Mustard plasters to limbs and over the heart should be given when there
are signs of failing heart and circulation, and over the epigastrium
when there is vomiting or hiccough. Smelling salts and strong ammonia
should be applied to the nostrils for their restorative action. Blister
over the nape of the neck is useful when cerebral symptoms are present.
Ice caps over the head is very useful and should be applied
continuously. The enlarged glands may be fomented with hot water or
spongio-piline wrung out of hot antiseptic solution. When they are much
painful, poppy or belladonna may be added to the water. Belladonna with
glycerine should be applied in the beginning and iodine afterwards. Hot
corrosive sublimate fomentations are also useful. If the glands
suppurate, they should be opened aseptically and dressed with
antiseptics. Proper drainage should be provided.
IV. _Internal._—Knowing as we do that the plague is due to the toxic
products metabolized by a pathogenic bacillus, the question comes—would
an antiseptic treatment be of any use? Can we by any means induce an
antiseptic action on the blood, or have we any drug which can act as
antitoxin? It must be at once stated that no drug that has been tried
yet fulfils the above conditions. The claims of quinine, however, should
be taken into account. This drug in small repeated doses acts as a
general antiseptic. I would, therefore, advocate its use especially in
the early stages. Plague is a disease in which collapse sets in early
and cardiac asthenia is a very early complication. There is, therefore,
great urgency for early stimulation. Alcohol may be given freely, but at
the same time it must be remembered that if the organs of elimination
are not acting properly, alcohol may do harm. For their stimulant
effects whiskey or iced champagne may be given. Carbonate of ammonia or
spirit ammonia aromatic are held to be very useful stimulants in plague
cases. They may be given in combination with cinchona, digitalis and
ether. A prescription like the following may be useful:—
Ammonia Carb. 5 grains.
Chloric Ether 20 minims.
Sulphuric Ether 15 ”
Tint. Digitalis 5 ”
Tint. Cinchona 1 dram.
Aquæ Camphor 1 ounce.
Every three hours.
For cardiac asthenia, the following may be tried:—(1) Caffeine,
hypodermically, 5-grains dissolved by the aid of 5 grains of Sodium
Benzoate in 20 minims of warm distilled water and injected three or four
times a day if needful; (2) Ether or ethereal solution of camphor
hypodermically; (3) Strychnine, hypodermically, beginning with gr. 1/60
every four or six hours till gr. 1/16 is injected, or Liquor Strychnia
in 5—10-minim doses every four hours; (3) Musk may be given in 5-grain
doses, or as in the following mixture:—
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