ORIGINAL TRANSLATIONS FROJVTTHE FRENCH IN EVERY NUMBER OF THE 
NEW YORK MEDICAL ABSTRACT. 
DIPSOMANIA. 1/ 
BY PROFESSOR MAGNAW. 
resistance, she obtains a supply of liquor and 
locks herself up for the sole purpose of secret 
and unrestricted drinking. The melancholy 
continues to increase and symptoms of alco- 
holic poisoning appear. Hallucinations take 
the place of sleep ; she sees skulls with flaming 
eyes and hideous faces grinning at her ; objects 
j assume all colors by turns and dance around 
her bedside. Her skin is troubled with sensa- 
tions which she ascribes to vermin. The 
[ symptoms disappear in a few days and the 
patient remains sober perhaps for three months, 
without even a desire to drink. The odor of 
liquor then becomes so disagreeable as to be 
almost nauseating. The patient denies that 
she has a liking for drink. She says that she 
proceeds wholly against her will. “This is 
not,” she said to us, “a passion with me ; it is 
in spite of myself that I drink.” During the 
attack she becomes irritable and has rushes of 
blood to the head. In each succeeding seizure 
the impulse to drink is more imperative and 
the resistance less powerful. Of this particular 
case I am unable to speak with certainty con- 
cerning hereditary predisposition. Of 8 cases 
now with us, however, two receive the impulse 
from both parents and five from either the 
father or the mother. 
The term monomania,introduced into science 
to explain “a kind of mental alienation char- 
acterized by a partial obscuration of the in- 
telligence, of the affections, or of the will,” is 
daily losing its force. In a general way I 
reject monomanias absolutely, without deny- 
ing that certain impulses may be the most 
striking features in certain forms of insanity. 
But they can have only a symptomatic value. 
Monomania is but a mental condition in the 
midst of which a particular tendency manifests 
itself. It i- not the essential d'Cease, though 
it sometimes so dominates and absorbs the 
patient’s mind as to give his trouble a special 
appearance. Enough will be shown to prove 
that if the necessity of drinking is, in the 
dipsomaniac, the most striking act, it does not 
constitute the disease. It is an episodical 
syndrome of a more profound mental state 
which is governed by heredity. One of my 
patients had suicidal melancholia, followed in 
turn by religious mania, nymphomania and 
homicidal impulses. Observers should be able 
to understand from such a case that all of these 
manifestations, far from being monomanias, 
are different presentments of a single patho- 
logical state. 
Dipsomania is essentially intermittent in 
character. The alcoholic delirium which 
becomes associated with its seizures after they 
have become very frequent, is a complication, 
nr»t a -symptom. The attacks of dipsomania 
leave behind them a cerebral restlessness which 
(Translated for the M KDiCAT'fltlWrRact.) 
The dominating influence in dipsomania is 
heredity. An occasional cause may have a 
certain action upon particular seizures, but the 
disturbance is secondary ; it has to do only 
with the manifestation present at the time of 
attack. Upon the morbid centres of action it 
has not the importance often attributed to it. 
Some writers instead of seeing in the morbid 
impulse to drink, the manifestation of an in- 
terior condition of profound disturbance, regard 
it as developing only after long periods of 
alcoholic excess. This opinion, together 
with that which would make of dipsomania a 
distinct malady, in an otherwise healthy indi- 
vidual, does not withstand careful investiga- 
tion. Esquirol saw in dipsomania a distinct 
malady characteiized by an unusual desire to 
drink, and paid no attention to antecedents. 
But in order to comprehend dipsomania, this 
inquiry must certainly be made. Nothing can 
be more certain than that dipsomaniacs, at 
various periods of their lives, and many years 
before the development of their disease, have 
presented eccentricities of character and serious 
intellectual difficulties which their after lives 
have amply accounted for. Other writers have 
confounded the symptoms of dipsomania with 
its causes. Dyspepsia, so often regarded as a 
cause of the drinking impulse, is only a conse- 
quence of the malady, though it afterward aids 
in giving rise to the drinking seizure. The 
same is true of certain curious conditions to 
which writers have too readily applied the term 
hysterical, and which constitute in reality the 
habitual condition of the physiological life of 
the dipsomaniac. So also with the periods of 
melancholy. Far from being the causes, they 
are the first manifestations of the disease To 
menstruation and the menopause have also 
been attributed a large importance in the causes 
of dipsomania. Their influence is slight, how- 
ever, and only at the time of the access, the 
return of which is sometimes hastened. But 
even if menstruation has a certain action upon 
the periodicity of the access, it would be a gross 
exaggeration to say that it had anything to do 
with the cause of the trouble. 
Marie D—, 45, had been in bad spirits for 4 
years—since her husband’s death. For 18 
months she had been seized at intervals with a 
violent desire to drink. Then followed a 
period of deeper sadness and discouragement, 
which immediately preceded her first seizure. 
