of the paroxysms; as inhalations (R.). Chloral, gr. v-x in spasmodic stage, relieves quickly (B.); gr. iij-viij every 4 hours (Porter). Carbolic Acid, as vapor, with steam atomizer; found to be very beneficial (J. L. Smith). Castanea, a decoction of chestnut leaves has been used with much success; dose ad libitum (B.); the fluid extract, in 3-doses, exercises a remarkable influence over the cough (W.). Valerian, said to control the paroxysms (R.). Nitric Acid, well diluted in sweetened water, after the subsidence of the catarrhal stage (B.). Gelsemium, in spasmodic stage (B.). Monobromide of Camphor, gr. v. in mucilage and syrup. tolu. 3 or 4 times a day, has been very serviceable (B.). Zinc Sulphate, gr. -j with ext. belladon., gr. 6-2, has varying degree of success (B.). Lactucarium, the syrup as vehicle for cough mixtures (B.). Quinine, in solution, locally to fauces (Dawson); the tannate with sodii bicarb. of each 5, and pulv. acacia 100 parts, used with an insufflator (Pollack). Petroleum, on rags around head of the bed, is recommended highly by Hildebrandt. Silver Nitrate, when acute stage passed (Tr.); probably inferior to alum (Wa.). [Compare COUGH.]

Prescriptions.

M. Sig.-A teasp. thrice daily for infants in the convulsive stage.

ing to age, every hour.

R. Olei Morrhuæ,

Mellis Despumat.,

3 ss. mx.

Pharyngitis.

Aconite and Belladonna, for acute attacks (B.); when high temperature (R.). Belladonna, is very useful, relaxes the pharyngeal muscles (W.). Capsicum, as gargle, 3j ad 0%1⁄2 aquæ, in very early stage only (R.). Alum, gargles, in chronic inflammations (R.). Silver Nitrate, gr. v-xx ad 3j, on sponge probang, successful if systematically applied (B.); in early stage of inflammation; also in chronic on brush, or as spray (R.). The solid stick to each diseased follicle, after scraping (A.). Ammonium Chloride, gr. ij with mxv of tinctura cubebæ, every half-hour, often controls acute pharyngitis; when a gouty diathesis exists add mx of the ammoniated tincture of guaiac, and give every hour (A. A. Smith). Xanthoxylum, a decoction of the bark locally to throat, and mx-xxx of the fluid extract thrice daily, a very successful remedy for chronic pharyngitis (B.). Tannin, insufflation to affected surface (B.). Cubebs, powdered, locally, useful (B.). Glycerin, pure, locally, with tannic acid, very serviceable (B.); in chronic inflammation of the throat (R.). Hydrastis, the fl. extr., locally, and gtt. v-x per stomach (B.). Alcohol, dilute, gargle in relaxed throat (R.). Cimicifuga, when pharynx dry and spotted over with inspissated mucus (R.). Ipecacuanha, the wine as spray in non-inflammatory sore throat, with hoarseness from congestion of vocal cords (R.). Pomegranate Bark, as gargle (P.).

Potassium Chlorate, as lozenge to stimulate the follicular secretions to a healthy condition (A.). Iron, Quinine, and Strychnine, as tonics, are mainly indicated (A.). Zinc Sulphate, as gargle, occasionally employed in relaxed throat (R.). Inhalation of vapors, or of pulverized fluids, by the atomizer, found very beneficial (Wa.). Food, of piquant kind, spices, pepper, mustard, etc., should be strictly prohibited. All fluids should be used at a moderate temperature (A.). Water, by throat compress, relieves; also in daytime, in obstinate cases. Rest to voice, and cultivation of beard, are useful aids.

Belladonna, as ointment, extract vij-ad xx of lard, has proved effectual (Wa.). Lupulin, 5-15 gr. doses, of advantage after operation, to keep penis at rest (Wa.). Surgical. Division of the prepuce by a bistoury and director; circumcision (D.). Cocaine, a 4 per cent. solution injected at several points around edge of prepuce, as local anesthetic during the operation of circumcision. Chloroform, or Ether, may be used as an anesthetic in paraphimosis, before attempting reduction (Wa.).

Phlebitis.

Hamamelis, has as decided an influence on the venous system as Aconite on the arterial (Pf.). Mercury, in frequent and liberal doses, to early and decisive constitutional impression, the best form being Calomel, or Calomel and Blue Mass (Gross). Rest, fomentations, poultices, early incision of abscesses, aperients, opium to relieve pain and insure quiet of mind and body (D.). Blister, over course of an inflamed superficial vein (R.). Diet, nutritious, and wine, especially if great loss of blood (D.). Stimulants, as Quinine and Iron, especially the tincture of the Chloride, also milk-punch, are needed to combat the depression which is sure to arise. The disease is always dangerous and often fatal (Gross). Incisions, must be freely made if abscesses form, and the internal organs watched for multiple abscess. Ulceration, if it occur, must be watched for hemorrhage, which should be arrested by compression and styptics (Gross). [Compare PHLEGMASIA, VARICOSIS.]

Phlegmasia Alba Dolens.

