Ipecacuanha tried several years in Nicaragua, Central America. Notwith standing its vaunted efficacy, no case de rived much benefit from it. Patients suf fering from dysentery cannot always retain large doses, as stated in text books. Half-ounce doses of a saturated solution of magnesium sulphate and 15 minims of dilute sffipliuric acid every two hours, with milk diet, caused all traces of blood to disappear from the stools in twenty-four hours, and there was, of course, a complete absence of the dis tressing nausea which is always present in the treatment of ipecacuanha. T. R. Wiglesworth (Brit. Med. Jour., Feb. 26, '98).
Ipeeac is indicated in alinost every form and type of acute dysentery owing to its simplicity, its safety, and iti.; certainty, compared with any other method. The promptitude with which the inflammation is stopped. The rapid ity with which repair takes place (a) by resolution or (b) by granulation and cicatrization. Conservatism of the con stitutional powers. Abbreviation of the period required for convalescence. De crease in the frequency of recurrence. Decrease in the frequency of abscess of the liver. Diminution of mortality in eases treated. The chief objection to ipecac is its frequent rejection from the stomach. Its administration in the form of compressed pills coated with salol reconn»ended to avoid this untoward feature. William Roberts Rour. Amer. Med. Assoc., April 11, 1903).
Corrosive sublimate, in doses of / 1, 100 grain, repeated every two hours, has been recommended by Ringer. Bismuth in large doses-1/, to 1 drachm every 2 hours, amounting to 12 to 15 drachms in 21 hours—often has a beneficial effect. Its effects are more pronounced in the chronic than in the acute cases.
The administration of antiseptic sub stances by the mouth for the purpose of disinfecting the intestinal canal has been employed. For this purpose benzo naphthol is the drug to be chosen when there is suspicion of liver or kidney dis ease, and in their absence it is as effective as betanaphthol and resorcin, which are also employed as intestinal antiseptics. The dose of benzonaphthol is 40 to 80 grains, given during 24 hours, in divided doses every 2, 3, or 4 hours. Betanaph thol and resorcin are given in quanti ties of from 30 to 50 grains in 24 hours in much the same way. The naphthol preparations, being insoluble, must be given in capsules or dissolved in oil and emulsified. Resorcin is soluble and can be readily administered. Naphthalin (20 grains per day) and salol (30 to 40 grains per day) are used for the same purpose. Opium is an invaluable remedy for the relief of pain and to quiet the peristalsis, but should be employed cautiously. It
is to be administered hypodermically in the form of morphine, according to the needs of the patient.
Sulphur successfully used in the treat. ment of dysentery. Twenty grains of sublimed sulphur are combined with 5 grains of Dover's powder; to be given four-hourly. In all of the cases that have been treated with sulphur the re covery has been rapid and the patient has seemed to derive relief more speed ily from his pain and straining than with other methods of treatment. The cure with sulphur seems to be more cer tain and stable, as chronic conditions and relapses have not occurred. Blood and mucus are easily stopped and the motions quickly become fx.cal. In some cases the number of motions per diem did not at once diminish, but the pain and straining were lessened and the character of the motions became more fmcal and contained little or no blood. As soon as the diarrhcea becomes less, it is advisable to give the pcm:ders less frequently. G. E. Richmond (Lancet, June 15, 1901).
Three acute and fifteen chronic cases of aimfbic dysentery were treated with sulphur of natural spring in the Philip pines. The acute cases were given one bath daily and plenty of the water to drink. In a month two were cured; the third, an alcoholic, had to be returned to medicinal treatment. The chronic cases were ,given two baths daily and the water to drink, and all were cured in from three to six weeks. The springs contained water at 220° F. and 92° F., with a large percentage of sulphur. T. 11. Wei.senburg (Phila. Med. Jour., March 14. 1903).
Irrigation of the bowel is both ra tional and useful. To overcome the ex treme irritability of the rectum in the acute cases a suppository or solution (4 per cent.) of cocaine should be intro duced as a preliminary measure. The irrigation is made with the long rectal tube, the patient being in the dorsal po sition, with a pillow under the hips. The substance to be injected is water at 100° alone or containing some astringent drug: alum, acetate of lead, sulphate of zinc or copper, nitrate of silver, or tan nin. Tannin, in 0.5 per cent. solution, is highly recommended by Kartulis, who also uses this drug in combating amcebic dysentery. Osler regards nitrate of sil ver as the best, although not in the very acute cases. In the chronic form it is, perhaps, the most satisfactory treatment. The solution, in this class of cases, is to be made 20 to 30 grains to the pint, and, if possible, 3 to 6 pints of fluid are in jected. At times the irrigation causes much pain and is immediately rejected.