She complains at the time of attack of a con- 
striction of the stomach and the throat. As 
the impulse increases she reproaches herself 
and tries desperately to surmount her desire to 
drink. Incapable, however, of a prolonged NEW YORK MEDICAL ABSTRACT. 
lessens by degrees, when the patients, re- I 
gretting their excess return to a habit of 
sobriety. The attack is always preceded by 
similar prodromas. Some of the important 
symptoms are noted in the following case : 
Louise B., 23, daughter of a drunkard whose 
father was a suicide ; mother intelligent; 
patient’s brother died of hydrocephalus. At 
20, Louise had periods of melancholy, nervous 
twitchings of the stomach, and a feeling of 
weight in the hypogastrium. The phenomena 
increased at the catamenial period. She had 
already remarked that a little wine allayed 
the uneasy feelings in the stomach. She 
married and became pregnant. She then 
became more melancholy and lost much of her 
interest in life. She felt a disgust for solid 
food and began to have an incessant thirst 
which would not be allayed, together with ex- 
treme heat and dryness of the throat. She 
began by using peppermint water, but soon 
commenced to take wine freely and finally 
decided upon small quantities of spirits. The 
relief she experienced caused increased drink- 
ing, and within a short time she became on 
one occasioi\ comnletely intoxicated. Then 
she remained absolutely sober for 15 days. 
Melancholy soon seized her again and, after a 
short struggle, she found that she must soon 
give way. Fearing the reproaches of her 
friends she left home with her portable property 
which she soon disposed of at insignificant 
prices. Then she bought a bottle of brandy, 
and taking a room at a hotel drank until she 
rolled to the floor unconscious. Her husband 
found her and took her home, but his protes- 
tations were useless ; she continued her habit 
at intervals until her child was born, an event 
which, strangely enough, took place at term 
and without accident. She now carried her 
excesses still further, and added absinthe to 
her list of excitants. Then this woman, so 
chaste and reserved in her intervals of sobriety, 
lost her modesty with a very remarkable facility, 
not only when under the influence of liquor, 
but when simply dominated by a desire to 
drink. For a drink she would give herself to 
the first comer. The saloons of the lowest 
order served her on these occasions as a place 
of refuge, and it was in the midst of the most 
degraded people and in company of the lowest 
prostitutes that she gave herself up to the most 
shameful forms of debauchery. Sometimes 
she was obliged to leave-a considerable portion 
of her garments to pay the cost of her pota- 
tions. The agents of police had found her 
more than once, lying in the street in a state 
of almost comlete nudity. The crisis past, the 
lady regains her self-possession, becomes pro- 
foundly grieved and makes resolutions which 
beyond question are sincere. She was then 
docile and ready to assist her friends in any 
effort they made for her. They placed her in 
a commercial house hoping that regularity of 
life and constant surveillance would benefit 
her. She did well fora time, but a single glass 
of wine broke through all of her precautions, 
and in 24 hours she was in the gutter. She 
was now sent to the house of a relative—a 
physician—where she improved for a short 
time. Soon afterward her husband on enter- 
ing his house found her lying fully intoxicated 
and almost nude upon the floor of her home. 
On one occasion she remained 4 days from her 
friends without food, but almost wholly in- 
toxicated with absinthe. She sometimes went 
into the streets at night and wandered about 
while waiting for the opening of a liquor saloon. 
At another time her husband found her at the 
Prefecture of police—she had been found drunk 
and nearly naked, lying in the street. Once, 
when apparently free from her appetite, she 
! went to walk, taking her little child with her 
in the belief that she would thus have the 
firmness to resist any temptation. She thought 
it no harm to take a glass of wine on the way 
as she felt some bodily distress. Her distress 
was in reality a seizure. She confided her 
child to a drunkard—a stranger whom she en- 
countered—and did not return until the next 
morning when she was accompanied by a 
workman whose services she requested. Some 
days afterward she was sent to friends who 
agreed to watch her ; but she soon escaped and 
wandered to a distant quarter of the city where 
she was arrested and fined for drunkenness 
twice in two days. To-day, the effects of these 
excesses remain profound and durable. Louise 
has lately drank habitually until she has fallen, 
unconscious, into a condition of complete pros- 
tration ; she often remains in a state of hebe- 
tude for 5 or 6 days. Since she has been 
brought to the Saint Anne Asylum she has 
been calm and reasonable. She fully under- 
stands her terrible situation and has often, she 
says, made up her mind to destroy herself. 
But she drinks alcohol to give her the necessary 
courage and takes so much of it that she soon 
loses recollection of her intended suicide and 
gives herself up to debauchery. 
Although in dipsomaniacs the impulse to 
drink is preceded by the same prodromas, per- 
sons of education soon perceive their malady 
and, for a long while, show much ability in 
concealing their habit. The struggle these 
people often make against their impulses in- 
dicate in the clearest manner how widely they 
differ from ordinary drunkards. The latter 
seek occasions to drink. The dipsomaniac 
avoids them, reproaches himself deeply for his 
impulses, and often seeks by a thousand means 
to destroy his desire for liquor. He even soils NEW YORK MEDICAL ABSTRACT. 
his drinks in the most disgusting ways in the 
effort to sicken himself with his destroyer. The 
ordinary drinker does not do this. 
