substitute for Belladonna [Atropa Belladonna, _Linn._, is an indigenous
shrub, in the Western Temperate Himalaya, alt. six to eleven thousand
feet; from Kashmir to Simla (Flora British India), and the Kuram Valley,
_Aitchison_]—in the treatment of _Cataract and other Diseases of the
Eye_. Its mydriatic (pupil-dilating) powers have been examined by
Sub-Assistant Surgeon Tarra Prosonno Roy (_Indian Med. Gaz._, Sept.
1870). He first applied a portion of a watery extract of the leaves of
D. alba around the eyes; the pupils became widely dilated, and continued
so for two days. He next tried an alcoholic extract of the seeds of the
same species prepared by macerating half an ounce of the seeds in four
ounces of country spirit, evaporating the tincture to dryness on a water
bath, and dissolving the residue in one ounce of water. Experiments made
with this solution prove beyond a doubt its power of causing dilatation
of the pupil when locally applied; the strength of this watery solution
being, at a rough estimate about equal in power to a four-grain (to the
ounce) solution of Atropine.
129. _In Asthma_, the dried leaves and stem cut small and smoked, like
tobacco, in a pipe, afford in many cases great relief. In some the
benefit is immediate and striking, in others it has little effect, and
in a few it acts injuriously; its value in any case can only be
ascertained by personal experiment, but it is worth a trial in all
cases. When the leaves fail, the dried seeds, which are thought to be
more powerful, may be tried. The earlier in the attack it is employed
the greater are the chances of success; it has little effect when the
attack has lasted for some hours. For a person subject to asthma, a good
plan is to adopt the habit of smoking a pipe of it the last thing at
night, whether an attack is threatening or not; at any rate, he should
keep a pipe of it already filled, with the means of lighting it, by his
bedside, so that, immediately on an attack commencing, he may use it.
From ten to twenty grains of the dried plant is sufficient to commence
with; it may subsequently be increased to thirty grains, but in all
cases it should be immediately discontinued if it produces giddiness, a
feeling of sickness, or any other unpleasant symptom. Serious, and even
fatal, consequences have followed its incautious use, hence too much
care cannot be exercised in its employment. In _Chronic Coughs_, where
the cough comes on in violent paroxysms, and is hard and dry, with
scanty expectoration, smoking Datura (_ante_) proves beneficial.
130. _For Rheumatic Swellings of the Joints_, _Lumbago_, _Painful
Tumours_, _Nodes_, _&c._, Datura, locally applied, often proves most
serviceable in relieving pain. There are four modes, in either of which
it may be advantageously employed: 1. POULTICE, made by bruising the
fresh leaves into a pulp, and mixing them, with the aid of a little
water, with an equal weight of rice flour, to the consistence of a
poultice. 2. EPITHEM; which consists of steeping a few entire leaves in
arrack or other spirit, and placing them, whilst wet, over the seat of
pain, and securing them in that position by a bandage. 3. FOMENTATION;
made by infusing the leaves in boiling water, in the proportion of one
ounce to each pint of fluid, and applying as directed in paragraph 393.
4. LINIMENT; prepared by macerating, for seven days, one ounce of the
bruised seeds in a pint of Sesamum or other bland oil, and straining. In
addition to the above-named affections, these preparations, applied to
the loins, are useful in relieving _the pain attendant on painful or
difficult Menstruation_, and in some _painful affections of the Uterus_;
in the latter, they may more advantageously be placed over the lower
part of the abdomen. They also prove beneficial in relieving _Neuralgic
pains, especially of the Face_; for this the liniment is best adapted,
well rubbed in over the seat of pain, and along the space immediately in
front of the ear, or rather, in the narrow space between the ear and the
jaw.
131. _In Tetanus or Lock-jaw, consequent on a wound_, Datura is worthy
of a trial in the absence of more effective agents. Poultices of the
leaves, renewed three or four times a day, should be kept constantly to
the wound, which should be further cleansed if covered with thick
discharge or slough, by the process of irrigation of tepid water (395).
