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Deputy Director, University of Kentucky College of Medicine
The disposition of being affected with the miasma of itch is found with almost everyone and under almost all circumstances medicine 4 the people order on line endep, which is not the case with the other two miasmata medicine and technology generic endep 75 mg with mastercard. No other chronic miasma infects more generally symptoms ectopic pregnancy order discount endep on-line, more surely, more easily and more absolutely than the miasma of itch; as already stated, it is the most contagious of all. It is communicated so easily, that even the physician, hurrying from one patient to another, in feeling the pulse has unconsciously * inoculated other patients with it; wash which is washed with wash infected with the itch; new gloves which had been tried on by an itch patient, a strange lodging place, a strange towel used for drying oneself have communicated this tinder of contagion; yea, often a babe, when being born, is infected while passing through the organs of the mother, who may be infected (as is not infrequently the case) with this disease; or the babe receives this unlucky infection through the hand of the midwife, which has been infected by another parturient woman (or previously); or, again, a suckling may be infected by its nurse, or, while on her arm, by her caresses or the caresses of a strange person with unclean hands; not to mention the thousands of other possible ways in which things polluted with this invisible miasma may touch a man in the course of his life, and which often can in no way be anticipated or guarded against, so that men who have never been infected by the psora are the exception. We need not to hunt for the causes of infection in crowded hospitals, factories, prisons, or in orphan houses, or in the filthy huts of paupers; even in active life, in retirement, and in the rich classes, the itch creeps in. The hermit on Montserrat escapes it as rarely in his rocky cell, as the little prince in his swaddling clothes of cambric. Nothing is seen on the skin during the first days; it remains unchanged, and, according to appearance, healthy. There is no eruption or itching to be noticed on the body during these days, not even on the spot infected. The nerve which was first affected by the miasma has already communicated it in an invisible dynamic manner to the nerves of the rest of the body, and the living organism has at once, all unperceived, been so penetrated by this specific excitation, that it has been compelled to appropriate this miasma gradually to itself until the change of the whole being to a man thoroughly psoric, and thus the internal development of the psora, has reached completion. Only when the whole organism feels itself transformed by this peculiar chronic-miasmatic disease, the diseased vital force endeavors to alleviate and to soothe the internal malady through the establishment of a suitable local symptom on the skin, the itch-vesicles. So long as this eruption continues in its normal form, the internal psora, with its secondary ailments, cannot break forth, but must remain covered, slumbering, latent and bound. Usually it takes six, seven or ten, perhaps even fourteen days from the moment of infection before the transformation of the entire internal organism into psora has been effected. Then only, there follows after a slight or more severe chill in the evening and a general heat, followed by, perspiration in the following night, (a little fever which by many persons is ascribed to a cold and therefore disregarded), the outbreak of the vesicles of itch, at first fine as if from miliary fever, but afterwards enlarging on the skin* - first in the region of the spot first infected, and, indeed, accompanied with a voluptuously tickling itching - which may be called unbearably agreeable (Grimmen), which compels the patient so irresistibly to rub and to scratch the vesicles of itch, that, if a person restrains himself forcibly from rubbing or scratching, a shudder passes over the skin of the whole body. This rubbing and scratching indeed satisfies somewhat for a few moments, but there then follows immediately a long- continued burning of the part affected. Late in the evening and before midnight this itching is most frequent and most unbearable. The itching not only compels the patient to rub, but on account of its violence, as before mentioned, to rub and scratch open the vesicles; and the humor pressed out furnishes abundant material for infecting the surroundings of the patient and also other persons not yet infected. The extremities defiled even to an imperceptible degree with this lymph, so also the wash, the clothes and the utensils of all kinds, when touched, propagate the disease. Only this skin symptom of the psora which has permeated the whole organism (and which as more manifestly falling under the cognizance of the senses has the name of itch), only this eruption, as well as the sores which later arise from it and are attended on their borders with the itching peculiar to psora, as also the herpes which has this peculiar itching and which becomes humid when rubbed (the tetter), as also the tinea capitis - these alone can propagate this to other persons, because they alone contain the communicable miasma of the psora. But the remaining secondary symptoms of the psora, which in time manifest themselves after the disappearance or the artificial expulsion of the eruption, i. They are, so far as we know, just as little able to transfer the psora to others, as the secondary symptoms of the venereal disease are able to infect other men (as first observed and taught by J. When the itch-eruption has only lately broken out and is not yet widely spread on the skin, nothing of the general internal malady of the psora is as yet to be noticed in the state of the patient. The emotional symptom acts as a substitute for the internal malady and keeps the psora with its secondary ailments as it were latent and confined. But if the disease is allowed to advance in its peculiar course without the use of an internal curative remedy or an external application to drive away the eruption, the whole disease within rapidly increases, and this increase of the internal malady makes necessary a corresponding increase of the skin-symptom. The itch-eruption, therefore, in order to be able to soothe and to keep latent the increased internal malady, has to spread and must finally cover the whole surface of the body. I examined a woman who was free from all the secondary symptoms of the venereal disease; with her a chancre had remained in its place untreated for two years, and had gradually acquired the size of almost an inch in diameter. The best preparation of Mercury, internally administered soon and entirely healed, not only the internal malady, but also the chancre. But so great a torture, as is caused by so unbearable an itching spread over the whole body, even the most robust man cannot continue to bear.
