HOW TO RELIEVE OUR CROWDED LUNATIC ASYLUMS

S.W.D. Williams
1871 The Lancet  
215 hours taken eighteen ounces of brandy, twelve ounces of beef-tea, and seven eggs. The brandy was now ordered to be reduced to twelve ounces in the twenty-four hours. During the next twenty-four hours there was no further application of the cold. The temperature oscillated between 1005° and 102-7°. The pulse remained about 96, and the respiration 24. On the 16th (the twentieth day of the disease and the sixth of this treatment) the strength was still further improved. The tongue was still
more » ... tongue was still furred; but she bad, in addition to twelve ounces of brandy, taken two pints of beeftea, three pints and a half of milk, and seven eggs in the previous twenty-four hours; and had passed a natural stool. There was no dulness over the lungs, and less moist rale; but still some weak breathing at the right base. The pulse (96) was small, but well sustained, and without dichrotism. The cardiac friction was diminished ; the apex murmur was faintly audible. She had passed seventy-two ounces of urine. The quinine was reduced to one grain every three hours, or eight grains in the twenty-four hours. On June 17th (the twenty-first day of the disease and the seventh of the treatment) the temperature fell to 984°. On the following day it never rose above 99.1°; and after this it remained normal, though falling on the 22nd to 97.9°. On the 18th, though only a week had elapsed since the excessive temperature, the patient sat up in bed, and ate a boiled sole for dinner. The rales in the back entirely disappeared on the 22ndthe twelfth day after the intense pyrexia, and the twentysixth day of the disease. The heart's sounds had now become natural, with the exception of a very faint friction at the base, which disappeared within the following two days. The apex had returned to its natural position, the dulness was at the lower border of the third interspace, and there was no murmur. From this time, though the patient remained feeble for a few days longer, there was uninterrupted improvement, with the exception that on the 1st of July (the thirty-fourth day) the morning temperature was 100°. This had, however, fallen to 98.5° in the evening; and there was no subsequent relapse. The patient got up, walked about the ward, and was discharged for Eastbourne on the 10th of July-thirty days after the intense pyrexia, and forty-four days after she was first taken ill.
doi:10.1016/s0140-6736(02)78229-9 fatcat:v27rsz4uyjfafjzqwgpwwug5u4