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VOMITING OF PREGNANCY.

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may be given with Ipecac., especially when tongue coated (R.). Iris, in vomiting with blinding right supraorbital pain; liver deranged (P.). Bismuth, in many forms of vomiting in children, especially when from gastric catarrh (R.). Carbolic Acid, with or without bismuth (B.); in nervous vomiting (W.). Creasote, in the vomiting of cancer, gastric ulcer, etc. (R.); gtt. j-ij (W.). Mercury, gr. of gray powder every two hours, especially in children with clayey stools (R.); Calomel, gr. j to Oj aquæ, first dissolved in 3j of limewater -a teasp. every ten minutes for the regurgitation of food in nursing children (A. A. Smith). Sulphurous Acid, mv-3j, well diluted, or less effectively, sodium sulphite. Sulphites often curative in vomiting of sarcinæ, and acid matter, due to acid fermentation of starchy elements (B.). Cocculus Indicus, efficient in cephalic vomiting (P.). Opium, will arrest many kinds; best in that of biliary or renal calculi, dysmenorrhoea, seasickness, pregnancy. Morphia, hypoder., gr. to (P.). Bryonia, bilious vomiting and headache (P.). Veratrum Album, in vomiting and purging of summer diarrhoea (R.). Hydrocyanic Acid, often very serviceable in nervous vomiting; acts promptly if at all (R.). Hydrobromic Acid, 3ss in 3j of water, four times daily, useful for the vomiting due to gastric ulcer. Chloroform, Mij-v, on sugar, for noninflammatory vomiting (R.); see YELLOW FEVER for formula. Bromides, in cerebral vomiting only; not in the gastric form (B.); potassium bromide in that of uterine disease (W.). Cinnamon or Cloves, will check vomiting (P.). Calumba, in vomiting from kidney disease and renal calculi; frequently allays that of pregnancy and dentition (P.). Serpentaria, for bilious vomiting (P.). Cerium Oxalate, in that of pregnancy and from cancer (B.); gr. j every three hours (R.). Sodium Bicarbonate, 3ss-j to a pint of milk, for infants especially if constipated (R.). Ammonium Carbonate, may relieve when vomited matter is acid (B.). Milk and Limewater, often relieves when other methods fail; also the effervescing soda powders in the vomiting of acute diseases, and the exanthemata (B.). Alcohol. Iced brandy or champagne in spoonful doses every1⁄2 hour in vomiting of cholera, pregnancy, and delir. trem. (B.). Counter-irritation, at epigastrium (R.). Nutrient Enemata (B.). [See ENEMATA.] Ice, sucked, with horizontal posture, absolute rest and quiet (Wa.). Iced champagne, 3ss every 4 hour (B.). Pepsin, for vomiting of food after meals; gr. x-xv before or during meals. Kumyss, has proved efficacious when no other food would remain on the stomach. [Compare the List of ANTI-EMETICS, on page 415, also the articles entitled HEMATEMesis, Nausea, SEA-SICKNESS, VOMITING OF PREGNANCY.]

R. Ac. Hydrocyan. Dil.,
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M. Sig.-A teasp. every 2 hours, water, 4 times daily. for nervous vomiting.

Vomiting of Pregnancy.

Ipecacuanha, or Nux Vomica, either will generally succeed where the other fails (R.); no other remedy of equal value to Ipecacuanha (P.). Nux Vomica, is useful but often fails; gtt. ss-j every hour or two in water (R.); in very minute doses (S.); gtt. ij-iij of the tincture every two or three hours, or gtt. x before each meal, with very hot water as a drink, is the best treatment (Parvin). Arsenic, Fowler's solution, gtt. j before each meal, will often relieve, when vomiting of food, retching and straining, with blood and pain (B.).

Creasote, checks the vomiting (R.). Carbolic Acid, drop-doses of crystals liquefied by heat, in mucilage ter die (Wa.). Staphisagria, has subdued when other remedies failed (P.). Cerium Oxalate, gr. j every three hours (R.); ordinary doses far too small, give as high as 10 grains (B.). Morphine, hypodermically in severe vomiting (R.). Pepsin, has been used with success. Ingluvin, seems almost specific (B.). Potassium Bromide, is often efficacious (W.); 3ss doses thrice daily, exceedingly effective in the combined diarrhoea and vomiting of pregnancy. The first dose should be given an hour before rising. Hydrocyanic Acid, often the best remedy (P.). [See ante, VOMITING.] Copper Sulphate, sometimes effective, not more than gr. ter die (B.). Iodine or Calumba, as tincture often useful; drop-doses every hour or two (B.). Bismuth, and Carbolic Acid, are effective (B.). Atropine, frequently effective (R.); never failed to give relief in many years of using it (Boys). Ether, sprayed over the epigastric region and the corresponding part of the spinal column, for 3 to 5 minutes every 3 hours, gives immediate relief (Lubelsky). Pop-corn, is a god-send in this complaint, having acted marvellously in several cases in which I have used it (Sweringen). Aconite, in full doses, is often very successful (W.). Dilatation of the cervical canal, by the index finger, is regarded as extremely efficient, and reasonably safe. It may bring on abortion, if too extensive, but from records of several cases since 1875, it may be said that it is a safe and sure remedy (Copman). Ice-bag to spine, an efficient measure (R.).

