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Sometimes a single injection curative of sciatica and neuralgia. Poultices containing laudanum useful in inflammation. Linimentum opii by friction, relieves pleurodynia, neuralgia, etc. The conjoint administration of Morphine and Antipyrine is much more efficient than the use of either agent alone to relieve pain. Opiates soon lose their influence in any certain dose, requiring increased quantities to keep up analgesic influence, so in chronic cases it is best to exhaust all other means before resorting to it (R.). Codeine, has special influence over abdominal pain, and that of the ovaries, besides being safe as to habit. Chloral, has no direct pain-relieving power, except in dangerous doses. To relieve pain and promote sleep, the best agent is a combination of chloral and morphine, cautiously, if heart trouble, or to old drunkards; gr. xv-xxx + gr. 4 (B.). Sometimes relieves neuralgia, chronic rheumatism, gall-stones, colic, gastralgia, and even cancer (R.) Aconitine, locally over seat of pain; one of the most certain and powerful palliatives in neuralgic, rheumatic, and gouty affections (Wa.); especially serviceable in neuralgia of 5th nerve (B.). Belladonna, the best remedy for every kind of pain in pelvic viscera (Anstie). Atropine hypodermically in local pain, neuralgia, sciatica, glaucoma, etc. When it succeeds, has more lasting effect than morphine (R.); sciatica, tic douloureux, etc. (B.). Iodides, are magical in syphilitic nocturnal pains of head (B.). The iodide of ammonium, gr. iij ad 3j ol. olivæ, with friction; causes the disappearance of nocturnal syphilitic pains (W.). Cimicifuga, relieves many kinds; neuralgia of 5th, rheumatic headache, ovarian neuralgia, dysmenorrhoea. Inferior to ergot in labor-pains or after-pains. 3j doses (B.). Conium, in cancer, rheumatism, neuralgia, ovarian pain, etc. (R.); also for the fulgurant pains of locomotor ataxia, chronic alcoholism, sciatica, phthisis, etc., doses of mx of a fluid extr. of the unripe fruit, every 1⁄2 hour, well watched (Madigan). Iron, with Belladonna, for the wandering pains of anæmia, in which morphine is dangerous and bromides useless (Waugh). Antipyrine, a most efficient analgesic, may be administered hypodermically. Is especially adapted to neuralgiæ, migraine, and gouty pains. [See ante, page 108, also Opium, above.] Theine, of very great value for neuralgic pain, affects the nerve outwardly along its course from the site of the injection (Mays). Chloroform, locally, inferior to other local anesthetics, two or three drops on cotton into the ear for faceache or toothache; vapor on raw surface of cancers, neuralgia of uterus, photophobic eye, etc., by inhalation in renal and biliary colic, and to produce general anæsthesia, which see (R.). Ether, spray for local anesthesia; inhaled for general anesthesia (R.). Carbolic Acid, as local anesthetic (R.). Cocaine, as a local anesthetic to mucous surfaces, or hypodermically for minor operations involving a small area, as circumcision, eye operations, etc., has no equal; a 4 per cent. solution of the hydrochlorate is generally employed (R.); has many applications, as odontalgia, otalgia, neuralgia of superficial nerves, etc., etc. Iodoform, as suppository in painful diseases of the rectum or bladder (R.). Stramonium, is used as ointment (R.). Duboisine, used instead of atropine (B.). Rhatany, relieves the pain of ulcerative disease of mucous membranes, pain of burns, ulcers, and especially of blisters (Tr.). Cannabis Indica, formerly used (B.). Aquapuncture (B.). [See NEURALGIA.] Galvanism, of an affected nerve gives certain relief. Positive pole on point of emergence; negative over superior ganglion of cervical sympathetic (B.). Heat, if pain is without fever or inflammation (B.); warm injections soothe the pain of cystitis, prostatitis and abdominal pains generally (B.). Hot Water, as bath, relieves pain most wonderfully. Napoleon, on St. Helena, suffering from cancer of the stomach, appreciated highly the pain-relieving power of the hot bath; often staying half and even whole days therein. Cold, when pain is inflammatory (B.). [See AFTERPAINS, ANESTHESIA, BOILS, CHEST-PAINS, COLIC, GASTRALGIA, HEADACHE, HEPATALGIA, INFLAMMATION, LUMBAGO, MYALGIA, NEURALGIA, ODONTALGIA, OTALGIA, OVARIAN NEURALGIA, RHEUMATISM, etc.]

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PARALYSIS-PAROTITIS.

Paralysis.

