Pityriasis.

Alkaline and Tonic Remedies generally control mild cases, together with baths and emollients; the more severe ones requiring constant envelopment in oil, as linseed or cod-liver oil (Bulkley). Mercury, in obstinate cases, Donovan's solution of Arsenic and Mercury is highly successful (Wa.); the green iodide, gr. x to 3j of lard, or a 5 per cent. solution of the oleate of mercury in oleic acid with one-eighth part of ether, applied by a camel's-hair brush (B.); citrine ointment, especially when the hairy parts of the face are affected (R.); an ointment of ammoniated mercury and calomel is very useful in ordinary cases of dandruff or pityriasis simplex (Bronson). Sulphur, 3j of sulphur lotum to 3j of vaseline applied every morning to the scalp, with sweet almond oil anointing at night (Jackson). Soap, the tincture of green soap as shampoo every morning for cleanliness, or Borax and water, or the yolks of three eggs beaten up in a pint of limewater with 3ss of alcohol, all of which make good shampooing mixtures (Jackson). Borax, to cleanse the scalp, a saturated solution; or the glycerite of borax (R.). Lead, the liquor plumbi, with glycerin equal parts, and two parts of water, as lotion for cases where there is high inflammation and abundant weeping (R.). Carbolic Acid, 2 parts to 3 of glycerin and water, twice daily, with the daily use of a carbolized soap, is often effectual (Wa.). Sulphides, 3ss of Potassa Sulphurata to Oj of Lime-water, as a lotion, or the Bareges Pomade, see formula below (B.). Baths, frequently, and hard rubbing after shampooing the scalp; avoid stimulating food in bad cases, as well as the use of a fine-toothed comb on children's heads. [Compare SEBORRHOEA, and for PITYRIASIS VERSICOLOR, see TINEA VERSICOLOR.]

Aconite, is useful for affections of plethoric subjects. Decidedly the best remedy for apoplexy in the plethoric (P.). Arsenic, used with advantage when determination of blood to the head (Wa.). Sulphur, as mild purgative for plethora, from cessation of the menses (Wa.). [Compare ABDOMINAL PLETHORA.]

Pleuritis.

Aconite, no remedy more effective prior to stage of effusion (R., P.). [See INFLAMMATION]. The tincture in doses of 1⁄2 drop every 3 hours to a child 3 years old, for 2 or 3 days (J. Lewis Smith). Veratrum Viride. Opinions differ as to whether it should be used in sthenic or asthenic forms (R.); gtt. viij of tincture every 3 hours, with a drop added to each dose until pulse reduced or nausea (Wa.). Bryonia, exceedingly valuable in second stage; should follow aconite (P.). Tartar Emetic, see INFLAMMATION. In early stages and young plethoric subjects, when much febrile action, small doses (gr. to 4) may be useful (Wa.). Digitalis, as antipyretic (R.); deranges intestinal canal (B.); aconite preferred (P.); the tincture in doses of one drop every 3 hours to a child of 2 years old (J. Lewis Smith). Potassium Iodide, to promote absorption of effusions, steadily for a long time (R.); also chest painted with tincture of iodine, one day on each wall alternately; may be washed off with iodide of potassium, alcohol or ether (B.); as a diuretic to remove effusion (Clark). Iodine, also as injections, with great benefit and without risk, in empyema and hydrothorax (B., R.). Quinine, has abortive power, increased by combination with morphine (gr. xv + gr. ss); also as restorative tonic in low type cases (B.). Opium, cannot be too highly extolled (P.); is especially beneficial; gr. ss of morphine hypodermically at beginning will often

PLEURODYNIA-PNEUMONIA.

655 cut short an attack. During the disease its effects are very beneficial. A slight physiological effect should be maintained (B.). Morphine for severe pain (Ř.). Burgundy Pitch, plaster externally as a mechanical support (P.). Asclepias, the popular" pleurisy-root," is a favorite remedy in the south (W.). Pilocarpus, in subacute cases to remove fluids (Caro); or the nitrate of pilocarpine, gr. 4 bis die, for children (Vigier); is too depressing and therefore unsafe (Smith). Sodium Chloride, 3ss in 3j of water, flavored with licorice, in tablesp. doses every 3 hours, often very useful in causing absorption of pleuritic serous exudations; but is contraindicated when exudation is purulent (Br.). Bloodletting, by cups or leeches, useful by reason of counter-irritation produced, and to relieve pain, only in robust sthenic cases (B.). Blisters, often greatly abused; are harmful during inflammatory stage (B.). Poultices, large, hot, and frequently renewed (R.). Water, cold wet-pack to chest probably better than a hot one, pinned tightly to limit movement of chest-walls (B.). Thoracentesis, by aspiration, if the quantity of fluid seriously embarrasses respiration. [For CHRONIC PLEURISY see EMPYEMA, also compare HYDROTHORAX, PLEUROPNEUMONIA.]

