TREATMENT OF DYSENTERY BY ISAPGHOL AND OTHER MUCILAGINOUS SEEDS versus IPECACUANHA. By Asst.-Surgeon Chetun Shah, R.B., Civil Medical Officer, Jliang. On commencing the practice of my profession I firmly believed that ipecacuanha was the most superior remedy for the cure of dysentery. This belief was not simply the result of lectures received from the worthy Professors of Medicine in the Medical College, nor simply of reading English medical books, but it was the result of careful and actual observations of the effects of the American drug on patients treated in the Lahore College Hospital. Here I found that, though the gastric sufferings of a majority of patients after taking ipecacuanha were often great in spite of all precautious taken to prevent them, they were more than amply compensated by the speedy change of dysentery into simple diarrhoea. For some time I remained an admirer and adherent of the ipecacuanha treatment. While in charge of the Peshawar Hospital, I came to substitute madar-root bark for ipecacuanha on financial grounds, and yet never found reason to regret the change from therapeutic considerations. However, nausea, vomiting, and, above all, a feeling of heat and oppression were as bad after taking madar as after taking ipecacuanha. No adjuncts and correctives could well overcome this difficulty. While well satisfied with the ipecacuanha and madar treatment as regards its ultimate effects, I always felt for the patients when they were troubled with feelings of heat and oppression. Yet I could find no satisfactory remedy for the evil. Mustard plaster ; opium before, with, or
after, ipecacuanha; ginger, peppermint, lying back, and avoiding fluids for sometime before and after the medicine, were undoubtedly but of
on
little avail. They could in many cases prevent check nausea and vomiting, but the sensation of heat and oppression was never absent. On entering into private practice amongst the nobility and gentry of Peshawar, where I had to compete with the so-called Yunani hakims, I found that, though many families had left their hakims and had made me their family physician, I could not long keep with me rich and delicate patients suffering from dysentery. These, after a short trial of my remedies, would prefer to call or
ISAPGHOL IN DYSENTERY.
Nov., 1885.]
si "Yunani hakim," aud would uot regret afterUnder these circumstances, as I had wards. already a knowledge of the Yunani and Vaidak modes of treating dysentery, I gave up Ipecacuanha, and resorted to the four demulcent seeds and opium. I got the better of the hakims, who generally dreaded the use of opium, which drug helped me a great deal in procuring rest and sleep for my patients. This gradually led me to use the same method of treatment at the Peshawar Hospital ; because the demulcents, though not so cheap as madar, were certainly far more economical than ipecacuanha, and far more agreeable to the
345 of
Treatment
iii
dysentery by
mucilaginous seeds is European practitioners, followed,
to
nor
it is
ipecacuanha.
not
mucilages
and then in order to quench thirst cents, in addition to ipecacuanha. What I want to assert is, that
successfully ipecacuanha
most
or
novelty to the but it is not extensively considered equal 01* superior Mucilages are given now a
cases
and in the
or as
we can
of dysentery same or
demul-
even
a
treat
without shorter
space of time, and that, in most cases, ipecacuanha is unnecessary, and to use it is to give un-
necessary trouble to our patients. No one can that ipecacuanha is not a pleasant thing to take, and if an extensive, patient, and unprepatients. After a time I found out that there were cases judiced trial be given to treatment by mucilain which mucilages and opium, though of service, ginous seeds, it will be found that these simple could not be relied upon exclusively. These seeds can well serve the ultimate purpose for the cases where, after great relief from which ipecacuanha is generally used. were Should I be borne out in what I have said by dysenteric symptoms, liver remained torpid and the In these cases, ipecacuanha or experience of other brother practitioners, bile deficient. nitro-muriatic acid, or emulsion of pomegranate and should these few lines do in some way tend of the mucilaginous seeds, puts the liver in order, aud thus assists in to a more general adoption of in treatment ipecacuanha treatment, I place effecting a cure. For many years I have never used ipecacu- feel confident that there will be a great saving anha except 011 a few rare occasions; and I am of trouble to the patients, and, I presume, of glad to be able to state that I have been very expense to the public institutions. I am sorry that the notes that I had kept of my successful in treating cases of dysentery, both in and Cabul are not available. private and hospital practice. I have often to cases at Peshawar At Jhang some short imperfect notes have been observe the effects of ipecacuanha used by my brother practitioners, and I find their success is recorded on the bed head-tickets of patients. at least in 110 way better than mine. They Notes of 27 cases are available. Of these, 11 occasion their patients some gastric trouble, from were treated in the Jail Hospital, 7 in the In private prac- Police Hospital, and 9 in the Civil Hospital. which my patients are saved. All these cases were treated with isapghol, had where I have some tice, competitors who would use ipecacuanha, I have always got the varying from dram 1?2 and Tincture Opii or Chlorodyne, varying from m. 5 to 20. Most of better of them. I have tried various simple and compound the cases were of acute or sub-acute dysentery : only were chronic cases. mucilaginous drugs, and I find simple isapghol four All recovered, and none of the acute cases kanaocha of seeds plantago Isphaghula) (the into the chronic form. (salvia sp, N. 0. Labiataj), quince seeds, and passed In 2 cases Plandysenteric symptoms ceased in I day. Bartung (seeds of plantago major N. 0. 3 days. ? 4 ,, ,, ,, ,, efficient. taginacije) quite ? 2 )) }) >) ,, a The mucilage of the seeds, singly or com5 1 >?> >> with a >> >> >) sweetened bined, is generally given sugar, The average is thus 2'3 days. and has 110 effect 011 the liver, but it soothes the The average time for complete cure to enable liver, relieves thirst, and changes dysentery into to resume work was as follows: the patients checked be which can by simple diarrhoea, 3 days. cases In 2 It there addition of or without them.
deny
?
astringents
be wind in the bowels, addition of emulsion of anise seeds or a little anise seed water proves useful. Cases characterized by bad taste or want of taste in the mouth and copious mucous discharges, instead of bitter taste in the mouth, and bloody stools?are better benefited by Hal el a Zangi (dried unripe cbebulic myrobalan) lubricated with almond oil or glycerine. As regards general management and treatment of complications, I follow the ordinary rules of European practice. It would, therefore, be a waste of time and space to go into the details of the. method in which my cases are managed.
