3. Use In Nervous Diseases

Alcohol is of service for many forms of diseases of the nervous system. Neuralgic pains are sometimes allayed by the use of alcoholic drinks which contain volatile ethers, but they should be prescribed with care. In any neuralgic or nervous affections, such as hysteria, which are more or less chronic, it is well to observe that many of the so-called elixirs, nerve tonics, etc., which are recommended for cases of this nature, and especially for treatment of nervous prostration, contain a large percentage of alcohol, and their constant and indiscriminate use is liable to establish permanent alcoholism. In the stomach alcohol may act as an anaesthetic in cases of irritant nervous dyspepsia.

4. Use In Fevers

The whole question of the employment of alcohol in fevers is obviously of grave importance.

The value of alcohol in the treatment of fevers is now universally recognised, and its beneficial effect is manifested in two ways: first, upon the vital functions of the nervous system, circulation, and heat regulation; and, secondly, in sparing the tissues from too rapid combustion and wasting by furnishing fuel in their stead. In fever the increased nitrogenous waste is evidenced by the greater elimination of urea from the kidneys, while the quantity of urine and perspiration are lessened. The use of alcohol meets all indications by lessening the production of nitrogenous waste, by acting as a diuretic, and by regulating the peripheral blood pressure and increasing the perspiration. To accomplish these results, usually six or eight ounces in the twenty-four hours, and often much more, must be given.

As a mere antipyretic the influence of alcohol is less striking than that of many special remedies which have the power of reducing the body temperature, but it has the decided advanta'ge over most of these remedies that its proper use is accompanied by stimulation rather than depression of the heart action.

It may be regarded as a general rule that when given in large quantities if the odour of alcohol is not present in the breath several hours after it has been ingested, and if the pulse is slowed and delirium is reduced under its use, the amount taken is clearly being oxidised as a food and is doing good. On the other hand, if the odour persists in the breath and the pulse is not improved, or the patient becomes more delirious, it indicates that too much alcohol is being given, and the dosage should be accordingly reduced.

The effect of alcohol in fevers is shown by the fact that in health, when drunk in large quantities, it excites gastric catarrh and occasions dyspepsia, whereas a similar amount taken in the height of an acute fever may be very beneficial.

It must not be inferred from the foregoing statements that alcohol should be given at once in fever, or that it should be given in every fever. There are many cases in which it is contraindicated. Such are of sthenic type and of short duration. There are others in which it is a mistake to give it too early, and its use should be postponed until the conditions are present of prostration and nervous exhaustion. There are still other cases in which it should be prescribed at once, as, for example, in pneumonia in feeble or elderly subjects.

The general indications for the use of alcohol as a food in continued fevers or for an increase of the quantity already being given are found in the predominance of one or more of the following symptoms: Increased weakness or faintness, low muttering delirium continued even when the patient is undisturbed, tremor of the tongue and hands, great dryness of the tongue, extreme feebleness of the voice, irregularities in the respiration and pulse, enfeebled or irregular heart action, and absence of either of the cardiac sounds.

There is a tendency at the present time to abandon excessive dosage of alcohol in severe acute febrile infectious diseases, such as pneumonia and typhoid fever, in which it was formerly given at the rate of an ounce an hour or twenty-four ounces per diem, for it is found that other stimulants, such as digitalis', strychnine, caffeine, etc., make it possible to use less spirits. A full discussion of this topic will be found under the heading Dietetic Treatment of Fever.

In the treatment of convalescence, when patients are able to digest and assimilate more and more food, less alcohol is required.