DRUNKENNESS may be either an act or a habit, the latter consisting in frequent repetitions of the former. As an act it may be an accident, most usually arising from the incautious use of one or other of the commonly employed intoxicating agents; as a habit it is one of the most degrading forms of vice which can result from the enfeeblement of the moral principle by persistent self-indulgence.

Drunkenness is a mere complexity of symptoms which may arise from many different causes. To be drunk is simply to be apoplectic; and the close resemblance between the pathological and the toxic phenomena has been the cause of many untoward accidents. Cold alone may produce such peculiar effects that Captain Parry has said, in his Journal, "I cannot help thinking that many a man may have been punished for intoxication who was only suffering from the benumbing effects of frost; for I have more than once seen our people in a state so exactly resembling that of the most stupid intoxication, that I should certainly have charged them with that offence had I not been quite sure that no possible means were afforded them on Melville Island to procure anything stronger than snow water."

But, apart from the pathological causes of seeming drunkenness, this condition may be actually produced by a multitude of agents whose use is so wide-spread throughout the world as inevitably to lead to the belief that their moderate employment must subserve some important object in the economy of nature. Moreover, the physiological action of all these agents gradually shades into each other, all producing or being capable of producing consecutive paralysis of the various parts of the nervous system, but only in doses of a certain amount,—a dose which varies with the agent, the race, and the individual. Even the cup so often said to "cheer, but not inebriate," cannot be regarded as altogether free from the last-named effect. Tea-sots are well known to be affected with palpitation and irregularity of the heart, as well as with more or less sleeplessness, mental irritability, and muscular tremors, which in some culminate in paralysis ; while positive intoxication has been known to be the result of the excessive use of strong tea (Third Annual Report of the Massachusetts Board of Health, p. 129). In short, from tea to haschisch we have, through hops, alcohol, tobacco, and opium, a sort of graduated scale of intoxicants, which stimulate in small doses and narcotize in larger,—the narcotic dose having no stimulating properties whatever, and only appearing to possess them from the fact that the agent can only be gradually taken up by the blood, and the system thus comes primarily under the influence of a stimulant dose. In certain circumstances and with certain agents—as in the production of chloroform narcosis—this precursory stage is capable of being much abbreviated, if not altogether annihilated; while with other agents -- as tea -- the narcotic stage is by no means always or readily produced. It is well to remember, also, that there is not a shadow of proof that the moderate use of any one of these agents as a stimulant has any definite tendency to lead to its abuse; it is otherwise with their employment as narcotics, which, once indulged in, is almost certain to lead to repetition, and to a more or less rapid process of degradation; but there are many exceptions to this latter statement. In regard to this matter it is interesting to know that opium, which, used in excess, is one of the most deleterious of these stimulants, is employed by 400,000,000, or nearly one-third of the whole human race, and that among these we have the Chinese, who almost to a man are opium smokers, and who nevertheless are well known to be one of the most frugal and industrious of peoples, "powerful, muscular, and athletic, and the lower orders more intelligent, and far superior in mental acquirements, to those of corresponding rank in our own country." It is also interesting to know that a late judge who lived to nearly ninety years of age believed he had prolonged his life and added greatly to his comfort by the moderate use of ether, which he was led to employ because neither wine nor tobacco agreed with him; while the immoderate use of the same agent has—particularly of late, and in the north of Ireland—given rise to a most deleterious form of drunkenness. And, however degrading, demoralizing, and pauperizing the vice of drunkenness may be, it is important to remember in all our thoughts concerning it, that it is the outcome of a craving innate in human nature, whether civilized or savage, and that there has been no period in the world’s history, and no nation on its surface, in which one or other, and often several simultants ously, of the many natural or artificial nervine stimulants have not been employed, and well it has been for those who have used them moderately. Two great influences have been regarded as of importance in regulating the prevalence of intemperance—temperature and race. Of these unquestionably race is by far the most influential. Within the isothermal lines of 77° Fahr. north and south of the equatorial line of 82° 4' Fahr. the mild native tribes seek their happiness in a quiet introspective self-complacency termed keyf, induced by opium or haschisch. Between the isothermal lines of 77° Fahr. and 50° Fahr, north and south lie those regions where the grape-vine grows luxuriantly, and in these riotous intemperance, though still comparatively rare, is no longer regarded as the disgraceful social crime it is looked on in the tropics ; while beyond the isotherms of 50° Fahr. north and south the vine is no longer grown, and the stronger beers and distilled spirits become the wide-spread sources of a deeper intoxication, which too often terminates in crime, a result almost unknown in southern latitudes. How much of this is actually due to the more highly intoxicating qualities of the fluids imbibed, and how much to what Parry would rightly have termed the intoxicating quality of the climate, has never been fairly ascertained ; but this much is known, that in these northern climes what is merely a stimulant dose in moderate weather becomes stupefying under the influence of cold;—not because cold increases the intoxicating power of any liquor, but because the previous excitement of the cerebro-spinal system produces a condition of functional exhaustion which makes it more readily succumb to the benumbing influence of cold,—renders it, as we say, more liable to become morbidly congested by the reflex action of cold applied to the surface.





