74 TREATMENT OF DISEASES 



These agents will probably moderate the heart's action and re- 

 lieve the pain ; should they fail to do so, we must resort to nauseants 

 and sedatives. The most popular nauseant for horses, is white helle- 

 bore, yet it is an agent that can only with safety be used under the 

 direction of a qualified practitioner. Mr, Morton recommends it to 

 be given in " doses of from twenty to thirty grains, every four or 

 six hours, until its action becomes manifest. As soon as this takes 

 place, the repetition of the dose must be carefully avoided, lest 

 efforts to vomit are produced." 



Should we fail in the use of one or more of the above remedies, 

 to lessen the heart's action, and the pulse be fifty or more per min- 

 ute, the breathing somewhat hurried, and the pain excruciating, then 

 a full dose of medicine must be given (about seven drachms of 

 aloes). It may be proper to administer a physic ball in the early 

 stage of the disease, and pei'haps employ the lancet ; these are mat- 

 ters which may be left discretionary with the medical attendant. 

 If a mild diaphoresis can be brought about, it wall do more good 

 than we can expect from the use of either lancet or cathartic. A 

 constipated state of the bowels, however, must be overcome either 

 by physic, mashes, clysters, or saline aperients. The bicarbonate of 

 soda is a very valuable adjunct in the treatment of acute rheuma- 

 tism, because, in seven cases out of ten, the whole system is in rn 

 acid condition, and if we can (in the language of the chemist) sat- 

 urate it with alkali, or in other words, establish an alkaline condition, 

 our patient is on the high road to health. 



Now, in case a cathartic be indicated, we must consider the con- 

 dition of the patient ; he may be suffering excruciating torment, 

 from inflammation of the pleura, pericardium, or sjTiovial mem- 

 branes, and if so, our object must be to mitigate pain in the use of 

 opium or some other narcotic ; should the patient, therefore, exhibit 

 lameness in one or more of the extremities, and the joints of the 

 hind or fore limbs become swollen and painful, a local application 

 may be of some service, and in this view we recommend the fol- 

 lowing: 



Sweet Oil 3 ounces. 



Spirits of Ammonia J " 



Tincture of Aconite .... 2 " 



Chloroform 2 " 



Mix. Apply a portion to the affected limb or joint, twice, daily. 

 In an inflammatory state of the joints it is customary to apply 



caused neither eraesis nor catharBis, but passed ofiF by the kidneys. In another case of acute syno- 

 vial attack, following clironic rheumatism, the same dose was prescribed without any good effect, 

 causing active catharsis. Again, half an ounce of nitrate of potassa, largely diluted, was given every 

 two to four hours, until the patient took three ounces in eighteen hours, with two doses of opium of 

 one grain each, with entire relief to the pain and fever. When the potash was reduced to drachm 

 doses, nausea and vomiting followed, which were relieved by vesication with aqua-ammonia, the blis- 

 ter being sprinkled with half a grain of morphine. The patient recovered. Another piiysitian had 

 used the remedy to the extent of half an ounce in twenty-four hours, for three successive days. He 

 found that If the salt be given well diluted, it will purge, and vice verM-. The physicians of the Mas- 

 J5acliuselts (leneral Hospital had used the remedy, one ounce in twenty-four hours, without good 

 feffccts, and its use was abandoned. It api>ears to be conceded, that it is sale to give the remedy in this 

 quantity, although symptoms of gastritis sometimes followed its use ; but it was always largely diluted, 

 and generally in demulcent liquids. We are in the habit of giving It in rheumatii^m and other Inflam- 

 matory affections, in doses of twenty or thirty grains, every two or three hours during the i)erLod of 

 excitement or exacerbation, combined with tartar emetic; but have been deterred from the exhibnion 

 of the larger doses above mentioned, from fear of its toxical effect. We have found this combination 

 particularly useful in pneumonia. — Memphis Medical Jieoorder, 