Prescriptions.

M. Sig.-Teasp. every 3 hours to a child of 4 or 5 years, in the second stage.

Pleurodynia.

Cimicifuga, curative when rheumatic, valuable in sympathetic cases from irritability of uterus (P.); or uterine derangements (R., Wa.). Croton Oil, in obstinate pleurodynia especially when blackened feces (R.). Belladonna, plaster or liniment; the latter generally best (R.). Chloral, made liquid with equal weight of camphor, rubbed in gently, often affords instant relief in severe pleurisy (R.). Sodium Salicylate, gr. xv-xx, every 2 or 3 hours, useful in most cases (Hughes). Ether, as spray, sometimes immediately and permanently removes the pain (R.). Opium, liniment rubbed in after warm fomentations (Wa.); or a hypodermic injection of morphine (R.). Iodine, as liniment painted on the chest, often relieves where mustard fails (R.). Blistering, often successful when other means fail; sometimes strong vesication necessary (R.). Rest, is important and may be obtained by strapping the affected side with strips of adhesive plaster. Poultices, very hot, followed by application of lint and oilskin. Belladonna liniment generally better (R.). Mustard, as a poustice, is generally efficient, and can be renewed when pain returns (R.). [Compare NEURALGIA, MYALGIA.]

Pleuro-Pneumonia.

Bryonia, often of great service; limits effusion and assists absorption (P.). Carbolic Acid, a 2 per cent, solution injected parenchymatously, once or twice a day, has had remarkable success (B). Sanguinaria, as a contra-stimulant (P.). Turpentine, as a fomentation (P.). Arnica, the tincture in doses of mx every 3 or 4 hours, very useful in controlling the heart's action (Wa.). Pilocarpine, gr. ss, or 3ij of the tincture of Jaborandi, benefits cases of pleuropneumonia (Wa.). [Compare PNEUMONIA.]

Pneumonia.

Aconite, gives good results in catarrhal and fibrinous (B.); has marked effect (R.); very valuable in first stages (P.); in several cases it apparently cut short the attack (Wa); to reduce circulation either Aconite or Veratrum Viride, until pulse is impressed (Da Costa). Veratrum Viride, valuable (P.); in the very incipiency (B.); opinions differ as to whether it should be used in sthenic or asthenic cases (R.). Bryonia, when pleural complications (P.). Phosphorus, especially when typhoid symptoms; approved by Fleischmann (R.). Bella

donna is useful in the first stage (P.); Harley esteemed it highly in pneumonia (Wa.); as an adjuvant to Digitalis in infantile pneumonia, to soothe the irritable nervous system and curtail superabundant secretion (Brown). Tartar Emetic, formerly given in large doses; now abandoned; small doses may be useful, but should be used with care, lest depression ensue (B.); at commencement with alcoholic stimulants, if patient be weak (R.); may benefit young, robust subjects (Wa.). [See PLEURITIS.] Sanguinaria, as a contra-stimulant, when fever abated, and graver symptoms have amended (P.). Iodides, none more efficient; the Iodide of Ammonium with Arsenic, to prevent caseation of inflammatory products (R.); Ethyl Iodide, gtt. v-xx ter die by inhalation, very valuable in catarrhal form (B.). The Iodide of Sodium is useful in catarrhal pneumonia (Da C.). Ipecacuanha, the wine in infantile pneumonia, should never be dispensed with, as it promotes expectoration, controls hemorrhage and regulates secretion (Brown). Senega, in advanced stages as expectorant, when cough is dry, irritating and painful, tightness and oppression of chest (P.). Opium, morphine by injection, sometimes needed for severe pain (R.); opium is very desirable in many cases, relieves the symptoms and arrests delirium (Wa.). Copper Acetate, Kissel regards it curative; under it the mortality was only 4 per cent. Ammonium Carbonate, at crisis for depression; give in infusion of senega (B.); see formula below; is useful as expectorant late in disease when lung tissue breaks down (Da C.). Digitalis, of doubtful value; may be useful for high temperature, ischemia, and low tension of vessels (B.); as case goes on and circulation is to be further controlled, digitalis is indicated (Da C.); the best agent to slow the heart in infantile pneumonia, with Belladonna as an adjuvant (Brown). Antipyrine, to reduce pyrexia; is decidedly more serviceable in pneumonia than quinine (Wa.); gr. xv several times a day, or 3 hourly doses each of gr. xxx, then stopping until temperature rises again (R.). Stimulants, in asthenic cases, those of malignant type, and those occurring in aged people (Wa.). Ammonia, the aromatic spirit as substitute for Ammon. Carbonate, in doses of 3ss in simple elixir (Da Ċ.). Turpentine, as stimulant at crisis (B.). Serpentaria, with carbonate of ammonium in low types, as a stimulant about the crisis. Quinine or Salicylic Acid, to reduce temperature (R.); Quinine as a tonic in cases which are asthenic from the first (P.); in conjunction with Aconite and Veratrum, gr. viij-xij daily at start, is beneficial (Da C.). Blisters, useful at very beginning only or at crisis of disease; harmful in inflammatory stage (B.); to lessen the pain, but should be used in moderation (R.). Wet-pack, hot, tightly pinned to limit motion of chestwalls (B.). Poultices, encircling whole chest in children (R.). Diet, farinaceous, mucilaginous drink, and rest in warm room (R.).

