Physical and Functional Characteristics of Chronic Inebriety. The habitual drunkard rarely exhibits traces of congenital degeneracy, but frequently that of an acquired character, especially paresis, facial hemiparesis, slight exophthalmia (see [Fig. 6]), inequality of the pupils, insensibility to touch and pain, which is often unilateral, especially in the tongue, thermoanalgesia, hyperæsthesia, experienced at various points not corresponding to the nervous territories and modified spontaneously or by esthesiogenic agents (Grasset), alphalgesia (sensation of pain at contact with painless bodies), a deficiency of urea in the urine, out of proportion to the general state of nourishment, and a proneness of the symptoms to return after trauma, poisoning, agitation, or serious illness.
The gravest phenomena, however, are atrophy or degeneration in the liver, heart, stomach, seminal canaliculi, and central nervous system, which give rise to serious functional disturbances; most of all, in the digestion—as manifested by the characteristic gastric catarrh, matutinal vomit and cramp—and in the reproductive system, with resulting impotence.
Psychic Disturbances—Hallucinations. The most frequent and precocious symptoms are delusions and hallucinations, generally of a gloomy or even of a terrible nature, and extremely varied and fleeting, which, like dreams, in nearly every instance arise from recent and strong impressions. The most characteristic hallucinations are those which persuade the patient that he experiences the contact of disgusting vermin, corpses, or other horrible objects. He is gnawed by imaginary worms, burnt by matches, or persecuted by spies and the police.
Fig. 16
Italian Criminal
A Case of Alcoholism
(see [page 82])
The strange pathological conditions resulting from chronic alcoholism give rise to other fearful hallucinations. Cutaneous anæsthesia and alcoholic anaphrodisia make the sufferers fancy they have lost the generative organs, nose, legs, etc.; dyspepsia, exhaustion, and paresis, that they have been poisoned or are being persecuted. The reaction following excessively prolonged stimuli causes furious lypemania and gloomy fancies. Sometimes chronic inebriates believe that they are accused of imaginary crimes and loaded with chains amid heaps of corpses. They implore mercy and try to kill themselves in order to escape from their shame; or they remain motionless, bewildered, and terrified. Not infrequently, because of the profound faith, which, unlike many other lunatics, they have in their hallucinations, they pass from melancholy broodings to a fit of mad energy, often of a homicidal or suicidal nature. They imagine they are struggling with thieves or wild beasts and hurl themselves from the window or rush naked through the streets, killing the first person that crosses their path. In some, this delirium of energy breaks out suddenly like an epileptic attack, which it resembles in its brevity and intensity. With hair standing on end, they rush about like savage beasts, grinding their teeth, biting, rending their clothes, or tearing up the sod, or hurling themselves from some height. These symptoms are preceded by vertigo, periodical cephalalgia, and flushing of the face, and are manifested more frequently by those who are already predisposed through trauma to the head, or through typhus or heredity, or after great agitation and prolonged fasting, and often bear no relation to the quantity of alcohol imbibed, which may be small, or to the general physical state; but depend on cerebral irritation caused by chronic alcoholism. The attacks may disappear in a few hours without leaving the slightest recollection in the mind of the patient (Krafft-Ebing, p. 182). They are, in short, a species of disguised epilepsy, and thus they may well be styled, since true alcoholic epilepsy is noted in many inebriates, specially in absinthe-drinkers.
Apathy. Another characteristic almost invariably found in inebriates who have committed a crime, is a strange apathy and indifference, a total lack of concern regarding their state—a trait common also to ordinary criminals, but in a less marked degree. They make themselves at home in prison without showing the faintest interest in their trial or in the offence which has caused their arrest, and only when brought before the judge do they rouse themselves for a moment from their lethargy.
A well-educated man, after a varied career as doctor, chemist, and clerk, during which time he had been constantly dismissed from his posts for drunkenness, met a policeman in the street and killed him, in the belief that the officer wanted to arrest him. When taken to prison, the first thing he did was to write to his mother begging her to send him some pomade. When interrogated, he informed the examining magistrate that the interrogatory was useless, since he had already chosen a fresh trade, that of photographer. It was only after several months of total abstinence in prison, that he began to come to his senses and to realise the gravity of his situation. (Tardieu, De la Folie, 1870.)