DYSENTERY. 247 



drink of any kind for about three hours, the medicine seldom causes any incon* 

 venience. Some people precede the ipecacuanha by a dose of thirty drops of laudanum, 

 to prepare the stomach, as they say, for its reception ; but this is quite unnecessary, 

 and involves the loss of valuable time. Should the ipecacuanha, however, be rejected 

 in spite of all precautions, it must be given in the form of an injection. The effects 

 of the medicine in suitable cases are almost instantaneous, the motions even in the 

 worst cases becoming natural in frequency and character. Very frequently, ninety 

 Bruins of the ipecacuanha will cut short at once severe attacks of dysentery, not only 

 restraining the discharge, but immediately freeing the patient from pain, and removing 

 the straining and griping. After a dose of sixty or ninety grains, an interval of ten 

 or twelve hours should be allowed to elapse before repeating it, and should the bowels 

 in the meantime have remained quiet, even the second dose may be unnecessary. 

 When only twenty or thirty grains have been given, the dose may be repeated in 

 about eight hours, the precautions respecting perfect quiet and abstinence from food 

 and drink being observed as before. After taking the medicine, the patient often 

 falls asleep, and awakes refreshed, and in fact quite another man. As a matter of 

 precaution, smaller doses of the ipecacuanha say ten, five, or three grains should 

 be given daily for some days. No other treatment is, as a rule, necessary ; but a 

 large mustard poultice applied over the abdomen often proves grateful to the patient. 

 During the acute attack no solid food should be given, but the patient's strength 

 should be supported by milk and similar unimtating diet. The disposition to relapse, 

 which is so common in acute dysentery, is seldom observed after this method of 

 treatment, a point of no small importance. 



The treatment should always be commenced with ipecacuanha, but in some 

 epidemics it is less successful than in others, and it is consequently an advantage 

 to have other methods of treating at our disposal. Mercury given frequently and 

 in small doses often proves successful. A tea-spoonful of the mixture (Pr. 48), given 

 hourly or every two hours, according to the severity of the case, rarely fails to free 

 the stools from blood and slime, although a diarrhoea of a different character may 

 continue for a little while longer, and perhaps require other remedies for its 

 removal. 



When the motions contain much blood, the tincture of hamamelis virginica 

 may be given hourly in drop doses, with the view of arresting the haemorrhage, 

 or Pr. 45 may be employed. 



In chronic dysentery both ipecacuanha and mercury may be used with almost 

 as much success as in the acute form. The precautions we have enjoined after 

 taking the ipecacuanha should be strictly observed. Chronic dysentery, however, 

 is an obstinate disease, and we cannot have too many strings to our bow, so we will 

 consider what other drugs will do for us. Alum often proves of service, and 

 acetate of lead in five-grain doses every four hours is a good remedy (Pr. 30). 



The solution of per-nitrate of iron does admirably in the case of men returning 

 to this country from tropical regions, more especially when they are suffering from 

 anaemia, as the result of loss of blood and the depraving influence of malaria. It 

 should be given in thirty-drop doses three times a day in a little water. Under the 

 influence of this remedy the whole system often rallies wonderfully, colour returns 



