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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    I I 2 bihty. If spasm should occur, the patient should be enjoined to keep perfectly calm, and attempt to draw air into the lungs. Should this fail a few drops of nitrite of amyl should be placed on a handkerchief, and the patient again urged to make another attempt at an inhalation. In Otorrhgea, nitrate of silver is employed, in the strengths of one grain to ten grains to the ounce. It is instilled in the external meatus in Perforation of the Tympanum, or carried by means of Blake's syringe directly into the middle ear through the perforation in the tym- panic membrane. A. H. Buck ^Trans. Otological Soc, 1873, P- 72) be- lieves '' that nitrate of silver should rank as one of the safest reagents to employ in stimulating the tympanic mucous membrane to healthy action. Nevertheless, degrees of strengths which are appropriate for one part of the affected mucous surface may over-excite an adjacent one. In ad- dition, the tenacious mucus may be converted into a tough coagulum and disguise the appearance of the underlying parts. As-a rule, a quantity of the mitigated stick of desired strength should be scraped so as to form a powder, to be applied by a probe or cotton-carrier to the selected spot. For Acute Inflammation of the External Meatus, weak solutions, from one to two grains to the ounce, are efficient (Kramer). In Moist Eczema, from ten to twenty grains to the ounce are well borne (W. H. Dalby). In the coarse fibroid granulations which sometimes surround the orifice in a neglected Aural Catarrh, with purulent discharge through the tympanic membrane, a solution of thirty to sixty grains to the ounce can be used with advantage. In the condition named, the solution should be carefully mopped on the growths, and the meatus subsequently flooded with a weak sodium chloride solution. Nitrate of silver is less frequently used in the Eustachian tube, though Kirchner recommends a weak solu- tion in Chronic Inflammation of the Lining Membrane. Forty grains, in solution, is claimed by O. D. Pomeroy {Med. Record, 1871, p. 31) to be an efficient application to Polypus of the middle ear. Perhaps nitrate of silver is used more frequently in this country for the treatment of Follicular Chronic Pharyngitis than is any other agent. Its value has been tested for so many years that its reputation may be con- sidered well established. After the mucus has been removed the agent is, as a rule, applied in solutions, the strength varying from forty to sixty grains. The hypertrophied masses are to be carefully sought for and each touched with the medicine carried to the affected spots on the end of a cotton carrier, sponge, or other proper instrument. The mucus is coagu- lated and the submucous infiltrations are actively absorbed. Mackenzie advises that in Granular Pharyngitis the separate nodules be incised and the solid stick be carried to the interior. On the whole, the agent is less efficacious in the naso-pharynx. The parts are here more easily excited by nitrate of silver, than is the case in the oro-pharnyx—a fact