But of the two great influences which regulate the prevalence of intemperance, that of race far exceeds that of temperature. A glance at the map of the world, coupled with some knowledge of its history, teaches us that, whether in temperate, subtropical, or tropical regions, wherever the Teuton is, there drunkenness prevails; and the wild orgies in which Tacitus tells us the Teuton of his day indulged in the cold climate of northern Europe are reproduced with wonderful circumstantiality irrespective of climate or temperature. It may be, as a recent speaker has said, that , "a national love for strong drink is a characteristic of the nobler and more energetic populations of the world ;" it may be, as he goes on to say, that it" accompanies public and private enterprise, constancy of purpose, liberality of thought, and aptitude for war; it," as be further adds, "exhibits itself prominently in strong and nervous constitutions, and assumes in very many instances the character of a curative of itself." In other words, in certain constitutions the moderate use of stimulants excites to action rather than to a sensual keyf, and the pleasurable stimulus of action renders such individuals less likely to fall into degrading habits of excess.

The effects of intoxicants are variously modified by the temperament of the individual and the nature of the inebriant. When that is alcohol, its action on an averace individual is first to fill him with a serene and perfect self-complacency. His feelings and faculties are exalted into a state of great activity and buoyancy, so that his language becomes enthusiastic, and his conversation vivacious if not brilliant. The senses gradually become hazy, a soft humming seems to fill the pauses of the conversation, and modify the tones of the speaker, a filmy haze obscures the vision, the head seems lighter than usual, the equilibrium unstable. By and by objects appear double, or flit confusedly before the eyes ; judgment is abolished, secretiveness annihilated, and the drunkard pours forth all that is within him with unrestrained communicativeness; be becomes boisterous, ridiculous, and sinks at length into a mere animal. Every one around him, the very houses, trees, even the, earth itself, seem drunken and unstable, he alone sober, till at last the final stage is reached, and he falls on the ground insensible—dead drunk—a state from which, after profound slumber, he at last awakes feverish, exhausted, sick, and giddy, with ringing ears, a throbbing heart, and a violent headache.

The poison primarily affects the cerebral lobes, and the other parts of cerebro-spinal system are consecutively involved, till in the state of dead-drunkenness the only parts not invaded by a benumbing paralysis are those automatic centres in the medulla oblongata, which regulate and maintain the circulation and respiration. But even these centres are not unaffected; the paralysis of these as of the other sections of the cerebro-spinal system varies in its incompleteness, and at times becomes complete, the coma of drunkenness terminating in death. More usually the intoxicant is gradually eliminated, and the individual restored to consciousness, a consciousness disturbed by the secondary results of the agent he has abused, and which vary with the nature of that agent. Whether, however, directly or indirectly, through the nervous system the stomach suffers in every case; thus nutrition is interfered with by the defective ingestion of food, as well as by the mal-assimilation of that which is ingested; and from this cause, as well as by the peculiar local action of the various poisons, we have the various organic degenerations induced which in most cases shorten the drunkard’s days.

The primary discomforts of an act of drunkenness are readily removed for the time by a repetition of the cause. Thus what has been an act may readily become a habit, all the more readily that each repetition more and more enfeebles both the will and the judgment, till they become utterly unfit to resist the temptation to indulgence supplied by the knowledge of the temporary relief to suffering which is sure to follow, and in spite of the consciousness that each repetition of the act only forges their chains more tightly. From this condition there is no hope of relief but in enforced abstinence ; any one in this condition must be regarded as temporarily insane, and ought to be placed in an inebriate asylum till he regain sufficient self-control to enable him to overcome his love for drink. The desire for stimulants is one of the strongest instincts of human nature. It cannot be annihilated, but may be regulated by reason, conscience, education, or by law when it encroaches on the rights of others or is injurious to the individual himself. By the Intoxicating Liquors Licensing Act of 1872 any one found drunk on a highway or public place or in a licensed house is liable to a fine of 10s., on a repetition of the offence within twelve months to one of 20s., and on a third offence within twelve months to one of 40s. To be drunk or riotous, or to be drunk while in charge of a horse, a carriage, or a gun is punishable with a fine of 20s. or imprisonment for one month. And by the Police and Improvement Act of Scotland, 25 and 26 Vict. c. 101, § 254, persons found drunk on the streets are subject to a fine of 40s. or 14 days’ imprisonment, wherever that Act has been adopted. These Acts, properly enforced, ought to restrain the public exhibitions of drunkenness; while for those seasoned easks who ruin their own health and pauperize their families, without perhaps ever appearing in public offensively drunk, the only remedy which appears to promise hope of reform would seem to be the power of temporarily consigning them to an inebriate asylum. (G. W. B.)






The above article was written by George William Balfour, LL.D., M.D.; formerly senior physician, Edinburgh Royal Infirmary; translated Casper's Handbook of Forensic Medicine; author of An Introduction to the Study of Medicine and Clinical Lectures on Diseases of the Heart.