August 19, 1911

Purgation in Delirium Tremens

JAMA. 1911;LVII(8):672. doi:10.1001/jama.1911.04260080236019

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To the Editor:  —After reading the article in the Therapeutics Department on "Delirium Tremens" in The Journal, August 5, I was struck by the omission of any reference to purgation. In the treatment of this condition, the incitement of an early and active purgation has seemed to me in the great majority of the cases the most important factor at our command. The thickly coated tongue, foul breath and unhealthy condition of the skin of many of these patients indicate that to the toxicity of the alcohol there is added the autotoxicity of faulty elimination. There is commonly a history of constipation and at times of inactive kidneys. An initial dose of from 3 to 5 grains of calomel followed in six hours by a saline has seemed to me so satisfactory that it has become my routine-practice and is rarely contra-indicated. In severer cases I give from 3 to

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