Pulv. Moschi 10 grains.
Mucilage Acacia 2 drams.
Syr. Aurantii 2 ”
Aquæ Camphor ½ ounce.
To be given every 6 hours.
Digitalis does not always give good results, a fact which Lowson
attributes to some inflammatory or fatty degenerative changes in the
small vessels giving rise to a tendency to hæmorrhage. Stropanthus may
be substituted. Transfusion of blood a hot saline solution and
inhalation of oxygen have been recommended for collapse. Dr. Viegas of
Bombay recommends Liquor Hydrasgyie Perchloride 10 to 15 minims every
four hours if there is no albumen in the urine. Dr. Dimmock has advised
subcutaneous injection of Guaicol 10 or 15 minims every two hours.
Permanganate of Potash 5 to 12 grains in 24 hours has also been
recommended. Dr. Blaney has recommended Medritina in two-dram doses
every two hours when the kidneys are involved. Camphor has been
recommended by some as a cardiac stimulant.
_TREATMENT OF SYMPTOMS._
(1). High temperature may be reduced by antipyretics, such as antipyrin,
phenacetin, antifebrine, &c. These drugs produce profuse perspiration
and a certain amount of depression; it is, therefore, advisable to
restrict their use during the first few hours only, and if not found
responding, they should be dropped altogether. Pyrexia is but a sign of
the intensity of the activities of the infective agent, and by
artificially reducing the body heat we really do not lessen the
virulence of the poison, as shown by the rise of the temperature again
as soon as the action of the antipyretic subsides. Hyperpyrexia itself
is, however, an injurious symptom, and when there is long continued high
temperature it is necessary to reduce it, either by an antipyretic,
quinine or cold bath, or cold sponging. Cold bath is not suitable in
plague patients on account of the movement of the body which it entails,
and also on account of the serious cardiac depression which accompanies
the disease. Two grains of phenacetin with 1 grain of hydrobromate of
quinine is a safe antipyretic. Brandy and tepid sponging are also very
useful.
(2). _Brain symptoms._—For headache a mustard plaster behind the upper
part of the neck and over the occiput. Ice cap or Lieter’s tube or plain
water should be applied over the temples and scalp. Nervine sedatives,
such as Potassium Bromide, may be given for insomnia when there is not
much depression. Otherwise full doses of alcohol may be tried. Opium
should not be used, but in mild cases, without great depression, 10 to
20 minims of Liquor Opii sedativus with 30 minims of Sal Volatile in an
ounce of camphor water may be given to soothe nervous unrest. For
insomnia Lowson speaks highly of Morpinæ gr. 1/8 to gr. ½. Hyoscine gr.
1/200 to gr. 1/75 may be tried. Meningites should be treated by cold to
the scalp and counter-irritation to the nape of the neck and occiput.
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