The General Practitioner As a Specialist

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: be traceable to other causes. There are not a few instances, however, where the addiction has been discovered only after death. One of the easy tests for the morphine addiction is to give several cups of strong coffee; there will follow a dilatation of the pupil and a nervous trembling, and after the...
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Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: be traceable to other causes. There are not a few instances, however, where the addiction has been discovered only after death. One of the easy tests for the morphine addiction is to give several cups of strong coffee; there will follow a dilatation of the pupil and a nervous trembling, and after the effects of the coffee begin to disappear, there will be apparent in the face and manner a vague yet marked alarm and uneasiness. Howard gives certain diagnostic hints as regards the morphine habit, especially noticeable in women, and calls attention to the necessity of keeping any suspicion from the patient. Watch the conditions, especially in the afternoon, to see whether she is under the effect of the drug. If she comes complaining of a distressed feeling, ill health, irritability, etc., treat the condition, but insist that the treatment must be continued for weeks, laying considerable emphasis on the importance of seeing the patient at a certain time. Make an appointment for the next day at an early hour. The next day the appointed hour passes, and when the patient finally arrives her excuses must be accepted. Again notice the general attitude of the patient. It may or may not vary with that noticed the day before, but the treatment must be the same. The physician must find out as to the conditions in the morning, as to the appetite, slowness of rising, etc. The patient is again late on the third day. Then he should appear at the house the next morning at a reasonable hour, with the excuse that he could not keep the office hour, and not wishing to have the day pass without seeing her, he called. It is probable that he will be told that she is not yet down, and will he wait? He may be detained half or three-quarters of an hour, when she appears, with every evidence of a has...