Delirium tremens as an expression of acute or subacute alcoholic poisoning is in no essential degree a surgical condition. This form of toxic delirium may occur while the individual is still drinking inordinately, or not until several days have elapsed after active drinking has ceased. It is precipitated in many cases, where otherwise it would simply remain imminent, by surgical injuries and operations. In one in whom it is feared, the surgeon should become apprehensive in proportion as the muscular system becomes unsteady and tremulous, the mind disturbed, and the individual sleepless. Patients in a well-marked condition of delirium tremens may become so uncontrollable and so lost to sensation of pain that it may be practically impossible to enforce the physiological rest which their surgical condition demands. The restraining sheet will answer for general purposes, but the strait-jacket and even the most carefully applied plaster splint or mechanical restraint will not always be sufficient to carry out the indication. Ingenuity may be taxed beyond its limit to enforce the needed rest, for patients will tear off bandages and injure themselves in various ways. =Treatment.=--The _local indications_ are in the direction of _physiological rest_. _Constitutionally_ the indications are in two directions: First, _to keep up nutrition_ and _excretion_; secondly, _to properly medicate_. Nutrition is difficult unless excretion is maintained. Hot-air baths, laxative enemas, preferably of cold water, when necessary, and administration of a fluid and easily assimilable diet are measures of the utmost importance. Should the case present features of an acute alcoholic gastritis, stomach feeding may be abandoned and the rectum utilized for this purpose. _Medication_ should consist mostly of stimulants, with such sedatives, laxatives, diuretics, etc., as may be necessary. In surgical cases it is not wise to abruptly deprive these patients of the alcohol which they have so abused. Consequently in many instances a mild degree of alcoholic stimulation, at least for a time, should be continued. Two stimulants rank higher than all others as substitutes for alcohol, and in some degree antidotes to its effect. These are _strychnine_ and _digitalis_. The former should be given preferably subcutaneously; the latter by the stomach if tolerated, otherwise by the rectum or beneath the skin. My own preference for the use of digitalis is in the direction of large and few doses. I have not hesitated in many instances to give 15 Cc. of ordinary tincture, repeated once or twice at intervals of a few hours, and then to discontinue it. The effect is to brace up the heart and to equalize the circulation, while at the same time it acts as an efficient diuretic. _Adrenalin_ may be necessary, but should be used with discrimination.