Belladonna, and Mercury, equal parts, as ointment, often of much benefit (Wa.). Hamamelis, has specific action on venous system (P.); extolled by Dr. Preston (R.). Blisters, in early stage; are extremely useful if judiciously employed (L.). Ammonium Carbonate, often valuable where great prostration; full doses (Wa.). Creasote, injections daily (Wa.). Hydrochloric Acid, 3 of dilute acid in Oij of barley-water, with 3ss of potassium chlorate, to be taken

PHLEGMON-PHOTOPHOBIA-PHTHISIS.

651

daily (Mackenzie) Opium, large doses internally, with leeches and anodyne ointments (Wa.); laudanum, if pain severe, sprinkled on hot fomentations (L.). Leeches, of great service during the acute inflammatory stage (Wa.). Bandaging, when the more acute symptoms subside; at first with flannel, afterwards with ordinary roller bandage (L.). Regimen, should be tonic (L.). Water, compresses in active stage; douches, hot and cold in chronic form.

Phlegmon.

Aconite, or Belladonna, are certainly efficacious. Aconite best (R.). Sulphides, to abort, or, inevitable, to promote; gr. ss-j every hour or two of Potassa Sulphurata (B.). Silver Nitrate, strong solution may check if applied early in the vicinity (B.). Carbolic Acid, injections; a 2 per cent. solution (B.); used with great success (W.). Iodine Injections, after evacuation (B.). [Compare ERYSIPELAS.]

Photophobia.

Atropine, a neutral solution of the sulphate, gr. j ad 3j, for adult, dropped into the eye every 4 hours (C.). If much lachrymation, so as to dilute the solution, it may be applied more frequently. In some cases belladonna irritates and has to be abandoned (Wa.). Conium, in scrofulous photophobia, gr. ss of Coniine in 3j of Ol. Amygdala, locally twice or thrice daily; or the vapor of Coniine (Wa.). Mercury, Calomel by insufflation (C.). Canthoplasty, for the spasm of the orbicularis in severe photophobia (C.). Glasses, of cobalt blue, the best (R.). Arsenic, in the condition described by old writers as strumous ophthalmia, with its attendant photophobia, is very valuable as an internal remedy (C.). Chloroform, the eye exposed to the vapor of a few drops in severe photophobia will be speedily relieved (Jones). Croton-Chloral, gr. v−x, in young people and those suffering from syphilitic corneo-iritis (Bader). Potassium Chlorate, internally, is most useful in some cases (Vernon). Cocaine, a solution of the hydrochlorate, from 2 to 4 per cent., a few drops upon the conjunctiva, will be found promptly efficient in most cases.

Phthisis.

Creasotum, gives excellent results (Bouchard); is directly curative, at least in the initial stage of the disease (Fräntzel); promotes the sclerotic change by means of which recovery is found to occur (Jaccoud); Morson's beechwood creasote should be used, in doses of mj in whiskey and glycerin, every 3 or 4 hours. Should be largely diluted to prevent irritation, and continued for many months,-relieves cough, diminishes expectoration, stops night-sweats, increases weight, decreases fever, promotes appetite, and in many cases improves the local condition, as shown by the physical signs (Robinson). Creasote, tar or carbolic acid, to check expectoration (R., P.); Creasote is often curable in many forms, gr. iij in a pill with Bals. Tolu., three or four times daily, the dose being increased until urine is darkened; or it may be inhaled with Iodine from hot water (B.). Iodine, or Iodoform with creasote, carbolic acid, eucalyptus, chloroform, alcohol and ether, as combination for an antiseptic inhalation (Br.); extremely useful; also as intra-pulmonary injection, a solution of the compound tincture of iodine 1 to 4 of distilled water, of which mx-xx injected once every 4 or 5 days, through the 1st, 2d or 3d intercostal spaces, anteriorly or in the axillary region, avoiding the pericardium and great vessels (Robinson). Iodoform, internally, has proved extremely effective in all forms, as witnessed by numerous observers in various countries (S. Smith); though not one of the most active germicides, it is very destructive to the bacillus tuberculosis (B.). Iodol may be advantageously substituted for Iodoform (B.). Cod-liver Oil, holds first rank as a remedy and food in the chronic forms; a teasp. after meals ter die is enough; when not well borne may be combined with aqua calcis, comp. tinct. of gentian; or, when not digested, with ether (B., R.); is of great utility by improving nutrition, and by affecting the

