In Barclay’s report of the fatal cases of disease of the brain, occurring during the last four years in St. George’s Hospital, in ten fatal cases of delirium tremens, tubercles were found in the lungs in six cases, once recent, and five times in the form of a cretaceous mass.
In seventy-three of Ogsten’s cases, there was effusion into the pleura in three cases; adhesions of the lungs in twenty-five cases; emphysema in twenty-one cases; tubercles, and those latent, in only one case. Ogsten says that the additional labor thrown upon the lungs, when Alcohol has entered the circulation, after its absorption and the retardation which takes place under these circumstances of their functional activity from this cause, as well as by toxical effects of the Alcohol on the medulla- oblongata, will alone go far to account for the frequency of morbid changes in these organs in drunkards; still, there can be but little room for hesitation in attributing many of these morbid changes, in part at least, to other causes, such as exposure to cold. Ogsten places much stress upon the frequent occurrence of emphysema in drunkards; and emphysema, it is well known, almost excludes tubercles. The emphysema of drunkards is supposed to arise from a lax or flabby, non-contractile or debilitated state of the lungs, as it never occurs unaccompanied by pulmonary collapse, or by one or the other form of pulmonary atrophy. There is probably a fatty degeneration, or some similar defective nutrition of the tissues of the lungs.
SKIN.
In the earlier stages of drinking, the skin is soft, velvety, and much disposed to perspiration; gradually this changes, and finally it becomes dry, rigid, thick, dirty, or yellowish grey, and a variety of eruptions are apt to break out, especially eczema and prurigo. Varices and ulcers of the legs also occur, but the latter may also be caused by eczema, erysipelas, accidental injuries, but they are always difficult to heal, and frequently break out afresh. The cellular and adipose tissues undergo various changes; at first they are generally the seat of a larger or smaller quantity of greasy greyish-white fat, which is deposited partly under the skin, partly between the muscles, and partly in the omentum, and in various portions of the abdomen. In the latter stages, this is reabsorbed and emaciation occurs; then we find a gelatine-like mass under the skin, followed by serous exudations and anasarca, or an excessive degree of emaciation.
