crises recurred at indeterminate intervals, separated by periods when the subject was generally sober. Similarly, in 1892 the influential English physician and mental health expert Daniel Hack Tuke defined dipsomania as a syndrome involving "an irresistible obsession and impulse to drink, coming on in attacks, during which the patients are in a condition of impotence of will and manifest great anguish." Tuke clarifies that dipsomania can be distinguished from what was at the time considered alcoholism by six key factors. First, "an alcoholic patient becomes insane because he drinks; a dipsomaniac is insane before he commences to drink." Second,"alcoholism is an intoxication which has as its cause alcohol; dipsomania has its cause in a defective mental condition, and alcohol is but a secondary factor, which may be replaced by any other poison, leaving to the syndrome all its psychological characters." Third, "dipsomania proceeds in paroxysmal attacks, and the appetite for strong drink is absent during the intervals between the attacks. Alcoholism has no definite course." Fourth, "a dipsomaniac satisfies a pathological and imperious want; he does not like alcohol, and takes it against his will," whereas "an alcoholic individual has no actual want; he only obeys a vice, a proclivity, and an alteration of his moral sense." Fifth, a dipsomaniac is conscious and ashamed of his condition, whereas an alcoholic is sometimes unaware of, but more often indifferent to it. Finally, he concluded that "dipsomania is a syndrome, always identical with itself, whilst alcoholism is an intoxication varying much in its clinical symptoms." Over time, the term dipsomania became less common, replaced by newer ideas and terms concerning chronic and acute drunkenness and alcohol use disorder. Examples in fiction Sebastian Flyte, a character from the novel Brideshead Revisited by Evelyn Waugh, who sarcastically describes himself as a dipsomaniac James O. Incandenza, a character in Infinite Jest by David Foster Wallace, described in the novel as having "crippling dipsomania" Dwight Carson, a talented writer in The Fountainhead, who is turned into a dipsomaniac on the whim of Gail Wynand Mrs. Ritchey (played by actress Charlotte Merriam in the 1931 movie Night Nurse) who exclaims that she is a dipsomaniac several times when confronted by Barbara Stanwyck's character (Lora Hart) with the fact that Ritchey's daughter is dying from malnutrition Peter Morgan Sr., (played by actor Charles Coburn) in the 1938 movie Vivacious Lady, talks about his nephew Keith Morgan's (played by