COMIL1011.
Strychnine hypodermically has been recommended. The nitrate or sulphate is usually administered in doses of 7„ to 7, grain daily, or oftener, as indicated by the gravity of the case.
Strychnine used, grain hypoder mically. gradually increasing the dose till physiological effects declared themselves, the highest dose thus injected being grain. At the same time V3, grain of strychnine nitrate is given by the stom ach every two hours, together with from to '/, grain of atropine sulphate in gentian infusion. J. H. Ward (Med. World, Dec., '93).
History of twenty-five cases of alco holic mania treated with nitrate of strychnine subcutaneously injected. The dose varied from to grain twice daily for ten days, then once daily for ten days, the highest dose being reached about the third or fourth day and con tinued to the close of the treatment. This administration is in accord with Spitzka's experiments, that to maintain its action the doses of strychnine must be at first increased; later the interval increased and the doses lessened. The border-line of tolerance was reached, in most cases, when 15 minims were used of a solution containing 2 grains of strychnine nitrate to 4 fluidraehms of water: equal to grain. Internally, cinchona. peroxide of hydrogen, and cap sicum were frequently prescribed in com bination. When sodium bromide failed to procure sleep paraldehyde always suc ceeded. In the latter case, strychnine, in doses of V. grain, with elixir of phos phates and calisaya, was ordered to be taken once or twice daily for four to five weeks after ceasing the injections. There were fourteen relapses known in these twenty-five eases from within one to eleven months. Though strychnine is useful in restoring temporary health, it does not prevent the possibility of fur ther relapse. J. Bradford McConnell (Quarterly Jour. of Inebriety, Jan., '94).
Several cases in which nitrate of strychnine, in doses of from to '/, grain, twice daily, was administered for ten days, then once daily for ten days. with temporary benefit. In many of the cases there was a relapse, sooner or later, showing the need for prolonged seclusion, with the operation of moral and hygienic conditions. J. Bradford McConnell (N. Y. Med. Jour., June 3, '93).
In the alcohol wards of the Bellevue Hospital the use of strychnine and the solanacem, with certain adjuvant tonics and moral influences, is employed in cases of periodic alcoholism. The drugs
selected arc those which the experience of ten years in the care of these cases has shown to be most useful. Selected patients, after having passed through an attack of acute alcoholism, and are con valescent, are allowed to remain two days. Only persons who have reasonable intelligence and who show real evidence of sincerity are chosen. The following solutions are used:— 13 Strychnine nitrate, V., grain.
Atropine sulphate, V„, grain.
Distilled water, 10 minims. M. Sig.: Inject t. i. d.
First day injection.
13 Strychnine nitrate, '/„ grain.
Atropine sulphate, grain.
Water, 10 ounces.
M. Sig.: Inject t. i. d.
Second day injection. C. L. Dana (Post-graduate, July, '96).
Once insomnia has disappeared, the propitious moment for the use of strych nine has arrived. The period of depres sion will be more or less prolonged; the malnutrition, already great during the acute attack, will increase; all the func tions will droop unless a stimulant is found to increase the vital forces, and, usually, alcohol is the stimulant instinct ively sought for by the victim, who thus treads in a vicious circle. To avoid this a stimulant other than alcohol must be selected for the patient, and not by him: a medicine, and not a sort of food. The most appropriate for this purpose is strychnine, as it meets all the require ments rendering its employment neces sary. Combemale (Le Bull. Mod., Apr. 12, '90).
The principal indication for the strych nine treatment. is found in cases of con firmed alcoholism without acute attacks. But, in fatty degeneration of the organs, the strychnine treatment does not and cannot produce any modification of the symptoms. It even constitutes a danger. Strychnine is slowly eliminated by the urine, the saliva, and the bile, even when the organs are intact and prevent accu mulation. Hence, cirrhosis of the liver and renal impermeability are two more great contra-indications to the employ ment of this drug. Case of an alcoholic, who suffered from cirrhosis of the liver with ascites, in whom tetanic symptoms occurred after the fifth injection. Mer cier (Gaz. Heb. de Med. et de Chir., May 16, '97).