Popular Science Monthly/Volume 34/February 1889/New Facts in Alcoholic Heredity
|NEW FACTS IN ALCOHOLIC HEREDITY.|
By T. D. CROTHERS, M. D.
SOME years ago I examined two inmates of the Deaf and Dumb Asylum, at Hartford, who from birth had distinct symptoms of acute intoxication. Both were boys, aged nine and thirteen years, who walked with a staggering gait and great muscular incoordination. One had a demented grin, and nodded continuously whenever he saw any one looking at him. The other had a dull, vacant stare, and congested, blear-eyed appearance. He was very irritable, and sensitive to observation, trembling with anger from any little cause. These and many other signs of intoxication were present, and had been noted from birth. The parents of both were inebriates. These cases aroused my attention, and since then I have gathered many notes and histories of similar cases.
Greatly to my surprise, I have found that these cases were not uncommon, especially in asylums and hospitals, and also in active life. Many of them are not so marked, and others require some peculiar conditions or circumstances to bring out these symptoms.
The history of the cases I have obtained may be divided into two classes: one, in which the symptoms of intoxication are present all the time; the other, in which these symptoms only appear from some peculiar circumstances or exciting causes.
In the first class, some prominent defect, such as idiocy, imbecility, and congenital deformity, is present, giving the case a distinctness irrespective of the signs of intoxication. Hence, these symptoms of drunkenness are not separate from other defects in observation. Thus, in a prominent family, one of the children, an imbecile, had all the suspicious hesitancy of manner, also the walk, of a drunkard. In a private school for the feeble-minded from the wealthier classes, three in fourteen cases had these unmistakable symptoms, which had not attracted attention.
In the home of a former patient I found a little girl, an idiot, whose voice and rambling utterance, with intensely red eyes and drunken expression, pointed back to causes and conditions that had not been noticed before. Other defects and deformities of the face and body cover up these peculiar signs of intoxication.
These symptoms may appear after birth, or be slowly evolved with the growth of the child, coming into prominence at or before puberty.
Of course, all the varied phases of idiocy, imbecility, progressive degeneration, and malformation go on. The presence of a special class of symptoms, resembling intoxication so clearly, suggests a distinct alcoholic causation. In the second class I have noted, the alcoholic symptoms are not present, unless from some exciting cause (non-alcoholic), such as anger, fear, sudden excitement, etc. In this class are idiots, imbeciles, and defectives of all degrees, who at times display distinct signs of intoxication, which subside after a period. Often in these cases appear the common delusions and deliriums of intoxication: also, the semi-paralysis and stupor. Teachers and superintendents of asylums and schools for this class realize clearly the danger of excitement on these dements and defectives, throwing them into various states of mania, as well as intoxication. In one instance, an imbecile boy would become agitated and fall into a state of intoxication if sharply watched, or excited by any cause.
In another case, an imbecile from his birth appears intoxicated when he first meets you, but quickly recovers himself, and all these symptoms pass away. The embarrassment of meeting strangers develops these signs of intoxication. The history of such cases uniformly points to inebriate ancestors. The common explanation of these symptoms is, that this pathological state reflects the condition of one or both parents at the time of conception, or some profound antenatal impression. To support this view the history of the parents gives evidence, and also, in some cases, the peculiar form of intoxication in the parent is seen in the children. Thus, in one case the father, when intoxicated, had a delirium of agitation, in which he moved about incessantly; two idiot children born to him both showed signs of intoxication and had muscular agitation and delirium.
In another case, a woman, when intoxicated, manifested hysterical fear of dogs. She had an imbecile child, which almost went into convulsions at the sight of a dog, and had all the symptoms of intoxication. Numerous instances are on record of profound impressions on the mother's mind leaving a similar impression on the offspring. In one instance an exceedingly nervous lady was greatly frightened by an intoxicated soldier. She gave birth to a boy that had all the signs of intoxication. He lived until twelve years of age, was an imbecile, and had all the marks of a person perpetually intoxicated; he staggered, and would scream out from time to time, without cause or reason. Another case is reported where the mother saw her husband stupidly intoxicated for the first time, and gave birth to an imbecile boy, who was stupid and acted as his father did when poisoned with spirits. It is often difficult to trace these peculiar symptoms, which resemble intoxication, to a similar state in one or both parents at the time of conception; but in most cases the probability of such a state is greatly strengthened by general circumstances and various marks of alcoholic defects and deformities. I find myself forced to conclude that these symptoms are inherited as special pathological states, representing the parents at the time of conception. Why they do not occur in all cases is not clear, but the fact is beyond question that children of inebriates bear marks of defective organization of almost infinite degree, form, and variety.
