Jacob Dissinger Albright.

The general practitioner as a specialist : a treatise devoted to the consideration of medical specialties online

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cases without confining the patient and without recourse to
asylum methods. Generally speaking, the only cases that
require sanatorium treatment are those who have no good
home in which they can be taken care of, or no one to attend
to their wants and wait on them, or those so thoroughly
wrecked by liquor that they are unable to follow the physi-
cian's instructions, and who need an overseeing hand to
keep them under restraint.

Various methods of treatment for inebriety have been
devised, and many remedies have been brought forward as
specifics, but the true specific has never yet been discovered
and never will be. No single remedy or combination of
remedies will cure all cases. Differently tempered and con-
stituted persons require different treatment. Inebriety
must be treated as any other disease; with an ultimate and
well defined object in view, and meeting indications en route
as good judgment and experience may dictate.

Quick cures for drug and liquor addiction have in recent
years appeared in considerable numbers, and while many
of the profession have chosen to condemn these without a
trial, others have taken them up and used them with consid-
erable success. The Quick Cure method is best adapted to
sanatorium work, as the treatment is vigorously applied and
requires almost constant attention from physician or nurse.
It is adapted to the treatment of persons who are continually
under the influence of liquor, not necessarily intoxicated,
and who have in many cases not sufficient self control to


permit them to make up their minds as to whether they wish
treatment or not.

Similar treatments to the following are frequently adver-
tised to the profession, which if not identical with this, are
not sufficiently different to merit the investigation and ex-
pense necessary to ascertain their exact composition, if such
is at all possible. Hyoscine Hydrobromate is the only drug
that produces the symptoms as outlined under the Forty
Eight Hour Cure for morphine addiction, and many of
the advertised remedies produce these without variation.

After attending to the preliminaries the patient is placed
on the following formula and an effort made to lessen the
quantity of liquor taken. It should be continued from ten
days to two weeks.

Formula A.

T$ Hyoscine Hydrobromate gr. 1-20.

Strychnine Nitrate gr. j.

Tr. Hydrastis Canad,

Tr. Valerian aa fl. § iiss.

Tr. Capsicum fl. § ss.

Tr. Cinchona Comp q. s. ad. fl. § viij.

Mix. Sig. Two drachms every four to six hours.

Under this treatment the patient will usually be able to
get along with a much less quantity of liquor than was his
custom, will improve in appearance and general health and
will be in condition to receive

Formula B.

I£ Hyoscine Hydrobromate gr. j.

Sol. Boracic Acid, 2 per cent fl. § ij.

Mix. Sig. Five to ten minims hypodermatically.

Directions for use. The directions given for the use of
Formula One, under the Forty-Eight Hour Cure for Mor-
phine and Opium, will apply to the use of this formula in the


treatment of inebriety. They are practically of the same
composition. Formula A is discontinued when Formula B
is begun, but is resumed again as hereafter directed.

Treatment with Formula B should be continued for
from four to six days, but it is not essential to continue it
through the night, but may be discontinued about 10 P. M,
and resumed in the morning. After four days' treatment,
before resuming in the morning, ask the patient whether a
desire for drink is present, and as long as the answer is
"Yes," continue the treatment. When the answer is "No,"
the treatment may be discontinued.

This class of patients frequently manifest more or less
destructive inclinations, and should they become unmanage-
able, they should be placed under restraint. If great ner-
vousness occurs they should be quieted with morphine in
doses of 1-4 to 1-2 gr. This will not retard the treatment,
as they are not addicted to morphine, and besides, they are
taking the morphine antidote. After a short sleep they will
awake refreshed and the treatment can be resumed. Should
the pulse rise to ioo or over, do not crowd the treatment ;
wait a short time and it will be reduced. Continue then, in
smaller doses, if deemed best. Occasionally a patient will
be met with who requires but half the ordinary doses, while
others require more than the usual. It is well therefore to
use the remedy according to effect. The semi-intoxicated
state should be maintained in a moderate degree throughout
the treatment, except during the night, as before noted,
always regulating the doses by the effects of the preceding
one. These patients do not as a rule vomit during the
treatment and retain their usual appetite. The same general
rules as to baths, nurses and confinement of patient, given
under the before mentioned opium treatment, apply to cases
of this nature. After the desire for liquor has been removed,
and the patient regained his normal mental condition, he
may be allowed to occupy his time about the house or go out
walking, care being taken that he does not become fatigued.


