R. Sinclair Smith
1890 The Lancet  
817 :and, in addition, a depressed action of the heart, much drowsiness, and slight loss of power ovei the inferior extremiities.-July 4th : Evening temperature 99 7°; restless and pain in the abdomen coincidently with vomiting. I prescribed beef-tea, soda and milk, and ice, sinapism to the epigastrium, and a compound senna mixture.-5th (6 A.M.) Passed a sleepless night; morning temperature 98.4°; gastric irritation better ; bowels relieved ; tongue furred ; more restless; has subjective and
more » ... ective disorders of perception ; urine normal. 9 A.M.: Delusions and incoherent talking, becoming more restless ; had him confined to a strong room, where he remained more quiet. .5 P.M.: Suddenly became violent, incoherent in speech with wild and furious shouting ; takes no food ; gave him a hypodermic injection of morphia (one-third of a grain), ;followed in two hours by twenty grains of sulphonal. 11 P.M. Patient has become quieter and is lying down in his cell. 12 P.M.: A return of violence, with an exacerbation of symptoms; walking about his cell, with disorder of intelligence, both objective and subjective. No sleep, has torn up his bedding, broken the windows, and taken off all his clothes.-6th (6 A.M.) : No sleep ; found it neceseary to strap him down to the bed, as he tried to thrust his head through the bars of his cell, wounding himself in both temples, and imagines he is about to be shot or hanged. 12 A.M. : Is getting a little quieter; taking some nourishment (beef-tea). Bowels not acting; has passed his urine in bed. 6 P.M.: Senses beginning to return, but still rather noisy. Released him from the strapping, and symptoms of ,exhaustion have supervened. Takes some milk and beeftea ; gave him a draught of compound senna mixture, followed by twenty grains of sulphonal, which procured him sleep. Temperature normal. -7th : Slept fairly well. Tongue furred, no pain, and quite sensible, with the .exception of a few hallucinations. Bowels relieved.
doi:10.1016/s0140-6736(01)90472-6 fatcat:gwjmdcv7nbhdrg6v4c4e7unscu