Beyond this range of cases there is another class, less common, yet with a distinct history and symptoms. Unlike the first class, they are persons who have average brain-power, and in many instances are men of genius and positive force, with a peculiar nerve-organization. They are usually temperate men, never using alcohol, yet under certain circumstances, and from some particular excitement, act and appear as if fully intoxicated.
In these cases some form of mental shock takes place, destroying the normal balance and bringing uppermost an inherited neurotic defect. In some instances alcohol can not be tolerated without producing nausea, vomiting, and extreme depression; and yet from some unknown cause, purely mental, they will suddenly exhibit all the usual signs of intoxication, which pass off as quickly as they came on.
These cases come from inebriate parents or moderate drinkers, and have inherited some defective nerve-organization which manifests itself in this way. I have collected a number of these cases and grouped them under two heads—one of inherited toxic states, and the other of acquired toxic states. In the first class the notes and histories I have gathered will serve as an outline for more exhaustive studies, and they also suggest many new fields of psychological heredity not yet explored. The following are histories of some of these cases:
First Case.—Joseph B——, a farmer of fifty-four, temperate, a man of character and wealth, who had never used any kind of spirits, suffered from a violent shock and alarm from a runaway horse. He was thrown out of the wagon and only slightly bruised, but could not walk after. His face was red, his voice jerking and husky, and his language silly, and he staggered with every appearance of a drunken man. He recovered, but was thought to have used spirits. Some months after, at the funeral of his child, all these and other marked symptoms of intoxication returned, to the great mortification of his friends and family. A year later another similar attack occurred from the burning of some outbuildings on his farm. A careful inquiry made it clear that he had not used any spirits, although he had all the signs except an alcoholic breath. His father was an excessive user of spirits, and his mother died of consumption, but could never tolerate the smell or taste of alcohol. He has been gradually becoming weaker for some years, and is now an imbecile.
Second Case.—The treasurer of a large manufactory, temperate but very nervous, and a hard-working man, of forty-eight, suddenly appeared intoxicated when accused by the president of falsifying the books. He was unable to talk rationally, and both appeared and walked like one who had drunk large quantities of spirits. The next day he recovered, and fully explained, to the satisfaction of all. He was ill for a week, with some general debility and indigestion, then went to his duties, became angry, and had a similar paroxysm. A short time after another attack came on at his house, and the physician called it congestion of the brain. In all these instances no evidence of having taken any spirits could be obtained. His father was a sailor and drank freely.
Third Case.—A merchant, of fifty-eight years, lost all his property in a series of unfortunate speculations. He was much depressed, and went to live with his brother-in-law, a physician. He had been a temperate man from principle, and was in good health up to his failure in business. One day, on the receipt of a letter with bad news concerning some business matters, he became to all appearance intoxicated. His brother-in-law, the physician, made a careful examination of all the facts and surroundings, and concluded that this was a case of what he called mind-intoxication, or drunkenness from causes other than alcohol or drugs. A few weeks later a similar occurrence followed an exciting interview with a creditor. During the two years which preceded his death, three distinct attacks were noted, each one lasting from two to six hours. He died suddenly from pneumonia. His ancestors were both moderate and excessive drinkers.
Fourth Case.—A recent one. A merchant, in good health and temperate, while at work in his counting-room, received a dispatch of the death of his daughter. He lay down on a sofa in his office, and very soon became wildly intoxicated. A physician made this diagnosis, although there was no odor of alcohol in the breath. He was taken home, and remained in bed a week. Two opinions prevailed: one, that he had drunk in his office; the other, that it was congestion of the brain. He denied having used spirits, but was confused about the events of the past. In this case a similar heredity from alcoholic ancestors was present.
These cases are sufficient to illustrate the clinical fact that I am attempting to demonstrate. I am informed by good authority that during the late war many similar cases were noted, and were the subject of much comment and speculation. Thus, men who were total abstainers would, under the excitement of the battlefield, exhibit the wild frenzy of a drunken man or be stupid and largely unconscious of the surroundings. As an illustration, a noted officer at Antietam came riding back from the "front," swaying in his saddle, and shouting parts of songs, in a marked drunken state.
