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Sedatives and narcotics in the treatment of the insane


In writing this thesis I have entirely confined myself to the therapeutic use of sedatives and narcotics, not caring, from the immensity of the subject, to touch on such influences as manual labour, walking exercise, hydrotherapy, or hypnotism. No one who comes into contact with the insane can over-estimate the value of such, but even with such factors one has always, as I have before pointed out, to resort to the use of drugs at some time or other.

Exception may be taken to the number of drugs I have treated of as being too few, but it is my belief that no more are required in any asylum, however large, and even if this list was reduced to an even smaller limit it would be far more satisfactory in every way.

In closing I would lay down a few maxims which I have learnt from experience :—

  1. (1)

    Give particular care and forethought as to what class of drug is indicated in each case.

  2. (2)

    Having given your drug, watch its effects carefully and graduate your dose accordingly.

  3. (3)

    Make frequent examinations into the physical condition of each patient under the influence of a drug, paying particular attention to the ratio between waste and repair, as shown by your weight book.

  4. (4)

    Never use a pure hypnotic in the daytime.

  5. (5)

    In cases of insomnia due to delusions of a visceral nature be always on the look-out for disease of the organ said by the patient to be the cause of the trouble.

  6. (6)

    If at all possible, try to do without the use of drugs, as they all have, without exception, a deleterious effect on the tissues of the body.

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A Thesis read for the Degree of Doctor of Medicine in the University of Dublin, July, 1905.

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Cullum, S.J. Sedatives and narcotics in the treatment of the insane. The Dublin Journal of Medical Science 120, 161–180 (1905).

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