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ness persist, while the prostration and weakness of the pulse increase until the patient dies of heart failure.

Treatment. The patient must be watched every minute and confined to a room. The attendants must treat him with gentleness and great patience. It may be necessary to restrain the patient in bed if he is weak. A sheet may be fastened across the body and bed, but it is unwise to tie the patient's limbs. Feeding with strong soups, beef tea, milk and raw eggs every two hours, putting considerable red pepper into the broths, is of chief importance. It is best to allow no alcohol. If the pulse is very weak, give aromatic spirit of ammonia (twenty drops in a wineglass of water) every hour. To procure sleep the following prescription may be used every two hours, for two or three doses, if the pulse permits.

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If this does not secure sleep, morphine1 is sometimes resorted to. A cold bath, or sponging with cold water, may produce a quieting effect, especially if there is fever. It is well to move the bowels thoroughly at the start, with five grains of calomel, or two compound cathartic pills, or other drugs.

'Caution. Morphine is a dangerous poison.

A physician's services are desirable, particularly to discover and treat any underlying and complicating condition, as pneumonia, broken rib, or other injury, to judge whether the patient's general condition warrants the use of such powerful remedies as are sometimes required, and to manage the mental aspect of the case.

ALCOHOLISM (Steady Drinking).—The steady drinker tends to lay on fat; his intellect becomes less acute, and he is irritable, restless, forgetful, and dull, especially in the morning. The judgment may become defective, and the mind is sometimes weak. Many exceptions occur in heavy, habitual drinkers who preserve a high degree of mental ability for some years. Epilepsy is sometimes a result. Chronic catarrhal inflammation of the stomach is one of the commonest effects of alcoholism, shown by a coated tongue, bad breath, and sinking feeling in the stomach, in the morning, and nausea or vomiting. The small veins on the face enlarge, producing a characteristic appearance; namely, the red nose and cheeks. There is trembling of the face and tongue. Inflammation of the nerves, especially in the legs, gives rise to pains, numbness, and, frequently, loss of strength. The heart and blood vessels become diseased. The vessels become brittle and are apt to break, occasioning apoplexy. Disease of the kidney often accompanies the change in the blood vessels and heart. The liver is often attacked, and enlargement followed by fatal contraction results.

Consumption is much more common in alcoholic persons. The children of alcoholic parents are more prone to suffer from various nervous diseases, such as neurasthenia, hysteria, chorea, epilepsy, insanity, idiocy, and also from rheumatism and gout. Occasional excess in drinking is much less apt to produce permanent injury than habitual, immoderate drinking. Individuals differ enormously in their tolerance to alcohol.

Treatment. The most useful and effective treatment can be conducted primarily, only where the patient is under complete control. Absolute abstinence from all forms of alcohol is the first requisite. Feeding every two hours with nutritious food will, in some degree, take away the craving for alcohol. Capsicum, one-thirtieth grain, with quinine sulphate, two grains three times daily, forms a good tonic. The medical treatment must be directed by a physician.

When the general health of the patient has been reëstablished a cure of the habit should be attempted. Means to this end must be carefully selected to suit each case. If the sincere coöperation of the patient can be obtained, an outdoor occupation, at first, with the constant companionship of a suitable attendant, may be tried, preferably at some place remote from former haunts, and, if possible, from all sources of temptation; but hope should be held out that eventually, with mental stamina restored, the patient might be able to resume an environment and occupation perhaps more congenial to him.

Part VI

WOMAN AND CHILD

BY

KENELM WINSLOW

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