The action of neurotic medicines in insanity / by T. S. Clouston.

  • Clouston, T. S. (Thomas Smith), 1840-1915.
Date:
1871
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Licence: Public Domain Mark

Credit: The action of neurotic medicines in insanity / by T. S. Clouston. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    between it and the drug action as regards immediate effect on the excitement. . , Appetite.—No effect of a drug is more important on a maniacal patient than its effect on his appetite for food. If that is much interfered with, the good effects of the medicine will have to be great and manifest indeed, to counterbalance so indisputable an evil. I have in Table II shown the number of times in which the patient s desire for food was clearly interfered with after each medicine given. Opium stands in bad pre-eminence at the head of the list as that which most frequently produced this result. In seven out of the twenty-nine experiments with opium, the patients could not be got to take the next meal. This was never the case after bromide of potassium at all, and only once after cannabis Indica and its com- bination with the bromide. This was one of acute excitement, with complete incoherence and absence of reason, being that most like the acute delirium of fever. In his case it caused on two occasions dry- ness of the tongue and lips as well as loss of appetite. Temperature.—The temperature of the body in maniacal excite- ment has been far too little attended to. It often rises in a direct ratio to the brain excitement present, it is most important as a diagnostic of organic disease, and it affords most valuable indica- tions for treatment in many cases. In Table III I have recorded the results of my observations in regard to temperature. The tendency of opium was to raise the temperature slightly; that of the bromide and cannabis Indica combined to depress it; of the bromide alone to raise it rather more than opium ; of the cannabis Indica alone Table III. Substances given. No. of Patients. No. of Experi- ments. Average Temperature. Average gain in each experiment. Average loss in each experiment. Before medicine. After medicine. Tinct. Opii . Tinct. Can. Ind., Potas., and Bromid. Potas. Bromid. Tinct. Can. Ind. Whisky Beef tea 9 }• 7 7 10 9 29 29 13 15 21 15 97-6° 98° 98-1° 97-5° 97-9° 98-16° 97-8° 97-7° 98-4° 97-6° 97-3° 98-14° •2° •3° •1° •3° •6° •02° to raise it very slightly; of the whisky to lower it most of all, and of the beef tea to lower it in the most trifling degree possible! It must be remembered that the temperature of the body in sucu maniacal patients is higher than in health. I think we must look on the action of opium, bromide of potassium, and tincture of cannabis, therefore, in this respect, as being away from the healthy