356 



On Delirium Tremens. 



legs ; pulse rapid and small ; con- 

 tracted pupil ; skin perspiring 

 profusely ; the constraint caused 

 him to struggle for release ; great 

 thirst. 



Night — has become quiet ; has 

 convulsive movements of hands 

 midnight — is violent again. 



4th morning — is quiet now 

 the fastenings have been loosen- 

 ed ; stupor with heavy breathing 

 occasional muttering ; subsultus 

 tendinum ; pupils contracted, in- 

 active ; clammy skin ; rapid, weak 

 pulse ; pallid tongue ; tumid belly 

 — 10 o'clock a. m. died. 



The laudanum in this case, as 

 also in the case No. 16, appear- 

 ed to be of no service. 



No. 18. August, age 28. — A 

 hard drinker — History. Says he 

 has been vomiting continually for 

 the last three days ; denies hav- 

 ing committed excess ; he has, 

 however, upon other occasions 

 been seen in liquor ; the vessel 

 has just arrived from sea ; on ad- 



4th morning — Calomel and Ja- 

 lap ; several turpentine enemata ; 

 sinapisms to legs; brandy and 

 water. 



Post Mortem Examination three 

 hours after death. 



During the opening of the head 

 several ounces of dark blood 

 escaped from vessels of the scalp 

 and from within the skull ; a con- 

 siderable effusion of serum within 

 the arachnoid upon the superior 

 surface of the brain ; the arach- 

 noid milky, its two layers adhe- 

 rent along the sides of the longi- 

 tudinal sinus ; serum beneath the 

 arachnoid raising it from the 

 pia mater. The minute rami- 

 fications of the vessels of the pia 

 mater, both on the surface and 

 between the convolutions, highly 

 injected; numerous bloody points 

 upon dividing the cerebral sub- 

 stance ; more than two ounces of 

 serum at the base of the brain, 

 within the ventricles and issuing 

 from the spinal canal ; choroid 

 plexus much congested. 



Chest. — Heart an atheroma- 

 lous condition of inner layer of 

 arch of aorta. Lungs loaded 

 with blood. Abdomen — stomach, 

 a highly injected state of mucous 

 membrane of great end : liver, ma- 

 culated externally, red and yel- 

 low, its texture, upon division, of a 

 nutmeg appearance, firmer and 

 more brittle than usual ; treacly 

 bile in gall bladder. 



No. 18. — During the first three 

 days he had repeated effervescing 

 draughts with Tr : Opii : M. xv. 

 in each ; a sinapism abdom : a 

 dose of laudanum each night, 

 which was given twice on the 2nd 

 night ; Mist : Sennse : Comp : on 

 the 3rd morning. 



