Therapeutic Memoranda

1875 BMJ (Clinical Research Edition)  
ness, he was supposed to know how to use judiciously. night, he took his usual draught about half-past ten o'clock, quently turned out to be pure tincture of opium, the ounce bottle. He immediately fell into a deep sleep (he very badly), and gradually passed into a state of coma. The pulse was slow and full ; breathing very laborious stertorous. The pupils were reduced to a pin's point, turned upwards. His teeth were tightly clenched, and cold perspiration all over his body. I immediately
more » ... stered of turpentine, and put flying blisters over the region of along the spine. Stertor became less marked, and the 6ii face were slightly relaxed. I was now able to force down his throat half a drachm of aromated spirit of ammonia in water, and in a few moments his breathing became natural. I now placed him in a sitting posture, and employed assistants to irritate the soles of his feet with feathers. In fifteen minutes, he became slightly conscious, and, after half an hour, he spoke and begged to be allowed to sleep. A drop of croton oil was given with sugar, and hot coffee was administered by consultant, now returned. We agreed to inject one-thirtieth of a grain of atropine under the skin of the forearm. Ten minutes afterwards, the pupils were perceptibly enlarged, and consciousness became more marked. At 7 A.M., I got him to the garden, and kept him walking about between two assistants. At 9 o'clock, the effects of atropine seemed to be passing off. I again injected one-thirtieth of a grain, which restored the pupils to their natural size ; but he saw very confusedly. At IO o'clock, he passed urine, but had no motion. I left for two hours, having given directions that he be kept walking about. On my return at 12 o'clock, the desire to be permitted to sleep continued; but his general condition was much improved. He had some more coffee, a little brandy and water, and some beef-tea. There had been no alvine evacuation. A second enema was administered. He was now (at 2 o'clock) perfectly conscious; but his mind began to wander. He fancied his wife was about to separate from him, and he threatened self-destruction if she persisted in it. At ii o'clock P. m. on the 14th, the bowels acted slightly. iHe was suffering much from congestive headache. I gave calomel and a draught of bromide of potassium on the I5tb. Hypercemia of the spinal cord set in, accompanied with much fever. I kept him under medical treatment, with bromide and tincture of belladonna, and had a small blister kept open on the vertex for a week. In the course of a month, he had perfectly recovered, and has never had a return of neuralgia since.
doi:10.1136/bmj.2.776.611 fatcat:7xujhoqnfjchpjnji6miw4qmzi