Madame N. was a woman of a serious char- 
acter, regular and of irreproachable habits. 
She became suddenly seized with a drinking 
impulse which became irresistible. She put in 
her wine substances calculated to inspire dis- 
gust—even excrement—yet she still craved for 
more liquor, and finding such to be the case 
would curse herself horribly. “Drink, then, 
drink, miserable drunkard !” she would ex- 
claim, “go forth, dishonor yourself and your 
family.” And she would do so though often 
sober at the time. 
When the dipsomaniac ends by succumbing, 
he does not behave like the ordinary drunkard. 
In the early stages of the disease he drinks 
furtively and generally conceals himself. The 
professional drinker is noisy, seeks companion- 
ship and in most cases disputes, or relates his 
own exploits. The one is insane before he 
drinks, the other becomes so because he drinks. 
Marie T., 51, maternal grandfather a suicide ; 
mother, at 40, was affected with melancholia. 
Patient was a Child of the Regiment \can- 
tiniere], and sometimes drank a little eau-de-vie, 
not because she cared for it, but, as she said, 
“it belonged to the business..” The curious 
point in this case is that though she was in 
reality a latent dipsomaniac, the disease did 
not then seize her, and when she left the busi- 
ness the habit of drinking ceased. At 34, how- 
ever, she complained of cramps in her right 
hand so severe as to compel her to learn to 
work with her left. Then the sensibility of 
the member slowly left it. Two years later, 
without apparent cause, she had an attack of 
melancholy. She tried to dissipate it by using 
a moderate quantity of brandy, but only suc- 
ceeded in losing her sleep. This attack was 
not yet, properly speaking, a well characterized 
seizure of dipsomania. But some time after- 
ward the woman fell into another condition of 
melancholy and suffered acutely for two days. 
Then followed stomachal spasms and at the 
same time a desire to drink strong liquor which 
soon became irresistible. She left her locality 
to escape observation and began the “run of 
the cabarets.” These attacks continued and 
were brought about, she thought, by horrible 
burning sensations in the stomach, and a feel- 
ing of obstruction of the throat. Alcoholic 
accidents brought her at last to the Pitie 
hospital, where, however, despite her absti- 
nence the mental disease which brought about 
the dipsomania steadily continued its course. 
Ideas of suicide pursued her steadily. She 
succeeded on one occasion in precipitating 
herself from a staircase. Finding that she was 
not seriously injured she crawled higher up 
and was about to jump when she was restrained. 
“ A voice,” she said, had commanded her to 
do this. On the following night she attempted 
to strangle herself with her clothing. Her 
hallucinations became terrifying. For 18 
months this condition has not been modified. 
As showing how dipsomania may exist 
without any alcoholic excess for months 
previous, the fact may be cited that she was 
once seized in the middle of the night with an 
attack of the disease, accompanied by frightful 
hallucinations. When the attack was over 
there was left but one hallucination ; a voice 
was continually saying to her, “ It is vain to 
resist, you will end by killing yourself.” This 
patient has developed a remarkable peculiarity. 
When she walks with another patient, she is 
always careful to place her at her right side, 
for it is impossible for her to feel the presence 
of anyone at the left. All objects that she 
looks at with the left eye seem to her to oscil- 
late. Her arteries are atheromatous ; all of 
her organs of sensibility on the left side are 
weakened. 
As to the liquors chosen by dipsomaniacs, 
all are good enough if they contain alcohol. 
One patient, however, the Count de R., who 
is well known in the medical world, has a 
preference for ether and sugar. His mother— 
also a dipsomaniac—has the same habit, and 
sometimes bathes herself in ether. Both of 
them, however, will seize any intoxicating 
liquor which comes to hand when the fit is on. 
A marked difference between the dipsomaniac 
and the drunkard is, that between their pota- 
tions the latter has no special dislike to his 
favorite drink, while the dipsomaniac feels fot 
it an almost insurmountable repugnance. Our 
first-mentioned case cannot, when sober, sup- 
port the odor of her customary drink ; of the 
two other patients, one drinks water habitually 
and the other will go for days without taking 
any liquid whatever. 
The state of exhaustion and self-humiliation 
in which the dipsomaniac finds himself after 
he has recovered from his seizure, should not 
be confounded with the phase of melancholy 
which precedes the attack. The prostration is 
a consequence of mental and physical fatigue, 
and especially of the repentance and despair 
which follow his act. His discouragement 
often leads to suicide, and his contemplation 
of such an end is almost always persistent. 
Sometimes he becomes very dangerous from 
the fact that the suicidal impulse is often com- 
plicated with the homicidal mania. 
