On the pathology of delirium tremens : and its treatment without stimulants or opiates / by Alexander Peddie.

  • Peddie, Alexander, 1810-1907.
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology of delirium tremens : and its treatment without stimulants or opiates / by Alexander Peddie. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    In the cases which I have formerly treated with opium, and which have at last terminated well, a salutary sleep has not taken place till the close of the third day, let the cpuantity of opium be what it would. I have, indeed, seen sleep induced by opium at an earlier period, but it was premature, it passed into a state of coma, and the patient died. I am satisfied, therefore, that in cases of delirium tremens, the patient, so far as the paroxysm alone is concerned, should be left to the resources of his own system, particularly that no attempt should be made to force sleep by any of the remedies which are usually supposed to have that tendency, more particularly that this should not be attempted by the use of opium. Dr Cahill1 also cites several cases of the genuine disease, in which lie found opiates decidedly injurious, and treatment without them salutary. The treatment recommended by Dr Graves,2 to which I have already alluded, is advocated on the ground that opium is highly dangerous in the early part of the paroxysm. His rule of practice is to begin with tartar emetic alone, with the view of combatincc vascular ex- citement, then to add a little opium, and gradually to increase the quantity, keeping its action carefully guarded and controlled by the antimony, until at length when engorgement of the cerebral vessels is no longer to be apprehended, to use opium alone. If opium is to be given at all in delirium tremens, this is certainly the safest mode of prescription. For some time I tried it, but from pre- vious experience of the beneficial effects of antimony in this dis- ease,3 I soon became convinced that it was from that asent solely, especially its effects in the first stage, that ultimate benefit was derived; that the relative quantity of opium employed at first is too small4 to counteract the power of the antimony, or to pro- duce any notable effect whatever; that in ordinary cases, ere the time arrives for increasing much the amount of the opium, the 1 Dublin Medical Journal. Observations on the Treatment of Delirium Tremens without Opium. Vol. xv. p. 397. J Clinical Lectures, vol. i. p. 630. 3 This experience of the effects of tartrate of antimony I had before I was aware that Dr Graves had recommended it with opium, or that Stoll, Goeden, Klapp, and others, had advised it in emetic doses. * Dr Graves' formula for first use is: Q Antimon Tart. gr. iv. Tinct. Opii. 3i. Aqure Sviij. 5igna. A tablespoonful to be taken every second hour. There is thus in each lose only five drops of laudanum to \th grain of antimony.