The Tincture of Datura, in doses of 20 to 30 drops in water, may also be
given internally three or four times daily. The dose must be regulated
by the effect produced, but it may be continued, unless the spasms
previously yield, till it produces full dilatation of the pupil with
some degree of giddiness, drowsiness, or confusion of ideas, beyond
which it is not safe to carry the medicine. If the spasms abate, _i.e._,
if they recur at more distant intervals, and are less severe and
prolonged when they do occur, the medicine, in smaller doses at longer
intervals, may be continued till the spasms cease altogether; but if,
under the use of the remedy, after it has produced its specific effects
on the system, the spasms show no sign of abatement, no good, but
perhaps harm, will result from continuing it. In addition to the above
means, Datura liniment (130) should be well rubbed in along the spine
several times daily. The patient should be confined to a darkened room
and protected from cold draughts of air; the bowels should be opened, if
necessary by turpentine enemas (364). The strength should be supported
by strong beef-tea, or mutton-broth (413), by eggs, beaten up with milk,
and by brandy-mixture (420) or other stimulants; if these cannot be
swallowed they should be given in enemas, for which purpose not more
than four ounces should be used at a time; larger quantities will not be
retained. The treatment detailed in this paragraph is advocated from the
success which has in some cases of Tetanus attended the use of
Belladonna—a drug to which Datura bears a very close resemblance in its
effects on the system: employed as above directed, it may be need with
perfect safety, provided that the case is carefully watched, and the
medicine diminished or discontinued on the full development of its
physiological effects.
132. _In cases of Guinea Worm_, a Datura poultice (130) is said to be
the most useful in relieving the pain, and hastening the expulsion of
the worm.
133. +Dill Seeds.+ The fruit of Anethum Sowa, _Roxb._
Sóyah, Suvá (_Hind._, _Punj._), Sóyí (_Duk._), Sóí-biól (_Kash._),
Shulphá, Shonvá, Shóvá (_Beng._), Shatta-kuppi-virai (_Tam._),
Shata-kuppi-víttulu (_Tel._), Shata-kuftá (_Mal._), Sab-basagi
(_Can._), Suvá-nu-bi (_Guz._), Sada-kuppa, Sata-kuppi (_Cing._), Samin
(_Burm._), Shatha-kupay, Adas pudus (_Malay_).
134. The Indian Dill Seed possesses no specific characters to
distinguish it from the European article, for which it may be
substituted. The Distilled Water, when procurable, is the best form, but
in its absence an infusion of the bruised seeds, 3 drachms to half a
pint of hot water, may be used; of this, when strained and cold, the
dose for an infant is a dessert-spoonful or more, sweetened with a
little sugar. It proves very effectual in relieving _Abdominal Pain,
Flatulence, and Colic in Children_. Its efficacy is often much increased
by the addition of a teaspoonful of lime water.
135. +Fish-liver Oil.+
Mach-chí-ká-tél (_Hind._, _Duk._), Machár-tail (_Beng._), Mín-yenney
(_Tam._), Chépa-núne (_Tel._), Mínnai, Malsyam-nai (_Mal._),
Míniná-yanne (_Can._), Mo-solícha-téla (_Mah._), Mín-tel, Mal-tel
(_Cing._), Miniak hati-yu putch (_Malay_).
136. Oil from the livers of the White Shark (Squalus Carcharias,
_Linn._), the Seir (Cybium Commersonii, _Cuv. et Val._), and other fish,
is now extensively prepared in various sea-coast towns of India. When
properly made it is of a fine amber colour; the smell and taste are
similar to Cod-liver Oil, but more strongly marked and more
disagreeable. The great objection to its use is its nauseous taste, but
this might probably, in a great measure, be obviated by extracting it by
the process of boiling the _fresh_ livers in water, instead of allowing
them to undergo a degree of putrefaction before the process of
extraction is commenced, as is the usual practice. As a medicinal agent
it appears to be quite equal to Cod-liver Oil, for which it forms an
excellent substitute; but where the stomach is very irritable, and the
aversion to it unconquerable, it may be advisable to have recourse to
the European imported article. "Turtle Oil," prepared from "turtles"
(tortoises?) which abound in the Straits of Manaar, between India and
Ceylon, has been proposed by Surgeon Y. Anthony Pillay (_Madras Journal
of Med. Science_, March 1870), as a substitute for Cod-liver Oil, over
which it has the advantage of being much cheaper. After two years'
experience of it in dispensary practice he reported highly of its
efficacy in that large class of scrofulous and anæmic cases in which
fish-oil is indicated. Specimens of this oil sent to the Madras Medical
Stores were pronounced unfit for medicinal use; but the principal
storekeeper (Dr. F. Day) adds, "If this turtle oil were prepared from
the animal after it had been well cleansed from all blood, and the
straining properly carried out, an oil would probably be produced but
little inferior to the present fish-oil." It seems well worthy of notice
in the southern portion of the Peninsula, where it is procurable at very
small cost.
137. _Remarks on its Use._—_a._ The best time for administering the oil
is immediately after or, to those who prefer it, during a solid meal.
Taken on an empty stomach it is almost sure to nauseate. Patients who
can take it at no other time will sometimes retain a dose if given the
last thing before going to bed.