tubercle; give 3ss thrice daily one hour after meals, with mx-xv of Ether, or an equal quantity of malt or whiskey; do not give it in hot weather (Da C.). Terebene, with Thymol and Carbolic Acid, equal parts of each, and 3ss to a pint of hot water as an inhalation: is extremely useful for the dyspnoea (Camman). Aconite, in small doses for the irritative fever, is a remedy of much value (DaCosta). Antipyrine in a 21⁄2 grain dose hourly for 3 doses daily, for the hectic fever. Phenacetine is better borne and is efficiently antipyretic; extensively employed in the hectic of phthisis. Cinchona, for the hectic and sweats, gr. xvxx quinine (B); if small doses fail, a dose of 6 or 8 grains at once, or in portions repeated hourly (R.). Ipecacuanha, spray to throat when bronchial asthma and emphysema combined with fibroid phthisis (R.). Opium, or Morphine, in a viscid vehicle for cough, or morphine lozenges when cough due to inflamed throat (R.); must in time be given for the cough, which is an irritative one. Codeine, gr. % to 4 in simple elixir, is useful and does not constipate (Da C.). Alcohol, an important remedy; may be given with cod-liver oil; or spt. frumenti 3-3ij with some bitter, immediately after meals, or the stronger wines. If it disagrees, it harms. Curiously, it induces an intractable form of phthisis (B.). Verbascum, the Mullein-plant, has long been a popular remedy in phthisis; it facilitates expectoration, improves the general condition, and palliates the cough. Calcium Phosphate, in diarrhoea, and in chronic forms of phthisis, with little or no fever (R.). Iodine, should be more used than it is; the compound solution, gtt. j-iij thrice daily, or when anæmia and not much fever use Iodide of Iron, gr. xv. of the syrup pushed to 3j ter die (Da Costa); as inhalation in chronic phthisis; to lessen expectoration and cough; also as liniment painted under clavicles, to allay harassing cough, and to check secretion (R.). Cimicifuga, useless in tuberculosis, but in phthisis it relieves cough, improves appetite, lessens intercurrent bronchitis, and so improves the patient's general condition (Wa.). Arsenic, valuable in chronic forms as in no other remedy; but not in caseous, or where much hectic; may be given by stomach or fumigation (B.). [See under ASTHMA.] As cigarettes, useful in the diarrhoea, probably diminishes temperature; caution required (R.); of great value in early stage, in later stages it is of no avail. Arsenious Acid, gr., or miij of Fowler's solution, thrice daily (Da Costa). Cocaine, locally for the throat symptoms, to be applied just before meals are eaten (Da C.). Sulphurous Acid, by inhalation, spray, or fumigation, in chronic phthisis (R.). Sanguinaria, helps expectoration, and revives the enfeebled stomach (P.).

Chloroform, with glycerin or honey, for the cough in fibroid phthisis (R.); by inhalation continuously as germicide, in connection with other agents of same action (Potter, see Pacific Medical Journal, October, 1890). Chlorine gas, by inhalation, also the hypodermic use of Iodine and Chloride of Gold and Sodium, extensively employed in pulmonary consumption with good results. (Gibbes and Shurly in Therapeutic Gazette, April, 1891, and April, 1892.) Ferrum, often prescribed; has no especial influence on deposit (B.). Prescribed in tuberculosis (Tr.). Liquor Ferri Perchloridi, 3j ad 3j aquæ, the most serviceable local application in laryngeal phthisis, diminishing irritability of the mucous membrane, and quieting cough (Mackenzie). Mercury, gr. Too of corrosive sublim. every two or three hours, for the diarrhoea (R.). Benzoin, as inhalation, to lessen cough and expectoration (R.). Acids, Mineral, for the indigestion. The acidum muriaticum dilutum (B.). Prunus Virginiana, the wild cherry has a domestic reputation, probably due to its influence over cough; the syrup is much used as vehicle for cough-mixtures (B.). Hypophosphites, are very useful in chronic cases (B.); have no special effect (Da C.). Digitalis, as antipyretic; deranges intestinal canal, therefore injurious to phthisis (B.). Phosphate of Copper in nascent form soluble in an alkaline body, is held to be specific by Prof. Luton of Rheims. His formula contains Neutral Acetate of Copper 0.15, Cryst. Phosphate of Sodium 0.75, Glycerin and Pulv. Licorice, aa q. s. for one pill. Copper Sulphate, gr., or Silver Nitrate, gr. 4, or Bismuth, gr. xx, for the diarrhoea (Da C.). Gaseous Enemata, Bergeon's treatment, made a noise for a few months, but soon fell into contempt. Baths, sea-bathing, if chronic, little or no fever, without active deposition of tubercle, or scrofulous

pneumonia; Turkish baths for the cough (R.). Grape-cure, is serviceable (B.). Aliment, should be nutritious and digestible, malt liquors better than wine or spirits. Extract of malt, cod-liver oil, plenty of meat, and alcohol in moderation (Da C.). Warm clothing, bathing and friction of skin, moderate exercise, and à suitable climate. Forced Alimentation, when anorexia appears, and superalimentation at all times, necessary to successful treatment. Washing out the stomach daily by syphon-tube, with warm water alkalinized with borax, and then feeding through tube (Robinson). Climate, the best by far is that of Egypt, or Algeria; next coming New Mexico, Southern California, especially in the desert along the Colorado River, South Carolina and portions of Georgia and Florida; the latter being especially suitable for cases having a co-existing bronchitis. For some cases Colorado is very good, and the Adirondack region for early cases in which there is no tendency to hemorrhage (Da Costa). Tuberculin or Koch's Lymph has been a deceptive bubble which for a short time commanded the attention and admiration of the whole world, but which has been ruthlessly pricked by the critical scalpel in the hands of the father of modern pathology (Senn). [Compare COUGH, HEMOPTYSIS, HECTIC FEVER, PERSPIRATION.]