil: — B Metallic iodi, 3j. Acetoni, 3iiss. Misce. Sig.: Paint boil once daily. Repeat in twenty-four hours if required. Hand-Book of Modern Treatment. 61 Ifc Ichthyolis, 3j. Emplast. plumbi, 3ij. Emplast. resinae, 3ij. Misce. Sig. : Apply to part. BRIGHT 'S DISEASE.— See Nephritis. BROMIDROSIS. IJ Formaldehydi (40-per-cent. sol.), 3ij. Adipis lanae hydrosi, gj. Misce et fiat unguentum. Sig.: Apply twice daily. Indication: Used in bromidrosis of feet and axillae. FORMALDEHYDE SOLUTION IN SWEATING FEET. Bromidrosis and hyperidrosis of the feet can be more quickly relieved and cured by a solution of formaldehyde than by any other remedy. The use of the drug combined in a powder is not as beneficial as when strong solutions are applied. Formaldehyde, 40 per cent., applied pure, is the most effective, but mixed with water, one part to five, and applied at bedtime for a week, will cure some of the most obstinate cases. Three applications of the pure solution are about as effective as seven of the dilute solution, but it is much more painful. Between the toes and on the top of the feet should not be painted as often as the soles and heels. The odor disappears almost at once, and the trouble rarely recurs.* IJ Pulveris talci, §iss. Bismuthi subnitratis, ""iss. Potassii permangan., gr. %. Sodii salicylatis, gr. xxx. Misce. Sig. : Apply over feet and between toes. I£ Formaldehydi (40 per cent, sol.), 3j. Acidi salicylatis, 3j. Pulveris talci, giv. Misce. Sig.: Sift into the stocking each morning 62 Hand-Book of Modern Treatment. This seems to harden and toughen the skin, and is useful whenever the feet are tender from any cause. BRONCHITIS. IJ Ammonii carb., 3ss. Tr. hyosciami, 3iv. Codeinae sulph., gr. ij. Syrupi pruni virginianae, 3ij. Aquae camphorae, q. s. ad §ij. Misce. Sig. : One teaspoonful every two hours. Indication: Used in early stage and unpro- ductive cough. Bronchitis frequently begins with an acute cold in the head, coryza, and perhaps pharyngitis, with symptoms of general malaise, fever, and muscular pain. There are also cases with laryngitis rapidly extending to the bronchi and others begin- ning primarily in the bronchi. In the first class, if there is much headache and frontal pain, the following is recommended : IJ Camphorae, gr. j. Ext. belladonnse, gr. i-iss. Quininae sulph., gr. i-ij. Morph. sulph., gr. 1 / 40 . Misce et fiat capsula no. j. Sig.: One such capsule every half-hour for four doses. Then one every three hours. IJ Olei picis liq., m xv. Fluidextracti marrubii (horehound), 3ss. Olei anisi, m j. Spts. frumenti, gj. Mellis despumati, q. s. ad Sij. Misce. Sig.: One-half to one teaspoonful three or four times a day. IJ Vini antimon., 3iv. Spir. chloroformi, 3iv. Spir. amnion, arom., §i. Liq. ammon. acet., §ij. Aquae, q. s. ad Bviij. Misce. Sig.: One tablespoonful every hour. Indication: Capillary bronchitis. Hand- Book of Modern Treatment. 63 R. Ammon. carb., gr. iij. Pot. iodidi, gr. iij. Sol. ammon. acetat., 3ij. Aquae camphorae, §j. Misce. Sig. : The entire amount to be taken once in four hours. Indication: Used in acute stage of the dis- ease. In aged individuals there is frequently a tendency to heart-failure, so that alcohol or strychnine may be in demand, or the following mixture may be of service in such cases : — Ifc Spts. aetheris sulph., gtt. xv. Spts. ammon. arom., gtt. xv. Syr. aurantii, 3ss. Aqua? camphorae, 3j. Misce. Sig.: One such dose every four hours. If necessary a few drops of the tincture of digitalis may be added to the foregoing combination. B Acidi nitrici dil., gtt. x. Tinct. nucis vom^ gtt. v. Spts. chloroformi, gtt. x. Infus. gent, comp., £j. Misce. Sig.: One such dose to be taken after each meal. Indication : During convalescence after cough is loosened up, this acid tonic is indicated. I£ Tinct. cinchonae, m xx. Acidi nitrici dil., m x. Syr. aurantii, 3j. Aquae chloroformi, gj. Misce. Sig. : One such dose after each meal. Indication: Stimulating tonic after cough is loosened. 64 Hand-Book of Modern Treatment. In some cases quinine is indicated; in others some prepar- ation of iron. In children a compound syrup of the phosphate of iron is useful. Malt extract and cod-liver oil are also of service. In debilitated individuals, when the earlier stages are not encountered, the following is recommended : — IJ Ammon. carb., gr. xl. Vini ipecac, m xl. Tinct. cinchonas, 3iv. Aquae chloroformi, q. s. ad Sviij. Misce et fiat mistura. Sig. : Two tablespoonfuls every four hours. I£ Tinct. aconit., m xxiv. Spiritus aether, nitrosi, 3ij. Aquas destillat., q. s. ad f£j. Misce. Sig.: Half teaspoonful to a child every hour. Indication: Rub chest of child with camphor liniment and give the above in acute stage. Ifc Ammonii chloridi, 3iv. Fluidextracti glycyrrhiz., f3iv. Aquae destillat., q. s. ad Jvj. Misce. Sig. : Two teaspoonf uls every three hours. Indication: Used in subacute stage with tenacious mucus. fy Ammon. chloridi, 3j. Fluidextracti glycyrrhiz., fgj. Codeinae sulphatis, gr. iv. • Aquae destillat., q. s. ad f^ij. Misce. Sig: Teaspoonful every two hours in water. Indication: When cough is excessive and no, or scanty, expectoration. I£ Terpin. hydrat., gr. ij. Ext. cannab. indicae. gr. x / m . Codeinae, gr. %. 01. menth. pip., gtt. %. Sacchari albi, gr. iij. Misce et fiat capsula no. j. Sig.: One every four hours until the cough is relieved. Indication: Used when cough is excessive. Hand-Book of Modern Treatment. 65 ]$ Potas. iodidi, 3iss. Potas. bicarb., 3iss. Ammon. chloridi, gr. xlv. Ext. glycyrrhizae, q. s. ad Sij- Misce. Sig. : One teaspoon ful in water four times daily. Indication : To relieve dyspnoea, difficult cough, and tenacious expectoration. J£ Sodii bicarb., gr. xv. Sodii chloridi, gr. v. Spts. chloroformi, gtt. x. Aquae anisati, q. s. ad 5ss. Misce. Sig. : One dose in warm water when waking. Indication.: Morning cough and difficulty in raising mucus. I£ Syr. picis liquidae, £ij. Syr. pruni virginianse, q. s. ad §iij. Misce. Sig. : Two tea spoonfuls every three or four hours. 1$, Potass, iodidi, 3iv. Syr. ferri iodidi, giss. Glycerini, q. s. ad §iiiss. Misce. Sig. : One teaspoonful in milk or water after each meal. Indication: Useful in chronic bronchitis and pleurisy. I£ Morphinae sulphatis, gr. j. Ammonii carbonatis, gr. xxx. • Mist, glycyrrhizae comp., f3xv. Syr. pruni virginianae, f3iv. Misce. Sig. : One teaspoonful in water every three hours to relieve cough. 1$ Acidi benzoici, 3j. Tannin, 3ss. Misce et facant chartulae no. xij. Sig. : One powder four times daily. Indication: Used in bronchorrhoea. 5 66 Hand-Book of Modern Treatment. I£ Sodii benzoatis, gr. xxx. Terpini hydratis, gr. iij. Syrupi tolu, §j. Syrupi acaciae, q. s. ad §iv. Misce. Sig. : Teaspoonful every three hours. Indication: Subacute bronchitis of children. I£ Copaibae, gtt. xx. Pulv. opii, gr. ij. Pulv. acaciae, q. s. Misce et fiant capsular no. x. Sig. : One every three hours. B Copaibae, gr. xx. Acidi gallici, gr. xxx. Pulv. acaciae, q. s. Misce et fiant capsular no. x. Sig. : One every three hours. Indication: Useful in bronchorrhoea. BRUISES. OLIVE-OIL IN BRUISES. In the treatment of contusion where there is extensive dis- coloration of the skin, if olive-oil be freely applied without rub- bing, the discoloration will quickly disappear. Absorbent cot- ton may be soaked in the oil and applied. If the skin is broken, a little boric acid should be applied over the abrasion. A black eye thus treated can be rendered normal in a few hours, especially if the oil be applied warm. IJ Tinct. opii, §j. Liquoris plumbi subacetatis, %]. Aquae destillatae, q. s. ad §xvj. Misce. Sig. : Apply freely on old soft rags or lint. Must not be employed if the skin is broken. If skin is broken, part must be dressed antisep- tically and hot or cold applications made. IJ Potass, chlorat., 3ss. Tinct. iodi, §ss. Aquae, §ss. Misce. Sig.: Apply locally. Hand-Book of Modern Treatment. Q'J I£ Spiritus camphorae, 3j. Tincture arnicae, £ij. Aquae hamamelidis, q. s. ad 3xvj. Misce. Sig. : May be used with gentle friction or applied with lint. I£ Ammonii ehloridi, gr. lxxx. Alcoholis, £xvj. Sig. : Evaporating lotion. A clean piece of linen is to be spread over injured part and kept wet with the lotion. BUBO. I£ Ichthyolis, 3j. Ung. hydrargyri, 3ij. Ung. belladonna^ 3j. Petrolatum, q. s. ad 3j- Misce. Sig. : Apply over bubo. 1$, Phenolis, gr. viij. Aquae destillatae, f^j. Misce. Sig. : Inject six or eight minims in bubo. Indication: To abort bubo. IJ Aquae hydrogenii dioxidi, §v. Sig.: Wash freely or inject in small quan- tities. Inject until froth is perfectly white again. IJ Iodoformi, gr. cc. Petrolatum molle, giv. Misce. Sig. : Inject and fill entire cavity. IJ Tincturae iodi, f3vi. Sig.: Paint over swollen gland and repeat several times at intervals. BUBONIC PLAGUE. ]$ Hoffkine's prophylactic vaccine. Indication: Used in doses of from 3 to 5 cubic centimeters as prophylactic against plague. Administered subcutaneously and repeated in fourteen days. This renders person immune for about six months. 68 Hand-Booti of Modern Treatment. BUNIONS. IJ Liquoris plumbi subaeetatis, §iss. Tincturae opii, £iss. Aquae destillatae, q. s. ad Sviij. Misce. Sig.: Local use. Apply freely on soft cloths. Indication: Used to relieve pain and inflam- mation. B Acidi salicylici, gr. xv. Petrol ati, 3j. Misce. Sig.: Apply freely for several nights. Then soak foot in hot water and remove softened scale. These painful enlargements, according to the Philadelphia Medical Times, are amenable to treatment by applying static sparks and galvanic applications with cocaine. If simply pain- ful, a fine static spark drawn through the shoe will suffice. In making the static application, a point in the center of the bunion will be found to be anaesthetic. Concentrate the sparks at this point until the patient feels the current. This may be repeated once or twice daily. The anodal spark has been used as a rule, but it seems to be the rapid vibrations that are beneficial; con- sequently either electrode may be applied with the rapid vibra- tion. BURNS AND SCALDS. I£ Acidi picrici, gr. xxxviiss. Aquae dest., Sviij. Misce. Sig.: Apply on gauze constantly saturated with this solution, cover with absorbent cotton, and bandage. Indication: To relieve pain and promote healing in superficial burns. 3$ Phenolis, 3ss. Olei lini, fgiv. Liq. calcis, fgiv. Misce. Sig.: Shake and apply on lint. Indication: Burns of first degree. Hand-Book of Modern Treatment. 69 Ifc Ext. opii, gr. viiss. Ichthyoli, f3iv. Liq. petrolati, f3vj. Lanolini, 5vj. Misce. Sig. : Apply locally on gauze in burns of first degree. IJ Ichthyoli, m xlv. Olei olivae, f3ij. Lanolini, 3iij- Misce. Sig. : Apply locally to burns of the third degree. IJ Cocainse hydrochloratis, gr. x. Camphorae carbolatis, §j. Olei olivae, 3j- Misce. Sig. : External use. The cocaine to be thor- oughly dissolved in the carbolate of camphor before adding olive oil. Painful burns are quickly relieved. 1$, Cocainae hydrochlor., gr. x. Liq. petrolati, f3iij. Lanolini, 3ij. Aquae destillatae, f3v. Misce. Sig.: Apply freely on painful surface. After washing the surface of the burn by allowing a solu- tion of 1 drachm of common soda dissolved in a pint of tepid water to run from a sponge over the surface, apply the follow- ing prescription: — R. Bismuthi subnitratis, 3j. Vaselini, 3j. Acidi carbolici, m v. Misce. Sig. : This added thickly and covered with a light dressing will relieve pain instantly. Indication: To relieve pain and keep burns from scarring. 70 Hand-Book of Modern Treatment. Baer records a severe burn in a child, 6 years old, with re- sults of treatment. The wound was caused by matches, with which the clothes were set on fire. The injury extended from the ninth rib on the left side to the axilla and thence to the elbow. The pain was most excruciating, and was relieved only by sustained treatment with opiates. Locally, carron-oil, cold cream, and unguentin were employed at different times, the former two being laid aside for the latter. The oil was objec- tionable because it stuck to the wound and made a dressing painful to wear, and especially so to remove. The consulting physicians agreed that extensive scarring would result no mat- ter what dressing was employed, and ordered cold cream. This was displaced by unguentin, which made the most satisfactory dressing in every particular. The result of treatment was rapid and uncomplicated cicatrization; and complete recovery fol- lowed, leaving not a vestige of scar-tissue or contraction. IJ Bismuthi subnitratis, 3j. Vaselini, Bj. Phenolis, m v. Misce. Sig. : Wash surface with a solution of com- mon soda (31) in pint of water, and then apply thickly and cover with a light dressing. Dr. T. S. Wassiljew records a case of extensive burns which seems to disprove the generally accepted view that such cases are hopeless when one-third of the surface of the body is affected. The patient, thoroughly chilled by tramping through mud and mire in a cold autumn night, lay down alongside a log fire in order to dry his clothes and warm his stiffened limbs. A quantity of whisky he had imbibed took effect, and he was soon in a deep slumber. Towards morning his clothing caught fire and he was terri- bly burned. When brought to the hospital about half of the trunk — i.e., the chest and abdomen, penis and scrotum — and the fingers of both hands were burned. In patches the epidermis was raised by collections of serous liquids, in other places it was hanging down in shreds. At least one-third the surface of the body was burned. Hand-Book of Modern Treatment. 71 Treatment consisted in soothing inflammation and pain, with cold compresses of solution of snbacetate of lead. Xero- form was then applied. Xeroform possesses great desiccant and deodorizing powers, inhibits pus-formation, and stimulates granu- lation. In this case it was used as a 5-per-cent. vaseline salve. It was applied on large pieces of gauze and the dressing renewed daily. Soon the epidermis and parts of the corium detached; the burned surfaces became raw and bleeding in spots obscured by particles of corium. After about two months everything was clean, suppuration had disappeared, and healing progressed rapidly, though places which had been most exposed to the flames cicatrized more slowly. The strength of the xeroform-vaseline salve was therefore raised to 10 per cent., which noticeably hast- ened the process. After about four months almost all the wounds had healed. Ifc Olei olivse, 3vj. Salolis, 3j. Liq. calcis, 3vj. Misce. Sig. : Local use. CALCULI, HEPATIC. B Chloroformi, f^ij. Sig. : Pour on gauze and inhale for relief of pains. B Morphinse sulphatis, gr. iij. Atropinse sulphatis, gr. Vis- Misce et fiant chartulae no. xij. Sig. : One dissolved in 10 minims of water and given hypodermically. B iEtheris. Sig.: Pour on gauze and inhale for relief of pain. 72 Hand-Book of Modern Treatment. CALCULI, RENAL. AND VESICAL. Ifc Morphinae sulphatis, gr. j. Atropine sulphatis, gr. VV Misce et fiant chartulae no. iv. Sig. : One in 10 minims of water, hypoder- mically, for pains. I£ Potas. bicarbonatis, ^iij- Sig. : Teaspoonful in cup of water three times daily after meals. Indication: When urine is acid. I£ Salolis, §j. Sig. : Ten grains three times daily and Celestins Vichy. ]$ Urotrbpin, 3ij. Sig. : Ten grains three times daily if urine is alkaline. CANCER. CANCER OF THE UTERUS. In the medical treatment of uterine carcinoma, A. Lutaud speaks of the importance of vaginal asepsis. This may be ef- fected by injection, as: — I£ Acidi picrici, 3iiss. Aquae, Oj%. Misce. Or:— IJ Resorcin., 3v. Aquae, Oj%. Misce. The injections should be made by the physician himself, after he has, by means of the speculum, located the site of disease. After the injection he employs a tampon of cotton, sat- urated with the following solution : — I£ Chloralis hydratis, 3ss. Cocainae hydrochlor., gr. iss. Aquae, 3v, Misce. Hand-Book of Modern Treatment. 73 When the disease involves the body of the womb he injects into the cervix a few drops of the following mixture : — IJ Hydrarg. chlor. corr., gr. iij. Cocainae hydroehlor., gr. xv. Aquae, 3iiss. Misce. Or he may employ a bougie of: — Ifc Iodoformi, gr. iss. Cocainae hydroehlor., gr. 5 / 6 . Olei theobrom., gr. viij. Misce. He prefers powders, however, as they absorb discharges and do not disturb the weakened patient as much as injections nor necessitate such frequent changes of dressings. Among the combinations which he recommends is : — I£ Iodoformi, 3x. Cupri sulphatis, 3iiss. Morphinae sulphatis, 3j. Misce. When a caustic action is no longer required, our author makes use of a simple disinfectant mixture : — B Salolis, 3j. Lycopodii, 3iiss. Acidi tannici, 3iiss. Misce. Or:— I£ Iodoformi, 3v. Pulv. carbonis lignis, 3v. Quininae sulphatis, 3ss. Ess. menth. pip., gtt. xv. Misce. In haemorrhage he may order: — I£ Ergotini, 3ss. Pulv. digitalis, gr. iij. Ext. hyoscyami, gr. iij. Misce et fiant pilulae no. xx. ; ' Sig. : From 4 to 6 pills daily. 74 Hand-Book of Modern Treatment. Or:— B Ext. cannab. Ind., gr. viij. Ergotin., 3j. Ext. hamamelid. n\, 3ij. Syr. krameriae, §j. Aquae destill., giij. Misce. Sig. : Tablespoonful every two hours. In relieving pain and keeping up the strength nothing equals morphine, given in sufficient doses and sufficiently often. In addition to these injections our author frequently employs also a suppository containing : — I£ Olei theobrom., gr. xlv. Ext. belladonna, gr. 1 / e5 . Ext. opii, gr. 7 3 . Thuja, which has a reputation in cancer, may be given in association with arsenic : — IJ Tinct. thujae, 3j. Liq. potass, arsenit., 3ss. Syr. acacite, £j. Aquae, £iss. Misce. Sig.: Teaspoonful before each of the two principal meals. The treatment of cancer by application of arsenous acid may be rendered painless by adding to the acid an equal amount of orthoform. IJ Bismuthi subnitratis, 3ij. Phenolis, m xvj. Spts. chloroformi, q. s. ad Sviij. Misce. Sig. : Tablespoonful before meals. Indication: To relieve pain, control vomit- ing, and prevent putrefaction in cases of gastric cancer. Hand-Book of Modem Treatment. 75 R Cocainae hydrochlor., gr. vij. Codeinae sulphatis, gr. vij. Liquoris calcis, %x. Misce. Sig. : Teaspoonful at one dose. Indication: Cancer of stomach. R Bismuthi subnitratis, 3j. Phenolis, gr. xv. Aquae destillatae, giv. Misce. Sig. : Teaspoonful hourly until pain has ceased. R Picrotoxini, gr. %. Morphinse hydrochlor., gr. %. Atropine sulphatis, gr. 15 / 100 . Ergotin, gr. xv. Pruni laurocerasi, 3iij. Misce. Sig. : Five to 6 drops before meal. R Aspirin, 3iv. Fiant chartulse no. xxxij. Sig. : One powder every half-hour if neces- sary until 30 grains are given to relieve ex- cessive pains. R Liquoris potassii arsenitis. Sig.: One to 3 drops in water three times daily. Indication: In cancer of stomach to retard growth and relieve pain and vomiting, and im- prove general nutrition. CARBUNCLE. Bosenbaum claims for the following method of treatment that it is painless, the healing is quicker, and no scar or cicatrix remains. A pad of eight layers of gauze somewhat larger than the inflamed surface is soaked in Thiersch's solution (acid. salicyl., oss; acid. bor.,-3iiiss; aq. Oij), covered with a layer of 10-per-cent. ichthyol ointment, applied to the carbuncle, and held in place by a rubber protective, cotton-wool, and a bandage. 76 Hand-Booh of Modern Treatment. This dressing is left for two days, after which the cores are found to have separated from their walls. They can be pain- lessly removed at the next dressing. Ifc Phenolis, gr. viij. Aquae destillatse, §j. Misce. Sig.: Inject 10 to 12 minims around seat of inflammation. This may be repeated every six hours during first twenty-four hours. Indication: To abort. I£ Tinct. ferri chloridi, f^ij. Sig.: Ten drops in water through glass tube every two to four hours. 1$ Hydrargyri oxidi rubri, 3i-ij. Menthol is, gr. xx. Pulv. camphorae, gr. xv. Cocainae hydrochlor., gr. x. Acidi carbol., m xx. Morphinae sulphatis, gr. v. Vaselini, Sj- Misce et fiat unguentum. The menthol, cam- phor, cocaine, and carbolic acid should first be mixed together. The red oxide of mercury and the vaselin likewise mixed together, then mixed with the other ingredients. Sig. : Spread on sterilized gauze and apply, changing the dressing four or five times a day. B Calcis sulphuratae, gr. v. Sig.: Give 1 / 10 grain every two hours. Indication: Limit suppuration. IJ Argenti nitratis, gr. xlv. Aquae destillatae, f^ij. Misce. Sig. : Paint over ulcerated surface and be- yond unhealthy skin night and morning. Indication: Used to destroy unhealthy granulations and limit spread of disease. Band-Book of Modern Treatment. 77 I£ Potassii iodidi, 3ss. Ferri pyrophosphates, 3j. Syrupi, Sij. Aquae, Bij- Misce. Sig. : One teaspoonful diluted in water after meals. CARIES. B Syrupi hypophosphiti compositi, f^vj. Sig. : One teaspoonful in water after meals. Indication: Used in anaemic subjects. CATARRH, ACUTE GASTRIC. IJ Bismuthi subnitratis, gr. x. Potassii bromidi, gr. xv. Acidi hydrocyanici diluti, m xv. Spt. chloroformi, m xx. Mucilaginis acacias, 3ij. Aquae, q. s. ad §j. Misce. Sig. : To be taken every three hours. Indication: Acute gastric catarrh. B Tinct. nucis vom., £ss. Tinct. physostigmatis, 5ss. Acidi hydrochloridi dil., 3ij. Pepsinae sacch., 3iij. Aquae, q. s. ad %iv. Misce. Sig.: Teaspoonful after meals. IJ Tinct. deod., m xvj Bismuth, subnit., 3ij. Syrupi simp., 3iv. Aquae cinnam., §iss. Misce. Sig. : Teaspoonful every two to four hours, for child one year old. Indication: Acute gastro-intestinal catarrh. 78 Band-Book of Modern Treatment. I£ Hydrargyri chloridi mitis, gr. j. Sacchari lactis, gr. x. Alcoholis, q. s. Misce et fiant triturationes no. vj. Sig.: One tablet every half-hour, followed in four hours by teaspoonful of Roehelle salts. Indication: Initial treatment or to overcome constipation. I£ Tinct. aconiti, m iv. Aquae, q. s. ad §j. Misce. Sig. : Teaspoonful every hour. Indication : Used in early stage to control vomiting. 1$ Acidi hydrocyanici diluti, 3j. Sig.: One drop in 10 drops of water every hour. Indication: Used to control vomiting. Ifc Resorcini gr. lxxv. Bismuthi salicylatis, Sss. Tannigen, £ss. Sacchari albi, 3ij. Sodii carbonatis, 3ij. Misce. Sig. : Small teaspoonful every two hours. Indication: Acute gastrointestinal catarrh. Ifc Morphinae sulphatis, gr. j. Aquae amygdalae amarae, 3j. Tinct. Valerianae aetheris, 3j. Aquae carbonicae, q. s. ad 3v. Misce. Sig. : One-half to 1 tablespoonful every two hours. Keep on ice and do not shake the bottle. Indication: To control pain and vomiting in adults. IJ Sodii bicarbonatis, 3ij. Infusi gentianae compositi, £iij. Misce. Sig. : Teaspoonful in water before meals. Indication: Useful in convalescence. dand-Book of Modern Treatment. 79 CATARRH, NASAL. I£ Sodii bicarb., 3ss. Sodii biborat., 3ss. Glycerini, gij. Listerini, gj. Aquae, Siij- The abo^e is a modification of Dobell's solution, and when slightly warmed and used as a spray is excellent for cleansing and disinfecting the nasal cavities. I£ Betul-ol (methyl-oleo-salicylate co.), mx. Acidi oleici, 3j. 01. amygdal. dulc, 3ij. Salol, gr. x. Misee. Sig. : To be used as spray. Ifc Acetat. aluminis, gr. j. Menthol is, gr. j. Acetanilidi, gr. j. Bismuthi subnit., 3j. Misce et fiat in vial. Sig.: Catarrh snuff. Its free use is also advised in the beginning of an ordinary cold in the head. It should be put up in a small vial to pre- vent deterioration. Apply it in the following manner: — Suppose you want to introduce the snuff into the right nostril. Place the palmar surfaces of the thumb, index, and mid- dle fingers of the right hand together so as to form a cone,- in the apex of which cone will be a natural fossa to hold a bit of the snuff (which you pour from the bottle with the left hand — the size of a grain of wheat). Then place the cone formed by the fingers holding the snuff against the right nostril, close the left nostril with the left hand, toss the head slightly back, and draw the snuff up into the nose with a strong inspiration. 80 Hand-Book of Modern Treatment. B Camphorae, gr. xv. Quin. hydrochlor., gr. xlv. Tinct. aconiti, m xl. Tinct. belladonnae, mxl. Sacchari lactis, q. s. Misce et fiant capsulae no. xv. Sig. : One capsule every two or three hours. Indication: Valuable in relieving acute con- gestion. B Acidi borici, 3j. Mentholis, gr. x. Cocainae, gr. v. Alcoholis (50 per cent.), rn v. Pulveris talci, S»ij. Misce. Sig. : To be used as snuff. I£ Sodii iodidi, 3j. Syrupi amari aurantii, 3j. Syrupi limonis, §j. Aquae, q. s. ad gvj. Misce. Sig. : A tablespoonful three times daily in milk. CERUMEN. After removing impacted cerumen from the ear, apply car- bolized hydrocarbol or albolin for a few minutes by means of a vaporizer until the meatus auditorius externus and the tym- panum are thoroughly lubricated, and you will find that flexibil- ity of the tympanum will be increased and the hearing con- sequently intensified. IJ Glycerini, gss. Sodii bicarb., gr. xx. Aquae, 3ss. Misce. Sig. : Wash out the ears two or three times a day. In dealing with impacted cerumen difficulty is at times en- countered with the syringe in removing the mass, so that there is a temptation to employ considerable force, which is not with- Hand-Book of Modern Treatment. 31 out clanger in the sudden removal of the plug, thereby doing damage to the tympanic membrane. In order to facilitate the removal of these impacted plugs various substances have been employed to soften or partly dissolve the mass. Among those that have been used are alcohol, glycerin, and the various salts of sodium, and, of late, peroxide of hydrogen has had some vogue. The writer has tried all of these solvents, but none has given such satisfaction in his hands as undiluted sulphuric ether, poured from a small bottle or a suitable pipette into the external auditory canal. The ether acts in a few seconds, partly dissolv- ing the cerumen from its attachment to the canal ; so that, with the most gentle syringing, the plug is promptly removed. I have not seen any dizziness or other ill effects from this use of the ether. For those who might hesitate at first to em- ploy pure ether in the ear, a mixture of equal parts of ether and alcohol might be used, with perhaps the same effect. CHANCRE. R. Mentholis, gr. v. Iodoformi, 3iv. Cetacei alb., 3ij. Gerati, q. s. ad 3j- Misce. Sig.: Apply locally once daily. R. 01. mirbani. m iv. Balsam. Peruv., 3iij. Iodoformi, 3ij. Yaselini, q. s. ad §j. Misce. Sig.: Apply locally once daily. R, Bismuthi subnitratis, 3iij. Acidi salicylici, gr. ij. Zinci oleatis, q. s. ad 3j. Misce. Sig. : Apply locally. B> Zinci chloridi, 3j. Zinci oxidi, 3x. Aquae, q. s. to make a paste. Misce. Sig. : Apply and leave 071 for twenty- four hours. 6 82 Band-Book of Modern Treatment. I£ Hydrargyri chloridi corrosivi, gr. v. Liquoris calcis, B x ' Misce. Sig. : Cleanse with this the initial sore. I£ Ung. potassii iodidi, gr. clxxxv. Ung. hydrargyri, gr. clxxxv. Ung. belladonna?, q. s. ad 3xss. Misce. Sig. : Apply several times daily. IJ Hydrargyri chloridi mitis, 3iiss. Dermatol, 3j, gr. xv. Misce. Sig. : Dust parts and keep them separated with gauze. I£ Argenti nitratis, gr. xxx. Aquae destillatse, f^j. Misce. Sig. : Apply with cotton swab once daily. Indication : Used to destroy unhealthy gran- ulations in indolent ulcers. CHANCROIDS. I^ Zinci stearatis cum acido borico, 3j. Sig. : Use as a dusting powder after cau- terizing. 1^ Ung. hydrargyri, 3iv. Ung. belladonnas, 3iv. Ung. ichthyolis, 3iv. Misce. Sig.: Apply once or twice daily. I£ Acidi nitrici, 3ij. Aquae, q. s. ad Sj- Misce. Sig. : Touch each ulcer. I£ Lotionis hydrarg. nigrae, fSviij. Sig. : Apply freely to ulcer on absorbent cot- ton and change frequently. Hand-BooJc of Modern Treatment. 83 B> Bismuthi subnitratis, 3j- Hydrarg. chloridi mitis, 5j- Misce. Sig. : Use freely as a dusting powder. B; Iodoformi, §j. Sig.: Apply freely to the ulcer. B Liquoris plumbi subacetatis, §j. Tinct. opii, Bj. Aquae destillatse, §xvj. Misce. Sig. : Apply continuously to ulcer on ab- sorbent cotton. B> Cupri sulphatis, 3ij. Aquse, Si J- Misce. Sig. : Apply once daily with swab. Indication: Used to promote healing of in- dolent ulcer. CHAPPED LIPS, HANDS, AND FACE. B Tinct. benzoini comp., 3ij. Glycerini, 3vj. Misce. Sig. : Apply three or four times daily with a camel's hair brush. Indication: Useful for chapped lips. B Oxidi hydrargyri flavi, gr. ij. Balsami Peruviani, gr. x. Vaselini, 3iv. Misce. Sig. : Apply to the parts. Indication : May be used for chapping occur- ring on any part of the body. If there is itch- ing, 2 grains of carbolic acid may be added to the above. B Spiritus eamphorse, 3ss. Tinct. benzoini comp., 3ij. Listerini, §j. Glyceriti hydrastis, q. s. ad §iv. Misce. Sig. : Shake and apply freely to hands, face, or lips several times a day. 84 Eand-Book of Modern Treatment. B Mentholis, 3ss. Salolis, 3j. Olei olivae, 3v. Lanolini, ^ij. Misce. Sig. : Apply night and morning. Indication: Chapped hands. I£ Glycerini, §iss. Balsam. Peru., f^ss. Sodii salicylatis, 3j. Aquae lactucarii, 3vj. Misce. Sig. : Apply to hands twice daily. Ifc Acidi tannici, gr. viiss. Glycerini, 3v. Aquae rosae, §iij. Misce. Sig. : Apply locally to hands. 1$ Phenolis, m xxv or 3ss. Olei cadini, m lx or 3j. Cremoris nutritioni, 3vj. Misce. Sig. : Rub in vigorously to promote circula- tion. It is a good plan to wear a pair of loose leather gloves at night. R Ichthyoli, 3j. Tinct. benzoini comp., 3j. Acidi borici, 3j. Petrolati, gij. Misce. Sig. : Apply frequently through the day. Indication : Chafing under the arms and in groins of infants. CHILBLAINS. B Pulveris saloli, gr. xlv. Balsami peruviani, m xlv. Vaselini, gj. Misce. Sig. : Apply locally. Hand-Book of Modern Treatment. S5 B Ichthyoli, f3ij. Unguenti potassii iodidi, 3iv. Olei terebinthinae, f3j. Adipis lanae hydrosi, q. s. ad 3ij. Misce. Sig. : Spread upon new unbleached muslin and apply. IJ Liquoris plumbi subacetatis, f^j. Tincturae opii, fgj. Aquae destillatse, q. s. ad Sxvj. Misce. Sig. : Keep applied freely on well-moistened soft cloth. Indication: Only to be employed when skin is unbroken. B Tinct. iodi, f3iv. Sig. : Apply with brush once or twice daily. CHLOASMA. 1$ Hydrarg. chloridi corrosivi, gr. iij. Acidi aeetici diluti, 3ij. Sodii boratis, gr. xl. Aquae rosse.. q. s. ad fgiv. Misce. Sig. : Apply night and morning. IJ Hydrarg. chloridi corrosivi, gr. iij. Zinci sulphatis, 3ss. Plumbi acetatis, 3ss. Aquae, q. s. ad %i\. Misce. Sig. : Apply night and morning. I£ Hydrarg. chloridi mitis. 3ij. Bismuthi subnitratis, 3ij. Pulveris amyli, 3iv. Glycerini, 3iv. Misce. Sig. : Apply as paste to parts during night and wash off, in the morning. Ifc Aquae hydrogenii dioxidi, fgv. Sig. : Apply with sponge twice daily. 86 Hand-Book of Modern Treatment. IJ Hydrarg. chloridi corrosivi, gr. iv. Tinet. benzoini comp., 3ij. Zinci sulphatis, gr. xx. Alcoholis, Aquae destillatse, of each, q. s. ad %iv. Misce. Sig. : Apply freely twice daily. I£ Acidi salicylici. gr. xxx. Adipis lanse hydrosi, 3iv. Ungt. aquae rosae, §ij. Misce. Sig. : Apply twice daily to parts affected. CHLOROSIS.— See Anaemia. CHOLERA. squibb's cholera mixture. I£ Tinct. opii, fgj. Tinct. capsici, f^j. Spir. camphorae, f£j. Cliloroformi, f3iij. Alcoholis, q. s. ad f^v. Misce. Sig.: Twenty to 40 minims. I£ Camphorae, gr. lxxv. Vini rubri, Oij. Sig. : First dissolve camphor in alcohol and then add wine. Give 1 to 2 teaspoonfuls every hour during the attack. B Acidi sulphurici aromatici, §j. Spiritus camphorse, §j. Vini rubri, q. s. ad 3vj. Misce. Sig.: One teaspoonful in water every three hours. Indication: To relieve purging, vomiting, and diarrhoea. Hand-Book of Modern Treatment. . 87 IJ Sodii cliloridi, gr. xliij. Aquae destillatae, cong. j. Misce. Sig. : Give by hypodermoclysis. Solution should be sterilized and warmed before in- jected. I£ Strych. sulphatis, gr. y 7 . Atrophinse sulphatis. gr. y 50 . Misce et fiant chartulse no. iij. Sig. : Dissolve in water and give by hypoder- moclysis, and repeat if required. Indication: Used to prevent collapse. CHOLERA INFANTUM. 1$. Bismuthi subnitratis, 3iss. Listerine, §ss. Glycerini, 3iv. Misturse cretae, q. s. ad §ij. Misce. Sig. : Teaspoonful every three or four hours. IJ Magnesii sulphatis, 3ss. Acidi sulphurici diluti, gtt. ij. Aquas, q. s. ad §ij- Misce. Sig. : Place on ice, and after cooling tea- spoonful every half-hour. Indication: Initial treatment, associated with gentle injection of large quantities of tan- nic acid solution (5 grains to 1 pint) into colon by means of fountain-syringe and soft-rubber catheter. B Olei ricini, 3iv. Tinct. opii camphoratae, 3j. Misce. Sig. : One to 2 teaspoonfuls and repeat if necessary. Indication : History of undigested food hav- ing passed. 88 Hand-Book of Modern Treatment. ~fy Resinse podophylli, gr. y 2 . Liq. potassii arseniti, m iij. Liquoris calcis, fSiij. Misce. Sig. : Teaspoonful every five hours. Indication: Unchecked diarrhoea and lost tone of parts. R. Hydrarg. cum creta, gr. j. Cretae prseparatse, gr. vj. Misce et fiant chartulse no. vj. Sig.: One every hour. Indication: Used to stimulate hepatic secretion. CHOLERA MORBUS. I^ Spiritus setheris comp., 3ij. Spiritus lavandulae comp., 3ij. Tinct. opii camph., 3ij. Tinct. capsici, m xv. Tinct. zingiberis, 3ij. Misce. Sig.: One-half to 1 teaspoonful every two hours, accompanied with turpentine stupes. One 3 of turpentine to 1 quart of water. Ii Acidi carbolici. gr. viij. Glycerini, 3j. Tinct. opii camph., gij. Aquae cinnamomi, giij. Misce. Sig.: For adult 1 teaspoonful after each paroxysm until they cease. I£ Olei ricini, §j. Tinct. opii, m xv. Misce. Sig. : Take in one dose. Indication: When irritant food is present. Hand-Book of Modern Treatment. 89 R Acidi sulph. aromat., f3ij. Fluidextracti hsematoxyli, f3ij. Spiritus chloroforini, f^ss. Syrupi zingiberis, q. s. ad f^iij. Misce. Sig. : Dessertspoonful every two hours. Indication: When diarrhoea is profuse and intestines lack tone. CHORDEE. R Fluidextracti ergotae, m xv. Tinct. gelsemii, m v. Potassii bromidi, gr. xx. Tinct. hyoscyami, 3ss. Syr. aurantii, q. s. ad §ss. Misce. Sig. : To be taken at bed time. Indication: To allay chordee and sexual ex- citability. R Liq. morphinse hydrochlor., m xv. Cocainse hydrochlor., gr. ss. Aquae destillatse, q. s. ad 3ij. Misce. Sig.: Inject into the urethra and hold five minutes, just before retiring. The bowels must be kept freely open by giving a cathartic pill every third clay during the acute stage and avoid saline purgatives. The urine should be kept alkaline by potas- sium bicarbonate and acetate, combined with the tincture of hyoscyamus. R Potassii bromidi, ^ij- Chloralis hydratis, 3ij. Misce. Pone in chartulae no. xvj. Sig. : One each night at bed time, and repeat once during night if necessary. R Morphinse sulphatis, gr. ^4. Atropine sulphatis, gr. i / m . Sig. : Inject hypodermically at bed time. 90 Hand-Book of Modern Treatment, CHOREA. IJ Tinct. ferri chloridi, 3ij. Liquoris arsenicalis, 3iij. Glyeerini, gj. Aquae chloroformi, q. s. ad giv. Misce. Sig. : One small teaspoonful in water after food three times a day. IJ Ferri reducti, gr. i-iij. Quininas sulphatis, gr. ii-v. Aeidi arsenosi, gr. Vso-Vao- Misce. Sig. : To be taken in pill or capsule three times a day. I£ Sodii arsenatis, gr. iss. Acidi carbolici, m iij. Aquae destillatse, 3iiss. Misce et fiat solutio. Sig. : Five minims as an initial dose and repeat, according to age. 1$, Asafoetida, gr. xx. Ext. Valerianae, gr. xx. Zinci oxidi, gr. xx. Castori pulv., gr. xx. Ext. belladonnas, gr. ij. Misce et fiant pil. no. xx. Sig. : One or two night and morning. I£ Liquoris potassii arsenitis. Sig. : One drop in water three times daily, and increase 1 drop each day until puffiness of eyelids or pain in bowels ensues. Then de- crease half the dose and continue till disease disappears. COLIC, HEPATIC. IJ Extracti belladonnae, gr. V 3 . Extracti opii, gr. 1 / 3 . Olei theobromatis, gr. xxx. Misce. Sig. : Make into one suppository, one such to be inserted every half-hour for two hours. Hand-Book of Modern Treatment. 91 Olive-oil has always been considered empirically as a specific remedy in hepatic colic, and even in gall-stones. But it has usually been administered during the attack, and more as a seda- tive than for preventive purposes. Dr. S. Artault de Vevet attempts to show that in oleic acid, the active principle of olive- oil, we possess a powerful preventive of biliary lithiasis. Ac- cording to the author, it is highly probable that to oleic acid the remedial effect of o'ive-oil in biliary colic is to be ascribed, and this conclusion has been completely borne out by observations covering a period of about six years. The effect of oleic acid in hepatic colic has always been uniform and remarkably good. The acid may be given in capsules of 8 minims each, one to be taken morning and evening, for a period of one to two weeks. If necessary 16 minims may be prescribed at a dose, and the acid taken for a prolonged time, with regular intermissions. In this manner the attacks of biliary colic may be prevented, and relieved when once established. This double efficiency is another valuable property of oleic acid. The author insists on the prime importance of obtaining the pure product, as often fraudulent substances are dispensed. The following conclusions seem to be warranted: 1. Oleic acid is a specific remedy for biliary lithiasis. 2. The remedy relieves promptly the pain of an attack of biliary colic, but its chief effi- ciency is shown in preventing the return of the paroxysm, by interfering with the further formation of stones. It is thus curative and preventive at the same time. 3. The single dose is 8 to 16 minims in capsules, one in the morning for ten days of the month, if the attacks recur monthly, or for fifteen days preceding the expected paroxysm. I£ Morphinse sulphatis, gr. %. Atropinse sulphatis, gr. x / 100 . Misee. Sig. : Use hypodermically to decrease pain and relax spasm of muscular coat of ducts. I£ Hydrarg. chloridi mitis, gr. x. Pone in capsulas no. Ix. Sig. : One capsule or tablet every four hours. Indication: Torpid liver. 92 Hand-Book of Modern Treatment. 1$, 01. terebinthinae, m v. Syrupi acaciae, f§ss. Sodii phenolsulphonat., gr. xx. Spiritus aetheris eomposit., mxv. Aquae menthae pip., q. s. ad f^j. Misce. Sig. : To be taken once or twice a day. COLIC, INFANTILE. 1$, Potassii bromidi, gr. viij. Chloralis hydratis, gr. iv. Aquae camphorae, q. s. ad f§j. Misce. Sig. : One teaspoonful every four hours. Indication: Severe colic and insomnia of children over one year old. Ifc Emulsi asafoetidae, f^ij. Sig.: One-half teaspoonful as required. Indication: Used for flatulence and pain. 1$ Spiritus aetheris compositus, fSj. Sig.: Five or 10 minims in cold water every two hours. Five drops of tincture of lobelia in 2 ounces of water, half a teaspoonful every few minutes, given warm, will cure many cases of infantile colic from whatever cause, will soothe ner- vous irritation, and induce sleep. In severe cases among children, Dr. Louis Starr says that bromide of potassium and chloral are most useful ; they may be combined as follows : — I£ Potassii bromidi, gr. xvj. Chloralis hydratis, gr. viij. Syrupi, Sss. Aquae menth. pip., q. s. ad 3ij- Misce. Sig. : One teaspoonful for a dose. Of this preparation it is rarely necessary to give more than two or three doses, at intervals of an hour. Hand-Boole of Modern Treatment. 93 In infantile colic the result of indigestion, overfeeding, con- stipation, or improper food, Illoway advises the following prepa- ration : — I^ Misturae rhei et sodae, §ss. Spiritus aetheris compositus, in xl. Syrupi rhei aromatiei, q. s. ad §j. Misce. Sig. : A half-teaspoonful of this may he given every half-hour or hour to an infant a month old or so. Under and over that age, the dose to be graduated accordingly. Two or three doses are usually sufficient. While paregoric has long been popular in the lay mind for painful troubles of this character in infants, it nevertheless is an unwise remedy to employ, and should always be reserved until after simpler measures have failed. McAlister gives as exciting causes of infantile colic, indul- gence of the mother in rest, in insufficient exercise, irregularity of diet, and the mental state. In bottle-fed babies the want of strict cleanliness in their care, overfeeding, and too rapid feed- ing, the last being a very prolific cause. Too long use of nip- ples causes them to become patulous and the flow is too free. Diagnosis of colic is important. All crying of babies is not from colic. Colic presents hardness of abdomen, palpation shows coils in intestine, drawing up of legs is present, and there is expulsion of flatus with vigorous crying. Great circumspec- tion should be exercised in the use of drugs. Opiates are con- demned. Encourage expulsion of flatus by manipulation of the abdomen, massage, and warmth to bowels. High acidity of bot- tle-fed infants has suggested the combination of alkaline prepar- ations with carminatives, as in the following: — I£ Sodii bicarb., gr. xl. Spts. amnion, aromat.. m xl. Glycerini, m xxx. Aquae menth. pip., q. s. ad §ij. Misce. Sig. : Teaspoonful between feedings. A towel dipped in boiling water, wrung out rapidly, folded to proper size, and applied to the abdomen with a dry flannel over the hot towel, acts like magic in infantile colic. 94 Rand-Booh of Modern Treatment. COLIC, INTESTINAL, ADULTS. 1$ Chloroformi, 3iss. Tinet. opii deodorat., 3j. Camphorse, gr. iv. 01. cajuputi, 3j. Aquae, gij. Misee. Sig. : Teaspoonful every hour or two. Indication: Acute colic. I£ Spir. chloroformi, 3ij. Tinct. belladonnas, m cl. Dionin, gr. v. Comp. tinct. cardamomi, q. s. ad §iv. Sig. : Teaspoonful in water every half-hour for adults. B Codeinse, gr. iij. Bismuthi subnit., 3j. Chloroformi (Squibb's), 3ij. Tinct. lavand. comp., 3j. Syr. pruni Virg., 3j. Spts. vini gal., gj. Misce. Sig.: One teaspoonful every fifteen minutes until relieved. Indication: Acute colic with cramps. Two to 5 ounces of butter stirred into 1 or 2 cups of black coffee, and taken at a draught. Follow with carbonated waters freely. Do not use opium or its preparations at the same time. This simple expedient is often of great and immediate value. COLIC, LEAD. Delearde treated five patients who were sick with lead colic by injecting 1 pint of physiological salt solution under the skin of the abdomen ; in all the cases muscular pain soon disap- peared ; after twenty-four hours, instead of the constipation, a beneficial diarrhoea set in, lasting two or three days, when it ceased. Hand-Book of Modern Treatment. 95 I£ Aluminis, gr. xx. Opii, gr. xx. Misce et fiant chartulse no. xij. Sig. : One every two hours. Indication: Used to relieve pain and consti- pation. COLIC, RENAL.— See Calculi, Renal and Vesical. CONDYLOMATA, COMMON. I£ Acidi salicylici — saturated sol, £ss. Sig. : Moisten the growth once or twice daily, and remove the softened coating from time to time. 3 Acidi lactici, f§ss. Sig. : Paint the growth once or twice daily. CONJUNCTIVITIS. I£ Hydrarg. oxidi flavi, gr. ij. Vaselini, 3ij. Misce. Sig. : Apply at night. Indication: Simple conjunctivitis or acute contagious. I£ Zinci sulphatis, gr. i or ij. Aquse destillatse, §j. Misce. Sig.: One drop in eye three times daily. Indication: Simple conjunctivitis or acute contagious. B Zinci sulphatis, gr. j. Morphines sulphatis, gr. ss. Atropinse sulphatis, gr. ss. Aquae destillatse, f^j. Misce. Sig.: Few drops in eye two or three times daily. 96 Hand-Book of Modern Treatment. IJ Acidi borici, 3ss. Sodii biboratis, 3ss. Aquae menthae pip., 3iij. Fluidextracti hamamelis, 3iv. Aquae camphorse, §ij. Aquae destillatae, 5ij- Misce. Sig. : Bathe the eyes freely. IJ Argenti nitratis, gr. ij. Aquae destillatae, 3j- Misce. Sig. : Paint eyelids once daily. Indication: Simple and purulent conjunc- tivitis. IJ Argenti nitratis, gr. x. Aquae destillatae, 3j. Misce. Sig. : Touch eyelids night and morning and wash off excess with salt solution. IJ Protargolis, gr. xx. Aquae destillatae, f^j. Misce. Sig. : Wash eye and apply to the lids twice daily. Indication: Purulent conjunctivitis. IJ Iodoformi, gr. iss. Cocainae hydrochlor., gr. j. Petrolati, 3iss. Misce. Sig.: Apply locally. Indication: Ulcer of cornea. IJ Acidi borici, gr. xx. Sodii chloridi, gr. ij. Aquae destillatae, f§j. Misce. Sig. : Wash out the eye frequently. IJ Glyceriti acidi tannici (10 per cent.), f3j. Sig.: Apply to everted lids. Hand-Book of Modern Treatment. , 97 I£ Boroglycerini (40 per cent.)? fBj. Sig. : Apply to everted lids. I£ Acidi tannici, gr. xl. Tinctura? iodi, m x. Glycerini, gj. Misce. Sig.: Apply to everted eyelids. Indication : Last three prescriptions used in granular conjunctivitis. CONSTIPATION. B Aloes extracti, gr. iss. Ipecacuanha? pulveris, gr. ss. Nucis vomica? extracti, gr. ss. Quinina? sulphatis, gr. j. Saponis, gr. ss. Misce et fiant pilula?. Sig. : One pill to be taken immediately be- fore dinner. The following formula lias been found to be an effective one I£ Aloina?, gr. %. Strychnina? sulphatis', gr. *■/&. Extracti belladonna?, gr. x / s . Pulveris ipecacuanha?, gr. 1 / 3 . Misce et fiant pilula?. Sig. : One pill to be taken daily. Employed alone, belladonna seems to be more efficacious in the case of women than of men, and appears especially applicable in those cases of constipation in which a painful condition of some of the pelvic viscera (uterus or ovaries) tends to constipa- tion by inhibition of intestinal peristalsis. B Sulphuris loti, gj. Potass, bitartratis, %]. Pulv. senna?, §ss. Syr. rhei, 3j. Ext. cascara? sagrada?, 3ij. Misce et fiat confectio. Sig.: Tablespoonful at night. 98 Eand-Book of Modern Treatment. A very successful remedy for constipation in infants is podophyllin, in small doses; iridin may be combined with it with good effect. Make a tincture of the following: — I£ Resinae podophyllini, gr. viij. Iridini, gr. v. Spiritus ammoniae aromatici, %]. Misce. Digest for several days and filter. Sig. : One or two drops of this may be given at bed time on a small piece of loaf sugar, or the dose may be combined in mixture along with syrup of orange. This is the dose for a child of one year and under. In cases of chlorosis or anaemia, it is well to prescribe con- fectio sulphuris 3j to be taken every morning, followed by this mixture : — I£ Ferri sulphatis, gr. xij. Magnesii sulphatis, gj. Quininae sulphatis, gr. x. Liquoris strychninae, f3ss. Acidi sulphurici diluti, m xl. Aquae dest., q. s. ad f 5 viij. Misce et fiat mistura. Sig. : Two tablespoonfuls to be taken once daily about one hour before dinner. I£ Extracti colocynthi, gr. l / 3 . Terebinthinae ( Venice ) , gr. 9 / 10 . Pulv. socotrinae aloes, gr. l L / 3 . Ext. nucis vomicae, gr. 7 G . Ext. hyosciami, gr. 9 / 10 . Misce for one pill. Sig. : One such pill to be taken twice daily. Indication: Constipation with flatulence. B Sulphuris loti, fgj. Potassii bitartratis, 3j. Pulv. sennae, 3iv. Syrupi rhei, f3ij. Fluidextracti cascarae sagradae, f3ij. Misce et fiat confectio. Sig. : One teaspoonf ul at night to move the bowels. Indication: Habitual constipation. Eand-Book of Modern Treatment. 99 CONSTIPATION IN CHILDHOOD. Dr. E. S. McKee advises the following treatment in a child two or three years old, suffering from chronic constipation: — Massage 8 to 10 minutes morning and evening over the course of the colon. Give juice of half an orange and a glass of water or Vichy on rising. For breakfast I would advise oat- meal with cream, dried bread and butter, one egg, half a glass of milk, with cream and water added; for dinner, soup, on? starchy vegetable (for example, potato with cream) and one green vegetable, beefsteak, baked apple, prunes, dried bread and butter, and water; for supper, cream toast, one egg, dried bread and butter or graham crackers, half a glass of milk with cream and water added; and suppositories of aloin, etc., at bed-hour. The well-known aloin, strychnia, and belladonna comp. pill divided into pills of one-fifth the ordinary strength, are very valuable in the treatment of constipation in children, repeating the pill one, two, or three times a day as necessary. In the constipation of sucklings a change in the diet of the mother may be tried, or. from one to three teaspoonfuls of cream may be given before each nursing. In artificially-fed children, the top milk with cream should be fed. Water, barley- water, or oatmeal will sometimes obviate the difficulty. As laxatives, simple syrup, manna, olive-oil, castor-oil, or fluid magnesia may be sufficient. A conical piece of soap inserted into the rectum is sometimes sufficient, as is even a ther- mometer if inserted at regular intervals. In infants after the fifth or sixth month costiveness is an indication for the intro- duction of starchy matter into the diet. The daily injection in infants of warm soapsuds by means of a soft-bulbed ear-syringe, or of glycerine gtt. xv-xx in a tea- spoonful of water, is very successful. The following may be given : — B Magnes. oxidi, gr. viiss. Sacch. lactis, gr. viiss. Put a piece of flaked manna in each bottle of artificially- fed infants' food. Ten drops of syrup of figs, 2 to 4 drops of fluid extract of cascara sagrada, a pinch of salt in the bottle, the addition of Mellin's food to the diet, the twice-daily massage, 100 Hand-Booh of Modern Treatment. the addition to each bottle of milk of 2 to 4 gr. phos- phate of soda, an increase in the proportion of cream, Tarrants' seltzer aperient, 10 grains in the milk, a little milk of magnesia added to the milk or water — these are usually suc- cessful, one or all, used in consecutive order. 1$ Magnesii sulphatis, 5 SS - Sodii sulphatis, §ss. Potassii sulphatis, gr. ij. Sodii bicarbonatis, gr. viij. Sodii chloridi, gr. xx. Aquse, q. s. ad Sviij. Misce. Sig. : Wineglass before breakfast. Indication: Artificial Hunyadi Janos for constipation. Spoeth has employed the following formula in the treat- ment of intestinal fermentation in the course of the infectious diseases, such as typhoid fever: — 1$ Creolini, 3iss. Alcoholis diluti,'wxv. Pulveris glycyrrhizse, 3iss. Extracti glycyrrhizae, 3iss. Mucilaginis tragacanthi, gr. xvr Misce. Sig. : Make into 100 pills and give one three times a day. For constipation in infants and small children cathartics ought not to be given. Instead, let a small quantity of glycerine — a half teaspoonful — to which has been added a few drops of water to make it flow, be injected into the rectum by means of a small hard-rubber syringe. This may be repeated every day when the act of evacuation does not take place naturally. The effect of the glycerine is that of a mild stimulant to the rectum, the result of which is expulsion of its contents. No harm can come of this treatment, while much damage does come from the use of cathartics. The first step must be to regulate the habits and life of the mother. She must be placed on a diet of fresh meat, fresh Hand-Book of Modern Treatment. 101 vegetables, and freshly-cooked fruit, with due provision for regular exercise, and restriction .in ' the matter of tea-drinking and other dietetic irregularities. This regime will diminish the proteid, and increase the fatty constituents of the milk, and will go far to rid the infant of the tendency to constipation. Should it fail, the best treatment for the child is the admin- istration of cream in doses of from 1 to 2 teaspoonfuls in warm water from time to time just before the periodical meal. Although there are exceptions to the rule, I find most cases of constipation are caused from a lack of attending to the call of Nature. Having some unfinished work to perform when Xature calls, it is put off until the work is finished, then the call is forgotten and the subject becomes habitually consti- pated. I first give the patient a severe lecture on his neglect to answer the call of Xature promptly. Then I instruct him to finish each meal with a good, ripe apple (and, if small, to eat two). And, as I consider the most appropriate time for the bowels to move is immediately after breakfast, I instruct the patient to fill an ordinary P. P. syringe with pure glycerine and inject, per rectum, immediately after that meal, which will usually cause a free passage within five or ten minutes, and to continue these injections until Xature calls at that time with- out its use. I have found the glycerine to be needed but a short time. The following combinations are serviceable remedies in correcting constipation in adults : — I£ Fluidextracti frangulse, 3vj. Fluidextracti cascarse, 3vj. Glvcerini, 3iij. Misce. Sig. : One or 2 teaspoonfuls at bed time. B Ext. cascarse, gr. 3 / 4 . Podophyllin, gr. V 7 . Ext. hyoscyami, gr. x /.. Euonymin, gr. 3 / 7 . Pulv. saponis, q. s. Misce et fiat pilula no. j. Sig. : One or two such pills at bed time. |02 Hand-Book of Modern Treatment. B Euonymin, gr. 3 / 10 . Podophyllini, gr. 3 / 10 . Ext. hydrastis Canaden., gr. ss. Pulv. saponis, gr. ss. Misce et fiant pilulse no. j. Sig. : One such pill at bed time. In considering the treatment of chronic constipation, J. A. MacMillan recommends rectal tampons in atonic con- stipation. This tampon should be made of absorbent cotton, cheese-cloth, or lamb's wool, and should be large enough to cause some distension of the bowel. It should be inserted through an ordinary proctoscope, and packed by means of a long forceps. The best location is at the recto-sigmoidal junction. A piece of string, of course, should be attached to the tampon, in order to facilitate its withdrawal after it has remained in place for from two to six hours. This treatment should be carried out every other day at first, and the interval between the treatments should be gradually lengthened as im- provement takes place. The value of this treatment, accord- ing to the author, is due to the distension of the intestine. He records success in the majority of the cases in which he has tried it, although not in all of them. In most of these cases enemata and cathartics should be discontinued from the first, in order that regularity of stools may be established. CONVULSIONS. 1$, Sodii bromidi, gr. viij. Chloralis hydratis, gr. viij. Sodii bicarb., gr. viij. Aquae, fgj. Sig.: Teaspoonful every hour to a child under four months old. I£ Chloralis hydratis, gr. viij. Camphorse, gr. xv. Tinct. moschi, gtt. xx. Aquae destillatae, §iij. Yelk of 1 egg. Sig.: As an enema. Hand-Book of Modem Treatment. 108 I£ Chloralis hydratis, gr. v. Moschi, gr. iij. Camphorae, gr. xv. Aquae, §iij. • Yelk of 1 egg. Sig. : As an enema. Indication: Persistent convulsions. I£ Chloroformi, f^ss. Sig. : Used by physicians. Small quantity on handkerchief until convulsion ceases. Indication: Infantile convulsions. Infantile convulsions or spasms may be arrested in one minute by the application of one or two dry cups on .the back, from the seventh cervical to the first dorsal vertebra. This se- cures a remission for other medication. Veratrum viride is an excellent remedy in convulsions. It may be given to infants, or in puerperal eclampsia, or in epi- lepsy. It may be given per orem or hypodermically. It must be given in full doses in severe cases. I£ Moschi, gr. vij. Gum acacia, 3ss. Aquae foeniculi, 3j. Syr. aurant. cort., Sj. Misce. Sig. : A teaspoonful every hour or two. Indication: Infantile convulsions. CORNS. Soften the corn at night by covering it with a piece of flannel coated with soap and some spirits of wine. Afterward scrape it with a curette or a knife. Apply on eight successive days a layer of the following collodion: — I£ Fluidextracti cannabis Indicae, gr. v. Acidi salicylici, gr. xv. Alcoholis (90 per cent.), 3ij. iEtheris, m xlv. Collodii flexile, gr. iv. Misce. 104 Hand-Booh of Modem Treatment. On the eighth clay, after bathing the foot for a long time in hot water, scrape away with a curette or knife the mass of collodion, and along with it the greater part or all of the eo'rn. If necessary, the treatment may be repeated. A common and often efficient remedy is to place upon the corn a round piece of lemon during one or several succeeding nights. Cantharidal collodion or salicylic ointment is also used. Different caustics should be used with extreme caution. Sur- round the very painful corns with a special ring of wool or a corn-plaster. When the corn is situated between the toes, keep the latter separated with a pad of fine cloth, and dust the corn with a powder of tannin, alum, or oxide of zinc. Certain au- thors recommend the following method: (1) moisten the corn Avith a concentrated solution of salicylic acid in alcohol; (2) cover with powdered salicylic acid and make a sealed covering with a small piece of cotton wadding; (3) renew the dressing in four or five days, and if there is any inflammation, stop the treatment. About the eighth day remove the corn by soaking. 1$ Extracti cannabis Indicae, gr. ij. Acidi salicylici, gr. xx. Olei terebinthinse, m x. Acidi acetici glaciale, gr. iv. Cocainae ( alkaloidal ) , m iv. Collodii, q. s. ad 3iiiss. Misce. Sig. : Apply a thin coating every night, put- ting each coating on top of the preceding one, until finally the whole drops off, bringing the indurated portion, and frequently the whole corn, with it. U Iodi, gr. ij. Collodii flexile, 3iij. Alcoholis, 3j. Potassii iodidi, gr. ij. Misce. Sig. : Paint the corn every night. Indication: Used in soft corns. A radical cure for corns consists in paring the callosity as closely as possible without causing any haemorrhage, then placing in the center of the corn a very small drop of croton-oil, Hand-Book of Modern Treatment. 105 and bandaging for twelve hours. Then remove the bandage and paint the corn with reliable cantharidal collodion; a pustular bleb will result, in the formation of which the entire callosity, nucleus and all, will be raised without very much pain from the tissues beneath, and can be easily removed. The pro- cess should be conducted under the care of a surgeon to insure prompt sterilization of the part after the callus is removed. Healing has always been rapid, not requiring more than three or four days, with no liability to recurrence unless the foot is afterward abused. I have treated active, working patients without a loss to them of more than half a day of time. CORYZA AND COUGH. B Extracti belladonna, gr. Vs- Pulveris camphorse, gr. j. Sulphatis quininse, gr. j. Pulveris opii et ipecacuanha?, gr. ij. Misce. Sig. : Take at one dose. For the slight colds often seen in the aged, even during warm weather, the main indication is for a stimulating expec- torant that will disturb the stomach as little as possible. Much better than the ordinary ammonium carbonate preparations, says International Clinics, under these circumstances, is the following formula : — B Spt. amnion, aromat., 3j. Spt. chloroform., 3ij. Aquae menthae pip., q. s. ad Biij- Misce. Sig. : Tea spoonful every four hours. Indication : Cold in old people. The following is a successful treatment of coryza in infants : — B Spts. camphorse, m v. Tr. belladonna?, mi]. Quininse sulphatis, gr. iij. Syrup tolutani, q. s. ad Sj- Misce. Sig. : One-half teaspoonful every three hours. 106 Hand-Book of Modern Treatment. The relief of the immediate symptoms is best assured by local treatment. The following is a favorite prescription : — 1$ Mentholis, gr. j. Camphors, gr. j. Petrolati liquidi, Sj- Misce. Sig. : One drop in each nostril several times a day. The menthol and camphor increase the roominess of the meatus and usually afford prompt relief. The oil may be intro- duced by a small cotton tampon or preferably a bit of cotton on an applicator. IJ Sodii salicylate gr. xx. Pulveris opii et ipecacuanhas, gr. ij. Misce. Sig. : Give at first every three hours and later three times daily. Indication: Used in acute coryza. IJ Atropinse sulphatis, gr. 3 / 25 . Camphorse, gr. vj. Quininse, gr. xij. Pilocarpines hydrochloride gr. 3 / 100 . Misce et fiant chartulse no. xij. Sig. : One every hour for six hours and re- peat in eight hours. Indication: Used when membranes are dry and swollen. IJ Pulveris camphorse, gr. vj. Extracti belladonnse, gr. iss. Bromidi quininse, gr. xij. Misce et fiant capsulse no. xij. Sig. : One every hour until four doses are taken and repeat in six hours. IJ Cocainse, gr. ij. Camphorse, gr. j. Olei rosse geranii, gtt. ij. Olei-albi, f£j. Misce. Sig.: Drop into nose or put on pledget of cotton and place on each tonsil four or five minutes, having three or four drops on each pledget. Hand-Book of Modern Treatment. \{)\ B Syrupi tolu, 3iv. Syrupi scillse, %iss. Vini ipecacuanha?, 3iss. Tinet. opii camphoratae, q. s. ad Svss. Misce. Sig. : One teaspoonful four times daily. Indication: Winter cough and cold. I£ Codeinse sulphatis, gr. iij. Chloroformi, 3j. Syrupi pruni virgiiiianse, 3j- Tinct. lavand. conip., 3j. Spts. vini gallici, 5j. Misce. Sig. : One teaspoonful every three or four hours. Indication: Used in early stages with exces- sive cough. 1^ Camphorse, gr. xv. Quininse hydrochloratis, gr. xlv. Tinct. aconiti, gr. xl. Tinct. belladonna?, gr. xl. Sacchari lactis, q. s. Misce et fiant -capsular no. xv. Sig. : One capsule every two or three hours. Indication: To relieve acute congestion. I£ Saliein, gr. xv. Potass, bicarbonatis, gr. xx. Spts. aetheris nitrosi, 3ss. Liquoris amnion, acet., 3iij. Aquae camphorse, q. s. ad £iss. Misce. Sig. : At one dose to be taken at bed time, B Codeinse. gr. iv. Acidi hydrochlor. diluti, 3ss. Spiritus chloroformi, 3iss. Syrupi limonis, §j. Aquae, q. s. ad §iv. Misce. Sig. : A teaspoonful frequently when cough is troublesome. Indication: Used in hacking, irritable cough of phthisis. 108 Hand-Book of Modern Treatment. Cannabis Indica is a good remedy in persistent coughs of pregnancy. Bromides sometimes are beneficial; the combined bromides of gold and strontium are also recommended. If the patient is anaemic as well as nervous, the three valerianates of quinine, iron, and zinc should be given an hour after each meal, in doses of one grain. One very often meets with an annoying condition wherein the patient complains of a "tickling in the throat which makes me cough constantly." This will be relieved by the following : — I£ Codeinse, gr. j. Acetphenetidini, gr. ij. Pulveris glycyrrhizae, gr. xvj. Sacchari lactis, q. s. Misce et fiant chartulse no. viij. Sig. : Dissolve one in mouth every hour. B Spiritus setheris nitrosi, 3ij. Amnion, muriat., 3j. Pulveris opii et ipecacuanha?, 3j. Syrupi simplicis, q. s. ad §iij. Misce. Sig. : Shake well and give from one to two teaspoonfuls according to age of child. Indication: Used in cough of measles. The following is a well-tried combination for the relief of the cough in bronchitis: — 1^ Codeinse sulph., gr. iij. Ammon. chloridi, 3iss. Spts. chloroformi, 3iss. Syr. tolutani, §j. Fluidextracti glycyrrhizae, §j. Acidi hydrocyanici dil., gtt. xv. Aqua?, q. s. ad §iv. Misce. Sig. : One teaspoonful every four hours. This might be made more palatable by the omission of the glycyrrhiza or of the syrup of Tolu, especially in cases with impaired digestion or appetite. Hand-Book of Modern Treatment. 109 I£ Amnion, muriat, gr. viiss. Mist, asafoetida, f3iv. Sig. : One dose as necessary for after-cough from habit. For the night cough of habit Borland gives 2 grains of terpin hydrate at bedtime and in the early morning. For the nervous cough of mothers during whooping cough in the house- hold, Bartholow gave : — 1^ Acidi hydrocyan. dil., m ii-iv. Syr. Tolu., m xxx-xl. Aquae laurocerasi, q. s. ad f3j. Misce. Sig. : A teaspoonful or two every three or four hours. COUGH OF CONSUMPTIVES. R. Morphinse sulphatis, gr. ij. Acidi sulph. dil., gtt. viij. Vlisce et adde Vini ipecacuanhas, 3iij. Tinct. serpentariae, 3vj. Spir. vini, 3j. Syr. prun. Virg., q. s. ad %\x. Misce. Sig. : Teaspoonful when required. It is certainly safer to allay cough by means of a non- poisonous local anaesthetic than by morphine or any other nar- cotic. Such an agent, according to Saenger, of Magdeburg, is menthol. A few crystals may be vaporized in a spoon over a flame and inhaled, or a- few drops of a 40- or 50-per-cent. alcoholic solution may be rubbed between the hands and the hands then held before the nose. At first the cough is intensi- fied, but it soon subsides. This result can be produced, how- ever, only if the mucous membrane is free from accumulated secretion. The remedy acts well in whooping-cough, but it should not be used in cases of acute inflammatory disease of the lung or pleura or if there is a tendency to haemoptysis. 110 Hand-Book of Modern Treatment. IJ Heroin, gr. ij. Syrupi tolu, 3iiss. Misce. Sig. : One teaspoonful three times daily. Indication: Used as sedative in excessive cough. IJ Tinct. opii camphoratae, 3ij. Vini ipecacuanhas, 3ij. Misce. Sig. : Ten to 15 drops. Indication: Sedative and expectorant for a , child. CRETINISM. IJ Glandular thyroideae siccae, gr. x. Saccharii lactis, gr. xxx. Misce et fiant tabellse no. xx. Sig. : One three times daily and increase according to need and toleration. CROUP, MEMBRANOUS.— See Diphtheria. CROUP, SPASMODIC. IJ Hydrargyri chloridi mitis, gr. iij. Saccharinae albae, gr. xxx. Misce et fiant chartulae no. viij. Sig. : One powder every two hours, alter- nating with the following: — IJ Apomorphinae hydrochlor., gr. x / a . Acidi hydrochlor. dil., m ij. Syr. simplicis, 3ij. Aquae dest., q. s. ad §iv. Misce. Sig.: One or two teaspoonfuls every two hours. The two remedies are given alternately every two hours ; so that the patient gets calomel one hour and apomorphine the next. For children under two years the dose of calomel is re- Hand-Book of Modern Treatment. m duced to Ve grain. Both prescriptions may be repeated, and in the author's cases more than two repetitions were never re- quired. The calomel should be discontinued as soon as ameli- oration sets in, lest untoward results appear. R. Chloralis, gr. lxxv. Potassii bromidi, gr. xlv. Ammonii bromidi, gr. xxx. Aquae cinnamomi, ^ij- Misce. Sig. : One teaspoonful and repeat in twenty minutes if not relieved. The bichromate of potash is of marked value in pharyn- geal irritations, and will be found eminently satisfactory in spasmodic croup. Many times the efficiency of this drug will be increased by combining with it apomorphine. One-tenth grain of each placed in 2 ounces of hot water and a teaspoon- ful of hot solution administered every fifteen minutes will pro- duce decidedly beneficial results after a few doses. S. E. Wertman, after having lost several cases of croup of an unusually severe and malignant character, resorted to hy- podermics of pilocarpine hydrochlorate, from which he obtained surprisingly good results. Injections of pilocarpine, from 1 / 48 to V 24 grain, were given. In each case improvement was no- ticed within a few hours; the disease was entirely checked, one or two clays being sufficient to effect a cure. In only one case was the second injection made. SPASMODIC OR CATARRHAL CROUP. I£ Mentholis, 3ij. Misce. Sig. : Volatilize about 10 grains in room, by placing in spoon and applying heat. Indication: Used to relieve attack. Wrap cold cloths around neck. An emetic is a valu- able adjunct to this treatment if child does not promptly improve. The following combination, containing creosotal, is recom- mended in the treatment of croup contracted by children be- tween the ages of five and ten years: — 112 Hand-Book of Modern Treatment. 1$, Creosotal,.gr. xlv-3j. Liq. amnion, anis., m xv. Syr. senegse, 5ss. Infus. ipecac, rad., §iss-3iij. Misce. Sig. : One teaspoonf ul every hour • until fever diminishes, then every two or three hours. 1^ Syrupi ipecacuanhas, f3iss. Tinct. opii camph., f3ij. Syrupi scillae, f Sj - Liq. potass, citrat., q. s. ad fSiij- Misce. Sig. : Teaspoonf ul every two hours. CYSTITIS. The following treatment is recommended in this condi- tion : In acute cystitis the chief indications are rest in bed, light diet, bowels kept open, urine rendered bland and unirri- tating by copious draughts of water, milk, buttermilk, whey, and lithia water. Hot fomentations to the pelvis or hot sitz baths lessen the congestion and relieve the pain. In women, hot vaginal douches should be given once or twice daily. These, as a rule, are sufficient to make the patient comfortable; if not, suppositories may be given. I£ Morphinse sulphatis, gr. V 12 . Ext. belladonnse, gr. y 4 . Ext, hyosciami, gr. V 4 . 01. theobrom., gr. xij. Misce et fiat suppos. no. j. Sig. : One such introduced into the rectum every few hours as required for the pain. Urotropin or cystogen in 5- to 10 : grain doses is valuable to make the urine antiseptic, but is particularly indicated when the urine is alkaline. The author states that irrigations should not be given in hyperacute cystitis or if there is an acute urethritis or nephritis, but may be used with decided benefit in the subsiding stage to prevent the cystitis from becoming chronic. The fluid should have about the same specific gravity as the urine. The following has given very satisfactory results : Hand-Book of Modern Treatment. H3 B Acidi borici, 3j. Sodii biboratis, 3j. Sodii chloridi, gr. xxx. Misce. Sig. : Dissolve in a quart of hot water and use as irrigation. As the disease becomes chronic the irrigations should be made more stimulating, as mercuric chloride, 1-5000 to 1-800; potassium permanganate, 1-12,000 to 1-1000, or nitrate of silver, 1-4000 to 1-800. As an antiseptic and sedative given internally the follow- ing :— I£ Fluidextracti belladonna?, m xx. Sodii boratis, 3ij. Aeidi benzoici, gr. xx. Tinct. opii camph., §iss. Olei gaultheriae, m xij. Syrupi, gij. Aqua? destil.. q. s. ad %\\. Misce. Sig.: One dessertspoonful in water four times a day. When the urine- is acid the following is of service as an antiseptic : — ~fy Potassii acetatis, 3iv. Solut. potassae, 3j. Fluidextracti uvae ursi, 3iv. Tinct. hyoscyami, 3iv. Tinct. lupulini, 3iv. Aquae, gij. Syr. zingiberis, q. s. ad §viij. Misce. Sig. : One tablespoonful in water after meals and at bed time. For cystitis, where there is a sanguineous discharge : — I£ Potassii bromidi, 3iv. Tinct. gelsemii, 3ij. Fluidextracti ergotee, 3ss. Spt. aetheris nitrosi, q. s. ad %\x. Mix and make into solution. Sig. : Teaspoonful three or four times daily in water. 