Part I.]
GENERAL REPORT.
13
Conium.
In the Rangoon asylum, Dr. Griffith obtained satisfactory results from
the employment of chloral, which he states has in his practice " quite super-
seded opium, except in some cases of melancholia, where morphia is found bene-
ficial." Conium he employed in the shape of an extract, as recommended by
American physicians in cases of recurrent mania, accompanied by irritability,
constant restlessness and sleeplessness, with agitation of manner and wild
incoherence; but after many trials he abandoned its use, and he believes it to be
inoperative, subsidence of the violence of the excitement never having followed
its free administration.
Dr. Corbyn gives the following valuable information concerning the thera-
peutical effects and value of several drugs :—
Hydrate of croton
chloral.
Hydrate of croton chloral.—This medicine acts much the same as the hydrate of chloral
in allaying pain and promoting sleep, but where I have found it most useful has been in
patients who have been suffering pain in the regions supplied by the fifth nerves, viz., the upper
and lower jaw, the face and supra-orbital region of the forehead.
I have also used it in private practice for severe headaches with good result.
I generally give 20 grains as a dose, dissolved in an ounce of syrup of orange; the patient
usually rests for about a couple of hours, and in most cases awakes free from pain.
Nitrate of amyl.
Nitrate of amyl in epileptic cases.—The nitrate of amyl is a most efficacious remedy in
epilepsy. I have given it to 20 epileptic patients in the asylum with marked success. Immediately
a patient is attacked with a fit, where the pulse is generally hardly perceptible, he is made to
inhale 5 minims of the nitrate of amyl. In about 30 seconds the pulse rises to 126 per minute,
a little later on there is a general warmth and glow all over the body, the mental and bodily
powers seem to return, and the patient sits up quite recovered. Sometimes a dose has to be
repeated. Several of the epileptics seem to be aware when a fit is coming on. In these cases,
if 5 minims of the nitrate of amyl is inhaled in time, the fit is usually arrested.
Carbozonate of
ammonia.
Carbozonate of ammonia in intermittent fever.—This promises to prove a most useful
remedy in intermittent fever, and may one of these days supersede the valuable but most expen-
sive medicine, sulphate of quinine. We have used it in several cases in the asylum and in the
dispensary with most beneficial results. About one-third of a grain is given daily; the second
or third dose generally suppresses the paroxysm of fever. It is a very cheap remedy, costing
two annas six pie the ounce.
Opium in melancho-
lia.
Use of opium in the treatment of melancholia.—I have found opium in small doses given
to patients suffering from melancholia of great benefit; it seems to act as a tonic and
stimulate the brain and the whole system, and to give strength and appetite, and it exhilarates
the patients, who certainly look much more lively and cheerful after they have been for some
time under its treatment. Fifteen minims of the tincture of opium combined with the same
quality of sulphuric ether is given daily.
Bromide of ammonia,
potassium, and chlo-
ral hydrate.
Bromide of ammonia, bromide of potassiam, the hydrate of chloral have all been employed
this year with benefit.
Hypodermic injection
of morphia.
Hypodermic injection of morphia.—This is a most excellent remedy for asylum practice,
especially in cases of furious madness. When the attacks come on, the patients rave and foam at
the mouth, are very abusive, dangerous and violent; at this period a quarter of a grain of morphia
is injected into the arm. In about ten minutes they become quiet and then go off into a sound
sleep for several hours, awaking up calm and cheerful as if nothing had happened. We have
also found hypodermic injection of morphia most useful in bad cases of dysentery and diarrhœa ;
one-fourth of a grain injected under the skin a little below the umbilicus.
Maintenance by
friends.
Applications for the removal of insanes from asylums by their friends would
seem to be becoming more frequent of late; and this is due to the law having been
more strictly enforced with regard to compelling well-to-do relatives of patients to
contribute towards the maintenance of their insane kindred whilst under treat-
ment. In all such cases security is required to be furnished before a harmless
lunatic, whose case is considered as not likely to benefit by further treatment, is
thus discharged. In this manner lunatic asylums might be made to contribute
greatly to good, the law opening up a means whereby to ensure the proper care
of those who are mentally deficient, without entailing any expense to the State.
The matter of putting the law in motion in every case where the friends are in
a position to maintain their sick relatives, is an important one which ought not
to be lost sight of by Superintendents and official visitors.
Standard plan upon
which to construct,
the asylums required.
A good standard plan upon which to construct new asylums, which must
sooner or later spring into existence, is an obvious necessity, as is proved by
the enormously expensive failures at Agra and Rangoon; what the former
building will cost when it is finished is not recorded, for much work still re-
mains to be done, but a sum of nearly Rs. 40,000 was expended upon it during
the year, the original designs, which had been partially carried out, having
been so far modified as to leave hardly any trace of the old buildings. It is by
d