Strychnine and brandy are practically useless. They merely whip the willing horse--the heart is doing full duty and cannot be further stimulated by such measures.
In _mild and moderately severe cases_ this form of treatment will suffice to tide the patient over the collapse stage and induce the stage of reaction. So soon as this _commences_, the rising temperature and vomiting heralding the change, the head of the bed should be lowered, hot bottles and blankets removed--the patient being covered with a linen sheet only--and all forms of stimulant avoided.
Calomel should be given by the mouth, 1 to 5 grains, according to the age of the patient. Headache may be relieved by applying ice-bags to the head, by tying round the forehead a handkerchief soaked in a weak solution of eau-de-Cologne, and by the administration of various drugs, more especially aspirin (10 grs.), antipyrin (10 grs.), and hyoscin (gr. ¹⁄₁₀₀).
In _more severe cases_ more radical measures must be adopted to combat the severe vaso-motor depression, with its consequent splanchnic congestion and cerebral anæmia. No method is more desirable than infusion. This method, with its attendant advantages and disadvantages, has been detailed on p. 118. It is merely necessary to add that infusion must not be carried out in a haphazard manner. Its application is based on scientific principles, and its results must be noted with the greatest care. The surgeon must keep a watchful eye on the temperature and blood-pressure, and he must be prepared at any moment to change his plan of campaign.
(_b_) _Of irritation._ The patient should be kept in a darkened room and should not be worried more than is absolutely necessary for diagnostic purposes. An attendant is usually required, whose methods should be persuasive rather than forcible. Great tact is required.
Morphia is of the greatest value in the treatment of this condition. It relieves the headache, acts as a damper on the hyperæmic brain, and keeps the patient from threshing about in bed and injuring himself. Sleep is essential for an early recovery and cure.
In the _more severe cases_ venesection should be carried out, and operative measures will be required if the rising temperature and slowed high-tension pulse herald the advent or indicate the presence of compression of the brain.