136 PRACTICE OF MEDICINE. 



which ensues ; with this intention, h'quor ammonise acetatis, with 

 excess of ammonia, and camphor mixture, may be given. Moderate 

 doses of opium, or of laudanum, with the view of lessening nervous 

 irritability and inducing sleep, should also be exhibited. Or tartar 

 emetic may be given in combination with opium, with the view of 

 quieting both nervous and vascular action. 



In the treatment of the second variety, or the true delirium ire- 

 mens, we should endeavour to cut short the disease by giving opwm, 

 with full doses of camphor and ammonia, and administering ene- 

 mata, containing laudanum and assafoetida. Dr. Blake recommends 

 the accustomed stimulus in moderate quantity and at short intervals ; 

 it may, however, cause too violent reaction, unless the head be 

 guarded by having frequent recourse to cold affusion. In some 

 cases, warm spiced negus, or punch, may be allowed. Stimulating 

 liniments applied over the epigastrium are occasionally very effica- 

 cious. When the symptoms of nervous irritation have been allayed, 

 we should direct our attention to the condition of the gastro-hepatic 

 system ; in which, frequently, there is derangement of function. By 

 the judicious combination of stimulants and medicines which will act 

 on the liver, such as calomel or camphor, and stimulating purgative 

 draughts, we again restore the proper secerning action of this gland, 

 and dissipate any sanguineous injection or infarction of its structure. 

 Having produced a proper action on the alimentary canal, we may 

 again have recourse to opium if any signs of irritation remain. The 

 use of opium is much abused in this disease, and in many cases it is 

 pushed to a most unjustifiable extent. It is an imj^jortant question. 

 In Jloiv many cases of deliriiMn tremens does the patient die in a 

 state of narcotism 1 It is certain that the use of large and repeated 

 doses of opium promotes the supervention of coma, effusion, and 

 paralysis ; and that its effects nearly resemble the phenomena of the 

 last stage of delirium tremens. During the convalescence, mild 

 tonics should be given, the diet should be light and nutritious, and a 

 suitable beverage, in moderate quantities, allowed. 



APOPLEXY. 



This affection is characterized by loss of consciousness, feelinsr, 

 and voluntary motion ; or, in other words, by a suspension of the 

 functions of the brain, respiration and circulati/^n being also more or 

 less disturbed.* 



The suspension of the cerebral functions may be connected with 

 any of the following pathological conditions: — 1. Great congestion 

 of the brain, in which the vessels of that organ are gorged, but with- 

 out extravasation of blood or serum ; this is termed, " co77gestive 

 apoplexy.'''' 2. Congestion of the vessels of the brain, with extra- 



* Dr. Copland's Dictionary. 



