Dipsomania

“ They may show themselves in periodical acts, as in dipsomania. This condition differs from the condition called inebriety in the fact that it is a periodical expression of degeneracy whose form has been accidently determined, but which would exist even were its form changed. The differences are excellently outlined by Dana, [261] who divides intemperate drinkers into four classes: Periodical inebriates or dipsomaniacs, pseudo-inebriates, common drunkards and victims of delirium inebriosum. The disease in the first class is a periodical insanity. ”

“ The modern textbook of psychiatry has no chapter on dipsomania, nor does it recognise it as a distinct variety of insanity. Modern psychiatry recognises many forms of alcoholic insanity and it calls them alcoholic dementia, alcoholic pseudo-paresis, alcoholic pseudo-paranoia, alcoholic hallucinosis, etc. Dipsomania is used by the modern psychiatrist to indicate a periodical impulse to drink. So far as the writer knows, no one has ever denied that Edgar A. Poe had dipsomania. ”

“ The hospital for the insane is, however, preferred to the workhouse, as announcing less publicly the disgrace of the victim, and therefore it is that dipsomania is so often stretched into insanity. With some physicians inebriety is confounded with insanity, while others deny the existence of an insanity whose sign is a passion for drink, and accordingly [515] fail to distinguish dipsomania from drunkenness or crime. These points need not, however, be discussed in a lecture intended to treat the subject socially. Social science asks whether this inebriety is a crime or a disease. ”

“ The part that heredity plays in all functional diseases or states of the nervous system is not to be misunderstood. It is safe to assert that no idiopathic case of insanity, chorea, hysteria, megrim, dipsomania, or moral insanity, can occur except by reason of inherited predisposition. ”

“ Dipsomania, a rare manifestation of impulsive insanity, differs entirely from the acquired alcohol habit, drunkenness, acute or chronic alcoholism, delirium tremens, or habitual intoxication, all of which conditions are also more readily developed in the neuro-psychopathic constitution than in persons with healthy brains, and may reach a point constituting insanity. ”

“ The dipsomaniac is often to be found in the full vigor of youth; a man rejoicing in a magnificent physique, and showing no external signs of impairment. He may have talent and wit, and be high in the social scale. But behind the mask something is found to be lacking. His liver, clogged with fatty deposit, is disordered, the coats of the stomach are more or less burnt out, dyspeptic symptoms are apparent. The man becomes moody and irritable if deprived of his stimulant, while gout and neuralgia perhaps add themselves to the list of symptoms. ”

“ This supervision should be carried into adult years, for there are instances on record of inherited diseases coming on at an advanced age, as in that of a grandfather, father, and son, who all became insane and committed suicide near their fiftieth year. Gout, apoplexy, insanity, chronic disease of the heart, epilepsy, consumption, asthma, and other diseases, are all more or less under the control of preventive measures. Some hereditary diseases, such as idiocy and cancer, we are impotent to prevent, in the present state of our knowledge. ”

“ Black suggests that some of my arguments might be used to disprove the hereditary tendency of insanity and consumption. Before the doctor's friends permit him to undertake another pathological controversy, I would advise them to enlighten his mind on the difference between functional and organic disorders, and thus enable him to understand the reason why consumption or cancer, but not dyspepsia, can be called an hereditary disease, and why hereditary diseases and not dyspepsia reappear in successive generations at the same period of life when they were first contracted. ”

“ The insufficient nourishment of the mother during her pregnancy, and the insufficient nourishment of [661] the child during the first years of his life, are especially fatal to him. Then those who are badly fed are predisposed to tuberculosis, scrofula, and rickets, which, in their turn, may be the causes of degeneracy.595 Rickety women often have a contraction of the pelvis, which hinders child-birth, and may cause a lesion to the infant’s brain. Note, for example, the opinion of Dr. Näcke, who says: “The social misery, bad hygiene and food ... ”

“ Treating the Wrong Disease.—Many times women call on their family physicians, suffering, as they imagine, one from dyspepsia, another from heart disease, another from liver or kidney disease, another from nervous exhaustion or prostration, another with pain here or there, and in this way they all present alike to themselves and their easy-going and indifferent, or over-busy doctor, separate and distinct diseases, for which he prescribes his pills and potions, assuming them to be such, when, in reality, they are all only symptoms caused by some womb disorder. ”

“ What we know of the endocrine factors in heredity leads us to suppose that it is the mating of one marked endocrine insufficiency with another that is often responsible for the inherited tendency to feeble-mindedness and insanity. The effect of the hormone system upon the vegetative apparatus may create the more obscure insanities and quasi-insanities. The direct action of the internal secretions upon the brain cells, producing a sort of hair trigger situation within them, may cause the explosive discharges from them which appear as overpowering impulses or uncontrollable conduct. ”

“ Like monstrosity, morbid predisposition is the result of a disturbed evolution. In the same way as in families anomalies in form may manifest themselves in very diverse localizations, so anomalies in structure may be variously seated. It is thus comprehensible how, under the influence of the different conditions that usually provoke the manifestations of hereditary diseases—puberty, menopause, fatigue, physical or moral shocks, intoxications, or infections—we observe diverse affections appearing in the same family, but most usually bearing upon the same system. ”

“ But he who intends to stay has to make up his mind that recovery can not be hoped for till he has not only discontinued his drug, but expiated the burden of sin which the stimulant outrage has added to the original cause of the disease. Nature has to overcome the effects both of malnutrition and of malpractice. The drug has complicated the disease.
In childhood chronic dyspepsia is nearly always the effect of chronic medication. Indigestion is not an hereditary complaint. ”