Louis H., 35, father drunkard, attempted 
suicide, mother hysterical. Patient has always 
had a predisposition to melancholy and his 
sadness is increased by the belief that he is a 
natural child. He knows “how it will all NEW YORK MEDICAL ABSTRACT. 
end,” for his mind has for several years been 
haunted with ideas of suicide. In Lyons he 
threw himself into the river through fear of 
entering barracks after one of his attacks. 
Later, after the rupture of a long contemplated 
marriage, he had a period of melancholy, dur- 
ing which he drank for 4 or 5 consecutive days. 
He then hung himself above the door of the 
lady to whom he had been engaged, but was 
rescued. Four years later, from a motive 
which he does not even remember, he attempted 
suicide, after one of his seizures. Later he 
was stepped as he was about to leap from the 
Austerlitz bridge. The following year, during 
another seizure, he attempted to open his veins 
in a bath-tub, but was surprised in the act by 
the attendant who had been struck with his 
wild appearance. He tried to poison himself, 
but his stomach rejected his mixtures; he 
afterward made a further attempt at suicide 
which was equally abortive. Every 3 or 4 
months he appears progressively melancholy 
and the seizures are much more marked. He 
loses appetite, complains of pain and constric- 
tion in the stomach ; his head feels as though 
bursting ; his sight is troubled—he feels as 
though trying to see clearly in a fog—and then 
comes the irresistible thirst for liquor. After 
drinking for 3 days he resumes work and his 
ordinary appetite returns. Apart from his 
attacks of alcoholic delirium this patient has 
some of the ideas of persecution. He often 
believes himself followed by men in the street 
who menace him with knives. Sometimes he 
hears at his left ear threats and insults of all 
sorts. Simultaneously at the right ear he 
hears agreeable things. For three years he 
has been troubled with an interior voice which 
urges him to strike at the life of some one. 
He fears greatly that he may one day give way 
to this impulse as he has to the others. The 
sight of a knife causes in him a painful im- 
pression ; he never touches one when he can 
avoid it. 
The attacks of dipsomania last from 2 to 15 
days. At the commencement of the disease, 
they occur generally but once or twice in a 
year and grow in frequency until they become 
separated by an interval of a few days only. 
Writers have altogether too strongly insisted 
upon the resistance of the constitution of dip- 
somaniacs to the effects of alcohol. When the 
quantity taken is sufficient these unfortunates 
will, sooner or later, be subject to the toxic 
delirium of the ordinary drinker in addition to 
their own special symptoms. At first, drunk- 
enness, which alone accompanies the seizures, 
leaves no trace, but as these crises come so 
nearly together as to act continuously, toxic 
symptoms will develope. Sometimes a true 
dipsomaniac comes to the asylum suffering 
from common alcoholic delirium, and it is only 
after the acute symptoms have disappeared 
that we find the profound indications of the 
principal malady. The coexistence in the 
same patient of several different species of 
delirium is a demonstrated fact. 
Hortense B., 53, whose father was a suicide, 
remained temperate until 40. She married at 
20, and was a widow 8 months afterward. 
From 21 to 27 she suffered from irregular 
attacks of gastralgia followed by vomiting. At 
31 remarried ; became greatly troubled through 
business losses. Drank occasionally, but was 
rarely intoxicated. It was much later when 
the gradual developement of dipsomania at- 
tracted her attention. The symptoms were 
pains in the head and stomach, pressure upon 
the back and the epigastrium, repugnance to 
food and insomnia. She was restless, sad and 
discouraged. Was filled with strange fancies. 
Everything wearied her; trifles exasperated 
her; a hallucination which seemed to her as 
“an image of death,” pursued her without 
ceasing. So great were her other troubles that 
she hailed this last appearance as an object 
which would soon bring deliverance. It was 
in this condition that she felt her first irre- 
sistible impulse to drink. She soon went from 
wine to brandy without being able to quench 
her thirst and in a few days had an attack of 
alcoholic delirium—apart from the dipsomania 
affection—and while suffering from hallucina- 
tions of sight and hearing. She believed she 
saw the dread shadows of the Commune and 
heard the musketry. She thought that all who 
met her in the street reviled her. Life became 
insupportable and she had been taken to the 
asylum in toxic delirium after a determined 
attempt upon it. Discharged in 3 months, she 
quietly and soberly resumed her work and re- 
mained in good health for 15 months. Then 
an attack like the first one led her to drink for 
several successive days and sent her again to 
the asylum. After her discharge came a further 
period of perfect sobriety for 8 months, fol- 
lowed by a further attack which ended in deeper 
mania and more terrible hallucinations. She 
believed herself about to be cut into pieces, 
thought she was to be arraigned for assassina- 
tion, and even falsely complained to the police 
that a person in her house had killed a child. 
