found to be the most beneficial in similar cases, leaving the settlement of abstract theories to others, and the results of his treatment will generally be entirely satisfactory.

Most of the cases that I have witnessed have been tormented with apprehensions of personal danger-filled with fear at the fancied approach of all kinds of disgusting reptiles and animals. One case, however, was so dissimilar, and presented to me at the time so many points of interest that I kept copious notes, and now extract the same from case book.

E

·P——, æt. 45. Was a graduate of the University at Philadelphia, and had been a prominent practitioner for several years. Accumulating wealth he retired from practice. Being very fond of the study of natural history, and a fine taxidermist, he devoted much of his time to collecting and preserving specimens of fowls and animals. Having been selected as his family physician, I became perfectly familiar with his virtues and his vices. From his youth he had indulged in the free use of ardent spirits, but for several years past had become an excessive drinker, rarely leaving his house without taking his "companion" with him. At night, when he retired to rest, his decanter, well filled with strong brandy, was placed within his reach, and its contents usually disappeared by morning. In the absence of his usual amount of alcoholic stimulant, for a few hours only, or from any sudden emotion, he would be seized with palpitation of the heart, tremor of the limbs, and a profuse perspiration would break out over the surface of the body, which he always averred smelt just like that accompanying yellow fever; a few drams of his potent fluid soon restored him, and he "would be himself again." About the first of July I was consulted with reference to the discontinuance of the use of spirits. I suggested the hazardous results that might be expected from the immediate withdrawal of a powerful stimulant, which had been assimilating his system to an unnatural and dangerous stimuli; recommending him to fill a five-gallon keg with his choice brandy, taking his accustomed drinks through the day and night, and at morning filling up the keg with water-continuing this from day to day, thus gradually diminishing the quantity of brandy until he could leave it off without danger to his health or a sudden revulsion to his system. To this he would not assent, saying that he had promised his wife to abandon its use eutirely, and that he would rather die in the noble effort of reformation than fill a drunkard's grave. Being a man strangly bent on his own will I dismissed the subject, simply recommending him to take fluid extract of valerian and small doses of morphia for a few nights.

July 10th.-Six days aftes the interview alluded to, I saw him standing in the door of one of the stores. Shaking hands with him I noticed a burning heat in the palms of his hands, and a great tremor of his arms and legs, he expressed great delight at seeing me, was unusually loquacious, and extremely hurried in his gesticulations and language. These, together with his haggard countenance, his glazed eyes, and the perspiration that stood in huge drops on his broad forehead, immediately excited my most serious apprehensions. To all my inquiries he gave the most satisfactory answers. His mind suddenly s diverged from the subject of conversation, running over various subjects, dwelling at length on natural history, inviting me to his house to examine some rare and beautiful specimens that he had just mounted. Turning suddenly to me, he remarked, "I believe that I am in a kind of reverie to-day, and that something ails my optic nerve, for each eye has become a separate and distinct organ, transmitting to the brain two objects, when I know only one exists; and the most beautiful imagery of parks, of mountain scenery, of cities and villages of transcendant beauty, pass before my wild vision like the shifting scenes of the magic lantern. The friends of former years, many of whom have long since passed away to the spirit land, gather around me, and greet me as they were wont to do in our jocund' days. I know that it is only imagination, but to me it is real." I prevailed on him to let his servant take him home in his buggy, assuring him that I would ride out in a few hours to examine his specimens. The day was unusually hot, and he had been much of the time exposed to the sun, being in an open buggy. Upon his return home his wife immediately dispatched a messenger for me. I arrived there about two o'clock, and found him rolling on the bed, but in no apparent pain. Everything that he had swallowed after a few hours of his ceasing to drink, had been immediately rejected by his stomach. His wife expressed as her belief that he had not slept for four days and nights, and that his sweating had been so profuse as to cause her to change his clothes and bedding several times during the days and nights intervening. He had remained in his room until this morning. Ordered tinct. vini gallici fz iv., morphia sulph. grs. ij.; one dessert-spoonful every hour. In case the stomach should not retain it to give enemas of tr. opii, repeating the same until sleep was induced. I visited him again during the evening, and remained during the night. He was quite delirious; trembling continued to increase--he fancied the room full of people, all of them enjoying themselves to their heart's content. Finding that enemas were not retained, and the stomach in such an irritable condition, I was compelled to adopt the Iatroleptic plan of treatment, using embrocations of spts. turpentine, chloroform and tinct. opium. About

midnight he complained, for the first time, of severe pain in his head, stating "that his skull was filled with liquid lava taken from the very centre of hell." Whether any pain actually existed or not, I am not prepared to say. But my opinion at the time was, that it was in the main, if not entirely, imaginative, having been so deceived with reference to his statements about his specimens, his abundant sleep and rest, and numerous other statements, made with the same apparent clearness as this statement. His pulse was somewhat rapid, but soft and compressible; his tongue moist and covered with a thick cream-like coating, the apex and edges somewhat red, with slight conjestion of the conjunctiva; perspiration undiminished. Thus far, the nervous exhaustion and the nervous irritability had marched along together, each apparenrly striving for the ascendancy. Temporary relief at times, seemed to be derived from the external treatment. Although the paroxysms returned with equal violence, and sometimes greater than previously, there was a marked increase of time between each one of them. I had taken the precaution at my first visit to have his room darkened, and enjoined quietness about the premises. He had lain for some time comparatively quiet, when bursting out suddenly in a rhapsody, he said, "Oh! how beautiful, how sublime, if this is only the garden of the Gods how much more grandeur must surround their tabernacle! Behold how far it extends; far beyond the limits of my transparent vision. One vast flowery carpet is spread out before my enraptured eyes. The stalks are festoons of pure gold, interlaced with vines of silver, while the flowerets are of diamonds, emeralds and other precious gems, far surpassing the imagination of earth-reflecting back the blazing light of glory to God's eternal throne, while music of the most enchanting notes from birds and beasts--a perfect band of choristers-fill the air with wild and melodious harmony to their mighty and mysterious creator." Then turning to me as a traveler to his guide, "can you not lead me on to greater beauties and more terrestrial grandeur-the gaiety of earth may tempt me---the Devil may offer me power over all his dominions-even my wife and daughter, with all their loveliness, may beckon me to return, but for an eternity of years, will I remain here, until I arrive at that degree of intelligence and purity, that the Gods and Angels will permit me to sit down with them at their great intellectual banquet, which I see spread out in the far distance." The ideal thoughts and sublime scenery suddenly passed away, giving place to one of the severest paroxysms that I witnessed during the treatment of the case, accompanied with cramps in the extremities. After their partial subsidence, he again answered my questions correctly and pertinently, telling me that I had misrepresented his case, perhaps intentionally, to his wife, but if I was treating

