Page:Treatise on poisons in relation to medical jurisprudence, physiology, and the practice of physic (IA treatiseonpoison00chriuoft).pdf/732

 giddiness, confusion of thought, delirium, and various mental affections, varying with individual character, and too familiar to require description here. These symptoms are soon followed by dozing and gradually increasing somnolency, which may at length become so deep as not to be always easily broken. After the state of somnolency has continued several hours, it ceases gradually, but is followed by giddiness, weakness stupidity, headache, sickness, and vomiting.

This degree of injury from alcohol may prove fatal, either in itself, by the coma becoming deeper and deeper,—or from the previous excited state of the circulation causing diseases of the brain in a predisposed habit,—or more frequently from the occurrence of some trifling accident, which in his torpid state the individual cannot avoid or remedy, such as exposure to cold, falling with the face in mud or water, suffocation from vomited matters getting into the windpipe, and the like.

Of simple poisoning by the gradual increase of coma the following judicial case in which I was consulted is a characteristic example. Two brothers drank in half an hour three bottles of porter, with which three half-mutchkins (24 ounces) of whisky had been secretly mixed by a companion, whose object was to fill them drunk by way of joke. In the course of drinking both became confused. In fifteen minutes after finishing the last bottle one of them fell down insensible, and had no recollection of what happened for twelve hours; but he recovered. The other staggered a considerable distance for an hour, and then became quite insensible and unable to stand. In four hours more consciousness and sensibility were quite extinct, the breathing stertorous and irregular, the pulse 80 and feeble, the pupils dilated and not contractile, and deglutition impossible. In this state he remained without any material change till his death, which took place in fifteen hours after he finished his debauch. A surgeon saw him when he had been five hours ill, but did little for his relief, as the case appeared hopeless.

There is a singular variety in the principal symptoms of this form of poisoning, even when completely formed. From a careful tabular analysis of no fewer than twenty-six cases, chiefly of the present denomination, collected by Dr. Ogston of Aberdeen from the experience of the police-office there, it appears that when the stage of stupor is fully formed, the person is sometimes capable of being roused, sometimes immovably comatose for a long time,—that the pulse is sometimes imperceptible or very feeble, sometimes distinct or even full, generally slow or natural, seldom frequent, very seldom firm,—that the pupils are occasionally contracted, much more generally dilated, and in a few instances alternating between one state and the other,—that the countenance is commonly pale, sometimes turgid and flushed,—and that the breathing is for the most part slow, and also soft, yet not unfrequently laborious, but very rarely stertorous. Convulsions are rare, having been observed twice only, and on both occasions in young people of the age of twelve or fourteen. Dr.