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Strychnine, gr. to gr. to (R.)]; also hypodermically into the affected muscles,-for hemiplegia, paraplegia, local, mercurial, paludal, rheumatismal, facial, infantile, and diphtheritic paralyses; in that of spinal muscles, of bladder and all local forms (B.); often of use in hysterical (P.); all forms, except, according to Barwell, in cerebral and spinal paralyses (R.). Nux Vomica, in hysterical, and in that from lead-poisoning; only in chronic cases (P.); in paraplegia from softening and wasting of cord (Brown-Séquard). Hyoscyamine, gr. gradually increased to in par. agitans, locomotor ataxia (B.). Rhus Toxicodendron, certainly efficacious in cases depending on rheumatism (P.). Ammonium, the iodide and carbonate to aid in absorption of thrombi and thus promote cerebral nutrition in cases of incipient hemiplegia, due to endarteritis deformans reducing the lumen of the vessels in the brain (B.). [See formula below.] Arnica, paralysis of the bladder, and many forms (P.). Phosphorus, with cod-liver oil in paralysis agitans, small doses; also in the paralysis of white softening of the brain (B.); in hysterical paralysis (R.); in myelitic paraplegia from excessive venery; the only drug which really affects the nerve-centres (W.). Belladonna, when depending on chronic inflammation of the cord (R.); externally as ointment along spine, with Ergot internally (Brown-Séquard). Physostigma, into the eye in ocular paralyses (B.); in general paralysis of the insane, also in progressive muscular atrophy without much mental disorder, long-standing hemiplegia, paraplegia, locomotor ataxia (R). Coniine, in some cases of paralysis agitans (B.). Ergot, in paralysis of bladder from over-distention (B.); paralytic dysuria, sensation of but partial emptying of bladder (P.); said to be useful in paraplegia (R.); in paraplegia complicated with menstrual irregularity and forms of paralysis arising from spinal congestion (Wa.); has cured cases of constipation of the paralytic when all the most powerful cathartics failed (Curran). Cocculus Indicus, valuable in hemiplegia, paraplegia, and paralytic stiffness (P.). Ignatia, in paralysis of lower extremities (P.). Cannabis Indica, for retention of urine from spinal disease (R.). Capsicum, in 1⁄2 to 2-grain doses every 4 hours as general stimulant (P.). Colocynth, in cerebral paralyses, sometimes seems to act favorably upon principles of revulsion or counter-irritation (P.). Mustard, as an emetic to stimulate failing heart in certain forms of paralysis (P.). Senega, in rheumatic, is a powerful help (P.). Nutmeg, the oil as external stimulant (P.). Oil of Bay, has been given; is obsolete (P.). Cajuput Oil, efficacious in palsy (P.). Counter-irritation, by blistering fluid in peripheral paralysis of the 7th nerve (R.). Cod-liver Oil, Anstie insists on it when low nutrition and faulty assimilation (B.). Galvanism, in hemiplegia and many forms (B.). Electricity, faradization of the muscles affected. Localized electricity probably of more importance in confirmed spinal paralysis than medicinal treatment. Massage, in infantile paralysis, given with lactophosphate of calcium and cod-liver oil. Strychnine injected into the muscles (B.). [Compare HEMIPLEGIA, LOCOMOTOR ATAXIA, TONGUE.]

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Aconite, in febrile conditions (R.). Mercury, grain of gray powder, 3 or 4 times a day, very useful, relieving pain and swelling (R.). Poultice of flaxseed meal, a good local application for gland. Leeching, often gives speedy relief, when pain is great and resists hot fomentations (Wa.). Care to avoid chilling, important. Incision, when suppuration occurs. Stimulants and

Tonics internally are very necessary in symptomatic parotitis, occurring as a complication or sequel of other diseases, with adynamic symptoms.

Pediculi.

Mercury. Citrine ointment or wash of corrosive sublimate, for lice on all parts of body. The oleate destroys lice immediately, and also kills the ova (R.). For crab-lice the ordinary blue oint. is very disagreeable, and often toxic in its effect on the patient. A better preparation is Calomel in 5 per cent. oint., or the Bichloride, a 1 per cent. solution in alcohol, of which a teasp. to a pint of water, as a bath to parts twice daily. Cocculus Indicus, destroys pediculi (P.) ; the tincture undiluted as a wash. Staphisagria, as oil or ointment of the powder (R.); "lice-bane" (P.); the tincture a very efficient application, and much more cleanly than an oil or an ointment. Acetum. Vinegar will kill the nits, as it softens the adhesive chitin by which the ova are glued to the hairs. Ether, washed over the parts, effectually destroys crab-lice. Tobacco, a decoction of the leaf is an efficient application, but requires care, especially if the surface is abraded (Wa.). Essential Oils, will kill, as rosemary, anise (P.); or powdered pyrethrum (R.). Cleanliness, cannot be dispensed with, and in many cases may alone be sufficient. Boil underclothing. Isolation of person, and of brushes, towels, etc., to prevent infection. In Vienna the following prescriptions are used :

