506 MATERIA MEDICA AND THERAPEUTICS. 



causes, Belladonna and Conium are often of use, e.g. in chordee, 

 spasmodic asthma, and laryngismus. The continuous battery 

 current and counter-irritants relieve painful spasm of the volun- 

 tary muscles. Lastly, Opium again is a most powerful anti- 

 spasmodic for general use. 



5. Consciousness may be said to demand temporary removal, 

 in anticipation of the excessive pain and anxiety attending 

 operations. The general anaesthetics in common use are Ether 

 and Chloroform, the selection and use of which are fully 

 described under their special therapeutics. Conditions of 

 excitement, such as delirium and mania, are to be met by two 

 sets of remedies, which must always be combined viz. first, 

 cerebral depressants, such as Opium, Chloral, Hyoscyamus, 

 Bromides, and, if necessary, Chloroform ; and secondly, 

 general nutrients and stimulants, chiefly in the form of abun- 

 dant food, and possibly a certain amount of alcohol. 

 Judicious moral treatment is an indispensable accompaniment. 



6. Loss of consciousness appears to require and receive treat- 

 ment in cases of fainting, drowning, accidents to the head, etc., 

 but the great centres of respiration and circulation are the real 

 objects of our anxiety. They have been depressed along with 

 the convolutions, and must be restored to activity if life is to be 

 preserved. Eestorative measures include the re-establishment 

 of the general and cerebral circulation by the recumbent pos- 

 ture and cardiac stimulants, and of respiration by artificial 

 chest movements and abundance of fresh air. Local nervous 

 irritants such as cold affusion, flagellation, or mustard applied 

 to sensitive parts, powerful odours, and Ammonia, must each 

 or all be employed. 



7. Disorders of Sleep will be rationally treated by pursuing 

 the course suggested by our previous considerations. Insomnia 

 may be met by the many indirect and direct hypnotics. In 

 every instance full advantage must be taken of the indirect 

 group. Bromides are indicated when the cerebral circulation is 

 excited by overwork ; and Chloral may be combined with it. 

 When pain is present Opium only will induce sleep. When 

 there is much mental distress Opium is again necessary, and 

 Alcohol at bedtime may be invaluable. In every instance the 

 time of administration of hypnotics must be carefully ordered. 

 Further, it must never be forgotten that the narcotics, in- 

 cluding Opium, Morphia, and Chloral, are all powerful de- 

 pressants of the respiration, circulation, and excretions, and 

 may produce disastrous results, whilst they afford the temporary 

 advantage of sleep. 



