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render the tongue dry and raspy, the epigastrium tense, the intestines filled with gas, the breathing hurried with a feeling of oppression and the pulse more frequent.
It is, however, the best remedy against all profuse hæmorrhages; such as bloody diarrhoea from ulceration of the bowels, or venous congestion with rupture of some of the capillaries. When the urine contains blood; in hæmorrhage from the womb; profuse epistaxis; when the petechia become ecchymotic, with suggillations; in profuse and exhausting perspirations.
It may be used by mouth, by injections, or as a wash to sponge the surface with.
Ipecac. will remove not only very severe attacks of diarrhoea, allay pre-existing nausea and vomiting; but benefit a dry, furred or bright-red tongue and meteorism. When there is a troublesome cough with ropy mucus in the bronchi, it will appease the irritation to cough and reduce the congestion of the mucus membrane of the airtubes.
Etheroleum-terebinthine may be given against simple diarrhoea, even if the abdomen be tense and tender, the tongue dry or moist, the pulse slow or frequent, the skin dry and hot, or warm and moist, and when there is slight delirium or stupor. During the use of turpentine the irritation to cough is lessened, the mucus in the bronchi is loosened, the catarrh is resolved, the fever lessened, the pulse becomes more full, the urine is increased and the skin becomes less hot and dry. It is one of the best remedies against pneumonia-typhoides; it prevents the congestion from passing into hepatization; resolves hepatization with a rapidity that could not be anticipated until it is tried. Huss thinks that the use of turpentine in some cases of typhus is one of the greatest steps forward which the medical art has of late made in the treatment of these forms of disease.
Wood (see Practice of Medicine) says, in typhoid-fever, when the tongue remains dry and the abdominal tension undiminished, the oil of turpentine will prove an excellent remedy. He cannot too strongly impress upon the profession his conviction of the importance of this medicine. It may be employed in all cases, in the advanced stages of the disease, when the tongue is dry and the pulse not strong. But there is a particular condition, and that not an uncommon, and sometimes a very dangerous one, in which he has often employed it, and never
known it to fail, viz. when the tongue instead of cleaning gradually from the edges and tip, often parts with its fur quickly and in large flakes, generally first from the middle or back part of the surface, which is left smooth and glossy as if deprived of its papillæ, or as if glazed or varnished. If, after this process, the tongue remains moist, a slow convalescence may be pretty confidently expected; but if it becomes dry again, there will generally be an increase of tympanitis, and an aggravation, or certainly no abatement of the other symptoms; this state of things frequently depends upon an active state of the ulceration of the bowels, and turpentine will almost unfailingly prove useful. In the course of twenty-four or forty-eight hours some amelioration of the symptoms will be observed; the tongue becomes gradually moister and covers itself with a whitish fur, the tympanitis ceases to augment, and after a time diminishes; the pulse becomes less frequent, the skin less dry and harsh, and the patient enters slowly but regularly into convalescence often without the aid of any other remedy. Wood has known such cases run for a considerable time, without material change, under various treatment and has seen them yield immediately to the turpentine. He has as much confidence in it as a uniform experience of more than twenty years may be considered a ground of confidence.
Opium.-Dr. Fort, of Milledgeville, Georgia, says, opium is a great remedy in typhus; it is useful in all the forms and varieties of this disease. How should it be otherwise? Typhoid fever prostrates the powers of life, deranges the nervous energy, produces local irritation in a hundred ways, and sometimes deprives the sufferer of all sleep and rest. For all these evils, what remedy is equal to opium?
In the highest, most congestive and dangerous forms of typhus, opium is our sheet-anchor. If the patient is struck down with coma, or has delirium, with rapid pulse and tossing from side to side; and if these symptoms occur on the 1st, 2d, 3d, or 4th, or any other day of the disease, give opium. If your patient is too comatose to swallow remedies, give opium by way of injection. Give this remedy a fair trial; give a second dose, if necessary; perhaps your patient may fall into a profound sleep, or run out of coma into a sleep for life, and not for death. If he sleeps, let him rest, and hope that he will awake with better symptoms. If this will not relieve him nothing else
will; he must take his fate. I (Fort) know that many other remedies are showered down on patients in these unhappy circumstances; they are bled, leeched, cupped, and fomented; they are bathed with cold water on the head, and hot water to the feet, tormented with blisters, pepper and mustard, and I (Fort) know not what else; but I (Fort) would give a single dose of opium for a thousand such remedies.
In milder cases of this disease opium still has its place; when there is a rise of fever and restlessness at night give opium when the fever is declining. The doses may be enlarged and repeated in cases of great restlessness. If the fever runs an even course without much rise at night, it may be given during the whole course of the disease. For many days during the first stage of typhoid fever, Fort often gives no other remedy but some preparation of opium.