POLYPUS-POULTICES-PREGNANCY.

Polypus.

657

Sanguinaria, has been employed as snuff for nasal polypi (P.); with doubtful benefit (W.). Tannin, finely powdered, as snuff blown daily into nostrils through a quill, is especially adapted to the soft and gelatinous varieties; while it has apparently no effect on the healthy mucous membrane, it causes the complete withering of the polypus (Wa.). Zinc Chloride, has been injected interstitially with success in a case of naso-pharyngeal polypus (Barthélemy). Iron, a solution of the perchloride is advised as an interstitial application (Auger). Acetic Acid, glacial, injected into the body of the tumor, will cause it to shrink up and to drop off in a few days. Alum, in powder, applied to point of origin to prevent recurrence (D.). Surgical. A nasal polypus should be seized with polypus forceps and twisted off at the neck; it may be removed through the mouth or the nostril. In a few cases the nostril must be dilated with a speculum, or the ala slit to give access to root of tumor (D.).

Poultices.

Poultices and Fomentations are simply local baths utilizing warmth and moisture, relaxing the tissues and relieving pain. If applied early they will check inflammation, or assist the evacuation of pus when suppuration has set in. Poultices should be applied thick (thin in peritonitis), as hot as possible, covered with cotton wool, and frequently changed; large at onset, very small after maturation. Belladonna and Glycerin, partes æquales, smeared over tissues under a poultice, aid the latter greatly, also Tinctura Opii, especially where skin is broken. Linseed-meal or Oatmeal, Starch, Bread, Bran, are best in the order mentioned; add meal to boiling water, stir and spread quickly on warm linen. Charcoal under the poultice, when foul sores are being treated.

An excellent method of preparing poultices is to make a lot of bags of various sizes, and of the fabric known as "Swiss," filling each one half-full of the linseed meal or other agent employed before sewing up its open end. When wanted for use one of these bags is submerged in boiling water for a few minutes and on taking it out the meal is found to have swelled so as to fill the bag, which should then be squeezed enough to rid it of the superfluous water, laid on the part and covered with oiled silk and a bandage.

Fomentations. Flannel should be wrung very dry out of boiling water, and covered with oiled silk. Spongio-piline, a fabric composed of sponge and wool, coated with india-rubber, is an excellent vehicle for the application of warmth and moisture. The inner surface is moistened with hot water; and its utility may be increased by sprinkling the moistened surface with charcoal, yeast; or saturating it with any desired lotion or liniment.

Pregnancy, Disorders of.

Mercury, a few grains of blue pill to correct clay-colored stools (L.). Iodine, the tincture internally for cardialgia (Wa.). Aloes, have cured piles in pregnancy, by removing constipation; cautiously (P.). Alum, Tannin or Catechu, in medicated pessaries for vaginal leucorrhoea (L.). Castor Oil, an excellent laxative (P.); to clear out the bowels in diarrhoea (L.). Cocculus Indicus, when intestines much distended with flatus, and frequent desire to urinate from flatulent pressure on bladder (P.). Bismuth, Calumba and Antispasmodics, with minute doses of Opium, for gastrodynia and pyrosis (L.). Potassium Bromide, with chloroform, as an antispasmodic in dyspnoea (L.). Sumbul, is invaluable in restlessness;-m xxx-xl of tincture with a little chloric ether, giving quiet nights for a long time (P.). Galla, unguentum gallæ cum opio, the best local application to hemorrhoids, also fomentations with sponges wrung out in very hot water, to relieve pain (L.). Digitalis, in infusion, very beneficial in albuminuria (L.). Potassium Acetate, with Basham's mixture (Liq. Ammonii Acetatis), when albuminuria with anæmia. Calcium Phosphate, believed to exert an influence on the foetus if administered during pregnancy, so that mothers

