On the pathology and treatment of delirium and coma : the Lumleian lectures for 1850 / by R.B. Todd.

Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology and treatment of delirium and coma : the Lumleian lectures for 1850 / by R.B. Todd. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Tuatuier; her pulse was 160, and tlio i’cs])i- ration 40. She was placed upon a freely stimidating treatment, with ammonia, and wine, and beef-tea; for several days she took half an ounce of wine every hour. On her admission the pulse was 160, and respi- ration . 40; the next day it had not di- minished in frequency : during these days she was taking half an ounce of wine every hour. On the 14th (the tliird day after admission) the pulse fell to 130, but the dolirhmi continued. She was sleepless; talked a great deal, and fancied some one was coming to take her away and kill her. The quantity was now increased to an ounce every hour. On the 17th (the sixth day after admission) she was reported to have slept well, and the delirium had conside- rably subsided. The pulse, however, was still 130. On the 19th she had improved still further, and the pulse had fallen to 120. I now gave her quinine (the tongue having become clean) ui doses of two grauas every fourth hour. On the 20:h tlie pulse was 108. The quantity of stimulants was now gradually diminished, and on the 8th of December the pulse had fallen to 88, and from this time she ra)iidly convalesced. You must deal with these cases of puer- peral delirium in much the same way as you deal with cases of erysijiclatous or typhoid delirium, because in all these conditions the patient suffers from a state of exliaus- tion detrimental to general nutrition. In puerperal delirium, liowever, we may give opium with great safety : in violent cases, in which sleep could not otherwise be pro- cured, I shoidd not object to achninister chloroform, bearing in mind the cautions to be obseiwed during and after its inhala- tion, wliich I mentioned in a former lecture. It remains for me to discuss the treat- ment of the epileptic dclu’ium : this, with some remarks on the treatment of the va- rious forms of coma, I propose shall form the subject of my next lecture.