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

  • Clouston, T. S. (Thomas Smith), 1840-1915.
Date:
1871
Catalogue details

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.

    19/48 (page 13)
    Weight.—They all lost weight while taking the large doses of the drug. In some of them the loss was considerable, in others trifling. The greatest loss was thirteen pounds, the smallest one pound. The aggregate loss in all the cases was forty-five pounds. The patients whose excitement was most subdued did not lose most, nor did they lose least. It may be thought that the total amount lost in weight by them all is very small indeed, but it must be remembered that all those patients had no doubt lost greatly in weight when they first became excited, and were mostly at the minimum consistent with such health as they enjoyed. The opposing tendencies of the excitement of the brain and the reparative powers of the food they ate had found their balance, as it were, in each of them, and the effect of the opium was to give some more strength than had previously existed to the exhaustive forces. Temperature,—On comparing the average temperature of each of those patients when taking no medicine, and during the whole time they were taking the opium, we find (Table V) that in every one of them but one it was lower while taking the medicine. The actual fall in each case is seen to vary from 1° to ■ 1° in the morning tem- perature, and from -5° to 1 in the evening temperature. The total amount of the loss of temperature in the seven was in the morning %'1°, and in the evening ri°. This seems small and unimportant, but it must be remembered how much the permanent lowering of one degree of temperature represents of loss in vital energy and re- parative action if it is already below the normal amount, and how much of good it may represent if it is above the natural standard. The average temperature of those patients was higher than most other classes of patients in the asylum, and higher than the average temperature of forty sane persons who were employes in the asylum, which I found to be 97-5° in the morning, and 96'7° at night. Was it not, therefore, a health tendency, this reduction of the temperature caused by the drug ? To answer this we must take into account certain facts in regard to the temperature of the insane. I found from an examination of the temperature of patients labouring under all forms of insanity, that a high evening temperature, as compared with the morning temperature, represents a large mortality in the class where this exists. Any drug that would have a curative tendency must reduce the evening tempera- ture. In the cases experimented on, it is seen that the reduction of the evening temperature is very slight as compared with the morning temperature of the patients, and that, therefore, the average evening temperature is relatively higher while they were taking the opium than when they were not, the difference between the average morning and evening temperature of the same persons was 8°, the difference in those seven patients taking no medicine was -3°, while the difference after they began to take the opium was nil. It seems to me, there-