Chapter I. Sedatives Commonly Used in the Control of Fevers—Antipyretics.
Note—During the entire history of the evolution of the present method of direct prescribing, the search of every investigator has been after a single remedy which may be applied to each of the common conditions which are found among both premonitory symptoms, and among those subsequently developing. The investigator, in the course of his work, develops an innate ability to quickly determine which of these indications are basic, and which are secondary. He endeavors at once from these, to determine what the disease is, and what is its cause.
Failing in this in the first examination, he does not under any circumstances wait until the entire condition can be determined without doubt, and the disease named, before he prescribes, but he at once prescribes for that most conspicuous condition, or for two or even more, if they seem to be sufficiently plain.
By this course, he is convinced that conditions are at once controlled which would have led to very important, serious, or, perhaps, fatal disorders. Prescribing for the total disease by name has led many a physician into error. It is important that he know what the group of symptoms is called, as soon as possible, but he must never lose sight of the specific indications present in that individual which require immediate attention.
With those of us who are trained in this method of practice, the first condition in acute disorders to which our attention is directed is the circulation. We endeavor to keep this always as near as possible to the normal point. The severity of any acute disease we are convinced, is in proportion to the variation of these conditions from a normal standard. In proportion then as we are able to bring the temperature to, and keep it near to the normal, are we able to restrain disease processes, or to remove the results of these processes in which the circulation and temperature are influenced.
Excessive action of any character in any of the body processes must be restrained. A violent impression will produce a correspondingly violent reaction. The persistent, steady effects of small, frequently repeated doses of medicine, with no reaction, are in every way superior to the violent effects of large doses. The violence of the disease is to be fully considered, however, and the dose prescribed accordingly.
The first four of the above named remedies are Motor Depressants, and are of first importance in the treatment of fevers. They may well be called Special Sedatives.
The progress of fever, its unarrested violence, is often the cause of localized inflammation—not always the result of it. Suppressed secretion is the cause of the fever in many cases, and the fever in time determines which is the susceptible organ, for there inflammation becomes seated.
Again, the severity of any acute inflammatory disorder depends upon the severity of the fever, and the control the physician is able to exercise over the fever determines the amount of control he exercises over the processes of the inflammation. No fever, however mild, notwithstanding frequent arguments to the contrary, should come to the knowledge of the physician, especially in children, without its being at once antagonized by the properly indicated remedy.
Masius and Stockweiss, Semmola., and others, confidently assert that fever is not an essential process to natural elimination and must be restrained.
In continued fevers the reaction which will follow the powerful depressing effects of large doses of active coal tar antipyretics is more injurious than the fever processes, if such reaction occurs. If not, the depression is apt to be fatal.
In continued fevers the steady impression induced by small but frequent doses of those agents which restrain heart action and heat production by their tonic effect upon the nerve centers and vital processes, is in every way superior to the large doses of the commoner synthetic antipyretics. The depressing action of the latter, without compensation, is entirely too great.
The American Materia Medica, Therapeutics and Pharmacognosy, 1919, was written by Finley Ellingwood, M.D.
It was scanned by Michael Moore for the Southwest School of Botanical Medicine.