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- 2, By those means which take off the spasm of the extreme vessels, which we suppose to be the chief cause of violent reaction.
128. The action of the heart and arteries may be diminished,
1, By avoiding or moderating those irritations, which, in one degree or other, are almost constantly applied to the body;
2, By the use of certain sedative powers;
3, By diminishing the tension and tone of the arterial system.
129. The irritations (128, 1) almost constantly applied, are the impressions made upon our senses; the exercise of the body and mind; and the taking in of aliments. The avoiding these as much as possible, or the moderating their force constitute what is rightly called the ANTIPHLOGISTIC REGIMEN, proper to be employed in al. most every continued fever.
130. The conduct of this regimen is to be directed by the following rules and considerations.
1, Impressions on the external senses, as being stimulant to the system, and a chief support of its activity, should be avoided as much as possible; those especially of more constant application, those of a stronger kind, and those which give pain and uneasiness.
No impression is to be more carefully guarded against than that of external heat; while, at the same time, every other means of increasing the heat of the body is to be shunned. Both these precautions are to be observed as soon as a hot stage is fully formed, and to be attended to during its continuance; excepting in certain cases, where a determination to sweating is necessary, or where the stimulant effects of heat may be compensated by circumstances which determine it to produce a relaxation and revulsion.
2, All motion of the body is to be avoided, especially that which requires the exercise of its own muscles; and that posture of the body is to be chosen which employs the fewest muscles, and which keeps none of them long in a state of contraction. Speaking, as it accelerates respiration, is particularly to be refrained from.
It is to be observed, that every motion of the body is the more stimulant in proportion as the body is weaker.
3, The exercise of the mind also is a stimulus to the body; so that all impressions which lead to thought, and those especially which may excite 'emotion or passion, are to be carefully shunned.
With respect to avoiding impressions of all kinds, an exception is to be made in the case of a delirium coming on, when the presenting of accustomed objects may have the effect of interrupting and diverting the irregular train of ideas then arising in the mind. !
4; The presence of recent aliment in the stomach always proves a stimulus to the system, and ought therefore to be as moderate as possible. A total abstinence for some time may be of service; but as this cannot be long continued with safety, we must avoid the stimulus of aliment, by choosing that kind which gives the least. We suppose that alimentary matters are more stimulant according as they are more alkalescent; and this leads to avoid all animal, and to use -vegetable food only.
· As our drinks also may prove stimulant, so all aromatic and spirituous liquors are to be avoided; and, in answering the present indication, all fermented liquors, excepting those of the lowest quality, are to be abstained from.
131. Beside these stimulant powers more constantly applied, there are others which, although occasional only, yet as commonly accompanying fevers, must be attended to and removed.
One is, the sense of thirst, which, as a power.. ful stimulus, ought always, in one way or other, to be removed.
Another stimulus frequently arises from crudi. ties, or corrupted humours, in the stomach ; and it is to be removed by vomiting, by dilution, or by the use of acids.
A third stimulus often arises from the pretera
natural retention of feces in the intestines; and ought to be removed by frequent laxative glysters.
A fourth stimulus to be constantly suspected in févers, is a general acrimony of the fluids, as produced by the increase of motion and heat, joined with an interruption of the excretions. This acri. mony is to be obviated or removed by the taking in of large quantities of mild antiseptic liquors. :
132. The avoiding of irritation in all these particulars, (190 and 131), constitutes the antiphlogistic regimen absolutely necessary for moderating the violence:of reaction, and, if I mistake not, is proper in almost every circumstance of continued fevers; because the propriety and safety of employing stimulants is often uncertain ; and because several of those above mentioned, beside their stimulant powers, have other qualities by which they may be hurtful.
It appears. to me, that the supposed utility of stimulants, in certain cases of fever, has often arisen from a mistake in having ascribed to their stimulant what's really depended upon their antispasmodic power. . .
133. A second head of the means (129, 2) for moderating the violence of reaction, comprehends Certain sedative powers, which may be employed to diminish the activity of the whole body, and, particularly that of the sanguiferous system.
The first of these to be mentioned is the applic cation of cold.
Heat is the chief support of the activity of the animal system, which is therefore provided in it. self with a power of generating heat. But; at the same time, we observe, that this would go to excess, were it not constantly moderated by a cooler temperature in the surrounding atmosphere. When, therefore, that power of the system generating heat is increased, as is commonly the case in fevers, it is necessary not only to avoid all means of increasing it further, but it seems proper also to apply air of a cooler temperature; or at least to apply it more entirely and freely, than in a state of health.
Some late experiments in the small-pox, and in continued fevers, shew that the free admission of cool air to the body is a powerful remedy in moderating the violence of reaction; but what is the mode of its operation, to what circumstances of fever it is peculiarly adapted, or what limitations it requires, I shall not venture to determine, till more particularly instructed by further experience.
134. A second sedative power which may be employed in fevers, is that of certain inedicines, known in the writings on the materia medica under the title of REFRIGERANTS.
The chief of these are acids of all kinds, when sufficiently diluted ; and they are, in several re.