Symptoms.--The face is red, the capillaries are dilated, eyes are watery,
conjunctiva is congested. There is chronic inflammation of the stomach,
which is characterized by morning vomiting; there is often hardening of
the liver, trembling of the hands and tongue; the memory is weakened and
judgment and will as well, especially until a stimulant has been taken;
often the person is irritable, careless, with loss of moral sense and in
extreme cases dementia. Peripheral neuritis is more common in men than in
women. It begins with sharp pain and tingling in the feet and hands;
paralysis affects the lower extremities, then the upper, and is most
marked in the further muscles of the limbs. The pain may be very severe,
with great tenderness. There is Arteriosclerosis (hardening of walls of
the arteries); often heart dilation.
DELIRIUM TREMENS.--This is a brain manifestation of chronic alcoholism
occurring in steady drinkers after excessive drinking or sudden withdrawal
of alcohol, or after sudden excitement or accident, pneumonia or other
illness, or lack of food.
Symptoms.--There are restlessness, insomnia (sleeplessness), mental
depression, then active delirium with great restlessness, talking,
muttering, hallucination of sight and hearing. He thinks he sees objects
in the room such as rats, mice, or snakes, and fancies that they are
crawling over his body, has them in his boots, etc. The terror inspired by
these imaginary objects is great, and has given the popular name of
"horrors" or "snakes" to the disease. You must watch the patient
constantly, or he may try to jump out of the window or escape. The patient
may think he hears sounds and voices, threats of imaginary enemies. There
is much muscular "shakings," the tongue is coated with a thick white fur
and, when protruded, trembles. The pulse is rapid and soft, sleeplessness
is a constant feature. Favorable cases improve in the third or fourth day,
the restlessness abates, the patient sleeps and the improvement sets in.
The shakings persist for some days, the hallucinations disappear
gradually, and the appetite returns. In the more serious cases, the
sleeplessness (insomnia) persists, the delirium is incessant, the pulse
becomes more frequent and feeble, the tongue dry, the prostration is
extreme and death takes place from gradual heart failure.
Treatment.--In acute alcoholic cases special measures are seldom required,
as the patient sleeps off the effect of his "spree." If there is deep
profound alcoholic coma, it may be proper to wash out the stomach and if
symptoms of collapse occur, the limbs should be rubbed, and hot
applications made to the body.
[INTOXICANTS AND SUN STROKES 373]
Chronic Alcoholism.--This is different; withdraw the alcohol and
substitute strychnine, one-thirtieth of a grain three or four times a day,
nourishing food, confinement in a sanitarium if necessary. Give the
bromides for the restlessness and sleeplessness. Drugging of the liquor
with apo morphine or tartar emetic.