She was again taken to the asylum and again 
discharged and continued in this way for 4 
years, with perfectly sober intervals lasting 6, 
8 and 15 months, when she was troubled with 
neither melancholy nor unnatural thirst. The 
fourth time she was admitted, she had attempted 
suicide and on the fifth was suffering horrible 
anguish from hallucinations in which she 
believed that dead persons whom she had 
known when living were talking to her. She NEW YORK MEDICAL ABSTRACT. 
thought her mother was not only reproaching 
her but beckoning her to follow her shade to 
the regions beyond. 
There are some dipsomaniacs who, outside 
of their periods of impulse, behave at times 
like common drunkards, and live under the 
worst possible hygienic conditions. These 
patients frequently end their lives in chronic 
alcoholism. But it is always possible to deter- 
mine whether the person drinks from unhealthy 
impulse or because he has adopted drunken 
habits. Impulsive drinking is always preceded 
by a phase of melancholy, and is characterized 
by a thirst which causes the victim to drink 
glass after glass in quick succession; he is filled 
with shame and constantly makes desperate 
efforts at reform hoping, on each occasion, 
never to fall again. His resolves are pathetic 
in their perfect sincerity. Our last patient has 
sent us a note in which his promise never to 
drink again is written in his own blood. 
The mental state of some dipsomaniacs is 
such, in the intervals of the attacks, that on a 
superficial examination one would believe them 
wholly cured ; their frequent lucidity of mind 
gives a misleading impression as to the real 
condition of their faculties. These appear- 
ances have caused them to be considered, even 
by some of the most eminent alienists, as sub- 
ject to a sort of partial delirium. But a careful 
nvestigation of the patients’ lives shows that 
there is no need of creating for them a special 
malady whose chief characteristic is an irre- 
sistible passion for fermented liquors. It is 
always possible, thanks to an attentive obser- 
vation of pathological facts, to reduce these 
depraved tendencies to their true generative 
causes. These are simply hereditary predis- 
position. The acts of the dipsomaniac always 
demonstrate that he is unbalanced. ‘ ‘ But they 
are only insane,” say some of the writers, 
“when their attack comes on.” This is an 
error. Dipsomaniacs present a host of other 
weaknesses which make them beings having a 
tendency to act from perverted instincts [itres 
instinctifs] and are possessed with all sorts of 
evil tendencies whose objective point varies 
according to education and surroundings. The 
essentially unhealthy nature of these beings 
should be too clearly understood to need demon- 
stration. Among their most salient impulses 
are those which lead to robbery, suicide, 
homicide and the erotic predisposition. It 
appears as though chance may decide the par- 
ticular direction of their morbid disposition, 
but none escape their logical ending. All are 
subject to similar impulses though, it may be, 
under different forms. All, or almost all, have 
insane antecedents ; many present peculiarities 
of mind from infancy. A man, now an ether 
drinker, states that in childhood he had already 
made two attempts at suicide, the first at 9 
years because he had been punished unjustly, 
the second at 16 because he had been separated 
from a friend. When his family vexed him he 
used to push pins into his body knowing that 
they feared he might open a vein. The physical 
development of the dipsomaniac also presents 
certain peculiarities in infancy. They develope 
too early or too late in the matter of intelli- 
gence, and show phenomena of a nervous, 
convulsive nature ; they often develope chorea. 
It is not rare also to find certain hysteric mani- 
festations, which explains to a certain extent 
why dipsomania is more frequent in women 
than in men. 
If dipsomaniacs are not always in delirium 
they constantly keep one foot in the domain of 
insanity. Without doubt the patient is wholly 
different in his paroxysmal state from what 
he appears when in his remittent period ; but 
many, even in their lucid intervals, conduct 
themselves like the veritably insane. Most all 
of them are not only unbalanced but fantastic, 
with the ever present tendency to sadness ; 
they exaggerate in all things ; with few excep- 
tions they are reasoning fools. To interrogate 
them is sufficient to demonstrate this fact. It 
is hardly possible to imagine a more dramatic 
and tempestuous life than it is the destiny of 
one of these unfortunates to lead. I will give 
a case in point. 
Eugenie M. is a school-teacher of 48, father 
was a drunkard,and her grandmother (maternal) 
drowned herself. Has two brothers in good 
health. Her early youth was passed without 
notable illness. At 20 she felt drawn to a 
religious life, entered a convent and gave her- 
self with fervor to a monastic life. Was 
nourished poorly, practiced fasting and absti- 
nence, and slept little, giving up a portion of 
her nights to self-discipline. The Superior 
pointed her out as a model. Eugenie’s first 
hallucination soon appeared, she thought her- 
self surrounded with the heads of angels. This 
soon gave place to the shadowy appearance of 
one of her religious companions, the extreme 
tenderness of whose expression affected her so 
profoundly that she fell into a condition of 
ecstacy which lasted for some hours. The cir- 
cumstance naturally created a strong affection 
between the two, and, at times of religious 
ceremony, when they were unable to speak 
together, they spent hours in looking into each 
others eyes. But their affection did not re- 
main confined to those straight paths of mys- 
ticism in which it took its rise. I will not 
speak at length of the details in this matter. 
