This section is from the book "Materia Medica And Therapeutics: An Introduction to the National Treatment of Disease", by John Mitchell Bruce. Also available from Amazon: The pharmacology and therapeutics of the materia medica.
(a) Injury or disease of the nervous system, as a cause of pyrexia, is generally beyond treatment. If the temperature rise to a dangerous height, it must be treated by the refrigerating measures presently to be described.
(b) Heat-fever is rationally treated by immediate removal of the patient to a cool, open atmosphere, and the application of refrigeration, in the form of cold affusion.
(c) Interference with the cooling function of the skin is rationally treated by increasing the loss of heat by refrigerants, Refrigeration is practically carried out by lowering the temperature of the external medium, by increasing the cutaneous circulation, and by stimulating the secretions, by the warm bath; hot, spiced alcoholic drinks, a brisk purgative.
When fever rises high, the temperature of the room must be kept low; the skin sponged; and if the pyrexia rise to a dangerous height, the prolonged cold bath or wet pack must be employed according to the method described in chapter xiv (The Body Heat, And Its Regulation : The Skin).
Diaphoretics are chiefly employed as refrigerants in symptomatic fevers, i.e. in the pyrexia attending ordinary local inflammation of the lungs, bronchi, fauces, or other parts. Alcohol, Hot Water, Liquor Ammoniae Acetatis, Ipecacuanha and Opium in the form of Dover's Powder, Antimony as the Pulvis Antimonialis or Vinum Antimoniale, and Tincture of Aconite are the drugs chiefly used to provoke perspiration in fever. With these, the use of the warm hath may he com-hined.
(d) A focus of increased heat-production, such as an abscess, must be removed as soon as possible.
(e) Increased metabolism generally, which is the principal cause of pyrexia, is rationally treated by Quinia, Salicin, Alcohol, the Phenol Derivates, and Aromatic Substances. The rule commonly followed is to give a single large dose of quinia, say 10 grains, when the temperature rises above a certain point-104° or 105°, according to circumstances; or repeated moderate doses or a single large dose may be given in anticipation of the exacerbation. Ague is thus combated by Quinia, and rheumatism by Salicin or the Salicylates.
(/) Foreign organisms or substances in the system.-Fever produced by these bodies and their life-processes would be rationally treated by destroying them. We attempt to do so by administering internally some of the substances which are destructive to lowly organised life apart from the body, or in wounds on the surface of the body-the antiseptics and disinfectants, and which may be named disinfectant antipyretics. The value of Quinia in ague is so great, that it is referred to a specific influence upon the organism of the disease. The powerful effect of Salicin upon rheumatism has been similarly explained.
(g) Combinations of causes.-Just as fever is generally traceable to a combination of the preceding causes, so it must, as a rule, be treated by the application of remedies which act in several ways, or by a combination of antipyretic measures. Thus Alcohol will be indicated in many cases of fever, because it dilates the vessels of the skin, increases the circulation through them, and stimulates the sweat glands, whilst it spares tissue damage, and acts as an antiseptic antipyretic. Quinia will be employed with advantage when the temperature mounts high, since it controls the metabolism not only of the animal tissues, but of the septic and foreign organisms which may be wasting these. Indeed all the measures which we have analysed under the preceding heads are to be freely combined, constituting the general treatment of fever. An abundant supply of nutritious and digestible food is essential, to compensate for the great increase of metabolism which is going on. Alcohol is a true food, easily taken, rapidly assimilated, and yielding abundance of energy at little cost to the tissues, and therefore it is in general use in fevers, although it is by no means an indispensable remedy.