TRANSACTIONS OF SOCIETIES. 
145 
duced by withdrawal of stimulus, is not true, and that in his 
large experience every case was produced by continued use of 
alcohol or abuse of opium; and in his article, to be found in 
Braithwaite’s Retrospect, he clearly demonstrates, to my mind, 
that continuance, and not withdrawal of stimulus, is the cause 
of the delirium tremens. He states, from the time the delirium 
first manifests itself, until it passes off entirely, is generally from 
20 to 60 hours, but it may not pass off till a much longer period 
expires; and that we need not be uneasy about the case until 9 
days have passed. Remove the cause of the disease, and it will 
generally be cured; and hence, by withdrawal of stimulus we 
will remove the cause, and unless there be some organic lesion 
of the brain, the case will terminate in health. 
Dr. Linton said he did not propose entering into a discussion 
as to the pathology of delirium tremens, but merely wished to 
state that the treatment which he pursues of late years in this 
disease is very similar to that which Dr. Johnston recommends ; 
that is, knowing that a great many cases will get well without 
any treatment, he pursued the expectant plan — left the case 
pretty much to nature, and was very careful in giving opium. 
In early life, believing sleep to be necessary to cure the disease, 
and opium the remedy to produce sleep, he had sometimes given 
too much opium. 
Dr. A. Hammer said he was much interested in the report of 
the remarkable case detailed before the Society. He could not 
go so far as Dr. Johnston— to discard all treatment in this dis- 
ease; but he thought, as in almost everything else, the middle 
ground was the safest. In this disease, whether it be delirium 
tremens or mania a potu, we must remember that we may have 
two very different conditions to deal with; one where there is 
simply derangement of the nervous centres, irritation or exhaus- 
tion, with derangement of the functions of the mind, produced 
by the poisonous effects of alcohol; all the tissues, the nervous, 
and the muscular, are saturated with alcohol; the mucous mem- 
branes are inflamed by it; and it will take a long time to elimi- 
nate this poison, to restore to the proper condition the muscular 
tissue, the nervous tissue, and the mucous membranes. This is 
one condition we have ; but we may have another and a very 
different and much more dangerous condition — viz : a passive or 
even active congestion of the brain ; the two requiring very dif- 
ferent treatment. In very slight cases, coming under the first 
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