114 Hand-Book of Modern Treatment. The following combination has proved very satisfactory in the treatment of cystitis associated with alkalinity of urine: — Ifc Saloli, gr. v. Acidi boracici, gr. v. Codeinae sulph., gr. %. Misce et fiat chartula no. j. Sig. : One powder after meals and at bed time. I£ Atropiae sulphat., gr. j. Acidi acetici, m xx. Alcoholis, §ss. Aquae, £ss. Misce. Sig.: Four drops in water before each meal, in acute cystitis. Indication: Used in acute cystitis. IJ Acidi benzoic!, 3iiss. Sodii biborat., 3v. 01. gaultheriae, m xv. Aquae, ad gij. Misce. Sig. : One drachm after meals. R Tinct. opii camphoratae, j$ij- Vini ipecacuanhas, Sij- Spiritus aetheris nitrosi, 5ij- Misce. Sig. : Teaspoonful three times a day. Elaterium is one of our best remedies in inflammatory difficulties like cystitis, when used in small, oft-repeated doses — when there is an uneasy burning after urinating, as if all had not been voided. Give : — I£ Tr. elaterii, 3ij. Tr. belladonnae spec, gtt. xvj. Mucilaginis acaciae, §j. Aquae dest., q. s. ad -giv. Misce. Sig.: A teaspoonful every one or two hours. This is specific for this condition. Hand-Book of Modern Treatment. 115 $ Morphinae acetatis, gr. iv. Tinct. veratri viridis, 3j. Tinct. hyoscyaini, 3ij. Syrupi zingiberis, 3j- Aquae, q. s. ad Siij- Misce. Sig. : Teaspoonful in water every four hours. Indication: Acute cystitis with haemorrhage and pain. Ifc Potassii acetat., 3j. Fluidextracti buchu, Sj- Sp. aetheris nitrosi, 5j- Codeinae sulph., gr. iv. Infus. tritici repent., q. s. ad Oj. Misce. Sig. : One-half ounce every three hours. IJ Fluidextracti pichi, Siv. Potassii citratis, 3iij. Tinct. hyoscyami, 3ij. Spt. aetheris nitrosi, 3iij. Elixiri aurantii, q. s. ad 3ij- Misce. Sig. : One teaspoonful in water one hour and a half after meals. Indication: Acute cystitis and urethritis. DANDRUFF. B Potassii carbonatis, 3ss. Amnion, carbonatis, 3ss. Glycerini, 3iv. Aquae, Sviij. Spiritus vini, gviij. Olei lavandulae, gtt. vj. Misce. Sig. : Hair-wash as indicated. I£ Resorcinolis, 3ij. Glycerini, f^ss. Alcohol, q. s. ad fgvj. Misce. Sig. : Clean scalp with soap and water and apply this lotion. 116 Hand-Bool- of Modern Treatment. 1$. Camphora, 3j. Alcoholis, f3vij. Aquae rosae, f3ij. Misce. Sig. : Apply directly to scalp by means of atomizer. I£ Ung. sulphuris, 3iv. Petrolati, 5ij. Misce. Sig. : Apply freely night and morning. DEBILITY.— See Asthenia. 1$ Acidi phosphorici diluti. 3j. Fluidextracti cocas, 3ss. Fluidextracti damianae, Sss. Tinct. nucis vomicae, m x. Syrupi zingiberis, 3j. Aquae, q. s. ad §j. Misce et fiat dosis. Sig.: To be taken in water at 11 A.M. and 6 P.M. R Ferri et ammon. citratis, gr. v. Tinct. nucis vomicae, m v. Tinct. cinchonae comp., q. s. ad 3j. Misce. Sig. : One teaspoonf ul three times daily after meals. Ifc Tinct. nucis vomicae, gr. v. Acidi phosphorici diluti, m viij. Syrupi hypophosphitis, q. s. ad 3j. Misce. Sig.: One teaspoonful three times daily. B Tinct. ferri chloridi, 3j. Elixiris gentianae comp., £ij. Misce. Sig. : One-half to 1 teaspoonful three times daily. Hand-Book of Modern Treatment. \\J DELIRIUM TREMENS.— See Alcoholism. In delirium tremens with insomnia, great excitability and inability to retain food, the following active cathartic is recom- mended : — I£ Pulv. jalapse co., gr. x. Hydrargyri chloridi mitis, gr. v. Sodii bicarb., gr. v. Misce et fiat chartula no. j. Sig. : To be taken at one dose. Should the heart show any signs of weakness the following is recommended : — I£ Tinct. capsici, 3iv. Tinct. digitalis, 3iv. Tinct. nucis vomicae, 3ij. Spts. amnion, arom., q. s. ad ^iij- Misce. Sig. : One teaspoonful in water every four hours. In cases of extreme nervousness accompanied by insomnia, sedatives will be required, and in extreme cases a hypodermic of morphine. Chirata has been used in India for many years as a cure for drunkenness. The plant is held • in high esteem among the natives, and the missionaries employ it extensively for the cure of drunkenness. A correspondent, who was chaplain to an army post and in charge of a mission in India for -many years, informs us that he has seen very good results from the use of chirata in habitual drunkenness. He adds that the drug seems to be more intensely bitter than gentian, quassia, etc., and attributes the effect of chirata upon alcoholics to this property. The disgust for drink which it creates is only tem- porary, however, and the patient must take the drug from time to time when the craving for alcohol returns. The best way to administer it is in the form of an infusion (V 2 ounce of 118 Hand-Book of Modern Treatment. chirata to 1 pint of boiling water), the dose of which is from 1 to 2 ounces three times daily. Some recommend the use of hyoscin hydrobromate in av- erage doses of 1 / 200 of a grain combined with V 600 grain of atropine sulphate and 1 / 150 grain of strychnine sulphate in the treatment of morphine and cocaine habitues and habitual drinkers. The treatment necessitates a special nurse day and night, inasmuch as the patient is purposely kept in a state of mild delirium for a period varying from thirty to ninety-six hours. The dosage varies with the patient, but it is repeated every two to six hours as indicated by dryness of mouth, dilatation of pupils, and delirium. Sleep is not usually produced. When the patient is allowed to emerge from the influence of the hyoscin he soon develops a vigorous appetite, sleeps soundly after the first two or three nights, regaining his normal vigor and weight in the course of a month. Too few cases are reported to make this article of more than passing interest, but as a large number of observ- ers have recently tried the same method, we shall, no doubt, soon have reliable data at our command. IJ Potas. bromidi, gr. v. „ Sodii bromidi, gr. v. <«Chloralis hydratis, gr. x. Tinct. zingiberis, m v. Tinct. capsici, m v. Spts. ammon. aromat., m x. Aquae, q. s. ad 3j. Misce. Sig. : One dose such as this three times daily. DENTITION. The argument that dentition is a purely physiological function and therefore cannot cause pathological phenomena is regarded as untenable. When the gums are hot and tense, then frequent rubbing with the following combination will give proper relief: — Hand-Book of Modern Treatment. H9 Ifc Potassii bromidi, gr. xx. Chloralis hydratis, gr. x. Tinct. aconiti rad., m v-xv. Spts. chloroformi, 3j. Mucilaginis, q. s. ad 3j- Misce. Sig. : Apply to the gums frequently by rub- bing. At the same time he recommends that the following be given internally : — IJ Potassii bromidi, gr. iii-v. Chloralis hydratis, gr. i-ij. Aquae destil., q. s. ad 3ij. Misce. Sig. : To be given at one dose by the mouth. The foregoing mixture may be given in double the size dose, per rectum, using starch-water as a vehicle. 1$ Tinct. iodi, m lxxx. Tinct. opii, m lxxx. Tinct. gallse, m lxxx. Acidi carbolici, m viij. Misce. Sig. : For painting on the gums twice daily. Indication: Useful in dental periostitis. B Phenolis, 3j. Essentia^ limonis, 3j. Alcohol, 3v. Misce. Sig. : Wash and dry the cavity, soak a small piece of cotton with the solution, insert, and then cover it with another small piece of cotton soaked in tincture of benzoin. Indication: Useful in dental caries. DERMATITIS. Ifc Ichthyolis, 3ij. Ung. zinci oxidi, q. s. ad Sij- Misce. Sig. : Apply freely once daily and wrap well in gauze. Indication: Useful in burns. 120 Hand-Book of Modern Treatment. Ifc Ung. zinci oxidi, £j. Ung. aquae rosae, 3j- Misce. Sig.: Apply freely. Indication: Useful in burns. I* Acidi picrici, gr. lxxv. Alcoholis, tSiiss. Aquae destillatae, Oij. Misce. Sig. : Soak gauze in this and apply and leave several days. Remove this and reapply and leave a week. I£ Balsami peruviani, 3j. Resorcini, gr. x. Ung: aquae rosae, 3j. Misce. Sig. : Treat antiseptically and apply. Indication: Useful in frost-bite. Ifc Liq. plumbi subacetatis, §iv. Tincturae opii, §j. Aquae, Sxvj. Misce. Sig. : Soak gauze and apply. Indication: Useful in ivy poisoning. 1$ Fluidextracti grindeliae robustae, 3iv. Aquae, Oij. Sig. : Apply continuously in ivy poisoning. $ Tinct. lobeliae, Sij- Aquae, Oij. Misce. Sig. : Apply gauze soaked in this in ivy poi- soning. DIABETES INSIPIDUS. A man of 49, previously healthy, developed a typical dia- betes insipidus after a severe concussion of the nervous system. Strychnine was administered — fifteen injections during twenty Rand-Book of Modern Treatment. 121 days — a total of 0.0905 gram of strychnine nitrate. The urine subsided from a daily 8000 cubic centimeters to 3400 cubic centimeters. The strychnine was discontinued on account of symptoms of intoxication, but the urine continued its down- ward course to 2400 and 1700 cubic centimeters and the patient is apparently cured. The density of the urine remained un- influenced by the strychnine. It ranged from 1.007 to 1.002. The persistence of this figure for the specific gravity forbids the assumption of a complete cure, but the subsidence of all the symptoms certainly justifies further trials of strychnine in such cases. I£ Acidi gallici, gss. Pone in capsulas no. xxiv. Sig. : One after each meal. R. Fluidextracti ergotse, §iv. Sig. : Thirty minims after each meal. DIABETES MELLITUS. The following combination containing boric acid, it is claimed, has been of curative benefit in treatment of diabetes. The cases in which it was used were young persons : — IJ Acidi borici, gr. xx. Glycerini, 3j. Liq. arsenici hydrochlor., m v. Liq. strych. hydrochlor., m x. Aquae destil., q. s. ad 3j. Misce. Sig.: To be taken at one dose and repeated three times a day. The arsenic and strychnine preparations are of 1-per-cent. strength as contained in the British Pharmacopoeia, and conse- quently the above close of strychnine is on the border-line of danger and probably should never be prescribed in such size doses. It should be prescribed in doses of 3 to 5 minims. Phosphoric acid diminishes thirst and lessens the quantity of urine. Pilocarpine nitrate, 1 / 24 grain in diluted spirit, may be placed on the tongue four times a day. Duchenne recom- 122 Hand-Book of Modem Treatment. mends potassium phosphate, 2 parts in 75 of water — a drachm of the solution twice or thrice daily in wine or hop tea. Faulds has employed with success an infusion of eucalyptus in the treatment of diabetes as follows : — 1^ Eucalyptus flores (dried), 3iv. •Aquae, gvj. Misce et fiat infusum. Sig. : One such draught to be taken twice daily. He states that he has obtained good results in 15 out of 16 cases. In one case, a girl of 18, in which there were 60 grains of sugar to the ounce of urine passed, after four days' treat- ment only 1 grain to the ounce was passed, and on the sixth day none. He, however, thinks it of service only in those cases due to gout, overindulgence in food, or cold. It does not seem to be of service in those cases dependent on vasomotor disturbance affecting the blood-supply to the hepatic cells, as no improve- ment was shown in those cases. Eucalyptus-oil or eucalyptol will not produce the same results as the infusion. Some recommend the use of aspirin in the treatment of glycosuria and diabetes mellitus. This preparation seems to have the most influence in the less severe forms and is less ser- viceable in the acute forms in young individuals. In order to produce any reduction in the milder forms it should be given in doses of 15 grains each four or five times a day. The pa- tient should be watched for the appearance of toxic symptoms. It is best to begin with a small dose, 10 grains two or three times a day, and gradually increase the dose. There is no disorder of the system in which empiricism has assumed a more important place in therapeutics than in the treatment of diabetes mellitus. W. R. Jones states that he derived splendid results from the use of uranium nitrate in the treatment of this disorder of metabolism. In every case in which this preparation has been used by the author great im- provement has resulted. It should be given in doses of from Ve t° V 2 grain four times a day, administered in water, alcohol, or glycerine. The salts of uranium, while not luminous, are strongly fluoresces t. which, according to the writer, lends inter- Hand-Book of Modern Treatment. 123 est because of the discussion of radium at the present time. But whether the fluorescent property in any way affects metab- olism cannot be stated. He refers to the action of uranium on the skin producing a fine desquamation of the superficial layers of the epidermis somewhat similar to the effect of the x-ray. The degree, however, is very moderate and gradual. The general nutrition and activity of the skin are increased as well as the diaphoretic action, so that it is recommended for its beneficial effects on metabolism. It is a yellowish-green, crystalline solid, soluble in water, alcohol, ether, and glycerine. Some authors give it in 1- to 2-grain doses. I£ Benzosol, gr. xlviij. Sodii benzoatis, 3iv. Acidi arsenosi, gr. j. Sodii salicylates, 3iij. Misce et fiant capsulse no. xlviij. Sig. : Two capsules one hour after meals and at bed time. Indication: Useful in subacute cases. I£ Sodii sulphocarbol., 3ij. Salicini, 3j. Phenacetini, 3ij. Ammon. benzoatis, 3iv. Misce et fiant capsular no. xlviij. Sig. : Two capsules one-half hour after meals. Diabetes mellitus can affect one of normal development as well as can the diabetes produced by brain or pancreas disease. That the primary disease is of little importance in the treat- ment is his belief. The greater number of cases of diabetes mellitus is met in persons who are predisposed, the disease being brought out by some deleterious influence. Adipose per- sons, and especially adipose children, are prone to develop the disease. In this class of individual excessive eating of carbohy- drates, sweets, and beer is to be avoided, while mental and physical exercise is to be encouraged. Milk, green vegetables, and unsweetened fruits are to be allowed. In this disease the 124 Hand-Book of Modem Treatment. capacity (tolerance) of each individual is to be determined. Medium and mild degree cases should receive treatment re- gardless of any complication, of which tuberculosis is the worst. The tolerance to sugars is to be increased, if possible, and the sooner a case is treated the greater is the chance of benefit, especially since the diabetes tends to grow worse in all cases with a percentage greater than one. Opium, quinine, arsenic, carbolic acid, etc., exert a beneficial influence on the sugar output, but it is not lasting. These remedies, however, are of value when used in conjunction with the dietetic regimen. The number of calories necessary for each individual is to be de- termined and his diet list arranged accordingly. The end to be obtained is a sugar-free urine, and in any case the sugar should be kept below one-half per cent, if possible. Where the sugar has disappeared a very gradual return to regular diet may be cautiously tried after two weeks in which no sugar has been present in the urine. Mild cases require about two months of treatment before the sugar-free period is obtained. Massage, baths, and gymnastics are of value in selected cases. The urine should be examined during the first six months every two weeks, after this every month; and every attack of indisposition should be investigated without delay. For secondary symptoms the following is recommended : — Stomatitis. — The stomatitis, gingivitis, and pyorrhoea, the loosening and caries of the teeth, may be due either to localized infections or to trophoneurotic influences. The mouth-manifes- tations are among the most distressing symptoms of diabetes. It is important that every case of diabetes should, from the beginning, be instructed carefully in regard to the possibility of mouth-complications, and taught how to obtain mouth asepsis and to perform the proper toilet of the teeth and gums. After each meal a diabetic should rinse his mouth and cleanse his teeth, preferably with a 3-per-cent. solution of sodium carbonate in warm water, to which may be added, as a flavor, a few drops of tincture of eucalyptus or a little menthol. Mechanical irregu- larities of the teeth should be corrected early, preferably during the aglycosuric period. All articles of food that can mechanic- ally scratch or injure the gums, and very hot beverages, should be forbidden. A hard tooth-brush should never be used. Hand-Book of Modern Treatment. 125 Excessive fcetor may be corrected by using the following mouth-wash : — I£ Beta-naphtholis, gr. ij. Sodii biboratis, 3iiiss. Aquae menthse pip., %\\. Aquae dest., q. s. Oij. If the gums are painful and bleeding, the following mouth- wash is useful: — I£ Tinct. opii, gr. xx. Potassii chloratis, m x. Sodii biboratis, m x. Syrupi althaeae officinalis, gij. Diarrhoea. — Fatty diarrhoea (steatorrhcea) is not uncom- mon. Here, possibly, the involvement of the pancreas and he- patic insufficiency can be made responsible. The fats in the diet should be reduced. Sodium carbonate, or calcium carbonate, in 10-grain doses, with pancreatin or ox-gall, of each, 5 grains, should be administered at frequent intervals during the day. Constipation. — Obstinate constipation is often a trouble- some and a dangerous complication. It, too, not infrequently precipitates coma if allowed to persist. Here absorption of bowel-poisons from stagnation and putrefaction of bowel-con- tents must be accused of determining the attack of coma. Usu- ally abundant fat-feeding and the restriction of carbohydrates are enough to counteract the constipation. Saline waters or a lemonade made as follows : — IJ. Glycerini, m vj. Acidi citrici, gr. x. Aquae, $iv. the whole quantity to be administered during the day, are all useful measures. The best medicines to counteract the con- stipation in diabetes are rhubarb and soda mixtures, either mistura rhei et sodae 2 drachms to 3 ounces, or the following powder : — 126 Band-Book of Modem Treatment. IJ Radicis rhei, gr. v. Sodii bicarbonatis, gr. v. Sulphuris pvaecipitati, gr. v. Misce. Sig.: To be taken at night, preferably in milk. Pruritis. — Pruritis, either general or localized, especially about the genitals, is one of the earliest, most distressing, and most obstinate symptoms of diabetes. General pruritis is pre- sumably due to irritation of the cutaneous nerves by circulat- ing sugar. In most cases its intensity fluctuates with the degree of glycosuria, and the symptom frequently disappears without further interference when the urine becomes sugar-free, only to reappear again, however, when more liberal carbohydrate feeding is instituted and the hyperglycemia increases. The best remedy for internal use, and almost a specific, is sodium salicylate, in doses of 30 grains, several times a day. Local applications are of very little value in general pruritis. In pruritus around the genitals, due in many cases to the development of fungi (mycosis vulvae), treatment directed towards, the reduction of the glycosuria, sodium saMcylate in- ternally and anodyne powders applied locally, usually relieves. A 5-per-cent. cocaine ointment or 2 / 3 -per-cent. eucaine ointment or a dusting powder containing 10 per cent, of orthoform, com- bined with frequent washing of the parts without rubbing or scratching, usually produces prompt relief. 1$ Saccharin, gr. x. Pone in cachetas no. xx. Sig.: Place one or two in a cup of coffee. Indication: Useful when you can't use sugar. B Codeinse sulphatis, gr. x. Misce fiant pilulse no. xx. Sig. : One three times daily after meals. IJ Pulveris opii, 3ss. Misce fiant chartulse no. xxx. Sig. : One three times daily one hour after meals. Hand-Boo fc of Modern Treatment. ^27 3 Sodii salicylatis, 3vj. Aquae, q. s. ad §iv. Misce. Sig. : One teaspoonful t.i.d. after meals. IJ Liquor potassii arsenitis, 3iv Sig. : One drop three times daily after meals and increase one drop daily until physiological effect is produced. Indication: Used in anaemic patients. Ifc Strontii salicylatis, 3iv. Liq. potassii arsenitis, m xx. Potassii iodidi, 3ij. Aquae, q. s. ad %vij. Misce. Sig.: One teaspoonful in water after meals. Indication: Used in anaemic and rheumatic patients. DIARRHOEA. IJ Tinct. opii camphoratae, fgij. Fluidextracti hamamelis, 5j. Acidi carbolici, 3j. Fluidextracti kino, f3ij. Tinct. zingiberis, f3ij. Calcis praecipitatae, §j. Syrupi, q. s. ad Bviij. Misce. Sig. : Shake before using and take 1 tea- spoonful every three hours. I£ Bismuth i subnitratis, 3ij. Iodoformi, gr. xxiv. Saloli, gr. xxiv. Acidi tannici, 3ij. Pone in cachetas no. xij. Sig. : One cachet every six hours. Indication: An intestinal tuberculosis. 128 Band-Book of Modern Treatment. R^ Bismuthi subnitratis, gr. xxx. Salolis, gr. v. Misce. Sig. : One such powder every six hours until relieved. To prevent recurrence continue the remedy for some time, giving it, however, less frequently. Restrict the diet principally to eggs and malted milk. Indication: Chronic fermentation diarrhoea. I£ Acidi carbolici, m xxiv. Tinct. opii deodoratse, 3j. Bismuthi subnitratis, 3iv. Acaciae pulv., q. s. Syrupus, q. s. ad Bviij. Misce et fiat emulsum. Sig. : Dessertspoonful every three hours. I£ Morphinae sulphatis, gr. j. Quininae sulphatis, 3j. Magnesii sulphatis, §ij. Acidi sulph. aromat., q. s. sol. Aquae menthae pip., q. s. ad 3iv. Misce. Sig. : One to two teaspoonfuls in a glass of water after meals. Indication: Chronic diarrhoea. R- Bismuthi subnitratis, gr. x. Sodii sulphocarbolatis, gr. iij. Cinnamomi, gr. ij. Opii, gr. ss. Misce. Sig. : One dose to be repeated every two or three hours as long as needed. R- Hydrargyri chloridi mitis. Pulveris opii. Bismuthi subnitratis. Misce et fiant chartulae no. vj. Sig. : Give one every hour until al 1 are taken or the diarrhoea is controlled. Hand-Book of Modern Treatment. 129 I£ Capsici, gr. viij. Cinnamomi, gr. xvj. Geranii, gr. xxxij. Misce et fiant chartulae no. viij. Sig. : One in hot water every one, two, or three hours until relieved. Indication: Diarrhoea in which there is much blood. In persistent diarrhoea of the tuberculous, according to the International Clinics, the following is said to give satisfactory results where other means have failed : — I£ Ichthyofcrmi, 3ss. Tannalbin, 3j. Bismuthi subgall., 3j. Codeinae, gr. iss. 01. menthae pip., m iss. Misce et divid. in chart, no. vj. Sig.: One powder every three or four hours according to indications. B Bismuthi salicylatis, 3iiss. Zinci sulphocarbolatis, gr. iij. Liquoris calcis, £iss. Tinct. opii camphoratae, 3iv. Aquae dest., §iss. Misce. Sig. : A teaspoonful every two hours and after each passage until the diarrhoea ceases. IJ Pulveris ipecacuanhse, gr. x. Pulveris papain, 3j. Pulveris capsici, 3iss. Pulv. nucis vomicae, gr. x. Misce et fiant no. xl. Sig.: One three times daily. Indication: Fermentation diarrhoea. Ifc Benzonaphtholis, gr. ij. Bismuthi salicylatis, gr. v. Resorcin, gr. ij. ' Misce et fiat pulver. Sig. : Some every three hours. 9 1 30 Eand-Booh of Modem Treatment. Ifc 01. ricini, 3iv-3j. Tinct. opii deodorati, m xv-xx. Misce. Sig. : Take at one dose. Indication: Used in acute diarrhoea with ab- dominal pain, due to eating decomposed or in- digestible food. In all diarrhoeas irritating foods and products of decomposition should be swept from the alimentary tracts before giving sedative or astringent remedies. IJ Tannigeni, 3ij. Bismuthi subnitratis, 3iv. Resorcini, gr. vj. Misce et pone in cachetas no. xij. Sig.: One cachet every two hours. Indication: Used in serous or mucous diar- rhoeas after ridding bowels of irritants and products of decomposition. For the diarrhoea that follows exposure to cold after a hearty meal, or that comes on from throwing off the bed clothes at night, the following is recommended : — I£ Tinct. capsici, 3iiss. Tinct. opii, 3iiss. Spti. camphors, 3iiss. Chloroformi, 3j. Alcoholis, q. s. ad Sij- Misce. Sig.: One teaspoonful every hour until re- lieved of pain; then one teaspoonful every two hours until the diarrhoea is effectually checked. B Tinct. kino, 3vj. Tinct. opii, 3j. Tinct. kramerise, 3vj. Tinct. chiratae, 3vj. Tinct. cardamomi comp., q. s. ad gvj. Misce. Sig.: One ounce every three hours in water. Indication: Used in serous or mucous diar- rhoea with abdominal pain after bowel is rid of irritating material. Hand- Book of Modern Treatment. 131 I£ Spiritus camphorae, 5iij- Spiritus chloroformi, §iij. Misce. Sig. : One teaspoonful in water every hour. Indication: Abdominal pain and diarrhoea. I£ Acidi (phenolis) carbolici, m x. Bismuthi strbnitratis, gr. c. Misce et fiant ehartulas no. x. Sig.: Take one every four hours. DIARRHOEA, CHILDREN. I£ Tannalbin, 3iss. Hydrarg. chloridi mitis, gr. j. Ipecacuanhae et opii, gr. xv. Saccharini, gr. %. Misce et fiant chartulae no. xx. Sig. : One every two hours for first three doses; then every four to six hours for a child of one year. Two powders per dose for child three years old. I£ Magnesii sulphatis, 3ij. Tinet. opii camphoratae, 3ij. Aquae, q. s. ad §iv. Misce. Sig. : One teaspoonful until you get watery action and then as needed until complete re- covery. Indication : Green mucous diarrhoea of chil- dren. I£ Tannalbin, 3ij. Spt. cinnamomi, m iij. Pulveris aromaticae, gr. xv. Sacchari, gr. xv. ; Misce et fiant chartulae no. xv. Sig. : One every three hours. $ Tinct. iodi, gtt. xv. Syrupi, giss. Aquae destil., q. s. ad £v. Misce. Sig.: One teaspoonful every two hours. Indication: Infantile diarrhoea. 132 Hand-Book of Modern Treatment. I£ Bismuthi subnitratis, 3j. Hydrarg. cum cretse, 3ss. Pulveris hydrastis, 3ss. Misce et fiant chartulse no. xxx. Sig. : One every two or three hours for a two-year-old child. Indication : Cholera infantum and summer complaint. WHEN TO GIVE OPIUM IN DIARRHOEA OF YOUNG CHILDREN. It is contraindicated (1) in the first stage of acute diar- rhoea, before the intestinal canal has been freed from decom- posing matter; (2) where the passages are infrequent and of bad odor; (3) when there is a high temperature or cerebral symptoms are present; (4) when its use is followed by an ele- vation of temperature or the passages become more offensive. It is indicated (1) when the passages are frequent with pain: (2) when the passages are large and watery; (3) in dysenteric diarrhoea, together with castor-oil or a saline; (4) in later stages with small, frequent, and nagging passages; (5) when the passages consist largely of undigested food, and the bowels act as soon as food is taken into them. • Most excellent results are secured from the use of gelatine in the diarrhoea of infants. Chemically pure gelatine is taken and dissolved in ten times its weight of boiled water. The so- lution is then sterilized in an autoclave at 120° C. for half an hour. The solution is then tubed, putting 10 cubic centimeters (representing 1 gram of gelatine) in each tube. The contents of one tube are then added to each bottle of milk given to the infant. In this way 8 grams of gelatine may be given a day, although 12 or even 14 grams have been used. The good effects of the treatment are seen very soon. The number of stools diminishes, they become more solid, and lose their green color and offensive odor. The general symptoms improve rapidly — often after four or five tubes. The medication finds its clearest indication in cases of dyspeptic diarrhoea without organic lesion. In true cholera infantum good effects are not obtained. The gelatine appears to have a direct effect upon the coagulation of the milk and upon the intestinal secretions. The fermentative and putrefactive Hand-Book of Modern Treatment. 133 processes are stopped, perhaps by a purely physical process, as some experiments outside the body would seem to indicate. IJ Bismuthi subnitratis, gr. x. Syrupi acaciae, m xx. Mist, cretae, q. s. ad f3j. Misce. Sig.: One such every two hours for a child one year old. Indication: Simple diarrhoea. IJ Magnesii sulphatis, gr. v-x. . Tinct. rhei dulcis, m x. Syrupi zingiberis, m x. Aquae, q. s. ad f3j. Misce. Sig.: This may be given every half-hour for several doses until free watery movement en- sues. IJ Bismuthi subcarb., 3j. Aquae cinnamomi, ^ij- Tinct. opii, gtt. ij. Misce. Sig. : Teaspoonful every one or two hours. IJ Phenolis, gtt. ii or vj. Mucilaginis, §ij. Misce. Sig. : Teaspoonful every two hours. IJ Argenti nitratis, gr. ij. Aquae desk, §ij. Misce. Sig. : Teaspoonful every two hours. IJ Resorcini, gr. ij. Aquae cinnamomi, gij. Tinct. opii, gtt. ij. Misce. Sig. : Teaspoonful every two hours. Indication: Each of the above four prescrip tions useful in cholera infantum. 134 Hand-Book of Modern Treatment. I£ Ammonii chloridi, gr. xxiv. Fluidextracti glycyrrhizae, $ss. Aquae, q. s. ad §iij. Misce. Sig. : One teaspoonful three times daily. Indication: Useful when much mucus is in stools. DIURETIC AND DIAPHORETIC. I£ Potassii acetatis, gr. xv. Potassii nitratis, gr. xv. Oxymelis scillae, 3iss. Syrupi sarsaparillae comp., 3iss. Infusii juniperus, §iiiss. Misce. Sig. : To be taken during the day. I£ Ext. stigmat. maidis, gr. xlv. Ext. convallariae majalis, gr. xlv. Sodii benzoat., gr. xlv. Lithii carbonat., gr. xlv. Misce et fiant pilulae no. lx. Sig.: Give from four to ten daily. The following is recommended by the Practitioner to pro- duce diaphoresis in combating colds: — I£ Pulv. camphorae, gr. v. Pulv. opii, gr. V3. Potass, acetatis, gr. iij. Sacchari, 3iiss. Misce et fiat chartula no. j. Sig. : One such powder to be taken in cup of tea at bed time. EFFERVESCING DIAPHORETIC DRAUGHT. This well-known combination is useful : — I£ Potassse carbonatis, 3ij. Aquae destillatae, %iv. Solve. Hand-Book of Modern Treatment. 135 R Succi limonis recentis, f§ij. Aque destillate, f^ij. Misce. Sig. : Mix two tablespoonf uls of the lemon- ade with one of the alkaline solution, and let the mixture be drunk while effervescing. To be repeated every two hours. This preparation is practically the well-known "neutral mixture," but is frequently better borne and its efferves- cence makes it more agreeable. t£ Digitalini crystal., gr. % . Pilocarpine hydrochlor., gr. y±. Sparteine sulph., gr. ss. Aquae destill., m xv. Misce. Sig. : For hypodermic use. Repeat if neces- sary. I£ Pulv. ipecacuanha et opii, 3j. Camphore, gr. v. Pulveris chocolate, 3ij. Misce et fiant chartulae no. x. Sig. : One at bed time with a warm drink. Indication : Diaphoretic. B Hydrarg. chloridi mitis, gr. j. Pulveris ipecacuanha?, gr. j. Sacchari lactis, gr. xx. Misce et fiant chartulae no. x. Sig. : One powder three times daily. Indication : Infants with green stools. R Tincture digitalis, f3iv. Sig. : Six minims four or five times daily. Indication : Diuretic. B Tinct. strophanthi, £3iv. Sig.: Five minims four times daily. R Theobromine sodii salicvlatis (diuretin), Sig.: Four grains six times daily. 136 Hand-Booh of Modern Treatment. DIPHTHERIA. If on account of poverty people cannot afford antitoxic serum, Curtius uses local treatment alone and has had excel- lent results with it. (Of 28 patients treated during one sum- mer with it alone, only 1 died.) He employs Loeffler's solution, the formula of which is as follows : — I£ Mentholis, gr. xxxviij. Solve in toluolis, m cxl. Alcoholis absol., 3iv. Liq. ferri chloridi, m xv. This he believes to be the most efficient antiseptic solution on the market. He applies this until all the membrane particles have disappeared ; at first every three hours and later three times daily. He first removes the membrane as well as he can with a cotton swab, then applies the solution with an applicator against the surface for ten seconds. Bascoul practices in Algiers, where it is not always possible to obtain fresh anti diphtheria serum. In the lack of it, he uses bromine, and states that seven years of experience with it have demonstrated its great efficiency. He administers from 5 to 10 drops of bromine in 200 grams of sweetened water, with 3 grams of potassium iodide. He uses for a gargle the same with from 20 to 30 drops of the bromine. He applies this treatment to all kinds of sore throats, including those of the eruptive fevers, and has found it both certain and effectual. If antitoxin cannot* be obtained early. Dr. Leonard Wil- liams recommends that, isolation be carried out in the usual way and a mixture containing the biniodide of mercury be given. The preparation is insoluble in water alone, but is freely solu- ble in an excess of potassium iodide. The following combina- tion is recommended : — ]$ Hydrargyri perchloridi, gr. j. Potassii iodidi, gr. xx. Glycerini, 3ij. Aquae, q. s. ad Bviij. Misce. Sig. : One teaspoon ful to a tablespoonful three or four times daily. Hand-Book of Modern Treatment. 137 In the foregoing mixture a double decomposition occurs, forming the biniodide of mercury, about 1 / 8 grain to the ounce. The glycerine is added in order to increase the tendency to adhere to the fauces and thus increase its local effects. As a bactericide the biniodide is said to be four times as powerful as the perchloride, and it does not have the tendency to throw down an inert albuminate when coming in contact with- the tissues. The author is emphatic in his statement that this prepara- tion of mercury, excepting, of course, antitoxin, is a more ef- fective foe of the Klebs-Loefner bacillus than any other drug or inhalation or local application which has ever been used. In all forms of sore throat the heart should be frequently examined as in rheumatism and chorea. B Seri antidiphtherici. Sig. : Inject 1500 to 2000 units into subcu- taneous tissues of the back and repeat in twelve hours. Dose should be repeated every six to twelve hours in severe cases. As a prophylactic should employ 500 units of the serum. B Hydrarg. chlor. corros., gv. y± 8 . Tinct. ferri chlor., m x. Glycerini, m x. Tinct. bellad., m ij. Aquse destill., f3j. Mi see. Sig. : Take every hour or two, well diluted. I£ Tinct. ferri chloridi, f§ss. Sig. : Two to ten drops every two or three hours. U Phenolis, fgj. Olei eucalypti, f5j. Olei terebinthinse, f§iij. Misce. Sig. : Use as directed. Place two table- spoonfuls of this in a quart of water, and this is placed in an open vessel and allowed to boil constantly. 138 Hand-Book of Modern Treatment. IJ Potassii permanganatis, gr. xx. Aquae, Oj. Misce. Sig. : Swab throat two or three times daily. DROPSY. 1$ Pulveris digitalis, gr. xlviij. Camphorse, gr. xlviij. Flor. benzoes. 3ij. Misce et fiant chartulse no. xxiv. Sig. : Three to four such powders each day. B Tinct. digitalis, 3ij. Sol. nitroglycerin! (1 per cent.), 3j. Tinct. strophanthi, 3j. Misce. Sig. : Fifteen drops four times daily. I£ Diuretini, §iij. Sig. : Thirty grains four times daily. IJ Tinct. digitalis, f3ss. Liq. ammon. acetat., f^ss. Spt. seth. nitrosi, f3ij. Syrupi tolu, f^ss. Aquae cari, q. s. ad f^iij. Misce. Sig.: Teaspoonful every two hours for a child 6 or 8 years old. R. Tinct. digitalis, f3ss. Elixiris simp., §ss. Liq. potassii citratis, q. s. ad 3iij. Misce. Sig. : One teaspoonful every two hours to a child 6 or 8 years old. 1$ Pulv. digitalis foliorum, gr. xx. Hydrarg. chloridi mitis, gr. xx. Pulveris scillae, gr. xx. Misce et fiant chartulae no. xx. Sig. : One powder after each meal. Indication: Cardiac dropsy. Hand-Book of Modern Treatment. 139 I£ Liq. potassii arsenitis, 3iv. Sig. : Two or three drops three times daily after meals. Indication: Useful in dropsy of old people. DYSENTERY. J. D. Hunter, who has resided in Peru for nearly forty years, where severe types of dysentery are endemic, usually gives ipecacuanha in a 45-grain dose as soon as the patient is seen, preceded, a half -hour before administering, by 15 to 30 min- ims of laudanum or a hypodermic of 1 / 6 grain of morphine and a sinapism to the pit of the stomach. In spite of the lauda- num and sinapism the patient is likely to experience severe nausea and vomiting. Peruvian practitioners usually give an infusion of the contused ipecac-root and sometimes enemata of this infusion. The clear decanted liquid, as used in these infu- sions, is rather less disgusting to most patients than the pow- dered ipecac. A second dose of the medicine is given within twenty-four hours, usually the next morning. When ipecac fails, or for any reason cannot be used, many Peruvian doctors use an emulsion of castor- and almond- oils in small, repeated doses, or other fats. Sulphur, grains xx, and Dover's powder, grains x, every four hours, is also good ; or the sulphates of magnesium or sodium may be profitably tried. Pes. podophylli, grain 1 / 8 , and powdered ipecac, grain 1 / 6 , every hour until the stools become bilious was also found to be effective in some cases. Turpentine, much lauded in chronic dysentery, the author also likes in acute cases, and recommends the fol- lowing : — B 01. terebinth., 3ij. Tinct. opii, 3j. Syr. acaciae, §iss. Mucil. acacise, gviiss. Misce. Sig. : Tablespoonful every two or three hours, reducing the dose after twenty-four hours if there is improvement. Indication : Acute dysentery. 140 Hand-Book of Modern Treatment. Lactic acid is beneficial if there are greenish, slimy stools, especially m children. Fifteen-grain doses are given, largely diluted, with syrup of acacia every two hours. Iodoform with small doses of opium acts well in some cases with severe abdom- inal pain. fy Acidi sulph. arom., f§ss. Tinct. opii deodorat., fgss. Magnesii sulphatis (sat. sol.), £ij. Misce. Sig. : Shake and give teaspoonful in water every three hours. This treatment should be commenced as early in the case as possible and continued until the bloody and mucous stools have changed to liquid or ordinary faecal discharges, which will usually be the case in from twenty-four to forty-eight hours. Dr. G. E. Eichmond reports two cases of dysentery in which the administration of 20 grains of sublimed sulphur com- bined with 5 grains of Dover's powder, every four hours, brought about rapid recovery. The discharge of blood and mucus quickly stopped, and the movements became faecal. The sulphur seems to act as a strong antiseptic and brings about a speedy healing of any ulcerated surfaces in the intes- tine. So far that author has not had a single failure in the treatment of dysentery by this method. R Cupri sulphatis. gr. ss. Magnesii sulphatis, £j. Acidi sulphurici dil., 3j. Aquse, §iv. Misce. Sig. : A tablespoonful every four hours. NO. 1. Ifc Chloralis hydratis, gr. xx-xxx. Liq. opii sed., m xx. Aquse, ad 3j. Syrupi aurantii, 3ij. Hand-Book of Modern Treatment. |41 NO. 2. I£ Pulv. ipecacuanha?, gr. xx-xxx. Aquae chloroformi, Sj- Mucilag. tragacanthi, q. s. Sig. : No. 1 draught is given, and usually takes effect in from ten to fifteen minutes. When the patient is just asleep he is suffi- ciently aroused to take No. 2. It must be shaken up in a phial and poured out just be- fore being taken. In many cases the patient will, after this treatment, sleep from three to six hours, and wake without experiencing any in- convenience. In some cases the ipecacuanha does produce sick- ness in spite of the chloral draught, but in these the author has not known it to come on in less than one and one-half hours, and in no case did the vomit contain ipecacuanha, showing that it had already been absorbed. 1$, Quininae sulphatis, gr. ij. Pulveris ipecacuanhse, gr. v. Amnion, chloridi, gr. x. Tinct. opii, m xij. Aquae, q. s. ad §j. Misce. Sig. : To be given every four hours. The following treatment for dysentery has proved of greatest value when a good deal of trouble through griping pains and frequent stools with mucus and blood were present : — 1^ Terebinthinse, m x. Tinct. opii, mx. Pulveris acacise, 3j. Saccharini, 3j. Aquae menthae pip., 3j. Misce. Sig. : To be taken three times daily for three days only, after cleansing the intestines with a dose of castor oil. At the expiration of this time: — I£ Pulveris ipecacuanhae, gr. x. Sig.: To be taken thrice daily, half an hour after the following draught: — . 142 Hand-Book of Modern Treatment. IJ Tinct. opii, m x. Tinct. cardamomii comp., 3ss. Aquse, §j. Misce. Sig. : Apply a sinapism over the pit of the stomach in order to prevent vomiting, which often attends the administration of ipecacu- anha in large doses. 1$ Bismuthi salicylatis, gr. ij. Guaiacolis benzoatis, gr. ij. Misce et pone in capsulas no. j. Sig. : One capsule every four hours. DYSMENORRHEA. Prescribe a pill, to be taken three" times a day, after a meal, containing: — IJ Phosphor., gr. V»- Ferri valerianate gr. j. Zinci valerianate gr. j. Quininse sulphatis, gr. j. Extracti aloes, gr. j. Then prescribe the following mixture: — IJ Tinct. cannabis Indicse, m x. Syr. chloralis hydratis, m xx. Glycerini, 3j. Aquae camphorse, ad §j. Sig. : For one dose. In spasmodic and neuralgic dysmenorrhcea the following prescription will prove beneficial if administered several days prior to and during the menstrual epoch : — IJ Fluidextracti hyoscyami, 3ij. Fluidextracti cannabis Indicse, 3j. Fluidextracti cimicifugae, 3iv. Spiritus camphorse, 3j. Spiritus etheris composite, q. s. ad §iij. Misce. Sig. : Teaspoonful in water three times a day. Eand-Book of Modern Treatment. \4\ I£ Am. hydrochlor., ^iiss. Tinct. stramonii, §ss. Tinct. cimicifugae, §j. Syr. glycyrrhizae, 3ij. Tongaline, §vj. Mi see. Sig. : Teaspoonful three times a day. Indication : Rheumatic dysmenorrhea. I£ Ext. cannabis Indicse, gr. %. Ext. belladonnas, gr. %. 01. theobrom., q. s. Misce. Sig.: This is sufficient for one suppository; five such ones may be made. One suppository may be introduced every evening, commencing the fifth day before the menses. Dysmenorrhea, frequently noticed in women with a ten- dency to asthma or subject to chronic diseases, is often cured or benefited by arsenic. I£ Asafcetidse, gr. ij. Ext. valerianis, gr. j. Ext. cannabis Indicse, gr. %. Misce for one pill. Sig. : One three times a day. Locally for the pain in the back the following ointment is of value : — I£ Ext. hyoscyami, gr. xxx. Ext. belladonna?, gr. xxx. Adipis, gj. Misce et fiat unguentum. Sig. : A small amount to be applied locally night and morning. The following combination is recommended in painful men- struation in which there is more or less inflammation present : — R- Berberinae phos., gr. xij. Tinct. hydrastis, 3ij. Syr. simp., q. s. ad §ij. Misce. Sig. : One teaspoonful every three or four hours. 144 Hand-Book of Modern Treatment. IJ Apiol, 3ij. Acetanilidi, gr. xl. Spt. chloroformi, m xxx. Spt. recti, q. s. ad ^ij . Misce. Sig.: Teaspoonful in water every two or three hours. Indication : Neuralgic dysmenorrhea. J^ Liq. potassii arsenitis. Sig. : One drop after meals increased to from three to five drops three times daily. Indication: In anaemic patients this is use- ful between attacks. fy Extracti belladonna? gr. y 2 . Olei theobromatis, q. s. Misce et fiat suppositorium no. j. Sig.: Insert in or against the os when pain is severe and persistent. R Amyl nitritis. Sig. : Three to five drops upon handkerchief by inhalation to relieve severe pains. DYSPEPSIA.— See Indigestion. I^ Acidi arsenosi, gr. %. Pulv. ignatiae, gr. viiss. Pulv. rhei, gr. xxxvj. Pulv. opii, gr. viiss. Ext. gentianae, q. s. Misce et fiant capsular no. 1. Sig.: One capsule after each meal. Indication: Dyspepsia accompanied by phos- phaturia. I£ Aquae chloroformi, Sij. Aquae menthae pip., §ij. Aquae dest., §ij. Misce. Sig.: One teaspoonful before meals. Hand-Book of Modern Treatment. 145 IJ Sodii bicarbonatis, 3ij. Pulveris saccharini, 3ij. Spt. ammon. aromatici, m xl. Aquae menthae pip., q. s. ad Sviij. Misce. Sig. : Tablespoonful after each meal. Indication: Each of above useful in flatu- lent dyspepsia. Ifc Tinct. ipecacuanhas, 3j. Tinct. calumbae, 3iij. Tinct. gentianae, 3iij. Misce. Sig.: Take five to 10 drops in a little water after eating, and repeat the dose in a half-hour, and again in an hour. Indication: Feeble digestion. Ifc Pepsini, gr. xlviij. Acidi hydrochlor. diluti, 3iv. Glycerini, 3iv. Aquae, q. s. ad 3iij- Misce. Sig. : One teaspoonful well diluted three times daily. 1$. Bismuthi subnitratis, 3iv. Pepsini, xlviij. Misce et fiant chartulae no. xxv. Sig. : One powder three times daily. Ifc Tinct. nucis vomicae, 3ij. Acidi nitromuriat. diluti, 3iv. Glycerini, 3v. Tinct. gentianae comp., q. s. ad grv. Misce. Sig.! One teaspoonful after meals. B Sodii salicylatis, 3ij. Bismuthi salicylatis, 3v. Magnesii carbonatis, 3v. Sodii bicarbonatis, 3v. Misce et fiant chartulae no. xij. Sig. : One powder three times daily after meals. 10 146 Hand-Book of Modern Treatment. R Acidi hydrochlorici, f«5iv. Fluidextracti condurango, f3vj. Tinct. gentianae comp., q. s. ad fSiij. Misce. Sig. : Teaspoonf ul in water after meals. Indication: Painful gastric dyspepsia with deficient secretion of gastric juice. R Acidi hydrochlorici diluti, 3vj. Tincturae capsici, 3iv. Tincturae nucis vomicae, 3ij. Tincturae quassias, q. s. ad §iv. Misce. Sig. : One teaspoonful in water after meals. For atonic dyspepsia of alcohol drinkers. R Zinci valerianatis, gr. iij. Acidi carbol., gr. ij. Acidi arsenosi, gr. V«>« Ext. cannabis Indicae, gr. V 4 . Misce et fiat capsula no. j. Sig.: One capsule after each meal. Indication : Nervous dyspepsia.- R Bismuthi salicylates, 3ij. Magnesii carb., 3ij. Carbonis pulv., 3iij. 01. menthae pip., gtt. xxx. Misce. Sig.: Of this powder give a small teaspoon- ful one-half to one hour after meals. Indication: Flatulent dyspepsia. R Acidi hydrocyanici dil., gtt. xl. . . Tinct. belladonnse, 3iij. Bismuthi subnitratis, 3vj. Aquae destil., q. s. ad %\i]. Misce. Sig.: Shake well and take one teaspoonful an hour before meals. Indication: Painful dyspepsia with excess- ive gastric secretion. Hand-BooTc of Modem Treatment. 147 IJ Bismuthi subnitratis, gr. x. Magnesii carbonatis, gr. xv. Solutionis potassae, mvj. Acidi hydrocyanici dil., m ij. Tinct. zingiberis, m v. Aquae menthae pip., q. s. ad 3j. Misce. Sig.: At one dose, to be repeated two or three times a day. Indication: Acid dyspepsia. Splendid. IJ Pepsini pur., gr. xxx. Pancreatic ext., gr. xxx. Pulv. carb. lig., gr. lx. Bismuthi subgal., gr. lx. Misce et fiant chartulae no. xij. Sig. : One before meals. Indication: Intestinal dyspepsia. IJ Creosoti, m iij. Tinct. card, co., mxv. Syr. aurantii, 3ss. Aquae, q. s. ad §j. Misce. Sig. : To be taken at one dose and repeated three times daily. IJ Bismuthi subnitratis, 3iss. Pepsini, 3iss. Strychnine sulpha tis, gr. j. Orexini tannati, 3j. Tinct. cardamomi comp., q. s. ad §iv. Misce. Sig. : A teaspoonful three times daily. Indication: Useful in atonic dyspepsia. DYSPNOEA. In the treatment of chronic dyspnoea due to vascular changes, Foxwell recommends the following combinations : — 148 Eand-Book of Modern Treatment. IJ Liq. strychnin® ( 1 per cent. ) , m v. Tinct. strophanthi, mx. Liq. trinitrini (.1 per cent.), m ij. Sodii bromidi, gr. xv. Tinct. card. co., 3ss. Aquae, q. s. ad §j. Misce. Sig.: To be taken in two or three divided doses, alternating with the following: — IJ Pulv. rhei, gr. i-ij. Hydrargyri chloridi mitis, gr. VarVio- Ext. hyoscyami, gr. i-ij. Misce et fiat capsula no. j. Sig. : One such capsule once or twice daily. IJ Chloralis hydratis, gr. xvi-xxxij. Potassi iodidi, gr. viii-xvj. Julapii, f^ij. Misce. Sig. : A teaspoonf ul every hour. Indication: A mixture for cardiac dyspnoea. IJ Chloralis, 3v. Sodii nitratis, gr. xlv. Tinct. stramonii, Siiss. Elixiris simp., q. s. ad §iv. Misce. Sig. : One teaspoonf ul every four hours in water. Indication: Asthmatic dyspnoea. IJ Spiritus glycerylis nitratis, gr. 1 / 100 . Amyli nitritis, gr. 1 / i . Mentholis, gr. l /«c Oleoresini capsici, gr. y i00 . Misce et pone in capsula no. j. Sig.: One capsule every four hours. IJ Morphinse sulphatis, gr. ij. Tinct. strophanthi, gtt. xcvj. Spiritus frumenti, %\]. Misce. Sig.: One teaspoonf ul night and morning. Indication: Cardiac dyspnoea. Eand-Book of Modem Treatment. 149 Ifc Fluidextracti digitalis, 3ij. Tinct. opii, 3ij. Misce. Sig. : Two to four drops every three hours. Indication: Cardiac dyspnoea. I£ Spartii sulphatis, gr. iss. Fluidextracti digitalis, gr. xv. Aquse, q. s. ad §ij. Misce. Sig.: A teaspoonful every two hours. EARACHE. TREATMENT OF EARACHE. It should be remembered that pain in the ear may be a sim- ple otalgia, but is also frequently secondary to dental caries, and especially to inflammations of the external ear, as a furuncle, and sometimes as the result of deeper inflammations of the ear. To relieve the pain four to six leeches applied in front of the tragus will usually have the desired effect. Besides this the ear may be washed out with a warm boric solution, which should be repeated every two hours for ten minutes at each application. In the intervals cotton saturated with carbolized oil (1 to 20 or 1 to 40) may be left in the ear. During the night the oil may be left in or, if the pain is very severe, may be replaced by the following : — IJ Morphine hydrochlor., gr. j. Cocainse hydrochlor., gr. xv. Aquae, 3v. Misce. Sig. : Six drops in the ear on retiring, to be used warm. FOR THE REMOVAL OF WAX IN THE EAR. Hardened wax in the external ear can often be removed readily by injections of warm water and soap, soda, or ammonia. Many cases resist this and require the softening effects of glycerine or sweet oil for a day or two before syringing. Do not bother with these long processes, but use a half-strength 150 Hand-Book of Modern Treatment. solution of hydrogen dioxide in the ear for about five or ten min- utes. This will disintegrate the hardest plugs and they can be removed with very little syringing. Too much force with the syringe is not to be used. The ear should be wiped perfectly dry with absorbent cotton and apply petrolatum. A small plug of cotton should be worn in the ear for one day after removal. IJ Acidi carbolici, m xl. Alcoholis, m xlv. Glycerini, ad 3j. Misce. Sig: One-half a dropperful warmed, to be instilled into the ear, for adults; less for a child. Indication : Useful in earache. IJ Acidi carbolici, m vij. Ext. opii fi., m vj. Cocainae hydrochlor., gr. vj. Atropinoe sulph., gr. iij. Aquae, m iij. Gelatini, gr. xviij. Glycerini, 3iij. Misce et div. in bougies no. xlvij. Sig.: Insert one bougie in the auditory canal every two hours. Indication: Earache in children and to be used before tympanic exudation occurs. Ifc Chloralis (camphorated), 3j. Glycerini, gj. Olei amygdalae dulcis, 3iiss. Misce. Sig. : Saturate a piece of cotton and intro- duce well into the ear. A SURE CURE FOR EARACHE. A small funnel of stiff paper is inserted into the ear, with a pledget of cotton saturated with chloroform into the outer, larger part. By this means the fumes of chloroform are blown into the ear, and instant relief is obtained.. Hand- Book of Modern Treatment. . 151 I£ Zinci oxidi, 3j. Acidi carbol., gr. x. Vaselini albi, 3j. Misce et fiat unguentum. Sig. : Insert a cylindrical tampon of cotton wool, covered with the ointment, into the canal. Indication: Useful for excruciating pains and furirncles in the ear. This tampon should be large enough to produce consider- able pressure. The greater the swelling the greater should be the pressure made by the tampon. The pain is at first severe, but disappears after tamponing. Before tamponing, use an antiseptic and repeat daily. Atropine in solution is an excellent remedy for earache. A drop or two of a solution of 4 grains to the ounce of water will be sufficient. Earache to be treated intelligently must be treated through the speculum. In the mild, congestive forms local applications may and often do prove beneficial, but if persisting more than twelve hours, paracentesis should be done. Early paracentesis, properly performed, is a harmless procedure, doing the greatest good to the patient with the minimum of danger and suffering. It anticipates nature, relieves pain, and reduces the chances of mastoid and intracranial complications. Preparatory to opera- tion, the doctor renders the external canal aseptic through syringing with a 1 to 10,000 bichloride solution, then drying with a few drops of alcohol. The procedure may be rendered painless by first applying over the line of incision a mixture of equal parts of menthol, phenol, and cocaine rendered syrupy with alcohol. I£ Phenolis, 3j. Glycerini, 3ij. Camphorse, gr. xx. Aqua, q. s. ad fgj. Misce. Sig.: Use this on pledget of cotton which fits tightly and place in ear. Leave in ear six to twelve hours. Remove and apply again. Follow this with purges. Indication: Furuncle in canal of ear. To abort. 152 Hand-Booh of Modern Treatment. I£ Sol. adrenalini, f3j. Cocainse, gr. x. Glycerini, f3j. Aquae, q. s. ad f^j. Misce. Sig. : Apply to ear warm, in drops. Indication: Useful in acute catarrhal otitis media. ECTHYMA. Ifc Sulphuris prsecipitati, 3j. Resorcini, gr. x. Acetanilidi, 3ss. Ung. petrolati, j$j. Misce. Sig. : Apply once daily. Indication: Useful in parasitic varieties. Ifc Liq. plumbi subacetatis, 3j. Tinct. opii, 3j. Aquse, gxvj. Misce. Sig. : Apply this on gauze or lint. Indication: Useful in inflammatory stage. B Aristol, 3ij. Acidi borici, 3ij. Acetanilidi, gr. x. Misce. Sig. : Use this as a dusting powder. ECZEMA. In an acute form of eczema, when redness and swelling of the skin are associated with burning and itching sensation, usu- ally a simple application of an absorbent powder, as talcum, rice, amylum with some oxide of zinc, or 1 per cent, of boric or salicylic acid often repeated, will answer the purpose. If there should be also some oozing, the powder will form a kind of paste and protect the excoriated epidermis, prevent the break- ing of the vesicles, and the acute inflammatory process will grad- ually subside. In cases of eczema intertrigo, the natural folds of Band-Book of Modern Treatment. 153 the skin must be separated with strips of lint or absorbent cotton. In some cases the simple application of powder does not re- lieve the inflammation, and bathing with solution of 2 per cent, of subacetate of lead or of aluminum is found useful to diminish the inflammation. But as soon as the purpose has been ob- tained it has to be stopped and dry applications resumed. In a general way moist applications macerate the epidermis, and for this reason are not so beneficial in eczema. In these cases, as a sedative lotion, a mixture of calamine in the following proportions will be found useful: — I£ Pulv. calamine prep., 3ij. Zinci oxidi, 3ij. Glycerini, ^iss. Aquae rosae, 5iss. Misce. Sig. : This is applied on the surface with a camel's hair brush, or with strips of lint dipped in the lotion. In cases of acute eczema with deep excoriations, accom- panied by abundant serous discharge and unbearable itching sen- sation, the use of ichthyol in liniment form will be found bene- ficial in many cases. Ifc Ichthyolis, 3ij. Olei amygd. dulc, 3iv. Aquse calcis, 3iv. Aquas rosae, %]. Glycerini, j$j. Misce. Sig. : This is applied on strips of lint satu- rated in the liniment, and the dressing is changed twice a day. Ichthyol cornifies the young epidermic cells of the cor- pus mucosum and forms a temporary protection to the papillary layer. It diminishes the exudation and relieves the itching sensation. The surface is washed with a mild solution of 1 per cent, of carbolic acid or of borate of sodium before the liniment is applied again. Cleanliness 154 Hand-Book of Modem Treatment. is necessary for eczema, and this thought has been greatly re- proached by some kind of superstition spread by general prac- titioners among the people, that eczematous surfaces have not to be washed. On the contrary, eczema has to be cleansed as stated, and if the water should be an irritant, olive-oil could be re- sorted to. When the excoriations begin to heal up and the irritation has ceased, it is necessary to apply some mixture, which may protect the young epidermic cells, giving them time to be re- produced; may prevent the exuded serum from forming crusts, and, at the same time, may possess certain antiparasitic proper- ties. For this purpose pastes are applied as continuation of the treatment. Lassar's paste is very useful and a good composi- tion : — Ifc Acidi salicyl., gr. x. Zinci oxidi, 3ij. Amyli, 3ij. Vaselini, 3j. Misce. Sig. : To this mixture we often add 3j of sulphur, which has good antiparasitic action. It is spread on the affected parts, and is easily removed, wiping it off with a little olive-oil. In cases of pustular eczema of the scalp or of the beard, a salve with white precipitate has given us good results. When the inflammation has subsided, the excoriations and the fissures have healed up, the infiltration has diminished, then the application of tar becomes useful: — l£ Ung. picis liquidi, 3iij. Zinci oxidi, 3iss. Ung. aquae rosse, 3iv. Misce. In a great many cases the old Wilson salve will be found greatly beneficial. Sometimes it seems that every application increases the trouble, and a few applications of this innocent salve have given satisfactory results. When the eczema has healed up, but the skin remains ten- der, itchy, easily cracks, the application of a solution of carbolic acid is very beneficial. Hand-Book of Modern Treatment. 155 3 Acidi carbolici, 3j. Glycerini, 3j. Aquae rosse, §iij. Alcoholis, 3iij- Misce. Sig. : With a moist cotton tampon the skin is gently rubbed, then dried and dusted with rice or amylum powder. It is necessary that the local treatment of eczema be asso- ciated with a hygienic and internal treatment. For this purpose the physician must study the condition of the general system of his patient and also his habits of living. In so doing he will detect troubles of the digestive organs, of the excretory func- tions, or of the general nutrition, or of defective metabolism, or of dietetic errors, which often are the true causes maintaining the eczema. In chronic forms of eczema, when the skin is thickly infiltrated, hard, inelastic, covered with hard epidermic scales, which conceal deep rhagades, the treatment must be rather of an irritant nature, so as to produce the reabsorp- tion of the exuded elements. The soap of potash, green soap, will be found a good application to dissolve and remove the epidermic masses, and as an irritant to produce the reabsorp- tion. It is rubbed on the surface, left for ten minutes or more, and then is washed off. As a permanent application the old Hebra diachylon in some cases, mixed with ichthyol, 1 drachm to 1 ounce, has given gratifying results. In cases of this kind, if the green soap does not produce the desired effect, we can resort to a strong solution of caustic pot- ash soda to remove the thickened epidermis. The rhagades must be touched up with a solution of nitrate of silver from 3 to 6 per cent, to obtain their healing. The following combinations containing mercury sulphate are recommended in the treatment of vesicular eruptions : — I£ Hydrarg. subsulph., 3ss. Olei amygdalae dulcis, Siiss. Adipis, 3ij. Misce et fiat unguentum. Sig.: To be applied locally. 156 Hand-Book of Modern Treatment. IJ Hydrarg. subsulph. (turpeth mineral), gr. xv. Glycerini, 3j. Olei amygdalae dulcis, 3j. Adipis, 5iss. Misce et fiat unguentum. Sig. : Apply locally. In gouty and rheumatic patients we recommend the follow- ing combinations : — B Quim hydrobrom., gr. j. Ext. colchici, gr. 1 / 6 . Pulv. digitalis fol., gr. x / 3 . Misce. Sig.: Two or three such pills daily. Ifc Quin. hydrobrom., gr. j. Ext. belladonnas, gr. Veo- Ext. gentianse, gr. j. Misce. Sig. : One such pill four to eight times daily. Ifc Sulphuris, 3iiss. Spts. vini rect., 3j. Glycerini, 3j. Misce. Sig.: Shake well and paint on the affected areas. B Sulphuris prsecip., 3iiss. Saponis viridis, 3ss. Olei cadini, 3j. Ung. zinci oxidi, 5j« Misce et fiat unguentum. Sig. : Apply locally. IJ Chrysarobini, 3iv. Acidi salicylici, 3iv. Sulph. prsecip., 3v. Saponis viridis, 3v. Olei cadini, 3v. Lanolini, 3iiss. Misce et fiat unguentum. Sig. : Apply locally. - Indication: Useful in chronic eczema. Hand-Book of Modern Treatment. 157 B Ichthyolis, 3j. Acidi salicylici, gr. v. Acidi borici, gr. xx. Paraffini, gr. xx. Petrolati, gj. Misce. Sig. : Apply at bed time. I£ Ichthyoli, gr. xv. Zinci oxidi, gr. xlv. Acidi borici, gr. xxx. Petrolati, 3j. Misce. Sig.: Apply twice daily. R Hydrarg. chloridi mitis, gr. j. Salol, gr. xx. Guaiacolis carb., gr. xv. Pulv. pepsini, gr. xxx. Misce et fiant chartulae no. xij. Sig. : One powder to be taken three times a day. A restricted diet is recommended; greasy foods and sweets, as well as fruits and pastry in any form, should be for- bidden. The following ointment is applied locally: — B Ung. picis liq., 3j. Ung. aquse rosse, §j. Ung. zinci oxidi, £ij- Misce. Sig. : To be used locally night and morning. Washing with plain water is forbidden, but twice a week water to which sufficient bran has been added to make it milky should be used, and the face kept clean with a cloth satu- rated with olive oil. Indication: Eczema due to intestinal auto- intoxication. IJ Cocainae hydrochlor., gr. iij. Atropinse sulphatis, gr. j. Morphinse sulphatis, gr. ij. Ung. acidi carbol., §j. Misce. Sig. : Apply locally once or twice a day. 158 Eand-Book of Modern Treatment. B> Tinct. nucis vomicae, gss. Acidi hydrochlor. diluti, gss. Tinct. cardamomi comp., %j. Fluidextracti curcasse, q. s. ad §iij. Misce. Sig. : One teaspoonful after meals. Indication: Useful stomach tonic and for constipation in eczema. I£ Bismuthi subnitratis, 3iv. Zinci oxidi, %j. Acidi carbol. liq., m xxx. Vaselini albi, §ij. Misce. Sig.: Apply locally night and morning. In the average case of eczema in babies, where moderate stimulation is required, the following formula, recommended by Starr, seems to act well : — R Zinci oxidi, §ij. Ung. picis liq., $ss. Ung. aquae rosse, §ss. Lanolini, Sj. Misce. I£ Acidi phos. dil., 3iv. Tinct. ferri perchlor., 3ij- Syr. limonis, £iij. Misce. Sig. : Teaspoonful in wineglassful of water after meals. Aloin comp. pills, 1 / 10 grain, night and morning, to relieve the constipation. R; Acid, carbol. pur., gr. xx. Ung. zinc. ox. benz., §j. Misce. Sig. : Apply. Begin the local treatment by cleaning the ears with this ointment spread upon cotton on the applicator, then make a free application of the same ointment. No fluids, soap, or water must be used, as they nearly al- ways prove deleterious. Indication: Eczema of auditory canal. Hand-Boole of Modern Treatment. 159 Leeds gives the following formula, which has given good results in the treatment of this condition: — IJ Pulv. sulphuris, 3iv. Cupri sulphatis, 3ij. Hydrargyri oxidi rubri, 3j. Vaselini albi, %\v. Misce. Sig. : Apply every night, allowing it to re- main ten minutes, then remove with warm, soft water and castile soap. I£ Acidi salicylici, gr. x. Pulveris amyli, 3ij. Petrolati, 3iv. Misce. Sig. : Use as paste on the diseased parts and cover with a cloth and light bandage. Indication: Useful in red eczema. I£ Liq. potassii arsenitis, f§ss. Sig. : Three drops in water after meals. Indication: Useful in dry subacute and chronic eczema. IJ Syrupi ferri iodidi, §ss. Sig.: Five drops in water after meals. Indication: Useful in strumous children. I£ Pulveris rhei, 3ij. Sodii bicarbonatis, 3ij. Aquse menthse pip., %iv. Misce. Sig.: Teaspoonful in water after meals. Indication: Infantile eczema. B Aquse hydrogenii dioxidi, §viij. Sig.: Apply freely twice or thrice daily. If area is extensive, dilute one-half with water. Indication: Acute and subacute stages. B Ung. zinci oxidi, §ij. Sig.: Apply well night and morning. Indication: Used in weeping eczema. Eas- ily digested food, exercise, and cleanliness are requisite in all forms and stages. The zinc ointment made with lanolin is preferable. 160 Hand-Book of Modern Treatment. EMISSIONS, SEMINAL. I£ Potassii bromidi, §j. Tinct. ferri chloridi, f§j. Syrupi aurantii, f^iij. Misce. Sig.: One to two teaspoonfuls after each meal. Patients suffering from gonorrhoea attended by extremely painful nocturnal erections are sometimes relieved by baths and large doses of Vichy water, with inunctions of the penis for several minutes with : — IJ Salicylate of methyl, gr. xv. Liquid vaseline, 3iiss. Misce. The penis is enveloped in a light layer of absorbent cotton, kept in place by a bandage of gummed taffeta. The inunction soon diminishes the pain and seems to reduce the force of the erection. EMPHYSEMA.— See Chronic Bronchitis. R Fluidextracti euphorbise piluliferse, f^iij. Sig. : One-half teaspoonful three times daily. B Strychninae sulphatis, gr. j. Extracti euphorbise piluliferse, gr. xxx. Extracti physostigmatis, gr. iij. Misce et fiant pilulse no. xxv. Sig. : One pill three times daily. EMPYEMA. B Iodi, gr. vj. Potassii iodidi, gr. vj. Aquse, f^xvj. Misce. Sig.: Use to irrigate the cavity once daily. Band-Booh of Modern Treatment. 161 I£ Elixiri ferri, quininae, et strychninse phos- phatis, §iv. Misce. Sig. : One teaspoonful after meals. Indication: Useful as a tonic. ENDOCARDITIS. W. H. Thompson has found mercuric chloride, 1 / 24 grain, three times a day for a week, very efficacious in the treatment of this condition. When chronic enlargement of the heart accom- panies the arterial disease, he prescribes 5 grains of sodium iodide three times a day for weeks or months. Indication: Useful in chronic stage. When the rheumatism has disappeared and the temperature has dropped to normal the patient may be placed on a combined tonic and alterative treatment, and for this purpose the syrup of ferri iodidum is recommended in moderate doses to correct the anaemia and changes in the valves as well as in the blood- vessels. Arsenic combined with iron and strychnia is a splendid combination during convalescence, as follows: — 1$ Acidi arsenosi, gr. 2 / 3 . Strychninse sulph., gr. ss. Ferri sulph., 3j. Sodii carb., 3j. Misce et fiant capsular no. xxx. Sig. : One after each meal three times a day. Indication: Useful in rheumatic form. B Sodii salicylatis, 3ij. .Potassii iodidi, 3ss. Tinct. aconiti radici, gtt. x. Tinct. verat. viridi, gtt. x. Aquae, q. s. ad £ij. Misce. Sig. : A teaspoonful every two hours, with sugar for children. Apply ice bag over heart. Ifc Tinct. ferri chloridi, 3iv. Aquae, q. s. ad ^ii j. Misce. Sig. : One teaspoonful every five or six hours. 11 162 Band-Booh of Modern Treatment. ENEMATA, NUTRIENT. I£ Liq. peptones, §ij. Eggs, 1 to 3. Sol. glucose (20 per cent.), Biij. Sodii chloridi, gr. xxiiss. Pulv. pepsini, gr. viiss. Tinct. opii, gtt. iij. Bouillon, gvj. Misce. Sig. : For one enema. 1. Beef tea, 3 ounces; yelk of 1 raw egg; brandy, Y-i ounce; liquor pancreaticus, 2 drachms. 2. One whole raw egg; table-salt, 15 grains; peptonized milk, 3 ounces; brandy, Y2 ounce. 3. Beef tea, 2 ounces; brandy, Y> ounce; cream, Y> ounce. 4. Beef tea, 2 ounces; 1 whole raw egg. 5. Beef juice, 1 ounce. 6. Beef essence, 6 ounces. 7. Whites of 2 raw eggs; peptonized milk, 2 ounces; 2 eggs. In many instances a nutrient enema composed only of whiskey and peptonized milk will not -be retained by the patient. A better combination, and one which will give more satisfactory results, is the following: — 1$ Beef peptonoids, 3ij. Yelk of egg, No. 1. Whiskey, ^ss. Tinct. opii, m v-x. Salt, q. s. Peptonized milk, q. s. ad §vj. Water and salts are readily absorbed from the rectum, and peptones also seem to be assimilated, but fatty material remains behind. Eectal feeding is an unsatisfactory substitute for the ordinary mode of taking food, and should not be adopted with- out absolute necessity. A useful nutrient enema consists of the whole substance (white and yelk) of one or two eggs, beaten up carefully with a little cold water till no threads of albumin are left. To this are added 250 cubic centimeters of warm water Rand-Book of Modern Treatment. 163 and 2 grams of salt for each egg used. The water in the above formula may be replaced by an equal amount of milk. I£ Normal salt solution, 3vj. Amnion, carb., gr. xx. Spt. frumenti, §ij. Misce. Sig. : Given at one dose as stimulating enema. ENTERALGIA. Ifc Spiritus ammoniae aromatici, §j. Spiritus chloroformi, 3j. Spiritus camphorae, 3ij. Tincturae hyoscyami, 3iv. Fluidextracti cannabis Indicse, 3j. Tincturae cardamomi comp., q. s. ad gvj. Misce. Sig. : Two teaspoonfuls in water every hour or two until pain is allayed. I£ Chloroformi, 3j. Morphinae sulphatis, gr. j. Pulveris gummi arabici, 3j. Aquae, q. s. ad §iij. Misce et fiat emulsum et adde Syrupi, 3iv. Aquae amygdalae amarae, 3j. Misce. Sig.: One teaspoonful every half-hour until relieved. IJ Spiritus setheris comp., f§ij. Sig.: Teaspoonful in water until pain is re- lieved. ENTERITIS.— See Diarrhoea and Dysentery, Ifc Acidi tannici, gr. xxiv. Pulveris ipecacuanhas et opii, gr. iij. Chocolati or saccharini, 3j. Misce et fiant chartulae no. xij. Sig. : One powder four times daily. 164 Hand-Book of Modern Treatment. B> Bismuth i subnitratis, 3ij. Ext. krameriae, 3j. Syrupi, 3ij. Aquae, q. s. ad §iiss. Misce. Sig. : Teaspoonf ul four times daily. IJ Olei ricini, §ss. Tinct. opii eamphoratae, 3ss. Misce. Sig. : One dose. Indication: The initial treatment to free bowels of irritating material. IJ Ammonii chloridi, 3ij. Fluidextracti glycyrrhizae, 3ij. Aquae, q. s. ad 3iij. Misce. Sig. : One or two teaspoonfuls after meals. Indication: Useful in chronic intestinal catarrh. B> Acidi (phenolis) carbolici, m x. Bismuthi subnitratis, gr. c. Misce et fiant chartulae no. x. Sig. : One powder every four hours. Indication: Used in acute and subacute ca- tarrhal enteritis. Bi Bismuthi subnitratis, 3j. Saloli, gr. xxiv. Syrupi tolutani, 3ij. Syrupi acacias, q. s. ad 3ij. Misce. Sig. : Teaspoonful every three hours after irritating material is evacuated. B> Bismuthi subnitratis, gr. x. Syrupi acacias, m xx. Mist, cretae, q. s. ad f3j. Misce. Sig.: One such dose every two hours for a child one year old. Indication: Useful in acute catarrhal en- teritis. Hand-Book of Modem Treatment. 