It seems unnecessary to add more on this part of the subject, than that experience derived from some of our large prison-establishments shows that while fully three fourths of the criminals committed belong to the intemperate classes, and a large num ber, especially of the debtor class, are habitual drinkers up to the moment of admis sion, no bad effects are observed from the sudden withdrawal of the wonted stimuli, and the substitution of prison-fare.
In regard to the treatment of this remarkable disease, it is evident, from a common sense consideration.of its phenomena and pathology, that the non-stimulating and non opiate plan must be the safest and best. if more spirits deepen the paroxysm, by pro ducing greater cerebral determination, then why administer even one drop additional? And if opiates combined with spirits, or given alone, act in the same manner, and tend to occasion congestion in the blood-vessels of the brain, why run the risk of inflammation, convulsions, and coma, in an endeavor to force on the salutary sleep? It must not be overlooked that this sleep is the normal termination of the paroxysm, and is not to bo viewed as a part of the affection, or in the same light as we are accustomed to regard a critical sweat or other discharge. • It indicates diminished activity of the cerebral circu lation and functions, and the commencement of convalescence. Hence, in a large proportion of instances, the sleep will take place spontaneously, and it will be safer to do nothing at all. The object, therefore, of treatment should rather be to remove all hindrances to sleep than to force it. In the more severe cases, this is best done by a moderate and well-regulated coursti of tartrate of antimony, the action of which, in this affection, appears to be remarkably sedative. It greatly diminishes excited action, induces weariness of muscle, general nervous exhaustion, and mental languor. It thus removes all obstacles to the occurrence of the salutary sleep, and favors it: and when the individual exhausted seeks his couch, he finds repose—not as a drugged sleep, but naturally and profoundly—awaking in general with restored reason and muscular con trol. Digitalis has been given with the same view, also ipecacuanha and aconite; but
none of these answer the various ends so well as antimony. In the milder cases, how ever, no medicine is required, and it seems enough to do in such, what is essentially necessary in the severer attacks—to support the strength—the organic functions of life— by suitable nourishment, such as soups, cafe au lair, and white-of-egg, and to soothe in every possible manner the excited feelings of the patient. Nothing is more hurtful in delirium tremens than restraint, particularly that of the strait•waistcoat. It increases the cerebral excitement by the never-ceasing struggles for liberty which ensue, so that fatal convulsions have very frequently been the result. All the control required is the presence of one or two judicious attendants, who will humor the patient in his whims and fancies; who will speak and act regarding them so as to assure him of safety, and to relieve him of that apprehension which Is the most characteristic feature of the delirium; and who will mildly but firmly interpose, if he attempts anything which may accidentally prove injurious to himself or others. The apartment, however, in which the patient is confined should be well secured, for he may rush out at the door, or leap, from a window, in the fright and frenzy of imagined danger. The larger, too, the room is, the better, that he may have space to advance and retreat, according as he wishes to scrutinize or avoid a suspicious or distressing object of his fancy; to arrange and rearrange the furniture; or to carry on, after a fashion, the imaginary duties of some bustling occupation. Besides this, there should be abundance of light, so as to dissipate terrifying hallucinations. The expenditure of muscular effort without any restraint, aids greatly in producing a safe kind of mental and physical exhaustion; and the indi vidual, languid and worn-out, lies down voluntarily, and falls, into the desired and restorative sleep.—The Pathology of Delirium Tremens, and its Treatment trithout Stimu lants or Opiates, by A. Peddle, M.D., pp. 51, 8vo.