Delirium Tremens. — Symptoms. — Although one of the
medical terms for the Sifiection, Mania a poiu (drunkard's mad-
ness) expresses its most common source, yet there are condi-
tions of a very different nature to which occasionally its origin
may be traced. Thus a predisposition to it is engendered by
excessive mental anxiety or exertion, while it may also be ex-
cited by any cause of debility operating secretly and suddenly,
such as loss of blood, a serious wound or injury, a severe men-
tal shock. Symptoms sometimes follow on these, precisely re-
sembling those seen in the ordinary delirium tremens, and it
would be incorrect morally and medically to attribute them in
such instances to the vice of intemp ce. The symptoms
generally appear suddenly, sometimes .^^r a premonitory state
of nervous restlessness, with disturbed sleep, loss of appetite,
and general derangement of the bodily health
Treatment. — Where the cause has clearly been intemper-
ance, the first, and, indeed, the cardinal point in the treatment,
is to get the alcohol that has caused the disease withdrawn from
the system. It is usual to administer freely of stimulants;
which plan possibly arose out of the proverbial treatment of
hydrophobia — "a hair out of the tail of the dog that bit you,'*
MEDICINAL. 310
The practice is contrary to reason, and has not the results of
experience in its support. The system being already more
than saturated with alcohol, it is surely heaping Pelion on Ossa
to administer more. The practice further places the victim of
his cwn bad habits at a disadvantage, by robbing him of the
opportunity of breaking them off. Too often, indeed, what-
ever pains may be taken to restrain him, "the sow that was
washed will return to her wallowing in the mire;" but no rea-
son is thereby supplied for holding the poor beast down in the
mire.
If the patient be preserved as much as possible from the
sources of excitement, by being kept in a quiet and darkened
chamber, protected by strong attendants from injuring himself
or others, and fed with light nourishing diet, such as beef-tea,
arrowroot, milk, eggs, etc., the delirium will gradually subside,
and sleep will follow. This plan of treatment, which has been
advocated by Dr. Wilks, of Guy's HoGi'tal, has the great ad-
vantage over the usual systematic administration of heroic
doses of opium, that it is safer. In the hands of non-profes-
sional persons, the attempt to cure delirium tremens by large
doses of opium, must succeed only by the death of many pa-
tients. If, as the delirium subsides, the pulse be found feeble,
ammonia may be given, or steel and quinine. In what has
now been laid down in regard to the delirium of mania a potu^
it is not intended to forbid the moderate use of stim lants and
opiates in delirium arising out of other causes of delirium than
drink. In the sleepless delirium of a brain exhausted by over-
work, from shock, or by other deb3j.»-;i,ting causes, small quan-
tities of wine or brandy, and dose" oi i ^over's powder, may be
advisable.
Page 228
Presented as published in 1883. Historical recipes may not meet modern food-safety standards. Cook from the modern interpretation, not the original instructions.
AI-modernized reading of the original text
Delirium Tremens. — Symptoms. — Although one of the medical terms for the affection, Mania a potu (drunkard's madness) expresses its most common source, yet there are conditions of a very different nature to which occasionally its origin may be traced. Thus a predisposition to it is engendered by excessive mental anxiety or exertion, while it may also be excited by any cause of debility operating secretly and suddenly, such as loss of blood, a serious wound or injury, a severe mental shock. Symptoms sometimes follow on these, precisely resembling those seen in the ordinary delirium tremens, and it would be incorrect morally and medically to attribute them in such instances to the vice of intemperance. The symptoms generally appear suddenly, sometimes after a premonitory state of nervous restlessness, with disturbed sleep, loss of appetite, and general derangement of the bodily health
Treatment. — Where the cause has clearly been intemperance, the first, and, indeed, the cardinal point in the treatment, is to get the alcohol that has caused the disease withdrawn from the system. It is usual to administer freely of stimulants; which plan possibly arose out of the proverbial treatment of hydrophobia — "a hair out of the tail of the dog that bit you,'*
The practice is contrary to reason, and has not the results of experience in its support. The system being already more than saturated with alcohol, it is surely heaping Pelion on Ossa to administer more. The practice further places the victim of his cwn bad habits at a disadvantage, by robbing him of the opportunity of breaking them off. Too often, indeed, whatever pains may be taken to restrain him, "the sow that was washed will return to her wallowing in the mire;" but no reason is thereby supplied for holding the poor beast down in the mire.
If the patient be preserved as much as possible from the sources of excitement, by being kept in a quiet and darkened chamber, protected by strong attendants from injuring himself or others, and fed with light nourishing diet, such as beef-tea, arrowroot, milk, eggs, etc., the delirium will gradually subside, and sleep will follow. This plan of treatment, which has been advocated by Dr. Wilks, of Guy's Hospital, has the great advantage over the usual systematic administration of heroic doses of opium, that it is safer. In the hands of non-professional persons, the attempt to cure delirium tremens by large doses of opium, must succeed only by the death of many patients. If, as the delirium subsides, the pulse be found feeble, ammonia may be given, or steel and quinine. In what has now been laid down in regard to the delirium of mania a potu, it is not intended to forbid the moderate use of stimulants and opiates in delirium arising out of other causes of delirium than drink. In the sleepless delirium of a brain exhausted by overwork, from shock, or by other debilitating causes, small quantities of wine or brandy, and doses of Dover's powder, may be advisable.