On the treatment of certain cases of delirium with insomnia / by W. Morrant Baker.

  • William Morrant Baker
Date:
[1883]
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Licence: Public Domain Mark

Credit: On the treatment of certain cases of delirium with insomnia / by W. Morrant Baker. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    /m [Reprinted from St. Bartholomew’s Hospital Reports, Vol. XIX.] ON THE TREATMENT OF CERTAIN CASES OF DELIRIUM WITH INSOMNIA. BY W. MORE ANT BAKER. All who have had much to do with cases of delirium tremens, especially as it occurs after injuries, will be able to recall instances in which sleep cannot be procured by any of the ordinary remedies. Opium or morphia, whether by the mouth or by subcutaneous injection, chloral, bromide of potassium, and all other internal remedies, are powerless; while the application of ice to the head or the cold douche is either inapplicable or fails to produce the desired effect. Under such circumstances I have been in the habit, for some years past, of occasionally combining two methods of treatment, either of which, by itself, would be insufficient. First, chloro- form has been administered until the patient is fully but not very deeply under its influence ; and then morphia in a moderate dose, say a sixth to a third of a grain, is injected subcutaneously ; ihe inhalation of the chloroform being continued until time has been given for the absorption of the morphia. The plan is so simple that I cannot doubt it has been often employed by others. But I cannot remember seeing any account of it; and this may be my excuse for drawing attention to it. I would lay stress upon the following points:—(i.) That only a. very small minority of cases of delirium are so intractable by ordinary means as to require the treatment referred to ; and (2.) the plan should be carried out with due caution. It is not requisite or advisable to administer chloroform for any long time or to inject the morphia in any other than very moderate doses. Many years have elapsed since I first employed this method, and I have not preserved notes of the earlier cases. The first