This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol1", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
Wines may be employed for all the purposes for which alcoholic stimulation is demanded, and, as a general rule, are greatly preferable to ardent spirits. Almost the only exceptions to this rule are in the cases of the habitually intemperate, and in those instances of great prostration, or extraordinary insensibility to the effects of alcohol, in which the system refuses to respond to the influence of wine. For some local purposes, also, the distilled liquors are preferable. Only a few practical observations, therefore, will be required; and these few will refer rather to the choice of particular wines than to their general use.
When the habitual use of alcoholic drinks, in moderation, may be deemed advisable, as in those disposed to scrofula and phthisis, or labouring under these diseases without the complication of acute inflammation, the lighter wines should always be preferred to the stronger. Sauterne, claret, hock, or burgundy should be given preferably to madeira, sherry, or port. The object is here not cerebral stimulation, but a sustained tonic effect, the promotion of the digestive, assimilative, and nutritive functions, and perhaps more than all, that condition of the blood which experience has shown to be unfavourable to the tuberculous formation. I am not now treating of the relative value of wines and malt liquors, but of the choice between the different kinds of wine. In relation to the state of the stomach, when that is disposed to be disordered, I think burgundy will generally be found to agree with it better than the clarets or hocks, though probably somewhat more stimulant to the brain.
When, on the contrary, wine is required for a temporary purpose, and for its stimulant influence solely, the stronger wines should generally be preferred. They answer the indication more effectively, and are less apt to produce acescency, and otherwise to disorder the stomach. They are usually also better adapted to cases attended with dyspepsia. To fulfil the indications offered in the low or typhoid states of fever, and in general prostration from any cause, the stronger wines should be chosen. Madeira or sherry is, in general, preferable to the other stronger wines, and especially the latter, as being more free from acid. When, however, there is a coincident indication for astringency, as when diarrhoea exists, or hemorrhage, especially from the bowels, port wine should be preferably employed. When the stomach, in cases requiring stimulation, is very irritable, and rejects the other wines, champagne or sparkling moselle will sometimes answer an admirable purpose; but those varieties should be selected which are most free from saccharine matter, and in which the fermentation has been most nearly completed. The factitious champagnes might, under these circumstances, prove noxious, rather than remedial. When wines are required in cases presenting a joint indication for a stimulant and diuretic, as sometimes happens in dropsy, the lighter acidulous wines should be employed; and the same remark is applicable to enfeebled states of the system, with copious phosphatic deposition in the urine.
Wine-whey is an excellent preparation for use in all low fevers, in the debility which often attends the advanced stages of acute diseases, when the violence of the special disease is past, and in the same condition occurring at the close of incurable affections. Whenever stimulation is required in these cases, it is best, as a general rule, to begin with wine-whey, and advance to pure wine only after that preparation may prove inadequate to the demands of the case. It should be prepared by boiling a pint of milk, adding half a pint of wine while it is still boiling hot, and stirring until the mixture is complete. After coagulation, the whey should be strained off, and given generally without sweetening. Madeira or sherry should be employed in its preparation. The proportion of wine mentioned is requisite, in order to ensure perfect coagulation. If desirable, the whey may afterwards be diluted with solution of gum, or one of the amylaceous matters, or by rennet-whey. It has the advantage over diluted wine of being more nutritious, and often more acceptable to the patient.
The dose of wine-whey is, ordinarily, in low febrile cases, a wine-glassful every two hours; but it must be diminished or increased, both in frequency and amount, according to the effects desired, and those produced. The stronger wines may be given in doses varying from a tablespoonful to a wineglassful, at the same interval. In chronic or protracted cases, the dose should, in general, be less frequently repeated. When the lighter wines are used, the quantity must be regulated altogether by their effects; but one strict rule should be adhered to; namely, never to allow their influence to proceed so far as to disturb the sound operation of the brain. To become intoxicated, or even to approach intoxication, would be quite unjustifiable in patients using these wines habitually for their health.
Wine may be given by enema, when, in consequence of irritation of stomach, it cannot be retained if swallowed. It has, indeed, been particularly recommended, in this mode of administration, in old and obstinate cases of exhausting diarrhoea.