ACUTE DISEASES OF 'IHE OKGANS OF EESPIKATION. 219 



If these simple remedies do not altogether avert, or at least bring 

 about subsideuce of the attack withiu a very shoi't time, we must have 

 recourse to medical treatment. 



442. Treatment of the attack. 



Neutral salts dissolved in water have a marked effect in relieving the 

 feverish symptoms. For this pm-pose two ounces of sulphate of soda or 

 one ounce of nitrate of potassa may be dissolved in a pailful of water, and 

 the patient may be allowed to drink as much as he pleases. If he finishes 

 the pailful, another may be given him. If the bowels are constipated, as 

 is often the case, two ounces of Epsom salts dissolved in water with half 

 an ounce of nitrate of potassa may be administered twice a day. The 

 constipation may, however, be relieved often permanently by repeated 

 enemas of warm soap and water. 



If the legs notwithstanding friction and bandages remain persistently 

 cold, a mustard plaster may be applied to them and washed off after 

 fifteen minutes and the bandages reapplied, or they may be rubbed with 

 turpentine liniment. 



Diffusible stimulants, which were recommended above dui'ing the pre- 

 monitoiy symptoms, are not suitable during the dry stage. But when 

 the strength begins to fail, as is often the case after the dry stage has 

 continued for some time, and during the second or moist stage diffusible 

 stimulants such as carbonate of ammonia in doses of from one to two 

 drachms combined with, small doses of gentian and ginger once or twice 

 a day, or an ounce of sweet spirits of nitre repeated every four or six 

 hours are very beneficial, and may be given from time to time as may 

 be required. 



During both the dry and moist stage much relief will be afforded by 

 frequently fomenting the sides with woollen blankets wrung out of hot 

 Avater and covered with a waterproof sheet, as recommended for Bron- 

 chitis. After each fomentation any parts not thoroughly dried may be 

 gently rubbed with liniment of ammonia with the view of preventing the 

 effects of the cold air, and covered with light warm clothing. 



The system which was formerly adojited of applying repeated appli- 

 cations of mustard, or mustard and ammonia, to the sides and chest in 

 lung diseases is rapidly becoming discontinued ; but as it is still adopted 

 by some practitioners, the Author considers the following remarks with 

 reference to the application of these external stimulants may be useful. 



The stimulating effect caused by these agents is produced very rapidly. 

 It will be sufficient to allow them to remain on the skin about ten or 

 fifteen minutes, after which they should be washed off. If the mustard 

 is allowed to remain on longer, it loses its stimulating action and is apt to 

 be absorbed into the system, where it will act injuriously. "When the 

 effect of the stimulant has passed off, say in a couple of hours, it may be 

 repeated and again washed off as before. These applications may be 

 used occasionally, if relief appears to be gained by them. If ordinary 

 household mustard, Avhich is usually largely adulterated with flour, be 

 used, half a pound, or about that quantity, will be required at each 



B 



