The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 4).
- Date:
- 1845
Licence: Public Domain Mark
Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 4). Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
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![body, or, in other words, cooling the skin, what- ever agent be employed, whether diluted acids, salts in a state of solution, cold air, or cold water or ice, the activity of the capillaries of the part is immediately diminished ; and as their action can- not be materially lessened without the whole vas- cular system being more or less influenced, the vigour of the heart and arteries is also materially depressed. The consequence of this diminished vascular action is immediately felt on the respira- tion ; the blood does not undergo its necessary change ; venous blood is conveyed to the brain, the function of which being impeded from defect of stimulus, a state somewhat resembling para- lysis of the nervous system ensues, so that torpor of every organ, the function of which depends on the energy of the brain and nerves, must neces- sarily follow. The effect of the abstraction of caloric on the nerves is strikingly illustrated by the numbness and insensibility which follow the exposure of the hands, in many individuals, in cold weather; a result which is more likely to arise from the direct influence of cold on the nerves themselves, than from the diminished supply of blood to the parts. Indeed, as in this case the effect on the nerves is partial, we can scarcely imagine any other cause of the diminished action of the capillaries than the depression of the nervous energy. Now if we suppose,—and the supposi- tion is far from being unreasonable,—that an effect resembling that produced on the surface takes place in the stomach when refrigerant agents are introduced into it, we may readily admit that the effect on the capillaries of that organ is extended by sympathy over the system. The possibility of such a result is equally probable in the one case as in the other. This opinion receives some support from the fact that nitrate of potassa operates as a powerful general refrigerant when it is swallowed at the instant of its solution ; but it acts as an excitant when it is not taken into the stomach until after it have been some time dis- solved. The sensation of cold which the nitre, during solution, causes in the stomach, is evi- dently owing ,to a partial abstraction of stimulus, and the effect of this being extended through the nerves to the heart and larger branches of the arterial S3'stem, a general reduction of action is produced, and this is followed by a sensation of cold over the whole body. Let us now inquire how far this theory is borne out by the known effects of refrigerants upon the functions of the stomach, the lungs, and other organs. ]. In the healthy condition of the stomachy re- frigerants exert little perceptible influence upon it; but when it is either in an irritable state, or affected with inflammation, the continued use of refrigerants, particularly cold and iced water and lemonades, allays the sensation of heat, nausea, and general uneasiness. Even when no local in- flammation exists, cold water and other cold, bland fluids, received into the stomach, moderate general excitement and control febrile action; an effect which can only be explained by the influence of the refrigerants on the nervous energy. The same results follow the administration of refri- gerants in enteritis. 2. Refrigerants exert no evident influence on the circulating and respiratory^ organs, in the state of health; although in some individuals:, owing to idiosyncrasy, acidulated fluids cannot be taken without so powerfully affecting the larynx as to cause a temporary loss of voice; but in a diseased state of these organs the influence of refrigerants is well marked. In an excited slate of the vascular system, when the pulse is both quicker and stronger than natural, acidulated drinks reduce both states, both moderating the action, and relaxing the tension of the pulse; nor is their effect on the capillaries less manifest; and it is to their influence on these that we must attribute the diminished tempera- ture which follows their administration. It is surely unnecessary to say how intimately this is connected with their impression on the nerves of the stomach. In the febrile state, the effects of refrigerants on the circulation are necessarily com- municated to the lungs; but besides this sympa- thetic influence, some of this class of medicines, in particular, acids, seem to operate directly on the pulmonary tissue. In acute inflammation of the air-tubes, or even of the pleura, acid fluids greatly augment the cough and oppress the breath- ing, when administered before the excitement be subdued ; and after this is effected, we still per- ceive the evidence of (heir action on the mucous membrane by the aid which they afford to ex- pectoration. 3. But the most decisive illustration of the extent to which the nervous system is influenced by refrigerants, is observed in the effects which acidulated fluids produce on those who are la- bouring under diseased conditions of the spinal cord. The author had an opportunity of wit- nessing this in a gentleman who was labouring under subacute inflammation of the spinal theca. Whenever he swallowed a spoonful of lemonade, or even an ordinary effervescing draught, a sensa- tion of pricking was felt over the surface, the skin became so sensitive as scarcely to admit of being touched, and the whole system restless and un- easy. Hypochondriacal and hysterical persons, not unfrequently, suffer in a similar manner from the internal use of acids ; and, as this effect is not confined to particular individuals, it cannot be ascribed to idiosyncrasy. Upon the whole, it is evident that refrigerants operate to a certain extent as sedatives ; diminish- ing the force and rapidity of the pulse, depressing morbid temperature, and calming, generally, the disturbance which always attends acute diseases. The substances employed as refrigerants operate either on the organic functions or on the sensi- bility of the body in a state of disease. 1. The refrigerants operating on the organic functions are chiefly vegetable acids. The in- fluence of acetic acid, in its diluted impure state or as vinegar, in cooling the body labouring under disease, was very early known. In its undiluted state it is a powerful stimulant; and when daily taken in large doses into the stomach in its diluted form, it produces great uneasiness, cramps, and colic, and gradually destroys so effectually the texture of the organ and its digestive function, as to cause emaciation of the body. When it is only occasionally taken, largely diluted with water and moderately sweetened, it displays decided soothing and refrigerant properties, and is em-](https://iiif.wellcomecollection.org/image/b21116799_0015.jp2/full/800%2C/0/default.jpg)
