THE BOTTLE’S EMPTY, WIVES RUN FOR COVER

There are a few rare cases of people who enjoy long life and excellent health in spite of their alcoholic excesses, while others who drink less decline after just a few months of excess.  Alcoholism depends on the quantities imbibed by a person on a daily basis, subject to certain conditions which are inherent in or acquired by an individual.  It is the permanent psychic anomalies and the neurological and general symptoms which define chronic alcoholism.  Initially the psychic symptoms vary, but as cerebral and general lesions develop, they soon become uniform, developing into alcoholic dementia.  The essence of the alcoholic character resides in emotional fragility, intensity of the emotions, weakness of willpower and absence of inhibitions.  Depending on upbringing, the alcoholic remains amiable in his relations with others, as long as he is not opposed.  If this occurs, with his family, his boss or occasionally his peers, then he can lose control, becoming aggressive and brutal.  During the first years of his alcoholic excesses, because he is pleasant and agreeable, as well as intelligent and not a little hypocritical, he is well-liked, while at home he is a tyrant, an abject creature who plunges his family into misfortune.  Frivolity is typical of the alcoholic: he is moved by external stimuli, his emotions are in constant flux.  His behavior is characterized by inconstancy, nonchalance, amorality, satisfaction of his immediate needs without heed of ethics or the consequences of his actions.  That superficial euphoria is typical of the alcoholic temperament, a certain odd sentimentality or an eternity of abrupt complaints, producing an impression of authenticity when it is merely hypocrisy.

His loss of energy (abulia) is likewise typical.  His intellect declines considerably, terminating in alcoholic dementia.  Mental disturbances occur in the following order, beginning with lack of attention, inability to concentrate, forgetfulness, inability to learn, reduction of the psychic horizon, and in addition to forgetfulness, loss of memory.  Associations are loose and superficial, he is incapable of thought and his judgment is unsound.  The alcoholic mentality is characterized by a search for excuses to stop drinking and for reasons to continue, but whether he is a refined intellectual, wealthy businessman or an illiterate laborer, for some reason he always attempts to justify himself.

The physical symptoms are what finally enable a diagnosis to be made: facial expression, trembling kinetic symptoms, motor symptoms, sensitive symptoms, skin reflexes, nutritional state, alterations in the heart and liver, changes in sleep patterns, sexual disturbances and, if any, convulsions.

An alcoholic has permanently reddish facial features with networks of broken capillaries at the end of his nose and on his cheeks.  Trembling when in need of sustenance is not invariable, nor is it exclusive to alcoholism, but it frequently appears as a regular tremor with minute twitching.

Kinetic symptoms such as a trembling moustache when talking, (for this to be visible, the moustache has to be thin, because if it is thick and aggressive like Magnum’s, not even someone with bionic eyes would be able to see), trembling of the upper eyelid, mioclonic contractions of various muscles and unsteady gait in the more advanced stages.  Motor symptoms are: superior polio encephalitis, hemiplegia or monoplegia following pachymeningitis, or cerebral hemorrhage in cases of serious cerebrovascular accident.  There is also partial paresis or a certain looseness of facial muscles.  Sensitive symptoms are erratic pains or hypesthesia of the lower limbs and cramps in the calves.  In the majority of cases skin reflexes are greatly intensified.  As for general nutrition, there are fat alcoholics (those who drink beer and wine), and thin alcoholics (those who drink spirits), but loss of weight even marasmus, is nearly always evident in severe alcoholism.  Cardiac hypertrophy and fatty degeneration, causing arrhythmia and heart failure, are also evident.  In their digestive systems alcoholics may also suffer initially from gastritis, which later develops into a gastro duodenal ulcer accompanied by vomitus matutinus.  Fatty degeneration occurs in the area of the liver, followed later by cirrhosis then finally failure of the liver.  Among the sleep disturbances, the most frequent is insomnia.  Toward the end of the illness convulsions of the comitial type may occur.  Sexually, the alcoholic has an elevated libido and reduced potency, the latter being responsible for his frequently delayed orgasm or ejaculation and later impotency, an affliction which increases his delusions of jealousy.  I have left delusions of jealousy to the end because these are a very frequent characteristic of chronic alcoholism.  This type of delusion is curious in that while the alcoholic remains insensitive to his wife’s certain infidelities, even condoning them, his fits of jealousy occur when there is the least reason for them.  Such fits occur when he arrives home drunk in the early hours of the morning and roughly accuses his wife of her infidelities, even looking between the sheets for traces of them (or looking for her lover underneath the bed and maybe even, alas, finding him) or in the closet, or for clues on his wife’s face or clothes, some indication in her excuses or in his children’s words or attitudes.  Such a rage of jealousy provokes blows, insults and not infrequently, the violent death of the unfaithful wife and, what is saddest, often without her being unfaithful at all.  This is why, when the bar closes at the hour of dawn and the liquor has all gone, the bottles empty… the wives run for cover.