Now Formula A is again commenced and continued for sev-
eral weeks longer, or as needed.

This treatment is a very successful one, having cured
cases who were "graduates" of renowned institutions. It
should not be used except under sanatorium facilities, or
in apartments adapted for the purpose. For general use, by
physicians in general practice or who do not devote any
special attention to the treatment of this class of cases, the
following methods are more suitable, and better adapted to
their facilities.

The Ideal Inebriety Cure.

For Liquor, Wines and All Alcoholic Beverages.

A treatment adapted to all cases. No special facilities
required. This treatment is recommended in all cases where
the patient is willing to be cured, such as come within the
reach of the physician in general practice, who usually has
neither the time nor facilities at his disposal, which are neces-
sary for the correct administration of the treatment pre-
viously mentioned. The time required to effect a cure varies
from ten to twenty days, according to the length of time the
patient has been addicted to drink, the quantity consumed
and his physical condition. The habitual tippler, the indi-
vidual who drinks three to thirty times a day without becom-
ing intoxicated, but whose physical condition demands a
constant and oft repeated "bracer," requires more treatment
than the person who indulges in a periodical debauch and
perhaps for a month afterwards does not touch liquor.
Carry one of the latter class over the time during which he


would become intoxicated and the greater part of the battle
will be won.

The "sickening process" has always been a closely
guarded secret in the treatment of inebriety. By this is
meant the part of the treatment directed toward impressing
the patient that liquor and his system are becoming antago-
nistic to each other. This is not accomplished through the
medium of the regular treatment, but by the secret substitu-
tion of an emetic at the proper time. This emetic is usually

This drug is given at the usual time for a hypodermatic
injection, and is substituted for it. The patient is, of course,
not informed of this change. When it is given in this man-
ner, and a drink of liquor shortly afterward, the patient will
attribute the resulting emesis to the treatment and will
become convinced that the treatment is doing its work.
Sooner or later he will, however, begin to doubt that he is
being benefited, and he will have a desire to see whether he
still cannot retain his customary beverage. In this wish he
should be gratified as much as possible, but it should be
arranged that the drink will be taken at about the time when
it is customary to give a hypodermatic injection, and apo-
morphine again substituted. The result will of course be as
disastrous as the first attempt, and there is usually no further
doubt on his part. Should there be, the same procedure is
repeated. Two or three times is usually sufficient. The
patient should have sufficient confidence in the physician
not to drink during the treatment, unless when allowed to do
so, but he may, of course, furnish his own whiskey.

Formula A.

1^ Hypo. Tablets Gold and Sodium

Chloride aa gr. i-io.

Sig. One tablet injected hypodermatically three times
daily, at intervals of six to eight hours.


Formula B.

^ Atropine Sulphate gr. 1-3.

Strychnine Nitrate gr. 1-2.

Fl. Ext. Erythroxylon Coca,

Tr. Cinchona Compound aa fl. § iss.

Glycerine, C. P q. s. ad. fl. § iv.

Mix. Sig. One drachm every four hours, during
waking hours.

In order to facilitate the cure the patient should be
willing to quit work a few weeks while taking treatment, but
it is not necessary to confine him to the house. Moderate
exercise is beneficial. Formula B can be entrusted to the
patient, but it must be taken regularly.

At the most convenient time during the day the patient
should call upon the physician for his hypodermatic injection
of Formula A, the time being so arranged to suit both
physician and patient. At breakfast, after noon and in the
evening will usually be convenient. The intervals, as stated,
should be from six to eight hours. Should the patient be-
come very nervous or show signs of delirium, stop the
treatment and give 1-4 grain of morphine sulphate to quiet
him. Resume the treatment as soon as thought advisable
and continue it for a period of ten to twenty days, or until
the patient expresses himself as feeling free from the desire
or need of liquor. During the first part of the treatment,
three or four days, small quantities of liquor may be allowed.
Usually one-half ounce, three or four times a day. This
applies only to the continual drinker, and not to the period-
ical, as the latter can well do without it. After four days of
treatment, in all cases, at one of the regular calls for a
hypodermatic injection, ask him whether he has a desire for
liquor. The continual drinker will probably say he has, and
if he has been taking some in small doses, tell him you would
like to see him take a good big drink, such as he was accus-
tomed to take. If he has not taken liquor during the treat-
ment, this remark will be omitted, but whether he says he has


a desire or not, tell him you would like to see whether the
treatment is acting properly, whether it is strong enough or
whether it has already produced an antagonism in his system
toward liquor.

