This section is from the book "A Text-Book Of Pharmacology, Therapeutics And Materia Medica", by T. Lauder Brunton. Also available from Amazon: A text-book of pharmacology, therapeutics and materia medica.
Alcohol as a Stimulant. - As a stimulant alcohol seems serviceable in acute diseases running a limited course, where we wish to sustain the patient's strength until the crisis is past, as well as to prevent it sinking from debility afterwards. The various rules which have been given for the administration of alcohol (in fever) may be condensed into one. If the alcohol tends to bring the patient nearer to his normal condition it is doing good; if it takes him further away from a healthy condition it is doing harm. The points which are usually specially attended to are the condition of the tongue, pulse, respiration, skin, and nervous system.
If it is found that the alcohol (a) renders the dry tongue moist, (b) slows and strengthens the pulse when it is too quick, or quickens it when it has been abnormally slow, (c) slows the hurried respiration, (d) renders the skin cooler or moister when too hot and dry, and (e) lessens delirium and brings on sleep, - then its action is beneficial. If it have an opposite effect it is harmful. Useful indications regarding the advantage of alcohol, and the amount to be given in any particular case may be obtained by the practitioner remaining beside the patient, counting the pulse, and watching the tongue, respiration, skin, and general condition for a quarter of an hour after the dose has been given. He will thus be able to give more definite directions than he otherwise could as to its continuance when he is absent. Particular care should be taken in the administration of alcoholic stimulants to patients in the small hours of the morning. It is about this time that attendants are most apt to become sleepy, and therefore careless, and just at this time, also, the external temperature is lowest, the fire is apt to get low, and the vital powers of the patient are most likely to sink. In giving alcoholic stimulants to support the strength in disease, care must be taken that they are not given so frequently and in such large quantities as to disorder the stomach and produce subacute gastritis. Sometimes, when given very freely to support the failing circulation, they have this effect; the result of which is that both food and stimulants are vomited, and the patient may be brought to death's door. The treatment here consists in the free administration of ice, along with two or three minims of solution of morphine and of hydrocyanic acid, frequently repeated until the vomiting is arrested.
During its elimination by the urine, alcohol may act as an irritant to the urinary passages when these are already inflamed. It is, consequently, injurious in gonorrhoea; and some sorts of beer, especially Bavarian beer, will even bring on gonorrhoea in persons who have previously had it, but who have been free from it at the time of taking the beer.