DELIRIUM¹ TREMENS, med. jur. A species of insanity² which has obtained this name, in consequence of the tremor³ experienced by the delirious⁴ person, when under a fit of the disorder⁵.

2. The disease called delirium tremens or mania⁶ a potu, is well described in the learned work on the Medical Jurisprudence of Insanity, by Dr. Ray, §315, 316, of which the following is an extract: "it may be the immediate⁷ effect of an excess, or series of excesses, in those who are not habitually⁹ intemperate¹⁰, as well as in those who are; but it most commonly occurs in habitual⁸ drinkers, after a few days of total abstinence from spirituous liquors. It is also very iable to occur in this latter class when laboring¹¹ under other diseases, or severe external injuries that give rise to any degree of constitutional disturbance¹². The approach ofthe disease is generally indicated by a slight tremor and faltering¹³ of the hands and lower extremities¹⁴, a tremulousness of the voice, a certain restlessness and sense of anxiety which the patient knows not how to describe or to account for, disturbed sleep, and impaired¹⁵ appetite. These symptoms having continued two or three days, at the end, of which time they have obviously increased in severity, the patient ceases to sleep altogether, and soon becomes delirious. At first, the delirium is not constant, the mind wandering during the night, but during the day, when its attention is fixed¹⁶, capable of rational discourse¹⁷. It is not long, however, before it becomes constant, and constitutes the most prominent feature of the disease. This state, of watchfullness and delirium continues three or four days, when, if the patient recover, it is succeeded by sleep, which, at first appears in uneasy and irregular naps, and lastly in long, sound, and refreshing¹⁸ slumbers¹⁹. When sleep does not supervene about this period, the, disease is fatal; and whether subjected to medical treatment, or left to itself, neither its symptoms nor duration are materially modified.

3. "The character of the delirium in this disease is peculiar²⁰, bearing a stronger resemblance to dreaming, than any other form of mental derangement²¹. It would seem as if the dreams which disturb and harass²² the mind during the imperfect sleep that precedes the explosion of the disease, continue to occupy it when awake, being then viewed as realities, instead of dreams. The patient imagines himself, for instance, to be in some particular situation, or engaged in certain occupations according to each individuals habits and profession, and his discourse and conduct will be conformed to this delusion²³, with this striking peculiarity²⁴, however, that he is thwarted²⁵ at every step, and is constantly meeting with obstacles that defy his utmost efforts to remove. Almost invariably, the patient manifests, more or less, feelings of suspicion and fear, laboring under continual apprehension²⁶ of being made the victim of sinister²⁷ designs and practices. He imagines that certain people have conspired²⁸ to rob or murder him, and insists that he can hear them in an adjoining apartment, arranging their plans and preparing to rush into his room; or that he is in a strange place where he is forcibly detained and prevented from going to his own home. One of the most common hallucinations is, to be constantly seeing devils, snakes, vermin, and all manner of unclean things around him and about him, and peopling every nook and corner of his apartment with these loathsome²⁹ objects. The extreme terror which these delusions³⁰ often inspire, produces in the countenance³¹, an unutterable expression of anguish³²; and, in the hope of escaping from his, fancied tormentors, the wretched patient endeavors to cut his throat, or jump from the window. Under the influence of these terrible apprehensions³³, he sometimes murders his wife or attendant, whom his disordered imagination identifies with his enemies, though he is generally tractable³⁴ and not inclined to be mischievous³⁵. After perpetrating an act of this kind, he generally gives some illusive³⁶ reason for his conduct, rejoices in his success, and expresses his regret at not having done it before. So complete and obvious is the mental derangement in this disease, so entirely³⁷ are, the thoughts and actions governed by the most unfounded and absurd delusions, that if any form of insanity absolves³⁸ from criminal responsibility, this certainly must have that effect. 3 Am. Jur. 5-20.