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after, ipecacuanha; ginger, peppermint, lying back, and avoiding fluids for sometime before and after the medicine, were undoubtedly but of
on
little avail. They could in many cases prevent check nausea and vomiting, but the sensation of heat and oppression was never absent. On entering into private practice amongst the nobility and gentry of Peshawar, where I had to compete with the so-called Yunani hakims, I found that, though many families had left their hakims and had made me their family physician, I could not long keep with me rich and delicate patients suffering from dysentery. These, after a short trial of my remedies, would prefer to call or
ISAPGHOL IN DYSENTERY.
Nov., 1885.]
si "Yunani hakim," aud would uot regret afterUnder these circumstances, as I had wards. already a knowledge of the Yunani and Vaidak modes of treating dysentery, I gave up Ipecacuanha, and resorted to the four demulcent seeds and opium. I got the better of the hakims, who generally dreaded the use of opium, which drug helped me a great deal in procuring rest and sleep for my patients. This gradually led me to use the same method of treatment at the Peshawar Hospital ; because the demulcents, though not so cheap as madar, were certainly far more economical than ipecacuanha, and far more agreeable to the
345 of
Treatment
iii
dysentery by
mucilaginous seeds is European practitioners, followed,
to
nor
it is
ipecacuanha.
not
mucilages
and then in order to quench thirst cents, in addition to ipecacuanha. What I want to assert is, that
successfully ipecacuanha
most
or
novelty to the but it is not extensively considered equal 01* superior Mucilages are given now a
cases
and in the
or as
we can
of dysentery same or
demul-
even
a
treat
without shorter
space of time, and that, in most cases, ipecacuanha is unnecessary, and to use it is to give un-
necessary trouble to our patients. No one can that ipecacuanha is not a pleasant thing to take, and if an extensive, patient, and unprepatients. After a time I found out that there were cases judiced trial be given to treatment by mucilain which mucilages and opium, though of service, ginous seeds, it will be found that these simple could not be relied upon exclusively. These seeds can well serve the ultimate purpose for the cases where, after great relief from which ipecacuanha is generally used. were Should I be borne out in what I have said by dysenteric symptoms, liver remained torpid and the In these cases, ipecacuanha or experience of other brother practitioners, bile deficient. nitro-muriatic acid, or emulsion of pomegranate and should these few lines do in some way tend of the mucilaginous seeds, puts the liver in order, aud thus assists in to a more general adoption of in treatment ipecacuanha treatment, I place effecting a cure. For many years I have never used ipecacu- feel confident that there will be a great saving anha except 011 a few rare occasions; and I am of trouble to the patients, and, I presume, of glad to be able to state that I have been very expense to the public institutions. I am sorry that the notes that I had kept of my successful in treating cases of dysentery, both in and Cabul are not available. private and hospital practice. I have often to cases at Peshawar At Jhang some short imperfect notes have been observe the effects of ipecacuanha used by my brother practitioners, and I find their success is recorded on the bed head-tickets of patients. at least in 110 way better than mine. They Notes of 27 cases are available. Of these, 11 occasion their patients some gastric trouble, from were treated in the Jail Hospital, 7 in the In private prac- Police Hospital, and 9 in the Civil Hospital. which my patients are saved. All these cases were treated with isapghol, had where I have some tice, competitors who would use ipecacuanha, I have always got the varying from dram 1?2 and Tincture Opii or Chlorodyne, varying from m. 5 to 20. Most of better of them. I have tried various simple and compound the cases were of acute or sub-acute dysentery : only were chronic cases. mucilaginous drugs, and I find simple isapghol four All recovered, and none of the acute cases kanaocha of seeds plantago Isphaghula) (the into the chronic form. (salvia sp, N. 0. Labiataj), quince seeds, and passed In 2 cases Plandysenteric symptoms ceased in I day. Bartung (seeds of plantago major N. 0. 3 days. ? 4 ,, ,, ,, ,, efficient. taginacije) quite ? 2 )) }) >) ,, a The mucilage of the seeds, singly or com5 1 >?> >> with a >> >> >) sweetened bined, is generally given sugar, The average is thus 2'3 days. and has 110 effect 011 the liver, but it soothes the The average time for complete cure to enable liver, relieves thirst, and changes dysentery into to resume work was as follows: the patients checked be which can by simple diarrhoea, 3 days. cases In 2 It there addition of or without them.
deny
?
astringents
be wind in the bowels, addition of emulsion of anise seeds or a little anise seed water proves useful. Cases characterized by bad taste or want of taste in the mouth and copious mucous discharges, instead of bitter taste in the mouth, and bloody stools?are better benefited by Hal el a Zangi (dried unripe cbebulic myrobalan) lubricated with almond oil or glycerine. As regards general management and treatment of complications, I follow the ordinary rules of European practice. It would, therefore, be a waste of time and space to go into the details of the. method in which my cases are managed.
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9
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