On the use of alcohol as a medicine / by T.K. Monro and John Wainman Findlay.
- Thomas Kirkpatrick Monro
- Date:
- [1904]
Licence: In copyright
Credit: On the use of alcohol as a medicine / by T.K. Monro and John Wainman Findlay. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![moribund, and was not seen during life by Dr. Gairdner. Alcohol was given in 1 case only of the 189, but this was long after the fever had run its course. The patient was a child with cancrum oris and great debility of the stomach. Gairdner calculates that, if his 189 young patients had died at the same rate as in the Glasgow Fever Hospital (1861-62), there would have been 9 deaths instead of 1. Loudon Fever Hospital, >, >> c.l2 ,, King's College Hospital (under Todd) ,, ,, 30 to 35 ,, „ But nowadays, for one patient who gets alcohol as a food, there are probably a dozen or more who get it as a cardiac stimulant. Alcohol, in a pretty strong solution, by irritating the mucous membrane of the stomach and of the mouth, causes not only local dilatation of blood-vessels, but also a rise of the general blood-pressure, and therefore an increase in the velocity of the intracranial circulation. We can thus understand the utility of brandy and whisky in cases of fainting, particularly as one or other of these is generally at hand; but it has been found that 15 drops of tincture of capsicum will cause a rise of blood-pressure even less transient, and therefore more satisfactory, than that caused by |- or f of an ounce of whisky. But it is obvious that reflex stimulation of the circulation, by the application of an irritant to the mucous membrane of the digestive tract, is not a procedure which it is desirable to keep up for days or weeks. The unsatisfactory and even rislcy nature of this treatment is emphasised by an experiment of Briggs,^ which showed that the rise of blood- pressure in a temperate adult, after | to 1 oz. of whisky, never lasted more than thirty minutes, and was followed by a slight but more lasting fall below the previous level. Clearly, this is not the kind of stimulation we want in acute or exhausting disease. We want something that will act directly upon the cardiac muscle or ganglia. I fancy we were all trained as students to regard alcohol as a cardiac stimulant of the kind just indicated—a stimulant which, if it did not actually add to the energy of the cardiac muscle, would encourage it to use more freely such reserve of strength as it possessed, and would postpone the risk of final collapse until the natural decline of the fever, aided by feeding, nursing, and medicines, should set aside that risk, and allow the exhausted oi'gan to recupei'ate. Of all aspects of the alcohol (luestion—so far as tlierapeutics are concerned—this is by far the most important. Is alcohol a cardiac stimulant or not ? 1 /]nU. Johns Hopk. Uosp., 1903, p. 36, a2](https://iiif.wellcomecollection.org/image/b21466749_0007.jp2/full/800%2C/0/default.jpg)