He was a total abstainer, and had not drunk any spirits, but had been at the "front" for hours under great excitement, having a horse shot under him. His conduct was so strange and wild that he was ordered back, under the impression that he was intoxicated. Different surgeons noted this strange frenzied state on many occasions, but in the excitement and change of battle could not ascertain whether it came from the use of spirits or from some mental state. On many occasions it was clear that by no possible ordinary means could spirits be obtained, and yet men previously temperate seemed fully intoxicated. When the battle was over and a degree of relaxation took place, many men would exhibit childish excitement and delirious irritability identical with alcoholic intoxication. At other times, after a period of prolonged strain and excitement, when coffee was given freely, the same inexplicable symptoms of intoxication would appear and be termed "coffee-drunk." When these symptoms appeared at the "front" under fire, they were termed "battle-drunks." Some facts very similar have been noticed in the navy, in the case of gunners, who after a short time of exciting work would become like drunken men and be obliged to go to their berths. This condition has been noticed in persons who were shocked or greatly alarmed at the time of great disasters. A railroad superintendent informed me that on two occasions he had noticed instances of the apparent intoxication of railroad-men who seemed to be at fault through an accident. The intoxication came on after the accident; but from a most careful inquiry he was convinced that they had not used any spirits then or ever, and that their condition was unaccountable.
An incident was related to me by a gentleman, who had been talking quietly in the cars with another man, when they were thrown down a steep embankment. The car-side was broken in, and both were thrown out, only a little bruised. In a few moments one was fully intoxicated. The other, the narrator, could not understand this state or explain it in any way. From these and other statements which I have gathered I conclude that these cases are not infrequent, but, from want of accurate observation and the difficulty of obtaining the facts, they are overlooked. As far as it could be determined, I think that every case had a prominent substratum of direct heredity from inebriate ancestors. In the partial history of some of these cases some form of brain-exhaustion was present, and the shock or paralysis brought to light the special pathological symptoms of alcoholic poisoning. It would be foolish to deny that this was a special nerve and brain defect transmitted from the parents, and only came to light from the action of some particular cause.
In the case of a total abstainer, who, during some state of excitement, manifested all the symptoms of intoxication, where beyond doubt he had not used any form of alcohol, and where inebriety existed in the ancestors, it would be, a most reasonable conclusion to infer an origin in heredity, which burst into activity in obedience to some unknown exciting cause. From this point many and varied questions start up, which future observations and studies alone can determine. I think these cases are of the same class as idiots and imbeciles, with special symptoms of alcoholic poisoning, as a direct heredity from the parents; any difference being simply in the fact that these special pathological defects are dormant, but only appear from the action of some peculiar cause. This seemingly represents the conditions of the parents at the time of conception or some antenatal impression. The second class of acquired toxic states have less of mystery, and are more common. They are of the class of men who have been inebriates or intoxicated, and have become total abstainers, but from the same unknown causes suddenly manifest all the old signs of intoxication. Some factor of heredity is present, and possibly some nerve-tracts, along which abnormal energy has been very active in the past, may come into prominence again. An outline of some cases will bring out these facts:
First Case.—The superintendent of a factory, a man who had been temperate and sober for fifteen years, his conduct and character beyond all reproach, was engaged to be married, under circumstances of great promise. The day of the wedding the bride received a letter, warning her against him, saying that he was a secret drinker and a bad man otherwise. This she sent to him by the hand of her brother. After reading it, he showed all the signs of intoxication, and went to bed. The wedding was postponed, and he afterward asserted so positively his innocence that I was called to give an opinion. An examination indicated that this was some condition of shock, or sudden congestion, in which symptoms of intoxication appeared; also his assertion of not having drunk was literally true. A history of moderate and excessive drinking was noted in his parents.
Second Case.—A clergyman, with a marked history of heredity. He was under my care for five months, when, one day, a brother clergyman paid him a visit, and no doubt talked very severely to him of the sin of drinking. I found him a short time after, in bed, with all the symptoms of intoxication. He had a childish, idiotic expression, and was in a semi-delirious state. He remained in bed two days, and had all the appearance of one who had suffered from alcoholic poisoning. This was the first pronounced case I had seen, and could not be mistaken. The sudden emotional excitement precipitated him into the pathological state of intoxication.
Third Case.—This case was sent to me for an opinion as follows:
A noted temperance lecturer, formerly an inebriate, for ten years or more had been an abstainer. One evening, while lecturing, he was given a dispatch from his wife, announcing the fatal illness of a child. He drank a glass of water, and attempted an explanation to the audience, became confused, staggered, and acted like a man rapidly becoming intoxicated. He was finally led from the stage, and laughed and shouted in a maudlin way. The audience supposed that he was drunk, but all the circumstances showed clearly that no spirits had been taken.