who have borne only rachitic or scrofulous children will bear healthy ones (W.). Berberine, found very useful in the periodical neuralgia of pregnancy, even in cases in which quinine had previously failed (Maclagan). Camphor, liniment, for lumbar pains (Wa.). Senna, the confection proves a mild and efficient purgative in the constipation of pregnancy (Wa.). Milk-diet, for albuminuria of pregnancy the best remedy, if strictly carried out (Parvin). Injections, must be used carefully, even tepid water often induces uterine contractions (L.). [Compare Vomiting of Pregnancy, PTYalism, AlbuminURIA, NEPHRITIS, NERVOUSNESS.]

Prolapsus Ani.

Nux Vomica. Strychnine, especially when in children, with constipation; in the latter event add nux vomica to a purgative, as tincture of rhubarb (R., P.), or strychnine hypodermically, gr. for an adult every 48 hours, 3/4 inch from anus and parallel to rectum, into the cellular tissue; generally requires 4 to 8 injections (Weber). Piper, the confectio piperis in doses of gr. lx-gr. cxx, persevered in for 3 or 4 months, in chronic, weak subjects (Wa.). Sulphur, has a beneficial effect in addition to its laxative value (R.). Alum, in solution, gr. vj to the 3(R.). Ice, locally, when parts inflamed (R.). Ergot, the fluid extract injected into the perineum, is followed by immediate relief (Vidal). Ferrum Sulphate, 3j to viij aquæ, of which one-third by enema twice daily. Podophyllin, in small doses for rectal prolapse in children (P.). Tannin, injection to restrain the prolapsus (R.). Hydrastis, by enema, or as a lotion (P.).

Prolapsus Uteri.

Cimicifuga, to prevent miscarriage in prolapsus uteri (R.); has a remarkable effect upon the uterus (P.). Astringents, decoctum quercus, decoctum gallæ, (Wa.). Pomegranate bark (P.). Tannin, as catechu, kino, red gum, rhatany. Alum, a solution gr. vj ad 3j (R.); lb. j ad Cj aquæ, as hip-bath, also should be passed well up vagina (Wa.). Ice, locally when parts inflamed (R.); applied to the spine (Wa.). Pessaries, in any form, are of but temporary benefit, and in the end positively detrimental (E.); but many cases cannot be treated without mechanical support of some kind.

Prostate, Hypertrophied.

Alkalies, for the cystic irritation with acid urine. Great benefit from liquor potassæ, citrates and acetates of potassium (B.). Triticum Repens, benefit follows its use in the prostatic enlargement of old men (Sir H. Thompson). Ammonium Benzoate, for the cystitis, urine alkaline (B.). Ammonium Chloride, is occasionally useful, gr. xv-xxx, 3 or 4 times daily (Wa.). Iodine Injections, through rectal walls (B.); a weak ointment applied by rectum (Wa.). Iodine, has been tried in all forms, but is of no value (Thompson). Iodoform, as suppository in rectum, has proven of great value (B.). Colchicum, in persons of a gouty diathesis (Wa.). Medicine is not likely to have any control over this condition, which is a simple hypertrophy. [Compare CYSTITIS.]

Prostatitis.

Cantharides, gtt. j of tincture (5 may be required) 3 or 4 times a day (R.). Triticum Repens, is found to be of benefit (Sir H. Thompson). Urino-Genitals, especially turpentine, cubeb, juniper, cantharis (B.); cubeb, in doses of gr. xx daily, is found of much benefit (Wa.); buchu relieves (P.). Silver Nitrate, a solution (gr. v-x ad 3j), applied to the prostatic urethra in chronic prostatitis, may be useful (Wa.). Blisters, in chronic prostatitis, a small blister on each side of the raphé of the perineum, kept open 4 to 6 weeks, has given the best results (Wa.). Tonic medicines and regimen should be prescribed (Wa.). Hot Injections, to relieve pain (R.). [Compare PROSTATORRHOEA.]