elevation of temperature, occurs so often in the tropics as a symptom, gravely complicating many other conditions, that taken per se, and apart from all contingent circumstances, it frequently imperatively calls for combative measures to be adopted against it. Notwithstanding that frequent necessities must arise in tropical climates for resorting to measures for the reduction of bodily heat, and the many powerful agents at our disposal for doing so, yet much diversity of practice exists, both to agents selected for use, and also the as circumstances under which they are severally employed. This lack of unity may in some parts be attributed to an imperfect appreciation of the different methods in which heat-reducing agents express themselves, and consequent disregard of the particular circumstances under which they are each indicated. A number of drugs have been grouped together under the term antipyretics, that is to say, whose employment in febrile conditions is followed by reduction of temperature. But although the physiological and therapeutic actions of these drugs have been most carefully investigated, yet none of the ordinary works on practical Medicine contain any definite instructions concerning the application of the several remedies to particular cases, based on a rational reference to the special modes of action of each. The present paper is undertaken with a hope that it may tend to unify our practice in the antipyretic treatment of fevers, and systematise it in accordance with known scientific principles. Before proceeding to the discussion of the various agents employed in reducing high temperatures, seeing that so much has been recently learnt on the subject, it will not be out of place at first to briefly summarise the latest views concerning heat production and the occurrence of pyrexia within the body. It has been customary to regard oxidation or combustion of blood and tissue as the primary source of animal heat, febrile excess being simply explained as due to hyper-oxidation, or excessive combustion, the skin by evaporation and radiation being the accredited agent by which a perfect thermo-equilibrium is maintained. Recent researches into the localisation of the functions of the brain lead us however to modify this view, and to regard heat production and the maintenance of heat balance, as a much more complicated process, which is directly under nervous control. That nervous energy is immediately converted into heat, or that there are direct thermo-genetic centres in the brain, we have still no conclusive proof; but experimental evidence has sufficiently demonstrated the existence of certain areas in the cerebral axis controlling the evolution of heat. This control is probably of an inhibitory nature, oxidation and thermo-genesis bei?

Fevers and Their Rational Treatment by Antipyretics.

Fevers and Their Rational Treatment by Antipyretics. - PDF Download Free
11MB Sizes 1 Downloads 9 Views