Divide into thirty pills, and give one after each discharge from the bowels, or oftener, if the urgency of the case requires it. Occasionally, however, there may be applied a large sinapism over the whole abdomen with advantage. Greenhow's aromatized brandy,[II] the aromatic tincture of guaiacum,[III] may sometimes be beneficially alternated with this pill. Should there be an overloaded condition of the alimentary canal, the fluid extract of rhubarb and potassa,[IV] three parts, with saturated tincture of prickly-ash berries, one part, may be administered in table-spoonful doses every hour, and continued until the bowels are properly evacuated, after which the above astringents may be given; but where the diarrhœa is excessive, it would be imprudent to wait for catharsis, as the discharge should be checked as speedily as possible.
In the second stage, when nausea, vomiting, and cramps are present, more active means should be pursued. To overcome the nausea or vomiting, the preparation of Dr. O. E. Newton, termed in the American Dispensatory compound mixture of camphor,[V] may be used with excellent effect; it is prepared as follows:
From a tea-spoonful to a table-spoonful may be given every five or ten minutes; and in cases where this does not act sufficiently prompt, the following may be administered:
| ℞. | Common salt, | ʒ j. |
| Black pepper, | ʒ j. | |
| Vinegar, | f ʒ v. | |
| Hot water, | f ℥ iv. | |
| Mix. |
Of this a table-spoonful may be given every ten or twenty minutes, and continued until the nausea ceases.
To remove the cramps, hot bricks, or bottles of hot water, etc., should be kept applied to the feet, legs and arms, and cloths wet in water as hot as can be borne, must be applied over the abdomen and changed every few minutes; this should be perseveringly pursued until relief is obtained. Sometimes advantage will ensue from stimulant applications along the whole length of the spine. Cramps of the muscles of the limbs may be overcome by bathing with the compound cajeput mixture,[VI] either alone or in combination with chloroform, and applying friction at the same time. This course usually checks the further progress of the disease, and the patient is saved; however, should it fail and the stage of collapse come on, in addition to the above treatment energetically pursued, the patient should be enveloped in blankets, wet with water as hot as can be borne, which should be renewed every ten or twenty minutes, and stimulants may likewise be given; the saturated tincture of prickly-ash berries will here be found beneficial, both by mouth and enema."
Dr. Morrow observes, that "to fulfill the most prominent indication, the production of an equilibrium in the circulation, and excitability, the compound tincture of guaiac[VII] may be given." This is prepared by adding gum guaiacum, cinnamon and cloves—each, one ounce to a quart of best brandy, and is administered in tea-spoonful doses in hot, sweetened water and brandy, every fifteen or twenty minutes till relief is obtained. As a general remedy, its exhibition is most salutary. In some cases where excessive nausea is the most prominent symptom, it may be advisable to administer an emetic to relieve the gastric irritability, to equalize the circulation and check the spasms. For this purpose, the acetous tincture of lobelia and sanguinaria,[VIII] with the addition of one-third spirituous tincture of aralia spinosa,[IX] is preferred. This is given in doses from a tea-spoonful to a table-spoonful every ten minutes in warm catnip-tea, sweetened. In very urgent cases, it may be given in larger doses and frequently repeated.
In most cases, the saturated tincture of xanthoxylum fraxinifolium bac. may be used with great advantage. It is a reliable, excellent and prompt remedy. When given in the early stages, it will frequently relieve in from ten to twenty minutes. In combination with the fluid extract of rhubarb and potassa,[X] it has generally proved very prompt and efficient. In cases of partial collapse, when the patient is suffering from severe cramps, Hunn's Antispasmodic Mixture[XI] is an excellent remedy. In cases of violent spasms, it has been administered every ten minutes in doses of from one to two tea-spoonsful in hot brandy-and-water sweetened, with great advantage, and it is peculiarly applicable in such cases where there is not too great irritability of the stomach. In many cases, camphor is very beneficially prepared, by adding one drachm of camphorated spirits to a half-pint of cold water and the mixture given in tea-spoonful doses every three or four minutes.
Dr. King states that in the early stage he has used very extensively the following preparation: