This section of the book is from the "Household Companion: The Family Doctor" book
Cooling (sedative) medicines are in place chiefly in inflammatory affections of the breathing organs, as pneumonia, bronchitis), and pleurisy. Tartar emetic is the most powerful of these. Once it was very largely used. Its harsh action upon the stomach and bowels has caused it to be now given mostly in very small doses; from the one-sixteenth to the one fourth of a grain only, for adults, at an early stage of a vio lent inflammation attended by fever. Tartar emetic is not suitable to be used as a domestic medicine.
Ipecacuanha resembles it in its disposition to bring on vomiting, but is very much milder and safer. Ipecacuanha is a very proper article for family use, under many circumstances.
Nitrate of Potassium is a sedative, cooling medicine, not now very largely used by physicians. Digitalis was once considered a sedative; now it is called a tonic to the heart. Ergot has great popularity in the medical profession at the present time, in the treatment of subacute inflammatory troubles, particularly of the spinal marrow. None of these last--nitrate of potassium, digitalis, or ergot—can be advantageously used without medical advice.
The nerve-centres have much influence over the movements of the blood, and some nervous sedatives are important in their secondary effects upon inflammation.
Aconite is one of these. It is a strong poison in any but very small doses, and must be used only with the greatest care. Tincture of aconite is the common preparation. Its dose is from half a drop to one or two drops, in water, every one, two, or three hours. Some physicians of experience give it in almost all cases of inflammation of the lungs, pleura, etc., even in children. If it is kept in the family medicine-chest, it should be distinctly marked poison.
Opium has obtained a very large place in the treatment of one dangerous inflammation, that of the peritoneum (peritonitis), which lines the whole interior of the abdomen. Opium tends to constipate the bowels, and powerfully affects the brain. It also tends to diminish secretion in the air-passages, and therefore it does not appear to be suitable, at least at an early stage, in inflammation of the bowels, brain, or lungs, or in acute bronchitis. After the excitement has subsided, in dysentery and in bronchitis, perhaps sometimes in pneumonia, it may aid in allaying pain and checking excessive discharges.
Counter-irritation is a term which explains itself. Endeavor is made to draw blood and nervous excitement from an inflamed part by a harmless irritation or inflammation somewhere else. Blisters are strong means of this kind. A blister is raised by leaving on the skin for a time a plaster made of ointment of cantharides; or painting the part with cantharidal collodion, and covering it, while moist, with a piece of oiled silk. With a child, an hour or two will generally be enough to allow the cantharides (Spanish fly) to act. In a grown person, it may require three, four, or more hours. There should always be a piece of gauze between the skin and the blistering plaster, so that it can be entirely removed at the proper time. When it is taken off, the scarf-skin (cuticle) being raised in watery swellings, these may be pricked with a point of any kind, to let the water out. Then there should be placed over the sore surface a piece of muslin or lint thickly spread with simple cerate, to heal it up in two or three days.
The time for blistering (which is only called for in rather bad attacks of internal inflammation) is not at the beginning of the case, but after the excitement of the circulation has ceased. The disorders, in the course of which, at such a stage, a blister is most likely to do good, are inflammation of the brain, pneumonia, pleurisy and membranous croup.
Other modes of counter-irritation are, painting the skin with tincture of iodine; rubbing over a small surface a drop or two of croton oil; or a little tartar emetic ointment.
Painting with iodine is a milder measure than blistering with cantharides; and it may be resorted to in a greater number of cases, of moderate violence. Croton oil and tartar emetic ointment are only employed in obstinate chronic cases of irritation of internal organs. They produce very sore, pimply, or pustular eruptions.*
* If either of these should be used, great care must be taken not to get the oil or ointment into any one's eyes. A patient of mine nearly blinded himself by neglecting this precaution; putting his fingers to his eyes just after rubbing croton oil upon a part of the skin.