It is not necessary every time to send for the physician, and he cannot at a moment’s notice be obtained. For many ailments the mother prescribes, and many times the early and judicious use of medicines or regimen not only relieves present suffering, but also prevents the developement of serious, and protracted and dangerous maladies. This is especially true in regard to incipient inflammation, and I shall here speak particularly of its treatment.
What has heretofore been said about inflammation gives us some guide to enable us to know whether the case calling for our care is one of an inflammatory character. If the pulse is full and hard and a little more frequent than usual, and there is restlessness and some pain we may conclude that there is IRRITATION that precedes inflammation at least, before such symptoms as depression, chilliness followed by heat, headache, a furred tongue, loss of appetite, and apparent weakness come on. But if any of these symptoms are present we should search for the cause. Perhaps if the inflammation is external we shall be able to ascertain what produces the trouble. In every case we ought to know the cause if possible, as we thus have more clear indications for treatment.
But we may use the sedative treatment in all cases where these symptoms come on in a person who has previously been healthy. Of course you will not bleed—that, if done at all, should be done by the doctor. But all sources of irritation ought to be removed, so that the patient may enjoy perfect quiet; the sick room should be ventilated, and kept at the temperature of about 60°; let the diet be light; allow ice and cold water freely, and if there is much febrile excitement use sedatives and saline refrigerants. The best sedative is veratrum viride, and the following is a convenient way of administering it: Drop 30 drops of the fluid extract of veratrum in 30 teaspoonfuls of water and give 1 teaspoonful every two hours. To adult subjects if there is considerable fever two drops of the extract, or two teaspoonfuls of the diluted preparation may be given at first and the dose may be repeated in an hour, but it will not be best to continue such large doses. Aperients may be given if there are fecal accumulations in the bowels. Although quinine is a tonic, six to ten grains of it are sometimes given with good effect in a case of inflammation.
Opium is a good remedy judiciously given; one dose (1 grain for an adult) is good in a case of catarrh or cold; successive doses are necessary in a case of peritonitis or enteritis, but this should be given on a physician’s advice. It acts probably by quieting the nerves—by sustaining the faltering action of the heart, and by keeping the inflamed part at rest. Sometimes cold, and sometimes hot applications are made to inflamed parts, and it is said that the sensations of the patient are the best criterion of their usefulness. Except, however, in cases of inflammation of the brain, and perhaps even then, I think that hot applications are the best. When we wish to promote suppuration hot fomentations should be applied.
Counter irritants relieve inflammation of the deeper parts by drawing the circulating fluid and the nervous energy to the surface. The milder kinds called rubefacients, produce merely local warmth and redness; these may often be used advantageously. Mustard applied so as to redden the skin is generally useful.
Vesicants, epispastics, or blistering agents are safe appliances but they are distressing, and their use may be deferred until a physician advises them.
I have said that the diet should be light while the pulse is hard and full. Afterwards when the pulse is natural, or if it becomes irregular or small, good broths or other nutrients are to be given, milk, cream, and even raw eggs may be administered. In general food should not be pressed upon a patient.
OF TOPICAL APPLICATIONS FOR INFLAMMATION.
I have mentioned counter irritants and I think it best at this time to advert to all the various topical applications, irritating, soothing and protective, and to give such instructions as I can in regard to them.
Counter irritants are frequently applied over or near the seat of the disease, and often also at a remote part to obtain what is called revulsive action. In both instances, however, their action may be revulsive. If applied to the thorax or chest, for example in a case of pneumonia, the cuticle to which it is applied is almost as remote from the lung by the way of the circulation, as is the cuticle of the wrist or ankle. But practically a sinapism may be very useful applied at either place—possibly more useful if applied over the seat of the inflammation, because there is a sympathy between the parts—they may be used very beneficially in domestic medication.