Mackenzie* states that he derived much benefit from a solution of the Nitrate (gr. iv. in Aq. Dest. fj.). This he applies by means of a tine camel's-hair brush, to the conjunctiva, having previously cleansed it with the following lotion: - Hyd. Bichlor. gr. j., Ammon. Hydrochlor. gr.vj., Aq. fviij. Small blisters are also advised behind the ears.
Nit. gr. iv. - vj. in Aq. fj. is stated to be efficacious, but, in my experience, most benefit is derived from the mode of treatment first proposed by Mr. Wormald, and subsequently advocated by Drs. Hocken and Lanyon. It is as follows: the eyelid is put on the stretch, so as to present a smooth surface, and, after being slightly moistened, the caustic is to be passed once or twice lightly over it, so as to produce a slight blackness of the skin. A single application often suffices to remove altogether the lachrymation, the photophobia, &c. Iodine, applied in the same manner, is equally efficacious. Another mode of treatment proposed by M. Tavignot,§ is to pencil the lining membrane of the nares with the Nitrate in substance, or with an ointment containing one-tenth of this salt. For adults, he prefers a snuff composed of 2 parts of the Nitrate, 1 of Can-tharides, 1 of Camphor, and 30 of Iris powder. He speaks highly of the efficacy of this treatment. In Ophthalmia Tarsi, a pencil of the Nitrate, lightly passed over the diseased surface, is advised by Quadri of Naples and others. In Epiphora, a solution of the Nitrate (gr. iij. ad Aq. fj.) once or twice daily is sometimes productive of great benefit. In Pterygium, especially when this is combined with Catarrhal Conjunctivitis, marked benefit occasionally follows its use. (Mackenzie. ||)
327. In Indolent Ulcers of the Cornea, which resist milder applications and antiphlogistic measures, a collyrium of the Nitrate of Silver (gr. j. - iv. ad Aq. fj.) will, in most cases, establish a healthy action, and accelerate the cure.
Mr. Bell and Dr. Hamilton have also testified to the efficacy of this application.
* Dis of the Eye, p. 403. lancet, Nov. 19, 1844. Ibid. June 21, 1843. § L'Union AleU. No. lxxix.
|| On Dis. of the Eye, p. 233. ¶ Monthly Journ. of Med. Science, April, 1851.
In Amenorrha, Dr. Lubanski* speaks highly of the efficacy of applying the Nitrate in substance lightly to the os uteri, at the time of the expected appearance of the menses. He states that in all cases, excepting where the Amenorrha is symptomatic of some other disease, it proved effectual. It has also been found successful by Dr. Egan, who recommends its employment in obstinate cases.
iij., Aq. Dest. fj.) is advised by Dr. Jewel as a vaginal injection. It may, however, be used of a much greater strength than this, or may even be applied in substance. Dr. Hudson§ states that, in Uterine Leucorrha, he has derived great benefit from the internal administration of the Nitrate. He relates several cases illustrative of its efficacy. The following formula is advised: -
Argent. Nit. gr. 1/4, Opii gr. 1/4, Pulv. Rhei; Ext. Hyoscyam. 3a gr. j., M. ft. pil. in die sumend.
331. In Gonorrhoea, the Nitrate in solution often proves an effectual injection Ricord advises in solution (gr.x. ad Aq. fviij.) at the outset of the attack; he states that, by this means, the disease may be invariably cut short, in the first stage. A similar opinion is expressed by Dr. Graves, Mr. Acton, and other experienced writers. The injection is to be repeated twelve times, desisting, however, if the discharge is rendered thin and bloody, an ordinary effect of the application; a weak solution of Zinc or Alum should then be substituted, and continued until the discharge ceases. Antiphlogistics, Aperients, and Copaiba should be employed at the same time. The above practice has been objected to, as being likely to induce Orchitis, and other bad consequences; but there appears to be no real foundation for this fear. (See Injections.)
In the Chronic stage of Gonorrha, an injection of Argent. Nit. (gr. j. - iv. in Aq. Dest. fj.) often proves serviceable.
In Gonorrhoea in the Female,|| Bicord advises the Nitrate to be applied, in substance, to the sides of the vagina and neck of the uterus. At first, the discharge rather increases, but after a few repetitions it is either much diminished or altogether arrested. It has also been successfully employed by Dr. Jewel,¶ and Dr. Egan* * states that he has found it very efficacious.
332 In the early stage of Cancer of the Uterus, Dr. Ashwell states that he has derived much benefit from the application of Nitrate of Silver in solution, thus: Argenti Nitratis gr. xxx. - xl., Aquse Destil. f3iv., M. ft. lotio, to be applied by means of a speculum, and states that he has found it particularly useful in those cases where the mucous membrane lining the channel of the cervix or around the margin of the os uteri has been red and tender, where there have been obvious ulcerations or a tendency to softening. The character of the mucous membrane generally improves after three or four applications.
* Ann. d'Obstet. 1843.
Dublin Journal, 1848.
On Leucorrha, 1S30.
§ Dublin Journ. vol. xvii. p. 238.
|| Bull Gen de Therap. June, 1835. ¶ Obs. on Leucorrha, 1830. ** Dublin Journ. of Med. 1848. On Diseases of Women, p. 393.
333. In Ulceration of the Os and Cervix Uteri, the application of the solid Nitrate has been advised and practised by the highest obstetric authorities of the present day. The real amount and character of the disease should, in the first place, be clearly ascertained by means of the speculum. That the practice is not devoid of danger is shown by a case related by Dr. Williams, of Swansea,* in which, in consequence of the inflammation caused by the application of the caustic, the edges of the Os Tineae were united so closely as to require to be separated by an operation, to allow the escape of the menses. In Inflammation of the Cervix, without ulceration or hypertrophy, Dr. J. H. Bennett regards the Nitrate as the most advantageous of all caustics.