On the pathology of delirium tremens, and its treatment without stimulants or opiates / by Alexander Peddie.

Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology of delirium tremens, and its treatment without stimulants or opiates / by Alexander Peddie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    lai'gely of salmon, stewed rhubarb, and sundry other articles, which had dis- ordered his stomach. At 5.30 next morning, he was seized with severe pain in the bowels, and soon thereafter with vomiting and purging. In the course of that and the following day, he had taken repeated doses of tincture of rhubarb, laudanum, and brandy, but without benefit, and I was sent for in the afternoon. I saw him at 7 evening. He was then much pained in the bowels and purged ; tongue exceedingly white; thirst considerable ; urine not passed for many hours ; pulse 90, rather full and vibrating ; and extremities cold. Fearing an attack of cholera, I ordered a large sinapism to be applied to the epigastrium, heat to the feet, 3vj. of castor oil to be given immediately, and an opium pill, 1 grain, after tlie first movement of the bowels. Three other opium pills of the same strength were prescribed, one to be given at intervals of from two to four hours, according as the diarrhoea should be more or less urgent. 2d day, 11 a.m.—Has had 4 grains of opium during the night, which has checked the diarrhoea; but he has slept none, and complains much of pain in the bowels, about which he is nervously anxious, fearing that some dangerous malady is in progress. His manner is considerably excited, and he is very restless. Pulse ] 00 ; pupils contracted. Another sinapism ordered to the epigastrium. I now perceived that an attack of delirium tremens was approach- ing, and regretted much that I had prescribed opium so freely. 6 P.M.—Pulse 116; tongue white; perspiring copiously; pupils still con- tracted ; no return of diarrhoea, and does not complain of abdominal pain ; hands slightly tremulous; considerable agitation of manner ; voice weak ; speech rapid and stuttering; and since the forenoon he has at times been talking incoherently, fancying that he saw strangers in the room, etc. To have ipeca- cuan wine TTL xx every two hours, and some tea, or weak coffee and milk and bread for diet. 10 P.M.—Pulse 120. Symptoms of a paroxysm of delirium tremens confirmed. Is now out of bed, dressed, cheerful and active, as if there had been no previous ailment. Says that he is quite well, but that a number of queer customers have been visiting him, etc. To be strictly and judiciously watched, and the ipecacuan to be continued. 3cZ day, 11 a.m.—Pulse 108, feeble ; pupils quite natural, but eyes dull and expressionless. Urine dark and turbid. Has not been in bed at all during the night, but busy arranging furniture and hunting rats, particularly two old fellows, which, he avers, are hiding among the bed-clothes. Continue the ipecacuan and give beef-tea occasionally. 6 P.M.—Pulse 116, rather firmer than in the morning. Was permitted to walk out for an hour in the afternoon, well attended. He is now much more excited, but not quite so tremulous. Is perspiring copiously, and very earnestly catching imaginary objects in the air, which, however, are no sooner secured than they invariably slip through his fingers, and are broken and lost, thus occasioning him great distress. Ipecac, etc. to be continued. A specimen of urine passed in the morning became turbid with heat, and on evaporation pre- sented a considerable abundance of phosphates. 10p.m.—Head bathed in perspiration; hands cold; pupils natural; pulse 112, and small. Urine high-coloured. Bowels not moved since early yesterday