The anatomy of drunkenness

by Robert Macnish

The jaundice of drunkenness is not an original disease, but merely a symptom of the one under consideration. A very slight cause will often bring it on; it is, consequently, not always dangerous. Dropsy is, for the most part, also symptomatic of diseased liver, but sometimes, more especially in dram-drinkers, it arises from general debility of the system. In the former case, effusion always takes place in the cavity of the abdomen. In the latter, there is general anasarca throughout the body, usually coupled with more or less topical affection. In every instance, dropsy, whether general or local, is a very dangerous disease.

II. State of the Stomach, &c.—Like the liver, the stomach is more subject to chronic than acute inflammation. It is also apt to get indurated, from long-continued, slow action going on within its substance. This disease is extremely insidious, frequently proceeding great lengths before it is discovered. The organ is often thickened to half an inch, or even an inch; and its different tunics so matted together that they cannot be separated. The pyloric orifice becomes, in many cases, contracted. The cardiac may suffer the same disorganization, and so may the œsophagus; but these are less common, and it must be admitted, more rapidly fatal. When the stomach is much thickened, it may sometimes be felt like a hard ball below the left ribs. At this point there is also a dull uneasy pain, which is augmented upon pressure.

Indigestion or spasm may arise from a mere imperfect action of this organ, without any disease of its structure; but when organic derangement takes place, they are constant attendants. In the latter case it is extremely difficult for any food to remain on the stomach; it is speedily vomited. What little is retained undergoes a painful fermentation, which produces sickness and heartburn. There is, at the same time, much obstinacy in the bowels, and the body becomes emaciated.

This disease, though generally produced by dissipation, originates sometimes from other causes, and affects the soberest people. Whenever the stomach is neglected, when acidity is allowed to become habitual, or indigestible food too much made use of, the foundation may be laid for slow inflammation, terminating in scirrhus and all its bad consequences.

Vomiting of bilious matter in the mornings, is a very common circumstance among all classes of drunkards. But there is another kind of vomiting, much more dangerous, to which they are subject; and that is when inflammation of the villous coat of the stomach takes place. In such a state there is not much acute pain, but rather a dull feeling of uneasiness over the abdomen, attended with the throwing up of a dark, crude matter, resembling coffee grounds. I have seen two cases in which the vomiting stopped suddenly, in consequence of metastasis to the head. In these, the affection soon proved fatal, the persons being seized with indistinctness of vision, low delirium, and general want of muscular power: the action of the kidneys was also totally suspended for three days before death. On examination, post mortem, there was effusion in the ventricles of the brain, besides extensive inflammation along the inner surface of the upper portion of the alimentary canal.

Bilious complaints, which were formerly in a great measure unknown to the common people, are now exceedingly common among them, and proceed in a great measure from the indulgence in ardent spirits to which that class of society is so much addicted.

There is nothing more indicative of health, than a good appetite for breakfast; but confirmed topers, from the depraved state of their stomachs, lose all relish for this meal.

Persons of this description are generally of a costive habit of body, but a debauch, with those who are constitutionally sober, is, for the most part, followed by more or less diarrhœa.

In the latter stages of a drunkard’s life, though he has still the relish for liquor as strongly as ever, he no longer enjoys his former power of withstanding it. This proceeds from general weakness of the system, and more particularly of the stomach. This organ gets debilitated, and soon gives way, while the person is intoxicated much easier, and often vomits what he had swallowed. His appetite likewise fails; and, to restore it, he has recourse to various bitters, which only aggravate the matter, especially as they are in most cases taken under the medium of ardent spirits. Bitters are often dangerous remedies. When used moderately, and in cases of weak digestion from natural causes, they frequently produce the best effects; but a long continuance of them is invariably injurious. There is a narcotic principle residing in most bitters, which physicians have too much overlooked. It destroys the sensibility of the stomach, determines to the head, and predisposes to apoplexy and palsy. This was the effects of the famous Portland Powder,[30] so celebrated many years ago for the cure of gout; and similar consequences will, in the long-run, follow bitters as they are commonly administered. Persons addicted to intemperance, have an inordinate liking for these substances; let them be ever so nauseous, they are swallowed greedily, especially if dissolved in spirits. Their fondness for purl, herb-ale, and other pernicious morning drinks, is equally striking.