A full dose of jaborandi will often change the entire condition medicinenetcom medications purchase 25 mg endep with visa, at once producing relaxation of the os medicine ethics buy endep toronto, free secretion treatment zenkers diverticulum buy genuine endep on line, more expulsive and less irritating pains and a general soothed and quiet condition. A French authority treated ten consecutive cases with satisfactory results, with the hydrochlorate of pilocarpine. He concludes that feebleness of the pulse, as long as the convulsions reappear, is not a contra-indication to a repetition of the dose. Its best influences are directed toward elimination of the urea, thus relieving the uremia and reducing dropsical effusions. Its anti-spasmodic influence, while not always, perhaps, to be depended upon alone, is exercised harmoniously with the indicated anti-spasmodic, whether it be veratrum, chloral, the bromides, morphia, passiflora or gelsemium. In exanthematous fevers of all kinds jaborandi in small doses is the remedy par excellence. In robust cases, with scarlet fever, the determination to the skin and the elimination from the skin is so prompt and efficient that post-scarlatinal nephritis need not be anticipated. Waugh is authority for the statement that the agent is efficacious in acute sthenic erysipelas. It may be given in twenty drop doses, every four hours, and any prostrating influences antagonized. Local applications should not be neglected, but should be selected with care, and prompt tonics and restoratives should be administered in conjunction. In asthenic cases the agent should not be unqualifiedly discarded, but it may be adapted in small doses to the case in hand. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 343 Pilocarpine has a selective action for the skin, and is prescribed by specialists in a number of skin diseases, notably in pruritus, eczema, prurigo, and in hyperhidrosis pedum. Its continued internal use for other conditions has been known to result in an increased growth of the hair with restoration of the original color of gray hair. Pilocarpine in the proportion of two grains to the ounce of lanoline is a common application to the scalp to restore the hair and prevent baldness. Ophthalmologists claim excellent results from its use in a number of diseases of the eye. It is beneficial after extraction of the lens, and is said to promote the absorption of opacities in the vitreous humor which have resulted from recent infiltration. Foltz employed the drug regularly in iridocyclitis, in plastic and traumatic iritis, in rheumatis iritis, in hylatis, in simple glaucoma and in some cases of optic neuritis; also in traumatism of the eye, where there is effusion of the blood into the aqueous or vitrious humors, in retinal hemorrhage, in chorio-retinitis, and in detachment of the retina. In interstital keratitis, and in chronic conjunctivitis, also in croupus and diphtheritic conjunctivitis. In dry catarrh of the middle ear, and in eczema of the external auditory canal it has some beneficial influence. In atrophic rhinitis, and pharyngitis, it increases the activity of the glands, and produces general salutary results. A few doses of from twenty to thirty drops of jaborandi are given internally in cases of severe rhus poisoning, combined with proper external applications. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 344 In the treatment of the bite of venomous snakes and in anticipated hydrophobia, and in poisoning from canned fish and other meats—in ptomaine poisoning, the salts are administered in maximum doses. It is eliminative in its influence, only the poison must be antidoted by the proper remedy, and in organic poisons the permanganate of potassium is an efficient remedy.
