Griesinger saw excessive diabetes insipidus follow a prolonged and severe attack of acute alcoholism in a man twenty-eight years old, and terminate fatally in the course of four months. Ebstein attributes the polyuria of acute alcoholism to lesions of the brain.
Glycosuria is rare among drunkards.
The Bladder.—Catarrh of the bladder is not rare in chronic alcoholism, especially in that form originating from excesses in malt liquors. This condition, however, scarcely occurs with sufficient frequency to be regarded as in any sense a symptom of alcoholism.
The Genital Organs.—The subjects of alcoholism are especially prone to sexual disorders of all kinds—a fact to be explained by the influence of alcohol on the imagination, and especially upon the sexual appetite, its debasing effect on the moral sense and upon the judgment, and the indifference to the consequences of exposure which it begets. In the later stages of chronic alcoholism sexual power is apt to be greatly enfeebled or wholly lost. This condition, which is usually attended also by loss of sexual desire, is to be attributed to the action of alcohol upon the nervous system rather than upon the sexual organs themselves. It has nevertheless been established that long-continued alcoholic excesses are apt to be followed by atrophy of the testicles. Lancereaux has described a condition of these organs resembling in all respects senile atrophy. On the other hand, Huss attributed the impotence of alcoholic subjects to loss of nervous tone. In the female, alcoholism produces disturbances of menstruation and premature menopause. Alcoholic excesses are said also to produce a liability to abortion, and Lancereaux has observed atrophy of the ovaries in alcoholic subjects.
2. Disorders of Special Structures.—a. Disorders of the Locomotive Apparatus.—The muscles at large, like the heart, are liable to fatty infiltration and degeneration. Fatty infiltration, frequent at some period in the course of the affection, is apt to be widespread. The muscles are paler than normal, softer in consistence, and streaked with fat. True fatty degeneration is less frequent, and apt to be localized. Here the muscular fibres lose their striation, and present within the myolemma minute fatty deposits in the form of granules. This change is accompanied by atrophy. The symptoms consist in feebleness and difficulty in movement and in locomotion.
Changes in the bones, notably enlargement of and increase in the contents of the medullary canal in the long bones, and arthropathies of various kinds, have been observed in alcoholic subjects.
b. Disorders of the Skin.—Alcohol is a sudorific, and is largely eliminated by the skin. This effect is purely physiological; therefore the moderate and occasional use of alcohol exerts an influence rather favorable than otherwise upon the tegumentary structures, but in repeated excesses it gives rise to more or less cutaneous irritation. The skin, partly for this reason, and partly because it shares in the general disturbance of nutrition, becomes dry, harsh, and scaly; after a time the face, and especially the nose and neighboring parts, assumes in many instances a violaceous hue, the minute superficial cutaneous veins are enlarged, and acne is common. The resulting appearance is almost characteristic of the habits of the individual. Alcoholic subjects frequently suffer from pruritis, urticaria, and eczema. In certain cases the skin, instead of being dry and harsh, is soft and unctuous, and in others, especially in the more advanced cases, it becomes slightly yellow or earthy in hue. Owing in part to changes in the nutrition, and in part to vascular dilatation, the skin of the extremities is not rarely mottled and cyanotic. In certain forms of alcoholism of the nervous system, and particularly in alcoholic paralysis, in which we have to do with multiple peripheral neuritis, the skin of the affected parts, especially that overlying the atrophied muscles, becomes, in consequence of trophic changes, dusky in color and hard, smooth, and glossy. It has been stated that chronic alcoholism is a cause of pellagra, and numerous observations have been advanced in support of this view (Hardy). The excessive rarity of this condition in countries in which the abuse of alcohol is most common renders it probable that the occasional association of these affections is accidental rather than causal. Chronic alcoholism predisposes to gangrene of the skin and to bed-sores; slight wounds readily inflame and are slow to heal; alcoholic subjects are especially predisposed to erysipelas, while the enfeeblement of the circulation and the lowered tone in the later stages of chronic alcoholism often result in œdema of the inferior extremities.
3. General Disorders.—In addition to the various local disorders thus far described, the prolonged excessive indulgence in alcohol leads to profound disturbances of the processes of nutrition, which are manifested in alterations in the blood, in excessive accumulation of fat, and in a well-marked cachexia.
a. The Blood.—The alterations in the blood, although sufficiently manifest in disorders of nutrition, have not yet been studied with satisfactory results. In chronic alcoholism the proportion of water is increased, while that of fibrin is diminished. After death the blood remains fluid. The red globules are diminished in number. The blood also contains free fat, to which it owes its pale, opalescent, and sometimes almost milky hue. The presence of fat has been demonstrated after the injection of alcohol into the veins of animals.