The Sunday telegram. [volume] (Clarksburg, W. Va.) 1914-1927, 1916-01-23

THAT delirium tremens is the direct
result OF overindulgence in alcohol is
wen understood. But how does over
indulgence act? And why should some
hard drinkers never "see snakes"
Z while other and much milder victims
! ,isualize them to such degree that
loss OF life follows! theories OF de-
| lirlum tremens are not wanting; but
! they are so many as to indicate that
the truth is yet undiscovered in its
completeness. says the Journal OF the
! American Medical Association. There
! appears to be an interesting. though
| disauieting, reason for revival OF re-
search in the subject just now. The
! writer tells us that since the Harri-
! son narcotic law went into effect many
I drug habitues. having exhausted their
supply and failing to obtain more,
have turned to alcohol as substitute.
| In some who had been drinking for
years the sudden and marked increase
in the amount of liquor consumed
! has led to the frequent occurrence OF
! delirium tremens. After noting that
Chronic alcoholic poisoning produces
well known changes in the central and
I peripheral nervous system" he adds,
! in substance:
( ,'As yet, however, no changes have
bes3 found in the brain which explain
1 why man who has been drinking for
/; MRS suddenly develops delirium
| which runs a definite course OF from
I three to five days or even LANCER.
at has been thought that delirium
| tremens is an acute Injection occur
ring in chronic alcoholics. Neverthe-
less, many cases run their entire
course without fever, and Nome found
blood cultures negative in fifteen con-
secutive cases examined by him. Doel-
ken belives that continued drinking
of alcohol results in the production
OF a poisonous substance in the brain
itself, and that an accumulation or
concentration of this substance pro-
duces delirium tremens. Jacobson
explains the delirium as an autoin-
toxication, the toxin arising from the
pneumococcus gaining entrance
through the liver, the kidney, or the
intestinal tract, and acting on brain
! which has been poisoned over long
period Of time by alcohol. The view
! of Hertz differs from this in that the
supposed poison which precipitates
the delirium comes from an insult
ticiency on the part Of the kidney.
/ According to Bonhoeffer, chronic al
iteration in the intestinal tract Is re-
sponsible for the elaboration OF poison
which is normally excreted through
: the lungs. Wagner Won Jauregg be-
lieves that the liver, rather than the
lungs, is the organ which fails to
eliminate the poison. and he thinks
that this failure is due to the changes
occurring in the liver in chronic al
coholism. Kaufman has asserted
that this poison is carbon deriva-
tive acting on a medulla altered as a
result Of chronic alcoholism. He be-
lieves that the delirium will persist
until the production Of this carbon
derivatiye stops"
All OF these theories presuppose a
poisoned central nervous system. 1t
has been objected, however, that
many chronic drinkers never suffer
delirium. 1t has been suggested that
different poisons may result from ex-
cessive drink and that only one OF
these may cause delirium tremens.
There are, however still other theo-
ries:
"The possibility that delirium is due
to an increase in the pressure and
amount Of the spinal fluid has recent
ly been considered. Jauregg, Of Vi
emma, assumes that the body OF the
chronic alcoholic protects itself by
the production Of an anti-alcohol
which is of the nature of an antitoxin.
When a hard drinker suddenly stops
taking alcohol this anti-alcoholic sub
stance, having no alcohol to which
to affix itself, acts on the body in such
a manner as TO produce delirium tre-
mems. Hare maintains that the de-
yelopment of delirium is due to a
sudden fall in the amount OF alcohol
circulating in the blood of alcoholics.
His evidence is drawn from study Of