may be well to notice. Thus, occasionally after the phenomena of ordinary intoxication have gone on gradually increasing without having attained a very great height, sudden lethargy supervenes at once, and may prove fatal with singular rapidity. My colleague, Dr. Alison, has communicated to me the particulars of a case of the kind where death took place from simple intoxication, twenty minutes after the state of lethargy began. The individual reached his home in a state of reeling drunkenness, but able to speak and give an indistinct account of himself. He then became lethargic, and died in the course of twenty minutes. On examining the body, Dr. Alison could not discover any morbid appearance, except some watery effusion on the surface of the brain and in the ventricles; but the contents of the stomach had a strong smell of spirits. Instances of such excessive rapidity, however, are rare, unless from the third form of poisoning.—An anomaly of a different kind, of which a remarkable example was brought judicially under my notice, is sudden supervention of deep insurmountable stupor, without the usual precursory symptoms, yet not till after a considerable interval subsequently to drinking. In May, 1830, a lad of sixteen, in consequence of a bet with a spirit-dealer, swallowed sixteen ounces of whisky in the course of ten minutes, and, pursuant to the terms of the wager, walked up and down the room for half an hour. He then went into the open air, apparently not at all the worse for his feat; but in a very few minutes, while in the act of putting his hand into his pocket to take out some money, he became so suddenly senseless as to forget to withdraw his hand, and so insensible that his companions could not rouse him. A surgeon, who was immediately procured, contented himself with giving several clysters and a dose of tartar-emetic, which did not operate; and the young man died in the course of sixteen hours. The cause of the retardation of the symptoms was partly perhaps that he had taken supper only an hour before drinking the spirits, but chiefly, I presume, because the stupor was kept off for a time by the stimulus of determination to win his bet.—Several cases somewhat similar have been described by Dr. Ogston. In these sudden insensibility came on while the individuals had been drinking freely for some time, without showing any marked sign of approaching intoxication.[1] The cause of the postponement and sudden invasion of the stupor does not exactly appear; but a familiar cause of its abrupt invasion in ordinary cases of drunkenness is sudden exposure to cold.
It is impossible to fix the extremes of duration of the present form of poisoning in fatal cases. For, on the one hand, one or other of the accidents mentioned above may bring the case to a speedy close; and, on the other hand, the supervention of apoplexy may protract it to several days. The ordinary duration in fatal cases seems to be from twelve to eighteen hours.
3. The third degree of poisoning is not so often witnessed, because, in order to produce it, a greater quantity of spirits must be swallowed
- ↑ Edin. Medical and Surg. Journal, xl. 278.
