The Providence news. (Providence [R.I.]) 1891-1906, 1897-01-14
CURE OF HEMORRHAGE
Treatment to Be Modified Accord
Ing to Circumstances.
Facts Relating to the Ravsges Of the
Cocaine Habit.

HcmOrrnago OF tno iuuge OF hnomop
tysis may be brought on by any unusual
effort, or by exposure TO cold; may be
symtomstic of certain kinds of poison
ing, or of ssphyxis. and may be due to
heart disease, but more frequently to
tn perculosis. This accident may occur
at any phase Of the tubercular process,
but just as it's abundance, lis more or
less frothy condition and color, vary
at the different periods. so the treatment
to be brought to bear is not always the
same, but has to be modified according
to the circumstances under which the
haemoptysis occurs.
A common variety of hemorrhage OF
tho lungs is that which happens In the
early stages of a tunercuIar lesion of the
apex, and which is simply due to excei-
sive coughing. in this case the niue Us
is simply slightly tinged with blood.
Codeine should first be given TO quiet the
coughing and, as soon as this has heen
accom- pills he'd, bydrochlorate Of ammonia,
ipecac or bicsrbonate of soda should
be prescribed TO liquefy the secretion
from the tronichsl tubes ana facilitate
its elimination. a'
The initial hasmoptysis of tubercular
infiltration of the lungs Is one OF The
most frequent foruns of pulmonary hemor-
rhsge, and 1T is distinguished by it's
abundance which is out OF all proportion
to the extent of the LESSONS existing at
that period. The patient should be put
to bed and absolute silencs enjoined; Ice
should be applied to the axpe OF the lung
and morphine and acetate OF lead given
every hour, the former In halt cent?
grsmme doses, the latter in five cent?
gramme doses.
When the coughing is violent from the
beginning, this dose of morphine should
be doubled. Injections Of ergotins are
only indicated when after temporary ces-
sation of the haemoptysis, coughing
occurs that cannot be stopped by MGR
phine, and during which the patient
brings back dark clots remaining from
the former hemorrhage mixed with fresh
blood. This proves that a new haemorr-
| hage is sendeavorine,to pass through the
clots that were left from the former one.
A Laemotypsis treated in this way gem
| orally stops in four days, and at that
moment the patient can be allowed to
speak and to move in bed. On the seventh
day the patient can get up, and can be
sent out on the tenth On condition Of
walking only leisurely and OF taking all
necessary precautions.
Haemopeysee occurring at more advanced
| stages Of the disease have to be treated
| in the same way. They are less profuse,
| as a rule, but have q tendency to recnr
and are usually accompanied by rise
| of temperature, which 10 q sign which
helps 10 disting Jish them from the initial
hemorrhage.
hemorrhage occurring In pulmonary
| cavities is characterized by the expul-
sion almost without any coughing of
small, dark clots IL the cavity is quite
moderate in size; OF blood mixed with
| purulent sputs, il it 10 Of larger dlmen-
sions, and finally by its.alarming course,
| in cases of large cavities. In the two
former instances ice should be applied to
| the lung in which the hsmorrhage Is
occurring. and . few doses should be given
|
codeiue and i've of acetate of lead for
each dose.
| Hemorrhage occurring In q lung OF
which large extent is broken down,
although there are no cavities prop
erly so.cslled, are also source Of appre-
hension, although their progress 10 not
| generally so rapid a. In the case of very
large cavities. The physician must then
sct quickly and with energy. giving fre-
| quent doses Of TWO centigrs MINES Of NOR
| pbise, applying q large mustard plaster
| on the entire anterior surface of the chest
and ice to the proper apex; the side OF
the chest corresponding to the lesion
| finally, ligature of the limbs should be
resorted to In cases OF great emergency.
| This is the course of action followed by
| M. Skreipka, of Roynsu-M -Merap, ia the
| treatment OF haemoptysis. lie has under
his care every year in the Tyrol q large
number of tubercular casss, and, As will
have been seen from the foregoing. varies
bis treatment sccor ding to the form Ct
haemoptysis.
| 81 have often spoken of cocaine an my
readers know that 1t is precious local
anaesthetic, whose reliable and rapid
action has been taken advantage OF by
surgeons in operations Of slight Import
ance. Instead of putting their patients
really to sleep and Of exposing. them to
the rare but always possible accidents
that may follow tho administration oi
chloroform or ether, they have only tc
make a hypodermic injection or even g
simple local application with solution
OF cocaine to Obtain complete insensi'
bility OF the region in question.
In this instance, as in all others, there
are minute precautions to be taken, both
as regards dose ana method of procedure,