“ Doctors assure us that savage nations, amidst whom the wants of life call for daily, hourly efforts, amidst whom all is exigency, activity, and resource, have no dyspepsia. If, then, I had reasoned on my condition,—which I did not,—I should have seen that the world went too smoothly with me, and that, in consequence, my health suffered. Just as the fish swallow stones to aid the digestion, we need the accidents and frictions of life to triturate our moral pabulum, and render it more easily assimilable to our constitutions. With dyspepsia I grew dull, dispirited, and dissatisfied. ”

“ At present our attempts to influence heredity should be limited to the heredity of disease only. We can certainly say that intermarriage between persons who have tuberculosis or in whose families the disease has prevailed is disadvantageous for the offspring; the same holds true for insanity and for nervous diseases of all sorts, for forms of criminality, for alcoholism, and for those diseases which are long enduring and transmitted by sexual contact such as syphilis and gonorrhoea. ”

“ There are other instances that might be cited, cases of dangerous organic disease, as cancer of the womb, in which, however improbable it might seem, pregnancy does occasionally occur; cases of insanity, of epilepsy, or of other mental lesion, where there is fear of transmitting the malady to a line of offspring; cases of general ill-health, where there is perhaps a chance of the patient becoming an invalid for life ”

“ Hereditary predisposition, mental worry, exhausting occupations, such as the sick-nursing of relatives, are the chief predisposing causes, while the direct exciting cause of the condition is due to the accumulation in the tissues of waste products, which so load the blood as to act in a toxic manner on the cells and fibres of the brain.
The onset of the disease is gradual and indefinite. The patient suffers from malaise, indigestion, constipation and irregular, rapid and forcible action of the heart. The urine become scanty and high coloured. ”

“ Society also utterly ignores the rights of unborn children in permitting the constant marriages of men and women having constitutions tainted with hereditary diseases, as insanity, syphilis, tuberculosis, etc.
[26] In Dipnoi, which are fishes with Amphibian characters, the paired fins have each a central segmented axis which bears on each side a series of radial pieces. The air bladder is a true lung, and is frequently used as such. The heart shows indications of becoming three chambered (two auricles and one ventricle) . The left auricle contains arterial blood from the lungs. ”

“ Heart disease, disease of the throat, excessive obesity, affections of the skin, asthma, disorders of the brain and nervous system, gout, rheumatism, and cancer, are all hereditary. A tendency to bleed frequently, profusely and uncontrollably, from trifling wounds, is often met with as a family affection.
The inheritance of diseased conditions is also influenced by the sex. A parent may transmit disease [Pg 149] exclusively to children of the same sex, or exclusively to those of the opposite sex. ”

“ A more delicate molecular shock during the maturation of the ovum, during its fertilisation, or finally during embryonic stages of the more complex, and therefore more readily disturbed and distorted human germ, accounts for the disastrous effect of insanity, emotion, or other mental or physical shock of the parent on the offspring. The cause of the majority of cerebral deformities exists in the germ prior to the appearance of the separate organs of the body. ”

“ But the tendency to dyspepsia in some families is even more literally hereditary than the diseases named, for every careful and wide-observing physician knows that the offspring of some parents, almost from the moment of birth, manifests a facility for indigestion from the most trifling indiscretions. Observant mothers know that their own or neighbors' children, all of like habits and conditions of life, are strikingly unequal in digestive strength. ”

“ Many people imagine that what is abnormal is necessarily diseased. That is not the case, unless we give the word disease an inconveniently and illegitimately wide extension. It is both inconvenient and inexact to speak of color-blindness, criminality, and genius as diseases in the same sense as we speak of scarlet fever or tuberculosis or general paralysis as diseases. Every congenital abnormality is doubtless due to a peculiarity in the sperm or oval elements or in their mingling, or to some disturbance in their early development. ”

“ As I said, he likes his glass of wine, and if he does not take care will come to like it too well. A doctor has no more immunity from dypso-mania than his patient. The former may inherit or acquire the disease as well as the latter."
"How does the doctor know that he has not from some ancestor this fatal diathesis? Children rarely if ever betray to their children a knowledge of the vices or crimes of their parents. The death by consumption, cancer or fever is a part of oral family history, but not so the death from intemperance. ”

“ That the systematic prevention of pregnancy, by whatever means, is also followed by prejudicial effects, affecting the nervous and the uterine systems, not unfrequently producing sterility from an organic cause, and laying the foundation of serious or incurable disease.
“8. That when such prevention is occasioned [Pg 106] by incompleted intercourse, by whatever means effected, the effect is equally bad for the husband’s health as for that of the wife—there resulting dyspepsia, functional or organic nervous disease, and at times impotence, temporary or persistent.” ”

“ Incapacity for bearing children can be acquired; it develops, however, abundantly on the grounds of a congenital predisposition.
4. In so far as the latter is the case, obstetrics contributes towards the diffusion of this incapacity.
[40]
5. The most serious obstacles to delivery are effected by deformities of the pelvis, in at least 90% of which heredity plays a part. In this connection, rickets, the predisposition to which is inherited, takes the foremost place.
6. German medical statistics make it appear probable that incapacity to bear children is on the increase. ”

“ It was found that they were nothing but the natural consequence of impure or imperfect blood, the result of malnutrition of the vital fluid, the malign effect of which increases in degree and manifestation the longer the impurity passes, by process of heredity, from one generation to another.
Instead of following the natural tendency to return to the normal, the blood becomes the fertile soil in which all manner of irregularities may germinate in abundance, and combine in strong attacks on the normal healthy organs, which will fast relax their natural power of resistance. ”