The doctor at home and nurse's guidebook / edited by George Black.

Date:
1909
Catalogue details

Licence: In copyright

Credit: The doctor at home and nurse's guidebook / edited by George Black. Source: Wellcome Collection.

    48/684 (page 24)
    which the physician is required to make such nice and difficult dis- tinctions, and in which life so com- pletely depends on the accuracy of his discrimination. At one time the vital energy of the brain is so far exhausted as of itself to threaten the total abolition of its functions ; at another time the arterial action or the venous congestion is so great as to threaten a large extravasation of blood. For states so opposite, opposite remedies must, of course, be required ; but the difficulty at all times is to interpret the outward signs aright. If together with the ordinary symptoms of drowsiness, giddiness, headache, and so on, there be a flushed countenance, a dull or suffused eye, a hot skin, a strong or full pulse, the abstraction of blood may be indispensable to the preservation of life ; but if, on the other hand, the countenance be pallid and sunk, the pulse full, and the skin cool, the smallest blood- letting may utterly exhaust the vital energies of a brain already greatly depressed. It is in clearly pointing out distinctions like these, and in guiding to the selection of the remedies appropriate to each, that science is the salvation of life. But such, too, are precisely the cases in which no skill on the part of the physician can succeed with- out the steady co-operation of the patient. The physician, duly weigh- ing the premonitory signs, may foresee the impending danger and give warning of it, and precisely prescribe the medicine and regimen fitted to avert it ; but if these be either altogether neglected, or only partially followed, the disease will hold on its course, and life be lost. And this loss of life is deplorably frequent from the neglect on the part of the patient of the appro- priate remedies in the primary stage of the disease, when such remedies may be employed with almost cer- tain success ; and the same is true of the neglect of such remedies in the stage subsequent to an apo- plectic paroxysm, although in this stage the best concerted measures have a much smaller chance of securing their object. As it would be vain to attempt here to enter into the modification of treatment required in the premonitory and the consecutive stages of the dis- ease, so it would be out of place to discuss the measures proper to be adopted in the paroxysm itself. The state, both of the brain and of the system, varies in every indi- vidual case, and safe, not to say successful, treatment must in every case be modified accordingly. It is only necessary to add here that whenever a person is seized with a'fit of apoplexy, he should be carried into a large room, the freest possible circulation of fresh air should be promoted around the body, which should be placed in the horizontal position, with the head, however, considerably raised. All bandages should be taken from about the head and neck—and especially from about the neck—and a medical man should be sent for instantly. Every observer of such a case should bear in mind that the loss of life may be the consequence of the loss of a minute. In cases of sudden seizure, as of apoplexy, epilepsy, convulsions, or fainting, speedy assistance is of the first importance. Some judgment is required to dis- tinguish the nature of the attack, and long before a medical attendant can arrive upon the spot the patient may be saved or lost. Under no circumstances what- ever should anything, even a drop of water, be given by the mouth. Alcohol is especially harmful.