3217. Therapeutic Uses

Acute Diseases. Since the appearance of the first edition of this work, the question, whether Alcohol be a food or a medicine, has been the subject of much discussion. From the experiments of Lallemand, Duroy, Perrin, and Dr. E. Smith, there appears no reason to doubt that some of the alcohol taken is discharged in an undecomposed state by the breath and the secretions, but whether the whole be so eliminated is an open question. The fact that persons have been supported for many weeks on a diet consisting purely of alcoholic stimulants would lead to the belief that a portion at least is assimilated. Before, however, the discussion of this question, the influence of alcoholic stimuli in the treatment of acute diseases had occupied a chief place in professional attention. It would not be too much to say that, as to the value of Alcohol as a medicine, the opinion of a very large section of medical men has within the lust twenty years undergone a great change. With some, as with the late Dr. Todd, alcoholic stimuli have taken the place of bleeding and mercury, and all other active measures, not only in the treatment of such diseases as Continued Fevers and Erysipelas, but in acute inflammations, such as Pneumonia and Pericarditis. Others, whilst they have not pushed the use of brandy and wine to the same extent as "was advocated by Dr. Todd,* have used them more freely in acute diseases, administered them earlier, and have, in the majority of cases, replaced the bleeding, purging, nauseating, and starving formerly in vogue, by a general supporting plan of treatment, of which the administration of brandy or wine in regular but moderate doses has been a principal feature. It would be entering on too wide a field were we here to discuss the various theories on which the opposite modes of treatment have been supported. There can be no doubt that much injury was formerly inflicted in certain diseases by the spoliative treatment; and whilst the reckless administration of Alcohol in every case of acute disease is neither supported by science nor by common sense, on the whole less harm is likely to accrue from over-stimulation than from over-depletion. In conclusion, we quote the results to which a long experience of the effects of the stimulating treatment, in Acute Inflammations of important organs and Fevers, has conducted Dr. Blakis-ton: - "1. The administration of stimulants was found advantageous in the great majority of acute diseases. 2. The earlier they were given, the less was the amount required in the course of the illness. 3. When given in an early stage of the disease, they seemed to shorten its duration in some cases, and in all to induce a speedy convalescence. 4. On the contrary, when the administration of stimulants was deferred, the course of the disease and the convalescence were more protracted, and much larger doses were required. 5. When the slightest sign of intoxication appeared, it was taken to point to the necessity of an immediate and considerable reduction in the amount.

* Lib. of Med., vol. v. p. 281.