They secretly held continual conversation, and 
that after a time Eugenie and the other 
Carmelite abandoned themselves to mutual 
caresses, and gave themselves to masturbation. NEW YORK MEDICAL ABSTRACT. 
Thirty years have passed, yet Eugenie in re- 
lating the circumstances to us stated that the 
thought of them even now made her almost 
beside herself. “ I have a remorse mingled 
with shame,” she said to us, “ which after all 
gives me a certain kind of pleasure.” At 
another time she said, “You would hardly 
believe how painful it is to be obliged to re- 
proach myself for the most agreeable souvenir 
of my life.” Following these practices she fled 
from the convent one day and looked for a 
husband. But the man of whom she dreamed 
was in no great hurry to marry. Then she was 
sorry she had broken her vows, and this fact 
followed by the threatened rupture of her 
negotiation of marriage led her to despair and 
she attempted suicide. Saved from this, she 
was the victim of further troubles, and then she 
commenced to drink, though in very small 
quantity. Married at last, her husband excited 
her by taking a mistress, and she drank more 
freely. This condition increased and she 
commenced to talk injuriously of her neighbors 
and to create scandal. One day she struck 
her husband, and on another occasion she 
struck him brutally in the midst of a large 
company at a dinner party. 
Eugenie gives an excellent account of her 
condition at that time. At present we observe 
the continued growth of dipsomania, she feels 
the irresistable longing, yet once it is satisfied 
may go for many days without the least desire 
to drink. The symptoms of attack in her are 
not unlike those of the others. She becomes 
sad and irritable, has headache, contraction of 
the stomach and a choking sensation in the 
oesophagus. She is one of those who mixes 
fecal matter and petroleum with her liquor 
without bringing about the disgust she hopes 
for. After the suicidal impulses become pro- 
nounced, homicidal ideas appear. Sometimes 
she wishes to strangle her husband. Some- 
times even, as she states, the idea occurs to 
her to kill persons for whom she has no enmity. 
Her husband finally became discouraged. 
Fearing that his wife might not always resist 
her desire to kill him, he left suddenly for 
Australia and has not since been heard of. 
Eugenie, although assisted by her brothers, 
could not resist the force of her predisposi- 
tions. One night her brothers became en- 
tangled in a crowd who were watching a 
drunken woman lying in the gutter—it was 
their sister. Hastily writing on a piece of 
paper the words, “ If you have any heart left 
you will for the honor of the family disappear 
to-morrow,” one of them put the billet in her 
pocket. The consequence was that Eugenie 
forthwith jumped into the Seine. She was 
rescued and made many other attempts at 
suicide which also miscarried. She was arrested 
many times and often wandered for days with- 
out eating, but drinking all she could obtain. 
She was now subject to terrible hallucinations 
and impulses. The latter took physical form ; 
one day she armed herself with a knife and 
attacked the brother who had written her the 
note. This brought her again to the asylum. 
“ I reason well enough,” she remarked, “ yet 
no one is more crazy than I am.” She easily 
returned to a lucid interval, became reason- 
able and resumed her habits of work. But the 
inevitable attack recurred. This time she 
made a desperate resistance, prayed with 
fervor and passed days in the churches. But 
the hallucinations redoubled and one morning 
she was picked up completely drunk and lying 
upon the steps of a church. Since the de- 
parture of her husband, Eugenie had been 
living with another man. This individual 
always tried to restrain her by force from 
drinking. At such times the woman would not 
hesitate to implore the assistance of her brothers 
to shake off the man, declaring in such 
moments that he was a perfect stranger to her. 
Once her attack was over, she would write him 
the most affectionate letters imploring his 
pardon and promising not to recommence her 
habit. On one occasion, after a stay of 3 
months in the hospital, she had a very marked 
attack. She felt it coming and purged herself, 
though with no preventive effect. She was 
extremely restless and went to bed, but rest 
was not to be had ; nightmares awakened her 
almost as soon as she commenced to sleep. A 
cold sweat covered her and her body grew icy. 
This condition, counting from the first day of 
uneasiness, lasted for nearly a week before she 
felt the need of drinking. Her thirst was very 
great, and her throat so parched as to leave her 
hardly enough saliva to enable her to speak. 
She ran at last to a rum-shop where she has- 
tened to intoxicate herself and then took refuge 
in a partly demolished house where she passed 
the night. At dawn she returned home and 
went to bed for 3 hours without taking any- 
thing but some milk and a little broth. Both 
wine and beer disgusted her and it looked as 
though the attack would prove abortive. Three 
days afterward, however, the seizure returned 
in full force ; she drank all day, slept in a 
cellar away from home at night, and on the 
following day locked herself in her chamber 
for xo days without drinking a drop of liquor. 
