Evening star. [volume] (Washington, D.C.) 1854-1972, 1876-01-29
/. DRINK or DYfnxo

The British Medical Journal makes room
Tor the following: "In several articles we
nave insisted on the difficulty there fire.
quently is In the diagnosis between intoxi-
catlon and fatal apoplexy. In particular we
have stated that apoplexy from cerebral
hemorrhage initiates not only the comatose
stage OF drunkenness, but occasionally what
we call the 'uproarious' stage. A recent case
exemplihes this remark. A gentleman was
found lying In gutter by policeman, AID,
Tor your uncle and also said part of the
Lords Prayer, he was supposed TO be drunk,
and was taken to the police Office. Later on |,
as ne seemed TO be in a fit, he was sent to
hospital. and died there next morning Of
apoplexy from disease of the brain. whether
that apoplexy was owing TO cerebral or
RnaW ghe aaetamo5rhage or we do not
est when there is no history, in hospital
and In police cases. The apopi1etic patient,
from the text books point of view,
circumstances in which the diagnosis,
SO far as to exclude drunkenness, is ready
made. In hospital and police practice, the
history Is too often like that OF this poor
gentleman, he is found IN a gutter insensi-
bic or uproarious. But Tot only may a pa
tlent be violent in cases OF apoplexy to be
sppare,lx deeo oHs he ay, when 0tnerwse
crate actions. Wemust be on our guard not
To be misled by these cases. Let us mention
one or two casea of automatic actions occur
ring during coma. We have never seen ac-
lions so striking as that OF singing q comic
song In case of apoplexy. The .suggestion"
OF the particular action often seems TO be
given by what the patient was doing when
his illness set in. Thus, a woman who hal
fractured her skull by falling down stairs
while she was laying down some Oil cloth,
kept arranging the cOunterpane when partIy
inkenslble; she died in q few hours. We have
seen n lady who during otherwise deep coma
would elaborately sponge her face when the
sponge was pot into her right hand, and this
only few hours before her death. By the
way, this lady's symptoms al the onset were
10 The popular mind SO like those OF drunk
enness, that she was hailed by the street
boys, "See the drunken lady,"when she wa
prought out or the house where she was tirst
ttlKen. sometimes the automatic action is
tne survival OF deeply organized habit.
Dr. Hughlings Jackson has recorded the casa
OF n man who during fatal coma elaborated v
tWiTled his moustache. 1t was forwards
found that this was q very Common trick of
his. He had been a soldier. We consider II
great misfortune that such cases are often
looked on as mere scientific curiosities, and,
again, that comparative study Is not mad
or the effects OF alcohol, epilepsy, and other
conatizing agents. We may refer our read
ers 10 two articles in this journal on the
comparative study of drunkenness. Wenow
insist, again, that the performance Of very
elaborate actions may be seen in cases of
apoplexy to be speedily fatal; they occur,
too after epileptic seizures, and after drink :
Ing. Hence, difficulties in diagnosis. The
cases are illustrative OF Laycock's doctrine
OF the reflex function Of the brain. A care
ful study OF automatic actions occurring in
numerous cases Of insensibility from various
causes, by the light of several princi ri IS
enunciated long ago by Laycock, would be
very profitable, not only as the means Of in
vestigating important problems In that
which is commonly called the sphysiology
OF mind but for the directly utilitarian pur-
poses OF diagnosis and prOgnosis.n