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Antipyrine, internally, for the itching, is efficient. Arsenic, is curative, espe. cially when chronic (B.); largest dose, mv liquor arsen. 3 times a day, on full stomach (R.); exercises a powerful influence (Wa.). Mercury. Citrine ointment is largely used (Wa.). Potassium Iodide, improves the condition in pemphigus (Wa.); with good, simple diet; quinine, cod-liver oil, etc. Silver Nitrate, in pemphigus, after the bullæ have burst, and excoriations remain (gr. ij ad 3j aquæ) (Wa.). Water Dressings, on lint, covered with oiled silk, constantly, in pemphigus and rupia (Wa.). Cod-liver Oil, with nutritious diet, is a powerful auxiliary to treatment (Wa.). Puncturing the blebs and evacuation of their contents is necessary as soon as formed. Then dusting-powders of zinc oxide, starch, or buckwheat flour, or lotions of liquor plumbi subacetatis dilutus.

Pericarditis.

Aconite, when violent throbbing and extreme pain (R.); of great value, if given early (P.); proves in the highest degree serviceable, when object is to diminish vascular excitement or irritability (Wa.). Spigelia Anthelmia, useful in rheumatic pericarditis (P.). Digitalis, when rapid and feeble heart, cyanosis and dropsy (P. N.); in second stage when heart flags, a tablespoonful of the infusion every 4 hours is beneficial. Bryonia, exceedingly valuable in second stage, that of exudation; fully equals any remedy in pericarditis (P.). Opium, regularly in grain doses, every 3, 4, 6, or 8 hours, is very beneficial (Wa.). Veratrum Viride, extract made by inspissating the juice of the root, of which gr. ij, with j of calomel, every 2 hours, valuable (Waring Curran). Quinine, gr. xv-xx may suppress an acute attack, if given at critical moment (B.); may be used as an antipyretic. Counter-irritation, has been much abused; useful at commencement, but not in acute inflammatory stage (B.). Iodine painted over the cardiac region, or flying blisters in the second stage. Iron, the tincture in full doses may be required in the second stage. Poultices,

PERIOSTITIS-PERITONITIS-PERSPIRATION.

647

large hot, often renewed (R.). Ice may be used instead of poultices in the early stage. Paracentesis, by aspiration may be required in the second stage. [Compare ENDOCARDITIS.]

Periostitis.

Mercury and MorMezereon, in the rheumatic and scrofulous form (P.). phine. The oleate externally (R.). Potassium Iodide, in syphilitic children, also in non-syphilitic periosteal thickening (R.); holds the first place for syphilitic affections of the bones (Wa.). Ammonium Iodide, cures periostitis most readily when syphilitic (Wa.). Staphisagria, when long bones affected (P.). Iodine, the tincture, or blisters locally of great service in chronic form (R.); Poultices, under the external use of Iodine it often rapidly improves (Wa.). after an early and free incision, when suppuration takes place (C.). Incisions, carried deeply, should be made without waiting for fluctuation, when great tension exists and there is a tendency to suppuration. The sides of the abscess should then be brought together with compresses and a bandage (Gross). Tonics and stimulants, as milk-punch, quinine, iron, and opium, in full and sustained doses, are imperatively demanded in many cases (Gross). [Compare NODES, ONYCHIA.]

Peritonitis.

Aconite, of great Phenacetine, as an antipyretic; is efficient and safe. utility when sthenic reaction; see Opium (B): should be given early in all inflammations of serous membranes (P.). Bryonia, exceedingly valuable in second stage, when exudation (P.). Mercury, when tendency to fibrinous exudations, is employed with good effect (W.). Opium, to quiet intestinal movements (R.); by far the best agent (P., B.). Morphine, gr. 1⁄2 hypoderAconite and Opium, the tinctures, mically, will often abort, if given early. gtt. ij of the former with gtt. vj of the latter, in water every hour or two; a Large doses easily borne in larger dose of opium if pain is severe (B.). this affection (Wa.). Cocculus Indicus, for tympanites; a few doses will often remove the pain and relieve distention (P.). Quinine, strongly urged by Trousseau; is naturally indicated in most inflammations (P.). Turpentine, for tympanites (P.); turpentine stupes, v-xv drops of turpentine on flannel wrung out of hot water during acute stage, then blisters for a short time (B.). Leeches, to abdomen, if patient plethoric, and sthenic reaction, relieve pain (B.). Purgatives, are inadmissible when from perityphlitis or inflammation of appendix vermiformis (B.). Poultices, large, hot, and frequently renewed. Should be thin, and covered with cotton-wool (R.). Ice, to abdomen (B.). Cold relieves (W.). Water, hot fomentations to relieve pain, sometimes cold compress better. Ice, sucked or swallowed, to assuage the vomiting; sips of cold water. Diet, after acuteness of attack passed, should be mild and unstimulating. [Compare PUERPERAL PERITONITIS.]

