After a debauch, a Mustard emetic (246) proves most useful in unloading the stomach of any spirit remaining in it. A few drops, six to twelve, of Liquor Ammoniæ in water subsequently given, are often of signal success. Strong Coffee, café noir, is also most useful. To allay the subsequent cravings for drink try Omum Water (320).
Dysentery.
In the early stages give Country Ipecacuanha (369) and Ispaghúl Seeds (304), or Sesamum leaves (338a), with or without Opium (289*, 289a), and apply Hot Fomentations to the abdomen and Leeches to the verge of the anus (211); the latter tend much to relieve the pain and straining, as do also Opiate enemas (289a). The treatment of Acute Dysentery by large doses of Ipecacuanha, reintroduced into practice in 1858 by Dr. Docker, is acknowledged by the most experienced authorities to be far more effectual than any other. It consists, in the main, of administering, as early in the disease as possible, 25 to 30 grains of Ipecacuanha, in as small a quantity of fluid as possible, premising half an hour previously 25 to 30 drops of Laudanum. The patient should keep perfectly still in bed, and abstain from fluids for at least three hours. If thirsty, he may suck a little ice, or may have a teaspoonful of cold water. It is seldom, under this management, that nausea is excessive, and vomiting is rarely troublesome, seldom setting in for two hours after the medicine has been taken. Mustard Poultices (247) or Turpentine Stupes (362) should be applied to the abdomen. In from eight to ten hours, according to the urgency of the symptoms and the effect produced by the first dose, Ipecacuanha in a reduced dose should be repeated, with the same precautions as before. The effects of this treatment are soon manifest and surprising; the griping and straining subside, the motions quickly become feculent, blood and slime disappear; and often, after profuse action of the skin, the patient falls into a tranquil sleep and awakes refreshed. The treatment may require to be continued for some days, the medicine being given in diminished doses, care being taken to allow a sufficient interval to admit of the patient taking some mild nourishment suited to the stage of the disease. As the disease abates, the dose should be reduced. It is well, however, to administer 10 or 12 grains at bedtime for a night or two, after the stools are, to all appearance, healthy. Fomentations or Turpentine Stupes to the abdomen lessen griping and diminish suffering. If a little diarrhœa without the dysenteric odour remain, it may be checked with a little astringent mixture, with or without Opium. Astringents in any shape during the acute stage are not only useless, but dangerous. (Dr. Maclean.) To sum up, it appears—1. That acute dysentery is more successfully and speedily treated by large doses of Ipecacuanha than by other means. 2. That it is more effectual in the acute than in the chronic forms. 3. That large doses, such as are mentioned above, may be given with perfect safety, without fear of ill effects; and 4. That it is less successful with the natives of India than with Europeans. In the acute dysentery of natives, small doses, e.g., from six to eight grains thrice daily, so as to keep up a slight degree of nausea, short of actual vomiting, seem to answer better than the large doses mentioned above. It may be advantageously combined with Opium, from a quarter to half a grain with each dose.
When of malarious origin or when occurring in the course of periodical Fevers, Quinine (three to five grains twice or thrice daily) should form part of whatever other treatment is being followed. In the advanced stages, or when it passes into Chronic Dysentery, apply Turpentine Stupes (362) to the abdomen, and give Sulphate of Copper (110), Bael (44), Infusion of Kariyát (191), Decoction of Pomegranate Rind (312), or Sal Ammoniac (331). When an aperient is required, give Sulphur and Cream of Tartar (344) or Castor Oil, with the addition of a small portion of Opium. For the Dysentery of Natives, Decoction of Sweet Flag (13), Galls (146), Mudar (243), Opium (289a), and Decoction of Pomegranate Rind (312) seem best suited. For the Chronic Dysentery of Children the Saccharated Solution of Lime (220), Bael (44), Sulphate of Copper (110), or Sulphate of Iron (181) are indicated. See also Diarrhœa of Children. N.B.—In all cases of dysentery the food should be mild and unirritating, and a flannel bandage worn round the abdomen. Soups containing mucilage of Abelmoschus (2) prove useful.
Dysmenorrhœa.
See Menstruation, Painful.
Dyspepsia.
See Indigestion.