Among foods, meats are to be used sparingly at first. The patient should remain in bed, reclining at full length most of the time during active treatment. Muscular exercise by massage for an hour a day should be given, or a walk in the open air with an attendant or a, few moments' exercise with ropes and pulleys. Daily baths should be continued with regularity and care. l'ersistent watchfulness over all acts of the patient should be kept up for or 8 weeks; then a rigid course or living and diet arranged, and its importance insisted upon, for a long period to come. T. D. Crothers (Phila. Med. Jour., May 28, '98).
All complications must be attacked, but, in the main, besides hygienic meas ures, nervine tonics are indicated in the endeavor to restore the lost energy and will-power which really constitute the disease. Of these tonics nux vomica and strychnine are the most effectual. Ar senic also is useful. I have found in this, as in other forms of narcomania, that an occasional replacement of the stronger nerve-tonics by milder ones is advantageous; I mean such as quinine, ealumba, and gentian. Galvanism has, in appropriate cases, its value.
Though it is often asserted that 3 to 6 months suffice to effect a cure, my ob servation has been that 12 months con stitute the shortest time in which such a result can be hoped for. There are, at the same time, a few exceptional cases in which a good result has been secured in a shorter period.
many co cainists will not apply for curative de tention of their own accord, it ought to be the duty of the constitutional author ities to lay hold on these miserable and utterly- helpless diseased persons, and in sist on their reception and therapeutic seclusion for a given time, in a retreat, home, or hospital provided for the spe cial treatment of such cases, with pro vision for persons with limited resources and for the very poorest. Such a pro vision would, in the long run, prove as economical as it would be invaluable to the welfare, physical and moral, of the whole community.
I am unaware of any trial for murder or for administering cocaine with intent to injure another person; but cocaine has been employed to commit suicide. It has been stated recently that forty cocainomaniacs appeared in the police courts of Chicago within the period of a few months in 1897. The habit was said to have been induced, in some cases, by the use of popular preparations as cures for colds, etc. In the charters of various special institutions in the 'United States power is given to the managers to re ceive and compulsorily detain habitual inebriates who are addicted to excess in any narcotic or inebriant, including co caine; but, in England, only excess in alcoholic liquors renders applicants eligi ble for admission into retreats under the voluntary provisions of the Inebriates' Acts.