2735. In Inflammation, Dr

Copland §§ observes that, after watching its effects for thirty years, he believes that there is no remedy more deserving of confidence, if appropriately and prudently prescribed. The operation of this medicine depends upon the dose, the frequency of the repetition, and the combination of it with other remedies. Hence, it may be made available in every form of inflammation. In the sthenic form, it is remarkably serviceable after depletions have been duly practised, and it may be used both externally and internally - in draughts or in enemata - in liniments, embrocations, or fomentations. In all inflammations tending to copious effusion, or to fibrinous exudation, after depletion has been resorted to, and more especially when it becomes doubtful whether general depletion should be prescribed, or repeated, or not, this substance, in hands experienced in its operation, is a most valuable remedy. In these cases it should be given in quantity sufficient to act upon the bowels and kidneys - either f3j. thrice daily, or from f3iij. to f3vj. once a day, alone, or with Castor Oil. It may also be administered once or twice a day in enemata, in larger quantities. Where it is desired to produce as rapid an impression as possible on the malady, not only should the one mode of exhibition be made subsidiary to the other, but both should be aided by the external use of the substance, in the form of a warm embrocation or fomentation. In such cases, Dr. Copland directs several folds of flannel, large in proportion to the extent and severity of the disease, to be wrung as dry as possible, out of very hot water, to be instantly freely sprinkled with Spirit of Turpentine (Turpentine stupes), and applied immediately over the affected organ - to be closely covered, by wash-leather or a dry cloth, to prevent evaporation - to be kept thus applied as long as possible or as the patient may endure it, and to be renewed as circumstances may require. In less severe cases, or at the commencement of inflammation, he has found a single application of this fomentation instantly arrest the disease, without depletion or any other means beyond a purgative being employed. The Spirit of Turpentine thus employed internally or externally, or both, need not prevent a recourse to Calomel or other mercurials; but may be used, particularly in the more urgent cases, in conjunction with them; the former aiding the operation of the latter. In Chronic Inflammations, liniments containing this substance may be used either as such, or as embrocations, or they may be applied over the affected organ, on the surface of warm flannel as described above. Although a remedy of great value in all forms of inflammation, its use requires much discrimination and experience, in order to obtain its proper effects; and in some acute inflammations, if injudiciously administered, it may be productive of much mischief. In the advanced stages of Inflammation of the Brain, attended by coma, rapid, irregular, and trembling pulse, with great depression of the vital energies, Dr. Copland found the following draught, given four hours after a full dose of Calomel and Camphor, productive of the best effects: - ℞ Ol. Terebinth., Ol. Ricini āā f3ij., T. Capsici xij., Ol. Cajeputi vj., Aq. Menth. Vir. fiss., M. In Sub-acute and Consecutive Nephritis, he advises Turpentine embrocations to the loins; or the Spirit may be given internally in small doses, with the view of exciting the nervous energy of the kidneys and the action of the congested vessels; but much caution is necessary in the selection of the cases in which it is applicable. In plethoric subjects, and where the vascular action and tone are not remarkably depressed, the local abstraction of blood, by cupping over the loins, should precede the use of these remedies. In Acute Laryngitis, Dr. Copland speaks in the highest terms of the application of hot Turpentine fomentations to the throat. If applied early and with decision, he observes that they have a remarkable effect in restraining inflammatory action, in parts near those to which they are applied, and in preventing and arresting the effusions and infiltrations consequent on inflammation. In the Acute and Chronic forms of Pneumonia, Pleuritis, and Bronchitis, the hot Turpentine fomentations, as directed above, prove most serviceable. Dr. Graves* prefers a liniment composed of Ol. Terebinth, fiss., Vitel. Ovi j., Acid. Acet. Fort. fj., Aq. fiij. Rub the three latter together, and then incorporate the Turpentine. In Enteritis, Peritonitis, and Gastritis, the same fomentations, diligently applied, are productive of decided benefit in the majority of cases.

* On Fevers, 1862, p. 283. Thoughts on Puerperal Fever, Lond. 1814. Med. Gaz., Jan. 28, 1850. § Loc. cit.

II Diseases of Females, p. 453. ¶ Obstetric Medicine, p. 895.

** Lib. of Med., vol. i. p. 355.

Theory and Practice of Midwifery, p. 471.

Bull. Gen. de Therap., May 30, 1858.

§§ Dict. Pratt. Med., vol. ii. p. 410, &c.

2736. In HAemorrhage, the Oil of Turpentine has long been highly esteemed as a styptic; indeed, John Hunter regarded it as the best, if not the only true one. Its use is generally confined to atonic and passive HAemorrhage, but Dr. Copland considers that the existence of inflammatory action does not contra-indicate its use, for it lowers, he observes, vascular excitement, and prevents effusion and the formation of coagulable lymph, especially when given in sufficiently large or repeated doses. When the powers of life are much impaired, and after copious evacuations of blood, small and frequent doses of it only ought to be given, conjoined with tonics, aromatics, restoratives, &c. In HAemoptysis, it was first recommended by John Hunter; and has been advised by Dr. Theophilus Thompson, who observes that it is probably one of the most certain and suitable remedies in the majority of instances. He prescribes it thus: -2735 In Inflammation Dr 233 Sp. Terebinth. f3ij., Mucilag. Acac. fij., Matico Infus. vel Aq. Cinnam. fiv., T. Capsici f 3ss., M. cap. fj. pro dos. In HAemoptysis connected with Phthisis, Dr. Marshall Hughes* states that he has frequently found f 3j. of the Spirit of Turpentine, taken at each accession of the hAemorrhage, succeed when other remedies have failed to arrest the bleeding. Dr. T. Smith suggests the inhalation of the vapour as a means of checking the discharge; and Dr. Copland advises Turpentine fomentations (a hot flannel sprinkled with the Spirit), with the same view. In HAematemesis, it proved successful in the hands of Hunter, who states that he has seldom found it fail, when given in doses of gutt. x., every two or three hours. In this case, its action is probably partly direct, the liquid coming in contact with the bleeding surface. In. HAematuria, it proved eminently successful in the hands of Mr. Vincent, who administered it internally in doses of gutt. x. every two or three hours. It is contra-indicated when the hAemorrhage is associated with inflammation or congestion. In extreme or prolonged cases of Uterine HAemorrhage, Dr. Copland states that he has had recourse to the Spirit of Turpentine, either in draught or in an enema, or in the form of fomentation applied over the hypogastrium, and always with success. In HAemorrhage after Abortion, as well as after Delivery at the full period, but particularly when the hAemorrhage proceeds from inefficient contraction of the uterus, and retention of the ovum or some portion of the appendages of the embryo, Dr. Copland§; states that he has prescribed with complete success an enema composed of fj. - fij. of the Oleum Terebinth. in a pint of water gruel. In profuse Hemorrhage after the extraction of a Tooth, Mr. Vincent || states that the most effectual application is the Oil of Turpentine; care being taken that no coagula be allowed to form, to interfere with the direct application of the remedy. He adds that he has seen the most profuse hAemorrhage arrested by these means. In Hemorrhage from Piles, its internal exhibition, in doses of f3ss. three or four times a day, according to Dr. Burne¶ not only arrests the bleeding, but prevents its recurrence. It is a valuable remedy in these cases. In Epistaxis and in Hemorrhage from Wounds, it may also be given internally, with great advantage; and in that from Leech-bites, it proves effectual when locally applied.

* Clin. Lect., vol. ii. p. 21.

Dict. Pract. Med., vol. ii. p. 69.

Lancet, July 19, 1851.