_b._ For disguising the nauseous taste and preventing subsequent
eructations, a good plan is to take a few grains of common salt, both
immediately before and after a dose. As a vehicle, a little orange-wine,
or solution of quinine, or lime juice, or hot strong coffee without
milk, have been advocated by various writers. A little Omum water (317)
is perhaps the best vehicle of all.
_c._ The bulk of the whole dose of the oil and vehicle together should
be so small that it may be swallowed at a single draught; therefore the
vehicle should not exceed a table-spoonful, with, at first, a
teaspoonful of the oil, to be gradually increased to a table-spoonful.
The spoon and glass used for taking it should be kept scrupulously
clean, as any oil left adhering to them soon turns rancid. In taking
this (as well as all other nauseous drugs) it is advisable to prevent,
as far as possible, the tongue from coming in contact with it; to effect
this the tongue should be projected on the surface of the glass or
spoon, and the fluid thrown down as far back in the throat as can
conveniently be done.
_d._ The dose, as a general rule, at the commencement is a teaspoonful
three times daily, gradually increased as the stomach is able to bear
it. It is rarely requisite to exceed a table-spoonful twice or thrice
daily; large quantities either derange the stomach and liver, or pass
off unabsorbed by the bowels.
_e._ The diet during the course of the oil should be plain and
nutritious, consisting of bread, fresh meat roast or boiled, poultry,
game, &c., with a fair proportion of vegetables, and fruit, and a
moderate quantity of liquids. All rich articles of food, as pastry, fat
meat, cream, &c., should be avoided. Wine is preferable to beer, the
latter often disagreeing. Should a bilious attack come on, the oil
should be discontinued, the diet lightened, and an occasional aperient
administered. In a few days, when the attack has passed off, the oil may
be resumed, beginning with the small doses as at the first. In all cases
during the use of the oil, the bowels should be kept regular, if
necessary, by mild aperients.
_f._ During its use the patient should be as much as possible in the
open air, and take gentle exercise.
138. It is _in Pulmonary Consumption_ that the value of Fish-liver Oil
is most manifest, but there are a large number of cases of a scrofulous
character in which it proves almost equally valuable. _In Scrofulous
Abscesses_, _Suppurating Glands_, _Ulcerations_, _Discharges whether
from the Nose or Ears_, _and Skin Diseases_, especially when the patient
is weak and emaciated, the oil is indicated and proves most beneficial.
It proves equally useful in _Scrofulous Affections of the_ _Joints and
Bones_, especially in _Rickets_; and in _Scrofulous Ophthalmia_.
139. _In the Mesenteric Affections of Children_ the best results often
follow its use; the little patient rapidly gains strength and flesh, the
tumefied belly becomes reduced, the stools lose their clayey colour and
become bilious and healthy. It should not only be given internally, but
should be _used as a liniment to the abdomen. The Obstinate Constipation
of Children_ sometimes yields to the use of the oil, and its return is
prevented while the remedy is continued. _In Stricture of the Rectum_,
as an adjunct to dilatation cod-liver oil is an excellent remedy: it
nourishes the patient, and softens the motions, rendering aperients
unnecessary. (_Mr. Curling._) It is also well worthy of a trial in cases
of _Chronic Hydrocephalus, or Water on the Brain_, occurring in children
of a scrofulous habit.
140. _In the advanced stages of Hooping Cough, and in other Spasmodic
Coughs, which often remain after an attack of Bronchitis_, especially
when occurring in weakly children, marked benefit follows its use.
141. _Chorea_ (_St. Vitus's Dance_) _and Epilepsy_ sometimes are
benefited by it when more active remedies have failed. The same remark
applies to some forms of _Neuralgia_, especially _Tic Douloureux_; but
the cases in which it will prove serviceable can only be ascertained by
trials with the remedy.
142. _In Chronic Rheumatism_ attended with much debility and emaciation,
it often proves useful; in fact, in all cases of _Atrophy_ (_wasting or
emaciation_), _whether connected with Rheumatism, Scrofula or defective
digestion or resulting from long-continued confinement in close rooms,
as in jails, &c._, a course of the oil offers the best prospects of
success. In some form of _Paralysis_ it is occasionally very beneficial.
In _Leprosy_ it is a remedy well worthy of careful trial; not so much as
a curative agent as a means of relieving many of the distressing
symptoms.
143. In all the above cases the remedy should be persevered in for weeks
or even longer; and the rules given above for its administration must be
carefully attended to. Its operation is most beneficial in the cold
season.
