DELIRIUM, a temporary form of brain disorder apt to occur in acute fevers, diseases and injuries of brain, exhaustion and some poisons; e.g., opium, Indian hemp, belladonna, chloroform and alcohol. It may vary from slight and occasional wanderings of the mind and incoherence of expression, to fixed delusions and maniacal excitement, or may be associated with insensibility. (See INSANITY and NEUROPATHOLOGY.) Delirium tremens is an acute symptom supervening on chronic alcoholism. Nevertheless, many habitual drunkards never suffer from delirium tremens.
It was long supposed that delirium tremens only comes on when the supply of alcohol has been suddenly cut off; but there is abundant evidence that it occurs while the patient is still continuing to drink. Even when several days have elapsed be tween the cessation from drinking and the seizure, premonitory symptoms, consisting in aversion to drink and food, have shown themselves. An attack is often precipitated by disease (pneu monia), accidents (burns), severe mental strain or starvation, even where the supply of alcohol is less than would have been likely to produce it otherwise.
The earliest indications of an approaching attack are sleepless ness, terrifying dreams, restlessness and irritability of manner, with trembling of the hands and a thick or tremulous articulation. The skin is perspiring, the countenance oppressed-looking and flushed, the pulse rapid and feeble. During the attack the patient is mentally confused, talks incessantly and incoherently, has a distressed and agitated or perplexed appearance, and a vague notion that he is pursued by some one seeking to injure him. His delusions are usually transient, but he is constantly troubled with visual hallucinations of disagreeable animals or insects. The trembling of the muscles from which the name of the disease is derived is a prominent but not invariable symptom. It is most marked in the muscles of the hands and arms and in the tongue. The character of the delirium is seldom wild or noisy, but is much more commonly a combination of busy restlessness and indefinite fear. When spoken to, the patient can answer cor rectly enough, but immediately thereafter relapses into his former condition of incoherence.
In uncomplicated cases the symptoms abate in three to six days, cessation of the attack being marked by the occurrence of sound sleep, from which the patient awakes in his right mind, although exhausted and partly or wholly oblivious of his condition during his illness. Serious and permanent impairment of intellect is com mon in confirmed drunkards who have suffered from frequent attacks of this disease.
Treatment.-In mild attacks entire withdrawal of stimulants, liberal supply of light food, quietude and gentle but firm control may be all that is required. In severer attacks sedatives may be necessary, but must be given only under medical supervision.