1(35 IJ Ext. opii, gr. V 8 . Ext. belladonna^ gr. V 8 . Cacao theobromatis, gr. v. Misce et fiat suppositorium no. j. Indication: To quiet pain in enterocolitis. IJ Tannalbin, gr. xv. Spt. cinnamomi, m ij. Misce et fiant chartulae no. x. Sig. : One every three hours to child 1 year old. Indication: Acute enteritis of children. IJ Liq. potassii arsenitis, 3ss. Sig. : Three or four drops in water after meals. Indication: Useful in chronic membranous enteritis. ENURESIS. IJ Fluidextracti rhois aromat., f3iij. Elixiris aromat., fgiss. Aquae cinnamomi, q. s. ad f^iij. Misce. Sig. : Half teaspoonful to be increased to one teaspoonful four times a day after meals. IJ Ferri citratis, gr. clx. Syrupi calcii lactophosphatis, §ij. Syrupi cascarae aromatici, ^ij. Misce. Sig.: A teaspoonful after dinner (noon). IJ Ext. rhois glabrae fluidi, m cccxx. Syrupi, q. s. ad £ij. Misce. Sig. : A teaspoonful at bed time. IJ Tinct. belladonnae, 3ij. Fluidextracti ergotae, 3iv. Tinct. nucis vomicae, 3ij. Aquae, q. s. ad 3iij. Misce. Sig. : One teaspoonful four times daily. Igg Hand-Book of Modern Treatment. IJ Fluidextracti rhois aromat., f3iiss. Fluidextracti ergotse, f§ss. Fluidextracti belladonnas, f3ss. Strych. sulph., gr. y±. Syr. aurantii cort., q. s. ad f§iv. Misce. Sig. : One teaspoonful four times a day. I£ Fluidextracti jaborandi, f3j. Fluidextracti belladonnas, f3ss-j. Fluidextracti tritici repentis, f§ss. Fluidextracti ergotas, f3j. Fluidextracti rhois aromat., f3j. Syrupi zingiberis, fgss. Misce. Sig. : One teaspoonful three times a day. We recommend massage of the neck of the bladder by way of the rectum for nocturnal enuresis. The index finger is used, and massage is practiced, at first mildly, later more energetic- ally, for two minutes at each session. The results have been excellent. The writer believes that the condition is brought about by some defect in the coordination of the function of the nerve-elements of the vesical sphincter, which is permanently relieved by massage. I£ Fluidext. ergotse, f3iij. Fluidext. rhus toxicodendron, f5j. Misce. Sig. : Five to ten drops every four to six hours. In cases of incontinence due to hyperesthesia of the neck of the bladder, irritating foods should be avoided, sitz baths em- ployed and the following antispasmodic mixture given: — 1^ Ext. hyoscyami, 3ss. Sodii bromidi, 3j. Aquae anisi, f§j. Syr. simp., q. s. ad f§ij. Misce. Sig. : One teaspoonful every four to six hours. Counter-irritation by means of mustard plasters should be employed over the lumbo- sacral region. Hand-Book of Modern Treatment. 167 We recommend that the child should sleep with the head lower than the pelvis, thus creating a mechanical obstacle to the passage of the urine, which no longer irritates the urethral sphincter. Stumpf has treated successfully twelve children and an adult by this method, which has also proved efficacious in two rebellious cases at the Institute for Deaf-mutes at Wurzburg. The duration of the treatment is about three weeks, after which the normal position may be resumed. E. H. Fenwick states for this distressing complaint, whether suddenly developed as the result of accident or operation, or in other cases where the incontinence of urine had been of several years 7 standing, he was acquainted with no drug which gave such entirely satisfactory results as the tincture of lycopodium. He had first given it to check the nocturnal enuresis of children ; but find- ing it so surprisingly successful, he next employed it for adults, with the result that micturition was quickly reduced from six or eight times an hour to once in two hours. Dose — 15 minims to 1 drachm. EPIDIDYMITIS AND ORCHITIS. B Ung. hydrarg., 3ij. Adipis lanse hydrosi, 3vj. Ichthyoli, 3j. Ext. belladonnse, gr. x. Misce. Sig. : Apply externally twice daily, preceded with rest in bed. hot fomentations and ano- dynes for the relief of pain. B Tinct. opii, §v. Liq. plumbi subacetatis, §v. Misce. Sig. : Add to warm poultice a tablespoonful of this and apply. Support testicles by means of a suspensory bandage. Indication : Useful during acute stage with pain and swelling. I£ Olei santali, 3iss. Fiant capsular no. xx. Sig. : One capsule after meals. 168 Hand-Book of Modem Treatment. $ Ichthyoli, 3v. Ung. belladonnas, 3iv. Ung. hydrargyri, 3iv. Petrolati, q. s. ad ^ij- Misce. Sig. : Apply daily to scrotum and support with a suspensory bandage. Indication: Used in subacute and chronic cases. I£ Potassii iodidi, 3ij. Tinct. gentianse eomp., 3iij. Aquse, q. s. ad ^iij. Misce. Sig. : One teaspoonful after meals. Indication: Used in acute and chronic cases. IJ Sodii bromidi, 3iv. Tinct. belladonnas, m xx. Liq. potassii, 3ij. Tinct. opii camphoratae, 3ij. Syrupi zingiberis, 3ij. Aquse, q. s. ad gvj. Misce. Sig. : One teaspoonful after meals. EPILEPSY. Ifc Sodii arsenatis, gr. 1 / 64 . Zinci phosphidi, gr. y u . Calcii phos., gr. j. Sodii benzoatis. gr. iij. Pancreatini, gr. iij. Misce. Sig. : At one dose three times a day before each meal. The arsenic and zinc preparations are nerve-tonics, the lat- ter being also a nerve-sedative, the former aiding the exhala- tion of nitrogen. The calcium phosphate reduces cerebral ex- citability. The pancreatin and sodium benzoate aid digestion and overcome intestinal fermentation. In an article upon epilepsy Dr. William F. Waugh says : — "Here is one remedy whose action in some cases of epilepsy seems too well proved to permit it to be neglected, and yet its Hand-Book of Modern Treatment. 169 mode of action is not at all explained. This is verbenin. It was introduced to my notice some years ago by Dr. H. D. Fair. After this, Dr. French took it up, and reported some un- doubted cures in which verbenin figured largely. He at- tributed the epilepsy to intestinal parasites of the maggot fam- ily, and believed verbenin acted upon these. A number of other cases have been reported in which verbenin proved useful, in which the parasites were not noticed, though I am not sure they were searched for in all cases. While some failures have been reported, this is not to be wondered at in dealing with a newly-introduced remedy whose action, physiological and thera- peutic, is as yet undetermined. That it has sometimes suc- ceeded is the interesting point. "I have been unable to find anything to show what effect verbenin exerts on the vital functions. The directions I have given in advising this remedy are to administer 1 / 3 grain four times a day, and add 1 / 3 grain a day whenever a fit occurs. Some persons report having reached doses of 19 grains a day without notable effects; but usually before 3 grains a day have been reached the good effects of the drug are manifested in the gradual lightening and final cessation of the convulsions. "In this connection it may be well to call attention to a remedy which has been termed 'anti-epilepsy/ It is composed of atropine and glonoin, 1 / 250 grain each. This remedy has proved quite effective, the patient carrying it about and taking 1 or more granules whenever the fit threatens. The glonoin flushes the face almost instantaneously, and this effect is sustained and prolonged by the atropine. By this means the convulsion is jugulated at the start. After the patient has learned to rely on this powerful and effective remedy he finds it acts even better than at first, so that in time the knowledge that he has an un- failing means of preventing the development of the convulsion will suffice to allay the irritability, without his needing to have recourse to its administration." We have in chloretone a drug which, in selected cases, is an excellent substitute for the bromides. It is a drug which in my experience gives good results with increasing dosage after the primary effect is obtained. In administering the drug it is usually put up in capsules, and sufficient is given in the begin- 170 Hand-Book of Modern Treatment. ning to produce an hypnotic effect. In a large class of epileptic cases the fits occur most frequently at night, and one dose of 15 or 20 grains a day is given at night until a drowsy effect on the following day is produced ; if the desired results in reducing the number of fits are obtained, the dose is reduced one-half and the patient kept on this indefinitely. The dietetic, hygienic, and constitutional treatment is rigidly enforced in conjunction with the administration of the chloretone. Ifc Potassii bromidi, 3x. Sodii bromidi, 3iij. Ammonii bromidi, 3iij. Sodii benzoati, 3iij. Aquae destil., Oij. Misee. Sig. : As a beginning dose take one table- spoonful after breakfast and at bed time. The dose should be increased so as to control the seizures. If the epileptic attack recurs at a regular hour each day, two- thirds of the daily amount should be given an hour before the time of the expected attack. I£ Acidi hydrobromici diluti, m x. Ferri bromidi, gr. j. Potassii bromidi, gr. x. Sodii salicylates, gr. ij. Spiritus rectificati, m x. Glyceroli pepsini, m x. Olei gaultheriae, m ss. Liq. ammonii citrati (B. P. ), 3ss. Misce. Sig.: At one dose. Double it if necessary. I£ Sodii bromidi, 3x. Fluidextracti solani Carol inense, Bij- Aquae camphorae, q. s. ad %iv. Misce. Sig. : One teaspoonful three times a day in water. I£ Bromidi strontii, 3j- Elix. curacoae, Siij- . Misce. Sig. : Teaspoonful in water four times a day. Hand-Book of Modern Treatment. 171 IJ Lactatis stanni, gr. xl. Elix. curacoae, 3iij. Misce. Sig. : Alternate these formulae weekly. Ap- ply a current of galvanism descending from the forehead to the sacrum daily, of from 10 to 50 milliamperes, for a half-hour. 1$. Potassii bromidi, 3iij. Infus. adonis vernalis, f^iv. Aquae dest., q. s. ad fgvj. Misce. Sig. : Dessertspoonful three times daily. Ifc Ammon. bromidi, §j. Antipyrinae, 3ij. Misce et fiant chartulae no. xxiv. Sig. : One powder twice daily. 1^ Liq. potassii arsenitis, 3iv. Sig. : Give three drops twice daily with the above description. I£ Potassii bromidi, 3iv. Tinct. belladonna? foliorum, 3ij. Sy'rupi simplicis, f3iij. Aquae, q. s. ad f^iij. Misce. Sig. : Teaspoonful in water after meals. EPISTAXIS. The best remedy for bleeding at the nose is the vigorous motion of the jaws. as if in the act of chewing. In the case of a child, a wad of paper should be inserted and chewed hard. It is the motion of the jaws that stops the flow of blood. The remedy is very simple, but has never been known to fail in a single instance, even in the severest cases. For epistaxis Hutchinson recommends that the patient soak his hands and feet in water as hot as can be borne : a method which he says never fails, even in obstinate cases. The treatment of nose-bleed is local and the most reliable means available is plugging the nostrils with cotton which is 172 Hand-Book of Modern Treatment. saturated with adrenalin chloride 1 to 2000. Compression of the artery on the upper lip near the nose by pressure against the jawbone will often control the haemorrhage. B Antipyrini, gr. viiss. Tannini, gr. xv. Pulv. saccharini, gr. cl. Sig. : To be used locally. I£ Gelatini, gr. cv. Acidi salicylic!, gr. iv. Aquae bullientis, 3iij. Misce. Sig. : Inject a teaspoonful into the nostril. In habitual epistaxis without regard to the cause, the fre- quency of the attacks, or their severity, Woodward says ammo- nium carbonate is an absolute specific. Two grains every ten minutes will stop the flow quickly during the attack. To cor- rect the tendency and overcome the habit, 2 grains should be given from three to six times each day. In a case of severe epistaxis Professor J. Chalmers Da Costa used Carnot's formula of: — 1$, Normal salt solution, 16 parts. Gelatine, 1 part. Misce. Saturating the cotton with this solution, he plugged the nose in the usual way. The advantage of this solution is that it forms an aseptic coagulum. Dr. Gillette recommends the use of a peroxide of hydrogen, a teaspoonful or more in full strength, injected by means of an ordinary syringe, as a remedy for epistaxis, claiming the relief to be immediate. In operations in the nasal cavity when bleed- ing obscures the vision, injection of peroxide of hydrogen will check the haemorrhage, and if the patient be asked to blow the nose the field will be found to be clear again. B Liq. adrenalini chloridi (1 to 1000). Sig. : Place on pledget of cotton and insert in the nose. Hand-Book of Modern Treatment. J 73 3 Pulv. aluminis, £ss. Pulv. amyli, j^ss. Misce. Sig. : Snuff up the nostrils. I£ Alumnol, 25 per cent, sol., %ss. Sig. : Place on pledget of cotton and place on bleeding point. I£ Argenti nitratis (40 per cent, solution), 3ij. Sig. : Touch the bleeding points with this. ty Acidi tannici, 3ij. Pulveris amyli, 3ss. Misce. Sig.: Use by insufflation. ERYSIPELAS. Mortimer recommends as prophylactic measures in the treatment of erysipelas that the patient should be isolated and that all dressings should be burned when removed. Proper ven- tilation should be established and thorough cleanliness observed. In the general management of the patient, small doses of calo- mel, V 8 grain, every two hours for eight doses, followed by a saline, should be given, as well as for the first twenty-four hours 1 / 4 minim of the tincture of aconite every two hours. When stimulation is required, alcohol should be adminis- tered freely, and if necessary, strychnine and nitroglycerine. An ice-bag or cold compresses applied to the head to relieve the pain are of service ; in addition the following may be given : — I£ Caffeinse, gr. ss. Camphor, monobrom., gr. ss. Acetanilidi, gr. ij. Misce et fiat capsula no. j. Sig. : One such capsule every two hours. Applied locally to the affected areas the author recommends compresses saturated with the following: — B Tinct. opii, fgj. Liq. plumbi subacet., f^ij. Aquse destil., Oj. Misce. Sig. : To be applied locally on compresses. 174 Hand-Book of Modem Treatment. Liquid nourishment should be given liberally and system- atically about every three hours. It should consist chiefly of milk, broths, and beef juice. Ice cream may be given, also cold water acidulated; lemonade may be substituted for the water. During convalescence a general tonic treatment is indicated with some form of iron : — IJ Strychninse sulph., gr. 1 / 50 . Acidi arsenosi, gr. 1 / 50 . Ext. gentianse, gr. ss. Quininse sulph., gr. ij. Misce et fiat capsula no. j. Sig. : One such capsule after meals. IJ Strychninae sulph., gr. y±. Liq. ferri et amnion, acet., f£vj. Misce. Sig. : One tablespoonful in water after meals. IJ Tinct. opii, 3iv. Fluidextracti aconiti, 3ij. Ext. belladonna, 3iv. Fluidextracti veratri, 3iij. Ichthyoli, q. s. ad §iv. Misce. Sig. : Apply every three hours. Indication: Erysipelas and traumatic in- flammation. IJ Phenolis, gr. xv. Tinct. iodi, gr. xv. Mucil. acacise, 3j. Alcoholis (pure), 3v. Misce. Sig. : Shake and paint over the affected area every two hours until the swelling and shiny redness have disappeared. IJ Ichthyolis, 3j. Ung. zinci oxidi, 3j- Misce. Sig. : Apply locally and cover with gauze. Band-Book of Modern Treatment. 175 I£ Tincturae ferri chloridi, f^ss. Sig. : Ten to twenty drops through a glass tube every four hours. I£ Ichthyolis, gij. Adipis lanse hydrosi, ^ij . Sig. : Apply freely and cover with gauze or cloth. R Tinct. iodi, 3vj. Olei camphorse, 3iij. Ichthyoli, 3iij. Misce. Sig.: Shake and apply locally two or three times a day. W. F. Waugh recommends in the treatment of erysipelas the use of pilocarpine in sthenic cases, and iron in asthenic cases. During a period of twenty-five years he has had good results with this line of treatment, and no deaths. No local treatment is recommended. In sthenic cases the pilocarpine is given every hour until sweating occurs. When this takes place the edges of the involved area begin to recede. This remedy is then sus- pended for a day, and if the eruption continues the treatment is resumed until it is evident that the remedy has perfect control of the disease. In asthenic cases the tincture of the chloride of iron, 30 drops every four hours, and nourishment crowded, when improvement sets in at once. Dr. M. J. Bliem writes that as an external application he paints the affected area once or twice a day with Norwood's tincture of veratrum viride. "It has produced quicker allevia- tion than any other treatment I have ever used. I will say nothing of the internal treatment, as that will, of course, depend." FAVUS. I£ Resorcini, 3ij. Adipis lanse hydrosi, gij. Vaselini, Sij. Misce. Sig. : Massage scalp thoroughly with this twice daily. 176 Hand-Book of Modern Treatment I£ Phenolis, 3j. Ung. picis liq., 3ij. Ung. hydrargyri nitrat., 3ij. Ung. sulphuris, 3iv. Misce. Sig. : Wash scalp with soap and water every day and rub this in well, and should be made up once weekly. I£ Acidi sulphurosi, §v. Sig. : Dilute with water and apply twice daily after washing the head. $ Unguenti hydrargyri, gj. Unguenti sulphuris, §ij. Misce. Sig. : Apply twice daily. Indication: Used after scales removed. fy Unguenti chrysarobini, 3ij. Ung. picis liquidse, 3ij. Misce. Sig. : Apply once daily after cleansing scalp. IJ Ung. sulphuris, Sss. Ung. picis liq., q. s. ad 3ij. Misce. Sig. : Apply to areas affected. Indication: Useful in favus of non-hairy regions. FELON. In treating felons do not waste time with poultices, but incise at once, drain, use antiseptic dressings, and in some cases place the extremity in splints. Take a hypodermic syringe and find the sensitive point, or take a lead-pencil and press the point down over the felon until you thus localize the sensitive point. Go down into the peri- osteum with the hypodermic and inject cocaine at this point, and keep injecting it as you draw out the syringe. Then cut down to the periosteum with a bistoury, and with a syringe or probe go down into the pocket and inject carbolic acid. You Hand-Book of Modern Treatment. 177 have then taken the necessary steps to kill the microbe. If you are afraid of carbolic acid poisoning, put in some alcohol. Put on a loose dressing. A commencing felon will always be aborted by the local ap- plication of alcohol under perfect air-exclusion. Cotton is sat- urated with alcohol and placed about the affected part, and a thin rubber finger-stall applied over all. Seventy-two hours usually suffices to give relief or even effect a cure. $ Tr. opii, I]. Liq, plumbi subacetatis, §j. Aquae, 3xvj. Misce. Sig. : Keep affected part well bandaged and soaked in the above. FCETER OF BREATH. ^ Potassii chloratis, gr. xxx. Tinct. myrrhae, m x. Elix. calisayae, f^iij- Misee. Sig. : Dilute one tablespoonful with two of water and use as a mouth wash. Ifc Potassi chloratis, gr. xlviij. Acidi muriat. diluti, f3j. Syrupi, fgss. Aquae, q. s. ad f^iij. Misce. Sig. : Teaspoonful every two hours for a child 3 years old. Indication: Foetor due to ulcerative stoma- titis. For such this is useful. I£ Pepsini (scale), 3iv. Acidi hydrochlorici diluti, f3iv. Strychninae sulphatis, gr. %. Aquae, q. s. ad f§viij. Misce. Sig.: A tablespoonful m water after meals. Indication: As a result of gastric fermen- tation due to an acidity. 12 178 Band-Book of Modern Treatment. IJ Creosoti, m xxx. Resorcini (sublimed), gr. xv. Alcoholis, f3iv. Aquae chloroformi, fSiij- Misce. Sig. : Tablespoonful in a little water after meals. FEVER. ]}• Quininae hydrochloratis, gr. xxxij. Acidi hydrochlorici diluti, f3j. Syrupi aurantii rubri, f3vij. Aquae, q. js. ad fSiij- Misce. Sig. : A dessertspoonful every four or five hours. Indication: Used in hectic fever. I£ Hydrarg. chloridi mitis, gr. ij. Sodii bicarbonatis, gr. x. Misce et fiant tabellse triturationes no. x. Sig. : One every one-half-hour and follow in four or five hours with saline purge. Indication: Used in fever due to an auto intoxication with constipation. I£ Tinct. aconitini, m xij. Spt. setheris nitrosi, f3iv. Syrupi, f3iij. Liq. potassii citratis, q. s. ad f^iij- Misce. Sig. : One or two teaspoonfuls every two hours. Indication: Used in acute sthenic fevers. 1^ Antipyrini, gr. xl. Sja'upi simplicis, f3iv. Aqu«, q. s. ad •&}. Misce. Sig.: Half to one teaspoonful every two hours for children. Indication : Used in sthenic fevers. Hand-Book of Modern Treatment. 179 IJ Tincturae digitalis, f3iij. Tincturae ferri chloridi, f3v. Misce. Sig. : Fifteen drops three times daily. Indication: Used in hectic fever. FEVER, INTERMITTENT AND REMITTENT. IJ Quininae bydrobromatis, gr. xxx. Hydrargyri chloridi niitis, gr. v. Pulveris capsici, gr. iss. , Pulveris Doveri, gr. v. Aloini purificati, gr. V 6 . Misce et fiant capsular no. vj. Sig. : One every four hours. IJ Quininae sulphatis, 3ij. Acidi sulphurici aromatici, f3j. Olei menthae piperitae, m v. Fluidextracti glycyrrhizae, f§j. Grlycerini, f§iv. Misce. Sig.: A teaspoonful or two every two or three hours. IJ Quininae sulphatis, 3j. Sodii arsenatis, gr. ij. Ext. ignatise ale, gr. ij. Misce et fiant pilulae no. xx. Sig. : A pill three times a day. IJ Quininae sulphatis, 3j. Acidi sulphurici aromat., 3j. Liquoris potassii arsenitis, 3j. Syrupi aurantii corticis, §j. Aquae, q. s. ad §v. Misce. Sig.: A tablespoonful twice a day after eating. Indication: Used to prevent relapse after paroxysms have passed. IJ Quininae sulphatis, 3j. Elixiris taraxici comp., gi j. Sig. : A teaspoonful twice a day after eat- ing. Indication: Used to prevent a relapse. 180 Hand-Book of Modem Treatment. The following formula, having the quinine in solution, is not very unpalatable, and cured many cases where the quinine alone failed : — IJ Quininae sulphatis, gr. 1 vel lxxx. Acidi hydrochlor. dil., f3iss vel iiss. Tinet. zingiberis, f3iiss vel iv. Tinet. opii camph., f3ii vel iv. Syr. limonis, f^ij. Aquae, q. s. ad f^viij. IVfisce. Sig.: Tablespoonful every four hours. Take through a straw. The following prescription is of much value in malaria where quick action is not necessary: — I£ Pulv. capsicum, gr. x. Euonymin, gr. xx. Quininae sulph., gr. xxx. Mi see. Sig.: Six grains every three hours. The following is a valuable prescription for malaria when the stomach is not irritated very much: — B Tinet. capsicum, 3j. Fluidextracti myrica cerifera, 3ij. Tinet. cinchonae, 3ix. Misce. Sig. : One drachm every one or two hours. The following is a most excellent combination for malaria complicated with pregnancy, where large doses of quinine could not safely be used, and also for a large class of patients who have an idiosyncrasy against the use of quinine proper: — ]$ Strych. sulph.., gr. iij. Acidi arsenosi, gr. v. Ferri reduct., 3ij. Quininae sulph., 3ij. Aloes soc, gr. xx. Misce et fiant pilulae no. c. Sig. : One pill every four hours. Indication: Used in chronic malaria. Hand-Book of Modern Treatment. 181 Eegarding the after-treatment for malaria, the following is most excellent : — Ifc Tinct. fer. mur., f§j. Strych. sul., gr. j. Liq. arsen. potassii, 3ij. Tinct. capsici, 3iij. Aeidi phos. dil., Biij. Glycerini, q. s. ad Sviij. Misce. Sig. : One teaspoonful three times a day in water. Protect teeth with quill or alkaline wash. Label "Shake." For children decrease the iron and strychnine according to age, and for infants the acid one-half. Keep the bowels well open and the skin active by freqnent cleansing. If the chills return while taking the tonic, stop it and check them with quinine ; then give tonic again. Don't promise relief in chronic malarial poisoning under three months' regular treatment. I£ Quininae sulphat., 3j. Tinct. ferri chloridi, 3v. Liq. acidi arsenosi, 3iss. Potassii chloratis, 3j. Syr. zingiberis, q. s. ad %iv. Misce. Sig. : Teaspoonful in water thrice daily after meals. Ifc Quininae sulphatis, 3ij. Acidi sulphurici aroma tici, 3iv. Tinct. ferri chloridi, §ij. Liquoris potassii arsenitis, 3iv. Strychninae sulphatis, gr. j. Elixiris aurantiae, q. s. ad §viij. Misce. Sig. : Shake and give a teaspoonful in a wineglass of water before meals, and at bed- time if necessary. Indication : Pernicious chronic malaria. B Tinct. iodi comp., 3ij. Liq. potassii arsenitis, 3j. Misce. Sig. : Ten or fifteen drops after each meal. 182 Hand-Book of Modern Treatment. Ifc Tinct. iodi, 3iss. Potassii iodidi, 3iss. Aquse dest., f£v. Misce. Sig. : One teaspoonful in water given in the beginning of the paroxysm and repeated in about fifteen minutes, if needed. Indication: This is supposed to be of special value in cases where the chill comes at irregu- lar intervals. I£ Liquoris potassii arsenitis, fSj. Sig. : Three to five drops after meals. Indication: In conjunction with quinine be- tween paroxysms as antiperiodic. Also in ma- larial cachexia. 1$ Acidi arsenosi, gr. 1 / 30 . Salicini, gr. iij. Ferri reducti, gr. ij. Strychnines sulphatis, gr. 1 / 60 . Phosphori, gr. V^. Podophyllini, gr. Vie- Capsici, gr. 7 8 . Extracti gentianae, q. s. Misce et fiat pilula no. j. Sig. : One pill after each meal. Indication: Used in pernicious malarial fever. 1$ Quininae hydrochloratis, 3j. Saloli, gr. xl. Codeinse sulphatis, gr. iij. Phenacetini, gr. xxx or xl. Misce et nant in capsulas no. xij. Sig. : One capsule every three or four hours. Indication: Used in both the intermittent and remittent forms. I£ Methylene blue, gr. j. Arseni iodidi, gr. 1 / i0 . Hydrarg. iodidi, gr. Vso- Ferri iodidi, gr. 1 / 12 . Strychninae sulphatis, gr. 1 / 60 . Misce et pone in capsulam no. j. Sig.: One capsule three times daily. Hand-Book of Modem Treatment. 183 The above combination is markedly beneficial in cases of chronic splenic enlargement due to malaria. It is advisable to discontinue the capsules at once, because there occurs a reaction which weakens the patient. In most cases of malaria you can dispense methylene blue in cinnamon-water every two hours until the chills disappear, and after that you can use the fol- lowing combination, which will stand you in good need: — IJ Methylene blue, gr. X / M . Liq. potassii arsenitis, m j. Aquae cinnamomi, 3j. Mi see. Sig. : This dose three times daily after meals. I£ Tetramethyli thionini chloridi, 3j. Methylene blue, Pone in capsulas no. xxiv. Sig. : One capsule every four hours. 1$ Euquinae, 3ij. Fiant chartulse no. xij. Sig. : A powder six, four, and two hours before repeated paroxysm. Indication: This is a tasteless salt and well suited for children. - 1$ Cinchonas sulphatis, 3ss. Liq. potassii arsenitis, f3iss. Tinct. ferri chloridi, f§ss. Syrupi zingiberis, fgiss. Aquae destillatae, q. s. ad f§iv. Misce. Sig. : A dessertspoonful after meals. Indication: Used in chronic cases. Ifc Tinct. cinchonas comp., f^iv. Tinct. nucis vomicae, f3j. Fluidextracti taraxaci, fgij. Fluldextracti rhamni purshianae, fSij. Misce. Sig.: Half to a tablespoonful in water three or four times a day. j g4 Hand-BooJc of Modern Treatment. F* Tinct. Warburgi, %\v. Sig. : A tablespoonful and repeat in four hours to prevent attack. One to two tea- spoonfuls after meals as a prophylactic. FEVER, RELAPSING. IJ Saloli, 3ss. Phenacetini, 3j. Misce et fiant chartulse no. xij. Sig. : One powder every two hours. Indication: Used to relieve muscular pains. To increase the elimination and as a febrifuge in scarlet fever : — I£ Tinct. aconiti, m viij. Potassii citratis, 3iij. Syr. limonis, §ss. Aqua, q. s. ad §iv. Misce. Sig. : One teaspoonful every hour or two. And as a gargle for the throat in scarlet fever the follow- ing :— R, Acidi carbolici, 3ss. Glycerini, %]. Aquae camphorse, Sj- Potassii chloratis, gr. x. Aquse dest., q. s. ad Svj. Misce. -' ■ - • Sig.: Use as a gargle or spray. Ointments for hastening desquamation and for the benefit of the skin in scarlatina: — B Ichthyoli, 3vj. . Olei olivarum, 3j. Lanolini, §x. Sig. : Rub in thoroughly over the entire body every six or twelve hours. Hand-Book of Modern Treatment. 185 B Ichthyoli, 3j. Glycerini, 3ij. Aquae rosae, £v. Misce. Sig. : Alternate every six hours with pre- ceding ointment or apply either one every six hours. The latter prescription will promote desquamation quicker than the first. IJ Glycerini, 3iv. Aquae hydrogenii dioxidi (15 volume), Sivss. Misce. Sig. : Use as inunction all over the body except the head, once daily. Indication: Shortens period of scarlatinal desquamation. B Sodii salicylatis, gr. xlviij. Aquae destillatae, f3ij. Syrupi aurantii, q. s. ad f-Jiij. , Misce. Sig. : A teaspoonful every hour during the day and every two or three hours at night, in a little water. Indication: Given throughout the attack and for some days after defervescence has en- sued. I£ Potassii chloratis, 3ij. Tinct. ferri chloridi, f3j. Aquae, q. s. ad Siij- Misce. Sig.: Dessertspoonful in a half glass of water used as gargle every two hours. Indication: Used for sore throat. B Ung. picis liq., 3i-£j. Ung. zinci oxidi, 3j. Vaselini albi, 3j. Misce. Sig. : Anoint as needed, once or several times daily. Indication: To prevent itching. 186 Band-Booh of Modern Treatment. B Ichthyoli, 3vj. Aquae, f3ij. Misce. Sig. : Fifteen drops placed in a capsule three times a day at times of administration for a child five years old, and use at the same time the following prescription: — I£ Olei terebinthinae, f^ss. Sig. : Five drops in milk three times daily for a child five years old. Indication: Used at same time as the above prescription. I£ Phenolis (acidi carbolici), f3j. Olei olivae, f§xvj. Misce. Sig. : Anoint the body several times daily. Indication: Used to allay itching. I£ Spt. aetheris nitrosi, f^j. Potassii citratis, 3ij. Aquse destillatae, q. s. ad fsvj. Misce. Sig.: A teaspoonful every two hours if urine is high colored. I£ Tinct. ferri chloridi, 3j- Sig. : Five minims diluted and through a glass tube three times daily. Indication : To combat anaemia and infec- tion during later stages and convalescence. Widowitz has never had a case of nephritis among one hundred and two scarlet fever patients treated since he intro- duced the plan of preventive administration of urotropin. He gives from 0.05 to 0.5 gram of urotropin three times a day, ac- cording to age, during the first three days of the disease, and again, at the beginning of the third week, for another three days. B Infusi digitalis, fgss. Spiritus aetheris nitrosi, fgss. Potassii bitartratis, 3ij. Misce. Sig. : A teaspoonful in water every two or three hours. Indication : Used when urine is scanty. Hand-Book of Modem Treatment. 187 FEVER, TYPHOID. THE WAY TO SPONGE FEVER PATIENTS. The following prize-winning description of how to sponge a patient is quoted from the Hospital. When about to com- mence to sponge a fever patient the exact temperature of the body must first be noted. For tepid sponging the water pre- pared should be from 80° to 90° F. Bemove all personal cloth- ing from the patient and place blankets both under and over him. Place beside the bed all basins, sponges, and towels, or anything that may be required, as under no circumstances should a patient be left during an operation. Commence at the head and sponge downward, exposing only one limb at a time. When the whole body has been sponged the patient should be wrapped in a warm blanket and left undisturbed for an hour or even longer. The temperature may then be taken again to ascertain how much it has been reduced. The same precautions should be used in cold sponging as in tepid. It will, however, be found advisable to sponge each limb over with tepid water before apply- ing the cold, as it will then cause less shock to the patient. It is wise to keep a hot bottle at the patient's feet during sponging, as with the feet warm there is less fear of chill, and in the case of a fever patient there is always more or less danger of col- lapse. When the temperature has been reduced the body must be gently dried and a flannel nightgown put on. After a cold sponge the temperature may fall from 1 to 6 degrees ■ the colder the water the sooner the reaction takes place. Ammonia, cologne-water, or vinegar added to the water makes it more cooling by its rapid evaporation. Sponging can also be done by wringing towe's out of cold water, dry enough not to drip, and placing them one after another from the neck downward. When the feet are reached, begin again at the head and renew each in succession, continuing as long as necessary. Absolute rest for the patient and bowels, -obtained by with- holding food for several hours and by the free exhibition of opium, preferably in the hypodermic injections of morphine or the following : — 188 Hand-Book of Modern Treatment. IJ Acidi tannici, gr. x. Tinct. opii, m x. Spiritus terebinthinae, m xv. Mucilaginis acaciae, 3ij. Tinct. chloroformi comp., m xx. Aquse menthae piperitae, q. s. ad 5j. Misce. Sig. : Tablespoonful at one dose. Indication: Used in intestinal haemorrhage. The following to prevent meteorism and aid in checking haemorrhage : — I£ Spiritus terebinthinae, 3ij. Spiritus aetheris nitrosi, 3ij. Spiritus chloroformi, 3ij. Emulsii amygd., q. s. ad §vj. Misce et fiat mistura. Sig. : Shake bottle and give tablespoonful at a dose every three to four hours as required. An ice-bag laid over right side of the abdomen; when haemorrhage is so profuse as to threaten life, ice-water enemata or a hypodermic injection of salt solution may be employed; in such cases 20 grains of chloride of calcium every few hours are of value. IJ Acidi sulphurici aromatici, f3ij. Fluidextracti haematoxyli, f3iij. Syrupi zingiberis, fSiij- Misce. Sig. : A teaspoonful in water every hour until relieved. Indication: Used when diarrhoea is trouble- some. R Spiritus glycerylis nitratis, ra xxiv. Tinct. nucis vomicae, m lxxij. Tinct. cardamomi comp., fSiij. Misce. Sig. : A teaspoonful three times a day after about the second week. Hand-Booh of Modern Treatment. 189 I£ Acidi hydrochlorici diluti, 3iv. Aquae, q. s. ad £vj. Misce. Sig. : One teaspoonf ul three times daily. Indication: Used to aid digestion. I£ Bismuthi subnitratis, 3ij. Fiant chartulae no. xij. Sig. : One powder every three or four hours. Indication: Used to control diarrhoea. I£ Olei terebinthinae, f3j. Olei olivae, f§iv. Emulsi asafoetidae, q. s. ad Oj. Misce. Sig. : Shake well and use as an injection. Indication: Used in excessive tympany. I£ Hydrarg. chloridi mitis, gr. j. Sodii bicarbonatis, gr. x. Misce et fiant chartulae no. vj. Sig. : One powder every fifteen minutes until one grain is taken, then followed with mag- nesium sulphate one-half ounce. Indication: Used during initial stage of dis- ease to empty the intestine. Ifc Urotropin, 3ij. Fiant chartulae no. xxiv. Sig. : One powder twice daily. Indication: Used to render urine sterile and act as an intestinal antiseptic. I£ Glycerini, 5viij. Aquae, §viij. Misce. Sig. : Mouth is washed frequently with this, to which a little lemon juice may be added. R Hydrarg. chloridi corros., gr. j. Elix. calisaya, £iij. Misce. Sig. : A teaspoonful four times a day. Indication: Useful after typhoid. 190 Sand-Book of Modem Treatment. James Bihingslea stated that in one year he had treated in private and hospital practice 150 cases of typhoid fever, with acetozone, and the results had surpassed his expectations, not a single death having occurred. This special treatment con- sisted in dissolving 15 to 20 grains of acetozone powder — equal to 73/2 or 10 grains of the benzoyl-acetyl-peroxide — in a quart of water and giving the patient this amount to drink in the twenty-four hours, both in water and in milk, diluting the milk : 1 part of acetozone solution to 3 parts of milk. The action of the drug would be materially aided by administering a mild saline laxative — say, sodium phosphate or magnesium sulphate — every other day. B Naphtholis, 3ij. Bismuthi salicylates, 3ij. Misce et fiant chartulse no. xv. Sig. : One powder every hour as required. Indication: Useful for children when diar- rhoea is profuse. FEVER, TYPHUS. I£ Antimonii et potassii tartratis, gr. iv. Tinct. opii, fgj. Aqaae camphorse, f§viij. Misce. Sig. : A tablespoonful every two hours. Indication: Used in sleeplessness and ex- treme nervous excitement. IJ Guaiacoli; f3iv. Sig.: Ten to twenty drops in teaspoonful of sweet oil applied over abdomen. Indication: Used to reduce fever. I£ Extracti opii, gr. iv. Fiant pilulae no. viij. Sig. : One pill every three hours until quiet. Indication: For restlessness when no lung complication is present. R. Acidi phosphorici diluti. Sig.: Twenty to thirty minims well diluted every four or six hours. Band-Book of Modern Treatment. 191 FEVER, YELLOW. IJ Hydrarg. chloridi mitis, gr. v. Sodii bicarbonatis, gr. x. Misce. Sig. : Place on the tongue. Indication : Used as initial purge. IJ Cocainse, gr. xxiv. Aquae, f^iij. Misce. Sig. : Teaspoonful every two hours. Indication: Used for vomiting. B Potassii iodidi, gr. ij. Liq. potassii arsenitis, gtt. ij. Misce. Sig. : One such dose every two or three hours. This should be given throughout the entire course of the disease, beginning with the second day. IJ Morphinae sulphatis, gr. ij. Fiant chartulae no. xij. Sig. : Dissolve one powder in twelve minims of water and give hypodermically as needed. Indication: Used to control vomiting and relieve from restlessness. IJ Tinct. digitalis, 3iij. Sig. : Five minims three times daily. Indication: Used to stimulate the circula- tory system. FISSURE OF ANUS AND NIPPLES. To relieve the pain and to promote healing the following may be used : — IJ Iodoformi, 3j. Acidi carbolici, gr. xx. Petrolati, §j. Misce. Sig. : Apply once daily. Indication: Used to relieve pain and pro- mote healing in anus. 192 Hand-Booh of Modern Treatment. IJ Sulphuris loti, 3vj. Potassii bitartratis, 3ij. Pulv. sennae, 3j. Misce et fiant cachetae, no. xij. Sig. : One at night as a laxative. Indication: Used in anus. IJ Bismuthi subnitratis, gr. x. Aristol, gr. ij. Pulv. opii, gr. ss. Olei theobrom., q. s. ad suppos. no. j. Misce. Sig. : Introduce one hour before bowels move. IJ Potassii bromidi, 3j. Glycerini, f3v. Misce. Sig.: Apply locally to cnus. IJ Phenolis (acidi carbolici), gr. xxiv. Aquae, fgj. Misce. Sig.: Apply several times daily to the nip- ples. IJ Ichthyoli, 3ij. Glycerini, 3iij. Lanolini, 3v. Misce. Sig.: Apply freely after nursing and remove by thorough washing before the next morning. IJ Acidi tannici, 3j. Iodiformi, 3j. ?vlisce. Sig. : Bathe nipples after each nursing and cover with gauze moistened with a saturated solution of boric acid. IJ Argenti nitratis, gr. x-xx. Aquae destillatas, §j. Misce. Sig. : Apply to fissure once daily. Indication: Used to produce healing. Rand-Book of Modem Treatment. 193 FISTULA. IJ Formaldehydi (40 per cent, solution), f5j. Sig. : Five to ten drops in half pint of water, and inject into fistula once daily. I£ Argenti nitratis, gr. xv. Aquae dest., f^j. Misce. Sig. : Inject a few drops into fistula once daily. Indication: Used to promote healing. 1^ Phenolis (pure), gr. viij. Olei olivse (boiled), f&j. Misce. Sig. : Apply on absorbent cotton. FLATULENCE. The following has been useful in flatulency and gastric fermentation : — 1^ Aquse chloroformi,' f^viij. Sig. : Tablespoonful before and after meals. Used in chronic gastric catarrh: — B Sodii sulphocarb., gr. iv-viij. Syr. aurantii, m xl. Aquse menthse pip., q. s. ad 3j- Misce. Sig.: One teaspoonful three times a day for two days. Indication: Used in flatulence of children. I£ Ext. colocynth. comp., gr. V 3 . Terebinthinse (Venice), gr. j. Pulveris aloes Soc, gr. iss. Ext. nucis vomicae, gr. 1 / 4 . Ext. hyoscyami, gr. j. Misce et fiat pilula no. j. Sig.: One such pill twice daily. Indication: For constipation with flatu- lence. 13 194 Hand-Book of Modern Treatment. 1^ Acidi salicylici, gr. xxiv. Oleoresinse capsici, gtt. vj. Strychninse sulphatis, gr. ss. Ext. gentianse, gr. xxiv. Misce et fiant pilulse no. xxiv. Sig. : One after meals. J^ Pulv. zingiberis, 3ij. Pulv. acaciae, 3ij. Sodii bicarb., 3ij. Bismuthi subnit., 3ij. Sacch. alb., 3ij. Misce. Sig. : Teaspoonful in water. Indication: Used in flatulency with gastro- intestinal catarrh. Flatulency is said to be relieved by 1-grain doses of cam- phor given three times a day. I£ Olei terebinthinse, f§j. Olei olivae, f^iss. Camphorse, gr. xx. Mucilaginis acacias, f^ss. Aquae, f§x. Misce. Sig. : To be injected as an enema for the relief of tympanites and to aid in the removal of hardened faeces. Stir thoroughly before using. I£ Betanaphtholis, 3j. Pone in capsulas no. xx. Sig.: One capsule three times daily after meals. Indication: Useful in gastric fermentation and flatulence. IJ Tinct. nucis vomicae, f3j. Tinct. physostigmatis, f3j. Tinct. belladonnas, f3j. . Misce. Sig.: Fifteen drops in a little water two or three times daily. Rand-Book of Modern Treatment. 195 H Aloes, gr. xxiv. Asafcetidae, gr. xlviij. Misce et fiant pilulae no. xxiv. Sig. : One after meals. Indication: Used in flatulence and constipa- tion of old people. I£ Tinct. asafcetidse, f3j. Aquae, q. s. ad f^viij. Misce. Sig.: A teaspoonful three or four times a day. I£ Magnesiae, 3j. Spiritus ammonias aromatici, f3j. Spiritus cinnamonii, f3iij. Aquae destillatae, f^vj. Misce. Sig. : A tablespoonful every two hours. Indication: Used in sour eructations. FROSTBITE.— See also Chilblains. B Fellis bovis recentis, Oss. Sig. : Warm and rub in well daily. B Ung. thioli (20 per cent, sol.), §ss. Sig.: Apply locally. B Tinct. iodi, gss. Sig. : Apply with a brush once or twice daily. Indication: Only to be employed when the skin is unbroken. R. Liq. plumbi subacetatis, Sj- Tinct. opii, §j. Aquae destillatae, q. s. ad §xvj. Misce. Sig. : Apply freely on well moistened soft cloth. Indication: Used in mild cases to relieve pain. 196 Eand-Book of Modern Treatment. I£ Olei cajuputi, f3vij. Olei amygdalae dulcis, f3xvij. Misee. Sig. : Apply three times daily on lint. 1$ Balsami peruviani, 3ij. Ichthyoli, 3ij. Adipis lanae hydrosi, 3iv. Misce. Sig.: Apply to affected part freely. FURUNCLE.— See also Carbuncle and Abscess. R Sodii boratis, 3j. Acidi borici, 3j. Acidi salicylici, 3j. Acidi tannici, 3j. Misce. Sig. : Sprinkle upon the surface of a yeast poultice and apply. IJ Quininae sulph., 3j. Ferri pyrophos., 3j. Strychnia sulph., gr. j. Acidi phosphori dil., f3ij. Syr. zingiberis, f^ij. Aquae dest., q. s. ad fgiv. Misce. Sig. : Teaspoonful three times a day. Or tinct. ferri mur., gtt. xxv ? in water just before each meal. 1$, Calcis chloridi, Sij- Aquae camphorae, %ir. Tinct. myrrhae, 3ij. Creosoti ( beech wood ) , m xx. Glycerini, §j. Misce. Sig. : Apply constantly in form of wet com- press. Indication: To abort furuncles. This will positively remove the most excruciating pain in three or four hours, and will render any form of surgical treat- Band-Book of Modern Treatment. 197 ment unnecessary if begun in time, and is constantly and faith- fully applied. I£ Europheni, 3j. Olei olivse, 3ij. Lanolini, 3v. Olei petrolati, 3v. Misee. Sig. : Apply locally and cover with sterilized gauze. • It is claimed by Dr. J. Eilus Eastman, professor of sur- gery in Central College of Physicians and Surgeons of Indian- apolis, that a commencing felon will always be aborted by the local application of alcohol under perfect air exclusion. Cot- ton is saturated with alcohol and placed about the affected part and a thin rubber finger-stall applied over all. Seventy-two hours usually suffices to give relief or even effect a cure. He . learned this in von Bergmann's polyclinic, in 1897, since which time he has not had occasion to lance a single felon, the treat- ment of which was begun in time by this method. Gallois and Courcoux employ a solution consisting of 4 grammes of iodine to 10 grammes of acetone for the abortive treatment of furuncles. The nodules are touched with an appli- cator carrying cotton saturated with the iodine solution. Lesions which have not suppurated, and even those which contain a drop or two of pus superficially, are aborted within twenty-four hours. Rarely a second application may be required. The solution is more caustic than the tincture and must be used with greater care. In an open wound it causes severe pain and may produce symptoms of iodism. IJ Argenti nitratis, gr. lxxx. Aquae dest., f3iv. Misce. Sig. : To be applied two or three times on the inflamed surface, and beyond it, on the healthy skin. R Calcii sulphidi, gr. iij. Ext. glycyrrhizse, q. s. Fiant pilulae no. xxx. Sig. : One pill every one or two hours. 198 Hand-Booh of Modern Treatment. GALL-STONE COLIC. The intermittent, sharp, stabbing-like pains of short dura- tion, denoting the progressive onward passage of small stones, can most positively be overcome by the following : — 1$ Fluidextracti podophylli, m xxiv. Fluidextracti dioscorese vil., f3iij. Tinct. lobelias, f3ij. Aquae chloroformi, ad fgiv. Misce. Sig. : A teaspoonful every half-hour. Olive-oil, so highly extolled, is not a specific, as some au- thors would have us believe, and it is certainly a nauseating medicine to most persons suffering the tortures of colic, with its reflex nausea and vomiting. Its action may be relied upon only when the obstruction is at the diverticulum of Vater. If it is combined with aromatics it is more likely to be retained. The following has been successful: — 1$, Olei cinnamomi, m v. Methylis salicylates, m vj. Mentholis, gr. ss. Saccharini, gr. j. Ess. anisi, m xv. Olei olivse, Oj. Misce. Sig.: At one dose. On being called to a case of gall-stone colic, order applied over the gall-duct and gall-bladder cloths wrung out of as hot water as the patient can bear. This gives slight temporary re- lief, and satisfies the patient that something is being done to alleviate the pain. Then prescribe the following: — Ifc Fluidextracti lobelise inflatse, f3iij. Syrupi pruni Virginianse, f§j. Water, q. s. ad fgiij. Misce. Sig. : A teaspoonful every five or ten min- utes until nausea or vomiting is produced, and then as often as is necessary to keep up the nausea. Hand-Book of Modem Treatment. 199 IJ Sodii bicarbonatis, 3iss. Acidi benzoici, 3ss. Sodii phosphatis, oij. Aquse bullientis, %iv. Dissolve, filter, and add cinnamon water 3vj- Sig. : Two tablespoonfuls of this mixture may be given three times a day in cases of uric acid gravel. GANGRENE. ]$ Acidi nitrohydrochlorici, 3j- Sig. : Apply to affected parts with a glass rod. If it burns too deeply apply a solution of soap. Used in hospital gangrene. I£ Tinct. ferri chloridi, §ij. Sig. : Give two minims every three hours, in water, and through a glass tube. Indication: Used to prevent pysemic infec- tion in moist gangrene. R Bromi, fgj. Sig. : Pour bromine into a glass of water, then draw into syringe and inject into the wound, and then cover wound with antiseptic fomentations. B Hydrargyri chloridi corrosivi, gr. xv. Aquae, Oij. Misce. Sig. : Cover affected area with gauze well saturated with this. GASTRALGIA. I£ Codeinse sulphatis, gr. v. Atropinse sulphatis, gr. 1 / 10 . Aconitinse, gr. 1 / 20 . Ext. cannabis Indices, gr. ij. Misce et fiant pilulse no. xx. Sig. : One pill every half-hour until four are taken; then one pill as indicated. Indication: To relieve acute pain. 200 Rand-Book of Modem Treatment. I£ Arseni trioxidi, gr. ss. Extracti gentianse, gr. xxiv. Mi see et fiant pilulas no. xij. Sig. : One pill three times daily between meals. R: Olei cajuputi, 3j. Tinct. capsici, 3iij. Lin. camphorse ammon., 3iv. Misce. Sig. : For external use. Rub in for five to ten minutes once or twice daily. Indication: Useful in severe cases as a counter-irritation over the epigastrium. B> Tinct. belladonnas, 3j. Tinct. calumbae, 3j. Tinct. arnicas, 3j. Tinct. opii camphoratas, 3j. Misce. Sig. : Five to ten drops in sugar-water every three hours until pain ceases. R Bismuthi subnitratis, gr. x. Bismuthi salicylatis, gr. x. Pulv. ipecacuanhas, gr. j. Benzoanaphtholis, gr. x. Misce. Sig. : One such powder after each meal. I£ Tinct. belladonnas, m xx. Tinct. capsici, m v. Tinct. gentianse comp., 3ij. Aquas dest., 5j. Misce. Sig. : One teaspoonful before each meal. Indication: To relieve pain if gastric fer- mentation is present. I£ Resorcini, 3iiss. Bismuthi salicylatis, 3iiss. Pulv. rhei rad., 3iiss. Sodii sulphatis, 3iiss. Saccharini lactis, jjsss. Misce. Sig. : One-half teaspoonful twice daily. Indication: Pain with gastric fermentation. Hand-Book of Modern Treatment. 201 B Codeinae sulpha tis, gr. iij. Ext. cannabis Indicae, gr. ij. Ext. nucis vomicae, gr. iij. Misce et fiant pilulse no. xij. Sig. : One three times daily after meals. Indication: Useful in excessive gastralgia in chronic gastritis. For many years Professor Whitford has taught his classes to prescribe the bicarbonate of soda freely where there is persist- ent pain in the stomach, often depending upon gastric ulcer. Sir Lauder Brunton has recently advised that a teaspoonful of the bicarbonate of soda in a little lime-water, to which the es- sence of peppermint has been added, gives a more speedy re- lief from pain from gastric ulcer than morphine. In many cases, by the neutralization of acid fluids present, it produces relief where morphine will not. When flatulence is associated with pain after food and coated tongue, indicating gastritis, the following prescription should be given: — r I£ Potassii bicarb, vel sodii bicarb., 3ij. Spts. ammonite aromatici, 3iss. Liq. strychninae ( P. B. ) , 3ss. Spt. cajuputi (P. B. ), 3iss-3ij. Spt. chloroformi, 3j. Infusi calumbse vel gentianse co., 3vj. Misce et fiant mist. Sig. : A sixth part three times a day be- tween meals. I£ Argenti nitratis, gr. v. Ext. hyosciami, gr. x. Misce et fiant pilulse no. xx. Sig. : One pill before meals. Indication: Useful in pain from gastric ulcer. 1$. Spiritus chloroformi, f3iv. Spiritus aetheris comp., f3iv. Misce. Sig. : One teaspoonful in water every hour until relieved. Indication: Used for relief of acute pain. 202 Hand-Book of Modern Treatment. I£ Condurango, f3iv. Acidi hydrochlorici, f3iv. Tinct. gentianae comp., £iss. Aquse dest., q. s. ad giij. Misce. Sig. : Teaspoonful after meals. Indication: Useful in gastralgia in gastric cancer. I£ Tinct. ferri chloridi, f^j. Acidi hydrochlorici diluti, f§ss. Liq. acidi arsenosi, fgss. Misce. Sig. : From four to fifteen drops in water after meals three times daily. Indication: Useful in anaemia complicating it. IJ Tinct. capsici, f3j. Tinct. cannabis Indicae, f£ss. Tinct. opii deodorati, f§j. Spt. chloroformi, f^j. Tinct. lavand. comp., q. s. ad f§iv. Misce. Sig. : Teaspoonful every hour until pain is relieved. Indication: Useful in gastralgia and other abdominal pains.. R Acidi hydrocyani diluti, f3j. Fluidextracti cannabis Indicae, f3j. Tinct. hyoscyami, f3iss. Spiritus chloroformi, f3ij. Misce. Sig. : One-half teaspoonful in water three times daily for an adult. 1$ Chloroformi, 3j. Morphinae sulphatis, gr. j. Pulv. gummi arabici, 3j. Aquse, q. s. ad §iij. Misce et fiat emulsio et adde Syrupi, 3iv. Aquae amygd. amar., 3j. Misce. Sig. : One teaspoonful every half -hour until relieved. Band-Book of Modern Treatment. 203 GASTRITIS, ACUTE. B> Bismuthi subnitratis, gr. v. • Bismuthi salicylatis, gr. v. Pulv. ipecacuanhas, gr. j. Benzoanaphtholis, gr. v. Misce et fiant chartulse no. j. Sig. : One such after each meal. R^ Bismuthi, gr. xl. Cerii oxalajtis, gr. xx. Misce et fiant chartulse no. xx. Sig. : One powder every two hours. Bi Sodii bicarbonatis, 3iiss. Calcinse magnesias, 3ij. Sodii bromidi, 3iiss. Bismuthi carbonatis, gr. lxv. Saccharini, 3iiss. Olei foeniculi, m iv. Misce. Sig. : From half a teaspoonful to a tea- spoonful to be taken an hour or two after eating, and a special dose in case of pain. Indication: Pain due to gastric acidity re- lieved by this. B; Betanaphtholis, gr. x. Bismuthi, gr. x. Bismuthi benzoatis, gr. x. Bismuthi salicylatis, gr. x. Magnesiae usta, gr. x. Menthol, gr. x. Saccharini, gr. v. Misce et fiat chartula no. j. Sig. : One powder three times daily. Indication : Useful in gastric fermentation. R> Ichthyoli, 3iss. Tinct. opii, 3ij. Bismuthi subcarb., 3iss. Syr. simplicis, 3iv. Aquae menth. pip., q. s. ad ^iv- Misce. Sig. : One dessertspoonful in water before meals. 204 Hand-Book of Modern Treatment. After evacuating the stomach with a siphon and cleansing the membrane with a solution of warm water, the following antiseptic solution may be used to wash out the stomach : — Ifc Thymol., gr. vj. Acidi borici, 5iv. Aquae destil., Oj. Misce. Sig.: To be introduced and withdrawn through the stomach-tube. When flatulence is associated with pain after food and coated tongue, indicating gastritis, the following prescription should be given : — I£ Potassii bicarb, vel sodii bicarb., 3ij. Spt. ammonias aromatici, 3iss. Liq. strychnines ( P. B. ) , 3ss. Spt. cajuputi (B. P. ), 3iss-ij. Spt. chloroformi, 3j. Infusi calumbas vel gentiante co., 5vj. Misce. Sig.: A sixth part three times a day be- tween meals. B Magnesias calcines, gr. vj. Sodii bicarbonatis, gr. vj. Sodii bromidi, gr. x. Bismuthi subnitratis, gr. ij. Misce et fiant chartules no. j. Sig. : One such before meals. Indication: Useful in acute catarrhal gas- tritis to stop fermentation. 1^ Saloli, 3j. Bismuthi subnitratis, 3iv. Tinct. opii camphoratas, f3iij. Tinct. zingiberis, f3iij. Misturas cretas, q. s. ad f^iij. Misce. Sig.: Two teaspoonfuls every three hours until the stools are formed, then one teaspoon- ful thrice daily. Indication: Good in acute gastro-enteritis. Eand-Book of Modern treatment. 205 R Sodii bicarbonatis, 3ij. Tinct. gentianae comp., 3iv. Elixiris aromat., q. s. ad 3ij- Misce. Sig. : One teaspoonful in water after meals. Indication: Useful in acute condition for children. R Tinct. nucis vomicae, 3j. Tinct. physostigmatis, 3j. Tinct. belladonnas, 3j. Sig.: Fifteen minims twice daily in water. Indication: Useful in acute gastritis with flatulence. R Bismuthi subnitratis, 3iij. Zinci sulphocarbolatis, gr. xij. Tinct. hyoscyami, 3iij. Glycerini, 3iv. Aquae, q. s. ad §iij. Misce. Sig. : One teaspoonful every four hours. Indication: Useful in gastro-enteritis. GASTRITIS, CHRONIC. In chronic alcoholism or delirium tremens, piscidia will prove its worth. The following combination has given good results : — R Fluidextracti piscidise, f3v-f§j. Fluidextracti erythroxylon cocae, f3iv. Fluidextracti hyoscyami, f3j. Tinct. capsici, m xxx. Spts. aetheris comp., q. s. ad fgij. Misce. Sig. : One or two teaspoonfuls every hour or two until sleep is secured; afterward one teaspoonful every three or four hours till the nervous system resumes its normal condition. R Argenti nitratis, gr. x. Aquae menthse pip., f£v. Misce. Sig.: One teaspoonful one hour before meals. 206 Hand-Booh of Modern Treatment. Ifc Bismuthi subcarb., 3ij. Magnes. usta, 3ij. Misce et fiant chartulse no. xv. Sig. : One powder after eating. Indication: If hydrochloric acid does not agree this is good. P* Pepsini (scale), 3ij. Acidi hydrochlor. diluti, f3iv. Aquse, q. s. ad fgviij. • Misce. Sig.: One teaspoonful in water after meals. Indication: Useful to assist feeble digestion. P* Sodii bicarbonatis, 3iij. Tint, gentianse comp., q. s. ad 3iv. Misce. Sig.: One teaspoonful after meals. Indication: Useful during convalescence. P* Oleoresini capsici, gr. x. Pancreatin, gr. xx. Pulv. zingiberis, gr. Ix. Pulv. carbonis lignis, gr. Ix. Misce et fiant pilulse no. xx. Sig. : One or two t.i.d. Indication: Very good in atonic or subacute gastric catarrh accompanied with much belch- P* Argenti nitratis, gr. v. Ext. hyoscyami, gr. x. Misce et fiant pilulse no. xx. Sig. : One pill one-half-hour before each meal. P* Sodii bicarbonatis, £ij. Tinct. nucis vomicae, §ss. Aquse, q. s. ad §iij. Misce. Sig.: One teaspoonful after meals. Indication: Useful in subacute gastric ca- tarrh. Hand-Book of Modern Treatment. 207 GASTRIC ULCER. In gastric ulcer Cohnheim has long relied on olive-oil as an adjunct in treatment. He believes that it relieves pain, lubri- cates surfaces of ulcers or fissures, reduces hyperacidity, and acts as an easily digested food. In employing olive-oil one should take precautions to make sure that the oil is pure, as in com- merce it is commonly adulterated to a large extent with cotton- seed-oil, a body whose therapeutic and nutritive qualities have not been fully examined. Sir Lauder Brunton states that he can stop the pain in a large percentage of cases by the administration of sodium bi- carbonate. He instructs the patient to dissolve one teaspoonful of the soda and slowly sip the solution until it is gone. He thinks it better to dissolve the soda in lime-water, flavoring it with some of the mint waters. His reason for using lime-water is that the sodium bicarbonate in plain water might soften the tissues to a great degree and thus predispose to haemorrhage. To lessen the constipation caused by the lime, fluid magnesia may be given in conjunction with the soda : — IJ Spts. menthse pip., 3iss. Cretse prep., 3ss. Mag. earb. calcined, 3j. Sod. bicarb., 3j. Misce. Sig. : One teaspoonful should be stirred in a half tumbler of water and slowly sipped until the pain is relieved. IJ Fluidextracti condurango, §ss. Acidi hydrochlorici, 3ij. Tinct. gentianae comp., giss. Aqua, q. s. ad §iij- Misce. Sig.: One teaspoonful after meals. Indication: Useful in gastric cancer. B Argenti nitratis, gr. v. Extracti hyoscyami, gr. x. Misce et fiant pilulae no. xx. Sig. : One pill one hour before meals. 208 Eand-Book of Modern Treatment. IJ Chloretan, Sij. Fiant pilulae no. xxx. Sig. : One pill four times daily. Indication: Good when pain is present. 1$. Bismuthi subnitratis, 3ij. Morphinae, gr. iv. Misce et fiant chartulae no. xij. Sig. : One powder three times daily or as often as necessary to relieve pain. I£ Olei terebinthinae, f3ij. Pone in capsulas no. xij. Sig. : One capsule every six hours. Indication: Good to prevent haemorrhage. IJ, Phenolis, gr. xx. Bismuthi subnitratis, §j. Misce et fiant chartulae no. xxiv. Sig. : One powder three times daily. B Fluidextracti eondurango, f3vj. Acidi hydrochlorici, f3iv. Tinct. gentianae comp., §iss. Aquae, q. s. ad 3iij. Misce. Sig. : Teaspoonful after meals. Indication: Useful in severe pain due to gastric cancer. GINGIVITIS (INFLAMMATION OF THE GUMS), Ifc Saloli, gr. xv. Spts. menth. pip., 3x. Tinct. catechu, 3j. Misce. Sig. : One teaspoonful in half a glass of warm water as a mouth wash. ]$ Acidi carbolici, gr. xx. Potassii chloratis, gr. xx. Syrupi, gj. Aquae camphorae, §iij. Misce. Sig. : One dessertspoonful as a mouth wash diluted in half a glass of water. Rand-Book of Modern Treatment. 209 Lance the gums : — (1) When a tooth is very near the surface, to spare need- less suffering. (2) When the gums are very red, hot, and swelled. (3) When the child has been feverish for a week or two and the tooth does not seem to advance, although the gum is tense and swelled. (4) When, during the progress of teeth- ing, a child is suddenly seized with convulsions for which there is no obvious cause. The irritation of the teeth may be the real cause; and the chance of relieving it by so simple a means is not to be thrown away. If the process of teething is going on quite naturally, no interference, medical or other, is necessary or proper. GLANDS, ENLARGED AND INFLAMED. I£ Syr. ferri iodidi, 5j- Sig. : Five to ten drops in water after meals. Indication: Useful in scrofula and anaemia. U Ichthyoli, 3j. Ung. hydrarg., 3j. Ung. belladonnas, 3j. Ung. petrolati, 3vj. Misce. Sig.: Apply locally night and morning. Indication: Where surgical interference is unadvisable in enlarged glands this is splendid. I£ Emulsi olei morrhuae, 5 xv j- Sig. : One teaspoonful in milk and increase, given one hour after meals. Indication: Useful in anaemic and scroiu- lous patients. B Tinct. iodi, f§j. Sig. : Paint over gland. Indication: In earliest stages of inflamma- tion or in chronic enlargement. B Phenolis, 2 per cent. sol. Sig. : Inject ten drops into gland with a hypodermic syringe. Indication: Useful when gland threatens suppuration. 14 210 Hand-Book of Modern Treatment. IJ Liq. plumbi subacetatis, 5j- Tinct. opii, %]. Misce. Sig. : Add one pint of water and apply freely on soft cloth. Indication: Useful in early stage to abort inflammation. IJ Calcii sulphuratae, gr. ij. Pone in granulas no. xx. Sig. : One every three hours. Indication: Useful to prevent suppuration. GLAUCOMA. IJ Eserinae sulphatis, gr. j. Aquas destillatae, f£j. Sig. : One drop in eye every three hours. Indication: Useful in acute attack. IJ Pilocarpine hydrochlor., gr. ij. Aquse, gj. Sig. : One drop in eye once daily. Indication: Useful when operation is de- layed. GLOTTIS (EDEMA. IJ Aluminis, gr. lxv. Tannin, gr. lxv. Extracti kramerise, Siiss. Aquae, Oj. Misce. Sig.: Used as a spray in the throat five or six times daily. GOITER. Roy gives the following plan : — First, in the case of each goiterous patient the author ad- vised him, if possible, to leave the affected circle, and if not, he was advised to take his drinking water after boiling. Hand-Book of Modern Treatment. 211 Much good result was obtained with the use internally of any preparation of iodine with thyroid or thymus gland extract. The author prescribed internally: — IJ Potassii iodidi, gr. v. Syrupi ferri iodidi, 3ss. Spiritus aminoniae aromatici, m xv. Liquor, thyroidii, m v. Aquae, q. s. ad 5j- Misce. Sig. : This dose three times a day. The dose of potassium iodide was raised gradually from 15 grains to 1 drachm daily, if the patient did not show any dis- tinct signs of improvement in a few weeks. He also prescribed tincture of iodine, 5 to 15 minims, three to four times a day, administered in a capsule. Ifc Iodoformi, gr. cxx. Pulv. ferri reduct., gr. xl. Ext. gentian., q. s. Misce et fiant massa in pil. no. xl div. Sig. : One pill three times daily after meals. I£ Iodoform!, gr. cxij. Collodii, 3iv. Misce. Sig. : Shake well : paint on swelling night , and morning. Should the skin become too sen- sitive and sore, omit for a day or two, then re- sume the painting once daily at bed time. For the nervous, irritable, and sleepless condition the follow- ing is recommended: — Ifc Sodii bromidi, gr. ij. Potassii bromidi, gr. ij. Amnion, bromidi, gr. ij. Liq. potassii arsenitis, m ij. Tinct. nucis vomica, m iv. Aquae camphorae, q. s. ad 3j. Misce. Sig.: Give half an ounce of such a solution well diluted three to four times a day. 212 Hand-Book of Modern Treatment. The following formula has also been recommended for ex- ophthalmic goiter with irregular and rapid heart and nervous- ness : — 1$. Potassii bromidi, 3ij. Infusi digitalis, q. s. ad Sviij. Misce. Sig. : Tablespoonful in water eA^ery six hours. Indication: Useful in exophthalmic goiter. William Cuthbertson says that the different forms of treat- ment of the various tumors of the thyroid gland are about as numerous as the writers on the subject. With the exception of the surgical cases, the treatment of goiter seemed to have been purely empirical, no definite classification, with its appro- priate treatment, apparently having been attempted, with the exception of the iodides and iodine having been recognized as specifics. Cuthbertson found in one case that hydrastis Cana- densis proved efficacious in effecting a cure in a goiter of preg- nancy, and this led him to the investigations which he has detailed. In each case of twenty-five cases of goiter of puberty and pregnancy which came under his care, a cure was effected in from six weeks to three months by the administration of hydrastis Canadensis, three times daily, after eating. He was well aware that some of these cases might have got well with- out treatment, but he made no selection of them, taking them as they presented themselves. One of the cases which was cured by this means had been treated with iodine and the iodides and with thyroid extract, becoming much worse under both forms of treatment. Immediately on instituting the hydrastis treatment the patient began to improve and was cured in six weeks. He presented hydrastis Canadensis as a new and successful remedy in the goiter of puberty and pregnancy. The remedy, when applied, will smart for a short time, es- pecially after it has caused the skin to chap or crack ; but if too severe the patient may omit the application two or three days, but should persist in the use of the remedy until cured. Hand-Book of Modern Treatment. 213 I£ Hydrarg. iodidi rubruin, gr. xx. Atropine, gr. j. Adipis, 5j- Misce. Sig. : Apply with a spatula made of soft wood, by rubbing the salve well into the skin; after which expose the part to the sun during twenty to thirty minutes so as to drive the remedy well in. The salve should be rubbed only over the upper half of the goiter, as it will run clown over the other portion sufficiently, and it is desirable not to give it over any more of the skin than is actually necessary. Internally give 1$. Potassii iodidi. 3ij. Tinct. strophanti^ 3ij. Tinct. iris versicolor, 3ij. Elixiris simplici, q. s. ad §iv. Misce. Sig. : A teaspoonful in water three times a day. Follow this up and it will give cure in any case of goiter in from four to ten weeks. R, Iodoformi, 3j. Spts. setheris, §v. Misce. Sig. : Fifteen minims injected into the en- larged gland every second or third day. By this mode of treatment improvement was noted in the headache, polypuria, and neuralgic pains, as well as a reduction is the rapid heart-action and the tremor. Indication: Useful in exophthalmic goiter. Ifc Sodii salicylatis. 3ij. Ext. glycyrrhizae, 3ij. Aquse dest., q. s. ad f^v. Misce. Sig.: Tablespoonful wall diluted every three hours. 214 Hand-Book of Modern Treatment. B Tinct. iodi, £j. Sig. : Apply with brush and repeat when skin exfoliates. Indication : Used in simple goiter. ]$ Glandulae suprarenalis siccae, 3iij. Pone in capsulas no. xxx. Sig. : One or two three times daily. Indication: Used in exophthalmic goiter with lowered arterial tension and cardiac pal- pitation. I£ Glandulse thyroidal siccae, 3iij. Pone in capsulas no. xxxvj. Sig. : One capsule three times daily. Indication : Used in simple hypertrophic en- largement of the thyroid. GONORRHOEA. I£ Zinci sulphatis, gr. xvj. Bismuthi subnitratis, 3iv. Glyceritis tannin, 3iv. Hydrastis, 3iv. Mucilaginis acaciae, 3ij. Aquae, q. s. ad §vj. Misce. Sig. : Use locally two or three times daily. Inject two teaspoonfuls and allow to remain in urethra but a short time. Indication: This is the best injection ever used in acute and subacute and chronic stages of gonorrhoea. I£ Iodi, gr. xv. Potassii iodidi, gr. xv. Argyrol, gr. lxxv. Aquae dest., q. s. ad §iij. Misce. Sig. : Inject three times daily. Indication: Used in acute, subacute, and chronic stages. Eand-Book of Modern Treatment. 215 I£ Copaibae para, 3iv. Saloli, 3iv. Oleoresinse cubebse, 3ij. Pepsini, gr. xxiv. Misee et pone in capsulas no. xxiv. Sig. : One capsule three times daily after meals. Indication: Used in subacute and chronic gonorrhoea. B ^ ng. belladonna, 3j. Ichthyoli, Sj. Ung. hydrargyri, 3ij. Petrolati, q. s. ad gj. Mi see. Sig. : Apply externally. Indication: Used as triple ointment for bubo. The treatment proper is given in the following manner: After the patient empties his bladder completely the urethra is irrigated with a hot solution of potassic permanganate, abont 1 to 3000. For this purpose use the Valentine irrigator, though, if nothing better is at hand, the urethra may be flushed out sev- eral times with the ordinary rubber-tipped hand-syringe. The packer is then dipped in a bottle of the solution used on the dressing, or glycerine may be used instead, after which the penis is grasped with the fingers of one hand and the packer intro- duced slowly and carefully into the urethra with the other hand. It is passed back about four inches in anterior gonorrhoea, and back to the neck of the bladder in posterior gonorrhoea and pros- tatic troubles. Force is never used in introducing the packer. The urethra is then lightly packed with one-inch continuous gauze strips, or, better, a loosely-spun cotton cord, saturated with one of the following solutions : — IJ Iodoformi. gr. xcv. Balsami peruviani, 3iv. Olei ricini, q. s. ad %\\. Sig. : Rub iodoform in castor oil, then add balsam of Peru. You will notice that the odor of iodoform is practically masked in this solu- tion. 216 Hand-Book of Modem Treatment. IJ. Ichthyoli, gr. xl. Resorcini, gr. xl. Balsami peruviani, 3iv. Olei ricini, q. s. ad %W, Misce et fiat solutio. The instrument is gradually withdrawn as the dressing is pushed through, and when it emerges from the meatus the cord dressing is clipped with scissors, leaving about one-eighth inch of the cord outside of the meatus, which can be taken between the fingers when the cord is to be removed. A small piece of cotton is placed over the head of the penis and treatment is complete. The patient is now instructed to go as long as he possibly can before urinating, when the cord is slowly removed. Use the following liniment from the beginning. Its action is exceedingly rapid and effective : — I£ Ammonii chloridi, 3ij. Potassii iodidi, 3ij. Alcoholis, f^ij. Aquae dest., fgij. Misce. Sig. : Apply with a small camel's-hair brush four times daily. Indication: Useful in gonorrhceal epididy- mitis. I£ Guaiacoli, 3ij. Lanolini, 3iij. Resorcini, 3iij. Misce et fiat unguentum. Sig. : Apply locally on gauze. Indication: Useful in gonorrhceal epididy- mitis. The following prescription is a most excellent, efficient, and bland antiphlogistic, possessing powerful properties in the sup- pression of the discharge, which it will almost invariably check in three days. without any untoward symptoms whatever: — Hand-Book of Modern Treatment. 217 Ifc Colorless hydrastis, ^iij . Potassii chloratis, gr. xx. Or sol. sat. Aquae, q. s. f§iv. Misce. Sig. : Inject a small syringeful four times daily. IJ. Tinct. aconiti, 3j. Tinet. gelsemii, 3ij. Antipyrini, 3ij. Fluidextracti ergotae, §j. Aquae, q. s. ad 5vj. Misce. Sig. : A dessertspoonful every two or three hours in a wineglassful of water. Indication: Useful in prostatic pain follow- ing gonorrhoea. The latest thing which is vouched for as a sure destroyer of the gonococcus is picric acid. It is claimed by those who have used this method that it exerts almost a specific action in chronic urethritis. In using the remedy, a solution of from 1 to 2 per cent, is employed, and it is always used by instillation. The soft or hard catheter is introduced into the urethra as far as the cut-off muscle, and the injection is slowly made until the fluid flows from the anterior urethra. It is claimed that many cases have yielded to this treatment that have resisted protargol, nitrate of silver, and permanganate of potassium. Ifc Acidi borici, 3iss. Tinct. iodi, 3ij. Glyeerini, gj. Aquae dest., %iv. Misce. Sig. : Use as an injection morning and even- ing. DIAGNOSIS OF GONORRHEAL VAGINITIS. It is said that the pus of gonorrhceal vaginitis is always alkaline. If for any reason a microscopical examination can- not be made, the use of a strip of litmus paper will, therefore, give a fairly accurate decision. 