These cases are most strikingly confirmed in many ways, and especially in circles of temperance reformers. One man of my acquaintance, after an eloquent lecture of an hour, during which he most dramatically portrays the conduct and manner of an inebriate, will go to his room and be practically intoxicated for some time, or until he can procure a few hours' sleep. This man has been an inebriate, but for the past five years has been lecturing on inebriety with great power and skill. He has been in the Prohibition campaign, and lectured for months incessantly. These phases of drunkenness are called "queer spells" by his friends, and are guarded from observation. When the lecture is over, he retires at once to his room, and will not be seen until next morning. In another case a man of talent and genius of a high order, who had drunk to great excess for ten years, stopped and became a lecturer. He told me that often the impulse to drink was so strong that he could only resist it by having an audience and opportunity to talk or plead for temperance. He was really intoxicated in his extravagant enthusiasm and dramatic portrayals of the evils of drink. After the lecture was over, he was greatly exhausted and had all the feelings of one who had just suffered from intoxication. The psychological student will find a rare field of study in the temperance meetings of the day, particularly where they are conducted and addressed by reformed inebriates.
These facts are along the line of every day's observation, and are sustained by many collateral evidences. Beyond this are still further ranges of facts, on the same psychological field, less common and more obscure.
A pathological state has been observed, which I call unconscious imitative inebriety, where persons, from the influence or contagion of the surroundings or some unknown factor, are, to all intents and purposes, intoxicated. Here, as elsewhere, a strong substratum of heredity exists. I present the notes of two cases which were sent me by accurate and very competent observers. One, J. H——, was a lawyer, a delicate, nervous man, employed in the State Department, where a monotonous, exact range of duties had been performed for many years. He was unable to use spirits, from the headache it produced. Although his father was an inebriate, he never could or would drink any form of alcohol. He was a society man, and spent his evenings at the club. For several years past it was noticed that, after an hour or more spent in company of men who were drinking to intoxication, he would take on their condition, and like them become intoxicated. He would be with them hilarious or stupid, and use only coffee moderately, while the others drank wine. Sometimes these states would go so far as to make him stupid and unable to walk, and he would need the assistance of a guide and carriage to get home. The next morning he would have a headache. These occasions were at first infrequent, then grew more common, until at present he can not remain an hour in the company of any friend who is intoxicated without appearing and acting like him. He is called by his friends the "coffee-drunkard," for this reason. He will be as stupid as any of them, and yet use nothing but coffee. He would fall into this state more slowly if strangers were present, and sometimes not at all, depending on some internal force that prevented him from giving way. He affirmed that the sensation was very pleasant, and he did not realize his own condition, but was always conscious of enjoyment, until the party broke up and he went home, when a feeling of misery and disgust came over him. The physician who examined him in these states considered that he was a perfect barometer of the mental surroundings, and that after a certain point he gave himself up to a species of mesmeric influence, making him do anything that the others did.
Second Case.—A wealthy farmer and strong temperance man was elected to Congress. He formed a strong attachment for a hard-drinking man in the same body, and, after being in his company for a few hours, would walk and talk like him. He would talk foolishly, and stagger, and act identically like him; but if called away, he soon recovered and was as before, yet in his company he used no spirits, and only occasionally soda. This imitation intoxication grew on him, and he seemed to fall into this state in any drinking party where several were intoxicated. He was not aware of his hilarity or stupidity in drinking company, and only remembered that he could not use spirits. He was reported to be intoxicated in the papers, and could with great difficulty make any defense. He is still in office, but has learned to keep away from all drinking men and state dinners where wine and intoxicated and hilarious drinkers are present. A hereditary taint of both insanity and inebriety was present in his case, I have made another group of these cases, that brings out some facts seen in other circles of life. They are cases of reformed men who show signs of intoxication from the contagion of others who are intoxicants. The following is an example:
A prominent military man, who had drunk moderately during the war, and had abstained from that time on, while attending a dinner with his old comrades, where most of them were intoxicated, suddenly became hilarious, made a foolish speech, and settled back in his chair in a drunken state, and was finally taken home quite stupid. He had not drunk any spirits, and had only used coffee and water, and yet he had all the symptoms of the others, only his was intoxication from contagion—the favoring soil had been prepared long ago in the army. Another case was that of a man who had been an inebriate years ago, but had reformed. He was recently elected to office and gave a dinner to some friends. Among them was a physician, who has been greatly interested in these studies. He sent me a long report, the substance of which was this: On the occasion referred to, many of the company became partially intoxicated, and the host, who drank nothing but water, became hilarious, and finally stupid with them. He was put to bed, with every sign of intoxication, but recovered, and next morning had only a confused notion of these events. The third case occurred four years ago. A reformed man, of twelve years' sobriety, went on a military excursion with a drinking company, and, although he drank nothing but lemonade, became as much intoxicated as the others. This event was the subject of much comment and loss to him, socially and otherwise, although he protested, and others confirmed his statements, that he did not take any spirits at this time.
