Stimuli, however, should always be used with much caution and prudence,
and never unless fully warranted by the train of symptoms under which
the patient is labouring at the time; when the circulation is restored
in the limbs, and is becoming throughout steady and more natural, all
sources of excitement must be abandoned and carefully avoided, as there
is considerable risk of reaction proceeding to too great a height.
The patient is to be kept quiet in a darkened room, cold applications
made to the head, previously shaved, and free motion of the bowels
procured by neutral salts with antimony, or by other purgatives not of
an irritating nature, and not given in such doses as to prove violently
cathartic. Enemata are in some cases preferable, and are always a
valuable adjunct, to the employment of purgatives by the mouth; they
procure evacuation from the larger intestines, in which feculent matter
chiefly accumulates; they ought to contain asafœtida and turpentine;
with these additions more salutary effects are produced than from mere
evacuants. The latter ingredient would seem, by its local stimulus, to
impart energy to the bowels sufficient for the correct performances of
their functions, while the former tends to allay spasm and irritation,
both locally and generally.
If the circulation becomes unduly excited, abstraction of blood
from the system, in sufficient quantities and at proper intervals,
is absolutely necessary; and the depletion must be regulated by the
symptoms and circumstances of each case. The action will in general
be more speedily and effectually moderated by one copious bleeding
at the commencement, than by repeated bleedings to a less extent. An
easy and open state of the bowels is of much importance in the excited
stage. Mercurial preparations are sometimes useful, as they are known
to possess the power of causing the absorption of coagulated lymph and
serum, and probably of preventing their effusion.
In cases where insensibility continues after the arterial excitement
has been subdued, counter-irritation on the head or the back of the
neck is often useful, as the application of blisters, or the rubbing in
of antimonial ointment. These are supposed to act by causing an unusual
influx of blood to the surface, producing a change in that fluid by the
copious purulent, serous, and lymphatic secretions from the irritated
part, and thereby diminishing the distended and engorged state of the
internal vessels, which might produce considerable compression of the
brain.
Public-domain text, read in full here on John Shaqi.
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