Alcoholism.  Acute Symptoms.—­The face is flushed, the breath has the odor of liquor, the pulse is full and bounding with deep respiration.  Reason, memory, judgment and will are first stimulated and then blunted.  The drinker’s peculiarities are exaggerated, the person becoming affectionate or quarrelsome.  There is a loss of coordination as shown by the staggering, swinging, the relaxation of the muscles, and finally deep sleep, with snoring breathing.  The person is unconscious, but can be partly aroused and will mutter when questioned or disturbed.  The pupils are contracted or dilated, and they will dilate when the face is slapped.  The urine is increased, but it is often retained.

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Chronic alcoholism.—­This results from protracted or periodic “sprees.”

Symptoms.—­The face is red, the capillaries are dilated, eyes are watery, conjunctiva is congested.  There is chronic inflammation of the stomach, which is characterized by morning vomiting; there is often hardening of the liver, trembling of the hands and tongue; the memory is weakened and judgment and will as well, especially until a stimulant has been taken; often the person is irritable, careless, with loss of moral sense and in extreme cases dementia.  Peripheral neuritis is more common in men than in women.  It begins with sharp pain and tingling in the feet and hands; paralysis affects the lower extremities, then the upper, and is most marked in the further muscles of the limbs.  The pain may be very severe, with great tenderness.  There is Arteriosclerosis (hardening of walls of the arteries); often heart dilation.

Delirium tremens.—­This is a brain manifestation of chronic alcoholism occurring in steady drinkers after excessive drinking or sudden withdrawal of alcohol, or after sudden excitement or accident, pneumonia or other illness, or lack of food.

Symptoms.—­There are restlessness, insomnia (sleeplessness), mental depression, then active delirium with great restlessness, talking, muttering, hallucination of sight and hearing.  He thinks he sees objects in the room such as rats, mice, or snakes, and fancies that they are crawling over his body, has them in his boots, etc.  The terror inspired by these imaginary objects is great, and has given the popular name of “horrors” or “snakes” to the disease.  You must watch the patient constantly, or he may try to jump out of the window or escape.  The patient may think he hears sounds and voices, threats of imaginary enemies.  There is much muscular “shakings,” the tongue is coated with a thick white fur and, when protruded, trembles.  The pulse is rapid and soft, sleeplessness is a constant feature.  Favorable cases improve in the third or fourth day, the restlessness abates, the patient sleeps and the improvement sets in.  The shakings persist for some days, the hallucinations disappear gradually, and the appetite returns.  In the more serious cases, the sleeplessness (insomnia) persists, the delirium is incessant, the pulse becomes more frequent and feeble, the tongue dry, the prostration is extreme and death takes place from gradual heart failure.