A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
In my experience, stimulating tonics, wine, and even coffee, increase
the morbid cerebral energy of the early stage of the disease, but are
sometimes of use later. Cod-liver oil and the hypophosphites do
better, and many of the disagreeable symptoms of the period of loss of
control over the involuntary muscles are relieved by strychnia. Ergot
and the judicious use of the bromides abate the cerebral congestion.
Gastro-intestinal disorders, when not controlled by attention to diet,
require the usual treatment.
Iodide of potassium in the large or small dose, and mercury, I have
never found to benefit those cases of general paralysis with a
previous history of syphilis. On the contrary, they have proved
debilitating and harmful.
When furious excitement is not relieved by prolonged warm baths, with
cool applications to the head if possible, and quiet, chloral is of
use, and sometimes opium and its preparations.
Frequently-repeated violent convulsions, the epileptic state, are
usually at once mitigated by chloral given by the rectum; the
inhalation of nitrite of amyl is reported also to have been of use.
There are few cases in which I find that morphine does not quiet
restlessness, calm delusions, abate distressing hallucinations, and
make the patient generally more comfortable; and I give it freely,
seldom more than twice a day, often almost daily, for two or three
years. In this way it can be used in quite moderate doses. Coca also
relieves symptoms.
Rest and quiet are most important in all stages of the disease. This
can be best accomplished in a quiet private house in the country,
which can be made a virtual hospital, and next in a private asylum.
But such care is beyond the reach of the vast majority of the insane,
to whom the public asylum becomes a necessity. Wherever they are, an
orderly life is best for them, with as little irritating interference
with their ways or control of them as is possible.
If the results of treatment are in the highest degree unsatisfactory,
and consist chiefly in meeting symptoms as they come up, without hope
of permanent recovery, it is not impossible that when we can put the
patient under treatment at the very beginning of his disease, as we
can now do in pulmonary consumption, the prognosis in the former
disease may change as much for the better as it has changed in the
latter.
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