On the Treatment of Delirium Tremens

1838 Boston Medical and Surgical Journal  
In some remarks on delirium tremens, which were published among the communications of the Massachusetts Medical Society a few years since, and which were founded exclusively on cases which had occurred under my own observation, 1 expressed the opinion that this disease was not capable of being arrested in its course by treatment-that the paroxysm of watchfulness and delirium was not shortened by remedies, but would continue a certain time, and then arrive at a spontaneous termination either in
more » ... eath or recovery-and that opium, so far from exercising, as many have supposed, a favorable influence on the event, served rather to increase than diminish the mortality. The opinions then expressed were not founded upon any strict or analytical examinaiion of the cases referred to, but were simply the result of the general impressions which are left upon the mind of the practitioner, by the observation of disease, as it presents itself in the routine of ordinary practice. I am fully sensible of the cautious reliance which should be placed on results which have been thus obtained, and it seemed, therefore, desirable to inquire how far these opinions would be confirmed by a more strict examination of the cases on which they were founded. Such ati inquiry has accordingly been made, and the results I now lay before the Society. Since the publication of the paper alluded to, a few cases of delirium tremens have fallen under my care, and these have been included in the examination. Other cases, on the contrary, which were then referred to, have been now rejected. The objects of that paper embraced a general history of this peculiar delirium, whether occurring in a distinct paroxysm or only as a transient symptom in the course of other diseases. 1 have now only included those cases in which the delirium presented itself in the form of a regular paroxysm. I have also excluded thirty-one cases which occurred under my care at the Boston Almshouse, as I have no notes of their history or treatment, but merely of the event of each case. The number of cases in private practice was 69, occurring during a period of about twenty years. Of these cases 63 occurred among males, and 6 among females. The whole number of deaths was 11-all the fatal
doi:10.1056/nejm183804180181101 fatcat:bzkc3sfodveezlmedh2qwym2ze