In alcoholically paralytic cases the pa retic symptoms are antedated.
Drunkenness should be discriminated from inebriety. Drunkards drink when they have the opportunity; inebriates are diseased persons who drink when their attack seizes them. The drunkard may so injure his brain, structurally or functionally, that he may become an inebriate; the inebriate, how-ever, is one who is generally born with an unsound brain. This is a transmissible cachexia. The child of an inebriate, born after the lesion has been established, inherits some nervous diathesis. The only security is by life-long abstinence on the part of the child. Stewart (Lancet, Jan. 9, '92).
Etiology. — Heredity has, by most authorities, been considered to be the chief predisposing influence. Crothers traced a family history of inebriety in one-half of his cases, besides 25 per cent. of defective brain-states from a neurotic or other morbid inheritance inclusive of insanity.
[In over 3000 eases I have found fully one-half with an inebriate ancestry, in addition to 6 per cent. with a pedigree of mental disease. Almost the same proportions have been the experience of the American, Fort Hamilton, and the English Dalrymple Homes. Bevan Lewis attributed 64 per cent. to parental ine briety, some form of transmitted neu rosis, or insanity. Piper, likewise, puts the proportion of hereditary to acquired eases at two to one. In my opinion, the number of cases in which an ancestral history of alcoholism has been traced is much below the actual amount, as it is frequently difficult to get relatives to admit the existence of an alcoholic taint. NORMAN KERR.] Heredity is said to be crossed when, in its single parental form, the children of the opposite sex to the inebriate parent only are affected. An important fact is that all these and other forms of alcoholic transmission may be handed down by a parent or parents who have never been known to have been intoxi cated, or to have exhibited any uncon trollable impulse to intoxication.
Double parental alcoholism causes al coholism; absinthism causes epilepsy; and combination of absinthism and epi lepsy a common cause of epilepsy in children. Legrain (Brit. Med. Jour.,
July 20, '95).
The proportion of hereditary cases has increased 50 per cent. over the acquired during the past twelve years. Holmes (Med. Pioneer, Aug., 95).
Neurotic intemperance possesses feat ures which serve to distinguish it from the common vice of occasional and de liberate drunkenness. Whereas the rice, once so prevalent and even fashionable among the men of all classes, is now all but confined to what are called the lower orders, the disease is confined to no class, and to neither sex, and instead of dimin ishing seems decidedly on the increase. The occasional drunkard seeks com panionship in his cups, and is generally more or less noisy and uproarious in his intoxication; but the victim of this dis ease inclines rather to shrink from obser vation, and is generally quiet and morose under the influence of alcohol. J. Strachan (Brit. Med. Jour., Oct. 1, '98).
Careful study of four hundred alco holics has been made during the last fifteen years at Zurich, under Eo•el's supervision, and again the fact of hered ity is emphasized. Forty-three per cent. of the cases had one or both parents alcoholic, and 40 per cent. of the parents were wholesale or retail dealers in liquors. One hundred and thirty-two, out of three hundred and forty-six, had become alcoholics without drinking liquors, consuming merely beer, wine, or ciders. Alcoholism is most frequent be tween 20 and 60 (93.5 per cent.). Below that age a case is most sure to be direct heredity. All the cases showed various physical, mental, and moral alterations; degeneration of heart, arteriosclerosis, affections of the stomach, tremor, ataxia, papillary troubles, general denutrition. etc. One-fifth were sexual perverts (hypermsthesia. precocious debauchery, inversion). Fourteen per cent. were epi leptics; in six cases the attacks followed alcoholic excess and disappeared entirely when the patients refrained from alcohol. Editorial (Quart. Jour. of Inebriety, Jan., '98).