218 Hand-Book of Modern Treatment. Hirsch reports the prompt cure of a threatening case of gonorrheal inflammation of one eye from auto-infection. He commends the technique following as promising surprising re- sults for such cases. He made a single subcutaneous injection of a 1 to 5000 solution of hydrargyrum oxycyanate to which a little acoin had been added. There was considerable irritative reaction, but the process was arrested and three days later the cure was completed by a repetition of the injection. Ifc Methyl salicylatis, 3ss. Petrolati, 3v. Misce. Sig. : Give warm baths, copious draughts of Vichy water, and anoint the penis with this ointment. Then apply a thin layer of wadding to the member, and cover the whole with adhe- sive taffeta. An editorial in the Journal of the American Medical Asso- ciation says that Popper was led to make urethral injections of a solution of nitric acid in order to avoid the generation of heat caused by the chemical decomposition of silver nitrate. Cocaine or eucaine may be added to the solution for anaesthetic purposes. In cases of acute gonorrheal urethritis a 10- or 15-per-cent. solution of pure concentrated nitric acid was injected from three to five times daily, the fluid being permitted to remain in the urethra for one or two minutes. In the course of from twenty-four to forty-eight hours the character of the copious discharge will have changed. The urine becomes clear, and contains only fibers. The secretion is viscid and considerably diminished. In the course of five or six days at times only a small drop can be expressed; later only in the morning. In the course of a week in most instances the discharge is even still less. The gonococci also rapidly diminish in number in the course of a da3<, and disappear wholly in from five to eight days. For three or four days after the gonococci have no longer been demonstrable the injections are made but twice a da}^ and then but once a day. After from twelve to fourteen days as- tringents are prescribed for the purpose of causing the disappear- ance of any filaments that may yet be present. If the discharge Hand-Book of Modern Treatment. 219 is not increased following a seminal emission, or gonococci do not appear, the injections are gradually discontinued; so that the treatment shall be concluded in from fifteen to thirty days. In chronic cases or in the presence of posterior urethritis, a 25-per-cent. solution of nitric acid is injected once daily by means of Guy oil's syringe. S. Chandler, Philadelphia, advocates the use of lactic acid for the treatment of gonorrhoea of the cervix as preferable to other methods. He has employed it in 34 cases, which are tabu- lated. His method is as follows : Cleanse the vagina and cer- vix thoroughly with warm water and cotton soaked in a water solution (4 to 6 ounces) of pyroligneous acid. Expose the cer- vix by drawing it downward and into view by an ordinary long tenaculum; then take an ordinary hypodermic syringe loaded with pure lactic acid, and inject just beneath the membrane a few drops of the acid. Continue this until the whole • of the cervix is exposed as the superior and inferior lip is injected. It may be done at one sitting or, in a nervous case, if desired, in two or three sittings. He concludes from his experience with this and other methods that lactic acid cures gonorrhoea, has no ill effects, and prevents the spread of the disease into the body of the uterus if used sufficiently early. Ordinary douches and painting of the cervix give only temporary relief; it is better to destroy the cervical glands, and this should be done as soon as a positive diagnosis is secured. Both the discharges and the cervi- cal membrane should be examined before excluding gonococci, which are the cause of most chronic discharges. This method of injecting the cervical glands with lactic acid, he believes, is the best prophylactic against future disease of the tubes, etc. A too deep injection of the lactic acid may cause an annoying, though not a dangerous, slough, lessening the good result. Caution against this is, therefore, advisable. Johannes von Tiling has secured excellent results from Bier's method of damming back the circulation with elastic bands in several painful cases of gonorrhoeal arthritis. He advises the use of a thin, pliant rubber bandage, which should be applied so as not to cause discomfort, but sufficient to pro- duce very perceptible hyperemia. Blueness and coldness of the limb, white or vermillion spots, and pain or paraesthesia indi- 220 Hand-Book of Modern Treatment. cate that the bandage is too tight and should be loosened. Properly applied, the most marked first effect is relief of pain, but this is not all; damming, he claims, has a bactericidal ef- fect, and dissolves away the adhesions, which are completely removed by massage after the removal of the bandage. At first the bandaging should be of short duration, a few hours at a time, but later it should be increased until it reaches ten hours a clay and ten hours at night. After removal of the bandage, massage lightly, then have the patient stand and move the joints. He claims that this method gives better results in most cases of gonorrhceal arthritis tending to stiffness of the joints than any other. I£ Acidi carbolici, gr. x. Iodi, gr. v. Olei olivae, 3ss. Lanolini, q. s. ad §j. Misce et fiat unguentum. Sig. : To be used, with or without prelimi- nary irrigations, by means of a Guyon catheter syringe, or a small silver tube with a short ter- minal curve screwed on to a hypodermic syr- inge, passed through the compressor muscle into the posterior urethra. The instillations may be performed every second, third, or fourth day, according to the strength of the ointment used, immediately after an irrigation. R Zinci sulphatis, gr. xij. Aquae rosae, Siij. Aquae dest., 3vj. Misce. Sig. : Inject in terminal stage when few shreds are passed in morning or there is pres- ent a little irritation in the fossa navicularis. I£ Copaibae para, 3ij. Olei santali, 3ij. Olei cinnamomi, m xxiv. Saloli, 3ij. Misce et fiant capsulae no. xxiv. Sig. : One after each meal. Band-Book of Modern Treatment. 221 I£ Sodii bromidi, 3iv. Tinct. belladonna?, gtt. xx. Liq. potassii, 3ij. Tinct. opii »camphoratae, 3iv. Syrnpi zingiberis, 3ij- Aquae dest., q. s. ad §vj. Misce. Sig. : Teaspoonf ul three times daily one hour after meals. Indication: Useful in nervous genito-uri- nary cases. R; Argyrol, 3vj. Aquae dest., f§v. Misce. Sig. : Inject once or twice daily and retain for ten to fifteen minutes. Allow to escape and inject again and retain for some time. Use this for one week and follow with milder injec- tions. GOUT. I£ Potassii iodidi, 3ij. Potassii bicarb., 3vj. Vini colchici, 3ij. Aquae camphorae, B X1 J- Misce et fiat mistura. Sig. : One tablespoonful three times a day, after meals, in a wineglassful of water. fy Tinct. seminis colchici, §ss. Tinct. aconiti rad., Sss. Tinct. guaiaci, gss. Elix. simplicis, §ss. Misce. Sig.: One-half a teaspoonful in water after meals. The following combination is recommended, administered in the form of pills: — ]$ Ext. colchici acetici, gr. xv. Ext. colocynth. comp. (B. P.)., gr. xviij. Pulv. ipecac, comp., gr. xviij. Misce et fiant pilulae no. xij. Sig. : One pill night and morning. 222 Hand-Book of Modern Treatment. I£ Ext. eolchici acetici, gr. vj. Ext. rhei, gr. v. Ext. aloes soc v gr. v. Ext. belladonna?, gr. j. Misce et fiant pilulae no. vj. Sig. : One pill twice a week at bed time. I£ Tinct. stramonii, f3j. Tinct. eolchici, f3iss. Tinct. guaiaci, fgij. Misce. Sig.: A teaspoonful three times a day in milk. Ifc Vini eolchici, fgss. Magnesii carbon., 3ij. Potassii bicarb., 3ij. Aquae menthse pip., f^vj. Misce. Sig. : A tablespoonful every four hours. I£ Potassii bicarb., 3ix. Potassii nitritis, 3vj. Sodii nitritis, gr. j. Misce et fiant chartulse no. xx. Sig.: One in the morning in a large glass of water. Indication: Good when arterial tension is high. I£ Tinct. aconiti rad., 3j. Morphinae sulph., gr. ij. Antimonii tartarati, gr. j. Syr. zingiberis, §ss. Aquse, q. s. ad §ij. Misce et fiat mistura. Sig.: One teaspoonful every three hours in water. I£ Lithii bromidi, §j. Vini eolchici radicis, 3j. Syr. tolutani, Sj- Sol. potassii citratis, %\v. Misce. Sig.: One teaspoonful well diluted in water after each meal. Indication: Useful in chronic gout. Hand-Book of Modern Treatment. 223 IJ Lithii benzoatis, 3ss. Sodii brom., 3ij. Potassii carb., 3ij. Potassii acetatis, giss. Sodii phos., §ss. Syr. zingiberis, Bvj. Aquae menth. pip., gvj. Misce. Sig. : One teaspoonful to a tablespoonf ul in half a glass of water every four or six hours after eating. Indication: Useful in gout and rheumatism. I£ Colchicinae salicylatis, gr. ss. Phenacetini, 3ij. Misce et pone in capsulas no. xlviij. Sig. : One capsule every four hours. Indication: Used to relieve pain in acute and subacute gout. Ifc Morphinae hydrochlor., gr. x. Linimenti belladonnas, £iij. Misce et fiat linimentum. Sig. : A teaspoonful mixed with a table- spoonful of hot water and applied on lint under oil silk every four hours. IJ Atropinae, gr. iij. Morphinae hydrochlor., gr. xv. Acidi oleici, §j. Misce et fiat linimentum. Sig. : To be painted over the painful part and the joint wrapped in cotton wool. For external application : — I£ 01. gaultherise, f3ij. 01. olivae, f3ij. Lini. saponis, f3ij. Tinct. aconiti, f3ij. Tinct. opii, f3ij. Misce. Sig.: Apply freely and cover with cotton batting. 224 Hand-Book of Modern Treatment IJ Potassii iodidi, f3ss. Linimenti saponis, f3ss. 01. cajuputi, f3ss. 01. carui, f3ss. Spirit, vini rectif., q. s. f^ij. Misce. Sig. : Apply on lint and cover with pro- tective. IJ Guaiacoli, gss. Olei gaultheriae, ^ss. Olei olivae, Bij - Misce. Guaiacol is readily absorbed by the skin and is said to reduce the temperature. A more ele- gant mixture, however is: — ty Mentholis, gj. Alcoholis, %iv. Glycerini, gj. Aquae laurocerasi, 3j- Misce. Indication: Useful as local application. HjEMATEMESIS. IJ Ergotae, gr. xlv. Fluidextracti Hydrastis, gr. xlv. Kramer iae syrupi, 3vj. Aquae dest., %iv. Misce. Sig. : A dessertspoonful every quarter of an hour and later every half-hour or hour. R Liquoris ferri subsulphatis, 3i> Sig. : Ten to twenty drops in two table- spoonfuls of water three times daily. R Olei terebinthinae, 3ss. Sig. : Five to ten minims three or four times daily. IJ Morphinae sulphatis. Sig. : One quarter of a grain hypodermically when needed. Indication: To allay mental distress. Hand-Book of Modern Treatment. 225 ADEENALIN IN GASTRIC HEMORRHAGE. Dr. S. S. Halderman describes the satisfactory treatment of a case. The patient was a man 65 years of age. The condition of the patient was most serious. He was in a cold, clammy perspiration, radial pulse imperceptible, and with every appear- ance of impending dissolution. He was given 10-drop doses of solution adrenalin chloride every half hour to one hour until he had taken 1 drachm of the solution. The vomiting and haemorrhage soon stopped, and for three weeks rectal ailmenta- tion was depended upon; also every day he was given, per rec- tum, 1 pint of normal salt solution, with instructions to retain it if possible, which was usually done. After three weeks he was allowed milk and bread, and has now resumed his usual diet and appears in better health than for a year. R. Tinct. hydrastis, 3iij. Tinct. viburni, 3iij. Tinct. hamamelidis, 3vj. Tinct. eastaneae (chestnut), 3vj. Misce. Sig. : Take fifteen to twenty drops each meal in sweetened water. Indication: To control haemorrhage from any cause. I£ Fluidextracti ergotae. Sig. : Twenty minims hypodermically and repeat several times if necessary. Chloride of calcium, in doses of 8 to 16 grains, every two to four hours, should be tried in all forms of persistent haemor- rhage, especially haemoptysis, haematuria, and intestinal haemor- rhage of typhoid fever, for this salt increases the coagulability of the blood. It should be remembered, however, that this drug should not be used more than three days continuously, for its prolonged use decreases the coagulability of the blood. • Dr. Arendt calls attention to a new method of controlling post-partum haemorrhage. He seizes the cervix with a bullet or volsella forceps and draws it down to the vulva. This kinks the afferent vessels, and so stops or lessens the flow of blood through them. Uterine action is excited by alternate traction 15 226 Hand-Book of Modern Treatment. and relaxation. He believes that tamponing of the uterus is effective mainly because of the incidental pulling down of the uterus. W. Coleman treated five cases of intestinal haemorrhage with adrenal substance. Four patients recovered, although in two of them the haemorrhage was very severe. The fifth patient died of toxaemia and exhaustion several days later, and not of haemorrhage. He advises the free use of adrenal substance; and gives 15 grains every two hours during the day and every four hours during the night, gradually diminishing the dose as re- quired. HEMATURIA. ffc Acidi gallici, 3j. Acidi sulphurici diluti, f3ij. Aquae dest., q. s. ad f^iij. Misce. Sig. : Teaspoonf ul in water every four hours. B Fluidextracti ergotae, Sij- Sig. : One teaspoonful three times daily when bleeding is from prostate or urethra. $ Adrenalini chloridi (1-1000), %]. Aquae, q. s. ad %x. Sig. : Inject in urethra one teaspoonful three times daily. Ii Sodii thiosulphatis, Sij- Sig. : One teaspoonful every two hours until free purgation takes place. I£ Calcii chloridi, 3j. Aquae, giss. Misce. Sig.: One teaspoonful four times daily for three days. I£ Aluminis, gr. xxxij. Aquae, Oj. Misce. Sig.: Inject four ounces into the bladder twice daily. Hand-Book of Modern Treatment. 227 HAEMOPTYSIS. I£ Extracti ergotse, gr. xxx. Pulv. digitalis foliorum, gr. xx. Extracti hyoscyami, gr. xx. Quininae sulphatis, gr. xxx. Misce et iiant pilulae no. xx. Sig. : Three to five pills may be taken daily. 1$ Liquoris ferri subsulphatis, gtt. xx. Aquas dest., f^iv. Misce. Sig.: Use in an atomizer every few minutes as a spray. I£ Potassii bromidi, 3ij. Chloralis, 3j. Syrupi acacias, 3iv. Aquae, q. s. ad gij. Misce. Sig. : Two teaspoonfuls in water at once, and then one teaspoonful every hour until the patient becomes quiet. Indication: To be used if heart is rapid, strong, and patient is excited. Ice-bag or coil on chest. IJ Tinct. aconiti, m iv. Aquae, I]. Misce. Sig. : Teaspoonful every hour until pulse becomes quiet and compressible. Indication: Used to quiet excited, overact- ing heart. I£ Acidi tannici, gr. xx. Glycerini, 3ij. Aquae dest., ad §iij. B Aluminis, gr. vj. Aquae dest., Siij- Indication: Useful as a spray if haemor- rhage is just beginning. 228 Hand-Book of Modern Treatment. IJ Fluidextracti hydrastis, 3iv. Tinct. hydrastis canadensis, 3iv. Misce. Sig. : From twenty to fifty drops to be taken three times daily. When the haemoptysis is arrested the treatment should be continued for two or three days, and the dose then rapidly reduced to cessation. Should obstinate cough prevent the haemo- static effect, morphine or codeine should be added, in the following proportions: To the foregoing prescription add from 4% to l 1 /-* grains of codeine, or from 2^4 to 4% grains of morphine. The same dose should be given as before. IJ Plumbi acetatis, gr. viij. Pulveris opii, gr. j. Misce et fiant chartulae no. iv. Sig.: One powder every two hours to quiet nervous and excited patient. I£ Calcii chloridi, gr. lx-3j. Syr. menthae pip., 3j. Aquae dest., §iij. Misce. Sig.: To be taken in twenty-four hours, a tablespoonful every two hours, and this may be renewed on the following day; and if the kid- neys act properly may be continued for a con- siderable time. HAIR TONIC. Shampoo with tar soap ten minutes; then wash and dry the scalp and apply: — ]$ Hydrarg. chloridi corrosivi, gr. vij. Glycerini, 3j. Aquae, gv. Misce. Sig.: Apply after adding a %-per-cent. so- lution of naphthol in absolute alcohol; then apply Hand-Book of Modern Treatment. 229 IJ Acidi salcylatis, gr. xxx. Tinct. benzoini, 3j. Olei olivse, Siij. Indication: Useful in parasitic alopecia. I£ Sulphuris prsecipitatis, 3ij. Pulv. camphorae, gr. x. Tinct. cantharidis, 3ij. Resorcini, gr. xx. Olei myrci«, gtt. x. Alcoholis, q. s. ad §ij. Misce. Sig. : Use once daily — well rubbed on. Indication: Useful in alopecia, secondary ind non-parasitic. I£ Tinct. cantharidis, 3ij. Tinct. capsici, 3iv. Olei ricini, 3ss. Alcoholis, q. s. ad %iv. Misce. Sig. : Apply once daily as a stimulant. HAY FEVER. ADRENALIN IN HAY FEVER. There is increasing evidence that adrenalin fully meets the indications as a remedial agent in hay fever. It controls the nasal discharge, allays congestion of the mucous membranes, and in that manner reduces the swelling of the turbinal tissues. As the nasal obstruction disappears, natural breathing is materially aided and the ungovernable desire to sneeze is mitigated. In short, a season of comparative comfort takes the place of the former condition of distress and unrest. Adrenalin blanches the mucous membrane by vigorously contracting the capillaries, and thus reduces local turgescence. It strengthens the heart and overcomes the sense of malaise so frequently a prominent feat- ure in cases of long standing. In the treatment of hay fever the solution of adrenalin chloride should be used. This preparation is supplied in the strength of 1 part adrenalin chloride to 1000 parts normal saline solution, and is preserved by the addition of 0.5 per cent, chlore- 230 Hand-Book of Modem Treatment. tone. The 1 to 1000 solution should be diluted by the addition of 4 parts normal salt solution and sprayed into the nares with a "cocaine" atomizer. In the office the 1 to 1000 solution may be applied in full strength. A small pledget of cotton is wrapped about the end of an applicator and moistened with a few drops of the solution (1 to 1000). The speculum is then introduced, the patient's head is tilted backward in a position most favorable for thorough illumination by the head-mirror;, and the visible portions of the lower and middle turbinate bodies and the septum are carefully and thoroughly brushed. The same application is made to the other nostril, when usually re- lief follows in a few moments. Should the benefit prove only partial, then the 1 to 5000 solution may now be sprayed into both nares, and a few drops instilled into both eyes. The effect of this treatment may be expected to last for several hours. Indeed, some physicians report that it is necessary to make but one thorough application daily to afford complete relief. It is also recommended that the solution of adrenalin chlor- ide be administered internally in 5- to 10-drop doses, beginning ten days to two weeks prior to the expected attack. In explana- tion of the beneficial effect of the drug when used in this man- ner, the suggestion has been made that hay fever is essentially a neurosis, characterized by a local vasomotor paralysis, affect- ing the blood-supply of the eyes, nose, face, and pharynx, and occasionally of the laryngeal and bronchial mucous membranes. Adrenalin overcomes this condition, restores the normal balance in the local blood-pressure, and thus aids in bringing about a cure. The profession is to be congratulated that it has at last an agent that, if not a specific, fulfills the therapeutic indica- tions more completely and with greater satisfaction than any other remedial measure recorded in the history of medicine. This combination is of value as a prophylactic measure and during the attack in rheumatic patients : — Ifc Brucinae pliosphatis, gr. iij. Ext. hyoscyami, gr. xv. Quininse valerianatis, 3j. Camphorse, gr. xxx. Misce et fiant capsular no. xxx. Sig. : One capsule four times a day. Hand-Book of Modem Treatment. 231 B Adrenalin chlor., gr. ss. Norm, saline sol., Bj. Phenol is, m j. Glycerini, 3ij. Aquae rosae, q. s. ad §ij. Sig. : Spray nose every two to three hours, and follow up with: — IJ Mentholis, gr. x. Cocainae, gr. x. Thymolis, gr. ij. Vaselini liq., q. s. ad §ij. Misce. Sig. : Use in an oil atomizer. I£ Resorcini, gr. v. Adrenalin chloridi, gr. ss. Acidi borici, gr. xv. Aquae camphorae (hot), fgss. Glycerini, f3ss. Aquae destillatae, q. s. ad fSij. Misce. Sig. : Use as a spray to eyes and nose four or five times a day. Use the following sprays in order indicated, one to three times daily : — No. 1. I£ Sodii bicarbonatis, gr. xx. Sodii boratis, gr. xx. Glycerini, fgss. Phenolis (chemically pure), gr. iv. Aquae rosae dest., q. s. ad %iv. Misce. Sig. : Cleanse the nasal passages thoroughly. No. 2. Ifc Adrenalin chloridi (1-1000), gtt. xv. Sodii chloridi (0.9 per cent.), gtt. xv. Misce. Sig. : Use in two applications. 232 Hand-Book of Modern Treatment. No. 3. Ifc Mentholis, gr. xx. Petrolati liq. (purified), §iv. Misce. Sig. : Use freely. I£ Terpin hydratis, gr. lxxv. Spt. vini gallici, f^ij. Syrupi lactucarii, §iij. Syrupi tolutani, Siij. Misce. Sig.: One or two dessertspoonfuls three or four times daily. 1$ Coeainse sulphatis, gr. xij. Morphinse sulphatis, gr. xij. Bismuthi subnitratis, 3j. Misce. Sig. : Use as a snuff. ' A method of using quinine locally in typical cases of hay fever has proved remarkably successful. The treatment con- sists of the employment of a saturated solution of the quinine sulphate, in sterilized water, as a nasal spray, and the appli- cation to the mucous membrane of the nares of an ointment consisting of quinine and vaseline in the proportion of 30 grains to the ounce, the applications being made every four or six hours. The use of the spray alone will not suffice, but should be used as an adjunct to the ointment. Spraying the nares will at once stop all symptoms of coryza, but the effect will soon disappear unless followed up by the thorough application of the ointment. Somewhat recently the attention of the profession, chiefly through the writings of Bishop, of Chicago, has been directed to the fact that the neurotic condition of the patient and the hypersensitiveness of the nasal passages were often due to an excess of uric acid in the blood, and that this excess could be eliminated by the ingestion of mineral acids. Probably any mineral acid would prove efficacious, but there are two which suggest themselves as peculiarly efficacious : Hy- drobromic acid, because of its sedative qualities, and nitromuri- atic acid, because it is thought to limit the production of uric acid. Hand-Book of Modern Treatment. 233 A writer's experience has been limited to the effects of nitro- muriatic acid, which for the past three years he has prescribed in doses of 3 to 5 drops of the freshly-prepared concentrated acid, after meals, and sometimes also at night. The dose should be diluted with a half-tumberful of water, and the patient, after taking the medicine, should rinse out his mouth and swa-low another half-tumblerful of water. The results of the remedy are apparent within forty-eight hours, and the relief of all hay fever symptoms is usually suffi- cient to enable the patient to remain at home and attend to his ordinary business engagements in comparative comfort. Ifc Orthoformi, Siij. Sig. : Insufflate a small quantity into each nostril twice daily. HEADACHE. 1$ Caffeinse citratae, gr. xv. Acetphenetidini, gr. xxx. Saccharini, gr. xv. Misce et fiant chartulee no. xv. Sig. : One every two hours until relieved. Ext. cannabis Indicee, gr. ij. Ext. belladonnas, gr. iij. Misce et fiant pilulse no. xij. Sig.: One every three hours until relieved. Indication: Useful in headache from meno- pause. I£ Sodii arsenatis, gr. ss. Atropinse sulphatis, gr. %. Extracti aconiti, gr. iv. Pulveris canellse. 3iij. Misce et fiant pilulse no. xxx. Sig. : One to four daily. Dose should be diminished if it causes dryness of throat or heat or tingling. Indication: Useful in chronic headache. 234 Hand-Boole of Modern Treatment. IJ Acidi salicylici, 3j. Ferri pyrophosphate, §j. Sodii phosphat., gr. xij. Aquae destil., q. s. ad 3vj. Misce. Sig. : One tablespoonf ul in water. Indication: Useful in gouty headache with anaemia. IJ Acidi nitrici diluti, 3j. Aquae, %v]. Misce. Sig. : Teaspoonful in a wineglassful of Avater three times daily. Indication: Useful for vertical headaches with flushings. 1$ Caffeinae citratae, gr. j. Sodii bromidi, gr. x. Sodii bicarbonatis, gr. xxx. Pulv. acidi tartarici, gr. v. Misce et fiat chartula no. j. Sig. : Take in water while effervescing. Indication: Useful in neurasthenic head- aches associated with low vascular tension. I£ Nitrohydrochlorici acidi diluti, f3ij. Strych. sulphatis, gr. 14. Spt. chloroformi, f3vj. Tinct. zingiberis, f3iij. Aquae, q. s. ad fSiij. Misce. Sig. : One teaspoonful in water three times day. Indication: Nervous headache. IJ Quininae valerianatis, gr. xv. Ext. colchici, gr. iv. Ext. digitalis, gr. iv. Ext. aconiti, gr. ij. Misce et fiant pilulae no. xij. Sig. : One after dinner and at night. Indication: Useful in gouty headache. Hand-Book of Modern Treatment. 235 Since there are various forms of headache, and since the remedy that will relieve one patient will utterly fail to relieve another with seemingly the same kind of head-pain, it is neces- sary that the physician should be armed with a variety of reme- dies. For some time past we have found minimum doses of iodide of potassium of great service in frontal headache. A heavy, dull headache, situated over the brow, and accompanied by languor, chilliness, and a feeling of general discomfort, with a distaste for food, which sometimes approaches to nausea, can generally be removed by a 2-grain dose of the potassic salt dis- solved in half a wineglassful of water, and this quietly sipped, the whole quantity being taken in about ten minutes. In many cases the effect of these small doses has been simply wonderful. A person who, a quarter of an hour before, was feeling most miserable and refused all food, wishing only for quietness, would now take a good meal and resume his wonted cheerfulness. The rapidity with which the iodide acts in these cases constitutes its great advantage. We make no claim of originality in the use of the remedy. If we mistake not, it was an Australian physician who first recommended it. The morbid condition here described is so very common we would invite others to give this remedy a trial. Five grains of the sulphite of soda three or four times a day will cure those cases of headache where the tongue is broad and pale and covered with a yellowish-white coat. I£ Ferri reducti, gr. c. Acidi arsenosi, gr. iv. Phosphori, gr. j. Ext. nucis vomicae, gr. xxv. Misce et fiant pilulse no. c. Sig. : One pill after each meal. Indication : Useful in anaemic headache. HEADACHE FROM EYESTRAIN". Dr. Casey A. Wood states that this form of headache is most frequently encountered in strain of the ciliary muscles. He recommends very cold or very hot compresses, gently pressed over the closed eyes and forehead, and advises them to be re- 236 Hand-Book of Modern Treatment. peatedly changed for ten minutes, and repeated every hour while the headache lasts. For local application he recommends : — IJ Spts. camphorae, Sss. Spts. lavendulae, §iss. Alcoholis, giss. Misce. Sig. : Apply locally. Or:— IJ Camphorae, 3j. Tinct. aconiti, 3j. 01. menthse pip., 3j. Chloroformi, §j. Alcoholis, q. s. ad £iij. Misce. Sig.: Shake well and apply every two or three hours. He further states that relief may be obtained by applying the galvanic current to the eyes, using a current-strength of 3 to 5 milliamperes, and placing the positive pole to the nucha, and the negative to the closed lids, for five or six minutes. IJ Ammonii muriatis, ^iij- Tint, belladonna?, 3j. Tinct. hyoscyami, 3ij. Aquae menthae pip., Siv. Aquae camphorae, q. s. ad f§xvj. Misce. Sig. : One-half to one teaspoonful in a little sweetened water every two or three hours. Indication: Useful in hemicrania and all forms of neuralgia. I£ Caffeinse citratis, gr. iij. Menthol is, gr. iij. Quininae sulphatis, gr. vj. Misce et fiant chartulae no. iv. Sig. : One powder every two hours. Band-Book of Modern Treatment. 237 I£ Quininae valerianatis, gr. xxx. Caffeinse citratis, gr. xv. Ext. cannabis Indicse, gr. iij. Misce et fiant pilulae no. xx. Sig. : One twice or three times daily Indication: Useful in hemicrania. I£ Caffeinse citratis, gr. xij. Phenacetini, 3j. Camphorse monobromatse, gr. xij. Misce et fiant pilulae no. xv. Sig. : One every three or four hours. Indication: Useful in migraine or neuralgic headache. PJ, Acetanilidi, gr. xx. Camphorae rnonobro., gr. v. Caffeinse citratis, gr. xl. Misce et pone in capsulas no. xx. Sig.: One every three hours until relieved. HEART DISEASE. I£ Sodii arsenatis, gr. V 6t . Potassii iodidi, gr. 3 / 4 . Pulv. nucis vomicae, gr. 1 / s . Pulv. rhei, gr. 3 / i . Extracti dulcamarae, gr. iss. Misce et fiant pilulae no. j. Sig. : One pill daily. Indication: Useful in fatty heart. IJ Potassii iodidi, gr. x. 'Sparteine sulphatis, gr. iss. Julapii, §iij. Syrupi amarse aurantii, f§j. Misce. Sig. : One tablespoonful every three hours so that entire amount be taken during the twenty-four hours. Indication: Heart disease with arterioscle- 238 Hand-Baok of Modern Treatment. ADOLESCENT HEART-STRAIN. Adolescent heart-strain is due to a want of muscular power of the cardiac muscles only, especially the musculi papillares, whose weakened condition permits of the regurgitant murmurs heard at the apex. The bruit present at the base is secondary to anaemia of the general system. Treatment should consist of rest in bed, seclusion, the administration of digitalis pushed until one has the physiological effects, and strychnine, preferably in the form of the tincture of nux vomica on account of its stimulating and appetizing properties. B Pulveris digitalis foliorum, gr. xx. Quininae hydrochloride gr. xx. Extracti nucis vomicae, gr. v. Misce et fiant pilules no. xx. Sig. : One pill three times daily. Indication: Unpleasant effects of digitalis upon stomach can be overcome, with increase of appetite, by this threefold combination. I£ Glandular suprarenalis siccae, 3ij. Pone in capsulas no. xxiv. Sig. : One capsule twice daily. Indication: Useful in cardiac enfeeblement due to obesity. I£ Acidi arsenosi, gr. ij. Extracti digitalis, 3j. Extracti nucis vomicae, 3j. Misce et fiant pilulae no. lx. Sig. : One pill three times daily. Indication: Useful in anaemia of feeble heart disease. IJ Acidi hydrochlorici diluti, 3iij. Aquae, q. s. ad §iv. Misce. Sig. : One teaspoonful three times daily. Indication: Useful in simple palpitation combined with sodium bromide, ten grains at each dose. Band-Book of Modem Treatment. 239 I£ Pulveris digitalis foliorum, gr. xx. Hydra rgyri chloridi mitis, gr. xx. Syrupi scillse, gr. xx. Misce et fiant pilulse no. xx. Sig. : One pill after each meal. Indication : Useful in cardiac dropsy. R Digitalis. 3j. Spiritus glycerylis nitratis, m xxiv. Tinct. gentianae comp., j^iij. Misce. Sig. : One teaspoonful every three hours. Indication: Useful in atheromatous condi- tion. I£ Tinct. digitalis, m xx. Tinct. aconiti, m xx. Tinct. belladonnse, m xxiv. Tinct. cardamomi comp., q. s. ad ^iij. Misce. Sig. : One teaspoonful every four hours. Indication: Useful in cardiac dropsy. I£ Tinct, strophanthi, 3ss. Sig. : Five to ten minims three times daily or three minims to children. Indication: Useful when digitalis fails and also for children. Vfi Morphinse sulphatis, gr. 1 / s . Tinct. strophanthi, gtt. vj. Spiritus frumenti, 3j. Misce. Sig. : Give in one dose. B Tinct. ext. digitalis, 3ij. Tinct. opii, 3ij. Misce. Sig.: Two to four drops every three hours. Indication: Useful in cardiac asthma and dyspnoea. I£ Chloralis hydratis, gr. x-xx. Sodii bromidi, gr. x-xx. Misce. Sig. : One dose at bed time. Indication: Insomnia due to heart trouble. 240 Hand-Book of Modern Treatment. Ifc Sparteine sulphatis, gr. iss. Fluidextracti digitalis, gr. xv. Aquae, q. s. ad §ij. Misce. Sig. : A teaspoonful every two hours. Indication : Same as above. I£ Pulveris digitalis, gr. i-ij. Camphorse, gr. i-ij. Acidi benzoici, gr. ii-v. Misce. Sig. : One such dose three times daily. Indication: Useful in pulmonary congestion in heart disease. I£ Podophyllini, gr. ss. Hydrargyri chloridi mitis, gr. x. Pulveris aromatici, gr. ij. Misce. Sig. : Give in one dose and follow with digitalis if necessary. Indication: Useful for hepatic congestion complicating heart disease. I£ Hyoscyaminae, gr. 7 100 . Sig.: One dose at bed time. Indication: Useful in insomnia with dysp- noea in heart trouble. HEMORRHOIDS. I£ Extracti opii, 3ss. 01. olivse, f3ij. Ung. zinci oxidi, §j. Pulv. gallse, 3ij. Misce. Sig. : Cleanse the parts thoroughly and ap- ply locally once or twice daily. R. Acidi gallici, 3j. Ext. opii, 3v. Ext. belladonnse, 3v. Ung. simp., §iij. Misce. Sig.: Apply locally to the painful parts. Rand-Book of Modern Treatment. 241 I£ Mentholis, gr. xv. Cocainae, gr. xxx. Fluidextracti secal. eornut., 3ss. Fluidextracti hamamel. Virg., §ss. Misce. Sig. : Apply locally. Or:— Ifc Alumini, gr. lxxv. Liq. plumbi subacet., gr. xv. Olei olivae, 3ss. Lanolini, §iss. Misce et fiat unguentum. Sig.: To be applied locally night and morn- ing after thoroughly cleansing the affected areas. Sir James Sawyer gives the following formula for an oint- ment for piles: Take the whole plant of the celadine (Kanun- culus ficaria), gathered when it is blooming in the spring, cut it into small segments, and keep it immersed in melted hog's lard, at a temperature of about 100° F., in the pro- portion of 1 part by weight of the plant to 3 parts of lard, for twenty-four hours. Then squeeze, strain, and allow it to cool and solidify. This use of the plant has long been recog- nized, as one of its old English names is pilewort. The following was prescribed by Darche for a man suffering with ulcerated haemorrhoids, and who wanted only palliative treatment : — B Mercurolis, gr. v. Chloretoni, gr. xv. Acidi borici, 3ss. Petrolati, Bj. Misce et fiat unguentum. Sig. : To be applied three times daily. Martin combats the bleeding from internal haemorrhoids by the use of a suppository of adrenal chloride or one containing the following ingredients : — 1£ 242 Hand-Book of Modern Treatment. I£ Pulv. suprarenal gland, 3j. Iodoformi, 3j. 01. theobrom., q. s. Misce et fiant suppos. no. xij. Sig. : One at night and one an hour before stool. A writer cautions as to the use of these highly astringent suppositories, as he has seen severe attacks of strangulation brought on by their too free application. Coating the supposi- tory with lycopodium is bad, as the powder is exceedingly irritat- ing to the sensitive rectal mucosa. The internal variety are rendered painless for a period of from two to three hours by a suppository of the following : — 1^ Orthoformi, gr. xv. Ext. belladonnas, gr. j. 01. theobromse, q. s. Misce et fiat in suppos. no. x. Or, if there be a tendency to slight haemorrhage from min- ute fissures, etc. : — I£ Acidi gallici, gr. xv. Ext. opii, gr. j. Orthoformi, gr. xv. Ext. belladonnae, gr. j. 01. theobromge, q. s. Misee et fiat suppos. no. x. Dr. J. P. Tuttle favors the treatment of haemorrhoids by means of injection, using a moderately strong solution of car- bolic acid in order to set up inflammatory induration, which will cut off a portion of the circulation to the growth and result in gradual atrophy. He claims, with the proper antiseptic precau- tions, that there is no danger of sepsis, abscess formation, or sloughing. He recommends the following combination to pro- duce the results above stated : — Hand-Book of Modern Treatment. 243 I£ Acidi carbol., 3ij. Acidi salicylici, 3ss. Sodii biboratis, 3j. Glycerini, q. s. ad ";j. Misce. Sig. : Five minims to be used as an injec- tion into the hemorrhoid. At the* end of one week, as a rule, the remaining tumors may be similarly treated. In the varicose style of external haemorrhoids prompt evacu- ation of the bowels should be obtained by administering a cold enema, after which the following ointment should be applied : — Ifc Ung. acidi tannici, ";j. Ung. belladonna?, "*j. Ung. stramonii, "",]'• Misce. Sig. : Apply freely to the affected parts. The following is recommended by Julie, as noted in Ameri- can Medicine. The parts should be thoroughly washed and an ointment of iodoform and vaseline applied to the hsemorrhoidal mass; 15 minims of the following solution is then injected into the base of the mass : — I£ Zinci chloridi, gr. viiss. Cocaine hydrochlor., gr. iij. Aquae destil., f3v. Misce. Sig.: Use as advised above. He states that patients do not complain of the pain, but the next day a slight inflammatory nodule is produced, which dis- appears on the fourth or sixth day. He does not believe that thromboses are liable to occur, especially if care is taken when making the injections to distribute the liquid. 244 Hand-Book of Modern Treatment. HEMORRHOIDS WITH PAIN. IJ Morphinse sulphatis, gr. vj. Cocainse muriatis, gr. xij. Hydrargyri chloridi mitis, gr. xl. Vaselini, 3j. Misce. Sig. : Apply locally night and morning. Sawyer states that this combination is the best local appli- cation that can be made when pain is present. If itching is present, or in case of pruritus, he recommends : — I£ Mentholis, 3ss-3j. Vaselini, §j. Misce. Sig. : Apply locally night and morning. IJ Pulveris opii, gr. xx. Pulveris gallae, gr. xxx. Plumbi acetatis, gr. xxx. Ichthyoli, §ss. Petrolati, Sj. Misce. Sig. : Cleanse the parts and apply. A writer has found more than once great relief or temporary cure speedily follow upon the free use of distilled extract of hamamelis as a rectal injection. The most convenient instru- ment for that purpose is the now well-known syringe designed for the injection of glycerine as an excitant of rectal contrac- tions. The quantity to use is from 2 to 4 drachms frequently during the day and evening. He has not noticed any unpleasant side-effects in those cases where he has had the opportunity of suggesting and watching the effect of this application of hama- melis. It may be that those who have been disappointed trusted to internal administration or too scanty local application of the drug. I£ Acidi gallici, gss. Fluidextracti hamamelis, 3ss. Tinct. benzoini comp., §ss. Tinct. belladonnae, 3j. Olei olivae (carbol. 3 per cent.), q. s. ad 5ij. Misce. Sig. : Apply with brush thrice daily. Hand-Book of Modern Treatment. 245 Ten to 15 drops of pure ichthyol in capsules three times daily will cure almost all cases of haemorrhoids, through its action upon the intestines and liver. Dr. H. A. Hare calls attention to the importance of non- operative treatment of the milder forms of haemorrhoids. He commends the use of the conical dilator, rubbed with a 10-per- cent, ointment of ichthyol in lanolin. When the haemorrhoids are small with general congestion, use the following: — IJ Fluidextracti hamamelis, §ij. Fluidextracti ergot, 3iiss. Fluidextracti hydrastis, Siiss. Tinct. benzo. comp., 3iiss. Olei carbol. (5 per cent.), q. s. ad Siv. Misce. Sig. : Inject a tea spoonful in the rectum with a small syringe night and morning. In- struct the patient to be quiet for a short time. I£ Hydrastin, gr. x. Pulveris aluminis, gr. x. Cocainse, gr. vj. Olei theobromatis, q. s. Misce et fiant rectal suppos. no. xij. Sig. : Insert one into the rectum every night and in severe cases insert one night and morn- ing. HEPATIC CIRRHOSIS. IJ Acidi hydrochlorici diluti, §j. Tinct. gentianse comp., §j. . Aquae, q. s. ad gvj. Misce. Sig.: One teaspoonful after each meal. Indication: Useful to aid in digestion. IJ Acidi nitrohydroehlorici, 3ij. Sig.: Three to five minims in' water through a glass tube every four hours. Indication: Useful in early stages of hepatic cirrhosis. 246 Hand-Book of Modern Treatment. I£ Potassii iodidi, 3j- Aquae, q. s. ad Biij- Misce. Sig. : Six minims three times daily and in- crease three minims daily up to thirty. R Sodii phosphatis, %iv. Sig. : A dessertspoonful to a tablespoonful, in water, before meals. HEPATITIS. IJ Potassii iodidi, 3j- Aquae, q. s. ad §iij. Misce. Sig. : Thirty minims three times daily. R Hydrargyri chloridi mitis, gr. iij. Pone in capsulas no. vj. Sig. : One every hour and follow with full dose magnesium sulphate. Indication: Useful when constipation is marked. IJ Potassii citratis, 3iv. Spiritus aetheris nitrosi, 3iv. Aquae, q. s. ad ^ii j. Misce. Sig. : Teaspoonful every two hours. Indication: Useful to prevent diuresis. HERPES. IJ Spiritus camphorae, f§j. Sig. : Apply several times daily. Ifc Zinci sulphatis, gr. xx. Aquae, giv. Misce. Sig. : Apply several times daily. B Tinct. benzoini, 3iv. Ung. aquas rosae, 3iv. Misce. Sig.: Apply at frequent intervals. Hand-Book of Modern Treatment. 247 ]$ Calamini, gr. xv. Zinci oxidi, gr. xxx. Alcoholis, 3iij. Acidi borici (sat. sol.), q. s. ad Siij- Misce. Sig. : Apply frequently. Indication: Useful in progenital herpes. IJ Zinci phosphidi, gr. v. Pone in capsulas no. xxx. Sig. : One capsule every four hours. Indication: Useful in herpes zoster. I£ Sodii salicylatis, 3iv. Aquse, q. s. ad §iv. Misce. Sig. : One teaspoonful four times daily. IJ Mentholis, gr. xlv. Amyli, 3iv. Zinci oxidi, q. s. ad 3iij. Misce. Sig.: Apply to the side twice daily. HICCOUGH. Chloral is perhaps the most generally useful drug in idio- pathic hiccough, given to an adult in doses of 10 grains (or even 20 grains) every hour until from 60 to 80 grains have been used. If after four or five hours the spasms still continue it will be inadvisable to go on with the chloral. Many times a sharp counterirritation on the surface of the epigastrium will stop the attack, used with or without the chloral internally. The simple act of sneezing will sometimes promptly check hiccough. Hiccough is usually of no consequence whatever, but dur- ing the course of acute diseases it becomes frequently a very dangerous and difficult complication. Dr. Kolipinski says that he was able to stop the hiccough in such a case by taking a large spoon-handle and pressing the tongue down and back with a steady force. He continued the pressure on the tongue with the hope of further knowing the action of the palate-muscles, 248 Hand-Book of Modem Treatment. when, to his surprise, the hiccoughs ceased. After the doctor's departure the hiccoughs returned, and the patient applied the spoon-handle himself to the back of the tongue, and with both hands pushed down firmly. The hiccough again ceased. The hiccough appeared several times, later, and was always promptly stopped by the application of the spoon-handle. This is a very valuable suggestion, as it can be used by any- body, and might be the means of saving many lives. ]$ Pilocarpine hydrochlor., gr. ss. Aquae, 3j. Misce. Sig. : Twenty to thirty drops hypodermic- ally and repeat if required to produce free sweating. Indication: Used in conjunction with hot pack in hiccough of uraemia. Noir reports a cure in a case of persistent hiccoughing by continuous traction of the tongue for one and one-half minutes. All other measures had failed to produce results. There was no recurrence. 1$ Sodii bicarbonatis, 3j. Tinct. nucis vomicae, f3j. Tinct. cardamomi, q. s. ad f§iij. Misce. Sig. : One teaspoonful before each meal. Indication : Useful when the hiccough is due to indigestion. R Spiritus aetheris composite fSj. Sig. : One teaspoonful in cold water. I£ Tinct. capsici, 3iv. Sig. : Two to fifteen minims, well diluted, in water. Noir reviews the various methods of treating obstinate hic- cough. He alludes to galvanization of the phrenic nerve, to the application of a faradic current to the epigastrium (Erb's method), to compression of the left phrenic nerve (Leloir's Hand-BooJc of Modern Treatment. 249 method), to the forcible elevation of the hyoid bone by the fingers (NothnageFs method), and finally to vigorous trac- tion Of the tongue (Laborde's method). He prefers the latter on account of its simplicity and efficiency. It has given excel- lent results in his hands. In a nervous girl, aged 6 years, who was completely exhausted by hiccough* of over six hours' dura- tion, traction of the tongue for a minute gave immediate relief. In a second case, a patient with advanced diabetes complicated with tuberculosis, hiccough which had already lasted several days and which had resisted all other remedial measures, promptly yielded to Laborde's treatment for about two minutes. HYDROCEPHALUS. Ifc Potassii iodidi, Sj- Aquae, q. s. ad §ij. Misce. Sig. : Two drops three times daily. Indication: Useful in condition due to syph- ilis. Ifc Syrupi ferri iodidi, §j. Sig.: Two to three drops three times daily. Indication: Useful in the strumous type. HYDROPHOBIA. IJ Phenolis, §j. Sig. : Incise freely and cauterize with this, and then apply alcohol. 1$, Potassii permanganatis, gr. ij. Aquse dest., §j. Misce. Sig. : Incise the wound, cauterize, and inject this solution around the wound. HYPERACIDITY. In patients who persistently complain of acidity of the stomach, associated with great discomfort or real pain, it be- comes necessary to counteract the hyperacidity by the frequent 250 Hand-Book of Modem Treatment. administration of alkalies. Ewald has obtained marked success by combining rhubarb and sugar with the alkalies: — IJ Magnes. ust., gr. Ixxv. Sodii carbonat., gr. Ixxv. Potassii carbonat., gr. Ixxv. Pulv. rhei, gr. cl. Sacch. lactis, 3vij. Misce. Sig. : Take three to five grains dry, on the tongue, every hour. The mechanical difficulty some patients experience in tak- ing magnesia, bismuth, or charcoal in powder form is appre- ciated by E. M. Harbin, who recommends the following ser- viceable mixture in the treatment of hyperchlorhydria : — B Strontii bromidi, 3iss. Carbo ligni, 3j. Bismuthi subnit., 3iv. Lactis magnesia?, 3iij. Aquae menth. pip., q. s. ad £vj. Misce. Sig. : Shake and take one tablespoonful one hour after meals. If an antiferment is indicated the mild chloride of mer- cury should be given in divided doses. I£ Sodii bicarbonatis, gr. viij. Hydratis magnesii, gr. xxix. Morphinae hydrochloratis, gr. l / 13 . Sacchari lactis, gr. xv. Cretan preparitae, 3ij. Misce. Sig.: One dose. I£ Sodii bicarbonatis, gr. v. Spt. ammonia? aromat., m xx. Aquae menthae pip., q. s. ad f3j. Misce. Sig. : One teaspoonful three times daily. Hand-Book of Modern Treatment. 251 HYPERHIDROSIS. Wash the affected parts with spirits of camphor and apply the following: — I£ Ichthyoli, 3ij. Spts. terebinthinae, 3ij. Ung. zinci oxidi, 3iv. Misee et fiat unguentum. Sig. : Apply locally. In the shoes the following may be sprinkled: — I£ Sinapis, 3j. Pulv. talci, ^iv. Misce. Sig. : To be dusted in the shoes and hose. IJ Balsami peruviani, gr. xv. Acidi formici, gr. xlv. Chloralis, gr. lxxv. Alcoholis absoluti, q. s. §iij. Sig.: Rub into hands or feet. Baths of formalin or potassium permanganate will cause the foetid odor to disappear rapidly. The former may be used as follows: — B Formalin, 3j. Aquae, Oij. Misce. Sig. : To be used as a bath locally. I£ Potassii permanganatis, 3iiss. Aquas, §x. Misce. Sig. : One dessertspoonful to a quart of water for a local sponge bath. Brocq recommends the following combination : — I£ Betanaphtholis, 3j. Glycerini, 3ij. Alcoholis, §iiss. Misce. Sig. : To be used locally, followed by a pow- der of salt, starch, bismuth subnitrate, or the following: — 252 Hand-Book of Modern Treatment. I£ Acidi salicylici, gr. xlv. Pulv. amyli, 3iiss. Pulv. talci, 3vss. Misce. Sig. : Apply locally as a dusting powedr. I£ Acidi salicylici, gr. xlv. Pulv. amyli, 3vss. Betanaphtholis, 3iiss. Sodii boratis, 3iiss. Pulv. sodii chloridi, 3ivss. Misce. Sig. : Apply locally. Once in eight days a few drops of the following combination may be dropped between the toes : — I£ Plumbi oxidi rubri, gr. xv. Sol. plumbi subacetatis, 3vij. Misce. Sig. : Apply locally between the toes once every eight days. HYPNOTICS. Kapiteau has observed that the combination of trional and paraldehyde gives a new hypnotic which is four or fixe times more active than trional alone, and which may be employed for a great length of time without the fear of forming a habit or of cumulative effects. He recommends its administration ac- cording to the following formulae : — First make a normal solution of the two drugs as follows : — i^ k f£ Trional, gr. xv. Paraldehyde, gr. xxx. Olei amygdalis dulcis, f§ss. Mix the trional and paraldehyde, then add the oil, and obtain a solution in a water-bath. Band-Book of Modern Treatment. 253 As a draught: — I£ Sol. trional et paraldehyde (normal), fSiss. Mucilaginis, fSiij- S} T r. pruni Virginianae, f^ss. Mi see. Sig. : One tablespoonful at bed time in cases of insomnia. Each tablespoonful of the foregoing will contain 5 grains of sulphonal and 10 grains of paraldehyde. The following is serviceable, to be given per rectum : — I£ Sol. trional et paraldehyde, f3ii-iv. Ovi vitelli uni. Lactis, ^ivss. Misee. Sig. : At one injection for an adult. In the form of a suppository: — B Trional, gr. iij. Paraldehyde gr. vj. Olei theobromae, f3j. Misce et fiat suppositorium no. j. Sig. : To be given at night for an adult. For a child these preparations may be given in the follow ing proportions : — R Trional, gr. %. Paraldehyde gr. iss. Olei theobromae, m x. Misce et fiat suppositorium no. j. Sig.: 'At bed time. To be given in a capsule either to children or adults in the proper-sized doses, the following form of administration is rec- ommended : — 254 Hand-Book of Modern Treatment. R Trional, gr. %. Paraldehyde gr. iss. Olei amygdalis dulcis, m x. Misce et fiat capsula no. j. Sig. : One capsule three to six times a day. Dr. W. M. Donald describes his experience with chloretone, according to which this new drug is one of the most reliable and safe hypnotics known at present. He reports one case in which the patient surreptitiously took chloretone within a very brief period to the extent of 120 grains. In consequence he slept almost continuously, with only brief lucid intervals, for six days, and with no visible bad or untoward effects, except that the stomach was somewhat irritable, which, however, may be ascribable rather to the fasting than the drug. HYSTERIA. R Elixiris ferri, quininse et stryclminse phos- phatis, §iv. Sig.: One teaspoonful three times daily. Indication: Useful in hysteria accompanied with anaemia. R Quininse valerianitis, gr. xx. Ferri valerianitis, gr. xx. Amnion, valerianitis, gr. xx. Misce et fiant pilulse no. xx. Sig. : One or two three times a day. Indication: Useful in nervous hysteria and when associated with anaemia. R Camphorae monobromatae, 3ij. Fiant pilulae no. xxx. Sig. : One pill three times daily. R Spiritus aetheris compositi, §ij. Sig. : One teaspoonful at bed time to pro- duce sleep. R Extracti ovarianae, 3ij. Fiant tabellae no. xxx. Sig. : One tablet daily until some effect is secured. Hand-Book of Modern Treatment. 255 ICHTHYOSIS. 1$ Chrysarobin, gr. xv. Ung. petrolati, 5j- Misce. Sig. : Wash with hot water and green soap and apply once daily. Ifc Ung. hydrarg. nitr., 3iv. Ung. sulphuris, 3iv. Misce. Sig. : Wash with hot water and apply and rub in well. I£ Acidi salicylici, gr. xl. Glycerini, m xl. Adipis lanae hydrosi, 3iv. Lardi benzoaci, 3vj. Petrolati, 3vj. Misce. Sig. : Wash parts with green soap and hot water, and then apply this. Ifc Ung. iehthyolis (10 per cent.), 3ij. Sig. : Apply locally once daily. I£ Ung. sulphuris, gij. Sig. : Apply locally once daily. IMPETIGO. Ifc Acidi salicylici, gr. xv. Bismuthi subnitrat., 3v. Pulv. amyli, 3ij. Ung. rosse, Siss. Misce. Sig. : External use. Indication: Useful for face and scalp in nursing children. If the impetigo is of the dry, squamous variety, use above ointment by inunction, frequently repeated. If moist, apply a thick coat of the ointment on gauze. Pruritus and congestion will rapidly diminish while the new, healthy epidermis forms under the ointment-crust. 256 Hand-Book of Modern Treatment. R Hydrarg. oxidi flavi, gr. xlv. Zinci oxidi, lxxv. Amyli, gr. lxxv. Adipis lanse hydrosi, gr. lxxv. Petrolati, 3iiss. Misce. Sig. : Used locally as required. I£ Acidi salicylates, gr. xx. Acidi carbolici, gr. xij. Ung. hydrarg. amnion., 3ij. Ung. zinci oxidi, q. s. ad Sj- Misce. Sig. : Crusts should be removed with warm water and soap, and then this thoroughly rubbed in three times daily. IMPETIGO CONTAGIOSA BULLOSA. When the disease is distributed over a large area and there is much crusting, a bland oil, such as Carron oil, liquid albolene. or sweet oil, to which is added 2 per cent, of salicylic acid, should be used. This is rubbed well over the surface, the bullae are opened, the crusts are gently detached, then the following pow- der is plentifully dusted on : — B Acidi salicylici, gr. xx-3ss. Acidi borici, 3ij. Zinci oxidi, 3ij. Amyli, 3ij. Misce. Baths are contraindicated. Ointments also seem irritating. A drying, mildly-antiseptic, soothing dusting-powder, with a bland oil to soften the crusts and prevent the clumping of the powder when mixed with the serous oozing and contents of the bullae, has been, with me, the most successful method of treat- ment. R, Acidi borici saturated solution, £ij. Phenolis, gr. x. Resorcini, gr. x. Misce. Sig. : Apply two or three times daily. Indication: Useful when accompanied with itching. Hand-Book of Modern Treatment. 257 IMPOTENCE. R Extracti cannabis Indicae, gr. xv. Extracti nucis vomica?, gr. xv. Extracti ergotae aquosi, 3j. Misce et fiant pilulae no. xxx. Sig. : One pill morning and evening. R Tinct. phosphori, f^iss. Tinct. cantharidis, 3iiiss. Elixiris simplicis, q. s. ad f§v. Misce. Sig. : One teaspoonf ul three or • four hours before retiring. Increase the dose carefully. R Phosphori, gr. j. Alcoholis absoluti, fgv. Glycerini, fgiss. Alcoholis, f3ij. Spt. menthae pip., f3j. Misce. Sig. : One-half teaspoonful three times daily. R Cam phone, gr. xxiv. Quinina:- hydrochloratis, gr. xxiv. Extracti nucis vomica?, gr. xij. Tinct. cantharidis, m xxiv. Oleoresinae capsici, gr. iv. Misce et fiant pilulae no. xxiv. Sig. : One pill after meals. Indication: Useful in debilitated subjects. INCONTINENCE OF URINE. RETRORECTAL SALINE INJECTIONS. All the ordinary methods of treatment failing to give relief, Patel injected 200 grammes of the solution into the retrorectal space of a female patient of 25. The following night there was no incontinence; there was, however, on the second night, and a second injection was made. The incontinence disappeared en- tirely, with no recurrence within six months. After the first injection in a second female patient of 20, the incontinence dis- 17 258 Hand-Booh of Modern Treatment. appeared for three days ; after the second injection for six days. The third injection (200 grammes) was followed by thirty days' continence; after the fourth injection (200 grammes) there was no recurrence. The needle of the syringe is introduced at the tip of the coccyx, or to one side of it, and is passed vertically upward. A finger in the rectum guides the needle as it is passed in, and pre- vents perforation of the rectal wall. The fluid is slowly intro- duced. No anaesthetic is required. IJ Sodii benzoatis, gr. xx. Sodii salicylatis, gr. xx. Fluidextracti belladonna^ gtt. ij. Aquae cinnamomi, f£iv. Misce. Sig. : A teaspoonful four or five times daily. Indication: Nocturnal incontinence of urine. IJ Potassii citratis, 3ij. Spt. aetheris nitrosi, f3ij. Aquae dest., q. s. ad f^iij. Misce. Sig. : A dessertspoonful every four hours in water. Indication: When urine is concentrated. IJ Syrupi ferri iodidi, f^ss. Sig.: Fifteen to twenty drops, well diluted, three times daily. IJ Atropinae sulphatis, gr. j. Aquae destillatae, fgj. Misce. Sig.: Four to eight drops in water for chil- dren. IJ Spt. aetheris nitrosi, f3vj. Syrupi, f3iv. Liq. potassii citratis, f^viij. Misce. Sig. : Tablespoonful in water every two hours/ Hand-Book of Modern Treatment. 259 IJ Arseni trioxidi, gr. 1 / 3 . Ext. nucis vomicae, gr. ij. Misce et fiant pilulae no. xx. Sig. : One pill three times daily after meals for children of eight or ten years. IJ Chloralis, gr. xvj. Potassii bromidi, gr. xxiv. Syrupi acacia?, f3ij. Aquae, q. s. ad j$j. Misce. Sig. : A teaspoonf ul in water at bed time. Indication: Used for a child of five or ten years of age with nocturnal incontinence. IJ Tinct. belladonnas, f^j. Sig.: Ten to twenty drops thrice daily. IJ Acidi benzoici, 3ij. Aquas cinnamomi, f^vj. Sig.: A tablespoonful thrice daily. IJ Syrupi ferri iodidi, f^ss. Sig. : Fifteen drops well diluted three times daily. IJ Tinct. cantharidis, f3iij. Sig. : One to two minims three times daily. Indication: Useful for aged women when in- continence occurs when coughing, sneezing, or laughing. IJ Fluidextracti rhois aromaticae, f3ij. Sig. : Five minims at two years, ten at four to gix, and fifteen to older children, in sweet- ened water. INFLUENZA. IJ Potassii bromidi, gr. iij. Codeinae, gr. 1 / 6 . Antipyrini, gr. ivss. Morphinae hydrochlor., gr. x / g . Misce et fiat capsula no. j. Sig.: One such to be taken two or three times daily. Indication: Useful to control cough. 260 Hand-Book of Modern Treatment. IJ Quininae salicylates, gr. xxxvj. Acetanilidi, gr. xxiv. Pulv. camphorae, gr. iv. Pulv. capsici, gr. ij. Pulv. ext. belladonnas, gr ij. Misce et fiant capsulae no. xij. Sig. : One every three hours if necessary. Indication: Useful to ameliorate the ca- tarrhal symptoms. IJ Heroin, gr. %. Ammon. chloridi, 3j. Syr. picis liq., gj. Syr. tolutani, Bj. Syr. pruni virginianae, ^ss. Misce. Sig.: Two teaspoonfuls every three or four hours. IJ Pulv. camphorae, gr. xij. Ammon. carbonatis, gr. xv. Pulv. opii et ipecacuanhas, gr. xx. Quininae bisulphatis, gr. xxj. Misce et fiant capsulae no. xv. Sig. : One every two hours. IJ Potassii carbonatis, gss. Tinct. belladonnas, 3ss. Aquae camph., q. s. ad %\v. Misce. Sig.: Apply to inflamed parts every hour. Indication: Useful for the muscular and joint pains of this condition. IJ Salicini, 3ij. Quininae hydrochlor., gr. xxiv. Misce et pone in capsulas no. xxiv. Sig.: One capsule every five hours. Indication: To relieve pain in limbs and joints. IJ Strychninae sulphatis, gr. j. Fiant tabellae no. xxx. Sig.: One tablet three times daily. Indication: Useful in convalescence. Hand-Book of Modern Treatment. 261 Ifc Pulv. opii et ipecacuanhas, gr. lx. Sig. : Two grains every three hours during early stages of the disease. Ifc Sodii benzoatis, gr. iss. Salol, gr. iss. Acetanilidi, gr. iss. Caffeinae, gr. %. Misce et fiat chartula no. j. Sig. : One powder every three hours to a child six years old, or, if the pain is severe and the child is kept awake, add l / 12 grain of codeine sulphate to each powder. Where children refuse to take powders, prescribe the fol- lowing mixture, again adding codeine if necessary: — Ifc Sodii benzoat., 3ss. Antipyrin., 3ss. Liquor amnion, anisat., 3ij. Syr. scillae comp., 3ij. Syr. althseae, f^ss. Aquae anisi, q. s. ad f^ij. Misce. Sig.: One drachm every three hours to a child six years old. INGROWING TOENAIL. Ifc Liquor is potassae, f3ij. Aquas destillatae, f§j. Misce. Sig. : Apply with pledgets of cotton wool to margin of nail at point of ulceration. I£ Pulv. plumbi acetatis, 3j. Tinct. opii, f£j. Aquae, q. s. ad fSviij. Misce. Sig. : Shake and apply constantly until in- flammation is reduced and pain alleviated. 262 Hand-Book of Modern Treatment. INSOMNIA. Ifc Morphinae sulph., gr. j. Fiant chartulae no. vj. Sig. : One powder dissolved in ten minims of water and given hypodermically at bed- time. Indication: Used for insomnia of sthenic fevers, exhausting disease, and heart disease. B Sodii bromidi, gr. xv. Chloralis hydratis, gr. xv. Tinct. hyoscyami, m xv. Misce. Sig.: Take at one dose and repeat in one hour if necessary. Indication: Insomnia of acute alcoholism. Ifc Chloralformamidi, gr. xl. Acidi hydrochlor. diluti, m v. Syrupi, f3ij. Aquae destillatae, fSij. Misce. Sig. : Take in two doses four hours apart in a little water. I£ Trionalis, gr. xv. Codeinse, gr. ss. Misce. Sig.: Take on retiring. B Trionalis, gr. xv. Phenacetini, gr. x. Misce. Sig. : Take on retiring and follow either of the last two with a glass of hot milk. IJ Morphinae sulph., gr. ij. Chloralis hydratis, 3ij. Syrupi, fgij. Aquae, q. s. ad f^iv. Misce. Sig. : One dessertspoonful at night. Hand-Book of Modern Treatment. 263 B Tinct. lobeliae, 3iv. Morphinae sulph., gr. V 3 . Elixiris simplicis, q. s. ad 3ij. Misce. Sig. : One teaspoonful at night or during the attack, and repeat in two hours if neces- sary. Indication: Insomnia of asthma. IJ Sodii bicarb., 3iss. Spt. ammon. aromat., 3v. Ammonii bromidi, 3iss. Tinct. card, comp., §j. Aquse menthae pip., q. s. ad Siv. Misce. Sig. : One dessertspoonful at bedtime and repeat in one hour if necessary. R. Ammon. bromidi, 3iij. Tinct. humuli, 3vj. Aquse carnphorae, q. s. ad 3iij. Misce. Sig. : One dessertspoonful in water at bed- time. Indication: Insomnia during climacteric. IJ Sulphonalis, gr. xxx. Syrupi, f3ij. Mucilaginis acaciae, f3ij. Aquae destillatae, q. s. ad f£j. Misce. Sig.: From half to all of this at one dose, as may be needed. B Tinct. hyoscyami fgij. Sig.: From one to four teaspoonfuls when opium is not well borne. IJ Hyoscinae hydrobromatis, gr. y s . Camphorse monobromatae, 3j. Misce et fiant capsulae no. xv. Sig.: One capsule at bedtime and repeat in six hours if necessary. Indication: Used to induce sleep in mel- ancholia, neurasthenia, and mania. 264 Hand-Book of Modern Treatment. I£ Urethani, 5ss. Aquae aurantii flor., f^ij. Misce. Sig. : One to four teaspoonfuls at bedtime. Indication : In nervous cases not bearing opiates. « I£ Morpliinae sulphatis, gr. j. Fluidextracti Valerianae, f§j. Elixiris humuli, f^j. Misce. Sig. : One or two teaspoonfuls as required. Indication: In insomnia of delirium tre- mens. INTERMITTENT FEVER.— See Fever. INTERTRIGO.— See Skin Disease. I£ Calaminae, 3j. Ung. zinci oxidi, 3vij. Misce. Sig. : Apply to eczematous spot. Indication : Useful in infantile forms. Ifc Lycopodii, 3v. Sig.: Used freely several times daily as a dusting powder. I£ Amyli, ^ss. Sig. : Used freely as a dusting powder. Ijk Pulv. zinci oxidi, Sj- Sig. : Apply freely to parts affected. I£ Pulv. acidi salicylici, gr. xv. Pulv. zinci oxidi, 3iij. Pulv. amyli, 3iij. Yaselini, 3vj. Misce et unguentum. Sig. : Apply locally and cover with cotton after rubbing in. Indication: Useful in squamous eczema and infantile intertrigo.. Hand-Book of Modern Treatment. 265 Ifc Ung. aquae rosae, 3ss. Sig. : Apply freely several times daily. INTESTINAL CATARRH.— See Diarrhoea, Enteritis, Etc. INTUSSUSCEPTION. I£ Hydrogenii. Sig.: Inject slowly into the bowel from rubber bag with rectal tube. Patient should be under anaesthetic, and buttocks raised and head lowered while the injection is being made. Used during first or second day; never later than fourth day. I£ Fellis bovini, gr. x-xxx. Aquae ferventis, Oi-iv. Misce. Sig. : Inject slowly into the bowel until it is fully distended. Use in knee-chest position. B Ext. opii, gr. iij. Ext. belladonnas, gr. iij. Olei theobromae, q. s. Misce et fiant supposit. no. xij. Sig. : At first one of these suppositories can be introduced every two hours, and later as necessary to relieve pain and tenesmus; and food only as much as necessary to sustain life. IRITIS. I£ Atropinae sulphatis, gr. j. Cocainae hydrochlor., gr. iv. Adrenalin (1-1000) , m xxx. Aquae, q. s. ad 3iiss. Misce. Sig.: One drop in eyes every three hours. Indication: Used when the inflammation is very acute. 266 Hand-Booh of Modern Treatment. IJ Ung. hydrargyria Siiss. Ext. belladonnae, gr. xv. Misce. Sig. : Rub over eyebrow. Indication: To relieve severe pains. Pain may be relieved by leeches to the temple and use of dry heat externally, or hot fomentations. B Scopolamine, gr. ss. Aquae destillatae, f§j. Misce. Sig. : One drop in eye morning and night. Indication: Used in cases where atropine causes irritation. IJ Duboisiae sulphatis, gr. j. Aquae destillatae, fSj. Misce. Sig. : One drop into eye once or twice daily. B Ung. hydrargyri, gij. Sig.: One drachm as an inunction at night. Indication: Used in plastic iritis, and when gums are touched discontinue. IJ Quininae sulphatis, gr. ij. Hydrargyri iodidi flavi, gr. %- 1 /^. Ext. hyoscyami, gr. *4. Misce et fiat pilula no. j. Sig. : One pill three to six times daily. Indication: Syphilitic plastic iritis. IJ Hydrargyri chlor. corros., gr. j. Potassii iodidi, 3j. Tinct. calumbae, f^ij. Aquae destillatae, q. s. ad fSvj. Misce. Sig.: Dessertspoonful in a glass of water two or three times daily. IJ Atropines sulphatis, gr. iv. Aquae destillatae, f§j. Misce. Sig. : One drop in eye two or three times daily, and bathing fifteen minutes every hour till pain is relieved. Hand-Book of Modern Treatment. 267 ITCH.— See Scabies. JAUNDICE.— See Biliousness, Catarrh, and Calculi. I£ Mentholis, gr. lxxx. Zinci oxidi, gr. lxxx. Amyli, gj. Talci, £j. Misce. Sig. : Dust on freely. Indication: Used as a dusting powder for the itching of jaundice. IJ Amnion, chloridi, gr. j. Syrupus aeacige, gss. Misce. Sig. : A teaspoonful every two hours. Indication: Jaundice in the new-born. IJ Hydrargyri chloridi mitis, gr. ij. Sodii bicarbonatis, 3ij. Misce et fiant chartulse no. xij. Sig. : One powder every half -hour, and fol- low with a laxative. Indication: Useful in catarrhal jaundice with constipation. B Phenolis, gr. xj. Glycerini, gj. Aquae, Sj. Misce. Sig. : Apply locally to affected parts. B Sodii phosphatis, giv. Sig. : Dessertspoonful in hot water three times daily before meals. B Saloli, gss. Fiant chartula? no. xlviij. Sig. : One powder six times daily or two before meals. Indication : Useful in jaundice with intes- tinal catarrh and flatulencv. 268 Hand-Book of Modern Treatment. I£ Fellis bovis purificata, 3j. Manganesii sulphatis, exsiccati, gr. xl. Resinse podophylli, gr. v. Misce et fiant pilules no. xx. Sig. : One pill three times daily. ' Indication: Catarrhal jaundice. I£ Amnion, iodidi, 3j. Liq. potassii arsenitis, f3ss. Tinct. calumbse, f§ss. Aquae destillatse, fgiss. Misce. Sig. : A teaspoonful three times a day be- fore meals. I£ Fluidextracti hydrastis, fgj. Sig.: Five to fifteen drops before meals daily for some weeks. IJ Amnion, chloridi, 3iij. Fluidextracti hydrastis, f£ss. Syr. sarsaparillse comp., fgiss. Aquse destillatae, q. s. ad %iv. Misce. Sig.: A dessertspoonful every three hours. JOINT, INFLAMED.— See Synovitis. KELOIDS. IJ Ichthyoli, gss. Adipis lanae hydrosi, q. s. ad 5j- Misce. Sig. : Apply freely to soften and absorb. Ifc Thiosinaminse, gr. xij. Alcoholis (absolute), q. s. ad 3ij. Misce. Sig. : Inject ten to fifteen minims directly into the part affected every fourth day. Hand-Book of Modern Treatment. 269 KERATITIS, INTERSTITIAL. B Ung. hydrarg., 3j. Sig. : One drachm used by inunction by night. Indication : In earlier stages until slight tenderness of gums. R, Atrophia? sulphatis, gr. j. Aquse destillatae, 3iij. Misce. Sig.: One drop in eye morning and night. Indication: To reduce irritation. May be combined with a weak solution of boric acid. I£ Hydrarg. oxidi flavi, gr. ij. Lanolini, 3j. Petrolati albi, 3j. Misce. Sig.: Small portion between lids, and upper lid gently rubbed over cornea for several min- utes. Indication: To hasten absorption of opaci- ties. Only indicated when all inflammation of disease has subsided. I£ Syr. ferri iodidi, 5j- Sig. : Ten drops in water after meals, in- creased gradually to twenty or thirty drops. KERATITIS, PHLYCTENULAR. B Syrupi ferri iodidi, f3vij. Liquoris potassii arsenitis, f3j. Misce. Sig. : Three to ten drops internally after meals. Indication: Tonic for strumous children. B Atropine sulphatis, gr. iv. Aquae destillatae, 3j. Misce. Sig. : One drop in the eye morning and night until pain ceases. 270 Hand-Book of Modem Treatment. KERATITIS, ULCERATIVE. IJ Atropinse sulphatis, gr. j. Aquse destillatae, 3iij. Misce. Sig. One drop in the eye morning and even- ing. R Physostigminse sulphatis, gr. %. Aquae destillatse, f£j. Misce. Sig.: One drop in the eye three times daily. Indication: Beneficial effect on the cornea. 1^ Pulv. iodoformi, 3iv. Sig. : Dust on the cornea. Ifc Phenolis, gr. xl. Aquae, f^viij. Fiat collyrium. Sig.: Any trace of ulceration on cornea is scraped, and cornea, lids, and conjunctiva are washed with the above .solution. Ifc Tinct. iodi, 3ij. Sig.: Apply to sides and floor of the ulcer and then inject into the conjunctival sac a few drops of olive oil to prevent irritation from the contact of the iodine with healthy mucous membrane. KOUMISS, PREPARATION OF. Once in a while it is advisable to make koumiss, on which occasions the following method of preparation as given by H. V. Sachse, in "How to Cook for the Sick," is the best :— Heat 2 quarts of milk to 100° F., or pasteurize and cool to 100° P. Dissolve 1 / 3 yeast-cake in 2 tablespoonfuls of the milk, boil 2 tablespoonfuls of sugar with 3 tablespoonfuls of cold water, mix all together and bottle at once. Cork firmly and stand in a warm (70°F.) place over night, Next morning lay the bottles carefully on their sides in a cool place for twenty- four hours. Open with a tap, or use ordinary beer-bottles. Hand-Book of Modem Treatment. 271 LABOR. R Chloralis hydratis, 3iiss. Sodii bromidi, 3iiss. Amnion, bromidi, 3iiss. Syrupi simp., ^ss. Aquae destillatae, q. s. ad 3ij- Misee. Sig. : One teaspoonful every hour until three doses are taken. Indication: A sedative in the first stage of labor. Ifc Lactis, fgj. Aquae, fgj. Chloralis, gr. xxx. Misce. Sig. : This may be given in first stage of labor to lessen pain, and as the head passes vulva the patient is given sufficient chloroform to dull the sensibility. Indication: Used as an injection to lessen later pain. FALSE LABOR-PAINS. Dr. Bennett, of Chicago, gives 15 grains of chloral-hydrate in solution in those cases of labor where there is a severe, irri- tating pain without progress of great labor or with rigid os uteri. This dose often corrects the whole train of symptoms. Dr. Archangelsky says that for several reasons the external application of chloroform to the abdomen in severe and irregular labor-pains is superior to chloroform anaesthesia. He employs a mixture of 1 part of chloroform to 2 or 3 parts of olive-oil, rubs it in well on the abdomen, and then applies a warm compress. In a very short time the pain is relieved, the contractions be- come regular and more effective. Its advantages over chloroform anaesthesia are: The patient remains fully conscious, the pulse and the respiration remain good, there is no nausea, vomiting, or uterine atony. 272 Hand-Book of Modern Treatment. fy Morphinae sulphatis, gr. ij. Aquae destillatae, 3j. Misce. Sig. : Five to ten minims hypodermically, repeated if necessary. Indication : Useful in protracted labor due to rigid os. I£ Vini opii, gtt. xl. Sig. : Inject with a little starch water, in two or three doses, in the course of a couple of hours. Indication: To prevent premature labor. 3 Fluidextracti kolae, f-^ss. Sig. : One-half teaspoonful in water every hour. Indication: Useful in protracted labor. 3 Quininae sulphatis, gr. xl. Acidi sulph. aromat., q. s. ut ft. sol. Syrupi zingiberis, fgj. Aquae, q. s. ad fSij. Misce. Sig. : A tablespoonful at once and a des- sertspoonful every four hours afterward. Indication: Useful in atony of the uterus. B Fluidextracti ergotae, fgss. Sig. : One or two tea spoonfuls. Indication: Used in post-partum haemor- rhage. Never to be administered before deliv- ery. LARYNGISMUS STRIDULUS (SPASMODIC CROUP) B Zinci valeriant., gr. 5 /e- Asafoetidae, gr. 5 / 6 . Pulv. gentianee, Ext. gentianee, of each, q. s. Misce et fiat pilula no. j. Sig. : One such pill morning and evening. Indication: Useful in spasms of the larynx. Hand-Book of Modern Treatment. 