IV. From Nitrous Oxide.—Though the inhalation of this gas is seldom attended with any risk, yet, in very plethoric habits, there might be a determination of blood to the head, sufficient to produce apoplexy. If a person, therefore, becomes, after the experiment, convulsed, stupified, and livid in the countenance, and if these symptoms do not soon wear away, some means must be adopted for their removal. In general, a free exposure to fresh air, and dashing cold water over the face, will be quite sufficient; but if the affection is so obstinate as to resist this plan, it will then be necessary to draw some blood from the arm, or, what is still better, from the jugular vein. When, in delicate subjects, hysteria and other nervous symptoms are produced, blooding is not necessary; all that is requisite to be done being the application of cold water to the brow or temples, and of hartshorn to the nostrils. In obstinate cases, twenty or thirty drops of the latter in a glass of water, may be administered with advantage.
CHAPTER X.
PATHOLOGY OF DRUNKENNESS.
The evil consequences of drinking, both in a physical and moral point of view, seem to have been known from the most remote antiquity. They are expressly mentioned in Scripture; nor can there be a doubt that the Homeric fiction of the companions of Ulysses being turned into swine by the enchanted cup of Circe, plainly implied the bestial degradation into which men bring themselves by coming under the dominion of so detestable a habit. Having mentioned these circumstances in favour of the accuracy of ancient knowledge, we shall simply proceed to detail the effects of drunkenness, so far as the medical practitioner is professionally interested in knowing them. The moral consequences belong more properly to the legislator and divine, and do not require to be here particularly considered.
I. State of the Liver.—One of the most common consequences of drunkenness is acute inflammation. This may affect any organ, but its attacks are principally confined to the brain, the stomach, and the liver. It is unnecessary to enter into any detail of its nature and treatment. These are precisely the same as when it proceeds from any other cause. The inflammation of drunkenness is, in a great majority of cases, chronic; and the viscus which, in nine cases out of ten, suffers, is the liver.
Liquors, from the earliest ages, have been known to affect this organ. Probably the story of Prometheus stealing fire from heaven and animating clay, alluded to the effects of wine upon the human body; and the punishment of having his liver devoured by a vulture, may be supposed to refer to the consequences which men draw upon themselves by over-indulgence—this organ becoming thereby highly diseased. Man is not the only animal so affected. Swine who are fed on the refuse of breweries, have their livers enlarged in the same manner. Their other viscera become also indurated, and their flesh so tough, that unless killed early, they are unfit to be eaten. Some fowl-dealers in London are said to mix gin with the food of the birds, by which means they are fattened, and their livers swelled to a great size. The French manage to enlarge this organ in geese, by piercing it shortly after the creatures are fledged.[28]
Neither malt liquors nor wine have so rapid and decided an effect upon the liver as ardent spirits. Indeed, it is alleged, although I cannot go this length, that the wine that is perfectly pure does not affect the liver: and the fact of our continental neighbours being much less troubled with hepatic complaints than the wine-drinkers among ourselves, gives some countenance to the allegation; for it is well known that to suit the British market, the vinous liquors used in this country are sophisticated with brandy. In wine that is perfectly pure the alcohol exists in such a state of chemical combination, as greatly to modify its effects upon the system. In the wine generally to be met with, much of it exists mechanically or uncombined, and all this portion of spirit acts precisely in the same manner as if separately used.[29]
The liver is a viscus which, in confirmed topers, never escapes; and it withstands disease better than any other vital part, except, perhaps, the spleen. Sometimes, by a slow chronic action, it is enlarged to double its usual size, and totally disorganized, and yet the person suffers comparatively little. The disease frequently arises in tropical climates, from warmth and other natural causes, but an excess in spirituous liquors is more frequently the cause than is generally imagined.
The consequences which follow chronic inflammation of the liver, are very extensive. The bile, in general, is not secreted in due quantity or quality, consequently digestion is defective, the bowels, from want of their usual stimulus, become torpid. The person gets jaundiced, his skin becoming yellow, dry, and rough, and the white of his eyes discoloured. As the enlargement goes on, the free passage of blood in the veins is impeded, and their extremities throw out lymph: this accumulating, forms dropsy, a disease with which a great proportion of drunkards are ultimately more or less affected.