In these cases, as in the others mentioned, two conditions were present: one, in which some special unknown nerve state was inherited, which readily reflected alcoholic states from contagions; the other, in which this particular alcoholic state had been acquired, and more readily responded to contagious surroundings than otherwise. In both cases, undoubtedly, heredity was present, but in the latter some previous pathological state existed. What form of brain and nerve defect, and what circumstances and conditions combined to develop this special pathological state must be determined in the future. Along this line are many psychological facts of great interest, that throw light on other mental states. Thus, actors, who essay to represent insanity or inebriety, are successful in proportion as they inherit a nervous organization predisposing them to these affections. A single glass of spirits may awaken a latent nerve defect, and soon after merge into inebriety. So the effort to imitate the manner and conduct of an intoxicated person may give impress and direction to an organism that may be permanent.
An actor, greatly praised for his skill in "Hamlet," was obliged to leave the stage, for the reason that this character was becoming so intimately his as to suggest insanity at an early day. A man who acted the part of a drunken man was, after a time, so completely intoxicated as to be unfit for his part. He could not use spirits, and had to give up this part of the play, for the same reason as mentioned above. A remarkable incident came to my notice along this line. A temperance writer, of great power and vividness of detail, said that he lived all the details of the hero he was describing, in his own mind. When the character was intoxicated, he had all the symptoms, and had to go to bed after writing that the hero did so. He suffered, was exhausted, had pain, mental agony, was joyous, happy, contented, and lived over every event which he described. This man was strictly temperate, but had a drunken father, from whom he inherited a peculiar nervous organization, that gave him power to realize the toxic state from alcohol and throw himself into it more perfectly.
He says that it would impair his health to write more on this theme, for he would be intoxicated most of the time while writing. Many of these states may be termed emotional trance states, and in some future time will be the subject of some very curious and wonderful psychological discoveries. Those who observe inebriates carefully, find them literally encyclopædias of psychological fact, that can not be understood by any present knowledge of the subject. For instance, reformed men, or those who have recently stopped the use of spirits, can not safely listen to a recital of the sufferings and struggles of others to become temperate, without taking on some form of mental shock that is fatal to their own resolutions. The more vivid and accurate the struggles of a drunkard are described, the more certainly the will of the hearer is weakened and rendered impotent to help itself. Temperance lecturers, who hope, by painting the horrors of drink so vividly, to deter any one in the audience from falling in that way, are deceived, and produce the very effect they seek to remedy.
In the same way, the sight of an intoxicated man produces a dangerous form of excitement in the mind of the reformer, and if this should last some time it would react in the same condition. I have embodied many of these curious facts in a paper, with the title of "Mental Contagion in Inebriety," published in the "Alienist and Neurologist" of October, 1884. In this brief glance of the subject I have endeavored to bring out the fact that states of intoxication are found in inebriates and defectives that are marked inheritances from parents. The organism has received a positive permanent impression, from which it never recovers. Also, that this pathological state of acute poisoning from alcohol may be covered up by other defects, and only come out from the application of some peculiar exciting cause. I have called attention to a class of cases, that, from some exciting cause, suddenly become to all appearance intoxicated, although they have not used spirits. An inherited predisposition to this form of defect, from inebriate ancestors, is present in these cases. Also a class of men who have been total abstainers for a long time, who, under similar conditions of excitement, appear intoxicated.
I have described a class of cases where the intoxication was purely from mental contagion, appearing in persons who have been previously drunk, but were temperate at this time. Undoubtedly, conditions of heredity, unknown at present, control and govern this condition. It will be clear from this outline -grouping of facts: (1) that symptoms of alcoholic poisoning can not be trusted as evidence of the immediate use of alcohol; (2) that the excessive use of alcohol leaves a permanent defect or impress on the brain, which will go down into the future with great certainty. It may be concealed for a lifetime in the child of a drinking parent, but at any moment may come to the surface, from the application of its special exciting cause; or it may appear in some other form of defect that can be traced back to the injury from the toxic action of alcohol. In brief, the range of facts that open up from this point are truly bewildering, and their discovery and the laws which govern them is the great future realm for investigation.
This grouping of general facts which I have presented, like a preliminary survey in a new country, are merely landmarks for other and more accurate studies.
This is the field into which specialists press forward with increasing enthusiasm, confident that behind all this mystery of drink-craving will be found a majestic order of forces coming from unknown causes, moving in unknown orbits and about un-known centers; also, with equal confidence, that, not far away, inebriety and its evils will be understood, treated, and prevented, as positively as any other disease.