273 Ifc Chloroformi, m x. Glycerini, f3j. Syrupi Tolutani, f3v. Aquae, fgij. Misce. Sig. : To be taken at the time of outset in doses of one teaspoonful every one-half-hour. ty Potassii bromidi, 3ij. Chloralis hydratis, 3ss. Syr. Tolutani, fgss. Aquas destillatae, f^iss. Misce. Sig.: A teaspoonful every half-hour. B Thymoli, gr. xx. Alcoliolis, fgij. Misce. Sig. : Evaporate a tablespoonful in the room every hour. Indication : Used to relieve laryngeal spasm. IJ Syrupi ipecacuanhas, f£j. Sig.: A teaspoonful every fifteen minutes until emesis. B Chloroformi, fBj. Sig. : A few drops inhaled from a handker- chief. Ifc Ferri citratis, 3ij. Aquae aurantii flor., fSvss. Syrupi simplicis, f3iv. Misce. Sig. : A teaspoonful to a tablespoonful thrice daily between paroxysms. Indication: Useful for the anaemic condi- tion. LARYNGITIS. I£ Olei succini, §iss. Olei olivae, q. s. ad gvj. Misce. Sig. : Rubbed well into pa rts affected. 18 274 Hand-Booh of Modern Treatment. IJ Sodii benzoatis, 3ss. Tinct. aconiti, m x. Aquae laurocerasi, 3ss. Syrupi Tolutani, 3j. Syrupi codeinae, §j. Aquae destillatae, £j. Misce. Sig. : To be taken in divided doses in the twenty- four hours. Indication: Useful in acute attacks of laryngitis and bronchitis. B Tinct. aconiti, m xl or lxxx. Sodii bromidi, 3ij. Syr. lactucarii, f£j. Aquae destillatae, q. s. ad fSiij. Misce. Sig.: Dessertspoonful every hour until six or eight doses are taken, Ifc Thymoli, gr. xv. Eucalyptol, gr. xx. Creosoti, 3ij. Olei gaultheriae, 3j. Olei pini sylvestris, 3v. Misce. Sig. : Take five or six drops four or five times daily. Indication: Chronic laryngitis. I£ Acidi muriat. diluti, f3j. Aluminis, 3iss. Mellis, fSj. Aquae, f^v. Misce. Sig.: Gargle every four hours. Indication: Useful for chronic form in children. 1$ Tinct. aconiti radicis, m xxx. Syrupi limonis, f^ss. Liq. ammonii acitatis, fSij. Misce. Sig.: A dessertspoonful every three hours. Indication: Useful in acute form. Hand-Book of Modern Treatment. 275 I£ Menthol, gr. xc. Olei pini sylvestris, f3j. Olei eucalypti, f3j. Tinct. benzoini, f3j. Tinct. Tolutani, f3j. Misce. Sig. : Inhale from a steam kettle or vapor- izer. I£ Potassii permanganatis, gr. ij. Aquae destillatae, fgij. Misce. Sig. : Use with atomizer several times daily. Indication: Useful in fetid variety of chronic laryngitis. IJ Menthol, gr. iij. Albolenae, fgj. Misce. Sig.: Use as a spray. Ifc Potassii iodidi, 3iv. Hydrarg. chloridi corrosivi, gr. j. Syrupi sarsaparillae compositi, f^ij. Aquas, q. s. ad f^vj. Misce. Sig. : Dessertspoonful three times daily. Indication: Used in syphilitic laryngitis. LEAD-POISONING. IJ Strychninse sulpha tis, gr. j. Confectionis rosae, 3ss. Misce et fiant pilulae no. xx. Sig. : One pill three times daily. Indication: Lead palsy. B Magnesii sulphatis, 3j. Acidi sulphurici diluti, f3j. Aquae, f^vj Misce. Sig. : A tablespoonful three times daily pre- ceded by five to ten grains of potassium iodide. 276 Hand-BoaJc of Modern Treatment. ty Acidi sulphurici, f3j. Syrupi acidi citrici, f^iv. Sacchari albi, giv. Aquae, fgxxx. Misce. Sig. : To b? taken in small eupfuls twice or thrice daily. Indication: Used as a preventive. P£ Potassii iodidi, §j. Aquae destillatae. fSiij. Misce. Sig.: A teaspoonful three times daily. Indication: Useful in chronic form. LENTIGO AND CHLOASMA. Ifc Hydra rg. chlor. corrosivi, gr. iij. Acidi hydrochlor. diluti, 3j. Alcoholis, 5j- Glycerini, £ss. Aquaa, q. s. ad §iv. Sig. : Apply at bedtime and remove with sugar water in the morning. IJ Hydrarg. chlor. corrosivi, gr. vj. Acidi acetici diluti, 3ij. Boracis, gr. xl. Aquae rosae, q. s. ad Siv. Misce. Sig. : Apply twice daily. Ifc Acidi citrici, 3ij. Ferri sulphatis puri, gr. xviij. Camphoraa, q. s. Aquae flor. sambuc, S"j- Misce. Sig. : The camphor is placed in the bottle in a lump, undissolved, and used freely. I£ Hydroquinone, gr. xlviij. Acidi phos. glac, gr. xxx. Glycerini, 3ij. Aquae destillatae, 3vj. Misce. Sig. : Apply to face. Hand-Book of Modern Treatment. 277 Ifc Hydrarg. chlor. corrpsivi, gr. xij. Acidi hydrochlor. diluti, 3iij. Tinct. amygd. diluti, ^iss. Glyeerini, §j. Tinct. benzoni, 3ij. Aquae florum aurant., q. s. Misce by dissolving the corrosive sublimate in three ounces of the orange flower water, add the HC1 and set aside. Blanche the bit- ter almonds, and bruise them in a mortar, add- ing the glycerine and using the pestle vigor- ously. Then add nine ounces of orange flower water, stirring constantly until a creamy emul- sion is the result. Subject this to a violent agitation and allow the tincture of benzoin to fall into it drop by drop. Then add the mer- curial solution, filter, and make up the whole to the measure of one pint with more orange flower water. . Sig. : With a fine sponge apply twice daily, and after awhile diminish frequency. Indication: Useful as an anti-freckle lotion. I£ Bismuthi subnitratis, 3ij. Ung. simpl., gij. Misce. Sig. : Apply to the skin at night to remove freckles and remove in the morning with a little cold cream previous to washing. Ifc Bismuthi oxidi, 3iv. Zinci oxidi, 3iv. Glyeerini, f^iv. Aquae rosse, q. s. ad f^viij. Misce. Sig. : Shake well, bathe and dry the face, and apply with soft cloth twice daily. Indication: Used in chloasma of pregnancy. LEUCOCYTHjEMIA. I£ Extracti glandulae suprarenal is. 3ij. Pone in capsulas no. xxiv. Sig. : One capsule two hours after each meal. 278 Hand-Book of Modem Treatment. IJ Acidi nitro-imiriatici diluti, f3j. Sig.: Ten to twenty drops in a wineglass- ful of water thrice daily. IJ Liq. potassii arsenitis, f§j. Sig.: One drop in water after meals and increase until physiological limit is reached, then reduce one-half and continue for a long period of time. IJ Acidi arsenosi, gr. ij. Quininae hydrochloratis, gr. xlviij. Massae ferri carbonatis, 3iij. Misce et fiant pilule no. lxviij. Sig. : One pill after meals. LEUCORRHCEA. If the discharge is watery the following formula will supply a valuable suppository for leucorrhoea : — IJ Hydrastininae hydrochloratis, gr. xij. Zinci boratis, gr. xij. Extracti belladonna?, gr. iij. Boroglycerini, 3iv. Misce et fiant suppositoria no. xij. Sig. : Introduce suppository into vagina at bedtime, after using a cleansing douche. The following treatment is said to cause considerable im- provement in the local symptoms, and in the general condi- tion : — IJ Quininae hydrobrom., 3ss. 01. theobrom., 3v. Misce et fiant suppos. no. x. Sig.: One suppository is to be inserted into the vagina daily. IJ Arseni trioxidi, gr. y^. Ferri reducti, gr. v. Quininae sulphatis, gr. xx. Misce et fiant pilulae no. xx. Sig.: One pill after meals for an adult. Indication: Useful in the anaemia that ac- companies this condition. Hand-Book of Modem Treatment. 279 I£ Acidi tamiici, 3v. Alcoholis, 3iij. Creosoti, 3ij. Aquae, q. s. ad Siv. Misce. Sig. : Teaspoonful to a quart of warm water as a douche three times a day. In an article by Seguirey attention is called to the use of lactic acid in neutralizing infectious bacteria in the vagina. He demonstrated that douches containing 3 per cent, of lactic acid quickly deodorized and diminished the discharge, besides chang- ing its color. It was found that lactic acid, either pure or in solution, caused an abundant desquamation of epithelium when applied to the cervix or to the cavity of the uterus, and led to a cure of endometritis or endocervicitis with ectropion. I£ Tinct. cinchonae comp., fgij. Tinct. gentianae comp., f^ij. Misce. Sig. : Dessertspoonful three times daily after meals. Indication: Useful in the anaemia that ac- companies this condition. Ifc Sodii bicarbonatis, 3j. Tinct. belladonnas, f3ij. Aquae, Oj. Misce. Sig.: Use as a vaginal wash. 1$ Argenti nitratis, gr. xxx. Aquae, fgj. Misce. Sig.: Apply to cervix daily with swab. Indication: Ulceration of cervix. R, Zinci sulphatis, 3ss. Plumbi acetatis, 3ss. Misce. Sig.: Put in sufficient water and douche once or twice daily. 280 Hand-Book of Modern Treatment. R, Potassii chloratis, §j. Sig. : A teaspoonful to a pint of water as a vaginal injection. Indication: Useful in simple cases. 1$. Potassii permanganatis, 3ss. Aquae, S x v. Misce. Sig. : Vaginal injection in fetid discharges. Ifc Aristol, Sj- Sig. : Apply freely as a dusting powder by means of a speculum every second or third day. IJ Iodoformi, Sj- Acidi tannici, §j. Misce. Sig. : Saturate a tampon with this and pack around a discharging uterus. IJ Liq. plumbi subacetatis, f^iv. Tinct. opii, f^iv. Misce. Sig. : Tablespoonful to a quart of water as a vaginal injection, three times a day, after a thorough cleansing douche. Indication: Useful in leucorrhcea with acute painful vaginitis. Landau has found injections of yeast into the vagina of great value in leucorrhcea, especially that form due to chronic gonor- rhoea. He has employed this treatment in 40 cases, and claims that in more than half all traces of discharge ceased after one or two applications. In a few cases there was considerable im- provement, and in a few cases there was none. Ordinary brew- ers' yeast was employed, diluted sufficiently with water so as to pass through a gonorrhceal syringe. From 10 to 20 cubic centi- meters were thrown into the vagina, a tampon being then intro- duced, and the fluid allowed to remain for twenty-four hours. This injection was repeated every two or three days, and con- tinued for one or more weeks. No unpleasant effects were no- ticed, except in a couple of cases, in which itching was excited, which was relieved by soda injections. The author offers the Hand-Book of Modern Treatment. 281 following explanation of the good effects of the yeast: 1. The crowding out of the organisms producing the leucorrhcea by the overgrowth of the yeast- fungi. 2. The consumption of nutrient substances necessary to the existence of the offending organisms. 3. The direct action of the metabolic products of the yeast- fungi. LICE. IJ Pulv. coeeulus Indici, 3j. Ung. aquae rosae, 3j- Misce. Sig. : Rub well into the part. Indication: Used for pediculi pubis and capitis. 1^ Johnson's ethereal soap, f§v. Sig. : Apply freely with hand twice daily and then bathe with warm water. Indication: Used for pediculi capitis and pubis. I£ Acidi carbolici (phenolis), 3i-3ij. Glycerini, §j. Aquae, q. s. ad fSviij. Misce. Sig. : Apply as a wash. Indication: To destroy lice or relieve pru- ritis. I£ Tinct. delphini, 3ij.- Aquae colonicusis, 3ij. Misce. Sig. : Apply night and morning. Indication: For pediculi pubis. I£ Hydra rg. chloridi corrosivi. gr. xv. Acidi acetici diluti, fBviij. Aquae, q. s. ad %xxj. Misce. Sig.: Use freely as a wash. Indication: Used for pediculi pubis and capitis. 282 Hand-Book of Modern Treatment. LOCOMOTOR ATAXIA. IJ Liq. potassii arsenitis, 5j- Sig. : One drop in water three times a day one hour after meals, and increasing daily till puffiness below eyes, and then decrease or cut down to one-half, and so continue in anae- mic subjects. IJ Hydrarg. chloridi corrosivi, gr. V*o« Auri et sodii chloridi, gr. \/ w . Zinci sulphidi, gr. Vw Strychninae sulphatis, gr. 1 / eo , Misce. Sig. : To be made into a pill and one such taken every three hours. Weiss, of Vienna, says that an early symptom of locomotor ataxia is an inability of the patient to walk backward, while in other ways he may walk with rapidity and certainty. I£ Ferri lactatis, gr. xl. Ext. cinchonae, 3j. Ext. nucis vomicae, gr. viiss. Ext. gentianse, q. s. Misce et fiant pilulae no. xx. Sig.: One or two pills three times a day. ty Antipyrini, gj. Syr. zingiberis, f^j. Aquae cinnamomi, q. s. ad f§iv. Misce. Sig. : A teaspoonf ul every one to four hours for three to six doses. Indication: Used in the lightning pain of locomotor ataxia. I£ Potassii iodidi, Sj. Aquae bullientis, f^j. Misce. Sig. : Ten drops in milk three times a day and increase until physiological effects are manifested. Indication: Used in locomotor ataxia re- sulting from syphilis or metallic poisoning. Hand-Book of Modern Treatment. 283 1^ Extract! physostigmatis, gr. x. Pulv. zingiberis, gr. xx. Misce et fiant pilulae no. xx. Sig. : One pill three times a day. R, Potassii bromidi, Sj. Fiant tabellae compressae no. xxiv. Sig. : Two tablets every four hours. Indication: Used in laryngeal crises. Dr. S. Leduc, basing his practice on the theory that the syphilitic origin of locomotor ataxia is scarcely contested to-day, for a past history of syphilis is found in nearly all ataxics, has injected daily into the muscles of the patient's thigh 2 grammes — about 30 minims — of the following solution: — B Hydrarg. chloridi corrosivi, gr. iij. Sodii chloridi (recrystalized), gr. iij. Aquae destillatse, m ccc. Misce. It is said that amelioration was at once manifest. Treat- ment was continued for periods of three weeks, followed by re- missions of fifteen days. Six years from the commencement of the treatment the patient has lost the knee-jerk, and, although some lightning pains persist, he walks well, even at night, and leads a very active life. LUMBAGO. I£ Sodii salicylatis, £ss. Potassii iodidi, 3ij. Syr. sarsaparillee comp., 3j« Aquae, q. s. ad 3hj- Misce. Sig. : Teaspoonful in water three times day after meals. I£ Antipyrini, 3j. Sodii salicylatis, 3j. Aquae, gij. Misce. Sig.: One teaspoonful four times daily. 284 Hand-Book of Modern Treatment. The local treatment is important. As a liniment the fol- lowing is recommended : — IJ Methyl salicylates, 3ij. Tinct. belladonnas, Sij- Tinct. opii, 3ij. Spiritus camphorae, §iv. Misce et fiat linimentum. Sig. : Apply locally twice daily with light massage. IJ Phenacetini, 3ij. Saloli, 3ij. Misce et fiant chartulse no. xxiv. Sig. : One powder every four hours. Ifc Ammonii chloridi, gr. xx. Ammonii carbonatis, gr. v. Misce. Sig. : At one dose, well diluted in water. B Ammonii chloridi, 3iij. Liq. hydrarg. perchloridi, §ss. Spir. chloroformi, 3ss. Infusi gentianse comp., q. s. ad j|vj. Misce. Sig. : One tablespoonful in water three times a day. The dose of ammonium chloride in either of these pre- scriptions approaches the maximum dose. 1$ Phenazoni, gr. iij. Aquae destillatse, f3j. Misce. Sig. : Inject deeply with a long needle into painful area. Indication: Used in obstinate cases. T$ Atropine sulphatis, gr. i'V 5 . Morphinse sulphatis, gr. xvj. Aquas destillatse, fSj. Misce. Sig. : Inject five minims deep into the mus- cular tissue. Hand-Book of Modern Treatment. 285 I£ Potassii iodidi, 3ss. Tinct. opii deod., 3ij. Spiritus lavandulae comp., 3j. Spiritus aetheris nitrosi, 3ss. Aquae destillatas, §xij. * Misce. Sig.: Two tablespoonfuls twice daily. Lumbago readily yields to a vigorous application of the fol- lowing ointment : — li Camphor-chloralis, 3j. Acidi salicylici, 3ss. Menthol, gr. xx. . Pulv. capsici, 3j. 01. sinapis, gtt. viij. Adipis lanae, 3iv. Petrolati, q. s. ad Bij- Sig. : Apply with vigorous friction three times a day. (Sometimes substitute ol. tiglii for ol. sinapis.) ty Tinct. opii, 3ij. Aquae ammonias, 3j. Tinct. cantharidis, 3iij. Ung. saponis, 3x. Misce. Sig. : Apply by rubbing thoroughly. B Tinct. iodi, 3ij. Tinct. aconiti radicis, 3iij. Spts. chloroformi, 3 SS - Linimenti saponis, q. s. ad 3iij- Misce. Sig. : Apply locally several times da^ly. Ifc Vini colchici radici, f3ij. Sodii salicylatis, 3iv. Potassii iodidi, f3ij. Essentiae pepsini, f^ij. Aquae, fgss. Misce. Sig. : A teaspoonful in water after meals. Indication : Used in gouty or rheumatic s jd- jects. I£ Empl. belladonnas. Sig. : Apply locally. 286 Hand-Book of Modern Treatment. LUPUS. Arthur H. Buck reports a case of lupus vulgaris of twelve years 7 standing treated with urea and cured. The patient was one who may be described as having been saturated with tubercle, and who possessed the tubercular diathesis to a large degree. His habits and diet have been opposed to the cure of any tu- bercular trouble, and during the process of treatment these con- ditions were not altered in any way. Lupus is perhaps the most intractable form of tuberculosis, especially to what are known as general or constitutional remedies. The lesion being on the sur- face, it was carefully watched, and between April 23d and May 21st the disease seemed to almost melt away. No bad symptoms occurred even with urea 1 drachm t.d.s., but, rather, the patient felt able to enjoy life for the first time for years. The treatment was begun with 30 grains t.d., and gradually increased to a drachm. I£ Liquoris potassii arsenitis, f^j. Sig. : One drop in water after meals and gradually increase to three drops. If pufnness of eyelids or colicky pain of bowels develops, reduce dose one-half. Indication: Used in anaemic and debilitated subjects. IJ Acidi salicylici, gr. x. Collodii flexilis, fSj. Misce. Sig.: Apply locally. R, Formaldehydi (40 per cent, sol.), f£j. Sig. : Apply to diseased area with a small cotton swab, first cocainizing the part. Indication: As cauterant. To be applied every second or third day after removing scales by poultices. B Olei myrrhae, f^ij. Syrupi ferri iodidi, f^ss, Misce et pone in capsulas no. xlviij. Sig.: One capsule two hours after meals. Indication: In debilitated and ansemic sub- jects. Hand-Book of Modern Treatment. 287 fy Acidi salicylici, 3iiss. Creosoti, 3v. Cerati simp., Siiiss. Cerse albi, gr. lxxv. Misce. Sig. : Use externally. MALARIA.— See Fever. MAMMARY INFLAMMATION.— See Abscess. The treatment in the prevention of mammary abscess should really begin during the latter months of pregnancy by manipulating and drawing out the nipples and bathing them in alcohol or borax-water to harden the epithelium. Absolute cleanliness is required; frequent washing of the nipples with soap and water, followed by a saturated solution of boric acid, keeping gauze pads saturated with this solution wrapped around the nipples during the day and sterilized vaseline applied during the night. As an application, also, the following combination is recommended : — IJ Tannici (glycerite), 3ij. Alcoholis, 5j- Aqu® rosae, q. s. ad Siij- Misce. Sig.: To be applied constantly on sterile gauze. For the pain give opium or codeine, or morphine hypo- dermically if the pain is unbearable, and apply lead-and-opium wash locally. Saline cathartics lessen the hyperemia of the breasts. Belladonna ointment applied locally often affords com- fort. Ice-bags are of great importance, and should be employed in order to prevent pus-formation. Support by bandages is necessary, employing the figure-of-eight in combination with the "straight-around" bandage, making gentle compression as well as support. Bacon's method of massage may be emp^yed by beginning in the axilla and rubbing under the clavicle, gently at first and gradually increasing the pressure. The stroking is all directed away from the breast, and not toward it. The pur- 288 Hand-Book of Modern Treatment. pose is to facilitate the flow of the blood and lymph back from the breast and to accelerate the flow in the efferent vessels. Very useful in acute inflammation with tenseness and of pain. Active saline purge at beginning of treatment: — B Ung. belladonna?, Sj- Ung. hydrargyri, 3iv. Ichthyoli, f3iv. Cerati plumbi subaeetatis, 3j. Misce. Sig. : Apply to breast freely, and employ tight breast-binder. Indication: Used in acute inflammation, ac- companied with tenseness and pain. Give sa- line purge at beginning of treatment. 1$. Ung. belladonnge, §j. Pulv. camphorse, 3ss. Misce. Sig.: Apply locally, supporting the breast with a bandage. 1$ Liq. plumbi subaeetatis, gij. Tinct. opii, §ij. Misce. Sig. : Add to one quart of water, and keep constantly applied to breast on soft cloths. Indication: Used to abort acute inflamma- tion. Keep the breasts tightly bandaged. I£ Hydrarg. chloridi mitis, gr. x. Pulv. jalapae, gr. x. Sig. : Take at once and at one dose. . Indication: Useful as a brisk purge for incipient mastitis. MANIA, ACUTE. Any physician who has not employed veratrum viride in acute mania has missed the best agency which is available for the cure of these distressing cases. It is one of the greatest ad- vantages a physician can have to see a feverish sufferer, under the application of this remedy, pass from absolute sleeplessness into a state of quiet rest. That many cases which would other- Hand-Boole of Modern Treatment. 289 wise go on to death are saved by the use of this remedy is a fact beyond question. The fear which many practitioners have of using veratrum viride, on account of the varying strength of its various preparations, must, of course, be met, when the drug is employed, by the use of Norwood's tincture. IJ Fluidextracti cimicifugae, §ss. Sig. : Twenty minims in water three times daily one hour after meals. Indication: Used in cases occurring after confinement, not due to permanent causes. I£ Paraldehyde f^ss. Sig.: Thirty to' fifty minims in an ounce or two of water by the rectum. R. Potassii bromidi, §j. Tinct. cannabis Indicse, f3j. Syrup i simplicis, f^ij. Aquae destillatse, q. s. ad f§iv. Misce. Sig.: A tablespoonful thrice daily. Indication: Used in restlessness and period- ical mania. IJ Hyoscini hydrobromatis, gr. 1 / 100 . Sig.: This dose by mouth in pill or hypo- dermically. Indication: Used to quiet excitement and produce sleep in violent cases. I£ Trional, 3vj. Fiant chartulae no. xij. Sig. : One powder at bedtime. 1^ Glandular thyroidal siccse. Sig. : Five grains three times daily, and this treatment continued for twenty to thirty days. MARASMUS. Arsenic is a drug too little employed in this affection, as it is prompt and efficient in selected cases. The arsenate is the preferable form of the drug, as given in this form it has a local 19 290 Hand-Book of Modern Treatment. stimulating effect on the mucous membrane of the stomach and bowels. The dose of this salt is 1 / 300 of a grain given three times a day after feeding. It controls the nausea and enlivens the pale mucosa of the stomach, but its good effects do not cease here, for it passes into the bowel, and a certain portion, being absorbed, is carried to the liver; being again eliminated in the bile, it is again absorbed and secreted in the bowels. It stimulates absorption and assimilation. It is, moreover, a tonic to the general system. B Syr. ferri iodidi, 5j. Sig. : Three to five minims thrice daily after meals, well diluted in water. I£ Olei morrhuse, f^ij. Acacise, 3iv. Extracti pancreati, f3ij. Aquae menthse viridis, f^ij. Aqua?, q. s. ad fSviij. Misce. Sig. : A teaspoonful three times a day. Indication: Used in strumous tubercular in- fants. 3 Olei morrhuse, f§ij. Aquae calcis, f3iv. Syr. calcis lactophosphatis, q. s. ad Siv. Misce. Sig. : A teaspoonful two or three times daily. Indication: Used in tubercular and stru- mous children. R, Olei morrhuse, Bxvj. Sig. : Anoint the body two or three times daily. Indication: Useful in struma and atrophy from indigestion or improper feeding. 1$, Hydrarg. cum cretse, 3j. Fiant chartulse no. xxx. Sig. : One powder three times daily, also anoint the body with codliver-oil. Indication: Used in syphilitic marasmus. Hand-Book of Modern Treatment. 291 MEASLES.— See Fever. Administer small initial doses of calomel, preceded by a glycerine suppository. The severe vomiting is usually best con- trolled by cracked ice, lime-water, or bismuth. The following is recommended to increase the elimination by the skin and kidneys : — i| Potassii citratis, 3ij. Vini ipecacuanha?, 3ij. Tinct. opii camph., 3iij. Syr. tolutani, £j. Aqua? cinnamoni, q. s. ad ^iij- Misce. Sig. : One teaspoonful every three hours. Indication: For the cough of measles. It is stated that good results may be obtained in the treat- ment of measles by rubbing the body with a salve, morning and night, consisting of : — i^ Ichthyoli, I]. Lardi, §iij. Misce. This practice was suggested by the favorable results ob- tained by the same treatment in variola. Only one or two rub- bings seem to be necessary to reduce the temperature to normal, when the patches gradually grow pale and disappear. It re- quires only four or five days to complete the results, after which a warm bath removes what is left of the salve. B Tinct. opii camph., f3iss. Spt. setheris nitrosi, f^j. Syrupi ipecacuanha?, f3j. Syrupi scillse, f^ss. Liq. potassii citratis, q. s. ad f§iij. Misce. Sig. : Teaspoonful every two hours for a child of four years. Indication: For cough and measles. B Liq- ferri et ammonii acetatis, f§viij. Sig.: Two or three teaspoonfuls after meals. 292 Eand-Book of Modern Treatment. 1$ Potassii bromidi, gr. xxiv. Chloralis, gr. viij. Syrupi acaciae, f3ij. Aquae, q. s. ad f§j. Misce. Sig. : Teaspoonful in water not oftener than twenty- four hours. Indication: Used for restlessness, insomnia, and headache. I£ Ammonii chloridi, 3j. Syrupi simplicis, §ss. Aquae menthae pip., q. s. ad Siij. Misce. Sig. : A teaspoonful every four hours to a child three or four years old. Indication: Used as an expectorant when bronchitis is present. MELANCHOLIA. I£ Zinci Valerianae, 3ss. Ferri Valerianae, 3ss. Quininae Valerianae, 3ss. Misce et fiant pilulae no. xxx. Sig. : One pill three times daily. IJ Acidi nitrohydrochlorici, U. S. P., f3iv. Sig. : Two to five drops in one-half glass water through a glass tube, after meals. Indication: Used in melancholia with oxa- luria. B Olei phosphorati, m xxiv. Olei morrhuae, fSj. Misce et pone in capsulas no. xxiv. Sig.: One capsule two hours after meals. Indication: Used in debilitated subjects. IJ, Paraldehyde Sj. Sig. : Thirty to forty minims at bedtime. Indication: Used for relief of insomnia. Eand-Book of Modem Treatment, 293 IJ Tinct. ferri chloridi, f^ij. Sig. : Ten to fifteen drops through a glass tube after meals. Laxatives must be used so that constipation does not result. MENINGITIS. $ Ung. Crede, §j. Sig. : An inunction of this applied, one drachm twice daily. IJ Tinct. aconiti, 3ij. Sig. : One minim every hour until pulse be- comes soft and compressible. Indication: Used in sthenic and early cases. IJ Morphinse sulphatis, gr. ij. Aquae destillatae, 3ij. Misce. Sig. : Five to ten minims hypodermically, according to age, as required to relieve rest- lessness and insomnia. Indication : Used during any period of the disease. IJ, Hydrarg. chloridi mitis, 3j. Pulv. jalapse, 3j. Sacchari albi, 3j. Misce et fiant chartulae no. x. Sig. : A powder every hour until free purga- tion occurs. Indication: In cerebrospinal meningitis. IJ Fluidextracti ergotee, f§j. Potassii bromidi, 3ij. Potassii iodidi, 3ij. Syrupi sarsaparillae, f^ij. Aqua? compositse, q. s. ad f§vj. Misce. Sig..: Two teaspoonfuls in water after meals. Indication: Used in chronic meningitis. 294 Hand-Book of Modern Treatment. I£ Sodii bromidi, 3ij. Chloralis hydratis, 3j. Syr. aurantii corticis, f§j. Aquae, q. s. ad Sirj- Misce. Sig. : A dessertspoonful every hour until excitement abates. MENOPAUSE. IJ Zinci Valerianae, gr. 3 A- Extracti hyosciami, gr. 1 / 3 . Extracti belladonnae, gr. x / a . Misce et fiat pilula no. j. Sig. : One such pill three times daily. IJ Camphorse monobromatae, gr. iss. Quininae Valerianae, gr. iss. Extracti hyosciami, gr. V 3 . Extracti belladonnae, gr. x / 6 . Misce -et fiat pilula no. j. Sig. : Four or five pills daily. Indication: Either of the above for nervous excitement and neuralgia. R Ammonii bromidi, 3ij. Potassii bromidi, 3iv. Spt. ammoniae aromatici, 3vj. Aquae camphorae, q. s. ad Svj. Misce. Sig. : A dessertspoonful every four hours. Indication : Nervousness. Gottschalk recommends, from personal observation in a number of cases, hot baths as a means of relieving the sweat- ing and hot flushes and associated disturbances occurring at the menopause or after removal of the uterus or adnexa. The hot baths are administered at bed-time, duration twenty minutes. Three or four weeks' treatment was sufficient to effect a cure. He does not state exactly what temperatures were employed, but baths at 92° to 96° are best for these .cases. Carefully-gradu- ated tonic treatment, consisting of wet-hand rubbing, cold fric- tion, the friction-mitt, cold wet-towel rubbing, and like measures are of great service. Hand-Book of Modern Treatment. 295 IJ Arnnionii bromidi, 3ij. Potassii bromidi, 3iv. Spts. ammon, aromat., f3vj. Aquae camphorae, q. s. ad f§vj. Misce. Sig. : Dessertspoonful to a tablespoonf ul every four hours. Ifc Sodii arsenatis, gr. ss. Extracti cannabis Indicae, gr. iv. Potassii bromidi, 3iv. Camphorae, gr. xxiv. Misce et fiant tabellae compressae no. xxiv. Indication: For relief of headache and nervousness. Sig. : One tablet after meals. MENORRHAGIA AND METRORRHAGIA. The coagulating properties of calcium chloride have been utilized by a French confrere as a prophylactic measure against monorrhagia, in the cases in which the menstruation is pain- less, but the flow excessive. He prescribes for a week before the expected period two tablespoonf uls a day of the following: — I£ Calcii chloridi, 3iiss. Syrupi, 3xv. Aquae, Bvj. Misce. Sig. : Two tablespoonf uls a day. This treatment, repeated each month for two or three times, has always cured the pathological excess of the menstrual flow. Nephritis is a contraindication. The enterorrhagia in typhoid fever is also favorably affected by calcium chloride. Mathieu reports eight cases successfully treated by an injection, once or twice a day, of a liter of water at 48° C. containing 4 grammes of calcium chloride, supple- mented by 2 grammes administered by the mouth in an aqueous solution during the day, and measures to immobilize the intes- tines. These hot injections clear the intestines of extravasated blood, and thus suppress a new source of intoxication and fever. 296 Hand-Book of Modern Treatment. I£ Fluidextracti hydrastis Canadensis, §j. Ergotin, 3j. Misce. Sig. : Twenty drops three or four times a day. I£ Hydrastininae hydrochloratis, gr. x. Aquae destillatse, 3iiss. Misce. Sig.: Inject one syringe (gr. j) two or three days in succession. I£ Quininse hydrobromatis, gr. ij. Hydrastininae hydrochloratis, gr. ss. Ergotin, gr. j. Misce et fiat pilula no. j. Sig. : Two such pills daily. Indication: Metrorrhagia from fibroma. These pills can be prescribed for ten days. The ten fol- lowing days recourse can be had to cannabis Indica or adrenalin. The latter has frequently succeeded — 10 drops of the 1 to 1000 solution morning and evening. Sometimes accidents occur: sensation of anguish and cardiac arhvthmia. The treatment should be carefully watched, and suspended on the slightest un- favorable symptoms. ty Codeinae sulphatis, gr. %. Chloralis hydratis, gr. xv. Amnion, bromidi, gr. xv. Aquae camphorae. §j. Misce. Sig.: To be taken while lying down. Indication: Painful menstruation. 1^ Fluidextracti hydrastis, 3iiss. Fluidextracti hamamelis, 3iiss. Fluidextracti viburnum, 3iVL- Misce. Sig.: Twenty drops in a little water three times a day. Indication: Useful in abundant metror- rhagia and menorrhagia Hand-Book of Modern Treatment. 297 In the treatment of menorrhagia in virgins fifteen minims of the fluid extract of senecio in a hot infusion of lemons is often effective. As soon as the menstrual period appears the patient is put to bed, poultices containing laudanum applied to the abdomen, and suppositories containing the following in- serted : — I£ Ext. cannabis Indict, gr. V 15 . Ext. belladonnas, gr. y i5 . Olei theobrom., q. s. Misce et fiat suppositoria no. j. Sig. : One such suppository inserted as often as necessary. As a substitute for the foregoing suppository enemata con- taining laudanum are recommended, or the following: — I£ Tinct. viburni prunifolii, gtt. x. Tinct. piseidise erythinse, gtt. x. Misce. Sig. : To be taken at one dose in a hot in- fusion. For the accompanying lumbar pains the following ointment is recommended : — B; Spts. chloroformi, 3iiss. Olei moschi, 3j. Essentia caryophilli, 3j. Spts. etheris, 3iv. Alcoholis. Siij- Misce. Sig. : To be applied locally to the lumbar region with thorough friction. R^ Fluidextracti ergotae, f^iij- Sig. : One-half to one teaspoonful thrice daily. J£ Potassii bromidi. 3ij. Fiant chartulae no. xij. Sig. : One powder in one-half glass of water twice daily for the irregular flow. Begin be- fore period and continue till it is over. 298 Hand-Book of Modern Treatment. I£ Stypticus, gr. xxx. Pone in capsulas no. xxx. Sig. : One capsule three times daily for sev- eral days before period and when flow slows; one grain every two or three hours during the period. 1$. Olei cinnamomi, f3j. Pone in capsulas no. xxx. Sig. : One capsule after meals. Indication: Useful in oozing haemorrhage. MERCURIALISM.— See Ptyalism. METRITIS. I£ Camphorae, gr. xv. Saloli, gr. xv. Betuloli, gr. xxx. Chloral is hydratis, gr. lxxv. Misce et facit applic. Sig. : Dilate cervical cavity and apply this antiseptic treatment. Make hot injections, thoroughly cleansing the parts before this ap- plication. The symptoms calling for belladonna in inflammation of the uterus are distended abdomen, with pains of a lancinating character, or as if the intestines were clasped by some sharp claws; painful pressure, as if everything would protrude through the vulva; abdomen very sensitive to contact; face red, with heat about the head and eyes; pressive headache, throbbing carotids ; pains in small of back as if it were broken ; lochia suppressed, or, if there is a discharge, it is free and offensive. I£ Tinct. iodi comp.. fgj. Sig.: Use locally on a probe wrapped with absorbent cotton, once or twice weekly. Two applications are made and a glycerine tampon is left against the cervix. In the intervals let the patient use hot water as a vaginal injec- tion twice daily. Hand-Book of Modern Treatment. 299 MIGRAINE.— See Headache. IJ Sodii sulph., 3ss. Sodii salicylatis, gr. x. Mag. sulph., gr. 1. Lithii benzoatis, gr. v. Tinct. nucis vom., m iij. Aquae destillatae, Siv. Misce. Sig. : To be placed in a siphon bottle and carbonated, and a small amount, sufficient to produce a laxative effect, taken daily before breakfast, and dose is to be regulated by ca- thartic effect. Active purgation is not desired. I£ Caffeines, gr. iv. Sodii salicylici, gr. viij. Cocainse hydrochl., gr. 1 / 3 . Aquse, gj. Syrupi simpl., 3iiss. Misce. Sig. : To be taken at once. Indication: Especially active where trigem- inal neuralgia accompanies the migraine. For the distressing nausea and vomiting: — B Tinct. zingiberis, 3j. Tinct. capsici, gtt. xxxvj. Syrupi zingiberis, %ss. Aquse menth. pip., ad §iij. Misce. Sig.: Two tea spoonfuls at dose as conditions indicate. I£ Zinci phosphidi, gr. 1 / 10 . Ferri reducti, gr. j. Ext. nucis vomicae, gr. 1 / 4 . Ext. cannabis Indicae, gr. V 4 . Misce et fiat pilula no. j. Sig. : One pill three times daily for one month. Then alternate for two weeks with some nerve tonic, after which use the pill for another month, and so on. 300 Hand-Book of Modern Treatment. ]$ Ext. cannabis Indices, gr. Ve« Acidi arseniosi, gr. 1 / Q0 . Ferri pulv., gr. j. Misce et fiat pilula no. j. Sig. : One pill three times a day. Indication: Useful in migraine accompany- ing anaemia. If an attack occurs during menstruation a sitz-batli should be taken and the following given internally : — I£ Spts. chloroformi. 3ij. Spts. ammon. arom.. 3ij. Tinct. card, co., 3ij. Liq. ammon. acet., q. s. ad giij. Misce. Sig.: Two teaspoonfuls and repeat in two hours if necessary. Citrophen, according to the author, acts admirably in some of these cases. I£ Acetanilidi, gr. xx. Camphorae monobromatae, gr. v. Caffeinos citrates, xl. Misce et pone in capsulas no. xl. Sig.: One capsule followed by others as necessary. R. Crotonchloralis, 3j. Pone in capsulas no. xij. Sig. : One capsule every four hours. Indication: Used in neuralgia of fifth nerve, not due to decayed tooth. I£ Ext. aconiti ale, 3j, Adipis, 3ij. Fiat unguentum. Sig.: Rub into affected temple every night Rand-Book of Modern Treatment. 301 IJ Ext. belladonnse, gr. v. Sig. : To be rubbed into the affected temple every night. I£ Potassii acetatis, ^vj. Infusi digitalis, f^vj. Misce. Sig. : A tablespoonful every third hour. 1^ Quininse valerianatis, gr. xv. Ext. colchici, gr. iv. Extracti digitalis, gr. iv. Extracti aconiti, gr. ij. Misce et fiant pilulse no. x. Sig. : One at night after evening meal. Indication: Gouty migraine. R. Sodii phenolsulphonatis, gr. v. Potassii permanganatis, gr. j. Betanaphtholis, gr. j. Misce et fiat pilula no. j, and coat with phenyl salicylate to insure entrance into the bowel before being dissolved. Indication: Useful in intestinal fermenta- tion when accompanied with migraine. MORNING SICKNESS.— See Vomiting. MOUTH-WASH. B Saloli, 3j. Tinct. catechu, 3ij. Spiritus menthse pip., gvij. Misce. Sig. : Use a teaspoonful to a glass of warm water. Indication: Mouth-wash for smokers. B Tinct. calen dulse, Siss. Phenolis, gr. xl. Aquae, q. s. ad Bviij. Misce. Sig.: Use as necessary. 302 Hand-Book of Modern Treatment. I£ Acidi thymici, gr. iij. Acidi benzoici, gr. xlv. Ess. menthse pip., m x. Tinct. eucalypti, 3ivss. Aleoholis, §iij. Misce. Sig. : Put a sufficient amount in the glass of water to render the water milky and use as a mouth-wash. I£ Acidi tannici, 3iij. Mentholis, 3ij. Thymolis, gr. xv. Tinct. benzoini, 3iss. Aleoholis, §iij. Misce. Sig. : Ten drops in half a glass of tepid water. I£ Olei menthse pip., m xxx. Olei clavi, m xv. Olei gaultherise, m xv. Glycerini, 3ss. Aquae destillatae, q. s. ad B"j. Misce. Sig. : Use as necessary. Indication: Mouth-wash for children suffer- ing with infantile diarrhoea, before feeding. For the first six weeks the infant's month should be washed before nnrsing and also after nursing, unless asleep, with a soft, small square of linen dipped in water. No square should be used more than twice, or at another nursing. By the time the child is three or four months old it will suffice to wash the mouth twice a day. During dentition, however, it should be frequently washed out with cold water. As long as the child subsists on milk and broths the teeth need cleansing with a bit of wet linen only; when solid food is taken a soft, fine tooth-brush should be used. The following makes a suitable powder : — Hand-Book of Modern Treatment. 303 R. Pulv. oss. sepiae, 3v. Magnesii carb., 3v. Pulv. rad. iridis nor., 3ss. 01. menth. pip., gtt. iij. Misce. Sig. : Tooth powder. Rinse the mouth well after using. P£ Acidi borici, 3ss. Aquae hydrogeni dioxidi, §j. Glycerini, §ss. Aquae rosae, q. s. ad 5iij- Misce. Sig. : Use before and after feeding. MUMPS. I£ Guaiacolis, 3j. Vaselini, 3x. Adipis lanae hydrosi, 3x. Misce et fiat unguentum. Sig.: Use morning and evening. Indication: Useful for the pain in mumps. I£ Ichthyolis, gr. xlv. Plumbi iodidi, gr. xlv. Ammon. chloridi, gr. xxx. Adipis lanae hydrosi, Bj- Misce et fiat unguentum. Sig. : Apply to swollen part three times daily. Vaseline may be used instead of lard and belladonnae added. 1$. Tinct. aconiti, 3j. Sig. : One minim every two hours during first twenty-four to thirty-six hours. I£ Pilocarpinae hydrochloratis, gr. j. Sacchari lactis, gr. xviij. Alcohol, q. s. Misce. Fiant tabellae triturationes no. xij. Sig. : One tablet every hour until mild sali- vation or diaphoresis. Indication: Used in the acute stage. 304 Hand-Book of Modern Treatment. MYALGIA. "We know a large number of affections better clinically than pathologically/' says Dr. A. A. Eshner, and continuing, has this to say : "One of these is that condition of peripheral soreness or painfulness, sometimes an affection of the muscles themselves or their fibrous sheaths, sometimes involving the peripheral sensory nerves. In the absence of definite knowledge as to the precise nature of cases of the kind referred to, I am in the habit of grouping them together under the common desig- nation of myalgia; and have found the following formula of service in the treatment of a large number of cases : — 1$. Fluidextraeti cimieifugse, §ss. Fluidextraeti erythroxyli §ss. Tinct. guaiac. ammon., 3ss. Misce. Sig. : A teaspoonful three times a day before meals. "When constipation co-exists, an equal proportion of fluid extract of cascara is added. I can warmly commend the em- ployment of this combination under the conditions indicated/' I£ Tinct. belladonna?, f3iss. Tinct. aconiti, f3vj. Tinct. opii, f3ij. Linimenti saponis, q. s. ad f§vj. Misce. Sig.: To be used externally and only as a liniment. R Linimenti belladonna, $v. Sig. : Rub in thoroughly several times daily. B Saloli, 3iv. Phenacetini, 3iv. Misce et fiant chartulae no. xxiv. Sig. : One powder after meals. Rand-Book of Modern Treatment. 305 MYXCEDEMA. I£ Glandulae thyroidese sicca?. 3j. Fiant tabellae compressse no. xij. Sig. : One to three tablets daily. Dose to be determined. NiEVUS. IJ Sodii ethylatis, gr. vj. Alcoholis absoluti, f 3ij. Misce. Sig. : Paint over naevus freely, and after drying cover with collodion. Allow to remain on ten to twenty days. Indication: Used to remove small birth marks. NASAL CATARRH.— See Catarrh. NEPHRITIS. IJ Tinct. aconiti, m xij. Spiritus aether is nitrosi, f3vj. Syrupi, f3ij. Liq. potassii citratis, q. s. ad fSiij. Misce. Sig. : Teaspoonful in water every two hours. Indication: To be used in early stage. 1$, Potassii acetatis, §ss. Infusi digitalis, f^vj. Misce. Sig. : Tablespoonful in a glass of water every six to eight hours. Indication: Used in late stages of acute or in chronic nephritis. B T^iq. ferri et ammonii acetatis, f^viij. Sig. : One to four teaspoonfuls in water after meals. Indication: Used for anaemia in chronic form. 306 Hand-Book of Modern Treatment. IJ Hydrarg. chloridi mitis, gr. j. Sodii bicarbonatis, gr. x. Misce et fiant chartula? no. vj. Sig. : One powder every one-half hour, to be followed by mag. sulphate. Indication: Purging good at the beginning. 1$. Spiritus glonoini, f3ij. Sig. : One drop every four hours. Indication: Used as a diuretic in later stages of acute and in chronic nephritis with high arterial tension. Jfc Fluidextracti jaborandi, f^j. Sig. : Five to ten minims every hour until a free diaphoresis is established. May be com- bined with digitalis. I£ Pulv. jalapa comp., 3j. Fiant chartulae no. xij. Sig. : One powder every four hours until free catharsis occurs. To be given after patient has been rolled in blankets wrung out of hot water. Indication: In acute nephritis. CHRONIC INTERSTITIAL NEPHRITIS. Dr. George F. Butler, in discussing the treatment of chronic interstitial nephritis, says that drug therapeusis has its place, it is true, but after all, the little, yet very essential things of eating, drinking, and doing influence the patient's comfort and gradually turn the scale of health in his favor. A good pre- scription to keep the patient on is the following: — I£ Sodii iodidi, gr. xv-xxx. Sodii phosphatis, gr. xxx-xlv. Sodii chloridi, 3iss. iVquae, Oij. Misce. This can be taken freely as a drink. The author states that besides being a good eliminant, the iodine is a vasodilator Hand-Book of Modern Treatment. 307 and of great value in progressive lessening of elasticity and contraction of the smaller arteries. Moreover, this combina- tion modifies the state of albuminoid substances in the blood. For failure of compensation, digitalin may be necessary, but it should be combined with some vasodilator (sodium nitrate, spirit of nitrous ether, or glonoin, as well as the iodides and opium). The objection to the nitrites is that they are much more rapid in their action than digitalin, while their effect is more transitory. In severe cases he is very partial to opium, as it not only strengthens the heart but dilates the arterioles, the dose of the deodorized tincture being from 2 to 4 minims. Dr. Butler lays particular stress on veratrine in doses of V134 grain as a vasodilator, and considers that it surpasses them all; he says that it is not a depressant as so many physi- cians believe, and that its action is uniform, and its effects cer- tain and unvaried; in addition, it is a stimulant to excretion; the dose given alone can be repeated every half-hour until the pulse is relaxed. He also discusses the combative measures for anasarca, dyspnoea, convulsions, and other uraemic symptoms. Kef erring to purgatives, the author states that they fulfill three indications, viz. : ( 1 ) in determining an irritation upon the intestinal mucous membrane, they produce a revulsion from the inflamed kidney; (2) in bringing about a hypersecretion from the glands of the intestines, they deplete the vascular system and thus combat the anasarca and oedema; (3) they enable the solid and toxic matters of the urine, in cases of uraemia, to find a supplementary way of excretion. Moore recommends the following, which has given him excellent results in increasing elimination and overcoming the drowsiness of impending uraemic coma: — I£ Sodii benzoatis, 3iv. Tinct. limonis, §j. Aquse destillatse, q. s. ad §vj. Misce. Sig. : Tablespoonful in half-glassful of hot water on arising in the morning, or as re- quired. 308 Hand-Book of Modern Treatment. I£ Pilocarpine hydrochloratis, gr. 1 / 6 . Mucilaginis acacise, Siij. Misce. Sig.: Three to six tablespoonfuls a day. Indication: A diaphoretic in nephritis when uraemia is imminent. Although the dose is small, the drug thus given will stim- ulate perspiration while causing no unpleasant symptoms. Dr. Harry Lowenburg recommends the free ingestion of water for preventing scarlatinal nephritis. By increasing the amount of urine, it dilutes the toxins present and dimin- ishes the acidity, thereby lessening kidney-irritation. The elimination of toxins is also facilitated, in that it stimulates catharsis and diaphoresis. The author employs water by mouth, by balneotherapy, and by enteroclysis, and states that the combination of those methods is essential to obtain the best results. He prescribes a definite amount to be given be- tween feedings with as much regularity as the food. To induce the patient to take a certain quantity he gives it in the form of lemonade or orangeade, and often adds a teaspoonful of potas- sium bitartrate to a pint of either. Hot-water irrigation of the bowels should be employed whenever the quantity of urine is diminished or when convul- sions occur. In a child aged 3 years, 500 to 700 cubic centi- meters of water at a temperature of 43° C. should be introduced by means of a rectal tube passed into the rectum for a distance of 2 1 / 2 millimeters. If the water is returned at once the process is repeated, and irrigation should be performed every six or eight hours. After three or four administrations the kidneys begin to act, and abundant diuresis takes place. G. Gross recommends calcium chloride administered per rectum in the treatment of hemorrhagic nephritis, also in cases of inoperable uterine carcinoma with profuse haemorrhages. After giving a cleansing enema the salt may be given as fol- lows : — I£ Calcii chloridi, 3iiss. Aquse destillatae, §viss. Misce. Sig. : The entire amount administered per rectum. Hand-Book of Modern Treatment. 309 The same may be given by the mouth as follows : — I£ Calcii chloridi, 3j. Syr. menth. pip., §j. Aquae destillatae, §iij. Misee. Sig. : One tablespoonful every two hours. 1$. Caffeinae citratis, 3j. Pone in eapsulas no. xx. Sig. : One after meals. Indication: Used as a diuretic in later stages of acute and in chronic nephritis. NERVOUSNESS.— See Hysteria. NETTLE RASH.— See Urticaria. NEURALGIA. I£ Quininae valerianatis, gr. iss. Ext. hyoscyami, gr. 3 / in . Ext. cinchonae, gr. 3 / i . Misce et fiat pilula no. j. Sig. : Take two to four such pills daily. B Chloralis, 5j. Camphorae, 3j. Mentholis, 3j. Misce. Sig. : With a brush spread a layer of this mixture (which is liquid) over the painful parts. Renew the application when the pain reappears. Indication: Useful in intercostal neuralgia. ty Emplastri belladonnae (3x3 inches). Sig. : Apply to part a ffected. Indication: Intercostal neuralgia. B Camphorae monobromidi, gr. iss. Pulv. capsici, gr. ij. Confectionis rosae, q. s. ad pilula no. j. Sig. : As required. Indication: Ovarian headache. 310 Hand-Book of Modern Treatment. IJ Butyl-chloralis, gr. ij. Caffeinae, gr. ij. Ext. gentianae, q. s. Misce et fiat pilula no. j. Sig. : One every third hour. Indication: Headache and neuralgia. IJ Potassii iodidi, 3iv. Saloli, 3ij. Misce et fiant tabellae compressaa no. xxiv. Sig. : One tablet after each meal. Indication: In rheumatic subjects. IJ Olei gaultheriae, m xx. Guaiacoli, m xx. Camphorae, gr. xv. Mentholis, gr. xv. Olei clavi, m v. Glycerini, 3j. Petrolati, 3j. Cerati, 3j. Adipis lanae hydrosi, 3j. Misce. Sig.: A small quantity to be rubbed in over seat of pain. This is also useful in painful finger-joints due to gout. IJ Phenacetinae, gr. xlv. Antipyrinae, gr. xlv. Quininae sulphatis, gr. xv. Misce et fiant chartulae no. vj. Sig. : One or two powders daily. Indication: Trigeminal neuralgia. IJ Antipyrinae, gr. xxx-3j. Caffeinae citratae, gr. xx. Misce et fiant chartulae no. x. Sig. : One every thirty minutes till relieved. IJ Atropines sulphatis, gr. ss. Aconitinae, gr. iss. Olei tiglii, gtt. ij. Ung. petrolati, 3ij. Misce. Sig. : Apply to affected part. Hand-Book of Modern Treatment. 31 1 Ifc Antipyrinse, gr. xxx. Caffeinse citratse, gr. x. Potassii bromidi, 3iij. Misce et fiant chartulse no. x. Sig. : One every half-hour until relieved. Castor-oil is advised for neuralgia and especially for the severe forms affecting the fifth nerve. One to 2 ounces are given three or four times a day. After two or three doses have been given the purgative effect is said to be lost, or, if not, an opiate is advised to prevent too great action upon the bowels. It is claimed by Dr. F. E. Waxham, whose attention was directed to the remedy by Dr. Mover, that its curative action is constitu- tional, and not due to the effect upon the intestinal tract. Dr. Henry Treve Barber describes a chronic and very severe case in which aconitine produced an excellent effect: — "Being convinced that I had to do with a very severe case of tic douloureux, I ordered her to take one granule containing y i0 milligramme of aconitine every four hours, and I was rather surprised to see that, after she had taken five, the pains were less than they had been for some time. In three days she had taken ten granules and was very much better and able to sleep. I then stopped the aconitine and gave her: — I£ Ferri sulphatis exsiccati, gr. viiss. Ext. anthemidis, gr. viiss. Misce et fiant pilulae no. ij. Of which she took two a day : one after each meal. "Aften ten days of this treatment the pains had almost left her, and the patient declared that the medicine was acting, for at night she would suddenly awake with a very acute, sharp, stabbing pain, which she said always came on whenever the pains were about to get better. These twinges would pass off in a few seconds, and she would then sleep until morning, and dur- ing the day the pain was very much better. In two or three weeks she was entirely free from pain, and still continued to take the pills." 312 Hand-Book of Modern Treatment. ]J Tinct. aconiti radicis, 3j. Tinct. colchici seminis, 3j. Tinct. belladonnas, 3j. Misce. Sig. : Six drops in water every six hours. Indication: Facial neuralgia. B Ichthyoli, 3j. Ung. hydrargyri, 3j. Chloroformi, 3vj. Spts. camphora?, 3vj. Misce. Sig. : Shake well before using and rub over the affected part. 1^ Thymoli, gr. xx. Fluidextracti aconiti, 3ij. Alcoholis, gj. Misce. Sig. : Paint over painful area and cover with a cotton compress and oiled silk. Indication: For facial neuralgia. Ifc Croton-chloralis, 3j. Pone in capsulas no. xx. Sig. : One capsule every two hours until re- lieved from pain. Indication: Used for relief of pain in neu- ralgia of 'the fifth nerve. I£ Tinct. cannabis Indicse, f3vj. Syrup i acacia?, f3iss. Aqua? destillatse, q. s. ad fgvj. Misce. Sig. : A tablespoonful every four to six hours. Indication: In sciatica. fy Thymoli, 3j. Camphorse, 3j. Alcoholis, fgj. Misce. Sig. : Apply over painful area with a brush. Indication: Used in neuralgia of superficial nerve. Hand-Book of Modern Treatment. 313 I£ Olei ricini, Siij- Olei cinnamomi, m v. Misce et pone in capsulas no. xxiv. Sig. : Four capsules at bedtime every second or third night. Indication : Castor oil has been found valu- able in the treatment of many persistent and severe forms of neuralgia, as well as in acute cases. If patient desires, the oil may be given floated upon coffee, soda water, or beer, instead of in capsules. IJ Ferri reducti, gr. c. Acidi arsenosi, gr. iv. Phosphori, gr. j. Ext. nucis vomicae, gr. xxv. Misce et fiant pilulse no. c. Sig.: One pill after each meal. Indication: Used in anaemic and debilitated cases. NEURASTHENIA. Pitres describes the mental state of the neurasthenic ac- cording to the ideas of Dr. de Fleury. The patient is con- tinually lamenting, watching himself minutely, and trying to analyze and to explain each trifling change noted. He is affected by his present ills; fears those to come; is sad, timid, discour- aged, and at times melancholic. The cause of this condition is fatigue, either from overwork or from some previous illness. These cases show a loss of will-power and of action. Both mus- cular exercise and prolonged thought or attention are impos- sible. Lassitude and pessimism result. Suggestion has no in- fluence upon his state of mind, but the weather, stimulants, time of day, etc., show their effects. Dr. Fleury considers this a con- dition of true fatigue, due to a diminution of vital force. The gray matter, from excessive sensation or some intoxication, shows hypovitality and a marked decrease in functional power. The neurons are but half -awake to stimuli. The psychical state of the neurasthenic is but the expression of the reduced physical condition. Thus the distinction from hysteria is plain, for in hysteria the idea, purely psychical, is diseased, the body remain- 314 Hand-Book of Modern Treatment. ing unaffected. So in the treatment of hysteria hypnotism works wonders, while rest, tonics, and hygiene will cure neu- rasthenia. The standard for the success of our treatment is the ques- tion whether the color of our patient is improving and later whether the flesh is becoming firmer and the weight increas- ing. Patients have been known to gain as much as forty pounds in twelve weeks' time, and Mitchell regards gain in weight as the most valuable index of a successful treatment. He considers it of more value than the persistence of backache, headache, or other general nervous feeling. These symptoms in the majority of cases grow fainter and fainter until they disappear. Where these symptoms appear to be permanent, it is undoubtedly true that actual changes have taken place in the nerve-cells. For the neurasthenic condition, as a tonic I prefer strych- nine sulphate, 1 / 16 or 1 / 20 grain before meals, and after meals give :— I£ Hydrargyri chloridi corrosivi, gr. 1 / 32 . Acidi phosphorici ( U. S. P. ) , m iv. Liq. potassii arsenitis, m ij. Tinct. ferri chloridi, m x. Syrupi limonis, q. s. ad 3j. Misce. Sig. : One dose after meals. Applications of cold water with friction with palm of hand to chest, abdomen, and back daily are very stimulating. Full warm bath at bed-time for sleeplessness, followed by brisk, cold rubbing. B Asafoetidse, 3j. Acidi arseniosi, gr. ss. Strychninse sulphatis, gr. ss. Ext. sumbul, 9 iss. Ferri subcarbonatis, ©ij. Quininse valerianatis, 3j. Misce et pone in capsulas no. xxiv. Sig. : One capsule after each meal. Hand-Book of Modern Treatment. 315 The diet must be regulated with particular attention to the blood-pressure. For high tension, a milk diet is given with massage and warm vapor baths, and liquids at meals are pro- hibited. For low tension, good food, meat, regulated exercise, baths, rest, deep massage, saline injections, and oxygen inhala- tions are prescribed. I£ Tinct. nucis vomicae, m iv. Acidi phosp. diluti, ni iv. Glycerini, m x. Fluidextracti gentianae, m ij. Alcoholis diluti, m xv. Vini xerici, q. s. ad f3j. Misce. Sig. : One teaspoonful three times daily one hour after meals. R, Acidi arsenosi, gr. ss. Ext. nucis vomicae, gr. v. Ferri reducti, gr. ij. Misce et fiant pilulae no. xx. Sig.: One three times daily after meals. IJ Auri.et sodii chloridi, gr. ij. Pulv. resinae guaiaci, gr. c. Misce et pone in capsulas no. xx. Sig. : One capsule one-half hour before each meal. NEURITIS. 3 Quininae salicylatis, gr. iij. Codeinae, gr. %. Quininae sulphatis, gr. j. Misce et fiat capsula no. j. Sig.: One such capsule every four hours. B Strychninse sulphatis, gr. 1 / 25 . Caffeine, gr. j. Quininae sulphatis, gr. ij. Misce et fiat capsula no. j. Sig. : One capsule every three hours. 316 Hand-Book of Modern Treatment. Mircoli strongly recommends the local application of tur- pentine in neuritis resulting from exposure to cold, and in sciatica especially. He recommends the following: — I£ Terebinthinse (Venetian), gj. Dissolve in Olei terebinthinse, 3ij. Olei olivse, §iss. Misce. Sig. : Apply locally once or twice daily with friction. The resin remaining will exert a con- i tinuous action upon the skin after each appli- cation. NIPPLES, SORE.— See Fissures. I£ Tinct. benzoini comp., f3ij. Listerinse, f3iv. Aquae camphorae, q. s. ad f^iij- Misce. Sig.: Shake. Bathe nipple and apply freely after each nursing. Indication : Used to prevent and heal fis- sures. I£ Tinct. benzoini comp., f3ss. Spiritus camphors, m xvj. Olei olivse, f3ij. Adipis lanae'hydrosi, q. s. ad 3j. Misce. Sig. : Apply freely to nipple after each nursing. Indication: Fissure of nipples. The following combination has been recommended in the treatment of cracks or fissures in the nipples : — IJ Phenolis, gtt. xv. Aquae laurocerasi, 3j. Glycerini, 3j. Sol. acidi borici (saturated), Oj. Misce. Sig.: Apply freely to the affected areas. Hand-Book of Modern Treatment. 317 Ifc Gutta-percha, gr. xx. Spiritus chloroform!, q. s. to dissolve. Misce. Sig. : Apply after each nursing. Fissure of the nipple has been very successfully treated by many physicians with orthoform. A few drops of a saturated solution of orthoform in 80-per-cent. alcohol is applied directly to the crack, and a dry compress is then placed above. As the pregnancy nears the end, the nipples demand spe- cial attention, not only to keep the mouths of the ducts and the crevices clean, but to render them hard and firm so that the epithelium may not be so readily removed by the infant in its early attempts at sucking. For this purpose there is nothing so good as frequent bathing, accompanied by gentle friction, with a saturated solution of boric acid in dilute alcohol. B> Olei rieini, 3ij. Bismuthi subnitratis, 3ij. Misce. Sig. : Apply freely to the sore nipple. Indication: Sore or cracked nipple. B> Olei olivse, 3ss. Adipis lanse hydrosi, %ss. Vaselini, §ss. Acidi borici, gr. xx. Misce. Sig. : Smear nipples gently. Cover with an- tiseptic gauze. Fissured nipples, when painted with a 2- to 5-per-cent. potas- sium-permanganate solution several times a day, will, according to Dombrowsky. rapidly heal. The excoriations disappear in about a week. The first applications cause a slight burning sensation, which, however, rapidly disappears. The treatment does not conflict with the nursing of the infant; however, in order that the nursling may not absorb any of the remedy while nursing, the nipple should be washed with a little warm water before the child is put to the breast, and the affected region should be covered with some impermeable material in which a small hole has been made for the nipple. 318 Hand-Book of Modern Treatment. Ifc Liq. ferri subsulphatis, f3ij. Glycerini, f3vj. Misce. Sig. : Apply with camel's hair brush to the nipple. NYMPHOMANIA. 1$ Sodii arsenatis, gr. ss. Hyoscinae hydrobromatis, gr. 1 / s . Potassii bromidi, 3j. Misce et fiant tabellae compressae no. xxx. Sig. : One tablet after meals. All sources of local irritation should be removed. I£ Potassii iodidi, gss- Aquae, f^ss. Misce. Sig.: Five drops three times daily after meals. OBESITY. The appended outline is the treatment for obesity recom- mended by the Journal of the American Medical Association, February 3, 1906 :— In outlining a treatment for obesity, the causes must be carefully looked into. In certain instances there is something wrong with the metabolism, consequently in the treatment, overeating, excessive drinking, sedentary life, increased con- sumption of fats and carbohydrates must be carefully regu- lated. Not infrequently a history of gout or diabetes is ob- tained, or perhaps anaemia in some form is present. The age of the patient must also be taken into consideration when a re- duction of fat is to be considered. Young individuals can not withstand such great and rapid reductions as those further along in life. In any case, in reducing flesh a gradual reduction should be the rule, and when a patient has lost from ten to fifteen pounds, after being placed on a strict diet, the diet should be made more liberal for a time. We can not recom- mend the administration of any preparations in a general way without a complete knowledge of the individual case. Thyroid Hand-Book of Modem Treatment. 319 extract is a preparation which is a valuable agent in some cases in the reduction of fat. It may be given in 5-grain doses three or four times a day; its effect on the heart, circulation, and nervous system must be carefully watched, as it is very liable to produce an increased nervous condition and to cause subjective symptoms of the heart. About all that can be recommended in this case is placing the patient on a system of diet purported to such reduction of fat. We would recommend that form of diet advised by Banting, Oertel, Ebstein, Weir Mitchell, or Yeo. Yon Xoorden, in Nothnagel's Handbuch, recommends the fol- lowing diet list in such cases: At 8 o'clock, 80 grams of lean cold meat, 25 grams of bread, one cup of tea, with milk and no sugar. At 10 o'clock, one egg. At 12 o'clock, one cup of strong broth. At 1 o'clock, a small plate of meat soup, 150 grams of lean meat, flesh or fish; 100 grams of potatoes with salad ; 100 grams of fresh fruit. At 3 o'clock, one cup of black coffee. At 4 o'clock, 200 grams of fresh fruit. At 6 o'clock, one-quarter liter of milk with tea. At 8 o'clock, 125 grams of cold meat, or 180 grams of meat, raw and grilled, and eaten with radishes and salads ; 30 grams of graham bread, and two or three teaspoonfuls of cooked fruit with sugar. I£ Magnesii citratis effervescentis, Sviij. Sig. : Tablespoonful in water before break- fast. Indication: Used as an adjunct to strictly regulated diet and exercise. From the fact that borax exercises in animals and man an inhibitory action upon the processes of nutrition, M. C. Ger- hardt conceived the idea of employing this salt in the treatment of obesity. He found that in the dose of 1.50 grams (nearly 24 grains) a day taken in three doses, borax is well supported and reduces excessive corpulence. In smaller quantities it pro- duces no appreciable effect in diminishing fat. B Tabellae glandulee thyroideae, gr. v. No. xxx. Sig. : One tablet after each meal and cau- tiously increased. 320 Hand-Booh of Modern Treatment. (EDEMA.— See Dropsy. O'Donovan finds that atropine is a remedy that rapidly contracts the vessels, powerfully stimulates the sympathetic sys- tem, increases the force of the heart's beat, raises arterial ten- sion, stimulates the respiratory centers, and dries up the secre- tions of the skin and mucous membrane. Its physiological ac- tion can be easily gauged by watching the amount of dilata- tion of the pupil. It is well to supplement it with some drug that acts promptly and surely as a direct stimulant to the heart, strychnine preferably. In cases of acute pulmonary oedema he has seen relief from the hypodermic injection of 1 / 100 grain of atropine with 1 / 50 grain of strychnine sulphate so immediate and complete that it seemed like magic. The pulse should be watched to see that the effect is not merely transitory. Time should not be wasted on remedies through the stomach, but the hypodermic method should be used at once. B Pulv. digitalis foliorum, gr. xx. Hydrarg. chloridi mitis, gr. xx. Pulveris scillae, gr. xx. Misce et fiant chartulae no. xx. Sig. : One powder after meals. Indication: (Edema due to cardiac disease. IJ Antimonii et potassii tartras, gr. ij. Pulveris scillse, 3j. Potassii sulpliatis, £ss. Potassii bitartratis, £iss. Misce et fiant chartulae no. xx. Sig. : One powder four times daily. Indication: Useful in general oedema. IJ Triturationis elaterini, gr. ij. Fiant chartulae no. xxx. Sig. : One powder on tongue every hour until nausea is produced or bowels begin to move. Indication: Cardiac oedema. IJ Liq. potassii arsenitis. Sig.: One drop to three in a half-glass of water after meals. Indication: In oedema in feet of old people. Hand-Book of Modern Treatment. 321 IJ Potassii iodidi, 5ss-Sj. Aquae destillatae, fgvj. Misce. Sig. : A tablespoonful three times daily. Indication: Useful in anasarca with scanty urine. ONYCHIA. B Thymol-di-iodidi, 3ij. Sig. : Apply freely and cover with antiseptic gauze, after removing diseased portions of matrix. I£ Pulv. plumbi nitratis, £ ss - Sig. : Dust on part affected twice daily. OPHTHALMIA.— See Conjunctivitis, Purulent. The secretions should he thoroughly removed from the lids by means of absorbent cotton, and the following lotion applied : — IJ Potassii perman., gr. v. Aquas destillatae, Oij. Misce. Sig. : To be used as an irrigation to the lids. Three or four hours later the following should be applied locally : — I£ Argenti nitratis (crys. ), gr. iij. Aquae destillatae, 3v. Misce. Sig.: To be applied locally by means of an applicator. This should be neutralized by a . solution of sodium chloride. Tf a 1- or 2-per-cent. solution of silver nitrate gives no relief in two or three days, it should be increased to 4 or 5 per cent. In case of corneal infiltration or ulceration, the silver nitrate should not be allowed to come in contact with the cornea. In such cases the following ointment should be applied: — 21 322 Hand-Book of Modern Treatment. IJ Iodoformi (dissolved in ether), gr. iv. Vaselini (neutral), 3iiss. Misce. Sig. : Apply locally. If perforation seems probable, instill a few drops of a 4- per-cent. solution of atropine into the eye. In ophthalmia neonatorum and all forms of catarrhal conjunctivitis : — I£ Hydrastin. hydrochlor., gr. iv-vj. Acidi borici, gr. xx. Tinet. opii deod., 3ij. Aquse destillatse, 3iv. Misee. Sig. : Eye lotion. SODIUM CACODYLATE IN" OCULAR AFFECTIONS. This salt has been employed internally in the treatment of various ocular affections with good results, particularly in rebellious herpetic keratitis. Galezowski has employed it locally in the eye in the form of an oily or aqueous collyrium as fol- lows : — * Ifc Cocainse hydrochloratis, gr. iv. Liquid vaselini, 3iv. Sodii cacodylatis, gr. ij. Misce. Sig. : A few drops in the eye two or three times daily. Calomel will meet the same indications as nitrate of silver in ophthalmia neonatorum, for which the latter drug is consid- ered almost a specific, and it has not the same inconveniences. The conjunctivae should be carefully cleansed with a solution of boric acid and then dried with tampons of cotton, and the calomel carefully dusted over the mucous membrane in a thin layer. The method is applicable among the poor, as it requires to be repeated but once a day, and in the vast majority of cases is followed by a prompt amelioration of the symptoms, the dura- tion of many of the cases not exceeding seven days. The au- Hand-Book of Modern Treatment. 323 thor's observations are based upon fifty-seven cases of ophthal- mia in which gonococci were noted in the discharge. Ifc Argenti nitratis, gr. x. Aquae destillatae, f§j. Misce. Sig. : Bathe the eyes frequently, remove all pus, and apply the above locally, followed by a solution of sodium chloride. IJ Protargolis, gr. xxv-c. Aquae destillatae, f^j. Misce. Sig. : To be applied to the everted lids twice daily after cleansing with a solution of boric acid. OPIUM HABIT. I£ Tinct. nucis vomicae, gtt. xij. Acidi phosphorici diluti, gtt. xx. Syr. pruni virginianae, f§ss. Misce. Sig. : To be taken twice daily. IJ Tinct. moschi, f3vj. Tinct. hyosciami, f3ij. Tinct. cannabis Indicae, f3iv. Spiritus camphorae, f3ii. Misce. Sig. : Teaspoonful every two to four hours. Indication: For restlessness and insomnia following withdrawal of opiates. ORCHITIS. B Ung. hydrarg., 3ij. Adipis lanae hydrosi, 3vj. Ichthyoli. 3j. Extracti belladonnae, gr. x. Misce. Sig. : Apply externally twice daily and then follow with a suspensory bandage. 324 Hand-Booh of Modern Treatment. B .Timet, iodi, fgss. Sig. : Apply locally to swollen testicle. B Tinct. opii, f3iv. Liq. plumbi subacetatis, f3iv. Misce. Sig. : Add pint of water and use locally. P* Guaiacoli, 3iv. Sig. : Paint a few drops twice daily. Indication: Used in acute stage while tes- ticle is supported by a suspensory bandage. OTITIS AND OTORRHCEA. I^ Ichthyoli, gr. xv. Glycerini, 3ij. Aquse destillatse, 3ij. Misce. Sig. : Instil into the ear thrice daily several drops of this mixture. Indication: Acute otitis. P* Phenolis, gr. ij. Mentholis, gr. iij. Eucalyptolis, mx. Olei pini pumil., m x. Benzoinolis, q. s. ad §j. Misce. Sig. : Use as a nasal spray and inhalant. In influenza, scarlet fever, measles, diphtheria, inflamma- tion of the nasal accessory cavities with purulent discharge into the naso-pharynx, it is of the greatest importance that the in- fection be prevented from gaining an entrance to the middle ear. To accomplish this the nasal cavities and naso-pharynx should be thoroughly irrigated at least four times in the twenty- four hours — i.e., once in six hours — with quantities of a warm, alkaline, cleansing solution. Immediately after the irrigation let the patient gently blow out the nostrils to rid them of any super- fluous solution and then spray into each nostril, having the patient inhale at the same time a few whiffs of some antiseptic protective as the above prescription. Hand-Book of Modern Treatment. 325 I£ Liq. plumb, subacet. dil., gtt. xx. Acidi acetici dil., gtt. vj. Vini opii, gtt., xx. Aquae destillatae, 3j- Misce. Sig. : Instill several times daily ten drops of the above mixture. Indication: Useful in otorrhoea. IJ Ferri chloridi, 3ss. Alcohol is, f3j. Aquae destillatae, f3j. Misce. Sig. : Three or four drops to be instilled into the external auditory meatus two or three times daily. Indication: Useful in otorrhcea. R. Nosopheni, 3ij. Sig. : Use as a dusting powder. Ifc Glyceriti acidi tannic!, §ss. Sig. : Fill the meatus and plug with cotton wool. Indication: Used in the chronic form. Ifc Aquae hydrogenii dioxidi, fgv. Sig. : Syringe the ear carefully with one part of solution to two of water, and when cleansed instill a few drops of the above solu- tion. Hot water is injected into the affected ear, which is then painted with : — I£ Phenolis (crystals), gr. xv-lxxv. Glycerini pur., m lxxv-cl. Misce. Sig. : Use locally. Later, when the flow has diminished, use : — IJ Glycerini pur., m cl. Hydrarg. chlor. cor., gr. 3 / w - z / & . Misce. Sig. : For local use. Indication: Chronic otorrhcea. 