Now, instead of giving him the usual injection of For-
mula A, substitute i-io grain of Apomorphine, and follow it
within a few minutes with the drink. Never give the drink
first, as something might occur which would delay or pre-
vent the giving of the apomorphine, and he would thus find
no untoward effect from the liquor. If the apomorphine is
given first and the drink delayed too long, so that nausea
occurs before the liquor is given, it can be attributed to
another cause. Due attention should be paid to these details
and to have everything ready. Have a basin or vessel con-
veniently hidden near by, so that the patient will not know
that you made preparations for what will occur, and wait for
developments. If the dose was large enough, free emesis
will occur in a short time. Should it not cause vomiting,
merely nausea, tell him that the treatment is acting all right
and that after a few days more treatment, he can probably
not retain liquor but would have to vomit. In a few days
repeat the experiment, taking precaution to give somewhat
of a larger dose, regulating it according to the effect pro-
duced by the former dose. Tartar Emetic is sometimes used
for this purpose, mixing it with the liquor, but this allows
the patient to form the opinion that you have drugged his
liquor, and thus his confidence in you will be shaken. By
the other method he may furnish his own liquor. Caution
him not to drink unless in your presence. Examine his
heart after he has taken the drink and tell him that it must
be carefully watched when he takes a drink, as it might
need immediate attention. Impress upon him that should
he drink while away from you, his heart might suddenly
need attention and as you would not be at hand the results
might be unpleasant. The reason for these admonitions
are obvious.


After he has been thoroughly sickened several times
he will probably refuse to touch liquor, even the smell or
sight of it is likely to produce nausea. Do not hesitate to
make him extremely sick; the nearer death he will think
himself, the more certain the cure.

Both formulae are given in conjunction during the ten
to twenty day period, but after the disgust for liquor has been
firmly established, and the patient seems to be getting along
well without the use of stimulants, the injections may be
discontinued, but the remedy, Formula B, should be con-
tinued for a week or more afterward. After the sickening
process is begun, all liquor should be discontinued. The
bowels usually remain normal, but if constipated, use sodium
phosphate, plenty of it ; nothing else, except all the water he
can drink. After a cure, do not fail to impress your patient
with the necessity of avoiding the association of intemperate
companions, the frequency of saloons or bar-rooms, and
never to touch, taste or handle. Tell him that as he once
acquired the taste and desire for liquor, he can do so again,
but as he is free from it now, he should assert his manhood
and conquer his bitterest enemy.

This treatment, properly administered to a person willing
to be cured, who will co-operate with the physician and obey
instructions, will do wonderful work, and cannot be too
highly recommended.


A Home Cure for Inebriety.

There is more or less of a demand for a treatment for
habitual drunkenness, which can be taken or administered
without the direct supervision of a physician, but it is evident
that such a treatment can at best only assist an individual
who will make an honest effort to overcome the recurrent
desire for stimulants. In this connection a few words may
be said in reference to the numerous home cures which are
advertised as specifics for drunkenness. Some of these, the
majority perhaps, are said to be capable of eradicating the
desire for liquor and establish an antagonism against it,
without the consent or even knowledge of the person to
whom it is administered. These claims are in direct opposi-
tion to the teachings of the best authorities on diseases of the
nervous system and entirely contrary to the experience of
physicians who have made the treatment of chronic alcohol-
ism a special study and treated hundreds of cases. It is
quite probable that the majority of these claims are fraudu-
lent, and in many instances devised to ensnare the unfortunate
wives and children of drunkards, and extract from them
the little means they manage to possess. Any drug which
can so affect the nervous structure of a person that a desire
and craving for liquor can be eradicated without the consent
or assistance, or even against the will of the person to whom
it is given, must be powerful indeed; probably poisonous,
and if so, dangerous. Some of them are however claimed
to be "entirely harmless." and this statement I will not dis-
pute. It is probably true.

