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The Differentiation of Delirium Tremens from Impending Hepatic Coma

Published online by Cambridge University Press:  08 February 2018

Esther A. Davidson
Affiliation:
Harvard Medical School; Psychiatry Boston City Hospital
Philip Solomon
Affiliation:
Harvard Medical School; Psychiatry Boston City Hospital

Extract

The problem of differentiating impending hepatic coma from delirium tremens is one which arises less commonly in Great Britain than in the United States. It is a problem which occurs, of course, chiefly in connection with alcoholic patients and while alcoholism has declined in Great Britain it is becoming an increasing medical and social problem in certain sections of the United States (1). Thus, at the Boston City Hospital alcoholism was a factor in over 45 per cent. of patients with cirrhosis of the liver at post-mortem (2). At the Hammersmith Hospital in London alcoholism was an aetiological factor in 5 per cent. of patients with the clinical diagnosis of cirrhosis (3). There is no doubt that the problem of differentiating impending hepatic coma from delirium tremens is a common and relatively easy one in Boston, whereas in London it is a rare and therefore more difficult one.

Type
Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1958 

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References

1. Keller, M., and Efron, V., Quart. J. Stud. A1c., 1955, 16, 4, 619.Google Scholar
2. MacDonald, R. A., New Eng. J. Med., 1956, 255, 1179.Google Scholar
3. Personal observation.Google Scholar
4. Hippocrates (460–370 b.c.): Quoted by Wortis, H., (9) below.Google Scholar
5. Sutton, T., Tracts on Delirium Tremens, on Peritonitis and Some Other Internal Inflammations, Infections, and on the Gout, 1813. London: Moyes.Google Scholar
6. Hayward, G., New Eng. J. Med. Surg., 1822, 11, 235.Google Scholar
7. Wake, J., Med. Commun. Mass. Med. Soc., 1831, 5, 136.Google Scholar
8. Kraepelin, E., Lectures on Clinical Psychiatry, 1904. New York: Wood & Co., p. 120.Google Scholar
9. Wortis, H., Quart. J. Stud. Alc., 1940, 1, 251.Google Scholar
10. Med. Res. Mid-century Survey, 1956, 2, 537. Boston: Little, Brown & Co. Wikler, A., Pescor, F. T., Fraser, H. F., and Isbell, H., Amer. J. Psychiat., 1956, 113, 106.Google Scholar
11. Victor, M., and Adams, R. D., “Metabolic and Toxic Disorders of the Nervous System”, Res. Publ. Ass. Res. Nerv. Ment. Dis., 1953, 32, 526.Google Scholar
12. Flink, E. B., Stutzman, F. L., Anderson, A. R., Konig, T., and Fraser, R., J. Lab. and Clin. Med., 1954, 43, 169.Google Scholar
Suter, C., and Klingman, W. O., Neurol., 1955, 5, 691.CrossRefGoogle Scholar
13. Baumann, E. D., Janus, 1931, 35, 153 and 185.Google Scholar
14. Galen (131200 a.d.): Quoted by Baumann, E. D.Google Scholar
15. Cheyne, J., Dublin Hosp. Rep., 1817, 1, 273.Google Scholar
16. Griffin, W., London Medical Gazette, 1834, 13, 801.Google Scholar
17. Bright, R., Guy's Hospital Rep., 1836, 1, 604.Google Scholar
18. Frerichs, R. T., “A Clinical Treatise on Diseases of the Liver”, 1860. London: New Sydenham Society.Google Scholar
19. Copland, J., A Dictionary of Practical Medicine, 1858. London.Google Scholar
20. Rolleston, H., Diseases of the Liver, Gall-bladder and Bile Ducts, 1912. 2nd edition. Philadelphia.Google Scholar
21. Jenkins, E. M., Brit. Med. J., 1884, i, 357.Google Scholar
22. Elliot, T. R., and Walshe, F. M. R., Lancet, 1925, i, 65.CrossRefGoogle Scholar
23. Willcox, W. H., Trans. Med. Soc. Lond., 1919, 42, 147.Google Scholar
24. Greene, G. H., Arch. Intern. Med., 1941, 67, 867.Google Scholar
25. Stokes, J. F., Owen, J. R., and Holmes, E. G., Brit. Med. J., 1945, ii, 642.Google Scholar
26. Zillig, G., Arch. Psychiat. Nervenkr., 1948, 181, 21.Google Scholar
27. Adams, R. D., and Foley, J. M., Res. Pub. Ass. Res. Nerv. Ment. Dis., 1953, 32, 198.Google Scholar
28. Sherlock, S., Summerskill, W. H. J., White, L. P., and Phear, E. A., Lancet, 1954, ii, 453.CrossRefGoogle Scholar
29. Summerskill, W. H. J., Davidson, E. A., Sherlock, S., and Steiner, R. E., Quart. J. Med., N.S., 1956, 98, 245.Google Scholar
30. Von Jauregg, W., Wien. Klin. Wochenschr., 1896, 9, 165.Google Scholar
31. Quastel, J. H., Lancet, 1932, ii, 1417.Google Scholar
32. Mayer-Gross, W., and Guttmann, E., J. Ment. Sci., 1937, 83, 440.Google Scholar
33. Leiderman, P. H., Mendelson, J., Wexler, D., and Solomon, P., Clinical Aspects of Sensory Deprivation. (Presented at Annual Meeting Amer. Med. Assoc., New York, June, 1957.)Google Scholar
34. Kennard, M. A., Bueding, E., and Wortis, S. B., Quart. J. Stud. Alc., 1945, 6, 4.Google Scholar
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