Delirium Tremens. Drunkard's Delirium.
Mania a Potu.
THIS is often mistaken for brain fever; but it is quite a different disease. It is not the result of inflammation of the brain, but of irritation. It is important to distinguish it from inflammation, because the remedies which are employed for that would be injurious if used for this.
The Symptoms are incessant talking, fidgeting with the hands, trembling of the limbs, a rapid pulse, profuse sweating, utter sleeplessness, and a mingling of the real with the imaginary in the busy talk. The patient is apt to think some one is about to do him a great injury, yet is unwilling to be alone. His face is pale and sallow (sometimes red and flushed), his eye is rolling, quick and expressive, his speech stuttering and inarticulate, bodily and mentally, he is busy day and night, and can with difficulty be confined to his bed or room. As the disease advances, and he has been long without sleep, he imagines vermin to be crawling upon his scalp and body; troops of rats run across his bed, or look at him out of the wall; giant boxers confront him, and he squares off for a round at fisticuffs; animals, figures of all shapes, and horrible monsters frighten his imagination; devils laugh at him, and dance before him. In long and sleepless hours, he talks and chatters with these spectral phantoms, now beckoning them, now shrinking from them, till he wears out and sinks from exhaustion. This is a disease of drunkards and opium eaters. The attack generally occurs in consequence of the withdrawal for three or four days of the accustomed stimulus.
If the delirium is the result of recent heavy drinking, an emetic should be administered to empty the stomach of what is remaining there. Sulphate of zinc, 20 grains well diluted with water, or ipecac, 30 grains may be given, after which a good cathartic such as 30 grains of compound jalap powder for unloadinf4 the bowels may be used. If the patient is depressed and nervous, spirits of aromatic ammonia may be used. In more marked cases, strong black coffee by the mouth or rectum; even strychnine in 1 30 grain doses will be needed for the heart. Bromide of soda, 30 grains dissolved in one third glass of water may be given every two hours to keep the patient quiet. Morphia and the other preparation of opium, while very valuable, should be used with great care; 20 drops of laudanum every two hours for two or three doses will usually, in conjunction with the bromide, quiet the patient, but the exclusive administration of opium or giving it in large amounts should be under the control of a physician. Bathing the patient in the tepid bath, during which cold applications are kept on the head, may be used for hours at a time if the patient does not rebel at this treatment, but usually the quieter he can be kept the sooner he will recover.
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