USE OF ANTIPYRETICS. 527 



fugo, I drive away,) is one of the most successful, as well as 

 rational, of therapeutical proceedings. 



1. Preventive Treatment: Antiperiodics. The periodical 

 return of fever may be prevented by means of antiperiodics. 

 The most powerful of these is Cinchona, with its constituents, 

 especially Quinia ; Salicin, Salicylic Acid, and Chinolin, are not 

 so powerful ; less important are Nectandra and its alkaloid 

 Beberia. 



2. Immediate treatment. With the abundant means at our 

 command which we have discussed in the second section, the 

 immediate treatment of pyrexia is very easy, inasmuch as we can 

 lower the temperature of the surface of the body to any degree 

 we please ; for instance, by the cold bath. But we soon discover 

 that it is one thing to reduce pyrexia, and another thing to 

 treat fever. We can readily assist the refrigerating mechanism 

 of the body, and we can even so far reduce the metabolic 

 activity of the tissues, but our remedies can rarely reach the 

 actual cause of the disorder, and the temperature rises again. 

 As far as possible, however, we are bound to begin by discovering 

 and attacking the causes ; and if we fail in this, we must then 

 combat the fever itself, so as to prevent its injurious effects on 

 the system. 



(a) Injury or disease of the nervous system, as a cause of 

 pyrexia, is generally beyond treatment. If the temperature 

 rise to a dangerous height, it must be treated by the refrigerat- 

 ing measures presently to be described. 



(b) Heat -fever is rationally treated by immediate removal of 

 the patient to a cool, open atmosphere, and the application of 

 refrigeration, in the form of cold affusion. 



(c) Interference with the cooling function of the skin is 

 rationally treated by increasing the loss of heat by refrigerants, 

 Refrigeration is practically carried out by lowering the tem- 

 perature of the external medium, by increasing the cutaneous 

 circulation, and by stimulating the secretions, by the warm 

 bath ; hot, spiced alcoholic drinks, a brisk purgative. 



When fever rises high, the temperature of the room must 

 be kept low ; the skin sponged ; and if the pyrexia rise to a 

 dangerous height, the prolonged cold bath or wet pack must be 

 employed according to the method described in chapter xiv. 



Diaphoretics are chiefly employed as refrigerants in sympto- 

 matic fevers, i.e. in the pyrexia attending ordinary local 

 inflammation of the lungs, bronchi, fauces, or other parts. 

 Alcohol, Hot Water, Liquor Ammoniae Acetatis, Ipecacuanha 

 and Opium in the form of Dover's Powder, Antimony as the 



