Tincture of benzoin, 50 parts. Copaiba, SO parts.
Oil of sweet almonds, enough to make 200 parts.
Thirty drops of this mixture are in jected into the rectum, in a little milk, and the amount is gradually increased to one or two teaspoonfuls. One injection daily is sufficient. The child experiences a temporary burning sensation to which it rapidly grows accustomed. If this treatment is persisted in for months, all the symptoms are said to diminish, and the general condition is correspondingly improved, even proceeding to a cure.
The ordinary commercial coal-tar creasote is highly recommended by Arnold Chaplin, the aim being to empty the dilated tubes of the foetid material and to prevent their becoming filled again. According to this author, and the argument is sustained by the excel lent results obtained, in order to fulfill the qualifications given above, a drug is needed which, while it is strongly anti septic, must at the same time be pungent and acrid enough to induce violent ex pulsive efforts. These conditions are, according to Chaplin, fulfilled by the common commercial coal-tar creasote. The mode of application is as follows: A room about seven feet square by seven feet high must be obtained, and this must be rendered tolerably air-tight. It is well to have the room on the top of the house, or away from it, as there will be less chance of the vapors generated from the creasote causing annoyance to those living in the house. In the centre of this room a small stand about feet high is placed, and on this an ordi nary spirit-lamp which admits of being raised or lowered. Over the spirit-lamp, on a tripod, an enameled-tin dish is placed, and into this is poured about half a pint of the coal-tar creasote. The creasote is heated until the dense pun gent fumes are given off. The patient, clothed in an old dressing-gown, is placed in the room as soon as the lamp is lighted. As soon as the fumes begin to come off, an urgent desire to cough comes on, and soon the cough becomes more or less incessant, and attended with the expulsion of large quantities of phlegm. After the sitting has lasted from a half to one hour the patient may leave the room, and wait until the next day before taking another sitting. This
should go on steadily from day to day for two months. For the first day or two not much benefit will be noticed, but very soon the expectoration becomes reduced and the odor less disgusting, and before very long the patient, who before was unbearable, is able to mix with his friends, and, unless he has a fit of coughing, his breath is quite free from smell. After two months the pa tient seems practically cured, but he must take a sitting at least three times a week if he will keep his expectoration free from odor. With the cessation of the fcetor comes increased appetite and strength.
Children do not bear the treatment well, and the benefit to them is not nearly so marked. The method is an unpleasant one, however, and it requires all the persuasive powers of the physician to keep the patient up to the necessity of going on with the application of the drug; but after a few sittings patients generally become used to it. Secondly, the fumes of the creasote produce run ning and smarting of the eyes and nose; but this can be prevented by introducing two plugs of cotton-wool into the nos trils and covering the eyes with a pair of glasses rimmed round with India rub ber. Beyond these there are no draw backs to the treatment, and it can con fidently be recommended as likely to improve the condition of the patient if persevered in for sufficient length of time.
Crensote found of much value, admin istered in the form of carbonate of crea sote, drachm three times a day. Price Brown (Canadian Practitioner, Feb., '00).
Surgical measures have been resorted to with the view of reaching, by ex ternal incision and draining, the cavi ties containing foetid accumulations. But the fact that the latter are very rarely localized within a restricted area at once condemns so severe a remedy, that involves complications, especially pneumonia, which may soon cause the patient's death. The only kind of case in which it might in the least be war rantable is where the presence of but a single bronchiectasic cavity can abso lutely be established by physical exami nation, and even then only when it is near the surface.