The anatomy of drunkenness

by Robert Macnish

There is nothing which has so strong a tendency to dispel the effects of a debauch as hard exercise, especially if the air be cold. Aperients and diaphoretics are also extremely useful for the same purpose.

For some days after drinking too much, the food should be light and unirritating, consisting principally of vegetables. Animal food is apt to heat the body, and dispose it to inflammatory complaints.[27]

II. From Opium.—When a dangerous quantity of opium has been taken, the treatment, in the first instance, is the same as with regard to spirits, or any other intoxicating fluid. Immediate vomiting, by the administration of similar emetics, is to be attempted, and when it has taken place, it should be encouraged by warm drinks, till there is reason to believe that the stomach has been freed of the poison. These drinks, however, should not be given before vomiting is produced, for, in the event of their failing to excite it, they remain upon the stomach, and thus dissolve the opium and promote its absorption. But when vomiting occurs from the action of the emetics, it will in all probability be encouraged by warm drinks, and the stomach thus more effectually cleared of the poison. Large quantities of a strong infusion of coffee ought then to be given, or the vegetable acids, such as vinegar or lemon-juice, mixed with water. These serve to mitigate the bad consequences which often follow, even after the opium has been brought completely up. If the person show signs of apoplexy, more especially if he be of a plethoric habit, the jugular vein, or temporal artery should be opened, and a considerable quantity of blood taken away. Indeed, it may be laid down as a general rule, that as soon as the poison is rejected, the patient ought to be bled, and the operation should be repeated according to circumstances. Every means must be used to arouse him from stupor. He must be moved about, if possible, from room to room, hartshorn applied to his nostrils, and all plans adopted to prevent him from sinking into lethargy. For this purpose, camphor, asafœtida, or musk, might be administered with advantage. It is also a good practice to sponge the body well with cold water; and the affusion of cold water on the head and over the body, is still more effectual. In cases where vomiting cannot be brought about by the ordinary means, M. Orfila suggests that one or two grains of tartar emetic, dissolved in an ounce or two of water, might be injected into the veins. In desperate cases, the stomach pump must be had recourse to. Purgatives are latterly necessary.

Many practitioners consider vinegar and the other vegetable acids antidotes to opium. This opinion M. Orfila has most satisfactorily shown to be erroneous. In a series of well-conducted and conclusive experiments made by him, it appears that the vegetable acids aggravate the symptoms of poisoning by opium, whenever they are not vomited. They hurry them on more rapidly, render them more violent, produce death at an earlier period, and give rise to inflammation of the stomach—an event which hardly ever occurs when they are not employed. These effects, it would appear, are partly produced by their power of dissolving opium, which they do better than the mere unassisted fluids of the stomach; consequently the absorption is more energetic. The only time when acids can be of use, is after the person has brought up the poison by vomiting. They then mitigate the subsequent symptoms, and promote recovery; but if they be swallowed before vomiting takes place, and if this act cannot by any means be brought about, they aggravate the disorder, and death ensues more rapidly than if they had not been taken.

Coffee has likewise a good effect when taken after the opium is got off the stomach; but it differs from the acids in this, that it does not, under any circumstances, increase the danger. While the opium is still unremoved, the coffee may be considered merely inert; and it is, therefore, a matter of indifference whether at this time it be taken or not. Afterwards, however, it produces the same beneficial effects as lemonade, tartaric acid, or vinegar. According to Orfila, the infusion is more powerful as an antidote than the decoction.

Drunkenness or poisoning from the other narcotics, such as hemlock, belladonna, aconite, hyoscyamus, &c., is treated in precisely the same manner as that from opium.

III. From Tobacco.—If a person feel giddy or languid from the use of this luxury, he should lay himself down on his back, exposed to a current of cool air. Should this fail of reviving him, let him either swallow twenty or thirty drops of hartshorn, mixed with a glass of cold water, or an ounce of vinegar moderately diluted. When tobacco has been received into the stomach, so as to produce dangerous symptoms, a powerful emetic must immediately be given, and vomiting encouraged by copious drinks, till the poison is brought up. After this, vinegar ought to be freely exhibited, and lethargy prevented by the external and internal use of stimuli. If apoplectic symptoms appear, blooding must be had recourse to. The same rule applies here, with regard to acids, as in the case of opium. They should never be given till the stomach is thoroughly liberated of its contents by previous vomiting.

Accidents happen oftener with tobacco than is commonly supposed. Severe languor, retching, and convulsive attacks sometimes ensue from the application of ointment, made with this plant, for the cure of the ring-worm; and Santeuil, the celebrated French poet, lost his life in consequence of having unknowingly drunk a glass of wine, into which had been put some Spanish snuff.