144. +Galls.+
Mái-phal, Mázu-phal (_Hind._), Mái-phal, Májú-phal (_Duk._), Máju-phal
(_Beng._, _Punj._, _Kash._), Máshik-káy (_Tam._), Máshi-káya (_Tel._),
Máshik-káya (_Mal._), Máchi-káyi (_Can._), Mái-phala, Máshi-ká
(_Mah._), Máyi-phal (_Guz._), Mása-ka (_Cing._), Pinza-káni-si,
Pinz-gáni-di (_Burm._), Manjakani (_Malay_).
145. Many varieties of Galls are met with in the bazaars; the best for
medical use are globular, about the size of a nutmeg, of a
yellowish-white colour and very astringent taste, with a small hole on
one side of the surface. In the absence of this kind the other varieties
of Galls may be employed, as they all partake, more or less, of the same
astringent qualities. The dose for an adult is from 10 to 20 grains in
powder or infusion; but a better form is Decoction, prepared by boiling
for ten minutes in an earthenware vessel 1½ ounces of bruised Galls in a
pint of Water; of this, when cold and strained, the dose is from 1 to 2
ounces thrice daily, oftener. This decoction forms also a useful
astringent wash, gargle, &c.
146. _In Chronic Diarrhœa, especially in Natives_, powdered Galls in 15
grain doses thrice daily often prove useful, and in obstinate cases its
efficacy is increased by the addition of half a grain of Opium with each
dose. A little powdered Cinnamon may be advantageously added, and the
whole given in honey. _In the advanced stages of Dysentery_ the
decoction (_ante_) seems to answer better, and it may be given in doses
of 1½ to 2 ounces thrice daily, with the addition of Opium, as above,
and a carminative. This treatment is adapted only for adults.
147. _In Prolapsus_ (_descent_) _of the Rectum_, the daily use of an
enema of decoction of Galls proves useful by constringing the parts; and
this may further be effected, especially in the case of children, by
keeping a pad saturated with the decoction over the external parts after
the protruded bowel has been returned. The same treatment is applicable
(the decoction being used as a vaginal injection) in cases of _Prolapsus
of the Uterus_ (_descent of the Womb_).
148. _In Piles unattended by increased heat or inflammation_, a very
useful application is an ointment composed of 1½ drachms of powdered
Galls, and 1 ounce of Ghee. The ingredients should be thoroughly mixed.
If there should be much pain half a drachm of Opium may be added to it.
It should be applied twice daily. Enemas of the decoction (_ante_) may
also be used with advantage.
149. _In Gleet and long standing Gonorrhœa_, 20 grains of powdered
Galls, twice or thrice daily, have sometimes a good effect in checking
the discharge. _In Leucorrhœa, and other Vaginal Discharges_, the same
treatment is applicable, and at the same time injections of the
decoction may be employed.
150. _In Relaxed sore Throat and Enlargement of the Tonsils_ a very
useful gargle is composed of 40 grains of Alum, six ounces of Decoction
of Galls (145), and one ounce of Honey.
151. _In the Intermittent Fevers of Natives_, powdered Galls, in doses
of 20 to 30 grains, three or four times a day, have been found
serviceable in some cases; or smaller doses (10 to 12 grains) may be
given in 1½ ounces of Infusion of Chiretta (98) repeated every hour, for
four or five times in succession, immediately before the period at which
the fever usually returns. An aperient should, in all cases, be taken
before commencing this treatment, which is only suited for adults.
152. _In Poisoning by Nux Vomica_, _Cocculus Indicus_, _Datura_,
_Opium_, _and Bish_ (_Aconite Root_), after the stomach has been freely
emptied by emetics (which is the first thing to be done), the Decoction
of Galls, in doses of 3 or 4 ounces, should be given every ten minutes
or quarter of an hour, for four of five times in succession. It is
thought to act as an antidote; in some cases it certainly seems to act
very beneficially.
153. +Ginger.+ The dried root of Zingiber officinalis, _Roscoe_.
Sónth, Sindhi (_Hind._), Sónth (_Duk._, _Beng._, _Punj._), Shó-ont
(_Kash._), Shukku (_Tam._), Sonti (_Tel._), Chukka (_Mal._), Vanasunthi
(_Can._), Súnt (_Guz._), Ingúrú, Velichaingúrú (_Cing._), Ginsi-khiáv
(_Burm._), Hulya-kring (_Malay_).
154. Dried Ginger is preferable to fresh or green Ginger for medicinal
use, but if not procurable the latter may be employed. It is best given
in the form of Infusion, made by macerating 1 ounce of bruised Ginger in
a pint of boiling water in a covered vessel for an hour and straining.
The dose is from 1 to 2 ounces. A very useful domestic remedy is made by
steeping 3 ounces of Ginger in a pint of Brandy for ten days. Of this a
teaspoonful or more may, with great advantage, be added to aperient,
antacid and other medicines.