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Counselling May cause drowsiness which may affect the ability to perform skilled tasks; if affected symptoms 5 days after iui 75mg endep amex, do not drive or operate machinery treatment juvenile rheumatoid arthritis generic endep 25mg otc, avoid alcoholic drink (theeffects of alcohol are enhanced) symptoms 8-10 dpo purchase cheap endep on line. This assessment is based on the full range of preparation and administration options described in the monograph. Efficacy and safety of patient controlled opioid analgesia for acute postoperative pain. Mild allergic reactions such as sneezing or mild asthma are warning signs that further injections may give rise to anaphylactic shock. Pabrinex Intramuscular High Potency Injection | 627 Technical information Incompatible with Not relevant Compatible with Not relevant pH No relevant Sodium content Negligible Excipients Contains benzyl alcohol. Fluid balance Regularly during * Dehydration increases the likelihood of renal treatment oxalate calculi formation with high dose ascorbic acid therapy. Ability to urinate Daily * High-dose ascorbic acid can cause renal oxalate calculi. Additional information Common and serious Immediate: Repeated injections of high concentrations of thiamine may undesirable effects causeanaphylacticshock. Pharmacokinetics Thiamine, riboflavin, pyridoxine, nicotinamide and ascorbic acid are widely distributed in the body tissues. Higher doses in excess of the body’s needs are rapidly eliminated unchanged in the urine. Significant interactions * Use of high-strength parenteral glucose solutions may "thiamine requirements and worsen symptoms. Actionincaseof overdose Stop treatment and give supportive therapy as appropriate. This assessment is based on the full range of preparation and administration options described in the monograph. Mild allergic reactions such as sneezing or mild asthma are warning signs that further injections may give rise to anaphylactic shock. Pabrinex Intravenous High Potency Injection | 629 * In thiamine deficiency "carbohydrate load including the use of high-strength parenteral glucose solutions may "thiamine requirements and worsen symptoms. Aminophylline, chloramphenicol sodium succinate, erythromycin, doxapram, propofol. Monitoring Measure Frequency Rationale Hypersensitivity During and for 1hour * Thiamine injections may give rise to anaphylactic reactions after administration shock and less severe hypersensitivity reactions such as mild asthma or sneezing. Ability to urinate Daily * High-dose ascorbic acid can cause renal oxalate calculi. Additional information Common and serious Immediate: Repeated injections of high concentrations of thiamine may cause undesirable effects anaphylactic shock. Pharmacokinetics Thiamine, riboflavin, pyridoxine, nicotinamide and ascorbic acid are widely distributed in the body tissues. Doses in excess of the body’s needs are rapidly eliminated unchanged in the urine. Significant * Use of high-strength parenteral glucose solutions may "thiamine interactions requirements and worsen symptoms. This assessment is based on the full range of preparation and administration options described in the monograph. Pre-treatment checks Do not use if there isknown hypersensitivitytopaliferminoranyE. Biochemical and other tests Bodyweight Dose In all cases be guided by the oncology team responsible for treating the patient. Standard dose: 60 micrograms/kg daily on three consecutive days (doses 1 to 3) before and three consecutive days after myeloablative chemotherapy (doses 4 to 6). Doses 1 to 3 are given on the three consecutive days prior to myeloablative chemotherapy, with the third dose administered 24--48 hours before chemotherapy.
Technical information Incompatible with Not relevant Compatible with Not relevant pH 4 medicine look up drugs cheap endep 25mg amex. Guanethidine monosulfate | 405 Monitoring Measure Frequency Rationale Blood pressure Every 30 minutes Response to therapy treatment effect endep 50mg without prescription. Electrolytes and urine Periodically Heart failure is a potential complication of prolonged output treatment medications known to cause seizures endep 10mg cheap. Terminal serum elimination half- life is around 5 days and elimination is prolonged in renal impairment. Keep the patient lying down and consider administration of fluid and electrolytes. This assessment is based on the full range of preparation and administration options described in the monograph. Oral treatment should succeed parenteral administration as soon as is practicable. Depending on response subsequent doses may be given every 4--6 hours, up to a maximum of 18mg/day. Haloperidol | 407 Technical information Incompatible with Do not mix with other drugs in the same syringe. Monitoring Measure Frequency Rationale Clinical effectiveness Post administration * To ensure that treatment is effective. Temperature Periodically after * Very rarely may cause neuroleptic injection malignant syndrome. Additional information Common and serious Injection-related: Local: Injection-site reactions. This assessment is based on the full range of preparation and administration options described in the monograph. Haloperidol decanoate 50mg/mL and 100mg/mL oily solution in 1-mL ampoules This preparation is a depot preparation and must not be confused with haloperidol injection for rapid tranquillisation. Pre-treatment checks * Do not administer to patients in comatose states, including alcohol, barbiturate or opiate poisoning or patients with Parkinson’s disease. Haloperidol decanoate | 409 * Caution if suffering from epilepsy, liver disease, renal failure, cardiac disease, depression, myas- thenia gravis, prostatic hypertrophy, narrow-angle glaucoma, hypothyroidism, hyperthyroidism, phaeochromocytoma, severe respiratory disease or if there are risk factors for stroke. Maintenance dose: repeat dose every 4 weeks, increasing if necessary by 50-mg increments to 300mg every 4 weeks. Technical information Incompatible with Do not mix with other drugs in the same syringe. Additional information Common and serious Injection-related: Local: Injection-site reactions. Counselling Advise patients not to drink alcohol especially at beginning of treatment. May impair alertness so do not drive or operate machinery until susceptibility is known. This assessment is based on the full range of preparation and administration options described in the monograph. Hartm ann’s solution (sodium lactate com pound, Ringer-lactate) 500-mL and 1-L infusion bags * Hartmann’ssolutionisacrystalloidintravenousfluidthatbehaveslikeNaCl0. Table H1 Electrolyte content of Hartmann’s solution Volume 500mL 1000mL Sodium (mmol) 65. The use of colloid solutions should be considered where plasma expansion is required owing to "losses.