The following method of treatment commends itself to
the ordinary cases of habitual drunkenness, and will afford
substantial assistance to any one possessed with an honest
desire to be freed from the craving for stimulants, and who


will make an effort in that direction. To the person who is
unable to make up his mind whether or not he wishes to quit,
its action will serve no purpose. The more moderate the
drinker and the less quantity consumed during the intermis-
sion between the periodical debauch, the easier will be the
cure. This treatment is not as powerful nor as rapid as the
foregoing, consequently the hardened inebriate, the one who
is unable to control himself or exercise any will power, will
make better progress under the former. As a preliminary to
either of the preceding treatments, it is of value.

Formula A.

I£ Atropine Sulphate gr. ss.

Strychnine Nitrate gr. j .

Tr. Capsicum fl. o ij

Tr. Pulsatilla , fl. •"> iij.

Fl. Ext. Erythroxylon Coca.

Tr. Hydrastis Canadensis aa fl. 5 ij.

Tr. Serpentaria fl. ;> j.

Tr. Cinchona Compound fl. % iij.

Elixir Aromatic q. s. ad. fl. § xij.

Mix. Sig. Two drachms before each of the three daily

Formula B.

B Fl. Ext. Passiflora Incarnata fl. § iij.

Fl. Ext. Avena Sativa fl. § ij.

Elixir Aromatic q. s. ad. fl. § vj.

Mix. Sig. One drachm at 9 A. M., 3 P. M. and before
retiring, or about 9 P. M.

Continue both formulae for four to eight weeks, accord-
ing to the progress of the case. Patients need not stop work
during treatment.


Other Methods of Treatment for


In the following pages other and well known methods
for treating inebriety will be detailed, all of which are cred-
ited with sufficient merit to warrant their use. Some of
them have had their origin and are successfully employed
in the practice of physicians of the highest professional
attainments, men who have given the subject much study
and attention, and whose objects in giving them to the pro-
fession at large is none other than to encourage more
thorough investigation and attain more definite results.

Bellevue Hospital Treatment.

Over four thousand cases of acute alcoholism are
received in Bellevue Hospital, N. Y., every year. A certain
percentage of these express a sincere desire to be relieved
from the tendency they have to indulge in periodical
debauches, and to such the following treatment is given. It
is the result of ten years' experience in the care of these cases.

After the effects of an acute attack of alcoholism have
disappeared, the following hypodermatic injection is given.
Each dose contains :

R Strychnine Nitrate gr. 1-15.

Atropine Sulphate gr. 1-300.

Distilled Water 1U x.

Mix. Sig. Inject three times a day, the first day of


The second day the following is given. Each dose
contains :

I£ Strychnine Nitrate gr. 1-20.

Atropine Sulphate gr. 1-200.

Distilled Water Vt{ x.

Mix. Sig. Inject three times a day for the second day
of the treatment.

Internally, patients are given in connection with the
injections, the following, each dose containing:

I£ Tr. Cinchona Comp T)\ xv.

Tr. Capsicum 1T\, ss. to j.

Tr. Solanum Carolin Tl\ ij.

Bitter Wine of Iron q. s. ad. fl. 5 j.

Mix. Sig. One drachm three times daily.

Nourishment. One-half to one glass of milk, (hot or
peptonized,) alternating with hot beef tea or broth, every
two hours.

Hypnotic. Used first and second nights if needed.

I£ Potassium Bromide gr. xxxij.

Chloral Hydrate gr. xvj.

Tr. Valerian fl. 5 j-

Water q. s. ad. fl. 5 iv.

Mix. Sig. Hypnotic. One ounce at a dose, repeated
as needed.

The stomach is washed out if necessary, to remedy any
catarrhal disturbance, and they are given an abundance of
nourishment. Two days of this treatment usually finds them
with the desire for liquor gone, and they are discharged with
the following- mixture, and directed to report weekly.


^ Tr. Columbo A- o J •

Tr. Capsicum HI xv.

Apomorphine gr. 1-3.

Tr. Nux Vomica fl. 5 j. to iss.

Tr. Cinchona Comp q. s. ad. fl. § iv -

Mix. Sig. One drachm in water after the three daily
meals. This is continued one month, when he may discon-
tinue taking this preparation, but he is kept supplied with
it, and directed to begin taking it the minute he feels a
desire for liquor, and report at once. He is then again given
the hypodermatic injections as before.

By this many persons are reclaimed and sent out with
confidence in themeslves and hope for the future, with a
staff upon which to lean in case of weakness.

