But instead of bleeding, the proper remedy may possibly be the very
reverse: it may be requisite to afford a stimulus. The change of
structure produced by the inflammatory process may not have proceeded to
such an extent as to be absolutely incompatible with life; but the
powers of life maybe so exhausted by the inflammatory excitement that,
unless aid be brought to them, they will be overpowered, and sink:
afford them appropriate aid, and they will rally, and, although slowly,
ultimately repair the lesion which the organs have sustained.
This is precisely the condition, and perhaps it is the only condition,
under which stimuli are really beneficial in fever. Whenever such
remedies are indicated, the vascular action is weak, and there appears
to be a want of due supply of arterial blood to the brain. Of all
stimuli, wine or brandy is the best. If it be doubtful whether a
stimulus can be borne, or will prove beneficial, a few ounces of wine
may be administered. It will soon be manifest whether it be the
appropriate remedy. If the restlessness, the heat, the delirium increase
under its use, it will be obvious that it cannot be borne; if, after
some hours, no perceptible impression be made upon any symptom, it is
seldom of the least service, given to any extent, or persevered in for
any length of time. If it be capable of doing any good, some improvement
in the symptoms is commonly perceptible in a few hours after it is first
administered. Sometimes that improvement is sudden and most striking;
more commonly it is slight, slow, but still easy to be seen. If the
pulse become firmer, and especially slower, the tremor slighter, the
delirium milder, the sleep sounder, the skin cooler, and, above all, if
the sensibility increase, and the strength improve, it is then the
anchor of hope. It will save the patient if it be not pushed too far,
and if it be withdrawn as soon as excitement is reproduced, should that
happen, which it often does.
Public-domain text, read in full here on John Shaqi.
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