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.

    128/554 (page 116)
    A twelve per cent, solution is one of the older methods in the treat- ment of Membranous Croup. Before the days of laryngoscopy a mixture of nitrate of silver and lycopodmm was inhaled from a small receiver placed far back into the pharynx. The strength of the powder varied from one per cent, to twelve per cent. Inhalations of the nascent forms of nitrate of silver have been recom- mended by Bidenkap in the treatment of Chronic Inflammation of the Lining Membrane of the Respiratory Tract. A writer in the Journal of Laryngology and Rhinology, 1887, page 322, believes that this method should be restricted to the treatment of Chronic Bronchitis and Emphysema and recommends the following plan: One part of nitrate of silver to three parts of ammonic nitrate are placed in a small crucible or evaporating dish, the whole heated by a spirit lamp. Each inhalation should last no longer than from thirty to forty-five minutes. The atmosphere of the room being suffused with minute portions of nitrate of silver capable of discoloring ail white textures they light upon, care should be taken to protect clothing, etc. Diseases of the Eye.—Nitrate of silver is perhaps more extensively used than any other coUyrium, and, though in modern practice it is applied less freely and generally than of old, as the indications for its use have been more clearly outlined, it has mainly held its own for many generations. In the treatment of Inflammatory Diseases of the Conjunctiva it would be better to be deprived of any or every other topical application than of this old and well-tried agent, for by judiciously varying the strength of the applications and the manner of making them we can get the effect of an astringent, caustic, stimulant or antiseptic. Simple Acute Conjunc^tivitis is better treated with milder applica- tions, such as boric acid, borax, alum and tannin, but in the more chronic form the nitrate is a most useful remedy. It is not well borne by the cornea and, according to some authorities, may cause permanent opacity where there are ulcerations, by its action in coagulating albumen. It should, therefore, not be dropped into the conjunctival sac in stronger solution than one or two grains to the ounce, and as a rule should be applied by the surgeon or under his immediate supervision, as its long continued use will cause an immovable and most unsightly staining of the conjunctiva. Some years ago it was not uncommon to meet with patients disfigured by this local argyria for life, but such an occur- rence is now fortunately very rare. In the Chronic Forms of Simple Conjunctivitis the mucous lining of the upper lid is most affected, and the application should be made to it directly, by means of a brush, or, better, of a pledget of absorbent cotton on the end of a fine probe or small stick, as the latter may be