him for congestive chills I would kill him, as he well knew that it was only delirium tremens that ailed him.

The tremor and paroxysms continued with little or no abatement up to noon the 14th. During the whole time sleep had not been induced, and such was the intensity of his imagination-at times marshaling his legions of invisible dragoons and urging them on to fields of conquest, to carnage and blood; giving descriptions of the valor of his spectral hosts; the beauty and symmetry of their horses, and the unique style of their paraphernalia; at other times exhibiting to innumerable spectators his fancied menagerie of wild animals-dwelling at length, and quite accurately, upon their habits and nativity, calling them to his side, and then ordering his slaves to turn them loose in wild confusion, and then he would laugh hysterically at the supposed fear and consternation he had produced among his visitors. Another favorite with him was a huge "diamond serpent," which he claimed "was a direct descendant from the one that visited Eve when she came fresh from the plastic hands of her Creator-retaining all the meekness and suavity of its illustrious ancestor." Its "ponderous weight would crush the leviathan, while it glides so mystically over me that it seems more like a shadow than the monster that it is."

4 o'clock P. M.-Nearly the same condition-spasms less frequent; nervous exhaustion rather increased. Enemas and solid opium had been used per anum. A slight and highly offensive discharge had taken place an hour previous to my visit; retching still continued, at times throwing up matter of a dark grumous, or coffee-ground appearance. [I should have mentioned at the proper place, that a hemorrhagic diathesis existed, suffering, frequently in years past, with bleeding from the lungs, and sometimes from the stomach.]

6 o'clock. No vomiting for the last two hours. Continued the embrocation until 8 o'clock. Finding his stomach more quiet than heretofore prescribed brandy f.ozj., chloroform iij dr., morphia gr., to be repeated every two hours. Shortly after taking the second dose he fell into a disturbed slumber, and slept for over three hours. On awakening gave beef tea, which was also retained. At 10 o'clock another paroxysm; after it had subsided gave idr. chloroform in a wine-glass of diluted brandy.

1 o'clock, A. M., 15th-Slept soundly, with sonorous breathing, until six in the morning. Tremors somewhat abated; still wandering; delirium. Ordered injections with 1 oz olei ricini every third hour. At 2 o'clock, P. M.. had a copious discharge from the bowels, of a tar-like appearance, which continued, at irregular intervals, for two days. Repeated brandy, chloroform and morphia at 5 P. M. Soon after sleep came to his relief, and he slept quite calm until 3 o'clock A. M.

16th-Awoke much refreshed. During this sleep his sweating abated considerably; still great nervous exhaustion. Gave valerianate of quinia in conjunction with the chloroform mixture. Ordered beefsteak slightly broiled, which agreed with him. Same treatment kept up during the 16th and 17th.

Up to 10 o'clock, P. M., of the 17th, the bad symptoms had been gradually yielding-wild imaginings still harrassed him-his voice had not that muttering, husky sound that had from the commencement characterized the disease. He spoke with clearness and distinctness, and, for the first time, manifested anything like fear. The fishing and hunting, the sports of his youth, his animals and dragoons, his bedfellows, an "hundred infants and a portly old gentleman," had all left his imaginative brain. His visits to the garden of the gods had ceased. He was now laboring under the hallucination that he was sentenced to be executed and awaiting his executioners. They came at last; he met them with a steady gaze, and for some time the tremor entirely subsided. Instead of that lax condition of the system, every nerve and every muscle seemed strained to its utmost tension. There was a fierce wildness in his actions and looks which is indescribable. · He gazed at his fancied visitors with the fierceness of a madman. "Come, let me examine your swords. I know my time has come. I know you can as easily execute your orders as I could in health hurl an infant into eternity. But think not to terrify me with your great bass drum clothed in black, from which that mean-looking imp beats out such doleful sounds. Nor by your swords. Are they keen and sharp?capable of doing your måster's bidding." Then apparently feeling the points and edges, he hurled them from him. "These are but stage fencing foils. Go back and get such as your victim is worthy of." Then bursting into his peculiar laugh, he said, "I have foiled them with their own foils." His head soon sank back into his pillows. He lay apparently quite languid for some time. The last preparation was repeated, when he shortly afterwards fell asleep and slept for eight hours. On awakening, reason had resumed its throne, and he immediately ordered his boy to get his buggy ready, in order that he might return home; having no recollection of anything that had transpired from the morning that he had left home in the open buggy up to the present time. The treatment, somewhat modified, was kept up for several days, followed with iron tonics, which was kept up for several weeks. Restoration to health was slow-appetite faulty, but he at last recovered. His appetite for tobacco and spirits never again returned to any great extent.

Since treating the above case, I have used chloroform both by inhalation and internally, and am convinced that it is one of our most