A physician[19] who had a very painful apthous ulcer at the point of his tongue, found great relief, when other remedies failed, from the application of fixed air to the part affected. He held his tongue over an effervescing mixture of potash and vinegar; and as the pain was always mitigated, and generally removed by this vaporisation, he repeated it, whenever the anguish arising from the ulcer was more than usually severe. He tried a combination of potash and oil of vitriol well diluted with water; but this proved stimulant and increased his pain; probably owing to some particles of the acid thrown upon the tongue, by the violence of the effervescence. For a paper stained with the purple juice of radishes, when held at an equal distance over two vessels, the one containing potash and vinegar, the other the same alkali and Spiritus vitrioli tenuis, was unchanged by the former, but was spotted with red, in various parts, by the latter.
In malignant fevers wines abounding with fixed air may be administered, to check the septic ferment, and sweeten the putrid colluvies in the primæ viæ. If the laxative quality of such liquors be thought an objection to the use of them, wines of a greater age may be given, impregnated with mephitic air, by a simple but ingenious contrivance of my friend Dr. Priestley.[20]
The patient's common drink might also be medicated in the same way. A putrid diarrhœa frequently occurs in the latter stage of such disorder, and it is a most alarming and dangerous symptom. If the discharge be stopped by astringents, a putrid fomes is retained in the body, which aggravates the delirium and increases the fever. On the contrary, if it be suffered to take its course, the strength of the patient must soon be exhausted, and death unavoidably ensue. The injection of mephitic air into the intestines, under these circumstances, bids fair to be highly serviceable. And a case of this deplorable kind, has lately been communicated to me, in which the vapour of chalk and oil of vitriol conveyed into the body by the machine employed for tobacco clysters, quickly restrained the diarrhœa, corrected the heat and fœtor of the stools, and in two days removed every symptom of danger[21]. Two similar instances of the salutary effects of mephitic air, thus administered, have occurred also in my own practice, the history of which I shall briefly lay before the reader. May we not presume that the same remedy would be equally useful in the Dysentery? The experiment is at least worthy of trial.
Mr. W——, aged forty-four years, corpulent, inactive, with a short neck, and addicted to habits of intemperance, was attacked on the 7th of July 1772, with symptoms which seemed to threaten an apoplexy. On the 8th, a bilious looseness succeeded, with a profuse hœmorrhage from the nose. On the 9th, I was called to his assistance. His countenance was bloated, his eyes heavy, his skin hot, and his pulse hard, full, and oppressed. The diarrhœa continued; his stools were bilious and very offensive; and he complained of griping pains in his bowels. He had lost, before I saw him, by the direction of Mr. Hall, a surgeon of eminence in Manchester, eight ounces of blood from the arm, which was of a lax texture; and he had taken a saline mixture every sixth hour. The following draught was prescribed, and a dose of rhubarb directed to be administered at night.
℞. Aq. Cinnam. ten. ℥j.
Succ. Limon. recent. ℥ß.
Salis Nitri gr. xij. Syr. è Succo Limon. ʒj. M. f. Haust.
4tis horis sumendus.
July 11. The Diarrhœa was more moderate; his griping pains were abated; and he had less stupor and dejection in his countenance. Pulse 90, not so hard or oppressed. As his stools continued to be fœtid, the dose of rhubarb was repeated; and instead of simple cinnamon-water, his draughts were prepared with an infusion of columbo root.
12. The Diarrhœa continued; his stools were involuntary; and he discharged in this way a quantity of black, grumous, and fœtid blood. Pulse hard and quick; skin hot; tongue covered with a dark fur; abdomen swelled; great stupor. Ten grains of columbo root, and fifteen of the Gummi rubrum astringens were added to each draught. Fixed air, under the form of clysters, was injected every second or third hour; and directions were given to supply the patient plentifully with water, artificially impregnated with mephitic air. A blister was also laid between his shoulders.
13. The Diarrhœa continued, with frequent discharges of blood; but the stools had now lost their fœtor. Pulse 120; great flatulence in the bowels, and fulness in the belly. The clysters of fixed air always diminished the tension of the Abdomen, abated flatulence, and made the patient more easy and composed for some time after their injection. They were directed to be continued, together with the medicated water. The nitre was omitted, and a scruple of the Confect. Damocratis was given every fourth hour, in an infusion of columbo root.
14. The Diarrhœa was how checked, His other symptoms continued as before. Blisters were applied to the arms; and a drachm and a half of the Tinctura Serpentariæ was added to each draught.