North Carolina Medical Journal. Vol. 3. No. 4. April, 1879 — John Shaqi
North Carolina Medical Journal. Vol. 3. No. 4. April, 1879Various
Science
North Carolina Medical Journal. Vol. 3. No. 4. April, 1879
Various
Medicine -- North Carolina -- Periodicals; Medicine -- Periodicals
When transpiration is determined, the pulse remains full and strong,
diuretics are indicated, and among these powder of digitalis associated
with nitre.
_Sulphate of Quinine._—Sulphate of quinine is one of the most powerful
and most useful remedies in the treatment of this disease; but it must
be well indicated, well administered, and in a suitable dose. What are
the indications of sulphate of quinine in yellow fever? There must be at
least remission, if there is not complete intermission of the fever. Its
application is then excluded from the continued type. When the fever has
yielded, by the use of the medicines of which we have spoken, or when,
with sweat or moisture of the skin, the pulse has sensibly lowered, the
employment of quinine is always good. Its effect will be shown, for the
strongest reason, in the intermittent type. In this last case, it acts
with the same precision and the same success, as in simple intermittent
fever.
As sulphate of quinine has a prompt and durable action, the mucous
membrane of the stomach ought to be in the best possible condition for
absorption. It must, therefore, be empty. An emetic and a purgative, at
least the latter, should precede the administration of sulphate of
quinine. I know that there are medical men, who administer quinine in
the height of the fever, regardless of the state of the stomach and of
the mucous membrane. If they have found this treatment beneficial, it is
by chance; for it is illogical, and its effects are commonly deplorable.
As for the dose in which sulphate of quinine ought to be prescribed, it
depends on the age, sex, and temperament of the patients. For adults and
men, the average is twenty grains in a single dose, in about three
ounces of black coffee, without sugar. If it is feared, that the
irritated stomach cannot bear so strong a dose, it should be dissolved
in a few ounces of distilled water with a sufficient quantity of
sulphuric acid, and given every hour by the large spoonful. If the
stomach cannot bear this, give an injection of a double dose, with the
precaution, not to inject more than one ounce of liquid at once, every
hour. The action of the medicine will be assisted by friction of quinine
ointment along the vertebral column, on the articulations of the wrist,
knees, and under the arm-pits, etc.
Some enthusiasts consider sulphate of quinine, as a preventive, and
direct it to be taken in a perfect state of health, or administer it in
the outset of the fever. I have tried this without having felicitated
myself. I will say as much of the association of calomel with sulphate
of quinine. This combination should be rejected.
I have nothing to add to what I have already said as to blisters.
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