Some considerations in regard to acute obstructive diseases of the lungs / by Andrew H. Smith.

  • Smith, Andrew H. (Andrew Heermance), 1837-1910.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Some considerations in regard to acute obstructive diseases of the lungs / by Andrew H. Smith. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    nutriment we force upon the patient does not add at once to the clogging and the overwork. But there is one form of food which is less liable than most others to defective assimilation, and this is alcohol. I say food advisedly, for, notwithstanding all that has been said to the contrary, I believe that in reasonable quantity it acts as such. Alcohol is easily taken into the circulation, is easily oxidized, and any excess is readily disposed of by the emunctories, in- stead of remaining to embarrass the vital processes. Moreover, it retards tissue-change, and thus lessens the amount of carbon dioxide which the lungs are required to dispose of. The use of alcohol as a food in these cases is justified, therefore, as fully by its physiological action as by its chemical effects. But aside from its nutritive value, its stimulating action is of the greatest importance. Nothing else meets the indications so fully when depression of the nervous system is pronounced. Especially in pneumonia, when under the shock of the infection we find the patient delirious, with tremor and ail the evidence of nervous exhaustion, tiie liberal use of alcohol is emphatically called for. But there is still another action of alcohol which, in my judgment, adds greatly to its value ; I refer to its power to relax the arterial system. And this brings us to the con- sideration of the class of medicines which are distinguished by this property. Chief among these are the nitrites, but the property is shared in a less degree by numerous other remedies and notably by aconite, the value of which in inflammatory diseases accompanied by high arterial tension is now universal- ly admitted. It was in connection with this drug that the idea of “bleeding a patient into his own vessels ” was first suggest- ed, and the phrase well expresses the peculiar action of this class of medicines. By their specific effect either upon the vasomotor nerves or directly upon the muscular fibre of the vessels, they cause a relaxation of the muscular coat and a con- sequent dilatation of the whole arterial s)’stem. The change in capacity which may be effected in this manner is much greater than is generally believed. On this point Ringer says, “ It has been shown that the vascular system is always in a state of