Absinthium

Volume I — Main text

ArtemiBia AbaintMum. I. Provtngs. — 1. Dr. H. P. Gatchell gave unknown quantity to a lady of good health but nervous temperament. She reports — great tranquillity, felt soothed as if going into a beautiful dream, followed by apathy, foolish look, idiotic manner; tremor, then thumping of heart, felt towards back; feet very coldj eructations i distension of stomach and abdomen $ great lassitude, wants to lie with head low | eyelids heavy \ stomach feels cold ; nausea ; tongue protrudes and feels thick, so that she cannot speak distinctly ; pain above eyes, which Itch; dizziness on rising up; constant desire to urinate; food lies heavy; darting pain in r* ovary. In e, ver)' much bloated; uncomfortable irritated feeline of stomach. Next d. still bloated ; very weak ; no appetite, loathes food j scalded feeling in throat ; urine of deep orange colour and strong horse^likesmelL (t/. SiaUs M(d. and Surg. Jour/t., v, 293.)

II. PouoMtngs. — I. a. The accidents which arise from intoxication with absinthe are above all derangements of motility. They are ftPJii/K/zrW phenomena. Foremost among them is epilepsy, which, unlike that incident to alcoholism, belongs to the début that is to say, may manifest itself after the first excesses, at the end of a relatively short time. The epilepsy of absinthe differs also from that of alcohol in its fiirm. Whilst the latter most frequently manifests itself at a very advanced stage, and generally presents only an analogy more or less close to a true attack of epilepsy, the absinthic epilepsy, on the contrary, has all the characters of a genuine and complete attack. The patient becomes pale, loses consciousness^ falls sometimes with a cry, the face is contorted ; this is followed by tonic convulsions, with tetanic rigidity of the limbs and trunk, which is raised up ; then clonic convulsions of the limbs, the face becomes violet and cyanotic, respiration rapid, irregular, stertorous, froth from the lips sometimes bloody if the tongue is bitten^ at last a comatose state, with stertorous respiration, which lasts a longer or a shorter time. After the person recovers consciousness he seems stupid, dazed, and recollects nothing of what has passed. Sensibility is very obtuse, and during the attack anaesthesia is complete. Sometimes the epilepsy of A, is not complete, but consists only in vertigo or temporary absence of mind, — as is seen in true epilepsy. The third characteristic of the epilepsy of A. is its short duration. It comes on violently after great excesses, and ceases completely as long as the patient remains sober, but as soon as he recommences drinking it makes its appearance afresh. There may be one attack only, or several during the d, or following days ; but usually there are three or four.

b. Is this epilepsy of A. the effect of acute or chronic intoxication ? We believe tbai it is an acute symptom which manifests itself at the outset of chronic intoxication, found more often in those who drink to excess habitually; its appearance is never long delayed after the person has begun to drink A. to excess. After drinking for six months or a year, some d. the person drinks to excess and the attacks come on. Acute alcoholic mania or delirium tremens is equally an acute symptom during chronic alcoholism j they also may come on in a relatively short time, while the epileptiform attacks of alcoholism show themselves only at a very advanced period.

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Persons who arc attacked bjr the epilepsy of A. drink 8» i«, or evwa »o glasses of A. a d. Others drink but j or 4, and yet have the paroxysms.

r, A circumstance of great importance is the predisposition* We find a lar^ number of drinkers who have never had attacks or only slight ones. There are otbtf% on the contrary, who arc attacked from their first excesses,

d, A large number of persons, habitually M>ber, on drinking occasionally a glis« of A, become affected with a kind of intoxication, with pains in the head and «cQU^ tion of constriction in the temples* Such persons tolerate^ without trouble^ a Urger quantity of alcohol, and experience no symptoms from it,

r. Dr. Vol sin says that the epilepsy produced by alcohol is usually chajtctcfbed by long intervaU between the attacks; the epilepsy of A. by the very larip- ",rTT,i«-* of attacks in a very short space of time, I have reported a case in which

from 150 to zoo attacks in 24. h, Drs. Maice and Magnan have observed ...

thing. (Challand, itudt sur tAbiinthlimif &c., 1871.)

