Cargill. Of the 100 thus treated, 61, or more than six-tenths, were cured, the average duration of treatment being 13 3/4 days. Twenty experienced great relief, but were not entirely cured; five were slightly relieved; three received no benefit; and three got worse. In the remaining eight, no positive conclusions could be arrived at. The usual dose commenced with in these cases was ij. thrice daily, in barley-water; and this was adhered to, in many instances, throughout, but in a large number it was increased to 3j., 3iss., 3ij. thrice a day; and in one instance, 5iij. every four hours was given without intermission for twelve days, without the smallest inconvenience to the patient, who was cured in that period. Dr. Cargill did not observe much advantage from combining it with other remedies. In some rare instances, it was found to create great constitutional disturbance, which rendered it necessary to discontinue the remedy. The symptoms were, general debility of the limbs, especially of the lower extremities; the knees, too, were particularly complained of: this symptom was sometimes very marked. There were also general tremblings, difficulty of speech, forgetfulness of the names of things, giddiness, and a painful rushing sound in the ears. These effects, which were generally observed in persons of a purely nervous temperament, subsided in a few hours by diuresis and copious perspiration. Dr. Cargill regards it as a point of great importance, that the remedy should be largely diluted with warm barley-water, not less than f viij. to each dose. In one case in which, by mistake, this point was not attended to, it produced intense griping, with pallor of the countenance, and cold perspiration, the pulse and heart's action much depressed, dry red tongue, with enlarged papillae, and much thirst. In cases wherein Mercury has been previously extensively taken, and when the disease arises from Syphilis, whether Mercury has been taken or not, the Nitrate of Potash is without power. The Iodide is the remedy then applicable.
* Brit. and For. Med. Rev., Oct. 1842.
Med. Gaz., Oct. 10,1851.
2225. In Scurvy, the Nitrate, in common with the other salts of Potash, exercises a powerful influence. Dr. Cameron,* R.N., strongly recommends the Nitrate,.in 3j. doses; Vinegar at the same time being used as a drink. Dr. Garrod endeavours to explain its efficacy on the ground that the Salts of Potash are deficient in the blood of scorbutic patients; but the theory has been stated by other observers to be untenable, no such deficiency having been proved to exist. The Carbonate (gr. xij. - gr. xx.) is preferred by some; but I have generally found the Nitrate (much more easily procured in the tropics) answer all the indications required. Should this, or the other Salts of Potash, not be obtainable, as in the case of prolonged sieges or long sea-voyages, I would suggest the employment of Gunpowder, which, from the large per-centage of Nitre which it contains, would doubtless prove an efficient anti-scorbutic. It has proved successful in the hands of Dr. A. Henderson; and Dr. Stratton § justly observes, that any medicinal qualities which it possesses cannot be too well remembered, as in military and naval practice it is always to be obtained, when medicines cannot be procured.
2226. In Purpura HAemorrhagica, Purpura Simplex, and in Passive HAemorrhage, Nitre has been employed with great success by Dr. Carlyon.|j In ordinary cases of Purpura Simplex, gr. x. thrice daily was found sufficient; but in more severe cases, gr. x. - 3j., every two or three hours, was required. He advises its exhibition with an equal quantity of sugar, in cold water. The diet should consist chiefly of gruel, farinaceous food, barley-water, &c.
2227. In Hemoptysis, and other internal Hemorrhages, accompanied by vascular excitement, Nitre has been found a valuable resource, diminishing the arterial excitement and fever; but it should not be relied upon solely for the cure of the disease. Dr. Gibbon¶ relates numerous cases in which it produced unequivocal benefit. It may be given in doses of gr. viij. - x., several times daily, largely diluted, or combined with Tartar Emetic or Digitalis.
2228. In Continued Fevers, the Nitrate of Potash largely diluted proves an excellent refrigerant and diuretic. It may be flavoured to the taste, and used as an ordinary beverage. I have seen decided benefit from its use. In cases where this salt is not to be obtained, Gunpowder may be substituted; both Dr. Craigie** and Dr. Dick have used it with benefit as a corrective to some disordered states of the stomach in fever; the charcoal, from its antiseptic property, may also prove useful. (See also Scurvy.) The first dose or two is apt to be rejected.
* Med.-Chir. Rev., March 1830. Prov. Med. Journ., Dec. 13, 1848. Edin. Med. Surg. Journ., July 1839. § Ibid., July 1, 1845.
|| Prov. Med. Journ., Dec. 13, 1848. ¶ Med. Cases and Reports, part ii. ** Practice of Physic, vol. i. p. 137. Edin. Med. Surg. Journ., Jan. 1839.
2229. In Dropsy and Dropsical Affections, Nitre proves of great service as a diuretic, "particularly when combined with Squills and other remedies of the same class. Dr. Delreyne * derived great benefit from the following mixture: - ℞ Potas. Nit. 5iij., Baccar. Juniper. 5xv., Vin. Albi Oiss., M. Dose, iss. daily.