ALCOHOLISM. The term employed to denote the symptoms of disease produced by alcoholic poisoning. In acute alcoholism, which is generally caused by the rapid absorption of a large quantity of alcoholic drinks, the first symptoms are animation of manner, ex altation of spirits, and relaxation of judgment. The emotions are altered and often perverted; muscular movements become irregular or ataxic; the mechanism of speech suffers. The further development of the symptoms presents a variety of effects. In the ordinary course of the action of the drug, dizziness, disturbance of sight and hearing, and other troubles due to disorder of the central nervous system, ensue, leading to heavy sleep or profound coma, from which it is sometimes impossible to rouse the individual, who lies completely paralyzed, breathing ster to•ously. Sometimes the alcohol affects so strongly the centres of respiration and circula tion that death is caused by paralysis of one or other, or both. This condition of coma requires to be carefully distinguished from opium poison ing. In the fanner, the face is usually flushed and the pupils dilated, while in the latter the face is pale and the pupils contracted. The odor of the breath is no criterion, inasmuch as sym pathizing bystanders are apt to administer spirits in every case of depression, often with hurtful effects. Fracture of the skull, delirium of meningitis, and coma after epilepsy or after cerebral hemorrhage are often undiscovered by the inefficient ambulance surgeon, who is led to diagnose a condition from an alcoholic breath. A second class of alcoholics act in an entirely different manner. Instead of sinking into stupor or coma, the individual becomes more and more excited, bursts into wild mirth or passionate auger, struggles violently with those who at tempt to soothe him, and may grievously harm himself or others. This is the condition known as alcoholic mania—the physical explanation of many fearful crimes. It is more apt to follow a somewhat protracted debauch. After a longer or shorter period of fierce excitement, it is in most eases succeeded by great depression, and sometimes during this condition there may be sudden death from failure of the respiration or circulation. In some patients the stage of ex citement culminates in a convulsive seizure. The convulsions are repeated at intervals, are very complicated in character, and produce remark able contortions of the body. These usually grow less violent, and, passing off, end in deep sleep; but here also death may occur from the action of the poison. Such cases of "alcoholic epilepsy" are comparatively rare, and occur prin cipally in acute exacerbations of chronic alcohol ism. Acute alcoholism is more apt to occur in those who are of unsound mind and weak nerv ous system, and this applies especially to the two last-described forms of the affection. In the treatment of acute alcoholism, it is always wise to wash out the stomach, in ease alcohol is present, or to accomplish much the same object by free vomiting and purgation. In the pro found coma, the administration of stimulants. such as ammonia and strychnine. may.be called for, and sometimes artificial respiration may be the only means of saving life. In the maniacal
and convulsive forms of the affection, sedatives must be used. After the immediate symptoms have passed away in all forms, the individual must be carefully fed with nutrient. enemata, on account of the disturbance of the digestive sys tem, along with remedies which will subdue the digestive irritation and overcome the depression of the nervous system.
Chronic alcoholism is caused by the prolonged use of overdoses of various alcoholic drinks. Changes (see ALCOHOL. PHYSIOLOGICAL AND POISoNoHs ACTioN or) are caused in every tissue of the body, but the nervous, respiratory, and circulatory systems are more especially affected, together with the liver and kidneys. There is always more or less catarrh of the digestive organs, shown by dyspepsia. heart-burn, vomit ing— especially in the morning — and usually diarrhea. The liver becomes enlarged from con gestion, and may afterward shrink, pressing on the veins and bringing back blood to the lieu it from the abdominal viscera, leading to conges tion of the bowels, hemorrhoids, and hemor rhages. From changes in the organs of circula tion there is a tendency to palpitation, fainting, and breathlessness on exertion. These altera tions are degenerations of the heart, which may be soft or even fatty; fibrous changes in the walls of the arteries; and dilatation of the cap illaries from paralysis of the vaso-motor nerves. This last condition gives the florid complexion and mottled appearance to chronic drinkers. There is, besides. usually some congestion of the kidneys: but it is erroneous to attribute Bright's disease mainly to alcohol. The lungs are subject to chronic congestion and catarrh of the bron chial tubes and lung tissues. The muscular sys tem suffers, the muscles becoming flabby and fatty. There is a great tendency to deposition of fat, and skin diseases are frequently induced by the vaso-moto• changes.
Two characteristic results of the action of the drug on the central nervous structures are delir ium tremens and alcoholic insanity. (See INSAN ITY.) In treating chronic alcoholism the great point is to prevent the employment of alcohol in any form, and to invigorate the bodily and men tal functions. See DELIRIUM.
Alcoholism is also the term used by many sociological writers, especially French and Ger man authors, in discussing the social evils aris ing from an abuse of intoxicants. Particularly important are the investigations of the relation of alcoholism to pauperism and crime, and the legal aspects of the subject as exhibited in the way various communities deal with drunkenness (qx.).
BIBLIOGRAPHY. The Committee of Fifty has Bibliography. The Committee of Fifty has made the best study of the subject in its volume on Economic Aspects of the Liquor Problem, (Boston, 1899). And consult also: "The Rela tions of the Liquor Traffic to Pauperism, Crime, and insanity," Twenty-sixth Annual Report of the Massachusetts Bureau of Labor Statistics (Boston. 1S95) ; and "Economic Aspects of the Liquor Problem." Twelfth Annual Report of the United States Department of Labor (Washing ton, 1898). See TEMPERANCE.