The Climatic Treatment of Disease
The Climatic Treatment of Disease
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疾病的气候治疗
DOI：
10.1136/bmj.1.2426.1572-c
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发表时间：
1907
影响因子：
--
通讯作者：
A. Bampton
中科院分区：
文献类型：
--
作者：
A. Bampton
阿托品和士的新碱成功治疗吗啡瘾。先生，-约翰·Q博士。唐纳德在6月8日《英国医学杂志》第1394页的信中问我的病人为什么和如何在来找我之前停止吸食鸦片，他这样做是出于需要，他的手段和他的朋友们的耐心已经耗尽。我已经描述了他随后的痛苦和痛苦的状态，他和我都看不出有丝毫的理由希望他会逐渐好起来，只是让他远离毒品。事实上，自从他意识到自己养成了这个习惯，他就一直在努力解放自己，最大的诱惑和更容易的环境都是一样的--失败了。因此，我认为没有理由认为“斗争实际上已经结束，我只是帮助了后遗症。“我已经解释过，他受到的待遇是非常不利的。“滋补品，新鲜空气，按摩，温和的运动，营养的饮食，身心的休息，”如唐纳德德利斯博士，是显着的，由他们的rab 3ence。相反，担心，不断的身心努力，缺乏和IL！熟食、不卫生的环境、不足的衣服以及所有其他赤贫的弊病都必须与之斗争。事实上，我之所以希望这个病例能证明是有趣的，也许是有启发性的，是因为在治疗中完全没有任何其他因素可以归因于他目前的状况。甚至暗示，这在某些情况下是有帮助的，在这里也没有。我对嗜酒狂的经验并不使我同意唐纳德博士的观点，即所谓的渴望是一种药物无法控制的精神状态。“精神和身体上的不安，往往预示着发作的开始，这只是病人可能抱怨的许多症状之一。我们知道，酒精对神经系统有毒性作用，重复和过量的剂量会引起一定的病理状态;而且，在每一个渴望酒精的病例中，都会发现出生前或出生后的酒精中毒史。因此，我无法理解为什么这种疾病应该被认为是纯粹的精神疾病。至于唐纳德医生所要求的病例的更完整的历史，也许以下细节就足够了：病人在治疗之日大约65岁，28岁时开始吸食鸦片。他在体格、智力和教育方面都远高于平均水平，但现在无法进行任何长时间的肌肉或精神上的努力，他在写作、计算数字等方面的记忆力下降。1906年4月20日开始治疗，使用阿托品。sulph.] F谷物，strych。尼特。A粒，每日三次; 4月30日增加到萎缩。5格令，番木鳖。2格令; 5月3日降为阿托品。e. moutb的干燥度等，从一个剂量持续到下一个是由于，并防止他吞咽食物。我从6月1日开始进一步减少阿托品的剂量，6月20日停止使用;士的宁的剂量一直维持到7月中旬，然后逐渐减少到零。大家会注意到，我让他服用大剂量药物的时间比M 'Bride医生建议的要长得多。我这样做是因为我的一个酗酒病例在两周的治疗后严重恶化，但在后来的八周疗程后，他一直保持良好（只有十五个月）。在过去的几个月里，他一直在经受一场严峻的考验，考验他的病情是否稳定，这场麻烦的感情不仅给他带来了相当大的痛苦，而且大大干扰了他谋生的努力。
MORPHINOMANIA TREATED SUCCESSFULLY WITH ATROPINE AND STRYCEININE. SIR,-Dr. John Q. Donald, in his letter in the BRITISH MEDICAL JOURNAL for June 8th, p. 1394, asks why and how my patient had stopped taking opium before coming to me. He did so from necessity, his means and the patience of his friends being exhausted. I have described his consequent state of misery and desperatiot, and neither he nor I saw the slightest reason to hope that he would gradually get all right by merely keeping him from his drug. As a matter of fact, ever since he realized that he had acquired the habit he had from time to time been making efforts to free himself, the sfrongest inducements and easier circumstances all alike--failing. I see no reason, therefore, to think that"'the struggle was practically over and that I only assisted the after-effects." I have already explained that the circumstances under which he was treated were about as unfavourable as they could well be." Tonics, fresh air, maesage, gentle exereise, nutritious diet, rest for mind and body," such as Dr. Donaldrelies on, were conspicuousby theirab3ence. Instead, worry, constant'effort of mind and body, scanty and il!-cooked food, unhygienic surroundings, insufficient clothing, and all the other ills of extreme poverty had to be contended with. In fact, my reason for hoping that the case would prove interesting, and perhaps instructive, was the entire absence of anyother factor in the treatment to which his present condition could be ascribed. Even suggestion, which is helpful ia some cases, was absent in this. My expprience of dipsomania does not lead me to agree with Dr. Donald that'the so-called craving is a mental condition over which drugs have no control." The restlessness, both mental and physical, which so often heralds the onset of an attack is only one of the many symptoms which patients may complain of. We know that alcohol has a toxic effect on the nervous system and that repeated and excessive doses give rise to definite pathological conditions; also that in every case of craving for alcohol there is to be found a history of alcoholism either before or after birth. I fail, therefore, to understand why the ailment should be considered purely mental. As to the fuller history of the case Dr. Donald asks for, perhaps the following particulars will suffice: The patient was agpd about 65 at the date of treatment and began smoking opium when 28. He had been much above the average in physique, intelligence, and education, but was now unable to make any prolonged muscular or mental effort, his memory lapsing when writing, totting up figures, etc. His family history was bad as regards alcoholism. Treatment was begun April 20th, 1906, with atrop. sulph.]-F grain, strych. nit. A-grain, thrice daily; increased by April 30th to atrop. 5 grain, strych.-2 grain; reduced on May 3rd to atrop. e the dryness of moutb, etc., lasting from one dose till next was due, and preventing his swallowing food. I began reducing atropine further on June lst, and stopped it on June 20th; the full doees of strychnine were maintained till middle of July and then gradually reduced to nil. It will be noticed that I kept him on large doses for a considerably longer period than Dr. M'Bride recommended. I did so because one of my alcoholic cases broke down badly after a fortnight's treat-ment, but after a later course prolonged for eight weeks bas kept perfectly well to date (just fifteen months). During the past couple of months he has been under-going a severe enough test of the stability of his condition in a troublesome affection which not only causes him considerable pain but also interferes greatly with his efforts to earn a livelihood …