Perspiration.

Belladonna, as liniment locally, also the tincture internally, especially in weakly children who sweat profusely (R.). Atropine, gr. o too hypoder. (or in exceptional cases even gr. in pill) in sweating of phthisis and exhausting diseases (R.); gr. at bedtime for sweats of phthisis (B.). Jaborandi, gr.

of pilocarpine, thrice daily, checks profuse perspiration (R., Pf.). Naphthol, in a 5 per cent. ointment or alcoholic solution, is a very efficient application for local sweating (Kaposi). Potentilla Sarmentosa, the Cinquefoil, an infusion of the vine, leaves, and root, may be drunk ad libitum, and is a very efficient remedy for night-sweats, having stopped them when Atropine failed to relieve (Pope). Agaricine, is used very successfully. (See formula below.) Salvia, the ordinary sage-tea is very efficient, used internally and locally by sponging the body. The infusion for night-sweats of phthisis (Da C.). Quinine, in exhausting diseases. In many, a night-draught of quinine, sulphate of zinc, and sulphuric acid, useful (R.). Opium, as Dover's powder, may succeed in profuse colliquative sweating (R.); a fact, though hard to account for it. (Wa.). Aro

matic Sulphuric Acid, to check sweats of phthisis. Bad for digestion (B.). Muscarine, has been used with great success in the sweats of phthisis and of other morbid states (R.). Zinc Oleate, rapidly controls excessive and offensive sweating on slight exertion in the axillæ and groins, also the night-sweats of phthisis (Murrell). Zinc Oxide, gr. iij, with gr. ss of ext. belladonnæ, in a pill at bedtime for the sweats of phthisis (R.). Gallic Acid, is very useful for the same condition, and may be combined with extract of belladonna (B.). Tannic Acid, may also be used with benefit. Aluminium, the oleate, checks hyperidrosis and antiseptizes the sweat, thus forming a useful application to the axillæ and groins of children (Wa.). Potassium Permang., gr. j-3j, for fetid perspirations of axillæ, feet, etc. (B.). Salicin, profuse sweats of hectic fever (Wa.). Salicylic Acid, in solution with borax, the most agreeable and efficient deodorant for fetid perspirations (B.). Carbolic Acid, 2 parts to 3 of glycerin and water, twice daily for fetid sweat (Wa.). Oils, rubbed into the whole skin to prevent sweating accompanying exhausting diseases, as phthisis; but sponging with a weak acid wash better (R.). Ergot, said to arrest sweating (R.). Sponging, with acidulated water, or very hot sponging in phthisis (R.). [Compare FEET.]

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Antipyrine, is successfully employed. Phenacetine, is highly praised. Aconite, in all acute congestions (P.); as a preventive or abortive remedy very efficient, when associated with ipecac. and cherry-laurel water (Dervieux). See formula below. Amyl Nitrite, with Carbolic Acid, in steam atomizer, has proved a very efficient inhalation (Bayliss). Ipecacuanha, useful in many cases (R.); mj for 5 years of age, every hour or two, with the greatest relief (P.); when bronchitic or pneumonic complications, combined with ammonium bromide (Wa.). Pulsatilla, gr. -j of anemonine (P.). Belladonna, obviously of value in febrile stage, is of special use when dentition is in progress; relieves the congestion of air-passages and also the determination of blood to the head (P.); good when profuse bronchial secretion; best in spasmodic stage. Children bear this drug well; mx of tinct. may be given hourly to a child 2 or 3 years old (R.). Benzoate of Sodium is highly efficient. See formula below. Conium, or the Hydrobromate of Coniine, in doses of gr. to gr. according to age, a very efficient remedy (W.). Drosera, small doses are very effective (Murrell). Chamomile Oil, a very useful remedy (P.). Coccus Cacti (Cochineal), in doses of gr. thrice daily for infants, has been highly recommended (W.); proves very effective in most cases. Hydrocyanic Acid, very serviceable in cough by habit, after cessation of whooping-cough proper, or in nervous sympathetic cough of mothers (B., P.). Opium, in convulsive stage, to produce and maintain slight heaviness (R.). Cocaine, a 5 per cent. solution, painted on tonsils, fauces, back of tongue, and if possible on larynx, is very efficient (Labrie). Bromides, relieve spasmodic element (B.); that of ammonium will readily cure many cases; gr. ij or iij ter die for infants (Wa.). Lobelia, in spasmodic stages; well tolerated by children; mx of tinct. every hour for child 2 years old; also additional dose when cough is imminent (R., P.). Alum, when acute stage over and no complication, gr. ij-vj every three hours, or less every hour in glycerin or honey (R.). Chloroform or Ether, to lessen severity

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