322. In Jaundice, The Nitrate, In Doses Of Gr

3/4 twice daily, is recommended on theoretical principles by Dr. Peebles (U.S.). He relates an illustrative case, in which the Jaundice disappeared on the third day after its first administration. He advises it, particularly, in Jaundice arising from a deranged state of the mucous membrane of the stomach and primAe viAe. It should be given on an empty stomach.

323. In Cholera

Mr. Garlike§; states that he has successfully employed the Nitrate of Silver. The mode of application which he advises is to inject into the colon, by means of a long flexible tube, a solution of the Nitrate (gr. xvj. in Aq. Dest. iv.). Ten minutes afterwards, he administers another enema, composed of T. Opii. f3iv., in fvj. of gruel. In the first case in which he employed this treatment, the patient was in a state of collapse, apparently sinking fast. After the introduction of the Nitrate, the purging ceased, but the vomiting continued; after forty-eight hours, the bowels acted naturally. A complete cure followed. Several others were treated in precisely the same way, and with "equally happy results." The quantity of the Nitrate employed must be regulated according to the age and strength of the patient, and the urgency of the symptoms. It merits a further trial. Dr. Barry* used it internally with great success (gr. j. after each stool) in an epidemic of this disease at Assam, in 1853.

* Med. and Surg. Journ. of N. W. Provinces, 1845.

Dublin Journal, vol.. xvii. p. 240.

Amer. Journ. of Med. Sciences, July, 1849 (R).

§ Med. Times, Jan. 27, 1849.

324. Diseases Of The Eye

In Purulent and Gonorrhal Ophthalmia, the Nitrate of Silver is a most valuable application. Mr. Guthrie recommends an ointment composed of Argent. Nit. gr.x., Adipis3j., Liq. Plumb. Diacet. exv. He directs the salt to be reduced to an impalpable powder (this is an important point), and to be thoroughly incorporated with the lard and Liq. Plumbi; great care should be taken in its admixture, and no metal utensil should be used in preparing it. It may be applied either with a fine brush or with the top of the little finger. It causes great pain for an hour or two, but when this subsides, much relief is experienced Strict antiphlogistic remedies, blood-letting, calomel, opium, and antimony, form the constitutional treatment. Fomentations, either hot or cold, according to the sensations of the patient, should be also employed. A strong solution (gr. x. Aq. in fj.) is preferred by many practitioners, a few drops applied twice or thrice daily; should this cause great pain, a small portion of olive oil, dropped into the eye, affords relief. Relays of leeches below the eye or to the temples are, in many cases, better than general blood-letting. Mr. Walker advises applying the Nitrate in substance freely to the conjunctiva for a few seconds once a day, insinuating the point beneath the margin of each lid. It is not admissible in that form of Ophthalmia which supervenes on Small-pox. Mr. Critchett§ lays it down as a rule that, in genuine Catarrhal Ophthalmia, the Nitrate is a specific, and that it is useful in all cases in which the conjunctival discharge is purulent or muco-puru-lent, provided that the discharge is limited to that membrane, and has not extended to the cornea and other tissues of the eye. Many surgeons are opposed to the use of these powerful means to so delicate an organ as the eye; amongst others, Mr. Walton|| opposes their use. He considers that applications, such as the above, which cause actual pain, are productive of harm; that they greatly irritate the conjunctiva, and induce chronic inflammation. In his own practice, he never employs a stronger solution than two grains to the ounce, and attaches great importance to the frequent use of the application. The eye should be well cleansed of purulent matter, previous to its application. (See also Collyrium. )

* Ind. Ann. of Med. Sci. i. p. 449. Wed. and Phys. Journ. vol. lx. p. 190. The Oculist's Vade Mecum, p. 82.

§ Ranking's Abstract, vol. xx. p. 135.

|| Clinical Lectures, Med. Times, Nov. 4, 1848.