The disease generally comes on with lassitude, loss of appetite, and
frequent exacerbations of cold. The pulse is weak and quick, and the
body covered with a chilly moisture. The countenance is pale, there are
usually tremors of the limbs, anxiety, and a total disrelish for the
common amusements of life. Then succeed retching, vomiting, and much
oppression at the pit of the stomach, with sometimes slimy stools. When
the person sleeps, which is but seldom, he frequently starts in the
utmost terror, having his imagination haunted by frightful dreams. To
the first coldness, glows of heat succeed, and the slightest renewed
agitation of body or mind, sends out a profuse perspiration. The tongue
is dry and furred. Every object appears unnatural and hideous. There is
a constant dread of being haunted by spectres. Black or luminous bodies
seem to float before the person: he conceives that vermin and all sorts
of impure things are crawling upon him, and is constantly endeavouring
to pick them off. His ideas are wholly confined to himself and his own
affairs, of which he entertains the most disordered notions. He imagines
that he is away from home, forgets those who are around him, frequently
abuses his attendants, and is irritated beyond measure by the slightest
contradiction. Calculations, buildings, and other fantastic schemes
often occupy his mind; and a belief that every person is confederated to
ruin him, is commonly entertained. Towards morning there is often much
sickness and sometimes vomiting. This state generally lasts from four to
ten days, and goes off after a refreshing sleep; but sometimes either
from the original violence of the disease, or from improper treatment, it
proves fatal.
Such, in nine cases out of ten, is the character of delirium tremens.
Sometimes, however, the symptoms vary, and instead of a weak there is a
full pulse; instead of the face being pallid, it is flushed and the eyes
fiery; instead of a cold clammy skin, the surface is hot and dry. This
state only occurs in vigorous plethoric subjects. An habitually sober
man who has thoughtlessly rushed into a debauch, is more likely to be
attacked in this mariner than a professed drunkard. Indeed, I never met
with an instance of the latter having this modification of the disease.
When the patient perishes from delirium tremens he is generally carried
off in convulsions. There is another termination which the disease
sometimes assumes: it may run into madness or confirmed idiotism. Indeed,
when it continues much beyond the time mentioned, there is danger of the
mind becoming permanently alienated.
Subsultus, low delirium, very cold skin, short disturbed sleep,
contracted pupil, strabismus, rapid intermittent pulse, and frequent
vomiting, are indications of great danger. When the patient is affected
with subsultus from which he recovers in terror, the danger is extreme.
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