MORBUS MACULOSUS WERLHOFII 497 



It is important that attention be paid to the fecal discharges on account of 

 possible hemorrhages and intestinal parasites (or their ova). In case of con- 

 stipation no salmes should be used, but only mild vegetable laxatives, such as 

 castor oil, tamarinds, rhubarb, caseara sagrada and others; enemata and irri- 

 gations of water may also be utilized. Laxatives should be changed frequently 

 so that the intestine may not become accustomed to a certain remedy 



_ Special Treatment.— Upon the authority of Werlhof, sulphuric acid is 

 given, even to-day, m the form of Haller's acid elixir, which Werlhof praised 

 as a specific. He also advised in purpura decoctum cortex chinje (8-10: 200, 

 a tablespoonful every two hours). The administration of ergot, of lead ace- 

 tate, turpentine, and liquor ferri sesquichlorati has been based upon the 

 pathology of the disease. In very stubborn, frequently relapsing cases, I 

 have seen good results from arsenic in the form of Fowler's solution, espe- 

 cially in combination with carbonated or warm baths rich in salt. I can 

 highly recommend this treatment, particularly in the cases in which all other 

 methods have been without result. 



Henoch has used ergot in the following manner : 



^l^ Ext. secal. cornut 1.5 



Aq. destill 150 



M., D., S. : For children a teaspoonful, for adults a tablespoonful, every 

 three hours. 



I cannot so strongly recommend this. Liquor ferri sesquichlorati may be 

 given in gruel, from one to five drops three times daily. 



The following medication is also advised, although I have never seen any 

 results from it : Twenty to thirty drops of the fluid extract of hydrastis cana- 

 densis every two to three hours. 



In poliosis rheumatica the employment of sodium salicylates, aspirin and 

 antipyrin is worthy of trial. 



In epistaxis, dorsal decubitus with the head low, cold to the nape of the 

 neck, and liquor ferri sesquichlorati are indicated. The insufflation of cold 

 water, to which a few drops of the previously mentioned iron salt are added, 

 will often control the hemorrhage. Tampons of cotton dipped in the iron 

 solution may also be necessary. Gastric and intestinal hemorrhages are to be 

 combated by ice in combination with opium. Therapeutic requirements are, 

 however, rarely necessary, as the condition is infrequent. The same is true 

 of renal hemorrhages. 



With symptoms of collapse, stimulants are to be used (wine, coffee with 

 brandy, champagne, camphor, ether). The application of heat may become 

 necessary (hot bottles, hot sand bags). In severe cases hypodermoclysis of 

 physiologic salt solution, to which oxygen has lately been added with success, 

 may be resorted to. 



During convalescence the patient must be placed on a nourishing diet. 



Eesidence in the country, by the sea, or in the mountains is advisable. Of 



drugs, iron is the best. The urine is to be frequently examined even after the 



actual disease has run its course, for sometimes in immediate sequence or a 



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