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Sodium Hyposulphite, an unfailing remedy in lotion for aphthæ of the vulva (R.). Arsenic, much used for eczema (T.). Lead Acetate, a concentrated solution in glycerin, for eczema of vulva (T.). [Compare PRURITUS, PRURIGO.]

Vulvitis.

Alum, as lotion in vulvitis of children; gr. lx-Oj aquæ, or less strong if found to increase discharge (R.). Lead, solutions of the acetate or the diace

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tate as wash, after the acute stage has subsided. Lime-water, as wash (R.). [Compare VAGINITIS.]

Warts.

Thuja, worthy of recommendation in the highest terms, for the cure of warts with a narrow base and pendulous body. A strong tincture locally three times a day, for one or two weeks, with 5 drops in a wineglassful of water internally, night and morning (P.). Iron, tincture of the chloride and dilute HCl acid, applied night and morning, equal parts, very effective (Bulkley). Nitric Acid, 3j-ij of the dilute acid to a pint of water, as wash, to keep small syphilitic warts constantly moist (R.). Sabina, as caustic (P.); j-ij of alum (Wa.). Rue, the oil, with honey, locally (P.). Arsenious Acid, as a caustic; enough to be used to excite active inflammation. Liq. arsenicalis painted over warts (R.); may be taken internally (B.). Mercurial Ointment, containing 5 per cent. of Arsenic, or a plaster having in each 8 square inches 154 grains of Arsenic and 77 grains of Mercury (Unna). Tannin, and Burnt Alum, equal parts, powdered over warts daily twice, gives good results. Chromic Acid, gr. 100 to 3j aquæ, with a glass rod, to saturate diseased growth. Remove any superfluous acid; dress with dry lint (R., Wa.). Mercuric Nitrate, locally (R.). Silver Nitrate, as caustic, but is usually too superficial (R.). Dermal Curette, is much used in Vienna to remove warts by enucleation. Strangulation, by tying a string tightly around the base, will cause them to drop off in a few days. Heat, is a most thorough measure for their radical removal; it may best be applied by touching the wart 3 or 4 times daily with the hot end of a cigar; the first few applications only give pain. Caustic Alkalies, locally (R.); a saturated solution of potassa fusa, carefully applied by a brush or sponge fastened to the end of a stick, is to be preferred (E. Wilson). [Compare CONDYLOMATA.]

Wen.

Extirpation, the least troublesome and most speedily effective method. Run a scalpel through it, seize the cut edge of the cyst, and gently tear it out with a touch or two from the knife. Dressing of lint and carbolic oil to cause suppuration and contraction (D.).

Worms.

Filix Mas, Brayera (Kousso), Rottlera (Kamala), Pepo, Granati Fructus Cortex, as tæniafuges (B.). Filix Mas to be taken on an empty stomach, for tape-worm, and followed by a purge (R., P.). Pepo, Zij as emulsion, taken fasting, one of the most efficient remedies against tænia (B.). Santonin, the best anthelmintic; laxative in morning, fasting all day, a dose (gr. ss-v) of santonin and calomel, or troches of santonin (j-x), at bedtime, a senna draught next morning. For ascarides (B., P.). For round and thread-worms, in castor oil by mouth, or as injection (R.). Iron, the Syrup of the Iodide internally and a solution of the tincture locally, for ascarides (B.); the tincture ferri sesquichlor. 3ss ad Oj aquæ, a good injection for thread-worms; coagulates albumen (R.). Quassia, the infusion an effectual injection, conjoined with simple bitters internally, for ascarides (R.). Pelletierine, the alkaloid of Granatum, is by far the best vermifuge for a tape-worm, repeated after a week for a second worm, as many as 3 having been found in one patient (Da