326 Hand- Book of Modem Treatment. Carbolated glycerine, besides acting as a cure, has a dis- tinct analgesic action in otorrhcea. N. G. Ward has obtained the best results in the treatment of suppurative middle-ear disease with formalin. The ear is thoroughly cleansed, and if the pus is not discharging and is abundant an incision is made in the drum at the postero-in- ferior quadrant. After cleansing, an aqueous solution of forma- lin, 5 drops to the ounce, is instilled. As a cleansing lotion, lysol, 15 to 30 drops in half a glass of warm water, is used with a soft-rubber pus-syringe. When the discharge no longer blocks 'the canal all syringing is stopped. In those cases not requiring syringing, and also ten minutes after syringing in those that do, the patient is directed to lie down on the opposite side, and 5 to 10 drops of the formalin solution, slightly warmed, is poured into the ear. The patient remains in this position to allow the fluid to penetrate and reach the tympanum. This is repeated night and morning. In acute cases 1 to 3 drops of for- malin to the ounce is sufficient; in chronic and obstinate cases alcohol is added, as follows : — 1$, Formal ini, gtt. v. Alcoholis, f3ij. Glycerini, f3ij. Aquae, q. s. ad f§j. Dr. Ward has treated forty cases by this method. In thirty-five cases the discharge ceased entirely in from three to fifteen days, the average being a week. There was improvement in the other cases, though no cessation of discharge. In two of them there was necrosis of bone. B Resorcini, gr. ix. Tinct. opii, m ix. Aquae destillatae, f3j. Misce. Indication : Purulent otitis media. The meatus is first washed out with a tepid boric acid solu- tion and then dried with absorbent cotton. From 8 to 15 drops of the above mixture, rendered lukewarm, are then instilled into the passage, where they are retained for from twenty to thirty Hand-Book of Modem Treatment. 327 minutes by bending the head toward the healthy side. The in- stillation is practiced once a day, and under its influence the otorrhcea disappears in from one to three weeks. This applica- tion is equally useful in furunculosis of the auditory canal and acute myringitis. Geronzi reports the result of formalin treatment of 55 cases of chronic purulent otitis media. He commenced with a 2-per-cent. glycerine solution and gradually increased the strength to 5-per-cent. The middle ear was tamponed with a small strip of gauze impregnated with the fluid, or two or three drops of the 5-per-cent. solution were instilled. This treatment was applied in those cases that had proved rebellious to ordin- ary measures. Improvement was manifest by the second or third application; and a complete cure between the tenth and fifteenth application was obtained in 31 out of the 55 cases. The duration of the affection in some of the cured cases was from 10 to 21 years. The formalin reduced the size of the granulations in the tympanum and, supplemented by silver nitrate, was able to accomplish their complete disappearance in a number of cases. He found that the addition of 5-per-cent. sodium carbonate to the 5-per-cent. solution of formalin in- creased the tolerance, while others have proved that it also enhanced its bactericidal power. I£ Potassii iodidi, gr. xxx. Tinct. iodi, Sij. Alcoholis, 3j- Glycerini, 3vj. Iodoformi, gr. xxx. Misce. Sig. : Inject into outer ear. Indication: Chronic otorrhcea. OXALURIA. Microscopical urinary sediments frequently contain few or many calcium-oxalate crystals. Physiologically this deposit may be due to the ingestion of one of many fruits or vegetables, such as beets, rhubarb, tomatoes, spinach, cauliflower, celery, carrots, beans, asparagus, apples, pears, grapes, peas, and cab- 328 Hand-Book of Modern Treatment. bage. Claret and effervescing drinks have the same effect. Oc- casionally when the urine stands for some time, calcium-oxalate crystals may form urates and uric acid. Pathologically oxal- uria is noted especially when there is defective digestion of fats and carbohydrates, with nervous and flatulent dyspepsia. The classical symptoms of oxaluria, due to indigestion as well as the irritation of the hard, sharp crystals, are vesical tenesmus and pain across the back, sometimes extending down the thighs or into the testicles; sexual neurasthenia, and hypochondriasis. 1$ Acidi nitrohydrochlorici diluti, 3ij. Tinct. gentianse comp., f§j. Tinct. cinchonae comp., fgj. Elixiris curacace, q. s. ad f^iij- Misce. Sig. : A dessertspoonful in water through a glass tube. B Acidi nitrohydrochlorici, f^ss. Sig. : Three drops in half a glass of water after meals, through a tube. Ifc Tinct. ferri chloridi, 3iss. Acidi hydrochlorici diluti, §ss. Aquae destillatae, q. s. ad §viij. Misce. Sig. : A tablespoonful three times a day through a glass tube. Indication: With anaemia and nervous atony. OZiENA. 1$ Thymoli, gr. ss-j. Spiritus vini rect., 3ss. Glycerini, 3ss. Aquae, q. s. ad 5j- Misce. Sig.: To be used as a stimulating spray. Bonnet speaks highly of nasal irrigation with a 2 1 / 2 -per- cent. solution of methyl-blue, practiced at first three times, and later once, daily. This method has the inconvenience of staining Hand-Book of Modern Treatment. 329 the nasal orifice and upper lip of a bluish tint, but it causes rapid disappearance of the foul odor, and a cure is commonly attained in three or four weeks. Dr. Sidlo claimed to have cured many cases of ozsena by daily washing out the nasal cavities with a 2-per-cent solution of chloride of potassium to which 10 per cent, of glycerine had been added. This is followed by inserting rolls of cotton in a mixture of 1 part of glycerine and 3 parts of water, the tam- pons to remain in place for one hour. IJ Hydrarg. amnion iati, gr. iv. Pulv. sacehari alb., £ss. Sig. : To be used as snuff after thoroughly blowing the nose. I£ Syr. ferri iodi, §j. Sig. : Five drops increased to thirty, thrice daily, after meals. I£ Sodii biboratis, gr. xx. Ammon. chloridi, gr. xx. Potassii permanganatis, gr. x. Sig.: Dissolve in one pint of water and use thrice daily with a syringe or douche. 1^ Aquse hydrogenii dioxidi, f^vj. Sig. : Two tablespoonfuls with a teaspoonful of borax, to a pint of tepid water used as a nasal douche several times daily. IJ Resorcini, 3ss. Glycerini, f3ij. Aquae destillatse, q. s. ad f^iv. Sig. : Use as a nasal spray every second day after using alkaline wash. Indication: Used to check secretion, heal ulcers, and prevent fcetor. B Aquse cinnamomi, 3j. Ext. hamamelid., §j. Liq. hydrogenii dioxidi, 5j- Misce. Sig. : Use two teaspoonfuls as a nasal douche twice daily. 330 Hand-Book of Modern Treatment. I£ Hydrarg. chloridi mitis, gr. xv. Sacchari albi, 3iv. Misce. Sig. : Used for insufflation. PALPITATION.— See Heart Disease. 1$ Sodii bromidi, q. s. Sig. : Ten to thirty grains once or twice daily, and ice-bag to the heart. Indication: Useful in emotional or nervous palpitation. B Tinct. digitalis, fgj. Sig. : Ten minims three times daily. Indication: In irritable heart with palpita- tion. 1$ Tinct. digitalis, m x-xx. Tinct. calumbse, f3j. Aquse camphor ae, f3x. Misce. Sig.: One dose twice daily. Indication: Nervous palpitation. B Tinct. aconiti, f3ij. Tinct. digitalis, m xlv. Tinct. belladonna?, f3iss. Tinct. gentianse comp., q. s. ad f§iij. Misce. Sig. : Teaspoonful every six hours. Indication: In palpitation with cardiac hy- pertrophy. 1$ Pulveris digitalis, gr. v. Pulveris scillse, gr. x. Pilulse hydrargyri, 3ss. Misce et fiant pilulse no. x. Sig. : One pill three times daily. Indication: Palpitation with anasarca. I£ Acidi hydrochlorici diluti, Sss. Sig. : Five minims in water after meals. Indication: In simple palpitation as an aid to digestion. Hand- Book of Modern Treatment. 331 I£ Potassii citratis, 3ij. Tinct. stramonii, f3j. Tinct. colchici seminis, f3ij. Infusi digitalis, f^iij- Aquae menthae pip., q. s. ad Sviij. Misee. Sig. : Two tablespoonfuls three times daily. Indication: In violent palpitation. PARALYSIS. B Sodii salicylatis, 3iij. Aquae, q. s. ad §iij. Misce. Sig. : One teaspoonf ul in two ounces of water and injected into the rectum three times daily. Indication: Acute ascending paralysis. Ifc Potassii iodidi, £j. Tinct. gentianae comp., q. s. ad f§vj. Misce. Sig. : Teaspoonful in water after meals. Indication: Used in hemiplegia after acute inflammation has subsided. Ifc Strychninae sulph., gr. j. Aquae destillatae, f3x. Misce. Sig. : Ten minims contains gr. 1 / 80 . Inject ten to twenty minims into substance of the muscle paralyzed. Indication: In diphtheritic paralysis. R Extracti physostigmatis, gr. iij. Extracti taraxaci, gr. xxiv. Misce et fiant pilulae no. xxx. Sig. : One pill every three hours. Indication : In locomotor ataxia, writer's cramp, etc. 332 Hand-BooJc of Modern Treatment. PARALYSIS AGITANS. IJ Sulphatis hyoscyaminee, gr. ss. Aquse destillatse, 3vj. Misce. Sig. : Five minims hypodermically once daily, or by stomach twice daily. Indication : In paralysis agitans. IJ Stryclminse sulphatis, gr. j. Acidi arsenosi, gr. ij. Ext. belladonnae, gr. v. Quininse sulphatis, gr. xx or xl. Pilulse ferri carbonatis, gr. xx or xl. Ext. taraxaci, gr. xx. Misee et fiant pilulse no. xl. Sig. : One pill three times daily. Indication: In paralysis agitans. PARTURITION.— See Labor. PEDICULL— See Lice. PEMPHIGUS. IJ Liq. potassii arsenitis, f3ij. Aquse destillatse, q. s. ad f^iij. Misce. Sig.: Begin with twelve drops t.i.d. and increase to from 48 to 60 drops after meals. 1$. Liniment' calcis, §ij. Sig. : Ap^iy after the bullae have been punc- tured. Parts should be fixed and no motion allowed. Indication: Used in painful cases. IJ Ung. zinci oxidi, §ss. Sig. : Apply locally. IJ Sodii arsenitis, gr. ss. Quininse hydrochloratis, 3j. Massse ferri carbonatis, 3ss. Misce et fiant pilulse no. xxx. Sig. : One pill after meals. Indication: Used in anaemic subjects. Hand-Book of Modern Treatment. 333 IJ Calaininse, Sij. Zinci oxidi, fSij. Liq. calcis, gij* Acidi borici (sat. sol.), q. s. ^viij. Misce. Sig. : Apply freely several times daily. I£ Pulv. acidi borici, §ss. Talci, Sss. Zinci oxidi, 5ss. Misce. Sig. : Apply freely. PERICARDITIS. Ifc Infusi digitalis, fSiv. Potassii acetatis, 3ij. Spiritus aetheris nitrosi, fSij. Aquae cassias, f^iss. Misce. Sig. : Tablespoonful every fourth hour. Indication: With pericardiac effusion. I£ Tinct. aconiti, fgss. Sig. : One drop every hour until pulse be- comes soft and heart quieted, then one drop every three hours. Indication: In acute stage with strong heart, and ice-bag over prsecordium. I£ Aspirni, gr. xxiv. Pone in capsulas no. viij. Sig. : One powder twice daily. Indication: Rheumatic pericarditis. I£ Sodii iodidi, Sj- Syrupi sarsaparillae comp., q. s. ad §iv. Misce. Sig. One teaspoonful after meals. Indication: In pericarditis with effusion. PERIOSTITIS. B Ung. plumbi iodidi, gj- Sig.: Apply twice daily. Indication : Used in chronic periosteal thick- ening. 334 Hand-Book of Modern Treatment. IJ Cadmi iodidi, 3ij. Ichthyoli, f3iv. Adipis lanae hydrosi, q. s. ad Sij. Misce. Sig. : Spread upon new cloth and apply to affected area. 1$ Potassii iodidi, 3ij. Amnion, iodidi, 3j. Tinct. cinchona? comp., f^iij- Misce. Sig.: A teaspoonful well diluted in water after meals. I£ Potassii iodidi, 3ij. Misce et fiant chartula? no. xij. Sig. : One in glass of milk morning and evening. I£ Syr. ferri iodidi, Sig. : Ten to fifteen drops in water after meals. Indication: In syphilitic or tubercular peri- ostitis. B Ung. hydrargyri, &]. Sig. : Apply over the affected area by inunc- tion or upon a new cloth daily. Indication : Used in syphilitic periostitis. PERITONITIS. IJ Morphinse sulphatis, gr. viij. Aquae destillatse, f§iv. Misce. Sig. : Begin with a dessertspoonful and wait two hours. If no effect give three tea spoonfuls and wait two hours. If still no effect give four teaspoonfuls and wait two hours. The medicine should be increased gradually to produce these effects, to allay pain, to produce gentle sleep, to reduce the respiration to twelve per minute. When aroused continue these effects two days and then gradually diminish the dose, but if symptoms return, increase again. Eand-Book of Modern Treatment. ?>35 B Guaiacoli carbonatis, gr. xx. Pone in capsulas no. xx. Sig. : One capsule after each meal and grad- ually increased. Indication : Tubercular peritonitis. I£ Magnesii sulphatis, §iss. Fiant chartulss no. xij. Sig. : One powder in hot peppermint water every hour until the bowels are freely opened. Indication: In acute peritonitis. Jfc Acetanilidi, gr. xxx. Fiant chartulse no. xv. Sig. : One powder every three or four hours for vomiting. Indication: Used to allay vomiting. I£ Olei terebinthinae, 3j. Emulsi asafcetidse, f^viij. Misce. Sig. : Warm, shake well, and inject in rec- tum. Indication: Used to relieve tympany. I£ Tinct. opii deodorati, f§j. Tinct. aconiti, 3ij. Misce. Sig. : Six to eight drops in water every two hours. B Olei terebinthinae, gvj. Sig. : Put a piece of flannel in hot water and then wring it out. Then dip it in the warm turpentine and wring again. Then spread over the abdomen. Indication: Used in tympany. B Linimenti hydrarg., fgv. Sig. : Daily inunctions over the abdomen and the application of flannel abdominal binder, which is not to be changed when soiled. Indication: In tubercular peritonitis. 336 Hand-Book of Modern Treatment. 1$ Syrupi ferri iodidi, f3ij. Olei morrhuae, f§iss. Misce et pone in eapsulas no. xxiv. Sig. : One capsule after each meal. Dose gradually increased to three capsules. Indication: Used in tubercular peritonitis. PERTUSSIS.— See Whooping Cough. PHAGEDENA. 1$ Acidi salicylici, Sss. Sig. : Dust over the slough. Ifc Potassii permanganatis, 3ss. Aquae, Oj. Misce. Sig. : Apply locally. PHARYNGITIS. I^ Tinct. ferri chloridi, m xxiv. Potassii chloratis, gr. xxiv. Syr. zingiberis, f^j. Aquae, q. s. ad f^iij- Misce. Sig. : Teaspoonful every two hours for a child of two years. I£ Ergotini, 3j. Glycerini, 3vj. Aquae destillatae, 3j. - Sig. : Use as a spray every one-half hour. One-tenth grain of ergotin by mouth may be used as an adjuvant. Indication: Acute pharyngitis. I£ Sodii bicarbonatis, 3iv. Sodii biboratis, 3iv. Sodii chloratis, 3iv. Potassii bicarbonatis, 3iv. Misce. Sig. : A quarter of a teaspoonful in a quar- ter of a glass of tepid water, and used by in- sufflation and gargle. Hand-Book of Modern Treatment. 337 I£ Iodi, gr. iij. Potassii iodidi, gr. v. Acidi trichloracetic!, gr. vij. Glycerini, f^ss. Aquae, fgss. Misce. Sig. : To be applied locally. Indication : Follicular pharyngitis. R> Aluminis, 3iss. Tinct. opii, 3ss. Mellis, 3ij. Syr. rosae (B. P. ), 3iij. Aquae, q. s. ad 5viij. Misce. Sig. : To be used as a gargle. B> Tinct. capsici, 3ss. Acidi tannici, 3ss. Infus. rosae acidi, Biij. Aquae, q. s. ad 3 V - Misce. Sig. : To be used as a gargle. Indication: When the throat is relaxed and reddened. I£ Aluminis, 3iv. Acidi tannici, 3j. Mellis, Sj- Aquae rosae, q. s. ad Sviij. Misce. Sig. : To be used as a gargle. I£ Amnion, chloridi, 3ss. Mellis, Sss- Syr. rosae, gss. Aquae, q. s. ad £vj. Misce. Sig. : As a gargle several times during the day. Indication: This and the following one are used as gargles in the chronic form. 338 Hand-BooJc of Modern Treatment. I£ Glycerin! acidi carbol. (B. P.), 3iiss. Acidi tannici, 3j. Tinet. capsici, 3ss. Infusi rosse acidi, q. s. ad svj. Misce. Sig. : To be used frequently as a gargle. In the chronic form of pharyngitis, Ingals recommends eliminants and tonics. Arsenous acid internally is also advised, combined with nux vomica, as follows: — I£ Acidi arsenosi, gr. j. Ext. nucis vomicae, gr. x. Ext. cascarae sagradae, gr. xij. Misce et fiant capsular no. xxiv. Sig. : One capsule before each meal. For chronic follicular pharyngitis, place half an ounce of pine tar in a pint bottle, and add to it ten ounces of 95 per cent, alcohol. Mix by shaking. Label the bottle "pine tar IJ" and keep for future use : — IJ Picis liquidae, 3iij. Glycerini ext. laurocerasi, 3j. Aquas, q. s. ad §iv. Misce. Sig. : Dose, a teaspoonful every two to six hours. Hold the dose in the throat for some little time, to get its soothing, healing influ- ence. Indication: Useful in chronic follicular pharyngitis. For a more drying effect, add belladonna. To stop a cough, add paregoric. IJ Pilocarpines hydrochloratis, gr. ij. Aquae, f^j. Glycerini, f^j. Misce. Sig. : A teaspoonful thrice daily. Indication: In atrophic or dry pharyngitis. Hand-Book of Modern Treatment. 339 Ifc Tinct. ferri chloridi. Sig. : Ten drops in water through a glass tube every two hours. Indication : Used in ulcerative infectious pharyngitis. I£ Tinct. aconiti, m vj. Sodii salicylatis, 3ij. x\quse menthse pip., f^iij- Misce. Sig. : Teaspoonful every hour. Indication: Used in acute pharyngitis with moderate fever and circulatory excitement. PHLEGMASIA ALBA DOLENS. IJ Fluidextracti hamamelidis, f^j. Syrupi simplicis, f§ss. Elixiris simplicis, f§ss. Misce. Sig. : One or two teaspoonfuls three or four times daily. I£ Phenacetini, 3ij. Fiant chartulse no. vj. Sig. : One powder every four hours. Indication: For relief of pain. IJ Fluidextracti hamamelidis, f^vj. Sig. : Apply locally. Ifc Tinct, iodi, fgiv. Sig. : Paint along the course of swollen veins on alternate days. 1^ Ung. belladonnse, 3j- Ung. hydrargyri, 3iv. Ichthyolis, f£j. Adipis lanse hydrosi, q. s. ad %W. Misce. Sig. : Apply gently without friction along the course of swollen veins. Indication : Useful in protracted cases. Wrap limb with cotton batting and keep ele- vated on cushions. 340 Hand-Book of Modern Treatment. Ifc Plumbi acetatis, gr. xxx. Tinct. opii, 3iij. Aquae, Oj. Misce. Sig. : Apply locally on gauze to the affected area. I£ Ung. belladonna, 3vj. Ung. zinci oxidi, Sj- Lanolini, 3x. Misce et fiat unguentum. Sig.: Apply locally and wrap the limb in cotton. The patient should be put to bed and the affected limb im- mobilized, after wrapping it in cotton, for thirty days. Locally, along the course of the inflamed vein, the following is applied : — Ifc Olei hyoscyami, 3iiss. Spiritus chloroformi, 3iiss. Misce. Sig. : Apply locally. In the treatment of the chlorotic condition a rich diet is prescribed and the following combination given internally : — I£ Ferri oxalatis, gr. ij. Magnes. carb., gr. iv. Pulv. gentianse, gr. iv. Pulv. rhei, gr. iij. Misce et pone in capsulas no. ij. Sig. : Two such capsules at one dose and re- peated twice daily before meals. PHTHISIS. — See Tuberculosis and Scrofulosis. Methylene-blue (medicinal) has been used largely in malaria, nephritis, gonorrhoea, cystitis, chyluria, and rheuma- tism, but only to a very limited extent in pulmonary tubercu- losis — we have seen but one report in this direction, that by Althen in 1892. Dr. Henry Herbert recently had occasion to use it in a case of malaria associated with phthisis, and was Hand-Book of Modern Treatment. 341 surprised to find the latter disease more benefited by it than the malaria. This led to a trial of it in nineteen other cases of consumption in various stages; 1 / 2 to 3 grains was given three times a day. It was observed that the methylene-blue in larger doses caused nausea and even vomiting; nearly all the cases complained of stranguary, which subsided after a short period; and in most eases the drug produced a sensation of choking — probably in consequence of impeding expectoration. The only advantageous feature noticed consists in a reduction of the amount of expectoration and relief of the cough. Dr. Herbert states that methylene-blue may safely be administered in chronic advanced cases of phthisis with profuse muco-purulent expec- toration, and that it is contraindicated in sensitive and hectic cases. When not accompanied by much expectoration the follow- ing mixture is recommended : — B Codeinse, gr. iv. Acidi hydrochlorici dil., 3ss. Spiritus chlorofornii, 3iss. Syrupi limonis, 3j. Aquae destillatae. q. s. ad 3iv. Mi see et fiat emulsio. Sig. : One teaspoonful at short intervals when cough is troublesome. Indication: Irritating cough. IJ Guaiacoli carbonatis. 3iv. Glycerini. 3x. Sodii chloridi. 3ij. Aqua? menthae pip., 3iiss. Misee. Sig.: Twenty to thirty drops to be taken daily. J£ Crepsoti (beechwood), gtt. xxxij. Tinct. gentianae, f3j. Alcoholis, f^j. Vini albi, q. s. ad §iv. Misce. Sig.: Teaspoonful in water or wine three times daily. 342 Hand-Book of Modern Treatment. IJ Codeinae, gr. iv. Acidi hydrochlorici diluti, m xxx. Spiritus chloroformi, f3iss. Syr. limonis, f5j. Aquae, q. s. ad f§iv. Misce. Sig.: One teaspoonful as necessary. Indication: To control cough. IJ Spiritus chloroformi, fgss. Morphina3 sulphatis, gr. i or ij. Syr. pruni Virginianae, f^iij. Misce. Sig.: Teaspoonful every four hours. Indication: To relieve excessive cough. IJ Guaiacoli carbonatis, 3ij. Dionini, gr. ij. Misce et fiant chartulae no. xxiv. Sig. : One powder three or four times daily. Indication : Used in early stages to improve conditions of bronchial mucous membranes and quiet cough. In absence of cough the dionin may be omitted. IJ Guaiacoli carbonatis, 3ij. Pone in capsulas no. xxiv. Sig. : One or two capsules three times a day after meals. IJ Acidi camphorae, 3iij. Pone in cachetas no. xviij. Sig. : One cachet about two hours before ex- pected sweat. Indication: Used to prevent night sweat. IJ Balsami copaibae, 3j. Syrupi tolutani, §j. Aquae menthae pip., 3j. Spiritus vini rectificati, gj. Spiritus aetheris nitrosi, f3j. Misce. Sig.: Two teaspoonfuls every two to four hours. Indication: In obstinate haemoptysis. Hand-Book of Modem Treatment. 343 Ifc Iodiformi, gr. xxiv. Guaiacoli carbonatis, 3ij. Misce. Pone in capsulas no. xxiv. Sig. : One capsule after meals. Indication: Used in tuberculosis of bladder. I£ Codeinae sulphatis, gr. iv. Acidi hydrocyanici diluti, gtt. xv. Amnion, chloridi, gr. xv. Syr. pruni virginianae, q. s. ad f^ij. Misce. Sig. : A teaspoonful every three or four hours. Indication: Useful for cough. 1$. Terpini hydratis, gr. Ixxv. Spiritus vini rectificati, f3v. Glycerini, f3x. Misce. Sig. : Teaspoonful or two in a little sweet- ened water two or three times daily. Indication : Expectorant. I£ Sodii iodidi, gr. Ixxv. Sodii. bromidi, 3iiss. Sodii chloridi, 3v. Aquae destillatse, f3j. Misce. Sig. : Teaspoonful every morning in cup of milk. "Summer codliver-oil," containing prin- cipal constituents of olei morrhuae. $ Tinct. ferri chloridi, f3j. Acidi nitrici diluti, f3j. Syrupi zingiberis, f3xiv. Aquae menthae viridis, f§iv. Misce. Sig.: Tablespoonful every four hours. Indication: Astringent tonic. IJ Iodiformi, §ss. Sig. : Use about ten or fifteen grains once or twice daily by insufflation into larynx. Indication : In laryngeal tuberculosis. 344 Hand-Book of Modern Treatment. IJ Amyli hydratis, 3iss. Morphinae muriatis, gr. 1 / 3 . Ext. glycyrrhizae, 3iiss. Aquae destillatae, f3xv. Misce. Sig. : The half to be taken at bed time. Indication: Insomnia of phthisis. IJ Heroinae, gr. ij. Acidi acetici diluti, f3ss. Syr. acidi citrici, f^j. Aquae cinnamomi, q. s. ad f^iij- Misce. Sig. : One to two teaspoonfuls to relieve cough. Indication: While quieting cough, heroin does not check secretions as do morphine and codeine. IJ Chloralis hydratis, 3iij. Syrupi tolutani, fgj. Aquae destillatse, q. s. ad f^iij. Misce. Sig. : A teaspoonful at bed time. Indication: Useful for insomnia. PILES.— See Haemorrhoids. IJ Tinct. hamamelidis, f£iv. Sig. : Inject into the rectum one-half to one cea spoonful in an ounce of cold water daily before rising. Also take internally two to five minims three times daily. IJ Ferri subsulphatis, gr. iij. Plumbi acetatis, gr. j. Massa hydrarg., gr. ss. 01 ei theobrom. q. s. et facit suppos. no. j. Sig.: Introduce one morning and evening. IJ Ung. belladonnas, gij. Camphorae, 3j. Tinct. camphorae comp., f3j. Misce et fiat unguentum. Sig.: Apply to painful piles. Hand-Book of Modern Treatment. 345 I£ Ext. opii, gr. viij. Ext. belladonna?, gr. ij. Olei theobromi, q. s. Misce et fiant suppos. no. viij. Sig. : One to be introduced into the bowel every four to six hours. B Acidi tannici, gr. xx-xxx. Aquae, f§vj. Misce. Sig. :• To be injected, after being cooled with ice, into the rectum. Indication: Used in bleeding piles. PITYRIASIS.— See Dandruff. PLEURISY. Dr. Samuel W. Kelley, after reviewing the usual signs and symptoms of pleurisy, says: "In the course of symp- toms which indicate the early stage of pleurisy, among which is the attitude of lying upon one side or bending toward or press- ing upon one side, this position changes, and the patient in- stinctively turns and prefers to lie upon the back or to be propped up high in bed, and avoids bending toward that side or pressing upon it. This is a sign of an effusion — probably of an effusion of considerable bulk and poured out with a degree of rapidity." This sign is not always present, but is conclusive, according to the author, when it occurs. The posture on the affected side in cases of effusion, as usually described by medical authors, is altogether a later phenomenon. Kelly's sign occurs at the time of onset of the effusion, and he attributes it to the assumption of a new position which allows the greatest freedom to the compressed viscera, thereby easing the breathing and cir- culation. Prozorovsky has used a mixture of guaiacol and tincture of iodine, 1 part of the former to 4 of the latter, as an applica- tion in serous pleurisy, painting it on twice daily, and covering it with an impermeable dressing. He believes that the exudate was absorbed more rapidly than by any other method of treat- meat with wlfoich he had experience ; and, unless too many appli- cations were made, it caused no irritation of the skin. 346 Rand-Book of Modern Treatment. IJ Ammonii chloridi, 3j. Ammonii carbonatis, 3j. Tinct. cubebse, 3iij- Syrupi tolutani, q. s. ad %iv. Misce. Sig. : Two teaspoonfuls every hour. Indication: Pleurisy with effusion. The stimulation of the natural recuperative forces by the local, prolonged application of alcohol has been found ex- tremely beneficial in pleurisy with effusion, articular rheuma- tism, and also in acute gout. Burwinkel reports in the Allge- meiner med. Centralzeitung, the application of an alcoholic com- press over night banished the pain in a peculiarly severe and rebellious case of articular rheumatism. A pleuritic effusion which had persisted unmodified by any measures rapidly sub- sided after four applications of alcohol for two hours each. The relief obtained in two cases of gout surpassed that secured by other measures in years of experience. He describes several other cases benefited in the same way. Ifc Podophyllin, gr. l / B , Hydrarg. chloridi mitis, gr. x. Quininae sulphatis, gr. x. Misce. Sig. : One dose. Indication: Earliest stage of acute pleurisy with pains. Strapping chest will give relief from pain. I£ Tinct. aconiti, m viij. Spiritus aetheris nitrosi, f§j. Syrupi, f3ij. Liq. potassii citratis, q. s. ad 3viij. Misce. Sig.: Tablespoonful every hour until pulse becomes soft and compressible, and then every two or three hours. Indication: Used in earliest stage of acute pleurisy. Ifc Pulveris opii et ipecacuanhse, gr. xx. Sig.: Two grains every two or three hours. Indication: To control pain in early stage. Hand-Book of Modem Treatment. 347 IJ Tinct. veratri viridis, 3ij. Sig. : Two or three minims every half-hour until patient is slightly nauseated or skin is moist. Indication: In early stage of an acute dry pleurisy. I£ Potassii acetatis, 3vss. Spiritus setheris nitrosi, 3ij. Aquae, q. s. ad 3viij. Misce. Sig.: A tablespoonful every three or four hours. Indication: In pleuritic effusion. I£ Potassii acetatis, 3ij. Infusi digitalis, q. s. ad §iij. Misce. Sig.: Teaspoonful every three hours to a child five years old. Indication: To remove effusion. I£ Potassii iodidi, §ss. Sodii salicylatis, 3j- Syr. sarsaparillae comp., f§ij. Aquas menthse viridis, q. s. ad f^viij. Misce. Sig.: Two teaspoonfuls in water after meals. Indication: Used in pleurisy with effusion. I£ Syr. ferri iodidi, §ss. Sig. : Ten to fifteen drops in water after meals. Indication: Used in strumous subjects. B Collodii cantharidati, f^ss. Sig. : Apply with a brush over a small area and paint new areas each day. Indication: In pleurisy with effusion to ab- sorb exudate and for relief of pain. PLEURODYNIA.— See Neuralgia. 348 Hand-Book of Modern Treatment. PNEUMONIA. B Potassii citratis, 3vj. Spiritus setheris nitrosi, 3iv. Tinct. opii camphoratae, 3iv. Liq. potassii citratis, q. s. ad §vj. Misce. Sig. : Dessertspoonful every three hours. Indication: Early cough and fever of pneu- The treatment of pneumonia as pursued in four great hos- pitals in New York City — Bellevue, New York, Roosevelt, and Presbyterian — was recently outlined by H. P. Loomis before the Medical Association of the Greater City of New York. In such institutions as these the most advanced therapeutic sug- gestions are tried, weighed, discarded or adopted; and accu- rate records are kept by which reliable and impartial conclusions may be reached. There was much uniformity in the treatment of the disease in these four hospitals. Upon admission the patient was usually given calomel in small, repeated doses, fol- lowed by a saline the next morning. Local applications to the chest were usually restricted to cases where intense pain and distress were felt; none were made as a routine practice. An exclusive milk diet — plain or modified — was adopted during the height of the disease. A temperature of 104 and over was not regarded necessarily as an indication for special treatment un- less nervous symptoms, marked restlessness or delirium accom- panied the fever. At the Presbyterian, when the degree was above 104, cold packs were applied to the anterior portion of the chest; in the New York, alcohol sponging was resorted to, and, failing that, the cold pack; at Bellevue, sponging with tepid water (80 to 85 degrees) was done; and at Roosevelt, alcoholic sponges or anterior packs. Only in the New York and the Presbyterian were tub baths given, and then only in cases of toxemic pyrexia or in alcoholic cases with nervous symp- toms. Codeine was given to. control cough, in doses from one- quarter to one grain every four hours; sometimes heroin (V 12 grain) and perhaps morphine. Trional, veronal, and codeine were given for insomnia. Pulmonary oedema was treated by Hand-Book of Modern Treatment. 349 hypodermic injections of adrenalin; also by atropine, cupping, and stimulation. The use of oxygen was restricted to cases of cyanosis and dyspepsia. The oxygen tank seemed still to hold its place as the forerunner of the end. The three cardiac stim- ulants were alcohol, strychnine, and digitalis; of these, the first named was also the most used and the most relied upon. The indications for these stimulants naturally varied in differ- ent cases. Only in Koosevelt was the last used to any great extent. Nitroglycerine had but occasional use. At Eoosevelt rectal saline injections were used, especially in alcoholics and when nutrition was failing. Eight ounces of a normal salt solution were introduced every four hours through a funnel attached to the end of a catheter; these injections were well retained and seemed to be of decided benefit. Dr. Loomis paid a glowing and certainly well-deserved tribute to the interne staffs of these hospitals, by whose industry and zeal these conclusions were made possible; and he empha- sized three points : Morphine should be used more hypoderrnically in the invasion of pneumonia, which is oftentimes characterized by shock to the nervous system from a sudden and overwhelming toxaemia, and by distressing pain, often amounting to the agony of a pleurisy. If any criticism could be offered of our treatment of pneumonia during the recent past, it must be upon the injudicious and often unwar- ranted use of alcohol. Lastly, Dr. Loomis believes that more patients are damaged than helped by the promiscuous drugging which is still too prevalent. IJ Ammon. iodidi, 3ss. Strychninae sulphatis, gr. y±. Creosoti (beechwood), mix. Glycerini, 3j. Ammon. acetatis, q. s. ad §iv. Misee. Sig. : A teaspoonful every two hours. This is for a child five years old. Indication: Creosote combined with ammo- nium iodide, which is a good stimulating ex- pectorant, and strychnine to safeguard the heart. 350 Hand-Booh of Modern Treatment. IJ Tinct. veratri viridis, m xxiv. Villi antimonii,, 3j. Ammonii bromidi, 3iiss. Liq. ammonii acetatis, §iiss. Syr. limonis, q. s. §iij. Mi see. Sig. : One teaspoonful every hour in water until easier, then every two hours. IJ Codeinae, gr. ij. Liq. ammon. acetatis, 3iv. Spiritus chloroformi, 3iv. Syr. lactucarii, q. s. ad §ij. Misce. Sig. : One teaspoonful every hour. Indication: To relieve cough and pain in pneumonia. For the last seven years H. J. Eobson has treated all cases of pneumonia — whether broncho-pneumonia or lobar pneumonia —by iron acetate, and severe cases by alternate doses of iron acetate and strychnine, with surprisingly good results. The prescriptions used are: — IJ Liquor ferri perchlor., m xv. Liquor ammon. acetatis, 3ij. Aqua chloroformi, q. s. ad Sss. Sig. : Take every four hours in water when given alone; take every six hours alternately with the strychnine mist, when this latter is needed. It is administered every six hours until the patient is well over the crisis; then it is given every eight hours, and later every twelve hours alternately with the strychnine. IJ Liquor strychnine, m v. Aquae chloroformi, ad §ss. Sig. : Take every six hours in water alter- nately with the ferri mist, and as above stated ( in severe cases only ) . IJ Pine oil, for dry inhalation on a clean handkerchief. Hand-Book of Modern Treatment. 351 Pneumonia in young children can be diagnosticated from other diseases by the following sign : There is a lack of expan- sion of the subclavicular region independent of the location of the pneumonia lesion. On placing the fingers upon the sub- clavicular region they are lifted as by a wave on the sound side, while on the other the lack of expansion is evident even in early stages of the disease. In pleurisy and pneumothorax the lack of expansion corresponds with the site of the lesion. fy. Potassii iodidi, 3j. Ammonii chloridi, 3iss. Misturse glycyrrhizse comp., gvj. Misce. Sig. : A tablespoonful four times daily. Indication: Useful in delaj T ed resolution in pneumonia. C. E. de M. Sajous states that as a febrile process advances, the alkaline salts are consumed, and being inadequately renewed, the vital and defensive functions are increasingly hampered until life ceases. After referring to the experimental bacteri- ology of an alkaline reaction of- the bloo& fluids in disease, and the more advanced teachings in the same direction by Jacques Loeb, he concludes that in febrile diseases there exists a close relationship between a deficiency of sodium and death. The author states that e^a. under normal conditions nearly one-half ounce of sodium chloride is excreted each day with the urine, but that the altered conditions during toxaemias, etc., greatly diminish the intake, and unless measures be taken to compen- sate for this, the defensive functions are increasingly hampered and the chances of death are correspondingly increased. Sajous also states that the opposition to the use of saline solution in pneumonia and other diseases has been based on the fact that the sudden elimination of waste-products ' tends to cause inflam- matory renal lesions, or to augment them if present ; whereas such lesions occur, he says, because the toxic wastes are allowed to accumulate in the organism, and on being suddenly liber- ated when the saline solution is used, they overtax the kidneys, but this is prevented when the saline solution is administered from the start. The formula of Dr. Todd is one admirably ad- justed to this purpose and is as follows : — 352 Band-Book of Modern Treatment. Ifc Sodii chloridi, gr. cccxx. Potassii bicarbonatis, gr. cxl. Fluidextracti aromatici, (U. S. P.) , m xxx. Aquse, q. s. ad §iv. Misce. Sig. : Teaspoonful in six to eight ounces of water every two hours with a teaspoonful of lemon juice. The patient is also allowed to drink water at will. A writer lays particular stress on the efficacy of hypoder- moclysis, but that it is usually employed as a last resort, and that the only way to obtain good results is to use the saline so- lution early, which can be done by the above method, so that the alkalinity of the blood is insured from the start in all febri'e toxaemias. I£ Mild chloride mercury, gr. v. Salol, gr. x. Sodii bicarbonatis, gr. x. Powdered ipecac, gr. ij. M. Divide in five capsules. Sig. : One every hour, followed by salts or sodium phosphate two hours after last powder, if patient's bowels have not moved freely. Indication: Form of treatment for lobar pneumonia. # Also timet, aconite, gtt. x, in water, 3x. A teaspoonful to be given every hour until pulse becomes soft. A tablet or two of acetanilid comp., with five grains of Dovers powder every two or three hours for pain. Mustard plaster to affected lung until sur- face is red, then a thick application of antiphlogistine hot, to be repeated every ten to fourteen hours until gray hepatization sets in. The second visit we order an emulsion containing fifteen drops of creosote carbonate to the dose every four hours, to be continued until convalescence is completed. After the first purge we keep the bowels open with sodium phosphate. About the third day we order strychnine sulphate 1 / 40 grain every four hours per orem, unless pulse becomes weak, when we give it more often. Also, we begin hot toddies twenty-four hours before the expected crisis, to be given between doses of Band-Book of Modem Treatment. 353 strychnia. A fluid diet and a tonic composed of eqnal parts of Fellows' hypophosphites and elix. lactated pepsin, two teaspoon- fuls after meals, complete the treatment. IJ Eucalypioli, m xlv. Ammon. iodidi, 3iiss. Vini picis liq., §j. Syrupi tolutani, Sj. Misce. Sig. : One teaspoonful in water every three hours. Indication: Good in clearing up stage. Avoid ammon. iodidi if phthisis is developing. Dr. Gustav Schirmer states that he never gives either narcotics, antipyretics, nor heart-tonics in the treatment of this disease. He administers the simple expectorants, nrotropin, and cathartics, and disinfects month and throat. The heart he ex- amines daily, but the chest only very little, and then with the patient lying on his side. The patient's position is occasionally shifted, but he himself must not stir a limb. Always fresh air and even temperature. Light diet, but no urging. From the very first he vaporizes in the sick-room a mixture as follows: — 1^ Acidi thymic, gr. xv. Olei gaultheriae, f§ij. Olei eucalypti, f^ij. Camphoroe, gr. xv. Misce. Sig. : Use in atomizer. Eectal injections, under low pressure, of 1 pint of 0.85 per cent, saline solution, are made every two hours as long as fever is high and toxic symptoms present. On the first day 1 ounce of unguentum Crede is thoroughly inuncted into the skin ; on the second day 1 / 2 ounce, and this is reduced daily, so that severe cases get in all 5 ounces. Iron he employs early. Even after the crisis patients must stay in bed quietly for ten days. He ascribes his good results to the inhalations and the silver treatment. When this therapy is instituted only late, the per- centage of cures is less. It is an error to wait with the treat- 23 354 Hand-Book of Modern Treatment. ment until the cases are severe; the best time has then been passed. When he began it on the first day every case was cured. IJ Morphinse sulphatis, gv. j. Syr. ipecacuanhas, fgss. Syr. tolutani, fgiiiss. Misce. Sig. : A teaspoonf ul every three hours to a child of five years. Indication: In the stage of hepatization. I£ Potassii iodidi, 3iss. Aquse destillatse, f^viij. Misce. Sig.: A tablespoonful every two hours. Indication: Double pneumonia complicated with pleurisy. Infusi serpentarise, f§iv. Misce. Sig. : A tablespoonful every three hours. Indication: Useful in the crisis. B Tinct. strophanthi, f3iv. Sig. : Five drops in water every six hours. Indication: In circulatory depression. I£ Liq. potassii citratis, f§v. Sig. : Two teaspoonfuls in water every two hours. Indication: Used if urine is scant and spe- cific gravity high. In pneumonia, Dr. T. J. Mays says: "Don't lose sight of the great value of tincture of capsicum in relieving great nervous depression, delirium, dry black-coated tongue, picking at the bedclothes, etc. Give it in from 1 / 2 to 1 teaspoonful doses, in water, every two or three hours, or oftener, in alcoholic pneu- monia." Hand-Book of Modern Treatment. 355 POISONING. The Carnegie Institute has granted an appropriation in aid of the investigation of snake-poisons now going on in the pathological laboratories of the University of Pennsylvania. The- investigation is conducted along lines suggested by Dr. S. Weir Mitchell, who has made a thorough study of the subject. Many experiments are being made with rattlesnakes, cobras, cop- perheads, and other venomous snakes, and the effect of their poison on animals is closely noted, the object being to find an antidote in each case. The experimenters find that alcohol is useful as a stimulant, but is not an antidote in any sense, as many people believe it to be. The best remedial agent is what they call the "intermittent ligature," provided it can be used in time. This consists of a band around the wounded limb, which is loosened for an instant at stated intervals, so that the poison can enter the system only in small quantities. Under this treatment the victim of the bite is enabled gradually to resist the effects. In the treatment of ivy poisoning: — I£ Sodii hyposulphite, §j. Mentholis, gr. v. Alcoholis. 3j. Spiritus aetheris nitrosi, 3j. ■ Aquse destillatae, q. s. ad Oj. Misce. Sig. : Apply locally with a soft sponge or on sterilized gauze. It is said that there is nothing better for ivy poisoning than the old prescription of calomel, 16 grains, and lime-water, 4 ounces, to be mixed and applied three times a day. Borate of sodium mixed with milk is said to be the best general antidote after the stomach has been emptied. For vegetable poisons permanganate of potassium in 1-per-cent. solution. For carbolic acid, vinegar. This is said to act well also externally. 356 Hand-Book of Modern Treatment. Dr. T. J. Daniel recommends: — B Quininae sulphatis, 3ij. Aquae, fgvj. Misce. Sig. : Apply locally as a specific for rhus- poisoning. .The way in which he came to use it was this. While in company with Dr. Strange, they were talking about rhus- poisoning. Dr. Strange told Dr. Daniel that quinine was his remedy, and said that he had tried it in a large number of cases and that it never failed to cure, and cured quickly. He said one time a man who had been poisoned with it came to his (Strange's) brother, who is also a physician, for treatment. His brother did not have what he wanted to give him, and to make the patient believe he was doing something for him he prepared a solution of quinine and gave it to him and told him to apply it thoroughly, and if he was not much better by the next morning to come back, and he would have the other remedy. He never came back; but in a few days he sent back for some medicine just like that given him, that another person was poisoned, and it cured him so quickly he wanted the same kind for him. The doctor sent it and it cured the patient at once. Since that time he has treated many cases, used nothing else, and every case was cured quickly. The doctor said he has never thought of using anything else since, and that it had never failed to cure. Dr. Daniels has had as good success and recommends it as a specific for rhus-poisoning. B Sol. hydrarg. perchloridi, m xx. Potassii iodidi, gr. v. Chloralis hydratis, gr. v. Acidi carbol., gr. j. Spiritus amnion, aromat., m xx. Aquae cliloroformi, q. s. ad Sss. Misce. Sig. : One dose every three or four hours ' till effects are gone. Indication: Useful in meat and fish poison- ing. Hand-Book of Modern Treatment. 357 L. Rogers describes a practical method of treating any kind of snake poison, which promises to be of great value in all cases seen early. It is so simple that any intelligent person can carry it out. The use of permanganate of potassium, as shown by Blyth, is the best-known substance as a practical antidote for snakebite. The fact that the results have not always been satis- factory is probably clue to improper administration. Brunton and Fayrer have recently suggested a more radical method of using permanganate. They advise ligation above the inocula- tion, then incision of the wound, followed by rubbing in of the pure crystals of the salt. It is positively established that the salt will destroy in vitro nearly its own weight in every class of snake-venom. It is possible that the free pouring out of lymph in the neighborhood of the wound will sufficiently retard the absorption of the venom so that a half hour or more may elapse between the infliction of the bite and the rubbing in of the per- manganate. At the suggestion of Sir Lauder Brunton a lance has been made, surrounded by a sheath, in the base of which permanganate crystals are kept, the whole outfit being easily carried in the vest pocket. IJ Sodii sulphitis, 3j. Glycerini, £ss. Aquae camphorae, §iv. Misce. Sig. : Apply locally to affected part on gauze. Indication: Useful in ivy poisoning. Ifc Ammonia, 3ij. Aquse, 3iv. Misce. Sig. : Apply to parts affected two or three times a day. Indication: Useful in rhus poisoning. If case presents soon after tumefaction of the skin, the following is of value: — R Glyeo-phenique, Aquse, Misce. Sig. : Apply often on lint. 358 Hand-Book of Modern Treatment. If the. case is two or three days old, one may use with advantage : — IJ, Glvco-phenique, Olei olivae, Misce. Sig. : Apply often on lint. Dr. W. C. Whiting writes as follows: — "Allow me to call attention to the efficacy of chlorate of potash in cases of poisoning by Paris green. In nine recorded cases I have not had one which proved fatal, though the quantity of poison ingested varied from 1 teaspoonful to 1 / 2 teacupful, the latter quantity producing inflammation of stomach and bowels (acting as a cathartic) and, of course, requiring subse- quent treatment suitable to those conditions. I have not seen any account of the use of chlorate of potash in Paris green poisoning in the text-books or medical journals; so I have taken the liberty to mention it, as it is nearly always at hand, whereas it is not always an easy matter to obtain hydrated sesquioxide of iron freshly prepared. I use a saturated solution of the potash (4 to 6 ounces) at frequent intervals as long as the matter returned from the stomach shows any signs of the poison. The color of the poison will be changed to a very dark brown or black by the potash. I am not sure of the chemical changes which take place, and would like to be informed. I am sure of the effect." There are two or three general rules that can be well re- membered and that always apply in the first treatment of cases of poisoning if the poison was taken by the mouth. 1. A glance at the patient's mouth will at once determine whether a corrosive or non-corrosive poison was used (in case positive information on this point is not afforded otherwise). And this will at once indicate whether or not an emetic should be resorted to. If a corrosive poison has been swallowed it is better at once to administer warm oil. If a non-corrosive sub- stance has been used, emetics (hot mustard water) are called for, or the stomach-tube. 2. After this first general action it may be wise, and even necessary, to inquire more thoroughly into the question of the Hand-Book of Modern Treatment. 359 kind of poison that is producing the effect under observation, with the view of at once employing specific antidotes. 3. The next requirement is to sustain the natural processes of life by all reasonable and quickly responsive means at hand. These three general principles will apply to quite every- case of the kind, and may be briefly recapitulated thus : — First. — Emetics or oil, according to whether or not the mouth is burnt. Second. — Special antidotes, if possible and needful. Third. — Support the patient. Workers, in brass or copper occasionally suffer from anaemia, debility, and nervousness, and neuralgic pains, and often show a green line at the base of teeth. Later there may be tremors, emaciation, cold sweats, cough, and extreme weakness, amount- ing almost to paraplegia. According to William Murray, potas- sium iodide is of little service in these cases, but dilute phos- phoric acid, 15 minims three times daily, will do much good. PRICKLY HEAT. R. Zinei carbonati prsecipitis, 3iv. Zinci oxidi, 3ij. Glycerini, f3ij. A quae rosse, fSviij. Misce. Sig. : Apply locally. In carding out the prophylactic treatment of prickly heat, the Cyclopaedia of Medicine and Surgery recommends that children should be lightly clad in thin woolens and exposed to heat as little as possible. Constipation should be avoided. The following is recommended, to be applied locally. IJ Acidi carbolici, m xxx. Acidi borici, 3j. Zinci oxidi, 3iss. Glycerini, 3ij. Alcoholis, 5ij- Aquae, q. s. ad Svj. Misce et fiat lotio. Sig. : To be applied locally to the skin. 360 Hand-Booh of Modern Treatment. Clinical Medicine suggests, since prickly heat is caused by the irritation from perspiration which cannot readily evaporate, that it will be found better to resort to soap and water, used frequently, and to avoid alcoholic and alkaline washes. Once a day, perhaps, the irritated parts should be gently bathed, then dried thoroughly, and afterward anointed with cocoanut-oil, which is absorbed readily, and should be applied with the hand. It is not greasy, and will not soil the clothing unless an ex- cessive quantity is used. As a dusting powder the following combination is of value : — R* Magnesii carbonatis, Sij- Acidi borici, 3ij. Pulv. amyli, 3ij. Misce et fiat pulvis. Sig. : To be dusted over the areas involved. R* Acidi hydrocyanici diluti, m x-xl. Glycerini, fSj. Misce et fiat lotio. Sig.: Apply locally. Re Acidi hydrocyanici, f§j. Liq. potassse, f3ij. Mist, amygdala?, fSviij. Misce et fiat lotio. Sig. : Use locally. The general treatment of the patient, according to Hyde, should consist in withdrawal from light and heat, the use of un- stimulating food and drink, unirritating apparel, and rest. The free use of lemonade or Vichy water or any reliable carbonate water is of value in aiding e^mination and in supplying the fluids demanded by the cutaneous loss through evaporation. Lassar's paste is serviceable in some cases of pruritus. It is composed as follows : — I£ Resorcini, 3j. Zinci oxidi, 3j. Pulvi. amyli, 3j. Liq. petrolati, 3ij. Misce et fiat unguentum. Sig.: To be applied locally. Eand-Book of Modern Treatment. 351 Or resorcin may be used in the following combination : — IJ Resorcini, gr. xxx. Creosoti, m xv. Lanolini, §ij. Misce et fiat unguentum. Sig. : To be applied locally to the affected areas. When the entire body is involved the patient should receive bran, starch, or alkaline baths. Hyde recommends lotions of lead or of lead and opium in some cases, or alcoholic and ethereal solutions containing cam- phor and glycerine similar to the following: — B Phenolis, 3iss. Glycerini, 3ij. Mentholis, 3j. Spiritus vini rectif., 3j. Aquae, q. s. ad §viij. Misce et fiat lotio. Sig.: To be applied locally. Or the following : — B Olei lini, gij. Liq. petrolati, 3ij- Olei bergamii, 3ss. Aquae calcis, q. s. ad Oj. Misce. Sig. : To be applied externally to the body. The foregoing combination makes a creamy solution which often is very grateful to the skin. If desired, zinc oxide or car- bolic acid may be added. PROSTATITIS. B Ext. glandular suprarenal is. 3iv. Pone in capsulas no. xlviij. Sig. : One capsule after each meal. Indication : Used in chronic enlargement of prostate. 362 Hand-Book of Modern Treatment IJ Tinct. opii camphoratae, %iss. Liquoris potassii, 3ij. Tinct. lupulini, 3iv. Tinct. hyoscyami, 3ij. Syrupi zingiberis, q. s. ad Biij« Misce. Sig. : Teaspoonful in half glass of water after meals and at bedtime. Indication: Useful in subacute prostatitis. 1$. Pulv. cocainae, 3j. Pulv. ext. cannabis Indicae, 3ij. Pulv. ext. hyoscyami, 3ij. Pulv. ext. belladonnae, 3iss. Use four ounces of paraffin, wax and three ounces of cacao butter. Melt them together and then add the remedies, mixing with a spoon till a consistent mass is obtained. You can injure the compound by using more heat than will keep it so as to run freely. Constantly stir the mass while rilling the molds and fill quickly, so the drug will be evenly suspended. IJ Argenti nitratis, gr. v. Aquae destillatae, f§j. Sig. : Instil a few drops into deep urethra once daily by means of a deep urethral syringe. Indication: Used in chronic prostatitis. 1$. Tinct. nucis vomicae, f3j. Tinct. ferri chloridi, f3iij. Misce. Sig. : Twenty drops three times daily. Indication : Useful in debilitated cases. I£ Tinct. cantharidis, m xvj. Syrupi simplicis, f§ss. Aquae destillatae, f^iss. Misce. Sig.: A teaspoonful every four hours. Hund-Book of Modern Treatment. 36o PRURIGO. 3 Phenolis, gtt. xv. Pulv. camphorae, gr. x. Alcoholis, 3ij. Glycerini, 3ij. Olei amygdalae, q. s. ad §j. Misce et fiat lotio. Sig. : Apply locally to allay itching. I£ Sulplmris praecipitatis, 3ij. Betaiiaphtholi. 3ss. Ung. petrolati, gj. Misce et fiat unguentum. Sig. : Apply locally. I£ Liq. potassii arsenitis, Sig. : One to three drops in water after meals. Indication: Iii anaemia and debility. Ifc Pilocarpinae hydrochloratis, gr. ss. Sacchari lactis, gr. xxxvj. Alcoholis, q. s. Misce et fiant tabellse triturationes no. xxiv. Sig.: One tablet three times daily. Indication: Skin is dry. PRURITUS. The male sex has been afflicted in about 95 per cent, of cases of pruritus ani. In nearly all cases the patients were more or less neurotic, and in the major portion of a decidedly bilious temperament. The cases demand the removal of all exciting causes, and regulation of patient's habits of life should precede and attend local treatment. The latter consists in the daily injection into the cavity of the rectum of from one drachm to two and one-half drachms of the following mixture : — R. Fhiidextracti hamamelis, §j. Fhiidextracti ergotse, §ij. Fhiidextracti hydrastis, 3ij. Tinet. benzoini comp., 3ij. Misce. Sis. : Shake well before usinsr. 364 Hand-Book of Modern Treatment. The patient should be advised, prior to using this injection, that a desire to evacuate the bowels will occur as a result of its use, but that if he will remain quiet upon the examining table the sensation will quickly disappear. If the skin has a very rough and dry appearance, the entire surface around the anus should be painted for several inches outwards with a concentrated solution of silver nitrate (960 grains per fluid ounce). If any break in the continuity of the skin exists as a result of previous scratching, a little of a 5-per- cent, cocaine or eucaine solution, applied to the abrasions, will prevent the suffering incident to the use of the silver salt. This application may be required two or three times before the desired effect is obtained, not oftener, however, than every fourth day. On the days between the silver applications the parts should be coated with full strength official citrine ointment, covered with cotton, and kept in place with a T-bandage. If itching should be severe the parts may be bathed with hot water, and then apply either the official black wash or calomel oint- ment. The removal of causative factors is imperative. An exact urinalysis should be made. The diet should be regulated. Alcohol and highly-seasoned foods should be interdicted. Eub- bing or scratching of the vulva snould be prohibited. The dis- eased parts should be washed with water and pure soap after each urination. The following should be applied to give relief from the itching: — T£ Cocainae. gr. xxx. Orthoformi. gr. xxiv. Menthol is. gr. viiss. Phenolis, gr. xv. Vaselini, 3v. Misee. Sig. : Apply to relieve the itching. Dr. P. C. Sutphin writes that he has used alumnol in pru- ritus ani and pruritus vulva? with the most decided success. He used it in three chronic cases of the former and one of the latter, with prompt relief and cure in all the cases. His formula is as follows : — Hand-Book of Modem Treatment. 305 I£ Alumnol, 9ii-3j. Camphorse, 9ij. Vaselini, §j. Misce et fiat unguentum. Sig. : Use night and morning. Rub camphor up fine and add tire alumnol and vaselin. Properly used, he thinks this quite a specific in the above- named diseases, and most likely, also, pruritic diseases generally, of the genital organs, and highly recommends it in these cases, often stubborn of cure, and always most harassing to the patient. In anal and vulvar pruritus the following formula will af- ford relief from the itching and irritation, to be applied locally : 1$. Sodii hyposulphis, 3j. Phenolis, 3ss. Glycermi, Sj- Listerini. Biij- Misce. A short time ago Mr. C. came into my office, complaining of a rash which had appeared on several parts of his body, par- ticularly on the hands, arms, chest, and back. The pruritus Aval intense, so much so that he was unable to sleep at night. I made the diagnosis of poisoning by Rhus toxicodendron and prescribed the usual treatment, without relief. Finally I made a lotion of 1 drachm of ichthyol in 4 fluidounces of water, and directed that this be thoroughly applied to the affected parts upon retiring at night. The patient was at once relieved of the pruritus, and after three or four days the rash had entirely dis- appeared. I report this case because I have never before heard this drug recommended for this affection. — Myron E. Fisher. B Sodii biboratis, 3j. Olei menth. pip., m v. Aquse, q. s. ad Oj. Misce. Another good lotion is liquor carbonis detergens. Some- times this acts like a charm in these cases. These lotions are especially useful when we find the irritation has been alleviated by the carbolic acid and we want a preparation which the patient can continue using to keep the pruritus from returning. 366 Hand-Book of Modern Treatment. Ifc Liquor carbonis detergens, m x. Plumbi subacetatis, m x. Aquse, q. s. ad f^j. Misce. This lotion should be diluted with an equal quantity of warm water. If we prefer to give it in ointment, a very good combination is : — 1$ Liquor carbonis detergens, f3j. Hydrarg. amnion, chlor., gr. x. Lanolini, 5j Misce. There is no doubt that lanolin is very much better than vaseline in cases of local irritation in the vulvar region. It is, however, more expensive. Ointments act much better than lo- tions, and the above is one of the best. Ifc Hydrargyri chloridi corrosivi, gr. ss. Ammonii chloridi, gr. iij. Phenolis, 3j. Glycerini, 3ij. Aquse rosse, gv. Misce. Sig. : Apply night and morning. Indication: Useful in pruritus ani. ffc Benzoini, 3ss. Hydrarg. amnion., gr. xij. Lanolini, q. s. ad §ss. Misce. Sig. : Apply night and morning after thor- oughly cleansing the parts. I£ Fluidextracti hamamelidis, Sj- Fluidextracti ergotae, Siss. Fluidextracti hydrastis, 3j. Tinct. benzoini co., 3iss. Olei lini cum phenolis (5 per cent.), §j. Misce. Sig. : Shake and apply locally night and morning. Indication: Pruritis ani. Hand-Book of Modern Treatment. 367 Patients suffering from acute pruritus should be placed on a strictly milk diet at first and later a milk-vegetable diet. To calm the itching, acetic acid lotions, followed by ointment of menthol and guaiacol, 1 to 2 per cent. The following ointment is recommended : — I£ Guaiacoli, gr. xv. Mentholis, gr. xv. Lanolini, ^iiiss. Misce et fiat unguentum. Sig. : Apply locally morning and evening. B Mentholis, 3j. Cerat. simp., ^ij. Olei amygdalae dulc, 3j. Phenolis, 3j. Pulv. zinci oxidi, £ij. Misce. Sig. : After cleansing the parts apply night and morning. 1$ Amnion, valerianatis, gr. viiss. Misce et fiat pilula no. j. Sig. : From two to three such pills daily. Locally the following may be used : — IJ Acidi hydrocyanici, gr. viiss. Hydrarg. bichloridi, gr. viiss. Phenolis, 3ij. Resorcini, 3ij. Chloralis hydratis, 3iij. Potassii bromidi, 3iv. Aquse, Oij. Misce. Sig.: To be applied locally. Alcoholic solutions of menthol, resorcin, or corrosive sub- limate, are equally as efficacious. After bathing the parts the following powder should be applied : — I£ Pulv. amyli, §iij. Bismuthi subnitratis, 3i-3vj. Acidi salicylici, gr. xv. Misce. Sig.: To be applied locally. 368 Hand-Book of Modern Treatment. IJ Cocainae hydrochloride gr. v. Mentholis, gr. xiv. Liq. petrol ati, §j. Misce et fiat unguentum. Sig. : Apply locally. In cases of genito-perineal pruritus, fissures and excoria- tions, parasites, discharges, diabetes, and albuminuria should be searched for. In vaginal itching the following is recommended : — 3 Cocainse hydrochloride gr. 1 / & - l / 2 . Morphinae hydrochloride gr. 1 / 3 - x / 2 - Olei theobromae, gr. xiv. Misce et fiat suppositorium no. j. Sig. : One introduced into the vagina night and morning. IJ Cocainse hydrochloride gr. vij. Tinct. eucalypti, m lxx. Chloralis hy drat is, gr. lxx. Aquae destillatae, q. s. ad Sviij. Misce. Sig. : Apply as required. Indication: Pruritus vulvae. Acetate of potassium, 10 grains, t.i.d. internally, and a 10- per cent, solution of nitrate of silver locally, to be followed by the following ointment : — I£ Mentholis, 3j. Cerati adipis, 5ij- Olei amygdali dulci, 3,1- Phenolis, 3j. Pulv. zinci oxidi, 3ij. Misce. Sig. : Apply morning, noon, and night after cleansing the parts. Indication: Pruritus ani. I£ Sodii salicylatis. 3iij. Syrupi acaciae, f§j. Aquae menthae pip., q. s. ad §iij. Misce. Sig.: Dessertspoonful three times daily. Indication : With rheumatic or diabetic dia- thesis. Hand-Booh of Modern Treatment. 359 PSORIASIS. I£ Syrupi ferri iodidi, 3iv Olei phosphorati, in c. 01 ei morrhuse, 3ij. Misce et pone in capsulas no. c. Sig. : One to four capsules two hours after meals. Indication : Used in psoriasis with anaemia, enlarged glands, or struma in youths or young adults. I£ Liq. potassii arsenitis, m xlviij. Olei morrhuse, §iv. Syrupi ferri iodidi, 3j. Acacias, §j. Aquse, q. s. ad Sviij. Misce et fiat emulsum. Sig. : One to two teaspoonfuls after meals. To.be followed by full draught of water. Indication: Useful in psoriasis with anaemia, enlarged glands, or struma in children, youths, and young adults. I£ Acidi salicylici, 3j. Sulphuris sublimati, 3j. Olei eucalypti, 3ss. Ung. aquae rosse, §j. Misce et fiat unguentum. Sig. : Rub a small amount in well on the patches. B Cieosoti, m ij. Pepsinae (scale), gr. ij. Misce et fiat capsula no. j. Sig. : One capsule three times a day after meals. I£ Podophyllotoxini, gr. x. Aloini, gr. x. Pulv. jalapae, gr. xxx. Massae hydrarg., gr. xxx. Olei menth. pip., m iij. Misce et fiant pilulas no. xxx. Sig. : One pill at bedtime. 24 370 Hand-Book of Modern Treatment. IJ Olei eadini, 3ss. Chrysarobini, gr. xx. Ung. zinci oxidi, Sj- Misce et fiat unguentum. Sig. : Apply locally to the affected areas. IJ Acidi hydrochlorici dil., gtt. ij. Essentia? pepsini, 3j. Misce. Sig. : To be taken at one dose and repeated after each meal. When itching is present, as is rarely the case, the following combination is recommended to give the patient relief: — IJ Chloralis hydratis, 3ss. Pulv. camphorse, gr. xx. Phenolis, m 1. Ung. aquae rosas, Sj. Misce et fiat unguentum. Sig. : To be applied locally. In any cases of psoriasis the cause should be ascertained and treated; chronic indigestion and a rheumatic diathesis are frequent causes of this trouble. The foregoing outline of treat- ment is applicable when a history of digestive disturbances is obtained. IJ Acidi salicj'lici, gr. xlvj. Acidi pyrogallici, gr. xlvj. Amnion, sulph. ichthyoli, gr. xlvj. Olei oliv8B, 3iiss. Adipis lanae, §iv. Misce. Sig. : Apply twice daily. This produces no irritation nor discoloration of the skin. IJ Acidi salicylici, 3iiss. Chrysarobini, 3v. Olei rusci ( birch tar ) , 3v. Sapo. viridi, 3viss. Vaselini, 3viss. Hand-Book of Modern Treatment. 371 For from four to six days the ointment is applied by the aid of a stiff brush to the affected area ( after this has dried somewhat it is well to apply a little starch or zinc powder). On the fifth or sixth day the patient starts taking hot baths daily for from one to three days; and after the bath, vaseline is to be well rubbed in from one to three times a day. This course of treatment, which embraces a period of eight days, may be repeated several times, according to the severity of the dis- ease, but as a rule the psoriasis patches disappear soon after the first treatment. 1$. Liq. potassii arsenitis, Sig. : Three to five drops, well diluted, thrice daily after meals. Ifc Liq. potassii arsenitis, f3ii-iij. Liq. potassii, f3iv-f3j. Aquae menthae pip., q. s. ad fSiij. Misce. Sig. : A teaspoonful in one glass of water after each meal. 1^ Ext. glandulae thyroideae, 3ij. Fiant tabellse compressae no. lx. Sig. : One three times daily. PTYALISM. I£ Tinct. myrrhae, 3iij. Potassii chloratis, 5ss. Sodii chloridi. 3ij. Aquae destillatae, q. s. ad Sviij. Misee. Sig. : Used as a mouth wash. Repeat every two hours. H Potassii chloralis, 3ij. Infusi rhois glabra radicis, Oj. Misce. Sig. : Use as mouth wash. I£ Listerini, fjiv. Sig. : Teaspoonful in a wineglassful of water as a mouth wash every two hours. 372 Hand-Book of Modern Treatment. Ifc Atropinae sulphatis, gr. j. Aquae destillatae, fgj. Sig. : Four minims three times daily. I£ Potassii permanganatis, gr. ii-x. Aquae destillatae, f5j. Misce. Sig. : Use as a .mouth wash. Indication: To correct the fetor. I£ Phenol sodique, f^viij. Sig.: Teaspoonful in one-half glass of water as a mouth wash every two or three hours. Indication : Used in mercurial ptyalism to check secretion and harden gums. PUERPERAL CONVULSIONS. In addition to the correct hygiene and dietetics of preg- nancy, always have the patient take daily a aose of the liver tonic par excellence, to wit : — I£ Euonymi, gr. Vs- Hydrarg. chloridi mitis, gr. y 8 . Pulv. ipecacuanhas, gr. Vs- Aloini, gr. V 12 . Podophyllini, gr. Vuo- Misce et fiat pilula no. j. This is the ordinary, average dose to be taken at bedtime. The amount of this combination suitable for a given case must be determined by a few nights' use. The best rule is to give just enough to cause one natural movement of the bowels daily. If one pill is too much, give a fraction; if too little, double. One will meet with cases requiring very different amounts — from 1 / 8 to 3 or 4. I£ Aquae destilla a?, f3ij. Syrupi pruni virginianae, f3ij. Chloralis hydratis, 3ss-j. Sodii bromidi, 3ss-j. Misce. Sig. : A tablespoonful in water every hour. Hand-Book of Modem Treatment. 373 I£ Elaterini, gr. %. Sacchari lactis, gr. iij. Misce et fiant chartulae no. iij. Sig. : One powder on tongue. Indication: Used during attack in sthenic cases to cause free watery purgation. PURPURA. IJ Calcii chloridi, 5 SS - Aquae, q. s. ad §iv. Misce. Sig. : One teaspoonful every eight hours for three or four days. Indication: To increase the coagulability of the blood. R. Liq. potassii arsenitis, §ss. Sig. : Five drops in water after meals three times daily. Indication: When due to iodism. R Fluidextracti hamamelidis, f§ij. Sig. : A teaspoonful every one to three hours. Ifc Olei terebinthinse. f3iij. Fluidextracti digitalis, f3j. Mucilaginis acacise, f§ss. Aquae menthae pip., f^j. Misce. Sig. : A teaspoonful every three hours. Indication : Used in the hemorrhagic form. Ifc Extract! glandulae suprarenalae, 3ij. Pone in capsulas no. xlviij. Sig. : One to four capsules three times a day after meals. Indication : Used in purpura with vasomotor relaxation. PYEMIA AND SEPTICEMIA. R. Tinct. ferri chloridi, 3iv. Sig. : Ten to fifteen drops, well diluted and through a glass tube, every four hours. 374 Hand-Booh of Modern Treatment. I£ Quininae sulphatis, 3ij. Pone in capsulas no. xxiv. Sig. : One three times daily. Indication : To aid in combatting infection and as a systemic stimulant. P£ Salopheni, 3ij. Fiant chartulse no. xij. Sig. : One powder three times a day. Indication: Used as an intestinal antiseptic and to neutralize and eliminate toxins. I£ Unguenti Crede, Sig. : One to two drachms by inunction twice daily. Indication: Used in all forms and stages of pyaemia and septicaemia. PYELITIS AND CYSTITIS. I£ Terebinthinae (Venice), 3iss. Pulv. camphor ae, 3iss. Ext. opii. gr. v. Ext. aconiti rad., gr. iij. Misce et fiant pilulae no. xx. Sig. : One pill every eight hours, with a glass of the infusion of uva ursi sweetened. Indication: Used in chronic pyelitis. The charge that has heen brought against turpentine, of speedily upsetting the stomach, may be brought with truth against benzoic acid and sodium benzoate, the drugs that of late years have replaced turpentine. The truth is that turpentine, taken in small doses with meals, does not upset the stomach in such a way as is asserted of it. So slight action as it has in that way may be overcome by combining it with the soft extract of cinchona, as follow r s: — 1^ Terebinthinae, gr. iss. Mollis extracti cinchonae, gr. iss. Misce et fiat pilula no. j. Sig. : Three during each of the principal meals. Indication : Used in the chronic form of pye- litis. Rand-Book of Modern Treatment. 375 R Terebinthinae canadensis, gr. iss. Balsami peruviani, gr. iss. Calcined magnesia, q. s. ad pilula no. j. Misce et fiat pilula no. j. Sig. : Three to be taken at each meal. Add the balsam of Peru to Canada balsam; the former is to some extent a peptic adjuvant; it doubles the anticatarrhal properties of turpentine; it prevents the ammoniacal fermen- tation of the urine consequent on the transformation into hip- puric acid of the cinnamic and benzoic acids contained in it; and it enjoys, rightly or wrongly, a special reputation for ex- pelling calculi. Dr. J. Pollock Simpson describes some cases in which he had employed urotropin with benefit. In a case which had proved resistant to many remedies, in a severe paroxysm of pain, and the urine being very foetid, he gave this drug a trial in 6-grain doses, with the happiest result ; the pain' was relieved in a very short time, the urine rendered free from odor or smell, the pus-corpuscles quickly disappeared from the urine, and the patient in a few weeks became free from the severe paroxysms that she had looked upon as a part of herself, as she could not carry her mind back to the time when she was free from these attacks. In a case of many years' standing speedy relief was obtained by use of the same remedy. A case of cystitis in a young girl is also described in which 4 grains thrice daily was productive of great amelioration. PYROSIS. R. Sodii bicarbonatis, 3iij. Fiant chartulae no. xij. Sig. : A powder in a wineglass of water after meals. IJ Hydrarg. cum cretae, gr. iij. Bismuthi subnitratis, gr. xij. Pulveris nucis myristicae, gr. iij. Misce et fiant chartulae no. yi. Sig. : One powder morning and night. 