In one of her attacks she determined not to 
give way, and accordingly soiled her quart of 
mixed wine and brandy with fecal matter. She 
slept awhile, but when she awoke she swallowed 
the frightful mixture with avidity. In the short 
time between the good resolution and the full 
onset of the disease her sufferings had become 
insupportable tortures. Taste, hearing and NEW YORK MEDICAL ABSTRACT. 
smell were involved, her body burned in 
agony and her mind was filled with fears and 
hallucinations. Her curious experiences have 
been almost numberless and they continue to 
grow worse. At this time she has an incom- i 
plete hemianesthesia, with a general weakness 
of all the functions of sensation. The pricking 
of a pin is almost unnoticed and the sensation 
of cold produced by ice water cannot be felt. 
The right ear appears to be reserved for the 
constant hearing of all sorts of supposed re- 
vilings from those she meets, while the pardons 
of an offended Deity and the encouragements 
of friends seem to be heard only on the left 
side. “ It has always been so,” she said, 
“even when I was at the convent 20 years 
ago that is, before she had tasted liquor at all. 
There are two indications for the treatment 
of dipsomania : first to combat toxic accidents 
and afterward to attempt to modify the course 
of the disease itself. As to the first, the 
patient must be protected against himself and 
from doing injury to others. Elimination of 
the poison must be favored in every way ; the 
physical forces must be sustained. For the 
modification of the deeper malady moral treat- 
ment is useful, no doubt, but is insufficient. 
Distractions, affectionate advice, and the ablest 
reasoning have little effect during the active 
period. Hydropathy methodically used, and 
particularly the cold douche applied upon all 
parts of the body except the head, give good 
results. The action of arsenic upon the gen- 
eral nutrition commends it greatly in these 
cases, and if its use is continued there will be 
more or less long intercalary periods of repose. 
My formula is: Q. Aq. dest. gram. 200; 
Sodii Arseniatis. centgr. 10 ; Aq. dest. prun. 
laurocerasi gram. 4. M. 
When excitation and insomnia persist, re- 
course must be had to warm mucilaginous 
baths—those of elm wood for instance—and 
doses of 4 to 6 grammes brom. pot. at night. 
Preference should be given to the polybromides 
if the treatment is to belong continued. Some- 
times the patient is deeply depressed and 
sulphur baths are indicated. Great benefit will 
also be derived from vapor baths of warm 
turpentine followed by immersion in cold water 
or an application of the douche. This is one 
of the most powerful alteratives and the patient 
rarely fails to be very favorably influenced by 
so energetic a therapeutical method. Good 
hygienic treatment and a tonic medication are 
necessary in using this system of alleviation. 
The isolation of the patient is indispensable. 
This will in time attenuate the impulsive pre- 
dispositions and if it does not prevent a repro- 
duction of the attacks, will delay them. Patients 
have had attacks of dipsomania with delirium 
despite the total discontinuance of spirituous 
liquors. Do not forget that patients must 
always be watched for suicidal or homicidal 
indications. The daily use of bitter drinks is 
recommended; it calms the desire of the patient 
for “something strong.” 
A large number of medico-legal questions 
arise in connection with dipsomania. We have 
seen that these patients have tendencies which 
are susceptible of interpretation through im- 
pulses of a diverse character. Hence, to 
become completely certain upon this subject it 
would be necessary to make a complete medico- 
legal history of hereditary insanity. But it 
may be said that all true dipsomaniacs are 
irresponsible for acts committed immediately 
before, during, and after their attacks. This 
is on account of their intellectual condition 
before the crisis, on account of the impulsive 
character of their actions, and on account of 
the toxic delirium with which it is often fol- 
lowed. In the eyes even of those who regard 
drunkenness as an aggravation of crime, the 
dipsomaniac should be regarded as irrespon- 
sible because he is not master of his desire to 
drink. As for the wrong, or even criminal, 
acts which they commit in their lucid intervals, 
we should never forget that they are possessed 
of a undeniably morbid disposition, that they 
have a defective intellectual organization, and 
are in reality beings who have degenerated.— 
Le Progres Medical, Nos. 4, 5, 6, 8, 10, 12; 1884. 
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93 Fulton Street, New York. ILLUSTRATIONS IN NEW YORK MEDICAL ABSTRACT, 
THE COUVEUSE FOR CHILDREN, M A. Auvard, translated from 
the French for the Medical Abstract. *This is from the original article on 
the subject, and gives all the illustrations which appear in the original—six. J 
MALFORMATIONS OF THE HEART IN THEIR RELATIONS TO 
THE PATHOLOGY OF CYANOSIS, David Newman, M.D. Six illustra- 
tions. ILLUSTRATIONS IN NEW YORK MEDICAL ABSTRACT. 
MICROORGANISMS AND DISEASE, E. Klein, M.D. This is the 
most complete article extant on the subject upon which it treats. It is illus- 
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THE SENSORIAL LOCALISATIONS IN THE CORTEX CEREBRI, 
Luigi Luciani, Florence. An interesting and valuable paper to those interested 
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practical article on the subject, with many illustrations of instruments, etc. ILLUSTRATIONS IN NEW YORK MEDICAL ABSTRACT. 