When the fever is high, pulse full and strong, and the patient's strength not yet exhausted, though the pain and restlessness may be great, there is doubt in some minds about the propriety of giving opium. The question is often doubtful and embarrassing. Writers say it may heighten all the symptoms of fever and render coma fatal; but this is the view of those who see inflammation in every heated body. Fort's opinion is, that the error has been in withholding opium, for the excitement of typhus differs from that of inflammation, and is especially allayed, quieted, and subdued by opium.
And now I (Fort) am to make my last appeal in favor of opium in typhoid fever. I (Fort) come to the great argument in every contest of this kind, my own experience. I have for thirty years, given opium; I think my practice more successful than a different course would have been. The immediate effect is most soothing to the sufferer, and its ultimate ill effects I have not seen. True, it does not always relieve delirium, or coma; it does not always still the agitation of the system. But it is also true, that in a great many cases, it affords the most obvious relief; it removes the wakefulness, restlessness and muscular pains, so troublesome at night in slight cases, like a charm. It often allays the graver symptoms of delirium and throbbing pulse, and I (Fort) have seen it successful in removing the deepest coma in the first stage of the complaint. The error has been in withholding opium in these cases.
Costiveness too, is not always an evil in typhoid fever;
the disease is one of universal torpor; mind, body, limbs and intestines are torpid; the patient will lie on his back for days and never rise to evacuate the bowels, or discharge urine unless he is urged. I (Fort) early learnt to dread cathartics, and bad nurses and poverty-stricken patients taught me not to fear costiveness. I have attended many who could not procure the administration of an injection and have seen them lie from one to three weeks without a discharge from the bowels. Such persons in almost every instance recovered, and it was so long that he had never seen a patient who was costive in typhusfever fail to recover, that he came to the conclusion that there was no danger while the bowels were fast. And even now, he can say, that the best symptoms which can be found in typhus, is a constipated state of the bowels. I (Peters) have generally relied upon opium and arsenicum, for eight or ten years, as the main remedies against typhoid fever; the former against the derangements of the vascular and nervous systems; the latter against all the symptoms which arise from irritation and ulceration of the bowels. In profuse hæmorrhages from the bowels, sulphuric-acid by mouth and injection is a perfectly reliable remedy, although aloes sometimes comes in play. In typhus versatilis, agaricus is the main remedy and far superior to belladonna. Beef-tea and wine-whey I have always used early and freely.
ON BLOOD-LETTING IN APOPLEXY.
(Condensed from the "Journal de la Société Gallicane de Médecine Homœopathique," for March, 1856.)
Is blood-letting sometimes dangerous in apoplexy? Such was the title of an article in the Union Médicale of the 5th of February, 1853.
*The gravity and urgency of most cases of apoplexy, together with the wide-spread prejudice existing in favour of immediate and free depletion in that disease, renders its treatment at all times a subject of much anxiety to the homoeopathic physician. We, therefore, have thought it desirable to premise the remarks, which we intend to give in our next number, upon the principles which ought to guide us in the homoeopathic treatment of apoplexy, by these extracts from some leading allopathic periodicals of Paris. They will show that, although blood-letting is indicated in apoplexy, according to allopathic notions, by the pathology of the disease; yet, experience proves it to be rather hurtful than beneficial.-ED.
The question placed at the head of this article, said the Union Médicale, will certainly startle every practitioner. M. Aussaguel has collected in his inaugural thesis, from which we borrow our facts, several cases requiring mature consideration.
In his lectures, says he, Professor Cruveilhier, when the treatment of cerebral hemorrhage is spoken of, never fails to say certainly, you must bleed; but be cautious." And then relates, that having been called to a person whom he found in imminent danger of an attack of cerebral apoplexy, he at once bled him, but that as, soon as the blood had ceased to flow, the patient was hemiplegic. Thus, adds he, the relatives of the patient did not fail to say that the puncture of my lancet had caused the mischief.
Since then, we have read the following case in a thesis by M. Cornil (April, 1851): "A woman whom I saw last year in M. Rostan's wards, was occupied with some household work, when she was suddenly seized with weakness in the left arm and leg; nevertheless she was able to walk, but not without some difficulty, to the house of her physician who resided at some distance. She was immediately bled; but after the bleeding she could not rise from the chair upon which she sat she was quite paralysed on one side."
Moreover, the following fact came under our own observation on the 24th February, one of our friends, L.B... called on us with his speech so inarticulate that it took him a quarter of an hour to make us understand that in the morning of the same day he was much astonished to find himself in that state. There was, in addition to this, only a little weakness in the limbs on the right side and chiefly in the right arm, which likewise had less feeling than the other; Dr. Batailhé having been called in bled him freely. The next day the difficulty of articulation having rather increased than diminished, he was bled again, syncope came on and lasted fifteen minutes; when he recovered from it he was completely paralysed on one