3211. In Hooping- Cough, Dr

Pidduck* states, that for thirty years he has adopted the following treatment (originally proposed by the late Dr. Sandars) with such success that he cannot recollect a single failure in the uncomplicated form of this disease. It consists in applying leeches immediately over the junction of the occiput and the atlas vertebra, to relieve the congestion of the vessels surrounding the origin of the pneumogastric nerve; and the subsequent application of a sinapism or blister between the shoulders. The rule to be observed is one leech for each year of the child's age, from one to six. These, and the sinapism, are to be repeated every three or four days, if necessary.

3212. Narcotics are medicines which cause stupor or sleep, this state being preceded by a certain amount of vascular and cerebral excitement. Other names have been given to this class of medicines, as Soporifics, Hypnotics, Cerebro-spinants, and Sedatives; but the last named are distinguished from narcotics by the absence of a primary state of excitement in their operation. Under the head of Narcotics are comprised Opium, Stramonium, Belladonna, Conium, Hyoscyamus, Cannabis, and Camphor.

The Objects for which they are employed. 1, to procure sleep; 2, to allay pain or spasm; 3, to arrest inordinate secretion; 4, to control inflammatory action or irritation.

Modus Operandi. The greater number of narcotics act mainly on the brain and spinal column. "Their primary action," observes Dr. A. T. Thompson,* "is not confined to the nerves of the stomach; for, if any narcotic be applied to the surface of the body, the same results follow, although in a minor degree, as display themselves when they are taken into the stomach. If the application be made to entire membranous surfaces, the energy of the narcotic influence is in ratio to the absorbing power of the surface; and if it be injected into the thorax between the lungs and the ribs, the action is more energetic than when a narcotic is taken into the stomach. Applied to a wound or denuded surface, they are absorbed into the system, and produce their specific effects. From these facts, it is evident that narcotics operate on the brain and spinal column, having been previously absorbed and carried to these organs by circulation." Fully admitting the justice of these observations, it appears undeniable that narcotics exert a degree of local influence directly on the nerves to which they are applied, independent of the brain and spinal cord, e.g. the immediate alleviation of pain, or pruritus in the extremities, by the application of Opium or Belladonna. "As a part of their general sedative influence upon the nervous system," observes Dr. Ballard,t "they diminish the secretions of the liver and kidneys, arrest more or less the performance of those functions which severally attach to the different parts of the alimentary canal, retard digestion, and constipate the bowels, both by lessening the secretions poured into them, and by rendering their movements sluggish. Some dilate, while others contract the pupil; some appear to concentrate their sedative action more particularly upon the functions of the encephalon, others upon the contractile power of the alimentary or bronchial tubes; while a strict distinction is to be drawn between those which occasion constipation and those which do not, all these things being of great practical importance."

* Lancet, June 16, 1849.