C.); gr. xv-xx of the tannate, followed in a few hours by Castor Oil (R.). Chloroform, a very efficient tæniafuge, 3j in 3 of mucilage, after 20 hours' fasting, followed one hour later by 3j of Castor Oil; this is an adult dose, zj should never be exceeded (Wilde). Lime Water, as injection for threadworms (R.); 3iij-iv repeated, for ascarides (Wa.). Sodium Chloride, in 3ss doses on empty stomach, expels ascarides and prevents reproduction (Wa.). Quinine, as a tonic; also cold sponging, out-door exercise and judicious diet. Useful probably by preventing the production of the abundant mucus which favors the growth of worms (R.); especially useful for ascarides; also as injection for thread-worms and tænia (Wa.). Ignatia, for convulsive symptoms (P.). Kamala (Rottlera), excellent for tænia, requires no purge (P.); gr. cl-clxxx for an adult (Wa.). Eucalyptus, as injection, for ascarides (B.). Aloes, are efficacious for ascarides (P.). Ailanthus, decoction of fresh bark, for tænia (B.). Tonics, as cod-liver oil and iron to restore intestinal canal to healthy condition (R.). Turpentine, as poison to tape and thread-worms (R.); also for tænia (Wa.). Scammony, for thread-worms in rectum (R.); with calomel, effective (Wa.). Tannin, as catechu, kino, red-gum, rhatany, hæmatoxylum, in injections to destroy thread-worms (R.). Alum, as solution for injection (R.). Ammonium Chloride, to prevent formation of thick mucus which serves as nidus for worms (R.). Valerian, especially when convulsions (R.). [Compare the List of Anthelmintics on page 419.]

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Arnica, very useful for external bruises and cuts, also for internal injuries; unites surfaces very rapidly after amputations. The infusion or decoction best (P.); very effectual (Wa.). Aconite, valuable in surgical fever (P.). Carbolic Acid, solutions check suppuration, and correct fetor (B.). The "antiseptic" treatment of wounds (Lister), especially surgical wounds. See Ag. vol. 1, page 187. Sulphurous Acid, in solution, diluted or not, constantly

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applied (R.); in solution or by fumigation, is regarded by some as superior in efficacy to carbolic acid, and less irritant (Wa.). Salicylic Acid, Thiersch prefers to Carbolic; may be applied pure in powder to gangrenous and sloughing wounds (B.). Mercury, the bichloride, gr. vijss to quart j of hot water, stirred with a stick, makes a solution of 1 to 2000; the best of all antiseptics for washing a wound or cavity, and for saturating the dressings. See List of Antiseptics on page 432. Boracic Acid, also applicable as Carbolic Acid (B.). Balsam of Peru, excellent for closing recent wounds (P.). Benzoin, the basis of healing "balsams" (P.). Aloes, topically as a slight stimulant; often purges (R.). Gum Tragacanth, a thick aqueous solution to granulating surfaces, to protect them from the air (Wa.). Opium, to quiet intestinal movements in wounds of the abdomen (R.); forwards the reparative processes (P.). Tannin, or glycerin of tannin to coat over wounds (R.). Collodion or Liquor Gutta-percha, to secure primary union of incised wounds (B.); as protective covering (P.). Iodoform, powdered and dusted over sloughing wounds, irritable and ill-conditioned ulcers, sores (B.). Iodoform 1, Collodion 9 parts, painted on a superficial wound while edges are held together (Gross); may be painted over edges when stitched together: gives excellent results. Galvanic Couplet, to wounds of indolent form (B.). [See BEDSORES.] Nitric Acid, as escharotic for gangrene (B.). Turpentine, one of the most efficient applications in hospital gangrene (B.). Aloes, pulverized fine, as a dressing for wounds, favoring cicatrization and closing them, also relieving the pain at once; requires removal only at long intervals (Millet). Poultices, are often abused. Yeast or charcoal best for foul wounds (B.). Alcohol, an excellent antiseptic dressing when suppurating; also favors cicatrization of open wounds (B.). Water, in universal use as dressing. Cold water often abused. Hot-water dressing as advocated by Hamilton, of New York, promises better results (B.). Turkish Bath, for pain in the seat of old wounds (R.). Ice and Salt, applied to wound prevents inflammation (R.). [Compare HEMORRHAGE, INFLAMMATION, PYÆMIA, SURGICAL FEVER, GANGRENE, ULCERS.]

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Treatment must all be done at the beginning, no time to be lost. Cold sponging early and frequently repeated. Calomel, Quinine and Salines at the start. Potassium Acetate for the kidneys. Morphine for gastric irritation, the feet to be in mustard water (Da Costa). Diaphoretics and Diuretics, also Laxatives, are very important throughout the disease (Da Costa). Mercury, a calomel purgative, gr. ss, 2 or 3 times on the first day, followed by a warmwater enema, is good treatment (B.); has many advocates, and many opponents (Wa.); should generally be abstained from (S.). Duboisine, gr., subcutaneously, the most efficient hypnotic and calmative (B.). Turpentine, when cardiac weakness, depression of vaso-motor system, dissolved state of the blood; mx-3ss; small doses, with tinctura ferri chloridi, in hemorrhagic form (B.). Quinine, has some strong evidence in its favor as an abortive

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