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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    all, this is a very small proportion to the number of dissipated and drunken characters gathered together there, and at once broken off from intemperate habits. Dr Gibson, however, states that he does not altogether enter into my views as to the proximate cause of delirium tremens, although he admits that it does not so frequently occur as the advocates of the theory, which attributes it to the total withdrawal of accustomed stimuli, such as Blake and others are in- clined to suppose; and he mentions, in proof of his objection, that he had never seen it occur in less than twenty-four or beyond seventy- two hours after apprehension, which necessarily put a stop to dram- drinking. As I have already explained, however, and as the cases given at the conclusion of this paper will show, there is always, whether the individual is drinking much or little, more or less of a premonitory stage present in this affection, distinguished by digestive derangement, nervous irritability, restlessness, and sleeplessness, before much tremor is displayed, or any illusions manifested; and it is easy to suppose that these might not be bi'ought immediately under the notice of the medical officer of a large criminal establishment, such as the Glasgow prison. But even granting that no incipient symptoms of the dis- ease vi'ere observed, and that this proportion of the habitual drunk- ards were not quite on the verge of being affected with it, it is quite in accordance with the views already advanced to suppose that, when there was a certain amount of alcoholization existing, the dis- ease might be hurried on more speedily than otherwise would have been the case in individuals of a nervous and excitable temperament, by the agitation or shock of apprehension, and the deprivation of liberty. But, further, I should suppose it a very just, nay moderate calculation, to assume that out of a population of 2000 confirmed drunkards belonging to any class of society, although enjoying un- restrained liberty and uninterrupted opportunities for indulgence to excess, at least fi'om three to six instances of delirium tremens would annually occur. But, in fine, on this point, the evidence communicated by Dr Simson, the medical officer to the prison board of this city {Letter, Ath July 1854), is sufficiently satisfactory; for while the number of civil and criminal prisoners, committed during the last year, was 5864 (which may be assumed as a sample of the previous fourteen years, over which Dr Simson's experience extends), only four cases of delirium tremens occurred within the last eighteen months. The average number of cases during former years, Dr S. states as from