(See ANOREXIA. NERVOSA, volume i.) Sitiophobia treated by first washing out the stomach through the stomach tube, and then introducing food through the same tube. There is, in most eases of refusal of food, a catarrhal state of the stomach at the bottom of the hal lucinations. Voisin (Bull. Gen. de Titer., Jan. 30, '91).
Complete refusal of food for twenty four hours by a strong, well-nourished patient, and the missing of two meals by a feeble one considered sufficient in dications for the stomach-tube. Harris Liston (Brit. Med. Jour., Feb. 13, '97).
I have found the subcutaneous in fusion of an albumin-salt solution ex tremely valuable in cases of sitiophobia, as well as in other conditions in which food could not be taken into or retained in the stomach. The fluid consists of a pint of sterilized normal salt solution (0.6 per cent. chloride of sodium, about 45 grains to the pint) in which the whites of two eggs have been whipped up and the whole strained through gauze. This is put into a nasal-douche bottle, to the tube of which is attached an aspirator needle of small calibre. The skin over the back, loins, or buttocks is disinfected and after the fluid is allowed to flow through the tube and needle to get rid of the contained air, the point of the needle is inserted well under the skin. The bottle is then moderately elevated and the fluid allowed slowly to penetrate the connective tissue. It takes about fifteen minutes to infuse a pint of fluid under the skin. The prominent swelling which results usually disappears in the course of an hour or two. The proceeding is not very painful, and leaves no bad local after-effects.
Case of somatic insanity treated by means of subcutaneous injections of salt solution, two quarts a day being used nntil 15 quarts had been introduced. The improvement was marked and im mediate. G. F. Keene (Boston :Med. and Surg. Jour., Oct. 4, '94).
In some eases of acute mental disease, cases showing autoinfective symptoms, and in cases refusing food, excellent re sults have followed the employment by hypodermic transfusion of large quanti ties (one litre) of 0.75-per-cent. blood warm sterilized solution of sodium chlo ride. The injections are made into the looSe areolar tissue of the abdominal wall or &teal region once daily. James T.
Searcy (Alienist and Neurol., Apr., '97).
The injection of a normal salt solution recommended. The patient lies prone on the bed, and the buttocks are washed with an aseptic boric-acid solution; a line trocar is plunged deeply into the muscular tissue of the buttock. The tro ear is connected with an lndia-rubber tube, to the other end of which a funnel or bottle is attached, and from the latter the sterilized normal salt solution is al lowed gradually to pass through the tube into the intermuscular tissue of the but tock. The solution should be of a tem perature between 37° and 40° C., an be slowly run into the tissues in quantities of about 1 pint at a time. De Boeck (Jour. of Mental Science, Apr., '99).
The writer states that the calmative action of certain remedies (duboisine, hyoscine, bromides, etc.) is augmented when these drugs are administered hypo dermically, dissolved in 400 cubic centi metres pint) of physiological salt solution, for this kind of internal lave meat seems to disembarrass the organ ism of the intoxication. By this method one obtains the same effects with only 4 decimilligrammes ('/,,, grain) of du boisine sulphate and 3 decimilligrarnmes (7„, grain) of hyoscine hydrate as are obtainable with twice that dose of the drugs given without the serum. A gramme of sodium bromide introduced in this way will suffice to induce a sensible and lasting sedative effect. Gaspero (New York Med. Jour., from Thee. der Gegenwart, Sept., 1902).
Among the means of treatment em ployed in acute cases of insanity, none surpasses, in effect, rest in bed. The tient with acute confusional insanity, mania, or melancholia, usually comes under the notice of the physician in a condition of great exhaustion. Bed-rest in these cases is imperative. I have found it better in these cases to treat the patient in an open ward, in the presence of other patients, and not in an isolating chamber. The suggestive influence of other persons in bed and apparently sick has a favorable effect, and the patient soon yields to the suggestions of cians and nurses and regards himself as sick and in need of treatment.