except very early; in appendicitis they are decidedly injurious. Richardson (Amer. Jour. Med. Sciences, Jan., '94).
Purgatives are to be deprecated or utilized only when the local symptoms, the dangers of perforation and of gen eralized peritonitis, are less. Castor-oil in teaspoonful closes enough to begin on. Le Gendre, Sevestre, Moizard, Mathieu (La Semaine MM., Nov. 2S, '94).
For every case of appendicitis treated, at least five met with showing symp toms so closely resembling those of in flammation of the appendix that it was impossible to say that appendicitis did not exist until free purgation had been used.
In simple eases the cautious use of enemata to remove irritating intestinal contents to be preferred. Later on they tend to break adhesions by peristalsis. open perforative ulcers, and spread the infection. Schell (N. Y. Med. Jour., Apr. 20, '95).
Three eases in which rectal injections of large doses of glycerin were advan tageously used. Joubert (Univ. Med. Jour., June, '95).
The diagnosis of pain in the abdomen, accompanied by fever. should be assisted by giving a purgative: in a number of eases this will lead to a rapid and com plete cure. Mordecai Price (Med. and Surg. Reporter, Jan. 2. '97).
Out of 51 cases under personal super vision, 44 were successfully treated with out operation. The method consists of at first giving cathartic doses of castor oil with olive-oil, followed with hot water, until the bowels are thoroughly emptied. This is followed by enemas of glycerin and olive-oil. Flaxseed poultices soaked in olive-oil are applied to the abdomen. The diet is restricted to very light, easily digested foods. To prevent a return of the inflammatory process, after the original treatment '7, ounce of olive-oil is given, followed by a glass of hot water before cm-h meal for several weeks. Terry (Medical Times; Canada Lancet, Mar.. '93).
When pus is present, also when the symptoms are severe from the outset, and in relapsing cases without tumefaction one should operate. If operation is not performed, rest in bed, quiet, ice-bags, hot turpentine stupes, calomel,—the dose fol lowed in six hours by magnesium sul phate,—or castor-oil alone are indicated.
Diet should be light: broths with white of egg, milk in small quantities. No opium. Ninety per cent. of all first cases treated thus will recover, at least tempo rarily. M. C. MeCannon (Medical and Surgical Ball., Aug. 9, '93).
Absolute rest is imperative, and only liquid food should be permitted.
For the pain, hot fomentations or poultices or the ice-bag may be applied over the meal region. If the ice-bag is used it should be shifted occasionally or removed at intervals.
It is bad practice to apply blisters and like remedies over the region of the ap pendix, when treating the disease, be cause, if operative measures are subse quently adopted, there will be more probability of suppuration and slough ing in the wound. 0. W. Braymer (Jour. Amer. Med. Assoc., Apr. 23, '93).
Two eases of appendicitis in both of which undiluted ichthyol was painted over the ileo-cmcal region twice daily and ice-bags applied. In the graver of the two ichthalbin was exhibited internally as well. Both patients, when discharged, had no tenderness on pressure over the deo-meal region. Action of the ichthal bin on the bowels was very beneficial. Fuchtenbusch (Amer. Med.-Surg. Bull., Dec. 25, '93).
Opium was at one time highly rec ommended, but it is now regarded by most clinicians as a dangerous remedy.
It masks the symptoms, and thereby tends to compromise the chances of operative procedures through delay; it locks the intestines and thereby prevents the expulsion of infectious discharges.
Opium, by holding the bowels quiet, allows the pus to become incapsulated by adhesions. Kottmann (Cures. 1. Schweizer Aerzte, July, '92).
Opium is the patient's greatest enemy; it masks the symptoms and renders diagnosis exceedingly difficult. J. T. Johnson (Med. News, Nov. 2S, '96).
If opium has been given, it will be ad visable for the surgeon to reserve his opinion, and if on withholding the seda tive for a few hours the pulse has in creased in frequency, and anxiety of countenance has declared itself, opera tion will be required. Mayo Robson (Brit. Med. Jour., Dec. 19, '96).