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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    powerful enough to destroy aural polypi, or the coarse granulations on an old ulcerated surface. It is admirably adapted, however, to coagulate the albumen on the surface of an ulcerated patch, givmg rest to the parts and, by creating a protectant, lessens pain and dmiinishes conges- tion Ind inflammation. It is, thus, chiefly used in Ulcerations of the Larynx, especially of the parts defining the aperture, including the epiglottis. It has little or no value in removing recent, infective exudates, though Gonzales Domingo {Gaceta Medica Catalana, Barcelona, Sept., 1886) claims that it is useful in Diphtheria. In closing superficial Fis- sures of the lips and tongue, and in obliterating congeries of small vessels in limited area by coagulating the connective tissue between them, the solid stick is in high repute, and often takes the place of the knife in removing blood from the affected spot. Keene recommends it in this way as a destructant of Aural Furuncle when seen in the first stage. As a hsemostatic it is of use only when the blood escapes from a small abrasion or ulcer. Under such conditions it acts promptly. Thus it often checks an Epistaxis. Since the albuminate which stops a bleeding vessel is thin and is soon absorbed, nitrate of silver cannot take rank as a hsemostatic with those styptics which ''tan the connective tissue. It may be applied fused- on the end of a probe, or a silver probe may be dipped in nitric acid. Care should be exercised in using fused nitrate of silver on the vocal cords; cicatricial nodules are described as following its use, especially when large areas are covered (C. E. Sajous, Trans. Laryng. Ass'n, 1878). Reflex spasm has been noted as a result, which may be now largely avoided by previously sponging the parts with a ten per cent, solution of cocaine. When the mitigated stick in any fixed strength is converted into a powder by scraping with a sharp knife, a convenient form is obtained for insufflation. More commonly, however, powders are prepared by mixing the fused nitrate of silver, which has been triturated, with starch, lycopodium, or sugar of milk. Herzog ( Der acute und chronische nasenrachen Catarrh, etc.) employs boric acid as the agent for dilution, and claims good results in the treatment of Acute and Chronic Inflam- mation OF THE NaSO-PHARYNX. The introduction into the glottis with a sponge saturated with the crystals of nitrate of silver, of the strength of forty, fifty, or even sixty grains of the salt to the ounce of water, does not produce, ordinarily, as much disturbance as the accidental imbibition into this cavity of a few drops of tea or pure water.—(^H. Green, '■'■A Treatise on the Diseases of the Air-passages,etc., 1858, p. xvi.) While this is undoubtedly true, nitrate of silver, in almost any strength of solution, applied to the inte- rior of the larynx, may cause violent spasm of the muscle of the glottis, and the physician should never be off his guard with respect to this possi-