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146 TRANSACTIONS OP SOCIETIES. 
head, the do-nothing plan of Drs. Johnston and Linton might 
answer very well; and when the symptoms are insomnia, with 
the peculiar tremors, when the organs are in pretty good con- 
dition you can do a great deal of good with opium. I don’t, of 
course, give opium with an idea of eliminating the poison of al- 
cohol from the system, but as a prophylactic against certain con- 
ditions whiqh may supervene if quiet and sleep are not procured, 
viz: passive congestion of the brain or complete exhaustion, 
when the patient is apt to die. I have in such cases given as 
much as 80 grains in the course of 24 hours with good effect. I 
would not, however, continue opium too long if it does not pro- 
duce sleep. In acute alcoholic poisoning or intoxication, we may 
have active congestion of the brain, and of course in such cases 
opium is contra-indicated because it has a tendency to produce 
congestion of the brain. Here we must use antiphlogistics and 
arterial sedatives, cold applications, purgatives, counter-irritants, 
or digitalis or veratrum viride. We must then, of course, make 
a proper and very careful diagnosis of every case and treat it 
accordingly. 
Dr. Boislinere. I saw the case reported to the society, and 
am very much obliged to Dr. Kennard for giving me the oppor- 
tunity. It was certainly a most remarkable one and was evi- 
dently treated very judiciously and with great care. I merely 
wish to refer here to a plan of treating this disease with ammo- 
nia, on the ground of its antidotal properties, which I think a 
very rational one. I have long known that ammonia will very 
rapidly cure drunkenness, have frequently proved it by experi- 
ment, and the same idea has been applied in France to the 
treatment of delirium tremens. 
Dr. Bland. I think Dr. Hammer takes the proper view of 
the pathology and treatment of this disease ; at any rate his 
views of the pathology accord entirely with mine. In this dis- 
ease we have two very different pathological conditions. 1st. 
An exhaustion of nervous power, derangement of the nerve 
centres, when we have the peculiar delirium, the hallucina- 
tions, so varied and characteristic of this disease, and the mus- 
cular tremors, the mind becoming entirely deranged from the 
poisonous effects of the alcohol on the whole system and the 
brain in particular. In these cases, the judicious use of opium 
is the proper plan. In the second class of cases we Have either 
a tendency to, or actual congestion or inflammation of the 
