From Antiquity to the N-Methyl-D-Aspartate Receptor: A History of Delirium Tremens.

Delirium associated with excessive alcohol consumption has been known since antiquity. This condition became more common as the supply of distilled fermented liquors increased. Delirium, including delirium associated with excessive alcohol consumption, was for many centuries regarded as a form of brain inflammation - "phrenitis" - and was treated with depletion. At the end of the eighteenth century treatment by depletion of alcohol-related delirium began to be replaced by sedation and led to significantly better outcomes. Thomas Sutton established that alcohol-related delirium was a disease sui generis, distinct from phrenitis, and he named it delirium tremens. Because historical accounts of this disease are rare, brief, and not easily accessible, we offer this account of events that culminated in the discovery of the molecular basis of delirium tremens.

Alcohol prescription by surgeons in the prevention and treatment of delirium tremens: historic and current practice.

Beer, other alcohol beverages, and IV alcohol are still used to prevent or treat alcohol withdrawal delirium on surgical services. The history of the use of alcohol by surgeons may play a role in its continued use for withdrawal. In this policy survey 32 inpatient hospital pharmacies were called and asked if alcohol was available, if it was used to treat alcohol withdrawal, and the medical specialties that requested it. Recommendations about the use of alcohol were examined in recent textbooks and from those published early in the twentieth century. One half of the 32 hospitals surveyed had alcoholic beverages available for patient use and eleven hospitals used either package alcohol or IV alcohol in the treatment of alcohol withdrawal. Surgeons used alcohol before anesthesia to help patients tolerate procedures, and the use of alcohol for treatment of alcohol withdrawal still appears in the surgical literature. This preliminary survey indicates that some hospitals still provide beverage alcohol for the treatment of alcohol withdrawal and that surgeons are the specialty ordering alcohol for their patients.

[Historical study of delirium tremens in Spain in the second half of the 19th century]. / Estudio histórico del delirium tremens en España durante la segunda mitad del siglo XIX.

The authors, after a brief historical introduction, review the clinical contributions about Delirium Tremens during the second half of the XIXth century in 9 Saniard authors: J. Santamaría del Alba (1952), Inocente Escudero (1857), R. Sanfrutos (1858), Tomás Santero y Moreno (1867), Candela (1871), Robert (1871), José Armesto (1877), J. M. Castañeda (1879-1880), R. B. de la Roche (1881). It is appropriate to underline their tidying up and clinical interest, medical-pathological and general, their interest in the evolutionary course, their therapeutical empiricism and a certain indifference in framing this nosological entity in a doctrinal corpus more specific, except for Robert, who use the chloral hydrate only two after its introduction in medicine by Liebreich and De la Roche, who complains about absence of a monographic study and explains it according to the anatomic-clinical model of the General Pathology of his epoch, in a appropriate bibliographical context. Included are 12 tables and 27 bibliographical references.

[Historical study of seven cases of delirium tremens in Spain in the first half of the XIX century]. / Estudio histórico de siete casos de Delirium tremens en España durante la primera mitad del siglo XIX.

The authors in the introduction provide an schematic historical scope of reference about the spaniard and european psychiatry from the XVIIIe to the XIXe century. They described the first seven clinical cases of Delirium found by them and published by spaniard physicians in the first half of the XIXe century. They revised mainly the clinical sintomatology, course and evolution, and went into deep detail in the hygienic-dietetical and pharmacological therapeutics used in this period, specially several galenic preparations of opium, tartarus emeticus, cremor, etc. Serapio Escolar y Morales (1808-1874) described the first clinical case of Delirium Tremens in 1839 in a 28 year old man, raising the differential diagnosis between intermittent fever, epilepsy and meningitis, and proposed a useless antiflogistic treatment (bleeding, leeches, poultice) and opium. The second case was described by an anonymous author (J.M.S.Z.) in 1845 in a 42 year old man. Francisco Castellvi y Pallares (1812-1879), in 1845, published another case in a 34 year old male, with an adequate description of the natural history of the disease, healing in 19 days with high doses of watery opium extract. The fourth clinical case was described by R.C.B. in 1846 in a 60 year old man with "alcoholic chorea", "ataxis fever" being the only one with a mortal outcome, treated also with opiates which he did not agree with. The fifth and sixth cases were published by Uliberry in 1847 in two males, 38 and 36 years old respectively. The seventh and last case was described in 1848 by F. Paula Barea, having to highlight the nosological, nosographical and evolutive perspectives in 3 clinical periods and a fourth of convalescence, the treatment differences and the etiopathogenical considerations. Included are 9 tables, 2 graphics and 29 bibliographical references.

[The pathomorphosis of alcoholic delirium]. / Patomorfoz alkogol'nogo deliriia.

The authors have examined case histories of 402 patients with delirium tremens treated in 1897-1931, in 1955-1970 and in 1971-1985. An analysis has demonstrated a reduction in the frequency of visual hallucinations of zoological contents and an increase of erotic hallucinations. The duration of the psychotic state in different time periods has been determined. Changes in manifestations of emotional disturbances are described.

Delirium tremens in the Royal Navy and British Army in the 19th century.

Nineteenth-century health records of the Royal Navy and British Army reveal remarkable differences in the prevalence and mortality of delirium tremens between commands and services.