ALCOHOL AND TOBACCO.
AMONG the cases recorded in other chapters of this work are several in the causation of which the use of alcohol was one of the factors. There are three cases, however, which occurred in the earlier years of my practice, in which the history of alcoholism and nicotism was so clear, that I think it may be well to give them a chapter to themselves.
CASE XXVIII.-HEART-PAIN WITH NERVOUS SYMPTOMS ARISING FROM ALCOHOLISM. ACTION OF Spigelia.
On the 24th of July, 1880, I was consulted by a young man, S.P., aged 27, for a pain at the heart, dizziness, noises in the head, excessive nervousness and inability to sleep. The contrast between the physique of the patient and the character of the symptoms he complained of was very striking. He was a ballast- quay labourer, considerably over six feet in height, powerfully built, well nourished, muscular, dark. That a man of his build should be complaining of nervousness, sleeplessness and dread of being alone in the dark showed plainly that there must be some cause at work, external to himself, giving rise to the disorder.
He told me he had been suffering in this way for two or three months. His tongue was dirty at the back; his bowels confined. His appetite was good, and he had no pain after food, though he had been troubled with it formerly. He had always been very strong.
On inquiring about his social habits I found that his occupation required him to go on board many vessels, and wherever he went liquor was offered to him, which he did not like to refuse, though, as he told me, he did not want it, and knew he was taking more than he ought. Besides this, he was a smoker, but not to excess.
This was quite sufficient to explain to me the anomaly of his case. Alcohol is a most powerful cardiac stimulant, and its free and persistent use in this case had brought on the natural result of all over-stimulation-weakness and perversion of function. The nervousness and other symptoms I considered were secondary to the state of the heart.
I explained to the patient the nature of his case. I told him that it was possible for medicines to relieve him, but whether they would cure him or not depended on himself. If he had the courage to refuse to take what he knew was not good for him, even when he got it “for nothing,” he would soon be quite well.
If he went on as he had been doing of late be would soon be beyond the reach of cure. He was so thoroughly alarmed about himself that he did not hesitate about his choice, and I believe left off the use of alcoholic drinks altogether. I gave him Spigelia 3, three times a day.
He returned a week later looking quite a different man. He had slept well, was less nervous, less giddy, his tongue was clean, and his bowels regular. (Here as in other cases Spigelia relieved constipation, as well as the symptoms which more particularly indicated it.)
I repeated his medicine, and the following week he reported still further improvement, though there was still a little giddiness and some gnawing pain at the heart. Pilules of Spigelia I were now given in the same way, and continued till September 8th. He had giddiness occasionally during this time, and slight palpitation at times, but was well able to carry on his work. His bowels were again a little confined, and he received Nux vomica I, three times a day, and this completed the cure. He returned in another week to say he was very much better. I gave him a fresh supply of Nux vomica, and told him he need not return unless he became worse. He was so exceedingly pleased with the favourable change that had come over him that I had little fear of his returning to his old habits.