The same treatment is also employed in treating mor-
phine addiction, but in these cases it must be continued
much longer and sometimes must be modified by adding
bromides or gradually reducing the morphine. The house
surgeon reported one case in which the morphine was stopped
immmediately, although thirty grains were taken daily. The
patient did not suffer in the least. From an article by Dr.
C. L. Dana, New York. — In the "Post Graduate."

Note : — Having ' seen the same treatment outlined in
another medical journal in which the dose of strychnine in
the first formula was given as 1-50 grain, and the dose of
Tr. Solanum in the third formula as Tit xij., I wrote to Dr.
Dana, and was informed by him that the formulae as I have
given them here are correct. J. D. A.


A "Whiskey Cure Institute 1 '

The following formulae were obtained from a physician
who was for a number of years connected with a high priced
"Institute," located in New York.

On reception of patient, he was given a thorough bath
and sweat, similar to the well known Turkish baths. This
was followed by a thorough evacuation of the bowels and
flushing of the colon with three quarts of water as warm as
could be borne. This usually left the patient in a relaxed
condition, when the following hypodermatic injection was
given :

I£ Strychnine Nitrate gr. 1-40.

Atropine Sulphate gr. 1-200.

Aqua Destil q. s. to dissolve.

Mix. Sig. Give this quantity at each injection, three
times a day for four days, twice a day for eight days and
once a day for four days.

Together with this, the following pill :

I£ Quinine Sulphate gr. lxxx.

Zinc Oxide gr. lxxx.

Powd. Capsicum gr. lxxx.

Strychnine Sulphate gr. j.

Acid Arsenious gr. 1-3.

Mix. Ft. pil No. xl.

Sig. One pill, three times a day, alternating with
hypodermatic injection. This is given throughout the treat-
ment. The pill is best given half an hour before the usuai
time for meals; the injections midway between meals and
retiring, while given three times daily, midway between
meals when given twice, and a few hours after breakfast
when given once.


If patient cannot sleep the following is given :

1^ Tr. Aconite Root n\ v.

Tr. Capsicum fl. 5 ss.

Tr. Opium Deodorized,

Fl. Ext. Hyoscyamns.

Chloral Hydrate.

Potassium Bromide aa 5 ij.

Peppermint Water q. s. ad. fl. 5 iv.

Mix. Sig. One-fourth to one-half ounce at bed-time.
Use as little as possible, and dilute freely with water.

If patient becomes much excited or borders on delirium
tremens, the following is useful :

IJ Hyoscine Hydrobromate gr. 1-200 to 1-100

Repeat pro re nata.
Patients receive abundant nourishment, soups, broths,
beef tea, milk, milk foods, peptonized milk, and plenty of
water in which sodium phosphate has been dissolved in the
proportion of one drachm to the pint.

(Remarks. — As a hypnotic, in the treatment of inebriety,
nothing excels the well known Bromidia. Its action is
prompt and it leaves no unpleasant after effects. J. D. A. )


Another " Institute" Cure.

In the State of Indiana there is in operation a sanitarium
dedicated to the cure of drunkenness and nervous diseases,
in which the following line of treatment is followed :

After a preliminary treatment such as was detailed in
the foregoing' treatment, the patient is placed in a room and
supplied with a bottle of good liquor with instructions to
help himself to as much as he wishes. At this time the
treatment is begun and the patient receives, four times daily,
a hypodermatic injection of the following composition:

I£ Chloride of Gold and Sodium gr. 1-10.

Strychnine Nitrate gr. 1-40.


In connection with the above he receives the following :

^ Chloride of Gold and Sodium gr. xij.

Ammonium Muriate gr. vj.

Strychnine Nitrate gr. j.

Atropine Sulphate gr. 1-4.

Fl. Ext. Cinchona Comp fl. § iij.

Fl. Ext. Erythroxylon Coca fl. % j.

Glycerine fl. ."> j .

Distilled Water fl. 5 j.

Mix. Sig. One drachm every two hours while awake.
The physician in charge sees the patient four times a
day and increases the doses of gold and strychnine in the
injection until the symptoms show that the patient is receiving
all he can bear. The first day the patient usually drinks
heavily of the whiskey left with him, but during the second
day he begins to lose his desire for it. He will usually refuse
to take any by the third or fourth day. The treatment is

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Online LibraryJacob Dissinger AlbrightThe general practitioner as a specialist : a treatise devoted to the consideration of medical specialties → online text (page 16 of 25)