Disturbances of the Heart: Discussion of the Treatment of the Heart in Its Various Disorders, With a Chapter on Blood PressureOsborne, Oliver T. (Oliver Thomas)
Science
Disturbances of the Heart: Discussion of the Treatment of the Heart in Its Various Disorders, With a Chapter on Blood Pressure
Osborne, Oliver T. (Oliver Thomas)
Blood pressure; Heart -- Diseases
To obtain cardiac stimulation from alcohol it must be given in
strong solutions, generally in the form of whisky or brandy, for
local irritation of the mouth, esophagus and stomach; reflexly the
heart is stimulated and the blood pressure rises. As soon as
complete absorption has taken place, the blood pressure falls. For
continuous stimulation, another dose of alcohol must be given before
this depression occurs. This may be in from one to three hours. To
continue such stimulation, the dose of alcohol must be increased.
The future of such treatment means an alcoholic sleep with
depression, alcoholic excitement which is not desired, or profound
nausea and vomiting, with peripheral relaxation and cold
perspiration.
Obviously none of these conditions is desirable; but in
arteriosclerosis, or when the blood pressure is high and the heart
labors tinder the disadvantage of contracting against an abnormal
circulatory resistance, alcohol may act perfectly to relieve this
kind of circulatory disturbance. In this condition the alcohol
should not be given concentrated, and as soon as it is thoroughly
absorbed vasodilatation occurs, peripheral circulation and therefore
warmth are increased, and the heart is relieved of its extra load.
In such instances, in proper doses not too frequently repeated,
rarely more than 1 or 2 teaspoonfuls every three hours, alcohol is a
valuable drug. Such good action of alcohol is often seen when the
surface of the body is cold from chilling, or the extremities are
cold from vasomotor spasm. A good-sized dose of alcohol, best given
hot, equalizes the circulation and acts for good. On the contrary,
it is obvious that, if the patient is cold from collapse and there
is cold perspiration and very low blood pressure, alcohol is not the
drug indicated, although one dose may be of benefit while other more
slowly acting cardiac tonics or stimulants are being administered.
During serious prolonged illness and when the patient has not had
sufficient food and is not taking sufficient food, alcohol in the
form of whisky or brandy, not more than a teaspoonful every three
hours, acts as a necessary food, and will more or less prevent
acidosis from starvation.
It will be seen that alcohol, except possibly in a single dose
occasionally, or for some special reason, is rarely indicated in
decompensation.
When alcohol is administered regularly, whether during a fever
process or for any other reason, if it causes a dry tongue, cerebral
excitement, flushed face and a bounding pulse or if there is the
odor of alcohol on the breath, the dose is too large, and alcohol is
contraindicated.
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