Page 188 - My FlipBook

186 DENTAL MEDICINE.
ers by severe injuries, surgical operations, or profound mental
impressions.
Collapse is a state of nervous prostration, and both it and shock
have been classed together. Collapse arises from various causes
of which shock may be one, but shock may occur instantaneously
in a healthy person, whereas collapse is generally manifested in
persons who have been subjected to a prolonged nervous strain
which has greatly exhausted them. Prolonged dental operations
depress the vital powers of those already exhausted from disease,
overwork of mind or body, and sometimes in chlorotic girls,
pregnant women, and delicate children ; hence, such conditions
should be recognized by the dentist, and properly appreciated,
and all operations of a painful or prolonged character should be
avoided, if possible, until such times as the improved condition
of the patient will justify ; or, if imperative, treatment which
will allay nervous irritability and prevent shock, should be
instituted.
Treatment.—The patient should be laid as flat on his back as
possible, or even with the head lower than the rest of the body
—the feet and extremities raised. Some authorities recom-
mend as a good plan occasionally to bandage the extremities from
their tip towards the body, in order that the blood they contain
naturally may be pressed to the vital organs. Should cyanosis
occur it indicates that the head is being too much depressed.
Warm stimulating drinks, such as of whiskey, brandy, etc.,
diluted, are serviceable if they can be swallowed. When the
patient cannot swallow, almost as much benefit can be gained by
resorting to enemata of hot coffee with brandy, with ammonium
carbonate, etc. Nitrite of amyl will assist in equalizing the cir-
culation. The hypodermic use of strychnia, and tincture of
digitalis, will stimulate the activity of the heart. Failing respira-
tion may be stimulated and sustained by atropia hypodermically
injected also. Care should be exercised in giving strong liquors,
for if the patient cannot swallow, some of the irritating fluid
may escape into the larynx, and the coughing may be so violent
as to prove fatal ; the same is true of inhalations of strong
volatile stimulants. Reaction must not be established too