If I may be pardoned for discussing things pharmacological in a text on
practice, I want to urge that chemicals as such, are usually a failure
in treatment. My results from various series of experimental work both
laboratory and clinical, show quite conclusively that there are very
few, if any, chemical substances that have actual value by virtue of
their chemical properties alone. There are, however, cases in which
chemical agents may be used to advantage to obtain desirable physical
results and physiologic reactions.
The salt mixture mentioned above increases the solvent power of
the water for mucus, pus, and other collected material and it also
renders the water less irritating to the mucous membranes. Other than
this, it has no value so far as I know. This solution is certainly
not antiseptic or germicidal, further than that cleanliness may be
considered an antiseptic procedure.
The phenol-glycerine (10% phenol and 90% glycerine) which we have
recommended, is somewhat germicidal, non-irritating, except to the
nasal mucosa, is a protectant to inflamed membranes in some instances
and is also somewhat hygroscopic. These virtues to the limited extent
that they may be of advantage, depend chiefly upon physical qualities.
Adrenalin in high dilutions (1 to 5000 to 1 to 10,000) is of value
in retracting the erectile tissues of the nares for purposes of
examination and for obtaining better drainage, etc. It also constricts
the small blood vessels and thus reduces the chances for hemorrhage or
absorption of narcotic drugs which may necessarily be used as local
anesthetics. The effects of adrenalin are very temporary and it is,
therefore, of little value in treatment.
Following irrigation I have used the petroleum oils (liquid petrolatum)
to advantage as a protection to the mucous membrane. One-half gram
each of menthol and camphor and two or three drops of cinnamon oil to
the pint of this oil, is readily dissolved and produces a pleasant,
soothing effect to inflamed membranes, but further than this, the added
substances have no particular value. The above named chemical agents
constitute, except in rare instances, my stock of “drugs” for treatment
purposes.