Diseased cravings and paralysed control : dipsomania, morphinomania, chloralism, cocainism / by T.S. Clouston.

  • Thomas Clouston
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Diseased cravings and paralysed control : dipsomania, morphinomania, chloralism, cocainism / by T.S. Clouston. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    2/46 page 690
    of simple mania by the dozen where excessive drinking was one of the earliest and most pressing symptoms. I had one case of irregular folia circulaire, amongst many such, whose excited period always began by excessive brandy drinking in company, and whose melancholic period was always liable to heavy solitary drinkiim to relieve his mental pain; who actually brought on short attacks of delirium tremens when suffering from simple mania on two occa- sions by such morbid drinking; who certainly could not control his craving; in whom the keeping drink from him was the most troublesome and difficult, but yet a perfectly essential, part of his treatment, and in whom this restraint from drink, I had reason to believe, shortened the attack of maniacal elevation. His reason- ing was very acute, he had almost no delusions, and he was perfectly coherent. Why was he not then a dipsomaniac ? Simply because I had clear evidence that a morbid brain elevation pre- ceded the tendency to drink; that he had lost control in many directions besides drinking; that he was changed intellectually, affectively, and morally; and, in brief, looking at his case clinically as a whole, that it was one of folio circulaire. Cases of this kind, or those subject to periodic or occasional recurrences of simple brain exaltation, are very common, and only some of them have drinking as a symptom. They should all be excluded from the category of dipsomaniacs. Then we have many cases of simple melancholia in which drinking is a symptom. The patients find that its effect on their brain is to deaden their mental pain, and to substitute for it a kind of transitory happiness, or confusion, or a partial lethargy. As a part of their melancholia, their inhibition is lessened, and so the desire for drink for this purpose cannot be resisted. The longer it is taken, the less becomes the power of control. But the direct effects of alcohol and all such substances that act specially on the functions of the higher brain centres being to lessen inhibition by constant use, a positive craving is soon set up. I had one such patient, who, on each of the many attacks of simple melancholia she had, became to her husband and to her doctor “ a dipsomaniac ” in this way. But, in my judgment, she suffered from melancholia, and her taking to drink at first was a deliberate attempt at self-therapeutics. There was not to begin with a craving for drink at all. My reasons for this conclusion were that the symptoms began by mental pain, a suicidal feeling, morbid suspicions, loss of power to do or think of work, lack of interest in everything, a conscious loss of affection for her husband and children, sleeplessness, loss of appetite, and falling off in flesh,— all these preceding the drinking. Then the symptoms, under proper treatment, ran the course of an ordinary case of melan- cholia. Clinically it was melancholia, not dipsomania. I have another case of melancholia in my mind that has become chronic, where all along a craving for drink is a symptom,
    No text description is available for this image
    No text description is available for this image
    No text description is available for this image