THERAPEUTIC VALUE OF ALCOHOL IN CHILDREN

Abstract

Doctor Abraham Jacobi's influence upon American pediatrics was greater than any other physician's of the present or past. It may surprise the younger pediatrician to read the following two quotations from Jacobi's writings concerning the esteem in which he held alcohol as a therapeutic agent for children. But practical observation shows us that there is at the present time no antiseptic which can be administered internally of equal value with alcoholic beverages. The worst forms of typhoid infection die without them; the septic forms of diphtheria which are inaccessible to antitoxin may still be reached by whiskey or brandy. In this seemingly hopeless condition it may be life-saving. Theoretical objections, ethical opposition should not count. A child of three or four years may be saved by 100 or 200 ccm. of whiskey given daily, if by nothing else and escape the undertaker. There is no better antiseptic than alcohol beverages. I claim as one of the most meritorious facts in my professional life, if there be any, to have proclaimed long before the time of most of you the necessity of giving large doses of alcoholic dilutions in the grave forms of diphtheria; indeed every case may be or become grave. There is almost no dose that is not well tolerated. What I have observed, and written these forty years, still holds good. Septic cases, with high fevers (also others so septic as to exhibit collapse), that will not improve after 100 or 200 centimetres of whiskey daily, are apt to do well with two or three times the dose, which, however, will cease to be tolerated as soon as the septic fever has passed by. Indeed I have seen such septic children of three or four years take 500.0 [ccm.] of whiskey a day, which had no bad influence on the brain while the sepsis lasted, but would cause alcoholic delirium as soon as convalescence began. For a marked antipyretic effect rather large doses of alcohol are required; that is why it should not be given except in sepsis when the reduction of temperature—while necessary—can be obtained in other ways. There is no reason, for instance, why the first stages of pneumonia should be treated with alcohol. At that time inanition is not threatening, and therefore the indication fulfilled by alcohol in moderate doses, viz., to avoid the disintegration of albuminoids and of fat, does not yet exist. It is only in later stages, and in chronic diseases, when starvation is threatening, that diluted alcohol, which is readily absorbed in the stomach and therefore quicker in its action, is of the greatest value.