178 CHAPTER 18. 



sight to be the simplest means of relieving the symptoms, must not be 

 resorted to (unless in very exceptional cases), both because they unduly 

 impair and lower the tone of the system, and because the sthenic stage 

 often so quickly runs into the asthenic. 



Extra clothing, bandages to the legs, hand-rubbing and other means 

 of restoring warmth to the extremities have a most beneficial effect in 

 equalising the circulation, the balance of which is disturbed by the con- 

 gestion of a large quantity of blood in one part. Good nursing in all 

 respects is of primary importance. The need of an abundant supply of 

 cool fresh air cannot be overstated. 



Under certain circumstances, which will be detailed more particularly 

 under the heads of various diseases, such as inflammation of the lungs, 

 the application of mild irritants repeated somewhat frequently is useful 

 in giving tone to the parts and in rousing the circulation. 



If the bowels are confined, as is frequently the case, a saline draught 

 made of four ounces of acetate of ammonia and four ounces of sulphate 

 of magnesia in a quart of water may be administered in the early stage. 

 A slight effect on the bowels may be looked for in twenty-four hours. If 

 necessary, the dose may be repeated. 



When the powers of nature begin to flag, as they generally do after a 

 time, vegetable tonics and diffusible stimulants may be administered 

 with great benefit. When the fever which usually accompanies the 

 attack has subsided, mineral tonics may be given. In the later stages 

 the bowels generally become costive from want of tone. The remedy at 

 this period will be found to consist, not so much in the administration 

 of aperients, as in tonics and nutritious diet, milk, &c., if the patient 

 can be persuaded to take food. 



365. Treatment of Asthenic inflammation. 



In attacks of an asthenic or low type our chief care must be devoted 

 to sustaining, and, if possible, raising the tone of the system, which 

 throughout is unduly and often excessively depressed. Throughout the 

 attack diffusible stimulants, such as carbonate of ammonia in combina- 

 tion with salines, may be given with the greatest advantage. The mode 

 in which these medicines act in such cases has been explained in Chapter 

 17 on the actions and uses of medicines. 



Every endeavour should be made to induce the patient to feed by 

 tempting hig appetite with grass, carrots, skim-milk or whatever he may 

 fancy. Vegetable tonics may be given with great advantage. They 

 give tone and vigour to the system, and often induce the animal to feed, 

 when he would otherwise refuse all nourishment. If there is no fever, 

 or in other cases when the fever has subsided, vegeto-mineral tonics, 

 such as hydrochloric acid with gentian, may be administered. 



Extra clothing, bandages to the legs, friction, and other means of 

 restoring and equalising the circulation, fresh air, and good nursing, are 

 of the utmost importance. Mild irritants, as mentioned in the preced- 

 ing paragraph, are also sometimes useful. 



