...When I nursed my poor master, Mr. Robisson, I had to give him port-wine and brandy constant, and a big glass at a time, added Mrs. Abel with a touch of remonstrance in her tone. ...a key was thrust through the inch of doorway, and Mr. Bulstrode said huskily, That is the key of the wine-cooler. You will find plenty of brandy there." French writer Émile Zolas novel The Drinking Den (LAssommoir) includes a character – Coupeau, the main character Gervaises husband – who has delirium tremens by the end of the book. American writer Mark Twain describes an episode of delirium tremens in his book The Adventures of Huckleberry Finn (1884). In chapter 6, Huck states about his father, "After supper pap took the jug, and said he had enough whisky there for two drunks and one delirium tremens. That was always his word." Subsequently, Pap Finn runs around with hallucinations of snakes and chases Huck around their cabin with a knife in an attempt to kill him, thinking Huck is the "Angel of Death". One of the characters in Joseph Conrads novel Lord Jim experiences "DTs of the worst kind" with symptoms that include seeing millions of pink frogs. English author M. R. James mentions delirium tremens in his 1904 ghost story "Oh, Whistle, and Ill Come to You, My Lad".
This combined with increased noradrenergic activity results in the symptoms of delirium tremens. Diagnosis
Diagnosis is mainly based on symptoms. In a person with delirium tremens it is important to rule out other associated problems such as electrolyte abnormalities, pancreatitis, and alcoholic hepatitis. Treatment
Delirium tremens due to alcohol withdrawal can be treated with benzodiazepines. High doses may be necessary to prevent death. Amounts given are based on the symptoms. Typically the person is kept sedated with benzodiazepines, such as diazepam, lorazepam, chlordiazepoxide, or oxazepam. In some cases antipsychotics, such as haloperidol may also be used. Older drugs such as paraldehyde and clomethiazole were formerly the traditional treatment but have now largely been superseded by the benzodiazepines.Acamprosate is occasionally used in addition to other treatments, and is then carried on into long-term use to reduce the risk of relapse. If status epilepticus occurs it is treated in the usual way.It can also be helpful to provide a well lit room as people often have hallucinations.Alcoholic beverages can also be prescribed as a treatment for delirium tremens, but this practice is not universally supported.High doses of thiamine often by the intravenous route is also recommended. Society and culture
Nicknames for delirium tremens include "the DTs", "the shakes", "the oopizootics", "barrel-fever", "the blue horrors", "bottleache", "bats", "the drunken horrors", "seeing pink elephants", "gallon distemper", "quart mania", "heebie jeebies", "pink spiders", and "riding the ghost train", as well as "ork orks", "the zoots", "the 750 itch", and "pint paralysis".