17(5 
HINTS TO TRAVELLERS. 
Let the patient lie quiet so as to retain the enema. Up to four enimols 
may be given in the day. Too much ipecacuanha cannot be given, but 
the effect of the opium should be watched, and if more ipecacuanha is 
wanted, administer it in the form of tabloids which do not contain opium. 
Sedatives, such as laudanum or chlorodyne, are of use only so far 
as they relieve pain, sickness, and great distress; the full dose in an 
ordinary case is twenty drops three times a day, but if less is sufficient, 
so much the better. Drowsiness is a sign that the patient has had as 
much as is good for him; no patient should take more than twenty drops 
at a time, unless it is ordered by a doctor. 
Poultices, mustard plasters, and hot fomentations to the belly, do 
good by lessening the congestion of the bowels and liver. 
If the lower bowel is uneasy, then a small enema, say of ten ounces of 
warm water, may afford considerable relief, or a soothing enema may be 
administered. (See Enemas, p. 234.) 
As the disease begins to abate, reduce the ipecacuanha and give tannin, 
five grains or more, three times a day; then half that amount. If diar¬ 
rhoea is very profuse, bismuth or tannin may be given during the attack 
to assist the bowel by their astringent action. Sulphate of iron, or the 
solution of perchloride of iron, are useful when the acute symptoms 
subside, as they are astringent and tonic. 
Bicarbonate of soda, five grains or more, dissolved in an ounce of 
water, is useful, as it allays irritation of the stomach; it may be given 
two or three times a day from the first. 
Treatment by Epsom Salts (Sulphate of Magnesia).—The guide to the 
amount of salts necessary is the frequency of the motions caused by 
them, and the amount of relief of the painful symptoms. After one or 
two motions caused by the salts, it is noticed that the patient has not the 
same constant desire to go to stool, and that fewer motions are passed ; 
that they are more copious, and gradually become a better colour. 
The object is not to violently purge the patient, but to keep the bowels 
gently acting. 
Recently, a great number of cases of dysentery have been treated with 
marked success by giving sixty grains of Epsom salts every four hours; 
sulphate of soda may be used instead of Epsom salts and is less irri¬ 
tating. This treatment cures by causing constant free action of the 
bowels, and the consequent immediate removal of poisonous material. 
