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    Turpentine Therapy



    This section is from the “A Practical Treatise On Materia Medica And Therapeutics” book, by Roberts Bartholow. Also available from Amazon: A Practical Treatise On Materia Medica And Therapeutics

    Turpentine Therapy

    Flatulence may be quickly relieved by a few drops (three to five) of turpentine, on a lump of sugar. This remedy is especially indicated in flatulence persisting from a paretic state of the muscular layer of the bowel. There is abundant evidence to prove the curative power of oil of turpentine in chronic intestinal catarrh. It is especially indicated when the tongue is dry and glazed, when there is tympanitic distention of the bowels, and when the alvine discharges consist either of fluid faeces or scybala, mixed with mucus and pale, watery blood. It is best administered in an emulsion, with almond- oil and opium, Rx O1. terebinthini, 3 j; ol. amygdal. express., oz ss; tinct. opii, 3 ij ; mucil. acaeiae, 3 v; aquae laur.-cerasi, oz ss. M. Sig.: A teaspoonful every three, four, or six hours. The same remedy, in a similar combination, is very effective in acute dysentery after the subsidence of the more acute symptoms. The following is probably the true explanation of its action in these cases: it gives tonicity to the vessels, and to the muscular fiber of the intestines; arrests the putrefactive and fermentative processes which take place in the vitiated mucus and articles of food, and increases the cutaneous capillary circulation, thus relieving congestion of internal organs.
    Stimulating enemata are made of turpentine, mucilage, oils, etc. These are especially indicated in constipation, and in impaction of the rectum. Rx O1. terebinthini, 3 ij— oz j; ol. ricini, oz ij; vitell. ovi unius; decoct, hordei, oz viij—Oj. M. Sig.: As an enema. Such injections are frequently used in tympanitic distention of the large intestine, in flatulent colic, in impaction of the caecum, etc.
    A combination of equal parts of turpentine and ether constitutes the well-known remedy of Durand for the solution and cure of biliary calculi. Notwithstanding the unquestionable utility of this remedy, we can not admit with Durand that its efficacy depends on its solvent power (Trousseau). During the attack of biliary colic this remedy may be administered with a view to its anodyne and antispasmodic effect; but, as Köhler states, it is by no means equal to morphine and chloral hydrate. In the after-treatment, clinical experience is in favor of the occasional administration of Durand’s remedy during a course of Vichy or Carlsbad water.
    Turpentine is one of the most effective remedies which we possess in the treatment of taeniae. Full doses ( 3 ss— 3 ij) are required, and the rules for preliminary treatment already laid down (see Anthelmintics) should be adhered to. Turpentine should be combined with a purgative, in order to insure prompt cathartic effect. If absorption of any considerable part of the turpentine takes place, violent intoxication will follow, and irritation of the kidneys, haematuria, and strangury, will be produced in the efforts at elimination. The oleo-resin of filix mas may be combined with turpentine. Rx O1. terebinthinae, 3 j; oleo-resinse filicis, 3 j; vitell. ovi no. ij; ol. ricini, oz j. M. Sig.: A draught. This is an effective, but by no means an agreeable, mixture. An ounce each of turpentine and castor-oil may be administered, as the cathartic, after the use of the decoction of pomegranate.
    Turpentine being a cardiac stimulant, and an excitant of the capillary circulation, is contraindicated in hypertrophy of the heart, and when advanced atheroma of the cerebral arteries may be presumed to exist. It is a serviceable cardiac stimulant when the action of the heart is weak, and the arterial tension low. In the passive haemorrhages we possess few agents more generally useful. The indications for its use are a condition of debility, relaxation of the vessels, and an impoverished condition of the blood. Transudations on the free mucous surfaces—epistaxis, bronchial haemorrhage, haematemesis, intestinal haemorrhages, hematuria—when associated with the state of constitutional depression defined above, are forms of haemorrhage in which turpentine should be used. Rx O1. terebinthinae, 3 iij; ext. digitalis fl., 3 j; mucil. acaciae, oz ss; aquae menthae pip., oz j. M. Sig.: A tea-spoonful every three hours. The hemorrhagic transudations which take place in purpura, in scorbutus, and allied states, are also arrested by turpentine. It need hardly be stated that active haemorrhage and a condition of plethora contraindicate the use of turpentine.
    As a stimulant to the vaso-motor nervous system, turpentine is indicated in fevers when the action of the heart is feeble, the arterial tension low, and the peripheral circulation languidTen drops in an emulsion is a suitable form, and every two hours is a proper interval for its administration in this condition of things. According to G. B. Wood, a dry tongue, peeling off in flakes, leaving a glazed surface beneath, is a special indication for the use of turpentine in fevers. The intestinal haemorrhage of typhoid may be restrained by turpentine.
    Clinical experience is in favor of the use of turpentine in puerperal fever and in yellow fever. The indications for its employment in these maladies are just the same as those mentioned above in typhoid. Cardiac weakness, depression of the vaso-motor nervous system, a dissolved state of the blood, are the conditions requiring turpentine. Tympanitic distention of the abdomen is an additional indication in puerperal fever. Similarly, turpentine is used in epidemic dysentery, traumatic erysipelas, hospital gangrene, etc. In these various states, employed with a well-defined conception of its real powers, this remedy is more generally serviceable as a stimulant than alcohol. As respects the dosage, in febrile diseases, a rule may be formulated as follows: for the intestinal complications, small doses frequently repeated (ten drops) ; as a stimulant to the vaso-motor nervous system, larger doses (τη x— 3 ss) at somewhat longer intervals.
    In the article on “Phosphorus” attention has been called to the utility of turpentine in poisoning by this substance.
    The physiological effects of turpentine indicate its utility in certain disorders of the nervous system. As an enema, turpentine has been used for its derivative effect in insolation or sunstroke (Levick, Wood), and in cerebrospinal meningitis (Hirsch). So accurate an authority as Topinard maintains the utility of this remedy in the cystic complications of posterior spinal sclerosis. Turpentine has long been used successfully in epilepsy, but in those cases only in which the seizures were due to the reflex impression of intestinal parasites (taeniae). Tic-doidoureux and sciatica, when rheumatic in origin, or when produced by fecal accumulations, have been cured by the vigorous use of turpentine, but we have now other means of treatment more generally useful and less disagreeable.
    As turpentine is largely eliminated by the bronchial and renal mucous membrane, decided effects are produced at these points. In diffusing outward, a change in the tonicity of the vessels, and in the character of the secretions, must necessarily be produced. Clinical experience confirms the deductions of theory. In chronic bronchitis, with profuse expectoration (bronchorrhcea), especially when the expectorated matters have a fetid odor, turpentine is an excellent remedy (Oppolzer). In gangrene of the lung, although it is not curative, it acts beneficially in diminishing the fetor. In pneumonia and capillary bronchitis, when the vital powers are depressed and the peripheral circulation is feeble, turpentine is one of the best stimulants which we can employ. The depression which occurs during the period of crisis in pneumonia, and the condition of purulent infiltration, especially indicate the use of this remedy. In the so-called humid asthma, and in emphysema with profuse bronchial catarrh, good results are obtained by the use of turpentine. In these various pulmonary maladies, the action of turpentine is largely local, as already explained, but it should not be forgotten that the powerful stimulation of the cutaneous circulation which it causes must contribute no small share of the curative action.
    In hydro-nephrosis and pyo-nephrosis turpentine is used as in bronchial catarrh, viz., to alter by actual contact the relaxed condition of the vessels, and the pathological secretions of the mucous membrane. It is, of course, contraindicated during the existence of acute symptoms. Chronic catarrh of the bladder is not infrequently much improved by the use of this agent. It is most serviceable in those cases resulting from a transference of urethral inflammation, or due to prostatic disease. Incontinence of urine, the result of atony of the muscular layer of the bladder, is sometimes removed by small doses of turpentine. Chronic gonorrhoea, gleet, spermatorrhoea, and prostorrhoea, when the discharges peculiar to these maladies are due to a relaxed condition of the affected parts, are not infrequently remarkably benefited by moderate doses of turpentine.