a, CI — Louiri, act. 31, came to Bicetie, jist Oct., 1863, This man^ who wa* in excellent health, had lived soberly until the beginning of i86i» at which rime be became a wine-seller. He contracted^ about this time, the habit of drinking. At first he took wine and brandy ; then a little absinthe. The alcoholic phenomena were not slow to make their appearance. Giddiness also occurred at times. Punng 1S63 CI — , to give himself more strength, partook more largely of the abdnthe. The fits of giddiness became frequent, and, at some days* interval^ there came on two attacks with sudden loss of consciousness^ falling, grimacing^ convulsions? of the arms and legs, blood v toRm on the lips, and biting ot the tongue. One of these attacks took place in cnurch during a funeral j the other occurred on the stairs ; in both cases in a most unexpected manner. Delirium with terrifying hallucinations soon distressed the patient, and made it necessary to put him under superviiion at Bicctre, He arrived there ytst Oct,^ 1S63, presenting symptoms of acute alcoholism. He recovered fairly quickly, and at the end of a month he was allowed to leave. On returning home he quickly betook himself to his former habits ; on the other side the alcoholic effects were not slow in making their appearance. A little lartr. after a fresh abuse of absinthe, there occurred an epileptic fit exactly like the ^ ones. The patient was again sent to Bicêtre 28th April, 1864, where he ^i recover himself, until the beginning of June. Let out ag;ain, he for some time forswore the absinthe, but he recommenced at the close ot each d. to take a little wine and brandy. His sleep became bad ; hallucinations showed themselves in their usual distressing manner; the appetite went, masses of phlegm were expectorated each m., and the limbs trembled and shook. This state lasted a months; but CI — . finding himself so weak, had resource once more to his favourite liqueur. The absinthe soon brought on new fits of epilepsy, Cl — entered Bicetre lor the third time 5th Dec, 1864, At the time of his entry he still bore upon his tongue the marks of his teeth, a striking token of his last fit.

Such is this observation, not to call it an experiment. The subject was a strong man, a stranger up to then to all effects of alcohol and to all convulsive phenomena. He began by an excess of wine and brandy and became alcoholic ; then he applied himself to absinthe and became epileptic. With the first residence at the asylum the alcoholic effects disvappeared ^ once out, he began to drink again, and then the alcoholic effects returned J he took abs'mthe — a new attack of epilepsy. Again at the hi^snltnl cessation of effects. For the third time, excess m wine ana brandy, ali excess in absinthe, epileptic fits added. The hospital again and sobriety, of effects. Could the effect be more intimately connected with the cause f not divide the two poisonings, that by the alcohol and that by the absinthe ? du Disp, Ha/m., viii, 1 16,)

1. A druggist's shopman was found early one m, lying on floor, pcrfediy to«eiisible, convuUed, and foaming at mouth. I was sent for, and found him no longer violently convulsed, but insensible ; jaws clenched, pupils dilated, pulse weak, slow, and compressible. From time to time he uttered incoherent expressions, and attempted to vomit. Under emetics, stimulants, and internal wanntn he gradiialjy Eccovered. He was found to have swallowed Js? of oil of wormwood. On recovering, he had totally forgotten all circumstances connected with the case. (Wii. Smith, Mtd.'Chir, Trans,, xlvi, 23.)

III. Experiment J on ammali, — 1« Essence of ab&inthe produces in animal s fully

Can one

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characterised attacks of epilepsy^ with precursory phenomena^ and often accompanied by psychical disorders of a very remarkable kind. (ChallanD| op, cit.)

1. Me^rs, Magnan and Bonchereau found out by simple and decisive experiments that the effects caused by the use of absinthe drunk as a liqueur, epilepsy in particular, were determined, not by the alcohol itself, but chiefly by the absinthe. The other plants which are used to impart an aromatic flavour to the absinthe have proved themselves harmless in experiments on animals. It has not been the same with absinthe^ as one can see by the following experiments ; — In a large glass bell is put 3 saucer filled with essence of absinthe, of which the vapours are exhaled in the confined air of the bell Introduce an animal^ for example, a guinea-pig, and examine it while it is there under the influence of the absinthe. The poor brute, at Krst surprised by the smell, stretches out in all directions its little pinic nose. The ■first moments of'the new order of things do not appear to it to be so very disagreeable ; but the pleasure, if it exists, is not ot long duration. The guinea-pig, after having repeatedly perambulated its gla-ss cage, begins to grow impatient; it runs with furious leaps, trying to find a way of escape. It has had enough of the absinthe. But (he way out does not exist. The animal ends by falling on its side ^ you see it draw up its little paws, which become stiff and motionless. Then all at once it shakes with convulsive shocks. The pointed nails ot the guinea-pig glide over the gla&s ; a frothy slime covers its &snout ; then the epileptic attack ceases, and the animal falls again inert. Absinthe causes the same epileptic attacks in cats, dog&, and rabbits. In a few minutes the mischief is done \ the absinthe has exerted its poisonous influence.

And the alcohol ? What part does it play under similar circumstances ? One can judge by the following : — Another guinea-pig was, in its turn, confined under a glass bell, in which had been previously placed a saucer filled with alcohol. At first the alcohol fumes excited the animal ; then the beast staggered like a dmnken man ; inactivity followed j and it ended by lying down in a state of the most

f profound indifference. The guinea-pig was simply intoxicated \ it was not in the east epileptic.

After these experiments, then, no one can refuse to admit the convulsive properties of absinthe poisoning, (VHom. Milit,^ Feb., itto, p* ^s. Boehm and Kobert, CtntralhL f, mid, Wisstnsck,,, 1S79, No» 37, have since obtained similar results,)

1. Necropsies of animals poisoned slowly by absinthe reveal strong congestion ot ^brain and cord, with their meninges. The hyperacmia of the medulla oblongata * vas excessive. There were in places small ecchymoses on the gastro-intestinal membrane and on the peri- and endo-caidium. (Joitm, of Fsych, Mtd,^ tx, 515*)