JAMA 100 Years Ago

September 15, 1888

ALCOHOLIC INEBRIETY, AS RELATED TO RESPONSIBILITY, AND CRIMINAL JURISPRUDENCE.

BY T. L. WRIGHT, M.D....

The anaesthetic, the benumbing, the paralyzing influence of alcohol upon the nervous system, and especially upon common sensation, always darkens knowledge and misleads the judgment. This follows from the fact that accurate perceptions are wholly dependent upon definite and normal sensations. When the senses are disturbed and impaired, perceptions are correspondingly disturbed and impaired; and they are unable to present to the mind facts as they truly are, as they really exist in the surroundings. The fine shadows, and uncertainties and doubts, which invariably attend all human transactions, escape the notice of a man who is intoxicated; and being unperceived by him, he imagines they do not exist. Every thing has, to his mind, the quality and energy of absolute demonstration. He never hesitates, never doubts....

Not only is the rational faculty injured by the influence of alcohol, producing confused, incoherent, and inconsequent ideas and beliefs, but the moral attributes are debased in an equal degree. The paralysis of alcohol, although incomplete, fails not to overcome the finer and more etherial sensibilities, while it leaves the coarser ones comparatively unaffected....

Nothing is more common than that men, after drunkenness, are amazed at the shocking things they have done, or said, or thought, while in a state of intoxication-indicating the latent state of the moral nature in drunkenness. But if the inebriation is continuous or nearly so, that is, if it is habitual, the shooting thoughts do not become the subjects of rational review; and thus the latency of the moral sense becomes fixed, and congenial to an unsound and deformed reason. The mind may seem to know the nature of morality perfectly, but if morality is wanted, 'it will not come at the call." It is therefore not surprising that steady drinking, even when not excessive, is more disastrous in the final outcome than the convulsive sprees of the neurotic inebriate. In the latter, the intervening seasons of total abstinence prevent the establishment of habitual disability in the nervous powers; while in the habitual drunkard, nervous disabilities, latencies and inhibitions be- come perpetual, insurmountable, in a word, constitutional.

. . . A gentleman of my acquaintance has been a steady drinker of ardent spirits for nearly thirty years. His moral nature is latent, if, indeed, he has any. He is not vicious or malignant, but he is an incessant and shameless, because motiveless, liar. With great coolness he will invent stories totally without foundation and on the most trifling subjects,-all the attendant circumstances and details being of the utmost exactness. And so he cackles on, and will continue so to do till the end of life.

Now this seems very foolish indeed, and likewise very inoffensive. But this man is, in truth, on the verge of insanity. Not only is he morally bankrupt, but his intellect is both sterile and disordered. Amongst the great army of the unrecognized insane there are none more common, or more really dangerous, than the chronic and steady drinkers of ardent spirits. These men in early life acquired the usual habits, both of thought and action, that belong to the average citizen. Automatically, with the guide and hints of the examples of others in their midst, they manage, without much effort, to keep in the ordinary grooves of daily life.... But let some supreme crisis intervene, so as suddenly to throw him upon his own unaided powers; let instant rage or, what is more consonant with his nerve defect, jealousy, come over his mind and disposition, he will then be thrown out of the grooves of automatic life and, acting upon his own true nature, he will herald to the world his real condition. Then desperation, murder, suicide, true representatives of his actual mental state, will burst unexpectedly upon the scene. To the great body of chronic inebriates this crucial test of insanity is never applied; they live without recognition, and die with their dreadful infirmity unknown and unsuspected....

(JAMA 1888;1 1:371-374)

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Edited by Elizabeth Knoll, PhD, and Micaela Sullivan-Fowler, Research Associate, AMA Division of Library and Information Management.

JAMA, Sept 23/30,1988—Vol. 260-No.12

JAMA 1 00 Years Ago