Treatment of Delirium Tremens.

Dr. Van de Warker, of Syracuse, N. Y., writing to the New York Medical Journal, refers to the dissatisfaction following the ordinary mode of treating delirium tremens, and thus proceeds:

"These doubts upon the routine treatment of delirium tremens I had long entertained, but not in sufficient force to lead me to cut adrift from the usual mode of medication in this disease. It was not until last January, when I saw another treatment carried out in the Onondaga Penitentiary, that I determined to try my ideas in the first case of uncomplicated delirium tremens which might come into my hands in private practice. The treatment at the institution named was simply no treatment at all. This did not occur, I am sure, from any want of kindness or attention on the part of the officers of the penitentiary—for I can personally testify to the uniform kindness with which sick convicts are treated—but from the fact that no medical officer is usually present except upon stated days. Thus, when the medical officer makes his rounds, he may find a case of delirium tremens has just been released from the 'octagon,' a cell set apart for these cases, perfectly cured, the prisoner having been admitted three days before; or that a case two or three days old is still confined in the 'octagon.' The institution being a penitentiary for short term prisoners, it is consequently a penal inebriate asylum mainly. A great many cases have, therefore, been presented at the prison, a large proportion of them receiving no treatment beyond a dose of salts to unload the bowels. A fatal case of the disease, I am told, never occurred in the prison. Some of the unfortunates have suffered in that prison the third attack of the disease. Mott Yates, an 'old offender,' as he is called, has had two attacks during my term of service, both occurring immediately on his admission. On the first attack in which I saw him (not Mott's first attack), he had just been removed from the 'octagon,' perfectly quiet, and without any tremors, in fact, well. He had not been given any medicine. On the second attack, about two months after the first, I saw him the morning after his admission. The mania was most active, the tremors of the muscles marked, the pulse was rapid and full. I took the hint from his first treatment, and gave him a large dose of Salts (Epsom). He drank this willingly. This was all the patient had in the way of medicine. On the third night he was quiet, and in the morning walked in the gallery, and on the fifth day was working at his trade (tailoring), without a complaint to make to me while on my rounds. There was one thing which struck me as remarkable in the cases thus non-treated, and that was the rapid convalescence of the patient; there was no period of prostration, mental and physical, which we usually observe as the sequelae. There was also little impairment of the digestive function, the patients taking kindly to the prison dietary.

The Eclectic Medical Journal, Vol. XXXIV, 1874, was edited by John M. Scudder, M.D.