and down between two men, who must be cautioned against yielding to his importunate entreaties and occasional struggles to get free and rest himself. For the sopor returns so rapidly, that I have known a patient answer two or three short questions quite correctly on being allowed to stand still, and suddenly drop the head in a state of insensibility while standing. The duration of the exercise should vary according to circumstances from three, to six, or twelve hours. When he is allowed at length to take out his sleep, the attendants must ascertain that it is safe to do so by rousing him from time to time; and if this should become difficult, he must be turned out of bed again and exercised as before.
It appears from some cases published not long ago by Mr. Wray[1] and Dr. Copland,[2] and more lately also by Dr. Bright,[3] that the most insensible may be roused to a state of almost complete consciousness for a short time, by dashing cold water over the head and breast. This treatment can never supersede the use of emetics: and as its effect is but temporary, it ought not to supersede the plan of forced exercise. But it appears to be an excellent way to insure the operation of emetics. If the emetic is about to fail in its effect, cold water dashed over the head restores the patient for a few moments to sensibility, during the continuance of which the emetic operates. Dashing cold water over the head may perhaps be dangerous in the advanced stage, when the body is cold and the breathing imperceptible; but the most desperate remedies may be then tried, as the patient is generally in almost a hopeless state. In one of the cases mentioned by Dr. Bright from the experience of Mr. Walne, complete recovery was accomplished, mainly by cold affusion of the head, where there appeared reason to believe that more than an ounce and a half of laudanum had disappeared from the stomach before evacuating remedies were used.—This treatment seems to have been first proposed in 1767 by a German physician, Dr. Gräter.[4] A suggestion, which is probably an improvement, has been recently made by Dr. Boisragon of Cheltenham, to alternate the use of cold with that of warm water, applied to children in the shape of warm bath, and to adults in the form of warm-sponging and the foot-bath. The alternating impression of heat and cold may act better as a stimulant than either agent singly; and the occasional employment of heat prevents the risk of collapse from too continuous exposure to cold. Dr. Boisragon saved in this way two cases in very unpromising circumstances.[5]
In some cases internal stimulants have been given with advantage, such as assafœtida, ammonia, camphor, musk, &c. It is always useful to stimulate the nostrils from time to time, by tickling them or holding ammonia under the nose; but the application should be neither
