140 THE TREATMENT OF DISEASES. 



but if there is much bleeding do not stop to weigh it, throw a little into a tumbler 

 of water, stir it up, and make him toss it off. If you have nothing but alum, 

 this must do ; dissolve some in water, and make him take that, and give him some 

 pieces to suck as well. Should faintness occur, it need excite no alarm, as it 

 favours the coagulation of the blood, and may tend to arrest the bleeding. Should" 

 the faintness persist, iced champagne is an excellent restorative, and is not likely 

 to excite vomiting. ; . 



After the first sharp bout is over, and all immediate danger is passed, abstinence 

 from solid food should be enjoined, with perfect rest in the horizontal position. The 

 room should be kept cool, and iced acidulated drinks should be taken at intervals. 

 It may be necessary to continue the use of one of the astringent mixtures. Probably 

 the best is the acetate of lead (Pr. 30), two table-spoonfuls being taken either 

 every three or four hours, according to the condition of the patient. After a 

 severe attack it may be necessary to abstain from giving any solid food by the mouth 

 for some days, the strength being supported by nutritive injections. If anything is 

 given by the mouth it had better be milk or beef -tea ; but these must be cold, and 

 nothing hot is to be taken. When there is much prostration it may be necessary to 

 resort to the use of beef-tea enemata, containing a little brandy and twenty drops 

 of laudanum. The laudanum allays the excitement, but should not be given oftener 

 than three times a day, and its use should be discontinued as soon as possible. "We 

 have recommended the addition of brandy where there is much exhaustion, but 

 stimulants should not be given unless there is some absolute necessity for them, as 

 they are very apt to excite the bleeding. In some cases it may be necessary to give 

 cream, raw eggs, essence of beef Brand's is the best various broths, and perhaps 

 even cod-liver oil. When the bleeding is known to be dependent on liver disease, 

 a good purge, say a compound jalap powder, or a three-grain calomel pill (Pr. 61), 

 at bed-time, and a black draught in the morning, will do good by getting rid of 

 the congestion, but this treatment would be hurtful in either ulcer or cancer of 

 the stomach. When the complaint becomes chronic, and there is only a little 

 spitting of blood occasionally, the gentian and acid mixture (Pr. 15) will often 

 answer well, and the quinine mixture (Pr. 9) also proves valuable in many 

 instances. 



We have by no means exhausted all our remedies for haematemesis. We have 

 already had occasion to refer to the employment of hamamelis virginica in different 

 kinds of bleeding, and it succeeds capitally in haemorrhage from the stomach. The 

 tincture should be given in drop doses in water every ten minutes, until the bleeding 

 is arrested. By many people it is considered to be the best remedy in these cases, 

 and undoubtedly it often acts admirably. When the haemorrhage is accompanied or 

 preceded by flushed face, shiverings, and quick pulse, aconite should be given accord- 

 ing to Pr. 38. When the blood is bright red, and the face is pale, ipecacuanha 

 should be tried (Pr. 50). It is often used after or in alternation with aconite. 

 Ipecacuanha is especially indicated in haematemesis vicarious of menstruation. In 

 these cases, when the catemenia desert their natural channel and seek an outlet 

 through the stomach, it will be well, while means are taken to discourage the 

 haematemesis, to endeavour to solicit the discharge in the right direction. And we 



