Cannabis indica is an excellent agent to cause tranquillity and destroy hallucinations. It seems to take the place of the morphine to a certain extent. It, too, must be given in large doses.
Hyoscyamus and hyoscyamia I have tried, and never derived much advantage from them. The former usually increases or produces diarrhœa. My failure to obtain good results has not been due to using too small doses.
Chloral, except in small doses, is a dangerous remedy, and one with which, if a good effect is had, the patient is apt to fall in love. It is not of much service as a sleep producer, save in dangerously large doses. Levenstein found that in some cases it produced violent excitement. I have seen a ten-grain dose produce urticaria that tormented the patient for several days.
Hydrocyanic acid was first recommended in the treatment of this affection by W. C. Blalock.[42] He claims that it supplies the place of morphine or opium. It does not do so. His formula reads as follows—
| ℞. | Acidi hydrocyanici dil., | gtt. xlviij | |
| Syr. simplicis, | ℥ ij | ||
| Aquæ, | ℥ j. | M. |
Sig.—A teaspoonful at 7 A.M., 12 and 8 P.M.
As a quieter of gastric irritation and nausea, and as a nerve stimulant, it is an excellent adjuvant in certain cases.
Lupulin and Lactucarium. I have not had sufficient opportunity to test these drugs fully, but in one case, which I have under treatment now, they seem to take the place of morphine with excellent results, the patient going twenty-four hours with but a small amount of discomfort on a minimum amount of morphine and large amounts of these drugs. In three days I have been enabled, by their use, to reduce the amount of morphine from twelve grains to half a grain, in the twenty-four hours, the patient being up and about. Whether the effect will hold, and whether these drugs can be easily abandoned, remains to be seen. It is in drugs of this class that we must look for a substitute for opium and its alkaloid. With other treatment we merely combat the symptoms that arise.
The fluid extract of lupulin may be used in from one to four drachm doses, by the mouth, or from thirty to sixty drops hypodermically. Lactucarium is best given in powder, in half drachm doses.