We have seen already that there is more than one kind of weakness from disease. There may be oppression, as in the early stage of almost any acute disorder; or depression (prostration) from a great shock, such as a railroad accident, crushing a limb, or from the lowering influence of typhus or typhoid fever; or exhaustion, such as will be produced by a large hemorrhage, an attack of cholera morbus, or a severe disease of some length of continuance.
For oppression, in a person of good constitution and strength, unloading the system is needed - by sweating, purging, and action of the kidneys.
For depression, support is called for. Experience indicates that alcoholic stimulation is, in sudden or great prostration from any cause, the most effectual. It may enable the system to tide over the time of weakness and danger, so that all will go on well again ; whereas, without it, the patient may sink and die.
Alcoholic stimulation is very often abused. It is employed when there is no occasion for it, and when required it is frequently too great in amount. Every little feeling of weakness does not properly call for a glass of wine or whiskey; far from it. Fainting is better treated by fresh air, as much as possible ; dashing or sprinkling with cold water on the face, and ammonia. Smelling salts (carbonate of ammonium) put, for a moment at a time, under the nostrils, will hasten recovery from a faint. When swallowing is possible, twenty or thirty drops of the aromatic spirit of ammonia may be taken in a wineglassful of water.
But when a person is almost dead from loss of blood, or an extensive burn, or the shock of a railroad accident, with white lips, shrunken cheeks, cold skin, and rapid, thready pulse, we need to stimulate with alcohol, but not too much. A teaspoonful of whiskey will be enough, in many instances, repeated in ten or fifteen minutes, if the patient does not show reaction. A tablespoonful will be a large enough dose at one draught in any case. More will do no better towards stimulation, and the after effect will be worse. Always, moreover, such stimulation must be withheld as soon as the depression has passed away, and then the less alcohol he has had put into his system the better.
After an acute disease with fever - as scarlet fever, measles, typhoid fever, etc.- convalescence is accompanied by more or less debility. But when everything goes well, appetite is then strong, and the losses of the system are made up by the appropriation of food. A person who was healthy before such an attack will commonly need no help from medicines to " build up "again.
Running down in strength, however, with or without acute disease, and often without any fixed disorder of any great organ, is not uncommon, from various causes. Too severe, monotonous, and long-continued labor, out of proportion to one's strength ; worry, particularly when it prevents refreshing sleep ; living in a close air, without change and exercise; these are some of the conditions in which people are apt to get down" below par" in strength.
To meet these, we have, besides rest from care, change of air, and generous feeding (all of which are of the greatest importance), three sorts of tonics : blood-renewers, appetizers, and nervines. Of the first class, referring to works on Materia Medica for others, the most valuable, in the generality of cases, are iron and cod-liver oil. To the second class belong the vegetable bitters, as gentian, quassia, columbo, chamomile, etc.; and the mineral acids, as aromatic sulphuric acid (elixir of vitroil), and others. Under the third head may be named quinine as most largely and safely applicable to general debility. Physicians also use, in some selected cases, strychnia and phosphorus, as powerful nervine tonics; but they are too dangerous to allow in the family medicine chest for use without medical advice. One preparation, if labelled poison, and kept out of the way of the children and of ignorant servants, may sometimes find safe use as a tonic both to the digestive organs and to the nervous system ; tincture of nux vomica; safe in the small dose of ten drops twice or thrice daily.