The internist often is called upon to manage patients with delirium tremens; yet many clinicians exhibit a surprising lack of comprehension concerning the cause, pathogenesis, and—in some cases—the management of this condition. Because of the complexity of the disease and its complications, patients are approached by many specialty groups with varying perspectives. From this situation arises much confusion and an inability to amass a large number of cases in one department for study and experience. Thus one readily can see why, until recently, relatively little progress had been made in clarifying the basic dynamics of delirium tremens. However, I feel that a few key studies undertaken in recent years have yielded much information which should point the way toward greater understanding and more fruitful research. In this regard, it is apparent that several questions regarding delirium tremens require thoughtful cogitation.

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