In Haemoptysis, HAematuria, HAemate-mesis, Epistaxis, and in internal HAemorrhages generally, Ipecacuanha appears to exercise a powerful influence. Dr. Osborne considers that the production of vomiting is necessary to develop its influence; but Mr. Trenor|| has published numerous interesting cases, in which it was given in such doses as to produce nausea, without actual vomiting: and this procedure was attended with marked benefit, arresting the haemorrhage and restoring heat and life to patients who were in a state of collapse from excessive loss of blood. The doses given by Mr. Trenor varied from gr. j. - ij. every fifteen or thirty minutes, until nausea was felt; when the benefit was generally evident, the medicine was discontinued. The value of Ipecacuanha in this class of diseases is not sufficiently attended to; at the same time it is better to avoid vomiting, particularly in haemorrhage from the lungs and stomach, although Dr. Osborne observes that he never saw it produce any ill effect. Prof. Graves* also bears testimony to the efficacy of this treatment.
* Med. Times and Gaz., Jan. 30, 1864. Amoen. Acad., vol. viii. p. 246. Med. Obs. and Inquiries, vol. vi
§ Trans, of Coll of Physicians, vol. ii. || Dub. Journ., vol xviii. p. 481.
1645. In Uterine HAemorrhage and Menorrhagia, Ipecacuanha, given in full emetic doses, has often been followed by the best effects. Dr. Osborne, a strong advocate for its use in these cases, advises j. of the powdered root in the evening, followed by an acidulated draught in the morning. The discharge usually ceased in twenty-four hours; and if a relapse occurred, a repetition of the emetic never failed to render the cure permanent. Dr. Tyler Smith % thus explains its action in these cases. "Ipecacuanha," he says, "by its emetic action, excites contraction of the abdominal muscles, and compression of the uterus, which may, in turn, re-excite some amount of uterine reflex action, but beyond this it appears to have a special action upon the uterus, increasing its contractile power beyond what could be imagined to occur from the merely secondary effects of vomiting." He adds, " Ipecacuanha, then, appears to influence the medulla oblongata and the lower medulla spinalis. This double action of Ipecacuanha upon the two extremities of the spinal centre is very extraordinary."
1646. In Typhus Fever, an emetic at the commencement of the attack is sometimes highly serviceable. "We have never seen," observes Dr. Duncan,§ " more decidedly beneficial effects from the use of any medicine whatever than from the exhibition of an emetic of Ipecacuanha at the commencement of Typhus Fever. This, succeeded by a diaphoretic regimen, when administered sufficiently early in the disease, frequently cuts it short at once; and when it fails in this desirable object, it always has a beneficial influence on the progress of the fever."
Hannay || strongly advises the following application as a counter-irritant: -Pulv. Ipecac. R., 01. OlivAe aa 3ij., Adip. ss., M. He directs the part which it is wished to irritate to be rubbed freely with this liniment, for fifteen or twenty minutes thrice daily, and then to be enveloped in flannel. This produces in thirty or thirty-six hours an eruption, which remains out for three or four days. He states that he has seen great amelioration of the symptoms follow the use of this ointment.
* Clin. Lect., vol ii. p. 141. Trans. of Irish Coll of Physicians, vol. v. p. 18. Lancet, Dec. 16, 1848.
§ Edin. Dispensatory, p. 80. || Edin. Med. and Surg. Journ., Oct. 1, 1843.
1648. In Hysteria, it is always of importance to keep off a paroxysm when one is impending, and Dr. Conolly* states that this may often be done by the prompt administration of Pnlv. Ipecac. 3ss. This will produce a full emetic effect, and, if it does not prevent, will at least greatly modify, the violence of the attack.