Postcataract extraction delirium : report of eleven cases / by Walter R. Parker.

  • Parker, Walter Robert, 1865-
Date:
[1913]
Catalogue details

Licence: In copyright

Credit: Postcataract extraction delirium : report of eleven cases / by Walter R. Parker. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    ful, frequently asserting she might be harmed. Never again disoriented. Always knew the names of those about her. Audi- tory hallucinations continued until the time of discharge on the twenty-first day. , Case 10.—M. E., man, aged 72. Urine examination nega- tive. July 17, 1912, combined extraction without accident. During night of second day after operation patient became delirious; nurse unable to control him. Out of bed, disoriented, had hallucinations of hearing and talked in a rambling man- ner. Pad was removed from unopened eye. Later he became nauseated and vomited a small amount of undigested food. No signs of delirium followed. Eye not injured. Case 11.—M. S., man, aged 69. Urine negative. July 12, 1912, combined extraction. During afternoon of second day became delirious. During night much worse, with hallucina- tions of hearing and disorientation. Given morphin sulphate % grain and tepid sponge bath; removed pad from unoperated eye. Later given 1/1000 grain scopolamin, after which he slept three hours. On waking the delirium was still marked. Next day he was quiet and had no return of delirium. Eye not injured. It will be noted, in the cases here reported, that the psychoses occurred only in the aged, the youngest male aifected being 69 years old, the oldest 80, average 74.28 j the youngest female 53, the oldest 82, average 68 years of age. Males were more .frequently affected than females, seven patients being men and four women. The psychoses began from twenty-four hours to six days after the bandages were applied. In five cases the delirium occurred during the daytime, in six during the night, but in every case the symptoms were more promi- nent at night. In no case did the patient show signs of deviation from a normal mental state, either before or at the time of operation. A general anesthetic was not administered. Four instillations of 4 per cent, solution of cocain were used at intervals of two minutes in each case. After operation the patients were quiet and tractable. Later they became restless, indifferent to precautions to remain quiet, often raised themselves without assistance, dis- turbed the bandages, etc. They usually answered ques- tions rationally, but gave little heed to instructions. With some patients the first manifestations become more marked at night; they get out of bed, perhaps allowed themselves to be quieted for a short time, or became obstinate, scolded and defended themselves. The major-