    External Uses of Turpentine

    The author long ago pointed out the fact that turpentine is one of the most efficient applications in hospital gangrene. The mortified parts are first removed with the scissors, and the remedy is then applied directly to the affected surface, by means of a piece of cotton cloth saturated with it. Fetor is removed and sloughing is arrested, and but little pain attends the application.
    Turpentine-stupes are much employed as a local and external means of treating internal inflammations. A piece of spongio-piline, or of flannel, large enough to cover the affected part, is first moistened with hot water, and then a few drops of turpentine (five to ten drops only) are sprinkled on it. As very severe smarting, inflammation, and vesication of the skin may occur from the application, and be experienced, indeed, some time subsequently to the removal of the stupe, care must be used not to continue it too long.
    Liniment of turpentine is a convenient counter-irritant in cases of myalgia, superficial neuralgia, lumbago, etc. An excellent counter-irritant application is made by mixing equal parts of oil of turpentine, acetic acid, and liniment of camphor (Stillé). The most successful treatment of severe burns is by the plan of Kentish, which consists in first washing the injured surface with turpentine, and then applying an ointment made by mixing basilicon-ointment with turpentine. Erysipelas has been treated by the same measures by Meigs, and the same applications are generally in use in chilblains.
    Inhalations of turpentine-vapor, or atomized turpentine, is an efficient means of local treatment in chronic laryngeal and bronchial affections. As a matter of curious therapeutics, it may be mentioned that gonorrhoea has been successfully treated by having the patient inhale the vapor of turpentine in an apartment filled with it.