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

Date:
1854
Catalogue details

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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    have originated. The error is a popular one, and has arisen from imperfect inquiry into the history of individual cases, and in- correct observation regarding the circumstances connected with the supposed reduction or abstraction. When called to see a case of delirium tremens, on inquiry as to the habits of the patient, we are frequently informed by his friends, that for a long time large quantities of spirits, or wine, or malt, or of all of these—and per- haps, in addition, morphia or opium—had been systematically con- sumed, but that for some time—a few weeks perhaps—much less had been taken, and within the last few days little or none ; and then the inference is drawn for us, that the unfortunate patient has actually brought on the attack by meritorious efforts to free himself from a habit of which he had begun to be ashamed. Now all this is very plausible, but not in accordance with the strict facts of the case, as the individual himself, if put on his word of honour, will probably confess. The statement ought to be, that he was formerly in the habit of consuming large quantities of his favourite stimulant, until he found that a much less dose began to affect the system ; that then he reduced the amount still further, but experienced an equal, if not greater, constitutional effect therefrom ; and thus, from day to day, reduction was forced on him by his own sensations of gastric irritation, nervous excitement, and muscular debility,—these feelings having been, in fact, neither more nor less than the pi'emoni- tory symptoms of the attack of delirium tremens, and just what might have been expected if—as I have ventm'ed to assert—the alcoholic principle is to be viewed as a cumulative poison. The habitual and excessive use of intoxicating liquor, however, does not aftect all individuals alUve. Some drinkers are early cut off by diseases of the liver, heart, or other organs, to which they may have a hereditary or constitutional liability; others in fevers or inflam- mations, which they have no stamina to contend against; othei's by apoplexy or paralysis, from the direct effects of a debaucli; and some from hereditary predisposition, or otherwise, are early doomed to spend the remaining years of a miserable existence in mania, idiocy, or in a general paralytic condition of the system.^ Some few drinkers, again, by reason of extraordinary constitutional vigour, escape all these ills, and live on to old age ; but the greater number who are not early removed from society by the diseases enumerated, suffer more ' This comprehends the group of affections described by Huss under tlie name of the Chi onic Alcohol Disease, and which has already been refeired to.