IN THE FEBRILE STATE. 



339- 



mucous membrane act in the same way ; but the 

 most direct as well as the most efficacious means, 

 is to introduce stimulants into the stomach. These 

 also act beneficially in several other ways. Am- 

 monia, chloric ether, and various kinds of alcohol 

 (when given not too much diluted) produce an imme- 

 diate though indirect influence upon the force of the 

 heart's contraction. The usefulness of this practice is 

 proved by the fact that very soon after a little wine, 

 brandy, or ammonia has been taken, when the heart 

 is acting very feebly, as during a partial faint, or 

 from the influence of chloroform inhalation, the vigour 

 of the heart's contractions becomes sensibly increased. 

 'The change is often noticed within a few seconds after 

 the stimulant has come into contact with the mucous 

 membrane of the stomach. This action is, no doubt, 

 reflex, and is due to an influence produced upon the 

 ganglia of the sympathetic, an impression being trans- 

 mitted by afferent nerve fibres from the skin (mucous 

 membrane) of the nose, throat, respiratory passages, 

 or stomach, as the case may be, to the ganglion cells. 

 Immediately an impulse is transmitted from the 

 ganglia along efferent fibres distributed to the mus- 

 cular tissue of the heart which contracts more strongly, 

 and, in consequence, the blood is propelled with greater 

 force through the arteries and capillaries of the body 

 generally, and the tendency to death from this cause 

 is at least postponed, and possibly averted. 



