A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

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    INTRODUCTION On the Local Action of Remedies.—Since much of the success of local medication depends upon the method adopted and the manner in which details are carried out, the following general comments may prove useful: — (1) All forms of inspissated secretions, desquamations and filth are in themselves exciting causes of disease; therefore the selected lotion, unguent, or powder is not to be applied until surgical cleanliness is secured. The skin is to be freed from detritus and fat, and, so far as is practicable, the mucous membrane from mucus. The surface, if that of an ulcer, should be cleansed of exudates. (2) In congestion it must remain a matter of judgment whether or not to deplete the blood-vessels before the employment of an anodyne or an astringent. It is certainly true that an agent will often fail on a region where the smaller vessels are constricted when it will succeed on one where they are of normal diameter or even dilated. (3) It is necessary to remember that agents act in exact correlation to the structures to which they are applied. Bone, periosteum, or the mucous membrane covering the alveolar processes and the roof of the mouth, must be attacked by stronger preparations than are safe to be used on the conjunctiva or the urethra. Even different regions of the general skin surface demand that discrimination be exercised in the choice of strength of remedies. To enforce the value of this remark, it is only necessary to contrast such localities as the sole, the palm, the scalp, and the region of the nape of the neck, with the scrotum, the perineum, the eyelids, and the mammae. A drug may excite in the one instance, but excoriate or destroy in the other. (4) Unless the constringing effect of cold be especially indicated, local applications should be of the temperature of the body, or slightly above it. Elevation of temperature may make the difference between success and failure. As a rule, all inhalations should be warm. Lotions to the nostrils and the throat are almost always increased in efficacy if the temperature is raised to 140° F. (5) The local uses of drugs, other than those which act as germicides, are subject to sharp limitations. Few of them are free from evil effects