Volume 2

Modern treatment : the management of disease with medicinal and non-medicinal remedies / in contributions by American and foreign authorities ; edited by Hobart Amory Hare ; assisted by H.R.M. Landis.

Date:
1911
Catalogue details

Licence: In copyright

Credit: Modern treatment : the management of disease with medicinal and non-medicinal remedies / in contributions by American and foreign authorities ; edited by Hobart Amory Hare ; assisted by H.R.M. Landis. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    39/946 (page 37)
    yet to observe a single instance in which this drug did not cure the disease, so far as active symptoms are concerned, if administered early enough, and in scores of cases where the drug was said to have produced dangerous symptoms I have found that in reahty these symptoms did not exist, the patient being frightened by the usual unpleasant symptoms caused by large doses. The substitutes for quinine should never be used if it is possi- ble to avoid it, as they are always less efficient than the drug itself, and often even more dangerous. General Treatment and Treatment of Pernicious Malarial Fevers.—While quinine is a specific for malarial disease its effect can be greatly enhanced by proper general treatment, which, of course, is symptomatic in character to a large extent. All sufferers from malarial fever should be confined to bed during the active symptoms of the disease and it is best to keep the patient in bed for a day or two after the active symptoms have ceased. It is necessary that patients suffering from estivo-autumnal fever keep the bed for at least two or three days after the cessation of active symptoms, for these infections are very apt to recur or become aggravated by physical strain during the intermission of the paroxysms. It is remarkable how greatly the sufferer may be weakened and exhausted by even one paroxysm of malaria, and for this reason it is always advisable to insist upon rest in bed for a few days. As soon as the patient is seen the bowels should be opened by magnesium sulphate or calomel, for this undoubtedly greatly assists the absorption of quinine. The latter drug should never be administered during the height of fever unless pernicious symptoms are present, as it greatly increases the distress of the patient if administered at that time. During the cold stage the application externally of heat is often com- forting and hot drinks are relished, while in the warm stage great relief is afforded by sponging the patient with tepid or cold water, or a mixture of equal parts of water and alcohol. When the fever is very high the ice-pack or bath should always be given unless the patient is too weak to react. The use of such antipyretics as phenacetin or acetanilide should be avoided on account of their depressing effect upon the heart. These drugs are not of any benefit in malaria, and their use is to be condemned. If nervousness is excessive, the headache very severe, or vomiting be exhausting, a hypodermic of morphine is tg be given, but never unless it is really needed. During the decline in the fever symptoms of collapse may develop, and then the use of hot baths, the application of heat to the skin, strong coffee, the hypodermic use of salt solution, or venous injection of the same^ are mdicated. If cardiac weakness be present, a hypodermic injection of strychnine or atropine should be administered, and aromatic spirits of ammonia or brandy by the mouth. During the first two days of the malarial infection the food should be liquid in character, consisting of broths, gruels, and milk, after which a more liberal diet may be allowed. The patient should not be restricted in the use of fluids during the active stage, and should be encouraged to drink plenty of water or lemonade.