GALL-STONES AND BILIARY COLIC. 299 



Now, as to the treatment of an attack of biliary colic. "What are you to do 

 when you are seized with the pain ? Take a draught containing twenty-five drops 

 of laudanum, fifteen drops of chloric ether, half a tea-spoonful of sal-volatile, and 

 twenty grains of carbonate of magnesia, in a wine-glassful of water. Should you 

 not have all the ingredients at hand, put in as many as you can. Anything that 

 ordinarily relieves spasm may do good. A stiff glass of hot gin and water is always 

 ivudily obtainable. 



A hot bath should be prepared as quickly as possible, and the patient should 

 stay in it as long as he can bear it, or until he feels some relief. As a rule the 

 pain is so great that he cannot remain quiet for any length of time, and soon 

 wants to come out. 



Hot poultices, or fomentations sprinkled with laudanum, or belladonna liniment 

 may then be applied to the abdomen. A mixture of equal parts of belladonna 

 liniment and chloroform liniment applied as a fomentation over the liver, or the 

 seat of pain, under oiled-silk, will often give great relief. 



Immediate relief is sometimes afforded by large draughts of hot water, con- 

 taining two drachms of bicarbonate of soda to the pint. The soda counteracts 

 the distressing symptoms produced by the acidity of the stomach, while the hot 

 water acts like a fomentation to the seat of pain. The first portions of water 

 are commonly rejected almost immediately, but it may be repeated, and after 

 some time it will usually be found that the pain will become less, and the water 

 will be retained. Another advantage is that the water abates the severity of 

 the retching, which is usually most severe and dangerous when there is nothing 

 on which the stomach can react. This plan does not supersede the use of laudanum, 

 and in some cases a few drops may be advantageously added to the bicarbonate of 

 soda solution, if it have been once or twice rejected. 



Should these measures fail to afford relief, a hypodermic injection of morphia 

 will have to be given, and it would be as well to send for the doctor. Half a 

 grain of morphia that is, six minims of a one-in-twelve solution injected under 

 the skin of the forearm will usually afford relief. This is the full dose, and should 

 not be exceeded. When much laudanum or opium in any form has been adminis- 

 tered, rather less morphia should be injected, say four or five minims. The great 

 advantage of the hypodermic injection of morphia is that it acts so promptly. 

 It must not be given to children or young people. When a hypodermic syringe 

 is not at hand, a pill containing a grain of solid opium, or a quarter of a grain 

 of morphia, may be given every two hours till three doses have been retained, 

 or the pain subsides. If the patient is at all drowsy he is not to have any more 

 opium or morphia in any form. 



Belladonna is another very excellent remedy, and is indicated when there is 

 any reason for not giving opium. Four pills may be ordered, each containing 

 half a grain of extract of belladonna, and one of these may be given every 

 two hours. A subcutaneous injection containing one-sixtieth of a grain of atropia 

 the active principle of belladonna with a quarter of a grain of morphia may 

 be administered, and repeated if necessary every two hours. We should advise 

 tJiat such remedies as these should be given only by a doctor ; but a patient is 



