Vol. 60, 1909 - University of North Carolina at Chapel Hill

356
THE CHARLOTTE MEDICAL JOURNAL.
in cases of low arterial tension, functional bility, after a sustained observation and
or organic diseases of the heart, or when a management, show marked improvement
heart Ionic is indicated, digitalis, strophan- and come to permanent relief. These pathus,
adonis, or nitro-glycerine, may be tients place upon a skimmed milk diet with
combined with the bromides with benefit, or without lime water. Order a saline purge
In anaemic, debilitated, or neurasthenic in the early morning usually in the form of
cases, combine bromide of soda with glyc- magnesia-citrate. Keep them on the milk j,
erophosphate of soda. Iron may also be diet for some time. When the precordial |1
given with benefit in such cases. A com- pain is relieved and not excited by more or ,'
bination of bromides with adonis vernalis less exercise, prescribe a more liberal diet. ;,
and codeine gives good results in some External Accidental Hemorrhage in a ji
cases. Bromipin (bromine and sesame oil) Case ol Normally Situated Placenta.— ;
and bromalin are remedies of some value, j^j. q Marshall says that his treatment J
especially in feeble or asthenic cases. Bi- consisted in two things: first, checking of 1
borate of soda, as an anti-spasmodic, is a hemorrhage; second, induction of labor. If I
valuableremedy when given with bromides, the uterus is healthy and we prevent the h
Belladonna, similarly administered, some- ^lood, which is being poured out from be- •
times proves efHcacious, when the bromides ^j^jj ^he placenta, from escaping out of the ::
alone fail. What is known as the Fleichsig uterus the pressure inside will become equal J
treatment—the opium-bromide method— ^o the blood pressure and hemorrhage will I
seems to.be more beneficial in the early ^ease. We can be assured that the uterus 'j
Stages or in young subjects than it is in con- ^g healthy if the physical look of hemorrhage
firmed cases. Horse nettle (Solanum Cario- jg ^^^^ ^^^j ^he fact of its being external. ,
linese) has value in some cases, and others The vagina was immediately tightly plugged :,{
have been benefited by the so-called intesti- .^j^h tampons. This did two things:—prac- •
nal antiseptics—beta-naphthol, salol and tically it stopped hemorrhage and brought i
other drugs of this class. Occasional doses qu labor. This coming on gradually did i^
of calomel and salines have apparently ^^^ increase shock from which patient was <
some influence, certainly in lessening the already suffering, but on the contrary, al- i
mental hebetude and irritability. Likewise, lowed "her time to rally from the collapse i
diuretics—the bromides being eliminated caused by loss of blood. The patient was i
chiefly by the kidneys—should be freely igft i,i ^gd for two hours. Then with as- (
given. Baths are useful adjuvants, in fact gistance from another physician she was
indispensable in encouraging needed bodily given an anesthetic. Packing was removelimination.
Hypochlorization, that is, the g^ ^jj^ cervix found to be dilated the size
suspension of sodium chloride from the diet, of g_ standard watch. Further dilatation
using instead the bromide salts, preferably was rapidly made with hand, and the memthe
sodium, with the food, has had good branes ruptured. Forceps were applied, '
,
effect in quite a number of cases. and fetus delivered but soon died. Placenta
was taken and uterus massaged. Patient ,
Treatment of Angina Pectoris.-Dr. A.
G. Brown believes that the attack in the
P^^^ to bed and given a dose of ergot (hypo- ,:
usual case can be treated with the follow- derrnically). Later gave stimulants and ,
, r T c c 11.- t^^^ smal doses of ergot. Patient recovered in :i
mg agents for relief of pain: chloroform, , , .. t ^ ^ i
f
° , ., ., ,. '^
1 , ,
, A^„,J the usual time, about two weeks.
'
amyl nitrite, morphine, chloral hydrate,
bromide potassium or sodium, nitroglycerin,
sodium nitrite. Absolute rest in recumbent
Vi>si'iia l\Icdical Semi-Monthly, Aug. 27, \\
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position, application of hot packs to chest, 1909.
sipping of a cup of very hot Epsom salts Uncenariasis.— Dr. J. R. Perkins gives J
solution. Those cases showing acute dila- the following treatment: ji
tation of the myocardium, with or without 'fhe most popular drugs used are thymol, ;.
great pain, should be stimulated by simul- male fern, and betanapthol. Thymol hasL
taneous use of strychnine, spartein, caffein, given excellent results in my cases, and I j
camphor, ammonia, and should not be de- have had no occasion to use the other reme- I
pressed but sustained, depending more upon dies mentioned. It is very necessary to j'
topical applications and gastrointestinal have the intestines empty and clear of mu- i
elimination of possible etiologic factors. cus before beginning treatment; if not, re- |l
If the case is one showing no marked suits will be disappointing. Some authors 1
cardiac vascular, or visceral lesion, and not
attributable to glands of internal secretion,
advise starving the patient the day before,
j;
giving calomel and podophyllin, and next,'
look for the main cause in the gastrointes- morning a large dose of salts, followed in a ;•,!
final tract. In these cases a strict diet, a short while by the thymol. This has upset:
j
limitation as to quantity and a selection of the stomach and produced such nausea that |:|
the kind of food used, will in all proba- the thymol could not be retained. Whenli|
:
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