The Use of Lactophenin as an Hypnotic.—Christiani (Il Manicomio moderno, 1898, No. 2) has recently very strongly advocated the use of lactophenin as an hypnotic in the sleeplessness of the insane. Although his paper has already been noticed in this country (see Brit Med. Journ., 1898, vol. ii, Epitome, par. 448), in view of the probable importance of the subject, and the fact that the alleged therapeutic value of the drug has received strong confirmation from the experiments of Namirez (Brit. Med. Journ., 1899, vol. i, Epitome, par. 128), it may perhaps be useful to give an account of his observations here. He states that he has used lactophenin as an hypnotic in over two hundred cases of insanity, including practically all its various forms. He administered it in doses of from two to three grammes suspended in sweetened mucilage, one hour after supper. He concludes that the drug has an hypnotic action which is certain, rapid, intense, prolonged, and free from any danger. This action manifests itself in from half an hour to one hour after administration. The sleep induced resembles natural sleep. It is profound, quiet, and restorative, lasting generally from four to nine hours. Return to consciousness is not accompanied by any sensory, motor, or gastro-intestinal disturbances. The drug has no cumulative action. Its prolonged use does not give rise to inconvenience of any kind. In one case of general paralysis its administration was followed by jaundice, which, however, he thinks may have been due to some other cause. He has not found any contra-indication to its use in the existence of morbid physical conditions in the insane, such as nephritis cardiac disease, senility, pneumonia. & c. It may be given in any form of mental disease. In some instances it has failed, chiefly in cases of severe delirium. Like other hypnotics, it tends in many cases to gradually lose its effect. He believes that lactophenin is the hypnotic par excellence in insomnia of the insane accompanied by serious involvement of the physical health.
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