Drachm-doses of a saturated solntion of Epsom salts, in combination with 10 minuns of dilute sulphuric acid, every hour, are strikingly effective. V. G. Thorpe (Brit. Med. Jour., Feb. 26, '93).
Sulphate of soda or sulphate of mag nesia may be given in drachm doses every quarter- to half- hour for the first four or six doses, and afterward at longer intervals until the motions assume a good yellow color. With the saline a little quinine and perchloride of mercury may be combined if desired. Series of 555 consecutive cases treated in this way, with only 6 deaths. For chronic or re lapsing cases the saline treatment is not nearly so efficacious, and, after one or two doses of the salt, castor-oil, bismuth, etc., should be given. Buchanan (Brit. Med. Jour., i, p. 300, 1900).
Salines nsed in S55 cases in Beno.al. There were only 9 deaths: a mortality of only a little over 1 per cent. The following mixture was used:— 1= Sodii sulphatis, 1 drachm. Aquce fceniculi, ad 1 ounce.
This was given four, six, or eight times a day (each dose represented 1 drachm of the saline) as the case re quired. No dose was repeated on the following day till the stool had been in spected. The saline was continued till every trace of blood and mucus had dis peared completely in two or three days; in others they returned on the third or fourth day, necessitating a repetition of the saline.
The saline treatment is advocated for acute eases only. It is not considered a safe method for chronic or relapsing cases with ulceration of the colon. In cases in which either the symptoms or the history point to the disease being either chronic or relapsing, the saline was used for one or two doses during an exacerbation of the chronic state, and then the case was treated with soda and bismuth or with salol, with an occa sional dose of castor-oil. For stools containing scybala nothing is so good as a dose of castor-oil guarded by 10 minims of laudanum.
When the patient can be admitted to hospital, the saline is the best method of treating acute dysentery, but it should not be applied in a routine fashion in out-patient practice, on ac count of the possibility of many patients having had previous attacks, and hav ing their bowels in a state of unhealed ulceration. The success which has this
year attended the treatment of the chronic cases in due to careful dieting on rice-water (mar), and boiled milk and tyre (dahi), the use of anthelmin tics (a large proportion of the inhabit ants of this part of Bengal harbor both round and tape- worms), and the careful occasional use of the saline, with Dover's powder and the intestinal anti septics. W. J. Buchanan (Brit. Med. Jour., Apr. 13, 1901).
Among the drugs used to combat the disease, ipecacuanha still maintains its reputation in the tropics. It is usually administered after a preliminary dose of laudanum or morphine,which is followed in half an hour by from 20 to GO grains of ipecacuanha. Should the dose be jected, it is repeated in a few hours. This mode of treatment was not satisfactory during the War of the Rebellion, and Osler has failed to see in sporadic eases the marked effects claimed for it by the physicians in the tropics.
Epidemic of dysentery in Alquizar, Cuba; 137 cases under treatment. The mortality among those treated with ipe cacuanha and calomel, opium, etc., amounted to '9 per cent., while that among those treated by benzonaplithol WiLS slightly above 2 per cent. Forty-five grains per diem were given to adults and but little less to children. Jose A. Clark (Lancet, July 20, '95).
Experience in Benga,1 has given great faith in ipecacuanha in large doses. Castor-oil should be given the night be fore and, after the bowels have moved in the early morning, tincture of opium, fol lowed in fifteen or twenty minutes by ipecacuanha in a dose of 25 or 30 grains. The patient should lie undisturbed for four or five hours. Should vomiting oc cur, ipeeacuanha to be repeated in half an hour and also if the stool has not much changed for the better within twenty-four hours. Ipecacuanlia in pill, in doses of from 3 to 5 grains, is utterly useless. W. J. Buchanan (Practitioner, Dec., '97).