If there is no vomiting for an hour, probably a good part of the
ipecacuanha has been digested; if it has been vomited, wait for
half-an-hour, and then give another full dose. If vomited again, wait for
two hours, and give twenty drops of chlorodyne, followed by twenty grains
of ipecacuanha; the chlorodyne is to quiet the stomach, enabling it to
retain the ipecacuanha. In about twelve hours from the first dose, repeat
it in exactly the same way. If thirty grains are too much at a time,
give twenty, three times a day, for not less than sixty grains should be
given in twenty-four hours. The drug is not a dangerous one, and, if the
patient can take it, too much can hardly be given. Between the doses feed
the patient, giving but little at a time. If the ipecacuanha is going
to do good, marked improvement should be apparent in four or five days;
failure of the drug is often due to its not being given or retained in
sufficiently large quantities.
In addition to the emetine or ipecacuanha treatment it is well, save in
mild or trivial cases, to give a saline mixture once a day, for example
one ounce of sodium or magnesium sulphate. Other methods which are
helpful are enemata of warm water, hot hip baths, or a soothing injection
made by soaking an ounce of linseed for several hours in two pints of
warm water. Sedatives, such as laudanum or chlorodyne, should be used
only in cases where there is severe pain, sickness and great distress.
The full dose in ordinary cases is twenty drops three times a day, but if
less is sufficient so much the better, and it is advisable to avoid these
remedies wherever possible.
The object of treatment is not to block up the bowel—as might be done by
giving large doses of opium or tannin—it is to cure the disease of which
the looseness is only one symptom. The most favourable sign during an
attack is a return of the colouring matter to the motions; this shows
that the liver is again acting, and that the treatment is doing good.
With the return of colour (which at first may be intermittent), the other
symptoms, such as pain and bloody discharge, will abate, and the motions
will become more solid and healthy.
In dysentery, as in severe diarrhœa, the patient should _not_ be allowed
to get up to stool. A box cut across obliquely will make a rough slipper
bed-pan; put sand in it, and pad the edges.
Public-domain text, read in full here on John Shaqi.
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