_Delirium cum Tremore._[152] Some cases have been related in the medical journals, in which this complaint was treated successfully by chloroform alone; but I prefer to use this agent only as an adjunct to the treatment by opium. Sometimes the patient is so violent and suspicious that he cannot be made to take opium; but it is much easier to make a person breathe a medicine, than swallow one. It is only necessary to hold a patient, and to apply the chloroform near his face, and he is obliged to breathe it, and as the effect of it subsides, he recovers the power of swallowing before his delirium returns; for whilst he is still unconscious, he will swallow whatever is poured into his throat. Opium can be administered, and the chloroform can be repeated occasionally so as to keep him asleep for an hour or two till the opium takes effect and prolongs the sleep. It is a great advantage of chloroform that the delirium may be subdued in a few minutes by it, and can be kept away till opium takes effect. In certain cases of delirium cum tremore, such a quantity of opium is taken without procuring sleep, that the medical attendant has, what I believe to be, a well-grounded fear of giving more. A patient whom I saw with Mr. Peter Marshall, in April 1850, had taken ten fluid drachms of laudanum and two grains of acetate of morphia, within twenty-four hours of my seeing him, without any sleep being procured. He was put to sleep immediately by chloroform, which was repeated on the following day. The patient got quite well in a few days. In December 1851, I saw a patient who had had no sleep for four days, except three intervals of a quarter of an hour each, although a great deal of opium had been given. He was very violent; and for the last twelve hours had spat out all the medicine that was given to him; his pulse was small and very rapid. He was made insensible in a few minutes, and the chloroform was repeated, at intervals, for half an hour, so as to keep him unconscious. Fifty minims of tincture of opium were given in one of the intervals. I waited an hour and a quarter after the chloroform was discontinued; the patient was still sleeping, and his pulse was less frequent. I learnt that when he awoke he was quite free from delirium, and he was well in a few days. _Delirium in Fever._ In November 1857, I administered chloroform to a youth of seventeen, who had been ill of typhoid fever for sixteen days. He had been in a state of constant delirium for upwards of forty-eight hours without having the least sleep, although he had had tincture of opium in divided doses to the extent of forty-five minims, and had taken a tablespoonful of wine every four hours. The chloroform was continued gently for half an hour; he slept for an hour afterwards, and at intervals during the night. He was a little better in the morning; and the delirium was not again so violent as it had been. He died on the nineteenth day of the fever, from a recurrence of diarrhœa.