_Insomnia in Chronic Alcoholism and Delirium Tremens._--The insomnia of chronic alcoholism is dependent upon the extensive morbid changes produced in the digestive apparatus and in the nervous system by the habitual use of alcoholic drinks. Sleep becomes greatly disturbed and unrefreshing. It is frequently broken by horrible dreams. The successful treatment of this condition requires complete abandonment of the use of alcohol, and a general correction of the condition of the alimentary canal. For the immediate relief of insomnia, full doses of bromide of sodium will be of service. Strong infusions of hops may be given _ad libitum_. Cannabis indica, in the form of the extract, so as to avoid the use of alcohol in the tincture, is of service. Hypodermic injections of morphia are frequently employed, but should be avoided if possible, for fear of the opium habit. Chloral hydrate is exceedingly useful, but should be given in milk, and as seldom as possible, for fear of adding to the injuries already sustained by the stomach. For the same reason the use of paraldehyde in such cases is quite inadmissable. When chronic alcoholism has culminated in _delirium tremens_, more energetic measures become necessary in order to procure sleep. If the patient be of a vigorous constitution, and if the delirium be very active, tartar emetic with morphia may be given, as advised by Graves. Large doses of tincture of digitalis, sometimes reaching an ounce every four hours, were used by Jones, of Jersey. Capsicum, in scruple doses every three hours, is said to induce sleep in many cases of delirium,[52] especially in exhausted conditions of the circulatory organs. Hydrate of chloral and bromide of sodium, each in scruple doses, may be given every two hours. Opiates should be used with moderation, and all attempts to induce profound narcosis should be avoided. Drachm doses of tincture of cannabis indica and of compound spirit of ether, may be given when a diffusible stimulant must be associated with the soporific. In desperate cases it is sometimes necessary to resort to inhalation of ether, but if sudden death should occur, it would be popularly ascribed to the effects of the anæsthetic. By reason of a certain tendency to death from syncope during this disease, it is imprudent to place such patients under the influence of chloroform or the other stronger anæsthetics.