Observations and experiments on the use of opium, bromide of potassium, and cannabis indica in insanity, especially in regard to the effects of the two latter given separately / by T. S. Clouston, M.D.

  • Clouston, T. S. (Thomas Smith), 1840-1915.
Date:
[1871], [©1871]
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Licence: Public Domain Mark

Credit: Observations and experiments on the use of opium, bromide of potassium, and cannabis indica in insanity, especially in regard to the effects of the two latter given separately / by T. S. Clouston, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    19/42 (page 17)
    treatment I have described witli the effects of bromide of potassium alone in large doses on the weight and pulse and temperature.^ 1 had been giving it to twenty epileptic patients for thirty-eight weeks in doses rising from five grains three times a day up to fifty grains three times a day, with the following results. Tliey gained steadily in weight for twenty-eight weeks, and their aggregate weight was then fifty-six pounds more than when they began to take the medicine. During the last ten weeks, when they were all taking 150 grains of the medicine per diem, they lost forty pounds. At the end of the time they were still sixteen pounds heavier in the aggre- gate than they had been to begin with. During the same time the effect of the medicine on their temperature was to lower it steadily until forty grain doses were reached. After that it rose, until at the end of the ten weeks of fifty grain doses it was above what it had been to begin with. Still the difference between the morning and evening temperature was greater at the end of the time than it had been to begin with. The effect on the pulse was to lower its average frequency steadily up to forty grain doses, and then to raise it slightly, but at the end of the time its average frequency was not so great as it had been to begin with. The patients who took the bromide of potassium being epileptics, the effects of the medicines above described cannot be compared with it with perfect precision, but still the general result holds good, that the tendency of the bro- mide of potassium was at least up to 120 grains per diem, in the direction of health, while from the beginning the effects of the opium were as regards the bodily state in a direction away from health, and the addition of the cannabis Indica to the bromide in the maniacal patients, while it had a good effect on the maniacal excitement, did not seem materially to interfere with the nutritive process. It has been the result of my experience with bromide of potassium given either in epilepsy or in insanity, given alone or in combination with cannabis Indica, that there is a certain dose which may be given with perfect impunity as regards the general health, and with great benefit to the disease for long periods, and that if this dose is increased cumulative effects will show themselves, and all the symp- toms of poisoning will come on. The safe and beneficial dose difi'ers in different cases. It would seem as though the kidneys (through which the salt is principally eliminated from the system) can only carry away a certain amount in each individual. I have given twenty-five grain doses three times a day to seventeen epileptics for two years, with a break of only one week, and in only two cases did any constitutional symptoms show themselves, and that was not till the end of a year. The others are all much the better for the medicine, having gained in weight, and improved in general health. 1 ' Journal of Mental Science/ Oct., 1868. 2