Ogston has tried to group these several symptoms together in classified cases; but the general conclusions at which he arrives are subject to important exceptions. Neither do any of the special symptoms seem to bear a marked relation to the ultimate event. It is peculiarly worthy of remark, that very many cases got well where the pupils were much dilated, the coma profound, and the pulse imperceptible.
In the present form of poisoning with alcoholic fluids, it usually happens that if the stage of stupor be completely overcome, recovery speedily ensues, without any particular symptom except headache, giddiness, sickness, and the customary consequences of a debauch. Hut on some occasions the comatose stage is succeeded by one which indicates much cerebral excitement,—by flushed face, injected eyes, restlessness, a febrile state of the pulse, and delirium, even of the violent kind. In other cases this affection puts on very much the characters of a slight attack of typhoid fever.
In the second variety of the second degree of intoxication, an apoplectic disposition is called into action by the excited state of the circulating system; and death ensues from apoplexy or some other disease of the brain, rather than from simple poisoning. Thus in some instances, as will be more fully mentioned under the head of the morbid appearances, extravasation of blood is found within the head after death, preceded by the usual phenomena of ordinary intoxication. Since this is a rare effect of intoxication, it must be considered as the result of poisoning with spirits, exciting sanguineous apoplexy in a predisposed constitution. In other cases the stupor of intoxication, after putting on all the characters of apoplexy for two days and upwards, terminates fatally without extravasation. Here the poison operates by developing a constitutional tendency to congestive apoplexy. Again, this mode of action is still more clearly shown in some cases, where an interval of returning health occurs between the immediate narcotic effects of the poison and the ultimate apoplectic coma which is the occasion of death. Such a course of events, which, however, is of rare occurrence, is well exemplified in the following cases. A man drank 32 ounces of rum one afternoon, and was comatose most of the ensuing night. Next morning, though very drowsy, he was sensible when roused; and in the evening he was considered convalescent. But two days afterwards he became delirious; in two days more he died comatose; and congestion was the only appearance found in the brain.[1] Another instance, most remarkable in its circumstances, is the following, which has been related by Dr. Golding Bird. A workman in a distillery, after drinking eight ounces of rectified spirit by mistake for water, suddenly fell down senseless and motionless, and remained so for eleven hours. He then began to recover, and came round so far that he returned to his work next morning. After this he continued to pass dark, pitch-like evacuations. In three weeks he became drowsy, mistook one thing for another, answered questions sluggishly,
- ↑ Cooke on Nervous Diseases, i. 219.
