156 DISEASES OF THE PARENCHYMA OF THE LUNG. 



fling and wiping the nose in epistaxis. Finally, remove all portions of 

 the clothing which press upon and confine the chest, and cause the 

 patient to assume a half-sitting posture in bed. The most powerful 

 means of combating the bleeding is the use of cold. We apply this 

 in the form of cold compresses, and, when the bleeding is very severe, 

 in the shape of frozen compresses.* 



In addition to this, let him swallow small pieces of ice, or give 

 small doses of ice-water ; or we may apply the cold in the form of clys- 

 ters, to which, from time immemorial, a little vinegar has always been 

 added. Besides cold, a number of substances have the reputation of ar- 

 resting haemorrhage without our being able, physiologically, to explain 

 how they act. Under this head, before all others, come two remedies : 

 common salt, and the acids, which, curiously enough, when taken in ex- 

 cess, occasion a scorbutic state of the blood, a bad nutritive state of the 

 capillaries, and lead to hemorrhage. However this may be, we must 

 make the patient swallow one or two spoonfuls of finely-powdered, dry 

 salt. Sulphuric, or phosphoric acids, are still more preferable, especial- 

 ly the elixir acidum Halleri, of which we give ten drops every two 

 hours, mixed in a sufficient quantity of water. A series of other haemos- 

 tatic remedies follow these, which are not of such generally acknowl- 

 edged efficacy as the acids, and which, being less innocent, are therefore 

 less highly esteemed. Among these is acetate of lead, of which the 

 English physicians maintain that, for internal haemorrhage, there is 

 " nullum simile aut secundum." Next come secale cornutum, oleum 

 terebinthinae, balsam copaivae, rhatany, and other medicines. 



Wunderlich particularly recommends the exhibition of secale cornu- 

 tum, in doses of from five to ten grains, until a prickling and numb sensa- 

 tion in the fingers sets in. A formula, much in use in very obstinate ha> 

 moptysis, is $. Balsam copaiv., syrup balsam, aquae menth. piper, spirit, 

 vim rectif. aa j ; spirit, ether nitrici 3 ss ; HI. S. 3 ij every two to four 

 hours. These various drugs are only to be made use of in very dangei- 

 ous cases, and we should not forget how impotent all these styptics are 

 in severe bleeding of the nose, where, moreover, we are able to apply 

 them directly to the bleeding point. Latterly, inhalations of a solu- 

 tion of sesquichloride of iron (3j to 3 ss with vj) has been recom- 

 mended as exceedingly serviceable against haemoptysis. The most 

 alarming haemorrhages are said to have been arrested, by this means, in 

 the course of four or five minutes. My own experience does not con- 

 firm this recommendation. The narcotics should be employed freely. 

 The more restless the patient, the more violent his cough, so much the 



* Fill a tin or copper warming-pan with ice, salt, and water, then lay it upon a 

 well^>queezed wet compress, the moisture of which soor freezes. These compresses 

 are greatly to be preferred to the heavy bladders of ice. 



