This section is from the book "A Treatise On Therapeutics, And Pharmacology Or Materia Medica Vol1", by George B. Wood. Also available from Amazon: Part 1 and Part 2.
Now and then, instead of the series of phenomena above presented, nausea and vomiting come on at some period in the progress of the debauch, and the further development of the symptoms is prevented. The patient goes to bed, and sleeps off the effects of the stimulant.
If the drinker have the prudence to cease before other cerebral disturbance is produced than the slight swimming of head alluded to, the excitement of system will gradually subside, perhaps with a copious diuresis, and there will be little observable depression afterwards. Should he, however, repeat the potation every day, he will, after a time, begin to find that, as the period approaches for recurring to the stimulant, there are feelings of uneasiness and of a want to be supplied, which are the inevitable penalty of over-indulgence; and there is always some danger, under these circumstances, of the formation of a very pernicious habit.
Every day, more and more will be required to relieve the uneasiness, and produce feelings of exhilaration; and, if the temptation to increase the quantity is yielded to, the power of resistance gradually diminishes, and confirmed intemperance ensues. The only preventive of this course of deterioration, when once entered upon, is to break off the use of the drink altogether, or to fix positive limits for the quantity daily used, which shall not be exceeded; and this quantity should not be large enough to produce sensible exhilaration. The former plan is much the safer.
The moderate use of these drinks, when a certain limit is never exceeded, and this falls short of obvious cerebral excitement, may be continued by many persons for a lifetime without serious injury. The system accommodates itself to the stimulus, which enters into the regular means of life, and no observable difference will be noticed between such an individual and another of the same natural constitution who is abstemious, except that the former, when from any cause diseased, has probably somewhat diminished powers of resistance, and stands more in need of artificial support.
But, if carried to the borders of intemperance or beyond them, the stimulant soon makes itself felt, in an individual before healthy, by an increased vigour or at least activity, of the digestive, assimilative, and nutritive functions. More and perhaps richer blood is made out of the same quantity of food, and the system passes into a plethoric condition, as shown by the fuller and stronger pulse, and the general redness of the surface, especially of the face. At the same time, the increased fulness of habit, and weight of body, prove that the nutrition has been promoted equally with the other processes; and in fact all the functions of the organic life are in a higher state of activity. This condition of things may continue long, in a constitution originally well balanced, without serious injury; and the individual may think himself in a high state of health. He is, however, on the brink of disease, and the slighest accident may precipitate him into it. If a considerable excess is maintained, the countenance, instead of the ruddy hue and fulness of health, assumes a deeper tint and a bloated appearance; and the signs of an excessive indulgence become obvious even to the most unobservant.
Poisoning by Alcohol. Every serious injury to the health, resulting either from a temporary debauch, or from the habit of drinking alcoholic liquids to excess, I consider as falling strictly under this head. First I shall treat of the acute, and secondly of the chronic poisoning.
Acute alcoholic poisoning is that in which life is endangered by large quantities of the stimulant taken at once, or in successive portions at short intervals, so that the conjoint effect is felt at the same time.
Sometimes, in such cases, death is almost instantaneous. Orlila, m his Toxicology, mentions two instances of this kind. Two soldiers drank each, four litres (eight pints) of brandy. One died immediately, the other while they were bearing him to the hospital. It is probable that, in such cases, death results from an overwhelming impression on the stomach, affecting the brain sympathetically; and that the symptoms are those of great prostration from the first.
But such instances are extremely rare. Generally there is a brief excitement, followed speedily by coma, from which, when the result is fatal, death usually takes place at a period varying from twelve to twenty-four hours. The symptoms differ considerably in different cases. In some, the coma is so profound that the patient can be made to show no signs of sensibility or intelligence; in others, he can be partially and temporarily roused. The pulse is usually slow and full, sometimes natural as to frequency, but towards the close extremely feeble, and at length imperceptible. The respiration is also slow. The face may be flushed, with a venous hue, or may be pale. The pupils, though occasionally contracted, are more commonly dilated. Complete immovability of the pupil is an unfavourable sign. Convulsions are rare. Death results from the suspension of the respiratory process, either through the direct alcoholic congestion, or the secondary prostration of the nervous centra in the encephalon. When recovery takes place, as the affection was functional, the patient, upon the disappearance of the coma, returns to health, after a short period of secondary depression, with an aggravation of the symptoms already mentioned as characterizing the same stag an ordinary debauch.
Another mode of acute alcoholic poisoning is by the supervention of apoplexy. This generally occurs in persons predisposed to that affection. In such cases, even a comparatively moderate indulgence may produce this effect by determining blood to the brain. It is no very uncommon event for persons thus predisposed to be attacked at the table. But occasionally the result is to be ascribed purely to the alcohol. The quantity of blood thrown into the brain produces a general congestion of the organ, and sometimes positive sanguineous effusion takes place. The patient may recover from either of these conditions; but, in the latter. paralytic symptoms will be apt to remain.