Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    200/976 (page 180)
    throat. The best thing for him in the stage of full collapse is to gratify pretty freely his instinctive desire for cold water. This can- not do harm :] a little may run off by the bowels, or be vomited, but if any remains to be absorbed in the reaction stages it will have the best possible effect. It is of no use to keep up the patient’s vomiting by giving him as much as his morbid thirst impels him to swallow ; but a considerable quantity may be given in the course of two or three hours by tablespoonfuls or wincglassfuls at a time; the colder the better. If ice be available it will be better to give iced water, or to place pieces of clear ice in the patient’s mouth frequently. This quenches his thirst, and seldom causes vomiting. There need be no restriction placed upon the quantity of water given beyond that it is advisable not to provoke too much vomiting by it. Although I have urged the uselessness, nay, mischief, of pouring down drugs and stimu- lants into a patient in the state of perfect collapse, there are certain conditions of collapse in which when given cautiously they may be of great use. The cases are those in winch collapse is not perfect, in which the circulation still goes on, though feebly, throughout the algide stage. In these the volatile stimuli, aether and ammonia, in mixtures, and weak brandy and water are certainly beneficial. They maintain the strength, as they do in any other diseases with exhaustion. Ten to twenty drops of liquor ammonia, or thirty of sulphuric aether pro- perty diluted with iced water or cold water, given every half hour or hour, with an occasional tablespoonful of brandy find water, may be continued while the pulse seems to be maintained by them. In these cases the Cholera mixtures and Cholera pills so often used in India are of service. They are made up in various ways, but contain gene- rally such stimulants as aether, ammonia, tincture of camphor, and essential oils, as cajeput, aniseed, cinnamon, peppermint, &c. or some of them. Most of them also contain laudanum, but it would be better to omit this, and add it to the dose when considered necessary. Cholera pills can be made up of camphor, two grains, assafcetida and long pepper, each one grain, with a little mucilage. A pill should be given every one and a half or two hours. They are useful in the same circumstances that the Cholera mixtures are. When acetate of lead has been used as the astringent, the liquor ammonia should be used in preference to the carbonates of ammonia, or their preparations. It will be observed that the principles advocated in the use of stimulants are that we should be guided in the administration by the pulse. While that remains, absorption and other vital actions go on, although perhaps in a diminished degree, and while these continue, stimulants may assist the patient through the crisis, and may prevent his passing