376 Hand-Book of Modern Treatment. 1$. Pulv. ipecacuanhas, 3j. Pulv. rhei, gr. ij. Sodii bicarbonatis, gr. xij. Misce et fiant chartulse no. xij. Sig. : One powder every four to six hours to an infant one year old. IJ Bismuthi subcarbonatis, 3iv. Tinct. hyoscyami, f3iv. Aquae camphorae, q. s. ad f§iij. Misce. Sig.: Shake. Teaspoonful one hour before meals. 1$ Tinet. nucis vomicae, f3ii-iv. Acidi nitrici diluti, f3vj. Syrupi zingiberis, q. s. ad fSiij- Misce. Sig. : A teaspoonful in a wineglass of water. R Sodii bicarbonatis, gss. Aquae menthae viridis, f^iv. Sig. : Shake and take a tablespoonful two hours before meals. R. Sodii salicylatis, 3j. Bismuthi salicylatis, 3iiss. Magnesii carbonatis, 3iiss. Sodii bicarbonatis, 3iiss. Misce. Sig. : One-half a teaspoonful in hot water before meals. I£ Sodii sulphatis, 3vj. Sodii chloridi, 3vj. Calcii sulphatis, 3ss. Sodii carbonatis, 3iiss. Sodii boratis, 3j. Misce. Sig. : Teaspoonful before each meal. Indication : Gastric acidity that is pro- nounced. Hand-Book of Modern Treatment. 377 QUINSY.— See Tonsillitis. I£ Tinet. guaiaci ammoniatse, fgij. Sig. : A teaspoonful in half a glass of milk three times daily in early stage. I£ Tabellas protonucleini no. xxiv, each gr. v. Sig. : One tablet dissolved in mouth every hour until flushing of face. Then one tablet every two or three hours. Indication: Used at onset. B Tinct. iodi, gtt. x. Aquae menthae pip., ^iss. Syrupi simplicis, §ss. Misce. Sig. : A teaspoonful every hour. I£ Tinct. aconiti radicis, fgss. Sig.: Half a drop every fifteen minutes for two hours, and afterward hourly. B Ichthyoli, f3iij. Ung. belladonnas, 3ij. Olei citronellae, m iv. Adipis lanae hydrosi, 3iij. Misce. Sig. : Apply freely externally. IJ Sodii salicylatis, 3iij. Syrupi acaciae, f^ss. Aquae cinnamomi. q-. s. ad §iij. Misce. Sig.: A dessertspoonful every three hours. I£ Aquae hydrogenii dioxidi, f^iv. Sodii bicarbonatis, 3iv. Aquae, q. s. ad 5 xv j- Misce. Sig. : Use as a gargle or spray every hour or two. Ifc Tinct. aconiti, gtt. vj. Potassii bromidi, 3j. Aquae, q. s. ad §iv. Misce. Sig. : Teaspoonful every two hours in water. 378 Hand-BooJc of Modern Treatment. 1$. Cocainae sulphatis, gr. iv. Aquae hydrogenii dioxidi, 5ij- Phenolis, m viij. Sodii bicarbonatis, 3ij. Aquae, q. s. ad %iv. Misce. Sig. : Use one or two teaspoonfuls as gargle every three or four hours. RABIES.— See Hydrophobia. RACHITIS (RICKETS, SCROFULA, STRUMA) IJ Liq. potassii arsenitis, 3iv. Sig. : One drop three times daily. I£ Olei morrhuae, f£v. Phosphori, gr. iij. Facit solutio. Sig. : One teaspoonful daily. 3 Olei morrhuae, fSvj. Syrupi calcis lactophosphatis, Siij- Liq. calcis, §iij. Misce. Sig. : One or two teaspoonfuls three or four times daily. 1^ Olei morrhuae, f§xvj. Sig. : Apply freely by inunction twice daily. R. Syrupi ferri iodidi, 16iv. Sig. : One to five drops in water or milk after meals. Indication: Used in anaemic and strumous children. 1^ Elixiris phosphori, f^ij. Sig. : Five to fifteen drops in water three times daily after meals. 1$. Syrupi calcis lactophosphatis, f^iv. Sig.: Adult dose a teaspoonful three times daily. Hand-Book of Modern Treatment. 379 I£ Arom. cascarse, §iv. Sig. : Use as conditions indicate. Indication: Useful in constipation compli- cating rickets. I£ Ferri et quininse citratis, gr. x. Olei morrhuae, f§ij. Glycerini, f^ij. Misce. Sig. : A tablespoonful three times daily. RATTLESNAKE BITE. I£ Potassii permanganatis, §ss. Aquae destillatae, giij. Sig. : Apply to the wound and inject hypo- dermically above the seat of injury. At same time take internally the following: — 1$, Aquae ammonise, §iv. Sig. : A half teaspoonful in water, repeated every ten or fifteen minutes. fy Tinct. iodi, f3iv. Sig. : Excise wound and swab out freely. REMITTENT FEVER.— See Fever. RENAL COLIC— See Calculi. 1$ Lithii citratis, 3j. Fluidextracti hydrangeas, 3iv. Infusi tritici, q. s. ad §vj. Misce. Sig. : One tablespoonful every four hours in water. B Lithii citratis, 3j. Potassii citratis, 3iss. Fluidextracti zeae, §j. Infusi uvae ursi, q. s. ad S v j- Misce. Sig. : One tablespoonful every four hours. 380 Hand-Booh of Modern Treatment. Infusion of birch-leaves has been recommended by Win- ternitz as a bland diuretic. Jaenicke states that its diuretic action is unimportant, but that it is a good solvent of renal calculi. In one case an eminent surgeon had decided to oper- ate, and the presence of calculi had been demonstrated by radio- graphy. Before consenting to an operation the patient consulted the writer. About thirty-five ounces of urine were passed in the twenty-four hours. It was acid, turbid, yellowish-white, and occasionally haemorrhagic. A cupful of infusion of birch- leaves was ordered to be taken twice daily, and liquor ferri per- chloridi was given to combat the haemorrhage. A generous meat diet, with sometimes a small amount of wine, was substituted for one which consisted chiefly of milk. Six weeks later the general condition had improved, the attacks of colic were less severe and less frequent, and the strangury was scarcely noticeable. After another six weeks the general condition was excellent. No severe attack of colic had occurred for some time, and the urine was in. all respects normal. RETENTION OF URINE. When you succeed in passing a catheter into the bladder in cases of considerable retention, do not empty it entirely or too suddenly, as it may give rise to haemorrhage, which is some- times very profuse, or to severe cystitis, or even to urinary sup- pression and death. It is well to partially plug the lumen of the catheter so as to allow the urine only to dribble out. I£ Atropinse sulphatis, gr. 1 / 30 . Morphinse sulphatis, gr. iss. Aquse destillatse, f3j. Misce. Sig. : Ten minims hypodermically and repeat once if required. Indication: Used in retention from spas- modic stricture. Patient should be immersed in hot bath for half an hour. Hand-Book of Modern Treatment. 381 RHEUMATISM. B Sodii salicylates, 3iv. Vini colchici, 3iv. Spiritus gaultheriae, gj- Spiritus aetheris nitrosi, Sj- Syrupi simplicis, q. s. ad 'iv. Misce. Sig. : One teaspoonf ul every three or four hours in ice-water. Indication : Acute inflammatory rheumatism. I£ Sodii salicylatis, §ss. Potassii iodidi, 3j. Methylis salicylatis, f3j. Extracti cimicifugae fluidi, f3ij. Alcoholis, f§ss. Aquae, q. s. ad f§iij. Misce. Sig. : A teaspoonful three times a day. I£ Potassii acetatis, Sij- Acidi salicylici, 3iv. Syrupi limonis, Sij- Aquas menthae pip., q. s. ad Bviij. Misce. Sig.: Tablespoonful every three hours. I£ Sodii salicylatis, 3iss. Sodii phosphatis, 3ij. Sodii bicarbonatis, 3ij. Aquae menthae viridis, q. s. ad §iv. Misce. Sig. : Tablespoonful every four hours. Indication: Acute articular rheumatism. This prescription is recommended by Eschner in acute and subacute rheumatism in which considerable involvement of the muscles and great pain exist: — I£ Antipyrini, 3ij. Sodii salicylatis, 3iij. Ammonii bromidi, 3iv. Aquae cinnamoni, q. s. ad ^iij. Misce. Sig. : Teaspoonful every three or four hours. 382 Hand-Book of Modem Treatment. 1$. Sodii salicylates, 3iv. Tinct. ferri chloridi, 3iv. Acidi citrici, gr. x. Glycerini, Sss-iss. Olei gaultheriae, m x-xxx. Liq. ammon. cit. ( B. P. ) , q. s. ad %iv. Misce. Sig. : Dessertspoonful every two, three, four, or six hours. Indication : Used in the acute form and those predisposing to anaemia. T$. Acidi salicylici, gr. x-xx. Ferri pyrophosphatis, gr. v. Sodii phosphatis (crys.), gr. 1. Aquae, Bss. Misce. Sig. : At a dose. 1$ Lithii benzoatis, 3ss. Sodii bromidi, 3ij. Potassii carbonatis (pura), 3ij. Potassii acetatis, %\$s. Sodii phosphatis, §ss. Syrupi zingiberis, Aquae menthae pip., of each q. s. ad gvj. Misce. Sig. : Two teaspoonfuls to a tablespoonful in a half-glass of water, every four to six hours, after food. Indication : Used in the acute form. I£ Acidi salicylici, §ss. Ferri pyrophos., 3j. Sodii phosphatis, 3x. Aqua?, q. s. ad §vj. Misce. Sig. : One tablespoonful every two hours well diluted in water. Indication: Useful in acute rheumatism. I£ Sodii salicylatis, 3ij. Ichthyoli, f§j. Adipis lanae hydrosi, 5j- Misce et fiat unguentum. Sig.: Apply freely to joint and envelop in cot ton- wool. Hand-Book of Modern Treatment. 333 ]$ Potassii iodidi, 3ij. Potassii bromidi, 3ij. Chloralis hydratis, 3iij. Glycerini, §ij. Syrupi sarsaparillse, gij. Ext. gaultherise, 3ij. Aquae, q. s. ad §iv. Misce. Sig. : A teaspoonful four times a day, after meals and at bedtime. 1$. Tinct. opii, f^ij. Glycerini, f^ij. Potassii bicarbonatis, £j. Aquas, q. s. ad f^xvj. Misce. Sig. : Warm and apply to joints on soft cloths. Indication : Useful in acute articular. 1^ Olei terebinthinse, 3iij. Betul-ol, 3ij. Acidi oleici, 3ij. Mentholis, 3j. Spiritus vini rect., 3iij. Misce et fiat linimentum. Sig. : For external use by friction, or, if the parts are too tender, apply to any muscular part of the body, as this liniment will be easily absorbed by the skin and carried by the circu- lation to the seat of the lesion. Indication: For painful stiff joints, sprains, and muscular rheumatism. 1$, Spiritus camphoree, §iss. Spiritus terebinthinse, §iss. Chloroformi, 3ij. Mentholis, 3j. Balsami Peruviani, Siss. Misce. Sig. : Apply with gentle friction. Indication: Useful in muscular rheumatism. The basis of the most rapid treatment of acute rheuma- tism is salicylic acid, preferably in its combination with soda. 384 Hand-Book of Modem Treatment. If pain be excessive some morphine may be conjoined. For instance : — IJ Sodii salicylates, gr. x. Morphinse sulphatis, gr. y 8 . Tinct. cardamomi com})., 3ss. Glycerini, 5%. Aquse, q. s. ad 3ij. Misce. Sig. : For one dose. One such dose to be given every three hours. Codeine may be substituted for morphine. If the narcotics • are omitted from the prescription a dose may be given hourly until six doses have been taken. Lead-water and laudanum is a good local application. Wrapping the affected joints in cot- ton-wool affords relief. When the temperature has returned to normal and the swelling is lessening it is well to add an alkali to the salicylate. Sodium bicarbonate or iodide answers a very good purpose. A little later the salicylate can be eliminated and the alkalies given until conva'escence is assured. In subacute cases, which are frequently attended by sluggish liver and constipated bowels, we have often found it of advantage to add enough cascara sagrada to each dose to secure free evacua- ation. In this class of cases salicylic acid has been found useful as a local remedy. It may be made into an ointment in the pro- portion of a drachm to an ounce. In the chronic and muscular forms salicin is more reliable than salicylic acid. The following will often give good results : — I£ Salicini, gr. iii-v. Ext. cimicifugae, gr. ss-j. Misce. Sig. : For one dose. One capsule to be given four times a day. B Acidi salicylici, 3vj. Fluidextracti pruni Virginianae, 3iv. Fluidextracti gentianse. 3ij. Fluidextracti glycyrrhizse, 3ij. Elixiris simplicis, 3 X - Misce. Sig. : Teaspoonful every three hours. Indication: Used in rheumatism as a tonic. Hand-Book of Modern Treatment. 385 I£ Fluidextracti taraxaci, 3vj. Fluidextracti pruni Virginianse, 3iv. Fluidextracti gentianse, gtt. x. Fluidextracti glycyrrhizae, gtt. ix. Elixiris simplicis, §x. Misce. Sig. : Teaspoonful every three hours. Indication: Used in rheumatism as a tonic. I£ Acidi salicylici, 3ij. Olei gaultheriae, 3j. Fluidextracti hamamelidis, 3j. Olei sinapis, gtt. v. Alcoholis, 5iv. Misce. Sig. : For external use only. Apply at night and in the morning if necessary. The above formula makes a clear solution. The wintergreen gives a pleasant odor, so that the most fastidious patients find no objections to its use. It does not stain the skin nor the cloth- ing, and is o'ean to use. The oil of mustard makes a comfortable warmth, and by its irritation accelerates the absorption of the acid. B Ichthyoli, §ij. Adipis lanae hydrosi, §ij. Misce. Sig. : Rub in well and ■ apply about the in- flamed part on lint. R- Salicini, 3j. Potassii bicarbonatis, 3iss. Sodii bicarbonatis, 3iss. Misce et fiant chartulae no. x. Sig. : One powder every three hours dis- solved in hot water or hot milk. Aspirin, a more recent preparation, is a very valuable sub- stitute for the salicylates, salol, or salophen, and its action being similar, it may be classified in this group. It may be prescribed as follows : — Ifc Aspirini, 3iss. Ext. nucis vomicae, gr. v. Misce et fiant capsulas no. xij. Sig.: One capsule every four hours. 25 386 Hand-Book of Modern Treatment. I£ Sodii salicylates, 3ij. Potassii iodidi, 3j. Tinct. veratri viridis, gtt. xv. Tinct. aconiti radicis, gtt. xv. Aquse, gij. Syrupi, q. s. ad §iij. Misce. Sig. : A teaspoonful every two hours for adults. One-half a teaspoonful every two or three hours for children. IJ Aspirini, £ss. Pone in cachetas no. xxiv. Sig. : One every three hours during the day. Indication: Used as a substitute for the salicylates. IJ Salopheni, ^ss. Fiant chartulse no. xxiv. Sig.: One powder every four to six hours. Indication: Used as a substitute for the salicylates. I£ Acidi salicylici, 3j. Adipis lanae hydrosi (lanolini), 3v. Misce et fiat unguentum. Sig. : Apply locally to the affected joint. 1^ Extracti belladonnas, gr. v. Acidi salicylici, gr. xx. Sodii salicylici, gr. xx. Adipis lanae hydrosi (lanolini), 3iv. Misce et fiat unguentum. Sig. : Apply locally. B Saloli, 5j. Mentholis, gr. xlv. Spiritus setheris nitrosi, 3j. Adipis lanae hydrosi, %]. Misce. Sig. : Apply locally. Hand-Book of Modern Treatment. 387 The following outline of treatment in acute rheumatism is recommended : — IJ Sodii iodidi, 3ij. Sodii salicylates, 3iij. Syrupi sarsaparillae comp., §iij. Misce. Sig. : One teaspoonful after each meal in water. I£ Olei gaultheriae, 3ss. Linimenti chloroformi, Siss. Misce et fiat linimentum. Sig.: To be applied locally night and morn- ing. As a combined alkaline and salicylate mixture the following may be given, which is according to the formula of Whitla : — IJ Sodii salicylatis, 3iv. Potassii bicarbonatis, 3v. Liq. morphinae hydrochloridi ( 1 per cent.), 3j. Aquae camphorae, q. s. ad Bviij. Misce. Sig. : One tablespoonful four times a day in one-half glass of water. B Sodii salicylatis, 3iss. Potassii iodidi, 3ss. Tinct. aconiti, gtt. x-xv. Aquae, gij. Misce. Sig. : One drachm three times daily. Indication: Used in acute rheumatism of children. There is a common notion that lemon-juice produces good effects in the treatment of rheumatic diathesis, but up to the present the employment of citric acid in acute articular rheu- matism has not been spoken of to any extent. For patients very susceptible to salicylates, it proved effective both in acute and subacute rheumatism. The dose of citric acid is 75 to 150 grains a day, and may be prescribed as follows : — 388 Hand-Book of Modern Treatment. * . Ifc Acidi citrici, gr. lxxv-3iiss. Syrupi tolutani, f3vij. Syrupi pruni Virginianae, f3vij. Aquse, f§viij. Misce. Sig. : To be taken during the day — two to three tablespoonfuls every two hours. Under this medication the pain and swelling disappeared from the joints in twelve hours in some cases. Ifc Codeinse sulphatis, gr. iv. Acetanilidi, gr. xlv. Sodii salicylatis, 3iiss. Alcoholis, gss. Syrupi rubi idsei, Sj. Glycerini, §ss. Misce. Sig. : Take one teaspoonful every three hours. Alcohol to dissolve the acetanilid; glycerin and raspberry syrup to render the pre- scription more palatable. Indication: Useful in neuralgia, rheuma- tism, pains, and fever. GONORRHCEAL RHEUMATISM. Of the first importance is the urethritis. The urethritis must be cured, the gonococcus must be destroyed. As long as the gonococcus has a dwelling place in the man's urethra and gener- ates gonotoxin, a radical cure is out of the question. The gono- coccus must be destroyed, and silver nitrate is still best for the purpose, if the urethritis is of a chronic character. If of acute or subacute character, protargol will prove more satisfactory. Internally the following combination is about the best: — I£ Saloli, gr. v. Antipyrinae, gr. x. Codeime, gr. ss. Misce et fiat chartula no. j. Make twenty- four such doses. Sig. : One in the morning, one in the after- noon, and two on going to bed. Hand-Book of Modern Treatment. 389 If the kidneys are in perfect condition, the dose of salol may be doubled. But the urine must be watched, and as soon as a suspicion of a blackish or smoky color is noticed, the salol should be discontinued. For the pain in the joints, painting with a solution or rubbing with a liniment or ointment is to be ordered. The solution, which sometimes produces a magic effect and sometimes fails entirely, has the following composition : — I£ Acidi salieyliei, 3j. Mentholis, gr. xv. Guaiaeoli, m xxx. Alcoholis, %]. Misce. Sig. : Paint with camel's hair brush and cover with cotton and oiled silk. The liniment has the following composition : — I£ Methyl, sal icy 1 at is, 3ij. Guaiaeoli, 3j. Oleat. veratrinae, 3j. Linimenti camphor*, 3j. Linimenti belladonnas, §j. Misce. Sig. : Rub in well and cover with cotton and oiled silk or muslin. The ointment has the following composition :— B Chloralis hydratis, 3j. Camphorae, 3ss. Mentholis, 3ss. Acidi salieyliei, 3j. Guaiaeoli, 3j. Atrophias , gr. ij. Petrolati, 3j- Lanolini, ad £ij. Misce. Sig. : Apply externally. Ten to fifteen drops of ol. sinapis volatile may be added to the above. While this ointment does excellent service in articular and muscular rheumatism, in lumbago, in sciatica, etc., its effects in gonorrhceal arthritis are only moderate; occasionally, however, it surprises us very agreeably. 390 Hand-Book of Modern Treatment. RHEUMATISM, CHRONIC. I£ Sodii iodidi, 3ij. Vini colchici rad., 3iv. Sodii salicylates, 3iij. Tinct. guaiaci ammon., gij. Syrupi sarsaparillae comp., q. s. ad £vj. Misce. Sig. : Dessertspoonful three times daily. I£ Pulv. guaiaci resinae, 3j. Potassii iodidi, 3j. Tinct. colchici seminis, 3iij. Syrupi simplicis, Sij- Aquae cinnamomi, q. s. ad 3vj. Misce. Sig. : Dessertspoonful to a tablespoonf ul twice daily. I£ Fluidextracti jaborandi, 3vj. Fluidextracti colchici, 3vj. Fluidextracti cimicifugae, 3vj. Aquae cinnamomi, Syrupi simplicis, of each, q. s. ad Bviij. Misce. Sig. : One teaspoonf ul every three hours — sufficient to keep the bowels loose. I£ Potassii et sodii tartratis, 3ss. Potassii nitratis, 3v. Vini colchici, 3ij. Aquae, q. s. ad §ij. Misce. Sig. : A teaspoonful three times daily. I£ Liq. potassii arsenitis, fS.j. Sig.: One drop in water after meals and gradually increase until slight puffiness under the eyes or slight intestinal pain. Then reduce dose and continue a long time. Indication: Used in anaemia and debility of chronic rheumatism. Hand-Book of Modern Treatment. 39 1 IJ Potassii bicarbonatis, 3ss. Vini colchici radicis, f3ij. Tinct. guaiaci, f^ij. Syrupi aurantii corticis, fgij. Misce. Sig. : A dessertspoonful thrice daily in water. Indication: In rheumatic arthritis. 1^ Potassii iodidi, 3iij. Vini colchici, §ij. Tinct. opii camphorata?, 3ij. Tinct. stramonii, 3vj. Tinct. cimicifugse, giij. Misce. Sig. : A teaspoonful three times daily. Ifc Liq. potassii arsenitis, f3ij. Potassii iodidi, 3ij. Syrupi simplicis, f^iij. Misce. Sig. : A teaspoonful thrice daily in water. Indication: Useful in rheumatic arthritis. I£ Sodii iodidi, 3iij. Vini colchici sem., f3iij. Spiritus gaultherise, f§iv. Misce. Sig. : A teaspoonful in water after each meal. » IJ Sodii iodidi, 3iiss. Liq. potassii arsenitis, 3iss. Olei gaultherise, 3iss. Spiritus gaultheriae, q. s. ad giv. Misce. Sig. : One teaspoonful in water after each meal. B Tinct. aconiti, 3ij. Chloroformi, 3ij. Aquas ammonias, 3ij. Linimenti saponis comp., q. s. ad §viij. Misce et facit linimentum. Sig. : Use locally. 392 Hand-Book of Modern Treatment. 1^ Tinct. iodi, 5ss. Alcoholis, 3ss. Misce. Sig. : Apply morning and evening. 1$. Tinct. aconiti, f§j. Tinct. opii, f3iv. Aquae amnion, fort., f3iv. . Linimenti chloroformi, f3vj. Misce. Sig. : Poison. Use as liniment to chronic- ally inflamed muscles and joints. I£ Ichthyoli, Sss-SjT Adipis lanse hydrosi, 5j- Misce. Sig.: Rub into the joint thoroughly. RHEUMATISM.— See Gonorrhoea! RHEUMATISM, MUSCULAR.— See Myalgia. RHINITIS.— See Catarrh. RICKETS.— See Rachitis. RINGWORM. Wash clean with hard green «oap and dry thoroughly. Then apply collodion in which pyrogallic acid has been dissolved in the proportion of 15 grains to the ounce. 1. The entire scalp is painted with tincture of iodine and then carefully dried. By this each diseased patch is stained a darker brown than the healthy skin, enabling one to attack places other- wise invisible. A circle is drawn with a blue pencil around each ring, and the hair epilated for 1 centimeter outside of it, the rest of the hair being cut short. 2. The patches are painted every day with the iodine until a certain amount of irritation of the skin is set up. The treatment is then suspended until the skin has regained its natural appearance, and the hair begins to grow. The treatment is especially applicable to the more com- mon variety of tinea caused by small spores. Rand-Booh of Modem Treatment. 393 IJ Sodii biboratis, 3j. Aceti destillatse, f§ij. Fiat lotio. Sig. : Apply locally. Indication: In ringworm of the scalp. I£ Iodi, 3ij. Adipis lanse hydrosi, 3ij. Misce. Sig. : Apply once daily. B Tinct. iodi, gss. Sig. : Apply with camel's hair brush once or twice daily. Indication: Useful in ringworm of the body. ROTHELN.— See Measles and Fever, RUPIA. I£ Olei cadini, 3ij. Ung. hydrargyri, 3ij. Vaselini, 3j- Misce et facit unguentum. Sig. : Apply locally. Indication: In psoriasis palmaris and plan- taris syphlitica. B Iodoformi, §ss. Sig. : Dust upon the lesion. IJ Hydrarg. protiodidi, gr. xii-xx. Ung. simplicis, §j. Misce. Sig. : Apply locally. Ifc Hydrarg. iodidi rubri, gr. iij. Potassii iodidi, 3i-ij. Alcoholis, f3ij. Syrupi zingiberis, f3iv. Aquae, q. s. ad f^iss. Misce. Sig. : Thirty drops three times daily. Indication: In rupia. 394 Eand-Book of Modern Treatment. SATYRIASIS. IJ Potassii bromidi, 3vj. Aquae destillatae, fgv. Misce. Sig.: Three teaspoonfuls before dinner and four at bedtime. IJ Potassii bromidi, 3iv. Potassii iodidi, 3iv. Aquae camphorse, q. s. ad Sviiij. Misce. Sig. : Tablespoonful in water three times daily after meals. Indication: All sources of local irritation should be removed. IJ Sodii arsenatis, gr. ss. Hyoscinae hydrobromatis, gr. y 8 . Potassii bromidi, %]. Misce et fiant tabellse compressae no. xxx. Sig.: One tablet after meals. SCABIES. Ifc Sulphuris sublim., 3ii-vj. Balsami Peruviani, 3ii-vj. Adipis benzoinat., Petrolati, of each q. s. ad 5iv. Misce. Sig. : First take a hot bath. The ointment is then rubbed in over entire surface, night and morning, for two to four days, patient wear- ing the same underwear continuously. Indication: For children and those of deli- cate skin. IJ Sulphuris sublim., 3iv-vj. Balsami Peruviani, 3iv. Betanaphtholis, 3i-ij. Adipis benzoinat., Petrolati of each q. s. ad %iv. Misce. Sig.: Apply locally as above, Hand-Book of Modern Treatment. 395 I£ Balsaini Peruviani, 3ij. Sulphuris praecipitatis, 3ij. Acidi salicylatis, 3ss. Ung. petrolati, §ij. Misce. Sig. : After scrubbing with, soap and water rub in thoroughly. B Sulphuris sublim., 3j. Balsaini Peruviani, 3ss. Lanolini, §j. Misce et fiat unguentum. Sig. : Apply locally. IJ Hydrarg. chloridi corros., gr. j. Ammonii chloridi, 5ss. Alcoholis, 3vj. Aquae rosae, q. s. ad §vj. Misce et fiat lotio. Sig.: Apply locally. R Sulphuris sublim., 3ij. Olei cadini, 3ij. Cretan prep., 3iiss. Saponis viridis, §j. Lanolini, §j. Misce et fiat unguentum. Sig.: Apply locally twice a day. SCARLATINA.— See Fever and Diphtheria. SCIATICA. Ifc Tinct. aconiti, 3ij. Tinct. colchici sem., 3ij. Tinct. belladonna? fol., 3ij. Tinct. chnicifugae, 3ij. Misce. Sig. : Six to twelve drops every six hours. I£ Liq. potassii arsenitis, f^j. Sig. : One drop, to be gradually increased until puffiness under the eyes, then reduce and continue several weeks. Indication: Useful in anaemia. 396 Hand-Book of Modern Treatment. B Spiritus glycerylis nitratis, 3ss. Tinct. capsici, 3ss. Aquae menthse pip., 3iij. Misce. Sig. : Five drops thrice daily in a tablespoon- ful of water for the first three days, and ten drops thrice daily on the following days. IJ Guaiacoli cry stall., gr. xv. Methylis salicylatis, 3iiss. Adipis, 3iiss. Lanolini, 3iiss. Misce. Sig. : Apply upon a linen cloth along the course of the sciatic nerve and cover with cot- ton and waxed taffeta IJ Cocainse hydrochloratis, gr. j. Morphinse hydrochloratis, gr. i-viij. Sodii chloridi, gr. j. Phenolis, m j. Aquse, q. s. ad §j. Misce. Sig. : Inject ten to fifteen drops deeply into tissues along course of nerve. I£ Salopheni, 3iv. Phenacetini, 3iv. Misce et fiant chartulae no. xxiv. Sig. : Two powders every four hours until pain is relieved; then one powder every six hours. IJ Calcii glycerophosphatis, 3iss. Sodii glycerophosphatis, 3iss. Ferri glycerophosphatis, gr. xxx. Misce et fiant capsular no. xxx. Sig. : One after each meal three times a day. IJ Acidi salicylici, 3ss. Ichthyoli, 3iv. Olei hyoscyami comp., 3iv. Adipis lanse hydrosi. Misce. Sig.: Apply locally. Hand-Book of Modern Treatment. 397 Dr. James Taylor reminds us of the well-known but too much ignored fact that electricity is very useful in sciatica. It is useful, first, in relieving the pain, which is often severe, and in the second place it is useful in stimulating muscles which have become wasted, and thus aiding their growth. In sciatica itself the best current to use is, he says, the constant current, and it is best applied by getting the patient to lie prone, with one of the flat conductors over the sciatic area, the other pole being stroked over the distribution of the nerve. He has known very great benefit, and, indeed, practically complete relief, af- forded in sciatica from comparatively few applications of the battery. IJ Acidi osmici, gr. ij. Aquae destillatae, m cc. Sig. : Sixteen minims hypodermically at the seat of pain, at first daily, then less frequently. IJ Tinct. gelsemii, §ij. Tinct. colchici, §ij. Misce. Sig. : Ten to twelve drops three times daily. IJ Potassii iodidi, 3iv. Sodii salicylatis, 3vj. Tinct. cimicifugse, f^ij. Syrupi sarsaparillae comp., f^ij. Aquae, q. s. ad fgvj. Misce. Sig. : Two teaspoonfuls in water after meals. Indication: Used in rheumatic subjects. IJ Aspirini, 3j. Phenacetini, gr. 1. Quininae salicylatis, gr. xx. Codeinae, gr. iiss. Misce et fiant chartulae no. x. Sig. : One powder every six hours. IJ Spiritus glonoini, m j. Morphinae sulphatis, gr. 1 / 3 - 1 /. z . Aquae destillatae, m xxx. Misce. Sig. : Injected by means of a long hypo- dermic needle deeply inserted into the tissues above the nerve. 398 Hand-Book of Modern Treatment. SCLERITIS. B Pilocarpine hydrochloride gr. 1 / 8 - 1 / 4 . Sig. : Injected hypodermically after a hot- bath. Sweating should continue for one or two hours. I£ Sodii salicylatis, 3iv. Potassii iodidi, 3iv. Vini colchici radicis, f3ij. Syrupi sarsaparillae comp., f^j. Aquae, q. s. ad fSiij. Misce. Sig.: Teaspoonful in water after meals. Indication: Used when due to gout or rheu- matism. SCLEROSIS.— See Locomotor Ataxia. SCROFULA. Codliver-oil should be given during the winter months if the stomach can retain it. In the summer the syrup of the tan- nate of iodine or the following may be given: — I£ Calcii iodidi, 3iss. Aquae calcis, §ij- Aquae menthae pip., 3iv. Misce. Sig. : One teaspoonful in a small amount of water twice daily after a meal. Every second day a bath should be taken, the water con- taining sodium bicarbonate, 2 ounces; and sodium chloride, 32 ounces. The body should receive a thorough rubbing daily, after which the following should be applied : — I£ Eau de cologne, 3iij. Spiritus lavendulae, 3iij- Misce. Sig. : To be rubbed thoroughly over the body. Hand-Book of Modern Treatment. 399 The diet should be rich in fats and phosphates. Conse- quently the patient's food should consist mainly of milk, eggs, farinaceous compounds, meat, chicken, and dry vegetables. The country and seaside are better locations for these cases. I£ Liq. potassii arsenitis, m xvj. Aquae destillatae, f^ij. Misce. Sig. : Teaspoonful three times daily after meals for child five years old. Ifc Olei morrhuae, f£vj. Syrupi calcis lactophosphatis, §iij. Liq. calcis, §iij. Misce. Sig. : One or two teaspoonfuls three or four times daily. I£ Olei morrhuae, f]$xvj. Sig. : Inunction night and morning. I£ Syrupi ferri iodidi, Siij. Syrupi simplicis, q. s. ad §v. Misce. Sig. : Teaspoonful three times daily after meals. SCURVY. Ifc Acidi hydrochlorici, f3j. Mellis, fSj. Aquae rosae, f§j. Misce. Sig. : Apply to affected gums three or four times daily. 1^ Potassii chloratis, 3ss. Listerinae, f3j. Acidi citrici, gr. vj. Aquae. f§ij. Misce. Sig. : Use several times daily as a mouth wash on soft cloth. 400 Band-Book of Modern Treatment. I£ Limonis succi, Sig. : Use ad libitum as a drink. SEA-SICKNESS. B Sodii bromidi, 3j. Amnion, bromidi, 3ss. Aquae menthae pip., f^v. Misce. Sig. : A tablespoonful before meals and at bedtime. To be used three days before embark- ing. I£ Aeetanilidi, gr. xlviij. Fiant chartulae no. xxiv. Sig. : One powder on tongue every two or three hours. B Spiritus glycerylis nitratis, 3ij. Sig. : One or two drops two or three times daily. Ifc Chloroformi, m xlv. Alcoholis, f^ss. Elixiris aromat., fBss. Misce. Sig. : Twenty to forty drops as needed. IJ Sodii bromidi, 3iij. Sig. : Sixty grains in divided doses three days before embarking, combined with strych- nine, gr. V 30 , three times daily. SEBORRHCEA.— See Dandruff. SEPTICEMIA.— See Pyaemia. SHINGLES.— See Herpes. SHOCK. Ifc Atropine sulphatis, gr. 1 / 60 - 1 / im . Sig.: Give hypodermically as required, espe- cially when the skin is moist. Hand- Book of Modern Treatment. 401 I£ Ammonii carbonatis, gr. viij. Syrupi, f3ij. Aquae camphorse, q. s. ad f^j. Misce. Sig. : Teaspoonful as required. Indication: Used in surgical shock in chil- dren. I£ Strychnin* sulphatis, gr. 1 / 20 - 1 /io Sig. : In ten minims of water hypodermic- ally. Ifc Caniphorse, gr. xxx. Olei olivae, fgss. Misce. Sig.: Give fifteen minims every fifteen min- utes until reaction began. SLEEPLESSNESS.— See Insomnia. SMALL-POX. I£ Linimenti calcis, §viiss. Olei eucalypti, 3iv. Calaminae prep., 3j. Misce. Sig.: Direct application to face by means of a large camel's hair brush every two to three hours. Indication: To prevent pitting. IJ Tinct. aconiti, m xij. Spiritus setheris nitrosi, f3iv. Liq. potassii citratis, q. s. ad f§iij. Misce. Sig. : One or two teaspoonful s in water every two hours. Indication : Used in early stage as a circula- tory sedative. 1^ Ichthyoli, 3ij. Guaiacoli, 3ij. Glycerini, £ss. Misce. Sig.: Apply locally with a feather three times a day. 26 402 Band-Book of Modern Treatment. The earlier it is commenced, the better. The face should be bathed before each application with hike-warm water and soap. As a stimulant in profound prostration, Stokes's cognac mixture : — '■ I£ Cognac optimi, f3xv. Aquae destillatae, f3xv. Vitelli ovi, no. j. Syrupi, f3vj. Misce. Sig.: A tablespoonful every two hours. To soften the scab nothing is better than a salve of the following composition : — IJ Sodii bicarbonatis, 3ij. Petrolati q. s. ad §j. Misce. When extensive impetigo exists employ a bichloride bath and then dust the patient with a weak aristol or iodoform talcum powder. An ointment which is useful in treating impetigo pus- tules is : — Ifc Hydrarg. ammonia ti, gr. x. Pulv. amyli, 5ij. Pulv. zinci oxidi, 3ij. Petrolati, 3ss. Misce et fiat unguentum. 1$ Ichthyoli, 3iss. Vaselmi, §ij. Misce. Sig. : Apply to pustules to prevent pitting. B Saloli, -gss. Fiant chartulse no. xij. Sig. : One powder every eight hours. Indication: Used to abort pustulation and prevent irritation and desire to scratch. Ingalls reports thirty-six cases of variola, of which one was hemorrhagic and thirteen confluent, treated by the bichlor- Band-Book of Modern Treatment. 403 ide baths without mortality. The treatment was given as fol- lows : A six-foot bath-tub was placed beside the patient's cot and filled with a fairly warm — 103°-105° — solution of bi- chloride, 1 to 10,000, and the patient placed therein, head and shoulders above the solution; the nurse then went over the entire body, using a soft cloth, being careful of force applied so as not to cause much pain. After remaining in the bath about ten or twelve minutes, the patient was removed, thoroughly dried, dressed in freshly laundered clothing, and placed in a clean bed. These baths were given night and morning. After removal from the bath the patient expressed much relief, but shortly after, owing to the drying effect, complained of a burning sen- sation "just beneath the skin." He found that all were like- wise affected, so, to obviate this, began a routine practice of anointing patients immediately after the bath with a mixture of carbolic acid, bismuth subnitrate, and olive-oil, with a very happy result. He makes the following deductions concerning the method: There is practically no mortality. The suppurative fever can be shortened four to six days if patient is treated from the onset; a minimum of pitting is secured and an almost entire absence of the characteristic, disagreeable odor; the period of desqua- mation is materially lessened, owing to the thinness of the scab- formation; pain is much reduced, morphine being rarely indi- cated; the great distortion of features, which gives us such repulsive looking patients, is eliminated to a great extent. I£ Liq. potassii acetatis, fSiiiss. Spiritus aetheris nitrosi, f£ss. Misce. Sig. : A tablespoonful every two or three hours in a wineglassful of water. B Argenti nitratis, gr. xl. Aquae destillatse, f^ij. Misce. Sig. : Paint the skin that is exposed to the light. Indication: To prevent pitting. 404 'Hand-Book of Modern Treatment. I£ Tinct. ferri chloridi, f5j. Sig. : Five to ten minims in water every four to six hours. Indication: To affect specifically the pyasmic fever. Ifc Caffeines citrates, gr. vj. Antipyrini, 3j. Misce. Sig.: One powder as required. Indication : Used to relieve pain in back and head. 1$ Potassii chloratis, f§ss. Tinct. myrrhas, f^ss. Aquas, q. s. ad 3xvj. Misce. Sig.: Shake well and use as mouth wash as necessary. Indication: Used for sore mouth. SNAKE-BITES.— See Bites and Stings. SPERMATORRHOEA. I£ Tinct. cantharidis, 3ij. Tinct. ferri chloridi, 3vj. Misce. Sig. : Twenty drops in water three times daily. Indication: Used in impotence with sperma- torrhoea. B Tinct. gelsemii, 3j. Tinct. belladonnas, 3ij. Misce. Sig. : Fifteen drops at bedtime. I£ Antipyrini, 3ij. Syrupi acacias, 3ss. Aquas cinnamomi, q. s. ad fgiv. Misce. Sig.: A dessertspoonful on retiring. Indication: Used when due to neurasthenia. Hand-Book of Modem Treatment. 405 I£ Potassii bromidi, 3j- Aquae destillatse, q. s. ad fgij. Misce. Sig. : A teaspoonful three times daily. Indication: Used in the strong and ple- thoric. I£ Potassii bromidi, 3iv. Fluidextracti ergotse, f3iv. Tinct. belladonnae, f3ij. Aqua? camphorae, q. s. ad f^viij. Misce. Sig.: Tablespoonful at bedtime. Indication: Used in cases with spinal hyper- esthesia and nocturnal pollutions. SPLENIC ENLARGEMENT.— See Fever, Intermittent. SPRAINS.— See Bruises. STINGS.— See Bites and Stings. STOMATITIS. A. J. Perkins says that this complaint, "nursing sore mouth/' is usually mild and easily palliated, but in many cases it is very severe and makes the nursing period one of great suffer- ing. It usually commences soon after the nursing commences, and continues until the child is weaned. He does not attempt to explain its etiology. For many years he has been looking for a remedy, and now thinks he has one which will make short work of the disease. This is sodium sulphite. He gives it in solution, a drachm to a cup of water, a teaspoonful every hour until* bed-time each day. For those who dislike the taste of the sulphite a syrup is used: — Ifc Sodii sulphitis, 3j. Pulv. rhei, gr. x-xx. Glycerini, fgii-iv. Aquae bullientis, q. s. ad Oj. Misce. Sig. : Teaspoonful every one, two, or three hours as urgency of symptoms indicates. 406 Hand-Book of Modem Treatment. I£ Potassii chloratis, 3v. Saponis medic, 3iiss. Calcii carbonatis, 3v. Olei menthse pip., m xv. Olei caryophylli, m iv. Misce. Sig. : Use as dentifrice. Indication: Mercurial stomatitis. Ifc Potassii chloratis, Tinct. myrrhse, gr. xlv. Aquse destillatse, 5vj. Misce. Sig. : Use externally as mouth wash or to wash oral cavity. Indication: Used in aphthous stomatitis. I£ Saloli, gr. xv. Catechu, gr. xxx. Spiritus menthse pip., £iss. Misce. Sig. : A teaspoonful in a tumbler of hot water. Indication: Used in smokers' stomatitis. STRANGURY. Ifc Extracti belladonnas, gr. i-iv. Olei theobromse, 3ss. Facit suppositorium no. j. Sig. : Introduce into the bowel and repeat in four hours if necessary. I£ Tinct. veratri viridis, f3ss. Morphinse acetatis, gr. ij. Spiritus astheris nitrosi, fSj- Liq. potassii citratis, q. s. ad f^viij. Misce. Sig. : Shake. Tablespoonful in water every two hours. Indication: Used in acute inflammation of the bladder and prostate. Hand-Book of Modern Treatment. 4Q7 I£ Tinct. cannabis Indices, f^j. Sig. : A half-teaspoonful every four hours. Indication: Used when urine is bloody and when due to spinal disease. I£ Pulveris opii, gr. ii-iv. Olei theobromae, 3j. Misce et fiant suppositoria no. ij. Sig. : Introduce one into the bowels and re- peat in four hours if necessary. STRUMA.— See Rickets and Scrofulosis. STYE. IJ Hydrarg. oxidi rubri, gr. xij. Petrolati, 3iv. Ung. aquae rosae, 3iv. Misce. Sig. : Apply night and morning after a thor- ough cleansing with hot boric solution. If very distressing and involving much of the lid the stye should be incised, with full antiseptic precautions. I£ Hydrarg. chloridi corrosivi, gr. 3 / 20 . Vaselini, gr. 3vii-xlij. Misce et fiat unguentum. Sig. : Ointment for eyelids. 1$, Sulphur, sublimati, gr. xlvj. Ammonii chloridi, gr. xv. Aquae rosae, f^j. Spiritus camphorae, f3iss. Misce et fiat collyrium. Sig. : For local use on eyelids. 1$, Hydrargyri oxidi flavi, gr. iss. Adipis lanae hydrosi, SiVs- Glycerini, q. s. Misce et fiat unguentum. Sig. : Eye ointment. 408 Hand-Book of Modem Treatment. According to an abstract in the Medical Becord, the lash should be removed from the center of the inflammatory area. The swelling should be carefully touched with tincture of iodine or pure carbolic acid. When pus is present it should be released by a small incision. The pain will be relieved by warm fomenta- tions. A weak mercurial ointment will. generally cause the dis- appearance of the remaining thickening of tissue. The diet should be regulated when there is any constitutional disturb- ance. 1$ Hydrarg. oxidi rubri, gr. iss. Vaselini, 3v. Misce et fiat unguentum. Sig. : For external use. 1$ Acidi borici, 3j. Aquae rosse, q. s. ad f§iv. Facit lotio. Sig. : Apply freely lukewarm. SUPPURATION.— See Abscess. SWEATING. In the night-sweats of phthisis camphoric acid in the dose of 1 / 2 drachm taken one hour before bed-time is a valuable remedy. This dose is best given on the tongue and washed down with a swallow of water. Other drugs of use are atropine, picro- toxin, agaricin, acetate of thallium, and guaiacolate of piperi- dine. Of late the opinion has been expressed by several observers that, since the perspiration of night-sweats has been found on analysis to contain tuberculin, no attempt should be made to lessen the sweating, but that, on the other hand, it should be encouraged. Ifc Balsami Peruvianas, m xv. Acidi formici, gr. lxxx. Chloralis hydratis, gr. lxxx. Alcoholis (pure), giiiss. Misce. Sig. : Sponge the body with the foregoing combination at bedtime. Hand-Book of Modern Treatment. 409 The following combination is frequently used locally in the treatment of night-sweats: — Ifc Aluminis, 3iv. Alcoholis, 3ij. Aquae, Oj. Misce. Sig. : Apply locally night and morning with a sponge. Indication: Night sweats due to tubercu- losis. I£ Plumbi acetatis, gr. x. Extracti gentianse, q. s. Misce et fiant chartulse no. xij. Sig. : Three to four powders daily. I£ Aluminis, 3iv. Acidi acetici diluti, fgiv. Aquae, q. s. ad Sxvj. Misce. Sig. : Sponge the body several times daily. Indication: Used to prevent night sweats. I£ Acidi borici, gr. xv. Sodii boratis, 3vj. Acidi salicylici, 3vj. Glycerini, §iss. Alcoholis, q. s. ad Siij- Misce et fiat lotio. Sig. : For local application. Indication: Sweating feet. Ifc Sodii salicylici, gr. xxx. Kali permanganatis, 3j. Bismuthi subnitratis, 3xij. Pulv. talci, q. s. ad 3iij- Misce et fiat pulv. Sig. : Dust on feet and into stockings and shoes every morning. B Acidi borici, §ij. 'Acidi salicylici, 3j. Misce. Sig. : Used as a dusting powder upon feet and also in the stockings. 410 Hand-Book of Modern Treatment. R, Tinct. belladonnse, §ss. Sig. : One or two drops three times daily, gradually increased to five or six. Indication: Used to control sweating. (1) Boot socks may be used made of filter paper, linen or cork, soaked in a mixture of potassium permanganate, 1 gram (15 grains) ; water, 100 cubic centimeters (3^4 ounces) ; thy- mol, 0.5 gram (8 grains) ; and then dried. They should be changed daily. (2) A lotion of naphthol, 5 parts; glycerine, 10 parts; alcohol., 100 parts; this to be followed by a powder of naphthol and starch, 1:90. (3) Socks may be powdered with talc, 40 parts; bismuth subnitrate, 45 parts; potassium per- manganate, 3 parts; sodium salicylate, 2 parts; rice powder, 60 parts. (4) Perchloride of iron, 30 parts; glycerine, 10 parts. (5) A lotion of quinine sulphate, 5 parts; tannin, 2 parts; alco- hol, 100 parts; water, 250 parts; to be followed by a powder of salicylic acid, 3 parts; starch, 10 parts; talc, 87 parts; alum, 45 parts. (6) Tincture of belladonna, 25 parts; eau de Cologne, 120 parts. SYCOSIS. B Sulphuris prsecipitati, 3ss-iss. Ichthyoli, 3i-iss. Petrolati, q. s. ad gj. Misce. 1$ Resorcini, 3j. Glycerini, f3ij. Ung. aquse rosse, q. s. ad Sij- Misce. Sig.: Apply several times daily. Indication : To be used after crusts have been softened with oil. R Liq. arsenici et hydrarg. iodidi, f3ij. Syrupi zingiberis, fgj. Aquse destillatae, q. s. ad fBiij. Misce. Sig.: Teaspoonful after each meal. Hand-Book of Modern Treatment. 411 IJ Hydrarg. oleatis (5 to 15 per cent.), 3ij. Sig. : Paint over the affected part. IJ Ung. hydrarg. nitratis, 3iv. Sulphuris, 3ij. Creosoti, gtt. x. Adipis lanse hydrosi, ^i-ij. Misce et fiat unguentum. Sig. : Rub in well. SYNOVITIS. R. Chloralis hydra tis, 3iv. Phenolis, 3ss. Aquae, q. s. ad Oj. Misce. Sig. : Apply as hot as possible upon layers of lint, changed every hour, and covered with oil silk. B Ichthyoli, £ij. Adipis lanse hydrosi, 3ij. Misce. Sig.: Apply freely upon cloth and place joint at rest. Indication: Used in acute cases. I£ Liq. plumbi subacetatis, §ij. Tinct. opii, §ij. Aquae bullientis, q. s. ad Sxxxij. Misce. Sig. : Apply upon soft cloths and place joint at rest. Indication: Used in acute synovitis. B Tinct. iodi, fgj. Sig. : Apply with a brush every second or third day. R Potassii iodidi, 3iv. Sodii salicylatis, f3iv. Aquae menthae pip., q. s. ad Siij. Misce. Sig. : A teaspoonful in water after meals. Hand-Book of Modern Treatment. R Emplastri cantharidis. Sig. : Apply every night until the skin is well reddened. If this does not avail, leave on until a bleb is formed, which may be cut, poul- ticed, and dressed with simply cerate. Indication: In the chronic form. SYPHILIS. Otto Lerch, in American Medicine, advocates the adminis- tration of mercury by inunctions in syphilis. He concludes that the virus spreads from the seat of infection along the lymph channels, and that the glands remain swollen when no other symptoms of the disease can be discovered. Secondary infec- tion of the vessels, viscera, and nervous system takes place, and late infection can be easily explained by such deposits of virus. In support of his views he states if the drug is used by mouth it has to travel a circuitous route to reach the original -deposits, and part of it is lost by way of the intestines, kidneys, and liver. If given by injections of soluble salts, it meets a similar fate, as it is largely taken up by blood-capillaries, and this is also true if administered by injection of insoluble salts, though better results seem to have been obtained by this method, which gives the lymphatics a better chance. It is true that the employment of mercury by inunction is inconvenient, dirty, and tiring, and that a stomatitis, intestinal colics, erythema, and eczema cannot always be avoided and that the exact amount of the mercury absorbed cannot be determined. Most of these defects are shared by the other methods, and es- pecially this last point upon which so much stress has been laid offers no more certainty than we encounter when the drug is administered by mouth or hypodermic injection. However, the mercury used by inunction is taken up by the lymphatics and brought immediately and directly in contact with the virus, immunizing the glands and making them unfit for deposits of the poison. Inunctions are painless, do not disturb the digestive system, and, above all, clinical experience shows "they give superior results." Hand-Book of Modern Treatment. 413 The following is the treatment used by Lerch : — If the ulcer can be extirpated without difficulty it ought to be done in every instance to insure healing by first intention, to modify favorably general infection, and perhaps prevent it altogether in a few cases. After positive diagnosis has been made, generally only after the appearance of constitutional symptoms, characteristic enlargement of glands, skin eruptions, etc., mercury ought to be administered. The mercury may be given by inunction in from 3 -gram to 7.78-gram (45 to 120 grains) doses; in severe cases, blue ointment should be used each twenty-four hours. The patient is directed to divide the amount into two equal parts, and use one for each leg over the inside, with vigor- ous massage. It is necessary to continue the rubbing for fifteen minutes over each side to cause absorption, and it is best to control the time by the watch, as the process is tedious and too often the time of rubbing shortened by the patient. The second day the process is repeated over the inside of the thighs in the same manner, the third day the inside of the arms, fourth day, chest and abdomen ; the fifth day the back must be treated, and on the sixth day a full warm bath for cleaning purposes is ad- ministered. To prevent colds, especially during the winter, the patients are directed to use the inunction before retiring. The patient may use the inunction himself during the first four days, after full instructions, or all may be given by a professional masseur. Thirty inunctions generally constitute a full treat- ment. In other words, the process has to be repeated six times. E. G-. Ballenger, after discussing the various mercurial and iodide treatments, says that cases are occasionally encountered where these drugs alone not only prove ineffectual, but actually aggravate the s}^mptoms and hasten the destruction of tissue. For these cases the author states that Cooper, in the Practi- tioner, of London, advises the Zittman treatment, which, after two weeks' use, will arrest the disease and cause a rapid healing of the lesions. The principle of the treatment consists in eliminating the poison from the system by purgation and sweat- ing. The patient is kept in a room, the temperature of which is maintained at 80° F. The evening before the treatment is be- gun two of the following pills are administered: — 414 Hand-Book of Modern Treatment. IJ Hydrarg. chloridi mitis, gr. ij. Ext. colocynthidis, gr. v. Ext. hyoscyami, gr. ij. Misce et fiant pilulae no. ij. The diet is regulated and for the first four days the patient drinks a half-pint of the following decoction, as hot as possible, at 9, 10, and 11 a.m., and 12 m. : — IJ Rad. sarcae contus., 3iv. Sem. anisi contus., §viiss. Sem. fceniculi contus., ^viiss. Fol. sennse, 5j- Rad. glycyrrh. contus., 3iv. Add in linen bag: — IJ Sacchr. alb., 3iss. Aluminis sulph., 3iss. Hydrarg. chlor. mit., 3iss. Hydrarg. bisulph. rub., gr. x. Aquae cong., iij. Boil gently down to one gallon, strain, and put into four 40-ounce bottles. On the same days, at 3, 4, 5, and 6 p.m., half-pint of the following decoction is taken cold: — To the dregs from No. 1 decoction add : — ■ IJ Rad. sarcae contus., §ij. Cort. limonis contus., 3j. Sem. cardamon. contus., 3j. Rad. glycyrrh. contus., 3j. Aquae cong., iij. Boil gently down to one gallon, strain, and put into four 40-ounce bottles. The patient is kept in bed except for an hour each evening, when he may sit up. On the fifth day he is given a hot bath and allowed to get up. In the evening two pills are admin- istered, the patient starting the decoctions again on the next day as before. The treatment goes on in the same way until the fifteenth day, when it is discontinued. Band-Book of Modern Treatment. 415 Good results are claimed from its use in all tertiary lesions of syphilis as well as in many skin diseases and in rheumatic and gouty affections. I£ Potassii iodidi, 3j. Ferri et ammon. citratis, 3j. Strychninae nitratis, gr. V 3 . Elaeosaccharum menth. pip., gr. lxxv. Aquae aurantii nor., q. s. ad f^iv. Misee. Sig. : One teaspoonful in a pint or more of water. I£ Tablets hydrarg. chlor. corros., gr. 1 / 25 Fiant tabellae no. xv. Sig. : One tablet hypodermically daily. 1$. Potassii iodidi, Hj- Aquae destillatae, §j. Misce. Sig. : Ten drops after each meal, in water, and gradually increase to the limit of tolerance. Sodium, ammonium, or strontium iodide can be substituted for the potassium. Indication : Headache in brain syphilis. I£ Hydrarg. biniodidi, gr. iss. Potassi iodidi, gr. ix. Sodii phosphatis, gr. xv. Aquae destillatae, §ij. Sol. sodii chloridi ( decinormal ) , §ij. Misce. Sig. : Sixteen drops by hypodermic injection once daily. I£ Hydrarg. protiodidi, gr. v-x. Strychninae sulphatis, gr. ss. Ferri sulphatis, gr. xx. Pepsini pulv., gr. xl. Misce et fiant capsular no. xx. Sig. : One capsule after each meal. Indication: Useful when there is malaise and anaemia. 416 Hand-Book of Modern Treatment. I£ Acidi salicylici, gr. xviij. Ichthyolis, gr. xxx. Ung. aquae rosae, 3viiss. Misce. I£ Hydrarg. chloridi mitis, gr. xv. Ung. aquae rosae, 3viiss. Misce. Sig. : Rub palms of hands each evening at bedtime, and wear gloves at night. Indication : ( 1 ) Used to cure palmar psoria- sis, and (2) to prevent its recurrence. I£ Hydrarg. chloridi corrosivi, gr. iij. Chloralis hydratis, 3j. Resorcini, 3ss. Olei ricini, gr. xv. Alcoholis, 31-0iij. Misce. Sig.: Apply daily. Indication : Used in syphilitic alopecia. Ifc Hydrarg. iodidi rubri, gr. j. Potassii iodidi, 3iv. Syrupi sarsaparillae comp., f^ij. Aquae fjjij. Misce. Sig.: A teaspoonful three times daily after meals. Indication: Mixed treatment. I?, Potassii iodidi, 3ii-iv. Hydrarg. chloridi corrosivi, gr. ss. Syrupi aurantii cort., f§j. Aquae destillatae, q. s. ad f^ij. Misce. Sig. : Teaspoonful three times daily. Indication: Mixed treatment. Ifc Hydrarg. chloridi corrosivi, gr. j. Potassii iodidi, 3ij. Tinct. gent, comp., f§iij. Misce. Sig. : Teaspoonful three times daily after meals. Indication: Mixed treatment. Hand-Book of Modern Treatment. 417 Jacobi recommends the following treatment: A syphilitic infant should be nursed by its mother but never wet-nursed; treatment should be carried out for two years, with periods of intermission. Mercury does not affect the mouth and bowels of infants like it does those of adults. Calomel, 1 / 8 grain, three times daily for many weeks; iron, if the infant is anaemic (no reliance is to be placed on mercury given to the mother) ; mer- cury with chalk, in doses of 1 / 6 to 1 /.> grain, may be given. Inunctions of blue ointment are of value, but are apt to do harm, as the skin of the infant is very sensitive. In urgent cases the hypodermic injection of 10 or 15 drops daily of the following solution is advantageous: bichloride, 1 part; sodium chloride, 2 parts ; water, 200 to 300 parts. Inject deep into the muscular tissue. Bichloride bath, 1 to 1000, in extensive skin-lesions, does well; iodides are not needed in the secondary stage; in syphilis tarda, potassium iodide. In iodism, affecting the mucous mem- brane, potassic chlorate and atropine ; in ill nutrition, iron and arsenic. Indication: Used in hereditary syphilis. IJ Iodoformi, 3iij. Camphorse, 3iij. Morphinse, gr. ij. Pulv. acaciae, 3ij. Acidi tannici, gr. x. Bismuthi subnitratis, 3iv. Misce. Sig. : Use with powder-blower. R Iodi puri, gr. xx. Kalii iodidi, gr. lx. Acidi carbolici. 3ss. Olei eucalypti, 3j. Boroglyceridi, 3iij. Olei menthse pip., m x. Glycerini tannat., q. s. ad §j. Misce. Sig.: Apply with a probang or camel's hair pencil. Indication: Used in syphilitic lesions of the throat and nose. 27 418 Band-Book of Modern Treatment. IJ Hydrarg. bichloridi, gr. xx. Tinct. cantharidis, §ss. Tint, capsici, 3ss. Glycerini, gj. Olei ricini, 3j- Spiritus eolognensis, q. 3. ad Sviij. Misce et fiat lotio. Sig. : Rub in scalp night and morning. IJ Hydrarg. biniodidi, gr. v. Olei verbena^, m ij. Vaselini, §j. Misce. Sig. : Rub well into the scalp at bedtime. The following formula for use in the tertiary stage : — IJ Iodi resubl., gr. viij. Potassii iodidi, 3viij. Syrupi sarsaparillse comp., Sviij. Misce. Sig. : One drachm dose. As a local application to the chancre : IJ Olei mirbani, m iv. Balsami Peruviani, 3iij. Iodoformi, 3ij. Vaselini, q. s. ad §j. Misce. IJ Hydrarg. chloridi mitis, 3ij- Lycopodii, 3ij. Misce. Sig. : Use as a snuff three times daily. Indication: Used in syphilitic lesions of the nose. IJ Hydrarg. cum creta% 3j. Fiant chartulae no. xl. Sig. : One powder three times daily. Indication: Used in infants instead of yel- low iodide. Hand-Book of Modem Treatment. 41 9 U Ung. hydra rgyri, 3ij. Pone in chartulae no. xvj. Sig. : One package applied by thorough in- unction once daily. TABES. — See Locomotor Ataxia. In 1901 Xegro announced that in 8 out of 11 cases of tabes the fulminating pains were arrested by administration of san- tonin, while two others were much improved and only one proved refractory. Combemale reports in Echo Medical his experience with it in 16 cases of various nervous affections. In ^ cases not the slightest effect was appreciable, whether the patients took larger or smaller doses, in shorter or longer courses. These were all cases of neurasthenia or ordinary neuralgia. On the other hand, in the 9 cases of tabes the fulminating pains were unmistakably arrested in 5 by the medication. Negro's dose was 15 centigrams of santonin in three doses of 5 centi- grams each at an hours interval, given during the attack. Combemale gave smaller amounts, longer continued, but has become convinced that Negro's method is preferable. He found that gastric crises followed the subsidence of the fulminating pains in one case in which the santonin had been given con- tinuously for a maximum period. He remarks that xanthopsia is the first sign of incipient intoxication and requires suspension of the drug, but at this early stage of intoxication there is no danger of serious consequences from it. He is inclined to try a preventive course of 15 centigrams in future when fulminating pains are imminent. M. Collet, of Lyons, writes that hitherto santonin has been employed against the fulgurant pains of tabes with different re- sults. In one case of severe and frequent laryngeal crises of several years' duration, and which had resisted all methods of treatment, the symptoms vanished in three days under the in- fluence of a daily dose of -45 centigrams of santonin, taken in three doses. This treatment was continued for two months without inconvenience. At the end of eight months there was a return of the laryngeal symptoms which obliged recourse again to the medicine, and on this occasion it was used with equal success (only one slight crisis in a month). Since the santonin 420 Hand-Book of Modern Treatment. influences favorably in certain cases the fulgurant pains of locomotor ataxia, it need not surprise us to see the same drug determine the disappearance of the laryngeal crises, a spasmodic phenomenon which has its point of departure from a sensory surface. The action of santonin upon the fulgurant pain being inconstant, it is probable that the action upon the laryngeal crises will be the same. The laryngoscope shows a paresis of the abductors of the glottis. Small doses of mercury and potassium iodide are a very efficient combination in the treatment of tabetic and neuritic pains, combined as follows: — B Hydrarg. biniodidi, gr. 1 / li . Potassii iodidi, 3j. Aquae, 3iij. Misce. Sig.: Thirty drops to be injected about the seat of the pain. The same treatment is also recommended in the obstinate late manifestations of syphilis. It aids in the rapid absorption of the gummatous lesion. IJ Hydrarg. benzoatis, gr. xv. Amnion, benzoatis, gr. lxxv. Aquae destillatae, q. s. ad giij. Misce. Sig. : Inject deeply into buttock, beginning with fifteen grains and increasing gradually to two drachms. I£ Hydrarg. biniodidi, gr. xv. Sodii iodidi, q. s. to dissolve the mercury. Aquae destillatae, q. s. ad giiiss. Misce. Sig.: Dose may be increased to 90 minims daily. I£ Liq. potassii arsenitis, §j. Sig.: One drop three times daily after meals and increase till oedema above the eyes. Then reduce to smaller dose. Hand-Book of Modern Treatment. 421 TAPEWORM. The patient is instructed to thoroughly clean out the bowels by purgatives the clay previous to the administration of the remedy. In the morning, as early as possible, a 20-grain capsule of pelletierine tannate is given, and after this has operated fully, which is usually in about two or three hours, the following pre- scription is administered: — R Oleoresime aspidii, 5ij. J^theris, Sij. Hvdrarg. chloridi mitis, gr. xij. This is divided into sixteen capsules and one given every ten minutes, no food being taken. In about two or three hours the worm will be expelled whole, with its head intact. IJ Granati radicis, Bss. Seminis peponis. §j. Ext. filicis maris ether, 3j. Pulv. ergotae, 3ss. Pulv. acaciae, 3ij. Olei tiglii, gtt. ij. Misce. Sig. : The pomegranate and pumpkin seed should be thoroughly mixed in a mortar with the ergot and boiled for fifteen minutes in water and strained. The croton oil is first mixed with the acacia and the male fern and then formed into an emulsion with the decoction. The following combination containing pelletierine tannate has been used with almost uniform success in treatment of tape- worm, but it disturbs the stomachs of some patients: — I£ Oleores. aspidii. f3iv. Olei terebinthinse. f3ij. Pelletierinse tannatis. 3j. Spiritus chloroformi. f3j. Misce. Sig.: Shake well. One teaspoonful in the morning on an empty stomach, followed in about two hours bv a saline cathartic. 422 Band-Book of Modern Treatment. After the contents of the intestinal canal have passed we may begin with the following prescription : — I£ Bismuthi subnitratis, 3j. Saloli, gr. xxiv. Syrupi tolutani, 3ij. Mucilaginis acacia?, q. s. ad §ij. Mi see. Sig. : Teaspoonf ul every three or four hours. 1$. Pepo (seeds), 3x. Ext. granati, 3iiss. Misce. Sig.: Divide into twenty parts and take five every half-hour, after fasting for twenty-four hours. One-half hour after the last dose a combination of tinctura jalapae composita and syrupus frangulse should be given. TETANUS. I£ Tinct. iodi, m xv. Alcoholis, m xxx. Misce. Sig. : Five drops in half a tumbler of hot water every half-hour. Indication: Tetanic uterine contractions. Ten minims of a 10-per-cent. carbolic acid solution were in- jected hypodermically, and after fifteen minutes 20 minims in addition, in a boy of 12, with general symptoms of tetanus, dyspnoea, and opisthotonos ten days after injury to the foot. After the third day there was improvement, and he gradually recovered. Ifc Ext. physostigmatis, gr. ij. Aquae destillatse, f3j. Misce. Sig. : Ten minims every two hours hypo- dermically as required. To be pushed just short of arresting breathing. Hand-Book of Modem Treatment. 423 IJ Chloralis hydratis, 3ss. Syrupi aurantii cort., §iss. Aquae, q. s. ad f^iij- Misce. Sig. : A dessertspoonful as required. I£ Liq. potassii arsenitis, f^j. Sig. : Five to eight drops, well diluted, every three hours. IJ, Potassii bromidi, 5iss. Fiant chartulse no. xij. Sig.: One powder in water every three or four hours. Indication: To relax spasm. R. Tetanus antitoxin, Sig. : Used as conditions indicate. THREADWORMS.— See Worms. THRUSH.— See Aphthae. I£ Sodii bicarbonatis, 3j. Sodii boratis, 3ss. Syrupus idasse, 3vj. Misce. Sig. : To be used as a mouth wash. ]$ Glycerini, 3vj. Amyli, 3j. Sodii boratis, 3j. Misce. Sig. : Apply with a camel's hair brush. A drachm of sodium hypophosphite to an ounce of rose- water makes an excellent mouth-wash for thrush. B Sodii hyposulphatis, gr. xx. Aquae destillatee. 3v. Glycerini, 3iij. Misce. Sig. : One teaspoonful every two hours to be taken internally, and it should be applied locally with a camel's hair brush. 424 Hand-Book of Modern Treatment. The following combination is also recommended as of great value as an antiseptic and astringent: — I£ Zinci sulphatis, gr. ii-v. Aquse rosos, §ij. Misce. Sig. : Apply locally. Baginsky recommends the application of potassium perman- ganate topically in a 1 to 25 solution, and resorcin internally in solution of 1 to 100, 1 to 4 teaspoonfuk being given daily. A writer places the greatest faith in the application of iodine com- bined as follows : — I£ Tinct. iodi, 3ss. Glycerini, 3iiiss. Misce. Sig. : Apply locally with a camel's hair pencil. By this latter treatment the disease is completely eradi- cated within three or four days after the first treatment. He does not ascribe all the curative properties to the iodine, but re- gards glycerine as a very important factor. This treatment surpasses any treatment heretofore instituted; it is harmless and rapid in its action. While thrush is most frequently a trifling affection and readily cured, it at times becomes a very serious trouble, so serious that it may threaten the life of the child. In the lighter forms of thrush, in which the parasite has as yet spread but little and its threads have not penetrated deeply into the epithe : lial layer, the treatment is not a very difficult matter. Here the hyposulphate of soda is preferred by some: — I£ Sodii hyposulphatis, gr. xx. Aquae destillatse, 3v. Glycerini, 3iij. Misce. Sig. : One teaspoonful every two hours inter- nally and applied topically with a large camel's hair brush. Rand-Book of Modern Treatment. 425 In severer cases the following should be used : — Ifc Tinct. iodi, 3ss. Glycerini, 3iiiss. Misce. Sig. : Apply with a large camel's hair pen- cil to the tongue, gums, and cheek. This application produces a remarkable effect. Some be- lieve that it surpasses any other that has hitherto been recom- mended. I£ Argenti nitratis, gr. x. Aquae, gj. Misce. Sig.: Apply with swab. I£ Hydrarg. cum cretse, gr. j. Pulv. hydrastis, gr. ij. Bismuthi subnitratis, gr. iij. Misce. Sig. : Use at one dose and repeat every three or four nours. When the secretions are very free, belladonna or atropine is useful. In some cases the treatment should be begun with small and frequent doses of lobelia, repeated until it acts as an emetic. Sodium sulphite will be of value when the tongue is broad, pallid, and a whitish or yellowish moist coating on it. In debilitated conditions, iron in some agreeable form, nux and other tonics will be very useful, as occasionally the disease will resist almost any remedy until the general health is built up. TIC DOULOUREAUX.-See Neuralga. 426 Hand-Book of Modern Treatment. TINEA TONSURANS.— See Ringworm and Sycosis. B Olei tiglii, 3j. Sulphuris praecipitati, 3ss. Phenolis, 3ss. Olei amygdalae, q. s. Adipis lanse hydrosi, q. s. ad 3j- Misce. Sig. : Epilation should be practiced daily, and a slight amount of folliculitis produced by use of the above prescription. In the treatment of tinea tonsurans of children the Medi- cal Eecord recommends that the hair be cut as close as possible once a week. Every third day the head should be washed with soap and warm water. Morning and evening the scalp should be massaged, triturating the diseased areas vigorously. Following the massage, prolonged friction should be applied with the fol- lowing application : — IJ Olei ricini, 3j. Tinct. cantharidis, 3j. Spiritus camphorse, %iv. Misce. Sig. : To be applied locally to the scalp. IJ Hydrarg. ammoniati, gr. vj. Hydrarg. oxidi rubri, gr. vj. Adipis lanse hydrosi, §j. Misce. Sig.: Use after epilation and washing. TINEA VERSICOLOR. I^ Resorcini, 3i-iiss. Olei ricini, 3xiss. Alcoholis, 3xxxviiiss. Balsami Peruviana?, gr. viiss. Misce. Sig.: Apply locally. Eand-Book of Modern Treatment. 427 I£ Acidi salicylici, gr. xlv. Sulphuris loti, 3iiss. Adipis lanse hydrosi, 3xiiss. Vaselini, 3iiss. Misce. Sig. : After rubbing well with tar soap, rub in the ointment well every evening, and wash off in the morning. TINNITUS AURIUM. J£ Acidi hydrobromici diluti (10 per cent.), Sig. : One-half to one teaspoonful in a wine- glassful of sweetened water thrice daily. 1$. Pilocarpine hydrochloratis, gr. j. Sacchari lactis, gr. xviij. Alcoholis, q. s. Misce et fiant tabellae triturationes no. xij. Sig. : One tablet night and morning. Indication: Used in rheumatic and gouty subjects with thickening of the ear drum. J£ Ammonii chloridi, 3iv. Tinct. cimicifugae, f§iss. Syrupi aurantii florum, q. s. ad f'Siij. Misce. Sig. : Teaspoonful in water after meals. Indication: Used in rheumatic subjects with chronic otitis media. TONSILLITIS.— See Quinsy. I£ Sodii salicylatis, 3iss. Ferri sulphatis, 3iss. Liq. amnion, acetatis, f^iss. Syrupi tolutani, q. s. ad §iij. Misce. Sig. : Teaspoonful three times daily in milk. Indication: Useful in rheumatic tendency. 428 Hdnd-Book of Modern Treatment. B Potassii chloratis, 3ss. Acidi hydrochlorici diluti, 3ij. Tinct. ferri chloridi, 3iij. Glycerini, 3j- Syrupi tolutani, q. s. ad Siij. Misce. Sig. : One teaspoonful in water every two hours. Indication: Used in acute follicular tonsil- litis, preceded by a mercurial or saline purge. IJ Tinct. aconiti, m xxiv. Sodii salicylatis, 3j. Spiritus etheris nitrosi, 3iv. Syrupi aurantii florum, 3j. Aquae destillatae, q. s. ad %\\]. Misce. Sig. : Teaspoonful every one or two hours during the fever. Indication: Used in acute tonsillitis. 1^ Argenti nitratis, 3ij. Aquae destillatae, q. s. ad £ij. Misce. Sig. : Apply with camel's brush once daily. Indication: Acute tonsillitis and will abort the disease in one case out of four. F£ Tinct. guaiaci amnion., 3vj. Tinct. cinch, comp., 3vj. Sodii chloridi, 3ij. Pulv. acacias, q. s. Aquae destillatae, ad §iv. Misce et fiat mistura. Sig.: Shake well. Add teaspoonful of mix- ture to wineglassful of water and use as gargle three times daily. I£ Quininae sulphatis, gr. xlviij. Acidi sulphurici diluti, m xlviij. Tinct. aconiti, m xlviij. Syrupi pruni virginianae, §j. Aquae, q. s. ad §iij. Misce. Sig. : One teaspoonful in water every four to six hours; dose for an adult. Indication: Used in acute cases. Hand-Book of Modern Treatment. 429 I£ Sodii salicylates, 5iv. Potassii iodidi, 3iv. Syrupi sarsaparillae comp., §j. Aqua, q. s. ad §iij. Mi see. Sig. : Teaspoonful in water three times daily. Indication: Used in chronic enlargement of this condition. In acute cases administer calomel in broken doses until the desired effect is produced, after which a tablet containing the following ingredients is administered : — I£ Tinct. aconiti rad., gtt. 1 / 5 . Tinct. bryoniae, gtt. V 10 . Tinct. belladonna?, gtt. V 10 . Hydrarg. iodidi rubri, gr. 1 / 100 . Misce et fiat tabla no. j. Sig. : One such tablet every hour to an adult until eight are given. Alternating with the foregoing, quinine is given in 1-grain doses for eight doses. I£ Creosoti, m x. Tinct. myrrhae, 3j. Glycerini, 5j- Aquae, q. s. ad §iv. Misce. Sig. : Use as a gargle or spray four or five times daily. I£ Liq. ferri subsulphatis, 3j. Glycerini, opt., §j. Spiritus frumenti, §j. Aquae purse, q. s. ad %iv. Misce. Sig. : A half-teaspoonful every hour or two, according to severity of the case. Can be u.^cd advantageously in form of a spray. Indication: Used in diphtheritic and other ulcerations of the throat. 430 Hand-Book of Modern Treatment. Ifc Tinct. guaiaci ammon., 3vj. Tinct. cinchonse eomp., 3vj. Sodii chloridi, 3ij. Pulv. acacise, q. s. Aquae destillatee, ad £iv. Misce et fiat mistura. Sig. : Shake well. Add teaspoonful of mix- ture to wineglassful of water and use as gargle three times daily. IJ Sodii salicylatis, 3ij. Aquae menthae pip., §vj. Misce. Sig. : Use as a gargle several times a day. In the way of general or systemic treatment of ordinary follicular tonsillitis, nothing has been found, in my hands, more serviceable than sodium benzoate. It will relieve and dissipate all of the unpleasant symptoms in a very short time. It may be prescribed according to the following formula: — J£ Sodii benzoatae, §ss. Glycerini, £j. Syrupi tolutani, q. s. ad §iij. Misce. Sig. : Teaspoonful every hour or two. IJ Tinct. iodi, gtt. iiss. Sodii chloridi, gr. v. Aquae, 5j. Misce. Sig. : As a gargle, to be repeated several times through the day. In chronic pharyngitis the following is recommended : — B Iodi, gr. x. Potassii iodidi, gr. xx. Glycerini, %]. Misce. Sig.: To be applied locally on a swab. Hand-Book of Modern Treatment. 