Maniacal symptoms have been reported from the use of various drugs, including iodoform, mercury, etc. Hasheesh dementia is not uncommon in the East. Acute delirium arises from hydrate of chloral and the preparations of opium analogous to acute alcoholic mania from excessive drinking, and chronic impairment from their prolonged use. Bromide of potassium rarely produces symptoms similar to those of mania; taken for a long time in even moderate doses, it tends to mental sluggishness, and in long-continued large quantities given uninterruptedly there is a danger of well-marked dementia.
All of these conditions may be prolonged beyond the usual action of the particular drug or give rise to symptoms in excess of those usually observed. The characteristic indications of the particular drug, sometimes marked by the combined use of several, will be found if they are carefully looked for.
The TREATMENT consists in breaking off the bad habit gradually or abruptly as each case may require, and in otherwise treating the persisting symptoms in accordance with the general principles already stated in considering the various mental diseases.
ALCOHOLIC INSANITY includes mental disorder from the use of alcohol in both the acute and chronic forms.
Acute alcoholic mania may come from a single excess in drinking, which in some individuals is always attended with maniacal symptoms. It may constitute the alcoholic trance described under the head of Transitory Insanity. From long drinking and exhaustion or by withdrawal of the accustomed stimulant we may have the familiar mania-a-potu or delirium tremens.
Under the prolonged use of alcohol primary delusional insanity, melancholia, mania, and dementia occur.
From long-continued drinking of alcohol, even to slight excess, for many years, it is rare not to find some mental impairment, if only an “uncontrollable violence of the instincts and emotions,” a sort of moral insanity.
The PROGNOSIS is more favorable than in most forms of insanity uncomplicated by the abuse of alcohol, especially in the case of primary delusional insanity, if the bad habits can be effectually corrected and if the alcoholic excesses have not been continued long enough to produce organic changes in the cerebral blood-vessels. In the latter case the dementia sometimes simulates that of general paralysis so closely as to be called pseudo-paralytic dementia from alcohol.
TREATMENT is rarely successful outside of some asylum.
SYPHILITIC INSANITY does not properly include those cases of mania, melancholia, and delusions of persecution of the ordinary type of which the exciting cause is found in the train of thought aroused and kept up by the consciousness of having contracted syphilis, but only such as depend upon the presence of the syphilitic poison in the system. There are no diagnostic marks to distinguish it from insanity not caused by syphilis, except in a certain proportion of cases of organic syphilitic disease of the brain.