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.

    122/554 (page 110)
    by diminution of secretion the amount of outflow of mucus is increased JNitrate of silver also aids in arresting bleeding, and is an excitant to absorption of the products of inflammation. Varying strengths of nitrate of silver are employed. Those usually named are one, two, five, ten, twenty, forty, sixty, eighty and one hun- dred grains, or a saturated solution which is represented by four hun- dred grains to the ounce of water. Any solution of a strength above forty grains is often spoken of as a stronger or concentrated solution Weak solutions convert transparent mucus into a white, less tenacious fluid, while stimulating the membranes on which the secretion rests. The stronger solutions destroy the epithelium. The coagulum is soon detached, thus presenting advantages over more adherent forms caused by application of solution of the salts of iron. The caustic impression of nitrate of silver is superficial; concentrated solutions coagulate the albumen in the submucous tissue to a slight depth. The eschar is at first white, then gray. All solutions are stable only when kept away from the light by being placed (small quantities at a time) in a bottle covered with blue paper. The action of the light is to decompose the nitrate and to substitute for it the oxide of silver, which is said to be comparatively useless. Perhaps there is no remedy in-the entire list of local therapeutics con- cerning which a greater variety of opinion has been expressed than is the agent now under consideration. It is a favorite remedy of many practi- tioners in the local treatment of the nose and larynx; rarely used by some, while discarded by others. Doubtless, the extensive range of drugs which have been introduced of late years for local medication have greatly limited the value of this time honored agent. In using the pure salt the following method is recommended : A small quantity is melted in a platinum crucible or test-tube. The warm roughened end of a platinum or aluminium probe is inserted in the molten mass, thereby causing a small quantity to firmly adhere. Such an applicator can be used without danger of any portion of the solid becoming detached. A saturated solution is readily obtained (when a small quantity only is needed) by rubbing a piece of a sponge on a crystal of the salt, by such means the dangers arising, from the use of the brittle fused stick is avoided. J. Solis Cohen refers to a case of fatal laryngitis caused by dropping a piece of nitrate of silver into the larynx. This writer commends for application to the pharynx what he terms the caustic pencil, which is a safe and admirable method of applying nitrate of silver. The pencil is in the form of a lead pencil, the nitrate of silver being enclosed between two pieces of wood, after the manner of the stick of plumbago. The cautery effect of the solid stick is comparatively weak. It is not