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ORGANS IN THE FROG, A. Milnes Marshall, M.D. Thirteen illustrations 
on plate paper. ILLUSTRATIONS IN NEW YORK MEDICAL ABSTRACT. 
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French. Eight illustrations. 
STUDIES OF POSTURES INDICATIVE OF THE CONDITION 
OF THE MIND, AS ILLUSTRATED IN WORKS OF ART, Francis 
Warner, M.D. Six illustrations. 
Closely related to this subject, and by the same author the Abstract has 
published Study of the Face as an Index of the Condition of the Brain, and Spon- 
taneous Positions of the Hand Considered as Indications of the Condition of the 
Brain. All the articles are interesting, and we hope soon to publish more from 
this writer’s gifted pen. ILLUSTRATIONS IN NEW YORK MEDICAL ABSTRACT. 
CHOLERA AND ITS BACILLUS, Robert Koch, M.D. This is a very 
interesting article on the subject of cholera and is well worth the attention of 
every physician. It is practical as well as scientific, eleven illustrations. 
MICROCOCCI IN RELATION TO WOUNDS, ABSCESSES AND 
SEPTIC PROCESSES, W. Watson Cheyne, M.B. ; 13 illustrations. A very 
interesting article. 
The illustrations given here show but a small part of matter appearing in 
the Abstract during the year, but they will serve to indicate its scope and 
value. 
Note: The Abstract is printed on highly calendared thin paper, is of 
handy size, inches, is highly illustrated, and very low in price. ILLUSTRATIONS IN NEW YORK MEDICAL ABSTRACT. 
HYSTERICAL CONTRACTION OF TRAUMATIC ORIGIN, M. 
Charcot. Translated from the French. 
VARIETIES OF APHASIA: VERBAL-BLINDNESS AND WORD- 
BLINDNESS, by the same author. Ten illustrations. 
THE HOTTENTOT \ ENUS, M. L. Capitar. Six illustrations. From 
the r rench. TO THE MEDICAL PROFESSION. 
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SVAPNIA 
PURIFIED OPIUM 
OR 
AND SOP°^N 
ALKALOIDS 
CODEIA, 
NARCEIA 
AND 
MORPHIA 
,S°"ous & Co^oV'S'Sl 
ALKALOIDS 
THEBAIN, 
NARCOTIN 
AND 
PAPAVERIN 
This article is not intended, for popular use, but only on prescrip- 
tion of the profession. It is to take the place of Opium in cases where 
that drug acts injuriously. 
DOSE, THE S-ALMCE AS OPIUM. 
Dr. John Harley, of London, in his “Old Vegetable Neurotics,” details a large 
number of experiments upon the human and animal system, with six of what he con- 
siders the narcotic alkaloids. He concludes that although all six possess both narcotic 
and hypnotic properties, yet these are so varied in degree and force, as to make their 
effects, when exhibited singly, very distinct from those following their exhibition in 
combination. 
Taking the experience of practical physicians with Dr. Harley’s results, as a basis, 
we would group them in the following order : 
First Group. 
Anodyne and Hypnotic Elements. 
1. Morphte. 
2. Narceia. 
3. Codeia. 
Second Group. 
Narcotic and Convulsive Elements. 
1. Thebain. 
2. Cryptopin. 
3. Papaverin. 
Now Svapnia is a distinctive name given to the first group, representing the 
anodyne and hypnotic elements ; the second group, or the narcotic and convulsive 
elements of Opium being eliminated; and is not. therefore, a simple principle, or a 
single constituent of Opium. 
The relative values of each being known, we can select and utilize those that are 
valuable, and reject those known to be deleterious and inert. 
This is what we claim, and all we claim for Svapnia. It can be relied upon and 
given in all cases where Opium or Morphia is indicated with equally good effects ; and 
in addition to this, there will be found in the practice of every physician, cases occurring 
almost every day, in which idiosyncrasy and peculiar states and diseases of the brain 
debar us from the use of Opium and Morphia, but where Svapnia can be exhibited with 
the happiest results. 
In Svapnia, there is retained all the Morphia and the greater part of the Codeia and 
Narceia, but combined with the native acids of Opium, meconic and thebolactic, in such 
a manner as to render those constituents soluble and active. 
Svapnia is uniform in its proportions, and is prepared to conform to a standard of 
Opium representing ten per cent, of Morphia. This is done by a simple proportion of 
the neutral excipient, after determining the actual amount of the alkaloids obtained from 
the Opium used. 
We may safely affirm that the danger of bad results is much diminished by a resort 
to that preparation of Opium, in which the poisonous elements are eliminated, and the 
anodyne elements in such a state of combination, as to reduce their toxic, and enhance 
their hygienic effects, such as has been proved to be the case with Svapnia. 
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