155. _In Colic_, _Flatulence_, _Vomiting_, _Spasms_, _and other painful
Affections of the Bowels unattended by fever_, the above Infusion,
especially if taken warm, in doses of 2 ounces every half-hour or hour,
often affords great relief. The addition of 20 or 30 grains of Carbonate
of Soda, if at hand, greatly increases its efficacy. For children a
tablespoonful of the infusion is sufficient.
156. _In Chronic Rheumatism_ Infusion of Ginger (2 drachms to 6 ounces
of boiling water and strained), taken warm the last thing before going
to bed, the body being covered with blankets so as to produce copious
perspiration, is often attended with the best effects. The same
treatment has also been found very beneficial in _Colds or Catarrhal
attacks_, and during _the cold stage of Intermittent Fever_.
157. _In Headache_ a Ginger plaister, made by bruising Ginger with a
little water to the consistence of a poultice, applied to the forehead,
affords in many instances much relief. _Toothache and Faceache_ are
sometimes relieved by the same application to the face.
158. _Relaxed Sore Throat_, _Hoarseness_, and _Loss of Voice_, are
sometimes benefited by chewing a piece of Ginger so as to produce a
copious flow of saliva.
159. +Gurjun Balsam+, or +Wood Oil+. The balsamic exudation of
Dipterocarpus lævis, _Ham._
Garjan-ká-tél (_Hind._), Gorjon-tail (_Beng._), Hora-tel (_Cing._),
Kanyen-si (_Burm._).
160. Gurjun Balsam, or Wood Oil, is a transparent liquid of the
consistence of olive oil, lighter than water, of a dark-brown sherry
colour, with an odour and taste resembling Copaiba, but less powerful.
It has been used as a substitute for this latter drug in the treatment
of _Gonorrhœa_, and trials with it in the hands of Europeans have shown
that it is a remedy of no mean value in this affection. It is only
advisable in the advanced stages, or when the disease has degenerated
into _Gleet_. In the latter affection it is stated to prove most useful.
It is also well worthy of a trial in _Leucorrhœa and other Vaginal
Discharges_. The dose is about a teaspoonful twice or thrice daily,
given floating on Omum or other aromatic water, or made into an emulsion
with lime water. It is apt occasionally to produce an eruption on the
skin similar to that which, in some instances, follows the use of
Copaiba.
161. _In Leprosy_ the use of Gurjun Balsam was introduced in 1873 by
Surgeon-Major J. Dougall, and the reported success of the remedy gave
rise to sanguine anticipations that a specific for this disease had at
last been discovered. Although subsequent experience proved this hope to
be fallacious, yet the lessons imparted by Dr. Dougall's treatment are
far from unimportant. His treatment consisted in the internal and
external use of the Balsam: for the former purpose it was given in
two-drachm doses, with lime-water, twice daily; for the latter, in the
form of ointment composed of 1 part of the Balsam and 3 of lime-water,
which was directed to _be thoroughly and perseveringly rubbed in over
the whole body for two hours a day by the patient himself, as far as
practicable_. This was insisted upon not only for the sake of the action
of the ointment on the skin, but because it was considered that any
gentle employment conjoined with exercise was likely to prove beneficial
both physically and mentally. Under this treatment (no change having
been made in the diet) Dr. Dougall obtained signal and manifest
improvement in numerous cases; but this was unhappily found to be of
only a temporary character, the discontinuance of the remedy being in
all cases followed by a relapse. Still further to test this treatment,
Dr. A. H. Hilson (_Indian Ann. of Med. Sci._, Jan. 1877) instituted two
sets of trials on leprous subjects (12 of each group), treated
respectively by Gurjun Balsam, used externally and internally on Dr.
Dougall's system, and by the ordinary Til (Sesamum) or Sweet Oil of the
bazaars, used externally only. The results which he arrived at are as
follows: 1. That the application of Gurjun oil removes the local
manifestations of leprosy to a great extent. 2. That it has no specific
influence over the constitutional taint or leprous cachexia. 3. That
ordinary Sweet Oil is equally efficacious as far as the local effect is
concerned, and therefore it is not improbable that the benefit which
patients experience from the application of Gurjun oil is due to the
friction producing absorption of the deposits which are effused into the
skin and cellular tissue during the course of the disease. Dr. Dougall
may have failed in finding in Gurjun oil a specific in leprosy, but he
has rendered important service in leading us to a knowledge of the vast
benefits to be derived from diligent oleaginous frictions in its
treatment; and, as he himself justly remarks, "even temporary
improvement is worth striving after in such a disease."