Unilateral phenomena point to in tracranial lesions; for instance, unequal pupils or ptosis of one eyelid or drooping of one corner of the mouth. There may also be found in the radial pulse a want of symmetry in fullness and strength upon the two sides of the body.
In a suspected case the patient should be kept under observation until the effects of a debauch have worn off; symptoms of head injury, which may have been masked by the acute alcohol ism, may then become manifest. John B. Huber (Med. Record, Feb. 20, '97).
Quinquaud's sign of alcoholism: The patient is to separate the fingers and rest them firmly across the observer's hand at right angles. For the first two or three seconds nothing unusual is noted, but then follow slight blows as if the bones of each finger were thrown back suddenly, the one upon the other, and struck the palm. The crepitations vary in character according to the individual; sometimes a slight rubbing and again a true crackling, which resembles that of a joint affected with dry arthritis. The pressure on the observer's hand should be moderate. In 52 epileptic women this sign was obtained but once: i.e., in a woman who had been com mitted many times for drunkenness. M. B. Damon (Northwestern Lancet, July 15, 1901).
Treatment. — External heat should be applied, especially to the abdomen and feet; the room should be heated; the stomach should be emptied and washed out with warm or tepid water. No alco hol is to be given, but warm milk; if emesis occur, milk with soda or lime water, barley-water, or rice-water; if there is collapse cinnamon (or ammonia in small doses) may be added to the milk, or cardamoms, cinnamon, and ginger in warm water. Chloroform, given with care, has been recommended against con vulsions.
In slight cases, an emetic and warmth. Ipecac or an hypodermic injection of grain of apomorphine may be used to produce emesis.
Ammonium carbonate has been used with great success in doses of 1 drachm dissolved in water. It acts as an emetic and antidepressant.
The patient should be deprived of alco hol, confined in bed, an1 then given blue pill, followed by a saline cathartic. In somnia should be met by the wet pack. Strychnine nitrate, to 'I, grain, should then be administered and nutri tion supported by water, milk, koumiss, broths, soups, meat-juice, raw eggs, arrowroot, fruits, etc. When required,
bromide and chloral or duboisine is ordered. Peterson (Jour. Amer. Med. Assoc., Apr. 15, '93).
In acute alcoholism apomorphine hy drochloride does in minutes what bro mides and chloral do in hours. It is far superior to morphine, as it eliminates the poison, while morphine dries up the se cretions. Injected hypodermically Vio grain of apomorphine hydrochloride caused free emesis in four minutes; rigidity changed to relaxation, and ex citement to sleep. Tompkins (Merck's Archives: Can. Pratt., Dec., '99).
In study of carefully kept records of 10 hospital eases and personal experience in the use of digitalis in fi eases the fol lowing personal conclusions are offered: 1. The indiscriminate use of large doses (half an ounce) of digitalis in acute alco holism is fraught with danger. 2. The kind of cases in which it should be given are the strong, robust patients in early life, suffering from no complications, and with violent delirium. In these cases the result will be exceptionally favorable. They become quiet, go to sleep with a certainty and promptness that is not ob tained by other methods. 3. If after three doses no narcotic effect is noted a continuance is not advised. In the above class of eases it can be used with perfect safety for a limited number of doses. 4. The failures in personal eases were in chronic alcoholic subjects, in middle and advanced life, in aniemie individuals with bad nutrition. 5. One fact noted in the cases which showed marked results from the treatment was that when they re covered and awoke from their sleep they were in such good condition that they were able to leave the hospital at once. This is an unusual experience, as ordi narily convalescence is delayed for two or three days. II. P. Loomis (Med. News, Aug. 18, 1900).
Many deaths ascribed to acute alco holism are really due to acute nephritis, but usually to an acute exacerbation of chronic alcoholic nephritis, as acute ne phritis, following an alcoholic debauch, in previously normal kidneys, is -ex tremely rare.