431 x\bout 3 minims of the oil of peppermint may be added to the foregoing if an anaesthetic effect on the mucous membrane is desired. Indication: Either of the above in inflam- matory, ulcerative, and diphtheritic sore throat. I£ Tinct. aconiti, m xl. Spiritus setheris nitrosi, fgj. Liq. potassii citratis, q. s. ad §iij. Misce. Sig. : Dessertspoonful every three hours to a child ten years old. Indication : During fever, preceded by calo- mel and saline purge. 1^ Aquae hydrogenii dioxidi, f§v. Sig. : Used as a spray every hour. Indication: Used in ulcerative tonsillitis to remove membrane. A pinch of sodium bicar- bonate should be added to each atomizer bottle of the solution. In cases where a rheumatic origin is suspected, guaiac is recommended as a fair substitute for the salicylates, combined as follows: — R. Potassii chloratis, gr. v-x. Tinct. aconiti, m ij-v. Tinct. guaiaci amnion., 3j. Mucilaginis acaciee, m xx. Aquae, q. s. ad 3j. Misce. Sig.: This amount to be taken at one dose and repeated every four hours. As soon as the temperature has fallen the aconite should be discontinued, but the other ingredients kept up for a time. When rheumatism and diphtheria are absent the author recom- mends rather a complicated combination, including the tincture of iron, which is of value in such cases : — 432 Hand-Book of Modern Treatment. 1$, Tinct. aconiti, m ii-v. Potassii chloratis, gr. v-x. Liq. ferri perchloridi, m-xx. Liq. hydrarg. perchloridi, m x. Glycerini, 3ij. Aquse chloroformi, §ss. Misce. Sig. : At one dose and repeated every four hours, or half the quantity every two hours. [The dose of potassium chlorate is larger than is usually recommended.] The mercurial preparation is added to combat any cocci which escape the iron preparation, and the glycerine is added to prolong its local effect in the fauces. Mills's medicinal treatment is to gargle with cheap claret wine, to obtain the benefit of the tannic acid therein, every two or three hours, or oftener. Aconite in small doses is often serviceable in simple tonsillitis, 10-per-cent. solution, 8-drop doses every hour, preferably in water. If we find very high fever, pulse full and bounding, face flushed, eyes red, and evi- dence of intense congestion of the throat, a 1-per-cent. solution of belladonna is the best remedy. For follicular tonsillitis the remedy par excellence is phytolacca in 1-drop doses as a 1-per- cent, solution, every one or two hours, according to the severity of the case. If suppuration does occur, nothing will clear it up more quickly than calcium sulphide in V 100 -grain doses. I£ Potassii bromidi, gr. lxxx. Sodii salicylatis, 3j. Tinct. opii deodorati, f3j. Cascarse cordialis, q. s. ad f^j. Misce. Sig.: A teaspoonful every four hours in water. Indication: Acute follicular tonsillitis. TONIC. 3 Acidi hydrochlorici diluti, 3iv. Tinct. gentianse comp., 3iv. Tinct. rhei vinos, 3iv. Tinct. cinchona? comp., 3iv. Misce. Sig. : Half a teaspoonful after eating. Band-Book of Modern Treatment. 433 IJ Strychninse sulphatis, gr. 1 / ao . Acidi phosphorici diluti, m v. Ferri phosphatis, gr. j. Quininae bisulphatis, gr. j. Glycerini, 3ss. Elixir aurantii, q. s. ad £ss. M. Fiat sol. Sig. : Take before each meal. Indication: A good general tonic. IJ Tinct. ferri chloridi, 3v. Tinct. digitalis, 3v. Acidi phosphorici diluti, 3x. Glycerini, Aquae, of each, q. s. ad %ix. Misce. Sig. : One teaspoonful in wineglassful of water after each meal, through a glass tube. Indication: Tonic after a surgical operation. IJ Acidi hydrochlorici diluti, 3j. Bismuthi subnitratis, 3j. Ess. pepsini, q. s. ad %iv. Misce. Sig. : Shake well. A teaspoonful in water after eating. IJ Tinct. nucis vomicae, m iv T . Acidi phosphorici diluti, m iv. Glycerini, m x. Fluidextracti gentianae, m ij. Alcoholis diluti, m xv. Vini xerici, q. s. ad f3j. Misce. Sig. : One teaspoonful after meals. Indication: Good general tonic. IJ Acidi arsenosi, gr. ss. Extracti nucis vomicae, gr. v. Ferri reducti, gr. ij. Misce et fiant pilulae no. xx. Sig. : One pill after meals. Indication: Used in anaemia. 28 434 Hand-Book of Modern Treatment. I£ Tinct. nucis vomicae, m iv. Acidi phosphorici diluti, m viij. Syrupi hypophosphitis, q. s. ad 3j. Misce. Sig. : One teaspoonful three times daily after meals. I£ Asafoetida, 3j. Acidi arsenosi, gr. ss. Strychninae sulphatis, gr. ss. Ext. sumbul, 9iss. Ferri subcarbonatis, 9ij. Quininae valerianatis, 9j. M. Make capsules no. xxiv. Sig. : One capsule after each meal. Indication: Nervine tonic. Ifc Hydrarg. chloridi corrosivi, gr. iij. Potassii iodidi, 3j- Syrupi sarsaparillae comp., Biij- Tinct. gentianse comp., giij. Aquae, q. s. ad -Jviij. Misce. Sig. : Teaspoonful one hour after meals. Indication: A splendid blood tonic. It has given excellent results. Iodine is recommended as a tonic and alterative in poorly nourished children, combined as follows : — I£ Tinct. iodi, gr. lxxv. Ext. catechu, 3v. Alcoholis, 3iiss. Glycerini, §iij. Syrupi idaei, Svij. Misce. Sig. : One tablespoonful once or twice daily. In rachitic children the following has been advised : — B Acidi calcii phosphatis, gr. lxxv. Tinct. essentiae anis., 3iiss. Syrupi simplicis, §vj. Misce. Sig. : One tablespoonful every morning be- fore breakfast. Hand-Book of Modern Treatment. 435 U Ferri et ammonii citratis, gr. v. Tinct. nucis vomicae, m v. Tinct. cinchonae comp., q. s. ad 3j. Misce. Sig. : One teaspoonf ul three times daily after meals. I£ Acidi nitrohydrochlorici diluti, m v. Tinct. nucis vomicae, m v. Tinct. columbae, m xxx. Syrupi limonis, q. s. ad 3j. Misce. Sig. : One teaspoonf ul three times daily after meals. I£ Acidi nitrohydrochlorici diluti, f3i-3ij. Tinct. nucis vomicae, f3j. Tinct. cardamomi comp., fgij. Tinct. gentianae comp., q. s. ad fgiv. Misce. Sig. : A teaspoonful in water after meals. Indication: Excellent tonic for use in con- valescence from prolonged -fevers. B Ferri et potassii tartratis, gr. lxxv. Extracti cinchonae, gr. lxxv. Extracti rhei, gr. lxxv. Extracti gentianae, gr. lxxv. Pulveris nucis vomicae, gr. viij. Olei anisi, m x. Misce et fiant pilulae no. c. Sig. : One or two pills with each meal. B Liq. potassii arsenitis, m xvj. Elix. kolae compositi, f^iv. Misce. Sig.: Dessertspoonful after meals. Indication: Used in debility where arsenic is indicated. 436 Hand-Book of Modem Treatment. TOOTHACHE. When this condition arises from a diseased tooth in which there is a cavity, Mason recommends that a few drops of the fol- lowing combination be placed upon a pellet of cotton and applied to the cavitv : — B Linimenti aeoniti (B. P. ), 3iij. Chloroformi, 3iij. Tinct. capsici, 3j. Tinct. capsici, 3j. Olei caryophylli, 3ss. Pulv. camphorae, 3ss. Sig. : A few drops on cotton placed in the cavity. I£ Olei clavi, m xxx. Olei cajuputi, m xxx. Chloroformi, m xv. Acetici aetheris, m xv. Mentholis, gr. ix. Camphorae, gr. iij. Misce. Sig. : Apply to tooth. IJ Chloralis hydratis, gr. lxxv. Cocainae hydrochloratis, gr. xv. Camphorae, gr. lxxv. Alcoholis, m x. Misce. Sig. : Apply to the cavity a tampon of cotton with a few drops of the solution. Ifc Chloroformi, in x. Glycerini, m x. Sol. phenolis sat., m x. Morph. sulph., gr. j. Misce. Sig. : Saturate a small pellet of cotton and place loosely in cavity of tooth. If gums are swollen and tender, paint with a solution of cocaine. Hand-Book of Modern Treatment. 437 I£ Linimenti iodi, m iij. Tinct. aconiti, m iij. Chloroformi, m xxx. Misce. Sig. : Dry the gums and apply with camel's hair brush. IJ Extracti opii. gr. xv. Pulv. camphorae, gr. xv. Balsami peruviani, gr. xv. Mastiche, gr. xxx. Chloroformi, 3v. Misce. Sig. : Wet a small piece of absorbent cotton with this solution and insert in the cavity of the tooth. Hildebrand states that orthoform instantly and completely relieves severe pain due to inflammation of the pulp in decayed teeth. It should be applied in alcoholic solution on absorbent cotton. H. B. Ray gives the following advice on the treatment of toothache by the practitioner: Toothache is essentially an in- flammatory condition, and in 99 per cent, of the cases there is a cavity in the tooth. In those cases where there is a cavity, but no nerve exposure, the treatment is simple — apply a sedative and exclude the secretions of the mouth from the cavity ; prompt relief will follow, and then advise the patient to visit a compe- tent dentist. A very effective agent, and one always at hand, is the oil of cloves. It should be applied by saturating a pledget of cotton with the remedy and introducing it into the cavity with a toothpick or other pointed instrument; that being done, the secretions are kept out by filling the cavity with a little beeswax, a household remedy always at hand. The wax can be applied by warming over a lamp on the point of a knife and forc- ing into the cavity. The wax filling serves not only the purpose of keeping the secretions of the mouth out, but prevents thermal changes from affecting the nerve when hot and cold things are taken into the mouth. 438 Hand-Book of Modern Treatment. IJ Creosoti, f 3i j . Sig. : Cleanse cavity and pack with cotton saturated with creosote. Indication: Used in caries with exposed IJ Morphinae sulphatis, gr. iv. Atropinse sulphatis, gr. j. Aqu* destillatse, f§j. Misce. Sig.: A few drops on cotton placed in the cavity. IJ Tinct. iodi, f3iv. Tinct. aconiti, f3j. Misce. Sig. : Paint the gums twice daily around the painful tooth. Indication: In dental periostitis. IJ Acidi arsenosi, gr. ij. Morphinse sulphatis, gr. j. Creosoti, q. s. Misce et fiat pasta. Sig. : Apply by a bit of cotton wool to cari- ous portion. TORTICOLLIS.— See Myalgia. TRICHINOSIS. IJ Tetramethyli thionin-chloridi. gr. xxx. Saloli, Siss. Misce et pone in capsulas no. xxx. Sig. : One capsule every four hours. Indication: Used in the intermediate stage. IJ Syrupi ipecacuanhse, f£j. Sig. : Tablespoonful and repeat in twenty minutes. Indication: Used to unload the stomach after ingestion of trichinous food. To be fol- lowed by brisk purge. Fever, nausea, vertigo, and diarrhoea are relieved by this treatment. Hand-Book of Modern Treatment. 439 1$, Sodii sulphocarbolatis, gr. ii-x. Aqua?, f§ij. Misce. Sig. : To be repeated every three or four hours. TRISMUS. R Fluidextracti gelsemii, m xlv. Syrupi simplicis, f3j. Aquae destillatae, q. s. ad fj^ss. Misce. Sig.: Half a teaspoonful every two to four hours. I£ Coniinae hydrobromatis, gr. Vio- Aquae destillatae, f3ij. Sig. : Two to four minims hypodermically and repeat frequently to relax spasm. Indication: For infant several days old. I£ Tinct. opii, gtt. v. Tinct. asaftetidae, f3iss. Syrupi simplicis, f3v. Aquae, q. s. ad f3xv. Misce. Sig. : Half a teaspoonful hourly. 1^ Chloralis, gr. xvj. Potassii bromidi, gr. xvj. Mucilaginis acaciae, . 3iv. Aquae, q. s. ad %\], Misce. Sig.: A teaspoonful in a little water until spasm is relaxed. Indication: For infant seven days old. TUBERCULOSIS. Ifc Iodoformi, gr. i-iij. Strychninae sulphatis, gr. x / i0 . Arsenii iodidi, gr. X / Vi . Balsami Peruvianae, gr. ii-v. Mix and encapsulate. Sig. : One capsule after meals three times daily. Indication : Useful in early stage of the dis- ease. 440 Hand-Book of Modem Treatment. The following prescription meets many indications in tuber- culous subjects : — I£ Acidi arsenosi, gr. ss. Ext. belladonnas, gr. iv. Ext. digitalis, gr. iij. Ext. nucis vomicae, gr. xv. Ferri sulphatis, gr. xxx. Quininae sulphatis, 3j. Creosoti (beech wood), gr. c. Misce et fiant capsular no. xl. Sig. : One after each meal and upon retir- ing. Indication : Useful in chronic pulmonary tu- berculosis. IJ Syrupi ferri iodidi, in v. Olei morrhuae, m xx. Ext. pancreati, gr. j. Misce et pone in capsula no. j. Sig. : One or two such capsules two hours after each meal. Indication: Useful in treatment of tuber- culous glands. I£ Ichthyoli, gr. x. Ung. zinci oxidf, 3ij. Adipis lanse hydrosi, 3ij. Misce et fiat unguentum. Sig. : Apply locally night and morning. Indication: Used as an external application in addition to tonics. 1^ Iodoformi, 3ij. Cocainae hydrochloride gr. iss. Morphinae sulphatis, gr. ss. Misce. Sig. : A small amount to be insufflated by the patient with a bent glass tube. Indication: To relieve from pain in the later stages of tuberculous laryngitis. It is advisable for patients suffering from this condition to take a liberal helping of beef or mutton twice a day, a plenti- ful supply of sugary food, and also of fatty food in the shape Hand-Book of Modern Treatment. 441 of milk, cream, butter, eggs, and fat bacon. It is advantageous to begin with one pint of milk per day for one week, increase to two pints during the second week, to three pints a day during the third week, and then to keep to this amount, or occasionally to go on to four pints a day. If a patient cannot take ordinary milk, whey may be tried. Koumiss is not advisable when there is active pyrexia, but is sometimes useful in other cases, per- haps, especially when there is bronchial catarrh. The expector- ation should not be swallowed, for one reason, because such a habit is one of the commonest causes of dyspepsia. The food should be eaten slowly, thoroughly masticated, and the patient should rest in the recumbent posture for about half an hour before meals and for one hour after meals. Lack of appetite may be caused by the presence of syrups in the cough mixture. The patient must also be encouraged to eat as much as he reasonably can, and in many cases an alkali with a vegetable bitter taken twenty minutes or so before meals is the best remedy. The fol- lowing is a useful prescription : — ■ IJ Sodii bicarbonatis, gr. xv. Tinct. nucis vomicae, m vij. Infus. gentian, comp., f§j. Misce. Sig. : Before the tAvo principal meals of the day. Or, when a sedative action is desired, hydrocyanic acid in appropriate dosage may be substituted for the mix vomica. In other cases, especially where there is a pale tongue, and flatu- lence is a prominent symptom, better results are obtained by the administration of acids, with or without strychnine, after food. When there are irritative symptoms, such as pain in the region of the stomach or vomiting, the codliver-oil, if given, should be stopped, the bowels should be opened, and bismuth and hydro- cyanic acid should be administered before meals. Sometimes morphia is necessary. Where there is a red glazed tongue, with loss of appetite and repeated vomiting, it is better to keep the patient in bed and to allow only liquid diet, and if this is not suc- cessful, it may be necessary to feed the patient by the bowel for a few days. 442 Hand- Book of Modern Treatment. I£ Calcii hyposulphitis, gr. 1 / G - 1 / 2 . Strychninse sulphatis, gr. Veo Acidi arsenosi, gr. Voo-Vso- Pulv. ulmi (elm), gr. iv. Misce et fiat cachet no. j. Sig. : One or two such cachets three times a day. Indication: Useful in pulmonary tuberculosis. For five years Koch has been making systematic use of cam- phor in pulmonary tuberculosis. At first he gave it in subcu- taneous injections of 1 gramme of camphorated oil for four days, with ten-day intervals. His results were extremely satis- factory, but the injection method has its drawbacks, so he gives the camphor now in inunctions. He makes a salve with about 0.4 gramme of camphor in the amount rubbed in at one time. He uses percutilan as a vehicle, a new substance which he says "actually slips through the skin." A little balsam of Peru is added and eucalyptus and rosemary oil. These inunctions are made by the patient on five successive days and then a ten-day pause. The amount of sputum increases remarkably by the sec- ond day and then expectoration almost ceases, while the other symptoms are correspondingly improved. Equally favorable re- sults were observed in emphysema and bronchitis. The following combination is recommended as a very effi- cient one in controlling the diarrhoea, which is due primarily to the general toxic condition : — 1$ Bismuthi subnitratis, 3vj. Fluidextracti coto, 3j. Pulv. cretse comp., 3iij. Tinct. opii deod., 3iss-3iij. Pulv. pepsini, 3j. Syrupi zingiberis, q. s. ad ^iij . Misce. Sig. : Shake and take one teaspoonful after each bowel movement. R Agaricin, gr. 1 / 3 . Zinci oxidi, gr. iij. Misce et fiat capsula no. j. Sig. : One such at bedtime. Indication: Used for night sweats. Hand-Book of Modern Treatment. 443 I£ Creosoti (beechwood), gtt. xxxij or 3j. Tinet. gentianae, f3j. Alcohol is, f§j. Vini albi, q. s. ad §iv. Misce. Sig. : A teaspoonful in water or wine three times a day. I£ Spiritus chloroformi, f^ss. Morphinse sulphatis, gr. j or ij. Syrupi pruni virginianse, q. s. ad §iij. Misce. Sig.: A teaspoonful every four hours. Indication: Used when cough is excessive. I£ Acidi hydrocyanici diluti, gtt. xxiv. Potassii bromidi, 3ij. Sol. morph. magendie, 3iss. Chloralis hydratis, 3ij. Spiritus frumenti, §j. Syrupi aurant., q. s. ad Sxij. Misce. Sig. : A tablespoonful when necessary to check cough. Indication: Used when cough is harassing. Cough-syrups are usually combinations of different opium ingredients : i.e., if they allay the cough promptly. Codeine is the least objectionable of this group. Combined with the follow- ing remedies it affords great relief : — B Codeinse, gr. iv. Tinct. belladonnse, 3ij. Syrupi scill., §ij. Misce. Sig. : Teasponful two to four hours apart, if coughing. TYMPANITES. B Glycerini, 3j. Terebinthinse, 3iv. Magnesii sulphatis, 3iv. Aquae, gvij. Misce. Indication: Tympanites after child-birth. 444 Hand-Book of Modern 'Treatment. In conjunction with the above he gives % grain of calomel every two hours until 4 grains have been given. If this fails to act, y^ grain of elaterium is given in two hours. IJ Sodii bromidi, 3j. Aquse destillatae, 5j- Aquae flor. aur., gij. Misce. Sig. : A tablespoonful every two hours, and ordering an enema of 1 ounce of glycerine to 2 to 3 ounces of hot water to be thrown into the rectum. Indication: Used in tympanites of typhoid fever. IJ Tinct. asafcetidae, §ss. Tinct. cardamomi comp., §ss. Spiritus ammon. aromat., m xxxij. Aquse menthae pip., Sj. Misce. Sig. : One or two teaspoonfuls in water every two or three hours. Indication: Used in tympanites of typhoid fever. I£ Guaiacoli carbonatis, 3j. Fiant chartulae no. xxx. Sig. : One powder every four hours. Indication : Used in tympany of typhoid fever or in any case with intestinal fermen- tation. 1$ Olei terebinth inae, 5j. Olei olivae, §iss. Camphorse, gr. xx. Decocti avenae, fSviij. Misce et fiat enema. Sig. : Inject into the bowel. Indication: Used in hysterical tympanites. B Olei terebinthinae, 3j. Pone in capsulas no. xij. Sig. : One every two or three hours. Indication: Used in tympany of typhoid fever, Hand-Book of Modern Treatment. 445 IJ Olei terebinth inse, f3j. Olei olivse, f3iv. Emulsi asafoetidse, q. s. ad f§viij. Misee et fiat emulsum. Sig.: Used by rectal injection. Indication: Used in tympany of typhoid fever and peritonitis. Also apply turpentine stupes to the abdomen. I£ Spiritus aetheris compositi, f§j. Tinct. cardamomi comp., f^j. Misce. Sig. : Teaspoonful every hour or two. Indication: Used in tympany of acute in- digestion. ULCER. GASTRIC ULCER. Usually in women 25 to 35 years of age. Pain comes on soon after eating. Pain lessened by vomiting. Vomitus contains food-rem- nants, mucus, and often blood. Severe dyspeptic symptoms usually present. Melsena rare. DUODENAL ULCER. Most frequent in men. Pain two to four hours after eating, and located in the right h ypochon dr ium . Vomiting does not relieve pain. Vomiting more rare than in gastric ulcer, and does not often contain blood. Dyspeptic symptoms slight. Melsena quent. comparatively fre- IJ Iodoformi, 3iv. Petrolati, gij. Misce. Sig. : Apply twice freely each day on sur- geon's lint. Indication: Of great value in syphilitic and tubercular ulcers. In a case of extensive ulcers of the legs of a somewhat rachitic child 2 years old, with ulcers over the back, treated in many ways unsuccessfully: — 446 Hand-Book of Modern Treatment. I£ Pulv. amyli, 3ij. Zinci oxidi, 3ij. Mercurolis, gr. xv. Chloretoni, 3ss. Petrolati, 3j. Misee et fiat unguentum. Sig. : To be applied on pieces of lint, con- stantly recovering the affected areas. I£ Argenti nitratis, gr. v. Balsami Peruviani, 3iss. Ung. simplicis, ■JSiij. Misce. Sig. : Apply locally to the affected areas after thoroughly cleansing the parts. Indication: Used in treatment of varicose ulcers. By the above method the ulcers become clean, the secretion and odor are diminished, and healing takes place rapidly. B Picrotoxini. gr. j. Morphinse hydrochloride gr. j. Atrophia? sulphatis, gr. l / 6 . Ergotini, m xx. Aquse lauroeerasi, 3iij. Misce. Sig. : Four to six drops five to ten minutes before each meal. Indication: Used in gastric ulcer. I£ Camphorse triturationse. 3ss. Zinci oxidi, 3viiiss. Lani, q. s. ad gvj. Misce. Sig. : Apply locally. Indication: Used on ulcers of the leg. Ifc Camphorse trituration*, 3ss. Zinci oxidi, §iij. Olei olivse, Siij. Misce. Sig. : Apply locally. Indication: Used on ulcers of leg. Hand-Book of Modern Treatment. 44' Ifc Chloroformi, m xviij. Bismuthi subnitratis, gr. xlv. Aquae, q. s. ad §vss. Misce. Sig. : One-half tablespoonful every hour or two. Indication: Used in chronic ulcer of the stomach. Ifc Ung. zinci oxidi, §ij. Sig.: Spread on lint and apply. Indication: Used in irritable painful ulcer B Pulv. iodoformi, 3ij. Pulv. saloli, 3ij. Bismuthi subnitratis, 3ij. Pulv. cinchonas, 3ij. Pulv. benzoini, 3ij. Pulv. carbonis, 3ij. Misce. Sig. : Use as dusting powder locally. Indication: Used on varicose ulcers. IJ Calcii chloridi, gr. lxxx. Syrupi acaciae, 3iv. Aquae menthae pip., §iv. Misce. Sig. : Tablespoonful every hour. Indication: Useful in gastric ulcer when haemorrhage occurs, to aid in coagulation of the blood. In order to insure success in cases of chronic ulceration of the legs it is absolutely necessary: (1) previously to bring the ulcer into an aseptic condition ; ( 2 ) to remove the edge of the ulcer before applying the grafts; (3) to treat varicose veins or other causes of the ulceration ; (4) to insist upon the patient's resting the leg for a considerable period afterward until the adhesion of the grafts has become firm. Indication: Used in varicose ulceration of the leg. 448 Hand-Book of Modern Treatment. 1^ Tinct. conii, f3ij. Morphinae sulphatis, gr. j. Phenolis, m iv. Syrup i acaciae, f§iij. Misce. Sig. : A teaspoonf ul when in pain. Ifc Hydrarg. ammoniat., gr. xv. Olei eucaplypti, m viij. Betanaphtholis, gr. x. Pulv. marantae, 3ij. Ung. zinci oxidi, 3j. Misce. Sig. : Apply locally. Indication: Used in chronic eczematous or weeping ulcers. B Argenti nitratis, gr. v. Pulv. opii, gr. iiss. Misce et iiant pilulae no. xx. Sig. : One pill thrice daily. Indication: Used in gastric ulcvr. I£ Formaldehydi (40 per cent, sol.), m viij. Aquae hydrogenii dioxidi, f§xvj. Misce. Sig.: Use locally as a wash. Indication: Used as cleansing and antisep- tic wash. I£ Acidi tannici, gr. lxxv. Hydrarg. nitratis acidi, gtt. xij. Adipis lanae hydrosi, 3viiss. Fiat unguentum. Sig. : Apply as a dressing. Indication: Used in chronic syphilitic ulcers. I£ Emplastri plumbi, 5ij. Ung. hydrargyri, £ss. Olei cadini, 3ij. Fiat unguentum. Sig. : Spread on linen and apply. Indication Used in inflamed syphilitic ulcers. Hand-Book of Modern Treatment. 449 Ifc Tinct. iodi, fgj. Acidi tannici, q. s. ad saturandum. Misce. Sig. : Apply locally to ulcers of rectum and anus. IJ Balsami peruviani, f3iv. . Tinct. benzoini comp., f3ij. Petrolati, q. s. ad §ij. Misce. Sig. : Spread on surgeon's lint and apply. Indication: Used in irritable painful ulcers. IJ Chloralis hydratis, 3ss-ij. Aquae, fSvj. Fiat lotio. Sig. : Use as a wash. Indication: Used in sluggish ulcers. B Argenti nitratis, gr. v. Ext. hyoscyami, gr. x. Misce et fiant pilulae no. xx. Sig.: One before each meal. Indication: Used in gastric ulcer. Ifc Bismuthi subnitratis, 3vj\ Pulv. opii, gr. vj. Misce et fiant chartulae no. xij. Sig. : One powder three times daily. Indication: Used for relief of pain in gas- tric ulcer. B Eserin sulphatis, gr. 1 / 4 . Hydrarg. oxidi flavi, gr. y„-j. Petrolati, 3j. Misce. Sig.: Apply to eye. Indication: «Used in ulceration of the cornea. URJEMIA. B Acidi benzoici, gr. c. Fiant chartulse no. v. Sig.: One powder every three hours well diluted. 450 Eand-Book of Modem Treatment. Ifc Caffeinae citratae, gr. xxiv. Fiant chartulae no. xij. Sig. : One powder every two hours until three powders have been taken each day. Indication : Used as a diuretic if arterial tension is high. I£ Pulveris jalapae comp., 3iv. Sig. : Teaspoonful once daily. Indication: Used as a brisk purge. B Spiritus glycerylis nitratis, gtt. xxiv. Aquse camphorse, Siij. Misce. Sig. : Teaspoonful every three or four hours. Indication: Used as a diuretic if arterial tension is high. Hot pack and hot bath are valuable adjuncts. I£ Pilocarpines hydrochloratis, gr. ij. Aquae destillatae, 3ij. Misce. Sig.: Inject five minims for a child of five; ten minims for an adult. Indication : Used in conjunction with a hot pack. In the presence of a weak heart the pilo- carpine is dangerous. Ifc Spiritus setheris nitrosi, f§j. Liq. ammon. acetatis, f§ij. Aquae, q. s. ad Sviij. Misce. Sig.: Tablespoonful in water every two hours. Indication: Used as a diuretic if the symp- toms are not urgent. I£ Chloralis hydratis, gr. xx. Sodii bromidi, 3j. Misce. Sig.: Place in three ounces of boiled starch and administer by the rectum. Indication: Used to relax spasm of uraemic convulsions. Hand- Book of Modem Treatment. 45 1 URIC ACID DIATHESIS.— See Gout. I£ Lithii benzoatis, 3ij. Tinct. belladonna? foliorum, m lxxij. Fluidextracti tritici, f§iij. Misce. Sig. : A teaspoonful every two or three hours in irritable bladder, depending on an excess of acid, and in uric acid calculi. IJ Piperazini, 3iij. Pone in capsulas no. xxx. Sig.: Dissolve a capsule in water and take after each meal. Indication: Used to relieve irritability of the bladder due to the uric acid diathesis. IJ Liq. potassii arsenitis, m v. Potassii bicarbonatis, gr. v. Ferri et potassii tartratis, gr. v. Infusi quassise, f^j. Misce. Sig. : To be taken in teaspoonful doses three times daily after meals. Indication: Used in asthenic cases. $ Lycetali, gj. Pone in phialas no. xlviij. Sig. : Dissolve the contents of a vial in water and take after each meal. Indication: Used in subacute and chronic cases. I£ Lithii carbonatis, 3iiss. Sodii iodidi, 3iiss. Ext. gentiange, gr. xxiij. Pulv. acacise, gr. xxiij. Ext. glycyrrhizse, gr. c. Misce et fiant pilulae no. c. Sig. : Preserve in a well-stopped bottle. One pill after meals. Indication: Used in chronic cases with tophi in the joints. 452 Hand-Book of Modern Treatment. I£ Sodii bicarbonatis, 3j. Tinct. calumbse, fSj. Infusi quassise, q. s. ad f§iij. Misce. Sig. : A tablespoonful four times daily. 1$ Aquse bullientis, 3xiiss. Sodii chloridi, gr. xv. Sodii phosphatis, gr. xxx. Sodii sulphatis, 3j. Misce. Sig. : Inject seventy-five minims morning and evening in the skin of the buttock. Indication: Used in cases of gastric intol- erance where diuretic medication is requisite. URINE, INCONTINENCE, RETENTION, ETC. In the physician's office laboratory two of the petty annoy- ances that he has to contend with in testing for albumin are dirty test-tubes and specimens that need nitration. I have found the following plan a simple method of obtain- ing a clean test-tube and a clear specimen : Take an ordinary cotton tampon on a string, such as is used in gynaecological work, push it to the bottom of a test-tube with a stick or glass rod, and pack it firmly. Then pour the urine into the test- tube and pull out the tampon very slowly by the string. This, on account of the atmospheric pressure, causes the urine to pass through the tampon and remain in the tube. The tampon car- ries out with it any particles that can be removed by filtration, and at the same time cleans the inside of the test-tube. If there are several specimens to be filtered, the tampon can be rinsed under the faucet, and used again. I find by this method my test-tubes are always bright and clean inside, and there is none of the delay occasioned in using filter-paper. The process can be repeated quickly two or three times if the first filtration is not satisfactory. In detecting very small traces of albumin, a per- fectly clean test-tube is of great importance. TESTING FOR TOTAL SOLIDS. Multiply the last two figures of the specific gravity of the urine by the number of ounces voided in twenty-four hours, and Hand-Book of Modern Treatment. 453 add 10 per cent, to the product. Thus, if the amount passed in twenty-four hours was thirty-six ounces, and the specific grav- ity 1.021, it would be 36 X 21 = 756 + 10 per cent. = 831, the number of grains of solids in the whole amount. By comparing this with the table it can readily be ascertained if the amount is above or below the normal standard for the body-weight of any patient. This method is Haines's modification of Basser's. I£ Atropinae sulphatis, gr. 1 / 30 . Morphinse sulphatis, gr. iss. Aquae destillatae, f3j. Misce. Sig. : Ten minims hypodermically and re- peat once if required. Indication: Used in retention from spas- modic stricture. Patient should be immersed in hot bath for half an hour. IJ Ext. rhus. arom., 5j- Syrupi arom., §ij. Aquae destillatae, £vj. Misce. Sig.: Teaspoonful three times a day. Indication: Used in incontinence. IJ Sodii benzoatis, gr. xx. Sodii salicylatis, gr. xx. Fluidextracti belladonnae, gtt. ij. Aquae cinnamomi, §iv. Misce. Sig.: A teaspoonful four or live times daily. Indication: Used in incontinence. The following has proven beneficial in a number of obstinate cases in older children and adults, whether due to lack of mus- cular tone of the bladder or paralysis : — IJ, Fluidextracti ergotae, 3j- Fluidextracti hydrangeae, §j. Fluidextracti triticum repens, §j. Fluidextracti belladonnae, m xv. Tinct. cantharidis, 3j. Olei gaultheriae, 3ss. Glycerini, q. s. ad §iv. Misce. Sig. : A teaspoonful three times a day. Indication: Used in incontinence. 454 Hand-Book of Modern Treatment. f£ Tinet. belladonnse, Sj- Sig. : Ten drops three times a day and in- crease one drop a day till the throat gets dry. With it give all the lemonade patient will drink (this makes the urine alkaline). Indication: Used in incontinence. HOW DRUGS AFFECT THE COLOR OF URINE. The urine is green after taking* saffron or salicylic acid; orange from chrysophanic acid and santonin (alkaline carmine) ; brown from senna (alkaline blood red) ; smoky brown or black from tar, salol, gallic acid, resorcin, uva ursi. and naphthalin; reddish from logwood (alkaline violet) or fuchsin; bright yel- low from picric acid; blue or greenish-blue from methylene- blue or methyl-violet. N. B. Gwyn has made a number of experiments to show the relative value of different disinfectants for urine. This is an important subject, since it is probable that urine, by reason of its apparent harmlessness, plays and has played the most im- portant part in the spread of typhoid fever. Bacilli are present in pure culture in 20 to 30 per cent, of the cases. Their num- ber is sometimes enormous; in one case there were 500,000,0*00 per cubic centimeter. Dr. Gwyn shows that for disinfection immediately or within five minutes a given volume of urine re- quires one-half its volume 1 to 20 carbolic-acid solution; one- fifth its volume 1 to 1000 bichloride solution; three-tenths its volume 10-per-cent. formalin solution; one-fortieth its volume chlorinated-lime solution; two-fifths its volume liquid chlorides. If a longer time for disinfection is allowed the bichloride be- comes proportionately more active. This and the chlorinated lime seem the most valuable, all things considered. The forma- lin is good, but expensive. Ifc Antipyrini, 3ij. Alcoholis, f§j. Aquae, f£j. Misce. Sig.: One teaspoonful at bedtime in small amount of water. Indication: Used in treatment of inconti- nence of urine in children. Hand- Book of Modern Treatment. 455 TEST FOR PUS IN URINE. The addition of a few drops of peroxide .of hydrogen to urine containing pus will cause bubbles to rise and froth to ap- pear on the surface, similar to its action on pus in other localities. This test is characteristic and reliable. TO REDUCE THE ALKALINITY OF URINE. Attention has been called by K. Hutchinson to the value of acid sodium phosphate as an acidifier of urine. According to this author it has the greatest acidifying power of any prepar- ation employed. It is a valuable agent in the treatment of cys- titis, accompanied by the use of urotropin, which produces its best results in acid urine. The foregoing preparation is readily soluble in water, and may be given in doses of from 30 to 60 grains every three or four hours if necessary. THE PROPHYLACTIC AND CURATIVE ACTION OF UROTROPIN. Under this caption Dr. Zaudy has published the report of a case of paraplegia in which urotropin was remarkably efficacious in relieving the bladder complication. It is rare that the oppor- tunity is presented of convincing one's self of the effect of urotropin by post-mortem examination. From the first day until the time of his death (May 11 to June 20, 1900), the patient, besides other treatment, was given 0.5 gramme (7V 2 grains) of urotropin in tablet form three times daily. He took altogether nearly 60 grammes (2 ounces) of urotropin; and though the amount of nourishment which could be administered was but very small, he never ob- jected to the tablets. By-effects which could be attributed to the drug were never seen; but, of course, it would have been difficult to demonstrate them in view of the severe general dis- ease and the apathy of the patient. Even in so short a time as eight days after beginning the treatment no more pus was voided by the urethra, and catheterization could be effected more easily. The post-mortem notes included the observation : — "Diagnosis as to the urinary organs: Urocystitis without serious lesions; punctiform haemorrhages in the pelvis of the kidney, but no other signs of pyelonephritis. 456 Hand-Book of Modem Treatment. "These post-mortem findings speak for themselves, and re- quire no further elucidation. They show more plainly than any clinical symptoms that the dangers which threatened the urin- ary passages from various sides were entirely warded off, prac- tically until the very end. It is the universal experience that patients suffering from paralysis and anaesthesia of the lower half of the body mostly succumb to the severe cystitis and rapidly-consecutive pyelitis. The kidneys are usually severely affected. That this was not the case here, that the post-mortem revealed that the urinary apparatus was not to any great degree involved, must necessarily be attributed to the action of the urotropin." The proper kind of milk must be prescribed for young in- fants, and older children should be forbidden to eat meat. To relieve the itching the following is recommended: — IJ Liq. earbonatis detergens, gr. lxxv. Zinci oxidi, 3v. Amyli, 3 v. Glycerini, gj- Aquae destillatse, Siiiss. Mi see. Sig. : Apply to the itching surface with a brush three times a day. A warm bath should be given twice weekly. The following as an internal antiseptic : — I£ Mentholis, gr. xv. Olei amygdalae dulcis, gr. iv. Misce et fiant capsulse no xxx (gelatin). Sig. : One capsule three times a day. Brewer's yeast, a teaspoonful in milk once or twice daily, may be substituted. In prurigo of infants the skin should be kept clean and the diet and digestion regulated. Internally intestinal antiseptics, iodine, and codliver-oil or dilute sulphuric acid. Sponge the parts affected with a 2-per-cent. solution of hux- sal (antiseptic salt) or apply as compresses to allay itching. Allow the body to dry and then apply some friction. Hand-Book of Modern Treatment. 457 Ifc Pulv. calarain, 3ij. Liq. calcis, Sviij. Phenolis, 3ss. Misce. Sig. : Use as a lotion, and if not sufficient to allay irritation and the burning is extreme, the following ointment is advised: — 1$ Mentholis, gr. x. Adipis lanae hydrosi, 3j- Misce. Sig. : Apply locally. Ifc Mentholis, 3j. Spiritus vini rect., 3j- Betul-ol (oleo-methyl-salicy. comp.), 3iv. Misce et fiat applic. Sig. : For external use only. Indication: Used in urticaria of arms and chest. Phosphate of soda in supersaturated solution and in drachm doses. Locally : — B Pulv. calamin., 3iss. Zinci oxidi, 3iss. Acidi carbolici, 3ss. Aquae calcis, 3ij. Aquae rosse, §iv. Misce. Sig. : Apply frequently and freely. 1$ Hydrarg. chloridi corrosivi, gr. ij. Chloroformi, m xx. Glycerini, Bij- Aquae rosae, 5vj. Misce. Sig. : Poison. Apply locally twice daily. Ichthyol in from 1- to 2-grain doses to children, and 5- to 6-grain doses to adults, relieves and cures. At the same time an ointment should be applied to the affected parts, or even all over the body. The strength of the ointment should be about 2 drachms of ichthyol to an ounce of petrolatum in children, and 1 / 2 ounce of ichthyol to 1 ounce of petrolatum for adults. 458 Hand-Book of Modern Treatment. I£ Phenazoni, 3j. Fiant chartulse no. xij. Sig. : One powder before meals. Indication: Used in lithseraic subjects and also in intestinal fermentation. I£ Sodii biboratis, §ss. Aquae destillatse, f^viij. Misce. Sig. : Use locally. Indication: Used also in chloasma or liver spots. Ifc Acidi benzoici, gr. viij. Aquse, f§iv. Misce. Sig. : Apply locally as a wash. IJ Salopheni, 3j. Fiant chartulse no. xij. Sig. : One powder before meals. Indication: Used in lithsemic subjects and also in intestinal fermentation. Ifc Sodii bicarbonatis, §ij. Sig. : A tablespoonful in a cup of water and apply freely with a sponge. Indication: Used to allay pruritus. IJ Liq. potassii arsenitis, f^j. Sig. : One to two drops in water after meals. Indication: Used in cases in which the at- tacks continue to recur. To be employed for a long period. VAGINISMUS. IJ Stront. bromidi, 3i%. Potassii bromidi, 3i%. Ammon. bromidi, 3i%. Aquae destillatoe, q. s. ad Sviij. Misce. Sig. : Tablespoonful twice a day. Hand-Book of Modern Treatment. 459 IJ Zinci valerianate gr. s /e- Quininae valerianate, gr. iss. Extracti opii, gr. 1 / 6 . Extracti belladonnas, gr. 1 / 6 . Misce et fiat pilula no. j. Sig. : Three to six pills daily. IJ Ext. kramerise. gr. iss. Morpliinse hydrochloratis, gr. 1 / 3 . Olei theobromat., 3j. Misce et fiat suppositorium no j. Sig. : Insert in vagina at night. IJ Cocainse hydrochloratis, gr. ij. Ext. belladonnas, gr v iss. Strontii bromidi, gr. iv. Olei theobromat., 3i%. Misce et fiat suppositorium no. j. Sig. : Insert in vagina at night. IJ Morpliinse hydrochloratis, gr. j. Olei theobromat., 3iiiss. Misce et fiant suppositoria no. iij. Sig. : Insert one in vagina when required. Indication: Used in vaginismus. VAGINITIS. IJ Acetanilidi, gr. xv. Acidi tannici, gr. viiss. Ext. hydrastis Canadensis, gr. iv. Sacch. lactis, 3iiss. Olei theobromat., q. s. Misce et fiat suppositorium no. j. Sig. : One to be inserted every other day. IJ Resorcini, gr. Ixxx. Acidi salicylici, gr. viij. Betanaphtholis, gr. j. Aquas, q. s. ad Sviij. Misce. Sig. : Add one tablespoonful to a quart oi warm water and use as a douche. 460 Rand-Book of Modern Treatment. IJ Salolis, gr. xlv-3ij. Glycerini, Bviij. . Misce. Sig. : To be applied locally on a tampon every second day. IJj Pulv. aluminis, §j. Zinci sulphitis, gj. Sodii biboratis, %]. Acidi carbolici, §j. Aquse, §vj. Misce. Sig. : A teaspoonful to a quart of lukewarm water, as a vaginal douche, twice daily. In most cases of vaginismus, if the surgeon looks carefully, he will find some lesion of the mucous membrane which seems to bear a causative relation to the existence of the trouble It is either red and erythematous or there are little fissures or tears, or protruding spots made by inflamed papillae. Forced dilata- tion of the vagina, with local treatment for the lesions, will give the best results. For gonorrhoeal vaginitis, John Cooke Hirst advises the occasional use of silver nitrate, 10 or 20 grains to the fluidounce, filling a cylindrical speculum with the solution and gradually withdrawing the instrument; also douches of mercuric chloride 1 to 4000. I£ Glyceriti acidi tannici, Sj. Sig. : Apply locally or diluted as an injec- tion. Indication: In chronic vaginitis of children. Ifc Argenti nitratis, gr. xl. Aquse destillatse, f^j. Misce. Sig. : Apply on a cotton pledget within the cervical canal and over the vaginal mucous membrane. I£ Potassii permanganatis, §v. Sig.: Half a teaspoonful in two quarts of water; as vaginal douche night and morning. Indication: Used in gonorrhoeal vaginitis. Hand-Book of Modern Treatment. 461 IJ Hydrastinse, gr. vj. Boroglycerini., 3iij. Misce et fiant suppositoria no. vj. Sig. : Insert a suppository after hot douche twice or thrice daily. I£ Phenolis, gr. xv. Bismuthi subnitratis, 3iss. Glycerini, 3vi 2 / 3 . Aquae, q. s. ad Oij. Misce. Sig.: Inject a small quantity after irrigat- ing the vagina with boric acid solution. VAGINAL DOUCHES. Powdered borax, 1 drachm to the quart of water, is a mild cleansing douche; zinc sulphate, 2 drachms to the quart, is as- tringent and disinfectant; alum, 1 drachm to the quart, is an efficient astringent; mercuric chloride, 1 to 3000 to 1 to 5000, is commonly employed. Tannic acid, potassium permanganate, and fluid extract of hydrastis all stain the clothing and are sel- dom prescribed. VALVULAR DISEASE.— See Heart Disease. VARICELLA. Ifc Spiritus aetheris nitrosi, 3iv. Potassii citratis, 3ij. Syrupi limonis, f3v. Aquae, q. s. ad §iij. Misce. Sig. : Teaspoonf ul in water every two hours. I£ Sodii bicarbonatis, %v. Sig. : Tablespoonf ul in a pint of water as a local application. Indication: Used as a wash to relieve itch- ing. 462 Hand-Book of Modern Treatment. VARICOSE VEINS. IJ Liq. plumbi subacetatis, f3iv. Aquae, q. s. ad f^viij. Misce. Sig. : Apply on cotton saturated with lotion. I£ Fluidextracti hamamelidis, fSiij- Sig. : A teaspoonful three or four times daily with compresses applied externally. Ifc Barii chloridi, gr. xxx. Aquae destillatae, q. s. ut ft. sol. Adipis lanae hydrosi, gr. ccxxv. Olei amygdalae dulcis, m lxxv. Misce et fiat unguentum. Sig.: Use three times daily, with friction where blue veins shine through the skin. VARIOLA.— See Small-pox. VERTIGO. 1$ Tinct. physostigmatis, 3ij. Tinct. nucis vomicae, 3ij. Tinct. belladonnae foliorum, 3ij. Misce. Sig. : Thirty drops in water morning and evening. Indication: Used to relieve headache that occurs at the change of life. I£ Pulv. serpentariae, gr. iiss. Pulv. camphorae, gr. 1 / 4 . Asafcetidae, gr. 1 / 4 . Extracti opii, gr. a / 40 . Misce et fiat capsula no. j. Sig.: From three to six pills, to be taken at intervals during the twenty-four hours. Indication: Used in vertigo following gas- tritis. Hand-Book of Modern Treatment. 4(33 I£ Potassii bromidi, 3iv. Syrupi aurantii corticis, 3iv. Aquae, q. s. ad giij. Misce. Sig. : Teaspoonf ul three times a day. Indication: Used in aural vertigo, and also in vertigo from insomnia and overwork. fy Spiritus glycerylis nitratis, 3j. Sig. : One drop in water three times a day, to be gradually increased until temporal head- ache. Indication: Used in aural vertigo. Ifc Sodii bromidi, 3ij. Antipyrini, 3j. Misce et fiant tabellae compressor no. xij. Sig. : One tablet three times a day. Indication: Used in aural vertigo. Quinine will be more effectual when it is combined with strychnine, blue mass, and capsicum than when given alone. The usual formula employed is : — I£ Quininse sulphatis, 3iiss. Pil. hydrarg., gr. iv. Pulv. capsici, gr. ij. Strychninae sulphatis, gr. j. Misce et fiant capsulse no. xxxvj. Sig. : One capsule four or five times a day. Indication: Used in malarial vertigo. After the attacks have subsided smaller closes of quinine are to be administered in connection with strychnine and iron, in- terspersed occasionally with a dose of blue mass or calomel, the aim now being to enhance the digestive powers and to maintain the strength of the body. Any fresh manifestation of vertigo is to be counteracted with the larger doses of quinine and its com- bination given in the above formula. 464 Band-Booh of Modern Treatment. IJ Tinct. gelsemii, fgj. Sig. : Ten minims three times daily. Indication : Used in aural vertigo. I£ Pulv. jalapse, gr. xij. Hydrarg. chloridi mitis, gr. iij. Potassii sulphatis, gr. vij. Misce et fiat chartula no. j. Sig. : To be taken at bedtime. Indication: Used in bilious vertigo. The special treatment should be directed to the different causes of vertigo, when they can be traced to affections of which vertigo is but one of the symptoms, such as syphilis, malarial fever, gout, gastric affections, etc. As regards general treatment, potassium iodide, 10 to 20 grains a day for months, with periods of rest, during which quinine is administered. However, the quinine should be given only when other methods fail, as it affects the hearing and leads, if prolonged, to absolute deafness. About six or eight 2-grain pills should be given daily for one week and then suspended for one week, after which the drug should be resumed for eight days, when a notable improvement takes place. Treatment should be continued in this manner until a cure is effected. Vertigo due to arteriosclerosis should be treated with small doses of potassium iodide as follows : — I£ Potassii iodidi, 3j. Aquse, 3x. Misce. Sig. : Two tablespoonfuls daily for three weeks in the month. At the same time 3 drops of a solution of nitroglycerine — 1 to 100 — might be given morning and evening, and a milk diet be prescribed for eight days every month, while laxatives should be given frequently. If tachycardia be present, one or two of the following pills should be ordered daily: — IJ Ext. convallarise, gr. ij. Sparteine sulph., gr. j. Misce et fiat pilula no. j. Sig.: One such daily. Hand-Book of Modern Treatment. 4(55 The insomnia is best treated with trional and oedema of the limbs by theobromine, 10 grains four times a day. If in spite of this treatment the oedema persists and increases, digitalis should be given and a milk diet instituted. A purgative of jalap and seammony should be prescribed once a week. VOMITING. I£ Mentholis. gr. v. Tinct. opii, 3iiss. Liq. pepsinse. §.!• Misce. Sig. : Ten to twenty drops before each meal. Indication: Used in vomiting of uterine origin. I£ Mentholis, gr. j. Sodii bicarb.. 3iss. Misce et fiant capsulse no. x. Sig.: One capsule three times a day. Indication: Nervous vomiting without any anatomical reason. Pernicious vomiting may be relieved by the hypodermic ad- ministration, in epigastric region, of 1 / 6 grain of cocaine hydro- chlorate. This was successful in five cases after administration by mouth had failed. Chloral dissolved in peppermint-water will promptly check vomiting in children. The dose varies from 1 / 2 to 2 grains, according to age. The following mixture is valuable in the vomiting of preg- nancy, and also in various cases of gastritis; — R Mentholis. gr. iss. Tinct. opii. m xv. Tinct. belladonna, m xv. Tinct. hvoscvami. m xv. Alcoholis, I 2 /.,. Misce. Sig.: Five drops in a little water every honr. 30 466 Hand- Book of Modern Treatment. REFLEX VOMITING. This type of emesis is often apparently causeless, with prominent symptoms referable to other organs. The tongue is usually clear. By way of general remedies may be mentioned bromides and chloral, cerium oxalate, quinine, acids, and min- ute doses of ipecac. For persistent cases William F. Mitchell recommends the application to the epigastrium of ice-cold com- presses changed every minute. For such obstinate cases Thorn- ton employs a mustard poultice over the abdomen, and gives a rectal injection of 20 grains of chloral hydrate and 1 drachm of potassium bromide in starch-water. In hepatic attacks it is well to wash out the stomach freely with warm water. R Phenolis, gr. v. Syrupi acacise, fgiss. Aquae cinnamomi, f§iss. Misce. Sig. : One teaspoonful before meals. Indication: Irritable vomiting. The following formula will be found useful for the relief of vomiting, even in the vomiting of pregnancy. fy Cocainse hydrochloratis, gr. iij. Hydrarg. chlor. mitis, gr. j. Cerium oxalate, gr. xxx. Pepsini, aseptic ( P. D. ) , gr. v. Bismuthi subnitratis, gr. xxx. Misce et fiant chartulae no. x. Sig. : One pro re nata. Jfc Vini ipecacuanha?, f§j. Sig. : One drop every hour to thrice daily. Indication: Suitable in all cases. R Sodii bicarbonatis, gr. xv. Acidi hydrocyanici diluti, m iss. Aqua? camphorse, f3x. Misce. Sig.: To be taken three times daily after meals. Indication: When due to acidity. Band-Book of Modern Treatment. 467 R. Phenolis, gr. iv. Bismuthi subnitratis, 3ij. Mucilaginis acacise, f^j. Aquae mentha? pip-, f^iij- Misce. Sig. : A tablespoonful every two, three, or four hours. Indication: Used when due to acute gastric and intestinal disorders. R Bismuthi subnitratis, 3ij. Acidi hydrocyanici diluti, f3ss. Mucilaginis acacia?, f^ij. Aquae menthae pip., f§ij. Misce. Sig. : A tablespoonful thrice daily. Indication: Used with gastric ulcer. I£ Tinct. aconiti, gtt'. xxx. Bismuthi subnitratis, 3iij. Misce et fiant chartulae no. x. Sig.: One powder every half-hour. Indication: Used in vomiting due to ex- citability of gastric mucous membrane. fy Tinct, nucis vomica?, m ij. Aquae laurocerasi, f3j. Misce. Sig. : Ten drops night and morning. Indication: Used in pregnancy. R, Liq. potassii arsenitis. f3ij. Sig. : One drop in water three times daily. Indication: Used in vomiting of pregnancy, ulcers of stomach, or morning vomiting of drunkards. B Mentholis, gr. ij. Cocainae hydrochloride gr. iij. Syrupi simplicis, %]. Spiritus vini rect., §ij. Misce. Sig.: Teaspoonful every hour. Indication: In sea-sick vomiting. 468 Hand-Book of Modern Treatment. R Orexini, gr. xxx. Fiant chartulse no. xv. Sig. : One powder three times daily. Indication: Used in vomiting of pregnane}. I£ Bismuthi salicylatis, 3j. Cerii oxalatis. 3j. Mentholis, gr. x. Cocainse muriatis. gr. iij. Spiritus vini rect., 3j. Elixiris aurantii, q. s. ad §vj. Misce. Sig. : Teaspoonful every three to four hours. Indication: Used in the vomiting of preg- nancy. Monin has been struck by the resemblance which the symp- toms presented by certain pregnant women bear to those of hy- persecretion. Gastric pain, heart-burn, acidity, nausea, and vom- iting, occurring especially in the morning and relieved by taking- food, are all symptoms commonly observed both in hypersecretion and during pregnancy. Monin believes that in both conditions the stomach, instead of excreting only at the digestive periods, does so more or less continuously, although Kaltenbach and JafTe state in the pregnant cases no excess of hydrochloric acid is present in the gastric juice as in hypersecretion. Satisfactory results have been obtained in the ease of pregnant women by administering daily five doses of sodium bicarbonate, each con- sisting of 2 grammes given in a capsule. I£ Chloralis, gr. xx. Potassii bromidi, 3j. Mucilaginis amyli. f§iv.* Misce. Sig.: Warm gently and use as a rectal in- jection after first using enema to unload the stomach. Indication: Used in obstinate reflex vomit- ing. Mustard poultices over abdomen. I£ Liq. calcis, f^iv. Sig. : A tablespoonful every tAvo hours. Indication: Used in vomiting with acidity. Eand-Book of Modern Treatment. 459 R> Phenol is or creosoti (beechwood), gtt. x or xx. Bismuthi subnitratis, Siij- Misce et fiant chartulae no. iij. Sig. : One powder every hour. Indication : Used in vomiting due to active fermentation. For the vomiting of pregnancy and bilious vomiting the following are given: — P* Acidi carbolici, gr. i-iv. Chloroformi, m v. Syrupi, 3xxx. Aquae destillatae, 3xxx. Misce. Sig. : A dessertspoonful every two hours. Some spoonfuls of water should then be admin- istered from time to time. VULVITIS. P* Aluminis, 3j. Aquae. Oij. Sig.: Apply locally. Indication: Used in vulvitis of children. P* Liq. plumbi subacetatis, f^j. Tinct. opii. fgj. Aquae, Oij. Misce. Sig.: Add a. quart of water and apply freely on absorbent cotton saturated with the lotion. Indication: Used to allay inflammation and reduce oedema. WAKEFULNESS.— See Insomnia. P* Sulphonalis. 3j. Fiant chartulae no. vj. Sig.: One in cup of hot water and repeat if necessary. Indication: Used in insomnia of drunkards. 470 Hand-Book of Modern Treatment. IJ Tinct. hyoscyami, f^ij. Sig. : One tea spoonful. Indication : Where opium is not borne. B Trionalis, 3j. Fiant chartulse no. iij. Sig.: One powder in hot milk. IJ Potassii bromidi, 3iv. Chloralis hydratis, 3ij. Syrupi pruni virginianse, fgj. Aquae, q. s. ad fSiij. Misce. Sig. : A dessertspoonful in a wineglassful of water at bedtime. Indication: Used in insomnia due to mental overwork, anxiety, or physical fatigue. IJ Morphinse sulphatis, gr. ij or iv. Chloralis hydratis, 3ij. Syrupi, fSij. Aquse, q. s. ad i$iv. Misce. Sig.: A dessertspoonful at night. Indication: Used when dangerously large doses of either are required to produce results. IJ Hypnal, m xv. Alcoholis, m xj. Syrupi, f§iss. Misce. Sig. : One dose to be followed by one-third of a tumbler of water. Indication: Used when insomnia is due to pain. B Paraldehyde fgss. Olei gaultherise, m xv. Pulv. acacise, 3ij. Syrupi pruni virginianas, q. s. ad fgiv. Misce. Sig.: A half to a tablespoonful in water every hour or two. Indication: Used in insomnia due to psych- ical disturbances. Hand-Book of Modern Treatment. 471 I£ Chloralis hydra tis, 3iij. Syrupi, f3iv. Aquae cinnamomi, q. s. ad f§iij. Misce. Sig. : Dessertspoonful at night. WARTS.— See Condylomata. B Resorcini, gr. xv. Liq. petrolati, §j. Misce et fiat linguentum. Sig. : To be applied locally after thoroughly cleansing the parts. The following combination is quoted as being a very val- uable caustic : — Ifc Plumbi oxidi, gr. ij. Potassii hydratis, gr. xx. Aquas, q. s. ad 3j. Misce. Sig.: Shake well and apply, by means of a brush, to the lesion. One or two applications are sufficient. Indication: Venereal warts. Ifc Acidi salicylici, 3ij. Ext. cannabis indicae, gr. xv. Adipis benzoinati, q. s. ad Sj- • Misce. Sig. : Apply freely for several days ; should be covered with absorbent cotton and collodion. For a corona of small warts just back of the ^lans penis, and traced to the irritative action of the vaginal secretions on a surface weakened by too much venery, use the following dust- ing powder, and insist upon continence for at least three months : B Hydrargyri chloridi mitis, 3ss. Acidi tannici, gr. xx. Bismuthi subnitratis, 3ss. Misce. Indication: Used on venereal warts. 472 Hand-Book of Modern Treatment. I£ Acidi salicylici, gr. xxx. Resorcini, gr. xxx. Collodion flexile, 3iv. Misce. Sig. : Paint on the warts every night for a week. Apply Fowler's solution of arsenic to the warts five or six times daily (or oftener) ; this is painless, and, in addition/ to make assurance doubly sure, particularly for very large warts, or where they are in great numbers, give from 5 to 8 (or even 10) minims of the drug internally, in a little water, three times daily. The internal or external use of Fowler's solution alone will remove them, but takes longer than when used both internally and locally. It is easy to dispose of the smaller varieties by caustic or the electrically excited needle, but annoying scars sometimes result which worry a sensitive patient more than the original blemish. Painting lightly with glacial acetic acid will cause the disappearance of all such blemishes. The application should be made twice each day. taking precaution that none of the fluid runs upon the sound skin, and suspending the paint- ing for two or three days whenever there is a sense of soreness felt, and again resuming as soon as the soreness disappears. If the application* is properly made, the blemish will be banished and no scar remain. Warts can be removed by the persistent application of castor-oil. The oil probably softens the growth. R, Formaldehydi (40 per cent, sol.), fgss. Sig. : Apply locally with small brush twice daily. Indication: Common condylomata. IJ Hydrarg. chloridi mitis. 3vj. Acidi boracici, 3iij. Acidi salicylici. 3j. Misce. Sig. : Dust over the vegetations. Indication; Used on venereal condylomata. Band-Book of Modern Treatment. 473 IJ Olei terebinthinae, f§j. Sig. : Paint vegetation well with brush daily. WHITLOW.— See Onychia. WHOOPING COUGH. 1$. Aeidi nitrici dil., §j. Tinet. cardamomi com p., 3iij. Syrupi simplicis, §iiiss. Aquae, gj. Misce. Sig. : One small teaspoonful every two hours. The foregoing is especially recommended as a prophylactic measure in infants who have been exposed to the disease. I£ Bromoformi, m ij. Chloretoni. gr. iss. Tinet. aurantii, m x. Mucilaginis acacia?, m xx. Aquas, q. s. ad 3j. Misce. Sig.: At one dose. Indication: To prevent vomiting of pertus- sis. I£ Chloralis hydratis, gr. xv-xlv. Potassii bromidi, gr. Ixxv. Syrupi aurantii. 3iij. Aquae destillatse, §ij. Misce et fiat mistura. Sig.: One small teaspoonful every two hours. The dose must be varied according to the age of the patient. ty. Ext. belladonnas, gr. 1 / 4S . Pulv. aluminis. gr. ss. Syrupi zingiberis. f3ss. Aquae. f3ss. Misce. Sig.: One teaspoonful every two hours for a child one year old. Indication: Useful as an anti-spasmodic mixture when expectoration is profuse. 474 Hand-Book of Modern Treatment. I£ Ext. cannabis Indicae, gr. xij. Ext. belladonnas, gr. vj. Spiritus vini rectif., 3iss. Glycerini,~3iss. Aquae, q. s. ad Siij. Misce et fiat mistura. Sig. : One-half teaspoonful to two teaspoon- fuls for a dose, according to the age, night and morning. (Not to be given to children under eight months old.) I£ Tinct. opii carnphoratae, f3j. Syrupi ipecacuanha, f3j. Syrupi scillae, f3iij. Syrupi tolutani, f§ss. Liq. potassii citratis, q. s. ad f^iij- Misce. Sig. : Teaspoonful every two or three hours for a child one year old. Indication: Useful during catarrhal stage as a simple expectorant. I£ Bromoformi, m xvj. Alcoholis, f3ij. Glycerini, f3xij. Tinct. cardamomi comp., q. s. ad fSij. Misce. Sig. : Teaspoonful in water three times daily. Indication: Used for relief of spasmodic cough . I£ Codeinae sulphatis, gr. %. Tinct. belladonna?, m vj. Spiritus chloroformi, m x. Syrupi pruni virginianae, q. s. ad 3j. Misce. Sig.: One dose at night. Indication: Useful as a sedative. IJ Potassii bromidi, 3j. Ess. pepsini (Fairchild's) , 3iv. Tinct. belladonnas, gr. vj. Aquae, q. s. ad 3iij- Misce. Sig. : One teaspoonful every three hours. Hand-Boole of Modern Treatment. 475 IJ Sodii bromidi, gr. 1. Antipyrini, gr. xv. Glycerini, f3iij. Aquse cinnamomi, q. s. ad fSiij. Misce. Sig. : A teaspoonful every two hours for a one-year-old child. SPECIFIC FOR PERTUSSIS. Dr. Asa Jones claims for Jamaica dogwood — dose. 3 drops in a teaspoonful of water, every three or four hours — a specific for whooping-cough, as much as quinine for chills. IJ Bromoformi. m xlviij. Alcoholis, 3iiss. Aquae laurocerasi, 3j. Aquse destillatae, §iv. Misce. Sig. : One teaspoonful four times daily. I£ Bromoformi, m xlviij. Olei amygdalae dulcis, %ss. Pulv. acacise, §ss. Aquse laurocerasi. 3j. Aquse destillatse, q. s. ad ^iv. Misce. Sig. : One teaspoonful three or four times daily. When administering bromoform the effects must be care- fully watched on account of its tendency in some cases to pro- duce depressing effects. Ii Resorcinolis, gr. xv. Antipy rinse, gr. xv. Syrupi simplicis. f§j. Syrupi acacise, f^iiiss. Misce. Sig. : Three to five dessertspoonfuls each day. Indication : During paroxysmal stages to de- crease duration and frequency of spasms. 476 Hand-Book of Modern Treatment. IJ Terpini hydratis, gr. xv. Antipyrini, gr. xv. Syrupi aurantii cort., fgij. Mucilaginis acacise, f^ij. Misce. Sig. : One or two ounces in divided doses several times daily. Indication: Used to decrease severity of the convulsive attacks. IJ Antipyrini, gr. ij. Sacchari albi, gr. xx. Misce et fiant chartulse no. xiv. Sig. : One powder three times during the day and once during the night for very young chil- dren. Dose increased up to fifteen grains for adults. IJ Aquae hydrogenii dioxidi, 3ij- Syrupi tolutani, 3iss. Aquse, §ss. Misce. Sig.: From ten drops to one teaspoonful. according to age. One dose each hour for two or three doses, then every two hours for six or eight doses, getting farther between doses as patient improves. IJ Creosoti (beech wood), 3iij. Eucalypti, 3ij. Spiritus chloroformi. 3vj. Terebeni, q. s. ad ^iij- Misce. Sig.: For inhalation. Fifteen drops on a sponge wrung out of hot water. IJ Antipyrini, gr. ss-j. Ammonii chloridi, gr. iiss-v. Syrupi limonis, 3ss. Aquse, q. s. ad 3j. Misce. Sig. : From one-half to one teaspoonful every three hours. Hand-Booh of Modern Treatment. 477 R Mentholis, gr. j. Sacchari, gr. xxj. Misce et fiant chartulse no. vj. Sig. : One powder every two hours. Indication: Used in vomiting of pertussis. I£ Fluidextracti castanese, §j. Fluidextracti belladonna 1 , gtt. iv. Fluidextracti hyoscyami. m x to 3j. ac- cording to age. Syrupi simplicis, q. s. ad §iv. Any desirable flavoring may be added. Sig. : One drachm every two hours. Children take it readily, as it is not unpleasant. The same size doses should be given at any age over 2 years, and 15 to 20 minims every two hours is sufficient. 1^ Tinct. stramonii sem., 3ij. Am. bromidi, 3ij. Elixiris simplicis, q. s. ad §ij. Misce. Sig. : One teaspoonful to a child of five years in water every two or three hours as may be necessary to quiet the cough. The after-treatment should consist in giving ammonium carbonate, 2 1 / 2 grams every three or four hours, as an expecto- rant, administered in a little whisky and milk. The foregoing- prescription should be given sufficiently often to control the cough. B Pulv. belladonna? rad., gr. iss. Quininse sulphatis, gr. viij. Sacchari albi, 3ss. Misce et fiant chartulse no. x. Sig. : One powder three times a day. As a spray the following may be used for children over C> years of age: — 478 Hand-Booh of Modern Treatment. Ifc Cocainae hydrochloride gr. x. Potassii chloratis, gr. iij. Aquse grad., giss Misce. Sig. : To be sprayed into the throat twice a day. As an insufflation, introducing it into the larynx by means of a glass tube curved at one end, the following is of value as an antiseptic and germicide: — 3 Pulv. benzoini, gr. lxxv. Bismuthi salicylatis, gr. lxxv. Quinines sulphatis, gr. xv. Misce et fiat pulvis. Sig. : A few grains to be used as an insuffla- tion into the larynx once daily. B Acidi carbolici, gr. xv. Spiritus vini recti f., m xv. Tinct. iodi, m x. Tinct. belladonna?, m xxx. Syrupi simplicis, q. s. ad gij. Misce et fiat mistura. Sig.: One teaspoonful every two hours, be- tween one and two years of age; half the quantity diluted with water for infants under one year of age. I£ Quininse hydrochloride gr. xxx. Sodii bicarbonatis, gr. xx. Pulv. acacise, 3iij. Misce et fiat pulvis. Sig.: A few grains to be insufflated into the throat two or three times a day. As a liniment to the chest the following combination is recommended : — IJ 01 ei eucalypti, gij. Linimenti camphorse, Sij- Olei cajuputi, £ss. Olei menth. pip., 3ij. Misce et fiat linimentum. Sig. : To be applied locally to the chest. Band-Book of Modern Treatment. 479 WORMS. B Santonini, gr. i-ij. Hydrarg. chloridi mitis, gr. i-iij. Pulv. aromatici, gr. iv. Misce et fiant chartulae no. iv. Sig. : One at bedtime to be followed by cas- tor oil in the morning. Indication : Used for round worms. Ifc Pelletierinae tannatis, gr. ij. Syrupi acaciae, f3iv. Aquae, q. s. ad f§j. Misce. Sig. : Given in two doses at intervals of half an hour, and followed in an hour by a brisk purge. Indication: Used in tapeworms in children of one to six years old; children under two should not be given pelletierine. 1^ Oleorisini aspidii, m xlv. Tinct. vanillae, m xlv. Pulv. acacias, 3ss. Aquae destillatae, f^j. Misce. Sig. : Take the entire amount after fasting, and follow in two hours by a full dose of mag- nesium sulphate. Indication: Used for tapeworm. B Olei chehopodii, f3j. Sig. : Five to ten minims on sugar night and morning. Follow last dose with calomel. Indication: Used to remove round worms in child two to four years old. I£ Aeidi salicylici, 3ss. Sodii borat., 3ss. Aquae, Oj. Misce. Sig.: Warm and inject into the bowels. For a child reduce this one-half in all its parts. Indication: Used in round worms. 480 Hand-Booh of Modem Treatment. B Fluidextracti spigelian, 3ij. Fluidextracti sennae, 3ij. Glycerini, 3ij. Misce. Sig. : A teaspoonful night and morning. Indication : Used to remove round worms in a child four or five years old. I£ Infusi quassia?, gvj. Sig. : Use as a rectal injection. Indication : Used in seat worms. R. Kamalse, 3ij. Confectionis sennse, 3j. Misce. Sig. : To be taken at one dose after fast- ing for twenty-four hours. Indication: Used for tapeworm — no purge required. B Olei tiglii, gtt. j. Chloroformi, f3j. Glycerini, f3viiss. Misce. Sig.: At night give a saline purge; the fol- lowing morning before breakfast give the above mixture. Indication : Used in taenia. WOUNDS. Dr. Burger recommends, in the treatment of wounds such as usually occur in factories, that the wound he cleansed with a sublimate solution, after which pure balsam of Peru be dropped over the affected areas and gauze immersed in the bal- sam applied. The gauze does not adhere to the wound as oc- curs in dry dressings, nor does it macerate the tissues as do moist dressings. The dressings should be changed every two or three days. In this way the wounds heal quickly and are easily kept clean. Varicose ulcers may be treated in the same way with fairly good results. Wagner advocates the treatment of healthy granulating wounds by exposing them to the air. Exposure to the atmos- phere causes a drying of the wound which binders the growth Hand-Book of Modern Treatment. 481 of micro-organisms, the granulations flatten, a thin scab forms over the surface, and epidermidization rapidly follows. The application of occlusive dressings and ointments produces a moist wound, which facilitates the growth of bacteria. Upon exposure to air a wound as large as the hand may heal within ten days. The danger from infection from the air is trivial, and he has never seen it occur. * Nugera recommends xeroform as a most valuable primary dressing, one that takes up. all secretions and destroys the germs of the wound. It has been used very extensively in the German army. After irrigating with 1 to 1000 bichloride, xeroform poAvder is put on the wound in a thin wool bandage. These dressings remain until saturated by the secretions, which are sterilized by the xeroform. Wounds heal well and rapidly, big cuts and gashes healing in from two to three weeks. Most of the cases so treated were not seen until a few days after the wound was received. Levassort applies bicarbonate of soda directly to the wound, sifting it freely over and packing the cavity with aseptic gauze, sometimes mixing it with the gauze. He leaves this dressing for from fifteen to twenty days, merely drawing up a sma-1 piece of the gauze and cutting it off every two or three days. When the last of the gauze is removed the depths of the wound are found filled with red, almost erectile, granulations, and healing is soon complete. He does not drain except in abdominal surgery. The bicarbonate does not injure the tissues, but aids in osmosis and stimulates and provides a nourishing fluid for the young cells that develop. Their proliferation is so intense that they crowd out all microbian elements and grow into and transform fibrous cicatricial or degenerated tissues, so that it is not necessary to remove the latter to the extent generally believed. To irrigate wounds or large cavities it is always best to employ solutions at or slightly above the temperature of the body, as cold appears to interfere with the reparative action of in- jured tissues. B Aeidi borici, 3ij. Aristolis, 3ij. Misce. Sig. : Use locally as dusting powder. 31 482 Hand-Book of Modem Treatment. fy Aeetanilidi, 3ij. Sig. : Use as a dusting powder. Ifc Iodoformi, 5«s. Sig. : Used as a dusting powder. Ifc Europheni, 3 i j . Sig. : Used as a dusting powder. fy Formaldehydi (40 per cent, solution), f§j. Sig. : Ten drops in a pint of water and ap- ply as a wash. This solution is much too strong to be used about the eyes. fy Hydrarg. chloridi corrosivi, gr. viiss. Aquae ferventis, Oij. Mi see. Sig.: Solution (1-2000). Used in washing wounds, irrigating cavities, or on saturated dressings. I£ Chloretone, 3ij. Acidi borici, 3ij. Sig. : Used as a dusting powder, acting as an efficient antiseptic dressing. j^ Collodii Hexilis, 3j- Sig.: Used as impervious dressing on slight wounds. X-RAY BURNS. Burns caused by the x-rays, which are generally found to be so intractable, are readily cured by the following ointment, the dermatitis soon disappearing: — B Plumbi oxidi, 3j. Zinci carbonatis, 3ij. Glycerini, Sj. Olei qlivse, 3ss. Adeps benzoatis, ad Sj- Misce et fiat unguentum. Sig. : To be applied freely. Hand-Boolc of Modern Treatment. 483 PREVENTION OF X-RAY BURNS. By the use of a single coat of paraffin, the x-ray burn can be prevented, according to recent demonstrations. The wax is applied either to the skin, or by using a wax-coated paper screen before the light. ACUTE X-RAY BURNS. Dr. Martin F. Engman has been called on to treat several x-ray burns. All of them have been of the second degree or milder, with one exception, a burn of the back, with small points of deeper ulceration. Infection and ulceration were not factors to combat in their treatment, the indications being to stop the intolerable itching, assist repair, and to keep the sur- face aseptic, for which the following dressing seems to be won- derfully successful : — IJ Acidi borici, 3xij. Zinci oxidi, 3j- Amyli, gj. Bismuthi subnitratis, 5j- Olei olivae, 5j. Liq. calcis, §iij. Adipis lanse hydrosi, Siij- Aquae rosae, 3xij. Mi see. The powder should be well rubbed up in a mortar and the lanolin added. The olive-oil and lime-water are well mixed, then this mixture slowly added to the powder and lanolin, con- stantly stirring. When this is thoroughly mixed the rose-water is added and the whole beaten up in the mortar into a light, creamy paste. If there is much pruritus, 1 per cent, or 2 per cent, of carbolic acid can be added to the whole. In applying this creamy paste it should be spread on sev- eral thicknesses of absorbent gauze and laid over the surface, and a sheet of gutta-percha tissue placed over it to prevent evaporation. The cream paste is very cooling on account of the great percentage of water it contains, and acts almost as a lotion without the disagreeable effects. YELLOW FEVER.— See Fever. \ N!f$ 1 1910 One copy del. to Cat. Div. IViAR 1 UIO