Volume 1

A manual of the practice and theory of medicine / by William Whitla.

  • Whitla, William, 1851-1933.
Date:
1908
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: A manual of the practice and theory of medicine / by William Whitla. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    33/940 (page 29)
    condition which may have been also the cause of the habit, as general paralysis, insomnia, dementia, &c. progrnosis.—When the affection is established, this is always serious. Much, if not all, depends upon the amount of will- power left. The writer's experience is that in those chronic cases where the patient glibly affirms that he can easily leave off alcohol there is always a bad ending. The longer that the patient can be kept from alcohol the greater the hope of a permanent reformation; and when one year's abstinence has expired his prospects are good, and after double this period there is every hope of a permanent cure, provided always that he remains a strict teetotaler. The prognosis is grave in patients with an hereditary history of alcoholism or insanity, and in those whose moral sense was below the average stan- dard prior to the establishment of the alcohol habit. The prognosis is good as regards the disappearance of insomnia, gastritis, cardiac disturbance and hepatic enlargement, and even neuritis, if the patient rigidly abstains. Treatment.—The writer has in the ' Dictionary of Treat- ment' (4th ed.), pp. 27-32, stated his conviction that the danger of the establishment of the alcohol habit is enormously increased by the practice of taking alcohol in concentrated form, and that preventive treatment based on this considera- tion would speedily alter the aspect of the great drink-evil if alcohol could be procurable only of the claret or sherry strength. The various remedies for the relief of the symptoms of chronic alcohoUsm are given in detail in the pages referred to, and need not be here repeated. The first question to be settled is the serious one of the sudden or gradual withdrawal of the poison, and there need be no hesitation in adopting the former method and immediately stopping supplies. It is generally found impossible to carry out for the neces- sary time prohibitory measures in ordinary domestic Ufe, and there can be no doubt about the wisdom of insisting upon the patient entering for a period of at least six months a good mebriate asylum. The value of the so-called ' gold ' cure, hypnotic suggestion, and other methods is yet to be demon- strated. Though the benefit of hypodermics of strychnine, alone or with atropine, is beyond doubt, it must be recognised that no drug-treatment is of any permanent use unless measures be at the same time taken for the elevation of the moral tone of the victim, and especially for assisting his weakened will- power or volitional defect. No hope must be held out that the cured or reformed individual can ever return to the habit of usmg alcohol, even in smallest quantities. His only hope can rest upon absolute abstinence for the remainder of his life.