After the relief of the more acute symptoms, tonics, as Quinine with a Mineral Acid and Gentian and Calumba, may be given. If the gastric symptoms continue after the disappearance of the craving, Bismuth or Oxide of Zinc, with a minute dose of Morphine, gr., may he given; or Pot. Bicarb., r oz.; Aqua! Laurocerasi, 6 drs.; Aquae to 12 oz.—a table spoonful, with an equal quantity of fresh lemon juice, every 2 hours.
For the persistent loss of appetite and want of energy, associated with restlessness and disturbed sleep, sometimes with traces of hallucinations following long after prolonged alcoholic excess, there is no better remedy than the following: Quinince Hydroch. gr. xx.
Acid. Nitro-Hyd. Dil. 5vj.
Exl. Cinchona Lig. 3iv.
Dcstillatee ad x. Misco.
Fiat mistura. Capt. coch. mug. ter die ex arna ante cib.
For the insomnia of chronic alcoholism, Opium should he sparingly employed. Bromides may be freely and continuously administered, and io to 30 grs. may be given in conjunction with any of the above combina tions. It is a good plan to give the Bromide of Potassium in doses, say, of zo grs. every 4 or 6 hours, alternating with the Sal Volatile and Capsicum Mixture. Trional, Sulphonal, Paraldehyde, and Hyoseine are all safe and useful. Chloral should never be trusted, owing to its dangerous depressing action upon the heart. (For the treatment of insomnia in delirium tremens, see under Delirium Tremens and Insomnia.) Long after alcoholic excess has terminated in the condition requiring the treatment mentioned in the previous pages, the patient should be seriously cautioned, and, if necessary, placed under mild restraint, and if the craving continues, and the will he unable to resist it, restraint should be insisted upon, and a residence in a good inebriate asylum he strongly advised for as long a period as possible. hypnotism has been extolled, but the writer has no
experience of its use. In the later stages muscular exercises to the extent of inducing fatigue are invaluable.
Dipsomania or Oinoruania must not he confused with ordinary inebriety. The mental or psychic element must be always before the mind of the physician when dealing with this disorder. and its victim must he treated and assisted as if he were the subject of a neurosis or degeneration either inherited or acquired. The treatment between the attacks will resolve Itself into such alteration in the environment of the patient, his habits, exercise, food, and morals as will tend to improve his physical condition, strengthen his will power, and elevate his moral sense. The manage ment of the case during or immediately after the drinking bout will be that indicated in ordinary acute drunkenness. The plan of tapering down gradually the quantity of alcohol or of mixing it with nauseating expectorants is to he condemned. In the hands of Dr. M. Bramwell hypnotic suggestion in these cases has given marked and satisfactory results, but the greatest care must be exercised to prevent this subtle agent being employed to the extent of causing diminution of will power or loss of the patient's sense of self-respect. In every case permanent total abstinence from all forms of alcoholic beverage must be rigidly insisted upon.