On the pathology of delirium tremens, and its treatment without stimulants or opiates / by Alexander Peddie.

Date:
1854
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Licence: Public Domain Mark

Credit: On the pathology of delirium tremens, and its treatment without stimulants or opiates / by Alexander Peddie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    produces a certain amount and kind of debility in the cerebral func- tions, but combined with over-action of the circulation tlii'ough the membranes of the brain, constituting a decided form of irritation, the tendency of which, if not allayed by judicious treatment, is to inflammatory action, and serious encephalic mischief,'- Scipio Pinel much more frequent, and earlier developed in Sweden and the noi'thern parts of Germany, owing, it is supj)osed, to the very pernicious composition of the alcoholic liquors in general use. With but few exceptions the symptoms have been caused by the potato brandy, which is served out over the counter of the spirit sliops to the lower classes of this metropolis. Spirit from grain is not common, and the distilled spirit freed from the volatile oil (finkelolja) does not suit the palled taste of the habitual spirit drinker. Tlie presence or absence of this oil must be carefully borne in mind in estimating the causes of the disorder.—P. 84, T>r Huss^s work. It further appears that these potatoes, skins and all, are generally diseased or decaj^ed ; that mildewed grain is also used, and various poisonous vegetable products, such as spurred rye, lolium (frequently mixed with bad barley), and the seeds of the rapliania raphanis- trum—which latter was by Linnreus himself thought to be the cause of this dis- ease ; and this poisonous mixture is likewise favoui'ed by preparation in copper vessels.—Revieiv, pp. 56, 57. While Dr Huss acknowledges that all this must greatly increase and confirm the maladies described by him, he regards the alcoholic jjrinciple as the chief cause. On the other hand, the reviewer ex- presses a doubt (p. 59) whether the alcoliolismus cJironims be really dependent even chiefly upon alcohol, and considers it probable that its phenomena result from the habitual use of alcoholic drinks holding various (narcotic and acrid-narcotic) poisons in solution in diff^erent amounts, and differing in their nature and action, but all having in common, that they exercise a highly dele- terious influence, especially on the nervous system. Besides the probability that the various maladies described by Dr Huss are not altogether owing to a condition of alcoholism, it must be borne in mind that there is a great want of uniformity in the character and course of the attending phenomena, that there is nothing in fact to point out a peculiar physiological action such as may be attributed solely to alcohol. It appears to me therefore that they must be regarded simply as bad effects from drinking habits on the cerebro-spinal sys- tem in particular, through the general impairment of the niitrition of the body ; and be placed on the same footing as those diseases of the heart, arteries, liver, kidneys, and other organs with their respective functions, also resulting from intemperance, and with which the so-called alcoliolismus chronicus is more or less associated. The application of the term alcoholism to such affections as these, appears to me to be inappropriate—that given by Romberg {Dis. of Ner- vous Systeni), namely, tremor potatorum, is preferable; and in the following pages, I trust it will be apparent that if there is one disease more than another arising from habitual excess in alcoholic drinks, in which a peculiar toxicologi- cal effect is manifested, it is delirium tremens. 1 Watson, Prac. of Phys., pp. 400, 401.