A text-book of medical treatment : diseases and symptons / by Nestor Tirard.

  • Tirard, Nestor Isidore Charles, Sir, 1853-1928.
Date:
1900
Catalogue details

Licence: In copyright

Credit: A text-book of medical treatment : diseases and symptons / by Nestor Tirard. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    those of angina pectoris. Dyspncea is intimately connected with the pain, and although this symptom is in some cases referable to the short respirations due to the instinctive effort to diminish movement, it nevertheless is frequently the result of accumulations of fluid within the pericardial cavity, and is then associated with great rapidity of the pulse and with palpitation. With acute pericarditis with effusion, the patient is necessarily confined to bed on account of the earlier sym- ptoms. Still, it becomes the more important to insist upon absolute repose, and indeed all movements should be limited as much as possible. Pain may often be relieved by the application of three or four leeches over the praecordia, followed by the use of a poultice or fomentation sprinkled with laudanum. As in the treatment of pneumonia, relief is sometimes afforded by placing an ice bag over the praecordial region ; but it is advis- able, when using cold applications, to watch the condition of the pulse and the aspect of the patient, since symptoms of collapse occasionally supervene with great rapidity and call for the immediate use of stimulants. If the fluid in the pericardium increases rapidly in amount, further relief may be obtained by the continuous employment of poultices, or by blistering the surface and subsequently using poultices. Apart from these local measures, it is generally desirable to employ salicylates freely when the condition is associated with acute rheumatism. Belief of pain may also be obtained by the internal use of preparations of opium, which, as in peritonitis, may often be combined with small doses of quinine. On account of the irregularity and weakness of the pulse it is generally necessary to employ stimulants some- what liberally, and this is particularly the case when sodium salicylate is being administered in large doses. In some forms of pericarditis, notably in the dry form which so often occurs with kidney diseases, it is necessary to avoid the ■ use of opium and also of preparations of cantharides, since, when the kidneys are affected, both of these remedies may produce undesirable symptoms. In such cases, restlessness may be quieted by the use of hyoscine or hyoscj^amine, or sometimes of chloral hydrate, although it is necessary to