Many eases cannot bear the bromides: they seem to intensify the debility and depression from spirits. Chloral should never be combined with bromides for its sedative effect. especially in inebriates. When the temperature falls and the heart becomes feeble, all bromides should he stopped. When low muttering de lirium comes on, with muscular enfeeble ment, the bromides are dangerous. Its indiscriminate use for all cases is nn safe. and its action should be watched carefully. Editorial (Quart. Jour. of In ebriety. Ap•., '98).
Exception taken to Reid's theory of immunity against drunkenness obtained by use of alcohol for successive genera tions. A certain degree of immunity to the action of alcohol on the tissues may be attained, but not to the taste or lik ing of alcohol. A direct transmission of the taste for alcohol never occurs. Drunkenness as a disease is not trans mitted, but only the weakly and unbal anced condition of the tissues of alco holic parents. G. Sims Woodhead (Lan cet, July 29, '99).
Conclusions regarding the use of aponeorphine hydroehlorate as hypnotic in alcoholism are: I. To obtain a hyp notic action with apomorphine it should be given hypodermically. 2. The dose cannot be fixed. It is best to begin with a small dose.—V" grain or less,— and to repeat this or give a slightly larger dose within a short time.
Fur ther doses should not be given after vomiting occurs until several hours have passed. 3. Doses repeated in two or three hours have but little beneficial effect. 4. The administration of apo morphine should not be repeated in pa tients who are weak. 5. The duration of the hypnotic action is only a few hours, and when the patient awakes his condition is practically unchanged, except in "ordinary drunks?' 0. The best results are obtained from apomor phine when it is followed in two or three hours by some recognized hyp notic, as bromide, chloral, paraldehyde, etc. 7. Solutions of apomorphine are unstable, and should be freshly made for use. Old solutions should never be used. S. Apomorphine may be employed as a hypnotic in selected cases of alco holism. The best results were obtained in "ordinary drunks" and in cases verg ing on delirium tremens. But in some of these eases the drug has no effect whatever. 9. The administration of apomorphine to patients in delirium tremens was, as personally observed, without beneficial result, and may even be attended with danger from its de pressing action. Warren Coleman and J. M. Polk (Amer. Med., March 8, 1902).
Fresh fruits (oranges, etc.), an emetic, or a cup of hot tea, coffee, or cocoa are frequently sufficient to counteract the drink crave or impulse.
For insomnia, hyoscine hydrobro 200 to mate, / grain, cautiously given, or a hot, wet pack is useful.
The use of hyoscine hydrobromate is to be recommended, hut its abuse will do more harm than good. The dose is from to grain, increased cau tiously to grain. Lionel Weatherley (Jour. of Mental Science, July, '91). Lott's treatment of alcoholic and morphine habits with hyoscine tried in 6 eases: The patients can take massive doses for days at a time, as much as grain each day hypodermically, with no evil effects on any vital func tion. They suffer very slightly, if at all, from the immediate withdrawal of the morphine. The desire for the drug is largely, if not entirely, dissipated after a few days. H. A. Hare (Med. News, June 7, 1902).
Chloralose has also been recommended as an hypnotic in these cases, its soothing effect continuing even after its influence as a soporific has been exercised.
In heart-failure the of ammonia, especially the aromatic spirits, are effective.
In the heart-failure of chronic inebri ates rest in bed and digitaline granules, one of grain being usually sufficient. Graham Steele (Med. Chronicle, Apr., '93).
Nitroglycerin is recommended against the vomiting of alcoholism. R. Hum phreys (Brit. Med. Jour., Apr. 1, '93).
The influence of surroundings should not be disregarded. The patient should be separated from those of his associates who cater to his weakness, and made to enjoy, if possible, the company of those who, on the contrary, tend to counteract his habits.
1. The patient should be instructed in regard to deceptive and injurious influ ences of alcoholic drinks, so that he is convinced that their use is, on all occasions, unnecessary. 2. The patient should be placed under good physical and social surroundings. For impaired di gestion, irritable nervous system, and dis turbed sleep, grain of digitaline with grain of strychnine at each meal, with from 20 to 30 minims of diluted hydrobromic acid at bed-time, will give excellent results. For constipation, 30 minims of fluid extract of rhamnus pur shiana may be added to the acid. In stead of the digitalis and strychnine, a pill or capsule of a grain of extract of hyoseyamus, with 3 grains of cerium oxalate, may be given. Before an antici gated period of dissipation a pill of 2 grains of quinine sulphate, the same amount of extract of eucalyptus globu les, and grain of extract of cannabi,i Indica should be given with each meal for two weeks. 3. The patient should be separated from his associates, and, if this cannot be done in any other way, lie should reside in a well-regulated asylum for six to twelve months. N. S. Davis (Quarterly Jour. of inebriety, Apr., '97).