Observations on M. Laennec's method of forming a diagnosis of the diseases of the chest by means of the stethoscope, and of percussion; and upon some points of the French practice of medicineScudamore, Charles
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Observations on M. Laennec's method of forming a diagnosis of the diseases of the chest by means of the stethoscope, and of percussion; and upon some points of the French practice of medicine
Scudamore, Charles
Chest -- Diseases -- Diagnosis; Laennec, R. T. H. (René Théophile Hyacinthe), 1781-1826
A solution is made in the proportion of half or the whole of a
grain, to half an ounce of simple or some lightly aromatic water,
sweetened; and it is given every two hours. The patient is desired
to drink very sparingly; for without this caution, the medicine
would most probably produce too much of emetic effect. In the first
instance, this result very commonly happens; but it is remarkable
how soon the stomach accommodates itself to large doses of this
active medicine. When its continued use produces sickness, syrup of
white poppy is added, in the proportion of an ounce to half a pint
of the antimonial solution; or, as an equivalent, a grain of extract
of opium. The total quantity of the tartar emetic is very commonly
increased to twenty grains and upwards in the twenty-four hours. I
saw an elderly man, who had, in this space of time, on the preceding
day, taken sixty grains without having experienced nausea, or any
other inconvenience.
M. Laennec considers that the tartar emetic, when administered with
the freedom which I have described, exerts a highly useful power
in diminishing inflammatory action in continued fever, and in the
phlegmasiæ; and he is most satisfied with its action, when, after the
first day or two, it ceases to produce any sensible effect on the
stomach.
Reflecting on the extraordinary circumstance of the exhibition of
this active medicine in such immense quantity with seeming impunity,
I thought it probable that the French preparation might be weaker
than our own; but on comparing the crystals which I procured at
Paris, with those prepared according to the London Pharmacopœia,
I could not discover any difference; nor is there the least
essential distinction in the mode of preparation, as directed by the
London Pharmacopœia and the French codex. I have lately had many
opportunities of prescribing tartar emetic on the principle of
treatment which I have described; and I have been perfectly satisfied
with its useful agency; but I have usually commenced with one grain,
and never exceeded two grains, for the first twenty-four hours; nor
found it necessary to go beyond eight in the progressive quantity;
except in one case of insanity, in which sixteen grains were given
daily for a short time, with the greatest advantage. In the quantity
of two grains, it has usually produced considerable sickness for
the first day or two; but afterwards, even the increased doses have
seldom caused any nausea.
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