FEYERS.—While alcohol is very useful in many cases of fever, there can be no reasonable doubt that all cases of fever do not require it, while many cases are best treated without it. The special in dications for its exhibition are: general debility; rapid, small, or irregular pulse; the condition known as the typhoid state and recognized by the presence of hebe tude, indifference, jactitation, muscular twitching, subsultus tendinum, mutter ing delirium; coma vigil or even a more active delirium, with signs of great weak ness; a dry or brown tongue, sordes, and, perhaps, involuntary evacuation of urine or faeces. If the patient is being benefited by the use of stimulants, the following effects will be observed: The tongue becomes moist; the pulse becomes slower; the skin becomes comfortably moist; the breathing becomes more and more tranquil; sleep is produced; delir ium is quieted or disappears.
While alcohol should not be given in every ease of fever, certain definite indi cations exist which imperatively call for its use: 1. Persistence of a high tem
perature. 2. Persistence of a rapid, feeble, irregular, dierotic pulse, whether associated with high, low, or irregular temperature. 3. Persistence of marked prostration.
If, however, after giving alcohol the pulse becomes quicker and more irreg ular, the skin hotter and drier, tongue browner and drier, breathing shallower and hollower, it means that the alcohol is doing no good even if it is doing no harm; it means that the little patient has passed from the stage of depression, in which alcohol is of decided utility, to the stage of exhaustion of the vital pow ers, in which it is of no value; nor is any other remedy, for that matter. Un der such circumstances alcohol had best be discontinued. Depression of vital powers, no matter how alarming, can be successfully combated by alcohol in con junction with other powerful and quickly acting stimulants. Exhaustion of the vital powers, whether in old age or in fancy, means death. A. E. Bieser (Pediatrics, Apr. 1, 1901).